NILM Pap slides from women 30 years of age and older with positive high-risk HPV DNA. Focused rescreening prior to report issuance, an enhanced quality control measure.

Objectives: Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) regulations specify that at least 10% of negative Papanicolaou (Pap) slides be rescreened as a quality control (QC) measure. With incorporation of human papillomavirus (HPV) DNA testing into screening guidelines for women aged 30 years or older, a population of patients exists who are HPV positive as well as negative for intraepithelial lesion or malignancy (NILM).

Methods: In this 9-month retrospective review with follow-up, 26,501 women 30 years of age and older underwent liquid-based Pap screening with concomitant high-risk HPV DNA testing at CellNetix Pathology and Laboratories, Seattle, WA.

Focused rescreening of NILM Pap slides from women ≥ 30 years of age with positive high risk HPV DNA: an enhanced quality control measure.

CLIA 88 regulations specify that at least 10% of negative for intraepithelial lesion or malignancy (NILM) Paps be rescreened as a means of quality control (QC). With the incorporation of HPV DNA testing into American Society for Colposcopy and Cervical Pathology guidelines for women ≥ 30 years of age, a population of NILM patients with positive HPV results exists. Slides from this cohort were rescreened to judge the value of focused QC.

Impact and outcomes of routine microstaging of sentinel lymph nodes in breast cancer: significance of the pN0(i+) and pN1mi categories.

Background: In 2003, the American Joint Committee on Cancer (AJCC) initiated the 6th edition staging criteria, including pN0(i+) and pN1mi categories for breast cancer. However, the clinical significance of these categories is debated in the literature.

Methods: A prospective registry was used to identify patients staged with sentinel lymph node (SLN) biopsy.

The utility of intraoperative evaluation of sentinel lymph nodes in breast cancer.

Background: In breast cancer treatment, intraoperative sentinel lymph node (SLN) evaluation is used to identify patients who may potentially benefit from immediate completion of axillary lymph node dissection.

Methods: Prospectively collected breast cancer registry data identified 516 SLN biopsies between January 2003 and December 2005. Intraoperative evaluation (IE) of the SLNs was performed in 479 axillae.

Accuracy of intraoperative imprint cytology of sentinel lymph nodes in breast cancer.

Background: In breast cancer treatment, immediate completion of axillary lymph node dissection (ALND) can be performed if the intraoperative sentinel lymph node (SLN) examination is positive. This study evaluates the accuracy of intraoperative imprint cytology (IC) for detecting SLN metastases.

Methods: Pathology reports from 385 SLN biopsy examinations were reviewed retrospectively.

Metaplastic breast cancer: clinical significance.

Background: Metaplastic breast carcinoma (MBC) is a rare poorly differentiated breast cancer characterized by coexistence of ductal carcinoma with areas of matrix producing, spindle-cell, sarcomatous, or squamous differentiation; ER/PR/HER2 negativity; and a reputation for poor outcome.

Methods: The Swedish Cancer Institute prospective breast cancer database (> 6500 patients; 1990-2005) has 24 MBC cases that were compared with typical breast cancer cases matched for age, date of diagnosis, stage, and ER/PR/HER2 status.

Results: The mean metaplastic primary tumor diameter was 2.

Image-guided tissue sampling: where radiology meets pathology.

Image-guided breast tissue sampling has become an acceptable alternative to open surgical biopsy for nonpalpable lesions. Advantages of minimally invasive core biopsy compared to open surgical biopsy include lower cost, lower complication rates, and less cosmetic deformity for patients. However, false-negative core biopsies can occur.

Emerging technologies in surgical planning for breast cancer.

Background: Computer-assisted diagnosis (CAD) has been applied to mammography and chest radiography to improve diagnostic accuracy, and has the potential to improve the accuracy of magnetic resonance imaging (MRI) for detecting nodal metastases in women with newly diagnosed breast cancer.

Methods: Six women with newly diagnosed breast cancer underwent MRI of the breast and axilla. Radiologists applied digital tissue recognition (DTR), a form of CAD, to the MR images to detect nodal metastases.

Association of human papillomavirus with penile carcinoma: a study using polymerase chain reaction and in situ hybridization.

Although carcinoma of the uterine cervix has been shown to be strongly associated with human papillomavirus (HPV) infection, a sexually transmitted disease, similar detailed data are lacking in penile carcinoma. To determine the association of HPV with penile carcinoma, we examined 30 specimens of penile carcinoma from 23 patients by the highly sensitive polymerase chain reaction (PCR) and in situ hybridization assays. We also examined nonneoplastic penile foreskins from 20 adults using the polymerase chain reaction assay.

Semiautomation of preparation of fixed paraffin-embedded tissue for DNA analysis.

The usual manual preparation of single-cell suspensions from fixed paraffin-embedded tissue sections for flow cytometric (FCM) DNA ploidy analysis is a time-consuming, labor-intensive technique that requires 70 minutes to deparaffinize and rehydrate 50 microns sections as the initial step. Manual deparaffinization was compared with two semiautomated methods using an automatic slide stainer with either a 70-minute or 35-minute schedule. Samples from 6 normal tissues and 21 tumors (13 diploid and 8 aneuploid) were prepared using all three methods and analyzed by FCM.

DNA ploidy studies of benign and malignant tumours: comparison of flow cytometry and image analysis techniques using two types of cytological specimen.

DNA ploidy studies were carried out on Feulgen stained smears and cytocentrifuge preparations from 35 malignant tumours and four benign neoplasms using the CAS image analyser. The smears were prepared from scrapings from fresh tumour tissue whereas the cytocentrifuge preparations were prepared from single nuclear suspensions from paraffin-embedded cell blocks from the same tumour. Histograms obtained by image analysis of the tumour scrapes were compared with those obtained on the cytocentrifuge preparations.

Distinction between carcinoma cells and mesothelial cells in serous effusions. Usefulness of immunohistochemistry.

The usefulness of an immunoperoxidase battery to distinguish carcinomatous from benign effusions was examined. Cell block sections from 90 previously diagnosed effusions were stained with antibodies to Leu-M1, B72.3, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and vimentin.

Potential risks in retrovenous revascularization of the myocardium.

Retrovenous perfusion of the myocardium via the coronary sinus and cardiac veins was one of the earliest attempted forms of myocardial revascularization. Although coronary artery revascularization has almost completely replaced venous revascularization as the procedure of choice, the latter approach is still occasionally performed. We present two cases of hemorrhage within viable and nonviable myocardium noted at autopsy in patients who had undergone retrovenous revascularization hours before death.

A 37-pound scrotal leiomyosarcoma: a case report and literature review.

We report a case of a 37-pound scrotal leiomyosarcoma. The literature is reviewed, and the presentation, diagnosis, treatment and survival of patients with scrotal leiomyosarcoma are discussed.