bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case of Small Polypoid Esophageal Carcinoma With Multidirectional Differentiation, Including Neuroendocrine, Squamous, Ciliated Glandular, and Sarcomatous Components
Authors: Kanamoto Akira , Nakanishi Yukihiro , Ochiai Atsushi , Shimoda Tadakazu , Yamaguchi Hajime , Tachimori Yuji , Kato Hoichi , Watanabe Hiroshi 
Published: January 2021

Abstract
A small composite esophageal carcinoma measuring 1.5 × 1.4 × 1.0 cm is described. The tumor had a polypoid elevation with a superficial extension. Histologic examination revealed invasion of the submucosal layer and multidirectional differentiation, including neuroendocrine, squamous, ciliated glandular, and sarcomatous components. The neuroendocrine component was strongly positive for chromogranin and formed the bulk of the polypoid tumor. The squamous cell carcinoma exhibited a superficial extension. The adenocarcinoma was located in a small region of the tumor and contained ciliated glandular cells. The spindle cell sarcomatous component, which was positive for α-smooth muscle actin and negative for cytokeratin, exhibited no specific mesenchymal differentiation. Each component was found in 60%, 10%, 5%, and 25% of the tumor, respectively. Cases of small composite esophageal carcinoma containing various carcinomatous and sarcomatous components are extremely rare.
Cholangiocarcinoma Occurring in a Liver With Multiple Bile Duct Hamartomas (von Meyenburg Complexes)
Authors: Röcken C. , Pross M. , Brucks U. , Ridwelski K. , Roessner A. 
Published: January 2021

Abstract
A 59-year-old woman presented with epigastric pain and weight loss. Ultrasound, computed tomography, and magnetic resonance imaging scans of the abdomen showed a tumor in segments 6 and 7 of the right liver lobe, measuring 8 cm in greatest diameter. The tumor was subsequently resected, and histopathology showed a poorly differentiated adenocarcinoma immunoreactive for CA 19-9 and cytokeratin 19. In the absence of any other clinically detectable primary tumor, the lesion was diagnosed as a peripheral intrahepatic cholangiocarcinoma. In addition, multiple bile duct hamartomas were found in the surrounding parenchyma. The tumor was unrelated to Caroli disease, primary sclerosing cholangitis, ulcerative colitis, or nonbiliary cirrhosis, as demonstrated by further clinical and histopathologic investigations, but probably was associated with the presence of multiple bile duct hamartomas. To our knowledge, this is the eighth reported case of a cholangiocarcinoma associated with multiple bile duct hamartomas.
Atypical Hairy Cell Leukemia
Authors: Wu Mark L. , Kwaan Hau C. , Goolsby Charles L. 
Published: January 2021

AbstractThe morphologic differential diagnosis of mature B-cell neoplasms with cytoplasmic projections includes splenic lymphoma with villous lymphocytes and hairy cell leukemia. Although the classification of hairy cell leukemia is not universally recognized, 3 variants have been described, namely, classic, variant, and Japanese variant, each of which has different clinical and immunophenotypic features. Classic hairy cell leukemia is virtually always CD11c+, CD25+, and CD103+. Variant and Japanese variant hairy cell leukemias are usually CD11c+, always CD25−, and occasionally CD103+. Each variant is characteristically CD10−. We present a case of hairy cell leukemia with a unique immunoprofile in that the cells were CD10+, CD25+, and CD103−, and we review the criteria helpful in differentiating “hairy” B-cell neoplasms. This case emphasizes the variability of hairy cell leukemia and the need to correlate all clinical and pathologic data in reaching a diagnosis.
Pathologic Evaluation of Sentinel Lymph Nodes in Colorectal Carcinoma
Authors: Wiese David A. , Saha Sukamal , Badin Julio , Ng Peter S-T. , Gauthier Jerry , Ahsan Aamir , Yu Lelia 
Published: January 2021

Abstract
Background.—The identification of lymph node metastases in colorectal resection specimens is necessary for accurate tumor staging. However, routine lymph node dissection by the pathologist yields only a subset of nodes removed surgically and may not include those nodes most directly in the path of lymphatic drainage from the tumor. Intraoperative mapping of such sentinel lymph nodes (SLNs) has been reported in cases of melanoma and breast cancer. We applied a similar method to cases of colorectal carcinoma, with emphasis on the pathology of the SLNs.
Methods.—Eighty-three consecutive patients with colorectal carcinoma were evaluated after intraoperative injection of 1 to 2 mL of 1% isosulfan blue dye (Lymphazurin) into the peritumoral subserosa. Blue-stained lymph nodes were suture-tagged by the surgeon within minutes of the injection for identification by the pathologist, and a standard resection was performed. Designated SLNs were sectioned at 10 levels through the block; a cytokeratin immunostain (AE1) was also obtained. To evaluate the possibility that increased detection of metastases in the SLN might be solely due to increased histologic sampling, all initially negative non-SLNs in the first 25 cases were sectioned also at 10 levels.
Results.—Sentinel lymph nodes were identified intraoperatively in 82 (99%) of 83 patients and accounted for 152 (11.9%) of 1275 lymph nodes recovered, with an average of 1.9 SLNs per patient. A total of 99 positive lymph nodes (38 positive SLNs and 61 positive non-SLNs) were identified in 34 node-positive patients. The SLNs were the only site of metastasis in 17 patients (50%), while 14 patients (41%) had both positive SLNs and non-SLNs. Three patients (9%) had positive non-SLNs with negative SLNs, representing skip metastases. In patients with positive SLNs, 91 (19%) of 474 total lymph nodes and 53 (12%) of 436 non-SLNs were positive for metastasis. In patients with negative SLNs, 8 (1%) of 801 total lymph nodes and 8 (1.2%) of 687 non-SLNs were positive for metastasis. Multilevel sections of 330 initially negative non-SLNs in the first 25 patients yielded only 2 additional positive nodes (0.6%). All patients with positive SLNs were correctly staged by a combination of 4 representative levels through the SLN(s) together with a single cytokeratin immunostain.
Conclusions.—Intraoperative mapping of SLNs in colorectal carcinoma identifies lymph nodes likely to contain metastases. Focused pathologic evaluation of the 1 to 4 SLNs so identified can improve the accuracy of pathologic staging.
M30 Expression Demonstrates Apoptotic Cells, Correlates With In Situ End-Labeling, and Is Associated With Ki-67 Expression in Large Intestinal Neoplasms
Authors: Carr Norman John 
Published: January 2021

Abstract
Context.—The monoclonal antibody M30 recognizes a neoepitope of cytokeratin 18 produced during apoptosis. It is reactive in formalin-fixed, paraffin-embedded tissue and has great potential in the study of apoptosis in clinical and experimental material.
Objectives.—To compare the results of M30 immunoexpression with a more established technique of demonstrating apoptosis in tissue sections, in situ end-labeling. A secondary objective was to compare the results with immunoexpression of the proliferation-associated antigen Ki-67.
Design.—Retrospective analysis of adenomas and adenocarcinomas of the large intestine.
Interventions.—Immunohistochemistry for M30 and Ki-67, and in situ end-labeling. Formalin-fixed, paraffin-embedded tissue was used.
Main Outcome Measures.—The number of cells positive for M30, Ki-67, and in situ end-labeling, expressed as a proportion of the total number of cells counted.
Results.—A strong positive correlation was found between in situ end-labeling and expression of M30, although the counts were widely scattered around the regression line. Counts of Ki-67 were strongly correlated with both M30 expression and in situ end-labeling. Immunoexpression of M30 was generally easier to interpret than in situ end-labeling, and the procedures for M30 immunohistochemistry were technically less exacting.
Conclusion.—These findings support the application of M30 immunoreactivity in the study of apoptosis.
CD13-Positive Anaplastic Large Cell Lymphoma of T-Cell Origin—A Diagnostic and Histogenetic Problem
Authors: Popnikolov Nikolay K. , Payne Deborah A. , Hudnall S. David , Hawkins Hal K. , Kumar Manjusha , Norris Brent A. , Elghetany M. Tarek 
Published: January 2021

Abstract
The expression of myelomonocytic-associated antigens in anaplastic large cell lymphomas (ALCLs), particularly those presenting in extranodal sites, can make their distinction from extramedullary myeloid cell tumors (EMCTs) or histiocytic tumors problematic. Yet, this distinction is clinically significant because of its therapeutic and prognostic implications. Herein, we describe a case of extranodal anaplastic lymphoma kinase–positive CD30-positive ALCL of T-cell origin in a 12-year-old boy, which was initially called an EMCT because of the expression of CD13 and HLA-DR detected by flow cytometry and the absence of other T-cell–related surface markers. However, the detection of cytoplasmic CD3 by flow cytometry prompted further studies. The tumor was composed of large cells with abundant slightly eosinophilic vacuolated cytoplasm and ovoid or reniform nuclei with a few small nucleoli. Using immunohistochemistry, the tumor was positive for CD45, CD30, CD45RO, and CD43 with a strong cytoplasmic and nuclear anaplastic lymphoma kinase stain. The tumor cells showed a T-cell clonal genotype. Electron microscopy revealed no ultrastructural features of myelomonocytic or histiocytic origin. The patient responded well to the chemotherapy and was in complete remission for 10 months at the time of submission of this manuscript. Review of the literature showed inconsistencies regarding the diagnosis, nomenclature, and, therefore, treatment and prognosis of these tumors. In addition, the CD13 expression in ALCL raises some histogenetic questions and may indicate origin from a pluripotent stem cell, misprogramming during malignant transformation, or a microenvironmental effect on lymphoid cell expression of surface antigens. Therefore, ALCL should be considered in the differential diagnosis of EMCTs or histiocytic tumors, particularly when surface marker lineage assignment is ambiguous.
Primary Nodal Marginal Zone B-Cell Lymphoma Arising From More Than One Clonal Neoplastic Population
Authors: Finch Clara N. , Nichols Margaret , Shrimpton Antony , Liu Dating , Hutchison Robert E. 
Published: January 2021

Abstract
Primary nodal marginal zone B-cell lymphoma is an uncommon monoclonal B-cell lymphoproliferative disorder. We report a case of a 79-year-old woman who presented with generalized lymphadenopathy. Histologic and immunohistochemical examinations of biopsy sections from an axillary lymph node were consistent with nodal marginal zone B-cell lymphoma. Flow cytometry analysis showed 2 distinct clonal B-cell populations expressing λ or κ light chain restriction. Subsequently, genomic deoxyribonucleic acid (DNA) isolated from a paraffin-embedded lymph node section was analyzed for the presence of gene rearrangements. Polymerase chain reaction (PCR) analysis of immunoglobulin heavy chain genes revealed 3 rearranged DNA bands, confirming the presence of more than one clonal B-cell population. These immunophenotypic and genotypic findings have not been previously described in association with this type of lymphoma. To our knowledge, this represents the first reported case of biclonal nodal marginal zone B-cell lymphoma.
Comparative Genomic Hybridization
Authors: Barrett Irene J. , Lomax Brenda L. , Loukianova Tatiana , Tang Steven S. , Lestou Valia S. , Kalousek Dagmar K. 
Published: January 2021

Abstract
Objective.—To demonstrate the effectiveness of comparative genomic hybridization (CGH) for analysis of reproductive pathology specimens in clinical cytogenetics laboratories.
Design.—A total of 856 CGH analyses were performed on various placental and fetal tissues derived from 368 specimens of spontaneous abortions and on placentas from 219 pregnancies with live-born infants. The live-born infants were clinically evaluated as normally developed, with either a normal birth weight or with intrauterine growth restriction; some live-born infants had an abnormal prenatal triple screen with normal cytogenetic results on amniotic fluid cell cultures.
Results.—Comparative genomic hybridization analysis was successfully performed on 856 samples from spontaneously aborted specimens and term placentas. Failure of analysis occurred in 1.6% of samples and was due to an insufficient amount of tissue for DNA extraction. Comparative genomic hybridization identified aneuploidy in 53% of spontaneous abortion samples and 3.1% of term placentas.
Conclusions.—Comparative genomic hybridization analysis is a useful clinical tool for detection of aneuploidy in placental and fetal tissues. It provides a genome-wide screen while eliminating tissue culture failures, culture artifacts, and maternal cell contamination. We present practical guidelines for interpreting CGH profiles derived from human reproductive specimens.
The PlA Polymorphism of Glycoprotein IIIa Functions as a Modifier for the Effect of Estrogen on Platelet Aggregation
Authors: Boudoulas Konstantinos D. , Cooke Glen E. , Roos Christine M. , Bray Paul F. , Goldschmidt-Clermont Pascal J. 
Published: January 2021

Abstract
Background.—Although estrogen has been shown to contribute to retardation of the development of coronary heart disease in premenopausal women, the efficacy of hormone replacement therapy for coronary heart disease prevention in women with established coronary heart disease remains controversial. Hence, additional research is needed to clarify the effects of hormone replacement therapy on the cardiovascular and clotting systems. We investigated the effect of estrogen on platelet aggregation induced by standard agonists (epinephrine and adenosine diphosphate), with and without the platelet antagonist aspirin. Furthermore, we analyzed our data according to the presence or absence of a prevalent polymorphism of the glycoprotein (GP) IIIa subunit of the platelet fibrinogen receptor GPIIb-IIIa, PlA2.
Methods and Results.—The effect of estrogen on aggregation of platelets was studied in healthy men (n = 20, 10 PlA1/A1 and 10 PlA1/A2) and premenopausal healthy women (n = 10, 5 PlA1/A1 and 5 PlA1/A2). The PlA1/A1 and PlA1/A2 individuals were matched for age and race. Platelet response to agonists was investigated in the presence of (1) estrogen (10−11 to 10−8 mol/L), (2) aspirin (0.056 to 56 μmol/L), (3) estrogen plus aspirin, and (4) estrogen plus ICI 182 780 (ICI, 10−9 mol/L, an inhibitor of the estrogen receptor). We found that physiologic concentrations of estrogen strongly and significantly inhibited the aggregation of PlA1/A2 platelets (P ;lt .005 for epinephrine and P ;lt .05 for adenosine diphosphate, induced aggregation, respectively) in both men and women. Concentrations of estrogen that were 1000-fold greater were required to observe the same level of inhibition with PlA1/A1 platelets. In the presence of aspirin, estrogen failed to provide additional inhibitory effect on aggregation of both PlA1/A1 and PlA1/A2 platelets. The estrogen-specific inhibitor ICI blocked the effect of estrogen on aggregation, suggesting that this effect is mediated by the estrogen receptor.
Conclusions.—Estrogen inhibits the aggregation of platelets, but such inhibition is highly dependent on the presence or absence of the PlA2 polymorphism of GPIIIa. However, in the presence of aspirin, the inhibitory effect of estrogen on aggregation was no longer detectable.
Use of Buccal Cells Collected in Mouthwash as a Source of DNA for Clinical Testing
Authors: Heath Ellen M. , Morken Nathaniel W. , Campbell Kristen A. , Tkach Dennis , Boyd Erin A. , Strom Daniel A. 
Published: January 2021

Abstract
Context.—To maximize the participation rate in population genetic studies, alternatives to invasive whole blood collection are increasing. One such alternative is buccal epithelial cell collection, which, in contrast to venipuncture and finger sticks, is painless. Buccal cells, if collected and purified efficiently, offer an acceptable source for DNA to be used in research and clinical applications.
Objective.—To develop a noninvasive sampling method for collecting cells for routine DNA testing in a clinical laboratory setting.
Design.—Five factors were used to evaluate several brands of mouthwash: (1) compatibility with the DNA purification chemistry, (2) DNA yield, (3) DNA quality, (4) DNA stability at room temperature, and (5) mouthwash taste. Next, an optimization study was undertaken to maximize DNA yield. Finally, a validation study was undertaken with the optimized protocol to test a panel of 14 donors for DNA yield and performance and to test for the stability of DNA held in mouthwash.
Setting.—Industrial research and development laboratory.
Results.—Of 5 mouthwashes tested, Scope brand mouthwash received the highest overall ranking. The addition of proteinase K and glycogen to the protocol significantly enhanced DNA yields, with a test panel (n = 14) giving a range of 12 to 60 μg of DNA per donor. In a 4-week room temperature stability study, the DNA in mouthwash samples was found to be stable for at least 2 weeks.
Conclusion.—A clinically validated DNA purification chemistry was adapted to a noninvasive specimen collection method. This method used a commercially available mouthwash, Scope, to collect buccal epithelial cells for the preparation of high-quality DNA in high yield.
Primary Leiomyosarcoma of the Pancreas
Authors: Nesi Gabriella , Pantalone Desiree , Ragionieri Ilaria , Amorosi Andrea 
Published: January 2021

AbstractPrimary leiomyosarcoma of the pancreas is a rare tumor for which only 21 reports appear in the world literature. We describe an additional case of pancreatic leiomyosarcoma in a 76-year-old man, who complained of persistent high fever. Histologic examination revealed a pleomorphic spindle cell tumor. Reactivity for muscle-specific actin, α-smooth muscle actin, and basement membrane components, along with negative staining for epithelial and neural markers, were consistent with a smooth muscle sarcoma. The patient died of disease 1 year after complete surgical excision. This report highlights the need to use a complete antibody panel in order to accurately immunophenotype pleomorphic malignant tumors of the pancreas. A review of the cases compiled in the literature indicates that pancreatic leiomyosarcoma, like its counterpart arising in deep soft tissues, is an aggressive neoplasm characterized by short survival and a high rate of metastases.
Immunostaining for Thyroid Transcription Factor 1 and Cytokeratin 20 Aids the Distinction of Small Cell Carcinoma From Merkel Cell Carcinoma, But Not Pulmonary From Extrapulmonary Small Cell Carcinomas
Authors: Cheuk W. , Kwan M. Y. , Suster Saul , Chan John K. C. 
Published: January 2021

AbstractObjective.—To study the expression of thyroid transcription factor 1 (TTF-1) and cytokeratin 20 (CK20) in pulmonary small cell carcinomas, extrapulmonary small cell carcinomas, and Merkel cell carcinomas, and thereby determine whether these markers are helpful in distinguishing these 3 groups of small cell neuroendocrine carcinomas.Materials and Methods.—Immunostaining for TTF-1 and CK20 was performed in 102 cases of small cell carcinoma (pulmonary, 52; extrapulmonary, 50) and 23 cases of Merkel cell carcinoma. The results for the 3 groups were compared.Results.—Thyroid transcription factor 1 was expressed in 82.7% of pulmonary small cell carcinomas, 42.0% of extrapulmonary small cell carcinomas (range, 33.3–53.3% for the various sites), and 0% of Merkel cell carcinomas. Cytokeratin 20 staining was consistently negative in pulmonary small cell carcinomas, and positive in 4.0% of extrapulmonary small cell carcinomas and 100% of Merkel cell carcinomas.Conclusions.—Immunostaining for TTF-1, especially when combined with immunostaining for CK20, can aid in the distinction between Merkel cell carcinoma and small cell carcinoma (both pulmonary and extrapulmonary). However, in individual cases, these markers cannot be used to distinguish between pulmonary and extrapulmonary small cell carcinomas due to the extensive overlap in immunophenotypes.
Distance of Lymph Nodes From the Tumor
Authors: Cserni Gábor , Tarján Miklós , Bori Rita 
Published: January 2021

Abstract
Context.—The nodal stage of colorectal cancers is prognostically important. Most current staging guidelines concentrate on the minimum number of evaluated lymph nodes required for an adequate node-negative stage.
Objective.—To evaluate the distance of the lymph nodes from the primary tumors as a possible qualitative feature that could help pathologists select between these nodes.
Design.—Prospective analysis of 100 colorectal carcinoma specimens.
Setting.—Department of Pathology of a medium-sized teaching hospital.
Patients.—Consecutive patients with colorectal cancer.
Interventions.—Nodes abluminal from the tumor and the adjacent bowel segments were recovered in 4 fractions (A through D) in 100 colorectal carcinoma specimens.
Main Outcome Measures.—Distribution of metastatic nodes in fractions A through D, and their influence on nodal stage.
Results.—All tumors but 1 were classified correctly as node-negative or node-positive on the basis of fraction A (nodes abluminal from the tumor and from the 1-cm-long segments proximal and distal to the tumor). All tumors but 1 were appropriately classified as pN0, pN1, or pN2 on the basis of fractions A and B (nodes abluminal from the tumor and from the 3-cm-long segments proximal and distal to the tumor).
Conclusions.—Lymph nodes should be recovered from fractions A and B, and if 3 nodes are reported positive, additional nodes should be sought to determine the extent of nodal involvement. This qualitative restriction of the grossing protocol may reduce the time spent in recovering nodes from colorectal carcinoma resection specimens.
Xanthogranulomatous Salpingitis and Oophoritis
Authors: Gray Yulia , Libbey N. Peter 
Published: January 2021

Abstract
A case of xanthogranulomatous salpingitis and oophoritis in a 47-year-old woman is presented. Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to affected organs; it is characterized by the presence of lipid-filled macrophages with admixed lymphocytes, plasma cells, and neutrophils. Only a few cases of xanthogranulomatous salpingitis and oophoritis have been reported to date. The case presented here is associated with Escherichia coli infection, endometriosis, and an intrauterine device.
A Practical Approach for Evaluating New Antibodies in the Clinical Immunohistochemistry Laboratory
Authors: Hsi Eric D. 
Published: January 2021

Abstract
Paraffin section immunohistochemistry (IHC) is widely used in diagnostic surgical pathology. Today, it is difficult to imagine the practice of surgical pathology without IHC. The availability of automated immunostainers with reagent rental contracts makes this technology commonplace. One potential danger is that many laboratories are now offering immunostains without significant prior knowledge or experience in IHC. As part of its mission, the Cell Markers Committee of the College of American Pathologists offers this manuscript as a basic guide to introducing new antibodies in the clinical IHC laboratory. Issues relating to regulatory developments, antibody selection, staining optimization, and test validation are addressed.