Real world validation of an adjunctive gene expression-profiling assay for melanoma diagnosis and correlation with clinical outcomes at an academic center.

A commercially available diagnostic gene expression profiling (GEP) assay (MyPath™) reportedly has high sensitivity and specificity in distinguishing nevi from melanoma based on manufacturer-conducted studies. However, data regarding the performance of this GEP assay in routine clinical practice are lacking. The purpose of this study was to better assess the real-world performance of GEP in a large academic practice.

Real-Time Telepathology Is Substantially Equivalent to In-Person Intraoperative Frozen Section Diagnosis.

Context.—: Intraoperative diagnosis by frozen section is a mainstay of surgical pathology practice, providing immediate feedback to the surgical team. Despite good accuracy with modern methods, access to intraoperative surgical pathology with an appropriate turnaround time (TAT) has been a limiting factor for small or remote surgical centers, with negative impacts on cost and patient care.

Autoamputation of Dermatofibrosarcoma Protuberans: A Novel and Rare Presentation of a Familiar Entity.

Dermatofibrosarcoma protuberans (DFSP) is categorized as a fibrohistiocytic tumor of intermediate malignant potential. It has significant risk for local recurrence and, less commonly, local or distant metastasis. Initially, these tumors typically arise as a firm plaque on the skin that slowly progresses to a nodular and protuberant dermal lesion.

Complete resolution of erythrodermic psoriasis with first-line apremilast monotherapy.

Erythrodermic psoriasis (EP) is the most serious type of psoriasis with high morbidity and mortality. First-line recommended therapies for EP, cyclosporine and infliximab have significant adverse effects. Cyclosporine increases the risk of hypertension, leucopenia, infections and renal failure.

Gene expression signature as an ancillary method in the diagnosis of desmoplastic melanoma.

Desmoplastic melanoma (DM) is a rare fibrosing variant of melanoma that can be difficult to diagnose. One of the diagnostic challenges is its distinction from a melanocytic nevus with desmoplasia. Here we investigate the use of a 23-gene signature, which has previously been shown to distinguish benign from malignant melanocytic neoplasms.

Pleomorphic fibroma of the skin with MDM2 immunoreactivity: A potential diagnostic pitfall.

Pleomorphic fibroma is a rare benign cutaneous neoplasm characterized by spindle-shaped cells and multinucleated giant cells scattered throughout collagenous stroma. These morphologic features can lead to diagnostic confusion, including atypical lipomatous tumor as one consideration. In contrast to atypical lipomatous tumor, previous studies have found pleomorphic fibroma to be negative for MDM2 immunohistochemical staining and MDM2 gene amplification.

Primary mucinous carcinoma of the skin: the Mayo Clinic experience over the past 2 decades.

Background: Primary mucinous carcinoma of the skin (PMCS) is a rare adnexal eccrine sweat gland neoplasm, often mistaken for metastasis from extracutaneous sites or misdiagnosed. Primary mucinous carcinoma of the skin is a slow-growing tumor with a high recurrence rate after conventional excision.

Objective: To describe clinicopathologic features, rate of recurrence, and metastasis and to review relevant literature.

Iron overload in allogeneic hematopoietic stem cell transplant recipients.

Context: Patients who undergo hematopoietic stem cell transplant are at an increased risk of developing iron overload.

Objectives: To describe the effect of hepatic iron overload on hematopoietic stem cell transplant recipients and to validate the utility of histologic scoring system of iron granules in the liver.

Design: Records of 154 post allogeneic hematopoietic stem cell transplant patients were reviewed.

Discordant Streptococcus agalactiae (Group B streptococcus) gestational infection in monochorionic/diamniotic and dichorionic/diamniotic twins.

Infection due to Streptococcus agalactiae or Group B streptococcus may be acquired during parturition or gestation. Discordant twin gestational Group B streptococcus infections are rarely reported. We describe two cases of fatal discordant gestational Group B streptococcus infection in both a monochorionic/diamniotic pregnancy and in a dichorionic/diamniotic pregnancy.

Naproxen-induced liver injury.

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to induce liver injury. Patterns of the injury usually range from mild elevations of liver enzymes to sometimes severe fulminant hepatic failure. Likewise, naproxen is a propionic acid derivative NSAID that was introduced in 1980 and has been available as an over-the-counter medication since 1994, but has rarely been reported to cause liver injury.

Comparison of time to positivity of the VersaTREK® REDOX 80-mL and the REDOX EZ draw 40-mL blood culture bottles for common bacterial bloodstream pathogens.

The VersaTREK(®) microbial detection system offers 2 media formulations, an aerobic and an anaerobic bottle available in a 40-mL direct draw format and an 80-mL format. The 40-mL EZ Draw(®) bottle can be inoculated with a maximum volume of 5 mL, while the REDOX 80-mL bottle accommodates a 10-mL volume. The effect of volume of blood inoculum on time to positivity (TTP) has not been clearly established with these bottle types.

Misidentification of Pandoraea sputorum isolated from sputum of a patient with cystic fibrosis and review of Pandoraea species infections in transplant patients.

Pandoraea species are considered emerging pathogens in cystic fibrosis (CF) patients, but few data exist regarding outcomes of patients colonized with these organisms. We report a case of Pandoraea sputorum colonization in a CF patient under consideration for lung transplantation and review five cases of lung transplantation involving Pandoraea species.

Desulfovibrio fairfieldensis bacteremia associated with choledocholithiasis and endoscopic retrograde cholangiopancreatography.

Desulfovibrio fairfieldensis is a gram-negative, curved, motile, anaerobic bacillus. D. fairfieldensis has been isolated only from human specimens and is considered a normal resident of the human gastrointestinal tract.

Peritonitis due to Cunninghamella bertholletiae in a patient undergoing continuous ambulatory peritoneal dialysis.

Peritoneal dialysis-associated peritonitis due to fungi of the class Zygomycetes occurs very rarely. A case of fungal continuous ambulatory peritoneal dialysis peritonitis due to Cunninghamella bertholletiae is reported in a 39-year-old Aboriginal woman with end-stage renal failure and diabetes mellitus. This isolate was found to be resistant in vitro to amphotericin B, 5-fluorocytosine, fluconazole, itraconazole, ketoconazole and voriconazole.

Peritonitis due to Curvularia inaequalis in an elderly patient undergoing peritoneal dialysis and a review of six cases of peritonitis associated with other Curvularia spp.

Fungal peritonitis due to Curvularia species in patients undergoing peritoneal dialysis is a very rare problem. We report a case of peritonitis caused by Curvularia inaequalis. This is the first report in the English literature of this species causing human infection.