bluuebunny/crossref_metadata_2025_split huggingface dataset:
Problems and Controversies in the Histopathology of Thyroid Carcinomas of Follicular Cell Origin
Authors: Ghossein Ronald 
Published: February 2021

Abstract
Context.—Despite past and recent efforts, many problems and controversies remain in the classification of thyroid carcinomas of follicular cell origin. These controversies have an impact on the prognosis and therapy of patients with thyroid carcinoma as well as on the development of robust cutting-edge research aimed at better outcome and quality of life.
Objective.—To focus on 3 contentious areas with significant clinical value: the follicular variant of papillary thyroid carcinoma, the extent of invasion in follicular carcinoma, and the poorly differentiated thyroid carcinomas.
Data Sources.—The published English language literature was reviewed.
Conclusions.—Recent data show that prognosis and therapy for many disease entities can be better delineated if a meticulous microscopic examination is performed. An accurate assessment of the extent of invasion (especially vascular) is crucial. Proliferative grading (ie, mitosis and necrosis) is of high prognostic value and should be looked for in every specimen. In addition, molecular data gathered to date can help reassess these tumors at the histologic level. Classification proposals based on personal experience rather than adequate and careful clinical follow-up should be discouraged.
Recommended Principles and Practices for Validating Clinical Molecular Pathology Tests
Authors: Jennings Lawrence , Van Deerlin Vivianna M. , Gulley Margaret L. 
Published: February 2021

AbstractContext.—The use of DNA- and RNA-based tests continues to grow for applications as varied as inherited disease, infectious disease, cancer, identity testing, human leukocyte antigen typing, and pharmacogenetics. Progress is driven in part by the huge growth in knowledge about the molecular basis of disease coupled with advancements in technologic capabilities. In addition to requirements for clinical utility, every molecular test also may have limitations that must be carefully considered before clinical implementation. Analytic and clinical performance characteristics as well as test limitations are established and documented through the process of test validation.Objective.—To describe the established principles of test validation, along with relevant regulations in the United States, in order to provide a rational approach to introducing molecular tests into the clinical laboratory.Data Sources.—PubMed review of published literature, published guidelines, and online information from national and international professional organizations.Conclusions.—These resources and recommendations provide a framework for validating clinical tests.
Number of Lymph Nodes Examined and Associated Clinicopathologic Factors in Colorectal Carcinoma
Authors: Shen Steven S. , Haupt Bisong X. , Ro Jae Y. , Zhu Jijiang , Bailey H. Randoph , Schwartz Mary R. 
Published: February 2021

Abstract
Context.—Nodal metastasis is one of the most important prognostic factors in colorectal carcinoma. The number of lymph nodes recovered and examined in resection specimens has been recently shown to be critical for proper staging and is associated with survival.
Objective.—To assess the clinicopathologic factors that may be associated with the number of lymph nodes harvested from surgical resections.
Design.—Clinicopathologic factors of 434 consecutive cases of colorectal cancers treated by surgical resection from a single tertiary medical center were retrospectively reviewed and correlated with number of lymph nodes recovered.
Results.—Our data show that patient age, tumor location, and length of resected bowel segment were associated with number of lymph nodes harvested in surgical resections of colorectal cancer. The average number of lymph nodes was 18.2 and 17.8 for patients younger than 50 years and aged 50 through 60 years, respectively, whereas it was 14.4, 15.1, and 14.9 for patients aged 61 through 70 years, 71 through 80 years, and 80 years and older, respectively. More lymph nodes were present in resection specimens of cecum/ascending colon and descending colon cancers than in those of transverse colon, sigmoid colon, and rectal cancers. There was a linear increase in number of lymph nodes examined with increasing length of bowel resection specimens. In multivariate regression analysis, the factors that remained independent predictors of removal of 12 or more lymph nodes from resection specimens were tumor location and length of resected bowel segment.
Conclusions.—The number of lymph nodes obtained in resection specimens for colorectal cancer was significantly associated with the length of resected segments of bowel, patient age, and location of the tumor.
Basal-like Breast Carcinoma: From Expression Profiling to Routine Practice
Authors: Rakha Emad , Reis-Filho Jorge S. 
Published: February 2021

Abstract
Context.—Advances in the understanding of the molecular and genetic mechanisms of breast cancer have led to realization of the heterogeneity of the disease and the promise of a new era of individualized management for patients with breast cancer. The advent and use of high-throughput molecular methods for the study of breast cancer have brought to the forefront the existence of the so-called basal-like breast cancers, which have been shown to have distinct biologic and clinical characteristics.
Objective.—To critically assess the clinicopathologic features of basal-like breast cancer, discuss the morphologic and immunophenotypic features of basal-like cancer, and explore the criteria that can be used to identify these tumors in routine practice.
Data Sources.—A Medline/PubMed search was conducted using the terms “basal-like,” “(basal OR basaloid OR basal-like) AND breast cancer.” All articles in English language were retrieved and critically reviewed.
Conclusions.—Basal-like breast cancers constitute a distinct, yet heterogeneous, class of neoplasms associated with specific histologic features and poor prognosis despite high response rates to neoadjuvant chemotherapy. Basal-like breast cancers have features that recapitulate those of tumors arising in BRCA1 mutation carriers, and the majority of patients with BRCA1 germline mutations develop basal-like breast cancers. At the molecular level, basal-like cancers harbor a transcriptome that is distinct from that of hormone-receptor–positive or HER2-amplified tumors, being characterized by the expression of genes usually found in basal/myoepithelial cells of the breast. However, translating the new concepts about basal-like cancer into clinical practice has proven a Herculean task, given the lack of an internationally accepted definition for these tumors and for the method of identification in routine practice.
Histopathologic Risk Factors in Retinoblastoma in India
Authors: Gupta Roshmi , Vemuganti Geeta K. , Reddy Vijay Anand P. , Honavar Santosh G. 
Published: February 2021

AbstractContext.—The presence of histopathologic risk factors is associated with development of metastasis in a patient with retinoblastoma. Adjuvant chemotherapy administered to such patients decreases the risk of metastasis.Objective.—To analyze the incidence of histopathologic risk factors in our patient population and the clinical predictors of such risk factors.Design.—This is a retrospective case series, with review of clinical data and histopathologic slides, in 142 consecutive eyes enucleated for retinoblastoma between 1996 and 2002.Results.—Histopathologic risk factors were present in 54.2% of 142 eyes enucleated for retinoblastoma and included infiltration of iris (7%), ciliary body (9%), choroid (40%), optic nerve lamina cribrosa (11%), retrolaminar optic nerve (17%), optic nerve to the line of transection (8%), sclera (9%), and extrascleral structures (6%). On univariate analysis, histopathologic risk factors correlated with age greater than 24 months at presentation and with glaucoma and iris neovascularization at presentation. On multivariate logistic regression analysis, age greater than 24 months and iris neovascularization correlated with infiltration of the choroid, while iris neovascularization correlated with infiltration of the retrolaminar optic nerve.Conclusion.—Histopathologic risk factors are present in a significant proportion of patients enucleated for retinoblastoma and have identifiable clinical predictors.
Variation of Monosomy 3 Status Within Uveal Melanoma
Authors: Schoenfield Lynn , Pettay James , Tubbs Raymond R. , Singh Arun D. 
Published: February 2021

Abstract
Context.—Determining the most significant prognostic variables in uveal melanoma is important for stratifying patients for metastasis surveillance and possible initiation of chemotherapy or immunotherapy. Monosomy 3, one such variable, can be determined using fluorescence in situ hybridization, either on enucleated samples, fine-needle aspiration biopsy, or tumor sample obtained by vitrector.
Objective.—To evaluate possible regional discordance in chromosome 3 by sites likely to be sampled by different biopsy methods.
Design.—Eighteen consecutive patients with uveal melanoma who underwent primary enucleation were studied. Representative paraffin blocks were selected based on review of hematoxylin-eosin stained sections, and the apex and base of each tumor was demarcated. Unstained paraffin sections, 4 μm in thickness, were prepared, and fluorescence in situ hybridization, looking for monosomy 3, was performed. The chromosomal analysis was also correlated with histologic evaluation for melanoma cell type (spindle vs epithelioid cell), ciliary body involvement, presence of positive periodic acid–Schiff vascular mimicry patterns, scleral or extrascleral spread and size. One case was excluded because of necrosis.
Results.—Ten of the 17 remaining cases (59%) demonstrated monosomy 3 (in either the base or both base and apex of the tumor) with 7 cases (41%) showing disomy. Seven cases (70%) with monosomy 3 demonstrated this in both the apex and the base locations, whereas 3 cases (30%) showed monosomy in one location only (always at the base). Fourteen of the 17 cases (82%) revealed concordance in chromosome 3–monosomy 3 (7 of 14, 50%) or chromosome 3–disomy 3 (7 of 14, 50%). All 3 discordant cases demonstrated the monosomy 3 at the base with disomy at the apex. Lack of concordance between the base and apex did not correlate with melanoma cell type.
Conclusions.—Prognostic variables are important in management of neoplasms, and this study points out that the site of tissue biopsy for prognostication in uveal melanoma could affect the results obtained, at least for the presence of monosomy 3.
Intraocular Lymphoma: Diagnostic Approach and Immunophenotypic Findings in Vitrectomy Specimens
Authors: Raparia Kirtee , Chang Chung-Che(Jeff) , Chévez-Barrios Patricia 
Published: February 2021

AbstractContext.—Diagnosis and classification of primary intraocular lymphoma can be challenging because of the sparse cellularity of the vitreous specimens.Objective.—To classify and clinically correlate intraocular lymphoma according to the World Health Organization (WHO) classification by using vitrectomy specimens.Design.—Clinical history, cytologic preparations, flow cytometry reports, and outcome of 16 patients diagnosed with intraocular lymphoma were reviewed.Results.—The study group included 10 women and 6 men. The mean age of the patients was 63 years (range, 19–79 years). Eleven patients had central nervous system involvement and 6 patients had systemic involvement. All cases were adequately diagnosed and classified according to the WHO classification by using combination of cytologic preparations and 4-color flow cytometry with a limited panel of antibodies to CD19, CD20, CD5, CD10, and κ and λ light chains. The cases included 9 primary diffuse large B-cell lymphomas of the CNS type; 2 diffuse large B-cell lymphomas, not otherwise specified; 1 extranodal, low-grade, marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT); 1 precursor B-lymphoblastic lymphoma; and 3 peripheral T-cell lymphomas, not otherwise specified. Of note, all 11 cases of diffuse large B-cell lymphoma were CD10−. All the patients received systemic chemotherapy and radiation therapy. Only 4 patients were free of disease at last follow-up (range, 18 months to 8 years), with severe visual loss.Conclusions.—Intraocular lymphoma cases can be adequately classified according to the WHO classification. Diffuse large B-cell lymphoma, CD10− and most likely of non–germinal center B-cell–like subgroup, is the most common subtype of non-Hodgkin lymphoma in this site, in contrast to ocular adnexal lymphoma for which MALT lymphoma is the most common subtype.
Bilateral Massive Retinal Gliosis Associated With Retinopathy of Prematurity
Authors: Houston S. K. Steven , Bourne T. David , Lopes M. Beatriz S. , Ghazi Nicola G. 
Published: February 2021

Abstract
Massive retinal gliosis (MRG) is a rare, benign intraocular condition that may develop in association with long-standing eye conditions including chronic inflammation, vascular disorders, glaucoma, trauma, or congenital abnormalities. It is thought to represent a nonneoplastic reactive tissue response to retinal injury. Here, we describe an unusual case of bilateral MRG in association with retinopathy of prematurity. To our knowledge, this may be the first report of such an occurrence. The differential diagnosis of MRG is discussed with specific emphasis on its relationship to vasoproliferative tumor of the retina and presumed acquired retinal hemangiomas. In addition, we hypothesize that MRG, vasoproliferative tumor of the retina, and presumed acquired retinal hemangiomas may represent different phenotypes along a spectrum of the same disease process.
Performance of Candida—Fungal-Induced Atypia and Proficiency Testing: Observations From the College of American Pathologists Proficiency Testing Program
Authors: Moriarty Ann T. , Darragh Teresa M. , Fatheree Lisa A. , Souers Rhona , Wilbur David C. 
Published: February 2021

Abstract
Context.—Candida may elicit cellular changes on otherwise negative screening Papanicolaou tests that may be misinterpreted as atypical squamous cells of undetermined significance. Although these changes have been correctly interpreted in the educational program of the College of American Pathologists, the Interlaboratory Comparison Program in Gynecologic Cytology, the performance of negative slides with Candida faltered when the same field validated slides were included in proficiency testing (PT).
Objective.—To identify the performance differences of negative for intraepithelial lesion (NILM) Candida challenges before and after PT.
Design.—We compare the performance of NILM College of American Pathologists slides with Candida as a single reference diagnosis, prior to PT (1991–2006) and after PT (2006–2007).
Results.—There were 147 186 responses for slides with NILM Candida from the College of American Pathologists programs from 1991 through 2007. After PT, 79.7% of incorrect participant responses identified Candida as Category C (low-grade squamous intraepithelial lesion), whereas prior to PT only 59.5% of the incorrect diagnoses were low-grade squamous intraepithelial lesion (P &lt; .001) in the field-validated component of the program. Validated Candida slides performed significantly more poorly in PT (97.2%) than prior to PT (98.3%) (P &lt; .001). Candida challenges performed better in the educational component post-PT (98.3% versus 97.2%; P &lt; .001). Cytotechnologists (97.9%) identified Candida more frequently than pathologists (97.3%) (P &lt; .001) and ThinPrep preparations performed the best of all preparation types.
Conclusions.—Proficiency testing adversely affects the performance of participants in the identification of NILM Candida. Slides with Candida are more likely to be identified as low-grade squamous intraepithelial lesion in a PT exercise. Misidentification is not due to lack of recognition but most likely an attempt of test takers to optimize their likelihood of passing the examination.
Limited Sampling of Radical Prostatectomy Specimens With Excellent Preservation of Prognostic Parameters of Prostate Cancer
Authors: Kim Kyungeun , Pak Pil June , Ro Jae Y. , Shin Dongik , Huh Soo-Jin , Cho Yong Mee 
Published: February 2021

Abstract
Context.—The widespread use of the serum prostate-specific antigen test has increased the early detection of prostate cancer and consequently reduced grossly definable prostate cancers.
Objective.—To find the most efficient gross sampling method for radical prostatectomy specimens not only preserving important prognostic factors but also being cost effective.
Design.—We initially analyzed clinicopathologic features of the entire prostate sections from 148 radical prostatectomy specimens, which then were used to examine the impact of 5 partial sampling methods on tumor stage, Gleason score, extraprostatic extension, resection margin status, and paraffin block numbers. The methods included submission of (1) alternative slices, (2) alternative slices plus biopsy-positive posterior quarters, (3) every posterior half, (4) every posterior half plus one midanterior half, and (5) alternative slices plus peripheral 3-mm rim of the remaining prostate.
Results.—Prostate cancers and their extraprostatic extension and resection margin involvement were commonly located in the right posterior portion of the prostate. Method 5 was most efficient, detecting all cases with extraprostatic extension and resection margin involvement and reducing 25% of paraffin blocks compared with the entire sampling of the prostate. The Gleason scores were retained in most of cases, except reversal of the primary and secondary Gleason grade component in only 2 cases (1%). Only 4 cases (3%) were downstaged within the same T2 stage.
Conclusions.—These results demonstrate that sampling of alternative slices plus peripheral rim of the remaining prostate is the most efficient partial sampling method for radical prostatectomy specimens.
Primary Leiomyosarcoma of Extragnathic Bone: Clinicopathologic Features and Reevaluation of Prognosis
Authors: Adelani Muyibat A. , Schultenover Stephen J. , Holt Ginger E. , Cates Justin M. M. 
Published: February 2021

AbstractContext.—Leiomyosarcoma most commonly involves the female genital tract and occasionally arises within the retroperitoneum, abdominal cavity, or the soft tissues of the extremity. Presentation as a primary bone tumor is extraordinarily uncommon, potentially leading to misdiagnosis. The prognosis is traditionally thought to be dismal. However, this conclusion is largely based on individual case reports and small series, in some of which the pathologic diagnosis is not well documented.Objective.—To review the clinicopathologic features of well-established cases of primary skeletal leiomyosarcoma and reevaluate the prognostic implications thereof.Data Sources.—A National Center for Biotechnology Information PubMed search of the English language literature identified 104 authenticated cases of primary leiomyosarcoma of extragnathic bone. An additional 3 cases are reported and illustrated herein.Conclusions.—Approximately half of all patients with primary skeletal leiomyosarcoma either presented with metastatic disease or developed metastases within 1 year of diagnosis. The 5-year overall and disease-free survival rates were 59% and 41%, respectively, comparable to that of other skeletal sarcomas. As for other bone and soft tissue sarcomas, high histologic grade and tumor stage are predictive of poor outcome.
Segmental Tandem Triplication of the MLL Gene in an Intravascular Large B-Cell Lymphoma With Multisystem Involvement: A Comprehensive Morphologic, Immunophenotypic, Cytogenetic, and Molecular Cytogenetic Antemortem Study
Authors: Deisch Jeremy , Fuda Franklin“Buddy” , Chen Weina , Karandikar Nitin , Arbini Arnaldo A. , Zhou Xin J. , Wang Huan-You 
Published: February 2021

Abstract
An association between intravascular large B-cell lymphoma (IVLBCL) and the mixed lineage leukemia (MLL) gene has never been demonstrated. Here, we report an IVLBCL in a 47-year-old Asian man. Morphologically, the atypical lymphoid infiltrate was entirely confined in the lumina of capillaries, small vessels, and sinusoidal space. Within the kidney, the neoplastic lymphoid cells exhibited both the glomerular and peritubular capillary distribution pattern. Conventional cytogenetic analysis from the bone marrow aspirates displayed a complex karyotype, with a notable triple tandem repeat at band segment q22–q25 of chromosome 11. Fluorescence in situ hybridization with an MLL probe set, performed on both interphase cells and metaphase spreads, confirmed the presence of 3 copies of the MLL gene on the derivative chromosome 11. From this finding and 3 other IVLBCL cases reported in the literature, we conclude that MLL may play an important role in the lymphomagenesis of IVLBCL at least in a subset of cases.
Mixed Epithelial and Stromal Tumors of the Kidney: An Overview
Authors: Mohanty Sambit K. , Parwani Anil V. 
Published: February 2021

Abstract
Mixed epithelial and stromal tumor of the kidney is a recently recognized distinct neoplasm that should be distinguished from other renal neoplasms. These tumors are relatively rare with a female preponderance. Imaging studies are not diagnostic but reveal a solid or solid and cystic mass in most cases. Histopathologically, these tumors reveal biphasic growth pattern comprising mesenchymal and epithelial elements with characteristic estrogen and progesterone receptor immunoreactive mesenchyme reminiscent of ovarian stroma. Malignant transformation, recurrence, and metastasis are rare; however, recently a few cases of malignant mixed epithelial and stromal tumors have been reported in the literature. Recently a case with translocation t(1;19) has been described. This article provides a brief overview of the current knowledge of mixed epithelial and stromal tumor of the kidney.
High-Resolution Computed Tomography Screening for Lung Cancer: Unexpected Findings and New Controversies Regarding Adenocarcinogenesis
Authors: Chirieac Lucian R. , Flieder Douglas B. 
Published: February 2021

Abstract
Context.—Recent advances in human imaging technologies reawakened interest in lung cancer screening. Although historic and current preliminary and noncontrolled studies have not shown a decrease in lung cancer mortality in screened populations, many explanations have been proffered while the lung cancer community awaits the results of several large controlled population studies.
Objective.—To critically review the current model of adenocarcinoma development against the background of lung cancer screening results combined with observational pathologic and radiographic studies.
Data Sources.—Published articles pertaining to lung cancer screening, lung adenocarcinoma pathology, and radiology accessible through PubMed form the basis for this review.
Conclusions.—The current adenocarcinogenesis model is probably valid for many but not all lung adenocarcinomas. Screening data combined with radiographic and pathologic studies suggest that not all lung adenocarcinomas are clinically aggressive, and it is uncertain whether all aggressive adenocarcinomas arise from identified precursors.