Abstract: Cross-site lung histopathology classification must account for stain variation, non-IID client data, missing classes, and the cost of adapting large pathology encoders. This study evaluates FedHisto-PAST v2 for three-way classification of adenocarcinoma (ACA), Normal, and squamous cell carcinoma (SCC). FedHisto-PAST v2 combines a frozen HIBOU-B foundation model with parameter-efficient adaptation, stain-conditioned paired-view prediction and feature consistency, reliability-aware prototype learning, and adaptive federated aggregation. Experiments used a five-client, non-IID, raw-data-local simulation with fixed internal evaluation, client-level analysis, component ablations, communication accounting, and a development-influenced exploratory LungHist700 cohort. All principal methods achieved near- ceiling internal performance, which limited discrimination on the fixed split. On LungHist700, FedHisto- PAST v2 achieved a Macro-F1 of 0.728560 and a balanced accuracy of 0.730454. Higher recognition of Normal and SCC was accompanied by lower ACA recall, and calibration remained imperfect. Prediction-level consistency was the only component with a clearly supported independent contribution in the external ablation analysis. Feature consistency and prototype regularization showed no conclusive independent overall gains in Macro-F1. The framework updated 1.253841% of the model parameters. The results provide exploratory cross-dataset evidence for stain-aware, parameter-efficient federation; they do not establish formal privacy, patient-level independence, prospective deployment, or clinical validation.
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