{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T11:57:55Z","timestamp":1780487875419,"version":"3.54.1"},"reference-count":52,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Clin Pathol"],"accepted":{"date-parts":[[2024,9,5]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Evaluation of \u2018alternative\u2019 vascularisation in human cancer is considered an important prognostic parameter; the 2022 WHO classification of parathyroid tumours despite progresses in clinical triaging of patients strongly emphasises new histopathological parameters to properly stratify these lesions. \u2018Alternative\u2019 and \u2018classic\u2019 vessels were here investigated for the first time in parathyroid tumours for their possible histopathological and clinical relevance during progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a double CD31\/PAS staining, microvessel density (MVD, \u2018classic\u2019 CD31+ vessels), mosaic vessel density (MoVD, \u2018alternative\u2019 CD31+\/\u2212vessels) and vessel mimicry density (VMD, \u2018alternative\u2019 CD31\u2212\/PAS+ vessels) were evaluated in 4 normal parathyroid glands (N), 50 Adenomas (A), 35 Atypical Tumours (AT) and 10 Carcinomas (K).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with N, MVD significantly increased in A (p=0.012) and decreased in K (p=0.013) with vessel counts lower than in AT and A (p&lt;0.001). MoVs and VMs, absent in normal tissue, were documented in non-benign parathyroid lesions (AT, K) (p&lt;0.001), with MoVs and VMs most represented in AT and K, respectively (p&lt;0.001), in peripheral growing areas. Vessel distribution was correlated to neoplastic progression (r=\u22120.541\u2009MVD; r=+0.760\u2009MoVD, r=+0.733\u2009VMD), with MVD decrease in AT and K inversely related to MoVD and VMD increase (r=\u22120.503\u2009and r=\u22120.456).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\u2018Alternative\u2019 vessel identification in parathyroid tumours is crucial because it: (1) explains the paradox of non-angiogenic tumours, consisting in a new bloody non-endothelial vessel network and (2) helps pathologists to unmask worrisome lesions. Furthermore, detection of alternative vascular systems in human tumours might explain the limited success of antiangiogenic therapies and encourage new oncological studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jcp-2024-209703","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T13:20:40Z","timestamp":1726579240000},"page":"830-835","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Vascular mimicry and mosaic vessels in parathyroid tumours: a new diagnostic approach?"],"prefix":"10.1136","volume":"78","author":[{"given":"Monica","family":"Falleni","sequence":"first","affiliation":[{"name":"Unit of Pathology, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1876-0487","authenticated-orcid":false,"given":"Matteo","family":"Dal Lago","sequence":"additional","affiliation":[{"name":"Unit of Pathology, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delfina","family":"Tosi","sequence":"additional","affiliation":[{"name":"Unit of Pathology, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Ghilardi","sequence":"additional","affiliation":[{"name":"Surgical Unit, Department of Health Sciences, University of Milan, ASST Santi Paolo e Carlo, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana","family":"De Pasquale","sequence":"additional","affiliation":[{"name":"U.O.S. 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