bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posttransplantation Lymphoproliferative Disorders in Pediatric Patients Undergoing Liver Transplantation
Authors: Koh Bong Y. , Rosenthal Philip , Medeiros L. Jeffrey , Zhou Yuehua , Osorio Robert W. , Roberts John P. , Ascher Nancy L. , Gelb Arnold B. 
Published: January 2021

AbstractObjectives.—To study the clinicopathologic and molecular genetic findings in posttransplantation lymphoproliferative disorders (PTLDs) following pediatric liver transplantation and to determine the applicability of a recently proposed consensus classification system.Design.—The clinical, pathologic, and molecular genetic findings of 11 PTLDs that occurred in 10 patients are presented. These 10 patients were derived from a group of 121 pediatric patients who underwent liver transplantation at the University of California, San Francisco. The PTLDs were classified using the proposed Society for Hematopathology scheme. Clonality was determined by immunohistochemical detection of monotypic immunoglobulin or by using polymerase chain reaction–based methods to detect monoclonal immunoglobulin heavy-chain gene rearrangements. Epstein-Barr virus (EBV) was detected by immunohistochemistry, in situ hybridization, or polymerase chain reaction. Epstein-Barr virus typing and the presence of LMP1 gene deletions were also analyzed by polymerase chain reaction.Results.—There were 3 early lesions, 4 polymorphic PTLDs, and 4 monomorphic PTLDs. Monoclonality was demonstrated in 8 of 9 cases assessed. Epstein-Barr virus was present in all cases; of 9 cases assessed by polymerase chain reaction, the virus was type A in 8 and type B in 1. No EBV LMP1 gene deletions were identified. The corresponding liver explants were negative for EBV in 8 cases and positive in 1 case. Greater than 3 foci of disease and monomorphic PTLD were associated with decreased actuarial survival (P &lt; .05).Conclusions.—The prognosis of pediatric patients with PTLD is favorable for early lesions and polymorphous PTLD, particularly in patients with localized disease. Multifocal disease and monomorphic PTLD are associated with an unfavorable prognosis.
Histologic Features of Zygomycosis
Authors: Frater John L. , Hall Gerri S. , Procop Gary W. 
Published: January 2021

Abstract
Objective.—Invasive zygomycosis is rapidly progressive and is associated with angioinvasion and infarction. Invasive disease requires emergent surgical and medical intervention. Because it is important for surgical pathologists to recognize these fungi and their preferential sites of growth, the objective of this article is to describe the fungal morphology and histopathologic findings in biopsies from patients with zygomycotic disease, with emphasis on preferential sites of fungal growth.
Design.—Medical record and histologic review identified 20 patients with zygomycosis. Inclusion criteria included the presence of typical ribbonlike hyphae and positive culture, a clinical history of invasive zygomycosis, or both. The histologic features of disease and the fungal morphology were assessed.
Results.—Fungus ball (15%), rhinocerebral (55%), and pulmonary (30%) disease were the types of disease represented. The inflammatory responses were predominantly neutrophilic (50%), predominantly granulomatous (5%), pyogranulomatous (25%), or absent (20%). Invasive disease was characterized by prominent infarcts (94%), angioinvasion (100%), and, surprisingly, prominent perineural invasion (90%) in biopsies that contained nerves for evaluation. At least rare hyphal septa were always seen (100%), and most branches (95%) varied from 45° to 90°.
Conclusions.—As known to mycologists, zygomycetes are pauciseptate, rather than aseptate, molds. Therefore, the presence of an occasional septum is expected. Perineural invasion is a common finding in invasive zygomycosis, as are angioinvasion and infarcts. Therefore, prior to excluding the presence of these fungi in biopsies suspected to contain zygomycetes, the perineural space should be carefully examined.
The New Hematology Analyzer Sysmex XE-2100
Authors: Ruzicka Katharina , Veitl Mario , Thalhammer-Scherrer Renate , Schwarzinger Ilse 
Published: January 2021

AbstractContext.—The new hematology analyzer Sysmex XE-2100 (TOA Medical Electronics, Kobe, Japan) has a novel, combined, white blood cell differential technology and a special reagent system to enumerate nucleated red blood cells.Design.—Performance evaluation of both technologies of the Sysmex XE-2100 according to the H20-A protocol of the National Committee for Clinical and Laboratory Standards and comparison of the results with those for the hematology analyzer Sysmex NE-8000 (TOA Medical Electronics).Specimens.—Five hundred forty-four blood samples randomly chosen from various inpatient and outpatient departments of the Vienna University hospital.Results.—Five-part white blood cell differential counts on the XE-2100 revealed excellent correlation with the manual reference method for neutrophils, lymphocytes, and eosinophils (r = .925, .922, and .877, respectively) and good correlation for monocytes and basophils (r = .756 and .763, respectively). The efficiency rates of flagging for the presence of ≥1% abnormal white blood cells were 83% (XE-2100) and 66% (NE-8000). The correlation of automated and microscopic nucleated red blood cell counts was excellent (r = .97).Conclusions.—From the present evaluation and our former experience with other types of Sysmex analyzers, we conclude that the new white blood cell differential technology of the XE-2100 represents a further development toward more efficient flagging of abnormal white blood cells.
Aberrant Localization of the Neuronal Class III β-Tubulin in Astrocytomas
Authors: Katsetos Christos D. , Del Valle Luis , Geddes Jennian F. , Assimakopoulou Martha , Legido Agustin , Boyd James C. , Balin Brian , Parikh Nehal A. , Maraziotis Theodoros , de Chadarevian Jean-Pierre , Varakis John N. , Matsas Rebecca , Spano Anthony , Frankfurter Anthony , Herman Mary M. , Khalili Kamel 
Published: January 2021

Abstract
Background.—The class III β-tubulin isotype (βIII) is widely regarded as a neuronal marker in development and neoplasia. In previous work, we have shown that the expression of βIII in neuronal/neuroblastic tumors is differentiation dependent. In contrast, the aberrant localization of this isotype in certain nonneuronal neoplasms, such as epithelial neuroendocrine lung tumors, is associated with anaplastic potential.
Objective.—To test the generality of this observation, we investigated the immunoreactivity profile of βIII in astrocytomas.
Design.—Sixty archival, surgically excised astrocytomas (8 pilocytic astrocytomas, WHO grade 1; 18 diffuse fibrillary astrocytomas, WHO grade 2; 4 anaplastic astrocytomas, WHO grade 3; and 30 glioblastomas, WHO grade 4), were studied by immunohistochemistry using anti-βIII monoclonal (TuJ1) and polyclonal antibodies. A monoclonal antibody to Ki-67 nuclear antigen (NC-MM1) was used as a marker for cell proliferation. Antibodies to glial fibrillary acidic protein (GFAP) and BM89 synaptic vesicle antigen/synaptophysin were used as glial and neuronal markers, respectively.
Results.—The βIII immunoreactivity was significantly greater in high-grade astrocytomas (anaplastic astrocytomas and glioblastomas; median labeling index [MLI], 35%; interquartile range [IQR], 20%–47%) as compared with diffuse fibrillary astrocytomas (MLI, 4%; IQR, 0.2%–21%) (P &lt; .0001) and was rarely detectable in pilocytic astrocytomas (MLI, 0%; IQR, 0%–0.5%) (P &lt; .0001 vs high-grade astrocytomas; P &lt; .01 vs diffuse fibrillary astrocytomas). A highly significant, grade-dependent relationship was observed between βIII and Ki-67 labeling and malignancy, but this association was stronger for Ki-67 than for βIII (βIII, P &lt; .006; Ki-67, P &lt; .0001). There was co-localization of βIII and GFAP in neoplastic astrocytes, but no BM89 synaptic vesicle antigen/synaptophysin staining was detected.
Conclusions.—In the context of astrocytic gliomas, βIII immunoreactivity is associated with an ascending gradient of malignancy and thus may be a useful ancillary diagnostic marker. However, the significance of βIII-positive phenotypes in diffuse fibrillary astrocytomas with respect to prognostic and predictive value requires further evaluation. Under certain neoplastic conditions, βIII expression is not neuron specific, calling for a cautious interpretation of βIII-positive phenotypes in brain tumors.
Ebola Virus Glycoprotein Demonstrates Differential Cellular Localization in Infected Cell Types of Nonhuman Primates and Guinea Pigs
Authors: Steele Keith , Crise Bruce , Kuehne Ana , Kell Wayne 
Published: January 2021

Abstract
Background.—In vitro studies have previously shown that Ebola virus glycoprotein (GP) is rapidly processed and largely released from infected cells, whereas other viral proteins, such as VP40, accumulate within cells.
Objective.—To determine infected cell types in which Ebola virus GP and VP40, individually, localize in vivo.
Methods.—Immunohistochemistry and in situ hybridization using GP- and VP40-specific antibodies and genetic probes were used to analyze archived tissues of experimentally infected nonhuman primates and guinea pigs and Vero E6 and 293 cells infected in vitro.
Results.—The GP antigen was consistently present in hepatocytes, adrenal cortical cells, fibroblasts, fibroblastic reticular cells, ovarian thecal cells, and several types of epithelial cells, but was not detected in macrophages and blood monocytes of animals, nor in Vero cells and 293 cells. All GP-positive and GP-negative cell types analyzed contained VP40 antigen and both GP and VP40 RNAs.
Conclusions.—Ebola virus GP appears to selectively accumulate in many cell types infected in vivo, but not in macrophages and monocytes. This finding suggests that many cell types may have a GP-processing pathway that differs from the pathway described by previous in vitro studies. Differential cellular localization of GP could be relevant to the pathogenesis of Ebola hemorrhagic fever.
GEWF Solution
Authors: Newell Ken J. , Sawka Barry W. , Rudrick Brian F. , Driman David K. 
Published: January 2021

Abstract
Background.—Lymph node status is an important prognostic factor in the staging of colorectal carcinoma. Several adjunctive solutions have been used to increase the yield of pericolic lymph nodes from colorectal cancer resection specimens.
Methods.—During 1998 at the Grey Bruce Regional Health Centre (Owen Sound, Ontario), 67 colonic resections were performed for colorectal cancer. Lymph nodes were identified using GEWF solution (glacial acetic acid, ethanol, distilled water, and formaldehyde) in 35 cases, and by the conventional method of sectioning, inspection, and palpation in 32 cases.
Results.—There were no significant differences between GEWF and non-GEWF cases with respect to patient age, length of resection, size of tumor, tumor histologic type, tumor differentiation, or depth of tumor penetration into the bowel wall. Use of GEWF led to a significant increase in the number of lymph nodes found (10.2 ± 4.9 per case) compared with non-GEWF cases (6.8 ± 3.9 per case) (P = .002). In GEWF cases 358 lymph nodes were identified, 82 with metastases, whereas in the non-GEWF cases 218 lymph nodes were found, 41 with metastases. The size of positive lymph nodes in the GEWF group (0.5 ± 0.2 cm) was significantly smaller than in the non-GEWF group (0.7 ± 0.4 cm) (P = .046). A greater percentage of positive lymph nodes in the GEWF cases (49/82, 60%) were 0.5 cm or smaller compared with the non-GEWF cases (17/41, 41%).
Conclusions.—GEWF increases the yield of lymph nodes recovered from colorectal cancer specimens and may lead to improved staging of this cancer; it is inexpensive and simple to use.
Correlation of Ki-67 and p53 With the New World Health Organization/International Society of Urological Pathology Classification System for Urothelial Neoplasia
Authors: Cina Stephen J. , Lancaster-Weiss Kristen J. , Lecksell Kristen , Epstein Jonathan I. 
Published: January 2021

Abstract
Objective.—The present study examines p53 and Ki-67 staining patterns of the diagnostic entities included within the new World Health Organization/International Society of Urological Pathology (WHO/ISUP) classification of urothelial neoplasms.
Design.—We retrospectively studied 151 bladder biopsies from 81 patients with the following neoplasms: normal urothelium (n = 34 biopsies); low-grade intraurothelial neoplasia (LGIUN; n = 19); high-grade intraurothelial neoplasia (HGIUN; n = 20); papillary hyperplasia (n = 4); papilloma (n = 3); papillary neoplasm of low malignant potential (LMP; n = 12); low-grade papillary carcinoma (n = 28); and high-grade papillary carcinoma (n = 31). Sections were labeled immunohistochemically with antibodies to p53 and Ki-67 (MIB-1). Two hundred cells from each lesion were visually counted, and the percentage of positive cells was tabulated without knowledge of the WHO/ISUP diagnosis.
Results.—In flat lesions, p53 positivity was of limited diagnostic utility; the marker was present in 6 of 34 benign biopsies, 6 of 19 LGIUNs, and 10 of 20 HGIUNs. In one case in which HGIUN was present elsewhere in the bladder, 29% of the benign urothelial cells were p53 positive. In papillary lesions, p53 positivity was not seen in 4 of 4 cases of papillary hyperplasia, 3 of 3 papillomas, and 8 of 12 LMP tumors. In contrast, p53 was detected in 18 of 28 low-grade and 26 of 31 high-grade papillary urothelial carcinomas. A p53 labeling index (LI) greater than 30% was only seen in HGIUNs and high-grade papillary carcinomas. In flat lesions, an increased Ki-67 LI separated out benign urothelium (mean LI, 0.62%) from dysplasia (mean LI, 3.3%) and HGIUN (mean LI, 11.6%). In papillary lesions, Ki-67 positivity was as follows: papillary hyperplasia (mean LI, 1.1%); papilloma (mean LI, 4.3%); LMP tumors (mean LI, 2.5%), low-grade papillary carcinoma (mean LI, 7.3%); and high-grade carcinoma (mean LI, 15.7%). A Ki-67 LI greater than 10% was seen only in low- and high-grade papillary carcinomas, HGIUN, and single cases of LGIUN and papillary neoplasm of LMP.
Conclusions.—An increased proliferative index as demonstrated by immunohistochemical staining for Ki-67 (MIB-1) is most often seen in papillary carcinoma and HGIUN. Marked p53 positivity is also characteristic of carcinoma but may be seen in benign-appearing urothelium, suggesting a “field effect” with occult molecular aberration.
Chronic Myelomonocytic Leukemia Revealed by Uncontrollable Hematuria
Authors: Bane A. L. , Enright H. , Sweeney E. C. 
Published: January 2021

Abstract
Nephrectomy was performed for uncontrollable unilateral hematuria in an apparently healthy 72-year-old man. The suburothelial connective tissue of the kidney was infiltrated by primitive myeloid cells with associated acute vasculitis and foci of extramedullary hematopoiesis. Subsequently, the patient was shown to have chronic myelomonocytic leukemia. Although renal involvement and vasculitis have been recorded previously in chronic myelomonocytic leukemia, this is the first occasion, to our knowledge, where their concurrence resulted in such a spectacular presentation.
Lymphoepithelioma-like Carcinoma of the Breast With Associated Sclerosing Lymphocytic Lobulitis
Authors: Naidoo P. , Chetty R. 
Published: January 2021

Abstract
The purpose of this article is to highlight an unusual form of breast carcinoma and discuss its differential diagnosis. A 50-year-old woman underwent wide local excision of a breast lump. Microscopic examination revealed features of a lymphoepithelioma-like carcinoma. Individual tumor cells were present within an abundant lymphoid stroma. Immunohistochemistry revealed the epithelial nature of the cells and excluded a diagnosis of lymphoma. In addition, surrounding nontumorous breast tissue displayed the histologic features of sclerosing lymphocytic lobulitis or lymphocytic mastopathy. This is the second report of a lymphoepithelioma-like carcinoma of the breast, but to the best of our knowledge, it is the first description of coexistent sclerosing lymphocytic lobulitis.
Retroperitoneal Mucinous Cystadenoma
Authors: Subramony Charu , Habibpour Saied , Hashimoto Luis A. 
Published: January 2021

Abstract
Primary retroperitoneal mucinous cystadenoma is an uncommon tumor found exclusively in women. Herein, we describe a patient who had resection of a large retroperitoneal cystic mass. Histologic, immunohistochemical, and electron microscopic examination of the lining epithelial cells showed features of mesothelial cells in addition to ovarian mucinous cystadenoma. These findings suggest that these tumors arise from inclusions of mesothelial cells and subsequent mucinous metaplasia of the lining cells to form a cystadenoma. Estrogen receptors may be implicated in tumor promotion, explaining the occurrence exclusively in women.
The Value of Second Opinion in Gastrointestinal and Liver Pathology
Authors: Hahm Geoffrey K. , Niemann Theodore H. , Lucas Joel G. , Frankel Wendy L. 
Published: January 2021

Abstract
Objective.—The value of routine second opinion review of liver and gastrointestinal pathologic material was evaluated to determine whether there were discrepancies in diagnoses and if these discrepancies had an impact on treatment or prognosis.
Materials and Methods.—All gastrointestinal and hepatobiliary histopathology referral diagnoses made during a 1-year period for patients being treated at Ohio State University Medical Center were compared with the outside pathologic diagnosis. All major discrepant diagnoses were reviewed by at least 2 pathologists. Diagnoses were classified as no diagnostic disagreement, diagnostic disagreement, or no diagnostic disagreement but pertinent information missing or terminology unclear. Discrepant cases were also classified according to the clinical significance of the discrepancy.
Results.—Pathology reports from 194 hepatobiliary and gastrointestinal cases were reviewed. Of the hepatobiliary cases, 57 (64.8%) of 88 cases showed no discrepancies. Discrepancies were noted in 31 cases (35.2%), including missing information or unclear terminology in the diagnosis in 23 cases (26.1%) and diagnostic disagreement in 8 cases (9.1%). Of the cases with discrepancies, 6 (6.8%) were of major significance. Of the gastrointestinal cases, 87 (82.1%) of 106 cases showed no discrepancies. Discrepancies were noted in 19 cases (17.9%), including missing or unclear information in 3 cases (2.8%) and diagnostic disagreements in 16 cases (15.1%). The cases with discrepancies included 8 cases (7.5%) for which the change was of major clinical significance.
Conclusions.—Routine pathologic review of gastrointestinal and hepatobiliary cases revealed notable discrepancies in diagnoses. In 14 cases (7.2%), the change in diagnosis or additional information had a significant effect on the proper treatment or a significant prognostic implication. Routine review of all pertinent pathologic material should be performed on all patients being transferred to a second institution for treatment or second opinion.
Evidence of an Inflammatory Pathologic Condition in “Normal” Appendices Following Emergency Appendectomy
Authors: Nemeth Laszlo , Reen Denis J. , O'Briain D. Sean , McDermott Michael , Puri Prem 
Published: January 2021

Abstract
Background.—Appendices removed from patients with suspected appendicitis often appear normal on histologic examination.
Objective.—To study appendix specimens for the expression of inflammatory markers as an indicator of presence of an inflammatory response in this subgroup of patients.
Methods.—Cyclooxygenase 1 and 2, prostaglandin E2, inducible nitric oxide synthase, and major histocompatibility complex class II were investigated by immunofluorohistochemistry using confocal laser microscopy in 15 acutely inflamed appendix specimens, 39 histologically classified “normal” appendices, and 11 negative control specimens.
Results.—Strong expressions of all the inflammatory mediators were found in the mucosa of inflamed appendices, in approximately 50% of histologically normal appendices from patients with a clinical diagnosis of appendicitis, and in none of the normal control specimens.
Conclusion.—This study confirms the existence of a subgroup of appendicitis within the so-called histologically normal appendices in which evidence of an inflammatory pathologic condition is only obvious at a molecular level. The initiating signal for this and all other forms of clinical appendicitis still remains elusive.
True Malignant Mixed Tumor (Carcinosarcoma) of Parotid Gland With Unusual Mesenchymal Component
Authors: Kwon Meeae Y. , Gu Mai 
Published: January 2021

AbstractTrue malignant mixed tumor (carcinosarcoma) of the salivary gland is an extremely rare tumor. By definition, it is composed of both malignant epithelial and malignant mesenchymal elements. The most common type of the former is squamous cell carcinoma or adenocarcinoma and the most common type of the latter is chondrosarcoma, followed in frequency by fibrosarcoma, leiomyosarcoma, osteosarcoma, and in rare instances liposarcoma. We report a case of true malignant mixed tumor of the parotid gland in association with a pleomorphic adenoma in a 47-year-old man that contained a very unusual type of malignant mesenchymal component, rhabdomyosarcoma. Cytologic and histologic features and immunohistochemical results are presented. In addition, the literature is reviewed, and the possible histogenesis and pathogenesis of malignant mixed tumor of the salivary gland are briefly discussed.
Rectal Pulse Granuloma
Authors: Pereira Telma C. , Prichard Jeffrey W. , Khalid Mushtaq , Medich David S. , Silverman Jan F. 
Published: January 2021

Abstract
Pulse granuloma is a rare benign entity, most likely representing a foreign body reaction to vegetable particles. We report a case of a pulse granuloma involving the rectum. The patient presented with a submucosal and intramuscular mass lesion found at routine rectal examination and subsequent colonoscopy. The mass was excised and the microscopic examination revealed acute and chronic inflammatory cells, foreign-body giant cells, vegetable matter, and convoluted hyaline rings and scattered circular structures containing basophilic granules, consistent with pulse granuloma. There are a few reports in the literature of pulse granulomas, with most occurring in the oral cavity or lungs. To the best of our knowledge, this is the first reported example of pulse granuloma in the rectum. Although rare, familiarity with this entity's distinctive histopathologic features may avoid a delay in diagnosis and prevent the expense of distinguishing it from its histologic lookalikes.
Evaluation of Characteristics Associated With Acute Splenitis (Septic Spleen) as Markers of Systemic Infection
Authors: Feig James A. , Cina Stephen J. 
Published: January 2021

Abstract
Context.—Acute splenitis, also known as acute splenic tumor or septic spleen, is loosely defined as a neutrophilic infiltrate and congestion within the red pulp accompanied by splenomegaly. Standard pathology texts state that the histologic finding of acute splenitis is reflective of septic states. However, this association has seldom been tested in the medical literature.
Objective.—The purpose of this study was to determine if sepsis can be predicted by the presence of quantitative characteristics used to identify acute splenitis.
Methods.—The postmortem splenic tissue of 20 clinically diagnosed cases of sepsis and 20 noninfectious control cases were retrospectively examined in a blinded fashion for amount of neutrophilic infiltration, weight (obtained from autopsy report), and presence of congestion.
Results.—No significant correlation could be found between the parameters of neutrophilic infiltrate or splenic weight and clinically diagnosed septicemia. The presence of splenic congestion was unexpectedly found to be more likely with noninfectious causes of death.
Conclusion.—Acute splenitis is presently ill defined, and no available evidence convincingly shows that its presence suggests a septic state.