Afreen Karimkhan MD, Rong Xia MD, PhD, DeAnna Diaz DO, Abigail Wald PhD, Steven Hodak MD, Babak Givi MD, Samer Khader MD, Liron Pantanowitz MD, PhD, MHA, Xiaoying Liu MD, MS, Tamar C. Brandler MD, MS
Background
Mutations in DICER1 are uncommon, poorly understood, and infrequently found in thyroid nodules.
Methods
The objective of this study was to investigate category III/IV thyroid nodules according to The Bethesda System for Reporting Thyroid Cytopathology with DICER1 gene mutations detected in fine-needle aspiration cytology samples using ThyroSeq v3 molecular testing, with a focus on an exploration of the clinical and histopathologic outcomes of these nodules. In this multicenter study spanning more than 6 years, nodules were retrospectively analyzed for patient demographics, clinical course, cytologic features, and histopathology, where available.
Results
In total, 88 patients with somatic DICER1 mutations were included, with a mean age of 39.6 years and a female predominance. All mutations were in the somatic hotspot region, most commonly at the codon 5437 site. Most excised nodules showed benign histologic features (65.9%). Interestingly, the rate of malignancy was higher in this cohort compared with that in the national average.
Conclusions
DICER1 mutations appear to confer a higher risk of malignancy, but are not associated with any specific cytological or histopathological distinguishing features.
{"title":"DICER1 mutations in Bethesda III/IV thyroid cytology samples: A multicenter observational study","authors":"Afreen Karimkhan MD, Rong Xia MD, PhD, DeAnna Diaz DO, Abigail Wald PhD, Steven Hodak MD, Babak Givi MD, Samer Khader MD, Liron Pantanowitz MD, PhD, MHA, Xiaoying Liu MD, MS, Tamar C. Brandler MD, MS","doi":"10.1002/cncy.70045","DOIUrl":"10.1002/cncy.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mutations in <i>DICER1</i> are uncommon, poorly understood, and infrequently found in thyroid nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The objective of this study was to investigate category III/IV thyroid nodules according to The Bethesda System for Reporting Thyroid Cytopathology with <i>DICER1</i> gene mutations detected in fine-needle aspiration cytology samples using ThyroSeq v3 molecular testing, with a focus on an exploration of the clinical and histopathologic outcomes of these nodules. In this multicenter study spanning more than 6 years, nodules were retrospectively analyzed for patient demographics, clinical course, cytologic features, and histopathology, where available.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 88 patients with somatic <i>DICER1</i> mutations were included, with a mean age of 39.6 years and a female predominance. All mutations were in the somatic hotspot region, most commonly at the codon 5437 site. Most excised nodules showed benign histologic features (65.9%). Interestingly, the rate of malignancy was higher in this cohort compared with that in the national average.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><i>DICER1</i> mutations appear to confer a higher risk of malignancy, but are not associated with any specific cytological or histopathological distinguishing features.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 10","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cystic lesions of the head and neck encompass a wide spectrum of benign and malignant entities, which often presents diagnostic challenges as a result of the region’s complex anatomy. Despite extensive literature, variability persists in diagnostic strategies and approaches. Fine-needle aspiration biopsy is a commonly used and highly effective method for the initial assessment of these lesions by offering a minimally invasive technique to collect cellular material for diagnostic evaluation. A multidisciplinary approach integrating clinical, radiologic, and cytologic findings is essential in diagnosing cystic lesions of the head and neck. This review provides readers with an organ-based algorithmic approach for integrating anatomic location (central vs. lateral neck), radiologic features, and cytomorphology to refine diagnoses and guide patient management.
{"title":"Diagnostic approach to FNA biopsy of cystic lesions of the head and neck","authors":"Stefen Andrianus MD, Olivia Leung MD, Zubair Baloch MD, PhD","doi":"10.1002/cncy.70036","DOIUrl":"10.1002/cncy.70036","url":null,"abstract":"<p>Cystic lesions of the head and neck encompass a wide spectrum of benign and malignant entities, which often presents diagnostic challenges as a result of the region’s complex anatomy. Despite extensive literature, variability persists in diagnostic strategies and approaches. Fine-needle aspiration biopsy is a commonly used and highly effective method for the initial assessment of these lesions by offering a minimally invasive technique to collect cellular material for diagnostic evaluation. A multidisciplinary approach integrating clinical, radiologic, and cytologic findings is essential in diagnosing cystic lesions of the head and neck. This review provides readers with an organ-based algorithmic approach for integrating anatomic location (central vs. lateral neck), radiologic features, and cytomorphology to refine diagnoses and guide patient management.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 10","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esther Diana Rossi MD, PhD, Christopher C. Griffith MD
The current review article deals with the evaluation of the oncocytic/oncocytoid lesions in the salivary gland. The authors will focus on the diagnosis of Warthin tumor (WT) as a launching point to detail important morphologic findings that should prompt designation of an aspirate as oncocytic salivary gland neoplasm of uncertain malignant potential or other Milan categories. Oncocytic cells are defined as cells with a moderate to abundant amount of eosinophilic finely granular cytoplasm, round-to-oval nuclei, and large-distinct nucleoli. In contrast, the term oncocytoid is also frequently used in this discussion and indicates tumor cells with similarly abundant and sometimes granular cytoplasm but lacking all the definitive features of a true oncocyte. Several helpful tips are provided in hopes of improving an accurate diagnosis of WT on an aspirate sample. Using these types allows for consideration of important differential diagnoses, including both benign and malignant entities, when faced with an oncocytic salivary gland neoplasm. The morphological criteria as well as the possible application of ancillary techniques are also discussed.
{"title":"Low-grade oncocytoid neoplasm in the Milan system: Tips for the diagnosis of Warthin tumor and other differential diagnostic considerations","authors":"Esther Diana Rossi MD, PhD, Christopher C. Griffith MD","doi":"10.1002/cncy.70037","DOIUrl":"10.1002/cncy.70037","url":null,"abstract":"<p>The current review article deals with the evaluation of the oncocytic/oncocytoid lesions in the salivary gland. The authors will focus on the diagnosis of Warthin tumor (WT) as a launching point to detail important morphologic findings that should prompt designation of an aspirate as oncocytic salivary gland neoplasm of uncertain malignant potential or other Milan categories. Oncocytic cells are defined as cells with a moderate to abundant amount of eosinophilic finely granular cytoplasm, round-to-oval nuclei, and large-distinct nucleoli. In contrast, the term oncocytoid is also frequently used in this discussion and indicates tumor cells with similarly abundant and sometimes granular cytoplasm but lacking all the definitive features of a true oncocyte. Several helpful tips are provided in hopes of improving an accurate diagnosis of WT on an aspirate sample. Using these types allows for consideration of important differential diagnoses, including both benign and malignant entities, when faced with an oncocytic salivary gland neoplasm. The morphological criteria as well as the possible application of ancillary techniques are also discussed.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 10","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>Every day, adult men in the United States may be eating or breathing in more than 300 bits of plastic, according to a recent estimate.<span><sup>1</sup></span> For women, the tally exceeds more than 250 bits. Every year, we are being exposed to tens of thousands of tiny plastic pieces—and until recently, scientists had little idea of the potential consequences.</p><p>“Our exposure is fairly total,” says Megan Wolff, PhD, MPH, executive director of the Physician and Scientist Network Addressing Plastics and Health in New Paltz, New York. “We know that microplastics are in the air, the water, the soil, the food, and pretty much everywhere that we look inside the human body, we find them.”</p><p>According to current trends, plastic production is doubling by volume every 14 years and creating vast new opportunities for plastics to break into ever-smaller pieces. Microplastics, typically defined as plastics measuring less than 5 mm in at least one dimension, can subsequently break down into nanoplastics, which measure less than 1 µm in size. At that scale, the tiny particles can be swept through the air with other particulate matter such as soot and can travel through blood vessels and infiltrate human cells.</p><p>Because plastics are ubiquitous in consumer products and because we spend most of our time indoors in close proximity to them and their breakdown products in concentrated sources such as household dust, Dr Wolff says that humans have far more exposure than the rest of the animal kingdom. Although many of the smallest bits have evaded traditional detection methods, she adds, every improvement in the technology is revealing more of them. The research is still early, but the danger signs are mounting quickly.</p><p>So far, the overall evidence of potential harm has been limited mainly to in vitro and animal studies; even so, the existing studies have pointed to multiple areas of concern. Tracey Woodruff, PhD, MPH, director of the Program on Reproductive Health and the Environment at the University of California, San Francisco, recently helped to draft a review of the effects of microplastic exposure on the human respiratory, digestive, and reproductive systems.</p><p>Her team’s review included 28 animal studies and three human observational studies published between 2018 and 2024; roughly three fourths of those studies were conducted in China, whereas none were conducted in the United States. “The United States has actually been very slow to invest in this health-related research,” Dr Woodruff notes. The overview, requested by the state of California and subsequently published as a rapid systematic review, concluded that microplastics have a “suspected” role in harming human reproductive, digestive, and respiratory health and a suggested role in increasing the risk of colon and lung cancer.<span><sup>2</sup></span></p><p>The heightened cancer risk, the review suggested, could be mediated through mechanisms such as inflammation and oxidative
根据最近的一项估计，美国成年男性每天可能会摄入或吸入300多块塑料对于女性来说，这个数字超过了250比特。每年，我们都会接触到成千上万的小塑料碎片，直到最近，科学家们才意识到潜在的后果。“我们的接触是相当全面的，”Megan Wolff博士说，他是公共卫生硕士，纽约新帕尔茨塑料与健康医生和科学家网络的执行董事。“我们知道，微塑料存在于空气、水、土壤、食物中，几乎在我们观察人体的任何地方都能找到它们。”按照目前的趋势，塑料产量每14年翻一番，这为塑料分解成更小的碎片创造了巨大的新机会。微塑料通常被定义为至少一个尺寸小于5mm的塑料，随后可以分解成尺寸小于1微米的纳米塑料。在这个尺度上，这些微小的颗粒可以与其他颗粒物质（如烟灰）一起穿过空气，并可以穿过血管并渗入人体细胞。沃尔夫博士说，由于塑料在消费品中无处不在，而且我们大部分时间都呆在室内，与塑料及其分解产物近距离接触，而这些分解产物集中在家庭灰尘中，因此人类比动物王国的其他动物接触到的塑料要多得多。她补充说，尽管许多最小的比特已经躲过了传统的检测方法，但技术的每一次进步都在揭示更多的比特。这项研究仍处于早期阶段，但危险的迹象正在迅速增加。到目前为止，潜在危害的总体证据主要局限于体外和动物研究；即便如此，现有的研究也指出了多个值得关注的领域。特雷西·伍德拉夫博士，公共卫生硕士，旧金山加利福尼亚大学生殖健康与环境项目主任，最近帮助起草了一份关于微塑料暴露对人类呼吸、消化和生殖系统影响的综述。她的团队回顾了2018年至2024年间发表的28项动物研究和3项人体观察研究；这些研究中大约有四分之三是在中国进行的，而没有在美国进行。伍德拉夫博士指出：“实际上，美国在投资与健康相关的研究方面一直非常缓慢。”这项概述是由加利福尼亚州要求的，随后作为一项快速系统审查发表的，其结论是，微塑料“怀疑”会损害人类的生殖、消化和呼吸健康，并可能增加患结肠癌和肺癌的风险。该综述认为，癌症风险的增加可能是通过炎症和氧化应激等机制介导的。即便如此，伍德拉夫博士也承认，这些结论只提供了潜在影响的一小部分。医学博士艾伦·沃克曼（Alan Workman）是哈佛医学院（Harvard Medical School）和波士顿麻省眼耳学院（Massachusetts Eye and Ear）的鼻科学和颅骨外科助理教授，他警告说，测量环境和人体中微塑料和纳米塑料的科学“充满了危险”，而且仍处于起步阶段。在阅读了早期关于上皮表面（如鼻腔和鼻窦通道）潜在炎症效应的论文后，他加入了这项研究。“这些微塑料正在嵌入我们的组织中吗？”它们是通过组织传播的吗？这就是我对它感兴趣的原因。”沃克曼博士说，科学家们曾经认为，微塑料和纳米塑料在人体组织中可能是相对惰性的。然而，到目前为止，他关于鼻上皮细胞的早期数据——来自健康的人类供体，并在模拟鼻气道表面的培养皿中生长——显示出接触塑料碎片后的一些炎症效应。这些影响包括与炎症途径相关的细胞因子蛋白的升高。他现在正试图通过在纳米尺度上拍摄细胞来确定炎症如何发生的时间过程，以观察塑料颗粒的最终归宿。在进行了体外研究之后，沃克曼博士计划让实验室老鼠接触微塑料和纳米塑料。他希望，这项工作将有助于为回答有关污染物的重大问题开辟一条道路：“如果它们在实验室组织中确实有这些炎症作用，那么这与我们的日常环境有什么关系？”与不同塑料相关的一系列特性、化学物质和风险使科学进一步复杂化。沃尔夫博士说：“在塑料的世界里，我们知道氯乙烯是致癌物，我们知道苯乙烯是致癌物。”
{"title":"New urgency for answers on the health impacts of microplastics","authors":"Bryn Nelson PhD, William Faquin MD, PhD","doi":"10.1002/cncy.70035","DOIUrl":"10.1002/cncy.70035","url":null,"abstract":"<p>Every day, adult men in the United States may be eating or breathing in more than 300 bits of plastic, according to a recent estimate.<span><sup>1</sup></span> For women, the tally exceeds more than 250 bits. Every year, we are being exposed to tens of thousands of tiny plastic pieces—and until recently, scientists had little idea of the potential consequences.</p><p>“Our exposure is fairly total,” says Megan Wolff, PhD, MPH, executive director of the Physician and Scientist Network Addressing Plastics and Health in New Paltz, New York. “We know that microplastics are in the air, the water, the soil, the food, and pretty much everywhere that we look inside the human body, we find them.”</p><p>According to current trends, plastic production is doubling by volume every 14 years and creating vast new opportunities for plastics to break into ever-smaller pieces. Microplastics, typically defined as plastics measuring less than 5 mm in at least one dimension, can subsequently break down into nanoplastics, which measure less than 1 µm in size. At that scale, the tiny particles can be swept through the air with other particulate matter such as soot and can travel through blood vessels and infiltrate human cells.</p><p>Because plastics are ubiquitous in consumer products and because we spend most of our time indoors in close proximity to them and their breakdown products in concentrated sources such as household dust, Dr Wolff says that humans have far more exposure than the rest of the animal kingdom. Although many of the smallest bits have evaded traditional detection methods, she adds, every improvement in the technology is revealing more of them. The research is still early, but the danger signs are mounting quickly.</p><p>So far, the overall evidence of potential harm has been limited mainly to in vitro and animal studies; even so, the existing studies have pointed to multiple areas of concern. Tracey Woodruff, PhD, MPH, director of the Program on Reproductive Health and the Environment at the University of California, San Francisco, recently helped to draft a review of the effects of microplastic exposure on the human respiratory, digestive, and reproductive systems.</p><p>Her team’s review included 28 animal studies and three human observational studies published between 2018 and 2024; roughly three fourths of those studies were conducted in China, whereas none were conducted in the United States. “The United States has actually been very slow to invest in this health-related research,” Dr Woodruff notes. The overview, requested by the state of California and subsequently published as a rapid systematic review, concluded that microplastics have a “suspected” role in harming human reproductive, digestive, and respiratory health and a suggested role in increasing the risk of colon and lung cancer.<span><sup>2</sup></span></p><p>The heightened cancer risk, the review suggested, could be mediated through mechanisms such as inflammation and oxidative","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 9","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144935248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramon Robledano MD, Allan Argueta MD, Tania Labiano MD, María D. Lozano MD, PhD
Lung cancer continues to be the leading cause of cancer-related mortality, with cytologic samples often serving as the primary diagnostic tool. However, differentiating between benign and malignant processes in lung cytology can be difficult because various non-neoplastic conditions closely resemble malignant lesions, which may lead to misdiagnosis. This review offers nine essential tips to help cytopathologists prevent false-positive diagnoses of malignancy in non-neoplastic processes. By examining common non-neoplastic entities that can mimic lung malignancies, this review emphasizes their key cytomorphologic features and distinguishing characteristics. The authors stress the importance of a thorough clinical and radiologic context, slide background evaluation, and identification of cytomorphologic features for an accurate diagnosis of these mimics. The objective of this review was to enhance diagnostic accuracy and prevent misdiagnosis, thereby improving patient management in lung cancer cytopathology.
{"title":"Pulmonary cytology: Pearls and pitfalls of non-neoplastic mimics of lung cancer","authors":"Ramon Robledano MD, Allan Argueta MD, Tania Labiano MD, María D. Lozano MD, PhD","doi":"10.1002/cncy.70039","DOIUrl":"10.1002/cncy.70039","url":null,"abstract":"<p>Lung cancer continues to be the leading cause of cancer-related mortality, with cytologic samples often serving as the primary diagnostic tool. However, differentiating between benign and malignant processes in lung cytology can be difficult because various non-neoplastic conditions closely resemble malignant lesions, which may lead to misdiagnosis. This review offers nine essential tips to help cytopathologists prevent false-positive diagnoses of malignancy in non-neoplastic processes. By examining common non-neoplastic entities that can mimic lung malignancies, this review emphasizes their key cytomorphologic features and distinguishing characteristics. The authors stress the importance of a thorough clinical and radiologic context, slide background evaluation, and identification of cytomorphologic features for an accurate diagnosis of these mimics. The objective of this review was to enhance diagnostic accuracy and prevent misdiagnosis, thereby improving patient management in lung cancer cytopathology.</p>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 9","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144929913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed S. Ahmed MD, Dianna Klippel-Almaraz MS, Sara E. Amin MD, Gloria H. Sura MD, Uma Rani Kundu MD, Wendong Yu MD, PhD, John M. Stewart MD, PhD, Qiong Gan MD, PhD, Savitri Krishnamurthy MD
Background
Rapid on-site evaluation (ROSE) of thyroid fine-needle aspiration biopsy (FNAB) improves diagnostic adequacy and facilitates ancillary molecular testing. In this prospective, multireader study, the authors evaluated the feasibility of using whole-slide images (WSIs) for ROSE to determine specimen adequacy and preliminary categorization (according to The Bethesda System for Reporting Thyroid Cytopathology [Bethesda]) of image-guided thyroid FNABs compared with conventional light-microscopic (LM) examination of the same specimens in a referral cancer center.
Methods
The authors evaluated 98 ultrasound-guided thyroid FNAB cases. Smears were stained with Papanicolaou and Diff-Quik and were scanned at ×20 magnification using a Leica Aperio CS2 scanner. Five cytopathologists evaluated specimen adequacy and Bethesda categorization using WSI followed by LM assessment after a 2-week washout. Intraobserver and interobserver agreements were calculated using Cohen and Fleiss kappa (κ) statistics. Scan time, interpretation time, and the need for ×40 magnification or z stacking were recorded.
Results
In total, 463 slides were scanned, with mean scan time of 5.48 minutes. WSI quality was acceptable in most cases. Z stacking and ×40 magnification were requested in 23% and 14% of reviews, respectively. Intrareader agreement between WSI and LM examination was excellent (κ = 0.86–0.95). Inter-reader agreement was moderate for both WSI (κ = 0.48) and LM examination (κ = 0.56). Concordance was highest for Bethesda categories I and VI and lowest for categories III–V. Interpretation with WSI took significantly longer than with LM examination (p < .0001).
Conclusions
WSI is a feasible alternative to LM examination for ROSE of thyroid FNABs, with high intrareader agreement and comparable inter-reader agreement. The limited need for high magnification and z stacking supports its practical utility.
{"title":"Utility of whole-slide imaging for rapid evaluation of thyroid FNA: A multireader prospective study","authors":"Mohammed S. Ahmed MD, Dianna Klippel-Almaraz MS, Sara E. Amin MD, Gloria H. Sura MD, Uma Rani Kundu MD, Wendong Yu MD, PhD, John M. Stewart MD, PhD, Qiong Gan MD, PhD, Savitri Krishnamurthy MD","doi":"10.1002/cncy.70046","DOIUrl":"10.1002/cncy.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rapid on-site evaluation (ROSE) of thyroid fine-needle aspiration biopsy (FNAB) improves diagnostic adequacy and facilitates ancillary molecular testing. In this prospective, multireader study, the authors evaluated the feasibility of using whole-slide images (WSIs) for ROSE to determine specimen adequacy and preliminary categorization (according to The Bethesda System for Reporting Thyroid Cytopathology [Bethesda]) of image-guided thyroid FNABs compared with conventional light-microscopic (LM) examination of the same specimens in a referral cancer center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors evaluated 98 ultrasound-guided thyroid FNAB cases. Smears were stained with Papanicolaou and Diff-Quik and were scanned at ×20 magnification using a Leica Aperio CS2 scanner. Five cytopathologists evaluated specimen adequacy and Bethesda categorization using WSI followed by LM assessment after a 2-week washout. Intraobserver and interobserver agreements were calculated using Cohen and Fleiss kappa (κ) statistics. Scan time, interpretation time, and the need for ×40 magnification or z stacking were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 463 slides were scanned, with mean scan time of 5.48 minutes. WSI quality was acceptable in most cases. Z stacking and ×40 magnification were requested in 23% and 14% of reviews, respectively. Intrareader agreement between WSI and LM examination was excellent (κ = 0.86–0.95). Inter-reader agreement was moderate for both WSI (κ = 0.48) and LM examination (κ = 0.56). Concordance was highest for Bethesda categories I and VI and lowest for categories III–V. Interpretation with WSI took significantly longer than with LM examination (<i>p</i> < .0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WSI is a feasible alternative to LM examination for ROSE of thyroid FNABs, with high intrareader agreement and comparable inter-reader agreement. The limited need for high magnification and z stacking supports its practical utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 9","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/cncy.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spotlight: Rising stars in cytology","authors":"David Kim MD","doi":"10.1002/cncy.70043","DOIUrl":"10.1002/cncy.70043","url":null,"abstract":"","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 9","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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