Journal of Cytology最新文献

{"title":"Critical Analysis of Laboratory Requisition Forms Received in a Cytopathology Laboratory of a Tertiary Care Centre: An Audit and Review of Literature.","authors":"Shivali Sehgal,&nbsp;Sujata Jetley,&nbsp;Zeeba S Jairajpuri,&nbsp;Sabina Khan","doi":"10.4103/joc.joc_160_21","DOIUrl":"https://doi.org/10.4103/joc.joc_160_21","url":null,"abstract":"<p><strong>Background: </strong>A laboratory requisition form (LRF) is the main communication link between the laboratories and the clinicians. In a cytopathology laboratory, incomplete forms with inadequate information significantly impact the quality of the results and waste precious time of the lab.</p><p><strong>Aims: </strong>The aim of this study was to audit the LRFs for adequacy of demographic and clinical data and to analyze the reasons for the same.</p><p><strong>Settings and design: </strong>A retrospective study was conducted in the cytopathology laboratory of a tertiary care center.</p><p><strong>Materials and methods: </strong>All the original LRFs received for Pap smears and FNACs of 1-month duration were retrieved. The forms were scrutinized for the presence of specific parameters which were classified as patient information, clinician information and clinical information. In addition to the completeness of the form, clarity of the data was also noted.</p><p><strong>Statistical analysis: </strong>The data were entered on excel worksheets and percentage of Pap smear and FNAC forms lacking information of various parameters was calculated.</p><p><strong>Results: </strong>A total of 431 LRFs were received in the month of January 2020. These included 274 Pap smear LRFs and 157 FNAC LRFs. Patient information was mentioned in predominantly all the forms, however, clinician and clinical information, which is indispensible for reporting, was missing in a significant proportion of the Pap smear and fine needle aspiration cytology (FNAC) forms.</p><p><strong>Conclusions: </strong>Receiving inadequately filled LRFs has been an age-old problem in all medical laboratories. Audit of inadequacy of LRFs helped in assessing the prevailing practices in the hospital and gave an insight into the quality of information available to the cytologists for reporting. Many clinicians withhold information out of ignorance about its importance or due to lack of time to fill up the details on the LRF. Also, filling out a LRF is a task usually delegated to the junior doctor in the OPD and the significance of filling the LRF correctly and comprehensively is often not emphasized upon adequately by the senior clinicians. This audit helped us taking preventive action by giving feedback to the clinicians and emphasizing to them the importance of clinical data on the LRF and in improvising the LRF using a more objective and user-friendly format.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 3","pages":"116-120"},"PeriodicalIF":1.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9585814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40567792","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":"The Indian Academy of Cytologists Guidelines for Reporting Serous Effusion (IACGRSE): An Interobserver Agreement Analysis.","authors":"Vaishali B Nagose,&nbsp;Meharbano M Kamal,&nbsp;Surbhi S Kathuria,&nbsp;Shraddha A Laddhad","doi":"10.4103/joc.joc_50_22","DOIUrl":"https://doi.org/10.4103/joc.joc_50_22","url":null,"abstract":"<p><strong>Context: </strong>The Indian Academy of Cytologists published Guidelines and categories for Reporting Serous Effusions (IACGRSE) in 2020 to improve consistency and reproducibility of fluid cytology reporting and to guide patient management.</p><p><strong>Aims: </strong>To evaluate category-wise agreement while using IACGRSE 2020 categories. To analyze interobserver agreement among participants with different level of training and years of experience.</p><p><strong>Settings and design: </strong>A retrospective interobserver variability study.</p><p><strong>Methods and material: </strong>Study was done with four participants: an expert cytopathologist and three cytopathology fellows with varying experience. Fluid smears from 60 cases with clinical and/or radiological evidence of malignancy were categorized into one of the five IACGRSE 2020 categories. The interpretations of expert cytopathologist were taken as standard.</p><p><strong>Statistical analysis used: </strong>Interobserver agreement was analyzed using Kappa statistics.</p><p><strong>Results: </strong>Previous cases without definitive category got classified into \"Atypical cells NOS\" (3.33%) and \"Atypical cells, Suspicious of Malignancy\" (15%). Agreement analysis for IACGRSE 2020 categories showed better concordance for inadequate (I), malignant (V), and benign (II) categories. The range of Kappa for interobserver agreement of fellows was fair to substantial (range 0.1692-0.7249). The participant with substantial diagnostic agreement with expert (κ = 0.729, 88.3%) had the most experience. Causes of major discordance were pertaining to paucity and distribution of cells, and to misinterpretation of reactive mesothelial cells.</p><p><strong>Conclusions: </strong>IACGRSE 2020 categories and participants' experience were important determinants in classifying the effusion fluid cytology smears and interobserver agreement; emphasizing the need to use IACGRSE2020, and sufficient time and training required for accurate diagnosis of fluid specimens.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 3","pages":"121-125"},"PeriodicalIF":1.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9585817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40567788","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":"Diagnostic Accuracy and Agreement Between Inter- and Intra-Observers in the Absence of Clinical History for Liquid-Based Preparation of Gynecology Specimens.","authors":"Nur Amirah Roslan,&nbsp;Mohd Nazri Abu,&nbsp;Farid Ridhuan Ismail","doi":"10.4103/joc.joc_68_22","DOIUrl":"https://doi.org/10.4103/joc.joc_68_22","url":null,"abstract":"<p><strong>Context: </strong>The clinical history in cytology is the best source of information to ensure the accuracy of diagnosis, facilitating a slide observer to interpret and relate their findings in screening gynecology slides.</p><p><strong>Aims: </strong>This study aims to evaluate the performance of slide observers to screen-blinded gynecology slides without providing any information on clinical history.</p><p><strong>Setting and design: </strong>A correlational study design was conducted at the cytology laboratory, Universiti Teknologi MARA Selangor, Puncak Alam Campus.</p><p><strong>Methods and materials: </strong>Fity-seven liquid-based preparation slides from gynecology specimens were screened blindly by five slide observers among Medical Laboratory Technology students who completed the enrollment of the cytology course.</p><p><strong>Statistical analysis used: </strong>The inter- and intra-observer reliability testing was measured using the kappa value of Fleiss' and Cohen's kappa value, respectively, while the diagnostic accuracy without a clinical history was determined by the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>The value of Fleiss' kappa (κ) was 0.221-this represents a fair strength of agreement between inter-observers. An intra-observer reliability test for each slide observer was analyzed using Cohen's kappa statistic and revealed that the kappa value varied between 0.116 and 0.696, indicating slight-to-substantial agreement between intra-observers. Additionally, the sensitivity value of 94.28%, specificity value of 72.40%, a positive predictive value (PPV) of 37.28%, a negative predictive value (NPV) of 72.40%, a likelihood ratio of 14.43, and the diagnostic accuracy of 75.09% were recorded.</p><p><strong>Conclusions: </strong>In conclusion, the students (slide observers) from the Centre of Medical Laboratory Technology Studies who took part in this study were able to interpret, classify, and diagnose the LBP gynecologic cytopathological cases into several categories (NILM and ECA) based on the 2001 Bethesda System reporting guideline.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 3","pages":"110-115"},"PeriodicalIF":1.3,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9585816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40583493","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 LBC Fixative Type and Fixation Time on Molecular Analysis of Pancreatic Cancer Cells: A Comparative Study of Cell Morphology, Antigenicity and Nucleic Acids.","authors":"Junya Izuhara,&nbsp;Kazuki Kanayama","doi":"10.4103/joc.joc_13_22","DOIUrl":"https://doi.org/10.4103/joc.joc_13_22","url":null,"abstract":"<p><strong>Introduction: </strong>Liquid-based cytology (LBC) has been widely used since 2000. Next-Generation Sequencing (NGS) analysis of residual specimens in LBC fixative may also be performed for pancreatic cancer in the near future. We examined cell morphology, antigenicity and nucleic acids in pancreatic cancer cells at different fixation times using two types of LBC fixatives.</p><p><strong>Methods: </strong>PANC-1 cells were fixed in 1 ml CytoRich Red (CR), CytoRich Blue (CB), 95% ethanol (95% AL) or 10% neutral buffered formalin (10% NBF) and evaluated for cell area, antigenicity and nucleic acids with fixation times of 1 hour and 1, 3, 9, and 14 days. Antigenicity was evaluated by immunocytochemical staining for p53 and CK20, and nucleic acid fragmentation was assessed by real-time PCR.</p><p><strong>Results: </strong>There was no difference in total cell area between 1 hour and 14 day fixation times for the CR group, but the CB group showed cell contraction with 9 days fixation. In immunocytochemical staining, the CR group showed high p53 and CK20 positivity even after 14 days fixation. The CB group had a lower p53 positive rate than the CR group from 1 hour fixation. For nucleic acid fragmentation, Ct values for the CR group increased with fixation time. The CB group had consistently low Ct values.</p><p><strong>Conclusion: </strong>Different LBC fixatives and fixation time can have varying effects on cell morphology, antigenicity and nucleic acids in pancreatic cancer cells. Therefore, fixative type and fixation time should be considered for molecular testing on residual samples in LBC fixatives.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 2","pages":"66-71"},"PeriodicalIF":1.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40491499","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":"Exfoliation of Uterine Leiomyosarcoma in Cervical Scrape Smear with Histopathological Correlation.","authors":"Priyanka Uttam,&nbsp;Ashish K Gupta,&nbsp;Nighat Hussain,&nbsp;Nidhi Rai","doi":"10.4103/joc.joc_165_21","DOIUrl":"https://doi.org/10.4103/joc.joc_165_21","url":null,"abstract":"","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 2","pages":"81-83"},"PeriodicalIF":1.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40491052","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":"Strength and Weaknesses of Application of International Academy of Cytology Yokohama System for Reporting Breast Fine-needle Aspiration Cytopathology.","authors":"Isha Makker, Preeti Agarwal, Shivanjali Raghuvanshi, Madhu Kumar, Mala Sagar","doi":"10.4103/joc.joc_12_22","DOIUrl":"10.4103/joc.joc_12_22","url":null,"abstract":"","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 2","pages":"89-90"},"PeriodicalIF":1.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40605784","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":"Association of Micronuclear Frequency with Dysplasia and Cytogenetic Changes (p53 Mutation and p16 Expression) in Oral Potentially Malignant Disorders.","authors":"Suvidha Tammewar,&nbsp;Rasika Gadkari","doi":"10.4103/joc.joc_198_21","DOIUrl":"https://doi.org/10.4103/joc.joc_198_21","url":null,"abstract":"<p><strong>Aims: </strong>The present study evaluated the frequency of micronuclei in oral potentially malignant disorders (OPMDs) and their association with the presence of dysplasia on cytology and biopsy as well as their association with p53 mutation and p16 expression. Cytological findings of dysplastic changes in OPMDs were compared to histological diagnoses.</p><p><strong>Material and methods: </strong>This was a cross-sectional, observational, descriptive study. Scrape smears (<i>n</i> = 74) were collected from lesions in patients with OPMDs. Punch biopsy was collected in patients showing dysplastic changes. Tissue microarray for p53 mutation and p16 expression was performed using paraffin embedded blocks. Cases were classified into grades of dysplasia using both scrape smears and biopsy. Micronuclei frequency was calculated per 100 cells using scrape smears. Mann-Whitney U test was used for correlation of cytology and histology for grade of dysplasia as well as micronuclear frequency with p53 mutation and p16 expression.</p><p><strong>Results: </strong>Micronuclear frequency was found to be increased in patients with dysplasia. A significant association of micronuclear frequency with dysplastic changes was seen on cytology. Sensitivity of cytological evaluation was found to be 64.7%. The association of the micronuclear frequency of samples with p53 mutation and p16 expression was nearly significant (n = 28, <i>P</i> = 0.069 and 0.095, respectively).</p><p><strong>Conclusion: </strong>Micronuclear frequency can be a reliable marker of mutagenic change in OPMDs. Cytological assessment of micronuclei can serve as useful, non-invasive, and relatively inexpensive tool to predict cancerous changes in OPMDs.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 2","pages":"53-58"},"PeriodicalIF":1.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40605789","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":"Xanthogranulomatous Cholecystitis with Coexisting Carcinoma- A Diagnostic Pitfall in Cytology.","authors":"Anupama Arya,&nbsp;Shaily Goyal,&nbsp;Dilip Kumar,&nbsp;Poonam Das","doi":"10.4103/joc.joc_124_21","DOIUrl":"https://doi.org/10.4103/joc.joc_124_21","url":null,"abstract":"","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 2","pages":"86-88"},"PeriodicalIF":1.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40491051","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":"Preliminary Cytomorphologic Diagnosis of Hematolymphoid Malignancies in Effusions: A Cyto-histo Correlation with Lessons on Restraint.","authors":"Bidish K Patel,&nbsp;Debasis Gochhait,&nbsp;Sreerekha Jinkala,&nbsp;Vidhyalakshmi Rangarajan,&nbsp;Narasimhapriyan Kannan,&nbsp;S Durgadevi,&nbsp;Neelaiah Siddaraju","doi":"10.4103/joc.joc_204_21","DOIUrl":"https://doi.org/10.4103/joc.joc_204_21","url":null,"abstract":"<p><strong>Background: </strong>Effusions as part of hematologic neoplasms are rare and as a primary presentation, rarer. In standalone laboratories of developing countries, resorting to techniques such as flow cytometry or immunohisto/cytochemistry may not be possible. A near definitive diagnosis on cytomorphology would, therefore, be an ideal beginning. To that end, we compiled our cases of primary hematolymphoid effusions, devising reproducible reporting categories and looked at their concordance with the final histopathology.</p><p><strong>Subjects and methods: </strong>Fifty-four cases of primary hematolymphoid effusions over 10 years with cytology-histopathology correlation were chosen. Post morphology assessment, the cases were organized into six categories: suspicious of hematolymphoid malignancy, non-Hodgkin lymphoma-high-grade (NHL-HG), low-grade NHL (NHL-LG), Burkitt lymphoma, acute leukemias, and plasma cell dyscrasias. Discordance with histology was assigned as major and minor based mainly on therapeutic implications.</p><p><strong>Results: </strong>Concordance was seen in a good number (81.5%) of cases. The NHL-HG and NHL-LG categories contributed to 33.3% each of major discordance. Tuberculosis and epithelial malignancies comprised the bulk of the major discordance. Overdiagnosis of a high-grade lymphoma for a histologically proven low-grade follicular lymphoma was the only case with minor discordance.</p><p><strong>Conclusion: </strong>The cytologic categories used are not foolproof for hematologic neoplasms but have a fairly good concordance. A scanty abnormal population should always be viewed with suspicion and definitive labels should be avoided. While morphologic examination is fraught with danger, a good assessment directs the judicious selection of ancillary methods, and hence cannot be supplanted.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 2","pages":"59-65"},"PeriodicalIF":1.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40605788","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":"Application of the Indian Academy of Cytologists Recommendations for Reporting Serous Fluid Cytopathology in Routine Reporting of Ascitic Fluid Specimen and Assessment of the Risk of Malignancy.","authors":"Shilpy Jha,&nbsp;Madhusmita Sethy,&nbsp;Amit Kumar Adhya","doi":"10.4103/joc.joc_88_21","DOIUrl":"https://doi.org/10.4103/joc.joc_88_21","url":null,"abstract":"<p><strong>Background: </strong>A five-tiered reporting system for effusion fluid cytology has been published by the Indian Academy of Cytologists (IAC). Only a single study has evaluated the applicability of this system in routine reporting.</p><p><strong>Aims: </strong>We intend to evaluate the practical utility of this system in routine reporting of ascitic fluid cytology.</p><p><strong>Materials and methods: </strong>Nine hundred and sixty-one cases of ascitic fluid cytology were included in this study. The clinical, radiological, cytomorphological, and follow-up data of these cases were reviewed. All cases were recategorized according to the proposed IAC system, and the risk of malignancy (ROM) for each category was estimated.</p><p><strong>Results: </strong>Age of the patients ranged from 1 to 92 years, and fluid volume ranged from 10 ml to 3 l. The number of cases included in each category and their respective ROM were as follows: category 1: 41, 21.42%; category 2: 805, 14.9%; category 3: 5, 33.3%; category 4: 31, 90%; and category 5:79, 96.4%.</p><p><strong>Conclusions: </strong>The new IAC guidelines for the serous fluid is representative, informative, and could be easily applied at our institutional level. We used the recommended diagnostic categories for reclassifying the ascitic fluid samples based on their cytosmear findings and conclude that the system has enormous utility at each level starting from the collection of fluid samples till the delivery of the report.</p>","PeriodicalId":50217,"journal":{"name":"Journal of Cytology","volume":"39 2","pages":"72-77"},"PeriodicalIF":1.3,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40605785","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}