Cancer Cytopathology最新文献

{"title":"The fascinating history of papillary thyroid carcinoma nuclei: revelation of two nuclear morphologies—“Classical papillary” and “papillary-like”, with different pathobiologic characteristics","authors":"N. Paul Ohori MD,&nbsp;Jeremy M. Minkowitz DO,&nbsp;Yuri E. Nikiforov MD, PhD,&nbsp;Raja R. Seethala MD","doi":"10.1002/cncy.70100","DOIUrl":"10.1002/cncy.70100","url":null,"abstract":"<p>The nucleus of papillary thyroid carcinoma (PTC) has had a fascinating history since its early descriptions by Lindsay in 1960 and his designation of follicular variant papillary thyroid carcinoma (FVPTC) as a subtype of follicular carcinoma (FC). Later, Chen and Rosai revived the awareness of FVPTC and aligned this neoplasm with PTC. From this era, PTC became a “nuclear” diagnosis and was expanded to include FVPTC, even when noninvasive and encapsulated. However, this practice was prone to interobserver variability. The main issue centered on the interpretation of two types of nuclei – the widely accepted “classical papillary nucleus” with well-developed features such as nuclear pseudoinclusions and grooves and the other “papillary-like nucleus” with subtle and delicate nuclear features. Subsequently, some individuals recognized “papillary-like nucleus” in most follicular-patterned neoplasms and diagnosed them as FVPTC, while others diagnosed them as follicular adenoma or FC. In the 2000s, noninvasive, encapsulated FVPTC was recognized as an indolent entity, and later relabeled as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Molecular analyses revealed two main families of drivers for PTC - BRAF V600E or BRAF V600E–like mutations which aligned with “classical papillary nucleus”, papillary architecture, and conventional PTC outcomes, and RAS or RAS–like mutations that were associated with “papillary-like nucleus”, follicular architecture, and follicular-patterned neoplasm outcomes. The story has made full circle and the recent proposal to incorporate FVPTC into FC is in keeping with Lindsay’s original concept. By our current understanding, these nuclei are classified better by molecular associations.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763203","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148089055","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148071595","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148071597","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":"Utility of ACR TI-RADS to determine need for repeat FNA in thyroid nodules with nondiagnostic cytology","authors":"Lauren Waters DO,&nbsp;Tiffany M. Cullen DO,&nbsp;Michael B. Goldstein MD,&nbsp;Sheila Sheth MD,&nbsp;Chrystia Slywotzky MD,&nbsp;Shahidul Islam DrPH,&nbsp;Tamar C. Brandler MD, MS,&nbsp;Gary D. Rothberger MD","doi":"10.1002/cncy.70093","DOIUrl":"10.1002/cncy.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nondiagnostic cytology for thyroid nodules, consistent with The Bethesda System for Reporting Thyroid Cytopathology category I (B1) poses a management dilemma for clinicians. The objective of this study was to define the malignancy risk of nodules with B1 cytology using American College of Radiology Thyroid Imaging Reporting &amp; Data System (TI-RADS) and to assess whether TI-RADS can help guide the decision to perform a repeat biopsy of these nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>This retrospective cohort study evaluated 139 B1 nodules that had a definitive diagnosis on repeat biopsy or surgical excision. Sonographic features were evaluated and classified according to TI-RADS. TI-RADS category and total points were compared to the final diagnosis to determine the malignancy risk of B1 thyroid nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 139 nodules, 11 (7.9%) were malignant. The malignancy risk of nodules assigned TI-RADS category 1 and 2 were both 0%, TI-RADS 3 was 2.9%, whereas TI-RADS 4 and 5 were 5.9% and 46.2%, respectively. The optimal cutoff for TI-RADS points predicting malignancy was 5 points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>B1 thyroid nodules in TI-RADS categories 1–3 may not require repeat biopsy given low malignancy risk. However, B1 nodules in TI-RADS categories 4 and 5 have a higher malignancy risk and thus should undergo repeat biopsy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644275","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148068438","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":"Bridging the global diversity gap in cancer genomics","authors":"Bryn Nelson PhD,&nbsp;William Faquin MD, PhD","doi":"10.1002/cncy.70087","DOIUrl":"10.1002/cncy.70087","url":null,"abstract":"&lt;p&gt;Major cancer data-generating efforts, such as The Cancer Genome Atlas (TCGA), have shown how detailed genomic information can provide a crucial base for precision medicine and discovery research. Even so, patients of European ancestry are overrepresented in TCGA and similar databases, and this sample bias limits their generalizability and clinical relevance to real-world populations.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Three major projects collecting cancer data from Africa, Latin America, and India, respectively, demonstrate how that diversity gap might be narrowed through collaborative database building.&lt;/p&gt;&lt;p&gt;Yaw Bediako, PhD, chief executive officer of Yemaachi Biotech in Accra, Ghana, initially focused his research on infectious disease and on malaria in particular. After losing his father to cancer, he thought more about the less well-documented but rapidly growing burden of cancer on the African continent and began to shift his focus. “Cancer already kills more people in Africa than malaria does,” he points out, noting that cancer rates are rising faster in Africa than nearly any other region in the world.&lt;/p&gt;&lt;p&gt;In 2021, he cofounded Yemaachi Biotech to help to develop the continent’s biotechnology industry. “The idea to focus on cancer was driven by this realization that cancer is very much a global health disease now,” Dr Bediako says. Less than 3% of genomic data have come from people of African descent, however. “That is a huge problem when you’re in an age of precision medicine and we’re trying to make treatments and diagnostics tailored to an individual, especially now in this AI revolution where everything is based on training sets,” he says. “If you’re not in the training data, you’re not in the solution, right? And most African people find themselves outside the training data.”&lt;/p&gt;&lt;p&gt;The company’s first signature project, The African Cancer Atlas (TACA), offers a way to help to address the imbalance.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Given the constraints on publicly funded research in Africa, Dr Bediako has sought partnerships with Roche and other pharmaceutical companies to help to fund TACA in exchange for a trove of highly diverse genomic data. “Healthcare solutions that historically have been based upon genomes from predominantly European-origin individuals are less and less effective even in the US, where you have growing black and Hispanic communities,” he says.&lt;/p&gt;&lt;p&gt;In that regard, the African continent offers a decided strength as home to the world’s most genetically diverse population. “Pretty much every genetic variant present on the planet can be found in Africa, so it’s also a really unique opportunity to move the needle when it comes to the understanding of health in people, regardless of where they’re from,” Dr Bediako says.&lt;/p&gt;&lt;p&gt;Over the next 5 years, if all goes well, TACA will sequence 15,000 cancer genomes drawn from 7500 individuals in more than 15 African countries. The sequences, representing breast, lung, colorectal, and f","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627485","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148097444","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":"Unraveling the nexus: Tumor mutational burden, PD-L1 expression, and oncogenic alterations in non–small cell lung cancer cytology specimens","authors":"Min Dai MD,&nbsp;Francis Anthony San Lucas PhD,&nbsp;Hector Alvarez MD,&nbsp;Leomar Ballester MD, PhD,&nbsp;Hui Chen MD, PhD,&nbsp;Keyur P. Patel MD, PhD,&nbsp;Asif Rashid MD,&nbsp;Shun Rao MS,&nbsp;Mark J. Routbort MD, PhD,&nbsp;Gloria Sura MD,&nbsp;Keith Sweeney MD,&nbsp;Gokce Toruner MD, PhD,&nbsp;Peng Wei PhD,&nbsp;Richard Yang MD, PhD,&nbsp;Hyvan Dang BA,&nbsp;Rajyalakshmi Luthra PhD,&nbsp;Sinchita Roy-Chowdhuri MD, PhD","doi":"10.1002/cncy.70090","DOIUrl":"10.1002/cncy.70090","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>PD-L1 expression and tumor mutational burden (TMB) are biomarkers for immune checkpoint inhibitor (ICI) therapy in non–small cell lung cancer (NSCLC); however, patients harboring oncogenic alterations have limited benefit from ICIs. The impact of oncogenic alterations on TMB and PD-L1 tumor proportion score in lung cytology specimens is poorly understood. Herein, the association between oncogenic alterations, TMB, and PD-L1 in NSCLC cytology specimens is explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Next-generation sequencing results from 312 NSCLC cytology specimens were retrospectively reviewed that interrogate 610 genes and select immuno-oncology signatures. TMB and PD-L1 immunohistochemical expression across oncogenic alterations were analyzed to explore associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 312 cases evaluated, 192 harbored NSCLC-specific oncogenic alterations. Relative to <i>EGFR</i>-mutated tumors, TMB was significantly higher in <i>KRAS</i> (<i>p</i>_adj = 2.7 × 10⁻⁴), <i>ERBB2</i> (<i>p</i>_adj = .023), and <i>BRAF</i> (<i>p</i>_adj = .023) -mutated tumors but lower in <i>ALK</i>-rearranged tumors (<i>p</i>_adj = .005). Significantly higher PD-L1 expression was seen in tumors with <i>KRAS</i> (<i>p</i>_adj = .002) and <i>MET</i> exon 14 (<i>p</i>_adj = 1.06 × 10⁻⁴) when compared to <i>EGFR</i>-mutated tumors. Strong positive correlations between TMB and PD-L1 were observed in <i>ERBB2</i>-, <i>KRAS</i>-, and <i>BRAF</i>-mutated tumors when evaluated as continuous variables. <i>TP53</i> mutations further enhanced immunogenicity when co-occurring with <i>KRAS</i>, <i>ERBB2</i>, or <i>BRAF</i> mutations but this effect was not observed in <i>EGFR</i>-mutated tumors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings demonstrate distinct TMB and PD-L1 profiles that may identify patients who will benefit from ICI therapy. Cytology specimens provide adequate material for biomarker testing, which underscores their value in guiding immunotherapy decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13022943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147527046","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":"Spindle cell lesions in cytology: Risks of malignancy and application of the upcoming World Health Organization Reporting System for Soft Tissue Cytopathology","authors":"Natalie A. H. Ellis MD,&nbsp;Wen-Chi Foo MD","doi":"10.1002/cncy.70089","DOIUrl":"10.1002/cncy.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Spindle cell lesions can be challenging to diagnose on cytology alone. The World Health Organization (WHO) is publishing a new WHO Reporting System for Soft Tissue Cytopathology (WHORSSTC). The authors examined the performance characteristics of spindle cell lesion diagnoses at their institution when reclassifying according to the WHORSSTC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Spindle cell fine-needle aspirations or fine-needle core biopsies diagnosed on cytology were collected from August 2021 through July 2024. Clinical information, procedural data, cytologic diagnoses, and surgical pathology diagnoses were obtained from the electronic medical records. Cases were reclassified according to the WHORSSTC, and relevant metrics were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 296 cases were identified from 164 women, 131 men, and one transgender female. The average age was 60 years. Biopsies were obtained as fine-needle core biopsies (<i>n</i> = 152), fine-needle aspirations (<i>n</i> = 130), or both (<i>n</i> = 12); and 127 patients (43%) had subsequent surgical pathology follow-up. Most lesions (<i>n</i> = 94; 74%) were mesenchymal on resection. These were initially diagnosed as negative (<i>n</i> = 3; 2%), atypical (<i>n</i> = 14; 11%), suspicious (<i>n</i> = 5; 4%), malignant (<i>n</i> = 35; 28%), and descriptive (<i>n</i> = 70; 55%), with absolute risks of malignancy of 0%, 43%, 80%, 100%, and 44%, respectively. To align with the WHORSSTC, these cases were recategorized as insufficient/nondiagnostic (<i>n</i> = 7; 6%), benign (<i>n</i> = 13; 10%), atypical (<i>n</i> = 12; 9%), soft tissue neoplasm of uncertain malignant potential (<i>n</i> = 54; 43%), suspicious for malignancy (<i>n</i> = 5; 4%), and malignant (<i>n</i> = 36; 28%), with absolute risks of malignancy of 0%, 0%, 42%, 57%, 80%, and 100%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although not all spindle cell lesions prove to be mesenchymal, they can be effectively categorized by the upcoming WHORSSTC with increasing risks of malignancy that better predict biologic potential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"134 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509667","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}