Journal of the American Society of Cytopathology最新文献

{"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}

{"title":"Primary tumor characteristics and immunohistochemical profile of renal cell carcinoma in serous fluid cytology","authors":"Mason Marshall DO ,&nbsp;Sigfred Lajara MD ,&nbsp;Gabriela Quiroga-Garza MD ,&nbsp;Dimitrios Korentzelos MD ,&nbsp;Maedeh Mohebnasab MD ,&nbsp;Samer Khader MD","doi":"10.1016/j.jasc.2024.11.002","DOIUrl":"10.1016/j.jasc.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma (RCC) involves serosal surfaces in 2%-3% of cases, and thus few papers describe serous fluid cytology (SFC) involvement by RCC. This diagnosis is challenging, given its rarity, nondescript cytomorphologic features and infrequent expression of widely used epithelial markers MOC31 and BerEP4. We describe our institutional experience with RCC in SFC specimens.</div></div><div><h3>Materials and methods</h3><div>Our institutional laboratory information system was queried for SFC specimens from patients with RCC between 2013 and 2023. Cases signed out as “Suspicious for Malignant Cells” and “Positive for Malignant Cells” were included. Patient demographics, immunohistochemical results, primary tumor characteristics, and molecular data were recorded.</div></div><div><h3>Results</h3><div>Sixty-one cases, 50 pleural, and 11 peritoneal fluid specimens were identified. Fifty (50) were signed out as positive for malignancy and 11 were signed out as suspicious for malignancy. MOC31 and BerEP4 were positive in 59% and 55% of cases, respectively. PAX-8, CA9, CD10, and RCC were positive in 85%, 82%, 73%, and 29% of cases, respectively. Primary tumor histologic subtypes included 39 clear cell, 6 papillary, 1 chromophobe, and 15 were not further subclassified. Fifty-nine percent (59%) of cases had a nuclear grade of 4%, and 37% had sarcomatoid or rhabdoid differentiation. Seventy-one percent (71%) of cases had stage 3 or 4 disease.</div></div><div><h3>Conclusions</h3><div>RCC metastases to serosal surfaces are more likely to be seen in patients with higher disease stage, high nuclear grade, and sarcomatoid or rhabdoid differentiation. MOC31 and BerEP4 performed poorly in this setting. We recommend the addition of cytokeratins, PAX-8, CD10, and CA-9 to confirm metastatic involvement.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 2","pages":"Pages 123-131"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847959","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":"Clinicoradiological Predictors of Malignancy in the Atypical Category by the Yokohama System for Reporting Breast Fine-Needle Aspiration Cytopathology","authors":"Possawat Peungkiatpairote MD ,&nbsp;Sayanan Chowsilpa MD","doi":"10.1016/j.jasc.2025.01.006","DOIUrl":"10.1016/j.jasc.2025.01.006","url":null,"abstract":"<div><h3>Introduction</h3><div>The atypical category (AC) by the Yokohama system is an indeterminate group characterized by predominantly benign cytomorphology of the lesions, with some uncommon features that may be seen in malignancy in breast fine-needle aspiration. The risk of malignancy (ROM) varies from 13% to 25%. Its management depends on the clinical and radiological findings. Since most cases are benign, selecting cases for further management may benefit patients. This study aims to determine the clinicoradiological predictors for malignancy in AC breast cytology.</div></div><div><h3>Materials and Methods</h3><div>All AC breast fine-needle aspirations at Chiang Mai University Hospital from 2015 to 2019 were selected from an electronic database for cyto-histological correlation and ROM calculation. The clinicoradiological factors calculated by ROM were analyzed using multivariable logistic regression for malignant prediction and screening scores.</div></div><div><h3>Results</h3><div>There were 218 aspirates from patients aged 15-77 years. The lesion size ranged from 0.2 to 9.2 cm. The ROM was 27.5%. The significant predictors were age ≥40 years (<em>P</em> = 0.03), lesion size ≥1 cm (<em>P</em>&lt; 0.01), and suspicious calcification on imaging (<em>P</em> &lt; 0.01). The ROM was numerically increased in Breast Imaging-Reporting and Data System 5. The screening score showed 88.3% sensitivity, 55.1% specificity, 42.7% positive predictive value, and 92.6% negative predictive value.</div></div><div><h3>Conclusions</h3><div>The AC diagnosis varies from benign to malignant. Age ≥40 years, a lesion size ≥1 cm, and suspicious calcification/Breast Imaging-Reporting and Data System 5 are useful predictors of malignancy. Selecting cases according to screening scores can reduce invasive procedures by up to 43.1%.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 3","pages":"Pages 170-181"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634758","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":"ROSE on small-cell lung carcinoma involvement of mediastinal lymph nodes: Performance evaluation at our institution","authors":"Xiaofeng Zhao MD, PhD,&nbsp;Suad Taraif MD, MBA,&nbsp;Aileen Grace Arriola MD","doi":"10.1016/j.jasc.2025.01.005","DOIUrl":"10.1016/j.jasc.2025.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Recognition of lymph node involvement by small-cell lung carcinoma (SCLC) is challenging, especially during rapid onsite evaluation (ROSE). This distinction might carry clinical significance especially for staging and potential therapy.</div></div><div><h3>Materials and methods</h3><div>Cases with ROSE of lymph nodes for assessment of involvement by SCLC between 2020 and 2024 at our institution were reviewed. Adequacy evaluation results were correlated with the final diagnosis. Smears used during ROSE from cases with diagnostic discrepancies between ROSE and final diagnosis were retrieved for additional review. Interpretation accuracy was measured, and useful features for recognizing SCLC and possible contributing factors for misrecognition were studied.</div></div><div><h3>Results</h3><div>The majority of the cases show concordance between ROSE interpretation and the final review. Most discrepancies are due to under-recognition of scant SCLC cells from background lymphocytes or abundant necrosis. Rapid Papanicolaou-stained smears showed better sensitivity and specificity for recognizing SCLC cells than Diff-Quick stain during ROSE. Pathologists in practice for a longer period (&gt;5 years) are more likely to accurately distinguish the carcinoma cells. Shorter time seems to have been spent onsite for evaluation of cases with under-recognized SCLC cells, but the association is not statistically significant.</div></div><div><h3>Conclusions</h3><div>Accurately recognizing lymph node involvement by SCLC during ROSE is important for timely diagnosis, triage, and management of cases. Several cytologic features should be utilized for accurately distinguishing SCLC cells from lymphocytes. Experience gained with practice increases diagnostic accuracy during ROSE, and rushing should be avoided. Knowledge of clinical impression and clear communication with clinicians should always be encouraged.</div></div>","PeriodicalId":38262,"journal":{"name":"Journal of the American Society of Cytopathology","volume":"14 3","pages":"Pages 191-198"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504663","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}