Acta Cytologica最新文献

{"title":"Evaluation of the cytomorphology, immunophenotype, and molecular genetics of lymphoblastic lymphoma/leukemia in serous effusion.","authors":"Wenjing Cui, Xiaochen Ding, Jiayan Liu, Peizhen Hu, Shirong Ma, Changwei Yang, Hong Xu","doi":"10.1159/000548726","DOIUrl":"https://doi.org/10.1159/000548726","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to elucidate the spectrum of clinical manifestations, cytomorphology, immunophenotype, and the molecular genetic features of lymphoblastic lymphoma/acute lymphoblastic leukemia (LBL/ALL) in the context of serous effusions (SE).</p><p><strong>Methods: </strong>A retrospective analysis evaluated the cytomorphological features, immunophenotype, and the cyto-histological correlations of twenty-one LBL/ALL associated with SE. Concurrently, bone marrow (BM) aspiration samples were analyzed using an integrated approach, including flow cytometry, RT-PCR, next generation sequencing (NGS) or whole transcriptome sequencing (WTS).</p><p><strong>Results: </strong>Of the 21 cases of SE LBL/ALL, 16 cases were T-LBL/ALL and 5 cases were B-LBL/ALL. The cases included 17 pleural, 2 peritoneal, and 2 pericardial fluid samples. Both T-LBL/ALL and B-LBL/ALL in SE exhibit a blast-like morphology, characterized by small to medium size, irregular nuclear membranes, and inconspicuous nucleoli, alongside frequent nuclear fragmentation and apoptotic bodies. LBL/ALL express immaturity markers such as TdT (7/17, 41.2%), CD10 (6/12, 50%), CD43 (8/8, 100%), and CD99 (6/6, 100%). T-LBL/ALL and B-LBL/ALL specifically express T-cell markers [CD2 (3/6, 50%), CD3 (10/12, 83.3%), CD5 (2/11, 18.2%), CD7 (10/10, 100%)] or B-cell markers [CD20 (3/5, 60%), CD79a (4/4,100%), PAX5 (5/5, 100%)], respectively. A high proportion of primitive and immature lymphocytes exceeding 25% in BM was observed in T-LBL/ALL (5/7) and in one case of B-LBL/ALL. No BCR/ABL gene rearrangements were detected in any cases. Furthermore, fusion gene MLL::ENL and PLCALM::MLLT10, as well as mutations in genes including WT1, NOTCH1, PAX5, IKZF, ARID1A, BCOR, SETD2, ARID2, TET2, JAK3, NF1, and CEBPA, were identified in LBL/ALL through RT-PCR, NGS, or WTS.</p><p><strong>Conclusion: </strong>The integration of clinical manifestations, cytological evaluation, and gene expression profiles is instrumental in achieving accurate diagnosis, sub-classification, and prognosis of LBL/ALL within the context of SE.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190629","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":"Applicability of fine-needle aspiration biopsy of lymph nodes using WHO reporting system: comparison between pediatric and adult Brazilian populations.","authors":"Leonardo Fávaro Ficoto, Deolino João Camilo Júnior, Gustavo Resende Nora, Vitor Bonetti Valente, Daniel Galera Bernabé, José Cândido Caldeira Xavier-Júnior","doi":"10.1159/000548652","DOIUrl":"https://doi.org/10.1159/000548652","url":null,"abstract":"<p><strong>Introduction: </strong>Fine-needle aspiration biopsy (FNAB) is a minimally invasive diagnostic method widely used in the evaluation of lymphadenopathies. However, there are few studies evaluating its applicability in different age groups, especially among the pediatric population. This study aimed to evaluate the cytological findings of lymph nodes FNAB between pediatric and adult patients using the WHO Reporting System for Cytopathology of Lymph Nodes, Spleen.</p><p><strong>Methods: </strong>This retrospective and observational study included 366 cases of lymph node FNAB collected and analyzed by a single pathological center (the Instituto de Patologia de Araçatuba), Brazil, from January 2016 to December 2024. Cytological diagnoses were categorized using the WHO Reporting System for Cytopathology of Lymph Nodes, Spleen, and Thymus into five categories (inadequate/insufficient, benign, atypical, suspicious for malignancy, and malignant) and correlated with histopathological outcomes, when available. Ancillary techniques and rapid on-site evaluation were not available. Statistical analyses included chi-square and Fisher's exact tests. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Among the 366 cases, 17 (4.6%) were pediatric and 349 (95.4%) were adult. The most frequent location of the lesions was the head and neck region (79%). Benign cytologic diagnoses were significantly more common in children (94.1%), while suspicious for malignancy and malignant results were exclusive to adults (29.3% and 14%, respectively; p = 0.001). Larger lymph nodes (> 2 cm) were significantly associated with malignancy (p < 0.0001). Considering the total population, the rates of ROM were 50% for category 'insufficient', 32.6% for benign, 82.8% for suspicious, and 97.5% for malignant cases. Respectively, from each category 28 (53.8%), 49 (27.7%), 35 (71.4%) and 16 (32.6%) patients were underwent to histopathological follow-up respectively.</p><p><strong>Conclusion: </strong>This study, despite the limited pediatric sample, demonstrates that the method is applicable to both pediatric and adult patients, including those outside cancer centers. The calculated risk of malignancy (ROM) was 50% for inadequate, 32.6% for benign, 82.9% for suspicious, and 97.6% for malignant categories. Deviations from WHO reference intervals for inadequate and benign cases may be attributed to the absence of ancillary techniques. Then, two main findings emerged: (i) benign cytologic diagnoses predominated in children, while suspicious and malignant results occurred exclusively in adults; and (ii) lymph nodes >2 cm were strongly associated with malignant cytological and histological outcomes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-22"},"PeriodicalIF":1.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147396","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":"An Artificial Intelligence-Based Method for Risk Stratification of Urothelial Carcinoma from Liquid-Based Urine Cytology Whole-Slide Images.","authors":"Lei Xiong, Jia Li, Xinyi Jin, Xinyi Cao, Pan Chen, Zichang Liu, Xiaodan Zhang, Ying Li, Lizhi Zhang, Jianbo Wang, Chang Shi, Fengqi Fang","doi":"10.1159/000548615","DOIUrl":"https://doi.org/10.1159/000548615","url":null,"abstract":"<p><strong>Introduction: </strong>Urine cytology is a non-invasive and widely used approach for the early detection of urothelial carcinoma (UC), but its diagnostic accuracy is limited, particularly for low-grade lesions. This study aims to develop a novel artificial intelligence (AI)-based framework for risk stratification of UC from whole-slide images (WSIs), offering a promising solution to enhance the diagnostic accuracy of urine cytology.</p><p><strong>Methods: </strong>A total of 385 urine cytology slides were included and stratified into three diagnostic groups based on cytological evaluation: Negative for High-Grade Urothelial Carcinoma (NHGUC), Low-risk (including atypical urothelial cells (AUC) and low-grade urothelial carcinoma (LGUC)), and High-risk (including suspicious for high-grade urothelial carcinoma (SHGUC) and high-grade urothelial carcinoma (HGUC)). Following digitization into WSIs, expert pathologists conducted detailed cell-level annotation. Cell detection and segmentation were performed using RTMDet and DuckNet, and the extracted features were aggregated into slide-level representations for training and evaluation of classification models.</p><p><strong>Results: </strong>Support Vector Machine demonstrated the highest overall performance among the classifiers, with an accuracy of 79%, recall of 79%, and a specificity of 90%. The model demonstrated strong classification performance across three risk stratifications. The High-risk group achieved a sensitivity of 73.1% and specificity of 90.2%, while the Low-risk group showed a sensitivity of 81.8% and specificity of 89.1%. Precision-recall curves indicated that the NHGUC group achieved the highest average precision, reaching 0.93, followed by the High-risk group at 0.85 and the Low-risk group at 0.82. ROC analysis further demonstrated strong discriminative capability for three risk groups, with the area under the curve measured at 0.95 for NHGUC and 0.91 for both the Low-risk and High-risk groups.</p><p><strong>Conclusion: </strong>The proposed AI-assisted framework shows robust and interpretable performance in stratifying UC cytological categories from WSIs. It holds strong potential as a supportive tool in urine cytology, especially in assisting with the diagnosis of high-risk UC cases.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-20"},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136060","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 Association Between Subcategorization, Cytomorphological Features and Ultrasonographic Characteristics With Surgical Outcomes of Atypia of Undetermined Significance Thyroid Nodules.","authors":"Ahmet Kursat Soyer, Aysegul Aksoy Altinboga, Gokcen Nailer Ertuna, Husniye Baser, Fatma Neslihan Cuhaci Seyrek, Abbas Ali Tam, Birol Korukluoglu, Oya Topaloglu, Reyhan Ersoy, Bekir Cakir","doi":"10.1159/000548285","DOIUrl":"https://doi.org/10.1159/000548285","url":null,"abstract":"<p><p>Introduction We aimed to investigate malignancy rates in atypia of undetermined significance (AUS) subcategories and their association with cytomorphologic and ultrasonographic features. Methods A total of 201 thyroid nodules with AUS cytology that underwent surgical resection were analy-zed, including 169 AUS-Nuclear (AUS-N) and 32 AUS-Other (AUS-O) nodules. Cytomorphological and ultrasonographic features, along with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS) and the European Thyroid Imaging Reporting and Data System (EU-TIRADS) classifications, were analyzed to assess the association between malignancy and AUS subcategories. Results The overall risk of malignancy (ROM) for AUS nodules was 19.4%, with a significantly higher rate observed in the AUS-N subgroup compared to AUS-O (21.9% vs. 6.3%, p = 0.04). A significantly higher ROM was observed in nodules with irregular margin, taller-than-wide shape, microcalcification, hypoec-hogenicity, and solid composition (OR = 9.63, 5.81, 3.33, 2.14, and 2.07, respectively). A statistically sig-nificant difference in ROM was observed across ACR-TIRADS and EU-TIRADS categories within the AUS nodules (p <0.001 for both) and the AUS-N group (p = 0.001 and <0.001). A marked increase in ROM was observed with nuclear overlapping, pseudoinclusions and enlargement (OR: 9.16, 4.47 and 2.80, respecti-vely), while oncocytic atypia was associated with a reduced risk (OR: 0.44). In multivariate analysis, nuc-lear overlapping, pseudoinclusions, and sonographic irregular margins remained as independent predictors of malignancy (OR = 6.97, 6.09, and 5.79, respectively). Conclusion To our knowledge, this is the first study to demonstrate a significant association between ACR-TIRADS classification and malignancy risk in the AUS-N subcategory.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938377","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 World Health Organization Reporting System for Lymph Node, Spleen, and Thymus Cytopathology - Part 1: Lymph node.","authors":"Immacolata Cozzolino, Mats Ehinger, Maria Calaminici, Andrea Ronchi, Mousa A Al-Abbadi, Helena Barroca, Beata Bode-Lesniewska, David F Chhieng, Ruth L Katz, Oscar Lin, L Jeffrey Medeiros, Martha Bishop Pitman, Arvind Rajwanshi, Fernando C Schmitt, Philippe Vielh, Pio Zeppa, Ian A Cree, William A Sewell, Bharat Rekhi, Andrew S Field","doi":"10.1159/000548199","DOIUrl":"https://doi.org/10.1159/000548199","url":null,"abstract":"<p><p>Fine needle aspiration biopsy (FNAB) of lymph nodes is a widely used method for evaluating lymphadenopathy. FNAB offers general advantages of rapid turnaround time, low cost and minimal morbidity, and more specific advantages in various clinical situations, such as deeply located lymph nodes or patients with significant comorbidities. The FNAB sample can be utilized for a wide range of ancillary tests, including microbiological studies, immunocytochemistry for primary and metastatic neoplasms and flow cytometry immunophenotyping in cases of lymphoid-rich samples, where there is a suspicion for lymphomas. The increasing application of FNAB in lymph node pathology has led to the development of a standardized reporting system, formalized in the World Health Organization (WHO) Reporting System for Lymph Node, Spleen and Thymus Cytopathology (WHO System). This system is equally applicable to lymph node, spleen and thymus; however, this article focuses on lymph nodes. The WHO System was established through a joint project of the WHO, the International Agency for Research on Cancer (IARC) and the International Academy of Cytology (IAC) and is structured into five diagnostic categories: Inadequate/Insufficient/Non-diagnostic, Benign, Atypical, Suspicious for Malignancy and Malignant. The WHO System provides a standardized and reliable means of categorizing various lymph node lesions based on cytopathology findings and enables pathologists to make more accurate and reproducible diagnoses, thereby improving clinical management and treatment decisions. Integrating cellular morphology and clinical-imaging data helps distinguish benign from malignant lesions, significantly reducing diagnostic variability. The primary goal is to reduce diagnostic uncertainty and improve patient outcomes through greater consistency and clarity in lymph node cytopathology reports. The WHO System emphasizes the use of rapid on-site assessment (ROSE) to improve diagnostic accuracy and reduce the need for additional diagnostic procedures. The risk of malignancy (ROM) varies by diagnostic category, with higher risks of malignancy in the \"Suspicious for malignancy\" and \"Malignant\" categories. The system also includes recommendations for ancillary tests and performance of additional biopsies when further clarification is needed. In conclusion, the WHO System represents a significant advancement in the standardization of lymph node, spleen and thymus cytopathology, facilitating interdisciplinary communication and improving risk stratification. However, diagnostic challenges remain, particularly in managing inadequate samples and interpreting atypical lesions, necessitating a multidisciplinary approach that integrates clinical, imaging, ancillary testing and, in some cases, core needle or excision biopsy material. The WHO System serves as a crucial tool for refining the diagnosis of the broad range of inflammatory, infectious, metastatic and lymphomatous processes in lymph node pa","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-24"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938312","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 Tumors of the Pancreas: A Tri-Focal Review - Integrated Cytopathological, Pathological, and Molecular Perspectives.","authors":"Matthew W Rosenbaum, Mauro Saieg, Vikram Deshpande","doi":"10.1159/000548119","DOIUrl":"10.1159/000548119","url":null,"abstract":"<p><strong>Background: </strong>Oncocytic differentiation in pancreatic neoplasms is uncommon but can be seen in a wide range of neoplasms which range from borderline to highly aggressive behavior. Certain tumors, such as intraductal oncocytic papillary neoplasm (IOPN) of the pancreas, are oncocytic by default but many, such as pancreatic neuroendocrine tumors (PanNETs), can be oncocytic in a rare subset, often with clinical significance (like aggressive behavior). As such, the differential diagnosis can be broad and expertise is critical in teasing out the true diagnosis to guide treatment.</p><p><strong>Summary: </strong>The differential diagnosis of an oncocytic neoplasm in the pancreas includes IOPN, acinar cell carcinoma, pancreatic ductal adenocarcinoma, PanNET, solid pseudopapillary neoplasms, and an array of other tumors (including metastatic disease). As the differential diagnosis is broad and diagnostic biopsies are often small, delineating these entities often requires examination of the clinical features, cytology, and immunohistochemistry, with molecular findings being useful in particularly difficult cases.</p><p><strong>Key messages: </strong>Corroboration between clinical/radiology findings, cytologic features, histologic features, immunohistologic results, and molecular abnormalities is all extremely useful in delineating a specific entity among the broad differential diagnosis of entities with oncocytic differentiation in the pancreas.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938288","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":"Application of the Sydney System in the Classification of 1,000 Lymph Node Fine Needle Aspirations and Assessment of Risk of Malignancy.","authors":"Merve Dogan Ayan, Senay Erdogan Durmus, Ozben Yalcın","doi":"10.1159/000548132","DOIUrl":"10.1159/000548132","url":null,"abstract":"<p><strong>Introduction: </strong>The evaluation of lymph nodes (LNs) through fine needle aspiration (FNA) is widely used as the first-line approach in the assessment of unexplained lymphadenopathy due to its minimal invasiveness, speed, and cost-effectiveness and the availability of provide material for various auxiliary techniques. The Sydney Lymph Node Cytology Reporting and Classification System was introduced in 2020. The aim of our study was to classify LN-FNAs according to the Sydney System and to evaluate the concordance with histological diagnoses and the rates of malignancy in the available cases.</p><p><strong>Methods: </strong>Between 2019 and 2023, FNAs were retrospectively reviewed. A total of 1,000 cases were categorized according to the Sydney System as ND (inadequate/insufficient), benign, AUS/ALUS (atypical lymphoid cells of uncertain significance), suspicious, and malignant. The risk of malignancy was calculated for histopathological follow-up available cases.</p><p><strong>Results: </strong>Cases were categorized into 5 groups: 58 cases (5.8%) as \"ND,\" 560 cases (56%) as \"benign,\" 24 cases (2.4%) as \"AUS/ALUS,\" 32 cases (3.2%) as \"suspicious,\" and 326 cases (32.6%) as \"malignant.\" In the malignant group, 315 cases were metastatic malignancies and 11 were lymphoid malignancies. Histopathological follow-up was possible in 294 cases (29.4%). Among these, 159 were diagnosed as malignant. Of the malignant cases, 33 were diagnosed as lymphoma and 126 as metastatic malignancies. Based on the available data, the concordance rate between cytological and histological diagnoses was 81.0%. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated as 91.11%, 69.49%, 77.36%, and 87.23%, respectively. The risk of malignancy was 52.9% for the nondiagnostic, 12.7% for the benign, 33.3% for the atypical, 80.0% for the suspicious, and 77.3% for the malignant categories.</p><p><strong>Conclusion: </strong>The Sydney System is easily applied to LN-FNAs and shows a high cytology-histology diagnosis concordance rate and sensitivity. By simplifying reporting and strengthening communication between cytopathologists and clinicians, it enhances the clinical management of malignancy risk.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144938342","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":"Mitochondria and the Metabolic Logic of Oncocytic Tumors.","authors":"Valdemar Máximo, Vania Nosé, Sule Canberk","doi":"10.1159/000547939","DOIUrl":"10.1159/000547939","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Oncocytic tumors, long recognized for their distinctive granular cytoplasm and exceptional mitochondrial burden, have historically posed challenges to classical cancer models due to their enigmatic molecular profiles. The understanding of mitochondria has evolved significantly, from early histological observations of ill-defined cytoplasmic \"granules\" to their recognized central role in cellular bioenergetics and, more recently, in modern metabolic theories of oncogenesis. This review revisits this historical trajectory to contextualize the unique pathology of oncocytic neoplasms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;Drawing parallels between the historical understanding of mitochondria and the pathology of oncocytic tumors, this article explores how profound mitochondrial dysfunction, rather than primary nuclear genomic instability, may fundamentally underlie the oncocytic phenotype. The Somatic Mutation Theory is critically re-examined in light of the emerging Mitochondrial Metabolic Theory (MMT), highlighting MMT's potential to provide a more comprehensive explanation for tumorigenesis through bioenergetic disruption. Despite their striking and consistent mitochondrial characteristics, including structurally abnormal mitochondria with disrupted cristae and impaired respiratory complexes, oncocytic tumors, particularly those of the thyroid, remain notably underrepresented in mainstream metabolic cancer models. By integrating insights from historical cytology, modern diagnostic pathology, and molecular oncology, this article proposes that oncocytic neoplasms serve as morphologically overt and biochemically aligned exemplars of the MMT, pointing the critical need for deeper cross-disciplinary dialog in cancer research. This article serves as a foundational contribution to this special issue of Acta Cytologica, which aims to re-center mitochondria in the discussion of oncocytic lesions. By providing this essential metabolic and historical context, it sets the stage for the subsequent organ-specific studies on oncocytic neoplasms, bridging the fields of cytopathology, pathology, and molecular biology. Its inclusion in Acta Cytologica highlights the journal's dedication to multidisciplinary synthesis, offering a comprehensive understanding of oncocytic lesions from their cellular presentation to their molecular underpinnings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;Oncocytic tumors represent a compelling model for understanding cancer through the lens of mitochondrial metabolic dysfunction, challenging the primacy of nuclear genomic mutations. Their unique morphological and functional mitochondrial abnormalities provide visible evidence of underlying bioenergetic disruption and might functionally align with the biochemical phenotype described by the MMT. Integrating historical pathological observations with contemporary molecular and metabolic research is crucial for advancing the understanding of these enigmatic tumors and c","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854199","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":"Role of Preanalytical Phase and Laboratory Process for Optimal Ancillary Testing in Cytopathology.","authors":"Sanna Suikkanen, Satu Maria Remes, Iina Tuominen","doi":"10.1159/000547240","DOIUrl":"10.1159/000547240","url":null,"abstract":"<p><strong>Background: </strong>Ancillary tests are increasingly important for primary cancer diagnosis, as well as predictive and prognostic information, and occasionally cytological samples are the only material readily available. Advanced ancillary testing, including immunohistochemistry (IHC), immunocytochemistry (ICC), in situ hybridization, and next-generation sequencing (NGS) should be carefully standardized and quality controlled in order to provide reliable results. The diversity of preanalytics in the cytological laboratory process poses challenges for quality management.</p><p><strong>Summary: </strong>Paraffin-embedded cell blocks (CBs) from cytological samples that are collected in and fixed with formalin appear to be the easiest option for ancillary tests, the majority of which are developed for formalin-fixed and paraffin-embedded (FFPE) samples. They can be stained with the same IHC protocols and on-slide controls without additional validation. Fixation time of FFPE CB samples should be controlled since nucleic acid quality and quantity decrease in formalin in a time-dependent manner. Ethanol and methanol, the standard fixatives in cytology, alter the tertiary structure of proteins, thus impairing ICC staining. Depending on the antibody, staining signals can be weaker or even absent in alcohol-fixed cells. Nevertheless, air-dried or methanol-fixed cytospins, liquid-cytology samples, cell-free supernatants, and unstained or stained smears can successfully be used for ancillary testing, but this requires careful protocol optimization and validation. Appropriate on-slide controls are not easily available for ICC, but these can be prepared for example from cell lines or left-over patient samples. If polymerase chain reaction (PCR) or NGS-based testing is performed in-house, different cytological sample types can be validated for routine use.</p><p><strong>Key messages: </strong>Ancillary tests like ICC need to be validated according to the up-to-date guidelines in order to use the optimal protocol for each sample and fixation type and to discover the possible limitations of the test. Appropriate controls that reflect the preanalytical conditions of the sample material ensure reliable and reproducible results. Cytological material suits well for molecular pathology and could be more widely exploited in diagnostics. European cytopathology laboratories need to recognize the requirements of the in vitro diagnostic (IVD) regulation especially in documenting validation, risk management, and clinical performance data of the laboratory-developed (in house) tests.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144797934","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":"Systematic Review and Meta-Analysis of the Diagnostic Accuracy of the World Health Organization International System for Reporting Pancreatic Cytopathology.","authors":"Sana Ahuja, Marzieh Fattahi-Darghlou, Rhea Ahuja, Apoorva Kabra, Sufian Zaheer","doi":"10.1159/000547624","DOIUrl":"10.1159/000547624","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization (WHO), in collaboration with the International Academy of Cytology and the International Agency for Research on Cancer, has introduced a standardized reporting system for pancreatic cytopathology. This system refines diagnostic categories, integrates malignancy risk estimates, and aligns with the WHO Classification of Tumours. It builds on the Papanicolaou Society of Cytopathology framework, improving risk stratification through categories such as pancreatic neoplasm low risk/grade (PaN-Low) and pancreatic neoplasm high risk/grade (PaN-High). This study evaluates the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) for pancreatic lesions using the WHO system.</p><p><strong>Methods: </strong>A systematic literature search was performed in the PubMed and EMBASE databases, using predefined keywords: \"pancreas\", \"FNAB\", and \"diagnostic accuracy\". Meta-analysis was conducted to determine sensitivity and specificity at different diagnostic thresholds: \"PaN-High considered positive,\" \"suspicious for malignancy considered positive,\" and \"malignant considered positive,\" excluding inadequate samples from each study. To assess diagnostic accuracy, summary receiver operating characteristic curves were generated, and the diagnostic odds ratio (DOR) was pooled.</p><p><strong>Results: </strong>Five studies met the inclusion criteria. The risk of malignancy ranged from 3% (negative) to 99% (malignant). Sensitivity and specificity varied across cutoffs: malignant (83%, 100%), suspicious and above (92%, 98%), and PaN-High and above (93%, 96%). DOR values confirmed high diagnostic accuracy.</p><p><strong>Conclusion: </strong>The system effectively stratifies lesions based on malignant potential, with the \"suspicious\" and \"malignant\" categories demonstrating high predictive value. Expanding the diagnostic threshold to include \"PaN-High\" further improves sensitivity without significantly compromising specificity, making it a valuable classification for clinical practice.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144726422","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}