bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Candigen Enzyme-Linked Immunosorbent Assay for Quantitative Detection of Candida Species Antigen
Authors: Elsayed Sameer , Fitzgerald Viivi , Massey Viki , Hussain Zafar 
Published: January 2021

Abstract
Objective.—To assess the clinical utility of an enzyme-linked immunosorbent assay method for the quantitative detection of Candida species antigen (Candigen; Biomerica Inc, Newport Beach, Calif) in patients with suspected disseminated candidiasis.
Methods.—Specimens of blood or cerebrospinal fluid from 75 patients with suspected disseminated candidiasis were analyzed by the Candigen test. Results were compared with those obtained by culture and polymerase chain reaction (PCR) analysis.
Results.—Thirty-seven patients had specimens positive for Candida species by either culture or PCR. Of these specimens, 4 were positive by both culture and PCR, 21 were culture positive but PCR negative, and 12 were PCR positive but culture negative. Five specimens were positive by the Candigen test, all of which were PCR positive but culture negative. The sensitivity, specificity, and positive and negative predictive values of the Candigen test compared to culture plus PCR were 13.5%, 100%, 100%, and 54.3%, respectively. Turnaround time for the Candigen test was approximately 3 hours.
Conclusion.—The Candigen test showed excellent specificity and turnaround time, but its poor sensitivity coupled with its inability to provide species information or susceptibility data make its clinical utility questionable.
Verumontanum Mucosal Gland Hyperplasia Is Associated With Atypical Adenomatous Hyperplasia of the Prostate
Authors: Muezzinoglu Bahar , Erdamar Sibel , Chakraborty Subhendu , Wheeler Thomas M. 
Published: January 2021

Abstract
Background.—Verumontanum mucosal gland hyperplasia (VMGH) and atypical adenomatous hyperplasia (AAH) are both small glandular proliferations that are histologically and topographically unique.
Methods.—One hundred ten randomly selected, whole-mount, radical prostatectomy specimens were reviewed to assess independently the normal histology of the prostatic urethra and periurethral area and the association of AAH with other pathologic features, including VMGH. The degree of nodular hyperplasia was evaluated by total prostate weight for comparison purposes.
Results.—Atypical adenomatous hyperplasia was found in 37 cases (33.6%) and was nearly always (32/37) associated with nodules of nodular hyperplasia. Verumontanum mucosal gland hyperplasia was present in 32 cases (29.1%; 21 with AAH, 11 without AAH). There was a significant association between presence of VMGH and AAH (P &lt; .001, Fisher exact test). The degree of nodular hyperplasia was not significantly different between prostates with and without VMGH or AAH.
Conclusions.—These results suggest that AAH and VMGH occur more commonly in prostates when the other is also present.
Low Triglyceride Levels Affect Calculation of Low-Density Lipoprotein Cholesterol Values
Authors: Wang Teh Y. , Haddad Michel , Wang Thomas S. 
Published: January 2021

Abstract
The Friedewald formula for the calculation of low-density lipoprotein cholesterol (LDL-C) values is fairly accurate provided the triglyceride value is less than 400 mg/dL. It is not clear whether the estimation is also valid in the presence of low triglyceride and high cholesterol levels. We describe herein a patient with a low triglyceride value of approximately 50 mg/dL, a high cholesterol level, and a discrepant LDL-C level. The LDL-C level using the Friedewald calculation turned out to be much higher than the LDL-C level using direct measurement. We, therefore, suggest that in the presence of low triglyceride and high cholesterol levels, the LDL-C level should be measured directly instead of using the Friedewald calculation.
Primary Liposarcoma of the Liver
Authors: Nelson Viera , Fernandes Neville F. , Woolf Graham M. , Geller Stephen A. , Petrovic Lydia M. 
Published: January 2021

Abstract
Liposarcoma is a rare mesenchymal malignant tumor, which usually originates in the retroperitoneum and the extremities. Seven cases of primary liposarcoma of the liver have been previously reported. We present the eighth case, which occurred in an adult female patient. Primary liposarcoma of the liver, although extremely rare, must be considered in the differential diagnosis of a hepatic mass that develops in a noncirrhotic liver, especially in patients who are potential candidates for orthotopic liver transplantation. Liposarcoma is an absolute contraindication for liver transplantation.
Primary Epstein-Barr Virus–Associated Hodgkin Disease of the Ileum Complicating Crohn Disease
Authors: Li Shiyong , Borowitz Michael J. 
Published: January 2021

Abstract
We describe a case of primary Hodgkin disease of the terminal ileum in a 38-year-old man with Crohn disease of 24 years' duration. The infiltrate was located in an ulcerated fistula involving the terminal ileum and urinary bladder. Reed-Sternberg cells and their variants were characteristically positive for CD15, fascin, and CD30 and showed focal positivity for CD20. Epstein-Barr virus messenger RNA was also detected in the neoplastic cells. Staging revealed no evidence of other lymph node or organ involvement. Although rare, primary gastrointestinal Hodgkin disease arising in the setting of Crohn disease may have a stronger association with Epstein-Barr virus infection than conventional Hodgkin disease.
Reference Laboratory Telephone Service Quality
Authors: Dale Jane C. , Novis David A. , Meier Frederick A. 
Published: January 2021

Abstract
Objectives.—To establish the rates with which reference laboratories resolve inquiries telephoned to them from primary laboratories and to identify reference laboratory practices associated with higher rates of inquiry resolution.
Design and Participants.—For 2 months, or until 50 contacts had occurred, 545 primary laboratories participating in the College of American Pathologists Q-Probes laboratory quality improvement program prospectively documented and characterized telephone inquiries they made to a reference laboratory of their choice. Participants also cataloged their own laboratory's demographic and practice characteristics and their reference laboratory's customer service characteristics.
Main Outcome Measure.—Rates with which reference laboratories resolved telephone inquiries.
Results.—Participants characterized 11 031 (78.7%) of 14 017 telephone inquiries as resolved by the reference laboratories. Ranked according to inquiry resolution rates, primary laboratories in the 90th percentile characterized reference laboratories as resolving 100% of their inquiries; those in the 10th percentile characterized reference laboratories as resolving only 54.2% of their inquiries. The rate of resolved inquiries was significantly higher (P = .0047) for participants using reference laboratories with 24-hour customer service than it was for participants using reference laboratories with less than 24-hour service. Most primary laboratories (80.9%) chose to monitor 1 of 11 national reference laboratories; in this subset, median rates of inquiry resolution ranged from 90.2% to 55.0% (P &lt; .0001), despite no significant variation in other measured customer service characteristics.
Conclusions.—Primary laboratories experience significant differences in the rates with which reference laboratories resolve telephone inquiries. The performance benchmark for reference laboratories is resolution of at least 90% of telephone inquiries from primary laboratory customers.
An Immunostaining Panel for Diagnosis of Malignancy in Mucinous Tumors of the Pancreas
Authors: Zhao Jin , Liang Sharon X. , Savas Lou , Banner Barbara F. 
Published: January 2021

Abstract
Background.—The diagnosis of malignancy in pancreatic mucinous cystic tumors depends on demonstrating invasion that may be focal and require extensive sectioning.
Objective.—To explore markers that may indicate malignant potential in mucinous cystic tumors.
Design.—Routinely processed sections from resected specimens of 12 normal pancreata, 14 pancreata with chronic pancreatitis, 9 mucinous cystic tumors, and 30 invasive adenocarcinomas were immunostained with antibodies to p53, HER-2/neu, epithelial growth factor receptor (EGFR), transforming growth factor α (TGF-α), and Ki-67.
Results.—Expression of p53, HER-2/neu, and Ki-67 was significantly more frequent in mucinous tumors than in normal pancreatic tissue and chronic pancreatitis tissue (P = .0003 to .05). Strong expression (more than one third of cells positive) and strong intensity (2+ and 3+) of staining of p53 and EGFR were seen only in carcinomas. Coexpression of p53/HER-2/neu and EGFR/HER-2/neu and a frequency of Ki-67+ nuclei of greater than 5% of cells discriminated between mucinous tumors and normal pancreatic tissue and chronic pancreatitis tissue. p53 expression was significantly more frequent in carcinomas than in mucinous tumor (P = .0326). Coexpression of p53/EGFR discriminated between mucinous tumors and carcinomas; however, TGF-α was not discriminative.
Conclusions.—The immunostaining panel of p53, HER-2/neu, Ki-67, and EGFR can be helpful in indicating malignant potential in mucinous tumors of pancreas in routine pathology practice.
Squamous Cell Carcinoma Detected by High-Molecular-Weight Cytokeratin Immunostaining Mimicking Atypical Fibroxanthoma
Authors: Gray Yulia , Robidoux Henry J. , Farrell David S. , Robinson-Bostom Leslie 
Published: January 2021

Abstract
Atypical fibroxanthoma can mimic other tumors, particularly spindle cell squamous cell carcinoma and spindle cell or desmoplastic melanoma. We describe a patient with chronic lymphocytic leukemia who developed acantholytic squamous cell carcinoma on the face, which recurred and metastasized to a cervical lymph node. This tumor was at first diagnosed as atypical fibroxanthoma because of its histologic and immunostaining similarity. It showed weak or negative keratin cocktail staining and strong vimentin staining. However, a recurrent tumor was immunostained for high-molecular-weight keratin and showed strong positivity. Aggressive behavior of this squamous cell carcinoma may be due to altered immune response secondary to chronic lymphocytic leukemia.
Pigmented Pleomorphic Xanthoastrocytoma
Authors: Sharma Mehar Chand , Arora Rina , Khanna Navin , Singh Virender Pal , Sarkar Chitra 
Published: January 2021

Abstract
We describe a rare case of melanotic pleomorphic xanthoastrocytoma in a 32-year-old man who presented with partial complex seizures. Radiologically, the mass was located in the medial temporal lobe and was solid and cystic. Microscopic examination revealed features of a pleomorphic xanthoastrocytoma with some heavily pigmented cells. The pigment was demonstrated to be melanosomal melanin, which was confirmed by special stains, immunohistochemistry, and electron microscopy.
Spindle Cell Lipoma of the Parotid
Authors: Fasig John H. , Robinson Robert A. , McCulloch Timothy M. , Fletcher Mavis S. , Miller Carolyn K. 
Published: January 2021

Abstract
A 47-year-old man presented to the otolaryngologist with a 7-year history of a mass of the cheek. Fine-needle aspiration revealed foci of spindled cells admixed with abundant fat and myxoid material. A diagnosis of spindle cell lipoma was rendered on the resected specimen. The cytologic findings of spindle cell lipoma of the parotid gland as seen by fine-needle aspiration are presented along with the histologic correlates.
The Prognostic Significance of DNA Topoisomerase II-alpha (Ki-S1), p21/Cip-1, and p27/Kip-1 Protein Immunoexpression in Oligodendrogliomas
Authors: Korshunov Andrey , Golanov Andrey 
Published: January 2021

Abstract
Objective.—To evaluate a possible association between clinical outcome of patients with oligodendroglioma and expression of 2 cyclin-dependent kinase inhibitors, p21/Cip-1 (p21) and p27/Kip-1 (p27), and of DNA topoisomerase II-alpha (Ki-S1), which has been recently used as a marker of cellular proliferation.
Design.—Ninety-one specially selected patients with cerebral oligodendrogliomas treated with surgery and radiotherapy were studied retrospectively. Tumor specimens were immunohistochemically examined with antibodies to p21, p27, and Ki-S1. A computerized color image analyzer was used to count immunostained nuclei.
Results.—The mean Ki-S1 labeling index (LI) was found to be significantly prominent for World Health Organization (WHO) high-grade tumors (9.5% vs 3.2% for WHO low-grade tumors). In contrast, the mean p27 LI was significantly higher for low-grade tumors (43.3% vs 25.7% for high-grade tumors). The number of p21-positive cases and the mean p21 LI were found to be relatively equal for low- and high-grade tumors. For low-grade oligodendrogliomas, the progression-free and overall survival times were found to be significantly shorter for tumors with p27 LIs less than 20%. For high-grade oligodendrogliomas, survival times were significantly reduced for tumors with Ki-S1 LIs greater than 10%. Regression-tree analysis identified 4 groups of oligodendrogliomas with distinctly different outcomes: (1) 32 patients with low-grade tumors and p27 LIs greater than 20%; (2) 14 patients with low-grade tumors and p27 LIs less than 20%; (3) 25 patients with high-grade tumors and Ki-S1 LIs less than 10%; and (4) 20 patients with high-grade tumors and Ki-S1 LIs greater than 10%.
Conclusions.—Immunoreactivity for Ki-S1 and p27 was found to be useful for further subdividing oligodendroglioma prognoses among low-grade and high-grade tumors. It seems unlikely that p21 immunohistochemistry will be of value for determining clinical outcomes for patients with oligodendrogliomas.
Low-Grade B-Cell Lymphoma With Coexpression of Both CD5 and CD10
Authors: Barekman C. L. , Aguilera N. S. I. , Abbondanzo S. L. 
Published: January 2021

Abstract
The coexpression of CD5 and CD10 has previously been reported in cases of intermediate- and high-grade lymphomas and in precursor B cells in normal or regenerating bone marrow. We report 3 cases of low-grade B-cell lymphoma that were found to coexpress CD5 and CD10 at the time of initial diagnosis. The first case was classified as small lymphocytic lymphoma; the second as follicle center lymphoma, follicular grade 1; and the third as small B-cell lymphoma otherwise not specified. Currently, the clinical implication of the coexpression of CD5 and CD10 is not known. We describe this finding to highlight the difficulty that may be encountered in classifying lymphomas in cases where this coexpression is present.
Metastatic Carcinomatous Cirrhosis and Hepatic Hemosiderosis in a Patient Heterozygous for the H63D Genotype
Authors: Mitchell Mark L. , Filippone Marciana D. , Wozniak Timothy F. 
Published: January 2021

Abstract
A 38-year-old woman had a mastectomy for infiltrating ductal carcinoma of the breast 3 years before her last admission and had received chemotherapy for known liver metastases. She developed the rapid onset of liver failure with portal hypertension and died in a hospice. Autopsy revealed macronodular cirrhosis of the liver secondary to metastatic carcinoma of the breast with associated florid fibrosis. This rare lesion, previously called metastatic carcinomatous cirrhosis, was also found, in this case, to have marked hepatic hemosiderosis, and analysis of the patient's DNA showed heterozygosity for the H63D genotype. The possibility of cirrhosis-associated hemosiderosis secondary to an iron metabolism abnormality associated with the H63D mutation of the HFE gene is proposed. Computed tomographic scans showed the development of cirrhosis during the 3-month period before the patient's last admission and suggested the possibility of a postnecrotic type origin.
Differential Expression ofrasSignal Transduction Mediators in Verrucous and Squamous Cell Carcinomas of the Upper Aerodigestive Tract
Authors: Lessard Julie L. , Robinson Robert A. , Hoffman Henry T. 
Published: January 2021

AbstractContext.—ras gene mutations and expression of its gene product have been described in verrucous and squamous cell carcinomas. Other downstream signal-transduction mediators, extracellular signal-regulated kinases 1 and 2 (ERK-1 and ERK-2) and Raf-1, have not yet been as extensively studied.Objective.—To determine patterns of expression of ERK-1, ERK-2, and Raf-1 in verrucous and squamous cell carcinomas of the upper aerodigestive tract.Design.—Seventeen verrucous carcinomas and 10 squamous cell carcinomas of the upper aerodigestive tract were examined for the immunohistochemical expression of ERK-1, ERK-2, and Raf-1 product.Results.—Raf-1 expression was intensely expressed in the most basal portions of the epithelium in verrucous carcinomas, but was minimally expressed in the suprabasalar areas. Anti-Raf-1 staining of the squamous cell carcinomas was diffuse and patchy throughout the tumor cells and was weak in intensity. There was no geographic preference of staining. The cytoplasmic expression of both ERK-1 and ERK-2 was predominantly negative in the most basal layers of the epithelium in the verrucous carcinomas, but was positive in the suprabasalar region of the epithelium. Immunohistochemical expression of ERK-1 and ERK-2 in the squamous carcinomas was diffuse throughout the tumor.Conclusion.—There is strong correlation of the geographic expression of these mediators of ras signal transduction in verrucous and squamous carcinomas, but the cause of these differences remains unclear at present. The expression of these mediator proteins may have potential for diagnosis, as well as in understanding the biologic behavior of these lesions.
The Role of Fine-Needle Aspiration Biopsy in the Diagnosis and Management of Juvenile Hemangioma of the Parotid Gland and Cheek
Authors: Khurana Kamal K. , Mortelliti Anthony J. 
Published: January 2021

Abstract
Background.—The current recommendation for the management of juvenile hemangiomas (JH) is to delay treatment in the hope of spontaneous regression. However, accurate diagnosis is necessary before considering conservative management. Traditionally, the diagnosis of JH has required excisional biopsy. The cytology literature on this relatively rare neoplasm is sparse.
Objective.—To present our experience with fine-needle aspiration in the diagnosis and management of JH.
Design.—Three cases with a cytologic diagnosis consistent with JH of the parotid gland and cheek were identified from our cytopathology files. Aspirate smears, immunohistochemical studies, computed tomographic scan findings, and clinical follow-up were reviewed.
Results.—Patients were female infants ranging in age from 3 to 9 months and presented with an oval firm mass (size range, 2.0–5.0 cm) involving the parotid gland (2 cases) and cheek (1 case). Computed tomographic scan with contrast demonstrated homogeneous enhancement. Aspirate smears revealed spindle-shaped cells in sheets and clusters in a background of blood. The parotid gland aspirates and cell block preparations revealed ductal structures entrapped in sheets of spindle-shaped cells. Immunohistochemical studies revealed prominent vascular spaces lined by CD34 and factor VIII–positive flattened endothelial cells. The diagnosis of JH was rendered on the basis of the cytologic findings in conjunction with the radiologic and clinical findings. On clinical follow-up (8–24 months), none of the patients has shown any progression of the lesion.
Conclusions.—Fine-needle aspiration, in conjunction with imaging studies, is a useful tool in the diagnosis and management of JH. It eliminates the need for surgical excision for diagnostic purposes and allows for clinical follow-up of patients with JH.
Pseudopapillary Solid Cystic Tumor Arising From an Extrapancreatic Site
Authors: Fukunaga Masaharu 
Published: January 2021

Abstract
A case of pseudopapillary solid cystic tumor arising in the omentum of a 46-year-old woman is presented. A well-defined, encapsulated tumor measuring 5.2 × 4.0 × 4.0 cm was histologically characterized by a combination of solid and pseudopapillary growth patterns of tumor cells with abundant pale-to-eosinophilic cytoplasm. No pancreatic tissue was observed within or adjacent to the tumor. Immunohistochemically, the tumor was positive for vimentin, epithelial membrane antigen, and α1-antichymotrypsin. Ultrastructurally, the tumor cells contained electron dense granules of variable sizes, most likely representing lysosomes. Flow cytometry showed a diploid DNA content with a high S-phase fraction. The patient was well without recurrence 3 months after diagnosis. It is important to include pseudopapillary solid cystic tumor in the differential diagnosis of omental tumors.
Is the Human Papillomavirus Test in Combination With the Papanicolaou Test Useful for Management of Patients With Diagnoses of Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesions?
Authors: Lee Nak-Woo , Kim Daesu , Park Jong-Tae , Kim Aeree 
Published: January 2021

Abstract
Objective.—To determine whether human papillomavirus (HPV) testing is useful in the evaluation of patients diagnosed with atypical squamous cells of undetermined significance (ASCUS)/low-grade squamous intraepithelial lesion (LSIL) and whether the HPV test is appropriate as an alternative screening method.
Design.—The results of Papanicolaou (Pap) tests and subsequent hybrid capture tube (HCT) II tests for high-risk–type HPV were analyzed for 457 patients. Among these tests, 208 histologic diagnoses were made and correlated with the results of Pap and HPV tests. The sensitivity and specificity of the Pap test, HPV test, and the combined method of Pap and HPV tests to detect cervical intraepithelial neoplasia (CIN) 2/3 and all CIN were also measured.
Results.—Sixty (63.8%) of 94 women with LSIL and 31 (26.3%) of 118 women with ASCUS tested positive for high-risk HPV. The sensitivity values for Pap tests in detecting all cases of CIN and CIN 2/3 were 91.4% and 92.9%, respectively. The sensitivity values of HCT II tests using the high-risk probe for detecting all cases of CIN and CIN 2/3 were 62.6% and 88.1%, respectively. Biopsies confirmed that 10 (22.7%) of 44 LSIL patients with high-risk HPV had CIN 2/3, but only 1 (4.5%) of 22 LSIL patients without high-risk HPV had CIN 2/3.
Conclusion.—Testing for high-risk HPV with the HCT II test is useful in the detection of CIN 2/3 in LSIL groups and in the selection of patients for colposcopy in ASCUS groups, but it is not suitable for cervical cancer screening tests.
Hodgkin Lymphoma in a Renal Transplant Recipient Associated With Low Peripheral Blood Epstein-Barr Virus Genome Copies
Authors: Craver Randall D. , Scheer Wm Douglas , Correa Hernan , Vehaskari V. Matti , Yu Lolie C. 
Published: January 2021

Abstract
Posttransplant lymphoproliferative disorders are often accompanied by &gt;500 Epstein-Barr virus (EBV) genome copies/105 lymphocytes, and they occur shortly after transplantation. Hodgkin lymphoma occurs rarely after transplantation, appearing a mean of 4.2 years posttransplant, and although Hodgkin lymphoma has strong associations with EBV, no quantitative analysis of peripheral blood EBV genome copies has been reported. A mixed cellularity Hodgkin lymphoma developed in a 17-year-old boy 4 years after a renal transplant. Serial EBV genome copy numbers from blood by competitive polymerase chain reaction had been obtained to assess for lymphoproliferative disease. Epstein-Barr virus genome copy numbers peaked at 500 copies/105 lymphocytes 8 months prior to Hodgkin lymphoma diagnosis but fell to 8 copies/105 lymphocytes at diagnosis. Reliance on EBV levels greater than 500 copies may result in delay of biopsy and diagnosis of Hodgkin disease in the posttransplant setting.