Cytopathology最新文献

The International System for Serous Fluid Cytopathology (TIS) is intended for reporting cytological specimens from serous cavities: pleural, abdominal and pericardial cavities. TIS is being adopted into practice in cytology laboratories worldwide. In this system, there are six diagnostic categories: non-diagnostic, negative for malignancy, atypia of undetermined significance, suspicious for malignancy, malignant-primary and malignant-secondary. Malignant-primary category almost always implies malignant mesothelioma and malignant-secondary usually refers to metastasis from carcinoma but also to involvement of serous cavity by haematolymphoid and other malignancies. When evaluating effusion cytological specimen adequacy, the factors that must be considered are sample volume, cellular content and cellular preservation. In the diagnostic analysis and interpretation, it is helpful to consider systematically all basic cytomorphological components in a sample. The basic components are architecture, cell populations, cell size, cytoplasm, nuclei and background elements. One important requirement for a successful evaluation of an effusion cytological specimen is sufficient clinical and radiological information in a referral. Clinical information may guide ancillary testing. In the present review, we provide a practical and educational approach to reporting serous effusion cytology based on the TIS.

Medullary thyroid carcinoma (MTC) is an uncommon neuroendocrine tumour that is usually asymptomatic at its onset and therefore may not present clinically until the patient has developed advanced or metastatic disease. Common metastatic sites include cervical lymph nodes, liver, bone and lung. This is the case of a patient who presented with an incidental posterior mediastinal mass. Because the posterior mediastinum is an unusual location for MTC, MTC was not a consideration and preliminary histopathological testing did not include calcitonin, which would have been diagnostic. This case highlights the importance of testing for calcitonin more regularly when encountering a mass of unknown origin with neuroendocrine morphology, which may lead to earlier detection of MTC and thus improved prognosis.

The FNAC smear and histopathology of stromal predominant Wilm's tumour with rhabdomyoblastic Differentiation along with immunostaining in a 7-year-old male. In this paper, the diagnostic potential of FNAC in identifying rare histological variants of paediatric renal tumours is highlighted.

A 74-year-old woman's persistent hyponatraemia led to the discovery of an adenosquamous carcinoma within an intrapulmonary bronchogenic cyst (IPBC), diagnosed 59 years prior. This is the first reported case of such a transformation in an IPBC. An adenosquamous carcinoma, originating from an intrapulmonary bronchogenic cyst identified 59 years prior, was discovered during the workup for a patient's unexplained, persistent hyponatraemia.

Objective: Malignant pericardial effusions are associated with a poor prognosis. Pericardial fluid cytology and pericardial biopsy are the primary methods for diagnosis. This study aimed to conduct a multi-institutional analysis to compare the diagnostic sensitivity of cytology and biopsy, and to investigate potential explanations for false-negative results in cytology.

Methods: A retrospective review of pericardial fluid cytology cases with concurrent biopsy was conducted across four different institutions. Results were compared using standard statistical methods with attention to sensitivity and histologic distribution. False-negative cytology cases were investigated for further exploration.

Results: A total of 309 cases were collected, of which 99 (32.0%) were confirmed malignant through repeat sampling or clinical history. Pericardial fluid cytology and biopsy identified 84 and 64 malignant cases, respectively. Our findings confirmed significantly higher sensitivity of cytology compared to biopsy (84.8% vs 65.7%). The most common sites of origin were lung, breast, and gastrointestinal, with adenocarcinoma being the most prevalent histologic subtype. Histologic review of 12 false-negative cytology cases revealed three key explanations; lymphoma was the most common missed diagnosis (33.3%); fibrinous pericarditis obscures neoplastic cells on the pericardial surface; and pericardial involvement can be seen without extension into the pericardial space.

Conclusion: This study demonstrated diagnostic superiority of pericardial fluid cytology over biopsy in the evaluation of malignant pericardial effusions. We identified several limitations in fluid cytology causing false negatives. In the context of an underlying malignancy with pericardial effusion, pathologists should consider immunohistochemistry studies to aid on the diagnosis.

An incidental finding in urine smears from a patient with a presumptive diagnosis of an IgA mesangial nephropathy is presented. A possible example of the potential value of urine cytology in functional renal disorders. We report a case of an incidental finding in urine cytology from a patient with a presumptive diagnosis of an IgA mesangial glomerulonephritis, previously diagnosed as atypical urothelial cells.

Introduction: Striated duct adenoma is a benign salivary gland tumour recently recognized by the World Health Organization. To date, no report has described the cytological features of this entity.

Materials and methods: We report the case of a 60-year-old woman with a tumour in the right parotid gland with a diameter greater than 2.4 cm confirmed by imaging tests.

Results: Two fine-needle aspiration cytologies (FNAC) were performed with inconclusive results, reporting epithelioid and spindle-shaped cellularity, with little stroma, and nuclei with abundant pseudoinclusions. Myoepithelioma and Schwannoma were proposed as differential diagnoses. An immunocytochemical panel was performed, showing positivity for S-100, SOX10, CK7 and vimentin, and negativity for both myoepithelial (p63 and calponin) and thyroid markers. In the absence of a conclusive diagnosis, the patient accepted surgery. The biopsy results confirmed diagnosis of striated duct adenoma, with immunohistochemical features superimposable to cytology.

Conclusion: Little information is available in the literature, both on biopsy and, more strikingly, on cytology of this neoplasm. The aim of this work is to provide cytological characteristics that allow diagnosis of this entity with FNAC and thus avoid unnecessary surgeries.