Natalia Pomjanski

Publications of Natalia Pomjanski

• Equivocal cytology in lung cancer diagnosis: improvement of diagnostic accuracy using adjuvant multicolor FISH, DNA-image cytometry, and quantitative promoter hypermethylation analysis.

  Authors: Martin Schramm, Christian Wrobel, Ingmar Born, Marietta Kazimirek, Natalia Pomjanski, Marina William, Rainer Kappes, Claus Dieter Gerharz, Stefan Biesterfeld, Alfred Böcking

  Cancer cytopathology. 03/2011; 119(3):177-92.

  Sometimes, cytological lung cancer diagnosis is challenging because equivocal diagnoses are common. To enhance diagnostic accuracy, fluorescent in situ hybridization (FISH), DNA-image cytometry, andSometimes, cytological lung cancer diagnosis is challenging because equivocal diagnoses are common. To enhance diagnostic accuracy, fluorescent in situ hybridization (FISH), DNA-image cytometry, and quantitative promoter hypermethylation analysis have been proposed as adjuncts. Bronchial washings and/or brushings or transbronchial fine-needle aspiration biopsies were prospectively collected from patients who were clinically suspected of having lung carcinoma. After routine cytological diagnosis, 70 consecutive specimens, each cytologically diagnosed as negative, equivocal, or positive for cancer cells, were investigated with adjuvant methods. Suspicious areas on the smears were restained with the LAVysion multicolor FISH probe set (Abbott Molecular, Des Plaines, Illinois) or according to the Feulgen Staining Method for DNA-image cytometry analysis. DNA was extracted from residual liquid material, and frequencies of aberrant methylation of APC, p16(INK4A) , and RASSF1A gene promoters were determined with quantitative methylation-specific polymerase chain reaction (QMSP) after bisulfite conversion. Clinical and histological follow-up according to a reference standard, defined in advance, were available for 198 of 210 patients. In the whole cohort, cytology, FISH, DNA-image cytometry, and QMSP achieved sensitivities of 83.7%, 78%, 79%, and 49.6%, respectively (specificities of 69.8%, 98.2%, 98.2%, and 98.4%, respectively). Subsequent to cytologically equivocal diagnoses, FISH, DNA-image cytometry, and QMSP definitely identified malignancy in 79%, 83%, and 49%, respectively. With QMSP, 4 of 22 cancer patients with cytologically negative diagnoses were correctly identified. Thus, adjuvant FISH or DNA-image cytometry in cytologically equivocal diagnoses improves diagnostic accuracy at comparable rates. Adjuvant QMSP in cytologically negative cases with persistent suspicion of lung cancer would enhance sensitivity.

• Hemodynamic support by left ventricular assist devices reduces cardiomyocyte DNA content in the failing human heart.

  Authors: Jeremias Wohlschlaeger, Bodo Levkau, Gero Brockhoff, Klaus Jürgen Schmitz, Moritz von Winterfeld, Atsushi Takeda, Nobuakira Takeda, Jörg Stypmann, Christian Vahlhaus, Christof Schmid, Natalia Pomjanski, Alfred Böcking, Hideo Andreas Baba

  Circulation. 02/2010; 121(8):989-96.

  Whether adult cardiomyocytes have the capacity to regenerate in response to injury and, if so, to what extent are still issues of intense debate. In human heart failure, cardiomyocytes harbor aWhether adult cardiomyocytes have the capacity to regenerate in response to injury and, if so, to what extent are still issues of intense debate. In human heart failure, cardiomyocytes harbor a polyploid genome. A unique opportunity to study the mechanism of polyploidization is provided through the setting of hemodynamic support by left ventricular assist devices. Hence, the cardiomyocyte DNA content, nuclear morphology, and number of nuclei per cell were assessed before and after left ventricular assist device support. In 23 paired myocardial samples, cardiomyocyte ploidy was investigated by DNA image cytometry, flow cytometry, and in situ hybridization. Nuclear cross-sectional area and perimeters were measured morphometrically, and the binucleated cardiomyocytes were counted. The median of the cardiomyocyte DNA content and the number of polyploid cardiomyocytes both declined significantly from 6.79 c to 4.7 c and 40.2% to 23%, whereas a significant increase in diploid cardiomyocytes from 33.4% to 50.3% and in binucleated cardiomyocytes from 4.5% to 10% after unloading was observed. The decrease in polyploidy and increase in diploidy after left ventricular assist device suggest a numeric increase in diploid cardiomyocytes (eg, through cell cycle progression with completion of mitosis or by increased stem cells). The cardiac regeneration that follows may serve as a morphological correlate of the recovery observed in some patients after unloading.

• Extrahepatic intraductal ectopic hepatocellular carcinoma: bile duct filling defect.

  Authors: Moritz Schmelzle, Hanno Matthaei, Nadja Lehwald, Andreas Raffel, Roy Y Tustas, Natalia Pomjanski, Petra Reinecke, Marcus Schmitt, Jan Schulte Am Esch, Wolfram T Knoefel, Claus F Eisenberger

  Hepatobiliary & pancreatic diseases international : HBPD INT. 12/2009; 8(6):650-2.

  BACKGROUND: Obstructive jaundice caused by an intraductal hepatocellular carcinoma is a rare initial symptom. We report a rare case of an extrahepatic icteric type hepatocellular carcinoma. METHODS:BACKGROUND: Obstructive jaundice caused by an intraductal hepatocellular carcinoma is a rare initial symptom. We report a rare case of an extrahepatic icteric type hepatocellular carcinoma. METHODS: A 75-year-old patient was admitted to our hospital because of obstructive jaundice 3 months after resection of multilocular hepatocellular carcinoma. A postoperative bile leakage was treated by placement of a decompressing stent in the common bile duct. Endoscopic retrograde choledochoscopy showed extended blood clots filling the bile duct system and computed tomography revealed a local swelling in the common extrahepatic bile duct. The level of alpha-fetoprotein (AFP) was only slightly elevated but that of CA19-9 was dramatically increased. Cholangiography showed an intraductal filling defect typical of a cholangiocellular carcinoma. RESULTS: Bile duct brushing cytology showed no cholangiocellular carcinoma but hepatocellular carcinoma cells in the extrahepatic bile duct. An extrahepatic bile duct resection was performed. Histological examination confirmed the diagnosis of extrahepatic intraductal growth of hepatocellular carcinoma. CONCLUSION: Ectopic hepatocellular carcinoma is a rare but important differentially diagnosed of extrahepatic bile duct filling defect.

• 9p21 Deletion in the diagnosis of malignant mesothelioma in serous effusions additional to immunocytochemistry, DNA-ICM, and AgNOR analysis.

  Authors: Fabiana Botelho de Miranda Onofre, Alexandre Sherlley Casimiro Onofre, Natalia Pomjanski, Birgit Buckstegge, Hans Juergen Grote, Alfred Böcking

  Cancer. 07/2008; 114(3):204-15.

  BACKGROUND: The diagnosis of malignant mesothelioma (MM) in serous effusions is difficult but may be achieved by the application of adjuvant methods. METHODS: The authors cytologically diagnosed 33BACKGROUND: The diagnosis of malignant mesothelioma (MM) in serous effusions is difficult but may be achieved by the application of adjuvant methods. METHODS: The authors cytologically diagnosed 33 effusions as suspicious or positive for MM cells by using DNA-image cytometry (DNA-ICM), immunocytochemistry and AgNOR analysis. The authors further detected 9p21 deletions by chromosomal fluorescence in situ hybridization (FISH). In addition, 31 cases of metastatic carcinomas and 39 of tumor cell-negative effusions were investigated. All diagnoses were confirmed by histologic and/or clinical follow-up. RESULTS: DNA aneuploidy was found in 71% of MMs, 100% of metastatic carcinomas, and in none of the negative effusions. Calretinin was positive in 100% of MMs, in none of the metastatic carcinomas, and in 94.9% of negative effusions. BerEP4 showed positivity in 15.6% of MMs, 87.1% of metastatic carcinomas, and in none of the negative effusions. With AgNOR analysis, 89.3% of MMs and 96.7% of metastatic carcinomas showed >or=2.5 AgNOR dots as satellites and >or=4.5 as total AgNOR counts. 9p21 deletions were demonstrated in 90.9% of MM cases, 45.2% of metastatic carcinomas, and in none of the negative effusions. By cytology alone, 81.8% of MMs were identified unequivocally. Addition of DNA-ICM improved the prevalence of tumor cell detection to 87.9% and of AgNOR analysis to 97%. The introduction of 9p21 deletions by FISH improved this prevalence to 100%. CONCLUSIONS: Because of these results, the authors propose the sequential application of immunocytochemistry, DNA-ICM, and AgNOR analysis to establish a cytological diagnosis of malignant mesothelioma in serous effusions. In persistent doubtful diagnoses, the authors recommend fluorescence in situ hybridization to analyze the 9p21 deletion.

• Immunocytochemical typing of primary tumors on fine-needle aspiration cytologies of lymph nodes.

  Authors: Alexandre Sherlley Casimiro Onofre, Natalia Pomjanski, Birgit Buckstegge, Alfred Böcking

  Diagnostic cytopathology. 05/2008; 36(4):207-15.

  The aim of this study was to analyze the role of immunocytochemistry as an ancillary method on routine FNACs of enlarged lymph nodes, using different markers. In a validating cohort study allThe aim of this study was to analyze the role of immunocytochemistry as an ancillary method on routine FNACs of enlarged lymph nodes, using different markers. In a validating cohort study all patients had confirmatory histological and/or clinical follow-up. 10 FNACs were analyzed for the differentiation of Non-Hodgkin Lymphoma (NHL) from metastatic carcinoma (MC), 30 cases to identify the sites of metastatic unknown primary tumors and 16 cases were checked to confirm clinical suspicion of a specific MC. Accuracy to differentiate NHL from MC was 100%, 92.3% to identify a primary tumor site of MC, and 100% to confirm a clinical suspicion of a specific MC. In 7 cases, the site of the primary tumor remained clinically unknown. Application of immunocytochemical markers on the same slide used for microscopic diagnosis is a useful tool in the routine assessment of FNACs of lymph nodes.

• Early cytological diagnosis of diffuse malignant mesothelioma of the peritoneum: a case report.

  Authors: Natalia Pomjanski, Hans Juergen Grote, Oliver Sander, Sebastian Heikaus, Klaus-Michael Müller, Alfred Böcking

  Diagnostic cytopathology. 03/2008; 36(2):120-3.

  Mesotheliomas are the most frequent primary malignant tumors of serosal cavities with a poor prognosis. A definitive and early diagnosis on effusion samples is important, because recent advances inMesotheliomas are the most frequent primary malignant tumors of serosal cavities with a poor prognosis. A definitive and early diagnosis on effusion samples is important, because recent advances in therapy for patients with mesothelioma may result in an improved outcome if they are applied to stage I disease.We report a case of malignant peritoneal mesothelioma diagnosed repeatedly by cytology in ascites fluids 1.5 yr before the diagnosis was confirmed by biopsy histology. The cytological diagnoses were supported by immunocytochemistry, DNA-cytometry, and AgNOR-analysis. Routine cytology supported by three adjuvant methods enabled us to correctly establish the diagnosis. Our case suggests that a cytological diagnosis of malignant mesothelioma supported by adjuvant methods should not be rejected even if based on negative histological results.

• Additional use of DNA-image cytometry improves the assessment of resection margins.

  Authors: Jörg Handschel, Döne Oz, Natalia Pomjanski, Rita Depprich, Michelle A Ommerborn, Stefan Braunstein, Norbert R Kübler, Ulrich Meyer, Alfred Böcking

  Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. 10/2007; 36(8):472-5.

  BACKGROUND: Despite the histopathologic findings of tumor-free margins, patients with oral squamous cell carcinoma (SCC) often suffer from local tumor relapse. The purpose of this study was toBACKGROUND: Despite the histopathologic findings of tumor-free margins, patients with oral squamous cell carcinoma (SCC) often suffer from local tumor relapse. The purpose of this study was to determine the prognostic value of DNA-image cytometry in the assessment of resection margins. METHODS: DNA-image cytometry was performed in 40 SCC patients with histologically tumor-free resection margins. The follow-up period since the tumor resection was at least 3 years. RESULTS: Twenty patients showed a locoregional relapse of the SCC. Fourteen of these patients had aneuploid cells in DNA-image cytometry. Two patients who were relapse-free revealed aneuploid cells too. The sensitivity of the adjuvant use of DNA-image cytometry was 70% and the positive predictive value was 87.5%. CONCLUSIONS: The additional use of DNA-image cytometry is a reasonable tool for the assessment of the resection margins of SCCs. DNA-image cytometry could help to find the appropriate treatment option for the patients and thus might improve their prognosis.

• Immunocytochemical diagnosis of hepatocellular carcinoma and identification of carcinomas of unknown primary metastatic to the liver on fine-needle aspiration cytologies.

  Authors: Alexandre Sherlley Casimiro Onofre, Natalia Pomjanski, Birgit Buckstegge, Alfred Böcking

  Cancer. 09/2007; 111(4):259-68.

  BACKGROUND: Difficulties with cytologic diagnoses on fine-needle aspiration cytology (FNAC) of the liver can be overcome by the application of immunocytochemical panels applied on smears. The aim ofBACKGROUND: Difficulties with cytologic diagnoses on fine-needle aspiration cytology (FNAC) of the liver can be overcome by the application of immunocytochemical panels applied on smears. The aim of the current study was to analyze the performance of a panel of monoclonal antibodies to differentiate hepatocellular carcinoma (HCC) from metastatic carcinoma (MC) or regenerative nodules, and to identify the to date unknown primary sites of carcinomas that had metastasized to the liver. METHODS: In a validating cohort study, 108 FNACs coin lesions in the liver were routinely evaluated applying immunocytochemistry as an ancillary method. All patients had confirmatory histologic and/or clinical follow-up. A total of 23 HCCs were analyzed for the distinction from MC or regenerative nodules applying a panel of HepPar1, alpha-fetoprotein, BerEP4, CD31, CD68, and Ki-67. A total of 85 cases of unknown primary tumor metastatic to the liver were used to identify the tumor sites applying a panel of CK5/6, CK7, CK20, CA 125, thyroid transcription factor-1 (TTF-1), and Cdx2. RESULTS: Typing accuracy to differentiate HCC from MC or regenerative nodules was 100% and 90.3%, respectively, to identify the primary tumor site of MC. In 23 cases, the site of the primary tumor remained clinically unknown. CONCLUSIONS: The application of immunocytochemical panels on the same slide used for microscopic diagnosis is a useful tool in the routine assessment of FNACs of the liver to discriminate HCCs from MC or regenerative nodules and for the identification of primary sites of MC. Their performance should be confirmed in a larger series of cases.

• Verrucous carcinoma of the buccal mucosa: histopathological, cytological and DNA-cytometric features.

  Authors: Dimitra Maraki, Alfred Boecking, Natalia Pomjanski, Mosaad Megahed, Juergen Becker

  Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. 12/2006; 35(10):633-5.

  We describe a patient with an exophytic oral lesion diagnosed as verrucous carcinoma. The lesion existed without metastases, at least 5 years. Local excisions led to recurrences and continuousWe describe a patient with an exophytic oral lesion diagnosed as verrucous carcinoma. The lesion existed without metastases, at least 5 years. Local excisions led to recurrences and continuous expansion. Scalpel biopsies for histopathological and polymerase chain reaction examination were obtained from characteristic regions of the lesion. Brush biopsies for exfoliative cytology (EC) were taken, in order to screen the mucosal area covered by the lesion. After Feulgen restaining of the smears, nuclear DNA contents were measured using a TV image analysis system. An exophytic lesion of the buccal mucosa was diagnosed as low-grade malignant through histopathology and EC combined with DNA-image cytometry (peritetraploid DNA-aneuploidy). Due to almost normal microscopic appearance of the epithelium of verrucous carcinoma, thorough cytological/DNA-cytometric and histological examinations are needed. Brush biopsies of such neoplastic oral lesions showing DNA-aneuploidy with peritetraploid stemlines should be used for diagnosis and follow-up examination of these patients.

• Cytologic and DNA-cytometric examination of oral lesions in lichen planus.

  Authors: Dimitra Maraki, Sebnem Yalcinkaya, Natalia Pomjanski, Mosaad Megahed, Alfred Boecking, Juergen Becker

  Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. 05/2006; 35(4):227-32.

  BACKGROUND: The aim of the present study was to evaluate the diagnostic value of exfoliative cytology (EC) and DNA image cytometry applied to oral lesions of lichen planus (LP; n = 56), in order toBACKGROUND: The aim of the present study was to evaluate the diagnostic value of exfoliative cytology (EC) and DNA image cytometry applied to oral lesions of lichen planus (LP; n = 56), in order to detect or exclude malignant transformation. METHODS: Brush and excisional biopsies were obtained from 56 patients. In cases of oral LP in which brush biopsies were suspicious for tumor cells, nuclear DNA contents were measured, using a TV Image Analysis System. RESULTS: In 50 patients EC yielded tumor cell-negative, doubtful in four cases and suspicious results obtained in two cases. DNA image cytometry revealed DNA-aneuploidy only in the two suspicious cases. The comparison between cytologic/DNA-cytometric diagnosis and biopsy histology resulted in a total agreement (LP without dysplasia: 54 and squamous cell carcinoma in LP: two cases). CONCLUSIONS: In conclusion, cytology with DNA-cytometry is a highly sensitive, specific, and non-invasive method, which can be used for periodical follow up of oral LP lesions in order to early detect or exclude malignancy.

• Immunocytochemical identification of carcinomas of unknown primary in serous effusions.

  Authors: Natalia Pomjanski, Hans Juergen Grote, Peyrüze Doganay, Viola Schmiemann, Birgit Buckstegge, Alfred Böcking

  Diagnostic cytopathology. 12/2005; 33(5):309-15.

  Metastases from carcinomas of unknown primary site (CUP) in serous effusion are a common clinical problem. Immunocytochemistry was applied as an adjunct to the cytological diagnosis of metastaticMetastases from carcinomas of unknown primary site (CUP) in serous effusion are a common clinical problem. Immunocytochemistry was applied as an adjunct to the cytological diagnosis of metastatic carcinomas in serous effusions.Subjects of this study were 118 pleural, 53 peritoneal, and 9 pericardial effusions from 180 patients routinely investigated in the Institute of Cytopathology. Specimens were primarily stained according to Papanicolaou (Pap). The avidin-biotin-complex method (ABC) was secondarily applied for the visualization of immunologic reactions.We have used a panel of six monoclonal antibodies (CK 5/6, CK 7, CK 20, CA 125, TTF-1, and cdx 2) so as to identify the primary tumor site of metastatic carcinoma cells in serous effusions. Applying an algorithm of immunocytochemical marker constellations, we were able to correctly diagnose primary tumor sites in 86 of 101 (85.1%) patients with CUP syndromes. The best result was achieved for the identification of metastatic carcinomas of the ovaries (94.7%) and the lungs (88.1%).We established an algorithm comprising six immunocytochemical markers that enabled a correct diagnosis of primary tumor sites in 85.1%. The panel studied could be useful in diagnostic routine for the identification of primary tumors of unknown origin metastatic to the serous membranes.

• Interobserver reproducibility of DNA-image-cytometry in ASCUS or higher cervical cytology.

  Authors: Vu Quoc Huy Nguyen, Hans Jürgen Grote, Natalia Pomjanski, Kristiane Knops, Alfred Böcking

  Cellular oncology : the official journal of the International Society for Cellular Oncology. 02/2004; 26(3):143-50.

  In the present study, the aim has been to investigate the interobserver reproducibility of DNA-image-cytometry (DNA-ICM) applied to routine Pap smears classified as Atypical Squamous Cells ofIn the present study, the aim has been to investigate the interobserver reproducibility of DNA-image-cytometry (DNA-ICM) applied to routine Pap smears classified as Atypical Squamous Cells of Undetermined Significance (ASCUS) or higher lesions (ASCUS+). 202 Pap smears diagnosed as ASCUS or higher were included in the study. After cytological assessment, smears underwent restaining according to Feulgen. First measurements were performed as routine workup. The second measurements were blinded to the result of the first and consecutively performed. DNA-ICM met the consensus statements of the European Society of Analytical Cellular Pathology (ESACP). Interobserver agreement was assessed by calculating Kappa statistics. The diagnosis of DNA-aneuploidy in the first measurements was confirmed in all cases. Second measurement detected 12 additional cases with aneuploidy. Nine out of these cases were classified as aneuploidy by detection of 9c Exceeding Events (9cEE). In three cases stemline-aneuploidy was disclosed. The overall proportion of observed agreement was 94.1%, kappa=0.87, 95% CI=0.74-0.99. Our study shows a good interobserver reproducibility of DNA-ICM performed on cervical smears with ASCUS or higher lesions. DNA-ICM thus represents a highly reproducible diagnostic procedure.

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• Immune cells in the anterior chamber of patients with immune reactions after penetrating keratoplasty.

  Authors: Thomas Reinhard, Alfred Böcking, Natalia Pomjanski, Rainer Sundmacher

  Cornea. 02/2002; 21(1):56-61.

  PURPOSE: Lymphocytes, monocytes, and macrophages are the predominating immune cells in graft rejection after keratoplasty in animal models. This study focuses on the isolation of immune cells fromPURPOSE: Lymphocytes, monocytes, and macrophages are the predominating immune cells in graft rejection after keratoplasty in animal models. This study focuses on the isolation of immune cells from the anterior chamber of patients with slight, moderate, and severe endothelial immune reactions after penetrating keratoplasty. METHODS: Anterior chamber puncture was performed in five patients with cataract without inflammation and without penetrating keratoplasty (C1), in three patients undergoing penetrating keratoplasty without immune reactions (C2), in four patients undergoing penetrating keratoplasty after complete resolution of endothelial immune reactions (C3), in seven patients undergoing penetrating keratoplasty with slight endothelial immune reactions (IMI), in 10 patients undergoing penetrating keratoplasty with moderate endothelial immune reactions (IM2), and in eight patients undergoing penetrating keratoplasty with severe endothelial immune reactions (IM3). In each patient, approximately 0.1 mL of aqueous humor was examined. Cells in suspension were directly centrifuged on glass slides using a Cytospin centrifuge, stained, and evaluated under the light microscope. RESULTS: Groups C1, C2, and C3 did not contain cells. Immune cells were identified in three of seven patients in IM1, in eight of 10 patients in IM2, and in eight of eight patients in IM3. Predominating cells were macrophages and monocytes followed by lymphocytes. Regarding all patients in IMI, IM2, and IM3, a statistically significant correlation between detected cells and patient age, period between penetrating keratoplasty and anterior chamber puncture, or period between first symptoms and anterior chamber puncture could not be revealed. Granulocytes were found statistically significantly less often in patients with high-risk indications, in patients with a history of immune reactions and under immunosuppression. Lymphocytes were found statistically significantly less often in patients with a history of immune reactions. CONCLUSIONS: The probability to isolate immune cells from the anterior chamber of patients undergoing penetrating keratoplasty correlates with the severity of the endothelial immune reactions. This study is a first step to evaluate how detailed immunologic findings from animal keratoplasty models fit to clinical reality in patients undergoing keratoplasty. In the next step, cells found in the aqueous humor of patients with endothelial immune reactions should be further characterized directly (determination of molecules on the surface of the cells) or indirectly (determination of cytokine levels in the aqueous humor).

• Diagnostic DNA-flow- vs. -image-cytometry in effusion cytology.

  Authors: Helma Motherby, Natalia Pomjanski, Mary Kube, Alexandra Boros, Thomas Heiden, Bernhard Tribukait, Alfred Böcking

  Analytical cellular pathology : the journal of the European Society for Analytical Cellular Pathology. 02/2002; 24(1):5-15.

  AIMS: To determine the sensitivity and specificity of flow- and image-cytometry for the detection of DNA-aneuploidy as a marker for malignant cells in effusions. METHODS: 200 effusions (80 tumorAIMS: To determine the sensitivity and specificity of flow- and image-cytometry for the detection of DNA-aneuploidy as a marker for malignant cells in effusions. METHODS: 200 effusions (80 tumor cell-positive, 74 negative and 46 cytologically equivocal) were stained with DAPI-SR for DNA-flow- and with Feulgen-Pararosaniline for -image-cytometry. They were measured using a PAS-flow-cytometer and an AutoCyte-QUIC-DNA-workstation according to the ESACP consensus reports for DNA-flow- and -image-cytometry, respectively [7,23,29,49]. RESULTS: Sensitivity of DNA-aneuploidy for the identification of malignant cells was 32.1% for DNA-flow- and 75.0% for -image-cytometry, specificity of -euploidy in benign cells was 100.0% for both methods. Positive predictive value of DNA-aneuploidy for the identification of malignant cells was 100.0% for both techniques, negative predictive value of DNA-euploidy was 48.6% for DNA-flow- and 72.0% for -image-cytometry. CONCLUSIONS: Searching for DNA-aneuploidy as a diagnostic marker for neoplastic cells in serous effusions image-cytometry revealed superior sensitivity as compared with monoparametric flow cytometry.