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American Journal of Clinical Pathology

Lara Goldstein, Mike Wells, Craig Vincent-Lambert
Objectives: To compare standard emergency department (ED) workflow to a protocolized pathway using upfront point-of-care (POC) tests performed prior to doctor evaluation to determine if this could produce a significant reduction in treatment time. Methods: We performed a prospective, randomized, controlled trial. Patients were randomized to receive the standard of care or one of the enhanced workflow pathways with POC tests. Results: There were 1,044 patients enrolled...
June 19, 2018: American Journal of Clinical Pathology
Elizabeth P Weinzierl, Robert C Jerris, Mark D Gonzalez, Julie A Piccini, Beverly B Rogers
Objectives: Group A Streptococcus (GAS) is the most common bacterial cause of pediatric acute pharyngitis, and its quick identification is important for subsequent treatment. We sought to determine whether molecular GAS-based testing can successfully replace GAS antigen testing and subsequent culture in a pediatric urgent care center. Methods: We tested 160 patient oropharyngeal samples by a rapid antigen GAS test, the Alere i Strep A test, and throat culture in a pediatric urgent care setting and calculated basic statistical metrics...
June 19, 2018: American Journal of Clinical Pathology
Vincent Rusanganwa, Jean Bosco Gahutu, Innocent Nzabahimana, Jean Marie Vianney Ngendakabaniga, Anna-Karin Hurtig, Magnus Evander
Objectives: We investigated the quality system performance in Rwandan referral laboratories to determine their progress toward accreditation. Methods: We conducted audits across five laboratories in 2017, using the Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist. Laboratories were scored based on the World Health Organization grading scale (0-5 stars scale) and compared with earlier audits. Results: Between 2012 and 2017, only one laboratory progressed (from four to five stars)...
June 19, 2018: American Journal of Clinical Pathology
Michael L Wilson
No abstract text is available yet for this article.
June 13, 2018: American Journal of Clinical Pathology
Maly Fenelus, Ellinor I B Peerschke
Objectives: To evaluate the use of a pretest probability score (4Ts score) in cancer patients to guide ordering of laboratory screening tests for heparin-induced thrombocytopenia (HIT). Methods: A retrospective chart review was conducted for patients (n = 140) in whom laboratory testing for HIT was requested. 4Ts scores were calculated and correlated with heparin-endogenous platelet factor 4 antibody enzyme-linked immunosorbent assay (ELISA) test results. Results: All patients with a high pretest probability of HIT (4Ts score = 6-7) had positive ELISA results, compared to 26...
June 13, 2018: American Journal of Clinical Pathology
Felicia Tang, Ehsan Malek, Susan Math, Christine L Schmotzer, Rose C Beck
Objectives: We investigated the frequency and pattern of detection of therapeutic monoclonal antibodies (t-mAbs) daratumumab and elotuzumab by routine serum protein electrophoresis (SPE) and immunofixation (IF) in treated patients with myeloma. Methods: Detection of t-mAb was assessed in 22 patients by retrospective review of SPE/IF ordered prior to, during, and after 26 individual courses of therapy. Results: t-mAb was distinguishable from M-protein in 16 of 26 courses, with daratumumab detected in nine of nine and elotuzumab in six of seven patients...
June 13, 2018: American Journal of Clinical Pathology
Ka Yu Tse, Keith Wan Hang Chiu, Karen Kar Loen Chan, Mandy Man Yee Chu, Siew Fei Ngu, Annie Nga Yin Cheung, Hextan Yuen Sheung Ngan, Philip Pun Ching Ip
Objectives: To review the clinicopathologic features of five patients with epithelioid trophoblastic tumor (ETT). Methods: Characteristics of patients diagnosed with ETT in 2000 to 2012 were reviewed. Results: Among 190 patients with gestational trophoblastic neoplasia (GTN), two had pure ETT and three had mixed ETT and choriocarcinoma. The median age was 32.5 years. All the patients had localized disease in the uterus. One patient with pure ETT had a recurrence in the ureter 6 years after the initial treatment...
June 11, 2018: American Journal of Clinical Pathology
Dong Woo Shin, Hyungsuk Kim, Yousun Chung, Jun Nyun Kim, Yun Ji Hong, Kyoung Un Park, Kyou-Sup Han
Objectives: This study was conducted to establish the Korean national registry, to evaluate the distribution of unexpected antibodies, and to determine the frequencies of specific antigen-negative blood units. Methods: Data added to the Korean national registry between July 2013 and April 2016 were analyzed. The distribution of unexpected antibodies and frequencies of specific antigen-negative blood units were estimated. Results: In total, 3,513 cases from 22 institutes were registered...
June 9, 2018: American Journal of Clinical Pathology
Omonigho Aisagbonhi, Abraham Birungi, Raymond Atwine, Paddy Behayo, Benon Ayebaziwe, Drucilla Roberts, Rosemary Tambouret
Objectives: The plasma-thrombin method is commonly used to make cell blocks from fine-needle aspiration (FNA) samples but requires centrifugation. We describe a modification to this method that does not require centrifugation for use in resource-limited settings. Methods: Pooled fresh plasma is aliquoted into 2-mL Eppendorf tubes and the FNA sample directly rinsed into the plasma. Two drops of reconstituted thrombin are added and gently mixed. A cell clot is transferred to a tissue bag, fixed in formalin, and processed...
June 9, 2018: American Journal of Clinical Pathology
Nicolas Lopez-Hisijos, Iskender Genco, Alex Gorbonos, Stefan E Pambuccian, Güliz Akdas Barkan
Objectives: There is little information regarding the utility of pathologic evaluation of the prostatic anterior fat pad (PAFP) in patients with a low preoperative probability of recurrence. Our study aimed to determine the utility of PAFP pathologic examination, especially for this group of patients. Methods: We analyzed a tertiary care academic center's radical prostatectomy (RP) specimens from 2009 to 2017. Results: Of 602 RP specimens, 420(70%) included the PAFP; four of 420 (1%) had lymph node involvement (LNI) in the PAFP...
June 8, 2018: American Journal of Clinical Pathology
Majed A Refaai, Grace W Conley, Kelly F Henrichs, Hannah McRae, Amy E Schmidt, Richard P Phipps, Sherry L Spinelli, Debra Masel, Jill M Cholette, Anthony Pietropaoli, Michael P Eaton, Neil Blumberg
Objectives: Washing cellular blood products is accepted to ameliorate repeated severe allergic reactions but is associated with RBC hemolysis and suboptimal platelet function. We compared in vitro hemolysis and platelet function in blood components after washing with Plasma-Lyte A (PL-A) vs normal saline (NS). Methods: RBC (n = 14) were washed/resuspended in NS or PL-A. Free hemoglobin and heme were determined at 0, 24, 48, and 72 hours. Platelet concentrates (PCs; n = 21) were washed with NS or PL-A and resuspended in same washing solution (n = 13) or ABO-identical plasma (n = 8)...
June 6, 2018: American Journal of Clinical Pathology
Somaye Zare, Leili Mirsadraei, Niloufar Reisian, Xiaoyan Liao, Andres Roma, Ahmed Shabaik, Farnaz Hasteh
Objectives: The Paris System for Reporting Urinary Cytology (TPS) is designed to standardize the criteria and terminology used in urinary tract cytology reporting. The aim of this study was to evaluate the impact of implementing TPS and to analyze the correlation with follow-up biopsies in order to assess its reproducibility. Methods: Urinary tract cytology specimens with follow-up biopsies over a 2-year period were reviewed and reclassified according to TPS criteria...
June 6, 2018: American Journal of Clinical Pathology
Hong Fang, Prashant Kapoor, Wilson I Gonsalves, Lori A Frederick, David Viswanatha, Matthew T Howard, Rong He, William G Morice, Ellen D McPhail, Patricia T Greipp, Stephen M Ansell, Robert A Kyle, Morie A Gertz, Jonas Paludo, Jithma Abeykoon, Rebecca L King
Objectives: Lymphoplasmacytic lymphoma (LPL) remains a poorly defined entity, even with the discovery of MYD88L265P mutations and association with Waldenström macroglobulinemia (WM). Among bone marrow (BM)-based, low-grade B-cell lymphoma with plasmacytic differentiation (LGBLPD) and immunoglobulin M (IgM) paraproteins, we sought to determine whether MYD88L265P defines a distinct entity and can help refine diagnostic criteria for LPL. Methods: BMs diagnosed with LGBLPD or LPL and serum IgM paraprotein were studied (2007-2013)...
June 2, 2018: American Journal of Clinical Pathology
Erik Kouba, Andrew Ford, Charmaine G Brown, Chen Yeh, Gene P Siegal, Upender Manne, Isam-Eldin Eltoum
Objectives: Fine-needle aspiration (FNA) of thyroid lesions may result in infarction and diagnostic difficulties on subsequent thyroidectomy specimens. Next-generation sequencing (NGS) methods for detection of hallmark driver BRAF V600E mutations may help characterize such tumors in which histologic alterations preclude definitive tissue diagnosis. Methods: Thyroidectomy specimens with both malignant FNA diagnoses and resultant infarction were identified from our institutional database...
June 2, 2018: American Journal of Clinical Pathology
Shih-Hon Li, David Harro, John Alfsen, Janet Bolterman, Hemamalini Ketha, Lee F Schroeder, Donald A Giacherio, David F Keren
Objectives: We evaluated the effect of diabetes on sickle hemoglobin (HbS) measurement on two common clinical hemoglobin separation platforms. Methods: We performed a method comparison between the Bio-Rad Variant II high-performance liquid chromatography (HPLC) and Sebia Capillarys 2 Flex Piercing capillary electrophoresis (CE) using clinical specimens from 38 patients without hemoglobin variants and 57 patients with sickle cell trait (AS) (HbA1c%, 4.1%-15.4%). We investigated the effect of intermethod Hb% differences on result interpretation by a panel of expert clinical observers...
May 29, 2018: American Journal of Clinical Pathology
Matthew W Rosenbaum, James G Flood, Stacy E F Melanson, Nikola A Baumann, Mark A Marzinke, Alex J Rai, Joshua Hayden, Alan H B Wu, Megan Ladror, Mark S Lifshitz, Mitchell G Scott, Octavia M Peck-Palmer, Raffick Bowen, Nikolina Babic, Kimia Sobhani, Donald Giacherio, Gregary T Bocsi, Daniel S Herman, Ping Wang, John Toffaletti, Elizabeth Handel, Kathleen A Kelly, Sami Albeiroti, Sihe Wang, Melissa Zimmer, Brandon Driver, Xin Yi, Clayton Wilburn, Kent B Lewandrowski
Objectives: In the United States, minimum standards for quality control (QC) are specified in federal law under the Clinical Laboratory Improvement Amendment and its revisions. Beyond meeting this required standard, laboratories have flexibility to determine their overall QC program. Methods: We surveyed chemistry and immunochemistry QC procedures at 21 clinical laboratories within leading academic medical centers to assess if standardized QC practices exist for chemistry and immunochemistry testing...
May 29, 2018: American Journal of Clinical Pathology
Hao Li, Lei-Lei Yang, Yao Xiao, Wei-Wei Deng, Lei Chen, Lei Wu, Wen-Feng Zhang, Zhi-Jun Sun
Objectives: The aims of this study were to investigate the relationship between Golgi phosphoprotein 2 (GOLPH2) and oral squamous cell carcinoma (OSCC) and explore the clinical significance of GOLPH2 in OSCC. Methods: Tissue microarrays from human OSCC samples were stained for GOLPH2 expression and clinicopathologic features. Kaplan-Meier analysis was used to compare the survival of patients with high GOLPH2 expression and patients with low GOLPH2 expression. Results: We found GOLPH2 is highly expressed in OSCC tissue, and the GOLPH2 expression in metastatic lymph nodes is higher than in tumor tissue...
May 16, 2018: American Journal of Clinical Pathology
Matthew M Klairmont, Jinjun Cheng, Mike G Martin, Joel F Gradowski
Objectives: Data characterizing the cytogenetic landscape of intravascular large B-cell lymphoma (ILBCL) are limited. Here, we developed a comprehensive karyotypic data set to identify recurrent cytogenetic abnormalities in ILBCL. Methods: Cases of ILBCL with complete cytogenetic analysis were identified from an institutional database and the literature. The combined data were systematically reviewed for the presence of recurrent abnormalities. Results: Four new cases were identified and combined with 25 karyotypes previously published in the literature...
May 14, 2018: American Journal of Clinical Pathology
Ahmed A Abdulrahman, Kirtesh H Patel, Tong Yang, David D Koch, Sarah M Sivers, Geoffrey H Smith, David L Jaye
Objectives: By convention, 500 cells are counted for bone marrow aspirate differentials. Evidence supporting such a cutoff is lacking. We hypothesized that 300-cell counts could be sufficient. Methods: Cell count results from 165 cases, for which values were recorded at 300 and 500 cells, were analyzed. We tested for statistical differences and changes in diagnostic classification between the two cutoffs. Results: Three hundred cell counts did not produce diagnostically different results, particularly for myeloblasts and plasma cells, where cell percentages are critical for disease classification...
May 10, 2018: American Journal of Clinical Pathology
Fan Lin, Jianhui Shi, Hanlin L Wang, Xiao-Jun Ma, Robert Monroe, Yuling Luo, Zongming Chen, Haiyan Liu
Objectives: Inconsistent data on detection of albumin expression by ribonucleic acid (RNA) in situ hybridization have been reported. We investigated the utility of RNAscope (Advanced Cell Diagnostics, Hayward, CA) in detection of albumin in hepatocellular carcinomas (HCCs), intrahepatic cholangiocarcinomas (ICCs), and carcinomas from various organs using manual and automated staining. Methods: RNAscope for albumin detection was performed on 482 cases on tissue microarray sections and on 22 cases of ICC, including 14 surgical resection and eight core biopsy specimens...
May 9, 2018: American Journal of Clinical Pathology
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