title: Microphthalmia transcription factor immunohistochemistry for FNA biopsy of ocular malignant melanoma.
abstract: BACKGROUND
  Microphthalmia transcription factor (MiTF) is a sensitive and specific immunohistochemistry (IHC) marker for malignant melanoma (MM) in surgical resections, but its utility in cytology specimens has not been extensively studied.
  
  
  METHODS
  A search of the pathology database identified fine-needle aspiration biopsies signed out as MM or suspicious for MM (1998-2012). The final diagnosis and the IHC results were recorded, and all slides were re-reviewed. MiTF IHC (C5/D5 cocktail) was performed on alcohol-fixed, Papanicolaou-stained direct smears. Any amount of nuclear staining was considered positive. Staining was scored on a scale of 1 to 4 (1, 1%-24%; 2, 25%-49%; 3, 50%-74%; 4, 75%-100%).
  
  
  RESULTS
  Two hundred seventy-four cases were diagnosed as MM, and 24 were diagnosed as suspicious for MM. IHC staining was performed for 25% (69 of 274) of the MM cases and for 33% (8 of 24) of the cases suspicious for MM. MiTF IHC of Papanicolaou slides was performed for 37% (101 of 274) of the MM cases (positive, 82% [83 of 101]; negative, 4% [4 of 101]; noncontributory, 14% [14 of 101]) and for 33% (8 of 24) of the cases suspicious for MM (positive, 38% [3 of 8]; noncontributory, 62% [5 of 8]). The majority of positive staining was scored as 3 or 4. The sensitivity of MiTF on Papanicolaou-stained slides was 95%.
  
  
  CONCLUSIONS
  MiTF is a useful IHC stain for the evaluation of ocular MM, and it is effective when it is performed on alcohol-fixed, Papanicolaou-stained aspirate smears.
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri.
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Perrino
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri.
authors.forename: Jeff F
authors.initials: JF
authors.lastname: Wang
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri.
authors.forename: Brian T
authors.initials: BT
authors.lastname: Collins
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D044963:Biopsy, Fine-Needle / Q000379:methods; D003581:Cytodiagnosis / Q000379:methods; D016208:Databases, Factual; D005134:Eye Neoplasms / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000473:pathology*; D051739:Microphthalmia-Associated Transcription Factor / Q000235:genetics / Q000378:metabolism*; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017678:Sex Distribution
chemical_list: D014408:Biomarkers, Tumor; D051739:Microphthalmia-Associated Transcription Factor
keywords: immunohistochemistry (IHC); malignant melanoma; microphthalmia transcription factor (MiTF); ocular