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Original Article
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Fine needle aspiration cytology diagnoses of follicular thyroid carcinoma: results from a multicenter study in Asia
Hee Young Na, Miyoko Higuchi, Shinya Satoh, Kaori Kameyama, Chan Kwon Jung, Su-Jin Shin, Shipra Agarwal, Jen-Fan Hang, Yun Zhu, Zhiyan Liu, Andrey Bychkov, Kennichi Kakudo, So Yeon Park
J Pathol Transl Med. 2024;58(6):331-340.   Published online November 7, 2024
DOI: https://doi.org/10.4132/jptm.2024.10.12
  • 2,342 View
  • 231 Download
AbstractAbstract PDFSupplementary Material
Background
This study was designed to compare diagnostic categories of thyroid fine needle aspiration cytology (FNAC) and incidence of thyroid tumors in the multi-institutional Asian series with a special focus on diagnostic category IV (suspicious for a follicular neoplasm) and follicular thyroid carcinomas (FTCs). Methods: Distribution of FNAC categories, incidence of thyroid tumors in resection specimens and cytologic diagnoses of surgically confirmed follicular adenomas (FAs) and FTCs were collected from 10 institutes from five Asian countries and were compared among countries and between FAs and FTCs. Results: The frequency of category IV diagnoses (3.0%) in preoperative FNAC were significantly lower compared to those in Western countries (10.1%). When comparing diagnostic categories among Asian countries, category IV was more frequent in Japan (4.6%) and India (7.9%) than in Taiwan (1.4%), Korea (1.4%), and China (3.6%). Similarly, incidence of FAs and FTCs in surgical resection specimens was significantly higher in Japan (10.9%) and India (10.1%) than in Taiwan (5.5%), Korea (3.0%), and China (2.5%). FTCs were more commonly diagnosed as category IV in Japan (77.5%) than in Korea (33.3%) and China (35.0%). Nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were more common in FTCs compared with FAs. Conclusions: Our study highlighted the difference in FNAC diagnostic categories of FTCs among Asian countries, which is likely related to different reporting systems and thyroid cancer incidence. Cytologic features such as nuclear pleomorphism, nuclear crowding, microfollicular pattern, and dyshesive cell pattern were found to be useful in diagnosing FTCs more effectively.
Case Study
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Uncommon granulomatous manifestation in Epstein-Barr virus–positive follicular dendritic cell sarcoma: a case report
Henry Goh Di Shen, Yue Zhang, Wei Qiang Leow
J Pathol Transl Med. 2025;59(2):133-138.   Published online October 31, 2024
DOI: https://doi.org/10.4132/jptm.2024.09.27
  • 1,658 View
  • 320 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Hepatic Epstein-Barr virus–positive inflammatory follicular dendritic cell sarcoma (EBV+ IFDCS) represents a rare form of liver malignancy. The absence of distinct clinical and radiological characteristics, compounded by its rare occurrence, contributes to a challenging diagnosis. Here, we report a case of a 54-year-old Chinese female with a background of chronic hepatitis B virus treated with entecavir and complicated by advanced fibrosis presenting with a liver mass found on her annual surveillance ultrasound. Hepatectomy was performed under clinical suspicion of hepatocellular carcinoma. Immunomorphologic characteristics of the tumor were consistent with EBV+ IFDCS with distinct non-caseating granulomatous inflammation. Our case illustrates the importance of considering EBV+ IFDCS in the differential diagnosis of hepatic inflammatory lesions. Awareness of this entity and its characteristic features is essential for accurately diagnosing and managing this rare neoplasm.

Citations

Citations to this article as recorded by  
  • Mesenchymal Tumors of the Liver: An Update Review
    Joon Hyuk Choi, Swan N. Thung
    Biomedicines.2025; 13(2): 479.     CrossRef
Original Articles
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Diagnosis of invasive encapsulated follicular variant papillary thyroid carcinoma by protein-based machine learning
Truong Phan-Xuan Nguyen, Minh-Khang Le, Sittiruk Roytrakul, Shanop Shuangshoti, Nakarin Kitkumthorn, Somboon Keelawat
J Pathol Transl Med. 2025;59(1):39-49.   Published online October 24, 2024
DOI: https://doi.org/10.4132/jptm.2024.09.14
  • 1,891 View
  • 289 Download
AbstractAbstract PDFSupplementary Material
Background
Although the criteria for follicular-pattern thyroid tumors are well-established, diagnosing these lesions remains challenging in some cases. In the recent World Health Organization Classification of Endocrine and Neuroendocrine Tumors (5th edition), the invasive encapsulated follicular variant of papillary thyroid carcinoma was reclassified as its own entity. It is crucial to differentiate this variant of papillary thyroid carcinoma from low-risk follicular pattern tumors due to their shared morphological characteristics. Proteomics holds significant promise for detecting and quantifying protein biomarkers. We investigated the potential value of a protein biomarker panel defined by machine learning for identifying the invasive encapsulated follicular variant of papillary thyroid carcinoma, initially using formalin- fixed paraffin-embedded samples.
Methods
We developed a supervised machine-learning model and tested its performance using proteomics data from 46 thyroid tissue samples.
Results
We applied a random forest classifier utilizing five protein biomarkers (ZEB1, NUP98, C2C2L, NPAP1, and KCNJ3). This classifier achieved areas under the curve (AUCs) of 1.00 and accuracy rates of 1.00 in training samples for distinguishing the invasive encapsulated follicular variant of papillary thyroid carcinoma from non-malignant samples. Additionally, we analyzed the performance of single-protein/gene receiver operating characteristic in differentiating the invasive encapsulated follicular variant of papillary thyroid carcinoma from others within The Cancer Genome Atlas projects, which yielded an AUC >0.5.
Conclusions
We demonstrated that integration of high-throughput proteomics with machine learning can effectively differentiate the invasive encapsulated follicular variant of papillary thyroid carcinoma from other follicular pattern thyroid tumors.
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Clinicopathological implications of immunohistochemical expression of TBX21, CXCR3, GATA3, CCR4, and TCF1 in nodal follicular helper T-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified
Bogyeong Han, Sojung Lim, Jeemin Yim, Young Keun Song, Jiwon Koh, Sehui Kim, Cheol Lee, Young A Kim, Yoon Kyung Jeon
J Pathol Transl Med. 2024;58(2):59-71.   Published online January 22, 2024
DOI: https://doi.org/10.4132/jptm.2024.01.04
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  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Background
The classification of nodal peripheral T-cell lymphoma (PTCL) has evolved according to histology, cell-of-origin, and genetic alterations. However, the comprehensive expression pattern of follicular helper T-cell (Tfh) markers, T-cell factor-1 (TCF1), and Th1- and Th2-like molecules in nodal PTCL is unclear.
Methods
Eighty-two cases of nodal PTCL were classified into 53 angioimmunoblastic T-cell lymphomas (AITLs)/nodal T-follicular helper cell lymphoma (nTFHL)-AI, 18 PTCLs-Tfh/nTFHL–not otherwise specified (NOS), and 11 PTCLs-NOS according to the revised 4th/5th World Health Organization classifications. Immunohistochemistry for TCF1, TBX21, CXCR3, GATA3, and CCR4 was performed.
Results
TCF1 was highly expressed in up to 68% of patients with nTFHL but also in 44% of patients with PTCL-NOS (p > .05). CXCR3 expression was higher in AITLs than in non-AITLs (p = .035), whereas GATA3 expression was higher in non-AITL than in AITL (p = .007) and in PTCL-Tfh compared to AITL (p = .010). Of the cases, 70% of AITL, 44% of PTCLTfh/ nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the TBX21 subtype; and 15% of AITL, 38% of PTCL-Tfh/nTFHL-NOS, and 36% of PTCL-NOS were subclassified as the GATA3 subtype. The others were an unclassified subtype. CCR4 expression was associated with poor progression-free survival (PFS) in patients with PTCL-Tfh (p < .001) and nTFHL (p = .023). The GATA3 subtype showed poor overall survival in PTCL-NOS compared to TBX21 (p = .046) and tended to be associated with poor PFS in patients with non-AITL (p = .054).
Conclusions
The TBX21 subtype was more prevalent than the GATA3 subtype in AITL. The GATA3 subtype was associated with poor prognosis in patients with non-AITL and PTCL-NOS.

Citations

Citations to this article as recorded by  
  • CXCR Family and Hematologic Malignancies in the Bone Marrow Microenvironment
    Yanquan Liu, Huanwen Tang
    Biomolecules.2025; 15(5): 716.     CrossRef
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Identification of invasive subpopulations using spatial transcriptome analysis in thyroid follicular tumors
Ayana Suzuki, Satoshi Nojima, Shinichiro Tahara, Daisuke Motooka, Masaharu Kohara, Daisuke Okuzaki, Mitsuyoshi Hirokawa, Eiichi Morii
J Pathol Transl Med. 2024;58(1):22-28.   Published online January 10, 2024
DOI: https://doi.org/10.4132/jptm.2023.11.21
  • 2,945 View
  • 245 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Follicular tumors include follicular thyroid adenomas and carcinomas; however, it is difficult to distinguish between the two when the cytology or biopsy material is obtained from a portion of the tumor. The presence or absence of invasion in the resected material is used to differentiate between adenomas and carcinomas, which often results in the unnecessary removal of the adenomas. If nodules that may be follicular thyroid carcinomas are identified preoperatively, active surveillance of other nodules as adenomas is possible, which reduces the risk of surgical complications and the expenses incurred during medical treatment. Therefore, we aimed to identify biomarkers in the invasive subpopulation of follicular tumor cells.
Methods
We performed a spatial transcriptome analysis of a case of follicular thyroid carcinoma and examined the dynamics of CD74 expression in 36 cases.
Results
We identified a subpopulation in a region close to the invasive area, and this subpopulation expressed high levels of CD74. Immunohistochemically, CD74 was highly expressed in the invasive and peripheral areas of the tumor.
Conclusions
Although high CD74 expression has been reported in papillary and anaplastic thyroid carcinomas, it has not been analyzed in follicular thyroid carcinomas. Furthermore, the heterogeneity of CD74 expression in thyroid tumors has not yet been reported. The CD74-positive subpopulation identified in this study may be useful in predicting invasion of follicular thyroid carcinomas.

Citations

Citations to this article as recorded by  
  • Diagnosis of invasive encapsulated follicular variant papillary thyroid carcinoma by protein-based machine learning
    Truong Phan-Xuan Nguyen, Minh-Khang Le, Sittiruk Roytrakul, Shanop Shuangshoti, Nakarin Kitkumthorn, Somboon Keelawat
    Journal of Pathology and Translational Medicine.2025; 59(1): 39.     CrossRef
  • Spatial Transcriptomics in Thyroid Cancer: Applications, Limitations, and Future Perspectives
    Chaerim Song, Hye-Ji Park, Man S. Kim
    Cells.2025; 14(12): 936.     CrossRef
Reviews
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Noninvasive follicular thyroid neoplasm with papillary-like nuclear features: its updated diagnostic criteria, preoperative cytologic diagnoses and impact on the risk of malignancy
Hee Young Na, So Yeon Park
J Pathol Transl Med. 2022;56(6):319-325.   Published online November 9, 2022
DOI: https://doi.org/10.4132/jptm.2022.09.29
  • 5,524 View
  • 281 Download
  • 9 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Due to the extremely indolent behavior, a subset of noninvasive encapsulated follicular variant papillary thyroid carcinomas has been classified as “noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)” since 2016 and is no longer considered carcinoma. Since the introduction of this new terminology, changes and refinements have been made in diagnostic criteria. Initially, the incidence of NIFTP was estimated substantial. However, the reported incidence of NIFTP varies greatly among studies and regions, with higher incidence in North American and European countries than in Asian countries. Thus, the changes in the risk of malignancy (ROM) in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) differ inevitably among regions. Because more conservative surgery is recommended for NIFTPs, distinguishing NIFTPs from papillary thyroid carcinomas in preoperative fine-needle aspiration cytology became one of the major concerns. This review will provide comprehensive overview of updates on diagnostic criteria, actual incidence and preoperative cytologic diagnoses of NIFTP, and its impact on the ROM in TBSRTC.

Citations

Citations to this article as recorded by  
  • Diagnosis of invasive encapsulated follicular variant papillary thyroid carcinoma by protein-based machine learning
    Truong Phan-Xuan Nguyen, Minh-Khang Le, Sittiruk Roytrakul, Shanop Shuangshoti, Nakarin Kitkumthorn, Somboon Keelawat
    Journal of Pathology and Translational Medicine.2025; 59(1): 39.     CrossRef
  • Papillae, psammoma bodies, and/or many nuclear pseudoinclusions are helpful criteria but should not be required for a definitive cytologic diagnosis of papillary thyroid carcinoma: An institutional experience of 207 cases with surgical follow up
    Tarik M. Elsheikh, Matthew Thomas, Jennifer Brainard, Jessica Di Marco, Erica Manosky, Bridgette Springer, Dawn Underwood, Deborah J. Chute
    Cancer Cytopathology.2024; 132(6): 348.     CrossRef
  • ThyroSeq overview on indeterminate thyroid nodules: An institutional experience
    Sam Sirotnikov, Christopher C. Griffith, Daniel Lubin, Chao Zhang, Nabil F. Saba, Dehong Li, Amanda Kornfield, Amy Chen, Qiuying Shi
    Diagnostic Cytopathology.2024; 52(7): 353.     CrossRef
  • Oncocytic Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: A Case Report
    Kaveripakam Ajay Joseph, Sana Ahuja, Sufian Zaheer
    Indian Journal of Surgical Oncology.2024; 15(S4): 606.     CrossRef
  • Cytologic hallmarks and differential diagnosis of papillary thyroid carcinoma subtypes
    Agnes Stephanie Harahap, Chan Kwon Jung
    Journal of Pathology and Translational Medicine.2024; 58(6): 265.     CrossRef
  • Preoperative evaluation of thyroid nodules – Diagnosis and management strategies
    Tapoi Dana Antonia, Lambrescu Ioana Maria, Gheorghisan-Galateanu Ancuta-Augustina
    Pathology - Research and Practice.2023; 246: 154516.     CrossRef
  • Reevaluating diagnostic categories and associated malignancy risks in thyroid core needle biopsy
    Chan Kwon Jung
    Journal of Pathology and Translational Medicine.2023; 57(4): 208.     CrossRef
  • Strategies for Treatment of Thyroid Cancer
    Deepika Yadav, Pramod Kumar Sharma, Rishabha Malviya, Prem Shankar Mishra
    Current Drug Targets.2023; 24(5): 406.     CrossRef
  • Identification of NIFTP-Specific mRNA Markers for Reliable Molecular Diagnosis of Thyroid Tumors
    So-Yeon Lee, Jong-Lyul Park, Kwangsoon Kim, Ja Seong Bae, Jae-Yoon Kim, Seon-Young Kim, Chan Kwon Jung
    Endocrine Pathology.2023; 34(3): 311.     CrossRef
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Follicular lymphoma: updates for pathologists
Mahsa Khanlari, Jennifer R. Chapman
J Pathol Transl Med. 2022;56(1):1-15.   Published online December 27, 2021
DOI: https://doi.org/10.4132/jptm.2021.09.29
  • 18,181 View
  • 879 Download
  • 17 Web of Science
  • 16 Crossref
AbstractAbstract PDF
Follicular lymphoma (FL) is the most common indolent B-cell lymphoma and originates from germinal center B-cells (centrocytes and centroblasts) of the lymphoid follicle. Tumorigenesis is believed to initiate early in precursor B-cells in the bone marrow (BM) that acquire the t(14;18)(q32;q21). These cells later migrate to lymph nodes to continue their maturation through the germinal center reaction, at which time they acquire additional genetic and epigeneticabnormalities that promote lymphomagenesis. FLs are heterogeneous in terms of their clinicopathologic features. Most FLs are indolent and clinically characterized by peripheral lymphadenopathy with involvement of the spleen, BM, and peripheral blood in a substantial subset of patients, sometimes accompanied by constitutional symptoms and laboratory abnormalities. Diagnosis is established by the histopathologic identification of a B-cell proliferation usually distributed in an at least partially follicular pattern, typically, but not always, in a lymph node biopsy. The B-cell proliferation is biologically of germinal center cell origin, thus shows an expression of germinal center-associated antigens as detected by immunophenotyping. Although many cases of FLs are typical and histopathologic features are straightforward, the biologic and histopathologic variability of FL is wide, and an accurate diagnosis of FL over this disease spectrum requires knowledge of morphologic variants that can mimic other lymphomas, and rarely non-hematologic malignancies, clinically unique variants, and pitfalls in the interpretation of ancillary studies. The overall survival for most patients is prolonged, but relapses are frequent. The treatment landscape in FL now includes the application of immunotherapy and targeted therapy in addition to chemotherapy.

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  • Relapsed/Refractory Follicular Lymphoma: Current Advances and Emerging Perspectives
    Giulio Caridà, Enrica Antonia Martino, Antonella Bruzzese, Daniele Caracciolo, Caterina Labanca, Francesco Mendicino, Eugenio Lucia, Virginia Olivito, Teresa Rossi, Antonino Neri, Ernesto Vigna, Pierfrancesco Tassone, Pierosandro Tagliaferri, Fortunato Mo
    European Journal of Haematology.2025; 114(5): 775.     CrossRef
  • Frequency and Distribution of Lymphomas in Northwestern India: A Retrospective Analysis of 923 Cases Using the Latest World Health Organization Classification 5th Edition
    Immanuel Paul Thayakaran, Biren Parikh
    Indian Journal of Hematology and Blood Transfusion.2025;[Epub]     CrossRef
  • IGH/IGK gene rearrangement in the diagnosis of B-cell non-Hodgkin lymphoma: experience from three centers
    Ke Yang, Zhizhong Wang, Beibei Xin, Yunhang Li, Jiuzhou Zhao, Rui Sun, Weizhen Wang, Dongxu Chen, Chengzhi Zhao, Yongjun Guo, Jie Ma, Bing Wei
    Annals of Hematology.2025;[Epub]     CrossRef
  • Imaging Evaluation of Periarticular Soft Tissue Masses in the Appendicular Skeleton: A Pictorial Review
    Francesco Pucciarelli, Maria Carla Faugno, Daniela Valanzuolo, Edoardo Massaro, Lorenzo Maria De Sanctis, Elisa Zaccaria, Marta Zerunian, Domenico De Santis, Michela Polici, Tiziano Polidori, Andrea Laghi, Damiano Caruso
    Journal of Imaging.2025; 11(7): 217.     CrossRef
  • Transformation of low-grade follicular lymphoma to a high-grade follicular lymphoma with the histopathological diagnosis from oral biopsy: a case report
    Gabriela Silveira de Araujo, Leandro Dorigan de Macedo, Alfredo Ribeiro-Silva, Hilton Marcos Alves Ricz, Lara Maria Alencar Ramos Innocentini
    Hematology, Transfusion and Cell Therapy.2024; 46: S380.     CrossRef
  • The follicular lymphoma tumor microenvironment at single-cell and spatial resolution
    Andrea J. Radtke, Mark Roschewski
    Blood.2024; 143(12): 1069.     CrossRef
  • Chronic pancreatitis for the clinician: complications and special forms of the disease. Interdisciplinary position paper of the Catalan Society of Digestology (SCD) and the Catalan Pancreatic Society (SCPanc)
    Xavier MOLERO, Juan R. AYUSO, Joaquim BALSELLS, Jaume BOADAS, Juli BUSQUETS, Anna CASTERÀS, Mar CONCEPCIÓN, Míriam CUATRECASAS, Gloria FERNÀNDEZ ESPARRACH, Esther FORT, Francisco GARCIA BOROBIA, Àngels GINÈS, Lucas ILZARBE, Carme LORAS, Miquel MASACHS, Xa
    Minerva Gastroenterology.2024;[Epub]     CrossRef
  • Concurrent identification of follicular lymphoma and papillary thyroid carcinoma
    Lama A. Alzelfawi, Norah ALhumaidan, Abrar H. Alageel, Buthaina J. Yahya, Saud D. Alrasheedi, Adel S. Alqahtani
    International Journal of Surgery Case Reports.2024; 122: 110009.     CrossRef
  • Impact of Primary Disease Site of Involvement by Early-Stage Follicular Lymphoma on Patient Outcomes
    Olivia Davis, Carmen Lessani, Rana Kasht, Andrew Cohoon, Sami Ibrahimi, Adam Asch, Silas Day, Taha Al-Juhaishi
    Clinical Lymphoma Myeloma and Leukemia.2024; 24(12): 837.     CrossRef
  • Recent developments in CD19-targeted therapies for follicular lymphoma
    Aditi Saha, Julio C. Chavez
    Expert Opinion on Biological Therapy.2024; 24(10): 1049.     CrossRef
  • Unraveling the complexity of follicular lymphoma: insights and innovations
    Xijing Li
    American Journal of Cancer Research.2024; 14(12): 5573.     CrossRef
  • Clinical features and prognostic factors in 49 patients with follicular lymphoma at a single center: A retrospective analysis
    Hao Wu, Hui-Cong Sun, Gui-Fang Ouyang
    World Journal of Clinical Cases.2023; 11(14): 3176.     CrossRef
  • A rare case of follicular lymphoma of the bladder
    Matthew DeSanto, Robert Strait, Jared Zopp, Kevin Brown, Samuel Deem
    Urology Case Reports.2023; 51: 102542.     CrossRef
  • Analysis of immunophenotypic features in hyaline vascular type Castleman disease
    Yu Chang, Yu Ma, Chen Chang, Wensheng Li
    Diagnostic Pathology.2023;[Epub]     CrossRef
  • Leg Edema Unveiled: The Uncommon Culprit of Follicular Lymphoma
    Syed Muhammad IbnE Ali Jaffari, Samaha Nisar, Narjis Malik, Syed Muhammad Aun Ali Jaffari, Omar Nisar
    Journal of Shalamar Medical & Dental College - JSHMDC.2023; 4(2): 125.     CrossRef
  • A Review of the Totality of Evidence in the Development of ABP 798, A Rituximab Biosimilar
    Patrick Cobb, Dietger Niederwieser, Stanley Cohen, Caroline Hamm, Gerd Burmester, Neungseon Seo, Sonya G Lehto, Vladimir Hanes
    Immunotherapy.2022; 14(9): 727.     CrossRef
Case Study
Article image
Composite follicular lymphoma and classic Hodgkin lymphoma
Han-Na Kim, Min Ji Jeon, Eun Sang Yu, Dae Sik Kim, Chul-Won Choi, Young Hyeh Ko
J Pathol Transl Med. 2022;56(1):57-60.   Published online November 16, 2021
DOI: https://doi.org/10.4132/jptm.2021.10.09
  • 5,618 View
  • 233 Download
  • 6 Web of Science
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AbstractAbstract PDF
Composite lymphoma is very rare and a combination of Hodgkin lymphoma and non-Hodgkin lymphoma and even histiocytic tumors can occur. Because of the unfamiliarity, not only can this cause diagnostic problems, but can also affect treatment plan. We report a case of composite lymphoma in a 40-year-old male. Initial biopsy showed a composite lymphoma of follicular lymphoma grade 1 and classic Hodgkin lymphoma. After chemotherapy, another lymph node was taken because of disease progression, which revealed follicular lymphoma, grade 3a without Hodgkin lymphoma component.

Citations

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  • Composite Lymphoma: A Rare Case of Vomiting
    Changqin Liu, Dongyan Han, Xiaomin Sun
    United European Gastroenterology Journal.2025; 13(5): 836.     CrossRef
  • T cell lymphoma and secondary primary malignancy risk after commercial CAR T cell therapy
    Guido Ghilardi, Joseph A. Fraietta, James N. Gerson, Vivianna M. Van Deerlin, Jennifer J. D. Morrissette, Gabriel C. Caponetti, Luca Paruzzo, Jaryse C. Harris, Elise A. Chong, Sandra P. Susanibar Adaniya, Jakub Svoboda, Sunita D. Nasta, Ositadimma H. Ugwu
    Nature Medicine.2024; 30(4): 984.     CrossRef
  • Double trouble: insights from a rare case of extranodal composite lymphoma in an elderly man, with comprehensive literature review
    Aadya Kerkar
    American Journal of Translational Research.2024; 16(6): 2599.     CrossRef
  • Composite Lymphoma with Follicular Lymphoma Transformation to Clonally Related Epstein–Barr Virus (EBV) Positive Diffuse Large B-Cell Lymphoma and EBV-PositiveClassic Hodgkin Lymphoma
    Christopher B. Ryder, Hayder Saeed, Mohammad Hussaini, Pier Paolo Piccaluga
    Case Reports in Hematology.2023; 2023: 1.     CrossRef
  • Plasticity in Classical Hodgkin Composite Lymphomas: A Systematic Review
    Alexis Trecourt, Marie Donzel, Juliette Fontaine, Hervé Ghesquières, Laurent Jallade, Gabriel Antherieu, Camille Laurent, Claire Mauduit, Alexsandra Traverse-Glehen
    Cancers.2022; 14(22): 5695.     CrossRef
Original Article
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Upward trend in follicular lymphoma among the Korean population: 10-year experience at a large tertiary institution
Meejeong Kim, Hee Sang Hwang, Hyungwoo Cho, Dok Hyun Yoon, Cheolwon Suh, Chan Sik Park, Heounjeong Go, Jooryung Huh
J Pathol Transl Med. 2021;55(5):330-337.   Published online September 2, 2021
DOI: https://doi.org/10.4132/jptm.2021.07.25
  • 4,591 View
  • 115 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary Material
Background
Follicular lymphoma (FL) is the second most common non-Hodgkin lymphoma (NHL) in Western countries. However, it is relatively rare in Asia. This study examined epidemiologic characteristics of FL in South Korea, with an emphasis on recent trends of increase in cases.
Methods
We retrospectively examined 239 cases of newly diagnosed FL at a large tertiary institution in Korea (Asan Medical Center, Seoul, Republic of Korea) between 2008 and 2017. Age-adjusted incidence rates and clinicopathological variables were analyzed, and joinpoint regression analysis was used to identify the changes.
Results
The age-adjusted incidence of FL significantly increased during the study period (p = .034), and the ratio of (relative incidence) patients with FL to patients with NHL increased from 4.28% to 9.35% in the same period. Over the 10-year study assessment duration, the proportion of patients with stage III/IV FL (p = .035) and expression of BCL2 (p = .022) or BCL6 (p = .039) significantly increased. From 2013–2017, the proportion of patients with highrisk Follicular Lymphoma International Prognostic Index (FLIPI) score increased (21.5% to 28.7%), whereas that of low-risk FLIPI decreased (55.4% to 38.6%), although those results were not statistically significant (p = .066).
Conclusions
We found an increasing incidence of FL, with a disproportionate increase in the incidence of high-stage disease and recent changes in the clinicopathologic features of the Korean patient population.

Citations

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  • Incidence Trend of Follicular Lymphoma in Taiwan Compared to Japan and Korea, 2001–2019
    Liang-Chun Chiu, Chih-Wen Lin, Hung-Ju Li, Jian-Han Chen, Fu-Cheng Chuang, Sheng-Fung Lin, Yu Chang, Yu-Chieh Su
    Journal of Clinical Medicine.2023; 12(4): 1417.     CrossRef
  • A Case Report on the Complete Response of a Patient with Recurrent Follicular Lymphoma Treated with Integrative Medicine
    Kyung-dug Park, Jisoo Kim, Yoona Oh, Beom-Jin Jeong, Yu-jin Jung, Sunhwi Bang
    The Journal of Internal Korean Medicine.2023; 44(3): 585.     CrossRef
  • Recent Updates on Diagnosis and Treatment of Follicular Lymphoma
    Ga-Young Song, Deok-Hwan Yang
    The Korean Journal of Medicine.2023; 98(5): 231.     CrossRef
  • Classical Hodgkin lymphoma following follicular lymphoma: a case report
    Bomi Kim
    Journal of Yeungnam Medical Science.2023; 40(Suppl): S113.     CrossRef
  • Incidence, clinicopathological features and genetics of in‐situ follicular neoplasia: a comprehensive screening study in a Japanese cohort
    Naoki Oishi, Takahiro Segawa, Kunio Miyake, Kunio Mochizuki, Tetsuo Kondo
    Histopathology.2022; 80(5): 820.     CrossRef
Case Study
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Morphologic variant of follicular lymphoma reminiscent of hyaline-vascular Castleman disease
Jiwon Koh, Yoon Kyung Jeon
J Pathol Transl Med. 2020;54(3):253-257.   Published online February 5, 2020
DOI: https://doi.org/10.4132/jptm.2019.12.17
  • 6,621 View
  • 229 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Follicular lymphoma (FL) with hyaline-vascular Castleman disease (FL-HVCD)-like features is a rare morphologic variant, with fewer than 20 cases in the literature. Herein, we report a case of FL-HVCD in a 37-year-old female who presented with isolated neck lymph node enlargement. The excised lymph node showed features reminiscent of HVCD, including regressed germinal centers (GCs) surrounded by onion skin-like mantle zones, lollipop lesions composed of hyalinized blood vessels penetrating into regressed GCs, and hyalinized interfollicular stroma. In addition, focal areas of abnormally conglomerated GCs composed of homogeneous, small centrocytes with strong BCL2, CD10, and BCL6 expression were observed, indicating partial involvement of the FL. Several other lymphoid follicles showed features of in situ follicular neoplasia. Based on the observations, a diagnosis of FL-HVCD was made. Although FLHVCD is very rare, the possibility of this variant should be considered in cases resembling CD. Identification of abnormal, neoplastic follicles and ancillary immunostaining are helpful for proper diagnosis.

Citations

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  • Unicentric Castleman Disease: Illustration of Its Morphologic Spectrum and Review of the Differential Diagnosis
    Siba El Hussein, Andrew G. Evans, Hong Fang, Wei Wang, L. Jeffrey Medeiros
    Archives of Pathology & Laboratory Medicine.2024; 148(1): 99.     CrossRef
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    Hung-Yu Lin, Yi-Jen Peng, Yi-Ying Wu, Ping-Ying Chang
    Journal of Medical Sciences.2023; 43(6): 292.     CrossRef
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    Yu Chang, Yu Ma, Chen Chang, Wensheng Li
    Diagnostic Pathology.2023;[Epub]     CrossRef
  • In‐situ follicular neoplasia: a clinicopathological spectrum
    Gurdip S Tamber, Myriam Chévarie‐Davis, Margaret Warner, Chantal Séguin, Carole Caron, René P Michel
    Histopathology.2021; 79(6): 1072.     CrossRef
Original Articles
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A Multi-institutional Study of Prevalence and Clinicopathologic Features of Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) in Korea
Ja Yeong Seo, Ji Hyun Park, Ju Yeon Pyo, Yoon Jin Cha, Chan Kwon Jung, Dong Eun Song, Jeong Ja Kwak, So Yeon Park, Hee Young Na, Jang-Hee Kim, Jae Yeon Seok, Hee Sung Kim, Soon Won Hong
J Pathol Transl Med. 2019;53(6):378-385.   Published online October 21, 2019
DOI: https://doi.org/10.4132/jptm.2019.09.18
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  • 16 Web of Science
  • 16 Crossref
AbstractAbstract PDF
Background
In the present multi-institutional study, the prevalence and clinicopathologic characteristics of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) were evaluated among Korean patients who underwent thyroidectomy for papillary thyroid carcinoma (PTC).
Methods
Data from 18,819 patients with PTC from eight university hospitals between January 2012 and February 2018 were retrospectively evaluated. Pathology reports of all PTCs and slides of potential NIFTP cases were reviewed. The strict criterion of no papillae was applied for the diagnosis of NIFTP. Due to assumptions regarding misclassification of NIFTP as non-PTC tumors, the lower boundary of NIFTP prevalence among PTCs was estimated. Mutational analysis for BRAF and three RAS isoforms was performed in 27 randomly selected NIFTP cases.
Results
The prevalence of NIFTP was 1.3% (238/18,819) of all PTCs when the same histologic criteria were applied for NIFTP regardless of the tumor size but decreased to 0.8% (152/18,819) when tumors ≥1 cm in size were included. The mean follow-up was 37.7 months and no patient with NIFTP had evidence of lymph node metastasis, distant metastasis, or disease recurrence during the follow-up period. A difference in prevalence of NIFTP before and after NIFTP introduction was not observed. BRAFV600E mutation was not found in NIFTP. The mutation rate for the three RAS genes was 55.6% (15/27).
Conclusions
The low prevalence and indolent clinical outcome of NIFTP in Korea was confirmed using the largest number of cases to date. The introduction of NIFTP may have a small overall impact in Korean practice.

Citations

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Cytologic Diagnosis of Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features and Its Impact on the Risk of Malignancy in the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience
Milim Kim, Joung Eun Kim, Hyun Jeong Kim, Yul Ri Chung, Yoonjin Kwak, So Yeon Park
J Pathol Transl Med. 2018;52(3):171-178.   Published online April 3, 2018
DOI: https://doi.org/10.4132/jptm.2018.04.03
  • 10,259 View
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  • 24 Web of Science
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AbstractAbstract PDF
Background
This study was performed to analyze cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) and its impact on the risk of malignancy (ROM) in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC).
Methods
Five thousand five hundred and forty-nine cases of thyroid fine-needle aspiration cytology (FNAC) diagnosed between 2012 and 2014 were included in this study. Diagnostic categories based on TBSRTC were compared with final surgical diagnoses, and the ROM in each category was calculated both when NIFTP was included in malignant lesions and when excluded from malignant lesions.
Results
Of the 5,549 thyroid FNAC cases, 1,891 cases underwent surgical resection. In final diagnosis, 1,700 cases were revealed as papillary thyroid carcinoma (PTC), and 25 cases were reclassified as NIFTP. The cytologic diagnoses of NIFTP were non-diagnostic in one, benign in five, atypia of undetermined significance (AUS) in 14, follicular neoplasm in two, and suspicious for malignancy in three cases. Collectively, NIFTP/encapsulated follicular variant of PTC (EFVPTC) were more frequently classified as benign, AUS, or follicular neoplasm and less frequently categorized as malignant compared to conventional PTCs. Exclusion of NIFTP from malignant diagnoses resulted in a slight decrease in malignancy rates in non-diagnostic, benign, AUS, follicular neoplasm, and suspicious for malignancy categories without any statistical significance.
Conclusions
The decrease in the ROM was not significant when NIFTP was excluded from malignant lesions. In thyroid FNACs, NIFTP/EFVPTCs were mostly classified into indeterminate categories. Therefore, it might be feasible to separate NIFTP/EFVPTC from conventional PTC on FNAC to guide clinicians to conservative management for patients with NIFTP/EFVPTC.

Citations

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  • High Rates of Unnecessary Surgery for Indeterminate Thyroid Nodules in the Absence of Molecular Test and the Cost-Effectiveness of Utilizing Molecular Test in an Asian Population: A Decision Analysis
    Man Him Matrix Fung, Ching Tang, Gin Wai Kwok, Tin Ho Chan, Yan Luk, David Tak Wai Lui, Carlos King Ho Wong, Brian Hung Hin Lang
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  • Spatial transcriptomics reveals prognosis‐associated cellular heterogeneity in the papillary thyroid carcinoma microenvironment
    Kai Yan, Qing‐Zhi Liu, Rong‐Rong Huang, Yi‐Hua Jiang, Zhen‐Hua Bian, Si‐Jin Li, Liang Li, Fei Shen, Koichi Tsuneyama, Qing‐Ling Zhang, Zhe‐Xiong Lian, Haixia Guan, Bo Xu
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    K Amita, HB Rakshitha, M Sanjay, Prashantha Kalappa
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  • Detailed fine needle aspiration cytopathology findings of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features with nuclear grading correlated to that of biopsy and Bethesda category and systematic review
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  • Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features Is Not a Cytological Diagnosis, but It Influences Cytological Diagnosis Outcomes: A Systematic Review and Meta-Analysis
    Elina Haaga, David Kalfert, Marie Ludvíková, Ivana Kholová
    Acta Cytologica.2022; 66(2): 85.     CrossRef
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  • Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors
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Cytological Features That Differentiate Follicular Neoplasm from Mimicking Lesions
Kanghee Han, Hwa-Jeong Ha, Joon Seog Kong, Jung-Soon Kim, Jae Kyung Myung, Jae Soo Koh, Sunhoo Park, Myung-Soon Shin, Woo-Tack Song, Hye Sil Seol, Seung-Sook Lee
J Pathol Transl Med. 2018;52(2):110-120.   Published online January 29, 2018
DOI: https://doi.org/10.4132/jptm.2018.01.17
  • 14,895 View
  • 210 Download
  • 6 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Background
It is difficult to correctly diagnose follicular neoplasms (FNs) on fine-needle aspiration cytology (FNAC) because it shares many cytological features with other mimicking lesions. The aim of this study was to identify the cytological features that differentiate FNs from mimicking lesions.
Methods
We included the cytological slides from 116 cases of thyroid FN diagnosed on FNAC, and included their subsequent histological diagnoses. We evaluated the cytological architectural pattern and nuclear features of the lesions according to their histological groups.
Results
The final histological diagnoses of the 116 cases varied, and included 51 FNs (44%), 47 papillary thyroid carcinomas (40%) including follicular variant, and seventeen cellular nodular hyperplasias (15%). Regardless of the final histological diagnosis, microfollicular pattern was observed in most cases. On the other hand, trabecular pattern was identified in 34% of FNs, but not in any other lesions. Additionally, elongated nuclei and ground glass chromatin were found in only some papillary thyroid carcinomas.
Conclusions
This study shows that the trabecular pattern is a representative cytological feature of FNs that can be used to distinguish FNs from mimicking lesions. In addition, nuclear shape and chromatin pattern can be used to further confirm the diagnosis of FNs from mimicking lesions through FNAC.

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  • АКТУАЛЬНІ ТЕНДЕНЦІЇ ДІАГНОСТИКИ ТА ЛІКУВАННЯ ФОЛІКУЛЯРНИХ НЕОПЛАЗІЙ ЩИТОПОДІБНОЇ ЗАЛОЗИ
    А. Я. Пасько, В. Д. Скрипко
    Art of Medicine.2025; : 82.     CrossRef
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    Heeseung Sohn, Kennichi Kakudo, Chan Kwon Jung
    Cytopathology.2024; 35(3): 383.     CrossRef
  • Fine needle aspiration cytology diagnoses of follicular thyroid carcinoma: results from a multicenter study in Asia
    Hee Young Na, Miyoko Higuchi, Shinya Satoh, Kaori Kameyama, Chan Kwon Jung, Su-Jin Shin, Shipra Agarwal, Jen-Fan Hang, Yun Zhu, Zhiyan Liu, Andrey Bychkov, Kennichi Kakudo, So Yeon Park
    Journal of Pathology and Translational Medicine.2024; 58(6): 331.     CrossRef
  • Using Deep Convolutional Neural Networks for Enhanced Ultrasonographic Image Diagnosis of Differentiated Thyroid Cancer
    Wai-Kin Chan, Jui-Hung Sun, Miaw-Jene Liou, Yan-Rong Li, Wei-Yu Chou, Feng-Hsuan Liu, Szu-Tah Chen, Syu-Jyun Peng
    Biomedicines.2021; 9(12): 1771.     CrossRef
  • The Role of Fine Needle Aspiration Biopsy with Bethesda System in the Evaluation of Thyroid Nodules
    Gizem AKKAŞ AKGÜN, Figen ASLAN
    Anadolu Kliniği Tıp Bilimleri Dergisi.2021; 26(1): 23.     CrossRef
  • Comprehensive DNA Methylation Profiling Identifies Novel Diagnostic Biomarkers for Thyroid Cancer
    Jong-Lyul Park, Sora Jeon, Eun-Hye Seo, Dong Hyuck Bae, Young Mun Jeong, Yourha Kim, Ja Seong Bae, Seon-Kyu Kim, Chan Kwon Jung, Yong Sung Kim
    Thyroid.2020; 30(2): 192.     CrossRef
  • Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
    Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
    PLOS ONE.2020; 15(11): e0241597.     CrossRef
The Intraoperative Immunohistochemical Staining of CD56 and CK19 Improves Surgical Decision for Thyroid Follicular Lesions
Ju Yeon Pyo, Sung-eun Choi, Eunah Shin, JaSeung Koo, SoonWon Hong
J Pathol Transl Med. 2017;51(5):463-470.   Published online August 2, 2017
DOI: https://doi.org/10.4132/jptm.2017.05.25
  • 10,558 View
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  • 2 Web of Science
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AbstractAbstract PDF
Background
When differential diagnosis is difficult in thyroid follicular lesions with overlapping histological features, the immunohistochemical staining can help confirm the diagnosis. We aimed to evaluate the effectiveness of rapid immunohistochemical stains of CD56 and cytokeratin 19 on frozen sections of thyroid follicular lesion and explore the possible gains and limitations of the practice. Methods: Eighty-six nodules of 79 patients whose intraoperative frozen sections were selected as the control group, and 53 nodules of 48 patients whose intraoperative frozen sections were subject to rapid immunohistochemistry were selected as the study group. Results: Five nodules (6%) in the control group were diagnosed as follicular neoplasm and six nodules (7%) were deferred. In the study group, six nodules (11%) were follicular neoplasm and none were deferred. Three nodules (4%) in the control group showed diagnostic discrepancy between the frozen and permanent diagnoses, but none in the study group. The average turnaround time for the frozen diagnosis of the control group was 24 minutes, whereas it was 54 minutes for the study group. Conclusions: Intraoperative rapid immunohistochemical stains significantly decreased the diagnostic discrepancy in this study. Considering the adverse effects of indefinite frozen diagnosis or discrepancy with permanent diagnoses, the intraoperative rapid immunohistochemical stain can help to accurately diagnose and hence provide guidance to surgical treatment.

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  • High-Contrast Facile Imaging with Target-Directing Fluorescent Molecular Rotors, the N3-Modified Thioflavin T Derivatives
    Yuka Kataoka, Hiroto Fujita, Arina Afanaseva, Chioko Nagao, Kenji Mizuguchi, Yuuya Kasahara, Satoshi Obika, Masayasu Kuwahara
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Case Study
Thymoma and Synchronous Primary Mediastinal Seminomas with Florid Follicular Lymphoid Hyperplasia in the Anterior Mediastinum: A Case Report and Review of the Literature
Hyang-im Lee, In-seok Jang, Kyung Nyeo Jeon, Gyung Hyuck Ko, Jong Sil Lee, Dong Chul Kim, Dae Hyun Song, Jeong-Hee Lee
J Pathol Transl Med. 2017;51(2):165-170.   Published online February 2, 2017
DOI: https://doi.org/10.4132/jptm.2016.08.24
  • 10,098 View
  • 143 Download
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AbstractAbstract PDF
Thymoma is the most common neoplasm of the anterior mediastinum and has malignant potential. Germ cell tumors (GCTs) found in the anterior mediastinum are usually benign, and malignant GCTs, such as seminomas, are rare. Histologically, mediastinal seminoma is indistinguishable from testicular seminoma except for site-associated morphological features such as lymphoid follicular hyperplasia. Therefore, excluding metastasis is very important. Recently, we treated a young adult patient with multiple thymic masses that occurred simultaneously. The patient underwent a thymectomy for the removal of the mediastinal masses, one of which was diagnosed as type B2 invasive thymoma, and two of which were diagnosed as primary mediastinal seminomas with massive follicular hyperplasia. The patient received adjuvant chemotherapy after surgical resection. To our knowledge, this is the first description of a thymoma and a mediastinal seminoma occurring simultaneously in the thymus. We present this case along with a literature review.

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    Annikka Weissferdt
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    Charlotte Holmes, Peh Sun Loo, Sion Barnard
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