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Objective Fine needle aspiration (FNA) is widely used in the diagnosis of metastatic melanoma, both at initial presentation and in the setting of recurrent disease. The purpose of this study was to evaluate the performance of confirmatory immunohistochemistry (IHC) and molecular analysis of the BRAF mutation in cytological preparations of metastatic melanoma. Methods A 2-year retrospective review of pathology reports was performed on cytological samples of metastatic melanoma at the University Health Network (Toronto, Canada) and the Santa Casa Medical School (Sao Paulo, Brazil). IHC was performed on cell block sections prepared from formalin-fixed, fresh samples or residuum of CytoLyt/PreservCyt post-fixed in formalin. BRAF V600E/K mutations were assessed by amplification refractory mutation system (ARMS) analysis. Results A total of 104 samples (94 FNAs and 10 fluids) from 83 patients (20 women, 63 men) were included. IHC was attempted in 43 cases (41.3%) and successful in 41 (95.3%). The panel number of antibodies ranged from 1 to 15 (median 3). The most frequently used melanoma markers included HMB-45, melanoma cocktail and S100 protein, used in 25 (58.1%), 23 (53.5%) and 18 samples (41.9%). Thirty cases (69.8%) used three or fewer markers. The BRAF V600E/K mutation was tested in eight samples, being successful in seven (87.5%) and positive in three (37.5%). Conclusions Cytological samples are a reliable and sufficient source for IHC and subsequent molecular analysis, allowing a reduced diagnostic time and rapid, appropriate treatment options in patients with advanced melanoma. [ABSTRACT FROM AUTHOR]

Primary leptomeningeal melanomatosis is an extremely rare, diffuse, malignant melanocytic neoplasm without a localised mass. In this case, both immunocytochemistry and molecular testing were successfully completed using a CSF sample, allowing confirmation of the diagnosis and determination of the mutational status of the melanoma. [ABSTRACT FROM AUTHOR]

Objective To review cytomorphological criteria and clinicopathological findings in combination with ancillary tests for the specific diagnosis of pulmonary marginal zone lymphoma ( MZL) in fine needle aspiration ( FNA) specimens. Methods Cases of pulmonary MZL diagnosed using cytological specimens from 2005 to 2012 were retrieved and reviewed by three cytopathologists. Results of immunophenotypic analysis, interphase fluorescence in situ hybridization ( FISH) and molecular assays were collated, together with clinical information and imaging data. Concurrent surgical biopsies were also retrieved. Results Fifteen lung FNA specimens were identified. The smears consisted predominantly of small centrocyte-like cells. Marked plasma cell differentiation was evident in 11 cases. All cases with slides available showed tissue fragments with lymphoid tangles ( TFLTs). Multinucleated giant cells were present in nine cases, two of which showed granulomas. Immunophenotyping confirmed B-cell clonality in all cases. B-cell clonality was detected by polymerase chain reaction ( PCR) in two samples. FISH identified MALT1 translocation in four of 10 cases tested and trisomy 3 in three of four cases. Concurrent surgical biopsies were diagnosed independently as MZL in seven cases. Conclusions Cytology smears from lung FNA samples consisting of small lymphoid cells with a relative abundance of plasma cells or plasmacytoid cells and large TFLTs should prompt immunophenotyping and other ancillary studies, even if multinucleated giant cells and poorly formed granulomas are also identified. Specific diagnosis of pulmonary MZL in FNA samples can be rendered on the basis of morphological features coupled with the demonstration of B-cell clonality by immunophenotyping or PCR and cytogenetic abnormalities by FISH. [ABSTRACT FROM AUTHOR]

Objective Detection of Epstein-Barr virus ( EBV) status might help in the diagnosis of EBV-related neoplasms. The rate of successful assays for the detection of EBV-infected cells in cytological preparations has not been fully explored. Our aims were to examine the rate of successful in situ hybridization ( ISH) assays for EBV-encoded RNA ( EBER) in cytological specimens and to explore reasons for failure. Methods An electronic search selected cases with ISH- EBER assays performed on cytological preparations during a 10-year period. Data regarding patient age, gender and immune status, sample type and site, type of preparation, ISH- EBER results, immunophenotyping and immunohistochemistry results, final diagnosis and correspondent histopathological samples were retrieved. Results Sixty specimens from 58 patients with diagnoses of lymphoproliferative disorder ( n = 35), carcinoma ( n = 24) and sarcoma ( n = 1) were identified. ISH- EBER assays were performed on 50 cell block sections and on 10 cytospin preparations, with 22 positive and 32 negative results. Six tests (four cytospins and two cell block sections) failed owing to loss of material during the assay and background staining, with an overall failure rate of 10% and 4% if cytospins were excluded. Assays were performed on 13 cytology and surgical specimens from the same site, with only one discrepant result. Conclusions Cell block sections had more successful ISH- EBER assays when compared with cytospins. Reasons for failure were loss of material on the slide and background staining. A high concordance rate with surgical specimens emphasizes the usefulness of cytological samples for determining EBV status in patients with exhausted or no histological material available. [ABSTRACT FROM AUTHOR]

Background Lung cancer leads cancer-related mortality in the world. The objective of the present systematic review was to compare fine-needle aspiration biopsy (FNAB) with core-needle biopsy (CNB) for diagnostic characteristics and yields for diagnosing lung cancer in patients with lung lesions. Methods The MEDLINE and EMBASE databases (from January 1, 1990, to September 14, 2009), the Cochrane Library (to Issue 4, 2009), and selected guideline Web sites were searched for relevant articles. Results For overall diagnostic characteristics (benign vs. malignant) of FNAB and CNB, the ranges of sensitivity were 81.3%-90.8% and 85.7-97.4% respectively; of specificity, 75.4%-100.0% and 88.6%-100.0%; and of accuracy, 79.7%-91.8% and 89.0%-96.9%. For specific diagnostic characteristics of FNAB and CNB (identifying the histologic subtype of malignancies or the specific benign diagnoses), the ranges of sensitivity were 56.3%-86.5% and 56.5-88.7% respectively; of specificity, 6.7%-57.1% and 52.4%-100.0%; and of accuracy, 40.4%-81.2% and 66.7%-93.2%. Compared with FNAB, CNB did not result in a higher complication rate (pneumothorax or hemoptysis). No study has yet compared the diagnostic yields of FNAB and of CNB for molecular predictive-marker studies in patients with lung lesions. Discussion and Conclusions The evidence is currently insufficient to support a difference between FNAB and CNB in identifying lung malignancies in patients with lung lesions. Compared with FNAB, CNB might have a higher specificity to diagnose specific benign lesions. Well-designed, good-quality studies comparing FNAB with CNB for diagnostic characteristics and yields in diagnosing lung cancer should be encouraged. [ABSTRACT FROM AUTHOR]