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肿瘤性内分泌病理学中的网状纤维框架评估

Reticulin Framework Assessment in Neoplastic Endocrine Pathology.

作者信息

Mortara Umberto, Orlando Giulia, Volante Marco, Papotti Mauro, Duregon Eleonora

机构信息

Pathology Unit, Città Della Salute E Della Scienza Hospital, Turin, Italy.

Department of Oncology, University of Turin, Orbassano, Turin, Italy.

出版信息

Endocr Pathol. 2025 Jun 4;36(1):21. doi: 10.1007/s12022-025-09867-y.


DOI:10.1007/s12022-025-09867-y
PMID:40465053
Abstract

The reticulin framework, composed mainly of type III collagen, is an essential structural component of biological tissues. Reticulin stains, particularly silver-based methods, enable detailed visualization of reticulin framework alterations, which have been proven to be quick, low-cost, and reliable solutions for highlighting quantitative and qualitative changes of reticulin framework and have been variably associated with neoplastic and non-neoplastic conditions. This review provides an updated overview of reticulin stain applications and reticulin framework assessment in endocrine and neuroendocrine neoplasms, including those of the pituitary, parathyroid, adrenal, and other neuroendocrine systems. In pituitary neuroendocrine tumors, reticulin framework loss serves as a distinguishing feature between normal and neoplastic adenohypophysis. Parathyroid neoplasms, including adenomas, atypical tumors, and carcinomas, exhibit varying degrees of reticulin framework disruption, which may aid in differential diagnosis. Similarly, in adrenocortical neoplasms, reticulin framework evaluation plays a crucial role in malignancy assessment, as defined in the reticulin algorithm, which incorporates reticulin framework alterations alongside three Weiss criteria: necrosis, high mitotic count (> 5/10 mm), and venous invasion. Moreover, specific reticulin framework patterns help to distinguish the different morphological subtypes of bilateral macronodular adrenocortical disease. Pheochromocytomas and paragangliomas display a range of reticulin framework patterns which might be related to the genetic background of the tumor. Finally, different neuroendocrine neoplasms exhibit variable reticulin framework integrity, with a more significant disruption observed in high-grade carcinomas. Advancements in digital pathology and artificial intelligence offer promising avenues for automated reticulin framework quantification, enhancing diagnostic precision and prognostic assessments. The integration of computational approaches may further improve the clinical utility of reticulin framework evaluation in endocrine pathology.

摘要

网状纤维框架主要由III型胶原蛋白组成,是生物组织的重要结构成分。网状纤维染色,特别是基于银的方法,能够详细观察网状纤维框架的改变,这些方法已被证明是突出网状纤维框架定量和定性变化的快速、低成本且可靠的解决方案,并与肿瘤性和非肿瘤性疾病存在不同程度的关联。本综述提供了网状纤维染色在内分泌和神经内分泌肿瘤中应用及网状纤维框架评估的最新概述,包括垂体、甲状旁腺、肾上腺及其他神经内分泌系统的肿瘤。在垂体神经内分泌肿瘤中,网状纤维框架缺失是正常腺垂体与肿瘤性腺垂体的一个区别特征。甲状旁腺肿瘤,包括腺瘤、非典型肿瘤和癌,表现出不同程度的网状纤维框架破坏,这可能有助于鉴别诊断。同样,在肾上腺皮质肿瘤中,网状纤维框架评估在恶性评估中起关键作用,如网状纤维算法所定义,该算法将网状纤维框架改变与三个Weiss标准(坏死、高有丝分裂计数(>5/10mm)和静脉侵犯)相结合。此外,特定的网状纤维框架模式有助于区分双侧大结节性肾上腺皮质疾病的不同形态亚型。嗜铬细胞瘤和副神经节瘤表现出一系列可能与肿瘤遗传背景相关的网状纤维框架模式。最后,不同的神经内分泌肿瘤表现出不同程度的网状纤维框架完整性,在高级别癌中观察到更明显的破坏。数字病理学和人工智能的进展为网状纤维框架的自动化定量提供了有前景的途径,提高了诊断准确性和预后评估。计算方法的整合可能进一步提高网状纤维框架评估在内分泌病理学中的临床应用价值。

相似文献

[1]
Reticulin Framework Assessment in Neoplastic Endocrine Pathology.

Endocr Pathol. 2025-6-4

[2]
Overview of the 2022 WHO Classification of Adrenal Cortical Tumors.

Endocr Pathol. 2022-3

[3]
The reticulin algorithm for adrenocortical tumor diagnosis: a multicentric validation study on 245 unpublished cases.

Am J Surg Pathol. 2013-9

[4]
Diagnosis of Adrenocortical Tumors by Reticulin Algorithm.

Indian J Endocrinol Metab. 2017

[5]
Diagnostic and prognostic assessments of adrenocortical carcinomas by pathological features, immunohistochemical markers and reticular histochemistry staining.

Diagn Pathol. 2024-5-27

[6]
Reticulin staining pattern in the differential diagnosis of benign parathyroid lesions.

J Endocrinol Invest. 2020-11

[7]
The Weiss score and beyond--histopathology for adrenocortical carcinoma.

Horm Cancer. 2011-12

[8]
Reticulin loss in benign fatty liver: an important diagnostic pitfall when considering a diagnosis of hepatocellular carcinoma.

Am J Surg Pathol. 2012-5

[9]
Rapid Reticulin Fiber Staining Method is Helpful for the Diagnosis of Pituitary Adenoma in Frozen Section.

Endocr Pathol. 2015-5

[10]
Diagnostic Utility of a Modified Reticulin Algorithm in Pediatric Adrenocortical Neoplasms.

Am J Surg Pathol. 2024-3-1

本文引用的文献

[1]
Somatic Molecular Heterogeneity in Bilateral Macronodular Adrenocortical Disease (BMAD) Differs Among the Pathological Subgroups.

Endocr Pathol. 2024-9

[2]
Hot Trends in Pheochromocytoma and Paraganglioma: Are We Getting Closer to Personalized Dynamic Prognostication?

Turk Patoloji Derg. 2024

[3]
Diagnostic Utility of a Modified Reticulin Algorithm in Pediatric Adrenocortical Neoplasms.

Am J Surg Pathol. 2024-3-1

[4]
Cutting-edge technology and automation in the pathology laboratory.

Virchows Arch. 2024-4

[5]
Revolutionizing Digital Pathology With the Power of Generative Artificial Intelligence and Foundation Models.

Lab Invest. 2023-11

[6]
Reticular fibre structure in the differential diagnosis of parathyroid neoplasms.

Diagn Pathol. 2023-7-4

[7]
Necrosis in lymph nodes and their differential diagnoses: application of reticulin staining.

Virchows Arch. 2024-7

[8]
Artificial intelligence-based reticulin proportionate area - a novel histological outcome predictor in hepatocellular carcinoma.

Histopathology. 2023-10

[9]
Impact of Morphology in the Genotype and Phenotype Correlation of Bilateral Macronodular Adrenocortical Disease (BMAD): A Series of Clinicopathologically Well-Characterized 35 Cases.

Endocr Pathol. 2023-6

[10]
Deep learning-enabled virtual histological staining of biological samples.

Light Sci Appl. 2023-3-3

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