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Evaluation of immunocytochemical staining as a method of improving diagnostic accuracy in a routine cytopathology
J F Wazir1, E Martin-Bates, G Woodward
1Department of Cytopathology, St Mary's Hospital, London.
Insights
Immunocytochemical stains are valuable tools in cytopathology for differentiating benign from malignant cells and identifying tumor types. This study found these stains highly effective in diagnosing problematic fine needle aspiration (FNA) and effusion cases.
Area of Science:
- Cytopathology
- Immunohistochemistry
- Oncology
Background:
- Immunocytochemical stains aid in distinguishing cell types and identifying tumors in cytopathology.
- Routine application can improve diagnostic accuracy for challenging cases.
Purpose of the Study:
- To evaluate the utility of immunocytochemical stains in a routine cytopathology laboratory.
- To assess the diagnostic value of various markers in fine needle aspiration (FNA) and effusion samples.
Main Methods:
- Thirty problematic cytopathology cases (12 FNA, 18 effusions) were analyzed.
- A panel of immunocytochemical markers including cytokeratin, CEA, LCA, PSA, and others were employed.
- Samples included lymph nodes, lungs, pleura, soft tissues, and various body fluids.
Main Results:
- Immunocytochemical stains proved valuable in diagnosing 11 out of 12 FNA samples.
- Diagnostic utility was observed in 15 out of 18 effusion samples.
- Specific markers like cytokeratin, CEA, and LCA demonstrated utility in differentiating cell origins.
Conclusions:
- Immunocytochemical staining is a valuable adjunct in cytopathology for diagnosing difficult FNA and effusion specimens.
- The application of these stains significantly enhances the accuracy of cytological diagnoses.
- This technique aids in precise tumor typing and distinguishing between benign and malignant cells.
Abstract:
Immunocytochemical stains in a routine cytopathology laboratory can be used to distinguish between benign and malignant cells, and to identify tumour type. In our laboratory 30 problematic cases were selected for immunocytochemical stains and the results analysed in this paper. The following markers were used: cytokeratin (CAM5.2), carcinoembryonic antigen (CEA), kappa and lambda light chains, leucocytic common antigen (LCA), chorionic gonadotrophin (hCG), prostate specific antigen (PSA), L26, UCHL1, S100-protein and vimentin. Twelve FNA (four lymph nodes, one parotid swelling, two from lungs, two from pleura and chest wall, one from lumbar region, two from soft tissue masses), and 18 effusions (12 pleural effusions, five ascitic fluids, one pericardial effusion) were investigated. We found immunocytochemical stains of value in formulating the cytological diagnosis in 11/12 of FNA and 15/18 of effusions.