Acta Cytologica最新文献

{"title":"Special Issue on Oncocytic Lesions in Cytopathology: A Warburgian Consensus of Cytopathology, Pathology, and Molecular Biology.","authors":"Sule Canberk, Valdemar Máximo, Vania Nosé","doi":"10.1159/000547123","DOIUrl":"10.1159/000547123","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-3"},"PeriodicalIF":1.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697314","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><strong>Background: </strong>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.</p><p><strong>Summary: </strong>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.</p><p><strong>Key messages: </strong>(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>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-22"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Artificial Intelligence-Based Cell Detection and Cytomorphological Variations Induced by Cell Processing Solutions: Usefulness of Data Augmentation in Artificial Intelligence Cytology.","authors":"Nanako Sakabe, Yuma Yoshizaki, Kenta Fukuda, Shouichi Sato, Katsuhide Ikeda","doi":"10.1159/000547485","DOIUrl":"10.1159/000547485","url":null,"abstract":"<p><strong>Introduction: </strong>Variations in cytomorphology due to differences in specimen preparation conditions hinder the implementation of artificial intelligence (AI) in cytology. In addition, small-scale research and insufficient datasets pose challenges. In this study, we aimed to examine the relationship between cytomorphological variations induced by cell processing solutions and AI-based cell detection accuracy and to demonstrate the usefulness of data augmentation in AI cytology.</p><p><strong>Methods: </strong>Samples of untreated MKN45 human gastric cancer cells and cells treated with four different cell processing solutions were used to prepare the specimens. These specimens were subjected to Papanicolaou staining, and the areas and hue, saturation, and brightness (HSB) values of the nucleus and cytoplasm were analyzed mathematically and statistically. Deep learning (DL) models were developed with and without data augmentation, and AI-based cell detection rates were evaluated.</p><p><strong>Results: </strong>Heparin sodium solution-treated (Hep) cells showed obvious differences from other groups and presented significant differences compared to control (Cont) cells in the analysis of areas and HSB values of the nucleus and cytoplasm. The AI-based cell detection rate of Hep cells was also significantly lower than that of Cont cells. The use of the DL model with data augmentation improved the AI-based cell detection rate for all samples.</p><p><strong>Conclusion: </strong>We identified the key cytomorphological features that AI focuses on when recognizing cells and demonstrated that data augmentation is an effective technique for improving AI-based cell detection accuracy.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144681783","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":"Mast Cell Sarcoma of the Small Intestine Diagnosed by Ascitic Fluid Cytology: A Case Report with Molecular and Immunophenotypic Correlation.","authors":"Kai Mizoguchi, Kentaro Tsuji, Yuki Teramoto, Shinya Otsuki, Masakazu Fujimoto, Mizuki Watanabe, Seigi Oshima, Tomoshige Shimizu, Noriyoshi Yoshinaga, Hiroaki Ito, Ayako Furuhata, Masahiro Hirata, Hironori Haga","doi":"10.1159/000547483","DOIUrl":"10.1159/000547483","url":null,"abstract":"<p><strong>Introduction: </strong>Mast cell sarcoma (MCS) is a rare and aggressive neoplasm with limited cytologic description, particularly in effusion specimens.</p><p><strong>Case presentation: </strong>A 55-year-old man presented with a small intestinal tumor and peritoneal dissemination. Ascitic fluid cytology revealed numerous large atypical cells with round to horseshoe-shaped nuclei and abundant cytoplasm containing metachromatic granules. Some cells displayed hand mirror-like morphology. Immunocytochemistry showed CD117 and tryptase positivity, and a KIT D816Y mutation was identified. The diagnosis of MCS was later confirmed by biopsy.</p><p><strong>Conclusion: </strong>This is the first reported case of MCS diagnosed by effusion cytology. Recognition of hand mirror-like morphology and metachromatic granules, combined with immunocytochemistry and molecular analysis, may support early diagnosis.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673688","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":"Utility of Fallopian Tube Brush Cytology and Cell Blocks as a Screening Tool for Epithelial Ovarian Cancer in Patients Undergoing Gynaecological Surgeries for Benign and Malignant Indications: Attempt at a Classification System.","authors":"Meenakshi Rao, Garima Yadav, Pratibha Singh, Navdeep Kaur Ghuman, Shashank Shekhar, Meenakshi Gothwal, Priyanka Kathuria, Anju G","doi":"10.1159/000546944","DOIUrl":"10.1159/000546944","url":null,"abstract":"<p><strong>Introduction: </strong>Fallopian tube (FT) cytology is an evolving and as yet not well-established field. Through this study, we aimed to establish the utility of FT brush cytology by stratification into cytological diagnostic categories.</p><p><strong>Methods: </strong>Cytological specimens were collected using an endobrush from the fimbrial end of the tubes at the time of gynaecological surgeries, and LBC preparation (liquid-based cytology slides prepared by SurePath technique) and cell blocks were prepared. Smears were stratified into unsatisfactory/non-diagnostic (ND), benign, atypical, suspicious of malignancy (SOM), and malignant. Correlation with histopathology was done, and the risk of malignancy (ROM) was calculated for each category. Negative predictive value (NPV) and positive predictive value (PPV) were calculated. Diagnostic accuracy was calculated.</p><p><strong>Results: </strong>A total of 392 tubal cytology specimens of 225 patients were collected. 8.2% (n = 32) of the specimens were unsatisfactory/ND, 87% (n = 343) were benign, 2.6% (n = 10) were atypical, 0.8% (n = 3) were SOM, and 1% (n = 4) were malignant. All the cases in the SOM and malignant categories were serous carcinomas on histopathology. Of the ten atypical cases, all were non-malignant on histopathology: two were serous tubal intraepithelial lesions and negative for serous tubal intraepithelial carcinoma (STIC), four showed salpingitis, and four showed normal histology. ROM for ND, benign, and atypical categories was 0%. ROM for the malignant category, as well as the SOM category, was 100%. NPV for the benign category, as well as the benign and atypical categories, was 100%. PPV for the malignant category, as well as the malignant and SOM categories, was 100%. Cell blocks were prepared for all cases, and the grey zone categories of atypical and SOM were reduced from 13 to 8. The diagnostic accuracy was 91.3% without and 99.4% with consideration of the ND category.</p><p><strong>Conclusion: </strong>FT brush cytology shows excellent concordance with the follow-up histopathology in all categories, barring the ND category. Excellent concordance with histopathology was seen in cases of the benign category, which comprised the majority of the samples (87.5%). Although excellent concordance was also seen in the other categories with the final histopathology, the number of samples in these categories was less for a definite conclusion. Cell block preparation, though useful, especially in the grey zone categories, did not offer statistically significant results. Another important finding was that not even a single case of incidental STIC was found. This finding raises questions on the accepted current routine practice of preventive salpingectomy for all in the correct setting.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-14"},"PeriodicalIF":1.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590219","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":"Artificial Intelligence in Gynecologic Cytology.","authors":"Lakshmi Harinath, Xinru Bai, Jeremy Minkowitz, Xianxu Zeng, Sarah Harrington, Chengquan Zhao, Liron Pantanowitz","doi":"10.1159/000546182","DOIUrl":"https://doi.org/10.1159/000546182","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is the fourth most common cancer in women globally with highest incidence and mortality identified in less developed and medically underserved areas in the world. The diminishing cytology workforce, unavailability of expert consultation, and the high volume of Pap tests needing manual screening are the main reasons for exploring innovative solutions to help mitigate the negative effects resulting from the dearth of timely cervical cancer screening in certain population groups.</p><p><strong>Summary: </strong>Developments in whole slide imaging and artificial intelligence (AI) have enabled the emergence of new computer-assisted systems that have the potential for transforming traditional cytopathology practice. However, AI-based systems are relatively new with limited published data on their validation and clinical utility in clinical practice. Our article aims to increase awareness of the availability of such systems, explores the history and development of AI-assisted screening platforms for Pap tests, compares the performance characteristics of various systems, elaborates on technical challenges associated with conducting clinical trials employing this technology, and discusses considerations around deploying such systems in routine cytopathology practice.</p><p><strong>Key message: </strong>Revolutionary AI-based systems are being developed and utilized in cytopathology practice to screen Pap tests. Some of these systems have good performance characteristics and provide opportunities to combat various issues such as workload and standardization faced by cytology laboratories globally. However, judicious review of these systems using evidence-based studies is imperative to promote widespread adoption and maintain high-quality standards for patient safety.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-20"},"PeriodicalIF":1.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590218","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 Systematic Review and Meta-Analysis on Sediment Cytology: An Adjunct to Early Diagnosis.","authors":"Ajay Kumar Verma, Anjali Narwal, Mala Kamboj, Anju Devi, Adarsh Kumar","doi":"10.1159/000547139","DOIUrl":"10.1159/000547139","url":null,"abstract":"<p><strong>Introduction: </strong>Sediment cytology, initially applied in urinary diagnostics, has expanded to formalin-fixed biopsy specimens, evaluating exfoliated cells suspended in formalin fixative. Though traditionally discarded, this sediment contains diagnostic material, especially in friable or malignant tissues. It offers a rapid, cost-effective, preliminary diagnostic tool when histopathology is delayed, such as in bone lesions requiring decalcification. This systematic review aimed to comprehensively assess the diagnostic accuracy, applicability, and limitations of sediment cytology across diverse anatomical sites.</p><p><strong>Methods: </strong>This systematic review followed PRISMA guidelines, and an electronic search was conducted across PubMed, Scopus, and Google Scholar databases until January 1, 2025, without year restrictions. Keywords included \"Sediment cytology,\" \"oral neoplasms,\" \"bone lesions,\" and related terms. Articles in English reporting sediment cytology on formalin-fixed biopsies with cytological-histological correlation were included.</p><p><strong>Results: </strong>Nine eligible studies were identified, involving various lesions including oral squamous cell carcinoma (OSCC), oral potentially malignant disorders (OPMDs), bone lesions, GIT, and cervical and ovarian neoplasms. Pooled sensitivity and specificity were 73.3% and 92.1%, respectively. Subgroup analysis revealed excellent concordance for OSCC and bone malignancies. Sensitivity was lower in benign lesions and OPMDs, attributed to poor cellularity and exfoliation. Methodological heterogeneity was noted, though overall bias remained low.</p><p><strong>Conclusion: </strong>Sediment cytology shows valuable diagnostic potential as a preliminary adjunct to histopathology, particularly for malignancies, warranting further standardized multicenter studies.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525945","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":"Cytomorphological Characteristics of Cervical Scrape from Controlled and Uncontrolled Diabetes Mellitus Patients Attending Tertiary Healthcare, Kenya.","authors":"Seth Shikuku Kolongolo, Tyrus Omondi, Everlyne Kutolo, Bernard Guyah","doi":"10.1159/000547062","DOIUrl":"10.1159/000547062","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Globally, the concurrence of diabetes mellitus and cervical cancer among women is compounded and increasing health burden. Furthermore, the incidence and prevalence of both diseases are increasing, particularly in middle- and low-income countries. In Kenya, 19.7% of new cancer cases among women are attributed to cervical cancer. While diabetes causes metabolic disorders and immune alterations that may promote persistent high-risk human papilloma virus infection, the magnitude of cervical cytomorphological abnormalities among diabetes women in Kenya remains unclear. The current study sought to determine the cytomorphological characteristics of cervical scrape samples obtained from patients with controlled and uncontrolled diabetes mellitus who visited the Kitale County Hospital, Kenya.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective, hospital-based analytical cross-sectional study was conducted between April 2023 and June 2024. A total of 156 patients with diabetes (n = 156) between the ages of 18 and 65 years were enrolled. Alcohol fixed cervical smears were processed using Papanicolaou staining method. The findings were reported using the 2014 Bethesda system for reporting cervical cytology. Images were captured for cytomorphological abnormalities using X20 mobile camera. RStudio 4.2.2 (2024-10-31 ucrt) software was used to analyze data. Mann-Whitney U test was used to compare distributions of laboratory characteristics between controlled and uncontrolled diabetes. Fisher's exact test was performed to explore associations between diabetes control and cytomorphological abnormalities. Chi-square tests were performed to determine relationship between diabetes control and presence of cervical abnormalities. Logistic regression was performed to assess the relationship between glycemic levels and presence of cytomorphological abnormalities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 156 cases, cytomorphological abnormalities were reported in 63.5%. Negative for intraepithelial lesion or malignancy accounted for 84.0%, while 16% were cervical intraepithelial lesions. Nonneoplastic abnormalities/infections were recorded in 48.1% of study participants. The study showed that there is statistically significant difference in the central tendency of age between controlled and uncontrolled diabetes mellitus (95% CI = 2.0-10.0, p = 0.001). There was statistical significance association between reproductive status and presence of cervical infections (odds ratio [OR] = 2.18, 95% CI = 1.15-4.18, p = 0.016). There was no significant association between diabetes control and occurrence of cervical cytomorphological abnormalities (OR = 1.47, 95% CI = 0.76-2.86, p = 0.704). While a unit increase in HBA1c was associated with (1.12) times higher odds of cytomorphological abnormality, it was not statistically significant (OR = 1.12, 95% CI = -0.11 to 0.245, p = 0.080).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The current study points both groups ","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367812","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":"Not Enough Cells: How Insufficient Cytological Specimens Are Mirrored by Reporting Systems - Journey from the Bethesda to the WHO Reporting Systems.","authors":"Ivana Kholová","doi":"10.1159/000546947","DOIUrl":"10.1159/000546947","url":null,"abstract":"<p><strong>Background: </strong>Pap classes have been replaced by organ-specific reporting systems in recent decades; however, part of the cytological specimens is insufficient. The present review summarizes how different organ-specific systems define the insufficient category: both quantitative and qualitative criteria are used. In addition, the sample volume may be evaluated in certain specimens.</p><p><strong>Summary: </strong>The reasons for an insufficient sample may vary and depend either on the lesion itself or the sampling procedure.</p><p><strong>Key messages: </strong>The management recommendations for insufficient specimens improve communication between cytopathologists and treating physicians.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-12"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315746","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":"Beyond the Microscope: Cytotechnologists' Integral Role in Quality Management.","authors":"Nathalie Andon, Savannah Bean, Vanda F Torous","doi":"10.1159/000546629","DOIUrl":"10.1159/000546629","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Summary: </strong>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><p><strong>Key messages: </strong>Cytotechnologists are essential to quality assurance and improvement in the cytopathology laboratory given their intimate knowledge and experience with cytopathology techniques and laboratory operations making them key contributors to maintaining and enhancing laboratory standards.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-6"},"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}