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American Journal of Clinical Pathology

Irène Villa, Marie-Christine Mathieu, Jacques Bosq, Anne Auperin, Jean-François Pomerol, Magali Lacroix-Triki, Jean-Yves Scoazec, Peggy Dartigues
Objectives: The current challenge for the various digital whole-slide imaging (WSI) systems is to be definitively validated for diagnostic purposes. We designed a concordance study between glass slide and digital slide diagnosis in real-life conditions, coupled with an ergonomic study. Methods: Three senior pathologists evaluated, first in glass slides and then in digital slides, 119 biopsy cases, including 749 slides, with 332 H&E saffron stains and 417 additional techniques, mainly immunohistochemistry...
February 14, 2018: American Journal of Clinical Pathology
Cory J Broehm, Carrie Y Inwards, Alyaa Al-Ibraheemi, Doris E Wenger, Sarah M Jenkins, Long Jin, Andre M Oliveira, Riyam T Zreik, Jodi M Carter, Jennifer M Boland, Karen J Fritchie
Objectives: Most giant cell tumors of bone (GCTs) occur in patients aged 20 to 40 years. We analyzed features of GCT in patients 55 years or older. Methods: GCTs were examined for fibrosis, matrix, cystic change, histiocytes, mitoses, and necrosis. Clinical/radiologic data were collected. Results: Thirty-four (5%) of 710 GCTs occurred in patients older than 55 years (14/20 male/female; 56-83 years) in long bones (n = 24), vertebrae (n = 6), pelvis (n = 3), and metacarpal (n = 1)...
February 7, 2018: American Journal of Clinical Pathology
Joanna L Conant, Julia Powers, Gregory Sharp, Paul S Mead, Christina A Nelson
Objectives: Lyme disease (LD) incidence is increasing, but data suggest some clinicians are not fully aware of recommended procedures for ordering and interpreting diagnostic tests. The study objective was to assess clinicians' knowledge and practices regarding LD testing in a high-incidence region. Methods: We distributed surveys to 1,142 clinicians in the University of Vermont Medical Center region, of which 144 were completed (12.6% response rate). We also examined LD laboratory test results and logs of calls to laboratory customer service over a period of 2...
February 7, 2018: American Journal of Clinical Pathology
Elizabeth Waibel, Edna Garcia, Melissa Kelly, Ryan Soles, Lee Hilborne
Objectives: To determine non-American Society for Clinical Pathology pathology- and laboratory-related Choosing Wisely recommendations that drive effective test utilization in the laboratory. Methods: Data were collected via a two-part web-based survey distributed to a broad sample of pathologists and laboratory professionals from a variety of institutions. Results: Pathologists' most relevant recommendation: "Do not transfuse more units of blood than absolutely necessary"; highest priority: "Do not transfuse more than the minimum number of RBC units necessary to relieve symptoms of anemia or to return a patient to a safe hemoglobin range (7-8 g/dL in stable, noncardiac inpatients)...
February 7, 2018: American Journal of Clinical Pathology
Su-Chieh Pamela Sun, JuanDavid Garcia, Joshua A Hayden
Objectives: To determine the need and impact of repeating critical values in hematology and coagulation. Methods: We prospectively evaluated the need for repeating critical values. The cost of this practice was estimated using a workflow analysis. Retrospective chart review before and after removal of this process was performed to assess the clinical impact of removing this practice. Results: Over 95% of the repeated values remained critical and all but one of the repeats were within the expected analytical precision of the assays...
February 7, 2018: American Journal of Clinical Pathology
Jing He, Lei Huo, Junsheng Ma, Jun Zhao, Roland L Bassett, Xiaoping Sun, Naoto T Ueno, Bora Lim, Yun Gong
Objectives: Inflammatory breast carcinoma (IBC) is rare but is the most lethal type of breast cancer. Programmed death ligand 1 (PD-L1) expression in IBCs has been understudied. Methods: In this study, tissue microarrays of 68 IBCs were immunostained with a PD-L1 antibody using an antibody clone (28-8) and detection system approved by the US Food and Drug Administration for selecting patients with non-small cell lung cancer and melanoma for anti-PD-L1 therapy. Results: Positive PD-L1 expression was found in 25 (36...
February 7, 2018: American Journal of Clinical Pathology
Robin T Vollmer
Objectives: To provide a mathematical background for understanding the phenomenon of analyte hemodilution using a kinetic analysis. Methods: The first assumption for this analysis is that change in concentration of any analyte, such as prostate-specific antigen (PSA), is due to the flux of the analyte from an organ into the blood minus its flux from the blood. What results is a relatively simple differential equation that emphasizes the importance of plasma volume, organ mass, and two rate constants...
February 7, 2018: American Journal of Clinical Pathology
Hyein Ahn, Hyunsung Kim, Rehman Abdul, Yesul Kim, Jongmin Sim, Dongho Choi, Seung Sam Paik, Su-Jin Shin, Dong-Hoon Kim, Kiseok Jang
Objectives: Recent research has demonstrated that forkhead box O3a (FoxO3a) may function as an oncogenic transcription factor. We sought to validate the clinicopathologic significance of FoxO3a expression in hepatocellular carcinoma (HCC). Methods: Western blotting and immunohistochemistry were used to determine FoxO3a expression. In vitro cell proliferation and migration assays were performed in a HepG2 cell line. Results: FoxO3a was overexpressed in 121 (64...
January 21, 2018: American Journal of Clinical Pathology
Jesus A Chavez, Daniel J Brat, Steven B Hunter, Jose Velazquez Vega, Jeannette Guarner
Objectives: Early and accurate diagnosis remains crucial in the therapeutic management of invasive central nervous system fungal infections. Different molds have intrinsic resistance to antifungal agents; thus, morphologic differentiation is helpful to clinicians. Methods: Using three examples, we present a guide on how to approach neuropathology specimens where hyphae are identified on initial histologic examination. Results: Hyphae can be classified into three basic groups: hyaline pauciseptated, hyaline septated, and pigmented or dematiaceous...
January 20, 2018: American Journal of Clinical Pathology
Andrew P Norgan, Vera J Suman, Charlene L Brown, Thomas J Flotte, Taofic Mounajjed
Objectives: To examine the performance of a commercial off-the-shelf (COTS) monitor vs a medical-grade (MG) monitor for small object enumeration in standardized digital pathology images. Methods: Pathologists reviewed 35 melanoma or 35 gastric biopsy images using the MG and COTS displays, with a 2-week washout period. Mitotic figure or Helicobacter pylori burden enumerations were compared with reference values reported by an expert subspecialist pathologist using a light microscope...
January 20, 2018: American Journal of Clinical Pathology
Tanu Goyal, Beenu Thakral, Sa A Wang, Carlos E Bueso-Ramos, Min Shi, Dragan Jevremovic, William G Morice, Qian-Yun Zhang, Tracy I George, Kathryn K Foucar, Siddharth Bhattacharyya, Adam Bagg, Heesun J Rogers, Juraj Bodo, Lisa Durkin, Eric D Hsi
Objective: T-cell large granular lymphocytic (T-LGL) leukemia is associated with B-cell lymphomas (BCLs), especially small BCLs. We aimed to explore and expand upon its association with BCLs. Methods: We retrospectively studied clinicopathologic features of T-LGL leukemia patients with coexisting BCL from January 2001 to December 2016. Results: Among 432 patients with T-LGL leukemia, 22 (5.1%) had an associated B-cell non-Hodgkin lymphoma...
January 20, 2018: American Journal of Clinical Pathology
Ryan P Lau, John D Paulsen, Tamar C Brandler, Cheng Z Liu, Aylin Simsir, Fang Zhou
Objectives: Noninvasive encapsulated follicular variant of papillary thyroid carcinoma (NEFVPTC) was recently reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Excluding "carcinoma" from the new terminology shifted NIFTP out of the malignant category and altered Bethesda System for Reporting Thyroid Cytopathology (BSRTC) rates of malignancy (ROMs) on thyroid fine-needle aspiration (FNA). Because of potential effects on management guidelines, we examined our ROM data...
December 19, 2017: American Journal of Clinical Pathology
Patan Gultawatvichai, Maria F Tavares, Pamela J DiQuattro, Tracey C Cheves, Joseph D Sweeney
Objectives: Hemolysis is one of the most prominent changes that occur during the liquid storage of RBCs in additive solution (AS), but most studies have measured hemolysis only on day 42. Methods: Prestorage leukoreduced RBCs in AS-1 and AS-3 were studied, one group on day 42 and a second group between day 0 and day 40. Each product was sampled for direct measurement of supernatant hemoglobin and hematocrit. Results: Ninety day 42 and 218 day 7 to day 39 RBCs showed a mean ± SD supernatant hemoglobin of 75 ± 100 vs 25...
December 16, 2017: American Journal of Clinical Pathology
Bin Wu, Kimberly Ingersoll, Rachel Jug, Lian-He Yang, Catherine Luedke, Amanda Lo, Pu Su, Xin Liu, Catherine Rehder, Jerald Gong, Chuanyi Mark Lu, Endi Wang
Objectives: Myeloid neoplasms (MNs) after solid organ transplant are rare, and their clinicopathologic features have not been well characterized. Methods: We retrospectively analyzed 23 such cases. Results: The ages ranged from 2 to 76 years, with a median of 59 years at the diagnosis. The median interval between the transplant and diagnosis was 56 months (range, 8-384 months). The transplanted organs included liver in five, kidney in six, lung in five, heart in six, and heart/lung in one case(s)...
December 7, 2017: American Journal of Clinical Pathology
Daniel P Cassidy, Francisco Vega, Jennifer R Chapman
Objectives: Posttransplant lymphoproliferative disorders (PTLDs) are a heterogeneous group of hematolymphoid proliferations arising in the context of chronic immunosuppression. The common and indolent B-cell lymphomas, including extranodal marginal zone lymphomas (ENMZLs) of mucosa-associated lymphoid tissue (MALT), are excluded from the category of PTLD in the current World Health Organization classification. Methods: We report a case of Epstein-Barr virus (EBV)-positive bronchial-associated lymphoid tissue (BALT) lymphoma involving the lungs of a transplant patient...
December 7, 2017: American Journal of Clinical Pathology
Amy E Schmidt, Kelly F Henrichs, Scott A Kirkley, Majed A Refaai, Neil Blumberg
Objectives: We evaluated thrombosis and mortality rates of hospitalized patients receiving prophylactic platelet transfusion prior to an invasive procedure. Methods: Patient age and underlying medical condition(s), preprocedure and postprocedure platelet counts, type of procedure, number of platelet products transfused, and any complications were recorded on every prophylactic platelet given prior to an invasive procedure. Results: A total of 376 prophylactic transfusion recipients were identified...
December 7, 2017: American Journal of Clinical Pathology
Caili Su, Shuangshuang Jia, Honggang Liu
Objectives: To evaluate CD163+ tumor-associated macrophages (TAMs), Ki-67, and cyclin D1 to differentiate laryngeal dysplasia in the 2017 World Health Organization classification. Methods: Immunohistochemistry for CD163, Ki-67, and cyclin D1 was performed using paraffin-embedded specimens. CD163+ TAMs infiltrating the epithelium were estimated. Ki-67 and cyclin D1 were evaluated in four parts of the epithelium-basal, parabasal, middle third, and upper third layers...
December 7, 2017: American Journal of Clinical Pathology
Ian L Gunsolus, Sara A Love, Louis P Kohl, Martin Schmidt, Fred S Apple
Objectives: The present study addressed the accuracy of calculated oxygen saturation (sO2) using point-of-care (POC) testing compared with measured values on a blood gas analyzer. Methods: In total, 3,323 sO2 values were measured in 1,180 patients using a CO-oximeter (ABL 800 Flex; Radiometer, Copenhagen, Denmark). Measured parameters were then used to calculate an expected sO2 for the POC method (Abbott i-STAT; Abbott POC, Princeton, NJ). Cases in which calculated sO2 differed from measured sO2 by 10% or more were analyzed...
December 7, 2017: American Journal of Clinical Pathology
Hong Fang, April Chiu, Kaaren K Reichard
Objectives: We report the clinicopathologic characteristics of eight cases of crystal-storing histiocytosis (CSH) with bone marrow (BM) involvement (BM-CSH) and review CSH cases published in the English literature. Methods: We queried our pathology database for BM cases with CSH mentioned in the final diagnosis/comments from June 2011 to August 2016. Results: Eight cases of BM-CSH were identified. The underlying diagnoses consisted predominantly of plasma cell disorders (88%) associated with monotypic κ light chain...
January 29, 2018: American Journal of Clinical Pathology
Gloria T Haskell, Yajuan J Liu, Hui Chen, Beiyun Chen, Reid G Meyer, Jason A Yuhas, Katherine B Geiersbach
Objectives: To develop and test an integrated approach to human epidermal growth factor receptor 2 (HER2) copy number analysis in breast cancer using in situ hybridization (ISH) and cytogenomic microarray (CMA). Methods: CMA was performed on four clinical breast cancer samples with nonclassical patterns of HER2 ISH results. Integrated analysis was performed by correlating the data from pathology review, ISH, and CMA. Results: Integrated analysis provided a more comprehensive view of the genomic copy number landscape that informed HER2 copy number analysis, but ISH provided essential data in all cases...
January 29, 2018: American Journal of Clinical Pathology
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