Cytopathology最新文献

{"title":"Commercially Available Artificial Intelligence Solutions for Gynaecologic Cytology Screening and Their Integration Into Clinical Workflow.","authors":"Yosep Chong, Andrey Bychkov","doi":"10.1111/cyt.70023","DOIUrl":"https://doi.org/10.1111/cyt.70023","url":null,"abstract":"<p><p>Historically, gynaecologic cytology, particularly cervical screening through Pap smear tests, has been instrumental in early cancer detection, but not without its challenges. These include variability in interpretation and the labour-intensive nature of manual screening processes. The advent of artificial intelligence (AI) technologies, especially machine learning and deep learning, heralds a new era in cytology, offering enhanced accuracy, consistency, and efficiency. These advancements promise to mitigate traditional limitations by automating routine analyses, aiding early cancer detection, and reducing the workload of laboratory personnel. This review thoroughly examines the current status of commercial AI software in gynaecologic cytology screening. We critically assess the capabilities, performance, and impact of these AI tools in a clinical context. Additionally, the review addresses the integration challenges and potential of AI in clinical practice, including workflow integration, regulatory compliance, and ethical considerations. Through this comprehensive analysis, we aim to provide insights into how AI is reshaping gynaecologic cytology, paving the way for more effective disease management and enhanced patient care in women's health.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of MammaTyper in Fine Needle Aspiration Cytology, Core Needle Biopsy and Surgical Breast Cancer Samples.","authors":"Maurizio Pinamonti, Daniela Santon, Cristina Bottin, Elisa Ober, Clara Rizzardi, Claudia Di Lecce, Fabiola Giudici, Jerry Polesel, Fabrizio Zanconati","doi":"10.1111/cyt.70026","DOIUrl":"https://doi.org/10.1111/cyt.70026","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance and concordance of the MammaTyper molecular test across cytological, biopsy and surgical samples from breast carcinomas, emphasising the applicability of cytology in molecular subtyping.</p><p><strong>Methods: </strong>29 breast carcinoma cases, each represented by cytological, biopsy and surgical samples, were retrospectively collected from 2021 to 2025 at the Pathology Unit of Trieste. Subtyping was performed using MammaTyper on all sample types. Concordance between MammaTyper results across different sample types was assessed using Lin's concordance correlation coefficient (CCC), overall concordance rate (OCR) and kappa statistics.</p><p><strong>Results: </strong>A total of 84 samples from breast carcinoma were analysed, including FNAC, CNB and surgical resection specimens. Molecular subtyping was technically successful in all cases. When comparing IHC and MammaTyper results retrieved in CNBs, we found almost perfect agreement for ER, substantial agreement for PgR and HER2 and moderate agreement for Ki-67. Concordance rates between cytology and FFPE samples (respectively CNB and surgical specimens) showed excellent agreement for ER (CCC 0.81 and 0.835), good agreement for PgR (0.714 and 0.78), excellent agreement for HER2 (0.855 and 0.854) and moderate agreement for Ki-67 (0.626 and 0.643). In particular, discrepancies in HER2 and Ki-67 status between cytological and FFPE samples were observed in a relevant subset of cases, potentially affecting therapeutic stratification.</p><p><strong>Conclusions: </strong>MammaTyper demonstrated high concordance and reliability on cytological and biopsy samples, supporting its use in minimally invasive diagnostics. Despite the discrepancies in some markers, cytology offers a cost-effective, less invasive alternative to biopsies for molecular subtyping, aligning with precision medicine goals.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Cytopathology: A Call for Implementation.","authors":"Guido Muharremi, Visar Vela, Philippe Vielh, Taulant Muka","doi":"10.1111/cyt.70024","DOIUrl":"https://doi.org/10.1111/cyt.70024","url":null,"abstract":"<p><p>Evidence-based medicine (EBM) emerged in the mid-1990s as a systematic and data-driven approach to clinical practice. It plays a crucial role in cytopathology, which focuses on identifying both neoplastic and non-neoplastic disorders. Despite its importance, cytopathology faces significant challenges in implementing EBM principles. These include diagnostic variability, interobserver discrepancies, and subjective interpretations, which can impact diagnostic consistency and patient outcomes. These issues often lead to inconsistencies in diagnosis, underdiagnosis, or overdiagnosis, ultimately compromising patient outcomes. To address these challenges, evidence-based cytopathology (EBC) emphasises the critical evaluation of diagnostic tests and the utilisation of well-designed and high-quality data to establish robust guidelines. EBC promotes the adoption of standardised diagnostic criteria, integrates robust study designs with the implementation of advanced technologies like artificial intelligence (AI), and leverages clinical decision support systems (CDSS) to enhance diagnostic accuracy and consistency. However, realising the full benefits of EBC requires collaborative research, multicenter trials, and continuous updates to guidelines. In this paper, we discuss the future efforts in improving EBC outcomes, with a focus on developing precise diagnostic instruments, refining methodologies, and exploring machine learning applications to improve diagnostic reliability, enhance patient care, and support informed clinical decision-making.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercenter Study of Interobserver Variability With Optical and Digital Imaging in Cervicovaginal Cytology. Simulation of a Quality Control Program.","authors":"Francesc Tresserra, Carme Dinarès, Olga Luque, Marta Serra, Miriam Castella, Lucia Retamales, Gemma Fabra, Santiago Valera, Ignacio Rodríguez","doi":"10.1111/cyt.70025","DOIUrl":"https://doi.org/10.1111/cyt.70025","url":null,"abstract":"<p><strong>Introduction: </strong>Participation in diagnostic intercomparison programs is a mandatory requirement for accreditation of cytology laboratories. Results described by these programs in cervico vaginal cytology (CVC) show a significant number of discrepancies. We hypothesised whether the use of IA systems, such as the ThinPrep Genius system, would improve diagnostic concordance.</p><p><strong>Methods: </strong>We simulated an intercomparison program between two centres in which four observers used the same 30 cases of CVC with negative diagnoses, ASCUS, LSIL and HSIL and observed them with light optic microscopy (OM) and two Genius (G1 and G2) systems, one from each centre.</p><p><strong>Results: </strong>The diagnostic agreement between OM and the two Genius was similar, with overall agreement values of 82% for G1 and 78% for G2 and OM, and similar kappa values for the three techniques. However, both Genius diagnosed glandular lesions that were not included in the selected cases and were not diagnosed with OM.</p><p><strong>Conclusion: </strong>The concordance obtained in both OM and Genius is acceptable and falls within the range of that obtained in what is described in intercomparison programs. We must consider the greater affinity for diagnosing glandular lesions with Genius and the fact that there may be discrete differences between two different devices, probably due to calibration.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytological and Immunocytochemistry Findings in Fallopian Tube Brush Specimens and Their Correlation With Histology","authors":"Jitka Hausnerová,&nbsp;Robert Slunečko,&nbsp;Petra Ovesná,&nbsp;Markéta Bednaříková,&nbsp;Lenka Zlámalíková,&nbsp;Jan Kosťun,&nbsp;Petr Stráník,&nbsp;Vendula Smoligová,&nbsp;Libor Viktora,&nbsp;Michaela Koblížková,&nbsp;Jiří Presl,&nbsp;Vít Weinberger","doi":"10.1111/cyt.70022","DOIUrl":"10.1111/cyt.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>High-grade serous carcinoma (HGSC), the most prevalent and lethal form of ovarian cancer, is increasingly recognised to originate in the fimbrial end of the fallopian tube (FT). Timely detection remains a critical unmet clinical need due to ineffective screening methods. This prospective observational study assesses the diagnostic potential of FT brush cytology by correlating cytomorphological and immunocytochemical findings with histologically confirmed HGSC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Material</h3>\u0000 \u0000 <p>A total of 134 FT from 89 patients undergoing salpingo-oophorectomy (with or without hysterectomy) were analysed. Liquid-based cytology samples were evaluated for morphological abnormalities and subjected to immunocytochemistry using p53 and Ki-67 markers. Cytological results were classified as benign, suspicious or malignant. Statistical analyses included sensitivity, specificity and odds ratio calculations via logistic regression (<i>α</i> = 0.05), performed using the R software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histopathology confirmed HGSC in 15 patients. Of these, brush cytology identified 12 as suspicious or malignant, demonstrating high diagnostic concordance. Aberrant p53 expression was found in 11 cases, and a high Ki-67 proliferation index was observed in 10. These findings underscore the strong correlation between cytological, immunocytochemical and histological features of tubal HGSC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In conclusion, FT brush cytology combined with p53 and Ki-67 immunocytochemistry shows promise as a minimally invasive approach for early HGSC detection. Future research should focus on larger prospective cohorts, ideally incorporating in vivo hysteroscopic sampling.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 6","pages":"578-588"},"PeriodicalIF":1.1,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediastinal Teratoma With Somatic-Type Adenocarcinoma: An Enigmatic Discovery by Fine Needle Aspiration Cytology.","authors":"Swetha Venkatakrishnan, Soundarya Ravi, Debasis Gochhait, Bhawana A Badhe, Ramsankar Padmanabhan","doi":"10.1111/cyt.70021","DOIUrl":"https://doi.org/10.1111/cyt.70021","url":null,"abstract":"<p><p>Mediastinal masses often present acutely as medical emergencies, necessitating prompt and accurate diagnosis. Imaging-guided fine needle aspiration cytology (FNAC) plays a pivotal role in rapidly identifying rare mediastinal tumours and differentiating them from other potential aetiologies, enabling timely intervention. Primary mediastinal germ cell tumours (PMGCTs) constitute approximately 15% of adult mediastinal neoplasms. The development of somatic-type malignancies, particularly colonic-type adenocarcinoma, in PMGCTs is rare and typically associated with a poor prognosis. Combining cytological findings with imaging, serum tumour marker analysis and immunohistochemistry can facilitate the detection of various germ cell components and aid in diagnosing GCTs. We report the case of a 35-year-old male presenting with symptoms of mediastinal compression. Contrast-enhanced computed tomography (CECT) revealed an ill-defined anterior mediastinal lesion measuring 9.2 cm in maximum dimension with a heterogeneous appearance. Emergency ultrasound-guided FNAC was performed, yielding highly cellular smears that showed malignant epithelial cell clusters with intracytoplasmic and extracellular mucin, as well as strips and clusters of benign intestinal epithelial cells. Based on the cytomorphological features, the patient's age and imaging findings, a diagnosis of somatic-type adenocarcinoma arising in a background of teratoma was suggested. Histopathological examination of the excised mass confirmed the cytological diagnosis. Adenocarcinoma in the mediastinum may arise from primary sites such as the aerodigestive tract or represent metastatic disease. However, in this case, the presence of a benign intestinal epithelial component strongly indicated a teratomatous origin. This report underscores the utility of imaging-guided FNAC as a minimally invasive and effective diagnostic tool, enabling early diagnosis and timely treatment initiation in patients presenting with acute mediastinal obstruction.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Unexpected Abdominal Mass in a 3-Year-Old.","authors":"Shruti Gupta, Vutla Saisree, Pankaj Kumar, Niraj Kumari, Sunita Singh, Arvind Rajwanshi","doi":"10.1111/cyt.70020","DOIUrl":"https://doi.org/10.1111/cyt.70020","url":null,"abstract":"<p><p>Paediatric abdominal masses encompass a wide range of differential diagnoses including various inflammatory, benign and malignant aetiologies. A thorough clinical examination and imaging are the preliminary investigations of choice to ascertain the nature and extent of the abdominal mass. Fine needle aspiration biopsy cytology (FNABC) is a rapid, reliable and cost-effective tool for the definitive diagnosis. In the present case, a 3-year-old child presenting with a gradually increasing large abdominal mass was subjected to FNABC.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Sneak Peek Into a Rare Case of Metastatic Cervix Adenocarcinoma in Pleural Fluid With an Approach to Diagnosis","authors":"Shilpi Thakur,&nbsp;Pooja Suteri,&nbsp;Daya Nand Sharma,&nbsp;Sandeep Mathur","doi":"10.1111/cyt.70016","DOIUrl":"10.1111/cyt.70016","url":null,"abstract":"<div>\u0000 \u0000 <p>Effusion samples are the minimally invasive cytology specimens, harbouring metastases from variable primary sites. Pleural metastasis from cervical carcinoma is quite rare and comprises 2.1%–6.1% of all the tumours. Endocervical adenocarcinoma with pleural metastasis is even rarer. Through this, we try to emphasise the cytomorphological and immunohistochemical approach along with histopathological correlation, all of which were indispensable in such a rare case.</p>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 6","pages":"619-622"},"PeriodicalIF":1.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncocytic Thyroid Tumours With Pathogenic FLCN Mutations Mimic Oncocytic Papillary Thyroid Carcinoma on Fine-Needle Aspiration.","authors":"Adeel M Ashraf, Faisal Hassan, Adrian A Dawkins, Julie C Dueber, Derek B Allison, Thèrése J Bocklage","doi":"10.1111/cyt.70019","DOIUrl":"https://doi.org/10.1111/cyt.70019","url":null,"abstract":"<p><strong>Background: </strong>Thyroid tumours occur in patients with Birt-Hogg-Dubé syndrome (BHD), a condition caused by germline alterations in the FLCN gene that confers an increased cancer risk. Somatic FLCN mutations may also contribute to tumorigenesis. In this study, we present the first description of the cytopathology of two thyroid tumours evaluated by fine-needle aspiration (FNA) and harbouring pathogenic FLCN mutations.</p><p><strong>Methods: </strong>We encountered two patients with oncocytic thyroid tumours in which comprehensive next-generation sequencing (NGS) identified pathogenic FLCN mutations. We present the FNA cytologic findings and corresponding histopathology, and discuss the diagnostic challenges posed by the FNAs, one of which was initially confounded by negative preoperative molecular testing.</p><p><strong>Results: </strong>Both patients were middle-aged females. Patient 1 had an incidental thyroid nodule and a history of BHD. FNA of a TI-RADS 5 mass was diagnosed as suspicious for papillary thyroid carcinoma (PTC), Bethesda V, leading to total thyroidectomy. Patient 2 presented with a palpable nodule. Compressive symptoms prompted lobectomy, revealing an angioinvasive oncocytic carcinoma. Subsequent FNA findings of a metastasis cytologically resembled oncocytic PTC; however, it was correctly diagnosed as oncocytic carcinoma after correlation with prior histologic findings. Expanded NGS testing facilitated the final diagnosis of FLCN-mutated oncocytic adenoma in Patient 1 and high-grade differentiated oncocytic carcinoma in Patient 2.</p><p><strong>Conclusion: </strong>Thyroid tumours harbouring FLCN mutations with oncocytic features may mimic PTC cytologically. Although rare, correct diagnosis of these tumours is essential to ensure appropriate treatment. For early detection, patients with BHD may benefit from thyroid ultrasound surveillance.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report—An Unusual Presentation of Cervical Meningioma as a Carotid Body Mass Diagnosed by Fine Needle Aspiration Cytology","authors":"Poorva Singh,&nbsp;Liam Chen,&nbsp;Zuzan Cayci,&nbsp;Khalid Amin","doi":"10.1111/cyt.70018","DOIUrl":"10.1111/cyt.70018","url":null,"abstract":"<p>We describe an unusual case of cervical meningioma presenting as a carotid body tumour. This case emphasises the importance of cytoradiologic correlation in lesions with atypical imaging findings; and the crucial role of fine needle aspiration cytology in accurately diagnosing masses in precarious anatomic sites of the head and neck.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 6","pages":"606-609"},"PeriodicalIF":1.1,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cyt.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979463","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}