Journal of the American Society of Cytopathology最新文献

{"title":"Cytologic testing for mismatch repair deficiency/microsatellite instability and NTRK gene fusion is not routinely indicated in primary pancreaticobiliary carcinoma cell block material","authors":"Courtney F. Connelly MD ,&nbsp;William S. Towne MD ,&nbsp;Niyati Desai MD ,&nbsp;Marie C. Smithgall MD, PhD ,&nbsp;Adela Cimic MD ,&nbsp;Swikrity U. Baskota MD","doi":"10.1016/j.jasc.2024.08.130","DOIUrl":"10.1016/j.jasc.2024.08.130","url":null,"abstract":"<div><h3>Introduction</h3><div>Pancreaticobiliary carcinomas rarely harbor targetable genetic alterations, including microsatellite instability (MSI) or neurotrophic tyrosine receptor kinase (<em>NTRK</em>) gene fusions. As these malignancies are typically present at an advanced stage and have suboptimal response to chemotherapy, the discovery of an actionable genomic alteration provides an additional avenue of treatment for chemotherapy-refractory cases.</div></div><div><h3>Materials and methods</h3><div>In this study, we evaluate 319 cases of pancreaticobiliary carcinoma diagnosed on fine-needle aspiration biopsy or biliary brushing for DNA mismatch repair (MMR) protein deficiency and pan-TRK overexpression by immunohistochemistry (IHC) and compare these results to MSI and <em>NTRK</em> gene fusion molecular testing.</div></div><div><h3>Results and Conclusion</h3><div>Although we find a high concordance between MMR protein IHC and MSI molecular testing in the evaluation of MMR deficiency and between pan-TRK IHC and <em>NTRK</em> fusion testing by next-generation sequencing, the low prevalence of either of these genetic alterations in our cohort casts doubt on the value of screening cases of pancreaticobiliary carcinoma for MMR protein deficiency and <em>NTRK</em> fusions.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Pages 413-419"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of serous fluid volume on next-generation sequencing: a significant step forward for optimization of serous fluid sample collection","authors":"Shaham Beg MD,&nbsp;Kemin Xu MD,&nbsp;James P. Solomon MD,&nbsp;Susan A. Alperstein CT (ASCP),&nbsp;Momin T. Siddiqui MD","doi":"10.1016/j.jasc.2024.07.001","DOIUrl":"10.1016/j.jasc.2024.07.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Current literature lacks data regarding the influence of serous fluid volume (SFV) on next-generation sequencing (NGS) performed on malignant cases. In this study, we highlight the impact of SFV and other parameters influencing the outcome of NGS analysis.</div></div><div><h3>Materials and methods</h3><div>We evaluated 827 samples of serous fluids from 607 patients. Of these, 72 samples underwent NGS analysis. Effusion volume, tumor cellularity, DNA, and RNA quality metrics, as well as clinicopathologic and molecular data were evaluated. Pleural fluid accounted for 56.3% of the fluid samples collected. The most common primary tumor site was gastrointestinal/pancreatobiliary, adenocarcinoma was the most common histologic type. Overall mean volume was 293 mL. The mean Qubit DNA of the 72 effusion samples that underwent NGS analysis was 14.3 ng/μL and mean Qubit RNA was 28.2 ng/μL. The mean Qubit DNA concentration increases in SFV up to 100 mL only.</div></div><div><h3>Results</h3><div>No correlation exists between SFV and mean tumor cellularity. In addition, 74.6% (50 of 67) of sequenced samples showed oncogenic drivers; <em>KRAS</em> was the most common driver followed by <em>EGFR.</em> Three cases displayed <em>ALK</em> fusions, and 1 case displayed <em>NTRK1</em> fusion. The DNA yield is higher in SFV of 100 mL as a cutoff. Beyond 100 mL, there is no impact of SFV on DNA yield. SFV does not impact RNA yield and mean tumor cellularity. Effusion samples should be submitted for molecular testing despite low tumor cellularity.</div></div><div><h3>Conclusions</h3><div>Our results as a pilot study are important in optimization of SFV for both diagnosis as well as NGS analysis for improving management.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Pages 397-405"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699791","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":"Cytopathology and clinicopathological correlation of renal neuroendocrine neoplasms","authors":"Xiaoqi Lin MD, PhD ,&nbsp;Tatjana Antic MD ,&nbsp;Tieying Hou MD ,&nbsp;Behtash G. Nezami MD","doi":"10.1016/j.jasc.2024.06.001","DOIUrl":"10.1016/j.jasc.2024.06.001","url":null,"abstract":"<div><h3>Introduction</h3><div>There is a lack of documentation regarding cytopathology<span> of renal neuroendocrine neoplasms (NENs) due to their rarity.</span></div></div><div><h3>Materials and methods</h3><div>Five cytology cases were gathered from 3 institutes.</div></div><div><h3>Results</h3><div><span><span><span><span>Cohort consisted of 4 females and 1 male. Fine needle aspiration biopsy and touch preparation slides of </span>core needle biopsy revealed cellular samples, composed of round, plasmacytoid, or columnar cells. Tumor cells were present in nested, acinar, 3D cluster, and individual cell patterns. Tumor cells in 3 cases exhibited uniformly round to oval small nuclei with inconspicuous </span>nucleoli, finely granular chromatin, and smooth </span>nuclear membranes<span><span>, whereas 2 other cases showed pleomorphic nuclei with conspicuous nucleoli, nuclear molding, and irregular nuclear membranes. Tumor cells displayed pale or granular cytoplasm, with 1 case showing small </span>vacuoles<span>. Examination of cores and cell blocks demonstrated tumor cells in sheets, nests, or acini. All tumor cells were positive for neuroendocrine immunomarkers. Based on mitotic count, Ki-67 index and morphology, 3 tumors were graded as well-differentiated neuroendocrine tumor (WDNET) (1 grade [G] 3, 1 G2, 1 G1) and 2 as </span></span></span>large cell neuroendocrine carcinoma<span><span>. Deletion of 7q, 10q, and 19q was detected in WDNETs. Two patients with large cell neuroendocrine carcinoma and 1 with WDNET G3 underwent chemotherapy due to aggressiveness, whereas nephrectomy was performed for patients with WDNET G1 and 2 without </span>metastasis.</span></div></div><div><h3>Conclusions</h3><div>Cytopathological characteristics of renal NENs closely resemble those affecting other organs. Despite its rarity, renal NENs should be kept in mind when confronted with morphological resemblances to NENs, to prevent misdiagnosis and inappropriate therapeutic interventions.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Pages 406-412"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141413052","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":"Accuracy and efficacy of Ion robotic-assisted bronchoscopic fine needle aspiration of lung lesions","authors":"Bernadette M. Boac MD ,&nbsp;Manita Kanathanavanich MD ,&nbsp;Xiaomo Li MD ,&nbsp;Taryne Imai MD ,&nbsp;Xuemo Fan MD, PHD ,&nbsp;Ann E. Walts MD ,&nbsp;Alberto M. Marchevsky MD ,&nbsp;Shikha Bose MD","doi":"10.1016/j.jasc.2024.08.129","DOIUrl":"10.1016/j.jasc.2024.08.129","url":null,"abstract":"<div><h3>Introduction</h3><div>The Ion Endoluminal Platform (ION) (IEPI Intuitive, Sunnyvale, CA), a minimally invasive robotic-assisted bronchoscopy platform, was recently US Food and Drug Administration approved for the performance of fine needle aspirations (FNAs) and biopsies of peripheral lung lesions. Rapid on-site intraoperative diagnosis (IOD) of FNAs and/or frozen section of biopsies help surgeons confirm adequate sampling of the targeted lesion and allow definitive treatment in selected cases.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed our experience with all FNAs of lung lesions sampled by interventional pulmonologists and thoracic surgeons using Ion from September 2020 to December 2022. IOD rendered during adequacy assessment were compared with final cytology diagnoses (Cyto-FD) and the ultimate final diagnoses (U-FD). The U-FD was based on the sum of all clinical, imaging, cytologic, and histologic diagnoses of the lung lesion which the clinical team used to treat the patient.</div></div><div><h3>Results</h3><div>The IOD and Cyto-FD were concordant in 62% of the 423 lesions that underwent intraoperative evaluation, yielding a sensitivity of 67% and a specificity of 99% for malignancy. The Cyto-FD and U-FD were concordant in 51% of the lesions with a sensitivity and specificity for malignancy of 66% and 100%, respectively.</div></div><div><h3>Conclusions</h3><div>IODs rendered during Ion were highly accurate but only moderately sensitive for a diagnosis of malignancy.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Pages 420-430"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297544","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":"Cervical cytology in endometrial cancer patients with Lynch syndrome: opportunities for early detection and limitations","authors":"Yongsang Park MD ,&nbsp;Megan E. Dibbern MD ,&nbsp;Kari L. Ring MD ,&nbsp;Anne M. Mills MD","doi":"10.1016/j.jasc.2024.08.002","DOIUrl":"10.1016/j.jasc.2024.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Timely detection of endometrial carcinoma in Lynch syndrome patients ensures prompt treatment and appropriate cancer screening for the patient and impacted family members. While cervical cytology is utilized primarily in cervical cancer screening, endometrial glandular abnormalities can be identified as part of routine cervical cancer screening or during work-up for abnormal uterine bleeding.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively evaluated cervical cytology samples from Lynch syndrome patients with endometrial carcinoma to determine how often atypical/malignant glandular cells were identified on prior/concurrent cytology.</div></div><div><h3>Results</h3><div>We identified 14 Lynch syndrome patients with cervical cytology available within a year of endometrial carcinoma diagnosis. The average patient age was 55 years (36-73). Cervical cytology preceded diagnostic biopsy in 57% and was concurrent in 43%. A glandular abnormality was identified on original diagnosis in 43% and ranged from atypical glandular cells (AGC), not otherwise specified to adenocarcinoma consistent with endometrial primary. In 4 cases, abnormal cervical cytology triggered the subsequent biopsy. Evaluation of 8 cases with accessible cytology slides revealed 2 previously unrecognized glandular abnormalities, leading to an abnormal rate of 63% among cases reviewed retrospectively and a final glandular abnormality detection rate of 57% based on either original or review diagnosis.</div></div><div><h3>Conclusions</h3><div>In summary, abnormal glandular cells were commonly identified in endometrial cancer patients with Lynch syndrome and led to endometrial cancer work-up and diagnosis in a subset. These results suggest that cervical cytology may have utility in endometrial cancer screening in this population and indicate that awareness of the patient’s familial cancer risk is important for maximizing sensitivity of this test. They also caution against primary human papillomavirus screening in the Lynch syndrome population, as this may result in missed opportunities for early endometrial carcinoma detection among these high-risk individuals.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Pages 438-443"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146497","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":"Investigating first instinct fallacy in cytology education and cytomorphology examination","authors":"Paul Z. Chiou DrPH, MPH, SCT(ASCP) ,&nbsp;Yuane Jia PhD","doi":"10.1016/j.jasc.2024.07.004","DOIUrl":"10.1016/j.jasc.2024.07.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The specific aims of the study are to assess whether answer changing on a high-stakes cytomorphology examination will lower the cytology examinees’ scores and to examine whether there is a difference in the frequency of responses changed between high-, average-, and low-performing cytology learners. The paper also seeks to explore if there is a correlation between outcomes of answer changes (success rates) and cytology learner’s levels of performance.</div></div><div><h3>Materials and methods</h3><div>The eraser marks and pen cross-outs on the cytology final image examinations from 2019-2023 were reviewed and the number of changes made by the examinees and the frequency to which scores were raised or lowered as a result was recorded. Moreover, the response change patterns and outcomes across low-, medium-, and high-performing cytology learners were further analyzed for possible relationships.</div></div><div><h3>Results</h3><div>Among the total number of questions where answer(s) were changed (n = 98), close to half (n = 47, 48.0%) of the changes resulted in raising the score, compared with about one-third (n = 34, 34.7%) that lowered it. When the students were classified into academic abilities, there was a significant correlation between the success rates of answers changed across low-, medium-, and higher-performing learners χ² (df = 24, n = 24) = 10.24, <em>P</em> &lt; 0.05. Our data also showed the average student group to have the highest “scores raised” to “scores lowered” ratio.</div></div><div><h3>Conclusions</h3><div>Based on these findings, those cytology examinees who are overly cautious about changing initial responses during a high-stake multiple-choice question BOC test may put themselves at a disadvantage.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Pages 451-456"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum regarding missing Declaration of Competing Interest statements in previously published articles","authors":"","doi":"10.1016/j.jasc.2024.07.002","DOIUrl":"10.1016/j.jasc.2024.07.002","url":null,"abstract":"","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Page 458"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735249","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 effect of carbomer versus noncarbomer lubricant on the adequacy of cervical cytology specimens","authors":"Megan E. Lander MD ,&nbsp;Kristina Feldman DO ,&nbsp;Barry Perlman DO ,&nbsp;Patricia Greenberg MS ,&nbsp;Debra S. Heller MD ,&nbsp;Mark H. Einstein MD, MS ,&nbsp;Jenna Z. Marcus MD","doi":"10.1016/j.jasc.2024.07.003","DOIUrl":"10.1016/j.jasc.2024.07.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Cervical cytology remains a critical screening tool for cervical cancer. While various factors can influence cytology quality, the effect of lubricant type used during specimen collection has been previously studied with inconclusive results. This study aimed to evaluate the impact of surgical lubricant on cervical cytology results and elucidate risk factors associated with unsatisfactory results. We hypothesized that switching from a carbomer-containing lubricant to a noncarbomer, water-soluble lubricant would improve specimen adequacy in cervical cytology.</div></div><div><h3>Materials and methods</h3><div>A retrospective chart review was performed examining patient cytologic results from January to December 2017 at a single academic institution. After historical rates of unsatisfactory cytology were higher than acceptable standards, the practice changed lubricant formulation from a carbomer containing lubricant to a noncarbomer, water soluble lubricant. Demographic data and treatment characteristics were collected for eligible patients. Matched analysis was performed to examine factors associated with an unsatisfactory cytology result.</div></div><div><h3>Results</h3><div>After the change in lubricant, there was a significant decline in the rates of unsatisfactory cytology from 9.6% to 5.7%, <em>P</em> = 0.01. This decline was also observed when patients were matched based on menopausal status, personal history of gynecologic malignancy, pregnancy status, and cytology specimen type (10.0% to 4.8%, <em>P</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>Change in lubricant from a carbomer containing to noncarbomer, water soluble product was associated with a statistically significant decline in the rates of unsatisfactory cytology. Although prior data have had mixed results as to the etiology of unsatisfactory cytology, we feel that this directly contributed to the high rates observed at our institution.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Pages 444-450"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689260","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":"Erratum regarding missing informed consent disclosure statements in previously published articles","authors":"","doi":"10.1016/j.jasc.2024.09.002","DOIUrl":"10.1016/j.jasc.2024.09.002","url":null,"abstract":"","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Page 457"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297545","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":"Evolving concepts in thyroid cytology","authors":"N. Paul Ohori MD","doi":"10.1016/j.jasc.2024.08.127","DOIUrl":"10.1016/j.jasc.2024.08.127","url":null,"abstract":"<div><div>Concepts in thyroid diagnostics are evolving. As cytopathologists, we benefit from understanding the changes taking place in cytopathology practice as well as intersecting areas that may have implications for us. In this review, we discuss recent changes to 1. Classification systems, 2. Ancillary molecular testing modalities, and 3. Key metrics that affect thyroid cytopathology. The recent World Health Organization, Bethesda Thyroid Cytopathology, and American Joint Committee on Cancer classification systems have aspects that are designed to harmonize the clinical, cytopathologic, histomorphologic, and molecular findings for improved communication and patient management. New terminologies such as thyroid follicular nodular disease and low-risk follicular cell-derived thyroid neoplasms are introduced to reflect the subtle biologic nuances involving benign non-neoplastic and low-grade neoplastic conditions. The Bethesda Thyroid Cytopathology System has simplified its terminology, updated risk of malignancy estimates, and expanded the discussions on molecular testing, clinical and imaging assessments, and pediatric cytopathology. There is now a single term for each of the 6 diagnostic categories. The American Joint Committee on Cancer has refined the staging criteria to provide improved stratification of patient prognostication. Molecular testing using next-generation technology now offers large panels of markers that are sensitive for detecting the wide range of thyroid neoplasms. These panels were developed in North America and whether other regions of the world will choose similar tests remain to be seen. Finally, metrics such as molecular-derived risk of malignancy and molecular risk group may be viewed as surrogates of resection information and used to complement diagnostics, management, and quality assurance.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"13 6","pages":"Pages 389-396"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297546","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}