Cytopathology最新文献

{"title":"Clear Cell Neoplasm in Salivary Gland FNA? Maybe It’s From Kidney!","authors":"Isabella Sorice,&nbsp;Anna Maria Carillo,&nbsp;Maria Salatiello,&nbsp;Caterina De Luca,&nbsp;Rosa Maria Di Crescenzo,&nbsp;Vincenzo Damiano,&nbsp;Giovanni Dell’Aversana Orabona,&nbsp;Elena Vigliar,&nbsp;Giancarlo Troncone,&nbsp;Claudio Bellevicine","doi":"10.1111/cyt.13506","DOIUrl":"10.1111/cyt.13506","url":null,"abstract":"<p>This article reports a rare case of metastatic clear cell renal cell carcinoma presenting as a parotid gland mass, clinically and cytologically mimicking a primary salivary gland neoplasm. It underscores the diagnostic value of integrating cytological evaluation with clinical history and immunocytochemical profiling.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 4","pages":"426-429"},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010178","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—Cytopathological Diagnosis of Metastatic Squamous Cell Carcinoma in Vitreous Fluid","authors":"Poorva Singh,&nbsp;Katlin T. Wilson,&nbsp;Linda Varghese,&nbsp;Jimmie Stewart","doi":"10.1111/cyt.13507","DOIUrl":"10.1111/cyt.13507","url":null,"abstract":"&lt;p&gt;Squamous cell carcinoma (SqCC) in the vitreous fluid is exceedingly rare and usually caused by metastasis from primary sites such as lung, breast, and cervix [&lt;span&gt;1-3&lt;/span&gt;]. Metastases to the vitreous from other primary sites are even rarer; when they do occur, they are most commonly from cutaneous melanoma in patients previously treated with immune checkpoint inhibitors [&lt;span&gt;4&lt;/span&gt;]. Most patients present with vision changes at advanced stages of malignancy with non-specific ocular symptoms, making diagnosis challenging [&lt;span&gt;2&lt;/span&gt;]. Given the scarcity of literature on this entity, there are no consensus therapy guidelines for these patients. Reporting individual cases is crucial for expanding the knowledge base, guiding clinical suspicion, and improving management strategies, especially because timely and accurate diagnosis could potentially impact the quality of life of affected patients. Herein, we present a case of oropharyngeal SqCC with metastasis to the vitreous humour.&lt;/p&gt;&lt;p&gt;Our patient is a 57-year-old male with HPV-associated squamous cell carcinoma of the oropharynx initially diagnosed in 2015. He had multiple local recurrences and metastases to the bone, retroperitoneum, and lung throughout the course of chemoradiotherapy. While on therapy with capecitabine, he developed a sudden decrease in vision and floaters in the left eye and was referred for ophthalmic evaluation. The examination was significant for intraretinal lesions, raising suspicion for panuveitis and posterior cyclitis. A pars plana vitrectomy was performed and sent for cytologic examination wherein the cell block showed a cluster of cells with nuclear enlargement, nuclear membrane irregularities, coarse chromatin, prominent nucleoli, and atypical mitoses (Figure 1A). These cells were strongly and diffusely positive for pancytokeratin and p40 immunohistochemistry (IHC, Figure 1B), raising the suspicion for involvement by the patient's known squamous cell carcinoma. Since ocular adverse effects are common in patients taking anti-metabolite chemotherapeutic drugs such as capecitabine, as was the case in this patient, the clinical suspicion for metastatic disease was low [&lt;span&gt;5&lt;/span&gt;]. Consequently, a membrane peel was obtained for corroboration of the cytologic findings. Surgical pathology examination of the epiretinal membrane confirmed the diagnosis of non-keratinising squamous cell carcinoma (Figure 2A) which stained strongly and diffusely with pancytokeratin (Figure 2B) and p16, serving as a surrogate marker for HPV (Figure 2C). The patient was counselled, and he elected to receive intravitreal Melphalan instead of local radiotherapy due to the marginally worse adverse effect profile of radiotherapy.&lt;/p&gt;&lt;p&gt;Non lymphatic distant metastases to the orbital soft tissue and vitreous humour have been documented to arise predominantly from breast and lung primaries, followed by a few articles reporting cervical SqCC as the primary tumor [&lt;span&gt;1-3&lt;/span&gt;], o","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 4","pages":"423-425"},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cyt.13507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054518","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":"Fine-Needle Aspiration Cytology Diagnosis of Pleomorphic Adenoma With Spontaneous Infarction in the Salivary Gland: A Multicenter Retrospective Study","authors":"Jie-Qiong Wang,&nbsp;Ge Li,&nbsp;Shao-Hua Wang,&nbsp;Bo Yang,&nbsp;Yun Liu,&nbsp;Yu Wan,&nbsp;Cong-Gai Huang,&nbsp;Fan Li","doi":"10.1111/cyt.13500","DOIUrl":"10.1111/cyt.13500","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Spontaneous infarction in salivary gland pleomorphic adenoma (PA) diagnosed by fine-needle aspiration cytology (FNAC) is rarely documented. This study aims to systematically analyse and summarise its cytopathological characteristics to reduce the risk of misdiagnosis and enhance diagnostic precision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five histopathologically confirmed cases (2017–2024) from two hospitals were retrospectively analysed. Clinical data, cytopathological findings and histopathology were reviewed, and causes of misdiagnosis were evaluated. Additionally, the cytopathological characteristics of salivary gland PA with spontaneous infarction were systematically analysed and comprehensively summarised, incorporating findings from relevant domestic and international literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only two cases (40%) were correctly diagnosed as PA or PA with infarction. Two cases (40%) were misdiagnosed as suspicious of malignancy, and one case (20%) was inconclusive. The cytopathological features are as follows: Fine-needle aspiration (FNA) specimens often appear as milky-white or brownish paste, with or without small tissue fragments. Microscopically, there is a background of necrotic debris with numerous scattered pleomorphic small cells resembling ‘naked nuclei’, characterised by hyperchromatic and irregular nuclei, accompanied by atypical squamous metaplastic cells, ‘ghost cells’ and eosinophilic cells with non-atypical nuclei, with or without the presence of tumour-associated glandular epithelial cells, myoepithelial cells, lymphocytes, neutrophils or other inflammatory cells, while mucinous or chondroid stroma is rarely observed or absent, and no abnormal mitotic figures are identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The cytological features of PA with spontaneous infarction can mimic malignancy. Recognising these features is crucial to reducing diagnostic errors and guiding appropriate management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 5","pages":"484-490"},"PeriodicalIF":1.1,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060575","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":"Diagnostic Category: Suspicious for Malignancy","authors":"Andre L. Moreira,&nbsp;Fernando Schmitt","doi":"10.1111/cyt.13498","DOIUrl":"10.1111/cyt.13498","url":null,"abstract":"<div>\u0000 \u0000 <p>The suspicious for malignancy category is used by pathologists to indicate a certain degree of uncertainty but is still able to convey to the treating physician a risk stratification of the deferred diagnosis. The category of suspicious for malignancy can be used in a vast possibility of cytomorphological features and clinical scenarios. Suspicious for malignancy is often used when there is an insufficient number of neoplastic cells for the establishment of a final diagnosis, but in many situations, the number of suspicious cells may be abundant but discrepant with the clinical presentation. In addition, the pathologist must be aware of the many mimickers of malignancy that, when present, may prompt the use of the category. Therefore, there is a need for better illustrations of the use of the category, its pitfalls and suggestions on when the category of suspicious for malignancy can be upgraded for a more definite diagnosis using ancillary studies, even in scant material.</p>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 5","pages":"458-466"},"PeriodicalIF":1.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058668","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":"Evaluating the Diagnostic Impact of the IAC Yokohama System for Breast Fine Needle Aspiration Biopsy Cytopathology: A Prospective Institutional Study","authors":"Chayanika Kala,&nbsp;Rajneesh Srivastava,&nbsp;Sanjay Kala,&nbsp;Lubna Khan,&nbsp;Neetu Purwar","doi":"10.1111/cyt.13499","DOIUrl":"10.1111/cyt.13499","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Fine Needle Aspiration Biopsy (FNAB) of the breast is a widely used diagnostic tool for detecting breast lesions, offering high sensitivity and positive predictive value. The International Academy of Cytology (IAC) established the Yokohama System in 2016 to standardise reporting of breast FNAB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To categorise FNAB samples according to the IAC Yokohama System, assess the ROM for each category and evaluate the sensitivity, specificity and predictive values for malignancy diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective observational study involved predominantly younger adults with the majority presenting with a palpable breast mass. FNAB samples were collected, stained and examined microscopically. Categories were assigned according to the Yokohama System, and the results were compared with histopathological examination (HPE). Diagnostic metrics and ROM were calculated using statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 428 patients, with malignant cases comprising 49.5% of the samples, benign cases 43.5%, atypical cases 4.2%, suspicious for malignancy cases 1.9% and insufficient material 0.9%. The risk of malignancy (ROM) was 100% for malignant, 87.5% for suspicious for malignancy, 22.2% for atypical, 2.15% for benign and 25% for the insufficient category. Sensitivity, specificity and accuracy varied across groups, with group A, group B and group C showing accuracy at 92.99%, 97.66% and 95.3%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The IAC Yokohama System effectively categorises breast FNAB samples, provides accurate diagnostic metrics for malignancy and aids clinical decision-making, particularly in resource-limited settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 5","pages":"491-497"},"PeriodicalIF":1.1,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010123","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":"Micronucleus and Nuclear Budding Help to Identify Malignancy in Thyroid Fine Needle Aspiration Cytology.","authors":"Nur Gizem Kocaoğlu Çelik, Ayşegül Aksoy Altınboğa, Tuba Dilay Kökenek Ünal","doi":"10.1111/cyt.13505","DOIUrl":"https://doi.org/10.1111/cyt.13505","url":null,"abstract":"<p><strong>Objective: </strong>Micronucleus (MN) and Nuclear Budding (NB) Have Been Used as an Important Stimulus for Nuclear Atypia in Revealing Chromosomal Damage and Cancer Risk. This Study Aims to Assess MN and NB as Nuclear Parameters and Explore Their Role in Differential Diagnosis of Thyroid FNA and \"Bethesda System for Reporting Thyroid Cytology\" (BSRTC).</p><p><strong>Methods: </strong>The Study Included 350 Thyroid FNA Samples Categorised According to BSRTC. NB And MN Were Evaluated in 1000 Thyrocytes on FNA Slides. The Thyroidectomy Sections Were Divided Into Three Categories as 'Malignant', 'Low-Risk' and 'Benign'.</p><p><strong>Results: </strong>A Total of 350 Cases Were Classified as follows: 55 (15.71%) Benign, 159 (45.43%) Atypia of Undetermined Significance (AUS), 20 (5.71%) Follicular Neoplasm (FN), 48 (13.71%) Suspicious for Malignancy (SFM) and 68 (19.43%) Malignant. In comparison to all other cytopathologic diagnostic groups, the benign group had significantly lower levels of MN and NB (p < 0.001). The AUS group's MN and NB counts were significantly lower than those of the FN, SFM and malignant groups (MN for AUS-FN/SFM/M p < 0.001, NB for AUS-FN p = 0.01, NB for AUS-SFM/M p < 0.001, respectively). MN and NB counts were greater in the AUS group for cases with a malignant histopathologic diagnosis than for those with a benign histopathologic diagnosis (p < 0.001). MN and NB cut-off values > 5.50 and > 14.50, respectively, suggest high sensitivity and specificity of malignancy.</p><p><strong>Conclusions: </strong>Increased Frequency of MN and NB closely associated with an increased risk of malignancy in thyroid FNA. Assessing MN and NB in thyroid FNA may help better stratify the risk in the AUS category.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063001","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 Cytopathological Diagnosis of Fumarate Hydratase (FH)-Deficient Renal Cell Carcinoma in Two Patients With FH Gene Mutation","authors":"Xianglan Zhu,&nbsp;Kaixin Lei,&nbsp;Xiaoyu Liu,&nbsp;Xueying Su","doi":"10.1111/cyt.13504","DOIUrl":"10.1111/cyt.13504","url":null,"abstract":"<p>Large tumour cells with abundant eosinophilic cytoplasm, coarse chromatin and irregular nuclear shapes are typical cytological signs of fumarate hydratase-deficient renal cell carcinoma. CK7-negative/CA9-negative/PAX8-positive and AKR1B10-positive/2SC-positive/FH-deficient immunophenotypes may serve as important diagnostic markers.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 4","pages":"418-422"},"PeriodicalIF":1.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049474","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":"Primary Cutaneous Rosai–Dorfman Disease in a Treated Case of Breast Carcinoma—Cytological Diagnostic Enigma","authors":"Sherrin Jacob,&nbsp;Balamurugan Thirunavukkarasu,&nbsp;Sudheer Kumar Arava,&nbsp;Rajinder Parshad","doi":"10.1111/cyt.13496","DOIUrl":"10.1111/cyt.13496","url":null,"abstract":"<p>This enigma portal case highlights the cytological features of Primary cutaneous Rosai–Dorfman Disease, which is a breast cancer survivor. The classic morphological features, key diagnostic points and differentials are discussed.</p><p>In this report, the classical cytological features of primary cutaneous Rosai–Dorfman disease isare highlighted.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 5","pages":"544-546"},"PeriodicalIF":1.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029738","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":"Can Aggressive Papillary Thyroid Carcinoma Variants With Oncocytıc Morphology (Tall Cell and Hobnail Variants) be Detected Cytologically? Is the Differentiation as Straightforward as Reported?","authors":"Burcu Özcan, Merve Cin, Zeynep Ece Demirbaş","doi":"10.1111/cyt.13502","DOIUrl":"https://doi.org/10.1111/cyt.13502","url":null,"abstract":"<p><strong>Objective: </strong>Identifying aggressive variants of throid papillary carcinoma correctly is paramount, as their diagnosis requires more extensive surgical interventions. Numerous cytologic scoring systems have been proposed to distinguish non-aggressive from aggressive variants. Oncocytic morphology is characterised by cells with abundant granular cytoplasm resulting from mitochondrial accumulation. This feature is particularly prominent in specific PTC variants. Tall cell and hobnail variants are aggressive variants with oncocytic morphology. The present study aims to evaluate the cytomorphological features of 51 histologically confirmed papillary thyroid carcinoma (PTC) cases with oncocytic morphology and to identify cytological features that could facilitate the distinction between aggressive (tall cell and hobnail) and non-aggressive (oncocytic and Warthin-like) variants during the FNA stage, thereby enabling early detection of aggressive variants.</p><p><strong>Methods: </strong>We retrospectively examined the cytological features of cases diagnosed with histologically confirmed aggressive variants with poor prognosis (tall cell and hobnail) and non-aggressive variants with good prognosis (oncocytic and Warthin-like), obtained from the pathology department of our hospital between 2014 and 2020.</p><p><strong>Results: </strong>39 cases (76.5%) classified into the good prognosis group, which included oncocytic variant (O-PTC) (33 cases) and Warthin-like variant (WL-PTC) (6 cases). The poor prognosis group included 12 cases (23.5%), comprising hobnail variant (HN-PTC) (2 cases) and tall cell variant (TC-PTC) (10 cases). The swirl pattern was significantly more frequent in the poor prognosis group (83.3% vs. 43.6%, p = 0.022), with a sensitivity of 83.3% and specificity of 56.4%. The presence of nuclear grooves was observed in all cases of the poor prognosis group (100%) while in 61.5% of the good prognosis group (p = 0.011). This feature exhibited 100% sensitivity and 38.4% specificity. Concerning cytoplasmic volume, scant-medium amount cytoplasmic volume was significantly more common in the poor prognosis group (66.7% vs. 20.5%, p = 0.005), showing 66.7% sensitivity and 79.4% specificity, and yielding the highest accuracy rate (76.4%) among all characteristics.</p><p><strong>Conclusions: </strong>Oncocytic morphology-based approaches may help identify poor prognosis variants and guide clinical decisions. In our study, cellular swirls, grooves and scant-medium cytoplasmic volume were the most significant cytological indicators for identifying poor prognosis variants. Despite previous emphasis on cell width/height ratio and foamy INCIs for TC-PTC diagnosis, no significant differences were found between the two groups in our study.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027747","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":"Malignancy Risk, Molecular Mutations, and Surgical Outcomes of Thyroid Nodules Classified as Atypia of Undetermined Significance in the Bethesda System: A Comprehensive Analysis.","authors":"Caroline Bourque, Gianluca Savoia, Maxine Noik, Livia Florianova, Saruchi Bandargal, Sabrina Daniela da Silva, Richard Payne, Marc Philippe Pusztaszeri","doi":"10.1111/cyt.13503","DOIUrl":"https://doi.org/10.1111/cyt.13503","url":null,"abstract":"<p><strong>Objectives: </strong>Thyroid nodules classified as atypia of undetermined significance (AUS) within the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) present a diagnostic challenge, with a risk of malignancy (ROM) of 5% to 50%. In 2017, TBSRTC introduced AUS subcategories to enhance ROM assessment. This study explores the correlation between AUS subclassification, molecular mutations, and surgical outcomes.</p><p><strong>Methods: </strong>Retrospective analysis was performed of 114 AUS cases with molecular profiling by ThyroSeqV3 and surgical follow-up. AUS subcategories as defined by TBSRTC included: AUS-Architectural, AUS-Nuclear, AUS-Nuclear and Architectural, and AUS-Hürthle cell. Pathology diagnoses were categorised as benign, malignant, or borderline, including noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP).</p><p><strong>Results: </strong>Of the 114 nodules, 32.5% were AUS-Architectural, 28.9% AUS-Nuclear and Architectural, 18.4% AUS-Nuclear, 19.3% AUS-Hürthle cell, and 0.9% AUS-Not Otherwise Specified. Papillary carcinoma, predominantly follicular variant, was the most common diagnosis (47.4%), followed by benign lesions (34.2%) and NIFTP (9.6%). RAS family mutations were the most prevalent molecular alteration (34.2%) followed by DICER1, EIF1AX, EXH1 mutations, CNA and GEP (29.8%). THADA fusions, PTEN, TSHR and BRAFK601E mutations were identified in 10.5% of cases, while high-risk mutations such as BRAF V600E, TERT, and TP53 were found in 8.8% of cases. AUS subcategories demonstrated distinct molecular profiles and were linked to varying surgical outcomes.</p><p><strong>Conclusions: </strong>AUS subcategorization is associated with specific molecular profiles and surgical outcomes, supporting the subclassification of AUS cases per TBSRTC guidelines for improved risk stratification and clinical management. Further prospective studies with larger cohorts are necessary for validation.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997313","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}