bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving the Quality of Surgical Pathology Reports for Breast Cancer: A Centralized Audit With Feedback
Authors: Onerheim Ronald , Racette Pierre , Jacques André , Gagnon Robert 
Published: February 2021

Abstract
Context.—Good communication of pathologic characteristics of a malignancy is crucial to therapy choices and accurate prognostication. The information must be easily retrieved from a surgical pathology report.
Objectives.—To evaluate, first in 1999, the quality of surgical pathology reports for segmental breast resections for cancer in Quebec hospitals. Subsequently, to reevaluate, in 2003, the same indicators to determine if the first surveillance, with feedback, was associated with an improvement in the quality of the reports.
Design.—All Quebec hospitals performing the preset number of 20 or more segmental breast resections for cancer in 1999 and 2003 participated. A committee of pathologists, after review of the literature, chose 7 diagnostic elements deemed vital to a surgical pathology report for conservative breast cancer surgery. Medical archivists in each institution were instructed on how to retrieve the data. The main outcome measure was the presence or absence of the diagnostic information clearly presented on the surgical pathology report.
Results.—Fifty-one hospitals participated in 1999 and 50 in 2003. Overall, conformity improved from 85.0% in 1999 for the first evaluation to 92.5% in 2003 for the second evaluation (P &lt; .001). Six of the 7 indicators showed an improvement in the level of conformity between the first and second evaluations. Conformity was weakest for recording the distance between the tumor and the resection margin (68.2%) and vascular/lymphatic invasion (61.4%) in 1999.
Conclusions.—Surveillance of quality of surgical pathology reports, with feedback, is significantly associated with an improvement in the quality of reports.
Use of In Situ Hybridization to Detect Human Papillomavirus in Head and Neck Squamous Cell Carcinoma Patients Without a History of Alcohol or Tobacco Use
Authors: Lee Walter T. , Tubbs Raymond R. , Teker Aysenur M. , Scharpf Joseph , Strome Marshall , Wood Benjamin , Lorenz Robert R. , Hunt Jennifer 
Published: February 2021

Abstract
Context.—Head and neck squamous cell carcinoma is commonly associated with tobacco and alcohol use. There are, however, a group of patients without a significant history of tobacco or alcohol use, and the etiology of these tumors is incompletely understood.
Objective.—To examine tumors in this subpopulation for association with human papillomavirus (HPV) using newly available in situ hybridization probes.
Design.—Between October 2004 and October 2005, 22 patients who did not use alcohol or tobacco were included. Formalin-fixed, paraffin-embedded tissue sections were used to perform in situ hybridization using newly available probe sets (Ventana Medical Systems, Tucson, Ariz). The slides were examined for the presence of integrated HPV using light microscopy. Positive and negative xenograft controls were run with the assay.
Results.—The mean age of the patients was 64 years. There were 14 men and 8 women. The most common anatomic sites included tongue (n = 8), tonsil (n = 7), and larynx (n = 7). All cases and controls were successfully stained. Only 2 cases were positive for high-risk HPV, and both demonstrated an integrated pattern. Both cases were tumors of the tonsil. No cases were positive for low-risk HPV.
Conclusions.—These results demonstrate that the new probe sets for HPV can be used very efficiently in clinical pathology material of head and neck squamous cell carcinoma. Our data show that high-risk HPV is an uncommon finding in head and neck squamous cell carcinoma from patients who do not have a history of tobacco or alcohol use; low-risk HPV was not seen in any case.
Patient Safety and Error Reduction in Surgical Pathology
Authors: Nakhleh Raouf E. 
Published: February 2021

Abstract
Context.—National patient safety goals and error reduction efforts should be addressed by each surgical pathology laboratory.
Objective.—To review issues relevant to patient safety and error reduction in surgical pathology in the context of continuous quality improvement.
Data Sources.—The literature is reviewed.
Conclusions.—Patient safety goals can and should be addressed within the context of a quality improvement plan. Multiple factors that contribute to errors in surgical pathology are discussed. The current literature defines the extent of these problems within specific segments of the test cycle (preanalytic, analytic, and postanalytic). Potential solutions are presented that may reduce or avoid errors. In addition, general principles are outlined that enhance the laboratory's ability to successfully and continuously address patient safety and error reduction.
Lymphoepithelial Carcinoma of the Parotid Glands and Its Relationship With Benign Lymphoepithelial Lesions
Authors: Schneider Manuela , Rizzardi Clara 
Published: February 2021

AbstractThe salivary glands, despite their relatively simple morphology, give rise to more than 30 histologically distinct benign and malignant tumors. Salivary gland neoplasms comprise less than 2% of all tumors in humans and 3% of all head and neck tumors. They arise in the parotid gland in 80% of cases, and approximately 80% are benign and 20% are malignant. Among them are lymphoepithelial lesions, rare lesions of the salivary glands and especially of the parotid gland that are characterized by lymphocytic infiltration associated with an epithelial proliferation. They are divided into benign, which is considered as a tumorlike condition, and malignant, which is a rare carcinoma of the salivary glands. This article provides a review of the current knowledge on lymphoepithelial carcinoma with a look at its association with benign lesions and on the importance of making the correct diagnosis for the appropriate treatment.
Application of Immunohistochemistry to Cytology
Authors: Fowler Larry J. , Lachar Whitney A. 
Published: February 2021

Abstract
Context.—The uses of monoclonal antibodies via immunochemistry have been reported frequently within the literature using various methodologies with applications to cytology specimens. The direct application of immunochemistry to cytology may have a variety of pitfalls that the general pathologist familiar with its application to histology may be unaware of when applying it prospectively to patient specimens.
Objective.—To review common pitfalls when applying immunochemistry to cytology specimens and to suggest approaches to the more common differential dilemmas that apply to a variety of cytology specimens that could be seen in a general pathology practice.
Data Sources.—The authors' own experiences of applying immunochemistry to cytopathology specimens within an academic setting along with supportive data from the literature.
Conclusions.—Immunochemistry can be used to increase the predictability of a cytology diagnosis if care is taken with the cytology sample preparation methodology and there is judicious use of select monoclonal antibody panels to support a specific cytology diagnosis. Up-to-date evidence-based antibody databases should be used when selecting antibody panels.
Application of Immunohistochemistry to the Diagnosis of Malignant Mesothelioma
Authors: Marchevsky Alberto M. 
Published: February 2021

AbstractContext.—The diagnosis of malignant mesothelioma (MM) is rendered with the aid of immunohistochemistry to demonstrate the presence of “mesothelial,” “epithelial,” or “sarcomatous” differentiation. Antibody panels that have been proposed for the distinction between MM and other neoplasms usually include 2 or more epithelial markers used to exclude the diagnosis of a carcinoma, such as monoclonal and polyclonal carcinoembryonic antigen, Ber-EP4, B72.3, CD15, MOC-31, thyroid transcription factor 1, BG8, and others, and 2 or more mesothelial markers used to confirm the diagnosis of MM, such as cytokeratin 5/6, calretinin, HBME-1, thrombomodulin, WT-1, mesothelin, D2-40, and podoplanin. In general, most antibody panels provide excellent sensitivity and specificity for the differential diagnosis between MM epithelial variant and adenocarcinoma, particularly of lung origin. However, the accuracy of these markers is lower for the diagnosis of sarcomatous MM and for the differential diagnosis between MM and squamous cell carcinoma and carcinomas of renal, ovarian, and other origin.Objective.—To identify optimal antibody panels for the diagnosis of MM.Data Sources.—Literature review to determine how many and which mesothelial and epithelial markers need to be included in differential diagnosis antibody panels.Conclusions.—Various antibody panels have been recommended for the diagnosis of MM, with no overall consensus about how many and which markers should be used. A recent study with Bayesian statistics has demonstrated that the use of many markers does not provide higher diagnostic accuracy than the use of selected single antibodies or various combinations of only 2 markers. There is a need for the development of evidence-based or consensus-based guidelines for the diagnosis of MM in different differential diagnosis situations.
Application of Immunohistochemistry to Infections
Authors: Eyzaguirre Eduardo , Haque Abida K. 
Published: February 2021

Abstract
Context.—Pathologists play an important role in the diagnosis or exclusion of infectious diseases. Traditionally, the diagnosis of infectious diseases rely on serologic assays and cultures. Serologic results may be difficult to interpret in the setting of immunosuppression, fresh tissue is not always available for culture, and culture of fastidious pathogens can be difficult and may take weeks or months to yield a result. Although some microorganisms or their cytopathic effects may be readily identifiable on routine and/ or histochemical stains, often these changes are not specific or are sparse in the sample evaluated. In these cases, additional immunohistochemical stains are often needed to establish the diagnosis of infection.
Objective.—To review the current value and limitations of the use of immunohistochemistry in the diagnosis of infectious diseases in formalin-fixed tissue samples.
Data Sources.—Literature in Medline and the authors' own experience.
Conclusions.—Immunohistochemistry has proven to be a useful tool in the diagnosis of infectious diseases in tissue samples. Immunohistochemistry is especially useful in the identification of microorganisms that are present in low numbers, stain poorly, are fastidious to grow, are noncultivable, or exhibit an atypical morphology. Finally, it is important to remember that there may be widespread occurrence of common antigens among bacteria and pathogenic fungi and both monoclonal and polyclonal antibodies must be tested for possible cross-reactivity with other organisms.
Application of Immunohistochemistry to Soft Tissue Neoplasms
Authors: Heim-Hall Josefine , Yohe Sophia L. 
Published: February 2021

AbstractContext.—Soft tissue tumors are composed of numerous and complex diagnostic entities. Because of this complexity and the recognition of an intermediate malignancy category including some tumors with a deceptively bland histologic appearance, soft tissue tumors may represent a major diagnostic challenge to the general practicing pathologist.Objective.—To correctly diagnose soft tissue tumors with the ancillary use of immunohistochemistry.Data Sources.—Review of the current literature with emphasis on those tumors for which immunohistochemistry has proven to be particularly useful.Conclusions.—Immunohistochemistry plays an important role in the diagnosis of soft tissue tumors. One of its major utilities is to correctly identify a tumor as being of mesenchymal or nonmesenchymal origin. Once mesenchymal origin has been established, histologic subtyping according to specific cell lineage may be achieved with the use of lineage-specific markers. Tumors of uncertain cell lineage and tumors with primitive small round cell morphology are often characterized by a unique immunohistochemical phenotype. In this group of tumors, immunohistochemistry is most widely applied and is of greatest value. Despite the rapid development of molecular genetic techniques, immunohistochemistry still remains the most important diagnostic tool in the diagnosis of soft tissue tumors aside from recognition of morphologic features and clinical correlation.
Formatting Pathology Reports: Applying Four Design Principles to Improve Communication and Patient Safety
Authors: Valenstein Paul N. 
Published: February 2021

Abstract
Context.—Eighty-two million surgical pathology and cytology reports were issued in the United States during 2007; a subset of these reports will be misunderstood by readers. Recent attention has focused on standardizing the content of pathology reports, particularly for common malignancies, to facilitate transmission of required information. Comparatively little attention has been focused on the format of reports—the arrangement of headlines, text blocks, and other report elements to optimize communication.
Objective.—To provide guidance to report designers and authors about how to format reports to maximize the speed, fidelity, and ease of information transfer.
Data Sources.—Review of relevant literature from commercial publishing and aviation and the fields of cognitive psychology and pathology, supplemented with an analysis of 10 000 pathology reports and the author's personal experience as a practicing pathologist.
Conclusions.—Four evidence-based and time-tested principles can help pathologists format information to communicate more effectively: (1) use of diagnostic headlines to emphasize key points, (2) maintenance of layout continuity with other reports and over time, (3) optimization of information density for readers, and (4) reduction of extraneous information or “clutter.” Practical advice is also provided to help pathologists minimize corruption of formatting as reports are transmitted electronically between medical information systems.
Gaucher Disease: Review of the Literature
Authors: Chen Mingyi , Wang Jun 
Published: February 2021

Abstract
We present a brief review of Gaucher disease, the most common lysosomal storage disease. Gaucher disease is a rare autosomal recessive disorder characterized by defective function of the catabolic enzyme β-glucocerebrosidase, leading to an accumulation of its substrate, glucocerebroside, in the mononuclear phagocyte system, especially histiocytes in the spleen, lymph nodes, and bone marrow; Kupffer cells in the liver; osteoclasts in bone; microglia in the central nervous system; alveolar macrophages in the lungs; and histiocytes in the gastrointestinal tracts, genitourinary tracts, and the peritoneum. Clinical signs and symptoms include neurologic dysfunctions, bone infarcts and malformations, hepatosplenomegaly and hypersplenism leading to anemia, neutropenia, and thrombocytopenia. Enzyme replacement therapy with recombinant glucocerebrosidase is the mainstay of treatment for Gaucher disease, which became the first successfully managed lipid storage disease. Future treatments may include oral enzyme replacement and/or gene therapy interventions.
The Informed Consent Process in Whole Blood Donation
Authors: Alaishuski Lindsay A. , Grim Rodney D. , Domen Ronald E. 
Published: February 2021

Abstract
Context.—Informed consent in transfusion medicine has been an area lacking of significant research and it is unknown if donors fully comprehend the risks associated with whole blood donation.
Objective.—To assess the adequacy of the informed consent process in whole blood donation.
Design.—A brief questionnaire was constructed and distributed to whole blood donors visiting various fixed and mobile donor sites of the Central Pennsylvania Blood Bank. Questions consisted of demographic information; donor opinions of information content, length, and comprehension; and a short quiz pertaining to donor risks and eligibility.
Results.—Analysis of 849 surveys demonstrated that donors comprehended a mean of 73.5% of the various donor eligibility and risks that were surveyed. Female and younger donors scored statistically higher on comprehension questions compared with male and older counterparts. Donors were most aware of (1) donor eligibility requirements related to acquired immunodeficiency syndrome comprehension, (2) the risk of dizziness postdonation, and (3) having lived in a certain country (93.7%–95.6% comprehension, respectively). Donors were least aware of (1) the risk of a possible referral to a physician for outstanding medical conditions or positive test results, (2) the risk of a positive test result, and (3) West Nile virus testing information (22.4%–49.3% comprehension, respectively).
Conclusions.—Whole blood donors believed that they were giving informed consent, but a significant percentage of donors were unaware of several of the risks associated with blood donation, including participation in West Nile virus research testing. Our data suggest that donors do not fully comprehend the risks of whole blood donation and that repetition of information to the donor, and in multiple formats, strengthens the level of comprehension and thus the informed consent process.
Ovarian Frozen Section Diagnosis: Use of Whole-Slide Imaging Shows Excellent Correlation Between Virtual Slide and Original Interpretations in a Large Series of Cases
Authors: Fallon Margaret A. , Wilbur David C. , Prasad Manju 
Published: February 2021

Abstract
Context.—Whole-slide images (WSI) are a tool for remote interpretation, archiving, and teaching. Ovarian frozen sections (FS) are common and hence determination of the operating characteristics of the interpretation of these specimens using WSI is important.
Objectives.—To test the reproducibility and accuracy of ovarian FS interpretation using WSI, as compared with routine analog interpretation, to understand the technology limits and unique interpretive pitfalls.
Design.—A sequential series of ovarian FS slides, representative of routine practice, were converted to WSI. Whole-slide images were examined by 2 pathologists, masked to all prior results. Correlation characteristics among the WSI, the original, and the final interpretations were analyzed.
Results.—A total of 52 cases, consisting of 71 FS slides, were included; 34 cases (65%) were benign, and 18 cases (35%) were malignant, borderline, and of uncertain potential (9 [17%], 7 [13%], and 2 [4%] of 52 cases, respectively). The correlation between WSI and FS interpretations was 96% (50 of 52) for each pathologist for benign versus malignant, borderline, and uncertain entities. Each pathologist undercalled 2 borderline malignant cases (4%) as benign cysts on WSI. There were no overcalls of benign cases. Specific issues within the benign and malignant groups involved endometriosis versus hemorrhagic corpora lutea, and granulosa cell tumor versus carcinoma, respectively.
Conclusions.—The correlation between original FS and WSI interpretations was very high. The few discordant cases represent recognized differential diagnostic issues. Ability to examine gross pathology and real-time consultation with surgeons might be expected to improve performance. Ovarian FS diagnosis by WSI is accurate and reproducible, and thus, remote interpretation, teaching, and digital archiving of ovarian FS specimens by this method can be reliable.
Limiting the Use of Atypical/Inconclusive as a Category in Nongynecologic Cytology Specimens
Authors: Koen Tracie M. , Mody Dina R. , Scheiber-Pacht Miriam , Fairley Todd , Thrall Michael J. 
Published: February 2021

Abstract
Context.—Atypical has served as a descriptive term in cytology since the birth of the specialty by Dr Papanicolaou. This indeterminate diagnosis often results in repeat biopsies or additional tissue sampling and a needless delay in patient care if used inappropriately. Because of the definitional ambiguity of this term and the associated physician frustration, we have made a concerted effort at Methodist Hospital since 1995 to minimize the use of atypical as a diagnostic category.
Objective.—To evaluate whether the dissolution of the atypical category has increased our cytologic-histologic discordance rate to more than the published reference range.
Design.—From March 3, 2006, through December 31, 2008, all nongynecologic cases with atypical/indeterminate listed as the general diagnostic category were identified and retrieved from our laboratory data files. We then assessed the cytologic-histologic correlation rate during the corresponding time frame.
Results.—A total of 48 atypical cases (0.2%) from 19 347 nongynecologic specimens were identified. Of the atypical cases, 52% (25 of 48) had intradepartmental consultation, 58% (28 of 48) had additional preparations examined, and 29% (14 of 48) documented limitations because of poor preservation. Our cytologic-histologic discrepancy rate for the period was 5.5% (214 of 3912 cases), with 89.3% (191 of 214 cases) resulting from sampling issues. On review of the small percentage of cytologic interpretative discrepancies, only one case was unhampered by less than 10% tumor cellularity or poor preservation.
Conclusions.—Not using atypical as a diagnostic category, unless defined by Bethesda guidelines, has not affected our cytologic-histologic correlation rate.
The Immunohistochemistry Laboratory: Looking at Molecules and Preparing for Tomorrow
Authors: Teruya-Feldstein Julie 
Published: February 2021

Abstract
Context.—Surgical and subspecialty pathologists rely heavily on the patient's clinical context, imaging studies, morphology, and on ancillary studies such as immunohistochemistry (IHC), cytogenetics, and molecular diagnostics in arriving at accurate, contemporary diagnoses. Lymphoma/leukemia classification has led the way in the number of antibodies used in IHC algorithmic diagnostic approaches to distinguish more than 40 diseases. As the era of genomics, transcriptomics, proteomics, and targeted pathway therapeutics unfolds—and as infusion of federal funds to programs such as Accelerating Clinical Trials of Novel Oncologic PathWays (ACTNOW) requires that correlative biomarker assays be performed in Clinical Laboratory Improvement Amendments of 1988 (CLIA)–certified IHC laboratories—we face changes and challenges for the future.
Objective.—To discuss the laboratory, pertinent daily diagnostic, prognostic, and therapeutic uses of IHC, and future directions and challenges.
Data Sources.—Recent literature review and ongoing current activities in our laboratory and institution.
Conclusions.—Meticulous attention at the microscope by expert subspecialty pathologists using ancillary methods is important in making correct diagnoses. Awareness of the literature and interactions with our research colleagues, including clinical, basic, and translational scientists, continue to expand our insights into and understanding of complex diseases; this will ultimately provide prognostic information to assist in appropriate clinical management of our patients and development of new targeted or combination therapies. Multimodality correlations will continue, with morphology, imaging data, immunophenotyping, and genetics as well as steadily increasing integration of pathway signaling, genome, sequenome, transcriptome, and proteome data used in clinical settings.