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ArticleEndocrine pathology2026

Validation of the Reticulin Algorithm for Adrenocortical Neoplasms: Assessing Diagnostic Accuracy Across All Age Groups and Histological Subtypes.

Hemlata Jangir, Sanjay Sriram, Sonali Dixit, Shipra Agarwal, Sameer Rastogi, Jagdish Prasad Meena, Yashdeep Gupta, Rajni Sharma, Rajeev Kumar, Om Prakash and 4 more

Abstract readValidation Study
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In one paragraph

Article in Endocrine pathology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Hemlata JangirDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.ORCID http://orcid.org/0000-0002-8357-8347
Sanjay SriramDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.ORCID http://orcid.org/0000-0002-4966-1518
Sonali DixitDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.ORCID http://orcid.org/0000-0002-6153-7421
Shipra AgarwalDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India. drshipra0902@gmail.com.ORCID http://orcid.org/0000-0001-7037-4444
Sameer RastogiDepartment of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
Jagdish Prasad MeenaDepartment of Pediatric Oncology, All India Institute of Medical Sciences, New Delhi, India.ORCID http://orcid.org/0000-0001-6024-9762
Yashdeep GuptaDepartment of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India.
Rajni SharmaDivision of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Rajeev KumarDepartment of Urology, All India Institute of Medical Sciences, New Delhi, India.
Om PrakashDepartment of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
Vishesh JainDepartment of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.ORCID http://orcid.org/0000-0002-9273-097X
Sandeep AgarwalaDepartment of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Mehar Chand SharmaDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.ORCID http://orcid.org/0000-0002-7935-6047
Venkateswaran K IyerDepartment of Pathology, All India Institute of Medical Sciences, New Delhi, 110029, India.ORCID http://orcid.org/0000-0003-1933-7562

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Adrenocortical carcinoma is a rare and clinically heterogeneous malignancy, often posing difficulty in accurate prognostication. Existing clinicopathological scoring systems, the Weiss, AFIP/Wieneke, and Lin-Weiss-Bisceglia (LWB) criteria, are constrained by their age/subtype-specific applicability and are not suitable for evaluating the rare myxoid and sarcomatoid morphologies or needle biopsies. The Reticulin Algorithm (RA) is a simplified approach for the histopathological assessment of adrenocortical neoplasms, but its prognostic utility requires further validation. We evaluated the prognostic performance of RA and its pediatric-adaptation (pRA) in 157 adrenocortical neoplasms, comprising 140 resection specimens and 17 needle biopsies from 118 adult and 39 pediatric patients, representing all histomorphological subtypes. Among adult tumors, the RA demonstrated diagnostic accuracy exceeding 90%, comparable to the Weiss system but with higher specificity and a markedly superior positive likelihood ratio, highlighting its stronger prognostic value. Its greatest impact was observed in oncocytic tumors, where it outperformed the LWB criteria and correctly reclassified most lesions previously designated as having uncertain malignant potential. In pediatric cases, RA’s performance was comparable to the AFIP/Wieneke criteria. Notably, pRA further improved predictive precision. All myxoid and sarcomatoid tumors were appropriately classified using the algorithm. RA application to needle biopsies showed complete concordance with clinical outcomes. Survival analyses confirmed significant stratification between RA-defined benign and malignant groups. In this large single-center study, RA demonstrated broad applicability and prognostic utility across age groups, histologic subtypes, and specimen types, supporting its potential role in risk stratification of adrenocortical neoplasms.

Indexed as

Adrenal Cortex NeoplasmsAdrenocortical CarcinomaAlgorithmsReticulinAdolescentAdultAgedAged, 80 and overChildChild, PreschoolFemaleHumansInfantMaleMiddle AgedPrognosisReticulinAdrenocortical neoplasmAFIP/Wieneke scoreLin-Weiss-Bisceglia criteriaPediatric Adrenocortical NeoplasmPrognosticationReticulin algorithmWeiss criteria

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.