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BACKGROUND Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC) is a unique form of carcinoma that is important to identify for prognosis and treatment. Immunohistochemistry (IHC) for p16 (also known as cyclin-dependent kinase inhibitor 2A, multiple tumor suppressor 1) is used as a surrogate marker for transcriptionally active, high-risk HPV. The primary objective of this study was to correlate p16 IHC of cell blocks from fine-needle aspirations (FNAs) with surgical pathology specimens of HPV-related oropharyngeal SCC. METHODS In total, 48 patients who had a diagnosis of oropharyngeal or nonoropharyngeal SCC and also had an FNA that demonstrated metastatic SCC with available cell block material were identified. IHC for p16 was evaluated on both FNA cell blocks and surgical pathology specimens. In situ hybridization for high-risk HPV messenger RNA was performed on 31 of the FNA cell blocks. RESULTS Although partial p16 staining was observed in the majority of cell blocks, there was concordance in 47 of 48 FNAs (98%) with surgical pathology specimens when strong positive p16 staining of at least 15% of tumor cells in FNA cell block material was present. In addition, high-risk HPV RNA in situ hybridization demonstrated a high correlation with p16 staining in surgical pathology specimens (96%) and FNAs (93%). CONCLUSIONS There was excellent correlation between p16 IHC of FNA cell blocks and surgical pathology specimens using a cutoff of at least 15% positive staining in cell blocks. The recommended threshold (70% positive staining) for surgical pathology specimens may yield a high rate of false-negative results if applied to FNA cell blocks. Cancer (Cancer Cytopathol) 2015;123:723-731. © 2015 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND Cell blocks are critically important in fine-needle aspiration (FNA) biopsies and the increasing requirements for personalized medicine testing further highlight their value. When a cell block is inadequate, it can necessitate additional procedures. The objective of the current study was to measure the impact and outcome of dedicated aspirate pass techniques and slide cellularity on cell block quality. METHODS Over a 6-month period, all FNA biopsy cases with cell blocks were identified. Procedural data including the number of dedicated aspirate passes were recorded. Individual cases were retrospectively reviewed and scored for multiple endpoints, including aspirate smear cellularity and cell block quality. RESULTS A total of 605 FNA biopsy and cell block cases were identified. The cell block quality score demonstrated a progressive improvement with an increasing number of dedicated biopsies. The performance of a single dedicated biopsy demonstrated a higher percentage of intermediate to high cell block quality scores in comparison with none (+12.1%; P = .0142). The performance of 3 dedicated biopsies demonstrated a higher percentage of intermediate to high cell block quality scores in comparison with a single pass (+13.5%; P = .0138). An intermediate-quality to high-quality terminal aspirate smear was more likely to have a high cell block quality score (+31.6%; P = .0001). CONCLUSIONS Performing at least 1 dedicated FNA biopsy pass was found to improve cell block quality and multiple dedicated biopsies resulted in nearly one-half having a higher quality score. A high-cellularity terminal FNA biopsy smear contributed significantly to obtaining a high-quality cell block. Performing dedicated FNA biopsies and the use of high-quality aspirate smears are effective clinical practices for improving cell block outcomes. Cancer (Cancer Cytopathol) 2015;123:540-547. © 2015 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND Microphthalmia transcription factor (MiTF) is a sensitive and specific immunohistochemistry (IHC) marker for malignant melanoma (MM) in surgical resections, but its utility in cytology specimens has not been extensively studied. METHODS A search of the pathology database identified fine-needle aspiration biopsies signed out as MM or suspicious for MM (1998-2012). The final diagnosis and the IHC results were recorded, and all slides were re-reviewed. MiTF IHC (C5/D5 cocktail) was performed on alcohol-fixed, Papanicolaou-stained direct smears. Any amount of nuclear staining was considered positive. Staining was scored on a scale of 1 to 4 (1, 1%-24%; 2, 25%-49%; 3, 50%-74%; 4, 75%-100%). RESULTS Two hundred seventy-four cases were diagnosed as MM, and 24 were diagnosed as suspicious for MM. IHC staining was performed for 25% (69 of 274) of the MM cases and for 33% (8 of 24) of the cases suspicious for MM. MiTF IHC of Papanicolaou slides was performed for 37% (101 of 274) of the MM cases (positive, 82% [83 of 101]; negative, 4% [4 of 101]; noncontributory, 14% [14 of 101]) and for 33% (8 of 24) of the cases suspicious for MM (positive, 38% [3 of 8]; noncontributory, 62% [5 of 8]). The majority of positive staining was scored as 3 or 4. The sensitivity of MiTF on Papanicolaou-stained slides was 95%. CONCLUSIONS MiTF is a useful IHC stain for the evaluation of ocular MM, and it is effective when it is performed on alcohol-fixed, Papanicolaou-stained aspirate smears. Cancer (Cancer Cytopathol) 2015;123:394-400. © 2015 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND Endobronchial ultrasound guided (EBUS) fine-needle aspiration (FNA) biopsy has become widely used to evaluate patients with thoracic abnormalities. Rapid on-site evaluation (ROSE) can provide the bronchoscopist with immediate evaluation findings during the procedure. This study examines EBUS FNA biopsy procedures with and without ROSE, and investigates the impact of ROSE service on the EBUS procedure and laboratory resource utilization. METHODS The cytopathology database at Washington University Medical Center, St. Louis, Missouri, was searched for EBUS FNA biopsy cases before and after introduction of ROSE service, and a matched cohort was collected. Reports were reviewed and pertinent data was collected, such as sites biopsied, ROSE performance, slide smears, cell blocks, and diagnostic categories. Statistical analysis of the results was performed. RESULTS A matched case-controlled EBUS FNA cohort of 340 patients (680 total) for each category of non-ROSE and ROSE service were identified. There was a 33% reduction in the number of sites biopsied with ROSE. A total of 68% of patients with ROSE had just one biopsy site compared to only 36% of non-ROSE patients. There was a 30% decrease in total slides (mean, 5.27 slides) after the introduction of ROSE. All of these improvements were statistically significant. CONCLUSIONS EBUS FNA biopsy ROSE service benefits patients by contributing to significantly fewer biopsies and improved utilization of health care resources. ROSE service results in substantially fewer total slides, which has a significant impact on the cytopathology laboratory work effort. The use of ROSE for EBUS FNA biopsy provides significant improvements in patient care and laboratory resource utilization. Cancer (Cancer Cytopathol) 2013;121:544-551. © 2013 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND Rapid on-site evaluation (ROSE) for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsy of the pancreas provides immediate feedback regarding cellular adequacy to aid in obtaining a definitive diagnosis and has the potential to avoid repeat procedures. The objective of the current study was to measure the impact of ROSE service on the incidence of repeat EUS FNA biopsy procedures. METHODS Over a consecutive 3-year period, the pathology database at Washington University Medical Center was searched for patients with both an initial and subsequent EUS FNA biopsy demonstrating a solid lesion of the pancreas. These were divided temporally between the time before and after the introduction of ROSE service. Reports were reviewed and results were recorded. RESULTS A total of 379 patients underwent ROSE service and 377 patients did not. The percentage of repeat non-ROSE EUS FNA cases was 5.8% and the percentage of repeat ROSE EUS FNA cases was 2.9%. The use of the ROSE service was found to decrease the number of repeat procedures by approximately 50% ( P = .024). For those patients who underwent a repeat EUS-FNA procedure, the ROSE service provided a higher rate of definitive diagnosis among patients undergoing repeat procedures (67%) versus the non-ROSE cohort (27%). CONCLUSIONS The use of ROSE for EUS-FNA biopsy of the pancreas was found to result in fewer patients undergoing repeat procedures. Patients who required a repeat procedure with the use of ROSE had a higher percentage of definitive diagnostic categorization on the repeat biopsy. Initial use of ROSE for EUS-FNA of solid pancreatic lesions was found to decrease the number of patients who required a repeat procedure. Cancer (Cancer Cytopathol) 2013;121:518-24. © 2013 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND: With the introduction of new treatment modalities and guidelines, it is important to subclassify primary pulmonary non-small cell carcinoma (NSCCA). Subsequent treatment and testing is dependent on accurate subclassification. Endobronchial ultrasound fine-needle aspiration (EBUS FNA) is used for primary evaluation and diagnosis, and can provide a cell block for ancillary testing. METHODS: EBUS FNA cases from primary pulmonary NSCCA with an immunohistochemical (IHC) panel performed on a cell block with concomitant surgical pathology biopsy were analyzed. Cell block preparations underwent an IHC panel including monoclonal antibodies for napsin A (nap-A), thyroid transcription factor (TTF-1), p63, and cytokeratin 5/6 (CK5/6). RESULTS: A total of 81 cases from 81 patients were identified. Of these, 69 cases (85%) were provided a specific diagnosis of adenocarcinoma (ADCA) or squamous cell carcinoma (SCCA) on the EBUS FNA. In 12 cases (15%), a diagnosis of NSCCA, not otherwise specified was provided. For specific subclassifications, there were 35 ADCA cases, 34 SCCA cases, and 12 NSCCA, not otherwise specified cases. For ADCA, nap-A showed granular cytoplasmic staining and TTF-1 nuclear staining. For SCCA, CK5/6 showed cytoplasmic staining and p63 nuclear staining. Surgical pathology concomitant material was present in 29 of 81 cases with 18 correlations and 11 noncorrelations. CONCLUSIONS: With new treatment guidelines for patients with primary pulmonary NSCCA, specific diagnosis is increasingly important. EBUS FNA with cell block provided a specific subclassification of NSCCA in 85% of cases when used in conjunction with a specific IHC panel including nap-A, TTF-1, CK5/6, and p63. Cancer (Cancer Cytopathol) 2013. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

The article focuses on a study on the outcomes between patients with spinal metastases from breast cancer treated with CyberKnife stereotactic radiosurgery and patients who received conventional external beam radiotherapy (CRT). The study found that CyberKnife and CRT groups were comparable along all matching dimensions and in performance status before treatment. Additionally, outcomes of treatment were similar for patients in both groups. The study also revealed that survival and the number of complications appeared to favor the CyberKnife group.

This article focuses on a survey which presents an evidence of recent population increases in common eiders breeding in Labrador and Newfoundland. Populations of several sea ducks are declining across their North American ranges, including populations of all 4 eider species. Factors identified as causing these declines include human disturbance, overharvesting, and climatic events. Labrador has breeding populations of the northern common eider, the American common eider and intergrades of the 2 subspecies. Researchers documented this zone of overlap, but the geographic extent and consequences for population structure and recruitment have not been fully explored. In 1998, the Canadian Wildlife Service in conjunction with the Labrador Inuit Association, initiated surveys on the Labrador coast to collect information to estimate breeding eider population trends. Results based on islands surveyed a minimum of 4 years showed an average apparent annual increase of 2 1.6% for Nain, 13.4% for Hopedale, and 18.1% for all areas over the 6-year period from 1998 to 2003.

Presents a letter to the editor about radiation recall dermatitis, published in the March 2004 issue of the "The Breast Journal."

An abstract of the article "Utilization Of The Indeterminate/Atypia Of Undetermined Significance Category in Thyroid Aspiration Cytology: How Often Is It Used," by Brian T. Collins, Lester J. Layfield, Evelyn V. Gopez, and Joel S. Bentz is presented.