Archives of pathology & laboratory medicine最新文献

{"title":"Optimization of Current Procedural Terminology Coding in Complex Genitourinary Surgical Specimens.","authors":"David B Behrman, Robert Achram, Carol McClure, Beverly E Allen, Christine Miller, Carla J Shoffeitt, Kelly R Magliocca, Scott M Steward-Tharp, Cindy Alexander, Twanda Triplet, Catherine Maloney, Chad W M Ritenour, Lara R Harik","doi":"10.5858/arpa.2024-0118-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0118-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Complex surgical specimens are associated with complex Current Procedural Terminology (CPT) coding.</p><p><strong>Objective.—: </strong>To assess and optimize the accuracy of CPT coding of complex genitourinary specimens at our institution.</p><p><strong>Design.—: </strong>Baseline CPT codes for nephrectomy and cystectomy surgical pathology specimens were examined during a 3-month period. Pathology reports were reviewed for accurate CPT coding, and commensurate tests of change were implemented. Post-test-of-change data were re-collected, analyzed, and compared to the baseline data.</p><p><strong>Results.—: </strong>Baseline data consisted of 71 genitourinary specimens (April to June 2021) and demonstrated undercoding in 46% (n = 33 of 71) of specimens, mostly in specimens with 2 or more billable organs. From findings in baseline data, we implemented test-of-change efforts consisting of awareness, education, and increased documentation and communication between all involved parties. Marked improvement was noted in the coding accuracy of specimens with 2 billable organs (pretest: n = 4 of 21, 19%; posttest: n = 14 of 21, 67%) and 3 or more billable organs (pretest: n = 0 of 16, 0%; posttest: n = 7 of 12, 58%) (P value = .002). Problematic areas included nephrectomy specimens resected with adrenal glands (pretest: n = 2 of 12, 17%; posttest: n = 12 of 14, 86%) and ureters for urothelial carcinoma (pretest: n = 0 of 10, 0%; posttest: n = 3 of 6, 50%), as well as regional lymph nodes commingled with resection specimens (pretest: n = 0 of 11, 0%; posttest: n = 7 of 9, 78%).</p><p><strong>Conclusions.—: </strong>A comprehensive approach involving all stakeholders is necessary for CPT coding of complex surgical specimens. Documentation and familiarity with coding rules, specifically bundling and unbundling, as well as clinical indications for resection, are important factors in optimizing CPT coding.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infections Due to Corynebacterium kroppenstedtii With Focus on Granulomatous Lobular Mastitis for Tissue Specificity, Pathogenesis, Bacteriologic Workup, and Treatment.","authors":"Qiong Gan, Yang Ding, Yun Wu, Yu Zhang, Qing H Meng, Qing Qing Ding, Huifang Lu, Samuel A Shelburne, Richard A Ehlers, Xiang Y Han","doi":"10.5858/arpa.2024-0365-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0365-OA","url":null,"abstract":"<p><strong>Context.—: </strong></p><p><strong>Objective.—: </strong>To report the isolation and significance of C kroppenstedtii, features of patients with GLM, pathologic findings and mechanism, bacteriologic workup, and optimal treatment.</p><p><strong>Design.—: </strong>Analysis of the cases with C kroppenstedtii at The University of Texas MD Anderson Cancer Center from 2016 to March 2024 for mechanistic insights.</p><p><strong>Results.—: </strong>During a period of 8 years, isolates of C kroppenstedtii were obtained from 10 women and 7 men. All of the women, with an average age of 34 years (range, 18-61 years), presented with chronic or subacute mastitis, and were subsequently diagnosed with GLM. The men, with an average age of 66 years, had neoplastic diagnoses with the bacterium being commensal in 6 cases. Thus, C kroppenstedtii shows a predilection to infect the female breast (P < .001). Predisposing risks for GLM included childbirth in 8 women and nipple inversion in 2 women. Histopathology revealed xanthogranulomatous inflammation and Gram-positive bacilli within fat droplets or extracellularly. From GLM aspirates or tissue, the liquid culture media and/or anaerobic incubation yielded 9 of 10 isolates. Up to 14 tested strains were susceptible to vancomycin, linezolid, rifampin, and gentamicin. Nine women received extensive antimicrobial therapy.</p><p><strong>Conclusions.—: </strong></p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An 18-Year Review of Hemoglobinopathy Proficiency Testing: Recommendations From the College of American Pathologists Hematology and Clinical Microscopy Committee.","authors":"Ifeyinwa Obiorah, Chad M McCall, Alexandra Balmaceda, Stephanie Salansky, Archana Agarwal, Olga Pozdnyakova","doi":"10.5858/arpa.2024-0386-CP","DOIUrl":"https://doi.org/10.5858/arpa.2024-0386-CP","url":null,"abstract":"<p><strong>Context.—: </strong>The College of American Pathologists Hematology and Clinical Microscopy Committee implemented a hemoglobinopathy proficiency testing and education program to monitor and assess the performance of participating laboratories.</p><p><strong>Objective.—: </strong>To evaluate the performance of clinical laboratories for hemoglobinopathy proficiency testing from 2005 to 2023.</p><p><strong>Design.—: </strong>The hemoglobinopathy challenges are composed of clinical case summaries and electrophoretic and chromatographic gel and tracing images. The participants are asked to determine (1) what hemoglobin chain is affected and (2) the hemoglobinopathy diagnosis.</p><p><strong>Results.—: </strong>A total of 365 to 676 laboratories were enrolled in the proficiency testing program each year. Overall, the error rates for determination of the affected globin chain and a hemoglobinopathy diagnosis ranged from 0.6% to 56.5% and 0.5% to 86.5%, respectively. Twenty-three of 66 surveyed hemoglobinopathies (34.8%) had an error rate exceeding the consensus threshold of 20%. The globin gene detection error rate of the compound hemoglobinopathies was significantly higher when compared with just the α (P = .01) and β (P = .003) gene disorders. However, the error rate for the overall compound α/β-globin interpretation, although high at 23%, was not statistically significant when compared with just the α- or β-globin chain disorders. In repeat testing of the variants, there was no consistent improvement in performance.</p><p><strong>Conclusions.—: </strong>The program participants demonstrated variable performance with one-third of the surveys exceeding the 20% error rate. The error rate for compound hemoglobinopathies was even higher. Our data illustrate a critical need for continuing educational efforts with an algorithmic approach to hemoglobin disorders.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant Waldenström Macroglobulinemia/Lymphoplasmacytic Lymphoma and Non-Immunoglobulin M Plasma Cell Neoplasm.","authors":"Yue Zhao, Philip Petersen, Sophie Stuart, Jiaqi He, Yaping Ju, Luis F Carrillo, Eric D Carlsen, Yi Xie, Alireza Ghezavati, Imran Siddiqi, Ling Zhang, Endi Wang","doi":"10.5858/arpa.2024-0270-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0270-OA","url":null,"abstract":"<p><strong>Context.—: </strong>The co-occurrence of plasma cell neoplasm (PCN) and lymphoplasmacytic lymphoma (LPL) is rare, and their clonal relationship remains unclear.</p><p><strong>Objective.—: </strong>To evaluate the clinicopathologic characteristics of concomitant LPL/PCN.</p><p><strong>Design.—: </strong>Retrospectively analyzed clinical and laboratory data of 14 cases.</p><p><strong>Results.—: </strong>Three patients initially presented with immunoglobulin (Ig) M paraprotein, 1 with IgG paraprotein, and 10 had simultaneous diagnoses of PCN and LPL. In 13 cases, flow cytometry detected both LPL and PCN in marrow biopsies. Furthermore, immunohistochemistry highlighted the 2 neoplastic populations, demonstrating an increased proportion of plasma cells and their expression of cyclin D1, CD56, and/or a non-IgM isotype restriction. All cases exhibited discordant heavy-chain isotypes between LPL and PCN. Thirteen of the 14 cases (92.9%) had concordant light-chain restrictions between the 2 neoplasms, and the remaining case (7.1%) showed discordant light-chain restrictions. Of the 12 patients with follow-up, 5 were treated with myeloma regimens, 2 with LPL regimens, 3 with combined therapy, and 2 with observation alone. Follow-up ranged from 2 to 146 months (median, 12.5 months). One patient died of PCN progression, one died of comorbidity, and 10 patients were alive with or without disease. Survival analysis showed no significant difference from the control.</p><p><strong>Conclusions.—: </strong>The discordant heavy-chain isotype restrictions between PCN and LPL suggest biclonal B-cell neoplasms, which is supported by PCN's phenotypic distinction, such as the expression of cyclin D1 and/or CD56. However, our series exhibited a tendency toward concordant light-chain restrictions between the 2 neoplasms, raising the possibility that PCN may evolve from LPL through class switching.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Performance on Longitudinal Knowledge Assessment in Continuing Certification: The ABPath CertLink Strategy.","authors":"Gary W Procop, Tyler Sandersfeld, Ty McCarthy, Ritu Nayar","doi":"10.5858/arpa.2024-0318-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0318-OA","url":null,"abstract":"<p><strong>Context.—: </strong>All member boards of the American Board of Medical Specialties have continuing certification (ie, maintenance of certification) programs. The efficacy of these programs has been questioned and, therefore, warrants study.</p><p><strong>Objective.—: </strong>To determine if the American Board of Pathology CertLink program, as structured, is associated with an improvement in the performance of participants on the assessment of content that was previously missed (ie, inaccurately answered).</p><p><strong>Design.—: </strong>We reviewed the performance of American Board of Pathology CertLink participants from January 2022 through December 2023 on the readministration of the content from 110 036 multiple-choice items that were previously missed by the participants in a program with enhanced learning strategies and incentives.</p><p><strong>Results.—: </strong>The correct response rate upon the assessment of readministered content that was previously missed increased from 0% to 62.2% (68 394 of 110 036), which exceeds that which would be achieved by guessing (P < .001).</p><p><strong>Conclusions.—: </strong>The American Board of Pathology CertLink program, which incentivizes learning and was constructed from adult learning principles and modern educational precepts to improve knowledge retention, interrupt forgetting, and introduce practice-relevant content, is associated with an improvement in the performance of diplomates on continuing certification knowledge assessments.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Window Size on Pathologists' Search for Rare Elements in a Digital Pathology Setting.","authors":"Alana Lopes, Sean Rasmussen, Bojana Djordjevic, Jose A Gomez, Maria Florencia Mora, Anurag Sharma, Joanna C Walsh, Bret Wehrli, Aaron D Ward, Matthew J Cecchini","doi":"10.5858/arpa.2024-0378-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0378-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Digital pathology requires pathologists to assess tissue digitally rather than on an analog microscope, which has been the mainstay tool for tissue assessment for more than a century. The impact of different digital interaction configurations on pathologists' performance is not well understood. This work focuses on the impact of the display window size for diagnostic assessment.</p><p><strong>Objective.—: </strong>To determine the effect of digital image viewer window size on pathologists' diagnostic performance when searching for tumors in lymph nodes while under a time limit.</p><p><strong>Design.—: </strong>Six pathologists assessed 8 breast lymph node whole slide images using 4 digital image viewer window sizes (8, 14, 24, and 32 inches) for tumors in lymph nodes while under a time limit. Eye-gaze data were collected. Pathologists were subsequently asked to rate their preference of window sizes.</p><p><strong>Results.—: </strong>The fraction of window not covered with foveated vision was significantly associated with window size ranging from 43% for 32 inches to 5% for 8 inches (P < .001). There was no statistically significant relationship between the number of false negatives or assessment time and window size (P = .21 and P = .28, respectively). The distance traversed per panning instance ranged from 301 pixels for 32-inch to 193 pixels for 8-inch windows (P = .002). All pathologists preferred the largest window size as it provided more context for diagnostic assessment.</p><p><strong>Conclusions.—: </strong>Window size does not significantly affect pathologists' diagnostic performance when searching for tumors in lymph nodes. However, pathologists adapted their slide navigation approach to accommodate the amount of context the window size permitted.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plexiform Fibromyxoma.","authors":"Julianne Szczepanski, Maria Westerhoff, Shula Schechter","doi":"10.5858/arpa.2024-0254-RA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0254-RA","url":null,"abstract":"<p><strong>Context.—: </strong>Plexiform fibromyxomas are uncommon gastrointestinal neoplasms that have histologic and molecular features that overlap with other gastrointestinal mesenchymal tumors and present a diagnostic challenge for surgical pathologists.</p><p><strong>Objective.—: </strong>To provide a review of the clinicopathologic, morphologic, immunohistochemical, and molecular features of plexiform fibromyxomas, with a brief discussion of key features that aid in differential diagnosis.</p><p><strong>Data sources.—: </strong>Analysis of the pertinent literature (PubMed) and clinical practice experience based on institutional and consultation materials.</p><p><strong>Conclusions.—: </strong>Plexiform fibromyxoma is a rare benign gastrointestinal mesenchymal tumor. Diagnosis is primarily based on morphology, immunohistochemistry, and the exclusion of other gastrointestinal mesenchymal tumors from the differential diagnosis.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age- and Sex-Dynamic Fluctuations and Reference Intervals for Alkaline Phosphatase Among the Spanish Population.","authors":"Laura Castells Vilella, Paula Sánchez-Pintos, José Félix Muñiz Llama, Matías Gámez Martínez, María Luz Couce, Jordi Antón","doi":"10.5858/arpa.2023-0335-OA","DOIUrl":"10.5858/arpa.2023-0335-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Interpretation of alkaline phosphatase (ALP) activity is essential for the diagnosis of certain diseases. ALP changes during life and may vary between different populations.</p><p><strong>Objective.—: </strong>To establish reference intervals (RIs) and percentile charts for ALP activity in the Spanish population through a multicentric observational study and to compare the RIs to those defined in other countries.</p><p><strong>Design.—: </strong>A total of 662 350 ALP measurements from individuals ages 0 to 99 years from 9 Spanish tertiary care centers collected between 2020 and 2022 were analyzed. This study is the largest published on this topic in the literature to date.</p><p><strong>Results.—: </strong>Continuous percentile charts for ALP according to sex and age were established which can be used as RIs. Higher levels are reached during the first weeks of life. In puberty, a differential evolution is observed in both sexes, reaching a peak at 10 to 13 years of age in boys and remaining stable in girls at this age. Significant differences were also observed in adults, higher in men between ages 20 and 49 years and between ages 50 and 79 years in women, as reported in some countries.</p><p><strong>Conclusions.—: </strong>ALP activity follows an age- and sex-dependent fluctuation with geographic differences. It is important to have appropriate reference values for each population in order to allow for a correct diagnostic interpretation and early diagnosis of diseases related to ALP abnormalities.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"e19-e25"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue Prior to the Initial Hematoxylin-Eosin Section Demonstrates Value as an Alternative Source of DNA for Molecular Testing.","authors":"Peter Sabatini, Robert Ta, Melanie Peralta, Melanie Anderson, Shehnaz Khan, Rosetta Belcastro, Andrea Arruda, Mark David Minden, Michael Cabanero, Anca Prica, Tong Zhang, Robert Kridel, Tracy Stockley, Daniel Xia","doi":"10.5858/arpa.2024-0222-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0222-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Small biopsies are used for histologic, immunophenotypic, cytogenetic, molecular genetic, and other ancillary studies. Occasionally, this diagnostic tissue is exhausted before molecular testing can be performed.</p><p><strong>Objective.—: </strong>To investigate a simple banking protocol for currently discarded tissues trimmed off prior to the initial hematoxylin-eosin section, as an alternative source of DNA for molecular studies.</p><p><strong>Design.—: </strong>Mock biopsies of lung adenocarcinomas, benign testes, and B-cell lymphomas were constructed from biobank blocks; these simulated biopsies were assessed via epidermal growth factor receptor (EGFR) p.L858R droplet digital polymerase chain reaction (PCR), Biomed B-cell clonality testing by PCR, or a custom next-generation sequencing panel for lymphomas. For each cancer mock biopsy, DNA amounts and molecular test results from the \"trimmings\" samples were compared to data from corresponding molecular samples acquired via a \"standard\" clinical protocol.</p><p><strong>Results.—: </strong>The data show that although trimmings samples usually contained less DNA than standard samples, both sample classes generally had sufficient DNA for testing and produced essentially identical molecular results. A single sample showed low-level carryover contamination on droplet digital PCR testing.</p><p><strong>Conclusions.—: </strong>Tissue trimmings banked by using the studied protocol demonstrated value as a potential alternative sample for molecular testing.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Implications of the Bethesda System in Fine-Needle Aspiration for Follicular Thyroid Carcinoma.","authors":"Hyunju Park, Young Lyun Oh, Myoung Kyoung Kim, Soo Yeon Hahn, Jun-Ho Choe, Man Ki Chung, Bogyeong Han, Sun Wook Kim, Jae Hoon Chung, Tae Hyuk Kim","doi":"10.5858/arpa.2024-0304-OA","DOIUrl":"https://doi.org/10.5858/arpa.2024-0304-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Fine-needle aspiration is an effective tool for sampling thyroid nodules; its results are classified according to the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), whose categories define malignancy risks.</p><p><strong>Objective.—: </strong>To compare the histologic outcomes and disease-free survival (DFS) with the preceding BSRTC categories, we hypothesized that the initial cytologic categories may reflect long-term outcomes in follicular thyroid carcinoma (FTC), similar to those observed in papillary thyroid carcinoma.</p><p><strong>Design.—: </strong>This retrospective study enrolled 134 patients with FTC who underwent preoperative cytology between April 2011 and December 2020. Results were classified into 6 categories according to the BSRTC: nondiagnostic, benign, atypia of uncertain significance (AUS), follicular neoplasm (FN), suspicious for malignancy, or malignant.</p><p><strong>Results.—: </strong>Overall, 8 of 134 patients (6.0%) were categorized as having a nondiagnostic FTC, 35 of 134 (26.1%) as benign, 51 of 134 (38.1%) as AUS, and 40 of 134 (29.9%) as FN. No lesions were classified as suspicious for malignancy or malignant. The nondiagnostic, AUS, and FN categories were associated with a progressively higher risk of vascular invasion, disease recurrence, and high-risk FTC, based on the 2022 World Health Organization classification (P for trend = .01, .01, and .01, respectively). Disease-free survival was lower in the FN group (log-rank P = .01).</p><p><strong>Conclusions.—: </strong>The initial BSRTC results may reflect not only the risk of malignancy but also the presence of vascular invasion and poor prognosis when the thyroid nodule is diagnosed as FTC. These results may provide prognostic information for therapeutic decision-making and clinical management of FTC.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}