Nodular pattern of bone marrow infiltration: frequent finding in immunosuppression-related EBV-associated large B-cell lymphomas

Different patterns of bone marrow (BM) infiltration by diffuse large B cell lymphomas (DLBCL) have been described. A pure nodular pattern is uncommon, and the pathologic features, as well as the clinical correlates of DLBCL manifesting this pattern in the BM have not been well characterized. We evaluated BM biopsies involved by large B cell lymphomas diagnosed at our institute over an 11-year period to assess the morphology, phenotype, cytogenetic abnormalities, and clinical features of cases associated with a nodular pattern. A distinct nodular pattern of BM involvement was noted in 14 out of 55 (25%) cases. Although both EBV+ and EBV− DLBCL with this pattern were identified, a pure nodular pattern was significantly more common in EBV+ DLBCL compared to EBV− DLBCL (8/9, 89% versus 6/46, 13%; P = 0.00002). The majority of EBV+ DLBCL associated with a nodular pattern had distinctive morphologic features (polymorphic cellular infiltrate and pleomorphic cytology), and CD30 expression was more commonly observed in this group (P = 0.0163). All EBV+ DLBCL and two out of six (33%) EBV− DLBCL had nongerminal center phenotypes. No recurrent cytogenetic abnormalities were detected in either group. Importantly, all EBV+ DLBCL occurred in individuals with immune dysfunction (organ transplant recipients, HIV infection) or in those >50 years of age. Our study indicates a much higher predilection for EBV+ DLBCL to involve the marrow in a nodular pattern compared to EBV− cases and highlights similarities in the morphologic pattern of BM involvement by previously recognized subsets of immunodeficiency-related EBV + lymphomas and the newer entity of “EBV+ DLBCL of the elderly.”     

Mitochondrion-rich differentiated adenocarcinomas of the stomach: clinicopathological, immunohistochemical and electron microscopy study of nine cases

Pathologic and prognostic data of nine patients with mitochondrion-rich carcinomas (MRC) were compared retrospectively to data of 101 patients with conventional gastric adenocarcinomas. MRC was defined as a tumour composed predominantly, or entirely, of columnar adenocarcinoma cells with eosinophilic cytoplasm and a strong supranuclear immunoreactivity for antimitocondrial antibody. Electron microscopy confirmed supranuclear distribution of mitochondria in MRC while immunostaining pattern was irregular or absent in the remaining 101 cases. MRC exhibited a tubulopapillary or cribriform growth pattern with focal infiltration of neutrophils in the tumour stroma. Prominent necrosis was present including segmental and intraluminal “dirty necrosis”, while mitotic and ki-67 proliferative rates were low. MRC showed immunohistochemical findings compatible with gastric differentiation (CK7⁺/CK20⁻/CDX⁻).When MRC were compared with non-MRC carcinomas, tumour size (<4 cm vs >4 cm, P < 0.01), frequency of lymph node metastases (11% vs. 80%, P < 0.01), low stage (I, II) at diagnosis (100% vs. 56%, P < 0.01), Goseki’s group I (100% vs. 6%, P < 0.01), and better survival (0% vs. 70%, P < 0.01) differed significantly. Our results suggest that MRC of the stomach may be considered a low-grade malignancy with an excellent prognosis.     

Cytologic features of pancreatic adenocarcinoma with “vacuolated cell pattern.” report of a case diagnosed by endoscopic ultrasound‐guided fine‐needle aspiration

The “vacuolated cell pattern” has only been recently described as a distinct morphologic variant of pancreatobiliary adenocarcinoma. Herein, we report the endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) cytologic features of a case of pancreatic adenocarcinoma with “vacuolated cell pattern” occurring in a 60‐year‐old man. The aspirate smears and cell block sections from the EUS‐FNA of a 23.5 mm hypoechoic pancreatic head mass were highly cellular, showing variably‐sized crowded three‐dimensional cell clusters, flat sheets, and numerous highly atypical single cells. The background was bloody and showed necrotic debris, but no discernible mucus. The most striking feature of the aspirate was the presence of numerous very large (20–50 µm) vacuoles, occupying the entire cytoplasm, pushing the nuclei to the side and indenting them, that imparted a cribriform appearance to the sheets of neoplastic cells. The non‐vacuolated neoplastic cells were large, had abundant dense (squamoid) cytoplasm, irregularly contoured hyperchromatic nuclei, and prominent macronucleoli. Histologic evaluation of the pancreatectomy specimen showed a “vacuolated cell pattern” adenocarcinoma composed of poorly formed glands, solid sheets, and infiltrating single cells with pleomorphic nuclei and large cytoplasmic vacuoles. To our knowledge, this is the first report describing the cytologic features of this rather uncommon morphologic variant of pancreatic adenocarcinoma. Recognition of this morphologic variant of pancreatic adenocarcinoma in ESU‐FNA samples allows its differentiation from primary and metastatic signet‐ring cell carcinomas. Diagn. Cytopathol. 2014;42:302–307. © 2014 Wiley Periodicals, Inc.     

Violence as a risk factor for postpartum depression in mothers: a meta-analysis

The objective of this paper is to examine the association between violence and postpartum depression (PPD). The data sources of this study are: Web of Science, PubMed, Elsevier, Springer Link were examined from their start date through July1, 2011. “Violence”, “domestic violence”, “physical violence”, “sexual violence”, “domestic violence”, “postpartum depression”, “postnatal depression”, and “puerperal depression” were some of the terms included in the purview of MeSH terms. Relevant studies from reference lists were also scanned. Studies examining the association between violence and postpartum depression have been included. A total of 679 studies were included in this screening. Essential information of these included studies was independently extracted by two raters. Newcastle–Ottawa scale was used to assess the clinical data of these research studies. Random-effects model was chosen in this meta-analysis for maintaining significant heterogeneity. Publication bias was evaluated with the help of a funnel plot. Six studies involving 3,950 participants were included in this clinical study. Violence was one of the factors responsible for PPD [OR = 3.47; 95% confidence interval (CI; 2.13–5.64)]. Significant heterogenity was found in this meta-analysis (P < 0.00001; I ² = 79%)and publication bias was detected through a funnel plot. A sensitivity analysis of 3.00, 95%CI (2.44–3.68), p < 0.00001 indicated that our findings were robust and reliable. Our meta-analysis indicated a positive correlation between violence and PPD. In women of reproductive age, PPD induced through violence can be prevented through early identification. In addition, due to heterogeneity and wide CIs in this meta-analysis, further research is evidently required.     

Differentiation between human and animal isolates of Cryptosporidium parvum using molecular and biological markers

Isolates of Cryptosporidium parvum obtained from infected humans, calves and lambs were typed using arbitrary primed polymerase chain reaction (AP-PCR) and isoenzyme electrophoresis. All animal isolates tested (n = 17) showed similar profiles in AP-PCR and isoenzyme typing. In AP-PCR assays, 9 out of 15 human isolates showed a distinct “human” profile while the remaining 6 isolates showed the “animal” profile. In isoenzyme typing, 5 human isolates which had shown “human” profiles in AP-PCR demonstrated a unique isoenzyme banding pattern, while 2 isolates which had shown “animal” profiles in AP-PCR gave the “animal” banding pattern. In a murine model of infection, all four animal isolates tested were highly infective but only one of four human isolates identified as “human” type in the AP-PCR and isoenzyme typing systems was infective. The good correlation between the data from the different typing systems supports the hypothesis that there are genetically distinct human and animal populations of C. parvum. Received: 27 May 1997 / Accepted: 15 September 1997     

Morphometric Analysis of Atherosclerotic Plaques in Human Carotid Arteries

Morphometric analysis of 35 biopsy specimens from patients with stable (n = 10) and unstable (n = 25) atherosclerotic lesions was carried out. The structure of the plaques and their connective tissue caps was studied by various methods of histological sections staining. A new morphometric approach to quantitative evaluation of atherosclerotic lesions instability is suggested. It consists in calculation of the morphological “rigidity” coefficient, due to which the plaque is characterized more accurately. The proportion of areas of the “rigid” (connective tissue and calcium salt deposition areas) to “soft” (atheronecrotic nuclei, microvessels, clots and hemorrhages) structures of the plaque is evaluated. Plaque instability (liability of a to rupture) is associated with changes in the extracellular matrix components in the cap: accumulation of collagen and reduction of elastic fiber content reducing vessel elasticity and making its locally more rigid.     

Brief report: biomarkers of aortic vascular prosthetic graft infection in a porcine model with Staphylococcus aureus

Aortic vascular prosthetic graft infection (AVPGI) with Staphylococcus aureus is a feared post-operative complication. This study was conducted to evaluate the clinical signs and potential biomarkers of infection in a porcine AVPGI model. The biomarkers evaluated were: C-reactive protein (CRP), fibrinogen, white blood cells (WBC), major histocompatibility complex II (MHC II) density, lymphocyte CD4:CD8 ratio and tumour necrosis factor-alpha (TNF-α) in vitro responsiveness. Sixteen pigs were included in the study, and randomly assigned into four groups (n = 4): “SHAM” pigs had their infra-renal aorta exposed by laparotomy; “CLEAN” pigs had an aortic graft inserted; “LOW” and “HIGH” pigs had an aortic graft inserted and, subsequently, S. aureus were inoculated on the graft material (5 × 10⁴ colony-forming units [CFU] and 1 × 10⁶ CFU, respectively). Biomarkers were evaluated prior to surgery and on day 2, 5, 7, and 14 post-operatively in blood samples. Of all biomarkers evaluated, CRP was superior for diagnosing S. aureus AVPGI in pigs, with a sensitivity of 0.86 and a specificity of 0.75.     

Electromyogram changes during sustained contraction after resistance training in women in their 3rd and 8th decades

The present study aimed at investigating the neuromuscular adaptations to 6 weeks of resistance training in women in their third (6 experimental, 8 controls) and eighth decades (8 experimental, 8 controls). The surface electromyogram (sEMG) was measured from the biceps brachii muscle during constant-force isometric contractions lasting 12 s at 80% of maximal voluntary contraction (MVC). All the signals were analysed adopting in the time domain the root mean square (RMS) as a measure of amplitude and in the frequency domain the median frequency (MDF) of the power spectrum. Quantitative analysis was performed from the 3rd to the 6th second, to describe the early phase of the contraction (“Early”), starting from point at which 80% of the MVC was reached, and from the 9th to the 12th second, to describe the last part of the constant-force sustained contraction (“Late”). After training, the MVC increased by 22.4% in the young (P < 0.0001) and by 13.4% in the older (P < 0.05) women. The “Early” RMS increased by 60.4% with respect to the pre-training condition in the young (P < 0.01) but not in the older women. In contrast, the “Late” RMS increased by 46.7% in the older (P < 0.05) but not in the young women. The MDF remained unchanged in both groups. These results indicate that young and older women showed different training-induced adaptation of the motor unit (MU) activation pattern, in order to keep a constant level of force during a sustained isometric contraction at 80% of MVC. Accepted: 11 March 2000     

The heterogeneity of choanomastigote-shaped trypanosomatids as analyzed by their kDNA minicircle size: taxonomic implications

The kDNA minicircle size was analyzed in 15 species of choanomastigote-shaped trypanosomatids and four main groups of species were identified: (1) “Crithidia”deanei, “C.”desouzai and “Herpetomonas”roitmani, which presented the largest molecules (≥ 3,800 bp), (2) “C.”oncopelti with minicircles of at least four different sizes within 1,300–2,650 bp, (3) C. fasciculata, C. guilhermei and C. luciliae, having at least two sizes of minicircle (2,650 bp and 3,000 bp) and (4) a heterogeneous group of species presenting minicircles of a single size, including several Crithidia spp. (having 1,600 bp or 1,700 bp minicircles) and two Proteomonas spp. presenting the smallest minicircles (about 1,500 bp). These results were compared with other observations and discussed from a taxonomic point of view. Received: 7 January 2000 / Accepted: 1 March 2000     

Cytoadherence of the malaria-infected erythrocyte membrane to C32 melanoma cells after merozoites are released from parasitized infected cells

Infections with the human malaria parasite Plasmodium falciparum are characterized by cytoadherence of infected erythrocytes to the venular endothelium of several organs. Video microscopy studies have shown that at the end of the asexual life of P. falciparum, the residual body containing haemozoin is released to the extracellular environment along with merozoites, leaving behind an infected erythrocyte “ghost”. It is possible that these infected erythrocyte “ghosts” could remain sequestered within the blood vessels of patients infected with P. falciparum even after merozoites have been released from infected erythrocytes. In this study an in vitro cytoadherence assay was developed to show that infected erythrocyte “ghosts” can interact with C32 melanoma cells. Adherent infected erythrocyte “ghosts” contain some of the subcellular compartments of the malaria-infected red blood cell such as the tubo-vesicular membrane network and remnants of the parasitophorous vacuolar membrane, but lack haemozoin. Received: 28 August 2000 / Accepted: 13 September 2000     

Spermiogenesis and spermatozoon ultrastructure of the diphyllidean cestode Echinobothrium euterpes (Neifar, Tyler and Euzet 2001) Tyler 2006, a parasite of the common guitarfish Rhinobatos rhinobatos

Spermiogenesis and the ultrastructural characters of the spermatozoon of Echinobothrium euterpes are described by means of transmission electron microscopy, including cytochemical analysis for glycogen. Materials were obtained from a common guitarfish Rhinobatos rhinobatos caught in the Gulf of Gabès (Tunisia). Spermiogenesis in E. euterpes is characterized by the orthogonal development of two unequal flagella followed by the flagellar rotation and the proximodistal fusion of these flagella with the median cytoplasmic process. The most interesting pattern characterizing the diphyllidean cestodes is the presence of a triangular body constituted by fines and dense granules without visible striation and assimilated at the striated rootlets. This pattern, only related in the Diphyllidea cestodes may be a synapomorphy of this order. Spermiogenesis is also characterized by the presence of a very short flagellum (around 1 μm long), observed in all the stages of spermiogenesis. This type of flagellum has never been commented in the diphyllidean cestodes and should be considered as an evolved character in this group. In the latest stage of spermiogenesis, this short axoneme probably degenerates. Thus, the mature spermatozoon of E. euterpes possesses only one axoneme of 9 + “1” trepaxonematan pattern. It also exhibits a single helical electron-dense crested body, a spiraled nucleus, few parallel cortical microtubules, and α-glycogen granules. Similitudes and differences between spermatozoa of diphyllideans are discussed.     

Integrated siphon-based metering and sedimentation of whole blood on a hydrophilic lab-on-a-disk

In this paper, we present a novel and fully integrated centrifugal microfluidic “lab-on-a-disk” for rapid colorimetric assays in human whole blood. All essential steps comprising blood sampling, metering, plasma extraction and the final optical detection are conducted within t = 150 s in passive, globally hydrophilized structures which obviate the need for intricate local hydrophobic surface patterning. Our technology features a plasma extraction structure (V = 500 nL, CV < 5%) where the purified plasma (c _RBC < 0.11%) is centrifugally separated, metered by an overflow and subsequently extracted by a siphon-based principle through a hydrophilic extraction channel into the detection chamber.     

Lamellodiscus crampus sp. nov. (Monogenea, Diplectanidae), a parasite of Dentex maroccanus (Teleostei, Sparidae) from off Tunisia

Lamellodiscus crampus sp. nov. (Monogenea, Diplectanidae) is described from the gills of Dentex maroccanus (Valenciennes) collected from the Gulf of Gabès (Tunisia) in the oriental part of Mediterranean Sea. The new species belongs to the “ignoratus” group (sensu Oliver 1987) characterized by a lamellodisc with complete lamellae and a “lyre” shaped male copulatory organ, and the “ignoratus” sensu stricto subgroup, characterized by a haptor with simple lateral dorsal bars, as proposed by Amine and Euzet (2005). Lamellodiscus crampus can be easily distinguished from all the congeneric species of the subgroup “ignoratus” by the presence, in the “lyre” male copulatory organ, of five spines in the distal portion on the axial side of the paired piece.     

Women’s responses to postnatal self-report mood and experience measures: does anonymity make a difference?

This study aimed to investigate whether endorsement of “difficulty coping” questions on two self-report measures would be affected by whether or not women had to put their name on the questionnaires. In addition, a small survey of mental health professionals was conducted to see what they thought the study would find. Women (n = 211) attending maternal and child health clinics completed two self-report measures of mood and experience of motherhood. Women were either asked to write their name on the forms and were told that the project officer would check their forms once completed (“named” condition) or asked not to put their name on the forms and that the forms would not be looked at (“anonymous” condition). Perinatal mental health professionals (n = 44) completed an anonymous survey asking them what they considered the study would find. Most health professionals (77.3%) expected that the anonymous condition would result in more “honest” responding by women—that is, there would be a higher rate of women admitting to not coping in the anonymous condition. To the contrary, however, this was not found. There were no differences between the rates of endorsement of “not currently coping” by women in the two conditions, a finding only expected by 13.6% of the professionals. There was a small, but statistically significant, difference in women reporting whether they had a prior history of difficulty coping, with more women in the named condition endorsing this. Rates of postnatal distress or depression, based upon responses to self-report mood or similar questionnaires, are unlikely to be affected by whether participants are required to put their name on the measures or not or whether they anticipate that their responses will be scrutinized. This is an unexpected finding by a sample of mental health professionals interested in the perinatal mental health field, and thus, the study has “new knowledge” significance.     

Prevalence of nasal methicillin-resistant Staphylococcus aureus colonization in healthcare workers in a Western Australian acute care hospital

Due to a longstanding comprehensive “search and destroy policy”, methicillin-resistant Staphylococcus aureus (MRSA) is not endemic in Western Australian (WA) acute care hospitals. As the prevalence of MRSA in the community has increased, healthcare workers (HCW) are at risk of importing MRSA into hospitals. We aimed to determine the prevalence of and risk factors for nasal MRSA colonization in our HCW population. A period prevalence study was conducted at an 850-bed tertiary hospital. Basic demographics and a nasal swab were obtained. A total of 1,542 HCWs employed in our centre were screened for MRSA, of whom 3.4% (n = 52) were colonized. MRSA colonization was more common in patient care assistants (6.8%) and nurses (5.2%) than in allied health professionals (1.7%) and doctors (0.7%) (p < 0.01). Working in “high-risk” wards that cared for MRSA colonized/infected patients was the strongest risk factor for HCW MRSA colonization (p < 0.001). ST1-IV and ST78-IV (the most common community clones in the region) were the most frequently identified clones. In conclusion, MRSA colonization of HCWs occurs primarily in HCWs caring for patients colonized or infected with MRSA. Surveillance screening of HCWs should be regularly performed on wards with patients with high MRSA colonization prevalence to prevent further spread in the hospital.     

Effect of ageing on the ventilatory response and lactate kinetics during incremental exercise in man

We investigated the effects of age on breathing pattern, mouth occlusion pressure, the ratio of mouth occlusion pressure to mean inspiratory flow, and venous blood lactate kinetics during incremental exercise. Mouth occlusion pressure was used as an index of inspiratory neuromuscular activity, and its ratio to mean inspiratory flow was used as an index of the “effective impedance” of the respiratory system. Nine elderly male subjects [mean (SD) age: 68.1 (4.8) years] and nine young male subjects [mean (SD) age: 23.4 (1.3) years] performed an incremental exercise test on a bicycle ergometer. After a warm-up at 30 W, the power was increased by 30 W every 1.5 min until exhaustion. Our results showed that at maximal exercise, power output, breathing pattern, and respiratory exchange values, with the exception of tidal volume and the “effective impedance” of the respiratory system, were significantly higher in the young subjects. The power output and oxygen consumption values at the anaerobic threshold were also significantly higher in the young men. At the same power output, the elderly subjects showed significantly higher values for minute ventilation, respiratory equivalents for oxygen uptake and carbon dioxide output (CO₂), mean inspiratory flow, occlusion pressure and lactate concentration than the young subjects. At the same CO₂ below the anaerobic threshold (0.5, 0.75, 1.00 and 1.25 l · min⁻¹), minute ventilation and lactate concentration were also significantly higher in the elderly subjects. We observed a significantly higher minute ventilation at CO₂ values of 0.5, 0.75, 1.00 (P < 0.001) and 1.25 l · min⁻¹ (P < 0.05) in the elderly men, and a significantly higher lactate concentration at CO₂ values of 1.00 (P < 0.05) and 1.25 l · min⁻¹ (P < 0.01). In conclusion, the ventilatory response in elderly subjects is elevated in comparison with that in young subjects, both below and above the anaerobic threshold. This study demonstrates for the first time that this ventilatory increase, both below and above the threshold, is partly due to an increased lactate concentration. Received: 30 March 1999 / Accepted: 24 June 1999     

Age and distress of women–results of a representative population-based study

Little research has been carried out on prevalence rates of distress (e.g. depression, posttraumatic stress symptoms (PTSS), hopelessness, and burnout) of women in different age groups. The aims of this study were to measure the prevalence rate of depression, posttraumatic stress symptoms, hopelessness, and burnout among women and to clarify the associations between age groups and distress. Cross sectional epidemiological study on women in Sweden (n = 6,000, aged 18–64 years, response rate 64.1%). Measures were questionnaires on socio-economic and work-related characteristics and on depression, posttraumatic stress symptoms, hopelessness, and burnout. Depression was measured with the “General Health Questionnaire” (GHQ), PTSS with the “Posttraumatic Symptom Scale”, hopelessness with the “Hopelessness Scale” and burnout with the “Shiron-Melamed Burnout Questionnaire” (SMBQ). The prevalence rate of depression varied from 12.5% to 14.1%; of posttraumatic stress symptoms from 23.5% to 33.3%; of hopelessness from 11.5% to 16%; and of burnout from 22.9% to 17.1%. Depression was not associated with age group. Hopelessness was associated with age group in univariate analysis bur not in multivariate analysis (OR = 0.7, 95% CI = 0.5–1.0). PTSS and burnout were associated with age group. Both symptoms were higher in the youngest age group, compared to the eldest age group (posttraumatic stress symptoms: OR = 1.6, 95% CI = 1.2, 2.1; burnout: OR = 1.5, 95% CI = 1.1–2.1). Younger women show higher prevalence rates of PTSS and burnout compared to elder women. The higher prevalence rates of PTSS and burnout among younger women may be associated with job strain and/or with violent life events.     

Neuroendocrine Tumors of the Head and Neck: A Selected Review with Emphasis on Terminology

Virtually every variant of neuroendocrine neoplasia can occur, at least rarely, in the head and neck region. This review focuses on the terminology surrounding neuroendocrine carcinomas of the larynx and their distinction from morphologically similar but biologically distinctive neoplasmas. It is suggested that rare typical laryngeal carcinoids be labeled as such. There is little evidence that these lesions are part of a morphologic continuum. In contrast, more common “carcinoid-like” carcinomas, previously referred to as “atypical carcinoids” are more appropriately labeled as “moderately differentiated neuroendocrine carcinomas”. These neoplasms should, in turn, be distinguished from “small cell neuroendocrine carcinomas,” although these latter two neoplasms do represent a morphologic and behavioral spectrum. Light microscopic and immunohistochemical features distinguishing neuroendocrine carcinomas of the larynx from paraganglioma, metastatic medullary carcinoma, malignant melanoma, and basaloid squamous cell carcinoma are presented. The second portion of this review outlines the clinicopathologic features of two head and neck neoplasms exhibiting varying degrees of neuroendocrine differentiation. Olfactory neuroblastomas have well-developed neuroendocrine differentiation, almost invariably arise from the olfactory mucosa, typically exhibit low-grade cytologic features, and may have protracted clinical course with an approximately 50% overall 5-yr survival. In contrast, sinonasal undifferentiated carcinoma is a microscopically high-grade neoplasm with minimal, abortive neuroendocrine features, a highly aggressive clinical course, and virtually 100% mortality. They can arise throughout the sinonasal region. Presented at the Endocrine Pathology Society—USCAP Meeting, Washington, DC, March 23, 1996.     

Characterizing the Clustered Microcalcifications on Mammograms to Predict the Pathological Classification and Grading: A Mathematical Modeling Approach

In this study, we explore a mathematical model to characterize the clustered microcalcifications on mammograms for predicting the pathological classification and grading. Our database consists of both retrospective cases (78 cases) and prospective cases (31 cases) with pathologically diagnosed clusters of microcalcifications on mammograms. The microcalcifications were divided into four grades: grade 0, benign breast disease including mastopathies (n = 12) and fibroadenomas (n = 20); grade 1, well-differentiated infiltrating ductal carcinoma (n = 12); grade 2, moderately differentiated infiltrating ductal carcinoma (n = 38); grade 3, poorly differentiated infiltrating ductal carcinoma (n = 27). A feature parameter, defined as the pattern form factor of microcalcification cluster θ by us, combines five computer-extracted image parameters of microcalcification clusters of those mammograms. In every case, only one imaging was selected for modeling analysis. A total of 109 imagings were adopted in current study. We find the existence of a positive relationship between the feature parameter θ and pathological grading G of microcalcifications in retrospective cases, which was expressed as G =  6.438 + 1.186 ×  Ln <θ>. The model above has been verified further by the prospective study with a comparative evaluation accuracy of approximately 77.42%. The binary predication simply for both benignancy and malignancy was also included using same but reshuffled data, and the receiver operating characteristic (ROC) analysis was performed with ROC value 0.74351∼0.79891. As one candidate for feature parameter in computer-aided diagnosis, the pattern form factor θ of clustered microcalcifications may be useful to predict the pathological grading and classification of microcalcification clusters on mammography in breast cancer.