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Abstracts & Presentations

Eric Burks (view biography)
– Pulmonary Immunopathology of COVID-19 Induced Diffuse Alveolar Damage: The utility of multiplex immunohistochemistry
– Multiplex IHC as a means to aide in the assessment of minimal residual disease (MRD)
for plasma cell neoplasms.

Hazel Chambers-Smith (view biography)
– The role of immunohistochemistry in the diagnosis of paediatric brain tumours

Bron Christiansen (view biography)
– Technical test approach: the pre-analytical phase

Regan Fulton (view biography)
– Immunohistochemistry assay validation: College of American Pathologists Guidelines

David Gan (view biography)
– MOCKTALES: A Mock RCPAQAP IHC Assessment

Zenobia Haffajee (view biography)
– Keeping ABREAST of your EQA results. Breast Markers Review – An RCPAQAP update.

Emiel Janssen (view biography)
– Molecular biomarkers in endometrial hyperplasia
– IHC and molecular diagnostics in non-small cell lung carcinoma

Julia Pagliuso (view biography)
– RCPA-QAP-external quality assessment update


MOCKTALES: A Mock RCPAQAP IHC Assessment
David Gan (view biography)
Supervisor of the Special Stains area in Anatomical Pathology
QML Pathology

As a participant in the RCPAQAP IHC module, it can be difficult to understand what is involved in assessing your slides. When a result comes back to the laboratory, opinions may range from “I totally agree with the expert comments and score”, to “Were they looking at the right slide?”
This presentation will attempt to clear up a few myths about assessments as well as include the audience in a mock assessment to get a better understanding of the process.
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Keeping ABREAST of your EQA results. Breast Markers Review – An RCPAQAP update.
Zenobia Haffajee (view biography)
Senior Scientist
Royal College of Pathologists of Australasia
Quality Assurance Program, Anatomical Pathology
St Leonards, NSW, Australia

RCPAQAP provides EQA assessment for proficiency testing for Immunohistochemistry (IHC) and bright field in situ hybridization (ISH) techniques for the detection of breast tumour markers. This specific EQA determines the quality of Oestrogen (ER), Progesterone (PR), HER2 IHC and HER2 ISH staining on formalin fixed paraffin-embedded tumour sections.

The Breast markers EQA pilot was implemented in 2002. This presentation is an overview of data collated over a period of 17 years and highlights the survey results and participant performance.

In keeping with the updated recommended ASCO/CAP guidelines from the RCPA, laboratories are recommended to ensure that their methods area validated against a reference method and that the assays performance is continuously monitored to identify any potential issues. This may have the potential to affect patient treatment.
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RCPA-QAP-external quality assessment update
Julia Pagliuso (view biography)
The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP), Anatomical Pathology,
St Leonards, NSW, 2065,
Australia

The Royal College of Pathologists of Australasia Quality Assurance Programs (RCPAQAP) provides world-class, peer-reviewed External Quality Assurance (EQA) programs and continuing professional education. Our programs are offered in Australia and internationally in over 80 countries. Our strength lies in the expertise and support provided by an extensive advisory network consisting of pathologists and scientific staff from Australia and internationally.

The RCPAQAP has undergone a number of changes over the last few years and is continuing to evolve. These changes will be communicated, along with a summary of the future directions and projects for the Anatomical Pathology discipline.

Changes discussed will include:

  • Informatics – new myQAP portal
  • Changes to programs –HER2 ISH (Bright field)
  • Online product catalogue – advertising of antibodies/stains for next year
  • New initiatives – PD-L1 NSCLC Interpretation, PDL-1 triple negative breast cancer, FISH

RCPAQAP is committed to provide an efficient and customer focused service to participants and feedback is welcome. RCPAQAP staff will be available to answer any questions during breaks.
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Technical test approach: the pre-analytical phase
Bron Christiansen (view biography)
The Royal Children’s Hospital
Parkville, VIC, Australia

There are many things prior to performing our IHC that can have an impact on getting the right results for our patients. This session will discuss some obvious, and some not so obvious, steps we need to take to ensure the quality of our testing.
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Immunohistochemistry assay validation: College of American Pathologists Guidelines
Regan Fulton (view biography)
Array Science, LLC
475 Gate 5 Road, #100
Sausalito, CA 94965, USA

IHC assay validation is a broad and confusing topic for many laboratorians. An IHC Laboratory Medical Director typically receives little or no training in this area and there are numerous considerations that can influence how validations are designed and performed. In this webinar, we will explore the motivations for optimizing and validating IHC assays, define relevant terms and concepts, and provide an overview of the current guidance from the CAP. Finally, we will discuss some of the available approaches that can simplify, as well as strengthen, the process.
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Molecular biomarkers in endometrial hyperplasia
Emiel Janssen (view biography)
Stavanger University and Stavanger University Hospital
Department of Pathology
Stavanger, Norway

Endometrial hyperplasia (EH) is an excessive proliferation of endometrial glands that leads to a higher gland/stroma ratio, compared with normal endometrium. EH is much more frequent than endometrial cancer; 5-10% of untreated EHs progress to endometrial endometrioid adenocarcinoma. EH can be evaluated by the 2003 World Health Organization (WHO) or the more current approach, endometrial intraepithelial neoplasia (EIN) system. The 2003 WHOclassification is based on glandular crowding and cytologic atypia that resulted in 4 subgroups with increasing cancer risk. Despite its worldwide use, the inter- and intraobserver reproducibility of cytologic atypia (the most important of the 2 prognostic WHO factors) is not very good. The EIN classification distinguishes benign reactive hyperplasias (a polyclonal lesion), which is the result of excessive stimulation by estrogens, and EIN, which is a monoclonal neoplasm. The EIN classification is based on morphometric data and molecular monoclonality.
The morphometric Dscore appears to be most reproducible of all existing prognostic classifications and prognostically to be the strongest.2 However, the computerized morphometric analysis technology that is required for D-score assessment is not available widely at the moment.
Although this will most likely change with the advent of digital pathologic evaluation, it would be preferable to have strong molecular immunohistochemical outcome predictors. An historic overview on the development and background for the D.score will be provided, furthermore the role of other immunhistochemical and molecular markers that can support EIN classification will be presented.
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IHC and molecular diagnostics in non-small cell lung carcinoma
Emiel Janssen (view biography)
Stavanger University and Stavanger University Hospital
Department of Pathology
Stavanger, Norway

Lung cancer is a disease with dismal prognosis. In addition it is a common disease, – implying its’ major impact on survival. For optimized treatment of lung cancer patients, an increasing number of biomarkers are being tested. In todays practice NSCLC patients are tested for treatment-predictive markers PD-L1, EGFR, AKL, BRAF and ROS1. While PD-L1 remains a protein-based analysis through IHC, the other three require (additional) molecular (DNA or RNA) analyses. Future holds the need for increasing molecular testing to identify a constantly increasing number somatic genetic alterations in driver genes. In addition to SNV and Indels, structural rearrangement in genes like ROS1, RET, ALK, BRAF and NTRK1-3 are recurrently seen in lung carcinomas, and for which targeted therapies are available. An overview on current practices and research on more immunohistochemical markers for the tumor microenvironment will be discussed.
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Pulmonary Immunopathology of COVID-19 Induced Diffuse Alveolar Damage: The utility of multiplex immunohistochemistry
Eric Burks (view biography)
Clinical Associate Professor of Pathology
Boston University School of Medicine

Severe COVID-19 results in a glucocorticoid responsive form of acute respiratory distress (ARDS)/diffuse alveolar damage (DAD). Using multiplex (5-plex: CD4, CD8, CD68, CD20, AE1/AE3) and SARS-CoV immunohistochemistry we characterized the immunopathology of lung tissue procured at autopsy in patients dying of SARS-CoV-2 with those dying of DAD prior to the COVID-19 pandemic. We observed a distinctive pseudopalisaded histiocytic hyperplasia interposed between the exudative and proliferative phase of COVID-19 associated DAD, which was most pronounced at the fourth week from symptom onset. Pulmonary macrothrombi were seen predominantly in cases with pseudopalisaded histiocytic hyperplasia and/or proliferative phase DAD. Neither pseudopalisaded histiocytic hyperplasia nor pulmonary macrothrombi was seen in non-COVID-19 DAD cases, whereas microthrombi were common in DAD regardless of etiology. The inflammatory pattern of pseudopalisaded histiocytic hyperplasia may represent the distinctive immunopathology associated with the dexamethasone responsive form of DAD seen in severe COVID-19 and may herald the onset of COVID-19 coagulopathy.
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Multiplex IHC as a means to aide in the assessment of minimal residual disease (MRD)
for plasma cell neoplasms.
Eric Burks (view biography)
Clinical Associate Professor of Pathology
Boston University School of Medicine

Phenotypic assessment of MRD in plasma cell neoplasms is currently performed by multiparametric flow cytometry in which aberrant expression of cytoplasmic makers such as CD56 and CD117 aide in the diagnosis. In addition, a subset of plasma cell neoplasms are characterized by a translocation involving CCND1 and thus these aberrantly express nuclear cyclin D1. After treatment for plasma cell myeloma and at diagnosis of AL-amyloidosis, neoplastic plasma cells frequently number less than 5% of nucleated bone marrow cells. The ability to multiplex aberrant markers (CD56, CD117, and cyclin D1) with normal plasma cell makers (CD138 cytoplasmic or Mum-1 nuclear) offers the ability to identify small abnormal populations which can exist in a background of normal plasma cells. A comparison of the sensitivity for dual IHC staining and optimization to match antigen intensity for matched multiparametric flow cytometry samples will be presented.
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The role of immunohistochemistry in the diagnosis of paediatric brain tumours
Hazel Chambers-Smith (view biography)
Senior Scientist
The Royal Children’s Hospital, Department of Anatomical Pathology
Parkville, VIC. Australia

Paediatric brain tumour pathology is a rapidly evolving area in Histopathology and is a distinct group from their adult counterparts. The need for integrated reporting using morphology, IHC and molecular techniques is essential for accurate diagnosis. In this talk, we will discuss several paediatric brain tumours and some uncommon antibodies that are used routinely for their diagnosis. We will also consider some technical aspects of using challenging antibodies to diagnose these tumours.
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Last update on: 2022/04/26 11:12:34 UTC/GMT time.