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Kapoor S, Samanta S, Kaur K. Role of Ancillary Techniques in Reporting Serous Fluid Cytology - "Redefining Categories, Refining Diagnosis". J Cytol 2024; 41:96-104. [PMID: 38779601 PMCID: PMC11108034 DOI: 10.4103/joc.joc_114_23] [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: 07/03/2023] [Revised: 10/17/2023] [Accepted: 03/08/2024] [Indexed: 05/25/2024] Open
Abstract
Background The "International System of Reporting Serous Fluid Cytology (TIS)" together with cytomorphology promotes the use of ancillary techniques to resolve difficulties in reporting serous fluid cytology. Objective To classify serous effusion fluid samples received at our department in line with "TIS", indicating the risk of malignancy (ROM), and directing appropriate usage of ancillary testing. Materials and Methods Prospective study carried out from October 2021 to September 2022. The study included all pleural, ascitic, and pericardial fluid samples, reported according to 'TIS'. Flow cytometry and immunocytochemistry were ancillary methods utilized to assist in reporting. Cases with available history and convincing correlations didn't require further assessment. Results A total of 1200 serous effusion samples were evaluated including 604 pleural, 591 ascitic, and 5 pericardial fluid samples. After categorization, there were 23 samples in non-diagnostic (ND, 1.9%), 575 in negative for malignancy (NFM, 47.91%), 44 in atypia of undetermined significance (AUS, 3.66%), 64 in suspicious for malignancy (SFM, 5.33%), and 494 in malignant category (MAL, 41.16%). Ancillary studies were beneficial in the recategorization of 26% (11/44) AUS cases, 29.6% (19/64) SFM cases, and it helped refine tumor characteristics in 35.42% (175/494) cases categorized as malignant. Final ROM calculated for each category: ND 25%, NFM 18.6%, AUS 66.6%, SFM 88%, and MAL 100%. Conclusion Serous fluid is an easily obtainable sample that can provide opportunities for ancillary testing with clinical implications. In AUS and suspicious category although, diagnostic yield is increased however, a larger number of cases are required to obtain definite results.
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Affiliation(s)
- Shilpa Kapoor
- Department of Oncopathology, Gujarat Cancer and Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - Satarupa Samanta
- Department of Oncopathology, Gujarat Cancer and Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - Kanwalpreet Kaur
- Department of Oncopathology, Gujarat Cancer and Research Institute (GCRI), Ahmedabad, Gujarat, India
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Lennartz M, Csomós H, Chirico V, Weidemann S, Gorbokon N, Menz A, Büscheck F, Hube-Magg C, Höflmayer D, Bernreuther C, Blessin NC, Lebok P, Sauter G, Steurer S, Burandt E, Dum D, Krech T, Simon R, Minner S, Jacobsen F, Clauditz TS, Luebke AM, Siraj AK, Al-Dayel F, Al-Kuraya KS, Hinsch A. Cadherin-16 (CDH16) immunohistochemistry: a useful diagnostic tool for renal cell carcinoma and papillary carcinomas of the thyroid. Sci Rep 2023; 13:12917. [PMID: 37558687 PMCID: PMC10412623 DOI: 10.1038/s41598-023-39945-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/02/2023] [Indexed: 08/11/2023] Open
Abstract
Cadherin-16 (CDH16) plays a role in the embryonal development in kidney and thyroid. Downregulation of CDH16 RNA was found in papillary carcinomas of the thyroid. To determine the expression of CDH16 in tumors and to assess the diagnostic utility a tissue microarray containing 15,584 samples from 152 different tumor types as well as 608 samples of 76 different normal tissue types was analyzed. A membranous CDH16 immunostaining was predominantly seen in thyroid, kidney, cauda epididymis, and mesonephric remnants. In the thyroid, CDH16 staining was seen in 100% of normal samples, 86% of follicular adenomas, 60% of follicular carcinomas, but only 7% of papillary carcinomas (p < 0.0001). CDH16 positivity was frequent in nephrogenic adenomas (100%), oncocytomas (98%), chromophobe (97%), clear cell (85%), and papillary (76%) renal cell carcinomas (RCCs), various subtypes of carcinoma of the ovary (16-56%), various subtyped of carcinomas of the uterus (18-40%), as well as in various subtypes of neuroendocrine neoplasms (4-26%). Nineteen further tumor entities showed a weak to moderate CDH16 staining in up to 8% of cases. Our data suggest CDH16 as a potential diagnostic marker-as a part of a panel-for the identification of papillary carcinomas of the thyroid, nephrogenic adenomas, and the distinction of renal cell tumors from other neoplasms.
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Affiliation(s)
- Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Henrietta Csomós
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Viktoria Chirico
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Franziska Büscheck
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Doris Höflmayer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Niclas C Blessin
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Till S Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Abdul Khalid Siraj
- Department of Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fouad Al-Dayel
- Department of Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Khawla S Al-Kuraya
- Department of Human Cancer Genomic Research, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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3
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Miceska S, Škof E, Novaković S, Stegel V, Jeričević A, Grčar Kuzmanov B, Smrkolj Š, Cvjetičanin B, Bebar S, Globočnik Kukovica M, Kloboves-Prevodnik V. Cytopathological assessment is an accurate method for identifying immunophenotypic features and BRCA1/2 mutations of high-grade serous carcinoma from ascites. Cancer Cytopathol 2023; 131:188-197. [PMID: 36399410 DOI: 10.1002/cncy.22664] [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: 08/26/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND High-grade serous carcinoma (HGSC) is the most common and aggressive type of ovarian cancer, and it is often associated with ascites at presentation. The objective of this study was to evaluate the accuracy of cytopathology to identify immunophenotypic features of HGSC and BRCA1/2 mutations from ascites. METHODS The study included 45 patients with histologically confirmed primary HGSC and malignant ascites. Immunocytochemistry (ICC) staining for PAX8, WT1, P53, P16, and Ki-67 was performed on cytospins and cytoblocks prepared from ascites. Next-generation sequencing (NGS) was used to detect germline/somatic BRCA1/2 mutations in the ascites. Both ICC and NGS results were compared with immunohistochemistry (IHC) and NGS results from tissue blocks of primary tumor. Cronbach α and χ2 statistics, respectively, were used. RESULTS ICC/IHC results for PAX8, WT1, P53, and P16 showed good reliability between cytospins, cytoblocks, and tissue blocks (α > 0.75), whereas poor reliability and significant differences were observed for Ki-67 between ascites and tissue blocks (α < 0.26; p < .001 [Kruskal-Wallis]). For germline BRCA1/2 mutations, 100% concordance was confirmed, but only 14% concordance was confirmed for somatic mutations. CONCLUSIONS These results demonstrate that cytopathology is an accurate method for identifying immunophenotypic features of HGSC and detecting germline BRCA1/2 mutations from ascites. However, further investigation is required for assessing the proliferation activity of HGSC in ascites and for detecting somatic BRCA1/2 mutations.
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Affiliation(s)
- Simona Miceska
- Institute of Oncology Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Erik Škof
- Institute of Oncology Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Vida Stegel
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | | | | | | | - Sonja Bebar
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Veronika Kloboves-Prevodnik
- Institute of Oncology Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Maribor, Ljubljana, Slovenia
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4
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Lou SK, Hodgson A, Nofech-Mozes S, Schwock J, Olkhov-Mitsel E, Mirkovic J, Ghorab Z. Cytohistologic immunohistochemical correlation of epithelial tubo-ovarian neoplasms: Can cell blocks substitute for tissue? Cancer Cytopathol 2023; 131:100-109. [PMID: 36103329 DOI: 10.1002/cncy.22642] [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: 06/28/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Cytologic specimens often represent the initial diagnostic material for tubo-ovarian neoplasms resulting from therapeutic paracentesis for patients presenting with high-volume ascites. However, subtyping and immunohistochemical (IHC) characterization, which have implications in preoperative management and downstream ancillary testing, are not routinely performed in many institutions. This study aims to perform cytohistologic correlation of commonly used IHC stains to establish their reliability in peritoneal fluids/washing specimens. METHODS A retrospective search of the laboratory information systems was performed to identify peritoneal fluid/washing specimens involved by borderline or malignant epithelial tubo-ovarian neoplasms and concurrent/subsequent surgical resection specimens. Cell blocks and tissue were stained for PAX8, WT-1, p53, p16, Napsin-A, estrogen receptor, and progesterone receptor, and staining between cytological and surgical specimens was compared. RESULTS A total of 56 case pairs were included, with the following final diagnoses on histological examination: 37 high-grade serous carcinomas, eight clear cell carcinomas, one endometrioid adenocarcinoma, two low-grade serous carcinomas, and eight serous borderline tumors. There was perfect cytohistologic correlation for PAX8 (Lin's concordance correlation coefficient [LINCCC] = 1.00) and WT-1 (LINCCC = 1.00), substantial/good correlation for p53 (LINCCC = 0.96), p16 (LINCCC = 0.93), napsin-A (LINCCC = 0.91) and ER (LINCCC = 0.77), and moderate correlation for PR (LINCCC = 0.54). CONCLUSIONS Immunohistochemical correlation between peritoneal fluid and surgical resection specimens for tubo-ovarian neoplasms is high. Common subtypes of tubo-ovarian carcinomas can be reliably distinguished on fluids using IHC.
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Affiliation(s)
- Si Kei Lou
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Anjelica Hodgson
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Sharon Nofech-Mozes
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Division of Anatomic Pathology, Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Joerg Schwock
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Department of Anatomical Pathology, Laboratory Medicine Program, University Health Network, Toronto, ON, Canada
| | - Ekaterina Olkhov-Mitsel
- Division of Anatomic Pathology, Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Jelena Mirkovic
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Division of Anatomic Pathology, Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Zeina Ghorab
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.,Division of Anatomic Pathology, Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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5
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Zhang PL, Macknis JK. Immunohistochemical Panels to Evaluate Important Immunophenotypes of Human Mesonephros. Fetal Pediatr Pathol 2023; 42:1-17. [PMID: 35289709 DOI: 10.1080/15513815.2022.2045402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background. The immunophenotypes and potential excretory function of human mesonephros are not well studied. Methods. Five mesonephros specimens of human embryos from the 6th to 10th weeks of gestation were stained with immunohistochemical markers. Results. PAX8 was universally expressed in all renal tubules, while α-methyacyl-CoA racemase (AMACAR) was positive in proximal tubules and GATA3 was positive in distal tubular mesonephric structures. At the 8th weeks of gestation, the mesonephric glomeruli were characterized by opened glomerular capillary loops with Periodic Acid Schiff (PAS)-positive glomerular basement membranes and GATA3-positive mesangial-like cells. By the 8th week, proximal tubules showed PAS-positive brush borders, indicating reabsorption capacity, and the proximal tubules also demonstrated positivity with kidney injury molecule-1 (KIM-1), representing tubular response to injury. Conclusion. Our overall findings show detailed phenotypes of the glomerular and tubular structures of the mesonephros and indicate that at the 8th week of gestation, the mesonephros may carry out temporary excretory function before metanephros becomes fully functional.
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Affiliation(s)
- Ping L Zhang
- Division of Anatomic Pathology, Beaumont Labs, Beaumont Health, Royal Oak, MI, USA
| | - Jacqueline K Macknis
- Division of Anatomic Pathology, Beaumont Labs, Beaumont Health, Royal Oak, MI, USA
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6
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McAlarnen LA, Gupta P, Singh R, Pradeep S, Chaluvally-Raghavan P. Extracellular vesicle contents as non-invasive biomarkers in ovarian malignancies. Mol Ther Oncolytics 2022; 26:347-359. [PMID: 36090475 PMCID: PMC9420349 DOI: 10.1016/j.omto.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Ovarian cancer most commonly presents at an advanced stage where survival is approximately 30% compared with >80% if diagnosed and treated before disease spreads. Diagnostic capabilities have progressed from surgical staging via laparotomy to image-guided biopsies and immunohistochemistry staining, along with advances in technology and medicine. Despite improvements in diagnostic capabilities, population-level screening for ovarian cancer is not recommended. Extracellular vesicles (EVs) are 40–150 nm structures formed when the cellular lipid bilayer invaginates. These structures function in cell signaling, immune responses, cancer progression, and establishing the tumor microenvironment. EVs are found in nearly every bodily fluid, including serum, plasma, ascites, urine, and effusion fluid, and contain molecular cargo from their cell of origin. This cargo can be analyzed to yield information about a possible malignancy. In this review we describe how the cargo of EVs has been studied as biomarkers in ovarian cancer. We bring together studies analyzing evidence for various cargos as ovarian cancer biomarkers. Then, we describe the role of EVs in modulation of the tumor microenvironment. This review also summarizes the therapeutic and translational potential of EVs for their optimal utilization as non-invasive biomarkers for novel treatments against cancer.
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7
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Insulinoma-Associated Protein 1 (INSM1): Diagnostic, Prognostic, and Therapeutic Use in Small Cell Lung Cancer. JOURNAL OF MOLECULAR PATHOLOGY 2022. [DOI: 10.3390/jmp3030013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Small cell lung carcinoma (SCLC) is an aggressive and difficult to treat cancer. Although immunohistochemistry is not mandatory for a SCLC diagnosis, it might be required, especially in small samples. Insulinoma-associated protein 1 (INSM1) is expressed in endocrine and nervous tissues during embryogenesis, generally absent in adults and re-expressed in SCLC and other neuroendocrine neoplasms. Its high specificity propelled its use as diagnostic biomarker and an attractive therapeutic target. Herein, we aim to provide a systematic and critical review on the use of INSM1 for diagnosis, prognostication and the treatment of SCLC. An extensive bibliographic search was conducted in PubMed® focusing on articles published since 2015. According to the literature, INSM1 is a highly sensitive (75–100%) and specific (82–100%) neuroendocrine immunohistochemical marker for SCLC diagnosis. It can be used in histological and cytological samples. Although advantageous, its standalone use is currently not recommended. Studies correlating INSM1 expression and prognosis have disclosed contrasting results, although the expression seemed to entail a worse survival. Targeting INSM1 effectively suppressed SCLC growth either as a suicide gene therapy regulator or as an indirect target of molecular-targeted therapy. INSM1 represents a valuable biomarker for a SCLC diagnosis that additionally offers vast opportunities for the development of new prognostic and therapeutic strategies.
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8
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Rekhi B, Karmarkar S, Gupta C, Deodhar KK, Menon S, Pathuthara S, Maheshwari A, Shylasree TS, Gupta S. Evaluation of cell blocks from effusion specimens in Gynecologic Oncopathology: An experience of 220 cases, diagnosed at a Tertiary Cancer Referral Center. INDIAN J PATHOL MICR 2021; 63:427-434. [PMID: 32769333 DOI: 10.4103/ijpm.ijpm_858_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
One of the common indications of ascitic fluid examination in gynecological oncopathology is the detection and classification of malignant cells, especially in cases of clinically suspicious tubo-ovarian masses. The present study was undertaken to assess and validate the diagnostic utility of cell blocks (CBs) and compare its results with the corresponding conventional smears, prepared from effusion samples. CBs were prepared by thromboplastin technique in 220 cases. In 208 cases, diagnostic concordance between results obtained from smears and corresponding CBs was evaluated. Various antibody markers were tested, as per individual case. The average age of patients was 52.2 years. Positive immunohistochemical (IHC) staining for various markers was observed in 182 cases (82.7%) The most frequently positive antibody marker was PAX8 (101/134), followed by p53 (85/92) [mutation type (either diffusely positive or completely negative)], WT1 (tumor cells) (80/112), calretinin (2/87) (diffuse), BerEP4 (21/49), CA125 (21/24), CK7 (31/39) and CK20 and CDX2, together (5/16). Various other IHC markers utilized, including their positive expression, were TTF1 (1/10), p40 (3/3), p63 (2/4), ER (21/29), HBME1 (1/7), GATA3 (1/4), and MIC2 (1/1). Complete diagnostic concordance between CBs and smears was observed in 170/208 cases (81.7%). There were 20 major discordances, 10 minor and 8 cases with sampling errors. IHC was useful in classifying 158/182 (86.8%) cases, including serous or Müllerian adenocarcinoma (n = 123), mostly high-grade (121); metastatic squamous carcinoma (3); gastrointestinal-type adenocarcinoma (8); pulmonary adenocarcinoma (1); breast adenocarcinoma (1); Ewing sarcoma (1); and mesothelioma (2). CBs are complementary to smears in the detection of gynecological malignancies, mostly high-grade serous adenocarcinomas. These provide an opportunity for testing several IHC markers, for a precise diagnosis, including in various uncommon case scenarios, associated with significant therapeutic implications.
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Affiliation(s)
- Bharat Rekhi
- Department of Surgical Pathology; Division of Cytopathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Srushti Karmarkar
- Department of Surgical Pathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Chhavi Gupta
- Department of Surgical Pathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Kedar K Deodhar
- Department of Surgical Pathology; Division of Cytopathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Santosh Menon
- Department of Surgical Pathology; Division of Cytopathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Saleem Pathuthara
- Division of Cytopathology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Amita Maheshwari
- Department of Surgical Oncology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - T S Shylasree
- Department of Surgical Oncology, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, Gynecology Disease Management Group, Tata Memorial Center, HBNI University, Mumbai, Maharashtra, India
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9
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Hou T, Gan Q, Joseph CT, Sun X, Gong Y. Insulinoma-associated protein 1 immunostaining for various types of neuroendocrine tumors on FNA smears. Cancer Cytopathol 2020; 128:725-732. [PMID: 32573984 DOI: 10.1002/cncy.22310] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Insulinoma-associated protein 1 (INSM1) has recently emerged as a reliable nuclear immunostaining marker for detecting neuroendocrine tumors (NETs) in paraffin-embedded surgical samples and cytologic cell blocks, but the reliability of INSM1 staining on cytologic smears is understudied. This study investigated the performance of INSM1 staining on cytologic smears for the detection of various NETs in comparison with chromogranin (CG) and synaptophysin (SYN). METHODS INSM1, CG, and SYN were stained on cytologic smears of 70 NETs, including 20 pancreatic NETs, 10 lung carcinoid tumors, 11 small cell lung carcinomas (SCLCs), 10 medullary thyroid carcinomas, 10 Merkel cell carcinomas, 4 thymic atypical carcinoid tumors, and 5 olfactory neuroblastomas. The detection rate, the percentage of positive cells, and the staining intensity were recorded. RESULTS The overall detection rate of INSM1 (94%) was higher than the rates of CG (79%) and SYN (89%). The detection rate of INSM1 was higher than the rates of CG and SYN in SCLC, Merkel cell carcinoma, and olfactory neuroblastoma; higher than the rate of CG and equal to the rate of SYN in pancreatic NETs and medullary thyroid carcinoma; equal to the rate of CG and higher than the rate of SYN in thymic atypical carcinoid tumors; and equal to the rate of CG and lower than the rate of SYN in lung carcinoid tumors. INSM1 staining was easier to interpret than CG and SYN staining, especially in high-grade NETs. CONCLUSIONS INSM1 can be reliably stained on cytologic smears and outperforms CG and SYN in the verification of clinically or radiologically suspected NETs.
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Affiliation(s)
- Tieying Hou
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qiong Gan
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Cicily T Joseph
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xiaoping Sun
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yun Gong
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Bansal A, Srinivasan R, Rohilla M, Sundaram A, Rai B, Rajwanshi A, Suri V, Saha SC, Gupta N, Gupta P, Dey P. Morphologic and Immunocytochemical Features of High-Grade Serous Carcinoma of Ovary in Ascitic Fluid Effusion and Fine-Needle Aspiration Cytology. Am J Clin Pathol 2020; 154:103-114. [PMID: 32271370 DOI: 10.1093/ajcp/aqaa028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES High-grade serous carcinoma (HGSC) is the most common ovarian malignancy. The role of cytopathology in obtaining tissue diagnosis before institution of neoadjuvant chemotherapy (NACT) was evaluated. METHODS All histopathology-proven HGSC specimens between 2015 and 2018 with prior cytopathologic diagnosis by ascitic fluid evaluation or fine-needle aspiration (FNA) of ovarian mass were reviewed with cell block immunocytochemistry for CK7, CK20, PAX8, WT1, and p53. RESULTS Of 288 cases of HGSC, pre-NACT cytology diagnosis was established in 32% (93/288), with specific HGSC diagnoses made on ascitic fluid in 88% (82/93) and by ovarian mass FNA in 12% (11/93). The ascitic fluid showed moderate/high cellularity with papillary clusters in 76% (71/93) cases. Cell block immunocytochemistry showed tumor cells positive for CK7, PAX8, and WT1. p53 showed mutant or null-type positivity in 65% (33/51) and 33% (17/51) of cases, respectively, with 100% concordance with subsequent histopathology specimens. Poor/intermediate response to chemotherapy was shown in 75% of cases. CONCLUSIONS Combined assessment of cytomorphology, cell block histomorphology, and ancillary immunohistochemical testing, including PAX8, WT1, and p53, allows for specific pre-NACT diagnoses of HGSC in ascitic fluid and ovarian FNA cytology. This practice allows for initiation of chemotherapy and diminution of disease burden prior to definitive surgical therapy.
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Affiliation(s)
- Akriti Bansal
- Cytology and Gynaecological Pathology, Chandigarh, India
| | | | - Manish Rohilla
- Cytology and Gynaecological Pathology, Chandigarh, India
| | | | - Bhavana Rai
- Radiotherapy and Oncology, Chandigarh, India
| | | | - Vanita Suri
- Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Subhash C Saha
- Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nalini Gupta
- Cytology and Gynaecological Pathology, Chandigarh, India
| | | | - Pranab Dey
- Cytology and Gynaecological Pathology, Chandigarh, India
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Ang PP, Tan GC, Karim N, Wong YP. Diagnostic Value of the EZH2 Immunomarker in Malignant Effusion Cytology. Acta Cytol 2019; 64:248-255. [PMID: 31352449 DOI: 10.1159/000501406] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/09/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Differentiating reactive mesothelial cells from metastatic carcinoma in effusion cytology is a challenging task. The application of at least 4 monoclonal antibodies including 2 epithelial markers (Ber-EP4, MOC-31, CEA, or B72.3) and 2 mesothelial markers (calretinin, WT-1, CK5/6, or HBME-1) are often useful in this distinction; however, it is not readily available in many resource-limited developing countries. Aberrant immunoexpression of enhancer of zeste homolog 2 (EZH2), a transcriptional repressor involved in cancer progression, is observed widely in various malignancy. In this study, we evaluate the diagnostic value of EZH2 as a single reliable immunomarker for malignancy in effusion samples. METHODS A total of 108 pleural, peritoneal, and pericardial effusions/washings diagnosed as unequivocally reactive (n = 41) and metastatic carcinoma (n = 67) by cytomorphology over 18 months were reviewed. Among the metastatic carcinoma cases, 54 were adenocarcinoma and others were squamous cell carcinoma (n = 1), carcinosarcoma (n = 1), and carcinoma of undefined histological subtypes (n = 11). Cell block sections were immunostained by EZH2 (Cell Marque, USA). The percentages of EZH2-immunolabeled cells over the total cells of interest were calculated. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off score to define EZH2 immunopositivity. RESULTS A threshold of 8% EZH2-immunolabeled cells allows distinction between malignant and reactive mesothelial cells, with 95.5% sensitivity, 100% specificity, 100% positive predictive value, and 93.2% negative predictive value (p < 0.0001). The area under the curve was 0.988. CONCLUSION EZH2 is a promising diagnostic biomarker for malignancy in effusion cytology which is inexpensive yet trustworthy and could potentially be used routinely in countries under considerable economic constraints.
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Affiliation(s)
- Piao Piao Ang
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Geok Chin Tan
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Norain Karim
- Raja Permaisuri Bainun Hospital, Perak, Malaysia
| | - Yin Ping Wong
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia,
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12
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Abstract
Carcinoma of unknown primary is defined as metastatic carcinoma without a clinically obvious primary tumor. Determining the tissue of origin in carcinoma of unknown primary is important for site-directed therapy. Immunohistochemistry is the most widely used tool for the work-up of metastases, but molecular profiling assays are also available. This review provides an overview of immunohistochemical stains in the work-up of metastatic carcinoma, with a focus on newer site-specific markers, and discusses the role of gene expression profiling assays for determining tissue of origin. The utility of cytopathology specimens in the evaluation of carcinoma of unknown primary also is highlighted.
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Affiliation(s)
- Erika E Doxtader
- Department of Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Deborah J Chute
- Department of Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
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13
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Tudrej P, Olbryt M, Zembala-Nożyńska E, Kujawa KA, Cortez AJ, Fiszer-Kierzkowska A, Pigłowski W, Nikiel B, Głowala-Kosińska M, Bartkowska-Chrobok A, Smagur A, Fidyk W, Lisowska KM. Establishment and Characterization of the Novel High-Grade Serous Ovarian Cancer Cell Line OVPA8. Int J Mol Sci 2018; 19:E2080. [PMID: 30018258 PMCID: PMC6073376 DOI: 10.3390/ijms19072080] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 12/16/2022] Open
Abstract
High-grade serous ovarian carcinoma (HGSOC) is the most frequent histological type of ovarian cancer and the one with worst prognosis. Unfortunately, the majority of established ovarian cancer cell lines which are used in the research have unclear histological origin and probably do not represent HGSOC. Thus, new and reliable models of HGSOC are needed. Ascitic fluid from a patient with recurrent HGSOC was used to establish a stable cancer cell line. Cells were characterized by cytogenetic karyotyping and short tandem repeat (STR) profiling. New generation sequencing was applied to test for hot-spot mutations in 50 cancer-associated genes and fluorescence in situ hybridization (FISH) analysis was used to check for TP53 status. Cells were analyzed for expression of several marker genes/proteins by reverse-transcription polymerase chain reaction (RT-PCR), fluorescence-activated cell sorting (FACS), and immunocytochemistry (ICC). Functional tests were performed to compare OVPA8 cells with five commercially available and frequently used ovarian cancer cell lines: SKOV3, A2780, OVCAR3, ES2, and OAW42. Our newly-established OVPA8 cell line shows morphologic and genetic features consistent with HGSOC, such as epithelial morphology, multiple chromosomal aberrations, TP53 mutation, BRCA1 mutation, and loss of one copy of BRCA2. The OVPA8 line has a stable STR profile. Cells are positive for EpCAM, CK19, and CD44; they have relatively low plating efficiency/ability to form spheroids, a low migration rate, and intermediate invasiveness in matrigel, as compared to other ovarian cancer lines. OVPA8 is sensitive to paclitaxel and resistant to cisplatin. We also tested two FGFR inhibitors; OVPA8 cells were resistant to AZD4547 (AstraZeneca, London, UK), but sensitive to the new inhibitor CPL304-110-01 (Celon Pharma, Łomianki/Kiełpin, Poland). We have established and characterized a novel cell line, OVPA8, which can be a valuable preclinical model for studies on high-grade serous ovarian cancer.
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Affiliation(s)
- Patrycja Tudrej
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Magdalena Olbryt
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Ewa Zembala-Nożyńska
- Thumor Pathology Department, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Katarzyna A Kujawa
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Alexander J Cortez
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Anna Fiszer-Kierzkowska
- Molecular Diagnostics Laboratory, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Wojciech Pigłowski
- Molecular Diagnostics Laboratory, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Barbara Nikiel
- Thumor Pathology Department, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Magdalena Głowala-Kosińska
- Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Aleksandra Bartkowska-Chrobok
- Department of Hematology and Bone Marrow Transplantation, Andrzej Mielęcki Independent Public Hospital, ul. Dąbrowskiego 25, 40-032 Katowice, Poland.
| | - Andrzej Smagur
- Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Wojciech Fidyk
- Department of Bone Marrow Transplantation and Hematology-Oncology, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
| | - Katarzyna M Lisowska
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowskaj-Curie Institute-Oncology Center, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland.
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Rhodes A, Vallikkannu N, Jayalakshmi P. Expression of WT1 and PAX8 in the epithelial tumours of Malaysian women with ovarian cancer. Br J Biomed Sci 2017; 74:65-70. [PMID: 28367736 DOI: 10.1080/09674845.2016.1220709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Ovarian cancer is particularly lethal due to late stage at presentation. The subtypes behave differently with respect to their biology and response to treatment. Two recent markers reported to be useful in assisting in the diagnosis are WT1 and PAX8. Malaysia, with its multi-ethnic population provides an opportunity to study the expression of these biomarkers in ovarian cancer in the three most populous ethnicities in Asia and ascertain their usefulness in the diagnosis of ovarian carcinoma. MATERIALS AND METHODS Tissues from ovarian epithelial neoplasms diagnosed between 2004 and 2012 were tested using antibodies to WT1 and PAX8. The slides were assessed to determine levels of marker expression and related to ethnicity, ovarian tumour type, grade and stage. RESULTS Serous tumours were the main histological type (n = 44), the remaining being endometrioid (n = 15), mucinous (n = 15) and clear cell tumours (n = 7). Late stage at diagnosis was significantly associated with serous (p < 0.001) and endometrioid (p 0.026) tumours. The vast majority of serous tumours were positive for WT1 (87%, p < 0.001) and PAX8 expression (86%, p < 0.001) whilst 40% of endometrioid tumours were positive for PAX8 and 13% for WT1. Few mucinous carcinomas (n = 1) and clear cell carcinomas (n = 2) expressed PAX8, and none expressed WT1. There was no significant difference in the tumour expression of either WT1 or PAX8 between the three Malaysian ethnicities. CONCLUSIONS In an Asian setting, PAX8 and WT1 are expressed in the vast majority of serous ovarian cancers and may be useful in distinguishing serous ovarian carcinomas from other poorly differentiated tumours.
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Affiliation(s)
- Anthony Rhodes
- a Faculty of Medicine, Department of Pathology , University of Malaya , Kuala Lumpur , Malaysia
| | - Narayanan Vallikkannu
- b Faculty of Medicine, Department of Obstetrics and Gynaecology , University of Malaya , Kuala Lumpur , Malaysia
| | - Pailoor Jayalakshmi
- a Faculty of Medicine, Department of Pathology , University of Malaya , Kuala Lumpur , Malaysia
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15
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Stiekema A, Van de Vijver KK, Boot H, Broeks A, Korse CM, van Driel WJ, Kenter GG, Lok CAR. Human epididymis protein 4 immunostaining of malignant ascites differentiates cancer of Müllerian origin from gastrointestinal cancer. Cancer Cytopathol 2017; 125:197-204. [PMID: 28199067 DOI: 10.1002/cncy.21811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/10/2016] [Accepted: 11/10/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND An accurate diagnosis of cancer of Müllerian origin is required before the initiation of treatment. An overlap in clinical presentation and cytological, histological, or imaging studies with other nongynecological tumors does occur. Therefore, immunocytochemistry markers are used to determine tumor origin. Human epididymis protein 4 (HE4) is overexpressed in tissue of epithelial ovarian cancer (EOC). It has shown to be a sensitive and specific serum marker for EOC and to be of value for the differentiation between EOC and ovarian metastases of gastrointestinal origin. The objective of the current study was to evaluate HE4 immunocytochemistry in malignant ascites for differentiation between cancer of Müllerian origin, including EOC, and adenocarcinomas of the gastrointestinal tract. METHODS Cytological specimens of 115 different adenocarcinomas (45 EOCs, 46 cases of gastric cancer, and 24 cases of colorectal cancer) were stained for HE4, paired box 8 (PAX8), and other specific markers. RESULTS 91% of the ascites samples from patients with EOC stained for both HE4 and PAX8. The 4 samples without HE4 staining were a clear cell carcinoma, a low-grade serous adenocarcinoma, an undifferentiated adenocarcinoma, and a neuroendocrine carcinoma. All high-grade serous adenocarcinomas (n = 37, 100%) stained with HE4, compared with 94% that stained positively for PAX8. In cases of gastric or colorectal cancer, 25% and 21% of cases, respectively, stained positive for HE4. No PAX8 staining was observed in colorectal or gastric adenocarcinomas. CONCLUSIONS HE4 staining in ascites is feasible and appears to have a high sensitivity for high-grade serous ovarian cancer. HE4 is a useful addition to the current panel of immunocytochemistry markers for the diagnosis of EOC and for differentiation with gastrointestinal adenocarcinomas. Cancer Cytopathol 2017;125:197-204. © 2016 American Cancer Society.
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Affiliation(s)
- Anna Stiekema
- Department of Gynecology, Center for Gynecological Oncology, Amsterdam, the Netherlands
| | - Koen K Van de Vijver
- Department of Pathology, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Henk Boot
- Department of Gastroenterology, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Annegien Broeks
- Core Facility-Molecular Pathology and Biobank, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Catharina M Korse
- Department of Clinical Chemistry, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Willemien J van Driel
- Department of Gynecology, Center for Gynecological Oncology, Amsterdam, the Netherlands
| | - Gemma G Kenter
- Department of Gynecology, Center for Gynecological Oncology, Amsterdam, the Netherlands
| | - Christianne A R Lok
- Department of Gynecology, Center for Gynecological Oncology, Amsterdam, the Netherlands
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16
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Leng B, Guo M, Zhao J, Gong Y. Utility and pitfalls of GATA3 immunocytochemistry for diagnosis of metastatic breast carcinoma and urothelial carcinoma on cytology specimens. J Am Soc Cytopathol 2017; 6:73-79. [PMID: 31042637 DOI: 10.1016/j.jasc.2016.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Although GATA3 expression has been studied extensively on histology specimens and has demonstrated a high level of accuracy in detecting carcinomas from breast or urothelial origin, its utility on cytology samples, especially the influence of different sample (fine-needle aspiration [FNA] versus effusion fluid) and preparation (cell block versus smear) on the staining, is understudied. MATERIALS AND METHODS We retrospectively searched our institution's pathology database for cytologic cases where GATA3 immunostaining was performed during diagnostic workup and identified a total of 178 cases, consisting of 89 metastatic breast carcinomas, 22 metastatic urothelial carcinomas, and 67 malignant neoplasms of other origin. Frequency of GATA3 expression was evaluated in each group. RESULTS For metastatic breast carcinomas, 75% expressed GATA3; 74% on FNA samples and 77% on fluid samples; 71% on cell block and 89% on smear. GATA3 was positive in 44% triple-negative breast carcinomas. Of the 22 metastatic urothelial carcinomas (21 FNA samples and 1 fluid; 21 cell blocks and 1 smear), all were positive for GATA3. Of the 67 malignancies of other origin, 4 (6%) were positive for GATA3 (ie, a metastatic ovarian serous carcinoma, a metastatic squamous cell carcinoma, a recurrent poorly differentiated skin adnexal carcinoma, and a metastatic thymic carcinoma). CONCLUSIONS GATA3 is a useful biomarker for detecting carcinomas of breast or urothelial origin on cytologic specimens. It may detect breast cancers with the triple-negative phenotype. Both cell block and smear preparations can be reliably used for the staining. GATA3-positive immunostaining is occasionally seen in other tumors, which may cause diagnostic confusion.
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Affiliation(s)
- Bing Leng
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ming Guo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jun Zhao
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yun Gong
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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17
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Thu KL, Papari-Zareei M, Stastny V, Song K, Peyton M, Martinez VD, Zhang YA, Castro IB, Varella-Garcia M, Liang H, Xing C, Kittler R, Milchgrub S, Castrillon DH, Davidson HL, Reynolds CP, Lam WL, Lea J, Gazdar AF. A comprehensively characterized cell line panel highly representative of clinical ovarian high-grade serous carcinomas. Oncotarget 2016; 8:50489-50499. [PMID: 28881577 PMCID: PMC5584155 DOI: 10.18632/oncotarget.9929] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 05/22/2016] [Indexed: 12/26/2022] Open
Abstract
Recent literature suggests that most widely used ovarian cancer (OVCA) cell models do not recapitulate the molecular features of clinical tumors. To address this limitation, we generated 18 cell lines and 3 corresponding patient-derived xenografts predominantly from high-grade serous carcinoma (HGSOC) peritoneal effusions. Comprehensive genomic characterization and comparison of each model to its parental tumor demonstrated a high degree of molecular similarity. Our characterization included whole exome-sequencing and copy number profiling for cell lines, xenografts, and matched non-malignant tissues, and DNA methylation, gene expression, and spectral karyotyping for a subset of specimens. Compared to the Cancer Genome Atlas (TCGA), our models more closely resembled HGSOC than any other tumor type, justifying their validity as OVCA models. Our meticulously characterized models provide a crucial resource for the OVCA research community that will advance translational findings and ultimately lead to clinical applications.
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Affiliation(s)
- Kelsie L Thu
- British Columbia Cancer Agency Research Centre and University of British Columbia, Vancouver, BC, Canada
| | - Mahboubeh Papari-Zareei
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA
| | - Victor Stastny
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA
| | - Kai Song
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA.,School of Chemical Engineering and Technology, Tianjin University, Tianjin, P.R. China
| | - Michael Peyton
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA
| | - Victor D Martinez
- British Columbia Cancer Agency Research Centre and University of British Columbia, Vancouver, BC, Canada
| | - Yu-An Zhang
- Hamon Center for Therapeutic Oncology Research, UT Southwestern Medical Center, Dallas, TX, USA
| | - Isabel B Castro
- Division of Medical Oncology, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | | | - Hanquan Liang
- Eugene McDermott Center for Human Growth & Development, UT Southwestern Medical Center, Dallas, TX, USA
| | - Chao Xing
- Eugene McDermott Center for Human Growth & Development, UT Southwestern Medical Center, Dallas, TX, USA
| | - Ralf Kittler
- Eugene McDermott Center for Human Growth & Development, UT Southwestern Medical Center, Dallas, TX, USA.,Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Sara Milchgrub
- Department of Pathology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Diego H Castrillon
- Department of Pathology and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| | - Heather L Davidson
- Cell Biology & Biochemistry, Internal Medicine, and Pediatrics, School of Medicine Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - C Patrick Reynolds
- Cell Biology & Biochemistry, Internal Medicine, and Pediatrics, School of Medicine Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Wan L Lam
- British Columbia Cancer Agency Research Centre and University of British Columbia, Vancouver, BC, Canada
| | - Jayanthi Lea
- Obstetrics & Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Adi F Gazdar
- Hamon Center for Therapeutic Oncology Research, Department of Pathology and Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
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18
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López-Urrutia E, Pedroza-Torres A, Fernández-Retana J, De Leon DC, Morales-González F, Jacobo-Herrera N, Peralta-Zaragoza O, García-Mendez J, García-Castillo V, Bautista-Isidro O, Pérez-Plasencia C. PAX8 is transcribed aberrantly in cervical tumors and derived cell lines due to complex gene rearrangements. Int J Oncol 2016; 49:371-80. [PMID: 27175788 DOI: 10.3892/ijo.2016.3515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 03/17/2016] [Indexed: 11/05/2022] Open
Abstract
The transcription factor PAX8, a member of the paired box-containing gene family with an important role in embryogenesis of the kidney, thyroid gland and nervous system, has been described as a biomarker in tumors of the thyroid, parathyroid, kidney and thymus. The PAX8 gene gives rise to four isoforms, through alternative mRNA splicing, but the splicing pattern in tumors is not yet established. Cervical cancer has a positive expression of PAX8; however, there is no available data determining which PAX8 isoform or isoforms are present in cervical cancer tissues as well as in cervical carcinoma-derived cell lines. Instead of a differential pattern of splicing isoforms, we found numerous previously unreported PAX8 aberrant transcripts ranging from 378 to 542 bases and present in both cervical carcinoma-derived cell lines and tumor samples. This is the first report of PAX8 aberrant transcript production in cervical cancer. Reported PAX8 isoforms possess differential transactivation properties; therefore, besides being a helpful marker for detection of cancer, PAX8 isoforms can plausibly exert differential regulation properties during carcinogenesis.
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Affiliation(s)
- Eduardo López-Urrutia
- Laboratorio de Genómica Funcional, Unidad de Biomedicina, FES-Iztacala, UNAM, Tlalnepantla, México
| | | | | | - David Cantu De Leon
- Unidad de Investigaciones Biomédicas en Cáncer, Instituto Nacional de Cancerología, Instituto de Investigaciones Biomédicas, UNAM, Tlalpan, México
| | | | - Nadia Jacobo-Herrera
- Unidad de Bioquímica, Instituto de Ciencias Médicas y Nutrición, Tlalpan, México
| | - Oscar Peralta-Zaragoza
- Centro de Investigaciones en Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Jorge García-Mendez
- Departamento de Posgrado y Educación Médica Continua, Instituto Nacional de Cancerología, Tlalpan, México
| | - Verónica García-Castillo
- Laboratorio de Genómica Funcional, Unidad de Biomedicina, FES-Iztacala, UNAM, Tlalnepantla, México
| | - Osvaldo Bautista-Isidro
- Laboratorio de Genómica Funcional, Unidad de Biomedicina, FES-Iztacala, UNAM, Tlalnepantla, México
| | - Carlos Pérez-Plasencia
- Laboratorio de Genómica Funcional, Unidad de Biomedicina, FES-Iztacala, UNAM, Tlalnepantla, México
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19
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Cheng F, Wang Q, Zhong D. [Value of Cell Block in the Diagnosis of Malignant Pleural Effusion]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2016; 18:652-5. [PMID: 26483339 PMCID: PMC6000087 DOI: 10.3779/j.issn.1009-3419.2015.10.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
背景与目的 恶性胸腔积液(malignant pleural effusion, MPE)是由原发于胸膜的恶性肿瘤或者是转移至胸膜的恶性肿瘤造成的胸腔积液。对于不明原因的单侧胸腔积液, 首要任务是排除或者是确诊恶性胸腔积液。胸腔积液沉淀物是将送检胸腔积液细胞学剩余的胸腔积液进行离心或者是自然静置所获得的细胞块。此技术具有操作简单、有创性小、重复性高、对恶性胸腔积液的诊断率相对较高等特点, 在恶性胸腔积液的诊断、治疗等方面起着重要的作用。本文主要从沉淀物的制作方法、免疫组织化学染色检查的鉴别诊断价值、沉淀物的诊断优势及沉淀物行基因检测的临床应用价值等方面来论述胸腔积液沉淀物对恶性胸腔积液的诊断价值。
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Affiliation(s)
- Fangyuan Cheng
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Qian Wang
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Diansheng Zhong
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China
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20
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Upadhyay A, Goel V, Batra U, Goyal P, Dutta K, Aggarwal M, Doval DC. Two cases of ovarian carcinoma with endobronchial metastases: Rare presentation. South Asian J Cancer 2016; 4:149. [PMID: 26942149 PMCID: PMC4756493 DOI: 10.4103/2278-330x.173170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- A Upadhyay
- Department of Medical Oncology Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - V Goel
- Department of Medical Oncology Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - U Batra
- Department of Medical Oncology Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - P Goyal
- Department of Medical Oncology Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - K Dutta
- Department of Medical Oncology Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - M Aggarwal
- Department of Medical Oncology Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - D C Doval
- Department of Medical Oncology Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
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21
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Amzerin M, Garcia C, Stanciu C, Veys I, Awada A, Errihani H, Gombos A. Case Report: Mammary and rectal metastases from an ovarian cancer: report of two cases and review of literature. F1000Res 2014; 3:255. [PMID: 25566350 PMCID: PMC4275024 DOI: 10.12688/f1000research.2644.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 11/20/2022] Open
Abstract
In this paper we report two interesting cases of metastatic ovarian cancer. The first case is a patient who developed rectal and breast metastases mimicking an inflammatory breast cancer. In the second case, subclinical breast and axillary lymph node metastases were revealed by PET/CT. Metastases in the breast originating from solid tumors are extremely rare. The ovarian primitive is the fourth most common origin. The occurrence of breast metastasis is associated with an advanced disease and a poor prognosis. Their incidence is increasing since they are found more often due to better imaging techniques and to better treatment that, accordingly, improve patients' survival. Thus, unusual sites of metastases are more and more reported. Indeed, some authors reported the occurrence of colorectal metastases from ovarian cancer. However, they remain much less frequent.
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Affiliation(s)
- Mounia Amzerin
- National Institute of Oncology, Université Mohammed V de Rabat, Rabat, 10100, Morocco
| | - Camilo Garcia
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - Claudia Stanciu
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - Isabelle Veys
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - Ahmad Awada
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
| | - Hassan Errihani
- National Institute of Oncology, Université Mohammed V de Rabat, Rabat, 10100, Morocco
| | - Andrea Gombos
- Jules Bordet Institute, Université Libre de Bruxelles, Brussels, 1000, Belgium
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Waters L, Crumley S, Truong L, Mody D, Coffey D. PAX2 and PAX8: useful markers for metastatic effusions. Acta Cytol 2014; 58:60-6. [PMID: 24334997 DOI: 10.1159/000356426] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE It was the aim of this study to determine the utility of PAX2 and PAX8 in cytology effusions with metastatic tumor. STUDY DESIGN PAX2 and PAX8 immunohistochemical staining was performed on cell blocks of 89 pleural, pericardial and peritoneal effusions with benign diagnoses (18 cases), or secondary to renal cell carcinoma (RCC; 9 cases), müllerian carcinoma (21 cases) or non-müllerian carcinoma (41 cases). RESULTS PAX2 stained 0% (0/18) of controls, 100% (8/8) of RCCs, 35% (7/20) of müllerian carcinomas, and 2% (1/41) of non-müllerian carcinomas. PAX8 stained 6% (1/18) of control cases, 100% (9/9) of RCC cases, 100% (20/20) of müllerian carcinomas, and 5% (2/41) of non-müllerian carcinomas. PAX2 was 35% sensitive and 95% specific for müllerian carcinoma and 100% sensitive and 95% specific for RCC. PAX8 was 100% sensitive and 95% specific for müllerian carcinoma and 100% sensitive and 95% specific for RCC. CONCLUSIONS PAX8 is more sensitive than PAX2 for metastatic effusions from müllerian carcinomas (100 vs. 35%), while also having a higher intensity of staining than PAX2. However, PAX2 and PAX8 are both highly sensitive and specific for RCCs. PAX2 and PAX8 are valuable diagnostic markers for metastatic müllerian carcinomas and RCCs in effusion cytology. PAX8 is superior for carcinomas of müllerian origin.
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Affiliation(s)
- Lindsay Waters
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Tex., USA
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Raidoo S, Singh S, Redline R, Debernardo R. Cyberknife radiotherapy and anastrozole for the treatment of advanced progressive low-grade papillary serous ovarian carcinoma: A case report. GYNECOLOGIC ONCOLOGY CASE REPORTS 2013; 6:42-4. [PMID: 24371718 PMCID: PMC3862215 DOI: 10.1016/j.gynor.2013.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Accepted: 09/10/2013] [Indexed: 11/28/2022]
Abstract
Low-grade papillary serous ovarian carcinoma has unique epidemiologic and disease-specific characteristics Cyberknife radiotherapy is a unique treatment that may successfully be used to treat unresectable disease Anastrozole is an effective treatment for hormone receptor-positive low-grade papillary serous ovarian carcinoma
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Affiliation(s)
- Shandhini Raidoo
- Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Sareena Singh
- Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Raymond Redline
- Department of Pathology, University Hospitals Case Medical Center, Cleveland, OH, USA
| | - Robert Debernardo
- Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, OH, USA
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Value of PAX8, PAX2, claudin-4, and h-caldesmon immunostaining in distinguishing peritoneal epithelioid mesotheliomas from serous carcinomas. Mod Pathol 2013; 26:553-62. [PMID: 23196794 DOI: 10.1038/modpathol.2012.200] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Distinguishing between peritoneal epithelioid mesotheliomas and papillary serous carcinomas involving the peritoneum can be difficult on routine histological preparations, but this differential diagnosis can be facilitated by the use of immunohistochemistry. Recent investigations have indicated that PAX8, PAX2, claudin-4, and h-caldesmon are immunohistochemical markers that can assist in distinguishing between these two malignancies; however, much of the information published on the value of these markers is either insufficient or contradictory. The purpose of this study is to resolve some of the existing controversies and to fully determine the practical value of these markers for assisting in the differential diagnosis between peritoneal mesotheliomas and serous carcinomas. In order to do so, a total of 40 peritoneal epithelioid mesotheliomas and 45 serous carcinomas (15 primary, 30 metastatic to the peritoneum) were investigated. PAX8 and PAX2 nuclear positivity was demonstrated in 42 (93%) and 25 (56%) of the serous carcinomas, respectively, whereas none of the mesotheliomas expressed either marker. Forty-four (98%) of the serous carcinomas exhibited claudin-4 reactivity along the cell membrane, whereas none of the mesotheliomas were positive for this marker. All of the serous carcinomas and mesotheliomas were negative for h-caldesmon. Based on these results, it is concluded that PAX8 and claudin-4 have a higher sensitivity and specificity for assisting in discriminating between peritoneal epithelioid mesotheliomas and serous carcinomas when compared with all of the other positive carcinoma markers that are, at present, recommended to be included in the immunohistochemical panels used in this differential diagnosis. Even though it is highly specific, PAX2 has little practical value in the diagnosis of peritoneal epithelioid mesotheliomas as its sensitivity is low. The h-caldesmon is not useful.
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Abstract
PAX2 is a member of the PAX family of transcription factors that, together with PAX8, is involved in the regulation of the organogenesis of the kidney and the Müllerian system. Recent investigations have demonstrated that, among tumors, PAX2 is commonly expressed in epithelial tumors of the kidney and female genital tract. Although PAX2 expression has also been reported in B-cell lymphomas and rhabdomyosarcomas, especially alveolar rhabdomyosarcomas, it has been suggested that the positivity in these tumors was most probably due to a cross-reactivity of the anti-PAX2 antibody used in those investigations with other members of the PAX protein family. An analysis of published studies indicates that PAX2 sensitivity for epithelial renal neoplasms and epithelial tumors of the female genital tract is lower than that of PAX8. In contrast to the latter marker, however, PAX2 does not appear to be expressed in epithelial tumors of the thyroid gland or thymus. Because of its restricted expression, PAX2 has proved to be a useful immunohistochemical marker with a wide range of diagnostic applications in surgical pathology, some of which will be briefly reviewed.
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Clear cell carcinoma of the female genital tract (not everything is as clear as it seems). Adv Anat Pathol 2012; 19:296-312. [PMID: 22885379 DOI: 10.1097/pap.0b013e31826663b1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Clear cell carcinoma has a storied history in the female genital tract. From the initial designation of ovarian clear cell adenocarcinoma as "mesonephroma" to the linkage between vaginal clear cell carcinoma and diethylstilbestrol exposure in utero, gynecologic tract clear cell tumors have puzzled investigators, posed therapeutic dilemmas for oncologists, and otherwise presented major differential diagnostic challenges for pathologists. One of the most common errors in gynecologic pathology is misdiagnosis of clear cell carcinoma, on both frozen section and permanent section. Given the poor response to platinum-based chemotherapy for advanced-stage disease and increased risk of thromboembolism, accurate diagnosis of clear cell carcinoma is important in the female genital tract. This review (1) presents the clinical and pathologic features of female genital tract clear cell carcinomas; (2) highlights recent molecular developments; (3) identifies areas of potential diagnostic confusion; and (4) presents solutions for these diagnostic problems where they exist.
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Abstract
PAX 8 is a transcription factor involved in the regulation of organogenesis of the thyroid gland, kidney, and Müllerian system. Recent studies have shown that, among tumors, PAX 8 is commonly expressed in epithelial tumors of the thyroid and parathyroid glands, kidney, thymus, and female genital tract. Although PAX 8 expression has also been reported in certain neuroendocrine tumors, including well-differentiated pancreatic neuroendocrine tumors, and duodenal and rectal carcinoids, as well as in B-cell lymphomas, it has recently been shown that the PAX 8 positivity reported in these tumors was due to a cross-reactivity of the antibody used with the N-terminal region of PAX 6 and PAX 5, respectively. Owing to its restricted expression, PAX 8 has proved to be a useful immunohistochemical marker with a wide range of diagnostic applications in surgical pathology, some of which are briefly reviewed.
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