bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relevance of Periglomerular Fibrosis in the Evaluation of Routine Needle Core Renal Biopsies
Authors: Jenkins Joseph , Brodsky Sergey V. , Satoskar Anjali A. , Nadasdy Gyongyi , Nadasdy Tibor 
Published: February 2021

AbstractContext—Renal interstitial fibrosis and, to a lesser extent, sclerotic glomeruli correlate with poor renal function. However, not all nonfunctional glomeruli are sclerotic. Many or most glomeruli with periglomerular fibrosis, while retaining blood flow, probably do not filter; therefore, they may not contribute to renal function.Objective—To examine the relationship of periglomerular fibrosis and the sum of globally sclerotic glomeruli and glomeruli with periglomerular fibrosis (GSG+PF) with interstitial fibrosis and renal function.Design—Native kidney biopsies from 177 patients with chronic renal injury were assessed for interstitial fibrosis, glomerular sclerosis, and GSG+PF. Renal biopsies with active or acute lesions were not included. The percentage of globally sclerotic glomeruli and GSG+PF was correlated with the degree of interstitial fibrosis and serum creatinine levels.Results—The percentage of GSG+PF correlates better with the degree of interstitial fibrosis and renal function than does the percentage of globally sclerotic glomeruli alone. This appears particularly true in chronic renal diseases of patients without diabetes. The number of globally sclerotic glomeruli correlates better with interstitial fibrosis and renal function than does the sum of globally and segmentally sclerotic glomeruli.Conclusions—The percentage of GSG+PF in a renal biopsy specimen provides a better estimate of chronic renal injury than does the percentage of sclerotic glomeruli alone, probably because many or most glomeruli with periglomerular fibrosis are nonfunctional. Therefore, we recommend that the number of glomeruli with periglomerular fibrosis also be provided in the renal biopsy report.
Sentinel Lymph Nodes in Cutaneous Melanoma: Handling, Examination, and Clinical Repercussion
Authors: Prieto Victor G. 
Published: February 2021

AbstractContext—Within the last 15 years, evaluation of sentinel lymph nodes (SLNs) has become the most popular method of early staging of several malignancies, including melanoma. Sentinel lymph nodes are usually examined on formalin-fixed, paraffin-embedded sections and by routine histology/immunohistochemistry (research protocols have used other techniques such as polymerase chain reaction). Approximately 20% of patients with cutaneous melanoma have metastasis in the SLN. In most studies, detection of positive SLN conveys a poorer prognosis for patients with cutaneous melanoma.Objective—To review the morphologic patterns of melanoma metastasis in the SLN, the differential diagnosis, and the quantification of tumor burden as a prognostic factor.Data Sources—Personal observations and review of the pertinent literature.Conclusions—Evaluation of sentinel lymph nodes is certainly becoming a widespread technique and most authors agree on its prognostic power for staging patients with cutaneous melanoma. Current studies are evaluating the possible therapeutic value of removal of positive SLNs.
Diagnostic Challenges in the Pathologic Evaluation of Barrett Esophagus
Authors: Yantiss Rhonda K. 
Published: February 2021

Abstract
Context.—Barrett esophagus represents an unstable epithelium resulting from chronic gastroesophageal reflux disease. Patients with Barrett esophagus routinely undergo endoscopic examination to detect dysplasia and early carcinoma. Although appropriate classification of Barrett esophagus and neoplasia is usually straightforward, persistent esophageal inflammation may induce epithelial changes that mimic, or mask, dysplasia. Recent data also indicate that specific molecular changes occur in nondysplastic Barrett mucosa and herald the development of dysplasia and/or carcinoma.
Objective.—To describe problematic aspects of biopsy interpretation in tissue samples of the gastroesophageal junction and distal esophagus, including the diagnostic criteria for Barrett esophagus, the importance of the gastric cardia, and pitfalls to the diagnosis of dysplasia. Ancillary studies that have recently emerged as potential adjuncts to the evaluation of patients with Barrett esophagus will be briefly discussed.
Data Sources.—A comprehensive review of the relevant literature indexed in PubMed (National Library of Medicine) was performed.
Conclusions.—Barrett esophagus is currently defined as the presence of intestinal metaplasia in samples obtained from an endoscopically evident abnormality in the distal esophagus. Diagnosis and grading of dysplasia in mucosal biopsies remain the most reliable method to assess risk for neoplastic progression, but its classification may be hindered by superimposed inflammatory changes and suffers from considerable interobserver variability. Therefore, immunohistochemical studies and molecular assessment for TP53, CDKN2A, and DNA content abnormalities have emerged as potential adjuncts to the detection of dysplasia.
Digital Microscopy: Past, Present, and Future
Authors: Hedvat Cyrus V. 
Published: February 2021

Abstract
Context.—Digital viewing of histologic images is moving from presentations and publications to incorporation into the daily work of practicing pathologists. Many technologic limitations have been overcome recently, which should make widespread adoption more practical. The task now is for pathologists to become actively involved in its development and implementation, to ensure that the technology is developed with the intent to optimize workflow and to maintain diagnostic accuracy. An understanding of the basic precepts of digital imaging is required to make informed decisions related to hardware and software implementation and to collaborate with vendors and professionals outside of pathology (eg, regulatory agencies) as the technology rapidly develops.
Objective.—To describe the state of digital microscopy as it applies to the field of pathology and to define specific issues related to adoption of whole slide imaging systems.
Data Sources.—The information is derived from the experience of the author and review of the literature.
Conclusions.—Digital microscopy is an important tool for surgical pathologists. It is currently an area of intense and rapid technologic development that will likely transform the workflow of many laboratories during the next several years.
Uniform Expression of Notch1, Suppressor of B-Cell–Specific Gene Expression, in Plasmablastic Lymphoma
Authors: Seegmiller Adam C. , Wang Huan-You , Hladik Christa , Chen Weina 
Published: February 2021

Abstract
Context.—Although the loss of B-lineage–specific gene expression is a distinctive feature of plasmablastic lymphoma, the underlying mechanism remains poorly understood. A candidate for this mechanism is Notch1 signaling, which interferes with the activity of B-cell–specific transcription factors E2A and early B-cell factor and positively regulates the mammalian target of rapamycin (mTOR) pathway.
Objective.—To explore the mechanism of loss of B-cell phenotype by correlating expression of B-cell markers with that of Notch1 and downstream targets of the mTOR pathway in plasmablastic lymphoma.
Design.—A combination of flow cytometric and immunohistochemical immunophenotyping techniques was used on 9 cases of plasmablastic lymphoma to correlate loss of B-cell markers with expression of Notch1 and downstream activation of the mTOR pathway. These results are compared with 5 cases of primary effusion lymphoma and 21 cases of plasma cell myeloma.
Results.—Plasmablastic lymphoma cases exhibit nearly complete loss of B-cell–associated markers and uniform expression of Notch1, with a predominantly nuclear staining pattern. There is a concurrent activation of the mTOR pathway, indicated by expression of mTOR targets eukaryotic initiation factor 4E–binding protein 1 and phosphorylated ribosomal protein S6 in most cases. Similar results are seen in cases of primary effusion lymphoma and plasma cell myeloma.
Conclusions.—These findings suggest that activation of Notch1 may be involved in suppression of B-cell–specific gene expression and global loss of the B-cell phenotype in plasmablastic lymphoma, similar to primary effusion lymphoma and plasma cell myeloma. Thus, there might be a role for the Notch1 and mTOR pathways in the pathogenesis and therapy of plasmablastic lymphoma.
Carcinoids and High-Grade Neuroendocrine Carcinomas of the Ampulla of Vater: A Comparative Analysis of 139 Cases From the Surveillance, Epidemiology, and End Results Program—A Population Based Study
Authors: Albores-Saavedra Jorge , Hart Alexandra , Chablé-Montero Fredy , Henson Donald E. 
Published: February 2021

Abstract
Context.—Neuroendocrine tumors of the ampulla of Vater constitute a heterogeneous group of neoplasms clinically and morphologically. Because they are rare, little is known about their demographics and biologic behavior.
Objective.—To analyze the demographics and the 5- and 10-year relative survival rates of 139 patients with carcinoid tumors and high-grade neuroendocrine carcinomas of the ampulla.
Design.—Using data from National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program from 1973 to 2006, we analyzed the demographics, morphology, and survival of patients with carcinoids and neuroendocrine carcinomas of the ampulla.
Results.—SEER recorded 6081 cases of malignant neoplasms of the ampulla, of which 82 were carcinoid tumors and 57 were high-grade neuroendocrine carcinomas. Of these 57, 42 were neuroendocrine carcinomas, not otherwise specified; 9 were small cell carcinomas; and 6 were large cell neuroendocrine carcinomas. The incidence was higher in men than in women. Patients with carcinoid tumors were younger (mean age, 61.6 years) than those with high-grade neuroendocrine carcinomas (mean age, 67.5 years). Carcinoid tumors were smaller than high-grade neuroendocrine carcinomas. The frequency of lymph node metastasis was 28.5% for carcinoid tumors and 62% for high-grade neuroendocrine carcinomas. The 5- and 10-year relative survival rates of patients with carcinoid tumors were 82% and 71%, respectively. The 5- and 10-year relative survival rate of patients with high-grade neuroendocrine carcinomas was 15.7%.
Conclusions.—Carcinoids of the ampulla of Vater are relatively rare. Carcinoids and high-grade neuroendocrine carcinomas of the ampulla are biologically and clinically similar to these tumors arising in other sites. Carcinoids were smaller and metastasized less frequently than high-grade neuroendocrine carcinomas.
Blue Nevus of the Prostate
Authors: Dailey Virginia L. , Hameed Omar 
Published: February 2021

Abstract
Blue nevus is one of the melanotic lesions that can incidentally arise in the prostate gland. A literature review identified 28 previously reported cases, and although rare, the blue nevus appeared to be the commonest melanocytic lesion arising in the prostate. The differential diagnosis includes melanosis and malignant melanoma, as well as nonmelanotic lesions due to deposition of lipofuscin, hemosiderin and, rarely, homogentisic acid. The distinction among these lesions can typically be made based on morphologic grounds but may also be aided by histochemical and immunohistochemical stains such as stains for iron, S100 protein, HMB-45, and CD68 as needed. Blue nevus of the prostate is a benign lesion with no malignant potential to date, so no further treatment is warranted.
Follow-up Findings in Young Females With High-Grade Squamous Intraepithelial Lesion Papanicolaou Test Results
Authors: Zhao Chengquan , Kalposi-Novak Pal , Austin R. Marshall 
Published: February 2021

AbstractContext.—New guidelines discourage cervical screening and procedures in young females, given available human papillomavirus vaccines, concerns regarding procedure-associated harms, and the rarity of cervical cancers.Objective.—To analyze histopathologic follow-up data on a large number of young females with high-grade squamous intraepithelial lesion (HSIL) Papanicolaou (Pap) test results.Design.—Hospital records were searched for HSIL Pap test results in females 20 years or younger between January 2002 and December 2007. Histopathologic and Pap test follow-up, age group variations, and impact of Pap test transformation zone/endocervical sampling were analyzed.Results.—Four hundred seventy-four females aged 20 years or younger had HSIL Pap test results during the study period. Three hundred thirty-five young females with at least one cervical biopsy were included. The average age was 18.6 years (range, 13–20 years). The average follow-up period was 24 months (range, 0.1–75 months), with a median of 22 months. Histopathologic detection rates were 44.2% for cervical intraepithelial neoplasia (CIN) 2/3 and 47.8% for CIN 1. The average period between the HSIL Pap test result and an initial diagnosis of CIN 2/3 was 5 months (range, 0.1–62 months), with a median of 2 months. Neither invasive carcinoma nor adenocarcinoma in situ was identified. Presence or absence of a transformation zone/endocervical sample did not significantly impact CIN 2/3 risk (44.5% versus 38.9%, P  =  .64).Conclusions.—Histopathologic CIN 2/3 was documented in 148 of 335 (44%) of biopsied young females with HSIL Pap results, likely reflecting both the reported high likelihood of HSIL regression in younger females and the challenge of colposcopic sampling of relatively short-lived smaller CIN 2/3 lesions. Although no cases of invasive carcinoma were identified in this study, updated guidelines pose new risks for maturing females with undetected cervical precancer.
A Survey-Based Assessment of United States Clinical Laboratory Response to the 2009 H1N1 Influenza Outbreak
Authors: Hayden Randall T. , Wick Megan T. , Rodriguez Alicia B. , Caliendo Angela M. , Mitchell Michael J. , Ginocchio Christine C. ,   for the Microbiology Resource Committee of the College of American Pathologists
Published: February 2021

Abstract
Context.—The recent outbreak of pandemic influenza created enormous economic, logistical, and analytical challenges for clinical laboratories. Laboratory response represented a critical element in the care of affected patients, but little has been published regarding this aspect of the pandemic.
Objective.—To assess the overall response of clinical diagnostic laboratories across the United States to the initial phase of the 2009 H1N1 influenza A pandemic.
Design.—A 24-question survey was developed and distributed by e-mail to determine current influenza testing practices and how those practices were changed in response to the outbreak of 2009 H1N1 influenza. The survey was distributed to participants in the College of American Pathologists proficiency testing programs related to viral diagnostics. Survey questions focused on laboratory safety, communication of results, testing volume and resources, and whether changes in resource allocation or laboratory practice were anticipated in preparation for the 2009–2010 influenza season.
Results.—A total of 24.3% (931) of laboratories responded to the survey. Overall, few laboratories reported changes in methodology in response to the 2009 H1N1 influenza outbreak, although, notably, the number of centers using molecular amplification methods more than doubled, from 41 to 91. Turn-around time for result reporting and safety methods used were largely as expected for individual testing modalities. Shortages in staffing, testing supplies, and personal protective equipment were reported, but most sites were able to maintain operations and did not feel that patient care was negatively affected.
Conclusion.—This report provides a comprehensive picture of clinical laboratory responses in the early stages of the 2009 H1N1 influenza pandemic. These data should assist in the continued laboratory management of this outbreak and in planning for future emerging infections.
Sinonasal Glomangiopericytoma: Case Report With Emphasis on the Differential Diagnosis
Authors: Dandekar Monisha , McHugh Jonathan B. 
Published: February 2021

Abstract
Glomangiopericytoma (sinonasal-type hemangiopericytoma) is an uncommon sinonasal neoplasm with a perivascular myoid phenotype. This tumor differs from conventional soft tissue hemangiopericytoma in location, biologic behavior, and histologic features. The proposed cell of origin is a modified perivascular glomuslike myoid cell. Glomangiopericytoma is an indolent tumor that tends to arise in the sinonasal tract of older adults and has a low malignant potential with excellent prognosis after surgical resection. Histologically, this lesion is composed of a diffuse, subepithelial proliferation of bland, uniform, closely packed spindled cells growing in a variety of patterns. A distinctive vascular network composed of variably sized vascular channels, the smaller of which demonstrate perivascular hyalinization, is often present. We report the case of a 48-year-old woman with epistaxis and nasal obstruction who was diagnosed with glomangiopericytoma and discuss the histologic differential diagnosis.
Fine-Needle Aspiration of Intrapancreatic Accessory Spleen, Mimic of Pancreatic Neoplasms
Authors: Lin Jingmei , Jing Xin 
Published: February 2021

Abstract
Intrapancreatic accessory spleen (IPAS) is a congenital abnormality, which mimics neoplasm. Distinguishing IPAS from pancreatic neoplasm/malignancy is extremely important from a treatment perspective. We report the case of a 67-year-old asymptomatic man who had a 1.3-cm, incidentally detected, pancreatic tail mass. The mass was round, well-circumscribed, and hypervascular with uniform enhancement. The image findings were highly suggestive of a pancreatic endocrine neoplasm. An endoscopic ultrasound-guided fine-needle aspiration was performed. Conventional smears revealed a polymorphous population of lymphocytes admixed with a subset of other inflammatory cells. Hematoxylin-eosin–stained cell block sections showed conspicuous thin-walled blood vessels in addition to inflammatory cells. Immunostaining for CD8 demonstrated strong positivity in endothelial cells of the thin-walled vessels. By correlating the cytologic findings with the result of immunostaining, we rendered the diagnosis of IPAS. Our experience supports the view that endoscopic ultrasound-guided fine-needle aspiration may enable a reliable, preoperative diagnosis of IPAS and thus prevent unnecessary surgery.
Acute Myeloid Leukemia Diagnosis in the 21st Century
Authors: Betz Bryan L. , Hess Jay L. 
Published: February 2021

Abstract
Context.—Rapid advances in understanding the molecular biology of acute myeloid leukemia are transforming the approach to diagnosis, prognostication, and treatment of these cases.
Objective.—To briefly review the current state of AML classification with a particular emphasis on the role of molecular studies and their impact on the management of acute myeloid leukemia and other malignancies.
Data Sources.—Current literature and experience of the authors.
Conclusions.—While morphology, immunophenotyping, cytogenetics, and clinical history continue to play an important role, an increasing number of molecular tests are now required to properly classify these cases.
The Collagenous Gastroenteritides: Similarities and Differences
Authors: Gopal Purva , McKenna Barbara J. 
Published: February 2021

Abstract
Collagenous gastritis, collagenous sprue, and collagenous colitis share striking histologic similarities and occur together in some patients. They also share some drug and disease associations. Pediatric cases of collagenous gastritis, however, lack most of these associations. The etiologies of the collagenous gastroenteritides are not known, so it is not clear whether they are similar because they share pathogeneses, or because they indicate a common histologic response to varying injuries. The features, disease and drug associations, and the inquiries into the pathogenesis of these disorders are reviewed.
Adrenocortical Tumors: An Integrated Clinical, Pathologic, and Molecular Approach at the University of Michigan
Authors: Giordano Thomas J. 
Published: February 2021

Abstract
Context.—The University of Michigan Health System has a rich tradition in the study and treatment of endocrine neoplasia. Recently, an integrated clinical and research program focused on primary cancer of the adrenal gland has been developed.
Objective.—To discuss the foundation of the University of Michigan Adrenal Cancer Program that consists of 3 components: (1) advancement of excellent clinical care, (2) dissemination of resources and knowledge, and (3) scientific discovery.
Data Sources.—Recent programmatic activity includes genome-wide transcriptomic evaluation of human adrenocortical tumors for diagnostic and prognostic evaluation; interrogation of the Wnt signaling pathway in adrenocortical carcinoma, using mouse models and transcriptome profiling; and clinical trials with targeted therapy focused on inhibition of insulin-like growth factor signaling pathway.
Conclusions.—This review article presents an overview of this program and its recent activity.
Acidophilic Nuclear Inclusions Are Specific for Florid Ductal Hyperplasia Among Proliferative Breast Lesions
Authors: Lauer Scott , Oprea-Ilies Gabriela , Cohen Cynthia , Adsay Volkan , Adams Amy L. 
Published: February 2021

Abstract
Context.—Recently we have observed distinctive acidophilic intranuclear inclusions in cases of usual intraductal hyperplasia of the breast. Similar inclusions were described almost 20 years ago in cases of mammary hyperplasia. These correlated ultrastructurally with so-called helioid inclusions. However, there since has been little discussion of these inclusions in the literature.
Objective.—To examine the incidence and specificity of these inclusions in proliferative lesions of the breast.
Design.—Forty cases of usual intraductal hyperplasia, 15 cases of atypical ductal hyperplasia, and 34 cases of low-grade ductal carcinoma in situ were examined for the presence of acidophilic intranuclear inclusions.
Results.—Acidophilic intranuclear inclusions were present in 50% of cases of usual intraductal hyperplasia (20 of 40) but were not identified in any cases of atypical ductal hyperplasia (0 of 15) or low-grade ductal carcinoma in situ (0 of 34).
Conclusions.—Acidophilic intranuclear inclusions appear to be a common, specific feature found in usual intraductal hyperplasia and may be helpful in distinguishing it from atypical ductal hyperplasia and low-grade ductal carcinoma in situ in some cases. Elucidating the nature of these inclusions may provide insight into the pathogenesis of usual intraductal hyperplasia.
Emergence of a High-Grade Sarcoma in a Recurrent Meningioma: Malignant Progression or Collision Tumor?
Authors: Oz Buge , Pekmezci Melike , Dashti Reza , Karaman Kutlay , Kuday Cengiz , Tihan Tarik 
Published: February 2021

Abstract
Anaplastic meningiomas that resemble sarcomas often reveal clues to their meningothelial differentiation or develop in a plausible setting that confirms their meningothelial origin. Malignant mesenchymal neoplasms without obvious evidence of meningothelial differentiation or origin are more likely to be true primary or metastatic sarcomas. Because of their clinical and biological differences, it is important to distinguish anaplastic meningioma from a sarcoma. We present a 67-year-old woman with multiple meningiomas, who developed a high-grade spindle cell tumor 6 months after the resection of a World Health Organization grade I meningioma. It was not clear whether this tumor represented a malignant transformation of meningioma or a primary sarcoma. Malignant transformation of a meningioma is exceptional within this short period and a coexisting sarcoma and meningioma are equally uncommon. Even though these malignant neoplasms are rare in general, they appear to be more prevalent in patients with multiple meningiomas including those with neurofibromatosis type 2.