Fetal Tissue Procurement for Karyotype Analysis: Clinician or Pathologist - Which is Better?

Unlabelled: Chromosomal abnormalities are detected in up to 13% of stillbirths and over 20% of those with developmental anomalies. These estimates may be low since up to 50% of samples fail to achieve a result due to microbial overgrowth or nonviability. Tissue for cytogenetics can be procured at bedside by the clinician or by the pathologist in the laboratory.

Urothelial Superior Vena Cava Syndrome with Limited Response to Radiation Therapy.

Radiation therapy (RT) is the standard of care for cases of superior vena cava (SVC) syndrome secondary to metastatic adenopathy. Histologies vary in radiosensitivity and response time, making alternative therapies such as chemotherapy and/or intravenous stenting preferable alternative options for certain diagnoses. Metastatic urothelial carcinoma is a particularly rare cause of SVC syndrome with only 3 cases reported in the literature.

Tubocutaneous fistula in a premature infant.

Fistulous tracts between the uterus and skin were more common in the preantibiotic era and most often occurred after pelvic surgery. Tubocutaneous fistulas constituted a subset of this form of operative complication. With the improvement of operative techniques and use of antibiotics, the incidence of these fistulas is greatly reduced.

What is adequate sampling of extraplacental membranes?: a randomized, prospective analysis.

Context: It is the generally accepted practice to submit 1 or 2 membrane rolls when examining placentas.

Objective: To determine whether obtaining additional sections would increase diagnostic yield and, if so, to what degree.

Design: A membrane roll section was prospectively procured from each quadrant of its respective singleton placenta.

Detection of occult sentinel lymph node micrometastases by immunohistochemistry in breast cancer. An NSABP protocol B-32 quality assurance study.

Background: Occult metastases, by definition, are not detected on initial examination. They may be present on slides but missed during screening or may be present in paraffin embedded tissue blocks and undetected without additional levels. Anticytokeratin immunohistochemistry (CK IHC) enhances detection of occult metastases, particularly micrometastases (> 0.

Significance of perivillous fibrin/oid deposition in uterine evacuation specimens.

A small proportion of miscarriage specimens obtained by uterine evacuation exhibit increased perivillous fibrin/oid deposition (PVFD). To understand the significance of this finding, the authors reviewed cases from 5/20/02 to 11/10/04 in which surgical pathologists recognized this finding and documented it in their reports. Of 55 cases initially collected, 29 contained at least 30 villi on the slide with at least 50% of villi showing adherent fibrin/oid, and showed no molar change or extensive coagulative necrosis.

Cutting injuries in an academic pathology department.

Context: Cutting injuries pose an infrequent but serious threat to anatomic pathology personnel. Although cut-resistant gloves may reduce this danger, it is imperative to recognize specific behaviors that increase the chance of an injury.

Objective: To examine the incidence of cutting injuries in an academic pathology department and the mechanisms by which such injuries occurred.

The protein C system in placental massive perivillous fibrin deposition.

Massive perivillous fibrin deposition (MPFD) is associated with intrauterine growth retardation and first-trimester and second-trimester spontaneous abortion. Histologically, villi near the maternal interface are completely surrounded by fibrinoid material. This work compared the expression of thrombomodulin (TM) and endothelial protein C receptor (EPCR) in early miscarriage specimens with and without MPFD.

Maternal vascular underperfusion: nosology and reproducibility of placental reaction patterns.

Placental examination can be a useful tool for specifying the etiology, prognosis, and recurrence risk of pregnancy disorders. The purpose of this study was to test the reliability of a predetermined set of placental reaction patterns seen with maternal vascular underperfusion in the hope that this might provide a useful diagnostic framework for practicing pathologists. Study cases (14 with clinical and pathologic evidence of maternal underperfusion plus 6 controls) were evaluated for the presence or absence of 11 lesions by eight perinatal pathologists.

Prenatal role of the ductus arteriosus in absent pulmonary valve syndrome.

Absent pulmonary valve with ventricular septal defect is associated with ductal agenesis and markedly dilated main and branch pulmonary arteries. The less common variant with intact ventricular septum generally exhibits a patent ductus and smaller branch pulmonary arteries, and may be associated with tricuspid atresia. We identified 7 patients with the prenatal diagnosis of absent pulmonary valve, 5 with ventricular septal defect (Group 1) and 2 with an intact ventricular septum (Group 2).