Hepatocyte paraffin 1 immunoexpression in esophageal brush samples

Abstract

Recently, Faquin et al. 1 brought to your readers' attention the presence of atypical cells in aspirates of cystic lesions of the thyroid gland. We believe these cells can be diagnosed more specifically as squamous metaplastic cells, as we have reported. 2Pathologists are familiar with the appearance of squamous metaplastic cells in cervicovaginal smears stained by the Papanicolaou method. However, many pathologists are not acquainted with squamous metaplastic cells in smears from thyroid aspirates. Because of the large size of these cells (compared with normal follicular cells), the variation in nuclear size and shape, and the visible nucleoli, they may be misinterpreted as malignant. Pathologists should be aware of this common alteration (16% of our thyroidal aspirates show some degree of it) to avoid misinterpreting these cells as atypical or malignant.Why are squamous metaplastic cells detected more easily in cytologic smears than in tissue sections? We offered an analogy with an onion and illustrated it.2 The tissue section is comparable to a cross section of an onion in which the layers or rings are evident but not the delicate membranes that separate these layers. If a part of this membrane is detached and spread flat on a surface, then it is easier to identify than in the cross section. This is comparable to the sheets of squamous metaplastic cells seen in the smears from thyroidal aspirates. We would like to remind the reader of mesothelial cells. The sheets of mesothelial cells are seen easily in smears from pleural effusions or from ascitic fluid. In tissue sections, the thin layer of pleura or the thin peritoneal lining is difficult to identify.We reiterate our conclusions from that publication: 1) Squamous metaplastic cells are a frequent finding in smears from fine-needle aspirations of cystic lesions of the thyroid. 2) Squamous metaplastic cells can be identified more easily in cytologic smears than in tissue sections. 3) Squamous metaplastic cells may be diagnosed erroneously as "atypical" or "malignant" by the inexperienced cytopathologist.

Video-endoscopy for evaluation of columnar lined esophagus in patients with gastroesophageal reflux disease

“…In addition, video-endoscopy may be a useful tool for teaching, education and telemedicine (telepathology, teleendoscopy) [31]. Future studies will have to evaluate the impact of video-endoscopy for surveillance of patients with Barrett esophagus [30][31][32][33]. Finally, video-endoscopy may be applied to investigate important morphologic issues related to Barrett esophagus (i.e.…”

Hepatocyte Paraffin 1 Immunoreactivity in Early Colon Carcinogenesis

“…Conflicting results have recently been reported on colorectal cancer: Hep par 1 positive cells were found respectively in 4% [14] and in 50% of large bowel carcinomas [17], in 22% of colon signet-ring cell carcinoma [12], and in 2% of colon adenomas with high grade dysplasia. In Barrett esophagus, Hep par 1 was found in a large percentage of cases, leading to suggest it a highly specific immunomarker [18]. Hep par 1 immunoreactivity, normally present in the small intestinal epithelial cells, was found to be absent in a large number of small intestinal adenocarcinomas, suggesting a functional role for the disappearance of this protein during small intestinal tumorigenesis [19].…”