Abstract:
OBJECTIVES:The incidence of lymphoproliferative disorders (LPDs) is increasing in sub-Saharan Africa (SSA) due to population growth, aging, and human immunodeficiency virus (HIV). Despite significant burden, resources for diagnosis and treatment of LPDs are limited, with little infrastructure to deliver modern pathology services. Diagnostic and therapeutic decisions are therefore frequently made without tissue confirmation, leading to high rates of misdiagnosis and inappropriate treatment. METHODS:We have established a laboratory in Malawi to support clinical and research efforts at a national teaching hospital. Consensus real-time diagnoses are rendered by local pathologists after weekly clinicopathologic teleconferences involving clinicians and pathologists from the United States and Malawi. Additional ancillary studies are then performed in the United States prior to final diagnosis. RESULTS:We report our first 2 years' experience and demonstrate high concordance between real-time diagnoses in Malawi and final diagnoses in the United States (5% major discordance rate for formalin-fixed, paraffin-embedded samples). In addition, we describe characteristics of pathologically confirmed LPDs in Malawi, highlighting differences by HIV status. CONCLUSIONS:Our multidisciplinary approach can be a model for strong pathology services that provide direct, real-time support to clinical care and research in SSA.
journal_name
Am J Clin Patholjournal_title
American journal of clinical pathologyauthors
Montgomery ND,Liomba NG,Kampani C,Krysiak R,Stanley CC,Tomoka T,Kamiza S,Dhungel BM,Gopal S,Fedoriw Ydoi
10.1093/ajcp/aqw118subject
Has Abstractpub_date
2016-10-01 00:00:00pages
423-30issue
4eissn
0002-9173issn
1943-7722pii
aqw118journal_volume
146pub_type
杂志文章abstract::Immunohistochemistry occasionally is used to determine the lineage of entirely necrotic tumors. However, the sensitivity and specificity of antibodies on necrotic tissue are unknown. To determine the usefulness of immunohistochemistry with necrotic lesions, a series of 24 known tumors consisting of 14 carcinomas, 2 ly...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/110.5.641
更新日期:1998-11-01 00:00:00
abstract::Cytologic features of the cell-stroma interface are useful in distinguishing between monomorphic adenomas of the basal cell type and adenoid cystic carcinoma. In basal cell adenomas, the collagenous stroma interdigitates with adjacent cells, whereas in adenoid cystic carcinoma, the two are separated by a sharp smooth ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1093/ajcp/106.1.35
更新日期:1996-07-01 00:00:00
abstract::By electrophoresis, prealbumin is seen as a discrete band anodic to the albumin fraction. Cases of duplicate bands in the prealbumin region have been described previously in serum, cerebrospinal fluid, and urine, and have had an association with varied clinical entities. The authors describe a novel association of sev...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/101.4.475
更新日期:1994-04-01 00:00:00
abstract::Cryostat sections from fully developed papular lesions of lymphomatoid papulosis (histologic subtype A or B) have been examined by immunoenzymatic staining with 24 monoclonal antibodies against lymphoid cells and their subsets. The lesions demonstrated essentially identical cellular compositions and consisted of T-lym...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/84.5.587
更新日期:1985-11-01 00:00:00
abstract::Two radioimmunoassay procedures (RIA-1 and RIA-2) were evaluated for the quantitation of prostatic acid phosphatase in serum and compared with the enzymatic method and counter immunoelectrophoresis method for their specificity and sensitivity. Sera from 168 patients were analyzed and these included: normals, 27; untre...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/76.4.430
更新日期:1981-10-01 00:00:00
abstract::The combined experience of four university medical centers with fine-needle aspiration biopsy (FNAB) of the mediastinum is reviewed. This series includes 189 cases, with 100 males and 89 females, 6 months to 86 years of age. The majority (71%) of diagnoses were neoplastic with the remainder equally distributed between...
journal_title:American journal of clinical pathology
pub_type: 杂志文章,多中心研究
doi:10.1093/ajcp/105.2.168
更新日期:1996-02-01 00:00:00
abstract::Heterogeneous expression or amplification is a challenge to HER2 diagnostics. A guideline defines heterogeneity as the presence of between 5% and 50% cells with HER2/CEP17 ratios of more than 2.20. We audited the frequency of such cells and their clinical impact in the results from 2 pathology laboratories combined wi...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCP0EN6AQMWETZZ
更新日期:2011-08-01 00:00:00
abstract:Objectives:Approximately 15% of breast cancers show equivocal human epidermal growth factor receptor 2 (HER2) results on HER2 immunohistochemistry (IHC) and are reflexed for fluorescence in situ hybridization (FISH). However, some cases remain equivocal. In this study, we evaluated these double-equivocal cases by using...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqw211
更新日期:2017-01-01 00:00:00
abstract::The authors illustrate two neoplasms arising in the pretibial soft tissue that are histologically identical to adamantinoma of the long bones. The tumors developed in a 24-year-old woman and a 31-year-old man. Both were treated by local excision. Histologically, one tumor had a tubular pattern and one was composed of ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/83.1.108
更新日期:1985-01-01 00:00:00
abstract::A 65-year-old man with lower back pain was found to have multiple myeloma. Unique findings in the marrow aspirate smears of this patient were tadpolelike plasma cells and cellular rosettes simulating those seen in neuroblastoma. This case documents yet another facet of the broad morphologic spectrum of neoplastic plas...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/98.6.630
更新日期:1992-12-01 00:00:00
abstract::An antithrombin assay (AA) and an antithrombin assay modified by the addition of heparin (H-AA) were performed using sera from healthy subjects, patients predisposed to thrombosis, and patients with thromboembolic disease. Characteristic AA, and H-AA patterns were found in each group. Normal controls and four of 39 "p...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/65.3.384
更新日期:1976-03-01 00:00:00
abstract::An immunohistochemical study was conducted of 108 papillary carcinoma cases, including 48 cases with intratumoral heterotopic ossification (IHO). In 48 cases, papillary carcinoma with IHO was accompanied by nodular fibrosis. Cases of papillary carcinoma with IHO or nodular fibrosis showed higher incidences of lymph no...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/AJCPQZQN50HKIAHA
更新日期:2013-05-01 00:00:00
abstract::DRC (dendritic reticulum cell) antigen expression was studied in 38 cases of B-cell lymphomas including follicular lymphoma. The results of this study showed DRC-1 to be expressed in 1/3 of small lymphocytic; 3/3 of mantle zone lymphoma (MZL); 10/10 of follicular, small cleaved; 6/7 of follicular, mixed; 1/2 of follic...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/89.4.488
更新日期:1988-04-01 00:00:00
abstract::Examination of kidneys of ten patients with uremia and severe hypertension treated by chronic intermittent hemodialysis revealed a deposition of glycogen within interstitial cells of the renal medulla. This is unlike any described renal distribution of glycogen. Electron microscopic studies performed in one case demon...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/72.3.400
更新日期:1979-09-01 00:00:00
abstract::Lymphocyte populations with abnormal kappa/lambda ratios have been described previously in B-cell non-Hodgkin's lymphomas and in lymphoid hyperplasia. The authors studied 12 patients in whom lymph nodes diagnostic of Hodgkin's disease contained evidence of monoclonal lymphocyte proliferation. One patient subsequently ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/82.6.674
更新日期:1984-12-01 00:00:00
abstract::A 67-year-old man presented with a malignant tumor involving abdominal lymph nodes, spleen, liver, and lungs, with associated protracted fever and night sweats. The tumor consisted of large pleomorphic cells, often surrounding microabscesses. Intracytoplasmic S100 protein, surface T6, Leu-3a (T4), and HLA-DR antigens ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1093/ajcp/85.6.739
更新日期:1986-06-01 00:00:00
abstract::Acute myeloid leukemia (AML) with normal cytogenetics represents approximately 40% to 50% of de novo AML. This heterogeneous AML subgroup constitutes the single largest cytogenetic group with an intermediate prognosis. Previous studies have suggested that the Fms-like tyrosine kinase-3 internal tandem duplication (FLT...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/NRTX9AKXHR5JBT93
更新日期:2008-04-01 00:00:00
abstract::Acute exacerbations of idiopathic pulmonary fibrosis/cryptogenic fibrosing alveolitis (IPF/CFA) are rare and typically terminal events, but their relationship to underlying patterns of idiopathic interstitial pneumonias is unknown. We reviewed autopsy material from patients who died of diffuse alveolar damage in the c...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1309/UVAR-MDY8-FE9F-JDKU
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:Pathogenic free-living amebae (FLAs) cause skin, ocular, and central nervous system (CNS) infections with significant morbidity and mortality. Diagnosis of FLA infections by pathologic examination of tissue sections can be aided using molecular assays. This study investigated the performance characteristics ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqz103
更新日期:2019-11-04 00:00:00
abstract::The authors describe an unusual variant of alkaline phosphatase (ALP) discovered in a patient with a 90-fold increase in serum ALP. The variant ALP was indistinguishable from the bone isoenzyme when subjected to chemical inhibition, heat inactivation, lectin precipitation, and routine electrophoresis. However, treatme...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/95.5.749
更新日期:1991-05-01 00:00:00
abstract::The case of a 3-week-old infant with Coxsackie B3 meningoencephalitis is discussed. Hypoglycorrhachia and neutrophils in the cerebrospinal fluid characterized the first ten days of her illness. Coxsackie B3 should be added to the list of enteroviruses that can cause hypoglycorrhachia during infections of the central n...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/70.6.947
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVES:Mantle cell lymphoma (MCL) may present de novo or undergo progression to a clinically aggressive variant, known as a blastoid or pleomorphic variant. We report an unusual case of classic MCL in a 78-year-old man with a typical immunophenotype, including CD5 positivity, who subsequently relapsed with CD5-nega...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/aqw194
更新日期:2016-12-01 00:00:00
abstract::A markedly elevated prothrombin time (PT) and activated partial thromboplastin time (APTT) were observed in a 24-year-old man who was admitted with a history of ethylene glycol ingestion. Further laboratory evaluation suggested that the coagulopathy was related to acquired factor deficiencies. The PT and APTT improved...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/104.6.663
更新日期:1995-12-01 00:00:00
abstract::This report concerns a particular benign histologic variant of Hodgkin's disease, the lymphocyte-predominant category of the Rye classification. The group of 24 cases, all involving localized disease, was first reported in 1960, and is now reappraised, incorporating subsequent data. The interpretations of the original...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/67.6.507
更新日期:1977-06-01 00:00:00
abstract::Squamous cell carcinoma (SCC) is by far the most common malignancy of the upper aerodigestive tract. Most conventional-type SCCs do not present the surgical pathologist with diagnostic difficulty. Certain variants, however, can histologically mimic benign and other malignant diseases. In such cases, correct diagnosis ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1309/CR5JXUY3J2YGTC1D
更新日期:2005-12-01 00:00:00
abstract::Urine dipstick jars often are left uncapped, which led the authors to wonder what effect prolonged air exposure might have on dipstick accuracy. Unexpired Ames Multistixs (Miles Inc., Elkhart, IN) were exposed to ambient air for intervals of up to eight weeks and were used to test urine for the presence or absence of ...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/96.3.398
更新日期:1991-09-01 00:00:00
abstract::Immunophenotypic analysis of acute leukemias is time consuming and often requires flow cytometric analysis. A 1-hour alkaline phosphatase-labeled streptavidin-biotin immunocytochemical procedure was evaluated as an alternative. Seventeen cases of acute leukemia, including 10 acute lymphocytic (ALL) and 7 acute nonlymp...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/97.6.876
更新日期:1992-06-01 00:00:00
abstract::The present immunoperoxidase study attempted to localize aldosterone and cortisol in formalin-fixed paraffin-embedded adrenal glands or tumors. Apparently, steroid substances are solubilized during routine tissue processing, and the cytoplasm of adrenal cortical cells is not stained by either antialdosterone or antico...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/75.1.92
更新日期:1981-01-01 00:00:00
abstract::Demonstration of prostate-specific acid phosphatase by immunologic methods in tissue sections or in plasma necessitates a monospecific antiserum. This is produced by immunizing rabbits with pure prostate-specific acid phosphatase antigen, prepared from seminal fluid. The ejaculate is centrifuged, dialyzed against a ci...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/72.6.944
更新日期:1979-12-01 00:00:00
abstract::In a child with renal failure and oliguria due to hyperoxaluria myelophthisis developed as a result of extensive bone-marrow replacement with calcium oxalate crystals and an accompanying fibrous proliferations. The histopathology associated with this metabolic disorder was demonstrated in posterior iliac crest bone-ma...
journal_title:American journal of clinical pathology
pub_type: 杂志文章
doi:10.1093/ajcp/66.6.991
更新日期:1976-12-01 00:00:00