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The Utility of Fallopian Tube Cytology in the Early Detection of Extrauterine Serous Gynecological Malignancies: A Narrative Literature Review. 输卵管细胞学在早期检测子宫外浆液性妇科恶性肿瘤中的应用:叙述性文献综述。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 Epub Date: 2023-04-12 DOI: 10.1159/000530600
Victoria Psomiadou, Sofia Lekka, Theodoros Panoskaltsis, Helen Tsouma, Natasa Novkovic, Helen J Trihia, Olympia Tzaida, Dimitrios Korfias, Panagiotis Giannakas, Christos Iavazzo, Christos Papadimitriou, Nikolaos Vlahos, George Vorgias

Introduction: The aim of the study was to analyze the published evidence for the use of fallopian tube brush cytology for the early detection of extrauterine serous gynecological cancer.

Methods: We systematically searched the literature and, additionally, cross-checked on the bibliographies of selected articles. The inclusion criteria involved studies assessing the utility of fallopian tube brush cytology and its applications in the diagnosis, screening, or follow-up of extrauterine serous gynecological cancer.

Results: The search strategy resulted in 21 abstracts or full-text articles, 5 of which met the inclusion criteria. The year of publication ranged from 2016 to 2022, and a total of 193 fallopian tube samples were investigated. Cytobrush, Tubebrush©, and Cytuity™ were used to obtain salpingeal samples for liquid-based cytology evaluation.

Conclusions: Our findings indicate that, at present, there is a lack of satisfying evidence-based data in the literature which would support the implementation of fallopian tube brush cytology as an adjunctive tool for early detection of extrauterine serous gynecological cancer. Thus, we believe that there is need for well-designed clinical studies to assess the effectiveness and diagnostic accuracy of the method as well as to validate the cytological criteria for the diagnosis and prediction of gynecological malignancies.

引言:本研究的目的是分析已发表的输卵管刷细胞学早期检测子宫外浆液性妇科癌症的证据。方法:我们系统地检索文献,并对所选文章的参考书目进行交叉核对。纳入标准包括评估输卵管刷细胞学的实用性及其在子宫外浆液性妇科癌症诊断、筛查或随访中的应用的研究。结果:检索策略得到21篇摘要或全文文章,其中5篇符合入选标准。发表年份为2016年至2022年,共调查了193个输卵管样本。Cytobrush、Tubbush©和Cytuity™ 用于获得输卵管样本进行基于液体的细胞学评估。结论:我们的研究结果表明,目前文献中缺乏令人满意的循证数据来支持输卵管刷细胞学作为早期检测子宫外浆液性妇科癌症的辅助工具的实施。因此,我们认为有必要进行精心设计的临床研究,以评估该方法的有效性和诊断准确性,并验证妇科恶性肿瘤诊断和预测的细胞学标准。
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引用次数: 0
Aptima HR-HPV Testing of Cytology Specimens Is an Effective Supplement for p16 Staining to Improve Diagnostic Accuracy for HPV-Related Oropharyngeal Squamous Cell Carcinoma. 细胞学标本的 Aptima HR-HPV 检测是 p16 染色的有效补充,可提高与 HPV 相关的口咽鳞状细胞癌的诊断准确性。
IF 1.6 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 Epub Date: 2022-12-13 DOI: 10.1159/000527951
Xin Yang, Chunfang Hu, Huan Zhao, Zhihui Zhang, Linlin Zhao, Jing Yu, Xiaoguang Ni, Huiqin Guo

Introduction: Regarding a small proportion of oropharyngeal squamous cell carcinoma (OPSCC) patients who tested p16-positive but human papillomavirus (HPV)-negative, we attempted to perform HPV testing to improve the accuracy of HPV detection in OPSCC patients.

Methods: We simultaneously performed Aptima HPV testing of cytological specimens and p16 immunohistochemistry (IHC) staining of histologic biopsies from the same cohort of patients with head and neck SCC (HNSCC). The cytological specimens included fine-needle aspiration specimens from patients with enlarged nodes and endoscopic brushing specimens from the primary lesions of patients without enlarged nodes. Cases with discordant results for p16 IHC staining and Aptima HPV testing were reexamined by a third method, RNAscope testing.

Results: Sixty patients with HNSCC (39 OPSCC and 21 non-OPSCC) were recruited for examination of HPV status. Among these patients, 28 were p16+/HPV+, 29 were p16-/HPV-, 2 were p16+/HPV-, and 1 was p16-/HPV+. The overall concordance rate between Aptima HPV testing and p16 IHC was 95.0%. Three cases with discordant results for these two methods were reexamined by RNAscope testing, and all were confirmed to be HPV negative. The prevalence of HPV in OPSCC and non-OPSCC patients was 61.5% (24/39) and 19.0% (4/21), respectively. The sensitivity and negative predictive values of Aptima HPV testing and p16 IHC were consistent at 100%, while the specificity and positive predictive values were 96.9% and 96.6% versus 93.8% and 93.3%, respectively. Additionally, 30 OPSCCs were simultaneously examined and diagnosed by both brush cytology and biopsy pathology; six of these SCCs were underdiagnosed by histopathology but accurately diagnosed by supplemental brush cytology.

Conclusion: Aptima HPV testing of cytology specimens can be used as an adjuvant examination to identify false-positive OPSCC patients after p16 IHC of biopsies, while brush cytology may be a supplemental method for the histologic diagnosis of malignant oropharyngeal tumors.

导言:有一小部分口咽鳞状细胞癌(OPSCC)患者的p16检测呈阳性,但人乳头状瘤病毒(HPV)检测呈阴性,针对这一情况,我们尝试进行HPV检测,以提高口咽鳞状细胞癌患者HPV检测的准确性:我们同时对细胞学标本进行了 Aptima HPV 检测,并对来自同一批头颈部 SCC(HNSCC)患者的组织学活检样本进行了 p16 免疫组织化学(IHC)染色。细胞学标本包括结节增大患者的细针穿刺标本和无结节增大患者原发病灶的内窥镜刷片标本。对于 p16 IHC 染色和 Aptima HPV 检测结果不一致的病例,则采用第三种方法(RNAscope 检测)进行复查:共招募了 60 例 HNSCC 患者(39 例 OPSCC 和 21 例非 OPSCC)进行 HPV 状态检查。在这些患者中,28 人 p16+/HPV+ ,29 人 p16-/HPV- ,2 人 p16+/HPV- ,1 人 p16-/HPV+ 。Aptima HPV 检测与 p16 IHC 检测的总体吻合率为 95.0%。三种方法结果不一致的三个病例通过 RNAscope 检测进行了复查,结果均证实为 HPV 阴性。OPSCC和非OPSCC患者的HPV感染率分别为61.5%(24/39)和19.0%(4/21)。Aptima HPV 检测和 p16 IHC 的灵敏度和阴性预测值均为 100%,特异性和阳性预测值分别为 96.9% 和 96.6% 与 93.8% 和 93.3%。此外,刷状细胞学和活检病理学同时检查和诊断了30个OPSCC;其中6个SCC组织病理学诊断不足,但补充刷状细胞学诊断准确:结论:细胞学标本的Aptima HPV检测可用作辅助检查,以鉴别活检p16 IHC后假阳性的OPSCC患者,而毛刷细胞学检查可作为恶性口咽肿瘤组织学诊断的补充方法。
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引用次数: 0
A Retrospective Analysis of the Application of the Newly Proposed International System for Reporting Serous Fluid Cytopathology on Serous Effusion Specimens: An Institutional Experience. 回顾性分析新提出的浆液细胞病理报告国际系统在浆液标本上的应用:一个机构的经验。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 DOI: 10.1159/000527398
Priyadarshini Kumaraswamy Rajeswaran, Vidhyalakshmi Srinivasan, Swaathi Shri Venkatasubramanian Mahesh, Arsha Usha Ashok

Introduction: The International Academy of Cytology and the American Society of Cytopathology recently proposed the International System for Reporting Serous Fluid Cytology (ISRSFC) to standardize serous fluid cytopathology reporting and guide further clinical management. The current study aimed to assess the feasibility of utilizing ISRSFC reporting categories for serous fluids, estimate the risk of malignancy (ROM) of each category, and scrutinize if the management protocols followed in our institution are as per the ISRFSFC recommendations.

Methods: All pleural, peritoneal, and pericardial effusions submitted for evaluation at our institute between January 2021 and December 2021 were retrieved. All these cases were reviewed and re-categorized into one of the five categories proposed by the ISRSFC: non-diagnostic (ND), negative for malignancy (NFM), atypia of uncertain significance (AUS), suspicious for malignancy (SFM), and malignant (MAL), and ROM was calculated for each category.

Results: The present study examined 596 serous effusions, of which 229 were pleural effusions, 358 were peritoneal effusions, and the remaining nine were pericardial effusions. Among 596 cases, 395 cases had a radiological or histological follow-up. The serous effusion samples were re-categorized as 61 (10.2%) ND, 449 (75.3%) NFM, 47 (7.8%) AUS, 17 (2.9%) SFM, and 22 (3.8%) MAL, and ROM for each above category were 10%, 4.4%, 19%, 83.3%, and 100%, respectively.

Conclusion: Categorizing serous effusion cytology samples per the ISRSFC diagnostic categories reduces reporting variability. The ISRSFC provides a standardized format to predict the ROM and thus improves the quality of clinical care.

简介:国际细胞学学会和美国细胞病理学学会最近提出了国际浆液细胞学报告系统(ISRSFC),以规范浆液细胞病理学报告并指导进一步的临床管理。本研究旨在评估在浆液中使用ISRSFC报告类别的可行性,估计每个类别的恶性风险(ROM),并审查我们机构所遵循的管理方案是否符合ISRFSFC的建议。方法:检索2021年1月至2021年12月期间在我们研究所提交评估的所有胸膜、腹膜和心包积液。对所有病例进行回顾,并将其重新分类为ISRSFC提出的5类:非诊断性(ND)、恶性阴性(NFM)、意义不确定异型(AUS)、可疑恶性(SFM)和恶性(MAL)之一,并计算每一类的ROM。结果:本研究检查了596例浆液积液,其中229例为胸腔积液,358例为腹膜积液,其余9例为心包积液。在596例病例中,395例进行了放射学或组织学随访。浆液积液样本重新分类为ND 61例(10.2%),NFM 449例(75.3%),AUS 47例(7.8%),SFM 17例(2.9%),MAL 22例(3.8%),ROM分别为10%,4.4%,19%,83.3%和100%。结论:根据ISRSFC诊断分类对浆液积液细胞学样本进行分类可以减少报告的可变性。ISRSFC提供了预测ROM的标准化格式,从而提高了临床护理的质量。
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引用次数: 1
A New Cytology Staining Method: A Fast Approach for Rapid On-Site Evaluation on Thyroid Fine-Needle Aspiration Cytology. 一种新的细胞学染色方法:甲状腺细针穿刺细胞学快速现场评价的快速方法。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 DOI: 10.1159/000527347
Paula de Melo Alves, Fernando Ferreira, Telma Oliveira, Daniela Alves, Sule Canberk, Fernando C Schmitt

Introduction: Thyroid fine-needle aspiration (FNA) is a well-established technique in the cytology literature. Through the introduction of rapid stains in cytology practice, the ever-increasing utility of rapid on-site evaluation (ROSE) has strengthened the place of FNA as a primary diagnostic method in patient management. There are few stain variants available in the market for ROSE, namely Diff-Quik (DQ), Toluidine blue, and ultrafast Papanicolaou stains. Recently, our group developed a new staining variant labeled as original "BlueStain®" technique that was not previously tested in this context.

Methods: 40 FNA thyroid cases were studied. At least two slides were prepared from each patient: one stained by DQ and the other by BlueStain®. Simultaneously, a ROSE diagnosis was performed as the two staining methods were compared, evaluating the parameters of background, cellularity, details of colloid presence, cell morphology, nuclear details, cytoplasmic details, and overall staining, scored on a scale from 1 to 3, representing poor, average, and good, respectively.

Results: The quality index was slightly better for BlueStain® (53% vs. 47%) but not significantly different between the two stains. BlueStain® provides better details in both the presence and type of colloid as well as nuclear details, which are regarded as very important for diagnosis in thyroid cytology. There were eight cases with discordant diagnosis when compared between two stains from the same patient. In five cases of indeterminate cases, BlueStain® allows to bring them to the benign category, probably because this staining method allows a clear observation of the colloid in the background of the smears. However, since we are observing two different slides, we cannot rule out that these differences are a question of sample collecting and/or smearing.

Conclusions: Our data demonstrates that BlueStain® is suitable to provide good-quality slides for primary assessments of thyroid aspirates studied by ROSE. In fact, in some aspects, this new staining method shows better preservation of colloid and cell details, revealing itself as an alternative to the DQ stain variant, upholding performance level while being 10 times cheaper and simpler because it requires just one step of staining.

简介:甲状腺细针穿刺(FNA)在细胞学文献中是一种成熟的技术。通过在细胞学实践中引入快速染色,快速现场评估(ROSE)的不断增加的效用加强了FNA作为患者管理的主要诊断方法的地位。市场上有几种ROSE染色剂可供选择,即diff - quick (DQ)、甲苯胺蓝和超快Papanicolaou染色剂。最近,我们的团队开发了一种新的染色变体,标记为原始的“BlueStain®”技术,以前没有在这种情况下进行过测试。方法:对40例FNA甲状腺病例进行分析。每位患者至少准备两张载玻片:一张用DQ染色,另一张用BlueStain®染色。同时,通过比较两种染色方法,进行ROSE诊断,评估背景、细胞度、胶体存在细节、细胞形态、核细节、细胞质细节和整体染色等参数,分别以1到3分进行评分,分别代表差、平均和良好。结果:BlueStain®的质量指数略好(53%对47%),但两种染色剂之间无显著差异。BlueStain®在胶体的存在和类型以及核细节方面提供了更好的细节,这对于甲状腺细胞学诊断非常重要。对同一患者的两种染色进行比较,有8例诊断不一致。在5例不确定病例中,BlueStain®允许将其带入良性类别,可能是因为这种染色方法可以清楚地观察到涂片背景中的胶体。然而,由于我们观察的是两种不同的载玻片,我们不能排除这些差异是样品收集和/或涂抹的问题。结论:我们的数据表明,BlueStain®适合为ROSE研究的甲状腺吸入物的初步评估提供高质量的载玻片。事实上,在某些方面,这种新的染色方法可以更好地保存胶体和细胞细节,显示出它是DQ染色变体的替代品,在保持性能水平的同时便宜10倍,更简单,因为它只需要一个染色步骤。
{"title":"A New Cytology Staining Method: A Fast Approach for Rapid On-Site Evaluation on Thyroid Fine-Needle Aspiration Cytology.","authors":"Paula de Melo Alves,&nbsp;Fernando Ferreira,&nbsp;Telma Oliveira,&nbsp;Daniela Alves,&nbsp;Sule Canberk,&nbsp;Fernando C Schmitt","doi":"10.1159/000527347","DOIUrl":"https://doi.org/10.1159/000527347","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid fine-needle aspiration (FNA) is a well-established technique in the cytology literature. Through the introduction of rapid stains in cytology practice, the ever-increasing utility of rapid on-site evaluation (ROSE) has strengthened the place of FNA as a primary diagnostic method in patient management. There are few stain variants available in the market for ROSE, namely Diff-Quik (DQ), Toluidine blue, and ultrafast Papanicolaou stains. Recently, our group developed a new staining variant labeled as original \"BlueStain®\" technique that was not previously tested in this context.</p><p><strong>Methods: </strong>40 FNA thyroid cases were studied. At least two slides were prepared from each patient: one stained by DQ and the other by BlueStain®. Simultaneously, a ROSE diagnosis was performed as the two staining methods were compared, evaluating the parameters of background, cellularity, details of colloid presence, cell morphology, nuclear details, cytoplasmic details, and overall staining, scored on a scale from 1 to 3, representing poor, average, and good, respectively.</p><p><strong>Results: </strong>The quality index was slightly better for BlueStain® (53% vs. 47%) but not significantly different between the two stains. BlueStain® provides better details in both the presence and type of colloid as well as nuclear details, which are regarded as very important for diagnosis in thyroid cytology. There were eight cases with discordant diagnosis when compared between two stains from the same patient. In five cases of indeterminate cases, BlueStain® allows to bring them to the benign category, probably because this staining method allows a clear observation of the colloid in the background of the smears. However, since we are observing two different slides, we cannot rule out that these differences are a question of sample collecting and/or smearing.</p><p><strong>Conclusions: </strong>Our data demonstrates that BlueStain® is suitable to provide good-quality slides for primary assessments of thyroid aspirates studied by ROSE. In fact, in some aspects, this new staining method shows better preservation of colloid and cell details, revealing itself as an alternative to the DQ stain variant, upholding performance level while being 10 times cheaper and simpler because it requires just one step of staining.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 3","pages":"289-294"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9925311","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
Utility of BAP1, p16, and Methylthio-Adenosine Phosphorylase Immunohistochemistry in Cytological and Histological Samples of Pleural Mesotheliomas. BAP1, p16和甲基硫代腺苷磷酸化酶免疫组化在胸膜间皮瘤细胞学和组织学样本中的应用。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 DOI: 10.1159/000530002
Vera Amacher, Peter Karl Bode, Holger Moch, Daniela Lenggenhager, Bart Vrugt

Introduction: In most cases, the diagnostic workup of pleural mesotheliomas (MPMs) starts with cytological examination of pleural effusion, but histology is needed to confirm the diagnosis. The introduction of BAP1 and methylthio-adenosine phosphorylase (MTAP) immunohistochemistry has become a powerful tool to confirm the malignant nature of mesothelial proliferations also in cytological specimens. The objective of this study was to determine the concordance of BAP1, MTAP, and p16 expression between cytological and histological samples of patients with MPM.

Methods: Immunohistochemistry of BAP1, MTAP, and p16 was performed on cytological samples and compared with the corresponding histological specimen of 25 patients with MPM. Inflammatory and stromal cells served as positive internal control for all three markers. In addition, samples of 11 patients with reactive mesothelial proliferations served as an external control group.

Results: Loss of BAP1, MTAP, and p16 expression was found in 68%, 72%, and 92% of MPM, respectively. Loss of MTAP was associated with loss of p16 expression in all cases. Concordance of BAP1 between cytological and corresponding histological samples was 100% (kappa coefficient 1; p = 0.008). For MTAP and p16, kappa coefficient was 0.9 (p = 0.01) and 0.8 (p = 0.7788), respectively.

Conclusions: Concordant BAP1, MTAP, and p16 expression is found between cytological and corresponding histological samples, indicating that a reliable diagnosis of MPM can be made on cytology only. Of the three markers, BAP1 and MTAP are most reliable in distinguishing malignant from reactive mesothelial proliferations.

简介:在大多数情况下,胸膜间皮瘤(MPMs)的诊断工作从胸膜积液细胞学检查开始,但需要组织学来确认诊断。引入BAP1和甲基硫代腺苷磷酸化酶(MTAP)免疫组化已成为细胞学标本中确认间皮增生恶性性质的有力工具。本研究的目的是确定MPM患者细胞学和组织学样本中BAP1、MTAP和p16表达的一致性。方法:对25例MPM患者细胞学标本进行BAP1、MTAP、p16的免疫组化,并与相应的组织学标本进行比较。炎症细胞和基质细胞是这三种标志物的阳性内控。此外,11例反应性间皮增生患者作为外部对照组。结果:BAP1、MTAP和p16的表达分别在68%、72%和92%的MPM中缺失。在所有病例中,MTAP的缺失都与p16表达的缺失相关。细胞学样本与相应的组织学样本BAP1的一致性为100% (kappa系数1;P = 0.008)。MTAP和p16的kappa系数分别为0.9 (p = 0.01)和0.8 (p = 0.7788)。结论:BAP1、MTAP、p16在细胞学和相应的组织学样本中表达一致,提示仅凭细胞学诊断可可靠诊断MPM。在这三种标志物中,BAP1和MTAP在区分恶性和反应性间皮细胞增殖方面是最可靠的。
{"title":"Utility of BAP1, p16, and Methylthio-Adenosine Phosphorylase Immunohistochemistry in Cytological and Histological Samples of Pleural Mesotheliomas.","authors":"Vera Amacher,&nbsp;Peter Karl Bode,&nbsp;Holger Moch,&nbsp;Daniela Lenggenhager,&nbsp;Bart Vrugt","doi":"10.1159/000530002","DOIUrl":"https://doi.org/10.1159/000530002","url":null,"abstract":"<p><strong>Introduction: </strong>In most cases, the diagnostic workup of pleural mesotheliomas (MPMs) starts with cytological examination of pleural effusion, but histology is needed to confirm the diagnosis. The introduction of BAP1 and methylthio-adenosine phosphorylase (MTAP) immunohistochemistry has become a powerful tool to confirm the malignant nature of mesothelial proliferations also in cytological specimens. The objective of this study was to determine the concordance of BAP1, MTAP, and p16 expression between cytological and histological samples of patients with MPM.</p><p><strong>Methods: </strong>Immunohistochemistry of BAP1, MTAP, and p16 was performed on cytological samples and compared with the corresponding histological specimen of 25 patients with MPM. Inflammatory and stromal cells served as positive internal control for all three markers. In addition, samples of 11 patients with reactive mesothelial proliferations served as an external control group.</p><p><strong>Results: </strong>Loss of BAP1, MTAP, and p16 expression was found in 68%, 72%, and 92% of MPM, respectively. Loss of MTAP was associated with loss of p16 expression in all cases. Concordance of BAP1 between cytological and corresponding histological samples was 100% (kappa coefficient 1; p = 0.008). For MTAP and p16, kappa coefficient was 0.9 (p = 0.01) and 0.8 (p = 0.7788), respectively.</p><p><strong>Conclusions: </strong>Concordant BAP1, MTAP, and p16 expression is found between cytological and corresponding histological samples, indicating that a reliable diagnosis of MPM can be made on cytology only. Of the three markers, BAP1 and MTAP are most reliable in distinguishing malignant from reactive mesothelial proliferations.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 4","pages":"444-450"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929664","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
Transthoracic Fine-Needle Aspiration Cytology of Pulmonary Spindle and Mesenchymal Neoplasms: A Pandora's Box. 肺梭形和间质肿瘤的经胸细针穿刺细胞学:潘多拉的盒子。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 DOI: 10.1159/000528843
Kanwalpreet Kaur, Trupti Patel, Sanjiban Patra, Priti Trivedi

Introduction: Pulmonary spindle cell and mesenchymal lesions are paradox for pathologists due to their rarity, overlapping morphology, and differentials ranging from benign to malignant lesions, and correct diagnosis is essential due to major treatment implications. This study highlights the role of fine-needle aspiration cytology, clot core biopsy, and immunohistochemistry in diagnosis of spindle cell lesions in lung, thus playing a key role in patient management.

Methods: It is a retrospective study of lung FNA with predominantly spindle and mesenchymal cells from 2015-2020 which were classified cytomorphologically into spindle, epithelioid, small round cell, and biphasic, and IHC panels are applied accordingly. FNA from mediastinum and chest wall was excluded.

Results: 60 cases of lung FNA with spindle and mesenchymal cells were identified and included 6 benign and 54 malignancies which included 24 primary pulmonary malignancies and 30 metastases. Most common primary malignancy was sarcomatoid carcinoma, and most common metastasis was malignant peripheral nerve sheath tumour. FNA was paucicellular in 7 cases and was reported as benign in 7 cases and malignant in 46 cases. There were two false-negative cases. One case of pulmonary blastoma was reported as inflammatory pseudotumour on cytology, and other case of chondrosarcoma was reported as chondroid tumour. Sensitivity and specificity of FNA in distinguishing benign lesions and malignancies were 93.8% and 100%, respectively.

Conclusion: FNA along with clot core biopsy/cell block and IHC plays a pivotal role in the subsequent pathway taken for diagnostic or therapeutic management of these patients without the need for second sampling or trucut biopsies in a low resource setting.

简介:肺梭形细胞和间质病变因其罕见、形态重叠、良恶性差异大,对病理学家来说是一个悖论,正确的诊断是重要的治疗意义。本研究强调细针穿刺细胞学、凝块核心活检和免疫组织化学在肺梭形细胞病变诊断中的作用,从而在患者管理中发挥关键作用。方法:对2015-2020年以梭形细胞和间充质细胞为主的肺FNA进行回顾性研究,细胞形态学上分为梭形细胞、上皮样细胞、小圆细胞和双相细胞,并采用免疫组化方法。排除纵隔和胸壁的FNA。结果:60例肺FNA伴梭形细胞和间充质细胞,其中良性6例,恶性54例,其中原发性肺恶性24例,转移性30例。原发肿瘤以肉瘤样癌多见,转移瘤以周围神经鞘恶性肿瘤多见。FNA 7例为少细胞性,7例为良性,46例为恶性。有两个假阴性病例。1例肺母细胞瘤细胞学上报告为炎性假瘤,另1例软骨肉瘤报告为软骨样瘤。FNA鉴别良性病变和恶性病变的敏感性为93.8%,特异性为100%。结论:在资源匮乏的情况下,FNA与凝块核心活检/细胞阻断和免疫组化在这些患者的诊断或治疗管理的后续途径中起着关键作用,而无需进行第二次采样或组织活检。
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引用次数: 0
Atypical Category of the Johns Hopkins Template Has Higher Risk of Malignancy than the Paris System but the Paris System Is More Applicable for Suspicious Category. 约翰霍普金斯模板的非典型类别比巴黎系统有更高的恶性风险,但巴黎系统更适用于可疑类别。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 DOI: 10.1159/000529484
Betul Celik, Gamze Kavas

Introduction: The aim of this study was to compare performance of individual categories between the Johns Hopkins template and the Paris system for reporting urinary cytology.

Methods: Medical records of patients with bladder biopsy and relevant cytology slides were obtained from archived material. Slides were reclassified according to Johns Hopkins template and the Paris system. Results were compared to histological diagnoses.

Results: BD SurePath preparations from 205 cases with biopsy follow-up (118 benign, 5 dysplasia, 23 low, and 59 malignant urothelial carcinoma [UC]) were reviewed. There were 2 inadequate specimens in each system. According to the Johns Hopkins template, there were 96 (46.8%) no urothelial atypia or malignancy, 37 (18%) atypical urothelial cells of uncertain significance (AUC-US), 21 (10.2%) atypical urothelial cells, cannot exclude high-grade urothelial carcinoma (HGUC), 38 (18.5%) HGUC, and 11 (5.4%) low-grade urothelial carcinoma (LGUC). The Paris system categorized 111 (54.1%) negative for high-grade urothelial carcinoma, 29 (14.1%) atypical urothelial cells (AUCs), 25 (12.2%) suspicious for HGUC (SHGUC), 36 (17.6%) HGUC, and 2 (1%) LGUC. The Johns Hopkins template had a sensitivity of 95.6%, specificity of 73.6%, positive predictive value of 61.5%, negative predictive value of 96.3, with an overall diagnostic accuracy of 79.8%. The Paris System had a sensitivity of 93.6%, specificity of 77.9%, positive predictive value of 65.6%, negative predictive value of 96.5, with an overall diagnostic accuracy of 82.8%. The risk of malignancy (ROM) for atypical category (AUC-US/AUC) in the Johns Hopkins template was 43.2%, while it has been 24.1% for the Paris System. The ROM for suspicious category was 47.6% and 68.0%, respectively. There were statistically significant differences between negative and atypical, suspicious, and HGUC categories in each system (p < 0.0001).

Conclusions: Discrete negative or benign urine cytology had the same sensitivity and specificity between two systems. Although atypical category was associated with a higher ROM with the Hopkins template, the ROM for the suspicious category yielded better result with the Paris system.

简介:本研究的目的是比较约翰霍普金斯模板和巴黎系统在报告泌尿细胞学方面的单个类别的表现。方法:从档案资料中获取膀胱活检患者病历及相关细胞学切片。根据约翰霍普金斯大学的模板和巴黎系统对幻灯片进行重新分类。结果与组织学诊断比较。结果:我们回顾了205例活检随访患者的BD SurePath制剂(118例良性,5例非典型增生,23例恶性,59例恶性尿路上皮癌[UC])。每个系统有2个样本不足。根据Johns Hopkins的模板,96例(46.8%)没有尿路上皮异型或恶性,37例(18%)不确定意义的非典型尿路上皮细胞(AUC-US), 21例(10.2%)非典型尿路上皮细胞,不能排除高级别尿路上皮癌(HGUC), 38例(18.5%)HGUC, 11例(5.4%)低级别尿路上皮癌(LGUC)。Paris系统将111例(54.1%)为高级别尿路上皮癌阴性,29例(14.1%)为非典型尿路上皮细胞(AUCs), 25例(12.2%)为可疑HGUC (SHGUC), 36例(17.6%)HGUC, 2例(1%)LGUC。Johns Hopkins模板的敏感性为95.6%,特异性为73.6%,阳性预测值为61.5%,阴性预测值为96.3,总体诊断准确率为79.8%。Paris系统的敏感性为93.6%,特异性为77.9%,阳性预测值为65.6%,阴性预测值为96.5,总体诊断准确率为82.8%。在约翰霍普金斯模板中,非典型分类(AUC- us /AUC)的恶性肿瘤(ROM)风险为43.2%,而在巴黎系统中为24.1%。可疑类别的ROM分别为47.6%和68.0%。各系统阴性与非典型、可疑、HGUC分类差异有统计学意义(p < 0.0001)。结论:离散阴性或良性尿细胞学在两种系统之间具有相同的敏感性和特异性。虽然非典型类别与霍普金斯模板的较高ROM相关,但可疑类别的ROM与巴黎系统产生更好的结果。
{"title":"Atypical Category of the Johns Hopkins Template Has Higher Risk of Malignancy than the Paris System but the Paris System Is More Applicable for Suspicious Category.","authors":"Betul Celik,&nbsp;Gamze Kavas","doi":"10.1159/000529484","DOIUrl":"https://doi.org/10.1159/000529484","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare performance of individual categories between the Johns Hopkins template and the Paris system for reporting urinary cytology.</p><p><strong>Methods: </strong>Medical records of patients with bladder biopsy and relevant cytology slides were obtained from archived material. Slides were reclassified according to Johns Hopkins template and the Paris system. Results were compared to histological diagnoses.</p><p><strong>Results: </strong>BD SurePath preparations from 205 cases with biopsy follow-up (118 benign, 5 dysplasia, 23 low, and 59 malignant urothelial carcinoma [UC]) were reviewed. There were 2 inadequate specimens in each system. According to the Johns Hopkins template, there were 96 (46.8%) no urothelial atypia or malignancy, 37 (18%) atypical urothelial cells of uncertain significance (AUC-US), 21 (10.2%) atypical urothelial cells, cannot exclude high-grade urothelial carcinoma (HGUC), 38 (18.5%) HGUC, and 11 (5.4%) low-grade urothelial carcinoma (LGUC). The Paris system categorized 111 (54.1%) negative for high-grade urothelial carcinoma, 29 (14.1%) atypical urothelial cells (AUCs), 25 (12.2%) suspicious for HGUC (SHGUC), 36 (17.6%) HGUC, and 2 (1%) LGUC. The Johns Hopkins template had a sensitivity of 95.6%, specificity of 73.6%, positive predictive value of 61.5%, negative predictive value of 96.3, with an overall diagnostic accuracy of 79.8%. The Paris System had a sensitivity of 93.6%, specificity of 77.9%, positive predictive value of 65.6%, negative predictive value of 96.5, with an overall diagnostic accuracy of 82.8%. The risk of malignancy (ROM) for atypical category (AUC-US/AUC) in the Johns Hopkins template was 43.2%, while it has been 24.1% for the Paris System. The ROM for suspicious category was 47.6% and 68.0%, respectively. There were statistically significant differences between negative and atypical, suspicious, and HGUC categories in each system (p < 0.0001).</p><p><strong>Conclusions: </strong>Discrete negative or benign urine cytology had the same sensitivity and specificity between two systems. Although atypical category was associated with a higher ROM with the Hopkins template, the ROM for the suspicious category yielded better result with the Paris system.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 4","pages":"425-433"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9984049","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: 1
Interobserver Agreement among Cytopathologists in False-Negative Cases by Cytological Diagnosis with Endoscopic Ultrasound-Guided Fine Needle Aspiration in Solid Pancreatic Lesions. 内镜超声引导下细针抽吸胰腺实体瘤细胞学诊断假阴性病例中细胞病理学家的观察者间一致性。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 Epub Date: 2022-12-20 DOI: 10.1159/000528747
Chen Shi, Suwen Li, Lihong Chen, Jianglong Hong, Junjun Bao, Zhangwei Xu, Jianming Xu, Qiao Mei

Introduction: Early detection and accurate pathological assessment are critical to improving prognosis of pancreatic cancer. EUS has been widely used in diagnosing pancreatic lesions and can obtain histological diagnosis by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). However, comprehensive assessment of the interobserver agreement (IOA) among cytopathologists evaluating EUS-FNA specimens is still limited. Therefore, this study evaluated IOA among cytopathologists for EUS-FNA specimens of solid pancreatic lesions, especially in false-negative cases of cytological diagnosis and analyzed the factors that influence cytological diagnosis of EUS-FNA so as to improve the diagnostic efficiency of EUS-FNA.

Methods: We retrieved EUS-FNA samples of pancreatic solid lesions from 2017 to 2021 and collected their clinical/cytological data. Two cytopathologists independently reviewed these cases using a quoted, novel standardized cytology scoring tool. Ultimately, we calculated IOA among cytopathologists and performed a binary logistic regression analysis to evaluate factors influencing the cytological diagnosis of EUS-FNA.

Results: 161 patients were included, and 60 cases with a clinical diagnosis of pancreatic cancer but a cytological diagnosis of benign and atypical constituted the false-negative group. IOAs for cytological diagnosis of overall patients and the false-negative group were in perfect/moderate agreement with Kendall's W values of 0.896 and 0.462, respectively. The number of diagnostic cells in the scoring tool had the highest level of agreement (κ = 0.721) for overall patients. There was at best moderate agreement on other quantity and quality parameters for both all cases and false-negative group. Logistic regression analysis showed the number of diagnostic cells (OR = 6.110, p < 0.05) and amount of blood (OR = 0.320, p < 0.05) could influence cytological diagnosis.

Conclusions: The false-negative rate of our study as high as 37.26% (60/161) is mainly related to strict standards of cytopathologists, and their ability to standardize pancreatic cytology is still improving. Suboptimal agreement among cytopathologists for cytological diagnosis and the number of diagnostic cells may be associated with the occurrence of false-negative diagnosis. Further regression analysis confirmed that the number of diagnostic cells and obscuring blood were important factors in cytological diagnosis. Therefore, refinement of cytological diagnostic criteria, standardization of specimen quality evaluation, and training of cytopathologists may improve the agreement of cytopathologists, thus improving the repeatability of cytological diagnosis and reducing the occurrence of false-negative events.

简介早期发现和准确的病理评估是改善胰腺癌预后的关键。EUS 已被广泛用于诊断胰腺病变,并可通过内镜超声引导下细针穿刺术(EUS-FNA)获得组织学诊断。然而,对评估 EUS-FNA 标本的细胞病理学家的观察者间一致性(IOA)的全面评估仍然有限。因此,本研究评估了细胞病理学家对胰腺实体病变EUS-FNA标本的IOA,尤其是细胞学诊断假阴性病例,并分析了影响EUS-FNA细胞学诊断的因素,以提高EUS-FNA的诊断效率:我们检索了2017年至2021年胰腺实体病变的EUS-FNA样本,并收集了其临床/细胞学数据。两名细胞病理学家使用引用的新型标准化细胞学评分工具对这些病例进行独立审查。最终,我们计算了细胞病理学家的IOA,并进行了二元逻辑回归分析,以评估影响EUS-FNA细胞学诊断的因素:结果:共纳入 161 例患者,其中 60 例临床诊断为胰腺癌,但细胞学诊断为良性和非典型,构成假阴性组。所有患者和假阴性组的细胞学诊断IOAs完全/中等一致,Kendall's W值分别为0.896和0.462。对所有患者而言,评分工具中诊断细胞数的一致性最高(κ = 0.721)。在所有病例和假阴性组中,其他数量和质量参数的一致性最多为中等。逻辑回归分析表明,诊断细胞数(OR = 6.110,P < 0.05)和血量(OR = 0.320,P < 0.05)会影响细胞学诊断:本研究中高达37.26%(60/161)的假阴性率主要与细胞病理学家的严格标准有关,他们规范胰腺细胞学的能力仍在不断提高。细胞病理学家在细胞学诊断和诊断细胞数量方面的意见不统一可能与假阴性诊断的发生有关。进一步的回归分析证实,诊断细胞数量和模糊血液是细胞学诊断的重要因素。因此,细化细胞学诊断标准、规范标本质量评估和培训细胞病理学家可提高细胞病理学家的一致性,从而提高细胞学诊断的可重复性,减少假阴性事件的发生。
{"title":"Interobserver Agreement among Cytopathologists in False-Negative Cases by Cytological Diagnosis with Endoscopic Ultrasound-Guided Fine Needle Aspiration in Solid Pancreatic Lesions.","authors":"Chen Shi, Suwen Li, Lihong Chen, Jianglong Hong, Junjun Bao, Zhangwei Xu, Jianming Xu, Qiao Mei","doi":"10.1159/000528747","DOIUrl":"https://doi.org/10.1159/000528747","url":null,"abstract":"<p><strong>Introduction: </strong>Early detection and accurate pathological assessment are critical to improving prognosis of pancreatic cancer. EUS has been widely used in diagnosing pancreatic lesions and can obtain histological diagnosis by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). However, comprehensive assessment of the interobserver agreement (IOA) among cytopathologists evaluating EUS-FNA specimens is still limited. Therefore, this study evaluated IOA among cytopathologists for EUS-FNA specimens of solid pancreatic lesions, especially in false-negative cases of cytological diagnosis and analyzed the factors that influence cytological diagnosis of EUS-FNA so as to improve the diagnostic efficiency of EUS-FNA.</p><p><strong>Methods: </strong>We retrieved EUS-FNA samples of pancreatic solid lesions from 2017 to 2021 and collected their clinical/cytological data. Two cytopathologists independently reviewed these cases using a quoted, novel standardized cytology scoring tool. Ultimately, we calculated IOA among cytopathologists and performed a binary logistic regression analysis to evaluate factors influencing the cytological diagnosis of EUS-FNA.</p><p><strong>Results: </strong>161 patients were included, and 60 cases with a clinical diagnosis of pancreatic cancer but a cytological diagnosis of benign and atypical constituted the false-negative group. IOAs for cytological diagnosis of overall patients and the false-negative group were in perfect/moderate agreement with Kendall's W values of 0.896 and 0.462, respectively. The number of diagnostic cells in the scoring tool had the highest level of agreement (κ = 0.721) for overall patients. There was at best moderate agreement on other quantity and quality parameters for both all cases and false-negative group. Logistic regression analysis showed the number of diagnostic cells (OR = 6.110, p < 0.05) and amount of blood (OR = 0.320, p < 0.05) could influence cytological diagnosis.</p><p><strong>Conclusions: </strong>The false-negative rate of our study as high as 37.26% (60/161) is mainly related to strict standards of cytopathologists, and their ability to standardize pancreatic cytology is still improving. Suboptimal agreement among cytopathologists for cytological diagnosis and the number of diagnostic cells may be associated with the occurrence of false-negative diagnosis. Further regression analysis confirmed that the number of diagnostic cells and obscuring blood were important factors in cytological diagnosis. Therefore, refinement of cytological diagnostic criteria, standardization of specimen quality evaluation, and training of cytopathologists may improve the agreement of cytopathologists, thus improving the repeatability of cytological diagnosis and reducing the occurrence of false-negative events.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 3","pages":"240-247"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797143","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
Chondroblastoma: Cytomorphologic Analysis of 10 Cases with Review of the Literature. 成软骨细胞瘤:10例细胞形态学分析并文献复习。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 DOI: 10.1159/000528932
Carla Saoud, Paul E Wakely, Liron Pantanowitz, Momin T Siddiqui, Syed Z Ali

Introduction: Chondroblastoma (CB) is a rare, benign cartilage-producing tumor, typically affecting the epiphysis of long bones in skeletally immature individuals. There have been only limited case reports describing the cytomorphologic features of this tumor, and thus the cytopathologic diagnostic criteria are controversial. Herein, we report the cytologic findings of 10 CB cases, discuss the diagnostic criteria and critical differential diagnosis, along with a comprehensive review of the literature.

Methods: We performed a retrospective search of our cytopathology and surgical pathology databases for cases diagnosed as CB that had corresponding cytology specimens from four large medical institutions. All available cytopathology specimens were retrieved and reviewed. Clinicopathologic and radiologic data were recorded.

Results: Ten cases were retrieved from 8 patients aged 15-42 years (mean, 24 years), five of whom were males. Eight cases represented primary tumors while 2 cases were recurrences. Three cases occurred in the femur, two cases occurred in the humerus, while 1 case occurred in each of the glenoid, talus, and proximal phalanx of the 3rd toe. The cytologic diagnosis of CB was achieved in 7 cases. The neoplastic mononuclear cells were present in all cases and their cytologic features were similar. These cells displayed round to oval eccentric nuclei, evenly distributed chromatin, and inconspicuous nucleoli; few of which had nuclear indentations. Multinucleated giant cells were present in 9 cases (90%). Fragments of chondromyxoid matrix were present in 4 cases on cytologic preparations (40%). Cell blocks were available in 8 cases. Mononuclear and multinucleated giant cells were present in all adequate cell blocks and their cytologic features were identical to those seen in the smears. The chondroid matrix was present in only three of the adequate cell blocks (43%).

Conclusion: We concluded that with the appropriate clinical and radiologic setting, the diagnosis of CB can be achieved on cytology if characteristic chondroblasts are present. The presence of chondromyxoid matrix is a helpful clue but is not necessary for the diagnosis. As in surgical pathology, cytologic evaluation of bone tumors should be interpreted in conjunction with clinical and radiologic findings.

成软骨细胞瘤(CB)是一种罕见的、产生软骨的良性肿瘤,通常影响骨骼未成熟个体的长骨骨骺。只有有限的病例报告描述了这种肿瘤的细胞形态学特征,因此细胞病理学诊断标准是有争议的。在此,我们报告了10例CB病例的细胞学结果,讨论了诊断标准和关键鉴别诊断,并对文献进行了全面的回顾。方法:我们对四家大型医疗机构的细胞病理学和外科病理学数据库中诊断为CB的病例进行了回顾性检索,这些病例具有相应的细胞学标本。所有可用的细胞病理学标本被检索和审查。记录临床病理和放射学资料。结果:8例患者10例,年龄15 ~ 42岁,平均24岁,其中男性5例。原发肿瘤8例,复发2例。3例发生在股骨,2例发生在肱骨,1例发生在关节盂、距骨和第3趾近端指骨。7例获得细胞学诊断。所有病例均可见肿瘤性单核细胞,其细胞学特征相似。细胞核呈圆形至卵圆形偏心,染色质分布均匀,核仁不明显;很少有核凹痕。多核巨细胞9例(90%)。细胞学检查有4例(40%)出现软骨粘液样基质碎片。8例可用细胞块。单核和多核巨细胞存在于所有适当的细胞块中,其细胞学特征与涂片中所见的相同。软骨基质仅存在于3个适当的细胞块中(43%)。结论:我们的结论是,在适当的临床和放射学背景下,如果存在特征性的成软骨细胞,则可以通过细胞学诊断CB。软骨粘液样基质的存在是一个有用的线索,但不是诊断所必需的。与外科病理学一样,骨肿瘤的细胞学评估应结合临床和放射学结果进行解释。
{"title":"Chondroblastoma: Cytomorphologic Analysis of 10 Cases with Review of the Literature.","authors":"Carla Saoud,&nbsp;Paul E Wakely,&nbsp;Liron Pantanowitz,&nbsp;Momin T Siddiqui,&nbsp;Syed Z Ali","doi":"10.1159/000528932","DOIUrl":"https://doi.org/10.1159/000528932","url":null,"abstract":"<p><strong>Introduction: </strong>Chondroblastoma (CB) is a rare, benign cartilage-producing tumor, typically affecting the epiphysis of long bones in skeletally immature individuals. There have been only limited case reports describing the cytomorphologic features of this tumor, and thus the cytopathologic diagnostic criteria are controversial. Herein, we report the cytologic findings of 10 CB cases, discuss the diagnostic criteria and critical differential diagnosis, along with a comprehensive review of the literature.</p><p><strong>Methods: </strong>We performed a retrospective search of our cytopathology and surgical pathology databases for cases diagnosed as CB that had corresponding cytology specimens from four large medical institutions. All available cytopathology specimens were retrieved and reviewed. Clinicopathologic and radiologic data were recorded.</p><p><strong>Results: </strong>Ten cases were retrieved from 8 patients aged 15-42 years (mean, 24 years), five of whom were males. Eight cases represented primary tumors while 2 cases were recurrences. Three cases occurred in the femur, two cases occurred in the humerus, while 1 case occurred in each of the glenoid, talus, and proximal phalanx of the 3rd toe. The cytologic diagnosis of CB was achieved in 7 cases. The neoplastic mononuclear cells were present in all cases and their cytologic features were similar. These cells displayed round to oval eccentric nuclei, evenly distributed chromatin, and inconspicuous nucleoli; few of which had nuclear indentations. Multinucleated giant cells were present in 9 cases (90%). Fragments of chondromyxoid matrix were present in 4 cases on cytologic preparations (40%). Cell blocks were available in 8 cases. Mononuclear and multinucleated giant cells were present in all adequate cell blocks and their cytologic features were identical to those seen in the smears. The chondroid matrix was present in only three of the adequate cell blocks (43%).</p><p><strong>Conclusion: </strong>We concluded that with the appropriate clinical and radiologic setting, the diagnosis of CB can be achieved on cytology if characteristic chondroblasts are present. The presence of chondromyxoid matrix is a helpful clue but is not necessary for the diagnosis. As in surgical pathology, cytologic evaluation of bone tumors should be interpreted in conjunction with clinical and radiologic findings.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 4","pages":"413-424"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9926138","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: 1
Subtyping of Non-Small Cell Lung Carcinoma into Adenocarcinoma and Squamous Cell Carcinoma by Cytological Structural Features. 非小细胞肺癌的细胞学结构特征分型为腺癌和鳞状细胞癌。
IF 1.8 4区 医学 Q3 PATHOLOGY Pub Date : 2023-01-01 DOI: 10.1159/000528882
Kosuke Inoue, Reiji Haba, Kana Kiyonaga, Toru Matsunaga, Seiko Kagawa, Toshitetsu Hayashi, Ryou Ishikawa

Introduction: This study aimed to clarify the diagnostic structural features in cytology specimens that are useful in subtyping non-small cell lung carcinoma (NSCLC) into adenocarcinoma (ADC) and squamous cell carcinoma (SQCC).

Methods: Cytology specimens (n = 233) of NSCLCs, which included ADCs (n = 149) and SQCCs (n = 84), were analyzed. The following cytological features were evaluated: isolated cell, flat sheet, three-dimensional cluster with irregular arrangement, papillary-like structure, micropapillary-like structure, acinar-like structure, palisading pattern, protrusion of nuclei at the periphery of the cluster, honeycomb pattern, streaming arrangement, three-dimensional sheets with regular arrangement, flattening at the periphery of the cluster, fuzzy pattern at the periphery of the cluster, and mutual inclusion.

Results: ADCs exhibited significantly higher frequencies of flat sheet (p < 0.001), papillary-like structure (p < 0.001), micropapillary-like structure (p = 0.028), acinar-like structure (p < 0.001), and protrusion of nuclei at the periphery of the cluster (p < 0.001) than SQCCs. The latter exhibited significantly higher frequencies of streaming arrangement (p < 0.001), three-dimensional sheets with regular arrangement (p < 0.001), flattening at the periphery of the cluster (p < 0.001), fuzzy pattern at the periphery of the cluster (p < 0.001), and mutual inclusion (p < 0.001) than ADCs.

Discussion: Cytological structural features, such as flat sheet, papillary-like structure, micropapillary-like structure, acinar-like structure, and protrusion of nuclei at the periphery of the cluster, indicated ADC, whereas streaming arrangement, three-dimensional sheets with regular arrangement, flattening at the periphery of the cluster, fuzzy pattern at the periphery of the cluster, and mutual inclusion indicated SQCC. Paying attention to these cytological structural features can enable the accurate subtyping of NSCLC into ADC and SQCC.

本研究旨在阐明细胞学标本的诊断结构特征,这些特征有助于将非小细胞肺癌(NSCLC)分为腺癌(ADC)和鳞状细胞癌(SQCC)。方法:对233例非小细胞肺癌细胞学标本进行分析,其中adc(149例)和sqcc(84例)。评价细胞的以下细胞学特征:孤立细胞、扁平片、排列不规则的三维簇、乳头状结构、微乳头状结构、腺泡状结构、栅栏状、簇周核突出、蜂窝状、流状排列、排列规则的三维片、簇周扁平、簇周模糊、相互包涵。结果:adc的扁平状结构(p < 0.001)、乳头状结构(p < 0.001)、微乳头状结构(p = 0.028)、腺泡状结构(p < 0.001)和簇周核突出(p < 0.001)的频率显著高于sqcc。与adc相比,后者表现出更高的流排列频率(p < 0.001)、排列规则的三维薄片频率(p < 0.001)、集群外围的平坦(p < 0.001)、集群外围的模糊模式(p < 0.001)和相互包含(p < 0.001)。讨论:细胞学结构特征如扁平片状、乳头状结构、微乳头状结构、腺泡状结构、簇周核突出提示ADC,而流状排列、排列规则的三维片状、簇周扁平、簇周模糊、相互包涵提示SQCC。关注这些细胞学结构特征可以使NSCLC准确分型为ADC和SQCC。
{"title":"Subtyping of Non-Small Cell Lung Carcinoma into Adenocarcinoma and Squamous Cell Carcinoma by Cytological Structural Features.","authors":"Kosuke Inoue,&nbsp;Reiji Haba,&nbsp;Kana Kiyonaga,&nbsp;Toru Matsunaga,&nbsp;Seiko Kagawa,&nbsp;Toshitetsu Hayashi,&nbsp;Ryou Ishikawa","doi":"10.1159/000528882","DOIUrl":"https://doi.org/10.1159/000528882","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to clarify the diagnostic structural features in cytology specimens that are useful in subtyping non-small cell lung carcinoma (NSCLC) into adenocarcinoma (ADC) and squamous cell carcinoma (SQCC).</p><p><strong>Methods: </strong>Cytology specimens (n = 233) of NSCLCs, which included ADCs (n = 149) and SQCCs (n = 84), were analyzed. The following cytological features were evaluated: isolated cell, flat sheet, three-dimensional cluster with irregular arrangement, papillary-like structure, micropapillary-like structure, acinar-like structure, palisading pattern, protrusion of nuclei at the periphery of the cluster, honeycomb pattern, streaming arrangement, three-dimensional sheets with regular arrangement, flattening at the periphery of the cluster, fuzzy pattern at the periphery of the cluster, and mutual inclusion.</p><p><strong>Results: </strong>ADCs exhibited significantly higher frequencies of flat sheet (p < 0.001), papillary-like structure (p < 0.001), micropapillary-like structure (p = 0.028), acinar-like structure (p < 0.001), and protrusion of nuclei at the periphery of the cluster (p < 0.001) than SQCCs. The latter exhibited significantly higher frequencies of streaming arrangement (p < 0.001), three-dimensional sheets with regular arrangement (p < 0.001), flattening at the periphery of the cluster (p < 0.001), fuzzy pattern at the periphery of the cluster (p < 0.001), and mutual inclusion (p < 0.001) than ADCs.</p><p><strong>Discussion: </strong>Cytological structural features, such as flat sheet, papillary-like structure, micropapillary-like structure, acinar-like structure, and protrusion of nuclei at the periphery of the cluster, indicated ADC, whereas streaming arrangement, three-dimensional sheets with regular arrangement, flattening at the periphery of the cluster, fuzzy pattern at the periphery of the cluster, and mutual inclusion indicated SQCC. Paying attention to these cytological structural features can enable the accurate subtyping of NSCLC into ADC and SQCC.</p>","PeriodicalId":6959,"journal":{"name":"Acta Cytologica","volume":"67 4","pages":"403-412"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929959","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
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