National society for histotechnology workload study.

In June and July 2021, the National Society for Histotechnology (NSH) conducted an online survey designed to assess productivity and staffing in the clinical histology laboratory. The Productivity Benchmarking Survey was developed by the NSH Quality Management Committee. The survey of histology professionals provides critical data that may be used to inform staffing decisions and develop a quality management program.

National society for histotechnology workload study.

The National Society for Histotechnology (NSH) Quality Management Committee conducted a Workload Study in response to numerous requests by NSH society members for current information examining productivity and staffing in the clinical histology laboratory. Data collection was conducted between October 11 and 9 November 2018 of 15,848 individuals with deliverable email addresses taken from the NSH database (3.6% net email bounce rate).

Bleeding after invasive procedures is rare and unpredicted by platelet counts in cirrhotic patients with thrombocytopenia.

Background: In cirrhotics with low circulating platelets (PLT), restoration of normal cell counts has been traditionally recommended before invasive procedures. However, there is neither consensus on the PLT transfusion threshold nor evidence of its clinical efficacy.

Patients: In order to fill this gap of knowledge, we prospectively collected and analyzed data on circulating PLT counts [and International Normalized Ratio (INR)] values in a case series of 363 cirrhotics scheduled to undergo invasive investigations.

Hepatocellular carcinomas <2 cm in diameter complicating cirrhosis: ultrasound and clinical features in 153 consecutive patients.

Purpose: To determine the frequencies of various echogenicity patterns in 153 consecutive unifocal hepatocellular carcinomas (HCCs) <2 cm detected in cirrhotic livers and to identify their relationships with clinical, laboratory, and microscopic features.

Patients And Methods: The tumors were classified as hypoechoic, hyperechoic, isoechoic, or nodule-in-nodule. Correlation was evaluated between hypoechoic and hyperechoic patterns and the following variables: age, gender, serum alphafetoprotein (AFP), tumor size, ultrasound features of liver parenchyma, cirrhosis etiology, and cyto/histological tumor grading.

Diagnosis of liver nodules observed in chronic liver disease patients during ultrasound screening for early detection of hepatocellular carcinoma.

Objectives: The aim of our study was to evaluate the nature of focal liver lesions detected during the ultrasound follow-up of a population (prevalently anti-hepatitis C virus [anti-HCV] positive) with chronic liver disease.

Methods: The study population consisted of 1827 consecutive newly diagnosed chronic liver disease cases without liver nodules at enrollment. Patients were screened at 4-month intervals by ultrasound and serum alpha-fetoprotein assessment.

Hemangioma-like lesions in chronic liver disease: diagnostic evaluation in patients.

Purpose: To quantify the risk of misdiagnosis of focal hepatic lesions manifesting at ultrasonography (US) as typical hemangiomas in a population at high risk for hepatocellular carcinoma (HCC) and to identify the most effective approach to their diagnostic evaluation.

Materials And Methods: A total of 1,982 patients with newly diagnosed cirrhosis underwent US and serum alpha-fetoprotein determinations for early detection of HCC. Focal lesions with typical features of hemangioma were evaluated with confirmatory findings of contrast material-enhanced dynamic or spiral computed tomography (CT) and/or single photon emission CT with technetium 99m-labeled red blood cells and, in the absence of confirmatory imaging findings, US-guided fine-needle biopsy.

Prognostic factors for survival in patients with compensated cirrhosis and small hepatocellular carcinoma after percutaneous ethanol injection therapy.

Background: The objective of this study was to identify clinical, biochemical, ultrasound, and/or pathologic parameters capable of predicting survival in a cohort of patients with well compensated cirrhosis and small hepatocellular carcinoma (HCC) who were treated with percutaneous ethanol injection (PEI).

Methods: The study group included 111 patients with Child--Pugh Class A cirrhosis and with one (93 patients) or two (18 patients) HCC nodules measuring < 5 cm in greatest dimension. All patients underwent multisession PEI.

Transcatheter arterial chemoembolization for hepatocellular carcinoma in patients with cirrhosis: evaluation of damage to nontumorous liver tissue-long-term prospective study.

Purpose: To evaluate damage to cirrhotic liver tissue after transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).

Materials And Methods: TACE was performed in 111 patients with HCC that involved less than 30% of the liver. Baseline liver function was evaluated with Child-Pugh scores and other indicators.

CA 19-9 production by a cystadenoma with mesenchymal stroma of the common hepatic duct: a case report.

A case of a CA 19-9 producing cystadenoma with mesenchymal stroma originating from the common hepatic duct is presented, with a review of the literature. The findings of ultrasound and CT scans and the endoscopic retrograde cholangiopancreatography picture allowed the establishment of a confident pre-operative diagnosis. Although there was an elevation of CA 19-9 serum levels, the resected specimen did not show any malignant focus at pathologic examination.

Risk factors for intrahepatic recurrence of hepatocellular carcinoma in cirrhotic patients treated by percutaneous ethanol injection.

Background: Hepatocellular carcinoma (HCC) complicating cirrhosis has a high intrahepatic recurrence rate after treatment by surgical resection or percutaneous ethanol injection (PEI). In this study, certain clinical, biochemical, and pathologic parameters were evaluated as risk factors for intrahepatic tumor recurrence in liver segments different from that of the first neoplasm in a group of 57 cirrhotic patients with single HCC < 5 cm treated by PEI.

Methods: After PEI treatment of HCC, the patients were followed for a mean period of 33 +/- 16 months.

Treatment of hepatocellular carcinoma: a single-center experience.

Purpose: The comparative efficacy of transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) in the treatment of hepatocellular carcinoma (HCC) was investigated.

Methods: Two hundred and sixty consecutive patients were retrospectively analyzed: 156 had received between one and six chemoembolization sessions at 3-month intervals, 33 had had PEI, and the remaining 71 patients refused any treatment. The follow-up ranged from 3 to 36 months.

Cytological vs microhistological diagnosis of hepatocellular carcinoma: comparative accuracies in the same fine-needle biopsy specimen.

There is still debate over the relative merits of cytology and histology in diagnosing hepatocellular carcinoma in cirrhotic livers. Previous comparisons of the diagnostic accuracies of these two methods may have been biased by sampling errors due to multiple punctures. We compared the diagnostic accuracies of cytology and microhistology using tissue and cells from the same point in liver nodules subsequently proved to be hepatocellular carcinoma.

Percutaneous biopsy in diffuse liver disease: increasing diagnostic yield and decreasing complication rate by routine ultrasound assessment of puncture site.

Objective: To evaluate the usefulness of routine ultrasound assessment of puncture site before performing percutaneous biopsy in diffuse liver disease. Seven hundred fifty-three consecutive patients were studied retrospectively.

Methods: Serial scanning of the last intercostal spaces allowed us to establish the most suitable access to the thicker liver parenchyma (assessing the most favorable angulation of the needle too), avoiding the puncture of adjacent organs; no more than 1 min was necessary for such a determination.

Free-hand technique with ordinary antisepsis in abdominal US-guided fine-needle punctures: three-year experience.

Purpose: To evaluate the adequacy of ordinary antisepsis in ultrasound (US)-guided free-hand fine-needle puncture.

Materials And Methods: Diagnostic and therapeutic procedures (n = 573) were performed in 456 patients. No puncture attachments, sterile gloves, or drapes or covers were used.

Linkage analysis identifies gene carriers among members of families with hereditary nonpolyposis colorectal cancer.

Background & Aims: Uncertainty about genetic risk in hereditary nonpolyposis colorectal cancer (HNPCC) may lead to unnecessary screening. The aims of this study were to show how gene linkage findings can elucidate who is at risk and requires intensive screening and how cancer control can be enhanced by screening high-risk family members. This information can be useful given the public health magnitude of HNPCC.

[Treatment of primary hepatocarcinoma with chemoembolization and alcohol injection. Personal experience].

The comparative efficacy of transcatheter arterial chemoembolization and percutaneous ethanol injection (PEI) in the treatment of hepatocellular carcinoma (HCC) was investigated in a series of 243 consecutive patients: 146 of them were submitted to 1-6 chemoembolization sessions at 1 and 3 months' intervals and 30 to PEI; the remaining 67 patients refused any treatment. The follow-up ranged 3 to 36 months. Survival rates were statistically analyzed with the life table analysis.

Fine-needle liver biopsy in patients with severely impaired coagulation.

Severe coagulation defects, as reflected by platelet count and prothrombin time, have always been considered a contraindication to needle biopsy of the liver, but there are very limited data on the actual rate of bleeding in patients with such severe alterations and none whatsoever on the bleeding risk associated with newer, fine-gauge needles that produce less trauma to the liver tissue. In addition, there has never been any evidence that platelet count and/or prothrombin time are the most sensitive indices of bleeding risk. This retrospective study of 85 patients, with platelet counts less than 50,000/mm3 and/or prothrombin times less than 50% of controls, subjected to ultrasound-guided fine-needle liver punctures for diagnostic or therapeutic (percutaneous ethanol injection) purposes showed no bleeding episodes after any of the 229 punctures performed.

[Primary hepatocarcinoma. Diagnostic imaging and chemoembolization].

The diagnostic and therapeutic approach by means of transcatheter arterial chemoembolization is analyzed in 100 patients affected with hepatocellular carcinoma (HCC): in all patients the HCC had been diagnosed by means of US-guided fine-needle biopsy: 75 of 100 patients were in Child A class, 24 in Child B and 1 in Child C class. The most sensitive imaging technique to identify HCC proved to be angiography (95%); post-Lipiodol CT was also of great value to stage the disease. The authors suggest a diagnostic-therapeutic approach including angiography and simultaneous chemoembolization right after US-guided biopsy, avoiding conventional CT; such a protocol allows high diagnostic accuracy at a lower cost.

[Clinical experience with thymostimulin (TP-1) therapy. Preliminary findings].

In order to verify the immunostimulant effect of thymus humoral factors, a bovine thymic extract (TP 1-Thymostimulin) was given to 9 patients affected by primary immunodeficiency (mild deficit T/B combined) and to 8 patients affected by acquired immunodeficiency because of old age, lung neoplasm or with recurrent herpes simplex labialis. 6 patients affected by chronic hepatitis HBsAg+ and 1 patient affected by Behçet's syndrome were also studied. At the end of the study, after six months, all the patients with primary or acquired immunodeficiency showed a normalization of their immunological parameters and a clinical improvement.