Abstract:
:We describe the development and testing of a novel pre-sign-out quality assurance tool for case diagnoses that allows for the random review of a percentage of cases by a second pathologist before case verification and release of the final report. The tool incorporates the ability to record and report levels of diagnostic disagreement, reviewers' comments, and steps taken to resolve any discrepancies identified. It is expandable to allow for the review of any percentage of cases in any number of subspecialty or general pathology "benches" and provides a prospective instrument for preventing some serious errors from occurring, thereby potentially affecting patient care in addition to identifying and documenting more general process issues. It can also be used to augment other more conventional methods of quality control such as frozen section/final diagnosis correlation, conference review, and case review before interdisciplinary clinicopathologic sessions. There has been no significant delay in case turnaround time since implementation. Further assessment of the tool's function after full departmental application is underway.
journal_name
Am J Clin Patholjournal_title
American journal of clinical pathologyauthors
Owens SR,Dhir R,Yousem SA,Kelly SM,Piccoli A,Wiehagen L,Lassige K,Parwani AVdoi
10.1309/AJCPLN9DU9LNXSXAsubject
Has Abstractpub_date
2010-06-01 00:00:00pages
836-41issue
6eissn
0002-9173issn
1943-7722pii
133/6/836journal_volume
133pub_type
杂志文章abstract::Estrogen receptor (ER), progesterone receptor (PR), and c-ERBB2 (HER2/neu) are therapeutically and prognostically important markers in the management of breast carcinoma. They are not always analyzed in distant metastatic and locally recurrent breast cancers. We compared immunohistochemical expression in a series of p...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCPJ57FLLJRXKPV
更新日期:2010-03-01 00:00:00
abstract::Pleomorphic adenoma (or benign mixed tumor) of the breast is a rare benign neoplasm that might be misinterpreted both clinically and pathologically as a malignant tumor. The authors present an additional case of this unusual lesion studied by immunohistochemistry, electron microscopy, and flow cytometry. A 77-year-old...
journal_title:American journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1093/ajcp/93.6.795
更新日期:1990-06-01 00:00:00
abstract::HMB45 is a melanoma-specific monoclonal antibody that has found widespread use in diagnostic pathology. Recent reports, however, have suggested that this antibody may cross-react with a small number of carcinomas and other epithelial cells. The authors tested the hypothesis that these latter reports represent examples...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/95.4.454
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVES:Sentinel lymph node (SLN)-based diagnosis in gastric cancers has shown varied sensitivities and false-negative rates in several studies. Application of the reverse transcription-polymerase chain reaction (RT-PCR) in SLN diagnosis has recently been proposed. METHODS:A total of 155 SLNs from 65 patients with ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqw055
更新日期:2016-05-01 00:00:00
abstract::We compared the morphologic findings of different types of marginal zone B-cell lymphoma (MZL) involving the bone marrow (BM), including 18 splenic (SMZL), 6 extranodal (mucosa-associated lymphoid tissue lymphoma), and 6 nodal cases. The median percentage of BM involvement was 15%, and multiple overlapping patterns of...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/HRHQFBFTR8B4LXT4
更新日期:2008-05-01 00:00:00
abstract::We investigated the pathologic significance of ductular reactions in chronic liver diseases with respect to cellular senescence. The expression of senescence-associated markers (p16(INK4a) and p21(WAF1/Cip1)), cell proliferation, cell cycle markers (cyclin D and cyclin A), and neural cell adhesion molecule (NCAM) was ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCPWMX47TREYWZG
更新日期:2010-02-01 00:00:00
abstract::Fifteen cases of low-grade B-cell lymphoma involving unusual extranodal sites have been studied in comparison to cases reported or observed arising in typical mucosa-associated lymphoid tissues. In every case, histopathologic features conformed to those characteristic for lymphomas of mucosa-associated lymphoid tissue...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/96.6.738
更新日期:1991-12-01 00:00:00
abstract::The cases of three patients who had clinical courses and hematologic data consistent with plasma-cell leukemia or a terminal leukemic phase of multiple myeloma are presented. A double Bence Jones protein was demonstrated in the urine of two of the patients. Immunoelectrophoresis and immunofluorescence studies demonstr...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/64.3.410
更新日期:1975-09-01 00:00:00
abstract::A method using the RNA polymerase chain reaction technique to diagnose infection retrospectively using single-stranded RNA enteroviruses in paraffin-embedded tissue blocks is reported. This method takes advantage of extreme sequence conservation in the 5' untranslated region of the enteroviral genome and uses two roun...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/96.5.568
更新日期:1991-11-01 00:00:00
abstract::Fine-needle aspiration (FNA) of thyroid bed (TB) lesions is a common diagnostic modality in monitoring patients for recurrent cancer after a thyroidectomy. To elucidate the value of TB FNA, we reviewed our experience at The Johns Hopkins Hospital, Baltimore, MD. We identified 57 TB FNA specimens from 50 patients. Of t...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCPD60AHRUCMDPF
更新日期:2010-08-01 00:00:00
abstract::Serum creatine kinase (CK) was measured in 515 healthy white women and 28 obligate carriers for Duchenne muscular dystrophy. There was substantial overlap between the control and carrier populations. To analyze the impact of the degree of overlap, the predictive value of a CK result was determined by (1) using sensiti...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/84.5.655
更新日期:1985-11-01 00:00:00
abstract::Hydatidiform moles can be subclassified based on their ploidy. In general, complete moles are diploid, and partial moles are triploid. The standard method for the determination of DNA content is flow cytometric analysis. In this study, the authors investigated whether static cytometric analysis with the CAS 200 Image ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/100.4.451
更新日期:1993-10-01 00:00:00
abstract::Two non-Hodgkin's lymphomas, one a follicular mixed cell type and the other a diffuse large cell type (Working Formulation), appeared 7 and 12 years, respectively, after the initial histopathologic diagnosis of Hodgkin's disease (nodular sclerosis) in an elderly male. The clinicopathologic implications of non-Hodgkin'...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/86.3.370
更新日期:1986-09-01 00:00:00
abstract::Neuroendocrine tumors comprise a family of neoplasms with a wide range of morphologic, functional, and behavioral characteristics. Their diagnosis depends on the recognition of characteristic morphologic features and on the presence of markers indicative of neuroendocrine differentiation. Neuroendocrine tumors can be ...
journal_title:American journal of clinical pathology
pub_type: 历史文章,杂志文章,评审
doi:10.1309/7GR5-L7YW-3G78-LDJ6
更新日期:2001-06-01 00:00:00
abstract::The blood counts and lactic dehydrogenase values of eight patients with thrombotic thrombocytopenic purpura (TTP) were reviewed in relation to the clinical course. Three of the eight patients died. In these patients, the hemoglobin was significantly lower and the LDH higher at the time of presentation than that of the...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/80.5.700
更新日期:1983-11-01 00:00:00
abstract:OBJECTIVES:B-lymphoblastic leukemia (B-LBL) arising in patients with chronic lymphocytic leukemia (CLL) is exceedingly rare and poorly characterized. METHODS:We describe four patients with CLL and concurrent or subsequent B-LBL diagnosed by morphologic, immunophenotypic, cytogenetic, and molecular analysis and reviewe...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCPXE5VMONMVLZ0
更新日期:2015-08-01 00:00:00
abstract::Monoclonal immunoradiometric assays (IRMA) for human chorionic gonadotropin (hCG) are available for either intact hCG (IhCG) or beta subunit hCG (beta hCG). The authors evaluated the clinical applications of both methods. Serum samples (N = 180) were divided into the following five clinical groups: Group 1: elevated l...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/93.3.347
更新日期:1990-03-01 00:00:00
abstract::Determination of urinary homovanillic acid (HVA) is an important analysis to establish the diagnosis and prognosis of neuroblastoma. A method is presented for the determination of this metabolite of dopamine using its reaction with 1-nitroso-2-naphthol and nitrous acid. The method has shown a sensitivity, specificity,...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/87.5.644
更新日期:1987-05-01 00:00:00
abstract::A three-and-a-half-year old boy suffering from streptococcal pneumonia developed hemolytic-uremic syndrome and disseminated intravascular coagulation (DIC). His red blood cells (RBC) were shown to be T- and Tk-activated; serial testing showed his mature RBCs as well as neocytes remained T-activated at 40 days. Anti-T ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/84.2.244
更新日期:1985-08-01 00:00:00
abstract::A 63-year-old white man had simultaneous onset of the Guillain-Barré syndrome and the nephrotic syndrome, three weeks after having an upper respiratory tract infection. Many granular casts were noticed in the urine sediment. Renal biopsy specimens showed early membranous glomerulonephritis and acute interstitial nephr...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/78.4.563
更新日期:1982-10-01 00:00:00
abstract::By studying more than 1,200 patients with cutaneous melanoma and long-term follow-up, I examined the relationship between solar elastosis and age at diagnosis of melanoma, key features of melanoma, and the outcome of overall survival in melanoma. I found that melanomas with elastosis were diagnosed significantly later...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/7MHX96XH3DTY32TQ
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:To examine Hedgehog signaling in cutaneous fibrosing disorders for which effective approved therapies are lacking, expand our knowledge of pathophysiology, and explore the rationale for targeted inhibition. METHODS:Stain intensity and percentage of cells staining for Sonic hedgehog (Shh), Indian hedgehog (I...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqw192
更新日期:2016-12-01 00:00:00
abstract::Few cases of secondary CD5+ diffuse large B-cell lymphoma (DLBCL) that are not Richter syndrome have been reported previously. We report 9 cases of non-Richter syndrome secondary CD5+ DLBCL. Among 529 cases of DLBCL, 38 (7.2%) were CD5+ DLBCL, including 9 of secondary CD5+ DLBCL. Five cases gained CD5 expression durin...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCP58FETFGLCKKW
更新日期:2009-03-01 00:00:00
abstract::Several authors have suggested that a plausible mechanism for variation in reported mean corpuscular volume (MCV) and hematocrit values for Hematology Survey Specimens may be due to the presence of hyperglycemia in the suspending matrix of the specimens, resulting in cell swelling due to an osmotic matrix effect. The ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:
更新日期:1983-10-01 00:00:00
abstract::Using digital cell image analysis performed on Feulgen-stained nuclei, the nuclear characteristics of prostatic neoplasia, ranging from benign (benign prostatic hyperplasia [BPH]), through dysplastic (prostatic intraepithelial neoplasia [PIN] 1-3), to carcinoma were studied. Four histopathologic groups were studied: g...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/96.5.628
更新日期:1991-11-01 00:00:00
abstract::The API-20 Enteric Strip has been proposed to have the capacity to differentiate the nonfermentative gram-negative bacilli. This multitest strip serves as the basis of an evolving system, which first provided a Register, then a Selector, and more recently a computer Index. Twenty-three strains of Pseudomonas aeruginos...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/69.1.41
更新日期:1978-01-01 00:00:00
abstract::Factor V Leiden (FVR506Q) is a genetic defect in the factor V (FV) molecule that confers resistance to proteolysis by activated protein C (APC) and is the most common abnormality detected in patients studied for hereditary thrombophilia. The initial screening test for this abnormality was a comparison of the activated...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/109.4.387
更新日期:1998-04-01 00:00:00
abstract::The amount of trapped plasma in the microhematocrit red blood cell column of samples from 25 normal individuals and 102 patients was investigated. The mean value for the normal individuals was 1.53%, and the mean values for the samples from the patient groups ranged from 1.41% to 1.82%. These groups included patients ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/78.5.770
更新日期:1982-11-01 00:00:00
abstract::An on-line computer-assisted pathology encoding and reportying system (CAPER) has been developed by the Department of Pathology and Laboratory of Computer Science of the Massachusetts General Hospital for a department of surgical pathology that processes more than 25,000 specimens yearly. CAPER performs clerical funct...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/68.6.715
更新日期:1977-12-01 00:00:00
abstract::A flow cytometric technic was developed to detect platelet surface-bound immunoglobulin in patients with thrombocytopenia. Elevated platelet surface IgG and/or IgM was detected in 90.9% of patients with immune thrombocytopenia purpura (ITP). False positive results occurred in 9.3% of patients with nonimmune thrombocyt...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/87.4.518
更新日期:1987-04-01 00:00:00