Guidelines for buccal smear collection in breast-fed infants

Buccal smear analysis is a noninvasive, fast, and relatively inexpensive diagnostic method. It is used commonly where rapid gender identification is necessary or, more recently, for detection of aneusomy, microdeletion syndromes, and a variety of polymerase chain reaction–based molecular genetic tests. Previously we have shown that maternal cells can contaminate buccal smears taken from breast-fed infants, resulting in difficulty with test interpretation. The aim of this study was to determine optimal timing and technique for buccal smear collection in breast-fed infants in order to avoid diagnostic errors. We analyzed prospectively 50 breast-fed male infants for presence of cells with XX signal pattern from buccal mucosa scrapings at different times after breast feeding. The efficiency of mucosal cleaning on elimination of maternal cells was evaluated by comparing the proportion of XX cells before and after wiping of buccal mucosa with a cotton swab. Maternal cells were present in 23 of 48 (47.9%) samples collected within 5 min of feeding. The proportion of XX signal pattern was significantly (P = 0.001) reduced in samples collected at 30 min (8/48, P = 0.001) and ≥60 min (2/29, P = 0.0002) after feeding. Mucosal cleaning prior to smear collection significantly decreased the number of XX positive samples from 23 of 48 to 10 of 48 (P = 0.002). Buccal smears should not be obtained in nursing neonates until at least 60 min after breast feeding. In addition, prior to sample collection, buccal mucosa should be cleaned thoroughly with a cotton swab applicator. The same guidelines are applicable to older nursing infants. Am. J. Med. Genet. 84:357–360, 1999. © 1999 Wiley-Liss, Inc.     

Application of fluorescent in situ hybridization with X and Y chromosome specific probes to buccal smear analysis

Conventional X- and Y-chromatin and fluorescent in situ hybridization (FISH) analysis based on X- and Y-chromosome specific probes were conducted from buccal smear, on 15 normal males, 15 normal females, and 9 cases suspected of sex chromosome anomalies. The proportion of X- and Y-chromatin in normal females and males was 12% ± 3% and 51.5% ± 4.9%, respectively, by the conventional X- and Y-chromatin procedure. The CEP-X/Y analysis by FISH for the same specimens provided a proportion of 98.8% ± 0.7% cells with XX signals in the normal females and 99.8% ± 0.4% cells with XY signals in the normal males. The FISH method was superior to the conventional procedure in nine cases suspected of sex chromosome anomalies, including one case of mosaicism. The results of CEP-X/Y will sometimes be false; it will not detect structural anomalies of sex chromosomes, and it is not intended to detect low level mosaicism. However, the test is useful for rapid screening of sex chromosome aneuploidy at a fraction of the cost for chromosome analysis. The FISH test is also appropriate to detect tissue specific sex chromosome mosaicism, especially if it is relatively high. This FISH test is best used as an adjunct to chromosome analysis whenever possible. © 1996 Wiley-Liss, Inc.     

Micronucleus assay in buccal smears of breast carcinoma patients

The aim of this study is to compare micronucleus assay in buccal smear of breast carcinoma patients versus normal benign cases as control group. In this prospective study, we selected a total 32 patients of carcinoma of breast and 49 patients of benign breast lesions diagnosed in fine needle aspiration cytology (FNAC). Acridine orange stain was done on buccal smears of these cases and micronucleus (MN) scoring was performed in 40× 0bjective in a fluorescent microscope. The MN score was expressed as positivity per 1,000 cells. The MN scoring in buccal smear was compared in malignant and benign breast cases. In fluorescence microscope, the micronucleus was detected as round orange shaped small intracytoplasmic structure around the nucleus. The mean MN scores in buccal smears of benign and carcinoma cases were 0.5014 ± 0.45768 and 2.1938 ± 1.08656 cases respectively. Independent sample Student's t test showed significantly high MN score in buccal smear of the cancer patients (P < 0.001). Micronucleated cells are significantly increased in buccal cells of the breast carcinoma cases. The increased number of MN in buccal smears raises the possibility that the genetic damage in breast cancer patients is generalized. In future, MN scoring could be used as biomonitoring of DNA damage and in early detection of high risk cases of carcinoma of breast.     

颊脂垫部分切除的临床解剖及应用

目的:熟悉颊脂垫的解剖,明确颊脂垫部分切除术的适应证及注意事项。方法:解剖4具(8侧)成人尸体颊脂垫,详细观察其位置、大小、形态、血液供应和毗邻关系等。对24例颊部饱满者行口内径路颊脂垫部分切除术矫正"孩童样"面颊。结果:颊脂垫由1个体部和4个突起在面侧区深部不同间隙内延伸而成,外被包膜,有多源性血液供应,与腮腺管、面神经颊支关系密切,颊突及部分体部为可手术切除部分。24例颊脂垫部分切除术后随访5~12个月,均获得满意美容效果。结论:手术切除颊脂垫颊突和部分体部对于矫正面颊部饱满是安全、有效的。     

New diagnostic method for Pallister-Killian syndrome: Detection of i(12p) in interphase nuclei of buccal mucosa by fluorscence in situ hybridization

Detection of the supernumerary isochromosome 12p [i(12p)] was performed on buccal smear preparations from 2 patients with Pallister-Killian syndrome, 21 (patient 1) and 15 months (patient 2) old, by interphase fluorescence in situ hybridization (FISH) using a chromosome 12-specific alpha satellite probe. Isochromosome 12p-positive cells were identified by observing 3 signals over the nucleus, while diploid cells had 2 signals. The proportion of i(12p)-positive cells thus identified was high in the epithlial cells of buccal mucosa at 68 and 53% from patients 1 and 2, respectively. Further, the frequencies of i(12p)-positive cells were also studied in PHA-stimulated peripheral lymphocytes, cultured skin fibroblasts (both patients), and directly harvested T and B-cells (patient 1). Of these tissues, buccal mucosa showed the highest proportion of i(12p)-positive cells. These findings indicate that epithelial cells of buccal mucosa are likely to retain i(12p)-positive cells. Detection of i(12p) using direct buccal smear preparations by interphase FISH is a rapid, effective and non-invasive method for confirming the diagnosis of the Pallister-Killian syndrome. © 1993 Wiley-Liss, Inc.     

Determination of the HER2 amplification status by in situ fluorescent hybridization and concordance with immunohistochemistry for breast cancer samples in Colombia

Objectives:

To determine the status of the HER2 amplification in Breast cancer performed in peripheral laboratories in Colombia by immunohistochemistry and its comparison with central laboratories and the FISH status.

Methods:

Four thousand one hundred and five cases referred for the determination of the HER2 status by FISH and/or IHQ to the Department of Pathology of the Fundacion Santa Fe were studied. The analysis included correlation between the IHQ HER2 score submitted by the peripheral laboratory (PL), the HER2 score emitted in the CL and the FISH studies performed in the central laboratory (CL).

Results:

Two thousand five hundred and eight HER2 IHQ studies were performed in the (CL), using the Dako Herceptest. With the following results: 68.2 % negative (0-1+); 16,4% indeterminate (2+); 15.3% 3+ and 2.3 % not adequate. 1360/ 1719 cases studied by FISH came from the (PL), and 329 (19.1%) from the (CL). Comparing the IHQ score emitted by the PL and the positive FISH status showed: 6/28 0+ were positive (21. 4%); 7/31 1+ (22. 5%); 397/1240 2+ (32.8%) and 74/91 3+ (81. 3%). In the CL the results were 1/9 0+ (11.1%); 3/18 1+ (16.7%); 154/292 2+ (53%); and 9/9 3+ (100%). Only 1/4 negative cases (0/1+) was in house.

Conclusion:

The false negative rate (22%), and false positive results (18.7%), of the HER2 status performed by IHQ in peripheral laboratories in Colombia is unacceptable high as well as the inadequacy of tissue indicating that pre-analytical factors have to be improved in Colombia in order to get optimal results.     

Perivascular epithelioid cell tumor of the uterine cervix identified on a conventional cervical smear

Perivascular epithelioid cell tumors (PEComas) most frequently involve the uterus, particularly the uterine corpus and very occasionally the cervix. One case of PEComa identified using a conventional cervical smear has previously been documented. Herein, we present the second such case. The patient was a 51‐year‐old woman with abnormal genital tract bleeding. Samples collected for conventional cervical smears were submitted for cytopathological examination, which revealed discohesive monotonous tumor cells showing epithelioid morphology, ample cytoplasm that was pale to weakly eosinophilic, and mildly enlarged nuclei. The cytopathological features were well correlated with histopathological findings. Upon immunohistochemistry, the tumor cells were positive for both melanocytic and smooth muscle markers. Based on these findings, PEComa was diagnosed. Subsequently, a total hysterectomy with bilateral salpingo‐oophorectomy was performed, revealing that the tumor (28 × 22 × 12 mm) was located at the superficial part of the endocervix. We propose that the cytopathological findings described herein can guide the diagnosis of PEComa, even though this tumor is rare. Diagn. Cytopathol. 2015;43:1011–1016. © 2015 Wiley Periodicals, Inc.     

Chain of events in Papanicolaou smear testing: impact on quality assurance

Quality assurance is defined in this article as a comprehensive program aimed at preventing and controlling errors from the time a test is ordered until test results are reported and utilized in the care of the patient. Quality control is only one facet of a total quality assurance program. Recently, the general public, professional organizations, and regulatory agencies have scrutinized the standards and practice of Papanicolaou smear testing. The components of quality assurance for gynecologic cytology are reviewed, and the chain of events in performing effective cytologic testing is described. The impact of various events on the outcome of Papanicolaou smear testing is thoroughly discussed.     

Evaluation of 37,438 consecutive cervical smear results in the Turkish population

Introduction

Retrospective evaluation of cervical smear results of women who attended our gynecology policlinics with various symptoms and discussion of the results in the light of the literature.

Material and methods

We performed a retrospective investigation on 37,438 Pap smear results of women who attended our hospital between January 2011 and December 2012 with a variety of symptoms.

Results

Average patient age was 43 (18–83) years. Of the Pap smear results analyzed, in 21,503 (57.4%) findings were within normal limits, while 153 (0.41%) showed epithelial cell abnormalities and 15,358 (41%) showed inflammation. Four hundred and twenty-four (1.1%) cases were reported to have inadequate Pap smear samples for evaluation. Of the epithelial cell abnormalities, 136 (88.8%) were squamous cell abnormalities and 17 (11.1%) were glandular cell abnormalities. Atypical squamous cells of unknown significance (ASCUS) were reported for 117 (0.3%) Pap smears, while other epithelial abnormalities included atypical glandular cells of unknown significance (AGUS) in 17 (0.05%) cases, low-grade squamous intraepithelial lesion (LSIL) in 8 (0.02%) cases, atypical squamous cells with possible high grade lesion (ASC-H) in 8 (0.02%) cases and high-grade squamous intraepithelial lesion (HSIL) in 3 (0.008%) cases.

Conclusions

Public awareness should be raised on the importance of Pap smear testing repeated at appropriate intervals in the prevention and early diagnosis of cervical cancer. Health education should become more widespread, and the importance of screening programs and regular check-ups should be emphasized more often on this issue in the media.     

Extraction of DNA from oral cytological samples by scraping and smear method suitable for restriction site mutation analysis: a pilot study

The restriction site mutation assay (RSM) can be used to measure base changes which occur in the DNA coding for bacterial restriction enzymes. The aim of this study was to investigate whether DNA, of sufficient quantity and quality for analysis by RSM, could be extracted from cells collected from precancerous lesions using a cytological smear technique. Six smears were collected from each of five lesions of leukoplakia displaying a variety of clinical appearances. Three methods for the extraction of DNA were compared. The commercial extraction method was shown to be most convenient and reproducible, routinely providing 1-5 microg of DNA per sample. Cell populations collected by a cytological smear technique can provide DNA of sufficient quantity and quality for analysis of RSM.     

Psammoma bodies in cervical smear in association with keratinizing squamous cell carcinoma of cervix: A case report

The presence of psammoma bodies (PBs) in cervical smears is a rare finding. These structures have been identified in association with a wide range of benign and malignant conditions within the female genital tract. PBs in cervical smears have usually been associated with malignant serous epithelial ovarian tumors. However, many PBs associated with atypical squamous cells were detected in cervical smears of an 83‐year‐old woman with complaint of postmenopausal bleeding. Colposcopic examination revealed an ulceroinfiltrative growth in the cervix. Histological examination of the biopsy specimen from the growth revealed keratinizing squamous cell carcinoma with multiple and singly arranged PBs. This report suggests that cytologists should aware of the possibilities, on finding PBs associated with atypical cells in cervical specimens and report the cases accordingly. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

Cytological features of choricarcinoma in a Pap smear: A case report and literature review

Choriocarcinoma is an aggressive malignant trophoblastic tumor that mostly occurs during reproductive years. Cytological features of choriocarcinoma in gynecologic Pap smears have not been described. Herein, we report a case of choriocarcinoma in a Pap smear of a patient who had a history of choriocarcinoma with metastatic disease. Diagn. Cytopathol. 2016;44:324–328. © 2015 Wiley Periodicals, Inc.     

骨髓活检与涂片联检对诊断骨髓增生异常综合征的临床意义

目的探讨骨髓活检切片与骨髓穿刺涂片联检对诊断骨髓增生异常综合征(myelodysplastic syndrome,MDS)的临床意义。方法对122例MDS患者采用骨髓抽吸与活检标本同步法取材,同步观察其涂片和切片。结果骨髓活检切片MDS诊断符合率明显高于骨髓涂片,骨髓增生活跃程度、骨髓涂片的明显活跃与切片差异均有统计学意义(P<0.05)。粒系病态造血骨髓切片检出率高于涂片(P<0.05),红系病态造血骨髓涂片检出率高于切片(P<0.05),巨核系病态造血检出率骨髓切片与涂片差异无统计学意义。结论骨髓涂片和活检切片在MDS的诊断和分型中各有优点、两者相互补充,同步观察更有利于提高MDS诊断和分型的准确性。     

Structural reactions of the buccal mucosa in diabetic parodontopathy

Pronounced changes in the capillaries, hemodynamic disorders, epitheliocyte degeneration and atrophy develop in the buccal mucosa of patients with types I and II diabetes mellitus in the absence of inflammatory cellular infiltration or with facultative infiltration. The morphogenesis of pathological changes can be regarded as primary diabetic microangiopathy causing metabolic disorders with the development of degenerative and atrophic changes in all structural components of the buccal mucosa and development of diabetic parodontopathy, a primary degenerative process. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 142, No. 11, pp. 581–584, November, 2006     

Patterns of cortisol reactivity in African-American neonates from low-income environments

Individual differences and stability in patterns of salivary cortisol reactivity were examined in 100 African-American neonates from low-income environments. A pattern of reactivity was defined by the change from prestressor to poststressor cortisol concentrations and the change following the poststressor during a recovery phase. Cortisol reactivity was measured in response to two stressors: the Neonatal Behavioral Assessment Scale (NBAS; T. B. Brazelton & J. K. Nugent) and the routine hospital heels-tick procedure. The use of two stressors allowed an examination of whether patterns of reactivity to different stimuli vary and whether there is individual stability in patterns of cortisol reactivity. Cortisol concentrations changed significantly across the three time points. The magnitude of change during the recovery period differed across stressors. Prestressor cortisol values were associated with cortisol reactivity. Both prestressor cortisol concentrations and pattern of cortisol response were significantly associated within individuals.     

Analysis of K-ras oncogene mutation directly applied to atypical cell clusters on cytologic smear slides of bile and pancreatic juice

To develop an objective reference for the cytological evaluation of atypical cells in bile and pancreatic juice, we analyzed K-ras oncogene mutation In atypical cell clusters, which were collected directly from cytological smear slides; 50 samples (cell clusters) from 31 smear slides of 21 patients with carcinomas of the pancreatic head region, and nine samples from eight cases of benign disease. These cell clusters (5–1000 cells/cluster) were selectively suspended In buffer containing proteinase K, and subjected to DNA extraction. K-ras codon 12 mutation was determined by polymerase chain reaction amplification, followed by digestion with BstNI. The K-ras gene was amplified in 20 of 21 cases with carcinoma (34/50 samples), and In seven of eight cases with non-neoplastic disease (8/9 samples). Among the cases of which primary tumors showed K-ras mutation, amplification was successful in 10 of 11 cases; mutation was demonstrated in three of seven cases with cytologically atypical cells (4/11 samples), and in three of three cases with cytologically malignant cells (5/7 samples). No mutation was Identified in the 10 cases of carcinoma without K-ras mutation (0/15 samples), or in eight cases of non-neoplastlc disease (0/8 samples). Cytological details could be comparatively evaluated between atypical cell clusters with or without mutation on the same smear slides in two cases. This type of direct analysis of atypical cell clusters may be useful in the self-assessment of cytological diagnosis of bile and pancreatic juice.     

Cervical tuberculosis detection in Papanicolaou‐stained smear: Case report with review of literature

Genital tract tuberculosis is usually secondary to an extragenital tubercular focus. Cervical tuberculosis, however, is rare accounting for up to 3% of all genital tract diseases. The diagnosis of tuberculosis is usually established on multiple cervical biopsies followed by bacteriological confirmation. There are only a handful of reports on the diagnosis of tubercular cervicitis in cervical smears. We hereby report a case of cervical tuberculosis which was diagnosed on cervical smear. We also carried out a brief literature review of the cases diagnosed previously on cervical smear. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

Parameters of microcirculation in hamster buccal pouches under conditions of reduced systemic blood pressure

Laser Doppler flowmetry studies showed that blood flow in the microcirculation bed of paired buccal pouches in hamsters decreased under conditions of reduced systemic blood pressure and this decrease is more pronounced in the left pouch. The transition of the circulatory bed to the new state is step-wise in the left pouch and continuous in the right one. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 145, No. 1, pp. 29–34, January, 2008