bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elder Maltreatment: A Review
Authors: Collins Kim A. 
Published: February 2021

Abstract
Context.—Elder maltreatment is not a new entity but is one that is recently recognized as a widespread and growing social problem. Unfortunately, few physicians are trained to recognize the different forms of elder maltreatment including physical abuse, sexual abuse, and neglect. The elder, age 65 years or older, is also a unique individual with respect to pathophysiology. The natural changes of aging must be considered when assessing any physical or laboratory findings.
Objective.—The practicing pathologist and resident/fellow in training must be familiar with the 6 forms of elder abuse, in particular the 3 forms that are seen in general and forensic pathology: physical abuse, sexual abuse, and neglect. Naturally occurring conditions must also be recognized so that these are not erroneously interpreted as trauma or neglect. Furthermore, the victims and perpetrators, scenarios and risk factors, common anatomic and clinical findings, the pathophysiology of aging, and possible imitators of abuse must be understood.
Data Sources.—This review explores the current medical and psychological understanding of elder maltreatment. Current scientific literature including peer-reviewed journal publications and texts is cited.
Conclusions.—As a prevalent form of domestic violence, we can only expect to see more cases of elder maltreatment as the number and percentage of elders in our population increase. The correct interpretation of physical and laboratory findings is needed to adequately classify these cases, certify the cause and manner of death, and prevent future incidents.
Low-Grade Fibromyxoid Sarcoma: A Brief Review
Authors: Vernon Stephen E. , Bejarano Pablo A. 
Published: February 2021

Abstract
Low-grade fibromyxoid sarcomas are uncommon deep soft tissue neoplasms first described by Evans in 1987. They exhibit a deceptively benign appearance, with a whorled or linear arrangement of spindle-shaped cells showing few to absent mitoses. A characteristic, but not specific, feature is the presence of areas of myxoid stroma. Recurrences are common, and late metastases have been recorded. A closely related but morphologically distinct tumor, the so-called hyalinizing spindle cell tumor with giant rosettes, has also been described; both neoplasms share the same cytogenetic abnormality, a balanced translocation resulting in a FUS/CREB3L2 fusion gene. Because of similar clinical behavior and the common cytogenetic abnormality, some authors prefer to consider both lesions as a single entity within the spectrum of low-grade sarcomas.
Interlaboratory Comparison of Immunohistochemical Testing for HER2: Results of the 2004 and 2005 College of American Pathologists HER2 Immunohistochemistry Tissue Microarray Survey
Authors: Fitzgibbons Patrick L. , Murphy Douglas A. , Dorfman David M. , Roche Patrick C. , Tubbs Raymond R. 
Published: February 2021

AbstractContext.—Correct assessment of human epidermal growth factor receptor 2 (HER2) status is essential in managing patients with invasive breast carcinoma, but few data are available on the accuracy of laboratories performing HER2 testing by immunohistochemistry (IHC).Objective.—To review the results of the 2004 and 2005 College of American Pathologists HER2 Immunohistochemistry Tissue Microarray Survey.Design.—The HER2 survey is designed for laboratories performing immunohistochemical staining and interpretation for HER2. The survey uses tissue microarrays, each consisting of ten 3-mm tissue cores obtained from different invasive breast carcinomas. All cases are also analyzed by fluorescence in situ hybridization. Participants receive 8 tissue microarrays (80 cases) with instructions to perform immunostaining for HER2 using the laboratory's standard procedures. The laboratory interprets the stained slides and returns results to the College of American Pathologists for analysis. In 2004 and 2005, a core was considered “graded” when at least 90% of laboratories agreed on the result—negative (0, 1+) versus positive (2+, 3+). This interlaboratory comparison survey included 102 laboratories in 2004 and 141 laboratories in 2005.Results.—Of the 160 cases in both surveys, 111 (69%) achieved 90% consensus (graded). All 43 graded cores scored as IHC-positive were fluorescence in situ hybridization-positive, whereas all but 3 of the 68 IHC-negative graded cores were fluorescence in situ hybridization-negative. Ninety-seven (95%) of 102 laboratories in 2004 and 129 (91%) of 141 laboratories in 2005 correctly scored at least 90% of the graded cores.Conclusion.—Performance among laboratories performing HER2 IHC in this tissue microarray–based survey was excellent. Cores found to be IHC-positive or IHC-negative by participant consensus can be used as validated benchmarks for interlaboratory comparison, allowing laboratories to assess their performance and determine if improvements are needed.
Grading of Soft Tissue Sarcomas: Review and Update
Authors: Coindre Jean-Michel 
Published: February 2021

Abstract
Context.—Histologic grading is the most important prognostic factor and the best indicator of metastatic risk in adult soft tissue sarcomas. The most commonly used systems are the French grading and the National Cancer Institute grading. Both are 3-grade systems and are mainly based on histologic type and subtype, tumor necrosis, and mitotic activity. Rules for using grading should be strictly respected and limitations of grading should be known to obtain the best performance. The most controversial point is the respective values of histologic typing and grading. Histologic typing should be clearly defined before any attempt at grading, and grading should not be used on tumors of intermediate malignancy such as atypical fibroxanthoma and on some sarcomas such as dedifferentiated liposarcoma. However, grading is useful in more than 90% of adult soft tissue sarcomas and has been adapted to pediatric nonrhabdomyosarcomatous sarcomas. Current grading is not suitable for core needle biopsies.
Objective.—To review the current value and limitations of histologic grading in soft tissue sarcomas.
Data Sources.—The reviews on grading and original studies on prognostic factors in soft tissue sarcomas were analyzed.
Conclusions.—Grading is the best predictor of metastasis outcome in adult soft tissue sarcomas and should be part of the pathologic report. Grading should be adapted to the modern management of patients and complemented by radiologic and molecular parameters.
Rhabdomyosarcomas in Adults and Children: An Update
Authors: Parham David M. , Ellison Dale A. 
Published: February 2021

AbstractContext.—Rhabdomyosarcomas comprise a relatively common diagnostic entity among childhood cancers and a relatively rare one among adult tumors. They may possess a variety of histologies that generally differ among age groups. These lesions appear to be separate biologic entities as well as morphologic categories, with embryonal tumors having genetic lesions related to loss of heterozygosity and aberrant parental imprinting, alveolar tumors containing genetic fusions between PAX and forkhead genes, and pleomorphic tumors showing an accumulation of genetic lesions similar to other adult high-grade sarcomas.Objective.—To present guidelines for diagnosis of rhabdomyosarcoma and recent finding concerning the biology and classification of these lesions.Data Sources.—Review of recent and older published literature and distillation of the authors' experience.Conclusions.—Infants and young children tend to have embryonal rhabdomyosarcomas, adolescents and young adults tend to have alveolar rhabdomyosarcomas, and older adults tend to have pleomorphic rhabdomyosarcomas, although there is some overlap. Newer rare entities, including spindle cell rhabdomyosarcoma and sclerosing rhabdomyosarcoma, have been described in children and adults. Fusion-positive tumors have a distinct molecular signature with downstream activation of a number of myogenic and tumorigenic factors. Genetic testing may be successfully used for diagnosis and may guide therapy in future clinical trials. Differential diagnosis has become simpler than in previous years, because of use of myogenic factors in immunohistochemistry, but classification based solely on histologic features remains challenging.
Lymphomas Involving the Pleura: A Clinicopathologic Study of 34 Cases Diagnosed By Pleural Biopsy
Authors: Vega Francisco , Padula Anthony , Valbuena Jose R. , Stancu Mirela , Jones Dan , Medeiros L. Jeffrey 
Published: February 2021

Abstract
Context.—Pleural involvement by lymphoma is relatively common. However, there are very few clinicopathologic studies reported in the literature of lymphomas involving the pleura.
Objective.—To characterize the clinicopathologic features of lymphomas involving the pleura.
Design.—We reviewed the clinicopathologic features of 34 patients with lymphoma involving the pleura proven by biopsy and classified these neoplasms using the World Health Organization classification.
Results.—There were 22 men and 12 women, with an average age of 62 years (range, 22–82 years). Nine (26.5%) patients had pleural involvement as the only site of disease, 22 (64.7%) had other sites of involvement, and 3 (8.8%) had inadequate staging data. Eighteen (56.2%) of 32 patients with adequate clinical data had a history of lymphoma (including 3 patients with pleural involvement as the only disease site). In 29 (85.3%) cases, a specific diagnosis according to the World Health Organization classification could be made: 17 (58.6%) diffuse large B-cell lymphoma, 5 (17.2%) follicular lymphoma (including a case with areas of diffuse large B-cell lymphoma), 2 (6.9%) small lymphocytic lymphomas/chronic lymphocytic leukemia, 2 (6.9%) precursor T-cell lymphoblastic lymphoma/leukemia, 1 (3.4%) mantle cell lymphoma, 1 (3.4%) posttransplant lymphoproliferative disorder, and 1 (3.4%) classical Hodgkin lymphoma. The other 5 cases were B-cell lymphomas that could not be further classified. Cytologic examination of pleural fluid was performed in 15 cases and was positive for lymphoma in 8 (53.3%) cases.
Conclusions.—Most patients with lymphoma involving the pleura have simultaneous evidence of systemic involvement. The most frequent type is diffuse large B-cell lymphoma, followed by follicular lymphoma. Cytologic examination can have negative results in patients with pleural involvement by lymphoma.
Mucinous Expression in Benign and Neoplastic Glandular Lesions of the Uterine Cervix
Authors: Baker Allyson C. , Eltoum Isam , Curry Rebecca O. , Stockard Cecil R. , Manne Upender , Grizzle William E. , Chhieng David 
Published: February 2021

Abstract
Context.—Mucins are glycoproteins produced by both normal and neoplastic glandular epithelial cells including endocervix.
Objective.—To determine the expression of mucins in uterine cervical glandular lesions and whether mucin expression correlates with the nature and origin of the glandular lesions.
Design.—Antibodies to MUC1, MUC2, MUC4, and MUC5AC were applied on 52 cases including 14 endocervical adenocarcinomas (including 4 adenosquamous carcinomas), 9 endometrial carcinomas (8 endometrioid adenocarcinomas and 1 adenosquamous carcinoma), 8 adenocarcinoma in situ (AIS), 2 glandular dysplasias, 6 tubal metaplasias, 10 microglandular hyperplasias, and 3 normal endocervix. The presence of any staining was considered positive.
Results.—All benign endocervical epithelia, including tubal metaplasia and microglandular hyperplasia, expressed MUC1, MUC4, and MUC5AC but not MUC2. Almost all endocervical AIS and carcinomas and all endometrial adenocarcinomas expressed MUC1; the exceptions were 2 cases of endocervical adenocarcinoma and 1 case of adenosquamous carcinoma of the endocervix. MUC2 staining was noted in 25%, 40%, and 22% of AIS, endocervical adenocarcinomas, and endometrial adenocarcinomas, respectively. About 38% of AIS, 75% of endocervical adenocarcinomas, and 44% of endometrial adenocarcinomas expressed MUC4. Half of AIS, most of endocervical adenocarcinomas, and 22% of endometrial adenocarcinomas expressed MUC5AC. The difference in MUC4 and MUC5AC expression between benign endocervical lesions and AIS and the difference in MUC5AC expression between endocervical and endometrial neoplasms were statistically significant.
Conclusions.—Mucin expressions differed among benign endocervical lesions and AIS and among endocervical and endometrial malignancies. These results suggest that mucin staining may potentially be helpful in differentiating various uterine cervical glandular lesions.
Expression of the Intestinal Transcription Factor CDX2 in Carcinoid Tumors Is a Marker of Midgut Origin
Authors: Jaffee Ian M. , Rahmani Mahdis , Singhal Maria G. , Younes Mamoun 
Published: February 2021

Abstract
Context.—Carcinoid tumors are classified according to their site of origin into foregut, midgut, or hindgut carcinoids, which have different presentations and prognosis. The intestinal transcription factor CDX2 has been found to be expressed in most intestinal adenocarcinomas but in less than one half of the gastrointestinal carcinoids according to 1 study.
Objective.—To determine whether CDX2 expression in carcinoid tumors varies by the site of origin and whether CDX2 expression is retained in metastatic disease.
Design.—Sections of formalin-fixed and paraffin-embedded tissue from 36 primary carcinoid tumors and 5 cases of metastatic carcinoid to the liver were immunohistochemically stained for CDX2. The percent of cells with nuclear immunoreactivity and the intensity of staining were assessed.
Results.—All 18 foregut carcinoids (10 pulmonary and 8 gastric) were negative (0%) for CDX2. All 11 midgut carcinoids (100%) were positive for CDX2 with moderate to strong staining in more than 50% of the cells. Only 2 (29%) of 7 of hindgut carcinoids were CDX2-positive with the 2 positive cases showing weak to moderate staining intensity in less than 10% of the cells. Expression of CDX2 in more than 50% of tumor cells was seen only in midgut carcinoids (P &lt; .001). CDX2 expression in metastatic tumors was consistent with the site of origin.
Conclusions.—Midgut carcinoid tumors and their metastases are distinct from foregut and hindgut carcinoids in that they express high levels of CDX2. Additional studies are needed to determine whether CDX2 immunostaining may be helpful in determining the primary site of metastatic carcinoid tumors of unknown origin.
Subinvolution of the Placental Site as an Anatomic Cause of Postpartum Uterine Bleeding: A Review
Authors: Weydert Jamie A. , Benda Jo Ann 
Published: February 2021

Abstract
Context.—Subinvolution of the placental site is an anatomic cause of delayed postpartum uterine bleeding that may be underrecognized by general surgical pathologists.
Objective.—To review the physiology of uteroplacental arterial development and normal postpartum involution, and to present the characteristic clinical and histopathologic features of subinvolution.
Data Sources.—Literature review (MEDLINE via PubMed and Ovid) regarding the pathology and pathophysiology of placental site subinvolution. Review of the clinical and pathologic characteristics of our own institution's previously diagnosed cases of subinvolution from hysterectomy and endomyometrial curettage specimens.
Conclusions.—Surgical pathologists must be aware of the cardinal histopathologic findings of subinvolution, and this diagnosis must be considered in every postpartum curettage or hysterectomy specimen presented to the surgical pathologist. Subinvolution of the placental site is an important diagnosis, as this process implies an idiopathic cause, rather than an iatrogenic cause, of postpartum uterine bleeding. The etiology of placental site subinvolution remains poorly characterized.
Primary Angiosarcoma of the Bladder
Authors: Seethala Raja R. , Gomez Jose A. , Vakar-Lopez Funda 
Published: February 2021

Abstract
Context.—Primary bladder angiosarcomas are extremely rare, and their clinical and pathologic features are not well described.
Objective.—To further refine the clinical features of primary bladder angiosarcomas and define their pathologic spectra.
Data Sources.—Relevant sources were identified using MEDLINE and a subsequent bibliographic search of all pertinent reports and reviews. We also searched the M. D. Anderson pathology archives.
Study Selection.—After excluding 4 cases that likely secondarily involved the bladder, we identified 9 true primary bladder angiosarcomas.
Data Extraction.—Data were extracted on the following: demographics, clinical presentation, predisposing factors, gross pathology, microscopic pathology, immunophenotype, therapy, and outcomes.
Data Synthesis.—Primary bladder angiosarcomas were found at a mean age of 64.2 years, with a male-female ratio of 8:1. Two cases arose in a postirradiation setting. Primary bladder angiosarcomas typically presented with hematuria and were grossly hemorrhagic, raised masses (mean size, 6.7 cm) of the trigone and/or dome. Histologically, most showed classic anastomosing channels lined by plump hyperchromatic cells, though many showed variant histology such as solid growth and epithelioid cytology. Three (43%) of 7 patients died within a year, but only 1 patient died with evidence of disease. The remaining patients were alive at the time of publication of their respective cases (mean, 22 months).
Conclusions.—Primary angiosarcomas of the bladder are typically rare tumors of middle-aged and elderly men that present with locally advanced disease and show a wide histologic spectrum. However, their prognosis may be better than previously thought.
Hamartomatous Polyps of the Colon: Ganglioneuromatous, Stromal, and Lipomatous
Authors: Chan Owen T. M. , Haghighi Parviz 
Published: February 2021

Abstract
Intestinal ganglioneuromas comprise benign, hamartomatous polyps characterized by an overgrowth of nerve ganglion cells, nerve fibers, and supporting cells in the gastrointestinal tract. This polyposis has been divided into 3 subgroups, each with a different degree of ganglioneuroma formation: polypoid ganglioneuroma, ganglioneuromatous polyposis, and diffuse ganglioneuromatosis. The ganglioneuromatous polyposis subgroup is not known to coexist with systemic disorders that often have an associated intestinal polyposis, such as multiple endocrine neoplasia type IIb, neurofibromatosis type I, and Cowden syndrome. We report a case of ganglioneuromatous polyposis plus cutaneous lipomatosis in a 41-year-old man with no established systemic disease. However, he possessed unique anatomic findings in addition to his ganglioneuromatosis, suggesting that the ganglioneuromatosis-lipomatosis in our patient may represent an unrecognized syndrome. This case report and brief review of the literature provide an overview of intestinal ganglioneuromatosis in relation to the hereditary polyposis syndromes and describe the individual ganglioneuromatosis subgroups.
Distinguishing Carcinoid Tumor of the Mediastinum From Thymoma: Correlating Cytologic Features and Performance in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology
Authors: Renshaw Andrew A. , Haja Jennifer C. , Neal Margaret H. , Wilbur David C. 
Published: February 2021

Abstract
Context.—The cytologic features of carcinoid tumor in mediastinal fine-needle aspiration are well described. Nevertheless, this tumor may be difficult to distinguish from thymoma in this site.
Objective.—We sought to correlate the cytologic features of carcinoid tumor of the mediastinum in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology with the frequency of misclassification as thymoma.
Design.—We reviewed 446 interpretations from 18 different cases of carcinoid tumor in mediastinum and correlated the cytologic features with performance.
Results.—Cases were more frequently classified as thymoma (158 responses, 35%) than as carcinoid tumor (126 responses, 28%). The best-performing case was classified as carcinoid tumor only 56% of the time. Three cytologic patterns were identified. Four cases consisted of isolated round cells with salt-and-pepper chromatin. Four cases consisted of isolated spindle and round cells with salt-and-pepper chromatin. The remaining 10 cases consisted of cohesive fragments of crowded cells with finely granular chromatin showing numerous pyknotic cells mimicking lymphocytes. Prominent vasculature patterns were not a feature of any of the cases. There was no correlation between any pattern and the rate of classification as carcinoid tumor or thymoma (P &gt; .05).
Conclusions.—Carcinoid tumor of the mediastinum is frequently misclassified as thymoma in this program. Although some cytologic patterns resemble thymoma, the lack of correlation of these patterns with performance suggests that at least part of the reason for misclassification may be failure to consider the correct diagnosis or a lack of familiarity with discriminating cytologic criteria.
Extensively Necrotic Retinoblastoma Is Associated With High-Risk Prognostic Factors
Authors: Chong Eva-Marie , Coffee Robert E. , Chintagumpala Murali , Hurwitz Richard L. , Hurwitz Mary Y. , Chévez-Barrios Patricia 
Published: February 2021

Abstract
Context.—Retinoblastoma is the most common malignant intraocular tumor in children. It has been shown that adjuvant therapy following enucleation in patients with high-risk histopathologic features significantly decreases the mortality. We describe the association of extensive necrosis of tumor and intraocular structures with 2 of the major risk factors: optic nerve invasion and choroidal invasion. This may alert the pathologist who makes the observation of extensive necrosis to carefully search for histologic features associated with adverse outcome.
Objective.—To determine whether extensively necrotic retinoblastoma is associated with high-risk histologic prognostic factors for metastatic disease and patient survival.
Design.—Retrospective case series. Forty-three eyes of 43 patients with retinoblastoma who underwent enucleation between 1990 and 2001 were evaluated. Medical records, histopathology specimens, pathology reports, and clinical photographs were reviewed. Tumors were designated as exhibiting extensive necrosis if more than 95% of tumor cells and intraocular tissues were necrotic. The main outcome measure was the association of extensive tumor necrosis with 3 high-risk histopathologic features: extraocular extension, optic nerve invasion, or choroidal invasion. Metastatic disease, patient survival, and associations with pathologic findings were also analyzed.
Results.—Optic nerve head invasion (P &lt; .001), post-lamina-cribrosal invasion (P &lt; .001), and choroidal invasion by tumor (P = .004) were observed more frequently in eyes with extensive necrosis compared with eyes without extensive necrosis. Two of the 11 patients with extensively necrotic intraocular retinoblastoma died from metastatic disease (P = .06). None of the 32 patients without extensive necrosis developed metastatic disease or died.
Conclusions.—Extensive ocular tissue and tumor necrosis is associated with histologic high-risk prognostic factors for tumor metastasis and mortality.