Acta Cytologica最新文献

{"title":"Cytological Findings in Pediatric Thoracic Tumors: A Review of Diagnostic Insights and Pitfalls.","authors":"Parikshaa Gupta, Pranab Dey","doi":"10.1159/000550227","DOIUrl":"10.1159/000550227","url":null,"abstract":"<p><strong>Background: </strong>Pediatric lung and mediastinal tumors constitute a rare and heterogeneous group of neoplasms, often of embryonal, germ cell, lymphoid, or mesenchymal derivation. Cytology (especially fine-needle aspiration) plays a critical role in the minimally invasive diagnosis of these masses, particularly in children, where surgical biopsy may carry a high risk.</p><p><strong>Summary: </strong>This review synthesizes the cytomorphologic spectrum of pediatric thoracic tumors, emphasizing distinguishing features, common pitfalls, and the integration of ancillary studies (immunocytochemistry, molecular testing). Special focus is on pleuropulmonary blastoma, inflammatory myofibroblastic tumor, germ cell tumors, lymphomas, Langerhans cell histiocytosis, neurogenic tumors, and small round cell tumors. We propose a structured diagnostic algorithm that incorporates clinical, radiologic, and cytologic data, along with the emerging roles of next-generation sequencing, AI-assisted cytology, and liquid-based methods in pediatric thoracic cytopathology.</p><p><strong>Key messages: </strong>(1) Accurate cytologic diagnosis in pediatric thoracic masses demands optimal sampling, careful morphologic assessment, and judicious use of ancillary techniques. (2) Improved standardization, multicenter collaborations, and integration of digital/molecular tools hold promise to enhance diagnostic yield and guide therapy in this challenging realm.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"320-345"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877351","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 Fine-Needle Aspiration Biopsy of Lymph Nodes Using WHO Reporting System: Comparison between Pediatric and Adult Brazilian Populations.","authors":"Leonardo Fávaro Ficoto, Deolino João Camilo Júnior, Gustavo Resende Nora, Vitor Bonetti Valente, Daniel Galera Bernabé, José Cândido Caldeira Xavier-Júnior","doi":"10.1159/000548652","DOIUrl":"10.1159/000548652","url":null,"abstract":"<p><strong>Introduction: </strong>Fine-needle aspiration biopsy (FNAB) is a minimally invasive diagnostic method widely used in the evaluation of lymphadenopathies. However, there are few studies evaluating its applicability in different age groups, especially among the pediatric population. This study aimed to evaluate the cytological findings of lymph nodes FNAB between pediatric and adult patients using the WHO Reporting System for Cytopathology of Lymph Nodes, Spleen.</p><p><strong>Methods: </strong>This retrospective and observational study included 366 cases of lymph node FNAB collected and analyzed by a single pathological center (the Instituto de Patologia de Araçatuba), Brazil, from January 2016 to December 2024. Cytological diagnoses were categorized using the WHO Reporting System for Cytopathology of Lymph Nodes, Spleen, and Thymus into five categories (inadequate/insufficient, benign, atypical, suspicious for malignancy, and malignant) and correlated with histopathological outcomes, when available. Ancillary techniques and rapid on-site evaluation were not available. Statistical analyses included chi-square and Fisher's exact tests. p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Among the 366 cases, 17 (4.6%) were pediatric and 349 (95.4%) were adult. The most frequent location of the lesions was the head and neck region (79%). Benign cytological diagnoses were significantly more common in children (94.1%), while suspicious for malignancy and malignant results were exclusive to adults (29.3% and 14%, respectively; p = 0.001). Larger lymph nodes (>2 cm) were significantly associated with malignancy (p < 0.0001). Considering the total population, the rates of risk of malignancy (ROM) were 50% for category \"insufficient,\" 32.6% for benign, 82.8% for suspicious, and 97.5% for malignant cases. From each category, 28 (53.8%), 49 (27.7%), 35 (71.4%), and 16 (32.6%) patients were underwent histopathological follow-ups, respectively.</p><p><strong>Conclusion: </strong>This study, despite the limited pediatric sample, demonstrates that the method is applicable to both pediatric and adult patients, including those outside cancer centers. The calculated ROM was 50% for inadequate, 32.6% for benign, 82.9% for suspicious, and 97.6% for malignant categories. Deviations from WHO reference intervals for inadequate and benign cases may be attributed to the absence of ancillary techniques. Then, two main findings emerged: (i) benign cytological diagnoses predominated in children, while suspicious and malignant results occurred exclusively in adults; and (ii) lymph nodes >2 cm were strongly associated with malignant cytological and histological outcomes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"289-298"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147396","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":"Cytological Features of Spindle Cell Lesions of the Head and Neck and Review of the Literature.","authors":"Kıvılcım Eren Ateş, Aysun Hatice Uğuz, Ivana Kholová, Aslı Aydoğdu Yeşiloğlu, Gülfiliz Gönlüşen, Hatice Elmas","doi":"10.1159/000549796","DOIUrl":"10.1159/000549796","url":null,"abstract":"<p><strong>Introduction: </strong>Spindle cell lesions in the head and neck often mimic sarcomas but may include a wide range of benign and malignant entities. Fine-needle aspiration (FNA) is a minimally invasive method used to evaluate such lesions, though cytological interpretation can be challenging due to overlapping features.</p><p><strong>Methods: </strong>This retrospective study included 12 primary spindle cell lesions of the head and neck, selected based on inclusion/exclusion criteria. Papanicolaou and May-Grünwald-Giemsa stains were used for smear evaluation. Cell blocks were prepared, and cytological diagnoses were compared with histopathological outcomes.</p><p><strong>Results: </strong>The 12 cases were diagnosed as follows: nodular fasciitis (n = 2), schwannoma (n = 2), malignant peripheral nerve sheath tumor (n = 1), leiomyosarcoma (n = 1), liposarcoma (n = 1), rhabdomyosarcoma (n = 1), osteosarcoma (n = 3), and chondroblastoma (n = 1). Cytological features showed moderate correlation with final histology.</p><p><strong>Conclusion: </strong>FNA is a valuable, cost-effective tool for evaluating spindle cell lesions in the head and neck. While morphological overlap poses diagnostic limitations, ancillary techniques and molecular studies enhance its accuracy and clinical utility.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"417-430"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627728","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":"10.1159/000551543","DOIUrl":"https://doi.org/10.1159/000551543","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"70 2","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147472327","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":"10.1159/000553665","DOIUrl":"10.1159/000553665","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"504"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547670","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":"Beyond the Microscope: Cytotechnologists' Integral Role in Quality Management.","authors":"Nathalie Andon, Savannah Bean, Vanda F Torous","doi":"10.1159/000546629","DOIUrl":"10.1159/000546629","url":null,"abstract":"<p><strong>Background: </strong>Cytotechnologists are integral members of the cytopathology team with their role extending beyond that of analyzing slides. They have a unique understanding of cytopreparation, laboratory systems, and workflows given their involvement in varied laboratory processes which makes them key players in quality control, quality assurance, and quality improvement measures. Many cytotechnologists endorse performing quality assurance and/or quality control activities as part of their duties.</p><p><strong>Summary: </strong>In this article, we review some of the key quality control and assurance measures cytotechnologists are involved in with an emphasis on how they can take a leading role in systems operations and improvements.</p><p><strong>Key messages: </strong>Cytotechnologists are essential to quality assurance and improvement in the cytopathology laboratory given their intimate knowledge and experience with cytopathology techniques and laboratory operations making them key contributors to maintaining and enhancing laboratory standards.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"107-112"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273847","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":"Special Issue: Quality Assurance/Quality Control in Cytopathology.","authors":"Ivana Kholová, Vanda F Torous, Adhemar Longatto-Filho","doi":"10.1159/000548888","DOIUrl":"10.1159/000548888","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"5-7"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278631","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":"Bronchoalveolar Lavage as a Candidate for Artificial Intelligence Integration: Insights into Differential Cell Count and Golde Score Using Conventional Cytology Smears.","authors":"Josua Schaefer, Fabienne Hagmann, Stefan Reinhard, Flordeliza Egli, Marjolein Hofland-Overdevest, Carole Bückelmann, Mladen Kovačević, Jasmin Cordey, Mafalda Trippel, Inti Zlobec, Tereza Losmanová","doi":"10.1159/000549346","DOIUrl":"10.1159/000549346","url":null,"abstract":"<p><strong>Introduction: </strong>Bronchoalveolar lavage (BAL) brings an important contribution in diagnosing pulmonary diseases. The analysis of standard cell distribution and the assessment of iron-laden macrophages (the Golde score) are integral to standard medical reports. However, the traditional cytological method of manual cell counting is subject to interobserver variability and staining quality issues.</p><p><strong>Methods: </strong>To address these issues, we trained AI-based algorithms to enhance the accuracy of differentiated cell counts of macrophages, lymphocytes, neutrophils, eosinophils, ciliated cells, and squamous cells as well as the Golde score, which assesses the hemosiderin content in macrophages. For this purpose, we assembled an internal sample cohort with 16 Hemacolor, 16 Papanicolaou, and 5 iron-stained smears. For validation, we used 10 slides each of Papanicolaou and Hemacolor staining and 5 with iron staining.</p><p><strong>Results: </strong>The algorithm achieved fair to excellent correlation compared to two cytologists: For Papanicolaou staining, the correlations were macrophages 0.96, lymphocytes 0.98, neutrophil granulocytes 0.99, eosinophils 0.58, ciliated cells 0.61, squamous cells 0.31. In Hemacolor staining the correlations were macrophages 0.97, lymphocytes 0.92, neutrophils 0.99, eosinophils 0.99, ciliated cells 0.58, squamous cells -0.145. The automated Golde score calculation deviated on average by 19 points from the manual evaluation.</p><p><strong>Conclusion: </strong>The study demonstrates the potential of AI-supported methods for BAL analysis in diagnostic cytology. The high accuracy in recognizing cell types and calculating the Golde score underlines the benefits of expanding the training data for broader clinical applications. Further research is encouraged to support the use of digital cytology on conventional smears in clinical practice.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"234-249"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145443582","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":"Cytological Features of Metastatic Clear Cell Renal Cell Carcinoma Diagnosed on Cytology: A Single-Center Experience with Literature Review.","authors":"Isabella Sorice, Anna Maria Carillo, Maria Salatiello, Pasquale Pisapia, Elena Vigliar, Giancarlo Troncone, Claudio Bellevicine","doi":"10.1159/000549506","DOIUrl":"10.1159/000549506","url":null,"abstract":"<p><strong>Introduction: </strong>Renal cell carcinoma frequently metastasizes to multiple sites, which often poses significant diagnostic challenges, particularly when the primary tumor is unknown or occult. This retrospective study analyzed 43 fine-needle aspiration (FNA) cases of metastatic ccRCC from a single institution to characterize metastatic patterns and evaluate the diagnostic utility of cytology combined with immunocytochemistry.</p><p><strong>Methods: </strong>We retrospectively reviewed FNA cases diagnosed as metastatic RCC from January 2003 to December 2024. Cytopathological evaluation included cellularity, architectural patterns, cytoplasmic and nuclear features, background elements, and immunocytochemical analysis when available.</p><p><strong>Results: </strong>Cytology demonstrated excellent diagnostic performance. The majority of cases were reported as malignant (91%), while the remaining 9% were classified as suspicious for malignancy or atypia of undetermined significance. Notably, in 42% of cases, FNA established the initial diagnosis of RCC, highlighting its value in detecting occult primary tumors. Diagnostic accuracy relied on cytomorphologic evaluation, complemented by immunocytochemical profiling, which was performed on cell blocks in 60.4% of cases.</p><p><strong>Conclusion: </strong>Key markers such as PAX8, CD10, and RCCma were critical in confirming renal origin and differentiating ccRCC from morphologically similar neoplasms in each organ. FNA cytology, corroborated by focused immunocytochemistry, plays a key role in diagnosing metastatic ccRCC, particularly when the presentation is uncommon or the primary tumor is hidden. This integrated method supports effective clinical management, avoiding unnecessary surgery in cases that may benefit from systemic therapy.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"175-184"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627709","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 Features of Lymphoepithelial Carcinoma of the Lung: A Comparative Analysis of Aspiration and Exfoliative Cytology.","authors":"Joanna K M Ng, Ken Ka Pang Chan, Shelly Y Ni, Joshua Li","doi":"10.1159/000550410","DOIUrl":"10.1159/000550410","url":null,"abstract":"<p><p><p>Introduction: Lymphoepithelial carcinoma of the lung shows distinctive histologic features but its cytologic description is limited in the literature. This study reviews and compares a large cohort of lung and lymph node aspirates, bronchial, serous fluid, and sputum exfoliative cytology from histology-proven cases, aiming to detail diagnostic features and cytologic specimen types preferable for diagnosis of this entity.</p><p><strong>Methods: </strong>Cytology specimens of patients with a histologic diagnosis of lymphoepithelial carcinoma on lung biopsy or resection were reviewed for cytomorphologic features associated with lymphoepithelial carcinoma, with comparison between cytologic specimen types performed.</p><p><strong>Results: </strong>Totally 13 aspiration (7 lung and 6 lymph node) and 22 exfoliative (18 bronchial, 1 serous fluid, and 4 sputum cytology) specimens were reviewed. The most common cytomorphologic features observed were macronucleoli (82.9%), marked nuclear membrane irregularity (82.9%), and naked tumor nuclei (74.3%). High cellular cohesion, presence of large tumor fragments, rich lymphoid background, and tumor-infiltrating lymphocytes, are also frequently seen (>60%). Lymphoid components, multinucleated tumor cells, and large epithelial fragments were more commonly seen in aspirations compared to exfoliative specimens (p < 0.05).</p><p><strong>Conclusion: </strong>Distinctive morphological features of lymphoepithelial carcinoma of lung are reproducible on cytologic specimens. Qualitative nuclear features (macronucleoli, marked nuclear membrane irregularity, and naked tumor nuclei) are the most consistently observed. Compared to exfoliative cytology, aspirated specimens show higher yield for diagnostic cytomorphologic features of lymphoepithelial carcinoma. </p>.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"442-449"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145964654","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}