November 2016—Metagenomic deep sequencing, or MDS, has scored another coup in the diagnosis of an unexplained disease in a patient who had already had extensive workup with all other available tools. MDS had been used in 2014 to detect unsuspected leptospirosis in a critically ill encephalitis patient, enabling appropriate treatment and full recovery. Now some of the same clinical scientists at the University of California San Francisco Medical Center who helped diagnose that patient have identified rubella virus infection in the eyes of a patient with bilateral chronic intraocular uveitis that had been misdiagnosed as idiopathic inflammation for 16 years.
Read More »November 2016
Big hopes, bigger questions with PD-L1
November 2016—Progress is a complicated minuet. One popular adage talks of “one step forward, two steps back,” which is not only discouraging but, in an even less-gleaming light, happens to be the title of one of Vladimir Lenin’s books, published in 1904. A more optimistic version (and one less centered on the crisis facing communists in turn-of-the-century Russia) suggests advances occur with two steps forward, mitigated by only one step back.
Read More »Up next for MALDI-TOF mass spec: AFB, molds
November 2016—Behold the humble API strip, made of plastic, with multiple miniature test chambers, interpreted with the aid of a color chart, and long a mainstay of microbiology laboratories.
Read More »Epi proColon fires up hopes of capturing screening dodgers
November 2016—When a Hollywood producer forecasts box office receipts, or a public health official contemplates action against a deadly but preventable cancer, there’s one hypothetical that might make both shudder: What if you held a screening and nobody came?
Read More »Who, what, when? Bringing order to influenza testing
November 2016—Raquel M. Martinez, PhD, D(ABMM), is very happy in her role as director of clinical and molecular microbiology at Geisinger Health System, Danville, Pa.
Read More »LIS of today a far cry from its ancestors
November 2016—When CAP TODAY magazine ran its first laboratory information systems product guide in the 1980s, an LIS was an LIS—nothing more and nothing less. Today, however, it’s a lot more, and the black and white of it have swirled to gray.
Read More »From the President’s Desk: When diagnosticians converse, 11/16
November 2016—This month’s column marks the midpoint of my term as CAP president. I have tried in the past year to write about topics that would foster discussion around certain underlying themes—most often communication, collaboration, and flexibility.
Read More »AMP case report: Detection of cnLOH as a sole abnormality in the diagnosis of myelodysplastic syndrome, November 2016
November 2016—Copy neutral loss of heterozygosity (cnLOH) is an acquired abnormality found in patients with cancer and hematologic disorders and can be detected by molecular techniques such as PCR-based analyses and hybridization-based chromosome genomic array testing (CGAT). We report a case in which cnLOH was the sole abnormality detected by CGAT in a patient with myelodysplastic syndrome. This case illuminates the importance of utilizing CGAT results, namely cnLOH findings, as one of the primary diagnostic indicators in order to expedite initial therapies.
Read More »Anatomic Pathology Abstracts, 11/16
November 2016—Relevance of papillary growth patterns of pulmonary adenocarcinoma, HPV involvement in head and neck cancers: assessment of biomarkers, Distinctive immunoregulatory microenvironment of medullary carcinoma of the colon, Diagnostic challenges caused by endoscopic biopsy of colonic polyps, MicroRNA expression profiling and expression of miR-205 in inflammatory breast cancer
Read More »Clinical Pathology Abstracts, 11/16
November 2016—Neonatal ICU quality initiative: identifying preanalytical variables that contribute to specimen hemolysis: Hemolysis is a major cause of sample rejection and the need to recollect a specimen from a patient. In the neonatal intensive care unit, this may be of particular concern because of limited venous access and the risk of causing iatrogenic anemia.
Read More »Molecular Pathology Selected Abstracts, 11/16
November 2016—Misclassification of genetic variants associated with hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy has a variable clinical presentation and may lead to sudden cardiac death. In many cases, it is associated with pathogenic genetic variants, enabling screening of relatives and, possibly, the ability to individualize treatment strategies through lifestyle modification or invasive procedures.
Read More »In memoriam: Tyra T. Hutchens, MD | 1921–2016
November 2016—Tyra T. Hutchens, MD, who served as CAP president from 1977 to 1979, died Aug. 28 at age 94. Dr. Hutchens was CAP vice president from 1975 to 1977 and a member of the Board of Governors from 1968 to 1974. He was a member of the Executive; Standards; and Budget, Planning and Review committees and of the Council on Government Relations and Liaison and the CAP History Editorial Board.
Read More »Shorts on Standards, 11/16
November 2016—The Laboratory Working Group of the National Kidney Disease Education Program and the IFCC Working Group for Standardization of Albumin in Urine are collaborating with IVD manufacturers to improve standardization of commercial measurement procedures. Urine albumin is an important biomarker for kidney damage.
Read More »Q&A column, 11/16
November 2016—As originally described, there are technically five Gleason patterns: 1, 2, 3, 4, 5. However, since patterns 1 and 2 are never used, there are no Gleason scores 1 + 1 = 2, 1 + 2 = 3, 2 + 1 = 3, 2 + 2 = 4, 2 + 3 = 5, and 3 + 2 = 5. Why is this? Isn’t this an alteration of Gleason’s original classification concept? Furthermore, there are cases in which a biopsy may contain a few glands that are diagnostic of carcinoma but insufficient to assign an accurate Gleason score. Would it simply be best to make a descriptive comment to that effect?
Read More »Newsbytes, 11/16
November 2016—How a pathology website can help build pathology websites: What if one could Google “biopsy orientation processing cassette” and receive detailed methodological instruction in surgical pathology as easily as finding a recipe for pound cake? Izak B. Dimenstein, MD, PhD, HT(ASCP), a grossing technologist retired from Loyola University Chicago Medical Center, believes highly specific information about laboratory methodologies should be easily accessible on the Web.
Read More »Put It on the Board, 11/16
November 2016—FDA approves Ventana PD-L1 (SP142) assay, Access TSH (3rd IS) assay cleared for Beckman systems, Advanced MALDI-TOF use subject of AMP report, FDA clearance for Quidel Solana influenza A+B
Read More »AMP case report: October 2016 test yourself answers
November 2016—In the October 2016 issue was a report, “Laser capture microdissection: Vanishing roles in tissue microdissection revalued in salvaging a melanoma with micrometastasis for BRAF V600E mutation detection,” written by members of the Association for Molecular Pathology. Here are answers (in bold) to the three “test yourself ” questions that followed that case report.
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