Diagnostic Cytopathology最新文献

This report introduces Dr. Sara E. Monaco, the incoming President-Elect of the American Society of Cytopathology (ASC) and System Director of Cytopathology at Geisinger Medical Center. Dr. Monaco has provided significant mentorship to me over the years and facilitated the development of my passion for cytopathology and education.

Pancreatic medullary carcinoma is an extremely rare tumor classified as a histological subtype of pancreatic ductal adenocarcinoma. We report a case of a pancreatic medullary carcinoma and describe its cytological features. A 75-year-old woman presented with lower back pain, epigastric discomfort, and a tumor-like lesion in the pancreatic body. Cytologic specimens obtained via endoscopic ultrasound-guided fine-needle aspiration revealed relatively uniform small round cells with a high nuclear-to-cytoplasmic ratio, appearing as isolated scattered cells or loosely aggregated small clusters in a bloody background containing mature lymphocytes. Histological examination showed cells similar to those observed in the cytological smear, and molecular testing revealed wild-type KRAS and high microsatellite instability. Consequently, the patient was diagnosed with pancreatic medullary carcinoma. To our knowledge, only 33 cases of pancreatic medullary carcinoma have been reported to date, and this is the first report to describe its cytological features.

Over four decades, Korea has advanced from a limited cytology service to a global model of digital and AI-integrated cytopathology. Since the founding of the Korean Society for Cytopathology (KSC) in 1986, a nationwide framework has been established—encompassing standardized practices, systematic education for specialists and cytotechnologists, and nationwide cervical screening through the National Cancer Control Program. A mandatory Quality Assurance Program (QAP) launched in 2005 ensured consistent diagnostic quality, achieving an unsatisfactory Pap test rate below 0.2% and cytology–histology discrepancy under 0.6% among over 10 million annual examinations. The 2021 STANBAI project digitized two decades of QAP slides into a standardized whole-slide image (WSI) archive, driving the development of multiple AI models. In parallel, the CytoAcademy web/mobile platform enabled interactive WSI-based education and global participation by over 200 institutions. Korea has also shared this model internationally through on-site and virtual programs in low-resource countries. By integrating national QA, digital infrastructure, AI innovation, and global training, Korea has built a future-ready cytopathology ecosystem—enhancing diagnostic precision and offering a scalable blueprint for global implementation.

NUT carcinoma (NC) is a rare and highly aggressive type of poorly differentiated carcinoma that originates from undefined anatomical sites, primarily in midline structures of the upper respiratory tract. We report the case of a male patient in his fifth decade of life who is a non-smoker. He presented with symptoms of dyspnea and cough, and had previously been treated for an atypical infectious process. A PET scan revealed a right pulmonary hilar mass alongside pathological lymphadenopathy. An endobronchial ultrasound-guided fine needle aspiration (EBUS-FNA) of the subcarinal lymph node was performed, followed by a cytomorphological evaluation in situ (Rapid On-Site Evaluation-ROSE) for sample management. The smear showed high hypercellularity with loosely cohesive cells arranged mostly in a single-cell pattern, exhibiting a poorly differentiated appearance. Immunohistochemical studies on the cell block indicated nuclear positivity for NUT expression, confirming the diagnosis of pulmonary NC. Poorly differentiated high-grade neoplasms in middle-aged patients present a significant challenge when the tumor sample is limited. The cytopathologist's role is to optimize the available material for a complete and accurate diagnosis, which is essential for appropriate treatment.