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Commentary on “Benchtop fine needle aspirations: An untapped source of cytologic educational material” 关于 "台式细针抽吸术:尚未开发的细胞学教材来源"。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-30 DOI: 10.1002/dc.25362
Divyanshu Mohan Arya MBBS, Shruti Gupta MD, Gargi Kapatia MD, Niraj Kumari MD
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引用次数: 0
A six-year comprehensive review of eye cytology cases received at a tertiary level hospital 对一家三级医院接诊的眼部细胞学病例进行六年全面回顾。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-29 DOI: 10.1002/dc.25341
Courtney F. Connelly MD, Niyati Desai MD, Adela Cimic MD, Abel A. Gonzalez MD, Swikrity Upadhyay Baskota MBBS, MD

Background

Ocular cytology is an effective method of diagnosing infective, benign, and malignant ocular disease processes due to easy accessibility and rapid turnaround time. However, these specimens pose significant diagnostic challenges due to rarity of the specimen type, sparse diagnostic material available for ancillary workup, and unfamiliarity of the diagnostic entities by the cytopathologist.

Methods

This study conducted a 6-year comprehensive review of 65 eye cytology cases received at a tertiary level hospital. Cytopathologic diagnoses of “negative for malignancy” and “atypical” were categorized as negative findings (70.8%, n = 46) and diagnoses of “suspicious for malignancy” and “positive for malignancy” were categorized as positive findings (23.1%, n = 15). A 44.6% (n = 29) of cases had subsequent histopathology and/or flow cytometry diagnoses. Premalignant and malignant lesions detected on histopathology were considered as significant findings. Statistical analysis was performed to evaluate the concordance of ocular cytology with associated histopathology and/or flow cytometry diagnoses.

Results

The accuracy of final cytology-histopathology and/or cytology-flow cytometry diagnoses in this cohort of cases is 86.2%. The sensitivity and specificity of ocular diagnosis by cytology are 66.6% and 100%, respectively. The positive and negative predictive values of ocular diagnosis by cytology are 100% and 80.9%, respectively.

Conclusion

Ocular cytology is a fast, effective, and sensitive method for diagnosing ocular pathology specimens. Familiarity with these specimen types by cytopathologists can help in diagnosing ocular diseases effectively on small, challenging cytologic preparations.

背景:眼部细胞学是诊断感染性、良性和恶性眼部疾病过程的一种有效方法,因为它易于获取且周转时间快。然而,由于标本类型罕见、用于辅助检查的诊断材料稀少以及细胞病理学家对诊断实体不熟悉,这些标本给诊断带来了巨大挑战:本研究对一家三级甲等医院接诊的 65 例眼部细胞学病例进行了为期 6 年的全面回顾。细胞病理学诊断为 "恶性肿瘤阴性 "和 "非典型 "的为阴性结果(70.8%,n = 46),诊断为 "恶性肿瘤可疑 "和 "恶性肿瘤阳性 "的为阳性结果(23.1%,n = 15)。44.6%的病例(n = 29)随后进行了组织病理学和/或流式细胞术诊断。组织病理学检测出的恶性肿瘤前病变和恶性病变被视为重要发现。统计分析评估了眼部细胞学与相关组织病理学和/或流式细胞术诊断的一致性:结果:在这批病例中,细胞学-组织病理学和/或细胞学-流式细胞术最终诊断的准确率为86.2%。细胞学眼部诊断的敏感性和特异性分别为66.6%和100%。细胞学眼部诊断的阳性预测值为100%,阴性预测值为80.9%:眼部细胞学是诊断眼部病理标本的一种快速、有效和灵敏的方法。细胞病理学家对这些标本类型的熟悉有助于在小的、具有挑战性的细胞学制剂上有效地诊断眼部疾病。
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引用次数: 0
Diagnostic accuracy and clinical impact of renal biopsy cytology 肾活检细胞学的诊断准确性和临床影响。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-27 DOI: 10.1002/dc.25357
Hongzhi Xu MD, PhD, Ian A. Taylor-Cho BA, Xiaoyin “Sara” Jiang MD, Wen-Chi Foo MD

Background

The role of fine needle biopsy cytology in the workup of renal mass lesions remains controversial. With advances in imaging technology and clinical management for renal masses, a critical reevaluation of the role of renal biopsy is needed. This study was designed to provide a comprehensive evaluation of the performance and clinical impact of fine needle biopsy in patients with renal masses.

Methods

A 5-year retrospective study of ultrasound or computer tomography (CT)-guided fine needle biopsies of renal masses diagnosed via cytopathology was conducted. Overall diagnostic rate, sensitivity, and diagnostic accuracy were calculated. Further analysis of the impact of fine needle biopsy cytology on clinical management was performed.

Results

A total of 227 cases of fine-needle aspiration and/or biopsy (FNA/B) of renal masses were identified, including 76 with subsequent nephrectomies. Complications were rare (<1%). The diagnostic rate and sensitivity of FNA/B were 83.3% and 89.5%, respectively. Diagnostic accuracy was 98.7% at the major categorical level and 94.7% at the tumor subtype level. Subsequent clinical actions were associated with a definitive cytologic diagnosis of malignancy/neoplasia (p < .05) and were affected by tumor subtype (p < .05).

Conclusion

This study demonstrates that FNA/B of renal masses is a safe and reliable minimally invasive diagnostic tool with excellent accuracy in confirmation of malignancy and subclassification of tumors. Diagnoses made on FNA/B play a key role in guiding a personalized clinical treatment plan.

背景:细针活检细胞学在肾脏肿块病变检查中的作用仍存在争议。随着成像技术和肾脏肿块临床治疗的进步,需要对肾脏活检的作用进行重新评估。本研究旨在全面评估肾肿块患者细针活检的效果和临床影响:对通过细胞病理学诊断的肾肿块进行超声或计算机断层扫描(CT)引导的细针活检进行了一项为期 5 年的回顾性研究。研究计算了总体诊断率、敏感性和诊断准确性。进一步分析了细针活检细胞学对临床治疗的影响:结果:共发现 227 例肾脏肿块细针穿刺和/或活检(FNA/B)病例,其中 76 例随后进行了肾切除术。并发症极少发生(结论:该研究表明,肾肿块的 FNA/B 切除术是一种有效的治疗方法:本研究表明,肾肿块 FNA/B 是一种安全可靠的微创诊断工具,在确认恶性肿瘤和肿瘤亚分类方面具有极高的准确性。FNA/B 诊断在指导个性化临床治疗方案方面发挥着关键作用。
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引用次数: 0
TRPS1 function beyond breast: A retrospective immunohistochemical study on non-breast cytology specimens TRPS1 在乳腺之外的功能:对非乳腺细胞学标本的回顾性免疫组化研究。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-25 DOI: 10.1002/dc.25359
Amr Ali MBBCH, Saroja Geetha MBBS, Dongling Wu MD, Karen Chau CT, Priyanka Karam MD, Seema Khutti MD, Silvat-Sheik Fayyaz MD, Kasturi Das MD, Cecilia Gimenez MD, Oana C. Rosca MD

Introduction

Trichorhinophalangeal syndrome type 1 (TRPS1) has emerged as a reliable immunohistochemistry (IHC) marker for identifying breast origin in metastatic carcinomas. This study investigates the utility of TRPS1 IHC in non-breast cytology specimens.

Materials and Methods

A retrospective search of our pathology database for the year 2021 identified fluids (pleural and peritoneal) and liver, lung and bone fine needle aspirations (FNAs) with surgical follow-up confirming non-breast metastatic carcinomas. Cell blocks from cases with sufficient neoplastic cells underwent immunostaining using a rabbit polyclonal antibody against human TRPS1. Cases lacking tumor on deeper levels after the original work-up were excluded from the study. Two pathologists independently interpreted the TRPS1 staining.

Results

Of 136 cases assessed, 31 (22.79%) exhibited positive TRPS1 staining, while 105 (77.21%) were nonreactive. Positivity rates were observed in tumors of Mullerian cell origin, gastrointestinal tract (GIT), and lung origin at 28.85%, 25%, and 21.57%, respectively. Of the tumors of Mullerian cell origin 10 (66.67%) were serous carcinomas, 4 (26.67%) were endometrioid carcinomas, and one (6.67%) was a clear cell carcinoma. Lung tumors comprised seven (63.64%) squamous cell carcinomas and four (36.36%) adenocarcinomas, while the gastrointestinal tumors consisted of 14 (80%) adenocarcinomas and one (20%) squamous cell carcinoma.

Conclusions

Although recognized as a sensitive marker for mammary carcinomas, TRPS1 immunostaining was also detected in Mullerian, lung, and GIT carcinomas. This highlights the significance of being cautious when depending solely on TRPS1 immunostaining to distinguish metastatic breast tumors.

简介:毛细血管畸形综合征 1 型(TRPS1)已成为一种可靠的免疫组化(IHC)标记物,可用于鉴别转移性癌的乳腺来源。本研究探讨了 TRPS1 IHC 在非乳腺细胞学标本中的应用:通过回顾性检索我们的病理数据库,确定了 2021 年的体液(胸膜和腹膜)以及肝、肺和骨细针抽吸术(FNA),并通过手术随访确认了非乳腺转移癌。对有足够肿瘤细胞的病例的细胞块进行免疫染色,使用的是针对人类 TRPS1 的兔多克隆抗体。最初检查后发现深层缺乏肿瘤的病例不在研究范围内。两名病理学家独立解读TRPS1染色结果:在评估的 136 例病例中,31 例(22.79%)显示 TRPS1 染色阳性,105 例(77.21%)无反应。穆勒细胞源肿瘤、胃肠道(GIT)肿瘤和肺源肿瘤的阳性率分别为28.85%、25%和21.57%。在穆勒氏细胞源性肿瘤中,10 例(66.67%)为浆液性癌,4 例(26.67%)为子宫内膜样癌,1 例(6.67%)为透明细胞癌。肺部肿瘤包括 7 例(63.64%)鳞状细胞癌和 4 例(36.36%)腺癌,而胃肠道肿瘤包括 14 例(80%)腺癌和 1 例(20%)鳞状细胞癌:结论:尽管TRPS1被认为是乳腺癌的敏感标记物,但在穆勒氏癌、肺癌和消化道癌中也检测到了TRPS1免疫染色。这强调了仅依靠TRPS1免疫染色来鉴别转移性乳腺肿瘤的重要性。
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引用次数: 0
Verifying a novel bile cytology scoring system 验证新型胆汁细胞学评分系统
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-24 DOI: 10.1002/dc.25358
Chie Hayakawa CT, IAC, Masahiro Hoshikawa MD, Johji Imura MD, FIAC, Takahiko Ueno PhD, Junki Koike MD

Background

The scoring system for bile cytology (SSBC) aims to improve bile cytology diagnostic accuracy. Here, the practicality of SSBC was verified by multiple cytotechnologists.

Methods

Bile cytological specimens were evaluated by 24 cytotechnologists using SSBC. The samples were assessed before using the SSBC (first-time assessment) according to three categories: benign, indeterminate, and malignant. A first scoring evaluation (FSE) was then performed using SSBC; each item in the scoring system was classified as present or absent. After distributing an instruction sheet with diagnostic criteria, a second scoring evaluation (SSE) was performed using SSBC. Each method was evaluated using diagnostic accuracy and interobserver and intraobserver agreement.

Results

Several samples were assessed as indeterminate in the first-time assessment. Although the specificity of the SSE improved, the sensitivity and accuracy decreased compared with those of the FSE. The overall interobserver agreement was fair for all parameters, including abnormal chromatin, irregular internuclear distances, irregularly overlapped nuclei, irregular cluster margins, and final evaluation in the FSE and SSE. The final evaluation by histological type exhibited slight agreement for well-differentiated tubular adenocarcinoma and almost perfect agreement for poorly differentiated tubular adenocarcinoma in the FSE and SSE. For moderately differentiated tubular adenocarcinoma, agreement was moderate in the FSE and fair in the SSE. For cholangitis, a slight agreement was observed in the FSE, which improved to fair in the SSE.

Conclusions

Although the SSBC is expected to improve specificity, there exists ambiguity regarding SSBC criteria and interindividual assessment differences. Therefore, the objective assessment method should be revised.

背景:胆汁细胞学评分系统(SSBC)旨在提高胆汁细胞学诊断的准确性。在此,多名细胞技术专家对 SSBC 的实用性进行了验证:方法:24 位细胞技术专家使用 SSBC 对胆汁细胞学标本进行评估。样本在使用 SSBC 之前按照良性、不确定和恶性三个类别进行评估(首次评估)。然后使用 SSBC 进行首次评分评估(FSE);评分系统中的每个项目都被划分为存在或不存在。在分发了包含诊断标准的说明单后,使用 SSBC 进行了第二次评分评估(SSE)。对每种方法的诊断准确性以及观察者之间和观察者内部的一致性进行了评估:结果:有几个样本在第一次评估中被评为不确定样本。与 FSE 相比,虽然 SSE 的特异性有所提高,但灵敏度和准确性却有所下降。在所有参数方面,包括染色质异常、核间距离不规则、核重叠不规则、核团边缘不规则以及 FSE 和 SSE 的最终评估,观察者之间的总体一致性尚可。在 FSE 和 SSE 中,按组织学类型进行的最终评估对分化良好的管状腺癌显示出轻微的一致性,而对分化不良的管状腺癌则显示出几乎完全的一致性。对于中度分化的肾小管腺癌,在 FSE 中的一致性为中等,在 SSE 中的一致性为一般。至于胆管炎,在 FSE 中观察到轻微的一致性,而在 SSE 中则改善为一般:尽管 SSBC 可望提高特异性,但 SSBC 标准和个体间评估差异仍存在不确定性。因此,应修订客观评估方法。
{"title":"Verifying a novel bile cytology scoring system","authors":"Chie Hayakawa CT, IAC,&nbsp;Masahiro Hoshikawa MD,&nbsp;Johji Imura MD, FIAC,&nbsp;Takahiko Ueno PhD,&nbsp;Junki Koike MD","doi":"10.1002/dc.25358","DOIUrl":"10.1002/dc.25358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The scoring system for bile cytology (SSBC) aims to improve bile cytology diagnostic accuracy. Here, the practicality of SSBC was verified by multiple cytotechnologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Bile cytological specimens were evaluated by 24 cytotechnologists using SSBC. The samples were assessed before using the SSBC (first-time assessment) according to three categories: benign, indeterminate, and malignant. A first scoring evaluation (FSE) was then performed using SSBC; each item in the scoring system was classified as present or absent. After distributing an instruction sheet with diagnostic criteria, a second scoring evaluation (SSE) was performed using SSBC. Each method was evaluated using diagnostic accuracy and interobserver and intraobserver agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several samples were assessed as indeterminate in the first-time assessment. Although the specificity of the SSE improved, the sensitivity and accuracy decreased compared with those of the FSE. The overall interobserver agreement was fair for all parameters, including abnormal chromatin, irregular internuclear distances, irregularly overlapped nuclei, irregular cluster margins, and final evaluation in the FSE and SSE. The final evaluation by histological type exhibited slight agreement for well-differentiated tubular adenocarcinoma and almost perfect agreement for poorly differentiated tubular adenocarcinoma in the FSE and SSE. For moderately differentiated tubular adenocarcinoma, agreement was moderate in the FSE and fair in the SSE. For cholangitis, a slight agreement was observed in the FSE, which improved to fair in the SSE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the SSBC is expected to improve specificity, there exists ambiguity regarding SSBC criteria and interindividual assessment differences. Therefore, the objective assessment method should be revised.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086596","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
Special issue: “A case of…” 特刊:"一个......的案例"。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-23 DOI: 10.1002/dc.25356
Poonam Vohra MD, Swikrity Baskota MD, Zubair Baloch MD
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引用次数: 0
Education and diversity in cytopathology: Past, present, and future 细胞病理学的教育与多样性:过去、现在和未来。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-18 DOI: 10.1002/dc.25342
Valerie A. Fitzhugh MD, Jordan P. Reynolds MD, Melina Flanagan MD, MSPH, Ronald Balassanian MD

Diversity, equity, and inclusion is a powerful goal which many of us strive toward in medicine, both in patient care and administrative leadership. As the world evolves, the practice of medicine must evolve with it. We are cognizant of the importance of the history of our medical specialties. If we do not acknowledge all parts of our history, we are doomed to repeat it. This special issue is unique and unlike anything that has previously been published in Diagnostic Cytopathology. This issue looks at some of the history of cytopathology. This historical review is followed by some of the present state of cytopathology. There are insights into global cytopathology. The final portion of this issue examines the critical need for cytotechnology schools in the United States. All of these areas are critical to the past, present, and future of cytopathology.

多元化、公平和包容是我们许多人在医学领域努力实现的一个强大目标,无论是在患者护理方面还是在行政领导方面。随着世界的发展,医学实践也必须与时俱进。我们认识到医学专业历史的重要性。如果我们不承认历史的所有部分,就注定要重蹈覆辙。本特刊独一无二,不同于以往在《细胞病理学诊断》上发表的任何文章。本期特刊回顾了细胞病理学的部分历史。历史回顾之后是细胞病理学的现状。本期还对全球细胞病理学进行了深入探讨。本期最后一部分探讨了美国对细胞技术学校的迫切需求。所有这些领域对于细胞病理学的过去、现在和未来都至关重要。
{"title":"Education and diversity in cytopathology: Past, present, and future","authors":"Valerie A. Fitzhugh MD,&nbsp;Jordan P. Reynolds MD,&nbsp;Melina Flanagan MD, MSPH,&nbsp;Ronald Balassanian MD","doi":"10.1002/dc.25342","DOIUrl":"10.1002/dc.25342","url":null,"abstract":"<p>Diversity, equity, and inclusion is a powerful goal which many of us strive toward in medicine, both in patient care and administrative leadership. As the world evolves, the practice of medicine must evolve with it. We are cognizant of the importance of the history of our medical specialties. If we do not acknowledge all parts of our history, we are doomed to repeat it. This special issue is unique and unlike anything that has previously been published in Diagnostic Cytopathology. This issue looks at some of the history of cytopathology. This historical review is followed by some of the present state of cytopathology. There are insights into global cytopathology. The final portion of this issue examines the critical need for cytotechnology schools in the United States. All of these areas are critical to the past, present, and future of cytopathology.</p>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956407","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
Commentary on “Fusion of old and new: Employing touch imprint slides for next-generation sequencing in solid tumors” 关于 "新旧融合:在实体瘤的下一代测序中采用触摸印记切片 "的评论。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-13 DOI: 10.1002/dc.25355
Archit Goel MBBS, Gargi Kapatia MD, DNB, PDCC, Brijdeep Singh MD, PDCC, Vandana Sharma MS
{"title":"Commentary on “Fusion of old and new: Employing touch imprint slides for next-generation sequencing in solid tumors”","authors":"Archit Goel MBBS,&nbsp;Gargi Kapatia MD, DNB, PDCC,&nbsp;Brijdeep Singh MD, PDCC,&nbsp;Vandana Sharma MS","doi":"10.1002/dc.25355","DOIUrl":"10.1002/dc.25355","url":null,"abstract":"","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140910867","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
World Health Organization Reporting System for Soft Tissue Cytopathology: Risk of malignancy and reproducibility of categories among observers 世界卫生组织软组织细胞病理学报告系统:恶性肿瘤风险和观察者分类的可重复性。
IF 1 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY Pub Date : 2024-05-11 DOI: 10.1002/dc.25340
Lester J. Layfield MD, Leslie Dodd MD, Magda Esebua MD

Introduction

In 2024, the World Health Organization (WHO) is scheduled to publish the WHO Reporting System for Soft Tissue Cytopathology (WHORSSTC). This system establishes categories with well-defined definitions, criteria, and estimated risks of malignancy (ROMs) for soft tissue tumors. The estimates of ROM are based on a relatively small number of published studies. Interobserver reproducibility is not addressed in the reporting system even though reproducibility of a reporting system is highly important.

Methods

A manual search of one authors personal consultation files and teaching set (L.J.L.) was conducted for all cytologic specimens of soft tissue tumors accessioned between January 1, 1985 and December 31, 2022. Only cases with documented surgical pathology follow-up were included in the study. Slides from each case were evaluated independently by three cytopathologists with each case assigned to one of the WHORSSTC categories. A ROM for each of the WHORSSTC categories was calculated. Interobserver agreement was evaluated by the kappa and weighted kappa statistics.

Results

Risk for malignancy by category were: Category 1: 0%, Category 2: 28%, Category 3: 57%, Category 4: 47%, Category 5: 63%, and Category 6: 88%. Kappa statistics for agreement between raters varied from 0.2183 to 0.3465 and weighted kappa varied from 0.3778 to 0.5217.

Conclusions

The WHORSSTC showed a progression of malignancy risk from the category “benign” (28%) to the category “malignant” (88%). Interobserver agreement was only fair.

导言:世界卫生组织(WHO)计划于 2024 年发布世界卫生组织软组织细胞病理学报告系统(WHORSSTC)。该系统为软组织肿瘤建立了具有明确定义、标准和估计恶性风险 (ROM) 的类别。ROM 的估计值基于相对较少的已发表研究。尽管报告系统的可重复性非常重要,但报告系统并未涉及观察者间的可重复性:方法:对一位作者(L.J.L.)的个人会诊档案和教学资料进行人工检索,检索范围为1985年1月1日至2022年12月31日期间获得的所有软组织肿瘤细胞学标本。研究只包括有手术病理随访记录的病例。每个病例的切片均由三位细胞病理学家独立评估,并将每个病例归入WHORSSTC的一个类别。计算每个 WHORSSTC 类别的 ROM。通过卡帕和加权卡帕统计来评估观察者之间的一致性:各类恶性肿瘤的风险分别为第 1 类:0%;第 2 类:28%;第 3 类:57%;第 4 类:47%;第 5 类:63%;第 6 类:88%。评分者之间的一致性卡帕统计从 0.2183 到 0.3465 不等,加权卡帕从 0.3778 到 0.5217 不等:世界乳腺癌发病率和死亡率分类显示恶性肿瘤的风险从 "良性"(28%)上升到 "恶性"(88%)。观察者之间的一致性尚可。
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引用次数: 0
Fine needle aspiration diagnosis of benign oncocytic lesions of the head and neck associated with false positive 18F-fluorodeoxyglucose uptake on positron emission tomography scan 头颈部良性瘤细胞病变的细针穿刺诊断与正电子发射断层扫描的 18F- 氟脱氧葡萄糖摄取假阳性有关。
IF 1.3 4区 医学 Q3 Medicine Pub Date : 2024-05-07 DOI: 10.1002/dc.25331
Mahreen Hussain MD, Hafiz Ghani MD, Yasir Ali MD, Cecilia Clement MD, Ranjana Nawgiri MD

Introduction

18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT) has become the mainstay for staging and post-therapy surveillance of cancer as malignant neoplasms generally demonstrate higher FDG uptake that benign entities. However, there are certain benign lesions, most notably oncocytic tumors, that can display very high uptake and fine needle aspiration (FNA) is usually done to confirm malignancy. Therefore, it is important to recognize that benign oncocytic lesions of the head and neck may also present as FDG-avid lesions to avoid a diagnostic pitfall.

Methods

Electronic search of institutional surgical and cytopathology archives was conducted to identify cases of benign oncocytic lesions involving the head and neck region diagnosed by FNA from January 2012 to April 2022. Chart review was used to assess whether lesions were initially discovered via PET scanning.

Results

One hundred and twenty-five cases of oncocytic lesions were identified; 12 (9%) PET positive lesions were identified in the head and neck region from patients being evaluated for metastasis or for suspicion of malignancy. Cytopathology of all 12 cases demonstrated benign oncocytic lesions; eight (67%) of these cases were consistent with Warthin tumor, one (8.3%) was a benign oncocytic lesion, and one (8.3%) was consistent wit a parathyroid adenoma. Most (58%) of the PET-positive lesions were in parotid region, two from thyroid gland (17%), one from submandibular gland (8%), one from paratracheal area (8%). The PET scan SUVs ranged from 3.3 to 19.5 g mL−1.

Conclusions

Oncocytic lesions including Warthin tumors can result in false-positive FDG uptake on PET scans. Clinicians and cytopathologists should be aware of PET-positive benign oncocytic head and neck lesions.

导言:正电子发射断层扫描/计算机断层扫描(PET/CT)显示的 18F-氟脱氧葡萄糖(FDG)摄取量已成为癌症分期和治疗后监测的主要方法,因为恶性肿瘤通常比良性肿瘤显示更高的 FDG 摄取量。不过,某些良性病变(最明显的是肿瘤细胞瘤)也会显示很高的摄取率,通常需要进行细针穿刺(FNA)来确认是否为恶性。因此,认识到头颈部良性肿瘤细胞病变也可能表现为FDG-avid病变以避免诊断陷阱非常重要:方法: 通过电子方式搜索各机构的手术和细胞病理学档案,以确定 2012 年 1 月至 2022 年 4 月期间经 FNA 诊断为头颈部良性肿瘤细胞病变的病例。病历审查用于评估病变是否最初通过 PET 扫描发现:结果:共发现125例肿瘤细胞病变,其中12例(9%)PET阳性病变是在头颈部地区发现的,这些病变来自正在接受转移评估或怀疑有恶性肿瘤的患者。所有12个病例的细胞病理学均显示为良性肿瘤细胞病变;其中8个病例(67%)与Warthin肿瘤一致,1个病例(8.3%)为良性肿瘤细胞病变,1个病例(8.3%)与甲状旁腺腺瘤一致。PET阳性病灶大部分(58%)位于腮腺区,甲状腺2例(17%),颌下腺1例(8%),气管旁1例(8%)。PET 扫描 SUV 值介于 3.3 至 19.5 g mL-1 之间:结论:包括Warthin肿瘤在内的肿瘤细胞病变可导致PET扫描的FDG摄取假阳性。临床医生和细胞病理学家应警惕PET阳性的头颈部良性肿瘤细胞病变。
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引用次数: 0
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Diagnostic Cytopathology
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