bluuebunny/crossref_metadata_2025_split huggingface dataset:
Desmoplastic Small Round Cell Tumors: Cytologic, Histologic, and Immunohistochemical Features
Authors: Chang Fuju 
Published: February 2021

Abstract
Desmoplastic small round cell tumor (DSRCT) is a recently recognized clinicopathologic entity that has a predilection for adolescent males and usually affects the abdominal cavity. Due to its uncommon nature, many pathologists lack experience with this tumor. The literature regarding DSRCT is reviewed with special attention to its histologic and cytologic diagnosis. Morphologic features of DSRCT and its immunohistochemical and cytogenetic profile are summarized and differential diagnosis with other small round cell tumors is discussed. As observed by both histologic and cytologic examinations, small round blue cells and fibrosclerotic stroma are the striking morphologic features of DSRCT. The typical immunohistochemical profile is characterized by coexpression of epithelial, mesenchymal, myogenic, and neural markers. Cytogenetically, this tumor harbors a specific karyotypic abnormality, namely t(11;22)(p13;q12). These features distinguish DSRCT from other members of the family of small round cell tumors.
Performance Accuracy of Antibacterial and Antifungal Susceptibility Test Methods: Report From the College of American Pathologists Microbiology Surveys Program (2001–2003)
Authors: Pfaller Michael A. , Jones Ronald N. 
Published: February 2021

Abstract
Context.—The College of American Pathologists Microbiology Surveys Program provides external proficiency samples that monitor the performance of nearly 3000 laboratories that perform and report antimicrobial susceptibility tests.
Objective.—To summarize results obtained with bacterial and yeast challenge samples (2001 through 2003).
Design.—One organism every 4 months was tested by surveys participants against antibacterials/antifungals by routinely used methods. Reports were graded by interpretive category (susceptible, intermediate, resistant) based on an 80% consensus of referees/participants.
Results.—The most common antibacterial test methods/ systems were Vitek (38%–43%), MicroScan (39%–43%), and the disk diffusion test (14%–15%), although Etest was most used for fastidious species. YeastOne was the dominant antifungal test (50%–55%). Antifungal results demonstrated continuous, improved accuracy (83%–88%), highest for YeastOne (96%) and broth microdilution (95%) methods. Antibacterial test accuracy was consistently greater than 97% against gram-positive organism challenges and greater than 98% against gram-negative challenges. For gram-negative strains with well-characterized resistance mechanisms, the accuracy by method was disk diffusion greater than broth microdilution greater than automated systems. Major problems identified were (1) Haemophilus influenzae control ranges require re-evaluation, (2) overuse of β-lactamase tests, (3) errors among Enterococcus faecium against penicillins (Vitek 2, MicroScan), (4) false-susceptible results with trimethoprim/sulfamethoxazole against coagulase-negative staphylococci (MicroScan), (5) macrolide false-susceptibility for β-hemolytic streptococcus (MicroScan), (6) flawed reporting for antimicrobials not active at the infection site, (7) use of outdated interpretive criteria, and (8) failure to follow Clinical and Laboratory Standards Institute testing/reporting recommendations.
Conclusions.—Susceptibility tests were generally performing satisfactorily as measured by the surveys, but serious errors were identified with some drug/organism combinations that may require action by the Clinical and Laboratory Standards Institute and/or the Food and Drug Administration.
No Residual Cancer on Radical Prostatectomy After Positive 10-Core Biopsy: Incidence, Biopsy Findings, and DNA Specimen Identity Analysis
Authors: Trpkov Kiril , Gao Yuan , Hay Robert , Yimaz Asli 
Published: February 2021

Abstract
Context.—It is uncertain whether extensive prostate-specific antigen (PSA) testing and extended biopsies currently performed will increase the incidence of no residual cancer on subsequent prostatectomy.
Objective.—To identify the incidence of cases with no residual cancer on prostatectomy after a positive 10-core biopsy and to review the clinical, biopsy, and prostatectomy findings and the results of specimen identity analysis.
Design.—We identified 9 patients with no residual cancer in 1351 consecutive prostatectomies and we reviewed the clinical, biopsy, and prostatectomy data from our institutional database. In 6 cases encountered after 2003, we also performed a polymerase chain reaction–based microsatellite analysis on formalin-fixed tissue to confirm the identity of the biopsies and prostatectomies.
Results.—All patients had positive biopsies in 1 or 2 cores: 1 in 7 and 2 in 2 patients (1 each, unilateral and bilateral). Mean total cancer length on biopsy measured 2.5 mm, which represented 1.7% of the total biopsy tissue. Gleason score 6 was found in 8 of 9 patients and 1 patient had Gleason score 9. Patients' age was 60.3 years, preoperative PSA was 6.0 ng/mL, and PSA density was 0.1 (all means). In 6 cases tested for microsatellite identity, the patient identity was confirmed.
Conclusions.—Incidence of no residual cancer on prostatectomy of 0.67% after 10-core positive biopsy is higher than previously reported. In most cases, finding no residual cancer on prostatectomy after exhaustive work-up may indicate minimal patient disease. Microsatellite analysis provides a useful and cost-effective test in establishing specimen identity.
Myeloid Sarcoma of the Urinary Bladder and Epididymis as a Primary Manifestation of Acute Myeloid Leukemia With inv(16)
Authors: Al-Quran Samer Z. , Olivares Adriana , Lin Pei , Stephens Tanya W. , Medeiros L. Jeffrey , Abruzzo Lynne V. 
Published: February 2021

Abstract
Myeloid sarcoma (MS) of the lower urinary tract is rare. We describe a 47-year-old man with hematuria, who was subsequently found to have MS involving bladder and epididymis. The neoplasm was composed predominantly of blasts that expressed CD68, CD117, myeloperoxidase, and lysozyme, with occasional immature eosinophils. Although blood and bone marrow examinations showed no morphologic evidence of leukemia, conventional cytogenetic studies of marrow demonstrated inv(16)(p13q22) in 4 of 20 metaphases; fluorescence in situ hybridization of the bladder neoplasm also showed inv(16). Following chemotherapy, the patient has been in complete remission for 32 months. In our literature review, we identified 7 cases of MS involving bladder, only 3 without evidence of an associated myeloid neoplasm in marrow, none with cytogenetic data. A high index of suspicion is required to establish the diagnosis of MS involving bladder. Cytogenetic analysis is useful for both demonstrating minimal marrow disease and classifying MS in paraffin-embedded tissue sections.
Proximal-Type Epithelioid Sarcoma With Elevated Serum CA 125: Report of a Case With CA 125 Immunoreactivity
Authors: Lee Hyang-Im , Kang Kil Hyun , Cho Young Mee , Lee Oak-Jun , Ro Jae Yoon 
Published: February 2021

Abstract
Proximal-type epithelioid sarcoma is a recently described rare soft tissue neoplasm. It is commonly found in the pelvic, perineal, and genital areas in middle-aged or older adults, as compared with the classic type of epithelioid sarcoma, which arises in the distal portion of the extremities in adolescents and young adults. Proximal-type epithelioid sarcoma has a more aggressive clinical behavior than the classic type of epithelioid sarcoma. Proximal-type epithelioid sarcoma is histologically characterized by a diffuse proliferation of epithelioid cells with prominent rhabdoid feature. Recently, a few cases have been reported of epithelioid sarcoma with elevated serum CA 125 level and CA 125 immunoreactivity in neoplastic cells. These cases raise the possibility that serum CA 125 and CA 125 immunoreactivity could be a useful tumor marker for diagnosing and monitoring epithelioid sarcoma. We describe a case of proximal-type epithelioid sarcoma with elevated serum CA 125 level (up to 3395 U/mL [reference range, &lt;35 U/mL]) in a 12-year-old girl who presented with a huge pelvic mass measuring 12 cm in greatest dimension. The serum CA 125 level dropped to 452 U/mL after a debulking operation of the mass. Immunostaining for CA 125 demonstrated a positive immunoreactivity in the neoplastic cells. She received one cycle of chemotherapy and died of the disease 2 months after diagnosis. This case represented a rare example of proximal-type epithelioid sarcoma with elevated serum CA 125 and immunoreactivity for CA 125 in the tumor cells. Based on the previous reported cases and the current case, serum CA 125 as well as immunohistochemical stain for CA 125 may be a useful tumor marker of proximal-type epithelioid sarcoma.
Renal Cell Carcinoma With Rhabdoid Features: An Aggressive Neoplasm With Overexpression of p53
Authors: Leroy Xavier , Zini Laurent , Buob David , Ballereau Charles , Villers Arnauld , Aubert Sebastien 
Published: February 2021

Abstract
Context.—Adult renal cell carcinoma (RCC) with rhabdoid features is a recently recognized morphologic variant of kidney carcinoma. To date, only very few studies have been published on this subject and p53 was not previously studied.
Objective.—To evaluate clinical attributes, morphology, and immunohistochemistry in RCC with rhabdoid component.
Design.—Reviewing a consecutive series of 310 RCCs, we identified 14 cases of RCC with rhabdoid features. All cases were reviewed and subjected to detailed clinical and pathologic studies with immunohistochemical evaluation of p53.
Results.—All tumors were clear RCCs with rhabdoid component representing from 5% to 50% of the tumor volume. Rhabdoid cells were large with a central eosinophilic intracytoplasmic inclusion and an eccentric atypical nucleus. Tumor necrosis was common (13/14) and sometimes extensive. Nine of 14 tumors were staged pT3, 4 of 14 were pT2, and only 1 tumor was pT1. On immunohistochemistry, rhabdoid cells were positive for vimentin (14/ 14), epithelial membrane antigen (11/14), and cytokeratin (9/14). Desmin and smooth muscle actin were always negative. p53 was positive in 10 of 14 tumors in the rhabdoid areas (5%–50% of tumor cells stained) but only in 5 of 14 cases in usual clear renal cell areas. In the follow-up, 10 of 14 patients developed metastases and 6 of 14 died of the disease. The median of survival was 8 months.
Conclusions.—We showed that RCC with rhabdoid features is a very aggressive neoplasm with a poor prognosis. We observed an overexpression of p53 in the rhabdoid component that may be implicated in the tumor dedifferentiation.
Differential Expression of Kinase Genes in Primary Hyperparathyroidism: Adenoma Versus Normal and Hyperplastic Parathyroid Tissue
Authors: Schachter Pinhas P. , Ayesh Suhail , Matouk Imad , Schneider Tamar , Czerniak Abraham , Hochberg Abraham 
Published: February 2021

Abstract
Context.—Differentiation between adenoma and hyperplasia or even normal parathyroid tissue is difficult and based mainly on the surgeon's skill. Exploration of genes that express differentially in these various tissues using microarrays and other sophisticated research tools will enable identification and perhaps development of new methods of perioperative diagnosis.
Objective.—To assemble a panel of kinase genes to differentiate parathyroid adenoma from normal and hyperplastic parathyroid tissue.
Design.—RNA was extracted from adenoma, hyperplasia, and normal parathyroid tissue and hybridized to a microarray containing 359 human cDNAs of known kinase genes. Signals of exposure were scanned and quantified with software for digital image analysis. Semiquantitative reverse transcriptase polymerase chain reaction analysis of sample genes was performed, up-regulated or down-regulated, to validate the microarray results.
Results.—The ratio values considered significant (&lt;0.5 or &gt;1.5) suggest that genes up-regulated in parathyroid adenoma are those responsible for blood vessel angiogenesis and genes belonging to the cyclin-dependent kinase inhibitor groups. Genes down-regulated in parathyroid adenoma are related to cellular growth and apoptosis—genes from the mitogen-activated protein kinase group and DNA-dependent protein kinase group. An interesting gene down-regulated in the parathyroid adenoma samples is related to the serine/threonine protein kinases that exert a key function in calcium handling. A panel of 5 genes was defined: p19, p21 and the gene for vascular endothelial growth factor from the up-regulated group, and the gene for protein kinase C and SGK from the down-regulated group. Reverse transcriptase polymerase chain reaction confirmed the microarray results for these genes.
Conclusions.—The kinase genes panel presented can be used to differentiate parathyroid adenoma from normal and hyperplastic parathyroid tissue in particular when histopathology fails to provide a decisive diagnosis.
Primary Peritoneal Serous Borderline Tumors
Authors: Hutton, MC C. P. T. Robert L. , Dalton, MC M. A. J. Scott R. 
Published: February 2021

Abstract
Context.—Primary peritoneal serous borderline tumor is a rare epithelial proliferation that can present as an incidental finding at laparotomy and raises concern for a primary ovarian tumor with peritoneal implants.
Objective.—To present a brief history of this condition and describe its distinctive histology and clinical presentation, as well as to review the chief differential diagnostic considerations, to include mesothelial proliferations, endosalpingiosis, endometriosis, high-grade primary peritoneal papillary serous carcinoma, and implants from primary ovarian serous neoplasms.
Data Sources.—Relevant articles indexed in PubMed (National Library of Medicine) between 1966 and 2005, references thereof, and reference surgical pathology texts.
Conclusions.—Primary peritoneal serous borderline tumor should be considered in the differential diagnosis of an epithelial proliferation with prominent psammoma bodies on the peritoneal surface of specimens submitted for nongynecologic complaints.
Critical Leadership and Management Skills for Pathology Practice
Authors: Brimhall Bradley B. , Wright Louis D. , McGregor Kelli L. , Hernandez James S. 
Published: February 2021

AbstractContext.—Managed care has changed the nature of medical practice. The practice of pathology has also changed and is likely to undergo further modification. Additional skills in leadership and management are needed to perform optimally in the current medical marketplace.Objective.—To determine whether pathologists view business and informatics skills as being important and valuable in their practices.Design.—A survey was sent electronically (via e-mail) to 2566 pathologists and pathology administrators.Results.—Two hundred sixteen survey recipients (8.4%) responded to the survey. The response rate to individual questions ranged from 86% to 99% (186 to 214 of 216 total respondents). Most who took the survey ranked communication (203/209; 97%), leadership skills (165/209; 79%), and systems thinking skills (155/209; 74%) as either “very important” or “essential.” Fewer respondents were willing to offer salary premiums for marketing (108/196; 55%), business or finance (92/196; 47%), or staff leadership (95/196; 48%) skills unless the candidate had a track record of measurable achievement using these skills. Those practicing in academia as well as those making hiring decisions by themselves were more likely to value leadership and management skills. Fewer than 1% of respondents in any category considered current pathology residency training in leadership and management to be adequate.Conclusions.—Prospective employers value leadership and management skills. Pathology residency programs must include meaningful training in pathology practice management and informatics to satisfy the demand for these skills in the modern pathology marketplace.
Atherogenic Lipid Phenotype in a General Group of Subjects
Authors: Van Joanne , Pan Jianqiu , Charles M. Arthur , Krauss Ronald , Wong Nathan , Wu Xiaoshan 
Published: February 2021

Abstract
Context.—The atherogenic lipid phenotype is a major cardiovascular risk factor, but normal values do not exist derived from 1 analysis in a general study group.
Objective.—To determine normal values of all of the atherogenic lipid phenotype parameters using subjects from a general study group.
Design.—One hundred two general subjects were used to determine their atherogenic lipid phenotype using polyacrylamide gradient gels.
Results.—Low-density lipoprotein (LDL) size revealed 24% of subjects express LDL phenotype B, defined as average LDL peak particle size 258 Å or less; however, among the Chinese subjects, the expression of the B phenotype was higher at 44% (P = .02). For the total group, mean LDL size was 265 ± 11 Å (1 SD); however, histograms were bimodal in both men and women. After excluding subjects expressing LDL phenotype B, because they are at increased cardiovascular risk and thus are not completely healthy, LDL histograms were unimodal and the mean LDL size was 270 ± 7 Å. A small, dense LDL concentration histogram (total group) revealed skewing; thus, phenotype B subjects were excluded, for the rationale described previously, and the mean value was 13 ± 9 mg/dL (0.33 ± 0.23 mmol/L). High-density lipoprotein (HDL) cholesterol histograms were bimodal in both sexes. After removing subjects as described previously or if HDL cholesterol levels were less than 45 mg/dL, histograms were unimodal and revealed a mean HDL cholesterol value of 61 ± 12 mg/dL (1.56 ± 0.31 mmol/L). HDL 2, HDL 2a, and HDL 2b were similarly evaluated.
Conclusions.—Approximate normal values for the atherogenic lipid phenotype, similar to those derived from cardiovascular endpoint trials, can be determined if those high proportions of subjects with dyslipidemic cardiovascular risk are excluded.
Epstein-Barr Virus Infection and Single Nucleotide Polymorphisms in the Promoter Region of Interleukin 10 Gene in Patients With Hodgkin Lymphoma
Authors: da Silva Glenda Nicioli , Bacchi Maura Moscardi , Rainho Cláudia Aparecida , de Oliveira Deilson Elgui 
Published: February 2021

Abstract
Context.—Hodgkin lymphoma is a neoplastic disease in which the immune system plays a major role in its pathogenesis. Interleukin 10 (IL-10), an immunosuppressive cytokine actively produced in patients with Hodgkin lymphomas, favors the survival of the Hodgkin/Reed-Sternberg cells. Individual variations in IL-10 levels may be due, in part, to the presence of single nucleotide polymorphisms in the IL10 gene promoter.
Objective.—To evaluate whether particular single nucleotide polymorphisms in the IL10 gene are found more frequently in Hodgkin lymphoma cases associated with Epstein-Barr virus infection.
Design.—The identification of single nucleotide polymorphisms at positions -1082 and -819/-592 in the IL10 gene was performed by polymerase chain reaction and restriction length fragment polymorphisms analysis in 65 cases of Hodgkin lymphoma and 50 cases of reactive benign follicular lymphoid hyperplasia (non-Hodgkin lymphoma control group).
Results.—The frequency of the genotype GG at position -1082 was found to be significantly higher in patients with Epstein-Barr virus–positive Hodgkin lymphoma compared with Epstein-Barr virus–negative cases.
Conclusions.—The results suggest that the presence of specific single nucleotide polymorphisms in the IL10 gene, notably those associated with high IL-10 production, may play a role in the susceptibility to Epstein-Barr virus–positive Hodgkin lymphoma development.
Nested Variant of Urothelial Carcinoma
Authors: Dhall Deepti , Al-Ahmadie Hikmat , Olgac Semra 
Published: February 2021

Abstract
Nested variant of urothelial carcinoma is a rare neoplasm that is histologically characterized by large numbers of small, closely packed, haphazardly arranged, poorly defined, confluent irregular nests of bland-appearing urothelial cells infiltrating the lamina propria and the muscularis propria. Due to the cells' deceptively bland appearance, the tumors are sometimes misdiagnosed as benign lesions, leading in some cases to a significant delay in establishing the correct diagnosis and thus contributing to this neoplasm's advanced stage. Nested variant of urothelial carcinoma must be differentiated from the benign proliferative lesions of urothelium, such as von Brunn nests, cystitis cystica, cystitis glandularis, nephrogenic adenoma, inverted papilloma, and paraganglioma.
Patterns of Add-on Tests for Hospitalized and for Private Patient Populations
Authors: Naumova Nadia N. , Schappert Joseph , Kaplan Lawrence A. 
Published: February 2021

Abstract
Context.—The policy of storing clinical samples in a pathology laboratory is based on long-standing practice rather than on objective data regarding the actual use of the stored samples.
Objective.—To determine the time after initial order that requests for add-on tests are submitted to the laboratory. These data might be useful for improving the efficiency of sample storage.
Design.—Two hundred sixteen add-on requests evenly divided between inpatients and private practice patients were reviewed for types of tests added on and the time of the requests.
Results.—Ninety-five percent of add-on test requests for inpatients were made by 0.75 day after the initial order (range, 0.01–4.3 days). However, the 95th percentile for private practice patients' add-on requests did not occur until 5.6 days later (range, 0.01–7.0 days). The pattern of add-on tests for hospitalized patients also differed from those for private practice patients. Most add-on tests for hospitalized patients were for routine hospital tests, and the private practice add-on requests were for assays that were not as routine, frequently for testing referred to the reference laboratory. This difference affected the rapidity of completing the add-on tests.
Conclusions.—Samples for hospitalized patients can be stored for 3 days, but samples from patients in private practices should be held for 7 days. This change of “usual” storage practice would increase the efficient use of laboratory space and personnel. Screening all requests for add-on tests for hospitalized patients might reduce the frequency of unnecessary add-on requests, further increasing the efficiency of the laboratory.
Novel Criteria for Parathyroid Hormone Levels in Parathyroid Hormone–Guided Parathyroid Surgery
Authors: de Vos tot Nederveen Cappel Robert , Bouvy Nicole , de Herder Wouter , de Rijke Yolanda , van Toor Hans , Bonjer Jaap 
Published: February 2021

Abstract
Context.—Novel criteria for decrease of perioperative parathyroid hormone measurement may improve the accuracy of perioperative quick parathyroid hormone (qPTH)–guided parathyroidectomy.
Objective.—To assess overall cure rate based on conventional criteria (50% decline of qPTH). Perioperative qPTH levels were evaluated to determine novel criteria for successful parathyroid surgery.
Design.—Analysis of perioperative qPTH measurement findings of all consecutive patients undergoing parathyroidectomy for hyperparathyroidism (72 with primary hyperparathyroidism and 28 with secondary or tertiary hyperparathyroidism or multiple endocrine neoplasia I/IIa disease).
Results.—Measurement of qPTH (based solely on the criterion of greater than 50% decline of parathyroid hormone) in 72 patients with primary hyperparathyroidism (77 procedures) showed true-positive results in 69, false-positive results in 4, and true-negative results in 4 procedures. In our series, false-positive and true-negative results were associated with high postexcision levels. However, when qPTH declines of greater than 70% and 80% were used in cases of postexcision qPTH levels of 100 to 200 ng/L and greater than 200 ng/L, respectively, no false-positive results were observed.
Conclusions.—Through adherence to these novel criteria, reexploration of the neck could have been prevented in 29% of patients with primary hyperparathyroidism due to multiple gland disease. These novel criteria demand future evaluation to establish their value.