Acta Cytologica最新文献

{"title":"Redefining Cytotechnologist Practice in Sweden: National Survey on Workload, Expanded Roles, and Future Competency Needs.","authors":"Vladimir Basic, Karin A Stacke, Genta Rexaj, Nadi Kirova, Maria Sanchez Benito, Belinda Englund, Katarina Omholt, Mohammed S I Mansour","doi":"10.1159/000551322","DOIUrl":"10.1159/000551322","url":null,"abstract":"<p><strong>Introduction: </strong>Cytotechnologists have long been central to cervical cancer screening, although their education and job responsibilities differ markedly across countries. The adoption of primary HPV testing has substantially reshaped cytotechnology workforce needs and professional roles. In Sweden, however, no comprehensive overview of these changes exists. This study therefore examined cytotechnologists' training, job tasks, and how HPV testing has affected their daily work and practice patterns.</p><p><strong>Methods: </strong>We conducted a nationwide survey of Swedish cytology laboratories using an electronic questionnaire developed by the Board of the Swedish Society of Cytotechnologists. The 84-item instrument addressed workload, diagnostic tasks, ancillary testing, digital cytology, job satisfaction, and managerial assessments. Responses were summarized descriptively.</p><p><strong>Results: </strong>Screening of gynecologic (86%) and non-gynecologic specimens (89%) remained widely practiced among cytotechnologists, together with involvement in rapid onsite evaluation (48%), quality assurance activities (41%), and fine-needle aspiration assessment (55%). The transition to HPV primary screening was associated with reductions exceeding 50% in cervical cytology volumes and contributed to marked workforce pressures; 30% cytotechnologists reported assuming novel responsibilities, 81% of laboratories reported recent cytotechnologist attrition, whereas only 15% anticipated new recruitment. Adoption of digital cytology remained limited (6%), and no laboratory reported the use of artificial intelligence-based tools. Interest in expanded professional roles was high among cytotechnologists (93%) and was substantially supported by managers (88%). Concerns regarding job satisfaction were evident, with 19% of cytotechnologists indicating an intention to leave their position within the forthcoming year.</p><p><strong>Conclusion: </strong>Sustaining cytology services will require proactive workforce planning, competency-based upskilling, role diversification, and strategic adoption of digital technologies.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13099131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343253","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":"Cytologic Diagnosis of Large B-Cell Lymphoma: Diagnostic Approach and Differential Diagnosis.","authors":"Oscar Lin, Mats Ehinger","doi":"10.1159/000551250","DOIUrl":"10.1159/000551250","url":null,"abstract":"<p><strong>Background: </strong>Large B-cell lymphoma (LBCL) encompasses a diverse group of aggressive lymphoid neoplasms, the most common of which is diffuse large B-cell lymphoma (DLBCL). A precise diagnosis is critical for determining prognosis and therapeutic strategies, particularly as new molecular subtypes and classification criteria have been introduced in the 5th edition of the World Health Organization (WHO) classification of hematolymphoid tumors (WHO-HAEM5, 2022). Fine needle aspiration cytology is a safe and minimally invasive diagnostic tool for assessing lymphadenopathy and extranodal masses.</p><p><strong>Summary: </strong>LBCLs are typically characterized by single cells with large nuclei, vesicular chromatin pattern, and prominent nucleoli. The diagnosis of LBCL and the distinction distinguishing between LBCL subtypes requires the integration of cytomorphologic features with ancillary techniques, including immunocytochemistry, flow cytometry, fluorescence in situ hybridization, and next-generation sequencing.</p><p><strong>Key messages: </strong>This review synthesizes the cytologic features, immunophenotypic profiles, molecular signatures, and clinical implications of LBCL subtypes, highlighting recent advances in cytopathology and classification.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343188","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":"Patterns of Colloid in Thyroid Fine-Needle Aspiration Smears.","authors":"Chung-Yen Huang, Ming-Hsiang Weng, Tsu-Yao Cheng","doi":"10.1159/000551251","DOIUrl":"10.1159/000551251","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-4"},"PeriodicalIF":1.5,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316037","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":"The Utility of the ThinPrep® for Determining Hormone Receptor and HER2 Status in Axillary Lymph Node Fine-Needle Aspiration in Metastatic Breast Cancer: Comparison with the Primary Tumor.","authors":"Evren Uzun, Suna Erkilic","doi":"10.1159/000551115","DOIUrl":"10.1159/000551115","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of breast cancer is made on ER, PgR, and HER2 results of primary tumor. However, immunoprofile may differ in axillary metastasis, and treatment may be inadequate or unsuccessful. The objective of this study was to analyze the results of ER, PgR, and HER2 expression and discordance rates in ThinPrep samples from axillary fine-needle aspiration cytology (FNAC) and breast Tru-Cut biopsies.</p><p><strong>Methods: </strong>The study was conducted on 372 cases. Comparative analysis was performed on ER, PgR, and HER2 results of breast Tru-Cut biopsy and axillary FNAC obtained concurrently. A comprehensive review of literature addressing this subject was carried out.</p><p><strong>Results: </strong>The results revealed discrepancies between two specimens in 4, 11, and 5 cases for ER, PgR, and HER2, respectively. All discordant cases in ER and PgR and 2 cases in HER2 exhibited a shift from positive to negative. Notably, in 2 cases, HER2 was found to be negative in Tru-Cut biopsy but positive in axillary lymph node FNAC. The HER2 dual silver in situ hybridization amplification was identified in a retrospective analysis of breast Tru-Cut biopsies. The cases examined using the ThinPrep method exhibited 98.93%, 97.1%, and 98.7% concordance for ER, PgR, and HER2, respectively, while the discordance rates were recorded at 1.07%, 2.9%, and 1.3%. The kappa values calculated for ER, PgR, and HER2 were 0.97362 (95% CI 0.94791-0.99932), 0.93443 (95% CI 0.89634-0.97252), and 0.95625 (95% CI 0.91817-0.99432), respectively.</p><p><strong>Conclusions: </strong>The ER, PgR, and HER2 results obtained using the ThinPrep in axillary lymph node FNAC had a lower discordance and higher concordance than the majority of studies in the literature. These results demonstrate that axillary lymph node FNAC and ThinPrep can be safely used for accurate treatment selection and diagnosis.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275422","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":"Editorial for Special Issue of Sydney System for Reporting Lymph Node Lesion Aspirations.","authors":"Kari Syrjänen","doi":"10.1159/000550788","DOIUrl":"10.1159/000550788","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-3"},"PeriodicalIF":1.7,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146218110","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":"Fine-Needle Aspiration Biopsy Diagnosis of T-Cell Non-Hodgkin Lymphomas: Morphologic Features, Ancillary Testing, and Diagnostic Pitfalls.","authors":"Immacolata Cozzolino, Pio Zeppa, L Jeffrey Medeiros","doi":"10.1159/000550789","DOIUrl":"10.1159/000550789","url":null,"abstract":"<p><strong>Background: </strong>T-cell and NK-cell lymphomas are a heterogeneous group of mature lymphoid neoplasms that usually pursue an aggressive clinical course and involve both nodal and extranodal sites. These neoplasms have diverse clinical presentations, histopathologic patterns, immunophenotypes, genetic features, and prognoses.</p><p><strong>Summary: </strong>Accurate classification, as outlined in the 5th edition of the WHO Classification of Haematolymphoid Tumours (WHO-HAEM5) and in the WHO Reporting System for Lymph Node, Spleen, and Thymus Cytopathology, requires integration of clinical information and the results of histopathology, immunophenotyping, viral status, and, when indicated, molecular analyses. Fine-needle aspiration biopsy (FNAB) provides a minimally invasive opportunity to sample nodal and extranodal lesions and can support either a definitive diagnosis or a highly suggestive provisional diagnosis in selected T-cell lymphoma subtypes, particularly when combined with immunocytochemistry, flow cytometry (including TRBC1), and molecular clonality testing. However, cytomorphologic overlap with reactive or other neoplastic conditions often limits the ability of FNAB alone to provide full subclassification. In this review, we summarize the cytologic features and ancillary test profiles of T-lymphoblastic lymphoma (T-LBL), systemic anaplastic large cell lymphoma (ALCL), breast implant-associated ALCL (BIA-ALCL), nodal T-follicular helper cell lymphoma-angioimmunoblastic type (nTFHL-AI), hepatosplenic T-cell lymphoma (HSTL), and peripheral T-cell lymphoma-not otherwise specified (PTCL-NOS). For each entity, we emphasize practical diagnostic algorithms in FNAB-based cytology, typical immunophenotypic and molecular patterns, common pitfalls, and situations in which histology - preferably excisional biopsy - remains mandatory. A comparative overview indicates which entities can be definitively subclassified on cytology with appropriate ancillary techniques and provides examples of structured reporting according to the WHO Reporting System.</p><p><strong>Key messages: </strong>FNAB, when appropriately triaged for preparation of a cell block, immunocytochemistry, flow cytometry, and molecular studies can provide a definitive or near-definitive diagnosis in some T-cell lymphomas (e.g., T-LBL, systemic ALCL, BIA-ALCL effusions), whereas in other entities it serves mainly to raise strong suspicion and guide tissue biopsy (e.g., nTFHL-AI, PTCL-NOS). Understanding which entities can be reliably recognized by cytologic assessment, which ancillary panels are most informative, and where the limits of cytopathology lie are essential for optimal patient management and for appropriate use of the WHO Reporting System in daily practice.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-22"},"PeriodicalIF":1.7,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103384","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 Approaches, Traps, and Pitfalls in the FNAC Diagnosis of Lesions of the Spleen.","authors":"Elisabetta Maffei, Mariarita Calaminici, Immacolata Cozzolino, Pio Zeppa","doi":"10.1159/000550763","DOIUrl":"10.1159/000550763","url":null,"abstract":"<p><strong>Background: </strong>Splenomegaly, presenting as diffuse enlargement, nodules, or masses, may occur in different clinical contexts and can be caused by a wide range of conditions, including increased splenic function, haematological diseases, cysts, vascular lesions, and inflammatory or infectious processes. Most of these entities, particularly inflammatory and vascular conditions, are diagnosed clinically or radiologically and do not require further investigation. Conversely, some nodular or diffuse lesions, mainly lymphomas, metastases, nonspecific lymphocytic hyperplasia in specific clinical settings, and other rare or equivocal entities, still require direct evaluation by fine-needle aspiration cytology (FNAC), core-needle biopsy, or endoscopic ultrasound-guided FNAC.</p><p><strong>Summary: </strong>Because of the infrequent clinical indication, FNAC of the spleen (sFNAC) has never achieved a clearly defined role in the diagnostic workup of splenomegaly and has not become as widely used as in other organs. Nevertheless, sFNAC has been successfully applied in various clinical contexts for the diagnosis of splenomegaly and of different pathological processes, although it is not free from diagnostic traps and pitfalls. This review provides a comprehensive evaluation of the cytomorphological features of sFNAC across different pathologies and clinical settings.</p><p><strong>Key messages: </strong>Splenic FNAC is generally well tolerated by all patients and complications are rare; it allows to obtain accurate diagnoses of different pathological entities avoiding more invasive procedures, which might be useless in case of benign lesions or not strictly necessary in case of staging of lymphoma.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091875","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":"Lymph Node Fine-Needle Aspiration Cytology: Technique, Rapid On-Site Evaluation, and Ultrasound Guidance.","authors":"Elisabetta Maffei, Immacolata Cozzolino, Iginio Donatiello, Alessandro Caputo, Pio Zeppa","doi":"10.1159/000550594","DOIUrl":"10.1159/000550594","url":null,"abstract":"<p><strong>Background: </strong>Lymph node fine-needle aspiration cytology (LN-FNAC) is a flexible diagnostic tool capable of integrating cytological features with a wide range of ancillary tests to achieve accurate and comprehensive diagnoses. This review examines how sampling techniques, rapid on-site evaluation (ROSE), and ultrasound (US) guidance synergistically enhance the accuracy, safety, and clinical utility of LN-FNAC in everyday practice.</p><p><strong>Summary: </strong>From the earliest aspiration techniques, LN-FNAC has progressed by adopting modern sampling strategies based on US-guided trajectories, a broad selection of needle types, and variable needling approaches. Each of these components can be tailored to optimize targeting across diverse anatomical sites. The combined use of B-mode and Doppler US improves LN evaluation, allows the identification of diagnostically relevant areas, and increases the precision of needle placement, particularly in deep-seated or highly vascular LNs; in cases of partial LN involvement, US guidance allows sampling of diagnostically significant areas. Equally essential, ROSE minimizes inadequate sampling, improves diagnostic yield, and enables real-time triage for the application of specific ancillary techniques according to the initial diagnostic orientation. These techniques allow LN-FNAC to move beyond simple morphological assessment and to produce complete and clinically meaningful diagnoses.</p><p><strong>Key messages: </strong>LN-FNAC is adaptable to a broad range of clinical scenarios, including infectious and inflammatory conditions as well as metastatic disease and lymphoproliferative disorders. By integrating US evaluation, high-precision image-guided LN-FNAC sampling, ROSE, and the targeted use of ancillary techniques, LN-FNAC moves beyond a simple screening approach and represents a cornerstone of modern minimally invasive diagnostics.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049960","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":"Cytopathologic Diagnosis of Lymphomas in Serous Effusions, Cerebrospinal and Vitreous Fluid.","authors":"Pamela Michelow, Liezel Coetzee, Rubina Razack","doi":"10.1159/000550549","DOIUrl":"10.1159/000550549","url":null,"abstract":"<p><strong>Background: </strong>Haematolymphoid lesions in serous effusion, cerebrospinal, and vitreous fluid are encountered regularly. In the paediatric clinical setting, haematolymphoid lesions are the most common cause of malignant serous effusions. Cytologists and cytopathologists should be prepared to evaluate such samples as part of routine diagnostic practice. This article provides a comprehensive overview of the cytomorphological features and diagnostic considerations of lymphomas involving serous fluids, cerebrospinal, and vitreous fluids.</p><p><strong>Summary: </strong>B-cell non-Hodgkin lymphomas are most often encountered in fluid cytology specimens. A practical method for triaging lymphocyte-predominant effusions involves assessing lymphoid cell size, specifically distinguishing between small-to-medium and large lymphoid cells. A significant differential diagnosis of small-medium lymphoid cells in fluid specimens is reactive lymphocytosis while that for large cells is metastatic malignant, and atypical or malignant mesothelial cells.</p><p><strong>Key points: </strong>Cytologic evaluation of fluids containing lymphocytes provides valuable information regarding the nature of these lesions. Accurate cytologic diagnosis, with clinicopathologic correlation and judicious use of ancillary testing where possible, is essential for identifying the underlying cause of effusion, guiding therapy, monitoring disease progression or relapse, and informing prognosis. To optimize diagnostic outcomes, proper collection, transport, and preparation of fluid specimens is required. Collaboration with haematopathologists and use of standardized cytologic reporting systems further contribute to diagnostic accuracy and consistency. Emerging technologies, including molecular profiling, liquid biopsy, single-cell multi-omics and artificial intelligence, offer promising avenues for advancing the diagnosis and prognostication of haematolymphoid malignancies in fluid-based samples. Further research will determine their clinical utility.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-15"},"PeriodicalIF":1.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049871","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":"10.1159/000550622","DOIUrl":"https://doi.org/10.1159/000550622","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146008716","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}