Virtual microscopy in prostate histopathology: simultaneous viewing of biopsies stained sequentially with hematoxylin and eosin, and alpha-methylacyl-coenzyme A racemase/p63 immunohistochemistry.
OBJECTIVE
Histopathological diagnosis of small focus carcinomas in prostatic needle biopsies is often assisted by IHC. To make a definitive diagnosis the pathologist must compare IHC findings with hematoxylin and eosin stained tissue morphology. We introduce what is to our knowledge a new application of virtual microscopy, in which hematoxylin and eosin, and IHC stains done sequentially on the same microscope slide can be simultaneously displayed and compared on a computer screen.


METHODS
A total of 30 hematoxylin and eosin stained prostatic needle biopsies were scanned with a computer controlled microscope. The slides were destained and then immunostained with a cocktail of AMACR and p63 antibodies, which labels the nuclei of nonmalignant basal cells (p63) and the cytoplasm of neoplastic glandular cells suspicious for malignancy (AMACR). The slides were then scanned again and the pairs of virtual slides were aligned for synchronized viewing.


RESULTS
The presented technique was found helpful when suspicious lesions were small and when examining the immunoprofile of specimens was warranted, in addition to examining hematoxylin and eosin stained tissue morphology. The usefulness of our approach based on virtual microscopy can be evaluated on the website , which also serves as an educational tool for self-learning the correlation between hematoxylin and eosin stained tissue morphology, and AMACR/p63 IHC in prostate biopsies.


CONCLUSIONS
The technology for simultaneously viewing sequentially hematoxylin and eosin and IHC stained prostate biopsies can be readily used for educational purposes, as exemplified by our website, and along with the availability of rapid virtual slide scanners it can also be used for clinical diagnostics.
Helin
Henrik O
HO
Institute of Medical Technology, University of Tampere, Tampere, Finland.
Lundin
Mikael E
ME
Laakso
Mervi
M
Lundin
Johan
J
Helin
Heikki J
HJ
Isola
Jorma
J
D001707:Biopsy, Needle / Q000379:methods; D004396:Coloring Agents; D004268:DNA-Binding Proteins; D004801:Eosine Yellowish-(YS); D005456:Fluorescent Dyes; D016147:Genes, Tumor Suppressor; D006416:Hematoxylin; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010750:Phosphoproteins / Q000032:analysis*; D011467:Prostate / Q000737:chemistry* / Q000473:pathology*; D019998:Racemases and Epimerases / Q000032:analysis*; D015534:Trans-Activators / Q000032:analysis*; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins
D004396:Coloring Agents; D004268:DNA-Binding Proteins; D005456:Fluorescent Dyes; D010750:Phosphoproteins; C115051:TP63 protein, human; D015534:Trans-Activators; D014157:Transcription Factors; D025521:Tumor Suppressor Proteins; D019998:Racemases and Epimerases; C108352:alpha-methylacyl-CoA racemase; D004801:Eosine Yellowish-(YS); D006416:Hematoxylin