Acta Cytologica最新文献

{"title":"Threshold-Dependent Diagnostic Performance of Fine-Needle Aspiration Cytology in Parotid Tumors: A Milan System-Based Analysis.","authors":"Seval Akay, Ozlem Yagiz Agayarov, Sercan On, Volkan Semiz, Ulku Kucuk, Ilker Burak Arslan, Dudu Solakoglu Kahraman, Ibrahim Cukurova, Olcun Umit Unal","doi":"10.1159/acy/abjag001","DOIUrl":"10.1159/acy/abjag001","url":null,"abstract":"<p><strong>Introduction: </strong>Fine-needle aspiration cytology (FNAC) is routinely used in the preoperative evaluation of parotid gland tumors, yet its diagnostic performance varies across categories of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC). This study evaluated category-specific malignancy risk and the clinical impact of different diagnostic thresholds.</p><p><strong>Methods: </strong>We retrospectively analyzed 277 patients who underwent parotidectomy with available preoperative FNAC. Cytologic diagnoses were classified according to the MSRSGC and correlated with final histopathology. Diagnostic performance was assessed using two thresholds: Milan V-VI and Milan III-VI. Trends in malignancy risk across Milan categories were examined, and false-negative and false-positive cases were reviewed by histopathological subtype. Overall discriminatory performance was evaluated using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Final histopathology revealed benign disease in 85.2% and malignancy in 14.8% of cases. Malignancy risk increased significantly across higher Milan categories (p = 0.006). Using Milan V-VI as the threshold yielded high specificity (97.0%) and negative predictive value (88.8%) but low sensitivity (29.3%). Expanding the threshold to Milan III-VI increased sensitivity (78.0%) but markedly reduced specificity (21.2%). Discriminatory performance was poor (AUC 0.622). False-negative results were mainly low-grade malignancies, particularly low-grade mucoepidermoid carcinoma, whereas false-positive results were largely benign oncocytic or hypercellular lesions.</p><p><strong>Conclusion: </strong>FNAC provides useful preoperative risk stratification for parotid gland tumors within the Milan framework, but its diagnostic value is highly threshold-dependent and limited by tumor biology.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863024","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":"Scrape Cytology of DEK::AFF2 Fusion-Associated Papillary Squamous Cell Carcinoma of the Sinonasal Tract Masquerading as Schneiderian Papilloma: A Case Report.","authors":"Hidetoshi Satomi, Keiichiro Honma, Yoji Kukita, Minako Ashimura, Yuki Koyanagi, Yoshinori Kodama, Satoshi Tanada","doi":"10.1159/acy/abjag004","DOIUrl":"10.1159/acy/abjag004","url":null,"abstract":"<p><strong>Introduction: </strong>DEK::AFF2 fusion-associated papillary squamous cell carcinoma is a recently characterized sinonasal neoplasm that closely mimics Schneiderian papilloma. Although one report has described fine-needle aspiration cytology of a metastatic lymph node, scrape cytological features from the primary site remain undocumented.</p><p><strong>Case presentation: </strong>We report the scrape cytology of this tumor in a 26-year-old woman. While certain features (perivascular arrangement and intracytoplasmic nuclear debris-like structures) overlapped with Schneiderian papilloma, several findings diverged: a predominantly discohesive pattern, nuclear enlargement with anisonucleosis, prominent nucleoli, stippled chromatin distinct from the neuroendocrine pattern, and a crackled cytoplasmic appearance. Immunohistochemistry for synaptophysin and chromogranin A was negative, excluding neuroendocrine differentiation. CD163 immunohistochemistry confirmed that the debris-containing cells were not histiocytes. E-cadherin showed heterogeneous downregulation in the initial biopsy, suggesting a candidate molecular basis for the discohesive pattern. The diagnosis was confirmed by AFF2 immunohistochemistry, DEK break-apart fluorescence in situ hybridization, and reverse transcription polymerase chain reaction with Sanger sequencing. Retrospective AFF2 immunohistochemistry of the initial biopsy, originally diagnosed as Schneiderian papilloma, was positive. The patient remained free of disease progression 34 months after completion of chemoradiotherapy for the antecedent lacrimal sac carcinoma.</p><p><strong>Conclusion: </strong>These findings provide the first comprehensive cytological documentation of this entity from a primary sinonasal site and delineate features diverging from Schneiderian papilloma that may prompt ancillary investigations.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786805","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":"Atypical Glandular Cell-Not Otherwise Specified and AGC-Favor Neoplastic: Does This Subcategorization Remain Necessary for Triage Cytology?","authors":"Massimo Confortini, Stephanie Pacella, Alessandra Mongia, Giampaolo Pompeo","doi":"10.1159/acy/abjag002","DOIUrl":"10.1159/acy/abjag002","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668074","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":"Maximizing Cytologic Specimen Supernatants: A New Player in the Molecular Toolbox.","authors":"Jonas J Heymann, Sinchita Roy-Chowdhuri","doi":"10.1159/acy/abjag003","DOIUrl":"10.1159/acy/abjag003","url":null,"abstract":"<p><strong>Background: </strong>Multiple cytologic preparations are available to cytopathologists to use for molecular testing (MT). Proper use of each is necessary to improve patient outcomes. Residual cytology specimens and cytology specimen supernatants (CSSs) are novel sources from which nucleic acid may be extracted for MT. CSSs may be of particular interest to the cytology community, as it is routinely discarded. If repurposed for MT instead, it may allow pathologists to preserve cellular material from traditional preparations for other ancillary studies.</p><p><strong>Summary: </strong>To evaluate the utility of CSS, it is first necessary to understand the metrics by which MT is evaluated. These include nucleic acid quantity and tumor percentage, the latter of which may be difficult to precisely quantify in CSS. Metrics of nucleic acid quantity include direct measures, such as degradation value (measure of nucleic acid fragmentation), and indirect measures, including many sequencing-derived metrics and concordance with formalin-fixed, paraffin-embedded tissue or cell blocks. Specimen contamination and turnaround time (TAT) are also critical for patient care. Human papillomavirus testing on residual cytology specimens serves as a model of the clinical utility of MT. More recently, studies have examined both the analytic and clinical value of a broad range of MTs performed on CSS derived from both exfoliative and fine needle aspiration cytology specimens and from specimens collected with and without fixative. These studies have demonstrated that CSS contains both cellular (genomic) and cell-free nucleic acid and that its great advantages lie in reductions in specimen contamination and improvements in TAT. Variations in nucleic acid quantity and quality among studies suggest that further specimen optimization is desirable as CSS becomes more widely adopted as a source of nucleic acid.</p><p><strong>Key messages: </strong>CSSs are no longer considered \"waste\" material. When handled properly, they can complement conventional cytomorphology and expand the role of cytopathology in precision medicine. Until CSSs are fully validated, the information derived from them should be integrated with other findings.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1"},"PeriodicalIF":1.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668043","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":"From the Franzen-KIFA Handle up to Digital Cytopathology: The Long Story of Lymph Node Fine-Needle Aspiration Cytology.","authors":"Elisabetta Maffei, Immacolata Cozzolino, Pio Zeppa, Alessandro Caputo","doi":"10.1159/000553609","DOIUrl":"10.1159/000553609","url":null,"abstract":"<p><strong>Background: </strong>Lymph node fine-needle aspiration cytology (FNAC) has a history spanning more than a century, reflecting advances in cytology, pathology, and related technical disciplines. Lymph nodes were among the earliest targets of FNAC, which is now used to diagnose a broad spectrum of pathological processes, ranging from reactive conditions to lymphomas and metastases.</p><p><strong>Summary: </strong>To address these diverse settings, nearly all ancillary techniques used in pathology practice have been applied to lymph node FNAC, with their use tailored to the pathological process, the quality and quantity of diagnostic material, and the clinical context. Over time, this evolution has also led to the development of different technical procedures, diagnostic algorithms, and classification systems. Despite its achievements and potential, lymph node FNAC is still not universally accepted and remains subject to skepticism among some clinicians and criticism from some pathologists. In many aspects, lymph node FNAC represents a paradigm of clinical cytology, and its history reflects both the period in which it evolved and the environments in which it has been practiced. This review retraces the development of lymph node FNAC from the dawn of cytopathology to the present, highlighting its major advances, current role, and future perspectives.</p><p><strong>Key messages: </strong>Lymph node FNAC has evolved into a versatile diagnostic tool for reactive, neoplastic, and metastatic lymph node lesions. The integration of ancillary techniques, technical innovations, and standardized classification systems has substantially expanded its diagnostic capabilities. Understanding the historical evolution of lymph node FNAC provides insight into its current role, ongoing limitations, and future perspectives in modern cytopathology.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-22"},"PeriodicalIF":1.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468269","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":"Serous Fluid Cytopathology: Landmark Developments in Techniques, Terminology, and Clinical Application.","authors":"Ashish Chandra, Ralf Heine, Leonie Wheeldon, Sinchita Roy-Chowdhuri, Merce Jorda, Claire W Michael, Guoping Cai","doi":"10.1159/000553613","DOIUrl":"10.1159/000553613","url":null,"abstract":"<p><strong>Background: </strong>This invited review for the special issue is a celebration of the continued growth of knowledge in the field of serous fluid cytopathology.</p><p><strong>Summary: </strong>The review begins by addressing the value of cytological examination of the fluid samples in conjunction with clinical, radiological, and biochemical data interpreted by the treating physician. It then covers the advances in cytopreparatory techniques with special reference to existing and emerging ancillary techniques available to obtain maximal diagnostic, prognostic, and therapeutic information for the practice of precision medicine. The concept of mesothelioma as a cytological diagnosis has been made possible in recent years through clinical research and advocacy by experts and this has added value to serous fluid samples especially when this is the only sampling method available for a patient. Advances in the recommended repertoire of immunostains and a standardized approach through the use of diagnostic categories has been made possible by The International System for Reporting Serous Fluid Cytopathology. The reporting system has found application to other types of fluid samples, most recently, cerebrospinal fluid cytology, which will be included in the forthcoming edition of the terminology system and is introduced in this special issue.</p><p><strong>Key messages: </strong>The review charts a journey commemorating important landmarks in our current understanding of serous fluids in diagnostic cytopathology.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-24"},"PeriodicalIF":1.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468251","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":"Predictive Immunohistochemical Biomarkers for Antibody-Drug Conjugate Therapy in Pulmonary Cytology.","authors":"Md Ali Osama, Zarine Kamaluddin, Lukas Bubendorf, Deepali Jain","doi":"10.1159/000553423","DOIUrl":"10.1159/000553423","url":null,"abstract":"<p><strong>Background: </strong>The management of lung cancer has undergone a major transformation with the advent of precision oncology, where treatment decisions increasingly rely on tumor-specific biomarkers rather than morphology alone. In advanced-stage disease, pulmonary cytology specimens are often the only diagnostic material available. Cytological preparations are increasingly important in the workup of NSCLC. Cell blocks are among the available preparation methods that can be used for morphological evaluation and ancillary testing, including immunohistochemistry (IHC) and molecular studies. With advances in transcriptomic and proteomic profiling, several novel biomarkers have emerged beyond conventional lineage-specific markers, expanding the role of IHC in prognostication, prediction of therapeutic response and therapeutic selection. This has become particularly important in the era of antibody-drug conjugates (ADCs), which selectively target tumor-associated antigens while minimizing damage to normal tissue.</p><p><strong>Summary: </strong>Cytology preparations, in all their forms, have become increasingly important in the diagnostic and predictive evaluation of non-small cell lung carcinoma (NSCLC). IHC remains one of the most practical and widely accessible methods for biomarker assessment, particularly in resource limited settings. Several ADC-related biomarkers, including HER2, MET, TROP2, and HER3 have recently gained therapeutic relevance, with multiple targeted agents either approved or under active clinical investigation. In addition, emerging biomarkers such as MTAP deficiency further broaden the predictive biomarker landscape and can be reliably assessed using IHC. This review summarizes the current understanding and evolving data regarding immunohistochemical biomarkers in pulmonary cytology, with special emphasis on ADC-related markers and their application in cell block preparations. The biological rationale, diagnostic utility, therapeutic implications, interpretation criteria, and limitations of these biomarkers are discussed.</p><p><strong>Key messages: </strong>Various cytological preparations from pulmonary cytology specimens can be used for diagnostic and predictive biomarker testing in lung carcinoma. IHC-based evaluation of emerging biomarkers is increasingly important for guiding personalized therapy, particularly in the context of ADCs and targeted treatment strategies. A clear understanding of the interpretation and limitations of these biomarkers is essential for pathologists involved in thoracic cytopathology and precision oncology.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148395370","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 Development Path of Gynecological Cytology after Papanicolaou: From Bethesda to Artificial Intelligence and Personalized Medicine.","authors":"Ivana Kholová, Christine N Booth, Henrik Edvardsson, Ritu Nayar, Giovanni Negri, Liron Pantanowitz","doi":"10.1159/000552509","DOIUrl":"10.1159/000552509","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is the fourth most common cancer whose incidence was significantly reduced with the help of Pap smear and organized cervical cancer screening. Implementation of HPV vaccination and addition of HPV primary screening, automation, and most recently digitalization and application of artificial intelligence have taken cervical cancer prevention into a new era.</p><p><strong>Summary: </strong>This review paper covers gynecological cytology from terminology and shows The Bethesda System as a model for further terminology systems. Liquid-based cytology enabled the application of ancillary techniques elegantly from one vial as well as digitalization and the implementation of artificial intelligence. HPV primary screening further shaped the field and led to the decline of cytology volumes. Nevertheless, genotyping and dual staining allow the implementation of personalized medicine in screening scenarios.</p><p><strong>Key messages: </strong>The field of gynecological cytology has slowly but surely evolved from the conventional Pap smear to liquid-based cytology, automation, and now digitalization, artificial intelligence, and inclusion of HPV testing with genotyping enabling personalized prevention in cervical cancer screening and diagnostics.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366565","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 Features of CIC-Rearranged Sarcoma: A Report of 5 New Cases and Review of the Literature.","authors":"Pawel Gajdzis, Jerzy Klijanienko","doi":"10.1159/000553217","DOIUrl":"10.1159/000553217","url":null,"abstract":"<p><strong>Introduction: </strong>CIC-rearranged sarcoma is a rare, Ewing-like round cell sarcoma and is poorly described in the cytology literature, with only seven cases reported to date.</p><p><strong>Methods: </strong>This report presents five new cases investigated and treated at the Institut Curie (four tumours showed CIC-DUX4 and one showed CIC-NUTM1 fusions) and reviews corresponding cytological literature.</p><p><strong>Results: </strong>Smears were cellular in all cases. They comprised of isolated and clustered round, oval, and short spindle cells, with rosettes in three cases. Cytoplasm varied in volume and occasionally showed microvacuolation. Marked pleomorphism and rhabdoid features were detected in one CIC-NUTM1 sarcoma and in one CIC-DUX4 sarcoma. CD99 was positive in three cases and negative in two. Original cytologic diagnoses included two round cell sarcomas (one with myxoid features), pleomorphic sarcoma with rhabdoid features, Ewing sarcoma, and rhabdomyosarcoma.</p><p><strong>Conclusion: </strong>Fine-needle aspiration appears to be at least as effective as core-needle biopsy for these malignancies. Cytomorphological features, together with the immunohistochemical profile and detection of CIC rearrangements, can help accurately diagnose this rare malignancy.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359054","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":"Pericardial Fluid Metastatic Tumor Distribution and Fluid Volume Analysis: A 10-Year Institutional Experience.","authors":"Mason Marshall, Timothy Ramseyer, Jacqueline Cuda, Andrea Jurado, Joshua Pantanowitz, Liron Pantanowitz, Samer Khader","doi":"10.1159/000553127","DOIUrl":"10.1159/000553127","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Cytologic examination of pericardial effusions is critical for detecting malignant involvement, which carries a dismal prognosis. However, contemporary large-scale studies characterizing the distribution of metastatic tumors and the impact of submitted fluid volume on diagnostic yield remain limited. This study evaluates the distribution of metastatic tumors in malignant pericardial effusions and examines the relationship between specimen volume and likelihood of malignant cytologic diagnosis in a large institutional cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 10-year retrospective review was performed of all pericardial fluid cytology specimens accessioned at a large tertiary academic medical center. Clinical, radiologic, and cytologic findings were recorded. Cases categorized as suspicious for malignant cells (SFM) or malignant (MAL) were included in the metastatic tumor distribution analyses after reviewing tumor cytomorphology and immunohistochemical profiles in conjunction with clinical and radiologic data. Specimen volumes were stratified by diagnostic category, and threshold-based analyses at 50 mL and 100 mL were compared across diagnostic categories using statistical methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1,591 cases were identified from patients with a median age 65 years and a male-to-female ratio of 0.98. Most cases were negative for malignant cells (NFM) (78.6%), while 14.4% classified as malignant (MAL). Among malignant cases (SFM + MAL), carcinomas accounted for 83.5%, followed by hematolymphoid malignancies (14.0%); mesotheliomas, sarcomas, and melanomas were rare. Lung carcinoma was the most common primary tumor (48.0%), followed by breast carcinoma (16.0%) and B-cell lymphoma (7.8%). Submitted specimen volume increased progressively across diagnostic categories (p = 0.0010), with malignant cases demonstrating higher median volumes than negative cases. Specimens ≥50 mL showed a significantly higher malignancy rate compared with those &lt;50 mL (18.4% vs. 10.6%, p &lt; 0.001), corresponding to nearly twofold higher odds of malignancy (OR 1.91, 95% CI: 1.43-2.55). A smaller but statistically significant association was observed at the 100 mL threshold (OR 1.35, 95% CI: 1.06-1.82), with no additional benefit at higher thresholds.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this 10-year institutional experience, malignant pericardial effusions were overwhelmingly metastatic in origin, most commonly arising from lung and breast carcinomas and hematolymphoid malignancies. Awareness of the metastatic distribution to the pericardium enhances diagnostic confidence and guides immunohistochemical workup on specimens with limited cellularity. Submitted fluid volume was significantly associated with a malignant cytologic diagnosis, with volumes ≥50 mL conferring nearly twofold increased odds of malignancy and diminishing incremental benefit beyond 100 mL. These findings support submission of at least 50 mL of","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-10"},"PeriodicalIF":1.5,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282856","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}