AMERICAN JOURNAL OF CLINICAL PATHOLOGY美国临床病理学杂志
AMERICAN JOURNAL OF CLINICAL PATHOLOGY(英文缩写 AM J CLIN PATHOL),ISSN 0002-9173,eISSN 1943-7722,中文译名:美国临床病理学杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 5.400 | Q1 |
| 2022 | 3.500 | Q2 |
| 2023 | 2.300 | Q2 |
| 2024 | 1.900 | Q3 |
| 2025 | 2.300 | Q2 |
AMERICAN JOURNAL OF CLINICAL PATHOLOGY 最新收录文献
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3. MGA::NUTM1 fusion sarcoma: expanding the spectrum of NUT-rearranged sarcomas with extensive review of the literature.
PMID:日期:2026-09-03We sought to present a rare case of MGA::NUTM1 fusion sarcoma, with a discussion of the differential diagnoses and approach to diagnosing these ultra-rare cases, which represent an emerging subset of NUTM1-rearranged mesenchymal neoplasms characterized by varied clinical behavior. Our review of the literature (17 cases) indicated bimodal age distribution, variable anatomical distribution, and frequent metastasis in these cases. Differential diagnosis has included synovial sarcoma and BCOR-associated sarcoma. The reported survival rates vary widely, from 1 month to 15 years. Here we report the case of a 16-year-old girl who presented with a large pelvic-abdominal mass and metastatic disease on a positron emission tomography/computed tomography scan. Based on TLE-1 positivity, the mass was initially diagnosed as synovial sarcoma at an outside center. Histologically, the patient's tumor showed monomorphic spindle to epithelioid cells within dense hyalinized stroma. Immunohistochemistry demonstrated diffuse nuclear NUT positivity along with TLE-1 and BCOR expression. Next-generation sequencing confirmed MGA::NUTM1 fusion, with additional alterations in TP53, CCND2, and PIK3CD. Despite chemotherapy, the patient's disease progressed, highlighting poor therapeutic response in these cases. This case highlights the overlapping and distinguishing features between MGA::NUTM1 fusion sarcomas and other common entities. Because survival in the reported MGA::NUTM1 fusion sarcomas varies widely, we hypothesized that more aggressive cases harbor second-hit alterations in the tumor suppressor genes (eg, our case had TP53 missense mutations). As the true biological nature of MGA::NUTM1 fusion sarcomas is still evolving, exploring this hypothesis by studying the second-hit alterations will be worthwhile in future cases and studies. The current lack of effective targeted therapies underscores the need for further research into novel treatment strategies for this disease.
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4. Impact of a 15-minute incubation on citrated TEG (thromboelastography) results in adult surgical patients-a prospective observational study.
PMID:日期:2026-09-03The thromboelastography (TEG) 6s Global Hemostasis Cartridge package insert recommends a 15-minute incubation of citrated blood prior to testing; however, most centers run samples immediately. Limited data are available to evaluate how incubation affects results and thus influences hemostatic transfusion decisions. In this single-center prospective study, 35 adult surgical and critical care patients were enrolled. Paired citrated samples were tested immediately upon laboratory arrival vs after a 15-minute benchtop incubation at room temperature. Primary endpoints included changes in citrated kaolin-reaction time (CK-R), kaolin with heparinase-reaction time (CKH-R), citrated kaolin-maximum amplitude (CK-MA), Citrated Rapid Thromboelastography Maximum Amplitude (CRT-MA), and citrated functional fibrinogen-maximum amplitude (CFF-MA) (fibrin-fibrinogen contribution). Paired t tests were used for analysis, and percent differences were calculated as [(Incubated - Immediate) / Incubated] × 100%. Categorical interpretation shifts (low/normal/high) were also assessed. A 15-minute incubation significantly shortened CK-R (8.5 ± 3.4 vs 7.4 ± 3.1 minutes; P < .01) and CKH-R (7.2 ± 2.7 vs 6.9 ± 2.5 minutes; P < .01), with mean percent changes of -17% and -12%, respectively. CK-MA decreased marginally (57.0 ± 16.0 vs 56.2 ± 12.4 mm; P < .01), while CFF-MA remained unchanged (P = .976). Notably, 23% of CK-R results shifted interpretation categories after incubation, whereas no CFF-MA categories changed. A 15-minute incubation significantly shortens CK-R/CKH-R and marginally decreases CK-MA, potentially normalizing hyper- or hypocoagulable readings. Omitting incubation risks misclassification and inappropriate plasma/prothrombin complex concentrate administration. Strict adherence to the manufacturer's incubation protocol is recommended except in emergencies, and local transfusion algorithms should specify whether "immediate" or "incubated" TEG cutoffs apply.
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5. LGALS3::POU5F1 gene fusion identified in a low-grade myxoid spindle cell tumor.
PMID:日期:2026-09-03Myoepithelial tumor (MET) of soft tissue can harbor POU5F1-associated fusions, including EWSR1/FUS::POU5F1 and SS18::POU5F1. We present a low-grade myxoid spindle cell tumor with a novel LGALS3::POU5F1 mimicking MET. Immunohistochemistry, DNA/RNA next-generation sequencing (NGS), and chromosomal microarray were performed. A 54-year-old man presented with a firm 4.5-cm left upper extremity mass superficial to the fascia. Microscopically, the tumor was partially encapsulated with extracapsular invasion and involvement of surrounding fat. The predominantly hypocellular tumor featured a reticular growth pattern with a myxoid stroma, mimicking extraskeletal myxoid chondrosarcoma. The hypercellular areas demonstrated epithelioid tumor cells embedded in sclerotic stroma, mimicking sclerosing epithelioid fibrosarcoma. Tumor necrosis was absent, and mitotic figures were rare. The tumor cells were only focally and weakly positive for S100 and CAM5.2, but negative for MUC4, AE1/3, CD34, EMA, desmin, GFAP, SMA, p63, SOX10, and calponin. Chromosomal microarray showed gains of whole chromosomes or segment of 5, 6, 7, 8, 12, 14q, and 16. DNA NGS did not show pathogenic mutations. More similar cases are needed to determine whether this LGALS3::POU5F1-positive low-grade myxoid spindle cell tumor represents a new tumor entity or a variant of a MET.
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6. Saline whole-blood impedance aggregometry for detection of heparin-independent platelet-activating anti-platelet factor 4 antibodies.
PMID:日期:2026-09-03This study evaluates the practice of incorporating a saline testing condition into the heparin-induced thrombocytopenia (HIT) functional assay using whole-blood impedance aggregometry (WBIA) to identify a subgroup of highly pathogenic anti-platelet factor 4 (PF4) antibodies with heparin-independent platelet-activating properties. From 2023 to 2025, we analyzed 150 evaluable patients (65 WBIA Negative, 85 WBIA Positive). Positive cases were subdivided into Classic-Positive (low-dose heparin positive only; n = 46) and Saline-Positive (positive under both low-dose heparin and saline; n = 35). The diagnosis of clinical HIT by hematologists was used as reference. PF4/IgG was measured by chemiluminescent immunoassay; WBIA was performed with low-dose heparin, high-dose heparin, and saline; and available serotonin release assay (SRA) results were analyzed. Saline-Positive patients exhibited significantly higher incidences of HIT-associated thrombosis (89% vs 54%, P = .005), delayed-onset HIT (23% vs 0%, P = .001), refractory HIT (40% vs 7%, P < .001), spontaneous HIT (14% vs 0%, P = .013), and more venous thromboembolism (pulmonary embolism and deep vein thrombosis, P < .05) compared with Classic-Positive patients. All 35 Saline-Positive cases were classified as autoimmune HIT (aHIT). The spontaneous HIT subset (n = 5) displayed a distinct pattern of low-titer anti-PF4 antibodies discordant with strong saline-WBIA reactivity and a high SRA false-negative rate (57.1%). High-dose intravenous immunoglobulin neutralized saline positivity in real time. Saline-positivity in WBIA identifies a heparin-independent aHIT phenotype with higher pathogenicity and thrombotic risk. This rapid saline protocol addresses diagnostic gaps where standard 2-condition SRA protocols may fail, offering a practical tool to identify high-pathogenic anti-PF4 antibodies and guide clinical management.
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7. BRAF V600E-mutated marginal zone lymphoma may exhibit features that partially overlap with hairy cell leukemia.
PMID:日期:2026-09-03To establish the occurrence of BRAF mutation in marginal zone lymphomas (MZLs) and study its impact on clinical presentation, pathologic features, and disease classification. Conventional histology, immunohistochemistry, flow cytometry, and molecular methods were used. We identified 2 BRAF‑mutated MZL cases: a nodal MZL (NMZL) with BRAF V600E and partial morphologic/immunophenotypic overlap with hairy cell leukemia (HCL) and an extranodal MZL with a non-V600E BRAF mutation co‑occurring with TET2, KRAS, and TP53 variants. The NMZL case showed strong CD25 and CD123 expression and patchy cyclin D1 expression; together with the presence of a BRAF V600E mutation, these features overlapped with HCL. However, the absence of annexin A1 and CD103 expression, along with the remaining morphologic features in the lymph node, supported accurate classification as NMZL. These 2 cases expand the mutational spectrum of MZL and illustrate important diagnostic pitfalls. These observations underscore that BRAF V600E, while highly specific and clinically useful for HCL in the context of a B‑cell lymphoproliferative process involving blood and marrow, is not entirely pathognomonic and must be interpreted alongside morphology and a full immunophenotypic panel. Integrating BRAF testing into the workup of challenging small B‑cell lymphomas may refine diagnosis and reveal rare, potentially targetable MAPK pathway lesions.
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8. Clinical and molecular spectrum of VEXAS with multiple UBA1 variants: case study and literature review.
PMID:日期:2026-09-03VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a rare adult-onset autoinflammatory disorder, caused by a single somatic UBA1 mutation. We report a novel case with 3 independent UBA1-mutated clones and compare its clinical, hematologic, and laboratory features with those of the only 3 previously reported cases harboring multiple UBA1 mutations. Droplet digital polymerase chain reaction (PCR) and targeted next-generation sequencing of peripheral blood DNA were performed to assess UBA1 variants. Bone marrow specimens were evaluated for morphologic, immunophenotypic, and cytogenetic abnormalities. Clinical and hematologic features included neck swelling, headache, elevated inflammatory markers, leukopenia, macrocytic anemia, and thrombocytopenia. Bone marrow biopsy specimens showed no dysplasia, increased blasts, or cytoplasmic vacuolization. Droplet digital PCR detected atypical positive signals across multiple targets, and next-generation sequencing identified 3 presumed independent UBA1 variants: p.M41V, p.M41L, and c.118-2A > T. Comparison with 3 previously reported VEXAS cases carrying multiple UBA1 variants revealed diverse clinical manifestations, including systemic inflammation, polychondritis, venous thromboembolism, arthritis, and arthralgia, with variable hematologic findings ranging from no neoplasm to myelodysplastic syndrome or multiple myeloma, as well as co-occurring clonal hematopoietic variants. This report describes a novel VEXAS case with multiple UBA1 variants and highlights the clinical and hematologic heterogeneity among patients harboring multiple UBA1 mutations. It also emphasizes the technical challenges in detecting these variants and the importance of sequencing studies for definitive diagnosis in complex or equivocal cases, supporting early identification of UBA1 mutations and closer hematologic surveillance in patients with inflammatory symptoms and cytopenias.
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9. Preanalytical variables in surgical pathology: practical sources of diagnostic error before microscopic interpretation.
PMID:日期:2026-09-03To review clinically important preanalytical variables in surgical pathology and their effects on diagnostic accuracy, ancillary testing, and patient safety. A narrative review was developed from selected literature on surgical pathology preanalytics, fixation, specimen handling, histotechnology, immunohistochemistry, molecular testing, tissue contamination, and quality improvement. Emphasis was placed on practical variables that affect routine anatomic pathology workflows. The diagnostic value of a surgical pathology specimen is shaped before microscopic interpretation. Ischemia time, delayed or inadequate fixation, tissue thickness, container and transport problems, labeling discrepancies, poor orientation, grossing variability, histotechnical artifacts, and tissue contamination can compromise morphology, margin assessment, staging, biomarker interpretation, and molecular testing. These effects are especially consequential in small biopsy specimens and precision oncology specimens, in which the same limited tissue may be required for diagnosis, immunohistochemistry, fluorescence in situ hybridization, polymerase chain reaction-based testing, and next-generation sequencing. Gross examination is a particularly important pathology-controlled preanalytical step because block selection determines what can be assessed microscopically. Preanalytical control should be regarded as a diagnostic quality and patient safety process rather than a technical background activity. Standardized fixation, specimen tracking, communication, grossing protocols, histotechnical quality assurance, and tissue stewardship are essential to reliable surgical pathology practice.
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10. How I diagnose Erdheim-Chester disease.
PMID:日期:2026-08-04Erdheim-Chester disease (ECD) is one of 3 major types of histiocytic neoplasms, along with Rosai-Dorfman disease and Langerhans cell histiocytosis. It was first recognized as a neoplasm in the 2016 World Health Organization Classification of Haematolymphoid Tumours. About 80% to 90% of cases harbor MAPK pathway mutations. We discuss the diagnosis of ECD using 3 illustrative cases, consider interpretative challenges, and present a diagnostic algorithm. Erdheim-Chester disease is a systemic disease that shows a characteristic pattern of organ involvement including bone, perinephric soft tissue, skin, heart, and central nervous system. Histologically, ECD shows a spectrum of xanthogranulomatous, lymphohistocytic, or fibrohistiocytic infiltrates. By immunohistochemistry, the neoplastic histiocytes have a macrophage phenotype with expression of CD163, negative to focal S100, and negative CD1a and langerin. These features alone are not specific and thus insufficient for diagnosis. Immunohistochemistry for cyclin D1 and BRAF V600E, correlation with clinical and imaging findings, and mutational analysis for MAPK pathway mutations all play important roles in establishing an ECD diagnosis. The diagnosis of ECD is often challenging due to its clinical and histologic overlap with reactive inflammatory processes. Correlation of histology features with clinical findings, immunohistochemistry, and genetic studies is essential for an accurate and timely diagnosis.