Electron Microscopy Renders the Diagnostic Capabilities of Cytopathology More Precise: An Approach to Everyday Practice

Turbat‐Herrera, Elba A.; Herrera, Guillermo A.

doi:10.1080/01913120500323415

Cited by 14 publications

(6 citation statements)

References 11 publications

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“…ES/PNET, neuroblastoma, DSRCT, and MRT are categorized as tumors of unknown histogenesis [ 8 , 31 ]. ES and PNET that present primarily in bone and soft tissues have been reported and previously studied as separate entities.…”

Section: Srct Of Unknown Histogenesismentioning

confidence: 99%

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Utility of Transmission Electron Microscopy in Small Round Cell Tumors

Kim

Cho³

2015

J Pathol Transl Med

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Small round cell tumors (SRCTs) are a heterogeneous group of neoplasms composed of small, primitive, and undifferentiated cells sharing similar histology under light microscopy. SRCTs include Ewing sarcoma/peripheral neuroectodermal tumor family tumors, neuroblastoma, desmoplastic SRCT, rhabdomyosarcoma, poorly differentiated round cell synovial sarcoma, mesenchymal chondrosarcoma, small cell osteosarcoma, small cell malignant peripheral nerve sheath tumor, and small cell schwannoma. Non-Hodgkin’s malignant lymphoma, myeloid sarcoma, malignant melanoma, and gastrointestinal stromal tumor may also present as SRCT. The current shift towards immunohistochemistry and cytogenetic molecular techniques for SRCT may be inappropriate because of antigenic overlapping or inconclusive molecular results due to the lack of differentiation of primitive cells and unavailable genetic service or limited moleculocytogenetic experience. Although usage has declined, electron microscopy (EM) remains very useful and shows salient features for the diagnosis of SRCTs. Although EM is not always required, it provides reliability and validity in the diagnosis of SRCT. Here, the ultrastructural characteristics of SRCTs are reviewed and we suggest that EM would be utilized as one of the reliable modalities for the diagnosis of undifferentiated and poorly differentiated SRCTs.

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Section: Srct Of Unknown Histogenesismentioning

confidence: 99%

“…Even with EM studies, some tumors still exhibit unknown lineage of differentiation, especially when the tumor cells are primitive and undifferentiated [ 28 ]. Although new models of digitalized EM have redeemed the time-consuming process and cost-ineffectiveness, EM has become unfamiliar to pathologists [ 12 , 29 - 31 ].…”

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confidence: 99%

Utility of Transmission Electron Microscopy in Small Round Cell Tumors

Kim

Cho³

2015

J Pathol Transl Med

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“…[54][55][56] In most instances, a tiny sample is more than enough for thoroughly characterizing an epithelial renal tumor if the appropriate diagnostic technique/s is/are selected at the time of tumor sampling. The pattern of tumor growth that is so important for surgical pathologists in order to recognize the different varieties of renal epithelial neoplasms may not be readily recognizable in limited samples.…”

Section: Practical Considerations/applicationsmentioning

confidence: 99%

Ancillary Diagnostic Techniques in the Evaluation of Adult Epithelial Renal Neoplasms

Herrera

Turbat‐Herrera

2014

Applied Immunohistochemistry &Amp; Molecular Morphology

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The role played currently by the different ancillary diagnostic techniques in the diagnosis of adult epithelial renal tumors continues to be debated. It has also become clear that in some instances light microscopic appearance alone cannot be used to classify these neoplasms into specific categories with the degree of precision required for therapeutic purposes. Renal cell carcinoma (RCC) subtypes may share common histologic characteristics but exhibit different biological behavior and response to therapy which clearly indicates the crucial role that advanced pathologic speciation plays in the current assessment of these neoplasms. Although immunohistochemistry is widely used for the purpose of categorizing renal tumors because of its widespread availability, the immunoprofiles of the various types of renal neoplasms overlap significantly, making definitive diagnostic determinations difficult and challenging at times. This manuscript will address how ancillary diagnostic techniques can be incorporated into the routine evaluation of neoplastic renal masses to improve classification. Both cytology and surgical specimens will be addressed, as fine needle aspiration (FNA) is being used with preference in many cases in the diagnosis of renal masses. Surgical and cytopathologists must intelligently select the ancillary diagnostic technique/s that will provide the information needed to solve the differential diagnosis under consideration in a given case. However, in some cases >1 of these techniques should be used to make an accurate diagnosis with the aim of arriving at an unequivocal diagnosis. The identification of specific signaling pathways that are defective in certain types of renal neoplasms has made possible the design of target-specific therapies that are directed towards the aberrant pathways associated with the defective proteins found in these tumors. This makes the exact classification of these neoplasms and the detection of these aberrant proteins targeted for treatment an absolute requirement for the application of these molecular-based therapeutic interventions. The role that the pathologic assessment plays in the classification of renal tumors becomes more important than ever to take advantage of this and similar new molecular-oriented therapies.

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“…In this situation, neoplastic cells are usually scanty and pattern recognition is impossible. Immunohistochemistry in fine-needle aspirates may be difficult to interpret, especially if specimens are bloody and/or the number of neoplastic cells available for evaluation is small [35]. Electron microscopy can provide accurate determination of cell type by identifying specific morphological markers, even when only a handful of cells are available in the sample ( Figure 6).…”

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confidence: 98%

Sarcoma and Look-Alikes: The Important Role of Ultrastructural Evaluation

Herrera

Turbat‐Herrera

2008

Ultrastructural Pathology

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Due to the variable light microscopic appearance of sarcomas, a large number of neoplasms may need to be considered in the differential diagnosis in some situations. In difficult cases, the surgical pathologist must approach the differential diagnosis using ancillary diagnostic techniques and should do so in an orderly fashion, recognizing that arriving at the correct diagnosis is without a doubt the most important goal. It is also imperative to take into account the expense and time that may be involved in arriving to the definitive diagnosis, which could influence how the workup is conducted. Therefore, the most reasonable route to address the differential diagnosis in order to make a final solid diagnostic assessment should be taken. Whether immunohistochemistry, electron microscopy, cytogenetics, and/or molecular diagnostics should be employed in a given case becomes the dilemma. In some instances a combination of the above-mentioned techniques is important not only to obtain an unequivocal diagnosis, but also to provide important additional information regarding prognosis and to facilitate the patient's management.

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Electron Microscopy Renders the Diagnostic Capabilities of Cytopathology More Precise: An Approach to Everyday Practice

Cited by 14 publications

References 11 publications

Utility of Transmission Electron Microscopy in Small Round Cell Tumors

Utility of Transmission Electron Microscopy in Small Round Cell Tumors

Ancillary Diagnostic Techniques in the Evaluation of Adult Epithelial Renal Neoplasms

Sarcoma and Look-Alikes: The Important Role of Ultrastructural Evaluation

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