American journal of clinical pathology最新文献

{"title":"Paneth cell differentiation associated with neoadjuvant therapy in esophageal adenocarcinoma.","authors":"Madhurya Ramineni, Sarah K Findeis, Jiqing Ye, Yansheng Hao","doi":"10.1093/ajcp/aqae098","DOIUrl":"10.1093/ajcp/aqae098","url":null,"abstract":"<p><strong>Objectives: </strong>Paneth cells and Paneth cell metaplasia are well-known in pathology as foundational components in the gastrointestinal system. When within malignant cells (Paneth cell differentiation [PCD]), however, the function and significance of these cells is less well understood. Here, we present findings from the first study focused on PCD in postneoadjuvant esophageal adenocarcinoma (EAC) resection specimens.</p><p><strong>Methods: </strong>Patients with EAC treated with neoadjuvant chemoradioation and followed by esophagectomy between 2012 and 2018 in our institution were retrospectively evaluated. A tissue microarray was constructed, and special and immunohistochemical stains were performed.</p><p><strong>Results: </strong>A total of 64 cases were collected, of which 8 had PCD, as highlighted by periodic acid-Schiff with diastase staining. Adenocarcinomas with PCD were more commonly seen in patients 60 to 70 years of age and typically had a poorly differentiated morphology, observationally fewer stromal mucinous changes, and less lymph node metastasis. β-catenin activation induced by neoadjuvant therapy was more frequent in the PCD-positive cases. Patients with PCD-positive disease had low programmed cell death 1 ligand 1 levels, no positive or equivocal ERBB2 (HER2) expression, and low CD8-positive T-cell infiltration; they were also mismatch repair proficient. Patients with PCD-positive disease showed a survival pattern inferior to that of patients with PCD-negative disease.</p><p><strong>Conclusions: </strong>When induced by neoadjuvant therapy in EAC, PCD is associated with high β-catenin activation, less expression of targetable biomarkers, and a potentially worse clinical prognosis.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"87-96"},"PeriodicalIF":2.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896480","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":"Umbilical cord blood as a substitute for neonatal blood in measuring serum albumin and immunoglobulin G levels.","authors":"Toshihiko Ikuta, Sota Iwatani, Seiji Yoshimoto","doi":"10.1093/ajcp/aqae089","DOIUrl":"10.1093/ajcp/aqae089","url":null,"abstract":"<p><strong>Objectives: </strong>In this study, we investigated the clinical feasibility of using umbilical cord blood as an alternative to neonatal blood for measuring serum albumin and immunoglobulin G (IgG) levels in newborns, including preterm newborns.</p><p><strong>Methods: </strong>Serum levels of albumin and IgG were measured in cord and neonatal blood from singleton newborns. We analyzed correlations and systematic errors between cord and neonatal blood measurements, stratifying the results for very preterm newborns (VPNs) born at a gestational age of less than 32 weeks and non-VPNs born at a gestational age of 32 weeks or later.</p><p><strong>Results: </strong>Among all 494 newborns (78 VPNs and 416 non-VPNs), serum albumin and IgG levels were determined for 95.7% and 88.7% of them, respectively. Strong correlations between cord and neonatal blood were observed for the serum albumin and IgG levels (rs = 0.864 and 0.966, respectively). Moreover, the measurement errors between cord and neonatal blood were small for all newborns (0.2 g/dL and 65 mg/dL, respectively). These findings were consistent with both VPNs and non-VPNs.</p><p><strong>Conclusions: </strong>Umbilical cord blood is a suitable substitute for neonatal blood in measuring serum albumin and IgG levels in newborns, even in premature newborns.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"20-27"},"PeriodicalIF":2.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750877","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 intestinal T-cell and natural killer-cell lymphomas: Clinicopathologic and prognostic features of 79 cases in South China.","authors":"Na Guo, Chunlu Zhou, Yu Wang, Jia Fu, Yueqiong Chen, Fang Wang, Huilan Rao","doi":"10.1093/ajcp/aqae102","DOIUrl":"10.1093/ajcp/aqae102","url":null,"abstract":"<p><strong>Objectives: </strong>Primary intestinal T-cell and natural killer-cell lymphomas (PITNKLs) are aggressive and make pathologic diagnoses in biopsy specimens challenging. We analyzed different subtypes' clinicopathologic features and treatment outcomes.</p><p><strong>Methods: </strong>Seventy-nine PITNKL cases were characterized by clinical, morphologic, and immunohistochemical features.</p><p><strong>Results: </strong>Among 79 cases of PITNKLs from 2008 to 2017 in our institution, 40 (50.63%) were extranodal NK/T-cell lymphoma, nasal type (ENKTL); 32 (40.51%) monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL); 6 (7.59%) intestinal T-cell lymphoma, not otherwise specified; and 1 (1.27%) indolent T-cell lymphoma of the gastrointestinal tract. Small intestine (n = 47) was the most common site. Monomorphic epitheliotropic intestinal T-cell lymphoma showed distinctive clinicopathologic features from other subtypes with high expression (96.88%) of spleen tyrosine kinase (SYK) and PD-L1 (87.5%) and the poorest prognosis (P < .001). CD30 was highly expressed in ENKTL (9/17, 57.94%) and irrelevant to prognosis (P > .05).</p><p><strong>Conclusions: </strong>Cases of PITNKL are biologically heterogeneous; most have a dismal prognosis. SYK and PD-L1 expression might be a significant marker for MEITL and helps differential diagnosis.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"121-133"},"PeriodicalIF":2.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141909743","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":"The significance of extensive HPV genotyping for cervical high-grade neoplasia among women with atypical glandular cells.","authors":"Xiao Tang, Megan L Zilla, Wei Jiang, Yanmei He, David Starr, Lei Li, Lingling Tong, Cheng Wang, Wei Wang, Kaixuan Yang, Rutie Yin, Chengquan Zhao","doi":"10.1093/ajcp/aqae103","DOIUrl":"10.1093/ajcp/aqae103","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the associated risk of cervical intraepithelial neoplasm grade 3+ (CIN3+) lesions in patients with AGC and extensive human papillomavirus (HPV) genotyping.</p><p><strong>Methods: </strong>Cases with atypical glandular cell (AGC) interpretation on a Papanicolaou (Pap) test were identified along with associated extensive HPV genotyping and histologic follow-up results.</p><p><strong>Results: </strong>Within this cohort of 469,694 Pap tests, 0.4% were diagnosed as AGCs. In total, 1267 cases had concurrent high-risk HPV (hrHPV) genotyping, and 40.3% were hrHPV positive. The percentage of AGC cases with cervical CIN3+ on histologic follow-up was 52.2% when hrHPV was positive, whereas it was 4.9% with a negative hrHPV result. The top 5 hrHPV genotypes associated with cervical CIN3+ in this cohort were HPV16, HPV18, HPV58, HPV52, and HPV33. Indeed, 92.8% of the hrHPV-associated CIN3+ lesions identified in this cohort were positive for at least one of these HPV genotypes. The sensitivity of detecting cervical CIN3+ lesions was 85.6% with the top 5 hrHPV genotypes (HPV16/18/58/52/33) and only increased to 89.0% when the additional 12 genotypes were included.</p><p><strong>Conclusions: </strong>In patients with an AGC Pap, the risk of having a cervical CIN3+ lesion is greatly increased by positivity for hrHPV types 16, 18, 58, 52, and/or 33. Incorporating comprehensive HPV genotyping into AGC cytology allows for refined risk stratification and more tailored management strategies.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"134-142"},"PeriodicalIF":2.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896481","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":"Evaluating pathologist practices in peripheral blood smear review: A comprehensive practice survey.","authors":"Margaret Moore, Xueyan Chen, Sam Sadigh, Robert Seifert, Andres E Mindiola Romero, Olga Pozdnyakova, Elizabeth L Courville","doi":"10.1093/ajcp/aqae091","DOIUrl":"10.1093/ajcp/aqae091","url":null,"abstract":"<p><strong>Objectives: </strong>Widely accepted standardized criteria for peripheral blood (PB) smear review do not exist. The aim of this study was to collect data regarding PB smear review practices across multiple institutions, with a focus on pathologist review.</p><p><strong>Methods: </strong>A 23-question survey was developed by members of the Society for Hematopathology (SH) Education Committee and distributed to SH members. The survey included questions on practice environment and PB smear review practices, including trainee involvement.</p><p><strong>Results: </strong>Of 725 members contacted, 137 (19%) completed the entire survey. Over half of practices examined 5 to 20 smears a day. All respondents reported using complete blood count/differential leukocyte count data and clinical history as part of smear review. The reported proportion of laboratory-initiated vs clinician-requested reviews varied across respondents. Clinician-requested smear reviews were more likely to be billed and issued as a separate pathology report. Glass slide review (as opposed to digital microscopy) was used by most respondents. All respondents affirmed that PB smear review is an essential component of pathology training programs. Numerous free-text comments were submitted by respondents regarding their own experiences with PB smear review and suggested improvements.</p><p><strong>Conclusions: </strong>This survey elucidated the spectrum of practice patterns for pathologist review of blood smears and identified potential areas for process improvement.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"42-51"},"PeriodicalIF":2.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733253","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":"Assessing knowledge gaps and educational needs in urine drug test interpretation among health care professionals.","authors":"Christine L H Snozek, Claire I Yee, Janetta Bryksin, Rejwi Dahal, Benjamin Gerson, Carmen Gherasim, Kristin D Hauff, Nicholas Heger, Marilyn A Huestis, Kamisha L Johnson-Davis, Claire E Knezevic, Sara A Love, Stacy E F Melanson, Jaime H Noguez, Michael Pikulski, Stephen Roper, Manoj Tyagi, Jill S Warrington, He Sarina Yang, Yifei K Yang","doi":"10.1093/ajcp/aqae095","DOIUrl":"10.1093/ajcp/aqae095","url":null,"abstract":"<p><strong>Objectives: </strong>Urine drug testing (UDT) is a critical tool used in medical, forensic, and occupational settings, but interpreting results can be challenging. We performed a study to assess the ability of health care professionals to interpret UDT results accurately.</p><p><strong>Methods: </strong>In total, 911 clinical and laboratory professionals in the United States and Canada responded to a survey with questions gauging expertise in UDT interpretation. Responses were analyzed to identify knowledge gaps.</p><p><strong>Results: </strong>Toxicologists and laboratory PhD scientists performed well, with means of 4.82 and 4.63 questions answered correctly (out of 6 possible), respectively. Physicians specializing in pathology, emergency medicine, primary care, and internal medicine, however, displayed concerning knowledge gaps, as did laboratorians with nondoctoral degrees. Experience and training correlated with interpretation accuracy. Identification of simulated compliance as well as understanding opioid exposure, metabolism, and immunoassay cross-reactivity were among the most clinically significant knowledge gaps. More than 30% of survey respondents indicated that they would seek UDT information from the internet or peers rather than clinical or laboratory experts.</p><p><strong>Conclusions: </strong>The study highlighted the need for targeted education and better collaboration between clinical and laboratory experts and other health care professionals to ensure that when physicians order UDT, they can accurately interpret results and reduce harm.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"69-79"},"PeriodicalIF":2.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141764814","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":"Diffuse expression of p16 in pancreatic neuroendocrine tumors (PanNETs) and the association of morphology variants.","authors":"John Yablonski, Chanjuan Shi, Wei Chen","doi":"10.1093/ajcp/aqae184","DOIUrl":"https://doi.org/10.1093/ajcp/aqae184","url":null,"abstract":"<p><strong>Objective: </strong>Distinguishing grade 3 pancreatic neuroendocrine tumors (PanNETs) from neuroendocrine carcinomas (PanNECs) is sometimes challenging. Recently, a diffuse p16-positive pattern was reported in PanNECs but not in grade 3 PanNETs, suggesting that p16 could help differentiate these entities. This study aimed to investigate p16 expression in PanNETs of various grades and its association with clinicopathologic features.</p><p><strong>Methods: </strong>A total of 114 PanNETs were selected, and their H&E resection slides were reviewed for pathologic features, with a focus on morphologic variants. Tissue microarrays were constructed, and p16 immunohistochemistry was performed. The results were categorized as diffuse positive, partial positive, or negative. Patient electronic health records were reviewed for follow-up data.</p><p><strong>Results: </strong>Among the 114 PanNETs reviewed, 13 (11.4%) exhibited diffuse p16 expression, 40 (35.1%) were negative, and 61 (53.5%) had partial expression. Diffuse p16 expression occurred in 6 of 38 (15.8%) grade 1, 6 of 60 (10.0%) grade 2, and 1 of 16 (6.3%) grade 3 tumors. Expression did not differ substantially with patient demographics, tumor size, grading, staging, or survival, but diffuse p16 expression was more frequent in body/tail tumors (12/65 [18.5%], P = .019) and in stromal-rich tumors (10/23 [43.5%], P < .001).</p><p><strong>Conclusions: </strong>Diffuse p16 expression is not uncommon in PanNETs and may be associated with stroma-rich variants.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143031764","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":"Abdominal and intra-abdominal fibromatoses: Outcomes over time.","authors":"Fireneh N Beshah, Monica Sanchez-Avila, Amr Abulaban, Diego Montoya-Cerrillo, Domenika Ortiz Requena, Temitope Kehinde, Alan S Livingstone, Francis J Hornicek, Gina D'Amato, Andrew E Rosenberg, Elizabeth A Montgomery","doi":"10.1093/ajcp/aqae182","DOIUrl":"https://doi.org/10.1093/ajcp/aqae182","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Abdominal wall and intra-abdominal fibromatoses are locally aggressive, nonmetastasizing neoplasms. Surgery has been the mainstay of local control, but new forms of therapy have been developed that may influence the clinical course and morbidity. We studied the clinical features and outcomes of patients with abdominal and intra-abdominal fibromatoses over time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ninety-one patients-46 with abdominal wall and 45 with intra-abdominal fibromatosis-treated in our hospital systems between 2009 and 2023 were included. The patients were allocated to 1 of 2 groups based on the year of their initial treatment: before and including 2016 vs 2017-2023. Medical records and available histologic slides were reviewed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-six patients were treated between 2009 and 2016, and 45 patients were treated between 2017 and 2023. Patient ages ranged from 1 to 85 years (median, 39 years), and most patients (70%) were women (2:2 men to women). Patients self-reported as Hispanic (49%), followed by White (28%), Black (20%), and Asian (3%). A subset (21%) had familial adenomatous polyposis (FAP)/Gardner syndrome. Individuals with intra-abdominal fibromatoses (37%) were more likely to have FAP than individuals with abdominal wall fibromatosis (4%) (P &lt; .0001). The most common initial treatment before and during vs after 2016 was surgical excision (78% and 51% respectively; P = .02), followed by active surveillance with other medical intervention (9% and 18%, respectively; P = .28) and use of tyrosine kinase inhibitors (0% and 18%, respectively; P = .014). The rate of multivisceral transplant in patients with FAP/Gardner syndrome was 47% vs 4% in patients with sporadic disease (P &lt; .001); most transplants (92%) were performed before and during 2016. The overall tumor recurrence/persistence rate in patients who had undergone surgery was 31%. The recurrence/persistence rate in patients treated before and during 2016 was 39% (median follow-up, 24 months), which fell to 13% (median follow-up, 18 months) in individuals treated after 2016 (P = .032). The overall recurrence/persistence rate in patients with FAP/Gardner syndrome was 64% vs 21% in patients with sporadic disease (P = .002). In patients with sporadic disease, there were recurrences in 29% of patients treated before and during 2016 and in 9% of patients treated thereafter (P = .086). Intra-abdominal vs abdominal wall lesions in patients with FAP and in patients with sporadic disease were more likely to recur (26% vs 10% and 16% vs 5%), but this occurrence did not reach statistical significance (P = .15). Most recurrent tumors were treated by surgical re-excision in both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our data suggest that a combination of less morbid surgical approaches and the addition of nonsurgical approaches (active disease surveillance, use of tyrosine kinase inhibitors and other interventions) have resulted i","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998671","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":"Bridging the gap: Evaluating ChatGPT-generated, personalized, patient-centered prostate biopsy reports.","authors":"Erin S Proctor, David J Nusbaum, John M Lee, Robert C Benirschke, Alexa Freedman, Gregory Raster, Alexander P Glaser, Craig V Labbate, Andrew M Higgins, Brian T Helfand, Eric F Glassy, Lija Joseph, Robert A Edelstein, Elizabeth A Krupinski, Hussein Alnajar, James T Kearns, John V Groth","doi":"10.1093/ajcp/aqae185","DOIUrl":"https://doi.org/10.1093/ajcp/aqae185","url":null,"abstract":"<p><strong>Objective: </strong>The highly specialized language used in prostate biopsy pathology reports coupled with low rates of health literacy leave some patients unable to comprehend their medical information. Patients' use of online search engines can lead to misinterpretation of results and emotional distress. Artificial intelligence (AI) tools such as ChatGPT (OpenAI) could simplify complex texts and help patients. This study evaluates patient-centered prostate biopsy reports generated by ChatGPT.</p><p><strong>Methods: </strong>Thirty-five self-generated prostate biopsy reports were synthesized using National Comprehensive Cancer Network guidelines. Each report was entered into ChatGPT, version 4, with the same instructions, and the explanations were evaluated by 5 urologists and 5 pathologists.</p><p><strong>Results: </strong>Respondents rated the AI-generated reports as mostly accurate and complete. All but 1 report was rated complete and grammatically correct by the majority of physicians. Pathologists did not rate any reports as having severe potential for harm, but 1 or more urologists rated severe concern in 20% of the reports. For 80% of the reports, all 5 pathologists felt comfortable sharing them with a patient or another clinician, but all 5 urologists reached the same consensus for only 40% of reports. Although every report required edits, all physicians agreed that they could modify the ChatGPT report faster than they could write an original report.</p><p><strong>Conclusions: </strong>ChatGPT can save physicians substantial time by generating patient-centered reports appropriate for patient and physician audiences with low potential to cause harm. Surveyed physicians have confidence in the overall utility of ChatGPT, supporting further investigation of how AI could be integrated into physicians' workflows.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998672","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":"Software solution for integration of frozen section quality assurance into daily practice.","authors":"Joanna A Gibson, Neil Mutnick, Peter Gershkovich, John Sinard","doi":"10.1093/ajcp/aqae188","DOIUrl":"https://doi.org/10.1093/ajcp/aqae188","url":null,"abstract":"<p><strong>Objective: </strong>Diagnoses rendered using the frozen section (FS) technique during surgical procedures are used to guide intraoperative decisions. Therefore, diagnostic FS errors have the potential to affect patient safety and quality of care. Diagnostic FS errors arise due to both technical and interpretative factors and present a challenge to surgical pathology laboratories to recognize, document, and manage in a timely fashion. Thus, there is a need to monitor discrepancies between FS and permanent diagnoses and effectively communicate with the clinical teams when an error is discovered to ensure an opportunity for timely interventions, if clinically indicated.</p><p><strong>Methods: </strong>Our FS practice is complex, with many contributing variables, such as a partially generalized FS pathology practice model among pathology faculty and/or surgeons with specific subspecialty expertise and different physical locations of FS facilities. We implemented a comprehensive frozen section quality assurance (FSQA) program using custom software solutions aimed at improving patient safety by monitoring recognition, increasing documentation, and facilitating communication in cases where there is a discordance between intraoperative and permanent diagnoses.</p><p><strong>Results: </strong>Our FSQA program allows for categorizing frozen section discrepancies according to the source of error, such as interpretive vs technical errors, to understand how errors arise and to develop appropriate mitigation strategies for reducing errors.</p><p><strong>Conclusions: </strong>Overall, our intervention to improve FSQA has engaged pathology faculty in a uniform and systematic manner, and our data show that our new FSQA program led to a markedly shortened time interval of FSQA, allowing for timely management and resolution of errors.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998674","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}