Journal of the American Society of Cytopathology最新文献

{"title":"Revisiting an old technique: rehydration of air-dried slides is a viable technique for Pap-stained fine needle aspiration slides for novel situations.","authors":"Justin Burk, Jiannan Li, Lauren Stark, Ryan D Mckinney, Cody Weimholt, Cory T Bernadt, Hannah Krigman","doi":"10.1016/j.jasc.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.03.002","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional Pap staining procedure involves immediate ethanol-fixation of prepared smears. When our department absorbed cytopathology services of an affiliate hospital using nonspecialized assistants, we had problems with poorly fixed slides. We evaluated an alternative approach of rehydration of air-dried slides in comparison to both immediate and delayed alcohol fixation for Pap staining.</p><p><strong>Materials and methods: </strong>Fine needle aspirations were performed on deidentified unfixed autopsy tissue. Sampled tissues included lung, liver, thyroid, breast, and a mediastinal mass. Paired aspirate smears were immediately fixed, air-dried and rehydrated before staining, or delayed fixation after a 5-minute air dry (DF). Additional smears were Diff-Quik stained for comparison. Slides were Pap-stained at 0 days, 1 day, 3 days, or 5 days postaspiration and numerically scored for cytomorphologic feature quality. Data were compared with one-way analysis of variance analysis.</p><p><strong>Results: </strong>We evaluated 237 pairs of smears. The immediately fixed and air-dried groups displayed higher quality for nuclear borders, nuclear detail, distinct cell borders, and cytoplasmic staining at every time point (all P values <0.05) compared to the DF group. Rehydration did not reverse the air-dry artifact from delayed fixation in the DF group.</p><p><strong>Conclusions: </strong>Air-drying with delayed rehydration/alcohol fixation maintains diagnostic quality in settings for which traditional preparative techniques are not optimal, technical assistance is limited, and transport is problematic. Our series demonstrates that air-dried slides maintained high quality when processed up to 5 days postaspiration. We demonstrate a technique that improves pathology outreach by providing better quality diagnostic material with minimal additional personnel costs.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796590","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 the triple diagnosis technique to endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic lesions: Impact on diagnostic accuracy and positive and negative predictive values.","authors":"Fnu Kiran, Deepak Kumar, Magda Esebua, Lester J Layfield","doi":"10.1016/j.jasc.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.03.001","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is an accepted method for the investigation of pancreatic solid mass lesions/solid masses. Reports have shown it to have high but imperfect diagnostic sensitivity and specificity. Sensitivity ranges from 77% to 98% with specificity varying from 25% to 100%. Negative predictive value (NPV) has been reported to be 72.7%, meaning a benign result does not exclude malignancy in a quarter of cases. We investigated if the correlation of cytology, imaging, and clinical evaluation would improve diagnostic accuracy.</p><p><strong>Materials and methods: </strong>An electronic search was carried out for EUS-FNA cases performed at our institution between 2018 and 2022. Each case was correlated with corresponding surgical pathology results or >2 years clinical follow-up. Cases with adequate follow-up were correlated with results of imaging and clinical diagnosis. Accuracy statistics were calculated for each method and for a triplet composed of clinical, imaging, and cytologic diagnoses.</p><p><strong>Results: </strong>The search documented 198 EUS-FNAs, of which 181 had adequate follow-up; 140 cases had clinical diagnoses and 141 had imaging diagnoses. The sensitivity, specificity, positive predictive value (PPV), and NPV of cytology was 72%, 100%, 1.00, and 0.79, respectively. The diagnostic triplet had a sensitivity of 93% with a specificity of 100%. The PPV and NPV were 1.00 and 0.96, respectively.</p><p><strong>Conclusions: </strong>The sensitivity and NPV of EUS-FNA cytology were low, indicating that a benign diagnosis did not exclude malignancy with nearly a quarter of benign specimens being false negatives. The triple diagnosis method improved diagnostic accuracy substantially with sensitivity, specificity, PPV, and NPV being 93%, 100%, 1.00, and 0.96, respectively.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781406","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":"Reliability of cytopathology and ancillary testing modalities in the diagnosis of extramedullary hematopoiesis and sclerosing extramedullary hematopoietic tumor: a 10-year institutional experience.","authors":"Rana Naous","doi":"10.1016/j.jasc.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.02.001","url":null,"abstract":"<p><strong>Introduction: </strong>Extramedullary hematopoiesis (EMH) is proliferation of hematopoietic elements outside of bone marrow that's commonly associated with hematologic diseases. While sclerosing EMH (SEMHT) has overlapping clinical features with EMH, it is less cellular and has solid appearance with fibrosis and atypical megakaryocytes. EMH/SEMHT are uncommon manifestations rarely reported in cytology. This study aims to investigate the reliability and utility of cytology in diagnosis of EMH/SEMHT in cytology samples at our institution.</p><p><strong>Materials and methods: </strong>The laboratory information system was queried over a 10-year period (2014-2024) to identify all cytology cases diagnosed on fluid cytology, fine-needle aspiration (FNA), and/or small-core biopsy with Touch preparations as EMH and/or SEMHT. History of hematopoietic disorders, specimen location, type, diagnosis, ancillary studies, and follow-up data were reviewed and correlated.</p><p><strong>Results: </strong>A total of 11 cases from 11 patients were identified. Age ranged from 57 to 84 years, and the male:female ratio was 0.8:1. History of transplant was noted in 3 patients, and hematopoietic disorders (1-myelodysplastic syndrome, 3-primary myelofibrosis, 1-chronic myeloid leukemia, 1-essential thrombocytosis) in 6 patients. Specimen origins were distributed as:1 peritoneal fluid, 2 pleural fluids, 8 soft tissue (4-paraspinal, 1-presacral, 1-peritoneal, 1-perigastric, 1-periportal lymph-node). This corresponded to 3 fluid cytology, 5 FNAs, and 3 core biopsies/Touch preparation. Five cases were diagnosed as atypical compatible with EMH, and 6 cases were diagnosed as negative for malignant cells with trilineage hematopoiesis compatible with EMH (5) and SEMHT (1). Flow cytometry was performed on 5 cases, while immunohistochemistry was performed on 6 cases, with both ancillary studies confirming the diagnosis of EHM/SEMHT in 9 of 11 cases (82%).</p><p><strong>Conclusions: </strong>Cytology can provide reliable and accurate method for diagnosing EMH/SEMHT. EMH is less commonly encountered in effusions (27.3%). Ancillary studies, including flow cytometry and immunohistochemistry, are reliable techniques that aid in diagnosis EMH/SEMHT in various cytology samples.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744224","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":"Endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy in the diagnosis of gastrointestinal lymphomas","authors":"Tianye Liu MD, PhD ,&nbsp;Swikrity Upadhyay Baskota MBBS, MD ,&nbsp;Abel Gonzalez MD","doi":"10.1016/j.jasc.2024.12.002","DOIUrl":"10.1016/j.jasc.2024.12.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The role of endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy (EUS-FNA/B) in the clinical management of gastrointestinal lymphoma has not been extensively studied. This study investigates the use of EUS-FNA/B in the diagnosis of first-time and recurrent gastrointestinal lymphomas at a large academic institution.</div></div><div><h3>Materials and methods</h3><div>A total of 40 patients who had final diagnosis of lymphoma according to the World Health Organization (WHO) classification of tumors of hematopoietic lymphoid tissues who underwent EUS-FNA/B were included in the study. Cases with concurrent forceps mucosal biopsies or lost to clinical follow-up were excluded. The diagnostic accuracy and clinical use of EUS-FNA/B was investigated by comparing EUS-FNA/B diagnosis with the final diagnosis.</div></div><div><h3>Results</h3><div>EUS-FNA/B diagnoses were concordant with the final WHO diagnosis for as high as 72.5% of the cases. Of the remaining 27.5%, 17.5% had enough cytologic features for lymphoma diagnosis with incomplete phenotyping, while the remaining 10.0% showed features suspicious for lymphoma. Cell block and flow cytometry quality significantly affected diagnostic accuracy. Number of passes between 1 and 5 yielded better diagnostic accuracy than 6 or more passes during FNA; however, no difference was identified during procedures that used FNB alone or combined with FNA. There is no significant difference in onsite adequacy diagnostic performance of EUS-FNA performed by cytopathologists or cytotechnologists.</div></div><div><h3>Conclusions</h3><div>EUS-FNA/B with concurrent ancillary studies such as immunocytochemistry in cell block and flow cytometry can be helpful in efficient first and recurrent diagnoses of gastrointestinal lymphomas.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 2","pages":"Pages 102-109"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898810","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":"Pericardial effusion cytology: malignancy rates, patterns of metastasis, comparison with pericardial window, and genomic correlates","authors":"Vanda F. Torous MD ,&nbsp;Cristiana M. Pineda MD, PhD ,&nbsp;Liza M. Quintana MD ,&nbsp;Ivan Chebib MD ,&nbsp;Paul A. VanderLaan MD, PhD","doi":"10.1016/j.jasc.2024.12.005","DOIUrl":"10.1016/j.jasc.2024.12.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Cytologic evaluation of pericardial fluid is essential for diagnosing malignant pericardial effusions secondary to metastatic disease and for guiding appropriate clinical management; however, large cohort and up-to-date studies on malignancy rates and distribution of primary tumor sites is lacking.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis of pericardial fluid specimens from 2 large academic medical centers over a 10-year period was conducted. Clinical and specimen characteristics were correlated with cytologic diagnoses, and compared with surgical pathology pericardial specimens when available. In addition, genomic testing results were examined in a subset of malignant cases.</div></div><div><h3>Results</h3><div>A total of 1667 pericardial fluid specimens were evaluated, with 15.3% diagnosed as malignant. Lung cancer (50.6%) was by far the most common primary tumor causing malignant pericardial effusions, followed by breast (13.0%), hematolymphoid (12.6%), and gastrointestinal (6.1%) cancers. A subset of patients with paired cytology and surgical pathology pericardial specimens showed concordance in 84.2% of cases, with discordant cases more frequently presenting with a positive cytology but negative surgical pathology result. Genomic analysis of a subset of malignant pericardial effusions revealed the most frequently mutated genes to be <em>TP53</em>, <em>KRAS</em>, <em>CDKN2A/B</em>, and <em>PIK3CA</em>, with a larger proportion of high tumor mutational burden (≥10 muts/Mb) in pericardial fluid samples compared to primary or metastatic sites.</div></div><div><h3>Conclusions</h3><div>While lung cancer is the most frequent cause of a cytology-confirmed malignant pericardial effusion, familiarity with relative frequencies of metastases from other sites can be particularly helpful, especially in the diagnostic work-up of an occult malignant pericardial effusion.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 2","pages":"Pages 132-141"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024934","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":"Benchmarking high-risk human papillomavirus testing against cytology and biopsy results in the detection of cervical dysplasia to inform clinical screening guidelines","authors":"Divya Salibindla MD ,&nbsp;Rachel Jug MB, BCh, BAO","doi":"10.1016/j.jasc.2024.11.003","DOIUrl":"10.1016/j.jasc.2024.11.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The United States Preventive Services Task Force (USPSTF) recommendation for cervical cancer screening includes the option to screen with high-risk human papilloma virus (hrHPV) alone, but some studies have reported that hrHPV testing alone missed precancerous and cancerous lesions. In this study, we evaluated the test performance characteristics of hrHPV in detecting cervical dysplasia with cervical cytology and biopsy as comparators.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective analysis of Papanicolaou smears between January and December 2019 performed at our institution with concurrent hrHPV and cytology testing. Cases were identified in the laboratory information system and abstracted data included patient age, hrHPV result, concurrent cytology result, and follow-up cervical biopsy result where available.</div></div><div><h3>Results</h3><div>A total of 3748 cases were identified with concurrent hrHPV and cytology testing and 79 cases with concurrent hrHPV and biopsy results. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) “hrHPV for detecting dysplasia on cytology was 70% (95% CI: 60.7%-77.8%), 98% (95% CI: 97.4%-98.4%), 53% (95% CI: 46.2%-58.8%), and 99% (95% 98.7%-99.2%), respectively (P value &lt;0.00001). The sensitivity, specificity, PPV, and NPV of hrHPV for detecting dysplasia on biopsy was 76% (95% CI: 61.1%-86.7%), 30% (95% CI: 14.7%-49.4%), 64% (95% CI: 57.0%-70.5%), and 43% (95% CI: 46.6%-61.0%), respectively (P value &lt;0.3).</div></div><div><h3>Conclusions</h3><div>hrHPV testing alone would have missed 30% of dysplastic samples identified by cytology and 24% of dysplastic samples confirmed by cervical biopsy. These findings support a comprehensive strategy of dual cervical cancer screening with cytology and hrHPV testing.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 2","pages":"Pages 86-90"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972528","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":"Analysis of 2023 cytologists employment survey","authors":"Donna K. Russell MS, CT(ASCP)HT, CFIAC ,&nbsp;Matt Riding SCT (ASCP) ,&nbsp;Catherine Bammert PhD, CT, MB (ASCP), CMIAC","doi":"10.1016/j.jasc.2024.12.004","DOIUrl":"10.1016/j.jasc.2024.12.004","url":null,"abstract":"<div><h3>Introduction</h3><div>To provide clinical cytopathology laboratories and educational cytology programs with a snapshot of the current state of the cytology profession, including wages, anticipated retirement statistics and scope of practice in the field.</div></div><div><h3>Materials and methods</h3><div>This survey was a collaborative initiative disseminated to the membership of the American Society for Cytotechnologists (ASCT) and the American Society for Clinical Pathology cytologists. Data collected from respondents via SurveyMonkey was collated and analyzed by the ASCT and the American Society for Clinical Pathology.</div></div><div><h3>Results</h3><div>Five hundred and seven responses were received and tabulated based on ASCT region and states. Position titles, salaries, employment demographics, years employed, anticipated retirement rates and reasons for leaving the profession were evaluated. Information regarding scope of practice and/or ancillary duties received from the ASCT and American Society for Clinical Pathology cytologists was also collated.</div></div><div><h3>Conclusions</h3><div>While anticipated retirement rates are comparable to those reported over the past several years, staffing shortages will be exacerbated due to cytologists leaving the field for a variety of reasons. Cytologists continue to evolve with the field of diagnostic cytology and qualitative feedback suggests that learning opportunities to facilitate career advancement and mitigate burnout would be valuable.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 2","pages":"Pages 78-85"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081667","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":"Comparative analysis of Ficoll-Hypaque and CytoLyt techniques for blood removal in breast cancer malignant effusions: effects on RNA quality and sequencing outcomes","authors":"Gloria H. Sura MD ,&nbsp;Kevin Tran MS ,&nbsp;Alexander J. Trevarton PhD ,&nbsp;Michal Marczyk PhD ,&nbsp;Chunxiao Fu PhD ,&nbsp;Lili Du PhD ,&nbsp;Jiaxin Qu PhD ,&nbsp;Rosanna Lau MS ,&nbsp;Amy Tasto PhD ,&nbsp;Rebekah E. Gould MS ,&nbsp;Agata Tinnirello PhD ,&nbsp;Bruno V. Sinn MD ,&nbsp;Lajos Pusztai MD, PhD ,&nbsp;Christos Hatzis PhD ,&nbsp;W. Fraser Symmans MD","doi":"10.1016/j.jasc.2024.11.001","DOIUrl":"10.1016/j.jasc.2024.11.001","url":null,"abstract":"<div><h3>Introduction</h3><div>To optimize RNA sequencing (RNA-seq) outcomes, we investigated preanalytical variables in malignant effusions containing metastatic breast cancer. We compared 2 processing methods—Ficoll-Hypaque density gradient enrichment and CytoLyt hemolysis—focusing on their effects on RNA quality, transcript abundance, and variant detection from cytospin slides, relative to fresh-frozen samples. Additionally, we compared read-based and Unique Molecular Identifier (UMI)-based library preparation methods.</div></div><div><h3>Materials and methods</h3><div>Thirteen malignant effusion specimens from metastatic breast cancer were processed using both the Ficoll-Hypaque and Cytolyt methods. RNA was extracted from fresh-frozen samples stored in RNA preservative and from cytospin slides fixed in Carnoy's solution. RNA quality was evaluated using RNA integrity number (RIN) and the percentage of fragments &gt;200 bases (DV200). Sequencing was conducted with both read- and UMI-based methods.</div></div><div><h3>Results</h3><div>Purified RNA was more fragmented by the Cytolyt method (mean RIN: 3.56, DV200: 78.97%), compared to the Ficoll-Hypaque method (mean RIN: 6.29, DV200: 88.08%). Sequencing data had high concordance correlation coefficient (CCC) for measurements of gene expression, whether from Cytolyt or Ficoll-Hypaque treated samples, and whether using the UMI- or read-based sequencing methods (read-based mean CCC: 0.967 from Cytolyt versus 0.974 from Ficoll-Hypaque, UMI-based mean CCC: 0.972 from Cytolyt versus 0.977 from Ficoll-Hypaque).</div></div><div><h3>Conclusions</h3><div>Despite the increased RNA fragmentation with the Cytolyt, RNA-seq data quality was comparable across Cytolyt and Ficoll-Hypaque methods. Both clearing methods are viable for short-read RNA-seq analysis, with read and UMI-based approaches performing similarly.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 2","pages":"Pages 91-101"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819681","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 International System for Serous Fluid Cytopathology (TIS) survey in preparation for TIS 2.0","authors":"Daniel F.I. Kurtycz MD ,&nbsp;Barbara Crothers DO ,&nbsp;Fernando Schmitt MD, PhD ,&nbsp;Ivana Kholova MD, PhD ,&nbsp;Basile Maldant-Savary ,&nbsp;Panagiota Mikou MD, MSc, PhD ,&nbsp;Sachiko Minamiguchi MD ,&nbsp;Binnur Önal MD ,&nbsp;Esperanza Teuzaba MD ,&nbsp;Christopher J. VandenBussche MD, PhD ,&nbsp;He Wang MD, PhD ,&nbsp;Ashish Chandra MD, FRCPath, DipRCPath (Cytol)","doi":"10.1016/j.jasc.2024.12.001","DOIUrl":"10.1016/j.jasc.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>The International System for Serous Fluid Cytopathology (TIS) has gained acceptance and has led to literature validating original concepts and suggesting refinements. In preparation for the second edition of TIS, editors generated a survey to solicit experience with and opinions about TIS.</div></div><div><h3>Materials and methods</h3><div>An online survey available from March 8 to June 15, 2024, included 56 questions, offered in 7 languages, related to the practice of serous fluid cytopathology.</div></div><div><h3>Results</h3><div>A total of 598 respondents accessed the survey. Information was collected regarding certification, work setting, work volume and years in practice. In the respondent group, 78% (401 of 513) were pathologists, 18% (92 of 513) cytologists of cytotechnologists, 2% (10 of 513) trainees, and 2% (10 of 513) medical scientists. A total of 23% of participants came from academia. Also, 59% of respondents were (280 of 474) from Asia, 17% Europe, 12% North America, and 10% South America. In all, 61% (287 of 474) have adopted TIS. Over 50% issue a preliminary report awaiting ancillary test results. Another 20% issue such a report depending on circumstance. The most frequent request for refinement of criteria centered around Atypia of Uncertain Significance (AUS). Only small numbers of participants provided data on diagnostic category percentage and risk of malignancy (ROM); however, those that did reported a decrease in nondiagnostic and atypical results with corresponding decreases in ROM for those categories. Variable use of cytochemical and immunocytochemical stains for resolving mesothelial proliferations was reported. Respondents indicated a desire for incorporation of recommendations on clinical management and extension of TIS into body fluid types beyond pleural, pericardial, and peritoneal.</div></div><div><h3>Conclusions</h3><div>This survey examines acceptance of TIS and advice for future directions.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 2","pages":"Pages 110-122"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967228","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":"American Society of Cytopathology’s cytopathology workforce survey in the United States","authors":"Swati Satturwar MD ,&nbsp;Margaret Compton MD ,&nbsp;Daniel Miller MD, PhD ,&nbsp;Allison Goldberg MD ,&nbsp;Cindy McGrath MD ,&nbsp;Maria Friedlander MPA CT (ASCP) ,&nbsp;Anupama Sharma MD ,&nbsp;Poornima Hegde MD ,&nbsp;Carol A. Filomena MD ,&nbsp;Swati Mehrotra MD","doi":"10.1016/j.jasc.2024.12.003","DOIUrl":"10.1016/j.jasc.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>To assess the current state of the cytopathology workforce shortage in the United States.</div></div><div><h3>Materials and methods</h3><div>A survey comprising 32 questions was developed by the Government Affairs and Economic Policy Committee of the American Society of Cytopathology using Survey Monkey software. It was distributed to the American Society of Cytopathology membership through email, and the anonymous responses were compiled into an Excel spreadsheet.</div></div><div><h3>Results</h3><div>We received a total of 200 responses nationwide. Of these, 86.7% of respondents experienced a cytopathology/laboratory workforce shortage with 35.8% facing this issue for more two years. The most significant reported shortages were cytologists (72.1%) followed by histotechnologist (52.9%) and cytopreparatory personnel (47.1%). The impact of these shortages included stress (70.4%), patient care compromise, and job changes. The primary cause cited was noncompetitive salaries along with a decline in cytologist training programs. Other factors included job security concerns, increased workload, negative work culture, lack of flexibility, lack of appreciation, limited career growth opportunities, government policies, geographic location, retirements, and the COVID-19 pandemic. The most common reported mitigation strategies include redistributing work amongst the existing staff, outsourcing excess workload to a reference laboratory, and offering overtime. Additional measures included employing travel cytologists, cross-training technical staff from other areas of the laboratory, and assigning pathologists to perform technical tasks.</div></div><div><h3>Conclusions</h3><div>This study enhances the understanding of the cytopathology workforce shortage in the United States, including perceived reasons of the shortage. The results offer valuable insights and a foundation for future surveys or intervention studies aimed at addressing this issue.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 2","pages":"Pages 65-77"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013500","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}