Cytopathology最新文献

{"title":"Diagnostic Value of Liquid-Based Cervical Cytology Test in Endometrial Carcinoma","authors":"Tingting He,&nbsp;Shuiping Xie,&nbsp;Chunxia Liang,&nbsp;Yan Qin","doi":"10.1111/cyt.13477","DOIUrl":"10.1111/cyt.13477","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Abnormal endometrial cells could be detected by liquid-based cervical cytology test due to the anatomical continuity of the uterine cavity with the cervix. Our aim was to evaluate the diagnostic value of Papanicolaou (Pap) test in endometrial cancer (ECa).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ECa cases with liquid-based Pap smears within 6 months before the histological diagnosis were retrospectively searched from an academic women's and children's hospital pathology archive. Corresponding smears were reviewed, and clinicopathological parameters and Pap test results were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 171 cases were identified. Among these patients, 43 (25.1%) cases were interpreted as abnormal, 32 (74.4%) of which suggested glandular abnormality in the routine screening (initial Pap smear reports). After re-examining all slides, 123 (72.5%) cases showed the presence of endometrial abnormality. Among these, 87 cases (70.7%) were diagnosed as atypical endometrial cells (AEC), 33 cases (26.8%) as adenocarcinoma (ADC), and 3 cases (2.4%) as benign endometrial cells. The cases with non-endometrioid histology were more likely to be interpreted cytologically as ADC, while endometrioid subtypes were often diagnosed as AEC (<i>p</i> &lt; 0.05). Except for the tumour type (<i>p</i> &lt; 0.05), the other clinicopathological factors were not significantly related to a higher percentage of positive Pap test results, including age, histological grade, myometrial invasion, cervical involvement, lymphovascular invasion, and FIGO stage(<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pap test plays a role in the detection of ECa. Detection could be improved in routine screening by paying more attention to endometrial lesions in high-risk populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 3","pages":"259-265"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574727","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":"One-Stop Diagnosis in Interventional Pathology: A 7-Year Experience With On-Demand Care for Superficial Nodules","authors":"Karen Villar-Zarra,&nbsp;Héctor Enrique Torres-Rivas,&nbsp;Nerea Guerrero-Fretes,&nbsp;María del Mar Olmo-Fernández,&nbsp;Raúl Castañeda Vozmediano,&nbsp;Santiago Nieto Llanos,&nbsp;Jesús Nieves-Alonso","doi":"10.1111/cyt.13478","DOIUrl":"10.1111/cyt.13478","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The growing demand for specialised healthcare often results in prolonged waiting times for diagnostic procedures, particularly in oncological pathology. Interventional pathology, wherein pathologists perform sample collection and diagnosis, offers a potential solution through same-day diagnostic services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aims to describe the operational framework of a One-Stop interventional pathology consultation and analyse its outcomes, focusing on response times and diagnostic performance for patients with superficial nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study was conducted in a tertiary hospital from 2016 to 2023. The consultation involved ultrasound-guided fine needle aspiration (USFNA) and core needle biopsy (USCNB) performed by an interventional pathologist. Data on procedure adequacy, response times, and diagnostic outcomes were collected and analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 877 procedures (718 USFNA, 159 USCNB) were performed. The median time from specialist request to definitive diagnosis was 2 days (interquartile range 1–4), with 18% of patients receiving a diagnosis on the same day. Adequacy rates were 98.6% for USFNA and 100% for USCNB, with low non-diagnostic rates (USFNA: 3.2%; USCNB: 0.6%). Lymph nodes were the most commonly sampled organ, and head-and-neck areas were the predominant anatomical sites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The One-Stop interventional pathology model significantly reduced diagnostic times and improved patient experience. This efficient, patient-centred approach demonstrates high diagnostic accuracy and low non-diagnostic rates, supporting its viability for broader adoption. Further multicentre studies are needed to validate findings and optimise implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 4","pages":"318-327"},"PeriodicalIF":1.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517333","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 Characteristics of Warthin-Like Papillary Carcinoma: A Report of Four Cases and Literature Review","authors":"Cao Ma,&nbsp;Xiaoying Wei,&nbsp;Zhe Chen,&nbsp;Lihua Zhang","doi":"10.1111/cyt.13476","DOIUrl":"10.1111/cyt.13476","url":null,"abstract":"<p>In this study, the author retrospectively analysed the clinical data, fine-needle aspiration (FNA) cytology features, BRAF V600E gene test results, and prognosis of four patients diagnosed with Warthin-like papillary thyroid carcinoma (WL-PTC) and reviewed the relevant literature.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 3","pages":"273-277"},"PeriodicalIF":1.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506167","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":"Thank You to Reviewers 2024","authors":"Philippe Vielh","doi":"10.1111/cyt.13470","DOIUrl":"https://doi.org/10.1111/cyt.13470","url":null,"abstract":"","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 2","pages":"216-219"},"PeriodicalIF":1.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379872","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 Bridge: Supernatant Derived From Cytological Sample Preparations","authors":"Sinchita Roy-Chowdhuri","doi":"10.1111/cyt.13475","DOIUrl":"10.1111/cyt.13475","url":null,"abstract":"<div>\u0000 \u0000 <p>The scope and extent of molecular cytopathology in the era of precision medicine has been expanding in recent years. The versatility of cytology specimen preparations has provided ample opportunity for the cytopathology community to evolve, innovate and ‘do more with less’ using limited amounts of tissue. More recently, cytology-derived supernatant liquid biopsy samples have been identified as a substantial source of high-quality genomic material that can be interrogated for genotyping for therapeutic decision-making, as well as other roles in cancer screening for early-stage disease, longitudinal monitoring for therapeutic response and disease prognostication. These novel substrates, including supernatants from body fluids such as urine, pleural effusion, ascitic fluid, cerebrospinal fluid, as well as fine-needle aspiration (FNA) specimens, serve as a bridge between tissue-based testing and conventional liquid biopsy testing from the patient's plasma. Cytologically derived liquid biopsy samples can only be used in situations where the tissue sample is inadequate for genotyping, or when plasma-based liquid biopsy fails to identify an oncogenic driver alteration, but they can be used as a stand-alone complementary specimen source that can provide reliable genomic information for therapeutic decisions. This review aims to highlight some of the advances in the field and the clinical applications of the cytology-derived supernatant specimen.</p>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 3","pages":"222-227"},"PeriodicalIF":1.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375040","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":"Automated Description Generation of Cytologic Findings for Lung Cytological Images Using a Pretrained Vision Model and Dual Text Decoders: Preliminary Study","authors":"Atsushi Teramoto,&nbsp;Ayano Michiba,&nbsp;Yuka Kiriyama,&nbsp;Tetsuya Tsukamoto,&nbsp;Kazuyoshi Imaizumi,&nbsp;Hiroshi Fujita","doi":"10.1111/cyt.13474","DOIUrl":"10.1111/cyt.13474","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Cytology plays a crucial role in lung cancer diagnosis. Pulmonary cytology involves cell morphological characterisation in the specimen and reporting the corresponding findings, which are extremely burdensome tasks. In this study, we propose a technique to generate cytologic findings from for cytologic images to assist in the reporting of pulmonary cytology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For this study, 801 patch images were retrieved using cytology specimens collected from 206 patients; the findings were assigned to each image as a dataset for generating cytologic findings. The proposed method consists of a vision model and dual text decoders. In the former, a convolutional neural network (CNN) is used to classify a given image as benign or malignant, and the features related to the image are extracted from the intermediate layer. Independent text decoders for benign and malignant cells are prepared for text generation, and the text decoder switches according to the CNN classification results. The text decoder is configured using a transformer that uses the features obtained from the CNN for generating findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The sensitivity and specificity were 100% and 96.4%, respectively, for automated benign and malignant case classification, and the saliency map indicated characteristic benign and malignant areas. The grammar and style of the generated texts were confirmed correct, achieving a BLEU-4 score of 0.828, reflecting high degree of agreement with the gold standard, outperforming existing LLM-based image-captioning methods and single-text-decoder ablation model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Experimental results indicate that the proposed method is useful for pulmonary cytology classification and generation of cytologic findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 3","pages":"240-249"},"PeriodicalIF":1.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366759","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":"Navigating Diagnostic Uncertainty in Thyroid Nodules: The Critical Role of Cytology and Histology in Oncocytic and Rare Patterned Lesions","authors":"Jaiden Townsend,&nbsp;Miguel Perez-Machado","doi":"10.1111/cyt.13473","DOIUrl":"10.1111/cyt.13473","url":null,"abstract":"&lt;p&gt;Thyroid nodules are prevalent in clinical practice with a prevalence of up to 60%, the majority are benign with a risk of malignancy being 7%–15% [&lt;span&gt;1, 2&lt;/span&gt;]. Fine-needle aspiration (FNA) cytology is a cornerstone in the evaluation of thyroid nodules, allowing for an early, minimally invasive assessment [&lt;span&gt;3&lt;/span&gt;]. FNA provide an economic and accurate diagnosis of nodular thyroid disease [&lt;span&gt;4&lt;/span&gt;]. This approach has significantly advanced the diagnostic process for thyroid nodules.&lt;/p&gt;&lt;p&gt;Despite this utility, FNA cytology has limitations, particularly in the evaluation of indeterminate thyroid nodules. The Bethesda (2023) terminology provides a standardised international framework for categorising FNA results into six categories. (i) non-diagnostic, (ii) benign, (iii) atypia of undetermined significance, (iv) follicular neoplasm, (v) suspicious for malignancy and (vi) malignant [&lt;span&gt;5&lt;/span&gt;]. These categories guide clinical management, with nodules classified as Bethesda III and above often warranting further consideration for surgical intervention.&lt;/p&gt;&lt;p&gt;Although FNA is a valuable diagnostic tool, it has limitations in distinguishing pathologies with overlapping cytological features. This is particularly difficult in those nodules with indeterminate morphological cytological features. It may fail to differentiate between benign and malignant lesions, particularly when critical features such as capsular or vascular invasion cannot be assessed cytologically. In such cases, histological evaluation is essential, as it provides a detailed examination of architectural features, including tissue invasion, which is crucial for definitive diagnosis. By complementing cytology, histology offers a more comprehensive assessment, facilitating accurate classification of thyroid nodules and informing appropriate clinical management.&lt;/p&gt;&lt;p&gt;Oncocytic cells are specialised cells characterised by an unusually high number of mitochondria, which gives them a distinctive granular, eosinophilic (pinkish) and often intensely staining cytoplasm. These cells can occur in various tissues and are frequently associated with both benign and malignant tumours, especially in organs like the thyroid, salivary glands, kidneys and adrenal glands. The term ‘oncocytic’ is derived from the Greek word &lt;i&gt;onkos&lt;/i&gt;, meaning ‘mass’ or ‘bulk’, reflecting the swollen or enlarged appearance of these cells due to their high mitochondrial content.&lt;/p&gt;&lt;p&gt;This report details the final diagnosis of a patient with an FNA in which oncyotoid cells were present with a diagnosis of a category IV-subtype oncocytic details a case of underscoring the importance of distinguishing cytological features and the use of histology to avoiding misclassification.&lt;/p&gt;&lt;p&gt;A 52-year-old male presented with a history of Hashimoto's thyroiditis presented with a 10 mm nodule in the right lobe of the thyroid. Ultrasound of the right lobe showed a U3 nodule. The patient underwent an FNA. Cytol","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 3","pages":"278-280"},"PeriodicalIF":1.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cyt.13473","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082242","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 Biopsy of Adrenal Gland Lesions: The Roles of Image Guidance, Rapid On-Site Evaluation and Additional Tissue Sampling","authors":"Sanhong Yu,&nbsp;Darin Dolezal,&nbsp;Harry R. Aslanian,&nbsp;Guoping Cai","doi":"10.1111/cyt.13472","DOIUrl":"10.1111/cyt.13472","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>An accurate fine-needle aspiration (FNA) diagnosis of adrenal lesions may be challenging. This study was to investigate roles of imaging guidance, rapid on-site evaluation (ROSE) and additional tissue sampling in FNA diagnosis of adrenal lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adrenal FNA cases were retrieved from pathology archive. Patients' demographics, lesion size and location, imaging guidance methods, cytologic diagnoses and histopathologic diagnoses were reviewed and analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study cohort included 72 cases of left (86%) and right (14%) adrenal lesions. Endoscopic ultrasound (EUS) and computed tomography (CT) were used in 47 (65%) and 25 (35%) cases, respectively. Left adrenal lesions were sampled mostly by EUS-FNA (73%), whereas right adrenal lesions by CT-guided FNA (80%). There were no differences between the EUS-FNA and CT-FNA groups in terms of non-diagnostic rate and cytologic diagnostic categories. The non-diagnostic rate and cytologic diagnostic categories were the same between ROSE and non-ROSE groups. In a subset of 18 cases with concurrent core tissue biopsy, a definite diagnosis was rendered in all biopsy cases including three cases with a non-diagnostic or indeterminate cytology diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study demonstrates that FNA has great efficacy for evaluation of adrenal lesions, either via EUS or CT guidance. Incorporation of ROSE evaluation into FNA procedure does not directly affect the performance of FNA biopsy but may help direct additional tissue sampling to salvage the cases with a non-diagnostic or indeterminate cytology diagnosis, increasing diagnostic yield.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 3","pages":"228-235"},"PeriodicalIF":1.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061571","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":"Thy1c Cytology Is a Reliable Method of Excluding Thyroid Cancer in Dominant Cystic Nodules","authors":"A. Regan,&nbsp;A. Boyd,&nbsp;N. Patel,&nbsp;M. J. Stechman,&nbsp;D. Scott-Coombes","doi":"10.1111/cyt.13471","DOIUrl":"10.1111/cyt.13471","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traditional teaching dictated that patients with recurrent thyroid cysts undergo excision owing to a 12% risk malignancy. Ultrasound evaluation now determines management of these patients augmented by fine needle biopsy. In UK, a non-diagnostic category for thyroid cysts (Thy1c) exists, whereas the Bethesda system combines ‘non-diagnostic—cyst fluid only’ into Category I along with paucicellular and acellular results. The aim was to assess the ability of Thy1c cytology to exclude malignancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We undertook a retrospective study of patients undergoing thyroidectomy with Thy1c cytology from analysis of the Unit database. Additionally, we made a retrospective search in our pathology database for reports combining ‘papillary thyroid carcinoma’ with ‘cyst’ or ‘cystic’ and compared histology with cytology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2003 and 2023 115 patients (97 women, median age 44y, range 16–72) underwent thyroidectomy following Thy1c cytology. Indications for surgery included recurrent cyst (90%); compressive symptoms (9%) and one thyrotoxicosis. In no patient was the primary diagnosis malignant; multinodular goitre was commonest (87.76%); benign cyst (19.16%); follicular adenoma (5.4%) and coincidental pT1a classical papillary thyroid carcinoma (PTC) (4.3%). In the retrospective audit, 61 pathology reports contained ‘PTC’ and ‘cyst’/‘cystic’. The cystic element was in primary tumour (31.51%); nodal metastasis (17.28%) and adjacent benign disease (13.21%). Only 5 (8%) patients had Thy1c cytology; 4 had pT1a tumours and one a benign cyst and a 19 mm PTC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Thy1c category reliably excludes significant malignancy. For patients with symptomatic cysts, ultrasound assessment and Thy1c cytology can guide the clinician to treat with either ablation or resection without the fear of mistreating a thyroid cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 3","pages":"236-239"},"PeriodicalIF":1.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025760","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":"Proposal for Clinical Management of Nodules Diagnosed as Atypia of Undetermined Significance via Thyroid Fine-Needle Aspiration Cytology in the Absence of Molecular Testing","authors":"Ayana Suzuki,&nbsp;Mitsuyoshi Hirokawa,&nbsp;Makoto Kawakami,&nbsp;Takumi Kudo,&nbsp;Akira Miyauchi,&nbsp;Takashi Akamizu","doi":"10.1111/cyt.13467","DOIUrl":"10.1111/cyt.13467","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Molecular testing is recommended for risk stratification of atypia of undetermined significance (AUS) nodules in the USA; however, it is not routinely performed in some countries owing to limited availability and affordability. Here, we propose a risk stratification algorithm for AUS nodules when molecular testing is unavailable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined 304 (4.3%) AUS nodules among 7073 thyroid fine-needle aspiration cytology specimens examined at Kuma Hospital from January 2020 to December 2020. Clinical data were obtained from the medical records of Kuma Hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AUS with nuclear atypia and AUS-other each accounted for half of the total AUS nodules. The repeat aspiration rate was 19.7%; 61.7% of the nodules were reclassified as benign or malignant upon repeat aspiration. Resection rate and overall risk of malignancy (ROM) were 32.6% and 12.8%, respectively. Architectural atypia showed the lowest (1.1%) overall ROM in the AUS nodules. For AUS with nuclear atypia, nodules ≤ 10 mm in size showed significantly lower overall ROM than those of &gt; 10 mm, and nodules with ultrasonographically low suspicion showed significantly lower overall ROM than those with intermediate to high suspicion. AUS nodules with atypical lymphoid cells, possible medullary thyroid carcinoma, or possible parathyroid lesion were confirmed using flow cytometry, biochemical testing using needle washout fluid or immunocytochemistry, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our proposed clinical management algorithm for each subdivision according to cytological findings, based on repeat aspiration rates, ROM, ultrasound findings and results of ancillary tests except for molecular testing, should be useful for the clinical management of AUS nodules.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 2","pages":"115-122"},"PeriodicalIF":1.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cyt.13467","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967459","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}