bluuebunny/crossref_metadata_2025_split huggingface dataset:
Necessity of Clinical Information in Surgical Pathology
Authors: Nakhleh Raouf E. , Gephardt Gordon , Zarbo Richard J. 
Published: January 2021

Abstract
Objectives.—To examine the frequency and nature of problems caused by inadequate clinical data provided on surgical pathology requisition forms.
Design.—Participants in the 1996 Q-Probes voluntary quality improvement program of the College of American Pathologists were asked to document prospectively all surgical pathology cases with inadequate information. Inadequate clinical information was defined as the pathologist's need for additional clinical information before a diagnosis could be rendered, regardless of the amount of information already present on the requisition slip. Cases that had no clinical information on a requisition slip were not counted if the lack of history did not hinder diagnosis. The study concluded when 3 months had elapsed or 40 surgical pathology cases were documented. The following data were recorded for each case: anatomic site, type of procedure, nature of disease, method of obtaining additional information, importance of obtained information, and the length of delay in the final diagnosis.
Participants.—Three hundred forty-one laboratories, 322 of which were from the United States.
Results.—A total of 5594 cases (0.73%) required additional clinical information for diagnosis (10th through 90th percentile range, 3.01% to 0.08%). Institutions with greater average occupied bedsize, a greater number of cases accessioned per year, and a greater number of pathologists had a lower percentage of cases with inadequate clinical data (P &lt; .05). Sixty-eight percent of these cases had no delay in completion of a case, 16.2% had a delay of 1 day or less, and 15.1% of cases were delayed more than 1 day. In 59.4% of cases, the additional clinical information obtained confirmed the initial diagnostic impression. In 25.1%, the information was not relevant to the pathologic diagnosis. In 6.1% there was a substantial change in the diagnosis or a revised report was issued, and in 2.2% no additional information could be obtained. Specific anatomic sites that correlated with a higher rate of changed diagnoses or revised reports in cases with inadequate information included the small bowel, the bronchus/lung, and the ovary. Resection specimens were also significantly associated with a higher rate of changed diagnoses or revised reports when additional information was obtained, as were malignant neoplasms and therapy-induced changes.
Conclusions.—This study establishes an aggregate rate of cases with inadequate clinical information for diagnosis (0.73%) and documents the extent of problems caused by inadequate clinical information. The criticality of appropriate clinical information provided to the pathologist is identified for specific anatomic sites and disease processes and is reflected in changed diagnoses or revised reports.
Comparison of the Vitek GPS-TB Card With Disk Diffusion Testing for Predicting the Susceptibility of Enterococci to Vancomycin
Authors: Williams-Bouyer Natalie , Reisner Barbara S. , Woodmansee Carla E. , Falk Pamela S. , Mayhall C. Glen 
Published: January 2021

Abstract
Objective.—To compare the ability of the Vitek GPS-TB card with disk diffusion testing for determining the susceptibility of enterococci to vancomycin.
Design.—Vitek susceptibility testing was performed using the GPS-TB card and software version R05.03. Disk diffusion susceptibility testing was performed according to National Committee for Clinical Laboratory Standards guidelines. When discrepancies occurred between the interpretation of Vitek and disk diffusion, both tests were repeated and the epsilometer test (E test) and agar screen containing 6 μg/mL vancomycin were performed.
Results.—Of 415 isolates tested, 313 were susceptible to vancomycin and 97 were resistant to vancomycin by both test methods. Two isolates were intermediate by Vitek and resistant by disk diffusion, 2 were intermediate by Vitek and susceptible by disk diffusion, and 1 was susceptible by Vitek and intermediate by disk diffusion. All but 1 of these latter 5 isolates (intermediate by Vitek and susceptible by disk diffusion) were available for retesting. On repeat testing, the 2 isolates that were intermediate by Vitek and resistant by disk diffusion were resistant by both methods, the 1 isolate that was intermediate by Vitek and susceptible by disk diffusion was susceptible by both methods, and the isolate that was susceptible by Vitek and intermediate by disk diffusion was also susceptible by both methods. These results were confirmed by E test and agar screen.
Conclusion.—We found the results of the GPS-TB card compared well with disk diffusion. However, isolates with intermediate results by Vitek should be retested using another method, such as the E test.
Immunohistochemical Detection of Parathyroid Hormone–Related Protein in a Cutaneous Squamous Cell Carcinoma Causing Humoral Hypercalcemia of Malignancy
Authors: Crespo Manuel , Sopeña Bernardo , Orloff John J. , Teijeiro Jorge F. Cameselle , Dann Pamela , Andrade María A. , Freire Mayca , de la Fuente Javier , Martinez-Vazquez César 
Published: January 2021

Abstract
Humoral hypercalcemia of malignancy is a cancer-related hypercalcemia caused by production of humoral factors by malignant cells in patients without bone metastases. Squamous cell carcinomas are the tumors most frequently associated with humoral hypercalcemia of malignancy, and parathyroid hormone–related protein is the main humoral factor implicated. In spite of the fact that normal keratinocytes produce parathyroid hormone–related protein, it is highly unusual for patients with squamous cell carcinomas of the skin to present with humoral hypercalcemia of malignancy. We present a well-documented case of cutaneous squamous cell carcinoma complicated by hypercalcemia in a patient with high levels of plasma parathyroid hormone–related protein and immunohistochemical evidence of high parathyroid hormone–related protein production by the tumoral cells.
Amplicor Enterovirus Polymerase Chain Reaction in Patients With Aseptic Meningitis
Authors: Hadziyannis Emilia , Cornish Nancy , Starkey Colleen , Procop Gary W. , Yen-Lieberman Belinda 
Published: January 2021

Abstract
Objective.—To evaluate the sensitivity and specificity of reverse-transcription polymerase chain reaction (RT-PCR) and routine cell culture for the detection of enterovirus in cerebrospinal fluid.
Methods.—Thirty-eight cerebrospinal fluid specimens were included. Cell culture was inoculated immediately and incubated for 14 days. An aliquot was kept frozen for Amplicor RT-PCR. Chart review was performed to determine the validity of the results.
Results.—Nine of 38 specimens were positive for enterovirus by culture, and 14 were positive by RT-PCR. There were 7 discrepancies between the 2 methods. Six specimens were positive by RT-PCR and negative by the culture method. The 1 culture-positive but RT-PCR–-negative specimen was determined to contain PCR inhibitors. All discrepant results were confirmed as true positives by chart review. Patients whose cerebrospinal fluid was negative by both methods had a final diagnosis other than enterovirus infection.
Conclusion.—Amplicor PCR is more sensitive than cell culture (93.3% vs 60%) and is very specific. With the incorporation of appropriate controls for the detection of amplification inhibitors, RT-PCR could be a valuable tool in the diagnosis of enteroviral meningitis.
Lipomatous Hemangiopericytoma
Authors: Ceballos Katherine M. , Munk Peter L. , Masri Bassam A. , O'Connell John X. 
Published: January 2021

Abstract
Hemangiopericytoma of soft tissue is a controversial pathologic entity. The relative nonspecificity of the characteristic branching capillary pattern and cytologic features of the constituent cells, in addition to the lack of a distinct immunohistochemical staining profile, has resulted in uncertainty and a lack of consensus regarding this subgroup of tumors. Notwithstanding the doubt surrounding this entity, a morphologically unique variant, designated lipomatous hemangiopericytoma, was reported in 1995. To our knowledge, there have been no further reports of these tumors since the original description. We describe a lipomatous hemangiopericytoma that arose within the thigh of a 41-year-old woman. The tumor presented as a slowly enlarging, minimally tender, pulsatile mass. The tumor was completely excised and was found to be composed of an admixture of typical hemangiopericytoma and predominantly mature adipose tissue. Unlike previous descriptions of this entity, the current example exhibited a full range of adipocyte differentiation, including many multivacuolated adipocytes of variable size with characteristic nuclear scalloping (lipoblast-like cells). The mitotic count was less than 2 per 10 high-power fields examined. The clinical course has been benign during the short follow-up period. We discuss the pathologic features, including the immunohistochemical staining profile and ultrastructural appearance of this distinctive tumor, and briefly discuss the relationship between hemangiopericytoma and solitary fibrous tumor of soft tissue, a neoplasm with many clinical and pathologic similarities.
Metastatic Leydig Cell Tumor With Sarcomatoid Differentiation
Authors: Gulbahce H. Evin , Lindeland Arthur T. , Engel William , Lillemoe Tamera J. 
Published: January 2021

Abstract
Leydig cell tumors of the testis are uncommon. Only about 10% of cases have a malignant course. It has been stated that the only definite criterion for malignancy is presence of metastasis. We present a 47-year-old patient with metastatic Leydig cell tumor 17 years after initial diagnosis, to our knowledge the longest reported interval between diagnosis and the development of metastasis. The primary tumor did not exhibit convincing features of malignancy. The initial metastasis in the right perirenal fat tissue showed a biphasic tumor with sarcomatoid differentiation not described previously in a metastatic Leydig cell tumor.
Lymphoma of the Breast
Authors: Topalovski Margarita , Crisan Domnita , Mattson Joan C. 
Published: January 2021

Abstract
Background.—Primary lymphomas of the breast are rare, accounting for 1.7% to 2.2% of extranodal lymphomas and 0.38% to 0.7% of all non-Hodgkin lymphomas. Although secondary breast lymphomas are also rare, they represent the largest group of metastatic tumors of the breast.
Objectives.—To investigate the clinicopathologic and immunophenotypic characteristics of breast lymphomas, the relative frequency of primary and secondary mammary lymphomas, and in selected cases, the role of gene rearrangement analysis in diagnosis and staging of these lymphomas.
Results.—We conducted a retrospective review of 22 cases of breast lymphoma diagnosed at William Beaumont Hospital, Royal Oak, Mich, during a 30-year period (1963–1994). Eleven of the 22 cases fulfilled the criteria for primary breast lymphoma; these cases represented 0.6% of all non-Hodgkin lymphomas seen in our hospital. Of the 11 cases, 5 were diffuse large B-cell lymphomas, 2 were follicle center lymphomas, 2 were marginal zone B-cell lymphomas (mucosa-associated lymphoid tissue type), 1 was a lymphoplasmacytoid lymphoma, and 1 was a peripheral B-cell neoplasm, unclassified. Using a panel of immunohistochemical stains (CD45RO, CD45RA, CD43, CD3, CD20, CD30, CD68, and HLA-DR), 8 cases demonstrated unequivocal B-cell phenotype and 3 cases had equivocal or weak staining patterns for B-cell markers. We identified no cases of T-cell lymphoma. Of 7 cases that had bone marrow biopsies for staging, 3 were positive morphologically for bone marrow involvement. Molecular analysis of B- and T-cell gene rearrangement was used to exclude bone marrow involvement in one case with bone marrow lymphoid aggregates and to confirm negativity in a case that was morphologically negative. Of the 11 secondary breast lymphomas, 5 were diffuse large B-cell lymphomas; 1 was diffuse large B-cell, primary mediastinal subtype; and 5 were follicle center lymphomas.
Conclusions.—Breast lymphomas represented 1.2% of all non-Hodgkin lymphomas in this study; the frequency of primary and secondary cases was equal. In both groups, right breast lesions were predominant, and the most frequent morphologic type was diffuse large B-cell lymphoma. Gene rearrangement analysis is helpful in selected cases to rule out bone marrow involvement, especially in older patients, in whom lymphoid aggregates are common.
Relevance of Apolipoprotein E Polymorphism for Coronary Artery Disease in the Saudi Population
Authors: Dzimiri Nduna , Meyer Brian F. , Hussain Syed S. , Basco Chona , Afrane Barima , Halees Zohair 
Published: January 2021

Abstract
Background.—The apolipoprotein E alleles ε2 and ε4 have been reported as independent risk factors for coronary artery disease (CAD) and as predictors for the development of atherosclerosis.
Methods and Results.—We determined by polymerase chain reaction the distribution of apolipoprotein E polymorphism in 320 Saudi blood donors (BD), 96 CAD patients, and 40 control subjects who had undergone angiography. Compared to controls, only ε4 was elevated in CAD patients. More than 61% (P &lt; .0001) of the patients had angina, and 52.1% (P &lt; .05) were diabetic; both of these factors were strongly associated with the presence of allele ε2. The ε2 allele was also associated with hypertension, elevated serum triglycerides, and total cholesterol. On the other hand, the allele ε4 appeared to be associated with increased risk of CAD and was also associated with hypertension, 3-vessel disease, and restenosis.
Conclusions.—Accordingly, ε4 may be associated with increased risk of CAD, whereas ε2 appears to be a predictor of several risk factors for atherosclerosis.
Very Low-Density Lipoprotein Receptor in Fetal Intestine and Gastric Adenocarcinoma Cells
Authors: Nakamura Yasuhiro , Yamamoto Munehiko , Kumamaru Eriko 
Published: January 2021

AbstractBackground.—A very low-density lipoprotein receptor (VLDLR) was recently identified. This receptor reportedly binds specifically to very low-density lipoproteins; however, its distribution and functions in vivo have yet to be elucidated. We investigated the expression and regulation of VLDLR in fetal and carcinoma cells.Objective.—The expression of VLDLR was examined by immunohistochemistry and reverse-transcriptase polymerase chain reaction using several specimens, including a fetus of 12 to 15 weeks' gestation, various tumors, AGS cells, and INT407 cells.Results.—Immunoreactive VLDLR was abundantly present in human fetal intestinal epithelial and gastric adenocarcinoma cells. This receptor was also noted in the intestinal cell line, INT407, and gastric cancer cell line, AGS. In addition, the VLDLR that was expressed in INT407 cells, AGS cells, and gastric adenocarcinoma tissue was present mainly in a variant form lacking the O-linked sugar domain.Conclusions.—These data suggest that an important function of VLDLR may be the mediation of cell growth in developing tissues, such as fetal intestinal and cancer cells. The INT407 and AGS cell lines appear to be useful for examining the regulation of VLDLR expression.
Expression of Telomerase Activity and Telomerase RNA in Human Soft Tissue Sarcomas
Authors: Yoo Jinyoung , Robinson Robert A. 
Published: January 2021

Abstract
Objective.—To investigate whether telomerase is reactivated in soft tissue tumor and whether telomerase activity is regulated at the transcriptional level.
Design.—Fresh tissue samples of 24 soft tissue sarcomas were analyzed for telomerase activity by a radioactive polymerase chain reaction–based telomeric repeat amplification protocol assay and for human telomerase RNA (hTR) by an in situ hybridization assay.
Setting.—Tertiary care teaching hospital.
Patients.—Twenty-four patients with soft tissue tumor were surgically treated. Twelve patients had malignant fibrous histiocytoma, 5 had liposarcoma, 6 had leiomyosarcoma, and 1 had rhabdomyosarcoma.
Results.—Telomerase activity was detected in 4 sarcoma samples (17%), all of which were positive for hTR. Expression of hTR was demonstrated in 13 sarcomas (54%), 4 of which were positive for telomerase and 9 of which were negative for telomerase. One (50%) of 2 grade 1 tumors, 9 (50%) of 18 grade 2 tumors, and 3 (75%) of 4 grade 3 tumors showed hTR expression.
Conclusions.—The relatively low frequency of telomerase activity in soft tissue sarcomas suggests that telomerase may not play an important role in tumorigenesis in these tumors. Telomerase ladders were demonstrated only in association with tumors expressing hTR. It is noteworthy that half of the patients with grade 1 and 2 tumors expressed hTR, suggesting that telomerase RNA may be useful as a marker for identifying tumor aggressiveness earlier than the conventional histopathologic grading scale.
Salivary Gland Basal Cell and Canalicular Adenomas
Authors: Zarbo Richard J. , Prasad Anil R. , Regezi Joseph A. , Gown Allen M. , Savera Adnan T. 
Published: January 2021

Abstract
Objective.—To evaluate cellular composition of salivary gland adenomas using 3 monoclonal antibodies that recognize a smooth muscle phenotype confirmed to be sensitive for myoepithelial differentiation.
Design.—Immunohistochemical evaluation of 25 salivary gland basal cell and canalicular adenomas.
Setting.—Archival pathology material from the files of Henry Ford Hospital, Detroit, Mich, and the University of California at San Francisco.
Results.—All basal cell adenoma variants exhibit some degree of myoepithelial cell participation with periductal, epithelioid, and spindled (stromal-like) morphologic structures. Only the canalicular adenomas, even if mixed with trabecular and solid patterns, are devoid of staining with these 3 antibodies, suggesting an adenoma composed exclusively of ductal luminal cells.
Conclusions.—There is an overlapping histomorphologic and common cellular composition of the basal cell adenoma variants with other recognized adenomas, such as pleomorphic adenoma and myoepithelioma. Relative differentiation toward 3 cell phenotypes (ductal luminal, basal, and myoepithelial) and the character of extracellular matrix production in varying proportions by the neoplastic myoepithelial cells distinguishes the spectrum of salivary gland adenomas identified in current classification schemes.
Pleomorphic Hyalinizing Angiectatic Tumor of Soft Parts
Authors: Groisman Gabriel M. , Bejar Jacob , Amar Mary , Ben-Izhak Ofer 
Published: January 2021

Abstract
We report morphologic, flow cytometric, and immunohistochemical findings in two cases of pleomorphic hyalinizing angiectatic tumor of soft parts. Both patients were middle-aged women with subcutaneous lesions located in the lower extremity. The tumors consisted of sheets of spindled and pleomorphic cells with frequent intranuclear pseudoinclusions associated with clusters of ectatic vessels surrounded by prominent perivascular hyaline material. Numerous, nonhyalinized vessels were also present, mostly in the peripheral areas of the lesions. Some of these vessels had their walls permeated by numerous small capillaries. Immunostaining for vascular endothelial growth factor (VEGF), a secreted protein that has been implicated in tumor-associated angiogenesis, demonstrated positive staining in both tumoral and endothelial cells. Tumor cells were also reactive to vimentin and CD34. Focal positivity for CD99 and factor XIIIa was also present. Flow cytometry yielded a diploid DNA histogram with S-phase fraction of 7%. Our findings corroborate those from previously reported cases. They further suggest that angiogenesis and the angiogenic factor VEGF may play a role in the development of this peculiar tumor.
Fulminant Parvovirus Infection Following Erythropoietin Treatment in a Patient With Acquired Immunodeficiency Syndrome
Authors: Borkowski Joanna , Amrikachi Mojghan , Hudnall S. David 
Published: January 2021

AbstractWe report the case of a 41-year-old black man with acquired immunodeficiency syndrome who developed a severe chronic anemia due to parvovirus infection. Bone marrow biopsy revealed erythroid aplasia. The infectious nature of the anemia was not recognized, and the patient was treated with erythropoietin. The patient's reticulocyte response was inadequate, however, and he remained anemic. A second bone marrow biopsy showed erythroid hyperplasia and prominent intranuclear parvovirus inclusions within erythroid progenitors. Erythropoietin was discontinued and was followed by a course of intravenous immunoglobulin, which resulted in rapid correction of anemia. To our knowledge, this is the first reported case of fulminant human parvovirus infection exacerbated by erythropoietin administration and documented by sequential bone marrow histologic examination. This case illustrates the critical importance of considering parvovirus in the etiology of chronic anemia with erythroid aplasia in immunocompromised patients.
Laboratory Abnormalities in Former Blood Donors Seropositive for Human T-Lymphotropic Virus Types 1 and 2
Authors: Glynn Simone A. , Murphy Edward L. , Wright David J. , Sacher Ronald A. , Fridey Joy , Schreiber George B. 
Published: January 2021

Abstract
Context.—The human T-lymphotropic viruses types 1 and 2 (HTLV-1 and HTLV-2) are highly prevalent among injection drug users in the United States. However, the clinical course of infection has not been well characterized.
Objective.—To understand HTLV-1–and HTLV-2–associated laboratory abnormalities, which may provide insights into their underlying pathophysiology.
Design.—Cohort study.
Setting.—Five US blood centers.
Participants.—A total of 133 HTLV-1–and 332 HTLV-2–seropositive former blood donors and 717 HTLV-seronegative donors followed up prospectively since 1991.
Main Outcome Measures.—Selected serum chemistry tests and complete blood cell counts were analyzed at enrollment and approximately 2 years later in participants. Repeated-measures analyses were conducted to evaluate the effect of HTLV infection on laboratory measures.
Results.—Compared with seronegative subjects, HTLV-1–seropositive subjects had 13% higher creatine kinase (P = .02) and slightly elevated lactate dehydrogenase (P = .03) levels at follow-up. The HTLV-2–seropositive participants had 11% higher absolute lymphocyte counts than seronegative subjects (P = .0001). Infection with HTLV-2 also appeared to be associated with slightly higher hemoglobin levels (P = .03) and hematocrit (P = .03) and with lower albumin levels (P = .01).
Conclusions.—These results further our understanding of the biological mechanisms underlying HTLV and suggest that HTLV-associated laboratory changes are unlikely to alter clinical evaluation or counseling of otherwise healthy HTLV-infected subjects.