bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ossified Intratesticular Mucinous Tumor
Authors: Mesia Lilia , Georgsson Sverrir , Zuretti Alejandro 
Published: January 2021

Abstract
We report a case of an ossified primary intratesticular mucinous tumor in a 69-year-old man, which was discovered incidentally during a consultation for erectile dysfunction. The 7.5 × 4.8 × 4–cm, predominantly solid, and partially cystic mass completely replaced the testis with no extension to tunica albuginea and epididymis. The multiloculated area was mostly covered by a single layer of bland mucinous epithelium with few areas of epithelial tufting, stratification, and nuclear atypia. The solid areas consisted of mature bone and fibrous stroma with cholesterol clefts, some multinucleated giant cells, moderate infiltration of lymphocytes, and foamy vacuolated macrophages. The bone showed occasional rimming of osteoblasts and rare osteoclasts. Rare foci of mature bone were found in the nonfibrosed wall and lumen cysts. The patient is alive and well 3 years after right orchiectomy with spermatic cord resection.
Subependymomas
Authors: Prayson Richard A. , Suh John H. 
Published: January 2021

Abstract
Background.—Subependymomas are uncommonly encountered ependymal tumors, which are important to distinguish from ordinary ependymomas because of their generally better prognosis.
Objective.—To review the clinicopathologic features and MIB-1 labeling indices (marker of cell proliferation) of 14 subependymomas.
Design.—Retrospective review of 14 subependymomas encountered in a tertiary care setting.
Results.—Fourteen ependymomas presenting in 8 men and 6 women between the ages of 18 and 78 years (mean, 53.6 years) comprise the study group. The most common clinical presentations included ataxia (n = 4), dizziness/vertigo (n = 3), nausea/vomiting (n = 3), headaches (n = 3), and incidental finding at autopsy (n = 2). Tumor locations included fourth ventricle (n = 7), lateral ventricle (n = 4), third ventricle (n = 2), and thoracic spinal cord (n = 1). Eight patients underwent gross total resection, and 4 had subtotal resection. Tumors were characterized by clustering of cell nuclei arranged against a fibrillary background. Focal cystic degeneration was seen in 10 tumors, hemosiderin deposition in 8 tumors, sclerotic vessels in 8 tumors, calcifications in 5 tumors, and focal nuclear pleomorphism in 2 tumors. Mitotic figures, vascular endothelial proliferation, and necrosis were not seen in any of these tumors. Cell proliferation marker MIB-1 labeling indices (percentage of positive staining tumor cells) ranged from 0 to 1.4 (mean, 0.3). In comparison, 13 myxopapillary ependymomas had labeling indices ranging from 0 to 5.5 (mean, 1.1). Thirty-nine low-grade ependymomas had MIB-1 labeling indices of 0.1 to 5.4 (mean, 1.1). Fourteen anaplastic/malignant ependymomas had MIB-1 labeling indices ranging from 0.4 to 34.0 (mean, 12.8). One subependymoma was treated with radiation therapy. Six patients were alive with no evidence of tumor at a mean follow-up of 94.4 months. Two patients were alive with residual tumor (follow-up of 4 and 53 months). Two patients died with tumor at 0.67 and 43.4 months. One patient was lost to follow-up, 1 is a recent case, and 2 were incidental findings at autopsy. None of the patients developed tumor recurrence.
Conclusions.—Subependymomas are generally low-grade lesions, as evidenced by their benign clinical course and low MIB-1 labeling indices. Compared with other ependymal tumors, subependymomas have the lowest rate of cell proliferation as evidenced by MIB-1 immunostaining.
Extramedullary Tumor of Monoblasts in the Central Nervous System
Authors: Dunphy Cherie H. , Martin David S. 
Published: January 2021

Abstract
An extramedullary tumor of monoblasts in the central nervous system has been described in the literature as a single case report, preceding the development of acute monocytic leukemia by 1 year. We report a previously undescribed presentation of acute monocytic leukemia as a left temporal lobe extra-axial mass with concomitant bone marrow involvement. We describe our findings in order to heighten awareness of this entity, which may be encountered in morphologic evaluation of central nervous system masses.
Sclerosing Hyaline Necrosis of the Liver in Bloom Syndrome
Authors: Wang Jun , Cornford Marcia E. , German James , French Samuel W. 
Published: January 2021

Abstract
Bloom syndrome is a rare autosomal recessive disorder characterized by normally proportioned but strikingly small body size, a characteristic facies and photosensitive facial skin lesion, immunodeficiency, and a marked predisposition to development of a variety of cancers. We describe here, we believe for the first time, pronounced sclerosing hyaline necrosis with Mallory bodies in the liver of a patient with Bloom syndrome. Mallory bodies are cytoplasmic eosinophilic inclusions, which are more common in visibly damaged, swollen hepatocytes in various liver diseases but are never found in normal liver. The possible pathogenesis of this finding in Bloom syndrome is discussed.
Fatal Pulmonary Tumor Embolism Caused by Chondroblastic Osteosarcoma: Report of a Case and Review of the Literature
Authors: Ahmed Atif A. , Heller Debra S. 
Published: January 2021

Abstract
Fatal pulmonary tumor embolism is an unusual phenomenon that has only rarely been reported with osteosarcoma. It usually presents with typical symptoms and signs of pulmonary thromboembolism. The authors report the case of a 65-year-old woman with chondroblastic osteosarcoma of the distal femur who suffered a fatal tumor embolism 30 hours after surgery and review the literature.
What Do the Accreditation Organizations Expect?: American Association of Blood Banks
Authors: Otter Jean , Cooper E. Shannon 
Published: January 2021

Abstract
In 1958, the American Association of Blood Banks introduced the first edition of Standards for Blood Banks and Transfusion Services. That same year, the association implemented the Inspection and Accreditation Program. This program served the association well for 40 years; however, factors such as the application of Current Good Manufacturing Practices by the Food and Drug Administration, the implementation of the Clinical Laboratory Improvement Amendments of 1988 by the Health Care Financing Administration, managed care, competition, and increased cost pressures have changed the way the blood banking community conducts its business. In the early 1990s the board of directors recognized the need to reevaluate the Inspection and Accreditation Program and developed a strategic plan for implementation of a new accreditation program, with an emphasis on prevention rather than detection of errors. The first step in the process was the development of the Accreditation Program Committee. The committee was charged to develop and coordinate a program that would bring the accreditation process in tune with the current climate of blood banking and move it into the 21st century. The board charged the committee with the development of a program that recognizes the differences and similarities within the diverse groups of American Association of Blood Banks institutional members and to take into consideration how they do business and respond to regulations, standards, and other requirements.
Influence of Etoposide on the Retention of Radiolabeled Low-Density Lipoprotein in the Arterial Wall
Authors: Krainer Michael , Rodrigues Margarida , Zielinski Christoph , Sinzinger Helmut 
Published: January 2021

Abstract
Background.—Cardiovascular toxicity of chemotherapy for testicular cancer is a matter of discussion, since highly efficient agents can achieve cure of the disease, even in the metastasized setting. Acute ischemic events during the treatment period and a persistently elevated serum cholesterol thereafter are observations of particular concern in these patients, and the underlying basic mechanisms are unknown to date.
Objective.—To evaluate etoposide, which is part of the standard treatment for testicular cancer, as a potential cause of atherogenesis in an experimental model.
Setting.—Aortic 125I-labeled low-density lipoprotein retention was studied in 72 cholesterol-fed rabbits under etoposide treatment and was quantified according to the morphologically assessed type of surface lining. Aortic cholesterol content was determined both by Sudan III staining and quantitatively by a biochemical assay.
Results.—A reduced uptake of 125I-labeled low-density lipoprotein in the arterial wall was observed in the etoposide-treated animals, which resulted in a size reduction of sudanophilic areas and cholesterol content. Whereas the breakdown of 125I-labeled low-density lipoprotein in the liver was not significantly enhanced, the plasma decay of 125I-labeled low-density lipoprotein was faster and serum cholesterol was lower in the etoposide group than in controls.
Conclusion.—Unexpectedly, we found an improvement of arterial wall lipid metabolism under etoposide treatment and can thus exclude this substance as a promoter of atherogenesis in this model.
Axillary Sentinel Lymph Node Examination in Breast Carcinoma
Authors: Kelley Scott W. , Komorowski Richard A. , Dayer Anne M. 
Published: January 2021

Abstract
Objective.—To evaluate whether the type of pathologic examination of breast sentinel nodes (frozen section, step sections, and immunoperoxidase staining) results in different percentages of nodes positive for metastatic disease.
Design.—Twenty-eight consecutive patients with breast sentinel node biopsies were evaluated by step-sectioning the sentinel node(s) along with performing immunoperoxidase stains for low-molecular-weight cytokeratin and epithelial membrane antigen.
Setting and Participants.—The patients were from a university hospital and large private hospital.
Main Outcome Measures.—The results of the step sections and immunoperoxidase stains were compared with routine examination, that is, intraoperative frozen section along with a single hematoxylin-eosin slide.
Results.—Nine cases were positive by routine evaluation, 10 by step sections, and 11 by immunoperoxidase staining.
Conclusions.—The large, multi-institutional studies of sentinel node utility must take into account the surgical pathology methods used to evaluate these specimens so that uniform techniques, which reliably predict the status of the axillary nodes, can be instituted at all institutions that use this procedure.
Optimizing the Cost-effectiveness of Quality Assurance in Transfusion Medicine
Authors: AuBuchon James P. 
Published: January 2021

Abstract
Although quality assurance efforts have been integrated into many aspects of American health care, their value has been questioned. They can consume large amounts of resources (monetary and/or temporal), calling into question their cost-effectiveness. To improve the yield of quality assurance efforts and limit their consumption of administrative resources, they need to be focused on those aspects of the operation where improvement is needed or where errors are particularly problematic and costly. Just as a quality assurance program needs to define the outcome required of the process being monitored, the outcome of the quality assurance process needs to be defined at the outset; the simplest possible system should then be designed to capture the necessary data to direct improvement. Although quality assurance efforts have been documented to yield substantial savings, their real payback is provided through better control of an operation and more complete knowledge of the status of that operation.
Myelolipoma of the Renal Sinus
Authors: Amin Mitual B. , Tickoo Satish K. , Schultz Daniel , Amin Mahul B. 
Published: January 2021

Abstract
Extra-adrenal myelolipomas are rare; approximately 36 cases have been reported to date. We document a case of myelolipoma presenting as a localized mass in the renal sinus of a 66-year-old man. The chief clinical and radiologic differential diagnostic considerations in this case included a malignant renal tumor arising in the hilum. The patient was being investigated for recurrent urinary tract infections and vague abdominal pains. Histologically, the lesion showed features characteristic of a myelolipoma. There was also marked chronic inflammation in and around the mass. The uneventful follow-up of 62 months is in keeping with the benign nature of this lesion. This report expands the possibilities of the differential diagnoses of renal hilar neoplasms, particularly in view of the increased use of imaging techniques that are bound to detect many incidental lesions in this region.
(Arch Pathol Lab Med.1999;123:631–634)
Gynecologic Cytology Turnaround Time
Authors: Jones Bruce A. , Valenstein Paul N. , Steindel Steven J. 
Published: January 2021

Abstract
Objectives.—To determine the turnaround time for gynecologic cytology in a large sample of laboratories and to identify laboratory and specimen characteristics associated with better and worse performance.
Design and Setting.—Prospective evaluation of gynecologic cytology turnaround times in 371 laboratories.
Main Outcome Measure.—Gynecologic cytology case turnaround time.
Results.—Three hundred seventy-one laboratories submitted information regarding laboratory characteristics and processes, and turnaround times of 66 042 gynecologic cytology cases. Half of the participating laboratories had mean turnaround times of 6 calendar days or less and were able to complete 90% of their cases within 8 calendar days. Ten percent of participants had mean turnaround times greater than 13 days and required 19 or more days to report 90% of their cases. Longer turnaround times were associated with the use of reference laboratories for all or part of the evaluation; contacting the physician's office for additional information; using cytotechnology students, residents, or fellows in the evaluation; and providing service on the weekend.
Conclusion.—Practice patterns contribute to the long turnaround times for gynecologic cytology found in some laboratories and may be improved by local site-specific process analysis.
Mucocutaneous Angiomyolipoma
Authors: Watanabe Kazuo , Suzuki Toshimitsu 
Published: January 2021

Abstract
Objective.—Angiomyolipoma (AML) is a distinctive tumor that usually occurs in the kidney and rarely in the liver. Angiomyolipoma of other sites is extremely rare, and, to our knowledge, only 2 cases have been described in the nasal cavity. We present 2 additional cases of AML of the nasal cavity and discuss the difference between them and renal AML.
Case Reports and Pathologic Findings.—Two tumors in a 66-year-old man and an 88-year-old woman without tuberous sclerosis are described. They showed 20-mm, well-circumscribed, polypoid shapes. Histologically, they were composed of mature smooth muscle cells, fat cells, and various-sized blood vessels. In addition, aggregated small lymphocytes were noted. Neither epithelioid smooth muscle cells nor HMB45 immunoreactivity was seen in either case.
Conclusions.—The clinicopathologic features of AML of the nasal cavity are distinct from renal and hepatic AML and are common to those of AML arising in the skin and oral and pharyngeal mucosa. The term mucocutaneous angiomyolipoma is thought to be appropriate to express these characteristic tumors.
Histopathologic Features and MIB-1 Labeling Indices in Recurrent and Nonrecurrent Meningiomas
Authors: Abramovich Caroline M. , Prayson Richard A. 
Published: January 2021

AbstractBackground.—Predicting the behavior of meningiomas based on histopathologic features alone has remained problematic.Design.—This study retrospectively compared several histopathologic features and MIB-1 labeling indices (LIs) in recurrent meningiomas with those of nonrecurrent meningiomas. Six histopathologic features, including mitoses, necrosis, loss of architectural pattern, hypervascularity/hemosiderin deposition, prominent nucleoli, and nuclear pleomorphism, were compared between 32 recurrent and 27 nonrecurrent meningiomas using Fisher exact tests. MIB-1 LIs (% positive tumor cell nuclei) were compared using the Wilcoxon rank sum test.Results.—The patients in the recurrent group included 26 women (mean age, 55 years), who developed 1 to 5 recurrences. Time intervals to the first recurrence ranged from 5 to 183 months (mean, 55 months). The nonrecurrent group included 21 women (mean age, 56 years), with follow-up ranging from 88 to 124 months (mean, 109 months). Of the histopathologic features evaluated, statistically significant differences between the recurrent and nonrecurrent groups were found only with respect to prominent nucleoli (P = .024) and nuclear pleomorphism (P &lt; .001), both of which were more common in the recurrent group. In the recurrent group, 9 tumors were considered malignant (defined by brain invasion or metastasis) versus 2 of the nonrecurrent meningiomas. Nineteen percent of nonrecurrent tumors versus 41% of recurrent tumors had 2 or more of the 6 histopathologic features. MIB-1 LIs in the nonrecurrent group ranged from 0 to 8.3 (mean, 1.5) and were generally lower than those in the recurrent group (range, 0–32.5; mean, 5.4); no statistical difference was identified between these groups. No statistically significant difference with regard to histology or MIB-1 LIs was noted between the initially excised recurrent tumor and the most recently resected recurrence.Conclusions.—Of the histopathologic features examined, only prominent nucleoli and nuclear pleomorphism were found to be statistically more common in recurrent than nonrecurrent meningiomas. The mean MIB-1 LI was higher in the recurrent than in the nonrecurrent group, although there was no statistical difference between means and there was clear overlap with regard to MIB-1 LI ranges.
Performance of a Fluid-Based, Thin-Layer Papanicolaou Smear Method in the Clinical Setting of an Independent Laboratory and an Outpatient Screening Population in New England
Authors: Díaz-Rosario Luis A. , Kabawat Salim E. 
Published: January 2021

Abstract
Background.—A patented, fluid-based, thin-layer method for preparation of Papanicolaou (Pap) smears (ThinPrep Pap test) has been reported to be significantly more effective than the conventional smear invented by George Papanicolaou. We tested this position by comparing the cytologic diagnosis and specimen adequacy results obtained using the ThinPrep method with data from conventional Pap smears obtained from a similar population.
Methods.—Test results of 56 339 ThinPrep specimens were compared with results from 74 756 conventional smear cases obtained from the same sources in a corresponding period of the previous year.
Results.—The use of ThinPrep for cervicovaginal cytology produced a 75.14% increase in the detection of low-grade squamous intraepithelial lesions and higher diagnoses. Detection of low-grade squamous intraepithelial lesions increased by 71.65% (from 1.58% to 2.71%), and detection of high-grade squamous intraepithelial lesions increased by 102.54% (from 0.26% to 0.52%). There was a 39.11% decrease in the atypical squamous cells of undetermined significance–intraepithelial lesion ratio (from 2.07 to 1.26). There were also marked decreases in the number of specimens categorized as “satisfactory but limited,” owing to obscuring inflammation (−94.34%), obscuring blood (−99.84%), and poor fixation (−99.25%).
Conclusion.—ThinPrep produced increased detection of premalignant precursors while improving specimen adequacy.
Infectious Mononucleosis in an Outpatient Population
Authors: Brigden Malcolm L. , Au Sandra , Thompson Susan , Brigden Sean , Doyle Patrick , Tsaparas Yotis 
Published: January 2021

AbstractObjectives.—To determine the sensitivity and specificity of 2 modern hematology analyzers in flagging heterophile-positive patients; to determine if heterophile-positive, instrument-flagged specimens contain a larger number or a different spectrum of atypical lymphocytes; to document the overall sensitivity and specificity of Hoagland's morphologic criteria in identifying heterophile-positive patients in an outpatient population with a clinical diagnosis of mononucleosis; and to examine whether individual morphologic features might aid in the diagnosis of suspected infectious mononucleosis.Design.—A prospective study of patients referred with a clinical diagnosis of infectious mononucleosis who subsequently tested positive for the heterophile antibody. The control group consisted of a similar population of patients who tested negative for the heterophile antibody.Intervention.—Hematology profiles of peripheral blood samples were determined with Coulter STKS and Sysmex NE-8000 analyzers. A corresponding Wright-Giemsa–stained blood smear was subsequently examined by a single skilled technologist, who performed a 200-cell white blood cell differential and a 200-cell lymphocyte differential. A specific morphologic search was made for the presence of smudge cells or lymphocytes with cloverleaf nuclei.Results.—Using a combination of all flagging criteria, the 2 analyzers identified 156 (86.2%) of 181 heterophile-positive patients as meriting further review. The sensitivity and specificity values of the Coulter analyzer in predicting positive heterophile status for the blast flag were 41% and 97.1%, respectively; for the variant lymphocyte flags, 72.4% and 79.1%, respectively; and for both flags, 40% and 98.1%, respectively. For the Sysmex analyzer, the sensitivity and specificity values in predicting positive heterophile status for the blast flag were 43.4% and 88.6%, respectively; for the variant lymphocyte flag, 15.8% and 90.8%, respectively; and for both flags, 10.5% and 96%, respectively. Considering the classic criteria developed by Hoagland, a lymphocytosis of at least 50% was present in 120 (66.3%) heterophile-positive patients, while an atypical lymphocytosis of at least 10% of the total WBC count was noted in 135 patients (74.6%). The sensitivity and specificity values of a lymphocytosis ≥50% for diagnosing heterophile-positive status were 66.3% and 84.5%, respectively, while the sensitivity and specificity of an atypical lymphocytosis ≥10% were 74.6% and 92.3%, respectively. The presence of smudge cells or cloverleaf lymphocyte nuclei was verified as having high specificity but low sensitivity for suggesting a diagnosis of infectious mononucleosis.Conclusion.—Although a number of patients did not meet Hoagland's criteria for the diagnosis of infectious mononucleosis, the flagging systems of modern hematology analyzers successfully identified most cases as requiring further review.