bluuebunny/crossref_metadata_2025 huggingface dataset:
Follow-up Findings for Women With Human Papillomavirus–Positive and Atypical Squamous Cells of Undetermined Significance Screening Test Results in a Large Women's Hospital Practice
Authors: Armah Henry , Austin R. Marshall , Dabbs David , Zhao Chengquan
Published: February 2021

Context.—Reflex human papillomavirus (HPV) testing has been designated in consensus guidelines as “preferred” for women with atypical squamous cells of undetermined significance (ASC-US) liquid-based cytology (LBC) results, and colposcopy is currently recommended for patients with HPV-positive ASC-US results. Data from large clinical practices using newer screening methods and current cytology terminology are limited.

Objectives.—We analyzed data from patients with ASC-US LBC and positive HPV test results. We also assessed the impact of the presence or absence of an endocervical cell/ transformation zone sample (EC/TZS) on biopsy diagnoses.

Design.—The information system of a large women's hospital serving an older-than-average population was searched over a 21-month period between July 1, 2005, and March 31, 2007, for HPV-positive cases interpreted as ASC-US (Bethesda System 2001) using computer-imaged LBC. Histologic diagnoses, patient ages, and presence or absence of an EC/TZS were analyzed. The average follow-up period was 7.5 months.

Results.—Among 4273 women with HPV-positive ASC-US results, the cumulative cervical intraepithelial neoplasia 2 or 3 (CIN 2/3) and CIN 1 rates for 2192 women with available biopsies were 5.1% and 43.6%, respectively. Cervical intraepithelial neoplasia 2/3 and CIN 1 rates for women with HPV-positive ASC-US results were not significantly different for women with and without an EC/TZS.

Conclusions.—The risk of CIN 2/3 in the study population was significantly lower than reported in widely cited trial data. Neither presence nor absence of an EC/TZS, nor the age of the patient, had a statistically significant impact on the likelihood of biopsy diagnoses of CIN 2/3 and CIN 1 for patients with HPV-positive ASC-US test results.
Circulating Tumor Cells From Well-Differentiated Lung Adenocarcinoma Retain Cytomorphologic Features of Primary Tumor Type
Authors: Marrinucci Dena , Bethel Kelly , Luttgen Madelyn , Bruce Richard H. , Nieva Jorge , Kuhn Peter
Published: February 2021

The detailed cytomorphologic appearance of circulating tumor cells (CTCs) in cancer patients is not well described, despite publication of multiple methods for enumerating these cells. In this case study, we present the cytomorphology of CTCs obtained from the blood of a woman with stage IIIB well-differentiated lung adenocarcinoma. Four years after she was diagnosed with her disease, 67 CTCs were identified in a blood sample using an immunofluorescent staining protocol and then subsequently stained with Wright-Giemsa. The cytomorphology of the CTCs was compared with the original tissue biopsy from 4 years prior. We found that CTCs and cells from the original biopsy had strikingly similar morphologic features, including large size in comparison to white blood cells and low nuclear to cytoplasmic ratios with voluminous cytoplasm. Careful cytomorphologic evaluation of CTCs will provide insights about the metastatic significance of these cells, which could yield widespread implications for the diagnosis, treatment, and management of cancer.
Basal-like Breast Carcinoma: A Phenotypically Distinct Entity
Authors: Haupt Bisong , Ro Jae Y. , Schwartz Mary R.
Published: February 2021

Gene microarray profiling of human breast carcinomas has recently categorized invasive breast carcinomas into 5 distinct subtypes; luminal A, luminal B, normal breastlike, human epithelial growth factor receptor 2 (HER2) overexpressing, and basal-like. Basal-like breast carcinomas are characterized by high expression of basal cytokeratins; low or absent expression of estrogen receptor, progesterone receptor, and HER2/neu; and expression of epidermal growth factor receptor (EGFR) and/or c-kit, and they are frequently associated with breast cancer 1 (BRCA1) mutations and poor clinical outcome. Recent studies have begun to provide insights into the molecular genetics, biology, morphology, and clinical outcome of this subtype of breast carcinoma. We reviewed the literature related to basal-like breast carcinomas to better understand this clinically significant subtype of breast carcinoma.
Diagnosis of Metastatic Neoplasms: Molecular Approaches for Identification of Tissue of Origin
Authors: Monzon Federico A. , Koen Tracie J.
Published: February 2021

Context

Tumors of uncertain or unknown origin are estimated to constitute 3% to 5% of all metastatic cancer cases. Patients with these types of tumors show worse outcomes when compared to patients in which a primary tumor is identified. New molecular tests that identify molecular signatures of a tissue of origin have become available.

Objective

To review the literature on existing molecular approaches to the diagnosis of metastatic tumors of uncertain origin and discuss the current status and future developments in this area.

Data Sources

Published peer-reviewed literature, available information from medical organizations (National Comprehensive Cancer Network), and other publicly available information from tissue-of-origin test providers and/or manufacturers.

Conclusions

Molecular tests for tissue-of-origin determination in metastatic tumors are available and have the potential to significantly impact patient management. However, available validation data indicate that not all tests have shown adequate performance characteristics for clinical use. Pathologists and oncologists should carefully evaluate claims for accuracy and clinical utility for tissue-of-origin tests before using test results in patient management. The personalized medicine revolution includes the use of molecular tools for identification/confirmation of the site of origin for metastatic tumors, and in the future, this strategy might also be used to determine specific therapeutic approaches.
Patient Misidentification in Laboratory Medicine: A Qualitative Analysis of 227 Root Cause Analysis Reports in the Veterans Health Administration
Authors: Dunn Edward J. , Moga Paul J.
Published: February 2021

Context

Mislabeled laboratory specimens are a common source of harm to patients, such as repeat phlebotomy; repeat diagnostic procedure, including tissue biopsy; delay in a necessary surgical procedure; and the execution of an unnecessary surgical procedure. Mislabeling has been estimated to occur at a rate of 0.1% of all laboratory and anatomic pathology specimens submitted.

Objective

To identify system vulnerabilities in specimen collection, processing, analysis, and reporting associated with patient misidentification involving the clinical laboratory, anatomic pathology, and blood transfusion services.

Design

A qualitative analysis was performed on 227 root cause analysis reports from the Veterans Health Administration. Content analysis of case reports from March 9, 2000, to March 1, 2008, was facilitated by a Natural Language Processing program. Data were categorized by the 3 stages of the laboratory test cycle.

Results

Patient misidentification accounted for 182 of 253 adverse events, which occurred in all 3 stages of the test cycle. Of 132 misidentification events occurring in the preanalytic phase, events included wrist bands labeled for the wrong patient were applied on admission (n  =  8), and laboratory tests were ordered for the wrong patient by selecting the wrong electronic medical record from a menu of similar names and Social Security numbers (n  =  31). Specimen mislabeling during collection was associated with “batching” of specimens and printed labels (n  =  35), misinformation from manual entry on laboratory forms (n  =  14), failure of 2-source patient identification for clinical laboratory specimens (n  =  24), and failure of 2-person verification of patient identity for blood bank specimens (n  =  20). Of 37 events in the analytic phase, relabeling all specimens with accession numbers was associated with mislabeled specimen containers, tissue cassettes, and microscopic slides (n  =  27). Misidentified microscopic slides were associated with a failure of 2-pathologist verification for cancer diagnosis (n  =  4), and wrong patient transfusions were associated with mislabeled blood products (n  =  3) and a failure of 2-person verification for blood products before release by the blood bank (n  =  3). There were 13 events in the postanalytic phase in which results were reported into the wrong patient medical record (n  =  8), and incompatible blood transfusions were associated with failed 2-person verification of blood products (n  =  5).

Conclusions

Patient misidentification in the clinical laboratory, anatomic pathology, and blood transfusion processes were due to a limited set of causal factors in all 3 phases of the test cycle. A focus on these factors will inform systemic mitigation and prevention strategies.
A Rare Case of Lipoprotein Glomerulopathy in a White Man: An Emerging Entity in Asia, Rare in the White Population
Authors: Boumendjel Redouane , Papari Mona , Gonzalez Miguel
Published: February 2021

Lipoprotein glomerulopathy is a rare entity that predominantly affects the Asian population, mainly the Japanese and Chinese. Lipoprotein glomerulopathy is clinically characterized by proteinuria and progression to renal failure and is caused by glomerular lipoprotein thrombi formation in association with increased levels of serum apolipoprotein E. The disease has a male predominance and can affect virtually any age group. We describe the third reported case, to our knowledge, of lipoprotein glomerulopathy to affect a white patient.
Activation-Induced Cytidine Deaminase Expression in Diffuse Large B-Cell Lymphoma With a Paracortical Growth Pattern: A Lymphoma of Possible Interfollicular Large B-Cell Origin
Authors: Aguilera Nadine S. , Auerbach Aaron , Barekman Carol L. , Lichy Jack , Abbondanzo Susan L.
Published: February 2021

Context.—Activation-induced cytidine deaminase, necessary for immunoglobulin somatic hypermutation and class switch recombination, is usually expressed within the follicular dendritic network but is also expressed in a population of interfollicular large B cells outside the germinal center.

Objective.—To report 7 cases of diffuse large B-cell lymphoma with a distinct paracortical distribution. Expression of activation-induced cytidine deaminase, previously described in interfollicular large B cells, was evaluated.

Design.—A panel of immunohistochemical markers, including double staining for activation-induced cytidine deaminase and CD20, was used to illustrate the cases. Molecular studies were performed by polymerase chain reaction in the paraffin-embedded tissue for t(14;18) chromosomal translocation and immunoglobulin heavy chain and T-cell receptor rearrangements.

Results.—Patients included 3 males and 4 females ranging in age from 11 to 59 years (mean, 39 years). All specimens were lymph nodes (4 from the groin, 2 from the neck, and 1 from the axilla). Malignant lymphocytes were positive for CD20 and negative for CD5 and CD10. Staining for CD30, CD43, and BCL-2 was variable. The malignant cells showed at least focal staining with activation-induced cytidine deaminase. All cases were found to be monoclonal by immunoglobulin heavy-chain gene rearrangement or showed light-chain restriction. None of the tested cases showed t(14;18).

Conclusions.—Diffuse large B-cell lymphoma with a paracortical distribution is unusual and may be a distinct morphologic variant. More study is necessary to determine the stage of B-cell development and the cell of origin of these tumors. However, activation-induced cytidine deaminase expression suggests they may arise from a putative interfollicular large B cell.