Acta Cytologica最新文献

{"title":"Beyond the microscope: cytotechnologists' integral role in quality management.","authors":"Nathalie Andon, Savannah Bean, Vanda F Torous","doi":"10.1159/000546629","DOIUrl":"https://doi.org/10.1159/000546629","url":null,"abstract":"<p><p>Cytotechnologists are integral members of the cytopathology team with their role extending beyond that of analyzing slides. They have a unique understanding of cytopreparation, laboratory systems, and workflows given their involvement in varied laboratory processes which makes them key players in quality control, quality assurance, and quality improvement measures. Many cytotechnologists endorse performing quality assurance and/or quality control activities as part of their duties. In this article, we review some of the key quality control and assurance measures cytotechnologists are involved in with an emphasis on how they can take a leading role in systems operations and improvements.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273847","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":"New WHO Reporting System for Lung Cytopathology: Reproducibility Test of the Diagnosis and Usefulness of an Online Tutorial System for the New Cytological Categorization.","authors":"Yuko Minami, Akemi Takenaka, Kenzo Hiroshima, Akihiko Yoshizawa, Reiji Haba, Kunimitsu Kawahara, Yasuo Shibuki, Shinji Miyake, Hirokuni Kakinuma, Yukitoshi Satoh","doi":"10.1159/000546179","DOIUrl":"https://doi.org/10.1159/000546179","url":null,"abstract":"<p><p>Introduction Since no universal cytological classification system for lung cancer has been established, the Japanese Lung Cancer Society and the Japanese Society of Clinical Cytology (JSCC) jointly established and reported four cytological categories: negative for malignancy, atypical cells, suspicious for malignancy, and malignancy. In 2022, the WHO Reporting System for Lung Cytopathology was published. This system presented five cytological classifications, including the four cytological category classifications above and insufficient/inadequate/nondiagnostic. The creation of a classification alone is not practical in actual clinical practice. Thus, we evaluated the reproducibility of the classification through tutorials and identified the issues and problems involved in the wide dissemination of this classification. Methods Forty-two cases were selected from those used in previously published articles, and diagnosis and tutorial systems were created. The first diagnostic round and tutorial and the second diagnostic round were conducted on the web. Participants were recruited via the JSCC website and emails. Images (100× and 400×) of the lesions to be diagnosed were categorizing by 4 cytological categories (benign, atypical, suspicious for malignancy, malignant), 7 suggestive pathological diagnoses, and 4 cytological features. The mean correct or incorrect answer rates for the 42 cases and the mean correct response rates for 105 participants were compared between the first and second rounds using McNemar's test and t-tests to identify cases with diagnostic difficulties and high tutorial effects. Results Comparing the correct response to cytological categories, the results showed that 17 of 42 cases improved significantly. The mean number of correct answers for the four cytological categories increased significantly from 16.0 (38.1%) in the first round to 20.3 (48.3%) in the second round (p < 0.001). For the seven suggestive pathological diagnoses, the mean number of correct answers increased significantly from 20.3 (48.3%) in the first round to 25.1 (59.8%) in the second round (p < 0.001). The mean number of correct responses increased significantly from 40.2 (38%) in the first round to 51.5 (49%) in the second round (p = 0.0147). Four cases were difficult to match even after the tutorial and three cases were highly affected by the tutorial. The most important basis for diagnoses was nuclear findings in the first and second rounds. Conclusion Comprehensive tutorials on diagnostic criteria are needed to effectively implement this system globally. In particular, devising ways to appropriately diagnose cancers with mild atypia or without characteristic morphology is important.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-37"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172190","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":"External Quality Assessment in Diagnostic Cytopathology: Current Programs, Challenges, and Perspectives.","authors":"Irena Srebotnik Kirbis, Margareta Strojan Flezar","doi":"10.1159/000546537","DOIUrl":"https://doi.org/10.1159/000546537","url":null,"abstract":"<p><strong>Background: </strong>External quality assessment (EQA), including Proficiency testing (PT), is a fundamental aspect of laboratory quality management and a key requirement for diagnostic laboratory accreditation.</p><p><strong>Summary: </strong>This review highlights significant gaps in comprehensive EQA/PT programs for diagnostic non-gynecological cytopathology that fully address all aspects of the diagnostic process, particularly in Europe.</p><p><strong>Key messages: </strong>Current EQA/PT programs for diagnostic cytopathology are mostly regional, national, and only partially cover the examination process. The unique challenges of diagnostic cytopathology, including small and limited patient samples, non-standardized laboratory procedures, biomarker testing tailored to specific cytology samples, and the qualitative subjective nature of cytopathologic reporting, necessitate adapted approaches for effective and meaningful EQA.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172187","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 respiratory cytology support system using a chromatin homology profile for clinical applications.","authors":"Kazuki Kanayama, Yuhki Yokoyama, Kento Iida, Kunimitsu Kawahara, Masako Onishi, Mai Iwasaki, Makiko Shibahara, Takashi Matsumoto, Sachiko Nagumo, Hirofumi Yamamoto, Kazuaki Nakane","doi":"10.1159/000546578","DOIUrl":"https://doi.org/10.1159/000546578","url":null,"abstract":"<p><strong>Introduction: </strong>In a previous study, we developed a chromatin homology profile (CHP) method using the mathematical concept of homology and an analysis application, \"Cell Checker\", to differentiate histological types of lung cancer in respiratory cytology. However, issues such as the analyzed field of view and data volume arose because the CHP method is based on images taken with a 100× objective lens. In this study, to overcome these challenges, we investigated the accuracy of the CHP method for differentiating histologic types of lung cancer using images obtained with a 40× objective.</p><p><strong>Methods: </strong>In total, 35 cases of lung cancer and benign tissue were selected, and 6 cancer cells and ciliated columnar epithelial cells per case were imaged with a 40× objective using a KEYENCE microscopy system. We analyzed chromatin contact (b1MAX value) and chromatin density (b1MAX/nuclear area value) with Cell Checker.</p><p><strong>Results: </strong>The b1MAX value was lower in small cell carcinoma and there was a significant difference between small cell and non-small cell carcinoma. Significant differences in b1MAX/nuclear area values were found between adenocarcinoma and squamous cell carcinoma. These results were similar to those obtained with images from the 100× objective. Moreover, significant differences in b1MAX and b1MAX/nuclear area values were observed between benign and malignant cases.</p><p><strong>Conclusion: </strong>We have overcome the problem associated with using images obtained with the 100× objective and shown that the CHP method can be used to differentiate between benign and malignant cases. The CHP method could be used as a diagnostic support system for respiratory cytology.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172185","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 Melanoma of the Lung - A Vanishing Entity.","authors":"Tanner Storozuk, Melissa Tjota, Prince Ntiamoah, Pankhuri Wanjari, Anna Biernacka, Ward Reeves, Tatjana Antic","doi":"10.1159/000546441","DOIUrl":"https://doi.org/10.1159/000546441","url":null,"abstract":"<p><p>Background Primary melanoma of the lung has been considered an extremely rare and highly aggressive malignancy that accounts for 0.01% of all primary lung tumors. Molecular studies, as well as pertinent clinical history, have since brought into question whether these tumors truly represent primary lesions of the lung. The current study evaluates a series of four melanomas of the lung to assess whether primary melanoma of the lung is truly a diagnostic consideration, or if these cases represent metastases of other primary sites. Methods The pathology archives at the University of Chicago Medical Center were searched for patients who underwent robotic or endobronchial ultrasound-guided fine needle aspiration from 2018 to 2024. Clinicopathologic data, including demographics, fine needle aspiration results, and follow-up information including molecular studies and surgical resections, was collected from patients' electronic medical record. Results In total 15959 robotic-guided/endobronchial ultrasound-guided FNAs were reviewed, with two cases (0.0001%) being metastatic melanoma with no known cutaneous primary after immunohistochemical and molecular studies. Both patients had molecular studies performed. Notable mutations included BRAF, TERT, NRAS, CDKN2A, and NF1, which are frequently seen in cutaneous melanomas. High tumor mutational burden (UV signature with >98 mutations per megabase) was also detected by next generation sequencing. Conclusion Based upon molecular signatures, clinical history, and presumed lack of precursor cell type within the bronchial epithelium, melanomas arising within the lung are most likely metastatic tumors.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075337","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":"PD-L1 in lung cytology: the path for standardization.","authors":"Mohammed S I Mansour, Gennaro Acanfora, Giancarlo Troncone, Hans Brunnström, Elena Vigliar","doi":"10.1159/000546275","DOIUrl":"https://doi.org/10.1159/000546275","url":null,"abstract":"<p><strong>Background: </strong>The advent of PD-1/PD-L1 inhibitors has revolutionized lung cancer treatment, necessitating accurate PD-L1 immunohistochemical (IHC) assessment. While standardized for formalin-fixed paraffin-embedded (FFPE) histological samples, PD-L1 testing on cytology remains challenging. This review aims to address the complexities of PD-L1 IHC in cytology, focusing on validation guidelines, quality assessment, cyto-histological correlation, and interobserver variability.</p><p><strong>Summary: </strong>This review synthesizes current guidelines and research on PD-L1 IHC in cytology; in particular, recent College of American Pathologists (CAP) guidelines emphasize the necessity for rigorous validation, particularly for non-formalin-fixed specimens. As far as cyto-histological concordance studies is concerned, the review of 48 original articles reveal significant variability in PD-L1 expression, with concordance rates ranging from 54-100% at the 1% cutoff and 82-100% at the 50% cutoff. Finally, interobserver variability, particularly in the 1-49% PD-L1 expression range, further complicates accurate assessment. The review also discusses the challenges associated with quality assessment in cytology, including the lack of standardized control materials and external quality assessment (EQA) programs specifically tailored for cytological samples.</p><p><strong>Conclusion: </strong>PD-L1 testing on cytology presents significant challenges, including validation complexities, quality control limitations, and interobserver variability. Standardized guidelines and rigorous validation are essential to ensure accurate and reliable PD-L1 assessment in cytological specimens.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-19"},"PeriodicalIF":1.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075335","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":"Assessment of ER, PR and HER2 on cell blocks and core needle biopsies in metastatic breast cancer: a real-world experience.","authors":"Chen Lossos, Sandra Sanchez, Hiro Nonogaki, Edward Gabrielson, Ashley Cimino-Mathews, Zahra Maleki","doi":"10.1159/000546274","DOIUrl":"https://doi.org/10.1159/000546274","url":null,"abstract":"<p><strong>Introduction: </strong>The status of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) plays a crucial role in the management of patients with metastatic breast cancer. Herein we report our experience on ER, PR and HER2 immunostains on cell block and core needle biopsy (CNB) specimens of metastatic breast cancers.</p><p><strong>Methods: </strong>Cytological samples of metastatic breast cancer with associated cell blocks or core needle biopsies were identified on which ER, PR, or HER2 were ordered from 2019 to 2021. Both fine needle aspiration specimens and body effusion fluids were included. Patients' demographics, cancer histological subtype, biopsy site, specimen type (cell block or CNB) for immunohistochemistry and ER, PR and HER2 expression were recorded.</p><p><strong>Results: </strong>192 specimens from 177 patients were identified. Patients' mean age was 58.5 years (range 24-96). The majority of samples were obtained from patients with invasive ductal carcinoma. Staining was performed on core biopsies (n=74/192, 38.5%) and on cell blocks (n=118/192, 61.5%). Pleural fluid (n=75) was the most commonly sampled site followed by the liver (n=48) and lymph nodes (n=44). ER, PR and HER2 were positive in 76.3%, 79.3% and 13.2% of samples, respectively. Concordantly, ER+PR+HER2- was the most common sample phenotype. Seven samples had insufficient tissue to evaluate ER, PR or HER2 status.</p><p><strong>Conclusion: </strong>ER, PR and HER2 immunohistochemical staining can be performed on cell block or CNB specimens of metastatic breast cancer and can provide reliable information to clinicians for optimal patient care. .</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-18"},"PeriodicalIF":1.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958849","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":"Risk of Malignancy Ranges and Category Percentage Assignment in Cytopathology Reporting Systems: Are They Useful Quality Assurance Indicators?","authors":"Lester J Layfield, Zubair W Baloch","doi":"10.1159/000546228","DOIUrl":"https://doi.org/10.1159/000546228","url":null,"abstract":"<p><p>Background Quality assurance (QA) is essential in cytopathology to ensure diagnostic accuracy. Common QA methods include peer reviews, 10% random reviews, and benchmarking against published standards. Benchmarking, which compares institutional data on specimen category assignment and risk of malignancy (ROM) with published body site reviews, helps evaluate performance and identify areas of improvement. Cytopathology reporting systems for various body sites categorize specimens based on ROM estimates. The diagnostic categories and ROM estimates in non-gynecologic cytopathology systems can serve as quality metrics to improve practices and maintain high standards of patient care. Summary A well-developed QA system in cytology is crucial for ensuring diagnostic accuracy and minimizing errors. By using tools like secondary reviews, retrospective analyses, and structured reporting systems, labs can improve practices, detect errors, and maintain high standards of patient care.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-28"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960304","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 Prognostic Significance of Ki-67 Expression in Breast Cancers Developing Malignant Effusions.","authors":"Ilias P Nikas, So Hyeon Yang, Sojung Lim, Hyebin Lee, Han Suk Ryu","doi":"10.1159/000546180","DOIUrl":"10.1159/000546180","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to investigate the prognostic significance of Ki-67 in breast cancer patients developing malignant effusions.</p><p><strong>Methods: </strong>In this retrospective study, 76 breast cancer patients developing a malignant effusion were enrolled. The Ki-67 immunohistochemistry (IHC) findings from both initial tissue and paired metastatic effusion samples of these patients were grouped into the following three categories: ≤5, 6-29, and ≥30%.</p><p><strong>Results: </strong>Triple-negative breast cancer (TNBC) showed higher Ki-67 levels at both initial diagnosis (p < 0.001) and malignant effusion samples (p = 0.015), compared to the non-TNBC phenotypes at the same tumor evolution phases, respectively. A Ki-67 ≥30% at initial diagnosis was associated with a shorter overall survival (p = 0.031; long-rank test), in addition to an earlier development of a malignant effusion (p < 0.001; long-rank test). A Ki-67 ≤5% at malignant effusion cell block samples was associated with a longer post-effusion survival (p = 0.015; long-rank test). Lastly, a Ki-67 index ≤5% at the effusion samples showed a significantly lower risk of mortality following the development of malignant effusions (HR: 0.355 [0.150-0.842; p = 0.019]), after being adjusted for the intrinsic subtype covariate (TNBC vs. non-TNBC).</p><p><strong>Conclusion: </strong>Estimating the Ki-67 IHC expression in malignant effusion cytology samples may have a prognostic significance, when evaluating patients with metastatic breast cancer. However, larger scale prospective studies would be necessary to provide more evidence on this topic.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962215","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":"Cervicovaginal Infections and Coinfections and Their Significance through the Papanicolaou Test: A Cross-Sectional Study in Pregnant and Non-Pregnant Women.","authors":"Eder Yair Walttuoni Picón, Víctor Abraham Rojas Zumarán, Gloria Cruz-Gonzales, Rocio Lozada-Diaz, Cleofe Del Pilar Yovera-Ancajima","doi":"10.1159/000543839","DOIUrl":"10.1159/000543839","url":null,"abstract":"<p><strong>Introduction: </strong>Cervicovaginal infections continue to be a public health problem for the female population. The aim of this study was to compare the prevalence of infections and coinfections diagnosed by cervical cytology in pregnant and non-pregnant patients at the San Bartolomé Hospital, Lima, Peru.</p><p><strong>Methods: </strong>An observational and cross-sectional study was conducted. A sample of 284 cervical reports from pregnant and non-pregnant women was included and screened by the Pap test during the period 2021-2023.</p><p><strong>Results: </strong>The overall prevalence of cervicovaginal infections was 52.8%, for pregnant women 59.2% and for non-pregnant women 46.5%, with statistically significant differences between the groups (p < 0.05). Bacterial vaginosis (43%) and Candida spp. predominated (26.8%), showing significant differences (p < 0.05). No significant differences were observed with other cervicovaginal infections (p > 0.05). The general prevalence of coinfections was 13.4%, for the pregnant group it was 19.7% and for the non-pregnant group it was 7.0%, observing differences with statistical significance between the groups (p < 0.05). The most predominant coinfection was bacterial vaginosis accompanied by Candida spp. (13.4%), finding significant differences (p < 0.05). No significant differences were observed with other cervicovaginal coinfections (p > 0.05).</p><p><strong>Conclusion: </strong>There is a higher prevalence of cervicovaginal infections and coinfections in pregnant women in contrast to non-pregnant women, observing statistically significant differences by means of the Pap test.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-8"},"PeriodicalIF":1.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955291","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}