Adaptation of a commercial fluorescent in situ hybridization test to the diagnosis of malignant cells in effusions

Guidelines for Pathologic Diagnosis of Malignant Mesothelioma: 2012 Update of the Consensus Statement from the International Mesothelioma Interest Group

“…The FISH technique for detection of 9p21 deletions has been shown to be a very powerful technique for confirming the diagnosis of malignant mesothelioma in effusion and formalin-fixed, paraffin-embedded tissue specimens ( Figure 19, A and B). 19,20,86,88,89 The diagnosis of atypical mesothelial proliferation is more common in cytologic specimens than in surgical specimens because the diagnosis of mesothelioma can be more challenging in cytologic specimens because of the inability to evaluate for tissue invasion and of the numerous cytomorphologic mimics of mesothelioma, including reactive mesothelial proliferations. In the diagnosis of MM in effusion cytology across all cytologic categories, studies showed an overall sensitivity of p16 FISH between 56% and 79% with a positive predictive value of 100%.…”

Pre-analytical issues in effusion cytology

“…The commercial FISH test UroVysion TM , which includes probes for chromosomes 3, 7 and 17, as well as chromosome 9p21, was applied to effusion specimens fixed in CytoLyt® solution and re-suspended in methanol-based fixative [50]. Changes in the same chromosomes were assessed in another study, in which smears fixed in Delaunay solution, containing ethanol and acetone, and PAP-stained smears were used [51].…”

Guidelines for the Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma

“…In some cases there is also a general reactivity to p53, indicating a malignant condition. The use of ploidy analysis by UroVysion® FISH will in most cases indicate malignancy [48]. …”