Acta CytologicaPub Date : 2024-01-01Epub Date: 2023-12-11DOI: 10.1159/000535694
Nicole Dan, Cecilia Norin, Eva Dafgård Kopp, Olga Strömberg, Edneia Tani, Elin Bohman
{"title":"Fine-Needle Aspiration Biopsy as a Diagnostic Modality for Orbital Adnexal Lymphoma.","authors":"Nicole Dan, Cecilia Norin, Eva Dafgård Kopp, Olga Strömberg, Edneia Tani, Elin Bohman","doi":"10.1159/000535694","DOIUrl":"10.1159/000535694","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to evaluate fine-needle aspiration biopsy (FNAB) as a diagnostic tool for lymphoproliferative orbital lesions in light of recent improvements in cytomorphological and immunologic analyses.</p><p><strong>Method: </strong>Retrospective case series including all orbital FNABs with a lymphoproliferative outcome at Karolinska University Hospital, Stockholm, Sweden during the period 2005-2015.</p><p><strong>Results: </strong>Of the 38 patients included, 31 (82%) were conclusively diagnosed as having lymphoma according to the first FNAB. Disease in 20 patients (65%) could be subclassified. The diagnosis in 7 patients (18%) was either inconclusive, suggestive of lymphoma, or reactive lymphatic infiltrate. These 7 patients were re-investigated, and the initial suspected diagnosis of malignant lymphoma was confirmed in four. Two of the remaining 3 patients were initially diagnosed as having non-lymphoproliferative disease; however, this was later changed to a lymphoproliferative diagnosis following reinvestigation, while the results of both reFNAB and incisional biopsy were inconclusive in the third.</p><p><strong>Conclusion: </strong>In the majority of the 38 patients, a definitive diagnosis of lymphoma could be made based on FNAB alone, using cytomorphological and immunological workup, and subclassification was possible in 20 patients (65%). Primary low-grade malignant orbital lymphomas are traditionally treated with low-dose radiotherapy regardless of subtype, and incisional biopsy was not needed to initiate treatment. Our findings suggest that FNAB is a valid first option for the diagnosis of suspected orbital lymphomas due to the minimal risk of complications compared to incisional biopsy, and the fact that it can be performed as an outpatient procedure with no anesthesia.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"26-33"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797135","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2024-08-28DOI: 10.1159/000541140
Shaarif Bashir, Asif Loya, Mudassar Hussain, Umer Nisar Sheikh, Hina Maqbool, Muhammed Aasim Yusuf
{"title":"Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration in a Paediatric Population: A Single-Centre Experience.","authors":"Shaarif Bashir, Asif Loya, Mudassar Hussain, Umer Nisar Sheikh, Hina Maqbool, Muhammed Aasim Yusuf","doi":"10.1159/000541140","DOIUrl":"10.1159/000541140","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a modern and minimally invasive technique to acquire diagnostic material from within the gastrointestinal tract, as well as from adjacent organs and structures, which can help in the diagnosis and staging of a variety of gastrointestinal malignancies, as well as for non-malignant conditions. Though well described in adults, there is limited literature on the diagnostic utility of EUS-FNA in paediatric patients. The objective of this study was to evaluate the diagnostic accuracy and clinical utility of EUS-FNA in paediatric patients performed at our centre over the last 17 years.</p><p><strong>Materials and methods: </strong>After obtaining Institutional Review Board approval, 63 cases of paediatric EUS-FNA performed at SKMCH&RC from 2005 to 2022 were retrieved. A 22-gauge EUS-FNA needle was used for obtaining samples with the use of suction (when required). The sample was then smeared onto glass slides, with half being stained with RAPI stain while the rest with the Papanicolaou stain. Demographic details, indication for the procedure, results of rapid on-site adequacy status (ROSE), site of lesion, and cytological diagnosis were reviewed and analysed.</p><p><strong>Results: </strong>Of the 63 patients, 55 (87.3%) had an adequate sample (confirmed on ROSE). Forty-two (66.7%) were male and the mean age was 12.4 years. The most frequent indication of EUS-FNA was a sampling of enlarged lymph nodes (74.6%). The most common sites of nodal aspiration were sub-carinal (33.3%) and celiac lymph nodes (14.3%). EUS-FNA of a pancreatic lesion accounted for an additional 17.5% of cases. Involvement by Hodgkin's lymphoma was the most common diagnosis (25.4%) followed by granulomatous inflammation (19.1%). Cases of solid pseudo-papillary tumour (4.8%) and recurrent Wilm's tumour (3.2%) were also diagnosed. No patient suffered complications, and none required hospital admission, post-procedure. The sensitivity, specificity, PPV, and NPV of EUS-FNA were 98.1, 83.3, 96.4, and 90.9%, respectively.</p><p><strong>Conclusion: </strong>EUS-FNA is a safe, well-tolerated, minimally invasive outpatient setting procedure with high sensitivity and significant utility in the diagnosis and staging of disease.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"397-404"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142091380","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2024-10-25DOI: 10.1159/000542040
{"title":"Message from the International Academy of Cytology.","authors":"","doi":"10.1159/000542040","DOIUrl":"10.1159/000542040","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"68 5","pages":"495-496"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492680","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2024-03-25DOI: 10.1159/000538464
Yan Gao, Dan Zi, Wentong Liang, Fang Qiu, Jie Zheng, Xuelian Xiao, Engli Jiang, Yuwei Xu
{"title":"PAX1 and SOX1 Gene Methylation as a Detection and Triage Method for Cervical Intraepithelial Neoplasia Diagnosis.","authors":"Yan Gao, Dan Zi, Wentong Liang, Fang Qiu, Jie Zheng, Xuelian Xiao, Engli Jiang, Yuwei Xu","doi":"10.1159/000538464","DOIUrl":"10.1159/000538464","url":null,"abstract":"<p><strong>Introduction: </strong>Methylation assays have demonstrated potential as dependable and high-precision approaches for identifying or triaging individuals with cervical cancer (CA) or cervical intraepithelial neoplasia (CIN). Our investigation aimed to assess the efficacy of the diagnosis and triage of the PAX1/SOX1 methylation panel in detecting CIN or CA.</p><p><strong>Methods: </strong>A total of 461 patients with abnormal high-risk human papillomavirus (hrHPV) or cytology test results were recruited for this study. Each patient underwent an assortment of assessments, comprising a cytology test, hrHPV test, colposcopy examination, and PAX1 and SOX1 methylation tests.</p><p><strong>Results: </strong>The extent of methylation of both genes demonstrates a positive correlation with the severity of CIN lesions and CA. To determine the correlation for patients with CIN2 or worse (CIN2+), the area under curve was 0.821 (95% CI: 0.782-0.853) for PAX1 and 0.800 (95% CI: 0.766-0.838) for SOX1, while for CIN3 or worse (CIN3+), 0.881 (95% CI: 0.839-0.908) for PAX1 and 0.867 (95% CI: 0.830-0.901) for SOX1. The PAX1/SOX1 methylation marker panel performed sensitivity and specificity of 77.16% and 91.67% for CIN2+, 84.76% and 90.50% for CIN3+, respectively. Regarding triaging hrHPV+ patients, the PAX1/SOX1 methylation test only referred 11.83% of the patients who are unnecessary for colonoscopy examination, which is comparatively lower than cytology, thereby signifying a promising triage strategy for hrHPV-positive women. Furthermore, we observed that the positive PAX1/SOX1 methylation test result for untreated CIN1 or fewer patients would result in a higher likelihood of progression upon a 24-month follow-up visit.</p><p><strong>Conclusion: </strong>The present investigation demonstrates that the PAX1/SOX1 methylation marker panel exhibits favorable diagnostic performance in CIN detection and holds the potential to be employed for individual CIN tests or hrHPV-positive triage.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"137-144"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140287936","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2024-07-18DOI: 10.1159/000540246
Elisabetta Maffei, Francesco De Giulio, Paola Chiara Rizzo, Pio Zeppa, Alessandro Caputo
{"title":"Fine-Needle Aspiration for Actionable Diagnosis of Mandibular Osteosarcoma Recurrence.","authors":"Elisabetta Maffei, Francesco De Giulio, Paola Chiara Rizzo, Pio Zeppa, Alessandro Caputo","doi":"10.1159/000540246","DOIUrl":"10.1159/000540246","url":null,"abstract":"<p><strong>Introduction: </strong>Mandibular osteosarcoma (MOS) is a rare malignant bone tumour known for its rapid and aggressive behaviour, particularly in cases of relapse. Early and accurate diagnosis is crucial for effective treatment.</p><p><strong>Case presentation: </strong>We report the case of a 48-year-old woman with recurrent MOS. Fine-needle aspiration cytology (FNAC) was utilized for diagnosis, facilitating prompt and appropriate treatment. The FNAC technique proved essential in confirming the diagnosis quickly, allowing for timely intervention.</p><p><strong>Conclusion: </strong>This case underscores the importance of FNAC in diagnosing MOS, especially in relapse situations where swift treatment is critical. FNAC can be a valuable tool in ensuring rapid and accurate diagnosis, leading to better patient outcomes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"314-318"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562388","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2024-07-18DOI: 10.1159/000540414
Daniel José Castilho da Silva, Caio Rodrigo Dos Santos, José Cândido Caldeira Xavier-Júnior
{"title":"Risk of Malignancy in Effusions according to the International System for Serous Fluid Cytopathology: A Review.","authors":"Daniel José Castilho da Silva, Caio Rodrigo Dos Santos, José Cândido Caldeira Xavier-Júnior","doi":"10.1159/000540414","DOIUrl":"10.1159/000540414","url":null,"abstract":"<p><strong>Introduction: </strong>The International Serous Fluid Cytopathology Reporting System (TIS) was developed to standardize communication among health professionals reporting analyses of serous fluid samples. The categories include non-diagnosis (ND), negative for malignancy (NFM), atypia of undetermined significance (AUS), suspected malignancy (SFM), and malignant (MAL). Each category was characterized by a risk of malignancy (ROM).</p><p><strong>Methods: </strong>We performed a literature review to analyze studies related to TIS using several sources, including PubMed, followed by a search of relevant cytopathology journal websites (American Cancer Society, Diagnostic Cytopathology, Journal of the American Society of Cytopathology, and Acta Cytologica and Cytopathology). The search included articles published between January 2020 and December 2023, using the terms \"international AND serous fluid system.\"</p><p><strong>Results: </strong>We identified 257 articles, of which 20 addressed the inclusion and exclusion criteria. The overall ROMs for each category were 23.55% for ND, 16.46% for NFM, 50.78% for AUS, 91.34% for SFM, and 98.21% for MAL.</p><p><strong>Conclusion: </strong>Considering the TIS-recommended ROM rates, the ND category was between the suggested intervals, while the SFM category rate was bigger than expected. The other categories (NFM, AUS, and MAL) were below expected values. SFM and MAL had a stronger association with MAL results. New studies are needed to determine each category's ROM rate from TIS accurately.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"384-393"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141722748","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2024-02-06DOI: 10.1159/000536663
Ramazan Ucak, Omer Faruk Dilbaz, Nedim Polat
{"title":"Analysis of the Differences between Bethesda Groups according to Conventional Smear and Liquid-Based Cytology Methods in Cervicovaginal Cytology: A Single-Center Experience with 165,915 Cases.","authors":"Ramazan Ucak, Omer Faruk Dilbaz, Nedim Polat","doi":"10.1159/000536663","DOIUrl":"10.1159/000536663","url":null,"abstract":"<p><strong>Introduction: </strong>Liquid-based cytology (LBC) has replaced conventional smear (CS) in the world. In this study, through a series with a large number of cases, we aimed to make a comparison and general evaluation in all groups, primarily epithelial abnormalities, according to LBC and CS methods. This study was carried out in a private pathology laboratory located in a metropolitan city, where cytological materials sent from many clinics were examined.</p><p><strong>Material and methods: </strong>There were 165,915 cases whose smears were examined between 2012 and 2020, most of them conventional (131,224 CS, 34,691 LBC). Cases were evaluated on the basis of the Bethesda 2014 classification and divided into sub-diagnostic categories after they were divided into two main groups as \"with epithelial abnormalities\" and \"without.\" χ2 and Fischer's precision statistical tests were conducted using SPSS 23.0 package. In the CS process, cervical samples were obtained using an endocervical brush and a spatula. Cells were directly spread onto the slides and promptly fixed in 95% ethanol, followed by staining with the standard Papanicolaou stain. For LBC ThinPrep, cervical specimens were gathered using a cervix brush. The brush was washed in a vial and discarded. Finally, cells were isolated through vacuum filtration and transferred to the slide using air pressure.</p><p><strong>Results: </strong>Squamous cell abnormalities (atypical squamous cells of undetermined significance [ASC-US], atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion [ASC-H], low-grade squamous intraepithelial lesion [LSIL], high-grade squamous intraepithelial lesion [HSIL], squamous cell carcinoma, atypical glandular cells of undetermined significance) were reported in 5,696 (3.43%) cases. ASC (ASC-US + ASC-H)/SIL ratio (1.36/2.04) was found to be 0.67 (recommended Bethesda ratio is <3). ASC-US (p < 0.001), ASC-H (p < 0.001), and HSIL(p < 0.001) detection rate of LBC was found to be significantly higher than CS. ASC-US (1.8/1.2), ASC-H (0.08/0.008), and HSIL (0.6/0.3) case ratios of LBC/CS were found to be significantly higher in LBC. LSIL (1.72/1.66) rate was similar.</p><p><strong>Conclusion: </strong>LBC is superior to CS in detecting epithelial lesions. In addition to being used as a screening method, it is clear that it makes a great contribution to reducing cervical carcinomas due to HPV typing. Definitive comments regarding comparison of methods on reactive changes and microorganism detection are challenging. Preanalytical factors might account for these situations.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"54-59"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139696678","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2023-12-20DOI: 10.1159/000535907
C Christofer Juhlin, Zubair W Baloch
{"title":"Pitfalls in Thyroid Fine-Needle Aspiration Cytopathology: An Approach to Atypical Findings.","authors":"C Christofer Juhlin, Zubair W Baloch","doi":"10.1159/000535907","DOIUrl":"10.1159/000535907","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodules are prevalent among the general population, thus imposing substantial demands upon healthcare providers to establish effective management paradigms when investigating these lesions. A pivotal component in the diagnostic process involves the cytomorphological evaluation of fine-needle aspiration (FNA) specimens extracted from the nodule under scrutiny. This examination serves the critical purpose of enabling a comprehensive assessment for the risk of either a neoplasm or malignancy, thereby providing the clinical team with the requisite information to render decisions regarding potential surgical intervention and/or a structured clinical follow-up. A subset of FNA specimens obtained from the thyroid gland present a vexing challenge for interpretation and cannot be classified based on cytomorphology as either benign or malignant and are classified as \"indeterminate\" for neoplasm or malignancy. The indeterminate thyroid FNA diagnosis in the third iteration of the Bethesda classification is termed as \"atypia of undetermined significance\" (AUS).</p><p><strong>Summary: </strong>The thyroid FNA specimens classified as \"atypical\" constitute a perplexing category, necessitating considerations such as repeated cytological evaluations, supplementary molecular analyses, diagnostic lobectomy, or vigilant surveillance. This review article draws upon the most recent Bethesda classification guidelines and delineates various potential pitfalls encountered during the interpretation of atypia observed in thyroid fine-needle aspiration and histopathologic counterparts. Additionally, it proffers strategic algorithms devised to effectively navigate these diagnostic challenges.</p><p><strong>Key messages: </strong>It is important to recognize the value of an integrated approach when triaging AUS lesions, considering various clinical, morphological, and sometimes also immunocytochemical or molecular features.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"179-193"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138827629","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2024-06-11DOI: 10.1159/000539692
Daniel Gomes Pinto, Fernando C Schmitt
{"title":"Overcoming Pitfalls in Breast Fine-Needle Aspiration Cytology: A Practical Review.","authors":"Daniel Gomes Pinto, Fernando C Schmitt","doi":"10.1159/000539692","DOIUrl":"10.1159/000539692","url":null,"abstract":"<p><strong>Background: </strong>Fine-needle aspiration cytology (FNAC) is a cornerstone technique for the initial assessment of breast lesions, offering a rapid and minimally invasive option for cytological evaluation. While FNACs can forego the need for core needle biopsies (CNBs), variations in technique, subjective interpretation, and intrinsic limitations present diagnostic challenges. The International Academy of Cytology (IAC) established the Yokohama system and is developing the WHO Reporting System for Breast Cytopathology jointly with IARC, to standardize diagnostic criteria, aiming to enhance diagnostic precision and consistency. Due to the preference for CNBs, expertise in breast FNAC is low in the developed world.</p><p><strong>Summary: </strong>This review assesses common pitfalls in breast cytopathology. These common and uncommon entities may easily lead to false-negative or false-positive diagnoses, due to morphological overlap or misleading clinical and radiological contexts. For instance, pauci-cellular lesions, such as lobular carcinomas, often lead to false-negative diagnoses, whereas complex sclerosing lesions, fibroadenomas, and papillary lesions may show concerning features, resulting in a false positive. The same is true for some benign inflammatory pathologies, such as steatonecrosis, and uncommon lesions, such as collagenous spherulosis. Ductal carcinoma in situ can lead to both false-negative and false-positive diagnoses, and high-grade lesions are impossible to tell apart from invasive carcinomas. These are discussed in detail. Procedural and preanalytical conditions, and the role of ancillary testing, are also briefly addressed.</p><p><strong>Key messages: </strong>Breast FNAB is a powerful diagnostic technique, fast and minimally invasive. Even in contexts which lack expertise, this technique can be successfully adopted with a cautious approach and as long as pitfalls are kept in mind, benefiting patients and healthcare systems.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"206-218"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305067","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}
Acta CytologicaPub Date : 2024-01-01Epub Date: 2024-01-16DOI: 10.1159/000536249
Pooja Sharma Kala, Mamta Gupta, Naveen Thapliyal
{"title":"Efficacy of Fine-Needle Aspiration Cytology in Diagnosing Secretory Carcinoma of Salivary Gland: A Systematic Review and Meta-Analysis.","authors":"Pooja Sharma Kala, Mamta Gupta, Naveen Thapliyal","doi":"10.1159/000536249","DOIUrl":"10.1159/000536249","url":null,"abstract":"<p><strong>Introduction: </strong>The diagnosis of salivary gland secretory carcinoma (SC) in fine-needle aspiration specimens is challenging because its low-grade nature makes it difficult to differentiate it from various benign or malignant salivary gland neoplasms. Currently, the gold standard is demonstration of ETV6-NTRK3 fusion gene. However, the decision for ordering this costly molecular testing can be facilitated by the correct recognition of its cytomorphological features. The aim of the review was to determine the accuracy of fine-needle aspiration cytology (FNAC) in diagnosis of salivary gland SC. The secondary objective was to recognize varied cytomorphological patterns, characteristic features of SC and differentiate it from other neoplasms.</p><p><strong>Methods: </strong>PubMed/MEDLINE, Science Direct, Embase, Cochrane review, and PROSPERO databases were searched for studies having the following key search terms: (\"secretory carcinoma of salivary gland\" OR \"mammary analogue secretory carcinoma of salivary gland\") AND (\"Cytology\" OR \"Cytological features\" OR \"aspirate\" OR \"cytodiagnosis\") published in the time frame of 2010 to June 2023. Studies reporting cytological features of the salivary gland tumors which were confirmed/diagnosed as SC on molecular investigation, were included in the systematic review. Finally, seventeen studies reporting a total of 45 cases were included in the metanalysis.</p><p><strong>Results: </strong>The sensitivity of the FNAC in diagnosing SC in salivary gland is 27.7% (95% CI: 16.6-42.5%). The LR+ (positive likelihood ratio) was 0.654 (0.344-1.245), LR- (negative likelihood ratio) was 1.023 (0.538-1.946), and diagnostic odds ratio was 0.421 (0.129-1.374). The molecular testing and/or immunohistochemistry performed on cell block increased the diagnostic accuracy.</p><p><strong>Conclusion: </strong>Recognition of subtle cytomorphological patterns, i.e., papillary formation, clusters, and singly dispersed cells along with presence of fine intracytoplasmic vacuolations were the characteristic findings in majority of cases, confirmed with diagnostic molecular profiling. This may be helpful in identification of this rare entity with limited published literature and help in increasing diagnostic accuracy.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"83-106"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139477805","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}