Evaluating the Risk of Malignancies of the Diagnostic Categories Proposed by the World Health Organization System for Reporting Lung Cytopathology: A 2-Year Single Institutional Experience.
{"title":"Evaluating the Risk of Malignancies of the Diagnostic Categories Proposed by the World Health Organization System for Reporting Lung Cytopathology: A 2-Year Single Institutional Experience.","authors":"Wei-An Lai, Chien-Chin Chen","doi":"10.1159/000539154","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The WHO System of Reporting Lung Cytopathology proposed a 5-tiered system in 2023. We report the risk of malignancies (ROMs) of bronchial washing/lavage and percutaneous fine-needle aspiration (FNA) specimens. We also evaluated the change of ROMs when image correlation is required.</p><p><strong>Methods: </strong>Lung cytology cases in 2021 and 2022 with histologic follow-up were included. CT reports were reviewed to identify cases with a solid nodule/tumor but benign cytological findings. These were reassigned from the \"benign\" to \"non-diagnostic\" category, and the ROMs were re-estimated.</p><p><strong>Results: </strong>A total of 1,031 bronchial washing/lavage and 206 FNAs were identified. The ROMs of bronchial washing/lavage were \"non-diagnostic\" 56.5% (13/23), \"benign\" 41.9% (320/764), \"atypical\" 71.7% (71/99), \"suspicious for malignancy\" 94.7% (72/76), and \"malignant\" 100% (70/70). The ROMs of FNAs were \"non-diagnostic\" 66% (33/50), \"benign\" 58.2% (39/67), \"atypical\" 70% (28/40), \"suspicious for malignancy\" 96.2% (25/26), and \"malignant\" 100% (70/70). When image finding was considered, cases initially assigned as \"benign\" were re-classified to \"non-diagnostic\" with decreases in ROMs for the \"benign\" category.</p><p><strong>Conclusions: </strong>Malignancy risks associated with the WHO System of Reporting Lung Cytopathology diagnostic groups were reported. Image correlation for the \"benign\" category led to a decrease in case number and ROM.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Cytologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000539154","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/2 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: The WHO System of Reporting Lung Cytopathology proposed a 5-tiered system in 2023. We report the risk of malignancies (ROMs) of bronchial washing/lavage and percutaneous fine-needle aspiration (FNA) specimens. We also evaluated the change of ROMs when image correlation is required.
Methods: Lung cytology cases in 2021 and 2022 with histologic follow-up were included. CT reports were reviewed to identify cases with a solid nodule/tumor but benign cytological findings. These were reassigned from the "benign" to "non-diagnostic" category, and the ROMs were re-estimated.
Results: A total of 1,031 bronchial washing/lavage and 206 FNAs were identified. The ROMs of bronchial washing/lavage were "non-diagnostic" 56.5% (13/23), "benign" 41.9% (320/764), "atypical" 71.7% (71/99), "suspicious for malignancy" 94.7% (72/76), and "malignant" 100% (70/70). The ROMs of FNAs were "non-diagnostic" 66% (33/50), "benign" 58.2% (39/67), "atypical" 70% (28/40), "suspicious for malignancy" 96.2% (25/26), and "malignant" 100% (70/70). When image finding was considered, cases initially assigned as "benign" were re-classified to "non-diagnostic" with decreases in ROMs for the "benign" category.
Conclusions: Malignancy risks associated with the WHO System of Reporting Lung Cytopathology diagnostic groups were reported. Image correlation for the "benign" category led to a decrease in case number and ROM.
期刊介绍:
With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.