bluuebunny/crossref_metadata_2025_split huggingface dataset:
Group for Research in Pathology Education Online Resources to Facilitate Pathology Instruction
Authors: Jones Kristopher N. , Kreisle Regina , Geiss Roger W. , Holliman John H. , Lill Patsy H. , Anderson Peter G. 
Published: January 2021

Abstract
Background.—The Group for Research in Pathology Education (GRIPE) is an organization of pathology educators whose purpose is to promote and facilitate excellence in pathology education. One important function of GRIPE is the maintenance of image and multiple-choice test question data banks. These resources have recently been made available online via the GRIPE Digital Library Web site. The purpose of the GRIPE Digital Library project was to develop an online searchable database that would facilitate access to the GRIPE resources for pathology education.
Design.—The GRIPE image bank—containing approximately 3000 peer-reviewed gross and microscopic pathologic images along with textual descriptions—was linked with the GRIPE test question bank using Gossamer Thread's DBMan Web database management program. The search and display templates create a functional user interface that integrates images, image descriptions, and test questions into a single online digital library. Using any Web browser, faculty can access the GRIPE Digital Library and search for images and/or test items that can be used in teaching.
Results.—In the first 18 months (February 2000 through July 2001), users at 40 GRIPE member institutions signed up and used the GRIPE Digital Library to perform more than 6000 individual searches and view more than 37 500 images. These digital images were used to produce lectures and laboratory modules that were posted on Web pages and made available to students remotely.
Conclusions.—The GRIPE Digital Library provides a unique resource that can facilitate development of educational materials for pathology instruction and helps to fulfill the educational mission of GRIPE.
Malakoplakia of Liver Diagnosed by a Needle Core Biopsy
Authors: Hartman Grace , Yong Sherri L. , Chejfec Gregorio 
Published: January 2021

Abstract
Although malakoplakia of the genitourinary tract and colon is reported frequently in the literature, malakoplakia that occurs primarily in the liver is rare, and only 4 cases have been described thus far. To our knowledge, this is the first case of malakoplakia of the liver diagnosed by a needle core biopsy. This case occurred in a 19-year-old man with small bowel ileus following Klebsiella pneumonia.
Xanthochromia
Authors: Edlow Jonathan A. , Bruner Kathy S. , Horowitz Gary L. 
Published: January 2021

Abstract
Context.—Diagnosis of subarachnoid hemorrhage is usually established by computed tomographic scanning; however, in a few patients, lumbar puncture to examine the cerebrospinal fluid for erythrocytes and xanthochromia is necessary. Some authorities recommend delaying lumbar puncture by 12 hours following onset of symptoms to ensure sufficient time has elapsed for xanthochromia to develop. This recommendation is based on measuring xanthochromia by spectrophotometry. Our hypothesis was that very few hospital laboratories in the United States use this method.
Objective.—To determine the percentage of hospital clinical laboratories that measure for xanthochromia using spectrophotometry.
Design, Setting, and Participants.—Mail survey to 3500 hospital clinical laboratory directors (in collaboration with the College of American Pathologists). Surveys were mailed in January 2001 and the results tabulated 1 month later. Participation was voluntary.
Main Outcome Measures.—Percentage of hospital clinical laboratories that use spectrophotometry versus visual inspection.
Results.—Of the 3500 laboratories surveyed, 2551 (72.9%) responded. Of these, 1944 (76.2%) indicated that they evaluated for xanthochromia. Of the 1952 laboratories that answered the question “How do you report your results?” 1947 (99.7%) reported using visual inspection.
Conclusions.—When evaluating for xanthochromia in cerebrospinal fluid, nearly all hospital clinical laboratories in the United States use visual inspection. Given this current reality, the recommendation of delaying lumbar puncture by 12 hours needs to be reassessed.
Outpatient Phlebotomy Success and Reasons for Specimen Rejection
Authors: Dale Jane C. , Novis David A. 
Published: January 2021

Abstract
Objectives.—To determine the rate with which blood collection is successful on the initial phlebotomy encounter, the rate with which laboratory personnel judge specimens unsuitable for analysis, and the practice characteristics associated with fewer unsuccessful collections and fewer rejected specimens.
Design.—Clinical laboratories participating in the College of American Pathologists Q-Probes laboratory improvement program prospectively characterized the outcome of outpatient phlebotomies for 3 months or until 20 unsuccessful phlebotomy encounters occurred. By questionnaire, participants provided information about test ordering, patient preparation, and specimen collection.
Setting and Participants.—Institutions in the United States (n = 202), Canada (n = 4), Australia (n = 3), and South Korea (n = 1).
Main Outcome Measures.—Percentage of successful encounters and percentage of unsuitable specimens.
Results.—Of 833289 encounters, 829723 were successful. Phlebotomies were unsuccessful because patients were not fasting as directed (32.2%), phlebotomy orders were missing information (22.5%), patients specimens were difficult to draw (13.0%), patients left the collection area before specimens were collected (11.8%), patients were improperly prepared for reasons other than fasting (6.3%), patients presented at the wrong time (3.1%), or for other reasons (11.8%). Only 2153 specimens (0.3%) were unsuitable; these samples were hemolyzed (18.1%), of insufficient quantity (16.0%), clotted (13.4%), lost or not received in the laboratory (11.5%), inadequately labeled (5.8%), at variance with previous or expected results (4.8%), or unacceptable for other reasons (31.1%). Facilities staffed by laboratory-administered phlebotomists reported higher success rates than facilities staffed by nonlaboratory-administered phlebotomists (P = .002).
Conclusions.—Most outpatient phlebotomy encounters are successful and result in specimens suitable for laboratory analysis.
Epithelioid Leiomyosarcoma of the External Deep Soft Tissue
Authors: Yamamoto Tetsuji , Minami Rieko , Ohbayashi Chiho , Inaba Mayumi 
Published: January 2021

AbstractEpithelioid leiomyosarcoma in the external deep soft tissue is extremely rare. Most epithelioid leiomyosarcomas occur in the uterus. We present a case of epithelioid leiomyosarcoma occurring in the muscle of the thigh of a 78-year-old man. Histologically, the tumor predominantly consisted of round or polygonal cells arranged in sheets with a focal spindle cell component. Immunohistochemical analysis revealed that the tumor cells expressed vimentin, α-smooth muscle actin, and α-sarcomeric actin. The tumor was negative for desmin, S100 protein, glial fibrillary acidic protein, pan-keratin, epithelial membrane antigen, CAM 5.2, HMB-45, leukocyte common antigen, factor VIII–associated antigen, and CD34. Electron microscopically, some tumor cells contained abundant actin-type filaments in their cytoplasm.
Storage and Distribution of Pathology Digital Images Using Integrated Web-Based Viewing Systems
Authors: Marchevsky Alberto M. , Dulbandzhyan Ronda , Seely Kevin , Carey Steve , Duncan Raymond G. 
Published: January 2021

Abstract
Context.—Health care providers have expressed increasing interest in incorporating digital images of gross pathology specimens and photomicrographs in routine pathology reports.
Objective.—To describe the multiple technical and logistical challenges involved in the integration of the various components needed for the development of a system for integrated Web-based viewing, storage, and distribution of digital images in a large health system.
Design.—An Oracle version 8.1.6 database was developed to store, index, and deploy pathology digital photographs via our Intranet. The database allows for retrieval of images by patient demographics or by SNOMED code information.
Setting.—The Intranet of a large health system accessible from multiple computers located within the medical center and at distant private physician offices.
Results.—The images can be viewed using any of the workstations of the health system that have authorized access to our Intranet, using a standard browser or a browser configured with an external viewer or inexpensive plug-in software, such as Prizm 2.0. The images can be printed on paper or transferred to film using a digital film recorder. Digital images can also be displayed at pathology conferences by using wireless local area network (LAN) and secure remote technologies.
Conclusions.—The standardization of technologies and the adoption of a Web interface for all our computer systems allows us to distribute digital images from a pathology database to a potentially large group of users distributed in multiple locations throughout a large medical center.
Morphologic Criteria for the Diagnosis of Prostatic Adenocarcinoma in Needle Biopsy Specimens
Authors: Varma Murali , Lee Min W. , Tamboli Pheroze , Zarbo Richard J. , Jimenez Rafael E. , Salles Paulo G. O. , Amin Mahul B. 
Published: January 2021

Abstract
Context.—The diagnosis of prostate adenocarcinoma in needle core biopsy specimens is based on multiple diagnostic criteria and supportive features, most of which have been defined mainly from observations in transurethral resection and prostatectomy specimens. There is little information on the frequency with which diagnostic and supportive features of prostate cancer occur within benign glands. The few reports dealing with diagnostic criteria of cancer in needle biopsies have been largely confined to analysis of selected cases that posed particular diagnostic difficulty.
Objective.—To analyze the frequency with which numerous diagnostic or supportive features of prostate cancer occur in an unselected, consecutively performed series of 18-gauge prostate needle biopsy specimens.
Design.—Two hundred fifty consecutive 18-gauge prostate needle biopsy specimens (150 malignant and 100 benign) were evaluated, using hematoxylin-eosin–stained histologic sections.
Results.—The frequency of the histologic features in malignant and benign glands was as follows: prominent nucleoli (94% and 25% of malignant and benign specimens, respectively), marginated nucleoli (88% and 7%), multiple nucleoli (64% and 0%), blue-tinged mucinous secretions (52% and 0%), intraluminal crystalloids (40.6% and 1%), intraluminal amorphous eosinophilic material (86.7% and 2%), collagenous micronodules (2% and 0%), glomerulations (15.3% and 0%), perineural invasion (22% and 0%), retraction clefting (38.6% and 7%), and invasion of fat (0.7% and 0%).
Conclusions.—Since not all diagnostic or supportive features of cancer are evident in any single case of cancer, particularly in needle biopsy specimens in which sampling is limited, awareness of these data would be helpful in the assessment of small foci of atypical glands being considered for cancer.
Activated Protein C Resistance, the Factor V Leiden Mutation, and a Laboratory Testing Algorithm
Authors: Van Cott Elizabeth M. , Soderberg Britt L. , Laposata Michael 
Published: January 2021

Abstract
Objectives.—To present the current understanding of factor V Leiden and activated protein C resistance, and to propose a laboratory testing algorithm.
Data Sources.—Publications on MEDLINE with the terms factor V Leiden or activated protein C resistance through mid 2001, as well as publications in the authors' files, were screened for inclusion in this report.
Study Selection.—Original studies that report a novel finding on testing or clinical features of activated protein C resistance or factor V Leiden are included.
Data Extraction.—The novel or key findings from the selected studies are analyzed.
Data Synthesis.—Protein C and protein S are the integral components of an anticoagulation pathway that limits fibrinogen conversion to fibrin through the degradation of factors Va and VIIIa. When factor Va is resistant to degradation by activated protein C, this anticoagulation pathway does not operate properly, and patients have an increased risk for thrombosis. This report describes the protein C/protein S pathway, the significance of activated protein C resistance and the factor V Leiden mutation, and the clinical testing used to detect activated protein C resistance and the factor V Leiden mutation. A proposed laboratory testing algorithm is also provided.
Conclusions.—Factor V Leiden is a risk factor for venous thrombosis and it is particularly common in white populations. A laboratory testing algorithm is proposed.
Colchicine Effect in a Colonic Hyperplastic Polyp
Authors: Torbenson Michael , Montgomery Elizabeth A. , Iacobuzio-Donahue Christine , Yardley John H. , Wu Tsung-Teh , Abraham Susan C. 
Published: January 2021

Abstract
Colchicine effect has been described recently in gastrointestinal biopsies, where it can result in accumulation of metaphase mitoses and epithelial disorganization. We describe the case of a colonic hyperplastic polyp with colchicine effect from a 52-year-old woman who was receiving colchicine for primary biliary cirrhosis. Biopsy of the polyp revealed prominent metaphase mitoses and focal loss of nuclear polarity in the surface epithelium, features that mimicked a serrated adenoma. Distinguishing between hyperplastic polyp and serrated adenoma is important because of the different management implications and the increased potential for neoplastic progression in the latter.
Misinterpretation of Normal Cellular Elements in Fine-Needle Aspiration Biopsy Specimens
Authors: Young Nancy A. , Mody Dina R. , Davey Diane D. 
Published: January 2021

Abstract
Context.—The College of American Pathologists Interlaboratory Comparison Program in Non-Gynecologic Cytopathology is a popular educational program for nongynecologic cytology, with 1018 participating laboratories by the end of 2000. Data generated from this program allow tracking pathologist performance in a wide variety of laboratory practices.
Objective.—To review performance of participating pathologists in making patient diagnoses with fine-needle aspiration biopsy specimens, with particular interest in the false neoplastic diagnoses (both benign and malignant neoplasms) that were submitted for benign aspirates containing only normal cellular components.
Design.—We reviewed the diagnoses made from 1998 through 2000 by participating pathologists through the use of glass slides containing benign fine-needle aspiration biopsy specimens of the liver, kidney, pancreas, and salivary gland that contained only normal cellular components.
Results.—The false neoplastic rate for kidney (60%) was the highest, followed by liver (37%), pancreas (10%), and salivary gland (6%). These rates are much higher than what has previously been reported in the literature.
Conclusions.—This study illustrates that normal cellular elements are a significant pitfall for overinterpretation of fine-needle aspiration biopsy specimens.
Immunohistochemical Expression of Galectin-3 in Benign and Malignant Thyroid Lesions
Authors: Herrmann Marille E. , LiVolsi Virginia A. , Pasha Theresa L. , Roberts Shelley A. , Wojcik Eva M. , Baloch Zubair W. 
Published: January 2021

Abstract
Context.—The expression of galectin-3, a human lectin, has been shown to be highly associated with malignant behavior of thyroid lesions.
Design.—We studied the immunohistochemical expression pattern of galectin-3 in a variety of follicular-derived thyroid lesions (13 benign and 62 malignant), including Hürthle cell and follicular carcinoma, papillary carcinomas and variants, and anaplastic and poorly differentiated carcinomas.
Results.—Immunoreactivity was strongest in papillary thyroid carcinomas, whereas staining was less intense in Hürthle cell and anaplastic carcinomas, and even weaker in the follicular variant of papillary thyroid carcinoma. Staining was absent or weak in the 3 follicular thyroid carcinomas and was negative in both insular carcinomas. In several tumors, staining was stronger at the advancing invasive edge of the lesion than in the central portion of the tumor. Galectin-3 was also expressed focally and weakly in reactive follicular epithelium and entrapped follicles in chronic lymphocytic thyroiditis. A variety of thyroid lesions showed prominent endogenous, biotin-like activity, which could cause flaws in interpretation if a biotin-detection system were used.
Conclusion.—We conclude that galectin-3 immunostaining, when used in biotin-free detection systems, may be useful as an adjunct to distinguish benign from malignant thyroid lesions.
Typical Histologic Features of Tunga penetrans in Skin Biopsies
Authors: Smith Marc D. , Procop Gary W. 
Published: January 2021

Abstract
Context.—Tunga penetrans is a flea that burrows into human skin, causing the disease tungiasis. Although the parasite is not endemic in the United States, patients may present with this disease upon returning from tropical locales. Histologic sections contain a variety of flea parts that may present a diagnostic dilemma for pathologists unfamiliar with this disease.
Objective.—To determine the typical histologic features of T penetrans in biopsies from patients with tungiasis.
Methods.—We reviewed biopsy specimens from 7 patients with tungiasis and sought 8 distinct structures: the exoskeleton, hypodermal layer, respiratory tract (tracheae), digestive tract, striated muscle, head, posterior end, and developing eggs.
Results.—The exoskeleton, hypodermal layer, tracheae, digestive tract, and developing eggs were present in all biopsy specimens reviewed. Striated muscle, the posterior end, and head, however, were present in 57%, 43%, and 0% of the biopsies, respectively. In addition, we noted a unique, pale-staining layer in the exoskeleton at the posterior end of the organism that, to the best of our knowledge, has not previously been described and that may be of diagnostic value.
Conclusions.—Despite the absence of 3 key morphologic features in many (posterior end and striated muscle) or all (head) of our biopsies, the exoskeleton with a hypodermal layer, tracheae, and developing eggs were uniformly present, and together these features are sufficient for a diagnosis of tungiasis.
Desmoplastic Fibroma of the Rib
Authors: Barbashina Violetta , Karabakhtsian Rouzan , Aisner Seena , Bolanowski Paul , Patterson Francis , Hameed Meera 
Published: January 2021

Abstract
Desmoplastic fibroma is a very rare primary tumor of bone, closely related to aggressive fibromatosis of soft tissue. Although considered a benign lesion, it is locally destructive, can extend into the soft tissues, and has a high rate of local recurrences after incomplete surgical excision. Recognition of this entity is important to ensure proper surgical treatment. According to the published data, the tumor is most common in the long tubular bones (56%), the mandible (26%), and the pelvis (14%). Rib involvement by desmoplastic fibroma is extremely rare, and to our knowledge, only 3 cases have been reported in the literature to date. We present the case of a desmoplastic fibroma in the rib of a 19-year-old man, adding a fourth case to the previously reported cases involving this unusual location. The clinical history and the radiological and pathologic findings are presented.
Synovial Metaplasia, A Specialized Form of Repair
Authors: Fowler Marjorie R. , Nathan Cherie-Ann O. , Abreo Fleurette 
Published: January 2021

Abstract
Synovial metaplasia is a change seen most frequently in the tissues surrounding silicone breast prostheses and in healing tissue adjacent to joint prostheses. It has also been described in skin and soft tissues, most frequently in healing or healed traumatic or surgical wounds. We report a case of synovial metaplasia occurring in a hitherto unreported location, namely, adjacent to a silicone low-pressure voice prosthesis. A review of cases of synovial metaplasia reported in the literature revealed that in most cases, spaces that form adjacent to foreign material (most commonly silicone breast prostheses) and the smooth gliding surfaces of the foreign material that resist penetration by fibroblast processes are frequent associated findings that precede the occurrence of synovial metaplasia. Thus, synovial metaplasia might represent a specialized form of healing in cases that have this combination of physical features.
Colocalized Granular Cell Tumor and Infiltrating Ductal Carcinoma of the Breast
Authors: Al-Ahmadie Hikmat , Hasselgren Per-Olof , Yassin Rawia , Mutema George 
Published: January 2021

Abstract
A 57-year-old woman presented with a 2-year history of a palpable mass in the upper inner quadrant of the right breast. A 1.1-cm, poorly circumscribed, firm tumor nodule was noted, consisting of 2 histologically distinct lesions in the same location, with some areas showing purely well-differentiated invasive ductal carcinoma and others composed of granular cell tumor. In 1 area, the 2 tumors collided and infiltrated each other. The invasive ductal carcinoma was admixed with ductal carcinoma in situ of solid and cribriform types. To our knowledge, this is the first case report demonstrating colocalization of these 2 neoplasms, which raises questions regarding causal relationship. We also review the literature on granular cell tumor of the breast.
CD34/QBEND10 Immunostaining in the Bone Marrow Trephine Biopsy
Authors: Torlakovic Goran , Langholm Ruth , Torlakovic Emina 
Published: January 2021

Abstract
Context.—The immunohistochemical detection of CD34 protein using QBEND10 antibody in bone marrow trephine biopsies was shown recently to be a precise method for quantitation of blasts and a possibly useful approach in diagnosis and classification of myelodysplastic syndrome.
Objectives.—To evaluate CD34+ cells in bone marrow biopsies with various diagnoses and to assess how counts obtained using this method correlate with blast counts obtained by traditional morphologic evaluation of bone marrow smears.
Design.—Bone marrow trephine biopsies from 108 adult patients were evaluated by immunohistochemistry using anti-CD34 antibody (QBEND10). CD34+ mononuclear cells were counted and compared with the blast counts in the bone marrow aspirate smears or imprints. CD34+ mononuclear cell clusters and CD34+ megakaryocytes were also recorded. The type of positivity (membranous vs cytoplasmic) and the percentage of CD34+ megakaryocytes were evaluated because the presence of CD34+ megakaryocytes was recently suggested to be present in myelodysplastic syndrome, but not in myeloproliferative disease or nonneoplastic bone marrow.
Results.—Six of 24 biopsies with partial involvement by non-Hodgkin lymphoma and 5 of 60 biopsies with reactive changes had 5% to 10% CD34+ mononuclear cells and were associated with lymphocytosis and increased hematogones. The CD34+ mononuclear cell clusters were found only in myelodysplastic syndrome and myeloproliferative disease. The CD34+ megakaryocytes were present in all diagnostic groups.
Conclusion.—The number of CD34+ mononuclear cells was often slightly higher than the number of myeloid blasts in the bone marrow smears, probably due to increased hematogones. The presence and the number of CD34+ megakaryocytes do not appear to have diagnostic value, but this finding should be further investigated in relation to clinical parameters.