bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilirubin Proficiency Testing Using Specimens Containing Unconjugated Bilirubin and Human Serum: Results of a College of American Pathologists Study
Authors: Lo Stanley F. , Doumas Basil T. , Ashwood Edward R. 
Published: February 2021

AbstractContext.—Specimens of the College of American Pathologists Neonatal Bilirubin and Chemistry surveys are inadequate for evaluating the performance of clinical laboratories in measuring serum bilirubin because they exhibit strong matrix interference. Recently published data indicate that at least 1 major clinical analyzer provided inaccurate bilirubin values for Neonatal Bilirubin Survey specimens. The composition of the specimens, bovine serum enriched with ditaurobilirubin, was responsible for the erroneous results.Objective.—This article evaluates the performance of major clinical analyzers using a survey specimen free of matrix interference.Design.—A human serum–based specimen enriched solely with unconjugated bilirubin was included in the 2003 Neonatal Bilirubin and Chemistry surveys. Its bilirubin concentration (19.4 mg/dL [332 μmol/L]) was determined by the reference method for total bilirubin.Results.—The coefficients of variation for the 4 major clinical analyzers (Dimension, Hitachi, Synchron, and Vitros) ranged from 1.9% to 3.7%. When compared to the bilirubin value measured by the reference method, mean bilirubin values of the 4 major clinical analyzers and College of American Pathologists (CAP) All Data (which refers to the grand mean and overall coefficient of variation of all method principles, all instruments according to CAP terminology) ranged from −3.5% to 5.1%. Direct bilirubin results from most field methods showed good specificity overall.Conclusion.—Human serum–based survey specimens, having their bilirubin concentrations determined by the reference method, should be included as frequently as feasible in the Neonatal Bilirubin Survey. Such specimens may be used by instrument manufacturers as standards for calibrating bilirubin methods and for assigning values to calibrators provided to instrument users. A substantial improvement in bilirubin measurements due to the reduction of systematic error is expected.
Bone Morphogenetic Proteins Are Expressed by Both Bone-Forming and Non–Bone-Forming Lesions
Authors: Khurana Jasvir S. , Ogino Shuji , Shen Ting , Parekh Hemant , Scherbel Uwe , DeLong William , Feldman Michael D. , Zhang Paul J. , Wolfe Hubert J. , Alman Benjamin A. 
Published: February 2021

Abstract
Context.—Bone morphogenetic proteins (BMPs) are thought to be responsible for bone formation; they cause bone to form in soft tissues and are clinically used in helping fracture union or tumor reconstructions. Skeletal metastases from epithelial tumors may be either bone-forming (blastic) or non–bone-forming (lytic).
Objective.—We studied the expression of BMPs in a variety of primary and secondary lesions of bone (both bone-forming and non–bone-forming) to determine if there was a consistent relationship between bone formation and BMP expression.
Design.—We compared a bone-forming lesion (fibrous dysplasia) with a non–bone-forming lesion (desmoid tumor), using reverse transcription–polymerase chain reaction, Northern blot analysis, and immunohistochemistry to detect BMPs. We also studied a number of non–bone-forming secondary lesions (carcinomas that formed lytic metastases to the skeleton) and found BMP production in most of these tumors.
Results.—We found that BMPs were expressed in both bone-forming and non–bone-forming benign musculoskeletal lesions. In the first part of the study, BMPs were found in both fibrous dysplasia and desmoid tumors. Bone morphogenetic proteins were also expressed by several tumors. In the next part of the study (paraffin-embedded tissue), BMPs were expressed by a variety of tumors, irrespective of the radiological nature (blastic or lytic) of their metastases.
Conclusions.—We conclude that BMP production alone cannot explain bone formation, and other factors either alone or in combination may be responsible for blastic metastases to the skeleton and for bone formation by primary bone lesions, such as fibrous dysplasia.
Soft Tissue Amyloidoma of the Extremities: A Case Report and Review of the Literature
Authors: Bardin Richard L. , Barnes Craig E. , Stanton Constance A. , Geisinger Kim R. 
Published: February 2021

Abstract
The deposition of amyloid as a distinct, clinically apparent mass is uncommon, particularly in soft tissues. Among reported sites of soft tissue amyloidomas, the extremities are quite rare. Amyloid tumors can mimic malignant neoplasms both clinically and radiologically. We report a case of AA amyloidoma presenting in the deltoid region with radiological features suggesting sarcoma. Cytomorphology from fine-needle aspiration material, tissue histology, and appearance by magnetic resonance imaging are described. The literature on soft tissue amyloidoma is reviewed.
Diffuse Giant Inflammatory Polyposis: A Challenging Clinicopathologic Diagnosis
Authors: Sheikholeslami Mohammad-Reza , Schaefer Robert F. , Mukunyadzi Perkins 
Published: February 2021

Abstract
Giant inflammatory polyposis of the colon is an uncommon manifestation of inflammatory bowel disease. We report a unique case of localized diffuse giant inflammatory polyposis in a 58-year-old white man, which was characterized by recurrence following initial surgical resection. The patient presented with symptoms of abdominal pain and passing blood per rectum. Colonoscopic examination revealed a near-obstructing, “fungating” mass in the sigmoid colon, which clinically was thought to represent colon carcinoma. Histology of several colon biopsies revealed marked acute inflammation with microabscess formation of the polyps and the adjacent mucosa. There was no evidence of dysplasia or malignancy. Because malignancy was strongly suspected and to relieve the obstructive symptoms, the patient underwent a segmental colectomy. The histologic features of the resected mass showed giant polyps with acute inflammation diagnostic of giant inflammatory polyposis. Again, there was no evidence of malignancy. Seven months later, following an uneventful initial postoperative recovery, the patient developed a recurrence of the mass with obstructive symptoms and required further surgical resection. The gross and histologic features of the lesion were similar to the previous findings. This case highlights the varied presenting symptoms and deceptive gross colonoscopic and radiologic features of localized diffuse giant inflammatory polyposis. Finally, the presence of inflammation at the resection margins appears to predict recurrence or persistence of the disease.
Severe Acute Respiratory Syndrome: Overview With an Emphasis on the Toronto Experience
Authors: Mazzulli Tony , Kain Kevin , Butany Jagdish 
Published: February 2021

AbstractObjective.—To provide an overview of the severe acute respiratory syndrome (SARS) outbreak in Toronto, Ontario, which experienced the largest outbreak outside Asia, and to review what has been learned during the past year.Data Sources.—MEDLINE search of all studies related to SARS, including review of the Centers for Disease Control and Prevention, World Health Organization (WHO), and Health Canada Web sites.Data Synthesis.—During the SARS outbreak in Toronto, 438 people had been diagnosed as having suspected or probable SARS and 44 people died. Elderly people and those with comorbid illnesses were at greatest risk of complications or death. Transmission was via direct contact with respiratory secretions. The use of gloves, gowns, N95 masks, and eye protection was effective in preventing transmission. No transmission occurred before symptom onset or after recovery. Serologic tests suggest that antibodies may not appear until 28 days after illness onset. Molecular tests give their greatest yield during the second week of illness. The value of ribavirin treatment remains questionable. The combination of interferon plus corticosteroids appears to be better than corticosteroids alone. Postmortem examination revealed pulmonary edema and evidence of diffuse alveolar damage. Very few morphological changes were noted in other organs despite the presence of viral RNA as detected by polymerase chain reaction.Conclusion.—On July 5, 2003, the WHO declared that the SARS outbreak was over. Since then, new cases of SARS have been reported in Asia. With global travel, the disease can rapidly spread throughout the world. Therefore, we must remain vigilant to prevent another pandemic.
Pulmonary and Ophthalmic Involvement With Erdheim-Chester Disease: A Case Report and Review of the Literature
Authors: Allen Timothy Craig , Chevez-Barrios Patricia , Shetlar Debra J. , Cagle Philip T. 
Published: February 2021

AbstractErdheim-Chester disease is a rare nonfamilial histiocytic disorder of unknown etiology with characteristic long bone findings. The 3-year survival rate for patients with Erdheim-Chester disease is 50%. Approximately 50% of patients have disease involvement in other tissues, including skin, retro-orbital and periorbital tissues, pituitary-hypothalamic axis, heart, kidney, retroperitoneum, breast, skeletal muscle, and sinonasal mucosa; about 20% of patients have lung involvement. Prognosis generally depends on the extent of the extraosseous disease. For patients with lung involvement, gender distribution is equal, but men typically present at an older age than do women. Approximately 80% of patients present with dyspnea, and most patients have diffuse interstitial infiltrates and pleural and/or interlobar septal thickening on chest radiology. Characteristic lung histopathology includes the accumulation of histiocytes with variable amounts of fibrosis and a variable lymphoplasmacytic infiltrate in a lymphangitic distribution. Immunostains are diagnostically useful, showing immunopositivity for CD68 and factor XIIIa and immunonegativity for CD1a. Birbeck granules are uniformly absent ultrastructurally.
Comparison of Performance of Conventional and ThinPrep Gynecologic Preparations in the College of American Pathologists Gynecologic Cytology Program
Authors: Renshaw Andrew A. , Young Nancy A. , Birdsong George G. , Styer Patricia E. , Davey Diane D. , Mody Dina R. , Colgan Terence J. 
Published: February 2021

Abstract
Context.—Results of clinical trials suggest that interpretation of liquid-based cytology preparations is more accurate and is associated with less screening error than interpretation of conventional preparations.
Objective.—In this study, the performance of participants in interpreting ThinPrep (TP) preparations was compared with participants' performance on conventional Papanicolaou tests in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology (PAP).
Design.—The results of the PAP from the year 2002 were reviewed, and the discordancies to series and exact-match error rates for the 2 cytologic methods were compared.
Results.—For this study, a total of 89 815 interpretations from conventional smears and 20 886 interpretations from TP samples were analyzed. Overall, interpretations of TP preparations had both significantly fewer false-positive (1.6%) and false-negative (1.3%) rates than those of conventional smears (P = .001 and P = .02, respectively) for validated or validated-equivalent slides, as assessed by concordance with the correct diagnostic series. In this assessment of concordance to series, interpretations of educational TP and conventional preparations were similar, except for high-grade squamous intraepithelial lesion, in which the performance was significantly worse for educational TP preparations (false-negative rate of 8.1% vs 4.1% for conventional smears, P &lt; .001). When interpretations were matched to the exact diagnosis, validated-equivalent TP preparations were generally more accurate for diagnoses in the 100 series and 200 series than were conventional smears. Notably, for the reference diagnosis of squamous cell carcinoma, the exact-match error rate on validated equivalent TP slides was significantly greater than that of conventional slides (44.5% vs 23.1%, P &lt; .001). Interpretations of educational TP preparations also had a significantly higher error rate in matching to the exact reference diagnosis for squamous cell carcinoma (33.7% vs 22.8%, P = .007).
Conclusions.—Overall, TP preparations in this program were associated with significantly lower error rates than conventional smears for both validated and educational cases. However, unlike the negative for intraepithelial lesion and malignancy, not otherwise specified, low-grade squamous intraepithelial lesion, and adenocarcinoma cytodiagnostic challenges, participants' responses indicated some difficulty in recognizing high-grade squamous intraepithelial lesion and squamous cell carcinoma.
Jejunal Gastrointestinal Stromal Tumor: A Cause of Obscure Gastrointestinal Bleeding
Authors: Sass David A. , Chopra Kapil B. , Finkelstein Sydney D. , Schauer Philip R. 
Published: February 2021

Abstract
In cases of obscure gastrointestinal bleeding, when a source for blood loss is not apparent from examination of the colon and upper gastrointestinal tract, the small bowel usually becomes the focus of investigation. A tumor with interesting pathologic features was found in a patient who presented with recurrent episodes of massive obscure gastrointestinal hemorrhage. This case highlights the importance of considering small intestinal tumors as the likely cause of obscure gastrointestinal hemorrhage in young patients and how a noninvasive test, eg, abdominal computed tomography scan, might obviate the need for more invasive testing.
Primary Small Bowel Carcinoid Tumor With Bilateral Breast Metastases: Report of 2 Cases With Different Clinical Presentations
Authors: Mosunjac Marina B. , Kochhar Ruby , Mosunjac Mario I. , Lau Stephen K. 
Published: February 2021

Abstract
Context.—Carcinoid tumor metastatic to the breast is uncommon and can closely mimic a mammary carcinoma. The differentiation of metastatic carcinoid tumor from primary breast tumor is important, however, owing to different clinical management and prognosis.
Objective.—The purpose of this study was to describe 2 patients with bilateral metastatic carcinoid tumors to the breast with different clinical manifestations.
Design.—We examined the radiological, clinical, cytologic, histologic, immunohistochemical, and ultrastructural features of these 2 cases.
Results.—In case 1, the tumor presented initially as a stellate mass on mammogram and was diagnosed as grade II infiltrating ductal carcinoma. It was only after the discovery of small intestinal, liver, ovarian, and contralateral breast masses, as well as careful morphologic and immunohistochemical evaluations, that the true nature of the tumor was realized. In case 2, the tumor initially presented as a small intestinal tumor with liver metastases and bilateral breast masses. The breast masses were diagnosed accurately as metastatic carcinoid tumor by morphologic and immunohistochemical evaluations.
Conclusions.—Metastatic carcinoid tumor to the breast is uncommon, but poses a diagnostic challenge in that morphologically it can closely mimic a primary breast tumor. Careful attention to clinical features and the use of auxiliary immunohistochemical studies can help in arriving at the correct diagnosis.
In-house Calibration of the International Sensitivity Index or Calibration Curve for Determination of the International Normalized Ratio
Authors: Brien William F. , Crawford Linda , Raby Anne , Richardson Harold 
Published: February 2021

Abstract
Context.—The international normalized ratio (INR) has been used since 1983 to standardize prothrombin time results for patients on oral anticoagulants. However, significant interlaboratory variations have been noted. Attempts have been made to address these differences with the use of instrument-specific International Sensitivity Index (ISI) values and in-house calibration of ISI values.
Objective.—To assess the performance of laboratories using a calibration curve for INR testing.
Design.—Attempts to improve performance of the INR include the use of instrument-specific ISI values, model-specific ISI values, in-house calibration of ISI values, and more recently, the preparation of a calibration curve. Several studies have shown an improvement in performance using these procedures. In this study of licensed laboratories performing routine coagulation testing in the Province of Ontario, Canada, the determination of the INR by a calibration curve was compared with the laboratories' usual method of assessment. These methods were subsequently analyzed by comparing the results to instrument-specific ISI, model-specific ISI, and in-house calibrators. International normalized ratios derived by both methods were analyzed for accuracy and precision. The stability of a calibration curve was also investigated.
Results.—Performance of INR testing has improved with use of a calibration curve or in-house calibrators.
Conclusion.—The results confirm that either in-house calibrators or the calibration curve improve performance of INR testing. The calibration curve may be easier to use and appears stable up to 4 months.
Testicular Extramedullary Myeloid Cell Tumor: Report of a Case With Unique Clinicopathologic Features and a Brief Review of the Literature
Authors: Rawal Ajay , Keeler Thomas C. , Milano Michelangelo A. 
Published: February 2021

Abstract
We report a case of testicular extramedullary myeloid cell tumor in a 37-year-old man who presented with an acute testicular hemorrhage. A pathologic examination revealed no gross tumor mass. A well-differentiated extramedullary myeloid cell tumor infiltrate was seen histologically, localized largely to the seminiferous tubules. The patient had no evidence of any past or concurrent myeloid disorders. The lack of the usual clinical features of a testicular mass and the presence of an intratubular pattern of infiltration can further compound the challenges in diagnosing this entity.
Pathology Abbreviated: A Long Review of Short Terms
Authors: Berman Jules J. 
Published: February 2021

Abstract
Context.—Abbreviations are used frequently in pathology reports and medical records. Efforts to identify and organize free-text concepts must correctly interpret medical abbreviations. During the past decade, the author has collected more than 12 000 medical abbreviations, concentrating on terms used or interpreted by pathologists.
Objective.—The purpose of the study is to provide readers with a listing of abbreviations. The listing of abbreviations is reviewed for the purpose of determining the variety of ways that long forms are shortened.
Design.—Abbreviations fell into different classes. These classes seemed amenable to distinct algorithmic approaches to their correct expansions. A discussion of these abbreviation classes was included to assist informaticians who are searching for ways to write software that expands abbreviations found in medical text. Classes were separated by the algorithmic approaches that could be used to map abbreviations to their correct expansions. A Perl implementation was developed to automatically match expansions with Unified Medical Language System concepts.
Measurements.—The abbreviation list contained 12 097 terms; 5772 abbreviations had unique expansions. There were 6325 polysemous abbreviation/expansion pairs. The expansions of 8599 abbreviations mapped to Unified Medical Language System concepts. Three hundred twenty-four abbreviations could be confused with unabbreviated words. Two hundred thirteen abbreviations had different expansions depending on whether the American or the British spellings were used. Nine hundred seventy abbreviations ended in the letter “s.”
Results.—There were 6 nonexclusive groups of abbreviations classed by expansion algorithm, as follows: (1) ephemeral; (2) hyponymous; (3) monosemous; (4) polysemous; (5) masqueraders of common words; and (6) fatal (abbreviations whose incorrect expansions could easily result in clinical errors).
Conclusion.—Collecting and classifying abbreviations creates a logical approach to the development of class-specific algorithms designed to expand abbreviations. A large listing of medical abbreviations is placed into the public domain. The most current version is available at http://www.pathologyinformatics.org/downloads/abbtwo.htm.
Comparison of Human Papillomavirus DNA Prevalence in Atypical Squamous Cells of Undetermined Significance Subcategories as Defined by the Original Bethesda 1991 and the New Bethesda 2001 Systems
Authors: Pirog Edyta C. , Erroll Maria , Harigopal Malini , Centeno Barbara A. 
Published: February 2021

Abstract
Context.—The new Bethesda System 2001 (TBS 2001) minimized the subclassification of atypical squamous cells of undetermined significance (ASCUS).
Objective.—The primary goal of this study was to determine the impact of the new subclassification on the accuracy of Papanicolaou (Pap) test diagnosis by examining the prevalence of human papillomavirus (HPV) DNA in different ASCUS subcategories, as defined by the new TBS 2001 versus the original TBS 1991. The second goal was to identify specific morphologic features of atypical squamous cells that are more frequently associated with HPV detection.
Design.—Consecutive cases of ThinPrep Pap tests were retrospectively reviewed by a panel of pathologists to obtain consensus diagnoses. The study group consisted of ASCUS cases; the positive control group consisted of low- and high-grade squamous intraepithelial lesions (LSILs and HSILs, respectively); and the negative control group consisted of cases “negative for intraepithelial lesion or malignancy.” All ASCUS cases were subclassified according to TBS 1991 into the following categories: favor reactive (ASCUS-R), favor LSIL (ASCUS-L), favor HSIL (ASCUS-H), and not otherwise specified (ASCUS-NOS). In a separate review, ASCUS cases were subclassified according to TBS 2001 into the following categories: atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H). Furthermore, morphologic ASCUS subtypes were recorded (atypical mature, immature, parakeratotic, and atrophic cells); in addition, individual morphologic features of atypical cells were recorded. Broad- spectrum HPV DNA amplification and genotyping was performed using short PCR fragment (SPF 10) polymerase chain reaction/Line Probe assays.
Results.—In cases classified according to TBS 1991, HPV was detected in 32% of negative, 49% of ASCUS, and 93% of LSIL/HSIL cases. On the second review, using the diagnostic categories of TBS 2001, which eliminated the ASCUS-;R category, the number of ASCUS cases decreased by 45%. The prevalence of HPV DNA in ASCUS cases downgraded to the negative category was 38%, which was not significantly different from HPV prevalence in negative cases as diagnosed under TBS 1991. Furthermore, HPV was detected in 56% of ASC-US and 71% of ASC-H cases. The prevalence of HPV in different morphologic subtypes of ASCUS was not significantly different, and none of the 8 individual morphologic features of atypical cells were more frequently associated with HPV detection.
Conclusion.—Elimination of the ASCUS-R category in TBS 2001 resulted in a significant decrease in the number of ASCUS diagnoses. Downgraded cases had a relatively low prevalence of HPV DNA. It is expected that TBS 2001 will increase specificity of the Pap test without compromising its sensitivity.