Use Of Histopathology Research Articles

Uncommon neoplasms mistakenly diagnosed as hidradenitis suppurativa: Report of three consecutive cases

Hidradenitis suppurativa (HS) poses diagnostic challenges due to its clinical overlap with various skin conditions and neoplasms, potentially leading to misdiagnoses. The absence of a definitive diagnostic test and infrequent use of histopathology contribute to diagnostic complexities, exacerbated by the recent increased focus on HS. Three cases initially diagnosed and treated as HS underwent clinical work-up and skin biopsies to resolve diagnostic complexities. Initially labeled as HS, the cases revealed a breast carcinoma on axillary ectopic tissue, a cutaneous gamma-delta T-cell lymphoma, and an infiltrating squamous cell carcinoma. Delayed recognition led to misguided therapies and adverse outcomes. This report stresses the need to explore alternative diagnoses for chronic skin nodules with or without ulcerations on the flexures. Timely skin biopsies are crucial for accurate diagnoses. Ongoing clinician education is essential to avoid misdiagnosis in challenging cases, in which histopathology aids in reaching a correct diagnosis.

Features of the skin diseases with pathological examination at Hue University of Medicine and Pharmacy Hospital

Background: Dermatopathology is an important tool that aids dermatologists in diagnosing skin disease. In order to provide useful information on the features of skin disease that needs to support a diagnosis by histopathology, the study was carried out with the objectives: (1) To make statistics on the skin disease with pathological exams and (2) To analyze the relationship between clinical diagnosis and dermatopathologic results. Methods: Cross-sectional study, 52 patients with pathological examination in Dermatologic Clinic at Hue University of Medicine and Pharmacy Hospital from May 2022 to March 2023 participated in the study. Results: The most common skin lesions were plaques (65.4%), followed by pigment lesions (44.2%), and papules/nodules (32.7%). Most of the disease duration is more than 6 months (53.8%). The number of initial clinical diagnoses was mainly one diagnosis (71.2%). The highest proportion of pathologic exams was 36.5%, belong to neoplastic skin diseases, followed by inflammatory skin diseases (34.6%). The match between the initial clinical diagnosis and histopathology reached 71.2%. The usefulness of histopathology for the final diagnosis was 86.5%. 25% of cases have yet to reach the final conclusion, mainly in the inflammatory skin diseases group. Conclusion: The highest proportion of pathologic exams was 36.5%, belong to neoplastic skin diseases, followed by inflammatory skin diseases. Key words: dermatopathology, skin biopsy, neoplastic skin disease, inflammatory skin disease.

Utility of histopathological examination in aseptic revision total hip arthroplasty: a preliminary analysis.

The utility of a routine histopathological examination in aseptic revision total hip arthroplasty (THA) has not been well explored. We aim to describe the approach and present the results of histopathological examination, focusing on its clinical usefulness in the setting of aseptic revision THA. We retrospectively reviewed 285 performed aseptic revision THA with available histopathological reports between 2015 and 2017 at a single institution. We described histopathological requests by the surgical team. Preoperative diagnoses, intraoperative findings, as well as histopathology and culture results were analysed. 13 painful THAs (4.5%) had preoperatively unknown diagnoses. In 10 of them, potential causes of pain were intraoperatively identified. Histopathology confirmed these findings in 8 THAs. 19 THAs (6.7%) revealed unexpected positive cultures (UPC). Histopathology was negative for infection in 18 of them. Among 16 consultants, 3 surgeons requested histopathology in 47% of the cases (130/285), usually to exclude infection (101/285; 35%). Documentation for tissue sample location was lacking in 51% (145/285), and for question asked by the surgeon in 47% (135/285). Histopathology is deemed a useful confirmatory tool in the context of ruling out infection in UPCs, and in documenting intraoperative findings in painful THAs with unknown preoperative diagnoses. Importantly, the approach to requesting histopathology should be optimised. Further large-scale studies, including cost analyses, are warranted to explore the usefulness of histopathology in routine utility.

Ibero-American Consensus Review and Incorporation of New Biomarkers for Clinical Practice in Colorectal Cancer.

Advances in genomic technologies have significantly improved the management of colorectal cancer (CRC). Several biomarkers have been identified in CRC that enable personalization in the use of biologic agents that have shown to enhance the clinical outcomes of patients. However, technologies used for their determination generate massive amounts of information that can be difficult for the clinician to interpret and use adequately. Through several discussion meetings, a group of oncology experts from Spain and several Latin American countries reviewed the latest literature to provide practical recommendations on the determination of biomarkers in CRC based on their clinical experience. The article also describes the importance of looking for additional prognostic biomarkers and the use of histopathology to establish an adequate molecular classification. Present and future of immunotherapy biomarkers in CRC patients are also discussed, together with several techniques for marker determination, including liquid biopsy, next-generation sequencing (NGS), polymerase chain reaction (PCR), and fecal immunohistochemical tests. Finally, the role of Molecular Tumor Boards in the diagnosis and treatment of CRC is described. All of this information will allow us to highlight the importance of biomarker determination in CRC.

Tuberculosis, A Great Masquerader: A Case Report of Disseminated Multifocal Skeletal TB and Tracheoesophageal Fistulae Mimicking Metastatic Cancer.

Disseminated tuberculosis (TB) can involve any system and may mimic many conditions.Tracheoesophageal fistula secondary to TB and multi-focal skeletal TB are both rare individually, with their co-occurrence being even more uncommon.Diagnosing and managing TB in endemic areas can be complex and challenging; the use of histopathology and molecular techniques prior to treatment is very important.

Determining the learning curve for a novel microsurgical procedure using histopathology

PurposeWet laboratories are becoming an increasingly important training tool as part of a push to a proficiency-based training model. We created a microsurgical wet laboratory to investigate the utility of histopathology use in assessing surgical outcomes and determine the learning curve of a novel microsurgical procedure.MethodsA microsurgical wet laboratory was established using pig eyes to simulate the human cornea. Three novice surgeons and an experienced surgeon performed an anterior cornea lamellar dissection and the duration of the procedure was recorded. With the aid of histological analysis, the thickness and characteristics of the dissected graft was recorded. The number of attempts to complete the experiment, defined as three successful dissections with mean thickness below 100 μm, was documented.ResultsThe use of histopathology was highly successful allowing in-depth analysis of the dissected graft for each attempt. Trainees reached the endpoint of the study in 21, 26 and 36 attempts (mean: 28 attempts) whilst the corneal surgeon completed the experiment in 12 attempts (p = 0.07). Mean dissection thickness decreased over time for all participants. The mean dissection time for trainees was 10.6 ± 4.2 min compared to the corneal surgeon with a mean of 8.2 ± 3.1 min (p = 0.03).ConclusionWe propose a corneal wet laboratory model that allows for simple, efficient, and flexible microsurgical training. The use of histopathological analysis allows for careful graft analysis, providing objective feedback throughout the training exercise. Trainees demonstrated improvements in the three key aspects of the procedure: accuracy as evidenced by decreasing histological thickness, confidence by self-report and fluidity by decreasing duration of the procedure.

Comparative Study of Histopathological and Immunohistochemical Features of Biopsies of Patients of Lung Cancer

Introduction: When it comes to pollution, smoking, infections, tuberculosis (TB), and allergies, the lungs are the most sensitive organs to damage. Pleural fluid is a fluid that fills the parietal and visceral layers of the pleura that surround the lungs and helps to keep them moist. An investigation of the link between age, gender, and immunohistochemistry findings in lung and pleural biopsy samples was conducted. Materials and procedures: This is a four-year retrospective study that will take place between May 2017 and May 2021. In the current study, a total of 112 cases were submitted for histological investigation, with 100 instances using lung biopsy and 12 cases involving pleural biopsy being the most prevalent. Immunohistochemical testing was carried out as and when it was necessary. Results: A total of 100 lungs were examined. There were 56 cases of neoplastic tumours, 35 cases of non-neoplastic tumours, and nine cases of inconclusive tumours. The most common type of cancer was squamous cell carcinoma. The most prevalent non-neoplastic lesion was angioedema, which was the most common type of lesion (4 percent ). Patients with lung tumours who have malignancy outweigh those who have inflammatory illnesses at our institution. Seven of the 11 pleural biopsy cases were malignant, whereas the other eleven were not. Adenocarcinoma was the most common kind of neoplastic pleural lesion, followed by tuberculosis. Conclusion: The use of histopathology in the diagnosis of lung and pleural lesions is essential. It is possible to increase the accuracy of histological diagnosis with the use of immunohistochemistry. Keywords: Lung biopsy, pleural biopsy, histopathological examination.

English

BACKGROUND Oral and maxillofacial pathology, is the very foundation of dentistry. It is a branch of dentistry where research meets clinical practice with the use of histopathology, cytopathology, haematology, immunohistochemistry, clinical biochemistry, microbiology, molecular science, forensic odontology, and a lot more, making it a unique and rare branch in its own way. It acts as a backbone of dental science, by investigating the causes, processes, and effects of the disease affecting the oral and maxillofacial region. Therefore, this branch requires timely up-gradation to analyse health data, research findings and treatment techniques to offer a diagnostic and therapeutic recommendation for individual patients. The application of digital technology in oral pathology is on the verge of becoming a standard of care, thereby eliminating the need for practising pathology on a conventional microscope. Globally, pathological laboratories need to be more efficient than before. Therefore, automation and digitalization are required to not only increase the efficiency, growth, quality, and capacity but also to standardise the processes. The purpose of this article is to introduce the readers, the incorporation of new ideas and technologies in the lab for a better and faster diagnosis, and would also like to explain the concept of standardizing the method of recording and maintaining the dental or medical records of the patients, and also standardizing the lab reports. KEY WORDS Innovation, Robotics, Digitalization, Artificial Intelligence, Upgradation, Maxillofacial Region

Inter-laboratory performance of ICE histopathology scoring to identify UN GHS Category 1 surfactants and non-extreme pH detergents

The inter-laboratory performance of Isolated Chicken Eye (ICE) histopathology scoring was assessed for predicting EU CLP/UN GHS Cat. 1 surfactants. Furthermore, the predictive capacity of ICE histopathology was evaluated for the combined dataset of surfactants and existing data for non-extreme pH (2 < pH < 11.5) detergents. Use of ICE histopathology led to increased sensitivity compared to the ICE test method alone for surfactants. When combined with the existing dataset of detergents, use of histopathology in addition to the standard ICE test method decreased the false negative rates from 64% (14/22) to 27% (6/22); increased accuracy from 53% (16/30) to 77% (23/30); and led to acceptable level of false positives (from 0/8 to 1/8 (12.5%). Moreover, good reproducibility of ICE histopathology predictions conducted on the same slides was found between pathologists and peer-reviewers from three independent laboratories (10/12 or 83%) and over time. Use of ICE histopathology was therefore found suitable to predict EU CLP/UN GHS Cat. 1 surfactants and non-extreme pH detergents. In addition, appropriate reproducibility of ICE histopathology was found, provided that i) an internal peer-review system was in place; ii) original slides were assessed to enable evaluation of three dimensional effects; and iii) appropriate training and proficiency appraisal were conducted.

Classification of Intervertebral Disc Disease.

Intervertebral disc disease (IVDD) has been recognized in dogs since the 1800s, when the first descriptions of extruded disc material within the vertebral canal were published. In the intervening time our understanding of intervertebral disc pathology in dogs and cats has increased dramatically, with many variations of IVDD described. Whilst the volume of literature and collective understanding of IVDD has expanded, there has also been scope for confusion as the definition of intervertebral disc disease, with its myriad different manifestations, becomes more complicated. A large volume of literature has aimed to combine the use of histopathology, diagnostic imaging and clinical findings to better understand the various ways in which IVDD can be classified. Much of this research has focused on the classification of mechanisms of intervertebral disc degeneration, centering around the differences between, and overlaps in, IVDD in chondrodystrophic and non-chondrodystrophic dog breeds. However, with the increasing availability of advanced imaging modalities allowing more accurate antemortem diagnosis, the concept of IVDD has expanded to include other clinical presentations that may not fit into traditional models of classification of IVDD. This review aims to provide an up to date overview of both historical and current systems of IVDD classification, highlighting the important findings and controversies underpinning them.

Myoid Angioendothelioma of the Spleen - Case Report and Literature Review

Abstract Myoid angioendothelioma (MA) represents an extremely rare nonhaematopoietic proliferation of the spleen. MA is a rare, benign, vascular tumour that consists of vascular elements and arranged stromal cells. Due to an absence of specific clinical signs and symptoms, MA is considered challenging to diagnose. Although the radiological presentation can indicate the vascular nature of the tumour, the diagnosis of MA is almost exclusively obtained from the use of histopathology after surgical excision and immunohistochemistry of the tissue. Due to its completely unclear biological behaviour and relationship with other primary and secondary tumours, the only effective therapy for MA is splenectomy and a regular postoperative follow-up. Herein, we report a case of a 26-year-old male patient with nonspecific abdominal pain and a radiologically detected tumour of the spleen who underwent a laparoscopic splenectomy. Histopathologic and immunohistochemical examinations confirmed a myoid angioendothelioma of the spleen.

A proposal of standardization for histopathological lesions to characterize fish diseases

AbstractThe use of histopathology in fish sciences is broadly extended, although it is currently devoid of standardization across the literature. There have been initiatives to standardize every step of the histological evaluation, including description, diagnosis, interpretation, data recording and reporting, and statistical analysis, but, in general, the histopathological systems applied to date present a series of limitations that hamper the reproducibility of the derived data. On top of these limitations, an agreed, organ‐by‐organ list of lesions to be recorded is currently lacking. Therefore, this communication proposes a validated and comprehensive list of features to record in skin, head, eye, nervous system, gastrointestinal tract, gonads, kidney, and other organs of farmed red and Nile tilapias (Oreochromis sp. and Oreochromis niloticus L., respectively), white cachama (Piaractus brachypomus), rainbow trout (Oncorhynchus mykiss) and other species. Once this list is agreed and accepted by fish pathologists and other fish scientists, it could be the cornerstone for the development of well‐established and reproducible histopathological scoring systems. This communication highlights the importance of standardization initiatives in fish histology to produce reliable and high‐quality data.

Kidney Histopathology and Prediction of Kidney Failure: A Retrospective Cohort Study

The use of kidney histopathology for predicting kidney failure is not established. We hypothesized that the use of histopathologic features of kidney biopsy specimens would improve prediction of clinical outcomes made using demographic and clinical variables alone. Retrospective cohort study and development of a clinical prediction model. All 2,720 individuals from the Biopsy Biobank Cohort of Indiana who underwent kidney biopsy between 2002 and 2015 and had at least 2 years of follow-up. Demographic variables, comorbid conditions, baseline clinical characteristics, and histopathologic features. Time to kidney failure, defined as sustained estimated glomerular filtration rate≤ 10mL/min/1.73m2. Multivariable Cox regression model with internal validation by bootstrapping. Models including clinical and demographic variables were fit with the addition of histopathologic features. To assess the impact of adding a histopathology variable, the amount of variance explained (r2) and the C index were calculated. The impact on prediction was assessed by calculating the net reclassification index for each histopathologic variable and for all combined. Median follow-up was 3.1 years. Within 5 years of biopsy, 411 (15.1%) patients developed kidney failure. Multivariable analyses including demographic and clinical variables revealed that severe glomerular obsolescence (adjusted HR, 2.03; 95% CI, 1.51-2.03), severe interstitial fibrosis and tubular atrophy (adjusted HR, 1.99; 95% CI, 1.52-2.59), and severe arteriolar hyalinosis (adjusted HR, 1.53; 95% CI, 1.14-2.05) were independently associated with the primary outcome. The addition of all histopathologic variables to the clinical model yielded a net reclassification index for kidney failure of 5.1% (P< 0.001) with a full model C statistic of 0.915. Analyses addressing the competing risk for death, optimism, or shrinkage did not significantly change the results. Selection bias from the use of clinically indicated biopsies and exclusion of patients with less than 2 years of follow-up, as well as reliance on surrogate indicators of kidney failure onset. A model incorporating histopathologic features from kidney biopsy specimens improved prediction of kidney failure and may be valuable clinically. Future studies will be needed to understand whether even more detailed characterization of kidney tissue may further improve prognostication about the future trajectory of estimated glomerular filtration rate.

Molecular profiling of key driver genes improves staging accuracy in multifocal non–small cell lung cancer

ObjectiveMultifocal non–small cell lung cancer has historically been separated into synchronous primary lung cancers or intrapulmonary metastases with the use of histopathology. We hypothesize that using targeted next-generation sequencing of key driver mutations in multifocal non–small cell lung cancer will improve our ability to differentiate intrapulmonary metastases from synchronous primary lung cancers. MethodsWe identified patients who underwent surgery for non–small cell lung cancer between 2013 and 2018 with multifocal tumors. Archived specimens were reviewed with a 4-gene next-generation sequencing panel identifying mutations of EGFR, KRAS, BRAF, and NRAS. Synchronous primary lung cancers were classified as lesions with different histopathologic subtypes or driver mutations. Tests of hypotheses were performed with the Fisher exact test. Calculations were performed in Stata (v13.0; StataCorp LLC, College Station, Tex). ResultsA total of 18 patients had non–small cell lung cancer tumor specimens (n = 41) available from 2 or more sites. The pathologic diagnosis was predominantly adenocarcinoma (39/41 specimens). We detected a driver mutation in 68.3% (28/41) of all tumors. The most common mutations observed were in KRAS (n = 17/41) and EGFR (n = 7/41). Eleven patients had synchronous primary lung cancers, and 4 patients had intrapulmonary metastases based on combined histopathologic and molecular profiling results. Three lacked driver mutations in either lesion. Eight synchronous primary lung cancers (8/18, 44%) were downstaged when compared with their original diagnosis (P = .08). Of these, 4 patients received adjuvant chemotherapy unnecessarily in hindsight. ConclusionsMolecular non–small cell lung cancer profiling using a 4-gene next-generation sequencing panel allows for better distinction between synchronous primary lung cancers and intrapulmonary metastases than histopathology alone. Routine use of next-generation sequencing for multifocal lesions prevents unnecessary adjuvant treatment for patients with histologically similar synchronous primary lung cancers.

Microscopic alterations in Fasciola hepatica from sheep treated with albendazole.

Currently, albendazole is one of the most commonly used drugs because of its affordability. The objective was to evaluate the histopathology of Fasciola hepatica specimens. For this, the efficacy test was performed on sheep treated with albendazole at the dose recommended for F. hepatica, in which the helminths recovered at necropsy were counted and separated for histology. Spermatogenic cells from parasites recovered from treated and control sheep were examined by microscopy. The fecal egg-count reduction test revealed 97.06% efficacy of albendazole in the treatment of F. hepatica. Changes in testicular tubule cells started 48 hours after treatment and became evident within 72 hours, at which point it became difficult to identify cell types. Primary and secondary spermatogonia became increasingly rare and intercellular vacuolization was more evident. Signs of apoptosis, with pycnotic nuclei and evidence of keriorrexia were observed at all times. Cell debris was identified 96 hours after treatment. The results indicated that parasitic spermatogenesis was severely affected by albendazole and demonstrated the importance of the use of histopathology for the diagnosis of therapeutic efficacy in field strains.

Diagnostic accuracy of diffusion weighted MRI in differentiating benign and malignant meningiomas

Objective:To determine the diagnostic accuracy of DWI in differentiating benign and malignant meningiomas keeping histopathology as gold standard.Methods:This was a descriptive analytical study conducted at Radiology Department, DUHS/Dr. Ruth K. M. Pfau Civil Hospital Karachi, from August 2016 to March 2018.It included152 patients clinically suspected of meningioma on conventional neuroimaging. Imaging features of DWI were compared with histopathology findings. The diagnostic accuracy of DWI was calculated in terms of sensitivity, specificity, accuracy, PPV and NPV using histopathology as gold standard.Results:There were 59 male and 93 female patients with mean age of 55.38±9.8 years. Mean duration of sign and symptoms was 5.67±2.57 months. Out of 152 patients, 117(77%) and 35(23%) were differentiated into benign and malignant meningiomas respectively by DWI while 135(88.82%) and17(11.18%) patients were diagnosed respectively on histopathology. The sensitivity, specificity, PPV, NPV and accuracy of DWI of 84.4%, 82.3%, 97.4%, 40%, and 84.2% respectively keeping histopathology as gold standard.Conclusion:DWI features along with calculation of ADC values is a reliable non-invasive technique for differentiating benign and malignant meningiomas. However the low negative predictive value necessitates the use of histopathology.

Abstract IA13: Imaging drug delivery and nanotherapeutics

Abstract Over 180 chemically distinct cancer drugs are currently in clinical use while new nanomaterials, small molecule inhibitors and newer immunotherapeutics are entering clinical trials. Preclinical testing usually involves measuring tumor sizes, survival endpoints, the use of histopathology and measurement of serum biomarkers. Yet, despite all of these advances, preciously little is known on how many of these compounds actually work (or fail) at the single cell level in vivo, what the spatial and temporal heterogeneity is and how efficacy can be improved. The latter is particularly vexing as the majority of patients show suboptimal responses and tumors often relapse within months-years. With the recent development of i) single cell in vivo imaging technology (Nat Commun 2013;4,1504), ii) fluorescent nanoparticles and encapsulated therapeutics (Science Transl Med, 2015;7:314; Nat Commun. 2015;6:8692), iii) in vivo reporters of host response, cell death or DNA damage (ChemMedChem, 2014;9:1131), iv) new computational analysis (Nat Methods, 2015;12:577), and v) armed with new biological insight from feasibility studies we are now able to address important cancer therapeutics questions in ways that were not previously possible. In this presentation I will review imaging approaches for the functional assessment of new therapeutics at the single cell level in vivo, addressing key questions on distribution (pharmacokinetics, PK) and specific cellular response (pharmacodynamics, PD). Citation Format: Ralph Weissleder. Imaging drug delivery and nanotherapeutics. [abstract]. In: Proceedings of the AACR Special Conference on Engineering and Physical Sciences in Oncology; 2016 Jun 25-28; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2017;77(2 Suppl):Abstract nr IA13.

Large-scale tissue clearing (PACT): Technical evaluation and new perspectives in immunofluorescence, histology, and ultrastructure.

Novel techniques, like CLARITY and PACT, render large tissue specimens transparent and thereby suitable for microscopic analysis. We used these techniques to evaluate their potential in the intestine as an exemplary organ with a complex tissue composition. Immunohistochemistry, light sheet-, and confocal scanning-microscopy enabled us to follow complex three-dimensional structures, like nerve fibers, vessels, and epithelial barriers throughout the entire organ. Moreover, in a systematic electron microscopic study, we analyzed the morphology and preservation of tissue on ultrastructural level during the clearing process. We also connect tissue clearing with classical histology and demonstrate that cleared tissues can be stained with Hematoxylin-Eosin and Heidenhain’s Azan stain, suggesting potential use in histopathology. These experiments showed that a neutral pH during the clearing process results in much better preservation of tissue ultrastructure and standard stainability. Volume changes of specimens were monitored and quantified during the course of the protocol. Additionally, we employed the technique to visualize the enteric nervous system and the epithelial barrier in post mortem human gut preparations. Our data show the high potential of tissue clearing throughout different tissue types supporting its usefulness in research and diagnosis, and contribute to the technical discussion of ultrastructural tissue-retention.

Tubercular Testicular Abscess in a Young Male-Rare Presentation of a Common Disease

Genitourinary tuberculosis is rare manifestation of extra pulmonary tuberculosis which itself is an fairly uncommon manifestation of a common global disease. Of these rare manifestations, we present a still rarer case of testicular tubercular abscess. We highlight the importance of testicular tuberculosis as a differential diagnosis of testicular mass / abscess and use of histopathology in clinching the diagnosis.

The Vital Role of Pathology in Improving Reproducibility and Translational Relevance of Aging Studies in Rodents.

Pathology is a discipline of medicine that adds great benefit to aging studies of rodents by integrating in vivo, biochemical, and molecular data. It is not possible to diagnose systemic illness, comorbidities, and proximate causes of death in aging studies without the morphologic context provided by histopathology. To date, many rodent aging studies do not utilize end points supported by systematic necropsy and histopathology, which leaves studies incomplete, contradictory, and difficult to interpret. As in traditional toxicity studies, if the effect of a drug, dietary treatment, or altered gene expression on aging is to be studied, systematic pathology analysis must be included to determine the causes of age-related illness, moribundity, and death. In this Commentary, the authors discuss the factors that should be considered in the design of aging studies in mice, with the inclusion of robust pathology practices modified after those developed by toxicologic and discovery research pathologists. Investigators in the field of aging must consider the use of histopathology in their rodent aging studies in this era of integrative and preclinical geriatric science (geroscience).