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1.
J Clin Pathol ; 75(11): 739-743, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36257676

RESUMEN

AIMS: To compare the ability of immunohistochemistry (IHC), multiparameter flow cytometry (MFC) and fluorescence in situ hybridisation (FISH) to detect clonal plasma cells. We also attempted to outline a testing strategy for monitoring multiple myeloma patients. METHODS: A retrospective review was performed on 278 CD138+sorted FISH studies from November 2019 to December 2020 along with their concurrent IHC and MFC results. A p value was computed using McNemar's test for paired data. Association was calculated using the non-parametric Spearman correlation coefficient. RESULTS: Using the Mc Nemar's test for paired data, CD138+sorted FISH studies achieved the highest proportion of positive results and was significantly greater than MFC (63% vs 53%, p=0.01). FISH had more positive results than IHC, although this did not reach statistical significance (60% vs 57%, p=0.34). IHC and MFC had high correlation and high agreement (90.3% agreement, kappa=0.805, p<0.0001). CD138+sorted FISH studies achieved the highest proportion of positive results relative to IHC and MFC, indicating that it may be a reliable marker for clonal plasma cell detection. CONCLUSIONS: While CD138+sorted FISH is primarily used for prognostication, it may be employed as a single test for detection and monitoring clonality in certain scenarios. Further studies are needed to monitor the outcomes of patients with positive FISH and negative IHC and MFC. Additionally, there was high agreement between IHC and MFC, suggesting that performing both tests may not be necessary.


Asunto(s)
Mieloma Múltiple , Células Plasmáticas , Humanos , Mieloma Múltiple/diagnóstico , Citometría de Flujo/métodos , Inmunohistoquímica , Hibridación Fluorescente in Situ
2.
J Clin Pathol ; 75(3): 154-158, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34782422

RESUMEN

Peripheral blood smear (PBS) review by a pathologist is a necessary and invaluable diagnostic tool. However, innovative highly sophisticated haematology analysers that flag peripheral blood abnormalities have decreased the need for a PBS review. Ordering practices including PBS reviews lumped as part of an 'order set' or with complete blood count (CBC) constituted most PBS requests at our institution. A retrospective review of all PBS review orders from 1 April 2016 to 31 January 2017 was performed to investigate the ordering practices at our institution. A total of 2864 PBS were ordered during the above study period. In many cases, the PBS report did not add any significant clinical information beyond that acquired by the CBC and differential count. These findings inspired policy changes within our institution for pathologist PBS reviews. Within the electronic order system, all PBS orders for inpatients were linked to a pop-up window with criteria for peripheral smear review and instructions on the approval policy. Outpatient orders required clinicians to request pathology approval. This implementation reduced total number of PBS orders by 42.5% with no adverse effect on patient management. Empowering pathologists and clinicians with guidelines on PBS review orders is a beneficial educational exercise of resource utilisation. Discussion with physicians regarding clinical indications reduces non-contributory PBS reviews, provides guidance to appropriate testing, and aptly allocates pathologist and laboratory staff time and resources.


Asunto(s)
Hematología/instrumentación , Recuento de Células Sanguíneas/economía , Análisis Costo-Beneficio , Humanos , Leucocitos Mononucleares , Patólogos , Estudios Retrospectivos
3.
Acta Cytol ; 65(4): 330-334, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33621977

RESUMEN

BACKGROUND: The application of computational technology to head and neck cytology material has been explored experimentally in several areas with a variety of potential applications. SUMMARY: This review summarizes the application of these techniques to the diagnosis of thyroid, salivary gland, and other head and neck fine-needle aspiration specimens. Current limitations and potential future applications in diagnosis are discussed along with the possibilities for therapeutic applications of computational methodology. Key Message: Particularly promising applications include resolving diagnostic uncertainty in indeterminate thyroid aspirates and assessing the tumor microenvironment in response to immunotherapy for squamous cell carcinoma.


Asunto(s)
Inteligencia Artificial , Diagnóstico por Computador , Interpretación de Imagen Asistida por Computador , Neoplasias de las Glándulas Salivales/patología , Carcinoma de Células Escamosas de Cabeza y Cuello/patología , Neoplasias de la Tiroides/patología , Biopsia con Aguja Fina , Humanos , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados
4.
Autops Case Rep ; 10(3): e2020144, 2020 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-33344290

RESUMEN

Arteriovenous malformation (AVM) is a rare lesion in the uterus, which can lead to abnormal uterine bleeding. While AVM has been described in other organs in the literature, there is a paucity of pathology reports of the AVM in uterus. On gross examination, the uterus was markedly enlarged and partly distorted with a pedunculated solid mass, which on the cut surface showed multiple well-circumscribed hemorrhagic cysts ranging from 0.1 to 4.0 cm in size. Microscopically, they were malformed dilated vascular structures containing organized thrombi. We present this case of uterine AVM with gross and microscopic findings, which can serve as a crucial reminder for pathologists to keep in the differential diagnoses as a potential cause of abnormal uterine bleeding.

5.
Autops. Case Rep ; 10(3): e2020144, 2020. graf
Artículo en Inglés | LILACS | ID: biblio-1131832

RESUMEN

Arteriovenous malformation (AVM) is a rare lesion in the uterus, which can lead to abnormal uterine bleeding. While AVM has been described in other organs in the literature, there is a paucity of pathology reports of the AVM in uterus. On gross examination, the uterus was markedly enlarged and partly distorted with a pedunculated solid mass, which on the cut surface showed multiple well-circumscribed hemorrhagic cysts ranging from 0.1 to 4.0 cm in size. Microscopically, they were malformed dilated vascular structures containing organized thrombi. We present this case of uterine AVM with gross and microscopic findings, which can serve as a crucial reminder for pathologists to keep in the differential diagnoses as a potential cause of abnormal uterine bleeding.


Asunto(s)
Humanos , Femenino , Embarazo , Persona de Mediana Edad , Malformaciones Arteriovenosas/patología , Hemorragia Uterina/etiología , Útero/lesiones , Quistes/etiología , Diagnóstico Diferencial
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