bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mast Cell Quantification in Normal Peritoneum and During Peritoneal Dialysis Treatment
Authors: Jiménez-Heffernan JoséA. , Bajo M. Auxiliadora , Perna Cristian , del Peso Gloria , Larrubia Juan R. , Gamallo Carlos , Sánchez-Tomero JoséA. , López-Cabrera Manuel , Selgas Rafael 
Published: February 2021

AbstractContext.—Mast cells (MCs) have been implicated in fibrogenesis, angiogenesis, and immunity against bacteria. These 3 mechanisms participate in the peritoneal pathology secondary to peritoneal dialysis (PD) treatment. Despite their potential relevance to PD-related pathology, few studies have focused on MCs.Objective.—To evaluate possible variations in the number of MCs during PD treatment.Design.—A quantitative study of tissue MCs in normal and pathologic peritoneum. Parietal peritoneal biopsies were collected from 4 groups: (1) normal controls (n = 9), (2) uremic non-PD patients (n = 16), (3) uremic patients on PD (n = 26), and (4) non-renal patients with inguinal hernia (n = 20). MCs were evaluated using immunohistochemistry for the detection of tryptase. The total number of cross sections of vessels per peritoneal field was examined in 22 of the 26 peritoneal biopsies of PD patients.Results.—PD tissue samples showed fibrosis, mesothelial cell loss, and variable hyalinizing vasculopathy. The number of MCs was similar in normal controls and non-PD uremic patients (mean ± SE: 7.13 ± 0.67 and 7.74 ± 0.74 MCs/mm2, respectively). Peritoneal dialysis patients showed a reduction (4 ± 0.38 MCs/mm2, P &lt; .001), whereas hernia sac samples showed an increase (10.59 ± 3.48 MCs/mm2). MC reduction showed no correlation with time on dialysis, fibrosis, number of vessels, or previous episodes of peritonitis.Conclusions.—The peritoneum of patients receiving PD treatment shows a reduction of MCs. Despite such a reduction, fibrosis takes place, suggesting that MCs do not play a critical role in fibrosis genesis. Mast cell loss may be a contributory factor to peritonitis episodes in PD patients.
Nonsecretory Plasma Cell Myeloma—Becoming Even More Rare With Serum Free Light-Chain Assay: A Brief Review
Authors: Shaw Gene R. 
Published: February 2021

Abstract
Context.—Nonsecretory plasma cell myeloma is characterized by an absence of detectable monoclonal protein in both the serum and urine. It is generally reported to comprise approximately 1% to 5% of all cases of plasma cell myeloma and, because of its rarity, requires a high index of suspicion and bone marrow biopsy to establish the diagnosis.
Objective.—Review the diagnostic strategy when nonsecretory plasma cell myeloma is a clinical consideration in light of a relatively new serum free light chain assay.
Data Sources.—Case study and review of the literature.
Conclusions.—Initial data using a recently developed nephelometric serum free light chain assay suggests that only about one fourth of nonsecretory plasma cell myeloma cases may be truly nonsecretory. The definition of nonsecretory plasma cell myeloma should be modified to exclude cases with evidence of clonality using the serum free light chain assay.
The Significance of Certification in Liquid-Based Cytology and Performance in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytopathology
Authors: Renshaw Andrew A. , Mody Dina R. , Walsh Molly , Bentz Joel S. , Colgan Terence J. 
Published: February 2021

Abstract
Context.—Morphology training and certification provided by the manufacturer is required before laboratories are allowed to prepare and interpret liquid-based cytology (LBC) gynecologic slides. Whether this certification is associated with improved LBC interpretation performance is not known.
Objective.—To determine whether LBC certification correlates with performance.
Design.—The results of the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytopathology for the year 2004 were reviewed. During this year a question on the answer form asked participants whether they were certified in LBC preparations. Participant responses were analyzed at 2 levels of agreement with the reference diagnosis of unknown glass slides mailed quarterly.
Results.—For cytotechnologists and pathologists, participants who were LBC certified had a significantly lower total discordant rate to series than participants who were not certified for validated LBC ThinPrep (Cytyc Corp, Marlborough, Mass) preparations (P &lt; .001 for both groups). The results were similar for validated conventional preparations for pathologists but not for cytotechnologists. The differences were present across most individual diagnostic series. Differences were most striking for low-grade squamous intraepithelial lesions. In addition, cytotechnologists and pathologists who were certified had a significantly lower total discordant rate to the exact diagnosis for validated LBC ThinPrep slides than those who were not certified (discordant rates for cytotechnologists, 14.14% and 23.36%, respectively, P &lt; .001; for pathologists, 15.99% and 24.07%, respectively, P &lt; .001).
Conclusion.—Although not all confounding factors were excluded in this study, LBC certification is associated with a significantly lower discordant rate to both series and exact diagnosis for validated LBC ThinPrep preparations.
Practical Pathology of Gunshot Wounds
Authors: Denton J. Scott , Segovia Adrienne , Filkins James A. 
Published: February 2021

AbstractContext.—Gunshot wounds are the most common cause of homicidal death in the United States. Analysis and interpretation of fatal gunshot wounds is an important and common practice among forensic pathologists. Additionally, for pathology residents, it is an integral aspect of their training during their rotations at medical examiner or coroner offices.Objective.—The correct interpretation of gunshot wounds by forensic pathologists not only provides valuable information that can assist law enforcement in their investigation but also is essential for the final determination of manner of death. Discussion of the practical, basic, and essential skills required to interpret gunshot wounds include distinguishing a classic entrance wound from an exit wound; recognizing atypical entrance and exit wounds; utilizing the features of soot and stippling patterns to differentiate among contact, close, and distant range gunshot wounds; understanding of the trauma produced by gunshot wounds; and understanding the importance of recovering and documenting/handling any projectiles recovered at autopsy.Data Sources.—This article reviews numerous standard forensic pathology textbooks and the pertinent literature to formulate practical guidelines to assist the pathologist in the performance of forensic autopsies and the investigation of gunshot wound fatalities.Conclusions.—Pathologists who perform investigations and autopsies to determine the cause and manner of death in gunshot wound cases must be aware of the implications, requirements, and pitfalls in interpretation of the injuries so that the examination fulfills its expectations to the community and the justice system.
Distinct Expression Patterns of E-Cadherin and β-Catenin in Signet Ring Cell Carcinoma Components of Primary Pulmonary Adenocarcinoma
Authors: Moon Kyung Chul , Cho Soo Youn , Lee Hye Seung , Jeon Yoon Kyung , Chung Jin-Haeng , Jung Kyeong Cheon , Chung Doo Hyun 
Published: February 2021

AbstractContext.—E-Cadherin and β-catenin complexes have been suggested to have critical roles in cancer development and progression. Primary signet ring cell carcinoma (SRCC) of the lung is a rare variant of pulmonary adenocarcinoma, and E-cadherin and β-catenin expressions of this tumor have not been documented, to our knowledge.Objective.—To characterize the E-cadherin and β-catenin expressions in SRCC of the lung.Design.—An immunohistochemical evaluation of E-cadherin and β-catenin expressions in 10 cases of SRCC of the lung, 10 cases of conventional pulmonary adenocarcinoma, 10 cases of gastric SRCC, and 10 cases of colorectal SRCC was performed.Results.—Membranous E-cadherin and β-catenin expressions were frequently reduced or absent in all types of tumors tested. Aberrant E-cadherin localization and nuclear β-catenin accumulation were frequently found in gastric (6/10 and 5/10, respectively) and colorectal (7/10 and 9/ 10, respectively) SRCCs, whereas SRCC of the lung rarely showed aberrant E-cadherin localization (1/10) or nuclear β-catenin accumulation (0/10).Conclusions.—Signet ring cell carcinoma of the lung rarely showed aberrant E-cadherin localization or β-catenin nuclear accumulation, which are frequent events in gastric and colorectal SRCCs. These results suggest that the biologic roles of E-cadherin and β-catenin complexes in SRCC of the lung differ from their roles in gastric or colorectal SRCCs.
Combination of D-Dimer and Amino-Terminal Pro-B-Type Natriuretic Peptide Testing for the Evaluation of Dyspneic Patients With and Without Acute Pulmonary Embolism
Authors: Melanson Stacy E. F. , Laposata Michael , Camargo, Jr Carlos A. , Chen Annabel A. , Tung Roderick , Krauser Dan , Anwaruddin Saif , Baggish Aaron , Cameron Renee , Sluss Patrick , Lewandrowski Kent B. , Lee-Lewandrowski Elizabeth , Januzzi James L. 
Published: February 2021

Abstract
Context.—D-dimer concentration can be used to exclude a diagnosis of acute pulmonary embolism. However, clinicians frequently order unnecessary supplemental testing in patients with low concentrations of D-dimer. Elevations in natriuretic peptides have also been described in the setting of pulmonary embolism.
Objective.—We investigated the integrative role of D-dimer with amino-terminal pro-B-type natriuretic peptide for the evaluation of patients with and without acute pulmonary embolism.
Design.—Patients were selected for analysis from a previous study in which levels of D-dimer and amino-terminal pro-B-type natriuretic peptide were measured. The presence of pulmonary embolism was determined by computed tomographic angiography.
Results.—The median levels of D-dimer were significantly higher in patients with acute pulmonary embolism. Similarly, the median levels of amino-terminal pro-B-type natriuretic peptide were higher in patients with pulmonary embolism.
Conclusions.—The Roche Tina-quant D-Dimer immunoturbidimetric assay provides a high negative predictive value and can be used to exclude acute pulmonary embolism in patients with dyspnea. Measurement of amino-terminal pro-B-type natriuretic peptide in addition to D-dimer improves specificity for acute pulmonary embolism without sacrificing negative predictive value. A combination of both markers may offer reassurance for excluding acute pulmonary embolism, and thus avoid redundant, expensive confirmatory tests.
Documentation of Surgical Specimens Using Digital Video Technology
Authors: Melín-Aldana Héctor , Carter Barbara , Sciortino Debra 
Published: February 2021

Abstract
Context.—Digital technology is commonly used for documentation of specimens in anatomic pathology and has been mainly limited to still photographs. Technologic innovations, such as digital video, provide additional, in some cases better, options for documentation.
Objective.—To demonstrate the applicability of digital video to the documentation of surgical specimens.
Design.—A Canon Elura MC40 digital camcorder was used, and the unedited movies were transferred to a Macintosh PowerBook G4 computer. Both the camcorder and specimens were hand-held during filming. The movies were edited using the software iMovie. Annotations and histologic photographs may be easily incorporated into movies when editing, if desired.
Results.—The finished movies are best viewed in computers which contain the free program QuickTime Player. Movies may also be incorporated onto DVDs, for viewing in standard DVD players or appropriately equipped computers. The final movies are on average 2 minutes in duration, with a file size between 2 and 400 megabytes, depending on the intended use. Because of file size, distribution is more practical via CD or DVD, but movies may be compressed for distribution through the Internet (e-mail, Web sites) or through internal hospital networks.
Conclusions.—Digital video is a practical, easy, and affordable methodology for specimen documentation, permitting a better 3-dimensional understanding of the specimens. Discussions with colleagues, student education, presentation at conferences, and other educational activities can be enhanced with the implementation of digital video technology.
“Benign,” Metastasizing Adenomyoepithelioma of the Breast: A Report of 2 Cases
Authors: Nadelman Celina M. , Leslie Kevin O. , Fishbein Michael C. 
Published: February 2021

Abstract
Adenomyoepitheliomas of the breast are rare tumors composed of a proliferation of 2 cell populations. For the most part, they are considered to be benign, but they locally recur. Those neoplasms that metastasize are deemed to have come from a histologically malignant primary tumor. Herein, we describe 2 cases of metastases of histologically “benign” adenomyoepitheliomas of the breast to the lung. In both cases, the primary neoplasms and the metastases did not show histologic features of malignancy. These unique cases represent another example of neoplasms that can metastasize in the absence of histologic features that would suggest malignant behavior. Establishing the diagnosis, determining optimal therapy, and predicting outcome are problematic because of the rarity of this entity. Perhaps, classification of adenomyoepitheliomas should be changed to recognize those neoplasms with malignant behavior.
Are Gadolinium-Based Contrast Media Nephrotoxic?: A Renal Biopsy Study
Authors: Akgun Hulya , Gonlusen Gulfiliz , Cartwright, Jr Joiner , Suki Wadi N. , Truong Luan D. 
Published: February 2021

AbstractGadolinium-based contrast media were originally introduced as alternatives to iodinated media for magnetic resonance imaging. Although originally thought to be nonnephrotoxic, gadolinium-based contrast media have recently been reported to be associated with acute renal failure; the mechanism and the underlying renal injury are not completely understood. We report what is, to our knowledge, the first renal biopsy in this context. A 56-year-old patient underwent 2 consecutive vascular imaging procedures in conjunction with gadolinium-based contrast medium administration. A few days later, the patient developed acute renal failure. A renal biopsy showed acute tubular cell injury including patchy tubular cell necrosis, tubular cell degeneration, and marked proliferation of tubular cells, together with mild interstitial edema and interstitial inflammation, but without significant glomerular or vascular changes. During supportive therapy, renal function was partially regained. This case emphasizes the potential nephrotoxicity of gadolinium-based contrast media and suggests that the nephrotoxicity is related to potentially reversible acute tubular cell injury.
Prognostic Significance of Histomorphologic Parameters in Diffuse Malignant Peritoneal Mesothelioma
Authors: Cerruto Carlos A. , Brun Erwin A. , Chang David , Sugarbaker Paul H. 
Published: February 2021

Abstract
Context.—Diffuse malignant peritoneal mesothelioma is currently regarded as a rare and lethal primary tumor arising from the peritoneal membrane. In the past, treatment plans with variable combinations of surgery and systemic chemotherapy were associated with a median survival of approximately 1 year. Standardized treatments using cytoreductive surgery and perioperative intraperitoneal chemotherapy have extended this survival.
Objective.—To critically analyze the prognostic significance of histomorphologic parameters as a determinant of survival.
Design.—Sixty-two consecutive patients with diffuse malignant peritoneal mesothelioma in whom data were prospectively accumulated were retrospectively analyzed by 14 different histomorphologic parameters. The influences of these pathologic characteristics on survival were critically statistically evaluated.
Results.—In a univariate analysis, histologic type, nuclear/nucleolar size, stroma, depth of invasion into the bowel, atypical mitoses, mitotic index, necrosis, lymph node involvement, and chromatin patterns were found to be significant. In the multivariate analysis, histologic type and nuclear/nucleolar size remained as determinant histomorphologic characteristics. Use of biphasic/sarcomatoid histologic type as a poor prognostic characteristic was limited in that only 8% of patients showed this histology.
Conclusions.—Histomorphologic parameters carry prognostic significance in predicting the survival of patients with diffuse malignant peritoneal mesothelioma when treated in a standardized fashion using cytoreductive surgery and perioperative intraperitoneal chemotherapy. Nuclear/nucleolar size was found to be a reliable histomorphologic assessment available to assess prognosis in these patients.
Interdigitating Dendritic Cell Sarcoma of the Duodenum With Rapidly Fatal Course: A Case Report and Review of the Literature
Authors: Kanaan Hassan , Al-Maghrabi Jaudah , Linjawi Ayman , Al-Abbassi Amira , Dandan Abdelghani , Haider Abdul Razzaq 
Published: February 2021

Abstract
Interdigitating dendritic cell sarcoma is an extremely rare malignancy derived from antigen-presenting cells. Dendritic cells constitute a heterogeneous group of cells, which includes Langerhans cells, dermal dendrocytes, follicular dendritic cells, and interdigitating dendritic cells present in lymphoid and nonlymphoid organs. We report the case of a 36-year-old woman who presented with epigastric pain, projectile vomiting, and significant weight loss. Upper gastrointestinal endoscopy showed a duodenal lesion; a biopsy of the lesion was taken and was diagnosed as sarcoma. She underwent a Whipple procedure. A final diagnosis of interdigitating dendritic cell sarcoma was made, with liver and peripancreatic lymph node involvement. The patient deteriorated rapidly and died 4 months later. Although interdigitating dendritic cell sarcoma of the duodenum is extremely rare, we think it should be included in the differential diagnosis of unusual spindle cell tumors with a rich lymphocytic infiltrate.
Diabetic Hepatosclerosis: Diabetic Microangiopathy of the Liver
Authors: Harrison Stephen A. , Brunt Elizabeth M. , Goodman Zachary D. , Di Bisceglie Adrian M. 
Published: February 2021

Abstract
Context.—Liver disease associated with diabetes mellitus is common and usually takes the form of simple steatosis or nonalcoholic steatohepatitis. After observing a noncirrhotic form of hepatic sinusoidal fibrosis in patients with long-standing diabetes mellitus who underwent liver biopsy, we set about to characterize this novel entity.
Design and Setting.—Cases with the hallmark histologic findings were gathered at Saint Louis University School of Medicine and the Armed Forces Institute of Pathology.
Patients.—The clinical records were examined in a systematic fashion. Results of light microscopy and prepared immunohistochemical stains were reviewed.
Main Outcome Measures.—Clinical findings of patients with the histologic, detailed light microscopic, and immunohistochemical findings on biopsies.
Results.—Twelve patients were identified from biopsy findings; all had a history of long-standing diabetes mellitus and a noncirrhotic form of hepatic sinusoidal fibrosis not associated with nonalcoholic steatohepatitis. Most of these patients had a body mass index less than 25 kg/m2 and had substantial evidence of microvascular complications, including retinopathy, nephropathy, and peripheral and autonomic neuropathy. Alkaline phosphatase elevation was common. Liver biopsy specimens showed extensive dense perisinusoidal fibrosis, and immunostaining revealed basement membrane components in a perisinusoidal distribution. Features of nonalcoholic steatohepatitis were not present in the biopsy specimens.
Conclusions.—We propose the term diabetic hepatosclerosis for this entity and suggest that it represents a form of diabetic microangiopathy affecting the liver. Further studies are needed to precisely characterize diabetic hepatosclerosis and to understand mechanisms of pathogenesis and the clinical significance.
Potential Predictive Patterns of Minimal Residual Disease Detected by Immunohistochemistry on Bone Marrow Biopsy Specimens During a Long-term Follow-up in Patients Treated With Cladribine for Hairy Cell Leukemia
Authors: Mhawech-Fauceglia Paulette , Oberholzer Martin , Aschenafi Senait , Baur Audrey , Kurrer Michael , Von Rohr Albert , Hsu-Schmitz Shu-Fang , Wagner Beatrice , Delacretaz Francoise , Hurwitz Nina 
Published: February 2021

Abstract
Context.—Minimal residual disease (MRD) in patients treated for hairy cell (HC) leukemia as assessed by immunohistochemistry has not been included routinely in evaluation of treatment results.
Objective.—To assess the presence of persistent HCs after treatment, as detected by immunohistochemistry, and to evaluate the correlation between the level of MRD and clinical outcome.
Design.—Percentages of DBA.44-positive HCs were assessed on 116 biopsy specimens from 17 patients. The patients had a median follow-up of 55.4 months.
Results.—Minimal residual disease was seen in 3 patterns. Group 1 (7 patients) had MRD levels ranging from “rare scattered suspicious HCs” to less than 1%. The MRD levels were stable throughout follow-up, and all patients remained in complete remission. Group 2 (6 patients) had MRD levels ranging from 1% to 5%, and 3 patients were in complete remission at 77.9, 63.8, and 108.0 months. Another patient showed evidence of disease activity (partial remission) at 47.6 months. Two other patients relapsed at 12.3 months and at 25.7 months, respectively, with greater than 1% HCs. Group 3 (4 patients) had MRD levels greater than 5%. Three patients relapsed at 11.3, 12.1, and 29.6 months, respectively, with greater than 5% HCs. The fourth patient had MRD levels of 5% at 14.6 months and 2% at 20.0 months but was subsequently lost to follow-up.
Conclusions.—Quantitative assessment of MRD may be of value in identifying patients at risk for relapse of hairy cell leukemia.
Normal and Neoplastic Cells of Brown Adipose Tissue Express the Adhesion Molecule CD31
Authors: Rosso Renato , Lucioni Marco 
Published: February 2021

AbstractContext.—CD31 (platelet-endothelial cell adhesion molecule-1; PECAM-1), an adhesion molecule involved in the process of angiogenesis, is used as a marker of normal and neoplastic vascularization. During the assessment of angiogenesis and vascular invasion in a thymic carcinoid tumor, we observed unexpected immunostaining for CD31 in perithymic brown fat nests.Objective.—To determine whether CD31 is expressed by normal and neoplastic cells of brown fat, a tissue whose thermogenetic activity depends heavily on high perfusion.Design.—Formalin-fixed, paraffin-embedded archival tissues were immunostained by the labeled avidin-biotin method using antibodies against CD31 (clones JC70A and 1A10) after retrieval of heat-induced epitopes. Archival tissues included perithymic, periadrenal, axillary, and neck adipose tissue in which were embedded nests of brown fat (n = 15), hibernoma (n = 3), lipoma (n = 6), well-differentiated liposarcoma (n = 4), and myxoid liposarcoma (n = 4).Results.—Invariably, multivacuolated and univacuolated adipocytes of normal brown fat and hibernomas were intensely positive for the CD31 antigen. The immunostaining “decorated” cell membranes and the membranes of intracytoplasmic vacuoles. No expression of CD31 was found in normal adipocytes of white fat, in neoplastic cells of lipomas, or in multivacuolated lipoblasts of well-differentiated and myxoid liposarcomas.Conclusions.—The spectrum of cell types that express CD31 is expanded to include normal and neoplastic brown fat cells. We speculate that the expression of CD31 may play a role in the development and maintenance of the vascular network characterizing this specialized adipose tissue. Moreover, CD31 may inhibit the Bax-mediated apoptosis of brown fat cells. For practical purposes, CD31 may be used as an immunohistochemical marker for distinguishing between white and brown fat and for diagnosing hibernoma in paraffin sections.