bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Overview of Testicular Germ Cell Tumors
Authors: Bahrami Armita , Ro Jae Y. , Ayala Alberto G. 
Published: February 2021

AbstractContext.—More than 90% of testicular neoplasms originate from germ cells. Testicular germ cell tumors (GCTs) are a heterogeneous group of neoplasms with diverse histopathology and clinical behavior.Objective.—To help the readers distinguish various subtypes of GCTs, to highlight the clinical manifestations and pathologic features of these tumors, and to review several newly developed immunohistochemical markers for GCTs.Data Sources.—Review of the pertinent literature and our experience.Conclusions.—The etiology of GCTs is largely unknown. Cytogenetic studies suggest a different pathogenesis for each group of infantile/prepubertal GCTs, postpubertal GCTs, and spermatocytic seminoma. Unclassified intratubular germ cell neoplasia is the precursor of all GCTs, excluding spermatocytic seminoma and infantile/prepubertal GCTs. Seminoma, the most common GCT in adults, does not occur before 5 years of age. Spermatocytic seminoma, a tumor of elderly men, typically has an indolent clinical behavior, but rarely it undergoes sarcomatous transformation associated with an aggressive behavior. Embryonal carcinoma is the most common component in mixed GCTs. Eighty percent or more of embryonal carcinoma component and vascular invasion are recognized predictors of occult metastasis for clinical stage I mixed GCTs. Most patients with prepubertal yolk sac tumor, the most common pediatric GCT, have stage I disease at presentation. Most choriocarcinomas present with metastatic symptoms because of the propensity for rapid hematogenous dissemination. Teratomas in children regardless of maturity and dermoid cysts in adults are benign; in contrast, teratomas in adults have a malignant behavior. With appropriate therapy, the majority of testicular GCTs are curable.
Small Round Cell Tumors of Bone
Authors: Hameed Meera 
Published: February 2021

AbstractContext.—Primary small round cell tumors of the bone are a heterogeneous group of malignant neoplasms presenting predominantly in children and adolescents. They include Ewing sarcoma/peripheral neuroectodermal tumor or Ewing family tumors, lymphoma, mesenchymal chondrosarcoma, and small cell osteosarcoma. Even though they share many morphological similarities, their unique biological and genetic characteristics have provided substantial insights into the pathology of these diverse neoplasms.Objective.—To provide an overview of the clinical, radiologic, pathologic, and genetic characteristics of these tumors along with a pertinent review of the literature.Data Sources.—A literature search using PubMed and Ovid MEDLINE was performed, and data were obtained from various articles pertaining to clinicopathologic, biological, and genetic findings in these tumors. Additionally, findings from rare cases have been included from author's subspecialty experience.Conclusion.—The diagnosis of small round cell tumors can be made accurately by applying clinicopathologic criteria, as well as a panel of immunohistochemical and genetic studies in appropriate cases. Molecular genetic studies may provide further insight into the biology, histogenesis, and prognosis of these tumors.
Clinicopathologic Aspects of 1p/19q Loss and the Diagnosis of Oligodendroglioma
Authors: Aldape Kenneth , Burger Peter C. , Perry Arie 
Published: February 2021

Abstract
Context.—Significant interobserver variability exists with respect to the diagnosis of oligodendroglial neoplasms, especially their distinction from astrocytoma and mixed oligoastrocytoma. Combined loss of the short arm of chromosome 1 and the long arm of chromosome 19 has been shown to be both relatively specific to oligodendroglioma and, when present, a marker of improved prognosis in patients with these tumors. In addition, 1p/19q loss has been shown to be a marker of “classic” oligodendroglial histology. These findings raise questions as to the role of 1p/19q testing in clinical practice, both as a prognostic marker and as a potential diagnostic marker among infiltrating glial neoplasms.
Objective.—This review discusses the issues raised above and tries to clarify the current status of 1p/19q evaluation in the diagnosis of oligodendroglioma.
Data Sources.—Sources for this review include recent literature as well as the experience of 3 practicing neuropathologists.
Conclusions.—1p/19q status is an important marker in oligodendroglioma. Loss of 1p/19q is associated with classic oligodendroglioma histology as well as improved prognosis. The combined 1p/19q marker will continue to be a clinically useful marker of prognosis and could potentially be incorporated into diagnostic criteria in the future.
Comparison of Ataxia-Telangiectasia Mutated Protein Expression in Diffuse Large B-Cell Lymphomas of Primary Central Nervous System and Non–Central Nervous System Origin
Authors: Kim Se Hoon , Cheong June-Won , Park Kwang Hwa , Kim Tai Seung , Yang Woo-Ick 
Published: February 2021

Abstract
Context.—The ataxia-telangiectasia mutated (ATM) gene encodes a nuclear 370-kd phosphoprotein known to be associated with chromosomal regions containing double-strand breaks. The mutations in the ATM gene may be involved in the development of some subtypes of sporadic lymphomas and leukemias. In primary central nervous system diffuse large B-cell lymphomas (PCNS DLBCLs), the pathogenetic role of ATM mutation has not been investigated.
Objective.—To investigate ATM protein expression in PCNS DLBCLs, in comparison with that in non–central nervous system (non-CNS) DLBCLs and to study the relationship of ATM protein loss with several clinicopathologic parameters.
Design.—This study included 42 cases of PCNS DLBCL and 33 cases of non-CNS DLBCL from immunocompetent patients. The ATM protein loss was analyzed by immunohistochemical staining. For the subclassification of DLBCL and analysis of the relationship between ATM and other prognostic markers, we performed immunohistochemical evaluation to detect the following markers: Bcl-6, CD10, multiple myeloma-1, CD138, Bcl-2, Ki-67, and p53.
Results.—The loss of ATM expression was statistically more frequent in PCNS DLBCLs (21/42 cases [50.0%]) than in non-CNS DLBCLs (0/33 cases [0.0%]; P &lt; .001). The loss of ATM expression was not a prognostic marker in PCNS DLBCLs (P = .64). The loss of ATM expression had a strong correlation with the germinal center B-cell–like subtype (P = .01), a low Ki-67 labeling index (P = .03), and low Bcl-2 expression (P = .01) among several clinicopathologic parameters.
Conclusions.—Our results suggest that the ATM protein is more strongly correlated with PCNS DLBCL lymphomagenesis than with non-CNS DLBCLs, especially in germinal center B-cell–like subtypes demonstrating low Ki-67 labeling indexes and low Bcl-2 expression.
Hemangiomas and Angiosarcomas of the Breast: Diagnostic Utility of Cell Cycle Markers With Emphasis on Ki-67
Authors: Shin Sandra J. , Lesser Martin , Rosen Paul Peter 
Published: February 2021

Abstract
Context.—Vascular tumors comprise a minor subgroup of tumors arising in the breast and represent variants of hemangiomas and angiosarcomas. Diagnostic challenges may arise when differentiating hemangiomas from types I and II angiosarcomas. Ki-67 expression has been used as an adjunct to distinguish between benign and malignant lesions exhibiting histologic overlap at various anatomic sites.
Objective.—To investigate the utility of Ki-67 and other cell cycle regulatory proteins (S-phase kinase-associated protein 2 [Skp2], p27, and cyclin D1) in the differential diagnosis of mammary vascular lesions.
Design.—Thirty-four vascular tumors (21 hemangiomas and 13 angiosarcomas) of the breast were studied. The Ki-67 index and immunoreactivity for Skp2, p27, and cyclin D1 were determined in each case. Appropriate statistical methods were used.
Results.—The mean value of Ki-67 index was statistically different when comparing hemangiomas and angiosarcomas (P &lt; .001). Angiosarcomas were typically positive for Skp2, whereas hemangiomas were negative (P &lt; .001). Sensitivity and specificity cutoffs for Ki-67 index to distinguish hemangiomas from angiosarcomas showed a candidate cutoff point of 175. The mean values of Ki-67 of low-grade angiosarcomas were significantly different from all hemangiomas (P &lt; .001) and also different from the subset of atypical hemangiomas (P = .02). Sensitivity and specificity cutoffs for Ki-67 index to distinguish all hemangiomas from low-grade angiosarcomas showed a candidate cutoff point between 150 and 175. Among angiosarcomas, positivity for Ki-67 was inversely related to that of p27 but not to Skp2 or cyclin D1. This was also true among hemangiomas.
Conclusions.—Ki-67 index can be used as a diagnostic tool to distinguish between benign and malignant vascular lesions of the breast. This can be particularly helpful in cases of histologic overlap such as low-grade angiosarcoma and hemangioma.
Thyroid Transcription Factor 1 Immunohistochemistry as an Intraoperative Diagnostic Tool at Frozen Section for Distinction Between Primary and Secondary Lung Tumors
Authors: Butcher David N. , Goldstraw Peter , Ladas George , Dusmet Michael E. , Sheppard Mary N. , Nicholson Andrew G. 
Published: February 2021

AbstractContext.—Intraoperative distinction between primary and metastatic carcinomas in the lung at frozen section remains problematic.Objective.—To assess the value and practicality of immunohistochemistry for thyroid transcription factor 1 at the time of intraoperative frozen section.Design.—Thirty-three patients presented with either a solitary pulmonary mass or 2 pulmonary masses and a history of carcinoma in a different organ. In addition to routine frozen section for assessment of tumor type, we looked for expression of thyroid transcription factor 1, using the EnVision system with abridged methodology.Results.—Ten cases were positive for thyroid transcription factor 1, which was confirmed on subsequent paraffin sections. Nine of these were confirmed as primary pulmonary adenocarcinomas, but 1 case proved to be a rare false-positive metastatic colonic carcinoma. Twenty-three cases were negative on frozen section and reported as favoring metastatic disease. In all cases, additional immunohistochemical data increased diagnostic confidence, but particularly in cases of positive primary pulmonary tumors and in cases with disease metastatic from sites other than the large bowel. The average time in addition to that of the basic frozen section was 24 minutes per test with a cost of £32 (US$57).Conclusions.—Frozen section immunohistochemistry for thyroid transcription factor 1 shows specificity and sensitivity similar to those seen for formalin-fixed tissues and is feasible within the time frame of a thoracotomy. Diagnostic confidence is increased, especially with positive primary pulmonary tumors. However, its practice should be properly planned within an operative procedure as liberal usage will likely have significant staff and cost implications.
Low Smooth Muscle Cell Densities Characterize Sites With Isolated Interstitial Lipid in Coronary Artery Intima
Authors: Tracy Richard E. 
Published: February 2021

Abstract
Context.—The initial step in the development of atherosclerotic lesions is suggested to be the retention of low-density lipoprotein. This suggestion would seem to imply that some interval of time ought to intervene between the initial retention of interstitial lipid and subsequent influx of fatty streak cellular elements. Yet no evidence for such a waiting interval has been offered.
Objective.—To describe findings from application to coronary arteries from forensic autopsy specimens of a new method for staining lipids in paraffin sections.
Design.—Isolated interstitial lipid (IIL) (extracellular lipid pools accompanied by no perceptible intracellular lipid or other fatty streak elements at the affected sites) was identified in various intimal compartments, and smooth muscle cell (SMC) numbers were counted at these sites.
Results.—Isolated interstitial lipid was a surprisingly frequent finding after age 35 years, seen in 87 (84%) of 104 cases. The number of SMCs per unit area of sectioned intima was high in specimens lacking IIL (15.5 SMCs/[100 μm]2), lowest at sites displaying IIL (8.3 SMCs/[100 μm]2), and intermediate at sites lacking IIL in specimens that do contain IIL at some other location (12.6 SMCs/[100 μm]2).
Conclusions.—These findings plus other evidence support the proposal that retention of lipid most often happens, in aging arteries, at sites where the architecture was previously altered by diluting of constant SMC numbers by expanding collagenous matrix, thereby lowering SMC densities.
Type IV Collagen Immunostaining Is a Simple, Reliable Diagnostic Tool for Distinguishing Between Adenomatous and Normal Pituitary Glands
Authors: Jarzembowski Jason , Lloyd Ricardo , McKeever Paul 
Published: February 2021

Abstract
Context.—Pituitary adenomas are clinically diagnosed based on radiologic studies and/or secondary effects of hormone production. Definitive pathologic identification relies on immunohistochemical detection of a clonal population of hormone-producing cells. However, not all adenomas secrete hormones, so performing a battery of stains is inefficient. Reports have shown decreased type IV collagen in the stroma of other epithelial tumors.
Objective.—To validate type IV collagen immunohistochemistry as a diagnostic method.
Design.—We immunostained 27 adenomas and 19 normal pituitaries. The areas with the sparsest type IV collagen fibers were viewed at 3 magnifications (×10, ×20, and ×40 objectives), counting 1, 3, or 10 microscopic fields. A field was scored as “traversable” if a path existed from any point on the periphery of the field to a point on the approximately opposite periphery that did not cross any stained fibers. Results were compared with reticulin staining and to the existing diagnosis previously determined by histology, hormone immunostaining, and clinical correlation.
Results.—Adenomas have less type IV collagen in their basement membranes, leading to sparser, trabecular staining in neoplasms versus a more rigid meshwork pattern in normal glands. One might envision the stained fibers as maze walls—one can traverse medium-powered fields in an adenoma, but one hits dead ends and gets trapped in those of a normal gland. Finding a single representative ×10 field to be traversable was 97.5% sensitive and 96.5% specific for an adenoma. Reticulin staining yielded identical results.
Conclusions.—Type IV collagen immunostaining is a simple and reliable method of diagnosing pituitary adenomas.
Quantitative Assessment of the BCR-ABL Transcript Using the Cepheid Xpert BCR-ABL Monitor Assay
Authors: Dufresne Scott D. , Belloni Dorothy R. , Levy Norman B. , Tsongalis Gregory J. 
Published: February 2021

Abstract
Context.—Chronic myelogenous leukemia (CML) and the assessment of the BCR-ABL transcript has become a new paradigm. Novel tyrosine kinase inhibitors as mainstream therapeutic options for the CML patient warrant routine quantification of the BCR-ABL transcript. The Xpert BCR-ABL Monitor assay is a nested reverse transcriptase polymerase chain reaction that greatly reduces technical time by using a single cartridge to isolate RNA and run a quantitative reverse transcriptase polymerase chain reaction.
Objective.—To evaluate the Xpert BCR-ABL Monitor assay for quantitative assessment of the BCR-ABL transcript in CML patients.
Design.—A standard curve of K-562 cells diluted in normal peripheral blood was used to test the sensitivity, linearity, and percent coefficient of variation of the assay. Specimen stability was tested by running standard curves immediately and after 24 hours or 96 hours of storage at 4°C. Specimens from normal controls, patients known to have CML, or patients suspected of having CML were also tested.
Results.—The sensitivity of the assay was sufficient to detect 1 K-562 cell in 105 normal cells. The R2 of the standard curve was 0.98 and the percent coefficient of variation for each data point was 15% to 24%. Eleven of 14 patients with known CML on imatinib treatment tested positive for the BCR-ABL transcript, whereas 10 normal controls tested negative.
Conclusions.—The Xpert BCR-ABL Monitor assay is a rapid, sensitive method for monitoring the presence of the BCR-ABL transcript in CML patients. The single-use cartridge minimizes hands-on technical time, minimizes the potential for contamination, and allows quantitative BCR-ABL testing to be performed in a random access fashion.
Relevance of Parvovirus B19, Herpes Simplex Virus 2, and Cytomegalovirus Virologic Markers in Maternal Serum for Diagnosis of Unexplained Recurrent Abortions
Authors: Zaki Maysaa El-Sayed , Goda Hossam 
Published: February 2021

Abstract
Context.—The impact of viral infections during pregnancy on adverse pregnancy outcomes is not understood fully.
Objective.—To assess the frequency of parvovirus B19, herpes simplex 2, and cytomegalovirus infections in relation to late abortions, in sera from Egyptian pregnant women to establish basic knowledge for future pregnancy care. In addition, to study the diagnostic value of specific immunoglobulin M (IgM) against those viruses compared with their genomes detection by polymerase chain reaction in maternal serum as a noninvasive method of laboratory diagnosis.
Design.—Patients were recruited at the Women's Clinic, Mansoura University. One group of patients with recurrent spontaneous abortions (RSA) and a second group of pregnant women without a history of RSA were evaluated including demographic, medical, and clinical data. Virologic markers were evaluated for specific IgM and for viral DNA to cytomegalovirus, herpes simplex virus 2, and parvovirus B19.
Results.—There was a statistically significant difference between the RSA group and the pregnant women without RSA group in frequency of parvovirus IgM (84% and 16.7%, respectively) (P &lt; .001) and herpes simplex IgM (40% for RSA) (P = .001). Parvovirus B19 viremia was positive in 48% RSA, herpes simplex virus 2 was positive in 32% RSA, and cytomegalovirus was positive in 12% RSA patients. For RSA patients with parvovirus viremia, the mean ± SD of IgM value was 78.5 ± 30.12 IU/mL, and for RSA patients with negative viremia it was 30.02 ± 17.64 IU/mL with statistically significant difference between both levels (P &lt; .001).
Conclusions.—From this study, we conclude that viral infections with parvovirus B19 and herpes simplex 2 were frequently associated with recurrent abortions, and careful investigation for this condition must include evaluating these patients for the previously mentioned viruses. Serologic study by specific IgM for parvovirus and herpes simplex seem to be reliable as screening tests for high-risk pregnancy.
Occult Primary Parotid Gland Acinic Cell Adenocarcinoma Presenting With Extensive Lung Metastasis
Authors: Tavora Fabio , Rassaei Negar , Shilo Konstantin , Foss Robert D. , Galvin Jeffrey R. , Travis William D. , Franks Teri J. 
Published: February 2021

Abstract
Acinic cell adenocarcinoma is a malignant salivary gland neoplasm with a relatively low rate of lymphangitic spread to regional lymph nodes. Distant metastases are rare and their occurrence typically indicates an unfavorable outcome. We encountered an unusual example of acinic cell adenocarcinoma that initially presented in the lung, whereas the primary parotid carcinoma, despite extensive clinical evaluation, only became apparent 1 year after initial diagnosis. The histologic, immunohistochemical, and ultrastructural features of the tumor in the parotid gland and lung were similar. The tumor displayed an aggressive behavior resulting in death within 2 years of the initial presentation. This presentation is unique, showing that peripheral lung tumors of salivary gland type are likely to be metastatic, and careful clinical evaluation is warranted in establishing their primary site of origin.
Molecular Pathology of Lymphangioleiomyomatosis and Other Perivascular Epithelioid Cell Tumors
Authors: Martignoni Guido , Pea Maurizio , Reghellin Daniela , Gobbo Stefano , Zamboni Giuseppe , Chilosi Marco , Bonetti Franco 
Published: February 2021

AbstractContext.Lymphangioleiomyomatosis (LAM) is a cystic lung disease that can be included in the wide group of proliferative lesions named PEComas (perivascular epithelioid cell tumors). These proliferative tumors are characterized by the coexpression of myogenic and melanogenesis-related markers. In all these lesions, genetic alterations related to the tuberous sclerosis complex (TSC) have been demonstrated. Striking improvements in the understanding of the genetic basis of this autosomal dominant genetic disease are coupled to the understanding of the mechanisms that link the loss of TSC1 (9q34) or TSC2 (16p13.3) genes with the regulation of the Rheb/m-TOR/p70S6K pathway. These data have opened a new era in the comprehension of the pathogenesis of LAM and have also suggested new therapeutic strategies for this potentially lethal disease.Objective.To present and discuss the pathologic and molecular features of LAM within the spectrum of PEComas, providing a rational approach to their diagnosis.Data Sources.The published literature and personal experience.Conclusions.The inclusion of LAM within the PEComa category is supported by a variety of biologic data and can significantly help in providing a comprehensive view of this interesting and clinically relevant group of lesions. The demonstration of molecular alterations of the mTOR pathway in LAM and other PEComas represents a rational basis for innovative therapeutic approaches with inhibitors of mTOR signaling.
Neurocysticercosis
Authors: Moskowitz Jack , Mendelsohn Geoffrey 
Published: February 2021

Abstract
Neurocysticercosis is a significant public health issue within the United States. Although cysticercosis was once thought to have been eradicated in the United States, the number of documented cases is rising and immigrants from endemic areas are at the highest risk for acquiring and developing this disease. The clinical presentation of neurocysticercosis is variable and vague neurologic symptoms or sudden unexplained death in individuals with risk factors may be the only available information warranting a consideration of neurocysticercosis. Radiologic and laboratory findings can help guide medical and surgical interventions, while histologic confirmation establishes a more definitive diagnosis. Encysted larvae can be found throughout the central nervous system and undergo progressive stages of decay. Degenerating vesicles elicit an inflammatory response, involving surrounding structures, and cause the major clinical symptomatology.
Precursor Lymphoblastic Lymphoma Reoccurring as a Donor-Derived Neoplasm: A Case Report and Review of the Literature
Authors: Dickson Brendan C. , Chung Catherine T-S. , Patterson Bruce J. , Riddell Robert H. , Kamel-Reid Suzanne , Messner Hans A. , Lipton Jeffrey H. 
Published: February 2021

Abstract
Precursor lymphoblastic lymphoma is an uncommon neoplasm. We report the case of a man who presented with precursor T lymphoblastic lymphoma and ultimately received an allogeneic bone marrow transplant from his human leukocyte antigen–identical sister. Four years later he developed recurrent disease. By means of DNA probing for the amelogenin locus and fluorescence in situ hybridization, the neoplastic cells of the recurrent lesion were found to be of donor origin. We offer the report of a patient with an unusual lymphoblastic lymphoma who, after successful bone marrow transplantation, developed the same disease of donor cell origin; further, we offer a literature review on donor cell lymphoma.