Cytopathology最新文献

英文中文

Artificial intelligence algorithm accurately assesses oestrogen receptor immunohistochemistry in metastatic breast cancer cytology specimens: A pilot study 人工智能算法准确评估转移性乳腺癌细胞学标本中的雌激素受体免疫组化：试点研究。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-03-22 DOI: 10.1111/cyt.13373

Brenna C. Li, Scott Hammond, Anil V. Parwani, Rulong Shen

Objective

The Visiopharm artificial intelligence (AI) algorithm for oestrogen receptor (ER) immunohistochemistry (IHC) in whole slide images (WSIs) has been successfully validated in surgical pathology. This study aimed to assess its efficacy in cytology specimens.

Methods

The study cohort comprised 105 consecutive cytology specimens with metastatic breast carcinoma. ER IHC WSIs were seamlessly integrated into the Visiopharm platform from the Image Management System (IMS) during our routine digital workflow, and an AI algorithm was employed for analysis. ER AI scores were compared with pathologists' manual consensus scores. Optimization steps were implemented and evaluated to reduce discordance.

Results

The overall concordance between pathologists' scores and AI scores was excellent (99/105, 94.3%). Six cases exhibited discordant results, including two false-negative (FN) cases due to abundant histiocytes incorrectly counted as negatively stained tumour cells by AI, two FN cases owing to weak staining, and two false-positive (FP) cases where pigmented macrophages were erroneously counted as positively stained tumour cells by AI. The Pearson correlation coefficient of ER-positive percentages between pathologists' and AI scores was 0.8483. Optimization steps, such as lowering the cut-off threshold and additional training using higher input magnification, significantly improved accuracy.

Conclusions

The automated ER AI algorithm demonstrated excellent concordance with pathologists' assessments and accurately differentiated ER-positive from ER-negative metastatic breast carcinoma cytology cases. However, precision in identifying tumour cells in cytology specimens requires further enhancement.

目的：Visiopharm 人工智能（AI）算法用于全切片图像（WSI）中的雌激素受体（ER）免疫组化（IHC），已在外科病理学中成功验证。本研究旨在评估该算法在细胞学标本中的有效性：研究对象包括 105 例转移性乳腺癌的连续细胞学标本。在常规数字工作流程中，将ER IHC WSI从图像管理系统（IMS）无缝集成到Visiopharm平台，并采用人工智能算法进行分析。ER人工智能评分与病理学家的人工共识评分进行了比较。对优化步骤进行了实施和评估，以减少不一致性：结果：病理学家评分与人工智能评分的总体一致性非常好（99/105，94.3%）。有 6 个病例出现了不一致的结果，包括 2 个假阴性（FN）病例，原因是大量组织细胞被 AI 误认为是阴性染色的肿瘤细胞；2 个 FN 病例，原因是染色较弱；2 个假阳性（FP）病例，色素巨噬细胞被 AI 误认为是阳性染色的肿瘤细胞。病理学家和 AI 评分之间 ER 阳性百分比的皮尔逊相关系数为 0.8483。优化步骤，如降低截止阈值和使用更高的输入放大倍率进行额外训练，显著提高了准确性：ER自动人工智能算法与病理学家的评估结果非常吻合，能准确区分ER阳性和ER阴性转移性乳腺癌细胞学病例。不过，细胞学标本中肿瘤细胞的识别精度还需要进一步提高。

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引用次数: 0

A sub-hepatic nodule in a young female: Chase the case 一名年轻女性的肝下结节：追踪病例

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-03-17 DOI: 10.1111/cyt.13374

Dipanwita Biswas, Parikshaa Gupta, Nalini Gupta, Radhika Srinivasan, Harish Bhujade

Sertoli–Leydig cell tumours (SLCTs) are rare, mixed sex-cord stromal tumours composed of varying proportions of both Sertoli and Leydig cells, which account for <0.5% of all ovarian tumours. The cytomorphologic features of SLCTs are not well described in literature. Herein, we describe the cytomorphologic features of an SLCT at an uncommon metastatic site in a young female.

Sertoli-Leydig细胞瘤（SLCT）是一种罕见的混合性脐带间质瘤，由不同比例的Sertoli细胞和Leydig细胞组成。

引用次数: 0

Uses and limitations of small-volume biopsies for the diagnosis of lymphoma 小体积活检在淋巴瘤诊断中的用途和局限性。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-03-10 DOI: 10.1111/cyt.13372

Megan J. Fitzpatrick, Aliyah R. Sohani, Amy Ly

Although surgical biopsy remains the gold standard for the diagnosis of lymphoma, small-volume biopsies including fine-needle aspiration and core needle biopsy are increasingly being used as a first line diagnostic tool. Small-volume biopsies are safe, rapid and cost effective; however, diagnostic utility varies by lymphoma subtype. It is important for pathologists and clinicians to recognize both the strengths and limitations of such biopsies.

尽管手术活检仍是诊断淋巴瘤的金标准，但包括细针穿刺和核心针活检在内的小量活检正越来越多地被用作一线诊断工具。小体积活检安全、快速、经济有效，但诊断效用因淋巴瘤亚型而异。病理学家和临床医生必须认识到这类活检的优势和局限性。

引用次数: 0

Cytomorphology of metastatic malignant peripheral nerve sheath tumour present in pleural fluid: Case study and literature review 胸腔积液中转移性恶性周围神经鞘瘤的细胞形态学：病例研究与文献综述。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-03-05 DOI: 10.1111/cyt.13371

Yun-Cui Pan, Yi Xu, Qian Wang, Zhi-Hong Xian, Shu-Hui Zhang

The cytomorphology of MPNST in effusion specimens is rarely described. In this paper, the detailed cytopathological and immunohistochemical characteristics of metastatic MPNST has been described in pleural effusion. Patients' medical history and the judicious utilization of ancillary studies contribute to ensure precise cytological diagnoses.

The cytomorphology of malignant peripheral nerve sheath tumour (MPNST) in effusion specimens can be diagnostically challenging. The author presents detailed cytopathological and immunohistochemical characteristics of a case of metastatic MPNST in pleural effusion.

很少有人对积液标本中 MPNST 的细胞形态学进行描述。本文详细描述了胸腔积液中转移性 MPNST 的细胞病理学和免疫组化特征。患者的病史和辅助检查的合理利用有助于确保精确的细胞学诊断。恶性周围神经鞘瘤（MPNST）渗出标本的细胞形态学诊断具有挑战性。作者详细介绍了一例胸腔积液中转移性 MPNST 的细胞病理学和免疫组化特征。

引用次数: 0

Telecytology – remote rapid on-site evaluation for ultrasound-guided head and neck fine needle aspiration utilising a clinical imaging assistant with an extended practice role 远程细胞学--利用临床成像助理的扩展实践角色，对超声引导下的头颈部细针穿刺进行远程快速现场评估。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-02-19 DOI: 10.1111/cyt.13370

Sarah Martyn, Leonie Wheeldon

Objective

Rapid On-Site Evaluation (ROSE) of fine needle aspirations (FNA) is widely accepted as best practice, resulting in better outcomes and delivery of care for patients. However, it is not always practical for cytology laboratories to release staff. To increase the availability of ROSE, this study aimed to robustly test the effectiveness of Telecytology ROSE (TCROSE) utilising a clinical imaging assistant (CIA) to prepare the samples and operate the microscope.

Methods

The study was divided into 3 phases. Phase 1, equipment testing, validation and in-house training for the CIA and the Consultant Biomedical Scientist (CBMS) performing TCROSE. Phase 2, Verifying TCROSE on the same site as the cytology laboratory and phase 3, TCROSE utilising a clinic at a peripheral site away from the cytology laboratory.

Results

78/80 (97% sensitivity, 95% accuracy) of TCROSE cases matched the final report for assessment of adequacy and sufficient sampling, demonstrating 94% reliability with a 95% confidence value. An appropriately trained CIA effectively prepared the samples and operated the microscope for remote interpretation. The samples were triaged effectively, and biopsy requests were appropriate to reduce the need for repeat procedures and delays in treatment. This approach received positive feedback from patients.

Conclusion

TCROSE utilising a CIA provides a highly effective alternative to conventional ROSE, minimising the resources required from cytopathology services and improving patient care and access to best practice. This study supports the validity of trained CIAs for a more involved role in the ultrasound-guided FNA service.

目的：对细针抽吸术（FNA）进行快速现场评估（ROSE）已被公认为最佳做法，可为患者带来更好的治疗效果和护理服务。然而，细胞学实验室并不总能腾出人手。为了提高远程细胞学ROSE的可用性，本研究旨在利用临床成像助理（CIA）准备样本和操作显微镜，对远程细胞学ROSE（TCROSE）的有效性进行有力的测试：研究分为三个阶段。第 1 阶段：设备测试、验证，并对 CIA 和执行 TCROSE 的生物医学科学家顾问（CBMS）进行内部培训。第 2 阶段，在细胞学实验室的同一地点验证 TCROSE；第 3 阶段，利用细胞学实验室外围地点的诊所进行 TCROSE：78/80（灵敏度为 97%，准确度为 95%）个 TCROSE 病例与最终报告中的适当性和充分取样评估相匹配，显示出 94% 的可靠性和 95% 的置信度。经过适当培训的 CIA 有效地准备了样本，并操作显微镜进行远程判读。对样本进行了有效的分流，并提出了适当的活检要求，以减少重复程序和治疗延误的需要。这种方法得到了患者的积极反馈：利用 CIA 的 TCROSE 为传统的 ROSE 提供了一种高效的替代方法，最大限度地减少了细胞病理学服务所需的资源，改善了患者护理并使患者能够获得最佳治疗。这项研究支持经过培训的 CIA 在超声引导 FNA 服务中发挥更重要的作用。

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引用次数: 0

Thyroid poorly differentiated carcinoma metastatic to pancreas diagnosed by fine-needle aspiration and demonstrating a novel BRAF fusion 通过细针穿刺诊断出转移至胰腺的甲状腺低分化癌，并显示出新型 BRAF 融合。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-02-15 DOI: 10.1111/cyt.13353

Saman Seyed Ahmadian, Daniel Jones, Paul Wakely Jr, Abberly A. Lott Limbach

Differentiating pancreatic duct adenocarcinoma from metastasis can be challenging by morphology alone. Metastasis from a classic papillary thyroid carcinoma can present as a poorly differentiated carcinoma and mimic pancreatic ductal adenocarcinoma's morphology.

仅从形态上区分胰腺导管腺癌和转移瘤很有难度。来自典型甲状腺乳头状癌的转移瘤可表现为分化不良癌，并模仿胰腺导管腺癌的形态。

引用次数: 0

A tumour with two-and-a-half faces—Primary lung adenosquamous carcinoma causing secondary squamous cell carcinoma in the colon 两面半的肿瘤--原发性肺腺鳞癌导致结肠继发性鳞状细胞癌。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-02-15 DOI: 10.1111/cyt.13369

Pierre T. C. Tran, Ziying Zhang, Qing Chang, Hayan Jaratli, Beena U. Ahsan

Adenosquamous carcinoma in the lung was the source of colonic squamous cell carcinoma. Next-generation sequencing confirmed the two tumours were the same, highlighting the importance of clinical suspicion and thorough workup, including genetic testing, in lung cancer cases.

肺腺鳞状细胞癌是结肠鳞状细胞癌的来源。下一代测序证实这两种肿瘤是相同的，这突出了临床怀疑和全面检查（包括基因检测）在肺癌病例中的重要性。

引用次数: 0

The diagnostic utility of Merkel cell polyoma virus immunohistochemistry in cytology specimens 细胞学标本中梅克尔细胞多瘤病毒免疫组化的诊断作用。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-02-14 DOI: 10.1111/cyt.13366

Aysha Mubeen, Jeffrey K. Mito

Objective

Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine neoplasm that predominantly affects elderly and immunocompromised patients. Merkel cell polyoma virus (MCPyV) is clonally integrated into the majority of MCCs and has been linked to patient outcomes, playing a central role in the pathogenesis of the disease. We aimed to assess the utility of MCPyV immunohistochemistry (IHC) in the diagnosis of MCC in cytology cell block specimens and correlating with clinicopathologic features.

Methods

Fifty-three cytology samples of MCC with sufficient cell block material were stained for MCPyV by IHC and scored semi-quantitatively in extent and intensity. Morphologic mimics of MCC including small cell lung carcinoma (n = 10), non-Hodgkin lymphoma (n = 10), basaloid squamous cell carcinoma (n = 6) and other neuroendocrine carcinomas (n = 8) were stained in parallel. Positive staining was defined as >1% of the tumour cells showing at least moderate staining intensity.

Results

The cytologic features of MCC were characterized by high nuclear-cytoplasmic ratios, hyperchromatic nuclei with ‘salt and pepper’ chromatin, and nuclear moulding. MCPyV was detected in 24 of 53 cases (45%). Staining was strong and diffuse in roughly half of the positive samples. Of the morphologic mimics, one follicular lymphoma showed strong and diffuse staining. In contrast to prior studies, we saw no association between MCPyV status and patient outcomes.

Conclusion

Merkel cell polyoma virus IHC is highly specific (97%) for the diagnosis of MCC in our cohort, and can serve as a useful diagnostic tool for distinguishing MCC for morphologic mimics.

目的：梅克尔细胞癌（MCC）是一种侵袭性皮肤神经内分泌肿瘤，主要影响老年和免疫力低下的患者。梅克尔细胞多瘤病毒（MCPyV）克隆整合到大多数梅克尔细胞癌中，并与患者的预后有关，在该病的发病机制中起着核心作用。我们的目的是评估 MCPyV 免疫组织化学（IHC）在细胞学细胞块标本中诊断 MCC 的效用以及与临床病理特征的相关性：方法：用 IHC 对 53 份有足够细胞块材料的 MCC 细胞学样本进行 MCPyV 染色，并对其范围和强度进行半定量评分。同时对 MCC 的形态学模拟物进行染色，包括小细胞肺癌（10 例）、非霍奇金淋巴瘤（10 例）、基底鳞状细胞癌（6 例）和其他神经内分泌癌（8 例）。大于 1% 的肿瘤细胞显示至少中等程度的染色强度即为阳性染色：MCC的细胞学特征为高核-胞质比率、染色质为 "盐和胡椒 "的高色素核以及核模塑。53 例病例中有 24 例（45%）检测到 MCPyV。大约一半的阳性样本染色较强，呈弥漫性。在形态学拟态样本中，有一个滤泡淋巴瘤出现了强烈的弥漫性染色。与之前的研究不同，我们发现 MCPyV 状态与患者预后之间没有关联：梅克尔细胞多瘤病毒 IHC 对我们队列中 MCC 的诊断具有高度特异性（97%），可作为一种有用的诊断工具，用于区分 MCC 与形态学拟态。

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引用次数: 0

Updates in head and neck cytopathology: Insights from European Congress of Pathology Short Course 头颈部细胞病理学的最新进展：欧洲病理学大会短期课程的启示。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-02-13 DOI: 10.1111/cyt.13368

Ivana Kholová, Ashish Chandra, William C. Faquin, Niels J. Rupp, Philip Touska, Esther O'Regan

Cytological specimens play a pivotal role in head and neck nodule/mass work up and diagnoses. The specimens´ importance has grown with the onset of personalized medicine and the routine use of molecular markers in the diagnostic work up. The Updates in Head and Neck Cytopathology Short Course ran during the 35th European Congress of Pathology held in Dublin, Ireland, in 2023 and brought together experts in cytopathology, pathology, and related fields to share their expertise and experience in the field of head and neck cytopathology and its future directions. Topics such as a one-stop clinic, the Milan System for Reporting Salivary Gland Cytopathology, next generation sequencing, and human papilloma virus detection in the head and neck area were covered during the short course. These topics are briefly summarized in the present review.

细胞学标本在头颈部结节/肿块的检查和诊断中起着举足轻重的作用。随着个性化医疗的出现以及分子标记物在诊断工作中的常规使用，标本的重要性与日俱增。头颈部细胞病理学最新进展短期课程于2023年在爱尔兰都柏林举行的第35届欧洲病理学大会期间举办，汇集了细胞病理学、病理学及相关领域的专家，分享他们在头颈部细胞病理学领域的专业知识和经验及其未来发展方向。短训班的主题包括一站式诊所、米兰唾液腺细胞病理学报告系统、新一代测序、头颈部人类乳头瘤病毒检测等。本综述对这些主题进行了简要总结。

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Molecular analysis of endobronchial ultrasound needle aspirates in patients with non-small cell lung cancer: Results from the SCOPE database 非小细胞肺癌患者支气管内超声针吸液的分子分析：来自 SCOPE 数据库的结果。

IF 1.3 4区医学 Q4 CELL BIOLOGY

Cytopathology

Pub Date : 2024-02-13 DOI: 10.1111/cyt.13367

Erik Vakil, Elaine Dumoulin, Daniel Stollery, Ashley-Mae Gillson, Paul MacEachern, Inderdeep Dhaliwal, Michael Mitchell, Pen Li, Colin Schieman, Nicholas Romatowski, Alex C. Chee, Chung Chun Tyan, Marc Fortin, Christopher A. Hergott, Alain Tremblay

Objective

Molecular subtyping of non-small cell lung cancer (NSCLC) is critical in the diagnostic evaluation of patients with advanced disease. This study aimed to examine whether samples from endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) of intrathoracic lymph nodes and/or lung lesions are adequate for molecular analysis across various institutions.

Methods

We retrospectively reviewed all cases of linear EBUS-TBNA with a final bronchoscopic diagnosis of NSCLC entered in the Stather Canadian Outcomes registry for chest ProcEdures database. The primary outcome was specimen inadequacy rate for each molecular target, as defined by the local laboratory or pathologist.

Results

A total of 866 EBUS-TBNA procedures for NSCLC were identified. Specimen inadequacy rates were 3.8% for EGFR, 2.5% for ALK-1 and 3.5% for PD-L1. Largest target size was not different between adequate and inadequate specimens, and rapid onsite evaluation did not increase specimen adequacy rates. One centre using next-generation sequencing for EGFR had lower adequacy rates than 2 others using matrix-assisted laser desorption/ionization time-of-flight mass spectrophotometry.

Conclusion

EBUS-TBNA specimens have a very low-specimen inadequacy rate for molecular subtyping of non-small cell lung cancer.

目的：非小细胞肺癌（NSCLC）的分子亚型鉴定对于晚期患者的诊断评估至关重要。本研究旨在探讨不同机构的胸内淋巴结和/或肺部病变的支气管内超声经支气管针吸术（EBUS-TBNA）样本是否足以进行分子分析：我们回顾性分析了所有经支气管镜最终诊断为 NSCLC 的线性 EBUS-TBNA 病例，并将其输入 Stather 加拿大胸部 ProcEdures 数据库的结果登记。主要结果是由当地实验室或病理学家定义的每个分子靶点的标本不足率：共确定了 866 例 NSCLC EBUS-TBNA 手术。EGFR、ALK-1和PD-L1的标本不足率分别为3.8%、2.5%和3.5%。最大靶标大小在标本合格与不合格之间没有差异，现场快速评估并不会提高标本合格率。使用新一代表皮生长因子受体测序法检测表皮生长因子受体的一个中心的标本合格率低于使用基质辅助激光解吸/电离飞行时间质谱法检测的另外两个中心：结论：EBUS-TBNA标本用于非小细胞肺癌分子亚型鉴定的标本不足率非常低。

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