Journal of Diagnostic Pathology最新文献

{"title":"The evolution of Gleason grading of prostate cancer","authors":"H. Samaratunga, B. Delahunt, L. Egevad, J. Srigley, J. Yaxley","doi":"10.4038/JDP.V12I1.7732","DOIUrl":"https://doi.org/10.4038/JDP.V12I1.7732","url":null,"abstract":"One of the most important prognostic indicators of prostate cancer is tumour grading and the system that has been accepted worldwide for more than half a century was that developed by Donald Gleason. From the time of the publication of Gleason’s original report, the prognostic significance of Gleason scores (GS) has been confirmed. This system was established in the pre-prostate specific antigen (PSA) era when the diagnosis and management of prostate cancer were quite different from current practice. While Gleason grading fulfilled the role of a powerful prognostic indicator for many years, it became evident that, for the grading system to remain relevant in modern practice, certain modifications were required. The initial changes were made by Dr Gleason himself and in 2005, the International Society of  Urological Pathology (ISUP), introduced significant improvements through a consensus conference attended by 52 International Urological Pathology experts. Since the 2005 ISUP conference Gleason scores 2-5 have effectively been abandoned for needle biopsies and as a consequence the lowest score found on a needle biopsy is now 6. The ISUP, through a further consensus conference in 2014,introduced ISUP grading consisting of 5 grades: Grade 1 (GS 3+3), grade 2 (GS 3+4), grade 3 (GS 4+3), grade 4 (4+4, 3+5, 5+3) and grade 5 (GS 9-10). Other changes introduced were to consider all cribriform cancers and tumours with glomerular patterns as grade 4, and to grade mucinous adenocarcinoma based on the underlying architecture. Given the significant new information in the literature, primarily relating to the prognostic significance of percentage of grade 4, it is likely that ISUP grading will evolve further.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125889514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stratification of risk of malignancy in atypical breast fine needle aspiration: a cytomorphological approach","authors":"J. Weigner, I. Zardawi, S. Braye, P. McElduff","doi":"10.4038/JDP.V12I1.7733","DOIUrl":"https://doi.org/10.4038/JDP.V12I1.7733","url":null,"abstract":"Although atypical (C3) breast cytology is a legitimate reporting category, it is not very useful clinically because it yields benign as well as malignant histological outcomes. Therefore, a cytomorphological approach to minimise inappropriate use of the C3 category may improve the clinical usefulness of this category. In a previous training set of 180 atypical breast cytology (C3) cases we had identified the best discriminating cytological criteria to predict the histological outcomes (malignant, benign proliferative and benign non-proliferative). Using a selection of these previously identified statistically significant criteria (cystic background, cohesiveness, myoepithelial cells or bare bipolar nuclei, papillary fragments and tubules) we tested their ability to predict the same outcomes on 182 subsequent C3 cases (validation set). The diagnostic accuracy for each outcome was compared with the training set. A probability calculator with nominated cut-points was developed to stratify and re-grade C3 cases. Cases outside the cut-points were either up-graded to suspicious (C4) or down-graded to benign (C2). Re-graded cases were reviewed to identify reasons for over or under-interpretation. Statistical analysis showed comparable diagnostic accuracy between the training set and the validation set for malignant and benign proliferative outcomes but not for the benign non-proliferative outcome. The probability calculator resulted in an up-grade of 18% (33/182) ofthe cases. Malignant histology was seen in 25/33 (76%) of the up-graded cases but 8/33 (24%) produced a proliferative non-malignant outcome. A meaningful lower cut-point could not be established without including malignant cases. The C3 category remains a legitimate with a heterogeneous mix of pathological entities. Attempts to minimise inappropriate allocation of C3 cases into this category have met with limited success.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130513876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinicopathological profile of malignancies in the ampullary region","authors":"L. B. D. J. Siriwikum, N. Samarakoon, S. Liyanage, B. Mahendra, R. Rathnayake, S. Hewavisenthi","doi":"10.4038/JDP.V11I2.7717","DOIUrl":"https://doi.org/10.4038/JDP.V11I2.7717","url":null,"abstract":"Introduction The ampulla is a poorly defined region, both anatomically and histologically, affected by malignancies arising in the duodenum, distal common bile duct, head of the pancreas and those centered around the ampulla. These tumours are collectively considered as ampullary carcinomas. The objective of this study was to describe the clinicopathological features of malignancies arising in the ampullary region. Methodology This was a retrospective study of 42 histopathology reports of resection specimens of malignant tumours in the ampullary region, received at the Department of Pathology, Faculty of Medicine, Ragama, over a period of four years. Clinical data and pathological features were collected and analyzed. Results The male to female ratio was 8:13. The median age of the patients was 57 years (range 15 -77). The single most common presentation was jaundice 15/42 (35.71%), but a majority of patients (16/42, 38.09%) presented with multiple symptoms (abdominal pain, weight loss and jaundice). The average duration of symptoms was 2.8 months. Malignancies included 5 biliary (B), 8 duodenal (D), 11 pancreatic (P) and 18 ampullary carcinomas (A). The histological types included adenocarcinoma 34/42 (80.95%), neuroendocrine tumours 5/42 (11.9%) and other types 3/42(7.14%) which included solid pseudopapillary neoplasm, acinar cell carcinoma of the pancreas and gastrointestinal stromal tumour. A majority of adenocarcinomas were moderately differentiated, i.e., 27/34 (B-4/5, D-4/5, P-5/8, A-14/16). Lymphovascular invasion was seen in 11/34 (B-1/5, D-2/5, P-3/8, A-5/16) and perineural invasion was identified in 12/34 (B- 2/5, D-2/5, P-5/8, A-3/16). The most common stage at presentation was IIB (T1/T2/T3, N1, M0 – TNM classification - UICC). Conclusion Ampullary malignancies were more common among females. The median age was 57 years. The majority was moderately differentiated adenocarcinomas with lymphovascular and perineural invasion and the commonest stage at presentation was IIB.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115501832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, clinicopathological characteristics and short term survival of triple negative and basal like breast carcinoma in a cohort of Sri Lankan patients","authors":"H. Wijesinghe, P. Thuvarakan, G. Wijesinghe, J. Fernando, U. Senarath, M. D. Lokuhetty","doi":"10.4038/JDP.V11I2.7723","DOIUrl":"https://doi.org/10.4038/JDP.V11I2.7723","url":null,"abstract":"Introduction Information on triple-negative (TNBC) and basal-like (BLBC) breast carcinoma (BCa) is limited in South-Asia. We aimed to determine the prevalence and clinicopathological characteristics of TNBC and BLBC and shortterm survival of TNBC among a cohort of BCa patients. Methodology Clinicopathological characteristics and short term survival of 211 women with BCa treated at the National Hospital of Sri Lanka from 2012-2014 were analyzed, excluding postneoadjuvant chemotherapy cases. Immunohistochemistry for hormonal and HER2 receptors and basal markers (CK5/6, CK14, EGFR, 34βE12) were performed on TNBCs. Data was analyzed using chi-squared test, logistic and Cox-regression. Results Forty-five (21.33%) were TNBC (95%, CI=15.8%-26.86%), correlating with younger age (p=0.03), premenopausal state (p=0.047), negative lymph nodes (p=0.016), lower stage (p=0.011), higher Nottingham grade (p Discussion TNBC prevalence was comparable to studies from the Indian-subcontinent, however, higher than in the West. Clinicopathological characteristics were similar. Lack of association with adverse short-term survival was possibly due to exclusion of postchemotherapy cases. Conclusion Triple negative breast carcinoma prevalence was 21.33%. Younger age, premenopausal status, low TNM stage, high tumour grade, necrosis, pushing margins, lymphoid infiltrate at tumour margin, absent DCIS and absent/mild central desmoplasia were predictive of triple negative breast carcinoma. Moderate/extensive necrosis in a tumour with this morphology was predictive of basal like breast carcinoma. Triple negative breast carcinoma was not predictive of adverse short-term survival.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115017808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of fine needle aspiration smear processing method for onsite immediate assessment","authors":"C. Sosai, A. Perera, A. A. S. Priyangika, K. Perera, E. Siriweera, S. Wijethunga, A. Priyani","doi":"10.4038/JDP.V11I2.7715","DOIUrl":"https://doi.org/10.4038/JDP.V11I2.7715","url":null,"abstract":"Introduction A suitable protocol to ensure rapid processing of smears for on-site immediate assessment (OSIA) is not available in Sri Lanka. The objective of this study was to validate the processing method of fine needle aspirates (FNA) for OSIA. Methodology Thirty five FNA obtained were processed as follows. The smear prepared from the first needle pass was fixed in 95% ethyl alcohol and stained with freshly prepared Harris haematoxylin for one minute each and assessed for adequacy of cellularity. It was then fixed for 20 minutes in the same fixative and stained by the Papanicolaou staining protocol (PSP). The smear prepared from the second needle pass was routinely processed and stained by PSP. Both smears were assessed by three histopathologists (A, B and C) independently and blind to the processing method for quality indicators, including air drying (ADpresence/ absence), nuclear differentiation(NDclarity of visibility of chromatin pattern as 1- poor, 2-intermediate and 3-clear,) and cytoplasmic clarity (CC-cell outline and clarity as 1-poor, 2- intermediate and 3-clear). Final quality of smear for reporting was categorized as satisfactory for reporting (absent AD and ND 2-3, CC 2-3), unsatisfactory but can report (absent AD and ND 1-2, CC 1-2) and unsatisfactory, cannot report (presence of AD and ND1, CC1). Statistical analysis was done using chi-square test. Results Of the 35 OSIA smears, pathologist A, B and C found (35/35) 100%, (26/35) 74.29%, and (28/35) 80% to be satisfactory for reporting, and (0/35) 0%, (1/35) 2.86%, and (1/35) 2.86% unsatisfactory for reporting. Of the 35 routinely processed smears, pathologist A, B and C found (29/35) 82.9%, (24/35) 68.6% and (16/35) 45.7% to be satisfactory for reporting: (4/35)11.4%, (4/35)11.4% and (3/35)8.6% to be unsatisfactory for reporting. Conclusion No significant difference (p< 0.05) was found by the three pathologists in the quality parameters of the smears from the two processing methods thus, validating the one minute processing method as comparable to the routine processing method.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116494573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An audit of histopathology reporting in Kausch-Whipple pancreaticoduodenectomy specimens","authors":"L. B. D. J. Siriwikum, N. Samarakoon, S. Liyanage, B. Mahendra, R. Rathnayake, S. Hewavisenthi","doi":"10.4038/JDP.V11I2.7718","DOIUrl":"https://doi.org/10.4038/JDP.V11I2.7718","url":null,"abstract":"Introduction Since histopathology reports of the resection specimens of malignant tumours should provide information of therapeutic and prognostic significance, national guidelines have been formulated on reporting common malignancies. However, no such guidelines are available locally for Kausch-Whipple pancreaticoduodenectomy (KWPD) specimens. The aim of this study was to audit the completeness of reporting of KWPD specimens against the minimum data sets formulated by the Royal College of Pathologists (RCP) UK. Methodology The histopathology reports of KWPD specimens of malignant tumours which were received at the Department of Pathology, Faculty of medicine, Ragama over a four year period were analyzed to determine whether the core data identified in the RCP minimum data set (BT-23, PT-24, DT-22 and AVT-22) was included. The percentage of items reported in each of the histopathology reports was calculated to ascertain the overall level of adequacy in each of the report. Results There were a total of 42 KWPD specimen reports including 18 tumours of the Ampulla of Vater (AVT), 11 pancreatic tumours (PT), 8 duodenal tumours (DT) and 5 biliary tumours (BT). The minimum number of core data items included was, BT-17/23, PT-17/24, DT-15/22 and AVT-14/22. Data that was poorly reported included the degree of differentiation, lengths of bile duct and lesser curvature and greater curvature of stomach, maximum tumour diameter (most poorly reported in AVT 16.67%, 3/18) and tumour involvement of margins in PT(0/11) and AVT(1/18, 5.56%). Conclusion Though overall reporting was found to be satisfactory in many of the reports, further improvements are required in reporting of certain data items. It is recommended that national guidelines and a proforma are introduced and followed.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133183849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histomorphological profile of uterine corpus malignancies: a single unit experience","authors":"T. Waravita, R. Rathnayake","doi":"10.4038/JDP.V11I2.7711","DOIUrl":"https://doi.org/10.4038/JDP.V11I2.7711","url":null,"abstract":"Introduction Primary uterine malignancy (PUM) is a common malignancy amongst females worldwide. According to the National Cancer Incidence data (2007), the age- specific incidence rate of uterine corpus malignancy is 2.7 per 100 000 population in Sri Lanka. The aim of this study was to describe the frequency, clinicopathological and prognostic parameters of PUM. Methodology Hysterectomy specimens (49) and biopsies (05) of PUM received over two years were retrieved to collect demographic and morphological data. The tumours were categorized as epithelial, mesenchymal or mixed. Histological subtypes of epithelial tumours were classified as type 1(T1) or type 2 (T2). Prognostic markers including grade (1-3), stage (FIGO I-IV) and vascular invasion were recorded. The concomitant pathological changes such as endometrial hyperplasia and intra epithelial neoplasia were assessed. Results Fifty four PUM were included. The mean age at presentation was 59 years. There were 45 (83.3%) endometrial carcinomas (EC), 5(9.3%) uterine sarcomas, 2(3.7%) carcinosarcomas (CS) and 2(3.7%) choriocarcinomas. Of the EC, 86.6 % (39/45) were T1 and 11.1% (6/45) were T2. The majority of T1 EC was endometrioid adenocarcinoma (37/45), while 5/45 T2 tumours were serous papillary adenocarcinomas. Ten cases of T1 EC had associated simple (6/10) and complex (4/10) endometrial hyperplasia and 2 cases of T2 EC had intraepithelial carcinoma. Of the endometrioid carcinomas, 13.5% (5/37), 64.8% (24/37) and 21.6% (8/37) were grade 1, 2 and 3 respectively. 3/5 cases of uterine sarcomas were low grade. Of all resection tumours, 63.2% (31/49), 22.4% (11/49) and 14.2% (7/49)) were FIGO stage I, II and III respectively. Of the resected tumours 51.02%(25/49) had more than 50% of myometrial invasion and 46.93% (23/49) had vascular invasion. Conclusion T1 endometrial carcinoma was the commonest primary uterine malignancy. Overall, although the patients present at an early stage, they had unfavourable prognostic factors such as deep myometrial invasion, vascular invasion and high histological grade.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132003024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a quantitative PCR assay to evaluate Human Epidermal Growth Factor Receptor - 2 status of Gastric carcinoma in a cohort of Sri Lankan patients","authors":"D. K. S. Kannangara, D. Subasinghe, M. D. Lokuhetty, R. Dassanayake, Y. Gunawardene","doi":"10.4038/JDP.V11I2.7712","DOIUrl":"https://doi.org/10.4038/JDP.V11I2.7712","url":null,"abstract":"Introduction Human epidermal growth factor receptor2 (HER2) protein over expression and/or HER2 gene amplification is linked to dismal outcome of gastric carcinoma (GCa). Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) are key methods to identify patients for HER2 targeted therapy. Draw backs of both methods warrant novel tests. The objectives were to determine whether quantitative Polymerase Chain Reaction (qPCR) could serve as a supplementary method to evaluate HER2 status of GCa and investigate the correlation between HER2 assessed by different methods and clinicopathological features. Methodology Twenty GCa patients with known IHC-HER2 scores were evaluated. qPCR was performed for HER2 gene and Amyloid precursor protein (reference gene) in formalin fixed paraffin embedded GCa tissue. Threshold values (Ct) were analyzed using Pfaffl-method to detect HER2 gene amplification. Results HER2 positivity by IHC (protein) and qPCR (gene) were 20% and 35% respectively. Sensitivity and specificity of qPCR was 67% and 76% respectively and results were reproducible. HER2 protein positivity was correlated with TNM-stage and Lauren histological types (P Discussion Discrepancies between HER2 positivity by IHC and qPCR were possibly due to transcription activation by other genes in the absence of HER2 gene amplification and the aberrant form of HER2 protein not detected by IHC. Studies also indicate a higher proportion of IHC negative, but HER2 gene amplified GCa by FISH. Conclusion qPCR may be used as a supplementary method for evaluation of HER2 status in gastric carcinoma proven to be HER2 negative by immunohistochemistry.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114645598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of Ki 67 and Phosphohistone H3 in oropharyngeal squamous cell carcinomas","authors":"E. Siriweera, I. Zardawi","doi":"10.4038/JDP.V11I2.7709","DOIUrl":"https://doi.org/10.4038/JDP.V11I2.7709","url":null,"abstract":"Introduction Cell proliferation is an important event in oncogenesis. Proliferative activity is a reliable prognostic factor in many cancers. The objectives were to elucidate the prognostic value of the proliferation markers, Ki67 and phosphohistone H3 (PHH3) in oropharyngeal squamous cell carcinomas(OPSCC) and determine the correlation between the two markers. Methodology A retrospective study of 56 OPSCC obtained following locoregional treatment served to gather clinicopathological prognostic details. Proliferative activity of the tumours was assessed by immunohistochemical expression of Ki67 and PHH3. Association of prognostic parameters with each marker was analyzed and correlation between Ki67 and PHH3 was determined. Results The mean age was 57 years (SD 11.6, range 24- 82 yrs). Floor of the mouth was affected the most (n=25, 44.6%). Ki67 index was significantly higher in the Discussion Ki67 is expressed by cells in G1, S, G2 and M phases of the cell cycle, but many may not necessarily complete the cell cycle. PHH3 is a mitosis-specific marker where phosphorylation of histone H3 is closely associated with mitotic chromatin condensation in late G2 and M phase. Although a significant association between high Ki67 and high PHH3 was found, Ki67 was of more value in evaluating prognostic factors in OPSCC. Conclusion Ki67 is superior to phosphohistone H3 as a prognostic parameter of oropharyngeal squamous cell carcinomas.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129281875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of thyroid cytology reporting in three peripheral hospitals in Sri Lanka","authors":"S. Senanayake, K. W. Dammika, E. Edirisuriya, I. Premarathna, A. M. S. A. Liyadipitiya","doi":"10.4038/JDP.V11I2.7706","DOIUrl":"https://doi.org/10.4038/JDP.V11I2.7706","url":null,"abstract":"Thyroid cytology is a widely used, cost effective outpatient procedure, which can be easily utilized in resource limited peripheral hospitals, available for preoperative assessment of thyroid nodules. We conducted the following study to analyze thyroid cytology reporting in three peripheral hospitals in Sri Lanka to assess their diagnostic utility, identify the associated problems and make recommendations for further improvement. This was a retrospective study performed on 300 thyroid cytology cases with a histological diagnosis. Thyroid cytology was reported according to BTA/RCP guidelines. Of the cytology diagnosis categories 72.7% were Thy 2, 22.3% were Thy 3, 4.7% were Thy 4 and 0.3% were Thy 5 lesions. Malignancy detection rate for each category were 2.3% for Thy 1, 13.4% for Thy 2, 64.3% for Thy 3 and 100% for Thy 4. The test had a 66.7% sensitivity, 97.7% specificity, 66.8% positive predictive value and 97.7% negative predictive value in diagnosing a malignancy. These parameters are comparable with the published parameters. However, the sensitivity of the test in the three hospitals showed significant variability. Concerted use of clinical and ultrasound findings in the interpretation of smears and multidisciplinary team meetings to discuss equivocal cases can be used to improve the diagnostic utility of thyroid cytology in these hospitals. Furthermore, performance of regular internal audits for each institution to identify problems is important since the study has shown variations in diagnostic parameters in different hospitals.","PeriodicalId":225127,"journal":{"name":"Journal of Diagnostic Pathology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121808356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}