bluuebunny/crossref_metadata_2025_split huggingface dataset:
C1 Inhibitor Infusion Modifies Platelet Activity in Hereditary Angioedema Patients
Authors: Coppola Ludovico , Guastafierro Salvatore , Verrazzo Giovanni , Coppola Antonino , De Lucia Domenico , Tirelli Angelo 
Published: January 2021

AbstractContext.—C1 inhibitor (C1-INH) is an α2-globulin that blocks esterolytic activity of the first component of the classic complement cascade. The α-granules of normal human platelets also contain C1-INH, which is expressed on the platelet surface during platelet secretion in healthy patients, but it is clearly reduced in patients with hereditary angioedema (HAE).Objective.—To evaluate the effects of in vivo C1-INH concentrate infusion on platelet responsiveness and coagulation system activity in patients with HAE.Design.—Assessment of the platelet activity and plasma levels of C1-INH, activated factor XII (XIIa), and prothrombin fragment F1.2 (F1.2) before and after infusion of 15 U/kg of C1-INH concentrate.Patients.—In 6 patients (4 men and 2 women), HAE was diagnosed according to the accepted clinical and laboratory criteria.Measurements.—Platelet aggregation (final concentrations: adenosine diphosphate, 0.5, 1.25, and 2.5μM; collagen, 5 μg/mL), C1-INH antigen (radial immunodiffusion), C1-INH activity (chromogenic substrates), and XIIa and F1.2 (enzyme-linked immunosorbent assay).Results.—After C1-INH infusion, we observed a prompt increase of C1-INH level and a slow return toward its plasma preinfusion values within 4 to 7 days, a significant decrease of both adenosine diphosphate– and collagen-induced platelet aggregation versus preinfusion values (maximum after 1–2 days; P &lt; .001), and a rapid decrease of high basal values of XIIa and F1.2 in 30 and 120 minutes, respectively.Conclusions.—These data show a role of C1-INH in the control of platelet activity and that its deficiency increases platelet aggregability and plasma levels of XIIa and F1.2 in patients with HAE.
Intraoperative Evaluation of Lumpectomy Margins by Imprint Cytology With Histologic Correlation
Authors: Creager Andrew J. , Shaw Jo Ann , Young Peter R. , Geisinger Kim R. 
Published: January 2021

Abstract
Background.—Several well-controlled studies have demonstrated significantly increased local recurrence rates in patients with low-stage breast carcinoma treated with breast conservation therapy in whom focally positive margins were not reexcised. Imprint cytology is a rapid technique for evaluating surgical margins intraoperatively, thus allowing reexcisions to be performed during the initial surgery. The large majority of studies on the use of intraoperative imprint cytologic examination of breast conservation therapy margins have been performed at university-based academic centers.
Objective.—To evaluate the utility of intraoperative imprint cytologic evaluation of breast conservation therapy margins in a community hospital setting.
Methods.—We retrospectively reviewed the intraoperative imprint cytology margins of 141 lumpectomy specimens that had been obtained from 137 patients between May 1997 and May 2001.
Results.—We evaluated 758 separate margins. On a patient basis, the sensitivity was 80%, the specificity was 85%, the positive predictive value was 40%, the negative predictive value was 97%, and the overall accuracy was 85%. There were no cytologically unsatisfactory margins.
Conclusions.—Imprint cytology is an accurate, simple, rapid, and cost-effective method for determining the margin status of breast conservation therapy specimens intraoperatively in the community hospital setting. This method allows a survey of the entire surface area of the lumpectomy specimen, which is not practical using frozen section evaluation.
Metastatic Renal Cell Carcinoma Presenting as a Hemorrhoid
Authors: Sawh Ravindranauth N. , Borkowski Joanna , Broaddus Russell 
Published: January 2021

AbstractMetastatic, noncolorectal carcinoma involving the anal canal is exceptionally rare, with only 3 cases being described in the medical literature. We report the case of a 53-year-old man with an anal mass clinically presenting as a large, thrombosed, internal hemorrhoid. The patient had a history of nephrectomy for renal cell carcinoma 9 years previously. The resected anal lesion was histologically identical to the primary tumor in the kidney, showing features of renal cell carcinoma of the clear cell type. To the best of our knowledge, this is only the fourth reported case of metastatic, noncolorectal carcinoma involving the anal canal and is the first report of a renal cell carcinoma metastasis to this site.
Histopathologic Characterization of Mammary Neoplastic Lesions Induced With 7,12 Dimethylbenz(α)anthracene in the Rat
Authors: Costa Irmgard , Solanas Montserrat , Escrich Eduard 
Published: January 2021

Abstract
Context.—The dimethylbenz(α)anthracene (DMBA) breast cancer model induced in the rat is used for the study of mammary carcinogenesis because it closely mimics human breast disease.
Objective.—To analyze the histopathologic features of mammary carcinomas induced in the DMBA experimental model, in a manner similar to that used in human pathology, to allow a comparative analysis between both systems.
Design.—Three experimental series of 20 animals were used. At 53 days of age, a single dose of 5 mg of DMBA per rat was given. Mammary tumors were collected when the rats were killed. Several histopathologic parameters were studied. For grading, the parameters described in the modified Scarff-Bloom-Richardson scheme were used, adapted to rat mammary tumors.
Results.—More than 50% of the carcinomas presented a pattern grade I, a nuclear grade I or II, and fewer than 10 mitoses/10 high-power fields (P &lt; .05). Although the tumors were generally well differentiated, they showed a range of differentiation. More than 85% of carcinomas did not display tumoral necrosis (P &lt; .05). This feature was observed mostly in high-grade carcinomas. There was no or scanty lymphoplasmacytic infiltration in more than 70% of carcinomas (P &lt; .05). The degree of infiltration increased with the histologic grade. Microcalcifications were found rarely (P &lt; .05). The carcinomas exhibited a mixed structural pattern, most with a predominant cribriform pattern (P &lt; .05). No or light (+) stromal response was seen in most cases (P &lt; .05). Some carcinomas, especially when poorly differentiated, presented a desmoplastic reaction. Most carcinomas presented scanty mast cell infiltration (P &lt; .05), no features of secretion (P &lt; .05), and absence of microcribriform pattern (P &lt; .05). These features were seen more often in low-grade carcinomas.
Conclusions.—Despite the presence of some structural differences, rat mammary adenocarcinomas and the most common human breast carcinomas share several morphologic similarities. Moreover, some features could be related to the aggressive behavior of the tumor. The analysis carried out in this study, similar to that done in human pathology, allows a more extensive understanding of mammary tumors in rats, as well as a more accurate use of this animal model, and has made it possible to develop an innovative classification of rat mammary lesions.
Histologic Features of Surgically Removed Fallopian Tubes
Authors: Hunt Jennifer L. , Lynn Amy A. A. 
Published: January 2021

Abstract
Context.—The fallopian tube is a common specimen in a pathology laboratory. It may be examined either alone as a salpingectomy or tubal ligation specimen, or as part of a more complex specimen from a hysterectomy and/or oophorectomy operation. Although the common histologic findings in the fallopian tube have been described previously, to our knowledge no study has documented the frequency of histologic changes in fallopian tubes removed for all reasons or associations with clinical history.
Design.—Hematoxylin-eosin–stained slides from 287 fallopian tube specimens were reviewed without knowledge of the clinical history. Three categories and associated subcategories of histologic findings were identified (listed in descending order of frequency): stromal and architectural alterations (fibrosis, intramuscular edema, cellular luminal contents, inclusion cysts, Walthard nests, pigmentosis tubae, Wolffian duct remnants, decidualized stroma, endosalpingiosis, and metastatic carcinoma), epithelial characteristics (cytologic atypia, vacuolization, metaplasia, and tufting), and inflammatory changes (intramuscular mast cells, plasma cells, neutrophils, and lymphoid follicles). Histologic findings were correlated with clinical history, surgery type, and age.
Results.—Intramuscular edema was identified in 12.5% of specimens, most frequently in postpartum women. Plical fibrosis (35.5% of specimens), epithelial atypia (7.3%), epithelial vacuolization (6.6%), and epithelial tufting/stratification (3.5%) correlated with increased patient age. Inflammatory cells were relatively common; 69% of specimens contained intramuscular mast cells, 19.9% had stromal plasma cells, 10.5% had neutrophils, and 2.1% had lymphoid follicles.
Conclusions.—This study provides data that may be valuable for surgical pathologists involved in identifying and characterizing common histologic changes in surgically removed fallopian tubes.
Soft Tissue Amyloidoma With Features of Plasmacytoma
Authors: Yin Hong , Alhasan Nasir , Ciervo Alfonso , Zinterhofer Louis 
Published: January 2021

Abstract
Soft tissue amyloidoma is rare, and soft tissue amyloidoma associated with plasmacytoma and without evidence of systemic amyloidosis is even more rare. We report a case of soft tissue amyloidoma associated with an apparently localized monoclonal proliferation of plasma cells (plasmacytoma).
Primary Yolk Sac Tumor of the Urachus
Authors: Huang Hsuan-Ying , Ko Sheung-Fat , Chuang Jiin-Haur , Jeng Yung-Ming , Sung Ming-Tse , Chen Wei-Jen 
Published: January 2021

Abstract
Pure yolk sac tumor is the most common malignant gonadal tumor of infants and toddlers. However, the majority of extragonadal germ cell tumors in the midline are either seminomas (germinomas) or teratomas, and pure yolk sac tumors account for only a small fraction of these lesions. To date, only 1 primary urachal pure yolk sac tumor has been reported in the literature. We describe another case, occurring in a 7-month-old male infant who presented with a rapidly enlarging intra-abdominal tumor with marked engorgement of the superficial venous plexus around the umbilicus. With periodic follow-up for 3 years following surgical extirpation of the tumor and adjuvant chemotherapy, this patient is still alive without evidence of disease. Notably, the glandular elements predominating in the frozen sections resulted in the initial misdiagnosis of the tumor as a urachal adenocarcinoma, although the entirely resected specimen revealed typical histologic patterns and Schiller-Duval bodies. Immunohistochemistry showed that the tumor cells were diffusely reactive to α-fetoprotein, α1-antitrypsin, and cytokeratin. Tumor cells were negative for p53 protein, but revealed overexpression for MDM2 protein. Flow cytometry demonstrated a diploid DNA content with S-phase being as high as 55.36%. This case emphasizes that pure yolk sac tumor can occur primarily in the remnant of the urachus in young children.
Incidentally Detected Giant Oncocytoma Arising in Retroperitoneal Heterotopic Adrenal Tissue
Authors: Corsi Alessandro , Riminucci Mara , Petrozza Vincenzo , Collins Michael T. , Natale Maria E. , Cancrini Antonio , Bianco Paolo 
Published: January 2021

Abstract
A nonfunctional retroperitoneal oncocytoma incidentally discovered in a 40-year-old woman is described. The tumor, which was 17 cm in largest dimension, was completely separated from the kidneys and adrenal glands and consisted of nests of polygonal cells with large, granular, eosinophilic cytoplasm. Significant nuclear atypia, necrosis, and mitosis were absent. Ultrastructural analysis confirmed the oncocytic nature of the neoplastic cells. Since neoplastic cells were not immunoreactive for chromogranin and did not contain dense-core secretory granules, the diagnosis of oncocytic paraganglioma was excluded. Cells immunoreactive for 3β-hydroxysteroid dehydrogenase, the enzyme catalyzing the conversions of pregnenolone to progesterone and dehydroepiandrosterone to androstenedione, were identified in the tumor, thus strongly indicating adrenocortical tissue origin. Multiple nests of 3β-hydroxysteroid dehydrogenase–positive cells were detected in the loose retroperitoneal connective tissue. These findings strongly support the origin of the tumor from heterotopic retroperitoneal rests of the adrenal gland. To our knowledge, only 1 similar case has been described in the literature to date.
Frozen Section Diagnosis of Pancreatic Lesions
Authors: Cioc Adina M. , Ellison E. Christopher , Proca Daniela M. , Lucas Joel G. , Frankel Wendy L. 
Published: January 2021

Abstract
Background.—The clinical and radiologic diagnosis of pancreatic cancer and the safety of pancreatic resections have improved. These improvements, together with the indication for resection in some cases of complicated chronic pancreatitis, have reduced the necessity for confirmed preoperative tissue diagnosis. We investigated the clinical use and accuracy of frozen section diagnosis for pancreatic lesions.
Design.—We searched archival files for the years 1989–2000 for patients with pancreatic lesions who had received a diagnosis based on frozen section results. We compared the diagnosis of all frozen section slides with that of the permanent sections and reviewed the clinical follow-up notes. We evaluated histologic features useful in differentiating between malignant and benign pancreatic lesions.
Results.—A total of 538 patients underwent surgical biopsy and/or resection for suspected pancreatic lesions. Frozen section was requested in 131 cases (284 frozen sections). Ninety cases had frozen section of the pancreatic lesions, 70 cases had frozen section of metastatic sites, and 29 cases had frozen section of surgical margins. Of the 90 cases in which frozen section of the pancreatic lesions was requested, malignancy was diagnosed in 44, a benign lesion was diagnosed in 37, and the diagnosis was atypical and deferred in 9. In total, 3 false-negative frozen sections and 1 false-positive frozen section were identified for respective rates of 1.2% and 0.3%. In all cases in which the frozen section diagnosis was deferred or was inconsistent with the operative impression, and the surgeon acted on his/her impression, the operative diagnoses were subsequently confirmed by additional permanent sections and/or clinical follow-up. The most useful histologic features for the diagnosis of pancreatic adenocarcinoma in frozen sections were variation in nuclear size of at least 4:1, disorganized duct distribution, incomplete duct lumen, and infiltrating single cells.
Conclusions.—Frozen sections are useful in conjunction with the impression at surgery for the management of patients with pancreatic lesions. Frozen sections of resection margins were 100% accurate; frozen sections of pancreatic lesions or metastatic sites were accurate in 98.3% of cases. We found an acceptable rate of deferred frozen section (6.6%). The experienced surgeon's impression of malignancy is reliable in cases in which frozen section is deferred or has negative findings.
Differential Expression of Cytokeratins 8 and 20 Distinguishes Craniopharyngioma From Rathke Cleft Cyst
Authors: Xin Wei , Rubin Mark A. , McKeever Paul E. 
Published: January 2021

Abstract
Background.—Craniopharyngiomas are epithelial neoplasms usually located in the sellar and suprasellar regions. Distinguishing craniopharyngioma from Rathke cleft cyst is sometimes difficult, and the distinction is clinically significant because Rathke cleft cysts have a better prognosis than craniopharyngiomas.
Design.—We retrieved 10 cases with a primary diagnosis of craniopharyngioma and 5 cases with a diagnosis of Rathke cleft cyst for analysis. Five cases of normal pars intermedia of pituitary glands from autopsy served as controls. We evaluated the expression patterns of a broad range of low– to intermediate–molecular weight cytokeratins (CK7, CK8, CK10, CK17, CK18, CK19, and CK20) and high–molecular weight cytokeratins (K903: a combination of CK1, CK5, CK10, and CK14; and CK5/6) in these cases.
Results.—Craniopharyngiomas had a cytokeratin expression pattern distinct from that of Rathke cleft cysts and pituitary gland pars intermedia: craniopharyngiomas did not express cytokeratins 8 and 20, whereas Rathke cleft cysts and pars intermedia of pituitary glands both expressed cytokeratins 8 and 20.
Conclusion.—The differential expression of cytokeratins distinguishes between craniopharyngioma and Rathke cleft cyst, and this difference could be useful for identifying craniopharyngioma in difficult cases in which only a small biopsy is available. The different cytokeratin profiles of craniopharyngioma and Rathke cleft cyst suggest that these lesions do not come from the same origin, or that they come from a different developmental stage of the pouch epithelium.
Immunohistochemical Comparison of Gastrointestinal Stromal Tumor and Solitary Fibrous Tumor
Authors: Shidham Vinod B. , Chivukula Mamatha , Gupta Dilip , Rao R. Nagarjun , Komorowski Richard 
Published: January 2021

Abstract
Context.—The differential diagnosis of gastrointestinal stromal tumors (GIST) and solitary fibrous tumors (SFT) may be a diagnostic challenging because of overlapping clinicopathologic features. Many studies have shown consistent immunoreactivity for CD117 (c-Kit) in GIST. However, only a few studies have evaluated CD117 expression in SFT, and these studies have used an antibody from Santa Cruz Biotechnology. In non-GIST lesions, reactivity with this antibody has been shown to differ from that with a CD117 antibody from Dako Corporation. The immunoreactivity of SFT with the Dako CD117 antibody has not been reported. Conversely, CD99 is a marker for SFT, and its expression in GIST has not been evaluated.
Objective.—To study the immunohistochemical profiles of GIST and SFT to evaluate their diagnostic overlap.
Design.—We studied the immunoreactivity of 27 unequivocal GIST and 19 unequivocal extra-abdominal SFT for CD117, CD34, CD99, α-smooth muscle actin, vimentin, CD31, S100 protein, and muscle-specific actin. All antibodies, including CD117, were from Dako Corporation.
Results.—We found positive immunoreactivity for CD117 in 100% of GIST and none of SFT; for CD34 in 89% of GIST, and 100% of SFT; for CD99 in 89% of GIST and 100% of SFT; for α-smooth muscle actin in 48% of GIST and 31% of SFT; for vimentin in 89% of GIST and 90% of SFT; and for muscle-specific actin in 22% of GIST and none of SFT. None of the GIST or SFT showed immunoreactivity for CD31 and S100 protein.
Conclusions.—The major difference between GIST and SFT was strong CD117 immunoexpression in all GIST and an absence of this expression in all SFT. With the exception of muscle-specific actin, the prevalence of immunoreactivity for the markers studied did not differ substantially between these 2 tumors. We conclude that GIST and SFT show distinctly divergent immunoprofiles with respect to CD117 and muscle-specific actin.
Intestinal Ischemia
Authors: Dee Simpson L. , Butt Khalid , Ramaswamy Gita 
Published: January 2021

Abstract
Context.—As rejection in renal transplantation has become better controlled, gastrointestinal complications have become increasingly important. Ischemic colitis and colonic perforation are the most common of these lesions, contributing to morbidity and mortality in the early postoperative period.
Objective.—We undertook this study to identify factors contributing to the risk of intestinal ischemia in patients undergoing renal transplantation and to define circumstances that may affect that risk.
Methods.—We studied 356 patients undergoing renal transplantation during a 40-month period. We reviewed medical records, surgical pathology reports, autopsy reports, and pathology slides.
Results.—Eleven (3.1%) of the patients developed ischemia of the small or large bowel or both within 20 days after transplantation, and 6 (54.5%) died as a result. Ten of these patients had received cadaveric kidneys and were older than 40 years. There was no sex predilection. The most common segment involved was the terminal ileum and ascending colon. We discuss possible reasons underlying these observations in this article.
Conclusion.—The mechanism behind posttransplantation intestinal ischemia is multifactorial, but regardless of etiology, it is important to emphasize the risk of intestinal ischemia in patients who develop abdominal symptoms during the early posttransplantation period, particularly in patients older than 40 years who have received cadaveric kidneys.
Passively Acquired Treponemal Antibody From Intravenous Immunoglobulin Therapy in aPregnant Patient
Authors: Rossi Karen Q. , Nickel James R. , Wissel Mary E. , O'Shaughnessy Richard W. 
Published: January 2021

Abstract
Intravenous immunoglobulin is purified, concentrated immunoglobulin G antibodies pooled from human blood donors. The passive transmission of various antibodies from intravenous immunoglobulin has been reported. However, to the best of our knowledge, there are no reports of acquisition of treponemal antibody from immunoglobulin therapy. A woman with a pregnancy complicated by neonatal alloimmune thrombocytopenia was treated with intravenous immunoglobulin to manage her fetal thrombocytopenia. The patient had no history of a syphilis infection. The patient's blood was screened for syphilis antibodies regularly and routinely because she donated platelets for transfusion to her fetus. During her intravenous immunoglobulin treatments, a positive result on a fluorescence antibody absorption test was confirmed, but the result on a rapid plasma reagin test was negative. Eleven weeks after her final dose, results of the fluorescence antibody absorption test were negative, with a negative rapid plasma reagin test result, suggesting passive acquisition of the treponemal antibody. Clinicians and pathologists must be aware of the possible acquisition of this antibody during the treatment and counseling of patients receiving intravenous immunoglobulin.
Laboratory Evaluation of Hypercoagulability With Venous or Arterial Thrombosis
Authors: Van Cott Elizabeth M. , Laposata Michael , Prins Martin H. 
Published: January 2021

Abstract
Objective.—To provide recommendations for hypercoagulation testing for patients with venous, arterial, or neurovascular thrombosis, as reflected in the medical literature and the consensus opinion of recognized experts in the field.
Data Sources, Extraction, and Synthesis.—The authors extensively examined the literature and current practices, and prepared a draft manuscript with preliminary recommendations. The draft manuscript was circulated to each of the expert participants (n = 30) in the consensus conference prior to the convening of the conference. The manuscript and recommendations were then presented at the conference for discussion. Recommendations were accepted if a consensus of the 28 experts attending the conference was reached. The discussions were also used to revise the manuscript into its final form.
Conclusions.—The resulting article provides 17 recommendations for hypercoagulation testing in the setting of venous, arterial, or neurovascular thrombosis. The supporting evidence for test selection is analyzed and cited, and consensus recommendations for test selection are presented. Issues for which a consensus was not reached at the conference are also discussed.