Diagnostic Cytopathology最新文献

{"title":"Extramedullary Hematopoiesis in Serous Cavity Fluids: A Closer Look at This Rare Phenomenon With Diagnostic Pitfalls and Prognostic Significance.","authors":"F N U Sakshi, Vinay Sakaleshpura Mallikarjuna, John M Stewart, Qiong Gan","doi":"10.1002/dc.25431","DOIUrl":"https://doi.org/10.1002/dc.25431","url":null,"abstract":"<p><strong>Background: </strong>Extramedullary hematopoiesis (EMH) is usually seen in the reticuloendothelial system such as the spleen and liver; however, there have been rare case reports when EMH is seen in serous fluids (SFs). The aim of this study included analyzing the cytomorphological features of EMH in SFs in correlation with various clinicopathologic parameters and recognizing potential diagnostic pitfalls as well as their prognostic significance.</p><p><strong>Methods: </strong>Clinicopathologic parameters and radiologic and pathologic information from the patients with a cytologic diagnosis of EMH were evaluated with cytology slides.</p><p><strong>Results: </strong>The cytomorphologic features of EMH and diagnostic pitfalls were evaluated. Seven patients with cytologically determined EMH in SF samples, including five pleural fluids, one ascitic fluid, and one cerebrospinal fluid, were identified over the past 20 years at a comprehensive cancer center. Their mean age was 67.5 years. Most patients (n = 5) had a history of advanced myelofibrosis.</p><p><strong>Conclusions: </strong>This study uncovered methods to differentiate EMH from peripheral blood (PB) contamination in samples in the SF. PB contamination is an important differential for EMH, and cytomorphology remains a salient parameter for the diagnosis. The comparison of the number of red blood cells and white blood cells in the PB and SF helped to distinguish EMH from PB contamination when megakaryocytes were absent. The study showed that most patients died within a year of their EMH diagnosis in SF, suggesting a strong prognostic association of this finding with poor survival outcomes.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Malignant Granular Cell Tumor in the Lymph Node: A Cytological Report With Immunocytochemical Analysis.","authors":"Hiroyuki Okanishi, Mitsuaki Ishida, Naoto Kohno, Hiroko Nakayama, Kozue Ariga, Shizuka Ono, Chihiro Deguchi, Reika Takeda, Yoshitaka Kurisu, Yoshinobu Hirose","doi":"10.1002/dc.25433","DOIUrl":"https://doi.org/10.1002/dc.25433","url":null,"abstract":"<p><p>Granular cell tumors (GCTs) are relatively rare, whereas malignant GCTs are extremely rare. This brief report describes a cytological case of metastatic malignant GCT in the lymph node with immunocytochemical analysis. A 77 years old Japanese female with a history of surgical resection for malignant GCT in the back 8 years earlier presented with swelling of the right neck. Intraoperative touch smear of the biopsy specimen of the neck lymph node showed the presence of clusters of polygonal neoplastic cells as well as single neoplastic cells containing rich granular cytoplasm and eccentrically located large round to oval nuclei in a background of granular material. Immunocytochemical analysis demonstrated that these neoplastic cells showed positivity for S-100 protein and SOX10, and negativity for Melan-A and HMB45. According to these findings, a cytodiagnosis of metastatic malignant GCT was made with consideration of her history. Histopathological analysis confirmed a metastatic malignant GCT. The present study indicates that immunocytochemical staining for S-100 protein and SOX10 combined with cytomorphological features might be useful for the cytodiagnosis of malignant GCT.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Cystic Endosalpingiosis in Cervical Lymph Nodes Mimicking Metastatic Papillary Thyroid Carcinoma Morphologically on Cytology: A Case Report and Literature Review of Diagnostic Challenges.","authors":"Elizabeth Davaro, Prih Rohra, Uma Kundu, Qiong Gan","doi":"10.1002/dc.25430","DOIUrl":"https://doi.org/10.1002/dc.25430","url":null,"abstract":"<p><p>The presence of cystic lymph nodes in the neck can present a challenging differential diagnosis, with considerations often including metastatic papillary thyroid carcinoma (PTC), cystic squamous cell carcinoma, and congenital cysts. The cytologic overlap between benign Müllerian inclusions and PTC features adds complexity, especially in unusual locations. A 45-year-old woman with a history of ovarian serous borderline tumor (SBT) and non-invasive Müllerian implants presented with cystic lymphadenopathy in the neck. Imaging revealed multiple suspicious, partially cystic lymph nodes. Fine-needle aspirations (FNA) from two nodes showed moderate cellularity, monolayered epithelial sheets, and nuclear features suggestive of PTC. FNA cytology, thyroglobulin level, and immunocytochemical profile revealed benign Müllerian cells within lymph nodes. Subsequent histologic evaluation of the excised lymph nodes confirmed cystic endosalpingiosis. This case emphasizes the value of comprehensive clinical-pathologic correlation and appropriate ancillary studies in the evaluation of cystic lymphadenopathy. Awareness of benign Müllerian inclusions and their mimicry of metastatic disease is essential for accurate diagnosis and optimal patient management.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric Cytology: A Supplement to Early Diagnosis of Gastric Malignancies.","authors":"Chaithra Gowthuvalli Venkataramana, K M Sinchana, Bhagat Singh Lali, Sharada Rai, Jyoti R Kini, Akhil Kocherlakota, Sriram Sujay Prasad, Saraswathi Ram Mohan","doi":"10.1002/dc.25432","DOIUrl":"https://doi.org/10.1002/dc.25432","url":null,"abstract":"<p><strong>Introduction: </strong>Gastric malignancies are one of the leading causes of morbidity and mortality globally. Rapid accurate interpretation of gastric cytology aids in early diagnosis and management. This study evaluates the utility of gastric cytology in diagnosing gastric malignancies.</p><p><strong>Methods: </strong>This retrospective, cross-sectional study was conducted in the Department of Pathology for a period of 3.5 years. The cases with clinical suspicion of gastric malignancy and those who have had both cytology and histopathology examinations were included. Cytology results were reported as positive for malignancy, suspicious for malignancy, atypical cells-favor reactive, and negative for malignancy. The cytology and histopathology results were correlated, and descriptive statistics were used to analyze data.</p><p><strong>Results: </strong>Among 118 patients included in the study, 103 cases were malignant and 15 were nonmalignant. Out of 103 malignant cases, 89 cases were detected in cytology. False positive cases consisted of four gastritis cases with florid reactive atypia and one with moderate dysplasia. False negative cases were of diffuse and intestinal subtypes of adenocarcinoma, followed by non-Hodgkin lymphoma. Sensitivity and specificity were found to be 86.41% and 66.67%, respectively. The positive predictive value is 94.68% with 41.67% negative predictive value and a diagnostic accuracy of 83.90%.</p><p><strong>Conclusion: </strong>Gastric cytology is a reliable screening and diagnostic tool with a high positive predictive value and acceptable sensitivity. Negative cytology in suspected cases of gastric malignancy should always be correlated with biopsy reports. Diffuse type, intestinal type gastric adenocarcinoma and non-Hodgkin lymphoma were the major pitfall on cytology. The cells in the background must be meticulously observed for the malignant features. Gastric cytology is cost-effective and yields rapid diagnosis with a high positive predictive value, sensitivity, and diagnostic accuracy.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poor Performance of Applicator Tampon-Based Self-Collection for Liquid-Based Cytology Among Women Attending a Tertiary Hospital in South Africa.","authors":"Teboho Amelia Tiiti, Varsetile Varster Nkwinika, Tebogo Loraine Mashishi, Kgotlaethata Aaron Molefi, Thembeni Lucia Msibi, Moshawa Khaba, Johannes Bogers, Ramokone Lisbeth Lebelo","doi":"10.1002/dc.25429","DOIUrl":"https://doi.org/10.1002/dc.25429","url":null,"abstract":"<p><strong>Background: </strong>The South African Cervical Cancer Prevention and Control Policy was updated in June 2017, recommending liquid-based cytology (LBC) as the preferred screening method and the investigation of self-sampling for cervical cancer screening.</p><p><strong>Aim: </strong>To compare the performance of the Self Collection Cervical Health Screening Kit [SelfCerv (applicator tampon)] to the Cervex-Brush Combi for cytology screening. The study further aimed to compare high-risk (hr-) human papillomavirus (HPV) and LBC test results from both methods.</p><p><strong>Methods: </strong>The study included 446 paired samples, comprising self-collected (SelfCerv) and healthcare provider-collected (Cervex-Brush Combi) samples from women aged ≥ 18 years attending gynaecology outpatient clinics at a tertiary hospital in Pretoria, South Africa. LBC slides were prepared using the ThinPrep 5000 processor and manually stained with Hematoxylin and Eosin (H&E). Detection of 14 hr-HPV types was performed using the Abbott RealTime HR-HPV assay. Statistical analyses were performed using STATA version 17.0 (Stata Corp., College Station, Texas, USA).</p><p><strong>Results: </strong>A statistically significant difference in cervical cytology detection between the two methods was observed (p = 0.0025). The Cervex-Brush Combi was more effective in collecting endocervical cells (73.4%; 95% CI: 69.0-77.9) compared to the SelfCerv applicator tampon (7.3%; 95% CI: 4.7-9.9); (p < 0.001). Cytological abnormalities were detected in 65.4% (136/208) of participants who tested positive for hr-HPV by healthcare provider sampling compared to 40.8% (84/206) by self-sampling. A fair agreement (κ: 0.35) with a concordance rate of 96.2% (95% CI: 94.4-98.0) was observed for specimen adequacy and diagnosis parameters [κ: 0.34, with a concordance rate of 67.7% (95% CI: 63.2-72.1)] between the two methods.</p><p><strong>Conclusion: </strong>The findings of this study do not support the implementation of applicator tampon-based self-collection as a method for cytology-based cervical cancer screening.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Human Papillomavirus-DNA Test on Salivary Gland Fine Needle Aspiration Cytology Samples Confirms the Absence of the Virus in Primary Neoplasms and Demonstrates for the First Time Its Presence in Salivary Intraglandular Cysts.","authors":"Immacolata Cozzolino, Andrea Ronchi, Marco Montella, Raffaella Ruggiero, Rosaria Cappiello, Giovanni Savarese, Giuseppe Colella, Renato Franco","doi":"10.1002/dc.25425","DOIUrl":"https://doi.org/10.1002/dc.25425","url":null,"abstract":"<p><strong>Background: </strong>The correlation between Human Papillomavirus (HPV) and salivary gland neoplasms is still controversial. Data in the literature are conflicting, reporting the presence of the HPV-DNA in a significant percentage of cases or none. We investigated the presence of HPV in a series of salivary gland neoplasms using fine needle aspiration cytology (FNAC) samples to explore its potential oncogenic role in salivary gland tumor development.</p><p><strong>Methods: </strong>The study included 66 salivary gland lesions from 65 patients. For all cases, residual cytological material in the needle hub, once direct smears were obtained, was fixed by rinsing the needle in Cytolyt hemolytic and preservative solution (Hologic Inc. Marlborough, MA 01752 USA). The samples fixed in the Cytolyt hemolytic and preservative solution (Hologic Inc. Marlborough, MA 01752 USA) were centrifuged at 252 g, then the sediment was transferred to the Preservcyt solution and used for the detection of HPV-DNA.</p><p><strong>Results: </strong>We found evidence of the presence of HPV in two salivary intraglandular cysts lined by squamous cell epithelium. Furthermore, we also found HPV in three metastatic oropharyngeal squamous cell carcinomas (SCC) located in the parotid gland. Regarding primary salivary gland tumors, the HPV test produced negative results in all cases.</p><p><strong>Conclusion: </strong>HPV testing produced negative results in all primary salivary gland tumors, failing to confirm the potential involvement of HPV infection in the pathogenesis of salivary gland tumors. Instead, the presence of HPV DNA in samples of salivary intraglandular cysts, never reported before, may be an interesting fact, which however requires further evaluation.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRPS1 Immunohistochemistry in Salivary Gland Neoplasms: Analysis on Cytology Cell Blocks and Surgical Follow-Up Correlation.","authors":"Saroja Devi Geetha, Amr Ali, Silvat Sheikh-Fayyaz, Cecilia Gimenez, Karen Chau, Kasturi Das, Oana C Rosca","doi":"10.1002/dc.25428","DOIUrl":"https://doi.org/10.1002/dc.25428","url":null,"abstract":"<p><strong>Introduction: </strong>In this study we aim to analyze the TRPS1 immunostaining of salivary gland tumors (SGT) on cytology cell blocks and compare the staining pattern on subsequent surgical resections.</p><p><strong>Methods: </strong>Malignant SGTs, oncocytomas and basal cell adenomas diagnosed on fine needle aspiration were retrieved from 2019 to 2021 database. Cases with surgical follow-up were selected. TRPS1 staining was performed on cytology cell blocks and surgical specimens. Scoring was interpreted by two pathologists independently.</p><p><strong>Results: </strong>Our cohort comprised of 58 cases: 45 malignant and 13 benign. TRPS1 scoring was interpreted for 44 cytology and 51 surgical cases. 14 cytology cases lacked tumor cells on deeper levels. For 7 cases, surgical blocks were not retrievable. TRPS1 positivity for cytology and surgical cases were 52% and 47% respectively. In the malignant cohort, TRPS1 was positive in 21/32 (66%) cytology cases and 21/43 (56%) surgical cases. All cases of basal cell adenocarcinoma, carcinoma ex pleomorphic adenoma and salivary duct carcinoma were TRPS1 positive on cytology. All cases of adenoid cystic carcinoma and acinic cell carcinoma were TRPS1 positive on surgical resections. In the benign cohort, TRPS1 was positive in 2/12 (17%) cytology cases; however, none of the surgically resected benign cases showed reactivity (0/8). Cytology-surgical correlation of TRPS1 staining was done in 37 cases. We found 21 concordant and 16 discordant cases. Discordance was highest in mucoepidermoid carcinoma.</p><p><strong>Conclusion: </strong>TRPS1 is not an entirely specific marker for breast carcinoma. TRPS1 positivity was noted in a substantial number of salivary gland malignant neoplasms. Cases demonstrating discordance in TRPS1 staining pattern on cytology-surgical correlation warrant further exploration.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fine Needle Aspiration Cytological Diagnosis of Primary Breast Large-Cell Neuroendocrine Carcinoma/Squamous Cell Carcinoma.","authors":"Wenjing Cui, Changwei Yang, Xiaochen Ding, Jiayan Liu, Hongjuan Zhang, Hong Xu","doi":"10.1002/dc.25427","DOIUrl":"https://doi.org/10.1002/dc.25427","url":null,"abstract":"<p><p>Primary breast large-cell neuroendocrine carcinoma (LCNEC)/squamous cell carcinoma (SCC), also referred to as mixed neuroendocrine/non-neuroendocrine neoplasms of the breast (Br-MiNENs), represents an exceedingly rare malignancy. We report the first case of primary breast LCNEC/SCC diagnosed via ultrasound-guided fine-needle aspiration (FNA) biopsy of the left supraclavicular and left internal mammary lymph nodes. The patient, a 40-year-old female, underwent a lumpectomy followed by breast-conserving surgery and was diagnosed with primary breast LCNEC. Notably, within merely four months following the breast-conserving surgery, PET-CT revealed lymph node enlargement, prompting the performance of FNA. FNA cytology of metastatic lymph nodes revealed two distinct tumor components, allowing for clear differentiation between LCNEC and SCC in the smear. The diagnosis was further corroborated by immunocytochemical (ICC) staining of the cell blocks. Subsequently, histopathological re-examination of the breast mass revealed occult SCC components comprising less than 1% of the tumor cells. Additionally, the case exhibited triple-negative breast cancer, with PIK3CA, TP53, RB1, and BCL2L11 mutations identified through next-generation sequencing (NGS). Br-MiNEN is exceedingly rare, and its cytological diagnosis poses significant challenges. It is recommended that a detailed and objective description of each tumor component and its proportion be provided. This report provides the first detailed description of the FNA cytology of LCNEC/SCC, thereby enhancing cytopathologists' comprehension of this tumor. Auxiliary studies, including ICC staining and molecular biology assays, are crucial for accurate diagnosis, therapy, and prognosis.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Diagnostic Precision and Clinical Outcomes With FNAC in Parotid Gland Masses.","authors":"Fatih Mutlu, Busra Yaprak Bayrak, Murat Ozturk","doi":"10.1002/dc.25426","DOIUrl":"https://doi.org/10.1002/dc.25426","url":null,"abstract":"<p><strong>Background: </strong>Parotid gland masses encompassing both neoplastic and non-neoplastic conditions present diagnostic challenges. Fine-needle aspiration cytology (FNAC) is commonly used to differentiate between benign and malignant lesions but has limitations such as variable sensitivity and potential sampling errors. This study assesses FNAC's accuracy for parotid gland lesions, evaluates the Milan Salivary Gland Cytopathology Reporting System (MSRSGC), and compares FNAC results with histopathological findings.</p><p><strong>Methods: </strong>This retrospective study at our medical center analyzed data from 2321 patients who underwent parotid gland FNAC followed by surgical resection over 20 years. Patients were included if they had both cytological analysis and surgery between January 2004 and July 2024. Surgical procedures varied based on mass characteristics and FNAC results, and all samples were assessed using MSRSGC. Statistical analysis compared FNAC results with histopathology findings, calculating sensitivity, specificity, and accuracy.</p><p><strong>Results: </strong>This study included 352 patients who underwent both FNAC and surgical resection. FNAC had an overall accuracy of 93.9%, with a sensitivity of 78.3% and specificity of 91.5%. The risk of malignancy was 30% for Milan Category I (nondiagnostic), 6.3% for Category II (non-neoplastic), 0% for Category III (Atypia of Undetermined Significance), 2.3% for Category IVa (benign neoplasm), 5.8% for Category IVb (neoplasm of uncertain malignant potential), 58.8% for Category V (suspicious for malignancy), and 95% for Category VI (malignant). The false negative rate was 2.4%, while the false positive rate was 3.4%. The malignancy risk increased with age, and malignant masses were larger and more likely to cause facial paralysis.</p><p><strong>Conclusion: </strong>FNAC is a key diagnostic tool for parotid gland masses, offering high specificity and accuracy despite some limitations. Patients with young ages and inappropriate histories should be assessed more carefully. MSRSGC is a useful system to show appropriate risk of malignancy.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the Lymphocyte Profile in Mediastinal Lymph Nodes in the Differential Diagnosis of Sarcoidosis and Tuberculous Lymphadenitis Patients Undergoing EBUS-TBNA.","authors":"Song Mi, Na Cui, Jing Wang, Liming Zhang, Kewu Huang","doi":"10.1002/dc.25418","DOIUrl":"https://doi.org/10.1002/dc.25418","url":null,"abstract":"<p><strong>Background: </strong>The value of lymphocyte profiling (LP) in mediastinal lymph nodes for the differential diagnosis of sarcoidosis has not been extensively studied, and existing literature presents mixed results.</p><p><strong>Methods: </strong>This was a prospective study of patients with intrathoracic lymphadenopathy who underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). LP in lymph node puncture fluid (LNPF) was evaluated using flow cytometry. The results of LP in sarcoidosis patients were compared with tuberculous lymphadenitis (TBLA) patients. Receiver operating characteristic (ROC) analysis was performed to determine the optimal cut-offs of the statistically significant parameters for screening for sarcoidosis. Based on the optimal cut-offs and the final diagnosis of sarcoidosis and TBLA, the sensitivity, specificity, and accuracy of every statistically significant parameter and different combinations of the above three parameters were calculated for the diagnosis of sarcoidosis.</p><p><strong>Results: </strong>Forty-five cases of sarcoidosis and 33 cases of TBLA were enrolled in this study. Compared with the LP in TBLA patients, in sarcoidosis patients, the proportion of CD4 T cells and CD4/CD8 ratio increased, and the proportion of CD8 T cells and natural killer (NK) cells decreased. Among all single parameters, the CD4/CD8 ratio had high diagnostic sensitivity (84.4%), specificity (81.8%), and accuracy (83.3%) for sarcoidosis. Among all the combinations of three parameters, the combination of CD4, CD8, and NKT/NK ratio had high diagnostic sensitivity (91.1%), specificity (84.8%), and accuracy (87.2%) for sarcoidosis.</p><p><strong>Conclusions: </strong>Assessment of LP in LNPF may improve the differential diagnostic accuracy of sarcoidosis from TBLA and further strengthen the importance of LP in LNPF in the diagnostic workup of sarcoidosis.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}