Cytopathology最新文献

Objective: The objective of this study is to evaluate the diagnostic performance of urine cytology using The Paris System (TPS 2.0) in comparison with TPS 1.0, and the Four-Tier Reporting System (FTRS) of our institute for identifying high-grade urothelial carcinoma (HGUC).

Methodology: A total of 789 urine cytology specimens from 240 patients including 12 UTUC cases with available histological and clinical details were included. Two hundred twenty-two cases were newly diagnosed, whereas 18 were recurrent tumours. Histopathological evaluation categorised the cases as non-neoplastic (33%, 13.7%), low-grade urothelial neoplasms (LGUNs) (94%, 39.2%), high-grade urothelial carcinoma (HGUCs) (110%, 45.8%) and other malignancies (3%, 1.3%).

Results: TPS 2.0 categorised the cases as 14 (5.7%) non-diagnostic or ND/U, 99 (41.5%) NHGUC, 37 (15.4%) AUC, 24 (10%) SHGUC and 66 (27.5%) HGUC. TPS 1.0 had 14 (5.7%) ND/U, 72 (30%) NHGUC, 61 (24.5%) AUC, 3 (1.3%) LGUC, 24 (10%) SHGUC and 66 (27.5%) HGUC. FTRS classified them as 19 (7.5%) ND/UNS, 44 (18.3%) NEG, 88 (36.7%) INC and 89 (37.1%) POS. The ROHM for TPS 2.0 was 71.4% for ND/U, 12.1% for NHGUC, 29.7% for AUC, 79.2% for SHGUC and 89.4% for HGUC. TPS 1.0 showed a similar ROHM for ND/U, SHGUC and HGUC, whereas had 13.8% for NHGUC and 19.7% for AUCs. FTRS, had 78.9% for UNS, 6.8% for NEG, 35.2% for INC and 73.1% for POS. TPS demonstrated a sensitivity of 70.91% and specificity of 90.77% for identifying HGUC, whereas FTRS showed 59.09% sensitivity and 81.54% specificity. Also, TPS was found to be 75% accurate with 62.5% sensitivity and 100% specificity for UTCC cases separately.

Conclusion: TPS 2.0 exhibits diagnostic accuracy with better performance in comparison to FTRS, making it a more reliable system for clinical practice. Our findings endorse the utility of TPS 2.0 in improving the accuracy of urine cytology in predicting histological diagnosis of HGUC.

Pleomorphic adenoma (PA) is the most common salivary gland neoplasm worldwide (50%-70%). Most cases of PA are straightforward diagnoses. However, the diagnosis may be challenging due to the morphological diversity of PAs, which in many cases is caused by the predominance of one of the three components or the presence of metaplastic epithelium. We present the case of a 64-year-old male with a history of prostate cancer and right submandibular gland excision 16 years ago with an unknown previous diagnosis and recent regrowth of his mass in the surgical bed. The tumour showed a predominant spindle cell morphology, cytokeratin-positivity, variable expression of myoepithelial markers in the cytology and surgical pathology specimens, and novel inversion of the chromosome 8, and LRP1B, PBRM1 and TCF3 mutations.

Fine needle cytology (FNC) is a pivotal diagnostic tool for distinguishing between benign and malignant lymphadenopathies mainly because of its minimal invasiveness, cost-effectiveness and accuracy. A major requirement for maximising diagnostic accuracy is proper sample management of aspirated cellular material. In this diagnostic process, the morphological evaluation of adequate smears is paramount, guiding cytopathologists in the selection of appropriate ancillary tests through the recognition of cell size and patterns of distribution. Here, we describe a peculiar 'concentric ovals distribution pattern', frequently observed in the FNC of benign reactive lymph nodes, which may represent an aid in the cytological diagnosis of reactive hyperplasia.

Objective: This study aims to provide a literature review of FNAC-diagnosed plasmablastic lymphoma (PBL) cases and present a case of PBL in an HIV patient diagnosed by FNAC.

Methods: A literature review was conducted across eight databases to compile information on FNAC-diagnosed PBL cases without restricting the site of involvement.

Results: The literature review included 23 PBL, with 13 (56.5%) affecting head and neck region. The mean age of patients was 49 years, with a male-to-female ratio of 1.9:1, and 13 (56.5%) patients were HIV positive. Ten (43.5%) of 23 patients tested positive for Epstein-Barr virus (EBV). Twenty-one FNAC procedures and two cytological smears were performed. Plasmacytoid/plasmablastic morphology was described in seven cases (30.4%). Large cells were observed in 17 cases (73.9%). Pleomorphism was noted in 10 cases (43.5%). A cytological diagnosis of malignancy was achieved in 91.3% of cases. In 20 cases assessed for concordance, complete agreement was found in 8 cases (34.8%), while discordance was noted in 12 cases (65.2%). We also report a case of PBL diagnosed via FNAC in a 55-year-old male patient who presented with a painful, hard, nonmobile mass in the left submandibular region, approximately 10 cm in size, with 1 month of evolution. FNAC was performed, and cytologic smears, along with cell block (CB) preparations, were made. After staining with Diff-Quik, HE and Papanicolaou stain, numerous cells exhibiting plasmacytic morphology were observed. Immunohistochemical analysis showed negativity for LCA, CD3, CD20, Pax5, CD79a, ALK and HHV-8, and positivity for CD138, MUM1 and Ki-67 (100%). EBV positivity was also confirmed, leading to a diagnosis of PBL.

Conclusion: This study highlights the efficacy of FNAC in diagnosing PBL. The immunophenotypic profile and morphological features observed through FNAC, combined with immunohistochemistry (IHC) and in situ hybridisation, were crucial for an accurate diagnosis. The literature review underscores the value of FNAC as a diagnostic tool for PBL, demonstrating a high rate of cytological diagnosis and significant cytohistological concordance.

Introduction/objective: Biliary brushing cytology (BB) to detect cholangiocarcinoma (CCA) is integral in the surveillance of patients with primary sclerosing cholangitis (PSC). Since reactive changes can mimic carcinoma, indeterminant results are frequent. Fluorescence in situ hybridization (FISH) using the UroVysion probe set has been advocated to enhance the detection of CCA. This study evaluates the performance of FISH for detecting CCA in patients with and without PSC.

Materials and methods: A query of our pathology database for atypical and suspicious BB with concurrent FISH results was performed from 2014 to 2021. FISH (using UroVysion probe set containing centromere enumeration probes to chromosomes 3, 7, and 17) was positive if at least 5 cells demonstrated polysomy. Electronic medical records were reviewed to identify patients with PSC and CCA. CCA was confirmed by pathology or clinical impression.

Results: Of the 65 patients (103 BB) in the PSC cohort, 59 patients (94 BB) without CCA and 6 patients (9 BB) with CCA were identified. 33 non-PSC patients (41 BB) with CCA were included for comparison. Positive FISH was highest in non-PSC patients with CCA (10/41 BB, 24%). Positive FISH was seen in both PSC with (1/9 BB, 11%) and without (2/94 BB, 2%) CCA.

Conclusions: FISH positivity was lower than expected and was positive in PSC patients without CCA. These results question the clinical utility of FISH for CCA surveillance in PSC patients.

The editorial summarises the key messages of the very successful XII. Congress of Molecular Cytopathology in Naples. The programme of this meeting covered many burning issues from all areas of cytology—from molecular testing to the role of liquid biopsy to the unification of terminology and its impact on patient management.