bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morphologic Features of 115 Lymphomas of the Orbit and Ocular Adnexa Categorized According to the World Health Organization Classification: Are Marginal Zone Lymphomas in the Orbit Mucosa-Associated Lymphoid Tissue–Type Lymphomas?
Authors: Lagoo Anand S. , Haggerty Christopher , Kim Young , Hammons Matthew , Neufeld Kenneth , Redher Catherine , Woodward Julie , Klintworth Gordon K. 
Published: February 2021

Abstract
Context.—Marginal zone lymphomas (MZLs) are the most common lymphomas encountered in the orbit and ocular adnexa. The accurate categorization of these lymphomas is critical to avoid undertreatment or overtreatment.
Objective.—To identify features of orbital MZLs that distinguish them from other lymphomas and reactive lymphoid infiltrates and support the categorization of orbital MZL as mucosa-associated lymphoid tissue (MALT)–type MZLs.
Design.—Biopsies from 149 patients with lymphoid lesions of ocular adnexa were examined. Additional immunohistochemical stains and fluorescence in situ hybridization study for the MALT1 locus were performed in selected cases, and patient charts were reviewed.
Results.—A total of 115 lymphomas and 34 reactive infiltrates were identified, of which B-cell lymphomas constituted 92% and MZLs constituted 54% of all lymphomas. Certain clinical features (young age, race, bilaterality) favored a reactive infiltrate, but none were diagnostic. Histologic features, such as infiltrative lesions, reactive B-cell follicles, and lymphoepithelial lesions, overlapped between reactive infiltrates and conjunctival MZL. In contrast to conjuctival MZL, orbital MZL infrequently showed reactive follicles, rarely showed epithelial tissue, and did not show lymphoepithelial lesions. Cytogenetic abnormality involving the MALT1 locus was demonstrated in only 15% of ocular adnexal MZLs.
Conclusion.—Many MZLs of orbital soft tissue lack key features associated with MALT-type MZL, and the designation MALT lymphoma should be avoided in their diagnosis.
Targeted Therapy in Non–Small Cell Lung Cancer: A Commentary
Authors: Murer Bruno 
Published: February 2021

Abstract
Context.—The development of targeted therapy provides an exciting prospect for treatment of advanced non–small cell lung cancer. In the last few years the epithelial growth factor receptor has emerged as one of the most important targets in very selected patients.
Objective.—To review current data on the role of the targeted therapy in advanced non–small cell lung cancer and offer some perspectives for the practitioner.
Data Sources.—This review is drawn from pertinent literature and the author's experience.
Conclusions.—Despite the remarkable development of targeted therapies in advanced non–small cell lung cancer, there is not yet a real improvement in overall survival. This might be due to (1) the development of primary or secondary resistance to therapy, (2) the biologic method used to select the population to treat, or (3) the molecular status of epithelial growth factor receptor may not be the most important predictor for targeted therapy. The understanding of interactions between epithelial growth factor receptor inhibitors and other molecules will be essential in the development of more effective treatment strategies.
Clinical Evaluation of Gen-Probe's Amplified Mycobacterium Tuberculosis Direct Test for Rapid Diagnosis of Mycobacterium tuberculosis in Egyptian Children at Risk for Infection
Authors: Zaki Maysaa El-Sayed , Hassan Samir Abou-El 
Published: February 2021

Abstract
Context.—Diagnostic detection of tuberculosis (TB) has improved considerably. Available, standardized, nucleic acid–based amplification techniques have been shown to yield reliable results within 4 to 7 hours of sample processing.
Objective.—To study the diagnostic performance of Gen-Probe's technique for direct detection of Mycobacterium tuberculosis in comparison with BACTEC 460 TB culture for both positive and negative Ziehl-Neelsen smears in Egyptian children at risk for TB infection.
Design.—We prospectively evaluated 50 children from families with a positive history of TB. All patients were referred from outpatient clinics of the Mansoura University Children's Hospital, Egypt. The children had a positive tuberculin skin test with an induration diameter of more than 10 mm and had scars from a bacille Calmette-Guérin vaccination within the past 2 years. Three consecutive sputum samples were taken from each patient. The samples were examined to detect M tuberculosis by means of the Gen-Probe technique, direct smear microscopy, and bacterial culture by BACTEC 460 TB.
Results.—Of the 50 cases, 30 (60%) had sputum samples that were positive for TB by BACTEC 460 TB culture, and 29 cases (58%) were positive by the Gen-Probe technique. Sensitivity and specificity of Ziehl-Neelsen smears was 83.3% and 100%, respectively, with overall accuracy of 90%. Sensitivity and specificity of the Gen-Probe technique were 96.7% and 100%, respectively, with overall accuracy of 98%.
Conclusions.—The results of this study suggest that the Gen-Probe technique is an accurate method for rapid detection of M tuberculosis complexes in respiratory samples from children at risk for TB. It can be used for diagnosis of smear-negative cases that are suspect for TB.
Molecular Pathology in Anatomic Pathology Practice: A Review of Basic Principles
Authors: Hunt Jennifer L. 
Published: February 2021

AbstractMolecular testing in pathology emerged shortly after polymerase chain reaction became a standard molecular biology assay.1 Testing efforts began in the clinical laboratories primarily with assays for genetically inherited diseases and assays for clonality in hematologic malignancies.12 Today, the field has evolved into “molecular diagnostics,” which encompasses testing in almost every area of anatomic pathology.3 Molecular testing is now even making its way definitively into both surgical pathology and cytopathology, although molecular anatomic pathology is still young with few standard tissue-based molecular assays. As more clinically valuable information is gained from molecular pathology testing of tissues, unique challenges are also becoming apparent at the intersection between tissue diagnosis and DNA diagnosis. This review focuses on basic molecular pathology concepts, with particular emphasis on the challenge of tissue-based testing in anatomic pathology.
Iris Melanoma
Authors: Henderson Evita , Margo Curtis E. 
Published: February 2021

AbstractThe iris is the least common site of primary uveal melanoma. The prognosis of iris melanoma is better than that of melanoma of the ciliary body and choroid, but the reason for this difference is unclear. One possible explanation is that iris melanoma is smaller than its posterior segment counterparts at the time of diagnosis. Most iris melanomas are spindle cell types, according to a modified Callender classification system. There is evidence that the proliferation of melanocytes of the anterior iris surface (iris plaque) and diffuse stromal invasion may be risk factors for local recurrence and metastasis, respectively.
Angiomatoid Fibrous Histiocytoma: A Review With Recent Genetic Findings
Authors: Thway Khin 
Published: February 2021

Abstract
Angiomatoid fibrous histiocytoma is a neoplasm of intermediate biologic potential most often arising in the extremities of children and young adults. Its rarity may lead to misdiagnosis as either a reactive lesion or a benign or higher-grade tumor. Originally described as a type of malignant fibrous histiocytoma, its differentiation remains enigmatic, with precise histogenesis still only hypothesized. Its morphology is distinct, as a circumscribed lesion with sheets of bland spindle to ovoid cells, peripheral lymphoplasmacytic infiltrate, and blood-filled cystic cavities, and half of the cases show strong desmin expression. Cytogenetically, 2 specific translocations, t(12:16)(q13:p11) and more recently t(12:22)(q13:q12), have been characterized. The literature on angiomatoid fibrous histiocytoma is reviewed, particularly with regard to recent molecular genetic developments and differentiation, and its morphology, immunohistochemistry, and differential diagnosis are summarized.
Serum Immunoglobulin G Fraction 4 Levels in Pancreatic Cancer: Elevations Not Associated With Autoimmune Pancreatitis
Authors: Raina Amit , Krasinskas Alyssa M. , Greer Julia B. , Lamb Janette , Fink Erin , Moser A. James , Zeh III Herbert J. , Slivka Adam , Whitcomb David C. 
Published: February 2021

AbstractContext.—Autoimmune pancreatitis is an uncommon, inflammatory disease of the pancreas that presents with clinical features, such as painless jaundice and a pancreatic mass, similar to those caused by pancreatic cancer. Patients with autoimmune pancreatitis frequently have elevated serum immunoglobulin G fraction 4 (IgG4) levels, and their pancreatic tissue may show IgG4-positive plasma cell infiltration. It is imperative to differentiate autoimmune pancreatitis from pancreatic cancer because autoimmune pancreatitis typically responds to corticosteroid treatment. A previous Japanese study reported that serum IgG4 greater than 135 mg/dL was 97% specific and 95% sensitive in predicting autoimmune pancreatitis.Objective.—To prospectively measure serum IgG4 levels in pancreatic cancer patients to ascertain whether increased levels might be present in this North American population.Design.—We collected blood samples and phenotypic information on 71 consecutive pancreatic cancer patients and 103 healthy controls who visited our clinics between October 2004 and April 2006. IgG4 levels were determined using a single radial immunodiffusion assay. A serum IgG4 level greater than 135 mg/dL was considered elevated.Results.—Five cancer patients had IgG4 elevation, with a mean serum IgG4 level of 160.8 mg/dL. None of our cancer patients with plasma IgG4 elevation demonstrated evidence of autoimmune pancreatitis. One control subject demonstrated elevated serum IgG4 unrelated to identified etiology.Conclusions.—As many as 7% of patients with pancreatic cancer have serum IgG4 levels above 135 mg/dL. In patients with pancreatic mass lesions and suspicion of cancer, an IgG4 level measuring between 135 and 200 mg/dL should be interpreted cautiously and not accepted as diagnostic of autoimmune pancreatitis without further evaluation.
Application of Immunohistochemistry to Liver and Gastrointestinal Neoplasms: Liver, Stomach, Colon, and Pancreas
Authors: Geller Stephen A. , Dhall Deepti , Alsabeh Randa 
Published: February 2021

AbstractContext.—Immunohistochemistry has become an integral component of the practice of pathology. Newer antibodies allow for increasingly precise diagnoses for tumors that previously could not be easily identified. Recently, immunohistochemical evaluations have begun to allow pathologists to actively assist in determining prognosis and even in selecting therapies.Objective.—To summarize the usefulness of currently available immunostains for the study of liver and gastrointestinal system neoplasms and to make recommendations for panels of immunostains that can be particularly helpful.Data Sources.—Information has been collected from recent literature as well as from personal experience and practice.Conclusions.—Many immunostains are now available for the practicing pathologist that allow for increasing accuracy in diagnosis of liver and gastrointestinal tract neoplasms. Panels of immunostains can be used to differentiate between various tumors and also to identify site of origin in the case of a metastatic neoplasm. Immunostains that allow for prognostic determinations and for guidance in the selection of chemotherapeutic agents can also be used by pathologists to assist in the management of patients with malignant tumors affecting the liver and gastrointestinal tract.
Shirt-Sleeve or Scanning Magnification as an Aid to the Diagnosis of Commonly Encountered Medical Lung Diseases
Authors: Mark Eugene J. , Ruangchira-Urai Ruchira , Kradin Richard L. 
Published: February 2021

AbstractShirt-sleeve magnification (holding a slide over a white sleeve) and low-power magnification serve as useful adjuncts in the general categorization of noninfectious medical lung disease. This article divides medical lung disease into chronic and acute, where the temporality is determined first by clinical circumstances and then confirmed by histopathology. The low-power patterns of various lung diseases overlap, sometimes greatly. Nevertheless, classic examples of chronic disease can be sorted as linear, lobular filling, nodular dispersed, nodular lymphangitic, or cystic patterns at shirt-sleeve or low-power magnification. Classic examples of acute disease generally produce a solidifying pattern at shirt-sleeve or low-power magnification, which can be followed by a determination as to whether alveolar filling is principally fibrotic or principally fluid or cells at higher magnification. This article gives a simple system for the categorization of medical lung disease by this approach, with an emphasis on the most common diseases to be encountered in a general surgical pathology practice. In our experience, this system also proves useful in arriving at some therapeutic decisions.
Reactive Versus Neoplastic Bone Marrow: Problems and Pitfalls
Authors: Hasserjian Robert P. 
Published: February 2021

Abstract
Examination of the bone marrow poses several unique challenges to the pathologist: it is a semisolid organ without helpful gross correlation, it exists in a dynamic state with the peripheral blood and other organs of the lymphohemopoietic system, and the diagnosis of diseases affecting bone marrow often depends heavily on ancillary special studies. The bone marrow examination ideally encompasses review of the bone marrow biopsy histology (with or without additional nondecalcified clot preparation material), bone marrow aspirate smear cytology, and the peripheral blood smear; optimal procurement and processing of these samples is critical in ensuring that a maximal level of diagnostic information can be extracted. The pathologist must be aware of the clinical context of the bone marrow and the results of ancillary tests, whether these are ordered by the pathologist or the clinician. A combination of excellent diagnostic samples, appropriate ancillary tests, and knowledge of the clinical context provides the best background to distinguish between the common reactive and neoplastic processes that involve the bone marrow and to avoid diagnostic pitfalls in making these distinctions.
Coronary Artery Aneurysm: A Review and Hypothesis Regarding Etiology
Authors: Nichols Larry , Lagana Stephen , Parwani Anil 
Published: February 2021

AbstractContext.—Coronary artery aneurysm is an uncommon condition that can be a cause of death when it thromboses or ruptures. It is always associated with destruction of the tunica media, usually associated with atherosclerosis, and commonly associated with chronic inflammation.Objective.—To review the pathology, epidemiologic and clinical features, and pathophysiology of coronary artery aneurysm, particularly new research results, drawing out implications for the understanding, diagnosis, and treatment of this condition.Data Sources.—Pertinent literature and illustrative cases at our institution.Conclusions.—Inflammation spilling over into the tunica media from the tunica intima may link atherosclerosis to aneurysm formation, but vasculitis without atherosclerosis causes coronary artery aneurysms in young children with Kawasaki disease. Increased proteolysis of extracellular matrix proteins is probably one mechanism of coronary artery aneurysm formation, either due to overactive matrix metalloproteinases or underactive inhibition of these proteinases, and an excess of transforming growth factor β may be another mechanism in the pathogenesis. Coronary atherosclerosis is a universal disease of adults, but only 1.5% of them have coronary aneurysms; this small group may be those with a second coronary artery disease, such as vasculitis.
Glial Choristoma in the Oral and Maxillofacial Region: A Clinicopathologic Study of 6 Cases
Authors: Sun Li-Sha , Sun Zhi-Peng , Ma Xu-Chen , Li Tie-Jun 
Published: February 2021

AbstractContext.—Glial choristoma is an uncommon developmental abnormality typically presenting at birth or in early childhood. The nasal region is most frequently affected. Palate, tongue, cheek, scalp, and orbit can also be affected but these occurrences are relatively rare.Objective.—To report 6 cases of glial choristoma arising in the oral and maxillofacial region and to document the clinical and pathologic features of these lesions.Design.—Histologic and immunocytochemical examinations were performed on 6 cases of glial choristoma. Biologic behavior, prognosis, and pathogenesis were discussed together with a review of the literature.Result.—The patients included 5 boys and 1 girl. They all presented with the lesions at birth or soon after birth. Four lesions occurred on the dorsal side of the tongue, near the foramen caecum. One lesion was present in the infratemporal fossa and parapharyngeal space, and the other one was in the submandibular region. All patients received surgical excision, and follow-up data revealed no recurrence for a period of 10 months to 5 years after surgery. Histologically, the lesions showed mature glial cells intermixed with connective tissue. The glial tissue was strongly positive for glial fibrillary acidic protein and S100 but negative for neurofilament.Conclusion.—Glial choristoma should be classified as a developmental malformation that occurs in many sites of the head and neck. In oral cavity, the tongue is the most frequently affected site. Although these lesions are rare, they should be included in the differential diagnosis of congenital masses in the oral and maxillofacial region.
Characterization of CXCR4 Expression in Chondrosarcoma of Bone
Authors: Bai Shuting , Wang Dezhi , Klein Michael J. , Siegal Gene P. 
Published: February 2021

AbstractContext.—Alterations in molecular elements derived from the CXC chemokine receptor 4 (CXCR4)/stromal-derived factor 1 (SDF-1) cytokine system have been found to strongly correlate with neoplastic progression leading to metastasis in a number of tumors, including osteosarcoma. Excluding hematologic malignancies, chondrosarcoma of bone is the most common primary malignant tumor of bone in adults in the United States. Like osteosarcoma, chondrosarcoma preferentially metastasizes to lung, bone, and very rarely to regional lymph nodes. However, the role of the signal pathway(s) driving neoplastic progression in chondrosarcoma has not yet been clearly elucidated.Objective.—To test whether CXCR4 was detectable in chondrosarcoma and whether CXCR4 expression levels correlated with chondrosarcoma grade.Design.—Twenty-two chondrosarcoma samples banked at our institution between 2001 and 2006 were retrieved for study. By using invasive ductal carcinoma of the breast and osteosarcoma as the positive controls, immunohistochemistry was performed on paraffin-embedded tissue sections and the intensity of the tumor cells was analyzed by morphometric techniques.Results.—All chondrosarcoma cases (22 of 22) were immunoreactive for CXCR4. However, the staining intensity of the CXCR4 between the low- and high-grade groups was significantly different. There was a higher staining intensity in high-grade chondrosarcoma cells (P &lt; .001).Conclusion.—CXCR4 is expressed in chondrosarcomas. CXCR4 expression levels were higher in high-grade chondrosarcoma cells than in low-grade specimens. A larger number of cases will be required to confirm these results and expand the observation, but preliminary data would argue for CXCR4 immunohistochemistry as a potential marker for biologic aggressiveness in chondrosarcoma of bone.
Diagnostic Utility of P504S/p63 Cocktail, Prostate-Specific Antigen, and Prostatic Acid Phosphatase in Verifying Prostatic Carcinoma Involvement in Seminal Vesicles: A Study of 57 Cases of Radical Prostatectomy Specimens of Pathologic Stage pT3b
Authors: Harvey Aaron M. , Grice Beverly , Hamilton Candice , Truong Luan D. , Ro Jae Y. , Ayala Alberto G. , Zhai Qihui “Jim” 
Published: February 2021

Abstract
Context.—Seminal vesicle invasion by prostatic carcinoma is directly associated with tumor staging; verification is challenging when the tumor demonstrates cribriform or papillary growth patterns or there are back-to-back small-gland proliferations. P504S is overexpressed in prostatic carcinoma and high-grade prostatic intraepithelial neoplasia with cytoplasmic immunoreactivity. p63 has positive immunoreactivity in basal cell nuclei of benign prostatic glands. Many researchers use a combination of these antibodies and their different colors.
Objective.—To evaluate the usefulness of a single-color P504S/p63 cocktail immunostain in verifying prostatic carcinoma within the seminal vesicle.
Design.—Sections from 57 radical prostatectomy specimens of pathologic stage pT3b that contain seminal vesicle with prostatic carcinoma involvement were immunostained with primary antibodies against prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) and a cocktail of antibodies against P504S and p63.
Results.—Prostatic carcinoma cells from all 57 cases were diffusely positive for P504S, PSA, and PAP with cytoplasmic staining and no p63 nuclear staining. Seminal vesicle epithelium from all 57 cases was negative for all 3 markers with distinct p63 nuclear staining of the basal cells. Benign prostatic tissue was positive for PSA and PAP, as well as for p63, but negative for P504S.
Conclusions.—The P504S/p63 one-color cocktail is a practical and cost-effective stain to differentiate prostatic carcinoma that involves the seminal vesicle from seminal vesicle epithelium. It is superior to PSA or PAP when sections contain both seminal vesicle and benign glands because PSA and PAP cannot distinguish benign from malignant glands.
Lobular Carcinoma In Situ Variants in Breast Cores: Potential for Misdiagnosis, Upgrade Rates at Surgical Excision, and Practical Implications
Authors: Sullivan Megan E. , Khan Seema A. , Sullu Yurdanur , Schiller Carol , Susnik Barbara 
Published: February 2021

Abstract
Context.—Differentiating ductal carcinoma in situ (DCIS) from lobular carcinoma in situ (LCIS) on core biopsy has important clinical implications. Lobular carcinoma in situ variants, including LCIS with necrosis and pleomorphic LCIS, share morphologic features with solid DCIS that may lead to misclassification.
Objectives.—(1) To review all LCIS variants diagnosed in core biopsies at Northwestern University, Feinberg School of Medicine, and determine the frequency of misinterpretation of variant LCIS as solid DCIS in archival core biopsies, and (2) to determine the frequency of upgrade to invasive carcinoma or DCIS in the surgical excision.
Design.—Consecutive core biopsies with original diagnoses of predominantly solid DCIS without invasion that were performed between January 2001 and December 2005 at Northwestern University, Feinberg School of Medicine, were selected for E-cadherin staining. The revised diagnosis of LCIS was based on E-cadherin negativity and morphology. The frequency of LCIS variants upgraded was then estimated from all core biopsies with original or revised diagnoses of pleomorphic LCIS or LCIS with necrosis.
Results.—Among 75 cases of solid DCIS, 10 (13.3%) were reclassified as LCIS, including 9 variants (5 pleomorphic LCIS, 4 LCIS with necrosis) and 1 classic LCIS. Twenty-eight patients comprised the entire group of LCIS variant cases (both reclassified and originally diagnosed cases). Seven patients with LCIS variants (25%) were upgraded to invasive lobular carcinoma in surgical excision (4 of 11 cases of LCIS with necrosis [36%] versus 3 of 17 cases of pleomorphic LCIS [18%]).
Conclusions.—About one-tenth of solid DCIS diagnosed in core biopsies in the past may represent LCIS variants. These show a 25% upgrade to invasive lobular carcinoma in surgical excision. The distinction of an LCIS variant from DCIS is important because of its implications for radiation therapy, although it may not affect surgical management.