The pathology of familial breast cancer: Immunohistochemistry and molecular analysis

Extensive studies of BRCA1- and BRCA2-associated breast tumours have been carried out in the few years since the identification of these familial breast cancer predisposing genes. The morphological studies suggest that BRCA1 tumours differ from BRCA2 tumours and from sporadic breast cancers. Recent progress in immunohistochemistry and molecular biology techniques has enabled in-depth investigation of molecular pathology of these tumours. Studies to date have investigated issues such as steroid hormone receptor expression, mutation status of tumour suppressor genes TP53 and c-erbB2, and expression profiles of cell cycle proteins p21, p27 and cyclin D(1). Despite relative paucity of data, strong evidence of unique biological characteristics of BRCA1-associated breast cancer is accumulating. BRCA1-associated tumours appear to show an increased frequency of TP53 mutations, frequent p53 protein stabilization and absence of imunoreactivity for steroid hormone receptors. Further studies of larger number of samples of both BRCA1- and BRCA2-associated tumours are necessary to clarify and confirm these observations

Repeat processing of residual ThinPrep pap tests: Sampling of the vial may not be invariably homogeneous

Objective: To re-evaluate the reproducibility of additional slides prepared from residual cervical ThinPrep (TP) samples. Study Design: Sixty paired specimens (conventional smears and direct-to-vial TP) were studied. Up to 10 additional slides were prepared from each TP vial. All slides were reviewed for adequacy of material, presence of abnormal cells and presence of normal flora or other pathogens. The additional TP slides were further evaluated for the presence of diagnostic elements which were not found on the conventional smear and primary TP slide. Results: Abnormal cells found on the primary TP slide were also identified on all additional slides in 48/50 cases (96%) with squamous cell lesions. The distribution of material on TP slides was evaluated as homogenous in 51 cases (85%) and as non-homogenous in 9 (15%). Using the primary slides (conventional smear and TP) as a reference, additional diagnostic cells upgrading the cytologic diagnosis were found on the repeat slides in 7 cases (11.7%) and fungi consistent with Candida in 3 (5%). Conclusion: Repeat processing of residual cervical TP samples may not be an invariably reproducible procedure and the first slide may not be necessarily representative of the specimen as a whole. Nevertheless, both primary and repeat TP slides seem to be extremely effective in detecting a lesion (regardless of grade) in abnormal cases. The exact impact of non-homogeneous sampling of the vial on the diagnostic accuracy of the TP method should be further investigated. Copyright © 2011 S. Karger AG, Basel

p53 protein expression in benign and malignant breast lesions

OBJECTIVE: To investigate p53 protein expression in imprints from benign and ductal breast carcinoma cases in relation to the histologic grade of malignancy and clinical stage. STUDY DESIGN: The study group consisted of 60 cases of primary ductal breast carcinomas and 20 benign lesions. For the demonstration of p53 ;protein expression, an immunocytochemical avidinextravidin complex technique was applied. Monoclonal antibody p53 was used as the primary antibody, diaminobenzidine as the chromogen and hematoxylin as the counterstain. RESULTS: Forty-five percent of breast cancer cases showed positive expression of p53. A statistically significant difference in p53 protein expression was observed between grade 1, 2 and 3 carcinomas and stage I, II and III cases. All benign lesions were native for p53 protein expression. CONCLUSION: Immunocytochemical p53 protein expression in cytologic material is a simple method that can be applied in routine cytologic laboratories for the identification of genetic alterations in primary ductal breast cancer

p53 protein expression and DNA ploidy in common epithelial tumors of the ovary

OBJECTIVE: To investigate p53 protein expression and DNA content in imprints from surgical biopsies of common epithelial tumors of the ovary. STUDY DESIGN: The study was based on 60 cases of epithelial tumors of the ovary (15 benign, 3 borderline and 42 malignant). For the demonstration of p53 protein, immunocytochemical staining with the avidin-extravidin technique was performed using monoclonal antibody p53 DO-7. DNA content was measured by image cytometry after Feulgen staining. RESULTS: There was a strong correlation between p53 expression and aneuploidy, with the difference between diploid and aneuploid tumors statistically significant (P < .001). A correlation was found between DNA ploidy, histologic grade and clinical stage (P < .001 and P < .05), respectively. There was no correlation between DNA ploidy and histologic type (P=.89). No correlation was observed between p53 protein expression and grade or clinical stage of the tumors. Nevertheless, a correlation of p53 expression between early (I, II) and advanced stages (III, IV) (P < .05) was observed. All benign and borderline tumors were diploid and did not express p53 protein. CONCLUSION: The results of the present study and the data in the literature stress the value of p53 expression and DNA ploidy in assessing the malignant potential of common epithelial ovarian cancers. However, the clinical application of these data requires further study. © 1997 The International Academy of Cytology Acta Cytologica

Strongyloides stercoralis in a bronchial washing specimen processed as conventional and thin-prep smears: Report of a case and a review of the literature

Strongyloidiasis is an opportunistic infection which may result in a fatal hyperinfection syndrome in immunocompromised patients. We report the case of a pulmonary infection with Strongyloides stercoralis in a 61-year-old male with a history of a long-term administration of corticosteroids. Cytologic examination of a bronchial washing specimen, processed both as conventional and as Thin-Prep smears, revealed an abundance of the typical larvae of Strongyloides stercoralis, amidst a cellular population comprising several acute inflammatory cells as well as bronchial epithelial cells with features of basal cell hyperplasia or regenerative atypia. To the best of our knowledge there is only one previous report describing Strongyloides stercoralis in thin-layer smears, and there are no previous studies comparing its morphology in conventional and thin-layer preparations. © 2009 Wiley-Liss, Inc

A comparative study of three variations of the learning vector quantizer in the discrimination of benign from malignant gastric cells

A prospective study was undertaken to investigate the potential value of morphometry and artificial neural networks (ANN) for the discrimination of benign and malignant gastric lesions. Two thousand five hundred cells from 23 cases of cancer, 19 cases of gastritis and 58 cases of ulcer were selected as a training set, and an additional 8524 cells from an equal number of cases of cancer, gastritis and ulcer were used as a test set. Images of routine processed gastric smears stained by the Papanicolaou technique were processed by a custom image analysis system. The application of the learning vector quantization (LVQ) classifier enabled correct classification of > 97% of benign cells and > 95% of malignant cells, obtaining an overall accuracy of > 97%. This study presents the capabilities of ANN, and also indicates that ANN and image morphometry may offer useful information on the potential of malignancy in gastric cells

Additional slides from residual ThinPrep Pap tests: Of potential diagnostic benefit in equivocal cases?

The aim of this study was to further evaluate the diagnostic significance of additional slides prepared from residual ThinPrep (TP) Pap Tests. Up to 10 repeat slides were prepared from 105 residual TP cervical samples. All additional slides were evaluated for the presence of diagnostic elements which were not found on the primary TP slide. After the evaluation of the repeat slides, an upgraded diagnosis was noted in 15 cases (14.3%). The reclassified cases included: three negative cases reclassified as two ASC-US and as one LSIL, seven cases of ASC-US reclassified as six LSIL and as one HSIL, and five cases of LSIL reclassified as HSIL. The highest rate (7/15 cases, 46.7%) of cases with an upgraded diagnosis was noted in the ASC-US diagnostic category. Our results suggest that repeat processing of residual TP cervical samples may represent an adjunctive diagnostic tool for a more accurate classification of ASC-US cases. Nevertheless, the practical value of this approach seems to be limited by its significant cost and its uncertain effectiveness. Diagn. Cytopathol. 2012. © 2011 Wiley Periodicals, Inc

Changes of chromosomes 1, 3, 6, and 11 in metastatic effusions arising from breast and ovarian cancer

This cytogenetic study deals with cell material obtained from 15 pleural fluids from 11 patients with breast cancer and 27 ascitic fluids from 16 patients with ovarian cancer; in addition, 8 pleural, 5 ascitic, and 1 pericardial fluid from patients with tuberculosis, liver cirrhosis, and heart insufficiency,were studied. Using mainly direct methods, as well as short-term cell cultures, the chromosome spreads were GTG-banded. Cancerous biopsies showed a plethora of numerical and structural chromosome anomalies and exhibited broad aneuploidy. Chromosomes participating more often in numerical and structural aberrations were 1,3,6,7, gi 9, 11, 12, and 17. This study provides further cytogenetic evidence for the involvement of these chromosomes in breast and ovarian malignancy. (C) Elsevier Science Inc., 1999. All rights reserved

Ascitic fluid cytology of yolk sac tumor of the ovary: A case report

Background: Yolk sac tumor (YST) of the ovary is a rare neoplasm typically affecting children and young women. We describe the cytomorphology of this tumor in ascitic fluid and discuss its differential diagnosis from other neoplasms. Case: Smear preparations of the ascitic fluid showed a predominance of clusters of malignant cells with vacuolated cytoplasm, mimicking a mucinous adenocarcinoma, and fewer syncytial-like and glandular structures. Hyaline globules were extremely rare. lmmunocytochemistry was positive for α-fetoprotein. Conclusion: The diagnosis of YST in ascitic fluid specimens may be challenging and requires the use of immunocytochemistry and the correlation of cytology with the remaining clinical and laboratory data. © The International Academy of Cytology