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Article: Collection and processing of effusion fluids for cytopathologic evaluation.

Shidham, Vinod B

2022 Volume 19, Page(s) 5

Abstract: Accumulation of fluid in serous cavities as effusions may have to be drained for therapeutic and diagnostic indications. As compared to many other procedures, the technicality of paracentesis procedures is relatively easy. As a result, effusion fluids ... ...

Abstract	Accumulation of fluid in serous cavities as effusions may have to be drained for therapeutic and diagnostic indications. As compared to many other procedures, the technicality of paracentesis procedures is relatively easy. As a result, effusion fluids comprise a significant proportion of specimens in most of the laboratories, including those in community settings. Because of relative complexities in the cytopathologic evaluation of effusion fluids, application of appropriately standardized protocol is critical for achieving optimum results by applying standardized steps from handling of specimens during the initial stages of collection to the final interpretation phase. Understanding various limitations and challenges during collection and processing phases by all the personnel involved, including clinicians, pathologists, and technologists is critical for optimum diagnostic yield. This review highlights various cytopreparatory techniques applicable to effusion cytology in one place. It is organized by projecting the details predominantly in the form of different tables and figures including summary of the recommended protocols with reagents and stains used. Also included is a sample of cytopathology report based on the approach discussed in this series.
Language	English
Publishing date	2022-01-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/CMAS_02_14_2021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Role of immunocytochemistry in cervical cancer screening.

Shidham, Vinod B

CytoJournal

2022 Volume 19, Page(s) 42

Abstract: The cervical cancer screening has been based conventionally on cytologic analysis. With advances in understanding the role of human papillomavirus, cotesting has been applied. But most of the patients subjected to colposcopy did not benefit, except in ... ...

Abstract	The cervical cancer screening has been based conventionally on cytologic analysis. With advances in understanding the role of human papillomavirus, cotesting has been applied. But most of the patients subjected to colposcopy did not benefit, except in cases with HSIL [high-grade squamous intraepithelial lesion] cytology. Because of this, a step to increase the sensitivity to detect cancers and pre-cancers but with higher specificity with minimal overdiagnosis leading to prevention of unindicated cervical biopsies is highly desired. Such triaging step in cases with abnormal screening results is expected to minimize invasive interventions because of low false positivity. With availability of methodologies leading to quantitatively and qualitatively enhanced cell-blocks from residual liquid based cytology specimens, immunostaining can be performed for multiple immunomarkers with potential objectivity to triage initial screening test results. This is enhanced further with inclusion of AV marker in the cell-blocks and application of SCIP (subtractive coordinate immunoreactivity pattern) approach. The cell-blocks are also resource for performing other ancillary studies including molecular pathology and proteomics/metabolomics as potential tests in future. This review explores application of residual liquid based cytology specimen for cell-blocking with application of ancillary studies in algorithmic manner as adjunct to ASCCP management guidelines for improved patient care.
Language	English
Publishing date	2022-06-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/CMAS_03_17_2022
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Metastatic Carcinoma in Effusions.

Shidham, Vinod B

CytoJournal

2022 Volume 19, Page(s) 4

Abstract: Serous cavity may be involved by any neoplasm, including very rare examples of involvement by central nervous system tumors leading to a malignant effusion. The serous cavity lining is rich in lymphatics with lymphatic lacunae opening directly through ... ...

Abstract	Serous cavity may be involved by any neoplasm, including very rare examples of involvement by central nervous system tumors leading to a malignant effusion. The serous cavity lining is rich in lymphatics with lymphatic lacunae opening directly through narrow gaps (stoma) in the lining. Carcinomas mainly metastasize to serosa via the lymphatic vessels, which may be blocked leading to effusion. Primary carcinomas of organs such as lung, intestines, liver, ovary, etc., lined by serosal membranes may spread by direct extension, resulting in malignant effusions. As standard of practice, unless specified, cytopathologic examination of serous effusions implies detection of malignant cells. As compared to a surgical biopsy from a small focal area of an extensive serosal surface, effusion fluid from respective cavity exfoliates the cells from the entire serosal surface with minimal chance of sampling artifact. Because of this, effusion fluid cytology generally provides a higher diagnostic yield as compared to biopsy of the serous lining, as demonstrated by some studies. However, various challenges related to effusion fluid cytology makes the interpretation of effusion fluid cytology a field with potential misinterpretations, especially for those without proper experience or training. Developing and following a methodical approach is important for appropriate cytologic examination of effusion fluids. Proper approach may achieve definitive interpretation even without ancillary tests. However, lack of appropriate approach and processing may introduce a significant variation in interpretation due to combination of well-recognized diagnostic pitfalls, which may lead to lower reproducibility and even serious misinterpretations. Current review discusses in brief appropriate approach to processing and evaluating effusion fluid cytology for metastatic carcinoma. At general level, this is comparable to that of other specimens; however, it is critical to modify with reference to the limitations associated with effusion cytology.
Language	English
Publishing date	2022-01-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/CMAS_02_09_2021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: HPV-negative and high-grade finding in Pap cytology.

Jain, Deepti / Elbashir, Leana / Shidham, Vinod B

CytoJournal

2024 Volume 21, Page(s) 2

Language	English
Publishing date	2024-01-04
Publishing country	United States
Document type	Case Reports
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/Cytojournal_57_2023
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Cell-blocks and other ancillary studies (including molecular genetic tests and proteomics).

Shidham, Vinod B

CytoJournal

2021 Volume 18, Page(s) 4

Abstract: Many types of elective ancillary tests may be required to support the cytopathologic interpretations. Most of these tests can be performed on cell-blocks of different cytology specimens. The cell-block sections can be used for almost any special stains ... ...

Abstract	Many types of elective ancillary tests may be required to support the cytopathologic interpretations. Most of these tests can be performed on cell-blocks of different cytology specimens. The cell-block sections can be used for almost any special stains including various
Language	English
Publishing date	2021-02-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/Cytojournal_3_2021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Diagnostic pitfalls in effusion fluid cytology.

Shidham, Vinod B

CytoJournal

2021 Volume 18, Page(s) 33

Abstract: Effusion fluid cytology has propensity for both false positives (in up to 0.5%) and false negatives (in up to 30%) results. Methodical approach from collection step to final interpretation stage could prevent both false positives and false negatives, if ... ...

Abstract	Effusion fluid cytology has propensity for both false positives (in up to 0.5%) and false negatives (in up to 30%) results. Methodical approach from collection step to final interpretation stage could prevent both false positives and false negatives, if the interpreter is familiar with various factors responsible for diagnostic pitfalls in effusion fluid cytology. For this discussion, these factors are categorized as mentioned below: Surface tension-related alterations in cytomorphologyImproper specimen processingMany faces of reactive mesothelial cells, overlapping with those of cancer cellsProliferation-related featuresDegenerative changes, such as nuclear hyperchromasia and cytoplasmic vacuolationUnexpected patterns and unusual entities.
Language	English
Publishing date	2021-12-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/CMAS_02_04_2021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: The panorama of different faces of mesothelial cells.

Shidham, Vinod B

CytoJournal

2021 Volume 18, Page(s) 31

Abstract: All effusions in serous cavities represent a pathologic processes secondary to inflammatory, neoplastic, hemodynamic, or mechanical/traumatic etiologies. This elicits reactive changes in the extremely sensitive mesothelial cells lining the serosal ... ...

Abstract	All effusions in serous cavities represent a pathologic processes secondary to inflammatory, neoplastic, hemodynamic, or mechanical/traumatic etiologies. This elicits reactive changes in the extremely sensitive mesothelial cells lining the serosal surfaces. The result is hypertrophy and hyperplasia which lead to broad changes with a wide range of morphological appearances. These reversible alterations may resolve entirely after the recovery of underlying pathology. Under the tertiary care situations, neoplastic effusion specimens are encountered more frequently. Although some non-neoplastic pathologic process may demonstrate a few diagnostic features, cytologic evaluation of malignant effusions usually show diagnostic malignant cells. However, the most versatile mesothelial cells demonstrate a very wide cytomorphological spectrum secondary to reactive challenges. These mesothelial cells are usually referred to as 'reactive mesothelial cells'. In addition other terms such as reactive mesothelial proliferation, reactive mesothelial hyperplasia, irritated mesothelial cells, activated mesothelial cells, hyperplastic mesothelial cells, hypertrophic mesothelial cells, and proliferative mesothelial cells. Rarely atypical mesothelial cells, although not recommended, is used inadvertently. Although there is a lack of general agreement defining these terms, some of these including atypical mesothelial cells, should not be preferred. With reference to this CMAS series, usually favored term 'reactive mesothelial cells' is preferred. The size of reactive mesothelial cells range from 15 to 30 µm (but may be up to 50 µm). These polyhedral cells with variable amount of cytoplasm and enlarged nuclei may show variation in sizes and shapes with conspicuous nucleoli. Bi- and multi-nucleation is frequent. Cohesive groups of mesothelial cells as sheets and three dimensional groups may be present. Some floridly reactive mesothelial cells with hyperchromatic enlarged nuclei with prominent nucleoli and scant cytoplasm may resemble malignant cells. This astonishingly wide morphological spectrum of reactive mesothelial cells is a significant interpretation challenge in effusion fluid cytology. Methodical interpretation approach with appropriate knowledge about this wide spectrum is important aspect in diagnostic cytopathology of effusion fluids.
Language	English
Publishing date	2021-12-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/CMAS_02_02_2021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Specimen-specific cell-blocking approaches.

Shidham, Vinod B

CytoJournal

2020 Volume 17, Page(s) 28

Abstract: The science of CellBlockistry highlights requirement for proper approach to process different types of cytopathology specimens with critical considerations during preparation of cell-blocks. Common cytopathology specimens which may be subjected for cell- ... ...

Abstract	The science of CellBlockistry highlights requirement for proper approach to process different types of cytopathology specimens with critical considerations during preparation of cell-blocks. Common cytopathology specimens which may be subjected for cell-blocking include FNA aspirates in addition to anterior fat pad aspirate, bone marrow aspirate, effusion fluids, and other fluids such as various washings and urine. In addition veterinary sciences and research fields including animal experiments and tissue/cell cultures may also be cell-blocked for improved diagnostic yield and research outcome.
Language	English
Publishing date	2020-12-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/Cytojournal_75_2020
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Updates in processing of anterior fat pad aspirate for amyloid (with video and sketches).

Shidham, Vinod B

CytoJournal

2020 Volume 17, Page(s) 15

Abstract: Fat pad aspiration is a commonly used method for detecting amyloid in tissue. Amyloid is detected in the small blood vessels of the aspirated adipose tissue. Optimum evaluation of amyloid with electron microscopy requires at least 15 blood vessels in the ...

Abstract	Fat pad aspiration is a commonly used method for detecting amyloid in tissue. Amyloid is detected in the small blood vessels of the aspirated adipose tissue. Optimum evaluation of amyloid with electron microscopy requires at least 15 blood vessels in the fat pad aspirate. The presence of a significant proportion of adipocytes in the aspirate dilutes the fibrovascular portion. This may compromise the evaluation for amyloid with electron microscopy and in FFPE with proteomic studies by mass spectroscopy for confirmation of the amyloid subtype. This video article describes the updated protocol for processing the anterior fat pad aspirate. It demonstrates how to remove the interference of blood and fatty component in the fat pad aspirate performed by the previously reported procedure.
Language	English
Publishing date	2020-06-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/Cytojournal_31_2020
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Immunocytochemistry of effusions: Processing and commonly used immunomarkers.

Shidham, Vinod B / Janikowski, Beata

CytoJournal

2022 Volume 19, Page(s) 6

Abstract: Definitive cytopathological interpretation of some of the effusion fluids may not be possible based on cytomorphological evaluation alone. As discussed in other reviews, this is due to various reasons specifically applicable to effusion fluids including ... ...

Abstract	Definitive cytopathological interpretation of some of the effusion fluids may not be possible based on cytomorphological evaluation alone. As discussed in other reviews, this is due to various reasons specifically applicable to effusion fluids including remarkably wide morphologic spectrum of reactive mesothelial cells overlapping with some well to moderately differentiated metastatic carcinoma. The challenge is subject to various factors including level of interpreter training or experience, institutional demographics (such as type of prevalent diseases, predominant sex and age group), technical advances in ancillary support, and expertise in cytopreparatory processing. In such cases immunohistochemistry performed on cell-block sections is simple objective adjunct with or without other ancillary techniques. Ongoing increase in number of immunomarkers along with rabbit monoclonal antibodies with relatively higher affinity is further refining this field. SCIP (subtractive coordinate immunoreactivity pattern) approach, discussed as separate dedicated review article, facilitates refined interpretation of immunoreactivity pattern in coordinate manner on various serial sections of cell-blocks. However, many variables such as delay after specimen collection, specimen processing related factors including fixation and storage; ambient conditions under which paraffin blocks are archived (for retrospective testing); antigen retrieval method; duration of antigen retrieval step; antibody clone and dilution; and antibody application time are common with application of immunohistochemistry in other areas. This review is dedicated to highlight technical aspects including processing of effusion specimens for optimum immunocytochemical evaluation along with commonly used immunomarkers in effusion cytopathology. This review focuses on the technical and general information about various immunomarkers.
Language	English
Publishing date	2022-01-31
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2158838-7
ISSN	1742-6413 ; 0974-5963
ISSN (online)	1742-6413
ISSN	0974-5963
DOI	10.25259/CMAS_02_15_2021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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