bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytologic Features of Adenocarcinoma, Not Otherwise Specified, in Conventional Smears: Comparison of Cases That Performed Poorly With Those That Performed Well in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology
Authors: Renshaw Andrew A. , Schwartz Mary R. , Wang Edward , Haja Jennifer , Hughes Jonathan H. 
Published: February 2021

Abstract
Context.—Characteristic cytologic features have been identified that distinguish cases that are consistently identified from those that are sometimes missed in the College of American Pathologists Gynecologic Cytology Program for a variety of different lesions and preparations.
Objectives.—To compare the cytologic features of cases of adenocarcinoma, not otherwise specified (NOS), in conventional smears that perform poorly and well.
Design.—The cytologic features of 21 conventional smear cases of adenocarcinoma, NOS, that performed poorly in the College of American Pathologists Interlaboratory Comparison Program were compared with 17 cases that performed extremely well.
Results.—Cases that performed well were significantly more likely to have greater than 1000 abnormal cells (P = .006), greater than 100 large abnormal cells (P = .006), large nuclei (P &lt; .001), marked nuclear atypia (P = .02), and hyperchromasia (P = .02). Repair-like features were rare in both groups and were not significant (P = .71).
Conclusion.—Conventional smears with a diagnosis of adenocarcinoma that were consistently identified were significantly more likely to have more abnormal cells, larger abnormal cells, larger nuclei, marked atypia, and hyperchromasia than cases that performed poorly.
Key Issues in Handling and Reporting Radical Prostatectomy Specimens
Authors: Srigley John R. 
Published: February 2021

Abstract
Context.—Patients with prostatic adenocarcinoma commonly undergo radical prostatectomy, and it is often difficult and time consuming to handle the resulting specimens and to report the findings. Pathologic information derived from the radical prostatectomy specimen is used for selecting adjuvant therapy, such as radiotherapy and hormone therapy, and for determining a patient's prognosis. The prostate specimen must be handled in a systematic fashion to derive the appropriate prognostic parameters.
Objective.—To review the prognostic factors of relevance in classifying radical prostatectomy specimens, using the College of American Pathologists categorization system, including a detailed survey of the morphologic-based factors but excluding other factors such as DNA ploidy and novel phenotypic and genotypic markers.
Conclusions.—Gleason score, pathologic stage, and margin status are considered category 1 prognostic factors, which are of proven prognostic significance and are useful in patient management. Factors such as tumor volume (intraglandular extent) and tumor subtype are considered category 2 prognostic factors, which show significant promise but require validation in multivariate analysis. Lymphovascular space invasion is a promising category 3 prognostic factor that needs additional study. Perineural invasion is an almost ubiquitous finding in radical prostatectomy specimens and is considered a category 3 prognostic factor.
After prognostic factors have been analyzed at the histologic level, it is critical to report the findings in a clear and unambiguous fashion. The synoptic style of reporting is ideal for describing complex cancer resection specimens. A synoptic report based on an evidence-based checklist, such as the one developed by the College of American Pathologists, effectively communicates complex cancer-related data, such as radical prostatectomy specimen findings. This information is used not only for individual case management with respect to treatment and prognostication but also for purposes such as education, research, quality monitoring, and system planning.
Gliosarcoma With Liposarcomatous Differentiation: The New Member of the Lipid-Containing Brain Tumors Family
Authors: Vlodavsky Eugene , Konstantinesku Marius , Soustiel Jean F. 
Published: February 2021

Abstract
Gliosarcoma is a rare malignant, biphasic brain tumor composed of glioblastoma multiforme and sarcomatous components. Various types of sarcomatous differentiation are described in this tumor: fibrosarcomatous, malignant fibrous histiocytoma-like, chondrosarcomatous and osteosarcomatous types. We report an extremely unusual variant of liposarcomatous differentiation in gliosarcoma in 72-year-old woman. Fat cells were presented by atypical multivacuolar and monovacuolar lipoblasts, stained positive for S100. p53 that was positive in both glial and mesenchymal cells of the tumor were negative in the lipoblasts. To the best of our knowledge, this is the first report in the literature of liposarcomatous differentiation in gliosarcoma.
Basal Cell–Signet-Ring Squamous Cell Carcinoma of the Eyelid
Authors: Proia Alan D. , Selim M. Angelica , Reutter Jason C. , Michon John J. 
Published: February 2021

Abstract
A 93-year-old woman developed a mass on her right lower eyelid that was present for more than 6 months but underwent rapid expansion during several weeks prior to her ophthalmological evaluation. Examination revealed an approximately 1.8 cm in diameter, fleshy, fungating growth involving more than 60% of the right lower eyelid. Excisional biopsy disclosed a neoplasm arising from the epidermis composed of adjoining basal cell and signet-ring squamous cell carcinoma, without a transition zone. The cells comprising the basal and squamous cell carcinomas were distinct immunophenotypically, with only the basal cell carcinoma reacting with Ber-EP4 and CAM 5.2 antibodies. To our knowledge, this case represents the first example of a collision tumor composed of basal cell and signet-ring squamous cell carcinoma.
Lipomatous Hypertrophy of the Interatrial Septum: An Overview
Authors: O'Connor Siobhan , Recavarren Rosemary , Nichols Lawrence C. , Parwani Anil V. 
Published: February 2021

AbstractLipomatous hypertrophy of the interatrial septum is a rare, but increasingly recognized, anomalous developmental or neoplastic lesion of the heart. This entity was first described in 1964 at autopsy and is identified before death based on its distinctive characteristics on echocardiography, computed tomography, and magnetic resonance imaging. Although it is often asymptomatic, the mass has been associated with supraventricular arrhythmias and sudden death. In rare patients who experience intractable symptoms, surgical excision of the lesion may provide relief. Therefore, lipomatous hypertrophy of the interatrial septum is of interest to the pathologist when a cardiac mass is received for evaluation or at autopsy when a patient has experienced sudden death from an unknown cause.
Review of Pediatric Autopsies Performed at a University Hospital in Ribeirão Preto, Brazil
Authors: Peres Luiz Cesar 
Published: February 2021

Abstract
Context.—Autopsy continues to provide important data for quality assurance, teaching, scientific purposes, and health planning, especially if performed according to a comprehensive protocol.
Objective.—To describe and analyze data from all perinatal and pediatric autopsies performed at a university hospital in Brazil.
Design.—Review of data from 1716 autopsies performed between April 1993 and April 1999, consisting of age at death, congenital defects, gender, and cause of death.
Results.—Age at death distribution: early neonatal deaths, 31.7%; stillbirth, 25.7%; 1 to 11 months, 19.6%; 1 to 5 years, 10.3%; late neonatal deaths, 6.3%; 11 to 15 years, 4%; 6 to 10 years, 2.5%. Cause of death: perinatal conditions, 51%; congenital malformation(s), 24.4%; infection, 11.9%; neoplasm, 3%; hematologic/immunologic, 2.3%; neurologic, 1.6%; gastrointestinal, 1.5%; cardiovascular, 0.7%; respiratory, 0.6%; genitourinary, 0.3%; other disorders, 0.5%. Gender distribution: male, 54.31%; female, 45.22%; indeterminate, 0.41%; data unavailable, 0.06%. Congenital anomalies were found in 31.5% of the autopsies and were the cause of death in 24.41% of the autopsies.
Conclusions.—High autopsy rates, combined with a comprehensive autopsy protocol, allowed the characterization of perinatal and pediatric deaths. The high proportion of perinatal deaths and stillbirths indicates the need for improvement in the prenatal care program. Congenital anomalies were highly prevalent because few pregnancies are interrupted in Brazil. The low number of cancer cases autopsied was attributed to the fact that most patients die at home, and to the high level of trust between the oncology team and the family, with the erroneous assumption that no relevant information would be provided.
Molecular Pathology: Future Issues
Authors: Kiechle Frederick L. , Zhang Xinbo , Holland Carol 
Published: February 2021

Abstract
Context.—The field of molecular pathology is expanding in complexity. To achieve competency, vigilance is required.
Objective.—To review the advances in clinically useful molecular biologic techniques and to identify their applications in clinical practice, as presented at the 13th Annual William Beaumont Hospital DNA Symposium.
Data Sources.—The 4 manuscripts submitted were reviewed and their major findings were compared with the literature on the same or related topics.
Study Selection.—Manuscripts address the use of molecular or immunophenotyping by flow cytometry to evaluate the origin or presence of sepsis, respectively; the use of imatinib mesylate to treat chronic myeloid leukemia and the nature of resistance to imatinib; and the use of 9 and 10 fluorochromes during clinical flow cytometric studies.
Data Synthesis.—The epidemiologic evaluation of a septic outbreak may be monitored using molecular techniques that track the relatedness of isolates. A potential biomarker for the presence of early sepsis is CD64. Intracellular signal transduction pathways are altered in malignancy. Imatinib mesylate inhibits the BCR-ABL kinase created by translocation of the long arms of chromosomes 9 and 22 in chronic myeloid leukemia. Resistance to imatinib may be secondary to mutation in the BCR-ABL kinase domain or residual leukemic stem cells that imatinib does not kill. The use of 9 or 10 fluorochromes simultaneously during flow cytometry has many clinical advantages; however, software for data analysis is needed.
Conclusion.—The current postgenomic era will continue to emphasize the use of microarrays and database software for genomic, transcriptomic, proteomic, nutrigenomic, and pharmacogenomics screening to search for a useful clinical assay. The number of molecular pathologic techniques will expand as additional disease-associated mutations are defined.
Mycobacterial Synovitis Caused by Slow-Growing Nonchromogenic Species: Eighteen Cases and a Review of the Literature
Authors: Olsen Randall J. , Cernoch Patricia L. , Land Geoffrey A. 
Published: February 2021

Abstract
Context.—Slow-growing nonchromogenic mycobacterial species are an infrequent cause of soft tissue infection. Because these organisms are rare, they are not often initially considered in the differential diagnosis of synovitis.
Objective.—To evaluate the clinical and pathologic characteristics of patients with synovitis resulting from slow-growing nonchromogenic mycobacterial species.
Design.—A 20-year retrospective review of records from The Methodist Hospital Microbiology Laboratory identified 18 culture-positive cases of synovitis that resulted from slow-growing nonchromogenic mycobacteria, including 14 caused by Mycobacterium avium complex, 1 caused by Mycobacterium malmoense, 1 caused by Mycobacterium haemophilum, and 2 caused by Mycobacterium nonchromogenicum isolates. In addition, a comprehensive literature search revealed an additional 48 cases of synovitis caused by slow-growing nonchromogenic mycobacteria.
Results.—The historic literature described the majority of the 48 patients as previously healthy, elderly individuals with a several-month history of monoarticular pain and swelling in the small joints of the upper extremity. In contrast, the current series demonstrated the probable role of multiple chronic coexisting medical conditions in promoting disease susceptibility. These patients were also unique in their significantly younger age distribution and diversity of infection sites. Histologic examination and direct acid-fast bacteria stains generally did not aid the diagnosis. Amputation was performed in 2 patients because of delayed identification of disease.
Conclusions.—The current series demonstrates that difficult identification and infrequent occurrence cause these organisms to be overlooked by physicians and laboratory personnel. A heightened clinical suspicion for slow-growing nonchromogenic mycobacterial species is necessary when routine culture and histopathologic findings do not readily isolate an organism, or when the patient does not respond to antibiotic and anti-inflammatory treatment.
Cruella: Developing a Scalable Tissue Microarray Data Management System
Authors: Cowan James D. , Rimm David L. , Tuck David P. 
Published: February 2021

Abstract
Context.—Compared with DNA microarray technology, relatively little information is available concerning the special requirements, design influences, and implementation strategies of data systems for tissue microarray technology. These issues include the requirement to accommodate new and different data elements for each new project as well as the need to interact with pre-existing models for clinical, biological, and specimen-related data.
Objective.—To design and implement a flexible, scalable tissue microarray data storage and management system that could accommodate information regarding different disease types and different clinical investigators, and different clinical investigation questions, all of which could potentially contribute unforeseen data types that require dynamic integration with existing data.
Design.—The unpredictability of the data elements combined with the novelty of automated analysis algorithms and controlled vocabulary standards in this area require flexible designs and practical decisions. Our design includes a custom Java-based persistence layer to mediate and facilitate interaction with an object-relational database model and a novel database schema. User interaction is provided through a Java Servlet–based Web interface.
Results.—Cruella has become an indispensable resource and is used by dozens of researchers every day. The system stores millions of experimental values covering more than 300 biological markers and more than 30 disease types. The experimental data are merged with clinical data that has been aggregated from multiple sources and is available to the researchers for management, analysis, and export.
Conclusion.—Cruella addresses many of the special considerations for managing tissue microarray experimental data and the associated clinical information. A metadata-driven approach provides a practical solution to many of the unique issues inherent in tissue microarray research, and allows relatively straightforward interoperability with and accommodation of new data models.
High Proliferative Activity Excludes Dermatofibroma: Report of the Utility of MIB-1 in the Differential Diagnosis of Selected Fibrohistiocytic Tumors
Authors: Hanly Andrew J. , Jordà Mercè , Elgart George W. , Badiavas Evangelos , Nassiri Mehdi , Nadji Mehrdad 
Published: February 2021

Abstract
Context.—Dermatofibroma is a benign fibrohistiocytic tumor composed of a mixture of fibroblastic and histiocytic cells. The diagnosis of this tumor is generally uncomplicated; however, rare variants may be difficult to distinguish from malignant fibrohistiocytic tumors. Deep penetrating dermatofibroma may be difficult to distinguish from dermatofibrosarcoma protuberans, and pseudosarcomatous dermatofibroma and dermatofibroma with monster giant cells share morphologic similarities with malignant fibrous histiocytoma and atypical fibroxanthoma.
Objective.—To find an immunohistochemical marker or markers that differentiate between fibrohistiocytic lesions of skin.
Design.—We evaluated the immunophenotypic characteristics of 83 fibrohistiocytic tumors (36 typical dermatofibromas, 16 cases of dermatofibrosarcoma protuberans, 16 malignant fibrous histiocytomas, and 15 atypical fibroxanthomas) using antibodies against MIB-1 (Ki-67), factor XIIIa, CD34 (HPCA-1), HHF35 (muscle-specific actin), 1A4 (smooth muscle actin), cytokeratin (AE1/AE3, CAM 5.2, and 34βE12), S100 protein, and desmin.
Results.—A high proliferative index detected by MIB-1 staining excluded the possibility of dermatofibroma and was diagnostically useful in separating this entity from dermatofibrosarcoma protuberans, malignant fibrous histiocytoma, and atypical fibroxanthoma. A low proliferative index, however, could not differentiate dermatofibroma from dermatofibrosarcoma protuberans. Factor XIIIa reactivity was not helpful for the diagnosis of dermatofibroma, whereas CD34 reactivity was statistically significant in the diagnosis of dermatofibrosarcoma protuberans. The sensitivity of these 2 markers is low and therefore of questionable practical diagnostic value.
Conclusion.—Evaluation of the proliferative index may further assist in distinguishing dermatofibroma from dermatofibrosarcoma protuberans, atypical fibroxanthoma, and malignant fibrous histiocytoma.
Quantification of the Morphologic Features of Fibroepithelial Tumors of the Breast
Authors: McKenna Ann Marie , Pintilie Melania , Youngson Bruce , Done Susan J. 
Published: February 2021

Abstract
Context.—Phyllodes tumors of the breast are uncommon, comprising 0.3% to 0.9% of female primary breast tumors. Owing in part to their rarity, definitive, objective, reproducible morphologic criteria that reliably distinguish benign from low-grade malignant or malignant phyllodes tumors have yet to be established.
Objective.—To use image analysis to quantitate and compare morphologic features of different groups of fibroepithelial tumors (FETs) of the breast.
Design.—Hematoxylin-eosin–stained sections of 41 FETs previously identified as fibroadenoma, benign phyllodes, low-grade malignant phyllodes, or high-grade malignant phyllodes were blinded and studied using a Leica DMRA2 microscope and OpenLab Image Analysis software. Features measured included mitotic rate per 10 high-power fields, stromal cellularity, nuclear size, stromal overgrowth, and the largest and smallest stromal-epithelial surface area ratios. Epithelial appearance was measured on a semiquantitative basis. Features of each case including tumor size, margin status, and the presence of necrosis or heterologous elements were also considered; these data were retrieved from surgical pathology reports.
Results.—Quantitative measures of stromal cellularity, stromal-epithelial ratio, mitotic rate, stromal overgrowth, and mean nuclear diameter were developed and found to stratify a population of FETs by the current classification system of fibroadenoma, benign, and low-grade or high-grade malignant phyllodes tumor.
Conclusions.—Quantitative morphologic features of FETs can be used to stratify these tumors by subtype. Use of these quantitative criteria could reduce interrater variability in histologically identifying FETs by subclass.
Laboratory Reporting of the International Normalized Ratio: Progress and Problems
Authors: Olson John D. , Brandt John T. , Chandler Wayne L. , Van Cott Elizabeth M. , Cunningham Mark T. , Hayes Timothy E. , Kottke-Marchant Kandice K. , Makar Robert S. , Uy Arby B. , Wang Edward C. 
Published: February 2021

Abstract
Context.—The international normalized ratio (INR) is widely used to monitor oral anticoagulation and to evaluate patients with coagulation disorders.
Objective.—To examine the variability of the performance and reporting of the INR and to evaluate laboratory calculation of the INR.
Design.—Between 1993 and 2003, laboratories participating in proficiency testing were surveyed. Participants provided the international sensitivity index and the mean normal prothrombin time used to calculate the INR. The INR was calculated from the data provided and compared with the INR reported to determine if the calculation was correct.
Results.—Survey data regarding the INR collected between 1993 and 2003 demonstrate an improvement in reporting, using appropriate anticoagulant, using lower international sensitivity index reagents, and matching international sensitivity index and prothrombin time method. The all-method coefficient of variation of the INR improved from 18% to 5.8%. Among 3813 laboratories studied in 2002 and 2003, 4.1% miscalculated INR. Of 29 laboratories that reported investigation of the INR miscalculation, 11 (38%) reported correcting an INR that was being reported in patient results and that this error was corrected as a result of the study. Since beginning grading of the INR calculation, miscalculation of the INR has fallen to less than 1%.
Conclusions.—Recommendations for change in laboratory practice made by consensus conferences are implemented during the course of many years. Difficulty calculating the INR was documented, and both the calculation and the variability in the reporting of the INR showed improvement. Proficiency testing, when closely evaluated and acted on, can have a direct impact on the quality of patient care.
Best Practices in Diagnostic Immunohistochemistry: Hepatocellular Carcinoma Versus Metastatic Neoplasms
Authors: Kakar Sanjay , Gown Allen M. , Goodman Zachary D. , Ferrell Linda D. 
Published: February 2021

Abstract
Context.—Immunohistochemistry plays a crucial role in the diagnosis of hepatocellular carcinoma and in its distinction from other primary and metastatic neoplasms. Because limited tissue is available with fine-needle and core biopsies, appropriate selection of antibodies is imperative.
Objective.—To review the antibodies used for the diagnosis of hepatocellular carcinoma and to outline an immunohistochemical approach in commonly encountered clinical situations.
Data Sources.—Our experience and review of research articles published in the English literature between 1987 and 2006.
Conclusions.—Hep Par 1 and polyclonal carcinoembryonic antigen are the most reliable markers for hepatocellular differentiation, but they have low sensitivity for poorly differentiated cases. Immunohistochemistry for glypican-3 shows promise for the diagnosis of poorly differentiated hepatocellular carcinoma and for its distinction from benign processes such as hepatic adenoma. Further studies with a large number of cases are required before it can be widely used. The combination of Hep Par 1 and MOC-31 will allow for the diagnosis of hepatocellular carcinoma in most cases and will guide the selection of immunohistochemical markers for further workup.