The Differential Diagnosis of Reparative Changes and Malignancy: Performance in the College of American Pathologists Pap Education and Proficiency Testing Programs.

Abstract:

CONTEXT.—:Repair is a challenging diagnosis and a significant source of false-positive (FP) interpretations in cervical cytology. No large-scale study of performance of repair in the liquid-based era has been performed. OBJECTIVE.—:To evaluate the performance of repair in the College of American Pathologists Pap Education and Proficiency Testing (PT) programs. DESIGN.—:The FP rate for slides classified as repair was evaluated by preparation type, participant type (cytotechnologist, pathologist, or laboratory), and program. The specific misdiagnosis category and individual slide performance were also evaluated. The rate of misclassification of slides as repair by participants for other diagnostic categories in the Pap Education program was assessed. RESULTS.—:The overall FP rate was 1700 of 12 715 (13.4%). There was no significant difference by program or preparation type. Within the Education program there was no difference by participant type, but pathologists' FP rate in the PT program (47 of 514, 9.1%) was significantly better than cytotechnologists in the PT program (51 of 380, 13.4%) and pathologists in the Education program (690 of 4900, 14.1%). High-grade squamous intraepithelial lesions/cancers (HSIL+) accounted for 1380 of 1602 FP interpretations (86%) in Education, but 43 of 98 (43.9%) in PT. Most slides had a low rate of misclassification, but a small number were poor performers. False-negative diagnosis of HSIL+ as repair was less common, ranging from 0.7% to 1.8%. CONCLUSIONS.—:Despite initial indications that liquid-based cytology might reduce the rate of misclassification of repair, FP interpretations remain common and are no different by preparation type. Misclassification is most commonly as HSIL or carcinoma, potentially resulting in significant patient harm.

journal_name

Arch Pathol Lab Med

authors

Staats PN,Souers RJ,Nunez AL,Li Z,Kurtycz DFI,Goodrich K,Witt BL,Davey DD,Booth CN

doi

10.5858/arpa.2019-0298-CP

subject

Has Abstract

pub_date

2019-11-22 00:00:00

eissn

0003-9985

issn

1543-2165

pub_type

杂志文章
  • Clinical Validation of Coexisting Activating Mutations Within EGFR, Mitogen-Activated Protein Kinase, and Phosphatidylinositol 3-Kinase Pathways in Lung Cancers.

    abstract:CONTEXT.—:Mutations within the same signature transduction pathway are redundant and, therefore, most are mutually exclusive. Laboratory errors, however, may introduce unexpected coexisting mutations. OBJECTIVE.—:To validate coexisting mutations within epidermal growth factor receptor (EGFR), mitogen-activated protein...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.5858/arpa.2017-0495-OA

    authors: De Marchi F,Haley L,Fryer H,Ibrahim J,Beierl K,Zheng G,Gocke CD,Eshleman JR,Belchis D,Illei P,Lin MT

    更新日期:2019-02-01 00:00:00

  • Performance of a fluid-based, thin-layer papanicolaou smear method in the clinical setting of an independent laboratory and an outpatient screening population in New England.

    abstract:BACKGROUND:A patented, fluid-based, thin-layer method for preparation of Papanicolaou (Pap) smears (ThinPrep Pap test) has been reported to be significantly more effective than the conventional smear invented by George Papanicolaou. We tested this position by comparing the cytologic diagnosis and specimen adequacy resu...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.1043/0003-9985(1999)123<0817:POAFBT>2.0.CO;2

    authors: Díaz-Rosario LA,Kabawat SE

    更新日期:1999-09-01 00:00:00

  • Use of a linear array for the detection of human papillomavirus genotypes in head and neck cancer.

    abstract:CONTEXT:Tumors of the head and neck commonly arise from the squamous and respiratory mucosa that lines the nasal and oral cavity, sinuses, pharynx, and larynx. The rate of oropharyngeal cancers diagnosed among Americans younger than 50 years is increasing. Infection of the oropharynx and tonsils by the human papillomav...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.1043/2009-0592-OAR.1

    authors: Black CC,Bentley HA,Davis TH,Tsongalis GJ

    更新日期:2010-12-01 00:00:00

  • Achieving quality reproducible results and maintaining compliance in molecular diagnostic testing of human papillomavirus.

    abstract::Laboratories contemplating either the addition of new molecular tests or modifying methods approved by the Food and Drug Administration for human papillomavirus testing should be aware of a variety of procedural, performance, and regulatory issues surrounding such activity. Diagnostic medical laboratory testing in the...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,评审

    doi:10.1043/1543-2165(2003)127<978:AQRRAM>2.0.CO;2

    authors: Seabrook JM,Hubbard RA

    更新日期:2003-08-01 00:00:00

  • Use of age-specific normal ranges for serum prostate-specific antigen.

    abstract:BACKGROUND:The traditional normal range for prostate-specific antigen has been 0.0 to 4.0 ng/mL. Two different age-specific normal ranges have been proposed, one by Oesterling et al and the other generated by the Prostate Cancer Awareness Week experience. METHODS:We studied 213 consecutive cases of biopsy-proven prost...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:

    authors: Slovacek KJ,Riggs MW,Spiekerman AM,Speights VO Jr

    更新日期:1998-04-01 00:00:00

  • Pathologic correlation in mammographically directed breast biopsies.

    abstract::In a series of 1137 diagnostic breast biopsy specimens in a 2-year period, nearly half (n = 534) underwent specimen mammography. Calcifications were found in 48% of the specimen mammograms. In a quarter of the cases, calcification was a marker either for carcinoma or a significant precursor lesion. Moreover, in the ma...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:

    authors: Symonds DA,Copeland BE,Drane A,Kaplan GN,Graham RR

    更新日期:1992-01-01 00:00:00

  • The use of a commercially available enzyme immunoassay for the detection of Clostridium difficile toxin A.

    abstract::A commercially available enzyme immunoassay (EIA) for the detection of Clostridium difficile toxin A (Premier Toxin A EIA, Meridian Diagnostics, Cincinnati, Ohio) was compared with tissue culture cytotoxicity assay, enterotoxigenic culture, and latex agglutination test for the laboratory diagnosis of C difficile-assoc...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:

    authors: Gilligan PH,Walden TP,Kelly WF,Wait KJ,Kraft JA,Willis DH

    更新日期:1993-05-01 00:00:00

  • Frozen section of thyroid and parathyroid specimens.

    abstract:CONTEXT:Preoperative fine-needle aspiration of thyroid lesions has greatly diminished the need for surgical evaluation. However, because thyroid nodules are common lesions, many still require surgical intervention and represent a substantial number of cases that the pathologist encounters in the frozen section laborato...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,评审

    doi:10.1043/1543-2165(2005)129[1575:FSOTAP]2.0.CO;2

    authors: Anton RC,Wheeler TM

    更新日期:2005-12-01 00:00:00

  • Cardiac myxomas. An immunohistochemical study using endothelial, histiocytic, and smooth-muscle cell markers.

    abstract::Previous immunohistochemical studies of cardiac myxomas are few in number, limited in scope and, in part, discrepant. We studied the immunoreactivity of five cardiac myxomas for factor VIII-related antigen, Ulex europaeus agglutinin I, smooth-muscle myosin, alpha 1-antitrypsin, and alpha 1-antichymotrypsin. Positive s...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:

    authors: Landon G,Ordóñez NG,Guarda LA

    更新日期:1986-02-01 00:00:00

  • Mucin expression in gastric cancer: reappraisal of its clinicopathologic and prognostic significance.

    abstract:CONTEXT:The clinical validity of mucin expression in gastric cancer is debated. Whereas several reports demonstrate a correlation between mucin expression and prognosis, others deny such an association. OBJECTIVES:This survival analysis study aims to elucidate the prognostic significance of mucin expression in gastric...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.5858/arpa.2012-0193-OA

    authors: Kim DH,Shin N,Kim GH,Song GA,Jeon TY,Kim DH,Lauwers GY,Park DY

    更新日期:2013-08-01 00:00:00

  • Expression of thyroid transcription factor-1 and other markers in sclerosing hemangioma of the lung.

    abstract:CONTEXT:Sclerosing hemangioma of the lung is well characterized histologically, but the line of differentiation expressed by the tumor cells has been unclear. Despite the implication by its name of a vascular neoplasm, sclerosing hemangioma is considered by most authorities to be an epithelial tumor, possibly related t...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.1043/0003-9985(2001)125<1335:EOTTFA>2.0.CO;2

    authors: Illei PB,Rosai J,Klimstra DS

    更新日期:2001-10-01 00:00:00

  • Intraosseous malignant peripheral nerve sheath tumor. Report of a case and review of the literature.

    abstract::We report a case of a malignant peripheral nerve sheath tumor arising in the distal femur of a 28-year-old man who had no stigmata of von Recklinghausen's disease. Roentgenograms and computed tomographic scans of the distal femur showed a single lytic intraosseous lesion with minimal soft tissue extension. Light micro...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Bullock MJ,Bedard YC,Bell RS,Kandel R

    更新日期:1995-04-01 00:00:00

  • Inflammatory myofibroblastic tumor of the liver.

    abstract::We report a case of hepatic inflammatory myofibroblastic tumor in a 26-year-old African American man who presented with right upper quadrant pain, weight loss, and fatigue during the previous year. Hepatomegaly was found on physical examination. Laboratory findings were significant for mild normocytic, normochromic an...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.1043/1543-2165(2006)130[1548:IMTOTL]2.0.CO;2

    authors: Solomon GJ,Kinkhabwala MM,Akhtar M

    更新日期:2006-10-01 00:00:00

  • Practical Applications in Immunohistochemistry: Evaluation of Rejection and Infection in Organ Transplantation.

    abstract:CONTEXT:-Immunohistochemical analysis of tissue biopsy specimens is a crucial tool in diagnosis of both rejection and infection in patients with solid organ transplants. In the past 15 years, the concept of antibody-mediated rejection has been refined, and diagnostic criteria have been codified in renal, heart, pancrea...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,评审

    doi:10.5858/arpa.2015-0275-CP

    authors: Troxell ML,Lanciault C

    更新日期:2016-09-01 00:00:00

  • Liver Pathologic Changes After Direct-Acting Antiviral Agent Therapy and Sustained Virologic Response in the Setting of Chronic Hepatitis C Virus Infection.

    abstract:CONTEXT.—:Treatment of chronic viral hepatitis C (HCV) infection with direct-acting antiviral agents (DAAs) results in cure, or sustained viral response (SVR), in more than 90% of patients. However, there are subsets of patients who have persistent liver inflammation and fibrosis and develop hepatocellular carcinoma (H...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.5858/arpa.2020-0008-OA

    authors: Celli R,Saffo S,Kamili S,Wiese N,Hayden T,Taddei T,Jain D

    更新日期:2020-08-18 00:00:00

  • Genomics, transcriptomics, proteomics, and numbers.

    abstract:OBJECTIVE:To review the advances in clinically useful molecular biologic techniques and to identify their applications in clinical practice, as presented at the 11th Annual William Beaumont Hospital DNA Symposium. DATA SOURCES:The 8 manuscripts submitted were reviewed, and their major findings were compared with liter...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,评审

    doi:10.1043/1543-2165(2003)127<1089:GTPAN>2.0.CO;2

    authors: Kiechle FL,Holland-Staley CA

    更新日期:2003-09-01 00:00:00

  • Ectopic or heterotopic liver (choristoma) associated with the gallbladder.

    abstract::A 43-year-old man with a history and symptomatology of hereditary spherocytosis underwent splenectomy and cholecystectomy for treatment of his underlying disease and of cholelithiasis. The removed gallbladder showed a serosal encapsulated nodule, supported by a short mesentery, measuring 11 x 6 x 4 mm, that histologic...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Tejada E,Danielson C

    更新日期:1989-08-01 00:00:00

  • Pseudomyogenic Hemangioendothelioma (Epithelioid Sarcoma-Like Hemangioendothelioma).

    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

    authors: Caballero GA,Roitman PD

    更新日期:2020-04-01 00:00:00

  • Jejunal gastrointestinal stromal tumor: a cause of obscure gastrointestinal bleeding.

    abstract::In cases of obscure gastrointestinal bleeding, when a source for blood loss is not apparent from examination of the colon and upper gastrointestinal tract, the small bowel usually becomes the focus of investigation. A tumor with interesting pathologic features was found in a patient who presented with recurrent episod...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.1043/1543-2165(2004)128<214:JGSTAC>2.0.CO;2

    authors: Sass DA,Chopra KB,Finkelstein SD,Schauer PR

    更新日期:2004-02-01 00:00:00

  • Review of pediatric autopsies performed at a university hospital in Ribeirão Preto, Brazil.

    abstract:CONTEXT:Autopsy continues to provide important data for quality assurance, teaching, scientific purposes, and health planning, especially if performed according to a comprehensive protocol. OBJECTIVE:To describe and analyze data from all perinatal and pediatric autopsies performed at a university hospital in Brazil. ...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.1043/1543-2165(2006)130[62:ROPAPA]2.0.CO;2

    authors: Peres LC

    更新日期:2006-01-01 00:00:00

  • Triaging Atypical Lobular Hyperplasia and Lobular Carcinoma In Situ on Percutaneous Core Biopsy to Surgery or Observation: Assiduous Radiologic-Pathologic Correlation Works, Quantitating Extent of Disease Does Not.

    abstract:CONTEXT.—:The management of lobular neoplasia (LN) found on core biopsy is controversial and ranges from obligatory surgical excision to clinical/imaging observation. OBJECTIVE.—:To determine if in cases of core needle biopsy yielding LN, quantification of normal and diseased terminal ductal lobular units (TDLUs) can ...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.5858/arpa.2018-0232-OA

    authors: Holbrook AI,Hanley K,Jeffers C,Kang J,Cohen MA

    更新日期:2019-05-01 00:00:00

  • Errors in transfusion medicine. Detection, analysis, frequency, and prevention.

    abstract::The Mayo Clinic (Rochester, Minn) Division of Transfusion Medicine evaluated the effect of methods of error detection, analysis, and prevention on the rate of errors occurring from 1982 through 1992. We defined an error as any deviation from the standard operating procedure. Twenty-four standard operating procedures w...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:

    authors: Taswell HF,Galbreath JL,Harmsen WS

    更新日期:1994-04-01 00:00:00

  • Proximal tubulopathies associated with monoclonal light chains: the spectrum of clinicopathologic manifestations and molecular pathogenesis.

    abstract:CONTEXT:Lesions associated with monoclonal light and heavy chains display a variety of glomerular, tubular interstitial, and vascular manifestations. While some of the entities are well recognized, including light and heavy chain deposition diseases, AL (light chain) and AH (heavy chain) amyloidosis, and light chain ("...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,多中心研究

    doi:10.5858/arpa.2013-0493-OA

    authors: Herrera GA

    更新日期:2014-10-01 00:00:00

  • Epithelioid sarcoma. Ultrastructural and immunohistologic features suggesting a synovial origin.

    abstract::A case of epithelioid sarcoma was studied light microscopically, ultrastructurally, and immunohistologically. The tumor was a deep antebrachial mass in a 57-year-old man, and led to antebrachial amputation. Light microscopically, the tumor consisted of nodules that often had central necrosis. The cells were uniform, w...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:

    authors: Miettinen M,Lehto VP,Vartio T,Virtanen I

    更新日期:1982-11-01 00:00:00

  • Lymphovascular invasion in micropapillary urothelial carcinoma: a study of 22 cases.

    abstract:CONTEXT:Micropapillary urothelial carcinoma (MPUC) is a known aggressive variant of urothelial carcinoma. However, the reasons for its aggressiveness remain unclear. OBJECTIVE:To investigate the frequency of lymphovascular invasion in 22 cases of MPUC. DESIGN:Consecutive tissue sections were stained with D2-40 and CD...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.5858/arpa.2011-0463-OA

    authors: McQuitty E,Ro JY,Truong LD,Shen SS,Zhai Q,Ayala AG

    更新日期:2012-06-01 00:00:00

  • Adenomatoid tumor of the uterus. Ultrastructural, histochemical, and immunohistochemical analysis.

    abstract::A uterine tumor from a 34-year-old woman was investigated morphologically and immunohistochemically. The tumor tissue was composed of multiple cystic spaces of various sizes. The cyst wall was covered by a single layer or occasionally multiple layers of flattened cells. Electron micrographs of the tumor tissue reveale...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:

    authors: Suzuki T,Yoshida Y,Kaku T,Kikuchi K,Mori M

    更新日期:1985-11-01 00:00:00

  • Unexpected autopsy findings arising from postmortem ocular examination.

    abstract:BACKGROUND:A full autopsy at our institution includes removal of the eyes for pathologic examination. To our knowledge, the rate of ophthalmic findings at autopsy has not been documented previously. DESIGN:We retrospectively reviewed 277 consecutive autopsies conducted between 1995 and 1999 in which the eyes were remo...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.1043/0003-9985(2001)125<1193:UAFAFP>2.0.CO;2

    authors: Butnor KJ,Proia AD

    更新日期:2001-09-01 00:00:00

  • Primary leiomyosarcoma of the pancreas: a case report and review of literature.

    abstract::Primary leiomyosarcoma of the pancreas is a rare tumor for which only 21 reports appear in the world literature. We describe an additional case of pancreatic leiomyosarcoma in a 76-year-old man, who complained of persistent high fever. Histologic examination revealed a pleomorphic spindle cell tumor. Reactivity for mu...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,评审

    doi:10.1043/0003-9985(2001)125<0152:PLOTP>2.0.CO;2

    authors: Nesi G,Pantalone D,Ragionieri I,Amorosi A

    更新日期:2001-01-01 00:00:00

  • Aggressive clear cell chondrosarcomas: do distinctive characteristics exist?: a report of 4 cases.

    abstract:CONTEXT:Clear cell chondrosarcoma (CCC) is commonly considered to be a low-grade subtype of chondrosarcoma. However, a few cases of CCC behave as high-grade lesions (with early metastases or multiple/synchronous locations). OBJECTIVE:To investigate morphologic features that can help predict the aggressiveness of these...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章

    doi:10.1043/1543-2165(2006)130[1673:ACCCDD]2.0.CO;2

    authors: Corradi D,Bacchini P,Campanini N,Bertoni F

    更新日期:2006-11-01 00:00:00

  • HER2/neu gene amplification and protein overexpression in gastric and gastroesophageal junction adenocarcinoma: a review of histopathology, diagnostic testing, and clinical implications.

    abstract::Amplification of the human epidermal growth factor receptor 2/neu (HER2/neu) gene and overexpression of the HER2 protein (HER2) have been shown to occur in gastric and gastroesophageal junction adenocarcinoma in a number of studies. With a dismal survival rate, patients with these cancers stand to benefit from the ide...

    journal_title:Archives of pathology & laboratory medicine

    pub_type: 杂志文章,评审

    doi:10.5858/arpa.2011-0168-RS

    authors: Hechtman JF,Polydorides AD

    更新日期:2012-06-01 00:00:00