Diagnostic Cytopathology最新文献

{"title":"Root Cause Analysis and Risk of Malignancy of Non-Diagnostic Category per the Milan System for Reporting Salivary Gland Cytopathology","authors":"Amr Ali,&nbsp;Saroja Geetha,&nbsp;Mohammed Abdelwahed,&nbsp;Nourhan Ahmed,&nbsp;Yonah Ziemba,&nbsp;Karen Chau,&nbsp;Seema Khutti,&nbsp;Cecilia Gimenez,&nbsp;Kasturi Das,&nbsp;Deepika Savant","doi":"10.1002/dc.25454","DOIUrl":"10.1002/dc.25454","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We aim to perform a root cause analysis (RCA) of the non-diagnostic (ND) category of the Milan System for Reporting Salivary Gland Cytopathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The salivary gland fine needle aspiration (FNA) samples with ND diagnosis and corresponding surgical resections from 2013 to 2023, in the age group of 18 years and above, were included in the cohort for RCA. The cytology and surgical resection slides of cases from this RCA cohort were reviewed. The demographic parameters, clinical features, radiologic characteristics, usage of rapid on-site evaluation (ROSE), corresponding surgical diagnosis, and repeat FNA were noted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2292 FNAs were performed between 2013 and 2023, of which 354 cases were ND. RCA was performed on 57 (16%) ND FNA cases that had corresponding surgical resection. The causes were grouped as man, method, machine, and material related. The primary cause predominantly was man-related sampling errors in 36 (63%) cases. There were no interpretative errors by the pathologist. The second most common primary cause was material related, found in 21 (37%) cases, due to cystic, fibrotic, vascular, and small lesions. The most common secondary cause was method related, in which 41 (72%) cases had no image guidance. There were no machine-related causes. The risk of malignancy in the RCA cohort was 17%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Majority causes of ND cytology were method-related due to lack of image guidance and ROSE. This proves that the FNA procedure under radiologic guidance with ROSE is an effective way to circumvent ND cytology of salivary gland FNAs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 6","pages":"272-282"},"PeriodicalIF":1.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566512","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":"Sinusoidal Large B-Cell Lymphoma: A Cytologic Mimic of Carcinoma and Intravascular Large B-Cell Lymphoma","authors":"Nolan Donahue,&nbsp;Rachel Gordezky,&nbsp;Robert Pooley Jr","doi":"10.1002/dc.25462","DOIUrl":"10.1002/dc.25462","url":null,"abstract":"<div>\u0000 \u0000 <p>Sinusoidal large B-cell lymphoma (SLBCL) is a rare morphologic variant of diffuse large B-cell lymphoma that is associated with poor outcomes. The diagnosis of SLBCL may be challenging due to its unique morphologic features on cytologic preparation and histologic section. This case report describes the incidental diagnosis of SLBCL with a focus on comparative cyto-histologic findings.</p>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 6","pages":"E108-E114"},"PeriodicalIF":1.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566514","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 Diagnoses of Lung Adenocarcinoma With Concomitant Metastasis From a Different Primary: A Case Series","authors":"Robert Pei,&nbsp;Shane M. Woods,&nbsp;Brant G. Wang","doi":"10.1002/dc.25460","DOIUrl":"10.1002/dc.25460","url":null,"abstract":"<p>Lung adenocarcinoma is a common malignancy that can metastasize. The lung is also a common site for metastasis from other sites. Prompt and accurate diagnosis is critical for patient management. The diagnosis of lung adenocarcinoma can be occasionally challenging due to overlapping clinical and pathological features with adenocarcinomas from other origins. We present three cases of lung adenocarcinomas with concomitant metastatic adenocarcinomas of different primaries in the same endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) or core biopsy procedures. The first case showed metastatic ROS-rearranged lung adenocarcinoma and metastatic ampullary adenocarcinoma involving different mediastinal lymph nodes, respectively, in a patient with no previous history of malignancy. The second case showed metastatic lung adenocarcinoma with MET exon 14 deletion and metastatic breast adenocarcinoma involving different mediastinal lymph nodes, respectively, in a patient with a previous history of breast carcinoma. The third case showed metastatic prostatic adenocarcinoma to a pre-existing lung mucinous adenocarcinoma in a patient with a previous history of prostatic adenocarcinoma. Our report highlights attention to details, judicious use of immunostains, and ancillary molecular studies in complex pathology cases. Cytohistological findings are also correlated with molecular test results.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 6","pages":"E102-E107"},"PeriodicalIF":1.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/dc.25460","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540552","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":"Utility of CINtec PLUS in Identification of High-Grade Lesions on Short-Term Follow-Up in Patients With Negative Cytologic Interpretation","authors":"Niyati Desai,&nbsp;William Towne,&nbsp;Courtney F. Connelly,&nbsp;Swikrity U. Baskota,&nbsp;John P. Crapanzano,&nbsp;Kanan Desai,&nbsp;Adela Cimic","doi":"10.1002/dc.25457","DOIUrl":"10.1002/dc.25457","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Screening for cervical cancer may include cervical cytology and/or high-risk human papillomavirus testing (HPV). The FDA (Food and Drug Administration)-approved CINtec <i>PLUS</i> dual stain (DS) for p16 and Ki-67 can provide helpful information for challenging follow-up care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 272 cases with negative intraepithelial malignancy (NILM) Papanicolaou (Pap) tests and positive HPV test results. All 272 women had colposcopy-directed biopsies or endocervical curettage (ECC) (histopathology) within a year. We compared DS test results with corresponding ECC/colposcopy specimens. Two subgroup analyses were conducted to examine the correlation of DS results with a prior history of abnormal Pap/colposcopy and to compare DS results with regard to HPV genotype. For analysis purposes, only high-grade lesions were considered positive, while low-grade lesions were grouped with negative results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 272 cases, 113 tested positive for DS, while 159 were negative. On follow-up histopathology within a year, three of the 113 positive cases (2.6%) showed high-grade lesions. In comparison, none of the 159 negative cases showed any high-grade lesions (95% confidence interval [CI]: −0.3% to 5.4% [<i>p</i> = 0.14]). Further analysis by HPV status showed that DS helped in risk discrimination in both subcategories (HPV16/18 and other 12 high-risk HPV), although it was not statistically significant (<i>p</i> = 0.99). Subgroup analysis based on the history of high-grade lesions demonstrated that in cases with no previous history, the risk difference was 2.8% between DS positive and negative results (95% CI −0.3% to 6%, <i>p</i> = 0.134).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All three high-grade lesions were in the DS positive category, suggesting DS may help in the risk stratification for HPV-positive NILM women (either HPV16/18 or other). Furthermore, DS may help with risk stratification, specifically in patients with no prior high-grade lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 6","pages":"265-271"},"PeriodicalIF":1.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540553","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":"A Comparison of Different Transfer Techniques in Evaluating Specimen Adequacy in FNAB: An Unexplored Topic","authors":"Mehmet Karagülle,&nbsp;Fatma Zeynep Arslan,&nbsp;Burcu Ozcan,&nbsp;Arzu Algun Gedik","doi":"10.1002/dc.25458","DOIUrl":"10.1002/dc.25458","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study compared two conventional smear methods during FNAB: The method where the green part of the syringe is touched to the slide (Technique 1) and the method where the contents are rapidly sprayed (Technique 2). We investigated differences in specimen adequacy, diagnostic outcomes, and variations among pathological subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>FNAB was performed on 128 lesions from 119 patients, and the samples were classified according to the Bethesda System. The two transfer techniques were compared in terms of cell count and diagnostic results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 128 lesions, 93 were diagnosed as adenomatous nodules. No significant difference was found in the nondiagnostic result rates between the methods. The p-value was found to be 0.65. The average cell count in Technique 1 was 1.95 (min: 0, max: 3+, SD: 1.03), while in Technique 2 it was 1.91 (min: 0, max: 3+, SD: 1.07). Although Technique 1 resulted in a slightly higher positive cell detection, the two techniques were not superior to each other in terms of cell count. The p-value was found to be 0.87. When both techniques were used together, more diagnoses could be made in more patients compared to when each technique was used separately. However, statistically, the combined use of both techniques was not superior to Technique 1 (<i>p</i> = 0.16) or Technique 2 (<i>p</i> = 0.083).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both techniques showed similar nondiagnostic rates. Technique 1 resulted in a slight increase in the average positive cell count, whereas Technique 2 may be preferred due to its simplicity and safety. It was also found that neither technique provided a clear superiority over the other, and using both techniques together was not superior to either Technique 1 or Technique 2. In determining standard FNAB procedures and improving diagnostic accuracy, factors such as nodule characteristics and needle caliber, along with smear techniques, should also be considered. Larger-scale studies are necessary to validate these findings and improve FNAB practices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"251-255"},"PeriodicalIF":1.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515059","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":"The Role of Fine-Needle Aspiration in Conjunction With Ancillary Immunophenotyping for Accurate Recognition of a Case of Splenosis in Perirectal Soft Tissue","authors":"Haval Ali,&nbsp;Manoop S. Bhutani,&nbsp;Savitri Krishnamurthy","doi":"10.1002/dc.25455","DOIUrl":"10.1002/dc.25455","url":null,"abstract":"<div>\u0000 \u0000 <p>Splenosis is the implantation of splenic tissue into other organs following splenectomy or traumatic spleen injury. It typically manifests in the peritoneal cavity but can appear in other locations. Splenic nodules are often incidentally discovered during imaging, with nuclear scintigraphy being the gold standard for recognition. We report a case of splenosis found incidentally upon computed tomography for evaluation of chronic anemia in the anterior perirectal space of a 74-year-old man who had previously undergone splenectomy. Despite advances in imaging techniques, tissue examination is necessary to confirm suspected splenosis and exclude neoplastic processes, and image-guided fine-needle aspiration biopsy is a valuable tool to this end. Our case was diagnosed by endoscopic ultrasound–guided fine-needle aspiration biopsy with ancillary immunohistochemistry and flow cytometry. Cytomorphological features alone may not be sufficient to recognize splenosis; ancillary immunostaining can highlight littoral cells lining the red pulp sinuses, with characteristic positive expression of CD8, WT1, ERG, and CD68, helping clinch the diagnosis.</p>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"E92-E97"},"PeriodicalIF":1.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515062","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":"An Unexpected Journey of Pediatric Hodgkin's Lymphoma Diagnosed via Pericardial Cytology: An Educational Case Report","authors":"Rahul Satarkar,&nbsp;Ruchira Palmal,&nbsp;Kartavya Kumar Verma","doi":"10.1002/dc.25459","DOIUrl":"10.1002/dc.25459","url":null,"abstract":"<div>\u0000 \u0000 <p>Hodgkin's lymphoma (HL) is a recognized hematological malignancy that typically appears in two specific age groups: the first peak occurs between 15 and 40 years of age, while the second peak arises in individuals aged over 60. While typically presenting as a mediastinal mass, rarer initial presentations include cardiac tamponade. In this case, we report a pediatric patient with HL presenting with massive pericardial effusion in the emergency department. We emphasize how a simple cytology test can facilitate diagnosis in such cases and discuss the role of cytological evaluation in guiding management. A 13-year-old male presented to our institution with fever and breathlessness. Radiological examinations indicated a mediastinal mass lesion. An emergency echocardiogram revealed pericardial effusion, which was subsequently drained and sent for cytological evaluation. Cytology revealed large atypical cells characterized by abundant cytoplasm, large nuclei, and prominent nucleoli, corresponding to Reed-Sternberg cells. Immunocytochemistry (ICC) on the cell block further confirmed the diagnosis of HL. Treatment commenced following biopsy confirmation, yielding favorable prognostic results from the patient's perspective. The primary goal of presenting this case is to underscore the unusual early presentation of HL and to illustrate how a simple test, combined with comprehensive diagnostic reasoning, can enable early diagnosis and enhance prognostic outcomes. Furthermore, we highlight the crucial role of ICC in the timely identification of this condition.</p>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 6","pages":"E98-E101"},"PeriodicalIF":1.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515060","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":"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}