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Seo Y, Prome SA, Kim L, Han JY, Kim JM, Choi SJ. Immunocytochemistry on frozen-embedded cell block for the diagnosis of hematolymphoid cytology specimen: a straightforward alternative to the conventional cell block. J Hematop 2024; 17:1-15. [PMID: 38175379 DOI: 10.1007/s12308-023-00569-0] [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: 08/17/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024] Open
Abstract
Agarose-based cell block (CB) technique can be modified to be combined with the frozen section technique for the preparation of a high-quality frozen-embedded CB (F-CB) from an effusion or fine-needle aspiration (FNA) cytology sample. This combined technique can be effectively used for the immunocharacterization of the hematolymphoid cells on F-CB. To demonstrate the applicability of performing diagnostic ICC on F-CB, we have analyzed the immunophenotype of the hematolymphoid cells in a series of eight cases of effusions and eight cases of FNA cytology specimens by using CB-ICC on sections cut from frozen-embedded CBs. The SurePathTM residue or cytologic material scraped off from the FNA cytology smear that was diagnostic for or suspicious of hematolymphoid malignancy was pelleted and pre-embedded in agarose. Half of the agarose-embedded pellet was frozen-embedded in OCT compound for the preparation of F-CB, while the other half was processed for the preparation of paraffin-embedded CB. Sections cut from the F-CB and P-CB were used for CB-ICC. Panels of ICC on the F-CBs could enable the immunocytochemical differential diagnosis of large cell hematologic malignancies that encompass anaplastic large cell lymphoma and other forms of large-cell hematolymphoid malignancies such as large B-cell lymphomas, anaplastic plasma cell myeloma, myeloid sarcoma, and T-lymphoblastic lymphoma. It also appeared that the small B-cell lymphomas in the effusions or FNAs could be differentially diagnosed with the aid of CB-ICC on the F-CB. A modified agarose-based CB technique can be combined with the frozen-embedded CB method for the preparation of F-CB that can be directly used for the immunocytochemical differential diagnosis of hematolymphoid cytology samples.
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Affiliation(s)
- Youjeong Seo
- Department of Pathology, Inha University Hospital, 27, Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea
- Department of Medicine, Inha University Graduate School, Incheon, Korea
- Department of Pathology, Inha University College of Medicine, Incheon, Korea
| | | | - Lucia Kim
- Department of Pathology, Inha University Hospital, 27, Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea
- Department of Medicine, Inha University Graduate School, Incheon, Korea
- Department of Pathology, Inha University College of Medicine, Incheon, Korea
| | - Jee Young Han
- Department of Pathology, Inha University Hospital, 27, Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea
- Department of Medicine, Inha University Graduate School, Incheon, Korea
- Department of Pathology, Inha University College of Medicine, Incheon, Korea
| | - Joon Mee Kim
- Department of Pathology, Inha University Hospital, 27, Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea
- Department of Medicine, Inha University Graduate School, Incheon, Korea
- Department of Pathology, Inha University College of Medicine, Incheon, Korea
| | - Suk Jin Choi
- Department of Pathology, Inha University Hospital, 27, Inhang-ro, Jung-gu, Incheon, 22332, Republic of Korea.
- Department of Medicine, Inha University Graduate School, Incheon, Korea.
- Department of Pathology, Inha University College of Medicine, Incheon, Korea.
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Ravi S, Devi AK, Manivannan P, Gochhait D, Kar R, Siddaraju N. The urgency of Burkitt lymphoma diagnosis in fluid cytology-A tertiary care experience. Cytopathology 2024; 35:275-282. [PMID: 38095270 DOI: 10.1111/cyt.13346] [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: 09/16/2023] [Revised: 11/04/2023] [Accepted: 11/25/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Burkitt lymphoma (BL) is an aggressive high-grade B-cell non-Hodgkin lymphoma commonly diagnosed in young age and is known to involve extra nodal sites. But the involvement of body fluids by BL is an uncommon presentation. Rapid diagnosis of BL is vital to prevent complications like tumour lysis syndrome. Cytological examination of body fluids continues to be an indispensable tool for rapid diagnosis of BL. OBJECTIVES In this study, we aim to study the clinical, cytomorphological and immunophenotypic characteristics of BL involving serous effusions and other fluids. MATERIALS AND METHODS In this retrospective study, 17 cases reported as BL in fluid cytology from 2016 to 2022 were collected and reviewed. We performed a comprehensive analysis of the clinical data, cytomorphological features, immunophenotyping data along with the haematological workup of these cases. We have also compared with the histopathological diagnosis for those cases where biopsy was available. RESULTS BL more commonly involved ascitic fluid (52%), followed by pleural fluid (4 cases) and cerebrospinal fluid (CSF; 4 cases). Primary diagnosis of BL in fluid was done in 88% of the cases. Bone marrow involvement was noted in two cases. Cytological smears showed discrete monomorphous population of medium-sized atypical lymphoid cells with frequent apoptotic bodies. Classic cytoplasmic punched out vacuoles were observed in 88% of the cases. Immunophenotyping data was available for 12 cases in which tumour cells showed positivity for CD20 (100%), CD10 (4 of 7 cases), BCL6 (3 of 5 cases) and cMYC (7 of 7 cases-100%) and were negative for Terminal deoxynucleotidyl transferase (TdT) (11 of 11 cases). Mean Ki67 labelling index was 95%. Histopathological diagnosis was available for 9 cases, and there was 100% agreement between cytological and histopathological diagnosis in 7 cases. CONCLUSION Precise diagnosis of BL can be rendered in body fluids by identification of classic cytomorphological features and by performing supportive ancillary tests in fluids for immunophenotyping.
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Affiliation(s)
- Soundarya Ravi
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Anu K Devi
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Prabhu Manivannan
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Debasis Gochhait
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Rakhee Kar
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Neelaiah Siddaraju
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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