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    17217 results match your criteria American journal of clinical pathology[Journal]

    1 OF 345

    Creation and Evaluation of a Laboratory Administration Curriculum for Pathology Residents.
    Am J Clin Pathol 2017 Sep 11. Epub 2017 Sep 11.
    Department of Pathology and Laboratory Medicine, Johns Hopkins University, Baltimore, MD.
    Objectives: A clinical laboratory management (CLM) curriculum that can objectively assess the Accreditation Council for Graduate Medical Education pathology systems-based practice milestones and can provide consistent resident training across institutions is needed.

    Methods: Faculty at Emory University created a curriculum that consists of assay verification exercises and interactive, case-based online modules. Beta testing was done at Emory University and Johns Hopkins. Read More

    Hyalinizing Clear Cell Carcinoma of the Lung: Case Report and Review of the Literature.
    Am J Clin Pathol 2017 Jul;148(1):73-80
    Division of Hematology and Oncology, University of Arkansas for Medical Sciences, Little Rock.
    Objectives: Hyalinizing clear cell carcinoma (HCCC) is common in head and neck sites but extremely rare in the lung. This case report describes an HCCC in the lung of a 54-year-old female patient.

    Methods: We summarize the histomorphologic, immunophenotypic, and molecular features for our and three previously reported HCCCs of the lung with emphasis on potential diagnostic pitfalls. Read More

    Frequency and Clinicopathologic Features of RUNX1 Mutations in Patients With Acute Myeloid Leukemia Not Otherwise Specified.
    Am J Clin Pathol 2017 Jul;148(1):64-72
    Departments of Laboratory Medicine.
    Objectives: To evaluate the frequency and clinicopathologic characteristics of RUNX1 mutations, focusing on patients with acute myeloid leukemia not otherwise specified (AML NOS).

    Methods: Diagnostic samples from 219 patients with AML NOS were analyzed for RUNX1 mutations using standard polymerase chain reaction and direct sequencing.

    Results: Thirty-one RUNX1 mutations were detected in 33 (15. Read More

    Myelodysplastic Syndrome, Unclassifiable (MDS-U) With 1% Blasts Is a Distinct Subgroup of MDS-U With a Poor Prognosis.
    Am J Clin Pathol 2017 Jul;148(1):49-57
    Department of Pathology and Laboratory Medicine, Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY.
    Objectives: Three situations qualify as myelodysplastic syndrome, unclassifiable (MDS-U): (1) refractory cytopenia with dysplasia and 1% blasts in peripheral blood (BL), (2) pancytopenia with unilineage dysplasia (Pan), and (3) persistent cytopenia, less than 5% bone marrow blasts, and less than 10% dysplastic cells and presence of MDS-defining cytogenetic abnormalities (CG). We compared the clinicopathologic features and mutational profiles for these three groups.

    Methods: MDS-U cases were reviewed at four major academic institutions. Read More

    Defining Papillary Carcinoma of the Thyroid: A Short Review and Analysis.
    Am J Clin Pathol 2017 Aug;148(2):100-107
    VA and Duke University Medical Centers, Durham, NC.
    Objectives: To review how changes in the pathologic definitions for papillary tumors of the thyroid during recent decades have affected outcomes for patients with these tumors.

    Methods: Forty-nine previous reports or studies involving collectively 53,606 patients were reviewed, and new analyses were performed on the data to include analyses of agreement, incidence, survival, and diagnostic categories.

    Results: The past emphasis on cytologic features to define papillary tumors has not resulted in ideal pairwise agreement between pathologists and has produced incidence and survival data suggesting overdetection and overdiagnosis. Read More

    Real-Time Clinical Decision Support Decreases Inappropriate Plasma Transfusion.
    Am J Clin Pathol 2017 Aug;148(2):154-160
    Departments of Pathology.
    Objectives: To curtail inappropriate plasma transfusions, we instituted clinical decision support as an alert upon order entry if the patient's recent international normalized ratio (INR) was 1.7 or less.

    Methods: The alert was suppressed for massive transfusion and within operative or apheresis settings. Read More

    Role of Histone H3K27 Trimethylation Loss as a Marker for Malignant Peripheral Nerve Sheath Tumor in Fine-Needle Aspiration and Small Biopsy Specimens.
    Am J Clin Pathol 2017 Aug;148(2):179-189
    Department of Pathology, Brigham and Women's Hospital, Boston, MA.
    Objectives: Accurate diagnosis of malignant peripheral nerve sheath tumor (MPNST) is often challenging on fine-needle aspiration (FNA) or core needle biopsy. Recurrent mutations in EED and SUZ12, which encode subunits of polycomb repressive complex 2 (PRC2), have been identified in 70% to 92% of MPNSTs; PRC2 inactivation leads to loss of trimethylation of lysine 27 of histone H3 (H3K27me3). We evaluated the utility of H3K27me3 immunohistochemistry for distinguishing MPNST from its cytomorphologic mimics. Read More

    Comparison of Oncotype DX With Modified Magee Equation Recurrence Scores in Low-Grade Invasive Carcinoma of Breast.
    Am J Clin Pathol 2017 Aug;148(2):167-172
    Department of Pathology, Wexner Medical Center at The Ohio State University, Columbus.
    Objectives: Several specific histologic types of invasive carcinoma of breast, including invasive tubular carcinoma (ITC), invasive mucinous carcinoma (IMC), and classical invasive lobular carcinoma (CILC), are considered low-grade carcinomas with favorable outcomes. We aimed to investigate the utility of Oncotype DX test in these tumors by comparing its recurrence score (RS) with the modified Magee equation RS.

    Methods: Oncotype DX RSs were collected and modified Magee equation RSs were calculated in 163 low-grade invasive breast carcinomas, including 105 CILCs, 41 ITCs, and 17 IMCs. Read More

    Typical and Atypical Granular Cell Tumors of Soft Tissue: A Clinicopathologic Study of 50 Patients.
    Am J Clin Pathol 2017 Aug;148(2):161-166
    Department of Pathology, Medical College of Wisconsin, Milwaukee.
    Objectives: Granular cell tumors are rare neoplasms of neural origin. Despite the mesenchymal nature of these tumors, they rarely occur in the soft tissue, and as a result, this subset is not well characterized. We present the largest case series to date comprising 50 patients with benign and atypical soft tissue granular cell tumors in an effort to better define the pathologic features in this subset of lesions. Read More

    Building a New Transfusion Service.
    Am J Clin Pathol 2017 Aug;148(2):173-178
    Department of Laboratory Medicine, University of Washington School of Medicine, Seattle.
    Objectives: For over 60 years, Harborview Medical Center (HMC) in Seattle has received its blood components and pretransfusion testing from a centralized transfusion service operated by the regional blood supplier. In 2011, a hospital-based transfusion service (HBTS) was activated.

    Methods: After 5 years of operation, we evaluated the effects of the HBTS by reviewing records of hospital blood use, quality system events, blood product delivery times, and costs. Read More

    Lineage Switch Between B-Lymphoblastic Leukemia and Acute Myeloid Leukemia Intermediated by "Occult" Myelodysplastic Neoplasm: Two Cases of Adult Patients With Evidence of Genomic Instability and Clonal Selection by Chemotherapy.
    Am J Clin Pathol 2017 Aug;148(2):136-147
    Department of Pathology, Duke University Medical Center, Durham, NC.
    Objectives: Lineage switch occurs in rare leukemias, and the mechanism is unclear. We report two cases of B-lymphoblastic leukemia (B-ALL) relapsed as acute myeloid leukemia (AML).

    Methods: Retrospective review of clinical and laboratory data. Read More

    Analysis of Daily Laboratory Orders at a Large Urban Academic Center: A Multifaceted Approach to Changing Test Ordering Patterns.
    Am J Clin Pathol 2017 Aug;148(2):128-135
    Departments of Pathology.
    Objectives: We sought to address concerns regarding recurring inpatient laboratory test order practices (daily laboratory tests) through a multifaceted approach to changing ordering patterns.

    Methods: We engaged in an interdepartmental collaboration to foster mindful test ordering through clinical policy creation, electronic clinical decision support, and continuous auditing and feedback.

    Results: Annualized daily order volumes decreased from approximately 25,000 to 10,000 during a 33-month postintervention review. Read More

    Ki-67 Expression in Breast Cancer Tissue Microarrays: Assessing Tumor Heterogeneity, Concordance With Full Section, and Scoring Methods.
    Am J Clin Pathol 2017 Aug;148(2):108-118
    Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY.
    Objectives: Ki-67 has been proposed to be used as a surrogate marker to differentiate luminal breast carcinomas (BCs). The purpose of this study was to determine the utility of and best approaches for using tissue microarrays (TMAs) and Ki-67 staining to distinguish luminal subtypes in large epidemiology studies of luminal/human epidermal growth factor receptor 2 (HER2)-negative BC.

    Methods: Full-section and TMA (three 0. Read More

    Prevalence of Anal Human Papillomavirus (HPV) and Performance of Cepheid Xpert and Hybrid Capture 2 (hc2) HPV Assays in South African HIV-Infected Women.
    Am J Clin Pathol 2017 Aug;148(2):148-153
    Institute of Infectious Disease and Molecular Medicine and Division of Medical Virology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
    Objectives: This study investigated anal high-risk HPV (HR-HPV) prevalence in HIV-infected women using the Cepheid Xpert HPV assay and compares its performance with that of Hybrid Capture-2 (hc2).

    Methods: A total of 199 HIV-infected women were recruited from Helen Joseph Hospital, Johannesburg. Stored ThinPrep anal swabs that had previously been tested using hc2 were tested for HPV using Xpert. Read More

    Performance of the cobas MRSA/SA Test for Simultaneous Detection of Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus From Nasal Swabs.
    Am J Clin Pathol 2017 Aug;148(2):119-127
    Medical and Scientific Affairs, Roche Molecular Diagnostics, Pleasanton, CA.
    Objectives: Health care-associated methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus aureus (SA) infections are continuing problems. Rapidly determining the MRSA colonization status of a patient facilitates practice to reduce spread of MRSA clinical disease. Sensitive detection of all SA prior to surgery, followed by decolonization, can significantly reduce postoperative infection from this pathogen. Read More

    Keratin 17 Is a Prognostic Biomarker in Endocervical Glandular Neoplasia.
    Am J Clin Pathol 2017 Sep;148(3):264-273
    Departments of Pathology.
    Objectives: Previous work in our laboratory identified keratin 17 (K17) as a specific and sensitive biomarker for high-grade squamous intraepithelial lesions and cervical squamous cell carcinoma (SCC). K17, however, has not been previously evaluated in endocervical glandular neoplasia. Based on the similar pathogenesis of squamous and glandular lesions of the cervix, we hypothesized that K17 overexpression could also be a diagnostic and/or prognostic biomarker for endocervical neoplasia. Read More

    CD200 Expression in Neuroendocrine Neoplasms.
    Am J Clin Pathol 2017 Sep;148(3):236-242
    PhenoPath Laboratories, Seattle, WA.
    Objectives: CD200 expression has been well studied in hematopoietic malignancies; however, CD200 expression has not been well-characterized in neuroendocrine neoplasms. We examined CD200 expression in 391 neuroendocrine neoplasms from various anatomic sites.

    Methods: Tissue blocks containing pulmonary small cell carcinoma, pulmonary carcinoid, large cell neuroendocrine carcinoma, pancreatic neuroendocrine tumor, gastrointestinal carcinoid, and Merkel cell carcinoma were evaluated for CD200 expression by immunohistochemistry. Read More

    Regional Variability in Percentage of Breast Cancers Reported as Positive for HER2 in California: Implications of Patient Demographics on Laboratory Benchmarks.
    Am J Clin Pathol 2017 Sep;148(3):199-207
    Department of Pathology.
    Objectives: The expected regional variability in percent human epidermal growth factor receptor 2 (HER2)-positive breast cancers is not currently clear.

    Methods: Data from the 2006 to 2011 California Cancer Registry were examined by county and health service area. The influence of demographic and pathologic features was used in a multivariable logistic regression model to compare expected with observed HER2-positive percentages by region. Read More

    Negative Predictive Value and Significance of Benign-Appearing Endometrial Cells in Papanicolaou Tests.
    Am J Clin Pathol 2017 Sep;148(3):274-279
    Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA.
    Objectives: Reporting benign-appearing endometrial cells (nEMCs) in Papanicolaou (Pap) smears of women 40 years and older, introduced in The Bethesda System 2001, may be interpreted as an abnormal finding and lead to unnecessary endometrial biopsies. To our knowledge, this is the first study on the negative predictive value (NPV) of this cytology finding.

    Methods: An 11-year database with 1,036,629 Pap test reports and 121,079 surgical pathology reports identified reports of nEMCs in women 40 years and older with follow-up endometrial histopathology within 6 months. Read More

    Atypical IgG4+ Plasmacytic Proliferations and Lymphomas: Characterization of 11 Cases.
    Am J Clin Pathol 2017 Sep;148(3):215-235
    The James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Boston.
    Objectives: To report the clinicopathologic features of monotypic immunoglobulin G4+ (IgG4+) lymphoid and plasmacytic proliferations.

    Methods: Cases were identified from the pathology files. Pathology and clinical materials were reviewed. Read More

    Primary Benign and Malignant Thyroid Neoplasms With Signet Ring Cells: Cytologic, Histologic, and Molecular Features.
    Am J Clin Pathol 2017 Sep;148(3):251-258
    Massachusetts General Hospital, Boston.
    Objectives: Signet ring cells (SRCs) can be seen in a variety of thyroid tumors and can pose a diagnostic pitfall on cytology. This study describes the cytologic, histomorphologic, and molecular aspects of a cohort of primary thyroid tumors with SRCs.

    Methods: A search was performed of the Massachusetts General Hospital and Brigham and Women's Hospital (Boston, MA) pathology archives for the keywords thyroid, signet, and signet ring features between 2000 and 2014. Read More

    Therapeutic Plasma Exchange and Its Impact on Drug Levels: An ACLPS Critical Review.
    Am J Clin Pathol 2017 Sep;148(3):190-198
    Department of Pathology and Laboratory Medicine, Alberta Health Services-Calgary Laboratory Services, Calgary, Canada.
    Objectives: To examine and summarize the current literature on the effects of therapeutic plasma exchange on medication levels.

    Methods: Literature review was performed via searches of the Cochrane Database and PubMed-MEDLINE (1996 to August 2016) looking for all case reports, case series, and human randomized controlled trials involving therapeutic plasma exchange (TPE)-associated drug removal.

    Results: Approximately 60 peer-reviewed articles were identified with the majority being case reports; no randomized controlled trials were identified. Read More

    Could the PD-1 Pathway Be a Potential Target for Treating Small Intestinal Adenocarcinoma?
    Am J Clin Pathol 2017 Sep;148(3):208-214
    Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, TN.
    Objectives: The programmed death 1 (PD-1) pathway is upregulated in the immune microenvironment of many cancers. In this study, we examined the PD-1 pathway and the immune microenvironment of small intestinal adenocarcinomas by immunohistochemistry.

    Methods: From our department pathology archives we identified 42 small intestinal adenocarcinomas from between 2000 and 2015, with blocks available for IHC studies. Read More

    Impact of Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Features on Adequacy Criteria and Risk of Malignancy of Thyroid Fine-Needle Aspiration.
    Am J Clin Pathol 2017 Sep;148(3):259-263
    Department of Pathology, Baptist Hospital, Miami, FL.
    Objectives: The impact of noninvasive follicular thyroid neoplasm with papillary-like features (NIFTP) on nondiagnostic and benign diagnoses is not well characterized.

    Methods: The results of all thyroid fine-needle aspirates (FNAs) performed from 1997 to June 2016 with corresponding resections were reviewed.

    Results: From 12,764 aspirates, there were 8,106 (64%) benign diagnoses with 412 (5%) resections and 1,888 (14. Read More

    Fibromatosis of the Breast: Diagnostic Accuracy of Core Needle Biopsy.
    Am J Clin Pathol 2017 Sep;148(3):243-250
    Department of Pathology.
    Objectives: Fibromatosis of the breast is an uncommon neoplasm with potential for local recurrence. Treatment has traditionally been surgical excision with current trends toward conservative management. Given the option of observation after diagnosis by core needle biopsy (CNB), we sought to evaluate the accuracy of CNB for diagnosing fibromatosis. Read More

    Atypical Histiocytoid Cells in Metastatic Papillary Thyroid Carcinoma: An Underrecognized Cytologic Pattern.
    Am J Clin Pathol 2017 Jul;148(1):58-63
    Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH.
    Objectives: Fine-needle aspiration (FNA) of head and neck lymph nodes (LNs) is useful in diagnosing metastatic papillary thyroid carcinoma (PTC) and most commonly shows classic cytologic features of PTC. Metastatic PTC, however, may occasionally present with a pattern unfamiliar to most pathologists: atypical histiocytoid cells (AHCs).

    Methods: All PTC thyroidectomy specimens with associated FNA of LNs were retrieved from our files for 2007 to 2013. Read More

    Sociodemographic Correlates of Clinical Laboratory Test Expenditures in a Major Canadian City.
    Am J Clin Pathol 2017 Jul;148(1):91-96
    Alberta Health Services Utilization Office, Calgary Laboratory Services, Calgary, Canada.
    Objectives: The increasing cost of clinical laboratory testing is a challenge in our health care system. This study aims to calculate the annual clinical laboratory test costs attributed to patients in a major Canadian city and to correlate them to their sociodemographic variables.

    Methods: Retrospective cohort study involving patients who received clinical chemistry, hematology, and microbiology tests in 2011 in Calgary, Canada (n = 610,409). Read More

    Molecular Diagnosis of Thalassemias and Hemoglobinopathies: An ACLPS Critical Review.
    Am J Clin Pathol 2017 Jul;148(1):6-15
    Department of Laboratory Medicine, University of Washington, Seattle.
    Objectives: To describe the use of molecular diagnostic techniques for patients with hemoglobin disorders.

    Methods: A clinical scenario is presented in which molecular diagnosis is important for genetic counseling. Globin disorders, techniques for their diagnosis, and the role of molecular genetic testing in managing patients with these disorders are described in detail. Read More

    Proposed Terminology for Anal Squamous Lesions: Its Application and Interobserver Agreement Among Pathologists in Academic and Community Hospitals.
    Am J Clin Pathol 2017 Jul;148(1):81-90
    Department of Pathology, Cleveland Clinic, Cleveland, OH.
    Objectives: To analyze interobserver reproducibility and compare practice patterns between academic and community settings of Lower Anogenital Squamous Terminology (LAST).

    Methods: In total, 132 anal biopsy slides were revised as well as p16 immunostains.

    Results: LAST was used in 49% of cases (academic center, 68%; satellite hospitals [community practice setting], 32%). Read More

    Comparison of Three Methods for Measuring Workload in Surgical Pathology and Cytopathology.
    Am J Clin Pathol 2017 Jul;148(1):16-22
    Department of Pathology, Stanford University School of Medicine, Stanford, CA.
    Objectives: Pathologist workload in the United States has traditionally been measured by relative value units (RVUs), which is often criticized for providing an inaccurate estimate of actual work. This study compares three methods for measuring workload.

    Methods: Surgical pathology and cytopathology workload for 1 representative month at Stanford Health Care was assessed using three different methods: RVUs, Royal College of Pathologists (RCP) point system, and University of Washington-Seattle (UW) slide count method. Read More

    Comprehensive Platelet Phenotypic Laboratory Testing and Bleeding History Scoring for Diagnosis of Suspected Hereditary Platelet Disorders: A Single-Institution Experience.
    Am J Clin Pathol 2017 Jul;148(1):23-32
    Special Coagulation Laboratory, Division of Hematopathology.
    Objectives: Patients with hereditary/congenital platelet disorders (HPDs) have a broad range of clinical manifestations and laboratory phenotypes. We assessed the performance characteristics of the International Society on Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT) and clinically validated platelet laboratory tests for diagnosis of HPDs.

    Methods: The records of 61 patients with suspected HPDs were reviewed and ISTH-BAT scores calculated. Read More

    Performance Evaluation of Serum Free Light Chain Analysis: Nephelometry vs Turbidimetry, Monoclonal vs Polyclonal Reagents.
    Am J Clin Pathol 2017 Jun;147(6):611-622
    From the Department of Laboratory Medicine, AZ Delta Roeselare-Menen, Roeselare, Belgium.
    Objectives: Free light chain (FLC) measurement gained a lot of interest for diagnostic workup of monoclonal gammopathy.

    Methods: We evaluated the performance of turbidimetric polyclonal Freelite (The Binding Site, Birmingham, UK) assays on Cobas 6000 (Roche Diagnostics, Rotkreuz, Switzerland) and nephelometric monoclonal N Latex (Siemens Healthcare Diagnostics, Marburg, Germany) assays on BN ProSpec (Dade Behring, Deerfield, IL) vs established nephelometric Freelite assays on BN ProSpec.

    Results: Analytical performance was acceptable. Read More

    Measurement Bias of Gross Pathologic Compared With Radiologic Tumor Size of Resected Lung Adenocarcinomas: Implications for the T-Stage Revisions in the Eighth Edition of the American Joint Committee on Cancer Staging Manual.
    Am J Clin Pathol 2017 Jun;147(6):641-648
    From the Departments of Pathology and.
    Objectives: The eighth edition of the AJCC Cancer Staging Manual now stratifies the T descriptor for lung cancers by each increasing 1.0 cm increment, up to 5.0 cm, with an additional category for tumor greater than 7. Read More

    Predominance of CD4+ T Cells in T-Cell/Histiocyte-Rich Large B-Cell Lymphoma and Identification of a Subset of Patients With Peripheral B-Cell Lymphopenia.
    Am J Clin Pathol 2017 Jun;147(6):596-603
    From Stanford University, Stanford, CA.
    Objectives: T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a morphologic variant of large B-cell lymphoma whose flow cytometry findings are not well characterized.

    Methods: Nineteen cases with flow cytometric immunophenotyping were identified from the case records of four institutions between 2001 and 2016.

    Results: In most cases, neoplastic B cells were not detected by flow cytometry. Read More

    The Prevalence and Role of Hemoglobin Variants in Biometric Screening of a Multiethnic Population: One Large Health System's Experience.
    Am J Clin Pathol 2017 Jun;147(6):589-595
    From the Department of Pathology and Genomic Medicine and.
    Objectives: To characterize and quantitate hemoglobin (Hb) variants discovered during biometric hemoglobin A1c (HbA1c) analyses in a large multiethnic population with a focus on the effect of variants on testing method and results.

    Methods: In total, 13,913 individuals had their HbA1c measured via ion-exchange high-performance liquid chromatography. Samples that had a variant Hb detected or HbF fraction more than 25% underwent variant Hb characterization and confirmation by gel electrophoresis. Read More

    Performance of Calculated and Directly Measured Low-Density Lipoprotein Cholesterol in a Pediatric Population.
    Am J Clin Pathol 2017 Jul;148(1):42-48
    Texas Children's Hospital, Houston.
    Objectives: An assessment of methods for the accurate measurement of low-density lipoprotein cholesterol (LDL-C) at decreased concentrations has not yet been carried out. We evaluated the performance of the Friedewald equation, a direct enzymatic assay, and a novel equation for determining LDL-C levels in a pediatric population with elevated triglycerides and reduced LDL-C levels.

    Methods: LDL-C concentrations of 127 pediatric patients were determined by the Friedewald equation, a direct enzymatic assay, and a novel equation. Read More

    Flow Cytometric Patterns of CD200 and CD1d Expression Distinguish CD10-Negative, CD5-Negative Mature B-Cell Lymphoproliferative Disorders.
    Am J Clin Pathol 2017 Jul;148(1):33-41
    Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
    Objectives: The importance of distinguishing mature B-cell lymphoproliferative disorders (B-LPDs) is highlighted by the distinct treatments used for and varying prognoses seen in association with these different diseases. Immunophenotyping allows for accurate and efficient differentiation of many B-LPDs. Recently, we showed that CD200 is highly expressed in hairy cell leukemia (HCL) but not in marginal zone lymphoma (MZL), lymphoplasmacytic lymphoma (LPL), or hairy cell leukemia-variant (HCL-v). Read More

    The Effects of Indirect- and Direct-Acting Anticoagulants on Lupus Anticoagulant Assays: A Large, Retrospective Study at a Coagulation Reference Laboratory.
    Am J Clin Pathol 2017 Jun;147(6):632-640
    From the Department of Pathology and.
    Objectives: To investigate the effects of indirect- and direct-acting anticoagulants on the interpretation of lupus anticoagulant (LAC) assays.

    Methods: A retrospective database review was performed to identify all LAC panels from November 2012 to November 2015. The positivity rates for three LAC tests were compared among various anticoagulant medications. Read More

    Diagnostic Performance of Ultrasound-Guided Fine-Needle Aspiration of Nonpalpable Breast Lesions in a Multidisciplinary Setting: The Institut Curie's Experience.
    Am J Clin Pathol 2017 Jun;147(6):571-579
    From the Departments of Tumor Biology.
    Objectives: To assess the diagnostic performance of ultrasound-guided fine-needle aspiration (USFNA) in nonpalpable breast lesions (NPBLs) in a multidisciplinary setting.

    Methods: In total, 2,601 NPBLs underwent USFNA by a radiologist-pathologist team. Gold-standard diagnosis was based on surgery, core-needle biopsy, or 1-year imaging follow-up. Read More

    Multicenter Evaluation of the Bruker MALDI Biotyper CA System for the Identification of Clinically Important Bacteria and Yeasts.
    Am J Clin Pathol 2017 Jun;147(6):623-631
    From Cleveland Clinic, Cleveland, OH.
    Objectives: A report on the multicenter evaluation of the Bruker MALDI Biotyper CA System (MBT-CA; Bruker Daltonics, Billerica, MA) for the identification of clinically important bacteria and yeasts.

    Methods: In total, 4,399 isolates of medically important bacteria and yeasts were assessed in the MBT-CA. These included 2,262 aerobic gram-positive (AGP) bacteria, 792 aerobic gram-negative (AGN) bacteria 530 anaerobic (AnA) bacteria, and 815 yeasts (YSTs). Read More

    Can p40 (Polyclonal) Replace p63 (Clone 4A4) in the Cytologic Diagnosis of Pulmonary Non-Small Cell Carcinoma?
    Am J Clin Pathol 2017 Jun;147(6):580-588
    From New York University Langone Medical Center, New York, NY.
    Objectives: Differentiating squamous cell carcinoma from adenocarcinoma (ACA) in cytology specimens can be challenging. Recent literature showed p40 had higher specificity than p63 for this purpose.

    Methods: We identified 190 cytology cases with p40 (polyclonal) and p63 (monoclonal clone 4A4) immunohistochemistry, including specimens from fine-needle aspirations (FNAs) and effusions. Read More

    Determination of VH Family Usage in B-Cell Malignancies via the BIOMED-2 IGH PCR Clonality Assay.
    Am J Clin Pathol 2017 Jun;147(6):549-556
    From the Department of Pathology, Center for Advanced Molecular Diagnostics, Brigham and Women's Hospital, Boston, MA.
    Objectives: To determine whether V H family usage in B-cell lymphoproliferative disorders can be deduced from polymerase chain reaction (PCR) product-length information obtained through the BIOMED-2 (Invivoscribe, San Diego, CA) clonality assay.

    Methods: We develop an algorithm that uses the sizing information of the BIOMED-2 immunoglobulin heavy chain (IGH) clonality assay to deduce V H family usage. PCR with family-specific primers on 51 clinical samples containing 54 rearranged alleles were used to validate the algorithm. Read More

    Diagnostic Testing Approaches for Activated Protein C Resistance and Factor V Leiden: A Comparison of Institutional and National Provider Practices.
    Am J Clin Pathol 2017 Jun;147(6):604-610
    From the Division of Hematology, Department of Medicine.
    Objectives: To analyze the economic impact of testing for activated protein C resistance (APC-R) due to factor V Leiden (FVL) mutation with APC-R with reflexive FVL genotyping (algorithmic approach) or genotyping alone.

    Methods: OptumLabs Data Warehouse (OLDW) data were used to assess testing approaches. Insurance claims for APC-R and FVL in 2013 were compared with the Mayo Clinic database. Read More

    A Limited Immunohistochemical Panel Can Subtype Hepatocellular Adenomas for Routine Practice.
    Am J Clin Pathol 2017 Jun;147(6):557-570
    Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA.
    Objectives: β-Catenin-activated hepatocellular adenomas have an elevated risk of harboring foci of hepatocellular carcinoma. Inflammatory adenomas also have an increased propensity for malignant transformation and are associated with a systemic inflammatory syndrome. Patients with these two adenoma subtypes benefit from excision. Read More

    Using the Modified Magee Equation to Identify Patients Unlikely to Benefit From the 21-Gene Recurrence Score Assay (Oncotype DX Assay).
    Am J Clin Pathol 2017 Jun;147(6):541-548
    From the Department of Pathology, The Ohio State University Wexner Medical Center, Columbus.
    Objectives: This study aimed to compare a modified Magee equation with Oncotype DX (Genomic Health, Redwood City, CA) recurrence score (RS) and identify patients who are unlikely to benefit from Oncotype DX.

    Methods: Magee equation RS was calculated in 438 cases and correlated with Oncotype DX RS.

    Results: The Pearson correlation coefficient ( r ) for the Magee equation and Oncotype DX RS was 0. Read More

    Survey of Institutional Policies for Provision of "CMV-Safe" Blood in Ontario.
    Am J Clin Pathol 2016 Nov;146(5):578-584
    Ryerson University, Toronto, Canada.
    Objectives: Debate continues on whether leukoreduction alone (LR) is sufficiently similar to leukoreduced cellular products drawn from cytomegalovirus (CMV)-seronegative (SN) donors to minimize the risk of transfusion-transmitted CMV (TT-CMV). We sought to determine the policy, inventory, and practice landscape of the province for TT-CMV mitigation.

    Methods: A web-based survey was distributed to hospitals in Ontario by Canadian Blood Services to collect data on their policies with respect to TT-CMV prevention. Read More

    CD25 Expression in B Lymphoblastic Leukemia/Lymphoma Predicts t(9;22)(q34;q11)/Philadelphia Chromosome Translocation (Ph) and Is Associated With Residual Disease in Ph-Negative Patients.
    Am J Clin Pathol 2016 Nov;146(5):632-638
    Department of Pathology.
    Objectives: CD25 expression is associated with t(9;22)(q34;q11)/Philadelphia chromosome translocation (Ph); BCR-ABL1 rearrangement in B lymphoblastic leukemia/lymphoma (B-LL). However, the significance of CD25 expression in Ph negative (Ph-) B-LL regarding residual disease (RD) and genetic abnormalities is largely unknown.

    Methods: CD25 expression by flow cytometry (FC) was correlated with Ph status in 95 newly diagnosed B-LL patients and with RD status in day 29 marrow measured by FC in the context of cytogenetic risk stratification in Ph- patients. Read More

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