Journal of Cytology最新文献

Background: Multiple myeloma (MM), a hematological malignancy marked by clonal plasma cells in the bone marrow, occasionally presents with myelomatous effusion-a rare condition with a median survival of <4 months. Central nervous system involvement (CNS-MM), characterized by plasma cell infiltration in the CNS, leptomeninges, or cerebrospinal fluid (CSF), is similarly rare and associated with dismal outcomes.

Aims: To analyze the plasma cell involvement in body fluids and CSF in plasma cell neoplasms, correlating these findings with treatment strategies and patient outcomes.

Materials and methods: This retrospective study was conducted in the Oncopathology Department of a tertiary state cancer institute over 10 years (2013-July 2024). It included cases of plasma cell neoplasms with confirmed involvement of body cavity fluids or CSF. Data reviewed included epidemiological profiles, biochemical and hematological findings, immunohistochemistry results, treatment regimens, and follow-up information.

Results: A total of 16 cases demonstrated neoplastic plasma cell involvement: 12 cases in pleural fluid and 4 cases in CSF. Of these, nine cases were diagnosed with MM, five cases with plasmacytoma, and two cases with plasma cell leukemia. Treatment included chemotherapy (10 patients), palliative radiotherapy (4 patients), combined palliative radiotherapy and chemotherapy (1 patient), and curative radiotherapy with chemotherapy (1 patient). Despite these interventions, the mean survival was only 2 months.

Conclusion: Myelomatous involvement of effusion fluids and CSF is associated with a grim prognosis. These findings underscore the urgent need for multidisciplinary research and the development of innovative therapeutic strategies to improve outcomes for these patients.

Background: This study investigated the determination of human papillomavirus (HPV) types in smears with and without lesions, and the sensitivity, specificity, positive predictive value, and negative predictive value of the ProExC and p16 biomarkers in smears with lesions.

Materials and methods: A total of 192 cervicovaginal smears were included in the study. ProExC (BD) and p16ink4a antibodies were applied to the lesion-containing samples by immunocytochemical method. If HPV was present, its type was determined. Patient biopsy specimens were used as a gold standard to confirm the lesion type. In addition, atypical squamous cells of undetermined significance, low-grade squamous intraepithelial lesion (SIL), atypical squamous cells, cannot exclude high-grade SIL (HSIL), and HSIL, atypical glandular cells, and the relationship between two biomarkers in cases diagnosed with squamous cell carcinoma were investigated.

Results: Of these, 192 cases included in our study, 119 had lesional smears and 73 had no lesional cells. Of the 191 cases in which HPV was investigated, 105 were negative and 86 were positive for HPV types 16, 18, and others. A statistically significant difference was found between HPV positivity and smears with lesions (P = 0.0001). p16 and ProExC positivity was extensive in cases with more severe lesions. A strong correlation was observed between high-risk HPV (+) and HSIL-detected cases.

Conclusion: ProExC and p16 are biomarkers that facilitate the diagnosis of HSIL. Nuclear staining for the ProExC marker is easier to apply to cytological samples than p16.

Background: Fine needle aspiration (FNA) cytology for salivary gland lesions is sensitive and specific for diagnosing and treating salivary gland pathologies. The objective of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is to organize the diagnostic information from the FNA into a uniform reporting terminology.

Aims: The study was conducted retrospectively to reclassify previous diagnoses into the MSRSGC categories to determine the cytohistological concordance and assess the risk stratification by calculating the risk of malignancy (ROM) for different categories.

Materials and methods: A total of 248 FNA cases of salivary gland lesions were analyzed and reclassified according to the second edition of the MSRSGC. The histological diagnosis was considered the gold standard. The ROM for each category was calculated based on 101 histopathologic follow-up cases.

Results: Of the 248 patients, 1.2% were classified as nondiagnostic, 37.9% as nonneoplastic, 1.2% as atypia of undetermined significance (AUS), 52.8% as benign neoplasm, 0.4% as uncertain malignant potential (SUMP), 0.4% as suspicious of malignancy (SFM), and 6.1% as malignant neoplasm. Histopathological correlation was available in 101 cases. The ROM was 0% for nonneoplastic lesions and benign neoplasms, and 100% for AUS, SUMP, SFM, and malignant categories. The sensitivity, specificity, positive predictive value, and negative predictive value of FNA cytology in diagnosing salivary gland lesions using MSRSGC were found to be 76.5%, 100%, 100%, and 95.3%, respectively.

Conclusion: The use of the MSRSGC helps in triaging patients with salivary gland lesions, increases the effectiveness of communication between clinicians and pathologists, and thus facilitates individualized patient management.

Context: High-risk human papillomavirus (hrHPV) is the most common viral pathogen responsible for cervical cancers. Determining the rates of HPV positivity, genotypic distribution, and obtaining regional epidemiological data can provide guidance for preventive strategies.

Aims: This study aims to assess HPV positivity rates, age distribution, genotyping in abnormal cytologies, and then obtain regional epidemiological data.

Settings and design: Descriptive study.

Materials and methods: This study included 3510 women aged ≥18, whose cervical smear samples were examined at the Microbiology Laboratory. HPV detection and genotyping in cervical smear samples were performed using the polymerase chain reaction (PCR) method. Pap smears were evaluated according to the Bethesda system.

Statistical analysis used: SPSS 23 (IBM Corp.) software was utilized for the statistical analysis of the data.

Results: The positivity rate for hrHPV infection was 10%. The most common genotype was other hrHPV. The rate of multiple hrHPV positive infections was 13.6%. The highest hrHPV positivity was observed in the age group ranging from 18 to 24 age group (28.7%). HPV infections were higher in abnormal cytologies (P < 0.001), with the highest positivity in LSIL (P < 0.001). The risk of having LSIL and HSIL cytology in HPV-positive individuals was 32.59 times higher than that in HPV-negative individuals (OR = 32.59; 95% CI 16.42-64.66).

Conclusions: The hrHPV positivity was 10%, with other hrHPV strain infections being the most detected, followed by HPV 16. Due to the high detection of other hrHPV strain positivity in patients with abnormal cytology, conducting regional studies determining each hrHPV type separately, monitoring the natural course of infection with types other than HPV 16 and HPV 18, and benefiting vaccine studies are considered essential.

Background: Fine-needle aspiration cytology (FNAC) being the first-line of technique is considered the most popular method for diagnosing lymphadenopathy. Diagnosis of a lymph node lesion is challenging due to the vast diversity in lymph node cytology. There has been a lack of standard guidelines for cytopathological reporting of lymph nodes. Sydney System has been recently proposed to provide consensus guidelines for the classification and reporting of lymph node FNAC and to maintain uniformity in reporting.

Aims: The present study aimed to analyze the utility of the proposed Sydney System.

Materials and methods: We retrospectively studied lymph node FNAC cases which were retrieved from hospital records with relevant clinical and radiological details along with the histopathological follow-up to assess the risk of malignancy in each category.

Results: A total of 1572 cases from lymph nodes were reclassified according to the Sydney System. The most common site was cervical lymph nodes followed by intrabdominal, mediastinal, inguinal, and axillary. The risk of malignancy was found to be highest for category V (93.5%) and least for category II (13.7%) followed by category IV (66.6%), category III (33.3%), and category I (25%). The diagnostic accuracy of our study was 90.1%.

Conclusions: The proposed Sydney System is helpful in the systematization and standardization of lymph node FNA diagnosis and reporting. It provides increased efficacy in clinical management with enhanced communication between clinicians and cytopathologists. Moreover, clinical practice would also benefit from management recommendations specific to diagnostic categories with increasing risk of malignancy.