Two-site evaluation of high-fluorescent cells for the detection of malignant cells: The importance of clinical information

Background: Abdominal paracentesis is a routine diagnostic procedure for assessment of patients with recent onset or worsening of ascites. Objectives: The objective of the study is to (1) review clinically confirmed cases of malignancy with negative, atypical, and suspicious cytology reports and provide reasoning for discrepancies and (2) recalculate sensitivity, specificity, and predictive values after review. Materials and Methods: Papanicolaou smears of ascitic fluid paracentesis samples received over one calendar year were reviewed retrospectively by an expert in cytopathology blinded to the final clinical and/or histopathological diagnoses. Cases with discrepancies after review were noted. Sensitivity, specificity, and predictive values were calculated before and after review of slides. Data were analyzed using SPSS version 16. Results: Malignant etiology was identified in 49/115 cases (42.6%) with female genital tract being the most common site of malignancy (22, 44.8%). The remaining 66 (57.4%) had a benign etiology with hepatic cirrhosis in 42 cases (63.6%). A review revealed discrepancies in five cases, three of which were earlier called negative for malignant cells (one case each of ovarian adenocarcinoma, cecal adenocarcinoma, and cholangiocarcinoma). Two cases of ovarian adenocarcinoma that were reported as atypical/reactive mesothelial hyperplasia showed malignant cells upon review. Sensitivity and specificity after review were 69.4% and 100%, respectively, with 100% positive predictive value. Conclusion: Being a minimally invasive procedure, abdominal paracentesis continues to be an important diagnostic tool in guiding patient management. A proper morphological assessment with adequate clinical information and correlation with other investigations can be used to arrive at a definitive diagnosis in most cases. The term “atypical” can be misleading and is often used for want of clinical information and is best avoided.

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The Value of Additional Conventional Transbronchial Biopsy in the Negative Results of Rapid On-site Evaluation During Endobronchial Ultrasound With Guide Sheath to Diagnose Small Peripheral Lung Cancer

Technology in Cancer Research & Treatment ◽

10.1177/15330338211043040 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110430

Author(s):

Takayasu Ito ◽

Shotaro Okachi ◽

Tadasuke Ikenouchi ◽

Futoshi Ushijima ◽

Takamasa Ohashi ◽

...

Keyword(s):

Lung Cancer ◽

Diagnostic Yield ◽

Lesion Size ◽

Malignant Cells ◽

Negative Group ◽

Peripheral Lung Cancer ◽

Peripheral Lung ◽

Site Evaluation ◽

The Rose ◽

Positive Results

Objective: The accuracy of rapid on-site evaluation (ROSE) during endobronchial ultrasonography with guide sheath (EBUS-GS) was reported to be approximately 90% for diagnosing small peripheral pulmonary lesions (PPLs). When ROSE during EBUS-GS for diagnosing small peripheral lung cancer is carried out and does not include malignant cells in a position whereby the probe was located within or adjacent to the lesion, the best technique for overcoming the lower diagnostic yield remains unknown. This study aimed to evaluate factors affecting positive results of ROSE during EBUS-GS in such a probe position. Moreover, when the results of ROSE were consistently negative, we evaluated the effectiveness of conventional transbronchial biopsy (TBB) in addition to EBUS-GS alone. Methods: We performed a retrospective analysis of consecutive patients who underwent EBUS-GS combined with ROSE for diagnosing small peripheral lung cancer (≤30 mm). We classified the results of ROSE into two groups based on the presence of malignant cells: the ROSE positive group (included malignant cells) and the ROSE negative group (did not include malignant cells). The significant predictors of positive ROSE results during EBUS-GS were analyzed using multivariate logistic regression analyses. Results: We identified 67 lesions (43 lesions in the ROSE positive group and 24 lesions in the ROSE negative group, respectively). Multivariate logistic analysis revealed that the significant factor affecting positive ROSE results was lesion size (>15 mm) (OR = 9.901). The diagnostic yield of additional conventional TBB to EBUS-GS was significantly higher than that of EBUS-GS alone (75.0% vs 33.3%, P = .041). Conclusion: The positive results of ROSE during EBUS-GS were significantly influenced by lesion size (>15 mm). When the results of ROSE during EBUS-GS were consistently negative in a position whereby the probe was located within or adjacent to the lesion, additional conventional TBB was effective to improve the diagnostic yield compared with EBUS-GS alone.

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Evaluation of high-fluorescent cells cut-off value for exclusion of malignant cells in serous body fluids performed on sysmex XN analyzer

Clinica Chimica Acta ◽

10.1016/j.cca.2019.04.014 ◽

2019 ◽

Vol 493 ◽

pp. S4

Author(s):

A. Sancho-Cerro ◽

L. Sanchez-Navarro ◽

B. Fernandez-Cidon ◽

C.E. Imperiali

Keyword(s):

Body Fluids ◽

Malignant Cells ◽

Fluorescent Cells

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Leptomeningeal Carcinomatosis: A Call for Optimizing Diagnostic Sensitivity by the Hematology Laboratory

Case Reports in Oncology ◽

10.1159/000518314 ◽

2021 ◽

pp. 1248-1253

Author(s):

Benjamin Lardinois ◽

Laurence Miller ◽

Adrien Randazzo ◽

Terry Laurent ◽

Régis Debois ◽

...

Keyword(s):

Ductal Carcinoma ◽

Leptomeningeal Metastasis ◽

Leptomeningeal Carcinomatosis ◽

Diagnostic Sensitivity ◽

Malignant Cells ◽

Blood Cell Count ◽

Positive Cytology ◽

Cytological Examination ◽

Biochemical Alterations ◽

Fluorescent Cells

In the cerebrospinal fluid (CSF), the demonstration of malignant cells by cytological examination is currently the gold standard for the diagnosis of leptomeningeal carcinomatosis (LC). However, a positive cytology is observed in only 50–60% of patients with LC and highly dependent on pre-analytical factors. The hematology laboratory could provide an immediate and accurate diagnosis, but diagnostic sensitivity is not always optimized once the sample is received. We hereby report a 49-year-old woman with a 3-year grade III invasive ductal carcinoma who was admitted to the emergency department due to headaches, nausea, and vomiting. The CSF revealed pleocytosis with suspicious high fluorescent cells on the hematology analyzer concomitantly with biochemical alterations. Cytomorphological examination confirmed tumor cells, thus diagnosing a leptomeningeal metastasis of her breast cancer. The patient was eventually transferred to palliative care. Cytological examination is a valuable tool for a rapid diagnosis of LC if diagnostic performance is optimized. In addition to repeated CSF collections with a sufficient volume (5–10 mL), this could be reached by processing the CSF as soon as possible, taking into account the fluorescence information from the analyzer, proceeding systematically to microscopic examination even with normal CSF white blood cell count, and providing quality improvement of the staff to identify malignant cells.

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Detection of malignant cells in serous body fluids by counting high-fluorescent cells on the Sysmex XN-2000 hematology analyzer

International Journal of Laboratory Hematology ◽

10.1111/ijlh.12393 ◽

2015 ◽

Vol 37 (5) ◽

pp. 715-722 ◽

Cited By ~ 19

Author(s):

D. Labaere ◽

N. Boeckx ◽

I. Geerts ◽

M. Moens ◽

M. Van den Driessche

Keyword(s):

Body Fluids ◽

Malignant Cells ◽

Hematology Analyzer ◽

Fluorescent Cells

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Nuclear coiled bodies and the nucleolus

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100167834 ◽

1994 ◽

Vol 52 ◽

pp. 20-21

Author(s):

K. Brasch ◽

J. Williams ◽

D. Gallo ◽

T. Lee ◽

R. L. Ochs

Keyword(s):

Mouse Liver ◽

Nuclear Body ◽

Nuclear Bodies ◽

Model Systems ◽

Coiled Body ◽

Rrna Processing ◽

Malignant Cells ◽

Sm Proteins ◽

Coiled Bodies ◽

Unique Protein

Though first described in 1903 by Ramon-y-Cajal as silver-staining “accessory bodies” to nucleoli, nuclear bodies were subsequently rediscovered by electron microscopy about 30 years ago. Nuclear bodies are ubiquitous, but seem most abundant in hyperactive and malignant cells. The best studied type of nuclear body is the coiled body (CB), so termed due to characteristic morphology and content of a unique protein, p80-coilin (Fig.1). While no specific functions have as yet been assigned to CBs, they contain spliceosome snRNAs and proteins, and also the nucleolar protein fibrillarin. In addition, there is mounting evidence that CBs arise from or are generated near the nucleolus and then migrate into the nucleoplasm. This suggests that as yet undefined links may exist, between nucleolar pre-rRNA processing events and the spliceosome-associated Sm proteins in CBs.We are examining CB and nucleolar changes in three diverse model systems: (1) estrogen stimulated chick liver, (2) normal and neoplastic cells, and (3) polyploid mouse liver.

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Rapid on site evaluation (ROSE) in der Lungnklinik Ballenstedt/Harz – 23 Jahre Erfahrung (1993 – 2016) – ein GOLD-Standard

Pneumologie ◽

10.1055/s-0037-1598382 ◽

2017 ◽

Vol 71 (S 01) ◽

pp. S1-S125

Author(s):

T Beyer

Keyword(s):

Gold Standard ◽

Site Evaluation

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An Automated Clinical Information System

Methods of Information in Medicine ◽

10.1055/s-0038-1636234 ◽

1964 ◽

Vol 3 (02) ◽

pp. 45-50 ◽

Cited By ~ 6

Author(s):

D. Yoder ◽

R. Swearingen ◽

E. Schenthal ◽

W. Sweeney ◽

J. Nettleton

Keyword(s):

Natural Language ◽

Clinical Information System ◽

Drug Evaluation ◽

Scientific Information ◽

Clinical Information ◽

Clinical Situation ◽

Field Variable ◽

Record System ◽

New Members ◽

Clinical Terminology

An automated clinical record system must have the following characteristics: as far as the physician is concerned it must operate in natural language on standard sized paper; it must be able to accept information from the physician at a time when he is oriented to clinical terminology and a clinical mode of thinking; it must have an output which is clinically useful for the care and management of a patient; each item of information must be addressable so that it may act as an index for scientific information retrieval; it must be capable of accepting quantative and natural language information.Clinical information constitutes a mathematical set, only a few members of which are applicable to any particular clinical situation, and to which new members are constantly being added. The members of this set are seldom mutually exclusive. An acceptable system which is capable of processing this type of information has been designed utilizing the concepts of self-encoding forms and variable-field, variable-length records. Applications of these principles will expedite hospital automation, the establishment of drug evaluation information systems, and of regional and nationwide medical record systems.

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Architecture Models to Facilitate Communication of Clinical Information

Methods of Information in Medicine ◽

10.1055/s-0038-1634410 ◽

1999 ◽

Vol 38 (04/05) ◽

pp. 326-331

Author(s):

S. Kay

Keyword(s):

Health Care ◽

Clinical Information ◽

Reference Architecture ◽

Context Model ◽

Electronic Health

AbstractThis is an account of the development and use of a context model for facilitating the communication of clinical information. Its function is to articulate the principle of context within a reference architecture for the Electronic Health Care Record (EHCR). The work required a re-examination of established models of communication, the purpose being to use them to support an architecture that could be reasonably expected to accommodate future, and by definition unforeseeable, developments in EHCR communication. The Context Model is built upon seven recognized constituents of communication. These constituents, although having their origin in the engineering of signal communication, have been found to be useful for explication both in the verbal and textual communication of narratives between people. The electronic health care record architecture supported by the model is the European prestandard ENV13606-1.

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