bluuebunny/crossref_metadata_2025_split huggingface dataset:
Best Practices in Contemporary Diagnostic Immunohistochemistry: Panel Approach to Hematolymphoid Proliferations
Authors: Garcia Christine F. , Swerdlow Steven H. 
Published: February 2021

AbstractContext.—The complexities of diagnostic hematopathology in the modern era are well known, and even in this molecular era, immunophenotypic studies, together with routine histopathology, remain a critical component in the evaluation of many lymphoid proliferations. With numerous antibodies that can be used on routinely fixed, paraffin-embedded tissue sections, immunohistochemistry has become increasingly valuable. It then becomes a challenge knowing the best approach to the selection of antibodies to use and how to interpret them.Objective.—To present a pragmatic immunohistochemical approach to the evaluation of lymphoid proliferations that stresses the utility of 2 limited panels to deal with the most commonly encountered lymphomas.Data Sources.—English-language literature published between 1990 and 2008.Conclusions.—A relatively limited panel of immunohistochemical stains may be used to diagnose and subclassify many of the more common lymphomas, although some cases will require additional stains and others fewer, depending on the case complexity. Immunohistochemical stains must always be interpreted in the context of the histopathologic and other ancillary studies.
Virtopsy: Postmortem Imaging of Laryngeal Foreign Bodies
Authors: Oesterhelweg Lars , Bolliger Stephan A. , Thali Michael J. , Ross Steffen 
Published: February 2021

AbstractContext.—Death from corpora aliena in the larynx is a well-known entity in forensic pathology. The correct diagnosis of this cause of death is difficult without an autopsy, and misdiagnoses by external examination alone are common.Objective.—To determine the postmortem usefulness of modern imaging techniques in the diagnosis of foreign bodies in the larynx, multislice computed tomography, magnetic resonance imaging, and postmortem full-body computed tomography–angiography were performed.Design.—Three decedents with a suspected foreign body in the larynx underwent the 3 different imaging techniques before medicolegal autopsy.Results.—Multislice computed tomography has a high diagnostic value in the noninvasive localization of a foreign body and abnormalities in the larynx. The differentiation between neoplasm or soft foreign bodies (eg, food) is possible, but difficult, by unenhanced multislice computed tomography. By magnetic resonance imaging, the discrimination of the soft tissue structures and soft foreign bodies is much easier. In addition to the postmortem multislice computed tomography, the combination with postmortem angiography will increase the diagnostic value.Conclusions.—Postmortem, cross-sectional imaging methods are highly valuable procedures for the noninvasive detection of corpora aliena in the larynx.
Identification and Biologic Significance of Micrometastases in Axillary Lymph Nodes in Patients With Invasive Breast Cancer
Authors: Sahin Aysegul A. , Guray Merih , Hunt Kelly K. 
Published: February 2021

AbstractContext.—The presence or absence of metastases in axillary lymph nodes is one of the most important prognostic factors for patients with breast cancer. During the past decade sentinel lymph node (SLN) biopsy has been increasingly adopted as a minimally invasive staging alternative to complete axillary node dissection.Objective.—Sentinel lymph nodes are more likely to contain metastases than non-SLNs. In routine clinical practice SLNs are assessed by diverse methodologies including multiple sectioning, immunohistochemical staining, and molecular diagnostic tests. Despite the lack of standard histopathologic protocols during the years detailed evaluation of SLNs has resulted in an increased detection of small (micro) metastases.Data Sources.—Breast cancer with micrometastases constitutes a heterogenous group of tumors with variable clinical outcome regarding the risk of additional metastases in the remaining axillary lymph nodes and to patients' survival.Conclusion.—The clinical significance of micrometastases has been subject to great controversy in patients with breast cancer. In this review we highlight controversies regarding micrometastases especially in relation to SLNs.
What Hematopathology Tells Us About the Future of Pathology Informatics
Authors: Hess Jay L. 
Published: February 2021

Abstract
The field of hematopathology has been a leader in the application of new technologies for both diagnostics and therapy. The ready accessibility of blood cells for examination, the ability to quantify important indices, and the relative responsiveness of otherwise fatal hematologic diseases to chemotherapy have all contributed to rapid advances in the field. Hematopathology provides many insights into the challenges that pathology informatics will face in addressing the needs of a growing and aging population in the era of personalized medicine.
Utility of Immunohistochemistry for Endothelial Markers in Distinguishing Epithelioid Hemangioendothelioma From Carcinoma Metastatic to Bone
Authors: Gill Ryan , O'Donnell Richard J. , Horvai Andrew 
Published: February 2021

Abstract
Context.—Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm of intermediate malignancy. Epithelioid hemangioendothelioma often presents a difficult diagnostic problem, especially in bone, because the epithelioid morphology and radiographic features raise the possibility of metastatic carcinoma. The current trend of small biopsies obtained with computed tomography–guided techniques exacerbates the problem. The markedly different treatment for EHE and metastatic carcinoma underscores the need for specific markers that can differentiate between these 2 entities.
Objective.—To determine the relative utility of endothelial markers in differentiating EHE from metastatic carcinoma, with emphasis on bone biopsies.
Design.—We used immunohistochemistry in formalin-fixed paraffin-embedded tissue to compare the utility of Fli-1, CD34, CD31, podoplanin, and keratin cocktail in 13 EHEs and 13 morphologically similar carcinomas metastatic to bone. Immunohistochemical data were evaluated using Fisher exact test, and specificity and sensitivity were calculated.
Results.—Significant proportions of EHEs were positive for Fli-1 (100%), CD34 (85%), and CD31 (100%) compared with metastatic carcinoma (Fli-1, 15%; CD34, 15%; CD31, 38%) (P &lt; .001, P = .005, and P = .01, respectively). However, these markers were not 100% specific for EHE. Cytokeratin cocktail stained significantly more metastatic carcinomas (100%) than EHEs (38%) (P = .01) but was not 100% specific. No significant difference was observed regarding immunostaining for podoplanin between the tumor types.
Conclusions.—Fli-1 is most helpful in distinguishing EHE from metastatic carcinoma. However, the absence of complete specificity of any of the endothelial markers for EHE, or of keratin cocktail for carcinoma, suggests that these markers are best used in combination.
Tissue Floaters and Contaminants in the Histology Laboratory
Authors: Platt Eric , Sommer Paul , McDonald Linda , Bennett Ana , Hunt Jennifer 
Published: February 2021

Abstract
Context.—Anatomic pathology diagnosis is often based on morphologic features. In recent years, an appropriate increased attention to patient safety has led to an emphasis on improving maintenance of patient identity. Decreasing or eliminating cross-contamination from one specimen to another is an example of a patient identity issue for which process improvement can be initiated.
Objective.—To quantify the presence of cross-contamination from histology water baths and the slide stainers.
Design.—We assessed for the presence of contaminants in water baths at cutting stations and in linear stainer stain baths. We assessed the potential for tissue discohesion and carryover in tissue samples and we assessed the potential for carryover onto blank slides sent through the stainer.
Results.—In the 13 water baths examined (totalling 195 L of water), only one fragment of tissue was identified. The stain baths, however, contained abundant tissue contaminants, ranging in size from 2 to 3 cells to hundreds of cells. The first sets of xylenes and alcohols were the most heavily contaminated. Cross-contamination to blank slides occurred at a rate of 8%, with the highest frequency in the late afternoon.
Conclusions.—Cross-contamination can present a significant challenge in the histology laboratory. Although the histotechnologists' water baths are not heavily contaminated, the stainer baths do contain contaminating tissue fragments. Cross-contamination does occur onto blank slides in the experimental setting.
Recent Developments in the Pathology of Renal Tumors: Morphology and Molecular Characteristics of Select Entities
Authors: Yan Benjamin C. , Mackinnon A. Craig , Al-Ahmadie Hikmat A. 
Published: February 2021

Abstract
Context.—Renal cell carcinoma is a heterogeneous group of tumors with distinct histopathologic features, molecular characteristics, and clinical outcome. These tumors can be sporadic as well as familial or associated with syndromes. The genetic abnormalities underlying these syndromes have been identified and were subsequently found in corresponding sporadic renal tumors.
Objective.—To review the recent molecular and genetic advancements relating to sporadic and familial renal carcinomas as well as those related to Xp11.2 translocation– associated renal cell carcinoma and renal medullary carcinoma.
Data Sources.—Literature review, personal experience, and material from the University of Chicago.
Conclusions.—Molecular genetic diagnostic techniques will continue to introduce new biomarkers that will aid in the differential diagnosis of difficult cases. The identification of specific signaling pathways that are defective in certain renal tumors also makes possible the development of new therapies that selectively target the aberrant activity of the defective proteins.
Diffuse Large B-Cell Lymphoma—More Than a Diffuse Collection of Large B Cells: An Entity in Search of a Meaningful Classification
Authors: Gurbaxani Sandeep , Anastasi John , Hyjek Elizabeth 
Published: February 2021

Abstract
Context.—Diffuse large B-cell lymphoma is a heterogenous group of lymphomas. In this review, we present a brief description of the large number of entities recognized in the recently published (2008) World Health Organization classification of tumors of hematopoietic and lymphoid tissues.
Objective.—We highlight the unique clinicopathologic and molecular genetic features of these new and previously recognized entities, to illustrate the rational for the development of this classification. To help simplify the understanding of this now large and complex group of diseases, we have attempted to create broader subgroups of related entities. We discuss large B-cell lymphoma that are not otherwise specified, those that are based on anatomic site, those that have unique histology or phenotype or genotype, those that are associated with Epstein-Barr virus or Kaposi sarcoma–associated herpesvirus and herpesvirus 8, and those that are unclassifiable.
Data Sources.—World Health Organization classification of tumors of hematopoietic and lymphoid tissues (2008), published literature from PubMed (National Library of Medicine), and primary material from the authors' institution were reviewed.
Conclusions.—Recognition of the different subtypes of diffuse large B-cell lymphoma as described in the World Health Organization classification scheme will lead to improved understanding of the unique clinicopathologic and genetic features associated with these subtypes of lymphoma.
Lack of Association of High-Risk Human Papillomavirus in Ocular Surface Squamous Neoplasia in India
Authors: Manderwad Guru Prasad , Kannabiran Chitra , Honavar Santosh G. , Vemuganti Geeta K. 
Published: February 2021

AbstractContext.—Ocular surface squamous neoplasia (OSSN) represents a spectrum of ocular surface tumors ranging from intraepithelial to invasive. The genesis of OSSN is multifactorial, possibly including human papillomavirus (HPV) infection, the role of which is controversial.Objective.—To evaluate the role of high-risk HPV16 and HPV18 in OSSN.Design.—Retrospective and prospective noncomparative case series. In this study, histologically proven cases of OSSN were evaluated in formalin-fixed, paraffin-embedded sections (n = 50) and fresh tissues (n = 7) for the presence of HPV by polymerase chain reaction using MY09/MY11 consensus primers, HPV16 and HPV18 type-specific primers, and in situ hybridization–catalyzed reporter deposition (ISH-CARD). Cervical tumors (n = 19) along with SiHa and HeLa cell lines served as positive controls for HPV analysis.Results.—The study included 48 patients with OSSN who accounted for 57 specimens, with a median patient age of 28.5 years (range, 1.5–70 years). These specimens included 36 squamous cell carcinomas and 21 conjunctival intraepithelial neoplasias. All of the cases were found to be negative for high-risk HPV using polymerase chain reaction and ISH-CARD assay, whereas the SiHa and HeLa cell lines were appropriately positive. Of the cervical tumors that served as positive controls, 18 were positive for HPV16, and 1 was positive for HPV18.Conclusions.—Sensitive, type-specific polymerase chain reaction for detection of HPV16 and HPV18, polymerase chain reaction assay for consensus HPV sequences, and ISH-CARD did not show the presence of high-risk HPV in OSSN. Thus, HPV appears to play no significant role in the etiology of OSSN in India.
Introduction of the 7th Edition Eyelid Carcinoma Classification System From the American Joint Committee on Cancer–International Union Against Cancer Staging Manual
Authors: Ainbinder Darryl J. , Esmaeli Bita , Groo Stephen C. , Finger Paul T. , Brooks Joseph P. 
Published: February 2021

Abstract
Context.—The American Joint Committee on Cancer (AJCC) and the International Union Against Cancer commissioned the Ophthalmic Oncology Task Force to modify and update the ophthalmic chapters of the 7th edition of the AJCC Cancer Staging Manual.
Objective.—To review the existing eyelid carcinoma chapter in the 6th edition of the AJCC Cancer Staging Manual for its clinical and research utility and to seek evidence-based revisions with the strongest medical foundation to use in updating the anatomically based TNM cancer staging system manual.
Data Sources.—The 4-year Ophthalmic Oncology Task Force consisted of 45 tumor specialists from 10 countries and an extensive internal and external peer review process. The 10-member Carcinoma of the Eyelid team included a diverse group of international authors. The group included extensive representation by clinicians, pathologists, surgeons, radiation therapists, and cancer registrars, all with advanced, ophthalmic cancer–related areas of subspecialty. Data sources included the above expertise applying a worldwide medical literature search, with no discrimination based on language, country of origin, discipline source, specialty source, or surgical practice.
Conclusions.—Revisions were made to the TNM classification in areas with the strongest basis in evidence and practical effect. Lymph node staging data were expanded markedly to reflect its significant prognostic value. T3 and T4 were redefined and stage groupings were added that applied current understanding in tumor biology, respected site-specific risk factors, and provided greater correlation with the common language of the overall AJCC Cancer Staging Manual. Evidence-based biomarkers and data-field modifiers were included to capture additional pathologically and clinically substantiated prognostic factors.
A TNM-Based Clinical Staging System of Ocular Adnexal Lymphomas
Authors: Coupland Sarah E. , White Valerie A. , Rootman Jack , Damato Bertil , Finger Paul T. 
Published: February 2021

Abstract
Context.—The ocular adnexal lymphomas (OAL) arise in the conjunctiva, orbit, lacrimal gland, and eyelids. To date, they have been clinically staged using the Ann Arbor staging system, first designed for Hodgkin and later for nodal, non–Hodgkin lymphoma. The Ann Arbor system has several shortcomings, particularly when staging extranodal non– Hodgkin lymphomas, such as OAL, which show different dissemination patterns from nodal lymphomas.
Objective.—To describe the first TNM-based clinical staging system for OAL.
Design.—Retrospective literature review.
Results.—We have developed, to our knowledge, the first American Joint Committee on Cancer–International Union Against Cancer TNM-based staging system for OAL to overcome the limitations of the Ann Arbor system. Our staging system defines disease extent more precisely within the various anatomic compartments of the ocular adnexa and allows for analysis of site-specific factors not addressed previously. It aims to facilitate future studies by identifying clinical and histomorphologic features of prognostic significance. This system is for primary OAL only and is not intended for intraocular lymphomas.
Conclusions.—Our TNM-based staging system for OAL is a user-friendly, anatomic documentation of disease extent, which creates a common language for multicenter and international collaboration. Data points will be collected with the aim of identifying biomarkers to be incorporated into the staging system.
Changes in the 7th Edition of the AJCC TNM Classification and Recommendations for Pathologic Analysis of Lacrimal Gland Tumors
Authors: Rootman Jack , White Valerie A. 
Published: February 2021

AbstractIn our recent work to update the American Joint Committee on Cancer's AJCC Cancer Staging Manual, we brought the staging system in line with that of salivary gland malignancies to better describe the range of these tumors. In addition, we have suggested that information be collected on biomarkers and clinical and histologic data points. This revised staging, along with careful histologic analysis and patient follow-up, may provide information that helps develop more targeted management for these lesions.
Patient Misidentification in Papanicolaou Tests: A Systems-Based Approach to Reducing Errors
Authors: Meyer Erin , Underwood R. Shawn , Padmanabhan Vijayalakshmi 
Published: February 2021

Abstract
Context.—Patient safety is of prime concern in every laboratory. Double labeling of glass slides is performed in many cytology laboratories where handwritten patient information on the frosted portion of the glass is overlaid with paper labels (sometimes containing bar codes). The cytotechnologists match this information by turning slides over. We use SurePath liquid-based cytology for Papanicolaou tests in our laboratory and noticed patient misidentification because of slide labeling errors, a problem that has not been addressed in the literature.
Objective.—To reduce slide labeling errors without increasing costs, using a systems-based approach.
Design.—All errors from mislabeled slides during November 2006 were documented, and an informal root-cause analysis was performed. Slides were labeled on opposite ends and monitored for errors.
Results.—Labeling on different ends of the glass slide reduced our error rate from 0.59% to 0%, made visual matching easy, and did not alter costs.
Conclusions.—The practice of overlaying handwritten information with printed labels for liquid-based Papanicolaou tests should be strongly discouraged and replaced with placing patient information in separate portions of the glass slide so that crucial patient identification is not hidden and visual matching is easy.
Anaplastic Large Cell Lymphoma Involving the Breast: A Clinicopathologic Study of 6 Cases and Review of the Literature
Authors: Miranda Roberto N. , Lin Lin , Talwalkar Sameer S. , Manning John T. , Medeiros L. Jeffrey 
Published: February 2021

Abstract
Context.—Lymphomas involving the breast are rare, and most cases are of B-cell lineage; T-cell neoplasms represent less than 10% of all breast lymphomas.
Objective.—To define the clinicopathologic spectrum of anaplastic large cell lymphomas (ALCLs) involving the breast.
Design.—Six cases of ALCL involving the breast were identified at a single institution during 21 years. The clinicopathologic and immunophenotypic features are presented, and the literature is reviewed.
Results.—All patients were women, with a median age of 52 years. There were 4 anaplastic lymphoma kinase– negative (ALK−) ALCL cases; 3 of these neoplasms developed around breast implants. Two patients with ALK− ALCL had a history of cutaneous ALCL. There were 2 ALK+ ALCLs; both patients had stage IV disease. Histologically, all neoplasms were composed of large anaplastic cells that were uniformly CD30+ and expressed markers of T-cell lineage. Four patients with adequate follow-up are alive, with a mean of 4.1 years (range, 1.5–9 years) after diagnosis of the breast tumor. Included in this group are 2 patients with ALK− ALCL associated with breast implants who were alive 4 years and 9 years after diagnosis.
Conclusions.—Including the 6 cases we describe, a total of 21 cases of ALCL involving the breast are reported. Fifteen cases, all ALK−, were associated with breast implants, suggesting a possible pathogenetic relationship, and associated with an excellent prognosis. Patients with cutaneous ALCL can subsequently develop ALK− ALCL involving the breast, and these tumors can be associated with breast implants.
Standardization of HER2 Immunohistochemistry in Breast Cancer by Automated Quantitative Analysis
Authors: Gustavson Mark D. , Bourke-Martin Brian , Reilly Dylan , Cregger Melissa , Williams Christine , Mayotte Jane , Zerkowski Maciej , Tedeschi Greg , Pinard Robert , Christiansen Jason 
Published: February 2021

Abstract
Context.—There is critical need for standardization of HER2 immunohistochemistry testing in the clinical laboratory setting. Recently, the American Society of Clinical Oncology and the College of American Pathologists have submitted guidelines recommending that laboratories achieve 95% concordance between assays and observers for HER2 testing.
Objective.—As a potential aid to pathologists for achieving these new guidelines, we have conducted an examination using automated quantitative analysis (AQUA analysis) to provide a standardized HER2 immunohistochemistry expression score across instruments (sites), operators, and staining runs.
Design.—We analyzed HER2 expression by immunohistochemistry in a cohort (n = 669) of invasive breast cancers in tissue microarray format across different instruments (n = 3), operators (n = 3), and staining runs (n = 3). Using light source, instrument calibration techniques, and a new generation of image analysis software, we produced normalized AQUA scores for each parameter and examined their reproducibility.
Results.—The average percent coefficients of variation across instruments, operators, and staining runs were 1.8%, 2.0%, and 5.1%, respectively. For positive/negative classification between parameters, concordance rates ranged from 94.5% to 99.3% for all cases. Differentially classified cases only occurred around the determined cut point, not over the entire distribution.
Conclusions.—These data demonstrate that AQUA analysis can provide a standardized HER2 immunohistochemistry test that can meet current guidelines by the American Society of Clinical Oncology/College of American Pathologists. The use of AQUA analysis could allow for standardized and objective HER2 testing in clinical laboratories.