bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pyogenic Spondylodiskitis
Authors: Lucio Emmanuel , Adesokan Adekunle , Hadjipavlou Alexander G. , Crow Wayne N. , Adegboyega Patrick A. 
Published: January 2021

AbstractBackground.—Intervertebral disk tissue is resistant to hematogenous infection because of its avascularity. However, spondylodiskitis is being diagnosed with increasing frequency because of advancement in magnetic resonance imaging technology. There is a dearth of information regarding the bacteriology, histomorphologic features, and radiopathologic correlation of spondylodiskitis.Design.—The study population consisted of 20 patients diagnosed as having spondylodiskitis by magnetic resonance imaging with and without gadolinium 67 enhancement and bone scans with technetium Tc 99m or gallium citrate Ga 67. Twenty-seven biopsy and debridement specimens were obtained from these patients. The specimens were cultured for microorganisms and also processed for histopathologic testing. Tissue sections were examined with hematoxylin-eosin and stains for infectious agents (Gomori's methenamine-silver, Gram, and Ziehl-Neelsen stains).Results.—Where intervertebral disk tissue was present (23 of 27 cases), the morphologic changes included vascularization (with or without granulation tissue), myxoid degeneration, and necrosis. Chronic osteomyelitis was present in all 27 specimens and was associated with acute osteomyelitis in 7 cases (25%). Twenty-one of 27 cases had positive culture results (mostly pyogenic bacteria), but special stains revealed microorganisms in sections of the disk in only 4 cases (3 cases with gram-positive cocci and 1 with yeast consistent with Blastomyces). Florid acute inflammation was present in all the 4 cases.Conclusion.—Histopathologic features of acute spondylodiskitis include vascular proliferation, myxoid degeneration, and necrosis of the disk tissue with adjacent chronic osteomyelitis. Acute inflammation is variable and when florid is usually associated with identifiable organisms on histologic examination. At biopsy, tissue should be submitted for culture, since culture has a high sensitivity and specificity for detecting the etiologic organism.
Lymphoepithelioma-like Carcinoma of the Uterine Cervix
Authors: López-Ríos Fernando , Miguel Pilar San , Bellas Carmen , Ballestín Claudio , Hernández Lucía 
Published: January 2021

Abstract
Lymphoepithelioma-like carcinomas have been reported outside the nasopharynx in many sites, including the uterine cervix. The association with the Epstein-Barr virus in the latter site is still controversial. To date, Epstein-Barr virus genome has only been demonstrated in Asian patients. We report a case of lymphoepithelioma-like carcinoma of the uterine cervix in a white woman in whom the Epstein-Barr virus infection was tested for by in situ hybridization and polymerase chain reaction. The results of both techniques were negative. Our case and a review of the literature support the contention that cervical lymphoepithelioma-like carcinoma is not associated with Epstein-Barr virus infection in non-Asian patients.
Solitary Fibrous Tumor of the Orbit With a t(9;22)(q31;p13)
Authors: Havlik Dean M. , Farnath Denise A. , Bocklage Therese 
Published: January 2021

Abstract
Solitary fibrous tumors are well-described neoplasms found predominantly in the subpleural region but also in many other body sites. They generally behave in a benign fashion, although a few cases that exhibit a malignant course have been reported. Genetic information on solitary fibrous tumors is sparse. This case illustrates a previously unreported finding of a tumor-specific t(9;22)(q31;p13) in a solitary fibrous tumor of the orbit of a 58-year-old man.
Primary Meningeal Rhabdomyosarcoma in a Child With Hypomelanosis of Ito
Authors: Xu Fushen , De Las Casas Luis E. , Dobbs Larry J. 
Published: January 2021

Abstract
Intracranial rhabdomyosarcomas are rare neoplasms, and those thought to be primary meningeal tumors are even more rare. Hypomelanosis of Ito is a neurocutaneous disorder believed to involve a defect in cells of neural crest origin. We report the case of a 15-month-old boy with hypomelanosis of Ito who developed a primary meningeal rhabdomyosarcoma. The patient initially presented with hydrocephalus and 2 months later developed neurologic signs localizing to the spinal cord. Radiologic studies revealed widespread leptomeningeal enhancement with compression of the spinal cord at C5-C7. A brain biopsy revealed a tumor diffusely involving the meninges. Microscopically, the tumor was composed of rhabdomyoblasts, many of which showed prominent cross-striations on routine hematoxylin-eosin staining. To the best of our knowledge, this is the first reported case of meningeal rhabdomyosarcoma in a patient with hypomelanosis of Ito and the fourth reported case of a primary meningeal rhabdomyosarcoma reported in the world literature.
College of American Pathologists Conference XXXV: Solid Tumor Prognostic Factors—Which, How and So What?
Authors: Hammond M. Elizabeth H. , Fitzgibbons Patrick L. , Compton Carolyn C. , Grignon David J. , Page David L. , Fielding L. Peter , Bostwick David , Pajak Thomas F. 
Published: January 2021

Abstract
The College of American Pathologists convened a prognostic factor conference in June 1999 to consider prognostic and predictive factors in breast, colon, and prostate cancer, and to stratify these factors into categories reflecting the strength of published evidence. Because so little progress in prognostic factor clinical utility has been made in the last 5 years, the conference participants focused their attention on decreasing variation in methods, interpretation, and reporting of these factors so that greater clarity of value could be achieved. The conference was organized to promote discussion, broad input, and future planning. An initial plenary session provided an overview of the status of tumor marker research, the impact of variation in medicine and pathology, and statistical issues related to prognostic factor research. In working group sessions for each cancer type, participants interactively evaluated and refined the documents created by the expert panels. A second plenary session dealt with issues common to all 3 groups, including the problem of micrometastases in lymph nodes in these sites; statistical issues that arose during the breakout discussions; and issues of variation in methods, interpretation, and reporting of immunohistochemical assays. A faculty session brainstormed strategies that could be used to implement the changes recommended. This session included invited representatives of the Food and Drug Administration, Health Care Financing Administration, Centers for Disease Control and Prevention, National Cancer Institute, American Joint Committee on Cancer, and International Union Against Cancer. Cancer site and general recommendations were presented and discussed during a final session to achieve consensus of the conference participants and to address feasibility of implementation of these recommendations. A final discussion focused on future initiatives that might lead to implementation of the changes proposed in the conference by the various organizations represented. This report summarizes the general conference recommendations, cancer working group recommendations, and plans for implementation of the recommendations.
Prognostic Factors in Breast Cancer
Authors: Fitzgibbons Patrick L. , Page David L. , Weaver Donald , Thor Ann D. , Allred D. Craig , Clark Gary M. , Ruby Stephen G. , O'Malley Frances , Simpson Jean F. , Connolly James L. , Hayes Daniel F. , Edge Stephen B. , Lichter Allen , Schnitt Stuart J. 
Published: January 2021

Abstract
Background.—Under the auspices of the College of American Pathologists, a multidisciplinary group of clinicians, pathologists, and statisticians considered prognostic and predictive factors in breast cancer and stratified them into categories reflecting the strength of published evidence.
Materials and Methods.—Factors were ranked according to previously established College of American Pathologists categorical rankings: category I, factors proven to be of prognostic import and useful in clinical patient management; category II, factors that had been extensively studied biologically and clinically, but whose import remains to be validated in statistically robust studies; and category III, all other factors not sufficiently studied to demonstrate their prognostic value. Factors in categories I and II were considered with respect to variations in methods of analysis, interpretation of findings, reporting of data, and statistical evaluation. For each factor, detailed recommendations for improvement were made. Recommendations were based on the following aims: (1) increasing uniformity and completeness of pathologic evaluation of tumor specimens, (2) enhancing the quality of data collected about existing prognostic factors, and (3) improving patient care.
Results and Conclusions.—Factors ranked in category I included TNM staging information, histologic grade, histologic type, mitotic figure counts, and hormone receptor status. Category II factors included c-erbB-2 (Her2-neu), proliferation markers, lymphatic and vascular channel invasion, and p53. Factors in category III included DNA ploidy analysis, microvessel density, epidermal growth factor receptor, transforming growth factor-α, bcl-2, pS2, and cathepsin D. This report constitutes a detailed outline of the findings and recommendations of the consensus conference group, organized according to structural guidelines as defined.
Increased Expression of Vascular Endothelial Growth Factor and Angiogenesis in the Early Stage of Multistep Hepatocarcinogenesis
Authors: Park Young Nyun , Kim Young-Bae , Yang Kyung Moo , Park Chanil 
Published: January 2021

Abstract
Background.—Hepatocellular carcinoma (HCC) is known to receive its blood supply principally from the hepatic arteries. Recent studies have reported differences in the vascular supply, especially arterial supply among low- and high-grade dysplastic nodules (DNs) (also referred to as adenomatous hyperplasia and macroregenerative nodules) and HCCs. Increased expression of vascular endothelial growth factor (VEGF) has been reported in HCC. In addition, VEGF may play an important role in the early phases of hepatocarcinogenesis.
Methods.—We immunohistochemically stained 7 low-grade DNs, 8 high-grade DNs, 11 early HCCs, 17 small HCCs, and 21 advanced HCCs with antibodies against VEGF, α-smooth muscle actin (to identify unpaired arteries, ie, arteries not accompanied by bile ducts, indicative of angiogenesis), CD34 (as a marker of sinusoidal capillarization), and proliferation cell nuclear antigen.
Results.—Expression of VEGF was found in the hepatocytes and HCC cells. The degree of VEGF expression increased gradually according to the stepwise development of hepatocarcinogenesis. It was higher in high-grade DNs and early HCCs than in low-grade DNs. The hepatocytes and HCC cells adjacent to peliosis and fibrous septa showed stronger VEGF expression. Angiogenesis, unpaired arteries, and sinusoidal capillarization developed from low-grade DNs and gradually increased. It was highest in HCCs. The proliferation cell nuclear antigen labeling indexes of hepatocytes and HCC cells also increased gradually as hepatocarcinogenesis progressed. Small HCCs showed a higher status of neoangiogenesis and cell proliferation activity than advanced HCCs. The degree of VEGF expression was correlated with angiogenesis and cell proliferation activity.
Conclusion.—We conclude that VEGF plays a significant role in angiogenesis, growth, and development of HCC.
Malignant Mesothelioma With CD30-Positivity
Authors: Dunphy Cherie H. , Gardner Laura J. , Bee Christopher S. 
Published: January 2021

Abstract
The activation marker CD3O is useful in the diagnosis of Hodgkin and non-Hodgkin lymphomas. It has also been described in nonhematopoietic tumors, including pancreatic carcinomas, salivary gland tumors, and embryonal carcinomas. We report a case of malignant mesothelioma with intense CD30 positivity. This finding has not previously been described and is important in broadening the differential diagnosis of a CD30+ cohesive large cell malignancy.
Carcinosarcoma of the Urinary Bladder—An Aggressive Tumor With Diverse Histogenesis
Authors: Baschinsky Dmitry Y. , Chen Janny H. , Vadmal Manjunath S. , Lucas Joel G. , Bahnson Robert R. , Niemann Theodore H. 
Published: January 2021

Abstract
Objective.—Carcinosarcomas of urinary bladder are rare malignant neoplasms. Seventy-eight cases have been previously described. The histologic composition of these tumors is variable, but diagnosis requires the presence of both epithelial and mesenchymal malignant components. We report 4 additional cases, with an emphasis on unusual histologic features.
Methods.—Histologic and immunohistochemical examinations were performed on bladder tumors from 4 patients. Clinicopathologic features of previously reported and current cases were reviewed and summarized.
Results.—Four patients (3 men, 1 woman) age 54 to 77 years were found to have polypoid masses in the urinary bladder. In all cases, histologic examination showed biphasic neoplasms with distinct mesenchymal and epithelial components. The morphologic and immunohistochemical characteristics of the tumors varied. One of the cases was remarkable for the presence of liposarcoma, malignant peripheral nerve sheath tumor, and micropapillary urothelial carcinoma. Two of the patients died 2 years after diagnosis, which is consistent with the previously reported aggressive nature of urinary bladder carcinosarcomas.
Conclusions.—Carcinosarcomas of the urinary bladder are rare, aggressive malignant neoplasms. To our knowledge, a liposarcomatous component has been reported in only 1 case previously, and components of micropapillary urothelial carcinoma and malignant peripheral nerve sheath tumor have not been reported previously in carcinosarcomas of the urinary bladder. Because of the aggressive biologic behavior of these tumors, they should be identified promptly and treated appropriately.
Ciliocytophthoria in Clinical Virology
Authors: Hadziyannis Emilio , Yen-Lieberman Belinda , Hall Gerri , Procop Gary W. 
Published: January 2021

Abstract
Direct immunofluorescence assays (DFAs) are used in the clinical virology laboratory for the rapid detection of viruses. An assessment of the cellularity of specimens submitted for DFA is necessary for the most effective use of this assay. This assessment ensures that an adequate number of the appropriate cells are present for examination. During this assessment, clinical virologists may encounter unfamiliar cellular elements or cellular fragments. One of these elements, ciliocytophthoria, has been misinterpreted as a parasite in specimens submitted for cytologic testing. We describe a similar case in which a technologist thought that ciliocytophthoria possibly represented a ciliated parasite in a nasopharyngeal specimen sent for respiratory syncytial virus DFA. After a thorough morphologic examination, the staff dismissed the possibility of a ciliated parasite. We confirmed this entity as ciliocytophthoria using morphologic criteria and the Diff-Quik stain. This near misidentification of ciliocytophthoria as a ciliated parasite affords us the opportunity to raise the awareness of clinical virologists about ciliocytophthoria. Additionally, we briefly review useful features for differentiating ciliocytophthoria from the only ciliate parasitic for humans, Balantidium coli. Finally, we present the utility of a commonly used cytologic stain, the Diff-Quik stain, for the confirmation of ciliocytophthoria.
Primary Bilateral Mucosa-Associated Lymphoid Tissue Lymphoma of the Breast With Atypical Ductal Hyperplasia and Localized Amyloidosis
Authors: Gupta Dilip , Shidham Vinod , Zemba-Palko Vlasta , Keshgegian Albert 
Published: January 2021

Abstract
Primary non-Hodgkin lymphoma of the breast is a rare disease. Primary mucosa-associated lymphoid tissue lymphoma is even rarer, and bilateral involvement is exceptional. We describe a case of primary bilateral breast mucosa-associated lymphoid tissue lymphoma with bilateral atypical ductal hyperplasia and bilateral localized amyloidosis in a 64-year-old woman with a history of arthritis and systemic lupus erythematosus and its clinical, histologic, and immunohistochemical features. Microscopic examination of the breast lesion showed dense periductal and perilobular small and plasmacytoid lymphocytes with eosinophilic amyloid in the vessels and the stroma. Bilateral single foci of atypical ductal hyperplasia were also noted. Fine needle aspiration showed small and large lymphocytes and plasma cells. Molecular analysis demonstrated a heavy chain immunoglobulin H gene rearrangement. Flow cytometry studies showed an abnormal B-cell population. The combined histologic, paraffin immunohistochemistry, flow cytometry, and molecular results were considered diagnostic for low-grade mucosa-associated lymphoid tissue lymphoma. The patient underwent bilateral local breast radiation without other organ or site involvement.
Undesirable Cytokeratin Immunoreactivity of Native Nonepithelial Cells in Sentinel Lymph Nodes From Patients With Breast Carcinoma
Authors: Xu Xiaowei , Roberts Shelley A. , Pasha Theresa L. , Zhang Paul J. 
Published: January 2021

Abstract
Context.—Use of cytokeratin immunohistochemistry on histologically negative sentinel lymph nodes (SLNs) in patients with breast carcinoma has been shown to be efficient in detecting false-negative nodes. Several recent studies have shown that micrometastases detected by immunohistochemistry constitute an independent predictor of disease-free period and overall survival for breast cancer patients. It has been demonstrated that the fibroblastic type of reticulum cells in lymph nodes also express cytokeratin, and unawareness of such cytokeratin reactivity in SLNs could result in difficulty in the interpretation of the results of immunohistochemistry.
Objectives.—To study the incidence of undesirable cytokeratin reactivity in reticulum cells and other native nonepithelial cells of SLNs and to compare the immunoreactivity of 3 commonly used cytokeratin antibodies (AE1/AE3, pancytokeratin [pan-CK], and CAM5.2).
Design.—Immunohistochemistry with pan-CK, AE1/AE3, and CAM5.2 antibodies was performed on paraffin sections of SLNs from patients with breast cancer. Correlation of undesirable cytokeratin reactivity with size and metastatic status of the SLNs was also analyzed.
Patient Material.—Paraffin sections of 84 SLNs from 38 consecutive patients with breast cancer in our tertiary-care, teaching hospital.
Results.—Cytokeratin reactivity was found in reticulum cells and plasma cells in 29 (35%) and 9 (10%) of the 84 SLNs, respectively, with pan-CK and CAM5.2 but not with AE1/AE3 (P &lt; .001). The presence of cytokeratin-positive reticulum cells did not correlate with the size and metastatic involvement of the SLNs.
Conclusions.—The incidence of undesirable keratin reactivity in SLNs from breast cancer patients could be limited by using an AE1/AE3 antibody cocktail. The AE1/AE3 antibody cocktail is a sensitive epithelial marker and appears to be more specific in recognizing epithelial cells in SLNs.
Proportion Positive for Epstein-Barr Virus, Cytomegalovirus, Human Herpesvirus 6,Toxoplasma,and Human Immunodeficiency Virus Types 1 and 2 in Heterophile-Negative Patients With an Absolute Lymphocytosis or an Instrument-Generated Atypical Lymphocyte Flag
Authors: Tsaparas Yotis F. , Brigden Malcolm L. , Mathias Richard , Thomas Eva , Raboud Janet , Doyle Patrick W. 
Published: January 2021

AbstractObjectives.—To determine the proportion of patients with evidence of an acute infection due to Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), Toxoplasma, or human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) in heterophile-negative patients with an absolute lymphocytosis or an instrument-generated atypical lymphocyte flag, and to develop a cost-effective testing algorithm for managing such heterophile-negative patients.Design.—We conducted a prospective investigation of 70 selected outpatients who tested negative for heterophile antibody in association with an absolute lymphocytosis or instrument-generated atypical lymphocyte flag. The control population consisted of 50 patients who were heterophile negative and had a normal absolute lymphocyte count and no instrument-generated atypical lymphocyte flag.Setting.—A large outpatient laboratory system.Intervention.—Viral serology for HHV-6 was performed by immunofluorescence, and all other serologies were performed by enzyme-linked immunoassay. All testing was for immunoglobulin (Ig) M antibodies, except in the case of HIV.Results.—The proportion of study patients positive for EBV was 40% (28/70); for CMV, 39% (27/70); for HHV-6, 25% (16/65); for Toxoplasma, 3% (2/70); and for HIV, 0% (0/70). All 50 control patients were negative for EBV IgM antibodies. When patients with more than 1 positive viral test were excluded from analysis, positivity was 20% (9/45) for EBV, 22% (10/45) for CMV, 9% (4/45) for HHV-6, and 2% (1/45) for Toxoplasma. Utilizing hypothesis-generating logistic regression models, Downey type II atypical lymphocytes were significantly associated with EBV positivity (P = .006), while Downey type III lymphocytes were significantly associated with HHV-6 positivity (P = .016), and there was a trend for the association of Downey type I lymphocytes with CMV positivity (P = .097).Conclusions.—A positive viral serology was identified in 70% of study patients. Multiple positive serologies complicate establishing a definitive diagnosis. Potential cost savings may be associated with the use of an appropriate testing algorithm.
Anaplastic Large Cell Lymphoma Arising in Bone
Authors: Lones Mark A. , Sanger Warren , Perkins Sherrie L. , Medeiros L. Jeffrey 
Published: January 2021

Abstract
Anaplastic large cell lymphoma (ALCL) represents approximately 2% of all non-Hodgkin lymphomas according to the recent Non-Hodgkin Lymphoma Classification Project. As defined in the revised European-American classification of lymphoid neoplasms (REAL), ALCL is a neoplasm of T-cell or null-cell lineage; 20% to 60% of cases are associated with the t(2;5)(p23;q35) translocation. ALCL commonly involves nodal as well as a wide variety of extranodal sites, although primary or secondary involvement of bone is rare. We describe the case of a 71-year-old man with stage IE T-cell ALCL, monomorphic variant, arising in the left anterior fifth rib and involving adjacent soft tissue without other sites of disease. The monomorphic histologic features hindered the initial recognition of this neoplasm as ALCL. However, strong uniform CD30 antigen expression and subsequent demonstration of the t(2;5)(p23;q35) translocation and anaplastic lymphoma kinase (ALK) immunoreactivity led to the correct diagnosis. We identified only 5 reported cases of T-cell and null-cell ALCL arising in bone and only 2 of these cases involved a single bone site. All 5 previously reported cases were ALCL of the classic type. We report a case of ALCL that is unique to our knowledge. This case of monomorphic ALCL was localized to bone and tumor cells contained the t(2;5)(p23;q35) translocation.