Acta Cytologica最新文献

{"title":"Cytopathologic Diagnosis of Hodgkin Lymphoma: Realities Outlined.","authors":"Mousa A Al-Abbadi, Husam Abuawad, Kawthar Alsoud, Khairat Abdelkader Battah","doi":"10.1159/000550267","DOIUrl":"10.1159/000550267","url":null,"abstract":"<p><strong>Background: </strong>The historical journey of Hodgkin lymphoma (HL) has undergone a unique path since its inauguration as a malignant entity. Then it was further classified into classical HL (cHL) and nodular lymphocyte-predominant HL (NLPHL). Since then, the diagnosis was traditionally made on histological examination of tissue sections. The procurement of core, open, or excisional tissue biopsy used to be the backbone prerequisite to make the diagnosis. This dependence of diagnosis on histological sections has recently been challenged.</p><p><strong>Summary: </strong>In this review, making the diagnosis of HL by aspiration cytology is offered. Emerging evidence supports that in specialized centers with appropriate tools (specifically immunophenotyping by immunohistochemical stains) the diagnosis of cHL can be made confidently on cytological specimens with high levels of accuracy. The recent improvements in flow cytometric technology further assists in supporting the diagnosis of cHL on cytology. New parameters are now being reported as flow cytometric features of cHL, potentially distinguishing it from close mimickers.</p><p><strong>Key messages: </strong>The diagnosis of cHL can be achieved utilizing cytomorphology in combination with appropriate necessary ancillary studies. On the other hand, NLPHL still lags behind in these newer discoveries and its final diagnosis should still be made on histological tissue sections.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877441","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 Non-Neoplastic Inflammatory Disorders of Lymphoid Organs.","authors":"Joy M Hoang, Havva Gokce Terzioglu, Matthew L Kleinjan, Tatjana Antic, Nalini Gupta, Manish Rohilla, Radhika Srinivasan, Arvind Rajwanshi, Eva M Wojcik, Güliz A Barkan, Mark A Russell, Swati Mehrotra","doi":"10.1159/000550178","DOIUrl":"10.1159/000550178","url":null,"abstract":"<p><strong>Background: </strong>Fine-needle aspiration biopsy (FNAB) is a minimally invasive, cost-effective, and accurate method for evaluating enlarged lymph nodes, especially useful in pediatric cases where most aspirates are benign. It can be performed by palpation or under ultrasound guidance for deeper lesions. Rapid onsite evaluation enhances specimen adequacy and guides ancillary testing. FNAB, often combined with flow cytometry, can reduce the need for surgical biopsies by up to 86%, with reported sensitivity and specificity of 85-95% and 98-100%, respectively.</p><p><strong>Summary: </strong>Despite its advantages, FNAB is sometimes undervalued due to misconceptions about its diagnostic capabilities. The recently introduced WHO Reporting System for Lymph Node, Spleen, and Thymus Cytopathology, based on the Sydney System, aims to standardize reporting. It categorizes aspirates into five diagnostic groups, each with an associated risk of malignancy (ROM) and management recommendations. The \"benign\" category is the most common and includes non-neoplastic inflammatory conditions. Cytopathologists assess cellularity and cytologic features to distinguish benign from atypical or malignant processes. Low-power evaluation of smear patterns helps differentiate infectious from reactive causes. Flow cytometry is crucial for identifying lymphoproliferative disorders and leukemic infiltrates. The ROM for benign FNABs ranges from 2 to 16%, with a pooled estimate of 5%. Management typically involves clinical follow-up, with repeat FNAB or biopsy reserved for persistent or suspicious cases. Familiarity with lymph node cytology and integrated diagnostic approaches is essential for accurate patient care.</p><p><strong>Key messages: </strong>Familiarity with lymph node cytology and integrated diagnostic approaches is essential for accurate patient care.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-20"},"PeriodicalIF":1.7,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809026","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":"Cerebrospinal Fluid Diagnosis in Pediatric Oncology: A Model of Cytopathological Classification.","authors":"Karina Munhoz de Paula Alves Coelho, Camila Barbosa, Hercilio Fronza Junior, Rosemary Aparecida Camilo, Ludmila Barbosa De Souza Balsimelli, Cindielly Ribeiro Dzevieski, Bruna Louise Silva, Paulo Henrique Condeixa de França, Rafael Roesler, José Cândido Caldeira Xavier-Junior","doi":"10.1159/000550122","DOIUrl":"10.1159/000550122","url":null,"abstract":"<p><strong>Introduction: </strong>Cytological evaluation of cerebrospinal fluid (CSF) is essential for the diagnosis and monitoring of pediatric neoplasms. However, its interpretation remains challenging, particularly due to the lack of a standardized classification system. The aim of this study was to review the institutional experience in the analysis of CSF samples from pediatric oncology patients and to propose a structured cytological classification model.</p><p><strong>Methods: </strong>This was a retrospective study analyzing 3,479 CSF samples from 466 patients aged 0-19 years. Samples were reclassified according to a six-category system based on morphological criteria (nondiagnostic, hemorrhagic, negative for malignancy, inflammatory/reactive, atypia of undetermined significance, positive for malignancy).</p><p><strong>Results: </strong>Most samples (89.2%) were classified as negative for malignancy. Samples positive for malignancy accounted for 2.6%, while 2.0% presented atypia of undetermined significance/suspicious for malignancy and 0.4% showed inflammatory or reactive changes. Hemorrhagic and nondiagnostic samples represented 5.6% and 0.2%, respectively. Acute lymphoblastic leukemia was the most frequent underlying diagnosis (46.6%).</p><p><strong>Conclusion: </strong>This study proposes a practical CSF cytological classification model, based on the experience of a pathology laboratory specialized in pediatric oncology. The proposed standardization may contribute to enhance diagnostic consistency, improved clinicopathological correlation, and support the development of future guidelines in pediatric CSF cytopathology.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145792989","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":"Pearls and Pitfalls of Real-Life Molecular Testing on Fine-Needle Aspiration and Core Biopsy in Pancreatic Adenocarcinoma Practice.","authors":"Cisel Aydin Mericoz, Ibrahim Kulac, Emrah Alper, Volkan Adsay, Pinar Firat","doi":"10.1159/000549794","DOIUrl":"10.1159/000549794","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic ductal adenocarcinoma (PDAC) frequently requires neo-adjuvant therapy, leaving cytologic preparations - especially endoscopic ultrasound-guided fine-needle aspiration smears - as the only naïve tissue available for molecular testing. However, their applicability remains underappreciated due to limited data and concerns about specimen adequacy. This study aimed to evaluate the feasibility of performing molecular analysis on cytologic smears to detect targetable alterations in PDAC.</p><p><strong>Methods: </strong>Molecular analysis was conducted on 120 PDAC samples: 41 cytology specimens, 50 core biopsies, and 29 resections. KRAS mutations and homologous recombination repair gene alterations were assessed. Rapid on-site evaluation guided triage in all FNA cases. DNA and RNA isolations were performed, followed by quality control (QC) assessment and sequencing.</p><p><strong>Results: </strong>DNA isolation succeeded in 92/95 cases (97%), with a 100% success rate in cytologic specimens. RNA isolation passed QC in 71/84 samples (83%), with failures more common in smears (n = 8). KRAS mutations were detected in 71/85 patients (82%), with the highest detection in cytologic specimens (92%) compared to biopsies (78%) and resections (80%).</p><p><strong>Conclusion: </strong>Molecular testing is feasible and may even be more successful in cytologic smears than in biopsies or resections. High diagnostic yield and rapid processing favor their integration into routine molecular workflows. The superior performance of smears may relate to reduced stromal content and minimal processing delays. Cytologic specimens showed 100% DNA QC success, even when RNA QC failed, supporting their reliability. Although RNA analysis had a modest failure rate, its overall success suggests it can be incorporated into routine testing, particularly as fusion-driven targets gain clinical relevance.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740459","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":"Evaluating the Impact of Sample Volume on Cytological Diagnosis of Pleural Effusion: A Single-Institution Study Using The International System for Reporting Serous Fluid Cytopathology.","authors":"Rachana Meena, Sherrin Jacob, Prabhat Singh Malik, Anant Mohan, Sandeep Mathur, Venkateswaran K Iyer, Aruna Nambirajan, Deepali Jain","doi":"10.1159/000549982","DOIUrl":"10.1159/000549982","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant pleural effusion is a frequent manifestation in cancer patients, with effusion cytology playing a vital role in diagnosis and subtyping. Present study evaluated the effect of sample volume on malignancy detection and estimated the risk of malignancy (ROM) by using The International System for Reporting Serous Fluid Cytopathology (TIS).</p><p><strong>Methods: </strong>Pleural effusions submitted from May 2021 to December 2022 were reclassified using The International System for Reporting Serous Fluid Cytopathology (TIS) into five categories: nondiagnostic (ND), negative for malignancy (NFM), atypia of uncertain significance (AUS), suspicious for malignancy (SFM), and malignant (MAL). ROM and performance metrics were calculated based on follow-up histology and/or repeat cytology, ancillary tests, and clinico-radiology. Volume data from 493 samples were grouped into six bins (0-10 mL to >300 mL), and malignancy fractions were analyzed. Generalized estimating equation logistic regression assessed the impact of volume, sex, and age on diagnostic outcomes. Analysis was performed in R.</p><p><strong>Results: </strong>Of 1,265 samples from 1,107 patients, 875 (69.2%) had follow-up data. ROM estimates were ND 23.6%, NFM 11.6%, AUS 57.1%, SFM 100%, MAL 97.5%. MAL samples had significantly higher median volume than NFM (100 vs. 35 mL; p < 0.000). False negatives had lower volumes than true positives (50 vs. 80 mL; p = 0.027). Malignancy detection was lowest in samples <10 mL (7.4%) and highest in >300 mL (40.4%). Volumes <25 mL were significantly associated with reduced odds of malignancy detection (p < 0.05).</p><p><strong>Conclusion: </strong>Sample volumes <25 mL are linked to lower malignancy detection, underscoring the importance of adequate volume and supporting TIS implementation in routine cytology.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145706960","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":"Blastemal Tumours: Cytological Features and the Usefulness of Fine Needle Aspiration.","authors":"Pawel Gajdzis, Jerzy Klijanienko","doi":"10.1159/000549899","DOIUrl":"10.1159/000549899","url":null,"abstract":"<p><strong>Background: </strong>Blastemal tumours are quite frequent malignancies in childhood. In many oncological centres, fine needle aspiration is a part of the specific diagnostic procedure. In this review, the cytological features of the most common entities - i.e., neuroblastic tumours, nephroblastomas, retinoblastomas, and hepatoblastomas - are covered.</p><p><strong>Summary: </strong>Blastemal tumours are composed of blastemal cells, which are frequently rounded or oval. This morphological similarity among different entities requires detailed clinical and radiological information for accurate diagnosis. Cytological specimens play a crucial role, especially when histological specimens are not available or in cases where a prompt initiation of treatment is needed.</p><p><strong>Key messages: </strong>Cytological smears are highly cellular and show specific patterns for accurate histological typing. The hypercellularity of cytological specimen allows for the use of high-quality material for ancillary techniques, which are important for assessing several prognostic factors.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686681","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 Assessment of Paediatric Breast Lesions: A Systematic Review.","authors":"Ana Elisa Teles, Fernando C Schmitt","doi":"10.1159/000549243","DOIUrl":"https://doi.org/10.1159/000549243","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric breast lesions are rare and mostly benign. Despite their benign nature, the presence of these lesions in this population often raises concerns. Fine-needle aspiration biopsy (FNAB) offers a minimally invasive, though its application in paediatric populations remains debated due to interpretative challenges. This systematic review aims to assess the utility, limitations, and diagnostic performance of FNAB in the evaluation of paediatric breast lesions.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed for articles published from January 2014 to February 2025. Non-humans and non-English language reports were excluded. Based on title and abstract screening, 25 articles were selected, and 13 additional articles were retrieved through reference list, yielding a total of 38 studies for qualitative analysis. Data were manually extracted and synthesized.</p><p><strong>Results: </strong>Benign lesions represented the majority of cases, with fibroadenomas being the most frequent (65%-95%), followed by benign phyllodes tumours, hamartomas, tubular adenomas, pseudoangiomatous stromal hyperplasia (PASH), and cystic lesions. Malignant lesions were rare and included metastatic tumours, malignant phyllodes tumours, secretory carcinoma, and primary breast sarcomas. FNAB demonstrated high diagnostic accuracy for benign lesions but showed limitations in distinguishing benign from malignant tumours. ROSE was identified as a valuable adjunct, improving sample adequacy, reducing the rate of inconclusive results, and enhancing diagnostic reliability.</p><p><strong>Conclusion: </strong>FNAB is an effective first-line diagnostic modality for paediatric breast lesions, offering high accuracy for benign conditions. However, limitations exist in discriminating borderline and malignant lesions, warranting correlation with clinical, radiological findings, and, in some cases, core biopsy confirmation. The integration of ROSE enhances FNAB diagnostic yield and may further refine management strategies. A multidisciplinary approach remains essential to ensure optimal, minimally invasive care for paediatric patients.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145675942","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":"1-14"},"PeriodicalIF":1.7,"publicationDate":"2025-11-27","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":"Diagnostic Performance of Adrenal Gland Cytology following the World Health Organization Standardized Categories: Systematic Review and Meta-Analysis.","authors":"Jitendra Singh Nigam, Jyotsna Naresh Bharti, Immanuel Pradeep, Ashutosh Rath","doi":"10.1159/000549667","DOIUrl":"10.1159/000549667","url":null,"abstract":"<p><strong>Introduction: </strong>Fine-needle aspiration cytology (FNAC) reporting systems for adrenal gland cytology lack global uniformity. Implementing a standardized global reporting system would improve diagnostic accuracy, risk assessment, clinical communication, and uniformity in adrenal gland cytology practices worldwide. The current systematic review and meta-analysis aimed to assess the proposed WHO-standardized reporting categories for adrenal gland cytology and evaluate the role of FNAC in adrenal lesion diagnosis.</p><p><strong>Material and methods: </strong>A comprehensive search was conducted in PubMed, Scopus, and Embase databases up to June 2024. Studies with more than 15 patients were included. The QUADAS-2 tool was employed for quality assessment of the selected studies. Heterogeneity and publication bias among the studies were also evaluated. Cytological categories were recategorized according to the proposed WHO reporting system. Pooled sensitivity, specificity, and risk of malignancy (ROM) ranges for each cytological category were calculated.</p><p><strong>Results: </strong>Fifteen studies met the inclusion criteria. Pooled diagnostic performance across studies showed high sensitivity (92.2%) and high specificity (99.5%). Heterogeneity and publication bias were low. Range and pooled ROM across cytology categories were as follows: inadequate/nondiagnostic/unsatisfactory - 0% to 100% (18%), benign - 0% to 14.7% (3.7%), atypical category - 0% to 50% (46.2%), \"suspicious for malignancy\" - 0% to 100% (76.5%), and malignant category - 94.4% to 100% (99.6%).</p><p><strong>Conclusion: </strong>High sensitivity and specificity, as well as ROM values across categories, demonstrate that the proposed WHO cytological categories offer reliable risk stratification for adrenal lesions, supporting accurate diagnosis and treatment decisions. The low heterogeneity and minimal publication bias ensure that the findings are applicable across various clinical settings and patient populations.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562189","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: Cytopathology in Pediatrics.","authors":"Jose Candido Caldeira Xavier-Júnior, Mauro Saieg","doi":"10.1159/000549665","DOIUrl":"10.1159/000549665","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"1-2"},"PeriodicalIF":1.7,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562151","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}