Cancer Cytopathology最新文献

{"title":"Reimagining the future of cancer clinical trials","authors":"Bryn Nelson PhD, William Faquin MD, PhD","doi":"10.1002/cncy.22837","DOIUrl":"10.1002/cncy.22837","url":null,"abstract":"<p>Oncology is facing a growing disconnect. Decades of advancement in basic research have spurred an unparalleled understanding of the pathology, molecular mechanisms, development, and immunology of cancers—spurring big dreams of personalized therapies and lasting cures. In 2024, however, taking a new anticancer drug from bench to bedside still requires nearly 8 years and $1.5 billion to $2.5 billion according to recent estimates, and the vast majority of efforts end in failure.<span><sup>1</sup></span> Meanwhile, clinical trial enrollment has lagged even at large academic medical centers, in part because information about particular trials often never reaches eligible patients.</p><p>New ideas are desperately needed, says Vivek Subbiah, MD, chief of early-phase drug development at the Sarah Cannon Research Institute in Nashville, Tennessee. The high cost and failure rate, “combined with the inherited inefficiencies and deficiencies that plague the siloed healthcare ecosystem, has led to a crisis in clinical research and drug development,” he says.</p><p>The coronavirus disease 2019 pandemic, interestingly, provided an unexpected opening for experimentation and reconsideration, Dr Subbiah and other experts note. Amid major disruptions to medical infrastructure and drug delivery systems, the US Food and Drug Administration (FDA) and other clinical trial sponsors permitted more flexible designs and a shift toward more patient-centric and intuitive evidence-generating strategies. The drug development community now is pondering whether some allowances could become permanent or least provide a framework for more flexibility in key areas without compromising patient safety.</p><p>One big trend is front-loading preclinical assessments and phase 1 trials to ramp up the early indications of a drug’s likelihood of success. Reformers have advocated leaning into the undeniably complex but rapidly expanding power of -omics technology—not just genomics and proteomics but also epigenetics, metabolomics, immunogenomics, and lipidomics—to make better sense of the data. The more granular information could give researchers a jump on understanding a drug’s promise in preclinical and early-phase trials and on identifying which patient subgroups are most likely to benefit. Phase 1 trials, for their part, traditionally have focused primarily on optimal dosage and safety. More recently, however, they also have begun to include demonstrations of a drug’s proof of mechanism or the treatment’s proof of concept.</p><p>“This upfront information, and all the information about the molecular portrait of every patient walking in the door with cancer, can enhance efficiency of trials by enrolling patients with a specific biomarker who have a higher likelihood of benefiting from an experimental drug—or any drug for that matter,” Dr Subbiah says.</p><p>Advances in precision medicine are adding new layers of complexity to the patient selection process. Clinicians are conducting incr","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 6","pages":"331-332"},"PeriodicalIF":3.4,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22837","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141198781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of different fixatives on immunostaining of lung adenocarcinomas in pleural effusion cell blocks","authors":"Mohammed S. I. Mansour CT, PhD,&nbsp;Louise Pettersson MD, PhD,&nbsp;Tomas Seidal MD, PhD,&nbsp;Ulf Strömberg PhD,&nbsp;Ulrich Mager MD,&nbsp;Lana Ali BSc,&nbsp;Sana Kumbaric BSc,&nbsp;Kim Hejny BSc,&nbsp;Fereshteh Taheri-Eilagh BSc,&nbsp;Joudy Mufti CT, BSc,&nbsp;Dawla Nakdali BSc,&nbsp;Hans Brunnström MD, PhD","doi":"10.1002/cncy.22833","DOIUrl":"10.1002/cncy.22833","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cell blocks (CBs) are widely used for biomarker analyses such as immunostaining. Although immunohistochemistry on formalin-fixed paraffin-embedded tissues is standardized, there are multiple preparation methods and fixatives for cytology. Our objective was to investigate the effect of different common fixatives on the immunoreactivity of pleural effusion CBs with metastatic lung adenocarcinomas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study included 24 malignant pleural effusions from different patients with lung adenocarcinoma. From each case, four identical CBs were fixed in 10% neutral buffered formalin, PreservCyt, CytoLyt, and CytoRich Red (only 17 of the cases), respectively. Samples containing &lt;100 malignant cells were excluded. All CBs were stained with thyroid transcription factor 1 (TTF-1; clones 8G7G3/1 and SPT24), napsin A, claudin 4, CEA, CK7, and epithelial cell adhesion molecule (EpCAM; clones BS14, Ber-Ep4, and MOC-31). The fraction and intensity of stained cells were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the investigated markers, a significant difference in staining proportion was seen for TTF-1 clone 8G7G3/1 and EpCAM clone MOC-31, especially with cases being negative in CytoLyt (33.3% and 83.3% positive, respectively) and PreservCyt (62.5% and 83.3%) whereas being positive in CytoRich Red (76.5% and 94.1%) and formalin (both 95.8%). A significantly weaker intensity of staining was seen for all alcohol-based fixatives compared to formalin for TTF-1 clone 8G7G3/1, napsin A, and EpCAM clone MOC-31, whereas EpCAM clone Ber-Ep4 was significantly weaker only in PreservCyt compared with formalin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Immunocytochemical expression and concordance with formalin-fixed CBs differ depending on the used fixative as well as the antibody and clone, warranting investigation of the reliability of each biomarker for non–formalin-fixed cytology.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"569-579"},"PeriodicalIF":2.6,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of ultrasensitive RNA in situ hybridization for kappa and lambda light chains assists in the differential diagnosis of B-cell non-Hodgkin and Hodgkin lymphomas in cytopathology practice","authors":"Hatem Kaseb MD, PhD, MPH,&nbsp;Diane Davis Davey MD","doi":"10.1002/cncy.22834","DOIUrl":"10.1002/cncy.22834","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 11","pages":"675-677"},"PeriodicalIF":2.6,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the ThyGeNEXT oncogene panel used in combination with the expanded miRNA panel ThyraMIRv2 in Indeterminate thyroid nodules: A large, blinded, real-world, observational study","authors":"Tanvi Verma MD,&nbsp;Cody Marshall DO,&nbsp;Kossivi E. Dantey MD,&nbsp;Diane V. Thompson MS,&nbsp;Anna Banizs MD,&nbsp;Sydney D. Finkelstein MD,&nbsp;Joseph DelTondo DO","doi":"10.1002/cncy.22829","DOIUrl":"10.1002/cncy.22829","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Molecular analysis of fine-needle aspiration biopsies (FNAB) improves the diagnostic accuracy of cytologically indeterminate thyroid nodules (ITNs). Recently, the use of MPTXv2 has been shown to further improve the accuracy of risk stratification of ITNs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 338 patient samples with atypia of undetermined significance (<i>n</i> = 258) or follicular neoplasm (<i>n</i> = 80) cytology diagnosis and corresponding surgical outcomes or clinical follow-up, collected between 2016 and 2020 were included [Correction added on 19 June 2024, after first online publication: In the preceding sentence, the <i>n</i> values 260 and 78 have been changed to 258 and 80, respectively.]. All samples underwent multiplatform testing (MPTXv1), which includes an oncogene panel (ThyGeNEXT^®) plus a microRNA risk classifier (ThyraMIR^®). A blinded, secondary analysis was performed to assess the added utility of MPTXv2 (ThyraMIR^®v2). The average length of follow-up for the surveillance group (<i>n</i> = 248) was 30 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sensitivity at moderate threshold was 96% and specificity at positive threshold was 99% for MPTXv2. At 14% disease prevalence, the negative predictive value at the moderate threshold was 99% and the positive predictive value at the positive threshold was 89% for MPTXv2. MPTXv2 had fewer patients classified into the moderate-risk group than MPTXv1, which was statistically significant (<i>p</i> &lt; .001). Using surgical resection, the gold standard for outcomes, MPTXv2 showed a statistically greater area under the curve (<i>p</i> = .028) than MPTXv1, demonstrating greater accuracy for MPTXv2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both test versions demonstrated robust performance with low false-positive molecular results. Data suggest that incorporation of MPTXv1, and more recently MPTXv2, into clinical practice within our healthcare network resulted in improved accuracy of ITN risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"556-563"},"PeriodicalIF":2.6,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22829","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility and performance of cell blocks in cerebrospinal fluid cytology: Experience at two teaching hospitals","authors":"Hyeji Yoon CT,&nbsp;Constance V. Chen MD,&nbsp;Vimal Krishnan MD,&nbsp;Jill Grochowski CT,&nbsp;Gioia Iezza MD,&nbsp;Poonam Vohra MD,&nbsp;Ronald Balassanian MD,&nbsp;Nancy Y. Greenland MD PhD","doi":"10.1002/cncy.22836","DOIUrl":"10.1002/cncy.22836","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cytology cell blocks (CBs) are not routinely made for cerebrospinal fluid (CSF) specimens. The goal of this study was to identify when CSF CB preparation improves diagnostic performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Under institutional review board approval, a retrospective review of CSF cytology cases was conducted at a tertiary university-based hospital and an affiliated county hospital. Patient history, CSF volume, final diagnosis, use of stains, and whether the CB was contributory was determined from the cytopathology report. CSF nucleated cell count data was obtained from the medical record.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 69 CSF specimens with CBs from January 2006 to March 2023 were identified from 61 patients. The median CSF volume was 8 mL (interquartile range, 4–13 mL; range, 1–800 mL), with immunohistochemical stains performed on 29 (42%) cases. Per cytology report, CB was contributory in 23 cases (33%), not contributory in 34 cases (49%), and not discussed in 12 cases (17%). The median volume was 8 mL for cases in which CB was contributory, not contributory, or not discussed. There was no difference in average nucleated cell counts between cases in which CB was contributory versus not contributory (73.9 vs. 40.0, <i>p</i> = .175).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CBs for CSF samples were contributory in a subset (33%) of cases. The authors were unable to identify any specific pre-analytic factors, including specimen volume and average nucleated cell counts, for cases in which CB was contributory. Further evaluation is needed to identify if there are scenarios in which CSF CBs should be routinely prepared.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 10","pages":"621-628"},"PeriodicalIF":2.6,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22836","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research and scholarly mentoring: A guide for pathology faculty and program directors","authors":"R. Lane Coffee Jr. PhD, MS,&nbsp;Stephen John Cico MD, MEd","doi":"10.1002/cncy.22835","DOIUrl":"10.1002/cncy.22835","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 10","pages":"605-608"},"PeriodicalIF":2.6,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malignant risk of pediatric Bethesda category III thyroid nodules subcategorized by nuclear atypia and other: A single institution experience","authors":"Xiaobing Jin MD,&nbsp;Xin Jing MD,&nbsp;Brian Smola BS,&nbsp;Amer Heider MD","doi":"10.1002/cncy.22831","DOIUrl":"10.1002/cncy.22831","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The 2023 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) divides AUS diagnoses into two major subcategories: atypia of undetermined significance (AUS) nuclear atypia (AUS-N) and other (AUS-O). This study aims to compare the histological outcome and malignant rate of pediatric AUS thyroid nodules classified into AUS-N and AUS-O subcategories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A search of our institutional electronic pathology database for the period from January 2012 to July 2023 was conducted to identify pediatric (&lt;21 years old) thyroid nodules that were interpreted as AUS and subsequently had surgery. Cases were further divided into AUS-N and AUS-O subcategories. Results of follow-up surgical resections were collected. The malignant rate was calculated and compared between AUS-N and AUS-O groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study identified 62 thyroid nodules from 58 pediatric patients. Among these nodules, 29 and 33 were subcategorized as AUS-N and AUS-O, respectively. Both groups exhibited a female predominance and displayed a similar nodule size distribution. Histological analysis revealed 15 carcinomas in AUS-N nodules, including 11 cases of classic papillary thyroid carcinoma (PTC) and four cases of follicular type of PTC. In contrast, in the AUS-O group, a total of five carcinomas were documented, including two PTCs and three oncocytic thyroid carcinomas. Notably, the malignant rate of AUS-N nodules (52%) is significantly higher than that of AUS-O nodules (15%) (<i>p</i> = .002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In pediatric AUS thyroid nodules, the malignant risk in AUS-N is significantly higher than that in AUS-O. These findings may guide more appropriate clinical triage and/or improve management of pediatric patients with AUS thyroid nodules.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"564-568"},"PeriodicalIF":2.6,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current role of cytopathology in the molecular and computational era: The perspective of young pathologists","authors":"Alessandro Caputo MD,&nbsp;Pasquale Pisapia MD, PhD,&nbsp;Vincenzo L'Imperio MD","doi":"10.1002/cncy.22832","DOIUrl":"10.1002/cncy.22832","url":null,"abstract":"<p>Cytopathology represents a well established diagnostic approach because of its limited cost, reliability, and minimal invasiveness with respect to other methodologies. The evolving complexity of the different classifications systems and the implementation of ancillary techniques to refine the diagnosis is progressively helping in the risk of malignancy stratification, and the adoption of next-generation sequencing techniques contributes to enrich this valuable tool with predictive information, which is always more essential in the tailored medicine era. The recent introduction of digital and computational pathology is further boosting the potentialities of cytopathology, aiding in the interpretation of samples to improve the cost effectiveness of large screening programs and the diagnostic efficiency within intermediate/atypical categories. Moreover, the adoption of artificial intelligence tools is promising to complement molecular investigations, representing a stimulating perspective in the cytopathology field. In this work, the authors tried to summarize the multifaceted nature of this complex and evolving field of pathology, synthesizing the most recent advances and providing the young pathologists’ perspective on this fascinating world.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 11","pages":"678-685"},"PeriodicalIF":2.6,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on performance characteristics of FNA of renal lesions: It is time for a standardized classification system","authors":"Kübra Katipoglu MD,&nbsp;Irem Kilic MD,&nbsp;Olcay Kurtulan MD,&nbsp;Yasemin Akdas PhD, MPH,&nbsp;Güliz A. Barkan MD","doi":"10.1002/cncy.22826","DOIUrl":"10.1002/cncy.22826","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The incidence of renal tumors has steadily increased over the past decade. In this study, the authors performed a systematic review and analysis of the literature on renal fine-needle aspiration (FNA) to determine its performance and explore whether a standardized classification system can be used for reporting renal FNA cytology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of published articles on <i>renal FNA</i> was conducted. The data on FNA and histologic diagnosis were extracted and categorized, and the risk of malignancy was calculated. Different scenarios were used to estimate FNA performance statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 3766 potentially relevant studies, 23 met the inclusion criteria of the study. The 2231 FNA cases included were re-categorized according to the classification system, rendering 142 (6.36%) <i>nondiagnostic</i>, 270 (12.1%) <i>nonneoplastic</i>, 271 (12.14%) <i>benign neoplasm</i>, 65 (2.91%) <i>renal neoplasm with unknown malignant potential, oncocytic type</i>, 25 (1.12%) <i>atypia of undetermined significance</i>, 60 (2.68%) <i>suspicious for malignancy</i>, and 1398 (62.66%) <i>malignant</i> FNA diagnoses. The risk of malignancy in these cases was 65.4%, 18.1%, 16.6%, 16.9%, 60%, 73.3%, and 96.9%, respectively. According to the classification system, the study indicated that the accuracy of renal FNA was between 91% and 95%, the sensitivity was 90.9%–96.7%, and the specificity was 82%–92% in different scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is a need for a standardized reporting in renal cytology that will improve the sensitivity and accuracy of renal cytology, reduce the rate of indeterminate diagnoses, and alter the management strategies of renal lesions. Based on the available literature, a new reporting system is proposed, including categories with an associated risk of malignancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 8","pages":"510-524"},"PeriodicalIF":2.6,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic germ cell tumors in serous cavities and cerebrospinal fluid: A single-center experience","authors":"Tieying Hou MD, PhD,&nbsp;Katrina Collins MD,&nbsp;Guohua Liang MD, PhD,&nbsp;Sheila E. Segura MD,&nbsp;Thomas M. Ulbright MD,&nbsp;Hector Mesa MD, PhD,&nbsp;Harvey M. Cramer MD","doi":"10.1002/cncy.22827","DOIUrl":"10.1002/cncy.22827","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metastatic germ cell tumors (GCTs) involving body cavity effusions and cerebrospinal fluid (CSF) are rare. Diagnosis is challenging because of limited morphological and clinicopathological information in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A database search of our institution from 1990 to 2024 identified 27 cases of metastatic GCTs, comprising five pediatric and 22 adolescent and adult patients, in serous cavities or the CSF, including peritoneal (15), pleural (nine), CSF (two), and pericardial (one) fluid.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most common primary site was the testis (<i>n</i> = 10), followed by the ovaries (<i>n</i> = 7), mediastinum (<i>n</i> = 4), retroperitoneum (<i>n</i> = 3), pineal gland (<i>n</i> = 2), and sacrum/coccyx (<i>n</i> = 1). The primary tumors in 14 patients were mixed GCTs (six with a seminoma component), followed by immature teratomas (six), yolk sac tumors (three), embryonal carcinomas (two), pure seminomas (one), and postpubertal teratomas (one). The median interval between primary tumor diagnosis and diagnosis of fluid positivity was 7 months (range: 0–134 months). In nine cases, the malignant fluid was diagnosed simultaneously with or within 1 month of the primary tumor. GCT subtyping was performed on 23 of the 27 cytological specimens. Twenty-four patients (89%) also had metastases to other sites. Thirteen patients died of the disease (48%), with a median survival time of 4 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Metastatic GCTs in serous effusions and CSF are often associated with disseminated disease and poor prognosis. Subtyping can be performed by cytomorphology combined with immunohistochemistry.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"132 9","pages":"549-555"},"PeriodicalIF":2.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.22827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}