Acta Cytologica最新文献

{"title":"Diagnostic Utility of The International System for Reporting Serous Fluid Cytopathology.","authors":"Akhil Kocherlakota, Chaithra Venkataramana, Deepa Sowkur Anandarama Adigaa, Ranjitha Rao, Dinesh Kumar Ambati","doi":"10.1159/000551683","DOIUrl":"https://doi.org/10.1159/000551683","url":null,"abstract":"<p><strong>Introduction: </strong>Serous effusions are common specimens in cytopathology, yet their reporting has historically lacked uniformity. The International System for Reporting Serous Fluid Cytopathology (TIS) provides a standardized five-tiered classification system to improve diagnostic clarity and clinical communication. This study was conducted to assess the diagnostic utility and applicability of TIS by determining the Risk of Malignancy (ROM) and diagnostic accuracy metrics for each category.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on all serous effusions (pleural, pericardial, ascitic fluids, and peritoneal washes) reported from January 2021 to December 2023. Cases were re-categorized according to the TIS framework. The ROM for each category was calculated with Diagnostic accuracy metrics, including sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV).</p><p><strong>Results: </strong>A total of 1,447 cases were included in the analysis. Distribution across TIS categories was as follows: Nondiagnostic (ND) (8 cases; 0.6%), Negative for malignancy (NFM) (1,170 cases; 80.9%), Atypia of undetermined significance (AUS) (40 cases; 2.8%), Suspicious for malignancy (SFM) (35 cases; 2.4%), and Malignant (MAL) (194 cases; 13.4%). The calculated ROM for each category was 62.5% for ND, 28.8% for NFM, 66.7% for AUS, 93.8% for SFM, and 98.7% for MAL. The sensitivity, specificity, PPV, and NPV is 33.8%, 99.5%, 97.9%, and 69.7%, when AUS and NFM are considered negative. Sensitivity, specificity, PPV and NPV is 38.1%, 98.1%, 92.9%, and 70.8%, when AUS, SFM and MAL cases are considered positive.</p><p><strong>Conclusion: </strong>The implementation of TIS provides a standardized framework for reporting serous effusions with definite categorization. The ROM for each category helps in risk stratification of cases reported under TIS. The system demonstrates high specificity and PPV, making it a robust tool for detection of malignancy.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-22"},"PeriodicalIF":1.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580097","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":"BRAFV600E and KRAS mutation in thyroid lesions: a study on Giemsa-stained fine needle aspiration archival smears.","authors":"Deepika Rana, Nimisha Dhankar, Meeta Singh, Ritika Srivastava, Jennifer Kimnuntluangi, Tapan Jyoti Saikia, Somya Goyal, Sarthak Bakhshi, Nita Khurana, Binita Goswami","doi":"10.1159/000551748","DOIUrl":"https://doi.org/10.1159/000551748","url":null,"abstract":"<p><p>Introduction Molecular diagnosis is an important adjunct to FNAC in the evaluation of thyroid nodules, especially when cytology results are indeterminate. BRAFexon 15 p. V600E mutations in the thyroid have been shown to be almost exclusive to thyroid cancer. RAS protooncogene is also described in differentiated thyroid carcinomas and is used as tumor marker. However, their prevalence varies widely among studies, probably as a result of the detection methods used. In the present study, we evaluate the BRAFV600E and KRAS mutations in thyroid lesions on fine -needle aspiration archival smears and compare them with histological diagnosis Method This retrospective study was conducted in the department of Pathology for a period of five years: January 2020 to July 2024. All thyroid FNACs were reported and reclassified according tothe Bethesda system of reporting thyroid cytopathology system, 2023 and histological correlation wherever possible/available was included. Archival smears were used for DNA extraction for BRAF V600E and KRAS analysis by ddPCR. Results A total of 2300 thyroid FNAC were performed and categorised as TBSRTC 2023. Genomic extraction for BRAFV600E was done in 73 cases out of which 16 cases were positive. KRAS was done in all the BRAF positive cases and 6 cases showed both the mutations. BRAF expression and concomitant BRAF-KRAS expression was seen in 41.6% and 16.6% respectively of all the biopsy proven malignant cases. The risk of malignancy for BRAF+ FNAC smears was 90% and for BRAF-KRAS+smears, it was 100.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-16"},"PeriodicalIF":1.7,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571790","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":"Thyroid nodules with a cytological diagnosis of follicular neoplasm (Bethesda IV): exploring approaches to risk stratification.","authors":"Boris M Shifman, Nadezhda M Platonova, Fatima M Abdulkhabirova, Ekaterina V Bondarenko, Liliya S Urusova, Tatyana V Soldatova, Alina A Matrosova, Marina V Utkina, Sergey V Popov, Ekaterina A Troshina","doi":"10.1159/000551745","DOIUrl":"https://doi.org/10.1159/000551745","url":null,"abstract":"<p><p>Follicular neoplasm (IV category in the Bethesda reporting system) is the cytopathological diagnosis given when a fine-needle aspirate from a thyroid nodule reveals one of two abnormal cell patterns (non-oncocytic or oncocytic) with a similar risk of malignancy, approximately 30%. Bethesda IV accounts for up to 7-10% of fine-needle aspiration biopsy (FNAB) findings. Surgery remains the primary management strategy for Bethesda IV nodules in some medical centers, despite the fact that most of these lesions prove to be benign on histological examination. In light of the above, researchers have been actively seeking ways to refine the malignancy risk of follicular neoplasm for many years. The review summarises the results of a wide range of studies on the efficacy of different approaches to clarify the malignancy risk of follicular neoplasm, and analyses the prospects for their use in personalising patient management. Besides molecular testing, which has been the most advanced field in differential diagnosis of follicular neoplasm, risk stratification based on ultrasound features seems promising and requires further investigation. Despite the paucity of studies and lack of consensus in terms on methods, the cytological risk stratification of follicular neoplasm also appears to be a perspective approach, especially for its non-oncocytic subtype. In the future, the development of a diagnostic algorithm for the risk stratification of follicular neoplasm, incorporating the complex evaluation of ultrasound, genetic and cytological features, has the potential to reduce the number of unjustified surgical interventions by personalising the decision between surgery and active surveillance.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-30"},"PeriodicalIF":1.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147519441","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":"Pleural Effusion with Schistosoma Ova in Cytologic Smears: A Rare Case Report in an Elderly Patient.","authors":"Fatlinda Sadiku, Drita Miftari Pazhari, Albina Ponosheci Biçaku","doi":"10.1159/000551685","DOIUrl":"https://doi.org/10.1159/000551685","url":null,"abstract":"<p><strong>Background: </strong>Schistosomiasis is a chronic parasitic disease with diverse clinical manifestations. Thoracic involvement is uncommon, and pleural effusion due to schistosomiasis is exceptionally rare. Cytological identification of Schistosoma ova in pleural fluid represents a valuable diagnostic finding in such atypical presentations.</p><p><strong>Case presentation: </strong>A 79-year-old male patient presented with a pleural effusion persisting for several months. Diagnostic thoracentesis was performed, and pleural fluid was submitted for cytological evaluation. Microscopic examination revealed erythrocytes, inflammatory cells, and characteristic Schistosoma ova, establishing the diagnosis of pleural schistosomiasis. No malignant cells were identified. The patient was subsequently treated, resulting in clinical improvement.</p><p><strong>Conclusion: </strong>This case highlights the pivotal role of pleural fluid cytology in the diagnosis of rare thoracic manifestations of schistosomiasis. Recognition of Schistosoma ova in cytological specimens allows for timely diagnosis and appropriate management, particularly in patients with persistent pleural effusion of unclear etiology.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502931","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":"10.1159/000551605","DOIUrl":"https://doi.org/10.1159/000551605","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472319","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 Characteristics and Clinical Significance of Ciliocytophthoria in Bronchoalveolar Lavages Specimens.","authors":"Ruhani Sardana, Vanda F Torous","doi":"10.1159/000551336","DOIUrl":"https://doi.org/10.1159/000551336","url":null,"abstract":"<p><strong>Objectives: </strong>Ciliocytophthoria (CCP) is traditionally described as a cytopathic degeneration pattern, yet its clinical and analytic relevance remains poorly defined. This study evaluated the clinicopathologic, microbiologic, and cytologic features of CCP in bronchoalveolar lavage (BAL) specimens.</p><p><strong>Methods: </strong>Fourteen BAL specimens with CCP were retrospectively analyzed. Clinical, demographic, imaging, microbiologic, and laboratory data were reviewed. Cytologic evaluation included background degeneration, inflammation, and CCP counts. Processing times were recorded, and correlations between preanalytic variables and CCP density were assessed.</p><p><strong>Results: </strong>The cohort included 7 men and 7 women (age range 29-73 years, mean 54.9). Dyspnea (57.1%), cough (50%), and fever (50%) were the most common presenting symptoms. Ground-glass opacities were the predominant imaging finding (71.4%). Acute-phase reactants were elevated in 90.9%, and immunologic markers positive in 88.9% of tested patients. Bacterial cultures were positive in 42.9%. Fungal cultures were positive in 21.4% of cases, although all fungal isolates were Candida albicans. Viral positivity occurred in 36.4%, including two with SARS-CoV-2 infection. Cytologic review showed variable degeneration and inflammation, with no viral inclusions. CCP counts ranged from 3 to >50 with no correlation seen between CCP counts and sample processing time (p=0.068) or background degeneration (p=0.802).</p><p><strong>Conclusions: </strong>This study highlights CCP as an under-recognized but reproducible cytomorphologic feature in bronchoalveolar specimens. The findings reinforce its interpretation as a nonspecific marker of epithelial injury and airway insult rather than a pathogen-specific change, and extend its clinical associations to include bacterial contexts in addition to previously described viral settings.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-18"},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455136","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":"Erratum.","authors":"","doi":"10.1159/000550888","DOIUrl":"10.1159/000550888","url":null,"abstract":"<p><p>In the article \"Improving Diagnostic Accuracy of Indeterminate Thyroid Fine-Needle Aspiration Using Results of Ultrasound Examination, Cyclin D1 Immunostaining, and Molecular Testing\" [Acta Cytologica. 2025;69(6):515-527; https://doi.org/10.1159/000545319] by He et al., the following is being corrected as Figures 1, 2, 5, 6, 7, and 8 had been previously published by He et al. [1-3] without obtaining appropriate copyright permission.The authors have now replaced all affected figures with previously unpublished images derived from the same patient cohort and experimental period. These replacement images have been cross-verified against original laboratory records to ensure accuracy and to prevent any copyright infringement.The original article has been corrected to reflect these changes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442138","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":"Signet-ring Cell Pattern in Pancreatic Juice Cytology Indicates Intestinal-type Intraductal Papillary Mucinous Neoplasm with High-grade Dysplasia or Invasive Carcinoma.","authors":"Yuki Obara, Yosuke Tajika, Megumi Orita, Kazuto Ikeda, Akiko Hashimoto, Ayumi Hagiwara, Yui Yoshida, Mari Fujioka, Kenichi Hirabayashi","doi":"10.1159/000551473","DOIUrl":"https://doi.org/10.1159/000551473","url":null,"abstract":"<p><strong>Introduction: </strong>Signet-ring cells (SRCs) or SRC-like cells are a characteristic cytological feature observed in several malignancies. However, the diagnostic significance of SRC-like cells, including SRCs, in intraductal papillary mucinous neoplasms (IPMN) remains unclear. Therefore, this study aimed to evaluate the diagnostic significance of SRC-like cells in pancreatic juice cytology (PJC) of patients with IPMN.</p><p><strong>Methods: </strong>We retrospectively analyzed the prevalence, quantity, and mucus coloration of SRC-like cells in PJC specimens from 63 patients with IPMN, categorized by the histological grade and subtype.</p><p><strong>Results: </strong>SRC-like cells were observed in 5.0% (1/20) of low-grade dysplasia (LGD), 26.9% (7/26) of high-grade dysplasia (HGD), and 47.1% (8/17) of invasive carcinoma (IC) cases. Based on receiver operating characteristic curve analysis, the presence of ≥ 30 SRC-like cells (termed the \"SRC pattern\") was identified as the optimal threshold for diagnosing HGD/IC, demonstrating 100% specificity and positive predictive value. Among the 16 patients with SRC-like cells, the histological subtypes were gastric (n = 4) and intestinal (n = 12). Gastric-type IPMN cases showed < 30 SRC-like cells with yellow to orange mucus, whereas intestinal-type IPMN cases showed ≥ 30 SRC-like cells with clear to pink mucus.</p><p><strong>Conclusions: </strong>SRC pattern, defined as the presence of ≥ 30 SRC-like cells in PJC, may be a supportive cytological finding for diagnosing IPMN with HGD/IC, particularly the intestinal subtype. Furthermore, the mucus coloration of SRC-like cells might reflect subtype‑related morphological tendencies.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-16"},"PeriodicalIF":1.7,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442059","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":"Immunocytochemical Detection of Napsin-A in Pulmonary Alveolar Proteinosis: A Report of Two Cases.","authors":"Patricia Muñoz-Hernández, Carlos H Gordillo, Pablo López-Casillas, Claudia Valenzuela, José A Jiménez-Heffernan","doi":"10.1159/000551480","DOIUrl":"10.1159/000551480","url":null,"abstract":"<p><strong>Introduction: </strong>Cytological evaluation of bronchoalveolar lavage (BAL) fluid is useful for diagnosing pulmonary alveolar proteinosis (PAP), with periodic acid-Schiff staining being the most used ancillary test. There are more specific diagnostic tests (ultrastructure, surfactant antibodies), but unfortunately, they are not available to most laboratories. Following the observation of case of PAP with intense expression of Napsin-A and a recently published study supporting this finding, we decided to test this antibody in BAL samples of patients with PAP.</p><p><strong>Cases presentation: </strong>We found two out of six cases of PAP that had adequate cytological samples for immunocytochemical evaluation. The patients were a 61-year-old man, and a 55-year-old woman diagnosed with secondary and primary PAP, respectively. Both had complete clinical and imaging study, as well as histopathologic analysis. Cytological and histological samples were evaluated for Napsin-A expression, with positive results in both cases. To serve as controls we selected 15 BAL samples from patients without PAP, five showing Pneumocystis jirovecii infection.</p><p><strong>Conclusion: </strong>We have observed intense Napsin-A expression in the globular bodies seen in BAL samples from patients with PAP. We believe that it is a useful marker for confirming this diagnosis, especially in the absence of electron microscopy or surfactant-specific antibodies. Its application to cytological samples increases diagnostic accuracy, allowing, in an appropriate clinical and imaging context, a more precise diagnosis.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442077","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":"Evaluation and Recommendations to Modernize Cervical Cancer Detection and Prevention Programs in Brazil: Challenges and Opportunities - A Narrative Review.","authors":"Toni Ricardo Martins, Steven S Witkin, Rosana Lima de Oliveira, João Guilherme de Souza Gadelha, Jhennyfer Assunção, Iasmin Albuquerque Alves, Emanuelle Cristina de Andrade Valente, Valquíria Alves Martins, Kátia Luz Torres, Allyson Guimarães da Costa, Adhemar Longatto-Filho, José Eduardo Levi, Maria Cássia Mendes Correa","doi":"10.1159/000550725","DOIUrl":"10.1159/000550725","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer remains a major public health problem particularly in low- and middle-income countries. Systematic screening of at-risk women, detection of oncogenic human papillomavirus (HPV) types, and vaccination against HPV are essential strategies for reducing the incidence and mortality of this malignancy.</p><p><strong>Summary: </strong>This narrative review details publications related to the panorama of cervical cancer in Brazil and highlights major deficiencies as well as advances related to prevention, screening, diagnosis, and treatment of this disease.</p><p><strong>Discussion: </strong>Cervical cytology, specifically the Papanicolaou test, has been the main method of cervical cancer screening in Brazil. The subsequent implementation of HPV testing, alone or combined with cytology, has been shown to have increased efficacy in the detection and elimination of precancerous lesions. Currently, regional inequities in access to cervical cancer screening, prevention, and treatment actions, as well as in expertise in HPV detection protocols, have resulted in large regional differences in the quality of patient care. Vaccination against HPV is available free of charge by the Unified Health System. However, coverage remains suboptimal due to barriers such as misinformation, resistance from legal guardians, and failures in distribution logistics.</p><p><strong>Key messages: </strong>State-of-the-art molecular testing and effective screening of at-risk vulnerable populations for cervical lesions and for the presence of HPV still face regional, logistical, and infrastructure barriers. To improve cervical cancer prevention, detection, and treatment in Brazil, it is necessary to provide upgraded vaccination, screening, and treatment strategies, with a focus on an equitable country-wide access to comparable health services.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-14"},"PeriodicalIF":1.7,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389017","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}