Celiac disease is a chronic, immune-mediated enteropathy precipitated by gluten exposure in genetically predisposed individuals, with a global prevalence of approximately 1%. Though diagnostic workflows incorporate serologic techniques with both histologic and genetic evaluation, each approach carries key pitfalls that contribute to diagnostic inaccuracy. Serology testing is limited by selective immunoglobulin A deficiency and low-titer antibodies, in addition to interlaboratory variability of calibration standards and specimen concentrations. While duodenal biopsy is considered the gold standard for celiac diagnosis, patchy villous atrophy (e.g., ultrashort celiac disease) mimics other enteropathies, and the inherent subjectivity of histologic interpretation can compromise accuracy. Furthermore, celiac predisposition is highly correlated with two human leukocyte antigen (HLA) alleles, HLA-DQ2 and HLA-DQ8. However, nearly 30–40% of the general population expresses one of these alleles, thus introducing the risk of overdiagnosis and limiting the practical implications of genetic testing. There exist special celiac presentations, such as seronegative or potential celiac disease, overlap syndromes, and enteropathy-associated T-cell lymphoma, that introduce additional challenges to diagnostic success. The serologic-histologic discordance and nonspecific symptoms associated with these cases may require divergence from the traditional workflow, as well as supplemental investigations, such as a gluten challenge or breath testing, to confirm a celiac diagnosis. These challenges in celiac diagnosis have driven research into novel biomarkers and molecular assays that can not only enable earlier, more accurate detection but also provide longitudinal disease monitoring. Such markers include intestinal fatty acid-binding proteins, specific microRNA expression, and microbiome signatures that are strongly linked to celiac disease, which may one day serve as adjunctive screening tools to optimize diagnostic yield. This narrative review identifies the key pitfalls in adult celiac disease diagnosis — from pre-analytic serology issues to patchy histology and overinterpretation of HLA — and proposes a guideline-aligned, stepwise algorithm (with emerging biomarkers) to enhance accuracy and reduce missed or delayed cases. Ultimately, continued refinement of a comprehensive, multimodal diagnostic strategy that can integrate with emerging molecular tools is necessary for overcoming the current limitations of individual approaches to celiac diagnosis.

Glioblastoma (GBM) is the most prevalent and aggressive form of primary brain malignancy in adults. Despite continuous advancements in standard treatment modalities, the prognosis for patients remains extremely poor, with a median survival of less than two years. In recent years, chimeric antigen receptor T-cell (CAR-T) therapy has achieved revolutionary success in hematologic malignancies, marking a significant breakthrough in the field of immunotherapy. However, the successful application of CAR-T therapy to GBM still faces dual challenges: antigen heterogeneity and the immunosuppressive tumor microenvironment. This review systematically summarizes these challenges encountered in CAR-T therapy for GBM and the innovative strategies currently under development to address these challenges, providing insights for the future clinical translation of CAR-T therapy in GBM.

Mesonephric carcinoma (MC) is a rare type of cervical carcinoma that arises from mesonephric remnants. It is characterized by a mixture of a wide variety of growth patterns and typically exhibits positive immunoreactivity for GATA binding protein 3, thyroid transcription factor 1, and apical common acute lymphoblastic leukemia antigen. A subset of adenocarcinomas in the uterine corpus and ovary with similar morphology and immunophenotype is classified as mesonephric-like adenocarcinoma (MLA) in the current World Health Organization classification. This review aimed to summarize the clinicopathological features of mesonephric remnants, mesonephric hyperplasia, and MC, provide an update on the current understanding of MLA, and highlight the molecular differences between MC and MLA.

A literature review was conducted on mesonephric remnants, mesonephric hyperplasia, MC, and MLA. The clinicopathological and molecular features were summarized from previously published studies and compared across these entities.

Both MC and MLA exhibit a mixture of growth patterns and show immunoreactivity for GATA binding protein 3, thyroid transcription factor 1, and common acute lymphoblastic leukemia antigen. They commonly harbor genetic alterations in KRAS and NRAS. However, key differences exist between these two entities. MC is associated with mesonephric remnants, whereas no such association has been identified for MLA. Additionally, although KRAS and NRAS mutations are common in both, a subset of MLA cases also harbors PIK3CA and/or PTEN mutations, genetic alterations commonly seen in endometrioid adenocarcinoma.

Although the exact pathogenesis of MLA remains unclear, it is favored to originate from Müllerian-derived epithelium undergoing differentiation along the mesonephric pathway, rather than from true mesonephric remnants. Both MC and MLA tend to follow a relatively aggressive clinical course, underscoring the importance of accurate diagnosis.

Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) is essential for non-invasively investigating brain function. However, conventional fMRI methods are limited by low spatial and temporal resolution. This narrative review evaluates recent advancements in deep learning techniques for high-resolution BOLD-fMRI reconstruction, focusing on super-resolution, segmentation, and image registration. A comprehensive literature search was conducted across PubMed, IEEE, Scopus, and Web of Science databases for the period 2000–2023. Studies employing deep learning methods, including convolutional neural networks, transformer-based models, and generative adversarial networks for super-resolution, segmentation, and registration of BOLD-fMRI, were included. Deep learning approaches demonstrated significant improvements in spatial resolution, segmentation accuracy, and registration robustness. Convolutional neural network-based models, particularly generative adversarial networks, notably improved image reconstruction quality and detail preservation. Preliminary studies targeting specific brain regions such as the cerebellum and hippocampus showed promise; however, systematic evaluations across broader brain areas and large-scale clinical validations remain limited. While deep learning techniques have led to substantial advancements in high-resolution BOLD-fMRI reconstruction, future research should focus on standardized protocols, multi-center validation, and improving computational efficiency and model generalization to enhance clinical utility.

Craniopharyngioma (CP), although histologically benign, is a surgically challenging sellar-region tumor for which stereotactic irradiation is increasingly used as an alternative or adjuvant strategy. This review summarizes the role of stereotactic radiosurgery (SRS) in managing CP, with a focus on treatment outcomes, technical advances, and emerging strategies to support evidence-based clinical practice. Literature reports indicate that Gamma Knife radiosurgery achieves variable tumor control rates (36–100%), with optimal outcomes (79.6–91.4%) when marginal doses ≥12 Gy are delivered and patients receive adequate follow-up. Smaller tumors (<5 cm3) and those with higher solid components show particularly favorable outcomes. SRS demonstrates a favorable safety profile, with visual impairment occurring in approximately 4% of cases and endocrine dysfunction in 6%. Compared to conventional radiotherapy, SRS significantly reduces the risk of hypothalamic obesity in pediatric patients. The identification of BRAF mutations in papillary CPs has created novel opportunities for combining targeted therapies with SRS. Collectively, these advances underscore the role of SRS as an essential component of multidisciplinary CP management, particularly in the treatment of residual or recurrent lesions. It offers a more favorable toxicity profile and may improve quality of life outcomes compared to conventional radiotherapy. Further studies are needed to optimize patient selection, dosing strategies, and integration with novel systemic therapies.

Insulinoma is a neuroendocrine tumor originating in the pancreas that secretes excess amounts of insulin, leading to severe hypoglycemia. The clinical presentation of hypoglycemia is classically described by Whipple’s Triad. Due to the rarity of this diagnosis, it can often be mistaken for other etiologies with similar presentations. In this paper, we present the case of a woman in her 70s with metastatic insulinoma involving the liver, who was initially diagnosed with an insulin-like growth factor 2-secreting hepatocellular carcinoma. Biochemical and immunohistochemical analyses were instrumental in distinguishing between these two etiologies.

Colorectal cancer (CRC) is a type of cancer that originates in the colon or rectum from precancerous polyps, which can evolve into cancerous growths over time. This review aimed to provide a comprehensive analysis of CRC, its subtypes, clinical manifestations, point-of-care diagnostic approaches, and management strategies. The clinical presentation of CRC often includes symptoms such as blood in stool, changes in bowel habits, abdominal discomfort, weight loss, fatigue, a feeling of incomplete bowel emptying, and anemia. The identification of these signs prompts healthcare professionals to initiate diagnostic measures without delay. Point-of-care diagnosis plays a pivotal role in the early detection of CRC, employing screening tests such as stool tests and colonoscopies. These diagnostic modalities enable healthcare professionals to identify precancerous polyps or early-stage tumors, facilitating timely intervention and significantly improving treatment outcomes. Adherence to screening guidelines is crucial for the prevention and early detection of CRC. Despite advancements in screening and treatment options, there remains a crucial need for more specific, minimally invasive screening methods with minimal side effects. By improving current detection methods, a better screening approach for CRC can be developed. Recent advancements, including single-cell sequencing, spatial transcriptomics, and artificial intelligence integration, hold great promise for enhancing early diagnosis and advancing personalized treatment strategies. Moreover, a healthy lifestyle, including a balanced diet, regular exercise, no tobacco use, and limited alcohol consumption, can significantly lower the risk of CRC. By emphasizing the importance of lifestyle modifications, early screening, and timely intervention, healthcare professionals can significantly reduce the burden of CRC and improve patient outcomes.

Primary biliary cholangitis (PBC) is a chronic progressive autoimmune disorder characterized by small non-purulent intrahepatic bile duct destruction (ductopenia) and cholestasis. While the etiology of PBC remains unclear, it is believed to involve genetic-environmental interactions. Emerging evidence highlights gut microbiota dysbiosis in PBC patients, with increased symbiotic bacteria and decreased pathogenic bacteria. Microbial alterations potentially influence disease pathogenesis through multiple mechanisms, including immune dysregulation, intestinal barrier damage, BA metabolic dysregulation, and cholestasis. These findings suggest that the gut microbiota can serve not only as a non-invasive biomarker for diagnosis and prognosis evaluation but also as a therapeutic target for the disease. In this review, we summarize changes in PBC patients’ gut microbiota, explain how these changes affect disease occurrence and development, and discuss treatment methods with potential clinical value that intervene in gut microbiota.

Soft tissue cytopathology plays a vital role in the diagnosis and management of soft tissue neoplasms, necessitating a standardized classification system to improve diagnostic accuracy and guide clinical decision-making. This article provides a concise review of the World Health Organization (WHO) Reporting System for Soft Tissue Cytopathology and presents a practical diagnostic approach to soft tissue cytopathology.

The WHO Reporting System is reviewed in conjunction with relevant literature. The reporting system employs a six-category framework: non-diagnostic, benign, atypical, soft tissue neoplasm of uncertain malignant potential, suspicious for malignancy, and malignant.

Each category is associated with a corresponding risk of malignancy and recommended clinical management guidelines. This classification aligns with the WHO Classification of Soft Tissue and Bone Tumours (5th edition) and incorporates cytomorphologic features, ancillary studies, and clinical correlation to enhance diagnostic reproducibility and communication among pathologists and clinicians. The system supports a probabilistic approach to risk stratification, enabling more consistent diagnostic and therapeutic strategies.

This framework provides a robust foundation for the interpretation of soft tissue fine-needle aspiration biopsies and optimized patient care.