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The carbon footprint of a surgical pathology laboratory in France Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-03-12 Constance Béchu, Anne Rullier, Pierre-Emmanuel Lesoin, Lucie Gaillot-Durand, Alexis Trecourt, Pierre Gosset, Cyprien Tilmant
Objectives The health sector contributes to climate disruption through greenhouse gas (GHG) emissions. It accounts for 8% to 10% of France’s GHG emissions. Although the medical community has been alerted to the problem, more data are needed. This study aimed to determine the carbon footprint of a surgical pathology laboratory. Methods The study was conducted in the surgical pathology laboratory at
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Analyzing clinical laboratory specimen rejection rates at a specialized hospital in Ethiopia: A 2-year document review Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-03-09 Teshiwal Deress, Yeshewas Abebaw, Yezena Esayas, Semegn Nebertu, Meseret Kinidie, Germaw Abebe, Biruk Bayleyegn
Objectives Accurate laboratory diagnosis is essential for effective patient care, but the rejection of specimens within laboratories can have serious consequences. Methods A retrospective cross-sectional study was conducted from September to November 2021 at the University of Gondar Comprehensive Specialized Hospital laboratory. Two years of laboratory data were collected from laboratory log books
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A 5-step root cause analysis model for test overutilization: A study on its application to plasma transferrin testing Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-03-06 Jiracha Jittapranerat, Wimol Chinswangwatanakul
Objectives This study aimed to develop a root cause analysis (RCA) model for test overutilization, applying it to transferrin overordering at our institution. Methods A comprehensive review was undertaken to establish a systematic RCA model. Upon implementation, the questionnaire identifying the root causes of transferrin overordering with infographic intervention was distributed to clinicians and
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Implementation of endometrial cancer molecular subtyping into a hybrid community-academic practice Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-03-02 Elizabeth O Ferreira, Alexandra M Schefter, Abby Brustad, Molly E Klein, Mahmoud A Khalifa, Boris Winterhoff, Andrew C Nelson
Objectives We sought to confirm utility of our institution’s modified Proactive Molecular Risk Classifier for Endometrial Cancer protocol in our daily practice, which includes mismatch repair (MMR), p53, and L1 cell adhesion molecule (L1CAM) immunohistochemistry with in-house next-generation sequencing for POLE, TP53, and CTNNB1. Methods We conducted a retrospective review of all patients in our institution
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Radical prostatectomy cancer grade and percentage of Gleason pattern 4 estimated by global vs individual tumor grading correlate differently with the risk of biochemical recurrence in Grade Group 2 and 3 cancers Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-27 Oleksandr N Kryvenko, Jonathan I Epstein, Ali Merhe, Oleksii A Iakymenko, Ricardo De Almeida E Silva, Dimple Kumar Chanamolu, Laurence M Briski, Deukwoo Kwon, Ivan Nemov, Sanoj Punnen, Alan Pollack, Radka Stoyanova, Dipen J Parekh, Merce Jorda, Mark L Gonzalgo
Objectives There are 2 grading approaches to radical prostatectomy (RP) in multifocal cancer: Grade Group (GG) and percentage of Gleason pattern 4 (GP4%). We investigated whether RP GG and GP4% generated by global vs individual tumor grading correlate differently with biochemical recurrence. Methods We reviewed 531 RP specimens with GG2 or GG3 cancer. Each tumor was scored separately with assessment
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Remote support of an external quality assessment program in 10 laboratories in Bhutan, Uganda, and Malawi: Pathologists Overseas experience between 2009 and 2017 Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-22 Roa Harb, Robert Tuggey, Jack H Ladenson, Timothy Amukele
Objectives This article describes Pathologists Overseas (PO) experience supporting external quality assessment (EQA) programs in 10 clinical laboratories across 3 countries between 2009 and 2017. Methods Laboratories were enrolled in the condensed chemical pathology EQA program provided by the Royal College of Pathologists of Australasia Quality Assurance Program. Participants were given an initial
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MED15::TFE3 fusion renal cell carcinoma with extensive cystic change: A clinicopathologic and molecular genetic study of 2 cases, with an emphasis on differential diagnosis Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-22 Xiaona Yin, Xingen Hu, Jiayun Xu, Danting Xiong, Ming Zhao
Objectives TFE3-rearranged renal cell carcinomas (RCCs) harbor gene fusions between TFE3 and 1 of many partner genes. MED15::TFE3 fusion RCC is rare, often cystic, and easily misdiagnosed. Methods This study aimed to characterize 2 cases of MED15::TFE3 fusion RCC with extensive cystic change using fluorescence in situ hybridization and targeted RNA sequencing. Results Both patients were young adult
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A longitudinal mixed-methods study of pathology explanation clinics in patients with newly diagnosed localized prostate cancer Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-22 Sarah E Bergholtz, Sophia R Kurnot, Esha Elahi, Melissa DeJonckheere, Sarah T Hawley, Scott R Owens, Simpa Salami, Todd M Morgan, Cathryn J Lapedis
Objectives To characterize the role of pathology explanation clinics (PECs) in prostate cancer care and determine their impact on patients, urologic oncologists, and quality of care. Methods Semistructured interviews with 10 patients with newly diagnosed prostate cancer were conducted before and after a PEC pilot and at the 1- and 6-month follow-up visits. Information about participants’ cancer knowledge
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Clinicopathologic features and survival outcomes of CD30 expression in extranodal natural killer/T-cell lymphoma Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-22 Ziyuan Shen, Yubo Wang, Ruiyang Xie, Qing Zhang, Xing Xing, Shuo Zhang, Hui Liu, Wei Sang
Objectives Previous studies have been inconsistent concerning the association between the prognostic value of CD30 expression and extranodal natural killer/T-cell lymphoma (ENKTL). Methods CD30 expression in 82 patients with newly diagnosed ENKTL (mean age, 50 years; 73.2% male) was assessed by immunohistochemistry on paraffin-embedded sections. The level of CD30 expression was categorized into negative
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Artificial intelligence–based algorithms for the diagnosis of prostate cancer: A systematic review Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-21 Stefano Marletta, Albino Eccher, Filippo Maria Martelli, Nicola Santonicco, Ilaria Girolami, Aldo Scarpa, Fabio Pagni, Vincenzo L’Imperio, Liron Pantanowitz, Stefano Gobbo, Davide Seminati, Angelo Paolo Dei Tos, Anil Parwani
Objectives The high incidence of prostate cancer causes prostatic samples to significantly affect pathology laboratories workflow and turnaround times (TATs). Whole-slide imaging (WSI) and artificial intelligence (AI) have both gained approval for primary diagnosis in prostate pathology, providing physicians with novel tools for their daily routine. Methods A systematic review according to the Preferred
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Immune checkpoint inhibitor–related colitis in patients on immunotherapy for cancer Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-20 Belinda L Sun, Alexis S Elliott, David Nolte, Xiaoguang Sun
Objectives Immune checkpoint inhibitors, a revolutionary class of cancer immunotherapy drugs, have transformed cancer treatment by bolstering antitumor immunity for various advanced-stage solid cancers. The US Food and Drug Administration has approved 7 immune checkpoint inhibitors that target 3 major immune checkpoint proteins: cytotoxic T-lymphocyte–associated protein 4, programmed cell death 1 protein
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Multicolor flow cytometric immunophenotyping is highly sensitive and specific in identifying aberrant mast cells in the diagnostic workup of systemic mastocytosis Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-19 Okechukwu Valentine Nwogbo, Hong Fang, Wei Wang, Jie Xu, Roberto N Miranda, Prithviraj Bose, Chi Young Ok, Jeffrey L Jorgensen, L Jeffrey Medeiros, Sa A Wang
Objectives Flow cytometric immunophenotyping (FCI) is a fast and sensitive method for characterizing hematolymphoid neoplasms. It is not widely used in the workup of systemic mastocytosis (SM), in part because of the technical challenges and in part because the utility of FCI in assessing mast cells is not well understood. The objectives of this study were to assess the diagnostic utility of FCI in
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To normalize or not?: Dilute Russell viper venom time testing Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-19 Yong Zhang, Michael Creer, Olajumoke O Oladipo
Objectives We conducted a comparison between the nonnormalized dilute Russell viper venom time (dRVVT) screen/confirm ratio (SCR) in patient plasma and the normalized SCR obtained using reference pooled plasma. The aim was to assess the impact of normalization on the lupus anticoagulant (LA) status in our patient population. Methods In our retrospective analysis, we included a total of 464 patients
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Assessing the feasibility of a multimodal liquid biopsy for the diagnosis of HPV-associated oropharyngeal squamous cell carcinoma Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-13 James S Lewis, Saskia Naegele, Vasileios Efthymiou, Mitra Mehrad, Kim A Ely, Tim Waterboer, Krystle A Lang Kuhs, Seth J Davis, Kelsey Richard, Dipon Das, Daniel L Faden
Objectives In this feasibility study, we explored the combined use of circulating tumor human papillomavirus (HPV) DNA (ctHPVDNA) and HPV serology as diagnostic tests for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). Methods Among patients with research-banked serum or plasma at diagnosis, IgG antibodies to oncoproteins from HPV types 16, 18, 31, 33, 35, 45, 52, and 58 were detected
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Characterization of T-/natural killer cell lymphoproliferative neoplasms associated with systemic, chronic, active Epstein-Barr virus in adults: A report of 5 cases in a Western population Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-12 Carlos Murga-Zamalloa, Michael Brandon Stone, Marc G Gutierrez, Neha Rajendra Hippalgaonkar, Hamza Tariq, Morteza Sadeh, Ankit Mehta, Irum Khan, Serhan Alkan, Kedar V Inamdar, Ryan Wilcox, Amir Behdad
Objectives Because of its low frequency in adult populations and clinical and laboratory overlap with hemophagocytic lymphohistiocytosis and other T-cell lymphomas, T-cell/natural killer (NK) cell systemic, chronic, active Epstein-Barr virus (EBV) (T/NK sCAEBV) infection remains underdiagnosed, preventing critical, prompt therapeutic interventions. Methods We report a 5-case series that included 2
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5-Hydroxymethylcytosine (5-hmC) loss is a marker of malignancy in biliary neoplasms Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-12 Miguel S Gonzalez-Mancera, Andrew Siref, Kambiz Kosari, Nicholas Nissen, Srinivas Gaddam, Andrew Hendifar, Arsen Osipov, Kevin Waters, Danielle Hutchings, Maha Guindi, Brent K Larson
Objectives Adenocarcinomas of the biliary tract frequently present diagnostic challenges because of their histologic overlap with benign and preinvasive lesions. The molecular profiles of biliary adenocarcinomas vary by anatomical location. Variations in IDH1/2, common in intrahepatic cholangiocarcinoma, can lead to defective production of 5-hydroxymethylcytosine (5-hmC). Limited ancillary studies
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Good correlation between tacrolimus concentrations using improved CMIA on the Alinity i analyzer and LC-MS/MS method from a reference laboratory but unexpected negative bias with another LC-MS/MS method from a different reference laboratory Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-12 Kelsey Woodard, Tracey Kisler, Amitava Dasgupta
Objectives We compared tacrolimus concentrations obtained by the more recently US Food and Drug Administration–approved tacrolimus assay (CMIA) on the Alinity i analyzer (Abbott Laboratories) with a liquid chromatography/tandem mass spectrometry (LC-MS/MS)–based method from 2 reference laboratories. We also investigated the correlation between the CMIA tacrolimus and Elecsys tacrolimus assays. Methods
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Characterizing the role of informal payments in the delivery of pathology and clinical laboratory services Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-12 Emily H Glynn, Timothy Amukele, Olusegun Soge, Geoffrey Baird, Taryn Vian
Objectives Informal payments (IPs) are unofficial cash or in-kind payments for goods or services that should be covered by the health care system. They are a common but regressive method of financing health care in low- and lower-middle-income countries (LMICs). This study aims to characterize the prevalence and impact of IPs on pathology and laboratory medicine (PALM) services. Methods From September
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Occult cancer in patients with unprovoked venous thromboembolism: A nested case-control study Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-10 Verónica Sánchez-López, Samira Marín-Romero, Marta Ferrer-Galván, Teresa Elías-Hernández, José Luis Lobo Beristain, Aitor Ballaz Quincoces, Luis Jara-Palomares, Francisco Javier Rodríguez Martorell, María José Castro, Carmen Marín Hinojosa, José Luis López-Campos, Remedios Otero-Candelera
Objectives Detecting occult cancer in patients with unprovoked venous thromboembolism (VTE) remains a significant challenge. Our objective was to investigate the potential predictive role of coagulation-related biomarkers in the diagnosis of occult malignancies. Methods We conducted a nested case-control study with a 1-year prospective cohort of 214 patients with unprovoked VTE, with a focus on identifying
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The role of multidisciplinary team meeting histopathology review and its impact on revised reports: Analysis of a national quality improvement program Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-02-08 Eoghan O’Connor, Ann Treacy, Aine Mitchell, Niall Swan
Objectives We conducted the first Irish national study assessing the value of multidisciplinary team meeting review in pathology practice and its impact on error detection before treatment. Methods Public and private pathology laboratories across Ireland capture their quality activities using standardized codes and submit their data to a centralized database (National Quality Assurance Intelligence
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Measuring the performance of an artificial intelligence–based robot that classifies blood tubes and performs quality control in terms of preanalytical errors: A preliminary study Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-01-29 Ali Rıza Şişman, Banu İşbilen Başok, İnanç Kara, Ayfer Çolak, Uğur Bilge, Ferhat Demirci, Nuri Başoglu
Objectives Artificial intelligence–based robotic systems are increasingly used in medical laboratories. This study aimed to test the performance of KANKA (Labenko), a stand-alone, artificial intelligence–based robot that performs sorting and preanalytical quality control of blood tubes. Methods KANKA is designed to perform preanalytical quality control with respect to error control and preanalytical
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Current gross examination and reporting patterns of post–neoadjuvant chemotherapy cystectomy specimens: Is it time for a standardized approach? Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-01-19 Katherine E Saunders, Nicola Gerken, Francesca Khani, Sean R Williamson, Sara E Wobker
Objectives Neoadjuvant chemotherapy (NACT) is recommended for muscle-invasive bladder cancer, and robust treatment response may result in lack of grossly identifiable tumor in the cystectomy specimen. Current gross examination and reporting protocols, however, do not include specific guidance on the approach to these specimens. Methods A Qualtrics survey was disseminated by email and X (formerly Twitter)
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Utilizing PTEN immunohistochemistry as a screening test for Cowden syndrome Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2024-01-11 Emily Hartsough, Mia S DeSimone, Mayra E Lorenzo, Dora Dias-Santagata, Vania Nose, Mai P Hoang
Objectives Cowden syndrome (CS) is a multisystem disease with an elevated lifetime risk of internal malignancy. We aim to assess the role of PTEN immunostain as a screening test for CS in a variety of common CS-associated neoplasms, with a particular focus on cutaneous tumors. Methods We retrospectively searched for patients meeting criteria for CS and/or demonstrating germline PTEN mutation from 2008
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Development of an open access, virtual bioinformatics lab for students in medical laboratory sciences Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-12-23 Hana S Fukuto, Gloria I Viboud
Objectives Despite the growing importance of bioinformatics in molecular diagnostics, not all medical laboratory sciences (MLS) programs provide instruction in this field. We developed and assessed a virtual laboratory learning unit to introduce basic bioinformatics concepts and tools to MLS students. Methods The unit included a video tutorial, written instructions for the online laboratory activity
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Staining, magnification, and algorithmic conditions for highly accurate cell detection and cell classification by deep learning Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-12-22 Katsuhide Ikeda, Nanako Sakabe, Chihiro Ito, Yuka Shimoyama, Kenta Toda, Kenta Fukuda, Yuma Yoshizaki, Shouichi Sato, Kohzo Nagata
Objectives Research into cytodiagnosis has seen an active exploration of cell detection and classification using deep learning models. We aimed to clarify the challenges of magnification, staining methods, and false positives in creating general purpose deep learning–based cytology models. Methods Using 11 types of human cancer cell lines, we prepared Papanicolaou- and May-Grünwald-Giemsa (MGG)–stained
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Detection and quantification of Babesia species intraerythrocytic parasites by flow cytometry Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-12-19 Patrick M Vanderboom, Anisha Misra, Kyle G Rodino, Allison R Eberly, Jason D Greenwood, Heather E Morris, Felicity C Norrie, Emily C Fernholz, Bobbi S Pritt, Andrew P Norgan
Objectives Recent work has demonstrated that automated fluorescence flow cytometry (FLC) is a potential alternative for the detection and quantification of Plasmodium parasites. The objective of this study was to apply this novel FLC method to detect and quantify Babesia parasites in venous blood and compare results to light microscopy and polymerase chain reaction methods. Methods An automated hematology/malaria
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Evaluation of ChatGPT pathology knowledge using board-style questions Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-12-02 Saroja D Geetha, Anam Khan, Atif Khan, Bijun S Kannadath, Taisia Vitkovski
Objectives ChatGPT is an artificial intelligence chatbot developed by OpenAI. Its extensive knowledge and unique interactive capabilities enable its use in various innovative ways in the medical field, such as writing clinical notes and simplifying radiology reports. Through this study, we aimed to analyze the pathology knowledge of ChatGPT to advocate its role in transforming pathology education.
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Initiative to reduce unnecessary routine daily testing of complete blood counts across 11 safety net hospitals Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-12-02 Hyung J Cho, Sigal Israilov, Surafel Tsega, Dan Alaiev, Joseph Talledo, Komal Chandra, Peter Alarcon Manchego, Milana Zaurova, Christopher M Petrilli, Mona Krouss
Objectives National societies recommend against performing routine daily laboratory testing without a specific indication. Unnecessary testing can lead to patient harm, such as hospital-acquired anemia. The objective of this study was to reduce repeat complete blood counts (CBCs) after initial testing. Methods This was a quality improvement initiative implemented across 11 safety net hospitals in New
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Identification of Hb Lepore, Hb anti-Lepore, and α-globin gene triplications by long-read single-molecule real-time sequencing Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-12-01 Anping Xu, Yinghui Ye, Yueying Huang, Yun Huang, Hui Guo, Ling Ji
Objectives Hemoglobin (Hb) Lepore and Hb anti-Lepore are infrequent fusion gene variants that result from nonhomologous crossovers during meiosis. Conventional molecular testing methods may face challenges in identifying these variants. During Hb analysis using capillary electrophoresis, we encountered 6 cases with unusual Hb variants. Our aim was to identify the alterations in their globin genes.
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Survey and situation analysis of personal, employer-related, and environmental factors affecting participation in continuous professional development (CPD) programs of laboratory professionals in Africa Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-12-01 Nqobile Ndlovu, Anafi Mataka, Carl Lombard, Rajiv T Erasmus, Annalise E Zemlin
Objectives To determine the level and evaluate factors affecting the participation of laboratory professionals in continuous professional development (CPD) programs in eastern and southern Africa. Methods A survey was conducted among laboratory professionals from 14 countries. The CPD participation was defined as low if it was fewer than 2 CPD trainings in the past 2 years. Associations between categorical
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Presence of 10 transformation zone cells in endocervical curettage should not be required for adequacy Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-12-01 Roa Alqabbani, Joanna Chan, Allison Goldberg
Objectives In another publication, we concluded endocervical curettage (ECC) should have a minimum number of squamous cells for adequacy, similar to the requirements for adequate cervical Papanicolaou smears. Here, we investigate if also, similar to cervical Papanicolaou smears, the presence of at least 10 cells from the endocervical/transformation zone (EC/TZ) in ECCs should be used as a quality assurance
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Did interventions in a massive transfusion protocol program change transfusion practice? Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 Ronald Devera, Jim Gorham
Current literature supports improved clinical outcomes in the setting of trauma when a Massive Transfusion Protocol (MTP) adheres to transfusion at, or close, to a 1:1 ratio (RBC:Plasma). At our institution, between 2008 and 2015, the number of MTP activations increased ten-fold, accompanied by increased wastage of blood products and stress on the transfusion service. In response, in 2016-2018, we
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Blood Type Verification Rejection Rate Reduction Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 M Abdelmonem, W Cai, S Kilambi, S Yoshizuka, A Nguyen, T Quach, E Howard, S Chang, K Vukic, H Shan, M Yunce
Introduction/Objective Specimen collection is an initial pre-analytical process that ensures accurate, reliable, and timely patient results. In accordance with AABB and CAP Standards, Transfusion Service rejects specimens if they do not meet predefined technical requirements for each specific analyte. First-time patients admitted to Stanford Health Care (SHC), requiring blood transfusions, must have
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Steroidogenic acute regulatory (StAR) protein is a useful marker for sex-cord-stroma tumors and normal/neoplastic adrenocortical tissue Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 M Lennartz, D Amirzada, N C Blessin, N Gorbokon, C Hube-Magg, G Sauter, R Simon, M Kluth, C Bernreuther, S Steurer, T Krech
Introduction/Objective Steroidogenic acute regulatory (StAR) protein is a mitochondrial transport protein with a critical regulatory role for steroid hormone production. As its expression is limited to few normal tissues, the immunohistochemical analysis of StAR was proposed to be diagnostically useful. Methods/Case Report To comprehensively evaluate the diagnostic utility of immunohistochemical StAR
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A t(14;18) Negative Nodal Diffuse Follicular Lymphoma with 1p36/TNFRSF14 LOH Detected by Cytogenomic Microarray Analysis Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 A Lazim, N Mackrides, J Nasibli, J Pei, R Nejati, N Mansoor
Introduction/Objective Among the already described variants of nodal follicular lymphoma (FL), there is a variant with diffuse growth pattern with a predilection to involve the inguinal lymph nodes and peculiar immunohistochemical and molecular characteristics. The diffuse growth pattern is manifested by the complete absence of follicles without a follicular/dendritic meshwork (negative CD21 and CD23)
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Development of a Machine Learning Decision Support System for Clinical Flow Cytometry Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 Joseph Lownik, Simeon Mahov, Jean Lopategui, Serhan Alkan, David Gibb, Akil Merchant, Sumire Kitahara
High parameter flow cytometry is a highly utilized tool in both research and clinical settings for accurate immunophenotyping in immunology, oncology, and many other disciplines. With increasing dimensionality, manual analysis of data becomes more complex and time consuming. Over the past decade, several automated methods have been developed for cell population clustering and dimensionality reduction
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Thoracic SMARCA4-deficient undifferentiated tumor: A rare entity and challenging diagnosis Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 F I Sami, M Lack, A Hamza
Introduction/Objective Thoracic SMARCA4-deficient undifferentiated tumor is a high-grade malignant neoplasm that frequently shows undifferentiated morphology and deficiency of SMARCA4. There is limited data in literature for this entity. The purpose of this report is to describe a case of this entity and to emphasize the importance of keep this entity in mind when dealing with poorly differentiated
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Veteran Healthcare System: A Unique Healthcare Setting Providing Equitable Access to all Patients with Metastatic Lung Cancer in the Era of Precision Diagnostics Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 S Dalal, J M Petersen, D Jhala, A Allbee
Introduction/Objective The National Comprehensive Cancer Network (NCCN) Non-Small Cell Lung Cancer (NSCLC) Guidelines Panel strongly advises broad molecular tumor profiling to identify mutations that help guide precision- based patient tailored therapy and subsequent patient counseling. Liquid biopsy with next generation sequencing represents a powerful tool to obtain this information through phlebotomy
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Systemic EBV-Positive T-cell Lymphoma of Childhood: A Case Report and Comprehensive Literature Review Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 C Hwang, W Sae-Ow
Introduction/Objective Systemic EBV-positive T-cell lymphoma of childhood (SETLC) is an extremely rare disease in which most cases have been reported in Eastern Asian countries. It is characterized by a clonal proliferation of EBV- infected cytotoxic T cells that most commonly affect immunocompetent children and young adults. Patients present with systemic disease with rapid disease progression and
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Comparative study on the effect of bacteriophage on MDR E.coli from Urinary tract infections Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 M Abdelmonem, R Eldaly, M Abdelmageed, M Saleh Abdelfattah, H Wasim
Introduction/Objective Background: Urinary tract infections (UTIs) associated with urethral catheters are the most common infections during hospitalization. Hospitalization's most common infections are urethral catheter-related UTIs. Bacteriophages infect bacteria exclusively. Phage therapy, especially in Eastern Europe, was widely used before antibiotics. Due to the overuse of antibiotics and the
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Beta-Catenin Nuclear Expression in Squamoid Morules in Colorectal Adenomas: Clinicopathologic Study of Fifteen Cases Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 B Centeno, M Ghayouri, K Jiang, G Lauwers, Y Nakanishi, D Perez, T Wu, R Bhalla
Introduction/Objective Squamoid morules are an intriguing finding rarely seen in colorectal adenomas, mimicking foci of microinvasion or neuroendocrine differentiation. Previous observations include mostly case reports and small series, with few examining the squamoid morules in detail. Methods/Case Report We identified fifteen colorectal adenomas with squamoid morules and collected clinicopathological
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Primary Chest Wall Ewing Sarcoma with Indolent Behavior in an Elderly Male Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 O Sagan, A L Schmidt, P McMullen
Introduction/Objective Ewing sarcoma (ES) is the second most common primary malignant bone tumor, primarily affecting children and young adults within the first two decades of life. Over 80% of cases are positive for CD99 and exhibit a characteristic t(11;22) translocation resulting in an EWSR1::FLI1 fusion. Extraosseous ES is extremely rare and most reported cases occur in patients less than 50 years
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A diagnostically challenging case of Lymphoplasmacytic lymphoma involving the kidney clinically mimicking benign hypertension associated chronic kidney disease Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 R S George, X Huang, A Lightle
Introduction/Objective Lymphomas involving the kidneys are under-recognized and often do not present clinically with signs and symptoms raising suspicion for a hematological malignancy. Worsening renal function may necessitate renal biopsy, but often the clinical picture may not warrant a biopsy. We herein present a case of lymphoplasmacytic lymphoma involving the kidney clinically mimicking benign
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Two Cases of Mixed Mullerian Adenosarcoma and Endometrioid Adenocarcinoma of the Uterus Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 Z N Kocas, P Cortes, S Ibrahim, J Cao
Introduction/Objective Endometrioid adenocarcinoma (EA) arising in close spatial association with Mullerian adenosarcoma (MA) is a recently described entity that should be distinguished from carcinosarcoma. Methods/Case Report We describe two cases of mixed MA and EA of the uterus that presented in our institution in the last 10 years. Both patients were in their 8th decade, showed low grade EA, low
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Prevalence of Bacteremia Due to Streptococcus/Enterococcus Species at an Academic/Community Health System Over a Five Year Period Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 Christopher Zarbock, Shannon M Gascoigne, Patricia Ferrieri
Timely surveillance of bacteremia is important for identifying emerging pathogens and to implement effective antimicrobial strategies and public health measures. Organisms in the genera Streptococcus and Enterococcus are often the cause of bacteremia and merit particular attention. The objective of this study was to determine the prevalence of bacteremia caused by several clinically significant Streptococcus
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ACTB::GLI1 Gene Fusion Small Bowel Mesenteric Tumor; a Case Report and Review of the Literature Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 O A Abdelsadek, A Mehreen, H Alnajar
Introduction/Objective GLI1 encodes a transcription factor that targets cell cycle regulators affecting stem cell proliferation. Activation of the GLI (glioma-associated oncogene homologue 1). GLI activity in adult tissues is restricted but has been identified in various neoplasms, as a result of mutations in the PTCH (patched) or SMOH (smoothened) genes, encoding components of the sonic hedgehog pathway
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Primary Central Nervous System ALK-Negative Anaplastic T-Cell Lymphoma is a Challenging and Uncommon Diagnosis Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 R Mohamed, D Howell, H Peng Cheng
Introduction/Objective Primary central nervous system lymphoma (PCNSL) accounts for only 1% of all lymphomas and 6% of all tumors in the central nervous system. Most of these lymphomas are B-cell types, while T-cell types are less common. Anaplastic T-cell lymphoma with ALK-negative is the least common form of anaplastic T-cell lymphoma. It has a similar morphology but is more aggressive than ALK-positive
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Case of Metastatic Atypical Meningioma to Lung: Utility of Cytological Preparations for Intraoperative Diagnosis Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 Y Guo, J E Valk, R Fecher, K O'Toole, A Saqi, J Sonett
Introduction/Objective Meningiomas are the most common primary intracranial and intraspinal tumors. They are typically benign with an indolent behavior but can metastasize extracranially to the skin, bone, lymph node and liver. Lung metastasis is exceptionally rare, and the diagnosis can be challenging, especially during intraoperative diagnosis without ancillary studies. We describe a metastatic atypical
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Sustained Culture of Safety After Select Agent Exposure Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 J Larsen, J Lau, J Karsten, T Grys, E Graf, R Wrobel, D Francis
Introduction/Objective In January of 2021 our laboratory experienced the occupational exposure of 3 technologists to the select agent Burkholderia pseudomallei due to improper recognition and manipulation outside a biosafety cabinet. Subsequently, an interactive computer module was created to train technologists on timely recognition, followed by a “fake” patient test to evaluate comprehension. In
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A rare case of cardiac calcified amorphous tumor in a 34-year-old woman diagnosed at autopsy Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 O Odujoko, M Asad, S K Bal, J Dodge, J Janjua
Introduction/Objective Cardiac calcified amorphous tumor (CAT) is an uncommon, non-neoplastic heart lesion with an unknown incidence due to its rarity. Some authors have reported a female predominance of 62.5%. Many cases are associated with end-stage renal disease, diabetes mellitus and coronary artery disease. Dysfunction of calcium- phosphorus metabolism and hypercoagulability are thought to contribute
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Difficulties in identifying antibodies of high frequency antigens: A case report of anti-Holley antibody Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 J Muldoon, A P Gabbard, N L LePage, K Bielen
Introduction/Objective The Dombrock blood group system consists of the Dombrock (Do), Gregory (Gya), Holley (Hy), and Joseph (Joa) antigens, of which, the Gya, Hy, and Joa represent high prevalence antigens. Anti-Hy antibodies have been implicated in hemolytic transfusion reactions and hemolytic disease of the fetus and newborn. Methods/Case Report We report a 22-year-old black female who presented
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Atypical Teratoid Rhabdoid Tumor: 28-years institutional experience Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 M Shaheen, A O Vortmeyer
Introduction/Objective Atypical teratoid/rhabdoid tumor (ATRT) is a malignant central nervous system tumor affecting young children, characterized by biallelic mutations of SMARCB1 (hSNF5/INI1), consisting of a varying mixture of rhabdoid cells, small round blue cell (SRBC) and epithelial/mesenchymal components. Combination of surgical resection, chemoradiotherapy and autologous stem cell transplantation
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Fine needle aspiration cytology of metastatic tumors to the thyroid: a 20-years single institution retrospective study Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 O A Saeed, S Segura, T Hou, M Saad, A Alkhaseen
Introduction/Objective Metastases to the thyroid are rare and represent approximately 2% to 3% of all thyroid malignancies. In this study we aim to report our institution experience with these tumors over the last twenty years. Methods/Case Report Our laboratory information system was searched for metastatic tumors to the thyroid diagnosed on fine needle aspiration cytology from 2003 to 2023. The pathology
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Demonstrable Equitable Access of Testing for Metastatic Prostate in a Veteran Affairs Medical Center (VAMC) Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 S Dalal, J M Petersen, D Jhala
Introduction/Objective Prostate adenocarcinoma that has metastasized carries a significantly worse prognosis than prostate adenocarcinoma that is contained within the prostate. When there are metastases outside of the prostate, biopsies to diagnose this metastasis can help direct management and treatment of the patient. While there are known differences in the incidence of prostate cancer between different
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Accuracy of prior cytology versus intraoperative consultation in predicting the final diagnosis of thyroid specimens Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 J Zhao, L Ding, P Fung, E Mathews, P Sullivan
Introduction/Objective The aim of this study was to assess the accuracy of preoperative cytology and the additional contribution of intraoperative frozen section in predicting the final diagnosis of thyroid surgical specimens. Methods/Case Report A retrospective search was conducted for cases that underwent pre-surgical cytology of thyroid surgical specimens received from January 2017 to June 2022
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Pleomorphic Adenoma With Cystic Change, Extensive Squamous Metaplasia and Positive Block-Like p16 Staining Pattern: A Sheep In Wolf’s Clothing Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 M Bikhet, H Mesa, O A Saeed, T Hou
Introduction/Objective Pleomorphic adenoma, the most common benign salivary gland neoplasm may show squamous metaplasia in up to 25% of cases, and less frequent cystic change. We report an unusual case of pleomorphic adenoma with cystic change, extensive squamous metaplasia and block-like p16 staining that was misdiagnosed as metastatic p16-positive squamous cell carcinoma in a limited core biopsy
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Opportunities for Promoting ASCPi Credentials in Current & Emerging International Markets Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 J Baker, A Spiczka, K Fong, C Gebhart, D Altenburger, R Famitangco, E Francis
Introduction/Objective The objective of this study is to identify the positive viewpoints while clarifying and mitigating misconceptions applicants have about the BOC’s credentials for internationally educated laboratory professionals (ASCPi) and the Credential Maintenance Program (CMP). With over 21,000 ASCPi credential holders worldwide since 2006, and an average yearly growth rate in the number
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Upregulation of TIM3 and reduced expression of PD-1 on immune cell subsets in advanced prostate cancers Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 N C Blessin, Z Huang, N F Debatin, E Bady, J Müller T Mandelkow, R Simon, M Lennartz, G Sauter, T S Clauditz, E Burandt, M Graefen, N Gorbokon
Introduction/Objective Although most prostate cancers behave in an indolent manner, a small proportion is highly aggressive. Both primary and advanced prostate cancer is widely known as a non-inflamed cancer that is characterized by a paucity of immune infiltration. Methods/Case Report To assess the spatial interplay of more than 30 TIM3, CTLA-4, PD-1/-L1 expressing leukocyte subpopulations in 453
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Histological anatomical levels of penile shaft. A histochemical evaluation of 15 cases Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 S Canete Portillo, A Theriault, D F Sanchez, A L Cubilla, L Celias, M Fernandez-Nestosa
Introduction/Objective Penile carcinomas (PeCa) arising in the skin of the shaft are rare. Staging systems for PeCa are based on tumor invasion of anatomical levels designed for tumors arising in the glans and foreskin but not for those primary of the shaft. There is scant information about anatomical levels in the shaft. The objective of this study was to evaluate and describe anatomical levels of
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Therapy-Related Acute Myeloid Leukemia After Chemotherapy For Osteosarcoma: Report of 2 Cases and Review of The Literature Am. J. Clin. Pathol. (IF 3.5) Pub Date : 2023-11-29 C Hwang, D Medeiros, W Kyono, K Thompson
Introduction/Objective Therapy-related acute myeloid leukemia (t-AML) and myelodysplastic syndrome (t-MDS) are rare but well-established late complications of chemotherapeutic agents or radiation therapy used to treat various malignancies. Many cases of t-AML/t-MDS have been described secondary to Hodgkin, non-Hodgkin lymphoma, and other solid tumors. However, only a few cases of t-AML and t-MDS have