bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concomitant Epstein-Barr Virus–Negative Large B-Cell Lymphoma (Richter Syndrome) and Epstein-Barr Virus– Positive B-Cell Lymphoproliferation After Treatment With Fludarabine and Cyclophosphamide in a Patient With B-Cell Chronic Lymphocytic Leukemia
Authors: Compérat Eva , Delmer Alain , Le Tourneau Agnes , Molina Thierry J. , Diebold Jacques , Audouin Josée 
Published: February 2021

Abstract
We report the case of a patient treated with a combination of fludarabine and cyclophosphamide after suffering from B-cell chronic lymphocytic leukemia for 10 years. Three months after treatment, the patient presented with an unusual association, not previously reported in the literature: Richter syndrome (monotypic Epstein-Barr virus– negative large B-cell lymphoma) with the proliferation of Epstein-Barr virus–positive B cells secreting a polytypic immunoglobulin A. The Epstein-Barr virus–positive lymphoproliferation can be accounted for by the type of immunosuppression induced by the treatment.
Pleuropulmonary Desmoid Tumors: Immunohistochemical Comparison With Solitary Fibrous Tumors and Assessment of β-Catenin and Cyclin D1 Expression
Authors: Andino Lizmarie , Cagle Philip T. , Murer Bruno , Lu Li , Popper Helmut H. , Galateau-Salle Francoise , Sienko Anna E. , Barrios Roberto , Zander Dani S. 
Published: February 2021

Abstract
Context.—Desmoid tumors arising in the lung and pleura are extremely rare and can resemble other, more common neoplasms native to these sites. Alterations of the adenomatous polyposis coli/β-catenin pathway have been detected in sporadic desmoid tumors and have been associated with nuclear accumulation of β-catenin and overexpression of cyclin D1.
Objective.—To analyze the expression of β-catenin and cyclin D1 in desmoid tumors and solitary fibrous tumors (SFTs), and to compare the utilities of these substances for distinguishing between these entities with those of other, more commonly used stains.
Design.—Formalin-fixed, paraffin-embedded sections of 4 desmoid tumors (1 pulmonary, 1 pleural, 2 pleural/chest wall), and 5 benign and 6 malignant SFTs of the pleura were immunostained for β-catenin, cyclin D1, ALK1, CD34, vimentin, desmin, smooth muscle actin, muscle-specific actin, S100, and pancytokeratin. Staining intensity and the percentage of stained tumor cells were assessed semiquantitatively.
Results.—Diffuse moderate or strong nuclear staining for β-catenin was found in all desmoid tumors, 4 of 5 benign SFTs, and 2 of 6 malignant SFTs. All cases except 1 benign SFT showed concurrent cytoplasmic staining. Nuclear and cytoplasmic cyclin D1 staining was increased in all groups. The best distinction between desmoid tumors and SFTs was provided by CD34 (desmoid tumors, 0/4; SFTs, 8/11) and smooth muscle actin (desmoid tumors, 4/4; SFTs, 0/11).
Conclusions.—Our findings suggest that alterations in the adenomatous polyposis coli/β-catenin pathway and cyclin D1 dysregulation may contribute to the pathogenesis of pleuropulmonary desmoid tumors and SFTs. CD34 and smooth muscle actin stains are particularly useful for differentiating between pleuropulmonary desmoid tumors and SFTs.
The Variability of Results Between Point-of-Care Testing Glucose Meters and the Central Laboratory Analyzer
Authors: Khan Adil I. , Vasquez Yolanda , Gray Jacquelyn , Wians Jr Frank H. , Kroll Martin H. 
Published: February 2021

Abstract
Context.—Point-of-care testing glucose meters are strongly recommended in the management of diabetes and are increasingly being used for making therapeutically important decisions. Thus, it is essential that their results correlate well with those of laboratory analyzers.
Objectives.—To test the reliability of point-of-care testing glucose meters.
Design.—Two studies were performed: (1), an in-house study comparing accuracy of point-of-care testing glucose meters with a reference analyzer using fresh whole blood specimens (2), a real-time comparison of (a) 2 successive glucose meter readings and (b) glucose meter reading to central laboratory analyzer reading.
Setting.—(1), Seven glucose meters from 4 manufacturers were compared with the Yellow Springs YSI 2300 blood glucose analyzer using whole blood without preservative. (2), (a) Whole blood samples were read within 5 minutes of each other using Accu-Chek meters and (b) between a glucose meter and a Hitachi laboratory analyzer.
Results.—(1) Within the Accu-Chek group of glucose meters, fresh, preservative-free whole blood samples showed the lowest bias. (2) At the hypoglycemic level, successive glucose meter readings agreed well, but there was considerable disagreement between glucose meter and central laboratory values. Because laboratory analyzers are of proven accuracy, they are used as the reference. In the glucose meter–central laboratory analyzer correlation, for both hypoglycemic and hyperglycemic values, readings in which the differences were greater than 10% occurred more than 61% of the time. In the hypoglycemic range, differences greater than 20% occurred 57% of the time.
Conclusions.—One should scrutinize point-of-care testing glucose meter readings at the hypoglycemic and hyperglycemic levels and whenever possible to corroborate these clinical results with central laboratory analyzers.
Thin Basement Membrane Nephropathy: Diffuse and Segmental Types
Authors: Ivanyi Bela , Pap Robert , Ondrik Zoltan 
Published: February 2021

Abstract
Context.—Diffuse thinning of the glomerular basement membrane (GBM) is the ultrastructural diagnostic criterion of thin basement membrane nephropathy (TBMN). However, there is no consensus regarding what diagnosis should be made if the attenuation is segmental.
Objective.—To develop a diagnostic approach to TBMN in cases with segmental GBM thinning.
Design.—We compared the diagnostic sensitivities of 2 methods used for the quantitative expression of GBM width in a consecutive series of renal biopsies from 26 patients (median age, 36 years; range, 15 to 59 years) with dysmorphic hematuria (a variable degree of proteinuria in 19 patients), a thin GBM, and absence of other renal disease. The harmonic GBM width was determined from orthogonal intercepts, and the actual width in the thinnest loops was obtained by direct measurement. The GBM attenuation was categorized into diffuse or segmental types by conventional inspection.
Results.—Segmental TBMN accounted for one third of the series. In neither type did the male patients have a higher harmonic mean GBM width than the female patients. Focal-global glomerulosclerosis was more common in diffuse TBMN. The laborious orthogonal intercept method proved insensitive for the verification of segmental TBMN, whereas the much simpler direct measurement technique captured all the cases.
Conclusions.—A considerable number of patients with TBMN display segmental GBM attenuation. Because the routine criterion excludes these cases from the diagnosis, we propose to define TBMN as a clinicopathologic entity of dysmorphic hematuria and a diffusely or segmentally thinned GBM confirmed by the direct measurement technique.
The Impact of the World Health Organization Classification and Clonality Assessment of Posttransplant Lymphoproliferative Disorders on Disease Management
Authors: Mourad Walid A. , Tulabah Asma , Al Sayed Adher , Raja Madras , Khafaga Yasser , El Gamal Hazem , Al Shabanah Mohamed , Al Meshari Khaled , Al Shaibani Khaled , Ezzat Adnan 
Published: February 2021

Abstract
Context.—The World Health Organization classification of posttransplant lymphoproliferative disorders divides them into 4 main categories.
Objective.—To classify cases of posttransplant lymphoproliferative disorders diagnosed in our institution according to the World Health Organization scheme and correlate the classification and clonality with clinical data.
Design.—Cases of posttransplant lymphoproliferative disorders were reviewed. They were classified according to the World Health Organization scheme. Clonality was determined by flow cytometry and/or polymerase chain reaction. Patients' charts were reviewed.
Results.—Thirty-one cases were identified. Median age was 33 years. There were 19 cases of kidney, 8 cases of liver, and 4 cases of bone marrow transplant. Immunosuppression consisted of cyclosporin A and prednisone (N = 24) or FK506 and prednisone (N = 7). Twenty cases (63%) were World Health Organization type 3, 7 cases (23%) type 2, 3 cases (6.4%) type 1, and 1 case type 4 posttransplant lymphoproliferative disorder. Ten patients received chemotherapy, 20 patients had reduction of immunosuppression, and 1 had no treatment. Follow-up was available on 25 patients. Seven (43.75%) of 16 with type 3 lesions with available follow-up died of their disease. Five of these patients received reduction of immunosuppression alone. Only 2 of 9 patients with type 3 disease who received chemotherapy died of disease. Two patients with type 2 disease died of unrelated causes. One patient is alive with disease; the remaining patients with types 1 and 2 disease are alive with no disease.
Conclusions.—The World Health Organization classification of posttransplant lymphoproliferative disorders is valuable in the identification of subtypes. It helps identify early lesions (1 and 2) requiring reduction of immunosuppression and type 3 disease, which requires chemotherapy from the outset.
Paratesticular Mucinous Cystadenoma Arising From an Oviduct-Like Müllerian Remnant: A Case Report and Review of the Literature
Authors: Uschuplich Vedran , Hilsenbeck John R. , Velasco Claude R. 
Published: February 2021

Abstract
A mucinous cystadenoma of the paratestis arising from an unequivocal oviduct-like structure in an 18-year-old man is reported. Mucinous cystadenomas of the testis and paratestis are extremely rare benign tumors of controversial origin. The diagnosis may be challenging and is of clinical importance because these lesions may mimic a teratoma, and teratomas in postpubertal males carry a malignant potential regardless of the degree of maturation. A few case reports and reviews of testicular and paratesticular mucinous neoplasms resembling ovarian tumors have suggested the possibility of a müllerian origin of these tumors. However, no histologic evidence has been found to support such a histogenesis. The current case demonstrates a clear transition from müllerian-type tubal epithelium to intestinal-type mucinous epithelium. This finding, in conjunction with immunophenotypic studies, strongly supports a derivation from a paratesticular müllerian remnant. To our knowledge this represents the first substantial evidence that, in at least some cases, mucinous cystadenomas of the testis and paratestis are of müllerian derivation.
An In-depth Look at Krukenberg Tumor: An Overview
Authors: Al-Agha Osama M. , Nicastri Anthony D. 
Published: February 2021

Abstract
Krukenberg tumor is an uncommon metastatic tumor of the ovary. This article provides an overview of the major pathologic manifestations of Krukenberg tumor, patient characteristics, clinical and laboratory features of the disease, prognostic factors, and current knowledge about its pathogenesis. Pathologists have to be familiar with the diagnostic histopathologic features of the tumor and its principal differential diagnoses. Awareness of the diagnostic manifestations of the tumor leads to the correct diagnosis and prevents tumor misclassification, thus avoiding improper clinical management. The article also addresses the potential clinical utility of serum CA 125 in patients with Krukenberg tumors. Prognosis of Krukenberg tumor is still very poor but our review of the literature reveals several factors that appear to have an impact on survival. There is no established treatment for Krukenberg tumors. A national registry and prospective studies are needed to set a therapeutic approach for Krukenberg tumors in the hope of improving the survival rate.
Gene Rearrangement and Comparative Genomic Hybridization Studies of Classic Hodgkin Lymphoma Expressing T-Cell Antigens
Authors: Aguilera Nadine S. I. , Chen Jian , Bijwaard Karen E. , Director-Myska Alison E. , Barekman Carol L. , Millward Carl , Lichy Jack , Abbondanzo Susan L. 
Published: February 2021

Abstract
Context.—Reed-Sternberg cells in classic Hodgkin lymphoma are enigmatic and difficult to study because they are so sparse. Tissue microdissection allows for the isolation of single Reed-Sternberg cells. Isolated Reed-Sternberg cells show clonal immunoglobulin gene rearrangement indicating a B-cell origin. Rarely, Reed-Sternberg cells in classic Hodgkin lymphoma express T-cell antigens, suggesting a possible T-cell origin.
Objective.—To determine whether there is a difference in genotype between classic Hodgkin lymphoma and classic Hodgkin lymphoma expressing T-cell antigens and to document T-cell clonality.
Design.—We studied 4 cases of Hodgkin lymphoma with a characteristic phenotype and immunoreactivity for CD2 and CD3. Single CD30+ Reed-Sternberg cells from each case were isolated by laser capture microdissection for immunoglobulin heavy chain and T-cell receptor-γ genes by polymerase chain reaction studies. Comparative genomic hybridization was performed in all cases.
Results.—Two of 4 cases showed clonal rearrangement of the T-cell receptor-γ; none showed immunoglobulin heavy chain rearrangement. Two control cases were negative for T cell receptor-γ but 1 showed immunoglobulin heavy chain rearrangement. Comparative genomic hybridization analysis revealed significant overlap in genomic alteration in Hodgkin lymphoma cases regardless of genotype or phenotype and several regions of imbalance specific to CD3+ Hodgkin lymphoma cases. All patients are alive with no evidence of disease from 10 to 44 months.
Conclusions.—Our findings suggest that a T-cell phenotype classic Hodgkin lymphoma can be supported by genotypic studies and that there may be cytogenetic differences between classic Hodgkin lymphoma and Hodgkin lymphoma expressing T-cell antigens.
Myelopoiesis in the Liver of Stillborns With Evidence of Intrauterine Infection
Authors: Miranda Roberto N. , Omurtag Kenan , Castellani William J. , De Las Casas Luis E. , Quintanilla Norma M. , Kaabipour Emad 
Published: February 2021

Abstract
Context.—Chorioamnionitis is the maternal and fetal response to an ascending intrauterine infection. The fetal response is manifested by funisitis and chorionic vasculitis, or as neutrophils within pulmonary spaces. Human hematopoiesis occurs in the liver primarily during the 6th to 22nd weeks of gestation.
Objective.—To establish the relationship between the presence of an intrauterine infection and the degree of fetal hepatic myelopoiesis in second- and third-trimester fetuses.
Design.—Liver and lungs from 49 fetal autopsies, 20 to 41 weeks of gestational age, and their associated placentas and membranes were analyzed for evidence of intrauterine infection and hepatic myelopoiesis. Hematoxylin-eosin– stained sections from fixed tissues were evaluated for the presence of amnionic fluid infection, defined by the presence of acute chorioamnionitis or funisitis. The degree of portal hematopoiesis, myelopoiesis and intra-alveolar neutrophils was assessed semiquantitatively with hematoxylin-eosin–stained sections and immunohistochemically with antimyeloperoxidase. The Kruskal-Wallis 1-way analysis of variance and the Wilcoxon-Mann-Whitney test were used to determine the significance of any observed difference.
Results.—The degree of portal and lobular myelopoiesis was significantly greater with the presence of inflammation in both the membranes and umbilical cord, and correlated with the presence of intra-alveolar neutrophils (P &lt; .001). A high correlation between the hematoxylin-eosin and immunohistochemistry assessment of myeloid cells was noted.
Conclusions.—There is increased portal and lobular myelopoiesis in 20-week to 41-week gestational age fetal livers that is associated with intrauterine ascending infection. The presence of increased portal or lobular myelopoiesis suggests the presence of an active fetal response to an intrauterine ascending infection.
Interference of Blood Cell Lysis on Routine Coagulation Testing
Authors: Lippi Giuseppe , Montagnana Martina , Salvagno Gian Luca , Guidi Gian Cesare 
Published: February 2021

Abstract
Context.—Preanalytical factors influencing the reliability of laboratory testing are commonplace. It is traditionally accepted that hemolytic samples are unsuitable for coagulation assays because of the release of hemoglobin, intracellular components, and thromboplastic substances from damaged blood cells.
Objective.—To evaluate the influence of blood cell lysis on routine coagulation testing.
Design.—Twelve aliquots prepared by serial dilutions of homologous lysated samples collected from 10 different subjects, and displaying a final percentage of lysis ranging from 0% to 9.1%, were tested for prothrombin time, activated partial thromboplastin time, fibrinogen, and dimerized plasmin fragment D. Lysis was achieved by subjecting citrated whole blood to a freeze-thaw cycle.
Outcome Measures.—Interference from blood cell lysis on routine coagulation testing.
Results.—Statistically significant increases in prothrombin time and dimerized plasmin fragment D were observed in samples containing final lysate concentrations of 0.5% and 2.7% respectively, whereas significant decreases were observed in activated partial thromboplastin time and fibrinogen in samples containing a final lysate concentration of 0.9%. The current analytical quality specifications for desirable bias are ±2.0% for prothrombin time, ±2.3% for activated partial thromboplastin time, and ±4.8% for fibrinogen. Percent variations from the baseline values exceeding the current analytical quality specifications for desirable bias were achieved for lysate concentrations of 0.9% (prothrombin time and activated partial thromboplastin time) and 1.8% (fibrinogen), corresponding to average free plasma hemoglobin concentrations of 1.7 and 3.4 g/L, respectively.
Conclusion.—Our results confirm that, although slightly hemolyzed specimens might still be analyzable, a moderate blood cell lysis, as low as 0.9%, influences the reliability of routine coagulation testing. Because the interference in coagulation assays has a wide interindividual bias, we do not recommend lysis correction and we suggest that the most appropriate corrective measure should be free hemoglobin quantification and sample recollection.
Immunohistochemical Classification of De Novo, Transformed, and Relapsed Diffuse Large B-Cell Lymphoma Into Germinal Center B-Cell and Nongerminal Center B-Cell Subtypes Correlates With Gene Expression Profile and Patient Survival
Authors: Haarer Chadwick F. , Roberts Robin A. , Frutiger Yvette M. , Grogan Thomas M. , Rimsza Lisa M. 
Published: February 2021

AbstractContext.—Diffuse large B-cell lymphoma (DLBCL) can be assigned to prognostic subgroups, including germinal center B-cell (GCB) and activated B-cell subgroups, by using gene expression profiling and, reportedly, immunohistochemistry for CD10, Bcl-6, and multiple myeloma-1/interferon regulatory factor-4 (MUM1/IRF4).Objective.—To compare 2 commercial MUM1/IRF4 antibody formulations for accuracy in subtyping DLBCL against gene expression profiling, compare subtyping to patient survival, and evaluate the usefulness of GCB and non-GCB subtyping in relapsed and transformed DLBCL.Design.—Evaluation of 2 commercial MUM1/IRF4 antibodies, ICSTAT/M17 and Mum-1p, by using 40 cases of de novo, relapsed, and transformed DLBCL; and comparison of the results obtained with gene expression profiling and survival.Results.—Immunohistochemistry predicted the gene expression profiling subtype 71.8% and 69.2% of the time overall with use of the Mum-1p and ICSTAT/M17 antibodies, respectively, and 100% and 91.7% of the time when MUM1/IRF4 expression determined subtype. Gene expression profiling and immunohistochemistry revealed nearly identical 5-year overall survival rates for the GCB vs non-GCB subtypes (68.0% for GCB vs 24.7% for non-GCB with use of gene expression profiling [P = .03] and 70.2% vs 18.4%, respectively, with use of immunohistochemistry [P &lt; .001]). When de novo, transformed, and relapsed cases were analyzed separately, 5-year overall survival rates were also significantly different.Conclusions.—Immunohistochemistry can be used to subclassify DLBCL, including a very small series of transformed and relapsed cases, into GCB and non-GCB subtypes and predict survival rates similar to those predicted by use of gene expression profiling. The 2 MUM1/IRF4 antibodies performed similarly.
BRCA1 and BRCA2 Mutation Screening Using SmartCycler II High-Resolution Melt Curve Analysis
Authors: Dufresne Scott D. , Belloni Dorothy R. , Wells Wendy A. , Tsongalis Gregory J. 
Published: February 2021

Abstract
Context.—Real-time polymerase chain reaction technologies have replaced many of the more labor-intense methods in the molecular diagnostics laboratory. Similarly, melt curve analysis can provide a rapid means of mutation screening.
Objective.—To determine if real-time polymerase chain reaction and melt curve analysis using the SmartCycler II could be used as a screening tool for 3 common mutations in BRCA1 and BRCA2.
Design.—Real-time polymerase chain reaction amplification with SYBR Green I detection was performed on DNA from cell lines known to carry the 185delAG or 5382insC mutation in BRCA1 or the 6174delT mutation in BRCA2. The melting temperatures and the melt curves were analyzed for differences between wild-type DNA and cell lines that were heterozygous for each mutation.
Results.—Significant differences were present in the melt curves for each of the mutations compared with those of the wild-type sequences. The melt curve for the 185delAG mutation showed a separate peak at a lower temperature, which represented the melting temperature of the heteroduplex. For the 6174delT mutation, the melt curve had a shoulder at a lower temperature, while the melt curve for the 5382insC mutation was shifted to the left and was broader than that for the wild-type sequences.
Conclusions.—High-resolution melt curve analysis is a quick, reliable method for identifying mutations due to small deletions or insertions. As a proof of principle, we used this assay to identify the 3 most common BRCA1 and BRCA2 mutations in the Ashkenazi Jewish population.
Prostatic Glands and Urothelial Epithelium in a Seminal Vesicle Cyst: Report of a Case and Review of Pathologic Features and Prostatic Ectopy
Authors: Aslan Deniz L. , Pambuccian Stefan E. , Gulbahce H. Evin , Tran Michael L. , Manivel J. Carlos 
Published: February 2021

Abstract
We report a case of a seminal vesicle cyst containing prostatic glands and urothelial epithelium in a patient with no other urogenital anomalies. The detection of prostatic tissue, which is of endodermal origin, in a seminal vesicle cyst, a mesonephric duct derivative, is unusual. We review the pathologic features of seminal vesicle cysts and discuss the histogenesis of prostatic and urothelial tissue.