Histological Pattern Research Articles

Updated Review of Cellular Dermatofibroma: Benign or Not?

Cellular dermatofibromas (CDFs) are uncommon benign fibrous histiocytomas with histologic patterns resembling malignancies. Despite their benign nature, CDFs can recur and metastasize. Physicians are uncertain about the management of CDF, given its resemblance to dermatofibrosarcoma protuberans. This review aims to review CDF's clinical and histologic features, differentiate it from similar presenting malignancies, and discuss treatments and outcomes for better clinical management. In April 2024, a PubMed and Google Scholar search was completed using "cellular dermatofibroma" through the University of California Davis Medical School's library databases. The search included meta-analyses, randomized controlled trials, observational studies, reviews, and case studies published within the past 70 years. References from retrieved articles were utilized as additional resources. Clinical signs of CDF include firm, skin-colored to hyperpigmented lesions usually larger than 2 cm, typically on extremities. Currently, there are no definitive indicators for CDF recurrence or metastasis. Diagnosis requires microscopic and histopathologic examination, with surgical excision as the preferred treatment. Recurrence is not uncommon, while metastasis is rare. CDFs often develop in young/middle-aged adults with a tendency to recur and in rare cases can metastasize. Future studies could explore lesion characteristics that are associated with potential for recurrence and metastasis.

WCN25-3106 Histological Pattern and associated factors of Glomerular Disease in Sylhet M A G Osmani Medical College Hospital, Bangladesh

WCN25-3106 Histological Pattern and associated factors of Glomerular Disease in Sylhet M A G Osmani Medical College Hospital, Bangladesh

Experimental model of non-alcoholic fatty liver disease in pregnant rats to evaluate the effectiveness of therapy

Background: The growing incidence of non-alcoholic fatty liver disease in the population contributes to the development of obstetric complications during pregnancy and demands searching effective methods of hepatoprotective therapy. Aim: The aim of this study was to evaluate the efficacy of therapy for non-alcoholic fatty liver disease in an experimental model in pregnant rats. Materials and methods: this experimental study was carried out on 19 female Wistar rats weighing 250–300 g, obtained from the laboratory animal nursery of SMK Stezar Ltd. (Vladimir, Russia). Using a high-fat diet, non-alcoholic fatty liver disease was simulated in the study groups as follows. Group 1 (n = 7) consisted of non-pregnant rats, group 2 comprised pregnant rats without therapy (n = 6), and group 3 included pregnant rats and intraperitoneal administration of 12 mg of the low-molecular sugar preparation from day 16 to day 20 of gestation (n = 6). During the experiment, the body weight of female rats was measured weekly. After the experiment was completed, we evaluated the blood serum levels of aspartate aminotransferase, alanine aminotransferase, ferritin, triglycerides, total cholesterol, total bilirubin, urea, total alkaline phosphatase, bile acids, glucose, C-reactive protein, cholinesterase, and malondialdehyde, as well as catalase activity. Histological examination of the rat liver was carried out using the standard method with hematoxylin and eosin staining. Results: This study showed that high-fat diet caused oxidative stress manifested by decreased the blood catalase level and increased malonovodialdehyde in both pregnant and non-pregnant females; the blood bile acids level also increased. In pregnant rats with non-alcoholic fatty liver disease, the serum C-reactive protein and total alkaline phosphatase levels increased, the cholinesterase level decreased, and the catalase activity decreased even more. In the study group using the low-molecular sugar preparation, biochemical parameters in non-alcoholic fatty liver disease improved, probably due to the effect on lipogenesis and oxidative stress in the liver. The histological pattern was characterized by the impaired structural characteristics of hepatocytes and the circulatory bed. With the use of the low-molecular-weight sugar preparation, we noted a tendency to restore the structure of the hepatic beam area and a decrease in the manifestations of steatosis. Conclusions: The use of the low-molecular-weight sugar preparation in the treatment of non-alcoholic fatty liver disease improves biochemical blood parameters and tends to restore the histological structure of the liver.

Expression Patterns of DLL3 Across Neuroendocrine and Non-Neuroendocrine Neoplasms Reveal Broad Opportunities for Therapeutic Targeting.

Neuroendocrine neoplasms (NENs) encompass a diverse set of malignancies with limited precision therapy options. Recently, therapies targeting DLL3 have shown clinical efficacy in aggressive NENs, including small cell lung cancers and neuroendocrine prostate cancers. Given the continued development and expansion of DLL3-targeted therapies, we sought to characterize the expression of DLL3 and identify its clinical and molecular correlates across diverse neuroendocrine and non-neuroendocrine cancers. Here, we interrogated paired DNA and RNA-sequencing from 1,589 NENs across 29 sites, as well as 203,252 tumors across 47 cancer types. We found that high transcriptomic levels of DLL3 correlated with more aggressive histologic and mutational patterns in NENs, with adverse survival outcomes being reflected in NENs originating from the lung, pancreas, stomach, and small bowel. The heterogeneity in DLL3 expression across NENs was largely explained by site of origin, with lung, prostate, and bladder NENs exhibiting relatively high levels of DLL3 whereas gastroenteropancreatic (GEP) NENs displayed relatively low expression levels. Although the therapeutic targeting of DLL3 may be less applicable for GEP-NENs, we did find an upregulation of alternative targets such as SEZ6, CELSR3, and SSTR2 in these settings. Lastly, expanding our investigation into non-neuroendocrine cancers, we detected an enrichment of DLL3 in both low-grade and high-grade gliomas, Merkel cell carcinomas, medulloblastomas, and melanomas, with such enrichment being associated with prolonged overall survival in gliomas, but worse overall survival in melanomas. Altogether, we demonstrate that DLL3 represents an attractive target for subsets of neuroendocrine and non-neuroendocrine cancers and uncover opportunities for future therapeutic strategies.

Pattern of abnormal uterine bleeding in a tertiary care hospital

Background: Abnormal uterine bleeding (AUB) is a significant clinical entity. Aim of the study was to observe the pattern of AUB in tertiary care hospital. Methods: All patients attending gynae OPD and ward presenting with AUB were included in the study. Results: A total 640 women had AUB in one year of study period. Highest incidence of AUB is observed in the age group 40-49 years. The most common clinical presentation of AUB was metrorrhagia followed by polymenorrhoea, menorrhagia, menometrorrhagia, oligomenorrhoea and hypomenorrhoea. On ultrasonography the commonest finding was leiomyoma uterus (28.15%) followed by increased endometrial thickness (18.46%). The most common histological pattern was proliferative endometrium (34.10%). According to PALM-COEIN classification the maximum incidence found was of AUB-L followed by AUB-O. Conclusions: The prevalent causes of AUB vary with age. So, all the patients presenting with AUB to gynaecology departments were included in the study irrespective of age. The information presented in this study adds to our understanding of patterns of the AUB.

Aspergillosis in 41 wild bird species in the eastern United States: a 22-year retrospective review.

Aspergillosis is the most commonly and widely reported fungal infection in birds. Disease development is often secondary to stressors that cause immunocompromise, and it is typically regarded as a disease of captivity. We retrospectively evaluated data from 133 birds diagnosed with aspergillosis at the Southeastern Cooperative Wildlife Disease Study from 2001-2023 to assess diversity and relative frequency across avian taxa, gross and histologic lesion patterns, and comorbidities. Of 10 taxonomic orders represented, Charadriiformes (shorebirds; n = 35) and Accipitriformes (raptors; n = 32) were most common. Among them, the laughing gull (Leucophaeus atricilla; n = 20) and bald eagle (Haliaeetus leucocephalus; n = 14) were infected most commonly. Gross lesions were most frequent in lung (n = 80), air sac (n = 71), or celomic cavity lining (n = 42). Four distinct gross lesion patterns were identified: 1) tan caseous plaques (n = 106), 2) hollow masses lined with mold (n = 26), 3) red pulmonary nodules (n = 15), and 4) necrotic brown plaques (n = 3). Histologically, fungal hyphae were most common in lung (n = 107) and air sac (n = 49). Comorbidities were diagnosed in 67 birds with a spectrum of viral (n = 19), bacterial (n = 11), parasitic (n = 6), other fungal (n = 4), and non-infectious (n = 50) causes. Six birds each were diagnosed with highly pathogenic avian influenza or salmonellosis. Twenty-two birds were emaciated. Free-ranging birds are susceptible to myriad stressors that can predispose them to the development of aspergillosis.

Histological pattern of non-infectious thoracic aortitis impacts mortality.

Non-infectious aortitis encompasses various histological patterns, but their specific cardiovascular outcomes remain unclear. To evaluate the mortality associated with non-infectious surgical thoracic aortitis. This retrospective multicenter study included patients who underwent thoracic aortic surgery and had histological evidence of aortitis. The study analyzed the characteristics of patients with non-infectious aortitis presenting either a granulomatous/giant cell histological pattern or a lymphoplasmacytic pattern. Factors associated with mortality were identified using multivariate analysis. Among 5666 patients who underwent thoracic aortic surgery, 197 were found to have non-infectious aortitis with either a granulomatous/giant cell histological pattern (n=138) or a lymphoplasmacytic pattern (n=59). The overall standardized mortality rate (SMR) for patients with non-infectious surgical thoracic aortitis was 1.61 (95% CI: 1.05; 2.39), with 31.5% of patients dying within 10 years of the initial procedure. After a median follow-up of 3.5 years [IQR: 0.5-6.8] post-surgery, 31% of deaths were due to aortic dissection or rupture. The 10-year cumulative incidence of death was 40.1% (95% CI, 17.7-61.8) for patients with a granulomatous/giant cell pattern and 14.4% (95% CI, 2.6-35.6) for those with a lymphoplasmacytic pattern. Granulomatous/giant cell histological pattern (HR 4.71 [vs lymphoplasmacytic pattern]; 95% CI, 1.37-16.2; p=0.023) and aortic dissection at diagnosis (HR 6.07 [vs aneurysm]; 95% CI, 2.89-12.7; p<0.0001) were independently associated with increased mortality. This multicenter study found that 31.5% of patients with non-infectious surgical thoracic aortitis are expected to die within 10 years of their initial surgery. The granulomatous/giant cell histological pattern is associated with higher mortality.

Gastrointestinal Disease in Common Variable Immunodeficiency Disorder (CVID): Histological Patterns, Diagnostic Clues and Pitfalls for the Pathologist and Gastroenterologist.

Background/Objectives: Gastrointestinal diseases are a major cause of morbidity in common variable immunodeficiency disorder (CVID), clinically often mimicking other conditions including celiac disease and inflammatory bowel disease (IBD). Hence, diagnosis of CVID remains challenging. This study aims to raise awareness and highlight histopathological clues for CVID in intestinal biopsies, emphasizing diagnostic pitfalls for the pathologist/gastroenterologist. Methods: We reviewed 63 (18 duodenal, 23 ileal, 22 colonic) biopsies and case histories from seven CVID patients, obtained over a 31-year period, with attention to active inflammation, intraepithelial lymphocytes, plasma cells, lymphoid hyperplasia, crypt/villous architecture, subepithelial collagen, apoptosis, granulomas, and infections. Clinical information of 41 pathology requests was reviewed. Results: Gastrointestinal symptoms were variable. Histological features included IBD-like (3/7), celiac disease-like (2/7), graft-versus-host disease (GVHD)-like (2/7), lymphocytic sprue/colitis-like (3/7), collagenous colitis-like (2/7), and acute colitis-like (4/7) patterns, often overlapping (2/7) and/or changing over time (3/7). Lymphoid hyperplasia was seen in 3/7 patients; 1/7 had giardiasis; and 5/7 had few plasma cells, usually only in part of the gut (3/5). Clinical information of 12/41 (29%) pathology requests mentioned known/suspected CVID, despite being known in 33/41 (80%). Conclusions: Clinical/histological features of CVID in the gut are diverse, often mimicking IBD, microscopic colitis, celiac disease and/or GVHD, hence the importance of adequate clinical information. Some histological features are atypical of these established entities and may indicate CVID, as may overlapping/changing histological patterns and/or few plasma cells in part of the gut. Awareness of the heterogenous clinical presentation and histopathological indicators of CVID may improve diagnosis.

Clinical, Pathologic, and Molecular spectrum of Angioinmmunoblastic T-cell Lymphoma Cutaneous Lesions: Clinical, Pathologic, and Molecular Analysis.

Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive malignancy that frequently presents with extranodal involvement. Cutaneous tropism is clinically and histopathologically variable, which may pose a diagnostic challenge. We conducted a retrospective analysis of 40 samples of 20 cases of cutaneous AITL, focusing on the clinicopathologic and molecular correlations between skin and lymph node (LN) samples. In all cases, cutaneous involvement was concurrent with or followed the diagnosis of nodal AITL, with no cases preceding systemic involvement. Clinically, cutaneous AITL presented in 2 main forms: an evanescent rash and persistent lesions, with histopathology revealing diverse infiltration patterns, including perivascular, nodular, granulomatous, panniculitic, vasculitis, and epidermotropic. Clinical presentation and histologic patterns tend to correlate. Histopathologically, plasma cells were present in 15/22 skin samples, 5 of them being kappa-light restricted but polytypic in corresponding LNs. Epstein-Barr virus+ B cells were present in 10 cutaneous lesions and were already present in corresponding LNs. Molecular studies found correlations in all but one case between LN and skin, particularly in the presence of RHOA and TET2 mutations, which were identified in 8 of 12 cases. Molecular analysis was also informative in 4 cases with low levels of infiltration. The study also highlighted unique cases with distinct clinical and histopathologic patterns coexisting in the same patient over time. One case exhibited simultaneous granulomatous and epidermotropic patterns in different skin lesions. Four cases of cutaneous B-cell lymphomas associated with AITL were identified. Our study underscores the importance of integrating clinical, histopathologic, and molecular data to accurately diagnose cutaneous AITL.

Deep learning for predicting prognostic consensus molecular subtypes in cervical cancer from histology images

Cervical cancer remains the fourth most common cancer among women worldwide. This study proposes an end-to-end deep learning framework to predict consensus molecular subtypes (CMS) in HPV-positive cervical squamous cell carcinoma (CSCC) from H&E-stained histology slides. Analysing three CSCC cohorts (n = 545), we show our Digital-CMS scores significantly stratify patients by both disease-specific (TCGA p = 0.0022, Oslo p = 0.0495) and disease-free (TCGA p = 0.0495, Oslo p = 0.0282) survival. In addition, our extensive tumour microenvironment analysis reveals differences between the two CMS subtypes, with CMS-C1 tumours exhibit increased lymphocyte presence, while CMS-C2 tumours show high nuclear pleomorphism, elevated neutrophil-to-lymphocyte ratio, and higher malignancy, correlating with poor prognosis. This study introduces a potentially clinically advantageous Digital-CMS score derived from digitised WSIs of routine H&E-stained tissue sections, offers new insights into TME differences impacting patient prognosis and potential therapeutic targets, and identifies histological patterns serving as potential surrogate markers of the CMS subtypes for clinical application.

Exploring the debates surrounding keratoameloblastoma: An in-depth review of an emerging entity.

Ameloblastoma is a benign odontogenic epithelial tumor characterized by its aggressive behavior and a high likelihood of local recurrence if not fully excised. Ameloblastomas are a common type of slow-growing, true jaw tumor which may present as solid, multicystic or unicystic forms and originate from odontogenic epithelium and exhibit a variety of histological patterns. Keratoameloblastoma is considered to be a rare variant of ameloblastoma associated with more intense keratinization. Therefore, in this present review, authors report a case of keratoameloblastoma in a 14-year-old male and review giving a sneak-peek into this lesion with insight into the literature concerning its presentation, incidence, aetiology, clinical features, radiological appearance, histopathological findings and treatment options along with the current literature about this lesion.

Epidemiology and clinicopathological features of soft tissue tumors in adolescents: a cross-sectional study

BackgroundSoft tissue tumors (STTs) in adolescents are relatively rare, and their characteristics and behavior have not been well studied in this age group. The aim of this study was to describe the clinicopathologic patterns of STTs in adolescents aged 10–19 years according to the 2020 WHO classification.MethodA 10-year retrospective cross-sectional study of 632 surgical samples from adolescents was conducted at a tertiary health facility to determine the frequency, histological patterns and characteristics of STTs in this population. The data were analyzed via SPSS 23.ResultsSTTs accounted for 12.5% of all histologically diagnosed lesions in adolescents, with a mean age of 15 ± 2.9 years, 54.4% occurring in females and 35.4% in middle adolescents. The majority (64.56%) of STTs were benign, while malignant and intermediate-grade neoplasms accounted for 25.32% and 10.13%, respectively. Vascular tumours were the most common, followed by adipocytic and fibroblastic/myofibroblastic tumours, with hemangiomas being the most common. The most prevalent symptom was a painless mass (82.3%), with the head and neck (25.3%) being the most commonly involved body site. Most of the STTs patients presented within the first two years of occurrence (36.7%, n = 29/79). However, age, age group and sex were not significantly associated with the WHO grades of these STTs.ConclusionThis study provided valuable insights into the characteristics and behavior of STTs in adolescents, highlighting the importance of early diagnosis and management. These findings suggest that adolescent STTs affect females more than males , involve the head and neck more and are more benign, with vascular tumours being the most common type of STT in this age group.

Adult Wilms Tumor With Inferior Vena Cava Thrombus on an Incomplete Duplex Collecting System Ureter Fissus Proximalis Managed at a Tertiary Hospital in Tanzania: A Case Report and Literature Review.

Wilms' tumor (WT), also known as nephroblastoma, is a malignant embryonal kidney tumor composed of embryonic cells and is the most prevalent tumor among children, but isolated cases occur infrequently in the adult population. Adult WT is defined according to the criteria of Kilton, Matthews, and Cohen, which comprise age above 15 years and histological patterns characteristic of WT. We report a case of an adult WT with venous thrombus on an incomplete duplex collecting system. To the best of our knowledge, this is the first case of adult WT with such a presentation. A 28-year-old female patient presented to our department with a 4-month history of right flank pain and flank mass and was diagnosed by abdominal contrasted CT to have a right renal tumor with tumor thrombi in the renal vein and the inferior vena cava. The CT scan also revealed a bilateral duplex collecting system with a partial (ureter fissus proximalis) on the tumor side and a complete duplex system on the contralateral side. Right radical nephrectomy with complete tumor thrombectomy via venacavotomy was performed successfully. Histopathological examination of the specimen revealed a triphasic nephroblastoma with immunohistochemistry confirmation. Postoperatively, adjuvant chemotherapy was initiated. The increasing incidence of non-syndromic WT cases associated with duplex collecting systems suggests a potential shared pathogenesis, necessitating further research.

Deep learning uncovers histological patterns of YAP1/TEAD activity related to disease aggressiveness in cancer patients.

Over the last decade, Hippo signaling has emerged as a major tumor-suppressing pathway. Its dysregulation is associated with abnormal expression of YAP1 and TEAD-family genes. Recent works have highlighted the role of YAP1/TEAD activity in several cancers and its potential therapeutic implications. Therefore, identifying patients with a dysregulated Hippo pathway is key to enhancing treatment impact. Although recent studies have derived RNA-seq-based signatures, there remains a need for a reproducible and cost-effective method to measure the pathway activation. In recent years, deep learning applied to histology slides have emerged as an effective way to predict molecular information from a data modality available in clinical routine. Here, we trained models to predict YAP1/TEAD activity from H&E-stained histology slides in multiple cancers. The robustness of our approach was assessed in seven independent validation cohorts. Finally, we showed that histological markers of disease aggressiveness were associated with dysfunctional Hippo signaling.

&lt;b&gt;Clinical insights on paratuberculosis in Arabian camels (&lt;i&gt;Camelus dromedarius&lt;/i&gt;): A review&lt;/b&gt;

Paratuberculosis (PTB) is a long-standing granulomatous infectious disease of both domesticated and wild ruminants. It is caused by Mycobacterium avium subsp. paratuberculosis (MAP). This review emphasizes the clinical, hematobiochemical, sonographic and pathologic findings as well as therapeutic and control measures in dromedary camels infected with PTB. The clinical signs include intermittent and/or chronic diarrhea, decreased milk yield, emaciation, submandibular edema, dehydration, irregular and weak rumen contractions and abdominal pain. Hematological changes include leukocytosis, neutrophilia and decreased erythrocytes, hematocrit percent and hemoglobin concentration. Biochemical alterations included hypoalbuminemia, hypoproteinemia, hyperglobulinemia, hypomagnesemia, hypoglycemia and increased alanine aminotransferase and aspartate aminotransferase activity and increased concentration of magnesium and calcium. Sonographically, the intestinal wall is either mildly, moderately or severely thickened along with mesenteric lymph nodes (LN) enlargement. The LN capsule is either anechoic or echoic and the contents are either echogenic, anechoic or heterogenous. Other sonographic findings include bright hepatic parenchyma, aggregation of echogenic materials separated with fluids among the intestines and pleural and pericardial effusions. The typical pathological lesions are corrugation of the small intestinal mucosa especially that of the ileum, and the colonic mucosa are folded. Mesenteric and ileocecal LNs are edematous, congested and granular. Other necropsy findings include fatty liver, and peritoneal, pericardial and pleural effusions. Histologically, proliferative enteritis and lepromatous granulomas are detected. Clusters of acid-fast bacilli are usually found in the intestinal mucosa and lamina propria. Accurate diagnosis of PTB depends on culture and identification of the causative organism MAP from tissue or feces. Herd screening is also performed through complement fixation, agar gel immunodiffusion, competitive enzyme linked immunosorbent assay, Ziehl-Neelsen staining of tissue or feces, histologic pattern of a granulomatous reaction, DNA probes and polymerase chain reaction. A trial for treatment of PTB in dromedary camels was carried out through IM injection of rifampin and streptomycin for 10 weeks. The diarrhea resolved within one week of treatment, and MAP disappeared from rectal scraping 5-9 weeks after treatment. In conclusion, early detection and eradication procedures of PTB should be more implemented for the control and prevention PTB in dromedary camels. More research should be directed towards vaccination program in those species.

Pathological Features and Differential Efficacy of Cisplatin-Based Adjuvant Chemotherapy in Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations

We aimed to elucidate the efficacy of conventional cisplatin-based adjuvant chemotherapy for patients with lung cancers harboring epidermal growth factor receptor (EGFR) mutation. This retrospective cohort study included 110 patients (EGFR mutation group: n = 51; EGFR wild-type group: n = 59) receiving cisplatin-based adjuvant chemotherapy following complete resection of non-small-cell non-squamous-cell lung cancer (2010-2021). Clinicopathological characteristics, recurrence-free survival (RFS), and overall survival (OS) were investigated. The pStage distribution was not statistically different. The EGFR mutation group was characterized by more advanced pN, papillary predominance, and presence of micropapillary components, whereas the EGFR wild-type group exhibited more advanced pT and solid predominant patterns. The median RFS was significantly worse in the EGFR mutation group (23.0 vs. 76.1 months, p = 0.017). Nevertheless, the median OS was not significantly different (85.6 months vs. not reached, p = 0.151). Multivariable analysis demonstrated that EGFR mutation and lymphatic invasion were significant risk factors in RFS; however, no independent factors were identified in OS. Cisplatin-based adjuvant chemotherapy might be less effective in patients with EGFR-mutated lung cancer. The style of progression and histological pattern related with EGFR mutation may be associated with the efficacy of adjuvant chemotherapy and poor RFS.

Glioma Image-Level and Slide-Level Gene Predictor (GLISP) for Molecular Diagnosis and Predicting Genetic Events of Adult Diffuse Glioma.

The latest World Health Organization (WHO) classification of central nervous system tumors (WHO2021/5th) has incorporated molecular information into the diagnosis of each brain tumor type including diffuse glioma. Therefore, an artificial intelligence (AI) framework for learning histological patterns and predicting important genetic events would be useful for future studies and applications. Using the concept of multiple-instance learning, we developed an AI framework named GLioma Image-level and Slide-level gene Predictor (GLISP) to predict nine genetic abnormalities in hematoxylin and eosin sections: IDH1/2, ATRX, TP53 mutations, TERT promoter mutations, CDKN2A/B homozygous deletion (CHD), EGFR amplification (EGFRamp), 7 gain/10 loss (7+/10-), 1p/19q co-deletion, and MGMT promoter methylation. GLISP consists of a pair of patch-level GLISP-P and patient-level GLISP-W models, each pair of which is for a genetic prediction task, providing flexibility in clinical utility. In this study, the Cancer Genome Atlas whole-slide images (WSIs) were used to train the model. A total of 108 WSIs from the Tokyo Women's Medical University were used as the external dataset. In cross-validation, GLISP yielded patch-level/case-level predictions with top performances in IDH1/2 and 1p/19q co-deletion with average areas under the curve (AUCs) of receiver operating characteristics of 0.75/0.79 and 0.73/0.80, respectively. In external validation, the patch-level/case-level AUCs of IDH1/2 and 1p/19q co-deletion detection were 0.76/0.83 and 0.78/0.88, respectively. The accuracy in diagnosing IDH-mutant astrocytoma, oligodendroglioma, and IDH-wild-type glioblastoma was 0.66, surpassing the human pathologist average of 0.62 (0.54-0.67). In conclusion, GLISP is a two-stage AI framework for histology-based prediction of genetic events in adult gliomas, which is helpful in providing essential information for WHO 2021 molecular diagnoses.

Proteomic profiling of kidney biopsies in nephrotic syndrome

Background Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are patterns of kidney injury observed in the filtering units of the kidney known as glomeruli. These histological patterns are seen in kidney biopsies from individuals with idiopathic nephrotic syndrome (iNS), which occurs in both children and adults. However, there is some indication that MCD and FSGS are within the same phenotypic spectrum. Methods From the NURTuRE cohort of individuals with NS, we performed laser microdissection and mass spectrometry analysis of kidney biopsy samples to identify proteomic patterns of disease. 56 individuals with iNS segregated by histological pattern (37 MCD and 19 FSGS) across three age groups: early childhood (0–6 years), late childhood (6–18 years) and adult (&gt;18 years). Results We found no distinct clustering of proteomic profiles between MCD and FSGS, but identified global differences in glomerular cell and extracellular matrix composition related to both histological pattern and age. The proteomic data are available via ProteomeXchange with identifier PXD053362. Conclusions The lack of distinct clustering between MCD and FSGS in our study suggests shared biological processes between these injury patterns of iNS, supporting the hypothesis that they are part of the same disease spectrum. The global differences observed in glomerular cell and extracellular matrix composition suggest involvement of diverse biogeological processes as different patterns of iNS manifests in different age groups. This study also demonstrates the feasibility of pooling bioresources, central processing of heterogeneous tissue samples, and developing laser-microdissection and proteomic analysis methodology.

Clinical and laboratory characteristics of paediatric systemic lupus erythematosus at secondary level hospital among local population in North East India

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammation and the presence of circulating auto antibodies directed against self-antigens with flare-ups and remissions. Childhood-onset SLE (cSLE) is a rare disease with an incidence of 0.3-0.9 per 100.000 children-years. The study among paediatric population of north east India were few and hence this study from north east India was undertaken. Objective of this study was to study the clinical and immunological profile of children with systemic lupus erythematosus (SLE). To study the distribution of Renal Lesions according to ISN/RPS Classification of Lupus Nephritis. Methods: Retrospective observational single centre study at secondary care hospital in North East India. Medical records of children with SLE admitted in Paediatric department from the period of 2018-2024 through the hospital information management were analysed. Clinico pathological features and immunological profile were compared with other studies. Results: Among 20 patients studied female to male ratio was 3:1. The mean patient’s age at the time of presentation was 12.4 years. The mean duration of illness was 8.5 months. Most common systems involved were hematological (85%), followed by kidney (75%) and mucocutaneous (75%). All (100%) cases were ANA positive. 45% were anti smith antibody positive, 20% were anti- dsDNA positive. Focal and segmental proliferative glomerulonephritis (ISN/RPS class III) was the most commonly seen histological pattern, seen in 5 (83%) patients who underwent biopsy. Diffuse proliferative glomerulonephritis (ISN/RPS class IV) was seen in 1 (16%) patient. Conclusions: Childhood onset SLE is still a challenge to diagnose and manage due to unpredictable clinical manifestations with variable disease activity at different age.

Distribution and Maturity of Medial Collagen Fibers in Thoracoabdominal Post-Dissection Aortic Aneurysms: A Comparative Study of Marfan and Non-Marfan Patients.

Thoracoabdominal aortic aneurysms (TAAAs) are rare but serious conditions characterized by dilation of the aorta characterized by remodeling of the vessel wall, with changes in the elastin and collagen content. Individuals with Marfan syndrome have a genetic predisposition for elastic fiber fragmentation and elastin degradation and are prone to early aneurysm formation and progression. Our objective was to analyze the medial collagen characteristics through histological, polarized light microscopy, and electron microscopy methods across the thoracic and abdominal aorta in twenty-five patients undergoing open surgical repair, including nine with Marfan syndrome. While age at surgery differed significantly between the groups, maximum aortic diameter and aneurysm extent did not. Collagen content increased from thoracic to infrarenal segments in both cohorts, with non-Marfan patients exhibiting higher collagen percentages, notably in the infrarenal aorta (729.3 nm vs. 1068.3 nm, p = 0.02). Both groups predominantly displayed mature collagen fibers, with the suprarenal segment containing the highest proportion of less mature fibers. Electron microscopy revealed comparable collagen fibril diameters across segments irrespective of Marfan status. Our findings underscore non-uniform histological patterns in TAAAs and suggest that ECM remodeling involves mature collagen deposition, albeit with lower collagen content observed in the infrarenal aorta of Marfan patients.