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American Journal of Clinical Pathology

Peter P Chen, Christopher A Tormey, Stephanie C Eisenbarth, Richard Torres, Susan S Richardson, Henry M Rinder, Brian R Smith, Alexa J Siddon
Objectives: To increase awareness of potential diagnostic test interference associated with alemtuzumab, which is a therapeutic immunoglobulin G1 κ monoclonal antibody used in hematologic malignancies, autoimmune diseases, and transplant-related disorders. Methods: Bone marrow and blood from patients with T-cell prolymphocytic leukemia treated with alemtuzumab were evaluated by flow cytometry. Healthy donor blood was analyzed with or without in vitro treatment with alemtuzumab for comparison...
October 10, 2018: American Journal of Clinical Pathology
Jonathan R Brestoff, Angus Toland, Khalid Afaneh, Abraham J Qavi, Barbara Press, Peter Westervelt, Friederike Kreisel, Anjum Hassan
Objectives: Bone marrow biopsies are essential for evaluating patients with suspected or confirmed hematopoietic disorders or malignancies, but little is known about how biopsy needle type affects biopsy length and/or quality. We sought to compare bone marrow biopsy quality in specimens obtained with two different needles. Methods: A retrospective analysis was performed on bone marrow specimens obtained with manual single-bevel (n = 114) or triple-bevel (n = 166) needles...
October 10, 2018: American Journal of Clinical Pathology
Sandra K White, Brandon S Walker, Kimberley E Hanson, Robert L Schmidt
Objectives: To determine the accuracy of Fungitell, a β-d-glucan (BDG) test, for the diagnosis of invasive fungal infection (IFI) among cancer patients. Methods: For this meta-analysis, MEDLINE and EMBASE were searched for references related to BDG testing. Study quality was evaluated using QUADAS-2. Statistical analysis was performed using Stata 14. Results: We screened 12,426 references and identified 189 studies for full-text review. Nineteen studies were included in the final meta-analysis...
October 10, 2018: American Journal of Clinical Pathology
Yong Kwan Lim, Ae Ja Park, Oh Joo Kweon, Jee-Hye Choi
Objectives: We evaluated performance and measurement uncertainty of the newly released ARCHITECT 25-OH vitamin D 5P02 assay (Abbott Diagnostics, Abbott Park, IL). Methods: In total, 300 samples were used to compare the results from ELECSYS Vitamin D Total (Roche Diagnostics, Mannheim, Germany) and ADVIA Centaur Vitamin D Total (Siemens, Tarrytown, NY). To quantify the measurement uncertainty, 25 samples and four levels of standard reference material (SRM) were measured using isotope dilution-liquid chromatography-tandem mass spectrometry according to international guidelines...
October 10, 2018: American Journal of Clinical Pathology
Mushal Noor, Philip J Katzman, Aaron R Huber, Jennifer J Findeis-Hosey, Christa Whitney-Miller, Raul S Gonzalez, Zhongren Zhou, Henriette D N'kodia, Kathryn Skonick, Rebecca L Abell, Lawrence J Saubermann, Laura W Lamps, Michael G Drage
Objectives: Indications for cholecystectomy have changed dramatically over the past three decades. Cystoisospora belli has been reported in cholecystectomy specimens of immunocompetent patients. The present study was designed to determine the prevalence and clinical association of C belli in the gallbladder. Methods: The study included retrospective review of cholecystectomy specimens (n = 401) removed for various indications, and a prospective cohort of cholecystectomy specimens (n = 22) entirely submitted for histologic evaluation...
October 4, 2018: American Journal of Clinical Pathology
Victor L Fulgoni, Sanjiv Agarwal, Mark D Kellogg, Harris R Lieberman
Objectives: To develop age- and sex-specific RBC reference intervals using the National Health and Nutrition Examination Survey (NHANES) 1999 to 2012, a large nationally representative, population-based, cross-sectional database (n = 44,328). Methods: Comprehensive medical data were used to define a "healthy" population. Reference intervals for RBC count, hemoglobin, hematocrit, mean cell hemoglobin, mean cell hemoglobin concentration, mean cell volume, and red cell distribution width were computed using piecewise regression, an evidence-based statistical procedure that identifies breakpoints...
October 4, 2018: American Journal of Clinical Pathology
Amy E Schmidt, Majed A Refaai, Myra Coppage
Objectives: To provide an overview of the complexities associated with the human leukocyte antigen (HLA)-mediated platelet refractoriness. HLA antibody detection technologies and limitations associated with methodologies are discussed. Methods: A case scenario and review of relevant literature describing platelet refractoriness are presented, followed by a discussion of HLA antibody testing. Results: Following diagnosis of HLA-mediated refractoriness, a decision is made regarding the approach to obtain the appropriate platelets...
October 3, 2018: American Journal of Clinical Pathology
Edna Garcia, Iman Kundu, Karen Fong
Objectives: To inform the pathology and laboratory field of the most recent national wage data. Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. Methods: The 2017 Wage Survey was conducted through collaboration between the American Society for Clinical Pathology's (ASCP's) Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, IL...
October 1, 2018: American Journal of Clinical Pathology
Jacob T Wooldridge, Amy Davis, Wayne G Fischer, Mohamed F Khalil, Min Zhang, Marjan Afrouzian
Objectives: Renal biopsy is the gold standard for the diagnosis of both native and allograft renal diseases. We studied the impact of tissue procurement at bedside (TPB) omission on the adequacy of renal biopsies. Methods: We compared 120 renal biopsies collected during 2015 using TPB with 111 renal biopsies collected during 2016 when TPB was discontinued. Adequacy criteria were applied as follows: by light microscopy, 10 glomeruli and two arteries for allograft biopsies and seven glomeruli for native biopsies...
September 28, 2018: American Journal of Clinical Pathology
Mitsuhiro Nakamura, Kyohei Nakade, Shunsuke Orisaka, Junpei Iwadare, Yasunari Mizumoto, Hiroshi Fujiwara
Objectives: To evaluate the clinical performance of novel detection kits for 14 high-risk human papillomavirus (hrHPV) types with the BD Onclarity HPV Assay (Onclarity; Becton Dickinson, Sparks, MD). Methods: Two cervical specimens from 144 women were obtained and placed in BD SurePath Collection Vials. The first specimen was used for cervical cytology and digene HC2 High-Risk HPV DNA Test (HC2; Qiagen, Germantown, MD), and the second specimen was used for Onclarity and Roche Cobas 4800 HPV (Cobas; Roche Molecular Systems, Pleasanton, CA)...
September 26, 2018: American Journal of Clinical Pathology
Michael Zaleski, Patrick Erdman, Joshua Adams, Amanda Michael, Abigail Rudy, Robert Boesch, Lauren Allison, Patricia Mailander, Wendell Hess, Debra Myers, David Craft
Objectives: Underfilling of blood culture bottles decreases the sensitivity of the culture. We attempt to increase average blood culture fill volumes (ABCFVs) through an educational program. Methods: Partnerships were established with four hospital units (surgical intensive care unit [SICU], medical intensive care unit [MICU], medical intermediate care unit [MIMCU], and hematology and oncology unit [HEME/ONC]). ABCFVs were continuously tracked and communicated to each unit monthly...
September 26, 2018: American Journal of Clinical Pathology
Michael P Phelan, Megan O Nakashima, Daniel M Good, Fredric M Hustey, Gary W Procop
Objectives: A CBC with leukocyte differential (CBC-DIFF) is a frequently ordered emergency department (ED) test. The DIFF component often does not add to clinical decision making. Our objective was to evaluate the impact of a performance improvement project on CBC ordering. Methods: ED orders for CBC-DIFF were identified through the laboratory information system. Two interventions were evaluated: an educational intervention regarding CBC-DIFF uses and a reprioritization of ED CBC-DIFF and CBC in the electronic medical record (EMR) orders...
September 22, 2018: American Journal of Clinical Pathology
Neda Kalhor, Cesar A Moran
Objectives: Twelve cases of thymomas with prominent alveolar-like growth pattern are presented. Methods: The 12 cases were identified during a review of more than 350 cases of thymomas. Results: The patients were five women and seven men between the ages of 48 and 69 years (mean, 58.5 years). Clinically, all patients presented with nonspecific symptoms. Grossly the tumors varied in size from 3.5 to 5 cm in greatest diameter. Histologically, all tumors showed a predominant alveolar-like growth pattern without a significant lymphocytic component...
September 22, 2018: American Journal of Clinical Pathology
Harold C Sullivan, Sean R Stowell, Erin K Meyer, Alexander D Duncan, Jeannette Guarner
Objectives: Knowledge of transfusion medicine by medical students is limited. Transfusion medicine physicians developed, implemented, and evaluated a half-day elective on transfusion medicine for fourth-year medical students. Methods: The course included a didactic lecture with integrated audience response questions and role-playing, as well as a "Jeopardy"-style game to review the material. The same 10-question knowledge quiz was administered before and after the elective...
September 18, 2018: American Journal of Clinical Pathology
Jane Date Hon, Wenjin Chen, Christine Minerowicz, Sumi Thomas, Nicola Barnard, Natalie Gilbert, Billie Fyfe
Objectives: To examine the fidelity of ink color identification using light microscopy (LM), telemicroscopy (TM), and virtual microscopy (VM). Methods: Twenty H&E-stained frozen section slides, prepared after tissue inking with five stain combinations, were assessed by three pathologists using LM, TM, and VM. TM was performed using Mikroscan D2 slide scanner/LiveQ software with various objectives. VM was performed using Mikroscan D2 scanner/Qumulus software, specimens digitized at20×...
September 17, 2018: American Journal of Clinical Pathology
Daniel Xia, Elizabeth A Morgan, David Berger, Geraldine S Pinkus, Judith A Ferry, Lawrence R Zukerberg
Objectives: We report four new cases of natural killer-cell enteropathy (NKCE) and similar lymphoproliferative disorders (LPDs), as well as review the literature concerning indolent natural killer (NK)-cell LPDs of the gastrointestinal tract. Methods: Pathologic and clinical data were obtained from institutional/referral records. Results: Patient 1 (45-year-old man) had anemia; a small intestinal lesion was endoscopically biopsied. Patient 2 (65-year-old woman) had biliary colic, treated with cholecystectomy...
September 13, 2018: American Journal of Clinical Pathology
Feng Yin, Wei Zheng, Misty D Lucas, Richard A Allen, Yaolin Zhou
Objectives: As pathologists and laboratorians, we can enhance patient care by promoting the appropriate ordering of diagnostic tests. Our goal was to improve the ordering of BCR-ABL1 tests by using the EPIDEM model of quality improvement. Methods: We applied the EPIDEM model, which emphasizes understanding local context, culture, and resources, to explore inappropriate BCR-ABL1 ordering, promote and implement a new reflexive testing strategy in-house, document and evaluate effectiveness, and make stepwise modifications...
September 13, 2018: American Journal of Clinical Pathology
Michelle N Stram, Christopher N Suciu, Jansen N Seheult, Melissa A McCullough, Muhamuda Kader, Alan Wells, A William Pasculle, Charles R Rinaldo, Nahed Ismail
Objectives: To determine a quantitative herpes simplex virus (HSV) DNA threshold in lower respiratory tract specimens that correlates with positive viral culture and clinical outcomes. Methods: Bronchoalveolar lavage and bronchial wash samples from 53 HSV culture-positive and 61 culture-negative matched controls were tested using HSV-1 and HSV-2 quantitative polymerase chain reaction (qPCR). Results: Median viral culture turnaround time was 21...
September 13, 2018: American Journal of Clinical Pathology
Daniel N Johnson, Allison B Cavallo, Imran Uraizee, Kevin Tanager, Ricardo R Lastra, Tatjana Antic, Nicole A Cipriani
Objectives: Bethesda category III (atypia of undetermined significance/follicular lesion of undetermined significance) includes sparsely cellular specimens with nuclear atypia (3N) and/or architectural atypia (3A). This study investigates whether the two types of atypia have different rates of malignancy (ROMs). Methods: Cytologic and histologic diagnoses of resected thyroid nodules were recorded. ROM was calculated for all Bethesda categories and for 3N and 3A subcategories...
September 13, 2018: American Journal of Clinical Pathology
Deepak K Pruthi, Sacha Oomah, Vivian Lu, Tommy Ting, Corey Knickle, Michael A Liss, Ian W Gibson, Iain D C Kirkpatrick, Thomas B McGregor
Objectives: To model renal function 2 years following radical nephrectomy with quantitative analyses using clinical, histopathologic, and renal composite cortical volumes (CCV). Methods: This retrospective study involved an assessment of the nonneoplastic kidney tissue by three blinded nephropathologists using modified Banff 1997 criteria for renal allograft pathology. Volumetric image acquisition was obtained by three independent radiologists using preoperative imaging...
September 13, 2018: American Journal of Clinical Pathology
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