The application of immunocytochemistry to direct smears in the diagnosis of effusions

Metastatic malignancy represents a common cause of effusions. Immunocytochemistry (ICC) is useful in confirming malignancy and gaining insight into the site of origin. Cell blocks are commonly utilized for this purpose; nonetheless, when the malignant cells are sparse, they may not be represented in cell blocks thereby precluding immunophenotypic characterization. Thus, we sought to investigate the utility of direct smear preparations as a platform for ICC in the diagnosis of effusions. Air‐dried, unstained direct smears were prepared from 49 malignant effusions and 17 reactive effusions for comparison. ICC for EMA and MOC‐31 highlighted the tumor cells in 91 and 98% of the malignant effusions tested, respectively. EMA immunoreactivity was focally observed within the calretinin‐positive mesothelial cell population in 1 (6%) of the 17 reactive effusions. ICC for MOC‐31 was negative in all reactive effusions. Site‐specific immunomarkers were also evaluated. Immunoreactivity for Napsin‐A and TTF‐1 were observed in 78 and 67% of metastatic lung adenocarcinomas, respectively. ICC for PAX8 highlighted metastatic Müllerian and thyroid carcinomas in 100% of cases tested. CDX‐2 immunoreactivity was observed in 25, 60, and 100% of metastatic gastric, pancreatic, and colorectal adenocarcinomas, respectively. Positivity for p63 was observed in 75% of metastatic urothelial cell carcinomas and the one case of pulmonary squamous cell carcinoma examined. Calretinin ICC highlighted the tumor cells in both malignant mesothelioma cases tested as well as the benign mesothelial cells in the reactive effusions. In conclusion, direct smears represent an effective platform for the performance of ICC in the diagnosis of malignant effusions. Diagn. Cytopathol. 2013. © 2012 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97537/1/22852_ftp.pd

The use of stained cytologic direct smears for ALK gene rearrangement analysis of lung adenocarcinoma

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100150/1/cncy21286.pd

The application of immunocytochemistry to cytologic direct smears of metastatic merkel cell carcinoma

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99093/1/dc22807.pd

p63, CK7, PAX8 and INI‐1: an optimal immunohistochemical panel to distinguish poorly differentiated urothelial cell carcinoma from high‐grade tumours of the renal collecting system

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90230/1/j.1365-2559.2011.04093.x.pd

California\u27s Suppression Statute-An Examination of Renal Code #1538.5

California Penal Code section 1538.5 codifies the motion to suppress evidence. This Article examines the practical application of Penal Code section 1538.5, including a discussion on the scope of coverage, the procedure at the hearing, and appellate review. The scope of Penal Code section 1538.5 is contentious. There is much concern regarding the grounds on which challenges to search, seizure, and admissibility of confessions can be made. However, one thing is clear: Penal Code section 1538.5 can be invoked in both felony and misdemeanor cases. In both cases, the superior court can review rulings on motions to suppress evidence de novo in a special hearing. In addition, appellate review is available. In misdemeanor cases, both sides can request review of an adverse ruling, whereas only a defendant can appeal an adverse ruling in felony cases. In felony and misdemeanor cases, the appellate court must review the facts in the light most favorable to the prevailing party using a substantial evidence test. This Article concludes by assessing changes to and the success of the statute

Application of immunocytochemistry and BRAF mutational analysis to direct smears of metastatic melanoma

BACKGROUND: The cytodiagnosis of melanoma in fine‐needle aspiration (FNA) specimens can be challenging, often requiring the use of immunocytochemistry. As constitutively activating mutations in the BRAF oncogene are present in at least 40% of melanomas, the use of FNA material to interrogate the BRAF mutational status is likely to increase. Because cell blocks, traditionally used for these studies, can occasionally exhibit insufficient tumor cellularity, the authors investigated the utility of direct smears for immunocytochemistry and BRAF mutational analysis. METHODS: Immunocytochemistry for S‐100, HMB‐45, and Mart‐1 was prospectively performed on direct smears in 17 FNAs of metastatic melanoma. Next, BRAF sequencing was performed using DNA isolated from archived Diff‐Quik–stained direct smears for 15 cases. In parallel, sequencing was performed using DNA obtained from corresponding cell blocks. RESULTS: S‐100 positivity in the tumor cells was observed in all 17 cases. HMB‐45 and Mart‐1 positivity was noted in 81% and 88% of cases, respectively. All 3 markers were positive in 76% of cases. Next, of the 15 archived melanoma FNAs tested, BRAF mutations were observed in 8 (53%); 5 and 3 melanomas harbored the V600E and V600K mutation, respectively. Corresponding cell blocks were also tested for all 15 cases, yielding concordant BRAF results in 14 (93%); 1 cell block yielded a false‐negative result. CONCLUSIONS: Cytologic direct smears represent a robust and valuable source of cellular material for immunocytochemistry and molecular studies, especially in instances in which inadequate cell block cellularity is anticipated or encountered. Cancer (Cancer Cytopathol) 2012. © 2011 American Cancer Society. This study demonstrates that direct smears represent a robust and valuable source of cellular material for ancillary studies used in the cytologic diagnosis of melanoma. Direct smears can be effectively used for confirmatory immunocytochemical studies and molecular assays designed to interrogate the BRAF mutational status of melanoma, especially in scenarios in which inadequate cell block cellularity is anticipated or encountered.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90193/1/20180_ftp.pd

Occult fallopian tube carcinoma detected in routine pelvic washing specimens submitted for staging: Another justification for pelvic washing cytology?

Peritoneal washing cytology is important in the staging, prognosis, and treatment schema for women diagnosed with gynecologic malignancies. Additionally, peritoneal washings are often performed before the specific diagnosis or even the distinction between benign or malignant lesion is known. Occasionally, the cytology and surgical pathology specimens, although obtained during the same procedure, will show unexpected and/or discordant findings. Perhaps, the greatest dilemma occurs when atypical cells suggestive of malignancy are identified in peritoneal washing specimens when a corresponding benign or discordantly low grade malignant diagnosis is made in the surgical pathology specimen. We present two such cases in which further investigation proved extremely valuable, not only leading to resolution of initially discrepant cytologic and surgical pathology findings but also in the process leading to second diagnoses of early fallopian tube carcinoma. Increasing evidence appears to be pointing to the fallopian tube as the site of origin of many serous carcinomas previously thought to be of primary pelvic or ovarian origin. These cases further confirm the utility of peritoneal washing cytology as a diagnostic modality when routine gross examination and sampling of the surgical specimens alone would have failed to provide the complete diagnosis. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64442/1/21129_ftp.pd

Wildland fire in ecosystems: Effects of fire on soil and water

This state-of-knowledge review about the effects of fire on soils and water can assist land and fire managers with information on the physical, chemical, and biological effects of fire needed to successfully conduct ecosystem management, and effectively inform others about the role and impacts of wildland fire. Chapter topics include the soil resource, soil physical properties and fire, soil chemistry effects, soil biology responses, the hydrologic cycle and water resources, water quality, aquatic biology, fire effectson wetland and riparian systems, fire effects models, and watershed rehabilitation

In the Race to Reach New Wine Drinkers Old World Taste is Losing Out

But this old world is losing its grip on the wine industry. French wine production and consumption are falling while the New World of wine is gaining ground in both areas. Experts say that new wine making techniques and higher consumption in New World markets like the United States have changed the French wine industry. For the French, more than just their wine industry is at stake. For many, the loss of French wine is a loss of French identity. “They can\u27t choose between the two. Because French people - we are wine and cheese - we are everything,” said Melyssa Rose, a French Jazz singer in NYC

Utility of PAX8 and PAX2 immunohistochemistry in the identification of renal cell carcinoma in diagnostic cytology

The diagnosis of metastatic renal cell carcinoma (RCC) in cytology specimens may be difficult to confirm on the basis of cytomorphology alone. Often, immunohistochemistry serves as an important adjunct in confirming this diagnosis. Recently, PAX2 was shown to be useful in this regard. In this study, we sought to compare the utility of PAX8 to that of PAX2 immunohistochemistry in the diagnosis of RCC in cytology specimens. First, we verified the performance of PAX8 immunohistochemistry on a tissue microarray (TMA) composed of 54 cases of RCC; PAX8 immunoreactivity was seen in at least 10% of the tumor cells in all cases. Next, we applied PAX8 immunohistochemistry to cell block sections prepared from 24 cases of RCC, obtained from fine‐needle aspirates and effusion specimens. PAX2 immunohistochemistry was performed for comparison. Immunopositivity was defined as the presence of nuclear staining in at least 10% of tumor cell nuclei. Immunoreactivity for PAX8 and PAX2 was seen in 21 (88%) and 20 (83%) of the 24 cases, respectively. The presence of either PAX8 or PAX2 immunostaining was present in 22 of 24 cases, thus showing a total sensitivity of 92%. Overall, the results indicate that PAX8 and PAX2 are diagnostically useful adjuncts in confirming the diagnosis of RCC in cytology specimens. Diagn. Cytopathol. 2012. © 2010 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92391/1/21590_ftp.pd