scholarly journals Predictive Evaluation on Cytological Sample of Metastatic Melanoma: The Role of BRAF Immunocytochemistry in the Molecular Era

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1110
Author(s):  
Andrea Ronchi ◽  
Marco Montella ◽  
Federica Zito Marino ◽  
Michele Caraglia ◽  
Anna Grimaldi ◽  
...  

Background: Cutaneous malignant melanoma is an aggressive neoplasm. In advanced cases, the therapeutic choice depends on the mutational status of BRAF. Fine needle aspiration cytology (FNA) is often applied to the management of patients affected by melanoma, mainly for the diagnosis of metastases. The evaluation of BRAF mutational status by sequencing technique on cytological samples may be inconvenient, as it is a time and biomaterial-consuming technique. Recently, BRAF immunocytochemistry (ICC) was applied for the evaluation of BRAF V600E mutational status. Although it may be useful mainly in cytological samples, data about BRAF ICC on cytological samples are missing. Methods: We performed BRAF ICC on a series of 50 FNA samples of metastatic melanoma. BRAF molecular analysis was performed on the same cytological samples or on the corresponding histological samples. Molecular analysis was considered the gold standard. Results: BRAF ICC results were adequate in 49 out of 50 (98%) cases, positive in 15 out of 50 (30%) cases and negative in 34 out of 50 (68%) of cases. Overall, BRAF ICC sensitivity, specificity, positive predictive value and negative predictive value results were 88.2%, 100%, 100% and 94.1%, respectively. The diagnostic performance of BRAF ICC results was perfect when molecular evaluation was performed on the same cytological samples. Hyperpigmentation represents the main limitation of the technique. Conclusions: BRAF ICC is a rapid, cost-effective method for detecting BRAF V600E mutation in melanoma metastases, applicable with high diagnostic performance to cytological samples. It could represent the first step to evaluate BRAF mutational status in cytological samples, mainly in poorly cellular cases.

Author(s):  
Prashant S. Mane ◽  
Aparna M. Kulkarni ◽  
Ravindra V. Ramteke

Background: Breast cancer is the most common cancer in women worldwide. Fine needle aspiration cytology is a cost effective, easy procedure in the diagnosis of breast lump.Methods: This was a one year retrospective study between January 2016 and December 2016. Needle aspiration was done in 100 patients presenting with breast lump. Histopathology correlation was done in 33 cases.Results: Fibroadenoma were most common lesions. Malignancy was reported in 13 cases. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were found to be 85%, 100%, 100%, 96.3% and 97% respectively.Conclusions: Fine needle aspiration cytology is a simple, easy, OPD based, cost effective procedure with high sensitivity, specificity and accuracy in diagnosis of breast lumps.


2018 ◽  
Vol 90 (5) ◽  
pp. 1-5 ◽  
Author(s):  
Ewa Machała ◽  
Jan Sopiński ◽  
Iulia Iavorska ◽  
Krzysztof Kołomecki

ABSTRACT Fine needle aspiration cytology (FNAC) is considered as the gold standard diagnostic test for the diagnosis of thyroid nodules. It is a cost-effective procedure that provides specific diagnosis rapidly with minimal complications. It plays an important role in the determination of treatment- patients with suspected malignancy diagnosis can be subjected to surgery. On the other hand it can decrease the rate of unnecessary surgeries. Aims: The aim of this study was to evaluate and compare the correlation, accuracy of fine needle aspirational cytology (FNAC) in the diagnosis of thyroid lesions with the final histopathologic diagnosis in the surgical specimens. Materials and Methods: In our study we have performed a retrospective analysis of a case series of patients who were admitted to the Department of Endocrine, General and Oncological Surgery of Hospital of M. Kopernik in Łodź (Poland) between May 2016 and December 2017 and underwent FNAC with subsequent surgery. Cytological diagnosis was classified into six Bethesda categories. Results: On cytological examination 1070/1262 were reported as benign, 49 malignant and 143 suspicious. On histopathological examination, 956/1070 cases were confirmed as benign but there were 114 discordant cases. Among the other cases histopathology diagnosis of malignancy matched in 45/49 and 128/143 cases.The sensitivity and specificity were 60,28% and 98,05% respectively. False positive rate was 1.95% and false negative rate was 39.72%. The positive predictive value was 90.1% and negative predictive value was 89.35%. Accuracy of FNA in differentiating benign from malignant thyroid lesions was 89,46%. Conclusions: Fine needle aspiration cytology is a simple, cost-effective and popular procedure for the diagnosis of thyroid cancer. It is recommended as the first line investigation for the diagnosis of thyroid lessions.


2020 ◽  
Vol 7 (7) ◽  
pp. 2325
Author(s):  
Arnab Mandal ◽  
Pradipta Jana ◽  
Sabyasachi Bakshi ◽  
Ram Krishna Mandal

Background: Early presentation and prompt diagnosis is the essential key in treatment of different variety of neoplastic as well as non-neoplastic breast disease. In this study usefulness of high-resolution ultrasonography (HRUSG), mammography, fine needle aspiration cytology (FNAC) and core needle biopsy in correlation with histopathological pattern, was assessed.Methods: After matching the criteria, 212 cases, were taken for this prospective, single center, observational study.Results: Out of 212 cases, 163 (76.88%) were benign lesions, 49 (23.11%) were malignant and 1 (0.47%) were of inflammatory pathology. Benign to malignant breast disease ratio was 3.3:1. Out of 49 malignant cases, 45 (91.83%) were ductal cell carcinoma and 4 (8.16%) was apocrine carcinoma. Maximum numbers of cancer patients were found in the 51-60-year age groups. The sensitivity, specificity, positive predictive value and negative predictive value of mammography in detecting carcinoma breast were 87.76%, 64.71%, 87.76% and 64.71% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of HRUSG in detecting carcinoma breast were 85.71%, 90.18%, 72.41% and 95.45% respectively. Among benign lesions, 47 (28.83%) were diagnosed by mammography and 147 (90.18%) were diagnosed by HRUSG. When these modalities were combined, >95% of the lesions was diagnosed accurately.Conclusions: Ultra sound used liberally as an adjunct to mammography, increase the cancer detection rate. Core needle biopsy is found more accurate but FNAC have limited value in evaluation of benign breast lump. This study also proves that preoperative categorization of breast lesions is utmost important for management of the patient and this will help to avoid unnecessary surgical treatment.


2016 ◽  
Vol 22 (3) ◽  
pp. 67
Author(s):  
B Sonnekus ◽  
J Steenkamp ◽  
M Louw ◽  
C F N Koegelenberg

<p>Background. Transbronchial needle aspiration (TBNA) is a minimally invasive bronchoscopic technique that is cost-effective and safe for diagnosing mediastinal and hilar adenopathy in lung cancer, other malignancies, sarcoidosis and infectious processes such as tuberculosis. Few studies have analysed the sensitivity, specificity and predictive values of TBNA for diagnosing lymphoma.</p><p>Objective. To evaluate the diagnostic yield of TBNA for diagnosing mediastinal and hilar adenopathy in suspected lymphoma.</p><p>Methods. We performed a retrospective analysis of collected data of patients with mediastinal and hilar adenopathy adjacent to the tracheobronchial tree detected by thoracic computed tomography, who underwent TBNA at Tygerberg Hospital between July 2010 and June 2013. We included 25 patients with suspected or proven lymphoma. Histology was used as the gold standard.</p><p>Results. Adequate samples for cytological evaluation were obtained for 22 (88%) patients. Cytological diagnosis was possible for 8 (32%). For 17 (68%) who could not be diagnosed by TBNA alone, histology provided final diagnosis. Rapid on-site examination (ROSE) was performed in 23 (92%). In 17/23 (74%) cases, these had similar results to formal cytology. Only 4 (16%) had flow cytometry requested. Twelve (48%) had lymphoma confirmed on histology. TBNA cytology had 100% specificity and positive predictive value for suspicion of lymphoma. Sensitivity was 33% and negative predictive value 62%.</p><p>Conclusion. TBNA is an appropriate first-line diagnostic procedure in evaluating mediastinal and hilar lymphadenopathy in suspected lymphoma. Biopsy should be the immediate second-line procedure when ROSE/cytology is suspicious of lymphoma or shows atypical cells. Patients with negative TBNA cytology, but high clinical or radiological suspicion of lymphoma, should be further investigated.</p>


2019 ◽  
Vol 6 (11) ◽  
pp. 3955 ◽  
Author(s):  
Shilpa M. Shetty ◽  
Kusuma K. N.

Background: Fine needle aspiration cytology (FNAC) is being widely used for pre-operative diagnosis of salivary gland lesions. It is a simple, cost effective and safe procedure that provides valuable information for planning appropriate management. The aim was to study cytohistopathological correlation of salivary gland lesions; to examine sensitivity, specificity and diagnostic accuracy of fine needle aspiration cytology of salivary gland lesions.Methods: A 4 year 8 months study was conducted from January 2015 to August 2019. Salivary gland lesion FNAC performed in the Department of Pathology, SIMS, Shimoga who were followed up with corresponding biopsy specimen were included in the study.Results: Total of 42 cases was included in the study. Pleomorphic adenoma was the commonest lesion encountered. The overall sensitivity, specificity, diagnostic accuracy, positive predictive value and negative predictive value was 50%, 97.22%, 90.47%, 75% and 92.10%. Diagnostic pit falls occurred because of sampling error and overlapping morphological features.Conclusions: Fine needle aspiration (FNA) though poses diagnostic dilemma in some cases, it still forms an easy and less invasive procedure that can assess therapeutic management of salivary gland lesions.


Author(s):  
Nandinee Lahkar ◽  
Manoj Kumar Deka ◽  
Nitu Mani Khakhlari

Background: Annual incidence of thyroid nodules ranges from 40,000 to 70,000 per 1 lac population worldwide. Fine Needle Aspiration (FNA) of the thyroid is widely accepted simple, cost effective and quick to perform outpatient procedure with minimal complication. The National Cancer Institute (NCI) Bethesda, Maryland, United States standardized the reporting system for thyroid FNA by using Bethesda system for reporting thyroid cytopathology.Methods: FNA was performed in total 155 patients presenting with the thyroid swelling with or without Ultrasonography (USG) guidance. All patients were analyzed for age, gender, type of lesions. FNA was done and smears were examined and reported according to Bethesda system of reporting for thyroid cytopathology. Findings were correlated with post-operative histopathological diagnoses in 103 cases who underwent surgery.Results: Out of total 155 patients, 32 were male and 123 were female. Average age of presentation was 38.4 years. On cytology, according to Bethesda system, most cases were in benign category (76.1%) followed by malignant (8.4%). On histopathological study most common diagnosis was colloid goiter followed by papillary thyroid carcinoma. From the study it was found that sensitivity, specificity and accuracy of fine needle aspiration cytology of thyroid lesions were 81.8%, 97.3% and 95.4% respectively.Conclusions: Fine needle aspiration cytology is simple, easy to perform, cost effective procedure with high sensitivity, specificity and diagnostic accuracy in case of thyroid lesions.


2015 ◽  
Vol 59 (2) ◽  
pp. 133-138 ◽  
Author(s):  
Kusum Kapila ◽  
Laila Qadan ◽  
Rola H. Ali ◽  
Mohammed Jaragh ◽  
Sara S. George ◽  
...  

Introduction: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) identifies 6 diagnostic categories in which the risk of malignancy increases respectively. The aim of our study was to assess TBSRTC reporting in our hospital and to evaluate its specificity based on cytohistological correlation. Methods: A histological diagnosis was available in 374 (110 males and 264 females) out of 7,809 thyroid aspirates examined at Mubarak Al-Kabeer Hospital, Kuwait, from 2004 to 2012. The aspirates were classified in accordance with TBSRTC. Results: Thyroid aspirates were classified as nondiagnostic (n = 18; 4.8%), benign (n = 114; 30.5%); atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS; n = 59; 15.8%), follicular neoplasm/suspicious for follicular neoplasm (FN/SFN; n = 17; 4.5%), suspicious for malignancy (SM; n = 80; 21.4%), or malignant (n = 86; 23.0%). In 75 of 86 malignant cases, a papillary carcinoma was detected. There were 3 (1.6%) false-positive aspirates and the sensitivity, specificity, negative predictive value, and positive predictive value were 91.0, 61.9, 84.2, and 75.3%, respectively. Conclusions: Our results are fairly comparable to those of various previous studies in the SM, AUS/FLUS, and SFN categories. The higher rates observed in the nondiagnostic and benign categories were possibly due to limited guided aspirations and a lack of on-site evaluation for all cases.


Author(s):  
Yaladahalli G. Lokesh ◽  
Dudda Ravi ◽  
Hodeyala J. Srikanth

<p class="abstract"><strong>Background:</strong> Patients with neck swellings are commonly seen in ENT outpatient and leads to dilemma in diagnosis. To prevent unnecessary investigations and surgery a simple and sensitive diagnostic tool is needed. Fine needle aspiration cytology (FNAC) is a simple and sensitive diagnostic tool that can provide results in minutes.</p><p class="abstract"><strong>Methods:</strong> This prospective study was done at the department of ENT, Mandya institute of medical sciences, Mandya, Karnataka, India from November 2017 to April 2019 including 100 cases of neck masses in patients aged above 18 years. FNAC was done for all neck masses and then these cases were subjected for biopsy. The cytological features was then reviewed with corresponding histopathology features.</p><p class="abstract"><strong>Results:</strong> Out of the 100 neck masses under study 67 (67%) were males and 33 (33%) were females with male:female ratio (1:2.03). Thyroid aspirations (43%) were most common followed by lymph node (24%), salivary gland aspirations (18%), congenital swellings (8%) and others (7%). Out of the 100 cases 26% were neoplastic and 74% were non-neoplastic. Histopathological correlations were available in all the 100 cases with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 84.2%, 98.65%, 95.65% and 94.81% respectively. FNAC was in correlation with histopathology in 86% of cases and found to be statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> FNAC is safe, simple and minimally invasive first line investigation of choice for the patients presenting with palpable neck masses and can provide results rapidly and but histopathology remains the gold standard.</p>


2012 ◽  
Vol 4 (1) ◽  
pp. 15-17
Author(s):  
MA Quddus ◽  
M Alimuzzaman ◽  
MKH Sardar

Background: Fine needle aspiration cytology (FNAC) provides diagnostic information as to the nature of a solitary cold thyroid nodule. Objective: This study was carried out to evaluate the effectiveness of FNAC as a diagnostic method of malignancy in solitary cold thyroid nodule. Methodology: This cross sectional study was carried out among 40 cases of solitary cold thyroid nodule who were admitted in the Department Surgery and ENT of DMCH during period of January 2006 to December 2007. This study was conducted using convient type of non-probability sampling technique Data were collected by face to face interview, clinical examination and finding of both cytological and histological examination. Result: The study revealed that the mean age of the patients was 35.8± 2.36 year with female to male ratio 2.6:1. For all the patients, FNAC were done preoperatively and after definitive surgery histopathology were done for confirmed diagnosis and results of FNAC were compared with histopathology reports. 30 cases were diagnosed as benign and 10 case diagnosed as malignant cold thyroid solitary nodules among 40 cases. In this study, the sensitivity of FNAC was 80% for the presence of malignancy and specificity 96.7% for the absence of malignancy in solitary cold thyroid nodules. The positive predictive value was 88.9% and negative predictive value was 92.5% and diagnostic accuracy was 92.5%. Conclusion: FNAC can be used as a diagnostic method for the evaluation of malignancy as well as in the management of solitary cold thyroid nodule which has reasonable sensitivity and specificity. Finally, it is a quick, cost effective procedure and has excellent patient compliance. DOI: http://dx.doi.org/10.3329/jssmc.v4i1.11997 J Shaheed Suhrawardy Med Coll, 2012;4(1):15-17


2015 ◽  
Vol 04 (01) ◽  
pp. 035-037 ◽  
Author(s):  
Challa Vasu Reddy ◽  
Y. G. Basavana Goud ◽  
R. Poornima ◽  
Vijayalakshmi Deshmane ◽  
B. A. Madhusudhana ◽  
...  

Abstract Background: Liver is one of the most common site of metastases in patients with malignancy and the evaluation of space occupying lesions (SOL) of liver in patients with malignancy is important. Its important to differentiate benign from malignant to take necessary decisions. Materials and Methods: We have performed a retrospective analysis of liver SOLs for which fine needle aspiration cytology (FNAC) was done in the year 2011. Risks and benefits associated with FNAC were evaluated. Results: We analyzed 755 patients who underwent FNAC of which 524 patients had secondary metastases to liver, 148 patients had primary hepatocellular carcinoma, 14 cases were benign neoplasms and 53 were nonneoplastic conditions. Histological correlation with FNAC was available in 112 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93%, 90.9%, 98.9%, 58.8%, and 92.8%, respectively. Though there were no incidence of bleeding, two patients developed track metastases following FNAC. One was a case of Hepatocellular carcinoma and the other a case of metastatic breast cancer. Conclusion: FNAC was very much useful in our setup where most of the patients could not afford for Computer tomography (CT) scan and was useful in counseling them especially in patients with advanced malignancy where no active cancer directed therapy is required.


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