Diagnostic Cytopathology最新文献

{"title":"Cytology Triage for HPV-Positive Postmenopausal Women in a Setting of Cervical Cancer Screening","authors":"Aparna Chacko,&nbsp;Vishaka C. Bidkar,&nbsp;Geeta Acharya,&nbsp;Julian Crasta","doi":"10.1002/dc.25456","DOIUrl":"10.1002/dc.25456","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Globally, cervical cytology continues to serve as the cornerstone of cervical cancer screening programs, but WHO 2021 guidelines advocate HPV DNA testing as the primary screening modality due to its heightened sensitivity. This method necessitates additional triage with cytology or colposcopy to detect precancerous lesions. Hormonal shifts and anatomical alterations in postmenopausal women may impact diagnostic outcomes in either modality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the spectrum of cytological lesions in HPV-positive postmenopausal women to detect precancerous lesions as part of cervical cancer screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Conventional cytology smears of high-risk HPV-positive postmenopausal women were reported according to The Bethesda System 2014. Results of follow-up biopsies of the positive smears were recorded, and cyto-histological correlation was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The retrospective study included conventional cytology smears of 124 postmenopausal women positive for high-risk HPV DNA with a mean age of 52 years. Of the 124 cases, 68 were positive for HPV 16 and/or 18, and 56 were positive for other high-risk HPV. On cytology, 78% were negative for intraepithelial lesions. HSIL+ lesions were noted in 12%, and low-grade lesions were noted in 10% of smears with HPV16/18 predominance. Follow-up biopsies of 17 smears revealed SCC in two cases, HSIL+ in 11 cases, LSIL in 2, and 2 were negative/benign lesions. Of the cyto-histological discordant cases, four were upgraded on review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Cytology is a useful triage tool in detecting preinvasive and early invasive tumors in HPV DNA-positive postmenopausal women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"246-250"},"PeriodicalIF":1.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515061","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":"DNA Flow Cytometry Analysis in Body Cavity Fluids Using Liquid-Based Cytology","authors":"Ayumi Ryu,&nbsp;Keiichiro Honma,&nbsp;Sayoko Tsuzaki,&nbsp;Risa Yoshioka,&nbsp;Satoshi Tanada,&nbsp;Takashi Yamamoto,&nbsp;Hidetoshi Satomi,&nbsp;Shigenori Nagata,&nbsp;Tomoyuki Yamasaki,&nbsp;Masayuki Ohue","doi":"10.1002/dc.25451","DOIUrl":"10.1002/dc.25451","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>DNA flow cytometry using LC-1000 is utilized for analyzing cellular and nuclear lengths and DNA content in individual cells with samples in cell preservation solutions to acquire the cell proliferation index (CPIx). This study aimed to evaluate the performance of body cavity fluid cytology using LC-1000. As cell preservation solutions, liquid-based cytology (LBC) by Cellprep (CP) was compared with CelVerse (CeV), specifically designed for the LC-1000.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall, we evaluated 43 samples (20 malignant and 23 benign) of body cavity fluids suspended in CeV and 59 samples (28 malignant and 31 benign) suspended in CP. The CPIx was compared between malignant and benign cases of CeV and CP. Further, the subject groups were divided according to the SubG1% in a sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CPIx in CeV was 0.14–10.22 (median 0.62) in malignant cases and 0.09–4.64 (median 0.19) in benign cases (<i>p</i> &lt; 0.001); additionally, CP displayed 0.14–9.87 (median 0.84) in malignant cases and 0.11–3.02 (median 0.22) in benign cases (<i>p</i> &lt; 0.001). The area under the curve (AUC) was 0.811 for CeV and 0.776 for CP. The difference in SubG1% between the CeV and CP groups was statistically significant (<i>p</i> &lt; 0.0001) and influenced the AUC in CP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CPIx in CeV or CP samples using the LC-1000 may be applicable as an objective indicator in body cavity fluid cytology. Samples preserved in CeV provided more consistent results, unaffected by SubG1%, when compared to those stored in CP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"227-237"},"PeriodicalIF":1.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499747","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":"Utility of Proliferation Markers Ki-67 and PHH3 in Predicting Malignancy in Basaloid Salivary Gland Neoplasms: A Study Using Digital Image Analysis of Cytology Cell Blocks","authors":"Yanki Yarman,&nbsp;Robert Post,&nbsp;Zachary Breslin,&nbsp;Charalambos C. Solomides,&nbsp;Stacey M. Gargano","doi":"10.1002/dc.25453","DOIUrl":"10.1002/dc.25453","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Basaloid salivary gland neoplasms (BSNs) are notoriously difficult to classify in fine needle aspiration (FNA) specimens due to the morphologic overlap of benign and malignant entities. Adenoid cystic carcinoma (AdCC) represents a particular diagnostic challenge, as it typically shows low-grade cytologic features despite its aggressive clinical behavior. We examined whether the proliferation markers Ki-67 and PHH3 could help predict malignancy in BSNs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective search was conducted to identify FNA cases of BSNs that had adequate tumor cellularity in the cell block and a subsequent excision specimen. Ki-67 and PHH3 immunohistochemical stains were performed. Aperio (Leica Biosystems) was used to calculate the percentage of tumor cell nuclear expression. Proliferation scores and final histopathologic diagnoses were correlated using a two-sided <i>p</i>-value test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten benign and 14 malignant basaloid neoplasms were analyzed. Benign cases showed low mean percentages of tumor cell staining for Ki-67 (1.14%) and PHH3 (0.84%), while malignant cases showed significantly higher mean percentages, especially with Ki-67 (19% for low-grade malignancies and 25.5% for high-grade malignancies). The difference in proliferation marker scores between the benign and low-grade malignant cases showed statistical significance for both Ki-67 (<i>p</i> = 0.0041) and PHH3 (<i>p</i> = 0.00397). The difference between benign entities and AdCC was also statistically significant for Ki-67 (<i>p</i> = 0.0013) and PHH3 (<i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Ki-67 and PHH3 analysis in cell block material may help predict malignancy in a cytologic specimen from a BSN, offering a valuable ancillary tool for cases with cytomorphologic ambiguity. In particular, the ability to suggest a sample is more likely to be AdCC rather than another morphologically similar low-grade BSN would be helpful for surgical planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"238-245"},"PeriodicalIF":1.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dc.25453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Cytomorphologic Features of Cervical Adenosquamous Carcinoma","authors":"Yee Sing Lin,&nbsp;Penny Athanasatos","doi":"10.1002/dc.25452","DOIUrl":"10.1002/dc.25452","url":null,"abstract":"<div>\u0000 \u0000 <p>Prior studies suggest that adenosquamous histology confers a poorer prognosis when compared with other histologic subtypes of carcinoma in the cervix. However, there is limited literature describing the cytologic features of this entity. Herein we report on a series of adenosquamous carcinomas of the uterine cervix diagnosed within our institution to evaluate the range of cytomorphologic features and integrate clinical and genotypic data.</p>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"256-261"},"PeriodicalIF":1.0,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482504","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":"Cytologic Diagnosis of Squamous Cell Carcinoma Arising From a Recurrent Cerebellopontine Angle Epidermoid Cyst in a 61-Year-Old Male","authors":"Hanan S. Elsarraj,&nbsp;Keenan Hogan","doi":"10.1002/dc.25450","DOIUrl":"10.1002/dc.25450","url":null,"abstract":"<div>\u0000 \u0000 <p>Here, we report an exceptionally rare event of malignant transformation of an intracranial epidermoid cyst into squamous cell carcinoma (SCC), diagnosed through cerebrospinal fluid cytology. A 61-year-old male with a prior history of left retrosigmoid craniotomy and partial resection of a large cerebellopontine angle epidermoid tumor 13 years ago presented with acute mental status changes and weakness. Imaging revealed recurrent epidermoid cyst elements with associated obstructive hydrocephalus. The patient underwent ventriculoperitoneal shunt placement, and cerebrospinal fluid cytology revealed clusters of atypical epithelial cells. Further cytopathological and immunohistochemical (IHC) evaluation confirmed a diagnosis of SCC. Despite the initiation of chemotherapy and immunotherapy, the patient's condition deteriorated, and he passed away 2 months later. This case highlights the need for vigilance in monitoring patients with epidermoid cysts and that early detection through CSF cytology with confirmatory IHC provides a minimally invasive diagnostic pathway to guide rapid clinical decision-making.</p>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"E87-E91"},"PeriodicalIF":1.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467292","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":"Cytologic Histotyping of Gynecologic Malignancies in Peritoneal Fluids Is Reliable When Compared to Its Corresponding Surgical Specimen","authors":"Thomas Sabljic,&nbsp;Si Kei (Sandy) Lou","doi":"10.1002/dc.25449","DOIUrl":"10.1002/dc.25449","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cytologic examination of peritoneal fluid (PTFL) often represents the first and only pathologic specimen available to guide management of gynecologic malignancies (GMs). This study examines the cytohistologic correlation between histotyping of GM in PTFL and its corresponding surgical specimen (SS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study retrospectively identified positive PTFL with a GM between 2017 and 2022. Cytologic specimens (CSs) that were obtained after or concurrently with its diagnostic SS (biopsy/resection) were excluded. Root cause analysis of discordant cases was performed by reviewing morphology, specimen characteristics, and immunophenotype of CS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GM affected 55.8% (502/899) of malignant PTFL, of which 15.7% (79)/22.3% (112) was the only/initial diagnostic sample, respectively. Compared to SS, when a subtype was rendered on CS (91.9%), the concordance rate is 91.2% (almost perfect agreement, <i>K</i> = 0.842). Factors contributing to incorrect/inadequate subtyping include specimen limitations (low volume and/or cellularity), cytopathologist preference, and insufficient immunophenotyping. In seven patients (1.4%), the CS was able to render a more definitive diagnosis than its preceding nondiagnostic SS due to the paucity of lesional cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>When compared to SS, histotyping of GM in PTFL is reliable and, at times, can be more definitive than its surgical counterpart. In some cases, subtyping is limited by extrinsic factors (i.e., specimen limitations). In other cases, the responsible cytopathologist prefers not to subtype despite supportive morphologic and immunohistochemical features. This highlights an opportunity for improvement in the diagnosis/subtyping of GM in PTFL, which may be the initial or only diagnostic specimen prior to patient treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"215-226"},"PeriodicalIF":1.0,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dc.25449","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytopathology Practice—Global Perspectives","authors":"Swikrity U. Baskota,&nbsp;Zubair Baloch","doi":"10.1002/dc.25448","DOIUrl":"10.1002/dc.25448","url":null,"abstract":"","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 4","pages":"149"},"PeriodicalIF":1.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373913","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":"Intranuclear Cytoplasmic Pseudoinclusions in a Pleomorphic Adenoma: A Letter to the Editor","authors":"Ferial Alloush,&nbsp;Vielka Fernandez,&nbsp;Robert Poppiti,&nbsp;Monica Recine,&nbsp;Sarah Alghamdi","doi":"10.1002/dc.25447","DOIUrl":"10.1002/dc.25447","url":null,"abstract":"","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 4","pages":"191-193"},"PeriodicalIF":1.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078913","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 Hobnail Papillary Thyroid Carcinoma Initially Diagnosed by Pleural Effusion: Case Report of a Rare and Intriguing Entity","authors":"Julia Hawes,&nbsp;Taylor Strange,&nbsp;Fatima Iqbal,&nbsp;Cecilia G. Clement","doi":"10.1002/dc.25445","DOIUrl":"10.1002/dc.25445","url":null,"abstract":"<div>\u0000 \u0000 <p>Hobnail papillary thyroid carcinoma (HNPTC) is an unusual and aggressive variant of PTC. Malignant pleural effusion secondary to thyroid carcinoma is a rare event reported in less than 1% of cases. Herein we present a case of metastatic HNPTC initially diagnosed by pleural effusion cytology, with a very poor outcome. A 42-year-old male with no previous cancer history, presented with an anterior neck mass growing for the past year. A computed tomography (CT) scan revealed a large complex cystic lesion with mass effect on the anterior thyroid gland, along with multiple neck and mediastinal necrotic lymph nodes, suspicion for metastasis. CT of the thorax showed lung nodules and a large left pleural effusion. Fluid was drained and sent for cytologic examination which revealed malignant cells predominantly in a micropapillary pattern with apically placed, bulged, “hobnail-like” appearance; intranuclear pseudo-inclusions or chromatin clearing was not seen. Based on cytomorphologic findings and immunohistochemical results (CK7 and PAX-8 positive; TTF-1, Napsin-A, and mesothelial markers negative), final diagnosis of HNPTC metastatic to pleural fluid was made. Fine-needle aspiration of neck mass showed similar cytomorphologic findings, confirming a thyroid origin. However, the patient experienced complications, rapid deterioration and died 6 months after diagnosis. The intersection of clinical-radiologic findings, cytology, and immunohistochemistry guided the identification of this rare variant of PTC as the origin of the malignant pleural effusion. We believe this case provides a valuable insight into the complexities involved in the diagnosis of thyroid carcinoma and emphasizes the significance of proper identification of rare variants.</p>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"E80-E86"},"PeriodicalIF":1.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064489","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":"Comprehensive Approach to Cytomorphology in Liquid-Based Bile Duct Brush Cytology: Integrating Cell Blocks and Histology","authors":"Wookjin Oh,&nbsp;Jaeyong Min,&nbsp;Baek-hui Kim","doi":"10.1002/dc.25443","DOIUrl":"10.1002/dc.25443","url":null,"abstract":"<div>\u0000 \u0000 <p>Bile duct brush cytology is a widely used and essential method for evaluating biliary tract lesions, although it remains challenging for pathologists. Liquid-based preparations provide a better vision of morphology and enable the preparation of cell blocks, thereby enhancing reliability. However, the establishment of reproducible interpretation criteria and utilization of cell blocks remain limited. This study aimed to investigate the morphological features of liquid-based cytology using objective and reproducible criteria, incorporating histological findings to identify diagnostic features. In total, 151 cases were selected and 42 morphologic criteria were evaluated within representative clusters. Notably, 14 features, including conventional cytologic features, significantly differed between the benign and malignant groups. Malignant cell clusters were more likely to be irregularly shaped and have larger nuclear sizes, increased nuclear pleomorphism, a non-euchromatic chromatin pattern, and a higher nucleus-to-cytoplasm (N/C) ratio. Multinucleation and nuclear molding were observed exclusively in malignant cases. The presence of inflammatory cells did not differ significantly between benign and malignant cases. An increased N/C ratio was observed in the cell blocks and the architectural information aided in diagnosis. The application of cell blocks may be beneficial, emphasizing the significance of nuclear pleomorphism. We also categorized features by analyzing the sensitivity, specificity, and importance of various features. In summary, our study reaffirms the importance of conventional cytomorphologic features in liquid-based preparations of bile duct cytology and suggests a diagnostic approach with more objective morphologic criteria, highlighting the utility of cell blocks.</p>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"204-214"},"PeriodicalIF":1.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064484","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}