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Histochemistry and Cell Biology Aug 2023Mismatch repair (MMR) testing on all new cases of colorectal cancer (CRC) has customarily been preferably performed on surgical specimens, as more tissue is available;...
Mismatch repair (MMR) testing on all new cases of colorectal cancer (CRC) has customarily been preferably performed on surgical specimens, as more tissue is available; however, new clinical trials for the use of immune checkpoint inhibitors in the neoadjuvant setting require MMR testing on biopsy samples. This study aims at identifying advantages, disadvantages and any potential pitfalls in MMR evaluation on biopsy tissue and how to cope with them. The study is prospective-retrospective, recruiting 141 biopsies (86 proficient (p)MMR and 55 deficient (d)MMR) and 97 paired surgical specimens (48 pMMR; 49 dMMR). In biopsy specimens, a high number of indeterminate stains was observed, in particular for MLH1 (31 cases, 56.4%). The main reasons were a punctate nuclear expression of MLH1, relatively weak MLH1 nuclear expression compared to internal controls, or both (making MLH1 loss difficult to interpret), which was solved by reducing primary incubation times for MLH1. A mean of ≥ 5 biopsies had adequate immunostains, compared to ≤ 3 biopsies in inadequate cases. Conversely, surgical specimens rarely suffered from indeterminate reactions, while weaker staining intensity (p < 0.007) for MLH1 and PMS2 and increased patchiness grade (p < 0.0001) were seen. Central artefacts were almost exclusive to surgical specimens. MMR status classification was possible in 92/97 matched biopsy/resection specimen cases, and all of these were concordant (47 pMMR and 45 dMMR). Evaluation of MMR status on CRC biopsy samples is feasible, if pitfalls in interpretation are known, making laboratory-specific appropriate staining protocols fundamental for high-quality diagnoses.
Topics: Humans; Retrospective Studies; Prospective Studies; Colorectal Neoplasms; Biopsy
PubMed: 37284845
DOI: 10.1007/s00418-023-02202-8 -
Minimally Invasive Therapy & Allied... Oct 2018The purpose of this study is to evaluate the accuracy of percutaneous fine needle biopsy (FNB) and brush biopsy (BB) at a cancer center. (Comparative Study)
Comparative Study
PURPOSE
The purpose of this study is to evaluate the accuracy of percutaneous fine needle biopsy (FNB) and brush biopsy (BB) at a cancer center.
MATERIAL AND METHODS
Retrospective analysis of all bile duct biopsies performed in Interventional Radiology between January 2000 and January 2015 was performed. FNB was performed under real-time cholangiographic guidance using a notched needle directed at the bile duct stricture. BB was performed by advancing a brush across the stricture and moving it back and forth to scrape the stricture. Biopsy results were categorized as true positive (TP), true negative (TN), false positive (FP) and false negative (FN) based on pathology reports and confirmed by surgical specimens or clinical follow-up of at least six months. Fisher's exact test was used to compare the rate of TP in FNB and BB.
RESULTS
One-hundred and nineteen patients underwent FNB or BB. Fifteen were censored because of lack of follow-up. The remaining 104 patients underwent a total of 117 bile duct biopsies during the study period: 34 FNB and 83 BB. There were no complications in either group. In the FNB group 22/34 (64%) biopsies were TP, 4/34(12%) were TN and there were 8(24%) FN biopsies. In the BB group, 20/83 (24%) were TP, 38/83 (46%) TN and 25/83 (30%) FN biopsies. There were no FP biopsies in either group. The sensitivity of detecting malignancy by FNB was significantly higher than that by BB (73% vs 44%, p < .0005). There were no complications associated with FNB or BB.
CONCLUSIONS
FNB of bile duct strictures is safe and has a higher sensitivity for detecting malignancy than BB.
Topics: Adult; Aged; Aged, 80 and over; Bile Duct Diseases; Bile Duct Neoplasms; Biopsy; Biopsy, Fine-Needle; Constriction, Pathologic; False Negative Reactions; False Positive Reactions; Female; Humans; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificity; Young Adult
PubMed: 29390936
DOI: 10.1080/13645706.2018.1427597 -
Urology Journal Oct 2020The main goal of this study was to assess the histopathological efficacy of renal mass biopsy and to check the concordance between pathological results and biopsy of the...
PURPOSE
The main goal of this study was to assess the histopathological efficacy of renal mass biopsy and to check the concordance between pathological results and biopsy of the final specimen, as well as interobserver variability in the assessment of biopsy cores.
MATERIALS AND METHODS
A hundred sets of core biopsies of postoperative specimens (renal masses) have been performed. Three core biopsies of the intact specimen had been performed once the kidney with the tumor, or the tumor alone were resected. The urologist aimed to obtain two cores from the peripheral sides of the tumor and one core from its center. The surgical specimen was evaluated by a single pathologist, whereas biopsy samples were referred to three independent pathologists who were blinded to the final results of the renal mass biopsy.
RESULTS
Nondiagnostic biopsy rates ranged from 13% to 22%. Sensitivity and specificity ranged 83-97% and 97-99% by excluding nondiagnostic results. The concordance between assessment of surgical specimen and biopsy in the Fuhrman grading system ranged 36.5-77.0%, respectively. Interobserver agreement between the three pathologists was substantial or moderate, depending on the tumor subtype. The Krippendorff's alpha coefficient, calculated by excluding the nondiagnostic results, was 0.28 (moderate agreement) for the Fuhrman grading system.
CONCLUSION
The agreement regarding grading of biopsies between three pathologists ranged from moderate to substantial. Therefore, a team of dedicated uropathologists should be engaged in final diagnosis of renal mass biopsy rather than single one before implementing the proper treatment.
Topics: Biopsy; Humans; Kidney; Kidney Neoplasms; Observer Variation; Reproducibility of Results
PubMed: 33000458
DOI: 10.22037/uj.v16i7.6024 -
Cancer Journal (Sudbury, Mass.)The advent of high-throughput technologies has enabled the analysis of minute amounts of tumor-derived material purified from body fluids, termed "liquid biopsies."... (Review)
Review
The advent of high-throughput technologies has enabled the analysis of minute amounts of tumor-derived material purified from body fluids, termed "liquid biopsies." Prostate cancer (PCa) management, like in many other cancer types, has benefited from liquid biopsies at several stages of the disease. Although initially describing circulating tumor cells in blood, the term "liquid biopsy" has come to more prominently include cell-free, circulating tumor DNA, as well as RNA, proteins, and other molecules. They provide tumor molecular information representing the entire, often-heterogeneous disease, relatively noninvasively and longitudinally. Blood has been the main liquid biopsy specimen in PCa, and urine has also proven beneficial. Technological advances have allowed clinical implementation of some liquid biopsies in PCa, in disease monitoring and precision oncology. This narrative review introduces the main types of blood-based PCa liquid biopsies focusing on advances in the past 5 years. Clinical adoption of liquid biopsies to detect and monitor the evolving PCa tumor biology promises to deepen our understanding of the disease and improve patient outcomes.
Topics: Male; Humans; Precision Medicine; Prostatic Neoplasms; Liquid Biopsy; Biopsy; RNA; Biomarkers, Tumor; Neoplastic Cells, Circulating
PubMed: 37471612
DOI: 10.1097/PPO.0000000000000672 -
Journal of Clinical Pathology Nov 2006The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the... (Review)
Review
The introduction of endoscopy of the upper digestive tract as a routine diagnostic procedure has increased the number of duodenal biopsy specimens. Consequently, the pathologist is often asked to evaluate them. In this review, a practical approach to the evaluation of a duodenal biopsy specimen is discussed. An overview of the handling of specimens is given and the normal histology and commonly encountered diseases are discussed. Finally, a description of commonly seen infections is provided, together with an algorithmic approach for diagnosis.
Topics: Algorithms; Biopsy; Celiac Disease; Diagnosis, Differential; Duodenal Diseases; Duodenitis; Duodenum; Humans; Infections; Intestinal Mucosa
PubMed: 16679353
DOI: 10.1136/jcp.2005.031260 -
Journal of the American College of... Feb 1990The benefits and risks of endomyocardial biopsy in infants, children and adolescents were determined by reviewing the indications for and complications and results of 66... (Review)
Review
The benefits and risks of endomyocardial biopsy in infants, children and adolescents were determined by reviewing the indications for and complications and results of 66 procedures in 53 patients aged 2 months to 20 years. One patient had a pneumothorax, and three had a right ventricular perforation. Ventricular tachycardia developed in four patients; it was treated with lidocaine in three and was self-limited in one. The procedure was unsuccessful in two patients. Among 25 patients with a prebiopsy diagnosis of idiopathic dilated cardiomyopathy, microscopic features were consistent with cardiomyopathy in 24 (96%) and were normal in 1. Of nine patients with clinically suspected myocarditis, only two (22%) had microscopic evidence of inflammation, and seven had chronic nonspecific features suggestive of dilated cardiomyopathy. Of eight patients with unexplained arrhythmias, six (75%) had microscopic findings compatible with dilated cardiomyopathy and two had myocarditis. Biopsy tissue samples from seven patients with nondilated forms of cardiomyopathy (four hypertrophic, three restrictive) were consistent with the clinical diagnosis in six and were inadequate in one. Cardiac biopsies were also performed in four patients with other disorders. Among the 51 patients with adequate biopsy specimens, microscopic features were considered diagnostic in 5, confirmatory in 44 and not helpful in 2 with normal tissue. The results indicate that endomyocardial biopsy is safe in infants, children and adolescents. It is useful for the evaluation of cardiomyopathy and specific secondary forms of myocardial disease. There seems to be little correlation, however, between clinical and tissue diagnoses of myocarditis.
Topics: Adolescent; Adult; Arrhythmias, Cardiac; Biopsy; Cardiomyopathy, Dilated; Cardiomyopathy, Hypertrophic; Cardiomyopathy, Restrictive; Child; Child, Preschool; Diagnosis, Differential; Endocardium; Female; Fibrosis; Heart Injuries; Humans; Infant; Male; Myocarditis; Myocardium; Tachycardia, Supraventricular; Wounds, Penetrating
PubMed: 2405039
DOI: 10.1016/s0735-1097(10)80074-9 -
Skeletal Radiology Nov 2020We propose the use of ultrasound-guided muscle biopsy as a viable method of obtaining muscle specimen to aid the diagnosis of myopathy. We retrospectively review the...
OBJECTIVE
We propose the use of ultrasound-guided muscle biopsy as a viable method of obtaining muscle specimen to aid the diagnosis of myopathy. We retrospectively review the diagnostic accuracy and patient feedback of ultrasound-guided muscle biopsies in our neuromuscular service.
METHOD
Multidisciplinary team meeting reviewed select patients and agreed on those suitable for ultrasound-guided muscle biopsy. They then underwent biopsy using direct ultrasound guidance and a modified Bergström needle. The specimens were sent for histopathological analysis, and patients were given a feedback form.
RESULTS
Ten patients underwent 11 ultrasound-guided muscle biopsies. Of these 11, one was processed incorrectly, but all others were good quality specimens suitable for analysis. All 10 of those processed correctly aided diagnosis. All patient feedback was rated good or excellent. In 4 patients with a previous unsuccessful surgical biopsy, ultrasound-guided biopsy was successful in obtaining suitable muscle. Of those 4 patients, 3 preferred ultrasound-guided biopsy, and 1 did not state a preference.
DISCUSSION
Our ultrasound-guided muscle biopsy technique offers a viable alternative to surgical biopsy. It yields high-quality specimen that aids diagnosis and receives good feedback from patients. It can be performed quickly as a day case and does not require theatre space. Furthermore, direct visualization of structures minimizes the risk of complications and allows biopsy of otherwise difficult to access targets.
CONCLUSION
Utilization of ultrasound guided-modified Bergström needle technique for muscle biopsy provides comparable success rates to other techniques and has practical, clinical, operational, and patient-centred benefits compared with alternative techniques.
Topics: Humans; Image-Guided Biopsy; Muscles; Muscular Diseases; Retrospective Studies; Ultrasonography, Interventional
PubMed: 32519182
DOI: 10.1007/s00256-020-03484-y -
Journal of Veterinary Diagnostic... May 2022Evaluation of gastrointestinal (GI) biopsies is a multistep process that includes reviewing an appropriate history, determining sample quality, and evaluating histologic...
Evaluation of gastrointestinal (GI) biopsies is a multistep process that includes reviewing an appropriate history, determining sample quality, and evaluating histologic sections. Selected diagnostic parameters that, in combination with intestinal histopathology, can be useful to localize disease to the intestinal tract in the horse include hypoproteinemia and hypoalbuminemia, ultrasound evidence of increased thickness of the small intestinal wall, and alterations in glucose or D-xylose absorption tests. Biopsies may be acquired either endoscopically, or via laparoscopy or standing flank incisional approaches. GI sections should be evaluated using a systematic approach that includes both architectural changes and inflammatory cell infiltrates. Although strategies have been developed for assessment of GI biopsies from the dog and cat, a standardized approach to interpretation of the equine GI biopsy has yet to be developed. GI biopsies pose several challenges to the pathologist, especially for endoscopic biopsies in which the quality of the specimen and its orientation may vary greatly. Architectural changes are arguably the most critical changes to evaluate. In a horse with chronic GI inflammation, such as occurs in idiopathic inflammatory bowel disease (IBD), the cell types encountered frequently are macrophages, eosinophils, lymphocytes, and plasma cells. Increased numbers of these cell types are categorized loosely as mild, moderate, and severe. Specific forms of idiopathic IBD have been further classified by this infiltrate as granulomatous enteritis, eosinophilic enteritis, and lymphoplasmacytic enteritis; there is limited information on microscopic changes with each. Unfortunately, microscopic GI lesions are usually nonspecific, and determination of etiology requires further investigation.
Topics: Animals; Biopsy; Cat Diseases; Cats; Dog Diseases; Dogs; Enteritis; Horse Diseases; Horses; Inflammatory Bowel Diseases
PubMed: 35354416
DOI: 10.1177/10406387221085584 -
Archives of Pathology & Laboratory... Aug 2010The combination of testicular biopsy and clinical evaluation for male infertility is becoming progressively more important because new technologies allow men previously... (Review)
Review
CONTEXT
The combination of testicular biopsy and clinical evaluation for male infertility is becoming progressively more important because new technologies allow men previously considered infertile to father children. Although most general pathologists are experienced with normal, neoplastic, and cryptorchid testicular specimens, the testicular biopsy for infertility requires understanding of a different set of diagnostic categories not otherwise commonly encountered.
OBJECTIVE
To highlight a standardized nomenclature for germ cell abnormalities allowing for effective communication with the urologist and maximal clinical benefit from the biopsy.
DATA SOURCES
Previously published consensus statements, review articles, peer-reviewed research publications, and abstracts.
CONCLUSIONS
A practical approach to evaluating testicular biopsies for fertility and the clinical implications for each abnormality are herein outlined.
Topics: Artifacts; Azoospermia; Biopsy; Humans; Male; Specimen Handling; Terminology as Topic; Testicular Diseases; Testis
PubMed: 20670143
DOI: 10.5858/2009-0379-RA.1 -
Dental and Medical Problems 2019A lack of knowledge about biopsy techniques and the management of biopsy specimens can cause artifacts. Artifacts are false structures that change the normal... (Review)
Review
A lack of knowledge about biopsy techniques and the management of biopsy specimens can cause artifacts. Artifacts are false structures that change the normal morphological and cytological features of tissues. This review article aimed to familiarize clinicians / dentists / surgeons with the factors causing artifacts and with the efficient strategies to prevent or minimize their occurrence. Non-adherence to several rules can result in the formation of artifacts. The clinician’s performance during and after the surgical procedure (until the sample is received by the laboratory) may damage the biopsy specimen or make it susceptible to damage. Artifacts may not be clinically considered noteworthy. However, by modifying the histopathological features of the specimen, they can lead to serious errors in the interpretation of lesions. Knowledge on the part of clinicians / dentists / surgeons regarding the factors and potential conditions that can lead to artifacts can decrease the risk of their occurrence, and considerably help pathologists and patients by paving the way for a correct diagnosis, and consequently an appropriate treatment plan.
Topics: Artifacts; Biopsy; Humans; Mouth Diseases
PubMed: 31577074
DOI: 10.17219/dmp/108597