bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glioblastomas in the Older Old
Authors: Kleinschmidt-DeMasters B. K. , Lillehei K. O. , Varella-Garcia M. 
Published: February 2021

Abstract
Context.—Recent studies have identified fundamental biological differences in the effects of epidermal growth factor receptor (EGFR) amplification on survival in older versus younger patients with glioblastoma multiforme (GBM). Cell cycle labeling indices have also been found to be inordinately high in older GBM patients and may contribute to the known adverse prognosis in this cohort. However, testing has not been conducted on significant numbers of patients of very advanced age, in whom these features might be expected to emerge as even more significant factors.
Objective.—To assess EGFR amplification status and MIB-1 indices in patients with GBM who are older than 75 years.
Design.—We identified 20 patients (female-male ratio, 11:9; 11 aged 75–79 years and 9 aged 80–87 years) and studied tumor tissue samples with immunohistochemistry for cell cycle labeling index and by fluorescence in situ hybridization for EGFR amplification. Survival data were obtained from the Colorado Tumor Registry.
Results.—Mean MIB-1 index was high (24.8%), but individual indices did not correlate with survival. EGFR amplification was detected in 25% of cases, with gain of chromosome 7 in all but one of the remaining patients. Ninety-five percent of patients manifested EGFR amplification and/or polysomy of chromosome 7. Heterogeneity was found within a given tumor, with 10% to 60% of cells showing gain of chromosome 7. Overall patient survival was poor (mean, 4.6 months), but was significantly longer in those with EGFR gene amplification (mean, 8.3 months; median, 10.5 months) versus those without (mean, 3.2 months; median, 2.0 months) (P = .04).
Conclusion.—The presence of EGFR amplification is a significant predictor of survival time in older old patients.
Hematologic Malignancies With Primary Retroperitoneal Presentation: Clinicopathologic Study of 32 Cases
Authors: Chen Lei Lei , Kuriakose Philip , Hawley Robert C. , Janakiraman Nalini , Maeda Koichi 
Published: February 2021

AbstractContext.—The retroperitoneum is an uncommon location for primary lymphomatous involvement. Initial presentation of disease in this site (primary retroperitoneal lymphoma) is considered to be rare. Because of the uncommon anatomic location, the diagnosis and subsequent management of these patients tend to be difficult for both pathologists and clinicians.Objective.—This report describes our experience during a period of 6 years 4 months with patients with hematologic malignancies primarily presenting in the retroperitoneum.Design.—A retrospective search of our medical records generated 32 patients who presented initially with abdominal pain or discomfort as their predominant symptom and who were found by imaging studies to have retroperitoneal mass or masses. All the histopathology slides were reviewed and classified based on the World Health Organization classification.Results.—There were 13 male and 19 female patients. Tumor types included diffuse large B-cell lymphoma (n = 12); grade 1 follicular lymphoma (n = 4); grade 3 follicular lymphoma (n = 1); B chronic lymphocytic leukemia/small lymphocytic lymphoma (n = 2); multiple myeloma (n = 1); mixed-cellularity Hodgkin lymphoma (n = 1); nodular sclerosis Hodgkin lymphoma (n = 1); aggressive B-cell lymphoma (n = 4); low-grade B-cell lymphoma (n = 4); lymphoblastic lymphoma, null cell type (n = 1); and precursor B-lymphoblastic lymphoma/leukemia (n = 1). More than half of the cases (17/32) were diagnosed on needle biopsy with immunophenotyping.Conclusions.—Although open lymph node biopsy is a preferred method for diagnosis, needle biopsy plays a significant role in this setting, and, coupled with other information such as flow cytometry and immunohistochemistry, it is considered a practical and reliable method.
Pulmonary Adenocarcinomas Associated With Rheumatoid Nodules: A Case Report and Review of the Literature
Authors: Baruch Amy C. , Steinbronn Karen , Sobonya Richard 
Published: February 2021

Abstract
Necrobiotic lung nodules and primary lung carcinoma both occur with some frequency in patients with rheumatoid arthritis; however, few reports exist of a primary lung carcinoma occurring within a rheumatoid nodule. We report a case of a 62-year-old woman with multiple pulmonary nodules discovered incidentally by computed tomography. Although 2 of the lesions were composed solely of necrotizing granulomas, 2 additional lesions contained malignant glands at the periphery of necrobiotic nodules. Immunohistochemical staining supported the diagnosis of both tumors as primary lung carcinomas. Our literature search revealed only 2 other reported cases of adenocarcinoma occurring in association with a rheumatoid nodule; these cases, as well as the association between rheumatoid disease and malignancy, are briefly reviewed.
Myocarditis Temporally Related to the Use of Gefitinib (Iressa)
Authors: Truell Jeff S. , Fishbein Michael C. , Figlin Robert 
Published: February 2021

Abstract
Gefitinib is a new drug that was approved by the US Food and Drug Administration in May 2003 for non–small cell cancer of the lung refractory to first- and second-line therapy. It is regarded as a rather safe drug with common adverse effects that include nausea, vomiting, diarrhea, rash, acne, and dry skin. However, it was reported in Japan to be associated with interstitial pneumonitis (2%–3% of subjects), presumably as a manifestation of a hypersensitivity reaction. The Food and Drug Administration studied this in US patients and found only a 0.3% occurrence and a slightly less than 0.1% mortality due to interstitial pneumonitis. To our knowledge, there has not been an association with fulminant myocarditis or acute myocarditis. We report the case of a 71-year-old man who died as a result of fulminant myocarditis 1 week after starting to take this new class of agent, gefitinib. On the basis of his medical history and our findings, we feel it necessary to consider hypersensitivity myocarditis related to gefitinib the probable cause of death.
Fine-Needle Aspiration Diagnosis of Angiosarcoma of the Spleen: A Case Report and Review of the Literature
Authors: Delacruz Victor , Jorda Merce , Gomez-Fernandez Carmen , Benedetto Pasquale , Ganjei Parvin 
Published: February 2021

Abstract
Primary angiosarcoma of the spleen is a very rare neoplasm with a poor prognosis. The definitive diagnosis is usually based on the histologic evaluation of the splenectomy specimen. We describe a case of angiosarcoma diagnosed by fine-needle aspiration cytology prior to splenectomy. A 69-year-old white woman presented with heterogeneous lesions in the spleen during a follow-up computed tomographic scan for a history of liposarcoma of the right buttock. A malignant endothelial neoplasm was diagnosed by fine-needle aspiration cytology using immunocytochemistry, and a splenectomy confirmed the presence of angiosarcoma. To our knowledge, this is the first well-documented and confirmed case of primary angiosarcoma of the spleen diagnosed by fine-needle aspiration cytology. This report emphasizes the value of fine-needle aspiration cytology as an important diagnostic tool in splenic neoplasms.
Intratesticular Mucinous Cystadenoma: Immunohistochemical Comparison With Ovarian and Colonic Tissue
Authors: Alasio Teresa M. , Borin James , Taylor Kevia , Bar-Chama Natan , Unger Pamela D. 
Published: February 2021

Abstract
We report a case of a primary intratesticular mucinous cystadenoma in an asymptomatic 39-year-old man. The mass was found incidentally during a consultation for infertility. Pathologic examination of the orchiectomy specimen revealed a unilocular cyst lined with bland mucinous epithelium and mucinous extravasation, consistent with a diagnosis of mucinous cystadenoma. Foci of bone were also found in association with extensive chronic inflammation. Immunohistochemical stains performed showed immunoreactivity for cytokeratin 7, and nonreactivity for cytokeratin 20, CA125, chromogranin, and synaptophysin. The immunohistochemical staining patterns of the present case are compared with those of known mucinous cystadenomas of the ovary and nonneoplastic colonic mucosa. The histogenesis of this entity is discussed in light of the literature and the immunohistochemical findings in this rare case.
Detection of t(14;18)(q32;q21) in B-Cell Chronic Lymphocytic Leukemia
Authors: Kern Wolfgang , Haferlach Torsten , Schnittger Susanne , Schoch Claudia 
Published: February 2021

Abstract
Cytomorphologic testing and multiparameter flow cytometry are the mainstays in diagnosing B-cell chronic lymphocytic leukemia, whereas fluorescence in situ hybridization that targets the translocation t(14;18)(q32;q21) often is used to identify follicular lymphoma. Therapy is highly diverse between both diseases. We describe a case with cytomorphologically and immunologically proven B-cell chronic lymphocytic leukemia in which t(14;18)(q32;q21) was found.
Three-Dimensional Virtual Microscopy of Colorectal Biopsies
Authors: Wu Mark Li-cheng , Varga Viktor Sebestyen , Kamaras Viktor , Ficsor Levente , Tagscherer Attila , Tulassay Zsolt , Molnar Bela 
Published: February 2021

Abstract
Conventional optical microscopy of specimens from colorectal biopsies commonly produces diagnostic errors due to incomplete sampling or poor orientation. Obtaining additional sections or re-embedding may help avoid these errors, but can prolong turnaround time. We describe new technology, which incorporates exhaustive sectioning, 3-dimensional reconstruction, and virtual microscopy, that may eliminate these problems by enabling pathologists to rapidly examine entire specimens and convert poorly oriented mucosa to well-oriented mucosa.
An Unusual Case of Peripheral T-Cell Lymphoma With CD56 Positivity and Angiocentric, Angiodestructive Morphology Arising in the Ileum
Authors: Frank Matthew C. , Bono Erika , Sun Tsieh 
Published: February 2021

Abstract
Natural killer cell and cytotoxic T-cell lymphomas are frequently difficult to distinguish because they share many common features, and yet it is important to make an accurate diagnosis because their prognoses differ. We report an unusual case of a white man with a CD56-positive T-cell lymphoma in the ileum. The histologic pattern was characterized by angioinvasion and angiodestruction. Immunohistochemical staining showed positive reactions to CD3, CD8, CD43, CD45RO, CD56, and T-cell intracellular antigen-1, but negative reactions to CD4, CD5, CD20, CD23, and CD57. Epstein-Barr virus (EBV) was not detected by EBV–latent membrane protein staining and EBV polymerase chain reaction technique. The T-cell receptor γ chain gene was rearranged. According to the World Health Organization classification, the absence of EBV excludes the diagnosis of extranodal natural killer/T-cell lymphoma, nasal type. However, the association of EBV with this lymphoma in white patients is not clear. Therefore, absence of EBV alone does not necessarily exclude nasal-type natural killer/T-cell lymphoma, particularly because the histologic pattern in this case is highly characteristic of this tumor.
Immunohistochemical Expression of Cyclooxygenase 2 in Follicular Carcinomas of the Thyroid
Authors: Haynik Denise M. , Prayson Richard A. 
Published: February 2021

Abstract
Context.—Cyclooxygenase 2 (COX-2) has been shown to be up-regulated and/or overexpressed in a variety of human neoplasms. However, limited data exist on the role of COX-2 in follicular carcinomas of the thyroid. Studies in this area are potentially significant, since therapeutic agents that inhibit COX-2 are currently available and could play a role in treatment.
Design.—A retrospective clinicopathologic review with COX-2 immunohistochemical staining of 34 follicular carcinomas and 7 follicular adenomas with incomplete capsular penetration was performed.
Results.—The study included 41 patients (25 women; mean age, 50.9 years). All patients underwent gross total resection of the neoplasm. Fifteen carcinoma patients received adjuvant radiotherapy. Seven patients with follicular carcinomas developed recurrent disease: 3 patients were alive (mean follow-up, 10.1 years) and 4 patients died of metastatic disease (mean follow-up, 3.5 years). All remaining patients were disease free (mean follow-up, 5.9 years). Only 1 follicular adenoma with incomplete capsular penetration recurred (patient alive at 9 years). The remaining patients were disease free (mean follow-up, 4.9 years). The COX-2 staining was positive in 11 tumors (9 of 34 follicular carcinomas, 2 of 7 follicular adenomas with incomplete capsular penetration). A greater percentage of recurrences (36% COX-2 positive vs 13% COX-2 negative) and fatal tumors (18% COX-2 positive vs 7% COX-2 negative) occurred in patients who had COX-2–positive staining neoplasms.
Conclusion.—Only a few follicular carcinomas (26%) and follicular adenomas with incomplete capsular penetration (29%) express COX-2 by immunohistochemical analysis. The data suggest that such expression of COX-2 may correlate with increased tumor recurrence and death; however, studies with larger numbers of patients will be needed to establish this.
Intracranial Extension of Acinic Cell Carcinoma of the Parotid Gland
Authors: Spencer M. Loreto , Galvao Neto Antonio , Fuller Gregory N. , Luna Mario A. 
Published: February 2021

AbstractWe report the case of a 47-year-old woman who experienced multiple recurrences of acinic cell carcinoma, lung metastasis, and intracranial extension of the tumor during a 32-year period. In this report, the clinical, microscopic, histochemical, and electron microscopy features of this acinic cell carcinoma are described, and a review of published information about this neoplasm is presented.
Allergic Bronchopulmonary Aspergillosis: An Overview
Authors: Zander Dani S. 
Published: February 2021

AbstractThis article provides an overview of the major pathologic manifestations of allergic bronchopulmonary aspergillosis; patient characteristics; clinical, radiographic, and laboratory features of the disease; and current knowledge about its pathogenesis. Although allergic bronchopulmonary aspergillosis is an infrequent complication of asthma or cystic fibrosis, recognition of this disorder is important to avoid progression of bronchiectasis and lung parenchymal damage. Clinical, laboratory, and radiographic criteria allow for diagnosis of most cases, but the pathologist may encounter clinically unsuspected or atypical cases that require morphologic confirmation.
Coccidioidomycosis of the Tongue
Authors: Rodriguez Rafael A. , Konia Thomas 
Published: February 2021

Abstract
A Spanish-speaking farm worker with type 2 diabetes mellitus presented to our institution with an ulcerating tongue lesion. He was initially evaluated for possible squamous cell carcinoma; however, histologic examination revealed coccidioidomycosis. Coccidioidal titers were elevated and consistent with disseminated disease, although the patient had no systemic symptoms and clinical evaluation was negative. He was ultimately treated with intravenous and oral antifungal medication, which was followed by improvement of his tongue lesion.
Nodular Mucinosis of the Breast: A Case Report With Pathologic, Ultrasonographic, and Clinical Findings and Review of the Literature
Authors: Sanati Souzan , Leonard Morton , Khamapirad Tuenchit , Eltorky Mahmoud A. 
Published: February 2021

AbstractNodular mucinosis is an extremely rare breast lesion. This benign mass usually presents clinically as a poorly circumscribed, subareolar, myxoid mass in young female patients. We report a case of this rare breast lesion and discuss its clinical, radiologic, and histopathologic features. A 21-year-old white woman presented with a mass in the left breast of 6 months' duration. She had never been pregnant or had any history of breast feeding, surgery, trauma, or use of exogenous hormones or a family history of breast cancer. Clinical breast examination demonstrated a 1 cm “rubbery” mass directly under and continuous with the left nipple. The skin that covered the mass had an edematous and irregular appearance without erythema or drainage from the nipple. Ultrasonography demonstrated a 1-cm, nonintraductal, circumscribed, homogeneous, isoechoic mass that was continuous or part of the base of the left nipple. The mass was smooth, with a thin echogenic rim. Doppler flow showed some vascularity. These findings suggested a benign breast lesion, including a fibroadenoma or nipple adenoma. Despite reassurance, the patient desired excision of the lesion. Gross examination revealed a nodular, rubbery-firm, ovoid, pink, polypoid mass that measured 1.5 × 0.9 × 0.8 cm. Microscopic examination showed a well-circumscribed tumor with a nodular appearance, which consisted of an accumulation of pink myxoid tissue and contained spindle cells with bland-appearing nuclei, no mitosis, and mild cellularity. The pink myxoid tissue was stained with Hale colloidal iron and Alcian blue. The Alcian blue stain was removed by pretreatment with hyaluronidase. The spindle cells stained with vimentin and smooth muscle actin; however, they did not express smooth muscle myosin or cytokeratin. This report presents and discusses the pathologic, ultrasonographic, and clinical findings of this rare entity.
Cytologic Identification of Reinke Crystalloids in Scrapings and Imprints of Fresh Testicular Tumors: A Simple and Rapid Technique for Intraoperative Use
Authors: Hribar Kambridge P. , Warner Nancy E. , Sherrod Andy E. 
Published: February 2021

Abstract
Although not required for the diagnosis, crystalloids of Reinke are pathognomonic for Leydig cell tumor. However, conventional frozen section rarely reveals their presence. A method of rapid identification of crystalloids of Reinke could improve the intraoperative diagnosis. We tested the efficacy of touch imprints and scrape smears for the identification of crystalloids in 2 cases of Leydig cell tumor of the testis. Intraoperative smears of the tumors yielded abundant crystals. Scrape cytologic testing was the better method. We speculate that the process of scraping, and to a lesser extent touch imprinting, disrupts the cytoplasm of the Leydig cells and releases the crystalloids. We conclude that cytologic testing is an effective method of identifying crystalloids of Reinke in Leydig cell tumors of the testis.
Papillary Thyroid Carcinoma: An Overview
Authors: Al-Brahim Nabeel , Asa Sylvia L. 
Published: February 2021

Abstract
Papillary carcinoma is the most common malignant tumor of the thyroid. It has a variable macroscopic appearance that differs according to the variant microscopic morphologies and the presence or absence of degenerative changes. The histologic variants can be challenging to the pathologist, and some are of clinical significance because of prognostic implications. In this short review, we discuss an approach to papillary carcinoma, the diagnostic dilemmas and controversies, and the ancillary studies that are helpful in resolving them, including immunohistochemistry and molecular studies.
Polycythemia Vera: New Clinicopathologic Perspectives
Authors: Cao Ming , Olsen Randall J. , Zu Youli 
Published: February 2021

Abstract
Context.—Polycythemia vera (PV) is a clonal myeloproliferative disease characterized by an erythroid dominant trilineage proliferation of hematopoietic precursor cells. Classified as a chronic myeloproliferative disease, PV represents a histopathologic spectrum of 2 recognized stages, the polycythemic and postpolycythemic phase. The clinical manifestations of hemorrhage, thrombosis, and increased red cell mass are directly related to primary bone marrow dysfunction. Prognosis is strongly associated with thrombosis risk and disease progression; thus, treatment is directed toward minimizing coagulopathic complications and preventing leukemic transformation. Recently, a specific point mutation in the Janus kinase 2 (JAK2) gene was described in a majority of PV patients. The potential diagnostic and/or prognostic value of JAK2V617F is discussed.
Objective.—To review important developments from the recent and historical literature. Modern diagnostic criteria and emerging molecular findings are emphasized.
Data Sources.—A comprehensive review was performed of the relevant literature indexed in PubMed (National Library of Medicine) and referenced medical texts.
Conclusions.—Modified clinical, histologic, and laboratory criteria have clarified the diagnosis of PV. Also, continuing studies on the recently discovered JAK2V617F gene mutation may significantly improve our understanding of PV pathogenesis and facilitate its medical management.
Chronic Idiopathic Myelofibrosis: Clinicopathologic Features, Pathogenesis, and Prognosis
Authors: Ahmed Arsalan , Chang Chung-Che(Jeff) 
Published: February 2021

Abstract
Context.—Chronic idiopathic myelofibrosis (CIMF) is a clonal myeloproliferative disease characterized by panmyelosis with intact maturation, progressive bone marrow fibrosis, and multiorgan extramedullary hematopoiesis.
Objective.—This review article aims to summarize the recent updates regarding the clinicopathologic features, molecular pathogenesis, cytogenetic abnormalities, diagnostic criteria, new diagnostic ancillary tests, and prognostic factors of CIMF.
Data Sources.—Important relevant articles indexed in PubMed/MEDLINE (National Library of Medicine) through the end of 2005 and referenced medical texts.
Conclusions.—Because CIMF has a variety of clinical presentations, diagnosis may be challenging; the prefibrotic stage of CIMF has always been a challenging disease for pathologists to diagnose accurately. The recently proposed European Clinical and Pathological criteria can be helpful in the diagnosis of CIMF, especially in its prefibrotic stage. The enumeration of CD34-positive cells in the peripheral blood and the presence of circulating endothelial progenitor cells are the new important ancillary tests for the diagnosis of a small subset of patients with CIMF with atypical presentation. The recent discovery of the new mutation affecting the Janus tyrosine kinase 2 (JAK2V617F), more frequently observed in patients with polycythemia vera, is seen in approximately 35% to 57% of patients with CIMF. This mutation can serve as another diagnostic tool. Important factors affecting prognosis in CIMF are anemia, age of the patient, white blood cell count, degree of fibrosis, and number of blasts in the peripheral blood.