{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:07:32Z","timestamp":1788826052076,"version":"build-2803163510"},"reference-count":29,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"William L. Roberts Memorial fund at ARUP Laboratories","award":["Project ID 553-Ornstead-03.17.23"],"award-info":[{"award-number":["Project ID 553-Ornstead-03.17.23"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>\n                    A clinical algorithm originally proposed by van Nederveen et al. recommends that succinate dehydrogenase B immunohistochemical testing (SDH IHC) be performed on all pheochromocytomas and paragangliomas to screen for SDH deficiency, with abnormal staining (loss) referred to genetic counselors for confirmatory testing. However, the interpretation of SDHB IHC is challenging, with frequent partial staining or weak diffuse expression. This study sought to better characterize atypical SDHB IHC staining patterns in patients with genetically confirmed germline pathogenic or likely pathogenic variants involving SDH subunit (\n                    <jats:italic toggle=\"yes\">SDHx<\/jats:italic>\n                    ) genes. The cohort was identified from patients with known\n                    <jats:italic toggle=\"yes\">SDHx<\/jats:italic>\n                    germline pathogenic or likely pathogenic variants within the familial cancer assessment and paraganglioma clinic of an academic tertiary medical center. Fifty-seven SDH-related tumors were identified (paraganglioma, pheochromocytoma, renal cell carcinoma, gastrointestinal stromal tumor, and seminoma) and stained with the SDHB immunohistochemical stain (polyclonal anti-SDHB antibody, Sigma Aldrich, HPA002868). Fourteen control specimens were identified from similar tumors. Stained slides were analyzed by a subspecialty genitourinary pathologist and a medical student completing a postsophomore fellowship in pathology. Twenty-eight of 57 tumors (49%) showed aberrant retained staining, divided into 4 observable staining patterns: fine granular staining\/blush (9\/28 abnormally staining tumors), focal retention (15\/28), retained staining weaker than internal control (2\/28), and retained staining either equal to internal control or without internal control present (2\/28). We recognize the clinical utility of SDHB IHC as an affordable, but nuanced, method for screening for\n                    <jats:italic toggle=\"yes\">SDHx<\/jats:italic>\n                    pathogenic or likely pathogenic variants and recommend subsequent genetic testing for any amount of abnormally lost staining.\n                  <\/jats:p>","DOI":"10.1177\/10668969261439732","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T18:31:33Z","timestamp":1776277893000},"page":"1737-1747","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Expression Patterns of Succinate Dehydrogenase B: An Immunohistochemical Study of 57 Tumors With Known\n                    <i>SDHx<\/i>\n                    Germline Pathogenic Alterations"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2545-5426","authenticated-orcid":false,"given":"Michael Jared","family":"Ornstead","sequence":"first","affiliation":[{"name":"University of Utah, Huntsman Cancer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0848-4172","authenticated-orcid":false,"given":"Deepika","family":"Sirohi","sequence":"additional","affiliation":[{"name":"University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Albertson","sequence":"additional","affiliation":[{"name":"University of Utah, Huntsman Cancer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha E.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathon","family":"Mahlow","sequence":"additional","affiliation":[{"name":"University of Utah, Huntsman Cancer Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-013-2942-5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-1498"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbabio.2011.07.003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAI.0b013e31828bfdd3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrc3648"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1530\/erc-24-0111"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.1461"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70164-0"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2009.12.005"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.13277"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2015.41"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.11381"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/biology10070677"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.14681"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-013-9269-4"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21186950"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2017.10.013"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000001792"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12869"},{"key":"e_1_3_2_21_2","unstructured":"National Comprehensive Cancer Network. Neuroendocrine and Adrenal Tumors (Version 2.2025). National Comprehensive Cancer Network; 2025. Accessed September 26 2025. https:\/\/www.nccn.org\/guidelines\/guidelines-detail?category=1&id=1448"},{"key":"e_1_3_2_22_2","unstructured":"Centers for Medicare & Medicaid Services. Clinical Laboratory Fee Schedule. Published online September 26 2024. Accessed October 11 2025. https:\/\/www.cms.gov\/medicare\/payment\/fee-schedules\/clinical-laboratory-fee-schedule-clfs"},{"key":"e_1_3_2_23_2","unstructured":"Continuing Appropriations and Extensions Act 2025. 2025:139 Stat. 9. https:\/\/www.congress.gov\/118\/plaws\/publ83\/PLAW-118publ83.pdf"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-25-00716"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP15725.OR"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1136\/jmedgenet-2020-107656"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.8.943"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/jmedgenet-2017-105127"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2009.02111.x"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10689-009-9234-z"}],"container-title":["International Journal of Surgical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10668969261439732","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10668969261439732","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10668969261439732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:17:48Z","timestamp":1788823068000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10668969261439732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":29,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/10668969261439732"],"URL":"https:\/\/doi.org\/10.1177\/10668969261439732","relation":{},"ISSN":["1066-8969","1940-2465"],"issn-type":[{"value":"1066-8969","type":"print"},{"value":"1940-2465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,15]]}}}