Ultrasonic decalcification offers new perspectives for Rapid FISH, DNA, and RT-PCR analysis in bone marrow trephines

University of Zurich, Zürich, Zurich, Switzerland
American Journal of Surgical Pathology (Impact Factor: 5.15). 08/2006; 30(7):892-6. DOI: 10.1097/01.pas.0000213282.20166.13
Source: PubMed


The requisite analyses on bone marrow biopsies are increasing: Molecular analyses such as fluorescence in situ hybridization (FISH), polymerase chain reaction (PCR), and reverse transcriptase (RT)-PCR are demanded in addition to morphology and immunohistochemistry to improve diagnostic accuracy. Moreover, analysis of certain molecular prognostic or predictive biomarkers is increasingly mandatory in the assessment of hematologic diseases. In some circumstances, only formalin fixed, bone-containing tissue is available for molecular analysis. Because various fixation and decalcification procedures can impair DNA and RNA quality, there is an urgent need for standardized decalcification protocols which allow FISH and PCR analysis. In this study we developed a routinely applicable decalcification protocol to optimize the molecular analysis method although preserving morphology and immunohistochemical results. Therefore, we compared 2 different approaches including ultrasonic decalcification versus nonultrasonic procedures and ethylenediaminetetraacetate-based reagents versus acid-based ones. In our hands, the combined use of ultrasound and ethylenediaminetetraacetate-based reagents permits successful interphase FISH, PCR, and RT-PCR analysis whereas concomitantly preserving morphology and antigeneicity.

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    • "reported to shorten the amount of time needed. Customized microwave or ultrasonic equipment has been reported as effective for reducing the time of the decalcification process (Kok and Boon, 1990a,b; Kok et al., 1988; Reineke et al., 2006). However, MW or US equipment with controlled temperature and other conditions are expensive items of equipment. "
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    ABSTRACT: Decalcification procedures are required in order to prepare histopathological preparations of hard tissues such as bone and teeth. Decalcification is usually performed by immersing the hard tissue in different decalcification fluids with various properties. These decalcification fluids typically include inorganic and organic acids, a neutral fluid containing a chelating agent, or a mixture of solutions. Unfortunately, there is no universal decalcification fluid that satisfies all the requirements of pathologists such as rapid decalcification, easy handling, and minimal tissue damage. Techniques involving use of microwaves (MW) or ultrasonic apparatus (US) have been shown to be useful for shortening the time for decalcification procedures. In the present study, we investigated a unique decalcification procedure that uses a common commercial ultrasonic cleaner and a decalcification fluid (formic acid) containing a free-radical scavenger (D-mannitol). The time required to complete the procedure is approximately half of that required to complete a standard decalcification procedure. In addition, tissue morphology and antigenicity is fairly well preserved after decalcification. The procedure is quick, easy to perform, and achieves decalcification of hard tissue with minimal tissue damage.
    Preview · Article · Jun 2014 · Acta histochemica
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    • "The bone marrow from the biopsy was decalcified using ultrasonic decalcification with ethylenediaminetetraacetic acid (EDTA) as described previously [11] and paraffin embedded. DNA was extracted from the tumor tissues as previously described [12,13]. "
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    ABSTRACT: It is generally believed that malignant gliomas never metastasize outside the central nervous system (CNS). However, the notion that oligodendrogliomas (OGDs) cells cannot spread outside CNS is being challenged. We described in detail the clinical story of one patient with anaplastic OGD, which metastasized to lymph nodes, bone marrowand bones Genetic analyses included detection of 1p and 19q chromosomal arms, methylation status of MGMT promoter, and PTEN exon mutations. A search of worldwide literature was conducted for reports of metastatic OGDs using NCBI-PubMed, with the keywords "extracranial", "extraneural", "oligodendroglioma", "oligodendrogliomas", "metastatic", "metastasis", and "metastases", in different combinations. An open biopsy of the infiltrated bones in our patient revealed that malignant cells had replaced the patient's marrow. Moreover, the diagnosis of multiple-organ metastases of anaplastic OGD was confirmed based on immunohistochemical staining. Genetic analyses showed that the tumors originated from previously resected brain lesions. None of the lesions had 1p and 19q deletions, but hypermethylation of MGMT promoter, and the G [rightwards arrow] A transversion at codon 234 of PTEN exon 2 were detected. Literatures review yielded 60 reports of metastatic OGDs from 1951 to the present, which with our patient makes 61 cases. Concerning these 61 patients, there were 110 infiltrated sites correlated closely with primary OGDs. The most frequent metastatic sites were bone and bone marrow (n = 47; 42.7%), lymph nodes (n = 22; 20.0%), liver (n = 7; 6.4%), scalp (n = 6; 5.5%), lung (n = 6; 5.5%), pleura (n = 4; 3.6%), chest wall (n = 3; 2.7%), iliopsoas muscle (n = 2; 1.8%), soft tissue (n = 2; 1.8%), and parotid gland (n = 2; 1.8%). Extracranial metastases in anaplastic OGD are very rare but they do occur; bone and bone marrow may be the most common sites. Detection of certain molecular markers such as deletion of 1p and 19q chromosomal arms, hypermethylation of MGMT promoter, and characteristic PTEN exon mutations may help differentiate subtypes which are more prone to extracranial metastases.Virtual slides: The virtual slide(s) for this article can be found here:
    Full-text · Article · Jan 2014 · Diagnostic Pathology
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    • "The utility of microwaves in pathological specimen production and rapid immunostaining is believed to be the result of the greater agitation effect produced by high-frequency vibrations (Leong et al. 1985; Kumada et al. 2004; Hatta et al. 2006). On the other hand, ultrasound is also known to produce high churning/osmosis effects resulting from repeated compression and depression of the liquid level, and these are expected to have the same effects as microwaves (Chu et al. 2006; Kitayama and Yamada 2006; Reineke et al. 2006). We hypothesized that immunostaining reaction time would be reduced using an ultrasonic generator, "
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    ABSTRACT: Although intraoperative rapid diagnosis is conventionally performed using hematoxylin-eosin (HE)-stained specimens, the use of additional special staining, together with immunostaining techniques, has been examined in recent years to improve diagnostic accuracy. In intraoperative rapid diagnosis, immunostaining should be completed within 7-10 min, because the pathologist is typically presented with an HE-stained specimen within the same time period. We hypothesized that ultrasound may enhance antigen-antibody reactions and reduce the number of immunostaining steps. To clarify the ability of ultrasound to support immunostaining, we first created an ultrasonic generator specifically for immunostaining. Next, we explored the optimal conditions for immunostaining of formalin-fixed specimens to examine the utility of the ultrasonic generator. Finally, we tried immunostaining with the ultrasonic generator using frozen specimens to simulate intraoperative rapid diagnosis. We report herein that ultrasound enables immunostaining of frozen specimens in approximately 10 min.
    Full-text · Article · May 2010 · Journal of Histochemistry and Cytochemistry
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