• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
02 Asc H Continued  Chivkula
 

02 Asc H Continued Chivkula

on

  • 982 views

A potpourri of ASC-H and related interpretations-

A potpourri of ASC-H and related interpretations-
(Part II)

Statistics

Views

Total Views
982
Views on SlideShare
982
Embed Views
0

Actions

Likes
0
Downloads
0
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    02 Asc H Continued  Chivkula 02 Asc H Continued Chivkula Presentation Transcript

    • Mamatha Chivukula MD, FASCP, FCAP Assistant Professor Associate Director of Immunohistochemistry lab Magee-Women’s Hospital of UPMC Pittsburgh, PA Study cases and application of two-color immunochemistry
    • Objectives
      • Present real time case studies to demonstrate the utility of cytomorphology in interpretation of ASC-H pap tests
      • Cytohisto correlation and follow-up HPV testing
    • Cytomorphology of ASC-H
      • MGH-like
      • Repair like
      • Atrophy-like- with single cells
      • Atrophy-like- with HCG of parabasal cell groups
      • ASC-H: NOS
      • Cyanophilic small atypical parakeratotic cells
      • HSIL- syncytial
      • HSIL- Single cell
    • Case 1
      • 35 year old woman w/ a routine Pap test
    •  
    •  
    • Groups of atypical cells (without distinct cell borders)
    • -
    • Hyperchromatic nuclei - Coarse to fine chromatin
      • Follow up HPV –DNA test is Positive for high risk HPV types
    •  
    • “ Syncytial cell” pattern Source: Chivukula M , Shidham V . CytoJournal 2006, 3:14
    • Case 2
      • 49 year old woman w/ a routine Pap test
      • - Abundant blue cytoplasm
      • Open chromatin , w/w out nucleoli
      • Follow up HPV –DNA test is Negative for high risk HPV types
    •  
    • p16
    • KI -67
    • Atrophic “ Single-cell” pattern Source: Chivukula M , Shidham V . CytoJournal 2006, 3:14
    • Case 3
      • 30 year old woman w/ a routine Pap test
    •  
    • Cohesive clusters
    • -Prominent nucleoli - Low N/C ratio
      • Follow up HPV –DNA test is Negative for high risk HPV types
    •  
    • “ School of fish” Repair – like pattern Source: Chivukula M , Shidham V . CytoJournal 2006, 3:14
    • Case 4
      • 35 year old woman w/ a routine Pap test
    •  
    •  
    •  
      • Follow up HPV –DNA test is Positive for high risk HPV types
    •  
    • “ Isolated cell pattern” Source: Chivukula M , Shidham V . CytoJournal 2006, 3:14
    • Case 5
      • 55 year old woman w/ a routine Pap test
    •  
    • - HCG of parabasal cells - Small dark nuclei - Variable, usually scant cytoplasm
      • Follow up HPV –DNA test is Negative for high risk HPV types
    •  
    • Atrophic “ Parabasal cell groups” Source: Chivukula M , Shidham V . CytoJournal 2006, 3:14
    • Application of two-color immunochemistry
      • P16 is over expressed and accumulates in nucleus and cytoplasm of dysplastic cervical cells
      • Studies on ASC-US, ASC-H
      • Advanced kits for immunostaining cervical specimens to detect both p16 and ki-67 simulatneously
      • In a normal cell w/ intact cell cycle, Simultaneous expression of anti-proliferative marker (p16), proliferative marker (ki-67) within the same cell, mutually excludes each other
      • Reversely, presence of both p16, ki-67 in the same cell, indicates disrupted cell cycle
      State of the art….work in progress
    •  
    •  
      • Thank you
      Thank you