American journal of clinical pathology
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Am. J. Clin. Pathol. · Jan 1998
ReviewValue of the Ber-EP4 antibody in differentiating epithelial pleural mesothelioma from adenocarcinoma. The M.D. Anderson experience and a critical review of the literature.
Although most studies have indicated that Ber-EP4 immunostaining can assist in differentiating epithelial pleural mesotheliomas from adenocarcinomas that metastasize to the pleura, the percentage of positive cases has varied greatly among different studies. Authors of a recent publication concluded that Ber-EP4 has no diagnostic utility in separating these conditions. To determine whether Ber-EP4 has any value in distinguishing mesothelioma from adenocarcinoma, 70 formalin-fixed epithelial pleural mesotheliomas, 20 pulmonary adenocarcinomas, 59 nonpulmonary adenocarcinomas, 4 squamous cell carcinomas of the lung, 6 transitional cell carcinomas, and 31 adenocarcinomas of unknown origin that metastasized to the pleura were stained with this antibody. ⋯ The staining in the mesotheliomas was focal and restricted to a limited number of cells, in contrast with staining in the pulmonary adenocarcinomas in which it was invariably diffuse. The extent of the staining in the nonpulmonary adenocarcinomas and the metastatic adenocarcinomas of unknown origin was less consistent--negative or focal in some cases and diffuse in others. Therefore, while Ber-EP4 seems to be helpful in separating epithelial pleural mesotheliomas from lung adenocarcinomas, its value in distinguishing mesotheliomas from other tumors metastatic to the pleura is more limited and depends largely on the site of origin of the metastatic tumor.
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Am. J. Clin. Pathol. · Nov 1997
Clinically important intermethod differences for physiologically abnormal ionized magnesium results.
We compared physiologically abnormal low and high ionized magnesium (iMg) results determined with the AVL 988-4 (AVL, Graz, Austria) and Nova CRT (Nova Biomedical, Waltham, Mass) ion-selective electrodes (ISEs) in serum samples from randomly selected patients. A result of < 0.39 mmol/L with either ISE constituted the low magnesium group and of > or = 0.65 mmol/L the high magnesium group. Within each group we found significant differences between the iMg results. ⋯ In contrast, all results with the AVL ISE for the high magnesium group were abnormally high, but 67% of the results with the Nova ISE were normal. The agreement for the clinical interpretation of iMg results based on the reference interval for each method was only 32%. The differences in iMg results between the two analyzers must be resolved before using the iMg test as measured with ISE for patient care.
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We describe the histologic and immunohistochemical findings in specimens from bone marrow (BM) biopsies performed for staging purposes in 13 patients with a previous tissue-based diagnosis of T-cell-rich B-cell lymphoma (TCRBCL). Bone marrow involvement was found in 8 (62%) of 13 cases and was often paratrabecular. The histologic appearance was not pathognomonic of TCRBCL, with the differential diagnosis including Hodgkin's disease and peripheral T-cell lymphoma. ⋯ The increased incidence of BM involvement in TCRBCL is significantly higher than that found in de novo B-cell diffuse large cell lymphoma, suggesting a possible biologic difference between the two entities. Our cases share some similar clinicopathologic features with histiocyte-rich B-cell lymphoma and with diffuse lymphocyte-predominant Hodgkin's disease, paragranuloma type. We discuss the possible relationship to these two entities.
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Am. J. Clin. Pathol. · Nov 1997
Case ReportsGranuloma inguinale (donovanosis): an unusual cause of otitis media and mastoiditis in children.
Granuloma inguinale (donovanosis) is seen predominantly in adults (it rarely occurs in children) and mainly affects genital skin and mucosa. Infection occurs at other skin and mucosal sites, and hematogenous dissemination to bone also has been described. The infection responds dramatically to appropriate antibiotic treatment. ⋯ The second child had a polypoid mass in the middle ear that on biopsy showed the features of granuloma inguinale. The mother of this child had biopsy-proven granuloma inguinale of the uterine cervix. These cases indicate that granuloma inguinale can be transmitted during vaginal delivery, and careful cleansing of neonates born to infected mothers is recommended.
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Am. J. Clin. Pathol. · May 1997
Comparative StudyDegree of agreement in plasma fibrinogen among two functional and one immunonephelometric assays.
The purpose of this study was to assess the interchangeability of the nephelometric (immunoassay), von Clauss, and optical (derived) fibrinogen assays. When the nephelometric assay was compared with either of the two functional assays (199 samples) and when the von Clauss and optical methods were compared (879 samples), Pearson and intraclass correlations were .96 to .97. ⋯ Analyses restricted to cases with a fibrinogen value of less than 2.0 g/L resulted in somewhat greater biases and higher upper limits of agreement. Laboratorians need more than correlations to make informed judgments regarding the interchangeability of these methods.