Comparative Analysis of Bone Marrow Aspiration Smears, Touch Imprints and Trephine Biopsy in Haematological Malignancies

Introduction: Inspection of the bone marrow is considered oneof the most valuable diagnostic tool to evaluate hematologicmalignancies. This study compares all three techniques ofbone marrow aspiration (BMA), bone marrow imprint (BMI)and bone marrow biopsy (BMB) in morphological diagnosisof hematological malignancies.Material and methods: The study was conducted on 63selected cases of various hematological malignancies. Onlythose cases in which bone marrow examination was done byusing all the three techniques were included in the study.Results: Out of total 63 cases,53 cases were diagnosed onbone marrow aspirate smears with diagnostic accuracy of84.12%, 60 cases were diagnosed on bone marrow imprintsmears with diagnostic accuracy of 95.23% and all 63 caseswere diagnosed on bone marrow biopsy with diagnosticaccuracy of 100%.Conclusion: It is concluded that bone marrow imprintsare equally useful as bone marrow biopsy in diagnosinghematological malignancies. Imprint cytology shouldtherefore be a standard practice for evaluating bone marrow incases of hematological malignancies.

Clinical and histopathological characteristics of cutaneous Leishmaniasis in Sanliurfa City of Turkey including Syrian refugees.

Background: The aim of our study was to investigate the clinical and histopathological characteristics of cutaneous leishmaniasis (CL) in the city of Sanliurfa in Turkey, where Syrian refugees also reside. Materials and Methods: At the Harran University Hospital outpatient clinics between 2012 and 2013, 54 CL cases, including 24 Syrian patients, underwent punch biopsy of the skin and/or a touch imprint. Patients in whom leishmania parasites were detected were included in the study. The clinical and histopathological data of the patients were obtained by a review of the patients’ medical records. All the slides of each patient were re-evaluated histopathologically. Results: Fiftyfour cases (mean age; 17 ± 12 years), consisting of 32 males (59.3%) and 22 females (40.7%), were examined. The most common site of involvement was the face (63%). The most common presentation was noduloulcerative lesions (57.4%). Histopathologically, the majority of the cases exhibited hyperkeratosis, follicular plugging of the epidermis, chronic infl ammatory infi ltration, leishmania amastigotes and non-caseating granulomatous infl ammation in the dermis. Conclusion: CL presents with a wide spectrum of expression, both clinically and histologically, and may mimic other infl ammatory and neoplastic diseases. The diagnosis of CL relies on the identifi cation of leishmania amastigotes in either a direct smear of the lesion or in a tissue section.

Touch Imprint Cytology Contributed to the Frozen Section Diagnosis of Merkel Cell Carcinoma : A Case Report / 대한세포병리학회지

Merkel cell carcinoma (MCC), a rare primary cutaneous small cell neuroendocrine carcinoma, is a tumor with distinct cytological features. In many cases, immunohistochemical staining (IHC) is required for the differentiation from other small round cell malignancies. Here we describe the cytological findings of Merkel cell carcinoma; these findings contributed to the diagnosis prior to performing IHC. A lower eyelid mass was excised and submitted for frozen section diagnosis. The frozen section diagnosis was consistent with a malignancy, but the more specific diagnosis was limited by the lack of specific histological features. Touch imprint cytology revealed a high cellularity with loosely cohesive small to large sized cells. The tumor cells showed hyperchromatic nuclei with fine chromatin and inconspicuous nucleoli, and thin-rimmed-cytoplasm including the characteristic eosinophilic button-like paranuclear inclusion, previously described as a pathognomonic cytological finding of MCC; this was not found in the H&E frozen section. In conclusion, we suggest that the touch imprint cytology may help in the differential diagnosis of small round cell neoplasms prior to performing IHC especially in frozen section diagnosis.

Evaluation of intraoperative touch imprint cytology diagnosis of sentinel lymph nodes in breast cancer / 中国癌症杂志

The surgery of the breast cancer has dramatically changed,sentinel lymph node(SLN) is one of the aspects.SLN biopsy can precisely predict the status of axillary basin.If the SLN is negative,the patients can spare the unnecessary axillary lymph node dissection(ALND) and reduce the morbidity of the surgery.One of the most important issues with sentinel node biopsy is the intraoperative pathological evaluation of the sentinel nodes.Accurate intraoperative pathological examination of sentinel nodes would enable the selection of candidates for ALND during the initial operation,eliminating the need for second surgery.This article will review the two techniques(touch imprint cytology and frozen section) employed for intraoperative examination of SLN and compare these two methods.And evaluate the role of touch imprint cytology and existing problems in introperative diagnosis of the sentinel lymph nodes and raise the probably ways to improve the sensitivity of touch imprint cytology initially.

Meaning Touch Imprint and Testicular Sperm Extraction(TEST) in Azoospermia Patients during Testis Biopsy / 대한비뇨기과학회지

PURPOSE: Because testicular biopsy traditionally has been performed as a separate operation, there are some needs for immediate interpretation of the testicular biopsy specimen in obstructive azoospermia patients. The realization that a proportion of patients with nonobstructive azoospermia harbor spermatozoa in their testicular parenchyma, combined with the ability of intracytoplasmic sperm injection(ICSI) to effect pregnancy with single sperm, has prompted clinicians to explore testicular sperm extraction(TESE) in these patients. We performed this study to investigate the meaning of touch imprint and TESE. MATERIALS AND METHODS: Fifty-two patients with azoospermia underwent touch imprint, TESE and simultaneous formal testicular biopsy. Testicular biopsy tissue was touched on a slide and stained using a Diff-Quik method. Tissue obtained from TESE was analyzed by intensive searching to find spermatozoa. RESULTS: Twenty-nine patients were determined as obstructive azoospermia including two cases of hypospermatogenesis, all patients had sperm seen on touch imprint and TESE. The other patients were diagnosed as nonobstructive azoospermia, testicular histology was divided into two main patterns: Sertoli cell only syndrome, spermatocytic arrest. Touch imprint failed to show sperm, but three of twenty patients(15%) with Sertoli cell only syndrome had sperm present during TESE. CONCLUSIONS: Touch imprint provides high quality cellular detail for immediate review, which can minimize the intraoperative time required to decide upon the appropriateness of correcting the ductal obstruction in obstructive azoospermia patients. Men with nonobstructive azoospermia may have mature spermatozoa present within their testicular parenchyma. Therefore intensive searching for presence of spermatozoa should be performed in tissue obtained from TESE by trained specialist.

Morphometric Analysis of Malignant Lymphoma

Nuclear morphology and size are important in the diagnosis and classification of non-Hodgkin's lymphoma. The recognition of morphologic features of the lymphoma cells and their interpretation are somewhat subjective and often difficult. We apply the morphometric study in touch imprints from 22 cases of non-Hodgkin's lymphoma classified by Working formulation. Determination of the exact size of the tumor cells and substantial diagnostic value of this method compared with histology are proposed. Morphometric parameters, including nuclear area, perimeter, maximal diameter (D-max), diameter of an equivalent circle for a measured area (D-circle), circularity factor (From PE) and regularity factor (Form AR) are measured, using Kontron, user-controlled image analyser (IBAS-1). The correlation between morphometric and histologic diagnosis is relatively good, except for 2 cases of Burkitt's lymphoma, measured as large cell and 2 cases of large cell lymphoma measured as medium cell. The most reliable parameter of the nuclear size is D-circle. The parameters for the nuclear shape, Form PE and Form AR, also reflect the nuclear cleavage and polymorphous pattern. The large cell group shows more wide standard deviation than small and medium cell groups, reflecting heterogeneity and variability in unclear size of large cell group. We suggests the morphometric analysis using touch imprints is complementary diagnostic tool for more accurate and reproducible diagnosis.