bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glomus Tumor
Authors: Gombos Zoltan , Zhang Paul J. 
Published: February 2021

AbstractGlomus tumor is a benign mesenchymal neoplasm comprising less than 2% of soft tissue tumors. It is composed of cells resembling modified smooth muscle cells of the normal glomus body. The glomus body, a thermoregulator, is a specialized form of arteriovenous anastomosis localized in dermal and precoccygeal soft tissue. Although glomus tumors are rare neoplasms, clinical misdiagnosis of many of these lesions as hemangiomas or venous malformations makes an accurate assessment of their actual prevalence difficult. A malignant counterpart of this lesion exists but is extremely rare.
Squamous Differentiation in a Sarcomatoid Chromophobe Renal Cell Carcinoma: An Unusual Case Report With Review of the Literature
Authors: Viswanathan Seethalakshmi , Desai Sangeeta B. , Prabhu S. R. , Amin Mahul B. 
Published: February 2021

Abstract
We describe an extremely rare occurrence of a squamous differentiation in a sarcomatoid chromophobe renal cell carcinoma in a 45-year-old woman with nodal and lung metastasis at presentation. The tumor on histology showed all 3 components intimately admixed with each other, which to the best of our knowledge is the first such case to be reported in the literature. The renal pelvis was smooth walled and uninvolved. Kidney-specific cadherin was positive in the chromophobe renal cell carcinoma areas and negative in the sarcomatoid and squamous areas.
Composite Adenomatoid Tumor and Myelolipoma of Adrenal Gland: Report of 2 Cases
Authors: Timonera Elizabeth R. , Paiva Maria Emilia , Lopes Jose Manuel , Eloy Catarina , van der Kwast Theodore , Asa Sylvia L. 
Published: February 2021

Abstract
Adenomatoid tumor and myelolipoma are benign, hormonally inactive tumors that are often incidental findings in the adrenal glands. Myelolipoma is more common than adenomatoid tumor in this location but both are rare, and as yet, the pathogenesis of both remains unclear. We report 2 cases of composite adenomatoid tumor and myelolipoma, incidentally found in the adrenal gland on investigation for other diseases. To our knowledge, composite adenomatoid tumor and myelolipoma of adrenal gland has not been previously reported.
Acute Leukemia Immunohistochemistry: A Systematic Diagnostic Approach
Authors: Olsen Randall J. , Chang Chung-Che , Herrick Jennifer L. , Zu Youli , Ehsan Aamir 
Published: February 2021

Abstract
Context.—The diagnosis and classification of leukemia is becoming increasingly complex. Current classification schemes incorporate morphologic features, immunophenotype, molecular genetics, and clinical data to specifically categorize leukemias into various subtypes. Although sophisticated methodologies are frequently used to detect characteristic features conferring diagnostic, prognostic, or therapeutic implications, a thorough microscopic examination remains essential to the pathologic evaluation. Detailed blast immunophenotyping can be performed with lineage- and maturation-specific markers. Although no one marker is pathognomonic for one malignancy, a well-chosen panel of antibodies can efficiently aid the diagnosis and classification of acute leukemias.
Objective.—To review important developments from recent and historical literature. General immunohistochemical staining patterns of the most commonly encountered lymphoid and myeloid leukemias are emphasized. The goal is to discuss the immunostaining of acute leukemias when flow cytometry and genetic studies are not available.
Data Sources.—A comprehensive review was performed of the relevant literature indexed in PubMed (National Library of Medicine) and referenced medical texts. Additional references were identified in the reviewed manuscripts.
Conclusions.—Immunophenotyping of blasts using an immunohistochemical approach to lymphoid and myeloid malignancies is presented. Initial and subsequent additional antibody panels are suggested to confirm or exclude each possibility in the differential diagnosis and a general strategy for diagnostic evaluation is discussed. Although the use of immunohistochemistry alone is limited and evaluation by flow cytometry and genetic studies is highly recommended, unavoidable situations requiring analysis of formalin-fixed tissue specimens arise. When performed in an optimized laboratory and combined with a careful morphologic examination, the immunohistochemical approach represents a useful laboratory tool for classifying various leukemias.
State of the Art in Trueness and Interlaboratory Harmonization for 10 Analytes in General Clinical Chemistry
Authors: Miller W. Greg , Myers Gary L. , Ashwood Edward R. , Killeen Anthony A. , Wang Edward , Ehlers Glenn W. , Hassemer David , Lo Stanley F. , Seccombe David , Siekmann Lothar , Thienpont Linda M. , Toth Alan 
Published: February 2021

Abstract
Context.—Harmonization and standardization of results among different clinical laboratories is necessary for clinical practice guidelines to be established.
Objective.—To evaluate the state of the art in measuring 10 routine chemistry analytes.
Design.—A specimen prepared as off-the-clot pooled sera and 4 conventionally prepared specimens were sent to participants in the College of American Pathologists Chemistry Survey. Analyte concentrations were assigned by reference measurement procedures.
Participants.—Approximately 6000 clinical laboratories.
Results.—For glucose, iron, potassium, and uric acid, more than 87.5% of peer groups meet the desirable bias goals based on biologic variability criteria. The remaining 6 analytes had less than 52% of peer groups that met the desirable bias criteria.
Conclusions.—Routine measurement procedures for some analytes had acceptable traceability to reference systems. Conventionally prepared proficiency testing specimens were not adequately commutable with a fresh frozen specimen to be used to evaluate trueness of methods compared with a reference measurement procedure.
The Effect of the Number of Biopsy Cores on the Concordance Between Prostate Biopsy and Prostatectomy Gleason Score: A Prostate Volume–Controlled Study
Authors: Antunes Alberto A. , Leite Katia Ramos , Dall'Oglio Marcos F. , Cury Jose , Srougi Miguel 
Published: February 2021

Abstract
Context.—Studies analyzing the concordance of biopsy and radical prostatectomy (RP) Gleason scores have limitations. Some included 2 or more centers, used historical controls from the early prostate specific antigen era or lacked a clear definition of the biopsy schemes. Furthermore, most did not control the results for prostate volume.
Objective.—To confirm whether prediction of RP Gleason score can be optimized by taking more biopsy cores in a contemporary series of patients, with pathologic samples analyzed by the same pathologist, and controlling these results for prostate volume.
Design.—The study comprised a retrospective case-control analysis of 393 patients with prostate cancer treated with RP. Patients were divided into 3 groups: those in group 1 underwent a 6-core biopsy; group 2, an 8-core biopsy; and group 3, a 10 or more–core biopsy. Concordance rates between biopsy and RP Gleason scores, as well as the rates of undergrading and overgrading, were determined for each biopsy scheme.
Results.—Concordance rates were 60.9%, 58.3%, and 64.6% for patients from groups 1, 2, and 3, respectively (P = .18). When we analyzed patients with prostate volumes of less than 50 cm3, concordance rates were 58.3%, 58.3%, and 65.1% for each group, respectively (P = .03). Among patients with prostate volumes of 50 cm3 or more, concordance rates were 70%, 58.1%, and 63.6%, respectively (P = .66).
Conclusions.—Taking 10 or more cores can improve the prediction of RP Gleason score in patients with prostate volumes of less than 50 cm3. For patients with prostate volumes of 50 cm3 or more, increasing the biopsy cores to 10 or more did not improve prediction of RP Gleason score.
Diagnosing Placental Membrane Hypoxic Lesions Increases the Sensitivity of Placental Examination
Authors: Stanek Jerzy 
Published: February 2021

AbstractContext.—Two relatively unknown and recently described placental membrane hypoxic lesions (laminar necrosis and microscopic chorionic pseudocysts) have never been compared with time-honored, focal (infarction), and diffuse hypoxic lesions of placental parenchyma.Objective.—To compare the effect on placental diagnosis of the above placental membrane hypoxic lesions and chorionic disc hypoxic lesions (infarctions and global hypoxic pattern of placental injury).Design.—Twenty-three clinical (maternal and fetal) and 32 gross and microscopic placental features were retrospectively compared in 4590 placentas from a placental database built during a 13-year period: 168 placentas with at least one hypoxic disc lesion (infarct or global hypoxia) and at least one membrane lesion (microscopic chorionic pseudocysts or laminar necrosis (group 1), 750 placentas with at least one hypoxic villous lesion but no membrane lesion (group 2), 480 placentas with at least one membrane lesion but no villous lesion (group 3), and 3192 placentas with no hypoxic villous or membrane lesions (group 4).Results.—Several clinical and fetal conditions and placental features known to be associated with in utero hypoxia had a statistically significant correlation with the index hypoxic placental lesions, both villous and membranous. Of placentas from patients associated with clinical conditions at risk for hypoxia, 15% featured only hypoxic membrane lesions without a chorionic disc hypoxic lesion.Conclusions.—Recognizing placental membrane hypoxic lesions increases the sensitivity of placental examination in diagnosing placental hypoxia by at least 15%. The risk of in utero hypoxia is increased when microscopic chorionic pseudocysts and laminar necrosis occur in conjunction with villous hypoxic lesions.
The Concentration of CD44 Is Increased in Hematopoietic Stem Cell Grafts of Patients With Acute Myeloid Leukemia, Plasma Cell Myeloma, and Non-Hodgkin Lymphoma
Authors: Krause Daniela S. , Spitzer Thomas R. , Stowell Christopher P. 
Published: February 2021

AbstractContext.—In autologous hematopoietic stem cell transplantation (autoHSCT), malignant cells remaining in the graft may reengraft leading to relapse of the original disease. CD44 is known to play a role in the engraftment of leukemia-initiating cells and is shed from the surface of malignant cells. Soluble CD44 is a cleaved fragment, which is found in the serum of patients with metastasized epithelial and hematologic malignancies and in some other cancers, and has been demonstrated to be correlated with clinical outcome.Objectives.—To investigate (1) a possible correlation between the concentration of CD44 in an autoHSCT graft and the type of hematologic malignancy and (2) a possible correlation between the concentration of CD44 in the autoHSCT graft with clinical outcome after autoHSCT.Design.—We measured CD44 in 157 hematopoietic stem cell grafts from patients with hematologic malignancies and from 43 healthy donors by enzyme-linked immunosorbent assay.Results.—Levels of CD44 were almost 2-fold higher in the patients' grafts. Highest levels were found in the grafts of patients with acute myeloid leukemia, diffuse large B-cell lymphoma, and plasma cell myeloma, congruent with known CD44 expression levels in these malignancies. The survival advantage among patients with CD44 levels less than 22 000 ng/mL was highly statistically significant.Conclusion.—These results show that CD44 levels in an autoHSCT graft may be linked to clinical outcome after autoHSCT.
Histologically Ambiguous (“Borderline”) Primary Cutaneous Melanocytic Tumors: Approaches to Patient Management Including the Roles of Molecular Testing and Sentinel Lymph Node Biopsy
Authors: Scolyer Richard A. , Murali Rajmohan , McCarthy Stanley W. , Thompson John F. 
Published: February 2021

AbstractIt is well recognized that the pathologic diagnosis of melanocytic tumors can sometimes be difficult. For some atypical melanocytic tumors that do not display clear-cut features of malignancy, it may be difficult or impossible to exclude a diagnosis of melanoma; this includes those showing some resemblance to Spitz nevi, blue nevi, deep penetrating nevi, and possible nevoid melanomas. When there is uncertainty about whether a primary melanocytic tumor is a nevus or a melanoma, we recommend that a second opinion be sought from one or more experienced colleagues. If diagnostic uncertainty persists, the evidence for or against the various differential diagnostic considerations should be presented in the pathology report and a “most likely” or “favored” diagnosis given. Molecular testing of the primary tumor by using techniques such as comparative genomic hybridization or fluorescence in situ hybridization may assist in establishing a diagnosis of melanoma if multiple chromosomal aberrations are identified. However, these tests require further independent validation and are not widely available at present. Complete excision of the lesion is probably mandatory, but plans for further management should be formulated on a case-by-case basis. While the safest course of action will usually be to manage the tumor as if it were a melanoma (taking into account the tumor's thickness and other prognostic variables), this may not always be appropriate, particularly if it is located in a cosmetically sensitive site such as the face. In some cases, it may be appropriate for the surgical oncologist to convey the diagnostic uncertainty to patients and to present them with management choices so that they can decide whether they wish to be managed aggressively (as for a melanoma) or conservatively. While a sentinel lymph node biopsy may be recommended on the basis of the primary tumor characteristics, the clinical significance of lymph node involvement for these tumors is not yet clear, and it may not have the same prognostic implications as nodal involvement from an unequivocal “conventional” melanoma.
Blue Nevi and Variants: An Update
Authors: Zembowicz Artur , Phadke Pushkar A 
Published: February 2021

Abstract
Context.—Blue nevi are a subset of melanocytic proliferations containing cells reminiscent of the embryonal neural crest–derived dendritic melanocytic precursors. They are common specimens in a general pathology practice, but some of their rare variants may pose diagnostic difficulty. Recent molecular studies provide new insights into genetics of blue nevi.
Objective.—To critically review clinical and histologic features of blue nevi with emphasis on diagnostic problems and rare variants, as well as to provide an update on the pathogenesis of blue nevi.
Data Sources.—Published peer-reviewed literature and personal experience of the authors.
Conclusions.—Challenging areas in diagnosis of blue nevi include recognition of amelanotic, desmoplastic, atypical, and malignant variants of blue nevus. Recent data show that mutations in genes responsible for common nevi or melanomas such as BRAF, NRAS, or c-kit are rare in blue nevi. Benign and malignant blue nevi harbor frequent mutations in the Gαq class of G-protein α subunits, Gnaq and Gna11 proteins.
Just Say No to the Use of No: Alternative Terminology for Improving Anatomic Pathology Reports
Authors: Renshaw Megan A. , Gould Edwin W. , Renshaw Andrew 
Published: February 2021

Abstract
Several organizations have recently suggested several approaches to make medicine safer, including defining “never events.” To date, never events have not been defined in anatomic pathology. We recently had a case in which the word “no” was left off the final diagnosis; as a result the diagnosis both made sense and was the exact opposite of what was intended. We therefore wondered if using the word “no” or “not” in the final diagnosis should be never events in pathology. We reviewed all amendments from the past 5 years and identified a total of 8 cases (0.5% of all amendments) where the words no or not were left out of the final diagnosis. One author (A.A.R.) attempted to avoid the words no and not in the final diagnosis during a 4-month period by using alternative words such as negative, benign, and unremarkable. If these words were left out, the resulting diagnosis no longer made sense. The use of no and not was reduced from 9.3% of all cases to 0.4% of all cases (P &lt; .001). We suggest that using the words no and not are dangerous in the final diagnosis and should be classified as never events in anatomic pathology.
Molecular Testing of Solid Tumors
Authors: Igbokwe Anne , Lopez-Terrada Dolores H. 
Published: February 2021

AbstractContext—Molecular testing of solid tumors is steadily becoming a vital component of the contemporary anatomic pathologist's armamentarium. These sensitive and specific ancillary tools are useful for confirming ambiguous diagnoses suspected by light microscopy and for guiding therapeutic decisions, assessing prognosis, and monitoring patients for residual neoplastic disease after therapy.Objective—To review current molecular biomarkers and tumor-specific assays most useful in solid tumor testing, specifically of breast, colon, lung, thyroid, and soft tissue tumors, malignant melanoma, and tumors of unknown origin. A few upcoming molecular diagnostic assays that may become standard of care in the near future will also be discussed.Data Sources—Original research articles, review articles, and the authors' personal practice experience.Conclusions—Molecular testing in anatomic pathology is firmly established and will continue to gain ground as the need for more specific diagnoses and new targeted therapies evolve. Knowledge of the more common and clinically relevant molecular tests available for solid tumor diagnosis and management, and their indications and limitations, is necessary if anatomic pathologists are to optimally use these tests and act as consultants for fellow clinicians directly involved in patient care.
The Recurrent Nevus Phenomenon: A History of Challenge, Controversy, and Discovery
Authors: Fox John C. , Reed Jon A. , Shea Christopher R. 
Published: February 2021

AbstractContext.—The diagnosis of recurrent nevus poses a potential challenge to practicing pathologists. Although most recurrent nevi show uniform microscopic findings and pose no great diagnostic difficulty, a few cases exhibit some histopathologic features similar to, and in some cases indistinguishable from, melanoma. Historically, the term pseudomelanoma has been used in the literature to describe such recurrent nevi, although this label has the potential for confusion and is no longer the favored term for recurrent pigmented melanocytic nevi.Objective.—To describe historical, histopathologic, and immunohistochemical features of recurrent pigmented melanocytic nevi and to review briefly the literature surrounding the mechanism of recurrence.Data Sources.—Published peer-reviewed literature and the authors' personal experience.Conclusions.—Recognition of the histopathologic pattern of recurrent nevi leads the pathologist to the correct diagnosis in most cases; however, in particularly challenging specimens or in circumstances in which there is insufficient clinical history, immunohistochemical studies have proved helpful in distinguishing recurrent nevi from melanoma.
Immunohistochemical Diagnosis of Renal Neoplasms
Authors: Truong Luan D. , Shen Steven S. 
Published: February 2021

AbstractContext—Histologic diagnosis of renal neoplasm is usually straightforward by routine light microscopy. However, immunomarkers may be essential in several contexts, including differentiating renal from nonrenal neoplasms, subtyping of renal cell carcinoma (RCC), and diagnosing rare types of renal neoplasms or metastatic RCC in small biopsy specimens.Objective—To provide a comprehensive review of the diagnostic utility of immunomarkers for renal neoplasms.Design—This review is based on published literature and personal experience.Conclusions—The following markers may have diagnostic utility in various diagnostic contexts: cytokeratins, vimentin, α-methylacyl coenzyme A racemase, carbonic anhydrase IX, PAX2, PAX8, RCC marker, CD10, E-cadherin, kidney-specific cadherin, parvalbumin, claudin-7, claudin-8, S100A1, CD82, CD117, TFE3, thrombomodulin, uroplakin III, p63, and S100P. Cytokeratins are uniformly expressed by RCC, albeit in a somewhat limited amount in some subtypes, requiring broad-spectrum anti-CK antibodies, including both low– and high–molecular-weight cytokeratins. PAX2 and PAX8 are sensitive and relatively specific markers for renal neoplasm, regardless of subtype. CD10 and RCC marker are sensitive to renal cell neoplasms derived from proximal tubules, including clear cell and papillary RCCs. Kidney-specific cadherin, parvalbumin, claudin-7, and claudin-8 are sensitive markers for renal neoplasms from distal portions of the nephron, including chromophobe RCC and oncocytoma. CK7 and α-methylacyl coenzyme A racemase are sensitive markers for papillary RCC; TFE3 expression is essential in confirming the diagnosis of Xp11 translocation RCC. The potentially difficult differential diagnosis between chromophobe RCC and oncocytoma may be facilitated by S100A1 and CD82. Thrombomodulin, uroplakin III, p63, and S100P are useful markers for urothelial carcinoma. Together with high–molecular-weight cytokeratins, PAX2, and PAX8, they can help differentiate renal pelvic urothelial carcinoma from collecting duct RCC. A sensitive marker for sarcomatoid RCC is still not available. Immunomarkers are most often used for diagnosing metastatic RCC. Compared with primary RCC, expression of the above-mentioned markers is often less frequent and less diffuse in the metastatic setting. Recognizing the variable sensitivity and specificity of these markers, it is important to include at least CD10, RCC marker, PAX2, and PAX8 in the diagnostic panel.