bluuebunny/crossref_metadata_2025_split huggingface dataset:
Case Review: Gastric-Type Adenocarcinoma of the Uterine Cervix and Precursor Lesions
Authors: Park Kay J. 
Published: September 2023

Abstract
A case of gastric-type endocervical adenocarcinoma that was originally diagnosed as possibly of endometrial or pancreatobiliary/upper gastrointestinal tract origin is reported. This report reviews the pertinent medical literature, differential diagnoses, etiology, and pitfalls of this disease, as well as use of immunohistochemistry and human papillomavirus (HPV) testing in establishing the diagnosis. The morphology of these tumors can range from extremely well differentiated (minimal deviation adenocarcinoma) to poorly differentiated, and therefore, the differential diagnosis can be quite varied. On one end of the spectrum, the tumor can be difficult to differentiate from benign endocervical glands, whereas at the other end, it can be difficult to determine the origin of the tumor. Because these tumors are not associated with HPV infection, the use of ancillary studies such as p16 can be misleading, and these may not be detected on standard Papanicolaou cytology with HPV screening. Molecular testing was also performed in this case with a TP53 hotpot mutation detected, along with mutations in ELF3 and PTPRS.
Metastatic Adenocarcinoma to the Uterine Cervix Versus Primary Cervical Adenocarcinoma
Authors: Djordjevic Bojana , Busca Aurelia , Parra-Herran Carlos 
Published: September 2023

Abstract
Adenocarcinoma metastases to the cervix can originate from the endometrium, the upper müllerian tract, or from extramüllerian sites such as the gastrointestinal and pancreatobiliary tract, bladder, breast, lung, or even the salivary gland. In some cases, the metastatic lesions have signet-ring morphology, infiltrative pattern, and/or extensive lymphovascular spread. In others, however, the distinction between a primary cervical lesion and a metastasis to the cervix is more challenging because metastases may mimic endocervical adenocarcinoma in situ by colonizing the native endocervical mucosa through intraepithelial spread. Careful morphologic interpretation, combined with immunohistochemistry, human papillomavirus molecular testing, and clinical correlation, is required in order to arrive at the correct diagnosis.
Accurate Assessment of Histologic Parameters That Impact Lung Cancer Staging: Implications for the American Joint Committee on Cancer Eighth Edition TNM Classification
Authors: Butnor Kelly J. 
Published: September 2023

Abstract
The eighth edition of the American Joint Committee on Cancer TNM Classification represents a paradigm shift in lung cancer staging. Some staging parameters, such as the visceral pleural invasion, have not changed. Others are a significant departure from the prior edition, including tumor size used to assign T category, which for the first time is based solely on the invasive component, excluding any lepidic component. Understanding how to assess these histologic parameters will allow pathologists to contribute to the improved care of lung cancer patients through accurate pathologic staging.
Pathologic Staging of Colorectal Adenocarcinoma: Changes and Updates in the American Joint Committee on Cancer (AJCC) 8th Edition and College of American Pathologists' Cancer Protocol
Authors: Kakar Sanjay 
Published: September 2023

Abstract
The eighth edition of the AJCC Cancer Staging Manual has been published, and the new staging schemes will be applicable in 2018. The College of American Pathologists has also released an updated protocol incorporating these changes. While the overall T and N categories are similar to the seventh edition, the definitions of intramucosal adenocarcinoma, T4a category, and tumor deposits have been made more precise. The category of M1c has been created for peritoneal metastasis because of its worse outcome. In the College of American Pathologists protocol, tumor budding and venous invasion have been incorporated as recommended (optional) elements, the scoring of tumor regression has been updated, and the importance of screening for microsatellite instability/mismatch repair proteins has been emphasized. This review provides a brief description and rationale for these changes and updates.
Pure Red Cell Aplasia Due to T-Cell Large Granular Lymphocytic Leukemia After Hematopoietic Stem Cell Transplantation
Authors: Rangan Aruna , Oliveira Jennifer L. , Jevremovic Dragan , Morice William G. , Chen Dong , Shi Min 
Published: September 2023

Abstract
Although reactive polytypic large granular lymphocyte (LGL) expansions after hematopoietic stem cell transplant (HSCT) due to viral infection are common, T-cell large granular lymphocytic leukemia (T-LGLL) is extremely rare and usually clinically indolent and requires no treatment in the post-HSCT setting. In contrast, here we present a case of post-HSCT donor-derived T-LGLL that led to pure red cell aplasia with severe patient morbidity. After diagnosis, the patient received immunosuppressive treatment with a dramatic response and has been transfusion independent for more than a year. To our knowledge, this is the first case of a post-HSCT T-LGLL with a documented significant adverse clinical impact requiring and responding to therapeutic intervention. It underscores the importance of recognizing such a rare entity in posttransplant patients.
Ultrasound-Guided Fine-Needle Aspiration Practice Patterns
Authors: Heller Howard T. , Cibas Edmund S. , Kraft Adele O. , Jiang Xiaoyin “Sara” , Foo Wen-Chi , Sanchez Miguel A. , Powers Celeste N. 
Published: September 2023

Abstract
How ultrasound-guided fine-needle aspiration (USFNA) is performed in the United States varies considerably among institutions. The critical role of the cytopathologist for diagnosis is indisputable, although the degree of collaboration with other specialties and the physical setting where the procedure is performed are highly individualized, as is the degree to which the cytopathologist takes an active role in performing the biopsy. We highlight the practice patterns at 4 health centers in the United States. At 1 medical center, USFNAs are performed using a team approach: the aspiration is performed by a cytopathologist or trainee but is guided by a radiologist. In the remaining 3 medical centers, many USFNAs are performed without radiology assistance, with minor differences related to scheduling, personnel involved, and results reporting policies. All 4 medical centers report favorable patient and provider satisfaction. In conclusion, a variety of methods, all targeted to optimizing patient care and rapid diagnosis, work well and are generally well received by the physicians who refer their patients for care.
Creating Custom Phantoms for Ultrasound-Guided Fine-Needle Aspiration Biopsy Training
Authors: Jug Rachel , Jiang Xiaoyin “Sara” 
Published: September 2023

Abstract
Ultrasound-guided fine-needle aspiration (US-FNA) is superior to conventional fine-needle aspiration biopsies and when performed by cytopathologists yields higher diagnostic rates than when performed by nonpathologists. Ultrasound-guided fine-needle aspiration allows operators to perform targeted biopsies while avoiding critical nearby structures, decreasing the risk of procedural complications. Traditionally, cytopathology training programs have purchased costly commercial phantom models on which to train residents and fellows and provide opportunities for cytopathologists to practice their US-FNA technique. While phantoms are effective training tools, they are sold by several vendors at well over $1000 and have limited life spans as with continued use needle track marks obscure the ultrasound's view of practice targets. We developed and tested 2 cost-effective and easy-to-make recipes for creating your own US-FNA phantoms in-house. The first recipe features a gelatin-based phantom that can be made from ingredients available at any local grocery store. The second recipe for a silicon-based phantom is more durable but requires some ingredients that may be purchased online or at specialty costume shops. Finally, we share ideas and directions for making target lesions to be placed inside your phantoms and invite readers to harness their creativity to customize these phantom recipes to suit their practices' and trainees' needs.
Extensive Intravascular Thyroid Vein Extension in Follicular Thyroid Carcinoma: Ultrasound Clues
Authors: Kraft Adele , Prasad Uma 
Published: September 2023

Abstract
The identification of intravascular tumor thrombi in thyroid at the time of fine-needle aspiration is important as it is, by definition, a diagnosis of malignancy. While ultrasound findings of tumor thrombi in the great veins of the neck have been well described, thrombi in the thyroid veins can be very difficult to detect and have been seldom reported. This case study, with extensive thyroid vein tumor involvement, provides clues for raising the possibility of a malignant process at the time of ultrasound-guided FNA, by correlating the pathology findings with the ultrasound images.
Hyperbilirubinemia in a Hepatitis C Virus Patient After Liver Transplantation
Authors: Tondon Rashmi , Stashek Kristen M. 
Published: September 2023

Abstract
Fibrosing cholestatic hepatitis C virus is a rare, cholestatic hepatitis that can occur in the setting of immunosuppression or after transplantation in individuals with active hepatitis C infection. Its onset is heralded by hyperbilirubinemia and rapidly progresses to graft failure without treatment. It is characterized histologically by ballooning hepatocyte degeneration, bile duct proliferation, cholestasis, and perisinusoidal fibrosis. It is important to distinguish fibrosing cholestatic hepatitis from other common causes of hyperbilirubinemia in the posttransplant setting, including biliary obstruction and acute cellular rejection.
Budd-Chiari Syndrome: What Pathologists Need to Know About Hepatic Venous Outflow Obstruction
Authors: Pittman Meredith E. 
Published: September 2023

Abstract
Hepatic venous outflow obstruction, known as Budd-Chiari syndrome, is a rare but significant cause of hepatic dysfunction. Worldwide, the most common cause of hepatic venous outflow obstruction is thrombosis of the hepatic veins and/or inferior vena cava secondary to an inherited or acquired hypercoagulable state (eg, factor V Leiden deficiency). Depending on the extent and acuity of the thrombosis, patients with Budd-Chiari syndrome may present in acute liver failure or as chronic compensated cirrhosis; almost all will have the classic (but nonspecific) pairing of abdominal pain and ascites. Histologic findings in the liver also vary according to the time course and magnitude of thrombosis and can range from zone 3 congestion to established cirrhosis. The cases reported herein demonstrate 2 variations of Budd-Chiari syndrome encountered in the daily practice of pathology. The aims of this review were to examine the clinical, radiological, and histologic features of Budd-Chiari syndrome and to discuss the differential diagnosis based on the observed histologic pattern.
A Rare Case of Neonatal Intrahepatic Cholestasis Caused by Citrin Deficiency in the United States
Authors: De Michele Simona , Vittorio Jennifer M. , Thomas Tiffany , Diaz George A. , Lefkowitch Jay H. , Lagana Stephen M. 
Published: September 2023

Abstract
We describe the case of a 9-week-old female infant of Ashkenazi Jewish descent who presented with failure to thrive, vomiting, and persistent jaundice. Laboratory tests showed positive urine reducing substances as well as an abnormal amino acid profile, with increased arginine, threonine, methionine, tyrosine, lysine, and grossly elevated citrulline levels. Liver biopsy demonstrated the presence of cholestatic hepatitis with mixed steatosis and siderosis. Based on the aforementioned findings, a preliminary diagnosis of neonatal intrahepatic cholestasis caused by citrin deficiency was made. This diagnosis was later confirmed by molecular testing. Neonatal intrahepatic cholestasis caused by citrin deficiency is typically seen in infants of East Asian descent, and to the best of our knowledge, this is the first reported case in an American infant of Ashkenazi Jewish descent.
A Composite Lymphoma Consisting of a Mantle Cell Lymphoma and a Peripheral T-Cell Lymphoma: A Rare Case With Literature Review
Authors: Katsushima Hiroki , Nakajima Shinji , Takagawa Masanori , Fukuhara Noriko , Ichikawa Satoshi , Itakura Yuko , Harigae Hideo , Ichinohasama Ryo 
Published: September 2023

AbstractA composite lymphoma (CL) is defined as 2 or more morphologically and immunophenotypically distinct lymphomas or lymphoid neoplasms that occur in the same organ or tissue. Many types of CL have been described in the literature, including 52 cases of CL with a component of mantle cell lymphoma (MCL) and only 2 cases of CL consisting of MCL and T-cell lymphoma. We hereby present a case of CL consisting of MCL and peripheral T-cell lymphoma, not otherwise specified. Morphologic features and flow cytometry analysis were both instrumental in the diagnosis of CL. In addition, we reviewed 52 reported cases of CL with MCL as a component. We found that the proliferation patterns of MCL have a relationship with the other component of the CL. We also found that many patients with CL had a history of lymphoproliferative disorders including lymphomas; this was observed in 9 of 52 cases, including 5 cases of MCL and 2 cases of another component of CL. This rate (approximately 17%) is relatively high and should not be ignored.
Endometrial Stromal Sarcoma With High-Grade Morphology and a JAZF1 Gene Rearrangement Presenting as Colonic and Cardiac Metastases: A Case Report and Review of the Literature
Authors: Jenkins Taylor M. , Cooper Kumarasen , Carolina Reyes M. , Deshpande Charuhas , Staats Paul N. , Schwartz Lauren E. , Stashek Kristen M. 
Published: September 2023

Abstract
Endometrial stromal tumors are a heterogeneous group of tumors with varied histologies and molecular alterations. JAZF1 rearrangements are typically characteristic of low-grade lesions, high-grade lesions usually harbor YWHAE alterations, and undifferentiated uterine sarcomas commonly present with complex karyotypes. We report a case of an endometrial stromal sarcoma with a JAZF1 gene rearrangement by fluorescence in situ hybridization and high-grade cytology presenting as cardiac and colonic metastases, in a patient with a remote history of hysterectomy for to “leiomyomas.”
Follicular Adenoma of the Thyroid With Spindle Cell Metaplasia Mimicking Insular Thyroid Carcinoma and Lacking Thyroglobulin Expression
Authors: Burke Allen , Staats Paul 
Published: September 2023

Abstract
We report a case of a well-encapsulated thyroid adenoma with areas of spindle cell metaplasia mimicking insular or poorly differentiated growth pattern. Emphasis on overall features, especially encapsulation and lack of invasion, is critical in the evaluation of thyroid neoplasms. In this example, there was loss of thyroglobulin expression, which to date has not been reported in spindled metaplasia but was not considered diagnostically relevant in the face of low proliferative activity and lack of mitotic figures.
Nonneoplastic Mimics of Appendiceal Mucinous Neoplasms
Authors: Misdraji Joseph 
Published: September 2023

Abstract
With the widespread acceptance of the term low-grade appendiceal mucinous neoplasm (LAMN) for relatively bland mucinous tumors of the appendix with pushing invasion and a propensity to disseminate to the peritoneal cavity, there has been increasing concern among pathologists of overlooking one of these tumors when an appendix shows extrusion of mucin into the wall or onto the serosa. The increased awareness of LAMN and its histologic features has caused some benign entities to be misinterpreted as LAMN based largely on the presence of mucin extrusion and hyperplastic and reactive appendiceal mucosa. The misinterpretation of some of these mimics as LAMN can have profound clinical consequences for patients, in terms of both overtreatment and anxiety. In this review, the most common nonneoplastic mimics of LAMN are reviewed. The most common of these mimics is ruptured diverticular disease of the appendix, which is frequently mistaken for ruptured LAMN. Retention mucoceles of the appendix can also cause confusion with LAMNs. Finally, a rare but curious form of endometriosis with intestinal metaplasia that occurs largely in the cecum and appendix can histologically mimic a mucinous neoplasm of the appendix.
Gastrointestinal Stromal Tumors—A Case Report With Review and Discussion of Updates
Authors: Barbieri Andrea Lynne , Jain Dhanpat 
Published: September 2023

Abstract
There has been tremendous growth in the understanding of gastrointestinal stromal tumors in the last 2 decades, particularly with regard to molecular classification. The role of the pathologist in appropriately assessing these tumors is more important than ever.
Primary Mesothelioma of the Liver: A Case Report
Authors: Wong Serena L. , Das Gargi , Cha Charles , Klimstra David S. , Jain Dhanpat 
Published: September 2023

Abstract
Primary hepatic mesotheliomas are very rare with only a few cases reported in the literature. Here we present a 55-year-old female with an 18 cm intrahepatic epithelioid mesothelioma with cystic changes who presented with non-specific abdominal pain and no prior history of exposure to asbestos. The tumor was resected with negative margins. The tumor was composed of islands of relatively monotonous epithelioid cells with extensive cystic degeneration. The nuclei were quite bland, round to oval with frequent grooves and inconspicuous nucleoli and minimal pleomorphism. Tumor necrosis was not seen. No keratinizaton or glandular differentiation was evident. The tumor background consisted of a rich inflammatory cell infiltrate composed of lymphocytes, plasma cells and histiocytes. The tumor was positive for mesothelial markers (calretinin, WT-1 and D2–40), keratins (CK5/6, CK7, CK19) and negative for a variety of other markers to exclude adenocarcinoma and other neoplasms. The patient is well and free of disease 8 years following the surgical resection.
Gastric Epithelial Carcinogenesis: From Atrophic Gastritis, Intestinal Metaplasia, and Dysplasia to Invasive Adenocarcinoma
Authors: Bosch Dustin E. , Truong Camtu D. , Yeh Matthew M. 
Published: September 2023

AbstractAtrophic gastritis and intestinal metaplasia, often in the setting ofHelicobacter pyloriinfection, are associated with higher risk of gastric adenocarcinoma. According to the Correa model, the pathway of gastric carcinogenesis is triggered by chronic inflammation, which leads to atrophic gastritis, intestinal metaplasia, gastric dysplasia, and gastric carcinoma. Histopathologic assessment of atrophic gastritis suffers from low interobserver concordance, but staging with the Operative Link for Gastritis Assessment system effectively stratifies risk of gastric carcinoma. Intestinal metaplasia is a more highly reproducible diagnosis and can be classified with multiple systems including the Operative Link for Gastric Intestinal Metaplasia. Gastric epithelial dysplasia and invasive carcinoma are most commonly classified using the Vienna system among Western countries. The 2 tiers of dysplasia (low and high grade) are distinguished by severity of cytologic atypia, complexity of glandular architecture, loss of nuclear polarity, and degree of mitotic activity. However, grading of dysplasia on biopsy specimens suffers from high interobserver variability, as well as relatively poor correlation to Vienna system classification on subsequent resections. Intramucosal carcinoma is distinguished from high-grade dysplasia by neoplastic invasion into the lamina propria or muscularis mucosae. Grade of intraepithelial neoplasm and depth of invasive carcinoma remain central to guiding treatment decisions, while clinical approaches to surveillance and therapy continue to evolve.
Transformed Nodular Lymphocyte-Predominant Hodgkin Lymphoma: Histologic Features and Relationship to T-Cell/Histiocyte–Rich Large B-Cell Lymphoma
Authors: Alqaidy Doaa , Kallen Michael E. , Singh Zeba , Wilding Emily 
Published: September 2023

Abstract
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon variant of Hodgkin lymphoma, with a generally indolent course in low-stage presentations. Recurrences can demonstrate features of the diffuse variant, resembling T-cell/histiocyte–rich large B-cell lymphoma (THRLBCL). Transformation can additionally occur, either THRLBCL-like lesion or a diffuse large B-cell lymphoma (DLBCL). Transformation to DLBCL may be detected concurrently with NLPHL, prior to NLPHL, or years to decades later. The prognosis of such transformation is controversial, but thought to be worse than NLPHL and similar to that of de novo DLBCL. T-cell/histiocyte–rich large B-cell lymphoma–like transformation is histologically indistinguishable from primary THRLBCL, reflecting significant histologic and genetic overlap between NLPHL and THRLBCL. We present a patient with NLPHL and transformation to DLBCL at 7 years after initial diagnosis, who ultimately developed a therapy-related myeloid neoplasm. We review the histologic spectrum of transformed NLPHL, its relationship with THRLBCL, and recent developments in its molecular pathogenesis. Cases of transformation may prove valuable in understanding complex biologic relationships between a spectrum of overlapping lymphoma entities and may ultimately help refine therapy and improve prognosis.
Richter-like Pleomorphic Mantle Cell Lymphoma Composed of Epstein-Barr Virus–Positive Hodgkin-like Cells, a Diagnostic Challenge
Authors: Alvarez Jessica , Algashaamy Khaled , Tan Yaohong , Mackrides Nicolas , Peng Jing Hong , Byrnes John , Alderuccio Juan P. , Alencar Alvaro , Vega Francisco , Chapman Jennifer 
Published: September 2023

Abstract
Mantle cell lymphoma (MCL) is an aggressive non-Hodgkin lymphoma with distinctive clinicopathologic features including the presence of t(11;14)(q13;q32) in almost all cases. Histologically identifiable variants are well described. Most MCLs are the classic variant, although more aggressive variants including blastoid and pleomorphic exist. The pleomorphic variant is a morphologic subtype composed predominantly of large atypical lymphoid cells. This variant can arise de novo or occur in patients with previous history of MCL as result of disease progression and clonal evolution. Mantle cell lymphoma is characteristically Epstein-Barr virus (EBV) negative. Here, we present an extremely unusual case of pleomorphic MCL that arose in a 69-year-old man with a previous 10-year history of indolent chronic leukemia. This case was unusual and diagnostically challenging because the large and pleomorphic lymphoma cells were EBV positive and had Hodgkin-like morphologic features and only focal cyclin D1 expression. Fluorescence in situ hybridization studies confirmed the presence of the CCND1-IgH gene rearrangement. The disease was clinically aggressive, and the patient died 12 months after diagnosis. Epstein-Barr virus–associated MCL and large cell progressions of MCL are only rarely reported. The additional features we describe, including only focal expression of cyclin D1 and Hodgkin-like morphology, make this an even more unusual and therefore difficult to identify lymphoma. Importantly, this case raises the question as to whether MCL can have histopathologic progressions analogous to the well-established EBV-associated Hodgkin-like Richter transformations of chronic lymphocytic leukemia/small lymphocytic lymphoma.