Acta Cytologica最新文献

{"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":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-09-25","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":"Insights into Thyroid and Salivary Gland Cytopathology: Highlights from a 45th European Congress of Cytology Slide Seminar.","authors":"Camille Brochard, Adam Kowalewski, Elena Vigliar, Rita Luis, Ozlem Aydin, Jerzy Klijanienko, Sule Canberk","doi":"10.1159/000543225","DOIUrl":"10.1159/000543225","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid and salivary gland cytopathology frequently present diagnostic challenges due to complex presentations, overlapping features between benign and malignant conditions, particularly with gray-zone entities and rare pathologies. To address these issues, the 45th European Congress of Cytology (ECC) held a slide seminar focused on challenging cases. This article reviews key findings from the 6 cases discussed, emphasizing the importance of a comprehensive diagnostic approach. The objective of this article was to illustrate the diagnostic challenges of rare thyroid and salivary gland lesions through case presentations, showing the need for a comprehensive, multidisciplinary approach to accurately reach a final diagnosis and steer the patient's management.</p><p><strong>Case presentation: </strong>The seminar presented cases involving fine-needle aspiration cytology followed by histopathological correlation, molecular and cytogenetic analyses or immunohistochemistry (IHC) markers to elucidate cytomorphological features, differential diagnoses, and final diagnoses of rare cases in thyroid and salivary gland cytopathology. Challenging thyroid cytology cases included differentiating thyroid sarcoidosis from malignancy, identifying intrathyroidal ectopic thymus versus lymphoid neoplasms, and recognizing poorly differentiated thyroid carcinoma initially misinterpreted as a benign follicular neoplasm. Complex salivary gland cases addressed the distinction of basal cell adenocarcinoma from adenoid cystic carcinoma, metastatic SMARCB1-deficient carcinoma diagnosed via IHC and a parotid mass initially identified as a Warthin tumor.</p><p><strong>Conclusion: </strong>These cases highlight the critical role of integrating cytological, clinical, and histopathological data to navigate the diagnostic complexities of thyroid and salivary gland lesions. A multidisciplinary approach and standardized algorithms are essential for improving diagnostic accuracy and patient outcomes.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"171-182"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862783","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":"Comprehensive Study of Thyroid Fine Needle Aspiration in Pediatric and Young Adults.","authors":"Erika F Rodriguez, Precious Ann V Fortes, Victoria Lee, Jeffrey D Goldstein, Neda A Moatamed","doi":"10.1159/000546006","DOIUrl":"10.1159/000546006","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid nodules are uncommon in the pediatric population, with a 1-1.7% prevalence. The Bethesda System of Reporting Thyroid Cytopathology (TBSTC) is a well-established thyroid fine needle aspiration (FNA) reporting system. While the TBSTC guides therapy for both adult and pediatric patients, the reported risk of malignancy (ROM) is variable in the literature. The aim of this study was to compare the ROM in pediatric age of <15 with ≥15 years old.</p><p><strong>Methods and materials: </strong>We searched for patients aged 21 or younger who underwent FNA of thyroid nodules from 2016 to 2021. Data included patient demographics, nodule size, FNA results, molecular results, and surgical pathology follow-up. Patients were divided into two cohorts: 0-14 (<15) and 15-21 (≥15) years old.</p><p><strong>Results: </strong>145 nodules from 102 patients (26 cases in <15 and 94 in patients ≥15) were analyzed. Diagnoses and ROM were nondiagnostic (n = 3), benign (108, ROM 50%), atypia of unknown significance (n = 13, ROM 67%), follicular neoplasm (n = 6, ROM 33%), suspicious for malignancy (n = 1, ROM 100%), malignant (n = 14, ROM 100%). No significant differences (p ≥ 0.2) between the age groups were noted. Based on surgical follow-up results, the overall malignancy rate was 8% and 19% for <15 and ≥15 years old groups, respectively.</p><p><strong>Conclusion: </strong>The ROM for thyroid nodules in the pediatric population is higher than in adults. There appears to be a trend toward a higher overall malignancy rate in patients aged 15-21 compared to those under 15, though this difference is not statistically significant. Further studies with larger patient numbers are required to determine if the ROM differs significantly between these age groups.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"336-343"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965072","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":"Primary Melanoma of the Lung: A Vanishing Entity.","authors":"Tanner Storozuk, Melissa Tjota, Prince Ntiamoah, Pankhuri Wanjari, Anna Biernacka, Ward Reeves, Tatjana Antic","doi":"10.1159/000546441","DOIUrl":"10.1159/000546441","url":null,"abstract":"<p><strong>Introduction: </strong>Primary melanoma of the lung has been considered an extremely rare and highly aggressive malignancy that accounts for 0.01% of all primary lung tumors. Molecular studies, as well as pertinent clinical history, have since brought into question whether these tumors truly represent primary lesions of the lung. The current study evaluates a series of four melanomas of the lung to assess whether primary melanoma of the lung is truly a diagnostic consideration, or if these cases represent metastases of other primary sites.</p><p><strong>Methods: </strong>The pathology archives at the University of Chicago Medical Center were searched for patients who underwent robotic or endobronchial ultrasound-guided fine needle aspiration from 2018 to 2024. Clinicopathologic data, including demographics, fine needle aspiration results, and follow-up information including molecular studies and surgical resections, were collected from patients' electronic medical record.</p><p><strong>Results: </strong>In total 15,959 robotic-guided/endobronchial ultrasound-guided FNAs were reviewed, with 2 cases (0.0001%) being metastatic melanoma with no known cutaneous primary after immunohistochemical and molecular studies. Both patients had molecular studies performed. Notable mutations included BRAF, TERT, NRAS, CDKN2A, and NF1, which are frequently seen in cutaneous melanomas. High tumor mutational burden (UV signature with >98 mutations per megabase) was also detected by next-generation sequencing.</p><p><strong>Conclusion: </strong>Based upon molecular signatures, clinical history, and presumed lack of precursor cell type within the bronchial epithelium, melanomas arising within the lung are most likely metastatic tumors.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"361-366"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075337","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 Characteristics of Cervical Scrape from Controlled and Uncontrolled Diabetes Mellitus Patients Attending Tertiary Healthcare, Kenya.","authors":"Seth Shikuku Kolongolo, Tyrus Omondi, Everlyne Kutolo, Bernard Guyah","doi":"10.1159/000547062","DOIUrl":"10.1159/000547062","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Globally, the concurrence of diabetes mellitus and cervical cancer among women is compounded and increasing health burden. Furthermore, the incidence and prevalence of both diseases are increasing, particularly in middle- and low-income countries. In Kenya, 19.7% of new cancer cases among women are attributed to cervical cancer. While diabetes causes metabolic disorders and immune alterations that may promote persistent high-risk human papilloma virus infection, the magnitude of cervical cytomorphological abnormalities among diabetes women in Kenya remains unclear. The current study sought to determine the cytomorphological characteristics of cervical scrape samples obtained from patients with controlled and uncontrolled diabetes mellitus who visited the Kitale County Hospital, Kenya.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective, hospital-based analytical cross-sectional study was conducted between April 2023 and June 2024. A total of 156 patients with diabetes (n = 156) between the ages of 18 and 65 years were enrolled. Alcohol fixed cervical smears were processed using Papanicolaou staining method. The findings were reported using the 2014 Bethesda system for reporting cervical cytology. Images were captured for cytomorphological abnormalities using X20 mobile camera. RStudio 4.2.2 (2024-10-31 ucrt) software was used to analyze data. Mann-Whitney U test was used to compare distributions of laboratory characteristics between controlled and uncontrolled diabetes. Fisher's exact test was performed to explore associations between diabetes control and cytomorphological abnormalities. Chi-square tests were performed to determine relationship between diabetes control and presence of cervical abnormalities. Logistic regression was performed to assess the relationship between glycemic levels and presence of cytomorphological abnormalities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 156 cases, cytomorphological abnormalities were reported in 63.5%. Negative for intraepithelial lesion or malignancy accounted for 84.0%, while 16% were cervical intraepithelial lesions. Nonneoplastic abnormalities/infections were recorded in 48.1% of study participants. The study showed that there is statistically significant difference in the central tendency of age between controlled and uncontrolled diabetes mellitus (95% CI = 2.0-10.0, p = 0.001). There was statistical significance association between reproductive status and presence of cervical infections (odds ratio [OR] = 2.18, 95% CI = 1.15-4.18, p = 0.016). There was no significant association between diabetes control and occurrence of cervical cytomorphological abnormalities (OR = 1.47, 95% CI = 0.76-2.86, p = 0.704). While a unit increase in HBA1c was associated with (1.12) times higher odds of cytomorphological abnormality, it was not statistically significant (OR = 1.12, 95% CI = -0.11 to 0.245, p = 0.080).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The current study points both groups ","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"567-575"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367812","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":"Oncocytic Tumors in the Salivary Gland: A Tri-Focal Review - Integrated Cytopathological, Pathological, and Molecular Features.","authors":"Alena Skalova, Alena Skálová, Martina Bradová, Arnaud Da Cruz Paula, William C Faquin","doi":"10.1159/000544802","DOIUrl":"10.1159/000544802","url":null,"abstract":"<p><p><p>Background: Primary oncocytic salivary gland tumors and oncocytic subtypes of traditionally non-oncocytic salivary gland neoplasms are occasionally encountered in fine needle aspiration specimens, biopsies, and resections. Oncocytes are cells, either non-neoplastic or neoplastic, containing increased numbers of mitochondria resulting in cells with abundant eosinophilic cytoplasm and a low N/C ratio. Summary: A broad range of salivary gland tumors can be oncocytic including oncocytoma, Warthin tumor, mucoepidermoid carcinoma, salivary duct carcinoma, and others, especially those tumors where the oncocytic pattern represents a subtype of neoplasm; the oncocytic pattern can create a diagnostic challenge due to marked similarities in the oncocytic pattern of cells. Key Messages: While their microscopic cytologic and histologic features may be similar, these tumors differ intrinsically at the molecular level. Ancillary studies such as immunologic (e.g., androgen receptor for salivary duct carcinoma) and molecular analysis, e.g., FISH for detecting the MAML2 or PLAG1/HMGA2 gene alterations in mucoepidermoid carcinoma and pleomorphic adenoma, respectively, can be used to classify these oncocytic tumors in difficult cases. </p>.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"441-452"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762680","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":"Oncocytic Tumors in the Kidney: A Tri-Focal Review - Integrated Pathological, Cytopathological, and Molecular Perspectives, Part 2.","authors":"Gladell Paner, Laura Lanteri, Elena Luppi, Alessia Cimadamore, Gladell P Paner, José A Jiménez Heffernan, Giuseppe Gasparre","doi":"10.1159/000545946","DOIUrl":"10.1159/000545946","url":null,"abstract":"<p><strong>Background: </strong>This second of two parts review is devoted to the practical aspects of fine needle aspiration biopsy diagnosis of renal oncocytoma and the interesting biology underlying the morphologic transformation of oncocytes.</p><p><strong>Summary: </strong>In the first section, we describe the most useful cytologic variables for the recognition of oncocytoma since its first cytologic description 44 years ago. The usefulness of the recently introduced cytologic diagnostic category of \"low-risk oncocytic neoplasm\" is discussed, as well as the known problems of differential diagnosis. The second section deals with the molecular aspects of oncocytes, with special emphasis on correlating it with the peculiar morphology of oncocytic tumors and their less aggressive behavior. First, why does this accumulation of abnormal mitochondria occur, and second, what are the consequences? Regarding oxidative phosphorylation, oncocytes show a dysfunctional respiratory complex that makes them unable to respond adequately to the hypoxia so typical of the neoplastic environment.</p><p><strong>Key messages: </strong>The low-risk oncocytic neoplasm category is so relevant that they may limit the possibility of an accurate diagnosis in small specimens, such as FNA and core biopsies. However, this must be compatible with the possibility of making a useful diagnosis for the therapeutic management of the patient. Further, we discuss the genes and molecules responsible for mitochondrial dysfunction, and, finally, the molecular differences between sporadic oncocytomas and those associated with a hereditary context.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"462-473"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962313","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":"10.1159/000543694","DOIUrl":"10.1159/000543694","url":null,"abstract":"","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"69 1","pages":"105"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603203","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":"Digital Pathology in Real-Life Conditions for Daily Cytopathological Diagnosis: A Feasibility Study.","authors":"Ranya Soufan, Alicia Larive, Irène Villa, Anne Auperin, Jean-Yves Scoazec, Voichita Suciu","doi":"10.1159/000545391","DOIUrl":"10.1159/000545391","url":null,"abstract":"<p><strong>Introduction: </strong>Nowadays, there is an increasing adoption of digital pathology for diagnostic purposes.</p><p><strong>Aim: </strong>Herein we study the feasibility of cytopathological diagnosis by whole-slide imaging (WSI) in daily practice.</p><p><strong>Methods: </strong>One hundred and ten consecutive non-gynecologic cytopathology cases, originally diagnosed under light microscopy (LM) by two pathologists, were scanned at ×40. Then, cases were diagnosed on WSI, by the same pathologist who originally rendered the conventional diagnosis. The pathologists were blinded to the diagnosis made by LM, but they had access to the same clinical information. The washout period was at least 3 months. WSI diagnoses were compared to the original LM diagnoses, and cases were considered concordant if the two types of diagnosis were identical.</p><p><strong>Results: </strong>LM and the WSI diagnoses were concordant in 87.3% [95% CI: 79.6; 92.9] of cases. Intra-observer agreement was lowest for thyroid fine-needle aspiration cytology (only 1 case out of 5). After the exclusion of thyroid cases, the concordance rate between WSI and LM was 90.5% [95% CI: 83.2%; 95.3%].</p><p><strong>Conclusion: </strong>Primary cytological diagnosis can be done using our digital system.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":" ","pages":"223-230"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750536","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":"22nd International Congress of Cytology 2025, May 11-18, 2025, Florence, Italy: Abstracts.","authors":"","doi":"10.1159/000545256","DOIUrl":"10.1159/000545256","url":null,"abstract":"<p><p>n/a.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"69 Suppl 1","pages":"1-94"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958853","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}