bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between p63 and p53 Expression in Normal and Neoplastic Breast Tissue
Authors: Ribeiro-Silva Alfredo , Ramalho Leandra N. Zambelli , Garcia Sérgio Britto , Zucoloto Sérgio 
Published: January 2021

Abstract
Context.—p63 is a recently described p53 homologue. Despite structural homology, they have different activities.
Objectives.—To obtain new insights into the role of p63 in normal and neoplastic breast tissue and to verify the possible association between p63 and p53 in breast carcinomas.
Design.—Immunohistochemistry in 85 breast carcinomas using p63, smooth muscle actin (1A4), p53, estrogen receptor, and progesterone receptor. The p63-positive cases were submitted to a double-immunolabeling study using p63 with 1A4, cytokeratin 7, and 34βE12. Clinical data were retrieved from medical files.
Results.—p63, like 1A4, stained a single and continuous layer surrounding normal breast ductal and alveolar epithelium. In carcinomas, p53 was expressed in 21.17% of carcinomas, whereas p63 was expressed only in poorly differentiated ductal carcinomas (11.76% of cases). p63-positive cells coexpressed 1A4 and 34βE12, but not cytokeratin 7. Expression of p63 correlated with pathologic staging, tumor size, histologic grading, nodal metastasis, and estrogen receptor negativity.
Conclusions.—p63 is a specific myoepithelial cell marker in normal breast tissue and is expressed in a minority of breast carcinomas, being seen only in grade III ductal carcinomas. In ductal carcinomas, malignant p63-positive cells have an immunophenotype similar to that of myoepithelial cells, suggesting that these cells originate from a primary progenitor cell that underwent divergent differentiation to ductal and myoepithelial cells during clonal expansion. Our study argues against a direct role in mammary tumorigenesis. However, p53 is rarely coexpressed with p63, suggesting that p63 could act indirectly as an oncogene by inhibiting p53. This hypothesis could also explain why p63 correlated with several other indicators of poor prognosis.
Sinus Histiocytosis With Massive Lymphadenopathy and Langerhans Cell Histiocytosis Express the Cellular Adhesion Molecule CD31
Authors: Slone Stephen P. , Fleming Donald R. , Buchino John J. 
Published: January 2021

AbstractContext.—We investigated expression of the adhesion molecule CD31 in sinus histiocytosis with massive lymphadenopathy (SHML) and Langerhans cell histiocytosis (LCH) because (1) SHML and LCH cells express a variety of cellular adhesion molecules and (2) SHML has been characterized as a reactive histiocytic proliferation, and tissue macrophages (histiocytes) are known to express CD31.Objective.—The purpose of this study was to determine whether SHML and LCH cells express CD31 and whether dual staining with CD31 and S100 facilitates diagnosis of these disease states.Methods.—Formalin-fixed, paraffin-embedded archival tissues were immunohistochemically stained via the labeled streptavidin-biotin method using antibodies against CD31 and S100 protein after heat-induced epitope retrieval. Archival tissues included SHML (n = 2), LCH (n = 10), malignant melanoma (n = 5), sinus hyperplasia (n = 4), granulomas (n = 4), granular cell tumor (n = 6), and normal skin (n = 4).Results.—Normal Langerhans cells in the epidermis were CD31−/S100+; neoplastic Langerhans cells in LCH were CD31+/S100+. Histiocytes in granulomas and in sinus hyperplasia were CD31+/S100−; abnormal histiocytes in SHML were CD31+/S100+. S100+ tumors (malignant melanoma and granular cell tumor) were CD31−.Conclusions.—The spectrum of cell types that express CD31 is expanded to include SHML and LCH. We speculate that up-regulation of CD31 in neoplastic Langerhans cells contributes to the migratory capability of LCH cells. CD31 may be a useful nonlysosomal marker of macrophages and their neoplastic counterparts (true histiocytic sarcomas). An immunohistochemical staining panel that includes CD31 and S100 facilitates the diagnosis of SHML and LCH.
Effect of Marathon Running on Total and Free Serum Prostate-Specific Antigen Concentrations
Authors: Kratz Alexander , Lewandrowski Kent B. , Siegel Arthur J. , Sluss Patrick M. , Chun Kelly Y. , Flood James G. , Lee-Lewandrowski Elizabeth 
Published: January 2021

Abstract
Context.—Prostate-specific antigen (PSA) is an important tumor marker for the most frequently diagnosed cancer in the United States. A major limitation of this marker is falsely elevated results in patients who are found not to have prostate cancer. The effects of vigorous physical exertion on PSA concentrations are controversial.
Objective.—To determine the effects of marathon running on PSA levels.
Design.—Measurement of total and free PSA levels in the sera of participants in a marathon before and within 4 and 24 hours after the race.
Results.—None of the participants had elevated total PSA levels before the race. Although we found no statistically significant changes in average total or free PSA concentrations at either time point, after the marathon, 2 (11%) of 18 runners had total PSA concentrations outside the standard reference range. Changes in total PSA levels did not correlate with age or prerace PSA concentrations. Free PSA levels were not statistically significantly changed after the race and did not allow a reliable determination of exercise-induced PSA elevations.
Conclusions.—Although it may not be necessary for men to abstain from exercise involving running before blood draws for PSA analysis, elevated PSA concentrations may be observed in some individuals after participation in a major sporting event. In these cases, repeat measurements should be considered at a time significantly removed from such exercise.
Factors Affecting Transfusion of Fresh Frozen Plasma, Platelets, and Red Blood Cells During Elective Coronary Artery Bypass Graft Surgery
Authors: Covin Randal , O'Brien Maureen , Grunwald Gary , Brimhall Bradley , Sethi Gulshan , Walczak Steven , Reiquam William , Rajagopalan Chitra , Shroyer A. Laurie 
Published: January 2021

Abstract
Context.—The ability to predict the use of blood components during surgery will improve the blood bank's ability to provide efficient service.
Objective.—Develop prediction models using preoperative risk factors to assess blood component usage during elective coronary artery bypass graft surgery (CABG).
Design.—Eighty-three preoperative, multidimensional risk variables were evaluated for patients undergoing elective CABG-only surgery.
Main Outcome Measures.—The study endpoints included transfusion of fresh frozen plasma (FFP), platelets, and red blood cells (RBC). Multivariate logistic regression models were built to assess the predictors related to each of these endpoints.
Setting.—Department of Veterans Affairs (VA) health care system.
Patients.—Records for 3034 patients undergoing elective CABG-only procedures; 1033 patients received a blood component transfusion during CABG.
Results.—Previous heart surgery and decreased ejection fraction were significant predictors of transfusion for all blood components. Platelet count was predictive of platelet transfusion and FFP utilization. Baseline hemoglobin was a predictive factor for more than 2 units of RBC. Some significant hospital variation was noted beyond that predicted by patient risk factors alone.
Conclusions.—Prediction models based on preoperative variables may facilitate blood component management for patients undergoing elective CABG. Algorithms are available to predict transfusion resources to assist blood banks in improving responsiveness to clinical needs. Predictors for use of each blood component may be identified prior to elective CABG for VA patients.
Cost-Effectiveness of Laboratory Testing
Authors: Hernandez James S. 
Published: January 2021

Abstract
Objective.—To illustrate how laboratorians and pathologists must demonstrate accountability for efficiency (how well something is done), effectiveness (what is done), and cost-effectiveness (a proxy for value, in which value equals quality per cost).
Data Sources.—A literature search was conducted, including documents in the National Library of Medicine.
Study Selection.—The literature on cost-effectiveness of laboratory testing was reviewed.
Conclusions.—The demand for proving the value of newer and more expensive medical technologies, including newer medical tests, will increase substantially. Payers, including Medicare, commercial insurers, and employers, will demand accountability and elimination of the abuse and misuse of ineffective testing strategies. Pathologists and laboratorians play a key role in guiding the most cost-effective use of testing strategies, including the judicious use of algorithms.
The Potential Role of Flow Cytometry in the Diagnosis of Small Cell Carcinoma
Authors: Cornfield Dennis , Liu Zach , Gorczyca Wojciech , Weisberger James 
Published: January 2021

Abstract
Context.—Virtually no information exists in the medical literature on the immunophenotyping of small cell carcinoma by flow cytometry. CD56, or neural cell adhesion molecule, is widely expressed by small cell carcinoma and easily measured by flow cytometry.
Objective.—To determine the potential usefulness of flow cytometry in the diagnosis of small cell carcinoma.
Design and Setting.—Retrospective data and archival material on 27 patients were obtained from community hospitals. Specimens (needle aspirations and tissue biopsies) from all patients demonstrated cytomorphologic and flow cytometric features consistent with small cell carcinoma. All measurements were performed at a large reference laboratory. Routine 3- and 4-color flow cytometry using a lymphoma antibody panel, including anti-CD56, was performed. Anti-cytokeratin antibody was also used in the last 12 cases. Immunohistochemical staining with a panel of conventional markers for neuroendocrine neoplasms was performed on available tissue for purposes of confirmation of small cell carcinoma.
Patients.—Twenty-seven patients whose tissue specimens showed a clearly defined population of CD45−CD56+ cells by flow cytometry and cytomorphologic features consistent with small cell carcinoma.
Interventions.—Needle aspiration (n = 3) and tissue biopsy (n = 24) from a variety of sites.
Results.—CD56 positivity by flow cytometry was 100 to 1000 times that of the matched isotype control in 25 cases and 10 to 100 times that of the control in 2 cases. Cytokeratin positivity by flow cytometry was found in 12 of 12 cases. Immunohistochemical staining showed positivity for at least 1 cytokeratin and 1 or more neuroendocrine markers in 26 of 27 cases and confirmed the diagnosis of small cell carcinoma.
Conclusions.—Routine flow cytometry can identify a neuroendocrine phenotype that shows a strong correlation with confirmatory immunohistochemical markers in cases exhibiting cytomorphologic features of small cell carcinoma. Flow cytometry appears to complement and may possibly be a satisfactory alternative to immunohistochemical staining when small cell carcinoma is suspected.
Cytokeratin 19 Immunolocalization in Cell Block Preparation of Thyroid Aspirates
Authors: Khurana Kamal K. , Truong Luan D. , LiVolsi Virginia A. , Baloch Zubair W. 
Published: January 2021

Abstract
Context.—Immunohistochemical staining for cytokeratin 19 (CK-19) is a useful ancillary technique for diagnosing papillary thyroid carcinoma (papillary carcinoma) in histologic specimens. Although similar results have been obtained on aspirate smears, to our knowledge the utility of CK-19 immunolocalization in cell block preparations as an adjunct to fine-needle aspiration diagnosis of papillary carcinoma has not been examined.
Objective.—The purpose of this study was to determine whether CK-19 immunostaining of cell block preparations of thyroid aspirates is a useful ancillary technique for diagnosing papillary carcinoma.
Materials and Methods.—Using a monoclonal antibody to CK-19 and a standard avidin-biotin complex technique, immunostaining was performed on paraffin-embedded cell blocks of 57 cases with the following cytologic diagnoses: (a) papillary carcinoma (20 cases); (b) atypical cytology, cannot exclude papillary carcinoma (19 cases); and (c) nonneoplastic thyroid (18 cases). The staining reaction in each case was graded on the basis of percentage of epithelial cells stained (1+, &lt;10%; 2+, &lt;10%–50%; 3+, &gt;50). Tissue follow-up was available in all cases.
Results.—Nineteen (95%) of 20 cases with an unequivocal diagnosis of papillary carcinoma were positive for CK-19 (3+). Tissue follow-up confirmed papillary carcinoma in all 20 cases. Of the 19 cases with a diagnosis of atypical cytology, cannot exclude papillary carcinoma, 7 (37%) cases displayed 3+ immunostaining and subsequent excision confirmed papillary carcinoma in all 7 cases. The remaining 12 cases with 1+ immunostaining included surgically confirmed goiter (6 cases), adenoma (2 cases), lymphocytic thyroiditis (3 cases), and papillary carcinoma (1 case). The follicular cells in 18 cases with a cytologic diagnosis of nonneoplastic thyroid showed 1+ immunostaining. Histologic follow-up of these cases confirmed the nonneoplastic cytologic diagnoses.
Conclusions.—Cytokeratin 19 immunostaining of cell block preparations of thyroid aspirates serves as a useful tool for the diagnosis of papillary carcinoma. Strong immunostaining (3+) for CK-19 aids in accurate diagnosis of malignancy in cytomorphologically equivocal cases of papillary carcinoma.
Molecular Monitoring of Cerebrospinal Fluid Can Predict Clinical Relapse in Acute Lymphoblastic Leukemia With Eosinophilia
Authors: Nuñez Cesar A. , Zipf Theodore F. , Roberts W. Mark , Medeiros L. Jeffrey , Hayes Kimberly , Bueso-Ramos Carlos E. 
Published: January 2021

Abstract
In a patient with precursor B-cell acute lymphoblastic leukemia (ALL) associated with eosinophilia that completely responded to induction chemotherapy, we assayed serial remission cerebrospinal fluid and bone marrow specimens for minimal residual disease using a quantitative polymerase chain reaction assay to assess for clone-specific immunoglobulin heavy-chain gene cluster (IGH) gene rearrangement. Cerebrospinal fluid eosinophilia and minimal residual disease were detected on day 406, preceding the morphologic diagnosis of central nervous system relapse on day 578. By day 841, the bone marrow had 35% blasts. Despite aggressive therapy, including unrelated umbilical cord blood transplantation, the patient developed testicular and bone marrow relapses and died of disease. We conclude that increasing levels of minimal residual disease in cerebrospinal fluid can predict recurrence of ALL prior to clinical and morphologic relapse. Furthermore, we demonstrate a novel translocation in this tumor, the t(5;9)(q31;p24), that possibly led to fusion of the interleukin-3 (IL3) (5q31) and JAK2 (9p24) genes and may explain the concomitant appearance of eosinophilia and ALL.
Comparative Analysis of Conventional Papanicolaou Tests and a Fluid-Based Thin-Layer Method
Authors: Limaye Anjali , Connor Amsy J. , Huang Xiaohua , Luff Ronald 
Published: January 2021

Abstract
Context.—A fluid-based, direct-to-vial method of thin-layer gynecologic cytology (ThinPrep Pap Test) is reported to be more effective than the conventional Papanicolaou test in the detection of squamous intraepithelial lesions.
Objective.—This retrospective analysis evaluated the validity of the findings on the thin-layer method using case material at a large independent laboratory and represented a comparison of performance of both methods over an identical period.
Methods.—Data for conventional and ThinPrep tests were compared for 2 periods. Period 1 included 1 421 080 conventional and 56 835 ThinPrep specimens, and period 2 included 564 270 conventional and 109 784 ThinPrep specimens. Squamous intraepithelial lesions were used to determine detection of disease. These 2 sets of data were also analyzed to eliminate effects of any selection bias toward ThinPrep for high-risk patients.
Results.—Use of ThinPrep showed a greater than 100% increase in the detection rate of squamous intraepithelial lesions (1.3%–3.4% in period 1 and 1.3%–2.9% in period 2), which was statistically significant after correcting for selection bias. We also found a significant decrease in the false-negative proportion (57% in period 1 and 35% in period 2). There was a marked improvement (233%) in the detection of high-grade squamous intraepithelial lesions in high-risk cases and a decrease in the atypical squamous cells of undetermined significance to squamous intraepithelial lesion ratio from 3.1 to 1.5 in period 2.
Conclusion.—ThinPrep is better than the conventional Papanicolaou test in detecting squamous intraepithelial lesions and is a superior screening test in detection of precancerous changes of the cervix.
Expression of p53, c-Myc, or Bcl-6 Suggests a Poor Prognosis in Primary Central Nervous System Diffuse Large B-Cell Lymphoma Among Immunocompetent Individuals
Authors: Chang Chung-Che , Kampalath Bal , Schultz Christopher , Bunyi-Teopengco Ellen , Logan Brent , Eshoa Camellia , Dincer Ayse P. , Perkins Sherrie L. 
Published: January 2021

Abstract
Context.—Primary central nervous system (CNS) diffuse large B-cell lymphoma (DLBCL) in immunocompetent individuals, although rare, has been rising in incidence. Currently, no reliable prognostic markers are available for these individuals.
Objective.—To study the implications of expression of a panel of oncogenic proteins (Bcl-2, Bcl-6, and c-Myc) and p53 for predicting clinical outcome, particularly overall survival, in immunocompetent individuals with primary CNS DLBCL.
Design.—Fourteen primary CNS DLBCL cases were retrospectively studied by immunohistochemistry on formalin-fixed, paraffin-embedded sections for the expression of c-Myc, Bcl-2, Bcl-6, and p53.
Results.—The overall frequencies of expression for p53, c-Myc, Bcl-2, and Bcl-6 in these cases were 29%, 50%, 71%, and 57%, respectively. Cases with expression of p53, c-Myc, or Bcl-6 had a poorer overall survival than those without (Kaplan-Meier survival analysis: 50% cumulative overall survival, 2 months vs 30–60 months, P = .02, log-rank test; 9–16 months vs 21–60 months, P = .03, log-rank test; and 9–16 months vs 21–60 months, P = .16, log-rank test, respectively). The expression of Bcl-2 or proliferation activity by MIB-1 showed no correlation with overall survival. Likewise, the clinical parameters, including age, location of tumors, multiplicity of tumor lesions, and lactase dehydrogenase levels revealed no impact on overall survival.
Conclusion.—Our results suggest that patients with expression of p53, c-Myc, or Bcl-6 have a poorer overall survival than those without. Since traditional prognostic markers in non-CNS DLBCL, such as staging and International Prognostic Index scores, are not applicable to primary CNS DLBCL, evaluation of p53, c-Myc, and Bcl-6 by immunohistochemistry may be warranted as part of prognostic evaluation in immunocompetent patients with primary CNS DLBCL. Further studies are indicated to confirm our observations.
A Microdissection and Molecular Genotyping Assay to Confirm the Identity of Tissue Floaters in Paraffin-Embedded Tissue Blocks
Authors: Hunt Jennifer L. , Swalsky Patricia , Sasatomi E. , Niehouse Laura , Bakker Anke , Finkelstein Sydney D. 
Published: January 2021

AbstractContext.—A recurring problem in surgical pathology practice is specimen mix-up and floater contamination. While many cases can be resolved histologically, a significant number remain unclear and may have serious clinical and medicolegal implications.Objectives.—To design a microdissection and genotyping assay to identify contaminating floater tissues in paraffin-embedded tissues that is optimized for small samples, and to use the assay to resolve a series of clinical cases with floater tissues.Materials and Methods.—Twenty-one cases of possible tissue floater contamination in paraffin-embedded tissue blocks were included. Using 4 unstained, 4-μm-thick histologic sections, multiple sites were microdissected under direct visualization either by hand or by laser capture microdissection. Nonneoplastic and neoplastic tissues were sampled. Polymerase chain reaction was performed for a panel of 10 polymorphic microsatellite markers at 1p34, 3p26, 5q21, 9p21, 10q23, and 17p13. Allele size and content were analyzed semiquantitatively by fluorescent capillary electrophoresis, and the genotypes for the tissues in the paraffin-embedded tissue blocks were compared for identity.Results.—Tissue identification was successful in all cases, despite small tissue sample size and fixation effects. Comparative analysis of neoplastic tissue floaters and the presumptive source tumor was performed when possible to control for possible allelic loss or microsatellite instability.Conclusions.—Microdissection and genotyping are effective and reliable means to objectively resolve problems of possible floater contamination. Even minute tissue samples provide sufficient DNA template for polymerase chain reaction microsatellite analysis. Because of the potential clinical implications of floaters, we recommend that all suspected floaters that would change a diagnosis from benign to malignant be subjected to genotyping assay to confirm the identity of the floater tissue.
Human Parainfluenza Virus Giant Cell Pneumonia Following Cord Blood Transplant Associated With Pulmonary Alveolar Proteinosis
Authors: Butnor Kelly J. , Sporn Thomas A. 
Published: January 2021

Abstract
Giant cell pneumonia secondary to human parainfluenza virus 3 has been reported only rarely in immunocompromised hosts. The few cases documented after bone marrow transplant have resulted in significant morbidity and mortality. To our knowledge, this entity has not been described following umbilical cord blood transplant. Pulmonary alveolar proteinosis, a rare condition that has been reported with increasing frequency in association with immunocompromise and infections, has not been documented in the setting of either umbilical cord blood transplant or human parainfluenza viral infection. We report what we believe is the first documented case of giant cell pneumonia caused by human parainfluenza virus 3 in an umbilical cord blood transplant recipient. To our knowledge, a unique associated feature of this case, a pulmonary alveolar proteinosis–like reaction, has not been reported previously in association with human parainfluenza virus pneumonia.