bluuebunny/crossref_metadata_2025_split huggingface dataset:
Appendiceal Mucinous Neoplasms: Controversial Issues
Authors: Misdraji Joseph 
Published: February 2021

Abstract
Low grade appendiceal mucinous neoplasms can spread to the peritoneum as pseudomyxoma peritonei even though they are not obviously invasive in the appendix. During the past several decades, several problematic issues surrounding this enigmatic tumor have been debated in the literature, including appropriate nomenclature for the appendiceal tumors and their peritoneal metastases. In this article, the most contentious issues in the area of appendiceal mucinous tumors are examined. First, the classification systems that have been proposed for these tumors are compared in the context of whether the appendiceal mucinous tumors are ruptured adenomas or invasive carcinomas. The controversy about the nature of pseudomyxoma peritonei and its classification systems is discussed in the following section. A brief discussion follows that examines the issue of localized pseudomyxoma peritonei and its clinical significance. Next reviewed is the largely resolved controversy about whether ovarian mucinous tumors in this setting are separate primaries or are metastases from the appendiceal tumor. Finally, the controversy about the most effective treatment of patients with pseudomyxoma peritonei is discussed.
Field Histology: Point-of-Care Microscopic Technique
Authors: Calhoun Kaumakaokalani , Lin Alexander , Bryant-Greenwood Peter , Lum Christopher , Johnson Douglas , Namiki Thomas 
Published: February 2021

Abstract
Context.—Standard histology services in geographically remote areas are often not available or have long turn-around time, resulting in delayed diagnosis or inappropriate treatment due to incomplete diagnostic data. The use of rapid tissue processing and a portable microtome technique may offer timely, point-of-care histologic diagnosis to patients in a low resources setting, such as medical missions.
Objective.—To present an alternative to the conventional histologic processing that will permit point-of-care histopathology service.
Design.—A total of 21 tissue samples from a variety of sites were collected and subjected to a protocol of rapid manual tissue processing, lightweight portable field microtome sectioning, and hematoxylin-eosin staining. The histologic preparations were evaluated for diagnostic quality. The scoring of the preparations was based on completeness and uniformity of the sections, integrity of architectural features, cytologic detail, staining quality, and overall adequacy for diagnosis.
Results.—Diagnostic quality microscopic slides were obtained from each of the 21 samples that included lesions of the skin, uterus, colon, and breast. The average preparation time, including routine hematoxylin-eosin staining, was 1.5 hours.
Conclusions.—We validated a point-of-care field histology technique that will be useful in settings of low resources, such as medical missions. Actual field testing of the procedure with special staining for fungi and acid-fast bacilli is the next step in the validation of the methodology.
The Use of Real-Time Polymerase Chain Reaction for Rapid Diagnosis of Skeletal Tuberculosis
Authors: Kobayashi Naomi , Fraser Thomas G. , Bauer Thomas W. , Joyce Michael J. , Hall Gerri S. , Tuohy Marion J. , Procop Gary W. 
Published: February 2021

AbstractWe identified Mycobacterium tuberculosis DNA using real-time polymerase chain reaction on a specimen from an osteolytic lesion of a femoral condyle, in which the frozen section demonstrated granulomas. The process was much more rapid than is possible with culture. The rapid detection of M tuberculosis and the concomitant exclusion of granulomatous disease caused by nontuberculous mycobacteria or systemic fungi are necessary to appropriately treat skeletal tuberculosis. The detection and identification of M tuberculosis by culture may require several weeks using traditional methods. The real-time polymerase chain reaction method used has been shown to be rapid and reliable, and is able to detect and differentiate both tuberculous and nontuberculous mycobacteria. Real-time polymerase chain reaction may become a diagnostic standard for the evaluation of clinical specimens for the presence of mycobacteria; this case demonstrates the potential utility of this assay for the rapid diagnosis of skeletal tuberculosis.
Drug-Herb Interaction: Effect of St John's Wort on Bioavailability and Metabolism of Procainamide in Mice
Authors: Dasgupta Amitava , Hovanetz Melissa , Olsen Margaret , Wells Alice , Actor Jeffrey K. 
Published: February 2021

AbstractContext.—St John's wort induces the activity of the cytochrome P450 enzyme system causing treatment failure because of increased metabolism of many drugs. Procainamide is metabolized by a different pathway to N-acetyl procainamide.Objective.—To study St John's wort–procainamide interaction using a mouse (Swiss Webster) model.Design.—One group of mice (group A, 4 mice in each group) was fed St John's wort each day for 2 weeks (last dose 1 day before administration of procainamide); another group (group B) received the same dose of St John's wort for 1 week. The third group (group C) received only a single dose 1 hour before administration of procainamide, and the control group (group D) received no St John's wort. All groups later received a single oral dose of procainamide. Blood was drawn 1, 4, and 24 hours after administration of procainamide and concentrations in serum of procainamide as well as N-acetyl procainamide were measured using immunoassays.Results.—The procainamide concentrations 1 hour after administration was highest in group C (mean, 11.59 μg/mL) followed by group A (9.92 μg/mL), whereas group B (7.44 μg/mL) and control group D (7.36 μg/mL) showed comparable values. The concentration in group C was significantly greater than the control group D (P = .03, 2-tailed independent t test). N-Acetyl procainamide concentrations and estimated half-life of procainamide among groups were comparable. In a separate experiment when mice were fed purified hypericin, the active component of St John's wort, a significant increase in bioavailability (53%) of procainamide was observed compared with the control group.Conclusions.—St John's wort has an acute effect to increase bioavailability of procainamide but has no effect on its metabolism.
Plexiform Fibrohistiocytic Tumor: A Brief Review
Authors: Taher Altaf , Pushpanathan Chitra 
Published: February 2021

Abstract
Plexiform fibrohistiocytic tumor is a rare mesenchymal neoplasm of intermediate malignancy, first reported by Enzinger and Zhang in 1988. It has a predilection for children and young adults but can occur at any age. The tumor usually involves the upper limbs as a slow-growing, painless mass. The tumor has a high local recurrence rate but metastasizes only rarely. Histologically, the tumor is characterized by poorly demarcated dermal or subcutaneous mass with multinodular plexiform growth and fibrohistiocytic cytomorphology. There are three distinct recognized growth patterns: fibrohistiocytic, fibroblastic, and mixed types. The tumor displays uniform immunoreactivity for vimentin and CD68. Ultrastructurally, the tumor cells have features of myofibroblasts and histiocyte-like cells. Complete surgical resection of the tumor, preferably with wider margins, is required to prevent local recurrence. Long-term follow-up is necessary to detect any nodal or pulmonary metastasis.
Recently Described and Emphasized Entities of Renal Neoplasms
Authors: Shen Steven S. , Truong Luan D. , Ayala Alberto G. , Ro Jae Y. 
Published: February 2021

Abstract
Context.—Recent advances of molecular biology and cytogenetics of renal cancer have resulted in the new classification of renal neoplasms and a number of subtypes are identified and emphasized. In addition, rare nonepithelial renal neoplasms are identified and characterized. Familiarity with these entities will help make the most accurate diagnosis and guide the treatment and follow-up of patients with renal neoplasm.
Objective.—To review the clinicopathologic entities of renal neoplasms that are recently defined or emphasized. Their clinical, gross, microscopic, and immunohistochemical features, as well as specific cytogenetic or molecular abnormalities, are discussed. Important differential diagnoses of each entity are also briefly discussed.
Data Sources.—Extensive review of published literature and our experience.
Conclusions.—A number of new entities of renal neoplasms or genetically defined renal cell carcinomas have been identified or emphasized because of their unique genetic or molecular changes. Recognition of these entities becomes important as some of them have different biologic behavior and treatment strategies may be different.
Para-arytenoid Cartilage Pseudodiverticulum Formation as a Sequela of Endotracheal Intubation
Authors: Gwin Che , Robinson Morton J. 
Published: February 2021

Abstract
Context.—Laryngotracheal injury secondary to endotracheal intubation results from ischemic necrosis, which develops within hours of intubation, with injury severity increasing with duration of intubation. Postextubation and postmortem observations demonstrate that laryngotracheal injury still occurs in a large number of intubated patients.
Objective.—To demonstrate laryngeal injury, specifically pseudodiverticulum formation, as a result of intubation.
Design.—A total of 41 autopsy cases from February 1970 to February 2006 were retrospectively reviewed. All patients had been intubated during their hospital course and had an endotracheal tube in place at the time of death. Continuous endotracheal intubation ranged from several hours to 33 days.
Results.—The earliest manifestations of laryngeal injury occurred within hours and included hyperemia, edema, and ovoid mucosal lesions over the arytenoid and inner posterolateral cricoid cartilages. Within 48 hours, superficial epithelial denudation progressed to mucosal ulceration, with inflammatory infiltrate into the submucosa. These ulcerations enlarged and deepened, and within 3 to 6 days they showed gross excavations and, in some cases, confluence with other ulcerations. Four cases had pseudodiverticulum formation in the area of the arytenoid cartilages, with deep, excavated lesions that extended to the underlying cartilage. Pseudodiverticulum formation occurred as early as 8 days of continuous intubation.
Conclusions.—Although endotracheal intubation is required for airway maintenance in many patients with respiratory dysfunction, the procedure carries risks. Laryngeal injury from intubation is very common, and the severity of injury is directly related to the duration of intubation. We add para-arytenoid pseudodiverticulum formation to the list of possible complications of endotracheal intubation.
Measuring the Clinical Impact of Pathologist Reviews of Blood and Body Fluid Smears
Authors: Sandhaus Linda M. , Wald David N. , Sauder Kenan J. , Steele Erica L. , Meyerson Howard J. 
Published: February 2021

Abstract
Context.—Despite the widespread practice of pathologist review of blood and body fluid smears, little is known about its impact on improving patient care.
Objective.—To assess the clinical usefulness of pathologist review of blood and body fluid smears.
Design.—Survey study. Pathology residents contacted the ordering physician after pathologist reviews were reported to assess their clinical impact.
Results.—Ninety-six pathologist reviews met criteria for study inclusion, and 64 ordering physicians were successfully contacted during the 2-month study period. Of the 64 cases, 19 reviews (30%) had been seen by the physician within 24 to 48 hours after the report was issued and 33 (51%) had not been seen; in 4 (6%) instances, physicians did not remember whether they had seen the review. Eight reviews (13%) were considered urgent enough to warrant immediate communication by the pathologist. Of the 27 reviews that were seen or directly communicated, 23 (85%) contributed to clinical diagnosis and/or patient management.
Conclusions.—This study demonstrates the contribution of pathologist reviews of blood and body fluids to clinical diagnosis and patient management. The results also highlight the problem of a lack of physician awareness of clinical pathology results.
The Impact of Amino-Terminal Pro-Brain Natriuretic Peptide Testing on Hospital Length of Stay and Morbidity in Patients With Acute Decompensated Heart Failure
Authors: Green Sandy M. , Redmond Patrick , Januzzi James L. , Aleryani Samir , Lee-Lewandrowski Elizabeth , Sluss Patrick , Lewandrowski Kent B. 
Published: February 2021

Abstract
Context.—In clinical trials, N-terminal pro-brain natriuretic peptide (NT-proBNP) testing has been shown to be valuable for diagnosis and triage of patients with acute decompensated heart failure. It is not yet clear what benefits might be expected from the initiation of NT-proBNP testing in an everyday clinical setting.
Objective.—To determine the effects of NT-proBNP testing on hospital length of stay as well as on 60-day morbidity and mortality in patients with acute decompensated heart failure before and after the test was implemented in the clinical laboratory.
Design.—We measured hospital length of stay and 60-day morbidity and mortality rates among patients with acute decompensated heart failure admitted before and after initiation of NT-proBNP testing in our hospital. Differences in demographics between preimplementation and postimplementation groups were compared with the χ2 test for categorical variables and the Wilcoxon rank sum test for continuous variables. Comparison between the hospital length of stay for each group was evaluated using the Mann-Whitney U test. Differences in rates of rehospitalization or death at 60 days following presentation were assessed using χ2 cross-tabulation.
Results.—Patients in the postimplementation group had similar clinical features as those in the preimplementation group. The hospital length of stay for patients in the postimplementation study group decreased both with respect to mean (1.86-day reduction) and median (1.3-day reduction) hospital stay (both, P = .03). Additionally, significantly lower rates of death (6.6% absolute risk reduction, P = .01), rehospitalization (12.1% absolute risk reduction, P = .005), and the composite of the 2 rates (18.7% absolute risk reduction, P = .008) were found following initiation of NT-proBNP testing.
Conclusions.—Implementation of NT-proBNP testing may result in significant reductions in hospital length of stay as well as improvements in rates of morbidity and mortality in patients with acute decompensated heart failure.
Alveolar Soft Part Sarcoma
Authors: Zarrin-Khameh Neda , Kaye Kim S. 
Published: February 2021

Abstract
This article provides an overview of the pathology of alveolar soft part sarcoma, focused on its morphology, special stains useful in diagnosis, and the clinical and radiographic features of the disease. Alveolar soft part sarcoma is a rare neoplasm of unknown histogenesis with poor prognosis. Although there are several immunohistochemical stains available to help reach the diagnosis, the morphology of the tumor should be considered the main diagnostic feature. The periodic acid–Schiff stain is the best single stain that supports the diagnosis.
Xp11.2 Translocation Renal Cell Carcinoma
Authors: Armah Henry B. , Parwani Anil V. 
Published: February 2021

Abstract
Xp11.2 translocation renal cell carcinomas (RCCs), a recently recognized distinct subtype, are rare tumors predominantly reported in young patients. They comprise at least one-third of pediatric RCCs, and only few adult cases have been reported. They are characterized by various translocations involving chromosome Xp11.2, all resulting in gene fusions involving the transcription factor E3 (TFE3) gene. In recent years, at least 6 different Xp11.2 translocation RCCs have been identified and characterized at the molecular level. These include a distinctive RCC that bears a translocation with the identical chromosomal breakpoints (Xp11.2, 17q25) and identical resulting ASPL-TFE3 gene fusion as alveolar soft part sarcoma. They typically have papillary or nested architecture and are composed of cells with voluminous, clear, or eosinophilic cytoplasm. Their most distinctive immunohistochemical feature is nuclear labeling for TFE3 protein. Although only limited data are available so far, they are believed to be rather indolent, but there have been increasing, recent reports of an aggressive clinical course in adult cases. The consistent immunohistochemical staining for TFE3 in all RCC with unusual histology, regardless of patient age, is likely to expand the spectrum of Xp11.2 translocation RCC with respect to age, clinical behavior, and molecular abnormalities.
Expression of Galectin-3 in Renal Neoplasms: A Diagnostic, Possible Prognostic Marker
Authors: Dancer Jane Y. , Truong Luan D. , Zhai Qihui , Shen Steven S. 
Published: February 2021

AbstractContext.Galectin-3, a member of the lectin family, was shown to be expressed in normal distal tubular cells and in renal cell carcinomas (RCC). However, its diagnostic and prognostic significance in RCC is as yet undefined.Objectives.To describe the expression of Galectin-3 among different histologic subtypes of renal neoplasms and to determine their diagnostic and prognostic significances.Design.The expression of Galectin-3 was evaluated in 217 renal neoplasms by tissue microarray and immunohistochemistry with semiquantitative analysis.Results.Strong expression of Galectin-3 was observed in 92 of 217 of renal neoplasms (42.4%). Although 22 of 23 oncocytomas (95.7%) and 19 of 21 chromophobe RCCs (90.5%) express Galectin-3, only 4 of 32 papillary RCCs (12.5%) and 47 of 137 clear cell RCCs (34.3%) express Galectin-3, suggesting that it may be used as a potential diagnostic marker. Galectin-3 expression was seen in 55% of high-grade (Fuhrman nuclear grades 3 and 4) versus 21% low-grade (grades 1 and 2) clear cell RCCs (P &lt; .001).Conclusions.This study confirms that Galactin-3 is strongly overexpressed in renal cell neoplasms of distal tubular differentiation, that is, oncocytoma and chromophobe RCCs, suggesting it might be used as a possible differential diagnostic tool for renal cell neoplasm with oncocytic or granular cells. Furthermore, we observed a strong association of overexpression of Galectin-3 and high nuclear grade in clear cell RCC. These results also suggest a possible pivotal role for Galectin-3 in the differentiation and prognosis of clear cell RCC.
Esophageal Lichen Planus
Authors: Chandan Vishal S. , Murray Joseph A. , Abraham Susan C. 
Published: February 2021

Abstract
Esophageal lichen planus is an underrecognized condition, with fewer than 50 cases reported to date. Unlike cutaneous lichen planus, esophageal lichen planus occurs almost exclusively in middle-aged or older women who also have oral involvement. It commonly involves the proximal esophagus and manifests as progressive dysphagia and odynophagia. Endoscopic findings can include lacy white papules, pinpoint erosions, desquamation, pseudomembranes, and stenosis. Histologic features of esophageal lichen planus have only rarely been illustrated. They differ from those of cutaneous disease in several respects, including the presence of parakeratosis, epithelial atrophy, and lack of hypergranulosis. Correct diagnosis of esophageal lichen planus is difficult but bears important therapeutic implications. It is typically a chronic and relapsing condition that can require systemic or local immunosuppressive therapy and repeated endoscopic dilatations for esophageal strictures. Esophageal lichen planus may have malignant potential, as evidenced by 3 patients who developed squamous carcinoma of the esophagus after longstanding disease.
Cutaneous Malakoplakia
Authors: Kohl Shane K. , Hans Christine P. 
Published: February 2021

Abstract
Malakoplakia is an acquired granulomatous disorder first described by Michaelis and Gutmann in 1902. The pathogenesis of malakoplakia is poorly understood, but it is thought to be secondary to an acquired bacteriocidal defect in macrophages occurring mostly in immunosuppressed patients or in the setting of autoimmune disease. Malakoplakia has been described in numerous anatomic locations, most commonly in the genitourinary tract. Microscopically, malakoplakia consists predominantly of sheets of macrophages known as von Hansemann cells with scattered targetoid intracytoplasmic inclusions known as Michaelis-Gutmann bodies. Cutaneous malakoplakia is a rare entity with less than 50 cases reported in the literature. In this article, we review cutaneous malakoplakia including the clinical, gross, and microscopic features as well as the treatment and prognosis of 40 cases of cutaneous malakoplakia identified in the literature.
Expression of Phosphatase of Regenerating Liver 1 and 3 mRNA in Esophageal Squamous Cell Carcinoma
Authors: Liu Yu-Qiong , Li Hui-Xiang , Lou Xi , Lei Jun-Yi 
Published: February 2021

Abstract
Context.—Phosphatase of regenerating liver (PRL) 3 messenger RNA (mRNA) was reported to express in human colorectal, gastric, ovarian, breast, and hepatic cancers.
Objective.—To examine the expression of PRL-1 and PRL-3 mRNAs in human esophageal squamous cell carcinoma (ESCC).
Design.—Expression of PRL-1 and PRL-3 mRNA was examined with reverse transcriptase–polymerase chain reaction in fresh tissue collected from 40 cases of ESCC with matched lymph node metastasis in 21 cases. The association of expression of PRL-1 and PRL-3 mRNAs with clinicopathologic parameters was analyzed.
Results.—The frequencies of PRL-1 and PRL-3 mRNA expression were significantly higher in ESCC than in normal esophageal tissue (P = .001; P = .01) and also significantly higher in ESCC with lymph node metastasis than in those without lymph node metastasis (P = .01; P = .03). The levels of PRL-1 and PRL-3 mRNA expression were significantly higher in ESCC with lymph node metastasis than in those without lymph node metastasis (P = .04; P = .04). The frequencies and levels of PRL-1 and PRL-3 mRNA expression were correlated with the later stages but not with tumor differentiation, tumor location in the esophagus, patient's sex, and age.
Conclusions.—PRL-1 and PRL-3 mRNAs may be involved in and used to predict the metastasis of ESCC. The possibility of using PRL-1 and PRL-3 as the therapeutical target is also discussed.
Analysis of Pathology Department Web Sites and Practical Recommendations
Authors: Nero Christopher , Dighe Anand S. 
Published: February 2021

Abstract
Context.—There are numerous customers for pathology departmental Web sites, including pathology department staff, clinical staff, residency applicants, job seekers, and other individuals outside the department seeking department information. Despite the increasing importance of departmental Web sites as a means of distributing information, no analysis has been done to date of the content and usage of pathology department Web sites.
Objective.—In this study, we analyzed pathology department Web sites to examine the elements present on each site and to evaluate the use of search technology on these sites. Further, we examined the usage patterns of our own departmental Internet and intranet Web sites to better understand the users of pathology Web sites.
Design.—We reviewed selected departmental pathology Web sites and analyzed their content and functionality. Our institution's departmental pathology Web sites were modified to enable detailed information to be stored regarding users and usage patterns, and that information was analyzed.
Results.—We demonstrate considerable heterogeneity in departmental Web sites with many sites lacking basic content and search features. In addition, we demonstrate that increasing the traffic of a department's informational Web sites may result in reduced phone inquiries to the laboratory. We propose recommendations for pathology department Web sites to maximize promotion of a department's mission.
Conclusions.—A departmental pathology Web site is an essential communication tool for all pathology departments, and attention to the users and content of the site can have operational impact.