Journal of the American Society of Cytopathology最新文献

{"title":"Patient-informed experiences in an interventional cytopathology clinic: how can we maximize patient satisfaction.","authors":"Nikka Khorsandi, Aaron Blevins, Elham Khanafshar","doi":"10.1016/j.jasc.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.04.004","url":null,"abstract":"<p><strong>Introduction: </strong>The pathologist-performed fine needle aspiration biopsy has been shown to be a diagnostically excellent study when performed by trained individuals. However, the patient perspective of pathology-performed fine needle aspiration biopsy, also known as interventional cytopathology, is less described.</p><p><strong>Materials and methods: </strong>This study investigates patient satisfaction at a single interventional cytopathology clinic between 2020 and 2023. The 34-question survey evaluated various aspects of patient satisfaction and included qualitative feedback to better understand factors contributing to patient satisfaction. Among the 682 survey respondents, the majority were Caucasian and English-speaking females ages 65-79 years, with either private insurance or Medicare.</p><p><strong>Results: </strong>Results demonstrated high satisfaction levels across all domains. Qualitative analysis identified key themes that improve patient satisfaction, including reduced anxiety, confidence in providers, perceived efficacy of the procedure, and overall procedural satisfaction.</p><p><strong>Conclusions: </strong>Based on these themes, we propose a conceptual model in which effective communication, a relaxed atmosphere, and thorough explanations play a crucial role in enhancing patient satisfaction. Our findings underscore the importance of patient-centered approaches in designing interventional cytopathology clinics. Clear communication between patients, providers, and care teams, along with adequate appointment time, is essential for improving patient experiences.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143984","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":"Performance characteristics of ThyroSeq, ThyGeNEXT/ThyraMIR, and Afirma molecular platforms in evaluation of 1252 cytologically-indeterminate thyroid nodules.","authors":"Courtney F Connelly, Marie C Smithgall, Niyati Desai, Adela Cimic, Swikrity U Baskota","doi":"10.1016/j.jasc.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.04.003","url":null,"abstract":"<p><strong>Introduction: </strong>The preoperative risk stratification of thyroid nodules with indeterminate cytology on fine needle aspiration has been streamlined with the application of molecular diagnostics. Most molecular platforms use genotyping and mRNA or microRNA expression profiling to assign a preoperative cancer risk to thyroid nodules.</p><p><strong>Materials and methods: </strong>In this study, we discuss the general methodology and compare the diagnostic accuracy of 3 commercially available molecular platforms, ThyroSeq, ThyGeNEXT/ThyraMIR, and Afirma, in the evaluation of 1252 cytologically indeterminate thyroid nodules.</p><p><strong>Results: </strong>Molecular evaluation showed an increased malignancy risk in 28.7% of cases. Of all cases, 209 underwent partial or complete thyroid resection. 34.9% of these resected thyroid nodules were benign and non-neoplastic, 16.3% were benign neoplasms and 48.8% were malignant neoplasms. 5.5% (n = 49) of cases with negative molecular testing were found to have a neoplasm on subsequent thyroid resection. 40.8% of these cases showed benign neoplasms and 59.2% showed a malignant neoplasm.</p><p><strong>Conclusions: </strong>The ThyroSeq, ThyGeNEXT/ThyraMIR, and Afirma molecular platforms demonstrate similar efficacy in ruling out malignancy in our cohort's cytologically indeterminate thyroid nodules, with sensitivities of 87.5%, 66.7%, and 73.1%, respectively, and negative predictive values of 80.0%, 70.0%, and 66.0%, respectively. Overall performance characteristics of these molecular platforms in our study are inferior to some previously published studies.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095218","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 Reporting Serous Fluid Cytopathology survey data reveal substantial variability in the reporting and utilization of pelvic washing and peritoneal fluid specimens among pathologists and gynecologic oncologists.","authors":"Christopher J VandenBussche, Amanda Jackson, Zaibo Li, Chengquan Zhao, Ashish Chandra, Fernando Schmitt, Daniel F I Kurtycz, Barbara Crothers","doi":"10.1016/j.jasc.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.04.002","url":null,"abstract":"<p><strong>Introduction: </strong>Pelvic and peritoneal washings (PW) are often taken during gynecologic resections when the presence of a neoplastic process is known or suspected. A positive PW may upstage a patient and/or impact a patient's prognosis and treatment. Two surveys were created to inform The International System for Serous Fluid Cytology, a standardized reporting system, regarding the practice and utilization of PW cytology.</p><p><strong>Materials and methods: </strong>Pathologists and cytotechnologists (n = 475) responded to a survey which examined their reporting preferences. Gynecologic oncologists (GONC) (n = 168) answered a separate survey which examined how they utilized PW specimens.</p><p><strong>Results: </strong>Most pathologists/cytotechnologists felt that bland-appearing epithelial cells of unknown origin should be classified as benign. Most favored reporting psammomatous calcification without associated epithelial cells as benign (64.1%), whereas 8.6% did not report this finding at all, 20.5% would report as atypical, and 6.8% would report as suspicious of a neoplasm. Most GONCs (63.9%) routinely obtained PW specimens during endometrial cancer staging; of those, 53% reported that a positive cytology result could change their management. Sixty-six percent of GONCs indicated that they treat indeterminate PW results as negative. Others indicated that an indeterminate PW may result in review of slides with the pathologist, counseling the patient, and/or closer observation. Most GONCs did not find utility in the reporting of psammomatous calcifications, presence of mucin, atypical cells favored to be benign, endometrial cells, or iatrogenic material.</p><p><strong>Conclusions: </strong>Substantial variability exists among pathologists in how PW specimens are reported, as well as how gynecologic oncologists utilize these specimens.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080325","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":"Comparison of fluorescence in situ hybridization and cytology for the accurate detection of malignant biliary strictures, with emphasis on unusual results.","authors":"Beena U Ahsan, Michelle Jin, Brian K Theisen, Sumit Singla, Dhananjay Chitale, Brandon Shaw, Nazila Azordegan, Zhengfan Xu, Daniel Schultz, Ziying Zhang","doi":"10.1016/j.jasc.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.04.001","url":null,"abstract":"<p><strong>Introduction: </strong>Biliary brushing cytology is the standard diagnostic approach for evaluating biliary strictures, but it has low sensitivity and a high rate of atypical diagnoses. Fluorescence in situ hybridization (FISH) has become an increasingly valuable adjunct to cytology. Therefore, the aim of this retrospective quality improvement study was to evaluate the relative diagnostic performance of traditional cytology and FISH for correctly determining malignant versus benign biliary strictures from biliary brushing samples and to evaluate whether adding FISH to the diagnostic pipeline improves diagnostic accuracy over relying on cytology alone.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study of biliary brushing and FISH results in patients evaluated for biliary strictures between April 2019 and March 2023.</p><p><strong>Results: </strong>A total of 228 specimens were retrieved. For cytology results: 151 negative, 55 atypical, 6 suspicious, and 16 positive. For FISH results: 105 negative, 71 equivocal, and 52 positive. When calculating performance measures, cytology atypical and FISH equivocal were excluded; cytology suspicious was considered positive. The sensitivity and specificity of cytology were 45.8% and 100%, respectively. The sensitivity and specificity of FISH were 84.2% and 96.0%, respectively.</p><p><strong>Conclusions: </strong>Our findings indicate that FISH exhibits considerably higher diagnostic sensitivity than routine cytology in identifying malignant biliary strictures. Furthermore, combining cytology with FISH may provide a more comprehensive diagnostic approach, reducing the likelihood of false-negative results. However, positive and equivocal FISH results should be interpreted carefully and considered alongside more specific cytology findings to minimize the risk of false-positive diagnoses.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031661","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":"Human papillomavirus genotype distribution and its correlation with intraepithelial neoplasia, vaccination, and ethnicity.","authors":"Rita Abi-Raad, Tong Sun, Uma Krishnamurti","doi":"10.1016/j.jasc.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.03.006","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer is primarily attributed to high-risk human papillomavirus (HPV), specifically genotypes 16 and 18. The introduction of HPV vaccines aimed to reduce the incidence of cervical cancer.</p><p><strong>Materials and methods: </strong>This study reviewed cases of High-Grade Squamous Intraepithelial Lesion (HSIL) and Atypical Squamous Cells Cannot Exclude HSIL (ASC-H) with positive high-risk HPV and HPV genotyping data. The prevalence of HPV genotypes 16/18 and non-16/18 was compared in cases with high-grade intraepithelial neoplasia (IN2+), across different ethnicities and with HPV vaccination status.</p><p><strong>Results: </strong>A total of 274 patients (94 HSIL and 180 ASC-H) were evaluated. HPV non-16/18 was significantly more prevalent in ASC-H (68%) than in HSIL patients (50%); (P = 0.003). HPV non-16/18 was more common in cases without -IN2+ (69%), but a significant proportion of IN2+ cases were also positive for non-16/18 HPV genotypes (56%); (P = 0.04). Overall, HPV non-16/18 was more prevalent in all ethnic groups. There was a trend to a higher prevalence in non-white and vaccinated compared with white and nonvaccinated women respectively, but the difference was not significant.</p><p><strong>Conclusions: </strong>HPV non-16/18 genotypes are more prevalent than HPV 16/18, even in women with high-grade lesions with a greater shift towards non-16/18 genotypes in non-white and in vaccinated women. The study suggests the need for extended HPV genotyping and vaccines targeting a broader range of HPV types to include HPV non-16/18 to improve prevention, particularly in certain ethnic groups.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050090","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":"Optimizing tissue adequacy for next-generation sequencing in small biopsies and fine-needle aspirations for nonsmall cell lung cancer: a root cause analysis and proposed solutions.","authors":"Liang Ding, Brittney Thiele, Angela Sorenson, Ying-Chun Lo, Joshua Deignan, Yajue Huang","doi":"10.1016/j.jasc.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.03.005","url":null,"abstract":"<p><strong>Introduction: </strong>Molecular testing is essential for managing advanced nonsmall cell lung cancer, yet up to 40% of biopsies can be inadequate due to insufficient tissue. This study aimed to identify causes of inadequate sampling through fine needle aspiration (FNA) and core needle biopsy (CNB) and propose solutions.</p><p><strong>Materials and methods: </strong>We analyzed 96 patients undergoing endobronchial ultrasound (EBUS)-guided FNA or CNB for nonsmall cell lung cancer, alongside 44 patients with CT-guided CNB. All patients were tested using the MayoComplete Solid Tumor Panel, a comprehensive next-generation sequencing assay. A root cause analysis identified factors affecting tissue adequacy, such as needle size, pass numbers, and specimen types.</p><p><strong>Results: </strong>Among EBUS biopsies, 35.3% of cases with FNA smears were inadequate, compared to 20% for CNB alone. The combination of both smears and tissue cores had the highest adequacy rate, with only 11.4% inadequacy for next-generation sequencing. We investigated the discrepancy between lymph nodes and lung tissue by examining nonpulmonary lymph nodes, liver, and soft tissue biopsies. Lymph node CNB had a 30% inadequacy rate, while liver and soft tissue showed 14.3% and 15.4%, indicating that lymph node heterogeneity may affect tissue adequacy. For CT-guided CNB, cases with 5 or more passes showed 85% adequacy, increasing to 100% with over 7 passes.</p><p><strong>Conclusions: </strong>Combining CNB with EBUS FNA improves sample adequacy, especially for lymph nodes. We recommend these approaches to optimize tissue yield for molecular testing, aiding timely therapy initiation and reducing repeat biopsies. Smaller gene panels may also be useful when tissue is limited.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989689","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":"Oncocytic subtype of well differentiated neuroendocrine tumor: clinicopathologic and molecular associations of a cohort diagnosed on fine needle aspiration (FNA).","authors":"Wen-Yu Hsiao, Shannon M O'Brien, Fareed Rajack, Talaat Tadros, Michelle D Reid","doi":"10.1016/j.jasc.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.jasc.2025.03.004","url":null,"abstract":"<p><strong>Introduction: </strong>Classical well differentiated neuroendocrine tumors (C-NETs) have plasmacytoid morphology and neuroendocrine differentiation. Oncocytic NETs (O-NETs) have been shown to be more clinically aggressive. Whether O-NETs are more akin to C-NETs or poorly differentiated neuroendocrine carcinomas (PDNECs) is not established.</p><p><strong>Materials and methods: </strong>Clinicopathologic characteristics and immunohistochemical expression of death domain-associated protein (DAXX), α-thalassemia/mental retardation syndrome X-linked genes (ATRX), retinoblastoma 1, p53, and SMAD4 in 30 O-NETs (25 pancreatic and 4 from luminal gastrointestinal tract) was compared to 32 C-NETs (23 pancreatic and 8 from luminal gastrointestinal tract). Whole exome sequencing was performed in a subset of each cohort.</p><p><strong>Results: </strong>O-NETs were male-predominant (65.6%) and had higher mean Ki-67 index (7.4% versus 2.9% in C-NETs) (P = 0.03), corresponding to more grade 2 or above (53.3%) tumors. O-NET patients had more advanced disease (pT3/pT4, 75% versus 36.8%) (P = 0.024), distant metastasis (50% versus 25%) (P = 0.042), progression (increased size/recurrence/new metastases) (n = 8 versus 3; P = 0.1), and death (n = 3 versus 1; P = 0.32). Forty percent of O-NETs (versus 12.5% of C-NETs; P = 0.041) showed DAXX/ATRX loss, with one showing coexisting retinoblastoma 1 and SMAD4 loss. P53 staining pattern was wild type in all cases. Whole exome sequencing of 10 cases showed DAXX, ATRX, and multiple endocrine neoplasia type 1 alterations in O-NETs and C-NETs, and coexisting DNMT3A and MTOR alterations in one O-NET.</p><p><strong>Conclusions: </strong>O-NET subtype is associated with advanced disease and unfavorable outcomes compared to C-NETs. O-NETs are cytologically distinct, male-predominant tumors that often present with higher grade and advanced disease. Their aggressive behavior is possibly related to frequent DAXX/ATRX loss and less likely PDNEC-related molecular alterations. Pathologists should be mindful of this aggressive morphologic subtype and clearly convey its presence in pathology reports.</p>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001657","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":"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}