Diagnostic accuracy of bronchial brush cytology and the added value of immunohistochemistry and fluorescence in situ hybridization of pulmonary neuroendocrine tumors

Jordan Reynolds, Jesse Voss, Shannon Brankley, Jill Caudill, Michael Henry, Amy Clayton, Kevin Halling, Aziza Nassar

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Bronchial brush (BB) cytology carries low sensitivity for detecting neuroendocrine carcinomas (NECs), including typical carcinoid (TC) tumors of the lung. We aimed to investigate the detection of neuroendocrine tumors including TC through BB routine cytology cell block (CB), immunohistochemistry (IHC), and fluorescence in situ hybridization (FISH). Materials and Methods: A SNOMED search showed 187 lung biopsy or resection specimens from 2008 through 2011 containing neuroendocrine or carcinoid in the diagnosis. Residual BB specimens retained in PreservCyt were used to prepare a ThinPrep slide for FISH analysis. CBs were stained with H and E and IHC for chromogranin and synaptophysin. Results: Of the 187 cases, 16 had residual BB material available within 1 year of diagnosis and were used in CB preparation for IHC and FISH slides. Cytologic evaluation determined 1 case positive for malignancy (small cell lung carcinoma [SCLC]), 1 suspicious for adenocarcinoma, and 14 negative for malignancy. On the basis of histologic diagnosis, FISH was performed. SCLC showed polysomy (86% abnormal cells); 2 TC tumors showed a gain of 7p12 (15% abnormal cells) and a gain of 5q15 (72% abnormal cells), respectively. Two cases had CBs with positive immunoreactivity for chromogranin and synaptophysin. The sensitivity for detection of NEC was 18.8%, 15.4%, and 25% for cytologic evaluation, CB, and FISH, respectively. Conclusion: Neuroendocrine tumors, including TC are difficult to detect with BB cytologic evaluation, most likely because tumor cells lack in the specimen. Assessment of further studies is needed to explore the role of cytology and ancillary methods for detection of these tumors.

Original languageEnglish (US)
Article number32
JournalCytoJournal
Volume11
Issue number1
DOIs
StatePublished - Nov 14 2014
Externally publishedYes

Fingerprint

Neuroendocrine Tumors
Fluorescence In Situ Hybridization
Carcinoid Tumor
Cell Biology
Immunohistochemistry
Lung
Chromogranins
Neuroendocrine Carcinoma
Synaptophysin
Small Cell Lung Carcinoma
Neoplasms
Systematized Nomenclature of Medicine
Adenocarcinoma
Biopsy

Keywords

  • Ancillary studies
  • carcinoid tumor
  • cytology
  • endobronchial sampling
  • pulmonary

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Diagnostic accuracy of bronchial brush cytology and the added value of immunohistochemistry and fluorescence in situ hybridization of pulmonary neuroendocrine tumors. / Reynolds, Jordan; Voss, Jesse; Brankley, Shannon; Caudill, Jill; Henry, Michael; Clayton, Amy; Halling, Kevin; Nassar, Aziza.

In: CytoJournal, Vol. 11, No. 1, 32, 14.11.2014.

Research output: Contribution to journalArticle

Reynolds, Jordan ; Voss, Jesse ; Brankley, Shannon ; Caudill, Jill ; Henry, Michael ; Clayton, Amy ; Halling, Kevin ; Nassar, Aziza. / Diagnostic accuracy of bronchial brush cytology and the added value of immunohistochemistry and fluorescence in situ hybridization of pulmonary neuroendocrine tumors. In: CytoJournal. 2014 ; Vol. 11, No. 1.
@article{ebb0ec3bd1b64c1dbf23cb46faaa2bfd,
title = "Diagnostic accuracy of bronchial brush cytology and the added value of immunohistochemistry and fluorescence in situ hybridization of pulmonary neuroendocrine tumors",
abstract = "Background: Bronchial brush (BB) cytology carries low sensitivity for detecting neuroendocrine carcinomas (NECs), including typical carcinoid (TC) tumors of the lung. We aimed to investigate the detection of neuroendocrine tumors including TC through BB routine cytology cell block (CB), immunohistochemistry (IHC), and fluorescence in situ hybridization (FISH). Materials and Methods: A SNOMED search showed 187 lung biopsy or resection specimens from 2008 through 2011 containing neuroendocrine or carcinoid in the diagnosis. Residual BB specimens retained in PreservCyt were used to prepare a ThinPrep slide for FISH analysis. CBs were stained with H and E and IHC for chromogranin and synaptophysin. Results: Of the 187 cases, 16 had residual BB material available within 1 year of diagnosis and were used in CB preparation for IHC and FISH slides. Cytologic evaluation determined 1 case positive for malignancy (small cell lung carcinoma [SCLC]), 1 suspicious for adenocarcinoma, and 14 negative for malignancy. On the basis of histologic diagnosis, FISH was performed. SCLC showed polysomy (86{\%} abnormal cells); 2 TC tumors showed a gain of 7p12 (15{\%} abnormal cells) and a gain of 5q15 (72{\%} abnormal cells), respectively. Two cases had CBs with positive immunoreactivity for chromogranin and synaptophysin. The sensitivity for detection of NEC was 18.8{\%}, 15.4{\%}, and 25{\%} for cytologic evaluation, CB, and FISH, respectively. Conclusion: Neuroendocrine tumors, including TC are difficult to detect with BB cytologic evaluation, most likely because tumor cells lack in the specimen. Assessment of further studies is needed to explore the role of cytology and ancillary methods for detection of these tumors.",
keywords = "Ancillary studies, carcinoid tumor, cytology, endobronchial sampling, pulmonary",
author = "Jordan Reynolds and Jesse Voss and Shannon Brankley and Jill Caudill and Michael Henry and Amy Clayton and Kevin Halling and Aziza Nassar",
year = "2014",
month = "11",
day = "14",
doi = "10.4103/1742-6413.146120",
language = "English (US)",
volume = "11",
journal = "CytoJournal",
issn = "0974-5963",
publisher = "Medknow Publications and Media Pvt. Ltd",
number = "1",

}

TY - JOUR

T1 - Diagnostic accuracy of bronchial brush cytology and the added value of immunohistochemistry and fluorescence in situ hybridization of pulmonary neuroendocrine tumors

AU - Reynolds, Jordan

AU - Voss, Jesse

AU - Brankley, Shannon

AU - Caudill, Jill

AU - Henry, Michael

AU - Clayton, Amy

AU - Halling, Kevin

AU - Nassar, Aziza

PY - 2014/11/14

Y1 - 2014/11/14

N2 - Background: Bronchial brush (BB) cytology carries low sensitivity for detecting neuroendocrine carcinomas (NECs), including typical carcinoid (TC) tumors of the lung. We aimed to investigate the detection of neuroendocrine tumors including TC through BB routine cytology cell block (CB), immunohistochemistry (IHC), and fluorescence in situ hybridization (FISH). Materials and Methods: A SNOMED search showed 187 lung biopsy or resection specimens from 2008 through 2011 containing neuroendocrine or carcinoid in the diagnosis. Residual BB specimens retained in PreservCyt were used to prepare a ThinPrep slide for FISH analysis. CBs were stained with H and E and IHC for chromogranin and synaptophysin. Results: Of the 187 cases, 16 had residual BB material available within 1 year of diagnosis and were used in CB preparation for IHC and FISH slides. Cytologic evaluation determined 1 case positive for malignancy (small cell lung carcinoma [SCLC]), 1 suspicious for adenocarcinoma, and 14 negative for malignancy. On the basis of histologic diagnosis, FISH was performed. SCLC showed polysomy (86% abnormal cells); 2 TC tumors showed a gain of 7p12 (15% abnormal cells) and a gain of 5q15 (72% abnormal cells), respectively. Two cases had CBs with positive immunoreactivity for chromogranin and synaptophysin. The sensitivity for detection of NEC was 18.8%, 15.4%, and 25% for cytologic evaluation, CB, and FISH, respectively. Conclusion: Neuroendocrine tumors, including TC are difficult to detect with BB cytologic evaluation, most likely because tumor cells lack in the specimen. Assessment of further studies is needed to explore the role of cytology and ancillary methods for detection of these tumors.

AB - Background: Bronchial brush (BB) cytology carries low sensitivity for detecting neuroendocrine carcinomas (NECs), including typical carcinoid (TC) tumors of the lung. We aimed to investigate the detection of neuroendocrine tumors including TC through BB routine cytology cell block (CB), immunohistochemistry (IHC), and fluorescence in situ hybridization (FISH). Materials and Methods: A SNOMED search showed 187 lung biopsy or resection specimens from 2008 through 2011 containing neuroendocrine or carcinoid in the diagnosis. Residual BB specimens retained in PreservCyt were used to prepare a ThinPrep slide for FISH analysis. CBs were stained with H and E and IHC for chromogranin and synaptophysin. Results: Of the 187 cases, 16 had residual BB material available within 1 year of diagnosis and were used in CB preparation for IHC and FISH slides. Cytologic evaluation determined 1 case positive for malignancy (small cell lung carcinoma [SCLC]), 1 suspicious for adenocarcinoma, and 14 negative for malignancy. On the basis of histologic diagnosis, FISH was performed. SCLC showed polysomy (86% abnormal cells); 2 TC tumors showed a gain of 7p12 (15% abnormal cells) and a gain of 5q15 (72% abnormal cells), respectively. Two cases had CBs with positive immunoreactivity for chromogranin and synaptophysin. The sensitivity for detection of NEC was 18.8%, 15.4%, and 25% for cytologic evaluation, CB, and FISH, respectively. Conclusion: Neuroendocrine tumors, including TC are difficult to detect with BB cytologic evaluation, most likely because tumor cells lack in the specimen. Assessment of further studies is needed to explore the role of cytology and ancillary methods for detection of these tumors.

KW - Ancillary studies

KW - carcinoid tumor

KW - cytology

KW - endobronchial sampling

KW - pulmonary

UR - http://www.scopus.com/inward/record.url?scp=85002340244&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85002340244&partnerID=8YFLogxK

U2 - 10.4103/1742-6413.146120

DO - 10.4103/1742-6413.146120

M3 - Article

AN - SCOPUS:85002340244

VL - 11

JO - CytoJournal

JF - CytoJournal

SN - 0974-5963

IS - 1

M1 - 32

ER -