Lab Diagnosis of Neoplasia

By Sarah Iqbal Ahmed

 These are the different methods used for
diagnosis and staging of Neoplasia:
2. Histological methods.
3. Cytological methods
4. Histochemistry and Cytochemistry
5. Immunohistochemistry
6. Tumour markers
7. Flow Cytometry
8. Newer methods
 1.Histological Methods
 Microscopic examination of properly fixed
tissue.
 Tissue sample taken by:

Needle Aspiration Cytologic Smears Excision or Biopsy

 Selection of site is very important.

 Samples are fixed in alcohol or
glutaraldehyde and then stained.
The samples are stained then examined
under microscope.
 2.Cytological Methods
 There are two methods:
1)Exfoliative Cytology/PAP smear:
 Study of cells shed off into body cavities.
 Used for gyneac & non gyneac purposes.
 Used for examination of :
1)Sputum 2)Bronchial washings
3)Pleural,Peritoneal & Pericardial effusions
4)Urine 5)Gastric secretions 6)CSF.
 FNAC(fine needle aspiration
cytology)
 Aspiration of cells and fluid under vacuum

 Followed by Cytologic examination of smear.

 It is most commonly used method with a
reliability of 75-80%
 It cannot be substituted for clinical judgment.
 Frozen Section and Cryostatic
Methods
 Method of freezing and immediate
examination of samples. Eg:Surgeon sends
margins of excised tumour to make sure if
entire malignancy has been removed.

3.Histochemistry and
Cytochemistry
 Special staining methods to.
identify composition of cells,
constituents and products.
 4.Immunohistochemistry

 Identifies specific components of cell by

specific monoclonal antibodies.
 Antigen antibody complex is made visible
by fluorescent dyes or enzyme systems.

Melanoma stained by 3 antibodies

(1)HMB-45 (2)CD-3.(3)CD-20
 Uses of
Immunohistochemistry
 Categorisation of undifferentiated
tumours.Eg:Presence of keratin indicates
epithelial cell tumour whereas desmin
presence indicates neoplasia of muscle.
 Determination of site of origin of
metastasis spread.
 Detection of molecules of prognostic
importance.Eg: hormone receptors
 Categorisation of Leukemia's and
lymphomas
 5.Tumour Markers
 They are biochemical indicators of tumours
in blood or body fluids.
 Products of tumour cells –also produced by
normal cells.
 They may be - cell surface
antigens,enzymes, cytoplasmic proteins and
hormones.
 Measurement of these in serum is done by
bioassays.
 They help in identification of tumour and in
measurement of prognosis.
TUMOUR TUMOURS
MARKERS
1. CEA Colorectal and
pancreatic neoplasm's
3. Alkaline Neoplasms of bone
phosphatase
4. Alpha fetoprotein Hepatocellular
carcinoma,germ cell
tumour of testis
Choriocarcinoma
7. HCG
8. PSA
Prostatic
adenocarcinoma
9. CA-125
Ovarian tumours
 6.Flow Cytometry
 It is a Computerised technique by which Cytokeratin
detailed characters of individual cells are HPV
recognized and stored
In-situ Hybridization:
 DNA/RNA sequences are
localized by specifically
labeled probe in the intact
cell
 Used for detection of oncogenes and viruses
 7.Other Methods
DNA Microarray Analysis:
 Conventional Molecular profiling of tumour
by gene chip technology.
 DNA probes substituted by silicon chip.
Molecular Diagnostic techniques:
 DNA/RNA extracted from cell and
analyzed.
 Eg:Southern blot,Northern blot and
PCR(Polymerase Chain Reaction).
Thank you for
listening!!!
Have a nice day.