Acta Cytologica最新文献

{"title":"Comparison of Cytological and/or Histopathological Results of Patients with Single and Multiple HPV Positivity.","authors":"Fatih Mehmet Kaya, Şafak Ersöz, Cihan Comba, Ömer Demir","doi":"10.1159/000550291","DOIUrl":"10.1159/000550291","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the impact of single and multiple human papillomavirus (HPV) positivity on cervical intraepithelial lesions, specifically focusing on whether the addition of high-risk HPV types to HPV-16 or HPV-18 affects the progression to high-grade lesions.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 612 HPV-positive patients from Karadeniz Technical University Faculty of Medicine, Department of Obstetrics and Gynecology (2018-2023), who underwent Pap smear and HPV genotyping. Demographic, cytological, and histopathological data were collected, with HPV types categorized as HPV-16, HPV-18, and other high-risk types. Colposcopic biopsy results were used to assess the risk of cervical intraepithelial neoplasia.</p><p><strong>Results: </strong>Among 612 HPV-positive patients, 137 had HPV-16 (17.4%), 39 had HPV-18 (4.9%), and 503 had other high-risk types (63.8%). HPV-16 and multiple high-risk HPV types exhibited a higher proportion of cytological abnormalities. Histopathological analysis showed that the presence of other high-risk HPV types alongside HPV-16 was associated with a lower risk of progression to high-grade lesions compared to HPV-16 alone. Specifically, HPV-16 combined with other high-risk types showed a significantly lower rate of cervical intraepithelial neoplasia.</p><p><strong>Conclusion: </strong>The addition of other high-risk HPV types to HPV-16 may slow the progression to high-grade cervical lesions, contradicting the literature that suggests multiple HPV infections increase the risk. These findings contribute to the ongoing debate on the role of multiple HPV types in cervical lesion progression.</p><p><strong>Key message: </strong>The presence of additional high-risk HPV types alongside HPV-16 may reduce the likelihood of progression to high-grade cervical lesions, suggesting a possible attenuating effect of multiple HPV infections rather than a synergistic risk.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"393-402"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877393","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":"Erratum.","authors":"","doi":"10.1159/000550888","DOIUrl":"10.1159/000550888","url":null,"abstract":"<p><p>In the article \"Improving Diagnostic Accuracy of Indeterminate Thyroid Fine-Needle Aspiration Using Results of Ultrasound Examination, Cyclin D1 Immunostaining, and Molecular Testing\" [Acta Cytologica. 2025;69(6):515-527; https://doi.org/10.1159/000545319] by He et al., the following is being corrected as Figures 1, 2, 5, 6, 7, and 8 had been previously published by He et al. [1-3] without obtaining appropriate copyright permission.The authors have now replaced all affected figures with previously unpublished images derived from the same patient cohort and experimental period. These replacement images have been cross-verified against original laboratory records to ensure accuracy and to prevent any copyright infringement.The original article has been corrected to reflect these changes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"503"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13002226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442138","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":"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":"450-460"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","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":"Not Enough Cells: How Insufficient Cytological Specimens Are Mirrored by Reporting Systems - Journey from the Bethesda to the WHO Reporting Systems.","authors":"Ivana Kholová","doi":"10.1159/000546947","DOIUrl":"10.1159/000546947","url":null,"abstract":"<p><p><p>Background: Pap classes have been replaced by organ-specific reporting systems in recent decades; however, part of the cytological specimens is insufficient. The present review summarizes how different organ-specific systems define the insufficient category: both quantitative and qualitative criteria are used. In addition, the sample volume may be evaluated in certain specimens. Summary: The reasons for an insufficient sample may vary and depend either on the lesion itself or the sampling procedure. Key Messages: The management recommendations for insufficient specimens improve communication between cytopathologists and treating physicians. </p>.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"72-83"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315746","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":"Cytological, Immunocytochemical, and Molecular Findings of Extraskeletal Round Cell Sarcomas in Paediatric Patients.","authors":"Pawel Gajdzis, Jerzy Klijanienko","doi":"10.1159/000550765","DOIUrl":"10.1159/000550765","url":null,"abstract":"<p><strong>Background: </strong>Round cell soft-tissue sarcomas in the paediatric population are a common cytomorphological group of tumours. The most common entity in this group is rhabdomyosarcoma. Other representatives include Ewing sarcoma, other undifferentiated small round cell sarcomas (so-called Ewing-like sarcomas, such as CIC-rearranged sarcoma, sarcoma with BCOR genetic alterations, and round cell sarcoma with EWSR1-non-ETS fusions), and desmoplastic small round cell tumour.</p><p><strong>Summary: </strong>The main cell population in round cell sarcomas is composed of small round cells. Other cell morphologies may be seen in specific entities, such as spindle cells in Ewing-like sarcomas or rhabdomyoblasts in rhabdomyosarcomas. Smear backgrounds may contain varying amounts and types of stroma, for example, fibromyxoid stroma in CIC-rearranged sarcoma or sarcoma with BCOR genetic alterations or desmoplastic stromal fragments in desmoplastic small round cell tumour. As cytological specimens are highly cellular, they are excellent material for molecular studies.</p><p><strong>Key messages: </strong>Round cell sarcomas share many morphological similarities, so the differential diagnosis can be broad; however, subtle differences between tumours can aid the final diagnosis. Nevertheless, most round cell sarcomas require molecular studies for accurate classification, and cytological specimens are usually high-quality material for such ancillary techniques.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"346-355"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091845","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":"476-484"},"PeriodicalIF":1.5,"publicationDate":"2026-01-01","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":"Evaluation of the Cytomorphology, Immunophenotype, and Molecular Genetics of Lymphoblastic Lymphoma/Leukemia in Serous Effusion.","authors":"Wenjing Cui, Xiaochen Ding, Jiayan Liu, Peizhen Hu, Shirong Ma, Changwei Yang, Hong Xu","doi":"10.1159/000548726","DOIUrl":"10.1159/000548726","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to elucidate the spectrum of clinical manifestations, cytomorphology, immunophenotype, and the molecular genetic features of lymphoblastic lymphoma/acute lymphoblastic leukemia (LBL/ALL) in the context of serous effusions (SE).</p><p><strong>Methods: </strong>A retrospective analysis evaluated the cytomorphological features, immunophenotype, and the cyto-histological correlations of twenty-one LBL/ALL associated with SE. Concurrently, bone marrow (BM) aspiration samples were analyzed using an integrated approach, including flow cytometry, reverse transcription PCR (RT-PCR), next-generation sequencing (NGS), or whole transcriptome sequencing (WTS).</p><p><strong>Results: </strong>Of the 21 cases of SE LBL/ALL, 16 cases were T-LBL/ALL and 5 cases were B-LBL/ALL. The cases included 17 pleural, 2 peritoneal, and 2 pericardial fluid samples. Both T-LBL/ALL and B-LBL/ALL in SE exhibit a blast-like morphology, characterized by small to medium size, irregular nuclear membranes, and inconspicuous nucleoli, alongside frequent nuclear fragmentation and apoptotic bodies. LBL/ALL express immaturity markers such as terminal deoxynucleotidyl transferase (7/17, 41.2%), CD10 (6/12, 50%), CD43 (8/8, 100%), and CD99 (6/6, 100%). T-LBL/ALL and B-LBL/ALL specifically express T-cell markers (CD2 [3/6, 50%], CD3 [10/12, 83.3%], CD5 [2/11, 18.2%], CD7 [10/10, 100%]) or B-cell markers (CD20 [3/5, 60%], CD79a [4/4, 100%], PAX5 [5/5, 100%]), respectively. A high proportion of primitive and immature lymphocytes exceeding 25% in BM was observed in T-LBL/ALL (5/7) and in one case of B-LBL/ALL. No BCR/ABL gene rearrangements were detected in any cases. Furthermore, fusion gene MLL::ENL and PLCALM::MLLT10, as well as mutations in genes including WT1, NOTCH1, PAX5, IKZF, ARID1A, BCOR, SETD2, ARID2, TET2, JAK3, NF1, and CEBPA, were identified in LBL/ALL through RT-PCR, NGS, or WTS analyses.</p><p><strong>Conclusion: </strong>The integration of clinical manifestations, cytological evaluation, and gene expression profiles is instrumental in achieving accurate diagnosis, subclassification, and prognosis of LBL/ALL within the context of SE.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"223-233"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190629","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":"10.1159/000552464","DOIUrl":"https://doi.org/10.1159/000552464","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"70 3","pages":"383"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925505","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":"PD-L1 in Lung Cytology: The Path for Standardization.","authors":"Mohammed S I Mansour, Gennaro Acanfora, Giancarlo Troncone, Hans Brunnström, Elena Vigliar","doi":"10.1159/000546275","DOIUrl":"10.1159/000546275","url":null,"abstract":"<p><strong>Background: </strong>The advent of programmed cell death-1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors has revolutionized lung cancer treatment, necessitating accurate PD-L1 immunohistochemical (IHC) assessment. While standardized for formalin-fixed paraffin-embedded histological samples, PD-L1 testing on cytology remains challenging. This review aims to address the complexities of PD-L1 IHC in cytology, focusing on validation guidelines, quality assessment, cytohistological correlation, and interobserver variability.</p><p><strong>Summary: </strong>This review synthesizes current guidelines and research on PD-L1 IHC in cytology; in particular, recent College of American Pathologists (CAP) guidelines emphasize the necessity for rigorous validation, particularly for non-formalin-fixed specimens. As far as cytohistological concordance studies are concerned, the review of 48 original articles revealed significant variability in PD-L1 expression, with concordance rates ranging from 54 to 100% at the 1% cutoff and 82-100% at the 50% cutoff. Finally, interobserver variability, particularly in the 1-49% PD-L1 expression range, further complicates accurate assessment. The review also discusses the challenges associated with quality assessment in cytology, including the lack of standardized control materials and external quality assessment (EQA) programs specifically tailored for cytological samples.</p><p><strong>Key messages: </strong>PD-L1 testing in cytology is feasible but faces substantial challenges compared to histological specimens. Validation of PD-L1 IHC protocols for cytological preparations, especially non-formalin-fixed samples, is essential. Concordance between cytological and histological PD-L1 expression is variable, highlighting the need for caution in interpretation. Interobserver variability, particularly in cases with intermediate PD-L1 expression (1-49%), affects diagnostic reproducibility. The development of standardized quality control materials and EQA programs for cytology is urgently needed to support consistent and reliable PD-L1 testing.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"91-106"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075335","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":"Artificial Intelligence in Gynecologic Cytology.","authors":"Lakshmi Harinath, Xinru Bai, Jeremy Minkowitz, Xianxu Zeng, Sarah Harrington, Chengquan Zhao, Liron Pantanowitz","doi":"10.1159/000546182","DOIUrl":"10.1159/000546182","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is the fourth most common cancer in women globally with highest incidence and mortality identified in less developed and medically underserved areas in the world. The diminishing cytology workforce, unavailability of expert consultation, and the high volume of Pap tests needing manual screening are the main reasons for exploring innovative solutions to help mitigate the negative effects resulting from the dearth of timely cervical cancer screening in certain population groups.</p><p><strong>Summary: </strong>Developments in whole slide imaging and artificial intelligence (AI) have enabled the emergence of new computer-assisted systems that have the potential for transforming traditional cytopathology practice. However, AI-based systems are relatively new with limited published data on their validation and clinical utility in clinical practice. Our article aims to increase awareness of the availability of such systems, explores the history and development of AI-assisted screening platforms for Pap tests, compares the performance characteristics of various systems, elaborates on technical challenges associated with conducting clinical trials employing this technology, and discusses considerations around deploying such systems in routine cytopathology practice.</p><p><strong>Key message: </strong>Revolutionary AI-based systems are being developed and utilized in cytopathology practice to screen Pap tests. Some of these systems have good performance characteristics and provide opportunities to combat various issues such as workload and standardization faced by cytology laboratories globally. However, judicious review of these systems using evidence-based studies is imperative to promote widespread adoption and maintain high-quality standards for patient safety.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"52-71"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590218","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}