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Journal of Clinical Pathology

Bethany Jill Williams, Dharshana Jayewardene, Darren Treanor
AIMS: To consider the value proposition of digitisation of clinical immunohistochemistry services, and to develop an approach to digital immunohistochemistry implementation and validation in a large clinical laboratory. METHODS: A methodology for slide scanning in the laboratory was developed, in addition to a novel validation exercise, to allow pathologists to identify the strengths and weaknesses of digital immunohistochemistry reporting, and train in digital immunohistochemistry slide assessment...
February 14, 2019: Journal of Clinical Pathology
Martin Graversen, Claus Fristrup, Thomas Kielsgaard Kristensen, Trine Rennebod Larsen, Per Pfeiffer, Michael Bau Mortensen, Sönke Detlefsen
AIMS: In this study, we investigated whether free intraperitoneal tumour cells (FITC) were detectable in ascites or peritoneal lavage fluid (PLF) from patients with peritoneal metastasis (PM) before and after treatment with pressurised intraperitoneal aerosol chemotherapy (PIPAC). METHODS: Ascites or PLF retrieved at the first and third PIPAC procedures was analysed by conventional cytology, carcinoembryonic antigen (CEA) and total protein concentration, and quantitative reverse transcriptase PCR (qRT-PCR) for mRNA expression of CEA, epithelial cell adhesion molecule (EpCAM) and cancer antigen 125 (CA-125)...
February 12, 2019: Journal of Clinical Pathology
Esa Kari, Hanna-Riikka Teppo, Kirsi-Maria Haapasaari, Milla Elvi Linnea Kuusisto, Aurora Lemma, Peeter Karihtala, Risto Pirinen, Ylermi Soini, Esa Jantunen, Taina Turpeenniemi-Hujanen, Outi Kuittinen
AIMS: Oxidative stress markers and antioxidant enzymes have previously been shown to have prognostic value and associate with adverse outcome in patients with diffuse large B cell lymphoma (DLBCL). Nuclear factor erythroid 2-related factor 1 (Nrf1) and factor 2 (Nrf2) are among the principal inducers of antioxidant enzyme production. Kelch ECH associating protein 1 (Keap1) is a negative regulator of Nrf2, and BTB (BR-C, ttk and bab) domain and CNC homolog 1 (Bach1) represses the function of both factors...
February 12, 2019: Journal of Clinical Pathology
Susan Prendeville, Patrick O Richard, Michael A S Jewett, John R Kachura, Joan M Sweet, Theodorus H van der Kwast, Carol C Cheung, Antonio Finelli, Andrew John Evans
AIMS: Renal tumour biopsy (RTB) is increasingly recognised as a useful diagnostic tool in the management of small renal masses, particularly those that are incidentally found. Intratumoural heterogeneity with respect to morphology, grade and molecular features represents a frequently identified limitation to the use of RTB. While previous studies have evaluated pathological correlation between RTB and nephrectomy, no studies to date have focused specifically on the role of RTB for the diagnosis of papillary renal cell carcinoma (PRCC) and its further subclassification into clinically relevant subtypes...
February 12, 2019: Journal of Clinical Pathology
Julia R Naso, Connie G Chiu, Michelle E Goecke, Debra Chang, Carolyn J Shiau
Benign spindle cell lesions of the breast include neoplastic and reactive entities that are diagnostically challenging given their rarity and similar histomorphology. Accurate diagnosis on percutaneous core biopsy within this category is essential as some lesions require excision and surveillance, whereas others may be observed. We present three cases of rare benign spindle cell lesions of the breast that reflect the diversity of this group: solitary fibrous tumour, nodular pseudoangiomatous stromal hyperplasia and nodular fasciitis...
February 9, 2019: Journal of Clinical Pathology
Mark Hankins, Curtis Edward Margo
The sclera is an uncommon site of primary inflammation. Biopsy is infrequently employed in the evaluation of scleritis, but familiarity with its differential diagnosis is instrumental in ensuring efficient histological evaluation. This review provides a clinical overview of scleritis and describes the context in which scleral biopsy might arise. Most cases are associated with systemic autoimmune disease, but a sizeable proportion occur as an isolated disorder. Conditions mimicking autoimmune scleritis include infection and neoplasm...
February 5, 2019: Journal of Clinical Pathology
Alice Westwood, Amy Glover, Gordon Hutchins, Caroline Young, Scarlet Brockmoeller, Rachel Robinson, Lisa Worrilow, Dave Wallace, Kate Rankeillor, Julian Adlard, Philip Quirke, Nicholas West
Colorectal cancer (CRC) is common with 3% of cases associated with germline mutations in the mismatch repair pathway characteristic of Lynch syndrome (LS). The UK National Institute for Health and Care Excellence recommends screening for LS in all patients newly diagnosed with CRC, irrespective of age. The Yorkshire Cancer Research Bowel Cancer Improvement Programme includes a regional LS screening service for all new diagnoses of CRC. In the first 829 cases screened, 80 cases showed deficient mismatch repair (dMMR) including four cases showing areas with loss of expression of all four mismatch repair proteins by immunohistochemistry...
February 5, 2019: Journal of Clinical Pathology
Mark A Catherwood, David Gonzalez, David Donaldson, Ruth Clifford, Ken Mills, Patrick Thornton
TP53 disruption in chronic lymphocytic leukaemia (CLL) is a well-established prognostic marker and informs on the appropriate course of treatment for patients. TP53 status is commonly assessed by fluorescence in situ hybridisation for del(17 p) and Sanger sequencing for TP53 mutations. At present, current screening methods for TP53 mutations fail to detect diagnostically relevant mutations potentially leading to inappropriate treatment decisions. In addition, low levels of mutations that are proving to be clinically relevant may not be discovered with current less sensitive techniques...
February 2, 2019: Journal of Clinical Pathology
Andrew J Colebatch, Alexander Dobrovic, Wendy A Cooper
In this review, we summarise the function and structure of telomerase reverse transcriptase ( TERT ) in humans, including its regulation. The dysregulation of telomerase through TERT promoter mutations across a range of cancers is discussed. The molecular mechanism activated by TERT promoter mutations is outlined. Finally, the timing of TERT promoter mutations during carcinogenesis is reviewed in the context of their potential utility as clinical biomarkers of malignant transformation.
January 29, 2019: Journal of Clinical Pathology
Anjelica Hodgson, Ekaterina Olkhov-Mitsel, Brooke E Howitt, Marisa R Nucci, Carlos Parra-Herran
AIMS: The International Endocervical Adenocarcinoma Criteria and Classification (IECC) was recently proposed as an improved method for categorising endocervical adenocarcinoma (EA) into human papillomavirus (HPV)-associated adenocarcinomas (HPVAs) and non-HPV-associated adenocarcinomas (NHPVAs). Such categorisation correlates with patient age and tumour size; however, its association with patient outcome remains to be established. METHODS: Institutional cases of EA with histological material available were selected...
January 24, 2019: Journal of Clinical Pathology
Hui Ming Tay, Yi Feng Lai, Ming Chai Kong, Edmund See, Shu Hui Yeang, Sei Keng Koh, Yuan Tying Shim, Fiona Seet Ling Chan, Wan Hui Wong, Clifton Xuan You Liew, Hartirathpal Kaur, Chuen Wen Tan, Liam Pock Ho, Wai Yoong Ng, Chin Pin Yeo, Heng Joo Ng
No abstract text is available yet for this article.
January 23, 2019: Journal of Clinical Pathology
Julian L Burton, Veroniek Saegeman, Ana Arribi, Jordi Rello, Laurent Andreoletti, Marta C Cohen, Amparo Fernandez-Rodriguez
Postmortem microbiology (PMM) is a valuable tool in the identification of the cause of death and of factors contributory to death where death has been caused by infection. The value of PMM is dependent on careful autopsy planning, appropriate sampling, minimisation of postmortem bacterial translocation and avoidance of sample contamination. Interpretation of PMM results requires careful consideration in light of the clinical history, macroscopic findings and the histological appearances of the tissues. This consensus statement aims to highlight the importance of PMM in the hospital setting and to give microbiological and pathological advice on sampling in deaths occurring in hospital...
January 19, 2019: Journal of Clinical Pathology
Runjan Chetty
The neurotrophic tropomyosin or tyrosine receptor kinase (NTRK) genes (1-3) are proto-oncogenes that when activated are encountered in a wide array of tumours. The recent advent of very specific and selective inhibitors of their gene fusions makes the NRTK gene fusions actionable. NRTK gene fusions are very characteristic of specific tumours: salivary mammary analogue secretory carcinoma, breast secretory carcinoma, infantile fibrosarcoma and congenital mesoblastic nephroma. Over 90% of these tumours bear NTRK gene fusions...
January 13, 2019: Journal of Clinical Pathology
Celestine M Trinidad, Carlos A Torres-Cabala, Victor G Prieto, Phyu P Aung
Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine carcinoma. The annual incidence of MCC is increasing in the USA. Timely diagnosis and proper staging of this tumour are crucial as MCC has high rates of regional recurrence and lymph node and distant metastasis. In this review, we outline the key differences between the tumor node metastasis (TNM) staging criteria for MCC in the seventh and eighth editions of the AJCC Cancer Staging Manual We also discuss histopathological parameters that are not included in the eighth edition of the manual but have been shown in other studies to predict a worse prognosis in patients with MCC...
January 13, 2019: Journal of Clinical Pathology
Maria Ryssdal Kraby, Signe Opdahl, Hege Giercksky Russnes, Anna M Bofin
AIMS: Tumour microvessel density (MVD) is assessed by counting vessels in the most vascularised tumour region, the vascular hot spot. Current uncertainty regarding the prognostic role of MVD in breast cancer could, in part, be explained by variations in field area size for MVD assessment. We aimed to identify the field area size that provides the most accurate prognostic information in breast carcinoma. METHODS: MVD was assessed in 212 tumours. von Willebrand factor positively stained vessels were counted in 10 consecutive visual fields in vascular hotspots...
January 10, 2019: Journal of Clinical Pathology
Kritsada Singha, Goonnapa Fucharoen, Supan Fucharoen
Interaction of βE -globin gene with an in trans β-thalassaemia gene leads to thalassaemia syndrome, known as haemoglobin (Hb) E-β-thalassaemia disease, with variable clinical and haematological severity. Here, we reported for the first time the Hb E-β-thalassaemia syndrome caused alternatively by an in cis interaction of βE and a novel IVSI#7;A>G mutation, namely the Hb E-Udon Thani (HBB:c.[79G>A;92+7 A>G]). The syndrome was found in an adult Thai man (32) who was generally healthy but had an unexplained hypochromic microcytosis...
January 10, 2019: Journal of Clinical Pathology
Dingbao Chen, Zhao Li, Weihua Zhu, Qian Cheng, Qiujing Song, Lihua Qian, Ji-Ye Zhu
AIMS: To evaluate stromal histopathological features and immunostaining expression for differential diagnosis of low- and high-grade dysplastic nodules (HGDN) to early and progressed hepatocellular carcinomas (eHCC, pHCC). MATERIALS: We evaluated sinusoid capillarisation (SC), solitary artery (SA), ductular reaction (DR), stromal invasion and expression of six biomarkers (GPC3, HSP70, GS, CD34, CK19, EpCAM) in a series of 97 cases. RESULTS: Stromal morphological changes, including SC, DR and SA, exhibited significant differences in differential diagnosis...
January 4, 2019: Journal of Clinical Pathology
Zhutian Yang, Eng Hooi Tan, Yingda Li, Brian Lim, Michael Patrick Metz, Tze Ping Loh
We determined the relative strengths of association between 23 most commonly ordered laboratory tests and the adverse outcome as indicators of relative criticalness. The lowest and highest results for 23 most commonly ordered laboratory tests, 24 hours prior to death during critical care unit (CCU) stay or discharge from CCU were extracted from a publicly available CCU database (Medical Information Mart for Intensive Care-III). Following this, the Random Forest model was applied to assess the association between the laboratory results and the outcomes (death or discharge)...
December 28, 2018: Journal of Clinical Pathology
Runjan Chetty, Aoife J McCarthy
Neoadjuvant chemoradiation (NACR) is now standard of care in stage II and III rectal cancer. The advent of this modality of treatment has impacted on the way the pathological evaluation of resection specimens that have been subjected to preoperative chemoradiation is conducted. The gross description, sectioning and microscopic examination have had to be adapted to accommodate the changes induced by NACR. Attempts at introducing a uniform approach to the gross triaging and reporting of these specimens have been met with muted response...
December 28, 2018: Journal of Clinical Pathology
Eman A El-Nabarawy, Nadia Saleh, Mona R E Abdel-Halim
CLINICAL QUESTION: A 26-year-old woman presented with asymptomatic skin coloured to whitish keratotic papules on the vulva, inguinal folds and inner thighs of 6 years duration. She had no similar lesions elsewhere and no family history. A biopsy was taken from one of the papules.Review the high-quality, interactive digital Aperio slide at and consider your diagnosis. WHAT IS YOUR DIAGNOSIS?: Darrier's diseaseHailey-Hailey diseaseGenital wartsPapular acantholytic dyskeratosis of genitocrural areaPemphigus vegetansThe correct answer is after the discussion...
December 20, 2018: Journal of Clinical Pathology
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