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An unusual association of calcifying pseudoneoplasm of the neuraxis with interhemispheric lipoma and agenesis of corpus callosum: case report
ABSTRACTS
Conflict of interest statement: This research was supported by the Department of Health and Ageing. The Department had no role in analysing the data or preparing this abstract. PERFORMANCE MONITORING IN GYNAECOLOGICAL CYTOPATHOLOGY Jennifer Ross RCPA Cytopathology QAP, Kelvin Grove, Brisbane, Qld, Australia Following the establishment of the Cytopathology Performance Review Committee this year, criteria for monitoring laboratory performance have been developed and a pilot phase will be undertaken in 2012. Criteria are based on both results from routine gynaecological Quality Assurance Program (QAP) surveys and Performance Measure data. The pilot phase will help determine the effectiveness of these criteria in assisting the National Association of Testing Authorities (NATA) to identify laboratories that may require early review. Criteria for the pilot are: one Performance Measure outside the National Standard set by NPAAC; non-submission of results for Performance Measures; one major error in a conventional gynaecological (GYN) survey; three unacceptable responses in any GYN survey in any 12 month period; non-submission of results for any GYN survey. Results will be reviewed within a rolling 12 month cycle. When a laboratory’s results have fallen outside these established criteria, the laboratory’s results will be forwarded to the Cytopathology Peer Review Committee for review. If results are assessed as unacceptable, notification letters will be sent to the laboratory in accordance with the framework developed by the Royal College of Pathologists of Australasia (RCPA) QAP. It is hoped the outcomes of the pilot phase of the Cytopathology Performance Monitoring Project will assist in evaluating criteria for unacceptable performance in Cytopathology. As the project progresses results will be monitored by the Cytopathology PRC and these criteria may be reviewed. LABORATORY MONITORING OF HEPARIN CONTAMINATION OF THE SAMPLE: COMPARISON OF PROTMAINE SULPHATE AND HEPARIN RESISTANT CALCIUM CHLORIDE Safoorah Sagheer, Akash Kalro, Merriane Wardle, Ferenc Szabo Pathology Department, Royal Darwin Hospital, NT, Australia Aims: To compare the extent of correction of prolonged activated partial thromboplastin time (APTT) on patients’ samples using protamine sulphate and heparin resistant calcium chloride. Methods: Citrated blood samples from inpatients with APTT >40 seconds were tested for correction of APTT using the two reagents. Results were then correlated with clinical details and history of use of any anticoagulants. Reagents were also compared after in vitro spiking of normal plasma with varying concentrations of unfractionated heparin. Results: Testing with spiked samples demonstrated that the procedure is effective at <2 U/mL heparin for both the reagents. Regarding patients’ samples, 37 samples with prolonged APTT were run and 17 (45.9%) of these showed complete correction of APTT with either of the reagents. Review of the clinical details revealed that all the patients were on heparin. Four patients (10.8%) were on warfarin and heparin and showed partial correction only. No correction was observed in 16 samples (43.2%) and
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the cause of prolonged APTT was liver disease, warfarin therapy or disseminated intravascular coagulation. Conclusion: Protamine sulphate and heparin resistant calcium chloride have comparable results in correction of APTT for samples contaminated with heparin. The degree of correction of APTT was found to be the same for both reagents. References 1. Dade Actin FSL Activated PTT Reagent: Product Insert. Dade, June 2006. 2. Dade CiTrol Heparin Controls, Low and High: Product Insert. Dade, May 2008. 3. Sysmex. Instructions for Use, Automated Blood Coagulation Analyser CA 500 Series, Operator’s Manual. Sysmex, 2003. 4. NCCLS. H21-A3 Collection, Transport and Processing of Blood Specimens for Coagulation Testing and General Performance of Coagulation Assays: Approved Guideline. Third edition, Volume 18, No 20. Wayne, PA: NCCLS, 1998. 5. Sysmex CA 540/ 560 Activated Partial Thromboplastin Time (QHPS). Brisbane, Queensland Health.
AN UNUSUAL ASSOCIATION OF CALCIFYING PSEUDONEOPLASM OF THE NEURAXIS WITH INTERHEMISPHERIC LIPOMA AND AGENESIS OF CORPUS CALLOSUM: CASE REPORT Alaa A. Salim1, Peter J. Wilson2, Ravi K. Cherukuri2, Sandra McKenzie3, Michael E. Buckland1 1 Department of Neuropathology, Royal Prince Alfred Hospital, Sydney, Departments of 2Neurosurgery and 3Anatomical Pathology, Wollongong Hospital, NSW, Australia Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare tumours that can occur anywhere in the central nervous system. The aetiology and natural history of these lesions is unclear. We report an unusual case of intraparenchymal CAPNON that occurred in association with interhemispheric lipoma and agenesis of the corpus callosum. The patient was a 47-year-old woman with known congenital absence of corpus callosum who presented with a progressive 6-month history of worsening headache, ataxic gait, blurred vision and poor memory. Magnetic resonance imaging (MRI) revealed complete agenesis of the corpus callosum with associated interhemispheric lipoma and an unusual calcified intraparenchymal mass, largely hypointense on T2 with intermediate signal centrally on T1, surrounded by an ill-defined vasogenic oedema. Histologically, the first lesion was confirmed as lipoma. The second lesion consisted of multiple nodules of chondromyxoid matrix partially rimmed by a single layer of palisading spindled to epithelioid cells and focal osseous metaplasia including mature lamellar bone. The final diagnosis was CAPNON associated with interhemispheric lipoma and agenesis of the corpus callosum. To our knowledge, this is the first reported association between these uncommon lesions. CAPNON have relatively non-specific radiological features with a broad differential diagnosis, but have distinctive histological features. Accurate identification of CAPNON will help avoid misdiagnoses and unnecessary therapeutic procedures since wide local excision is curative. ANALYSIS OF POSITIVE BACTERIOLOGY CULTURES AT A REGIONAL MICROBIOLOGY IN VIEW OF UNDERSTANDING LOCAL EPIDEMIOLOGY AND IMPROVING THE QUALITY OF SERVICES H. T. Samarasekara, J. Branley, R. Vaz Department of Microbiology, Orange Hospital, Orange, NSW, Australia Aim: Analysis of positive bacteriology specimens performed over one year to determine local epidemiology data and to improve methods and reporting procedure.
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited. Copyright
Conflict of interest statement: This research was supported by the Department of Health and Ageing. The Department had no role in analysing the data or preparing this abstract. PERFORMANCE MONITORING IN GYNAECOLOGICAL CYTOPATHOLOGY Jennifer Ross RCPA Cytopathology QAP, Kelvin Grove, Brisbane, Qld, Australia Following the establishment of the Cytopathology Performance Review Committee this year, criteria for monitoring laboratory performance have been developed and a pilot phase will be undertaken in 2012. Criteria are based on both results from routine gynaecological Quality Assurance Program (QAP) surveys and Performance Measure data. The pilot phase will help determine the effectiveness of these criteria in assisting the National Association of Testing Authorities (NATA) to identify laboratories that may require early review. Criteria for the pilot are: one Performance Measure outside the National Standard set by NPAAC; non-submission of results for Performance Measures; one major error in a conventional gynaecological (GYN) survey; three unacceptable responses in any GYN survey in any 12 month period; non-submission of results for any GYN survey. Results will be reviewed within a rolling 12 month cycle. When a laboratory’s results have fallen outside these established criteria, the laboratory’s results will be forwarded to the Cytopathology Peer Review Committee for review. If results are assessed as unacceptable, notification letters will be sent to the laboratory in accordance with the framework developed by the Royal College of Pathologists of Australasia (RCPA) QAP. It is hoped the outcomes of the pilot phase of the Cytopathology Performance Monitoring Project will assist in evaluating criteria for unacceptable performance in Cytopathology. As the project progresses results will be monitored by the Cytopathology PRC and these criteria may be reviewed. LABORATORY MONITORING OF HEPARIN CONTAMINATION OF THE SAMPLE: COMPARISON OF PROTMAINE SULPHATE AND HEPARIN RESISTANT CALCIUM CHLORIDE Safoorah Sagheer, Akash Kalro, Merriane Wardle, Ferenc Szabo Pathology Department, Royal Darwin Hospital, NT, Australia Aims: To compare the extent of correction of prolonged activated partial thromboplastin time (APTT) on patients’ samples using protamine sulphate and heparin resistant calcium chloride. Methods: Citrated blood samples from inpatients with APTT >40 seconds were tested for correction of APTT using the two reagents. Results were then correlated with clinical details and history of use of any anticoagulants. Reagents were also compared after in vitro spiking of normal plasma with varying concentrations of unfractionated heparin. Results: Testing with spiked samples demonstrated that the procedure is effective at <2 U/mL heparin for both the reagents. Regarding patients’ samples, 37 samples with prolonged APTT were run and 17 (45.9%) of these showed complete correction of APTT with either of the reagents. Review of the clinical details revealed that all the patients were on heparin. Four patients (10.8%) were on warfarin and heparin and showed partial correction only. No correction was observed in 16 samples (43.2%) and
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the cause of prolonged APTT was liver disease, warfarin therapy or disseminated intravascular coagulation. Conclusion: Protamine sulphate and heparin resistant calcium chloride have comparable results in correction of APTT for samples contaminated with heparin. The degree of correction of APTT was found to be the same for both reagents. References 1. Dade Actin FSL Activated PTT Reagent: Product Insert. Dade, June 2006. 2. Dade CiTrol Heparin Controls, Low and High: Product Insert. Dade, May 2008. 3. Sysmex. Instructions for Use, Automated Blood Coagulation Analyser CA 500 Series, Operator’s Manual. Sysmex, 2003. 4. NCCLS. H21-A3 Collection, Transport and Processing of Blood Specimens for Coagulation Testing and General Performance of Coagulation Assays: Approved Guideline. Third edition, Volume 18, No 20. Wayne, PA: NCCLS, 1998. 5. Sysmex CA 540/ 560 Activated Partial Thromboplastin Time (QHPS). Brisbane, Queensland Health.
AN UNUSUAL ASSOCIATION OF CALCIFYING PSEUDONEOPLASM OF THE NEURAXIS WITH INTERHEMISPHERIC LIPOMA AND AGENESIS OF CORPUS CALLOSUM: CASE REPORT Alaa A. Salim1, Peter J. Wilson2, Ravi K. Cherukuri2, Sandra McKenzie3, Michael E. Buckland1 1 Department of Neuropathology, Royal Prince Alfred Hospital, Sydney, Departments of 2Neurosurgery and 3Anatomical Pathology, Wollongong Hospital, NSW, Australia Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare tumours that can occur anywhere in the central nervous system. The aetiology and natural history of these lesions is unclear. We report an unusual case of intraparenchymal CAPNON that occurred in association with interhemispheric lipoma and agenesis of the corpus callosum. The patient was a 47-year-old woman with known congenital absence of corpus callosum who presented with a progressive 6-month history of worsening headache, ataxic gait, blurred vision and poor memory. Magnetic resonance imaging (MRI) revealed complete agenesis of the corpus callosum with associated interhemispheric lipoma and an unusual calcified intraparenchymal mass, largely hypointense on T2 with intermediate signal centrally on T1, surrounded by an ill-defined vasogenic oedema. Histologically, the first lesion was confirmed as lipoma. The second lesion consisted of multiple nodules of chondromyxoid matrix partially rimmed by a single layer of palisading spindled to epithelioid cells and focal osseous metaplasia including mature lamellar bone. The final diagnosis was CAPNON associated with interhemispheric lipoma and agenesis of the corpus callosum. To our knowledge, this is the first reported association between these uncommon lesions. CAPNON have relatively non-specific radiological features with a broad differential diagnosis, but have distinctive histological features. Accurate identification of CAPNON will help avoid misdiagnoses and unnecessary therapeutic procedures since wide local excision is curative. ANALYSIS OF POSITIVE BACTERIOLOGY CULTURES AT A REGIONAL MICROBIOLOGY IN VIEW OF UNDERSTANDING LOCAL EPIDEMIOLOGY AND IMPROVING THE QUALITY OF SERVICES H. T. Samarasekara, J. Branley, R. Vaz Department of Microbiology, Orange Hospital, Orange, NSW, Australia Aim: Analysis of positive bacteriology specimens performed over one year to determine local epidemiology data and to improve methods and reporting procedure.
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited. Copyright