bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Pulmonary Follicular Dendritic Cell Neoplasm: A Case Report and Review of the Literature
Authors: Denning Krista L. , Olson Peter R. , Maley, Jr Richard H. , Flati Veronica R. , Myers Jeffrey L. , Silverman Jan F. 
Published: February 2021

AbstractFollicular dendritic cell tumor (FDCT) is an uncommon neoplasm that typically presents as a slow-growing, painless mass without systemic symptoms. Histologically, FDCT is characterized as a proliferation of spindle to ovoid cells having plump eosinophilic cytoplasm with indistinct borders and nuclei with vesicular or granular chromatin and small distinct nucleoli. The immunohistochemical profile of FDCT includes positive staining for CD21, CD23, CD35, vimentin, fascin, HLA-DR, epithelial membrane antigen, clusterin, and D2-40. Follicular dendritic cell tumor occurs primarily in lymphoid tissue; however, involvement of extranodal sites such as the tonsils, spleen, and gastrointestinal tract has been reported. Lung involvement typically represents metastatic disease with, to our knowledge, only 2 prior cases of extranodal primary FDCT of the lung reported. We report the third case of primary pulmonary FDCT arising in a 64-year-old woman.
Perivascular Epithelioid Cell Tumor
Authors: Armah Henry B. , Parwani Anil V. 
Published: February 2021

Abstract
Perivascular epithelioid cell tumors are mesenchymal neoplasms defined by the presence of histologically and immunohistochemically distinctive perivascular epithelioid cells. The perivascular epithelioid cell has no known normal tissue counterpart and coexpresses myoid and melanocytic markers. This tumor family shows marked female predominance and includes angiomyolipoma, clear cell sugar tumor, lymphangioleiomyomatosis, and a group of rare, morphologically and immunophenotypically similar tumors arising at a variety of visceral and soft tissue sites. This latter subset has been collectively termed perivascular epithelioid cell tumors–not otherwise specified. They are usually composed of epithelioid, but occasionally spindled, cells with clear to granular eosinophilic cytoplasm and focal perivascular accentuation. The mainstay of treatment is wide excision. Although most cases are benign, a subset behaves in a malignant fashion. Since few malignant cases have been reported, firm criteria for malignancy have yet to be established. This review focuses on the perivascular epithelioid cell tumors–not otherwise specified subset.
Necrotizing Sialometaplasia: A Practical Approach to the Diagnosis
Authors: Carlson Diane L. 
Published: February 2021

Abstract
Context.—Necrotizing sialometaplasia is a benign, self-limited lesion of both major and minor salivary glands, although more commonly the latter. It can represent a diagnostic dilemma and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as invasive squamous cell carcinoma. A major causal relationship has been ascribed to ischemia. Bulimia, an eating disorder with increasing prevalence in our society, may also be an underlying underreported cause.
Objective.—To discuss the potential pathogenesis, diagnostic pitfalls, and the application of immunohistochemistry as an aid in the diagnosis of necrotizing sialometaplasia.
Data Sources.—This report uses a previously published case history for illustrative purposes and a review of the current literature.
Conclusions.—The diagnosis of necrotizing sialometaplasia may be difficult and is reliant upon a well-oriented biopsy section and a complete clinical history. Diagnosis may be further supplemented via immunohistochemistry, demonstrating focal to absent immunoreactivity for p53, low immunoreactivity for MIB1 (Ki-67), and the presence of 4A4/p63- and calponin-positive myoepithelial cells. Interpreted in context collectively, these findings may be helpful adjuncts in the diagnosis of necrotizing sialometaplasia; nonetheless, to date, hematoxylin-eosin staining remains the gold standard.
Challenges in the Interpretation of Peritoneal Cytologic Specimens
Authors: Lin Oscar 
Published: February 2021

Abstract
Context.—The presence of malignant cells in peritoneal washings leads to classification as International Federation of Gynecology and Obstetrics stage IC or higher in ovarian carcinomas and at least International Federation of Gynecology and Obstetrics stage IIIA in endometrial carcinomas. Unfortunately, the morphologic examination of cytologic specimens has not proven to be a sensitive or specific diagnostic tool. Malignant cells might be few in number and might be unrecognized among a large population of mesothelial cells and/or macrophages, or reactive mesothelial cells might be misinterpreted as neoplastic cells leading to unnecessary chemotherapy.
Objective.—To evaluate the main pitfalls in the evaluation of peritoneal washings in patients with gynecologic malignancies and analyze the ancillary studies that might be helpful to achieve the correct diagnosis with an emphasis on immunocytochemistry.
Data Sources.—A comprehensive review of the literature was performed.
Conclusions.—Peritoneal effusions may represent major challenges to the pathologist and can have important clinical implications. Immunostains for epithelial markers such as B72.3, MOC-31, and Ber-EP4 represent the best available markers to identify epithelial cells. Caution is advised to not overdiagnose endometriosis or endosalpingiosis as adenocarcinoma.
The T1799A BRAF Mutation Is Absent in Cribriform-Morular Variant of Papillary Carcinoma
Authors: Schuetze David , Hoschar Aaron P. , Seethala Raja R. , Assaad Adel , Zhang Xiatong , Hunt Jennifer L. 
Published: February 2021

Abstract
Context.—Cribriform-morular variant of papillary thyroid carcinoma (CMVPTC) is one of the rare types of papillary carcinoma. It has been associated with familial adenomatous polyposis, though it can also occur sporadically. The molecular pathogenesis of this tumor is incompletely understood. It appears that there can be molecular contributions from the RET/PTC translocations and from mutations in the APC gene and β-catenin gene, which are both part of the Wnt signaling pathway. However, one of the most common mutations in papillary carcinoma, the BRAF mutation, has not been reported in this variant of papillary carcinoma.
Objective.—To investigate the BRAF mutational status in CMVPTC.
Design.—Four cases of CMVPTC (1 associated with familial adenomatous polyposis and the others apparently sporadic) were identified from the files of 3 large centers. Deoxyribonucleic acid was extracted and successfully amplified from each case. The polymerase chain reaction products were sequenced and evaluated for the T1799A BRAF mutation.
Results.—None of the 4 cases harbored the T1799A BRAF mutation (0/4).
Conclusions.—The T1799A BRAF mutation does not appear to play a role in the tumorigenesis of CMVPTC.
Epithelioid Sarcoma
Authors: Armah Henry B. , Parwani Anil V. 
Published: February 2021

Abstract
Epithelioid sarcomas are rare, mesenchymal tumors of unknown histogenesis and display multidirectional differentiation, which is predominantly epithelial. They have no normal cellular counterpart and differ from both synovial sarcoma and carcinoma. They account for less than 1% of all soft tissue sarcomas and are usually slow growing, with peak incidence in young adult men and occur predominantly in extremities. Histologically, they form nodules, with central necrosis surrounded by bland, polygonal cells with eosinophilic cytoplasm and peripheral spindling. They regularly express vimentin, cytokeratins, epithelial membrane antigen, and CD34, whereas staining is usually negative with S100, desmin, and FLI-1. Ultrastructurally, they display epithelial and mesenchymal features, including myofibroblastic differentiation. They manifest no specific cytogenetic findings, but several cases have displayed chromosomal abnormalities in 22q region. Clinically, they have a high recurrence rate, and up to 50% of epithelioid sarcomas metastasize. Proximal, fibroma-like, and angiomatoid variants have been described. The proximal variant (with larger cells, prominent nucleoli, and rhabdoid changes) is clinically more aggressive.
Flat Ductal Intraepithelial Neoplasia of the Breast: A Review of Diagnostic Criteria, Differential Diagnoses, Molecular-Genetic Findings, and Clinical Relevance—It Is Time to Appreciate the Azzopardi Concept!
Authors: Moinfar Farid 
Published: February 2021

AbstractContext.—More than 25 years ago, John G. Azzopardi described a distinctive intraepithelial neoplastic breast lesion, which he designated “clinging carcinoma in situ”; he considered it as another variant of ductal carcinoma in situ, an early lesion that can easily be missed because the changes are mainly cytologic rather than architectural. The lesion remained widely unrecognized and/or ignored until recent years when its neoplastic nature was confirmed at the molecular-genetic level.Objective.—To deal with historical aspects of the evolving concept of “clinging” and to focus on several important issues such as characteristic morphologic features with particular attention to the diagnostic criteria and differential diagnoses, recent molecular-genetic findings, appropriate terminology and classification, as well as the significance of this type of lesion for both surgical pathologists and clinicians.Data Sources.—A thorough search of the literature was performed and publications using a variety of designations including “clinging carcinoma in situ,” “flat epithelial atypia,” “ductal intraepithelial neoplasia-flat type,” “atypical cystic lobules,” “columnar cell change with atypia,” “columnar cell hyperplasia with or without atypia,” “columnar alteration with prominent apical snouts and secretion,” and so forth were reviewed.Conclusions.—This distinctive lesion represents one of the earliest morphologically recognizable neoplastic alterations of the breast that is commonly associated with mammographically suspicious microcalcifications. It is characterized by mildly to severely atypical cells simply replacing the single layer of native epithelial cells in a flat fashion without appreciable proliferation; tufting, intraluminal bridging, micropapillary structures, and so forth are typically absent or very focal and minimal, if present at all. Based on the degree of cytologic atypia, low- and high-grade flat ductal intraepithelial neoplasia need to be separated. Although additional studies are needed to better understand the clinical significance of flat ductal intraepithelial neoplasia, several lines of evidence strongly support the concept of clinging. Indeed, as pointed out by Azzopardi, surgical pathologists need to pay more attention to the cytologic alterations of the breast lesions by analyzing the involved cell populations using high-power magnification.
Safety and Efficiency Considerations for the Introduction of Electronic Ordering in a Blood Bank
Authors: Georgiou Andrew , Greenfield Tony , Callen Joanne , Westbrook Johanna I. 
Published: February 2021

Abstract
The introduction of computerized provider order entry (CPOE) systems is associated with major changes in work processes. Implementation strategies need to consider how the technology will affect and be affected by the organization in which it is being installed. The aim of this study was to examine the potential effect of the introduction of a CPOE system on key work processes in a hospital blood bank by using qualitative data from focus groups, interviews, and participant observation and quantitative data of telephone communication. We found that work practices in the blood bank are made up of a mosaic of collaborative processes underpinned by communication channels to facilitate safe and efficient work practices. The introduction of CPOE systems requires consideration of these channels and of the ways that CPOE may disrupt existing communication processes. There needs to be high levels of staff preparedness to minimize patient risk and optimize performance.
Laboratory Sanctions for Proficiency Testing Sample Referral and Result Communication: A Review of Actions From 1993–2006
Authors: Killeen Anthony A. 
Published: February 2021

Abstract
Context.—The Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations for proficiency testing (PT) include prohibitions against intentional PT sample referral or result communication, and specify sanctions against laboratories that violate these regulations. There has been little published analysis of sanctions against clinical laboratories because of PT violations.
Objective.—To examine the application of principal sanctions as reported by the Centers for Medicare and Medicaid Services annually in the Laboratory Registry and to examine relevant aspects of judicial hearings and appeals in these cases.
Design.—The Laboratory Registry was examined for all available years (1993–2006) to determine the incidence of application of principal sanctions for PT violations. In addition, the decisions from the US Department of Health and Human Services hearings and appeals were reviewed to better understand the judicial disposition of these cases.
Results.—During the 14-year period examined, 78 laboratories received a principal sanction for a PT violation involving sample referral or result communication. During the same period, the number of laboratories in nonexempt states that would be expected to have participated in PT averaged 45 983. The interpretive meaning of the key terms intentional and referral, and the implications for sanctioned laboratories and their owners and operators are discussed.
Conclusions.—Applications of a principal sanction for a PT violation were rare during the period of this study. However, the consequences of the imposition of such a sanction are severe. Suggestions are offered on policies and practices to minimize the risk of a PT sample referral or result communication.
Update on Immunohistochemical Methods Relevant to Dermatopathology
Authors: Wasserman Justin , Maddox Jessica , Racz Mark , Petronic-Rosic Vesna 
Published: February 2021

Abstract
Context.—Dermatopathology covers a large variety of entities, some having very similar histologic appearances. Immunohistochemistry is an incredibly helpful tool that is useful in diagnosis as well as prognosis of selected skin tumors.
Objective.—To provide a comprehensive review of recent trends and immunohistochemical stains used by dermatopathologists. Emphasis is placed on new stains as well as novel uses of existing stains.
Data Sources.—All data were gathered from published journal articles available through the National Center for Biotechnology Information PubMed database.
Conclusions.—New immunohistochemical targets are continually being found, contributing to more accurate diagnosis and classification of skin tumors. The presence of specific markers can be used to determine the aggressiveness of malignanicies and design treatment strategies. In addition, application of existing stains can help determine intravascular spread of malignancy in primary cutaneous lesions. And use of rapid immunohistochemical staining techniques on frozen sections can assist in more complete excision of tumor margins. Immunohistochemistry is a highly versatile and growing tool of dermatopathologists.
Update on Esophagitis: Controversial and Underdiagnosed Causes
Authors: Noffsinger Amy E. 
Published: February 2021

Abstract
Context.—Esophagitis is a common cause of symptoms for which patients seek the advice of a physician. Esophagitis of differing etiologies often demonstrate overlapping histopathologic features, making their distinction difficult. This is especially true in esophageal disorders associated with increased numbers of intraepithelial eosinophils, some of which have just recently been recognized.
Objective.—This review discusses the important clinical and pathologic features of the 2 most common disorders associated with esophageal eosinophilic infiltrates—reflux esophagitis and eosinophilic esophagitis—with special emphasis on features that allow the surgical pathologist to distinguish between these disorders. The various forms of drug-induced esophagitis are also discussed because these are frequently underrecognized by pathologists.
Data Sources.—Data were extracted from articles identified through PubMed-based research. Histologic figures have been taken from the personal case collection of the author.
Conclusions.—Reflux and eosinophilic esophagitis demonstrate overlapping histologic features, which may make their distinction difficult. Drug-induced esophagitis is probably a common phenomenon but is underrecognized by pathologists.
Update in Neoplastic Lung Diseases and Mesothelioma
Authors: Gordon Ilyssa O. , Sitterding Stephanie , Mackinnon A. Craig , Husain Aliya N. 
Published: February 2021

Abstract
Context.—Lung cancer is a common disease frequently seen by the surgical pathologist. Although secondary to improvements in screening and radiologic techniques and aggressive resection of small pulmonary nodules, the diagnosis of preneoplastic lesions is increasing in frequency and importance. Consequently, a greater understanding of their role in the development of lung carcinoma is needed for optimal patient care. Two lesions often encountered as small pulmonary nodules are bronchioloalveolar carcinoma and adenocarcinoma, which can be challenging to distinguish. Recently, updates to the TNM classification of non–small cell lung carcinoma have been reported that directly impact prognosis and treatment algorithms. Identification of new molecular targets in pleural mesothelioma and in preneoplastic lesions may lead to improved therapeutic strategies.
Objective.—To present recent advances in our understanding of neoplastic lung diseases and mesothelioma and to describe how these advances relate to the current practice of pulmonary pathology.
Data Sources.—Published literature from PubMed (National Library of Medicine) and primary material from the authors' institution.
Conclusions.—It is important for the surgical pathologist to understand current diagnostic classifications of non– small cell lung cancer and to be aware of the range of preneoplastic lesions, as well as the features useful for distinguishing bronchioloalveolar carcinoma from adenocarcinoma in small pulmonary nodules. Although pleural mesothelioma has distinct features, it can also overlap histologically with adenocarcinoma, and immunohistochemistry can greatly aid in accurate diagnosis. New therapies targeting molecular markers in both non–small cell lung cancer and mesothelioma rely on accurate histopathologic diagnosis of these entities.
Guidelines for Pathologic Diagnosis of Malignant Mesothelioma: A Consensus Statement from the International Mesothelioma Interest Group
Authors: Husain Aliya N. , Colby Thomas V. , Ordóñez Nelson G. , Krausz Thomas , Borczuk Alain , Cagle Philip T. , Chirieac Lucian R. , Churg Andrew , Galateau-Salle Francoise , Gibbs Allen R. , Gown Allen M. , Hammar Samuel P. , Litzky Leslie A. , Roggli Victor L. , Travis William D. , Wick Mark R. 
Published: February 2021

AbstractContext.—Malignant mesothelioma (MM) is an uncommon tumor that can be difficult to diagnose.Objective.—To develop practical guidelines for the pathologic diagnosis of MM.Data Sources.—A pathology panel was convened at the International Mesothelioma Interest Group biennial meeting (October 2006). Pathologists with an interest in the field also contributed after the meeting.Conclusions.—There was consensus opinion regarding (1) distinguishing benign from malignant mesothelial proliferations (both epithelioid and spindle cell lesions), (2) cytologic diagnosis of MM, (3) key histologic features of pleural and peritoneal MM, (4) use of histochemical and immunohistochemical stains in the diagnosis and differential diagnosis of MM, (5) differentiating epithelioid MM from various carcinomas (lung, breast, ovarian, and colonic adenocarcinomas and squamous cell and renal cell carcinomas), (6) diagnosis of sarcomatoid mesothelioma, (7) use of molecular markers in the differential diagnosis of MM, (8) electron microscopy in the diagnosis of MM, and (9) some caveats and pitfalls in the diagnosis of MM. Immunohistochemical panels are integral to the diagnosis of MM, but the exact makeup of panels used is dependent on the differential diagnosis and on the antibodies available in a given laboratory. Immunohistochemical panels should contain both positive and negative markers. The International Mesothelioma Interest Group recommends that markers have either sensitivity or specificity greater than 80% for the lesions in question. Interpretation of positivity generally should take into account the localization of the stain (eg, nuclear versus cytoplasmic) and the percentage of cells staining (&gt;10% is suggested for cytoplasmic membranous markers). These guidelines are meant to be a practical reference for the pathologist.
Lymph Node Melanosis in a Patient With Metastatic Melanoma of Unknown Primary
Authors: Malafronte Patrick , Sorrells Timothy 
Published: February 2021

Abstract
Tumoral or nodular melanosis in the skin is considered a variation of completely regressed melanoma, presenting clinically as a suspicious pigmented papule or nodule. Microscopically, the lesion consists of a nodular accumulation of heavily pigmented melanophages in the dermis, staining positive for immunohistochemical markers of histiocytic lineage (CD68) and negative for those of melanocytic lineage (S100, HMB-45, Melan-A). This process is rarely described in lymph nodes. We present a report of a patient with melanosis involving multiple lymph nodes of an axillary dissection, done for metastatic melanoma with an unknown primary, and discuss possible prognostic and treatment factors.
Best Practices in Diagnostic Immunohistochemistry: Spindle Cell Neoplasms of the Gastrointestinal Tract
Authors: Turner Matthew S. , Goldsmith Jeffrey D. 
Published: February 2021

Abstract
Context.—The proper classification of spindle cell neoplasms of the gastrointestinal tract frequently requires the use of immunohistochemistry, as the histologic appearance of these lesions often overlaps.
Objective.—To review the antibodies used in the diagnosis of spindle cell neoplasms of the gastrointestinal tract, and to outline an approach to the evaluation of these lesions by using immunohistochemistry.
Data Sources.—The authors' experience and a review of the English literature from 1976 to 2008.
Conclusions.—The most common spindle cell neoplasm of the gastrointestinal tract is gastrointestinal stromal tumor; this lesion is readily diagnosed with c-kit immunohistochemistry in most cases. Other stains, such as smooth muscle actin, desmin, S100 protein, and β-catenin, are also useful in the diagnosis of smooth muscle tumors, schwannomas, desmoid-type fibromatoses, and metastatic melanoma.