bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population-Based Analysis of Pathologic Data: A New Approach to the Investigation of Uterine Endometrial and Ovarian Endometrioid Carcinomas
Authors: Henson Donald Earl , Schwartz Arnold M. , Tilara Amy , Grimley Philip M. , Anderson William F. 
Published: February 2021

Abstract
Context.—Population-based analysis of the histopathology of endometrioid adenocarcinoma of the endometrium and ovary combined with epidemiologic techniques offer a new approach to exploring the relationship of tumors that share a similar range of morphologic phenotypes.
Objective.—To evaluate the contribution of the Surveillance, Epidemiology, and End Results database to our understanding of gynecologic pathology. Specifically, to test and compare whether the etiology/pathogenesis of ovarian endometrioid cancer is as dependent upon the reproductive environment as uterine endometrial carcinoma.
Design.—Graphic plots of the epidemiologic patterns were analyzed relating to incidence and age-specific rates of ovarian and uterine endometrioid carcinomas. The graphic analysis included evaluation of age frequency density plots and logarithmic plots (log-log) of age-specific incidence rates.
Results.—At all ages, uterine endometrioid carcinomas have higher incidence rates than their ovarian homologues. Up to the age of 50 years, the log-log plots of age-specific incidence rates for each of these tumors remain essentially parallel. In contrast, after age 50 (menopause), the incidence rates begin to diverge: the rates for uterine endometrial carcinomas continue to rise, whereas the rates for ovarian endometrioid carcinomas plateau. This divergence persists even when the age-specific incidence is stratified according to histologic grade. Interestingly, endometrial stromal sarcomas follow an incidence rate pattern nearly identical to that of ovarian endometrioid carcinomas.
Conclusions.—The continuum of cellular and molecular events predisposing to gynecologic cancers of endometrioid phenotype apparently cease to operate in the ovary after menopause, but additional cellular and molecular events appear to occur in the ageing uterine endometrium.
Mucoepidermoid Carcinoma of the Bronchus: A Review
Authors: Liu Xiuli , Adams Amy L. 
Published: February 2021

Abstract
Although mucoepidermoid carcinoma of the salivary gland is relatively common, mucoepidermoid carcinoma arising from the mucous glands of the bronchus is rare. Bronchial mucoepidermoid carcinoma usually presents as an intraluminal mass producing luminal occlusion. Symptoms are airway obstruction and recurrent pneumonia. Macroscopically, mucoepidermoid carcinoma appears as an exophytic intrabronchial mass with intact or ulcerated bronchial mucosa. Microscopically, the tumors are located in the submucosa of the large bronchi. The tumors are usually well differentiated and contain a combination of mucus-secreting, squamous, and intermediate cells. The increased frequency of this tumor in the pediatric population suggests a genetic abnormality. Recent genetic studies have demonstrated reciprocal chromosomal translocations including t(1;11)(p22;q13), t(11;19)(q14-21;p12), and t(11; 19)(q21;p13). Chromosome 11 in the first translocation appears to have been altered resulting in up-regulation of the cyclin D1 gene and overexpression of cyclin D1. The t(11;19)(q21;p13) encodes a novel fusion product capable of disrupting the Notch signaling pathway.
New Immunohistochemical Markers in the Evaluation of Central Nervous System Tumors: A Review of 7 Selected Adult and Pediatric Brain Tumors
Authors: Takei Hidehiro , Bhattacharjee Meenakshi B. , Rivera Andreana , Dancer Yeongju , Powell Suzanne Z. 
Published: February 2021

Abstract
Context.—Immunohistochemistry (IHC) has become an important tool in the diagnosis of brain tumors.
Objective.—To review the latest advances in IHC in the diagnostic neuro-oncologic pathology.
Data Sources.—Original research and review articles and the authors' personal experiences.
Data Synthesis.—We review the features of new, useful or potentially applicable marker antibodies as well as the new uses of already established antibodies in the area of diagnostic neuro-oncologic pathology, focusing on the use of IHC for differential diagnosis and prognosis. We discuss (1) placental alkaline phosphatase, c-Kit, and OCT4 for germinoma, (2) α-inhibin and D2-40 for capillary hemangioblastoma, (3) phosphohistone-H3 (PHH3), MIB-1/Ki-67, and claudin-1 for meningioma, (4) PHH3, MIB-1/Ki-67, and p53 for astrocytoma, (5) synaptophysin, microtubule-associated protein 2, neurofilament protein, and neuronal nuclei for medulloblastoma, (6) INI1 for atypical teratoid/ rhabdoid tumor, and (7) epithelial membrane antigen for ependymoma. All the markers presented here are used mainly for supporting or confirming the diagnosis, with the exception of the proliferation markers (MIB-1/Ki-67 and PHH3), which are primarily used to support grading and are reportedly associated with prognosis in certain categories of brain tumors.
Conclusions.—Although conventional hematoxylin-eosin staining is the mainstay for pathologic diagnosis, IHC has played a major role in differential diagnosis and in improving diagnostic accuracy not only in general surgical pathology but also in neuro-oncologic pathology. The judicious use of a panel of selected immunostains is unquestionably helpful in diagnostically challenging cases. In addition, IHC is also of great help in predicting the prognosis for certain brain tumors.
Cytokeratin and Epithelial Membrane Antigen Expression in Angiosarcomas: An Immunohistochemical Study of 33 Cases
Authors: Al-Abbadi Mousa A. , Almasri Nidal M. , Al-Quran Samer , Wilkinson Edward J. 
Published: February 2021

Abstract
Context.—Expression of epithelial cell markers can occur in mesenchymal tumors and has been reported in angiosarcomas with variable frequency. In these situations, establishing the diagnosis becomes problematic.
Objective.—To determine the expression of cytokeratin and epithelial membrane antigen in angiosarcoma.
Design.—To address this issue, 33 well-documented cases of angiosarcomas were retrieved from the archival material of Shands Hospital at the University of Florida, Gainesville, and Jackson Memorial Hospital at the University of Miami, Miami, Florida. These cases were all reviewed and studied using a cytokeratin cocktail (CAM 5.2 and AE1/AE3) and epithelial membrane antigen using standard immunohistochemical techniques. All 33 cases had available material for cytokeratin analysis; however, only 20 cases had enough material for epithelial membrane antigen staining.
Results.—In the 33 cases studied, the age range of the patients was 2 to 88 years (mean, 63 years). There were 23 (70%) men and 10 (30%) women. One (3%) of 33 was cytokeratin-immunoreactive and 2 (10%) of 20 were epithelial membrane antigen-immunoreactive.
Conclusion.—Cytokeratin and epithelial membrane antigen immunoreactivity in angiosarcomas is infrequent but may be encountered. Interpretation of such expression should be done with caution and in conjunction with the characteristic clinical and morphologic features of the tumor as well as the expression of endothelial cell antigens.
Malakoplakia Outside the Urinary Tract
Authors: Yousef George M. , Naghibi Bibi 
Published: February 2021

AbstractContext.—Malakoplakia is a rare granulomatous disease that occurs commonly in the urinary tract. Histologically, it is defined by sheets of histiocytes (Hansemann cells) with accumulation of granular basophilic periodic acid-Schiff– positive, diastase-resistant inclusions and calcified Michaelis-Gutmann bodies, which are pathognomonic but not necessary for diagnosis. In addition to the urinary tract, malakoplakia has been reported in other organs, including the gastrointestinal tract, central nervous system, female genital tract, and the tongue.Objectives.—To review the literature of reported sites of malakoplakia outside the urinary tract and their variable clinical presentations, and to discuss the main diagnostic features and differential diagnoses of malakoplakia. The pathogenesis and possible etiologic factors are also presented.Data Sources.—Data for this work were collected from the published literature, textbooks, and the Internet.Conclusions.—It is important to be aware of the existence of this entity in abnormal locations. In many situations, malignancy can be mimicked, especially when the lesion is ulcerated and is accompanied by lymph node involvement. Misinterpreting large, rapidly growing nodules of malakoplakia as tumor might lead to overstaging. Pathologists should be also aware of the possibility of malakoplakia coexisting with other lesions, such as tuberculosis and carcinoma, in the same specimen.
Primary Central Nervous System Histiocytic Sarcoma With Relapse to Mediastinum: A Case Report and Review of the Literature
Authors: Cao Ming , Eshoa Camellia , Schultz Christopher , Black Jennifer , Zu Youli , Chang Chung-Che 
Published: February 2021

Abstract
Histiocytic sarcoma is a rare, malignant neoplasm of the lymphohematopoietic system that usually occurs in the skin, lymph node, and intestinal tract. Here we describe a unique case of primary central nervous system histiocytic sarcoma that initially showed an indolent clinical course following local resection and radiotherapy. However, relapse of disease within the mediastinum was noted 3½ years later. Biopsies of the initial brain lesion and subsequent mediastinal recurrence each revealed an identical, diffuse proliferation of histiocytes with expression of CD45, CD68, and CD163 but not pan-cytokeratin, epithelial membrane antigen, CD3, CD15, CD20, CD30, CD43, CD79a, CD138, myeloperoxidase, ALK-1, PAX-5, CAM 5.2, S100, CD1a, or glial fibrillary acidic protein. In the literature, central nervous system histiocytic sarcoma portends a poor prognosis with median survival of 4.5 months. To our knowledge, this case represents the first case of “low-grade” primary central nervous system histiocytic sarcoma with relatively indolent clinical course. A thorough discussion of the differential diagnosis of histiocytic sarcoma and a review of primary central nervous system histiocytic sarcoma are also presented.
Intranodal Palisaded Myofibroblastoma
Authors: Nguyen Thong , Eltorky Mahmoud A. 
Published: February 2021

Abstract
Intranodal palisaded myofibroblastoma (IPM) usually presents as a painless, slow-growing inguinal mass. Our review of 42 cases from 13 publications indicates that two thirds of IPMs occur between the ages of 45 and 55 years, the male-female ratio is 2:1, and there is a lack of ethnic predilection. Grossly, the IPM cut surface shows areas of hemorrhage. Five microscopic features are seen: (a) compressed remnants of lymphoid tissue at the periphery; (b) spindle cells with nuclear palisading; (c) intraparenchymal hemorrhage and erythrocyte extravasation; (d) so-called amianthoid fibers; and (e) intracellular and extracellular fuchsinophilic bodies that stain positive for smooth muscle actin. Immunohistochemically, IPM is positive for smooth muscle actin and cyclin D1 and negative for S100, glial fibrillary acidic protein, CD34, and desmin, and it shows a low proliferative index of Ki-67. Electron microscopy demonstrates features of myofibroblasts and smooth muscle cells. Excellent prognosis is seen after surgical treatment, with an approximately 6% recurrence rate and no malignant transformation.
An In-Depth Look at Leydig Cell Tumor of the Testis
Authors: Al-Agha Osama M. , Axiotis Constantine A. 
Published: February 2021

AbstractLeydig cell tumor (LCT) is a rare tumor of the male testicular interstitium. This article provides an overview of the major pathologic manifestations of LCT of the testis; patient characteristics; clinical, radiologic, and laboratory features; prognosis; and management. LCTs of the testis are frequently hormonally active, leading to either feminizing or virilizing syndromes. The tumor is usually benign, but malignant variants can occur. The pathologic diagnosis of LCT is usually made based on morphologic characteristics of the tumor cells. The significance of Reinke crystals in the diagnosis of LCT both cytologically and histologically is underscored. Pathologists have to be familiar with the diagnostic histopathologic features, immunohistochemical panel of this tumor, and its principal differential diagnoses to prevent tumor misdiagnosis.
Transbronchial Biopsy Interpretation in the Patient With Diffuse Parenchymal Lung Disease
Authors: Leslie Kevin O. , Gruden James F. , Parish James M. , Scholand Mary Beth 
Published: February 2021

Abstract
Context.—The most common lung tissue samples seen by pathologists worldwide are obtained with the flexible bronchoscope. Specimens taken for examination of diffuse or multifocal parenchymal lung abnormalities pose special challenges for the general surgical pathologist, and these challenges are often compounded by high clinical expectations for accurate and specific diagnosis.
Objective.—To present and discuss the most common histopathologic patterns and diagnostic entities seen in transbronchial biopsy specimens in the setting of diffuse or multifocal lung disease. Specifically, acute lung injury, eosinophilic pneumonia, diffuse alveolar hemorrhage, chronic cellular infiltrates, organizing pneumonia, alveolar proteinosis, sarcoidosis, Wegener granulomatosis, intravenous drug abuse-related microangiopathy, Langerhans cell histiocytosis, and lymphangioleiomyomatosis are presented. Clinical and radiologic context is provided for the more specific diagnostic entities.
Data Sources.—The published literature and experience from a consultation practice.
Conclusions.—The transbronchial biopsy specimen can provide valuable information for clinical management in the setting of diffuse or multifocal lung disease. Computed tomographic scans are useful for selecting appropriate patients to undergo biopsy and in limiting the differential diagnosis. Knowledge of the clinical context, radiologic distribution of abnormalities, and histopathologic patterns is essential. With this information, the surgical pathologist can substantially influence the diagnostic workup and help guide the clinician to an accurate clinical/radiologic/pathologic diagnosis.
Diminished Need for Folate Measurements Among Indigent Populations in the Post Folic Acid Supplementation Era
Authors: Joelson Dean W. , Fiebig Eberhard W. , Wu Alan H. B. 
Published: February 2021

Abstract
Context.—The mandated fortification of processed grains with folic acid in the United States and Canada in 1998 was intended to reduce the incidence of neural tube defects in pregnant women. The incidence of folate deficiency in most populations has declined dramatically since then.
Objective.—To determine the rate of folate deficiency in a cohort of indigent patients, a population among those at highest risk for folate deficiency.
Design.—Using data from 3 years (1997, 2000, and 2004), we examined results of laboratory tests for red blood cell folate ordered at 3 hospitals that predominately service the needs of indigent patients. Folate concentration cutoffs were 160 ng/mL (363.6 nmol/L) and 94 ng/mL (213 nmol/L).
Results.—Using a red blood cell folate cutoff concentration of 160 ng/mL (363.6 nmol/L), the combined incidence of folate deficiency decreased from 4.8% in 1997 to 0.6% in 2004. At a cutoff of 94 ng/mL (213 nmol/L), the incidence went from 0.98% to 0.09% in 1997 and 2004, respectively. Even when the folate concentration was found to be low, the majority of these subjects did not have macrocytosis.
Conclusions.—These data suggest that folate deficiency has become a rare event in the United States, and the utility of routine folate measurements for patients with anemia and/or increased mean corpuscular volume are difficult to justify.
Ensuring Timely Completion of Type and Screen Testing and the Verification of ABO/Rh Status for Elective Surgical Patients
Authors: Saxena Sunita , Nelson Janice M. , Osby Melanie , Shah Mrugesh , Kempf Raymond , Shulman Ira A. 
Published: February 2021

Abstract
Context.—A blood bank can provide compatible blood for an elective surgical procedure, provided a blood sample is received by the laboratory with sufficient time to allow pretransfusion testing and acquire enough compatible red blood cell units. With the push for same-day admission surgical procedures, a patient's pretransfusion blood sample is often collected the morning of surgery. However, if blood is needed, compatible units might not be immediately available.
Objective.—To define and improve the process of completing presurgical/preadmission type and screen testing and verifying the ABO/Rh status of scheduled surgical patients before they receive a transfusion.
Study Design.—A list of surgical procedures that might necessitate blood transfusion was created. A checklist was used to ensure that the preoperative clinic nurse collects a baseline pretransfusion blood sample for type and screen testing from patients scheduled for a listed procedure. A new pretransfusion specimen was received on the day of surgery, if needed, so that a current specimen would be available for compatibility testing and to verify the accuracy of the patient's ABO/Rh status in case blood was requested.
Results.—During the 1-year study period, 666 patients qualified for baseline type and screen testing. Cholecystectomy was the most commonly scheduled surgery. In 99% of cases, a baseline type and screen specimen was received in the laboratory at least 1 day before surgery. The interval between the preoperative clinic visit and date of surgery varied from same day (6 patients) to 3 months.
Conclusion.—Timely receipt of a presurgical specimen for type and screen testing and verification of a patient's ABO/Rh status can be ensured when clinical services collaborate and when the hospital blood utilization committee provides oversight to improve compliance.
Clinical Laboratory Specimen Rejection—Association With the Site of Patient Care and Patients' Characteristics: Findings From a Single Health Care Organization
Authors: Stark Azadeh , Jones Bruce A. , Chapman Deborah , Well Karen , Krajenta Richard , Meier Frederick A. , Zarbo Richard J. 
Published: February 2021

Abstract
Context.—Programs to track laboratory quality have reported aggregated specimen rejection rates ranging from 0.30% to 0.83%. Because the performance of the laboratory, rather than errors, has been the focus, reasons for specimen rejection or demographic characteristics of individuals at risk for specimens of poor quality may not be fully understood.
Objective.—To calculate the proportions of rejected specimens stratified by point of collections and demographic information of patients.
Design.—Retrospective cross-sectional study. Data were retrieved from the intrainstitutional electronic databases.
Results.—The proportions of specimens that were rejected in the emergency department and inpatient services were 2-fold and more than 5-fold higher, respectively, than for the outpatient services. Assessment of data by patients' ethnic heritages yielded no significant differences among African Americans (0.38%), Caucasians (0.38%), or “Others” (0.35%) in the outpatient services (P = .07). In the emergency department, the proportions of rejected specimens for African Americans (2.24%) were almost twice that of Caucasians (1.39%) and 30% higher than for Others (1.70%). A similar finding was observed for the inpatient services.
Conclusions.—The effect of ethnicity on the proportions of rejected specimens was significant for samples that were collected in the emergency department and inpatient services, even after adjusting for the total number of specimens. A constellation of factors, that is, disease severity and seriousness, practice of blood sample collection, and lesser proficiency of the nursing staff in phlebotomy may be reasons for this observation. However, the likelihood of differential care, although unlikely, cannot be refuted by the present data.
Perineurioma: A Distinctive and Underrecognized Peripheral Nerve Sheath Neoplasm
Authors: Macarenco Ricardo S. , Ellinger Fred , Oliveira Andre M. 
Published: February 2021

AbstractContext.—Perineuriomas are benign peripheral nerve sheath neoplasms composed of perineurial cells with characteristic immunohistochemical and ultrastructural features. They have been traditionally classified into two main types according to their location—intraneural and extraneural—and overlap histologically with many other tumors, which may be diagnostically challenging to general surgical pathologists.Objective.—To review the clinical, morphologic, immunohistochemical, ultrastructural, cytogenetic, and molecular genetic aspects of perineurioma, as well as to discuss its clinicopathologic variants and differential diagnosis.Data Sources.—English-language literature published between 1966 and 2005 was reviewed.Conclusions.—The correct identification of perineuriomas is important to avoid unnecessary overtreatment. The histologic diagnosis should be confirmed through immunohistochemical studies (including epithelial membrane antigen, S100 protein, and more recently described antibodies such as claudin-1 and GLUT1) or electron microscopy. Cytogenetic and molecular genetic studies are still of limited value for the diagnosis of perineuriomas but may play a fundamental role in excluding important differential diagnoses and also in helping elucidate the biology of these poorly known neoplasms.
Transfusion Medicine for the Practicing Pathologist/Physician With Responsibilities for the Transfusion Service
Authors: Sazama Kathleen 
Published: February 2021

Abstract
Transfusion medicine is a challenging and complex medical practice that occurs in virtually every hospital, except perhaps rehabilitation and mental health facilities, on a frequent, often daily, basis. The knowledge base required to effectively meet the standard of care for transfusion practice is increasing at a rapid pace. It is not unusual for patients with successful ABO changes due to bone marrow or stem cell transplantation to be treated in their local community hospital or even to receive such transplantations much closer to home than previously. Routine transfusions for patients with anemia, hemoglobinopathies, elective surgeries, and trauma, as well as the special needs of neonates and geriatric patients, are provided in hospital transfusion services of all sizes. In some hospitals, there are board-certified physician specialists in transfusion medicine who provide hands-on consultative services to their colleagues, whereas in other facilities, the technical specialists (including blood banking and specialist in blood banking certified personnel) shoulder much of the burden of providing these services.