Interlaboratory Gleason grading variation affects treatment: a Dutch historic cohort study in 30 509 patients with prostate cancer
Conclusion Our study shows that the odds that a patient undergoes AT or PLND, depends on laboratories’ grading practices in a substantial number of patients. This likely influences patient prognosis and outcome, necessitating standardisation of GG to prevent suboptimal patient outcome. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Flach, R. N., van Dooijeweert, C., Aben, K. K. H., Suelmann, B. B. M., Willemse, P.-P. M., van Diest, P. J., Meijer, R. P. Tags: JCP Education Original research Source Type: research

Predicting the likelihood of a BRCA1/2 pathogenic variant being somatic by testing only tumour DNA in non-mucinous high-grade epithelial ovarian cancer
Conclusions We predict the likelihood of a tumour BRCA1/2 PV being somatic is 99.8% in non-familial cases of NMEOC diagnosed aged ≥75, where the VAF is ≤30% and there is no regional germline commonality. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Morgan, R. D., Burghel, G. J., Flaum, N., Bulman, M., Smith, P., Clamp, A. R., Hasan, J., Mitchell, C., Salih, Z., Woodward, E. R., Lalloo, F., Shaw, J., Desai, S., Crosbie, E. J., Edmondson, R. J., Schlecht, H., Wallace, A. J., Jayson, G. C., Evans, D. G Tags: Original research Source Type: research

Verification and validation of the anti-PD-L1 antibody, Clone 22C3 on a laboratory-developed test
Conclusions In conclusion, we propose to open for discussion the deconstruction of the current practice of a compulsory companion diagnostic test (CDT) for a particular PD-L1 immunohistochemical assay. The implementation of laboratory developed tests as an alternative to the CDT poses as a novel and readily available method to surmount limitations posed to pathology laboratories. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Brennan, S., O'Neill, J., Kennedy, S. Tags: Original research Source Type: research

Update regarding the role of PD-L1 in oncocytic thyroid lesions on cytological samples
Conclusions These data suggest that PD-L1 expression is expressed in oncocytic thyroid lesions. While weak PD-L1 expression failed to discriminate benign from malignant lesions, OFC demonstrated more intense cytoplasmic and membranous expression. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Dell'Aquila, M., Tralongo, P., Granitto, A., Martini, M., Capodimonti, S., Curatolo, M., Fiorentino, V., Pontecorvi, A., Fadda, G., Lombardi, C. P., Raffaelli, M., Pantanowitz, L., Larocca, L. M., Rossi, E. D. Tags: Original research Source Type: research

New autopsy technique in COVID-19 positive dead bodies: opening the thoracic cavity with an outlook to reduce aerosol spread
Conclusions The advantage of this approach is that the autopsy surgeon and pathologists do not have to open the chest cavity by dissecting the Sternum, and hence the chance of droplet infection becomes almost nil. This technique is complete, simple, less time-consuming and conducive for sample collection, and even reduces the possibility of body fluid seepage following a postmortem examination (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Das, S., Roy, A., Das, R. Tags: COVID-19 Original research Source Type: research

Cost analysis of archives in the pathology laboratories: from safety to management
Conclusions A new emergent feeling in the pathology laboratory is growing for archives management; the digital pathology era is a great opportunity to apply innovation to tracking systems and samples preservation. The main aim is a critical evaluation of the return of investment in developing automatic and tracked archiving processes for improving not only quality, efficacy and efficiency of the labs but also patients’ healthcare. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Eccher, A., Dei Tos, A. P., Scarpa, A., L'Imperio, V., Munari, E., Troncone, G., Naccarato, A. G., Seminati, D., Pagni, F. Tags: Open access, Best practice Source Type: research

Through the looking crystal: clarifying the pathogenesis and laboratory work-up of cryocrystalglobulinaemia
Cryoglobulins are immunoglobulins that precipitate or gel out of serum at temperatures less than 37°C and resolubilise on warming.1 Cryoglobulinaemia can cause vascular sludging or immune-mediated inflammation that classically presents with Meltzer’s triad of pupura, arthralgia and weakness.2 Cryocrystal formation is rare and can induce occlusive vasculopathy, thrombosis and inflammation.3 The aetiology of cryoglobulinaemia commonly includes infections, autoimmune diseases and haematological malignancies.2 Cryoglobulins are classified into three types based on clonality and immunoglobulin typing.4 Type 1 consists...
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Punchoo, R. Tags: JCP Education Grand rounds commentary Source Type: research

57-year-old woman with purpura fulminans and acute kidney injury
Clinical presentation A 57-year-old woman was admitted to Peking University First Hospital with a fever (temperature 38.5°C), and a 5-month history of a systemic purpura-like rash. Four days before admission, the rash worsened after exposure to cold weather for around 4 hours during a trip and involved the skin on her feet, ankles to thighs, buttocks and face (figure 1A–C). She had suffered from repeated but progressive ankle pain and fatigue over the previous 2 years. The initial laboratory investigations showed IgG 18.5 g/L (normal 7.23–16.85) and erythrocyte sedimentation rate (ESR) 41 mm/hour (0–1...
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Su, T., Jin, Q., Zhao, T., Wang, S. Tags: JCP Education, COVID-19, Grand rounds Source Type: research

Sox10
The SOX gene encodes for transcription factors that are involved in embryogenesis and cell differentiation. Specifically, SOX10 aids with neural crest shuttling and development. In diagnostic histopathology, Sox10 immunostain is a helpful ancillary test due to its high sensitivity for melanocytic and peripheral nerve sheath neoplasms, and its role in distinguishing triple-negative breast carcinomas from gynaecological carcinoma, cutaneous adnexal neoplasms and salivary glands neoplasms from histological mimics. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - September 19, 2023 Category: Pathology Authors: Sy, A. L., Hoang, M. P. Tags: Editor's choice, Gene of the month Source Type: research

Assessing transfer of value from industry to physicians: the importance of studying and reporting the appropriate population
In this study, Murayama and Hirota analysed general and research payments made to pathologists in the USA from 2013 to 2021 using the Open Payments database. The results reported by the authors may have significant implications for physician–industry relationships, biomedical researchers and the overall healthcare system in the USA. Therefore, we believe it is important to consider several limitations not addressed by the authors in their study. The Open Payments database was established by the Physician Payments Sunshine Act (42 U.S.C. § 1320a–7b), which requires manufacturers of drugs, medical devices, b...
Source: Journal of Clinical Pathology - August 17, 2023 Category: Pathology Authors: Jacobs, J. W., Adkins, B. D., Booth, G. S. Tags: PostScript Source Type: research

Preparing for the next pandemic: lessons learnt from the implementation of point-of-care SARS-CoV-2 testing in an emergency department
We describe collaborative governance between pathology and clinical specialities, quality assurance, testing (volume and positivity rates), impact on patient flow and focus on lessons learnt during implementation that should be incorporated into revised pandemic preparedness planning. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - August 17, 2023 Category: Pathology Authors: Donnelly, J. A., Russell, M., O'Brien, G., O'Neill, I., Fitzpatrick, F., O'Connell, K. Tags: COVID-19 Short report Source Type: research

Prevalence of elevated serum concentrations of biotin in patients from South East England, Korea, Singapore and Thailand and risk of immunoassay interference
Biotin interference in immunoassays using biotin-streptavidin binding technology is well recognised by clinical laboratories, though the prevalence of elevated biotin in patient populations is largely unknown. We determined serum biotin concentrations in 4385 patient samples received sequentially by 6 laboratories for routine immunoassay analysis in England, and Korea, Singapore and Thailand (3 countries within the Asia Pacific region, APAC). Samples were initially analysed using a research use-only immunoassay, with those identified as having potentially elevated biotin concentrations referred for definitive analysis by L...
Source: Journal of Clinical Pathology - August 17, 2023 Category: Pathology Authors: Brady, S., Bates, K., Oddy, S., Jeon, Y. L., Pichayayothin, T., Tetteh, R., Voong, K., Harrington, D. J. Tags: Short report Source Type: research

One-step genotyping of {alpha}-thalassaemia by multiplex symmetric PCR melting curve
Conclusions This method is rapid, accurate, low-cost and easy to operate, which can be used for molecular screening and genetic diagnosis of α-thalassaemia in clinical practice. The multiplex symmetric PCR melting curve strategy designed in this study can also provide an effective approach to the method development for high GC content templates and multiple mutations. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - August 17, 2023 Category: Pathology Authors: Qin, J., He, J., Li, Y., Liu, N., Tao, F., Zhang, P., Guo, W., Qin, Q., Zhou, W. Tags: Original research Source Type: research

Beyond the routine CBC: machine learning and statistical analyses identify research CBC parameter associations with myelodysplastic syndromes and specific underlying pathogenic variants
Conclusions CBC research parameters can be used as an adjunct to the haematological workup of cytopenia(s) to help screen for patients with high likelihood of MDS. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - August 17, 2023 Category: Pathology Authors: Pozdnyakova, O., Niculescu, R. S., Kroll, T., Golemme, L., Raymond, N., Briggs, D., Kim, A. Tags: JCP Education Original research Source Type: research

Implementation of the updated NICE haematological cancers (NG47) improving outcomes guidelines across Specialist Integrated Haematological Malignancy Diagnostic Services (SIHMDS) in England: a UK NEQAS LI survey
Conclusions Our survey highlights variable implementation of NICE guidance across SIHMDS, with likely inequity of access, standardisation and quality in haemato-oncology diagnostics. Provision of a more structured framework for guideline implementation could assist in increasing compliance to meet the goals of quality and equity of access to harmonised haemato-oncology diagnostics across the NHS in England. This would provide a basis for evaluating the clinical benefits and health economic impact of the SIHMDS model on patient care and outcomes. (Source: Journal of Clinical Pathology)
Source: Journal of Clinical Pathology - August 17, 2023 Category: Pathology Authors: Cartwright, A., Snowden, J. A., Whitehouse, H., Scott, S., Whitby, L. Tags: Open access Original research Source Type: research