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Archives of Pathology & Laboratory Medicine

Anna P Matynia, K David Li, Philippe Szankasi, Jonathan Schumacher, Michael Liew, Mohamed E Salama, Todd W Kelley
CONTEXT: - B-cell lymphomas exhibit balanced translocations that involve immunoglobulin loci and result from aberrant V(D)J recombination, class switch recombination, or somatic hypermutation. Although most of the breakpoints in the immunoglobulin loci occur in defined regions, those in the partner genes vary; therefore, it is unlikely that 2 independent clones would share identical breakpoints in both partners. Establishing whether a new lesion in a patient with history of lymphoma represents recurrence or a new process can be relevant...
July 6, 2018: Archives of Pathology & Laboratory Medicine
Huifei Liu, William R Sukov, Jae Y Ro
CONTEXT: - Pleomorphic hyalinizing angiectatic tumor (PHAT) of soft parts, hemosiderotic fibrolipomatous tumor (HFLT), and myxoinflammatory fibroblastic sarcoma (MIFS) are 3 distinct entities of low-grade spindle cell mesenchymal neoplasm. These tumors have similar clinical presentations and partially overlapping but distinctive pathologic features. A recurrent translocation, t(1;10)(p22;q24), has been detected in a subset of PHAT, HFLT, MIFS, and HFLT/MIFS hybrid cases. Translocation t(1;10)(p22;q24) involves transforming growth factor beta-receptor 3 ( TGFBR3) and meningioma-expressed antigen 5 ( MGEA5) genes on chromosomes 1p22 and 10q24, respectively...
July 6, 2018: Archives of Pathology & Laboratory Medicine
Yani Zhao, Fang-Ming Deng, Hongying Huang, Peng Lee, Hebert Lepor, Andrew B Rosenkrantz, Samir Taneja, Jonathan Melamed, Ming Zhou
CONTEXT: - In Gleason score GS (7) prostate cancers, the quantity of Gleason pattern 4 (GP 4) is an important prognostic factor and influences treatment decisions. Magnetic resonance imaging (MRI)-targeted biopsy has been increasingly used in clinical practice. OBJECTIVE: - To investigate whether MRI-targeted biopsy may detect GS 7 prostate cancer with greater GP 4 quantity, and whether it improves biopsy/radical prostatectomy GS concordance. DESIGN: - A total of 243 paired standard and MRI-targeted biopsies with cancer in either standard or targeted or both were studied, 65 of which had subsequent radical prostatectomy...
July 2, 2018: Archives of Pathology & Laboratory Medicine
Pratibha Sharma Shukla, Khushbakhat Mittal
CONTEXT: - Inflammatory myofibroblastic tumor is a mesenchymal neoplasm of low malignant potential. It was first described in lung, but is known to occur in many extrapulmonary sites including female genital organs, most commonly the uterus. It has a high recurrence rate and a low risk for metastasis. A more recently described aggressive variant, epithelioid myofibroblastic sarcoma with a predilection for the abdominal cavity of males, has also been recently reported to occur in ovary...
July 2, 2018: Archives of Pathology & Laboratory Medicine
Banseok Kim, Yongjung Park, Jin-Su Park, Kyoung Ja Jang, Hyo Jun Ahn, Min Hyuk Choi, Chan Hee Lee
CONTEXT: - Anticyclic citrullinated peptide antibodies are important serologic markers for the diagnosis of rheumatoid arthritis. Several kinds of test reagents for automated immunoassay systems have been developed and used in recent years. OBJECTIVE: - To evaluate the analytic and diagnostic performance of the new ADVIA Centaur anticyclic citrullinated peptide assay (Siemens Healthineers, Erlangen, Germany) compared with the Elecsys assay (Roche Diagnostics, Mannheim, Germany)...
June 27, 2018: Archives of Pathology & Laboratory Medicine
Thomas M Ulbright
CONTEXT: - In 2016 the World Health Organization published a revised classification of testicular neoplasms based upon advances in understanding their pathogenesis and molecular biology. The rationale for this revision and additional clinically relevant observations were the topics of a talk given to the Houston Society of Clinical Pathologists in April 2017. This paper summarizes that talk. OBJECTIVE: - To summarize and explain the most important changes to the classification of testicular neoplasms in the World Health Organization 2016 revision...
June 27, 2018: Archives of Pathology & Laboratory Medicine
Asangi R Kumarapeli, William Bellamy, Ericka Olgaard, Nicole Massoll, Soheila Korourian
CONTEXT: - A thorough gross examination of specimens for breast cancer requires the tissue to be very thinly sectioned, which is often difficult in large mastectomy samples. We have implemented rapid chilling of mastectomy specimens before formalin fixation. OBJECTIVE: - To evaluate the effects of rapid chilling of breast tissue on subsequent biomarker and molecular testing. DESIGN: - Mastectomy specimens were chilled at -80°C for 20 minutes to facilitate uniform sectioning of tissue at 4-mm intervals and enhance proper fixation and identification of small lesions...
June 22, 2018: Archives of Pathology & Laboratory Medicine
Melissa Alexander, Jessica Beyda, Anupma Nayak, Shabnam Jaffer
CONTEXT: - Mammographic screening has increased the incidence of ductal carcinoma in situ (DCIS), but this has not been accompanied by a decline in the incidence of invasive carcinoma (IC). Consequently, the surgical treatment of DCIS has recently been questioned, with some advocating only surveillance (with or without neoadjuvant endocrine therapy) after a core biopsy diagnosis of DCIS. OBJECTIVES: - To examine the predictive value of a core biopsy diagnosis of DCIS, particularly the upgrade rate to IC, and to identify associated factors...
June 22, 2018: Archives of Pathology & Laboratory Medicine
Mark D Zarella, Matthew R Quaschnick, David E Breen, Fernando U Garcia
CONTEXT: - Whole-slide imaging has ushered in a new era of technology that has fostered the use of computational image analysis for diagnostic support and has begun to transfer the act of analyzing a slide to computer monitors. Due to the overwhelming amount of detail available in whole-slide images, analytic procedures-whether computational or visual-often operate at magnifications lower than the magnification at which the image was acquired. As a result, a corresponding reduction in image resolution occurs...
June 18, 2018: Archives of Pathology & Laboratory Medicine
Douglas J Demetrick
Context Specimen misidentification is the most significant error in laboratory medicine, potentially accounting for hundreds of millions of dollars in extra health care expenses and significant morbidity in patient populations in the United States alone. New technology allows the unequivocal documentation of specimen misidentification or contamination; however, the value of this technology currently depends on suspicion of the specimen integrity by a pathologist or other health care worker. Objective To test the hypothesis that there is a detectable incidence of unsuspected tissue specimen misidentification among cases submitted for routine surgical pathology examination...
June 18, 2018: Archives of Pathology & Laboratory Medicine
Armen Khararjian, Prakash Mathew, Ajuni Choudhary, Alexander Baras
CONTEXT: - Intraoperative pathology consultation is an important tool for many surgical procedures and is deemed appropriate when the pathology result immediately alters surgical management. OBJECTIVE: - To evaluate the utility of intraoperative gross examinations of colorectal resections and to better understand the associated costs. DESIGN: - The pathology database of our institution was searched for colorectal resections for primary disease, and those cases were separated into 3 categories: frozen section performed, intraoperative gross examination performed, and no intraoperative consultation...
June 14, 2018: Archives of Pathology & Laboratory Medicine
Peter P Luk, Christina I Selinger, Annabelle Mahar, Wendy A Cooper
CONTEXT: - A small proportion of non-small cell lung cancers harbor rearrangements of ALK or ROS1 genes, and these tumors are sensitive to targeted tyrosine kinase inhibitors. It is crucial for pathologists to accurately identify tumors with these genetic alterations to enable patients to access optimal treatments and avoid unnecessary side effects of less effective agents. Although a number of different techniques can be used to identify ALK- and ROS1-rearranged lung cancers, immunohistochemistry and fluorescence in situ hybridization are the mainstays...
June 14, 2018: Archives of Pathology & Laboratory Medicine
Barina Aqil, Grace Triska, John Frater, Anjum Hassan, Marianna B Ruzinova, Amanda Cashen, Yvette Reese, Friederike Kreisel
Context Immunophenotypic variations in mantle cell lymphoma (MCL) from the classic CD5+ /CD10- /CD23- /FMC-7+ immunophenotype have been reported in the literature, but correlation with clinical behavior and outcome has not been fully studied. Objective To investigate clinicopathologic and prognostic differences between immunophenotypically aberrant MCL and immunophenotypically typical MCL. Design We evaluated differences in clinical presentation, laboratory parameters, prognostic indices, response to initial treatment, and progression-free and overall survival between patients with aberrant MCL and patients with immunophenotypically typical MCL...
June 5, 2018: Archives of Pathology & Laboratory Medicine
Eunhee S Yi, Geon Kook Lee
Context Air space invasion or aerogenous spread of lung adenocarcinoma is a relatively new concept and has been implicated as a potential prognostic factor as well as has been added as an exclusion point in the diagnosis of minimally invasive adenocarcinoma. Potential role for Ki-67 immunostaining as diagnostic and prognostic marker in pulmonary carcinoid tumors has been suggested in the literature, given the significant interobserver variability and the difficulty in predicting their clinical behavior. Objective To review the concept of air space invasion in lung adenocarcinoma and the current controversies regarding the role of Ki-67 immunostaining on pulmonary carcinoid tumors Data Sources PubMed search of English literature...
June 5, 2018: Archives of Pathology & Laboratory Medicine
Antonio C Wolff, M Elizabeth Hale Hammond, Kimberly H Allison, Brittany E Harvey, Pamela B Mangu, John M S Bartlett, Michael Bilous, Ian O Ellis, Patrick Fitzgibbons, Wedad Hanna, Robert B Jenkins, Michael F Press, Patricia A Spears, Gail H Vance, Giuseppe Viale, Lisa M McShane, Mitchell Dowsett
PURPOSE: - To update key recommendations of the American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) human epidermal growth factor receptor 2 (HER2) testing in breast cancer guideline. METHODS: - Based on the signals approach, an Expert Panel reviewed published literature and research survey results on the observed frequency of less common in situ hybridization (ISH) patterns to update the recommendations. RECOMMENDATIONS: - Two recommendations addressed via correspondence in 2015 are included...
May 30, 2018: Archives of Pathology & Laboratory Medicine
Leah B Strickland-Marmol, Carlos A Muro-Cacho, Kay Washington, Philip R Foulis
CONTEXT: - Cancer registrars should work closely with pathologists to ensure compliance with reporting standards. Many registrars, however, have little contact with pathologists, resulting in a lack of "real-time" interaction that is essential for their professional activities and development. OBJECTIVE: - To facilitate registrars' case management, as cancer biology becomes more complex, we developed the ATP (Ask the Pathologist) forum as a place to ask pathology-related questions about neoplasms, such as terminology, biology, histologic classification, extent of disease, molecular markers, and prognostic factors...
May 30, 2018: Archives of Pathology & Laboratory Medicine
John Turchini, Michael E Buckland, Anthony J Gill, Shane Battye
CONTEXT: - Three-dimensional (3D) photogrammetry is a method of image-based modeling in which data points in digital images, taken from offset viewpoints, are analyzed to generate a 3D model. This modeling technique has been widely used in the context of geomorphology and artificial imagery, but has yet to be used within the realm of anatomic pathology. OBJECTIVE: - To describe the application of a 3D photogrammetry system capable of producing high-quality 3D digital models and its uses in routine surgical pathology practice as well as medical education...
May 30, 2018: Archives of Pathology & Laboratory Medicine
Mariana Moreno Prats, Eizaburo Sasatomi, Heather L Stevenson
CONTEXT: - In this era of minimally invasive procedures for diagnosis, prognosis, and treatment, pathologists are at the forefront of analyzing specimens and are expected to make more specific diagnoses, providing additional information from the material they receive. OBJECTIVE: - To familiarize pathologists with the essential components of surgical pathology reports for colorectal liver metastases (CRLM) resections. DATA SOURCES: - Colorectal cancer is the third most common cancer in the world and the liver is the most frequent site of metastases...
May 23, 2018: Archives of Pathology & Laboratory Medicine
Beverly B Rogers, James L Adams, Alexis B Carter, Francine Uwindatwa, Cynthia B Brawley, Charles G Cochran, Leah N Bryan, Elizabeth P Weinzierl, Sampath Prahalad
CONTEXT: - Disruption of outpatient laboratory services by routing the samples to commercial reference laboratories may seem like a cost-saving measure by the payers, but results in hidden costs in quality and resources to support this paradigm. OBJECTIVE: - To identify differences when outpatient tests are performed at a Children's Hospital lab compared to a commercial reference lab, and the financial costs to support the reference laboratory testing. DESIGN: - Outpatient testing was sent to 3 different laboratories, specified by the payer...
May 23, 2018: Archives of Pathology & Laboratory Medicine
James R Wright, Samuel J M M Alberti, Christopher Lyons, Richard S Fraser
CONTEXT: - In the early 1900s, it was common practice to retain, prepare, and display instructive pathologic specimens to teach pathology to medical trainees and practitioners; these collections were called medical museums. Maude Abbott established her reputation by developing expertise in all aspects of medical museum work. She was a founder of the International Association of Medical Museums (later renamed the International Academy of Pathology) and became an internationally renowned expert on congenital heart disease...
May 7, 2018: Archives of Pathology & Laboratory Medicine
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