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Akahoshi K, Tamura S, Akahoshi K, Shiratsuchi Y, Koga H, Oya M, Ohishi Y, Koga T. Efficacy and histologic frequencies of endoscopic ultrasonography-guided tissue acquisition using conventional fine-needle aspiration needles for gastric subepithelial hypoechoic mass. Australas J Ultrasound Med 2024; 27:89-96. [PMID: 38784701 PMCID: PMC11109998 DOI: 10.1002/ajum.12382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Introduction/Purpose For gastric subepithelial lesions (GSELs) showing a hypoechoic mass (HM) on endoscopic ultrasonography (EUS) imaging, the utility of EUS-guided tissue acquisition using conventional fine-needle aspiration needles (EUS-TA-CFNAN) and the frequency of histological types remain unclear. This study aimed to examine this issue. Methods This prospective observational study enrolled 291 consecutive patients who underwent EUS-TA-CFNAN for GSELs showing an HM (GSELHM) on EUS imaging. Immunohistochemical analysis was performed for all EUS-TA-CFNAN and surgically resected specimens. The main outcome measures were the technical results of EUS-TA-CFNAN and the frequency of histological types in GSELHM. Results The endoscopic ultrasound-guided tissue acquisition using conventional fine-needle aspiration needle diagnosis rate for GSELHM was 80.1% (95% confidence interval [CI]: 75.0-84.5, 233/291). It was significantly lower for antrum (P = 0.004) and lesions smaller than 2 cm (P = 0.003). There were no adverse events. The immunohistochemical diagnoses of EUS-TA-CFNAN included 149 cases of gastrointestinal stromal tumour (GIST) (51.2%), 48 cases of leiomyoma (16.5%), 11 cases of schwannoma (3.8%), 8 cases of the ectopic pancreas (2.7%), 5 cases of subepithelial lesion like cancer (1.7%), 12 cases of other lesions (4.1%), and 58 cases of undiagnosable lesions (19.9%). The frequency of malignant or potentially malignant tumour in GSELHM was 55.0% (95% CI: 49.1-60.8, 160/291). Surgery was performed in 149 patients according to the conclusive EUS-TA-CFNAN results, in which the diagnostic accuracy of EUS-TA-CFNAN was 97.3% (95% CI: 94.7-99.9, 145/149). Conclusion The use of EUS-TA-CFNAN for GSELHMs is safe and accurate. Gastric subepithelial lesions showing a hypoechoic mass have a reasonably high possibility of containing malignant or potentially malignant tumours, including GISTs.
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Affiliation(s)
| | | | | | | | - Hidenobu Koga
- Clinical Research Support OfficeAso Iizuka HospitalIizukaJapan
| | - Masafumi Oya
- Department of PathologyAso Iizuka HospitalIizukaJapan
| | | | - Tadashi Koga
- Department of SurgeryAso Iizuka HospitalIizukaJapan
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Tummidi S, Shankaralingappa A, Aravindakshan R. Rapid on-site evaluation and cell blocks: getting the most from the least invasive method in cytopathology. J Am Soc Cytopathol 2024:S2213-2945(24)00028-0. [PMID: 38702209 DOI: 10.1016/j.jasc.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Fine needle aspiration cytology (FNAC) sampling is a minimally invasive procedure done to identify the pathology behind superficial and deep-seated lesions. Rapid on-site evaluation (ROSE) can be an adjunct to the FNACs. Our study aimed to identify the role of ROSE in diagnostic adequacy and to check the benefit of cell block (CB)/cell buttons prepared from the ROSE samples. MATERIAL AND METHODS A prospective study was conducted where all patients referred for FNAC were included. ROSE using 1% aqueous toluidine blue stain and CB/cell button preparations were done for the identification of various cytological lesions. RESULTS Among 600 cases included in the study most common age group was third and fourth decades with a mean age of 41.6 years and M: F ratio of 1:1.7. Ultrasound-guided procedures were done in 20% of cases. CB preparation was available in 14% of cases. Most CBs were from the cases wherein ROSE was performed 81% (77 out of 86), with CB helping in making an accurate diagnosis in 17% of cases. Lymph nodes 26%, and thyroid 23% were the most common sites for sampling with the highest number of repeat procedures from non-ROSE cases (14%). The non-diagnostic rate for non-ROSE cases was 7.7% (23/300) even after the repeat procedures as compared to 1.3% (4/300) for ROSE. Three slides on average were consumed in ROSE-performed procedures, as compared to an average of 5 slides in non-ROSE. The average turnaround time was 1.7 days for non-ROSE cases and 1.05 for ROSE cases respectively. Cyto-histopathological correlation was available in 40% of cases with a sensitivity of 98.1%, specificity of 96.7%, positive predictive value of 90%, negative predictive value of 99.4%, and diagnostic accuracy of 97%. The correlation of CB, number of slides consumed, and turnaround time among the 2 groups were statistically significant (P value < 0.001). CONCLUSIONS ROSE is a method used to assess material aspirated at the time of FNAC procedures to determine the adequacy and to an extent to identify whether the lesion is neoplastic or non-neoplastic. CBs have helped in increasing diagnostic accuracy apart from the fact that the paraffin-embedded tissue material can be used for further studies.
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Affiliation(s)
- Santosh Tummidi
- Department of Pathology & Lab Medicine, AIIMS, Kalyani, West Bengal, India.
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Del Mar Olmo Fernandez M, Wheeldon L, Villar-Zarra K. Key roles of the cytotechnologists and biomedical scientists in interventional pathology: The foundation of a seamless workflow. Cytopathology 2024. [PMID: 38519868 DOI: 10.1111/cyt.13375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/08/2024] [Accepted: 03/10/2024] [Indexed: 03/25/2024]
Abstract
This paper delves into the integral role of cytotechnologists (CTs) and biomedical scientists (BMSs) in interventional pathology, emphasizing their multifaceted responsibilities. From meticulous pre-procedural preparations to real-time decision-making and post-procedural care, CTs/BMSs significantly contribute to diagnostic efficiency. Their involvement is critical in optimizing patient outcomes.
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Affiliation(s)
| | - Leonie Wheeldon
- Diagnostic Cytopathology, Royal Cornwall Hospital, Cornwall, UK
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Yang F, Dou W, Wang H, Cui D, Li C. Application of ultrasonic cavitation combined with rapid pathological tissue processing method of novel environmental protection reagents in pathological diagnosis. Medicine (Baltimore) 2023; 102:e35535. [PMID: 37861485 PMCID: PMC10589546 DOI: 10.1097/md.0000000000035535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/15/2023] [Indexed: 10/21/2023] Open
Abstract
To investigate the effect of pretreatment of tumor biopsy specimens using fixed, dehydrated and transparent three-in-one composite environmental protection reagent ultrasound tissue rapid processing technique on subsequent detection. From April 2020 to October 2020, a total of 100 cases including breast, stomach and lung tissues were submitted to our diagnosis, and 3 specimens were collected from each specimen and divided into the control group (traditional biopsy tissue processing method), experimental group 1 (3.7% neutral buffered formaldehyde fixation, compound environmental protection reagent rapid ultrasound tissue processing technique, processing temperature 48 °C, time 20 minutes/time, twice, wax immersion temperature 62 °C, time 25 minutes) and experimental group 2 (3.7% neutral buffered formaldehyde fixation, compound environmental protection reagent rapid ultrasound tissue processing technique, processing temperature 50 °C, time 15 min/time, twice, Wax dipping temperature 64 °C, time 20 minutes). The effects of different treatments on hematoxylin eosin section, immunohistochemistry (IHC) and molecular pathological examination were analyzed. The detection results of hematoxylin eosin, fluorescence in situ hybridization and IHC against human epidermal growth factor receptor 2 and epidermal growth factor receptor gene mutation in the experimental group were completely consistent with those in the control group. There was no significant difference in the results between experiment 1 and experiment 2 groups. The rapid processing technique of ultrasound tissue with compound environmental protection reagent can be applied to the rapid detection of tumor biopsy specimens, and different processing temperatures and durations have no significant effect on the accuracy of HE staining, IHC, fluorescence in situ hybridization and gene mutation detection.
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Affiliation(s)
- Fan Yang
- Pathological, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Wei Dou
- Clinical Pathological Diagnosis Center, The Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Haisu Wang
- Clinical Pathological Diagnosis Center, The Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Dandan Cui
- Clinical Pathological Diagnosis Center, The Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Chunyan Li
- Pathological, Qiqihar Medical University, Qiqihar, Heilongjiang, China
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Wang Y, Zhao L, Zhang K, Liu Y, Guo L, Jing W, Hou H, Shi G, Bin Y, Zhang S, Zhang G, Li Q. Micro-histology combined with cytology improves the diagnostic accuracy of endometrial lesions. Cancer Med 2023; 12:17028-17036. [PMID: 37458126 PMCID: PMC10501300 DOI: 10.1002/cam4.6338] [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: 12/06/2022] [Revised: 06/26/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND In the study, we aimed to evaluate the ability of micro-histology combined with cytology to improve the quality of slides and diagnose endometrial lesions. METHODS Endometrial specimens were collected from Li Brushes. Every specimen was prepared for micro-histological and cytological slides, using cell block (CB) and liquid-based cytology (LBC) technologies. Semi-quantitative scoring system was used to evaluate the qualities of slides. CB slides were assessed by 5-category scoring system. Diagnostic accuracy was calculated in LBC, CB, and LBC + CB groups based on the histological gold standard. Endometrial atypical hyperplasia, and endometrial cancer were considered positive, whereas others were considered negative. RESULTS A total of 167 patients were enrolled. CB slides were inferior to LBC slides only in cellularity (p < 0.001), but superior in the other six parameters (all p < 0.001). The satisfaction rate of micro-histology accounted for 92.3%. The accuracy index in the CB group was higher than in the LBC group in terms of sensitivity (85.5% vs. 82.7%) and specificity (98.9% vs. 95.7%). The sensitivity and specificity in the LBC + CB group were increased to 94.2% and 99.0%, respectively. CONCLUSIONS The quality of micro-histological slides was higher than that of cytological slides. By combining micro-histology with cytology, higher accuracy was achieved for endometrial lesions diagnosis.
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Affiliation(s)
- Yiran Wang
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Lanbo Zhao
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Kailu Zhang
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Yu Liu
- Department of PathologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Lin Guo
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Wei Jing
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Huilian Hou
- Department of PathologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Guizhi Shi
- Aviation General Hospital of BeijingMedical University and Beijing Institute of Translational Medicine, University of Chinese Academy of SciencesBeijingChina
| | - Yadi Bin
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Siyi Zhang
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Guanjun Zhang
- Department of PathologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
| | - Qiling Li
- Department of Obstetrics and GynecologyThe First Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiChina
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Deban M, Châtelain J, Fasquelle F, Clerc D, Toussaint L, Hübner M, Teixeira Farinha H. The role of cytology in patients undergoing pressurized intraperitoneal aerosol chemotherapy (PIPAC) treatment for peritoneal carcinomatosis. Pleura Peritoneum 2023; 8:75-81. [PMID: 37304163 PMCID: PMC10249751 DOI: 10.1515/pp-2022-0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/20/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives Cytology of ascites or peritoneal washing is a routine part of staging of peritoneal metastases (PM). We aim to determine value of cytology in patients undergoing pressurized intraperitoneal aerosol chemotherapy (PIPAC). Methods Single-center retrospective cohort study included consecutive patients having PIPAC for PM of different primary between January 2015 and January 2020. Results A total of 75 patients (median 63 years (IQR 51-70), 67 % female) underwent a total of 144 PIPAC. At PIPAC 1 59 % patients had positive and 41 % patients had negative cytology. Patients with negative and positive cytology only differed in terms of symptoms of ascites (16% vs. 39 % respectively, p=0.04), median ascites volume (100 vs. 0 mL, p=0.01) and median PCI (9 vs. 19, p<0.01). Among 20 patients who completed 3 PIPACs (per protocol), cytology changed in one from positive to negative, and in two from negative to positive. Median overall survival was 30.9 months in the per protocol group and 12.9 months in patients having <3 PIPACs (=0.519). Conclusions Positive cytology under PIPAC treatment is more frequently encountered in patients with higher PCI and symptomatic ascites. Cytoversion was rarely observed and cytology status had no impact on treatment decisions in this cohort.
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Affiliation(s)
- Mélina Deban
- Department of Visceral Surgery, Faculty of Biology and Medicine UNIL, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Section of Surgical Oncology, Department of Surgery, University of Calgary, Calgary, Canada
| | - Julien Châtelain
- Department of Visceral Surgery, Faculty of Biology and Medicine UNIL, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - François Fasquelle
- Faculty of Biology and Medicine UNIL, Institute of pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Daniel Clerc
- Department of Visceral Surgery, Faculty of Biology and Medicine UNIL, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Laura Toussaint
- Department of Visceral Surgery, Faculty of Biology and Medicine UNIL, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Martin Hübner
- Department of Visceral Surgery, Faculty of Biology and Medicine UNIL, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Hugo Teixeira Farinha
- Department of Visceral Surgery, Faculty of Biology and Medicine UNIL, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Batool S, Sadaf S, Chughtai AS, Qasim A, Zafar A, Jamil A. Diagnostic Accuracy of Cell Block and Immunohistochemistry in Effusion Cytology. Cureus 2023; 15:e34958. [PMID: 36938247 PMCID: PMC10018576 DOI: 10.7759/cureus.34958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Although the cytology of effusion fluids is considered a routine laboratory test, it has recently emerged as an essential tool in determining the primary site of origin of carcinoma of unknown primary. The sensitivity for diagnosing malignancy has enhanced with the inclusion of cytospin, cell block (CB), and immunohistochemistry (IHC) to effusion fluid cytology due to the improvement in morphological preservation and good cellular yield. The purpose of this study was to assess the diagnostic yield, sensitivity, specificity, positive predictive value, and negative predictive value of IHC and CB in effusion cytology. Methodology An institution-based cross-sectional study was conducted over a period of six months on 150 cases of effusion fluids submitted for diagnostic purposes. After the preparation of cytospin, the residual amount of centrifuged deposit was mixed with CytoLyt solution, thrombin, and plasma, and CBs were prepared. IHC was applied to the CB. Calretinin was used for mesothelial cells, and BerEP4, TTF-1, ER, WT-1, and CD-X2 were used for the confirmation and origin of malignant cells. Results The mean age of the patients was 51.75 ± 16.63 years. The male-to-female ratio was 1:1.24. Out of 150 cases, 78 were pleural effusions, 68 were peritoneal effusions, and four were pericardial effusions. Out of 150 cases, based on cytological examination alone, 66 (44%) were classified as benign, 27 (18%) as malignant, and 57 (38%) were suspicious for malignancy. When cytology was combined with CB and IHC, the diagnostic yield was increased to benign 95 (63.33%), malignant 48 (32%), and suspicious for malignancy 7 (4.67%). The most common cause of malignant pleural effusion was breast carcinoma in females and lung carcinoma in males. The most common primary tumor in malignant peritoneal effusion was ovarian carcinoma in females and colonic adenocarcinoma in males. The sensitivity and specificity of combined cytology with cell block and IHC were 92.31% and 98.95%, respectively. This combination produced significantly better results (p-value = 0.001) for detecting malignancy and reduced suspicious cases from 38% to 4%. Conclusion CB, in combination with IHC, increases the diagnostic yield and aids in detecting malignancy at an unknown primary site in effusion fluids. Both of these techniques can thus enhance the sensitivity and specificity of the diagnosis of effusion cytology. Hence, CB and IHC have advanced utility over cytological smears in effusion fluid cytological diagnosis.
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Affiliation(s)
- Saima Batool
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | - Safana Sadaf
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | | | - Aafia Qasim
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | - Asma Zafar
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
| | - Anum Jamil
- Histopathology, Chughtai Institute of Pathology, Lahore, PAK
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Kassirian S, Hinton SN, Cuninghame S, Chaudhary R, Iansavitchene A, Amjadi K, Dhaliwal I, Zeman-Pocrnich C, Mitchell MA. Diagnostic sensitivity of pleural fluid cytology in malignant pleural effusions: systematic review and meta-analysis. Thorax 2023; 78:32-40. [PMID: 35110369 DOI: 10.1136/thoraxjnl-2021-217959] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 12/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Pleural fluid cytology is an important diagnostic test used for the investigation of pleural effusions. There is considerable variability in the reported sensitivity for the diagnosis of malignant pleural effusions (MPE) in the literature. OBJECTIVE The purpose of this review is to determine the diagnostic sensitivity of pleural fluid cytology for MPE, both overall and by tumour type, to better inform the decision-making process when investigating pleural effusions. DATA SOURCES A literature search of EMBASE and MEDLINE was performed by four reviewers. Articles satisfying inclusion criteria were evaluated for bias using the QUADAS-2 tool. DATA EXTRACTION For quantitative analysis, we performed a metaanalysis using a binary random-effects model to determine pooled sensitivity. Subgroup analysis was performed based on primary cancer site and meta-regression by year of publication. SYNTHESIS Thirty-six studies with 6057 patients with MPE were included in the meta-analysis. The overall diagnostic sensitivity of pleural fluid cytology for MPE was 58.2% (95% CI 52.5% to 63.9%; range 20.5%-86.0%). There was substantial heterogeneity present among studies (I2 95.5%). For primary thoracic malignancies, sensitivity was highest in lung adenocarcinoma (83.6%; 95% CI 77.7% to 89.6%) and lowest in lung squamous cell carcinoma (24.2%; 95% CI 17.0% to 31.5%) and mesothelioma (28.9%; 95% CI 16.2% to 41.5%). For malignancies with extrathoracic origin, sensitivity was high for ovarian cancer (85.2%; 95% CI 74.2% to 96.1%) and modest for breast cancer (65.3%; 95% CI 49.8% to 80.8%). CONCLUSIONS Pleural fluid cytology has an overall sensitivity of 58.2% for the diagnosis of MPE. Clinicians should be aware of the high variability in diagnostic sensitivity by primary tumour type as well as the potential reasons for false-negative cytology results.PROSPERO registration numberCRD42021231473.
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Affiliation(s)
- Shayan Kassirian
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Stephanie N Hinton
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sean Cuninghame
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rushil Chaudhary
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Alla Iansavitchene
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Kayvan Amjadi
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Inderdeep Dhaliwal
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Cady Zeman-Pocrnich
- Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Michael A Mitchell
- Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Rani SSS, Vamshidhar IS, John NA, John J. Diagnosis of Pleural Fluid Effusions by Cell Block and Pleural Biopsy - A Comparative Study. J Cytol 2022; 39:169-173. [PMID: 36605871 PMCID: PMC9809426 DOI: 10.4103/joc.joc_91_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/10/2021] [Accepted: 10/14/2022] [Indexed: 11/09/2022] Open
Abstract
Background Cytological smear and cell block are commonly used to diagnose pleural fluid effusion. However, there is a paucity of information in the literature where a comparison between a cytological smear and a cell block with corresponding pleural biopsy has been done. This study aimed to evaluate the accuracy of cytological smears, cell blocks, and pleural biopsy for the diagnosis of malignant tumors. Material and Methods In this cross-sectional study, analysis of successive pleural fluid samples received by the department was done. The sample was divided into equal halves of 5 ml each. One was used for conventional smear and the second was used for the preparation of cell block. The cell block was prepared by centrifuging the specimen of fluid at 2500 rpm for 15 min. A pleural biopsy was obtained by using Cope's pleural biopsy needle. Results A total of n = 50 cases were included in the study. A total of n = 8 cases were diagnosed as malignant by cell smear and n = 4 cases were suspicious for malignancy. By cell block, n = 10 cases of malignancy were diagnosed and n = 1 case was suspicious for malignancy. By biopsy, n = 11 cases were diagnosed as malignant and n = 1 case was suspicious for malignancy. Out of the total, n = 2 cases were diagnosed as squamous cell carcinoma by biopsy; one case was diagnosed by cell block; and the other was reported as suspicious for malignancy. Conclusion The study shows that cell blocks are complementary to the cell smear technique in over diagnosis and categorization of benign as well as malignant cells. The cell blocks were more useful in the diagnosis of malignancy because of better preserved architectural patterns as seen in corresponding histopathology sections. It, therefore, appears that the cell blocks are a perfect fit to bridge the cytology and histopathology.
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Affiliation(s)
- S. S. Sabitha Rani
- Department of Pathology, ESIC Medical College and Hospital, Sanathnagar, Hyderabad, Telangana, India
| | | | - Nitin Ashok John
- Department of Physiology, All India Institute of Medical Sciences (AIIMS), Bibinagar, Telangana, India
| | - Jyoti John
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India
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Shimizu T, Koshita S, Ohira T, Harada Y, Kanno Y, Ogawa T, Yamagata T, Kusunose H, Sakai T, Tsuchiya T, Oikawa M, Noda Y, Sawai T, Ito K. Endoscopic Ultrasonography-guided Fine-needle Aspiration Cytology Combined with a Cell-block Method for Gastrointestinal Subepithelial Lesions. Intern Med 2022; 61:935-942. [PMID: 34511568 PMCID: PMC9038475 DOI: 10.2169/internalmedicine.7889-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective The diagnostic accuracy of an endoscopic ultrasound-guided fine-needle aspiration cytology/biopsy combined with a cell-block method (FNA-CB) for gastrointestinal subepithelial lesions (GI-SELs) has not been fully studied. Methods A total of 109 patients (with 110 GI-SELs) were evaluated to clarify the rate of obtaining evaluable histology specimens using FNA-CB. In addition, we investigated the following: 1) the accuracy for determining the histology, 2) effects of the number of cell clusters obtained via FNA-CB, 3) correlation of the Ki67 labelling index (Ki67LI) of the gastrointestinal stromal tumor (GIST) lesions between FNA-CB and resected specimens, and 4) clinical courses for patients followed up after FNA-CB. Results Of the 110 GI-SELs for which FNA-CB was performed, 95 (86%) were able to be histologically evaluated using the first FNA-CB. For the 70 resected GI-SELs, the accuracy of FNA-CB to determine histology was 96%, remaining at 90% even when only a few cell clusters were obtained. The concordance rate of the risk-grouping of GIST (high-risk, Ki67LI ≥8; low-risk, <8) between FNA-CB and resected specimens was 84%. Of the 29 patients followed up after the first FNA-CB, 12 with benign GI-SELs determined using the first FNA-CB showed no obvious increases in their GI-SEL sizes. Conclusion Since FNA-CB can be used to determine the histology and reproductive activity of GI-SELs accurately, not only preoperative histological confirmation but also reliable information to determine clinical plans, such as follow-up without surgery or neoadjuvant chemotherapy, can be obtained.
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Affiliation(s)
- Takeshi Shimizu
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | - Shinsuke Koshita
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | - Tetsuya Ohira
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | - Yoshihiro Harada
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | - Yoshihide Kanno
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | - Takahisa Ogawa
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | - Taku Yamagata
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | - Hiroaki Kusunose
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | - Toshitaka Sakai
- Department of Gastroenterology, Sendai City Medical Center, Japan
| | | | - Masaya Oikawa
- Department of Surgery, Sendai City Medical Center, Japan
| | - Yutaka Noda
- Department of Gastroenterology, Sendai City Medical Center, Japan
- Department of Pathology, Sendai City Medical Center, Japan
| | - Takashi Sawai
- Department of Pathology, Sendai City Medical Center, Japan
| | - Kei Ito
- Department of Gastroenterology, Sendai City Medical Center, Japan
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Bhattacherjee S, Bhunia C, Chatterjee S, Kundu D. Comparative Evaluation of Cell Block Histopathology and Conventional Smear Cytology in FNAC of Clinically Suspected Cervical Lymph Node Malignancy. MEDICAL JOURNAL OF BABYLON 2022. [DOI: 10.4103/mjbl.mjbl_106_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Das S, Chaudhary N, Sinha S. Comparative evaluation of diagnostic efficacy of cell block versus aspiration cytology. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_98_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Anand N, Agrawal T, Gupta A, Shukla S, Pradhan R, Husain N. Diagnostic Efficacy of BRAFV600E Immunocytochemistry in Thyroid Aspirates in Bethesda Category IV and Papillary Thyroid Carcinoma. J Cytol 2021; 38:113-119. [PMID: 34703086 PMCID: PMC8489694 DOI: 10.4103/joc.joc_248_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/01/2021] [Accepted: 07/29/2021] [Indexed: 11/04/2022] Open
Abstract
Background In papillary thyroid carcinoma (PTC), BRAFV600E is a common mutation and is associated with aggressive clinical behaviour. Immunocytochemistry (ICC) and molecular testing are recommended in the Bethesda System for Reporting Thyroid Cytopathology 2017 (TBSRTC) category III, IV and V. Aims The current study aimed to evaluate the diagnostic efficacy of conventional FNAC versus FNAC with BRAFV600E immunostaining in cases of TBSRTC category IV, cases of suspicious for PTC and cases of PTC. Methods and Material The study included a prospective case series of 45 patients with clinically palpable thyroid nodules with TBSRTC category IV, category V (suspicious for PTC) and PTC. The corresponding histology specimens of all the 45 cases were also analyzed. Immunostaining for BRAFV600E was performed on FNAC cell blocks and their corresponding histology sections using anti-BRAF (VE1) clone (Ventana). The diagnostic efficacy of the BRAFV600E immunostaining was compared on cytological specimens with histological specimens. Results BRAFV600E immunostaining helped to improve the sensitivity of the cytology to confirm the PTC as a diagnostic aid for thyroid FNAs. Cytology alone had a sensitivity of 62.96% and a lower specificity of 60.70%. The combination of both the tests together provided 84.62% sensitivity and much higher specificity of 100%. PPV was also increased to 100% and NPV was raised 94.12%. Conclusions The performance of BRAFV600E immunostaining on the cytological specimen is a rapid, simple and cost-effective test and could be considered in TBSRTC category IV and suspicious and malignant cases of PTC.
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Affiliation(s)
- Nidhi Anand
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Tushar Agrawal
- Department of Pathology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Anurag Gupta
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Saumya Shukla
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Roma Pradhan
- Department of Endocrine Surgery, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nuzhat Husain
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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14
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Marrinhas C, Oliveira LF, Sampaio F, Moreira R, Canadas-Sousa A, Pereira A, Santos M, Marcos R. Needle rinse cell blocks as an ancillary technique: Diagnostic and clinical utility in gastrointestinal neoplasia. Vet Clin Pathol 2021; 50 Suppl 1:47-54. [PMID: 34642969 DOI: 10.1111/vcp.13073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/26/2021] [Accepted: 08/29/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Fine-needle aspirate (FNA) cytology is often the first-choice method for diagnosing gastrointestinal nodular lesions. The FNA material can be converted to histopathology specimens by a needle rinse cell block (NRCB) technique, allowing ancillary studies to refine the cytologic diagnosis. Despite use in human pathology, NRCB has never been applied to canine or feline gastrointestinal neoplasia. OBJECTIVE This study described NRCB methodology and its diagnostic utility in specific cases of neoplastic gastrointestinal lesions. METHODS Needle rinses with saline were performed after ultrasound-guided FNAs of two intestinal lymphomas (canine and feline) and a canine gastrointestinal stromal tumor (GIST). The NRCB was prepared using the cell tube block technique and processed for paraffin embedding. Routine immunohistochemistry protocols (using CD3, PAX-5, and Ki-67 for lymphoma cases and vimentin, desmin, S-100, and KIT markers for GIST) were applied to NRCB sections, and the results were compared with matched tissue biopsies. RESULTS NRCBs with adequate cell numbers, preservation, and good separation of blood were obtained. The diagnosis and immunophenotyping were confirmed in both cases of lymphoma in NRCBs. In the GIST, the immunolabeling of the neoplastic cells in NRCB was completely concordant with the tissue biopsy. CONCLUSIONS The described methodology is suitable for veterinary settings, having few technical requirements and low invasiveness. The presented cases of gastrointestinal neoplasia highlight the utility of NRCBs as a platform to conduct ancillary studies and refine the cytologic diagnosis.
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Affiliation(s)
- Carla Marrinhas
- Cytology Diagnostic Services, Institute of Biomedical Sciences Abel Salazar, ICBAS - UP, University of Porto, Porto, Portugal.,Hospital do Baixo Vouga, OneVet Group, Águeda, Portugal
| | - Luísa F Oliveira
- Cytology Diagnostic Services, Institute of Biomedical Sciences Abel Salazar, ICBAS - UP, University of Porto, Porto, Portugal.,Anicura CHV Porto, Porto, Portugal
| | - Filipe Sampaio
- Cytology Diagnostic Services, Institute of Biomedical Sciences Abel Salazar, ICBAS - UP, University of Porto, Porto, Portugal.,INNO, Braga, Portugal
| | | | | | | | - Marta Santos
- Cytology Diagnostic Services, Institute of Biomedical Sciences Abel Salazar, ICBAS - UP, University of Porto, Porto, Portugal
| | - Ricardo Marcos
- Cytology Diagnostic Services, Institute of Biomedical Sciences Abel Salazar, ICBAS - UP, University of Porto, Porto, Portugal
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15
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Chen YA, Lai YC, Lin SJ, Yang CS. Utility of cell block as an adjunct to liquid-based cytology for diagnosing papillary thyroid carcinoma. INDIAN J PATHOL MICR 2021; 63:581-586. [PMID: 33154309 DOI: 10.4103/ijpm.ijpm_999_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Although liquid-based cytology (LBC) has gained popularity among clinical laboratories, it is unclear whether it is equivalent to conventional smears for making a definite diagnosis of papillary thyroid carcinoma (PTC). The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) suggests a definite diagnosis of PTC is preferred when there are at least one of three features (papillary architecture, psammomatous calcifications, and frequent pseudonuclear inclusions) plus other typical cytomorphological findings. This study evaluated whether an additional cell block (CB), prepared from the residual LBC material, could help improve the diagnosis of PTC. Materials and Methods A total of 62 cases with both ThinPrep LBC and CB preparations and histopathological follow-up of PTC were retrieved between November 2016 and March 2019. The ThinPrep LBC and CB slides were reviewed separately to identify any papillary architecture, psammomatous calcifications, or pseudonuclear inclusions for diagnosing PTC. Results Among the 51 cases with cytological diagnosis of PTC in the LBC+CB slides, the CB provided additional diagnostic information in 15 cases, which were initially diagnosed as suspicious for PTC based on the LBC slides alone. This information included papillary architecture (n=11), psammomatous calcification (n=1) and pseudonuclear inclusions (n=5). The number of specimens in the 51 cases containing at least one of the three features increased from 42 (LBC) to 51 (LBC+CB). The accuracy for diagnosing PTC increased from 58.1% for LBC alone to 82.3% for the LBC+CB examination. Conclusion An adjunctive CB preparation may improve the LBC technique for diagnosing PTC.
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Affiliation(s)
- Yun-An Chen
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ying-Ching Lai
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shu-Jiuan Lin
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital; Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Chi-Shun Yang
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital; Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan
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16
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Culture Cell Block Controls as a Tool to the Biomolecular Diagnosis of Infectious Diseases. Appl Immunohistochem Mol Morphol 2021; 28:484-487. [PMID: 31633490 DOI: 10.1097/pai.0000000000000811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The cell block (CB) technique has allowed easy obtainment of samples such as cellular and culture suspensions, to perform specific molecular tests such as immunohistochemistry and in situ hybridization. It has been improved along time, accuracy, and quality of the diagnoses, however, the cost of a commercial gel matrix for the preparation of CB is high and not suitable depending on the situation. The objective of this study is to test agarose as an alternative to the commercial gel matrix in the preparation of Aspergillus fumigatus' CB.
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17
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Satturwar S, Pantanowitz L. Architectural aspects of cell-blocks as small biopsies. Cytojournal 2021; 18:5. [PMID: 33880128 PMCID: PMC8053489 DOI: 10.25259/cytojournal_4_2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 01/01/2023] Open
Abstract
Cell-block preparations have become an essential part of integrated cytology diagnosis. They are essentially microbiopsies that are formalin fixed and embedded in paraffin. This has become more prevalent with greater sample procurement due to the advent of newer biopsy techniques and needles. Cell-blocks allow retrieval of small tissue fragments from cytology specimens that sometimes cannot be processed by alternate cytologic techniques. They represent concentrated, cell-enriched preparations that provide cytologists with the opportunity to evaluate cellular architecture, as well as to perform ancillary testing. A cell-block compatible sample may thus obviate the need for a more invasive procedure such as a tissue biopsy. Microscopic examination of cell-blocks is quick, avoids obscuring material, permits cells to be evaluated in one focal plane, and allows the histologic architecture such as glandular differentiation, papillary formations, and sometimes invasion to be easily identified. This new era of “cytohistology” accordingly requires practicing cytologists to become more familiar with histopathology. This review article discusses the benefit of various architectural patterns identifiable in cell-blocks employed as an adjunct to Pap tests, exfoliative fluid specimens, and fine-needle aspirations.
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Affiliation(s)
- Swati Satturwar
- Department of Pathology, University of Pittsburgh Medical Center, Pennsylvania, United States
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Michigan, United States
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18
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Kanjilal B, Das RN, Chatterjee U, Sengupta M, Sarkar R, Saha K. Utility of cell block preparation in diagnosis of paediatric abdominal neoplasms. Diagn Cytopathol 2020; 49:404-411. [PMID: 33226199 DOI: 10.1002/dc.24670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/27/2020] [Accepted: 11/09/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Paediatric abdominal neoplasms are fairly common. Fine needle aspiration cytology (FNAC) is used for the initial evaluation of paediatric abdominal neoplasms. However, sometimes FNA interpretation can be difficult on limited material, owing to tumour heterogeneity and overlapping features. Therefore, we attempted to obtain additional information using cell block (CB) preparation from residual aspiration material along with immunohistochemistry (IHC) to enhance the diagnostic accuracy. AIM To evaluate the correlation between CB preparation and FNAC in diagnosis of paediatric abdominal tumours with the help of an extended panel of IHC markers and to highlight some of the diagnostic difficulties. MATERIALS AND METHODS A total of 113 cases of paediatric abdominal masses were studied. In addition to routine FNA smears, CBs were prepared from the residual material for IHC analysis as considered appropriate. RESULTS This study included a total of 113 children with abdominal masses. Histopathology following surgical resection was available in 53 cases. Histology was taken as gold standard to measure the diagnostic accuracy with reference to sensitivity (Sn), specificity (Sp), positive predictive value and negative predictive value. The Sn of FNA alone was 87.5% and Sp was 97.78%. The Sn and Sp increased with use of CB alone and were 100% and 97.78% respectively. The highest Sn and Sp were observed when CB was combined with IHC where both the values were 100%. CONCLUSION CB with IHC is a useful adjunct to the routine FNA smears that further contributes to enhance the accuracy of the cytopathological diagnosis and is useful for choosing pre-operative chemotherapeutic regimen.
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Affiliation(s)
| | - Ram Narayan Das
- Department of Pathology, MJN Medical College and Hospital, Coochbehar, India
| | | | | | | | - Koushik Saha
- Department of Pediatric Surgery, NRS Medical College, Kolkata, India
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19
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Ha HJ, Kim EJ, Kim JS, Shin MS, Noh I, Park S, Koh JS, Lee SS. Major Clues and Pitfalls in the Differential Diagnosis of Parathyroid and Thyroid Lesions Using Fine Needle Aspiration Cytology. ACTA ACUST UNITED AC 2020; 56:medicina56110558. [PMID: 33114338 PMCID: PMC7690923 DOI: 10.3390/medicina56110558] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 01/25/2023]
Abstract
Background: It is difficult to distinguish parathyroid lesions (PLs) from thyroid lesions using fine needle aspiration cytology (FNAC) because of their proximity and their similar cytomorphological features. Methods: FNAC smears of 46 patients with pathologically proven PLs that were histologically diagnosed as parathyroid adenoma (PA, n = 35), parathyroid hyperplasia (PH, n = 3), atypical parathyroid adenoma (APA, n = 1), and parathyroid carcinoma (PC, n = 7) were retrospectively reviewed and analyzed. Results: Our initial cytological diagnoses indicated correct diagnoses in 31 of 46 PL patients (67%). The 15 erroneous diagnoses were 5 patients with non-specific benign disease (11%), 4 with nodular hyperplasia of the thyroid (9%), 5 with atypical cells (11%), and 1 with a metastatic papillary thyroid carcinoma (2%). Follicular pattern, papillary structures, colloid-like material, and macrophages, which often suggest thyroid lesions, were also present in some PLs. We found that branching capillaries along the papillary structures, stippled nuclear chromatin, and frequent occurrence of naked nuclei were useful for determining a parathyroid origin. Conclusions: It is important to be aware that PLs are frequently mistaken for thyroid lesions based on FNAC. The specific and unique characteristics of PLs identified here may be helpful in diagnosis.
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Affiliation(s)
- Hwa Jeong Ha
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Korea; (H.J.H.); (J.-S.K.); (M.-S.S.); (S.P.); (J.S.K.)
- Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 01811, Korea;
| | - Eun Ju Kim
- Division of Radiation Biomedical Research, Korea Institute of Radiological & Medical Sciences, Seoul 0182, Korea;
- Radiological & Medico-Oncological Sciences, University of Science & Technology, Daejeon 34113, Korea
| | - Jung-Soon Kim
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Korea; (H.J.H.); (J.-S.K.); (M.-S.S.); (S.P.); (J.S.K.)
| | - Myung-Soon Shin
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Korea; (H.J.H.); (J.-S.K.); (M.-S.S.); (S.P.); (J.S.K.)
| | - Insup Noh
- Convergence Institute of Biomedical Engineering and Biomaterials, Seoul National University of Science and Technology, Seoul 01811, Korea;
- Department of Chemical and Biomolecular Engineering, Seoul National University of Science and Technology, Seoul 01811, Korea
| | - Sunhoo Park
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Korea; (H.J.H.); (J.-S.K.); (M.-S.S.); (S.P.); (J.S.K.)
| | - Jae Soo Koh
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Korea; (H.J.H.); (J.-S.K.); (M.-S.S.); (S.P.); (J.S.K.)
| | - Seung-Sook Lee
- Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences, Seoul 01812, Korea; (H.J.H.); (J.-S.K.); (M.-S.S.); (S.P.); (J.S.K.)
- Correspondence: ; Tel.: +82-2970-1268
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20
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Obiajulu FJN, Daramola AO, Anunobi CC, Ikeri NZ, Abdulkareem FB, Banjo AA. The diagnostic utility of cell block in fine needle aspiration cytology of palpable breast lesions in a Nigerian tertiary health institution. Diagn Cytopathol 2020; 48:1300-1306. [PMID: 32780930 DOI: 10.1002/dc.24576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/21/2020] [Accepted: 07/20/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Although fine needle aspiration cytology (FNAC) is highly accurate for detecting breast malignancies, concerns remain among cytopathologists about false-positive and false-negative diagnoses. Cell block (CB) preparations have been advocated by some cytopathologists as one of the methods to improve and consolidate the diagnostic accuracy of FNAC. The aim of this study was to determine the diagnostic utility of CB in FNAC of palpable breast lesions among female patients. METHODS Following FNA, CBs were prepared using 10% neutral-buffered formalin from the residual breast aspirates of 100 consecutive female patients attending the FNAC clinic. The slides of the conventional smears, CB and excisional biopsies were examined, and results were analysed using the SPSS. RESULTS Of the 100 patients that had FNAC, 44 (44%) had excisional biopsy performed. An additional 13% diagnostic yield for malignancy was obtained with the use of CB preparations. CB reduced equivocal diagnoses by 25%, corresponding with 90.9% improvement on definitive diagnoses. CONCLUSION In our setting, the addition of CB to smear remarkably improved the diagnostic utility of breast FNAC by minimising atypical and suspicious for malignancy diagnostic categories.
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Affiliation(s)
| | - Adetola Olubunmi Daramola
- Department of Anatomic and Molecular Pathology, University of Lagos College of Medicine, Lagos, Nigeria
| | - Charles Chidozie Anunobi
- Department of Anatomic and Molecular Pathology, University of Lagos College of Medicine, Lagos, Nigeria
| | - Nzechukwu Zimudo Ikeri
- Department of Anatomic and Molecular Pathology, University of Lagos College of Medicine, Lagos, Nigeria
| | - Fatimah Biade Abdulkareem
- Department of Anatomic and Molecular Pathology, University of Lagos College of Medicine, Lagos, Nigeria
| | - Adekunbiola Aina Banjo
- Department of Anatomic and Molecular Pathology, University of Lagos College of Medicine, Lagos, Nigeria
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21
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Sale MS, Kulkarni VV, Kulkarni PV, Patil CA. Efficacy of modified cell block cytology compared to fine needle aspiration cytology for diagnostic oral cytopathology. Biotech Histochem 2020; 96:197-201. [PMID: 32552083 DOI: 10.1080/10520295.2020.1780314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Cell blocks and fine needle aspirations can be used for cytopathological diagnosis. Conventional fine needle aspiration smears provide limited material for diagnosis. The cell block technique provides more tissue, which improves diagnostic accuracy. We compared a modified cell block cytology to fine needle aspiration for providing optimal preservation of histochemical and immunocytochemical properties. We used 30 fine needle aspirates from oral lesions in two groups: group 1, fine needle aspiration cytology; group 2, cell block cytology. Smears of fine needle aspirates were stained with Papanicolaou. For the modified cell block technique, aspirated material was centrifuged to create a cell pellet, which then was fixed with Nathan alcohol formalin substitute. After routine histopathological processing, cell pellets were embedded in paraffin, then sectioned and stained with hematoxylin and eosin. Sections were compared to Papanicolaou stained smears of fine needle samples. Cellular morphology and staining quality of modified cell block samples were superior to fine needle aspiration cytology; both methods exhibited distinct nuclear morphology. Modified cell blocks provide excellent cytopathologic features compared to fine needle aspiration cytology.
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Affiliation(s)
- M S Sale
- Department of Oral Pathology and Microbiology, Bharati Vidyapeeth (Deemed to Be University) Dental College and Hospital, Sangli, India
| | - V V Kulkarni
- Department of Oral Pathology and Microbiology, Bharati Vidyapeeth (Deemed to Be University) Dental College and Hospital, Pune, India.,Department of Prosthodontics, Bharati Vidyapeeth (Deemed to Be University) Dental College and Hospital, Sangli, India
| | - P V Kulkarni
- Department of Oral Pathology and Microbiology, Bharati Vidyapeeth (Deemed to Be University) Dental College and Hospital, Pune, India.,Department of Prosthodontics, Bharati Vidyapeeth (Deemed to Be University) Dental College and Hospital, Sangli, India
| | - C A Patil
- Department of Oral Pathology and Microbiology, Bharati Vidyapeeth (Deemed to Be University) Dental College and Hospital, Sangli, India
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22
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Adhikari A, Mandal P, Pradhan S, Gangopadhyay M, Rupsha D, Bhattacharya S. Evaluation of role of cell block with immunohistochemistry in differentiating hepatocellular carcinoma from metastatic adenocarcinoma. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2020. [DOI: 10.4103/cjhr.cjhr_17_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Fujii Y, Koizumi J, Hara T, Sekiguchi T, Itou C, Asano K, Iwasaki M, Nakamura N, Imai Y. Endovascular Catheter Biopsy for the Diagnosis of Pulmonary Artery Sarcoma. Ann Vasc Dis 2019; 12:256-259. [PMID: 31275488 PMCID: PMC6600104 DOI: 10.3400/avd.hdi.19-00001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The diagnosis of pulmonary artery sarcoma (PAS) is challenging, and its definitive diagnosis is mainly confirmed using specimens obtained during surgery or autopsy. Endovascular catheter biopsy was performed in five patients with suspected PAS to establish a definitive diagnosis. Aspiration biopsy was performed in all patients, and forceps biopsy was performed in one patient. Three patients were diagnosed with PAS, and no definitive diagnosis was obtained in two patients with squamous cell lung carcinoma with pulmonary artery infiltration. Endovascular catheter biopsy is helpful in the diagnosis of PAS and should be performed when a tumor is suspected.
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Affiliation(s)
- Yoshimi Fujii
- Department of Diagnostic Radiology, Fujisawa City Hospital, Fujisawa, Kanagawa, Japan
| | - Jun Koizumi
- Department of Diagnostic Radiology, School of Medicine, Tokai University, Isehara, Kanagawa, Japan
| | - Takuya Hara
- Department of Diagnostic Radiology, School of Medicine, Tokai University, Isehara, Kanagawa, Japan
| | - Tatsuya Sekiguchi
- Department of Diagnostic Radiology, School of Medicine, Tokai University, Isehara, Kanagawa, Japan
| | - Chihiro Itou
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Koichiro Asano
- Division of Pulmonary Medicine, Department of Medicine, School of Medicine, Tokai University, Isehara, Kanagawa, Japan
| | - Masayuki Iwasaki
- Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Tokai University, Isehara, Kanagawa, Japan
| | - Naoya Nakamura
- Department of Pathology, School of Medicine, Tokai University, Isehara, Kanagawa, Japan
| | - Yutaka Imai
- Department of Diagnostic Radiology, School of Medicine, Tokai University, Isehara, Kanagawa, Japan
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24
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Güldaval F, Anar C, Polat G, Gayaf M, Yavuz MY, Korkmaz A, Alıcı İO, Karadeniz G, Büyükşirin M, Aydoğdu Z. Contribution of Cell Block Obtained by Thoracentesis in the Diagnosis of Malignant Pleural Effusion. J Cytol 2019; 36:205-208. [PMID: 31741579 PMCID: PMC6844012 DOI: 10.4103/joc.joc_99_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 03/01/2019] [Accepted: 04/19/2019] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this study wass to compare the cytological features of pleural exudative fluids by conventional smear (CS) method and cell block (CB) method and also to assess the utility of the combined approach for cytodiagnosis of these effusions. Materials and Methods In all, 113 pleural exudative fluid samples were subjected to evaluation by both CS and CB methods over a period of 2 years. Cellularity, architecture patterns, morphological features, and yield for malignancy were compared, using the two methods. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for diagnosis of malignancy were calculated for both the methods, using histology as a gold standard. Results CB method provided higher cellularity, better architectural patterns, and additional yield for malignancy when compared with CS method. For 22 (40%) patients, histologic subtype was determined with CB especially for adenocarcinoma. The sensitivity, specificity, positive, and negative predictive values of cytology and CB were 48%, 100%, 100%, 67.8% and 59.2%, 100%, 100%, 72.8%, respectively. Conclusion CB technique definitively increased detection of malignancy in pleural fluid effusion when used as an adjunct to CSs. Also, CB provides material suitable for molecular genetic analysis for targeted therapies especially in the treatment of adenocarcinoma.
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Affiliation(s)
- Filiz Güldaval
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Ceyda Anar
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Gülru Polat
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Mine Gayaf
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Melike Yüksel Yavuz
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Ali Korkmaz
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - İbrahim Onur Alıcı
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Gülistan Karadeniz
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Melih Büyükşirin
- Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Zekiye Aydoğdu
- Department of Pathology, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir, Turkey
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25
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Gonsales FF, Fernandes NCCA, Mansho W, Montenegro H, Guerra JM, de Araújo LJT, da Silva SMP, Benites NR. Feline Sporothrix spp. detection using cell blocks from brushings and fine-needle aspirates: Performance and comparisons with culture and histopathology. Vet Clin Pathol 2019; 48:143-147. [PMID: 30861158 DOI: 10.1111/vcp.12708] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/08/2018] [Accepted: 08/31/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sporotrichosis is an emerging zoonotic mycosis that presents as a cutaneous lymphatic or disseminated disease, caused by fungi from the Sporothrix schenkii (S schenkii) clinical clade. Its importance is growing, primarily due to an outbreak that occurred in Brazil, affecting mainly cats and people. OBJECTIVES In Brazil, an S schenkii diagnosis is often made using cultures, which allows genus identification and sufficient growth to perform molecular biology testing. Despite its advantages, fungal cultures are slow to develop and can delay public health measures, highlighting the importance of developing additional diagnostics techniques. METHODS Cell block cytology (CBLC) is an older method that regained importance after liquid-based cytology (LBC) was introduced, and it has been previously and successfully applied to veterinary diagnostics. We aimed to standardize and compare CBLC from cervical brush exfoliation of open wounds and fine-needle aspirates with culture and immunohistochemistry of skin biopsies for sporotrichosis in cats, as a novel method. RESULTS For this purpose, we selected 40 cats with skin lesions suspected of having sporotrichosis in Guarulhos city, São Paulo state, Brazil. We achieved 97.5% and 95% positivity using CBLC and culture, respectively, and 100% of feline skin biopsies were positive for Sporothrix spp on histopathology/immunohistochemistry. CONCLUSIONS Cell block cytology is an efficient and rapid tool to diagnose sporotrichosis in cats, particularly during epidemics.
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Affiliation(s)
- Fernanda F Gonsales
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Natália C C A Fernandes
- Anatomic Pathology Department, Pathology Center, Adolfo Lutz Institute, São Paulo, SP, Brazil
| | - Wilson Mansho
- Technical division, Zoonosis Control Center of Guarulhos, SP, Brazil
| | | | - Juliana M Guerra
- Quantitative Pathology Department, Pathology Center, Adolfo Lutz Institute, São Paulo, SP, Brazil
| | | | - Silvana M P da Silva
- Anatomic Pathology Department, Pathology Center, Adolfo Lutz Institute, São Paulo, SP, Brazil
| | - Nilson R Benites
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine, University of São Paulo, São Paulo, SP, Brazil
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Torous VF, Chen Y, VanderLaan PA. Comparison of plasma-thrombin, HistoGel, and CellGel cell block preparation methods with paired ThinPrep slides in the setting of mediastinal granulomatous disease. J Am Soc Cytopathol 2019; 8:52-60. [PMID: 31287420 DOI: 10.1016/j.jasc.2018.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/02/2018] [Accepted: 09/06/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Various cell block (CB) preparation methods are utilized by different laboratories, and not all laboratories perform CBs in tandem with ThinPreps (TPs). To compare the performance of different CB methods and their diagnostic value when used in conjunction with TP, we assessed the quantity and size of granulomas obtained from endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) of lymph nodes in the evaluation of granulomatous mediastinal disease. MATERIALS AND METHODS A retrospective analysis of mediastinal lymph node EBUS-TBNA specimens that detected granulomas at our institution was performed. A total of 264 specimens from 124 patients had a TP followed by a CB (either plasma-thrombin, HistoGel, or CellGel) prepared from the residual material in the PreservCyt vial. The number and size of granulomas on each preparation was assessed using digital software. RESULTS Granulomas were detected only on the CB in 18.9% of cases and only on the TP in 5.3%. All 3 CB preparation methods showed significantly more and larger granulomas compared with the paired TP, with the plasma-thrombin and CellGel methods yielding more diagnostic material than the HistoGel method. In addition, the average number of granulomas (4.0 ± 0.4 versus 15.3 ± 1.1) and granuloma size (119.2 ± 3.2 μm versus 271.8 ± 7.3 μm) were significantly lower on TP compared with CB, respectively. CONCLUSIONS Plasma-thrombin and CellGel CB preparation methods had a higher granuloma yield compared with the HistoGel method. Additionally, significantly more numerous and larger granulomas were present on CBs compared with TP slides. Therefore, solely relying on TP slide evaluation may unintentionally overlook larger tissue fragments obtained during needle aspirations.
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Affiliation(s)
- Vanda F Torous
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Yigu Chen
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Paul A VanderLaan
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
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Alwahaibi N, Alghallabi A, Alsinawi S, Aldairi N. Cytological Smear and Cell Block Versus Tissue Biopsies in the Diagnosis of Malignant Tumours in Non-Gynaecologic Specimens. Ethiop J Health Sci 2019; 28:583-588. [PMID: 30607073 PMCID: PMC6308769 DOI: 10.4314/ejhs.v28i5.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Cytological smear and cell block (CB) are routinely used to diagnose non-gynaecologic specimens. However, there is scanty information in the literature to compare cytological smear and CB with the corresponding tissue biopsies. This study is aimed at evaluating the accuracy of cytological smear and CB in the diagnosis of malignant tumours in non-gynaecologic specimens. Materials and Methods A total of 70 malignant cases were subjected to cytological smear and CB. Corresponding histopathology was also included. The most frequent immunomarkers found between CB and tissue biopsies were also correlated. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false positive and false negative values were analyzed for each method. Results The accuracy, sensitivity and positive predictive value for cytological smear were 92.8%, 100.0% and 92.9%, whereas for CB were 91.4%, 98.4% and 92.7%, respectively. In CB method, the accuracy, sensitivity and positive predictive value for CK7 were 88.9%, 91.7% and 95.6%, whereas for CK5/6 were 75%, 100% and 57.1%, respectively. Conclusion Cytological smear and CB are very sensitive and accurate in the detection of malignant tumours in nongynaecologic specimens. Additional corresponding tissue biopsies should be re-evaluated.
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Affiliation(s)
- Nasar Alwahaibi
- Department of Allied Health Sciences, Sultan Qaboos University
| | | | | | - Najat Aldairi
- Department of Pathology, Sultan Qaboos University Hospital
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Subbarayan D, Bhattacharya J, Rani P, Khuraijam B, Jain S. Use of Panel of Markers in Serous Effusion to Distinguish Reactive Mesothelial Cells from Adenocarcinoma. J Cytol 2019; 36:28-31. [PMID: 30745736 PMCID: PMC6343394 DOI: 10.4103/joc.joc_13_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Although cytological examination helps in diagnosis of malignancy in serous effusion, at times it is difficult to differentiate atypical reactive mesothelial cells from adenocarcinoma (AC) cells. To resolve this problem, various ancillary methods have been used. Immunocytochemistry (ICC) is one such commonly used technique in which various panel of antibodies has been tried. Unfortunately, so far no unique marker is available to solve this issue. Hence, the present study evaluates the efficacy of four antibody panel comprising of MOC-31, epithelial membrane antigen (EMA), calretinin (CAL), and mesothelin (MES) to solve this problem. Materials and Methods: Forty-two cases suspected of malignant effusion in pleural/peritoneal fluid and 42 cases of reactive effusion were included. Cytospin smears were prepared and stained with Giemsa stain for cytomorphological diagnosis. Cytospin smears and cell blocks were made forICC. ICC for MOC-31, EMA, CAL, and MES was performed. Results: Among the suspected malignant effusion cases, 30 cases were AC and 12 cases were suspicious for malignancy by cytomorphology. MOC31 demonstrated 100% sensitivity (Sn) and 95.24% specificity (Sp), and EMA had 88.1% Sn and 92.86% Sp for AC cases. CAL demonstrated 100% and 97.62%, and MES 97.62% and 88.1% Sn and Sp in reactive mesothelial cells, respectively. Conclusion: In conclusion, combination of MOC-31 and CAL as a limited panel will be helpful in giving an appropriate diagnosis in difficult cases and thereby, help in patient management. In addition, ICC on cytospin smears gave results similar to cell blocks, and if standardised cytospin is simple technique to perform, unlike cell blocks.
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Affiliation(s)
- Devi Subbarayan
- Pathology Department, Chettinad Hospital and Research Institute, Kelambakkam, Chennai, Tamil Nadu, India
| | - Jenna Bhattacharya
- Pathology Department, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Poonam Rani
- Pathology Department, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Bembem Khuraijam
- Pathology Department, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Shyama Jain
- Pathology Department, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
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Gupta V, Shukla S, Husain N, Kant S, Garg R. A Comparative Study of Cell Block versus Biopsy for Detection of Epidermal Growth Factor Receptor Mutations and Anaplastic Lymphoma Kinase Rearrangement in Adenocarcinoma Lung. J Cytol 2019; 36:13-17. [PMID: 30745733 PMCID: PMC6343387 DOI: 10.4103/joc.joc_66_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Lung cancer is a leading cause of deaths attributed to cancer worldwide. Epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement are commonly found in patients of adenocarcinoma lung against, which targeted therapy is available. In this era of personalized medicine, it is a rationale to detect these molecular alterations in cases of lung carcinomas. Aims The objectives were to compare the diagnostic efficacy of cytological samples for the detection of EGFR and ALK protein expression using immunocytochemistry in nonsmall cell lung carcinoma. Materials and Methods We compared 22 cell blocks and biopsies for the detection of EGFR and ALK protein expression by immunohistochemistry (IHC). EGFR IHC was performed using EGFR Receptor (E746-A750 del Specific) (6B6) monoclonal antibody and ALK IHC was done using Ventana anti-ALK (D5F3) monoclonal primary antibody. Results Two cases were found to be positive; 20 cases were negative for EGFR IHC both in biopsies and cell blocks. ALK IHC was positive in one case; negative in 21 cases. The results of IHC were also concordant for biopsies and cell blocks. The sensitivity and specificity were 100% for immunocytochemical detection of ALK and EGFR in cell blocks with respect to biopsies. Conclusion We conclude that cell blocks can serve as a potential substitute for biopsies for detection of EGFR and ALK protein by immunocytochemistry, whenever patient presents with effusion and biopsy cannot be done or when tissue is not adequate.
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Affiliation(s)
- Vani Gupta
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Saumya Shukla
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nuzhat Husain
- Department of Pathology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Surya Kant
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Rajiv Garg
- Department of Pulmonary Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
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Desai KM, Angadi PV, Kale AD, Hallikerimath S. Assessment of cell block technique in head and neck pathology diagnoses: A preliminary study. Diagn Cytopathol 2018; 47:445-451. [PMID: 30578602 DOI: 10.1002/dc.24137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/07/2018] [Accepted: 12/05/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The head and neck region is a composite site made of multiple tissue components. These tissues when affected by disease or pathology present with an array of changes in the tissue architecture and pattern. It is essential to visualize the cellular details and tissue patterns for accurate diagnosis and treatment planning. Aspiration cytology primarily makes use of the cellular details for diagnosing lesions of the head and neck. Despite the promising results, its use is still limited in certain cases of the head and neck. The reason implicated could be the indiscernible appearance of cells in the absence of tissue integrity. In this regard, cell blocks are known to facilitate the visualization of the cytomorphological as well as the tissue arrangement patterns. Thus, the present study was designed to evaluate the role of cell block cytology in the diagnosis of various lesions of the head and neck. METHODS Odontogenic lesions, epithelial carcinomas and connective tissue pathology of the head and neck origin were included in the study (n = 45). Aspiration cytology smears and cell block diagnosis were compared with tissue biopsy diagnosis for determining their sensitivity (%) and diagnostic efficacy. RESULTS Cell blocks showed distinct preservation of the architectural pattern. In case of fluid-filled lesions, the contents were preserved and correlated with the tissue biopsy results. The results of cell blocks were similar to that of tissue biopsy in majority of the cases (95.56%). CONCLUSION We recommend using cell blocks as a part of routine laboratory practice for all head-neck cases.
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Affiliation(s)
- Karishma M Desai
- Department of Oral Pathology and Microbiology, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences and Hospital, Belagavi, Karnataka, India
| | - Punnya V Angadi
- Department of Oral Pathology and Microbiology, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences and Hospital, Belagavi, Karnataka, India
| | - Alka D Kale
- Department of Oral Pathology and Microbiology, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences and Hospital, Belagavi, Karnataka, India
| | - Seema Hallikerimath
- Department of Oral Pathology and Microbiology, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences and Hospital, Belagavi, Karnataka, India
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Jiang K, Zhou J, Lei J, Liu Y, Li J, Su X, Li Z, Wei T, Jiang Y, Zhu J. Cell block is a valuable adjunct to conventional smear for thyroid fine needle aspiration: 2395 cases with histological correlation. Cytopathology 2018; 29:525-530. [PMID: 30238537 DOI: 10.1111/cyt.12633] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/03/2018] [Indexed: 02/05/2023]
Affiliation(s)
- Ke Jiang
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Junyi Zhou
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Jianyong Lei
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Ying Liu
- Department of Laboratory Medicine; West China Hospital of Sichuan University; Chengdu China
| | - Jinnan Li
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Xueying Su
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Zhihui Li
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Tao Wei
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
| | - Yong Jiang
- Department of Pathology; West China Hospital of Sichuan University; Chengdu China
| | - Jingqiang Zhu
- Thyroid and Parathyroid Surgery Center; West China Hospital of Sichuan University; Chengdu China
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Dantey K, Pantanowitz L, Xing J, Cuda J, Nestler R, Monaco SE. Cell block preparation in urine cytology: examination of utility and workflow in an academic practice. J Am Soc Cytopathol 2018; 8:61-68. [PMID: 31287421 DOI: 10.1016/j.jasc.2018.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/02/2018] [Accepted: 11/05/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Urine cytology is a common non-invasive test to screen for urothelial carcinoma. Urine cell blocks may sometimes be prepared as a diagnostic aid (eg, to characterize architecture or perform immunohistochemistry). The aim of this study was to determine whether routinely preparing cell blocks on urine specimens improves diagnostic sensitivity. MATERIALS AND METHODS Three time periods were compared: time period 1 (prior to November 2009; 1437 consecutive selected cases), when cell blocks were rarely prepared; period 2 (November 2009 to May 2010; 1230 selected cases), when cell blocks were prepared on all cases; and period 3 (after May 2010; 1499 consecutive selected cases), when cell blocks were made only when indicated (for samples with substantial cellular pellets or when requested by a pathologist). RESULTS Patient demographics and the type of specimens received were relatively similar during the 3 time periods. Increased preparation of cell blocks was not accompanied by a notable improvement in specimen adequacy rate, given that <1%, 2%, and 1% of samples were unsatisfactory for the 3 periods. Only the proportion of atypical cases differed during the time periods, being highest in period 1 (23%), but lower in periods 2 and 3. Turnaround time was fastest for period 1 (mean: 47 hours, median: 33 hours), and slower for period 2 and period 3. CONCLUSION These data show that routinely preparing cell blocks for urine samples did not improve our laboratory's specimen adequacy rate. Nonetheless, cell block preparation on urine samples did help lower the proportion of atypical diagnoses, when routinely or selectively prepared. Because preparation of cell blocks on all urine cases can be costly and only provides minimal added clinical benefit, our recommendation is to rather judiciously utilize cell blocks when screening urine cytology samples.
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Affiliation(s)
- Kossivi Dantey
- Department of Pathology, Allegheny General Hospital, Pittsburgh, Pennsylvania
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Juan Xing
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jackie Cuda
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Rick Nestler
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sara E Monaco
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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Krogerus L, Kholová I. Cell Block in Cytological Diagnostics: Review of Preparatory Techniques. Acta Cytol 2018; 62:237-243. [PMID: 29909418 DOI: 10.1159/000489769] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/03/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The cell block (CB) technique refers to the processing of sediments, blood clots, or grossly visible tissue fragments from cytological specimens into paraffin blocks that can be cut and stained by the same methods used for histopathology. The technique brings additional tissue architectural information. CB can be used for ancillary techniques such as immunocytochemistry and molecular techniques. STUDY DESIGN We reviewed the literature on the various preparatory techniques of CBs. RESULTS There is a wide range of preparatory techniques for CBs and no golden standard for CBs exists: tens of methods are used in various institutions. The majority of the methods are modified in house techniques with a few commercially available kits. The techniques most commonly used are the plasma/thrombin method, the agar method, and commercially available Histogel- and Cellient CB-methods. Dissatisfaction with the cellular yield of the CBs is common. CONCLUSIONS In the CBs, the cytological material is preserved for future use, which is a tremendous advantage in the era of targeted therapy and biobanking. The CB is thus central to the future of cytology: more can be done with less material and with less invasiveness to the patient.
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Affiliation(s)
- Leena Krogerus
- Department of Pathology, HUSLAB, Jorvi Hospital, Espoo, Finland
| | - Ivana Kholová
- Department of Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
- Department of Pathology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
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Poojan S, Kim HS, Yoon JW, Sim HW, Hong KM. Determination of Protein Expression Level in Cultured Cells by Immunocytochemistry on Paraffin-embedded Cell Blocks. J Vis Exp 2018. [PMID: 29863662 PMCID: PMC6101295 DOI: 10.3791/57369] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Immunofluorescent staining is currently the method of choice for determination of protein expression levels in cell-culture systems when morphological information is also necessary. The protocol of immunocytochemical staining on paraffin-embedded cell blocks, presented herein, is an excellent alternative to immunofluorescent staining on non-paraffin-embedded fixed cells. In this protocol, a paraffin cell block from HeLa cells was prepared using the thromboplastin-plasma method, and immunocytochemistry was performed for the evaluation of two proliferation markers, CKAP2 and Ki-67. The nuclei and cytoplasmic morphology of the HeLa cells were well preserved in the cell-block slides. At the same time, the CKAP2 and Ki-67 staining patterns in the immunocytochemistry were quite similar to those in immunohistochemical staining in paraffin cancer tissues. With modified cell-culture conditions, including pre-incubation of HeLa cells under serum-free conditions, the effect could be evaluated while preserving architectural information. In conclusion, immunocytochemistry on paraffin-embedded cell blocks is an excellent alternative to immunofluorescent staining.
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Affiliation(s)
- Shiv Poojan
- Omics Core Lab, Research Institute, National Cancer Center
| | - Han-Seong Kim
- Department of Pathology, Inje University Ilsan Paik Hospital
| | - Ji-Woon Yoon
- Omics Core Lab, Research Institute, National Cancer Center
| | - Hye Won Sim
- Omics Core Lab, Research Institute, National Cancer Center
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Žemaitis M, Musteikienė G, Miliauskas S, Pranys D, Sakalauskas R. Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Cytological Smears and Cell Blocks: A Single-Institution Experience. MEDICINA (KAUNAS, LITHUANIA) 2018; 54:E19. [PMID: 30344250 PMCID: PMC6037240 DOI: 10.3390/medicina54020019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 01/15/2023]
Abstract
Background and Objective: Endobronchial ultrasound (EBUS) is a minimally invasive endobronchial technique, which uses ultrasound along with a bronchoscope to visualize the airway wall and structures that are adjacent to it. Indications for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) are samplings of mediastinal, hilar lymph nodes, and tumors adjacent to airway walls. EBUS-TBNA has been used in our clinic since 2009. The aim of the study is to evaluate the sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy of cytological and histological specimens, and the safety of EBUS-TBNA in an unselected patient population that has been referred to our hospital. Materials and Methods: We have retrospectively analyzed the medical documentation of 215 patients who had EBUS-TBNA performed in our clinic from April 2009 to February 2014. Results: There were 215 patients who underwent EBUS-TBNA. A total of 296 lymph nodes were sampled. EBUS-TBNA was diagnostic in 176 (81.9%) cases of cytological, 147 (68.4%) cases of histological, and 191 (88.9%) cases of the combined evaluation. In the lung cancer patients, EBUS-TBNA cytology had a sensitivity of 72.9% and histology of 72.9%, and in the sarcoidosis group, it had a cytology of 55.8% and histology of 64.5%. As all positive cytology and histology specimens were assumed to be true positive, specificity and positive predictive value (PPV) were 100%. The sensitivity and diagnostic accuracy was significantly higher when cytology and histology specimens were combined, compared with cytology or histology results evaluated separately (p < 0.05) (for lung cancer 84.1% and for sarcoidosis 78.8%). The sensitivity and diagnostic accuracy of EBUS-TBNA procedures increased significantly over time, with increased experience. There were no complications with EBUS-TBNA in our clinical practice. Conclusions: EBUS-TBNA had a high diagnostic yield and was safe in the diagnosis of lung cancer and sarcoidosis. It was most informative when cytology and histology were combined. The informative value of EBUS-TBNA histology increased with our experience.
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Affiliation(s)
- Marius Žemaitis
- Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania.
| | - Greta Musteikienė
- Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania.
| | - Skaidrius Miliauskas
- Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania.
| | - Darius Pranys
- Department of Pathological Anatomy, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania.
| | - Raimundas Sakalauskas
- Department of Pulmonology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307 Kaunas, Lithuania.
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Costa M, Canena J, Mascarenhas-Lemos L, Loureiro R, Silva M, Carvalho D, Capela T, Russo P, Ramos G, Mateus-Dias A, Ferraz-Oliveira M, Veiga PM, Coimbra J. Outcomes of Different Methods for Analysis of Biliary Brush Cytology and of Factors Associated with Positive Diagnosis in an Age-Dependent Retrospective Review. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2018; 26:5-13. [PMID: 30675499 DOI: 10.1159/000487153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/18/2018] [Indexed: 12/17/2022]
Abstract
Background and Aims Brush cytology during endoscopic retrograde cholangiopancreatography (ERCP) is the most frequently used strategy for obtaining a tissue sample from an indeterminate biliary stricture. A recent study reported that age is a factor associated with positive yields, but further analysis of how age influences the results was lacking. We aimed to evaluate clinical effectiveness of biliary cytology and prognostic factors for a positive outcome, especially age. Methods This study was a single-center, retrospective, clinical study of 77 consecutive patients who underwent brush cytology during ERCP to obtain a diagnosis of an indeterminate biliary stricture. We compared 2 routine cytology techniques: A (smear); B (centrifugation of the cytological material collected and the cut-off brush + cell block when sufficient amount of material was available). The data were collected aiming to compare the accuracy of the different techniques used and the prognostic factors affecting the outcome, with a particular focus on age. The yield for brush cytology was compared with the gold standard defined as either definitive histology or the long-term clinical course. Results The overall accuracy of the 2 used methods was 75.3%. Sensitivity was 52.5%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 66.1%. Although not statistically significant, there was a trend toward accuracy for method B compared with method A (80.4 vs. 65.4%; p = 0.153). Multiple logistic regression analysis showed that younger age was the only independent prognostic factor associated with a positive diagnosis (OR 0.95; 95% CI 0.90-0.99; p = 0.039). Receiver operating characteristic curves for age yielded an area under the curve value of 68.2%. On the basis of the Youden index, 69 years was found to be the optimal cutoff for age. Conclusions In this series, the accuracy of routine biliary brush cytology was not equal for all methods and ages; in particular, younger patients (below 69 years) tended to have a higher probability of a correct diagnosis.
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Affiliation(s)
- Mariana Costa
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
| | - Jorge Canena
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Luís Mascarenhas-Lemos
- Department of Pathology, São José Hospital do Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Rafaela Loureiro
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
| | - Mário Silva
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
| | - Diana Carvalho
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
| | - Tiago Capela
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
| | - Pedro Russo
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
| | - Gonçalo Ramos
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
| | - António Mateus-Dias
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
| | - Mário Ferraz-Oliveira
- Department of Pathology, São José Hospital do Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - Pedro Mota Veiga
- Curva de Gauss - Research, Training and Consulting, Canas de Senhorim, Portugal
| | - João Coimbra
- Department of Gastroenterology, Santo António dos Capuchos Hospital do Centro Hospitalar Lisboa Central, Nova Medical School/Faculty of Medical Sciences, Lisbon, Portugal
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Shivkumar V, Patil B, Gangane N. Utility of MOC-31 monoclonal antibody in differentiating metastatic adenocarcinoma cells and reactive mesothelial cells in effusion cytology. INDIAN J PATHOL MICR 2018; 61:90-93. [DOI: 10.4103/ijpm.ijpm_86_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Fruchter O, Breslavsky A, Brozgol T, Grossman A, Kessi M, Bugayov A, Shimelis K, Vaknine H, Sukmanov O. The diagnostic value of tissue button technique for specimen accusation during endobronchial ultrasound-guided transbronchial fine-needle aspiration. CLINICAL RESPIRATORY JOURNAL 2017; 12:1802-1808. [PMID: 29124891 DOI: 10.1111/crj.12741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/01/2017] [Accepted: 11/05/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The quality of tissue acquisition during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a major determinant of the diagnostic yield of the procedure. In the tissue button (TB) technique, the retrieved cellular specimen is fixed in ethanol and subsequently scraped from slide using surgical blade into formaldehyde and processed like ordinary tissue biopsy thus potentially increasing its diagnostic value. OBJECTIVES To retrospectively evaluate the diagnostic yield of a TB technique in patients undergoing EBUS-TBNA for various malignant and benign conditions. METHODS The diagnostic yield of specimen obtained by two methods (TB and traditional cell-block technique) performed during the same procedure are outlined in 46 patients who underwent EBUS-TBNA (median age = 65, range 19-85 years). RESULTS Overall, in both malignant and benign conditions, TB resulted in clear diagnostic material in 43/46 (93.4%) patients. Specifically, TB provided clear histological diagnosis of malignancy (either primary lung cancer or metastases from extra-thoracic cancer) in 30/46 (65.2%) patients and granulomatous inflammation in 11/46 (23.9%) of patients. Only in two patients TB did not provide diagnostic material. CONCLUSIONS The newly introduced TB technique provides valuable histological diagnostic material during EBUS-TBNA both malignant and benign conditions. Given its simplicity and its high diagnostic yield, TB should be considered to be used as one of the preferred specimen acquisition modalities during EBUS-TBNA specimen processing. Direct comparison to alternative tissue processing techniques during EBUS-TBNA should be explored in further randomized prospective studies.
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Affiliation(s)
- Oren Fruchter
- Pulmonary Division, Wolfson Medical Center, Holon, Israel.,The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel
| | - Anna Breslavsky
- Pulmonary Division, Wolfson Medical Center, Holon, Israel.,The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel
| | - Tatyana Brozgol
- Pulmonary Division, Wolfson Medical Center, Holon, Israel.,The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel
| | - Anna Grossman
- Pulmonary Division, Wolfson Medical Center, Holon, Israel.,The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel
| | - Mikhailova Kessi
- Pulmonary Division, Wolfson Medical Center, Holon, Israel.,The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel
| | - Alexey Bugayov
- Pulmonary Division, Wolfson Medical Center, Holon, Israel.,The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel
| | - Kassa Shimelis
- Pulmonary Division, Wolfson Medical Center, Holon, Israel.,The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel
| | - Hananya Vaknine
- The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel.,Pathology Department, Wolfson Medical Center, Holon, Israel
| | - Oleg Sukmanov
- The Sackler School of Medicine, Tel Aviv University, The Internal Medicine Division, Tel Aviv, Israel.,Pathology Department, Wolfson Medical Center, Holon, Israel
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Comparison of cytological and histological preparations in the diagnosis of pancreatic malignancies using endoscopic ultrasound-guided fine needle aspiration. Hepatobiliary Pancreat Dis Int 2017; 16:418-423. [PMID: 28823373 DOI: 10.1016/s1499-3872(17)60035-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 03/15/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has become a crucial diagnostic technique for pancreatic malignancies. The specimen obtained by EUS-FNA can be prepared for either cytological or histological examinations. This study was to compare diagnostic performance of cytological and histological preparations using EUS-FNA in the same lesions when pancreatic malignancies were suspected. METHODS One hundred and eighteen patients who underwent EUS-FNA for suspected pancreatic malignancies were consecutively enrolled. All procedures were conducted by a single echoendoscopist under the same conditions. Four adequate preparations were obtained by 22-gauge needles with 20 to-and-fro movements for each pass. The 4 preparations included 2 cytological and 2 histological specimens. The pathologic reviews of all specimens were conducted independently by a single experienced cytopathologist. Sensitivity, specificity, and accuracy of the 2 preparations were compared. RESULTS The enrolled patients consisted of 62 males (52.5%), with the mean age of 64.6±10.5 years. Surgery was performed in 23 (19.5%) patients. One hundred and sixteen (98.3%) lesions were classified as malignant, while 2 (1.7%) were benign. Sensitivity of cytology and histology were 87.9% and 81.9%, respectively, with no significant difference (P=0.190). Accuracy was also not significantly different. Cytological preparation was more sensitive when the size of lesion was <3 cm (86.7% vs 68.9%, P=0.033). CONCLUSIONS Our results suggested that the diagnostic performances of cytological and histological preparations are not significantly different for the diagnosis of pancreatic malignancies. However, cytological preparation might be more sensitive for pancreatic lesions <3 cm.
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Miceli R, Scognamiglio G, Camerlingo R, Rea G, Lettiero A, Cantile M, Greggi S, Losito NS, Pirozzi G, Botti G. New cell block containing agarose for cytopathological diagnosis of tumor samples. Diagn Cytopathol 2017; 45:1057-1060. [PMID: 28664554 DOI: 10.1002/dc.23778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/13/2017] [Accepted: 06/15/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Roberta Miceli
- Department of Experimental Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Giosuè Scognamiglio
- Pathology Unit, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Rosa Camerlingo
- Department of Experimental Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Giuseppina Rea
- Department of Experimental Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Antonio Lettiero
- Pathology Unit, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Monica Cantile
- Pathology Unit, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Stefano Greggi
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Nunzia Simona Losito
- Pathology Unit, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Giuseppe Pirozzi
- Department of Experimental Oncology, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
| | - Gerardo Botti
- Pathology Unit, Istituto Nazionale Tumori "Fondazione G. Pascale" - IRCCS, Naples, Italy
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Cristo APD, Goldstein HF, Faccin CS, Maia AL, Graudenz MS. Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 60:367-73. [PMID: 27533613 PMCID: PMC10118724 DOI: 10.1590/2359-3997000000180] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 03/09/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Ultrasound-guided fine-needle aspiration (US-FNA) biopsy has proven to be an accurate and efficient tool in thyroid nodule evaluation. We evaluated whether cell block adds to the diagnostic accuracy of US-FNA. SUBJECTS AND METHODS Three hundred twenty-eight consecutive patients underwent US-FNA, cytology and cell block evaluation. Six slides were prepared for each patient and stained by Papanicolaou and Giemsa techniques. The residual hemorrhagic aspirate in the syringe and needle was fixed in 10% formalin and paraffin-embedded (cell block). The histological sections were examined as a complementary diagnostic tool to US-FNA. RESULTS The study population comprised 89% females and the mean age was 57.4 ± 13.7 years. The mean nodule size was 2.3 ± 1.2 cm. US-FNA cytological results were as follows: Bethesda I, 17.1% (n = 56); Bethesda II, 61.6% (n = 202); Bethesda III, 9.5% (n = 31); Bethesda IV, 5.8% (n = 19); Bethesda V, 2.4% (n = 8), and Bethesda VI, 3.6% (n = 12). Cell blocks were obtained in 100% of cases and were considered diagnostic in 89.6%. Combined cytological and cell block (cyto-cell block) results were as follows: unsatisfactory, 4.3% (n = 14); benign, 72.6% (n = 238); indeterminate, 11.3% (n = 37); follicular lesion, 5.8% (n = 19); suspicious for malignancy, 2.4% (n = 8), and malignant, 3.6% (n = 12). The sensitivity and specificity for cyto-cell block was 100% and 90%, respectively, and the accuracy was 94%. Cyto-cell block analysis reduced the rate of unsatisfactory samples (p < 0.001). CONCLUSIONS The cyto-cell block interpretation improved the efficiency of US-FNA. This simple, fast and low-cost technique should be used as an adjunctive test in thyroid nodule evaluation. Arch Endocrinol Metab. 2016;60(4):367-73.
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Affiliation(s)
- Ana Patrícia de Cristo
- Programa de Pós-Graduação em Medicina: Endocrinologia, Universidade Federal do Rio Grande do Sul (UFRGS); Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brasil
| | - Heloísa Folgierini Goldstein
- Serviço de Patologia, Hospital de Clínicas de Porto Alegre (HCPA); Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| | - Carlo Sasso Faccin
- Serviço de Radiologia, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brasil
| | - Ana Luiza Maia
- Unidade de Tireoide, Serviço de Endocrinologia, Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| | - Marcia Silveira Graudenz
- Serviço de Patologia, Hospital de Clínicas de Porto Alegre (HCPA); Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
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Zhang H, Wen J, Xu PL, Chen R, Yang X, Zhou LE, Jiang P, Wan AX, Liao QP. Role of Liquid-based Cytology and Cell Block in the Diagnosis of Endometrial Lesions. Chin Med J (Engl) 2017; 129:1459-63. [PMID: 27270542 PMCID: PMC4910370 DOI: 10.4103/0366-6999.183431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Liquid-based cytology (LBC) offers an alternative method to biopsy in screening endometrial cancer. Cell block (CB), prepared by collecting residual cytological specimen, represents a novel method to supplement the diagnosis of endometrial cytology. This study aimed to compare the specimen adequacy and diagnostic accuracy of LBC and CB in the diagnosis of endometrial lesions. Methods: A total of 198 women with high risks of endometrial carcinoma (EC) from May 2014 to April 2015 were enrolled in this study. The cytological specimens were collected by the endometrial sampler (SAP-1) followed by histopathologic evaluation of dilatation and curettage or biopsy guided by hysteroscopy. The residual cytological specimens were processed into paraffin-embedded CB after LBC preparation. Diagnostic accuracies of LBC and CB for detecting endometrial lesions were correlated with histological diagnoses. Chi-square test was used to compare the specimen adequacies of LBC and CB. Results: The specimen inadequate rate of CB was significantly higher than that of LBC (22.2% versus 7.1%, P < 0.01). There were 144 cases with adequate specimens for LBC and CB preparation. Among them, 29 cases were atypical endometrial hyperplasia (11 cases) or carcinoma (18 cases) confirmed by histology evaluation. Taking atypical hyperplasia and carcinoma as positive, the diagnostic accuracy of CB was 95.1% while it was 93.8% in LBC. When combined LBC with CB, the diagnostic accuracy was improved to 95.8%, with a sensitivity of 89.7% and specificity of 97.4%. Conclusions: CB is a feasible and reproducible adjuvant method for screening endometrial lesions. A combination of CB and LBC can improve the diagnostic accuracy of endometrial lesions.
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Affiliation(s)
- Hui Zhang
- Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Jia Wen
- Department of Obstetrics and Gynecology, Tsinghua Chang Gung Hospital, Beijing 102218, China
| | - Pi-Li Xu
- Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Rui Chen
- Department of Obstetrics and Gynecology, Tsinghua Chang Gung Hospital, Beijing 102218, China
| | - Xi Yang
- Department of Obstetrics and Gynecology, Tsinghua Chang Gung Hospital, Beijing 102218, China
| | - Lian-Er Zhou
- Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Ping Jiang
- Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - An-Xia Wan
- Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Qin-Ping Liao
- Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Jain E, Mohan H, Singhal N, Bisht B. The utility of vapor fixation for cell block preparation in fine needle aspiration of malignant lesions of lymph nodes. J Histotechnol 2017. [DOI: 10.1080/01478885.2016.1215624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ekta Jain
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Harsh Mohan
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
| | - Niti Singhal
- Department of Clinical and Anatomical Pathology, Brightpoint Royal Women’s Hospital, Abu Dhabi, United Arab Emirates
| | - Bhumika Bisht
- Department of Pathology, Government Medical College and Hospital, Chandigarh, India
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Mathew EP, Nair V. Role of cell block in cytopathologic evaluation of image-guided fine needle aspiration cytology. J Cytol 2017; 34:133-138. [PMID: 28701825 PMCID: PMC5492749 DOI: 10.4103/joc.joc_82_15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Context: Fine needle aspiration cytology (FNAC) of superficial or deep-seated lesion is an increasingly common practice, eliminating time consuming and costly diagnostic procedures and providing rapid and safe diagnosis. Aims: To assess utility of cell block preparation method in increasing sensitivity of cytodiagnosis in deep-seated image-guided FNACs. Settings and Design: This was a hospital-based observational study conducted in the Department of Pathology, over a period of one and a half years. Materials and Methods: A total of 46 cases of abdomino-pelvic and intrathoracic masses subjected to guided FNACs were included. Along with conventional smears, cell blocks were prepared by using AAF (95% Ethanol 34 ml + formalin 4 ml + Glacial acetic acid 2 ml) as fixative agent. Statistical Analysis Used: Done using MedCalc Version 12.7.5.0 to find out the sensitivity, specificity, and diagnostic accuracy of conventional smears and cell blocks. Results: The sensitivity, specificity, and diagnostic accuracy of cell blocks in our study was 71.11%, 100%, and 71.73%, respectively. The figures for FNA smears were 62.22%, 100%, and 63.04%, respectively. Conclusions: Cell block technique by AAF fixative is a simple, inexpensive procedure. Cell block method allows the recovery and processing of minute amounts of cellular material, facilitating better classification of tumor when reviewed along with cytological smears, the ability to obtain many sections for immunostains and other studies to be performed akin to paraffin sections produced in histopathology.
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Affiliation(s)
- Elizabath P Mathew
- Department of Pathology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
| | - Vijayalakshmi Nair
- Department of Pathology, Amala Institute of Medical Sciences, Thrissur, Kerala, India
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Erer OF, Erol S, Anar C, Aydoğdu Z, Özkan SA. Contribution of cell block obtained by endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of malignant diseases and sarcoidosis. Endosc Ultrasound 2017; 6:265-268. [PMID: 27121292 PMCID: PMC5579913 DOI: 10.4103/2303-9027.180763] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and minimally invasive procedure that can be performed in outpatient settings. Several studies have demonstrated the usefulness of EBUS-TBNA in the diagnosis of sarcoidosis and malignant diseases. This study focused on the role of cell block (CB) analysis in determining the diagnostic yield of EBUS-TBNA in malignant diseases and sarcoidosis. MATERIALS AND METHODS The study was conducted at a training and research hospital. Records of patients who underwent EBUS-TBNA between March 2011 and December 2014 for diagnosed sarcoidosis or malignancy were retrospectively analyzed. Results of all EBUS-TBNA smears and CB were separately evaluated to determine the diagnostic value of each. RESULTS There were 84 sarcoidosis and 179 malignancy patients. In the malignancy group, CB contributed to cancer diagnosis in 15 (8.3%) patients and subclassification in 19 (10.6%) patients. In the sarcoidosis group, for 45.2% of patients (38/84), smears were not diagnostic but CB showed granulomatous inflammation. CONCLUSION CB significantly increases the diagnostic yield of EBUS-TBNA for sarcoidosis. In our study, in the malignancy group the diagnostic yield was low but it was helpful for subclassification, especially for adenocarcinoma.
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Affiliation(s)
- Onur Fevzi Erer
- Deparment of Chest Diseases, Izmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Izmir, Turkey
| | - Serhat Erol
- Deparment of Chest Diseases, Izmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Izmir, Turkey
| | - Ceyda Anar
- Deparment of Chest Diseases, Izmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Izmir, Turkey
| | - Zekiye Aydoğdu
- Deparment of Pathology, Izmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Izmir, Turkey
| | - Serir Aktoğu Özkan
- Deparment of Chest Diseases, Izmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Izmir, Turkey
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Miyoshi S, Sasada S, Izumo T, Matsumoto Y, Tsuchida T. Diagnostic Utility of Pleural Fluid Cell Block versus Pleural Biopsy Collected by Flex-Rigid Pleuroscopy for Malignant Pleural Disease: A Single Center Retrospective Analysis. PLoS One 2016; 11:e0167186. [PMID: 27880851 PMCID: PMC5120864 DOI: 10.1371/journal.pone.0167186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/09/2016] [Indexed: 12/03/2022] Open
Abstract
Background Some trials recently demonstrated the benefit of targeted treatment for malignant disease; therefore, adequate tissues are needed to detect the targeted gene. Pleural biopsy using flex-rigid pleuroscopy and pleural effusion cell block analysis are both useful for diagnosis of malignancy and obtaining adequate samples. The purpose of our study was to compare the diagnostic utility between the two methods among patients with malignant pleural disease with effusion. Methods Data from patients who underwent flex-rigid pleuroscopy for diagnosis of pleural effusion suspicious for malignancy at the National Cancer Center Hospital, Japan between April 2011 and June 2014 were retrospectively reviewed. All procedures were performed under local anesthesia. At least 150 mL of pleural fluid was collected by pleuroscopy, followed by pleural biopsies from the abnormal site. Results Thirty-five patients who were finally diagnosed as malignant pleural disease were included in this study. Final diagnoses of malignancy were 24 adenocarcinoma, 1 combined adeno-small cell carcinoma, and 7 malignant pleural mesothelioma (MPM), and 3 metastatic breast cancer. The diagnostic yield was significantly higher by pleural biopsy than by cell block [94.2% (33/35) vs. 71.4% (25/35); p = 0.008]. All patients with positive results on cell block also had positive results on pleural biopsy. Eight patients with negative results on cell block had positive results on pleural biopsy (lung adenocarcinoma in 4, sarcomatoid MPM in 3, and metastatic breast cancer in 1). Two patients with negative results on both cell block and pleural biopsy were diagnosed was sarcomatoid MPM by computed tomography-guided needle biopsy and epithelioid MPM by autopsy. Conclusion Pleural biopsy using flex-rigid pleuroscopy was efficient in the diagnosis of malignant pleural diseases. Flex-rigid pleuroscopy with pleural biopsy and pleural effusion cell block analysis should be considered as the initial diagnostic approach for malignant pleural diseases presenting with effusion.
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Affiliation(s)
- Shion Miyoshi
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
- Department of Respiratory Medicine, Toho University Omori Medical Center, Ota-Ku, Tokyo, Japan
| | - Shinji Sasada
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Minato-Ku, Tokyo, Japan
- * E-mail:
| | - Takehiro Izumo
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
| | - Yuji Matsumoto
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
| | - Takaaki Tsuchida
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan
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Yadav MK, Manoli NM, Madhunapantula SV. Comparative Assessment of Vitamin-B12, Folic Acid and Homocysteine Levels in Relation to p53 Expression in Megaloblastic Anemia. PLoS One 2016; 11:e0164559. [PMID: 27780269 PMCID: PMC5079580 DOI: 10.1371/journal.pone.0164559] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 09/09/2016] [Indexed: 01/03/2023] Open
Abstract
Background Megaloblastic anemia (MBA), also known as macrocytic anemia, is a type of anemia characterized by decreased number of RBCs as well as the presence of unusually large, abnormal and poorly developed erythrocytes (megaloblasts), which fail to enter blood circulation due to their larger size. Lack of vitamin-B12 (VB12) and / or folate (Vitamin-B9, VB9) with elevated homocysteine is the key factor responsible for megaloblastic anemia. Prior studies have demonstrated the induction of apoptosis in these abnormal under-developed erythrocytes. However, it is not clear whether this apoptosis induction is due to elevated p53 level or due to any other mechanism. Furthermore, it is also not fully known whether decreased vitamin-B12 and / or folate are responsible for apoptosis induction mediated by p53 in pre-erythroblasts. Methods Levels of serum VB9, VB12 and homocysteine in 50 patients suffering from MBA were compared with 50 non-megaloblastic anemia control subjects, who were referred by the clinicians for bone marrow examination for medical conditions other than MBA. Next, we have measured the p53 expression in the paraffin embedded blocks prepared from bone marrow biopsy, using immunohistochemistry, and the expression levels correlated with VB9 and VB12 levels. Results Out of 50 MBA patients 40 (80%) and 44 (88%) subjects had very low VB12 and VB9 levels respectively. In contrast, only 2 (4%) and 12 (24%) non-megaloblastic anemia controls, out of 50 subjects, had low VB12 and VB9 respectively. Correlating with low vitamin B9 and B12, the homocysteine levels were high in 80% cases. But, only 20% non-megaloblastic controls exhibited high homocysteine in plasma. Immunohistochemical analysis for p53 expression showed a significantly high level of expression in MBA cases and no—or very low—expression in control subjects. Our correlation studies comparing the VB12 and VB9 levels with p53 expression concludes unusually high p53 levels in patients suffering from VB12 and VB9 deficiency induced MBA compared to control subjects not suffering from MBA. Conclusion Tumor protein p53 is the key protein expressed heavily in the bone marrow biopsies of patients suffering from VB12 and VB9 deficiency induced MBA but not in control subjects. Hence, p53 expression could be used as a surrogate marker for confirming the VB9 and VB12 induced MBA.
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Affiliation(s)
- Manish K Yadav
- Department of Pathology, JSS Medical College, JSS University, Mysuru - 570015, Karnataka, India
| | - Nandini M Manoli
- Department of Pathology, JSS Medical College, JSS University, Mysuru - 570015, Karnataka, India
| | - SubbaRao V Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Medical College, JSS University, Mysuru - 570015, Karnataka, India
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Saqi A. The State of Cell Blocks and Ancillary Testing: Past, Present, and Future. Arch Pathol Lab Med 2016; 140:1318-1322. [PMID: 27557411 DOI: 10.5858/arpa.2016-0125-ra] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cell blocks are an integral part of cytology, but their utility is recognized probably more now than ever before, largely owing to the significant role they play in ancillary testing, particularly molecular diagnostics. Modifications to improve the cell block method initially introduced more than a century ago have been made over the years. Though their value is acknowledged and they are widely used across laboratories, cell block preparations are not standardized and results of ancillary testing performed on them are inconsistent. This article reviews the state of cell blocks-summarizes the more common, currently available and used methods and their corresponding advantages and shortcomings, outlines the role of alternative techniques (eg, smears), and proposes methods to optimize results.
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Affiliation(s)
- Anjali Saqi
- From the Department of Pathology, Columbia University Medical Center, New York, New York
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Bridge JA. Reverse transcription-polymerase chain reaction molecular testing of cytology specimens: Pre-analytic and analytic factors. Cancer Cytopathol 2016; 125:11-19. [DOI: 10.1002/cncy.21762] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 06/22/2016] [Accepted: 06/23/2016] [Indexed: 01/02/2023]
Affiliation(s)
- Julia A. Bridge
- Department of Pathology and Microbiology; University of Nebraska Medical Center; Omaha Nebraska
- Department of Pediatrics; University of Nebraska Medical Center; Omaha Nebraska
- Department of Orthopedic Surgery; University of Nebraska Medical Center; Omaha Nebraska
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Usefulness of Discarded Vitreous Samples from Routine Vitrectomy. J Ophthalmol 2016; 2016:2380764. [PMID: 27213051 PMCID: PMC4861774 DOI: 10.1155/2016/2380764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/17/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To describe the histopathological features of vitreous samples obtained after vitrectomy surgery from diabetic and nondiabetic patients. Methods. Vitreous specimens from 137 patients who underwent vitrectomy for different clinical conditions were analysed. All samples were centrifuged and each resulting pellet was fixed and processed as part of routine paraffin section histopathology. The histopathological features were categorized in a semiquantitative fashion. The samples from diabetic and nondiabetic patients were compared. Results. The 125 included patients (58 diabetic, 60% males) were aged 64.2 ± 13.9 years. The presence of hemorrhage, inflammatory cells, and histiocytes was significantly higher in the diabetic group (P < 0.001, P = 0.028, and P = 0.016, resp.), showing more vessels (P < 0.001) and ghost vessels (P = 0.049). The presence of inflammatory cells was the feature with the highest sensitivity for detecting diabetes mellitus (98%) and also the highest negative predictive value (89%). In the multivariate analysis, three variables emerged as independent significant predictors of diabetes in vitrectomy samples: hemorrhage, endothelial-lined vessels, and age (P < 0.001, P < 0.001, and P = 0.019, resp.). Conclusions. Different histopathological features can be found in vitreous samples from diabetic patients. Analysis of vitrectomy samples may serve as a tool for diabetes management.
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