bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glomus Tumor Arising in a Mature Teratoma of the Ovary
Authors: Silver Susan A. , Tavassoli Fattaneh A. 
Published: January 2021

Abstract
Glomus tumors involving the female genital tract are rare. Herein we report the case of a glomus tumor constituting the major component of a mature teratoma of the ovary. This lesion represented an incidental finding in a 43-year-old woman who underwent bilateral salpingo-oophorectomy at the time of detection of locally recurrent squamous carcinoma of the cervix. The glomus tumor was initially interpreted as a metastasis due to its superficial morphologic resemblance to the recurrent carcinoma in the vagina. It was, however, morphologically similar to glomus tumors that classically arise in the extremities. The diagnosis was supported by immunohistochemistry and ultrastructural examination. To our knowledge, no similar tumor has been described in the ovary or in teratomas at any other site.
Myospherulosis in Renal Cell Carcinoma
Authors: Chau Kai Y. , Pretorius Janli M. , Stewart Alistair W. 
Published: January 2021

Abstract
Objective.—To study retrospectively the identification, characteristics, and localization of myospherulosis in different types of renal cell carcinomas.
Design.—Twenty-seven consecutive renal cell carcinomas treated by radical nephrectomy in 1 year were studied. All the tumor and nontumor slides were examined for myospherulosis. The demographic data, histological type of renal cell carcinoma, Robson stage, and Fuhrman grades were recorded.
Results.—Myospherules were found in 10 cases. They were associated with the clear cell type and a higher nuclear grade. The cell type remained the only significant factor when these 2 factors were tested together with the tumor stage by logistic regression. Myospherulosis tended to be found in younger patients but was not associated with the sex or the side of the tumor. They were scattered within tumor cystic spaces or among sheets of tumor cells. Some of the myospherules might arise from histiocytes or even tumor cells. Compared with previous reports of myospherulosis associated with exogenous or endogenous lipid, the myospherules associated with renal cell carcinoma were smaller and more uniform in size. There is no associated fibrosis or foreign body giant cell reaction.
Conclusion.—As far as we know, this is the first report of myospherulosis occurring in malignant tumors in human, and their associated features are different from those previously described for myospherulosis related to exogenous or endogenous lipid.
Enterocytozoon bieneusi as a Cause of Proliferative Serositis in Simian Immunodeficiency Virus–Infected Immunodeficient Macaques (Macaca mulatta)
Authors: Chalifoux Laura V. , Carville Angela , Pauley Douglas , Thompson Brendon , Lackner Andrew A. , Mansfield Keith G. 
Published: January 2021

Abstract
Context.—Enterocytozoon bieneusi is the most frequent microsporidian parasite of human patients with acquired immunodeficiency syndrome and is a significant cause of diarrhea and wasting. Recently, this organism has also been recognized as a spontaneous infection of several species of captive macaques. As in humans, E bieneusi frequently causes enteropathy and cholangiohepatitis in immunodeficient simian immunodeficiency virus (SIV)–infected macaques.
Objective.—To examine E bieneusi as an etiologic agent of nonsuppurative proliferative serositis in immunodeficient rhesus macaques (Macaca mulatta).
Design.—Retrospective analysis of necropsy material obtained from immunodeficient SIV-infected rhesus macaques.
Results.—Examination of SIV-infected rhesus macaques (n = 225) revealed E bieneusi proliferative serositis in 7 of 16 cases of peritonitis of unknown origin. The organism could be identified by in situ hybridization and polymerase chain reaction in sections of pleura and peritoneum obtained at necropsy. Serositis was always accompanied by moderate-to-severe infection of the alimentary tract, and morphologic evidence suggested dissemination through efferent lymphatics. Colabeling experiments revealed most infected cells to be cytokeratin positive and less frequently positive for the macrophage marker CD68. Sequencing of a 607–base pair segment of the small subunit ribosomal gene revealed 100% identity to sequences obtained from rhesus macaques (Genbank accession AF023245) and human patients (Genbank accession AF024657 and L16868).
Conclusions.—These findings indicate that E bieneusi disseminates in immunodeficient macaques and may be a cause of peritonitis in the immunocompromised host.
Epididymal Rhabdomyoma
Authors: Wehner Margaret S. , Humphreys James L. , Sharkey Francis E. 
Published: January 2021

Abstract
Genital rhabdomyoma is a rare tumor of skeletal muscle origin that is usually found in the vulvar area of young women. The English literature contains only 2 previous case reports involving men, both of whom were 19 years old. One of these lesions originated in the tunica vaginalis of the testis, and the other originated in the prostate gland. We present the clinical, histologic, and immunohistochemical findings of an epididymal rhabdomyoma in a 20-year-old man. To our knowledge, this is the first such case reported in this location.
The Characteristic Appearance of Non-Alcoholic Duct Destructive Chronic Pancreatitis
Authors: Scully Kerry A. , Li Shuan C. , Hebert James C. , Trainer Thomas D. 
Published: January 2021

Abstract
We report 2 patients with an unusual form of chronic pancreatitis, both of whom were treated for clinical suspicion of pancreatic malignancy. The surgical specimens revealed a dense lymphoplasmacytic infiltration of the main and interlobular branches of the pancreatic duct, causing sclerosis of the duct wall, diffuse irregular lumenal narrowing, extensive parenchymal fibrosis, and organ enlargement. Neither case showed calcifications, fat necrosis, or cyst formation, features usually seen in alcoholic pancreatitis, nor was there any evidence of neoplasia. One patient had an unusual form of acalculous cholecystitis, but without cystic duct inflammation or fibrosis. Both patients recovered well from the surgical procedure and have not had any complications or relapse of their symptoms. To the best of our knowledge, these cases are representative of the recently described non-alcoholic duct destructive chronic pancreatitis, which is thought to be immune-mediated.
Concomitant Well-Differentiated Adenocarcinoma and Leiomyosarcoma of the Uterus
Authors: Sheyn Irena , Mira Jose L. , Blanco Ramon , Walton Mava B. , Husseinzadeh Nader 
Published: January 2021

Abstract
We describe a case of a concomitant well-differentiated endometrial endometrioid adenocarcinoma and leiomyosarcoma of the uterus in a 66-year-old woman who presented with a 6-month history of vaginal bleeding. The patient underwent total hysterectomy for endometrial carcinoma diagnosed by endometrial biopsy. Gross examination of the specimen revealed an endometrial mass bulging into the endometrial cavity and an underlying well-circumscribed nodule separated from the endometrial mass by a myometrial band. Frozen section performed at the time of the total hysterectomy rendered a diagnosis of malignant mixed-müllerian tumor. Histologic examination of the permanent sections revealed well-differentiated endometrial endometrioid adenocarcinoma clearly separated from a high-grade leiomyosarcoma. Differential diagnosis included malignant mixed-müllerian tumor. However, no admixture of carcinomatous and sarcomatous elements was present. There were no heterologous elements. To the best of our knowledge, no similar case has been described in the English literature.
Neutrophilic Thrombophagocytosis
Authors: Lee J. C. , Tripathy Kumud 
Published: January 2021

Abstract
Thrombocytopenia as a complication of B-cell lymphoma usually results from the removal of platelets from the circulation by splenic and hepatic mononuclear phagocytes.1,2 In the present paper, we describe a case of B-cell lymphoma with thrombocytopenia in which the platelets were phagocytosed by the patient's own neutrophilic granulocytes. This finding suggests that neutrophilic granulocytes actively participate in immune platelet clearance.
Isolated Visceral Leishmaniasis Presenting as an Adrenal Cystic Mass
Authors: Brenner David S. , Jacobs Stephen C. , Drachenberg Cinthia B. , Papadimitriou John C. 
Published: January 2021

Abstract
A 69-year-old woman presented with a large left retroperitoneal suprarenal mass. Radical resection of the left kidney and the mass revealed a cystic adrenal tumor with a weight of 1500 g. Histologic examination showed that the cyst was composed mostly of partially organized clotted blood. The periphery of the mass consisted of a thin rim of cortical and medullary adrenal tissue with superimposed granulomatous chronic inflammation. The infectious nature of the process was manifested by the scattered intracellular and extracellular Leishmania amastigotes that were found throughout the lesion. The differential diagnosis of cystic adrenal masses and the unusual presentation of visceral leishmaniasis are discussed in this context.
Regression of Human Cirrhosis
Authors: Wanless Ian R. , Nakashima Eisuke , Sherman Morris 
Published: January 2021

AbstractContext.—Cirrhosis is widely regarded as being irreversible. Recent studies have demonstrated that fibrosis may decrease with time in humans and experimental animals if the disease activity becomes quiescent. The histologic appearance of regressing cirrhosis in the human has not been described in detail.Objectives.—To define histologic parameters that indicate regression of cirrhosis and to provide an interpretation of how regression occurs from a histologic point of view.Design.—A patient who underwent a series of biopsies that showed apparent regression of hepatitis B cirrhosis is presented. In addition, 52 livers removed at transplantation having cirrhosis or incomplete septal cirrhosis were graded for histologic parameters that suggest progression or regression of fibrosis. Progression parameters were steatohepatitis, inflammation, bridging necrosis, and piecemeal necrosis. The regression parameters (collectively called the hepatic repair complex) were delicate perforated septa, isolated thick collagen fibers, delicate periportal fibrous spikes, portal tract remnants, hepatic vein remnants with prolapsed hepatocytes, hepatocytes within portal tracts or splitting septa, minute regenerative nodules, and aberrant parenchymal veins.Results and Conclusions.—Regression parameters were found in all livers and were prominent in the majority. Livers with micronodular cirrhosis, macronodular cirrhosis, and incomplete septal cirrhosis demonstrate a histologic continuum. A continuum of regressive changes was also seen within individual livers. These appearances allow one to understand visually how fibrous regions of hepatic parenchyma can be returned toward a normal appearance. Many examples of incomplete septal cirrhosis could be the product of regressed cirrhosis.
Redesigned Proficiency Testing Materials Improve Survey Outcomes for Prostate-Specific Antigen
Authors: Sokoll Lori J. , Witte David L. , Klee George G. , Chan Daniel W. 
Published: January 2021

AbstractContext.—Large disparities in prostate-specific antigen (PSA) results from different assays have been observed in the College of American Pathologists (CAP) Ligand Assay Survey, with interassay results varying severalfold. Survey specimens are predominately composed of free PSA and do not reflect the composition of typical patient specimens.Objectives.—To characterize a pilot material developed for CAP in which pooled sera samples were spiked with purified PSA and α1-antichymotrypsin–bound PSA at targeted concentrations and to compare it to CAP survey and reference materials.Design.—CAP survey, reference, and pilot materials were analyzed using 10 total PSA and 7 free PSA assays. These assays included Food and Drug Administration–approved assays and assays for research use only.Results.—Variability among the 10 total PSA methods was greatest for the 1997 ligand survey material (CV range, 56%–65%) followed by the pilot material (CV range, 10%–29%) and the reference material (CV range, 6%–13%). In contrast, interassay variability for the 7 free PSA methods was similar for the 3 preparations, with the exception of one specimen close to the limit of detection of the assays. As determined with the Hybritech Tandem-R method, the ligand survey specimens were essentially composed of all free PSA, whereas the reference and pilot materials were composed of approximately 10% and 35% free PSA, respectively.Conclusions.—The newly formulated pilot material prepared using a human base that contained defined concentrations of free PSA and α1-antichymotrypsin–bound PSA more closely resembled patient specimens and minimized differences among methods compared with the semen-supplemented original survey material.
Molecular Evidence of Bacteremia by Gastrointestinal Pathogenic Bacteria in an Infant Mummy From Ancient Egypt
Authors: Zink Albert , Reischl Udo , Wolf Hans , Nerlich Andreas G. 
Published: January 2021

Abstract
In this study, we describe an infant mummy from ancient Egypt that showed macromorphologic signs of chronic anemia and vitamin C deficiency. From this infant, we have obtained a sterile sample from a metatarsal bone to extract ancient bacterial DNA. Following polymerase chain reaction amplification and subcloning of the amplicons, the sequence of the 16S ribosomal DNA was determined in several resulting clones. The presence of pathogenic and apathogenic bacteria, such as Escherichia coli, are indicated by our result, providing evidence of bacteremia, which probably contributed to death due to septicemia. These findings suggest that the infant, who already had chronic anemia and vitamin C deficiency, acquired a gastrointestinal infection, which finally led to a systemic spread. To our knowledge, this is the first case identifying potentially septicemic bacterial dissemination in an ancient Egyptian mummy. Using our approach, we hope to investigate distinct paleomicrobiological aspects of ancient populations, which will potentially enlighten our understanding of the development and evolution of pathogenic bacteria.
Right Middle Lobe Atelectasis Associated With Endobronchial Silicotic Lesions
Authors: Chien Hsiu-Ping , Lin Tao-Ping , Chen Hsiao-Ling , Huang Thomas W. 
Published: January 2021

Abstract
Background.—In a period of 18 months, we have encountered 4 cases of right middle lobe atelectasis associated with endobronchial silicotic lesions of right middle lobe bronchi. All patients had occupational exposure to mineral dusts (3 coal miners and 1 sand blaster) for months to decades.
Methods.—The nature of the endobronchial silicotic lesions that caused the bronchial obstruction has been confirmed by endobronchial biopsies and energy-dispersive spectrometry of the lesions. Extrinsic compression has been excluded by careful radiographic and computed tomographic image analysis.
Results.—The endobronchial silicosis does not appear to correlate with the degree of pneumoconiosis of the lung parenchyma. The endobronchial silicosis may cause bronchial obstruction in the absence of radiographic evidence of pulmonary silicosis.
Conclusion.—The endobronchial silicosis and consequent lung atelectasis may be associated with silica exposure.
Serum Hepatitis C Virus RNA Levels and Histologic Findings in Liver Allografts With Early Recurrent Hepatitis C
Authors: Park Young Nyun , Boros Peter , Zhang David Y. , Sheiner Patricia , Kim-Schluger Leona , Thung Swan N. 
Published: January 2021

Abstract
Background.—Histopathologic features of early recurrent hepatitis C after orthotopic liver transplantation (OLTx) may be modified by immunosuppressive therapy or complicated by other conditions. Hepatitis C virus (HCV) RNA level usually increases after OLTx, but its correlation to histologic findings is not clear.
Objective.—To evaluate the histologic findings of early recurrent hepatitis C in liver allografts and its correlation to serum HCV RNA level.
Methods.—We studied 14 patients who underwent OLTx for chronic HCV infection. Thirty liver biopsy specimens and HCV RNA levels of 22 corresponding plasma samples obtained during the first 6 months following OLTx were analyzed. The control group (9 patients, 25 biopsy specimens) was chosen at random from patients with chronic liver disease other than HCV who were undergoing OLTx, and all tested negative for HCV RNA by polymerase chain reaction after OLTx.
Results.—Statistically significant pathological features of early recurrent HCV infection were the number of acidophilic bodies, piecemeal necrosis, lymphocyte predominance in the portal tracts, and fibrous septum. These findings and histologic activity index scores increased with time after OLTx. The HCV RNA levels determined by branched DNA assay showed no significant correlation with histologic features. However, patients with higher histologic activity index scores tended to have higher RNA levels.
Conclusions.—Liver biopsy specimens are helpful for the diagnosis or confirmation of early recurrent hepatitis C in liver allografts, but serial biopsy specimens are sometimes required for definite diagnosis. The HCV RNA levels are usually higher in patients who display signs of more severe liver damage.
Metastatic Osteosarcoma Presenting as a Small-Bowel Polyp
Authors: Panizo-Santos Angel , Sola Iosu , Lozano María Dolores , de Alava Enrique , Pardo Javier 
Published: January 2021

AbstractGastrointestinal metastases of osteosarcoma are an extraordinarily rare event and, as far as we can determine, have been reported previously only 5 times; these cases represent an unusual pattern of progression. We describe a 21-year-old man with an osteosarcoma of the right tibia that was removed 4 years previously. Two years later, the patient showed lung metastases. At his most recent presentation, he complained of abdominal pain, nausea, vomiting, and anorexia. Radiologic examination revealed an abdominal mass close to the jejunum and 3 nodules in the liver. One metastasis was an ulcerated and pedunculated polypoid mass located in the mucosa of the bowel, and the other involved the entire thickness of the jejunum. This unusual phenomenon represents an alteration in the natural history of osteosarcoma as a result of increased long-term survival.
Primary T-Cell–Rich B-Cell Lymphoma Masquerading as a Meningioma
Authors: Amaker Barbara H. , Ghatak Nitya R. , Jebraili Sean A. , Ferreira-Gonzalez Andrea , Kornstein Michael J. 
Published: January 2021

Abstract
Primary dural lymphoma is rare, and few of the small number of cases reported to date have been classified using immunohistochemical techniques. To our knowledge, we report the first case of T-cell–rich B-cell lymphoma (diffuse mixed small cell and large cell) presenting as a solitary intracranial dural mass. Cytologic and frozen sections prepared during intraoperative consultation revealed a polymorphic population of lymphocytes suspicious for an inflammatory process. Permanent sections of the dura showed a diffusely infiltrating mass composed of mature lymphocytes peppered with large atypical lymphocytes. Immunohistochemical stains identified the small lymphocytes as T cells (CD3 and CD43) and the large atypical lymphocytes as B cells (CD20). Evidence of rearranged immunoglobulin heavy-chain genes demonstrated B-cell monoclonality. Differentiating between inflammatory and neoplastic lymphocytic masses of the dura obviously has important therapeutic and prognostic significance and may require immunohistochemical and molecular techniques.
Succinate Dehydrogenase Deficiency
Authors: Vladutiu Georgirene D. , Heffner Reid R. 
Published: January 2021

Abstract
Background.—Partial succinate dehydrogenase deficiency (15% to 50% of normal reference enzyme activity) in skeletal muscle causes mitochondrial myopathy with various symptoms, for example, brain involvement, cardiomyopathy, and/or exercise intolerance. The deficiency may be isolated or may coexist with other respiratory-chain enzyme defects. The histopathologic assessment of succinate dehydrogenase activity in muscle biopsies of patients with suspected mitochondrial myopathies has focused on the finding of increased staining, usually in ragged-red fibers, rather than on reduced staining.
Objectives.—To determine the prevalence of muscle succinate dehydrogenase deficiency among patients with respiratory-chain defects and to determine whether the reduced activity is present histochemically and is comparable to the quantitative reduction found in muscle homogenates.
Patients and Methods.—One hundred eight muscle biopsies were evaluated from patients with suspected mitochondrial myopathies by qualitative histochemical analysis and quantitative biochemical analyses of respiratory-chain enzymes using standard methodologies.
Results.—Fifty-two patients had defects in respiratory-chain complexes; of these patients, 12 (23%) had partial deficiencies in succinate dehydrogenase activity either alone or together with reductions in other enzymes. The reduced activity was detectable histochemically in muscle biopsies with residual enzyme activity of up to 34% of the normal reference activity, while 2 biopsies with higher residual activity (49% and 68% of normal) could not be distinguished from normal biopsies.
Conclusions—Of the patients with respiratory-chain enzyme defects, 23% had partial deficiencies of succinate dehydrogenase activity in muscle biopsies. This reduction could be detected histochemically in biopsies in most cases. The marked prevalence of succinate dehydrogenase deficiency among patients with respiratory-chain defects and its detection initially by histochemical analysis are important findings.
Loss of High-Molecular-Weight Cytokeratin Antigenicity in Prostate Tissue Obtained by Transurethral Resections
Authors: Multhaupt Hinke A. B. , Fessler James N. , Warhol Michael J. 
Published: January 2021

Abstract
Objective.—Staining of prostatic basal cells for the expression of high-molecular-weight cytokeratin has been suggested as a way of distinguishing benign from malignant prostate glands. We evaluated the utility of high-molecular-weight cytokeratin in the diagnosis of malignancy in prostate specimens obtained in various ways.
Design.—Prostate tissues obtained from needle biopsies, transurethral resections, and total prostatectomies were immunostained with monoclonal antibody 34βE12, an antibody directed against high-molecular-weight cytokeratins.
Results.—Antiserum to high-molecular-weight cytokeratin only stained the basal cells in normal glands in 3 (12%) of 25 specimens obtained by transurethral resection. Other antigens, such as the alternate 10-nm filament protein vimentin, were unaffected and were detected in 100% of these specimens. However, keratin antigenicity in transurethral biopsies could be restored in these specimens by antigen retrieval in a low pH citrate buffer using a microwave heat technique. Keratin staining in needle biopsies and total prostatectomies was unaffected.
Conclusion.—In summary, our results indicate the technique of transurethral resection results in a specific loss of keratin antigenicity. This limits the utility of anticytokeratin 34βE12 in interpreting transurethral resections without the application of antigen retrieval.