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American Journal of Clinical Pathology

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https://www.readbyqxmd.com/read/28633426/atypical-histiocytoid-cells-in-metastatic-papillary-thyroid-carcinoma-an-underrecognized-cytologic-pattern
#1
Mariana Canepa, Tarik M Elsheikh, Debra A Sabo, Ashley M Kolosiwsky, Jordan P Reynolds
Objectives: Fine-needle aspiration (FNA) of head and neck lymph nodes (LNs) is useful in diagnosing metastatic papillary thyroid carcinoma (PTC) and most commonly shows classic cytologic features of PTC. Metastatic PTC, however, may occasionally present with a pattern unfamiliar to most pathologists: atypical histiocytoid cells (AHCs). Methods: All PTC thyroidectomy specimens with associated FNA of LNs were retrieved from our files for 2007 to 2013. We aimed to assess cytologic features of metastatic PTC, as well as the presence of AHCs and their morphology...
June 15, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28605433/sociodemographic-correlates-of-clinical-laboratory-test-expenditures-in-a-major-canadian-city
#2
Jocelyn Barber, Maggie Guo, Leonard T Nguyen, Roger Thomas, Tanvir Chowdhury Turin, Marcus Vaska, Christopher Naugler
Objectives: The increasing cost of clinical laboratory testing is a challenge in our health care system. This study aims to calculate the annual clinical laboratory test costs attributed to patients in a major Canadian city and to correlate them to their sociodemographic variables. Methods: Retrospective cohort study involving patients who received clinical chemistry, hematology, and microbiology tests in 2011 in Calgary, Canada (n = 610,409). Test volumes were obtained from a laboratory informatics database...
June 12, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28605432/molecular-diagnosis-of-thalassemias-and-hemoglobinopathies-an-aclps-critical-review
#3
Daniel E Sabath
Objectives: To describe the use of molecular diagnostic techniques for patients with hemoglobin disorders. Methods: A clinical scenario is presented in which molecular diagnosis is important for genetic counseling. Globin disorders, techniques for their diagnosis, and the role of molecular genetic testing in managing patients with these disorders are described in detail. Results: Hemoglobin disorders, including thalassemias and hemoglobinopathies, are among the commonest genetic diseases, and the clinical laboratory is essential for the diagnosis of patients with these abnormalities...
June 12, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28605400/proposed-terminology-for-anal-squamous-lesions-its-application-and-interobserver-agreement-among-pathologists-in-academic-and-community-hospitals
#4
Andres A Roma, Xiuli Liu, Deepa T Patil, Hao Xie, Daniela Allende
Objectives: To analyze interobserver reproducibility and compare practice patterns between academic and community settings of Lower Anogenital Squamous Terminology (LAST). Methods: In total, 132 anal biopsy slides were revised as well as p16 immunostains. Results: LAST was used in 49% of cases (academic center, 68%; satellite hospitals [community practice setting], 32%). After pathology review and consensus interpretation, 23 (17%) case diagnoses were reclassified: eight (34...
June 12, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28582484/comparison-of-three-methods-for-measuring-workload-in-surgical-pathology-and-cytopathology
#5
Daniel Cloetingh, Rodney A Schmidt, Christina S Kong
Objectives: Pathologist workload in the United States has traditionally been measured by relative value units (RVUs), which is often criticized for providing an inaccurate estimate of actual work. This study compares three methods for measuring workload. Methods: Surgical pathology and cytopathology workload for 1 representative month at Stanford Health Care was assessed using three different methods: RVUs, Royal College of Pathologists (RCP) point system, and University of Washington-Seattle (UW) slide count method...
June 5, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28575217/comprehensive-platelet-phenotypic-laboratory-testing-and-bleeding-history-scoring-for-diagnosis-of-suspected-hereditary-platelet-disorders-a-single-institution-experience
#6
Juliana Perez Botero, Deepti M Warad, Rong He, Cindy B Uhl, Shulan Tian, Gregory E Otteson, Ryan L Barness, Mary C Olson, Susan C Gossman, Jon E Charlesworth, William L Nichols, Rajiv K Pruthi, Dong Chen
Objectives: Patients with hereditary/congenital platelet disorders (HPDs) have a broad range of clinical manifestations and laboratory phenotypes. We assessed the performance characteristics of the International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT) and clinically validated platelet laboratory tests for diagnosis of HPDs. Methods: The records of 61 patients with suspected HPDs were reviewed and ISTH-BAT scores calculated. Results: Nineteen (31%) patients had thrombocytopenia, and 46 (75%) had positive ISTH-BAT scores...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28575159/performance-of-calculated-and-directly-measured-low-density-lipoprotein-cholesterol-in-a-pediatric-population
#7
Stephen M Roper, Jing Cao, Estella Tam, Sridevi Devaraj
Objectives: An assessment of methods for the accurate measurement of low-density lipoprotein cholesterol (LDL-C) at decreased concentrations has not yet been carried out. We evaluated the performance of the Friedewald equation, a direct enzymatic assay, and a novel equation for determining LDL-C levels in a pediatric population with elevated triglycerides and reduced LDL-C levels. Methods: LDL-C concentrations of 127 pediatric patients were determined by the Friedewald equation, a direct enzymatic assay, and a novel equation...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28575142/flow-cytometric-patterns-of-cd200-and-cd1d-expression-distinguish-cd10-negative-cd5-negative-mature-b-cell-lymphoproliferative-disorders
#8
Emily Mason, Olga Pozdnyakova, Betty Li, Graham Dudley, David M Dorfman
Objectives: The importance of distinguishing mature B-cell lymphoproliferative disorders (B-LPDs) is highlighted by the distinct treatments used for and varying prognoses seen in association with these different diseases. Immunophenotyping allows for accurate and efficient differentiation of many B-LPDs. Recently, we showed that CD200 is highly expressed in hairy cell leukemia (HCL) but not in marginal zone lymphoma (MZL), lymphoplasmacytic lymphoma (LPL), or hairy cell leukemia-variant (HCL-v)...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28575180/performance-evaluation-of-serum-free-light-chain-analysis-nephelometry-vs-turbidimetry-monoclonal-vs-polyclonal-reagents
#9
Anne-Sophie Messiaen, Maxime M W De Sloovere, Paul-Emile Claus, Martine Vercammen, Lieve Van Hoovels, Olivier Heylen, Johan Debrabandere, Hilde Vanpoucke, Dieter De Smet
Objectives: Free light chain (FLC) measurement gained a lot of interest for diagnostic workup of monoclonal gammopathy. Methods: We evaluated the performance of turbidimetric polyclonal Freelite (The Binding Site, Birmingham, UK) assays on Cobas 6000 (Roche Diagnostics, Rotkreuz, Switzerland) and nephelometric monoclonal N Latex (Siemens Healthcare Diagnostics, Marburg, Germany) assays on BN ProSpec (Dade Behring, Deerfield, IL) vs established nephelometric Freelite assays on BN ProSpec...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28575179/measurement-bias-of-gross-pathologic-compared-with-radiologic-tumor-size-of-resected-lung-adenocarcinomas-implications-for-the-t-stage-revisions-in-the-eighth-edition-of-the-american-joint-committee-on-cancer-staging-manual
#10
Kevin R Anderson, Benedikt H Heidinger, Yigu Chen, Alexander A Bankier, Paul A VanderLaan
Objectives: The eighth edition of the AJCC Cancer Staging Manual now stratifies the T descriptor for lung cancers by each increasing 1.0 cm increment, up to 5.0 cm, with an additional category for tumor greater than 7.0 cm. Bias in pathologic versus radiologic measurements may impact tumor staging. Methods: The gross pathologic measurements of 493 resected lung adenocarcinomas were compared with presurgical computed tomography radiologic measurements. Also, pathologic tumor measurement data from the Surveillance, Epidemiology, and End Results (SEER) program database were examined...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28575178/predominance-of-cd4-t-cells-in-t-cell-histiocyte-rich-large-b-cell-lymphoma-and-identification-of-a-subset-of-patients-with-peripheral-b-cell-lymphopenia
#11
Christian Kunder, Michael J Cascio, Anthony Bakke, Girish Venkataraman, Dennis P O'Malley, Robert S Ohgami
Objectives: T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a morphologic variant of large B-cell lymphoma whose flow cytometry findings are not well characterized. Methods: Nineteen cases with flow cytometric immunophenotyping were identified from the case records of four institutions between 2001 and 2016. Results: In most cases, neoplastic B cells were not detected by flow cytometry. Overall, cases showed a predominance of CD4+ T cells, which in some cases was marked...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28575177/the-prevalence-and-role-of-hemoglobin-variants-in-biometric-screening-of-a-multiethnic-population-one-large-health-system-s-experience
#12
Clayton R Wilburn, David W Bernard, Arthur W Zieske, Julia Andrieni, Tara Miller, Ping Wang
Objectives: To characterize and quantitate hemoglobin (Hb) variants discovered during biometric hemoglobin A1c (HbA1c) analyses in a large multiethnic population with a focus on the effect of variants on testing method and results. Methods: In total, 13,913 individuals had their HbA1c measured via ion-exchange high-performance liquid chromatography. Samples that had a variant Hb detected or HbF fraction more than 25% underwent variant Hb characterization and confirmation by gel electrophoresis...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28525532/the-effects-of-indirect-and-direct-acting-anticoagulants-on-lupus-anticoagulant-assays-a-large-retrospective-study-at-a-coagulation-reference-laboratory
#13
Jansen N Seheult, Michael P Meyer, Franklin A Bontempo, Irina Chibisov
Objectives: To investigate the effects of indirect- and direct-acting anticoagulants on the interpretation of lupus anticoagulant (LAC) assays. Methods: A retrospective database review was performed to identify all LAC panels from November 2012 to November 2015. The positivity rates for three LAC tests were compared among various anticoagulant medications. Results: This analysis included 7,721 LAC panels. Direct oral anticoagulants, warfarin, and unfractionated heparin (UFH) were associated with higher LAC positivity rates compared with patients not receiving documented anticoagulation (83% for argatroban, 58% for dabigatran, 72% for rivaroxaban, 53% for apixaban, 56% for warfarin, and 36% for UFH vs 29% for no anticoagulation, P < ...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28505308/diagnostic-performance-of-ultrasound-guided-fine-needle-aspiration-of-nonpalpable-breast-lesions-in-a-multidisciplinary-setting-the-institut-curie-s-experience
#14
Josep A Farras Roca, Anne Tardivon, Fabienne Thibault, Carl El Khoury, Séverine Alran, Virginie Fourchotte, Véronique Marck, Bernard Alépée, Birigitte Sigal, Yann de Rycke, Roman Rouzier, Jerzy Klijanienko
Objectives: To assess the diagnostic performance of ultrasound-guided fine-needle aspiration (USFNA) in nonpalpable breast lesions (NPBLs) in a multidisciplinary setting. Methods: In total, 2,601 NPBLs underwent USFNA by a radiologist-pathologist team. Gold-standard diagnosis was based on surgery, core-needle biopsy, or 1-year imaging follow-up. USFNA's diagnostic performance was analyzed in different clinical and imaging subgroups. Results: USFNA's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were, respectively, 92...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28505220/multicenter-evaluation-of-the-bruker-maldi-biotyper-ca-system-for-the-identification-of-clinically-important-bacteria-and-yeasts
#15
Deborah A Wilson, Stephen Young, Karen Timm, Susan Novak-Weekley, Elizabeth M Marlowe, Neil Madisen, Jennifer L Lillie, Nathan A Ledeboer, Rebecca Smith, Josh Hyke, Christen Griego-Fullbright, Patricia Jim, Paul A Granato, Matthew L Faron, Joven Cumpio, Blake W Buchan, Gary W Procop
Objectives: A report on the multicenter evaluation of the Bruker MALDI Biotyper CA System (MBT-CA; Bruker Daltonics, Billerica, MA) for the identification of clinically important bacteria and yeasts. Methods: In total, 4,399 isolates of medically important bacteria and yeasts were assessed in the MBT-CA. These included 2,262 aerobic gram-positive (AGP) bacteria, 792 aerobic gram-negative (AGN) bacteria 530 anaerobic (AnA) bacteria, and 815 yeasts (YSTs). Three processing methods were assesed...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28498881/can-p40-polyclonal-replace-p63-clone-4a4-in-the-cytologic-diagnosis-of-pulmonary-non-small-cell-carcinoma
#16
Melissa Alexander, Jeanine Chiaffarano, Fang Zhou, Joan Cangiarella, Melissa Yee-Chang, Aylin Simsir
Objectives: Differentiating squamous cell carcinoma from adenocarcinoma (ACA) in cytology specimens can be challenging. Recent literature showed p40 had higher specificity than p63 for this purpose. Methods: We identified 190 cytology cases with p40 (polyclonal) and p63 (monoclonal clone 4A4) immunohistochemistry, including specimens from fine-needle aspirations (FNAs) and effusions. Results: ACAs of lung origin stained for p40 and p63 in 21% and 20% of cases, respectively, regardless of specimen site...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28472420/determination-of-vh-family-usage-in-b-cell-malignancies-via-the-biomed-2-igh-pcr-clonality-assay
#17
Thomas J McDonald, Linus Kuo, Frank C Kuo
Objectives: To determine whether V H family usage in B-cell lymphoproliferative disorders can be deduced from polymerase chain reaction (PCR) product-length information obtained through the BIOMED-2 (Invivoscribe, San Diego, CA) clonality assay. Methods: We develop an algorithm that uses the sizing information of the BIOMED-2 immunoglobulin heavy chain (IGH) clonality assay to deduce V H family usage. PCR with family-specific primers on 51 clinical samples containing 54 rearranged alleles were used to validate the algorithm...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28472350/diagnostic-testing-approaches-for-activated-protein-c-resistance-and-factor-v-leiden-a-comparison-of-institutional-and-national-provider-practices
#18
Juliana Perez Botero, Julie A Majerus, Ann K Strege, Ryan D Johnson, Dong Chen, Rajiv K Pruthi
Objectives: To analyze the economic impact of testing for activated protein C resistance (APC-R) due to factor V Leiden (FVL) mutation with APC-R with reflexive FVL genotyping (algorithmic approach) or genotyping alone. Methods: OptumLabs Data Warehouse (OLDW) data were used to assess testing approaches. Insurance claims for APC-R and FVL in 2013 were compared with the Mayo Clinic database. Centers for Medicare & Medicaid Services diagnostic fee schedules were used to assign costs...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28472207/a-limited-immunohistochemical-panel-can-subtype-hepatocellular-adenomas-for-routine-practice
#19
Brent K Larson, Maha Guindi
Objectives: β-Catenin-activated hepatocellular adenomas have an elevated risk of harboring foci of hepatocellular carcinoma. Inflammatory adenomas also have an increased propensity for malignant transformation and are associated with a systemic inflammatory syndrome. Patients with these two adenoma subtypes benefit from excision. We assessed whether β-catenin-activated and inflammatory adenomas could be identified using a limited immunohistochemical panel. Methods: Forty-six adenomas were assessed by morphology and β-catenin, serum amyloid A, and glutamine synthetase immunostains...
June 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28449064/using-the-modified-magee-equation-to-identify-patients-unlikely-to-benefit-from-the-21-gene-recurrence-score-assay-oncotype-dx-assay
#20
Yanjun Hou, Gary Tozbikian, Debra L Zynger, Zaibo Li
Objectives: This study aimed to compare a modified Magee equation with Oncotype DX (Genomic Health, Redwood City, CA) recurrence score (RS) and identify patients who are unlikely to benefit from Oncotype DX. Methods: Magee equation RS was calculated in 438 cases and correlated with Oncotype DX RS. Results: The Pearson correlation coefficient ( r ) for the Magee equation and Oncotype DX RS was 0.6645 ( P  < .00001), and the overall agreement was 66...
June 1, 2017: American Journal of Clinical Pathology
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