The importance of subclassifying pulmonary nonsmall cell carcinoma (NSCLC) in cytologic material is becoming increasingly paramount. Occasionally, cell blocks traditionally used for ancillary studies are sparsely cellular or acellular. Hence, we investigated the diagnostic utility of immunocytochemistry for Napsin-A, TTF-1, and p63 on direct smears of NSCLC. Immunohistochemistry for Napsin-A was initially tested on a tissue microarray (TMA) composed of pulmonary adenocarcinoma. Subsequently, in 25 cases, immunocytochemistry for Napsin-A, TTF-1, and p63 was performed on cytologic direct smears. Smears were prepared from tumor cells scraped from lung resection specimens (n = 10), endobronchial ultrasound-guided transbronchial fine-needle aspirates (n = 13), and pelleted cell material from pleural effusions (n = 2). Immunohistochemistry utilizing the TMA revealed Napsin-A positivity in 73% of pulmonary ADCs. Next, immunocytochemistry on direct cytologic smears demonstrated a Napsin-A(+)/TTF-1(+) immunophenotype in 15 of 18 adenocarcinomas; p63 was completely negative (n = 12) or only focally positive (n = 3) in these 15 adenocarcinomas. The remaining three adenocarcinomas were negative for all three markers. All six squamous cell carcinomas were Napsin-A(-)/TTF-1(-) and diffusely p63(+). In conclusion, direct smears represent a feasible and robust source of cellular material for immunocytochemical studies to diagnose pulmonary ADC and SQC. Our method allows the cytologist to confirm on site that material for diagnostic immunocytochemistry is present thereby serving as a safeguard in instances where the cell block is of insufficient cellularity.
The diagnosis of metastatic prostate carcinoma frequently requires the use of immunohistochemical adjuncts. Immunohistochemistry for prostate-specific antigen (PSA) is commonly used for this purpose but can be of limited utility. Recently, prostate-specific membrane antigen (PSMA) has been shown to be a promising marker for the identification of metastatic prostate carcinoma in surgical specimens. The utility of this marker has yet to be reported for cytology specimens. We sought to compare the sensitivities of PSMA and PSA immunohistochemistry and investigate the specificity of PSMA by utilizing cell block preparations from cytologic cases of metastatic prostate carcinoma (n = 19) and carcinomas of nonprostatic origin (n = 33). The sensitivity of PSMA immunohistochemistry was higher (16/19; 84%) in detecting metastatic prostate carcinomas than that of PSA immunohistochemistry (11/19; 58%). Strong, diffuse staining for PSMA was seen in 13 (81%) of 16 PSMA-positive cases whereas strong, diffuse staining for PSA was observed in six (55%) of 11 PSA-positive cases. Positivity for either PSMA or PSA was seen in 17 of 19 cases of metastatic prostate carcinoma for a combined sensitivity of 89%. PSMA immunohistochemistry was completely negative in 32 of 33 cytology cases of nonprostatic carcinomas. Therefore, the specificity of this marker was 97% in this study. In conclusion, our results indicate that PSMA is a highly sensitive and specific immunomarker for the detection of metastatic prostate carcinoma in cytology specimens.
way that will be more broadly applicable to the disciplines of theatre and performance studies. This kind of close analysis may work for a journal article, or for a specialist publisher, but will rarely be comprehensive enough for a book-length monograph at a larger scholarly press, and editors will often suggest to authors of such texts that additional examples be included and the examination widened. ON THE CONFERENCE CIRCUITBecause a finished book is an object that requires careful handling, storing, and shipping, publishers are cautious when organizing conference exhibitions. Authors (and readers) need to know that there are financial implications involved with shipping and displaying books, and all these factors must be considered as a publisher decides which events to attend and how many books to bring to those events. If books are damaged during shipping and handling to and from a conference, they cannot be sold later and must be destroyed; this too must be factored into any decision to attend and display titles.That said, publishers and their editorial teams don't just attend conferences to sell books; they also want to know that a conference's participants are interested in their titles and pleased that they are there. Often we know which conferences are important in our field and should be attended each year, but we also rely on our authors to let us know about important new events and on attendees to let us know our presence matters to them. A conference book exhibit offers a wonderful space for editors to see authors they know and to meet new people, to hear new book ideas, to discuss the state of the field, and, frankly, just to have a good chat. So at your next conference, don't be shy: please do visit our displays, meet with editors, and see what's new. Even if you don't buy, it's very useful for us to make contact, and that contact makes it worth the effort to bring our books and products to the conference.For an academic publisher it is not a matter of making a profit, but if each book can pay its own way, the firm will remain healthy and able to publish and contribute further to our shared discipline. Ours is a delicate balance between funding and publishing: working together, publisher and author can create and nurture a strong balance among the needs of the finished book, the needs of its market, and the needs of our readership.
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