Acta Cytologica最新文献

{"title":"Oncocytic Tumors in the Thyroid: A Tri-Focal Review - Integrated Cytopathological, Pathological, and Molecular Perspectives.","authors":"Maria A Gubbiotti, Sule Canberk, Zubair W Baloch","doi":"10.1159/000544739","DOIUrl":"10.1159/000544739","url":null,"abstract":"<p><strong>Background: </strong>The thyroid gland is a treasure trove of pathology ranging from the benign to the overtly malignant. Both neoplastic and nonneoplastic thyroid lesions can exhibit oncocytic change. Here we present an overview of cytologic and histopathologic findings encountered in these oncocytic neoplasms with a focus on the molecular aspects that drive their tumorigenesis.</p><p><strong>Summary: </strong>Oncocytic change is unique to a subset of thyroid lesions ranging from nonneoplastic nodular hyperplasia to high-grade malignancy. It can also be encountered in non-follicular-derived neoplasms as well as in the adjacent parathyroid glands. At the genetic level, these lesions demonstrate a different genetic signature from classic follicular-derived lesions, often involving alterations of mitochondrial genes.</p><p><strong>Key messages: </strong>Oncocytic change can be seen in nonneoplastic and neoplastic thyroid pathology. Rarely, oncocytic change can be seen in medullary thyroid carcinoma and certain subtypes of papillary thyroid carcinoma as well as the parathyroid gland. Oncocytic neoplasms of the thyroid harbor molecular alterations often involving mitochondrial genes, which is distinct from other thyroid neoplasia.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432168","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":"Insights into Thyroid and Salivary Gland Cytopathology: Highlights from a 45th European Congress of Cytology Slide Seminar.","authors":"Camille Brochard, Adam Kowalewski, Elena Vigliar, Rita Luis, Ozlem Aydin, Jerzy Klijanienko, Sule Canberk","doi":"10.1159/000543225","DOIUrl":"10.1159/000543225","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid and salivary gland cytopathology frequently present diagnostic challenges due to complex presentations, overlapping features between benign and malignant conditions, particularly with gray-zone entities and rare pathologies. To address these issues, the 45th European Congress of Cytology (ECC) held a slide seminar focused on challenging cases. This article reviews key findings from the 6 cases discussed, emphasizing the importance of a comprehensive diagnostic approach. The objective of this article was to illustrate the diagnostic challenges of rare thyroid and salivary gland lesions through case presentations, showing the need for a comprehensive, multidisciplinary approach to accurately reach a final diagnosis and steer the patient's management.</p><p><strong>Case presentation: </strong>The seminar presented cases involving fine-needle aspiration cytology followed by histopathological correlation, molecular and cytogenetic analyses or immunohistochemistry (IHC) markers to elucidate cytomorphological features, differential diagnoses, and final diagnoses of rare cases in thyroid and salivary gland cytopathology. Challenging thyroid cytology cases included differentiating thyroid sarcoidosis from malignancy, identifying intrathyroidal ectopic thymus versus lymphoid neoplasms, and recognizing poorly differentiated thyroid carcinoma initially misinterpreted as a benign follicular neoplasm. Complex salivary gland cases addressed the distinction of basal cell adenocarcinoma from adenoid cystic carcinoma, metastatic SMARCB1-deficient carcinoma diagnosed via IHC and a parotid mass initially identified as a Warthin tumor.</p><p><strong>Conclusion: </strong>These cases highlight the critical role of integrating cytological, clinical, and histopathological data to navigate the diagnostic complexities of thyroid and salivary gland lesions. A multidisciplinary approach and standardized algorithms are essential for improving diagnostic accuracy and patient outcomes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"171-182"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862783","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":"Comprehensive Study of Thyroid Fine Needle Aspiration in Pediatric and Young Adults.","authors":"Erika F Rodriguez, Precious Ann V Fortes, Victoria Lee, Jeffrey D Goldstein, Neda A Moatamed","doi":"10.1159/000546006","DOIUrl":"10.1159/000546006","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid nodules are uncommon in the pediatric population, with a 1-1.7% prevalence. The Bethesda System of Reporting Thyroid Cytopathology (TBSTC) is a well-established thyroid fine needle aspiration (FNA) reporting system. While the TBSTC guides therapy for both adult and pediatric patients, the reported risk of malignancy (ROM) is variable in the literature. The aim of this study was to compare the ROM in pediatric age of <15 with ≥15 years old.</p><p><strong>Methods and materials: </strong>We searched for patients aged 21 or younger who underwent FNA of thyroid nodules from 2016 to 2021. Data included patient demographics, nodule size, FNA results, molecular results, and surgical pathology follow-up. Patients were divided into two cohorts: 0-14 (<15) and 15-21 (≥15) years old.</p><p><strong>Results: </strong>145 nodules from 102 patients (26 cases in <15 and 94 in patients ≥15) were analyzed. Diagnoses and ROM were nondiagnostic (n = 3), benign (108, ROM 50%), atypia of unknown significance (n = 13, ROM 67%), follicular neoplasm (n = 6, ROM 33%), suspicious for malignancy (n = 1, ROM 100%), malignant (n = 14, ROM 100%). No significant differences (p ≥ 0.2) between the age groups were noted. Based on surgical follow-up results, the overall malignancy rate was 8% and 19% for <15 and ≥15 years old groups, respectively.</p><p><strong>Conclusion: </strong>The ROM for thyroid nodules in the pediatric population is higher than in adults. There appears to be a trend toward a higher overall malignancy rate in patients aged 15-21 compared to those under 15, though this difference is not statistically significant. Further studies with larger patient numbers are required to determine if the ROM differs significantly between these age groups.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"336-343"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965072","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":"Primary Melanoma of the Lung: A Vanishing Entity.","authors":"Tanner Storozuk, Melissa Tjota, Prince Ntiamoah, Pankhuri Wanjari, Anna Biernacka, Ward Reeves, Tatjana Antic","doi":"10.1159/000546441","DOIUrl":"10.1159/000546441","url":null,"abstract":"<p><strong>Introduction: </strong>Primary melanoma of the lung has been considered an extremely rare and highly aggressive malignancy that accounts for 0.01% of all primary lung tumors. Molecular studies, as well as pertinent clinical history, have since brought into question whether these tumors truly represent primary lesions of the lung. The current study evaluates a series of four melanomas of the lung to assess whether primary melanoma of the lung is truly a diagnostic consideration, or if these cases represent metastases of other primary sites.</p><p><strong>Methods: </strong>The pathology archives at the University of Chicago Medical Center were searched for patients who underwent robotic or endobronchial ultrasound-guided fine needle aspiration from 2018 to 2024. Clinicopathologic data, including demographics, fine needle aspiration results, and follow-up information including molecular studies and surgical resections, were collected from patients' electronic medical record.</p><p><strong>Results: </strong>In total 15,959 robotic-guided/endobronchial ultrasound-guided FNAs were reviewed, with 2 cases (0.0001%) being metastatic melanoma with no known cutaneous primary after immunohistochemical and molecular studies. Both patients had molecular studies performed. Notable mutations included BRAF, TERT, NRAS, CDKN2A, and NF1, which are frequently seen in cutaneous melanomas. High tumor mutational burden (UV signature with >98 mutations per megabase) was also detected by next-generation sequencing.</p><p><strong>Conclusion: </strong>Based upon molecular signatures, clinical history, and presumed lack of precursor cell type within the bronchial epithelium, melanomas arising within the lung are most likely metastatic tumors.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"361-366"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075337","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":"10.1159/000543694","DOIUrl":"10.1159/000543694","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"69 1","pages":"105"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603203","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":"Digital Pathology in Real-Life Conditions for Daily Cytopathological Diagnosis: A Feasibility Study.","authors":"Ranya Soufan, Alicia Larive, Irène Villa, Anne Auperin, Jean-Yves Scoazec, Voichita Suciu","doi":"10.1159/000545391","DOIUrl":"10.1159/000545391","url":null,"abstract":"<p><strong>Introduction: </strong>Nowadays, there is an increasing adoption of digital pathology for diagnostic purposes.</p><p><strong>Aim: </strong>Herein we study the feasibility of cytopathological diagnosis by whole-slide imaging (WSI) in daily practice.</p><p><strong>Methods: </strong>One hundred and ten consecutive non-gynecologic cytopathology cases, originally diagnosed under light microscopy (LM) by two pathologists, were scanned at ×40. Then, cases were diagnosed on WSI, by the same pathologist who originally rendered the conventional diagnosis. The pathologists were blinded to the diagnosis made by LM, but they had access to the same clinical information. The washout period was at least 3 months. WSI diagnoses were compared to the original LM diagnoses, and cases were considered concordant if the two types of diagnosis were identical.</p><p><strong>Results: </strong>LM and the WSI diagnoses were concordant in 87.3% [95% CI: 79.6; 92.9] of cases. Intra-observer agreement was lowest for thyroid fine-needle aspiration cytology (only 1 case out of 5). After the exclusion of thyroid cases, the concordance rate between WSI and LM was 90.5% [95% CI: 83.2%; 95.3%].</p><p><strong>Conclusion: </strong>Primary cytological diagnosis can be done using our digital system.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"223-230"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750536","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":"22nd International Congress of Cytology 2025, May 11-18, 2025, Florence, Italy: Abstracts.","authors":"","doi":"10.1159/000545256","DOIUrl":"10.1159/000545256","url":null,"abstract":"<p><p>n/a.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"69 Suppl 1","pages":"1-94"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958853","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":"Comparative Diagnostic Utility of Squash, Scrape, and Imprint cytology in Intraoperative Diagnosis of Ovarian Tumours.","authors":"Gajendra Kumar Yadav, Ravi H Phulware, Ashok Singh, Arvind Kumar, Prashant Durgapal, Nilotpal Chowdhury, Shalinee Rao, Shalini Rajaram, Sanjeev Kishore, Rajlaxmi Mundhara","doi":"10.1159/000545110","DOIUrl":"10.1159/000545110","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative cytology in ovarian tumours involves collecting cell samples from the ovarian sample sent during surgery and quickly examining them for diagnostic information. Frozen section provides rapid diagnosis to guide intraoperative patient management. The indications of frozen section are identification of tissue, evaluation of margins, and identification of lymph nodes metastasis.</p><p><strong>Materials and methods: </strong>Intraoperative tissue from clinico-radiologically suspected ovarian tumour for frozen section taken and processed in Department of Pathology and Laboratory Medicine. Squash smear, scrape smear, and imprint smear were made. Three stains rapid May-Grünwald Giemsa, rapid papanicolaou (Pap), and rapid hematoxylin and eosin with expected turnaround time of <15 min were done. Intraoperative cytological smear (squash, scrape, and imprint smear) were correlated with frozen section and histopathology slide. Final assessment of intraoperative cytological smears for diagnostic accuracy was done using statistical study. The aim of this study was to evaluate comparative diagnostic utility of squash smear, scrape smear, and imprint cytology with frozen section in intraoperative ovarian tumour is the aim of study.</p><p><strong>Results: </strong>Sensitivity, specificity, and diagnostic accuracy for frozen and cytology were: sensitivity of frozen section, squash cytology, and scrape cytology was 91.67% in all three, whereas sensitivity of imprint was 87.5%. Specificity of frozen section, imprint cytology, squash cytology, and scrape cytology was 96.77%, 93.55%, 90.32%, and 90.32%, respectively, and accuracy was 94.55%, 90.91%, 90.91%, and 90.91%, respectively.</p><p><strong>Conclusion: </strong>Imprint, squash, and scrape cytology have similar sensitivity and specificity compared to frozen section in identifying the nature of lesion and can be an alternative to frozen section in resource stricken setting.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"399-407"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699304","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":"Diagnostic Performance of the Milan System for Reporting Salivary Gland Cytopathology and a Proposed Algorithm for Fine-Needle Aspiration Cytology of Salivary Gland Lesions.","authors":"Norihide Mochizuki, Hirotaka Fujita, Takuma Tajiri, Masataka Ueda, Makiko Kurata, Chie Inomoto, Tomoko Sugiyama, Daisuke Maki, Shuichi Shiraishi, Tomohisa Machida, Hitoshi Ito, Yohei Masugi, Naoya Nakamura","doi":"10.1159/000546005","DOIUrl":"10.1159/000546005","url":null,"abstract":"<p><strong>Introduction: </strong>We evaluated concordance between Milan System for Reporting Salivary Gland Cytopathology (MSRSGC)-based categorization of salivary gland masses/lesions screened by fine-needle aspiration cytology (FNAC) and final histopathologic diagnoses, aiming to identify factors predictive of concordance, with the goal of appropriate case management.</p><p><strong>Methods: </strong>The study was retrospective and involved 101 cases of salivary mass/lesion examined by FNAC. We compared MSRSGC categories against the final histopathologic classes (non-neoplasm, benign neoplasm, or malignant neoplasm) and calculated diagnostic concordance in each class. Concordance was defined as: MSRSGC categorization of a lesion as a category II lesion and a histopathologic classification as a non-neoplasm; MSRSGC categorization of a lesion as a category IV-A lesion and a histopathologic classification as a benign neoplasm; or MSRSGC categorization of a lesion as a category V or VI lesion and a histopathologic classification as a malignant neoplasm. We then compared clinicopathologic factors between concordant and discordant cases.</p><p><strong>Results: </strong>Diagnostic concordance for non-neoplasms, benign neoplasms, malignant neoplasms, and total cases was 81.8% (9/11), 81.7% (58/71), 66.6% (8/12), and 79.8% (75/94), respectively, with no significant between-class difference. We found the shortest distance from the body surface to the salivary lesion differed significantly between the concordant group and the discordant group (5.35 mm vs. 7.30 mm), and the optimal cutoff was determined to be 8.00 mm (p < 0.01).</p><p><strong>Conclusion: </strong>Based on the distance of either <8 mm or ≥8 mm from the body surface to the mass/lesion, we believe our proposed FNAC algorithm of treatment strategies is a reliable guide for otolaryngologists on evaluating salivary gland lesions.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"324-335"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960999","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":"New WHO Reporting System for Lung Cytopathology: Reproducibility Test of the Diagnosis and Usefulness of an Online Tutorial System for the New Cytological Categorization.","authors":"Yuko Minami, Akemi Takenaka, Kenzo Hiroshima, Akihiko Yoshizawa, Reiji Haba, Kunimitsu Kawahara, Yasuo Shibuki, Shinji Miyake, Hirokuni Kakinuma, Yukitoshi Satoh","doi":"10.1159/000546179","DOIUrl":"10.1159/000546179","url":null,"abstract":"<p><strong>Introduction: </strong>Since no universal cytological classification system for lung cancer has been established, the Japanese Lung Cancer Society and the Japanese Society of Clinical Cytology (JSCC) jointly established and reported four cytological categories: negative for malignancy, atypical cells, suspicious for malignancy, and malignancy. In 2022, the WHO Reporting System for Lung Cytopathology was published. This system presented five cytological classifications, including the four cytological category classifications above and insufficient/inadequate/nondiagnostic. The creation of a classification alone is not practical in actual clinical practice. Thus, we evaluated the reproducibility of the classification through tutorials and identified the issues and problems involved in the wide dissemination of this classification.</p><p><strong>Methods: </strong>Forty-two cases were selected from those used in previously published articles, and diagnosis and tutorial systems were created. The first diagnostic round and tutorial and the second diagnostic round were conducted on the web. Participants were recruited via the JSCC website and emails. Images (×100 and ×400) of the lesions to be diagnosed were categorizing by 4 cytological categories (benign, atypical, suspicious for malignancy, malignant), 7 suggestive pathological diagnoses, and 4 cytological features. The mean correct or incorrect answer rates for the 42 cases and the mean correct response rates for 105 participants were compared between the first and second rounds using McNemar's test and t tests to identify cases with diagnostic difficulties and high tutorial effects.</p><p><strong>Results: </strong>Comparing the correct response to cytological categories, the results showed that 17 of 42 cases improved significantly. The mean number of correct answers for the four cytological categories increased significantly from 16.0 (38.1%) in the first round to 20.3 (48.3%) in the second round (p < 0.001). For the seven suggestive pathological diagnoses, the mean number of correct answers increased significantly from 20.3 (48.3%) in the first round to 25.1 (59.8%) in the second round (p < 0.001). The mean number of correct responses increased significantly from 40.2 (38%) in the first round to 51.5 (49%) in the second round (p = 0.0147). Four cases were difficult to match even after the tutorial and three cases were highly affected by the tutorial. The most important basis for diagnoses was nuclear findings in the first and second rounds.</p><p><strong>Conclusion: </strong>Comprehensive tutorials on diagnostic criteria are needed to effectively implement this system globally. In particular, devising ways to appropriately diagnose cancers with mild atypia or without characteristic morphology is important.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"386-398"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172190","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}