17,340 results match your criteria American journal of clinical pathology[Journal]


A Randomized Controlled Trial to Assess the Impact of Upfront Point-of-Care Testing on Emergency Department Treatment Time.

Am J Clin Pathol 2018 Jun 19. Epub 2018 Jun 19.

Department of Emergency Medical Care, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.

Objectives: To compare standard emergency department (ED) workflow to a protocolized pathway using upfront point-of-care (POC) tests performed prior to doctor evaluation to determine if this could produce a significant reduction in treatment time.

Methods: We performed a prospective, randomized, controlled trial. Patients were randomized to receive the standard of care or one of the enhanced workflow pathways with POC tests. Read More

View Article
June 2018
1 Read

Comparison of Alere i Strep A Rapid Molecular Assay With Rapid Antigen Testing and Culture in a Pediatric Outpatient Setting.

Am J Clin Pathol 2018 Jun 19. Epub 2018 Jun 19.

From the Departments of Pathology and Laboratory Medicine, 1Children's Healthcare of Atlanta, Atlanta, GA.

Objectives: Group A Streptococcus (GAS) is the most common bacterial cause of pediatric acute pharyngitis, and its quick identification is important for subsequent treatment. We sought to determine whether molecular GAS-based testing can successfully replace GAS antigen testing and subsequent culture in a pediatric urgent care center.

Methods: We tested 160 patient oropharyngeal samples by a rapid antigen GAS test, the Alere i Strep A test, and throat culture in a pediatric urgent care setting and calculated basic statistical metrics. Read More

View Article
June 2018
1 Read

Clinical Referral Laboratories in Rwanda: The Status of Quality Improvement After 7 Years of the SLMTA Program.

Am J Clin Pathol 2018 Jun 19. Epub 2018 Jun 19.

Department of Clinical Microbiology, Virology.

Objectives: We investigated the quality system performance in Rwandan referral laboratories to determine their progress toward accreditation.

Methods: We conducted audits across five laboratories in 2017, using the Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist. Laboratories were scored based on the World Health Organization grading scale (0-5 stars scale) and compared with earlier audits. Read More

View Article

The Future of Pathology and Laboratory Medicine-Again.

Authors:
Michael L Wilson

Am J Clin Pathol 2018 Jun 13. Epub 2018 Jun 13.

Department of Pathology and Laboratory Services, Denver Health, Denver, CO.

View Article

HITTING the Diagnosis: Testing for Heparin-Induced Thrombocytopenia in Cancer Patients.

Am J Clin Pathol 2018 Jun 13. Epub 2018 Jun 13.

Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY.

Objectives: To evaluate the use of a pretest probability score (4Ts score) in cancer patients to guide ordering of laboratory screening tests for heparin-induced thrombocytopenia (HIT).

Methods: A retrospective chart review was conducted for patients (n = 140) in whom laboratory testing for HIT was requested. 4Ts scores were calculated and correlated with heparin-endogenous platelet factor 4 antibody enzyme-linked immunosorbent assay (ELISA) test results. Read More

View Article

Interference of Therapeutic Monoclonal Antibodies With Routine Serum Protein Electrophoresis and Immunofixation in Patients With Myeloma: Frequency and Duration of Detection of Daratumumab and Elotuzumab.

Am J Clin Pathol 2018 Jun 13. Epub 2018 Jun 13.

School of Medicine, Case Western Reserve University, Cleveland, OH.

Objectives: We investigated the frequency and pattern of detection of therapeutic monoclonal antibodies (t-mAbs) daratumumab and elotuzumab by routine serum protein electrophoresis (SPE) and immunofixation (IF) in treated patients with myeloma.

Methods: Detection of t-mAb was assessed in 22 patients by retrospective review of SPE/IF ordered prior to, during, and after 26 individual courses of therapy.

Results: t-mAb was distinguishable from M-protein in 16 of 26 courses, with daratumumab detected in nine of nine and elotuzumab in six of seven patients. Read More

View Article
June 2018
1 Read

A Case Series of Five Patients With Pure or Mixed Gestational Epithelioid Trophoblastic Tumors and a Literature Review on Mixed Tumors.

Am J Clin Pathol 2018 Jun 11. Epub 2018 Jun 11.

Department of Pathology, the University of Hong Kong.

Objectives: To review the clinicopathologic features of five patients with epithelioid trophoblastic tumor (ETT).

Methods: Characteristics of patients diagnosed with ETT in 2000 to 2012 were reviewed.

Results: Among 190 patients with gestational trophoblastic neoplasia (GTN), two had pure ETT and three had mixed ETT and choriocarcinoma. Read More

View Article
June 2018
3 Reads

Metastatic Involvement of the Prostatic Anterior Fat Pad: Implications for the Pathologist.

Am J Clin Pathol 2018 Jun 8. Epub 2018 Jun 8.

Departments of 1Pathology, Maywood, IL.

Objectives: There is little information regarding the utility of pathologic evaluation of the prostatic anterior fat pad (PAFP) in patients with a low preoperative probability of recurrence. Our study aimed to determine the utility of PAFP pathologic examination, especially for this group of patients.

Methods: We analyzed a tertiary care academic center's radical prostatectomy (RP) specimens from 2009 to 2017. Read More

View Article

Establishment and Utilization of a Transfusion Recipient Registry in Korea: Estimating the Frequencies of Specific Antigen-Negative Blood Units.

Am J Clin Pathol 2018 Jun 9. Epub 2018 Jun 9.

Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea.

Objectives: This study was conducted to establish the Korean national registry, to evaluate the distribution of unexpected antibodies, and to determine the frequencies of specific antigen-negative blood units.

Methods: Data added to the Korean national registry between July 2013 and April 2016 were analyzed. The distribution of unexpected antibodies and frequencies of specific antigen-negative blood units were estimated. Read More

View Article

Modified Plasma-Thrombin Method of Cell Block Preparation for Fine-Needle Aspiration Biopsies in Resource-Limited Settings.

Am J Clin Pathol 2018 Jun 9. Epub 2018 Jun 9.

Department of Pathology, Massachusetts General Hospital, Boston.

Objectives: The plasma-thrombin method is commonly used to make cell blocks from fine-needle aspiration (FNA) samples but requires centrifugation. We describe a modification to this method that does not require centrifugation for use in resource-limited settings.

Methods: Pooled fresh plasma is aliquoted into 2-mL Eppendorf tubes and the FNA sample directly rinsed into the plasma. Read More

View Article
June 2018
1 Read

Decreased Hemolysis and Improved Platelet Function in Blood Components Washed With Plasma-Lyte A Compared to 0.9% Sodium Chloride.

Am J Clin Pathol 2018 Jun 6. Epub 2018 Jun 6.

Department of Pathology and Laboratory Medicine, Transfusion Medicine Division, Rochester, NY.

Objectives: Washing cellular blood products is accepted to ameliorate repeated severe allergic reactions but is associated with RBC hemolysis and suboptimal platelet function. We compared in vitro hemolysis and platelet function in blood components after washing with Plasma-Lyte A (PL-A) vs normal saline (NS).

Methods: RBC (n = 14) were washed/resuspended in NS or PL-A. Read More

View Article
June 2018
2 Reads

A Single Institutional Experience With the Paris System for Reporting Urinary Cytology: Correlation of Cytology and Histology in 194 Cases.

Am J Clin Pathol 2018 Jun 6. Epub 2018 Jun 6.

Department of Pathology, University of California San Diego, La Jolla.

Objectives: The Paris System for Reporting Urinary Cytology (TPS) is designed to standardize the criteria and terminology used in urinary tract cytology reporting. The aim of this study was to evaluate the impact of implementing TPS and to analyze the correlation with follow-up biopsies in order to assess its reproducibility.

Methods: Urinary tract cytology specimens with follow-up biopsies over a 2-year period were reviewed and reclassified according to TPS criteria. Read More

View Article

Defining Lymphoplasmacytic Lymphoma: Does MYD88L265P Define a Pathologically Distinct Entity Among Patients With an IgM Paraprotein and Bone Marrow-Based Low-Grade B-Cell Lymphomas With Plasmacytic Differentiation?

Am J Clin Pathol 2018 Jun 2. Epub 2018 Jun 2.

Division of Hematopathology, Mayo Clinic, Rochester, MN.

Objectives: Lymphoplasmacytic lymphoma (LPL) remains a poorly defined entity, even with the discovery of MYD88L265P mutations and association with Waldenström macroglobulinemia (WM). Among bone marrow (BM)-based, low-grade B-cell lymphoma with plasmacytic differentiation (LGBLPD) and immunoglobulin M (IgM) paraproteins, we sought to determine whether MYD88L265P defines a distinct entity and can help refine diagnostic criteria for LPL.

Methods: BMs diagnosed with LGBLPD or LPL and serum IgM paraprotein were studied (2007-2013). Read More

View Article

Detection of BRAF V600E Mutations With Next-Generation Sequencing in Infarcted Thyroid Carcinomas After Fine-Needle Aspiration.

Am J Clin Pathol 2018 Jun 2. Epub 2018 Jun 2.

Department of Pathology, University of Alabama-Birmingham, Birmingham, AL.

Objectives: Fine-needle aspiration (FNA) of thyroid lesions may result in infarction and diagnostic difficulties on subsequent thyroidectomy specimens. Next-generation sequencing (NGS) methods for detection of hallmark driver BRAF V600E mutations may help characterize such tumors in which histologic alterations preclude definitive tissue diagnosis.

Methods: Thyroidectomy specimens with both malignant FNA diagnoses and resultant infarction were identified from our institutional database. Read More

View Article

Correction.

Authors:

Am J Clin Pathol 2018 May;150(1):92

View Article

Effect of Diabetes Mellitus on Sickle Hemoglobin Quantitation in Sickle Cell Trait.

Am J Clin Pathol 2018 May 29. Epub 2018 May 29.

Department of Pathology, University of Michigan, Ann Arbor.

Objectives: We evaluated the effect of diabetes on sickle hemoglobin (HbS) measurement on two common clinical hemoglobin separation platforms.

Methods: We performed a method comparison between the Bio-Rad Variant II high-performance liquid chromatography (HPLC) and Sebia Capillarys 2 Flex Piercing capillary electrophoresis (CE) using clinical specimens from 38 patients without hemoglobin variants and 57 patients with sickle cell trait (AS) (HbA1c%, 4.1%-15. Read More

View Article

Quality Control Practices for Chemistry and Immunochemistry in a Cohort of 21 Large Academic Medical Centers.

Am J Clin Pathol 2018 May 29. Epub 2018 May 29.

Department of Pathology, Massachusetts General Hospital, Boston.

Objectives: In the United States, minimum standards for quality control (QC) are specified in federal law under the Clinical Laboratory Improvement Amendment and its revisions. Beyond meeting this required standard, laboratories have flexibility to determine their overall QC program.

Methods: We surveyed chemistry and immunochemistry QC procedures at 21 clinical laboratories within leading academic medical centers to assess if standardized QC practices exist for chemistry and immunochemistry testing. Read More

View Article
May 2018
1 Read

Overexpression of Golgi Phosphoprotein 2 Is Associated With Poor Prognosis in Oral Squamous Cell Carcinoma.

Am J Clin Pathol 2018 May;150(1):74-83

The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.

Objectives: The aims of this study were to investigate the relationship between Golgi phosphoprotein 2 (GOLPH2) and oral squamous cell carcinoma (OSCC) and explore the clinical significance of GOLPH2 in OSCC.

Methods: Tissue microarrays from human OSCC samples were stained for GOLPH2 expression and clinicopathologic features. Kaplan-Meier analysis was used to compare the survival of patients with high GOLPH2 expression and patients with low GOLPH2 expression. Read More

View Article
May 2018
3 Reads

Recurrent Cytogenetic Abnormalities in Intravascular Large B-Cell Lymphoma.

Am J Clin Pathol 2018 May;150(1):18-26

Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis.

Objectives: Data characterizing the cytogenetic landscape of intravascular large B-cell lymphoma (ILBCL) are limited. Here, we developed a comprehensive karyotypic data set to identify recurrent cytogenetic abnormalities in ILBCL.

Methods: Cases of ILBCL with complete cytogenetic analysis were identified from an institutional database and the literature. Read More

View Article

Is a 500-Cell Count Necessary for Bone Marrow Differentials?: A Proposed Analytical Method for Validating a Lower Cutoff.

Am J Clin Pathol 2018 May;150(1):84-91

Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA.

Objectives: By convention, 500 cells are counted for bone marrow aspirate differentials. Evidence supporting such a cutoff is lacking. We hypothesized that 300-cell counts could be sufficient. Read More

View Article

Detection of Albumin Expression by RNA In Situ Hybridization Is a Sensitive and Specific Method for Identification of Hepatocellular Carcinomas and Intrahepatic Cholangiocarcinomas.

Am J Clin Pathol 2018 May;150(1):58-64

Geisinger Medical Center, Danville, PA.

Objectives: Inconsistent data on detection of albumin expression by ribonucleic acid (RNA) in situ hybridization have been reported. We investigated the utility of RNAscope (Advanced Cell Diagnostics, Hayward, CA) in detection of albumin in hepatocellular carcinomas (HCCs), intrahepatic cholangiocarcinomas (ICCs), and carcinomas from various organs using manual and automated staining.

Methods: RNAscope for albumin detection was performed on 482 cases on tissue microarray sections and on 22 cases of ICC, including 14 surgical resection and eight core biopsy specimens. Read More

View Article

Extended Human Papillomavirus Genotype Distribution and Cervical Cytology Results in a Large Cohort of Chinese Women With Invasive Cervical Cancers and High-Grade Squamous Intraepithelial Lesions.

Am J Clin Pathol 2018 May;150(1):43-50

Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Objectives: To study the human papillomavirus (HPV) genotype distribution of cervical cancer (CxCa) and cervical intraepithelial neoplasia grade 2/3 (CIN2/3) in China and to evaluate cotesting of HPV and cytology in CxCa screening.

Methods: Patients with histopathologic CxCa and CIN 2/3 diagnoses reported between January 2012 and June 2016 and extended HPV genotype testing in the prior 6 months were documented in the institute. Available prior Papanicolaou (Pap) test results were also documented. Read More

View Article

Contemporary Evaluation of Breast Lymph Nodes in Anatomic Pathology.

Am J Clin Pathol 2018 May;150(1):4-17

Department of Pathology, Brigham and Women's Hospital, Boston, MA.

Objectives: Management of the axilla in breast cancer patients has evolved considerably since the introduction of the sentinel lymph node (SLN) biopsy in the 1990s. Several new clinical and technological developments in the last decade warrant special consideration due to their impact on pathology practice.

Methods: This review covers the SLN biopsy procedure, issues in the histopathologic and molecular diagnosis of the SLN, and most importantly, evidence from recent practice-changing clinical trials. Read More

View Article

Clinical Significance of Complex Glandular Patterns in Lung Adenocarcinoma: Clinicopathologic and Molecular Study in a Large Series of Cases.

Am J Clin Pathol 2018 May;150(1):65-73

Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.

Objectives: To explore whether complex glandular patterns (CGPs) have a potential role in the clinical management of patients with lung adenocarcinoma.

Methods: We included 356 patients with lung adenocarcinoma with available clinicopathologic information, gene mutations, and clinical outcomes for analysis.

Results: We identified 54 (15. Read More

View Article
May 2018
2 Reads

Low Estrogen Receptor (ER)-Positive Breast Cancer and Neoadjuvant Systemic Chemotherapy: Is Response Similar to Typical ER-Positive or ER-Negative Disease?

Am J Clin Pathol 2018 May;150(1):34-42

Division of Breast and Gynecologic Pathology, Department of Pathology, Pittsburgh, PA.

Objectives: Pathologic complete response (pCR) rate after neoadjuvant chemotherapy was compared between 141 estrogen receptor (ER)-negative (43%), 41 low ER+ (13%), 47 moderate ER+ (14%), and 98 high ER+ (30%) tumors.

Methods: Human epidermal growth factor receptor 2-positive cases, cases without semiquantitative ER score, and patients treated with neoadjuvant endocrine therapy alone were excluded.

Results: The pCR rate of low ER+ tumors was similar to the pCR rate of ER- tumors (37% and 26% for low ER and ER- respectively, P = . Read More

View Article
May 2018
2 Reads

Variability of High-Sensitivity Troponin T Concentrations in Emergency Settings: Impact for the Diagnosis of Myocardial Infarction.

Am J Clin Pathol 2018 May;150(1):51-57

Département de biologie médicale, IUCPQ, Université Laval, Québec City, Canada.

Objectives: To assess biological variation of troponin T in emergency settings and establish limits for interpretation of serial results.

Methods: We studied 6,557 consecutive patients with troponin measurements. A stable reference subset was selected to estimate biological variation and threshold limits. Read More

View Article
May 2018
5 Reads

The Five Es of Efficient Engagement: Attaining Esprit de Corps.

Am J Clin Pathol 2018 May;150(1):1-3

Cleveland Clinic, Cleveland, OH.

View Article
May 2018
1 Read

An Audit of Repeat Testing at an Academic Medical Center: Consistency of Order Patterns With Recommendations and Potential Cost Savings.

Am J Clin Pathol 2018 May;150(1):27-33

Department of Pathology, Health Sciences Center, University of Utah, Salt Lake City.

Objectives: To evaluate the prevalence of potentially unnecessary repeat testing (PURT) and the associated economic burden for an inpatient population at a large academic medical facility.

Methods: We evaluated all inpatient test orders during 2016 for PURT by comparing the intertest times to published recommendations. Potential cost savings were estimated using the Centers for Medicare & Medicaid Services maximum allowable reimbursement rate. Read More

View Article

Test Cost and Test Accuracy in Clinical Laboratories in Kampala, Uganda.

Am J Clin Pathol 2018 Apr;149(6):522-529

Department of Medicine, Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD.

Objectives: To assess the accuracy and costs of laboratory tests in Kampala, Uganda.

Methods: A random selection of 78 laboratories tested external quality assurance samples at market rates. There were 40 moderate- to high-complexity and 38 low-complexity laboratories. Read More

View Article
April 2018
1 Read

Facing the Inevitable: Being Prepared for Regulatory Requirements for Laboratory Developed Tests.

Am J Clin Pathol 2018 Apr;149(6):484-498

Industrial and Systems Engineering, Wayne State University, Detroit, MI.

Objectives: We introduce regulatory terms, definitions, and the Quality System Regulation as proposed by the US Food and Drug Administration in the 2014 draft guidance entitled Framework for Regulatory Oversight of Laboratory Developed Tests and explore medical device requirements applicable to a laboratory environment to design, develop, and validate laboratory developed tests (LDTs).

Methods: We performed nine interviews with laboratory professionals to explore concerns and challenges regarding the draft, translated the results into operational factors, and surveyed professionals to test the factors that would comprise a regulatory quality management system framework.

Results: Nine interviewees and 35 survey respondents shared concerns of risk classification, process validation, patient safety, and general ambiguity regarding the proposed requirements for development of LDTs. Read More

View Article
April 2018
1 Read

Evaluation of the Utility of Bone Marrow Morphology and Ancillary Studies in Pediatric Patients Under Surveillance for Myelodysplastic Syndrome.

Am J Clin Pathol 2018 Apr;149(6):499-513

Department of Laboratories, Seattle, WA.

Objectives: To evaluate the utility of flow cytometry, karyotype, and a fluorescence in situ hybridization (FISH) panel in screening children for myelodysplastic syndrome (MDS).

Methods: Bone marrow morphology, flow cytometry, karyotype, and FISH reports from 595 bone marrow specimens (246 patients) were analyzed.

Results: By morphology, 8. Read More

View Article
April 2018
1 Read

Overexpression of FIBCD1 Is Predictive of Poor Prognosis in Gastric Cancer.

Am J Clin Pathol 2018 Apr;149(6):474-483

Department of General Surgery, Nantong University Affiliated Hospital, Nantong, China.

Objectives: Fibrinogen C domain containing 1 (FIBCD1) is a newly identified acetyl group recognition receptor. The aim of this study was to evaluate the prognostic significance of FIBCD1 in gastric cancer.

Methods: This study included 706 samples, and the clinical data of all patients were recorded in detail. Read More

View Article
April 2018
1 Read

RNA and microRNA Stability in PAXgene-Fixed Paraffin-Embedded Tissue Blocks After Seven Years' Storage.

Am J Clin Pathol 2018 Apr;149(6):536-547

Integrated Biobank of Luxembourg, Dudelange, Luxembourg.

Objectives: To evaluate the stability of RNA and microRNA (miRNA) in PAXgene-fixed paraffin-embedded tissue blocks after 7 years' storage.

Methods: RNA and miRNA were extracted from PAXgene-fixed paraffin-embedded (PFPE) blocks in 2009 then stored at -80°C. Seven years later, RNA and miRNA were again extracted from the same blocks. Read More

View Article
April 2018
3 Reads

Gastric Adenocarcinoma of the Fundic Gland Type: Update and Literature Review.

Am J Clin Pathol 2018 Apr;149(6):461-473

Department of Pathology, Yale University School of Medicine, New Haven, CT.

Objectives: Gastric adenocarcinoma of the fundic gland type (GA-FG) is a newly described entity with a lack of awareness amongst general surgical pathologists and this review highlights the key features and controversies associated with this uncommon neoplasm.

Methods: A literature search through PubMed using synonyms for GA-FG was conducted to obtain 111 cases.

Results: GA-FG is a well-differentiated neoplasm of oxyntic mucosa, that is comprised of chief cells and parietal cells. Read More

View Article
April 2018
1 Read

Pulmonary Non-Small Cell Carcinoma With Morphologic Features of Adenocarcinoma or "Non-Small Cell Carcinoma Favor Adenocarcinoma" in Cytologic Specimens Share Similar Clinical and Molecular Genetic Characteristics.

Am J Clin Pathol 2018 Apr;149(6):514-521

From the Department of Pathology, Division of Cytopathology, Johns Hopkins School of Medicine, Baltimore, MD.

Objectives: Define if the presence of morphologic features of adenocarcinoma (ACA) in non-small cell lung carcinoma (NSCLC) on cytology specimens correlates with clinical and biologic features.

Methods: A total of 209 cases of NSCLC diagnosed on fine-needle aspiration in a 3-year period were included.

Results: After morphologic review, the cases were classified as ACA (n = 115), NSCLC favor ACA (n = 43), and NSCLC-not otherwise specified (NOS) (n = 18). Read More

View Article
April 2018
2 Reads

The Impact of an Electronic Expensive Test Notification.

Am J Clin Pathol 2018 Apr;149(6):530-535

Cleveland Clinic, Cleveland, OH.

Objectives: The impact of clinical decision support tools (CDSTs) that display test cost information has been variable.

Methods: We retrospectively analyzed the 3-year impact of a passive CDST that notified providers when the test order cost was $1,000 or more. We determined the most common expensive tests ordered, the frequency with which providers abandoned the order after notification, and the costs saved through this intervention. Read More

View Article
April 2018
1 Read

Obtaining a Correct Diagnosis Rapidly in the United States Is Associated With Many Barriers Not Present in Other Countries.

Authors:
Michael Laposata

Am J Clin Pathol 2018 Apr;149(6):458-460

Department of Pathology, University of Texas Medical Branch, Galveston.

View Article
April 2018
1 Read

Body Fluid Processing Workspace Quality Improvement Initiative in a High-Volume Reference Laboratory.

Am J Clin Pathol 2018 Mar;149(5):434-441

Mayo Clinic, Rochester, MN.

Objectives: In a clinical laboratory, the design of the workspace directs the workflow and significantly affects the productivity of clinical laboratory scientists (CLS). With the chronic shortage of CLS, a well-designed workspace is essential to take full advantage of available staff, especially in high-volume laboratories.

Methods: Through the use of quality improvement tools, a manual body fluid testing workspace was redesigned to address weaknesses in the layout that led to excessive physical steps taken by staff. Read More

View Article
March 2018
1 Read

Diagnostic Utility of Twist1, Ki-67, and E-Cadherin in Diagnosing Molar Gestations and Hydropic Abortions.

Am J Clin Pathol 2018 Mar;149(5):442-455

Department of Obstetrics & Gynecology, Faculty of Medicine, Minia University, Minia, Egypt.

Objectives: This study aims to assess whether the expression of Twist1, Ki-67, and E-cadherin can guide the differential diagnosis of complete hydatidiform mole (CHM), partial hydatidiform mole (PHM), and hydropic abortion (HA).

Methods: Differential expression of Twist1, Ki-67, and E-cadherin was analyzed in gestational products from 55 cases of CHM, PHM, and HA using immunohistochemistry. Prior to analysis, the studied cases were confirmed for their diagnosis by flow cytometric assessment of DNA ploidy and p57 immunostaining. Read More

View Article
March 2018
1 Read

Increased Rate of ASCUS Diagnosis With Concomitant Request for High-Risk Human Papillomavirus Reflex Testing May Be Due to Cognitive Bias.

Am J Clin Pathol 2018 Mar;149(5):425-433

Department of Pathology and Laboratory, School of Medicine, University of North Carolina at Chapel Hill.

Objectives: To determine if concomitant high-risk human papillomavirus (HPV-HR) reflex testing may bias the cytologic interpretation of Papanicolaou (Pap) tests.

Methods: Percentage of atypical squamous cells of undetermined significance (ASCUS) and HPV-HR positivity was compared between Pap tests with HPV-HR cotesting and HPV-HR reflex testing for ASCUS, with subset analysis of cytopathologists' experience.

Results: ASCUS in the reflex group (41. Read More

View Article
March 2018
10 Reads

Performance Evaluation and Clinical Associations of Immunoassays That Detect Antibodies to Negatively Charged Phospholipids Other Than Cardiolipin.

Am J Clin Pathol 2018 Mar;149(5):401-411

Rheumatology/Internal Medicine, University of Texas Medical Branch, Galveston.

Objectives: We evaluate the performance characteristics of antiphosphatidylserine (anti-PS), antiphosphatidylinositol (anti-PI), and antiphospholipid mixture (APhL) enzyme-linked immunosorbent assays (ELISAs) compared with anticardiolipin (aCL) and anti-β2 glycoprotein I (anti-β2GPI) in a large group of patients with antiphospholipid (aPL)-related diseases.

Methods: Serum samples from 548 patients from the Hopkins and Jamaican systemic lupus erythematosus cohorts, the PROMISSE cohort, and the Antiphospholipid Standardization Laboratory were examined for immunoglobulin G (IgG)/immunoglobulin M (IgM) positivity in aCL, anti-β2GPI, anti-PS, anti-PI, and APhL ELISA assays.

Results: All IgG assays were associated with one or more thrombotic and/or obstetric manifestations, with an increased risk associated with higher antibody titers. Read More

View Article
March 2018
2 Reads

Limited Utility of Fluorescence In Situ Hybridization for Recurrent Abnormalities in Acute Myeloid Leukemia at Diagnosis and Follow-up.

Am J Clin Pathol 2018 Mar;149(5):418-424

Department of Pathology and Laboratory Medicine, Vanderbilt University Medical Center, Nashville, TN.

Objectives: Acute myeloid leukemia (AML) is classified in part by recurrent cytogenetic abnormalities, often detected by both fluorescent in situ hybridization (FISH) and karyotype. The goal of this study was to assess the utility of FISH and karyotyping at diagnosis and follow-up.

Methods: Adult AML samples at diagnosis or follow-up with karyotype and FISH were identified. Read More

View Article
March 2018
1 Read

Preparing for a Computational Pathology Future Through Informaticians and a Computational Technologist Workforce.

Am J Clin Pathol 2018 Mar;149(5):369-372

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.

View Article
March 2018
1 Read

Acinar-Predominant Pattern Correlates With Poorer Prognosis in Invasive Mucinous Adenocarcinoma of the Lung.

Am J Clin Pathol 2018 Mar;149(5):373-378

Respiratory Department, Institute of Respiratory Diseases of Sun Yat-sen University, Guangzhou, China.

Objectives: Invasive mucinous adenocarcinoma (IMA) is a variant of lung adenocarcinoma with several growth patterns, such as lepidic acinar and papillary. However, to our knowledge, no study regarding prognostic and clinicopathologic aspects of IMAs with different growth patterns has been reported.

Methods: Of 2,236 patients with primary lung adenocarcinoma, 16 were identified as having lepidic-predominant IMA and 10 as having acinar-predominant IMA. Read More

View Article
March 2018
4 Reads

Upregulation of miR-125b, miR-181d, and miR-221 Predicts Poor Prognosis in MGMT Promoter-Unmethylated Glioblastoma Patients.

Am J Clin Pathol 2018 Mar;149(5):412-417

Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

Objectives: To evaluate the prognostic values of microRNAs (miRNAs) in glioblastoma, and to see if there is an association between miRNAs and MGMT promoter methylation status.

Methods: We collected paraffin blocks from resection specimens from 114 glioblastoma patients who had received temozolomide treatment and radiotherapy. Real-time quantitative PCR was performed to determine the expression levels of five miRNAs. Read More

View Article
March 2018
1 Read

Multinodular Goiter Progression Toward Malignancy in a Case of DICER1 Syndrome: Histologic and Molecular Alterations.

Am J Clin Pathol 2018 Mar;149(5):379-386

Department of Pathology Pediatric Department, Centro Hospitalar São João, Porto, Portugal.

Objectives: Multinodular goiter (MNG) and well-differentiated thyroid carcinoma (WDTC) are emerging phenotypes of DICER1 syndrome.

Methods: Histologic and molecular findings of botryoid-type embryonal rhabdomyosarcoma (bERMS) and thyroid nodules from a 12-year-old DICER1 mutation carrier (p.Arg1060Ilefs*7) were investigated, providing interesting clues for understanding thyroid carcinogenesis. Read More

View Article
March 2018
2 Reads

The American Society for Clinical Pathology's 2016-2017 Vacancy Survey of Medical Laboratories in the United States.

Am J Clin Pathol 2018 Mar;149(5):387-400

ASCP Evaluation, Measurement and Assessment Department, Chicago, IL.

Objectives: To determine the extent and distribution of workforce shortages within the nation's medical laboratories.

Methods: The 2016-2017 Vacancy Survey was conducted through collaboration between the American Society for Clinical Pathology's Institute of Science, Technology, & Policy in Washington, DC, and the Evaluation, Measurement, and Assessment division and Board of Certification in Chicago, Illinois. Data were collected via an internet survey that was distributed to individuals who were able to report on staffing and certifications for their laboratories. Read More

View Article
March 2018
2 Reads

Prognostic Significance of Modified Residual Disease in Breast and Nodes (mRDBN) Algorithm After Neoadjuvant Chemotherapy for Breast Cancer.

Am J Clin Pathol 2018 Mar;149(4):332-343

Department of Pathology, Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA.

Objectives: We hypothesized that prognostic accuracy of the residual disease in breast and lymph nodes (RDBN) method, which is calculated using residual tumor size, nodal involvement, and tumor grade, may be improved by incorporating residual tumor cellularity.

Methods: Cases included 614 patients who underwent neoadjuvant therapy for breast cancer. Tumor size was adjusted for residual cellularity of invasive carcinoma and used to calculate modified RDBN (mRDBN) and compared with unmodified gross tumor size (gRDBN). Read More

View Article
March 2018
4 Reads

Loss of Full-Length GATA1 Expression in Megakaryocytes Is a Sensitive and Specific Immunohistochemical Marker for the Diagnosis of Myeloid Proliferative Disorder Related to Down Syndrome.

Am J Clin Pathol 2018 Mar;149(4):300-309

Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

Objectives: Myeloid proliferative disorders associated with Down syndrome (MPD-DS), including transient abnormal myelopoiesis and myeloid leukemia associated with Down syndrome (DS), harbor mutations of GATA1, a transcription factor essential for erythroid and megakaryocytic development. These mutations result in a N-terminally truncated GATA1 (GATA1s) and prohibit the production of the full-length GATA1 (GATA1f). Here, we demonstrate the utility of immunohistochemical GATA1f reactivity in diagnosing MPD-DS. Read More

View Article
March 2018
1 Read