Acta Cytologica最新文献

{"title":"Multiplex Cryoimmunostaining in Fine-Needle Aspiration Biopsies and Effusion Samples: Preliminary Results.","authors":"Simona Miceska, Ivana Kholová, Veronika Kloboves Prevodnik","doi":"10.1159/000550736","DOIUrl":"10.1159/000550736","url":null,"abstract":"<p><p><p>Introduction: Immunocytochemistry (ICC) on cytospins and cell blocks is usually limited to a single marker per slide, often restricting diagnostic accuracy when sample cellularity is low. Multiplex cryoimmunostaining (mCryo), though not yet used in a routine cytopathology practice, may help overcome these limitations. Our study evaluated the applicability of mCryo compared with standard ICC on routinely prepared cytospins.</p><p><strong>Methods: </strong>Residual fine-needle aspiration biopsy and effusion samples from various diseases were used. mCryo staining with antibody panel consisting of EpCAM, CK7, CD56, TTF-1, p40, CD45, and calretinin (X-ZELL, Singapore) was tested on methanol-fixed cytospins, corresponding ICC-stained cytospins served as controls. All slides were reviewed blindly.</p><p><strong>Results: </strong>Forty-two samples were included in the analysis (21 carcinomas, eight lymphomas, five melanomas, eight non-neoplastic). mCryo revealed preserved morphology and no background staining in most of the cases. A 100% of true positivity was observed for EpCAM (21/21), CK7 (21/21), p40 (3/3), and TTF-1 (1/1) in carcinomas matching ICC results. TTF-1 was also true-positive in 2/2 benign thyroid nodule samples. CD45 was detected in all samples with both methods, labeling lymphocytes. Calretinin was true-positive only in 2/6 effusion samples. CK7 positivity was unexpectedly detected in all melanomas (5/5) by mCryo but not by ICC. Moreover, CD56 was also positive in all carcinomas and melanomas by mCryo (26/26), while only 9 cases were positive by ICC, raising the question of unspecific staining, antibody cross-reactivity, or spectral overlap of fluorochromes.</p><p><strong>Conclusions: </strong>mCryo enables simultaneous evaluation of multiple markers per slide on routinely prepared cytospins, offering potential diagnostic advantages for paucicellular samples. However, further method and panel improvement, and validation are essential for accurate diagnostic implementation into routine practice. </p>.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"485-501"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146148721","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":"Ongoing Challenges in Maintaining the Diagnostic Quality of Cervical Cytopathology: Is It Possible to Minimize Differences in Morphological Interpretations?","authors":"Adhemar Longatto-Filho, Fernando C Schmitt","doi":"10.1159/000542618","DOIUrl":"10.1159/000542618","url":null,"abstract":"<p><strong>Background: </strong>The efficiency of the cytological test largely depends on the control and quality assurance of laboratory procedures, to avoid false results. The objectives of this descriptive review were to point out and discuss the main mechanisms for controlling and ensuring the quality of cytological diagnosis.</p><p><strong>Summary: </strong>A critical revision was performed to identify the principal challenges involved in the processes of all the main issues related to the morphological alterations that characterize a true-related lesion in the daily routine of the Pap test examination. Principles of QC and QA are already being implemented worldwide, and the positive aspects and limitations of these are discussed as well as proposing alternatives when pertinent. Most of the articles evaluated highlighted the necessity of implementing audit mechanisms to control the performance of the professionals involved with the cytology evaluation.</p><p><strong>Key message: </strong>Promising data from the new image-based technological arsenal appear to be a remarkable tool for improving cytological evaluation, reducing errors of interpretation and serving as a powerful arm for cytology teaching.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"40-45"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685737","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":"Unveiling Occult Nasopharyngeal (Undifferentiated) Carcinoma: A Case Series Highlighting the Worth of Fine-Needle Aspiration Cytology as a Frontline Diagnostic Tool for Hidden Lethal Malignancies.","authors":"Aditi Das, Sulagna Sahoo, Ajay Singh Thakur","doi":"10.1159/000548856","DOIUrl":"10.1159/000548856","url":null,"abstract":"<p><strong>Introduction: </strong>Nasopharyngeal carcinoma (NPC) represents a significant burden in Asia, especially in Southern China, with cervical lymph nodes being one of the most common sites of metastasis. At times, peripheral lymphadenopathy may be the only manifestation of an occult primary tumor.</p><p><strong>Case presentation: </strong>We report three cases: the first with classical cervical lymphadenopathy, while two with rare unusual presentations - right preauricular and right periorbital lesions. The cytological evaluation in all revealed metastatic undifferentiated NPC, which led to the identification of an occult nasopharyngeal primary.</p><p><strong>Conclusion: </strong>This series highlights the indispensable role of FNAC with a dual-stain approach and intricate diagnostic challenges in deciphering occult undifferentiated NPC. To the best of our knowledge, this is the first series to formally document a significant observation - stain-dependent cytologic shift in undifferentiated NPC: tumor cells appeared as dispersed with hyperchromatic homogeneously dark-stained naked nuclei mimicking lymphoma on May-Grünwald-Giemsa (MGG), but as loosely cohesive clusters or syncytial sheets with vesicular nuclei on Papanicolaou. MGG alone risks mimicking lymphoma, and Papanicolaou alone risks mimicking metastatic carcinoma. Such perplexing cytomorphological variations with two stains risk erroneous diagnoses, yet offer a unique clue to undifferentiated NPC. Thus, extensive cytologic sampling with dual-stain strategy enables early recognition of an aggressive, elusive, and often misdiagnosed malignancy, significantly improving survival in cases that would otherwise be fatal.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"273-279"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353491","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":"Updates about Thyroid Lesions in Pediatric Population Focusing on the ROM from 3rd Edition of The Bethesda System for Reporting Thyroid Cytopathology Categories from Distinct Pediatric Series: A Review Article.","authors":"Esther Diana Rossi, Patrizia Straccia, Alessia Piermattei, Federica Cianfrini, Natalia Cappoli, Antonino Mule, Liron Pantanowitz","doi":"10.1159/000551041","DOIUrl":"10.1159/000551041","url":null,"abstract":"<p><strong>Background: </strong>The interpretation of pediatric thyroid lesion represents a challenging diagnostic tool for fine-needle aspiration cytology (FNAC). As for the adult lesions, it represents the first diagnostic tool for correct characterization of these nodules. Recent data from the National Cancer Institute (NCI) have proven that the incidence of thyroid malignancy has been increasing, especially in adolescents. These data are mostly linked to an estimated higher prevalence of well-differentiated cancers with 90% diagnosed as papillary thyroid cancer; some specific malignant subtypes, such as diffuse sclerosing subtype, are more frequently diagnosed in children, with, not uncommonly, a more aggressive behavior, which justifies the increased number of surgical procedures. For this reason, the American Thyroid Association (ATA) recommended the performance of neck ultrasonography and FNAC in the evaluation of pediatric thyroid nodules. In this regard, the performance of an FNAC has high sensitivity and diagnostic accuracy in pediatric series, sharing the same problematic issues encountered in adult population, mostly in the diagnosis of the indeterminate lesions.</p><p><strong>Summary: </strong>Since 2023, the diagnosis of a pediatric lesion was based on the risk of malignancy used for the adulthood. The introduction of the third edition of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) introduced, for the first time, a specific adoption of diagnostic categories combined with their own and personalized ROM and management in pediatric thyroid lesions. In this review, we focused on the analysis of the ROM and data from literature hinged on the evaluation of the adoption of the 3rd edition of TBSRTC in pediatric thyroid lesions.</p><p><strong>Key message: </strong>Briefly, the primary source of the reviewed publications was the PubMed, Scopus, and Web of Science database using the keywords (thyroid) and (carcinoma or neoplasm or cancer) AND (Bethesda or TBSRTC) and (Paediatric). The search consisted of literature published from January 2023 to September 2025 with the objective of calculating the risk of malignancy for III, IV, V, and VI diagnostic categories of the 3rd edition of TBSRTC in pediatric group. We limited our search to English-language articles.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"365-374"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146193799","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":"Message from the International Academy of Cytology.","authors":"","doi":"10.1159/000553666","DOIUrl":"10.1159/000553666","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"505-506"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547622","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":"Integration of Digital Cytology in Quality Assurance Programs for Cytopathology.","authors":"Yosep Chong, Maria Jesús Fernández Aceñero, Zaibo Li, Andrey Bychkov","doi":"10.1159/000547486","DOIUrl":"10.1159/000547486","url":null,"abstract":"<p><p><p>Background: Quality assurance (QA) and quality control (QC) are fundamental to maintaining high standards in cytopathologic diagnostics. The recent adoption of digital cytology (DC) has led to transformative changes in cytopathology workflows, including primary diagnosis, telecytopathology-based consultations, and rapid on-site evaluations (ROSEs). These technological developments call for a conceptual shift and redefinition of QA and QC frameworks in the DC era. Summary: This review explores the evolving landscape of QA and QC in cytopathology, with a focus on the integration of DC into existing quality systems. We examine the role of DC as both a QC tool and a platform for implementing DC-specific QA/QC protocols. Practical applications discussed include leveraging DC for conventional QA/QC tasks, such as education and training of laboratory staff and cytopathologists, and facilitating digital proficiency testing through cloud-based platforms. Additionally, we review current international recommendations for the adoption of DC in cytopathology and propose strategies for the safe and efficient management of digital environments. Key Messages: (i) DC is reshaping the practice of cytopathology and requires updated QA/QC strategies. (ii) DC can enhance QA/QC activities through improved training, proficiency testing, and collaborative diagnostics. (iii) The development and implementation of DC-specific protocols are essential for ensuring accuracy and reliability in digital cytopathologic practice. </p>.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"126-147"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681782","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":"Hyperthyroidism-Related Epithelial Hyperplasia as a Potential Pitfall of Thyroid Cytology: Institutional Cytomorphological Analysis of Histologically Verified Cases.","authors":"Eliisa Eveliina Viljanen, Lotta Virtanen, David Kalfert, Marie Ludvíková, Ivana Kholová","doi":"10.1159/000548613","DOIUrl":"10.1159/000548613","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperthyroidism-related epithelial hyperplasia is seldomly listed as a pitfall in thyroid cytology. Therefore, we focused on the cytomorphological characteristics of epithelial hyperplasia and compared these features with papillary thyroid carcinoma (PTC).</p><p><strong>Methods: </strong>Study group consisted of 76 patients (133 FNA specimens) histologically diagnosed with hyperthyroidism-related epithelial hyperplasia without a concomitant malignancy. The control group contained 21 histologically verified FNAs of PTCs. A total of 48 cytomorphological features were quantitatively evaluated.</p><p><strong>Results: </strong>Statistically significant differences between the study groups were discovered on the architectural, cellular, and nuclear levels. Nuclear features varied most: nuclear elongation, grooves, irregular nuclear membrane, pseudoinclusions, the presence of nucleoli or small eccentric nucleoli were clearly more common in PTC group.</p><p><strong>Conclusion: </strong>Fine-needle aspiration referrals with clinical data and thyroid function test results can facilitate the interpretation of cytomorphological features and reduce the use of undetermined categories in cases of hyperthyroidism-related epithelial hyperplasia.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"151-159"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278676","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":"External Quality Assessment in Diagnostic Cytopathology: Current Programs, Challenges, and Perspectives.","authors":"Irena Srebotnik Kirbis, Margareta Strojan Fležar","doi":"10.1159/000546537","DOIUrl":"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":"84-90"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","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":"Human Papillomavirus Primary Screening and Collaboration in Quality Assurance Work between Laboratories.","authors":"Henrik Edvardsson, Joakim Dillner","doi":"10.1159/000544988","DOIUrl":"10.1159/000544988","url":null,"abstract":"<p><strong>Background: </strong>Cervical screening is changing to the use of human papillomavirus (HPV) testing as the primary screening test. It is essential that the well-established and critically important systems for quality assurance based on laboratory audits of seemingly negative samples taken before HSIL and cervical cancer are maintained. They provide a means of verifying if the actual screening is effective for the intended purpose. Together with international proficiency panels, audits provide a simple and unambiguous way to evaluate if the screening is adequate. Detailed knowledge of how these systems work and how they are dependent on the genotyping of HPV, biobanking, and screening registries is vital to cytologists and pathologists involved in quality assurance work and follow-up of cervical lesions and cervical cancer. Interpretation and communication of outcome and results are equally important for successful quality assurance work and should ideally be done together with expertise in HPV.</p><p><strong>Summary: </strong>The internationally defined procedures for laboratory audit, similar to those used for cytology, require sensitivities before HSIL of >95% and before invasive cervical cancer of >90%. If also results on blinded proficiency panels and international criteria for analytic sensitivity, specificity, and reproducibility are achieved, the HPV screening test can be said to be adequate.</p><p><strong>Key messages: </strong>Performance of HPV screening tests in a cervical screening program includes similar laboratory audits as hitherto used for cytology. Similarly, technical proficiency of a laboratory is established using blinded proficiency panels with defined contents of virus. Detailed knowledge of quality assurance work is necessary for cytologists and pathologists. Communication of outcome and results depends on collaboration between laboratories.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"46-51"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603140","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":"Special Issue: Cytopathology in Pediatrics.","authors":"Jose Candido Caldeira Xavier-Júnior, Mauro Saieg","doi":"10.1159/000549665","DOIUrl":"10.1159/000549665","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"287-288"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562151","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}