Diagnostic Nomenclature Research Articles

A systematic review and meta-analysis comparing the severity of core symptoms of attention-deficit hyperactivity disorder in females and males.

In the past decade, there have been substantial changes in diagnostic nomenclature. This study investigated sex differences in attention-deficit/hyperactivity disorder (ADHD) symptom severity based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV, DSM-IV(TR), and DSM-5 criteria, separating rating scale and clinical interview data in children and adults with ADHD. PubMed, PsycINFO, and Scopus were searched for published studies (1996-2021) reporting severity of attention, and hyperactivity/impulsivity in males and females. We compared data: (1) across the entire lifespan aggregating rating scale and clinical interview data (51 studies), (2) drawing solely on rating scale data (18 studies), and (3) drawing solely on clinical interview data (33 studies). Fifty-two studies met inclusion criteria comparing data for females (n = 8423) and males (n = 9985) with ADHD across childhood and/or adulthood. In total, 15 meta-analyses were conducted. Pooled data across the lifespan aggregating both rating scale and clinical diagnostic interview data, showed males had significantly more severe hyperactivity/impulsivity symptoms than females. Rating scale data were similar; boys had significantly more severe hyperactivity/impulsivity than girls. In adulthood, men were rated to have significantly more severe inattention than women with no difference in the hyperactivity/impulsivity dimension. All significant differences were of small effect size. No significant sex differences in the severity of symptoms emerged for clinical interview data for children or adults, in contrast. Possible reasons for the discrepancy in findings between rating scales and clinical diagnostic interviews are discussed.

Atlas Florae Europaeae notes, 34. Distributions and two conservation profiles of East European species of the Cytisusratisbonensis group (Fabaceae).

The Cytisusratisbonensis group (Fabaceae) includes small shrubs with attractive yellow flowers, used in ornamental cultivation. It is widely distributed in southern forest, forest steppe and steppe zones of Eastern Europe, both in the lowlands and low mountains. This group is notorious for its taxonomic complexity and difficulties in identification, which accounted for incongruent taxonomic treatments and common identification errors, and resulted in a poor understanding of the distribution areas. The increasing availability of herbarium collections and accumulation of human observations through digital resources require their critical taxonomic revision and update in order to provide reliable data for plant species mapping, conservation and analysis of distribution areas. This paper describes a distributional dataset of East European species of the Cytisusratisbonensis group, which was prepared for the pan-European grid mapping project, Atlas Florae Europaeae. The taxonomic revision includes seven species and two interspecific hybrids and is based on the critical evaluation of diagnostic characters, nomenclature and synonymy. The territorial scope of this study is Eastern Europe, but it also includes some data from Central Europe, the Caucasus and the neighbouring territories of Siberia and Kazakhstan, which are included in order to trace eastern and south-eastern limits of the species distributions and to establish reliable synonymy. We report 3699 native occurrence records included in the dataset; these records are based on major herbarium collections which are known to hold specimens from Eastern Europe (DNZ, KRA, KRAM, KW, LE, LW, LWKS, MHA, MSK, MSKH, MSKU, MW), complemented by selected specimens from other herbaria (BUNS, CSAU, H, NNSU, NS, NSK, OXF, PVB, RWBG, TUL). The herbarium collections were examined largely de visu, but partly online. Besides the herbarium specimens, recognisable photographs documenting human observations on online platforms (florafauna.by, iNaturalist, Plantarium, UkrBIN) were also examined and included. All specimen records are accompanied with textual data and georeferences, which were produced for this dataset. Point and contour distribution maps are created for each accepted species. According to the distributional data, the Cytisusratisbonensis group may be classified as temperate lowland and steppic in Eastern Europe. Among European endemic shrubs, C.cinereus (as C.paczoskii) was assessed in 2017 as Near Threatened, whereas its new IUCN protection status is proposed as Least Concern because the new data demonstrated that its distribution area is much greater than previously believed. A species restricted to the Crimea, C.wulffii, is assessed here for the first time as Vulnerable because of its restricted area and small population size (criteria D1,2).

Epidemiology of Avoidant/Restrictive Food Intake Disorder

Avoidant/restrictive food intake disorder (ARFID) is a relatively new category within DSM-5 feeding and eating disorders, which expands beyond developmentally normative picky eating. Given its recent introduction to the diagnostic nomenclature, research on the epidemiology of ARFID is in its infancy. Prevalence estimates for ARFID vary considerably by methodology, setting, and population, but growing evidence suggests that ARFID is just as common as other more well-known eating disorders, affecting approximately 0.3% to 15.5% of children and 0.3% to 4.1% of adults. Despite common misconceptions, ARFID impacts a wide range of individuals across ages and genders, and both medical and psychiatric comorbidities are common. Limited research has investigated prognosis, but existing longitudinal studies highlight the persistence of the disorder and the possibility of diagnostic crossover to other eating disorders. [ Psychiatr Ann . 2024;54(2):e42–e46.]

Definition and validation of the nursing diagnosis label “wish to die”: a research protocol

BackgroundEuthanasia has been incorporated into the health services of seven countries. The legalisation of these practices has important repercussions for the competences of nurses, and it raises questions about their role. When a patient with advanced disease expresses a wish to die, what is expected of nurses? What are the needs of these patients, and what kind of care plan do they require? What level of autonomy might nurses have when caring for these patients? The degree of autonomy that nurses might or should have when it comes to addressing such a wish and caring for these patients has yet to be defined. Recognising the wish to die as a nursing diagnosis would be an important step towards ensuring that these patients receive adequate nursing care.This study-protocol aims to define and validate the nursing diagnosis wish to die in patients with advanced disease, establishing its defining characteristics and related factors; to define nursing-specific interventions for this new diagnosis.MethodsA prospective three-phase study will be carried out. Phase-A) Foundational knowledge: an umbrella review of systematic reviews will be conducted; Phase-B) Definition and validation of the diagnostic nomenclature, defining characteristics and related factors by means of an expert panel, a Delphi study and application of Fehring’s diagnostic content validation model; Phase-C) Definition of nursing-specific interventions for the new diagnosis. At least 200 academic and clinical nurses with expertise in the field of palliative care or primary health care will be recruited as participants across the three phases.DiscussionThe definition of the wish to die as a nursing diagnosis would promote greater recognition and autonomy for nurses in the care of patients who express such a wish, providing an opportunity to alleviate underlying suffering through nursing-specific interventions and drawing attention to the needs of patients with advanced disease. The new diagnosis would be an addition to nursing science and would provide a framework for providing care to people with advanced disease who express such a wish. Nurses would gain professional autonomy about identifying, exploring and responding clinically to such a wish.

Childhood trauma, PTSD/CPTSD and chronic pain: A systematic review.

Despite the growing body of literature on posttraumatic stress disorder (PTSD) and chronic pain comorbidity, studies taking into account the role of childhood exposure to traumatic and adverse events remains minimal. Additionally, it has been well established that survivors of childhood trauma may develop more complex reactions that extend beyond those observed in PTSD, typically categorized as complex trauma or CPTSD. Given the recent introduction of CPTSD within diagnostic nomenclature, the aim of the present study is to describe associations between childhood trauma in relation to PTSD/CPTSD and pain outcomes in adults with chronic pain. Following PRSIMA guidelines, a systematic review was performed using the databases Pubmed, PsychInfo, Psychology and Behavioral Sciences Collection, and Web of Science. Articles in English or French that reported on childhood trauma, PTSD/CPTSD and pain outcomes in individuals with chronic pain were included. Titles and abstracts were screened by two authors independently and full texts were consequently evaluated and assessed on methodological quality using JBI checklist tools. Study design and sample characteristics, childhood trauma, PTSD/CPTSD, pain outcomes as well as author's recommendations for scientific research and clinical practice were extracted for analyses. Of the initial 295 search records, 13 studies were included in this review. Only four studies explicitly assessed links between trauma factors and pain symptoms in individuals with chronic pain. Findings highlight the long-term and complex impact of cumulative childhood maltreatment (e.g., abuse and neglect) on both PTSD/CPTSD and chronic pain outcomes in adulthood. This review contributes to current conceptual models of PTSD and chronic pain comorbidity, while adding to the role of childhood trauma and CPTSD. The need for clinical and translational pain research is emphasized to further support specialized PTSD/CPTSD treatment as well as trauma-informed pain management in routine care.

“Healed” Appendix is not actually “Healed” from the surgeon’s perspective: Is it a histopathologic misnomer?

The study aims to present a refute for the use of histopathologic diagnostic nomenclature of the word “Healed” in the perspective of the appendix after appendectomy. Appendectomy is being done worldwide for the acute inflammation of the appendix in golden hours or as an interval appendectomy after the subsidence of the features of inflammation for recurrent appendicitis. The word “Healed” presents a negative psychological impact on the patients as they think that their already “Healed” appendix is unnecessarily removed by the surgeon whereas the pathologist friends use this nomenclature only by the presence of features of any healing wound like fibrosis, eosinophils etc. We also present gross examination findings, histopathologic microscopic features along with photomicrographs of the few appendectomy specimens which were laparoscopically operated for the recurrent appendicitis.

The International System for Reporting Serous Fluid Cytopathology-An Updated Review.

The International System (TIS) for reporting serous fluid cytopathology was published in December 2020 as a joint project by the International Academy of Cytology and the American Society of Cytopathology. The purpose was to standardize the diagnostic criteria and nomenclature used in reporting serous fluid samples, thereby improving the reproducibility of reports and improving communication between pathologists and clinicians. TIS defines a five-tier system consisting of nondiagnostic, negative for malignancy, atypia of uncertain significance, suspicious for malignancy and malignant categories. This review provides an updated summary of the reporting system, risk of malignancy, potential diagnostic pitfalls, and a practical diagnostic approach to serous fluid specimens.

INNV-38. PREDICTING THE CLINICAL PHENOTYPE IN NF2 RELATED SCHWANNOMATOSIS PATIENTS

Abstract BACKGROUND Different genetic scores have been proposed to predict the phenotype of NF2 related Schwannomatosis (NF2 -SCHW MIM # 101000) , a rare autosomal dominant familial cancer syndromes caused by pathogenic variants of the NF2 gene. The UK NF2 Reference Group proposed the Genetic Severity Score (GSS) based on the type and location of NF2 germline variant observed. Catasus et al. suggested a new score based also on a functional assay of Merlin and its downstream pathways (FGSS). Recently Teranish et al. used targeted deep sequencing to predict functional prognosis in those patients. Material and METHODS 70 patients (median age 40) were identified by scanning the electronic NF2-SCHW patient database at Fondazione IRCCS C. Besta,. The median follow-up was 14 yrs. Clinical diagnosis was established following the Updated diagnostic criteria and nomenclature for neurofibromatosis type 2 and schwannomatosis”. All patients underwent NF2, SMARCB1 and LZTR1 mutational screening by NGS and MPLA analysis using blood DNA or the tissue of two different tumors when available. NF2 gene germline pathogenic were found in 45 subjects (64%), in most cases NF2 point mutations, but in 4 cases and whole gene deletions was observed and in 2 a ring NF2 chromosome was identified, in four cases a mosaic NF2-SCH was identified and in 21 (30%) patients no pathogenic variant was found. We assessed NF2 clinical phenotype in relation to the UK GSS and FGSS to validate their use. RESULTS The disease phenotype differed significantly depending both on clinical and genetic factors.. GSS and FGSS showed significant correlation with several measures, allowing stratification of patients with severe and mild disease but not with moderate phenotype. Furthermore, we provided evidence on correlation between whole NF2 deletion extent and phenotype severity. Large cohorts of NF2-SCHW patients are needed to identify more accurate scores.

Existential issues in the fictional writing of haruki murakami

AbstractExistential analyses of Murakami's fiction have dealt mostly with identity issues during adolescence and adulthood. This article presents a different existential conceptualization by examining how Yalom's four ultimate life concerns—isolation, meaninglessness, freedom, and death ─ are embodied in the life of some of Haruki Murakami's fictional protagonists. In this work, I will also bring standard diagnostic nomenclature and psychoanalytic conceptualizations into dialog with the existential tradition, by demonstrating how certain mental conditions, which are considered by clinicians as forms of psychopathology, can also be interpreted as modes of existence in an alienated reality, and as non‐conformity.

Proceedings of the 2023 Division of Translational Toxicology Satellite Symposium.

The 2023 annual Division of Translational Toxicology (DTT) Satellite Symposium, entitled "Pathology Potpourri," was held in Summerlin, Nevada, at the Society of Toxicologic Pathology's 41st annual meeting. The goal of this symposium was to present and discuss challenging diagnostic pathology and/or nomenclature issues. This article presents summaries of the speakers' talks along with select images that were used by the audience for voting and discussion. Various lesions and topics covered during the symposium included induced and spontaneous neoplastic and nonneoplastic lesions in the mouse liver, infectious and proliferative lesions in nonhuman primates, interesting presentations of mononuclear cell infiltrates in various animal models and a complex oral tumor in a rat.

P20.03.A PREDICTING THE CLINICAL PHENOTYPE INNF2 RELATED SCHWANNOMATOSIS PATIENTS USING NEW GENETIC SCORES

Abstract BACKGROUND NF2 related Schwannomatosis (NF2 -SCHW MIM # 101000) is a rare autosomal dominant familial cancer syndromes caused by mutations in the NF2 gene, mainly due to NF2 point mutations or intragenic deletions. NF2 patients. In 95% of patients, bilateral vestibular schwannomas are present, but NF2 -SCHW patients can develop other tumors and show ophthalmic and dermatological signs. Several studies established a genotype-phenotype correlations; the UK NF2 Reference Group proposed a Genetic Severity Score (GSS) based on the type and location of NF2 germline variant observed. Catasus et al. after validation of the score in a Spanish cohort suggested a new score based also on a functional assay of Merlin and its downstream pathways (FGSS). Recently Teranish et al. used targeted deep sequencing to predict functional prognosis in those patients. MATERIAL AND methods 70 patients (median age 40) were identified by scanning the electronic NF2-SCHW patient database at Fondazione IRCCS C. Besta, where the patients had undergone full neurological, ophthalmic, and audiological assessment. The median follow-up was 14 yrs. Clinical diagnosis was established following the Updated diagnostic criteria and nomenclature for neurofibromatosis type 2 and schwannomatosis”. All patients underwent NF2, SMARCB1 and LZTR1 mutational screening by NGS and MPLA analysis using blood DNA or the tissue of two different tumors when available.NF2 gene germline pathogenic were found in 45 subjects (64%), in most cases NF2 point mutations, but in 4 cases and whole gene deletions was observed and in 2 a ring NF2 chromosome was identified, in four cases a mosaic NF2-SCH was identified and in 21 (30%) patients no pathogenic variant was found. We assessed NF2-SCHW clinical phenotype in relation to the UK GSS and FGSS to validate their use as clinical and research tools, despite the significant phenotypic variability observed. RESULTS The disease outcome differed significantly depending both on clinicaland genetic factors. Among these factors,” Age of symptom onset” “Truncating”, “Mosaic”, and “whole gene deletion” had the most significant effects on functional disability. Conclusion GSS and FGSS showed significant correlation with several measures, allowing stratification of patients with severe and mild disease but not with moderate phenotype. Furthermore, we provided evidence on correlation between whole NF2 deletion extent and phenotype severity. Large cohorts of NF2-SCHW patients are needed to identify more accurate scores, becoming useful tools for patient management.

A New Definition for Multisystem Inflammatory Syndrome in Children.

In Spring 2020, public health agencies worldwide rapidly issued alerts about a rare, hyperinflammatory illness in children, presumed to be a post-infectious immune response to COVID-19, using somewhat different diagnostic criteria and nomenclature. In the US, the Centers for Disease Control and Disease Prevention (CDC) termed it the Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19.

Updates of Prostate Cancer from the 2022 World Health Organization Classification of the Urinary and Male Genital Tumors.

Prostate cancer is a heterogeneous disease with a wide spectrum of pathological, clinical, and molecular features. The diagnosis and classification of prostate cancer have been constantly modified with the incorporation of new data. The 5th edition of the World Health Organization (WHO) Classification of Urinary and Genital Tumors was recently published six years after the 4th edition. In this new edition, the classification of prostate cancer has been refined in the diagnostic criteria, grading, nomenclature, and genomics. This paper reviews significant updates to the new WHO classification of prostate cancer, including high-grade prostatic intraepithelial neoplasia, acinar adenocarcinoma, intraductal carcinoma, ductal carcinoma, and neuroendocrine tumors. Controversial issues in the Gleason grading are discussed, such as intraductal carcinoma and tertiary grade. We also highlight distinct genetic and epigenetic alterations in prostate cancer that may contribute to its diverse clinicopathologic features. Overall, the 5th edition of the WHO classification provides a comprehensive assessment of prostate cancer with morphologic, immunohistochemical, genomic, and clinical data, which may represent an optimal paradigm for diagnosing and treating prostate cancer.

The current understanding of germline predisposition in non-syndromic sagittal craniosynostosis: a systematic review.

The objective of this literature review was to provide a comprehensive and up-to-date overview of the current understanding of the genetic etiology for non-syndromic sagittal craniosynostosis. Using the PubMed database and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we systematically reviewed relevant records on germline genetics in children with non-syndromic sagittal craniosynostosis. Two hundred two records were identified, of which 25 were included following title and abstract screening and subsequent full-text review. The 25 records in combination included 829 children with non-syndromic sagittal craniosynostosis. A likely pathogenic or pathogenic germline variant was reported for 9.8% of the 827 patients for whom germline genetic testing was performed. The reported variants were distributed across 50 different genes, with more than one variant detected in 13 genes. Based on the existing literature, genetic predisposition is likely to play a role in at least 9% of children with non-syndromic sagittal craniosynostosis. Future studies will benefit from international consensus in terms of diagnostic nomenclature and a higher level of standardization across study methodologies and bioinformatic approaches.

Clinicopathologic parameters and outcomes of mucinous neoplasms confined to the appendix: a benign entity with excellent prognosis

AbstractAppendiceal mucinous neoplasms (AMNs), characterized by expansile or “pushing” growth of neoplastic epithelium through the appendix wall, are sometimes accompanied by peritoneal involvement, the extent and grade of which largely determine clinical presentation and long-term outcomes. However, the prognosis of tumors entirely confined to the appendix is still debated and confusion remains regarding their biologic behavior and, consequently, their clinical management and even diagnostic nomenclature. We evaluated AMNs limited to the appendix from 337 patients (median age: 58 years, interquartile range (IQR): 47–67), 194 (57.6%) of whom were women and 143 (42.4%) men. The most common clinical indication for surgery was mass or mucocele, in 163 (48.4%) cases. Most cases (N = 322, 95.5%) comprised low-grade epithelium, but there were also 15 (4.5%) cases with high-grade dysplasia. Lymph nodes had been harvested in 102 (30.3%) cases with a median 6.5 lymph nodes (IQR: 2–14) per specimen for a total of 910 lymph nodes examined, all of which were negative for metastatic disease. Histologic slide review in 279 cases revealed 77 (27.6%) tumors extending to the mucosa, 101 (36.2%) to submucosa, 33 (11.8%) to muscularis propria, and 68 (24.4%) to subserosal tissues. In multivariate analysis, deeper tumor extension was associated with older age (p = 0.032; odds ratio (OR): 1.02, 95% confidence intervals (CI): 1.00–1.03), indication of mass/mucocele (p < 0.001; OR: 2.09, CI: 1.41–3.11), and wider appendiceal diameter, grossly (p < 0.001; OR: 1.61, CI: 1.28–2.02). Importantly, among 194 cases with at least 6 months of follow-up (median: 56.1 months, IQR: 24.4–98.5), including 9 high-grade, there was no disease recurrence/progression, peritoneal involvement (pseudomyxoma peritonei), or disease-specific mortality. These data reinforce the conclusion that AMNs confined to the appendix are characterized by benign biologic behavior and excellent clinical prognosis and accordingly suggest that revisions to their nomenclature and staging would be appropriate, including reverting to the diagnostic term mucinous adenoma in order to accurately describe a subset of them.

Disordered gambling in a longitudinal birth cohort: from childhood precursors to adult life outcomes.

Despite its introduction into the diagnostic nomenclature over four decades ago, there remain large knowledge gaps about disordered gambling. The primary aims of the present study were to document the long-term course, childhood precursors, and adult life outcomes associated with disordered gambling. Participants enrolled in the population-representative Dunedin Study were prospectively followed from birth through age 45. Disordered gambling was assessed six times from age 18; composite measures of childhood social class, general intelligence, and low self-control were based on assessments obtained from birth through age 15; adult socioeconomic, financial, and legal outcomes were obtained through age 45. Lifetime disordered gambling was predicted from the three childhood precursors and the adult outcomes were predicted from lifetime disordered gambling. Past-year disordered gambling usually occurred at only a single time point and recurrence was relatively uncommon. Lower childhood social class, general intelligence, and self-control significantly predicted lifetime disordered gambling in adulthood. In turn, lifetime disordered gambling in adulthood significantly predicted occupational, educational, and financial problems in adulthood (ds = 0.23-0.41). These associations were markedly reduced and sometimes rendered nonsignificant after adjusting for childhood precursors (ds = 0.04-0.32). Socioeconomic, financial, and legal outcomes in adulthood are not merely consequences of disordered gambling, but also are predicted from childhood precursors. Deflecting the trajectories of young people at risk for developing disordered gambling may help to ameliorate not just the development of later disordered gambling, but also other associated adverse outcomes.

A revision to the United States national ALS registry’s algorithm to improve Case-Ascertainment

Objective To evaluate the impact of 1) updating the existing algorithm to improve case-finding sensitivity and 2) reclassifying the Registry’s diagnostic status nomenclature into four new categories (“confirmed ALS,” “likely ALS,” “undetermined ALS,” or “not ALS”) versus the current three (“definite ALS,” “possible ALS,” or “not ALS”) to be more inclusive and descriptive of cases and individuals. Methods A retrospective analysis of Registry data from 2011–2017 was conducted to follow “possible ALS” individuals over time to determine what qualifier caused them to convert, if at all and when, to Registry-eligible cases (i.e. “confirmed ALS” or “likely ALS”). Results In 2011, 720 individuals were classified by the Registry algorithm as having “possible ALS”. By 2017, 42% of these had converted to Registry-eligible ALS cases. Approximately 14% of those who were identified solely based on an ALS prescription drug never converted to Registry-eligible cases. This analysis indicates that “possible ALS” individuals with a single prescription for an ALS drug should be converted to Registry-eligible cases which would add between 300–500 cases per year on average. Conclusions The Registry’s existing algorithm likely results in the under-ascertainment of ALS cases. However, updating the algorithm with the inclusion of patients having been prescribed ALS-specific drugs, even with a single prescription, leads to improved epidemiologic estimates of ALS in the US. This and future algorithmic updates will help the Registry more accurately depict the true disease burden of ALS in the US.

Managing post traumatic stress disorder with homoeopathy: A case report

The reporting of Post-Traumatic Stress Disorder (PTSD) cases is less as the diagnosis is usually missed and considered under other diagnostic nomenclatures like depression, anxiety than actual PTSD, unless carefully interrogated. Such cases should be dealt with utmost care and with homoeopathy being the most gentle and rapid healing art, effective cures can be done. The present case was initially taken up as a case of depression, but after counselling and vigorous interrogation with the patient in successive follow-ups, it was diagnosed as a PTSD case. This highlights the importance of history taking and building a rapport with the patient. It is one-of-a-kind case where the patient’s entire personality was altered after the trauma and homoeopathy helped her in retrieving her self-confidence and improving interpersonal and social relationships. The following case report presents a case of 32 years old female suffering from gradual weight loss and general weakness from the past 1 year. On detailed case history, it was found that the cause of her presenting complaints and disinterest in the husband and family was due to the past event of trauma which she suffered 4 years ago, before marriage. Following homoeopathic psycho-somatic disease treatment approach (HPDTA) along with supportive psychotherapy, the below mentioned case of PTSD was retrieved to health completely. Individualized homoeopathic medicine Sepia officinalis was prescribed based on the totality of symptoms and reportorial analysis. The clinical outcome was assessed by Hamilton depression rating scale (HDRS) and PTSD Scale-Self Report for DSM-5 (PSS-SR5). The case is a perfect demonstration of the usefulness of homoeopathy in cases predominantly presenting with symptoms of mind and disposition, even years after the actual event of trauma.

Human herpesvirus 8-negative effusion-based large B-cell lymphoma: a distinct entity with unique clinicopathologic characteristics

AbstractRare cases of human herpesvirus 8 (HHV8)-negative effusion-based large B-cell lymphoma (EB-LBCL) occur in body cavities without antecedent or concurrent solid mass formation. In contrast to HHV8 + primary effusion lymphoma (PEL), EB-LBCL has no known association with HIV or HHV8 infection. However, the small sample sizes of case reports and series worldwide, especially from non-Japanese regions, have precluded diagnostic uniformity. Therefore, we conducted a retrospective, multi-institutional study of 55 cases of EB-LBCL and performed a comprehensive review of an additional 147 cases from the literature to identify distinct clinicopathologic characteristics. In our study, EB-LBCL primarily affected elderly (median age 80 years), immunocompetent patients and manifested as lymphomatous effusion without a solid component. The lymphomatous effusions mostly occurred in the pleural cavity (40/55, 73%), followed by the pericardial cavity (17/55, 31%). EB-LBCL expressed CD20 (53/54, 98%) and PAX5 (23/23, 100%). Most cases (30/36, 83%) were of non-germinal center B-cell subtype per the Hans algorithm. HHV8 infection was absent (0/55, 0%), while Epstein-Barr virus was detected in 6% (3/47). Clinically, some patients were managed with drainage alone (15/34, 44%), while others received rituximab alone (4/34, 12%) or chemotherapy (15/34, 44%). Eventually, 56% (22/39) died with a median overall survival (OS) of 14.9 months. Our findings were similar to those from the literature; however, compared to the non-Japanese cases, the Japanese cases had a significantly higher incidence of pericardial involvement, a higher rate of chemotherapy administration, and longer median OS. Particularly, we have found that Japanese residence, presence of pericardial effusion, and absence of MYC rearrangement are all favorable prognostic factors. Our data suggest that EB-LBCL portends a worse prognosis than previously reported, although select patients may be managed conservatively. Overall, EB-LBCL has distinct clinicopathologic characteristics, necessitating the establishment of separate diagnostic criteria and consensus nomenclature.

Proceedings of the 2022 National Toxicology Program Satellite Symposium.

The 2022 annual National Toxicology Program Satellite Symposium, entitled "Pathology Potpourri," was held in Austin, Texas at the Society of Toxicologic Pathology's 40th annual meeting during a half-day session on Sunday, June 19. The goal of this symposium was to present and discuss challenging diagnostic pathology and/or nomenclature issues. This article presents summaries of the speakers' talks along with select images that were used by the audience for voting and discussion. Various lesions and topics covered during the symposium included induced and spontaneous neoplastic and nonneoplastic lesions in the mouse lung, spontaneous lesions in the reproductive tract of a female cynomolgus macaque, induced vascular lesions in a mouse asthma model and interesting case studies in a rhesus macaque, dog and genetically engineered mouse model.