Lauren J Miller, Isabella M Holmes, Heather I Chen-Yost, Brian Smola, Madelyn Lew, Judy Pang
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.
引言/目的:胆道刷状细胞学(BB)检测胆管癌(CCA)是监测原发性硬化性胆管炎(PSC)患者不可或缺的一部分。由于反应性变化可模拟癌变,因此经常出现不确定的结果。使用 UroVysion 探针组进行荧光原位杂交(FISH)可提高 CCA 的检测率。本研究评估了荧光原位杂交技术在PSC患者和非PSC患者中检测CCA的性能:从 2014 年到 2021 年,我们在病理数据库中查询了非典型和可疑 BB,并同时获得了 FISH 结果。如果至少有5个细胞显示多体,则FISH(使用UroVysion探针组,其中包含3、7和17号染色体的中心粒计数探针)结果为阳性。审查电子病历以确定 PSC 和 CCA 患者。CCA由病理或临床印象证实:在 65 名 PSC 患者(103 名 BB)中,有 59 名患者(94 名 BB)未患有 CCA,6 名患者(9 名 BB)患有 CCA。33名患有CCA的非PSC患者(41名BB)被纳入对比。在患有 CCA 的非 PSC 患者中,FISH 阳性率最高(10/41 BB,24%)。在患有(1/9 BB,11%)和未患有(2/94 BB,2%)CCA的PSC患者中,FISH均呈阳性:结论:FISH阳性率低于预期,而且在无CCA的PSC患者中也呈阳性。结论:FISH 阳性率低于预期,在无 CCA 的 PSC 患者中呈阳性。这些结果对 FISH 在 PSC 患者 CCA 监测中的临床实用性提出了质疑。
{"title":"Detecting Cholangiocarcinoma in the Setting of Primary Sclerosing Cholangitis: Is Biliary Tract Fluorescence In Situ Hybridization Helpful?","authors":"Lauren J Miller, Isabella M Holmes, Heather I Chen-Yost, Brian Smola, Madelyn Lew, Judy Pang","doi":"10.1111/cyt.13452","DOIUrl":"https://doi.org/10.1111/cyt.13452","url":null,"abstract":"<p><strong>Introduction/objective: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376343","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}
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.
{"title":"Cytology Is No Longer ‘Just Cytology’: The Clear Message of the XII. Congress of Molecular Cytopathology in Naples","authors":"Aleš Ryška","doi":"10.1111/cyt.13451","DOIUrl":"10.1111/cyt.13451","url":null,"abstract":"<p>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.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 6","pages":"662-663"},"PeriodicalIF":1.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367553","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}
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.
{"title":"Practical Approach to Reporting Based on the International System for Serous Fluid Cytopathology","authors":"Eliisa Viljanen, Ivana Kholová, Ashish Chandra","doi":"10.1111/cyt.13450","DOIUrl":"10.1111/cyt.13450","url":null,"abstract":"<p>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.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 1","pages":"12-22"},"PeriodicalIF":1.2,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367554","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}
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.
{"title":"Metastatic Medullary Thyroid Carcinoma Presenting as an Incidental Posterior Mediastinal Mass","authors":"Chaya Goldberg, DeAnna Diaz, Tamar Brandler","doi":"10.1111/cyt.13449","DOIUrl":"10.1111/cyt.13449","url":null,"abstract":"<p>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.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"36 1","pages":"71-74"},"PeriodicalIF":1.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332721","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}
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.
{"title":"Rare case of stromal predominant Wilm's tumour with rhabdomyoblastic differentiation in FNAC smears.","authors":"Anjali Gupta, Radhika Srinivasan, Manish Rohilla, Nandita Kakkar, Nitin J Peters","doi":"10.1111/cyt.13445","DOIUrl":"https://doi.org/10.1111/cyt.13445","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332722","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}
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.