Pathology is committed to publishing peer-reviewed, original articles related to the science of pathology in its broadest sense, including chemical pathology, experimental pathology, genetics, haematology, histopathology, immunology, microbiology, molecuar pathology and morbid anatomy. Call for Papers Manuscripts to be considered for publication should be submitted to the Editor: Professor C. S. Lee, Editorial Office, Royal College of Pathologists of Australasia, Durham Hall, 207 Albion Street, Surry Hills, NSW 2010, Australia. Tel: +61 2 8356 5858; Fax: +61 2 8356 5828. All submissions will be independently judged by at least two referees. Authors should consult the ' Notes for Contributors ' before sending a manuscript.
Journal Impact: 0.51*
Journal impact history
|2016 Journal impact||Available summer 2017|
|2015 Journal impact||0.51|
|2012 Journal impact||0.07|
|2011 Journal impact||0.30|
|2010 Journal impact||0.73|
|2009 Journal impact||1.99|
|2008 Journal impact||1.84|
|2007 Journal impact||1.09|
|2006 Journal impact||1.24|
|2005 Journal impact||1.26|
|2004 Journal impact||1.17|
|2003 Journal impact||0.87|
|2002 Journal impact||0.58|
|2001 Journal impact||0.53|
|2000 Journal impact||0.61|
Journal impact over time
|Other titles||Pathology (Online)|
|Material type||Document, Periodical, Internet resource|
|Document type||Internet Resource, Computer File, Journal / Magazine / Newspaper|
Publications in this journal
- [Show abstract] [Hide abstract] ABSTRACT: Background: Lately, very few studies have shown diagnostic value of INI1/SMARCB1/BAF47 expression in synovial sarcomas (SSs). Aims: To evaluate immunohistochemical (IHC) expression of INI1/SMARCB1 in SSs and in other tumours, including differential diagnoses of SSs. Methods: Sixty-eight SSs, in the form of various specimens, including 26 cases confirmed with positive molecular cytogenetic results (SYT rearrangement), using Vysis SYT dual color break apart probe; along with 151 other tumours were tested for IHC expression of INI1. Results: Forty monophasic spindle cell-type (58.8%), 13 biphasic (19.1%), 12 poorly differentiated (17.6%) and 3 calcifying-type SSs (4.4%) were positive for EMA(46/62, 74.1%), AE1/AE3 (31/47, 65.9%), CK 7 (20/31, 64.5%), BCL2 (62/66, 93.9%), MIC2 (cytoplasmic) (61/63, 96.8%), TLE1 (diffuse) (29/31, 93.5%), CK19 (14/24, 58.3%), S100-P (1/13, 7.6%) and CD34 (0/52). INI1 expression was ‘weak to absent’ in 60/68 (88.2%) SSs; in 1/3 malignant ossifying myxoid tumours (MOFMTs) and in 3/10 (30%) malignant peripheral nerve sheath tumours (MPNSTs) of various types, while ‘completely absent’ in 10/10 (100%) epithelioid sarcomas (ESs), 4/4 (100%) malignant rhabdoid tumours, single pediatric undifferentiated sarcoma, 5/19 (26.3%) myoepithelial carcinomas and in 2/4 (50%) epithelioid subtype of the MPNSTs. Remaining 104 tumours, including 12 Ewing sarcomas, 15 carcinomas, 8 solitary fibrous tumours (SFT), 7 extraskeletal myxoid chondrosarcomas and various other tumours retained INI1 expression. Conclusions: A unique ‘weak to absent’ INI1 expression is highly sensitive (88.2%) and specific (97.3%) for a SS, irrespective of its various subtypes and biopsy specimens, especially in differentiating it from Ewing sarcoma, ES, SFT, carcinomas and some MPNSTs. A similar INI1 expression is also seen in few OFMTs. INI1 may be included as a useful marker in an optimal diagnostic panel of a SS comprising other markers such as EMA, AE1/AE3, BCL2, MIC2, TLE1 and CD34, especially in settings lacking molecular and/or cytogenetic analysis.
- [Show abstract] [Hide abstract] ABSTRACT: We report two compound heterozygous mutants that caused severe type I protein C (PC) deficiency in two independent Chinese families.PC antigen was determined by enzyme-linked immunosorbent assay (ELISA), and PC activity was measured by chromogenic assay. Genetic mutations were screened with polymerase chain reaction (PCR) followed by direct sequencing. PC mutants were transiently expressed in COS-7 cells for the evaluation of PC secretory activity and function. The subcellular location was visualised by immunofluorescence assay. The structural analysis of mutation was performed as well.Compound heterozygous mutations of Arg178Trp and Asp255His with reduced PC activity and antigen levels were identified in Proband 1, a 28-year-old male with deep vein thrombosis (DVT) and pulmonary embolism. The other mutations of Leu-34Pro and Thr295Ile with reduced PC activity and antigen levels were identified in Proband 2, a 19-year-old male with DVT. The PC activities with Arg178Trp, Asp255His, Leu-34Pro and Thr295Ile mutations decreased significantly. Immunofluorescence assay demonstrated that only trace amount of PC with novel Thr295Ile mutation was transported to the Golgi apparatus. Subsequent structural analysis indicated severe impairments of intracellular folding and secretion.The two rare compound heterozygous mutations could cause type I PC deficiency via impairment of secretory activity of PC.
- [Show abstract] [Hide abstract] ABSTRACT: Large cell transformation of mycosis fungoides (MF-LCT) occurs in 20-50% of advanced MF, and is generally associated with poor prognosis, although some patients have indolent disease. We sought to identify clinicopathological prognostic factors in a large number of patients with MF-LCT.We identified patients with MF-LCT treated between 1991 and 2012 at a referral centre for cutaneous lymphoma. Clinical and pathological records, and histopathological slides were reviewed. Associations of clinicopathological variables with disease-specific survival were analysed.In 51 patients with MF-LCT, factors significantly associated with shorter survival were: age >60 years (25 versus 61 months, p = 0.01), stage III/IV (25 versus 44 months, p = 0.049), high serum lactate dehydrogenase (LDH; 24 versus 53 months, p = 0.007), absent papillary dermal involvement (8 versus 30 months, p = 0.008); follicular mucin at transformation (24 versus 42 months, p = 0.007); and the absence of fibrosis at transformation (21 versus 42 months, p = 0.03). Patients presenting with transformation at diagnosis had better survival than those who started with a small cell phenotype (p = 0.02). Age >60 years was independently associated with poorer survival (HR 5.61, 95%CI 1.17-26.8, p = 0.03), and the presence of fibrosis at transformation was independently associated with improved survival (HR 0.30, 95%CI 0.09-0.97, p = 0.045).In patients with MF-LCT, clinical features (age, stage, serum LDH) are important in assessing prognosis. Additional clinical and pathological features identified in this study may also assist in prognostic stratification. Studies of larger cohorts should be performed to validate the prognostic significance of these features.
Article: Urologic Pathology[Show abstract] [Hide abstract] ABSTRACT: A 53-year-old male complained of urination discomfort and pain for three weeks. Physical examination noted swelling of legs and enlarged prostate. Imaging studies revealed irregular mass involving the prostate and seminal vesicles with obscured structural features, enlarged peri-iliac artery and peri-aortal lymph nodes, and suspicious metastatic lesions in the 4th-5th lumbar vertebrae. Serum PSA was not elevated. Ten cores of ultrasound-directed needle biopsies of the prostate were collected and submitted to the pathology department. Routine H&E histology reveals medium sized tumor cells infiltrating fibromuscular stroma in sheets or nests.Some tumor cells were distorted with indistinct morphology and hyperchromatic nuclei. Occasional perineural invasion was observed.
Article: Head and Neck Pathology[Show abstract] [Hide abstract] ABSTRACT: Research has elucidated the detailed molecular mechanisms of carcinogenesis, tumour progression, and metastasis in different head and neck tumours in the recent decade. These advances have great impacts on pathology practices in areas including oral and head/neck squamous cell carcinoma, papillary thyroid carcinoma, head and neck paraganglioma and salivary gland tumours. (1) In oral and head/neck squamous cell carcinoma, human papilloma virus is an important independent prognostic variable and predictive factor for responsiveness to treatment. The presence of the virus is best reflected by immunohistochemical staining of p16. (2) In papillary thyroid carcinoma, presence of BRAF mutation is predictive of aggressive biological behaviour and could be useful for the diagnosis of papillary thyroid carcinoma. (3) For head/neck paragangliomas, the clinical impact in pathology is the role of pathologist in the detection of SDHB by immunohistochemistry in paraganglioma as SDHB mutations are correlated with presence of metastasis and poor prognosis. (4) In salivary gland tumours, chromosomal translocations as detected by FISH, are useful for diagnosis of tumours like hyalinising clear cell carcinoma and mammary analog secretory carcinoma. In conclusion, awareness of new advances in molecular pathology is essential for proper management of patients with head and neck tumours.
Article: Neuropathology[Show abstract] [Hide abstract] ABSTRACT: Mucormycosis is a rare and often fatal infection caused by fungi of the Mucorales order, commonly affecting immunocompromised patients and adults with diabetic ketoacidosis. Infants are infected through the gastrointestinal tract or the nasopharynx, from where infection can spread to the brain. Mucor fungus is angiotropic, causing thrombosis, infarction and tissue necrosis.A case of neonatal death by mucor encephalitis is reported. The mother had gestational diabetes on insulin. The female infant was diagnosed with Fallot tetralogy and was admitted to NICU. There was a progressive clinical deterioration with signs of infection, but with repeatedly negative full septic screens including fungi, and negative viral control. The brain showed lytic lesions on imaging. Despite treatment with antibiotics and later with anti-fungal drugs, the baby's condition rapidly worsened and she died on day 34.The post-mortem examination revealed mucor hyphae in the brain causing vasculitis and necrotising encephalitis. In addition to tFallot, there was thymus hypoplasia, suggestive of DiGeorge phenotype. CATCH22 cytogenetic examination was negative.Diagnosis of infection with mucor and related fungi is difficult, as cultures are frequently negative. Direct microscopic visualisation of the fungal hyphae in affected tissues is important for the diagnosis, which is often made with delay or only post-mortem.
Article: Pulmonary Pathology[Show abstract] [Hide abstract] ABSTRACT: Tuberculosis (TB), a multi-systemic disease with myriad presentations and variable manifestations, is endemic in almost every part of the world and continues to remain the most common cause of infectious diseaserelated mortality and morbidity. The infection occurs most often via the pulmonary route through aerosols, producing pulmonary and/or extra-pulmonary disease. A remarkable feature of the organism M. tuberculosis is its ability to lie dormant within alveolar macrophages/granulomas that leads to active disease in 5-10% of immune-competent individuals; the endogenous reactivation usually causes abnormalities in the upper lobes of one or both lungs. Now, there has been a rise of progressive disease due to overt immune-suppression and emergence of drug-resistant strains. In the recent years, at autopsy, we have noted a definite affinity of the organisms for the intra-parenchymal bronchial tree with prominent or sole broncho-centric inflammation. The bronchial spread is often associated with consolidations (often in the lower lobes) and vasculitis. Many of the cases of miliary lesions are associated with diffuse alveolar damage and organizing pneumonia.
Article: Dermatopathology[Show abstract] [Hide abstract] ABSTRACT: Giant cell fibroblastoma is a rare fibroblastic tumor occurring mainly in young patients. Back of thigh, inguinal region and chest wall are the most common sites of involvement. The tumor is characterized by a locally aggressive behavior with no reported metastatic potential. Microscopically, it is composed of spindle cells with a moderate degree of nuclear pleomorphism that infiltrate deep dermis and subcutis. A distinctive feature of this tumor is the presence of peculiar pseudovascular spaces lined by a discontinuous row of multinucleated cells. Features very similar to dermatofibrosarcoma protuberans can be seen. Immunohistochemically, it shows positive staining for CD34, while being negative for S-100 protein and vascular markers. The molecular changes are overlapping with dermatofibrosarcoma protuberans. A case of giant cell fibroblastoma will be presented illustrating the clinicopathological and molecular features of this tumor.
Article: Pathology Education[Show abstract] [Hide abstract] ABSTRACT: The postgraduate education programs in the Arab countries have intra- and intercountry differences in the availability of human resources and adequate training centers. The Arab Board of Pathology was established in 2010 to improve the health services in these countries, to set comprehensive and uniform standards for postgraduate training centers, and to establish uniform assessment of the training programs and the proficiency of the trainees. This presentation covers the foundations and the experience of the Arab Board of Pathology since its inception. It describes the structure of the exams and the performance of the trainees. Despite the noted improvement in the training programs over the past few years, many challenges remain and these relate to the growing populations of the countries of the region and the increasing demand for qualified pathologists, shortage of adequate training facilities and resources, disruptive political instability, differences in the adopted structure of the training programs based on external educational influences by European programs, and lack of national strategies to address these problems.The presentation also includes a brief comparison of the leading certification programs of postgraduate education in pathology in different regions of the world and questions the readiness for a global certification program.
Article: Molecular Pathology[Show abstract] [Hide abstract] ABSTRACT: After the introduction of HER2 as a target molecule for trastuzumab therapy, rapid increase of the molecular targeted cancer therapy has highlighted the roles of pathologists in the appropriate patient care for various cancers. The list of the current available therapy for various cancers and target molecules has been rapidy increasing. The targeted cancer therapy is divided into several groups such as humanized monoclonal antibodies and tyrosine kinase inhibitors and others.We pathologists perform immunohistochemistry (HER2, EGFR), in situ hybridization (DISH, FISH) and mutational analysis (EGFR, KRAS, BRAF, others) in order to suggest the most appropriate therapy for the particular cancers. Recent application of the next generation sequencing (NGS) gives us more extensive genomic changes and is expected to give the best suitable anti-cancer therapy for the particular cancers.Somatostatin analogue, octreotide, targets somatostatin receptor (SSTR2) on the tumor cells of gastro-entero-pancreatic neuroendocrine tumors (NETs.) Immunohistochemical positive staining of SSTR2 is well associated with therapeutic response to octreotide therapy. The pathologists play an essential role in detecting SSTR2 by immunohistochemistry.
Article: Bone and Soft Tissue Pathology[Show abstract] [Hide abstract] ABSTRACT: In this session, the detailed clinicopathological and genetic findings, and the differential diagnosis of the following five unusual soft tissue tumors will be demonstrated. 1) Inflammatory myofibroblastic tumor occurs in abdominal soft tissue, GI tract, and lung of children and young adult. The prediction of biological behavior is difficult. Cytogenetic study demonstrates ALK rearrangement in more than half cases. 2) Pseudomyogenic hemangioendothelioma is rarely metastasizing endothelial neoplasm. It was initially named as epithelioid sarcoma-like hemangioendothelioma and mimicking myoid tumor or epithelioid sarcoma. FLI1 and ERG are useful markers for this tumor. 3) Myoepithelioma predominantly involve lower or upper limb of young to middle aged adult. This intermediate tumor have broad spectrum of biological behavior, according to cytological atypia. 45% of the tumor shows EWSR1 rearrangement. 4) Malignant rhabdoid tumor is very aggressive tumor and it arises in the deep axial location, such as neck and paravertebral region of infants and children. Tumor cells show the loss of SMARCB1/INI1 protein expression and its gene alterations. 5) PEComa predominantly affects retroperitoneum, uterus and GI tract of female. Definitive criteria of malignant PEComa has not been established yet. The tumor with malignant histology shows aggressive biological behavior.
Article: Renal Pathology[Show abstract] [Hide abstract] ABSTRACT: Hypocomplementemic urticarial vasculitis syndrome (HUVS) is a rare immune-complex small vessel systemic vasculitis involving kidney in about 50% of patients. Characteristic clinical features are recurrent urticaria, decreased serum complement, skin vasculitis, arthritis, eye inflammation, abdominal pain, glomerulonephritis and positive anti-C1q antibodies. We report a 36-year-old woman with a 12-year history of recurrent urticaria and 2 years of urticarial vasculitis. On admission, she also had arthritis, pleuritis and pericarditis, abdominal pain, pathologic urinalysis, low serum values of C3, C4 and CH50. All immunoserology was negative except for ANA 1:80 and anti-C1q 620 IU. 'Full-house' immune complex vasculitis was demonstrated in skin and lung biopsies. A kidney biopsy showed diffuse proliferative segmental active and sclerosing glomerulonephritis with mesangial and endocapillary proliferation, neutrophil exudation, necrosis, extracapillary crescents and segmental and global glomerulosclerosis. 'Full-house' glomerular and extensive extraglomerular vascular and tubulointerstitial immune deposits with dominant IgG, C3 and C1q were noted by immunofluorescence. Electron microscopy revealed electron dense deposits with an ultrastructural 'fingerprint' pattern in the glomerular mesangium, transmembranous in capillary walls and in the arteriolar wall. Our patient fulfilled the criteria for HUVS and SLE, in accordance with the not infrequent clinical and immunoserological overlapping of the two diseases.
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