Acta Cytologica最新文献

{"title":"Diagnostic Accuracy and Clinical Utility of Fine-Needle Aspiration in Breast Lesions: A Correlation with Surgical Pathology.","authors":"Alaa S Hrizat, Kelly A Doxzon, Robert P Post, Elena F Brachtel","doi":"10.1159/000542811","DOIUrl":"10.1159/000542811","url":null,"abstract":"<p><strong>Introduction: </strong>Fine-needle aspiration (FNA) is a valuable diagnostic tool for evaluating breast lesions, yet its use is less frequent compared to core needle biopsies in high-resource settings. This study aimed to assess the diagnostic performance and clinical utility of FNA in correlation with surgical pathology outcomes.</p><p><strong>Methods: </strong>We performed a 3-year retrospective search (2021-2023) using our institutional database to identify cases of breast mass FNAs performed by interventional radiologists under ultrasound guidance. We retrieved and re-evaluated all glass slides from the archive. Additionally, we reviewed the cytopathology reports and correlated the cytologic diagnoses with concurrent or subsequent surgical pathology results.</p><p><strong>Results: </strong>A total of 65 breast FNA cases from patients were reviewed. The diagnostic outcomes were 55% negative for malignancy, 23% insufficient for diagnosis, 11% atypical, 8% suspicious for malignancy, and 3% positive for malignancy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value of FNA for detecting malignancy were 76%, 96%, 93%, and 85%, respectively. One false positive case, categorized as atypical due to degenerative changes, was later confirmed as benign apocrine metaplasia. Three false-negative cases, initially categorized as non-diagnostic, were later diagnosed as invasive ductal carcinoma, Hodgkin lymphoma, and papillary carcinoma. An additional false-negative case, categorized under negative for malignancy, was later diagnosed as invasive ductal carcinoma.</p><p><strong>Conclusion: </strong>Breast FNAs, while less frequently performed than core needle biopsies, provide significant diagnostic insights, particularly for cystic lesions. The study demonstrates high specificity and PPV for FNA in detecting malignancy, underscoring its value as a diagnostic tool when integrated with imaging and clinical assessment. These findings support the continued use of FNA in the diagnostic evaluation of breast lesions.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"114-121"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142737974","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":"Applicability of the International Cytopathology Reporting System of Serous Fluids in a Brazilian City.","authors":"Caio Rodrigo Dos Santos, Daniel José Castilho da Silva, Deolino João Camilo-Júnior, José Candido Caldeira Xavier-Júnior","doi":"10.1159/000543045","DOIUrl":"10.1159/000543045","url":null,"abstract":"<p><strong>Introduction: </strong>The International Academy of Cytology and the American Society of Cytopathology developed the International System of Serous Fluid Cytopathology (TIS) to standardize cytological reports. Effusions in pleural, peritoneal, and pericardial cavities are valuable sources of information for medical diagnosis, especially in oncological scenarios. The TIS classification is divided into five categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of uncertain significance (AUS), suspected malignancy (SFM), and malignant (MAL). It facilitates global communication between specialists, aiming for future clinical management guidelines based on malignancy risk assessment.</p><p><strong>Methods: </strong>This quantitative analytical and retrospective study evaluated serous fluids (pleural, pericardial, and peritoneal) sent to the Instituto de Patologia de Araçatuba (IPAT), São Paulo, Brazil, from public and private hospitals between January 2017 and December 2022. Epidemiological and clinical data were collected from institutional files, including biopsies and immunohistochemical results.</p><p><strong>Results: </strong>The study included 719 patients with 763 serous fluid samples (pericardial, pleural, and peritoneal) analyzed over 6 years. The majority of samples were from pleural effusions (n = 438; 57.4%), followed by peritoneal (n = 293; 38.4%) and pericardial effusions (n = 32; 4.2%). Samples were classified using the International Serous Fluid Cytopathology System (TIS), revealing the following distribution: ND (0.41%), NFM (70.30%), AUS (0.95%), SFM (11.90%), and MAL (16.44%). The risk of malignancy calculated for each category was ND 66.67%, NFM 23.39%, AUS 28.57%, SFM 48.28%, and MAL 84.17%.</p><p><strong>Conclusion: </strong>The ROM was out of the interval proposed by the TIS in all categories. These findings suggest the applicability of TIS even outside of the cancer center environment, although the presented ROM frequencies were out of the recommended range.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"154-160"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799059","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 p16INK4a Staining on Cell Blocks Prepared from Residual Liquid-Based Cervicovaginal Material.","authors":"Shabana Andleeb Ansari, Anshu","doi":"10.1159/000544071","DOIUrl":"10.1159/000544071","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical cancer screening using Pap smears is affected by false-negative results. Liquid-based cytology (LBC) offers the technical advantage of preparing cell blocks from residual fluid to conduct ancillary tests on them. The p16INK4a gene product has been shown to be strongly overexpressed in dysplastic cervical epithelia and serves as surrogate marker for high-risk human papilloma virus infection.</p><p><strong>Materials and methods: </strong>Microwave-processed cell blocks were prepared from residual material in vials after ThinPrep slide preparation, stained with hematoxylin and eosin and p16INK4a. Nuclear staining with or without cytoplasmic staining on p16 slides was considered positive. Four parameters were evaluated: percentage of positive cells, intensity of staining, number of positively stained cells in close contact, and full-thickness epithelial staining. We compared sensitivity and specificity of ThinPrep smears and p16-stained cell blocks in diagnosing invasive malignancy.</p><p><strong>Results: </strong>The intensity and percentage of p16-positive cells was found to increase with increasing grade of cervical abnormality. We found good concordance between ThinPrep smear and cell block diagnoses in cases which were negative for intraepithelial lesion or malignancy (97.6%), in low-grade squamous intraepithelial lesions (90%), high-grade squamous intraepithelial lesions (100%), and squamous cell carcinomas (93.5%). Of 16 discrepant cases, 9 were reported unsatisfactory on ThinPrep smears due to abundant necrosis or scant cellularity. All these turned out to have malignancies on follow-up and review of histology. The sensitivity of ThinPrep and p16-stained cell blocks in diagnosing invasive malignancy were 70.2% and 85.1%, respectively, while the specificity of both was 100%.</p><p><strong>Conclusions: </strong>Cell blocks prepared from residual fluid in LBC vials have the potential to reduce the rates of inadequacy and are feasible in routine practice. While the cost of p16 on cell blocks may be too prohibitive for use in routine cervical screening programs, if used judiciously in combination with clinical suspicion, a lot of valuable material which is usually discarded in the residual LBC vials can prove to be crucial in arriving at the correct diagnosis.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"248-258"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389838","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":"10.1159/000545354","DOIUrl":"https://doi.org/10.1159/000545354","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"69 2","pages":"221"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960662","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":"Quality Assurance in Immunocytochemistry: A Review and Practical Considerations.","authors":"Maria D Lozano, Ramon Robledano, Allan Argueta","doi":"10.1159/000540532","DOIUrl":"10.1159/000540532","url":null,"abstract":"<p><strong>Background: </strong>Cytological samples play a critical role in diagnosing advanced-stage tumors and those arising in difficult-to-reach anatomical sites such as the pancreatobiliary tract, lung, thyroid, suprarenal, pelvis, and others such as salivary glands. These samples are often the only available material for accurate diagnosis and for performing ancillary studies, such as immunocytochemistry (ICC) or the detection of molecular biomarkers.</p><p><strong>Summary: </strong>While the use of immunohistochemistry is well established and standardized on formalin-fixed-paraffin-embedded histological tissue, in cytological samples, it presents unique challenges. Methods used for obtaining and processing these specimens are complex and are not standardized among laboratories. Moreover, there is also diversity in the types of cytological samples potentially suitable for ICC.</p><p><strong>Key messages: </strong>This review explores the current landscape of ICC practices in European and North American laboratories, highlighting variability in methods and the need for standardization to ensure reliable results and reproducibility of ICC on cytological specimens.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"60-68"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756500","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":"Role of Immunocytochemistry in the Cytological Diagnosis of Mesothelioma.","authors":"Claire W Michael, Shannon Alexandra Rodgers","doi":"10.1159/000543048","DOIUrl":"10.1159/000543048","url":null,"abstract":"<p><strong>Background: </strong>Mesothelioma is an aggressive malignancy of the serosal surfaces with very poor prognosis. It traditionally manifests in older patients and at an advanced stage which results in minimal improvement in prognosis despite the recent advances in management. Early detection would therefore significantly impact management and potentially improve survival. Mesothelioma frequently presents with recurrent effusions, posing cytology as the initial procedure in the workup. A definitive diagnosis would not only spare the patients additional diagnostic procedures but also potentially afford them an opportunity for early surgical intervention and therapy.</p><p><strong>Summary: </strong>In this article, we review the role of immunocytochemistry (ICC) in the workup of mesothelioma. The various ICC markers to confirm or rule out mesothelial lineage are reviewed. In addition, newly introduced molecular surrogates that confirm the malignant nature of the mesothelial cells and support a definitive diagnosis of mesothelioma are discussed. We also briefly discuss the theranostic implications of such markers and potential impact of such recent advances on the cytological diagnosis and reporting of mesothelioma.</p><p><strong>Key messages: </strong>The cytological diagnosis of mesothelioma no longer requires the extensive expertise in morphological analysis and can be offered based on supporting ICC that confirms the mesothelial lineage and malignant nature of the cells.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"26-43"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142816990","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":"Rapid On-Site Evaluation with Pancreatic Fine-Needle Biopsies: Successes and Challenges.","authors":"T Leif Helland, M Lisa Zhang, Martha B Pitman, Vanda F Torous","doi":"10.1159/000544737","DOIUrl":"10.1159/000544737","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using larger, next-generation cutting needles is a minimally invasive method for the diagnosis of pancreatic lesions. Rapid on-site evaluation (ROSE) is employed to render preliminary diagnoses, ensure specimen adequacy, and triage tissue for ancillary testing and can be performed on FNB cores. Given the difficulty of pancreatic cytology and the novelty of ROSE with these larger cutting needles, this study was performed to evaluate discrepancies between ROSE and the final diagnosis to uncover challenging diagnostic areas.</p><p><strong>Methods: </strong>Final reports from pancreatic FNBs with ROSE between January 2019 and December 2021 were reviewed, and the ROSE and final diagnoses were compared. Cases were categorized into nondiagnostic (ND), negative for malignancy (NEG), atypical, neoplastic (NEO), suspicious for malignancy (SFM), and positive for malignant cells (POS). A major discrepancy was defined as an ND/NEG versus NEO/SFM/POS interpretation.</p><p><strong>Results: </strong>A total of 454 cases were identified. The ROSE versus final diagnosis breakdown was as follows: ND/NEG 18.7% versus 16.3%, atypical 6.4% versus 5.1%, NEO 10.8% versus 11.9%, SFM 4.4% versus 2.0%, and POS 59.7% versus 64.8%. The concordance rate was high at 96.9% with only 14 (3.1%) major discrepancies, which included 6 due to interpretive error, 3 due to sampling error, and 5 due to a combination of both. While the majority of lesions in the cohort were conventional ductal adenocarcinomas (76%), there was an over-representation of non-ductal tumors constituting major discrepancies (6/14; 42.9%).</p><p><strong>Conclusions: </strong>ROSE using pancreatic EUS-FNB is possible and provides an accurate interpretation in most cases. Diagnostic challenges remain with non-ductal tumors.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"291-303"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447574","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 Criteria of Bile Cytology: A Multicenter Comparative Study of Conventional and Liquid-Based Cytology in Japan.","authors":"Yoshiki Naito, Akihiko Kawahara, Ryo Makino, Takako Tokumitsu, Daisuke Nagayama, Eiji Sadashima, Kaori Nakamura, Ryoji Nishizaki, Tadasuke Nagatomo, Yukina Fujino, Chie Hayakawa, Keishi Mizuguchi, Tatsuya Mori, Kenichi Hirabayashi, Takuma Tajiri","doi":"10.1159/000544997","DOIUrl":"10.1159/000544997","url":null,"abstract":"<p><strong>Introduction: </strong>The use of liquid-based cytology (LBC) in non-gynecological fields has progressively increased. However, studies focusing on the application of LBC in bile cytology are limited, and its efficacy remains uncertain. In this study, we assessed the potential of LBC in bile cytology by evaluating the interobserver agreement.</p><p><strong>Methods: </strong>Bile cytology specimens were collected between 2015 and 2022 by using endoscopic retrograde cholangiopancreatography. Eleven cytotechnologists participated in the evaluation. Digital images of bile cytology specimens prepared using conventional smear (CS), ThinPrep LBC (TP-LBC), and SurePath LBC (SP-LBC) methods (20 cases per preparation method) were assessed for interobserver agreement on 21 diagnostic criteria. The diagnostic accuracy was evaluated using 50 bile cytology cases per preparation method.</p><p><strong>Results: </strong>High interobserver agreement (exact kappa > 0.6) was observed for features, including the loss of nuclear polarity, irregular nuclear spacing, nuclear size variation, and increased nuclear-to-cytoplasmic ratio across the CS, TP-LBC, and SP-LBC methods. Malignant cells in TP-LBC appeared smaller and rounder, and formed flat aggregates compared with those in CS. In contrast, the malignant cells in SP-LBC formed three-dimensional clusters that overlapped and exhibited higher cellularity than those in CS. The sensitivity of bile cytology was 76.4%, 84.8%, and 93.2% for CS, TP-LBC, and SP-LBC, respectively.</p><p><strong>Conclusion: </strong>The observers consistently recognized malignant cell features in bile cytology, irrespective of the preparation method. Understanding common features and method-specific cellular morphology is crucial for enhancing diagnostic accuracy. Our findings suggest that LBC methods can be effectively applied to bile cytology, potentially offering improved diagnostic accuracy compared with conventional methods.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"269-279"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536333","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":"Immunocytochemistry in Cytology: Myth or Reality.","authors":"Deepali Jain, Lukas Bubendorf","doi":"10.1159/000543867","DOIUrl":"10.1159/000543867","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"5-6"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063083","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":"\"Immunocytochemistry in Cytology: Myth or Reality\": Unraveling the Myth - Immunocytochemistry Applications in Thyroid Lesions.","authors":"Mitsuyoshi Hirokawa, Ayana Suzuki","doi":"10.1159/000540366","DOIUrl":"10.1159/000540366","url":null,"abstract":"<p><strong>Background: </strong>Fine-needle aspiration cytology serves as an important preoperative diagnostic tool for thyroid nodules. Despite its excellent diagnostic accuracy, diagnoses based solely on morphological observation can be challenging. Therefore, various ancillary diagnostic techniques have been applied, including immunocytochemistry (ICC). This review discusses the application and evaluation of ICC in thyroid fine needle aspiration.</p><p><strong>Summary: </strong>Currently, three immunostaining preparation methods are available for cytological materials: liquid-based cytology, cell block, and cell transfer. ICC proves valuable in scenarios such as tumour diagnosis, assessment of differentiation and grading of carcinomas, estimation of primary organs in metastatic carcinomas, and detection of gene abnormalities. However, ICC, while useful, is not as accurate as immunohistochemistry and is more difficult to evaluate.</p><p><strong>Key messages: </strong>If the pitfalls and limitations are understood and effectively navigated, ICC could play a significant role in decreasing the non-diagnostic rate, thus leading to more accurate and valuable diagnoses and reductions in the re-aspiration rate.</p><p><strong>Background: </strong>Fine-needle aspiration cytology serves as an important preoperative diagnostic tool for thyroid nodules. Despite its excellent diagnostic accuracy, diagnoses based solely on morphological observation can be challenging. Therefore, various ancillary diagnostic techniques have been applied, including immunocytochemistry (ICC). This review discusses the application and evaluation of ICC in thyroid fine needle aspiration.</p><p><strong>Summary: </strong>Currently, three immunostaining preparation methods are available for cytological materials: liquid-based cytology, cell block, and cell transfer. ICC proves valuable in scenarios such as tumour diagnosis, assessment of differentiation and grading of carcinomas, estimation of primary organs in metastatic carcinomas, and detection of gene abnormalities. However, ICC, while useful, is not as accurate as immunohistochemistry and is more difficult to evaluate.</p><p><strong>Key messages: </strong>If the pitfalls and limitations are understood and effectively navigated, ICC could play a significant role in decreasing the non-diagnostic rate, thus leading to more accurate and valuable diagnoses and reductions in the re-aspiration rate.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"7-15"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615631","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}