Journal of Cytology最新文献

{"title":"Non Pathogenic Fungal Contaminants in Cytological Specimens: Beware the Imitation.","authors":"Neha Kawatra Madan, Meetu Agrawal, Vyomika Teckchandani, V Shaktivel, Malini R Capoor, Sutapa Das","doi":"10.4103/joc.joc_45_25","DOIUrl":"10.4103/joc.joc_45_25","url":null,"abstract":"<p><strong>Context: </strong>Identification of nonpathogenic fungal contaminants is of utmost importance to ensure diagnostic accuracy in cytology. At times, these elements mimic pathogenic organisms and mislead the cytologist. In this study, we share our experience with the presence of various fungal contaminants in cytology slides that pose frequent diagnostic challenges.</p><p><strong>Aim/objective: </strong>The main objective of this study was to identify nonpathogenic fungal contaminants in cytopathology specimens.</p><p><strong>Materials and methods: </strong>Records of all cytology specimens (fluids, PAP smears, and FNA samples) received in our institute over a period of 1-year were included in the initial analysis. Fluid samples showing presence of fungal elements included non-sterile and sterile fluids such as bronchoalveolar lavage, gastric lavage, urine, CSF, synovial fluid, pleural, pericardial, and ascitic fluids. Apart from these, their presence was noted in conventional and liquid based cervical cytology specimens. Most of these cases had microbiological culture correlation. Simultaneously, the glass slides and reconstituted stains in our lab were also tested for the presence of fungi.</p><p><strong>Statistical analysis used: </strong>The percentage of samples showing positive fungal elements was calculated.</p><p><strong>Results: </strong>More than 11,000 cytology specimens were received over a span of 1 year in sterile containers and smears were prepared from various clinical specialities. The most common contaminants identified were Fusarium species. The second most prevalent contaminant was Alternaria, which may be causative agent of phaeohyphomycosis. Microbiological cultures of these specimens were often negative but yielded respective fungal species at other times.</p><p><strong>Conclusion: </strong>Fungal contaminants were observed to be the most ubiquitous and mischievous imitators which can perplex the cytologists.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 4","pages":"199-203"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Analysis of Various Cytopreparatory Techniques in Evaluation of Serous Effusion Fluids.","authors":"Kuchanur Vidya, K Byranahalli SunilKumar, Patil Appu","doi":"10.4103/joc.joc_104_25","DOIUrl":"10.4103/joc.joc_104_25","url":null,"abstract":"<p><strong>Background: </strong>Cytological evaluation of serous fluids is a widely used diagnostic tool, especially when other methods are not feasible. Differentiating benign from malignant effusions is essential for guiding prognosis and treatment. However, distinguishing reactive mesothelial cells from malignant cells remains a key challenge, particularly with conventional smear (CS) techniques.</p><p><strong>Objectives: </strong>To compare the technical and cytomorphological features of serous effusion fluids using CS, cytocentrifuge smear, liquid-based cytology (LBC), and cell block (CB) preparations, and to assess the diagnostic yield of each method in detecting malignant effusions.</p><p><strong>Materials and methods: </strong>A total of 410 serous fluid samples over a period of 2 years were processed using CS, cytocentrifuge, EziPREP^TM LBC, and CB methods. Cytological features and diagnostic utility for malignancy were compared. Statistical analysis was performed using the Wilcoxon rank-sum and Friedman's ANOVA tests.</p><p><strong>Results: </strong>Samples comprised 277 pleural, 129 peritoneal, and four pericardial effusions. LBC provided statistically significant clearer back ground, while CS and CB provided significantly better staining quality and sharper morphological features. CB and LBC provided significantly high cellularity. Minimal overlapping of cells was significantly seen in cytocentrifuge and LBC smears. Additional yield for malignancy was 4% more by use of the CB method.</p><p><strong>Conclusion: </strong>Each cytological method has distinct advantages. LBC offers clearer backgrounds; CSs and CBs provide better morphology. CB and LBC show higher cellularity, with CB detecting 4% more malignancies. Combining methods may enhance the diagnostic accuracy.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 4","pages":"209-217"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Contrast Media on Cytological Evaluation of Urothelial Carcinoma: An <i>In vitro</i> Study with Relevance to Upper Tract Diagnostics.","authors":"Yuki Matsuoka, Rikiya Taoka, Kazuya Katakura, Zhang Xia, Akram Hossain, Hirohito Naito, Satoshi Harada, Reiji Haba, Mikio Sugimoto","doi":"10.4103/joc.joc_109_25","DOIUrl":"10.4103/joc.joc_109_25","url":null,"abstract":"<p><strong>Background: </strong>Urinary cytology plays a pivotal role in the non-invasive diagnosis of upper tract urothelial carcinoma (UTUC), especially where histological sampling is limited or technically challenging. The second edition of the Paris System for Reporting Urinary Cytology standardizes for evaluating cytological specimens. However, in clinical practice, urinary samples obtained from the UT often contain residual contrast media (CM) due to prior imaging studies; hence, the effect of CM on urinary cytology accuracy remains unclear.</p><p><strong>Aims: </strong>The aim of this study was to examine the impact of CM on diagnostic performance of Paris system.</p><p><strong>Settings and design: </strong>This was a controlled <i>in vitro</i> laboratory study using RT112 human bladder cancer cells to model UTUC.</p><p><strong>Materials and methods: </strong>Cells were exposed to 100%, 50%, and 30% CM. Morphology, membrane integrity, and viability were assessed through time-lapse microphotography, Trypan blue, and MTT assay. Cytology was evaluated by a cytotechnologist.</p><p><strong>Results: </strong>CM exposure caused concentration- and time-dependent cellular degeneration. After 60 min, viability dropped to 2.0 ± 0.1% (100%), 29.0 ± 4.7% (50%), and 75.1 ± 2.0% (30%), while membrane integrity declined similarly. Trypan blue staining showed integrity of 1.6 ± 0.1%, 15.1 ± 1.6%, and 46.5 ± 2.8%, respectively. Cells treated with 100% or 50% CM were classified as atypical urothelial cells (AUC) after 1 h, while 30% CM preserved high-grade urothelial carcinoma (HGUC) features up to 6 h. However, 24-hour exposure to 30% CM led to nuclear degeneration and cytoplasmic loss, again resulting in AUC classification.</p><p><strong>Conclusion: </strong>CM at higher concentrations and longer durations significantly compromise cellular morphology and diagnostic accuracy in urinary cytology.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 4","pages":"204-208"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12674477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catch Me If You Can! Keeping an Eye Out to Detect Unusual Malignancies Appearing in Cervical Pap Smear.","authors":"Sayantan De, Majal Chetankumar Dharaiya, Satarupa Samanta, Priti P Trivedi","doi":"10.4103/joc.joc_87_25","DOIUrl":"10.4103/joc.joc_87_25","url":null,"abstract":"<p><strong>Background: </strong>Metastatic involvement of the uterine cervix by extrauterine non-gynecological malignancies is exceptionally rare due to the cervix's unique lymphatic and vascular characteristics. Detection of such unusual malignancies in cervical Papanicolaou (Pap) smears poses significant diagnostic challenges but can offer critical early clues.</p><p><strong>Objective: </strong>This study aimed to evaluate the spectrum and cytomorphological features of extrauterine nongynecological malignancies involving the cervix detected incidentally on routine cervical Pap smears.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 12,980 cervical Pap smears screened between January 2019 and December 2024 in a tertiary care center. Twenty-seven cases of extrauterine nongynecological malignancies were identified. Cytological findings were correlated with clinical, radiological, histopathological, and immunohistochemical data.</p><p><strong>Results: </strong>The mean patient age was 54 years (range: 22-84). The most common metastatic sites were the lower gastrointestinal tract (33.3%), breast (14.8%), vagina (22.2%), and other sites, including gallbladder, urinary bladder, retroperitoneum, and hematologic malignancies. In 33.3% of cases, the Pap smear provided the first diagnostic clue for an unknown malignancy. Cytological features varied across primary sites: gastrointestinal metastases showed tall columnar cells and signet-ring morphology; breast carcinoma displayed poorly differentiated cells; and melanomas exhibited pigmented cells with prominent nucleoli. Rare diagnoses included metastatic urothelial carcinoma, anaplastic large cell lymphoma, and retroperitoneal leiomyosarcoma.</p><p><strong>Conclusion: </strong>Although rare, extrauterine malignancies can be detected on cervical Pap smears and may even present as the first sign of disease. Awareness of subtle cytomorphological patterns, combined with clinical correlation and immunohistochemical studies, is essential to avoid misinterpretation and ensure accurate diagnosis and timely management.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 4","pages":"218-223"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Acantholytic Squamous Cell Carcinoma: Diagnostic Dilemma in Cytology.","authors":"Nimisha Dhankar, Tapan Jyoti Saikia, Bembem Khuraijam, Deepika Rana, Vipul Ranjan Bhatt, Varuna Mallya, Harish Chandra Taneja","doi":"10.4103/joc.joc_205_23","DOIUrl":"10.4103/joc.joc_205_23","url":null,"abstract":"<p><p>Acantholytic squamous cell carcinoma (ASCC) is an uncommon variant of squamous cell carcinoma characterized by loosening of intercellular bridges. It usually involves the sun-exposed areas of the head and neck region and affects the elderly population. The histological features of ASCC have been well documented in the literature, but there is a paucity of studies on cytological features. We describe the cytological findings in the fine-needle aspiration smears of the cervical lymph node in a 70-year-old-male along with the diagnostic pitfalls.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 4","pages":"239-242"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating the Utility of the Milan System of Reporting Salivary Gland Cytopathology for the Diagnosis of Salivary Gland Fine-Needle Aspirates in a North Indian Tertiary Care Center and Comparing the Risk of Malignancy with its Two Editions.","authors":"Rao Ram Nawal, Singh Anshima, Singh Ankita, Manogaran Ravi Sankar","doi":"10.4103/joc.joc_156_24","DOIUrl":"10.4103/joc.joc_156_24","url":null,"abstract":"<p><strong>Background: </strong>Salivary gland (SG) fine-needle aspiration (FNA) is a well-accepted tool for preoperative management of salivary gland lesions (SGLs). First and second editions of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) were published in the years 2018 and 2023, respectively. The MSRSGC aims to improve patient care by providing better communication between clinicians and institutions. It has six ascending diagnostic categories having a definite risk of malignancy (ROM) and corresponding management schema. Our study assessed the incidence and corresponding ROM of each MSRSGC category within a tertiary care northern India referral center and compared each ROM with those laid down in the two editions of the MSRSGC.</p><p><strong>Aims and objectives: </strong>The main aims and objectives are as follows:1. Validating the utility of the MSRSGC for the diagnosis of SG-FNAs in a North Indian Tertiary Care Center.2. Comparing the Risk of Malignancy with its Two Editions.</p><p><strong>Materials and methods: </strong>Data on SG-FNAs performed between 01.01.2010 and 31.03.2024 were searched from the hospital information system. The cytopathology and histopathological slides were retrieved, and each case was separately reviewed and retrospectively classified into the I) non-diagnostic (ND), II) non-neoplastic (NN), III) atypia of undetermined significance (AUS), IVA) benign neoplasms (NB), IVB) SG neoplasm of uncertain malignant potential (SUMP), V) suspicious for malignancy (SFM), or VI) malignant categories according to the MSRSGC. Cyto-histopathological correlation analysis was performed, and the ROM for each category was calculated.</p><p><strong>Results: </strong>A total of 793 such cases were obtained. Histopathological follow-up was available in 267 cases, which included 2 (0.7%) ND, 29 (10.9%) NN, 5 (1.9%) AUS, 190 (71.2%) NB, 11 (4.1%) SUMP, 10 (3.7%) SFM, and 20 (7.5%) malignant cases. The calculated ROM for these ascending categories were 0%, 27.6%, 60%, 11.8%, 45.5%, 90%, and 100%, respectively.</p><p><strong>Conclusion: </strong>MSRSGC is a valuable means to standardize the reporting and preoperatively stratify SGLs as per the ROM for each ascending risk category. This study, to the best of our knowledge, is the largest Indian study to authenticate the utility and reproducibility of the MSRSGC in our tertiary care institute.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 3","pages":"113-123"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning of Urine Cytology Highlights Increased Neutrophil Count in Muscle-Invasive Urothelial Carcinoma.","authors":"Moe Kameda, Sayaka Kobayashi, Yoshimi Nishijima, Ryosuke Akuzawa, Rio Kaneko, Rio Shibanuma, Seiji Arai, Hayato Ikota, Kazuhiro Suzuki, Hideaki Yokoo, Masanao Saio","doi":"10.4103/joc.joc_158_24","DOIUrl":"10.4103/joc.joc_158_24","url":null,"abstract":"<p><strong>Objective: </strong>This study conducted an unsupervised learning cluster analysis on urine cytological images of high-grade urothelial carcinoma to assess their explanatory potential.</p><p><strong>Materials and methods: </strong>A total of 124 urine cytology specimens of urothelial carcinoma, collected between December 2010 to December 2021 at Gunma University Hospital, were analyzed. Ten cytological image fields per specimen were captured, and pathological T factors were examined using principal component analysis and t-distributed stochastic neighbor embedding (t-SNE) with machine learning (ML) software. Common image features were also verbalized and manually reevaluated.</p><p><strong>Results: </strong>In the t-SNE analysis, the T1-dominant region was characterized by \"few cells in the background,\" whereas the T2-dominant region showed \"many cells in the image,\" \"numerous neutrophils in the image,\" and \"abundant tumor cells in the image.\" Human reassessment identified significant differences related to muscle invasion status for all findings except \"abundant tumor cells in the image.\" Furthermore, we confirmed that histological neutrophil infiltration was related to the abundance of neutrophils in the cytological specimens.</p><p><strong>Conclusion: </strong>This study is noteworthy as the cluster analysis identified previously unreported variations in background cell types and quality linked to muscle invasion status, and it also demonstrated the explainability of ML-derived findings through manual reassessment.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 3","pages":"124-133"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Analysis of Diagnostic Performance and Cytomorphologic Features Between Newly Developed WellPrep^® and SurePath™ in Serous Effusion Cytology.","authors":"Ji Eun Choi, Min-Sun Jin, Da Sol Kim, Ilias P Nikas, Han Suk Ryu","doi":"10.4103/joc.joc_16_25","DOIUrl":"10.4103/joc.joc_16_25","url":null,"abstract":"<p><strong>Introduction: </strong>Whereas liquid-based cytology (LBC) is often the preferred method in gynecological and non-gynecological cytopathology compared to conventional preparation, it does have several limitations. This study aims to evaluate the diagnostic accuracy and specific cytomorphologic characteristics of the newly developed WellPrep^® (WP) in comparison with SurePath™ (SP) in serous effusion cytology.</p><p><strong>Materials and methods: </strong>A total of 178 body cavity effusion samples were collected, which were divided and further processed using both WP and SP methods. The LBC slides of the cases were independently evaluated regarding their cytomorphologic features by three pathologists. Among them, the diagnosis of 66 cases (42.6%) was confirmed as non-neoplastic or malignant using a combination of histopathological, clinical, and/or radiological follow-up. Statistical analysis was conducted to assess the diagnostic concordance and differences in selected cytomorphologic features between the two LBC methods.</p><p><strong>Results: </strong>WP demonstrated diagnostic performance comparable to SP, with a concordance rate of 75.7% (kappa = 0.659; Spearman's <i>ρ</i> = 0.920). Furthermore, the diagnostic accuracy measures tested were not different between WP and SP. No case processed with WP or SP showed suboptimal slide quality. For cytomorphologic features, cellular degeneration was less frequently observed in WP than in SP. SP showed more even cellular distribution and better preservation of architectural patterns. SP also more frequently exhibited prominent nucleoli, cytoplasmic vacuoles, and signet ring cell features.</p><p><strong>Conclusion: </strong>WP offers comparable slide quality and diagnostic accuracy with SP in serous effusion cytopathology. However, more research using larger patient cohorts would provide more evidence regarding WP.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 3","pages":"142-150"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of Touch Imprint and Crush Cytology with Histopathology in Upper Gastrointestinal Endoscopic Biopsies.","authors":"Akanksha Kalita, Prajwala Gupta, Kanika Rastogi, Vaishali Bhardwaj","doi":"10.4103/joc.joc_102_24","DOIUrl":"10.4103/joc.joc_102_24","url":null,"abstract":"<p><strong>Background: </strong>Touch imprint and crush cytology are simple, rapid, and cost-effective methods to distinguish between benign and malignant lesions, particularly in sentinel lymph nodes, ovarian neoplasms, and central nervous system tumors. This study was undertaken to assess the utility of imprint and crush cytology in making the diagnosis of both malignant as well as non-neoplastic diseases of the upper gastrointestinal (UGI) tract and compare the results with corresponding histopathology.</p><p><strong>Materials and methods: </strong>The study was conducted on patients who underwent UGI endoscopic biopsies over a period of 1.5 years. Touch imprints and crush smears were prepared for each case and stained with Giemsa and Papanicolaou stains. The cytology results were compared with the corresponding histopathology.</p><p><strong>Results: </strong>The overall sensitivity and specificity of imprint and crush cytology when compared to histopathology were found to be 95.7% and 98.8%, respectively. For <i>Helicobacter pylori</i> infection, the sensitivity, specificity, and diagnostic accuracy of cytology were 71.4%, 99%, and 97.19%, respectively. Both crush and imprint smears had similar efficacy in rendering the cytological diagnosis.</p><p><strong>Conclusion: </strong>Imprint/crush smear cytology is a valuable complement to histopathology in UGI endoscopic biopsies. Evaluation of biopsy adequacy, distinguishing between malignant and benign lesions, and diagnosing specific infections such as <i>H. pylori</i>, Candia, and Herpes simplex virus are reliably possible on impression cytology.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 3","pages":"163-169"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytology and Core Biopsy for Cystic Lesions of the Pancreas: A Comparison of Three Cytological Grading Systems.","authors":"Andrei Bancu, Matthew Hanks, Lauren Ackroyd, Suresh Venkatachalapathy, Dileep N Lobo, Abed M Zaitoun","doi":"10.4103/joc.joc_6_25","DOIUrl":"10.4103/joc.joc_6_25","url":null,"abstract":"<p><strong>Introduction: </strong>Cytological appearances may be insufficient to establish the diagnosis of pancreatic cystic lesions, especially for premalignant neoplasms. This study aimed to evaluate three commonly used cytological grading systems [C1-C5, Papanicolaou (Pap), and World Health Organization (WHO) classification systems] in assessing pancreatic cystic lesions.</p><p><strong>Materials and methods: </strong>A total of 210 pancreatic cytology specimens were classified based on the aforementioned grading systems, 127 of which had supporting histology reported across 6 years, at a single-tertiary referral center.</p><p><strong>Results: </strong>We excluded 26 cases because of inadequate cytology. The most common cystic lesions were intraductal papillary mucinous neoplasms (IPMNs, <i>n</i> = 71) and pseudocysts (<i>n</i> = 55). Among IPMN, 27 were moderate/high-grade, and 44 were low-grade. There were 12 mucinous cystic neoplasms, 75 benign cysts (pseudocysts, serous cystadenomas, lymphoepithelial cysts, and others), and 15 malignant cases, with 11 cysts being of uncertain etiology. There were 21 high-risk and potentially malignant (WHO grade V) cases in comparison with 42 cases using the C grading (C4 and C5). However, according to Pap grading, 87 had varying risks of malignancy (Category IVB). According to the WHO classification, 63 cases were classified as low-risk pancreaticobiliary neoplasms (WHO grade IV). The remaining cases 85 were benign to very low-risk malignant potential and, therefore, were less likely to be considered for surgical intervention. Diagnostic concordance was higher between cytology and core biopsies in low-grade IPMN.</p><p><strong>Conclusion: </strong>The WHO system provides better risk stratification for neoplasms, optimizing surgical management. However, the C1-C5 system does not recognize cystic lesions with malignant potential.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"42 3","pages":"151-162"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}