Pre-analytical issues in effusion cytology

Michael, Claire W.; Davidson, Ben

doi:10.1515/pp-2016-0001

Cited by 27 publications

(35 citation statements)

References 87 publications

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“…The mechanical reading of immunostains as positive and negative may appear less time‐consuming than the careful morphologic examination and may thus give the cytopathologist a sense of safety. However, when the question is finding rare malignant cells, the interpretation of IHC stains may be cumbersome and time‐consuming, as the slides may have to be scrutinized at high power, cells in the cell block may have to be mapped to the cytologic preparations, and several artifacts and preanalytical factors must be considered . Incentives attached to the IHC use, taking the form of relative value units, laboratory information system settings facilitating the ordering of IHC stain panels, as well as concern with turnaround times may lead to ordering many immunostains at once.…”

Section: Discussionmentioning

confidence: 99%

The utilization and utility of immunostains in body fluid cytology

Alshaikh

Lapadat

Atieh

et al. 2020

Cancer Cytopathology

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BACKGROUND: Body fluid cytology (BFC) is an important tool in the diagnosis and staging of malignancy and is aided by the judicious use of immunohistochemistry (IHC). The aim of this study was to determine the usage rates of IHC stains in BFC, their type and indications, and their diagnostic impact. We also attempted to estimate the optimal rate of IHC use in BFC by comparing the entire laboratory's and each individual cytopathologist's IHC use rates with their respective indeterminate and malignant diagnosis rates. METHODS: We conducted a retrospective study of IHC stain use in BFC during a 5.5-year interval (2013-2018) and determined the laboratory's and each individual cytopathologist's IHC usage patterns according to the final diagnosis, site, and indications for their use. RESULTS: A total of 477 out of 4144 (11.5%) BFC cases had 2128 individual immunostains performed, with an average of 4.5 immunostains per case. Individual cytopathologists usedIHC stains on 6.7% to 22% of their BFC cases. Pathologists with higher rates of IHC stain use than the laboratory's mean were less experienced and had higher rates of indeterminate but not of malignant diagnoses. The most common indication for the use of IHC stains was differentiating mesothelial from malignant cells. MOC31, calretinin, Ber-EP4, CD68, and D2-40 were the most commonly used of the 67 different IHC stains used in BFC. CONCLUSIONS: The laboratory's mean may represent the optimal IHC use rate, as higher IHC use rates did not lead to more diagnostic certainty or higher pickup rates of malignant cells. Cancer Cytopathol 2020;128:384-391.

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Section: Discussionmentioning

confidence: 99%

The utilization and utility of immunostains in body fluid cytology

Alshaikh

Lapadat

Atieh

et al. 2020

Cancer Cytopathology

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“…The principal aim was to test the proof of concept without confounding variables. Moreover, 1 mL of plasma was aliquoted, whereas in practice, the amount may vary and be less than 1 mL . For example, some protocols recommend 0.5 mL of plasma, whereas others propose modifying the quantity according to the specimen size…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, 1 mL of plasma was aliquoted, whereas in practice, the amount may vary and be less than 1 mL. 15 For example, some protocols recommend 0.5 mL of plasma, 6,16 whereas others propose modifying the quantity according to the specimen size. 17 In addition, the potential of thrombin, which may contain epithelial cells, 18 as a source of DNA was not examined.…”

Section: Discussionmentioning

confidence: 99%

Plasma‐thrombin cell blocks: Potential source of DNA contamination

Sung

Sireci

Remotti

et al. 2019

Cancer Cytopathology

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Background Cell blocks are being used more frequently in cytology for ancillary testing, including molecular diagnostics. There are several different methods of processing cell blocks, with plasma‐thrombin being one of the most common. Plasma is a blood‐derived product and may be a source of DNA. The aim of this study was to determine whether the plasma used for the plasma‐thrombin cell block method has amplifiable DNA that may potentially interfere with molecular testing results. Methods Expired bags of fresh frozen plasma were collected from a blood bank. From each sample, DNA was extracted from a 1‐mL aliquot with the QIAsymphony MIDI kit (Qiagen). The concentration of DNA was measured on a NanoDrop instrument. The amplifiable DNA quality was assessed by polymerase chain reaction (PCR) with primers to generate amplicons of various sizes. Characterization was performed with the AmpFLSTR Identifiler Plus PCR kit with capillary electrophoresis. Results Twenty samples from 20 bags were collected. All samples showed amplifiable DNA despite low DNA concentrations in a few cases. PCR amplification revealed the presence of high‐quality amplifiable DNA (up to 600 base pairs). DNA was amplified at the 16 loci interrogated in all samples tested with the AmpFLSTR Identifiler Plus PCR kit. Conclusions The presence of genomic DNA in plasma may theoretically interfere with results of molecular testing. Particularly in clinical samples with low cellularity, the DNA in plasma may potentially either mask the presence of minute amounts of tumor‐derived DNA or lead to a false‐positive result.

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“…Drainage fluid from a collection container usually shows extensive degenerative changes. Degeneration also is an issue in washings and the morphology of mesothelial cells can be quite altered in washing material compared to spontaneously accumulated effusion fluid …”

Section: Acquisitionmentioning

confidence: 99%

“…The use of these media is indeed a part of the routine processing if one of the liquid‐based cytology techniques (SurePath™ or ThinPrep™) will be used for final preparation. Once the sample is pre‐fixed by adding any of these alcohol‐based preservatives, preparing direct smears may be difficult and Papanicolaou stain should be chosen as the staining procedure since the Romanovsky stains will not give satisfactory results …”

Section: Acquisitionmentioning

confidence: 99%

Management of cytological material, pre‐analytical procedures and bio‐banking in effusion cytopathology

et al. 2019

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Serous effusion fluid is one of the most commonly encountered specimens in routine cytopathology practice. It provides invaluable information about the patient and the clinical status; but to get the most of it, specimen handling and processing must be carried out properly. Cytomorphology is the basis of a successful analysis which should complemented by ancillary tests when needed. A wide spectrum of ancillary techniquesranging from immunocytochemistry and flow cytometry to different assays of molecular pathologycan be applied to serous effusions. This article describes the acquisition and management of serous effusion fluids, methods for preservation and transportation, different techniques of cytopreparation, application of immunocytochemistry, flow cytometry, and fluorescence in-situ hybridization (FISH), as well as DNA extraction for polymerase chain reaction (PCR) and next generation sequencing (NGS). Principles of bio-banking of effusion samples are also discussed which is getting more important in correlation with the developments in personalized medicine. K E Y W O R D S bio-banking, effusion cytology, fluorescence in situ hybridisation, immunocytochemistry, molecular tests, preparation techniques, serous effusion 1 | INTRODUCTION Serous effusion fluid-pleural effusion, ascites and pericardial effusion-is one of the most commonly examined specimen types in cytopathology. Serous effusions occur in the context of a wide spectrum of benign and malignant diseases. In many clinical situations, effusion fluid is the first sample obtained and analysed, and, more often than not, this sample is the key to precise and timely diagnosis. Classical cytomorphology is still the basis of the application of all ancillary techniques. Immunocytochemistry can be accepted as part of the routine procedure since it has been used as a complementary method for years to increase the diagnostic accuracy of effusion cytology. All ancillary tests, including the modern techniques of molecular pathology, can be applied to serous effusions in routine workflow. It is a rapidly evolving field; however, some basics do not change, such as the selection of the right area/sample for DNA extraction or for fluorescence in situ hybridisation (FISH) analysis. This paper intends to be a practical handout for readers who deal with effusion samples. The acquisition and management of effusion samples are considered; preparation techniques for morphological examination and application of ancillary tests are discussed. The last part of the text deals with bio-banking of effusion specimens, which deserves sincere attention for the future of effusion cytology, regarding the new therapy options and research facilities. | ACQUISITIONEffusion fluid can be obtained in three ways:• by thoracentesis, paracentesis, pericardiocentesis with aspiration of fresh fluid into a syringe or vial,

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Pre-analytical issues in effusion cytology

Cited by 27 publications

References 87 publications

The utilization and utility of immunostains in body fluid cytology

The utilization and utility of immunostains in body fluid cytology

Plasma‐thrombin cell blocks: Potential source of DNA contamination

Management of cytological material, pre‐analytical procedures and bio‐banking in effusion cytopathology

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