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Thyroid cytology comes to Bethesda.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19846804 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Stanley MW Tags: Am J Clin Pathol Source Type: journals

The Bethesda System For Reporting Thyroid Cytopathology.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
To address terminology and other issues related to thyroid fine-needle aspiration (FNA), the National Cancer Institute (NCI) hosted the NCI Thyroid FNA State of the Science Conference. The conclusions regarding terminology and morphologic criteria from the NCI meeting led to the Bethesda Thyroid Atlas Project and form the framework for The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). For clarity of communication, TBSRTC recommends that each report begin with 1 of 6 general diagnostic categories. The project participants hope that the adoption of this flexible framework will facilitate communication amo...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Cibas ES, Ali SZ Tags: Am J Clin Pathol Source Type: journals

Epidemiology and susceptibilities of methicillin-resistant Staphylococcus aureus in Northeastern Ohio.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This report sheds further light on the rapid spread of MRSA across Northeastern Ohio, stressing the need for better education in preventive measures and infection control at the level of community and health care settings. PMID: 19846806 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Delorme T, Rose S, Senita J, Callahan C, Nasr P Tags: Am J Clin Pathol Source Type: journals

Is the QuantiFERON-TB blood assay a good replacement for the tuberculin skin test in tuberculosis screening? a pilot study at Berkshire Medical Center.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a pilot study comparing the QFT-GIT and TST results for screening health care workers (HCWs) at Berkshire Medical Center (BMC; Pittsfield, MA), the second hospital in Massachusetts to use QFT-GIT. For the study, 40 BMC HCWs, 20 TST+ and 20 TST-, were screened with the QFT-GIT test. All 20 TST- subjects were also QFT-GIT-, while only 10 of 20 TST+ subjects were QFT-GIT+. The overall agreement between the QFT-GIT and TST results was 75% (kappa = 0.5; 95% confidence interval, 0.268-0.732). The suboptimal agreement was partially due to a higher specificity of QFT-GIT. Confounding factors (eg, bacille Calmette-Gué...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Zhao X, Mazlagic D, Flynn EA, Hernandez H, Abbott CL Tags: Am J Clin Pathol Source Type: journals

Relative quantity of cerebrospinal fluid herpes simplex virus DNA in adult cases of encephalitis and meningitis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The objective of this study was to assess differences in semiquantitative PCR values, based on the crossing threshold (Ct) value for cases of HSV meningitis and encephalitis. A retrospective chart review was performed for 29 patients with a documented diagnosis of HSV meningitis or encephalitis during the course of 5 years from a large urban academic hospital. Demographic information, cerebrospinal fluid (CSF) laboratory findings, and PCR data were obtained for each patient. There was no statistically significant difference in the Ct values in patients with meningitis or encephalitis. In addition, no differences were found...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Murphy RF, Caliendo AM Tags: Am J Clin Pathol Source Type: journals

Aberrant underexpression of CD81 in precursor B-cell acute lymphoblastic leukemia: utility in detection of minimal residual disease by flow cytometry.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We studied CD81 expression by flow cytometry (FC) on benign precursor B cells (hematogones) and leukemic blasts in precursor B-cell acute lymphoblastic leukemia (pre-B-ALL) and established its usefulness in minimal residual disease (MRD) assays. Hematogones showed uniformly bright CD81 expression. In 98 pre-B-ALLs at diagnosis or overt relapse, 80 (82%) showed aberrantly decreased CD81 intensity. We used hematogones in 139 MRD- specimens to set a lower threshold for normal CD81 expression. In 133 specimens positive for residual pre-B-ALL, 87.2% showed increased CD81-dim immature B cells (>10%) and/or a discrete clus...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Muzzafar T, Medeiros LJ, Wang SA, Brahmandam A, Thomas DA, Jorgensen JL Tags: Am J Clin Pathol Source Type: journals

Immunophenotypic variations in mantle cell lymphoma.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study, we evaluated 52 patients with confirmed diagnoses of MCL and identified variant immunophenotypes in 21 patients (19/48 classical and 2/4 variant MCLs), including CD5- in 6 (12%) of 52, CD10+ in 4 (8%) of 50, CD23+ in 10 (21%) of 48, and FMC7- in 4 (11%) of 37 cases. Three cases showed variations in 2 antigens, including CD5-/CD23+, CD10+/FMC7-, and CD23+/FMC7-; they were all classical MCLs. One blastoid variant MCL was CD23+, and one was FMC7-. Evaluation for proliferation index by immunohistochemical analysis for Ki-67 demonstrated no significant difference between MCLs with variant immunophenotypes and MCL...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Gao J, Peterson L, Nelson B, Goolsby C, Chen YH Tags: Am J Clin Pathol Source Type: journals

Lymphocyte-depleted thymic remnants: a potential diagnostic pitfall in the evaluation of central neck dissections.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report 3 cases of lymphocyte-poor thymic remnants identified in central cervical (level VI) lymph node dissections for unrelated benign and malignant pathology. In each, the rests were nearly completely composed of bland epithelial cells with rare admixed lymphocytes. These cells were immunophenotypically similar to thymic epithelial cells, although they differed in the paucity of associated thymic lymphocytes and lack of Hassall corpuscles. Lymphocyte-depleted thymic remnants in the central cervical compartment are not well described in the literature. It is important to be aware of these and other benign inclusions to...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Talmon GA, Lewis JE Tags: Am J Clin Pathol Source Type: journals

Clinical performance of JAK2 V617F mutation detection assays in a molecular diagnostics laboratory: evaluation of screening and quantitation methods.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The presence of the JAK2 V617F mutation is now part of clinical diagnostic algorithms, and JAK2 status is routinely assessed when BCR/ABL- chronic myeloproliferative neoplasms (MPNs) are suspected. The aim of this study was to evaluate performance of 3 screening and 1 quantitative method for JAK2 V617F detection. For the study, 43 samples (27 bone marrow aspirates and 16 peripheral blood samples) were selected. The screening assays were the JAK2 Activating Mutation Assay (InVivoScribe, San Diego, CA), JAK2 MutaScreen kit (Ipsogen, Luminy Biotech, Marseille, France), and a home-brew melting curve analysis method. Ipsoge...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Cankovic M, Whiteley L, Hawley RC, Zarbo RJ, Chitale D Tags: Am J Clin Pathol Source Type: journals

T-cell receptor gene rearrangement and CD30 immunoreactivity in traumatic ulcerative granuloma with stromal eosinophilia of the oral cavity.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We examined the immunoreactivity for CD30 and T-cell receptor (TCR) gamma gene rearrangement in 37 TUGSE cases. Clonal TCR gene rearrangements were demonstrated in 7 (24%) of 29 cases with amplifiable DNA, and the morphologic features and CD30 immunoreactivity of these cases did not differ from those with polyclonal TCR gene rearrangements. Clinical follow-up was available for 5 of 7 TUGSE cases with clonal TCR gene rearrangement for an average period of 1.75 years after the initial biopsy or excision, and there was no evidence of local recurrence or development of systemic T-cell lymphoproliferative disorder. Without morp...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Salisbury CL, Budnick SD, Li S Tags: Am J Clin Pathol Source Type: journals

Flow cytometric immunophenotyping and minimal residual disease analysis in multiple myeloma.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Presence of normal plasma cells (PCs), hemodilution of bone marrow aspirate, and changes in the immunophenotype are important considerations in minimal residual disease (MRD) assessment in multiple myeloma (MM). We evaluated 124 subjects-107 with MM, 11 with Hodgkin lymphoma, and 6 allogeneic stem cell transplantation donors-for the immunophenotype of neoplastic, reactive, and normal PCs respectively. Of the patients with MM, 36 were evaluated for MRD and 23 for a change in immunophenotype after chemotherapy. The immunophenotype of normal and reactive PCs was similar and differed from that of neoplastic PCs with respec...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Gupta R, Bhaskar A, Kumar L, Sharma A, Jain P Tags: Am J Clin Pathol Source Type: journals

Significant CD5 expression on normal stage 3 hematogones and mature B Lymphocytes in bone marrow.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
B-cell maturation from hematogones to mature B cells in bone marrow exhibits a consistent, complex spectrum of sequential antigen expression. CD5 expression, however, has not been characterized. We studied the dynamics of CD5 expression on developing B cells by 4-color flow cytometry in 32 patients, aged 9 months to 63 years, with hematogone hyperplasia (>3.5% of total events). The mean percentage of hematogones was 8.1%. We demonstrate consistent CD5 expression on normal, polytypic B cells in a continuum, predominantly at later stages of maturation, specifically on stage 3 hematogones and mature B cells. Awareness ...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Fuda FS, Karandikar NJ, Chen W Tags: Am J Clin Pathol Source Type: journals

Fine-needle aspiration biopsy of chondromyxoid fibroma: an investigation of four cases.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the cytologic features of chondromyxoid fibroma in fine-needle aspiration biopsy specimens in 4 patients. We analyzed rapid Romanowsky- and Papanicolaou-stained slides with a respect to overall cellularity, the presence of hypercellular chondromyxoid fragments (HCFs), nuclear atypia, cytoplasmic features, and the presence of giant cells. The most consistent and diagnostically useful feature was the presence of HCFs, which were present in all 4 cases. Mild to moderate nuclear atypia was additionally present in all 4 cases. Most cases were hypocellular (3/4). Giant cells were present in 2 cases, with 1 case exhib...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Bergman S, Madden CR, Geisinger KR Tags: Am J Clin Pathol Source Type: journals

Time trends in fungal infections as a cause of death in hematopoietic stem cell transplant recipients: an autopsy study.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Infectious complications remain an important cause of death in hematopoietic stem cell transplant (HSCT) recipients. We undertook a 20-year (1988-2007) retrospective review of all autopsies performed on HSCT recipients in our institution, with emphasis on infections, especially fungal infections, as the cause of death. Of the 2,943 autopsies performed in our institution from 1988 to 2007, 395 (13.4%) involved HSCT recipients (117 pediatric; 278 adult). Of the patients, 298 had received allogeneic, 46 autologous, 41 umbilical cord blood, and 3 autologous plus allogeneic types, and 7 were unknown HSCT types. The most com...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Alsharif M, Cameron SE, Young JA, Savik K, Henriksen JC, Gulbahce HE, Pambuccian SE Tags: Am J Clin Pathol Source Type: journals

Evaluation of cell surface expression of phosphatidylserine in ovarian carcinoma effusions using the annexin-V/7-AAD assay: clinical relevance and comparison with other apoptosis parameters.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present the first evidence of annexin-V expression in ovarian carcinoma effusions. The higher annexin-V expression compared with other apoptosis parameters and its association with high-grade disease and poor survival in postchemotherapy patients suggest a role in cell survival rather than apoptosis in effusions. PMID: 19846818 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Dong HP, Holth A, Kleinberg L, Ruud MG, Elstrand MB, Tropé CG, Davidson B, Risberg B Tags: Am J Clin Pathol Source Type: journals

Should pathologists send all or only selected slides for patient-requested interlaboratory second opinion?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
For interlaboratory second opinions requested by patients or clinicians, whether all or selected slides should be sent is unknown. We compared the disagreement rate for requested second opinions for 4 years of sending selected slides with the rate for 1 year of sending all slides. Disagreements were identified in 81 (13.6%) of 596 cases (468 selected slides, 128 all slides). The disagreement rate was less when sending selected slides (n = 58 [12%]) vs all slides (n = 23 [18%]; P = .03). Only 5 cases were identified with disagreement related to whether all or selected slides were sent (selected slides, 1 case [slide of ...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Renshaw MA, Renshaw AA, Gould EW Tags: Am J Clin Pathol Source Type: journals

The Becton Dickinson FocalPoint GS Imaging System: clinical trials demonstrate significantly improved sensitivity for the detection of important cervical lesions.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Location-guided screening in cervical cytology offers a potentially significant advance over routine manual screening. A prospective, 2-armed, masked clinical trial of the BD FocalPoint GS Imaging System using SurePath slides (BD Diagnostics-TriPath, Burlington, NC) compared routine manual screening and quality control rescreening with computer-assisted, field-of-view screening and device-directed quality control rescreening. The results obtained in the 2 arms were compared with adjudicated reference diagnoses for each slide. Sensitivity, specificity, and negative predictive value were calculated for the detection of a...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Wilbur DC, Black-Schaffer WS, Luff RD, Abraham KP, Kemper C, Molina JT, Tench WD Tags: Am J Clin Pathol Source Type: journals

p16(INK4a) expression analysis as an ancillary tool for cytologic diagnosis of urothelial carcinoma.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We immunochemically studied p16(INK4a) expression in 116 urine cytologic samples and compared results with 190 histologic samples. The cytologic samples were classified into 4 groups: 1, mild cellular atypia; 2, moderate cellular atypia; 3, severe cellular atypia; and 4, malignancy. Overexpression of p16(INK4a) was detected in none of 32 cases in group 1, 8 (16%) of 50 cases in group 2, 5 (42%) of 12 cases in group 3, and 11 (50%) of 22 cases in group 4. In addition, by histologic analysis, p16(INK4a) overexpression was not detected in nonneoplastic urothelium, except for a few cases of reactive atypia, but it was dete...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Nakazawa K, Murata S, Yuminamochi T, Ishii Y, Ohno S, Nakazawa T, Kondo T, Katoh R Tags: Am J Clin Pathol Source Type: journals

Accuracy of urine cytology and the significance of an atypical category.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The "atypical urothelial cell" cytologic category is nonstandardized. We subclassify atypical cases to "atypical, favor a reactive process" or "atypical, unclear if reactive or neoplastic." We evaluated the predictive significance of atypical cases by looking at their histologic follow-up. Among the 1,114 patients and 3,261 specimens included, 282 specimens had histologic follow-up. An atypical diagnosis did not carry a significant increased risk of urothelial neoplasia compared with the benign category. Although an "atypical unclear" diagnosis carried a higher rate of detection of high-grade cancer on follow-up biopsy...
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Brimo F, Vollmer RT, Case B, Aprikian A, Kassouf W, Auger M Tags: Am J Clin Pathol Source Type: journals

Embolization of hydrophilic catheter coating to the lungs: report of a case mimicking granulomatous vasculitis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of embolization of hydrophilic coating of a central venous catheter to the lung that resulted in cavitary lung nodules in a 34-year-old woman. The microscopic features of this unusual complication warrant emphasis so that pathologists will not overlook the embolic foreign material and make a faulty diagnosis of noniatrogenic granulomatous vasculitis. PMID: 19846823 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Allan RW, Alnuaimat H, Edwards WD, Tazelaar HD Tags: Am J Clin Pathol Source Type: journals

Assessment of platelet function in whole blood by multiple electrode aggregometry: transport of samples using a pneumatic tube system.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19846825 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Braun S, von Beckerath N, Ellert J, Kastrati A, Schömig A, Vogt W, Sibbing D, Paniccia R, Gori AM, Marcucci R, Prisco D, Abbate R, Antonucci E, Maggini N, Romano E Tags: Am J Clin Pathol Source Type: journals

Measuring of ESR with test 1 is more useful than the Westergren method in rheumatoid arthritis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19846826 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Lee WS, Kim TY Tags: Am J Clin Pathol Source Type: journals

On the meaning of the erythrocyte sedimentation rate.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19846827 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - October 24, 2009 Category: Pathology Authors: Fiorucci G Tags: Am J Clin Pathol Source Type: journals

Diabetic microangiopathy in the liver: an autopsy study of incidence and association with other diabetic complications.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study supports the presumed vascular etiology of DH, confirms the rarity of the lesion, and supports the suggestion that it is usually accompanied by other end-organ damage. PMID: 19762525 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Hudacko RM, Sciancalepore JP, Fyfe BS Tags: Am J Clin Pathol Source Type: journals

In situ evidence of KRAS amplification and association with increased p21 levels in non-small cell lung carcinoma.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Recent advances in the characterization of the lung cancer genome have suggested that KRAS may frequently be amplified, although little is known regarding the significance of this finding. This is in contrast with activating mutations of KRAS, which occur in approximately 20% of non-small cell lung carcinomas (NSCLCs). We used fluorescence in situ hybridization to provide direct evidence of KRAS amplification for the first time in clinical specimens. We detected amplification in 7 of 100 consecutive NSCLCs, with a concurrent activating KRAS mutation in 4 cases. KRAS amplification was associated with greater expression ...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Wagner PL, Perner S, Rickman DS, LaFargue CJ, Kitabayashi N, Johnstone SF, Weir BA, Meyerson M, Altorki NK, Rubin MA Tags: Am J Clin Pathol Source Type: journals

The assessment of specimens procured by endoscopic ampullectomy.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Endoscopic ampullectomy (EA) is increasingly used in the management of ampullary neoplasia. Although studies on the safety and efficacy of this procedure exist, no study has specifically addressed the histopathologic features of the specimens. We review our experience with 45 EA specimens assessed for the following: diagnosis, high-grade dysplasia (HGD), submucosal ampullary gland/ductule involvement, specimen integrity, and margin status. Familial adenomatous polyposis (FAP) status and the endoscopist's impression of completeness of removal were also ascertained. Previous biopsy diagnoses were compared with ampullecto...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Bellizzi AM, Kahaleh M, Stelow EB Tags: Am J Clin Pathol Source Type: journals

Chromogenic in situ hybridization: a multicenter study comparing silver in situ hybridization with FISH.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Our purposes were to perform a robust assessment of a new HER2 chromogenic in situ hybridization test and report on concordance of silver in situ hybridization (SISH) data with fluorescence in situ hybridization (FISH) data and on intraobserver and interlaboratory scoring consistency. HER2 results were scored from 45 breast cancers in 7 laboratories using the Ventana (Tucson, AZ) INFORM HER-2 SISH assay and in 1 central laboratory using a standard FISH assay. Overall, 94.8% of cases were successfully analyzed by SISH across the 6 participating laboratories that reported data. Concordance for diagnosis of HER2 amplifica...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Bartlett JM, Campbell FM, Ibrahim M, Wencyk P, Ellis I, Kay E, Connolly Y, O'Grady A, Di Palma S, Starczynski J, Morgan JM, Jasani B, Miller K Tags: Am J Clin Pathol Source Type: journals

Usefulness of a synoptic data tool for reporting of head and neck neoplasms based on the College of American Pathologists cancer checklists.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report our experience with synoptic reporting on head and neck neoplasms, demonstrating, in particular, how this can be customized according to needs of each institution. PMID: 19762529 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Kang HP, Devine LJ, Piccoli AL, Seethala RR, Amin W, Parwani AV Tags: Am J Clin Pathol Source Type: journals

CDX-2 expression is a common event in primary intestinal-type endocervical adenocarcinoma.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We studied the expression of cytokeratin (CK) 7, CK20, CDX-2, and p16 in 119 cervical adenocarcinomas (65 usual type [50 invasive; 15 in situ], 37 intestinal type [21 invasive; 16 in situ], 10 endometrioid, 5 adenosquamous, and 2 signet-ring carcinomas) in comparison with 55 cases of rectal adenocarcinomas. The percentage of cells staining was considered negative if 0% to 5% stained; more than 5% was considered positive. For p16, staining of more than 50% was considered positive. CK7 was expressed in all cervical cases and in 12 rectal adenocarcinomas (22%). CK20 was expressed in 17 cervical adenocarcinomas (14.3%) and...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Saad RS, Ismiil N, Dubé V, Nofech-Mozes S, Khalifa MA Tags: Am J Clin Pathol Source Type: journals

Emerging technologies for assessing HER2 amplification.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Patients with human epidermal growth factor receptor-2 (HER2)+ breast cancer are eligible for trastuzumab treatment; therefore, accurate assessment of HER2 status is essential. Until recently, only 2 methods were validated for determining the HER2 status of breast tumors in the routine diagnostic setting: immunohistochemical analysis and fluorescence in situ hybridization (FISH). Recently, bright-field in situ hybridization techniques such as chromogenic in situ hybridization (CISH) and silver-enhanced in situ hybridization (SISH), which combine features of immunohistochemical analysis and FISH, have been introduced fo...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Penault-Llorca F, Bilous M, Dowsett M, Hanna W, Osamura RY, Rüschoff J, van de Vijver M Tags: Am J Clin Pathol Source Type: journals

Influence of credentials of clinical laboratory professionals on proficiency testing performance.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The influence of the training, experience, and credentials of testing personnel in the increasingly complex laboratory is a significant concern. A retrospective study compared the relationship of proficiency testing (PT) performance with the credentials of the testing personnel using logistic regression analyses. Predictor variables included the practitioner's college major, degree, certification, and years of laboratory experience. There were 14,326 valid PT results and 359 practitioners of whom 245 (68.2%) had a clinical laboratory science major. Logistic regression analysis revealed that participants without a clini...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Delost MD, Miller WG, Chang GA, Korzun WJ, Nadder TS Tags: Am J Clin Pathol Source Type: journals

Implementing and validating transcutaneous bilirubinometry for neonates.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Noninvasive, transcutaneous bilirubin (TcB) measurement is an attractive option for neonates, but opinions about its usefulness vary among studies. We collected paired measurements of TcB and serum bilirubin (SB) in 343 term neonates using the BiliCheck meter (SpectRx, Norcross, GA) and 3 different SB methods. Correlations between SB and TcB were similar for all laboratory methods and TcB measurement sites. However, TcB bias varied depending on the comparison SB method and TcB measurement site. TcB bias also varied with race when measurements were done on the forehead but not when they were done on the sternum. Several...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Holland L, Blick K Tags: Am J Clin Pathol Source Type: journals

Use of a FLAER-based WBC assay in the primary screening of PNH clones.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) with flow cytometry traditionally involves the analysis of CD55 and CD59 on RBCs and neutrophils. However, the ability to accurately detect PNH RBCs is compromised by prior hemolysis and/or transfused RBCs. Patients with aplastic anemia (AA) and myelodysplastic syndrome (MDS) can also produce PNH clones. We recently described a multiparameter fluorescent aerolysin (FLAER)-based flow assay using CD45, CD33, and CD14 that accurately identified PNH monocyte and neutrophil clones in PNH, AA, and MDS. Here, we compared the efficiency of this WBC assay with a CD59-based ...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Sutherland DR, Kuek N, Azcona-Olivera J, Anderson T, Acton E, Barth D, Keeney M Tags: Am J Clin Pathol Source Type: journals

Distinct expression patterns of CD123 and CD34 on normal bone marrow B-cell precursors ("hematogones") and B lymphoblastic leukemia blasts.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We compared the expression of CD123, the alpha chain of the interleukin-3 receptor, on normal B-cell precursors in bone marrow ("hematogones") from 75 specimens and on leukemic blasts in 45 newly diagnosed B-acute lymphoblastic leukemias (B-ALL) cases. We found that the less mature hematogones (dim CD45+) that express CD34 lack CD123 expression, whereas the more mature hematogones (moderate CD45+) lack CD34 but always express CD123. In contrast with this discordant pattern of CD34 and CD123 expression in hematogones, blasts in 41 (91%) of 45 cases of B-ALL showed concordant expression of the 2 antigens: 80% (36 of 45) ...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Hassanein NM, Alcancia F, Perkinson KR, Buckley PJ, Lagoo AS Tags: Am J Clin Pathol Source Type: journals

Extramedullary plasmacytoma-like posttransplantation lymphoproliferative disorders: clinical and pathologic features.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This report describes the clinical, histologic, phenotypic, and genotypic findings in 4 cases of plasmacytoma-like PTLD (2 nodal, 1 adenoidal, and 1 cutaneous) and compares the findings with extramedullary involvement by plasma cell neoplasms arising in immunocompetent patients. Plasmacytoma-like PTLDs characteristically arise late after transplantation (mean, 7.0 years), show a variable association with Epstein-Barr virus (2/4 cases positive), and demonstrate histologic and phenotypic findings that overlap with immunocompetent extramedullary plasma cell neoplasms. None of the patients with plasmacytoma-like PTLD developed...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Richendollar BG, Hsi ED, Cook JR Tags: Am J Clin Pathol Source Type: journals

High expression of the inhibitory receptor BTLA in T-follicular helper cells and in B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
B- and T-lymphocyte attenuator (BTLA) is a lymphoid receptor that inhibits lymphocyte activation on interaction with its ligand, herpesvirus entry mediator (HVEM). We developed monoclonal antibodies against BTLA and HVEM to study their expression using immunohistochemical and flow cytometric analyses in human tissues. In reactive lymph nodes, they were both expressed in interfollicular T cells and in B cells from mantle and marginal zones. Within germinal centers, B cells were negative, whereas T follicular helper (TFH) cells were BTLA+ and follicular dendritic cells were HVEM+. BTLA was strongly expressed in chronic l...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: M'Hidi H, Thibult ML, Chetaille B, Rey F, Bouadallah R, Nicollas R, Olive D, Xerri L Tags: Am J Clin Pathol Source Type: journals

Plasmablastic lymphomas with MYC/IgH rearrangement: report of three cases and review of the literature.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study brings the total number of reported cases in the literature to 6. All patients were HIV+ with very low CD4 counts at diagnosis. The involved locations were mediastinum, anus, and bone marrow. Tumors exhibited predominantly immunoblastic/plasmablastic morphologic features and had a plasma cell-like immunophenotype. Bright CD38 expression by flow cytometry had a tendency to be more common in these cases compared with PBL without MYC rearrangement. All cases were positive for Epstein-Barr virus-encoded RNA but lacked human herpesvirus-8 latent nuclear antigen. The 2 patients with follow-up died within 3 months. The...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Bogusz AM, Seegmiller AC, Garcia R, Shang P, Ashfaq R, Chen W Tags: Am J Clin Pathol Source Type: journals

Automated assay for fondaparinux (Arixtra) on the Dade Behring BCS XP.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
An assay for fondaparinux (Arixtra) is described based on a modified commercial assay for heparin. The assay is automated on a Dade Behring BCS XP (Siemens Healthcare Diagnostics, Deerfield, IL) and uses the inhibition of activated factor X to quantitate the drug. The assay was unaffected by platelet contamination or the presence of warfarin. The assay was affected by the antithrombin level, and the value obtained in the assay decreased significantly when the antithrombin level was less than 60%. The assay is, however, not specific for fondaparinux. Specimens containing unfractionated or low-molecular-weight heparin wi...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Sanfelippo MJ, Tillema VB Tags: Am J Clin Pathol Source Type: journals

Newer antiphospholipid antibodies predict adverse outcomes in patients with acute coronary syndrome.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Antiphospholipid antibodies (aPLs) have been implicated in atherogenesis. We studied 344 patients with acute coronary syndromes; approximately 40% were aPL+ in 1 or more tests and 60% aPL-. In 215 patients, coronary artery disease (CAD) was angiographically documented, with 43.7% positive for aPL vs 34.9% of patients without CAD positive for aPLs. Anti-beta(2)-glycoprotein I (beta2GPI; 54%) and anti-oxidized low-density lipoprotein (oxLDL)/beta2GPI (48%) were most frequent, accounting for 87% of all aPL+ CAD cases. aPLs correlated with severity of CAD (P = .012). Adverse events occurred in 16.7% of patients with CAD, m...
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Greco TP, Conti-Kelly AM, Greco T, Doyle R, Matsuura E, Anthony JR, Lopez LR Tags: Am J Clin Pathol Source Type: journals

Separating thalassemia trait and iron deficiency by even simpler inspection.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19762541 [PubMed - in process] (Source: American Journal of Clinical Pathology)
Source: American Journal of Clinical Pathology - September 21, 2009 Category: Pathology Authors: Gibbs G Tags: Am J Clin Pathol Source Type: journals

Implementation of a rapid whole blood D-dimer test in the emergency department of an urban academic medical center: impact on ED length of stay and ancillary test utilization.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Overcrowding and prolonged patient length-of-stay (LOS) in emergency departments (EDs) are growing problems. We evaluated the impact of implementing a rapid whole blood quantitative D-dimer test (Biosite Triage, Biosite Diagnostics, San Diego, CA) in our ED satellite laboratory on 252 patients before vs 211 patients after implementation. All patients also underwent testing with the existing central laboratory method (VIDAS D-dimer, bioMérieux, Durham, NC). D-dimer turnaround time (from blood draw to result) decreased approximately 79% (approximately 2 hours vs 25 minutes). The mean ED LOS declined from 8.46 to 7.1...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Lee-Lewandrowski E, Nichols J, Van Cott E, Grisson R, Louissaint A, Benzer T, Lewandrowski K Tags: Am J Clin Pathol Source Type: journals

Effect of the method to measure levels of glycated hemoglobin on individual clinical decisions: comparison of an immunoassay with high-performance liquid chromatography.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Our objective was to compare in a prospective study the clinical performance of the reference and an alternative method to measure blood levels of glycated hemoglobin. A total of 178 samples from patients with diabetes were tested by both methods, and results were analyzed for correlation and comparison of sensitivity, specificity, and positive and negative predictive values to classify patients according to glycemic control. There was a significant linear correlation between methods (r = 0.645; P < .0001); the sensitivity, specificity, and positive and negative predictive values of the alternative method to identif...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: García-Alcalá H, Ruiz-Argüelles A, Cedillo-Carvallo B Tags: Am J Clin Pathol Source Type: journals

Exertional dysnatremia in collapsed marathon runners: a critical role for point-of-care testing to guide appropriate therapy.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Dysnatremia may cause life-threatening encephalopathy in marathon runners. Hypernatremia and exercise-associated hyponatremia (EAH) may manifest with mental status changes and, if untreated, progress to coma and death. We reviewed the on-site blood sodium testing and treatment in collapsed runners at the finish-line medical tent at the Boston marathons from 2001 through 2008. Dysnatremia was diagnosed in 429 (32.5%) of 1,319 collapsed runners. Hypernatremia was present in 366 (27.7%) and hyponatremia in 63 (4.8%). Hypernatremic runners unable to drink fluids were treated with intravenous normal (0.9%) saline. Hyponatre...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Siegel AJ, d'Hemecourt P, Adner MM, Shirey T, Brown JL, Lewandrowski KB Tags: Am J Clin Pathol Source Type: journals

Postchemotherapy histiocyte-rich pseudotumor involving the spleen.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report 2 cases of splenic postchemotherapy histiocyte-rich pseudotumor. Each patient had a history of diffuse large B-cell lymphoma, treated with multiagent chemotherapy. Computed tomography scans performed on both patients showed splenic masses. A positron emission tomography scan performed on 1 patient showed increased metabolic activity. The preoperative diagnosis in both patients was recurrent lymphoma, prompting splenectomy. The splenectomy specimens showed multiple, tan-white, firm nodules, up to 3.5 cm in diameter, that were histologically composed of central necrotic B cells (CD20+/CD3-), consistent with necroti...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Chandra P, Wen YH, Tuli S, Raphael BG, Amorosi EL, Medeiros LJ, Ibrahim S Tags: Am J Clin Pathol Source Type: journals

Validation of the Agilent 244K oligonucleotide array-based comparative genomic hybridization platform for clinical cytogenetic diagnosis.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present validation data for the Agilent Human Genome Microarray Kit 244K for clinical application. The platform contains approximately 240,000 distinct 60-mer oligonucleotide probes spanning the entire human genome. We studied 45 previously characterized samples (43 abnormal, 2 normal), 32 with knowledge of prior results and 13 in a blinded manner with 11 performed in a reference laboratory providing microarray testing. Array analysis confirmed known aberrations in 43 samples and a normal result in 2. The array analysis corrected 1 karyotype and clarified 2 additional cases. Array data from 6 patients with 22q11.2 delet...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Yu S, Bittel DC, Kibiryeva N, Zwick DL, Cooley LD Tags: Am J Clin Pathol Source Type: journals

Characterization of c-Maf transcription factor in normal and neoplastic hematolymphoid tissue and its relevance in plasma cell neoplasia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
c-Maf, a leucine zipper-containing transcription factor, is involved in the t(14;16)(q32;q23) translocation found in 5% of myelomas. A causal role for c-Maf in myeloma pathogenesis has been proposed, but data on c-Maf protein expression are lacking. We therefore studied the expression of c-Maf protein by immunohistochemical analysis in myelomas and in a wide variety of hematopoietic tissue. c-Maf protein was detected in a small minority (4.3%) of myelomas, including a t(14;16)(q32;q22-23)/IgH-Maf+ case, suggesting that c-Maf protein is not expressed in the absence of c-Maf rearrangement. In contrast, c-Maf was strongly...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Natkunam Y, Tedoldi S, Paterson JC, Zhao S, Rodriguez-Justo M, Beck AH, Siebert R, Mason DY, Marafioti T Tags: Am J Clin Pathol Source Type: journals

Pseudolipomatosis affects specimens from endometrial biopsies.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Pseudolipomatosis refers to optically clear vacuoles that artifactually contaminate specimens, and it most commonly affects the gastrointestinal tract. Pseudolipomatosis closely resembles adult white fat and is of group "A" or "B" when vacuoles have mild or marked variation in size, respectively. Pseudolipomatosis has yet to be reported to occur in the endometrium. Pseudolipomatosis in the endometrium might be easily mistaken for extrauterine adipocytes and misdiagnosed as perforation. We retrospectively reviewed 50 consecutive specimens from endometrial biopsies to determine the prevalence of endometrial pseudolipomat...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Deshmukh-Rane SA, Wu ML Tags: Am J Clin Pathol Source Type: journals

Effect of human papillomavirus on cell cycle-related proteins p16, Ki-67, Cyclin D1, p53, and ProEx C in precursor lesions of cervical carcinoma: a tissue microarray study.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In-depth study of cell cycle proteins and human papillomavirus (HPV) genotyping can provide useful information about the malignant potential of precursor lesions of cervical carcinoma (CC). Immunostaining of cell cycle-related proteins (p16, cyclin D1, Ki-67, p53, and ProEx C) was evaluated using tissue microarrays, and HPV genotypes were identified in 144 cervical tissue specimens encompassing normal or benign epithelial lesions, low- and high-grade squamous intraepithelial lesions (LSIL and HSIL, respectively), and CC. In addition, 14 cases with atypical immature metaplasia (AIM) were included to compare their immuno...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Conesa-Zamora P, Doménech-Peris A, Orantes-Casado FJ, Ortiz-Reina S, Sahuquillo-Frías L, Acosta-Ortega J, García-Solano J, Pérez-Guillermo M Tags: Am J Clin Pathol Source Type: journals

Primary lung cancer vs metastatic breast cancer: a probabilistic approach.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study, a mathematical and probabilistic model is used to study the probability that a lung tumor is a primary vs a metastasis from cancer of the breast. The model uses information from immunohistochemical stains for thyroid transcription factor (TTF)-1, mammaglobin, p63, and estrogen receptor and epidemiologic data about primary lung and metastatic breast cancers in women. The results demonstrate that these 4 stains can yield nearly certain diagnoses in approximately 80% of tumors falling into the pool of this differential diagnosis. Nevertheless, uncertainty of diagnosis remains for the 19% of tumors in the pool t...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Vollmer RT Tags: Am J Clin Pathol Source Type: journals

A comparison of estrogen receptor SP1 and 1D5 monoclonal antibodies in routine clinical use reveals similar staining results.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study on mostly previously frozen tissue implied that 1D5 fails to identify some women who may benefit from endocrine therapy. The current prospective study compared SP1 and 1D5 immunostaining on routinely processed consecutive cases of breast carcinoma. ER was classified using the same positive threshold used in the prior study (<1% negative; > or = 1% positive). Of 508 carcinomas, 2 were SP1+/1D5-, and none were SP1-/1D5+. Although SP1 is our preferred antibody, with more intense nuclear staining, both MAbs give similar results in tissue from routine clinical samples with discrepant results in fewer than 0.5% ...
Source: American Journal of Clinical Pathology - August 20, 2009 Category: Pathology Authors: Brock JE, Hornick JL, Richardson AL, Dillon DA, Lester SC Tags: Am J Clin Pathol Source Type: journals