Melissa Randolph

Utilization of cell-transferred cytologic smears in detection of EGFR and KRAS mutation on adenocarcinoma of lung

Cell-transfer technique has been proven useful for performing immunocytochemistry on fine-needle aspiration smears. However, its utility for EGFR and KRAS molecular testing has not been validated. Molecular testing was performed using the cell-transfer technique on both Papanicolaou-stained ethanol-fixed and Hema 3-stained air-dried smears from 32 fine-needle aspiration samples that had diagnoses of adenocarcinoma of the lung, and then was compared to the results of the corresponding formalin-fixed paraffin-embedded tissues. The molecular testing was successfully performed on 32 of 32 ethanol-fixed and 31 of 32 air-dried samples. The molecular results on ethanol-fixed and air-dried smears showed 100% agreement. There is 100% (32/32) agreement for the EGFR and 97% (31/32) agreement for the KRAS between the cell-transfer technique and formalin-fixed paraffin-embedded tissues. One discrepant case was due to low percentage of tumor cells on the smears. Cell-transfer technique is a reliable alternative method for EGFR and KRAS testing if the cell blocks lack adequate cellularity.

Detection of BRAF Mutations on Direct Smears of Thyroid Fine-Needle Aspirates Through Cell Transfer Technique

OBJECTIVES To determine the utility of the cell transfer technique (CTT) for BRAF molecular testing on thyroid fine-needle aspiration (FNA) specimens. METHODS Polymerase chain reaction (PCR)-based BRAF molecular testing was performed on tissues obtained through CTT from both air-dried and ethanol-fixed direct smears of thyroid FNA specimens and then compared with the corresponding thyroidectomy formalin-fixed, paraffin-embedded (FFPE) tissues on 30 cases. RESULTS BRAF testing was successfully performed on 29 of 30 air-dried CTT, 27 of 30 ethanol-fixed CTT, and 27 of 30 FFPE tissues. The results exhibited 11, 13, and 13 BRAF mutations and 18, 14, and 14 wild types for the air-dried CTT, the ethanol-fixed CTT, and the FFPE tissues, respectively. The concordance rate was 96% between air-dried and ethanol-fixed CTT tissues, 88% between air-dried CTT and FFPE tissues, and 92% between ethanol-fixed CTT and FFPE tissues. CONCLUSIONS PCR-based BRAF mutational testing can be reliably performed on the direct smears of the thyroid FNA specimens through the application of CTT.

Improvements in cell block processing: The Cell-Gel method

The ability to produce adequate cell blocks profoundly impacts the diagnostic usefulness of cytology specimens. Cell blocks are routinely processed from fine‐needle aspiration specimens or concentrated fluid samples. Obtaining directed passes for the sole purpose of producing a cell block is common practice, particularly when the cytopathologist anticipates the need for ancillary immunocytochemical stains and/or molecular studies.

Prospective Assessment of the Performance of a New Fine Needle Biopsy Device for EUS-Guided Sampling of Solid Lesions

Background/Aims Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) remains the most common EUS-guided tissue acquisition technique. This study aimed to evaluate the performance of a new Franseen tip fine needle biopsy (FNB) device for EUSguided sampling of solid lesions and compare it with the historical FNA technique. Methods Acquire® 22 G FNB needle (Boston Scientific Co., Natick, MA, USA) was used for solid tumor sampling (Study group). Tissue was collected for rapid on-site evaluation, and touch and crush preparations were made. Historical EUS-FNA samples obtained using Expect® 22 G FNA needle (Boston Scientific Co.) were used as controls (Control group). All specimens were independently evaluated by two cytopathologists blinded to the formal cytopathological diagnosis. Results Mean cell block histology scores were significantly higher (p=0.046) in the FNB group (51 samples) despite a significantly lower (p<0.001) mean number of passes compared to the FNA group (50 specimens). The overall diagnostic yields for the FNB vs. FNA groups were 96% vs. 88%. The degree of tumor differentiation was adequately assessed in all cell block qualifying lesions in the FNB group. Two patients developed post-FNB abdominal pain. Conclusions The new Franseen tip FNB device provides histologically superior and cytologically comparable specimens to those obtained by FNA, but with fewer passes.

Reprocessing unsatisfactory ThinPrep papanicolaou tests using a modified SurePath preparation technique.

The frequency of unsatisfactory gynecologic specimens has increased in the study laboratory over the last few years due to the advent of personal lubricants. Similarly, lysed blood, protein, and necrotic debris present a challenge in terms of negative cell transference caused by a clogged filter. In the current study, the authors evaluated the potential use of a modified SurePath reprocessing technique to decrease the frequency of unsatisfactory specimens.

Detection of BRAF mutation in metastatic melanoma utilizing cell-transferred cytological smears.

Objectives: Fine-needle aspiration (FNA) is frequently used to diagnose metastatic melanoma. In this study, we validated the use of cell-transferred cytological smears for BRAF molecular testing. Study Design: We conducted a search of our laboratory information system for the period 2011-2013 in order to identify surgical pathology cases of either primary or metastatic melanomas in which BRAF mutation analyses had already been performed. Thirty FNA cases with diagnoses of metastatic melanoma from the same patients were identified. Direct smears from each FNA case were selected for mutation analyses using the cell transfer technique. Results: Mutation analyses were successfully performed on 28 of 30 FNA cases (93%) using the cell-transferred cytological smears. In 25 cases (8 BRAF mutations and 17 BRAF wild types), there was 100% agreement for the BRAF mutation between the cell-transferred cytological smears and the formalin-fixed paraffin-embedded tissues. Three FNA cases showed BRAF mutations that had not been detected in the correlated surgical specimens which were tested twice, and 2 cases failed to work. Conclusions: Cell-transferred cytological smears are a reliable and alternative resource for detecting BRAF mutations in metastatic melanoma.

A retrospective analysis of the performance of the RosettaGX® Reveal™ thyroid miRNA and the Afirma Gene Expression Classifiers in a cohort of cytologically indeterminate thyroid nodules

Molecular tests are increasingly used to triage cytologically indeterminate thyroid nodules for surgery and/or follow‐up. We retrospectively compared the performance of the Afirma Gene Expression Classifier (AGEC) with that of the more recently developed RosettaGX® Reveal™ miRNA Classifier (Reveal) in a cohort of Bethesda III–V thyroid FNAs with surgical follow‐up.

In Memoriam - A Tribute to Alexander Meisels (1926-2014)

awards, among them the Goldblatt Award of the IAC (1975), the Papanicolaou Award of the ASC (1982) and the membership in the Order of Canada (2000). All members of the Executive Council and the entire membership of the IAC pay tribute to this great man and express their feelings of loss and sadness. Alex will be sadly missed. Volker Schneider, Freiburg i.B. Dr. Alexander Meisels died peacefully in September 2014 at the age of 88 years. His service to the International Academy of Cytology is legendary as he was a member of the Executive Council of the IAC for 39 years. He served as Secretary-Treasurer from 1971 to 1986 and continued subsequently as President, Treasurer and Member until 2010. He was responsible as Secretary or President for six International Congresses of Cytology organized by the IAC (Miami 1974, Tokyo 1977, Munich 1980, Montreal 1983, Brussels 1986 and Buenos Aires 1989). His contributions to the field of cytopathology were decisive and manifold. He considered his discovery of the relationship between the infection by human papillomavirus and the development of cervical carcinoma to be his most significant contribution, of which he was understandably proud. In 1976, he postulated that the koilocytotic changes in cervical epithelial cells represent an expression of viral infection and the initial step of carcinogenesis [1] , a hypothesis which was then controversially debated and is now common knowledge. Born in Berlin, he had to flee Germany with his parents and received his early schooling in Paris, France. He later attended the National University of Mexico, where he obtained his BSc and MD in 1951. In 1960 he moved to Quebec, Canada, where he worked until his retirement at the St. Sacrement Hospital and Laval University as Director of the Department of Pathology and the School of Cytotechnology. He educated numerous cytotechnologists, residents of pathology and foreign guests, who subsequently spread around the world. He was fluent in four languages, was an eloquent and gifted speaker, and travelled widely. He was particularly interested in the Spanish-speaking world and spread the cytologic gospel throughout Latin America. He received numerous Published online: October 29, 2014