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In Response

In Response Appl Immunohistochem Mol Morphol Volume 18, Number 2, March 2010 Letters to the Editor intraepithelial neoplasia. Mod Pathol. 2002; IHC or ISH for the detection of testing are worthy of further considera- 15:1339–1347. HPV and to establish if these stains tion and investigation. 3. Hopman AH,Kamps MA,Smedts F,etal. could clarify the nature of atypical I would like to thank you for HPV in situ hybridization: impact of differ- cells in certain cases. We concluded in giving me the opportunity to review ent protocols on the detection of integrated our study that cell block sections the article. Please let me know if you HPV. Int J Cancer. 2005;115:419–428. 4. Nieminen P, Vuorma S, Viikki M, et al. prepared from residual SurePath Pap have any further question. Comparison of HPV test versus conventional test material could be used for detec- and automation-assisted Pap screening as tion of HPV DNA by both IHC and potential screening tools for preventing Alaa Afify, MD ISH and clarify the nature of atypical cervical cancer. BJOG. 2004;111:842–848. Department of Pathology 5. Kotaniemi-Talonen L, Malila N, Nieminen cells on cell block sections. These tests University of California P, et al. Test positivity cutoff level of a high could represent an additional reliable Davis Medical Center risk human papillomavirus test could be tool in the evaluation of cervical Sacramento, CA increased in routine cervical cancer screen- samples. ing. Int J Cancer. 2008;123:2902–2906. The authors fear that our con- 6. Ordi J, Alonso I, Torne A, et al. Human papillomavirus load in hybrid capture clusions may leave readers with the Diffuse Membranous II assay: does increasing the cutoff im- false assumption that ISH is the most prove the test? Gynecol Oncol. 2005;99: Immunoreactivity of sensitive method for routine screening 313–319. of HPV. We did not conclude that 7. Triglia RM, Metze K, Zeferino LC, et al. CD56 and Paranuclear HPV in situ hybridization signal patterns ISH and IHC are the most practical as a marker for cervical intraepithelial neo- choice for routine HPV screening. In Dot-like Staining plasia progression. Gynecol Oncol. 2009; the discussion we stated that IHC 112:114–118. Pattern of Cytokeratins may be the most practical choice for 8. Bewtra C, Xie Q, Soundararajan S, et al. routine screening in the future. We Genital human papillomavirus testing by in AE1/3, CAM5.2, situ hybridization in liquid atypical cytolo- also mentioned the use of IHC is gic materials and follow-up biopsies. Acta better than ISH as it is easier to and OSCAR in Cytol. 2005;49:127–131. perform, it is well established in 9. Qureshi MN, Rudelli RD, Tubbs RR, et al. Undifferentiated most laboratories, and it is a faster Role of HPV DNA testing in predicting cervical intraepithelial lesions: comparison method compared with ISH or any (Embryonal) Sarcoma of HC HPV and ISH HPV. Diagn Cyto- other method available to detect HPV pathol. 2003;29:149–155. DNA. The authors agreed that ana- of the Liver 10. Davis-Devine S, Day SJ, Freund GG. Test lysis of tissue section used for IHC or performance comparison of Inform HPV ISH allows for visualization of stain- and hybrid capture 2 high-risk HPV DNA tests using the SurePath liquid-based Pap To the Editor: ing in abnormal cells; this would test as the collection method. Am J Clin allow the pathologist to determine if Undifferentiated (embryonal) sar- Pathol. 2005;124:24–30. abnormal cells were present, sparse coma of the liver (UESL) is an un- or absent. In the discussion we also common, rapidly growing malignant mentioned that there has been con- spindle cell tumor that usually occurs This letter is to address certain cern regarding adequacy evaluation in children and young adults, as issues related to the article ‘‘Hybrid of HPV testing performed directly from characterized by Stocker and Ishak Capture-2 is Better Than In situ the residual sample in the vial such as in 1978. This neoplasm manifests Hybridization: A Study Comparison HC-2. For instance, a negative HPV itself in children primarily between With Cervical Biopsies’’. result may actually be a false negative 5 and 10 years of age, without sex pre- 2,3 First, I would like to thank the as there may be insufficient abnormal dilection. Microscopically, UESL is authors for acknowledging that our cells in the residual material to be composed of loosely arranged, med- study is quite clever. The authors stated tested. Several recent studies indicated ium-to-large spindles, oval and stel- that in our study we concluded that in- that thenegativepredictivevalue for late pleomorphic cells with poorly situ hybridization (ISH) and immuno- HC-2 testing may be compromised defined cell borders, and giant cells histochemistry (IHC) may be the most when the copy number of the HPV with severe atypia. In addition, intra- practical choice for routine human DNA is low, and a negative test result cellular and extracellular periodic papilloma virus (HPV) screening. They may be falsely negative in patients with acid-Schiff-positive diastase-resistant also fear that our conclusions may abnormal colposcopic findings or con- hyaline globules (thanatosomes) may leave readers with the false assumption current cytologic findings. be observed throughout the neoplasm. that ISH is the more sensitive method. In summary the key issue is that Compact areas with more uniform We would like to inform the the results of our study provide evi- and pleomorphic cell morphology re- authors that the main purpose of dence that cell blocks prepared from sembling malignant fibrosarcoma and our study was to determine if tissue residual SurePath Pap test material fibrous histiocytoma, respectively, have 2,3 sections from cell blocks prepared represent an additional reliable tool in also been described. An abundant from the residual cellular sediment the evaluation of cervical samples. The alcian blue-positive matrix is character- of Pap test vials could be used for use of cell blocks for IHC and ISH istic of UESL; however, solid fibrous r | 2010 Lippincott Williams & Wilkins www.appliedimmunohist.com 195 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Applied Immunohistochemistry & Molecular Morphology Wolters Kluwer Health

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ISSN
1541-2016
DOI
10.1097/PAI.0b013e3181bbd5ea
Publisher site
See Article on Publisher Site

Abstract

Appl Immunohistochem Mol Morphol Volume 18, Number 2, March 2010 Letters to the Editor intraepithelial neoplasia. Mod Pathol. 2002; IHC or ISH for the detection of testing are worthy of further considera- 15:1339–1347. HPV and to establish if these stains tion and investigation. 3. Hopman AH,Kamps MA,Smedts F,etal. could clarify the nature of atypical I would like to thank you for HPV in situ hybridization: impact of differ- cells in certain cases. We concluded in giving me the opportunity to review ent protocols on the detection of integrated our study that cell block sections the article. Please let me know if you HPV. Int J Cancer. 2005;115:419–428. 4. Nieminen P, Vuorma S, Viikki M, et al. prepared from residual SurePath Pap have any further question. Comparison of HPV test versus conventional test material could be used for detec- and automation-assisted Pap screening as tion of HPV DNA by both IHC and potential screening tools for preventing Alaa Afify, MD ISH and clarify the nature of atypical cervical cancer. BJOG. 2004;111:842–848. Department of Pathology 5. Kotaniemi-Talonen L, Malila N, Nieminen cells on cell block sections. These tests University of California P, et al. Test positivity cutoff level of a high could represent an additional reliable Davis Medical Center risk human papillomavirus test could be tool in the evaluation of cervical Sacramento, CA increased in routine cervical cancer screen- samples. ing. Int J Cancer. 2008;123:2902–2906. The authors fear that our con- 6. Ordi J, Alonso I, Torne A, et al. Human papillomavirus load in hybrid capture clusions may leave readers with the Diffuse Membranous II assay: does increasing the cutoff im- false assumption that ISH is the most prove the test? Gynecol Oncol. 2005;99: Immunoreactivity of sensitive method for routine screening 313–319. of HPV. We did not conclude that 7. Triglia RM, Metze K, Zeferino LC, et al. CD56 and Paranuclear HPV in situ hybridization signal patterns ISH and IHC are the most practical as a marker for cervical intraepithelial neo- choice for routine HPV screening. In Dot-like Staining plasia progression. Gynecol Oncol. 2009; the discussion we stated that IHC 112:114–118. Pattern of Cytokeratins may be the most practical choice for 8. Bewtra C, Xie Q, Soundararajan S, et al. routine screening in the future. We Genital human papillomavirus testing by in AE1/3, CAM5.2, situ hybridization in liquid atypical cytolo- also mentioned the use of IHC is gic materials and follow-up biopsies. Acta better than ISH as it is easier to and OSCAR in Cytol. 2005;49:127–131. perform, it is well established in 9. Qureshi MN, Rudelli RD, Tubbs RR, et al. Undifferentiated most laboratories, and it is a faster Role of HPV DNA testing in predicting cervical intraepithelial lesions: comparison method compared with ISH or any (Embryonal) Sarcoma of HC HPV and ISH HPV. Diagn Cyto- other method available to detect HPV pathol. 2003;29:149–155. DNA. The authors agreed that ana- of the Liver 10. Davis-Devine S, Day SJ, Freund GG. Test lysis of tissue section used for IHC or performance comparison of Inform HPV ISH allows for visualization of stain- and hybrid capture 2 high-risk HPV DNA tests using the SurePath liquid-based Pap To the Editor: ing in abnormal cells; this would test as the collection method. Am J Clin allow the pathologist to determine if Undifferentiated (embryonal) sar- Pathol. 2005;124:24–30. abnormal cells were present, sparse coma of the liver (UESL) is an un- or absent. In the discussion we also common, rapidly growing malignant mentioned that there has been con- spindle cell tumor that usually occurs This letter is to address certain cern regarding adequacy evaluation in children and young adults, as issues related to the article ‘‘Hybrid of HPV testing performed directly from characterized by Stocker and Ishak Capture-2 is Better Than In situ the residual sample in the vial such as in 1978. This neoplasm manifests Hybridization: A Study Comparison HC-2. For instance, a negative HPV itself in children primarily between With Cervical Biopsies’’. result may actually be a false negative 5 and 10 years of age, without sex pre- 2,3 First, I would like to thank the as there may be insufficient abnormal dilection. Microscopically, UESL is authors for acknowledging that our cells in the residual material to be composed of loosely arranged, med- study is quite clever. The authors stated tested. Several recent studies indicated ium-to-large spindles, oval and stel- that in our study we concluded that in- that thenegativepredictivevalue for late pleomorphic cells with poorly situ hybridization (ISH) and immuno- HC-2 testing may be compromised defined cell borders, and giant cells histochemistry (IHC) may be the most when the copy number of the HPV with severe atypia. In addition, intra- practical choice for routine human DNA is low, and a negative test result cellular and extracellular periodic papilloma virus (HPV) screening. They may be falsely negative in patients with acid-Schiff-positive diastase-resistant also fear that our conclusions may abnormal colposcopic findings or con- hyaline globules (thanatosomes) may leave readers with the false assumption current cytologic findings. be observed throughout the neoplasm. that ISH is the more sensitive method. In summary the key issue is that Compact areas with more uniform We would like to inform the the results of our study provide evi- and pleomorphic cell morphology re- authors that the main purpose of dence that cell blocks prepared from sembling malignant fibrosarcoma and our study was to determine if tissue residual SurePath Pap test material fibrous histiocytoma, respectively, have 2,3 sections from cell blocks prepared represent an additional reliable tool in also been described. An abundant from the residual cellular sediment the evaluation of cervical samples. The alcian blue-positive matrix is character- of Pap test vials could be used for use of cell blocks for IHC and ISH istic of UESL; however, solid fibrous r | 2010 Lippincott Williams & Wilkins www.appliedimmunohist.com 195

Journal

Applied Immunohistochemistry & Molecular MorphologyWolters Kluwer Health

Published: Mar 1, 2010

There are no references for this article.