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Archives of Pathology & Laboratory Medicine

Sarah M Choi, Bryan L Betz, Anamarija M Perry
CONTEXT: - Follicular lymphoma is a common small B-cell lymphoma, likely to be encountered by any practicing pathologist, regardless of specialty. Although the features of typical follicular lymphoma are well known and in most instances easily identifiable, there are lesser-appreciated morphologic appearances that can raise alternative diagnostic possibilities. The limited tissue available in core needle biopsies can make it additionally challenging to thoroughly evaluate those features in the context of architecture...
September 17, 2018: Archives of Pathology & Laboratory Medicine
Ming Guo, Abha Khanna, Jianping Wang, Michelle D Williams, Neda Kalhor, Yun Gong, Li Xu, Erich M Sturgis, Gregg Staerkel
CONTEXT: - Human papillomavirus (HPV) DNA in situ hybridization (ISH) assay and p16 immunohistochemistry (IHC) are used to determine high-risk HPV status in formalin-fixed, paraffin-embedded (FFPE) tissues in oropharyngeal squamous cell carcinoma (SCC). Although high sensitivity and specificity for HPV can be obtained by combined p16-IHC and HPV DNA-ISH, the occasional discrepancy between these assays has prompted evaluation of Cervista HPV assays in FFPE tissue from patients with oropharyngeal SCC...
September 17, 2018: Archives of Pathology & Laboratory Medicine
Ron B Schifman, Peter L Perrotta, Rhona Souers, Barbara J Blond
CONTEXT: - Managing the utilization of laboratory tests is an important quality improvement activity that adds value to health care. OBJECTIVE: - To examine utilization of 3 laboratory tests and identify factors that impact performance. DESIGN: - Test utilization performance was evaluated by determining the frequency with which appropriate preconditions for testing were met. This included 30 testing episodes each involving (1) free prostate-specific antigen (PSA) when total PSA was within an appropriate interpretable range, (2) total anti-hepatitis A virus antibody when previous anti-hepatitis A virus antibody results were either negative or not done, and (3) factor V Leiden mutation when a previous result was not already available...
September 11, 2018: Archives of Pathology & Laboratory Medicine
May P Chan
CONTEXT: - Histologic distinction between condyloma acuminatum and various benign and malignant condyloma-like lesions in the anogenital area poses a common diagnostic challenge to pathologists across subspecialties. OBJECTIVE: - To review the overlapping and distinguishing features of condyloma acuminatum and its mimics, and to clarify confusing terminology and diagnostic criteria for problematic entities. DATA SOURCES: - A review of the literature on condyloma acuminatum (ordinary and giant types), verrucous carcinoma, warty/warty-basaloid high-grade squamous intraepithelial lesion and squamous cell carcinoma, papillary squamous cell carcinoma, bowenoid papulosis, verruca vulgaris, epidermolytic acanthoma, and verruciform xanthoma was performed...
September 11, 2018: Archives of Pathology & Laboratory Medicine
Rebecca J Baldassarri, Deepika Kumar, Stephen Baldassarri, Guoping Cai
CONTEXT: - Respiratory cytology continues to play an important role in the diagnosis of lower respiratory tract infections. Prompt, accurate diagnosis of causative organisms is of paramount importance, particularly in immunosuppressed patients. In addition, a rapidly expanding arsenal of ancillary testing is now available, aiding tremendously in organism identification. OBJECTIVE: - To provide an updated review on the cytomorphologic features of common organisms in lower respiratory tract infection...
September 11, 2018: Archives of Pathology & Laboratory Medicine
Federico De Marchi, Lisa Haley, Henderson Fryer, Junaid Ibrahim, Katie Beierl, Gang Zheng, Christopher D Gocke, James R Eshleman, Deborah Belchis, Peter Illei, Ming-Tseh Lin
CONTEXT: - Mutations within the same signature transduction pathway are redundant and, therefore, most are mutually exclusive. Laboratory errors, however, may introduce unexpected coexisting mutations. OBJECTIVE: - To validate coexisting mutations within epidermal growth factor receptor (EGFR), mitogen-activated protein kinase, and phosphatidylinositol 3-kinase pathways. DESIGN: - In this retrospective study for quality assessment of next-generation sequencing in a clinical diagnostics setting, coexisting mutations within EGFR, KRAS, NRAS, BRAF, AKT1, and PIK3CA genes were examined in 1208 non-small cell lung cancers...
September 7, 2018: Archives of Pathology & Laboratory Medicine
Pooja Navale, Ira J Bleiweiss, Shabnam Jaffer, Anupma Nayak
CONTEXT: - The College of American Pathologists guidelines recommend testing additional tumor foci in multifocal invasive breast carcinomas for the biomarkers estrogen receptor (ER), progesterone receptor, and HER2, only if the carcinomas show different morphologies or grades. OBJECTIVE: - To assess clinical significance of testing for biomarkers in additional tumor foci in multifocal invasive breast tumors. DESIGN: - Retrospective analysis of 118 patients diagnosed with ipsilateral synchronous multifocal breast carcinomas from January 2015 through March 2016 at Mount Sinai Hospital (New York, New York)...
September 7, 2018: Archives of Pathology & Laboratory Medicine
Famke Aeffner, Crystal Faelan, Steven A Moore, Alexander Moody, Joshua C Black, Jay S Charleston, Diane E Frank, Johannes Dworzak, J Kris Piper, Manish Ranjitkar, Kristin Wilson, Suzanne Kanaly, Daniel G Rudmann, Holger Lange, G David Young, Anthony J Milici
CONTEXT: - Duchenne muscular dystrophy is a rare, progressive, and fatal neuromuscular disease caused by dystrophin protein loss. Common investigational treatment approaches aim at increasing dystrophin expression in diseased muscle. Some clinical trials include assessments of novel dystrophin production as a surrogate biomarker of efficacy, which may predict a clinical benefit from treatment. OBJECTIVES: - To establish an immunofluorescent scanning and digital image-analysis workflow that provides an objective approach for staining-intensity assessment of the immunofluorescence dystrophin labeling and determination of the percentage of biomarker-positive fibers in muscle cryosections...
August 31, 2018: Archives of Pathology & Laboratory Medicine
Brandon Umphress, Kirtee Raparia
CONTEXT: - Rhinoscleroma is a rare, chronic, infectious granulomatous process involving the upper respiratory tract, caused by gram-negative bacilli, Klebsiella rhinoscleromatis. The site most commonly affected is the nasopharynx; however, lesions in various other locations have been described. OBJECTIVE: - To review the literature for all the reported cases of rhinoscleroma in the past 5 years. DATA SOURCES: - Published cases of rhinoscleroma from the PubMed (National Center for Biotechnology Information, Bethesda, Maryland) search were reviewed...
August 31, 2018: Archives of Pathology & Laboratory Medicine
Ali Akalin, Ayşegül Ergin, Stanley Remiszewski, Xinying Mu, Dan Raz, Max Diem
This paper reports the results of a collaborative lung cancer study between City of Hope Cancer Center (Duarte, California) and CIRECA, LLC (Cambridge, Massachusetts), comprising 328 samples from 249 patients, that used an optical technique known as spectral histopathology (SHP) for tissue classification. Because SHP is based on a physical measurement, it renders diagnoses on a more objective and reproducible basis than methods based on assessing cell morphology and tissue architecture. This report demonstrates that SHP provides distinction of adenocarcinomas from squamous cell carcinomas of the lung with an accuracy comparable to that of immunohistochemistry and highly reliable classification of adenosquamous carcinoma...
August 24, 2018: Archives of Pathology & Laboratory Medicine
Barbara A Crothers, Mohiedean Ghofrani, Chengquan Zhao, Leslie G Dodd, Kelly Goodrich, Mujtaba Husain, Daniel F I Kurtycz, Donna K Russell, Rulong Z Shen, Rhona J Souers, Paul N Staats, Z Laura Tabatabai, Benjamin L Witt, Diane Davis Davey
CONTEXT: - Obtaining diagnostic concordance for squamous intraepithelial lesions in cytology can be challenging. OBJECTIVE: - To determine diagnostic concordance for biopsy-proven low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) Papanicolaou test slides in the College of American Pathologists PAP Education program. DESIGN: - We analyzed 121 059 responses from 4251 LSIL and HSIL slides for the interval 2004 to 2013 using a nonlinear mixed-model fit for reference diagnosis, preparation type, and participant type...
August 22, 2018: Archives of Pathology & Laboratory Medicine
Lori Cory, Mark A Morgan
CONTEXT: - Clinical management of gynecologic malignancies is often multimodal. Pathologic diagnoses, patient-related factors, and disease-related factors all contribute to clinical decision making. OBJECTIVE: - To review the role of surgical pathology in treatment planning among women with gynecologic malignancies. DATA SOURCES: - An analysis of relevant literature (PubMed Plus [National Center for Biotechnology Information, Bethesda, Maryland] and Medline [Ovid, New York, New York]) and the authors' clinical-practice experience were used...
August 22, 2018: Archives of Pathology & Laboratory Medicine
Jerad M Gardner, Timothy C Allen
Recent privacy breaches by a major social media company have again raised questions from some pathologists regarding the legality and ethics of sharing pathology images on social media. The authors examined ethical principles as well as historic and legal precedents relevant to pathology medical photography. Taking and sharing photographs of pathology specimens is embedded into the culture of the specialty of pathology and has been for more than a century. In general, the pathologist who takes the photograph of a gross or microscopic specimen owns the copyright to that photograph...
August 22, 2018: Archives of Pathology & Laboratory Medicine
Jonathan Harris, Laila O AbdelWareth, Sara Lari, Kate O Callaghan, Peter Anderson, Imran Mirza
CONTEXT: - The health care industry is growing rapidly and is continually seeking more-innovative ways to deliver patient care. The growing demands of clinicians seeking faster and more-efficient ways of providing care to their patients presents challenges to clinical laboratory services. Point-of-care testing (POCT) is frequently seen as a viable solution to address this dilemma. The role of POCT is widely established and accepted in many circumstances provided certain criteria are met...
August 20, 2018: Archives of Pathology & Laboratory Medicine
David L Wachter, Peter W Wachter, Peter A Fasching, Matthias W Beckmann, Carolin C Hack, Marc-Oliver Riener, Arndt Hartmann, Johanna D Strehl
CONTEXT: - Paget disease of the breast, in most cases, represents intraepidermal spread of ductal carcinoma in situ. Molecular subtypes of invasive carcinoma of the breast have prognostic and therapeutic significance and show characteristic distribution. Little is known about the distribution of molecular subtypes in Paget disease of the breast. OBJECTIVES: - To examine the distribution of molecular subtypes in Paget disease of the breast and to compare them to concurrent invasive carcinoma of the breast, if present...
August 20, 2018: Archives of Pathology & Laboratory Medicine
Manuel Algora, Gloria Grabski, Anna Liza Batac-Castro, James Gibbs, Nyaradzo Chada, Sharhabil Humieda, Shafeeq Ahmad, Peter Anderson, Priscila I Figueroa, Imran Mirza, Laila AbdelWareth
CONTEXT: - Opening a new hospital is a once in a lifetime experience and can be very inspiring for those involved in its activation. However, establishing a safe transfusion practice in a greenfield environment comes with unique challenges and opportunities. OBJECTIVE: - To highlight critical activation components such as on-boarding of new personnel, establishing clinical practices, and integrating critical laboratory software. DESIGN: - Our staff initially faced challenges in standardizing transfusion medicine clinical practice inside the laboratory...
August 13, 2018: Archives of Pathology & Laboratory Medicine
Rachel Jug, Xiaoyin Sara Jiang, Sarah M Bean
CONTEXT: - Feedback is the delivery of information based on direct observation that is meant to improve performance. Learning is at the heart of feedback, and as such, feedback is a required competency in pathology resident education. In the laboratory setting, the ability of laboratory professionals in all practice settings and experience levels to give and receive feedback is crucial to workflow and ultimately patient care. OBJECTIVE: - To summarize the importance of feedback, strategies for optimizing feedback exchange, and overcoming barriers to giving and receiving feedback...
August 13, 2018: Archives of Pathology & Laboratory Medicine
Jing Li, Stephanie Gan, Alan Blair, Kyungji Min, Taraneh Rehage, Corey Hoeppner, Harkanwal Halait, Victoria H Brophy
CONTEXT: - KRAS Mutation Test v2 is used for the qualitative detection and identification of 28 mutations in exons 2, 3, and 4 of the human KRAS gene. OBJECTIVE: - To verify the performance of KRAS Mutation Test v2 and to evaluate its accuracy by correlation with a next-generation sequencing method on Illumina MiSeq. DESIGN: - In the study, we used formalin-fixed, paraffin-embedded tissue and plasma specimens from non-small cell lung cancer, colorectal cancer, and pancreatic cancer patients...
August 8, 2018: Archives of Pathology & Laboratory Medicine
Raj P Kapur, Miguel Reyes-Mugica
CONTEXT: - Intestinal neuronal dysplasia type B (IND B) is a controversial histopathologic phenotype that has been associated with intestinal dysmotility, either as an isolated condition or in conjunction with established pathologic disorders (eg, Hirschsprung disease). Many factors contribute to the debate over the existence and/or clinical significance of IND B, including a large body of published data based on inconsistent diagnostic criteria and methods, which have fostered many unwarranted conclusions that lack sufficient scientific basis...
August 8, 2018: Archives of Pathology & Laboratory Medicine
Yi Tat Tong, Nghia D Nguyen, Amer Wahed
CONTEXT: - Howell-Jolly body-like inclusions have been previously associated with patients who are human immunodeficiency virus (HIV) infected, taking antiviral medications, and immunosuppressed. These inclusions appear in neutrophils and resemble Howell-Jolly bodies of normoblasts in abnormal erythropoiesis. In granulocytes, they are thought to represent detached nuclear fragments produced from dysplastic granulopoiesis. To the best of our knowledge, no association of Howell-Jolly body-like inclusions and myelodysplastic syndrome (MDS) has been reported previously...
July 30, 2018: Archives of Pathology & Laboratory Medicine
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