Utility of Immunohistochemistry in the Pancreatobiliary Tract

2015 ◽  
Vol 139 (1) ◽  
pp. 24-38 ◽  
Author(s):  
Fan Lin ◽  
Zongming Eric Chen ◽  
Hanlin L. Wang
Keyword(s):  
Pancreatic Neoplasms ◽  
Pancreatic Neoplasm ◽  
Diagnostic Algorithm ◽  
Diagnostic Error ◽  
Research Data ◽  
Ancillary Study ◽  
Practice Experience ◽  
Therapeutic Decisions ◽  
Prognostic Outcome

Context Immunohistochemistry has become a useful ancillary study in the identification and classification of pancreatic neoplasms. The diagnostic accuracy has been significantly improved because of the continuous discoveries of tumor-associated biomarkers and the development of effective immunohistochemical panels. Objectives To identify and classify pancreatic neoplasms by immunohistochemistry. Data Sources Literature review and authors' research data and personal practice experience were used. Conclusions To better guide therapeutic decisions and predict the prognostic outcome, it is crucial to make an accurate diagnosis of a pancreatic neoplasm. Application of appropriate immunohistochemical panels enables pathologists to differentiate pancreaticobiliary adenocarcinomas from reactive conditions and to identify rare types of pancreatic neoplasms. Knowing the utilities and pitfalls of each tumor-associated biomarker is essential to avoiding a potential diagnostic error because an absolutely cancer-specific biomarker does not exist. This article reviews frequently used tumor-associated biomarkers, provides lists of effective immunohistochemical panels, and recommends a diagnostic algorithm as a standard approach to pancreatic neoplasms.

Immunohistochemistry in Undifferentiated Neoplasm/Tumor of Uncertain Origin

2014 ◽  
Vol 138 (12) ◽  
pp. 1583-1610 ◽  
Author(s):  
Fan Lin ◽  
Haiyan Liu
Keyword(s):  
Literature Review ◽  
Diagnostic Accuracy ◽  
Diagnostic Errors ◽  
Research Data ◽  
Data Sources ◽  
Tissue Specific ◽  
Ancillary Study ◽  
Practice Experience ◽  
Therapeutic Decisions

Context Immunohistochemistry has become an indispensable ancillary study in the identification and classification of undifferentiated neoplasms/tumors of uncertain origin. The diagnostic accuracy has significantly improved because of the continuous discoveries of tissue-specific biomarkers and the development of effective immunohistochemical panels. Objectives To identify and classify undifferentiated neoplasms/tumors of uncertain origin by immunohistochemistry. Data Sources Literature review and authors' research data and personal practice experience were used. Conclusions To better guide therapeutic decisions and predict prognostic outcomes, it is crucial to differentiate the specific lineage of an undifferentiated neoplasm. Application of appropriate immunohistochemical panels enables the accurate classification of most undifferentiated neoplasms. Knowing the utilities and pitfalls of each tissue-specific biomarker is essential for avoiding potential diagnostic errors because an absolutely tissue-specific biomarker is exceptionally rare. We review frequently used tissue-specific biomarkers, provide effective panels, and recommend diagnostic algorithms as a standard approach to undifferentiated neoplasms.

An Algorithmic Approach to the Diagnosis of Pancreatic Neoplasms

2009 ◽  
Vol 133 (3) ◽  
pp. 454-464 ◽  
Author(s):  
David S. Klimstra ◽  
Martha B. Pitman ◽  
Ralph H. Hruban
Keyword(s):  
Differential Diagnosis ◽  
Pancreatic Neoplasms ◽  
Pancreatic Neoplasm ◽  
Diagnostic Information ◽  
Data Sources ◽  
Algorithmic Approach ◽  
Normal Gland ◽  
Pathologic Evaluation ◽  
Additional Diagnostic Information

Abstract Context.—The pancreas gives rise to an array of distinct neoplasms that can be solid, cystic, or intraductal and can recapitulate the various lines of differentiation present in the normal gland. Objective.—To develop an algorithmic approach to the diagnosis of pancreatic neoplasms that simplifies their pathologic evaluation. Data Sources.—We reviewed literature related to the classification of pancreatic neoplasms on the basis of their gross, histologic, and immunohistochemical features. Conclusions.—By using a series of dichotomous decisions, the differential diagnosis of a pancreatic neoplasm can be narrowed, and in cases of the more common neoplasms, accurate classification can be achieved. Uncommon neoplasms not accounted for by this approach are also discussed, and the additional diagnostic information needed for complete pathologic reporting is presented.

The Utility of Immunohistochemistry in the Differential Diagnosis of Gynecologic Disorders

2015 ◽  
Vol 139 (1) ◽  
pp. 39-54 ◽  
Author(s):  
Hanna G. Kaspar ◽  
Christopher P. Crum
Keyword(s):  
Genetic Alterations ◽  
Therapeutic Modalities ◽  
Immunohistochemical Markers ◽  
Practice Experience ◽  
Therapeutic Decisions ◽  
Specific Proteins ◽  
Increasing Demand ◽  
Identification And Characterization

Context Immunohistochemistry has assumed an increasing role in the identification and characterization of gynecologic disorders including lesions with deceptively bland morphology, uncommon and underdiagnosed neoplasms, and neoplasms with specific genetic alterations associated with overexpression or loss of expression of specific proteins. The diagnostic accuracy has been significantly improved owing to the discovery and increasing experience with the tumor-associated biomarkers, and the increasing demand for precise tumor classification to assess suitability for the expanding therapeutic modalities including clinical trials. Objective To differentiate lesions of the gynecologic tract through the use of effective immunohistochemical panels. Data Sources Literature review and authors' personal practice experience. Conclusions The application of diagnostic and prognostic immunohistochemical panels has enabled pathologists to better guide therapeutic decisions and to better predict the clinical outcome. It is now well established that the use of ancillary testing, including immunohistochemistry, has a significant power in the identification, differentiation, and classification of reactive, premalignant, and malignant gynecologic disorders. This article discusses the utilities and pitfalls of the commonly used immunohistochemical markers in the context of overlapping morphologic features encountered in the uterus, ovaries, and fallopian tubes.

scholarly journals Utility of Immunohistochemistry in the Diagnosis of Pleuropulmonary and Mediastinal Cancers: A Review and Update

2014 ◽  
Vol 138 (12) ◽  
pp. 1611-1628 ◽  
Author(s):  
Kai Zhang ◽  
Hongbin Deng ◽  
Philip T. Cagle
Keyword(s):  
Diagnostic Errors ◽  
Cost Effective ◽  
Lung Tumors ◽  
Specific Gene ◽  
Molecular Testing ◽  
Promising Alternative ◽  
Practice Experience ◽  
Cost Effective Approach ◽  
Therapeutic Decisions ◽  
Prognostic Outcome

Context Immunohistochemistry has become an indispensable ancillary tool for the accurate classification of pleuropulmonary and mediastinal neoplasms necessary for therapeutic decisions and predicting prognostic outcome in the era of personalized medicine. Diagnostic accuracy has significantly improved because of the continuous discoveries of tumor-associated biomarkers and the development of effective immunohistochemical panels. Objective To increase the accuracy of diagnosis and classify pleuropulmonary neoplasms through immunohistochemistry. Data Sources Literature review, authors' research data, and personal practice experience. Conclusions This review article has shown that appropriately selecting immunohistochemical panels enables pathologists to effectively diagnose most primary pleuropulmonary neoplasms and differentiate primary lung tumors from a variety of metastatic tumors to the lung. The discovery of new mutation-specific antibodies identifying a subset of specific gene-arranged lung tumors provides a promising alternative and cost-effective approach to molecular testing. Knowing the utilities and pitfalls of each tumor-associated biomarker is essential to avoiding potential diagnostic errors.

scholarly journals How I treat hypereosinophilic syndromes

Blood ◽  
2009 ◽  
Vol 114 (18) ◽  
pp. 3736-3741 ◽  
Author(s):  
Amy D. Klion
Keyword(s):  
Kinase Inhibitors ◽  
Therapeutic Agents ◽  
Peripheral Eosinophilia ◽  
Therapeutic Decisions ◽  
Organ Manifestations ◽  
Diagnosis And Classification ◽  
Humanized Monoclonal Antibodies ◽  
Peripheral Blood Eosinophilia

Abstract Hypereosinophilic syndromes (HESs) are a heterogeneous group of uncommon disorders characterized by marked peripheral eosinophilia and end organ manifestations attributable to the eosinophilia or unexplained in the clinical setting. Whereas corticosteroids remain the mainstay of treatment for most patients, recent diagnostic advances and the development of novel targeted therapies, including tyrosine kinase inhibitors and humanized monoclonal antibodies, have increased the complexity of therapeutic decisions in HESs. This review presents a treatment-based approach to the diagnosis and classification of patients with peripheral blood eosinophilia of 1.5 × 109/L (1500/mm3) or higher and discusses the role of currently available therapeutic agents in the treatment of these patients.

Classification of Error in Abdominal Imaging: Pearls and Pitfalls for Radiologists

2018 ◽  
Vol 69 (4) ◽  
pp. 409-416 ◽  
Author(s):  
Csilla Egri ◽  
Kathryn E. Darras ◽  
Elena P. Scali ◽  
Alison C. Harris
Keyword(s):  
Peer Review ◽  
Diagnostic Errors ◽  
Diagnostic Error ◽  
Abdominal Imaging ◽  
Patient Harm ◽  
Contributing Factors ◽  
Abdominal Radiology ◽  
Pictorial Review ◽  
Classification Of Error

Peer review for radiologists plays an important role in identifying contributing factors that can lead to diagnostic errors and patient harm. It is essential that all radiologists be aware of the multifactorial causes of diagnostic error in radiology and the methods available to reduce it. This pictorial review provides readers with an overview of common errors that occur in abdominal radiology and strategies to reduce them. This review aims to make readers more aware of pitfalls in abdominal imaging so that these errors can be avoided in the future. This essay also provides a systematic approach to classifying abdominal imaging errors that will be of value to all radiologists participating in peer review.

scholarly journals STRUKTUR DAN FUNGSI SOSIAL CERITA RAKYAT LEGENDA INYIAK SUSU SABALAH DI KANAGARIAN KOTO GADANG KECAMATAN TANJUNG RAYA KABUPATEN AGAM

2019 ◽  
Vol 6 (3) ◽  
pp. 394
Author(s):  
Mayona Sri Devi ◽  
Hasanuddin WS Hasanuddin WS
Keyword(s):  
Data Collection ◽  
Qualitative Study ◽  
Social Function ◽  
Research Data ◽  
Oral Traditions ◽  
Phase 2 ◽  
Social Functions ◽  
The Social ◽  
Two Stages

This research is aimed to describe: (1) the structure of folklore legends Inyiak Susu Sabalah in Koto Gadang Village, West Tanjung Raya, District Agam; and (2) the social function of folklore legends Inyiak Susu Sabalah in Koto Gadang Village, West Tanjung Raya, District Agam. This sort of research is a qualitative study using descriptive methods. This research data is structure and social function of folklore legends Inyiak Susu Sabalah in Koto Gadang Village, West Tanjung Raya, District Agam. Data is collected from informants through two stages, that is (1) recording folklore legends Inyiak Susu Sabalah, and (2) data collection about storytelling environment. The data were analyzed by the steps of: (1) a data inventory phase; (2) classification of data; (3) the stage of discussion or conclusion from data classification results; and (4) the stage of reporting. Based on the research, was found the following statements. (1) The structure of folklore legends Inyiak Susu Sabalah in Koto Gadang Village, West Tanjung Raya, District Agam including: (a) language style; (b) characterization; (c) background; (d) storyline; (e) theme; and (f) mandate. (2) Social functions contained in folklore is inheritance of oral traditions, owner’s society identity, and social control.Keywords: legends, Inyiak Susu Sabalah, Minangkabau

Taxonomy and Epidemiology of Error in Radiology

2019 ◽  
pp. 29-74
Author(s):  
Michael A. Bruno
Keyword(s):  
Working Memory ◽  
Cognitive Biases ◽  
Confirmation Bias ◽  
Diagnostic Error ◽  
Attentional Focus ◽  
Relative Contribution ◽  
Anchoring Bias ◽  
Classification Of Error

This chapter provides an overview of the prevalence and classification of error types in radiology, including the frequency and types of errors made by radiologists. We will review the relative contribution of perceptual error—in which findings are simply not seen—as compared to other common types of error. This error epidemiology will be considered in the light of the underlying variability and uncertainties present in the radiological process. The role of key cognitive biases will also be reviewed, including anchoring bias, confirmation bias, and availability bias. The role of attentional focus, working memory, and problems caused by fatigue and interruption will also be explored. Finally, the problem of radiologist error will be considered in the context of the overall problem of diagnostic error in medicine.

scholarly journals Data Perturbation Independent Diagnosis and Validation of Breast Cancer Subtypes Using Clustering and Patterns

2006 ◽  
Vol 2 ◽  
pp. 117693510600200 ◽  
Author(s):  
G. Alexe ◽  
G.S. Dalgin ◽  
R. Ramaswamy ◽  
C. Delisi ◽  
G. Bhanot
Keyword(s):  
Breast Cancer ◽  
Data Perturbation ◽  
Luminal A ◽  
Cancer Subtypes ◽  
Luminal B ◽  
Molecular Stratification ◽  
Core Cluster ◽  
Therapeutic Decisions ◽  
Disease Subtypes

Molecular stratification of disease based on expression levels of sets of genes can help guide therapeutic decisions if such classifications can be shown to be stable against variations in sample source and data perturbation. Classifications inferred from one set of samples in one lab should be able to consistently stratify a different set of samples in another lab. We present a method for assessing such stability and apply it to the breast cancer (BCA) datasets of Sorlie et al. 2003 and Ma et al. 2003. We find that within the now commonly accepted BCA categories identified by Sorlie et al. Luminal A and Basal are robust, but Luminal B and ERBB2+ are not. In particular, 36% of the samples identified as Luminal B and 55% identified as ERBB2+ cannot be assigned an accurate category because the classification is sensitive to data perturbation. We identify a “core cluster” of samples for each category, and from these we determine “patterns” of gene expression that distinguish the core clusters from each other. We find that the best markers for Luminal A and Basal are (ESR1, LIV1, GATA-3) and (CCNE1, LAD1, KRT5), respectively. Pathways enriched in the patterns regulate apoptosis, tissue remodeling and the immune response. We use a different dataset (Ma et al. 2003) to test the accuracy with which samples can be allocated to the four disease subtypes. We find, as expected, that the classification of samples identified as Luminal A and Basal is robust but classification into the other two subtypes is not.

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