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Mebratie DY, Dagnaw GG. Review of immunohistochemistry techniques: Applications, current status, and future perspectives. Semin Diagn Pathol 2024; 41:154-160. [PMID: 38744555 DOI: 10.1053/j.semdp.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024]
Abstract
The Hematoxylin and Eosin stain is a cornerstone in histopathology that facilitates the microscopic examination of tissue samples for identifying infections and tumors. However, challenges arise from the similar appearances of diseases and cells, prompting the emergence of Immunohistochemistry (IHC) as an important technique. This review summarizes the principles, procedures, and applications and future perspectives of IHC, a prevalent immunostaining method allowing the detection of specific proteins in tissue sections. The multistep IHC process involves fixation, embedding, sectioning, antigen retrieval, blocking, detection, counterstaining, mounting, and visualization, with interpretation relying on factors such as microanatomic distribution and staining intensity. Common errors in IHC such as non-specific staining, tissue artifacts, inadequately inactivation of endogenous peroxidase activity and cross-reactivity, can substantially affect the accuracy and reliability of results, thereby impacting the interpretation of biological findings. Serving diagnostic, prognostic, predictive, and therapeutic roles in various conditions, including tumors, infectious diseases, neurodegenerative disorders, and muscle diseases, IHC remains pivotal despite its intricate nature. The adoption of digital pathology emerges as a progressive enhancement, addressing limitations and ensuring more accurate analyses in histopathology.
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Affiliation(s)
- Dinku Yigzaw Mebratie
- University of Gondar, College of Veterinary Medicine and Animal Sciences, Department of Pathobiology, Ethiopia
| | - Gashaw Getaneh Dagnaw
- University of Gondar, College of Veterinary Medicine and Animal Sciences, Department of Biomedical Sciences, Ethiopia.
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Isham IM, Abd-Elsalam RM, Mahmoud ME, Najimudeen SM, Ranaweera HA, Ali A, Hassan MSH, Cork SC, Gupta A, Abdul-Careem MF. Comparison of Infectious Bronchitis Virus (IBV) Pathogenesis and Host Responses in Young Male and Female Chickens. Viruses 2023; 15:2285. [PMID: 38140526 PMCID: PMC10747771 DOI: 10.3390/v15122285] [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: 10/27/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Infectious bronchitis virus (IBV) is an avian coronavirus that causes a disease in chickens known as infectious bronchitis (IB). The pathogenesis of IBV and the host immune responses against it depend on multiple factors such as the IBV variant, breed and age of the chicken, and the environment provided by the management. Since there is limited knowledge about the influence of the sex of chickens in the pathogenesis of IBV, in this study we aim to compare IBV pathogenesis and host immune responses in young male and female chickens. One-week-old specific pathogen-free (SPF) White Leghorn male and female chickens were infected with Canadian Delmarva (DMV)/1639 IBV variant at a dose of 1 × 106 embryo infectious dose (EID)50 by the oculo-nasal route while maintaining uninfected controls, and these chickens were euthanized and sampled 4- and 11-days post-infection (dpi). No significant difference was observed between the infected male and female chickens in IBV shedding, IBV genome load in the trachea, lung, kidney, bursa of Fabricius (BF), thymus, spleen, and cecal tonsils (CT), and IBV-induced lesion in all the examined tissues at both 4 and 11 dpi. In addition, there was no significant difference in the percentage of IBV immune-positive area observed between the infected male and female chickens in all tissues except for the kidney, which expressed an increased level of IBV antigen in infected males compared with females at both 4 and 11 dpi. The percentage of B lymphocytes was not significantly different between infected male and female chickens in all the examined tissues. The percentage of CD8+ T cells was not significantly different between infected male and female chickens in all the examined tissues except in the trachea at 11 dpi, where female chickens had higher recruitment when compared with male chickens. Overall, although most of the findings of this study suggest that the sex of chickens does not play a significant role in the pathogenesis of IBV and the host immune response in young chickens, marginal differences in viral replication and host responses could be observed to indicate that IBV-induced infection in male chickens is more severe.
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Affiliation(s)
- Ishara M. Isham
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
| | - Reham M. Abd-Elsalam
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
- Faculty of Veterinary Medicine, Cairo University, Giza 12211, Egypt
| | - Motamed E. Mahmoud
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
- Department of Animal Husbandry, Faculty of Veterinary Medicine, Sohag University, Sohag 82524, Egypt
| | - Shahnas M. Najimudeen
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
| | - Hiruni A. Ranaweera
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
| | - Ahmed Ali
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
- Department of Pathology, Beni-Suef University, Beni Suef 62521, Egypt
| | - Mohamed S. H. Hassan
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
- Department of Avian and Rabbit Medicine, Faculty of Veterinary Medicine, Assiut University, Assiut 71515, Egypt
| | - Susan C. Cork
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
| | - Ashish Gupta
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
| | - Mohamed Faizal Abdul-Careem
- Health Research Innovation Center 2C53, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada; (I.M.I.); (R.M.A.-E.); (M.E.M.); (S.M.N.); (H.A.R.); (A.A.); (M.S.H.H.); (S.C.C.); (A.G.)
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Galactosidase-catalyzed fluorescence amplification method (GAFAM): sensitive fluorescent immunohistochemistry using novel fluorogenic β-galactosidase substrates and its application in multiplex immunostaining. Histochem Cell Biol 2023; 159:233-246. [PMID: 36374321 DOI: 10.1007/s00418-022-02162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2022] [Indexed: 11/16/2022]
Abstract
Multiplex immunohistochemistry/multiplex immunofluorescence (mIHC/mIF) enables the simultaneous detection of multiple markers in a single tissue section by visualizing the markers in different colors. Currently, tyramide signal amplification (TSA) is the most commonly used method because it is heat resistant to multiplexing. SPiDER-βGal (6'-(diethylamino)-4'-(fluoromethyl)spiro[isobenzofuran-1(3H),9'-[9H]xanthen]-3'-yl β-D-galactopyranoside), a novel fluorogenic substrate of β-galactosidase (β-gal) was reported recently. Its properties are favorable for application in sensitive mIF based on quinone methide chemistry. Combining SPiDER-βGal with its related substrates, a novel, sensitive fluorescent IHC method for formalin-fixed paraffin-embedded (FFPE) sections was developed, named the galactosidase-catalyzed fluorescence amplification method (GAFAM). Evaluation of GAFAM indicated the following characteristics: (1) the entire GAFAM procedure was complete within a few hours; (2) the optimal working concentration of the substrates was 20 μM; (3) the fluorescent product was heat resistant; (4) the GAFAM exhibited sensitivity comparable with that of TSA, which was higher than that of conventional IF; and (5) the GAFAM was applicable to mIF and multispectral imaging. GAFAM is expected to be applicable to IF (or mIF in combination with TSA), and is a promising tool for facilitating morphological research in various fields of life science.
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Infectious Proctitis Masquerading as Solitary Rectal Ulcer Syndrome: A Potential Pitfall. ACG Case Rep J 2022. [DOI: 10.14309/crj.0000000000000891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Muacevic A, Adler JR. Hypertrophic Perianal Herpes Mimicking Squamous Cell Cancer: A Case Report and a Review of the Literature. Cureus 2022; 14:e30649. [PMID: 36439566 PMCID: PMC9684622 DOI: 10.7759/cureus.30649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 12/03/2022] Open
Abstract
Clinical practice frequently involves the discovery of perineal lesions. The human papillomavirus, molluscum contagiosum, and herpes simplex virus are to blame for the majority of these anogenital lesions. In the majority of cases, these lesions may be identified by their distinctive appearance. It is challenging to make a clinical diagnosis in immunocompromised people since these lesions might be large and have uncommon appearances. Verrucous perianal herpes is a rare type of herpes that resembles squamous cell carcinoma in gross appearance. We present a case of a 71-year-old man on azathioprine, an immunosuppressive drug for autoimmune pancreatitis, who developed a perianal lesion resembling squamous cell carcinoma. Excisional biopsy revealed a benign ulcerative lesion with herpetic inclusions. The patient received antiviral treatment, and the perianal wound completely healed. He developed a similar lesion in the perineum at one year follow up, which was successfully treated with oral and topical antivirals.
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Oumarou Hama H, Aboudharam G, Barbieri R, Lepidi H, Drancourt M. Immunohistochemical diagnosis of human infectious diseases: a review. Diagn Pathol 2022; 17:17. [PMID: 35094696 PMCID: PMC8801197 DOI: 10.1186/s13000-022-01197-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/18/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Immunohistochemistry (IHC) using monoclonal and polyclonal antibodies is a useful diagnostic method for detecting pathogen antigens in fixed tissues, complementing the direct diagnosis of infectious diseases by PCR and culture on fresh tissues. It was first implemented in a seminal publication by Albert Coons in 1941. MAIN BODY Of 14,198 publications retrieved from the PubMed, Google, Google Scholar and Science Direct databases up to December 2021, 230 were selected for a review of IHC techniques, protocols and results. The methodological evolutions of IHC and its application to the diagnosis of infectious diseases, more specifically lice-borne diseases, sexually transmitted diseases and skin infections, were critically examined. A total of 59 different pathogens have been detected once in 22 different tissues and organs; and yet non-cultured, fastidious and intracellular pathogens accounted for the vast majority of pathogens detected by IHC. Auto-IHC, incorporating patient serum as the primary antibody, applied to diseased heart valves surgically collected from blood culture-negative endocarditis patients, detected unidentified Gram-positive cocci and microorganisms which were subsequently identified as Coxiella burnetii, Bartonella quintana, Bartonella henselae and Tropheryma whipplei. The application of IHC to ancient tissues dated between the ends of the Ptolemaic period to over 70 years ago, have also contributed to paleomicrobiology diagnoses. CONCLUSION IHC plays an important role in diagnostic of infectious diseases in tissue samples. Paleo-auto-IHC derived from auto-IHC, is under development for detecting non-identified pathogens from ancient specimens.
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Affiliation(s)
- Hamadou Oumarou Hama
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Gérard Aboudharam
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
- Aix-Marseille-Univ., Ecole de Médecine Dentaire, Marseille, France
| | - Rémi Barbieri
- IHU Méditerranée Infection, Marseille, France
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
| | - Hubert Lepidi
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France
- Laboratoire d'Histologie, Faculté de Médecine, Université de la Méditerranée, Marseille, France
| | - Michel Drancourt
- IHU Méditerranée Infection, Marseille, France.
- Aix-Marseille-Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France.
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8
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Hoel IM, Ali IAM, Ishtiaq S, Sviland L, Wiker H, Mustafa T. Immunochemistry-Based Diagnosis of Extrapulmonary Tuberculosis: A Strategy for Large-Scale Production of MPT64-Antibodies for Use in the MPT64 Antigen Detection Test. Antibodies (Basel) 2021; 10:34. [PMID: 34462410 PMCID: PMC8406093 DOI: 10.3390/antib10030034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/26/2021] [Accepted: 08/24/2021] [Indexed: 02/04/2023] Open
Abstract
Tuberculosis (TB) is a global health problem. The immunohistochemistry (IHC)-based MPT64 antigen detection test has shown promising results for diagnosing extrapulmonary TB in previous studies. However, the anti-MPT64 antibody currently used in the test is in limited supply, and reproduction of a functional antibody is a prerequisite for further large-scale use. Various antigen-adjuvant combinations and immunisation protocols were tested in mice and rabbits to generate monoclonal and polyclonal antibodies. Antibodies were screened in IHC, and the final new antibody was validated on clinical human specimens. We were not able to generate monoclonal antibodies that were functional in IHC, but we obtained multiple functional polyclonal antibodies through careful selection of antigen-adjuvant and comprehensive screening in IHC of both pre-immune sera and antisera. To overcome the limitation of batch-to-batch variability with polyclonal antibodies, the best performing individual polyclonal antibodies were pooled to one final large-volume new anti-MPT64 antibody. The sensitivity of the new antibody was in the same range as the reference antibody, while the specificity was somewhat reduced. Our results suggest that it possible to reproduce a large-volume functional polyclonal antibody with stable performance, thereby securing stable supplies and reproducibility of the MPT64 test, albeit further validation remains to be done.
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Affiliation(s)
- Ida Marie Hoel
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (I.A.M.A.); (T.M.)
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway;
- Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway;
| | - Iman A Mohammed Ali
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (I.A.M.A.); (T.M.)
| | - Sheeba Ishtiaq
- Department of Histopathology, Gulab Devi Chest Hospital Lahore, Lahore 54000, Pakistan;
| | - Lisbet Sviland
- Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway;
- Department of Pathology, Haukeland University Hospital, 5021 Bergen, Norway
| | - Harald Wiker
- Department of Clinical Science, University of Bergen, 5020 Bergen, Norway;
| | - Tehmina Mustafa
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (I.A.M.A.); (T.M.)
- Department of Thoracic Medicine, Haukeland University Hospital, 5021 Bergen, Norway
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Goyal G, Zinger T, Warfield D, Cao W. The Trends of Immunohistochemistry for Tissue-Invasive Cytomegalovirus in Gastrointestinal Mucosal Biopsies: A Large Single Academic Center Study. Arch Pathol Lab Med 2021; 146:360-365. [PMID: 34133720 DOI: 10.5858/arpa.2020-0425-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Cytomegalovirus (CMV) immunohistochemistry (IHC) is the most widely used method to diagnose CMV infection/reactivation in tissues in a pathology laboratory. OBJECTIVE.— To improve the efficiency of CMV IHC testing by evaluating immunopositive staining trends of tissue-invasive CMV in the gastrointestinal system. DESIGN.— A total of 1479 individual orders for CMV IHC on gastrointestinal biopsy specimens from 2016 to 2018 were included. The analysis was performed to identify the significant factors contributory to CMV-positive test results. RESULTS.— The overall positivity rate of CMV IHC in our institution is 4.73% (70 of 1479). The positivity rate from physician-requested and pathologist-initiated tests was significantly different (7.54% versus 3.83%, P = .004). Cases with severe inflammation showed a higher positive CMV rate than those with mild inflammation (5.37% versus 2.60%, P = .04). Cytomegalovirus positivity in biopsies from posttransplant patients, inflammatory bowel disease, human immunodeficiency virus (HIV)/common variable immunodeficiency (CVID), cancer, and others was 19.69%, 3.84%, 23.33%, 9.00%, and 2.84%, respectively. The positivity rate among posttransplant, HIV/CVID, or cancer patients was significantly higher than in other populations. Cases tested with multiple tissue blocks generated a higher positivity rate than those with a single block (7.77% versus 3.23%, P < .001). Testing 3 to 4 blocks per case almost tripled the positive CMV detection rate (9.04%). Interestingly, using 5 or more blocks did not further ameliorate the positive CMV detection rate. CONCLUSIONS.— The data revealed that physician request, immunosuppression, multiple blocks, and severe inflammation were strongly related to positive CMV IHC detection rate. These findings might provide value in helping pathologists manage CMV IHC testing more efficiently.
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Affiliation(s)
- Geetika Goyal
- From the Department of Pathology, New York University Langone Health, New York (Goyal, Zinger, Warfield, Cao).,The Department of Pathology, Saint Barnabas Medical Center, Robert Wood Johnson Barnabas Health, Livingston, New Jersey (Goyal)
| | - Tatyana Zinger
- From the Department of Pathology, New York University Langone Health, New York (Goyal, Zinger, Warfield, Cao)
| | - Dana Warfield
- From the Department of Pathology, New York University Langone Health, New York (Goyal, Zinger, Warfield, Cao)
| | - Wenqing Cao
- From the Department of Pathology, New York University Langone Health, New York (Goyal, Zinger, Warfield, Cao)
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Moysi E, Del Rio Estrada PM, Torres-Ruiz F, Reyes-Terán G, Koup RA, Petrovas C. In Situ Characterization of Human Lymphoid Tissue Immune Cells by Multispectral Confocal Imaging and Quantitative Image Analysis; Implications for HIV Reservoir Characterization. Front Immunol 2021; 12:683396. [PMID: 34177929 PMCID: PMC8221112 DOI: 10.3389/fimmu.2021.683396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 05/13/2021] [Indexed: 11/13/2022] Open
Abstract
CD4 T cells are key mediators of adaptive immune responses during infection and vaccination. Within secondary lymphoid organs, helper CD4 T cells, particularly those residing in germinal centers known as follicular helper T cells (Tfh), provide critical help to B-cells to promote their survival, isotype switching and selection of high affinity memory B-cells. On the other hand, the important role of Tfh cells for the maintenance of HIV reservoir is well documented. Thus, interrogating and better understanding the tissue specific micro-environment and immune subsets that contribute to optimal Tfh cell differentiation and function is important for designing successful prevention and cure strategies. Here, we describe the development and optimization of eight multispectral confocal microscopy immunofluorescence panels designed for in depth characterization and immune-profiling of relevant immune cells in formalin-fixed paraffin-embedded human lymphoid tissue samples. We provide a comprehensive library of antibodies to use for the characterization of CD4+ T-cells -including Tfh and regulatory T-cells- as well as CD8 T-cells, B-cells, macrophages and dendritic cells and discuss how the resulting multispectral confocal datasets can be quantitatively dissected using the HistoCytometry pipeline to collect information about relative frequencies and immune cell spatial distributions. Cells harboring actively transcribed virus are analyzed using an in-situ hybridization assay for the characterization of HIV mRNA positive cells in combination with additional protein markers (multispectral RNAscope). The application of this methodology to lymphoid tissues offers a means to interrogate multiple relevant immune cell targets simultaneously at increased resolution in a reproducible manner to guide CD4 T-cell studies in infection and vaccination.
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Affiliation(s)
- Eirini Moysi
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Perla M Del Rio Estrada
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Fernanda Torres-Ruiz
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Gustavo Reyes-Terán
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.,Comisión Coordinadora de Institutos Nacionales de Salud y Hospitales de Alta Especialidad, Secretaría de Salud, Mexico City, Mexico
| | - Richard A Koup
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Constantinos Petrovas
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States.,Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital, Lausanne, Switzerland
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Bonacho T, Rodrigues F, Liberal J. Immunohistochemistry for diagnosis and prognosis of breast cancer: a review. Biotech Histochem 2019; 95:71-91. [PMID: 31502889 DOI: 10.1080/10520295.2019.1651901] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Breast cancer is the most prevalent malignant tumor and main oncologic cause of mortality in women. Although most diagnosis of breast pathology is accomplished using hematoxylin and eosin stained sections, some cases require immunohistochemistry for proper evaluation. We investigated the latter cases including distinctions between ductal and lobular carcinoma, in situ and invasive carcinoma, typical ductal hyperplasia and atypical ductal hyperplasia/ductal carcinoma in situ, papillary and spindle cell lesion assessment, metastasis evaluation, and assessment of prognostic and therapy markers. E-cadherin is used to differentiate ductal and lobular carcinoma; 34βE12, CK8, p120 catenin and β-catenin also produce consistent results. Myoepithelial cell (MEC) stains are used to evaluate in situ and invasive carcinoma; calponin, smooth muscle myosin heavy chain and p63 are sensitive/specific markers. 34βE12 and CK5/6 are positive in ductal hyperplasia, which enables its differentiation from atypical ductal hyperplasia and ductal carcinoma in situ. CK 5/6, ER and MEC markers are consistent options for evaluating papillary lesions. Spindle cell lesions can be assessed using β-catenin, SMA, CD34, p63, CKs and hormone receptors. It is important to differentiate primary carcinomas from metastases; the most commonly used markers to identify breast origin include mammaglobin, GCDFP-15, GATA3 and ER, although none of these is completely sensitive or specific. Immunohistochemistry can be used to evaluate central prognostic and predictive factors including molecular subtypes, HER2, hormone receptors, proliferation markers (Ki-67) and lymph-vascular invasion markers including ERG, CD31, CD34, factor VIII and podoplanin. Owing to the complexity of mammary lesions, diagnosis also depends on each particular situation, evaluation of cytological characteristics revealed by immunochemistry and correlation with histological findings.
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Affiliation(s)
- T Bonacho
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - F Rodrigues
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal.,Qualidade de Vida no Mundo Rural (QRural), Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal.,Sport, Health & Exercise Unit (SHERU), Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
| | - J Liberal
- Escola Superior de Saúde Dr. Lopes Dias, Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal.,Qualidade de Vida no Mundo Rural (QRural), Instituto Politécnico de Castelo Branco, Castelo Branco, Portugal
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Katsarou K, Bardani E, Kallemi P, Kalantidis K. Viral Detection: Past, Present, and Future. Bioessays 2019; 41:e1900049. [PMID: 31441081 DOI: 10.1002/bies.201900049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/04/2019] [Indexed: 12/26/2022]
Abstract
Viruses are essentially composed of a nucleic acid (segmented or not, DNA, or RNA) and a protein coat. Despite their simplicity, these small pathogens are responsible for significant economic and humanitarian losses that have had dramatic consequences in the course of human history. Since their discovery, scientists have developed different strategies to efficiently detect viruses, using all possible viral features. Viruses shape, proteins, and nucleic acid are used in viral detection. In this review, the development of these techniques, especially for plant and mammalian viruses, their strengths and weaknesses as well as the latest cutting-edge technologies that may be playing important roles in the years to come are described.
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Affiliation(s)
- Konstantina Katsarou
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Heraklion, GR-70013, Greece.,Department of Biology, University of Crete, Heraklion, GR-70013, Greece
| | - Eirini Bardani
- Department of Biology, University of Crete, Heraklion, GR-70013, Greece
| | - Paraskevi Kallemi
- Department of Biology, University of Crete, Heraklion, GR-70013, Greece
| | - Kriton Kalantidis
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, Heraklion, GR-70013, Greece.,Department of Biology, University of Crete, Heraklion, GR-70013, Greece
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Cinetto F, Scarpa R, Pulvirenti F, Quinti I, Agostini C, Milito C. Appropriate lung management in patients with primary antibody deficiencies. Expert Rev Respir Med 2019; 13:823-838. [PMID: 31361157 DOI: 10.1080/17476348.2019.1641085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Human primary immunodeficiency diseases (PIDs) include a broad spectrum of more than 350 disorders, involving different branches of the immune system and classified as 'rare diseases.' Predominantly antibody deficiencies (PADs) represent more than half of the PIDs diagnosed in Europe and are often diagnosed in the adulthood. Areas covered: Although PAD could first present with autoimmune or neoplastic features, respiratory infections are frequent and respiratory disease represents a relevant cause of morbidity and mortality. Pulmonary complications may be classified as infection-related (acute and chronic), immune-mediated, and neoplastic. Expert opinion: At present, no consensus guidelines are available on how to monitor and manage lung complications in PAD patients. In this review, we will discuss the available diagnostic, prognostic and therapeutic instruments and we will suggest an appropriate and evidence-based approach to lung diseases in primary antibody deficiencies. We will also highlight the possible role of promising new tools and strategies in the management of pulmonary complications. However, future studies are needed to reduce of diagnostic delay of PAD and to better understand lung diseases mechanisms, with the final aim to ameliorate therapeutic options that will have a strong impact on Quality of Life and long-term prognosis of PAD patients.
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Affiliation(s)
- Francesco Cinetto
- Department of Medicine - DIMED, University of Padova , Padova , Italy.,Internal Medicine I, Ca' Foncello Hospital , Treviso , Italy
| | - Riccardo Scarpa
- Department of Medicine - DIMED, University of Padova , Padova , Italy.,Internal Medicine I, Ca' Foncello Hospital , Treviso , Italy
| | - Federica Pulvirenti
- Department of Molecular Medicine, "Sapienza" University of Roma , Roma , Italy
| | - Isabella Quinti
- Department of Molecular Medicine, "Sapienza" University of Roma , Roma , Italy
| | - Carlo Agostini
- Department of Medicine - DIMED, University of Padova , Padova , Italy.,Internal Medicine I, Ca' Foncello Hospital , Treviso , Italy
| | - Cinzia Milito
- Department of Molecular Medicine, "Sapienza" University of Roma , Roma , Italy
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Ayoade F, Gonzales Zamora JA, Tjendra Y. Herpes Simplex Virus Proctitis Masquerading as Rectal Cancer. Diseases 2019; 7:diseases7020036. [PMID: 31010103 PMCID: PMC6630232 DOI: 10.3390/diseases7020036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 04/20/2019] [Accepted: 04/21/2019] [Indexed: 12/02/2022] Open
Abstract
Herpes simplex virus (HSV) is the leading cause of proctitis in HIV-infected individuals. However, no cases of rectal masses secondary to HSV infection have been reported to date. Herein, we present the case of a 45-year-old man with HIV infection who developed rectal pain and bleeding, along with dysuria and voiding difficulty. Colonoscopy revealed proctitis and a rectal mass with features concerning for rectal cancer. Histologic sections of the rectal mass biopsy demonstrated colorectal mucosa with viral cytopathic changes, ulceration, granulation tissue, marked inflammatory infiltrate, and fibrinopurulent exudate. Immunohistochemistry for herpes simplex virus-1 was positive in epithelial cells demonstrating a viral cytopathic effect. The patient was treated with valacyclovir for 3 weeks, which led to complete resolution of his symptoms. Follow-up sigmoidoscopy at 6 months did not show any masses. Our case illustrates the importance of considering HSV in the differential diagnosis of rectal masses. We advocate the routine use of viral immunohistochemistry for the evaluation of rectal tumors, especially in patients with clinical manifestations and endoscopic findings consistent with proctitis.
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Affiliation(s)
- Folusakin Ayoade
- Division of Infectious Diseases. Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
| | - Jose Armando Gonzales Zamora
- Division of Infectious Diseases. Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
| | - Youley Tjendra
- Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
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Ku NK, Pullarkat ST, Kim YS, Cheng L, O'Malley D. Use of CD42b immunohistochemical stain for the detection of Histoplasma. Ann Diagn Pathol 2018; 32:47-50. [PMID: 29414398 DOI: 10.1016/j.anndiagpath.2017.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/13/2017] [Indexed: 11/18/2022]
Abstract
In pathologic specimen, Histoplasma capsulatum can frequently be identified by morphology and special stains such as GMS and PAS. Incidentally, we noted unusual staining of the platelet associated marker CD42b/GP1b expressed on the surface of fungal organisms. Evaluation of additional cases demonstrated that a majority of histoplasmosis cases (15/18 cases; 83%) showed positive staining with CD42b/GP1b, comparable to GMS stain results. Other platelet associated markers such as Factor VIII and CD61 showed no or rare expression (1/18 cases with Factor VIII). Studies have shown that 14-3-3 proteins bind directly to cytoplasmic domain of CD42b/GP1b. Significant homology is seen between fungal and human 14-3-3 proteins which may represent a molecular basis for our observation. Our study demonstrated that CD42b/GP1b staining by immunohistochemistry can aid in detection of Histoplasma organisms. Further studies with organisms with similar morphologic features such as Blastomyces and Leishmania may demonstrate a diagnostic utility in speciating organisms.
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Affiliation(s)
- Nam K Ku
- Department of Pathology, University of California, Davis, Sacramento, CA, United States.
| | - Sheeja T Pullarkat
- Department of Pathology, University of California, Los Angeles, Los Angeles, CA, United States.
| | - Young S Kim
- Department of Pathology, City of Hope National Medical Center, Duarte, CA, United States.
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, United States.
| | - Dennis O'Malley
- Neogenomics, Aliso Viejo, CA, United States; Department of Hematopathology, M.D. Anderson Cancer Center, Houston, TX, United States.
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Panarelli NC. Other Forms of Esophagitis: It Is Not Gastroesophageal Reflux Disease, So Now What Do I Do? Surg Pathol Clin 2017; 10:765-779. [PMID: 29103532 DOI: 10.1016/j.path.2017.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Esophagitis results from diverse causes, including gastroesophageal reflux, immune-mediated or allergic reactions, therapeutic complications, and infections. The appropriate clinical management differs in each of these situations and is often guided by pathologic interpretation of endoscopic mucosal biopsy specimens. This review summarizes the diagnostic features of unusual forms of esophagitis, including eosinophilic esophagitis, lymphocytic esophagitis, esophagitis dissecans superficialis, drug-induced esophageal injury, and bullous disorders. Differential diagnoses and distinguishing features are emphasized.
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Affiliation(s)
- Nicole C Panarelli
- Department of Pathology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10467, USA.
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18
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Troxell ML, Lanciault C. Practical Applications in Immunohistochemistry: Evaluation of Rejection and Infection in Organ Transplantation. Arch Pathol Lab Med 2016; 140:910-25. [PMID: 26759930 DOI: 10.5858/arpa.2015-0275-cp] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT -Immunohistochemical analysis of tissue biopsy specimens is a crucial tool in diagnosis of both rejection and infection in patients with solid organ transplants. In the past 15 years, the concept of antibody-mediated rejection has been refined, and diagnostic criteria have been codified in renal, heart, pancreas, and lung allografts (with studies ongoing in liver, small intestine, and composite grafts), all of which include immunoanalysis for the complement split product C4d. OBJECTIVES -To review the general concepts of C4d biology and immunoanalysis, followed by organ-allograft-specific data, and interpretative nuances for kidney, pancreas, and heart, with discussion of early literature for lung and liver biopsies. Additionally, practical applications and limitations of immunostains for infectious organisms (Polyomavirus, Adenoviridae [adenovirus], and the herpes virus family, including Herpes simplex virus, Cytomegalovirus, Human herpes virus 8, and Epstein-Barr virus) are reviewed in the context of transplant recipients. DATA SOURCES -Our experience and published primary and review literature. CONCLUSIONS -Immunohistochemistry continues to have an important role in transplant pathology, most notably C4d staining in assessment of antibody-mediated rejection and assessment of viral pathogens in tissue. In all facets of transplant pathology, correlation of morphology with special studies and clinical data is critical, as is close communication with the transplant team.
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Affiliation(s)
| | - Christian Lanciault
- From the Department of Pathology, Oregon Health & Science University, Portland
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Challa S, Uppin SG, Uppin MS, Pamidimukkala U, Vemu L. Diagnosis of filamentous fungi on tissue sections by immunohistochemistry using anti-aspergillus antibody. Med Mycol 2015; 53:470-6. [PMID: 25980002 DOI: 10.1093/mmy/myv004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/07/2015] [Indexed: 12/28/2022] Open
Abstract
Identification based on histology alone has limitations as Aspergillus species share morphology with other filamentous fungi. Differentiation of Aspergillus species from hyalohyphomycetes and dematiaceous fungi is important as the antifungal susceptibility varies among different species and genera. Given these problems, ancillary techniques are needed to increase specificity. Our aim was to study the utility of immunohistochemistry (IHC) with anti-Aspergillus antibody in the identification of Aspergillus species and to differentiate them from other filamentous fungi. Fifty formalin fixed, paraffin embedded tissue sections including 47 from cases of culture proven filamentous fungi, 3 from colonies of cultures of hyalohyphomycetes, and 11 smears from cultures were subjected to IHC studies using polyclonal rabbit anti-Aspergillus antibody (Abcam, UK) after antigen retrieval. The IHC on tissue sections was positive in 88% cases involving culture proven Aspergillus species. There was no cross reactivity with Mucorales species, Candida species, dematiaceous fungi and hyalohyphomycetes. Hence immunohistochemistry can be used as an ancillary technique for the diagnosis of Aspergillus species.
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Affiliation(s)
- Sundaram Challa
- Department of Pathology, Nizam's Institute of Medical Sciences, Andhra Pradesh, India
| | - Shantveer G Uppin
- Department of Pathology, Nizam's Institute of Medical Sciences, Andhra Pradesh, India
| | - Megha S Uppin
- Department of Pathology, Nizam's Institute of Medical Sciences, Andhra Pradesh, India
| | - Umabala Pamidimukkala
- Department of Microbiology, Nizam's Institute of Medical Sciences, Andhra Pradesh, India
| | - Lakshmi Vemu
- Department of Microbiology, Nizam's Institute of Medical Sciences, Andhra Pradesh, India
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Abstract
CONTEXT Immunohistochemistry is not a diagnostic test but a highly valuable tool that requires interpretation within a context. OBJECTIVE To review the current status and limitations of immunohistochemistry in dermatopathology. DATA SOURCES English-language literature published between 1980 and 2014. CONCLUSIONS Although immunohistochemistry is rarely completely specific or sensitive, it is an important adjunctive technique in dermatopathology and can be helpful in a series of diagnostic dilemmas.
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Affiliation(s)
- Tammie Ferringer
- From the Departments of Dermatology and Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania
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Molina-Ruiz AM, Santonja C, Rütten A, Cerroni L, Kutzner H, Requena L. Immunohistochemistry in the Diagnosis of Cutaneous Viral Infections—Part I. Cutaneous Viral Infections by Herpesviruses and Papillomaviruses. Am J Dermatopathol 2015; 37:1-14; quiz 12-4. [DOI: 10.1097/dad.0000000000000203] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Galiza GJ, Tochetto C, Rosa FB, Panziera W, Silva TMD, Caprioli RA, Kommers GD. Utilização de três métodos imuno-histoquímicos na detecção de aspergilose e zigomicose em animais. PESQUISA VETERINARIA BRASILEIRA 2014. [DOI: 10.1590/s0100-736x2014000700005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Visando a otimização do uso da técnica de imuno-histoquímica (IHQ) na detecção de Aspergillus spp. e zigomicetos (membros da família Mucoraceae), utilizaram-se dois anticorpos monoclonais fungo-específicos em fragmentos de tecidos de animais (fixados em formol e embebidos em parafina) com diagnóstico histomorfológico prévio de aspergilose e zigomicose, os quais foram submetidos a três sistemas de detecção diferentes (dois biotinilados e um não biotinilado). Os dois anticorpos apresentaram alta especificidade e sensibilidade nos tecidos examinados. Não ocorreram reações cruzadas entre os anticorpos utilizados e os agentes etiológicos avaliados (incluindo casos de aspergilose, zigomicose, candidíase e pitiose). No entanto, reações inespecíficas foram observadas nas hifas em alguns casos, as quais puderam ser eliminadas através de um dos métodos de detecção utilizados. Para a aspergilose, o método da estreptavidina-biotina-fosfatase alcalina não apresentou reações inespecíficas nas hifas. Enquanto que nos casos de zigomicoses, as reações inespecíficas não ocorreram no método por polímero (não biotinilado). A técnica de IHQ mostrou-se uma ferramenta muito útil na detecção e confirmação dos casos de aspergilose e zigomicose neste estudo retrospectivo.
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Ferringer T, Ko CJ. The basics. Dermatopathology (Basel) 2014. [DOI: 10.1016/b978-0-7020-5527-0.00001-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Peña L, Gama A, Goldschmidt MH, Abadie J, Benazzi C, Castagnaro M, Díez L, Gärtner F, Hellmén E, Kiupel M, Millán Y, Miller MA, Nguyen F, Poli A, Sarli G, Zappulli V, de las Mulas JM. Canine mammary tumors: a review and consensus of standard guidelines on epithelial and myoepithelial phenotype markers, HER2, and hormone receptor assessment using immunohistochemistry. Vet Pathol 2013; 51:127-45. [PMID: 24227007 DOI: 10.1177/0300985813509388] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Although there have been several studies on the use of immunohistochemical biomarkers of canine mammary tumors (CMTs), the results are difficult to compare. This article provides guidelines on the most useful immunohistochemical markers to standardize their use and understand how outcomes are measured, thus ensuring reproducibility of results. We have reviewed the biomarkers of canine mammary epithelial and myoepithelial cells and identified those biomarkers that are most useful and those biomarkers for invasion and lymph node micrometastatic disease. A 10% threshold for positive reaction for most of these markers is recommended. Guidelines on immunolabeling for HER2, estrogen receptors (ERs), and progesterone receptors (PRs) are provided along with the specific recommendations for interpretation of the results for each of these biomarkers in CMTs. Only 3+ HER2-positive tumors should be considered positive, as found in human breast cancer. The lack of any known response to adjuvant endocrine therapy of ER- and PR-positive CMTs prevents the use of the biological positive/negative threshold used in human breast cancer. Immunohistochemistry results of ER and PR in CMTs should be reported as the sum of the percentage of positive cells and the intensity of immunolabeling (Allred score). Incorporation of these recommendations in future studies, either prospective or retrospective, will provide a mechanism for the direct comparison of studies and will help to determine whether these biomarkers have prognostic significance. Finally, these biomarkers may ascertain the most appropriate treatment(s) for canine malignant mammary neoplasms.
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Affiliation(s)
- L Peña
- Department of Animal Medicine, Surgery and Pathology, Veterinary School, Carretera de la Coruña s/n, Ciudad Universitaria, 28040 Madrid, Spain.
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Necrotizing granulomatous inflammation: what does it mean if your special stains are negative? Mod Pathol 2012; 25 Suppl 1:S31-8. [PMID: 22214968 DOI: 10.1038/modpathol.2011.155] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Necrotizing granulomas are commonly encountered in surgically resected specimens. The majority will be proven infectious with special stains for microorganisms. These need to be distinguished from other granulomatous processes such as Wegener's granulomatosis (WG). Although there may be histological overlap between these different processes, the identification of a true necrotizing vasculitis is specific to WG in the context of necrotizing granulomas. Otherwise, the combination of histological features should lead to a specific diagnosis. Despite a thorough histological examination and assessments of special stains, a significant proportion of necrotizing granulomas will appear infectious with no obvious infectious etiology. There are only few clinically available ancillary tests that can be performed on paraffin-embedded tissue and include real-time PCR for tuberculous mycobacteria. Despite correlation with clinical, serological and other microbiological studies, some necrotizing granulomas remain unexplained. Patients with such granulomas appear not to require any additional treatment and do experience a favorable outcome.
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Dzabic M, Rahbar A, Yaiw KC, Naghibi M, Religa P, Fellström B, Larsson E, Söderberg-Nauclér C. Intragraft cytomegalovirus protein expression is associated with reduced renal allograft survival. Clin Infect Dis 2011; 53:969-76. [PMID: 21960711 DOI: 10.1093/cid/cir619] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) infection is a risk factor for acute and chronic rejection of transplanted organs and is thought to mediate rejection indirectly. METHODS In this retrospective observational cohort study, early- and end-stage biopsies from renal allografts lost because of chronic allograft dysfunction (n = 29) were examined for CMV antigens and DNA using immunohistochemistry, in situ hybridization, and real-time polymerase chain reaction. RESULTS CMV immediate-early and late proteins were present in 27 (93%) of 29 of the end-stage chronic allograft dysfunction biopsies and in 64% of the corresponding early biopsies but not in pretransplant biopsies from CMV-seronegative donors (n = 3). Graft survival time was reduced in patients with moderate or high CMV levels in the graft soon after transplantation compared with that in patients with no or low CMV levels in the graft. No significant difference was observed in serum creatinine obtained at the time of early biopsies. CONCLUSIONS We provide evidence that intragraft CMV protein expression is associated with end-stage chronic renal allograft dysfunction, that intragraft CMV levels increase as graft function deteriorates, and that CMV protein expression in the grafts soon after transplant is associated with reduced graft survival. Thus, CMV may have a pathological role in chronic renal allograft dysfunction.
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Affiliation(s)
- Mensur Dzabic
- Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Pseudoepitheliomatous Hyperplasia Mimicking Vulvar Cancer in a Patient With AIDS. J Low Genit Tract Dis 2011; 15:66-8. [DOI: 10.1097/lgt.0b013e3181f0b8f5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chakhtoura M, Abdelnoor AM. Monoclonal antibodies used as prophylactic, therapeutic and diagnostic agents. Immunopharmacol Immunotoxicol 2010; 32:533-42. [DOI: 10.3109/08923971003646597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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31
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Kradin RL, Iafrate AJ. General Principles in the Diagnosis of Infection. DIAGNOSTIC PATHOLOGY OF INFECTIOUS DISEASE 2010. [PMCID: PMC7151840 DOI: 10.1016/b978-1-4160-3429-2.00002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Cathomas G. Molecular diagnostic in infectious disease pathology: An update. Ann Pathol 2009; 29 Spec No 1:S19-21. [DOI: 10.1016/j.annpat.2009.07.053] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Accepted: 07/28/2009] [Indexed: 12/17/2022]
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Sangoi AR, Rogers WM, Longacre TA, Montoya JG, Baron EJ, Banaei N. Challenges and pitfalls of morphologic identification of fungal infections in histologic and cytologic specimens: a ten-year retrospective review at a single institution. Am J Clin Pathol 2009; 131:364-75. [PMID: 19228642 DOI: 10.1309/ajcp99ooozsniscz] [Citation(s) in RCA: 164] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Despite the advantages of providing an early presumptive diagnosis, fungal classification by histopathology can be difficult and may lead to diagnostic error. To assess the accuracy of histologic diagnosis of fungal infections vs culture ("gold standard"), we performed a 10-year retrospective review at our institution. Of the 47 of 338 positive mold and yeast cultures with concurrent surgical pathology evaluation without known history of a fungal infection, 37 (79%) were correctly identified based on morphologic features in histologic and/or cytologic specimens. The 10 discrepant diagnoses (21%) included misidentification of septate and nonseptate hyphal organisms and yeast forms. Errors resulted from morphologic mimics, use of inappropriate terminology, and incomplete knowledge in mycology. The accuracy did not correlate with preceding antifungal therapy (P = .14) or use of special stains (P = .34) and was not operator-dependent. Among 8 discrepancies with clinical follow-up available, 2 potential adverse clinical consequences resulted. While histopathologic identification of fungi in tissue sections and cytologic preparations is prone to error, implementation of a standardized reporting format should improve diagnostic accuracy and prevent adverse outcomes.
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[Infectious lesions and the cytopathological analysis of a neck nodule]. Ann Pathol 2008; 28 Spec No 1:S78-9. [PMID: 18984310 DOI: 10.1016/j.annpat.2008.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Lester SC. Special Studies. MANUAL OF SURGICAL PATHOLOGY 2008. [PMCID: PMC7271186 DOI: 10.1016/b978-0-323-06516-0.10007-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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