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Archives of Pathology & Laboratory Medicine

Amir Behdad, Xiao Yi Zhou, Juehua Gao, Kirtee Raparia, David Dittman, Stefan J Green, Chao Qi, Bryan Betz, Paul Bryar, Qing Chen, Yi-Hua Chen
CONTEXT.—: The pathogenesis of primary ocular adnexal marginal zone lymphoma (POAMZL) remains unclear. The reported associations with Chlamydia psittaci infection and MYD88 mutations are highly variable. OBJECTIVE.—: To examine MYD88 L265P mutation in ocular marginal zone lymphomas and correlate with clinicopathologic features and Chlamydia infection. DESIGN.—: Presence of MYD88 L265P mutation and Chlamydia infection in lymphoma was analyzed by using sensitive polymerase chain reaction (PCR) methods...
November 16, 2018: Archives of Pathology & Laboratory Medicine
Ricardo Garcia Pastorello, Mauro Ajaj Saieg
Secondary tumors of the thyroid gland, although uncommon, can sometimes pose as diagnostic dilemmas on fine-needle aspiration cytology, frequently mimicking primary thyroid neoplasms. An accurate diagnosis of such lesions, however, is critical for patient management and prognosis. The present study reviews the cytologic aspects of secondary involvement of the thyroid, listing the most common primary malignancies that metastasize to this gland. Knowledge of such morphologic aspects, combined with prompt clinical correlation, is essential for the cytopathologist to achieve a proper, definite diagnosis...
November 16, 2018: Archives of Pathology & Laboratory Medicine
Oluwatobi Odetola, Vijayalakshmi Ananthanarayanan
Primary immunodeficiency disorders typically have an onset in childhood. The suspicion for these conditions usually arises from a history of recurrent respiratory, gastrointestinal, or cutaneous infections with a history often dating back to infancy or early childhood. However, adults can also be affected. Common variable immunodeficiency, which usually has an onset/diagnosis in adulthood, is the most common symptomatic primary immunodeficiency. However, as its presentation could be manifold, its diagnosis is often delayed...
November 16, 2018: Archives of Pathology & Laboratory Medicine
Sasan Setoodeh, Li Liu, Sarag A Boukhar, Amit G Singal, Maria Westerhoff, Akbar K Waljee, Tasneem Ahmed, Purva Gopal
CONTEXT.—: Conflicting data about the clinical significance of microscopic Crohn disease (CD) activity at resection margins have led to varying practice patterns for routine reporting by pathologists. OBJECTIVE.—: To characterize the association between active disease at resection margins with postoperative CD recurrence and time-to-recurrence in the era of anti-tumor necrosis factor therapy. DESIGN.—: We performed a multicenter retrospective cohort study of 101 consecutive CD bowel resections during 10 years...
November 16, 2018: Archives of Pathology & Laboratory Medicine
Pei Hui
CONTEXT.—: Gestational trophoblastic tumors include 3 distinct entities: gestational choriocarcinoma, placental site trophoblastic tumor, and epithelioid trophoblastic tumor. Accurate diagnosis is important for clinical management of the patient. OBJECTIVE.—: To review clinical features and pathologic diagnosis of gestational trophoblastic tumors. DATA SOURCES.—: Literature and personal experience are the sources for this study. CONCLUSIONS...
November 8, 2018: Archives of Pathology & Laboratory Medicine
Diping Wang, Norbert Sule
Urachal neoplasms are uncommon and represent a minor portion of bladder tumors. According to the recently updated World Health Organization classification (2016), these tumors are classified as adenomas, adenocarcinomas, nonglandular neoplasms, and mixed carcinomas. The mucinous cystic neoplasms represent a small percentage of urachal tumors with morphologic spectrum ranging from benign mucinous cystadenoma to borderline mucinous cystic tumor of low malignant potential and to malignant mucinous cystadenocarcinoma...
November 6, 2018: Archives of Pathology & Laboratory Medicine
Adam L Booth, Matthew S Katz, Michael J Misialek, Timothy Craig Allen, Lija Joseph
CONTEXT.—: Pathologists evaluate human disease and teach medical students, residents, and clinicians. Historically recognized as the "doctor's doctor," pathologists are well suited to be a direct patient resource of individualized, accurate information. OBJECTIVE.—: To develop and implement a pathology consultation service whereby patients review their tissue slides directly with the pathologists. DESIGN.—: A pathologist conducted patient consultations, reviewing biopsy or surgery findings on a multiheaded microscope or computer screen...
November 6, 2018: Archives of Pathology & Laboratory Medicine
David J Gross, Mary Kennedy, Tarush Kothari, David O Scamurra, Myra L Wilkerson, James M Crawford, Michael B Cohen
CONTEXT.—: As part of its Value-Based Care initiative, the College of American Pathologists has pursued research to better understand the role pathologists can have in population health. OBJECTIVES.—: To answer the following questions: (1) what is the impact of population health and population health management on pathologists; (2) what roles are pathologists playing in population health management; (3) is population health something that pathologists in both larger and smaller settings can engage in; (4) are pathologists in a position to analyze laboratory data for population health, and, if so, what are the key information sources those pathologists must access; and (5) what steps can a pathologist take to become involved in population health? DESIGN...
November 6, 2018: Archives of Pathology & Laboratory Medicine
Nicole K Andeen, Xiaoyu Qu, Tatjana Antic, Scott S Tykodi, Min Fang, Maria S Tretiakova
CONTEXT.—: Cytogenomic analysis provides a useful adjunct to traditional pathology in the categorization of renal cell carcinomas (RCCs), particularly in morphologically ambiguous cases, but it has disadvantages, including cost. OBJECTIVE.—: To define the clinical scenarios in which this technology has direct clinical applications. DESIGN.—: DNA was isolated from paraffin-embedded tissue from 40 selected cases of RCC. Chromosome genomic array testing was performed using the OncoScan...
November 1, 2018: Archives of Pathology & Laboratory Medicine
Cristiane M Ida, Patrick A Lundquist, Karen Weck, W Edward Highsmith
CONTEXT.—: The College of American Pathologists' proficiency testing program has been instrumental in identifying problems in clinical testing. OBJECTIVE.—: To describe how this program was used to identify a single-nucleotide polymorphism that affects clinical testing for spinocerebellar ataxia type 3. DESIGN.—: A proficiency testing sample with discordant results for spinocerebellar ataxia type 3 analysis was further evaluated by targeted Sanger sequencing and genotype polymerase chain reaction using multiple DNA polymerases...
November 1, 2018: Archives of Pathology & Laboratory Medicine
Tatiana Villatoro, Julie Katz Karp
Babesiosis is most commonly caused by Babesia microti and is transmitted via the bite of an infected Ixodes spp tick. However, Babesia is also transmitted via blood transfusion. In the United States, the first case of transfusion-transmitted babesiosis was recognized in 1979, and in recent years, the incidence has rapidly increased. Because most of the infected blood donors do not experience any symptoms, they pose a significant risk to the blood supply. Donor deferral for a history of babesiosis is currently performed but is ineffective...
October 30, 2018: Archives of Pathology & Laboratory Medicine
Savitri Krishnamurthy, Kechen Ban, Kenna Shaw, Gordon Mills, Rahul Sheth, Alda Tam, Sanjay Gupta, Sharjeel Sabir
CONTEXT.—: Rapid advances in the fields of biophotonics, computer science, and instrumentation have allowed for high-resolution imaging of biologic tissues. OBJECTIVE.—: To evaluate the quality of images from an optimized confocal fluorescence microscopy (CFM) platform for rapid evaluation of small fragments of tissue, compared with hematoxylin-eosin staining. DESIGN.—: Tissue fragments (up to 1.0 × 0.3 cm) were stained with 0.6 mM acridine orange for 60 seconds and imaged using a CFM platform at 488-nm and 785-nm wavelength...
October 30, 2018: Archives of Pathology & Laboratory Medicine
Jason D Merker, Kelly Devereaux, A John Iafrate, Suzanne Kamel-Reid, Annette S Kim, Joel T Moncur, Stephen B Montgomery, Rakesh Nagarajan, Bryce P Portier, Mark J Routbort, Craig Smail, Lea F Surrey, Patricia Vasalos, Alexander J Lazar, Neal I Lindeman
CONTEXT.—: Next-generation sequencing-based assays are being increasingly used in the clinical setting for the detection of somatic variants in solid tumors, but limited data are available regarding the interlaboratory performance of these assays. OBJECTIVE.—: To examine proficiency testing data from the initial College of American Pathologists (CAP) Next-Generation Sequencing Solid Tumor survey to report on laboratory performance. DESIGN.—: CAP proficiency testing results from 111 laboratories were analyzed for accuracy and associated assay performance characteristics...
October 30, 2018: Archives of Pathology & Laboratory Medicine
Jonathan J Lee, Christine G Lian
CONTEXT.—: The steady rise in the incidence of cutaneous malignant melanoma and its inherently difficult-to-interpret histopathology continues to fuel an increasing demand for diagnostically and prognostically insightful adjunctive molecular tests among both clinicians and dermatopathologists. A number of DNA, RNA, and epigenetically based assays have now been developed and are at various stages of experimental and/or clinical use. OBJECTIVE.—: To examine the evidence for the utility and limitations of these leading candidates for the diagnosis and risk stratification of melanoma and related melanocytic neoplasms...
October 24, 2018: Archives of Pathology & Laboratory Medicine
Mark Benedict, Xuchen Zhang
Calcifying nested stromal epithelial tumor is a rare entity that has gone by a variety of names in the literature: ossifying malignant mixed epithelial and stromal tumor, ossifying stromal-epithelial tumor, and desmoplastic nested spindle cell tumor of the liver. To our knowledge, approximately 38 cases have been reported in the literature. The histogenesis is still largely unknown but histopathologically is characterized by nests of spindle and epithelioid cells in an organoid arrangement surrounded by a prominent dense myofibroblastic stroma with occasional psammomatous calcification and focal heterotopic ossification...
October 24, 2018: Archives of Pathology & Laboratory Medicine
Katrina Collins, Saverio Ligato
CONTEXT.—: Duodenal epithelial polyps are reported in 1.5% to 3% of individuals referred for upper endoscopy. Most duodenal epithelial polyps are asymptomatic and nonneoplastic; however, a small subset is neoplastic and may progress to adenocarcinoma. Recent advances in immunohistochemical and molecular techniques have helped further characterize these polyps, shedding light on their origin, classification, and risk of progression to adenocarcinoma. OBJECTIVE.—: To provide a comprehensive clinicopathologic review of nonneoplastic and neoplastic duodenal epithelial polyps, with particular emphasis on recent developments in classification schemes and risk stratification based upon immunohistochemical and molecular profiles...
October 24, 2018: Archives of Pathology & Laboratory Medicine
Yen-Wen Lu, Yi-Chen Yeh
Ciliated muconodular papillary tumor is a rare tumor of the lung with 38 cases reported to date in the English literature. It is typically found incidentally in older adults (average age, 67 years) as a small, peripheral, ground glass opacity or nodule on computed tomography. Microscopically, the tumor is composed of a mixture of ciliated columnar, mucous, and basal cells in a variety of architectural patterns including glandular, papillary, lepidic, and micropapillary growth patterns. Recently, studies have shown the tumor has several associated gene alterations, supporting that the lesion is indeed neoplastic...
October 24, 2018: Archives of Pathology & Laboratory Medicine
Daniel B Schmolze, Andrew H Fischer
CONTEXT.—: Thyroid nodules are a common clinical problem. Cytologic evaluation via fine-needle aspiration is often employed in the diagnostic workup, and rapid on-site assessment of adequacy can help ensure an adequate sample is obtained. However, rapid on-site assessment of adequacy only examines part of the sample, a part that may not then be available for ancillary testing. Moreover, the procedure is time-consuming and poorly reimbursed. OBJECTIVE.—: To develop an automatable fluorescence-based image analysis system for assessing the adequacy of thyroid fine-needle aspirations that uses the entire aspirated sample...
October 24, 2018: Archives of Pathology & Laboratory Medicine
Erik Thunnissen
No abstract text is available yet for this article.
October 11, 2018: Archives of Pathology & Laboratory Medicine
Mark D Zarella, Douglas Bowman, Famke Aeffner, Navid Farahani, Albert Xthona, Syeda Fatima Absar, Anil Parwani, Marilyn Bui, Douglas J Hartman
CONTEXT.—: Whole slide imaging (WSI) represents a paradigm shift in pathology, serving as a necessary first step for a wide array of digital tools to enter the field. Its basic function is to digitize glass slides, but its impact on pathology workflows, reproducibility, dissemination of educational material, expansion of service to underprivileged areas, and intrainstitutional and interinstitutional collaboration exemplifies a significant innovative movement with far-reaching effects...
October 11, 2018: Archives of Pathology & Laboratory Medicine
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