bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nonneoplastic Alterations of the Mammary Epithelium Can Mimic Atypia
Authors: Murray Melissa 
Published: February 2021

Abstract
Context.—The pathologist evaluating breast biopsy specimens sometimes encounters nonneoplastic alterations of the mammary epithelium that raise the differential diagnosis of atypia. Because the identification of atypical ductal hyperplasia of the breast has significant clinical implications, it is important to correctly recognize its nonneoplastic morphologic mimics.
Objective.—To highlight a spectrum of physiologic and treatment-related changes that can occur in the mammary epithelium and to discuss the differential diagnosis with true atypia.
Data Sources.—A comprehensive review of the published English literature on physiologic and treatment-related changes of the breast epithelium was performed.
Conclusions.—Among physiologic alterations of the ductal epithelium, luteal-phase changes and secretory changes can sometimes be overinterpreted as atypical. Treatment-related changes, secondary to chemotherapy and radiation, can pose a major diagnostic challenge and their misinterpretation as neoplastic carries major clinical consequences. Familiarity with the morphology of both physiologic and treatment-related alterations of the mammary epithelium is essential to avoid misdiagnosis.
Detection, Distribution, and Pathologic Significance of BK Virus Strains Isolated From Patients With Kidney Transplants, With and Without Polyomavirus-Associated Nephropathy
Authors: Boldorini Renzo , Allegrini Sara , Miglio Umberto , Paganotti Alessia , Veggiani Claudia 
Published: February 2021

Abstract
Context.—BK virus strains or regulatory region sequence variations may play a role in the pathogenesis of polyomavirus-associated nephropathy (PVAN), although no definite relationship has yet been demonstrated.
Objective.—To investigate the pathologic significance of BK virus strains and regulatory region sequence variations.
Design.—Eight (3.5%) of 226 patients with renal transplants developed PVAN; the remaining 218 cases were used as controls. From the patients who developed PVAN, 70 urine samples, 63 blood samples, and 17 renal biopsy samples were taken, and 682 urine samples, 677 blood samples, and 101 renal biopsy samples were taken from the control cases. Amplification and sequence analyses of regulatory region were obtained, and the sequences were analyzed using the Basic Local Alignment Search Tool program.
Results.—The WWT strain was more frequently detected in PVAN cases than in the control cases (urine: 88.5% vs 22.1%; blood: 85.2% vs 40%; renal biopsies: 77.8% vs 0%), and the AS and WW strains were only isolated from controls. Strain 128-1 was frequently associated with JC virus coinfection in both groups (PVAN: 78.3%; controls: 98%). Major WWT rearrangements were detected in 29.6% of the urine samples, 30.4% of the blood samples, and one renal biopsy from the PVAN cases, but in only one urine sample from the controls. Insertion of 8 base pairs (P block) was found in all 128-1 strains; WW and AS were archetypal in 78.9% and 57.7% of the samples, respectively.
Conclusions.—Although the study included only 8 PVAN cases, regulatory region sequence variations seem to be frequent and independent of the development of the disease, and the WWT strain seems more frequently related to the development of nephropathy than other strains.
Teaching Pediatric Laboratory Medicine to Pathology Residents
Authors: Pysher Theodore J. , Bach Philip R. , Geaghan Sharon M. , Hamilton Marilyn S. , Laposata Michael , Lockitch Gillian , Brugnara Carlo , Coffin Cheryl M. , Pasquali Marzia , Rinaldo Piero , Roberts William L. , Rutledge Joe C. , Ashwood Edward R. , Blaylock Robert C. , Campos Joseph M. , Goldsmith Barbara , Jones Patricia M. , Lim Megan , Meikle A. Wayne , Perkins Sherrie L. , Perry Deborah A. , Petti Cathy A. , Rogers Beverly B. , Steele Paul E. , Weiss Ronald L. , Woods Gail 
Published: February 2021

AbstractContext.—Laboratory data are essential to the medical care of fetuses, infants, children, and adolescents. However, the performance and interpretation of laboratory tests on specimens from these patients, which may constitute a significant component of the workload in general hospitals and integrated health care systems as well as specialized perinatal or pediatric centers, present unique challenges to the clinical pathologist and the laboratory. Therefore, pathology residents should receive training in pediatric laboratory medicine.Objective.—Children's Health Improvement through Laboratory Diagnostics, a group of pathologists and laboratory scientists with interest and expertise in pediatric laboratory medicine, convened a task force to develop a list of curriculum topics, key resources, and training experiences in pediatric laboratory medicine for trainees in anatomic and clinical pathology or straight clinical pathology residency programs and in pediatric pathology fellowship programs.Data Sources.—Based on the experiences of 11 training programs, we have compiled a comprehensive list of pediatric topics in the areas of clinical chemistry, endocrinology, hematology, urinalysis, coagulation medicine, transfusion medicine, immunology, microbiology and virology, biochemical genetics, cytogenetics and molecular diagnostics, point of care testing, and laboratory management. This report also includes recommendations for training experiences and a list of key texts and other resources in pediatric laboratory medicine.Conclusions.—Clinical pathologists should be trained to meet the laboratory medicine needs of pediatric patients and to assist the clinicians caring for these patients with the selection and interpretation of laboratory studies. This review helps program directors tailor their curricula to more effectively provide this training.
Current Techniques Used for the Radiologic Assessment of Intracranial Neoplasms
Authors: Debnam J. Matthew , Ketonen Leena , Hamberg Leena M. , Hunter George J. 
Published: February 2021

Abstract
Context.—Radiologic studies are obtained for diagnostic and treatment planning purposes in the evaluation of patients with intracranial neoplasms. These studies are discussed at radiology/pathology working conferences and are often beneficial in the analysis of pathologic specimens for tissue diagnosis. Therefore, clinical pathologists should be aware of the current and evolving imaging techniques that are used in the radiologic assessment of intracranial neoplasms.
Objective.—To describe the imaging techniques used in the assessment of intracranial neoplasms and provide current references.
Data Sources.—We searched PubMed for articles published between 1995 and 2006 and also reviewed several textbooks on intracranial neoplasms, to prepare a discussion of basic modalities such as computed tomography (CT) and magnetic resonance (MR) imaging as well as advanced imaging techniques such as CT and MR angiography and venography, CT and MR perfusion, MR spectroscopy, functional MR imaging, and positron emission tomography.
Conclusions.—Knowledge of currently used imaging techniques for the assessment of intracranial neoplasms will assist the clinical pathologist in communications with neuroradiologists, surgeons, and referring clinicians. This review will also aid the pathologist in understanding the new and rapidly evolving imaging techniques that will likely become the standard of care in the future.
Safe Handling and Administration of Blood Components: Review of Practical Concepts
Authors: Osby Melanie A. , Saxena Sunita , Nelson Janice , Shulman Ira 
Published: February 2021

Abstract
Context.—The more advanced we become, the more evident are the infectious and noninfectious risks of the blood supply. Infectious risks are somewhat straightforward and are addressed by implementing stricter donor criteria and testing. The noninfectious risks, however, are more complicated. Each step in the transfusion process, beginning with the physician who orders a transfusion to the actual transfusion of the component, is subject to adverse outcomes and increases the noninfectious risks of transfusion. The challenges to provide the safest blood possible with zero risk have resulted in the implementation of stringent standards from both the American Association of Blood Banks and the Joint Commission on Accreditation of Healthcare Organizations.
Objective.—A series of case scenarios serve as the basis for discussion of the risks, which affect the safety and administration of blood components, inherent in the transfusion process.
Data Sources.—Journals, textbooks, Internet.
Conclusions.—The transfusion process is a complex multistep process with inherent risks. Infectious risks of transfusion are being adequately addressed such that the noninfectious risks of transfusion are becoming much more evident. Patient safety can be compromised if each step of the transfusion process is not completed according to established policies and procedures at each individual institution.
Pathology Services in Developing Countries—The West African Experience
Authors: Adeyi Oyedele A. 
Published: February 2021

Abstract
Context.—Histopathology, like other branches of medicine in West Africa, has suffered largely from economic, political, social, and infrastructural problems, becoming a shadow of the top quality that had been obtained in the past. To address the prevailing problems, one needs to attempt defining them.
Objective.—The existing structure of training and practice are discussed, highlighting the author's perception of the problems and suggesting practical ways to address these while identifying potential roles for North American pathology organizations.
Design.—The author's past and ongoing association with pathology practice in Nigeria forms the basis for this review.
Results.—Pathology practice is largely restricted to academic medical centers. The largest of academic centers each accession around 4000 or fewer surgical specimens per year to train 9 to 12 residents. Histopathology largely uses hematoxylin-eosin routine stains, sometimes with histochemistry but rarely immunohistochemistry. Pathologists depend largely on their skills in morphology (with its limitations) to classify and subclassify tumors on routine stains, including soft tissue and hematolymphoid malignancies. Immunofluorescence, intraoperative frozen section diagnosis, electronic laboratory system, and gross and microscopic imaging facilities are generally not available for clinical use.
Conclusion.—The existing facilities and infrastructure can be augmented with provision of material and professional assistance from other pathology associations in more developed countries and should, among other things, focus on supplementing residency education. Virtual residency programs, short-visit observerships, development of simple but practical laboratory information systems, and closer ties with pathologists in these countries are some of the suggested steps in achieving this goal.
Pulmonary Preneoplasia
Authors: Dacic Sanja 
Published: February 2021

Abstract
Context.—Improved screening techniques for lung cancer have resulted in detection of lesions that are considered to represent precursors of invasive lung carcinomas. These lesions may cause a diagnostic dilemma particularly on small biopsy or cytology specimens. Ancillary studies are usually not helpful, and diagnosis is based on morphology alone. Recognition of these lesions is very important to prevent potential diagnostic mistakes that may result in inadequate patient management. Future molecular studies may provide clinically useful diagnostic and prognostic gene markers.
Objective.—To review currently proposed morphologic criteria for precursor lesions of non–small cell lung carcinomas including squamous dysplasias, atypical adenomatous hyperplasia, and diffuse idiopathic neuroendocrine cell hyperplasia. Major molecular abnormalities are briefly discussed.
Data Sources.—Published literature and recent World Health Organization classification of lung tumors.
Conclusions.—Practicing surgical pathologists must be familiar with morphology of recognized pulmonary preneoplastic lesions that are more frequently detected radiographically and subjected to diagnostic procedures. Future understanding of underlying molecular abnormalities associated with progression of these lesions into invasive lung carcinoma may result in a development of molecular assays with potential diagnostic and prognostic importance.
Pulmonary Langerhans Cell Histiocytosis and Other Pulmonary Histiocytic Diseases: A Review
Authors: Allen Timothy Craig 
Published: February 2021

AbstractContext.—Pulmonary Langerhans cell histiocytosis is the most common and best known pulmonary histocytic lesion; however, the realm of pulmonary histiocytic lesions also includes an assortment of uncommon diseases that may exhibit pulmonary involvement.Objective.—To review pulmonary Langerhans cell histiocytosis and other pulmonary histiocytoses to better ensure correct diagnosis and optimal assessment of prognosis and treatment.Data Sources.—Literature review and primary material from the author's institution.Conclusions.—This review discusses the most common pulmonary histocytosis, pulmonary Langerhans cell histiocytosis, and also reviews the uncommon pulmonary histiocytic lesions, which are distinct from pulmonary Langerhans cell histiocytosis.
Update on the Diagnosis and Treatment of Barrett Esophagus and Related Neoplastic Precursor Lesions
Authors: Odze Robert D. 
Published: February 2021

Abstract
Context.—At present, Barrett esophagus is the most common cause of esophageal adenocarcinoma. In the past 20 years, the incidence of esophageal adenocarcinoma in white males has exceeded that of tumors of the colorectum, lung, prostate, and skin.
Objectives.—To (1) provide an evidence-based review of the diagnosis, classification, and histologic differentiation of Barrett esophagus from gastric carditis, (2) provide a summary of the key pathologic features of precursor lesions, such as dysplasia, and (3) evaluate adjunctive markers of dysplasia and predictive markers for the development of cancer. The natural history and risk of cancer in patients with Barrett esophagus is also reviewed.
Data Sources.—For this review, selected published peer reviewed articles were chosen from a search through PubMed between the years 1970 and 2007.
Conclusions.—The current definition of Barrett esophagus is partially flawed because not all cases are endoscopically recognizable, nongoblet epithelium is biologically intestinalized, and determination of the presence or absence of goblet cells is susceptible to sampling error. Differentiation of ultrashort segment Barrett esophagus from chronic gastric carditis can be accomplished, in a minority of cases, by evaluating for the presence or absence of histologic features that are known to be associated with Barrett esophagus. Dysplasia in Barrett esophagus begins in the crypt bases and then extends more superficially to include the upper portions of the crypts and surface epithelium. Low- and high-grade dysplasia are distinguished by the presence of marked cytologic and/or architectural abnormalities in the latter compared with the former. There are few, if any, reliable adjunctive diagnostic techniques that can help differentiate nondysplastic from dysplastic epithelium. However, α-methylacyl coenzyme A racemase staining has been shown to be useful in 2 separate studies. Both low- and high-grade dysplasia are progressive lesions, and in general, the extent of dysplasia, particularly low grade, is a strong risk factor for progression to carcinoma. Of all the biologic and genetic biomarkers studied to date, evaluation of DNA content is the most reliable and specific. The management of patients with dysplasia is variable among institutions and ranges from aggressive surveillance, endoscopic mucosal resection, mucosal ablation, or total esophagectomy.
Cytologic Malignancy Versus Benignancy: How Useful Are the “Newer” Markers in Body Fluid Cytology?
Authors: Lyons-Boudreaux Virganeyce , Mody Dina R. , Zhai Jim , Coffey Donna 
Published: February 2021

Abstract
Context.—Differentiating reactive effusion, malignant mesothelioma, and metastatic adenocarcinoma in body cavity fluids can be challenging. Interpreting immunohistochemical markers in cell block preparations can be difficult because of nonspecific staining, focal staining, or poor staining quality. We selected a panel of conventional and newer markers to assess their utility in evaluating effusions.
Objective.—To evaluate the efficacy of 5 immunohistochemical markers in the differential diagnosis of reactive mesothelial proliferation, malignant mesothelioma, and metastatic adenocarcinoma in body cavity fluids.
Design.—A total of 72 formalin-fixed, paraffin-embedded cell block specimens from pleural and peritoneal effusions, including 5 mesotheliomas, 48 adenocarcinomas, and 19 benign effusions were stained with antibodies against calretinin, D2-40, XIAP, MOC-31, and WT1.
Results.—All benign effusions and mesotheliomas demonstrated diffuse membranous staining with D2-40. All mesotheliomas displayed calretinin positivity, whereas only 58% of benign effusions stained focally with calretinin. MOC-31 was positive in all cases of adenocarcinoma, whereas all benign effusions and mesotheliomas were negative. All cases of the metastatic adenocarcinoma were negative for calretinin and D2-40. However, background reactive mesothelial cells were positive for calretinin and D2-40. Overall, D2-40 highlighted more mesothelial cells than calretinin. WT1 was positive in 50% of benign effusions, 60% of mesotheliomas, and 27% of adenocarcinomas. XIAP stained most mesotheliomas (80%), some adenocarcinomas (51%), and rare benign effusions (11%).
Conclusions.—MOC-31 and D2-40 were very sensitive and specific markers of epithelial and mesothelial cells, respectively. Compared with calretinin, D2-40 was a more sensitive marker of mesothelial cells. WT1 proved to be nonspecific. XIAP was not a sensitive marker for malignancy and had a limited value in cytology. We recommend using a panel to include MOC-31 and D2-40 to improve diagnostic accuracy in body cavity effusions.
Analysis of Expression Patterns of Breast Cancer–Specific Markers (Mammaglobin and Gross Cystic Disease Fluid Protein 15) in Lung and Pleural Tumors
Authors: Takeda Yuji , Tsuta Koji , Shibuki Yasuo , Hoshino Tatsuhiro , Tochigi Naobumi , Maeshima Akiko Miyagi , Asamura Hisao , Sasajima Yuko , Ito Tsuyoshi , Matsuno Yoshihiro 
Published: February 2021

Abstract
Context.—The lung is the most common site of metastasis during the natural history of malignant tumors. Breast carcinoma has a propensity for distant metastasis, and the lung and pleura are among the most common metastatic sites. Although it is often difficult to make a clear-cut differential diagnosis between the two, distinguishing primary lung carcinoma from breast carcinoma metastatic to the lung is important because the treatment modalities are different.
Objective.—To elucidate the utility of mammaglobin and gross cystic disease fluid protein 15 (GCDFP-15), which are known to be breast-specific antigens, in distinguishing various primary lung and pleural tumors from breast carcinoma metastasizing to the lung.
Design.—A total of 20 cases of breast carcinoma metastatic to the lung and 263 tumors of nonbreast origin located in the lung and pleura were analyzed.
Results.—Of the 20 cases of breast carcinoma metastatic to the lung, 10 (50.0%) were immunoreactive for mammaglobin and 9 (45.0%) for GCDFP-15, the frequency of positivity being slightly higher for the former than for the latter. The area immunopositive for mammaglobin showed more diffuse staining than the area immunopositive for GCDFP-15. Furthermore, the specificity of mammaglobin for breast carcinoma metastatic to the lung was superior (98.9%) to that of GCDFP-15 (91.8%).
Conclusion.—The sensitivity of mammaglobin is equal or superior to that of GCDFP-15 for investigation of breast carcinoma. Immunopositivity for mammaglobin is more diffuse than that for GCDFP-15. In terms of practical diagnosis, mammaglobin immunohistochemistry can serve as a differential marker of breast carcinoma and should be added to the immunohistochemical panel.
Application of Immunohistochemistry to Breast Lesions
Authors: Yeh I-Tien , Mies Carolyn 
Published: February 2021

Abstract
Context.—Immunohistochemistry has an expanding role in mammary pathology that has been facilitated by a growing list of available antibodies and a better understanding of biology.
Objective.—To explore the key role of immunohistochemistry in guiding adjuvant therapy decisions and sentinel node staging in breast cancer, as well as the role of immunohistochemistry as an aid to distinguishing usual ductal hyperplasia from atypical ductal hyperplasia/low-grade carcinoma in situ; subtyping a carcinoma as ductal or lobular, basal or luminal; ruling out microinvasion in extensive intraductal carcinoma; distinguishing invasive carcinoma from mimics; and establishing that a metastatic carcinoma of unknown primary site has originated in the breast.
Data Sources.—Current literature is reviewed, including clinical and pathologic journals.
Conclusions.—As new, targeted treatments for breast cancer are developed, pathologists can expect additional immunohistochemistry applications in the future.
Smooth Muscle Tumors of the Uterus: A Practical Approach
Authors: Toledo Gemma , Oliva Esther 
Published: February 2021

Abstract
Smooth muscle tumors (SMTs) are the most frequent mesenchymal tumors of the uterus. The majority of the uterine SMTs are readily classificable as benign or malignant based on their gross and microscopic appearances. However, when unusual features are seen in some leiomyoma variants, the differential diagnosis with a leiomyosarcoma may become challenging. Moreover, diagnostic criteria for the different subtypes of leiomyosarcoma are not uniform. Finally, non–smooth muscle tumors that originate in the uterus may show overlapping histologic and even immunohistochemical features with uterine SMTs, more commonly with the spindle and epithelioid variants, complicating their correct classification. The diagnosis of malignant uterine SMTs has important prognostic and therapeutic implications. This review provides a practical approach to the diagnosis of uterine leiomyosarcoma based on a systematic assessment of histologic parameters as well as a systematic approach to its differential diagnosis based on histologic and immunohistochemical features.
Gastric Polyps: Classification and Management
Authors: Park Do Youn , Lauwers Gregory Y. 
Published: February 2021

Abstract
Gastric polyps can be broadly defined as luminal lesions projecting above the plane of the mucosal surface. They are relatively frequent in routine pathology practice, where the main goal is to rule out the possibility of malignancy. Various subtypes of gastric polyps are recognized and generally divided into nonneoplastic and neoplastic. We will review herein only a limited subset of gastric polyps representing the most common or, sometimes, challenging.