Comparative Analysis of Electron Microscopy and Immunocytochemistry in the Cytologic Diagnosis of Malignant Small Round Cell Tumors

Brahmi, Urmil; Srinivasan, Radhika; Komal, Harbhajan Singh; Joshi, Kusum; Gupta, Subhash K.; Rajwanshi, Arvind

doi:10.1159/000326548

Cited by 10 publications

(12 citation statements)

References 21 publications

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“…This is in concordance with the results reported by other authors. [8–11] Cell blocks in ICC offer a number of advantages. Kung et al .…”

Section: Discussionmentioning

confidence: 99%

“…[38111214–21] In our study, ICC was limited to a panel of antibodies to determine the cell line of differentiation, namely carcinoma, lymphoma, melanoma, sarcoma, restricting the use of cell-specific antigens to a limited number of cases only. Inconclusive results were obtained because of negative immunostaining and lack of specific markers, which may classify tumors, especially for mesenchymal tumors and those with a divergent differentiation.…”

Section: Discussionmentioning

confidence: 99%

“…By performing separate passes by needle aspiration for EM, we obtained sufficient material and observed performances similar to those of other authors. [4821–24] Table 4 summarizes the usefulness of various ultrastructural studies on cytology samples as reported by other authors. [146822–24] While most of the studies were not restricted to any particular site like in the present, the studies by Neil et al .…”

Section: Discussionmentioning

confidence: 99%

“…[6] and Brahmi et al . [8] were restricted to FNAC of mediastinal masses and malignant round cell tumors, respectively. The main difficulty of EM as applied to FNAC is ensuring that the material observed on thin sections corresponds to the neoplastic cells examined with LM.…”

Section: Discussionmentioning

confidence: 99%

“…[2630] However, there remains a definitive role for EM as a limited panel of broad-spectrum CKs cannot distinguish between metastatic neoplasms of unknown primaries. Brahmi et al .,[8] in their study of the contributions of EM and ICC as adjuncts in cytodiagnosis, concluded that while ICC is the ancillary method of choice in the cytological diagnosis, EM contributes to the diagnosis and improves diagnostic accuracy. Zbieranowsky and Bedard[15] have discussed the value of EM and ICC in preoperative diagnosis of schwannomas and they found EM to be more useful in predicting the cell of origin.…”

Section: Discussionmentioning

confidence: 99%

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Value of ancillary studies in the evaluation of fine-needle aspiration specimens: Our experience

Mutreja

Nijhawan

Srinivasa

et al. 2012

J Cytol

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Background:The cytological diagnosis of poorly differentiated tumors is challenging because the tumor cells may have morphologically difficult presentations in materials obtained by fine-needle aspiration cytology (FNAC). With the application of FNAC in primary diagnosis of malignant lesions, there has been a significant increase in the use of ancillary studies in the aspirated material.Aims:We evaluated the value of ancillary studies, namely cell blocks, immunocytochemistry (ICC) and electron microscopy (EM), in the final interpretation of FNAC smears.Materials and Methods:Sixty-nine cases of neoplastic swellings were subjected to FNAC. Material acquired was divided for ICC, consisting of immunoperoxidase staining of direct smears, and/or cellblocks and EM, in addition to routine light microscopy (LM). Correlation with the available histological material with immunohistochemistry and/or pertinent clinical information was used as a “gold” standard.Results:Five (7.2%) cases were excluded from the study, the material being necrotic or insufficient. Cell blocks were available in 46/64 (71.8%) cases, ICC evaluation was performed in 41/64 cases (64%) and EM studies were done in 57/64 cases (89%). Diagnostic accuracy of LM alone was 32/64 (50%). Cell blocks improved the diagnoses in 8/46 (17%) cases. The ICC data were diagnostic in 18/41 (43.9%) cases, helpful in 8/41 (19.6%) cases and non-helpful in 15/41 (36.5%) cases. EM studies were diagnostic in 22/57 (38.5%) cases, helpful in 18/57 (31.5%) cases and non-helpful in 17/57 (30%) cases. In 34/64 (53.1%) cases, all ancillary techniques (cell blocks, ICC and EM) were applied and their diagnostic accuracy was compared.Conclusions:With appropriate case selection, ancillary studies performed on aspirated material can provide useful information in FNAC.

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“…This is in concordance with the results reported by other authors. [8–11] Cell blocks in ICC offer a number of advantages. Kung et al .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Value of ancillary studies in the evaluation of fine-needle aspiration specimens: Our experience

Mutreja

Nijhawan

Srinivasa

et al. 2012

J Cytol

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Cytopathology of uncommon malignant renal neoplasms in the pediatric age group

et al. 2005

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Malignant renal neoplasms are common solid tumors in pediatric oncology practice. These include the common Wilms' tumor/nephroblastoma and the uncommon neoplasms such as clear-cell sarcoma of the kidney (CCSK), rhabdoid tumor, renal-cell carcinoma, and others. The aim of this study was to describe in detail the cytopathological features of the histopathologically proven uncommon pediatric renal tumors. Aspirates from Wilms' tumor, which are mesenchyme predominant, show clusters of spindle cells associated with the matrix material. Evidence of rhabdomyoblastic differentiation may be present. CCSK, classic subtype, is characterized by round to oval cells arranged perivascularly and also in sheets and clusters intimately associated with a metachromatic matrix mucopolysaccharide material better appreciated in May-Grunwald-Giemsa (MGG)-stained smears. The cells also have more abundant cytoplasm and may show nuclear grooves. Spindle-cell pattern of CCSK is difficult to diagnose on aspiration cytology. Renal-cell carcinoma of childhood shows similar cytological features as its adult counterpart. Rhabdoid tumor of the kidney is characterized by a monomorphic population of cells with abundant cytoplasm, eccentric nuclei with prominent nucleoli. Intrarenal yolk sac tumor is a rare neoplasm and shows severely pleomorphic cells on aspiration. Awareness of these entities is important for the practicing cytopathologist. Further, non-Wilms' renal malignant neoplasms must be distinguished from the common Wilms' tumor so that appropriate chemotherapy protocols may be instituted in cases where the tumor is in an advanced stage of malignancy.

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Cytological evaluation of head and neck tumors in children—A pattern analysis

et al. 2006

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A total of 135 pediatric head and neck tumors diagnosed in our institute were reviewed with a view to elucidate the overall cytological patterns and analyze the important cytological features. Ninety-four tumors (69.6%) were aspirated for a primary diagnosis, and in 41 (30.4%) cases, fine-needle aspiration cytology was performed to document relapse, recurrence or a metastasis. Among the 94 tumors aspirated for a primary diagnosis, 66 cases (70.2%) were accurately diagnosed, in 22 cases (23.4%) a broad working diagnosis was offered, and 6 cases (6.4%) were misdiagnosed. The accuracy rate was higher (79.3%) when relapse-recurrent and metastatic tumors were included. The smears were broadly divided into six patterns, viz. round cell, epithelial, anaplastic, giant cell, mixed inflammatory, and spindle cell patterns. The round cell pattern was the most frequent one encountered in this group. The cytological features that stood the test of variability were lymphoglandular bodies and a noncohesive cell population in hematolymphoid malignancies, pale chromatin and cytoplasmic vacuoles in primitive neuroectodermal tumor/Ewing's sarcoma (PNET/ES), neuropil and rosettes in neuroblastoma, and plasmacytoid rhabdomyoblasts in rhabdomyosarcoma. A fairly good accuracy was seen in the diagnosis of metastatic undifferentiated carcinoma and anaplastic lymphoma, but the giant-cell and spindle-cell tumors continued to pose a problem in diagnosis. Ancillary techniques such as immunocytochemistry and electron microscopy applied in limited cases helped evaluate Langerhans cell histiocytosis, alveolar rhabdomyosarcoma, and the PNET/ES family of tumors.

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Comparative Analysis of Electron Microscopy and Immunocytochemistry in the Cytologic Diagnosis of Malignant Small Round Cell Tumors

Cited by 10 publications

References 21 publications

Value of ancillary studies in the evaluation of fine-needle aspiration specimens: Our experience

Value of ancillary studies in the evaluation of fine-needle aspiration specimens: Our experience

Cytopathology of uncommon malignant renal neoplasms in the pediatric age group

Cytological evaluation of head and neck tumors in children—A pattern analysis

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