Journal of Pathology and Translational Medicine

Original Articles

Intraoperative Frozen Cytology of Central Nervous System Neoplasms: An Ancillary Tool for Frozen Diagnosis: Myunghee Kang, Dong Hae Chung, Na Rae Kim, Hyun Yee Cho, Seung Yeon Ha, Sangho Lee, Jungsuk An, Jae Yeon Seok, Gie-Taek Yie, Chan Jong Yoo, Sang Gu Lee, Eun Young Kim, Woo Kyung Kim, Seong Son, Sun Jin Sym, Dong Bok Shin, Hee Young Hwang, Eung Yeop Kim, Kyu Chan Lee; J Pathol Transl Med. 2019;53(2):104-111. Published online January 14, 2019; DOI: https://doi.org/10.4132/jptm.2018.11.10

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Background
Pathologic diagnosis of central nervous system (CNS) neoplasms is made by comparing light microscopic, immunohistochemical, and molecular cytogenetic findings with clinicoradiologic observations. Intraoperative frozen cytology smears can improve the diagnostic accuracy for CNS neoplasms. Here, we evaluate the diagnostic value of cytology in frozen diagnoses of CNS neoplasms.
Methods
Cases were selected from patients undergoing both frozen cytology and frozen sections. Diagnostic accuracy was evaluated.
Results
Four hundred and fifty-four cases were included in this retrospective single-center review study covering a span of 10 years. Five discrepant cases (1.1%) were found after excluding 53 deferred cases (31 cases of tentative diagnosis, 22 cases of inadequate frozen sampling). A total of 346 cases of complete concordance and 50 cases of partial concordance were classified as not discordant cases in the present study. Diagnostic accuracy of intraoperative frozen diagnosis was 87.2%, and the accuracy was 98.8% after excluding deferred cases. Discrepancies between frozen and permanent diagnoses (n = 5, 1.1%) were found in cases of nonrepresentative sampling (n = 2) and misinterpretation (n = 3). High concordance was observed more frequently in meningeal tumors (97/98, 99%), metastatic brain tumors (51/52, 98.1%), pituitary adenomas (86/89, 96.6%), schwannomas (45/47, 95.8%), high-grade astrocytic tumors (47/58, 81%), low grade astrocytic tumors (10/13, 76.9%), non-neoplastic lesions (23/36, 63.9%), in decreasing frequency.
Conclusions
Using intraoperative cytology and frozen sections of CNS tumors is a highly accurate diagnostic ancillary method, providing subtyping of CNS neoplasms, especially in frequently encountered entities.

Citations

Citations to this article as recorded by

Intraoperative Integrated Diagnostic System for Malignant Central Nervous System Tumors
Takahiro Hayashi, Kensuke Tateishi, Shinichiro Matsuyama, Hiromichi Iwashita, Yohei Miyake, Akito Oshima, Hirokuni Honma, Jo Sasame, Katsuhiro Takabayashi, Kyoka Sugino, Emi Hirata, Naoko Udaka, Yuko Matsushita, Ikuma Kato, Hiroaki Hayashi, Taishi Nakamur
Clinical Cancer Research.2024; 30(1): 116. CrossRef
Unveiling the potential application of intraoperative brain smear for brain tumor diagnosis in low-middle-income countries: A comprehensive systematic review
Muhammad Shakir, Ahmed Altaf, Hawra Hussain, Syed Muhammad Aqeel Abidi, Zoey Petitt, Mahnoor Tariq, Ahmed Gilani, S. Ather Enam
Surgical Neurology International.2023; 14: 325. CrossRef
A comparative study of squash smear cytology diagnosis and radiological diagnosis with histopathology in central nervous system lesions
BN Kumarguru, G Santhipriya, SKranthi Kumar, RRamesh Kumar, AS Ramaswamy, P Janakiraman
Journal of Cytology.2022; 39(1): 1. CrossRef
Intraoperative squash cytology provides a qualitative intraoperative diagnosis for cases in which frozen section yields a diagnosis of equivocal brain tumour
Hirotaka Fujita, Takuma Tajiri, Tomohisa Machida, Nozomi Nomura, Suguru Toguchi, Hitoshi Itoh, Shinichiro Hiraiwa, Tomoko Sugiyama, Masaaki Imai, Shinri Oda, Masami Shimoda, Naoya Nakamura
Cytopathology.2020; 31(2): 106. CrossRef
Intraoperative frozen cytology of intraosseous cystic meningioma in the sphenoid bone
Na Rae Kim, Gie-Taek Yie
Journal of Pathology and Translational Medicine.2020; 54(6): 508. CrossRef
Use of 5-Aminolevulinic Acid for Confirmation of Lesional Biopsy Sample in Presumed High-Grade Glioma
Victoria L. Watson, Jeffrey W. Cozzens
World Neurosurgery.2019; 132: 21. CrossRef

Immunohistochemical Detection of p53 Gene Mutation in Urine Samples in the Patients with Bladder Cancer.: Sang Sook Lee, Ji Yeon Bae, Yu Na Kang, Young Rok Cho, Nam Jo Park, Seun Young Kim, Jung Hi Kim; Korean J Cytopathol. 1996;7(2):144-150.

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Abstract PDF: Although bladder cancers are very common, little is known about their molecular pathogenesis. It is known, that p53 alteration is found in about 60%p of muscleinvasive bladder cancer, necessiating aggressive therapy and poor outcome. We examined the nuclear expression of p53 protein, using D07 monoclonal antibody in the urine samples, from 31 patients with transitional cell carcinoma of the bladder to investigate the correlation of p53 overexpression with histologic grades and depth of invasion. The positive rate of p53 protein was 27%o in superficial bladder tumor, but increased up to 71% in the invasive bladder carcinomas. The overexpression of p53 protein increased according to Mostofi grading system from 18% in grade I, 45% in grade Il, and up to 100% in grade ill. The p53 expression tended to be higher in the invasive and high grade bladder cancers than in the superficial and low grade ones(p<0.05). These results suggest that immunohistochemical analysis of the urine specimen in the bladder cancer patients could be a useful method of screening for the presence of p53 mutant protein. The mutant p53 protein expression may be an indicator of bladder cancer with more proliferative potential and/or aggressive biologic behavior.

Diagnostic Application of p53 IMMUNOSTAINING in Bronchial Brush Specimens.: Sang Sook Lee, Ji Yeon Bae, Yu Na Kang, Young Rok Cho, Si Nam Kim, Nam Jo Park, Seun Young Kim, Jung Hi Kim; Korean J Cytopathol. 1996;7(2):163-168.

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Abstract PDF: Abnormalities of p53 gene are common in lung cancers and are associated with immunologically detectable p53 protein. p53 immunoreactivity is uncommon in normal cells but is frequently seen in neoplasia. Therefore, assessment of p53 expression may assist in the cytological diagnosis of malignancy. The usefulness of p53 immunostaining as a marker of malignancy in the cytological analysis of bronchial brush specimens from the patients with lung cancers was investigated in this study. A total of 71 bronchial brush samples submitted for cytologic diagnosis were immunostained with D07, a monoclonal antibody to recombinant p53 protein.
Result
ant p53 data were correlated with cytologic diagnosis and clinical information. Of the 17 smears with a benign cytodiagnosis, all were p53 negative. Of the 40 cases with a malignant cytodiagnosis(histologically confirmed), 35 were p53 positive and 5 were negative. Of the 14 cases that were cytologically suspicious but nondiagnostic for malignancy, 11 were p53 positive, 9 of which were subsequently proved to be malignant by histologic examination, and the remaining 2 cases were tuberculosis clinically. Forty four of 51 histologically confirmed lung carcinomas were p53 positive, including 25 of 28 squamous cell carcinomas, 13 of 17 small cell carcinomas, 3 of 3 adeno- carcinomas, and 3 of 3 large cell undifferentiated carcinomas. These results suggest that p53 immunostaining could be of value as a marker of malignancy in the cytologic examination of bronchial brush specimens. Furthermore, we have shown the possible clinical utility of p53 immunostaining in cytopathological diagnosis, that is, as a valuable adjunct to morphological assessment in the analysis of cytopathologically suspicious cases.

Expressions of E2F4 and E2F2 Transcription Factors in Breast Carcinoma.: Eun Young Kim, Hyun Jin Jo, Mi Ja Lee; Korean J Pathol. 2005;39(5):301-306.

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Abstract PDF: BACKGROUND
The E2F family (E2F1 to E2F6) of transcription factors plays a key role in cell cycle progression. Some act as oncogenes and others act as tumor suppressor genes (TSG) in a tissue-specific manner. E2F4 may function as a TSG. However, the role of E2F4 in breast carcinogenesis remains controversial. Also the clinical impact of E2F2 expression on breast cancer remains unknown.
METHODS
Expressions of E2F4 and E2F2 were assessed immunohistochemically in 113 breast carcinomas and were compared with clinicopathological variables, expressions of G1/S checkpoint proteins (p16, cyclin D1 and Rb), and DNA ploidy to identify their possible role and to assess their prognostic value in breast cancer.
RESULTS
Expressions of E2F4 and E2F2 were detected in 48 cases (42.5%) and 66 cases (58.4%), respectively. Expressions of E2F4 and E2F2 were significantly correlated with large tumor size (p<0.001) and lymph node metastasis (p<0.001). There was no correlation between expressions of E2F4 or E2F2 and any other variables, including age, histologic grade, DNA ploidy and expressions of p16, cyclin D1 and Rb.
CONCLUSIONS
These results suggest that expressions of E2F4 and E2F2 are associated with growth and spread of breast cancer and indicate poor prognosis.

Significance of CD99 Immunoreactive Cells in relation to Gastrin-producing Cells in Human Gastric Mucosa.: Eun Young Kim, Jong Im Lee, Jung Ran Kim; Korean J Pathol. 2003;37(4):263-269.

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Abstract PDF: BACKGROUND
CD99 is characteristically expressed in Ewing's sarcoma/primitive neuroendocrine tumors and its immunoreactivity has also been reported in gastrointestinal neuroendocrine tumors. However, the normal distribution of CD99 reactive cells in gastrointestinal mucosa and their function are not fully understood.
METHODS
We performed an immunohistochemical study using antibodies to CD99 and gastrin on formalin fixed and paraffin embedded tissue of the stomach.
RESULTS
CD99 were strongly expressed in the gastric glands of neonate (3/3) and infant (1/1) cases but not detected in the fetal period (0/30). In adults, CD99 was observed in 36.8% (7/19). The number of CD99 positive cells were fewer in adult (3.48+/-6.43) than in neonate (5.66+/-0.58) and infant (11.33+/-2.21). CD99 was mostly located along the cytoplasmic membrane of glandular cells but cytoplasmic expression was also evident in neonate and infant cases. The G cells and CD99 expressed cells were reduced in the area showing intestinal metaplasia and atrophic change. As a result of the double stain, some of the G cells coexpress CD99 antigen, which were more in neonate (29%) than in adult (2.6%).
CONCLUSIONS
The CD99 positive cells were found in the gastric pyloric antrum during the postnatal period and progressively reduced with age. This suggests the participation of CD99 protein in the differentiation and secretory process of neuroendocrine cells.

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