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Hoshino A, Oana Y, Ohi Y, Maeda Y, Omori M, Takada Y, Ikeda T, Sotome K, Maeda H, Yanagisawa T, Takeuchi O, Kuronuma S, Sangai T, Shibahara Y, Murakumo Y, Saegusa M, Kanomata N, Nagasawa S, Yamaguchi R, Yoshida M, Kozuka Y, Matsumoto H, Tsugawa K, Maeda I. Using the DNA Integrity Number to Analyze DNA Quality in Specimens Collected from Liquid-Based Cytology after Fine-Needle Aspiration of Breast Tumors and Lesions. Acta Cytol 2024; 68:145-152. [PMID: 38555634 DOI: 10.1159/000538071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 02/25/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Cancer genome analysis using next-generation sequencing requires adequate and high-quality DNA samples. Genomic analyses were conventionally performed using formalin-fixed paraffin-embedded sections rather than cytology samples such as cell block or smear specimens. Specimens collected from liquid-based cytology (LBC) have the potential to be sources of high-quality DNA suitable for genetic analysis even after long-term storage. METHODS We collected breast tumor/lesion fractions from 92 residual LBC specimens using fine-needle aspiration (FNA) biopsy, including breast carcinoma (1 invasive carcinoma and 4 ductal carcinomas in situ), papillomatous lesion (5 intraductal papillomas), and fibroepithelial lesion (19 phyllodes tumors and 53 fibroadenomas) samples, and others (1 ductal adenoma, 1 hamartoma, 1 fibrocystic disease, and 7 unknown). DNA was extracted from all samples and subjected to DNA integrity number (DIN) score analysis. RESULTS Average DIN score collected from 92 LBC specimens was significantly higher score. In addition, high-quality DNA with high DIN values (7.39 ± 0.80) was successfully extracted more than 12 months after storage of residual LBC specimens. CONCLUSION Residual LBC specimens collected from FNA of the breast were verified to carry high-quality DNA and could serve as an alternate source for genetic analysis.
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Affiliation(s)
- Akiyoshi Hoshino
- Department of Diagnostic Pathology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan,
- Department of Pathology, Kitasato University School of Medicine, Tokyo, Japan,
| | - Yoshiyasu Oana
- Department of Diagnostic Pathology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Yasuyo Ohi
- Department of Pathology, Sagara Hospital, Kagoshima City, Kagoshima, Japan
| | - Yukari Maeda
- Department of Pathology, Sagara Hospital, Kagoshima City, Kagoshima, Japan
| | - Masako Omori
- Department of Pathology, Kurashiki Medical Center, Kurashiki City, Okayama, Japan
| | - Yuki Takada
- Department of Pathology, Kurashiki Medical Center, Kurashiki City, Okayama, Japan
| | - Tadashi Ikeda
- Department of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Keiichi Sotome
- Department of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Hinako Maeda
- Department of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Takako Yanagisawa
- Department of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Osamu Takeuchi
- Biomedical Laboratory, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Satoshi Kuronuma
- Biomedical Laboratory, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Takafumi Sangai
- Department of Surgery, Kitasato University Hospital, Sagamihara City, Sagamihara, Japan
| | - Yukiko Shibahara
- Department of Pathology, Kitasato University Hospital, Sagamihara City, Sagamihara, Japan
| | - Yoshiki Murakumo
- Department of Pathology, Kitasato University Hospital, Sagamihara City, Sagamihara, Japan
| | - Makoto Saegusa
- Department of Pathology, Kitasato University Hospital, Sagamihara City, Sagamihara, Japan
| | - Naoki Kanomata
- Department of Pathology, St. Lukes International Hospital, Tokyo, Japan
| | - Satoi Nagasawa
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa City, Chiba, Japan
| | - Rin Yamaguchi
- Department of Pathology, Nagasaki University Hospital, Nagasaki City, Nagasaki, Japan
| | - Masayuki Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuji Kozuka
- Department of Pathology, Mie University Hospital, Tsu, Japan
| | | | - Koichiro Tsugawa
- Divison of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Ichiro Maeda
- Department of Diagnostic Pathology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
- Department of Pathology, Kitasato University School of Medicine, Tokyo, Japan
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Mahajan S, Rajwanshi A, Srinivasan R, Radotra BD, Panda N. Should Liquid Based Cytology (LBC) be Applied to Thyroid Fine Needle Aspiration Cytology Samples?: Comparative Analysis of Conventional and LBC Smears. J Cytol 2022; 38:198-202. [PMID: 35002112 PMCID: PMC8670454 DOI: 10.4103/joc.joc_6_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 04/05/2017] [Accepted: 09/01/2021] [Indexed: 12/23/2022] Open
Abstract
Context: Liquid-based cytology (LBC) is a cyto-preparatory technique that may be applied to fine-needle aspiration (FNA) samples. However, its efficacy over conventional smears (CS) in thyroid is controversial. Aims: The aim of this study was to compare CS versus LBC (SurePath, BD) preparations in thyroid FNA samples for diagnostic efficacy. Settings and Design: Prospective case-control study using split sample analysis in 200 non-consecutive cases of thyroid FNA reported as per the Bethesda system. Methods and Material: Detailed cytomorphological features were evaluated in CS and LBC preparations. Cellularity was scored as 0–3. Based on diagnostic efficacy, they were categorized into three groups:(i) CS and LBC equivalent for diagnosis, (ii) CS better than LBC, and (iii) LBC better than CS for providing the diagnosis. Statistical Analysis Used: Paired t test for cellularity scores and descriptive for diagnostic efficacy. Results: There were 7 unsatisfactory, 118 benign, 10 atypia or follicular lesion of undetermined significance, 25 follicular neoplasms, 6 suspicious for malignancy, and 34 malignant thyroid FNA cases based on routine conventional smears. Cellularity of conventional smears was significantly higher than paired LBC smears (paired t test, P < 0.005). Comparison of overall diagnostic efficacy showed that LBC and CS were equivalent in 59% of cases; CS was superior to LBC in 37% cases and LBC was better than CS in 4% cases only. LBC smears showed higher unsatisfactory rate as compared to CS (18% vs. 3.5%). In category 2, the two techniques were equivalent in 87% of cases. In categories 4 and 6, CS were superior to LBC. Conclusions: In thyroid FNA cases, conventional smears are superior to LBC preparation in terms of cellularity and diagnostic efficacy and hence, LBC preparations should not replace conventional smears for making a routine cytomorphological diagnosis.
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Affiliation(s)
- Swati Mahajan
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bishan Dass Radotra
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Panda
- Department of Cytology and Gynecological Pathology, Histopathology, Otolaryngology and Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Sharma V, Gupta V, Parmar P, Jain P, Thakran D, Sen R. Comparative Analysis of Liquid based and Conventional Cytology Smears in Fine Needle Aspirates from Breast Lesions. J Cytol 2019; 36:89-93. [PMID: 30992643 PMCID: PMC6425781 DOI: 10.4103/joc.joc_61_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Context Liquid-based cytology (LBC) is being extensively used for the evaluation of both gynecological and non-gynecological specimens. Suspension of cells in monolayer makes better morphological assessment possible. Along with this, inherent morphological changes such as altered, reduced, or lost background material, fragmented cell clusters, smaller cell size, nucleolar prominence, etc., need to be considered. Aim Present study was aimed at comparative evaluation of utility of LBC versus conventional smear (CS) in assessing breast lesions and whether it can be used as an alternative to conventional preparation. Settings and Design Present study was a prospective study in which 75 cases of breast fine-needle aspiration cytology from patients with palpable breast lumps constituted the study group. Material and Methods The first pass was used for CS and LBC; a second pass was given. The representative CS and LBC smears were compared using several criteria. Statistics Each feature was scored individually and evaluated statistically using Wilcoxon's signed rank test on the SPSS program. Results A statistically significant difference was found in informative background and background blood-debris, whereas the difference was not statistically significant in other features such as cellularity, cytoarchitectural pattern, presence of monolayer, and nuclear and cytoplasmic details. Conclusion LBC is a promising technique in the field of cytology. It has the potential to decrease the number of slides screened per case and decrease the turn-around-time.
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Affiliation(s)
- Vasundhara Sharma
- Department of Pathology, Pt. B D Sharma, PGIMS, Rohtak, Haryana, India
| | - Veena Gupta
- Department of Pathology, Pt. B D Sharma, PGIMS, Rohtak, Haryana, India
| | - Padam Parmar
- Department of Pathology, Dr. S. N Medical College, Jodhpur, Rajasthan, India
| | - Promil Jain
- Department of Pathology, Pt. B D Sharma, PGIMS, Rohtak, Haryana, India
| | - Deepak Thakran
- Medical Officer, Army Medical Corps, 415 Field Hospital, Amritsar, Punjab, India
| | - Rajeev Sen
- Department of Pathology, Pt. B D Sharma, PGIMS, Rohtak, Haryana, India
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Jangsiriwitayakorn P, Patarapadungkit N, Chaiwiriyakul S, Thongbor R, Sirivech P, Nititarakul L. Comparative Analysis of Modified Liquid-Based Cytology and CytoRich Red Preparation in Assessment of Serous Effusion
for Cancer Diagnosis. Asian Pac J Cancer Prev 2018; 19:1571-1575. [PMID: 29936781 PMCID: PMC6103581 DOI: 10.22034/apjcp.2018.19.6.1571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: We aimed to compare the cytomorphological diagnosis in serous effusion and quality of background
between modified liquid-based cytology (modified-LBC) and CytoRich Red (CRR) preservative. Methods: We used
an experimental study design: 110 fresh serous effusions were received from 50 cases negative for malignant effusions
and 60 cases positive for malignant effusions. All fresh serous effusions were processed using both the CRR solution
and the modified-LBC preparation. Blind sample slides were interpreted for cytomorphological diagnosis and the
quality of background by 2 cytotechnologists. Result: All cases had the same diagnosis irrespective of the method.
There was no statistically significant difference in the cytological diagnosis between the CRR and modified-LBC
preparations (p>0.999). The quality of the background smear for the CRR preparation was clean (54%), moderate in
42%, and poor in 4%. By comparison, the modified-LBC preparation was clean in 46%, moderate in 47%, and poor in
7%. The difference between the quality of background smears between the two methods was not statistically significant
(p= 0.527). Conclusion: There was no statistically significant difference in the diagnosis or quality of background
between CRR and modified-LBC preparations. The serous effusion specimen prepared by modified-LBC solution was
less expensive than CRR. The modified-LBC could be an alternative preparation when commercial preparations are
too expensive.
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Rossi ED, Bizzarro T, Longatto-Filho A, Gerhard R, Schmitt F. The diagnostic and prognostic role of liquid-based cytology: are we ready to monitor therapy and resistance? Expert Rev Anticancer Ther 2016. [PMID: 26204907 DOI: 10.1586/14737140.2015.1053874] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Here, we evaluate the diagnostic and prognostic role of liquid-based cytology (LBC) in different body lesions, including thyroid, lung, effusions and malignant breast lesions. LBC has gained consensus after being applied to both non-gynecologic and fine-needle aspiration cytology. Although some remain sceptical regarding the diagnostic efficacy of LBC, mainly when used alone, in recent years, good results have been obtained as long as it showed a high diagnostic accuracy. Here, we discuss the additional possibility of storing material for the application of ancillary techniques (immunocytochemistry-molecular analysis) with several diagnostic and prognostic advantages, which may pave the way for the challenging evaluation of both monitoring responses to treatment and resistance to targeted therapies in thyroid, lung, breast carcinoma or malignant effusions. Furthermore, it provides the use of several molecular spots as specific targets for personalized therapy.
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Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology - Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
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Agarwal P, Yadav S, Kumar A, Goel MM. Liquid-based versus conventional cytology in solid pediatric neoplasm: Comparison of their diagnostic and morphological spectra. J Cytol 2016; 33:199-204. [PMID: 28028334 PMCID: PMC5156982 DOI: 10.4103/0970-9371.190454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Background: Conventional cytology (CC) is a well-established and effective methodology for the evaluation of pediatric tumors. Liquid-based cytology (LBC) is a better technique of smear preparation and is at present the standard protocol in cervical cytology samples. Aims: In the present study, we analyzed both smear preparatory techniques in fine-needle aspiration (FNA) samples from solid pediatric neoplasms in terms of adequacy and efficacy with objectives to study the changes in background and morphology of tumor cells in LBC smears. Materials and Methods: This was a prospective observational study conducted in a tertiary care teaching hospital, which included 52 pediatric patients with clinical diagnosis of malignancy and an assessable lump. Both conventional aspiration cytology and LBC smears were prepared as per standard protocols (SurePath BD™) from FNA samples of cases and examined. Results and Conclusion: On comparing the diagnostic efficacy of cytology smears prepared by both techniques, LBC alone was diagnostic in 80.8% of the cases and conventional smear (CS) alone was diagnostic in 71.2% of the cases (agreement was 83.7%, P = 0.3). Cellular morphology was better preserved in LBC and interpretation was easier. There was a lower inadequacy rate in LBC and none of the samples was inadequate due to poor morphology in LBC smears (P = 0.0003). LBC showed an overall 40% improvement in inadequate cases by CS. LBC has been recommended as a complement to CC in nongynecological samples. Improved morphology and lower inadequacy rate make LBC a finer technique compared to CS in pediatric tumors as well.
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Affiliation(s)
- Preeti Agarwal
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sunita Yadav
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Archana Kumar
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Madhu M Goel
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Nagarajan N, Najafian A, Schneider EB, Zeiger MA, Olson MT. Conventional smears versus liquid-based preparations for thyroid fine-needle aspirates: a systematic review and meta-analysis. J Am Soc Cytopathol 2015; 4:253-260. [PMID: 31051762 DOI: 10.1016/j.jasc.2015.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Thyroid fine-needle aspiration has traditionally been prepared using conventional smears (CS). Liquid-based preparations (LBP) have grown in popularity and yet, there is a lack of consensus about which method is superior. This review compared CS and LBP as an intervention in the management of thyroid nodules. MATERIALS AND METHODS Medline, EMBASE, Scopus and ClinicalTrials.gov were searched to locate relevant studies. Observational studies comparing CS and LBP of consecutive thyroid fine-needle aspirations were included. Two reviewers independently screened, extracted, and entered data. Double data extraction included the following outcomes: (1) the proportion of inadequate smears and (2) the proportion of indeterminate smears. Studies were also assessed for risk of bias and heterogeneity. RESULTS From 599 unique studies, title/abstract screening identified 136 studies, and full text screening identified 13 studies. The 13 studies included 24,307 fine-needle aspirations from 19,433 patients and had high clinical, methodological, and statistical heterogeneity with low risk of bias. For CS and LBP, a meta-analysis of 12 studies showed no difference in the proportion of inadequate smears (risk difference: -0.00; 95% confidence interval [CI]: -0.04-0.04); 13 studies showed no difference in the proportion of indeterminate smears (risk difference: -0.02; 95% CI: -0.05-0.01). Sensitivity analysis of studies with low risk of bias had similar results. CONCLUSIONS There is no difference between CS and LBP in the proportion of inadequate and indeterminate smears. Recommendations of one method over the other should be based on cost, feasibility, and accuracy, all of which require further study.
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Affiliation(s)
- Neeraja Nagarajan
- Center for Surgical Trials Outcomes Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alireza Najafian
- Center for Surgical Trials Outcomes Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Endocrine Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eric B Schneider
- Center for Surgical Trials Outcomes Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Martha A Zeiger
- Division of Endocrine Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Matthew T Olson
- Division of Cytopathology, Department of Pathology, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, Maryland.
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Zhang Z, Yuan P, Guo H, Zhao L, Ying J, Wang M, Zhao H, Pan Q, Xu B. Assessment of Hormone Receptor and Human Epidermal Growth Factor Receptor 2 Status in Breast Carcinoma Using Thin-Prep Cytology Fine Needle Aspiration Cytology FISH Experience From China. Medicine (Baltimore) 2015; 94:e981. [PMID: 26091472 PMCID: PMC4616547 DOI: 10.1097/md.0000000000000981] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Estrogen receptor (ER) and progesterone receptor (PR) overexpression can be used to predict patient prognosis in breast cancer (BC). Human epidermal growth factor receptor 2 (HER2) is a reliable predictive marker in invasive breast cancer (IBC). Thin-Prep (TP) specimens are commonly utilized for immunocytochemistry (ICC) in fine needle aspiration cytology (FNAC). Thus, we sought to investigate if the incorporation of molecular diagnosis performed on TP-processed specimens is applicable in clinical practice. Hormone receptors (HRs) and HER2 immunocytochemistry was performed on 542 primary breast cancer FNAC specimens using the TP method. One hundred fourteen HER2 fluorescence in situ hybridization (FISH) analyses were performed on HER2 ICC 2+ FNAC specimens and the corresponding tissue samples. HRs results of TP slides and those of formalin-fixed paraffin-embedded (FFPE) slides were correlated well for ER (concordance rate = 3.3%, kappa value = 0.85) and PR (concordance rate = 88.6%, kappa value = 0.75). HER2 results for the TP slides and those of the matched FFPE slides also correlated well (concordance rate = 80.0%, kappa value = 0.62). The specificity of HER2 was 97.3%; however, the sensitivity was only 67.1%. Cytological specimens and histological samples showed a strong correlation (concordance rate = 99.1%, kappa value = 0.98) while being used to evaluate HER2 gene amplification. FNAC is a minimally invasive technique that can be used as an alternative method to collect tissue especially in cases where an excisional or core biopsy is difficult to obtain, or when recurrence is present. The results of ICC HRs in FNAC TP specimens may be used instead, but HER2 assessment may not be reliable enough for clinical use. FISH testing is necessary in this setting.
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Affiliation(s)
- Zhihui Zhang
- From the Department of Pathology (ZZ); Department of Medical Oncology (PY, HG, LZ, JY, MW, HZ, QP, BX), Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Pan Z, Yang G, Wang Y, He H, Pang X, Gao Y, Shi W, Li Y, Dong L, Song Y. Thinprep plus Papanicolaou stain method is more sensitive than cytospin-coupled Wright Giems stain method in cerebrospinal fluid cytology for diagnosis of leptomeningeal metastasis from solid tumors. PLoS One 2015; 10:e0122016. [PMID: 25850010 PMCID: PMC4388538 DOI: 10.1371/journal.pone.0122016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 02/05/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The present study was designed to determine whether the Thinprep plus Papanicolaou stain (Thinprep) method is more sensitive than the Cytospin-coupled Wright-Giemsa (WG) stain (Cytospin) method in diagnosis of leptomeningeal metastasis (LM) from malignant solid tumors in cerebrospinal fluid (CSF). We also explored if the Thinprep method could be used in the differential diagnosis of the type of primary tumor cells based on the morphology of tumor cells in CSF samples. METHODS The morphological features of tumor cells in fresh CSF samples were analyzed using both methods. The tumor cell detection rates were compared between the two methods. RESULTS Using the Thinprep method, we found that each type of tumor cells in the CSF samples had specific identifiable morphological features linked to their primary cancer origins, such as adenocarcinomas originated from the lungs, breast, and stomach, and lung squamous cell carcinomas, small cell lung cancer, large-cell neuroendocrine lung cancer, hepatocellular carcinoma, and malignant melanoma. In a retrospective study with 88 LM patients, cancer cells were detected in 80 out of the 88 CSF samples. In the comparative study with 45 LM patients, the initial detection rate of the Thinprep method was significantly higher than that of the Cytospin method (73.3% vs. 57.8%, P<0.01). The cell morphology was better preserved and subcellular structures were clearer using the Thinprep method, compared to the Cytospin method. CONCLUSIONS The Thinprep method is more sensitive and suitable for LM diagnosis in CSF in patients with malignant solid tumors than the Cytospin method. The Thinprep method may facilitate primary tumor detection and help design early treatment regimens for LM patients with tumors of unknown primary origin.
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Affiliation(s)
- Zhenyu Pan
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Guozi Yang
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Yongxiang Wang
- Department of Clinical Laboratory, the First Hospital, Jilin University, Changchun, China
| | - Hua He
- Cancer Center, the First Hospital, Jilin University, Changchun, China
| | - Xiaochuan Pang
- Department of Clinical Laboratory, the First Hospital, Jilin University, Changchun, China
| | - Yan Gao
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Weiyan Shi
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Yu Li
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
| | - Lihua Dong
- Department of Radiation Oncology, the First Hospital, Jilin University, Changchun, China
- * E-mail: (LD); (YS)
| | - Yuanyuan Song
- Department of Clinical Laboratory, the First Hospital, Jilin University, Changchun, China
- * E-mail: (LD); (YS)
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Nagarajan N, Schneider EB, Ali SZ, Zeiger MA, Olson MT. How do liquid-based preparations of thyroid fine-needle aspiration compare with conventional smears? An analysis of 5475 specimens. Thyroid 2015; 25:308-13. [PMID: 25420135 DOI: 10.1089/thy.2014.0394] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fine-needle aspiration (FNA) plays a pivotal role in the initial evaluation of patients with thyroid nodules. Traditionally, aspirated material is expelled directly onto the microscope slide to make a conventional smear (CS). Recently, liquid-based preparations (LBP) have gained in popularity. This study compares the accuracy of these two preparation techniques in diagnosing thyroid nodules. METHODS A clinical database containing 5475 thyroid cytology consults from 2009 to 2013 was queried to identify 5169 CS and 306 LBP cases. Cytological diagnostic frequency rendered before and after second review were compared between LBP and CS. Correlation with the histology diagnosis was also calculated for each preparatory technique. RESULTS Age, sex, and nodule size were comparable between patients who had FNA processed by LBP and CS. More LBP cases than CS cases were inadequate (17% vs. 10%; p<0.001). LBP cases had fewer benign diagnoses (39% vs. 47%; p=0.003) and tended to have more malignant diagnoses (16% vs. 12%; p=0.09) when compared to CS. Indeterminate and suspicious categories were comparable between LBP and CS. Correlation with histology was also comparable between both techniques. CONCLUSION LBP was associated with a significantly higher proportion of inadequate and a lower proportion of benign diagnoses. Thus, universal adoption of LBP may introduce more inadequate samples. Future investigations should explore the lack of on-site evaluation with LBP as a potential source for the high inadequate rate.
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Affiliation(s)
- Neeraja Nagarajan
- 1 Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University , Baltimore, Maryland
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11
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Pawar PS, Gadkari RU, Swami SY, Joshi AR. Comparative study of manual liquid-based cytology (MLBC) technique and direct smear technique (conventional) on fine-needle cytology/fine-needle aspiration cytology samples. J Cytol 2014; 31:83-6. [PMID: 25210235 PMCID: PMC4159902 DOI: 10.4103/0970-9371.138669] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Liquid-based cytology technique enables cells to be suspended in a liquid medium and spread in a monolayer, making better morphological assessment. Automated techniques have been widely used, but limited due to cost and availability. Aim: The aim was to establish manual liquid-based cytology (MLBC) technique on fine-needle aspiration cytology (FNAC) material and compare its results with conventional technique. Materials and Methods: In this study, we examined cells trapped in needles hub used for the collection of FNAC samples. 50 cases were examined by the MLBC technique and compared with the conventional FNAC technique. By centrifugation, sediment was obtained and imprint was taken on defined area. Papanicolaou (Pap) and May-Grünwald Giemsa (MGG) staining was done. Direct smears and MLBC smears were compared for cellularity, background, cellular preservation, and nuclear preservation. Slides were diagnosed independently by two cytologists with more than 5 years’ experience. Standard error of proportion was used for statistical analysis. Results: Cellularity was low in MLBC as compared with conventional smears, which is expected as remnant material in the needle hub was used. Nuclei overlap to a lesser extent and hemorrhage and necrosis was reduced, so cell morphology can be better studied in the MLBC technique. P value obtained was <0.05. Conclusion: This MLBC technique gives results comparable to the conventional technique with better morphology. In a set up where aspirators are learners, this technique will ensure adequacy due to remnant in needle hub getting processed
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Affiliation(s)
| | - Rasika Uday Gadkari
- Department of Pathology, S. R. T. R. M. C. Ambajagai, Beed, Maharashtra, India
| | - Sunil Y Swami
- Department of Pathology, S. R. T. R. M. C. Ambajagai, Beed, Maharashtra, India
| | - Anil R Joshi
- Department of Pathology, S. R. T. R. M. C. Ambajagai, Beed, Maharashtra, India
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Gerhard R, Schmitt FC. Liquid-based cytology in fine-needle aspiration of breast lesions: a review. Acta Cytol 2014; 58:533-42. [PMID: 25115652 DOI: 10.1159/000362805] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 04/08/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Fine-needle aspiration (FNA) is a safe and cost-effective technique for the diagnosis of breast lesions, especially when correlated with clinical and imaging studies. However, the success of breast FNA is highly dependent on the adequate preparation of cytological conventional smears (CS). The liquid-based cytology (LBC) technique consists of an automated method for preparing thin-layer cytological samples from cell suspensions collected in alcohol-based preservative. LBC is designed to improve CS by avoiding limiting factors such as obscuring material, air-drying and smearing artifacts. STUDY DESIGN We performed a review of the published literature about LBC applied to breast FNA. RESULTS LBC preparations of breast aspirates demonstrated better cellular preservation, less cell overlapping and elimination of blood and excessive inflammation compared to CS. Conversely, alterations in architecture and cell morphology as well as loss of myoepithelial cells and stromal elements have been described in LBC specimens, requiring training before applying this technique for diagnosis. Studies have shown a similar accuracy between LBC and CS for the diagnosis of breast lesions. LBC also permits the use of residual material for ancillary tests, which is an important advantage compared to CS. CONCLUSIONS LBC can be safely applied to breast FNA, showing a similar diagnostic accuracy to CS.
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Affiliation(s)
- Rene Gerhard
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, and Department of Pathology, University Health Network, Toronto, Ont., Canada
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Heymann JJ, Halligan AM, Hoda SA, Facey KE, Hoda RS. Fine needle aspiration of breast masses in pregnant and lactating women: experience with 28 cases emphasizing Thinprep findings. Diagn Cytopathol 2014; 43:188-94. [PMID: 24976078 DOI: 10.1002/dc.23197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 06/11/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND Fine needle aspiration (FNA) of breast masses in pregnant or lactating women is an uncommon procedure, and cytological interpretation is considered problematic due to atypia inherent to secretory change in glandular epithelia. Previous descriptions of "lactating adenoma" (LAd), the most common tumor in this population, have been on direct smears (DS), while ThinPrep (TP, Hologic, Boxborough, MA) findings therein remain largely uncharacterized. METHODS FNA cases from breast masses in pregnant or lactating women (2005-2012), processed as TP and/or DS were retrospectively reviewed. RESULTS 28 cases from as many patients (mean age 36 years), at 23 weeks of pregnancy to 10 months postpartum, were reviewed. Size of mass ranged from 1.0 to 4.5 cm. Corresponding histopathology was available in 21/28 cases. TP was available in 24/28 cases. Relative to DS, in TP, LAd showed "lacy" fragments, tissue paper-like texture, and globular clumps of "milky" background material, with embedded singly dispersed "bare" epithelial cell nuclei containing cherry-red macronucleoli. Architecture appeared disrupted in TP with isolated cells, smaller cell clusters, and lobules in LAd. Cellular morphology was better preserved in TP. Cytological features of carcinoma on TP were similar to DS. There were no false-positive cases. In this series, LAd was the most common diagnosis for breast masses in pregnant and lactating women (78.5%) and demonstrated background, architectural, and cellular alterations on TP. CONCLUSION In this setting, malignancy is an important consideration (encountered in 3/28, 11% of cases, including one false-negative angiosarcoma case).
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Affiliation(s)
- Jonas J Heymann
- Department of Pathology and Cell Biology, New York Presbyterian Hospital, College of Physicians & Surgeons, Columbia University, New York, New York
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Heymann JJ, Bulman WA, Maxfield RA, Powell CA, Halmos B, Sonett J, Beaubier NT, Crapanzano JP, Mansukhani MM, Saqi A. Molecular testing guidelines for lung adenocarcinoma: Utility of cell blocks and concordance between fine-needle aspiration cytology and histology samples. Cytojournal 2014; 11:12. [PMID: 24987443 PMCID: PMC4058904 DOI: 10.4103/1742-6413.132989] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 02/20/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Lung cancer is a leading cause of mortality, and patients often present at a late stage. More recently, advances in screening, diagnosing, and treating lung cancer have been made. For instance, greater numbers of minimally invasive procedures are being performed, and identification of lung adenocarcinoma driver mutations has led to the implementation of targeted therapies. Advances in molecular techniques enable use of scant tissue, including cytology specimens. In addition, per recently published consensus guidelines, cytology-derived cell blocks (CBs) are preferred over direct smears. Yet, limited comparison of molecular testing of fine-needle aspiration (FNA) CBs and corresponding histology specimens has been performed. This study aimed to establish concordance of epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) virus homolog testing between FNA CBs and histology samples from the same patients. MATERIALS AND METHODS Patients for whom molecular testing for EGFR or KRAS was performed on both FNA CBs and histology samples containing lung adenocarcinoma were identified retrospectively. Following microdissection, when necessary, concordance of EGFR and KRAS molecular testing results between FNA CBs and histology samples was evaluated. RESULTS EGFR and/or KRAS testing was performed on samples obtained from 26 patients. Concordant results were obtained for all EGFR (22/22) and KRAS (17/17) mutation analyses performed. CONCLUSIONS Identification of mutations in lung adenocarcinomas affects clinical decision-making, and it is important that results from small samples be accurate. This study demonstrates that molecular testing on cytology CBs is as sensitive and specific as that on histology.
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Affiliation(s)
- Jonas J Heymann
- Address: Department of Pathology and Cell Biology, Departments of Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - William A Bulman
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Roger A Maxfield
- Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Charles A Powell
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, The Mount Sinai Medical Center, New York, NY 10029, USA
| | - Balazs Halmos
- Division of Hematology/Oncology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Joshua Sonett
- Department of Surgery, Division of General Thoracic Surgery, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Nike T Beaubier
- Department of Pathology, Northwestern Memorial Hospital, Chicago IL 60611, USA
| | - John P Crapanzano
- Address: Department of Pathology and Cell Biology, Departments of Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Mahesh M Mansukhani
- Address: Department of Pathology and Cell Biology, Departments of Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA
| | - Anjali Saqi
- Address: Department of Pathology and Cell Biology, Departments of Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY 10032, USA
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Fine-needle aspiration cytology can play a role in neoadjuvant chemotherapy in operable breast cancer. ISRN ONCOLOGY 2013; 2013:935796. [PMID: 23936675 PMCID: PMC3725715 DOI: 10.1155/2013/935796] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 06/18/2013] [Indexed: 12/19/2022]
Abstract
Despite the fact that CNB has been progressively replaced by FNAC in the investigation of nonpalpable lesions or microcalcifications without a clinical or radiological mass lesion, FNAC has yet a role in palpable lesions provided it is associated with the triple diagnosis and experienced cytologist. In these conditions, FNAC is a safe, effective, economical, and accurate technique for breast cancer evaluation. Numerous literature reviews and meta-analyses illustrated the advantages and disadvantages of both methods CNB and FNAC. The difference does not seem significant when noninformative and unsatisfactory FNAC was excluded. Recently, cytological methods using liquid-based cytology (LBC) technology improve immunocytological and molecular tests with the same efficiency as classical immunohistochemistry.
The indications of FNAC were, for palpable lesions, relative contraindication of CNB (elderly or frailty), staging of multiple nodules in conjunction or not with CNB, staging of lymph node status, newly appearing lesion in patient under neoadjuvant treatment, decreasing of anxiety with a rapid diagnosis, evaluation of biomarkers and new biomarkers, and chronological evaluation of biomarker following the neoadjuvant therapy response.
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Feoli F, Ameye L, Van Eeckhout P, Paesmans M, Marra V, Arisio R. Liquid-based cytology of the breast: pitfalls unrecognized before specific liquid-based cytology training - proposal for a modification of the diagnostic criteria. Acta Cytol 2013; 57:369-76. [PMID: 23860126 DOI: 10.1159/000348721] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 02/06/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To describe the pitfalls encountered in switching over from conventional smears (CSm) to liquid-based cytology (LBC). To explore modifications of our usual diagnostic criteria. STUDY DESIGN 190 ThinPrep breast samples with paired biopsies were retrospectively evaluated by two breast cytopathologists experienced only in CSm. They were again studied after LBC training. The diagnostic performances were compared. In additional calculations we included those C4/suspicious samples containing 70% high-grade nuclei and up to 30% nonmalignant cells in the C5/positive category, simulating that they harbored a malignant one-cell population. We prospectively validated this modification of our diagnostic criteria. RESULTS Training resulted in higher complete sensitivity: 94 versus 86% (p value 0.003) and lower false negative ratio: 4 versus 12% (p value 0.003). Training generated higher complete sensitivity than collaboration without training: 94 versus 89% (p value 0.008). In the simulation, the modified criteria increased absolute sensitivity to 74% with a 0.6% false positive rate. In the validation series, they generated up to 91% absolute sensitivity, 12% suspicious rate and no false negative and false positive diagnoses. CONCLUSION Training in breast LBC may increase diagnostic performance. Samples containing 70% high-grade nuclei or more can be categorized as malignant.
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Affiliation(s)
- Francesco Feoli
- Institut Bordet, Université Libre de Bruxelles, Brussels, Belgium.
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Sauer T, Roskell D. The breast. Diagn Cytopathol 2010. [DOI: 10.1016/b978-0-7020-3154-0.00004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chae SW, Kim SH, Park HD, Park WS, Cho YH, Kang SH, Kim DH, Sohn JH. Comparison of Liquid-based (SurePath™ and Conventional Preparations in Thyroid Fine Needle Aspiration. KOREAN JOURNAL OF PATHOLOGY 2010. [DOI: 10.4132/koreanjpathol.2010.44.6.651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Seoung Wan Chae
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sun Hee Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Dae Park
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woon Sun Park
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Hye Cho
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Hee Kang
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Hoon Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Hee Sohn
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Wauters CAP, Kooistra B, Strobbe LJA. The role of laboratory processing in determining diagnostic conclusiveness of breast fine needle aspirations: conventional smearing versus a monolayer preparation. J Clin Pathol 2009; 62:931-4. [DOI: 10.1136/jcp.2009.066589] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aim:To compare breast fine needle aspiration (FNA) specimens prepared by conventional smearing (CS) versus monolayer preparation (MP), with respect to the conclusiveness of the cytopathological diagnosis.Methods:From 1992 to 1996, aspirators prepared aspirates themselves by direct smearing onto 2–4 slides. From 1999 to 2003, aspirate preparation was performed in the laboratory, creating a MP, using a Hettich cytocentrifuge. FNA diagnoses were categorised into inadequate (C1), benign (C2), atypical (C3), suspicious for malignancy (C4) and malignant (C5). The reference standard constituted histological follow-up. A conclusive FNA diagnosis was defined as C2 in lesions benign on follow-up and C5 in lesions malignant on histology.Results:From 1992 to 1996, 692 aspirates were processed by CS, whereas from 1999 to 2003, 1301 aspirates were processed by MP. More FNA were ultrasound-guided in the MP group (85.6% versus 21.5%, p<0.001). When compared with CS, MP-prepared FNA had conclusive diagnoses significantly more often (72.8% versus 58.5%, p<0.001). This effect remained significant when corrected for the difference in ultrasound guidance (adjusted odds ratio 1.7, 95% confidence interval 1.3 to 2.2, p<0.001), and was larger for malignant lesions than for benign lesions (51.7% versus 79.9%, p<0.001).Conclusion:Patients presenting with breast lesions can more often be offered a same-day, conclusive cytopathological diagnosis when FNA are prepared by a manual MP processing technique.
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Hanley KZ, Birdsong GG, Cohen C, Siddiqui MT. Immunohistochemical detection of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 expression in breast carcinomas: comparison on cell block, needle-core, and tissue block preparations. Cancer 2009; 117:279-88. [PMID: 19551847 DOI: 10.1002/cncy.20034] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Fine-needle aspiration (FNA) is a rapid and accurate procedure for the detection of breast carcinomas. The evaluation of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression by immunohistochemistry (IHC) is performed routinely on formalin-fixed, paraffin-embedded needle-core (NC) or excision tissue block (TB) preparations, according to the American Society of Clinical Oncology/College of American Pathologist guidelines. In this retrospective study, the authors compared expression levels of ER, PR, and HER2 in ethanol-fixed BC FNA cell block (CB) samples with expression levels in formalin-fixed NC and TB samples. METHODS Forty-one breast carcinoma CB samples with concurrent or subsequent NC and TB samples were identified. Patients who had received neoadjuvant or adjuvant chemotherapy were excluded. CB samples initially were fixed in 50% ethanol (4-12 hours), and this was followed by formalin fixation (minimum, 6 hours). NC samples were placed promptly in formalin for a minimum of 6 hours. Within 4 to 8 hours, TB samples were fixed in formalin for 6 to 48 hours. Fluorescence in situ hybridization (FISH) results were also compared. RESULTS IHC for ER on alcohol-fixed CB samples had good correlation with NC and TB samples. PR results on TB samples had excellent agreement with NC samples. A higher discordance rate wais observed when PR results were compared between CB samples and NC samples. HER2 detection on ethanol-fixed CB samples resulted in a higher rate of positive and equivocal staining than NC or TB samples. HER2 IHC on TB samples demonstrated better correlation with FISH results than CB or NC samples. CONCLUSIONS Alcohol fixation did not affect ER results in breast carcinoma, but it may alter tumor cell PR antigenicity. The authors concluded that CB samples could be used to triage patients for tamoxifen therapy, but they are not reliable for the assessment of HER2 status; therefore, CB results should be correlated with results from NC or TB samples.
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Affiliation(s)
- Krisztina Z Hanley
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta, Georgia 30322, USA.
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Kim JY. Liquid-Based Cytology in Fine-Needle Aspirates of the Thyroid and Breast. KOREAN JOURNAL OF PATHOLOGY 2009. [DOI: 10.4132/koreanjpathol.2009.43.2.99] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Ji-Young Kim
- Department of Pathology, CHA Gangnam Medical Center, CHA University, Seoul, Korea
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22
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Saleh HA, Hammoud J, Zakaria R, Khan AZ. Comparison of Thin-Prep and cell block preparation for the evaluation of Thyroid epithelial lesions on fine needle aspiration biopsy. Cytojournal 2008; 5:3. [PMID: 18364046 PMCID: PMC2291068 DOI: 10.1186/1742-6413-5-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Accepted: 03/25/2008] [Indexed: 11/25/2022] Open
Abstract
Background The objective of this study was to compare the utility of Thin-Prep (TP) cytologic preparation with that of Cell Block (CB) preparation in the diagnosis of thyroid lesions, mainly follicular epithelial lesions, by fine needle aspiration biopsy (FNAB). Feasibility of using the TP slides for immunocytochemical stains is also discussed. Methods A total of 126 consecutive cases of thyroid FNAB with TP slides and 128 consecutive cases of thyroid FNAB with CB slides were reviewed blindly by two cytopathologists. The presence of colloid, follicular cells, macrophages and lymphocytes/plasma cells were recorded and scored 0–4 on each case based on TP or CB slide review. The cytologic diagnoses were grouped as follows: cyst, colloid nodule, colloid nodule with cystic change, chronic thyroiditis, atypical/neoplastic and non-diagnostic. Results The TP slides had higher diagnostic rate than CB slides. The diagnostic yield was 68% of the TP slides whereas only 24% of the CB slides were diagnostic. Also, only 4 atypical/neoplastic lesions were diagnosed on the TP slides and the corresponding direct smears, while 5 cases of atypical/neoplastic lesions were diagnosed on the smears but could not be diagnosed on the corresponding CB slides. Additionally, the TP slides revealed cytologic features that were not observed on the direct traditional smears of the same case. Conclusion In thyroid FNAB cases, TP slide preparation is superior to CB slide preparation and is more likely to have greater cellularity for diagnosis and detect atypical/neoplastic thyroid lesions, particularly those of follicular cell origin. Furthermore, TP slides appear to detect helpful diagnostic cytologic features and should be considered complementary to, rather than replacing, direct smears.
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Affiliation(s)
- Husain A Saleh
- Department of Pathology, Wayne State University/Sinai- Grace Hospital, Detroit, MI, 48302, USA.
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Jeong JY, Kim JS, Kim YS, Kim HJ, Park JY. Manual Liquid-Based Cytology (Liqui-PREP™) in Breast Fine Needle Aspiration Cytology: Comparison with the Conventional Smears. ACTA ACUST UNITED AC 2008. [DOI: 10.3338/kjc.2008.19.1.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ji Yun Jeong
- Department of Pathology, KyungPook National University Hospital, Daegu, Korea
| | - Jeong Shik Kim
- Department of Pathology, KyungPook National University Hospital, Daegu, Korea
| | - Young Su Kim
- Department of Pathology, KyungPook National University Hospital, Daegu, Korea
| | - Hye Jung Kim
- Department of Radiology, KyungPook National University Hospital, Daegu, Korea
| | - Ji Young Park
- Department of Pathology, KyungPook National University Hospital, Daegu, Korea
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Racz MM, Pommier RF, Troxell ML. Fine-needle aspiration cytology of medullary breast carcinoma: report of two cases and review of the literature with emphasis on differential diagnosis. Diagn Cytopathol 2007; 35:313-8. [PMID: 17497662 DOI: 10.1002/dc.20639] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Medullary carcinoma is a rare variant of breast carcinoma with a relatively good clinical prognosis as strictly defined. Characteristic features on fine-needle aspiration cytology (FNAC) allow medullary carcinoma to be considered in the cytologic differential diagnosis. We present two FNAC cases with such features, including high cellularity with clusters and single intact malignant cells, bizarre stripped nuclei with prominent nucleoli in a lymphoplasmacytic background, and illustrate one case in liquid-based preparation. Surgical excision revealed that one patient had medullary carcinoma, while the second patient had high-grade infiltrating ductal carcinoma. Breast FNAC samples with syncytial fragments, bizarre nuclei with prominent nucleoli, and a chronic inflammatory infiltrate should raise the possibility of medullary carcinoma. However, the differential diagnosis also includes high-grade ductal carcinoma, lymphoma, or metastasis to breast or intramammary lymph nodes; thus, histopathologic analysis is required for definitive diagnosis.
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Affiliation(s)
- Melinda M Racz
- Department of Pathology, Oregon Health & Science University, Portland, Oregon 97239, USA
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Abstract
PURPOSE OF REVIEW Fine needle aspiration has been used for many years as a diagnostic tool for breast lesions, with high sensitivity and specificity. There is controversy as to whether this technique should be replaced by other diagnostic procedures such as core biopsy. This review aims to re-evaluate the usefulness of breast fine needle aspiration. RECENT FINDINGS During the past 10 years many institutions have replaced fine needle aspiration by core biopsy and related techniques such as vacuum-assisted core biopsy and advanced breast biopsy instrument action. Other institutions continue to use fine needle aspiration as a first line of investigation for breast lesions. This technique is especially useful in radiologically benign lesions and when combined with image guidance. The use of the 'triple test' (combined cytologic, clinical and radiologic findings) decreases false-negative and false-positive results. SUMMARY Fine needle aspiration continues to be an acceptable and reliable procedure for the preoperative diagnosis of breast lesions, particularly in developing countries, and when used as part of the 'triple test'. Accurate diagnosis requires experience in both aspiration technique and specimen interpretation. Clinicians should be mindful of the limitations of the technique. The choice between fine needle aspiration and core biopsy should be individualized for the patient.
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Affiliation(s)
- Benjaporn Chaiwun
- Department of Pathology, Chiang Mai University, Chiang Mai, Thailand.
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Hoda RS. Non-gynecologic cytology on liquid-based preparations: A morphologic review of facts and artifacts. Diagn Cytopathol 2007; 35:621-34. [PMID: 17854077 DOI: 10.1002/dc.20698] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Liquid-based preparations (LBP) are increasingly being used both for gynecologic (gyn) and non-gynecologic (non-gyn) cytology including fine needle aspirations (FNA). The two FDA-approved LBP currently in use include ThinPrep (TP), (Cytyc Corp, Marlborough, MA) and SurePath (SP), (TriPath Imaging Inc., Burlington, NC). TP was approved for cervico-vaginal (Pap test) cytology in 1996 and SP in 1999 and both have since also been used for non-gyn cytology. In the LBP, instead of being smeared, cells are rinsed into a liquid preservative collection medium and processed on automated devices. Even after a decade of use, the morphological interpretation of LBP remains a diagnostic challenge because of somewhat altered morphology and artifacts or facts resulting from the fixation and processing techniques. These changes include cleaner background with altered or reduced background and extracellular elements; architectural changes such as smaller cell clusters and sheets, breakage of papillae; altered cell distribution with more dyscohesion and changes in cellular morphology with enhanced nuclear features, smaller cell size and slightly more three-dimensional (3-D) clusters. Herein, we review the published literature on morphological aspects of LBP for non-gyn cytology.
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Affiliation(s)
- Rana S Hoda
- Department of Pathology, Cytopathology Unit, University of Rochester, Rochester, New York, USA.
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Chang F, Chandra A, Culora G, Mahadeva U, Meenan J, Herbert A. Cytologic diagnosis of pancreatic endocrine tumors by endoscopic ultrasound-guided fine-needle aspiration: A review. Diagn Cytopathol 2006; 34:649-58. [PMID: 16900463 DOI: 10.1002/dc.20503] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Precise localization and diagnosis of pancreatic endocrine tumors (PETs) is important, because pancreatic PETs have different clinical and biological behavior and treatment modalities than do exocrine pancreatic tumors. In contrast to the much more common exocrine adenocarcinomas, cytologic studies of PET are relatively rare and many cytopathologists lack experience with the cytomorphologic features of these tumors.During the last 10 yr, endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) has matured into an accurate, highly sensitive, and cost-effective modality for the preoperative localization of pancreatic PETs. This has resulted in an increased number of PETs first sampled as cytology specimens. This manuscript focuses on the cytomorphologic features most suggestive of pancreatic PETs, differential diagnosis, and diagnostic pitfalls of PETs. The technical development of EUS-guided FNA and the ancillary studies for pancreatic PETs are also reviewed. The data summarized in this review indicate that EUS-FNA is a valuable method in the recognition of pancreatic PETs and in most cases cytopathologists could reach a correct diagnosis of these tumors, including their hormone producing capability on aspirated cytologic material.
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Affiliation(s)
- Fuju Chang
- Department of Histopathology, St Thomas' Hospital, London, UK.
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Abati A, Simsir A. Breast Fine Needle Aspiration Biopsy: Prevailing Recommendations and Contemporary Practices. Clin Lab Med 2005; 25:631-54, v. [PMID: 16308084 DOI: 10.1016/j.cll.2005.08.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In 1996, a National Cancer Institute conference was held in Bethesda,Maryland to define parameters for the practice of breast fine needle aspiration (BFNA). Representatives of the American Society of Cytopathology, Papanicolaou Society of Cytopathology, American College of Radiology, American College of Obstetricians & Gynecologists, Society of Surgical Oncology, American Academy of Family Physicians, College of American Pathologists, National Consortium of Breast Centers, International Academy of Cytology, American Society of Clinical Pathologists, American Cancer Society, American College of Surgeons, and American Society for Cytotechnology developed and reviewed recommendations. These guidelines were referred to as "The Uniform Approach to Breast Fine Needle Aspiration Biopsy." This article reviews these recommendations and the contemporary evolution of the practice of BFNA since their original publication.
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Affiliation(s)
- Andrea Abati
- Cytopathology Section, National Cancer Institute/National Institutes of Health, Bethesda, MD 20892, USA.
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Abstract
A definitive cytologic diagnosis of breast cancer is usually possible when using the six major criteria of malignancy (cellularity, dyshesion, monomorphism, anisonucleosis, irregular nuclear membranes, prominent nucleoli) as part of the triple test. Carcinomas of special type have unique clinical and cytologic features that pathologists need to consider, because these may confuse interpretation. Complete subtyping of carcinomas may not always be possible by fine needle aspiration. Diagnostic accuracy for breast carcinoma is excellent. False-negative diagnoses are infrequent and chiefly due to sampling issues. False-positive diagnoses are extremely rare. Uniform report terminology should be used to ensure that diagnostic information is conveyed appropriately and consistently to guide the next diagnostic or treatment step.
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Affiliation(s)
- Lydia Pleotis Howell
- Department of Pathology, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
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Sartelet H, Lagonotte E, Lorenzato M, Duval I, Lechki C, Rigaud C, Cucherousset J, Durlach A, Graesslin O, Abboud P, Doco-Fenzy M, Quereux C, Costa B, Polette M, Munck JN, Birembaut P. Comparison of liquid based cytology and histology for the evaluation of HER-2 status using immunostaining and CISH in breast carcinoma. J Clin Pathol 2005; 58:864-71. [PMID: 16049291 PMCID: PMC1770887 DOI: 10.1136/jcp.2004.024224] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND HER-2 amplification is an important prognostic biomarker and treatment determinant in breast carcinoma. AIMS To correlate immunocytochemical (ICC) expression of HER-2 and gene amplification determined by chromogenic in situ hybridisation (CISH) using liquid based cytology (LBC) with immunohistochemistry (IHC) and CISH using histological samples of the same breast carcinomas. METHODS Frozen sections and cytobrushings of 103 breast carcinomas were analysed. Four techniques were performed on each tumour: two on LBC samples (ICC, and CISH, both graded as positive, indeterminate, or negative) and two on histological samples (IHC and CISH). Two cell lines (MCF-7, negative; BT 474, positive) were used as controls for cytological analysis. A complementary fluorescence in situ hybridisation technique was carried out in histological samples with low amplification (4-10 dots/nucleus). RESULTS Interobserver agreement for the four techniques calculated by the kappa coefficient indicated a substantial agreement. Nine cases failed in cytology because of poor cellularity. Among 94 cases, 19 were amplified; 73, 12, and 9 tumours were scored 0 or 1+, 2+, and 3+, respectively by IHC and 75, 13, and 6, respectively, by ICC. CISH found no amplification in 72 tumours. Correlations between the IHC and CISH results in the histological and cytological samples were always significant. CONCLUSIONS Her-2 status could be determined in LBC samples and correlated well with reference histological methods using in situ hybridisation. ICC was less reliable because of the presence of the cytoplasmic membrane. However, these results should be confirmed by a large multicentre study.
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Affiliation(s)
- H Sartelet
- Laboratoire Pol Bouin, Centre Hospitalier et Universitaire de Reims, 45, Rue Cognacq-Jay, 51092 Reims Cedex, France.
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