bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Pancreatic Sinus Histiocytosis With Massive Lymphadenopathy (Rosai-Dorfman Disease): An Unusual Extranodal Manifestation Clinically Simulating Malignancy
Authors: Podberezin Mark , Angeles Ronald , Guzman Grace , Peace David , Gaitonde Sujata 
Published: February 2021

Abstract
Sinus histiocytosis with massive lymphadenopathy (SHML), also called Rosai-Dorfman disease, is a rare entity. Its etiology and pathogenesis are still essentially unclear. The histologic hallmark of this disease is proliferation of distinctive histiocytes within lymph node sinuses and in extranodal sites. Approximately 23% of patients with SHML, documented in the SHML Registry, presented with disease primarily in extranodal sites, and very few cases of SHML (&lt;1%) involving the gastrointestinal system have been described in the literature. We report an unusual case of primary pancreatic SHML with infiltration of the process into peripancreatic, perinephric, and perisplenic adipose tissue, simulating malignancy.
Pseudoneoplasms of the Gastrointestinal Tract
Authors: Petris Giovanni De , Leung Stanley T. 
Published: February 2021

Abstract
Context.—The pathologist plays the leading role in distinguishing pseudoneoplasms from truly neoplastic lesions in the gastrointestinal tract.
Objective.—This review was conducted to heighten awareness of pseudoneoplasms, to help differentiate among the various types of pseudoneoplasms, and to help distinguish pseudoneoplasms from malignancies.
Data Sources.—This review is based on the medical literature on pseudoneoplasms in MEDLINE and the authors' own experiences. Reference lists of retrieved articles were also reviewed to identify additional articles.
Conclusions.—A classification of pseudoneoplasms, according to the mechanism of injury to the gastrointestinal tract, morphologic patterns, and heterotopia, may be useful in providing a diagnostic framework in which ancillary techniques often have a diagnostic role. Several pseudoneoplasms may be closely associated with true neoplasms (eg, malakoplakia, prolapsetype lesions) because of the nonspecific nature of the response of the intestine to injury.
Pseudoneoplastic Lesions of the Female Genital Tract
Authors: Medeiros Fabiola , Bell Debra A. 
Published: February 2021

Abstract
Context.—Numerous benign, proliferative, or reactive processes, often related to hormone stimulation or inflammation, occur throughout the female genital tract and may mimic benign or malignant tumors. Several of the more common pseudoneoplastic lesions are discussed in this article, including microglandular hyperplasia of the cervix mimicking well-differentiated endometrial adenocarcinoma, reactive epithelial changes in the fallopian tubes mimicking adenocarcinoma or carcinoma in situ, and pregnancy changes in the ovary including pregnancy luteoma and large solitary luteinized follicular cyst of pregnancy and puerperium that may mimic ovarian neoplasms.
Objectives.—To discuss and illustrate several common lesions of the female genital tract that mimic neoplasms.
Data Sources.—Material derived from consultation cases and review of the literature.
Conclusions.—Many benign hyperplastic or reactive processes that occur in the female genital tract may be mistaken for neoplasms both clinically and pathologically. Awareness of the features of such lesions will aid in their correct diagnosis and prevent overtreatment of benign processes.
Pseudoneoplasms of the Nervous System
Authors: Donev Kliment , Scheithauer Bernd W. 
Published: February 2021

AbstractContext.—Pseudoneoplasms of the nervous system vary greatly in nature. Ranging from inflammatory to autoimmune, infectious, malformative, reactive, degenerative, and radiation induced, they all mimic true tumors. Thus, they have the potential to mislead clinicians, radiologists, and pathologists alike. Their clinical and/or neuroimaging and histologic features are readily misinterpreted as tumor. Knowledge of the pitfalls is essential to avoid mismanagement, specifically overtreatment. In such instances, pathologists must take the entire clinical picture into consideration, acquainting themselves with presenting symptoms, physical findings, and neuroimaging.Objective.—To present 10 examples of pseudoneoplasms of the nervous system, analyze the basis for their mimicry, and discuss their differential diagnosis.Data Sources.—Review of the pertinent literature related to pseudoneoplasms of the nervous system and review of the consultation files of one of the authors (B.W.S.).Conclusions.—The identification of tumor mimics may be difficult under the best of circumstances, and maintaining a broad differential diagnosis as well as application of a variety of immunocytochemical and occasionally ultrastructural and/or molecular genetic methods is essential to arrive at a correct diagnosis.
The Pittsburgh Cervical Cancer Screening Model: A Risk Assessment Tool
Authors: Austin R. Marshall , Onisko Agnieszka , Druzdzel Marek J. 
Published: February 2021

Abstract
Context.—Evaluation of cervical cancer screening has grown increasingly complex with the introduction of human papillomavirus (HPV) vaccination and newer screening technologies approved by the US Food and Drug Administration.
Objective.—To create a unique Pittsburgh Cervical Cancer Screening Model (PCCSM) that quantifies risk for histopathologic cervical precancer (cervical intraepithelial neoplasia [CIN] 2, CIN3, and adenocarcinoma in situ) and cervical cancer in an environment predominantly using newer screening technologies.
Design.—The PCCSM is a dynamic Bayesian network consisting of 19 variables available in the laboratory information system, including patient history data (most recent HPV vaccination data), Papanicolaou test results, high-risk HPV results, procedure data, and histopathologic results. The model's graphic structure was based on the published literature. Results from 375 441 patient records from 2005 through 2008 were used to build and train the model. Additional data from 45 930 patients were used to test the model.
Results.—The PCCSM compares risk quantitatively over time for histopathologically verifiable CIN2, CIN3, adenocarcinoma in situ, and cervical cancer in screened patients for each current cytology result category and for each HPV result. For each current cytology result, HPV test results affect risk; however, the degree of cytologic abnormality remains the largest positive predictor of risk. Prior history also alters the CIN2, CIN3, adenocarcinoma in situ, and cervical cancer risk for patients with common current cytology and HPV test results. The PCCSM can also generate negative risk projections, estimating the likelihood of the absence of histopathologic CIN2, CIN3, adenocarcinoma in situ, and cervical cancer in screened patients.
Conclusions.—The PCCSM is a dynamic Bayesian network that computes quantitative cervical disease risk estimates for patients undergoing cervical screening. Continuously updatable with current system data, the PCCSM provides a new tool to monitor cervical disease risk in the evolving postvaccination era.
Immunohistochemical Profile and Fluorescence In Situ Hybridization Analysis of Diffuse Large B-Cell Lymphoma in Northern China
Authors: Li Ting , Medeiros L. Jeffrey , Lin Pei , Yin Hongfang , Littlejohn Martin , Im Whan , Lennon P. Alan , Hu Peter , Jorgensen Jeffrey L. , Liang Mei , Guo Hua , Yin C. Cameron 
Published: February 2021

AbstractContext.—Gene expression profiling of diffuse large B-cell lymphoma using complementary DNA microarrays has revealed 2 major prognostic groups in Western countries: germinal center B-cell–like and nongerminal center B-cell–like lymphomas. Immunohistochemical analysis using antibodies specific for CD10, BCL6, and MUM1 has been proposed as a surrogate for gene expression profiling.Objective.—To study the immunohistochemical features of diffuse large B-cell lymphoma cases from northern China because geographic differences for this disease are known to exist.Design.—Morphologic, immunohistochemical, and fluorescence in situ hybridization analyses of 63 cases of diffuse large B-cell lymphoma from northern China.Results.—There were 38 men and 25 women with a median age of 57 years (range, 12–87 years). CD10 was positive in 19 cases (30%), BCL6 was positive in 22 cases (35%), and MUM1 was positive in 32 cases (51%). Twenty-one (33%) cases were germinal center B-cell–like lymphoma, and 42 (67%) were nongerminal center B-cell–like lymphoma. BCL2 was expressed more often in nongerminal center B-cell–like disease versus germinal center B-cell–like disease (60% versus 24%, P  =  .01) and in nodal versus extranodal (64% versus 30%, P  =  .01) cases. Fluorescence in situ hybridization analysis showed BCL6, MYC, and BCL2 rearrangements in 11 of 32 (34%), 8 of 27 (30%), and 11 of 50 (22%) cases, respectively.Conclusions.—These results add to what is known about the geographic variation of diffuse large B-cell lymphomas. In northern China, the frequency of the germinal center B-cell–like type and BCL6 expression and/or BCL6 rearrangement is less and the frequency of MYC rearrangement is greater than have been reported in Western countries.
Do Eosinophil Numbers Differentiate Eosinophilic Esophagitis from Gastroesophageal Reflux Disease?
Authors: Genevay Muriel , Rubbia-Brandt Laura , Rougemont Anne-Laure 
Published: February 2021

Abstract
Context.—Although the healthy esophageal mucosa contains no eosinophils, eosinophilic infiltration is observed in 2 major clinicopathologic settings: gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EE). The prevalence of EE is increasing in many countries, and this increase seems only partly to be due to a better awareness of the pathology, following the relatively recent description of EE. Gastroesophageal reflux disease and EE represent 2 entities that do not respond to the same treatment modalities and, thus, need to be distinguished. However, diagnostic criteria of EE have been defined arbitrarily, and the more recent articles tend to prove that the overlap with GERD is probably greater than initially believed, leading the authors to advise strict exclusion of GERD before considering the diagnosis of EE.
Objectives.—To provide pathologists with the currently proposed histologic criteria of GERD and EE, to stress the need to combine these criteria with clinical data and endoscopic findings, and to outline the remaining controversies.
Data Sources.—This review is based on selected articles identified by a PubMed (US National Library of Medicine, Bethesda, Maryland) search of the literature in English for GERD and EE, a recent review by the American Gastroenterological Association (Bethesda), the Proceedings of the First International Gastrointestinal Eosinophil Research Symposium, and the authors' experience.
Conclusions.—Proper identification of the etiology of eosinophilic infiltration of the esophagus allows accurate medical or surgical treatment and follow-up. Eosinophilic esophagitis and GERD diagnoses require integration of the histologic findings with the clinical and endoscopic data.
Immunoexpression of Multidrug-Resistance Protein 2 and Cyclooxygenase 2 in Medullary Thyroid Carcinomas
Authors: Ruggeri Rosaria Maddalena , Sciacchitano Salvatore , Vitarelli Enrica , Trimarchi Francesco , Barresi Gaetano , Trovato Maria 
Published: February 2021

Abstract
Context.—Chemoresistance is due to the expression of multidrug-resistance proteins (MRPs). Cyclooxygenase 2 (COX2), a key enzyme in prostaglandins synthesis, upregulates MRP1. MRP1 is overexpressed in medullary thyroid carcinomas (MTCs), but it is not involved in resistance to doxorubicin and cisplatin, which are commonly used in MTC treatment. MRP2 is specifically involved in resistance to both chemotherapeutic agents, but no data exist on the expression of MRP2 and COX2 in MTC.
Objective.—To evaluate MRP2 and COX2 expressions in MTC.
Design.—We analyzed immunohistochemical expression of MRP2 and COX2 in 12 MTCs and in 6 lymph node metastases. Results were correlated with pTNM and clinical stage.
Results.—MRP2 and COX2 expressions were observed only in tumor samples and metastases. Nine MTCs, all pTNM stage T4, were positive for MRP2, whereas 3 MTCs, pTNM stages T2 and T3, were unreactive for MRP2. Six metastatic MTCs at stage T4 showed higher proportion of MRP2+ cells, compared with primary tumors. All 12 MTCs were positive for COX2. Three MTCs, pTNM stage T2 and T3, showed COX2 positivity in all cells. The proportion of COX2+ cells decreased with increased pTNM stage. Four out of 6 metastatic MTCs, stage T4, showed a lower proportion of COX2+ cells, compared with primary tumors. The proportion of MRP2+ cells was inversely related to the proportion of COX2+ cells.
Conclusions.—MRP2 and COX2 expression correlated with pTNM stage. High MRP2 and low COX2 expression may explain resistance to doxorubicin and cisplatin, which is observed in advanced stage MTC. Evaluation of the expression pattern of these 2 proteins may be useful to predict chemosensitivity of these types of tumors.
Atypical Small Acinar Proliferation in the Prostate: Clinical Significance in 2006
Authors: Bostwick David G. , Meiers Isabelle 
Published: February 2021

Abstract
About 2% of contemporary prostate needle biopsy specimens contain collections of small acini that are suspicious for cancer but that fall below the diagnostic threshold and are reported as atypical small acinar proliferation suspicious for but not diagnostic of malignancy. Prostate cancer has been identified in specimens from subsequent biopsies in up to 60% of cases of atypical small acinar proliferation, indicating that this finding is a significant predictor of cancer. Identification of atypical small acinar proliferation warrants repeat biopsy for concurrent or subsequent invasive carcinoma.
The Utility of Immunohistochemistry and In Situ Hybridization in Placental Pathology
Authors: Nuovo Gerard 
Published: February 2021

Abstract
It has long been recognized that routine histologic examination of the placenta has limitations, especially with regard to the diagnosis of infectious diseases and the concomitant cytokine response that may cause severe in utero fetal damage. Immunohistochemical testing of the placenta in such situations can be very useful in terms of identifying the infectious agent as well as in demonstrating a marked increase in cytokines such as tumor necrosis factor α and interleukin 8, produced primarily by cells native to the villi and fetal membranes. One hundred placentas (20 normal childbirths, 20 with severe neonatal morbidity of known cause, 25 idiopathic stillbirths where autopsy material was available, 35 with severe idiopathic neonatal morbidity) were examined for a wide variety of infectious diseases and cytokine production. An infectious agent was evident in 19 (76%) of 25 placentas from stillbirths and 28 (80%) of 35 placentas associated with idiopathic severe neonatal morbidity. No infectious agent was noted in the placentas from normal childbirths or cases of known neonatal morbidity. The most common infectious agent was coxsackie virus (51% of infections) followed by bacterial infections (24% of infections). The same infectious agent found in the placenta was found in the corresponding autopsy material from the stillbirths, with the spleen containing the greatest number of infected cells. There was a strong correlation between the number of cells demonstrating cytokine expression (tumor necrosis factor α and interleukin 8) and the presence of an infectious disease in the placenta and stillborn. No histologic feature was associated with an in utero infection. Immunohistochemical testing of placentas gives much insight into their structure and function, including, besides infectious disease detection, the marked diversity of function of trophoblasts, the rarity of committed B cell response, and the strong potential of contractility of villi.
Grading of Follicular Lymphoma: Comparison of Routine Histology With Immunohistochemistry
Authors: Martinez Antonio E. , Lin Li , Dunphy Cherie H. 
Published: February 2021

Abstract
Context.—Follicular lymphoma (FL) grading is based on the average number of large transformed cells in 10 neoplastic follicles at ×40 high-power field (×10–40 high-power field) examination (grade 1, 0–5 centroblasts per high-power field; grade 2, 6–15 centroblasts per high-power field; grade 3, &gt;15 centroblasts per high-power field).
Objective.—Since there may be significant interobserver variability, we analyzed the usefulness of immunohistochemical stains in grading FLs more reliably.
Design.—Forty-three FLs initially graded by World Health Organization criteria (grade 1, 12; grade 2, 18; grade 3, 13) were reviewed and stained with CD3, CD20, Ki-67, CD30, CD68, PAX-5, and BCL-6. Retrospective review was performed for the average number of large cells, of large lymphoid cells, of large cells staining with CD3, CD20, BCL-6 (40 cases), and PAX-5, and of all cells staining with CD68, Ki-67, and CD30.
Results.—By histologic review, 8 of 43 FLs had a significant grade change (4 cases upgraded and 4 cases downgraded). CD3 and CD30 stained only 0 to 3 large cells and 0 to 3 cells, respectively, in neoplastic follicles. CD68+ cells represented the large nonlymphoid cells. Increasing FL grades demonstrated increases in Ki-67+ cells. The original grade showed substantial agreement with CD20 and moderate agreement with PAX-5 and BCL-6. The original histologic grade agreed with immunohistochemical-based grade using 2 or more antibodies in 5 of 8 discordant cases (4 by CD20 or BCL-6 and PAX-5; 1 by CD20, PAX-5, and BCL-6).
Conclusions.—Interobserver variability of histologic FL grading may be significant; we showed low-end “substantial agreement.” Immunohistochemical stains (ie, CD20, PAX-5, and BCL-6) may more reliably determine the number of large transformed cells in neoplastic follicles; Ki-67 staining correlates with higher FL grades. Immunohistochemical stains may be evaluated in clinical trials of FL patients to determine prognostic significance.
Utility of MIB-1 (Ki-67) in Evaluating Diminutive Colorectal Polyps With Cautery Artifact
Authors: Groisman Gabriel M. , Amar Mary , Meir Alona 
Published: February 2021

Abstract
Context.—Accurate interpretation of colorectal polyp histology is essential in the decision-making process during treatment and surveillance following polypectomies. However, interpretation of diminutive colorectal polyps removed by thermal electrocoagulation (hot biopsy technique) is often problematic as a result of cautery artifact.
Objective.—To evaluated the usefulness of the proliferation marker MIB-1 (Ki-67) as an aid in the differential diagnosis of diminutive colorectal polyps with cautery artifact, as adenomatous and nonadenomatous polyps display different patterns of epithelial proliferation.
Design.—Seventy-five diminutive colorectal polyps with extensive cautery artifact displaying at least the upper portions of 3 adjacent crypts with the corresponding surface epithelium were evaluated and immunolabeled with MIB-1. They included 25 cases in which a definitive or presumptive diagnosis could not be reached (indeterminate polyps), 25 cases diagnosed as compatible with adenomatous polyp, and 25 cases diagnosed as compatible with nonadenomatous polyp.
Results.—MIB-1 immunoreactivity was well preserved in the cauterized areas. Among indeterminate polyps, MIB-1 stained upper crypts and surface epithelium in 14 cases (adenomatous polyp staining pattern) and revealed minimal or absent staining in these areas in 11 cases (nonadenomatous polyp staining pattern). All cases diagnosed as compatible with adenomatous polyp displayed the adenomatous polyp staining pattern. In contrast, all cases diagnosed as compatible with nonadenomatous polyp revealed the nonadenomatous polyp staining pattern.
Conclusions.—Immunoreactivity for MIB-1 may be used as a beneficial adjunctive test to help diagnose diminutive colorectal polyps with extensive cautery artifact.
Expression of p63 Differs in Peritoneal Endometriosis, Endometriomas, Adenomyosis, Rectovaginal Septum Endometriosis, and Abdominal Wall Endometriosis
Authors: Poli Neto Omero B. , Ferreira; Hebert M. , Ramalho Leandra N. Z. , Rosa e Silva Júlio C. , Candido dos Reis Francisco J. , Nogueira Antonio A. 
Published: February 2021

Abstract
Context.—Although there is evidence that endometriosis results from basal endometrium dislocation, the underlying biology is not fully understood. One protein that plays an important role in regulating epithelial proliferation and differentiation is the 63-kDa membrane protein (p63), which is also a marker of basal and reserve cells in the female genital tract.
Objective.—To determine whether p63 is expressed differently in peritoneal endometriosis, endometriomas, and adenomyosis, as well as in deep endometriotic nodules of the rectovaginal septum and abdominal wall.
Design.—This study includes a prospective series of consecutive patients (Canadian Task Force classification II-2) from a tertiary care university hospital. Specimens collected from 83 patients (15 peritoneal endometriosis specimens, 22 endometrioma specimens, 36 adenomyosis specimens, and 10 rectovaginal septum/abdominal wall specimens) were evaluated. Diagnostic and operative laparoscopies or laparotomies were performed, and tissue samples were obtained. Immunohistochemistry was used to evaluate p63 expression.
Results.—Positivity for p63 was detected in 93.3% of the peritoneal endometriosis specimens, 81.8% of the endometrioma specimens, 36.1% of the adenomyosis specimens, and none of the rectovaginal/abdominal wall endometriosis specimens (P &lt; .001). Distribution of p63 immunostaining in the positive specimens was homogeneous.
Conclusions.—Endometriotic lesions express p63 differently, and some retain the basal/reserve cell immunophenotype. Nevertheless, it remains unclear whether the lack of p63 expression in some lesions is related to the extent of the disease, to its clinical behavior, or to exacerbation of the accompanying symptoms.
Histologic Variants of Infiltrating Urothelial Carcinoma
Authors: Zhai Qihui J. , Black Jennifer , Ayala Alberto G. , Ro Jae Y. 
Published: February 2021

Abstract
Context.—The spectrum of urothelial carcinoma is broad, and variant morphologies are being reported continually. Many of these variants have been extensively documented and even established as subclasses of urothelial carcinoma.
Objective.—To review the established and more recently described variants of urothelial carcinoma. The significance of recognizing these variants is discussed.
Data Sources.—The literature is reviewed in conjunction with our experience pertaining to urothelial carcinomas of the bladder and ureters.
Conclusions.—Urothelial carcinoma displays many forms, and some of these variant morphologies may introduce diagnostic difficulties because of their similarity to other malignancies and/or benign lesions. Additionally, it is important to recognize variants that are associated with different outcomes from conventional urothelial carcinoma. For these reasons, familiarity with the diverse morphology of urothelial carcinoma is not simply an academic exercise but is important in providing quality care for patients affected by this disease.