American journal of clinical pathology最新文献

{"title":"Evaluating the potential for iodinated radiocontrast agents to interfere with ADAMTS13 activity testing via fluorescence resonance energy transfer methodology.","authors":"Jeremy W Jacobs, Melissa S Stuart, Julie I Tange, Rachel R Leger, Aneel A Ashrani, Dong Chen, Rajiv K Pruthi, Meera Sridharan, Jansen N Seheult","doi":"10.1093/ajcp/aqae160","DOIUrl":"https://doi.org/10.1093/ajcp/aqae160","url":null,"abstract":"<p><strong>Objectives: </strong>Fluorescence resonance energy transfer (FRET)-based ADAMTS13 activity assays are critical for the diagnosis of thrombotic thrombocytopenic purpura. However, these assays are susceptible to interference. As iodide has been suggested to interfere in laboratory testing via fluorophore quenching or promotion, we aimed to determine whether iodinated contrast (Omnipaque) interferes with the ATS-13 ADAMTS13 Activity Assay 2.0.</p><p><strong>Methods: </strong>We evaluated the excitation, emission, and absorbance spectrum of Omnipaque alone and spiked in patient plasma with known ADAMTS13 activity and ADAMTS13 activity on Omnipaque alone, an abnormal control of patient plasma previously observed to display elevated baseline relative fluorescent units, and variable concentrations of patient plasma with known ADAMTS13 activity spiked with Omnipaque.</p><p><strong>Results: </strong>No atypical fluorescent peaks were observed on any sample (Omnipaque alone or spiked in plasma) between 250 and 700 nm. There was no difference in the mean ADAMTS13 activity among the various concentrations of plasma spiked with Omnipaque or plasma spiked with saline.</p><p><strong>Conclusions: </strong>Iodinated contrast does not appear to interfere-either via spectral overlap of the fluorophore or through physiologic inhibition of the ADAMTS13 enzyme-with ADAMTS13 activity FRET-based assays based on the findings from this in vitro analysis. Delaying sample collection for ADAMTS13 activity testing from suspected patients with thrombotic thrombocytopenic purpura following administration of iodinated radiocontrast agents is not necessary, and recent contrast administration should not yield erroneous ADAMTS13 activity results.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826969","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":"TRPS1 is a useful marker in differentiating metastatic breast carcinoma from pancreatic adenocarcinoma in fine-needle aspiration specimens.","authors":"Bahadir Yildiz, Jerome Jean-Gilles, Ellen J Giampoli, Sierra Kovar-Peltz, Qi Yang, Hiroshi Miyamoto, Ying Wang","doi":"10.1093/ajcp/aqae155","DOIUrl":"https://doi.org/10.1093/ajcp/aqae155","url":null,"abstract":"<p><strong>Objectives: </strong>Distinction of metastatic breast carcinoma (BC) to the pancreas from primary pancreatic adenocarcinoma (PAC) is essential but challenging. Breast carcinoma shares similar morphology and exhibits an overlapping immunohistochemistry (IHC) profile with PAC. We investigated the utility of recently reported trichorhinophalangeal syndrome type 1 (TRPS1) IHC in differentiating metastatic BC from PAC in fine-needle aspiration (FNA) specimens.</p><p><strong>Methods: </strong>We assessed consecutive patients of PAC (n = 49). Due to limited cases of metastatic BC to the pancreas (n = 3), cases of metastatic BC (n = 23) in various locations, including lymph node, lung, bone, or soft tissue, were included. Immunohistochemistry for TRPS1 was performed by using the cell blocks obtained from FNA. A quantitative score for TRPS1 expression was calculated by multiplying the intensity and the percentage of positive cells. Immunoreactivity scores were assigned as negative, low positive, intermediate positive, or high positive.</p><p><strong>Results: </strong>In 49 PAC cases, 47 (95.9%) exhibited negative while 2 (4.1%) exhibited low positive TRPS1 expression. However, TRPS1 expression was high positive in 23 (88.0%) of 26 metastatic BC cases, including 10 (83.3%) of 12 triple-negative BC (TNBC) and 13 (92.9%) of 14 non-TNBC cases.</p><p><strong>Conclusions: </strong>Our results suggest that TRPS1 IHC represents a highly accurate and reliable method for differentiating metastatic BC from PAC.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827013","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":"Correction to: Escalation process of critical values when these cannot be communicated on first attempt: A hospital-wide process improvement project.","authors":"","doi":"10.1093/ajcp/aqae157","DOIUrl":"10.1093/ajcp/aqae157","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674883","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":"Correction to: Pilomatrix-like breast carcinoma: A mammary analog of pilomatrix-like high-grade endometrioid carcinoma (PiMHEC).","authors":"","doi":"10.1093/ajcp/aqae154","DOIUrl":"https://doi.org/10.1093/ajcp/aqae154","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612151","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":"Survey of clinical microbiology and infectious disease testing capabilities among institutions in Africa.","authors":"Jeremy W Jacobs, Brian D Adkins, Danny A Milner, Evan M Bloch, Quentin Eichbaum","doi":"10.1093/ajcp/aqae148","DOIUrl":"https://doi.org/10.1093/ajcp/aqae148","url":null,"abstract":"<p><strong>Objectives: </strong>Inadequate laboratory infrastructure and testing capabilities are a major impediment to addressing the infectious disease burden in Africa. Therefore, the aims of this study were to characterize the clinical microbiology/infectious disease laboratory capabilities among countries in Africa.</p><p><strong>Methods: </strong>A survey to assess the microbiological testing capabilities at hospitals, government laboratories, and free-standing public and private laboratories in African countries was developed by subject matter experts. Questions included institutional demographics and microbiology services in the broad categories of bacteriology, virology, mycology, parasitology, and rapid diagnostics/point-of-care testing. The survey was distributed using the American Society of Clinical Pathology email listserv between June and August 2022.</p><p><strong>Results: </strong>In total, 131 unique institutions in 28 countries endorsed at least 1 type of microbiology service, with parasitology (80.9%, 106/131) and bacteriology (77.9%, 102/131) being most common, while mycology (45.0%, 59/131) and virology (45.8%, 60/131) laboratories were less prevalent. The most frequently performed bacteriology test was bacterial identification (90.2%, 92/102), followed by aerobic bacterial cultures and antimicrobial susceptibility testing (both 89.2%, 91/102). Among all clinical microbiology/infectious disease laboratories, the most commonly tested agents were HIV (90.8%, 119/131), Treponema pallidum (78.6%, 103/131), Plasmodium falciparum (76.3%, 100/131), Mycobacterium tuberculosis (76.3%, 100/131), and hepatitis C virus (74.8%, 98/131).</p><p><strong>Conclusions: </strong>These findings provide contemporary data regarding the availability of critical infectious disease testing capabilities among institutions in Africa. These results and future additional studies will be crucial for understanding where strategic investment in the laboratory and public health infrastructure is warranted.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612185","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":"Simplifying acquisition of essential diagnostics: A comprehensive costing tool for anatomic pathology.","authors":"Analise LeJeune-Stodieck, Daniel Seymour, Katy Graef, Elisee Hategekimana, Djibril Mbarushimana, Marie Claire Ndayisaba, Emilio Augusto Campos Pereira de Assis, Girogis Okubazgi Yeabyo, Michael Chukwugozium Nweke, Bereket Berhane, Hakizimana Emmanuel, Deo Ruhangaza, Callie Weber, Debby Basu, Kenneth Landgraf, Dan Milner","doi":"10.1093/ajcp/aqae138","DOIUrl":"https://doi.org/10.1093/ajcp/aqae138","url":null,"abstract":"<p><strong>Objectives: </strong>Histopathology is the core diagnostic tool for cancer in pathology laboratories around the world, but there are disparities in access to diagnostics globally. As recognition of the need for cancer care and treatment grows, especially in the wake of World Health Organization programs for cervical, breast, and pediatric cancers, policymakers and health care funders are seeking tools and processes that allow for the largest number of patients to receive a diagnosis at the lowest cost.</p><p><strong>Methods: </strong>As histopathology represents the most cost-effective diagnostic method by sheer number of tumor types and volume, understanding the detailed logistics and costs for histology as well as the impactful benefits of economies of scale (ie, larger volumes are less expensive per patient) and scope (ie, the multiple stains available after basic histology sectioning) is paramount to planning an effective publicly funded or government laboratory. Understanding the economic structure of a country's population along with the financial model of a histology laboratory also leads to a market understanding of private laboratories, which can provide services at a profit as well as pro bono services more cost-effectively than purely public laboratories.</p><p><strong>Results: </strong>We have developed a comprehensive, scalable costing tool of a functioning histology laboratory that accounts for all feasible costs and variations in models of service. The tool allows for a standardized approach to selecting goods needed to provide histology services and serves as a guide for implementation of pathology services.</p><p><strong>Conclusions: </strong>Using the tool, laboratories can achieve self-sustainment and long-term financial health while incorporating a proportion of impoverished patients who cannot afford out-of-pocket expenses.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612174","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":"Analytical performance of a point-of-care CBC hematology analyzer, including a 5-part differential: A prospective study to evaluate a microfluidic flow cytometry-based analyzer in waived settings.","authors":"Jane F Emerson, Hao Wang, Imran N Siddiqi","doi":"10.1093/ajcp/aqae149","DOIUrl":"https://doi.org/10.1093/ajcp/aqae149","url":null,"abstract":"<p><strong>Objectives: </strong>A microfluidic flow cytometer-based point-of-care (POC) analyzer was validated against an in-laboratory hematology analyzer (Sysmex XN Automated Hematology System). Concordance on a full complete blood cell count (CBC) with 5-part differential, as performed by operators with no prior clinical laboratory experience, was evaluated.</p><p><strong>Methods: </strong>We prospectively collected 376 venous blood specimens (376) from individuals with self-reported medical conditions and from apparently healthy individuals. Forty-six additional remnant specimens were acquired to ensure coverage of analytic measuring ranges. Parallel testing was performed, with up to 7 hours between testing on the POC and Sysmex XN analyzers.</p><p><strong>Results: </strong>Regression analysis resulted in r values of 0.998 to 0.932 for all parameters of a 5-part differential CBC other than basophils (0.709). The mean percentage bias from the reference method, inclusive of the upper and lower reporting limits, was less than 2% for parameters other than lymphocytes (-6.4%), monocytes (25.9%), eosinophils (12.2%), and basophils (-15%). Overall agreement on abnormal flagging was 93.3%.</p><p><strong>Conclusions: </strong>The Cito CBC microflow cytometer (CytoChip Inc) provides a CBC with a 5-part differential with accuracy, precision, and abnormal flagging equivalent to a moderate-complexity hematology analyzer. It has the key features required of a POC device that can be operated in a waived setting: minimum space requirements, rapid results, single-action measurement (no sample processing or dilution), ease of use, and minimal blood volume.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612147","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":"Factors impacting tumor displacement artifact and pseudo-lymphovascular invasion in testicular germ cell tumors.","authors":"Reem O Ahmed, Debra L Zynger","doi":"10.1093/ajcp/aqae147","DOIUrl":"https://doi.org/10.1093/ajcp/aqae147","url":null,"abstract":"<p><strong>Objectives: </strong>Testicular germ cell tumors are susceptible to tumor displacement artifact (TDA), which produces pseudo-lymphovascular invasion (LVI) and confounds the identification of true LVI. Our study aimed to evaluate tumor displacement artifact and pseudo-LVI in testicular germ cell tumors and determine if prolonged fixation improves histological quality.</p><p><strong>Methods: </strong>A retrospective search identified 121 orchiectomies with slides that were reviewed to assess TDA and pseudo-LVI.</p><p><strong>Results: </strong>Seminoma had more TDA (68% vs 45%, P = .01) and pseudo-LVI (53% vs 19%, P < .001) than mixed germ cell tumor. Seminoma and mixed germ cell tumor with TDA and pseudo-LVI were larger than those without. Mixed germ cell tumor with ≥50% composition of seminoma had a higher rate of TDA (89% vs 38%, P = .008) and pseudo-LVI (44% vs 15%, P = .06) than those with less. TDA was reduced in seminoma with >1 night fixation compared to no fixation (50% vs 82%, P = .046), with a similar trend in mixed germ cell tumor (31% vs 60%, P = .15). A trend in reduction of pseudo-LVI was seen with >1 night fixation compared to no fixation in seminoma (64% vs 39%, P = .12).</p><p><strong>Conclusions: </strong>Seminomas and larger germ cell tumors were more prone to TDA and pseudo-LVI. Prolonged formalin fixation improved histological quality in testicular germ cell tumors. Based on these data, we recommend fixation for at least 2 nights before sectioning orchiectomy specimens, particularly for larger tumors.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612170","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":"Integrative immunophenotypic and genetic characterization of acute myeloid leukemia with CBFB rearrangement.","authors":"Fnu Sameeta, Sa A Wang, Zhenya Tang, Joseph D Khoury, Hong Fang, Dylan Wang, Jie Xu, Shaoying Li, Zhihong Hu, Shimin Hu, Jeffrey L Jorgensen, L Jeffrey Medeiros, Wei Wang","doi":"10.1093/ajcp/aqae060","DOIUrl":"10.1093/ajcp/aqae060","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to characterize the immunophenotype of acute myeloid leukemia (AML) with CBFB rearrangement and correlate the results with cytogenetic and molecular data.</p><p><strong>Methods: </strong>Sixty-one cases of AML with CBFB rearrangement were evaluated.</p><p><strong>Results: </strong>The sample population consisted of 33 men and 28 women, with a median age of 49 years. Flow cytometry immunophenotypic analysis showed that myeloblasts were positive for CD34 and CD117 in all cases, and myeloperoxidase was positive in 52 of 55 (95%) cases. The most common abnormalities included decreased CD38 in 90%, increased CD13 in 85%, increased CD123 in 84%, and decreased HLA-DR in 84% of cases. Monocytes were increased, with a mature immunophenotype, and accounted for 23.7% of total cells. Among 60 cases with available karyotype, inv(16)(p13.1q22) was most common in 50 (83%) cases, followed by t(16;16) (p13.1;q22) in 6 (10%). Type A CBFB::MYH11 transcript was most common, detected in 84% of cases. Mutational analysis showed mutations of NRAS in 37%, FLT3 in 25%, and KIT in 24% of cases. Comparing cases with type A vs non-type A transcripts, blasts in type A cases more frequently exhibited CD64 positivity and increased CD13 levels while showing a lower frequency of CD7 and CD56 expression. Trisomy 22 and mutations in KIT, NF1, and TET2 were identified only in cases with type A transcript.</p><p><strong>Conclusions: </strong>Myeloblasts of AML with CBFB rearrangement are positive for CD34, CD117, and myeloperoxidase. These neoplasms most frequently carry inv(16)(p13.1q22) and type A fusion transcript. NRAS mutation was the most common mutation. Some immunophenotypic and genetic correlations occurred with different types of transcripts.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"455-463"},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154551","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":"Diagnostic accuracy of upper tract urothelial carcinoma using biopsy, urinary cytology, and nephroureterectomy specimens: A tertiary cancer center experience.","authors":"Jianping Zhao, Yuan Shen, Ming Guo, Surena F Matin, Donna E Hansel, Charles C Guo","doi":"10.1093/ajcp/aqae065","DOIUrl":"10.1093/ajcp/aqae065","url":null,"abstract":"<p><strong>Objectives: </strong>We studied the diagnostic accuracy and discordance of upper tract urothelial carcinoma (UTUC) by comparing biopsy and urinary cytology with matched nephroureterectomy specimens.</p><p><strong>Methods: </strong>Sixty-nine patients with UTUC without neoadjuvant treatment were retrospectively identified who had matched biopsy and nephroureterectomy specimens. Twenty patients had concurrent upper tract cytology. H&E and cytology slides were re-reviewed. Statistical analysis was performed.</p><p><strong>Results: </strong>Patients included 48 men and 21 women with a mean age of 69 years. A concordant grade between biopsy and surgical specimen was present in 49 (71%) patients. The mean size of biopsy specimens in the discordant group was significantly smaller than that in the concordant group. Invasion was evaluated in 48 biopsy cases that had adequate subepithelial tissue, and 33 of them were diagnosed with concordant invasion status. Mean tumor size in both tumor grade and invasion discordant groups was significantly larger than that in the concordant group. High-grade urothelial carcinoma was detected in 84% of cases using urinary cytology.</p><p><strong>Conclusions: </strong>Our study demonstrates the diagnostic challenges of UTUC on small biopsy specimens. Biopsy specimen size and tumor size are significantly associated with the diagnostic discordance. Upper tract cytology showed high diagnostic accuracy and should be complementary to the biopsy.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"492-499"},"PeriodicalIF":2.3,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141299707","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}