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Oncocytic/Hürthle cell lesions have the same implied risk of neoplasm/malignancy as their follicular counterparts 肿瘤细胞/Hürthle 细胞病变与滤泡性病变具有相同的肿瘤/恶性肿瘤隐含风险。
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-07-16 DOI: 10.1111/cyt.13424
Diana Lin, C. Alexandra Hanna, Andra Frost, Allison Wrenn, Isam Eltoum

Introduction

There are conflicting results on whether the presence of oncocytes modifies the risk of neoplasm (RON) or malignancy (ROM) for thyroid fine-needle aspirates (FNAs): Atypia of undetermined significance AUS and Follicular Neoplasm, FN, or Oncocytic Neoplasm, ON. To our knowledge, the effect of non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) has not yet been studied. We compared RON and ROM between follicular type AUS (AUS-FT) and oncocytic type AUS (AUS-OT) and between FN and ON.

Materials and Methods

We retrospectively analysed all thyroid FNAs with the diagnostic category of AUS-other or Neoplasm (2005–2015). AUS-FT had predominance of microfollicles and AUS-OT had predominance of oncocytes. Histology follow-up was then reviewed and RON, ROM was then calculated and compared (significant at p < 0.05). We repeated the search for 2018 to evaluate for NIFTP effect.

Results

Pre-NIFTP, 859/5063 cases (17%) were AUS-FT, AUS-OT, FN, and ON. Histology follow-up was available for 297 cases (35%). RON was 83/183 (45%) for AUS-FT, 35/76 (46%) for AUS-OT, 15/25 (60%) for FN and 11/13 (85%) for ON. Post-NIFTP, RON was 11/31 (35%) for AUS-FT, 5/8 (63%) for AUS-OT, 1/2 (50%) for FN and 4/5 (80%) for ON. For both periods, RON, ROM of AUS-FT was not significantly different than AUS-OT, and no significant differences were observed comparing FN and ON.

Conclusion

The predominance of oncocytes does not modify the implied RON, ROM for categories of AUS or FNON, even after the adoption of NIFTP.

导言:关于癌细胞的存在是否会改变甲状腺细针穿刺(FNA)的肿瘤(RON)或恶性(ROM)风险,目前尚存在相互矛盾的结果:意义未定的不典型性(AUS)和滤泡性肿瘤(FN)或肿瘤细胞性肿瘤(ON)。据我们所知,目前尚未研究过具有乳头状核特征的非侵袭性甲状腺滤泡性肿瘤(NIFTP)的影响。我们比较了滤泡型甲状腺瘤(AUS-FT)和肿瘤细胞型甲状腺瘤(AUS-OT)之间以及FN和ON之间的RON和ROM:我们对所有诊断类别为AUS-其他或肿瘤(2005-2015年)的甲状腺FNA进行了回顾性分析。AUS-FT以微滤泡为主,AUS-OT以肿瘤细胞为主。然后对组织学随访进行复查,计算并比较 RON、ROM(以 p 为显著结果):NIFTP前,859/5063例(17%)为AUS-FT、AUS-OT、FN和ON。297例(35%)获得了组织学随访。AUS-FT的RON为83/183(45%),AUS-OT为35/76(46%),FN为15/25(60%),ON为11/13(85%)。NIFTP 后,RON 在 AUS-FT 为 11/31(35%),AUS-OT 为 5/8(63%),FN 为 1/2 (50%),ON 为 4/5(80%)。在这两个时期,AUS-FT的RON、ROM与AUS-OT没有明显差异,FN和ON也没有明显差异:结论:即使在采用 NIFTP 后,肿瘤细胞的优势也不会改变 AUS 或 FNON 类别的隐含 RON、ROM。
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引用次数: 0
Accuracy of ultrasound-guided fine-needle aspiration cytology in evaluation of thyroid nodules using different ultrasonographic and cytological features 超声引导下细针穿刺细胞学利用不同的超声和细胞学特征评估甲状腺结节的准确性。
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-07-13 DOI: 10.1111/cyt.13420
Fayed Al-Yousofy, Mukhtar Hamood, Abdullah M. Almatary, Abdullatif Mothanna, Saleh Al-Wageeh, Saeed T. Nasher, Ammar Alselwi, Huda Hassan, Anwer Al-Yousofy, Radwan H. Ahmad

Background

Fine-needle aspiration cytology (FNAC) is a reliable method for preoperative evaluation of thyroid nodules particularly if ultrasound-guided (USG-FNAC). The main purpose of this study is to evaluate the efficacy of USG-FNAC and its accuracy.

Methods

We retrospectively studied 212 thyroidectomy cases with preoperative ultrasonography and FNAC data during the period 2015–2022 using TI-RADS for final ultrasound diagnosis and Bethesda system for cytological diagnosis.

Results

The studied cases were 200 females and 12 males. Thyroid cancer was more prevalent under 20 years old (78.5%). Papillary thyroid carcinoma comprises 84% of all cancer cases. Significant ultrasound features (p-value <0.05) favour malignancy were hypoechogenicity (66%), mixed echogenicity (84%), irregular border (61%), microcalcification (68%) and rim halo (63.6%). Malignancy was found in 21% of TI-RADS-2, 65% of TI-RADS-4 and 100% of TI-RADS-5. There is a significant difference between different categories of Bethesda system. All cases in Cat-VI were malignant (100%). Malignancy was also found in 81% of Cat-V, 20% of Cat-IV, 33% of Cat-III, 16% of Cat-II and 43% of Cat-I. Cytological features consistent with malignancy were as follows: grooving (94%), nuclear irregularities (89%), nuclear pseudoinclusion (89%) and little colloid (82%). In our study, USG-FNAC sensitivity was 83%, specificity 85%, PPV 85%, NPV 83% and accuracy 84%.

Conclusion

Ultrasound features in favour of malignancy in thyroid nodules are hypoechoic or complex echogenicity, irregular border, punctuate calcification and presence of rim halo. Cytological features in favour of malignancy are grooving, nuclear irregularities, nuclear pseudoinclusion and little or absent colloid.

背景:细针穿刺细胞学检查(FNAC)是甲状腺结节术前评估的可靠方法,尤其是在超声引导下(USG-FNAC)。本研究的主要目的是评估 USG-FNAC 的疗效及其准确性:我们回顾性研究了 2015-2022 年间 212 例甲状腺切除术病例的术前超声和 FNAC 数据,使用 TI-RADS 进行最终超声诊断,使用 Bethesda 系统进行细胞学诊断:研究病例中有 200 名女性和 12 名男性。甲状腺癌的发病年龄多在 20 岁以下(78.5%)。甲状腺乳头状癌占所有癌症病例的 84%。重要的超声特征(P值 结论:有利于甲状腺结节恶性的超声特征是低回声或复合回声、边界不规则、点状钙化和边缘光环。有利于恶性的细胞学特征是沟纹、核不规则、核假包涵、胶体少或无。
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引用次数: 0
Cytomorphological characteristics of low-grade papillary urothelial carcinoma in voided urine samples: Distinction from benign and high-grade papillary urothelial carcinoma 排空尿液样本中低级别乳头状尿路上皮癌的细胞形态学特征:与良性和高级别乳头状尿路上皮癌的区别。
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-07-11 DOI: 10.1111/cyt.13413
Kotaro Takeda, Adebowale J. Adeniran, Angelique W. Levi, Haiming Tang, Guoping Cai

Objective

Given its frequent recurrence and the potential for high-grade transformation, accurate diagnosis of low-grade papillary urothelial carcinoma (LGPUC) in urine cytology is clinically important. We attempted to identify cytomorphologic features in urine samples, which could be helpful for the identification of LGPUC.

Methods

We conducted a retrospective review of voided urine specimens collected from patients with histopathologic diagnoses of LGPUC. Their cytomorphological features were compared with those from patients with benign conditions and high-grade papillary urothelial carcinoma (HGPUC).

Results

A total of 115 voided urine specimens were evaluated, including 30 benign, 41 LGPUC, and 44 HGPUC cases. In LGPUC, 18 cases (44%) were diagnosed as atypical, a proportion significantly higher than that observed in benign cases (4 cases, 13%), while the remaining 23 cases (56%) were diagnosed as negative. LGPUC urine samples tended to have higher cellularity than benign cases, but the difference was not statistically significant. Three cytological features, namely nuclear enlargement, higher nuclear-to-cytoplasmic (N/C) ratio, and presence of small cell clusters, were statistically more prevalent in LGPUC compared to benign cases, although the changes were relatively subtle. In contrast, cytomorphological distinction between LGPUC and HGPUC was evident, as high cellularity, nuclear enlargement, hyperchromasia, high N/C ratio, irregular nuclear membrane, and apoptosis were significantly more prevalent in HGPUC cases.

Conclusions

Several cytomorphologic features in voided urine samples were more prevalent in cases with LGPUC, albeit not observed in all instances. Since these alterations were relatively subtle, meticulous attention to these cytomorphologic details is crucial to suggest the possibility of LGPUC.

目的:鉴于低级别乳头状尿路上皮癌(LGPUC)经常复发并可能发生高级别转化,因此在尿液细胞学中准确诊断低级别乳头状尿路上皮癌(LGPUC)具有重要的临床意义。我们试图确定尿液样本中的细胞形态学特征,这可能有助于鉴别 LGPUC:我们对组织病理学诊断为 LGPUC 患者的排空尿液标本进行了回顾性研究。方法:我们对组织病理学诊断为 LGPUC 患者的排空尿液标本进行了回顾性研究,并将其细胞形态学特征与良性病变和高级别乳头状尿路上皮癌(HGPUC)患者的细胞形态学特征进行了比较:结果:共评估了 115 份排尿标本,包括 30 例良性病例、41 例 LGPUC 和 44 例 HGPUC。在 LGPUC 中,18 例(44%)被诊断为非典型,这一比例明显高于良性病例(4 例,13%),而其余 23 例(56%)被诊断为阴性。与良性病例相比,LGPUC 尿液样本的细胞率较高,但差异无统计学意义。与良性病例相比,LGPUC 的三个细胞学特征,即核增大、核与细胞质(N/C)比值升高和出现小细胞团,在统计学上更为普遍,尽管这些变化相对细微。相比之下,LGPUC和HGPUC的细胞形态学区别很明显,因为高细胞度、核增大、高色素沉着、高N/C比值、不规则核膜和细胞凋亡在HGPUC病例中明显更普遍:结论:尽管并非在所有情况下都能观察到LGPUC病例,但排空尿液样本中的一些细胞形态学特征在LGPUC病例中更为普遍。由于这些改变相对微妙,因此仔细观察这些细胞形态学细节对提示 LGPUC 的可能性至关重要。
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引用次数: 0
Does HPV-18 co-infection increase the risk of cervical pathology in individuals with HPV-16? HPV-18 合并感染是否会增加 HPV-16 感染者发生宫颈病变的风险?
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-07-11 DOI: 10.1111/cyt.13422
Mustafa Gökkaya, Aysun Alcı, Okan Aytekin, Mehmet Unsal, Caner Cakır, Okan Oktar, Necim Yalcin, Alper Kahraman, Alp Tokalioglu, Burak Ersak, Hande Esra Koca Yıldırım, Sevgi Koc, Tayfun Toptas, Fatih Kilic, Fatih Celik, Nurettin Boran, Yaprak Ustun, Ozlem Moraloglu Tekin, Gunsu Kimyon Comert, Vakkas Korkmaz, Taner Turan, Isin Ureyen

Objective

We aimed to investigate differences between HPV-16 mono- and HPV-16/18 co-infections in terms of cervical dysplasia and invasive cancer.

Methods

This multicentre, retrospective study spanned from December 2017 to December 2020, involving women who visited gynaecological oncology clinics for colposcopy with either HPV-16 or HPV-16/18 positivity. A total of 736 patients, 670 in Group 1 (HPV-16 positivity) and 66 in Group 2 (HPV-16/18 positivity), were compared for the presence of CIN2+ lesions detected by colposcopic biopsy or endocervical curettage (ECC). Exclusions included hysterectomized patients, those with prior gynaecological cancers, and patients with HPV positivity other than types 16 and 18.

Results

Among the included patients, 42.4% had a diagnosis of CIN2+ lesions. The cytology results demonstrated abnormal findings in 45.3% in Group 1 and 42.2% in Group 2, with no significant difference between the groups. ECC revealed CIN2+ lesion in 49 (8.7%) patients in group 1, while only 1 (1.7%) patient had CIN2+ lesion in group 2. There was no difference between 2 groups in terms of ECC result (p = 0.052). In group 1, 289 (43.1%) patients had CIN2+ lesion, while 23 (34.8%) patients had CIN2+ lesions in group 2. There was no difference between group 1 and 2 in terms of diagnosis of CIN2+ lesions (p = 0.19).

Conclusion

This multicentre retrospective study found no significant differences between HPV-16 mono- and HPV-16/18 co-infections regarding cervical pathologies. Larger studies are needed to validate and further explore these findings.

目的我们旨在研究HPV-16单感染和HPV-16/18合并感染在宫颈发育不良和浸润性癌症方面的差异:这项多中心回顾性研究的时间跨度为 2017 年 12 月至 2020 年 12 月,研究对象为前往妇科肿瘤诊所进行阴道镜检查的 HPV-16 或 HPV-16/18 阳性的女性。共对 736 名患者进行了比较,其中 670 人属于第 1 组(HPV-16 阳性),66 人属于第 2 组(HPV-16/18 阳性),通过阴道镜活检或宫颈内口刮宫术(ECC)检测是否存在 CIN2+ 病变。不包括子宫切除患者、曾患妇科癌症的患者以及除 16 型和 18 型以外的 HPV 阳性患者:在纳入的患者中,42.4%确诊为 CIN2+ 病变。细胞学结果显示,第 1 组和第 2 组分别有 45.3% 和 42.2% 的患者发现异常,组间差异不显著。第 1 组有 49 名(8.7%)患者的 ECC 显示病灶为 CIN2+,而第 2 组仅有 1 名(1.7%)患者的 ECC 显示病灶为 CIN2+,两组 ECC 结果无差异(P = 0.052)。第 1 组中有 289 例(43.1%)患者有 CIN2+ 病变,而第 2 组中有 23 例(34.8%)患者有 CIN2+ 病变。 第 1 组和第 2 组在 CIN2+ 病变的诊断方面没有差异(p = 0.19):这项多中心回顾性研究发现,HPV-16 单感染与 HPV-16/18 合并感染在宫颈病变方面没有明显差异。需要更大规模的研究来验证和进一步探讨这些发现。
{"title":"Does HPV-18 co-infection increase the risk of cervical pathology in individuals with HPV-16?","authors":"Mustafa Gökkaya,&nbsp;Aysun Alcı,&nbsp;Okan Aytekin,&nbsp;Mehmet Unsal,&nbsp;Caner Cakır,&nbsp;Okan Oktar,&nbsp;Necim Yalcin,&nbsp;Alper Kahraman,&nbsp;Alp Tokalioglu,&nbsp;Burak Ersak,&nbsp;Hande Esra Koca Yıldırım,&nbsp;Sevgi Koc,&nbsp;Tayfun Toptas,&nbsp;Fatih Kilic,&nbsp;Fatih Celik,&nbsp;Nurettin Boran,&nbsp;Yaprak Ustun,&nbsp;Ozlem Moraloglu Tekin,&nbsp;Gunsu Kimyon Comert,&nbsp;Vakkas Korkmaz,&nbsp;Taner Turan,&nbsp;Isin Ureyen","doi":"10.1111/cyt.13422","DOIUrl":"10.1111/cyt.13422","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to investigate differences between HPV-16 mono- and HPV-16/18 co-infections in terms of cervical dysplasia and invasive cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicentre, retrospective study spanned from December 2017 to December 2020, involving women who visited gynaecological oncology clinics for colposcopy with either HPV-16 or HPV-16/18 positivity. A total of 736 patients, 670 in Group 1 (HPV-16 positivity) and 66 in Group 2 (HPV-16/18 positivity), were compared for the presence of CIN2+ lesions detected by colposcopic biopsy or endocervical curettage (ECC). Exclusions included hysterectomized patients, those with prior gynaecological cancers, and patients with HPV positivity other than types 16 and 18.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the included patients, 42.4% had a diagnosis of CIN2+ lesions. The cytology results demonstrated abnormal findings in 45.3% in Group 1 and 42.2% in Group 2, with no significant difference between the groups. ECC revealed CIN2+ lesion in 49 (8.7%) patients in group 1, while only 1 (1.7%) patient had CIN2+ lesion in group 2. There was no difference between 2 groups in terms of ECC result (<i>p</i> = 0.052). In group 1, 289 (43.1%) patients had CIN2+ lesion, while 23 (34.8%) patients had CIN2+ lesions in group 2. There was no difference between group 1 and 2 in terms of diagnosis of CIN2+ lesions (<i>p</i> = 0.19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This multicentre retrospective study found no significant differences between HPV-16 mono- and HPV-16/18 co-infections regarding cervical pathologies. Larger studies are needed to validate and further explore these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 6","pages":"757-760"},"PeriodicalIF":1.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581575","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}
引用次数: 0
Cytological features of ependymal and choroid plexus tumours 上皮和脉络丛肿瘤的细胞学特征。
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-07-10 DOI: 10.1111/cyt.13418
Kristof Egervari, Ekkehard Hewer

Ependymal and choroid plexus tumours arise in anatomically related regions. Their intraoperative differential diagnosis is large and depends on factors such as age, tumour site and clinical presentation. Squash cytology can provide valuable information in this context. Cytological features of conventional ependymomas, subependymomas and myxopapillary ependymomas as well as choroid plexus tumours are reviewed and illustrated. Differential diagnostic considerations integrating morphological and clinical information are discussed.

外胚叶肿瘤和脉络丛肿瘤发生在解剖学上相关的区域。它们的术中鉴别诊断范围很广,取决于年龄、肿瘤部位和临床表现等因素。壁细胞学在这方面可以提供有价值的信息。本文回顾并阐述了传统上皮瘤、亚独立瘤、肌乳头状上皮瘤以及脉络丛肿瘤的细胞学特征。讨论了结合形态学和临床信息进行鉴别诊断的注意事项。
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引用次数: 0
The evolving role of interventional cytopathology from thyroid FNA to NGS: Lessons learned at Federico II University of Naples. 从甲状腺 FNA 到 NGS,介入细胞病理学的作用在不断演变:那不勒斯费德里科二世大学的经验教训。
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-07-09 DOI: 10.1111/cyt.13415
Elena Vigliar, Anna Maria Carillo, Mariantonia Nacchio, Domenico Cozzolino, Gennaro Acanfora, Maria Salatiello, Pasquale Pisapia, Umberto Malapelle, Giancarlo Troncone, Claudio Bellevicine

Fine-needle aspiration (FNA) guided by ultrasound (US) has emerged as a highly precise diagnostic method for managing thyroid nodules, significantly diminishing unnecessary surgeries. The effectiveness of US-guided FNA is high when a single specialist performs the FNA procedure and the microscopy. This paradigm has paved the way for the evolution of interventional cytopathology, a specialist with a pivotal role in the preoperative diagnostic process, encompassing patient history review, clinical examination, FNA execution under US guidance, preparation, and microscopic interpretation of cytological samples. As the landscape of precision medicine unfolds, molecular testing assumes greater importance in thyroid cytopathology, particularly in refining the risk of malignancy for indeterminate nodules. The updated Bethesda classification system underscores the clinical significance of molecular tests, emphasizing their role in refining diagnostic accuracy. With this evolving landscape, interventional cytopathologists must adapt by acquiring expertise in molecular technologies and addressing ongoing challenges in workflow harmonization and optimization. This paper delves into our decade-long experience as interventional cytopathologists, focusing on recent endeavours to ensure adequate samples not only for microscopic diagnosis but also for molecular testing. Additionally, here we review the challenges of integrating next-generation sequencing (NGS) technology into clinical practice, highlighting the importance of integrating clinically meaningful molecular data into comprehensive molecular cytology reports.

超声波(US)引导下的细针穿刺术(FNA)已成为治疗甲状腺结节的一种高度精确的诊断方法,大大减少了不必要的手术。如果由一名专家进行 FNA 手术和显微镜检查,那么 US 引导下 FNA 的有效性就会很高。这种模式为介入性细胞病理学的发展铺平了道路,介入性细胞病理学专家在术前诊断过程中扮演着举足轻重的角色,包括患者病史回顾、临床检查、在 US 引导下执行 FNA、准备细胞学样本并进行显微镜解读。随着精准医学的发展,分子检测在甲状腺细胞病理学中的重要性日益凸显,尤其是在细化不确定结节的恶性风险方面。更新后的贝塞斯达分类系统强调了分子检测的临床意义,强调了分子检测在提高诊断准确性方面的作用。面对不断变化的形势,介入性细胞病理学家必须掌握分子技术方面的专业知识,应对工作流程协调和优化方面的持续挑战。本文深入探讨了我们作为介入性细胞病理学家长达十年的经验,重点介绍了我们最近为确保样本不仅能用于显微诊断,还能用于分子检测所做的努力。此外,我们还回顾了将新一代测序(NGS)技术融入临床实践的挑战,强调了将具有临床意义的分子数据整合到全面的分子细胞学报告中的重要性。
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引用次数: 0
Vacuoles in a bone marrow smear: Not always reactive 骨髓涂片中的空泡:不一定有反应
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-07-09 DOI: 10.1111/cyt.13421
Karan Mayani-Mayani, Marcelo Pedro Barrios-Suvelza, Cristina Bilbao-Sieyro, Emilio González-Arnay

Vacuoles are a common observation in bone marrow smears, often related to reactive causes. The authors report a clinical case with this cytology finding in a 67-year-old male patient with systemic symptoms.

空泡是骨髓涂片中常见的现象,通常与反应性原因有关。作者报告了一个临床病例,该病例是一名 67 岁的男性患者,伴有全身症状。
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引用次数: 0
Unleash your potential: Inside interventional pathology. 释放您的潜能:走进介入病理学。
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-07-09 DOI: 10.1111/cyt.13417
Karen Villar-Zarra, Ronald Balassanian, Philippe Vielh

Interventional pathology has emerged as a pivotal force in modern healthcare, heralding a paradigm shift from traditional diagnostic approaches to patient-centered care. This innovative field bridges the gap between pathology and cytopathology, empowering pathologists to streamline diagnoses and reduce waiting times for patients. Collaborative mentorship and knowledge sharing ensure a lasting legacy of diagnostic excellence for future generations. Interventional pathology stands as a symbol of innovation and patient empowerment, offering a unified approach to diagnostics and improved care in the era of personalized medicine. This narrative chronicles the evolution of interventional pathologists from behind-the-scenes diagnostic specialists to frontline innovators. This is the story of the rise of the interventional pathologist: a testament to innovation, dedication, and an unwavering commitment to patient well-being.

介入病理学已成为现代医疗保健领域一支举足轻重的力量,预示着从传统诊断方法到以患者为中心的医疗模式的转变。这一创新领域填补了病理学与细胞病理学之间的空白,使病理学家有能力简化诊断,减少患者的等待时间。合作指导和知识共享可确保为后代留下卓越诊断的永久遗产。介入病理学是创新和患者赋权的象征,在个性化医疗时代提供了统一的诊断方法和更好的护理。本书记录了介入病理学家从幕后诊断专家到一线创新者的演变过程。这就是介入病理学家崛起的故事:创新、奉献和对患者福祉坚定不移的承诺的见证。
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引用次数: 0
Evaluation and application of American College of Radiology Thyroid Imaging Reporting and Data System for improved malignancy detection in paediatric thyroid nodules 评估和应用美国放射学会甲状腺成像报告和数据系统,改进儿科甲状腺结节的恶性肿瘤检测。
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-06-30 DOI: 10.1111/cyt.13414
Carlos A. Ortega, Jean-Nicolas Gallant, Irem Kilic, Siddharth Patel, Sheau-Chiann Chen, C. Burton Wood, Ryan Adams, Fadi Azer, Huiying Wang, Jiancong Liang, Sara H. Duffus, Ryan H. Belcher, Rochelle F. Andreotti, Rekha Krishnasarma, Jennifer E. Lim-Dunham, Güliz A. Barkan, Fei Ye, Vivian L. Weiss

Objective

The American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) is a widely used method for the management of adult thyroid nodules. However, its use in paediatric patients is controversial because adult fine needle aspiration biopsy (FNAB) recommendations may lead to delayed diagnoses of cancer in children. The objectives of this study were to evaluate the performance of TI-RADS in paediatric thyroid nodules and to tailor FNAB recommendations for children.

Methods

Consecutive surgically resected paediatric thyroid nodules from two tertiary care centres between 2003 and 2021 were reviewed. Ultrasounds were blindly scored by radiologists according to TI-RADS. Management recommendations based on TI-RADS were evaluated. Various modelling methodologies were used to determine the optimal cutoff for FNAB in children.

Results

Of the 96 patients, 79 (82%) were female and the median age at surgery was 16.1 years. Fifty (52%) nodules were malignant on surgical pathology. The area under the receiver operating characteristic curve of TI-RADS for predicting malignancy was 0.78. Adult TI-RADS recommendations would have resulted in 4% of cancerous nodules being lost to follow-up. Modifications to TI-RADS (FNAB of all TR3 nodules ≥1.5 cm, FNAB of TR4 and TR5 nodules ≥0.5 cm, surveillance of nodules ≥1 cm, consider surgery for nodules >4 cm) reduced this missed malignancy rate to 0%.

Conclusions

TI-RADS can risk-stratify paediatric thyroid nodules. However, the system requires modifications to reduce the missed malignancy rate in paediatric thyroid nodules. Our data suggest that lower size thresholds for FNAB are warranted in children.

目的:美国放射学会甲状腺成像报告和数据系统(TI-RADS)是一种广泛用于成人甲状腺结节管理的方法。然而,由于成人细针穿刺活检(FNAB)建议可能导致儿童癌症诊断延迟,因此该系统在儿童患者中的应用还存在争议。本研究的目的是评估TI-RADS在儿科甲状腺结节中的表现,并为儿童量身定制FNAB建议:方法:对2003年至2021年期间在两家三级医疗中心连续手术切除的儿童甲状腺结节进行回顾性研究。放射科医生根据 TI-RADS 对超声波进行盲法评分。对基于 TI-RADS 的管理建议进行了评估。采用各种建模方法确定儿童 FNAB 的最佳临界值:在 96 名患者中,79 名(82%)为女性,手术时的中位年龄为 16.1 岁。手术病理结果显示,50 个(52%)结节为恶性。TI-RADS预测恶性的接收者操作特征曲线下面积为0.78。成人 TI-RADS 建议会导致 4% 的癌症结节失去随访机会。对 TI-RADS 的修改(对所有 TR3 结节≥1.5 厘米进行 FNAB,对 TR4 和 TR5 结节≥0.5 厘米进行 FNAB,对≥1 厘米的结节进行监测,对>4 厘米的结节考虑手术)将恶性肿瘤的漏诊率降至 0%:结论:TI-RADS 可以对儿科甲状腺结节进行风险分级。结论:TI-RADS 可以对儿科甲状腺结节进行风险分级,但需要对该系统进行修改,以降低儿科甲状腺结节的恶性漏诊率。我们的数据表明,应降低儿童 FNAB 的尺寸阈值。
{"title":"Evaluation and application of American College of Radiology Thyroid Imaging Reporting and Data System for improved malignancy detection in paediatric thyroid nodules","authors":"Carlos A. Ortega,&nbsp;Jean-Nicolas Gallant,&nbsp;Irem Kilic,&nbsp;Siddharth Patel,&nbsp;Sheau-Chiann Chen,&nbsp;C. Burton Wood,&nbsp;Ryan Adams,&nbsp;Fadi Azer,&nbsp;Huiying Wang,&nbsp;Jiancong Liang,&nbsp;Sara H. Duffus,&nbsp;Ryan H. Belcher,&nbsp;Rochelle F. Andreotti,&nbsp;Rekha Krishnasarma,&nbsp;Jennifer E. Lim-Dunham,&nbsp;Güliz A. Barkan,&nbsp;Fei Ye,&nbsp;Vivian L. Weiss","doi":"10.1111/cyt.13414","DOIUrl":"10.1111/cyt.13414","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) is a widely used method for the management of adult thyroid nodules. However, its use in paediatric patients is controversial because adult fine needle aspiration biopsy (FNAB) recommendations may lead to delayed diagnoses of cancer in children. The objectives of this study were to evaluate the performance of TI-RADS in paediatric thyroid nodules and to tailor FNAB recommendations for children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive surgically resected paediatric thyroid nodules from two tertiary care centres between 2003 and 2021 were reviewed. Ultrasounds were blindly scored by radiologists according to TI-RADS. Management recommendations based on TI-RADS were evaluated. Various modelling methodologies were used to determine the optimal cutoff for FNAB in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 96 patients, 79 (82%) were female and the median age at surgery was 16.1 years. Fifty (52%) nodules were malignant on surgical pathology. The area under the receiver operating characteristic curve of TI-RADS for predicting malignancy was 0.78. Adult TI-RADS recommendations would have resulted in 4% of cancerous nodules being lost to follow-up. Modifications to TI-RADS (FNAB of all TR3 nodules ≥1.5 cm, FNAB of TR4 and TR5 nodules ≥0.5 cm, surveillance of nodules ≥1 cm, consider surgery for nodules &gt;4 cm) reduced this missed malignancy rate to 0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TI-RADS can risk-stratify paediatric thyroid nodules. However, the system requires modifications to reduce the missed malignancy rate in paediatric thyroid nodules. Our data suggest that lower size thresholds for FNAB are warranted in children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 6","pages":"749-756"},"PeriodicalIF":1.2,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cyt.13414","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472764","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}
引用次数: 0
Primary pulmonary epithelioid hemangioendothelioma metastatic to the pleura and mediastinal lymph node with a prominent rhabdoid cytomorphology showing CAMTA1::WWTR1 fusion and novel PRDM1 and TNFRSF14 mutations 转移至胸膜和纵隔淋巴结的原发性肺上皮样血管内皮细胞瘤,具有突出的横纹肌样细胞形态,显示CAMTA1::WWTR1融合以及新型PRDM1和TNFRSF14突变。
IF 1.2 4区 医学 Q4 CELL BIOLOGY Pub Date : 2024-06-28 DOI: 10.1111/cyt.13416
Maria F. Gonzalez, Anjali Seth

Cases of epithelioid hemangioendothelioma with WWTR1::CAMTA1 fusion can show rhabdoid cytomorphology. Lack of intracytoplasmic luminal spaces, marked rhabdoid cytomorphology, and variability in the expression of vascular markers makes the diagnosis of EHE challenging. Therefore, a high level of suspicion and ancillary studies (immunohistochemistry and next generation sequencing) help reach a definitive diagnosis in these cases.

WWTR1::CAMTA1融合的上皮样血管内皮瘤病例可表现为横纹细胞形态。由于缺乏胞浆内腔隙、明显的横纹状细胞形态以及血管标志物表达的多变性,EHE 的诊断具有挑战性。因此,高度怀疑和辅助研究(免疫组化和新一代测序)有助于对这些病例做出明确诊断。
{"title":"Primary pulmonary epithelioid hemangioendothelioma metastatic to the pleura and mediastinal lymph node with a prominent rhabdoid cytomorphology showing CAMTA1::WWTR1 fusion and novel PRDM1 and TNFRSF14 mutations","authors":"Maria F. Gonzalez,&nbsp;Anjali Seth","doi":"10.1111/cyt.13416","DOIUrl":"10.1111/cyt.13416","url":null,"abstract":"<p>Cases of epithelioid hemangioendothelioma with <i>WWTR1</i>::<i>CAMTA1</i> fusion can show rhabdoid cytomorphology. Lack of intracytoplasmic luminal spaces, marked rhabdoid cytomorphology, and variability in the expression of vascular markers makes the diagnosis of EHE challenging. Therefore, a high level of suspicion and ancillary studies (immunohistochemistry and next generation sequencing) help reach a definitive diagnosis in these cases.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":55187,"journal":{"name":"Cytopathology","volume":"35 5","pages":"654-657"},"PeriodicalIF":1.2,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472765","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}
引用次数: 0
期刊
Cytopathology
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