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Trilineage Extramedullary Hematopoiesis in Pleural Effusion: A Rare Phenomenon 胸腔积液中三龄髓外造血:罕见现象。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2026-01-10 DOI: 10.1002/dc.70080
Nithye Parvathy, Reetu Kundu, Praveen Sharma, Nidhi Prabhakar, Alka Khadwal
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引用次数: 0
Meta-Analysis of Non-Blood Liquid Biopsy Specimens: Diagnostic Performance in Cancer Detection 非血液液体活检标本的荟萃分析:癌症检测的诊断性能。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2026-01-07 DOI: 10.1002/dc.70077
Kartavya Kumar Verma

Background

Non-blood liquid biopsy specimens represent an emerging frontier in cancer diagnostics, offering anatomically relevant alternatives to traditional blood-based analyses. These specimens provide unique advantages including proximity to tumor sites and potentially higher concentrations of tumor-derived biomarkers.

Objective

To systematically evaluate the diagnostic performance of various non-blood liquid biopsy specimens across multiple cancer types through comprehensive meta-analysis.

Methods

A systematic literature search was conducted across PubMed databases for studies published between 2013 and 2024. Studies evaluating non-blood liquid biopsy for cancer detection were included. Data extraction focused on diagnostic accuracy metrics including sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratios. Random-effects meta-analysis was performed using hierarchical modeling to account for heterogeneity.

Results

Twenty studies encompassing 13,486 participants were analyzed across nine specimen types. Overall pooled diagnostic performance demonstrated sensitivity of 76.2% (95% CI: 71.2%–81.2%) and specificity of 77.8% (95% CI: 72.8%–82.8%), with a diagnostic odds ratio of 11.2. Aqueous humor achieved the highest individual performance with 96% sensitivity and 100% specificity for retinoblastoma detection. Cerebrospinal fluid (CSF) demonstrated excellent performance across brain tumor types with 88.9% sensitivity and 76.1% specificity. Heterogeneity was observed across specimen types and cancer contexts. The significant variability observed among different specimen types, especially in saliva where the I 2 value for specificity is 78.9%.

Conclusions

Non-blood liquid biopsy specimens demonstrate clinically meaningful diagnostic performance across diverse cancer types, with specimen-specific advantages for anatomically relevant malignancies. The identification of optimal specimen-cancer pairings provides immediate clinical utility for precision cancer diagnostics. Future research should focus on standardization of collection protocols and larger validation studies.

背景:非血液液体活检标本代表了癌症诊断的新兴前沿,为传统的基于血液的分析提供了解剖学相关的替代方案。这些标本具有独特的优势,包括靠近肿瘤部位和潜在的更高浓度的肿瘤来源的生物标志物。目的:通过综合meta分析,系统评价多种非血液液体活检标本对多种癌症类型的诊断价值。方法:系统检索PubMed数据库中2013 - 2024年间发表的研究。评估非血液液体活检检测癌症的研究被纳入。数据提取侧重于诊断准确性指标,包括敏感性、特异性、阳性和阴性似然比以及诊断优势比。随机效应荟萃分析采用分层模型来解释异质性。结果:包括13486名参与者的20项研究分析了9种标本类型。总体汇总诊断结果显示,敏感性为76.2% (95% CI: 71.2%-81.2%),特异性为77.8% (95% CI: 72.8%-82.8%),诊断优势比为11.2。房水在视网膜母细胞瘤检测中具有最高的灵敏度和100%的特异性。脑脊液(CSF)在脑肿瘤类型中表现优异,敏感性为88.9%,特异性为76.1%。在不同的标本类型和癌症背景下观察到异质性。在不同的标本类型中观察到显著的差异,特别是在唾液中,特异性的I2值为78.9%。结论:非血液液体活检标本在不同癌症类型中具有临床意义的诊断性能,在解剖相关的恶性肿瘤中具有标本特异性优势。最佳标本-癌症配对的鉴定为精确的癌症诊断提供了直接的临床效用。未来的研究应侧重于收集方案的标准化和更大规模的验证研究。
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引用次数: 0
Role of Fine-Needle Aspiration Cytology in Evaluating Superficial Lymphadenopathy in a Resource-Limited Setting, Eastern Ethiopia. 细针抽吸细胞学在评估资源有限的埃塞俄比亚东部地区浅表淋巴结病中的作用。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2026-01-06 DOI: 10.1002/dc.70076
Addisu Alemu, Biniyam Tedla Mamo, Mehabuba Aliyou, Nebil Fuad, Yehenaw Tadele, Abel Tefera

Background: Lymphadenopathy is the enlargement of lymph nodes that can be caused by various factors, ranging from infectious to malignant. Fine-needle aspiration cytology (FNAC) is a simple, minimally invasive, and cost-effective diagnostic method for lymphadenopathy.

Objective: This study aimed to evaluate the cytopathological patterns and diagnostic accuracy of fine-needle aspiration in patients presenting with lymphadenopathy.

Methods: A retrospective, hospital-based study was conducted at Hiwot Fana Comprehensive Specialized University Hospital in Eastern Ethiopia, from January 2019 to December 2022. Patients with lymphadenopathy and FNAC were included in this study. Data were collected by extracting information from cytopathology reports. Descriptive statistics were used to describe the independent variables. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with cancerous lymphadenopathy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were assessed to evaluate the diagnostic accuracy of FNAC.

Result: This study included a total of 741 patients with lymph node FNAC. Of those patients, 75.9% were under the age of 30, and 53.4% were male. Cervical lymphadenopathy accounted for 528 (71.3%) of the total lymphadenopathy cases. More than half were diagnosed with tuberculous lymphadenitis (386; 52.1%), followed by reactive lymphadenopathy (226; 30.5%), lymphomas (8.9%), and secondary metastasis (6.7%). The likelihood of malignant lymphadenopathy increased with age, male sex, and involvement of two or more lymph node regions. Lymph node FNAC had an overall diagnostic accuracy of 92.06% with a sensitivity of 86.44%, specificity of 93.78%, PPV of 80.95%, and NPV of 95.77% as compared with lymph node histopathology.

Conclusion: FNAC remains a simple, valid, reliable, rapid, and cost-effective method for diagnosis, treatment, or indicating further diagnostic work-up in resource-limited countries, such as Ethiopia. FNAC has high diagnostic accuracy, preventing unnecessary surgical removal of lymphadenopathy for diagnosis. However, clinicopathological correlation, repeating the FNAC, or performing an incisional lymph node biopsy is recommended for enhanced efficiency.

背景:淋巴结病是由多种因素引起的淋巴结肿大,从传染性到恶性不等。细针穿刺细胞学(FNAC)是一种简单、微创、经济有效的淋巴结病诊断方法。目的:本研究旨在评价细针穿刺在淋巴结病患者中的细胞病理学表现和诊断准确性。方法:2019年1月至2022年12月,在埃塞俄比亚东部的Hiwot Fana综合专科大学医院进行了一项回顾性的医院基础研究。本研究纳入了淋巴结病和FNAC患者。通过提取细胞病理报告信息收集数据。采用描述性统计对自变量进行描述。进行双变量和多变量logistic回归分析以确定与癌性淋巴结病相关的因素。通过敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)评估FNAC的诊断准确性。结果:本研究共纳入741例淋巴结FNAC患者。其中年龄在30岁以下的占75.9%,男性占53.4%。宫颈淋巴结病变528例(71.3%)。超过一半的患者被诊断为结核性淋巴结炎(386例,52.1%),其次是反应性淋巴结病(226例,30.5%)、淋巴瘤(8.9%)和继发性转移(6.7%)。恶性淋巴结病的可能性随着年龄、男性和累及两个或更多淋巴结区域而增加。与淋巴结组织病理学相比,FNAC的总体诊断准确率为92.06%,敏感性为86.44%,特异性为93.78%,PPV为80.95%,NPV为95.77%。结论:在埃塞俄比亚等资源有限的国家,FNAC仍然是一种简单、有效、可靠、快速和具有成本效益的诊断、治疗或指示进一步诊断的方法。FNAC诊断准确率高,避免了诊断时不必要的淋巴结切除手术。然而,临床病理相关性,重复FNAC,或执行切口淋巴结活检被推荐为提高效率。
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引用次数: 0
Performance Characteristics of Milan System for Reporting Salivary Gland Cytopathology: An Experience From Western Saudi Population. 唾液腺细胞病理学报告米兰系统的性能特点:来自沙特西部人群的经验。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2026-01-01 DOI: 10.1002/dc.70028
Samah Saharti, Reem Aljohani

Introduction: Salivary gland tumors are rare but diverse, with a higher prevalence of benign tumors in the parotid gland and a greater incidence of malignancy in other glands. Fine needle aspiration (FNA), enhanced by the Milan Reporting System, is widely used to evaluate these tumors. This study aimed to assess the diagnostic accuracy of the Milan Reporting System in a Saudi Arabian setting.

Methods: This retrospective study included 117 patients from the western region of Saudi Arabia who underwent salivary gland FNA cytology with histological confirmation. Data were analyzed to evaluate demographic variables, Milan system category distribution, and diagnostic accuracy using SPSS Version 25.

Results: The study cohort had a slight male predominance, with most patients being middle-aged or older. Tumors were most commonly found in the parotid glands. Pleomorphic adenoma and squamous cell carcinoma were the most frequent benign and malignant tumors, respectively, in this study. The Milan Reporting System demonstrated excellent diagnostic performance, with high sensitivity (87.9%), specificity (99.5%), Positive Predictive Value (98.1%), and Negative Predictive Value (96.4%). The system correctly classified all benign tumors, indicating high diagnostic concordance and showed high sensitivity for malignant tumors. Statistical analysis revealed a significant correlation between the Milan Reporting System and histological diagnosis (p = 0.000).

Conclusion: Our study evaluated the Milan Reporting System for salivary gland cytopathology in the western region of Saudi Arabia, revealing it to be a highly reliable screening tool for salivary gland tumors. The system demonstrated exceptional performance, particularly for common entities, such as pleomorphic adenoma and squamous cell carcinoma. This promotes early and accurate detection. However, when malignancy is suspected but the Milan Reporting System results are negative, it is crucial to perform additional confirmatory tests (such as repeating the FNA or performing a core biopsy) to avoid missing a diagnosis of cancer.

简介:唾液腺肿瘤罕见但多样,腮腺良性肿瘤发生率较高,其他腺体恶性肿瘤发生率较高。细针抽吸(FNA)在米兰报告系统的加强下,被广泛用于评估这些肿瘤。本研究旨在评估米兰报告系统在沙特阿拉伯的诊断准确性。方法:本回顾性研究包括来自沙特阿拉伯西部地区的117例患者,他们接受了涎腺FNA细胞学检查并进行了组织学证实。使用SPSS Version 25对数据进行分析,以评估人口统计变量、米兰系统类别分布和诊断准确性。结果:研究队列有轻微的男性优势,大多数患者为中老年。肿瘤最常见于腮腺。多形性腺瘤和鳞状细胞癌分别是本研究中最常见的良恶性肿瘤。米兰报告系统表现出优异的诊断性能,具有高灵敏度(87.9%)、特异性(99.5%)、阳性预测值(98.1%)和阴性预测值(96.4%)。该系统对所有良性肿瘤的分类均正确,诊断一致性高,对恶性肿瘤的诊断敏感性高。统计分析显示,米兰报告系统与组织学诊断之间存在显著相关性(p = 0.000)。结论:本研究对沙特阿拉伯西部地区的唾液腺细胞病理学米兰报告系统进行了评估,发现该系统是一种高度可靠的唾液腺肿瘤筛查工具。该系统表现出优异的表现,特别是对常见的实体,如多形性腺瘤和鳞状细胞癌。这促进了早期和准确的检测。然而,当怀疑恶性肿瘤,但米兰报告系统结果为阴性时,进行额外的确认性检查(如重复FNA或进行核心活检)以避免遗漏癌症诊断是至关重要的。
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引用次数: 0
The Bethesda System Revisited: Malignancy Risk Estimation and NIFTP Impact in a Large Cohort From Northern India. 再访Bethesda系统:恶性肿瘤风险评估和NIFTP对印度北部大队列的影响。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-12-30 DOI: 10.1002/dc.70074
Shruti Singh, Chanchal Rana, Pooja Ramakant, Kul Ranjan Singh, Anand Mishra

Background: Thyroid nodules are common in clinical practice, and fine-needle aspiration cytology (FNAC) remains the primary test for malignancy risk assessment. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) standardizes interpretation and guides management. This study evaluated the distribution of Bethesda categories, risk of neoplasia (RON) and malignancy (ROM), and the impact of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on risk stratification.

Methods: A retrospective review of 2578 thyroid FNACs (2016-2024) was conducted at King George's Medical University, Lucknow. Cytological diagnoses were classified using TBSRTC (2017 and 2023). Histopathological correlation was available in 1043 cases (40.5%). RON and ROM were calculated for each category, with ROM assessed before and after excluding NIFTP. Smears were independently reviewed by two cytopathologists, and diagnostic metrics (sensitivity, specificity, accuracy) were derived using histopathology as reference; 95% confidence intervals were estimated by exact binomial methods.

Results: Most cases were Benign (73.2%), followed by Malignant (7.2%) and Follicular Neoplasm (6.1%). Malignancy was confirmed in 245 cases. ROM ranged from 3.7%-9.9% (Benign) to 58.6%-100% (Malignant), showing a progressive rise across categories. Reclassification of NIFTP notably reduced ROM for indeterminate categories (AUS: 43.2% → 31.8%; FN: 40.2% → 28.4%; SM: 52.4% → 42.9%).

Conclusion: TBSRTC reliably stratifies malignancy risk in thyroid nodules. Reclassification of NIFTP has a substantial impact on ROM in indeterminate categories, underscoring the need for precise cytologic-histologic correlation and regional validation to optimize patient management.

背景:甲状腺结节在临床实践中很常见,细针穿刺细胞学(FNAC)仍然是恶性肿瘤风险评估的主要测试。Bethesda甲状腺细胞病理学报告系统(TBSRTC)规范了解释和指导管理。本研究评估了Bethesda分类的分布、肿瘤(RON)和恶性(ROM)的风险,以及具有乳头状样核特征的非侵袭性滤泡性甲状腺肿瘤(NIFTP)对风险分层的影响。方法:对勒克瑙乔治国王医科大学2016-2024年2578例甲状腺FNACs患者进行回顾性分析。细胞学诊断采用TBSRTC(2017年和2023年)分类。1043例(40.5%)有组织病理学相关性。计算每个类别的RON和ROM,并在排除NIFTP之前和之后评估ROM。涂片由两名细胞病理学家独立审查,并以组织病理学为参考得出诊断指标(敏感性、特异性、准确性);95%置信区间用精确二项法估计。结果:良性占73.2%,恶性占7.2%,滤泡性肿瘤占6.1%。245例确诊为恶性肿瘤。ROM范围从3.7%-9.9%(良性)到58.6%-100%(恶性),在不同类别中呈渐进式上升。重新分类NIFTP显著降低了不确定类别的ROM (AUS: 43.2%→31.8%;FN: 40.2%→28.4%;SM: 52.4%→42.9%)。结论:TBSRTC可可靠地对甲状腺结节的恶性风险进行分层。NIFTP的重新分类对不确定类别的ROM有重大影响,强调需要精确的细胞学-组织学相关性和区域验证以优化患者管理。
{"title":"The Bethesda System Revisited: Malignancy Risk Estimation and NIFTP Impact in a Large Cohort From Northern India.","authors":"Shruti Singh, Chanchal Rana, Pooja Ramakant, Kul Ranjan Singh, Anand Mishra","doi":"10.1002/dc.70074","DOIUrl":"https://doi.org/10.1002/dc.70074","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodules are common in clinical practice, and fine-needle aspiration cytology (FNAC) remains the primary test for malignancy risk assessment. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) standardizes interpretation and guides management. This study evaluated the distribution of Bethesda categories, risk of neoplasia (RON) and malignancy (ROM), and the impact of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) on risk stratification.</p><p><strong>Methods: </strong>A retrospective review of 2578 thyroid FNACs (2016-2024) was conducted at King George's Medical University, Lucknow. Cytological diagnoses were classified using TBSRTC (2017 and 2023). Histopathological correlation was available in 1043 cases (40.5%). RON and ROM were calculated for each category, with ROM assessed before and after excluding NIFTP. Smears were independently reviewed by two cytopathologists, and diagnostic metrics (sensitivity, specificity, accuracy) were derived using histopathology as reference; 95% confidence intervals were estimated by exact binomial methods.</p><p><strong>Results: </strong>Most cases were Benign (73.2%), followed by Malignant (7.2%) and Follicular Neoplasm (6.1%). Malignancy was confirmed in 245 cases. ROM ranged from 3.7%-9.9% (Benign) to 58.6%-100% (Malignant), showing a progressive rise across categories. Reclassification of NIFTP notably reduced ROM for indeterminate categories (AUS: 43.2% → 31.8%; FN: 40.2% → 28.4%; SM: 52.4% → 42.9%).</p><p><strong>Conclusion: </strong>TBSRTC reliably stratifies malignancy risk in thyroid nodules. Reclassification of NIFTP has a substantial impact on ROM in indeterminate categories, underscoring the need for precise cytologic-histologic correlation and regional validation to optimize patient management.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862304","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}
引用次数: 0
Cytopathologic Features of Metastatic Malignant Mesothelioma With SMARCB1 (INI-1) Deficient Diagnosed by Ultrasound-Guided Fine-Needle Aspiration: A Case Report. 超声引导细针穿刺诊断SMARCB1 (ni -1)缺陷转移性恶性间皮瘤的细胞病理学特征1例
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-12-29 DOI: 10.1002/dc.70073
Jun Yang, Juandi Liu, Jing Jin, Deng Pan, Lei Shao

Malignant mesothelioma (MM) is a rare yet aggressive neoplasm that arises from mesothelial cells lining the thoracic and abdominal cavities, the pericardium, and the tunica testis. Characterized by rapid progression, high invasiveness, and a poor prognosis, MM poses significant clinical challenges. SMARCB1, also referred to as INI-1, hSNF5, or BAF47, is located on chromosome 22q11.2 and serves as a critical subunit of the SWI/SNF chromatin remodeling complex. INI-1 functions as a tumor suppressor and plays a vital role in DNA damage repair and regulation of cell growth. Case Presentation: A 37-year-old Chinese male with no history of asbestos exposure but a 10-year smoking history (30 cigarettes per day) presented with a cough lasting one month and a fever persisting for one day. Computed tomography (CT) showed multiple enlarged supraclavicular lymph nodes measuring up to 30 × 15 mm bilaterally. An ultrasound-guided fine-needle aspiration (FNA) of the left supraclavicular lymph nodes was subsequently performed. The SurePath-prepared liquid-based cytopathology (LBC) using Papanicolaou-staining revealed tumor cells organized in clusters with indistinct borders. The cells exhibited abundant cytoplasm and pleomorphic round nuclei, which displayed prominent nucleoli and mitotic activity. Additionally, scattered lymphoid fragments were observed in the background. The FNA sample was formalin-fixed and paraffin-embedded for cell block; 4-μm thick sections were prepared. Histological examination using HE-stained cell block revealed a solid sheet-like tumor growth characterized by minimal stroma and the absence of fibrovascular cores. The neoplastic cells had well-defined borders, abundant eosinophilic (partially clear) cytoplasm, and round-to-oval nuclei displaying focal atypia, finely dispersed chromatin, and prominent nucleoli. Immunohistochemistry (IHC) demonstrated positive staining for CK(pan), calretinin, D2-40, and SMARCA4, whereas NapsinA, TTF-1, P40, NUT, and WT-1 yielded negative results. The confirmed loss of INI-1 expression ultimately led to the diagnosis of metastatic INI-1 deficient MM. Conclusion: This case highlights the cytomorphological features and immunophenotype of INI-1 deficient MM diagnosed through FNA. An accurate diagnosis requires a thorough clinicopathological correlation and a comprehensive IHC panel.

恶性间皮瘤(MM)是一种罕见但侵袭性的肿瘤,起源于胸腔、腹腔、心包和睾丸膜的间皮瘤细胞。MM的特点是进展迅速,侵袭性高,预后差,给临床带来了重大挑战。SMARCB1,也被称为ni -1、hSNF5或BAF47,位于染色体22q11.2上,是SWI/SNF染色质重塑复合体的一个关键亚基。i -1作为肿瘤抑制因子,在DNA损伤修复和细胞生长调控中发挥重要作用。病例介绍:37岁中国男性,无石棉接触史,吸烟10年(每日30支),咳嗽1个月,发烧1天。计算机断层扫描(CT)显示双侧锁骨上多发肿大淋巴结,尺寸达30 × 15 mm。超声引导下细针抽吸左侧锁骨上淋巴结(FNA)。使用papanicolaou染色的surepath制备的液体细胞病理学(LBC)显示肿瘤细胞组织成集群,边界模糊。胞质丰富,细胞核呈多形性圆形,核仁和有丝分裂活性明显。此外,在背景中观察到分散的淋巴碎片。FNA样品经福尔马林固定,石蜡包埋用于细胞块;制备厚度为4 μm的切片。he染色细胞块组织学检查显示实片状肿瘤生长,间质极少,无纤维血管核心。肿瘤细胞边界清晰,细胞质嗜酸性丰富(部分透明),核圆至卵圆形,局灶非典型性,染色质精细分散,核仁突出。免疫组化(IHC)结果显示CK(pan)、calretinin、D2-40和SMARCA4呈阳性,而NapsinA、TTF-1、P40、NUT和WT-1呈阴性。结论:本病例突出了FNA诊断的i -1缺陷MM的细胞形态学特征和免疫表型。准确的诊断需要彻底的临床病理相关性和全面的免疫组化检查。
{"title":"Cytopathologic Features of Metastatic Malignant Mesothelioma With SMARCB1 (INI-1) Deficient Diagnosed by Ultrasound-Guided Fine-Needle Aspiration: A Case Report.","authors":"Jun Yang, Juandi Liu, Jing Jin, Deng Pan, Lei Shao","doi":"10.1002/dc.70073","DOIUrl":"https://doi.org/10.1002/dc.70073","url":null,"abstract":"<p><p>Malignant mesothelioma (MM) is a rare yet aggressive neoplasm that arises from mesothelial cells lining the thoracic and abdominal cavities, the pericardium, and the tunica testis. Characterized by rapid progression, high invasiveness, and a poor prognosis, MM poses significant clinical challenges. SMARCB1, also referred to as INI-1, hSNF5, or BAF47, is located on chromosome 22q11.2 and serves as a critical subunit of the SWI/SNF chromatin remodeling complex. INI-1 functions as a tumor suppressor and plays a vital role in DNA damage repair and regulation of cell growth. Case Presentation: A 37-year-old Chinese male with no history of asbestos exposure but a 10-year smoking history (30 cigarettes per day) presented with a cough lasting one month and a fever persisting for one day. Computed tomography (CT) showed multiple enlarged supraclavicular lymph nodes measuring up to 30 × 15 mm bilaterally. An ultrasound-guided fine-needle aspiration (FNA) of the left supraclavicular lymph nodes was subsequently performed. The SurePath-prepared liquid-based cytopathology (LBC) using Papanicolaou-staining revealed tumor cells organized in clusters with indistinct borders. The cells exhibited abundant cytoplasm and pleomorphic round nuclei, which displayed prominent nucleoli and mitotic activity. Additionally, scattered lymphoid fragments were observed in the background. The FNA sample was formalin-fixed and paraffin-embedded for cell block; 4-μm thick sections were prepared. Histological examination using HE-stained cell block revealed a solid sheet-like tumor growth characterized by minimal stroma and the absence of fibrovascular cores. The neoplastic cells had well-defined borders, abundant eosinophilic (partially clear) cytoplasm, and round-to-oval nuclei displaying focal atypia, finely dispersed chromatin, and prominent nucleoli. Immunohistochemistry (IHC) demonstrated positive staining for CK(pan), calretinin, D2-40, and SMARCA4, whereas NapsinA, TTF-1, P40, NUT, and WT-1 yielded negative results. The confirmed loss of INI-1 expression ultimately led to the diagnosis of metastatic INI-1 deficient MM. Conclusion: This case highlights the cytomorphological features and immunophenotype of INI-1 deficient MM diagnosed through FNA. An accurate diagnosis requires a thorough clinicopathological correlation and a comprehensive IHC panel.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848941","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}
引用次数: 0
Fine Needle Aspiration of Thyroid Nodules: From Conventional Smears to Liquid-Based Cytology—The 8-Year Cleveland Clinic Abu Dhabi Experience 细针穿刺甲状腺结节:从传统涂片到液体细胞学-克利夫兰诊所阿布扎比8年的经验。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-12-23 DOI: 10.1002/dc.70072
Ayoub Nahal
<div> <section> <h3> Background</h3> <p>The transition from conventional smear (CS) cytology to liquid-based cytology (LBC) in thyroid fine-needle aspiration (FNA) has been a subject of debate, with varying reports on diagnostic performance. This retrospective observational study evaluates this institution's 5-year experience with LBC in thyroid cytology from 2020 to 2024, comparing its advantages and results with past experience using CS combined with rapid on-site assessment (ROSE) from 2016 to 2018, and correlating cytological diagnoses with histopathological outcomes.</p> </section> <section> <h3> Methods</h3> <p>We performed a retrospective analysis of all thyroid FNAs processed and reported at the cytopathology department of Cleveland Clinic Abu Dhabi—National Reference Laboratory (CCAD/NRL) using the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). A total of 741 nodules were aspirated from January 2016 to May 2018 using primarily conventional smears with the routine practice of ROSE (pre-LBC), while 4993 nodules were aspirated via LBC (ThinPrep) between July 2020 and September 2024 without ROSE (post-LBC). Cases with subsequent surgical resection were reviewed and correlated with the pre-operative cytology diagnosis to assess diagnostic accuracy. Data analysis before and after transitioning to LBC was performed to compare diagnostic performance, Bethesda category distribution, and surgical outcomes.</p> </section> <section> <h3> Results</h3> <p>LBC was associated with improved pre-analytical standardization, with nondiagnostic rates stabilizing at 10.8% compared with 4%–7% during the pre-LBC period when ROSE was routinely used. The atypia of undetermined significance (AUS; Bethesda III) rate significantly decreased from 16% pre-LBC to 7% post-LBC, with architectural atypia alone comprising 3% post-LBC. Histologic correlation was available for 199 pre-LBC and 258 post-LBC nodules. Pre-LBC cytology demonstrated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 80.8%, 95.1%, 93.3%, and 85.3%, respectively. Post-LBC metrics improved to 92.3% sensitivity and PPV, and 98.8% specificity and NPV. Among Bethesda II nodules, the false-negative rate decreased from 14.3% pre-LBC to 2.3% post-LBC. AUS nodules with nuclear atypia demonstrated a 92.3% malignancy rate post-LBC, compared to 40.4% in unstratified AUS cases pre-LBC. Oncocytic cell-rich indeterminate nodules were predominantly benign in both cohorts.</p> </section> <section> <h3> Conclusion</h3> <p>LBC is associated with several practical advantages over CS in thyroid cytology. In addition to streamlining and standa
背景:甲状腺细针穿刺(FNA)从传统涂片(CS)细胞学到液体细胞学(LBC)的转变一直是一个有争议的话题,对诊断表现有不同的报道。本回顾性观察性研究评估了该机构从2020年到2024年5年甲状腺细胞学LBC的经验,比较了其优势和结果与以往2016年至2018年使用CS联合快速现场评估(ROSE)的经验,并将细胞学诊断与组织病理学结果相关联。方法:我们使用Bethesda甲状腺细胞病理学报告系统(TBSRTC)对克利夫兰诊所阿布扎比国家参考实验室(CCAD/NRL)细胞病理学部门处理和报告的所有甲状腺FNAs进行回顾性分析。2016年1月至2018年5月,共有741个结节通过常规涂片与ROSE (LBC前)进行抽吸,而在2020年7月至2024年9月期间,4993个结节通过LBC (ThinPrep)进行抽吸,未进行ROSE (LBC后)。我们回顾了手术切除的病例,并将其与术前细胞学诊断相关联,以评估诊断的准确性。转换为LBC前后进行数据分析,比较诊断性能、Bethesda分类分布和手术结果。结果:LBC与改进的分析前标准化相关,未诊断率稳定在10.8%,而常规使用ROSE时,LBC前的未诊断率为4%-7%。未确定意义的异型性(AUS; Bethesda III)率从lbc前的16%显著下降到lbc后的7%,仅建筑异型性占lbc后的3%。199例lbc前结节和258例lbc后结节具有组织学相关性。lbc前细胞学检测的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为80.8%、95.1%、93.3%和85.3%。lbc后的指标提高到92.3%的敏感性和PPV, 98.8%的特异性和NPV。在Bethesda II型结节中,假阴性率从lbc前的14.3%下降到lbc后的2.3%。合并核非典型性的AUS结节在lbc后的恶性肿瘤发生率为92.3%,而未分层的AUS患者在lbc前的恶性肿瘤发生率为40.4%。在两个队列中,富含嗜瘤细胞的不确定结节主要是良性的。结论:在甲状腺细胞学检查中,LBC与CS相比具有几个实际优势。除了简化和标准化诊断工作流程外,它还显著有助于提高诊断准确性。我们观察到AUS率显著下降,减少了解释的不确定性,并增强了对核非典型性恶性肿瘤的检测。这些发现证实了Bethesda对不确定细胞学进行更细粒度分类的建议。非诊断率在lbc后略有上升,这是ROSE停药的可预测效果。然而,这种适度的增长被LBC在工作流程效率和整体诊断准确性方面的巨大收益所抵消。这种长期的经验强化了LBC作为甲状腺FNA评估和更好的风险分层的可靠和有效的方法。
{"title":"Fine Needle Aspiration of Thyroid Nodules: From Conventional Smears to Liquid-Based Cytology—The 8-Year Cleveland Clinic Abu Dhabi Experience","authors":"Ayoub Nahal","doi":"10.1002/dc.70072","DOIUrl":"10.1002/dc.70072","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The transition from conventional smear (CS) cytology to liquid-based cytology (LBC) in thyroid fine-needle aspiration (FNA) has been a subject of debate, with varying reports on diagnostic performance. This retrospective observational study evaluates this institution's 5-year experience with LBC in thyroid cytology from 2020 to 2024, comparing its advantages and results with past experience using CS combined with rapid on-site assessment (ROSE) from 2016 to 2018, and correlating cytological diagnoses with histopathological outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We performed a retrospective analysis of all thyroid FNAs processed and reported at the cytopathology department of Cleveland Clinic Abu Dhabi—National Reference Laboratory (CCAD/NRL) using the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). A total of 741 nodules were aspirated from January 2016 to May 2018 using primarily conventional smears with the routine practice of ROSE (pre-LBC), while 4993 nodules were aspirated via LBC (ThinPrep) between July 2020 and September 2024 without ROSE (post-LBC). Cases with subsequent surgical resection were reviewed and correlated with the pre-operative cytology diagnosis to assess diagnostic accuracy. Data analysis before and after transitioning to LBC was performed to compare diagnostic performance, Bethesda category distribution, and surgical outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;LBC was associated with improved pre-analytical standardization, with nondiagnostic rates stabilizing at 10.8% compared with 4%–7% during the pre-LBC period when ROSE was routinely used. The atypia of undetermined significance (AUS; Bethesda III) rate significantly decreased from 16% pre-LBC to 7% post-LBC, with architectural atypia alone comprising 3% post-LBC. Histologic correlation was available for 199 pre-LBC and 258 post-LBC nodules. Pre-LBC cytology demonstrated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 80.8%, 95.1%, 93.3%, and 85.3%, respectively. Post-LBC metrics improved to 92.3% sensitivity and PPV, and 98.8% specificity and NPV. Among Bethesda II nodules, the false-negative rate decreased from 14.3% pre-LBC to 2.3% post-LBC. AUS nodules with nuclear atypia demonstrated a 92.3% malignancy rate post-LBC, compared to 40.4% in unstratified AUS cases pre-LBC. Oncocytic cell-rich indeterminate nodules were predominantly benign in both cohorts.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;LBC is associated with several practical advantages over CS in thyroid cytology. In addition to streamlining and standa","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"54 3","pages":"219-229"},"PeriodicalIF":1.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145818517","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}
引用次数: 0
Neutrophil Cannibalism by Tumor Cells in Squamous Cell Carcinoma: Cytologic Features and Clinical Implications. 鳞状细胞癌肿瘤细胞嗜中性粒细胞相食:细胞学特征和临床意义。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-12-16 DOI: 10.1002/dc.70071
Sophia Zhang, Jan F Silverman

Neutrophil cannibalism or engulfment by tumor cells is a feature often associated with aggressive malignancies. Although metastatic squamous cell carcinoma is commonly diagnosed by fine needle aspiration cytology, there are only rare reports of neutrophil cannibalism by squamous cell carcinoma in current cytology literature. We present two cases of metastatic squamous cell carcinoma featuring prominent neutrophil cannibalism diagnosed by fine needle aspiration cytology, describe their unique cytologic features, and discuss the prognostic implications of this diagnosis.

嗜中性粒细胞相食或被肿瘤细胞吞噬是侵袭性恶性肿瘤的特征。虽然转移性鳞状细胞癌通常通过细针穿刺细胞学诊断,但在目前的细胞学文献中,只有罕见的鳞状细胞癌嗜中性粒细胞食人的报道。我们报告两例通过细针穿刺细胞学诊断为嗜中性粒细胞相食的转移性鳞状细胞癌,描述其独特的细胞学特征,并讨论这种诊断的预后意义。
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引用次数: 0
When the Rare Becomes Rarer: Metastasis of Epithelioid Malignant Peripheral Nerve Sheath Tumor (MPNST) to Lymph Node and Pleural Fluid 当罕见变得更罕见:上皮样恶性周围神经鞘瘤(MPNST)转移到淋巴结和胸膜液。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-12-16 DOI: 10.1002/dc.70070
Nitika Gupta, Nilay Nishith, Pranab Dey

Epithelioid malignant peripheral nerve sheath tumor (MPNST) is a rare and aggressive soft tissue sarcoma variant, seldom presenting with lymph node or pleural metastasis. We report a rare instance of a 22-year-old female with recurrent epithelioid MPNST metastasizing to cervical lymph nodes and pleural fluid—a phenomenon rarely documented in literature. Clinical history, cytomorphological assessment, and immunohistochemistry were pivotal in establishing the diagnosis. This case underscores the diagnostic complexity and extreme rarity of epithelioid MPNST metastasizing to serous cavities.

上皮样恶性周围神经鞘瘤是一种罕见的侵袭性软组织肉瘤,很少表现为淋巴结或胸膜转移。我们报告一例罕见的22岁女性复发性上皮样MPNST转移到颈部淋巴结和胸膜液,这一现象在文献中很少有记载。临床病史,细胞形态学评估和免疫组织化学是建立诊断的关键。本病例强调了上皮样MPNST转移到浆液腔的诊断复杂性和极端罕见性。
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引用次数: 0
The New WHO Lung Cytopathology Reporting System in Practice: Diagnostic Performance and Risk of Malignancy in a Tertiary Care Setting 新的世卫组织肺细胞病理学报告系统在实践:诊断性能和恶性肿瘤的风险在三级保健设置。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2025-12-14 DOI: 10.1002/dc.70068
Shalini Bhalla, Mahak Lamba, Mamta Dwivedi, Shivanjali Raghuvanshi, Malti kumari Maurya, Madhu Kumar

Background

Respiratory cytology plays a vital role in the early diagnosis of pulmonary diseases, particularly lung cancer, which remains a leading cause of cancer-related mortality worldwide. To enhance standardization and reduce inter-observer variability in lung cytology reporting, the World Health Organization (WHO), in collaboration with the IAC and IARC, introduced a new five-tiered reporting system for lung cytopathology in 2023. This study aims to retrospectively apply the WHO system to respiratory samples at a tertiary care center in India and evaluate diagnostic performance and risk of malignancy (ROM) for each category.

Material and Methods

A retrospective observational study was conducted from June 2022 to May 2024, analyzing 736 respiratory cytology samples, including BAL, EBUS-TBNA, bronchial wash, bronchial brush, and sputum. Samples were reclassified using the WHO system, and 193 cases had histopathological correlation. ROM was calculated for each category, and diagnostic performance metrics sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (DA) were assessed using histopathology as the gold standard. Given that histologic correlation was available in only 26.2% of cases, diagnostic performance estimates were interpreted with caution and may have been influenced by verification bias.

Results

Of the total cases, 10.2% (75/736) were insufficient/inadequate, 80.1% (589/736) benign, 3.0% (22/736) atypical, 2.0% (15/736) suspicious, and 4.7% (35/736) malignant. The ROM was 43.7% for insufficient, 39.7% for benign, 50.0% for atypical, 75.0% for suspicious, and 100% for malignant. Bronchial brush demonstrated the highest DA (81.3%), while BAL had low sensitivity (10.0%) despite high specificity (98.5%). EBUS-TBNA showed moderate sensitivity (50.0%) and lower specificity (55.6%).

Conclusion

The WHO Reporting System provides an effective framework for stratifying respiratory cytology samples. While categories such as malignant and suspicious showed high diagnostic reliability, false negatives in benign and inadequate categories highlight the need for integrated clinical and radiological assessment. Bronchial brush and wash emerged as the most diagnostically accurate specimen types. Further prospective studies are warranted to validate these findings across broader clinical settings.

背景:呼吸细胞学在肺部疾病,特别是肺癌的早期诊断中起着至关重要的作用,肺癌仍然是世界范围内癌症相关死亡的主要原因。为了加强肺细胞学报告的标准化并减少观察者之间的差异,世界卫生组织(世卫组织)与国际咨询委员会和国际癌症研究机构合作,于2023年推出了肺细胞病理学新的五层报告系统。本研究旨在回顾性地将世卫组织系统应用于印度一家三级保健中心的呼吸样本,并评估每个类别的诊断表现和恶性肿瘤(ROM)风险。材料与方法:回顾性观察研究于2022年6月至2024年5月进行,分析736例呼吸细胞学样本,包括BAL、EBUS-TBNA、支气管洗涤、支气管刷和痰液。使用WHO系统对样本进行重新分类,193例具有组织病理学相关性。计算每个类别的ROM,并以组织病理学为金标准评估诊断性能指标敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和诊断准确性(DA)。考虑到组织学相关性仅在26.2%的病例中可用,诊断性能评估被谨慎解释,可能受到验证偏差的影响。结果:不足/不充分占10.2%(75/736),良性占80.1%(589/736),非典型占3.0%(22/736),可疑占2.0%(15/736),恶性占4.7%(35/736)。ROM不足43.7%,良性39.7%,不典型50.0%,可疑75.0%,恶性100%。支气管刷的DA最高(81.3%),BAL的敏感性低(10.0%),但特异性高(98.5%)。EBUS-TBNA敏感性中等(50.0%),特异性较低(55.6%)。结论:世卫组织报告系统为呼吸道细胞学样本分层提供了一个有效的框架。虽然恶性和可疑等类别显示出较高的诊断可靠性,但良性和不充分类别的假阴性突出了综合临床和放射学评估的必要性。支气管刷检和洗检是诊断最准确的标本类型。进一步的前瞻性研究有必要在更广泛的临床环境中验证这些发现。
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引用次数: 0
期刊
Diagnostic Cytopathology
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