bluuebunny/crossref_metadata_2025_split huggingface dataset:
Audit of Transfusion Procedures in 660 Hospitals
Authors: Novis David A. , Miller Karen A. , Howanitz Peter J. , Renner Stephen W. , Walsh Molly K. 
Published: January 2021

Abstract
Context.—Hemolytic transfusion reactions are often the result of failure to follow established identification and monitoring procedures.
Objective.—To measure the frequencies with which health care workers completed specific transfusion procedures required for laboratory and blood bank accreditation.
Design.—In 2 separate studies, participants in the College of American Pathologists Q-Probes laboratory quality improvement program audited nonemergent red blood cell transfusions prospectively and completed questionnaires profiling their institutions' transfusion policies.
Setting and Participants.—A total of 660 institutions, predominantly in the United States, at which transfusion medicine services are provided.
Main Outcome Measures.—The percentages of transfusions for which participants completed 4 specific components of patient and blood unit identifications, and for which participants monitored vital signs at 3 specific intervals during transfusions.
Results.—In the first study, all components of patient identification procedures were performed in 62.3%, and all required patient vital sign monitoring was performed in 81.6% of 12 448 transfusions audited. The median frequencies with which institutions participating in the first study performed all patient identification and monitoring procedures were 69.0% and 90.2%, respectively. In the second study, all components of patient identification were performed in 25.4% and all patient vital sign monitoring was performed in 88.3% of 4046 transfusions audited. The median frequencies with which institutions participating in the second study performed all patient identification and monitoring procedures were 10.0% and 95.0%, respectively. Individual practices and/or institutional policies associated with greater frequencies of patient identification and/or vital sign monitoring included transporting units of blood directly to patient bedsides, having no more than 1 individual handle blood units in route, checking unit labels against physicians' orders, having patients wear identification tags (wristbands), reading identification information aloud when 2 or more transfusionists participated, using written checklists to guide the administration of blood, instructing health care personnel in transfusion practices, and routinely auditing the administration of transfusions.
Conclusions.—In many hospitals, the functions of identification and vital sign monitoring of patients receiving blood transfusions do not meet laboratory and blood bank accreditation standards. Differences in hospital transfusion policies influence how well health care workers comply with standard practices. We would expect that efforts designed to perfect transfusion policies might also improve performance in those hospitals in which practice compliance is substandard.
Conference Summary, Strategic Science Symposium
Authors: Zarbo Richard J. , Hammond M. Elizabeth H. 
Published: January 2021

Abstract
Context.—Practicing pathologists often encounter controversial clinical issues and nonstandardized laboratory approaches to the evolving science of predictive/prognostic tumor marker assays. This dilemma becomes especially acute when the assay is the sole determinant for selection of a specific therapy.
Objectives.—To summarize the areas of practical agreement and identify opportunities for improvement in Her-2/neu testing of breast cancer.
Design.—The College of American Pathologists created a new comprehensive education model, called Strategic Science, with expert speakers integrating new and evolving basic, clinical, and scientific issues of Her-2/neu testing with aspects of laboratory management.
Setting.—Symposium held May 4 and 5, 2002, in Rosemont, Ill.
Participants.—Ten speakers and more than 100 attendees.
Results.—Components addressed were new technology assessment, practice guidelines, quality assurance, regulatory compliance, risk and liability, billing and coding, cost analysis, consultation, information management, and results reporting.
Conclusions.—This Strategic Science symposium derived areas of practical agreement, defined the current state-of-the-art, and identified areas for improvement in Her-2/neu testing.
Cystic Sebaceous Neoplasms in Muir-Torre Syndrome
Authors: Abbott Jared J. , Hernandez-Rios Pablo , Amirkhan Robin H. , Hoang Mai P. 
Published: January 2021

Abstract
Cystic sebaceous neoplasms have been seen only in patients with Muir-Torre syndrome (MTS) and have recently been characterized as marker lesions of MTS. Histologically, these lesions form a spectrum of tumors ranging from benign cystic adenomas to proliferative cystic sebaceous tumors. We describe 2 proliferative cystic sebaceous tumors in a 53-year-old man whose workup revealed colonic adenocarcinoma and other sebaceous tumors consistent with MTS. Both the chest wall and the left thigh masses were grossly cystic, measuring 1.0 and 1.5 cm, respectively. Histologic sections demonstrated well-circumscribed cystic neoplasms located in the deep dermis and subcutaneous tissue. Each had a focally infolded cyst wall composed of immature basaloid cells with prominent nucleoli and mitoses, consistent with a proliferative cystic sebaceous tumor. Recognition of cystic sebaceous neoplasm by pathologists and communication to clinicians of its strong association with MTS is of diagnostic importance.
Intracytoplasmic Filamentous Inclusions in the Peripheral Blood of a Patient With Chronic Lymphocytic Leukemia
Authors: Dorion R. Patrick , Shaw John H. 
Published: January 2021

Abstract
Intracellular inclusions in lymphoproliferative disorders are not common. Multiple different types of inclusions have been reported in chronic lymphocytic leukemia (CLL), including vacuoles, crystals, and pseudocrystals. Most of the reported cases were seen in the bone marrow lymphocytes, and the majority of these on electron microscopy. We report a case of long-standing CLL with no therapy that had filamentous cytoplasmic inclusions in the peripheral blood that were readily seen by light microscopy. Electron microscopy demonstrated dilated cisternae of the rough endoplasmic reticulum filled with amorphous electron-dense material. By immunofluorescence, the material proved to be immunoglobulin G-λ deposits. The immunophenotype had the typical CLL pattern with positive staining with CD19, CD5, and CD23, and low-density CD20 staining; however, it also had unusual staining with CD25 and intermediate-intensity staining with CD22.
Innate Immune-Related Receptors in Normal and Psoriatic Skin
Authors: Curry Jonathan L. , Qin Jian-Zhong , Bonish Brian , Carrick Ryan , Bacon Patricia , Panella Jeffrey , Robinson June , Nickoloff Brian J. 
Published: January 2021

Abstract
Context.—A precise role for the innate immune system in psoriasis remains to be determined. Surface receptors, including Toll-like receptors (TLRs) that recognize bacterial ligands and CD91, which recognizes heat shock proteins (HSPs), are implicated in both innate and adaptive immunity.
Objective.—Since skin is exposed to various exogenous stimuli, which can provoke or exacerbate psoriasis, we characterized expression and function of TLRs, CD91, and HSPs in normal and psoriatic skin.
Design.—A variety of skin-derived cells and blood-derived cells were analyzed both in vivo and in vitro; samples were obtained from 24 different individuals for innate immune-related receptor expression and function. By comparing and contrasting individuals with healthy skin and psoriatic patients, several specific differences were identified.
Results.—Immunohistochemistry-based expression profiling revealed TLR1 expression in epidermal dendritic cells (DCs) and dermal dendritic cells (DDCs) in normal skin, as well as in pre-psoriatic skin and psoriatic plaques, with enhanced basal layer keratinocyte (KC) expression in pre-psoriatic and psoriatic plaques compared with normal skin; TLR2 expression primarily by DDCs; and TLR4 expression by epidermal DCs and DDCs, with mid-epidermal-layer KCs displaying cell surface staining. No TLR9 or CD14 was detected on DCs or KCs, although psoriatic plaques contained CD14-positive macrophages. Analysis of psoriatic epidermis revealed HSPs 27, 60, and 70. Keratinocytes were CD91 negative, but CD91 was expressed by fibroblasts and DDCs in normal and pre-psoriatic skin, with prominent accumulation of CD91-positive DDCs in psoriatic plaques. Cultured KCs revealed no surface expression of TLR2, TLR4, TLR9, or CD91. Exposure of fibroblasts, but not KCs, to lipopolysaccharide or HSPs triggered nuclear factor (NF)-κB activation. Heat shock proteins did induce maturation of blood-derived DCs accompanied by increased interleukin-12 production and enhanced antigen-presenting function.
Conclusions.—These data demonstrate distinctive patterns of innate immune-related receptors by specific subsets of cells in normal and psoriatic skin, suggesting functional roles for HSPs and DCs in psoriasis.
Lack of Specificity of Cyclosporine Immunoassays
Authors: Soldin Steven J. , Steele Bernard W. , Witte David L. , Wang Edward , Elin Ronald J. 
Published: January 2021

Abstract
Objective.—To evaluate the cross-reactivity of the 6 most abundant cyclosporine A (CsA) metabolites in commonly used assays for CsA.
Design.—Whole blood samples containing either only 62 ng/mL CsA (A) or 62 ng/mL CsA and between 49 and 86 ng/mL of 1 of the 6 most abundant CsA metabolites (B) were lyophilized. One sample of A and 1 of B were mailed to each of the laboratories participating in the College of American Pathologists Proficiency Testing Program quarterly during a 3-year period (1999–2001). Method means and coefficients of variation were calculated for each mailing.
Results.—The study showed significant cross-reactivity of metabolites in all the immunoassay systems studied. Overall degree of interference decreased from Abbott TDx polyclonal &gt; Abbott TDx monoclonal &gt; DiaSorin &gt; Syva EMIT. High-performance liquid chromatography methods gave results close to those found using mass spectrometric techniques.
Conclusions.—Significant metabolite interference was found to occur with the immunoassay systems studied.
Incidence and Significance of Cytoplasmic Thyroid Transcription Factor-1 Immunoreactivity
Authors: Bejarano Pablo A. , Mousavi Fathema 
Published: January 2021

Abstract
Context.—The immunohistochemical identification of thyroid transcription factor-1 (TTF-1) is regarded as the presence of a nuclear pattern of staining and is used to identify tumors of thyroid or pulmonary origin. Although there have been reports of cytoplasmic expression of TTF-1, the significance of this pattern has not been studied in detail.
Objectives.—To determine the incidence at which cytoplasmic immunostaining for TTF-1 occurs and to analyze the diagnostic value of this pattern of immunoreactivity.
Design.—Histologic sections of 361 consecutive cases of neoplasms stained for TTF-1 were reviewed, and those showing cytoplasmic staining in the tumor cells or in nonneoplastic cells were selected. Clinical correlation was obtained on the latter cases regarding the origin of the tumor.
Setting.—An immunohistochemistry laboratory in a tertiary-care institution.
Results.—The 361 tumors were obtained from 29 organ sites and corresponded to primary and metastatic neoplasms. Twenty-three (6.3%) tumors showed cytoplasmic staining for TTF-1. In 13 of these, the primary site of origin was established with certainty: 7 were lung carcinomas (3 primary lung adenocarcinomas, 1 primary large cell carcinoma, 1 metastatic small cell carcinoma to the liver, 1 metastatic adenocarcinoma to a neck lymph node, and 1 metastatic adenocarcinoma to thigh soft tissue), 3 colonic adenocarcinomas (2 metastases to vertebrae and 1 to lung), 1 metastatic breast ductal adenocarcinoma to femur, 1 metastatic laryngeal squamous cell carcinoma to liver, and 1 meningioma involving the orbit bone. There were 3 lung carcinomas with concomitant nuclear immunostaining. Nonneoplastic liver tissue was the most frequent nontumoral tissue in which the cytoplasm stained with TTF-1 antibody.
Conclusion.—Occasional cytoplasmic staining for TTF-1 in tumors is seen, but it is a nonspecific finding; when present, it should be disregarded for diagnostic purposes.
Large Cell Neuroendocrine Carcinoma of the Ampulla of Vater
Authors: Cavazza Alberto , Gallo Marco , Valcavi Roberto , De Marco Loredana , Gardini Giorgio 
Published: January 2021

Abstract
We report a large cell neuroendocrine carcinoma arising in the ampulla of Vater. The patient, a 74-year-old woman, presented with a 3-cm ulcerated mass located in the ampullary region. She died of disease 8 months after surgery. Microscopically, the tumor was extensively necrotic. It was composed of islands and trabeculae irregularly infiltrating the muscular wall of the duodenum. Neoplastic cells were large and had a high mitotic index. Immunohistochemically, they expressed cytokeratin, chromogranin, synaptophysin, and neuron-specific enolase. Large cell neuroendocrine carcinoma is very rare in the ampulla of Vater, and it shares with its more common pulmonary counterpart the same morphology and probably the same poor prognosis.
Pathologic Review of Atypical Hyperplasia Identified by Image-Guided Breast Needle Core Biopsy
Authors: Yeh I-Tien , Dimitrov Diana , Otto Pamela , Miller Alexander R. , Kahlenberg Morton S. , Cruz Anatolio 
Published: January 2021

AbstractContext.—Management of breast needle core biopsies diagnosed as atypical ductal hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ is controversial. Current recommendations involve excisional biopsy to rule out ductal carcinoma in situ and/or invasive carcinoma, which have been reported in more than 50% of cases in some series.Objective.—To determine how frequently these diagnoses made on needle core biopsy are ultimately found to represent in situ or invasive carcinoma based on excisional biopsy specimens, in order to identify predictive factors.Design.—One thousand eight hundred thirty-six image-guided needle core biopsies were performed between January 1, 1995 and May 1, 2001. Fifty-four (2.9%) patients diagnosed with atypical ductal hyperplasia (n = 36), atypical lobular hyperplasia (n = 12), atypical ductal hyperplasia + atypical lobular hyperplasia (n = 3), or lobular carcinoma in situ (n = 3) subsequently underwent breast excisions. Pathologic features were reviewed in each of the needle core biopsies using Page's criteria and were then correlated with excision specimens.Setting.—University medical center.Results.—Review of the needle core biopsy cases with either ductal carcinoma in situ or invasive carcinoma + ductal carcinoma in situ on final excision showed that nucleoli were evident in most of the needle core cases, with foci of nuclear pleomorphism and individual cell necrosis or apoptosis.Conclusion.—A more precise diagnosis can be made by using strict criteria for atypical ductal hyperplasia versus ductal carcinoma in situ on needle core biopsy. Cytologic atypia, even if in a small area, particularly when there is apoptosis/individual cell necrosis, correlates with the finding of a more serious lesion on excision.
Prevalence and Incidence of Cytoplasmic Yellow Bodies in Thyroid Neoplasms
Authors: Rothenberg Harold J. , Goellner John R. , Carney J. Aidan 
Published: January 2021

Abstract
Context.—Cytoplasmic yellow bodies are a common and frequent histologic finding in hyalinizing trabecular adenoma of the thyroid gland, a morphologically distinctive neoplasm, and are visible in fine-needle aspiration biopsy of the tumor.
Objective.—To determine the prevalence and frequency of cytoplasmic yellow bodies in common thyroid tumors.
Design.—Microscopic slides of random cases of papillary carcinoma (61 cases), follicular adenoma (27 cases), and Hürthle cell adenoma (12 cases) were searched for cytoplasmic yellow bodies.
Setting and Patients.—Slides were from patients who had undergone surgery at Mayo Clinic, Rochester, Minn, and were obtained from the Mayo Clinic Tissue Registry.
Main Outcome Measure.—Presence or absence of cytoplasmic yellow bodies.
Results.—Cytoplasmic yellow bodies were found in papillary carcinoma (62%), follicular carcinoma (22%), and Hürthle cell adenoma (83%) but were very infrequent numerically in each tumor type.
Conclusions.—Cytoplasmic yellow bodies may be present in papillary carcinoma and in follicular and Hürthle cell adenomas, but because they are uncommon in these tumors, they are unlikely to be found in fine-needle aspiration biopsy smears. Therefore, cytoplasmic yellow bodies are a useful cytomorphologic indicator of hyalinizing trabecular adenoma of the thyroid gland.
Automation of Gross Photography Using a Remote-Controlled Digital Camera System
Authors: Park Rae-Woong , Eom Joon-Hoe , Byun Ho-Yong , Park Peom , Lee Kyi-Beom , Joo Hee-Jae 
Published: January 2021

Abstract
Context.—Conventional gross photography requires a series of tedious and time-consuming steps, including taking, developing, labeling, sorting, filing, and tracking numerous photographs.
Objective.—To describe how to automate the gross photographic process by way of controlling a digital camera remotely.
Design.—After defining the requirements of automation regarding gross photography, a remote control board, foot switch, barcode system, and image retrieval system were devised.
Setting.—The surgical pathology laboratory of a university medical center with a commercially available megapixel digital camera.
Results.—The digital camera zoom and shutter were controlled remotely by a foot switch. A large portion of the gross photographic process, including specimen number labeling, image downloading, labeling, sorting, filing, and tracking, were automated. In addition, the elimination of several manual specimen-processing steps, along with not having to wait for the developing and mounting of conventional 35-mm film, reduced the entire time span required in conventional gross photography from 2 to 5 days, to a few minutes. It was also possible to review the gross images at the time of microscopic sign-out.
Conclusions.—The automation of gross photography using a remote-controlled digital camera changes the conventional gross workflow markedly. We found use of a remote-controlled gross photography system to be practical, convenient, and efficient.
Gastric Toxoplasmosis in a Patient With Acquired Immunodeficiency Syndrome
Authors: Ganji Masoud , Tan Ailyn , Maitar Michael I. , Weldon-Linne C. Michael , Weisenberg Elliot , Rhone Douglas P. 
Published: January 2021

Abstract
Toxoplasmosis is a common opportunistic pathogen in patients with acquired immunodeficiency syndrome (AIDS). It usually presents with ocular, central nervous system, or pulmonary disease. Gastric toxoplasmosis is uncommon in AIDS patients, especially in the absence of central nervous system manifestations. In the few reported cases, patients have presented with abdominal pain and other digestive complaints that usually are attributed to the more common gastrointestinal manifestations of human immunodeficiency virus infection. We describe a 49-year-old man with AIDS who presented with abdominal pain, diarrhea, dry cough, and systemic symptoms and was diagnosed with toxoplasmosis by a gastric biopsy.
Diffuse Fibrous Pseudotumor of the Testicular Tunics Associated With an Inflamed Hydrocele
Authors: Seethala Raja R. , Tirkes A. Temel , Weinstein Susan , Tomaszewski John E. , Malkowicz S. Bruce , Genega Elizabeth M. 
Published: January 2021

Abstract
Fibrous pseudotumors of the testicular tunics and paratesticular soft tissue are uncommon lesions. They typically arise as painless scrotal masses that may be associated with a hydrocele or history of trauma or infection. Although these lesions are clinically worrisome for a malignant neoplasm, they are thought to be reactive in nature, since they are composed of dense fibrous tissue with interspersed bland fibroblasts and myofibroblasts and mixed inflammatory cells. Once excised, these lesions behave in a benign fashion. Typically, these masses are multinodular, but in rare cases they are diffuse, bandlike myofibroblastic proliferations that encase the testis and are termed fibromatous periorchitis. Herein, we describe a 57-year-old man with a diffuse fibrous pseudotumor/fibromatous periorchitis that encased the left testis and adnexa and arose in close apposition to an inflamed hydrocele.
Giant Blastoconidia of Candida albicans
Authors: Alasio Teresa M. , Lento Patrick A. , Bottone Edward J. 
Published: January 2021

Abstract
We describe a patient with extranodal non-Hodgkin lymphoma who developed systemic candidiasis after treatment with a cyclophosphamide-based chemotherapy regimen. Histologically, the fungal organisms demonstrated markedly enlarged blastoconidia with a variety of morphologic forms, mimicking other mycotic organisms, such as Cryptococcus neoformans, Blastomyces dermatitidis, and Paracoccidioides brasiliensis. The in vivo occurrence of such giant forms is rare, and when observed histologically may result in an erroneous diagnosis or a diagnosis of multiple mycotic organisms.
Postirradiation Angiosarcoma of the Prostate
Authors: Chandan Vishal S. , Wolsh Loren 
Published: January 2021

Abstract
Angiosarcomas are high-grade sarcomas of vascular origin that rarely arise in the prostate. We describe a unique case of angiosarcoma arising in the prostate 10 years after radiotherapy for adenocarcinoma of the prostate. A review of literature regarding angiosarcomas of prostate is also discussed.
Lymphangitic Spread of Hepatocellular Carcinoma
Authors: Molina D. Kimberley , Valente Philip T. 
Published: January 2021

Abstract
Pulmonary lymphangitic carcinomatosis is a well-documented phenomenon caused by spread of carcinoma to the pulmonary vasculature and lymphatics, often resulting in respiratory failure and cor pulmonale. It has been described in numerous types of carcinoma, most commonly occurring with carcinomas of the breast and stomach and with choriocarcinoma. We report the case of a patient who presented with increasing shortness of breath and dyspnea on exertion. Autopsy findings revealed diffuse pulmonary vascular spread of a hepatocellular carcinoma to the lungs. To our knowledge, this is the first reported case of lymphangitic spread of a hepatocellular carcinoma causing respiratory compromise (lymphangitic carcinomatosis).
Sclerosing Adenosis of the Prostate
Authors: Luque Rafael J. , Lopez-Beltran Antonio , Perez-Seoane Carlos , Suzigan Sueli 
Published: January 2021

Abstract
Sclerosing adenosis of the prostate is a pseudoneoplastic lesion that can mimic prostate cancer. Because the lesion is more common in the transition zone, which is only rarely sampled in needle biopsy, it is uncommon to see examples of this lesion in biopsy specimens. Because sampling of the transition zone of the prostate is likely to become more frequent, practicing surgical pathologists must be aware of the morphologic features of sclerosing adenosis of the prostate in needle biopsy specimens, in order to avoid misinterpretation of sclerosing adenosis of the prostate, a benign lesion, as prostate adenocarcinoma. We report the morphologic findings of sclerosing adenosis of the prostate in 3 needle biopsy specimens from 2 patients diagnosed as having sclerosing adenosis. We found a combination of histologic (mainly a cellular myxoid stroma and a double-cell population of acinar cells) and immunohistochemical features demonstrating a continuous basal cell layer with myoepithelial differentiation to be diagnostic.