bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determination of Plasma Glycoprotein 2 Levels in Patients With Pancreatic Disease
Authors: Hao Ying , Wang Jing , Feng Ningguo , Lowe Anson W. 
Published: February 2021

AbstractContext.—Blood tests possessing higher diagnostic accuracy are needed for all the major pancreatic diseases. Glycoprotein 2 (GP2) is a protein that is specifically expressed by the pancreatic acinar cell and that has previously shown promise as a diagnostic marker in animal models of acute pancreatitis.Objective.—This study describes the development of an assay for GP2, followed by the determination of plasma GP2 levels in patients with acute pancreatitis, chronic pancreatitis, and pancreatic cancer.Design.—Rabbit polyclonal antisera and mouse monoclonal antibodies were generated against human GP2 and used to develop an enzyme-linked immunosorbent assay. The assay was tested in patients with an admitting diagnosis of pancreatic disease at 2 tertiary care facilities. The diagnosis of acute or chronic pancreatitis and pancreatic cancer was determined using previously established criteria that incorporated symptoms, radiology, pathology, and serology. Plasma GP2 levels were determined in 31 patients with acute pancreatitis, 16 patients with chronic pancreatitis, 36 patients with pancreatic cancer, and 143 control subjects without pancreatic disease. Amylase and lipase levels were also determined in patients with acute pancreatitis.Results.—The GP2 assay's sensitivity values were 0.94 for acute pancreatitis, 0.81 for chronic pancreatitis, and 0.58 for pancreatic cancer, which were greater than the 0.71 for acute pancreatitis and 0.43 for chronic pancreatitis (P = .02) observed for amylase. The lipase assay sensitivity for acute pancreatitis was 0.66. The accuracy of the GP2 assay was greater than that of the amylase or lipase assays for acute pancreatitis (GP2 vs lipase, P = .004; GP2 vs amylase, P = .003) when analyzed using receiver operator characteristic curves. When daily serial blood samples were obtained for 13 patients with acute pancreatitis, GP2 levels remained abnormally elevated for at least 1 day longer than the amylase or lipase levels.Conclusion.—The GP2 assay is a useful new marker for acute and chronic pancreatitis.
Malignant Melanoma With a Rhabdoid Phenotype: Histologic, Immunohistochemical, and Ultrastructural Study of a Case and Review of the Literature
Authors: Abbott Jared J. , Amirkhan Robin H. , Hoang Mai P. 
Published: February 2021

Abstract
Malignant melanoma is known to display tremendous histologic diversity. One rare variant is the rhabdoid phenotype, so called because of the appearance of cells resembling rhabdomyoblasts seen in malignant rhabdoid tumors of the kidney. We present the histologic, immunohistochemical, and ultrastructural features of a malignant melanoma composed entirely of rhabdoid cells. A 62-year-old man presented with a 6.5-cm lung mass. Although presumed to be a metastatic lesion, extensive workup failed to reveal a primary tumor site. Histologic sections showed a mass composed entirely of polygonal neoplastic cells with prominent nucleoli and large hyaline cytoplasmic inclusions. The tumor cells were strongly immunoreactive with S100 protein, vimentin, and CD56, and were focally reactive with Mart-1. Tumor cells were negative for Melan-A, tyrosinase, HMB-45, AE1/AE3, cytokeratin (CK) 7, CK8/ 18, CK20, CK903, CAM 5.2, epithelial membrane antigen, smooth muscle actin, desmin, leukocyte common antigen, Bcl-2, CD3, CD20, CD30, CD138, κ and λ light chains, CD68, CD34, factor VIII, synaptophysin, and glial fibrillary acidic protein. Electron microscopy showed cytoplasmic whorls of intermediate filaments containing entrapped rough endoplasmic reticulum, mitochondria, and lipid. Recognition of this rare variant of malignant melanoma is important in the evaluation of tumors with rhabdoid morphology.
Dedifferentiated Liposarcoma With a Paraganglioma-like Histologic Pattern: A Case Report and Review of the Literature
Authors: Liu Dating , Quinonez Guillermo , Latosinsky Steven 
Published: February 2021

Abstract
A 53-year-old man presented with a 4-month history of increasing abdominal discomfort and distension. A large retroperitoneal mass was found on imaging. Image-guided needle core biopsy demonstrated a poorly differentiated malignant neoplasm. A 30 × 32 × 33-cm soft tissue mass was removed. Microscopically, the tumor consisted of predominantly epithelioid malignant cells arranged in a paraganglioma-like growth pattern. Immunohistochemically, these cells were strongly positive for neuron-specific enolase. Stains for synaptophysin and chromogranin, however, were negative. There was no ultrastructural evidence of neuroendocrine differentiation. Adjacent sarcomatous areas were composed of spindled cells arranged in storiform and fibrosarcoma-like growth patterns. A small area of well-differentiated liposarcoma was identified, and a diagnosis of dedifferentiated liposarcoma was established. To the best of our knowledge, this represents the first reported case of dedifferentiated liposarcoma with a paraganglioma-like histologic pattern. A brief review focusing on the morphologic variations of dedifferentiated liposarcoma is also presented.
Solitary Fibrous Tumor of Nasal Cavity in Patient With Long-Standing History of Cocaine Inhalation
Authors: Chauhan Suman S. , Krishnan Jayshree , Heffner Denis K. 
Published: February 2021

Abstract
We report a solitary fibrous tumor in the nasal cavity of a 48-year-old woman who presented with a history of bilateral nasal obstruction and long-standing cocaine inhalation. Physical examination revealed a large mass involving the right nasal cavity and extending into the posterior aspect of the left nasal cavity. The computed tomography scan showed opacification of airways. During surgery, the mass was found to involve the entire nasal cavity, with extension to the right maxillary sinus, posterior nasal airways, and left nasal cavity. The mass was completely excised. Pathologic examination revealed a polypoid mass 3.7 × 3.0 × 1.2 cm. This tumor was composed of spindle cells that were cytologically bland in a background of ropey and nodular collagen, giving a “patternless” pattern. Immunohistochemically, the neoplastic cells stained for CD34 and vimentin but not for S100 protein, keratin, desmin, HMB-45, and c-Kit. This immunohistochemical pattern confirmed the diagnosis of solitary fibrous tumor. Although solitary fibrous tumors are usually found in the pleura, they can occur in various other locations, such as the orbit, nasal cavity, paranasal sinuses, mediastinum, breast, vagina, meninges, and soft tissues. This case is of interest because the tumor occurred in a patient with prolonged cocaine inhalation. Such an association has not been previously described. The exact causal relationship between cocaine inhalation and the tumor is not known.
Pigmented “Black” Pheochromocytoma of the Adrenal Gland: A Case Report and Review of the Literature
Authors: Bellezza Guido , Giansanti Michele , Cavaliere Antonio , Sidoni Angelo 
Published: February 2021

Abstract
A pigmented “black” mass was discovered incidentally in a 72-year-old woman. The tumor, which was detected near the upper pole of the left kidney, was cystic and intensely black throughout with the presence of abundant, coarse, dark brown to black pigment granules. Histologic examination showed a proliferation of monomorphous neoplastic cells arranged in a typical zellballen growth pattern. These features indicated a diagnosis of pheochromocytoma. Immunostains for chromogranin A, synaptophysin, and neuron-specific enolase were positive. The immunostain for HMB-45 was negative. Electron microscopy showed neurosecretory-type granules and larger pleomorphic granules, which were considered most consistent with neuromelanin, a waste product of catecholamine metabolism. The evidence of melanin or melanin-like pigment in the adrenal gland has been described in only 10 cases in the literature and is always a microscopic finding. The case reported here is unique for the characteristic black macroscopic appearance and the abundance of pigment.
Clear Cell Papulosis of the Skin: A Case Report From Singapore
Authors: Kumarasinghe Sujith Prasad Wanniarachchi , Chin Giam Yoke , Kumarasinghe Marian Priyanthi 
Published: February 2021

Abstract
Clear cell papulosis of the skin is a rare condition; to our knowledge only 12 cases have been reported. Here, we report for the first time a case of clear cell papulosis with cytokeratin 7 expression and provide a comprehensive literature review. A 16-month-old girl presented with 3 hypopigmented lesions in the pubic region that were 3 to 9 mm in diameter; 1 lesion was papular, and the other 2 were macular. A skin biopsy revealed acanthosis with a proliferation of clear cells along the basal and suprabasal layers of the epidermis occurring in small clusters and singly. The cells had round to oval regular nuclei with abundant to moderate lightly eosinophilic to clear cytoplasm and intracytoplasmic mucin. Immunostaining produced positive results for carcinoembryonic antigen, AE1/3, epithelial membrane antigen, cell adhesion molecule 5.2, and cytokeratin 7 and negative results for gross cystic fluid disease protein, S100, and HMB-45. Clear cells of clear cell papulosis are mucin-positive and S100-negative glandular-secretory epithelial cells with histogenetic features of Toker cells of nipple and Paget cells. Immunohistochemical features support an eccrine secretory cell origin because the clear cells are consistently and strongly positive for carcinoembryonic antigen, positive for cell adhesion molecule 5.2, and negative or rarely positive for gross cystic fluid disease protein.
Solitary Fibrous Tumor of the Auditory Canal
Authors: Rezk Sherif , Yousef Mohammad , Zamansky Marshall , Khan Ashraf 
Published: February 2021

Abstract
Solitary fibrous tumor (SFT) is an uncommon spindle cell neoplasm of increasing incidence that was originally described to be of pleural origin; however, more recently, SFT has been reported in extrapleural sites, including the orbit, liver, salivary glands, tongue, nose, paranasal sinuses, larynx, retroperitoneum, meninges, and thyroid. The increase in the number of SFTs does not necessarily mean increased incidence of this tumor but rather an increased understanding of this tumor, especially recognition of this tumor in extrapleural locations, which has been aided by immunohistochemical analysis. We report a case of SFT in the auditory canal, which to our knowledge has not been previously reported, as evident by morphologic findings and immunophenotype.
Carcinosarcoma of the Urinary Bladder Following Cyclophosphamide Therapy
Authors: Mukhopadhyay Sanjay , Shrimpton Anthony E. , Jones Lee A. , Nsouli Imad S. , Abraham Naif Z. 
Published: February 2021

Abstract
We report a case involving a 45-year-old man with a 12-year history of Wegener granulomatosis, who developed a carcinosarcoma of the urinary bladder after long-term cyclophosphamide therapy. Cyclophosphamide is well recognized as an etiologic agent for urothelial carcinoma of the urinary bladder. However, only 5 cases of carcinosarcoma of the urinary bladder following cyclophosphamide therapy have been reported. We used loss of heterozygosity studies and microsatellite markers to define the molecular basis of this rare neoplasm. These studies revealed evidence supporting a monoclonal origin for the 2 components of this tumor. We also demonstrated allelic loss of chromosome 9p. This loss associated with carcinosarcoma of the urinary bladder is in agreement with previous studies, suggesting a possible role for the tumor suppressor gene p16 in the pathogenesis of this tumor.
Error and Error Reduction in Pathology
Authors: Sirota Ronald L. 
Published: February 2021

Abstract
Context.—Since publication of the Institute of Medicine's report on medical error in late 1999, there has been widespread interest in improving patient safety and in error reduction in all disciplines of medicine. In fields other than medicine, considerable knowledge has been obtained concerning error and error reduction. This body of knowledge can be successfully applied to pathology in order to make the specialty safer and less error prone.
Objectives.—To review the fundamental conclusions of the Institute of Medicine's report on medical error, to provide a taxonomy of error that can be adapted to pathology, to provide a framework for studying and analyzing error in pathology, to contrast different approaches to error, and to explain the concept of a culture of safety.
Design.—Review of pertinent literature, analysis of concepts of error reduction and safety used in other disciplines, analysis of pathology workflow, and adaptation of safety practices to the practice of pathology.
Results.—A taxonomy for error is described and adapted to pathology, a framework for error in the specialty is described, and characteristics of a culture of safety for pathology are proposed.
Conclusions.—Fundamental concepts of error reduction and safety improvement exist in other disciplines and can successfully be adapted to pathology.
An Insurer's Perspective on Error and Loss in Pathology
Authors: Troxel David B. 
Published: February 2021

Abstract
Objectives.—To identify errors in surgical pathology practice that lead to malpractice claims, and to define the frequency and severity of pathology malpractice claims and discuss the implications.
Design.—Three hundred seventy-eight pathology malpractice claims reported to The Doctors Company of Napa, Calif, between 1998 and 2003, were reviewed. Nuisance claims and autopsy claims were excluded; the 335 remaining claims were analyzed.
Results.—Pathology claim frequency is low. Pathology claim severity is high, especially for claims involving a misdiagnosis of melanoma or a false-negative Papanicolaou test. Fifty-seven percent of claims involved the following 5 categories: breast specimens, melanoma, Papanicolaou smears, gynecologic specimens, and operational error. Sixty-three percent of claims involved failure to diagnose cancer, resulting in delay in diagnosis or inappropriate treatment.
Conclusion.—A false-negative diagnosis of melanoma is the single most common reason for filing a malpractice claim against a pathologist. Nearly one third of misdiagnoses involve melanoma misdiagnosed as Spitz nevus, “dysplastic” nevus, spindle cell squamous carcinoma, atypical fibroxanthoma, and dermatofibroma.
Anatomic Pathology Databases and Patient Safety
Authors: Raab Stephen S. , Grzybicki Dana M. , Zarbo Richard J. , Meier Frederick A. , Geyer Stanley J. , Jensen Chris 
Published: February 2021

Abstract
Context.—The utility of anatomic pathology discrepancies has not been rigorously studied.
Objective.—To outline how databases may be used to study anatomic pathology patient safety.
Design.—The Agency for Healthcare Research and Quality funded the creation of a national anatomic pathology errors database to establish benchmarks for error frequency. The database is used to track more frequent errors and errors that result in more serious harm, in order to design quality improvement interventions intended to reduce these types of errors. In the first year of funding, 4 institutions (University of Pittsburgh, Henry Ford Hospital, University of Iowa, and Western Pennsylvania Hospital) reported cytologic-histologic correlation error data after standardizing correlation methods. Root cause analysis was performed to determine sources of error, and error reduction plans were implemented.
Participants.—Four institutions self-reported anatomic pathology error data.
Main Outcome Measures.—Frequency of cytologic-histologic correlation error, case type, cause of error (sampling or interpretation), and effect of error on patient outcome (ie, no harm, near miss, and harm).
Results.—The institutional gynecologic cytologic-histologic correlation error frequency ranged from 0.17% to 0.63%, using the denominator of all Papanicolaou tests. Based on the nongynecologic cytologic-histologic correlation data, the specimen sites with the highest discrepancy frequency (by project site) were lung (ranging from 16.5% to 62.3% of all errors) and urinary bladder (ranging from 4.4% to 25.0%). Most errors detected by the gynecologic cytologic-histologic correlation process were no-harm events (ranging from 10.7% to 43.2% by project site). Root cause analysis identified sources of error on both the clinical and pathology sides of the process, and error intervention programs are currently being implemented to improve patient safety.
Conclusions.—A multi-institutional anatomic pathology error database may be used to benchmark practices and target specific high-frequency errors or errors with high clinical impact. These error reduction programs have national import.
Capillary Hemangioma of the Endometrium: A Case Report and Review of the Literature
Authors: Johnson Cary , Reid-Nicholson Michelle , Deligdisch Lianne , Grinblat Svetlana , Natarajan Suneetha 
Published: February 2021

Abstract
A 39-year-old woman with menorrhagia of 7 years' duration was found to have a capillary hemangioma of the endometrium. Initial diagnosis by curettage was considered questionable but was later confirmed at hysterectomy. A thorough search and review of the literature was performed.
Testing for Defective DNA Mismatch Repair in Colorectal Carcinoma: A Practical Guide
Authors: Burgart Lawrence J. 
Published: February 2021

Abstract
Context.—Significant bench and clinical data have been generated during the last decade regarding DNA mismatch repair in colorectal carcinoma.
Objectives.—To review clinically relevant aspects of defective DNA mismatch repair in colorectal carcinoma and to suggest testing algorithms for identification of these tumors in the sporadic and familial settings.
Data Sources.—This article is based on literature review and clinical testing experience of more than 2000 patient samples.
Conclusions.—Approximately 15% of colorectal carcinomas arise as a result of defective DNA mismatch repair. Ninety percent of these carcinomas are sporadic, arising as a result of methylation of the MLH1 gene promoter, silencing expression. These sporadic carcinomas have improved stage-specific prognosis and can be identified by demonstrating aberrant loss of expression with an MLH1 immunoperoxidase stain. Familial colorectal carcinomas with defective DNA mismatch repair (Lynch syndrome) are due to a germline defect in one of several DNA mismatch repair genes. The familial carcinomas are best identified with a combination of immunohistochemistry and molecular microsatellite analysis. This testing facilitates subsequent directed genetic testing of the proband and family members.
Attenuated Familial Adenomatous Polyposis: A Case Report With Mixed Features and Review of Genotype-Phenotype Correlation
Authors: Ionescu Diana N. , Papachristou Georgios , Schoen Robert E. , Hedge Madhuri , Richards C. Sue , Monzon Federico A. 
Published: February 2021

Abstract
Familial adenomatous polyposis represents approximately 1% of all colorectal cancers and is caused by germline mutations in the adenomatous polyposis coli (APC) gene. Most mutations are located within the first 2000 codons, and several mutational hot spots have been identified. The relative location of the mutation may be associated with the number of polyps and partially predicts specific phenotypic expression. Mutations associated with the attenuated phenotype are found predominantly in the 5′ region of the gene or in the last third. We describe a patient with a mutation in codon 161 of the APC gene, which displays a phenotype most closely resembling the attenuated form of familial adenomatous polyposis, and review the literature, the implications of this mutation, and the importance of the molecular testing in the proper and more complete characterization of these patients. Differences in the APC mutation sites alone cannot completely account for intrafamilial and interfamilial variation in the polyposis phenotypes.
The Genesis of Barrett Esophagus: Has a Histologic Transition From Gastroesophageal Reflux Disease–Damaged Epithelium to Columnar Metaplasia Ever Been Seen in Humans?
Authors: Riddell Robert H. 
Published: February 2021

Abstract
Has a histologic transition from gastroesophageal reflux disease–damaged epithelium to columnar metaplasia ever been seen in humans? The answer to this question seems to be that it has but that we either do not readily recognize it or it is not readily recognizable with regular light microscopy. There are at least 3 possible mechanisms for the genesis of Barrett esophagus. The first is ulceration at the gastroesophageal junction with subsequent repair by an epithelium that differentiates into Barrett epithelium. The second is metaplasia through multilayered epithelium. The third is creeping columnar metaplasia at the Z-line proximally followed by intestinalization. These 3 hypotheses may not be mutually exclusive, and all may be operative, depending on the local circumstances, amount of inflammation, erosion, ulcers, healing, acid and alkaline reflux, and use of proton pump inhibitors. Any of the epithelial types involved could be stable and not progress. They might even be reversible, which may also in part explain the mosaic of epithelial types that typify Barrett esophagus, and may be modified by any of the molecular mechanisms that turn protein transcription on and off (eg, promoter methylation, mutations). These mechanisms ultimately may also be involved in the genesis of neoplastic transformation.
What Is Dysplasia in the Gastrointestinal Tract?
Authors: Appelman Henry D. 
Published: February 2021

Abstract
Dysplasia in the gastrointestinal tract is considered both a carcinoma precursor and a marker of high cancer risk for the site at which it is found. Dysplasia is defined as unequivocally neoplastic epithelium, yet the specific criteria for making that determination are imperfectly defined. The current criteria actually include a mix of architectural and cytologic features, all of which occur in different intensities in different epithelia that are given the same diagnosis. Gastrointestinal dysplasias are divided into 2 grades, but there are problem areas in diagnosis at the lower end where low-grade dysplasias overlap with regenerating epithelia and in the middle where low- and high-grade dysplasias overlap. The diagnosis of dysplasia is too subjective with less than optimal reproducibility to be as useful a marker as needed. Pathologists need a dysplasia stain or a whole set of new markers of high cancer risk, presumably molecular and/or genetic, that are not dependent on pathologists' diagnoses of dysplasia and their inherent subjectivity.