Héctor-Enrique Torres-Rivas, Luis Manuel Fernández Fernández, María de la Paz González Gutiérrez, Mario Luis Berríos Hernández, José Fernando Pérez Fontán, Ashish Chandra, Alessandro Caputo, Ana Belén Dávila Lemos, Karen Villar Zarra
Introduction: Despite the established role of the interventional pathologist, their diagnostic performance is difficult to establish. At least in Spain training of pathology residents in ultrasound-guided interventional procedures for specimen collection is limited or absent in most institutions. We present our teaching experience in the instruction of ultrasound-guided fine-needle aspiration (FNA) to pathology residents in a tertiary-level hospital.
Materials and methods: The training of pathology residents who rotated through the interventional unit of the pathology department and the application of ultrasound-guided FNA and rapid on-site evaluation (U-ROSE) was documented over 5 years. The training period was broken down into learning phases and included the number of ultrasound-guided FNA performed, anatomical location, and their diagnostic performance, among other aspects.
Results: Nineteen (19) pathology residents were trained in U-ROSE, and performed a total of 4003 procedures, with a mean of 211 per resident. In 53% of cases only one pass was required for an adequated sample. The specimen was diagnostic in more than 97% of cases. The most frequently sampled anatomical sites were the thyroid gland (n = 2347), followed by lymph node (n = 667), soft tissues (n = 663) and salivary glands (n = 322).
Conclusion: The results support the training programme followed by pathology residents in learning U-ROSE, which is essential to lay the foundations for the future interventional pathologist.
{"title":"Resident training in interventional pathology: Ultrasound-guided fine-needle aspiration and rapid on site evaluation-5 years of teaching experience in a single university hospital.","authors":"Héctor-Enrique Torres-Rivas, Luis Manuel Fernández Fernández, María de la Paz González Gutiérrez, Mario Luis Berríos Hernández, José Fernando Pérez Fontán, Ashish Chandra, Alessandro Caputo, Ana Belén Dávila Lemos, Karen Villar Zarra","doi":"10.1111/cyt.13355","DOIUrl":"https://doi.org/10.1111/cyt.13355","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the established role of the interventional pathologist, their diagnostic performance is difficult to establish. At least in Spain training of pathology residents in ultrasound-guided interventional procedures for specimen collection is limited or absent in most institutions. We present our teaching experience in the instruction of ultrasound-guided fine-needle aspiration (FNA) to pathology residents in a tertiary-level hospital.</p><p><strong>Materials and methods: </strong>The training of pathology residents who rotated through the interventional unit of the pathology department and the application of ultrasound-guided FNA and rapid on-site evaluation (U-ROSE) was documented over 5 years. The training period was broken down into learning phases and included the number of ultrasound-guided FNA performed, anatomical location, and their diagnostic performance, among other aspects.</p><p><strong>Results: </strong>Nineteen (19) pathology residents were trained in U-ROSE, and performed a total of 4003 procedures, with a mean of 211 per resident. In 53% of cases only one pass was required for an adequated sample. The specimen was diagnostic in more than 97% of cases. The most frequently sampled anatomical sites were the thyroid gland (n = 2347), followed by lymph node (n = 667), soft tissues (n = 663) and salivary glands (n = 322).</p><p><strong>Conclusion: </strong>The results support the training programme followed by pathology residents in learning U-ROSE, which is essential to lay the foundations for the future interventional pathologist.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405369","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}
Nada Shaker, Zaibo Li, Judith Bamporiki, Omar P. Sangueza, Abdul Abid
<p>An 81-year-old male presented with a concerning skin lesion on his right thumb. The lesion had been causing pain, and bleeding, and had been progressively enlarging over time (Figure 1). A shave biopsy of the lesion and expression of Melan A and S100 is depicted in Figure 2A–D. Three years and a half following the initial diagnosis, the patient returned with a new concern of an enlarged right axillary lymph node. A fine needle aspiration (FNA) was performed. Diff Quik staining demonstrates epithelioid foamy cells with round to ovoid eccentrically located nuclei with low nuclear to cytoplasmic ratio (Figure 3A,B). Pap smear-stained slide demonstrates sheets of cohesive, large, and spindle-shaped foamy cells with abundant cytoplasm and a low nuclear to cytoplasmic ratio. No pigmentation was present (Figure 3C).</p><p><b>1. c.</b> Balloon cell melanoma (BCM) is an exceptionally uncommon histological subtype, representing less than 1% of all malignant melanomas. It is characterized by the presence of balloon-like, clear cytoplasmic vacuoles within melanoma cells. The nuclei within may often display cellular atypia, nuclear enlargement, irregularity, and hyperchromasia. Furthermore, BCM may contain varying amounts of melanin pigmentation, presenting as granules or pigmentary inclusions within the vacuolated cytoplasm.</p><p><b>2. a.</b> The utility of melanocytic markers such as S-100, HMB-45, and Melan-A is crucial for establishing a diagnosis of metastatic melanoma. PAX8 and CAIX are valuable for diagnosing clear cell renal cell carcinoma.</p><p><b>3. c.</b> Tumour thickness and positive margins are often associated with an increased risk of distant metastasis and disease progression. The initial sampling exhibited a diagnosis of balloon cell melanoma with a minimum Breslow thickness of at least 0.41 mm. The risk of metastatic melanoma is higher in patients with cutaneous melanomas with increased thickness and higher stages of the disease (thickness of ≥1.0 mm, and higher stages T2-4). The outcome of metastatic melanoma is influenced by various factors, such as the stage of the disease, distant metastatic spread, and whether the primary melanoma originated on the skin or in non-cutaneous sites. Generally, metastasis to regional lymph nodes is associated with a favourable prognosis when compared to metastasis to internal organs.</p><p>Metastatic melanoma is a highly aggressive and potentially life-threatening form of cutaneous malignancy characterized by the spread of melanoma cells from the primary tumour site to distant organs or lymph nodes. In general, cutaneous metastases typically occur close to the primary tumour site with an often occurrence on the head and neck region and the extremities. Common extracutaneous sites of melanoma metastasis include the lymph nodes, lungs, liver, bones, central nervous system, and less frequently the gastrointestinal tract, kidneys, adrenal glands, and thyroid gland. Metastases of melanoma may occur via lymp
气球细胞黑色素瘤（BCM）是一种极为罕见的组织学变异，占全球黑色素瘤的 70%。
{"title":"Cutaneous balloon-cell melanoma metastases to the axillary lymph node: Exploring cytomorphologic features and differential diagnoses on fine needle aspiration biopsy","authors":"Nada Shaker, Zaibo Li, Judith Bamporiki, Omar P. Sangueza, Abdul Abid","doi":"10.1111/cyt.13354","DOIUrl":"10.1111/cyt.13354","url":null,"abstract":"<p>An 81-year-old male presented with a concerning skin lesion on his right thumb. The lesion had been causing pain, and bleeding, and had been progressively enlarging over time (Figure 1). A shave biopsy of the lesion and expression of Melan A and S100 is depicted in Figure 2A–D. Three years and a half following the initial diagnosis, the patient returned with a new concern of an enlarged right axillary lymph node. A fine needle aspiration (FNA) was performed. Diff Quik staining demonstrates epithelioid foamy cells with round to ovoid eccentrically located nuclei with low nuclear to cytoplasmic ratio (Figure 3A,B). Pap smear-stained slide demonstrates sheets of cohesive, large, and spindle-shaped foamy cells with abundant cytoplasm and a low nuclear to cytoplasmic ratio. No pigmentation was present (Figure 3C).</p><p><b>1. c.</b> Balloon cell melanoma (BCM) is an exceptionally uncommon histological subtype, representing less than 1% of all malignant melanomas. It is characterized by the presence of balloon-like, clear cytoplasmic vacuoles within melanoma cells. The nuclei within may often display cellular atypia, nuclear enlargement, irregularity, and hyperchromasia. Furthermore, BCM may contain varying amounts of melanin pigmentation, presenting as granules or pigmentary inclusions within the vacuolated cytoplasm.</p><p><b>2. a.</b> The utility of melanocytic markers such as S-100, HMB-45, and Melan-A is crucial for establishing a diagnosis of metastatic melanoma. PAX8 and CAIX are valuable for diagnosing clear cell renal cell carcinoma.</p><p><b>3. c.</b> Tumour thickness and positive margins are often associated with an increased risk of distant metastasis and disease progression. The initial sampling exhibited a diagnosis of balloon cell melanoma with a minimum Breslow thickness of at least 0.41 mm. The risk of metastatic melanoma is higher in patients with cutaneous melanomas with increased thickness and higher stages of the disease (thickness of ≥1.0 mm, and higher stages T2-4). The outcome of metastatic melanoma is influenced by various factors, such as the stage of the disease, distant metastatic spread, and whether the primary melanoma originated on the skin or in non-cutaneous sites. Generally, metastasis to regional lymph nodes is associated with a favourable prognosis when compared to metastasis to internal organs.</p><p>Metastatic melanoma is a highly aggressive and potentially life-threatening form of cutaneous malignancy characterized by the spread of melanoma cells from the primary tumour site to distant organs or lymph nodes. In general, cutaneous metastases typically occur close to the primary tumour site with an often occurrence on the head and neck region and the extremities. Common extracutaneous sites of melanoma metastasis include the lymph nodes, lungs, liver, bones, central nervous system, and less frequently the gastrointestinal tract, kidneys, adrenal glands, and thyroid gland. Metastases of melanoma may occur via lymp","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 3","pages":"427-431"},"PeriodicalIF":1.3,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cyt.13354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Fine needle aspiration cytology (FNAC) is a widely accepted diagnostic technique, but performance varies according to expertise. Little is known about variation in FNAC training practices worldwide. We surveyed pathologists using social media networks to determine FNAC training practices internationally.
Design: Pathologists were surveyed on questions related to FNAC simulation training using direct messaging on the Twitter and WhatsApp platforms. Survey responses over a period of 2 weeks were collected.
Results: In total, 149 pathologists participated (96.1% response rate). The respondents came from 24 countries and 87 institutions. The majority of the pathologists (63.8%) performed FNAC directly on patients for the first time. Only 36.2% of them had simulation instruction during their training. It was performed on food items such as fruit (64.8%), surgical specimens (37.0%), autopsies (13.0%) and others (9.3%), including commercially available phantom simulators for ultrasound-guided FNAC (US-FNAC) (two pathologists).
Discussion: Most pathologists did not receive formal training in a simulated environment, and of the pathologists who had simulation instruction, food items were commonly used for education. A few participants used a commercial US-FNAC simulator, but since most pathologists perform FNAC by palpation, this method of simulation training is not applicable to many practices. Social media is an effective and efficient way to perform survey research, yielding a very high response rate.
{"title":"How do cytopathologists learn fine needle aspiration techniques? An international survey.","authors":"Eduardo Alcaraz-Mateos, Idaira Jael Exposito-Afonso, Tania Labiano-Miravalles, Lara Pijuan, Jordi Temprana-Salvador, Qing Zhao, Xiaoyin Sara Jiang","doi":"10.1111/cyt.13352","DOIUrl":"https://doi.org/10.1111/cyt.13352","url":null,"abstract":"<p><strong>Introduction: </strong>Fine needle aspiration cytology (FNAC) is a widely accepted diagnostic technique, but performance varies according to expertise. Little is known about variation in FNAC training practices worldwide. We surveyed pathologists using social media networks to determine FNAC training practices internationally.</p><p><strong>Design: </strong>Pathologists were surveyed on questions related to FNAC simulation training using direct messaging on the Twitter and WhatsApp platforms. Survey responses over a period of 2 weeks were collected.</p><p><strong>Results: </strong>In total, 149 pathologists participated (96.1% response rate). The respondents came from 24 countries and 87 institutions. The majority of the pathologists (63.8%) performed FNAC directly on patients for the first time. Only 36.2% of them had simulation instruction during their training. It was performed on food items such as fruit (64.8%), surgical specimens (37.0%), autopsies (13.0%) and others (9.3%), including commercially available phantom simulators for ultrasound-guided FNAC (US-FNAC) (two pathologists).</p><p><strong>Discussion: </strong>Most pathologists did not receive formal training in a simulated environment, and of the pathologists who had simulation instruction, food items were commonly used for education. A few participants used a commercial US-FNAC simulator, but since most pathologists perform FNAC by palpation, this method of simulation training is not applicable to many practices. Social media is an effective and efficient way to perform survey research, yielding a very high response rate.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038231","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}
We report a case of guar beans in a peritoneal fluid sample and describe the thought process that enabled us to make sense of this previously unreported finding.
{"title":"Guar beans in a peritoneal fluid sample","authors":"Edward J. Gutmann, Jonathan D. Marotti","doi":"10.1111/cyt.13351","DOIUrl":"10.1111/cyt.13351","url":null,"abstract":"<p>We report a case of guar beans in a peritoneal fluid sample and describe the thought process that enabled us to make sense of this previously unreported finding.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 3","pages":"425-426"},"PeriodicalIF":1.3,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833118","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}
{"title":"The Kymi Odyssey Honorary Ceremony celebrated the life and career of Dr. George N. Papanicolaou; and the future, dedicated museum","authors":"Panagiota Mikou, Nikolaos Chantziantoniou","doi":"10.1111/cyt.13349","DOIUrl":"10.1111/cyt.13349","url":null,"abstract":"","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 2","pages":"324-325"},"PeriodicalIF":1.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813704","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}
Joseph Reznicek, Nima Sharifai, Pouya Jamshidi, Nitin Wadhwani, Jared T. Ahrendsen
Embryonal and pineal tumours represent a diverse group of central nervous system (CNS) neoplasms. While many of the small round blue cell tumours that make up the embryonal neoplasms share similar histologic qualities, there are several morphologic and cytologic characteristics that are useful in distinguishing different tumour types. Similarly, pineal parenchymal tumours represent clinically diverse tumours, ranging from benign to overtly malignant. The most recent iteration of the World Health Organization Classification of CNS Tumours expanded greatly on the significance of molecular alterations in brain tumour diagnostics. In this article, we summarize the salient cytologic and histologic features of CNS embryonal and pineal tumours, and highlight diagnostically relevant molecular alterations within each tumour type.
{"title":"Embryonal and pineal tumours","authors":"Joseph Reznicek, Nima Sharifai, Pouya Jamshidi, Nitin Wadhwani, Jared T. Ahrendsen","doi":"10.1111/cyt.13350","DOIUrl":"10.1111/cyt.13350","url":null,"abstract":"<p>Embryonal and pineal tumours represent a diverse group of central nervous system (CNS) neoplasms. While many of the small round blue cell tumours that make up the embryonal neoplasms share similar histologic qualities, there are several morphologic and cytologic characteristics that are useful in distinguishing different tumour types. Similarly, pineal parenchymal tumours represent clinically diverse tumours, ranging from benign to overtly malignant. The most recent iteration of the World Health Organization Classification of CNS Tumours expanded greatly on the significance of molecular alterations in brain tumour diagnostics. In this article, we summarize the salient cytologic and histologic features of CNS embryonal and pineal tumours, and highlight diagnostically relevant molecular alterations within each tumour type.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 5","pages":"561-571"},"PeriodicalIF":1.2,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cyt.13350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138688150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soundarya Ravi, Anu K. Devi, Prabhu Manivannan, Debasis Gochhait, Rakhee Kar, Neelaiah Siddaraju
Background
Burkitt lymphoma (BL) is an aggressive high-grade B-cell non-Hodgkin lymphoma commonly diagnosed in young age and is known to involve extra nodal sites. But the involvement of body fluids by BL is an uncommon presentation. Rapid diagnosis of BL is vital to prevent complications like tumour lysis syndrome. Cytological examination of body fluids continues to be an indispensable tool for rapid diagnosis of BL.
Objectives
In this study, we aim to study the clinical, cytomorphological and immunophenotypic characteristics of BL involving serous effusions and other fluids.
Materials and Methods
In this retrospective study, 17 cases reported as BL in fluid cytology from 2016 to 2022 were collected and reviewed. We performed a comprehensive analysis of the clinical data, cytomorphological features, immunophenotyping data along with the haematological workup of these cases. We have also compared with the histopathological diagnosis for those cases where biopsy was available.
Results
BL more commonly involved ascitic fluid (52%), followed by pleural fluid (4 cases) and cerebrospinal fluid (CSF; 4 cases). Primary diagnosis of BL in fluid was done in 88% of the cases. Bone marrow involvement was noted in two cases. Cytological smears showed discrete monomorphous population of medium-sized atypical lymphoid cells with frequent apoptotic bodies. Classic cytoplasmic punched out vacuoles were observed in 88% of the cases. Immunophenotyping data was available for 12 cases in which tumour cells showed positivity for CD20 (100%), CD10 (4 of 7 cases), BCL6 (3 of 5 cases) and cMYC (7 of 7 cases—100%) and were negative for Terminal deoxynucleotidyl transferase (TdT) (11 of 11 cases). Mean Ki67 labelling index was 95%. Histopathological diagnosis was available for 9 cases, and there was 100% agreement between cytological and histopathological diagnosis in 7 cases.
Conclusion
Precise diagnosis of BL can be rendered in body fluids by identification of classic cytomorphological features and by performing supportive ancillary tests in fluids for immunophenotyping.
{"title":"The urgency of Burkitt lymphoma diagnosis in fluid cytology—A tertiary care experience","authors":"Soundarya Ravi, Anu K. Devi, Prabhu Manivannan, Debasis Gochhait, Rakhee Kar, Neelaiah Siddaraju","doi":"10.1111/cyt.13346","DOIUrl":"10.1111/cyt.13346","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Burkitt lymphoma (BL) is an aggressive high-grade B-cell non-Hodgkin lymphoma commonly diagnosed in young age and is known to involve extra nodal sites. But the involvement of body fluids by BL is an uncommon presentation. Rapid diagnosis of BL is vital to prevent complications like tumour lysis syndrome. Cytological examination of body fluids continues to be an indispensable tool for rapid diagnosis of BL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In this study, we aim to study the clinical, cytomorphological and immunophenotypic characteristics of BL involving serous effusions and other fluids.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In this retrospective study, 17 cases reported as BL in fluid cytology from 2016 to 2022 were collected and reviewed. We performed a comprehensive analysis of the clinical data, cytomorphological features, immunophenotyping data along with the haematological workup of these cases. We have also compared with the histopathological diagnosis for those cases where biopsy was available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>BL more commonly involved ascitic fluid (52%), followed by pleural fluid (4 cases) and cerebrospinal fluid (CSF; 4 cases). Primary diagnosis of BL in fluid was done in 88% of the cases. Bone marrow involvement was noted in two cases. Cytological smears showed discrete monomorphous population of medium-sized atypical lymphoid cells with frequent apoptotic bodies. Classic cytoplasmic punched out vacuoles were observed in 88% of the cases. Immunophenotyping data was available for 12 cases in which tumour cells showed positivity for CD20 (100%), CD10 (4 of 7 cases), BCL6 (3 of 5 cases) and cMYC (7 of 7 cases—100%) and were negative for Terminal deoxynucleotidyl transferase (TdT) (11 of 11 cases). Mean Ki67 labelling index was 95%. Histopathological diagnosis was available for 9 cases, and there was 100% agreement between cytological and histopathological diagnosis in 7 cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Precise diagnosis of BL can be rendered in body fluids by identification of classic cytomorphological features and by performing supportive ancillary tests in fluids for immunophenotyping.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 2","pages":"275-282"},"PeriodicalIF":1.3,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632117","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}
Cases of metaplastic pleomorphic adenoma can be diagnostically challenging. Many of these cases fall into the Milan system's SUMP category, and some may be misdiagnosed. The author shows a case of pleomorphic adenoma with extensive squamous and mucinous metaplasia and a novel MALAT1::PLAG1 fusion.
{"title":"Pleomorphic adenoma with extensive squamous and mucinous metaplasia and a novel MALAT1::PLAG1 fusion gene","authors":"Maria F. Gonzalez","doi":"10.1111/cyt.13347","DOIUrl":"10.1111/cyt.13347","url":null,"abstract":"<p>Cases of metaplastic pleomorphic adenoma can be diagnostically challenging. Many of these cases fall into the Milan system's SUMP category, and some may be misdiagnosed. The author shows a case of pleomorphic adenoma with extensive squamous and mucinous metaplasia and a novel MALAT1::PLAG1 fusion.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 2","pages":"283-285"},"PeriodicalIF":1.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632415","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}
Nada Shaker, Poonam Vohra, Zaibo Li, Omar P. Sangueza, Abdul Abid
<p>Eccrine Spiradenoma (ES) is a rare benign dermal-based adnexal tumour that was first described in 1956 by Kersting and Helwig.<span><sup>1</sup></span> ES usually affects adults between 15 and 35 years of age with no gender preference .<span><sup>2</sup></span> In most cases, ES presents as a solitary asymptomatic nodule predominantly in the head and neck region<span><sup>3</sup></span> and less commonly encountered in the extremities and trunk.<span><sup>4</sup></span> ES is usually asymptomatic, although a painful presentation has been described in the literature.<span><sup>5</sup></span> The precise etiology is unknown and most cases occur sporadically. The clinical presentation of multiple skin lesions and the association of other adnexal tumour types suggest a further assessment for a defect in the CYLDI gene at chromosome 16 at location 12.1 for Brooke-Spiegler syndrome evaluation.<span><sup>6</sup></span></p><p>Due to the rarity of ES occurrence on cytology specimens, limited data regarding its cytomorphologic characteristics have been reported in the literature. Our objective is to present an expanded analysis of the characteristic cytologic features and the immunohistochemical (IHC) staining pattern of ES, along with a discussion on the differential diagnosis of this rare entity on cytology specimens. Furthermore, we aim to provide a literature review of ES cases to highlight the importance of clinicopathologic correlation and histopathological evaluation accompanied by IHC that is essential for an accurate diagnosis.</p><p>A 75-year-old male with a notable medical history of metastatic malignant melanoma of the posterior base of the neck presented with a new firm, round and smooth nodule on the scalp. Given the patient's history of malignant melanoma, there was a heightened suspicion of a metastatic melanoma prompting the performance of an fine needle aspiration (FNA) biopsy. Cytologic smears and cell block evaluation revealed a cohesive multilayered cluster of biphasic cellular composition, consisting of a round to oval epithelioid cell population with relatively vesicular nuclei and eosinophilic cytoplasm, and few myoepithelial cells with hyperchromatic nuclei and scant cytoplasm. Prominent deposition of thick basement membrane-like material and focal duct formation were noted. No definitive lymphocytes were present. No necrosis or increased mitotic figures activity were noted Figure 1A,B. To further confirm the diagnosis, a panel of IHC stains was performed on the cell block. Positive staining for p40, P63 and SOX-10 was observed, while CK7 showed patchy staining within the tumor cells and ER highlighted scattered cells Figure 2A–D. CK20, PR, Synaptophysin and mCEA showed negative staining Figure 3A–C. A surgical resection of the lesion was performed and showed two distinct cell populations of centrally located large pale cells and small peripherally located dark basaloid cells. The surgical findings correlated with the cytologic
{"title":"Cutaneous eccrine spiradenoma: Insights into cytomorphological features via fine needle aspiration biopsy and a comprehensive literature review","authors":"Nada Shaker, Poonam Vohra, Zaibo Li, Omar P. Sangueza, Abdul Abid","doi":"10.1111/cyt.13348","DOIUrl":"10.1111/cyt.13348","url":null,"abstract":"<p>Eccrine Spiradenoma (ES) is a rare benign dermal-based adnexal tumour that was first described in 1956 by Kersting and Helwig.<span><sup>1</sup></span> ES usually affects adults between 15 and 35 years of age with no gender preference .<span><sup>2</sup></span> In most cases, ES presents as a solitary asymptomatic nodule predominantly in the head and neck region<span><sup>3</sup></span> and less commonly encountered in the extremities and trunk.<span><sup>4</sup></span> ES is usually asymptomatic, although a painful presentation has been described in the literature.<span><sup>5</sup></span> The precise etiology is unknown and most cases occur sporadically. The clinical presentation of multiple skin lesions and the association of other adnexal tumour types suggest a further assessment for a defect in the CYLDI gene at chromosome 16 at location 12.1 for Brooke-Spiegler syndrome evaluation.<span><sup>6</sup></span></p><p>Due to the rarity of ES occurrence on cytology specimens, limited data regarding its cytomorphologic characteristics have been reported in the literature. Our objective is to present an expanded analysis of the characteristic cytologic features and the immunohistochemical (IHC) staining pattern of ES, along with a discussion on the differential diagnosis of this rare entity on cytology specimens. Furthermore, we aim to provide a literature review of ES cases to highlight the importance of clinicopathologic correlation and histopathological evaluation accompanied by IHC that is essential for an accurate diagnosis.</p><p>A 75-year-old male with a notable medical history of metastatic malignant melanoma of the posterior base of the neck presented with a new firm, round and smooth nodule on the scalp. Given the patient's history of malignant melanoma, there was a heightened suspicion of a metastatic melanoma prompting the performance of an fine needle aspiration (FNA) biopsy. Cytologic smears and cell block evaluation revealed a cohesive multilayered cluster of biphasic cellular composition, consisting of a round to oval epithelioid cell population with relatively vesicular nuclei and eosinophilic cytoplasm, and few myoepithelial cells with hyperchromatic nuclei and scant cytoplasm. Prominent deposition of thick basement membrane-like material and focal duct formation were noted. No definitive lymphocytes were present. No necrosis or increased mitotic figures activity were noted Figure 1A,B. To further confirm the diagnosis, a panel of IHC stains was performed on the cell block. Positive staining for p40, P63 and SOX-10 was observed, while CK7 showed patchy staining within the tumor cells and ER highlighted scattered cells Figure 2A–D. CK20, PR, Synaptophysin and mCEA showed negative staining Figure 3A–C. A surgical resection of the lesion was performed and showed two distinct cell populations of centrally located large pale cells and small peripherally located dark basaloid cells. The surgical findings correlated with the cytologic ","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 2","pages":"301-306"},"PeriodicalIF":1.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cyt.13348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Salimian, Angela N. Viaene, Jason Chiang, Cheng-Ying Ho
Objective
The detection of neoplastic cells in cerebral spinal fluid (CSF) is pivotal for the management of patients with central nervous system (CNS) tumours. This article delves into the CSF cytological characteristics of common CNS neoplasms, aligning with the 2021 World Health Organization (WHO) classification of CNS tumours.
Methods
A retrospective review of CSF specimens positive for primary CNS neoplasms was performed at three tertiary medical centres. Only cases that had histopathologic confirmation and/or molecular workup were included.
Results
Common primary CNS neoplasms seen in CSF cytology specimens include medulloblastoma, (non-WNT/non-SHH as well as SHH-activated and TP53 mutant), pineoblastoma, atypical teratoid/rhabdoid tumour (AT/RT), IDH-wildtype glioblastoma, and primary diffuse large B-cell lymphoma of the CNS. Ependymomas and germinomas can also have CSF involvement but are less common. Although the typical histologic architecture of these tumours may not be preserved in the CSF, unique cytomorphologic features such as nuclear moulding, nuclear pleomorphism, rhabdoid cells, prominent nucleoli and rosette formation can still be appreciated.
Conclusion
Adopting the updated terminology and correlating cytologic observations with molecular findings will streamline the diagnostic process, reducing the complexities and ambiguities pathologists often encounter when analysing CSF specimens for potential primary CNS neoplasms.
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