bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent Intranodal Palisaded Myofibroblastoma With Metaplastic Bone Formation
Authors: Creager Andrew J. , Garwacki Christopher P. 
Published: January 2021

Abstract
Intranodal palisaded myofibroblastoma (IPM) is a rare primary nonlymphoid tumor of the lymph node, which can easily be mistaken for other spindle cell tumors. Intranodal palisaded myofibroblastoma is thought to arise from intranodal myofibroblasts, a finding that is supported by its immunophenotype, positive immunostaining for actin and vimentin, and negative immunostaining for desmin. Characterized by a benign clinical course, IPM is treated by simple surgical excision. We describe a 49-year-woman, who had cadaveric renal transplantation in 1992 and recurrent IPM 4½ years after its original excision. To our knowledge, this case represents only the second known case of recurrent IPM. The histologic feature of metaplastic bone formation in this case has not been previously described in IPM.
An Examination of Ethical Issues Raised in the Pretreatment of Normal Volunteer Granulocyte Donors With Granulocyte Colony-Stimulating Factor
Authors: Volk Emily E. , Domen Ronald E. , Smith Martin L. 
Published: January 2021

Abstract
Objective.—To explore some of the ethical issues surrounding the administration of granulocyte colony-stimulating factor (G-CSF) to healthy individuals for the purpose of retrieval of granulocytes.
Design.—Review of the historical precedent of drug administration to normal blood donors and review of the literature concerning the side effects of G-CSF administration to healthy individuals, particularly as related to granulocyte collection. We identify and discuss some of the ethical questions regarding this issue.
Results.—Although the short-term side effects of G-CSF use in normal donors are generally felt to be benign, little is known about the long-term side effects. Ethical questions regarding the administration of this drug to normal donors for the purpose of collecting large numbers of granulocytes include the following: Does the potential benefit to a patient/recipient justify the unknown risks to the medicated granulocyte donor? Who should act as an advocate for donors so that their best interests are protected? What is the role and quality of informed consent for donors undergoing G-CSF administration? Is monetary compensation appropriate for donors administered G-CSF as part of a research protocol?
Conclusions.—We recommend the establishment of a donor registry to collect the needed data on the side effects of G-CSF on normal donors. Until adequate data are collected, the use of G-CSF and similar agents in normal donors should be regarded as experimental and subject to review by institutional review boards.
Using Outlier Events to Monitor Test Turnaround Time
Authors: Steindel Steven J. , Novis David A. 
Published: January 2021

Abstract
Objectives.—To determine the causes of excessive test turnaround time (TAT) and to identify methods of improvement by studying reasons for those tests reported in excess of 70 minutes from the time the test was ordered (ie, outliers).
Design.—Self-directed data-gathering of stat outlier TAT events from intensive care units and emergency departments, with descriptive parameters associated with each event and additional descriptive parameters associated with the participant.
Participants.—Laboratories enrolled in the 1996 College of American Pathologists Q-Probes program.
Main Outcome Measures.—Components associated with outlier TAT events and outlier TAT rates.
Results.—Four hundred ninety-six hospital laboratories returned data on 218 551 stat tests, of which 10.6% had TATs in excess of 70 minutes. Ten percent of stat emergency department tests and 14.7% of stat intensive care unit tests were outliers. Major areas in which delays occurred were test ordering, 29.9%; within-laboratory (analytic) phase, 28.2%; collection of the specimen, 27.4%; postanalytic phase, 1.9%; and undetermined, 12.5%. The type of test performed was a significant factor and was independent of location: Chemistry–Multiple Test appeared most frequently (∼40%), followed closely by Hematology–Complete Blood Count (∼20%) and Chemistry–Single Test (∼18%). Factors of outlier TAT components for intensive care unit specimens were identified using statistical modeling and included hour of day, type of health care personnel collecting specimen, performing the test in a stat laboratory, and reason for delay. Outlier rates were not associated with any identified factors. The practice parameters of laboratories with outlier rates in the lowest 10th percentile significantly differed from those with rates in the top 10th percentile in test request computerization, report methods, and ordering methods.
Conclusions.—We observed that outlier analysis yields new information, such as type of test and reason for delay, concerning test delays when compared with TAT determination alone. Laboratories experiencing stat test TAT problems should use this tool as an adjunct to routine TAT monitoring for identifying unique causes of delay.
Primary Hepatic B-Cell Lymphoma of Mucosa-Associated Lymphoid Tissue
Authors: Kirk Cheryl M. , Lewin David , Lazarchick John 
Published: January 2021

Abstract
Mucosa-associated lymphoid tissue (MALT) lymphomas are low-grade B-cell lymphomas that occur in a variety of extranodal sites but rarely as a primary hepatic lymphoma. We describe the histological findings, immunophenotype, and immunohistochemistry of one such lymphoma found incidentally in a 69-year-old woman. The lymphoid infiltrate invaded the liver in a serpiginous configuration with entrapment of nodules of normal liver. Reactive follicles were surrounded by intermediate-sized lymphoid cells with slightly irregular nuclei and pale cytoplasm. Only a few scattered lymphoepithelial lesions were identified since most of the bile ducts were destroyed. The immunophenotype determined by flow cytometry identified the lymphoid cells as being CD19, CD20 positive and exhibiting λ light chain restriction. CD5, CD10, and CD23 were negative. Immunohistochemistry showed the neoplastic cells to be positive for CD20 (L-26) and bcl-2. The reactive follicles were negative for bcl-2. CD3 showed only a few scattered T cells. Cyclin D1 did not stain the neoplastic cells. Cytokeratin (AE1/AE3) highlighted the lymphoepithelial lesions and residual bile ducts. MALT lymphomas need to be recognized and distinguished from other B-cell lymphomas, particularly mantle cell lymphomas, because of the difference in behavior and treatment.
Munchausen Syndrome Presenting as Pulmonary Talcosis
Authors: Egan A. J. Matthew , Tazelaar Henry D. , Myers Jeffrey L. , Abell-Aleff Patrice C. 
Published: January 2021

Abstract
We describe a patient with self-induced inhalational pulmonary talcosis originally diagnosed as asthma. A 35-year-old female respiratory technologist developed severe asthma that was refractory to steroids and methotrexate. An open lung biopsy specimen showed scattered aggregates of refractile golden crystals within membranous and respiratory bronchioles. The particles ranged in size from 30 to 100 μm and were birefringent when viewed with polarized light. Following review of the lung biopsy specimen, the patient admitted to regularly inhaling large amounts of hospital baby powder. Analysis of the lung biopsy specimen and a sample of the hospital baby powder by x-ray energy dispersion showed identical spectroscopic peaks, including elemental peaks for magnesium silicate. Many patients with self-induced illness lack the picturesque symptomatology classically attributed to Munchausen syndrome. Awareness of these more subtle and varied patterns of presentation may aid in earlier recognition.
Evaluation of a Fully Automated High-Performance Liquid Chromatography Assay for Hemoglobin A1c
Authors: Khuu Hanh M. , Robinson C. Andrew , Goolsby Kathy , Hardy Robert W. , Konrad Robert J. 
Published: January 2021

Abstract
Introduction.—Measurement of hemoglobin A1c (HbA1c) is used as an objective measure of long-term blood glucose control in diabetic patients. Recent improvements in automation combined with new recommendations for precision and accuracy have caused us to reevaluate our methods for measuring HbA1c.
Objective.—We evaluated a newly automated high-performance liquid chromatography (HPLC) instrument for measurement of HbA1c (Tosoh A1c 2.2 Plus Glycohemoglobin Analyzer, Tosoh Medics, Foster City, Calif) and compared the results obtained by HPLC to those obtained with an immunoassay (Hitachi 911, Boehringer Mannheim Corporation, Indianapolis, Ind).
Results.—The Tosoh analyzer was found to be linear in a range of 5.3% to 17% and had a throughput of 20 samples per hour. HbA1c results for 102 patient samples by the 2 techniques showed good correlation, with a slope of 0.87 and an intercept at 1.27% ± 0.15%. Both the total and within-run coefficients of variation were consistently lower for the HPLC method compared with the immunoassay method. The HPLC method produces a chromatogram that shows the different hemoglobin fractions, allowing identification of abnormal hemoglobin variants. In heterozygous individuals, HbA1c measurements are made with no interference from the hemoglobin variant. In the case of homozygous or doubly heterozygous hemoglobin variants, the Tosoh HPLC identifies the hemoglobin variants as such and correctly does not report a HbA1c value in the presence of a markedly decreased amount of hemoglobin A.
Conclusions.—The Tosoh HPLC provides adequate throughput and improved precision, and the method is traceable to the Diabetes Control and Complications Trial.
Intrathecal Methotrexate–Induced Megaloblastic Anemia in Patients With Acute Leukemia
Authors: Sallah Sabah , Hanrahan L. Robert , Phillips Debra L. 
Published: January 2021

Abstract
Objective.—To evaluate the occurrence of megaloblastic anemia induced by the infusion of therapeutic or prophylactic methotrexate in patients with acute leukemia.
Design.—Data on 3 patients with acute leukemia receiving intrathecal methotrexate were prospectively analyzed.
Setting.—Large tertiary-care center.
Results.—All 3 patients with acute leukemia developed megaloblastic anemia confirmed by examination of the bone marrow aspirate and biopsy. Two of the 3 patients had low folic acid levels, while all patients had normal serum B12 levels. All patients responded favorably to a therapeutic trial of folic acid. The median time for recovery of the hematologic parameters in these patients was 7 days.
Conclusions.—Intrathecally administered methotrexate may result in megaloblastic changes in the bone marrow of leukemic patients. The morphologic clues suggestive of folate deficiency in patients with acute leukemia may be masked by coexisting factors, such as the effects of cytotoxic treatment, prior transfusions, or persistent changes from the leukemic clone itself. Caution should be exercised to avoid attributing these changes to the neoplastic process, since the prognosis and treatment for the conditions involved are totally different. Repeat examination of the bone marrow, obtaining folic acid and vitamin B12 levels, and a therapeutic trial of folic acid may help identify and reverse these changes.
The Myoepithelial Immunophenotype in 135 Benign and Malignant Salivary Gland Tumors Other Than Pleomorphic Adenoma
Authors: Prasad Anil R. , Savera Adnan T. , Gown Allen M. , Zarbo Richard J. 
Published: January 2021

AbstractBackground.—We have previously studied the immunoreactivity of 3 novel smooth muscle–specific proteins, α-smooth muscle actin, smooth muscle myosin heavy chains, and calponin, to assess myoepithelial differentiation in pleomorphic adenomas.Objective.—To further expand our knowledge of myoepithelial differentiation in other benign and malignant salivary gland tumors.Design.—Formalin-fixed paraffin sections of 135 salivary gland tumors with associated normal glands were stained with monoclonal antibodies using the avidin-biotin complex immunoperoxidase method and enzymatic and microwave heat–induced epitope retrieval.Results.—In adenoid cystic carcinomas and epithelial-myoepithelial carcinomas, all 3 markers exclusively highlighted the myoepithelial cell components and the epithelial cells were entirely negative. No immunostaining was detected in canalicular adenomas, oncocytomas, Warthin tumors, acinic cell carcinomas, mucoepidermoid carcinomas, squamous cell carcinomas, and polymorphous low-grade adenocarcinomas. Salivary duct carcinomas and adenocarcinomas, not otherwise specified had a distinctive pattern of uniform periductal staining of reactive myofibroblastic cells, and in salivary duct carcinomas some ducts retained a peripheral immunoreactive myoepithelial cell layer.Conclusion.—Immunoreactivity for these 3 smooth muscle–specific proteins confirms the known neoplastic myoepithelial component of adenoid cystic carcinomas and epithelial-myoepithelial carcinomas. The consistently positive staining pattern in adenoid cystic carcinomas may be diagnostically useful in discriminating histologically similar but consistently negative polymorphous low-grade adenocarcinomas. Periductal linear staining in adenocarcinoma, not otherwise specified and salivary duct carcinomas is distinctive and appears to represent a tight cuff of myofibroblasts associated with the infiltrating glands.
Myiasis Secondary to Dermatobia hominis (Human Botfly) Presenting as a Long-standing Breast Mass
Authors: Kahn Douglas G. 
Published: January 2021

Abstract
A case of a 54-year-old woman who presented with a breast mass is reported. Histologically, a chronic granulomatous inflammatory response was observed. The response was associated with an organism diagnosed as a fly larva, Dermatobia hominis (human botfly). The incidence of myiasis, infestation by fly larvae, presenting as a long-standing breast mass and mimicking a neoplasm is extremely rare, especially in the United States.
Osteosarcoma Arising in a Solitary Osteochondroma of the Fibula
Authors: Lamovec Janez , Špiler Marko , Jevtić Vladimir 
Published: January 2021

Abstract
We present a case of osteosarcoma arising in an osteochondroma of the right fibula in a 30-year-old woman. The available radiographic studies of the lesion were not suggestive of malignant transformation. The lesion and underlying bone were excised. Histologic examination showed a conventional high-grade osteoblastic osteosarcoma that focally eroded the fibrocartilaginous cap. The patient received postoperative chemotherapy and shows no evidence of disease 27 months following operation. The occurrence of osteosarcoma in an osteochondroma is an extremely rare event, and only a few cases are on record in the literature.
Epithelioid Hemangioendothelioma, Multiple Focal Nodular Hyperplasias, and Cavernous Hemangiomas of the Liver
Authors: Bralet Marie-Pierre , Terris Benoit , Vilgrain Valérie , Brégeaud Laurence , Molas Georges , Corbic Michèle , Belghiti Jacques , Fléjou Jean-François , Degott Claude 
Published: January 2021

Abstract
Malignant vascular neoplasms of the liver are uncommon. We report the case of a young woman who developed an epithelioid hemangioendothelioma of the liver associated with multiple focal nodular hyperplasias and hepatic cavernous hemangiomas. Such an unusual association is probably not fortuitous and could support the theory that focal nodular hyperplasia is a reaction to an abnormal vascular supply rather than a true neoplasm.
Platelets
Authors: Silberman Simone 
Published: January 2021

AbstractObjective.—To summarize current knowledge and recent progress pertaining to platelet concentrate preparations, modifications, and future prospects for platelet substitutes.Methods.—Current publications identified through a search of an electronic literature database were evaluated and reviewed. Relevant data were abstracted into this article. Abstractions of the data were made depending on their relevance. This review starts with standard methods of platelet preparation and goes on to describe different modifications intended to optimize the product and increase its safety. The article concludes with a discussion of the use of hematopoietic growth factors and novel kinds of platelet components for future use.Conclusions.—Many modifications in the preparation of platelet transfusions have occurred in recent years. Platelets prepared by standard techniques contain significant numbers of donor leukocytes, which are responsible for several adverse effects. Awareness of this problem has lead to the development of effective means for their removal. Several methods to reduce the risk of viral and bacterial transmission through platelet transfusions are emerging. New technologies in the use of platelet substitutes have attempted to prolong the platelet storage potential and prevent the development of recipient alloimmunization. As the biological activities of growth factors become better understood, the clinical applications of novel recombinant products may redefine the concept of future platelet transfusions. It is important that research continues into the optimal methods for the preparation and use of platelet transfusions to provide maximal clinical benefits with minimal risk of complications.
Neuroendocrine Carcinoma of the Posterior Mediastinum
Authors: Horie Yasushi , Kato Masako 
Published: January 2021

Abstract
A paravertebral mass was noted in the posterior mediastinum in a 47-year-old man. Microscopically, the tumor showed solid and trabecular patterns and consisted of poorly differentiated atypical cells that often formed Flexner-Wintersteiner rosettelike glands. Immunohistochemically, the tumor cells expressed both epithelial and neuroendocrine markers, including cytokeratin (AE1/3), carcinoembryonic antigen, epithelial membrane antigen, neuron-specific enolase, chromogranin A, and synaptophysin, but were negative for CD99 (MIC2). Ultrastructurally, numerous desmosomes and neurosecretory granules were identified in the tumor cells. The present lesion was a primary neuroendocrine carcinoma of the posterior mediastinum—an unusual site for such a lesion.
A Case of Familial Angiolipomatosis With Lisch Nodules
Authors: Cina Stephen J. , Radentz Stephen S. , Smialek John E. 
Published: January 2021

AbstractFamilial angiolipomatosis is a rare syndrome that may be confused clinically with neurofibromatosis type 1. This condition is most often inherited in an autosomal recessive manner; however, several reports have been published suggesting an autosomal dominant mode of inheritance. Angiolipomatosis, although somewhat disfiguring, is a benign condition with no known association with malignant neoplasms. This is in contradistinction to neurofibromatosis, an autosomal dominant syndrome associated with a myriad of benign and malignant neoplasms. It is, therefore, important to discriminate this entity from neurofibromatosis when a patient presents with multiple subcutaneous tumors and a family history of similar lesions. Described is a case of a prison inmate with a history of seizures and “neurofibromatosis” without clinical documentation. Lisch nodules were noted on the irides. Postmortem examination showed multiple subcutaneous yellow tumors on the chest and arms. Fine-needle aspiration of 1 mass yielded adipose tissue with prominent vessels; histologic sections of another mass showed angiolipoma. The remainder of the autopsy showed significant coronary artery disease and a remote cerebral infarction of the temporal lobe but no signs of neurofibromatosis. We feel that the presence of multiple angiolipomas in combination with Lisch nodules lends credence to the proposed relationship between fatty tumors and neurofibromatosis suggested by other authors.
Practice Guidelines for Autopsy Pathology
Authors: Hutchins Grover M. , Berman Jules J. , Moore G. William , Hanzlick Randy 
Published: January 2021

Abstract
The Autopsy Committee of the College of American Pathologists has prepared this revised guideline to reflect changes that have occurred in the reporting of autopsies since the original guideline was published in February 1995. It is intended to be an instrument to assist pathologists in the reporting of autopsies. The guideline is to be regarded as being primarily an educational tool. Application of these recommendations on autopsy reporting is to be made on the basis of the judgment of the pathologist engaged in a specific case.
Lack of Epstein-Barr Virus Infection in Cervical Carcinomas
Authors: de Oliveira Deilson Elgui , Monteiro Talita Antônia Furtado , de Melo Wyller Alencar , Moreira Marise Amaral Rebouças , Alvarenga Marcelo , Bacchi Carlos E. 
Published: January 2021

Abstract
Context.—The Epstein-Barr virus (EBV) is a ubiquitous microorganism strongly associated with lymphoproliferative disorders and a large number of human neoplasms, mainly undifferentiated nasopharyngeal carcinoma and Burkitt lymphoma. The viral DNA has been detected in other tumors, such as carcinomas from tonsil, salivary glands, and thymus, and malignancies of the female genital tract. Some authors have proposed that EBV could play a role in the carcinogenesis of cervical tumors; however, other studies do not support this hypothesis.
Objective.—To assess whether EBV is associated with female genital tract neoplasms.
Design.—Sixty-five biopsy specimens (5 in situ carcinomas, 24 invasive squamous cell carcinomas, 6 lymphoepithelioma-like carcinomas, and 30 endocervical adenocarcinomas) were used to perform EBV detection through RNA in situ hybridization.
Results.—None of the cervical carcinoma cases studied was positive for EBV infection.
Conclusions.—The results suggest that it is still premature to incriminate EBV in the carcinogenesis of cervical carcinoma.
Invasive Cystic Hypersecretory Ductal Carcinoma of Breast
Authors: Herrmann Marille E. , McClatchey Kenneth D. , Siziopikou Kalliopi P. 
Published: January 2021

Abstract
Few individual cases of invasive cystic hypersecretory ductal carcinoma of the breast have been described. Review of 33 cases of cystic hypersecretory carcinoma, including the current case, indicate that only 6 cases presented with invasive disease. Two of these cases had positive nodes and 2 had distal metastases. The case presented here is unique in an additional aspect: the contralateral breast harbored lobular breast carcinoma 10 years after mastectomy of the first malignancy. Bilateral breast disease resulting in bilateral mastectomies over long-term follow-up, as in the case presented here, was reported in 3 of 33 cases.
Squamous Cell Carcinoma Arising in a Ciliated Hepatic Foregut Cyst
Authors: Vick Dan J. , Goodman Zachary D. , Ishak Kamal G. 
Published: January 2021

Abstract
Ciliated hepatic foregut cysts are rare congenital lesions derived from the embryologic foregut. They are considered benign, and a review of 64 published cases revealed no instances of malignant transformation. We report a case of squamous cell carcinoma arising in a ciliated hepatic foregut cyst in a 51-year-old man. The tumor was found during a routine cholecystectomy and involved the adjacent mesentery and duodenal wall. There was histologic evidence of perineural and perivascular involvement. Despite an en bloc resection of the tumor and contiguous areas of gross involvement, the patient died 2 months later. Although aspiration of cyst contents is an accepted treatment for asymptomatic lesions, this case suggests that most ciliated hepatic foregut cysts should be excised, especially when radiologic studies yield equivocal results.