Acta Cytologica最新文献

{"title":"Pitfalls in Urinary Tract Cytopathology.","authors":"Mahmoud A Hashim, Asma Arshia, Shafi Rehman, Ashish Chandra","doi":"10.1159/000537737","DOIUrl":"10.1159/000537737","url":null,"abstract":"<p><strong>Background: </strong>Urine cytopathology is a cost-effective method to diagnose and follow patients with high-grade urothelial carcinoma (UC). However, some benign, reactive, and metaplastic changes may mimic UC and pose a diagnostic challenge for cytopathologists.</p><p><strong>Summary: </strong>Our comprehensive review focuses on summarizing common pitfalls encountered in urine cytopathology, based on the 2nd edition of The Paris System (TPS) for reporting urinary tract cytopathology and other recent published literature. These pitfalls include urothelial tissue fragments, degenerative changes, treatment effects, viral cytopathic changes, iatrogenic and metaplastic changes. Our aim was to provide a clear understanding of these mimics in order to avoid diagnostic errors.</p><p><strong>Key message: </strong>It is crucial for cytopathologists to recognize benign, reactive, or metaplastic lesions that sometimes resemble UC. An awareness of these cytological changes is essential to make an accurate diagnosis.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"250-259"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139728719","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":"10.1159/000536462","DOIUrl":"10.1159/000536462","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"81"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038505","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":"Meeting Report: The Kymi Odyssey Honorary Ceremony and the Future G.N. Papanicolaou Museum.","authors":"Kari J Syrjänen","doi":"10.1159/000535445","DOIUrl":"10.1159/000535445","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-3"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138457131","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":"Fine-Needle Aspiration versus the CytoCore® Motorized Rotating Needle Device for Thyroid Nodule Biopsies: A Retrospective Cohort Study.","authors":"Adarsh Verma, Rhonda McDowell, Anthony Porreca","doi":"10.1159/000541374","DOIUrl":"10.1159/000541374","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, an FDA cleared motorized fine-needle aspiration device (CytoCore®, Praxis Medical) has become available which is designed to reduce sample variability by enabling more consistent sampling due to the rotational drilling action of the device in combination with the standard in and out motion used to access the thyroid nodule with a needle. The rotation of the needle permits the ability to collect a higher quantity of intact cellular material, which is optimal for determining adequacy and, ultimately, for making a diagnosis. The present study compares the diagnostic performance of a motorized fine needle aspiration (FNA) device to a historical cohort of patients biopsied using ultrasound-guided fine needle aspiration (US-FNA).</p><p><strong>Methods: </strong>Data from 120 patients with thyroid nodules biopsied using a motorized FNA device was retrospectively analyzed. Patient demographics, lesion characteristics, number of passes, Bethesda category, and cellularity scores were compared to a historical control cohort of 100 patients who underwent US-FNA. Nondiagnostic and indeterminate samples rates for motorized FNA were separately compared to literature controls.</p><p><strong>Results: </strong>A significantly reduced median number of passes were required with motorized FNA compared to US-FNA (1.48 ± 0.62 vs. 2.64 ± 1.63, p < 0.001). Adequate samples were obtained after the first pass for 58% of biopsies with motorized FNA compared to 11% with US-FNA. The cumulative percentage of adequate samples increased to 98% after two passes for motorized FNA versus 58% for the US-FNA group. The mean cellularity score was also significantly greater for motorized FNA (3.42 ± 0.63 vs. 1.9 ± 0.59; p < 0.001). A determinant diagnosis was possible for a greater number of samples in the motorized FNA group compared to the control group (91.6% vs. 78%; p = 0.05). The motorized FNA also had a lower nondiagnostic rate compared to US-FNA (2.0% vs. 10%) and a lower indeterminate rate compared to published rates associated with the use of FNA (8.3% vs. 20.0%; p = 0.05).</p><p><strong>Conclusion: </strong>The motorized FNA device required less passes to obtain an adequate biopsy than US-FNA. Its use is also associated with obtaining samples with a higher cellularity and lower nondiagnostic and indeterminate sample rates.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"405-412"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11548101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278635","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":"Cytopathology of Chondromyxoid Fibroma: Report of 2 Cases with Immunocytochemical Expression of GRM1.","authors":"Shiori Watabe, Yoshinao Kikuchi, Toru Motoi, Asako Yamamoto, Jungo Imanishi, Toru Tokizaki, Kenji Sato, Junji Mukaiyama, Shuhei Minami, Tsuyoshi Ishida, Hirotaka Kawano, Hiroshi Uozaki","doi":"10.1159/000536459","DOIUrl":"10.1159/000536459","url":null,"abstract":"<p><strong>Introduction: </strong>Chondromyxoid fibroma (CMF) is a rare, benign bone tumor that occurs predominantly in the second and third decades of life, more frequently in males. Overexpression of GRM1 as a consequence of tumor-specific gene rearrangement of GRM1 has recently been reported as a useful immunohistochemical marker for histopathological diagnosis of CMF. However, the usefulness of GRM1 staining of cytology specimens has not yet been evaluated. In this report, the cytological findings and GRM1 immunocytochemistry of two cases of CMF are described.</p><p><strong>Case presentations: </strong>Case 1 was a 15-year-old girl with a rib tumor. Imaging findings suggested a benign neurogenic tumor such as schwannoma. The tumor had increased in size over a 2-year period and was resected. Case 2 was a 14-year-old boy with a metatarsal tumor involving his left first toe. Imaging findings were suspicious of a benign neoplastic lesion. Biopsy findings suggested a benign tumor, and the patient underwent tumor resection. Cytologically, in both cases the tumor cells were predominantly spindle-shaped or stellate, with a myxoid to chondromyxoid background matrix and multinucleated giant cells, and these matrices were metachromatic with Giemsa staining. Cellular atypia was more accentuated in case 2 than in case 1. Immunocytochemical staining for GRM1 was positive in both cases.</p><p><strong>Conclusion: </strong>Due to the overlap in cytological findings, it is often difficult to differentiate CMF from chondroblastoma and chondrosarcoma grade 2. Immunocytochemical staining for GRM1 may support the diagnosis of CMF, and the reuse of Papanicolaou-stained specimens is applicable. The present cases further demonstrated the difficulty of differentiating CMF from other mimicking tumors such as chondroblastoma and chondrosarcoma grade 2. In such instances, immunocytochemistry for GRM1 is applicable to the diagnostic process, the value of which is strengthened by reusing Papanicolaou-stained specimens.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"66-72"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569428","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":"10.1159/000540267","DOIUrl":"10.1159/000540267","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"68 3","pages":"299"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733227","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":"Multi-Tissue Controls and Multiplex Immunocytochemistry in Pulmonary Cytology.","authors":"Antti Vuorisalo, Teppo Haapaniemi, Ivana Kholová","doi":"10.1159/000540367","DOIUrl":"10.1159/000540367","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization 2021 lung cancer classification highlights the central role of immunohistochemistry (IHC) in diagnostic pathology. Despite traditional IHC being essential, its limitation to one marker per tissue section brings challenges, particularly when facing cytological limitedly sized samples. To overcome these challenges, multiplex immunocytochemistry (mICC) techniques offer the simultaneous detection of multiple markers from a single section. These advances complement the highly complex imaging techniques that enable additional analyses of cellular interactions.</p><p><strong>Methods: </strong>The present study outlines a comprehensive mICC methodology of an automated multiplex immunoperoxidase staining method and multiple tissue hybrid controls for ICC/mICC. Protocols are presented in detail and demonstrate a careful approach to optimizing various markers for diagnostic workup including immunotherapy.</p><p><strong>Conclusion: </strong>Multiplex IHC/ICC emerges as a transformative force in biomedical diagnostics and research. Beyond simultaneous marker detection, it unravels complexities within tissues - unveiling co-localization nuances, deciphering expression patterns, and enhancing understanding of cellular populations. As personalized treatments gain prominence, the study emphasizes the heightened importance of diagnostic tools and sample adequacy. The present methodological study, encapsulating an automated multiplex immunoperoxidase staining method, symbolizes a stride towards precision in pulmonary carcinoma diagnosis. Multi-tissue controls represent a key element in quality assurance in pathology laboratories.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"481-493"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141854511","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":"Systematic Review and Meta-Analysis of the Diagnostic Accuracy of the Sydney System for Reporting Lymph Node Fine-Needle Aspiration Biopsy in Diagnosing Malignancy.","authors":"Sana Ahuja, Adil Aziz Khan, Rhea Ahuja, Pragun Ahuja, Sufian Zaheer","doi":"10.1159/000535797","DOIUrl":"10.1159/000535797","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to perform the first meta-analysis for assessment of the pooled risk of malignancy of each category of the Sydney system for reporting of lymph nodal aspirates along with the evaluation of diagnostic accuracy.</p><p><strong>Methods: </strong>PubMed/MEDLINE and Embase were searched with the following keywords: \"(Lymph node) AND (fine needle aspiration biopsy) OR (International system OR Sydney system)\" in the timeframe 2020 to August 4, 2023. The selected articles were assessed for the risk of bias by the QUADAS-2 tool. The meta-analysis for sensitivity (SN) and specificity for each cut-off, that is, \"atypical considered positive,\" \"suspicious of malignancy considered positive,\" and \"malignant considered positive\" for the lesions, was carried out after excluding the inadequate samples in each study. To assess the diagnostic accuracy, summary receiver operating characteristic curves were constructed, and the diagnostic odds ratio was pooled in both scenarios.</p><p><strong>Results: </strong>Nine studies, all of which were retrospective cross-sectional studies, were evaluated with a total of 13,205 cases. The SN and specificity for the \"atypical and higher risk categories\" considered positive for malignancy were 97% (95% CI, 95-99%) and 96% (95% CI, 91-98%), respectively. The SN and specificity for the \"suspicious of malignancy and higher risk categories\" considered positive for malignancy were 91% (95% CI, 85-95%) and 99% (95% CI, 97-100%), respectively. The SN and specificity for the \"malignant\" considered positive for malignancy were 75% (95% CI, 65-84%) and 100% (95% CI, 99-100%), respectively. The pooled area under the curve was 99-100% for each of the cut-offs.</p><p><strong>Conclusion: </strong>This meta-analysis highlights the accuracy of the Sydney system in reporting lymph node aspirates. It exhibits the significance of the \"suspicious\" and \"malignant\" categories in diagnosing malignancy and of the \"benign\" category in excluding malignancy.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"13-25"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797138","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":"Cytomorphological Assessment in Aspirates of Ductal Carcinoma in situ: Correlations with Histopathologic Grade, Architectural Pattern, and Invasion.","authors":"Joshua J X Li, Maria B C Y Chow, Joanna K M Ng, Julia Y Tsang, Gary M Tse","doi":"10.1159/000535836","DOIUrl":"10.1159/000535836","url":null,"abstract":"<p><strong>Introduction: </strong>Fine-needle aspiration biopsy (FNAB) of the breast is an effective and widely adopted diagnostic technique. Histopathologic grading of ductal carcinoma in situ (DCIS) has prognostic significance. In this current study, FNAB of DCIS was reviewed to identify parameters that predict grading, histopathologic architecture, and presence of invasion in DCIS.</p><p><strong>Methods: </strong>Aspirates from histopathology-proven cases of DCIS were retrieved and reviewed for cytomorphologic parameters including cellularity, composition, epithelial fragment architecture cellular/nuclear features.</p><p><strong>Results: </strong>In total 104 aspirates were reviewed. Cytopathologic cellular features - large nuclear size (p = 0.005), prominent nucleoli (p = 0.011), increased nuclear membrane irregularity (p = 0.043), high variation in nuclear size (p = 0.025), and presence of apoptotic figures in epithelial structures (p &lt; 0.001); and background debris (p = 0.033) correlated with a high-grade diagnosis. Cytoplasmic vacuolation (p = 0.034) was seen exclusively in non-high-grade aspirates. Epithelial fragment architecture did not correlate with grading. A predominance (≥50%) of solid aggregates and papillary fragments on FNAB correlated with histopathologically solid (p = 0.039, p = 0.005) and papillary (p = 0.029, &lt; p = 0.001) patterns. No parameter showed correlation with invasion.</p><p><strong>Conclusion: </strong>FNAB is effective in predicting DCIS grading. Epithelial fragment architecture assessment is limited to papillary or solid types, and FNAB cannot predict focal invasion in DCIS.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"45-53"},"PeriodicalIF":1.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10994590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138827627","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":"Pitfalls in Lymph Node Fine Needle Aspiration Cytology.","authors":"Min En Nga","doi":"10.1159/000535906","DOIUrl":"10.1159/000535906","url":null,"abstract":"<p><strong>Background: </strong>Fine needle aspiration cytology (FNAC) is an accurate, minimally invasive, and cost-effective biopsy method for enlarged lymph nodes. While the role of lymph node FNAC in the diagnosis of infectious or reactive conditions and metastatic malignancy is unquestioned, differing views still exist on its role in the diagnosis of lymphoma. Nevertheless, regardless of the practice setting, pitfalls and potential for error exist, and it is incumbent upon the pathologist to be aware of these pitfalls, as this is the first line of defence against errors.</p><p><strong>Summary: </strong>This discussion will focus on potential interpretational errors, specifically highlighting scenarios leading to false-negative and false-positive diagnosis and errors in tumour classification, with an emphasis on cytomorphology. Potential entities that may fly below the radar of the pathologist - so-called off-radar entities - are also discussed, as a reminder to consider broad differentials in cases with unusual morphologic features. Some reasons for false-negative diagnoses include low-grade lymphomas that mimic a mixed, polymorphous reactive lymphoid population or aspirates with a paucity of lesional cells, through either sampling error or the intrinsic nature of the entity, e.g., nodular lymphocyte predominant Hodgkin lymphoma. Some of the potential causes of false-positive diagnoses that are discussed include viral-associated lymphadenopathy, Kikuchi-Fujimoto lymphadenitis, or benign adnexal lesions mimicking metastatic malignancy. Errors in tumour classification covered include metastatic carcinoma, sarcoma, melanoma, and lymphoma mimicking each other, and Hodgkin lymphoma and its mimics. Finally, less common entities such as follicular dendritic cell sarcoma and others are briefly mentioned, to remind us of conditions that may slip under our diagnostic radar.</p><p><strong>Key messages: </strong>A systematic review of diagnostic pitfalls and traps is elucidated here, with some tips to avoid these traps. The triple approach to the diagnostic workup is emphasised, which includes rigorous clinicopathologic correlation, attention to cytomorphology, and judicious application of ancillary tests.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"260-280"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138827628","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}