bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Studies for Thrombophilia in Women on Hormonal Therapy and During Pregnancy, and in Children
Authors: Brenner Benjamin R. , Nowak-Göttl Ulrike , Kosch Andrea , Manco-Johnson Marilyn , Laposata Michael 
Published: January 2021

AbstractObjective.—To review the role of acquired and inherited prothrombotic risk factors that increase the risk of thrombosis in oral contraceptive users, during pregnancy, and in neonates, infants, and children; and to determine by the consensus opinion of recognized experts in the field which risk factors should be determined in which individuals at which time.Data Sources.—Review of the medical literature and current clinical practice by a panel of experts in the field of thrombophilia.Data Extraction and Synthesis.—The experts made an extensive review of the published literature and prepared a draft manuscript, which included preliminary recommendations. The draft manuscript was circulated to participants in the College of American Pathologists Conference XXXVI: Diagnostic Issues in Thrombophilia prior to the conference. The manuscript and recommendations were then presented at the conference for discussion. Recommendations were accepted if a consensus of the 26 experts attending the conference was reached. The results of the discussion were used to revise the manuscript into its final form.Conclusions.—This report reviews the options for testing for thrombophilic states in women using oral contraceptives, during pregnancy, and in neonates and children. General guidelines for testing in these clinical situations are provided, along with citation of the appropriate supporting literature.
Antithrombin Deficiency
Authors: Kottke-Marchant Kandice , Duncan Alexander 
Published: January 2021

AbstractObjective.—To review the current understanding of the pathophysiology of antithrombin deficiency and its role in congenital thrombophilia. Recommendations for diagnostic testing of antithrombin function and concentration, derived from the medical literature and consensus opinions of recognized experts in the field, are included. These recommendations specify whom, how, and when to test.Data Sources.—Review of the published medical literature.Data Extraction and Synthesis.—A summary of the medical literature and proposed testing recommendations were prepared and presented at the College of American Pathologists Conference XXXVI: Diagnostic Issues in Thrombophilia. After discussion at the conference, consensus recommendations presented in this article were accepted after a two-thirds majority vote by the participants.Conclusions.—Antithrombin deficiency is an infrequent genetic abnormality that may be a significant contributing cause of thrombophilia. Antithrombin deficiency also may be observed in conjunction with other genetic or acquired risk factors. Assay of antithrombin plasma levels is appropriate in the laboratory evaluation of individuals with thrombophilia, preferably using a functional, amidolytic antithrombin assay. The diagnosis of antithrombin deficiency should be established only after other acquired causes of antithrombin deficiency, such as liver disease, consumptive coagulopathy, or heparin therapy, are excluded. A low antithrombin level should be confirmed with a subsequent assay on a fresh specimen, and family studies may be helpful to establish the diagnosis. Antigenic antithrombin assays may be of benefit in subclassification of the type of antithrombin deficiency and to confirm the decreased antithrombin level in patients with type I deficiency.
Heparin Cofactor II Deficiency
Authors: Tollefsen Douglas M. 
Published: January 2021

Abstract
Objectives.—To review of the state of the art relating to congenital heparin cofactor II deficiency as a potential risk factor for thrombosis, as reflected by the medical literature and the consensus opinion of recognized experts in the field, and to make recommendations for the use of laboratory assays for assessing this thrombotic risk in individual patients.
Data Sources.—Review of the medical literature, primarily from the last 10 years.
Data Extraction and Synthesis.—After an initial assessment of the literature, including review of clinical study design and laboratory methods, a draft manuscript was prepared and circulated to participants in the College of American Pathologists Conference XXXVI: Diagnostic Issues in Thrombophilia. Recommendations were accepted if a consensus of experts attending the conference was reached. The results of the discussion were used to revise the manuscript into its final form.
Conclusions.—Consensus was reached that there is insufficient evidence to recommend testing for heparin cofactor II deficiency in patients with thromboembolic disease.
Impact of Nucleic Acid Testing for Human Immunodeficiency Virus and Hepatitis C Virus on Blood Product Availability, Outdating, and Patient Safety
Authors: Sherman Laurence A. 
Published: January 2021

Abstract
Context.—Limited data are available about the impact of nucleic acid testing for human immunodeficiency virus and hepatitis C virus in donated blood as part of a nationwide investigational study that affected greater than 90% of the blood supply.
Objective.—To assess the impact of nucleic acid testing on supply, outdating, and patient safety.
Design.—Participants in the College of American Pathologists 2001 American Association of Blood Banks/College of American Pathologists Viral Marker C survey were asked questions about supply, outdating, and implementation of a full quarantine of blood pending nucleic acid testing results. The number of respondents for each question ranged from 197 to 219 for blood centers and from 462 to 504 for hospitals.
Results.—Shortages were more common for platelets (29% and 23% of blood centers and hospitals, respectively) than for red blood cells (13%, 11%). Similarly, outdating of platelets (13%, 11%) was more common than outdating of red blood cells; outdating of red blood cells was negligible for both blood centers and hospitals. Forty-two percent of blood centers did not meet the mid 2000 target date for quarantining red blood cells, and 18% were not quarantining as of September 2001. The hospital figures were 66% not quarantining in mid 2000 and 39% not quarantining as of September 2001. Higher proportions of centers and hospitals were not quarantining platelets at these 2 dates.
Conclusions.—Unfavorable trends in both blood shortages and outdating were attributed to nucleic acid testing. Greater effects may have been masked by delayed implementation of full quarantine nationwide. This delay meant continued patient risk, and lack of full benefit, in a trial that was in effect a national standard. In the future, added systems will be needed for similar new endeavors to ensure uniformity of care and to avoid shortages.
Chronic Lymphocytic Leukemia With t(14;18) and Trisomy 12
Authors: Sen Filiz , Lai Raymond , Albitar Maher 
Published: January 2021

Abstract
The chromosomal abnormality t(14;18) is most commonly associated with neoplasms of follicular center cell origin. However, t(14;18) also has been reported in rare cases of chronic lymphocytic leukemia (CLL). In 2215 cases of CLL studied by conventional cytogenetics in our institution, we identified 2 cases of CLL carrying t(14;18). Both patients were men, aged 52 and 71 years at the time of diagnosis. One patient presented with leukemia and the other primarily with nodal disease. In addition to t(14;18), trisomy 12 (+12) was identified in the same clone in both cases. Atypical morphologic features were identified: case 1 contained more than 15% lymphoid cells with cleaved nuclei, whereas case 2 contained more than 15% plasmacytoid lymphoid cells. The immunophenotype of case 2 was also unusual for CLL, showing weak CD23 expression and FMC7 positivity. We identified 6 other t(14;18)-carrying CLL cases in the literature; 2 had t(14;18) as the sole abnormality and 2 contained +12 as the additional abnormality. To conclude, cases of CLL carrying t(14;18) are exceedingly rare, and +12 appears to be the most common cytogenetic abnormality coexisting with t(14;18) in CLL.
Tissue Plasminogen Activator Plasma Levels as a Potential Diagnostic Aid in Acute Pulmonary Embolism
Authors: Flores Julio , García-Avello Angel , Flores Victor M. , Navarro JoséL. , Canseco Felipe , Pérez-Rodríguez Esteban 
Published: January 2021

Abstract
Context.—Pulmonary embolism (PE) is a potentially fatal and frequent complication of deep venous thrombosis, and the most reliable techniques for the diagnosis of PE are not universally available and have other limitations.
Objective.—To determine the efficacy of 4 different fibrinolysis system parameters, namely, tissue plasminogen activator (tPA), tissue plasminogen activator inhibitor type 1 (PAI-1), plasmin-antiplasmin complexes (PAP), and D-dimer, in the diagnosis of acute PE.
Setting.—A 350-bed university hospital serving an area with 280 000 inhabitants.
Patients.—Sixty-six consecutive outpatients with clinically suspected PE. The diagnosis of PE was based on ventilation-perfusion (V/Q) lung scan in combination with clinical assessment, lower limb study, and (when required) pulmonary angiography.
Main Outcome Measures.—At the moment of clinical suspicion, a sample of venous blood was obtained to measure levels of tPA, PAI-1, PAP, and D-dimer using an enzyme-linked immunosorbent assay method.
Results.—Twenty-seven patients (41%) were classified as PE positive (high clinical probability and V/Q lung scan [n = 12], nondiagnostic V/Q lung scan and high clinical probability [n = 1], inconclusive V/Q lung scan and positive lower limb examination for deep venous thrombosis [n = 11], and positive pulmonary angiography [n = 3]), and 39 patients (59%) were classified PE negative. The sensitivity/negative predictive value for tPA, using a cutoff of 8.5 ng/mL, and PAI-1, using a cutoff of 15 ng/mL, were 100%/100% and 100%/100%, respectively. A tPA level lower than 8.5 ng/mL occurred in 13 (19.7%; all PE negative) of 66 patients with suspected PE, and PAI-1 levels were lower than 15 ng/mL in 9 (13.6%; all PE negative) of 66 patients with suspected PE. The D-dimer, using a cutoff of 500 ng/mL, showed a sensitivity and negative predictive value of 92.6% and 87.5%, respectively.
Conclusions.—Our data indicate that tPA and PAI-1 levels are potentially useful in ruling out PE, although tPA seems to be the better parameter. The sensitivity levels and negative predictive values for the rapid enzyme-linked immunosorbent assay for D-dimer used in this investigation were low compared with previous studies using the same test.
Comparison of Polymerase Chain Reaction With Histopathologic Features for Diagnosis of Tuberculosis in Formalin-Fixed, Paraffin-Embedded Histologic Specimens
Authors: Park Do Youn , Kim Jee Yeon , Choi Kyung Un , Lee Jin Sook , Lee Chang Hun , Sol Mee Young , Suh Kang Suek 
Published: January 2021

Abstract
Objective.—To investigate the relationship between various histopathologic features and the results of the tuberculosis (TB)–polymerase chain reaction (PCR) method in routinely submitted histologic specimens for the histopathologic diagnosis of TB.
Design.—We used 95 formalin-fixed, paraffin-embedded tissue blocks from 81 patients who were clinically suspected of having TB. We assessed the presence of histopathologic features including well-formed granuloma, poorly formed granuloma, caseous necrosis, and Langhans-type giant cells. We performed nested PCR for IS6110 and Ziehl-Neelsen staining for acid-fast bacilli (AFB).
Results.—Of the 81 patients studied, 53 patients had chronic granulomatous inflammation, whereas 28 patients had only chronic inflammation without definite granulomatous inflammation. Of the 53 cases with chronic granulomatous inflammation, 17 (32%) were AFB positive and 36 (68%) were TB-PCR positive. Among cases with chronic granulomatous inflammation, the percentage that were positive and negative by TB-PCR differed significantly with the presence of various histopathologic features. All of the 13 cases with well-formed granuloma, caseous necrosis, and Langhans-type giant cells were TB-PCR positive; however, 10 (36%) of the 28 cases with chronic inflammation without granulomatous lesions were also TB-PCR positive.
Conclusions.—TB-PCR is a rapid, sensitive method for the diagnosis of TB in routinely processed formalin-fixed, paraffin-embedded histologic specimens and is readily available in histopathology laboratories. We recommend use of TB-PCR when TB is suspected clinically, especially in cases of chronic inflammation without definite evidence of granulomatous inflammation.
Posttransplant CD30+ (Ki-1) Anaplastic Large Cell Lymphoma
Authors: Lee Lisa Y. , Harpaz Noam , Strauchen James A. 
Published: January 2021

AbstractPosttransplant CD30+ (Ki-1) anaplastic large cell lymphoma (ALCL) is rare. A review of the literature revealed only 3 such cases. All 3 cases were developed after single-organ transplantation. We describe CD30+ (Ki-1) ALCL in a dual-organ (liver and heart) transplantation recipient. The patient was a 68-year-old white female who underwent an orthotopic heart transplantation in 1999 and a liver transplantation in 2000. She presented with nausea and was found to have CD30+ (Ki-1) ALCL by pathologic examination of the gastric antrum biopsy specimen. To our knowledge, this patient represents the first reported case of posttransplant CD30+ ALCL following a dual-organ transplantation.
Solitary Fibrous Tumors in the Central Nervous System
Authors: Tihan Tarik , Viglione Michael , Rosenblum Marc K. , Olivi Alessandro , Burger Peter C. 
Published: January 2021

Abstract
Context.—Solitary fibrous tumors (SFTs) of the central nervous system are rare neoplasms that usually present as dura-based masses and clinically resemble meningiomas. Histologically, they can be similar to fibrous meningioma or hemangiopericytoma (HPC). In particular, densely cellular regions seen in some SFTs can be indistinguishable from HPC. Little is known about the biological behavior of SFTs, although most seem amenable to total resection.
Objectives.—To define the clinicopathologic spectrum of SFTs in the central nervous system and to outline their differences from HPC and meningioma.
Design.—We present the clinicopathologic features of 18 patients with SFT and compare them with those of an age- and sex-matched cohort of HPCs.
Results.—Eleven SFTs were supratentorial, 3 were infratentorial, and 4 were intraspinal. Four of the 18 tumors were intra-axial (2 in the lateral ventricles and 2 within the spinal cord). Histologically, SFTs were similar to their soft tissue counterparts. Six tumors (6/18) had densely cellular regions, and 1 tumor showed frankly anaplastic features. All but 3 patients underwent gross total resection, and there were no metastases or tumor-related mortalities during the median follow-up of 40 months. In contrast, there were 15 local recurrences (83%), 5 extracranial metastases (27%), and 4 tumor-related deaths (22%) in the HPC cohort.
Conclusions.—Our study presents the clinicopathologic features of SFT as a distinct entity from both meningioma and HPC. We also present unusual examples of anaplastic, intraventricular, and intramedullary spinal SFTs that expand the clinicopathologic spectrum of these uncommon and sometimes diagnostically difficult neoplasms.
Results of a Physician Survey on Ordering Viral Load Testing
Authors: Hofherr Louise K. , Francis Diane P. , Astles J. Rex , Schalla William O. 
Published: January 2021

Abstract
Objective.—To profile physicians' practices, utilization, and understanding of human immunodeficiency virus type 1 RNA (viral load) testing and the laboratory's role in this testing.
Design.—Cross sectional study using a 34-item self-report survey mailed to physicians identified as requesting viral load testing, with follow-up mailings to nonresponders.
Participants.—A sampling of US physicians specializing in infectious diseases, internal medicine, and family practice associated with high, medium, and low human immunodeficiency virus/acquired immunodeficiency syndrome incidence areas.
Results.—Most respondents using viral load results were infectious diseases specialists practicing in urban areas. The reasons most frequently given for requesting viral load testing were (1) to assist in patient follow-up or monitoring (75.4%), and (2) to initiate/guide therapy (62.5%). Respondents indicated that the interpretation and use of viral load results presented difficulty in the areas of patient treatment and in determining what change from baseline was clinically significant. Few respondents used the testing laboratory pathologist as a resource for interpreting viral load test results.
Conclusions.—Our study indicates that physicians have questions about (1) the meaning of viral load tests, (2) how often to monitor the viral load, and (3) what change from baseline of the viral load is significant. Few physicians avail themselves of the expertise available in the laboratory for testing viral loads and interpreting such results.
Histology of Gastroesophageal Junction in Fetal and Pediatric Autopsy
Authors: Park Young S. , Park Hyo Jin , Kang Gyeong Hoon , Kim Chong Jai , Chi Je G. 
Published: January 2021

Abstract
Context.—There is much debate over whether the gastric cardia exists from birth as a normal structure or is a metaplastic structure that develops as the result of gastroesophageal reflux disease. This question has become a matter of concern since the incidence of adenocarcinoma at the gastroesophageal junction has been increasing rapidly in the Western world for more than 2 decades. Various groups of investigators have tried to clarify this matter by examining the histology of the gastroesophageal junction in autopsy cases, and there have been striking discrepancies in their findings. In one group, it was observed that cardiac mucosa was present in all pediatric autopsies. On the contrary, another group concluded that pure cardiac mucosa was absent in 56% of their autopsy cases.
Objective.—Without regard to the definition of the cardiac mucosa, we focused on the distance between the squamocolumnar junction and the most proximal parietal cells to elucidate the histologic features of the gastroesophageal junction on the gastric side.
Design.—The entire gastroesophageal junction and the proximal part of the stomach from 23 fetal and pediatric autopsies were mapped. We measured the distance from the squamocolumnar junction to the most proximal parietal cells identified. The extent of the transitional zone, defined as the mucosa between the squamocolumnar junction and the fundic mucosa, was also evaluated.
Results.—The transitional zone was identified in 78% of cases, and it always harbored some scattered parietal cells in mucous glands. The parietal cells were consistently identified adjacent to the squamocolumnar junction in all cases. Although the transitional zone in fetal stomach was usually composed of several pits of foveolar epithelium without glandular portions, it contained glandular structures in the pediatric cases.
Conclusions.—The mucosa composed of pure mucous cells does not exist as a normal developmental structure.
Severe Gastritis Secondary to Epstein-Barr Viral Infection
Authors: Zhang Yanlong , Molot Ross 
Published: January 2021

Abstract
Infectious mononucleosis is usually a self-limited clinical syndrome caused by primary Epstein-Barr virus infection. It is occasionally compounded by severe complications involving many different organ systems. Predominant gastrointestinal involvement is rarely documented. We present an unusual case of acute Epstein-Barr virus infection–associated gastritis with diffuse atypical lymphoid hyperplasia in gastric mucosa. The clinical, radiographic, histopathologic, immunohistochemical, and in situ hybridization features needed for accurate diagnosis and differentiation from gastric malignancies are discussed.
Nitrergic Hyperinnervation in Appendicitis and in Appendices Histologically Classified as Normal
Authors: Nemeth Laszlo , Rolle Udo , Reen Denis J. , Puri Prem 
Published: January 2021

Abstract
Context.—The pathogenesis of appendicitis remains poorly understood. Despite new diagnostic techniques, appendices removed from patients with suspected appendicitis often appear histologically normal on conventional examination. There is increasing evidence of involvement of the enteric nervous system in immune regulation and in inflammatory responses in the gastrointestinal system.
Objective.—To investigate the nitrergic innervation of (a) acutely inflamed appendices, (b) appendices classified as histologically normal from patients with a clinical diagnosis of appendicitis, and (c) normal control appendix specimens, using the whole-mount preparation technique.
Patients and Design.—Full-thickness specimens were collected from 28 acutely inflamed appendices (age range, 3.2–13.4 years), 31 histologically normal appendices removed from patients (age range, 5.7–13.6 years) with suspected appendicitis, and 23 histologically normal appendices from patients (age range, newborn to 12.1 years) undergoing elective abdominal surgery (controls). Whole-mount preparation using nicotinamide adenine dinucleotide phosphate (NADPH) diaphorase histochemistry and neuronal nitric oxide synthase immunohistochemistry were performed. The density of myenteric plexus was measured with a computerized analysis system.
Results.—The density of myenteric plexus in normal appendix specimens was similar to that of large bowel from the newborn period up to 3 years of age; this density decreased significantly thereafter. The myenteric plexus of normal appendix specimens from patients older than 4 years demonstrated smaller ganglia connected by thin nerve bundles, compared to larger ganglia and nerve bundles in large bowel. Significant neuronal hypertrophy was found in 55% of acutely inflamed and 41% of histologically classified normal appendix specimens. The myenteric plexus of these appendix specimens had even thicker nerve bundles connecting an increased number of ganglion cells.
Conclusions.—Differences in the architecture of the myenteric plexus in patients older than 3 years suggest an altered function and motility of appendix in the early years of life. The significant increase in neuronal components of the myenteric plexus in a high proportion of acutely inflamed and histologically normal appendix specimens is unlikely to have developed during a single acute inflammatory episode. This suggests an underlying chronic abnormality as a secondary response to chronic luminal obstruction or repeated inflammatory episodes in the histologically normal appendix.