bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital Nursing Satisfaction With Clinical Laboratory Services: A College of American Pathologists Q-Probes Study of 162 Institutions
Authors: Jones Bruce A. , Walsh Molly K. , Ruby Stephen G. 
Published: February 2021

Abstract
Context.—Monitoring customer satisfaction is an important and useful quality improvement tool and is required of most clinical laboratories in the United States.
Objective.—To survey the level of nursing satisfaction with hospital clinical laboratory services.
Design.—Participating laboratories provided information regarding laboratory demographics and practices. These laboratories then surveyed hospital nursing personnel regarding their level of satisfaction with defined aspects of laboratory service.
Setting.—College of American Pathologists Q-Probes laboratory quality improvement study in 162 hospital laboratories.
Main Outcome Measures.—Nursing overall satisfaction score (ranging from 1, not satisfied, to 5, very satisfied) and satisfaction scores for 13 specific aspects of clinical laboratory services.
Results.—One hundred sixty-two institutions submitted data from a total of 7033 nursing surveys. The overall satisfaction score for all institutions ranged from 2.5 to 4.6. The median overall score for all participants was 3.9 (10th percentile, 3.2; 90th percentile, 4.2). Nursing personnel were most satisfied with the accuracy of test results, phlebotomy courtesy toward patients and nursing staff, and notification of abnormal results. They were least satisfied with stat test turnaround time, laboratory management responsiveness and accessibility, phlebotomy responsiveness to service requests, and routine test turnaround time. The most important aspect of laboratory service reported by nursing personnel was stat test turnaround time.
Conclusions.—Most nursing personnel are satisfied with the clinical laboratory services that are provided to the patients in their care. Although test result accuracy is very highly regarded, there is room for improvement in several aspects of service, particularly in test turnaround time and laboratory management accessibility and responsiveness.
Odontogenic Myxoma: A Clinicopathologic Study of 25 Cases
Authors: Li Tie-Jun , Sun Li-Sha , Luo Hai-Yan 
Published: February 2021

Abstract
Context.—Odontogenic myxoma is an uncommon tumor that has the potential for extensive destruction of the jaws.
Objective.—To document the clinical, pathologic, and behavioral features of odontogenic myxomas.
Design.—Histologic and immunocytochemical examinations were performed on odontogenic myxomas from 25 Chinese patients. Clinical and available follow-up data were analyzed.
Results.—In the present series, 13 were male and 12 female. The age at diagnosis ranged from 6 to 66 years, with a mean age of 28.8 years. Twelve tumors involved the mandible and 13 occurred in the maxilla, with a predilection for posterior areas. The posterior maxillary tumors frequently (9/10) involved the maxillary sinus. Of the 23 cases with radiographic records, 22 lesions presented with a multilocular appearance. Although 80% of the mandibular lesions showed a well-defined border, only 33.3% of the maxillary tumors were well-defined. Histologically, odontogenic myxomas were mainly composed of spindled or stellate-shaped cells in a mucoid-rich intercellular matrix. Tumors containing noticeable fibrous components were evident in 13 cases. Apart from 5 cases treated conservatively by enucleation, the remaining 20 cases were treated by relatively radical procedures, including block/segmental resection and partial or total maxillectomy or mandibulectomy. Follow-up data were available on 22 patients and only 1 patient initially treated by enucleation had a recurrence.
Conclusions.—Odontogenic myxomas have a very bland histologic appearance that lacks atypia and may easily lead to misdiagnosis. The tumors are infiltrative with no capsulation and may recur after inadequate surgery.
Comparative Analysis of Routine Histology, Immunohistochemistry, Reverse Transcriptase Polymerase Chain Reaction, and Fluorescence In Situ Hybridization in Diagnosis of Ewing Family of Tumors
Authors: Jambhekar Nirmala A. , Bagwan Izhar N. , Ghule Prachi , Shet Tanuja M. , Chinoy Roshni F. , Agarwal Sandhya , Joshi Rupali , Amare Kadam Pratibha S. 
Published: February 2021

Abstract
Context.—The Ewing family of tumors are often difficult to distinguish from other malignant small round cell tumors, but more than 90% have EWS-FLI1 chimeric transcript, which acts as a potential molecular diagnostic marker.
Objective.—To do a comparative analysis of 32 cases with EWS-FLI1: Ewing family of tumors (n = 30), desmoplastic small round cell tumor (n = 1), and undifferentiated sarcoma (n = 1).
Design.—The initial diagnosis was made on core biopsy (n = 22) and open biopsy (n = 4) specimens by using morphology and immunohistochemistry and on fine-needle aspiration cytology ([FNAC], n = 6) specimens. EWS-FLI1 was detected by reverse transcriptase polymerase chain reaction on all 32 fresh FNAC samples and by fluorescence in situ hybridization on 16 paraffin blocks.
Results.—The 19 male and 13 female patients had bone (n = 19) or soft tissue (n = 13) tumors. Histologic groups were typical Ewing sarcoma (n = 15), atypical Ewing sarcoma (n = 4), Askin Rosai tumors (n = 5), desmoplastic small round cell tumor (n = 1), undifferentiated sarcoma (n = 1), and cases diagnosed as malignant small round cell tumors on FNAC (n = 6). All tumors except desmoplastic small round cell tumor and undifferentiated sarcoma were CD99 positive. EWS-FLI1 by reverse transcriptase polymerase chain reaction was noted in 15 cases of typical Ewing sarcoma, 4 cases of atypical Ewing sarcoma, 5 cases of Askin Rosai tumor, and no cases of desmoplastic small round cell tumor or undifferentiated sarcoma. With use of fluorescence in situ hybridization, EWS break was detected in 10 of 11 paraffin blocks used and was negative in desmoplastic small round cell tumor.
Conclusions.—The excellent correlation of routine histologic findings in Ewing family of tumors with results on immunohistochemistry and fluorescence in situ hybridization on archival material and reverse transcriptase polymerase chain reaction on fresh FNAC specimens underscores that the traditional observation on routine histologic examination is a time-tested tool. The diagnosis of Ewing family of tumors can be validated on archival material or fresh biopsy samples, including those obtained by FNAC.
Does Physiologic Breakdown Mask Significant Pathology in Endometrial Biopsies? A Retrospective Case-Control Study
Authors: Galan Mark , Kim Young Bae , Hecht Jonathan L. 
Published: February 2021

Abstract
Context.—Adequacy criteria for endometrial biopsy samples do not exist.
Objective.—To assess the sensitivity of endometrial sampling for detecting neoplasia in the setting of extensive glandular and stromal breakdown.
Design.—Retrospective case-control study. Surgical pathology records between 1996 and 2005 at Beth Israel Deaconess Medical Center (Boston, Mass) were searched for endometrial samples with diagnoses containing the key words “menstrual” or “extensive breakdown.” Hospital records for these women were parsed for demographics, clinical indications, and follow-up with rebiopsy within 6 months. Age cutoffs enriched the population for women at higher risk for carcinoma. A control group, consisting of 2 age-matched control patients for each test patient, was also studied; each control patient had an endometrial sample taken within a 6-month period and was not diagnosed with extensive breakdown, menstrual endometrium, or neoplasia on initial sampling.
Results.—Fifty-four cases were identified. The primary biopsy reports had benign descriptive diagnoses (ie, proliferative, secretory, polyp). Follow-up biopsies showed benign pathology in all cases and specific causes of bleeding—including polyp, leiomyoma, or endometritis—in 28 (52%) of 54. In the control group, neoplasia was found in 2 of the 108 follow-up biopsies. Only 5 other controls had specific diagnoses; all were polyps.
Conclusions.—Extensive breakdown or menstrual-pattern endometrium may mask other specific benign pathologies but does not commonly mask cancer.
Pediatric CD56+ Anaplastic Large Cell Lymphoma: A Review of the Literature
Authors: Dunphy Cherie H. , DeMello Daphne E. , Gale Gordon B. 
Published: February 2021

Abstract
Context.—Anaplastic large cell lymphomas (ALCLs) are a heterogeneous group of CD30+ large cell lymphomas that, according to the World Health Organization classification, are defined as being of T-cell origin, based on immunophenotype, and/or the finding of a T-cell gene rearrangement by molecular studies. Most cases express cytotoxic granule-associated proteins. Relatively recent data have suggested that some T-cell ALCLs are derived from cytolytic CD4+ cells, γδ T cells, or natural killer–like (CD56+ or CD57+) T cells. We encountered a pediatric case of CD56+, anaplastic lymphoma kinase-positive ALCL of apparent natural killer–like T-cell origin (showing positivity for CD2, cytoplasmic CD3, surface CD3 partial positivity, CD7, CD8, CD56, TIA-1, and granzyme B). The patient had initial lymph node and multiple sites of cutaneous involvement and an aggressive clinical course with multiple recurrences after varying periods of complete remission.
Objective.—To review the current pediatric literature regarding the incidence, differential diagnosis, and clinical course of such cases.
Data Sources.—Relevant articles indexed in PubMed (National Library of Medicine) between 1975 and 2006.
Conclusions.—Our review did not confirm a uniformly aggressive clinical course in pediatric cases of CD56+ ALCLs. Such cases suggest the usefulness of the analysis of CD56-positivity in additional cases of ALCL in an attempt to accrue additional information on this condition. Future accrual of such cases may address whether such cases should be treated more aggressively or with possible targeted therapeutic regimens.
Birt-Hogg-Dubé Syndrome: Clinicopathologic Findings and Genetic Alterations
Authors: Adley Brian P. , Smith Norm D. , Nayar Ritu , Yang Ximing J. 
Published: February 2021

Abstract
Context.—Birt-Hogg-Dubé (BHD) syndrome is a rare clinicopathologic condition transmitted in an autosomal dominant fashion. This complex entity is characterized by cutaneous fibrofolliculomas, kidney tumors, pulmonary cysts, and spontaneous pneumothorax. Recently, the gene possibly responsible for the clinical manifestations of BHD syndrome has been cloned and characterized. The few reviews of BHD syndrome found in the English literature mostly focus on the skin lesions or genetics, with limited information on other pathologic changes, particularly the kidney lesions.
Objective.—To review the literature on this subject with a special emphasis on BHD syndrome-associated renal pathology as well as recent advances in molecular genetic discovery of the BHD syndrome.
Data Sources.—We used all data available after performing a literature search using MEDLINE and searching under the headings “Birt-Hogg-Dubé,” “hybrid oncocytic tumors,” and “folliculin.”
Conclusions.—The presence of BHD syndrome should be investigated in any patient with multiple bilateral kidney tumors, especially if the predominant histologic type is chromophobe renal cell carcinoma or the so-called hybrid oncocytic tumor. The genetic alteration for BHD syndrome has been mapped to chromosome 17p12q11, and the gene in this region has been cloned and believed to be responsible for the BHD syndrome. The function of the BHD product, called folliculin, is still unknown, although it is speculated to be a tumor suppressor gene. Numerous mutations have been described in the BHD gene. Studies are ongoing to determine the relationship between the BHD gene and development of sporadic renal cell carcinoma and other lesions.
Radiation-Associated Extraskeletal Osteosarcoma of the Chest Wall
Authors: Orta Lurmag , Suprun Ulana , Goldfarb Alisan , Bleiweiss Ira , Jaffer Shabnam 
Published: February 2021

Abstract
Radiation-associated sarcoma is a rare but potential complication of radiation therapy. Most reported cases of osteosarcoma of the chest wall following radiation therapy for breast cancer arise from the chest wall skeletal structures. In contrast, few cases of extraskeletal osteosarcomas have been reported. We report a rare example of an extraskeletal osteosarcoma involving the pectoralis major muscle occurring after radiation therapy for breast cancer. Extraskeletal osteosarcomas are rare soft tissue tumors with a high rate of local recurrence and a poor prognosis.
Solitary Fibrous Tumor of the Larynx: A Case Report and Review of the Literature
Authors: Dotto Jorge E. , Ahrens William , Lesnik David J. , Kowalski Diane , Sasaki Clarence , Flynn Stuart 
Published: February 2021

Abstract
Solitary fibrous tumors are relatively rare mesenchymal neoplasms that were originally described as pleural- or peritoneal-based lesions. Although they were considered a form of mesothelioma, subsequent investigation failed to reveal mesothelial differentiation. Characterization of their histologic and immunohistochemical features, as well as identification in a multitude of nonmesothelial-based locations has further served to distinguish these lesions from the more diffuse and aggressive mesothelioma. Reports of solitary fibrous tumor in the larynx are extremely rare. We report a case of solitary fibrous tumor of the larynx in a 38-year-old man.
Key Issues in Reporting Common Cancer Specimens: Problems in Pathologic Staging of Colon Cancer
Authors: Compton Carolyn C. 
Published: February 2021

Abstract
Context.—Standardized pathologic assessment is a quality measure for cancer care.
Objective.—Pathologic staging parameters and the clinically important stage-independent pathologic factors that pathologists find most problematic to evaluate in colorectal cancer resection specimens are reviewed. The objective of this review is to provide practical guidance for the practicing surgical pathologist.
Data Sources.—Published literature related to the TNM staging system for colorectal cancer of the American Joint Committee on Cancer and the International Union Against Cancer and to stage-independent tissue-based prognostic factor evaluation was included in the review.
Study Selection, Data Extraction, and Synthesis.—Published guidelines from authoritative sources and published peer-reviewed data related to colorectal cancer staging and pathologic prognostic factor assessment were included for consideration. The general and site-specific rules of application of the American Joint Committee on Cancer and International Union Against Cancer TNM staging system for the colorectum and the protocol for evaluation of colorectal cancer resection specimens of the Cancer Committee of the College of American Pathologists served as the basis for discussion and amplified with practical advice on specific application.
Conclusions.—Standardization of pathologic evaluation of colorectal cancer resection specimens is essential for optimal patient care and is aided by the use of data-driven guidelines that are easily understood and consistently applied.
The Value of Monitoring Frozen Section–Permanent Section Correlation Data Over Time
Authors: Raab Stephen S. , Tworek Joseph A. , Souers Rhona , Zarbo Richard J. 
Published: February 2021

Abstract
Context.—The effectiveness of the long-term monitoring of errors detected by frozen section–permanent section correlation is unknown.
Objective.—To determine factors important in laboratory improvement in frozen section–permanent section discordant and deferral rates by participation in a multi-institutional continuous quality improvement program.
Design.—Participants in the College of American Pathologists Q-Tracks program self-reported the number of anatomic pathology frozen–permanent section discordant and deferred cases in their laboratories by prospectively performing secondary review of intraoperative consultations. Laboratories participated in the program for 1 to 5 years and reported their data every quarter. We calculated mean and median discordant and deferred case frequencies and used mixed linear modeling to determine if length of participation in the program was associated with improved performance.
Participants.—One hundred seventy-four laboratories self-reported data.
Main Outcome Measures.—Mean frozen–permanent section discordant and deferred diagnostic frequencies and changes in these frequencies over time were measured.
Results.—The mean and median frozen–permanent section discordant frequencies were 1.36% and 0.70%, respectively. The mean and median deferred diagnostic frequencies were 2.35% and 1.20%, respectively. Longer participation in the Q-Tracks program was significantly associated (P = .04) with lower discordant frequencies; 4- or 5-year participation showed a decrease in discordant frequency of 0.99%, whereas 1-year participation showed a decrease in discordant frequency of 0.84%. Longer participation in the Q-Tracks monitor was associated with lower microscopic sampling frequencies for discordant diagnoses (P = .04). Increased length of participation in the Q-Tracks program was significantly associated (P = .04) with lower deferred diagnostic frequencies.
Conclusions.—Long-term monitoring of frozen–permanent section correlation is associated with sustained improvement in performance.
Expression of Transforming Growth Factor β1, β2, and β3 in Chronic, Cancer-Associated, Obstructive Pancreatitis
Authors: Fukumura Yuki , Kumasaka Toshio , Mitani Keiko , Karita Kanae , Suda Koichi 
Published: February 2021

Abstract
Context.—Myofibroblasts are considered to play central roles in pancreatic fibrosis. The potent fibrogenic capacities of transforming growth factor βs (TGF-βs) have been emphasized in vitro and in animal studies. However, the roles of TGF-βs in human chronic pancreatitis have not been fully clarified.
Objective.—To investigate whether expressions of TGF-βs are related to myofibroblast distribution in chronic, cancer-associated, obstructive pancreatitis (COP).
Design.—Histopathologic studies using hematoxylin-eosin and Elastica-Masson trichrome and immunohistochemical studies using antibodies against α-smooth muscle actin (SMA); CD68; TGF-β1, -β2, and -β3; and TGF-β soluble receptor type II were performed in 19 COP cases and 6 controls. By classifying COP tissues into 3 fibrosis phases by the amount of collagen deposits, immunoreactivities for TGF-βs, histopathologic changes, and myofibroblast distribution were examined for each fibrosis phase.
Results.—Six cases were categorized in the early stage of fibrosis, 8 in the intermediate stage, and 5 in the advanced stage. Immunoreactivities for all 3 isoforms of TGF-β were observed in occasional myofibroblasts. In the early and intermediate stages, TGF-β1–expressing macrophages and neutrophils were distributed in the midst of myofibroblasts. TGF-β2 and TGF-β3 expressions were observed in ductal structures, sometimes even in sites where no or few myofibroblasts were seen. TGF-β soluble receptor type II was immunoreactive for myofibroblasts, endothelium, and ductal structures.
Conclusions.—All 3 isoforms of TGF-βs may contribute to fibrosis in COP. Macrophages and neutrophils may be sources of fibrogenic TGF-β1. Infiltration of these cells appears to play an important role in the progression of COP fibrosis.
Neutrophil Volume Distribution Width: A New Automated Hematologic Parameter for Acute Infection
Authors: Chaves Fernando , Tierno Bethany , Xu Dongsheng 
Published: February 2021

Abstract
Context.—The number of band forms and immature neutrophils increases during acute bacterial infection. However, the determination of band counts and other neutrophil morphologic changes, such as the presence of toxic granulation, toxic vacuolization, and Dohle bodies in the cytoplasm, is labor intensive and time consuming, as it requires manual examination by an experienced medical technologist.
Objective.—To investigate the value of the neutrophil volume distribution width (NDW), generated by VCS technology of the Coulter LH 750 hematology analyzer, as an additional predictor of acute infection.
Design.—Total white blood cell count, percentage of neutrophils, and NDW data from 70 patients with positive blood cultures for bacteria and from 35 age-matched control subjects were retrospectively analyzed.
Results.—A significant increase in the NDW was observed in the bacteremic patients compared with the controls (24.7 ± 4.5 vs 19.0 ± 1.5; P &lt; .001). Such increase was observed even in patients with white blood cell counts less than 11 000/μL (23.0 ± 5.6 vs 19.0 ± 1.5; P &lt; .001) or with percentages of neutrophils less than 85% (24.0 ± 4.9 vs 19.0 ± 1.5; P &lt; .001). The more dramatic increases were seen in patients with leukocytosis (25.7 ± 3.2, P &lt; .001) or with neutrophilia (25.9 ± 3.4, P &lt; .001). Using an NDW cutoff of 23, a 100% specificity and a 69% sensitivity were achieved.
Conclusions.—As a quantitative parameter, the NDW has potential for use as an additional indicator for diagnosing acute infection.
Postirradiation Osteosarcoma of the Mandible With Heterologous Differentiation
Authors: Seethala Raja R. , Sturgis Erich M. , Raymond A. Kevin , Deavers Michael T. 
Published: February 2021

Abstract
Heterologous differentiation in osteosarcoma is rare, with only 17 cases previously described in the literature. We report a case of a mandibular osteoblastic osteosarcoma with rhabdomyosarcomatous differentiation in a 45-year-old man who had a history of Hodgkin lymphoma that was treated with chemotherapy and radiation. Radiographs showed a destructive osteoblastic tumor of the mandible that was proven by biopsy to be osteosarcoma. After the patient underwent neoadjuvant chemotherapy, the tumor was resected. It contained a high-grade osteosarcoma composed of osteoblastic and chondroblastic elements that had no definitive response to therapy. Within the center of the lesion was a discrete focus of pleomorphic cells with rhabdomyosarcomatous differentiation that was confirmed by immunohistochemical stains for desmin, myogenin, and myogenic differentiation antigen 1. The patient received additional chemotherapy and radiation therapy but developed lung, brain, and spinal metastases and died 7 months after surgery. To our knowledge, this is the first report of osteosarcoma of the mandible with heterologous differentiation.
Asthma: Pathology and Pathophysiology
Authors: Barrios Roberto J. , Kheradmand Farrah , Batts La Keisha , Corry David B. 
Published: February 2021

AbstractContext.—Asthma has been defined as a chronic inflammatory disorder of the airways that is associated with recruitment of inflammatory cells and the clinical development of wheezing, shortness of breath, chest tightness, and cough. Asthma is a major public health issue. It affects 5% of the United States population and accounts for 2 million emergency department visits, 470 000 hospitalizations, and 4500 deaths annually.Objective.—To review the pathophysiology and characteristic pathologic patterns of this disease and discuss the possible mechanisms of production of the lesions.Data Sources.—We searched the literature using MEDLINE and OVID. We also searched related conference abstracts and bibliographies of selected studies.Conclusions.—There has been a significant evolution in our understanding of asthma. Specific pathways and mechanisms in recent years have been studied; however, numerous mediators and cell receptors have raised new questions that remain to be answered.