bluuebunny/crossref_metadata_2025_split huggingface dataset:
Benign Fibroblastic Polyps of the Colon
Authors: Huber Aaron R. , Shikle James F. 
Published: February 2021

Abstract
Benign fibroblastic polyps of the colon are a recently described entity among mucosal polyps found in the colorectum. These polyps are typically discovered on routine screening colonoscopy within the distal colon. Benign fibroblastic polyps occur most commonly in adult women in the sixth decade of life. Histologically, benign fibroblastic polyps are bland spindle cell lesions that fill the lamina propria and displace the surrounding crypts. The spindle cell proliferation lacks atypia and significant mitotic activity. Hyperplastic changes are frequently present both in the adjacent epithelium and within the lesions. Immunohistochemically, the cells of benign fibroblastic polyps are invariably positive for vimentin with rare focal positivity for CD34 and smooth muscle actin. They are negative for CD117 and S100 protein. Ultrastructurally, benign fibroblastic polyps have features of fibroblastic differentiation. These polyps are benign with no reports, to our knowledge, of recurrence or metastasis.
Increasing the Efficiency of Autopsy Reporting
Authors: Siebert Joseph R. 
Published: February 2021

Abstract
Context.—When autopsy reports are delayed, clinicians and families do not receive information in a timely fashion.
Objective.—Using lean principles derived from the Toyota Production System, we set out to streamline our autopsy reporting process.
Design.—In a formal workshop setting, we identified the steps involved in producing an autopsy report, then sought to eliminate, abbreviate, or reschedule them into a more efficient format. We established intermediate deadlines for each case, taking care to make them visible; we initiated a weekly quality assurance review, giving attention to both scientific issues and approaching deadlines.
Results.—By adopting a more standardized approach, eliminating redundancy, and improving the visibility of tasks, we improved the mean completion time of autopsy reports from 53 days (N = 47 cases) to 25 days (N = 47 cases). Previously, 17% of reports were completed by 30 days and 71% by 60 days; in the 15 months following initiation of the program, 72% of reports were completed by 30 days and 100% by 60 days. A follow-up survey of attending physicians revealed continuing appreciation for the autopsy and timely communication, with no perceived diminution in the quality of reports.
Conclusions.—This approach was of great benefit in our laboratory and may assist others in reducing the turnaround time of their autopsy reports. It may also benefit other areas of the laboratory.
Gastrointestinal Basidiobolomycosis: An Unusual Fungal Infection Mimicking Colon Cancer
Authors: Nemenqani Dalal , Yaqoob Nausheen , Khoja Hatem , Al Saif Osama , Amra Nasir K. , Amr Samir S. 
Published: February 2021

Abstract
Context.—Basidiobolomycosis is a rare disease caused by the fungus Basidiobolus ranarum, an environmental saprophyte found worldwide. Patients with B ranarum infection may present with subcutaneous, gastrointestinal, or systemic lesions. Gastrointestinal basidiobolomycosis poses diagnostic difficulties, as its clinical presentation is nonspecific, with no identifiable risk factors.
Objective.—To discuss and compare the clinical features and histopathologic findings and other ancillary techniques that could be helpful in identifying gastrointestinal basidiobolomycosis.
Design.—We report 3 cases of gastrointestinal basidiobolomycosis and describe the clinical and morphologic findings while emphasizing the importance of identifying this unusual entity on endoscopic biopsies, thus avoiding unnecessary major surgeries. Fungal cultures were also performed, which are of diagnostic significance. Our first patient was lost to follow-up; however, patients 2 and 3 were followed up for 4 and 2 years, respectively.
Results.—In all 3 cases, patients presented with a clinical profile suggestive of malignancy. None of the patients gave any specific history. There was widespread abdominal disease with peritoneal involvement and colonic masses. Colonoscopic biopsy specimens showed nonspecific inflammation in 1 case; however, they showed only granulomatous inflammation in a second case and granulomas associated with fungal hyphae in a third. Typical morphology included hyphae, irregularly branched, thin-walled, occasionally septated and surrounded by a thick eosinophilic cuff (Splendore-Hoeppli phenomenon).
Conclusion.—Gastrointestinal basidiobolomycosis can be detected on small endoscopic biopsy. The unequivocal diagnosis requires microbiologic cultivation of the fungus obtained from tissues. The prognosis for this disease is usually favorable as seen in 3 of our cases; however, cases with fatal outcome are on record.
Strategies for Improving the Collection of 24-Hour Urine for Analysis in the Clinical Laboratory: Redesigned Instructions, Opinion Surveys, and Application of Reference Change Value to Micturition
Authors: Tormo Consuelo , Lumbreras Blanca , Santos Ana , Romero Luis , Conca Minerva 
Published: February 2021

Abstract
Context.—The preanalytic phase of 24-hour urine collection, before clinical analysis, requires the active participation of patients and usually takes place outside the laboratory.
Objective.—We verify whether distribution of adequate information to health care personnel and patients will result in fewer preanalytic incidents. We also determine the intraindividual biologic variability associated with micturition and the corresponding reference change value (RCV).
Design.—The intervention provided training for 24-hour urine collection to the health care personnel of the 20th health district of the Valencian community in Spain. The preanalytic incidents related to 24-hour micturition were estimated before and after the intervention. An opinion survey on the problems involved in urine collection was also conducted among patients. The Harris formula was used to calculate the RCV.
Results.—Before the intervention, 130 preanalytic incidents were recorded (11.5%) and after the intervention, 76 (8.6%) (P = .04) were recorded. Of the 130 incidents recorded before the intervention, 63 (48.5%) involved omission to indicate the urine volume, and of the 76 incidents recorded after the intervention, only 1 (1.3%) (P &lt; .001) involved this omission. Forty of 302 patients (13.2%) surveyed reported problems and more than half (175; 57.9%) had to collect various urine samples sequentially. The RCV determined was 54.5% for a percentage of variation in volume of 24-hour urine (PVVI) of 19.0 ± 16.5%. Therefore, micturition associated with a PVVI &gt;±54.5% suggests that 24-hour urine collection by the patient was incomplete. The results obtained when applying the RCV after the intervention showed that 6.3% of the 24-hour urine samples should be rejected.
Conclusions.—The percentage of preanalytic incidents was reduced by providing health care personnel with information and training. The percentage of variation in volume of 24-hour urine can be used to evaluate the variation in patients' micturition. Reference change value was shown to be useful when determining whether 24-hour urine was properly collected.
The Renal Biopsy
Authors: Walker Patrick D. 
Published: February 2021

AbstractContext.—The first renal biopsy was carried out more than a century ago, but its widespread introduction into clinical use, beginning in the 1950s, helped develop nephrology into the powerful subspecialty of internal medicine that it is today. In the past 25 years, the use of the spring-loaded biopsy gun, in combination with newer visualization techniques, including ultrasound and computed axial tomography scanning, has led to greater tissue yield and to a much lower risk of complication. During this same time, our understanding of renal pathology has increased many fold. Correct fixation and processing of renal biopsy tissue is critical, and the laboratory must be skilled with renal biopsy light microscopy, immunohistochemistry, and transmission electron microscopy preparation.Objectives.—To provide an overview of the renal biopsy, including the techniques and its complications, and to summarize proper laboratory methods for processing renal biopsy tissue.Data Sources.—This article is based on a review of the literature and on the experience of the author.Conclusions.—The experienced nephropathologist, knowledgeable in both renal medicine and pathology and thus able to correlate subtle tissue-derived information with appropriate clinical data, remains the most important key to the development of an accurate clinicopathologic diagnosis.
The Spectrum of Eosinophilic Cystitis in Males: Case Series and Literature Review
Authors: Popescu Oana-Eugenia , Landas Steve K. , Haas Gabriel P. 
Published: February 2021

AbstractContext.—Eosinophilic cystitis (EC) is an inflammatory condition of the bladder that has been linked to food allergens, infectious agents, drugs, and other genitourinary conditions. Like interstitial cystitis, EC has a strong female predominance. It is characterized by an intense eosinophilic infiltrate in the acute phase and fibrosis in the chronic phase.Objectives.—To document and focus on specific features of EC in males and highlight the relationship between clinical and histopathologic findings.Design.—The bladder biopsies of male patients were reviewed. Eight cases of EC were selected.Results.—Several known associations were noted as well as unreported features and associations such as Charcot-Leyden crystals, celiac disease, lupus anticoagulant, and additional viral and bacterial agents.Conclusions.—Eosinophilic cystitis represents a response to a variety of agents and may often be overlooked. The temporally biphasic morphologic features are the hallmark of this condition. Because clinical and imaging studies are not specific, a high index of clinical suspicion is often crucial to the correct diagnosis and proper management of EC.
Raymond's Paragraph System: An Alternative Format for the Organization of Gross Pathology Reports and Its Implementation in an Academic Teaching Hospital
Authors: Dayton Annette S. , Ro Jae Y. , Schwartz Mary R. , Ayala Alberto G. , Raymond A. Kevin 
Published: February 2021

Abstract
Context.—Traditionally organized gross pathology reports, which are widely used in pathology resident and pathologists' assistant training programs, may not offer the most efficient method of communicating pertinent information to treating physicians. Instructional materials for teaching gross pathology dictation are limited and the teaching methods used are inconsistent. Raymond's Paragraph System, a gross pathology report formatting system, was developed for use at a cancer center and has been implemented at The Methodist Hospital, Houston, Tex, an academic medical center. Unlike traditionally organized reports in which everything is normally dictated in 1 long paragraph, this system separates the dictation into multiple paragraphs creating an organized and comprehensible report. Recent literature regarding formatting of pathology reports focuses primarily on the organization of specimen diagnoses and overall report layout. However, little literature is available that highlights organization of the specimen gross descriptions.
Objective.—To provide instruction to pathologists, pathology residents and fellows, and pathologists' assistant students about an alternative method of organizing gross pathology reports.
Data Sources.—Review of pertinent literature relating to preparation of gross pathology reports, report formatting, and pathology laboratory credentialing requirements.
Conclusions.—The paragraph system offers a viable alternative to traditionally organized pathology reports. Primarily, it provides a working model for medical professionals-in-training. It helps create user-friendly pathology reports by giving precise and concise information in a standardized format. This article provides an overview of the system and discusses our experience in its implementation.
Subcutaneous Panniculitis-like T-Cell Lymphoma: Redefinition of Diagnostic Criteria in the Recent World Health Organization–European Organization for Research and Treatment of Cancer Classification for Cutaneous Lymphomas
Authors: Parveen Zahida , Thompson Karen 
Published: February 2021

Abstract
Subcutaneous panniculitis-like T-cell lymphoma is a primary T-cell lymphoma that preferentially involves the subcutaneous tissue. Although subcutaneous panniculitis-like T-cell lymphoma has been recognized as a distinctive entity in the category of peripheral T-cell lymphoma in the World Health Organization classification, its diagnostic criteria has been redefined by the recent World Health Organization–European Organization for Research and Treatment of Cancer classification for primary cutaneous lymphomas. Subcutaneous panniculitis-like T-cell lymphoma is now restricted to primary cutaneous T-cell lymphoma expressing αβ T-cell receptor phenotype. These lymphomas are usually CD3+, CD4−, CD8+, and CD56−, and usually have an indolent clinical course. The clinicopathologic features, differential diagnosis, immunophenotypic characteristics, and molecular features of subcutaneous panniculitis-like T-cell lymphoma are presented in light of the recent World Health Organization–European Organization for Research and Treatment of Cancer classification.
Endocrine Neoplasms of the Pancreas: Pathologic and Genetic Features
Authors: Capelli Paola , Martignoni Guido , Pedica Federica , Falconi Massimo , Antonello Davide , Malpeli Giorgio , Scarpa Aldo 
Published: February 2021

AbstractContext.—Pancreatic endocrine neoplasms (PENs) are diagnostically challenging tumors whose natural history is largely unknown. Histopathology allows the distinction of 2 categories: poorly differentiated high-grade carcinomas and well-differentiated neoplasms. The latter include more than 90% of PENs whose clinical behavior varies from indolent to malignant and cannot be predicted by their morphology.Objectives.—To review the literature and report on additional primary material about the clinicopathologic features, classification, staging, grading, and genetic features of PENs.Data Sources.—Literature review of relevant articles indexed in PubMed (US National Library of Medicine) and primary material from the authors' institution.Conclusions.—The diagnosis of PEN is generally easy, but unusual features may induce misdiagnosis. Immunohistochemistry solves the issue, provided that the possibility of a PEN has been considered. Morphology allows the distinction of poorly differentiated aggressive carcinomas from well-differentiated neoplasms. The World Health Organization classification criteria allow for the discernment of the latter into neoplasms and carcinomas with either benign or uncertain behavior. The recently proposed staging and grading systems hold great promise for permitting a stratification of carcinomas into clinically significant risk categories. To date, inactivation of the MEN1 gene remains the only ascertained genetic event involved in PEN genesis. It is inactivated in roughly one-third of PENs. The degree of genomic instability correlates with the aggressiveness of the neoplasm. Gene silencing by promoter methylation has been advocated, but a formal demonstration of the involvement of specific genes is still lacking. Expression profiling studies are furnishing valuable lists of mRNAs and noncoding RNAs that may advance further the research to discover novel markers and/or therapeutic targets.
Familial Pancreatic Cancer
Authors: Shi Chanjuan , Hruban Ralph H. , Klein Alison P. 
Published: February 2021

AbstractContext.—Approximately 5% to 10% of individuals with pancreatic cancer report a history of pancreatic cancer in a close family member. In addition, several known genetic syndromes, such as familial breast cancer (BRCA2), the Peutz-Jeghers syndrome, and the familial atypical multiple mole melanoma syndrome, have been shown to be associated with an increased risk of pancreatic cancer. The known genes associated with these conditions can explain only a portion of the clustering of pancreatic cancer in families, and research to identify additional susceptibility genes is ongoing.Objective.—To provide an understanding of familial pancreatic cancer and the pathology of familial exocrine pancreatic cancers.Data Sources.—Published literature on familial aggregation of pancreatic cancer and familial exocrine pancreatic tumors.Conclusions.—Even in the absence of predictive genetic testing, the collection of a careful, detailed family history is an important step in the management of all patients with pancreatic cancer. While most pancreatic cancers that arise in patients with a family history are ductal adenocarcinomas, certain subtypes of pancreatic cancer have been associated with familial syndromes. Therefore, the histologic appearance of the pancreatic cancer itself, and/or the presence and appearance of precancerous changes in the pancreas, may increase the clinical index of suspicion for a genetic syndrome.
Molecular Alterations in Exocrine Neoplasms of the Pancreas
Authors: Ranganathan Prathibha , Harsha H. C. , Pandey Akhilesh 
Published: February 2021

AbstractContext.—Pancreatic cancer is one of the leading causes of cancer-related deaths. Most cases are diagnosed at an advanced stage when the disease is beyond surgical intervention. Molecular studies during the past decade have contributed greatly to our understanding of this disease. Various germ-line and somatic mutations associated with pancreatic cancers have been characterized, along with abnormal variations in the gene expression patterns. A thorough characterization of molecular alterations such as genetic and epigenetic changes, alterations in the expression of genes and changes in proteins, and posttranslational modifications in pancreatic cancer could lead to a better understanding of its pathogenesis.Objective.—To provide an overview of the various molecular alterations in pancreatic cancer and the methodologies used to catalog such alterations.Data Sources.—Published studies about various molecular alterations at the genomic, epigenetic, transcriptomic, and proteomic levels in pancreatic cancer.Conclusions.—The available data from pancreatic cancer suggests that there are a large number of molecular alterations at genomic, epigenetic, transcriptomic, and proteomic levels. It is now possible to initiate a systems approach to studying pancreatic cancer especially in light of newer initiatives to dissect the pancreatic cancer genome.
Pancreatic Cysts: Pathologic Classification, Differential Diagnosis, and Clinical Implications
Authors: Basturk Olca , Coban Ipek , Adsay N. Volkan 
Published: February 2021

AbstractContext.—Cystic lesions of the pancreas are being recognized with increasing frequency and have become a more common finding in clinical practice because of the widespread use of advanced imaging modalities and the sharp drop in the mortality rate of pancreatic surgery. Consequently, in the past 2 decades, the nature of many cystic tumors in this organ has been better characterized, and significant developments have taken place in the classification and in our understanding of pancreatic cystic lesions.Objective.—To provide an overview of the current concepts in classification, differential diagnosis, and clinical/biologic behavior of pancreatic cystic tumors.Data Sources.—The authors' personal experience, based on institutional and consultation materials, combined with an analysis of the literature.Conclusions.—In contrast to solid tumors, most of which are invasive ductal adenocarcinomas with dismal prognosis, cystic lesions of the pancreas are often either benign or low-grade indolent neoplasia. However, those that are mucinous, namely, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms, constitute an important category because they have well-established malignant potential, representing an adenoma-carcinoma sequence. Those that are nonmucinous such as serous tumors, congenital cysts, lymphoepithelial cysts, and squamoid cyst of pancreatic ducts have no malignant potential. Only rare nonmucinous cystic tumors that occur as a result of degenerative/necrotic changes in otherwise solid neoplasia, such as cystic ductal adenocarcinomas, cystic pancreatic endocrine neoplasia, and solid-pseudopapillary neoplasm, are also malignant and have variable degrees of aggressiveness.
Nonneoplastic Mimickers of Pancreatic Neoplasms
Authors: Zamboni Giuseppe , Capelli Paola , Scarpa Aldo , Bogina Giuseppe , Pesci Anna , Brunello Eleonora , Klöppel Günter 
Published: February 2021

AbstractContext.—A variety of nonneoplastic conditions may form pancreatic masses that mimic carcinoma. Approximately 5% to 10% of pancreatectomies performed with the clinical diagnosis of pancreatic cancer prove on microscopic evaluation to be pseudotumors.Objectives.—To illustrate the clinical and pathologic characteristics of the 2 most frequent pseudotumoral inflammatory conditions, autoimmune pancreatitis and paraduodenal pancreatitis, and describe the criteria that may be useful in the differential diagnosis versus pancreatic carcinoma.Data Sources.—Recent literature and the authors' experience with the clinical and pathologic characteristics of autoimmune pancreatitis and paraduodenal pancreatitis.Conclusions.—The knowledge of the clinical, radiologic, and pathologic findings in both autoimmune pancreatitis and paraduodenal pancreatitis is crucial in making the correct preoperative diagnosis. Autoimmune pancreatitis, which occurs in isolated or syndromic forms, is characterized by a distinctive fibroinflammatory process that can either be limited to the pancreas or extend to the biliary tree. Its correct preoperative identification on biopsy material with ancillary immunohistochemical detection of dense immunoglobulin G4-positive plasma cell infiltration is possible and crucial to prevent major surgery and to treat these patients with steroid therapy. Paraduodenal pancreatitis is a special form of chronic pancreatitis that affects young males with a history of alcohol abuse and predominantly involves the duodenal wall in the region of the minor papilla. Pathogenetically, the anatomical and/or functional obstruction of the papilla minor, resulting from an incomplete involution of the intraduodenal dorsal pancreas, associated with alcohol abuse represents the key factor. Endoscopic drainage of the papilla minor, with decompression of the intraduodenal and dorsal pancreas, might be considered in these patients.
Recurrent Challenges in the Evaluation of Fibroepithelial Lesions
Authors: Giri Dilip 
Published: February 2021

Abstract
Context.—The morphologic spectrum of mammary fibroepithelial lesions ranges from fibroadenoma, a common benign neoplasm, to phyllodes tumor, an uncommon lesion that can sometimes recur and metastasize.
Objective.—To focus on problems encountered in the diagnostic evaluation of fibroepithelial tumors, highlighting the diagnostically relevant morphologic features and providing an update on the immunohistochemical profile and genetic alterations of these rare neoplasms.
Data Sources.—A PubMed search of the English-language literature identified published reports on fibroepithelial lesions, with a special focus on phyllodes tumor. The results and conclusions of these studies form the basis of this review.
Conclusions.—The distinction between fibroadenoma and phyllodes tumor is usually not problematic, especially in excision specimens. In some cases, however, the diagnostic evaluation of fibroepithelial lesions can be challenging, especially if only limited material is available. Morphologic predictors of local recurrence of phyllodes tumor include cellularity and cytologic atypia, mitotic activity, positive margins, infiltrative borders, fibroproliferative satellite nodules, and past history of fibroadenoma. Predictors of distant metastasis include size, tumor necrosis, and stromal overgrowth. None of these parameters, however, constitutes a definite marker of malignancy. Presently, molecular and immunohistochemical techniques play a limited role in the diagnosis of fibroepithelial lesions.