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Article

Comparison Approach for Identifying Missed Invasive Fungal Infections in Formalin-Fixed, Paraffin-Embedded Autopsy Specimens

by
Sota Sadamoto
1,2,
Yurika Mitsui
3,
Yasuhiro Nihonyanagi
1,
Kazuki Amemiya
1,
Minoru Shinozaki
1,
Somay Yamagata Murayama
2,
Masahiro Abe
2,
Takashi Umeyama
2,
Naobumi Tochigi
1,*,
Yoshitsugu Miyazaki
2 and
Kazutoshi Shibuya
1
1
Department of Surgical Pathology, Toho University School of Medicine, Tokyo 143-8541, Japan
2
Department of Fungal Infection, National Institute of infectious Diseases, Tokyo 162-8640, Japan
3
Department of Hematology and Oncology, Toho University School of Medicine, Tokyo 143-8541, Japan
*
Author to whom correspondence should be addressed.
J. Fungi 2022, 8(4), 337; https://doi.org/10.3390/jof8040337
Submission received: 4 March 2022 / Revised: 19 March 2022 / Accepted: 23 March 2022 / Published: 24 March 2022
(This article belongs to the Special Issue Molecular Tissue Diagnosis of Fungal Infections)
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Abstract

Invasive fungal infection (IFI) has a high mortality rate in patients who undergo hematopoietic stem cell transplantation, and it is often confirmed by postmortem dissection. When IFI is initially confirmed after an autopsy, the tissue culture and frozen section are challenging to secure, and in many cases, formalin-fixed, paraffin-embedded (FFPE) samples represent the only modality for identifying fungi. Histopathological diagnosis is a useful method in combination with molecular biological methods that can achieve more precise identification with reproducibility. Meanwhile, polymerase chain reaction (PCR) using fungal-specific primers helps identify fungi from FFPE tissues. Autopsy FFPE specimens have a disadvantage regarding the quality of DNA extracted compared with that of specimens obtained via biopsy or surgery. In the case of mucormycosis diagnosed postmortem histologically, we examined currently available molecular biological methods such as PCR, immunohistochemistry (IHC), and in situ hybridization (ISH) to identify fungi. It is reasonable that PCR with some modification is valuable for identifying fungi in autopsy FFPE specimens. However, PCR does not always correctly identify fungi in autopsy FFPE tissues, and other approaches such as ISH or IHC are worth considering for clarifying the broad classification (such as the genus- or species-level classification).
Keywords: formalin-fixed paraffin-embedded (FFPE); invasive fungal infection (IFI); autopsy; polymerase chain reaction (PCR); in situ hybridization (ISH); immunohistochemistry (IHC); mucormycosis; Cunninghamella formalin-fixed paraffin-embedded (FFPE); invasive fungal infection (IFI); autopsy; polymerase chain reaction (PCR); in situ hybridization (ISH); immunohistochemistry (IHC); mucormycosis; Cunninghamella

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MDPI and ACS Style

Sadamoto, S.; Mitsui, Y.; Nihonyanagi, Y.; Amemiya, K.; Shinozaki, M.; Murayama, S.Y.; Abe, M.; Umeyama, T.; Tochigi, N.; Miyazaki, Y.; et al. Comparison Approach for Identifying Missed Invasive Fungal Infections in Formalin-Fixed, Paraffin-Embedded Autopsy Specimens. J. Fungi 2022, 8, 337. https://doi.org/10.3390/jof8040337

AMA Style

Sadamoto S, Mitsui Y, Nihonyanagi Y, Amemiya K, Shinozaki M, Murayama SY, Abe M, Umeyama T, Tochigi N, Miyazaki Y, et al. Comparison Approach for Identifying Missed Invasive Fungal Infections in Formalin-Fixed, Paraffin-Embedded Autopsy Specimens. Journal of Fungi. 2022; 8(4):337. https://doi.org/10.3390/jof8040337

Chicago/Turabian Style

Sadamoto, Sota, Yurika Mitsui, Yasuhiro Nihonyanagi, Kazuki Amemiya, Minoru Shinozaki, Somay Yamagata Murayama, Masahiro Abe, Takashi Umeyama, Naobumi Tochigi, Yoshitsugu Miyazaki, and et al. 2022. "Comparison Approach for Identifying Missed Invasive Fungal Infections in Formalin-Fixed, Paraffin-Embedded Autopsy Specimens" Journal of Fungi 8, no. 4: 337. https://doi.org/10.3390/jof8040337

APA Style

Sadamoto, S., Mitsui, Y., Nihonyanagi, Y., Amemiya, K., Shinozaki, M., Murayama, S. Y., Abe, M., Umeyama, T., Tochigi, N., Miyazaki, Y., & Shibuya, K. (2022). Comparison Approach for Identifying Missed Invasive Fungal Infections in Formalin-Fixed, Paraffin-Embedded Autopsy Specimens. Journal of Fungi, 8(4), 337. https://doi.org/10.3390/jof8040337

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