Abstract:
CONTEXT:The advent of new endoscopic optical techniques is likely to change pathologists' role in diagnosis. OBJECTIVE:To describe how confocal laser endomicroscopy (CLE) works, show its advantages and limitations compared to cytohistologic biopsy, and explore how it may affect the practice of pathology. DATA SOURCES:Literature review. CONCLUSIONS:Confocal laser endomicroscopy is proving its ability to provide histology-like images of tissues in vivo to help avoid risks and costs of conventional biopsies. Confocal imaging restricts light to 1 plane, emulating a paraffin section, and topical or systemic optical contrast agents allow subcellular resolution. New contrast agents could theoretically permit molecular characterization. In vivo imaging has begun to demonstrate novel, dynamic types of diagnostic features. Decreased histologic biopsies can be anticipated for a few scenarios. Significant limitations of CLE include the inability to create a tissue archive for broad molecular classification, suboptimal contrast agents, small fields of view and shallow penetration, paucity of clinical validation studies, and problems with reimbursement. Confocal laser endomicroscopy exposes new opportunities for pathologists: CLE technologies can be exploited in pathology, and diagnostic criteria expanded based on endoscopists' discoveries. Potential synergy exists between CLE and cytology, allowing the low-magnification diagnostic architectural changes by CLE and cytomorphology to emulate the full diagnostic information in a histologic biopsy while providing an archive of material for molecular or immunohistochemical studies. Confocal laser endomicroscopy will decrease some types of biopsies, but offers an opportunity for pathologists to find new ways to provide value and improve patient care.
journal_name
Arch Pathol Lab Medjournal_title
Archives of pathology & laboratory medicineauthors
Paull PE,Hyatt BJ,Wassef W,Fischer AHdoi
10.5858/arpa.2010-0264-RAsubject
Has Abstractpub_date
2011-10-01 00:00:00pages
1343-8issue
10eissn
0003-9985issn
1543-2165journal_volume
135pub_type
杂志文章,评审abstract:CONTEXT:Although much has been said and written about medical error and about error in pathology since the publication of the Institute of Medicine's report on medical error in 1999, precise definitions of what constitutes error in anatomic pathology do not exist for the specialty. Without better definitions, it is imp...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2006)130[604:DEIAP]2.0.CO;2
更新日期:2006-05-01 00:00:00
abstract:CONTEXT:The pathogenesis of respiratory epithelial adenomatoid hamartoma (REAH) and inverted papilloma (IP) is poorly understood, especially compared with sinonasal adenocarcinoma (SNAC). One feature of malignant glandular lesions is loss of the basal/myoepithelial layer. The immunophenotype of the basal/myoepithelial ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2007)131[530:MCICSR]2.0.CO;2
更新日期:2007-04-01 00:00:00
abstract:CONTEXT.—:With increasing use and efficacy of antiretroviral therapy for human immunodeficiency virus (HIV) infection, deaths from acquired immunodeficiency syndrome (AIDS)-defining conditions have decreased. OBJECTIVE.—:To examine trends in the cause of death of HIV-infected patients who underwent autopsy at a major ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.5858/arpa.2019-0144-OA
更新日期:2020-05-01 00:00:00
abstract:CONTEXT:Accreditation Council for Graduate Medical Education guidelines require the evaluation of residents in 6 competencies. Pathology residents demonstrate medical knowledge, patient care, communication, and practice-based learning competencies in their attainment of competency in surgical pathology diagnosis. OBJE...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
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更新日期:2006-02-01 00:00:00
abstract::Pseudomyogenic hemangioendothelioma (PMH) is a rare vascular tumor that presents more frequently in young adults and has a male predominance. It is usually located in the superficial or deep soft tissues of the extremities, but concurrent bone involvement can be present. In approximately two-thirds of patients this di...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.5858/arpa.2018-0395-RS
更新日期:2020-04-01 00:00:00
abstract::We describe a case of a 2-year-old girl with an unusual finding of amorphous hematoxyphilic substance in the pulmonary and myocardial vascular lumina. The patient had a prolonged history of intestinal obstruction necessitating extended periods of total parenteral nutrition. The patient terminally had hypercalcemia wit...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract:CONTEXT:- Current 2013 World Health Organization classification of tumors of soft tissue arranges these tumors into 12 groups according to their histogenesis. Tumor behavior is classified as benign, intermediate (locally aggressive), intermediate (rarely metastasizing), and malignant. In our practice, a general approac...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.5858/arpa.2016-0417-RA
更新日期:2017-08-01 00:00:00
abstract:CONTEXT:Recent discoveries have expanded the spectrum of nonneoplastic pulmonary lymphoproliferative disorders and have provided new insights into their pathogenesis and treatment. OBJECTIVE:To review the thoracic manifestations of immunoglobulin (Ig) G4-related sclerosing disease and summarize current concepts and di...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/1543-2165-134.5.691
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:The term heterotopia, a term derived from Greek, implies "other place." It refers to the finding of normal tissues at foreign sites. Heterotopic gastric tissue rarely involves the large bowel. We report 2 cases of this rare entity. DATA SOURCES:Case reports of 2 patients with sessile polypoid lesion in the r...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/0003-9985(1999)123<0222:SPGHOR>2.0.CO;2
更新日期:1999-03-01 00:00:00
abstract::Primary synovial sarcoma rarely originates in the renal parenchyma. When this occurs, origin of this unusual tumor type has been the subject of debate in the literature, with a suggestion that previously reported cases may be more correctly described as renal cell carcinoma with sarcomatoid dedifferentiation. Synovial...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2005)129<238:PRSSCB>2.0.CO;2
更新日期:2005-02-01 00:00:00
abstract::We describe the pathomorphologic features of 29 autopsy cases of thorium dioxide-related angiosarcoma (AGS) of the liver. The average (+/- SD) latent period after thorium dioxide injection was 36.2 +/- 5.2 years. Macroscopically, thorium dioxide-related AGS was divided into four types as follows: diffuse micronodular,...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract::Metastatic Crohn disease is a rare cutaneous disorder characterized by noncaseating, granulomatous skin lesions present at sites anatomically separate from the gastrointestinal tract. It is the least common dermatologic manifestation of Crohn disease, and the differential diagnosis includes numerous similarly appearin...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.5858/arpa.2010-0666-RS
更新日期:2012-03-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/1543-2165(2007)131[1805:THFGEA]2.0.CO;2
更新日期:2007-12-01 00:00:00
abstract::Fatal measles (rubeola) pneumonia, confirmed by viral culture and electron microscopy, occurred in a previously healthy 19-year-old man. Autopsy disclosed measles pneumonia but no recognizable disease that would predispose to such an infection. However, the prolonged course of the measles infection and very low levels...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::The salivary glands, despite their relatively simple morphology, give rise to more than 30 histologically distinct benign and malignant tumors. Salivary gland neoplasms comprise less than 2% of all tumors in humans and 3% of all head and neck tumors. They arise in the parotid gland in 80% of cases, and approximately 8...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/1543-2165(2008)132[278:LCOTPG]2.0.CO;2
更新日期:2008-02-01 00:00:00
abstract::Tumors of the umbilical cord, and especially angiomyxomas, are extremely unusual placental lesions. Sonography three weeks after the finding of a slightly elevated amniotic fluid alpha-fetoprotein, detected a cystic lesion of the umbilical cord in a 35-year-old woman at 19.5 weeks gestation. Two prior sonograms had be...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract::Concerns regarding significant levels of inappropriate medical services--as high as 20% or more--continue to influence discussions regarding medical care quality, utilization, and costs. The basis of these concerns are findings from a series of studies of the appropriateness of use of several medical and surgical serv...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract::The fluorescent dye thioflavin T stains intensely the deposits in dense deposit disease and can be used for identification purposes. Comparison of thioflavin T staining with electron microscopy was carried out in 25 patients and showed excellent congruity. Thioflavin T is much easier to use, but is less specific than ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract::A review was made of the clinical histories, treatment, and renal histologic features of 12 patients with anti-glomerular basement membrane antibody-induced glomerulonephritis (anti-GBM disease). Two patients had milder histopathologic changes in their kidney biopsy specimens and achieved clinical remission. The other...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract::Rhabdoid tumor of the thyroid gland is a very rare neoplasm, characterized by significant metastatic potential. All of the 6 cases reported in the recent literature had poor outcomes. We report an additional case involving, to our knowledge, the oldest patient reported so far. A 67-year-old woman had a nodular goiter ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2005)129
更新日期:2005-03-01 00:00:00
abstract:CONTEXT:Myofibroblastic proliferations of the urinary bladder, which share some similarities with nodular fasciitis, were first reported in 1980. Since then, they have had several designations, the most frequently used being inflammatory myofibroblastic tumor. Based on both histopathologic and prognostic grounds, some ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.5858/arpa.2012-0326-RA
更新日期:2013-08-01 00:00:00
abstract:CONTEXT:Endometrial tissue specimens are commonly encountered in daily practice. It is well known that a number of problematic diagnostic scenarios occur relative to these specimens. OBJECTIVE:To emphasize practical aspects of endometrial specimen handling and reporting, with selected comments on common diagnostic pit...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/1543-2165(2007)131[372:TE]2.0.CO;2
更新日期:2007-03-01 00:00:00
abstract:CONTEXT:- This review examines challenges and opportunities in preparing laboratories in a startup phase for accreditation by both the College of American Pathologists (CAP) and International Organization for Standardization (ISO) 15189 in an international setting as it relates to our experience at Cleveland Clinic Abu...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.5858/arpa.2016-0567-RA
更新日期:2018-09-01 00:00:00
abstract::Calbindin-D28k is a highly conserved 28,000 (dalton) molecular-weight (Mr) calcium binding protein with broad tissue distribution, yet cell-type-specific expression predominantly in subpopulations of central and peripheral nervous system neurons, distal tubular cells of the kidney, and enteric neuroendocrine cells. A ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract::We report a large cell neuroendocrine carcinoma arising in the ampulla of Vater. The patient, a 74-year-old woman, presented with a 3-cm ulcerated mass located in the ampullary region. She died of disease 8 months after surgery. Microscopically, the tumor was extensively necrotic. It was composed of islands and trabec...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/0003-9985(2003)127<221:LCNCOT>2.0.CO;2
更新日期:2003-02-01 00:00:00
abstract:CONTEXT:In immunohistochemistry, nonstandardized antigen retrieval protocols and fluids, poor-quality antibodies, and the presence of endogenous biotin frequently lead to incorrect results. Recently, advanced reagents including bifunctional SkipDewax pretreatment solution (BSPS), rabbit monoclonal (RM) antibodies, and ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.1043/1543-2165(2007)131[1047:TCOBSP]2.0.CO;2
更新日期:2007-07-01 00:00:00
abstract::Leydig cell tumor (LCT) is a rare tumor of the male testicular interstitium. This article provides an overview of the major pathologic manifestations of LCT of the testis; patient characteristics; clinical, radiologic, and laboratory features; prognosis; and management. LCTs of the testis are frequently hormonally act...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:10.1043/1543-2165(2007)131[311:AILALC]2.0.CO;2
更新日期:2007-02-01 00:00:00
abstract::We describe a 14-year-old boy with a solitary cavernous hemangioma in the proximal small intestine that caused recalcitrant iron deficiency anemia beginning at 3 years of age. After a number of attempts to ascertain the cause of the anemia were unsuccessful, the vascular tumor was ultimately diagnosed in the jejunum, ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-09-01 00:00:00
abstract:CONTEXT:Diagnostic use of immunohistochemistry has been extensively studied in prostate needle biopsy, but its use in routine practice and the quality assurance and associated cost have not been previously addressed. OBJECTIVE:To examine the routine use of immunohistochemistry in prostate biopsies in a tertiary academ...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:10.5858/arpa.2012-0145-OA
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To investigate the possibility of a viral agent in the central nervous system of patients with epidemic neuropathy. DESIGN:Virus isolation attempts, in cell cultures and suckling mice, from cerebrospinal fluid (CSF) of neuropathy patients and controls undergoing lumbar puncture for unrelated reasons. Serolog...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1997-08-01 00:00:00