Nineteen breast pathologists agreed only moderately on phyllodes features, and training barely helped

The edition in brief

An agreement study of 19 subspecialist breast pathologists found only moderate agreement on the features that grade phyllodes tumours: stromal cellularity (two-tier κ 0.675), stromal atypia (κ 0.446, poor on a three-tier scale) and tumour border (κ 0.532). Structured virtual training changed little except to make most pathologists more conservative. Targeted sequencing of pancreatic tumours in Korea found homologous-recombination-deficiency alterations (BRCA1/2, ATM, FANCD2) in seven of eight acinar cell carcinomas, a possible but untested target for PARP inhibitors, while amphicrine-like acinar carcinomas were molecularly mixed. A Norwegian cohort of 423 adults with mean 25-hydroxyvitamin D of 34 nmol/L found no one with the full biochemical triad of osteomalacia; the most permissive pattern reached 8.3%, and vitamin D lowered PTH and alkaline phosphatase in a nested trial. A Chinese study of 20 patients with suspected 21-hydroxylase deficiency found long-read sequencing resolved chimeras, novel deletions and '2+0' carriers that MLPA and related methods missed. Today's pearl covers pre-analytical causes of a high potassium.