Archives of pathology & laboratory medicine最新文献

{"title":"Twenty-Four Years' Experience With a Pulmonary Pathology Journal Club: What Have We Learned?","authors":"Henry D Tazelaar, Marie-Christine Aubry, Anja C Roden, Cynthia Heltne, Carolyn Mead-Harvey, Matthew J Cecchini, Donald Guinee, Jeffrey L Myers","doi":"10.5858/arpa.2024-0331-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0331-OA","url":null,"abstract":"<p><strong>Context.—: </strong>A monthly pathology journal club has met for 24 years. It was established to help members stay apprised of the literature relevant to diagnostic pulmonary pathology.</p><p><strong>Objective.—: </strong>To assess whether the journal club met its goal and to report on opportunities identified for improvement.</p><p><strong>Design.—: </strong>To determine whether articles chosen for discussion as opposed to notation were more significant, Scopus citation indices for article types reviewed from January 2007 to November 2023 were compared. A survey of current faculty was undertaken to determine if the club was meeting expectations and to identify improvement opportunities.</p><p><strong>Results.—: </strong>Articles from January 2007 to November 2023 included 858 discussed and 3385 noted. Mean (SD) citation count was 103.0 (409.80) for discussion and 64.9 (259.77) for notation articles (P < .001). The citation count was noticeably right skewed, as articles with high citation counts inflated the mean. Members were mostly satisfied with the way the journal club was structured and managed. Members most valued the summary of the articles, followed by the live discussion. Opportunities for improvement included decreasing the number of journals scanned, decreasing detail in summaries, and using generative artificial intelligence (AI) to facilitate summary generation. A pilot using AI anecdotally reduced preparatory time, but the human-edited summary included more specific context, critical commentary, and enhanced take-home messages, providing a more nuanced analysis.</p><p><strong>Conclusions.—: </strong>The journal club met its initial goal. Opportunities for improvement have been identified including the use of generative AI to facilitate article summarization.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Evaluation of Pediatric Bone and Soft Tissue Lesions: Retrospective Analysis of 595 Frozen Sections With Emphasis on Discrepancy and Diagnostic Pitfalls.","authors":"Benjamin L Coiner, Hernán Correa, Joyce E Johnson, Jiancong Liang, Huiying Wang","doi":"10.5858/arpa.2024-0329-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0329-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Frozen section (FS) evaluation of pediatric bone and soft tissue (BST) lesions is infrequently encountered and may pose considerable diagnostic challenges. Limited data exist about the accuracy and related diagnostic difficulties.</p><p><strong>Objective.—: </strong>To identify and analyze discrepancy between the FS diagnosis and final diagnosis in order to increase the awareness of common diagnostic pitfalls in FS evaluation of pediatric BST lesions.</p><p><strong>Design.—: </strong>We retrospectively reviewed 595 consecutive FSs of pediatric BST lesions from 373 patients and analyzed the accuracy and causes for interpretation errors.</p><p><strong>Results.—: </strong>Discrepant diagnoses were found in 23 of 595 FSs (3.9%). Discrepancy rates were slightly higher in benign, soft tissue lesions and FSs requested for diagnosis/adequacy, although no statistically significant difference was observed. Pathologist misinterpretation contributed to discrepancy in 17 of 23 FSs (73.9%), which were classified into 6 patterns of error. For margin, 3 patterns were found: normal hematopoietic elements versus malignant cells in Ewing sarcoma bone marrow margin (n = 3), prominent sinonasal vasculature and stroma versus sinonasal tract angiofibroma (n = 3), and atrophic skeletal muscles versus malignant cells in rhabdomyosarcoma and Ewing sarcoma (n = 2). For diagnosis, another 3 patterns were identified: misclassification of benign bone tumors (n = 5), misclassification of benign spindle neoplasms (n = 2), and vascular malformation versus normal tissue (n = 2).</p><p><strong>Conclusions.—: </strong>FS is a valuable tool for guiding surgical management of pediatric BST lesions, which can be challenging entities and represent significant diagnostic pitfalls. Awareness of these FS pitfalls may help in further increasing diagnostic accuracy.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pathologic Diagnosis of Eosinophilic Esophagitis.","authors":"Mamoun Younes, Dorina Gui","doi":"10.5858/arpa.2024-0392-ED","DOIUrl":"https://doi.org/10.5858/arpa.2024-0392-ED","url":null,"abstract":"","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Scoring Method on Accuracy and Reproducibility of Hans Cell-of-Origin Prediction in Excisional Biopsies of Diffuse Large B-Cell Lymphoma, Not Otherwise Specified.","authors":"Oleksandr Yanko, Andrew G Lytle, Pedro Farinha, Merrill Boyle, Graham W Slack, David W Scott, Jeffrey W Craig","doi":"10.5858/arpa.2024-0366-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0366-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Aided by tissue microarray (TMA) technology, several RNA-correlated immunohistochemistry-based algorithms have been developed for cell-of-origin (COO) prediction in diffuse large B-cell lymphoma, not otherwise specified (DLBCL-NOS). However, there is currently no empirical evidence to guide the optimal application of these algorithms to whole tissue sections (WTSs).</p><p><strong>Objective.—: </strong>To assess the impact of various scoring methods on the accuracy and reproducibility of the popular Hans algorithm.</p><p><strong>Design.—: </strong>We compared 3 different WTS-based scoring methods, designated as global, selective, and hotspot scoring, to a matched TMA evaluation and gold standard RNA analysis (Lymph2Cx; germinal center B cell n = 64; activated B cell/unclassified n = 68) using a representative series of 132 excisional biopsies of de novo DLBCL-NOS. Positivity scores (10% increments) were submitted by 3 expert lymphoma pathologists, with 30% or more defining positivity.</p><p><strong>Results.—: </strong>Sixty-eight of the 132 cases of DLBCL-NOS (52%) exhibited variation in Hans immunohistochemistry marker phenotype as a consequence of scoring method and/or interscorer discordance. Although this led to changes in Hans COO assignment in 27 of 132 cases (20%), none of the WTS-based scoring methods were statistically inferior to one another in terms of raw accuracy. Hotspot scoring yielded the lowest proportion of borderline scores (20%-40% range) for BCL6 transcription repressor (BCL6) and IRF4 transcription factor (MUM1) but negatively impacted the balance between sensitivity and specificity for these markers. Selective scoring was associated with significantly worse interscorer concordance compared to TMA evaluation, which it was designed to replicate.</p><p><strong>Conclusions.—: </strong>Overall, our data favor the use of global scoring for its noninferior accuracy, solid interscorer concordance, nonnegative influence on individual Hans markers, and current widespread use.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ZMIZ1::ABL1 Fusion: An Uncommon Molecular Event With Clinical Implications in Pediatric Cancer.","authors":"Kevin T A Booth, Rachael R Schulte, Laurin Smith, Hongyu Gao, Ryan A Stohler, Yunlong Liu, Shalini C Reshmi, Gail H Vance","doi":"10.5858/arpa.2024-0082-OA","DOIUrl":"10.5858/arpa.2024-0082-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Pediatric B-cell acute lymphoblastic leukemia is genetically and phenotypically heterogeneous, with a genetic landscape including chromosomal translocations that disrupt ABL proto-oncogene 1, non-receptor tyrosine kinase (ABL1).</p><p><strong>Objective.—: </strong>To characterize an uncommon chromosomal translocation in acute leukemia.</p><p><strong>Design.—: </strong>Genetic testing, including karyotype and fluorescence in situ hybridization (FISH) analysis, was used to determine the underlying genetic aberration driving the disorder and to guide disease classification and risk stratification. More-detailed testing using RNA sequencing was performed based on the results from these assays. Three-dimensional molecular modeling was used to visualize the impact of aberrant fused transcripts identified by transcriptome profiling.</p><p><strong>Results.—: </strong>Karyotype analysis of the bone marrow demonstrated a complex karyotype with, most notably, a t(9;10)(q34.1;q22) translocation. ABL1 break-apart probe FISH findings supported ABL1 disruption. Bone marrow transcriptome analysis revealed mutant ZMIZ1::ABL1 (ZMIZ1, zinc finger MIZ-type containing 1) fusion transcripts as a consequence of t(9;10)(q34.1;q22). Three-dimensional modeling of the mutant ZMIZ1::ABL1 fusion protein confirmed an altered ABL1 protein structure compared to that of the wild type, suggesting a constitutively active conformation.</p><p><strong>Conclusions.—: </strong>The t(9;10) translocation resulting in ZMIZ1::ABL1 fusion transcripts is an uncommon form of BCR::ABL1-like (BCR, BCR activator of RhoGEF and GTPase) acute lymphoblastic leukemia. Although the karyotype was complex, identifying the t(9;10)(q34.1;q22) translocation, ABL1 disruption, and ZMIZ1::ABL1 transcript enabled effective ABL1-targeted treatment. Our data support the use of tyrosine kinase inhibitors to treat ZMIZ1::ABL1-derived B-cell acute lymphoblastic leukemia.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"159-164"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introducing Diagnostic Testing for Chronic Myeloid Leukemia in a Public Hospital Setting in Western Kenya.","authors":"Millicent Orido, Teresa Cherop Lotodo, Nicholas Kigen, Ryan Stohler, Terry A Vik, Gail H Vance","doi":"10.5858/arpa.2024-0264-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0264-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by proliferation of the granulocytic cell line. The incidence of CML in Kenya is estimated at near 2000 cases annually. The disorder is associated with a poor prognosis without treatment. Tyrosine kinase inhibitors are approved for treatment in adults and children with confirmed disease. Diagnostic testing for CML in the public setting in Kenya is limited and not covered by the Kenyan National Health Insurance Fund.</p><p><strong>Objective.—: </strong>To establish a clinical fluorescence in situ hybridization assay for the diagnosis of CML in the Academic Model Providing Access to Healthcare (AMPATH) Reference Laboratory in Eldoret, Kenya.</p><p><strong>Design.—: </strong>Peripheral blood and bone marrow smears were split between the AMPATH Reference Laboratory and the Indiana University Cytogenetics Laboratory for concordance studies.</p><p><strong>Results.—: </strong>Seventeen specimens from patients with a provisional diagnosis of CML were studied by fluorescence in situ hybridization in both the AMPATH and Indiana University Cytogenetics laboratories. The analysis for 1 specimen could not be completed by both laboratories, and the results for 1 other specimen were discordant. The interpretations of 15 of 16 specimens (93.7%) were concordant. Normal specimens were also studied to establish the normal range for the assay.</p><p><strong>Conclusions.—: </strong>We report the establishment of diagnostic testing for CML in the AMPATH Reference Laboratory and the Moi Teaching and Referral Hospital in Eldoret, Kenya.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addition of Lay Language Comments in Placental Pathology Reports Increases Provider Understanding and Comfort.","authors":"Linda M Ernst, Alexa A Freedman, Sonia Gilani, Sunitha C Suresh","doi":"10.5858/arpa.2024-0105-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0105-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Placental pathology reports may contain terminology that obstetric providers do not feel comfortable discussing with their patients.</p><p><strong>Objective.—: </strong>To determine if lay language comments appended to the placental pathology report increase provider comfort and understanding of the report.</p><p><strong>Design.—: </strong>We drafted a priori lay language comments explaining the major pathologic findings in the placenta. To test the acceptability and value of the comments, we designed an anonymous and randomized provider survey aimed to assess understanding of the terminology in the pathology report and comfort with explaining the report to their patients. Survey respondents were randomly assigned to receive 2 hypothetical placental pathology reports, one with and one without lay language comments. Respondents were asked to rate their understanding and comfort level explaining the report to their patients on a scale of 1 to 4. Within-provider differences in understanding and comfort by report type and pathology type were assessed by using repeated measures analysis of variance.</p><p><strong>Results.—: </strong>Thirty-one providers responded to the survey. Providers reported greater complete understanding of the report when reading the report with lay language comments as compared to the report without the comments (mean comfort of 3.5 for lay language versus 2.97 for original report, P < .001), as well as greater comfort with the report (mean comfort of 3.29 for lay language versus 2.81 for original report, P = .002). There was no difference in provider understanding or comfort by the pathology findings represented (P = .66).</p><p><strong>Conclusions.—: </strong>Our survey results indicate that the inclusion of lay language comments in the placental pathology report can improve provider understanding of the placental findings and therefore improve their comfort when discussing the findings with a patient and considering future treatment options.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Grade Astrocytoma With Piloid Features.","authors":"Mark A Rudolf, Sean P Ferris","doi":"10.5858/arpa.2024-0268-RA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0268-RA","url":null,"abstract":"<p><strong>Context.—: </strong>High-grade astrocytoma with piloid features (HGAP) is a newly recognized glioma defined by its methylation profile. Understanding of its clinical, histologic, and molecular characteristics continues to evolve.</p><p><strong>Objective.—: </strong>To review the HGAP literature, emphasizing updates in our understanding of the entity since its codification in the 2021 World Health Organization (WHO) Blue Book. Additionally, to present a case series illustrating a single institutional experience with HGAP.</p><p><strong>Data sources.—: </strong>The English-language HGAP literature from 2018 to 2024 was reviewed. Four cases of HGAP were reviewed, along with relevant medical records.</p><p><strong>Conclusions.—: </strong>HGAP is an important consideration in the differential diagnosis of isocitrate dehydrogenase-wild-type gliomas and is more frequently encountered in adults. A handful of studies published following the entity's codification in the 2021 WHO Blue Book have refined our understanding of its clinical, histologic, and hallmark molecular characteristics. The most substantial updates include the description of 3 provisional subtypes, further characterization of an association with neurofibromatosis 1 syndrome, identification of new rare molecular alterations, and documentation of a unique case of possible transformation of pilocytic astrocytoma into HGAP. Clues to the diagnosis of HGAP include histologic infiltrating glioma with moderate pleomorphism, posterior fossa location, CDKN2A/B (cyclin dependent kinase inhibitor 2A/B) deletion, MAPK (mitogen-activated protein kinase) pathway alterations, ATRX (alpha thalassemia/mental retardation syndrome X-linked) loss, and association with neurofibromatosis 1 syndrome in some cases; these findings should prompt further molecular testing, including genome-wide DNA methylation analysis, which is currently essential for diagnosis.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of Current Procedural Terminology Coding in Complex Genitourinary Surgical Specimens.","authors":"David B Behrman, Robert Achram, Carol McClure, Beverly E Allen, Christine Miller, Carla J Shoffeitt, Kelly R Magliocca, Scott M Steward-Tharp, Cindy Alexander, Twanda Triplet, Catherine Maloney, Chad W M Ritenour, Lara R Harik","doi":"10.5858/arpa.2024-0118-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0118-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Complex surgical specimens are associated with complex Current Procedural Terminology (CPT) coding.</p><p><strong>Objective.—: </strong>To assess and optimize the accuracy of CPT coding of complex genitourinary specimens at our institution.</p><p><strong>Design.—: </strong>Baseline CPT codes for nephrectomy and cystectomy surgical pathology specimens were examined during a 3-month period. Pathology reports were reviewed for accurate CPT coding, and commensurate tests of change were implemented. Post-test-of-change data were re-collected, analyzed, and compared to the baseline data.</p><p><strong>Results.—: </strong>Baseline data consisted of 71 genitourinary specimens (April to June 2021) and demonstrated undercoding in 46% (n = 33 of 71) of specimens, mostly in specimens with 2 or more billable organs. From findings in baseline data, we implemented test-of-change efforts consisting of awareness, education, and increased documentation and communication between all involved parties. Marked improvement was noted in the coding accuracy of specimens with 2 billable organs (pretest: n = 4 of 21, 19%; posttest: n = 14 of 21, 67%) and 3 or more billable organs (pretest: n = 0 of 16, 0%; posttest: n = 7 of 12, 58%) (P value = .002). Problematic areas included nephrectomy specimens resected with adrenal glands (pretest: n = 2 of 12, 17%; posttest: n = 12 of 14, 86%) and ureters for urothelial carcinoma (pretest: n = 0 of 10, 0%; posttest: n = 3 of 6, 50%), as well as regional lymph nodes commingled with resection specimens (pretest: n = 0 of 11, 0%; posttest: n = 7 of 9, 78%).</p><p><strong>Conclusions.—: </strong>A comprehensive approach involving all stakeholders is necessary for CPT coding of complex surgical specimens. Documentation and familiarity with coding rules, specifically bundling and unbundling, as well as clinical indications for resection, are important factors in optimizing CPT coding.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infections Due to Corynebacterium kroppenstedtii With Focus on Granulomatous Lobular Mastitis for Tissue Specificity, Pathogenesis, Bacteriologic Workup, and Treatment.","authors":"Qiong Gan, Yang Ding, Yun Wu, Yu Zhang, Qing H Meng, Qing Qing Ding, Huifang Lu, Samuel A Shelburne, Richard A Ehlers, Xiang Y Han","doi":"10.5858/arpa.2024-0365-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0365-OA","url":null,"abstract":"<p><strong>Context.—: </strong></p><p><strong>Objective.—: </strong>To report the isolation and significance of C kroppenstedtii, features of patients with GLM, pathologic findings and mechanism, bacteriologic workup, and optimal treatment.</p><p><strong>Design.—: </strong>Analysis of the cases with C kroppenstedtii at The University of Texas MD Anderson Cancer Center from 2016 to March 2024 for mechanistic insights.</p><p><strong>Results.—: </strong>During a period of 8 years, isolates of C kroppenstedtii were obtained from 10 women and 7 men. All of the women, with an average age of 34 years (range, 18-61 years), presented with chronic or subacute mastitis, and were subsequently diagnosed with GLM. The men, with an average age of 66 years, had neoplastic diagnoses with the bacterium being commensal in 6 cases. Thus, C kroppenstedtii shows a predilection to infect the female breast (P < .001). Predisposing risks for GLM included childbirth in 8 women and nipple inversion in 2 women. Histopathology revealed xanthogranulomatous inflammation and Gram-positive bacilli within fat droplets or extracellularly. From GLM aspirates or tissue, the liquid culture media and/or anaerobic incubation yielded 9 of 10 isolates. Up to 14 tested strains were susceptible to vancomycin, linezolid, rifampin, and gentamicin. Nine women received extensive antimicrobial therapy.</p><p><strong>Conclusions.—: </strong></p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}