Malignant fibrous histiocytoma of bone. Clinical pathology and histological diagnosis

Malignant fibrous histiocytoma of bone is a histologically well-defined tumor. Our aim is to describe five own cases and to analyze the published cases in order to demonstrate, the controversial aspects of clinical pathology. The essential histological criteria are the storiform tissue pattern and the presence of fibroblastic and histiocytic cells and giant cells. Inclusive of our cases, the total number reported stands at 196. There are features of malignant fibrous histiocytoma of bone about which there is almost general agreement: 1. The tumor occurs at all ages with an average onset from the age of 10 to the age of 50. 2. The tumor occurs in both the long and flat bones, but the main sites are the distal femur and the proximal tibia. 3. The tumor lacks any initial distinctive features in its clinical phase, but with respect to its biological behaviour, malignant fibrous histiocytoma of bone can be distinguished from osteosarcoma.     

Internal quality assurance in a clinical virology laboratory. II. Internal quality control.

AIMS--In April 1991 additional quality control procedures were introduced into the virology section of the Clinical Microbiology and Public Health Laboratory, Cambridge. Internal quality control (IQC) samples were gradually included in the serological assays performed in the laboratory and supplemented kit controls and standard sera. METHODS--From April 1991 to December 1993, 2421 IQC procedures were carried out with reference sera. RESULTS--The IQC samples were evaluated according to the Westgard rules. Violations were recorded in 60 of 1808 (3.3%) controls and were highest in the IQC samples of complement fixation tests (25/312 (8%) of controls submitted for complement fixation tests). CONCLUSIONS--The inclusion of IQC samples in the serological assays performed in the laboratory has highlighted batch to batch variation in commercial assays. The setting of acceptable limits for the IQC samples has increased confidence in the validity of assay results.     

Internal quality control for antimicrobial susceptibility test: an experience feedback

Internal quality control (IQC) position in antimicrobial susceptibility testing must be evaluated attentively before using. Ours S. aureus ATCC 25923 use during year 2011 has given precious information that can be useful for other laboratories. First, IQC should never be used before checking that all the realisation process steps are controlled. It will then appear that reagents are the most susceptible to give false results. That's what happens in 2.74% of antimicrobial susceptibility test. IQC is then useful to limit their clinical's impact. However, IQC use also shows that quality improvement will be difficult without industrial producer's involvement.     

Internal quality control of cytology

Quality control on cytology in Japan has not been sufficiently carried out. Herein, we describe the current internal quality control on cytology in Japan, and introduce our experience in Kawasaki Medical School. We come up against many difficulties to establish internal quality control, such as a lack of understanding and a manpower, special circumstances on diagnostics, a wage differential, and legal controls. To begin with, we should recognize an importance of quality control.     

生殖激素放射免疫分析法室内质控

目的：为了控制生殖激素放射免疫分析法常规测定的质量及回顾性评价的稳定性。方法；每次测定时放置高低值质控标本。结果：利用质控知清定值及实测结果绘制质控图来衡量每批测定的质量及计算标准曲线３个有效剂量１２批以上的均数与标准差，综合多批质控实测结果行方差分析回顾性评价批内，批间误差。     

重视乳腺癌病理工作质量控制的实践

近年来,乳腺癌在诊治方面取得的重大进步已直接影响了乳腺病理学的内涵和工作重点,使病理学在乳腺疾病诊治中发挥着更加重要的作用川.2005年第九届ST.Gallen乳腺癌大会共识中对乳腺癌的复发转移风险评估,包括年龄、组织学分级、肿瘤大小、脉管浸润、淋巴结状况及激素受体/HER2状态6项重要指标做出了要求,除年龄因素外,其余5项均属病理内容,即使肿瘤大小也要求大体测量后经显微镜下准确校正.     

重视乳腺癌病理工作质量控制的实践

近年来,乳腺癌在诊治方面取得的重大进步已直接影响了乳腺病理学的内涵和工作重点,使病理学在乳腺疾病诊治中发挥着更加重要的作用川.2005年第九届ST.Gallen乳腺癌大会共识中对乳腺癌的复发转移风险评估,包括年龄、组织学分级、肿瘤大小、脉管浸润、淋巴结状况及激素受体/HER2状态6项重要指标做出了要求,除年龄因素外,其余5项均属病理内容,即使肿瘤大小也要求大体测量后经显微镜下准确校正.     

The first experience of external quality control of immunohistochemical studies in the diagnosis of lymphoproliferative diseases

The paper presents the results of estimating the quality of immunohistochemical (IHC) staining in 36 pathologic laboratories of the Russian Federation. The results of IHC stains were assessed in 17 markers (CD3, CD5, CDIO, CD15, CD20, CD23, CD30, Bcl2, Bcl6, Pax5, TdT, Mum1, Cyclin D1, Ki-67, Kappa, Lambda, ALK), which are frequently used in the diagnosis of lymphoproliferative diseases, in the sections of specially formed tissue matrices. The study conducted in most participating laboratories has revealed the considerable IHC staining technology flaws that can critically affect the quality of diagnosis of lymphoproliferative diseases; the diagnostic capacities of some participating laboratories are inconsistent with the solved problems for a number of key antibodies being unavailable.     

Internal quality control and external quality assurance in the IVF laboratory

The existence of internal quality control programmes and external quality assurance schemes is important in enabling the maintenance of good service to patients. All aspects of our work in laboratories involved in the diagnosis and treatment of human infertility can benefit from such programmes and schemes, moving the work from being a subjective art form to an objective science. Equally, many clinical procedures are amenable to such scrutiny. Acceptance and introduction of such schemes and programmes will rely initially on the self-motivation of the laboratories themselves and then pressure brought to bear by accrediting authorities.     

Topographical and histological presentation of mammographic pathology in breast cancer.

Between 1979 and 1985 surgical resections from 680 cases of primary breast cancer were examined histologically. The patients were divided into four groups: (i) patients aged between 45 and 69 years who had been screened (n = 316); (ii) those younger than 45 who had not been screened (n = 55); (iii) those aged between 45 and 69 who had not been screened (n = 104); and (iv) those older than 69 who had not been screened (n = 205). The material was compared in terms of the association between in situ and invasive carcinoma. There was a low incidence of lobular carcinoma in situ (LCIS) in all groups and a high incidence of ductal carcinoma in situ (DCIS) which declined with age. Ninety nine group i patients had in situ carcinoma or early invasive carcinoma (less than 1 cm in diameter) compared with 19 of group iii cases. Screened patients had fewer multicentric cancers and a lower incidence of large invasive cancer compared with unscreened patients. Group ii patients had a higher incidence of whole quadrant in situ carcinoma, multiple cancer, and lymph node metastases. Group iv patients had a lower incidence of in situ cancer, and more low grade cancer than the other groups. Cases were divided into four types on the basis of this analysis.     

Internal quality assurance in a clinical virology laboratory. I. Internal quality assessment.

AIMS--In April 1991 an internal quality assessment scheme (IQAS) was introduced into the virology section of the Clinical Microbiology and Public Health Laboratory, Cambridge. The IQAS was established to identify recurring technical and procedural problems, to check the adequacy of current techniques, and to calculate the frequency of errors. METHODS--Between April 1991 and December 1993, 715 anonymous clinical serum samples were submitted to the laboratory to test 3245 individual procedures of diagnostic viral serology. RESULTS--A total of 485 (14.9%) procedural and 61 (1.9%) technical discrepancies were observed, the technical discrepancies mainly being recorded in complement fixation tests. Twenty two (0.7% of total procedures) of the technical discrepancies were diagnostically significant. CONCLUSIONS--Evaluation criteria developed with the introduction of IQAS to viral serology, and technical and procedural discrepancies are assessed. As yet, IQAS has not been introduced to other sections of the diagnostic virology laboratory (virus isolation, electron microscopy, immunofluorescence, and enzyme linked immunosorbent assays for viral and chlamydial antigens).     

Quality control for histological grading in breast cancer: an Italian experience

Although the diagnostic criteria for histological grading in breast cancer have been improved by the introduction of the Nottingham/Tenovus classification, good results in terms of reproducibility are hard to obtain. The objective of this study was to validate a methodological protocol for external quality control. We assessed the intra- and interlaboratory reproducibility for grading score and its components. Our findings revealed a less than optimal level of agreement for both intra-observer and interobserver reproducibility. Each grading class contributed in a different way to the reproducibility and class G2 provided the poorest contribution to the observed agreement. Nuclear pleomorphism appeared to be the least reproducible, followed by mitotic count and tubule formation. In conclusion, our results suggest the need for quality control programs that should be conceived as a dynamic feedback process to better understand the reasons for some unsatisfactory performances and to implement the necessary corrective actions.     

Heart transplant pathology: the British experience.

An account of human heart transplantation as seen by the histopathologists involved at the two UK transplant centres is presented. Between January 1979 and July 1984 179 patients received 186 hearts and 124 are still alive up to four years after operation. Cyclosporin A based immunosuppression has been used in the last 120 patients. Four patients developed neoplastic lesions. The commonest reason for transplantation was ischaemic heart disease (63%), followed by congestive cardiomyopathy (35%). The seven retransplants were for acute or chronic rejection. The monitoring of rejection by endomyocardial biopsies is described, and the causes of death and necropsy findings are presented.