American journal of clinical pathology最新文献

{"title":"Revision of interpretation criteria to define microsatellite instability in mismatch repair-deficient neoplasms with subtle electropherogram changes.","authors":"Ming-Tseh Lin, Eric Christenson, Suping Chen, Emily Adams, Matthew Bayes, James R Eshleman","doi":"10.1093/ajcp/aqaf011","DOIUrl":"10.1093/ajcp/aqaf011","url":null,"abstract":"<p><strong>Objectives: </strong>To improve analytic performance characteristics of a microsatellite instability (MSI-V1.2) assay in endometrial cancers (ECs).</p><p><strong>Methods: </strong>Nonneoplastic and neoplastic DNA from colorectal cancers (CRCs) and ECs were compared to define MSI by calculating base shifting of the highest peak and the 5% peak (the leftmost peak with a peak height >5% of the highest peak).</p><p><strong>Results: </strong>We first demonstrated highly precise sizing by capillary electrophoresis. However, relative intensity of multiple peaks, characteristic for microsatellite amplicons, might show a 1-base, but not a 2-base or more, shift of the highest or 5% peak among duplicate runs of nonneoplastic DNA. This inherent bias of the polymerase chain reaction-based MSI assay may lead to false-positive interpretation if MSI was defined by a 1-base shift or more. Subsequently, MSI was evaluated by a 2-base shift or more of the highest peak (original criteria) or a 2-base shift or more of either the highest or 5% peak (revised criteria) without subjective interpretation of a subtle change of electropherogram configuration (the so-called shoulder pattern). While both criteria were highly sensitive in CRCs, the revised criteria improved sensitivity (83% vs 67%) and accuracy (89% vs 79%) and maintained 100% specificity in ECs.</p><p><strong>Conclusions: </strong>The revised criteria provided sensitive, specific, and objective interpretation to examine subtle changes of MSI.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"866-876"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of neuroendocrine immunostains in the evaluation of atrophic gastritis.","authors":"Saryn Doucette","doi":"10.1093/ajcp/aqaf019","DOIUrl":"10.1093/ajcp/aqaf019","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"951"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative EBV detection from whole blood on the COBAS 6800 system in response to Song J, Kim S, Kwak E, Park Y. Applicability of the cobas 6800 System for Epstein-Barr viral load quantitation using whole-blood specimens. Am J Clin Pathol. 2024 Mar 1;161(3):273-282. doi: 10.1093/ajcp/aqad146. PMID: 37936258.","authors":"Radhika Nagappan, Sarah Sarah, Saed Miri Nargesi, Gary McAuliffe, Erasmus Smit","doi":"10.1093/ajcp/aqaf004","DOIUrl":"10.1093/ajcp/aqaf004","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"948-949"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression of CD47 protein in hematolymphoid neoplasms: Implications for CD47-mediated cancer immunotherapy.","authors":"Jingjing Zhang, Philip L Bulterys, Sebastian Fernandez-Pol, Sheren F Younes, Shuchun Zhao, Adnan Mansoor, Yasodha Natkunam","doi":"10.1093/ajcp/aqaf018","DOIUrl":"10.1093/ajcp/aqaf018","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies show that blocking CD47-SIRPα interactions is a promising target in checkpoint inhibition for cancer immunotherapy. However, to date, the expression of CD47 is not well characterized in various hematolymphoid neoplasms.</p><p><strong>Methods: </strong>This study evaluates CD47 expression in a wide range of hematolymphoid neoplasms using immunohistochemistry on 834 cases.</p><p><strong>Results: </strong>Results show variable but widespread CD47 expression among tumor types and within individual samples in both intensity and percentage. The highest CD47 expressions in both percentage of positive lymphoma cells and intensity was seen in small B-cell lymphomas, particularly chronic lymphocytic leukemia/small lymphocytic lymphoma, mantle cell, marginal zone, and follicular lymphomas. T and B lymphoblastic, diffuse large B-cell, peripheral T-cell, γδ T-cell, angioimmunoblastic T-cell lymphomas and myelodysplastic syndrome showed moderate CD47 expression. Acute and chronic myeloid leukemia as well as classic Hodgkin, anaplastic large cell, and natural killer/T-cell lymphomas showed low expression. Burkitt lymphoma is a notable standout, with little to no CD47 expression in all 14 cases examined.</p><p><strong>Conclusions: </strong>Understanding the prevalence of CD47 expression in hematolymphoid neoplasms is crucial for identifying potential therapeutic targets and selecting patients who may benefit from CD47-targeted therapies. Additionally, CD47 may serve as a valuable diagnostic marker in neoplasms such as Burkitt lymphoma.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"883-897"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coagulation abnormalities following brown recluse spider (Loxosceles reclusa) envenomation: A description of 2 cases and review of the literature.","authors":"Stephanie A Hart, David Gailani, Lorin A Bibb, Jeffrey P Zwerner, Garrett S Booth, Jeremy W Jacobs","doi":"10.1093/ajcp/aqaf001","DOIUrl":"10.1093/ajcp/aqaf001","url":null,"abstract":"<p><strong>Objective: </strong>Hemostatic abnormalities, including disseminated intravascular coagulation (DIC), are often cited as a common finding in patients following Loxosceles spider envenomation (ie, loxoscelism). The prevalence and severity of coagulopathy, however, particularly following L reclusa (ie, brown recluse) envenomation, is not well described. This study aimed to characterize coagulation laboratory parameters and coagulopathy in patients following L reclusa envenomation.</p><p><strong>Methods: </strong>We evaluated the coagulation laboratory parameters (eg, prothrombin time, partial thromboplastin time, coagulation factor activity levels, lupus anticoagulant [LA] testing) of 2 patients seen at our institution following brown recluse spider envenomation. We also comprehensively reviewed the literature for all reported cases of brown recluse spider envenomation and assessed patient demographics, clinical presentations, coagulation laboratory parameters, and outcomes.</p><p><strong>Results: </strong>We identified 2 patients with loxoscelism (1 cutaneous only, 1 systemic with hemolysis) with prolonged partial thromboplastin times but with normal clotting factor levels following envenomation. Literature review identified 263 patients: 12 patients had at least 1 prolonged clotting time, 31 reported a platelet count below 150 × 109/L, and there was clinical concern for DIC in 12 cases. The odds of death were statistically significantly higher in patients with clinical concern for DIC than in cases without concern for DIC or coagulopathy (odds ratio, 82.9 [95% CI, 12.6-433.8]; P < .001).</p><p><strong>Conclusions: </strong>Following brown recluse spider envenomation, hemostatic perturbations are infrequent and clinical coagulopathy is uncommon, but the odds of death following a brown recluse spider bite are statistically significantly greater if DIC develops, even when compared to individuals with hemolysis without DIC.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"822-836"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12137049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic utility of lymphocyte enhancer factor 1 in aggressive B-cell lymphoma with MYC rearrangement.","authors":"Xin Wang, Maria Faraz, Anne Chen, Tipu Nazeer, Xiaoyan Huang","doi":"10.1093/ajcp/aqae189","DOIUrl":"10.1093/ajcp/aqae189","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to investigate the diagnostic value of lymphocyte enhancer factor 1 (LEF1) expression in aggressive B-cell lymphomas (BCL) with MYC gene rearrangement (MYC-R).</p><p><strong>Methods: </strong>Sixty-seven cases of BCL were studied and included Burkitt lymphoma (BL) (23 cases); diffuse large B-cell lymphoma (DLBCL), not otherwise specified (NOS) with MYC-R (13 cases); and DLBCL/high-grade B-cell lymphoma with MYC, BCL2, and/or BCL6 rearrangements (double-hit [DH] or triple-hit [TH], 17 cases). Random DLBCL-NOS (14 cases) without MYC-R was recruited as a control group. By immunohistochemical stains, 3 patterns of LEF1 staining were recorded as pattern 0 (negative), pattern 1 (weak and heterogeneous staining, <80%), and pattern 2 (moderate/strong and uniform staining, ≥80%).</p><p><strong>Results: </strong>Pattern 1 can be seen in all BCLs with MYC-R included in this study and more commonly seen in DLBCL without MYC-R (8/14 cases). Pattern 2 is characteristic (positive predictive value = 86%) for Epstein-Barr virus (EBV)-negative BL, while pattern 0 was seen in 22 (76%) of 29 cases of DLBCL-MYC-R/DH/TH (P < .001). Seven of 8 EBV-positive BL cases showed pattern 0, which was completely opposite to the common pattern 2 in EBV-negative BL (12/15 cases). Pattern 2 was not detected in all DH/TH cases.</p><p><strong>Conclusions: </strong>Weak and heterogeneous staining of LEF1 can be seen in all the BCLs with and without MYC-R. Strong and uniform staining of LEF1 is highly characteristic of EBV-negative BL among all aggressive BCLs with MYC-R, while the negative staining of LEF1 is mostly suggestive of DLBCL-MYC-R/DH/TH. Lymphocyte enhancer factor 1 provides additional diagnostic value in the differentiation of BL from other aggressive BCLs with MYC-R, especially in a limited specimen.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"815-821"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary low-grade salivary gland-type intraductal carcinoma of the lung with CCDC6::RET fusion: Case presentation and literature review.","authors":"Bei Wang, Xiaowei Wang, Ziyi Chang, Dingrong Zhong","doi":"10.1093/ajcp/aqaf014","DOIUrl":"10.1093/ajcp/aqaf014","url":null,"abstract":"<p><strong>Objectives: </strong>Salivary gland-type intraductal carcinoma (IC) is a rare type of low-grade salivary gland neoplasm. Given that the clinical and imaging features of primary lung IC are nonspecific, the diagnosis requires pathologic analysis.</p><p><strong>Methods: </strong>We report a 63-year-old woman with primary low-grade salivary gland-type IC of the lung, characterized by an origin from the bronchus submucosa, an intraductal or intracavity growth of ductal epithelium, an absence of interstitial infiltration, and harboring an RET::CCDC6 fusion.</p><p><strong>Results: </strong>Through case presentation and a literature review, we discuss the differential diagnosis and clinical management of salivary gland-type IC of the lung.</p><p><strong>Conclusions: </strong>Molecular testing is not necessary for histologic subtyping but can aid in the differential diagnosis of IC.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"877-882"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASCP explores the cancer biomarker testing navigator as a novel role to improve laboratory operations and workflows: A special report from the ASCP Biomarker Testing Navigator Project Team.","authors":"Lynnette Pineault, Karla Valencia, Jennifer Buhay, Alexandra Brown, Suzanne Ziemnik, Melissa Kelly, James Morgante, Ananya Datta Mitra, Lindsay Yanamura, Marie Gilliland, Amy Ferea, Joseph Kim","doi":"10.1093/ajcp/aqaf028","DOIUrl":"10.1093/ajcp/aqaf028","url":null,"abstract":"<p><strong>Objective: </strong>Cancer biomarker testing is a critical element in precision oncology, guiding treatment decisions and improving patient outcomes. However, the complexity and variability of biomarker testing processes present significant challenges for cancer centers, often leading to delays and inefficiencies that can compromise care quality. The American Society for Clinical Pathology explored the concept of a novel laboratory professional role: the cancer biomarker testing navigator (BTN).</p><p><strong>Methods: </strong>This study explored the feasibility and impact of the BTN role on laboratory operations and workflows through a 3-phase project consisting of a quantitative needs assessment, qualitative focus group discussions, and a short-term feasibility pilot conducted at 2 cancer centers.</p><p><strong>Results: </strong>The needs assessment revealed that many laboratories lack dedicated staff for coordinating biomarker testing, leading to operational inefficiencies. The roundtable discussions highlighted common challenges in biomarker testing and identified potential benefits of the BTN role, such as improved communication, better tracking of send-out tests, and enhanced task efficiency. The feasibility pilot demonstrated that BTNs could coordinate multigene next-generation sequencing panels and expedite key steps to ensure optimal preanalytical processes, reduce delays in testing, and smooth operations. The BTN role represents a feasible and beneficial addition to pathology laboratories that addresses key operational challenges in cancer biomarker testing and offers a promising solution to streamline laboratory operations, improve multidisciplinary communication, and enhance patient care coordination.</p><p><strong>Conclusions: </strong>Further exploration is warranted to refine the BTN role and assess its long-term sustainability in and impact on diverse laboratory settings.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"926-935"},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing electronic health records: Integration of human factors engineering for enhanced pathology report display and accessibility.","authors":"Ethan P Larsen, Mohammad Jalloul, Moira P Larsen","doi":"10.1093/ajcp/aqaf024","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf024","url":null,"abstract":"<p><strong>Objective: </strong>The integration of human factors engineering (HFE) into electronic health records (EHRs) is essential to enhance the display and accessibility of pathology reports. Pathology testing is central to clinical decision-making, yet the current EHR interfaces present challenges in test ordering and result interpretation, contributing to diagnostic errors. This study explores the application of HFE principles to redesign EHR visual displays, specifically for HIV and urine toxicology testing.</p><p><strong>Methods: </strong>By involving pathologists and clinicians in the design process, we developed user-centric templates that improve result clarity and accessibility. We also describe case examples of one successful template prototype implementation and one where technical barriers highlight limitations of applying user-centered design within the constraints of EHR and Laboratory Information System applications. The redesigned reports emphasize critical information through standardized color codes and organized data presentation, making nonstandard findings more prominent.</p><p><strong>Discussion: </strong>These interventions have the potential to create improved clinician comprehension and workflow efficiency, ultimately supporting better patient care. The study highlights the importance of incorporating HFE principles into EHR design and advocates for broader adoption to enhance usability and safety in health care settings.</p><p><strong>Conclusions: </strong>Further collaboration with regulatory bodies could establish standardized guidelines, fostering more effective EHR systems across the industry.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KRAS may facilitate transformation of chronic lymphocytic leukemia to histiocytic sarcoma with indeterminate dendritic cell features.","authors":"Farhan Hassan, Hailing Zhang, Dietrich Werner Idiaquez, Nagehan Pakasticali, Elizabeth Hyjek, Mohammad Hussaini","doi":"10.1093/ajcp/aqaf041","DOIUrl":"https://doi.org/10.1093/ajcp/aqaf041","url":null,"abstract":"<p><strong>Objective: </strong>We sought to investigate the molecular mechanism underlying transformation of chronic lymphocytic leukemia (CLL) to histiocytic sarcoma (HS) with indeterminate dendritic cell (IDC) features.</p><p><strong>Methods: </strong>Extensive NGS-based genomic profiling was performed on samples of a patient who had CLL, secondary HS with IDC features, and CMML. Clonotypic evaluation of VDJ rearrangement status was performed to confirm clonal relatedness.</p><p><strong>Results: </strong>HS is a rare proliferation of malignant tissue histiocytes that is usually primary, although secondary HS exists and often demonstrates mutations in the Ras/Raf/MAPK or PI3K/AKT/mTOR pathways, but HS with indeterminate dendritic cell (IDC) features has not been previously reported. A 77-year-old man with chronic lymphocytic leukemia (CLL) presented with an oropharyngeal mass. Biopsy specimen showed large atypical histiocytic cells with oval-to-irregular indented nuclei. They were positive for CD33, CD4, CD68 (subset, weak), CD163 (subset, weak), BCL6, S100 (subset), CD1a, cyclin D1 (subset), and lysozyme (weak) but negative for Langerin, BRAF V600E, CD21, CD23, CD35, CD123, TCF4, TCL1, MPO, CD20, CD79a, CD10, MUM1, and BCL2. The patient was diagnosed with secondary HS with IDC features as well as chronic myelomonocytic leukemia (CMML) in the bone marrow. Careful genomic dissection of all 3 types of malignant cells showed that SF3B1 p.E622D was present in both CLL and HS but not CMML. In addition, the HS acquired KRAS p.G13D, which we hypothesize drove the transdifferentiation of CLL to HS. Moreover, next-generation sequencing (NGS) clonotypic evaluation of variable-diversity-joining (VDJ) rearrangements in both the HS and CLL established relatedness but not the CMML.Conclusion: This is the first report of secondary HS with IDC features arising from CLL. We establish by both IGH NGS analysis and mutational profiling that the CLL and HS are clonally-related and posit that acquisition of KRAS p.G13D drove transdifferentiation. This has therapeutic implications for targeting the RAS-BRAF-MAPK-ERK pathway.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}