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Archives of Pathology & Laboratory Medicine

Mariam Rodríguez-Lee, Anand Kolatkar, Madelyn McCormick, Angel D Dago, Jude Kendall, Nils Anders Carlsson, Kelly Bethel, Emily J Greenspan, Shelley E Hwang, Kathryn R Waitman, Jorge J Nieva, James Hicks, Peter Kuhn
CONTEXT: - As circulating tumor cell (CTC) assays gain clinical relevance, it is essential to address preanalytic variability and to develop standard operating procedures for sample handling in order to successfully implement genomically informed, precision health care. OBJECTIVE: - To evaluate the effects of blood collection tube (BCT) type and time-to-assay (TTA) on the enumeration and high-content characterization of CTCs by using the high-definition single-cell assay (HD-SCA)...
November 16, 2017: Archives of Pathology & Laboratory Medicine
Esmeralda Celia Marginean, Barbara Melosky
CONTEXT: - Colorectal cancer (CRC) represents the third most-common cancer in developed countries and is a leading cause of cancer deaths worldwide. Two recognized pathways contribute to CRC development: a more-common chromosomal instability pathway and, in 15% of cases, a deficient mismatch repair or microsatellite instability-high (MSI-H) pathway. The MSI-H CRC can be associated with somatic or germline mutations. Microsatellite status has been recognized as a prognostic and predictive biomarker...
November 16, 2017: Archives of Pathology & Laboratory Medicine
Soomin Ahn, Junghye Lee, Min-Sun Cho, Sanghui Park, Sun Hee Sung
CONTEXT: - The Ki-67 index is strongly prognostic and is used as a surrogate marker to distinguish luminal A from luminal B breast cancer types. OBJECTIVE: - To investigate differences in Ki-67 index between core needle biopsy samples and matched surgical samples in breast cancer. DESIGN: - We included patients with invasive breast cancer who did not receive neoadjuvant therapy. A total of 89 pairs of core needle biopsies and surgical specimens were collected, and the Ki-67 index was assessed in hot spot areas using an image analyzer...
November 16, 2017: Archives of Pathology & Laboratory Medicine
Esmeralda Celia Marginean, Barbara Melosky
CONTEXT: - The world of oncology has changed dramatically in the past few years with the introduction of checkpoint inhibitors and immunotherapy. The promising findings of a small, phase 2 clinical trial that led to the US Food and Drug Administration breakthrough designation and approval of the anti-programmed death receptor-1 (PD-1) drug pembrolizumab (Keytruda, Merck, Kenilworth, New Jersey) to treat metastatic/refractory microsatellite instability-high colorectal cancer (CRC) has significantly boosted interest in immunomodulatory therapies in microsatellite instability-high CRC...
November 9, 2017: Archives of Pathology & Laboratory Medicine
Rondell P Graham, Amanda L Treece, Neal I Lindeman, Patricia Vasalos, Mu Shan, Lawrence J Jennings, David L Rimm
CONTEXT: - Recurrent epidermal growth factor receptor (EGFR) mutations are seen in a subset of pulmonary adenocarcinomas. These mutations are targeted by EGFR inhibitors and are a biomarker for response to EGFR inhibitor therapies. Initial data have indicated an increased frequency of activating EGFR mutations in nonsmoking Asian females. However, there are very few studies of global scope that address the question of mutation distribution across the population of lung cancer. OBJECTIVE: - To determine the frequency of EGFR mutations in exons 18 through 21 detected in clinical laboratories participating in the College of American Pathologists proficiency testing program for EGFR in calendar year 2013...
November 6, 2017: Archives of Pathology & Laboratory Medicine
Michael P Phelan, Edmunds Z Reineks, Jesse D Schold, Frederic M Hustey, Janelle Chamberlin, Gary W Procop
CONTEXT: - Hemolysis of emergency department blood samples is a common occurrence and has a negative impact on health care delivery. OBJECTIVES: - To determine the effect of preanalytic factors (straight stick, intravenous [IV] line, needle gauge, location of blood draw, syringe versus vacuum tube use, tourniquet time) on hemolysis in emergency department blood samples. DESIGN: - A single 65 000-visit emergency department's electronic health record was queried for emergency department potassium results and blood draw technique for all samples obtained in calendar year 2014, resulting in 54 531 potassium results...
November 6, 2017: Archives of Pathology & Laboratory Medicine
Natasha Rekhtman, Darren J Buonocore, Dorota Rudomina, Maria Friedlander, Crisbane Dsouza, Gitika Aggarwal, Maria Arcila, Marcia Edelweiss, Oscar Lin
CONTEXT: - Cell block preparation methods vary substantially across institutions and are frequently suboptimal. The growing importance of biomarker testing in the era of targeted therapies makes optimization of cell block preparation critically important. OBJECTIVE: - To develop an improved cell block preparation method. DESIGN: - Ex vivo fine-needle aspirates and scrapes from surgically resected tumors were used to develop an improved HistoGel (Thermo Fisher Scientific, Waltham, Massachusetts)-based cell block preparation method...
November 2, 2017: Archives of Pathology & Laboratory Medicine
Z Laura Tabatabai, Ritu Nayar, Rhona J Souers, Barbara A Crothers, Diane Davis Davey
CONTEXT: - Body fluid cytology is an important diagnostic tool used to identify various conditions. However, an accurate diagnosis in this setting can sometimes be challenging. OBJECTIVE: - To identify the performance characteristics of body fluid cytology by analyzing participant responses from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology. DESIGN: - Participant responses from 5102 slides were analyzed for concordance to the general category (GC) and to the reference diagnosis (RD)...
October 19, 2017: Archives of Pathology & Laboratory Medicine
Radhika Tandon, Yuis Jimenez-Cortez, Robert Taub, Alain C Borczuk
CONTEXT: - Diagnosis of malignant mesothelioma is more common in the chest than it is in the abdomen. Most published immunohistochemistry data are more applicable to pleural than to peritoneal mesothelioma. OBJECTIVE: - To clarify the practical utility of 17 immunohistochemistry markers in the differential diagnosis of peritoneal mesothelioma with an emphasis on stains for which there is either contradictory information or a paucity of literature. DESIGN: - Consultation files of peritoneal mesothelioma diagnoses rendered from 1999 to 2014 were reviewed; 242 cases are identified...
October 19, 2017: Archives of Pathology & Laboratory Medicine
Laxmi B Chavali, Adana A M Llanos, Jing-Ping Yun, Stephanie M Hill, Xiang-Lin Tan, Lanjing Zhang
CONTEXT: - According to the American Joint Committee on Cancer's Cancer Staging Manual, 7th edition, TNM classification, tumor deposit (TD)-positive colorectal cancers (CRCs) are classified as N1c. The effects of radiotherapy and the effects of the updated American Joint Committee on Cancer 7th edition TNM N1c classification for patients with TD-positive CRC are unclear. OBJECTIVE: - To investigate outcomes of radiotherapy in patients with resected TD-positive CRC...
October 19, 2017: Archives of Pathology & Laboratory Medicine
Rakesh Nagarajan, Angela N Bartley, Julia A Bridge, Lawrence J Jennings, Suzanne Kamel-Reid, Annette Kim, Alexander J Lazar, Neal I Lindeman, Joel Moncur, Alex J Rai, Mark J Routbort, Patricia Vasalos, Jason D Merker
CONTEXT: - Detection of acquired variants in cancer is a paradigm of precision medicine, yet little has been reported about clinical laboratory practices across a broad range of laboratories. OBJECTIVE: - To use College of American Pathologists proficiency testing survey results to report on the results from surveys on next-generation sequencing-based oncology testing practices. DESIGN: - College of American Pathologists proficiency testing survey results from more than 250 laboratories currently performing molecular oncology testing were used to determine laboratory trends in next-generation sequencing-based oncology testing...
October 13, 2017: Archives of Pathology & Laboratory Medicine
James R Wright, Jeanne Abrams
CONTEXT: - In the early 20th century, the future of hospital-based clinical pathology practice was uncertain and this situation led to the formation of the American Society for Clinical Pathologists in 1922. Philip Hillkowitz and Ward Burdick were its cofounders. No biography of Hillkowitz exists. OBJECTIVE: - To explore the life, beliefs, and accomplishments of Philip Hillkowitz. DESIGN: - Available primary and secondary historical sources were reviewed...
October 13, 2017: Archives of Pathology & Laboratory Medicine
Yaolin Zhou, Gary W Procop, Jacquelyn D Riley
CONTEXT: - The incorporation of best practice guidelines into one's institution is a challenging goal of utilization management, and the successful adoption of such guidelines depends on institutional context. Laboratorians who have access to key clinical data are well positioned to understand existing local practices and promote more appropriate laboratory testing. OBJECTIVE: - To apply a novel approach to utilization management by reviewing international clinical guidelines and current institutional practices to create a reliable mechanism to improve detection and reduce unnecessary tests in our patient population...
October 5, 2017: Archives of Pathology & Laboratory Medicine
Ramesh Babu, Daniel L Van Dyke, Vaithilingam G Dev, Prasad Koduru, Nagesh Rao, Navnit S Mitter, Mingya Liu, Ernesto Fuentes, Sarah Fuentes, Stephen Papa
CONTEXT: - Chromosome analysis on bone marrow or peripheral blood samples fails in a small proportion of attempts. A method that is more reliable, with similar or better resolution, would be a welcome addition to the armamentarium of the cytogenetics laboratory. OBJECTIVE: - To develop a method similar to banded metaphase chromosome analysis that relies only on interphase nuclei. DESIGN: - To label multiple targets in an equidistant fashion along the entire length of each chromosome, including landmark subtelomere and centromere regions...
October 5, 2017: Archives of Pathology & Laboratory Medicine
Kaveh Naemi, Michael J Stamos, Mark Li-Cheng Wu
CONTEXT: - Colonic inertia is a debilitating form of primary chronic constipation with unknown etiology and diagnostic criteria, often requiring pancolectomy. We have occasionally observed massively enlarged submucosal ganglia containing at least 20 perikarya, in addition to previously described giant ganglia with greater than 8 perikarya, in cases of colonic inertia. These massively enlarged ganglia have yet to be formally recognized. OBJECTIVE: - To determine whether such "massive submucosal ganglia," defined as ganglia harboring at least 20 perikarya, characterize colonic inertia...
October 5, 2017: Archives of Pathology & Laboratory Medicine
Frank Schneider, Samuel A Yousem, Chester V Oddis, Rohit Aggarwal
CONTEXT: - Patients with anti-aminoacyl-tRNA synthetase syndrome (ARS), a subset of idiopathic inflammatory myopathy, have a high prevalence of lung involvement. Autoantibodies directed against alanyl-tRNA synthetase (anti-PL-12 Abs) represent 1 of the 8 autoantibodies currently described under the rubric of ARS. OBJECTIVE: - To describe the clinical, radiographic, and pulmonary histopathologic findings in patients possessing anti-PL-12 autoantibodies. DESIGN: - Patients with anti-PL-12 ARS were identified in the University of Pittsburgh Idiopathic Inflammatory Myopathy registry...
October 2, 2017: Archives of Pathology & Laboratory Medicine
Arunima Ghosh, G Thomas Brown, Paul Fontelo
CONTEXT: - Telepathology is the practice of pathology at a distance, transmitting images using telecommunication methods for second opinion and/or diagnostic assistance, or for educational purposes. It may be the only means of consultation for some pathologists. OBJECTIVE: - To retrospectively review and evaluate a subset of telepathology consultations from June 1996 to March 1997, and to determine the concordance between the telepathology diagnosis of the contributor and pathologists at the Armed Forces Institute of Pathology (AFIP), Washington, District of Columbia, as well as the concordance between the telepathology diagnosis and the glass slide diagnosis, when available...
October 2, 2017: Archives of Pathology & Laboratory Medicine
Javier A Arias-Stella, Alpa B Shah, Nilesh S Gupta, Sean R Williamson
CONTEXT: - Urinary bladder flat carcinoma in situ (CIS) is a worrisome lesion, requiring aggressive surveillance and treatment. Cytokeratin 20 (CK20) and p53 are common immunohistochemical antibodies used to supplement CIS diagnosis in biopsy samples. However, existing data come primarily from unequivocally benign and malignant specimens. OBJECTIVE: - To correlate these markers in specimens with borderline histology with outcomes. DESIGN: - CK20 and p53 immunohistochemistry was analyzed for staining pattern, classified as CIS pattern (both stains yielding strong labeling of the area of concern), discordant (only 1 stain yielding CIS pattern), indeterminate (1 or both stains yielding partial or equivocal labeling), or benign (both stains yielding a benign pattern)...
October 2, 2017: Archives of Pathology & Laboratory Medicine
Peter Catomeris, Nancy N Baxter, Sheila C Boss, Lawrence F Paszat, Linda Rabeneck, Edward Randell, Mardie L Serenity, Rinku Sutradhar, Jill Tinmouth
CONTEXT: - Although promising for colorectal cancer screening, hemoglobin (Hb) stability remains a concern with fecal immunochemical tests. This study implemented a novel, standardized method to compare Hb stability across various fecal immunochemical tests. The method can be used to inform decisions when selecting a kit for use in colorectal cancer screening. In so doing, this work addressed a critical need for standardization in this field. OBJECTIVE: - To compare the stability of Hb across 5 different immunochemical kits and one guaiac kit...
October 2, 2017: Archives of Pathology & Laboratory Medicine
Ann E Walts, Alberto M Marchevsky
CONTEXT: - Tumor spread through alveolar spaces (STAS) has been correlated with unfavorable prognosis in lung adenocarcinomas treated with sublobar resection, but it is unknown whether STAS can be reliably identified in frozen section (FS) to help stratify patients for lobectomy or sublobar resection. OBJECTIVE: - To evaluate STAS in FS. DESIGN: - Tumor spread through alveolar spaces was evaluated in hematoxylin-eosin-stained FS, FS control slides, and all additional slides with lung tissue adjacent to tumor (AdLT) from 48 pT1-2 adenocarcinomas operated on using video-assisted thoracotomy (n = 25) or open thoracotomy (n = 23)...
October 2, 2017: Archives of Pathology & Laboratory Medicine
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