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Infections Due to Corynebacterium kroppenstedtii With Focus on Granulomatous Lobular Mastitis for Tissue Specificity, Pathogenesis, Bacteriologic Workup, and Treatment. 克氏棒状杆菌引起的感染:肉芽肿性小叶乳腺炎的组织特异性、发病机制、细菌学检查和治疗。
Pub Date : 2025-01-13 DOI: 10.5858/arpa.2024-0365-OA
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

Context.—:

Objective.—: To report the isolation and significance of C kroppenstedtii, features of patients with GLM, pathologic findings and mechanism, bacteriologic workup, and optimal treatment.

Design.—: Analysis of the cases with C kroppenstedtii at The University of Texas MD Anderson Cancer Center from 2016 to March 2024 for mechanistic insights.

Results.—: 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.

Conclusions.—:

上下文。-:目的。-:报道克氏杆菌的分离及意义、GLM患者的特点、病理表现及机制、细菌学检查及最佳治疗方法。-:对2016年至2024年3月德克萨斯大学MD安德森癌症中心的C kroppenstedtii病例进行分析,以了解其机制。-:在8年的时间里,从10名女性和7名男性身上分离到了克氏杆菌。所有女性,平均年龄34岁(范围18-61岁),表现为慢性或亚急性乳腺炎,随后被诊断为GLM。这些男性平均年龄为66岁,其中6例被诊断为肿瘤,细菌共生。因此,C kroppenstedtii更倾向于感染女性乳房(P < 0.001)。GLM的易感风险包括8名妇女分娩和2名妇女乳头内陷。组织病理学检查显示脂肪滴内或细胞外有黄色肉芽肿性炎症和革兰氏阳性杆菌。从GLM抽吸物或组织中,液体培养基和/或厌氧培养产生10个分离株中的9个。对万古霉素、利奈唑胺、利福平、庆大霉素敏感的菌株达14株。9名妇女接受了广泛的抗菌治疗。
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引用次数: 0
An 18-Year Review of Hemoglobinopathy Proficiency Testing: Recommendations From the College of American Pathologists Hematology and Clinical Microscopy Committee. 血红蛋白病熟练程度测试的18年回顾:来自美国病理学家血液学和临床显微镜委员会的建议。
Pub Date : 2025-01-13 DOI: 10.5858/arpa.2024-0386-CP
Ifeyinwa Obiorah, Chad M McCall, Alexandra Balmaceda, Stephanie Salansky, Archana Agarwal, Olga Pozdnyakova

Context.—: The College of American Pathologists Hematology and Clinical Microscopy Committee implemented a hemoglobinopathy proficiency testing and education program to monitor and assess the performance of participating laboratories.

Objective.—: To evaluate the performance of clinical laboratories for hemoglobinopathy proficiency testing from 2005 to 2023.

Design.—: The hemoglobinopathy challenges are composed of clinical case summaries and electrophoretic and chromatographic gel and tracing images. The participants are asked to determine (1) what hemoglobin chain is affected and (2) the hemoglobinopathy diagnosis.

Results.—: A total of 365 to 676 laboratories were enrolled in the proficiency testing program each year. Overall, the error rates for determination of the affected globin chain and a hemoglobinopathy diagnosis ranged from 0.6% to 56.5% and 0.5% to 86.5%, respectively. Twenty-three of 66 surveyed hemoglobinopathies (34.8%) had an error rate exceeding the consensus threshold of 20%. The globin gene detection error rate of the compound hemoglobinopathies was significantly higher when compared with just the α (P = .01) and β (P = .003) gene disorders. However, the error rate for the overall compound α/β-globin interpretation, although high at 23%, was not statistically significant when compared with just the α- or β-globin chain disorders. In repeat testing of the variants, there was no consistent improvement in performance.

Conclusions.—: The program participants demonstrated variable performance with one-third of the surveys exceeding the 20% error rate. The error rate for compound hemoglobinopathies was even higher. Our data illustrate a critical need for continuing educational efforts with an algorithmic approach to hemoglobin disorders.

上下文。美国病理学家血液学和临床显微镜委员会实施了一项血红蛋白病熟练程度测试和教育计划,以监测和评估参与实验室的表现。-:评价2005 - 2023年血红蛋白病临床实验室能力检验的表现。血红蛋白病挑战由临床病例总结和电泳和色谱凝胶和示踪图像组成。参与者被要求确定(1)什么血红蛋白链受到影响,(2)血红蛋白病的诊断结果。-:每年共有365至676个实验室参加能力测试计划。总体而言,确定受影响的珠蛋白链和诊断血红蛋白病的错误率分别为0.6%至56.5%和0.5%至86.5%。66例血红蛋白病中有23例(34.8%)的误差率超过20%的共识阈值。复合血红蛋白病的基因检测错误率显著高于单纯α (P = 0.01)和β (P = 0.003)基因疾病。然而,整体复合α/β-珠蛋白解释的错误率虽然高达23%,但与α-或β-珠蛋白链紊乱相比,没有统计学意义。在对这些变体的重复测试中,性能并没有持续的提高。-:项目参与者表现出不同的表现,三分之一的调查错误率超过20%。复合型血红蛋白病的错误率更高。我们的数据表明,迫切需要继续教育努力与算法的方法,以血红蛋白疾病。
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引用次数: 0
Concomitant Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma and Non-Immunoglobulin M Plasma Cell Neoplasm. 合并Waldenström巨球蛋白血症/淋巴浆细胞性淋巴瘤和非免疫球蛋白M浆细胞肿瘤。
Pub Date : 2025-01-13 DOI: 10.5858/arpa.2024-0270-OA
Yue Zhao, Philip Petersen, Sophie Stuart, Jiaqi He, Yaping Ju, Luis F Carrillo, Eric D Carlsen, Yi Xie, Alireza Ghezavati, Imran Siddiqi, Ling Zhang, Endi Wang

Context.—: The co-occurrence of plasma cell neoplasm (PCN) and lymphoplasmacytic lymphoma (LPL) is rare, and their clonal relationship remains unclear.

Objective.—: To evaluate the clinicopathologic characteristics of concomitant LPL/PCN.

Design.—: Retrospectively analyzed clinical and laboratory data of 14 cases.

Results.—: Three patients initially presented with immunoglobulin (Ig) M paraprotein, 1 with IgG paraprotein, and 10 had simultaneous diagnoses of PCN and LPL. In 13 cases, flow cytometry detected both LPL and PCN in marrow biopsies. Furthermore, immunohistochemistry highlighted the 2 neoplastic populations, demonstrating an increased proportion of plasma cells and their expression of cyclin D1, CD56, and/or a non-IgM isotype restriction. All cases exhibited discordant heavy-chain isotypes between LPL and PCN. Thirteen of the 14 cases (92.9%) had concordant light-chain restrictions between the 2 neoplasms, and the remaining case (7.1%) showed discordant light-chain restrictions. Of the 12 patients with follow-up, 5 were treated with myeloma regimens, 2 with LPL regimens, 3 with combined therapy, and 2 with observation alone. Follow-up ranged from 2 to 146 months (median, 12.5 months). One patient died of PCN progression, one died of comorbidity, and 10 patients were alive with or without disease. Survival analysis showed no significant difference from the control.

Conclusions.—: The discordant heavy-chain isotype restrictions between PCN and LPL suggest biclonal B-cell neoplasms, which is supported by PCN's phenotypic distinction, such as the expression of cyclin D1 and/or CD56. However, our series exhibited a tendency toward concordant light-chain restrictions between the 2 neoplasms, raising the possibility that PCN may evolve from LPL through class switching.

背景浆细胞瘤(PCN)和淋巴浆细胞性淋巴瘤(LPL)同时出现的情况非常罕见,它们之间的克隆关系仍不清楚:评估LPL/PCN并发症的临床病理特征:回顾性分析14例患者的临床和实验室数据:3例患者最初表现为免疫球蛋白(Ig)M副蛋白,1例为IgG副蛋白,10例同时诊断为PCN和LPL。在 13 例患者中,流式细胞术在骨髓活检中检测到了 LPL 和 PCN。此外,免疫组化也突出了这两种肿瘤细胞群,显示浆细胞比例增加,并表达细胞周期蛋白 D1、CD56 和/或非 IgM 同型限制。所有病例均显示 LPL 和 PCN 的重链同型不一致。14 例中有 13 例(92.9%)两种肿瘤的轻链限制一致,其余一例(7.1%)表现出不一致的轻链限制。在随访的12名患者中,5人接受了骨髓瘤治疗方案,2人接受了LPL治疗方案,3人接受了联合治疗,2人仅接受了观察。随访时间从 2 个月到 146 个月不等(中位数为 12.5 个月)。一名患者死于 PCN 进展,一名死于合并症,10 名患者有病或无病存活。生存期分析表明,与对照组相比没有明显差异:PCN和LPL之间不一致的重链同型限制提示为双克隆B细胞肿瘤,PCN的表型区分(如细胞周期蛋白D1和/或CD56的表达)也支持这一结论。然而,我们的系列研究显示,这两种肿瘤之间的轻链限制趋于一致,这就提出了 PCN 可能是通过类别转换从 LPL 演变而来的可能性。
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引用次数: 0
Improved Performance on Longitudinal Knowledge Assessment in Continuing Certification: The ABPath CertLink Strategy. 持续认证中纵向知识评估的改进绩效:ABPath CertLink策略。
Pub Date : 2025-01-13 DOI: 10.5858/arpa.2024-0318-OA
Gary W Procop, Tyler Sandersfeld, Ty McCarthy, Ritu Nayar

Context.—: All member boards of the American Board of Medical Specialties have continuing certification (ie, maintenance of certification) programs. The efficacy of these programs has been questioned and, therefore, warrants study.

Objective.—: To determine if the American Board of Pathology CertLink program, as structured, is associated with an improvement in the performance of participants on the assessment of content that was previously missed (ie, inaccurately answered).

Design.—: We reviewed the performance of American Board of Pathology CertLink participants from January 2022 through December 2023 on the readministration of the content from 110 036 multiple-choice items that were previously missed by the participants in a program with enhanced learning strategies and incentives.

Results.—: The correct response rate upon the assessment of readministered content that was previously missed increased from 0% to 62.2% (68 394 of 110 036), which exceeds that which would be achieved by guessing (P < .001).

Conclusions.—: The American Board of Pathology CertLink program, which incentivizes learning and was constructed from adult learning principles and modern educational precepts to improve knowledge retention, interrupt forgetting, and introduce practice-relevant content, is associated with an improvement in the performance of diplomates on continuing certification knowledge assessments.

上下文。-:美国医学专业委员会的所有成员委员会都有持续认证(即维护认证)计划。这些项目的有效性受到质疑,因此值得研究。-:确定美国病理委员会CertLink项目的结构是否与参与者在评估之前遗漏的内容(即回答不准确)方面的表现改善有关。-:我们回顾了美国病理委员会CertLink参与者在2022年1月至2023年12月期间对110 036个选择题内容的重新管理表现,这些选择题是之前参与者在强化学习策略和激励计划中错过的。-:对先前遗漏的补药内容进行评估的正确回复率从0%提高到62.2%(11036例中的68394例),超过了通过猜测获得的结果(P < 0.001)。-:美国病理学委员会CertLink计划,激励学习,根据成人学习原则和现代教育原则构建,以提高知识保留,中断遗忘,并引入与实践相关的内容,与提高外交官在持续认证知识评估中的表现有关。
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引用次数: 0
The Effect of Window Size on Pathologists' Search for Rare Elements in a Digital Pathology Setting. 窗口大小对病理学家在数字病理设置中搜索稀有元素的影响。
Pub Date : 2025-01-02 DOI: 10.5858/arpa.2024-0378-OA
Alana Lopes, Sean Rasmussen, Bojana Djordjevic, Jose A Gomez, Maria Florencia Mora, Anurag Sharma, Joanna C Walsh, Bret Wehrli, Aaron D Ward, Matthew J Cecchini

Context.—: Digital pathology requires pathologists to assess tissue digitally rather than on an analog microscope, which has been the mainstay tool for tissue assessment for more than a century. The impact of different digital interaction configurations on pathologists' performance is not well understood. This work focuses on the impact of the display window size for diagnostic assessment.

Objective.—: To determine the effect of digital image viewer window size on pathologists' diagnostic performance when searching for tumors in lymph nodes while under a time limit.

Design.—: Six pathologists assessed 8 breast lymph node whole slide images using 4 digital image viewer window sizes (8, 14, 24, and 32 inches) for tumors in lymph nodes while under a time limit. Eye-gaze data were collected. Pathologists were subsequently asked to rate their preference of window sizes.

Results.—: The fraction of window not covered with foveated vision was significantly associated with window size ranging from 43% for 32 inches to 5% for 8 inches (P < .001). There was no statistically significant relationship between the number of false negatives or assessment time and window size (P = .21 and P = .28, respectively). The distance traversed per panning instance ranged from 301 pixels for 32-inch to 193 pixels for 8-inch windows (P = .002). All pathologists preferred the largest window size as it provided more context for diagnostic assessment.

Conclusions.—: Window size does not significantly affect pathologists' diagnostic performance when searching for tumors in lymph nodes. However, pathologists adapted their slide navigation approach to accommodate the amount of context the window size permitted.

上下文。数字病理学要求病理学家以数字方式评估组织,而不是在模拟显微镜上,一个多世纪以来,模拟显微镜一直是组织评估的主要工具。不同数字交互配置对病理学家表现的影响尚不清楚。本工作主要研究显示窗口大小对诊断评估的影响。-:确定数字图像查看器窗口大小对病理学家在一定时间内搜索淋巴结肿瘤诊断性能的影响。-: 6名病理学家在限定时间内使用4种数字图像查看器窗口尺寸(8、14、24和32英寸)评估8张乳腺淋巴结全切片图像。收集眼球注视数据。病理学家随后被要求评价他们对窗口大小的偏好。-:未被注视视力覆盖的窗户比例与窗户尺寸显著相关,范围从32英寸的43%到8英寸的5% (P < 0.001)。假阴性数或评估时间与窗口大小之间无统计学意义(P = 0.21和P = 0.28)。每个平移实例遍历的距离从32英寸的301像素到8英寸窗口的193像素不等(P = 0.002)。所有病理学家都倾向于选择最大的窗口大小,因为它为诊断评估提供了更多的背景。-:窗口大小对病理学家寻找淋巴结肿瘤的诊断效果无显著影响。然而,病理学家调整了他们的幻灯片导航方法,以适应窗口大小允许的上下文数量。
{"title":"The Effect of Window Size on Pathologists' Search for Rare Elements in a Digital Pathology Setting.","authors":"Alana Lopes, Sean Rasmussen, Bojana Djordjevic, Jose A Gomez, Maria Florencia Mora, Anurag Sharma, Joanna C Walsh, Bret Wehrli, Aaron D Ward, Matthew J Cecchini","doi":"10.5858/arpa.2024-0378-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0378-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Digital pathology requires pathologists to assess tissue digitally rather than on an analog microscope, which has been the mainstay tool for tissue assessment for more than a century. The impact of different digital interaction configurations on pathologists' performance is not well understood. This work focuses on the impact of the display window size for diagnostic assessment.</p><p><strong>Objective.—: </strong>To determine the effect of digital image viewer window size on pathologists' diagnostic performance when searching for tumors in lymph nodes while under a time limit.</p><p><strong>Design.—: </strong>Six pathologists assessed 8 breast lymph node whole slide images using 4 digital image viewer window sizes (8, 14, 24, and 32 inches) for tumors in lymph nodes while under a time limit. Eye-gaze data were collected. Pathologists were subsequently asked to rate their preference of window sizes.</p><p><strong>Results.—: </strong>The fraction of window not covered with foveated vision was significantly associated with window size ranging from 43% for 32 inches to 5% for 8 inches (P < .001). There was no statistically significant relationship between the number of false negatives or assessment time and window size (P = .21 and P = .28, respectively). The distance traversed per panning instance ranged from 301 pixels for 32-inch to 193 pixels for 8-inch windows (P = .002). All pathologists preferred the largest window size as it provided more context for diagnostic assessment.</p><p><strong>Conclusions.—: </strong>Window size does not significantly affect pathologists' diagnostic performance when searching for tumors in lymph nodes. However, pathologists adapted their slide navigation approach to accommodate the amount of context the window size permitted.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924170","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}
引用次数: 0
Plexiform Fibromyxoma. Plexiform Fibromyxoma .
Pub Date : 2025-01-02 DOI: 10.5858/arpa.2024-0254-RA
Julianne Szczepanski, Maria Westerhoff, Shula Schechter

Context.—: Plexiform fibromyxomas are uncommon gastrointestinal neoplasms that have histologic and molecular features that overlap with other gastrointestinal mesenchymal tumors and present a diagnostic challenge for surgical pathologists.

Objective.—: To provide a review of the clinicopathologic, morphologic, immunohistochemical, and molecular features of plexiform fibromyxomas, with a brief discussion of key features that aid in differential diagnosis.

Data sources.—: Analysis of the pertinent literature (PubMed) and clinical practice experience based on institutional and consultation materials.

Conclusions.—: Plexiform fibromyxoma is a rare benign gastrointestinal mesenchymal tumor. Diagnosis is primarily based on morphology, immunohistochemistry, and the exclusion of other gastrointestinal mesenchymal tumors from the differential diagnosis.

上下文。丛状纤维黏液瘤是一种罕见的胃肠道肿瘤,其组织学和分子特征与其他胃肠道间质肿瘤重叠,是外科病理学家诊断的一个挑战。综述丛状纤维黏液瘤的临床病理、形态学、免疫组织化学和分子特征,并简要讨论有助于鉴别诊断的关键特征。数据源。-:对相关文献(PubMed)和基于机构和咨询材料的临床实践经验进行分析。丛状纤维黏液瘤是一种罕见的良性胃肠道间质肿瘤。诊断主要基于形态学,免疫组织化学,并从鉴别诊断中排除其他胃肠道间质肿瘤。
{"title":"Plexiform Fibromyxoma.","authors":"Julianne Szczepanski, Maria Westerhoff, Shula Schechter","doi":"10.5858/arpa.2024-0254-RA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0254-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Plexiform fibromyxomas are uncommon gastrointestinal neoplasms that have histologic and molecular features that overlap with other gastrointestinal mesenchymal tumors and present a diagnostic challenge for surgical pathologists.</p><p><strong>Objective.—: </strong>To provide a review of the clinicopathologic, morphologic, immunohistochemical, and molecular features of plexiform fibromyxomas, with a brief discussion of key features that aid in differential diagnosis.</p><p><strong>Data sources.—: </strong>Analysis of the pertinent literature (PubMed) and clinical practice experience based on institutional and consultation materials.</p><p><strong>Conclusions.—: </strong>Plexiform fibromyxoma is a rare benign gastrointestinal mesenchymal tumor. Diagnosis is primarily based on morphology, immunohistochemistry, and the exclusion of other gastrointestinal mesenchymal tumors from the differential diagnosis.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916507","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}
引用次数: 0
Age- and Sex-Dynamic Fluctuations and Reference Intervals for Alkaline Phosphatase Among the Spanish Population. 西班牙人口碱性磷酸酶的年龄和性别动态波动及参考区间。
Pub Date : 2025-01-01 DOI: 10.5858/arpa.2023-0335-OA
Laura Castells Vilella, Paula Sánchez-Pintos, José Félix Muñiz Llama, Matías Gámez Martínez, María Luz Couce, Jordi Antón

Context.—: Interpretation of alkaline phosphatase (ALP) activity is essential for the diagnosis of certain diseases. ALP changes during life and may vary between different populations.

Objective.—: To establish reference intervals (RIs) and percentile charts for ALP activity in the Spanish population through a multicentric observational study and to compare the RIs to those defined in other countries.

Design.—: A total of 662 350 ALP measurements from individuals ages 0 to 99 years from 9 Spanish tertiary care centers collected between 2020 and 2022 were analyzed. This study is the largest published on this topic in the literature to date.

Results.—: Continuous percentile charts for ALP according to sex and age were established which can be used as RIs. Higher levels are reached during the first weeks of life. In puberty, a differential evolution is observed in both sexes, reaching a peak at 10 to 13 years of age in boys and remaining stable in girls at this age. Significant differences were also observed in adults, higher in men between ages 20 and 49 years and between ages 50 and 79 years in women, as reported in some countries.

Conclusions.—: ALP activity follows an age- and sex-dependent fluctuation with geographic differences. It is important to have appropriate reference values for each population in order to allow for a correct diagnostic interpretation and early diagnosis of diseases related to ALP abnormalities.

背景解读碱性磷酸酶(ALP)活性对诊断某些疾病至关重要。ALP 在人的一生中会发生变化,在不同人群中也会有所不同:通过一项多中心观察研究,确定西班牙人群中 ALP 活性的参考区间(RIs)和百分位图,并将 RIs 与其他国家确定的 RIs 进行比较:分析了 2020 年至 2022 年期间从西班牙 9 个三级医疗中心收集的 0 至 99 岁人群的 662 350 次 ALP 测量结果。这项研究是迄今为止发表的文献中规模最大的一项研究:根据性别和年龄建立了连续的 ALP 百分位图,可用作相关指数。生命最初几周的ALP水平较高。在青春期,男女两性的变化有所不同,男孩在 10-13 岁时达到峰值,而女孩在这个年龄段保持稳定。在成人中也观察到显著差异,如一些国家报告的那样,男性在 20 至 49 岁之间,女性在 50 至 79 岁之间,ALP 活性较高:结论:ALP 活性随年龄和性别波动,并存在地域差异。重要的是,每个人群都要有适当的参考值,以便正确诊断和早期诊断与 ALP 异常有关的疾病。
{"title":"Age- and Sex-Dynamic Fluctuations and Reference Intervals for Alkaline Phosphatase Among the Spanish Population.","authors":"Laura Castells Vilella, Paula Sánchez-Pintos, José Félix Muñiz Llama, Matías Gámez Martínez, María Luz Couce, Jordi Antón","doi":"10.5858/arpa.2023-0335-OA","DOIUrl":"10.5858/arpa.2023-0335-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Interpretation of alkaline phosphatase (ALP) activity is essential for the diagnosis of certain diseases. ALP changes during life and may vary between different populations.</p><p><strong>Objective.—: </strong>To establish reference intervals (RIs) and percentile charts for ALP activity in the Spanish population through a multicentric observational study and to compare the RIs to those defined in other countries.</p><p><strong>Design.—: </strong>A total of 662 350 ALP measurements from individuals ages 0 to 99 years from 9 Spanish tertiary care centers collected between 2020 and 2022 were analyzed. This study is the largest published on this topic in the literature to date.</p><p><strong>Results.—: </strong>Continuous percentile charts for ALP according to sex and age were established which can be used as RIs. Higher levels are reached during the first weeks of life. In puberty, a differential evolution is observed in both sexes, reaching a peak at 10 to 13 years of age in boys and remaining stable in girls at this age. Significant differences were also observed in adults, higher in men between ages 20 and 49 years and between ages 50 and 79 years in women, as reported in some countries.</p><p><strong>Conclusions.—: </strong>ALP activity follows an age- and sex-dependent fluctuation with geographic differences. It is important to have appropriate reference values for each population in order to allow for a correct diagnostic interpretation and early diagnosis of diseases related to ALP abnormalities.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"e19-e25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155940","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}
引用次数: 0
Tissue Prior to the Initial Hematoxylin-Eosin Section Demonstrates Value as an Alternative Source of DNA for Molecular Testing. 在初始苏木精-伊红切片之前的组织证明了作为分子测试DNA的替代来源的价值。
Pub Date : 2024-12-31 DOI: 10.5858/arpa.2024-0222-OA
Peter Sabatini, Robert Ta, Melanie Peralta, Melanie Anderson, Shehnaz Khan, Rosetta Belcastro, Andrea Arruda, Mark David Minden, Michael Cabanero, Anca Prica, Tong Zhang, Robert Kridel, Tracy Stockley, Daniel Xia

Context.—: Small biopsies are used for histologic, immunophenotypic, cytogenetic, molecular genetic, and other ancillary studies. Occasionally, this diagnostic tissue is exhausted before molecular testing can be performed.

Objective.—: To investigate a simple banking protocol for currently discarded tissues trimmed off prior to the initial hematoxylin-eosin section, as an alternative source of DNA for molecular studies.

Design.—: Mock biopsies of lung adenocarcinomas, benign testes, and B-cell lymphomas were constructed from biobank blocks; these simulated biopsies were assessed via epidermal growth factor receptor (EGFR) p.L858R droplet digital polymerase chain reaction (PCR), Biomed B-cell clonality testing by PCR, or a custom next-generation sequencing panel for lymphomas. For each cancer mock biopsy, DNA amounts and molecular test results from the "trimmings" samples were compared to data from corresponding molecular samples acquired via a "standard" clinical protocol.

Results.—: The data show that although trimmings samples usually contained less DNA than standard samples, both sample classes generally had sufficient DNA for testing and produced essentially identical molecular results. A single sample showed low-level carryover contamination on droplet digital PCR testing.

Conclusions.—: Tissue trimmings banked by using the studied protocol demonstrated value as a potential alternative sample for molecular testing.

上下文。小型活组织检查用于组织学、免疫表型、细胞遗传学、分子遗传学和其他辅助研究。有时,在进行分子检测之前,该诊断组织已耗尽。-:研究一种简单的储存方案,用于在初始苏木精-伊红切片之前修剪的当前丢弃的组织,作为分子研究的另一种DNA来源。-:利用生物库块构建肺腺癌、良性睾丸和b细胞淋巴瘤的模拟活检;这些模拟活检通过表皮生长因子受体(EGFR) p.L858R液滴数字聚合酶链反应(PCR)、Biomed b细胞克隆检测或定制的下一代淋巴瘤测序面板进行评估。对于每个癌症模拟活检,将“修剪”样本的DNA数量和分子检测结果与通过“标准”临床方案获得的相应分子样本的数据进行比较。-:数据显示,虽然修剪样品通常比标准样品含有更少的DNA,但两类样品通常具有足够的DNA进行测试,并产生基本相同的分子结果。单个样品在液滴数字PCR检测中显示出低水平的携带性污染。-:使用所研究的方案储存的组织切屑显示了作为分子测试的潜在替代样品的价值。
{"title":"Tissue Prior to the Initial Hematoxylin-Eosin Section Demonstrates Value as an Alternative Source of DNA for Molecular Testing.","authors":"Peter Sabatini, Robert Ta, Melanie Peralta, Melanie Anderson, Shehnaz Khan, Rosetta Belcastro, Andrea Arruda, Mark David Minden, Michael Cabanero, Anca Prica, Tong Zhang, Robert Kridel, Tracy Stockley, Daniel Xia","doi":"10.5858/arpa.2024-0222-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0222-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Small biopsies are used for histologic, immunophenotypic, cytogenetic, molecular genetic, and other ancillary studies. Occasionally, this diagnostic tissue is exhausted before molecular testing can be performed.</p><p><strong>Objective.—: </strong>To investigate a simple banking protocol for currently discarded tissues trimmed off prior to the initial hematoxylin-eosin section, as an alternative source of DNA for molecular studies.</p><p><strong>Design.—: </strong>Mock biopsies of lung adenocarcinomas, benign testes, and B-cell lymphomas were constructed from biobank blocks; these simulated biopsies were assessed via epidermal growth factor receptor (EGFR) p.L858R droplet digital polymerase chain reaction (PCR), Biomed B-cell clonality testing by PCR, or a custom next-generation sequencing panel for lymphomas. For each cancer mock biopsy, DNA amounts and molecular test results from the \"trimmings\" samples were compared to data from corresponding molecular samples acquired via a \"standard\" clinical protocol.</p><p><strong>Results.—: </strong>The data show that although trimmings samples usually contained less DNA than standard samples, both sample classes generally had sufficient DNA for testing and produced essentially identical molecular results. A single sample showed low-level carryover contamination on droplet digital PCR testing.</p><p><strong>Conclusions.—: </strong>Tissue trimmings banked by using the studied protocol demonstrated value as a potential alternative sample for molecular testing.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960251","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}
引用次数: 0
Prognostic Implications of the Bethesda System in Fine-Needle Aspiration for Follicular Thyroid Carcinoma. Bethesda系统细针穿刺治疗滤泡性甲状腺癌的预后意义。
Pub Date : 2024-12-30 DOI: 10.5858/arpa.2024-0304-OA
Hyunju Park, Young Lyun Oh, Myoung Kyoung Kim, Soo Yeon Hahn, Jun-Ho Choe, Man Ki Chung, Bogyeong Han, Sun Wook Kim, Jae Hoon Chung, Tae Hyuk Kim

Context.—: Fine-needle aspiration is an effective tool for sampling thyroid nodules; its results are classified according to the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), whose categories define malignancy risks.

Objective.—: To compare the histologic outcomes and disease-free survival (DFS) with the preceding BSRTC categories, we hypothesized that the initial cytologic categories may reflect long-term outcomes in follicular thyroid carcinoma (FTC), similar to those observed in papillary thyroid carcinoma.

Design.—: This retrospective study enrolled 134 patients with FTC who underwent preoperative cytology between April 2011 and December 2020. Results were classified into 6 categories according to the BSRTC: nondiagnostic, benign, atypia of uncertain significance (AUS), follicular neoplasm (FN), suspicious for malignancy, or malignant.

Results.—: Overall, 8 of 134 patients (6.0%) were categorized as having a nondiagnostic FTC, 35 of 134 (26.1%) as benign, 51 of 134 (38.1%) as AUS, and 40 of 134 (29.9%) as FN. No lesions were classified as suspicious for malignancy or malignant. The nondiagnostic, AUS, and FN categories were associated with a progressively higher risk of vascular invasion, disease recurrence, and high-risk FTC, based on the 2022 World Health Organization classification (P for trend = .01, .01, and .01, respectively). Disease-free survival was lower in the FN group (log-rank P = .01).

Conclusions.—: The initial BSRTC results may reflect not only the risk of malignancy but also the presence of vascular invasion and poor prognosis when the thyroid nodule is diagnosed as FTC. These results may provide prognostic information for therapeutic decision-making and clinical management of FTC.

上下文。-:细针穿刺是甲状腺结节取样的有效工具;其结果根据Bethesda甲状腺细胞病理学报告系统(BSRTC)进行分类,其分类定义了恶性肿瘤风险。为了比较组织学结果和无病生存期(DFS)与之前的BSRTC分类,我们假设初始细胞学分类可能反映滤泡性甲状腺癌(FTC)的长期结果,类似于甲状腺乳头状癌的观察结果。-:这项回顾性研究纳入了134例FTC患者,他们在2011年4月至2020年12月期间接受了术前细胞学检查。结果根据BSRTC分为6类:非诊断性、良性、意义不确定异型(AUS)、滤泡性肿瘤(FN)、可疑恶性、恶性。总体而言,134例患者中有8例(6.0%)被归类为非诊断性FTC, 35例(26.1%)为良性,51例(38.1%)为AUS, 40例(29.9%)为FN。未发现可疑恶性或恶性病变。根据2022年世界卫生组织的分类,非诊断性、AUS和FN分类与血管侵犯、疾病复发和高风险FTC的风险逐渐升高相关(趋势P分别= 0.01、0.01和0.01)。FN组无病生存率较低(log-rank P = 0.01)。-:当甲状腺结节被诊断为FTC时,最初的BSRTC结果可能不仅反映了恶性肿瘤的风险,还反映了存在血管侵犯和预后不良。这些结果可为FTC的治疗决策和临床管理提供预后信息。
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引用次数: 0
In Reply to Letter from Parkash and Smith. 回复 Parkash 和 Smith 的来信。
Pub Date : 2024-12-30 DOI: 10.5858/arpa.2024-0417-LE
Albert Mason, Megan E Dumas
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引用次数: 0
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Archives of pathology & laboratory medicine
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