Intraoperative fine needle aspirations - diagnosis and typing of lung cancer in small biopsies: challenges and limitations

Biancosino, Christian; Krüger, M.; Vollmer, Ekkehard; Welker, Lutz

doi:10.1186/s13000-016-0510-6

Cited by 21 publications

(21 citation statements)

References 25 publications

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“…In a previous cytological study, carcinoid and neuroendocrine cancer were diagnosed based on morphology and immunocytochemical analysis (17). In examinations that involve a comparison of the intraoperative cytologic diagnosis in small specimen with final histologic diagnosis of the resected specimen, the cytodiagnostic sensitivity and specificity are 86.7 and 98.7% respectively to diagnose pulmonary neuroendocrine tumor (18). As carcinoid tumors of the middle ear exhibit the same histopathological and morphological characteristics exhibited in pulmonary neuroendocrine tumors, FNAC with immunocytochemical analysis is a reliable examination for patients with carcinoid tumor of the middle ear.…”

Section: Discussionmentioning

confidence: 99%

Significance of cytodiagnosis in primary carcinoid tumor of the middle ear: A case report

et al. 2018

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Primary carcinoid tumors of the middle ear are uncommon. Cytodiagnosis of the middle ear is not usually performed as a preoperative examination because of the anatomical structure of the middle ear. To the best of our knowledge, the present study reports for the first time a case of a carcinoid tumor of the middle ear, which was preoperatively diagnosed using cytodiagnosis, and also review current literature. A 22-year-old woman complained of left-sided otalgia. A subcutaneous tumor in the left middle ear was observed. Magnetic resonance imaging revealed that the tumor was primarily present in the tympanic cavity of the middle ear and extended to the mastoid antrum and mastoid cells of the middle ear and to the external acoustic meatus. Fine needle aspiration cytology was performed from the tumor protruding into the external acoustic meatus. Cytologically, the tumor was composed of small uniform cells with small round nuclei and granular eosinophilic cytoplasm, arranged in a nested pattern. Tumor cells were immunocytochemically positive for synaptophysin and cytokeratin CAM5.2. These results indicated that this was a neuroendocrine tumor. No other tumor lesions were identified on computed tomography scans, and the tumor was considered to be the primary lesion. Tympanoplasty and mastidectomy were then performed and carcinoid tumor was diagnosed in the postoperative pathological diagnosis. To the best of our knowledge, the present study is the first to report on preoperative cytodiagnosis for carcinoid tumors of the middle ear.

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Section: Discussionmentioning

confidence: 99%

Significance of cytodiagnosis in primary carcinoid tumor of the middle ear: A case report

et al. 2018

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“…The concordance rate for the screening process was 96.5%. Seventeen studies [21-37] were included after full text review of the 34 potentially relevant studies. This set of studies included 2,235 cases.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic Accuracy of Fine-Needle Aspiration Cytology for Discrimination of Squamous Cell Carcinoma from Adenocarcinoma in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

et al. 2018

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Objective: To determine the accuracy with which morphology alone can distinguish adenocarcinoma and squamous cell carcinoma in non-small cell lung cancer. Methods: We performed a systematic review and meta-analysis. Three data bases (MEDLINE, EMBASE, Scopus) were searched for studies on the diagnostic accuracy of subtyping non-small cell lung cancer. Accuracy data was abstracted and synthesized using bivariate mixed effects logistic regression as implemented in the midas package in Stata 14. Heterogeneity was assessed using the Higgins I². Results: We included 17 studies (2,235 cases). Most studies had a low risk of bias. The pooled diagnostic accuracy for cytological diagnosis of adenocarcinoma resulted in a sensitivity of 63% (48–76%) and specificity of 95% (87–98%). The I² values were 93 and 88% for sensitivity and specificity, respectively. The pooled diagnostic accuracy for the cytological diagnosis of squamous cell carcinoma resulted in a sensitivity of 84% (79–88%) and a specificity of 90% (84–94%). The I² values were 69 and 86% for sensitivity and specificity, respectively. Conclusion: Accuracy varies widely by study and summary estimates do not provide a useful representation of accuracy. Squamous cell carcinoma was diagnosed more accurately than adenocarcinoma.

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“…However, in a substantial proportion of problem cases, particularly in small biopsy specimens or poorly differentiated tumors, standard morphology alone is insufficient to appropriately classify the subtypes and warrants further histopathological characterization. Thus, distinguishing cancer subtypes can often present a formidable challenge to the pathologist (9)(10)(11)(12).…”

Section: Original Articlementioning

confidence: 99%

Thymidylate synthase (TS) immunostaining in the diagnosis of the myoepithelial cells, basal cells, stratified epithelium cells, and associated tumors

Guo¹,

Tian²,

Zhang³

et al. 2020

Transl Cancer Res TCR

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Background: Thymidylate synthase (TS) is an important prognostic biomarker for resistance to 5FUbased adjuvant chemotherapy. Recently, we found that TS was specifically expressed in the nucleus of the myoepithelial cell (MEC), basal cell (BC), transitional epithelial cell (TEC), squamous epithelial cell (SEC), and associated tumor using immunostaining. This prompted us to examine whether TS could be used as a diagnostic biomarker for MEC, BC, TEC, SEC, and associated tumors. Methods: Formalin-fixed, paraffin-embedded specimens from 186 cases of tumors were immunostaining for expression of TS and p63. The diagnostic capability of TS as a reliable diagnostic marker was evaluated and compared with the expression of p63.Results: TS exhibited a strong specific and stable nuclear immunoreactivity in all specimens including MEC, BC, TEC, and SEC when compared with p63. Notably, a variable degree of TS cytoplasmic positive immunoreactivity was observed in 58.3% of squamous-cell carcinoma (SQCC), 37.5% of basal cell carcinoma (BCC), 44.4% transitional-cell carcinomas (TCC), 41.7% mixed tumor (MT) and 56.5% of adenocarcinoma (ADC) specimens. Conclusions:In addition to being used as a strong prognostic factor for 5-FU resistance, TS also serves as a promising putative diagnostic marker for identifying MEC, BC, SEC, and TEC from GEC, and for distinguishing SQCC, BCC, TCC, and MT from ADC.

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Intraoperative fine needle aspirations - diagnosis and typing of lung cancer in small biopsies: challenges and limitations

Cited by 21 publications

References 25 publications

Significance of cytodiagnosis in primary carcinoid tumor of the middle ear: A case report

Significance of cytodiagnosis in primary carcinoid tumor of the middle ear: A case report

Diagnostic Accuracy of Fine-Needle Aspiration Cytology for Discrimination of Squamous Cell Carcinoma from Adenocarcinoma in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis

Thymidylate synthase (TS) immunostaining in the diagnosis of the myoepithelial cells, basal cells, stratified epithelium cells, and associated tumors

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