Journal of Cytology最新文献

Background: Agriculture is vital to India's economy, with farm workers playing a crucial role. Extensive pesticide use in farming raises concerns about its potential genotoxic effects on workers. Despite India's status as an agricultural hub, research focusing on these risks remains limited. This study aims to investigate the cytogenotoxic effects of pesticides on exfoliated buccal epithelial cells using the buccal cytome assay (BMCyt).

Aim: To assess the cytogenotoxic effects of pesticides on farm workers' buccal epithelial cells and to inform healthcare strategies for this occupational hazard.

Materials and methods: A total of 128 male farm workers were divided into four groups (32 per group) based on pesticide exposure and compared with age-matched unexposed controls. Cytologic characteristics, including micronuclei (MN), karyorrhexis (KR), binucleation (BN), pyknosis (P), and karyolysis (KL), were evaluated in PAP-stained slides.

Results: The mean frequency of all nuclear anomalies was higher in the pesticide-exposed groups, with the highest observed in those exposed for over 18 years (MN: 9.28 ± 9.14, KR: 5.81 ± 7.18, KL: 15.68 ± 13.16, P: 0.71 ± 1.25, BN: 2.59 ± 2.07), followed by those with less than 18 years of exposure, while unexposed workers had the lowest anomalies. Significant intergroup and intra-group differences were found, highlighting the cumulative effects of prolonged pesticide exposure.

Conclusion: The study supports using micronuclei and other nuclear anomalies as screening tools for farm workers, advocating for periodic medical evaluations to protect their health and well-being.

Deep learning (DL) is an emerging area of artificial intelligence and has the immense potential to reshape the field of cytology. In last few decades, there are many significant progresses in the digital pathology that includes significant increase of the computational power, data storing facilities, and whole slide imaging system. These changes have facilitated the applications of DL. DL can be used in cancer screening, disease identification and classification, predicting biomarkers, prognostic assessment, molecular data interpretation, and precision medicine. There are many obstacles to implement DL. Data collection, storage, security, computational power, and medico-legal issue are the major hurdles. The proper guidelines, finance, organization, and collaboration with multiple disciplines are needed to implement DL. Till date, the majority of the cytologists are not totally aware of the potential of DL. In this review, the overview of the DL system along with its potential clinical applications has been discussed.

Background: The intra-osseous lesions of oral and maxillofacial region are mostly cystic pathologies or solid tumors which undergo cystic changes. They are diagnostically challenging to clinician due to overlapping clinical and radiographic presentations. As a preliminary diagnostic tool, fine needle aspiration cytology is indicated for these lesions. Identifying the epithelial cells is mandatory in cystic aspirates to arrive at the preoperative diagnosis and treatment plan.

Aims: The aim of the study was to detect the epithelial cells from a smear prepared before and after centrifugation of intra bony cystic aspirates.

Materials and methods: Aspirates from 15 clinically diagnosed oral cystic lesions were chosen. Totally four smears were prepared, two from non-centrifuged cystic fluid and the another two from centrifuged cystic fluid. They were stained with hematoxyline and eosin (H&E) and papanicolau (PAP) stains, the smears were assessed for the presence of epithelial cells. A comparison has been made to find out which technique and stain is appropriate for identifying epithelial cells and concordance between cytological and histopathological features.

Results: Epithelial cells were identified in smears prepared with or without centrifugation. The smears prepared after centrifugation showed presence of epithelial cells in all 15 cases. The comparison for the presence of epithelial cells using Chi-square test with and without centrifugation in PAP and H&E smears were found to be significant (P ≤ 0.001). The concordance between cytological and histopathological diagnosis was 60%.

Conclusion: The smear prepared after centrifugation of cystic fluid stained with PAP stain was more representative.

Context: Identification of nonpathogenic fungal contaminants is of utmost importance to ensure diagnostic accuracy in cytology. At times, these elements mimic pathogenic organisms and mislead the cytologist. In this study, we share our experience with the presence of various fungal contaminants in cytology slides that pose frequent diagnostic challenges.

Aim/objective: The main objective of this study was to identify nonpathogenic fungal contaminants in cytopathology specimens.

Materials and methods: Records of all cytology specimens (fluids, PAP smears, and FNA samples) received in our institute over a period of 1-year were included in the initial analysis. Fluid samples showing presence of fungal elements included non-sterile and sterile fluids such as bronchoalveolar lavage, gastric lavage, urine, CSF, synovial fluid, pleural, pericardial, and ascitic fluids. Apart from these, their presence was noted in conventional and liquid based cervical cytology specimens. Most of these cases had microbiological culture correlation. Simultaneously, the glass slides and reconstituted stains in our lab were also tested for the presence of fungi.

Statistical analysis used: The percentage of samples showing positive fungal elements was calculated.

Results: More than 11,000 cytology specimens were received over a span of 1 year in sterile containers and smears were prepared from various clinical specialities. The most common contaminants identified were Fusarium species. The second most prevalent contaminant was Alternaria, which may be causative agent of phaeohyphomycosis. Microbiological cultures of these specimens were often negative but yielded respective fungal species at other times.

Conclusion: Fungal contaminants were observed to be the most ubiquitous and mischievous imitators which can perplex the cytologists.

Background: Cytological evaluation of serous fluids is a widely used diagnostic tool, especially when other methods are not feasible. Differentiating benign from malignant effusions is essential for guiding prognosis and treatment. However, distinguishing reactive mesothelial cells from malignant cells remains a key challenge, particularly with conventional smear (CS) techniques.

Objectives: To compare the technical and cytomorphological features of serous effusion fluids using CS, cytocentrifuge smear, liquid-based cytology (LBC), and cell block (CB) preparations, and to assess the diagnostic yield of each method in detecting malignant effusions.

Materials and methods: A total of 410 serous fluid samples over a period of 2 years were processed using CS, cytocentrifuge, EziPREP^TM LBC, and CB methods. Cytological features and diagnostic utility for malignancy were compared. Statistical analysis was performed using the Wilcoxon rank-sum and Friedman's ANOVA tests.

Results: Samples comprised 277 pleural, 129 peritoneal, and four pericardial effusions. LBC provided statistically significant clearer back ground, while CS and CB provided significantly better staining quality and sharper morphological features. CB and LBC provided significantly high cellularity. Minimal overlapping of cells was significantly seen in cytocentrifuge and LBC smears. Additional yield for malignancy was 4% more by use of the CB method.

Conclusion: Each cytological method has distinct advantages. LBC offers clearer backgrounds; CSs and CBs provide better morphology. CB and LBC show higher cellularity, with CB detecting 4% more malignancies. Combining methods may enhance the diagnostic accuracy.

Background: Urinary cytology plays a pivotal role in the non-invasive diagnosis of upper tract urothelial carcinoma (UTUC), especially where histological sampling is limited or technically challenging. The second edition of the Paris System for Reporting Urinary Cytology standardizes for evaluating cytological specimens. However, in clinical practice, urinary samples obtained from the UT often contain residual contrast media (CM) due to prior imaging studies; hence, the effect of CM on urinary cytology accuracy remains unclear.

Aims: The aim of this study was to examine the impact of CM on diagnostic performance of Paris system.

Settings and design: This was a controlled in vitro laboratory study using RT112 human bladder cancer cells to model UTUC.

Materials and methods: Cells were exposed to 100%, 50%, and 30% CM. Morphology, membrane integrity, and viability were assessed through time-lapse microphotography, Trypan blue, and MTT assay. Cytology was evaluated by a cytotechnologist.

Results: CM exposure caused concentration- and time-dependent cellular degeneration. After 60 min, viability dropped to 2.0 ± 0.1% (100%), 29.0 ± 4.7% (50%), and 75.1 ± 2.0% (30%), while membrane integrity declined similarly. Trypan blue staining showed integrity of 1.6 ± 0.1%, 15.1 ± 1.6%, and 46.5 ± 2.8%, respectively. Cells treated with 100% or 50% CM were classified as atypical urothelial cells (AUC) after 1 h, while 30% CM preserved high-grade urothelial carcinoma (HGUC) features up to 6 h. However, 24-hour exposure to 30% CM led to nuclear degeneration and cytoplasmic loss, again resulting in AUC classification.

Conclusion: CM at higher concentrations and longer durations significantly compromise cellular morphology and diagnostic accuracy in urinary cytology.

Background: Metastatic involvement of the uterine cervix by extrauterine non-gynecological malignancies is exceptionally rare due to the cervix's unique lymphatic and vascular characteristics. Detection of such unusual malignancies in cervical Papanicolaou (Pap) smears poses significant diagnostic challenges but can offer critical early clues.

Objective: This study aimed to evaluate the spectrum and cytomorphological features of extrauterine nongynecological malignancies involving the cervix detected incidentally on routine cervical Pap smears.

Materials and methods: A retrospective analysis was conducted on 12,980 cervical Pap smears screened between January 2019 and December 2024 in a tertiary care center. Twenty-seven cases of extrauterine nongynecological malignancies were identified. Cytological findings were correlated with clinical, radiological, histopathological, and immunohistochemical data.

Results: The mean patient age was 54 years (range: 22-84). The most common metastatic sites were the lower gastrointestinal tract (33.3%), breast (14.8%), vagina (22.2%), and other sites, including gallbladder, urinary bladder, retroperitoneum, and hematologic malignancies. In 33.3% of cases, the Pap smear provided the first diagnostic clue for an unknown malignancy. Cytological features varied across primary sites: gastrointestinal metastases showed tall columnar cells and signet-ring morphology; breast carcinoma displayed poorly differentiated cells; and melanomas exhibited pigmented cells with prominent nucleoli. Rare diagnoses included metastatic urothelial carcinoma, anaplastic large cell lymphoma, and retroperitoneal leiomyosarcoma.

Conclusion: Although rare, extrauterine malignancies can be detected on cervical Pap smears and may even present as the first sign of disease. Awareness of subtle cytomorphological patterns, combined with clinical correlation and immunohistochemical studies, is essential to avoid misinterpretation and ensure accurate diagnosis and timely management.

Acantholytic squamous cell carcinoma (ASCC) is an uncommon variant of squamous cell carcinoma characterized by loosening of intercellular bridges. It usually involves the sun-exposed areas of the head and neck region and affects the elderly population. The histological features of ASCC have been well documented in the literature, but there is a paucity of studies on cytological features. We describe the cytological findings in the fine-needle aspiration smears of the cervical lymph node in a 70-year-old-male along with the diagnostic pitfalls.