Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000318
W. Twaddell
Adenosquamous carcinoma (ASC) of the esophagus is an uncommon primary esophageal malignancy of uncertain pathogenesis, with several challenges complicating the establishment of a correct diagnosis. Neither the natural history nor the prognostic and therapeutic implications are well understood for this tumor. We report a case of a 71-year-old man who was found to have an ASC at the gastrointestinal junction. The clinicopathologic features as well as what is known of the epidemiology, pathogenesis, and prognosis and treatment of ASC are discussed, along with other possible coexisting disease.
{"title":"Adenosquamous Carcinoma Involving the Gastroesophageal Junction in a 71-Year-Old Man","authors":"W. Twaddell","doi":"10.1097/PCR.0000000000000318","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000318","url":null,"abstract":"\u0000 Adenosquamous carcinoma (ASC) of the esophagus is an uncommon primary esophageal malignancy of uncertain pathogenesis, with several challenges complicating the establishment of a correct diagnosis. Neither the natural history nor the prognostic and therapeutic implications are well understood for this tumor. We report a case of a 71-year-old man who was found to have an ASC at the gastrointestinal junction. The clinicopathologic features as well as what is known of the epidemiology, pathogenesis, and prognosis and treatment of ASC are discussed, along with other possible coexisting disease.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"74 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84520538","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}
Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000316
Serena Wong, G. Das, Charles Cha, D. Klimstra, D. Jain
Primary hepatic mesotheliomas are very rare with only a few cases reported in the literature. Here we present a 55-year-old female with an 18 cm intrahepatic epithelioid mesothelioma with cystic changes who presented with non-specific abdominal pain and no prior history of exposure to asbestos. The tumor was resected with negative margins. The tumor was composed of islands of relatively monotonous epithelioid cells with extensive cystic degeneration. The nuclei were quite bland, round to oval with frequent grooves and inconspicuous nucleoli and minimal pleomorphism. Tumor necrosis was not seen. No keratinizaton or glandular differentiation was evident. The tumor background consisted of a rich inflammatory cell infiltrate composed of lymphocytes, plasma cells and histiocytes. The tumor was positive for mesothelial markers (calretinin, WT-1 and D2–40), keratins (CK5/6, CK7, CK19) and negative for a variety of other markers to exclude adenocarcinoma and other neoplasms. The patient is well and free of disease 8 years following the surgical resection.
{"title":"Primary Mesothelioma of the Liver: A Case Report","authors":"Serena Wong, G. Das, Charles Cha, D. Klimstra, D. Jain","doi":"10.1097/PCR.0000000000000316","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000316","url":null,"abstract":"\u0000 Primary hepatic mesotheliomas are very rare with only a few cases reported in the literature. Here we present a 55-year-old female with an 18 cm intrahepatic epithelioid mesothelioma with cystic changes who presented with non-specific abdominal pain and no prior history of exposure to asbestos. The tumor was resected with negative margins. The tumor was composed of islands of relatively monotonous epithelioid cells with extensive cystic degeneration. The nuclei were quite bland, round to oval with frequent grooves and inconspicuous nucleoli and minimal pleomorphism. Tumor necrosis was not seen. No keratinizaton or glandular differentiation was evident. The tumor background consisted of a rich inflammatory cell infiltrate composed of lymphocytes, plasma cells and histiocytes. The tumor was positive for mesothelial markers (calretinin, WT-1 and D2–40), keratins (CK5/6, CK7, CK19) and negative for a variety of other markers to exclude adenocarcinoma and other neoplasms. The patient is well and free of disease 8 years following the surgical resection.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"25 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76841039","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}
Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000319
D. Bosch, C. Truong, M. Yeh
Atrophic gastritis and intestinal metaplasia, often in the setting of Helicobacter pylori infection, are associated with higher risk of gastric adenocarcinoma. According to the Correa model, the pathway of gastric carcinogenesis is triggered by chronic inflammation, which leads to atrophic gastritis, intestinal metaplasia, gastric dysplasia, and gastric carcinoma. Histopathologic assessment of atrophic gastritis suffers from low interobserver concordance, but staging with the Operative Link for Gastritis Assessment system effectively stratifies risk of gastric carcinoma. Intestinal metaplasia is a more highly reproducible diagnosis and can be classified with multiple systems including the Operative Link for Gastric Intestinal Metaplasia. Gastric epithelial dysplasia and invasive carcinoma are most commonly classified using the Vienna system among Western countries. The 2 tiers of dysplasia (low and high grade) are distinguished by severity of cytologic atypia, complexity of glandular architecture, loss of nuclear polarity, and degree of mitotic activity. However, grading of dysplasia on biopsy specimens suffers from high interobserver variability, as well as relatively poor correlation to Vienna system classification on subsequent resections. Intramucosal carcinoma is distinguished from high-grade dysplasia by neoplastic invasion into the lamina propria or muscularis mucosae. Grade of intraepithelial neoplasm and depth of invasive carcinoma remain central to guiding treatment decisions, while clinical approaches to surveillance and therapy continue to evolve.
{"title":"Gastric Epithelial Carcinogenesis: From Atrophic Gastritis, Intestinal Metaplasia, and Dysplasia to Invasive Adenocarcinoma","authors":"D. Bosch, C. Truong, M. Yeh","doi":"10.1097/PCR.0000000000000319","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000319","url":null,"abstract":"\u0000 Atrophic gastritis and intestinal metaplasia, often in the setting of Helicobacter pylori infection, are associated with higher risk of gastric adenocarcinoma. According to the Correa model, the pathway of gastric carcinogenesis is triggered by chronic inflammation, which leads to atrophic gastritis, intestinal metaplasia, gastric dysplasia, and gastric carcinoma. Histopathologic assessment of atrophic gastritis suffers from low interobserver concordance, but staging with the Operative Link for Gastritis Assessment system effectively stratifies risk of gastric carcinoma. Intestinal metaplasia is a more highly reproducible diagnosis and can be classified with multiple systems including the Operative Link for Gastric Intestinal Metaplasia. Gastric epithelial dysplasia and invasive carcinoma are most commonly classified using the Vienna system among Western countries. The 2 tiers of dysplasia (low and high grade) are distinguished by severity of cytologic atypia, complexity of glandular architecture, loss of nuclear polarity, and degree of mitotic activity. However, grading of dysplasia on biopsy specimens suffers from high interobserver variability, as well as relatively poor correlation to Vienna system classification on subsequent resections. Intramucosal carcinoma is distinguished from high-grade dysplasia by neoplastic invasion into the lamina propria or muscularis mucosae. Grade of intraepithelial neoplasm and depth of invasive carcinoma remain central to guiding treatment decisions, while clinical approaches to surveillance and therapy continue to evolve.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76409353","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}
Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000322
K. Koro, P. Swanson, M. Yeh
Adenocarcinomas of the stomach and gastroesophageal junction are commonly encountered by practicing pathologists. In cases of advanced unresectable or metastatic disease, a patient may be a candidate for anti–human epidermal growth factor receptor 2 (HER2) targeted therapy. Eligibility for anti-HER2 therapy is determined by the pathologist, following an algorithm utilizing HER2 immunohistochemistry alone or in combination with chromogenic or fluorescence in situ hybridization. HER2 immunohistochemistry is interpreted using 4-tier scoring criteria that were devised and validated specifically for gastric adenocarcinomas. Here, current guidelines for utilization and interpretation of HER2 immunohistochemistry and in situ hybridization are reviewed. Also included is a discussion of some of the interpretation difficulties and pitfalls that may be encountered in routine pathology practice.
{"title":"HER2 Testing in Gastric and Gastroesophageal Adenocarcinoma—Review and Update","authors":"K. Koro, P. Swanson, M. Yeh","doi":"10.1097/PCR.0000000000000322","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000322","url":null,"abstract":"\u0000 Adenocarcinomas of the stomach and gastroesophageal junction are commonly encountered by practicing pathologists. In cases of advanced unresectable or metastatic disease, a patient may be a candidate for anti–human epidermal growth factor receptor 2 (HER2) targeted therapy. Eligibility for anti-HER2 therapy is determined by the pathologist, following an algorithm utilizing HER2 immunohistochemistry alone or in combination with chromogenic or fluorescence in situ hybridization. HER2 immunohistochemistry is interpreted using 4-tier scoring criteria that were devised and validated specifically for gastric adenocarcinomas. Here, current guidelines for utilization and interpretation of HER2 immunohistochemistry and in situ hybridization are reviewed. Also included is a discussion of some of the interpretation difficulties and pitfalls that may be encountered in routine pathology practice.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76778625","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}
Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000315
Whitney L. Reid, Jesse L. Cox, W. Livingston, G. Talmon
Iron-induced mucosal damage is a common finding within the upper gastrointestinal tract. Because of physiologic factors, however, high concentrations of iron rarely reach the distal gastrointestinal tract, thus injury there has not been reported. Here, we present a case in which multiple factors contributed to iron-induced injury in the colon.
{"title":"Iron-associated Colitis: A Common Entity in an Uncommon Location","authors":"Whitney L. Reid, Jesse L. Cox, W. Livingston, G. Talmon","doi":"10.1097/PCR.0000000000000315","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000315","url":null,"abstract":"\u0000 Iron-induced mucosal damage is a common finding within the upper gastrointestinal tract. Because of physiologic factors, however, high concentrations of iron rarely reach the distal gastrointestinal tract, thus injury there has not been reported. Here, we present a case in which multiple factors contributed to iron-induced injury in the colon.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"85 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84329237","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}
Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000311
Kenrry Chiu, Lik Hang Lee, W. Xiong
Most gastric polyps are fundic gland polyps and hyperplastic polyps. Adenomas, inflammatory fibroid polyps, and neuroendocrine tumors are other types of gastric polyps that occur less frequently. Rarely, a gastric polyp may be associated with a syndrome, including hereditary cancer syndromes. Some of these syndromes are also associated with an increased risk of gastric cancer. We present a case of a 50-year-old woman with known Cowden syndrome who presents with multiple gastric hamartomatous polyps. We then review the clinical, endoscopic, and pathologic features of various syndromes that are associated with gastric polyps. Fundic gland polyp–predominant syndromes include familial adenomatous polyposis, gastric adenocarcinoma and proximal polyposis of the stomach, and MUTYH-associated polyposis, all of which are hereditary cancer syndromes. Gastric hamartomatous polyps are found in patients with juvenile polyposis syndrome, Peutz-Jeghers syndrome, PTEN hamartoma tumor syndrome including Cowden syndrome, and Cronkhite-Canada syndrome. Syndromic gastric polyps may be biopsied in patients with a previously established diagnosis of the underlying syndrome, such as surveillance endoscopies in familial adenomatous polyposis. On other occasions, the pathologic assessment of gastric polyps may prompt or contribute to a diagnostic workup of an underlying syndrome in conjunction with other clinical and endoscopic findings.
{"title":"Gastric Polyposis Syndromes","authors":"Kenrry Chiu, Lik Hang Lee, W. Xiong","doi":"10.1097/PCR.0000000000000311","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000311","url":null,"abstract":"\u0000 Most gastric polyps are fundic gland polyps and hyperplastic polyps. Adenomas, inflammatory fibroid polyps, and neuroendocrine tumors are other types of gastric polyps that occur less frequently. Rarely, a gastric polyp may be associated with a syndrome, including hereditary cancer syndromes. Some of these syndromes are also associated with an increased risk of gastric cancer. We present a case of a 50-year-old woman with known Cowden syndrome who presents with multiple gastric hamartomatous polyps. We then review the clinical, endoscopic, and pathologic features of various syndromes that are associated with gastric polyps. Fundic gland polyp–predominant syndromes include familial adenomatous polyposis, gastric adenocarcinoma and proximal polyposis of the stomach, and MUTYH-associated polyposis, all of which are hereditary cancer syndromes. Gastric hamartomatous polyps are found in patients with juvenile polyposis syndrome, Peutz-Jeghers syndrome, PTEN hamartoma tumor syndrome including Cowden syndrome, and Cronkhite-Canada syndrome. Syndromic gastric polyps may be biopsied in patients with a previously established diagnosis of the underlying syndrome, such as surveillance endoscopies in familial adenomatous polyposis. On other occasions, the pathologic assessment of gastric polyps may prompt or contribute to a diagnostic workup of an underlying syndrome in conjunction with other clinical and endoscopic findings.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"55 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78651624","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}
Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000321
C. Inomoto, Yusuke Kondo, K. Hirabayashi, N. Kumaki, K. Hatanaka, Takuma Tajiri, Naoya Nakamura
A 60-year-old woman presented to our hospital with a 1-month history of dysphagia. She smoked and consumed alcohol but had no notable past medical history. Physical examination revealed epigastric tenderness, and abdominal computed tomography revealed diffuse thickening of the esophageal wall and stenosis of the esophageal lumen. She underwent a barium-swallowing examination. A tumor that measured approximately 4 cm in length was detected with ulceration and stenosis in the distal esophagus and gastroesophageal junction. Tumor biopsy showed squamous cell carcinoma. Esophagectomy was performed. The pathological diagnosis was squamous cell carcinoma with a neuroendocrine carcinoma component; the latter component made up less than 30% of the lesion. Regional lymph node metastasis, consisting of squamous cell carcinoma and neuroendocrine carcinoma components, was also observed. The patient was diagnosed with multiple liver metastases 2 months postesophagectomy. She died 11 months after the surgery. Here, we present the above case and a review of relevant literature.
{"title":"Squamous Cell Carcinoma With a Focal Neuroendocrine Carcinoma Component at the Esophagogastric Junction","authors":"C. Inomoto, Yusuke Kondo, K. Hirabayashi, N. Kumaki, K. Hatanaka, Takuma Tajiri, Naoya Nakamura","doi":"10.1097/PCR.0000000000000321","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000321","url":null,"abstract":"\u0000 A 60-year-old woman presented to our hospital with a 1-month history of dysphagia. She smoked and consumed alcohol but had no notable past medical history. Physical examination revealed epigastric tenderness, and abdominal computed tomography revealed diffuse thickening of the esophageal wall and stenosis of the esophageal lumen. She underwent a barium-swallowing examination. A tumor that measured approximately 4 cm in length was detected with ulceration and stenosis in the distal esophagus and gastroesophageal junction. Tumor biopsy showed squamous cell carcinoma. Esophagectomy was performed. The pathological diagnosis was squamous cell carcinoma with a neuroendocrine carcinoma component; the latter component made up less than 30% of the lesion. Regional lymph node metastasis, consisting of squamous cell carcinoma and neuroendocrine carcinoma components, was also observed. The patient was diagnosed with multiple liver metastases 2 months postesophagectomy. She died 11 months after the surgery. Here, we present the above case and a review of relevant literature.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"63 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78389920","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}
Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000309
A. Barbieri, D. Jain
There has been tremendous growth in the understanding of gastrointestinal stromal tumors in the last 2 decades, particularly with regard to molecular classification. The role of the pathologist in appropriately assessing these tumors is more important than ever.
{"title":"Gastrointestinal Stromal Tumors—A Case Report With Review and Discussion of Updates","authors":"A. Barbieri, D. Jain","doi":"10.1097/PCR.0000000000000309","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000309","url":null,"abstract":"\u0000 There has been tremendous growth in the understanding of gastrointestinal stromal tumors in the last 2 decades, particularly with regard to molecular classification. The role of the pathologist in appropriately assessing these tumors is more important than ever.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"132 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74541237","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}
Pub Date : 2019-07-01DOI: 10.1097/PCR.0000000000000320
K. Matsukuma, M. Torbenson
Autoimmune gastritis is a relatively common but likely underdiagnosed form of chronic gastritis that is associated with iron-deficiency anemia as well as vitamin B12/cobalamin deficiency. This disease confers a 13-fold increased risk of gastric well-differentiated neuroendocrine tumors, due to persistently elevated gastrin levels, and a 3- to 7-fold increased risk of gastric adenocarcinoma. The case described here has a typical presentation of the disease, and the following review highlights key histologic features that aid in the identification of this inflammatory process. Additionally, background information on ancillary testing and mechanisms of disease are discussed with a focus on details most useful for the pathologist who is presented with the opportunity to make this often unexpected but medically significant diagnosis.
{"title":"Autoimmune Gastritis: An Underappreciated Entity","authors":"K. Matsukuma, M. Torbenson","doi":"10.1097/PCR.0000000000000320","DOIUrl":"https://doi.org/10.1097/PCR.0000000000000320","url":null,"abstract":"\u0000 Autoimmune gastritis is a relatively common but likely underdiagnosed form of chronic gastritis that is associated with iron-deficiency anemia as well as vitamin B12/cobalamin deficiency. This disease confers a 13-fold increased risk of gastric well-differentiated neuroendocrine tumors, due to persistently elevated gastrin levels, and a 3- to 7-fold increased risk of gastric adenocarcinoma. The case described here has a typical presentation of the disease, and the following review highlights key histologic features that aid in the identification of this inflammatory process. Additionally, background information on ancillary testing and mechanisms of disease are discussed with a focus on details most useful for the pathologist who is presented with the opportunity to make this often unexpected but medically significant diagnosis.","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"19 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83629040","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}
Pub Date : 2017-11-01DOI: 10.1097/pcr.0000000000000221
Steven C. Smith
{"title":"An Update on Kidney Tumors","authors":"Steven C. Smith","doi":"10.1097/pcr.0000000000000221","DOIUrl":"https://doi.org/10.1097/pcr.0000000000000221","url":null,"abstract":"","PeriodicalId":43475,"journal":{"name":"AJSP-Reviews and Reports","volume":"19 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74305645","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}
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