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American Journal of Clinical Pathology

Vladimir Volel, Tarush Kothari, Diane Groppi, Claudine Alexis, Mike Ragnauth, Raheela Qureshi, Amy Entin, Amy Alexander, Oksana Yaskiv, James M Crawford, Nina Kohn, Tawfiqul Bhuiya
OBJECTIVES: A validated and objective method to quantify the gross dissection time of pathologists' assistants (PAs) does not exist. We propose a method to calculate standardized work units (dissection time values [DTVs]) to monitor PA productivity. METHODS: The Current Procedural Terminology system specifies six levels of specimen complexity encompassing 176 unique specimen types. Using our institutional dictionary, we designated all specimen types into a priori five levels of complexity based on expected dissection time...
March 18, 2019: American Journal of Clinical Pathology
Jason M Schenkel, Christopher B Hergott, Graham Dudley, Mai Drew, Karry Charest, David M Dorfman
OBJECTIVES: We tested whether combined flow cytometric assessment of loss of blast heterogeneity and decreased hematogones is a diagnostically useful approach for evaluation of myelodysplastic syndrome (MDS). METHODS: Bone marrow samples from patients with known MDS were analyzed by 10-color flow cytometric immunophenotyping and compared with normal bone marrow samples. RESULTS: There was loss of blast heterogeneity in patients with MDS compared with normal bone marrow samples, based on the relative size of the dominant blast population (83...
March 11, 2019: American Journal of Clinical Pathology
Eman Bahrani, Panitta Sitthinamsuwan, Timothy H McCalmont, Laura B Pincus
OBJECTIVES: We observed keratoses with "clonal" nests present as numerous tiny collections, in which cells in "pagetoid" array are found, a configuration we termed microclonal seborrheic keratosis (MSK). To better distinguish MSK from pagetoid Bowen disease (PBD), we investigated use of immunohistochemical staining. METHODS: Biopsy specimens of 26 MSKs, 17 PBDs, and 11 borderline cases were reviewed for histopathology and stained with p53, Ki-67, and p16...
March 10, 2019: American Journal of Clinical Pathology
Howard H Wu, Fatimah Alruwaii, Bao-Rung Zeng, Harvey M Cramer, Chiung-Ru Lai, Jen-Fan Hang
OBJECTIVES: Multi-institutional studies are required for the validation of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). METHODS: A total of 1,560 fine-needle aspirations of the salivary glands were retrieved from two institutions for a 12-year period. The diagnoses were reclassified based on the MSRSGC. Risk of malignancy (ROM) for each category was calculated based on 694 histologic follow-up cases. RESULTS: The ROM for each category was: 18...
March 10, 2019: American Journal of Clinical Pathology
Kaleigh E Lindholm, Cesar A Moran
OBJECTIVES: Ten cases of thymomas with an extensive xanthomatous component are presented. METHODS: Cases were identified during a review of more than 500 cases of thymomas. Histologic material from surgical resections was evaluated. RESULTS: The patients included five men and five women aged 47 to 64 years who had nonspecific symptoms. Grossly, all tumors were solid, measuring 2.5 to 4.5 cm. Eight tumors were encapsulated; two were minimally invasive...
February 28, 2019: American Journal of Clinical Pathology
Michelle L Khieu, Devin R Broadwater, James K Aden, Jean M Coviello, David T Lynch, Jordan M Hall
OBJECTIVES: To determine the utility of phosphohistone H3 (PHH3) mitotic count (MC) in grading follicular lymphoma (FL). METHODS: FL cases were identified (2005-2017). Three hematopathologists recorded their average Ki-67 proliferation index, MC/high-power field (hpf) using PHH3 and H&E stains, and number of centroblasts/hpf. Results were assessed for correlations and interobserver variability. RESULTS: Forty-three cases of FL were studied...
February 21, 2019: American Journal of Clinical Pathology
Aileen Grace P Arriola, Sahar J Farahani, Hersh K Bhargava, Thomas J Guzzo, John S J Brooks, Priti Lal
OBJECTIVES: Limited literature is available on the tumor microenvironment (TM) of upper tract urothelial carcinoma (UTUC). This study comprehensively reviews programmed death 1 receptor (PD-1)-positive and CD8+ tumor-infiltrating lymphocytes (TILs) and programmed death ligand 1 (PD-L1) expression on tumor epithelium (TE). METHODS: Seventy-two nephroureterectomy specimens were analyzed for PD-L1, PD-1, and CD8. One percent or more tumor and lymphohistiocyte PD-L1 expression was considered positive...
February 18, 2019: American Journal of Clinical Pathology
Sarah B Hugar, Rohit Bhargava, David J Dabbs, Katie M Davis, Margarita Zuley, Beth Z Clark
Objectives: We present a retrospective review of 111 breast core biopsy specimens with flat epithelial atypia (FEA) and corresponding excision to better understand rates of upgrade following this diagnosis. Methods: In total, 252 breast core biopsy specimens were identified. Cases were excluded if biopsy slides or excision results were unavailable, for ipsilateral carcinoma or other findings warranting excision, or biopsy performed for indications other than mammographically detected calcifications...
February 11, 2019: American Journal of Clinical Pathology
Joesph R Wiencek, Eric A Gehrie, Amaris M Keiser, Penny C Szklarski, Kamisha L Johnson-Davis, Garrett S Booth
Objectives: To determine the concentrations of nicotine and nicotine metabolites in RBC units as a means to estimate the point prevalence of exposure within the healthy donor pool. Methods: Segments from 105 RBC units were tested for the presence of nicotine, cotinine, or trans-3'-hydroxycotinine by liquid chromatography-tandem mass spectrometry. Results: Of the 20 (19%) units that contained detectable concentrations of nicotine, cotinine, or trans-3'-hydroxycotinine, 19 (18...
February 3, 2019: American Journal of Clinical Pathology
Ithiel J Frame, Parag H Joshi, Caroline Mwangi, Ian Gunsolus, James A De Lemos, Sandeep R Das, Ravi Sarode, Jyoti Balani, Fred S Apple, Alagarraju Muthukumar
Objectives: To investigate biotin interference on three cardiac troponin (cTn) assays and demonstrate a method to overcome biotin interference. Methods: cTn levels were measured in (1) plasma from healthy volunteers on 10-mg daily biotin supplementation mixed with a plasma with known elevated troponin, (2) plasmas with known elevated cTn after mixing in reagent biotin to simulate supplementation, and (3) biotin-spiked plasma specimens pretreated with streptavidin-agarose beads...
February 2, 2019: American Journal of Clinical Pathology
Antonio Travaglino, Antonio Raffone, Gabriele Saccone, Caterina De Luca, Antonio Mollo, Massimo Mascolo, Giuseppe De Placido, Luigi Insabato, Fulvio Zullo
Objectives: CTNNB1 exon 3 mutations have shown independent prognostic value in endometrial cancer. We aimed to assess whether nuclear β-catenin expression is an accurate surrogate, as immunohistochemistry is cheaper, faster, and more widely applicable than sequencing. Methods: A systematic review was performed by searching electronic databases for all studies assessing the association between β-catenin immunohistochemical expression and CTNNB1 mutations. Meta-analysis of diagnostic accuracy was performed by calculating sensitivity, specificity, positive and negative likelihood ratios (LR+ and LR-), diagnostic odds ratio (DOR), and area under the curve (AUC) on summary receiver operating characteristic curves...
February 2, 2019: American Journal of Clinical Pathology
Natasha D Novikov, Gabriel K Griffin, Graham Dudley, Mai Drew, Vanesa Rojas-Rudilla, Neal I Lindeman, David M Dorfman
Objectives: Flow cytometry immunophenotyping is limited by poor resolution of T-cell clones. A newly described antibody was recently used to distinguish normal peripheral blood T cells from malignant T-cell clones. Here, we evaluate this antibody as a new diagnostic tool for detecting T-cell clonality in mature peripheral T-cell lymphomas. Methods: Immunostaining for the T-cell receptor β chain constant region 1 (TRBC1) along with routine T-cell markers was performed on 51 peripheral blood and two bone marrow samples submitted to the flow cytometry laboratory for suspected T-cell malignancy...
January 31, 2019: American Journal of Clinical Pathology
Amir Momeni Boroujeni, Elham Yousefi, Alejandro Zuretti
Objectives: Long-term hospitalized patients have a higher risk of adverse outcomes and mortality rate. These patients often rapidly deteriorate, leading to death. We aim to evaluate end-of-life laboratory values time trends among deceased long-term inpatients. Methods: Time-stamped laboratory data for adult inpatients who had died in the hospital were extracted. The data were normalized and time-series analysis was performed. The patients were also clustered based on the laboratory result trends...
January 28, 2019: American Journal of Clinical Pathology
Frank Schneider, Yulan Jin, Kevin Van Smaalen, Evin H Gulbahce, Rachel E Factor, Xiaoxian Li
Objectives: Accurate evaluation of human epidermal growth factor receptor 2 (HER2) in breast cancer is critical. Methods: HER2 fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) tests were performed on 52 cases using a US Food and Drug Administration (FDA)-approved kit (HercepTest, FDA kit) and a laboratory-developed test (LDT) with the HercepTest antibody and a Leica Bond automated stainer. Results: By FISH, 22 were HER2 positive, 29 were negative, and one was equivocal...
January 21, 2019: American Journal of Clinical Pathology
Nima D Badizadegan, Sarah Greenberg, Heather Lawrence, Kamran Badizadegan
Objectives: Radiofrequency interference (RFI) is a known medical device safety issue, but there are no documented cases of interference resulting in erroneous laboratory results. Methods: We investigated unexpected failure of a hematology analyzer resulting in erroneous WBC counts. Hardware failure was initially suspected, but temporal association with increased power output from a nearby antenna prompted investigation for RFI. Results: Power output from an antenna located approximately 4 feet from the analyzer was increased to ensure sufficient signal for emergency communications in the building...
January 21, 2019: American Journal of Clinical Pathology
Naoto Sassa, Hidehiro Iwata, Masashi Kato, Yota Murase, Shuko Seko, Toshinori Nishikimi, Ryohei Hattori, Momokazu Gotoh, Toyonori Tsuzuki
Objectives: We prospectively evaluated the utility of UroVysion in urothelial carcinomas of the upper urinary tract (UCUUTs). Methods: Ninety patients who received nephroureterectomy for UCUUT were enrolled. We performed urinary cytology and UroVysion before nephroureterectomy. We also performed the assays on 23 volunteers without a history of urothelial carcinoma. Results: Seventy-five high-grade urothelial carcinomas (HGUCs), 10 low-grade urothelial carcinomas, and five other conditions were enrolled...
January 21, 2019: American Journal of Clinical Pathology
Mark H Stoler, Thomas C Wright, Valentin Parvu, Karen Yanson, Karen Eckert, Salma Kodsi, Charles Cooper
Objectives: To determine the BD Onclarity human papillomavirus (HPV) assay performance and risk values for cervical intraepithelial neoplasia grade 2 (CIN2) or higher and cervical intraepithelial neoplasia grade 3 (CIN3) or higher during Papanicolaou/HPV cotesting in a negative for intraepithelial lesions or malignancies (NILM) population. Methods: In total, 22,383 of the 33,858 enrolled women were 30 years or older with NILM cytology. HPV+ and a subset of HPV- patients (3,219/33,858 combined; 9...
January 14, 2019: American Journal of Clinical Pathology
Aaron R Huber, Brandon Buscaglia, Brooke R Koltz, Jill Henry, Loralee McMahon, James Guo, David G Hicks, Christa L Whitney-Miller
Objectives: Human epidermal growth factor receptor 2 (HER2) is expressed in some gastric and gastroesophageal junction adenocarcinomas. There were two goals: assess the impact of specimen type on HER2 status and evaluate HER2 concordance with multiple specimens. Methods: All cases were evaluated by immunohistochemistry (IHC) for HER2 and interpreted using established criteria. Fluorescence in situ hybridization (FISH) was performed on a subset. Results: Of 460 specimens, 83...
January 8, 2019: American Journal of Clinical Pathology
Andrea Hernandez, Tamar C Brandler, Fang Zhou, Andre L Moreira, Nina Schatz-Siemers, Aylin Simsir
OBJECTIVES: To evaluate whether non-small cell lung carcinoma (NSCLC) cytology specimens are reliable for programmed death-ligand 1 (PD-L1) immunohistochemical (IHC) testing. METHODS: Fifty-two cell blocks (CBs) with corresponding surgical pathology PD-L1 IHC testing were stained with a Dako PD-L1 pharmDX antibody (clone-22C3). Tumor cellularity was recorded as <100 or ≥100 cells. PD-L1 IHC was scored by percentage of tumor cells staining (<1%, ≥1%-49%, ≥50%) and compared between matched cases...
March 1, 2019: American Journal of Clinical Pathology
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February 4, 2019: American Journal of Clinical Pathology
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