Journal articles on the topic 'Cytology'
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Anastasiadis, Panagiotis, Nikoleta Koutlaki, Vasilios Liberis, Panagiotis Tsikouras, Marina Dimitraki, Anastasios Liberis, and George Galazios. "The Contribution of Rapid Intraoperative Cytology in the Evaluation of Endometrial Cancer Spread." Annals of the Academy of Medicine, Singapore 40, no. 2 (February 15, 2011): 80–83. http://dx.doi.org/10.47102/annals-acadmedsg.v40n2p80.
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Introduction: Peritoneal washing cytology and imprint cytology of pelvic lymph nodes samples were used to evaluate the rapid cytologic detection of peritoneal and retroperitoneal spread of endometrial cancer. Materials and Methods: We undertook a study on 194 endometrial cancer patients who underwent primary treatment in the Gynecologic Clinic, Democritus University of Thrace. All patients were subjected to peritoneal washing (PW) cytology and imprint cytology performed on lymph node sampling. The cytologic specimens were stained by May-Grünwald Giemsa (MGG) and Haematoxylin eosin (HE) techniques. Cell-blocks prepared from peritoneal washings (PWs) and the lymph node samples were sent for histologic examination. The cytologic findings were correlated to histologic results. Results: Rapid intraoperative cytology provides a useful diagnostic technique for the assessment of endometrial cancer spread. HE and MGG stain presented different values of sensitivity and specificity in the detection of peritoneal and retroperitoneal spread of endometrial cancer. Conclusion: Cytologic assessment of intraperitoneal and retroperitoneal spread of endometrial cancer is a rapid, intraoperative procedure, which provides the surgeon with useful information regarding the stage of the disease and the subsequent therapeutic approach. Key words: Endometrial cancer, Imprint cytology, Lymph node dissection, Peritoneal washing cytology
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Bahr, Katherine L., Leslie C. Sharkey, Tsuyoshi Murakami, and Daniel A. Feeney. "Accuracy of US-Guided FNA of Focal Liver Lesions in Dogs: 140 Cases (2005–2008)." Journal of the American Animal Hospital Association 49, no. 3 (May 1, 2013): 190–96. http://dx.doi.org/10.5326/jaaha-ms-5851.
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Medical records from dogs having abdominal ultrasound (US) performed between March 2005 and October 2008 were reviewed for detection of focal liver lesions (FLL) with both cytologic and histologic sampling. Samples were classified as to either the presence or absence of major categories of pathologic processes, including malignant neoplasia, inflammation, hyperplasia/benign neoplasia, vacuolar change, extramedullary hematopoeisis, cholestasis, necrosis, and no microscopic abnormalities. Evaluation of selection bias was performed by review of the relative distribution of cytologic diagnoses for cases with histology compared with cases excluded from the comparison analysis because histology results were not available. Cytology had the highest sensitivity for vacuolar change (57.9%), followed by neoplasia (52.0%). Cytology had the highest positive predictive value (PPV) for neoplasia (86.7%) followed by vacuolar change (51.6%). Cytology had lower sensitivity and PPVs for inflammation, necrosis, and hyperplasia. The ability of cytology to characterize disease in canine FLL varies by pathologic process. Clinicians can have a high degree of confidence when a cytologic diagnosis of neoplasia is given; however, cytology is less reliable for excluding the potential for neoplasia. Cytology has a low sensitivity and PPV for inflammation and a limited diagnostic performance for the diagnosis of vacuolar change.
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Confortini, Massimo, Paolo Bulgaresi, Maria Paola Cariaggi, Francesca Maria Carozzi, Silvia Cecchini, Ida Cipparrone, Cristina Maddau, et al. "Conventional Pap Smear and Liquid-based Cervical Cytology Smear: Comparison from the Same Patient." Tumori Journal 88, no. 4 (July 2002): 288–90. http://dx.doi.org/10.1177/030089160208800409.
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Background The results of blind reading of smears obtained with liquid-based cytology in patients previously screened by conventional cytology were compared. Material and methods Cases selected for the study were a consecutive series of 99 subjects undergoing colposcopy within the screening program of the Florence District. The Pap test samples were processed utilizing the Thin Prep 2000 (Cytyc Corporation, Boxborough, MA). The liquid-base cytology smears were randomly admixed and read by seven expert cytologists with more than 15 years of experience in Pap smear reading. For each case, a consensus diagnosis was created and considered as the definitive diagnosis. Cytologic reports in conventional and liquid-based cytology smears were compared by the κ statistic to evaluate diagnostic agreement. Results The study showed that the conventional and liquid-based cytology provide comparable cytologic reports and that the latter is not less sensitive than the former in detecting CIN2+ lesions of the cervix. Discussion Such evidence suggests the feasibility of randomized studies comparing the two methods, which are needed before adopting liquid-based cytology as the current method when screening for cervical cancer.
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Hwang, Shin Hye, Ji Min Sung, Eun-Kyung Kim, Hee Jung Moon, and Jin Young Kwak. "Imaging-Cytology Correlation of Thyroid Nodules with Initially Benign Cytology." International Journal of Endocrinology 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/491508.
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Objective. To determine the role of imaging-cytology correlation in reducing false negative results of fine-needle aspiration (FNA) at thyroid nodules.Methods. This retrospective study included 667 nodules 1 cm or larger in 649 patients diagnosed as benign at initial cytologic evaluation and that underwent follow-up ultrasound (US) or FNA following a radiologist’s opinion on concordance between imaging and cytologic results. We compared the risk of malignancy of nodules classified into subgroups according to the initial US features and imaging-cytology correlation.Results. Among included nodules, 11 nodules were proven to be malignant (1.6%) in follow-up FNA or surgery. The malignancy rate was higher in nodules with suspicious US features (11.4%) than in nodules without suspicious US features (0.5%,P<0.001). When a thyroid nodule had discordant US findings on image review after having benign FNA results, malignancy rate increased to 23.3%, significantly higher than that of nodules with suspicious US features (P<0.001). However, no significant difference was found in the risk of malignancy between the nodules without suspicious US features (0.5%) and imaging-cytology concordant nodules (0.6%,P=0.438).Conclusions. Repeat FNA can be effectively limited to patients with cytologically benign thyroid nodules showing discordance in imaging-cytology correlation after initial biopsy, which reduces unnecessary repeat aspirations.
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Gilani, Syed M., Adebowale J. Adeniran, and Guoping Cai. "Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytologic Evaluation of Intraductal Papillary Mucinous Neoplasm and Mucinous Cystic Neoplasms of Pancreas." American Journal of Clinical Pathology 154, no. 4 (June 26, 2020): 559–70. http://dx.doi.org/10.1093/ajcp/aqaa079.
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Abstract Objectives To evaluate the role of endoscopic ultrasound-guided fine needle aspiration cytology in identifying mucinous cystic lesions (MCLs) in histologically proven cases of intraductal papillary mucinous neoplasm (IPMN) or mucinous cystic neoplasm (MCN) and risk of malignancy associated with each cytologic category based on the Papanicolaou Society of Cytopathology (PSC) guidelines. Methods All resected cases with histologic diagnosis of IPMN or MCN at our institution from January 1, 2004, to August 31, 2019, with associated cytology were included. Available cytology slides of nondiagnostic (ND), negative/benign (BN), and atypical cytology (AC) cases were reviewed and reclassified based on the PSC guidelines. Results A total of 120 cases were identified, including 57 IPMNs with low-grade or moderate dysplasia (LGD/MD) and high-grade dysplasia (HGD), 34 MCNs with LGD/MD or HGD, and 29 IPMNs with invasive malignancy. After cytology slide review and reclassification, we observed that ND and BN cases were paucicellular and lacked ancillary testing (carcinoembryonic antigen levels or KRAS mutation analysis). The risk-of-malignancy rates were 33% for ND, 11% for BN, 28.5% for AC, 17% for MCL, and 100% for suspicious/positive cytologic diagnosis. Conclusions A multidisciplinary approach including combined use of cytology and ancillary testing is helpful in establishing a diagnosis of MCL and identifying associated malignancy.
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Kurita, Tomoko, Yusuke Matsuura, Chiho Koi, Seiji Kagami, Toshinori Kawagoe, and Toru Hachisuga. "The Relationship between Positive Peritoneal Cytology and the Prognosis of Patients with Uterine Cervical Cancer." Acta Cytologica 59, no. 2 (2015): 201–6. http://dx.doi.org/10.1159/000382068.
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Objective: We investigated the association of positive peritoneal cytology with prognosis in uterine cervical cancer. Study Design: We reviewed the medical records and cytologic materials of 225 Japanese patients with FIGO IB1-IVB uterine cervical cancer who had undergone surgery at our University Hospital between 1993 and 2012. Univariate and multivariate regression analyses were performed for statistical analysis. Results: Positive peritoneal cytology was noted in 6 of 225 patients (2.7%). Positive peritoneal cytology was found in 4 of 149 patients (2.6%) with squamous cell carcinoma (SCC) and in 2 of 70 patients (2.8%) with non-SCC (p = 0.9434). The 5-year survival rate of patients with positive peritoneal cytology was significantly lower than that of patients with negative cytology (50 vs. 84.6%, p = 0.001) in univariate survival analysis. However, peritoneal cytology no longer remained significant in multivariate analysis. Conclusion: Although we conclude that positive peritoneal cytology in uterine cervical cancer is a poor prognostic factor, further investigation and multi-institutional studies are necessary.
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Keijser, S., G. S. Missotten, D. De Wolff-Rouendaal, S. L. J. Verbeke, C. M. Van Luijk, M. Veselic-Charvat, and R. J. W. De Keizer. "Impression Cytology of Melanocytic Conjunctival Tumors Using the Biopore Membrane." European Journal of Ophthalmology 17, no. 4 (July 2007): 501–6. http://dx.doi.org/10.1177/112067210701700404.
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Purpose To compare a new Biopore membrane impression cytology method with the routinely used exfoliative cytology in patients with a melanocytic lesion of the conjunctiva. Methods Sixty-eight consecutive patients with a conjunctival melanocytic lesion underwent Biopore membrane impression cytology as well as exfoliative cytology. A histologic sample was also available in 26 cases. All Biopore samples were stained immediately with RAL 555. Both Biopore and exfoliative cytology samples were assessed by two cytopathologists and graded into four different categories of atypia. Results Twenty-three out of 26 Biopores and 20 out of 24 for the exfoliative smears correlated with the corresponding histologic sample. Biopore cytology resulted in higher numbers of cells with a greater density compared to exfoliative cytology. Conclusions Biopore cytology can be used for cytologic sampling of conjunctival melanocytic lesions. Because of the larger amount and higher density of cells obtained with the Biopore membrane, interpretation by a pathologist is easier and faster. Sampling of the fornix, caruncula, and ocular material in children is difficult with the Biopore method, and exfoliative cytology seems to be the favorable test in those situations.
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Nahhas, W. A., M. A. Clark, and M. Brown. "‘Abnormal’ Papanicolaou smears and colposcopy in pregnancy: ante- and post-partum findings." International Journal of Gynecologic Cancer 3, no. 4 (1993): 239–44. http://dx.doi.org/10.1046/j.1525-1438.1993.03040239.x.
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Abnormal Papanicolaou smears and colposcopic findings suggesting human Papilloma virus (HPV) infection and cervical intraepithelial neoplasia (CIN) may occur during pregnancy. Condylomata acuminata often grow rapidly during pregnancy and may regress spontaneously following delivery. However, the post-partum outcome of the untreated ante-partum abnormal cytologic smear and colposcopy has not been defined clearly. Seventy-three pregnant patients were examined by colposcopy because of genital warts and/or abnormal Papanicolaou smears. Cytologic, colposcopic and histologic re-evaluation was conducted after delivery. Only one of the patients had a normal ante-partum colposcopic examination. This number increased to 15 after delivery. Forty-one patients had normal post-partum cytologic smears, but only 13 had normal histology. Abnormal post-partum cytology was highly predictive of abnormal colposcopy and histology. In contrast, normal post-partum cytology was not very accurate in predicting normal colposcopy and histology. It is concluded that a few pregnant patients may have partial regression of clinical HPV infection and abnormal cytology and colposcopy after delivery. However, the majority will continue to have abnormal findings 4 months following delivery in spite of normal post-partum cytology and even colposcopy.
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Yang, Yi Jun. "Gynecomastia With Marked Cellular Atypia Associated With Chemotherapy." Archives of Pathology & Laboratory Medicine 126, no. 5 (May 1, 2002): 613–14. http://dx.doi.org/10.5858/2002-126-0613-gwmcaa.
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Abstract Gynecomastia is a common benign male breast disease, which may exhibit mild cellular atypia in cytology specimens. However, marked cytologic atypia can be seen in gynecomastia superimposed by chemotherapy. The case described in this report demonstrated severe cytologic atypia of gynecomastia mimicking carcinoma in a patient treated with chemotherapy for acute leukemia. A distinct cytologic feature helpful in avoiding the diagnostic error is described, namely, atypical cells admixed with bland ductal cells and appearing at a different plane. The importance of applying strict diagnostic criteria in breast cytology and clinical correlation is also emphasized.
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Ferguson, John, Michal Kazimir, Michael Gailey, Frank Moore, and Earl Schott. "Predictive Value of Pleural Cytology in the Diagnosis of Complicated Parapneumonic Effusions and Empyema Thoracis." Pulmonary Medicine 2020 (May 21, 2020): 1–5. http://dx.doi.org/10.1155/2020/7175451.
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Introduction. Complicated parapneumonic effusions (CPE) are distinguished from uncomplicated parapneumonic effusions (UPE) by the ability to resolve without drainage. Determinants include pleural pH, pleural glucose, and pleural LDH, along with microbiologic cultures. Inflammation mediated by neutrophil chemotactic cytokines leads to fibrinous loculation of an effusion, and the degree of this inflammation may lead to a CPE. One role of the pathologist is to evaluate for the presence of malignancy in a pleural effusion; however, the ability of the pathologist to distinguish a CPE from UPE has not been evaluated. Materials and Methods. A single-center retrospective study was performed on pleural cytology specimens from 137 patients diagnosed with a parapneumonic effusion or empyema over a five-year interval. Pleural cytology was characterized as either uncomplicated or complicated by two pathologists based on cellular composition and the presence or absence of fibrinous exudate in the fluid. Cohen’s kappa was calculated for interobserver agreement. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of cytologic diagnoses were calculated. Determinants of cytologic accuracy were assessed using Wilcoxon rank sum test, unpaired t-test, and logistic regression. Results. Kappa interobserver agreement between pathologists was 0.753. Pleural fluid cytology sensitivity, specificity, PPV, and NPV for CPE/empyema were 76.0%, 95% CI [65.0, 84.9]; 50%, 95% CI [29.1, 70.9]; 83.3%, 95% CI [76.7, 88.4]; and 38.7%, 95% CI [26.5, 52.5], respectively. The presence of pleural bacteria, elevated pleural LDH, and reduced pleural pH were nonsignificant determinants of cytologic accuracy. Logistic regression was significant for the presence of pleural bacteria (p=0.03) in determining a successful cytologic diagnosis. Conclusion. Pleural cytology adds little value to traditional markers of distinguishing a UPE from CPE. Inflammation on pleural fluid cytology is suggestive of empyema or the presence of pleural fluid bacteria.
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Daneshbod, Yahya, Ahmad Oryan, Mehdi Davarmanesh, Sadegh Shirian, Shahrzad Negahban, Azita Aledavood, Mohammad Ali Davarpanah, Hossein Soleimanpoor, and Khosrow Daneshbod. "Clinical, Histopathologic, and Cytologic Diagnosis of Mucosal Leishmaniasis and Literature Review." Archives of Pathology & Laboratory Medicine 135, no. 4 (April 1, 2011): 478–82. http://dx.doi.org/10.5858/2010-0069-oa.1.
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Abstract Context.—Mucosal leishmaniasis (ML) is a rare disease in the world, even in endemic areas such as Iran. Clinical, histologic, or cytologic assessment may help in the diagnosis of ML. Objective.—To describe clinical, histologic, and cytologic findings in ML. Design.—Review of our files showed 11 patients diagnosed with ML, of whom 7 patients had oral lesions, 1 of whom was a known patient with oral leishmaniasis with recurrence of oral lesions; 2 had laryngeal lesions; and 3 had nasal lesions. One case of laryngeal leishmaniasis was a recurrence of prior oral lesions. Cytologic smears were prepared by scraping the lesions with a scalpel or cytobrush. Histology on the biopsies was done for 7 patients. In 2 patients with nasal lesions, exfoliative cytology was made by washing the nasal cavity. Smears were both air dried and fixed in alcohol and stained. Results.—Cytologic findings showed free Leishman-Donovan bodies, intrahistiocytic Leishman-Donovan bodies, atypical organisms, granuloma, acute and chronic inflammatory cells, histiocytes, multinucleated giant cells, mast cells, binucleated histiocytes (Reed-Sternberg–like cells), and plasma cells. In 6 of the patients, biopsy was inconclusive and in subsequent cytology the organism was detected. In 3 cases, findings from clinical and cytologic examinations were suggestive for leishmaniasis; however, with response to treatment, the diagnosis was confirmed. In 5 patients a malignant tumor was suspected because of clinical or histologic findings, but cytology helped to diagnose leishmaniasis. Conclusions.—Clinically or histologically, ML can be mistaken for benign and malignant lesions. Scraping or exfoliative cytology is an easy, reliable, and cost-effective method for diagnosing ML. Thus, clinical, histologic, and cytologic features together may help in ML diagnosis.
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Khan, Jaffar, Carlo De la Sancha, Mohammed Saad, Ahmad Alkashash, Asad Ullah, Fatimah Alruwaii, Luis Velasquez Zarate, Harvey M. Cramer, and Howard H. Wu. "The Role of Fluorescence In Situ Hybridization in Pancreatobiliary Brushing Cytology: A Large Retrospective Review with Histologic Correlation." Diagnostics 12, no. 10 (October 14, 2022): 2486. http://dx.doi.org/10.3390/diagnostics12102486.
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(1) Background: Although the specificity of brush cytology for the detection of malignant pancreaticobiliary strictures is high, its sensitivity is low. Fluorescence in situ hybridization (FISH) can be used to detect chromosomal aneuploidy in biliary brushing specimens, and when used as an adjunct to routine cytology, it significantly improves diagnostic sensitivity. (2) Methods: We searched our laboratory information system to identify all bile duct brush cytology cases with follow-up surgical pathology between January 2001 and September 2019. Cytologic diagnoses were classified as negative, atypical, suspicious, or malignant. Correlated surgical pathological diagnoses were classified as benign or malignant. FISH test results were obtained for a subset of cytology cases with concurrent FISH testing, and the sensitivity, specificity, positive predictive value, and negative predictive value in identifying malignancy for cytology alone, FISH alone, and combined cytology and FISH were calculated. (3) Results: A total of 1017 brushing cytology cases with histologic correlation were identified. A total of 193 FISH tests were performed concurrently with cytological specimens. Malignant diagnoses were identified in 623 of 1017 patients, while 394 patients had benign strictures. The sensitivity, specificity, positive predictive, and negative predictive rate were 65%, 78%, 83%, and 49% for cytology alone; 72%, 67%, 63%, and 68% for FISH alone; and 85%, 42%, 60%, and 74% for combined cytology and FISH, respectively. Among FISH-positive cases, the risk of malignancy for polysomy was 82% and 32% for trisomy. (4) Conclusions: FISH improves the sensitivity and negative predictive rate of bile duct brush cytology. The combination of cytology and FISH has increased the sensitivity from 65% to 85% and the negative predictive rate from 49% to 74% when compared to cytology alone. A patient with a polysomy FISH result had a significantly higher risk of malignancy than a patient with a trisomy 7 result (82% vs. 32%, p < 0.00001).
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Cecchini, Silvia, Rita Bonardi, Anna lossa, Marco Zappa, and Stefano Ciatto. "Colposcopy as a Primary Screening test for Cervical Cancer." Tumori Journal 83, no. 5 (September 1997): 810–13. http://dx.doi.org/10.1177/030089169708300506.
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Aim and background To evaluate the cost effectiveness of screening by colposcopy compared to conventional cytology. Methods A prospective study was performed in the Florence District screening center on 3,000 consecutive women, self referring, who were examined by cytology and colposcopy in a blind fashion. Further assessment was based on cytologic report or on colposcopy-directed punch biopsy. Actual costs of the whole screening process were known. The cost effectiveness of different possible simulated screening scenarios was then determined. Results Overall, 18 high-grade lesions (CIN3 = 9, CIN2 = 9) were detected. Four different screening scenarios were compared, namely a) cytology alone, b) cytology + repeat smear for ASCUS (atypical squamous cells of undeterminate significance) cases, c) colposcopy + cytology for cases of condyloma at punch biopsy, and d) colposcopy alone. Although they had a higher cost per examined woman (a) = 17.98, b) = 19.40, c) = 23.86, d)= 22.10 US$), scenarios c) and d) had a higher relative sensitivity (a = 44.4, b = 61.1, c = 100, d = 88.8%) and a lower cost per high-grade lesion detected (a = 6,743, b = 5,291, c = 3,977, d = 4,144 US$). Conclusions Screening by colposcopy is a feasible procedure which is more sensitive and more cost effective than conventional cytologic screening. At least in those settings where access to cytopathology may be difficult, screening by colposcopy should be considered as a possible alternative.
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McClain, Jonathan, and Michael J. Glantz. "The predictive value of protein, glucose, and lactate for a diagnosis of neoplastic meningitis." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e12005-e12005. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e12005.
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e12005 Background: Neoplastic Meningitis (NM) is a complication of many common cancers that occurs with an incidence as high as 15% in some cancer types. Diagnosis remains elusive with poor screening tools and insensitive diagnostic options. Methods: A retrospective analysis of 341 consecutive patients with suspected NM was undertaken. Clinical presentation, demographic, cytologic and MRI data were recorded. Using cytology as the diagnostic gold standard, sensitivity, specificity, ROC curves and likelihood ratios were calculated. Results: 210 patients met inclusion criteria, 87 with primary brain tumors (PBT), 72 with non-CNS solid tumors, and 44 with lymphomas. 111 patients were male; 123 (58.6%) ultimately had a positive cytology. Only 59% of patients with positive cytology presented with symptoms concerning for NM. 32.9% of patients with PBTs and positive CSF cytology exhibited neurologic symptoms suggestive of NM. Patients with non-CNS solid tumors and positive CSF cytology presented with symptoms concerning for NM 80% of the time. Patients with cytology-positive, MRI-positive and symptom-positive NM had very different survivals. Potentially informative CSF values are in table below. Conclusions: A definitive diagnosis for patients with suspected NM remains elusive without a positive cytology, but some clinical, radiographic, and CSF findings are useful for raising diagnostic concern, and for screening in at-risk populations. Symptom-positive or MRI-positive NM may represent different diseases than cytology-positive NM. [Table: see text]
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Renshaw, Andrew A. "Quality Improvement in Cytology: Where Do We Go From Here?" Archives of Pathology & Laboratory Medicine 135, no. 11 (November 1, 2011): 1387–90. http://dx.doi.org/10.5858/arpa.2010-0606-ra.
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Context.—Cytology is a success because of the many quality controls used to ensure the accuracy of its results. Nevertheless, additional information is becoming available to the cytologist, often from untraditional sources, and the best way to use that information to improve the quality of cytology is not yet known. Objective.—To review ways to use new information to improve the quality of cytology. Data Sources.—Review of relevant literature. Results.—Information contained in many sources can be used in new ways to improve the quality of cytology. These include the timing of cytologic and histologic correlation, electronic medical records, workload information, prior aspirations, and molecular tests. Conclusions.—To maintain their high standard of excellence, cytologists should seek to define the most appropriate way to incorporate this new information into their interpretation of individual cases.
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Lozano, Maria D., José I. Echeveste, Marta Abengozar, Luis D. Mejías, Miguel A. Idoate, Alfonso Calvo, and Carlos E. de Andrea. "Cytology Smears in the Era of Molecular Biomarkers in Non–Small Cell Lung Cancer: Doing More With Less." Archives of Pathology & Laboratory Medicine 142, no. 3 (March 1, 2018): 291–98. http://dx.doi.org/10.5858/arpa.2017-0208-ra.
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Context.— The rapid advances in targeted therapies in non–small cell lung cancer (NSCLC) make the optimization and implementation of cytology specimens for molecular testing a priority. Up to 70% of patients with NSCLC are diagnosed at advanced stages and tissue biopsies often cannot be taken. Although cytology samples provide high-quality material for molecular testing, molecular cytopathology is not yet well known or widely used. Objective.— To report the many advances in molecular cytopathology and the suitability and utility of cytology samples in molecular and genetic testing of NSCLC. Data Sources.— Data sources comprised published peer-reviewed literature and personal experience of the authors. Conclusions.— Molecular testing can be performed on cytologic specimens, especially on direct smears. Rapid on-site evaluation by cytopathologists has improved the adequacy and the management of cytology samples for molecular testing. Mutational profiling of NSCLC using next-generation sequencing can be performed on cytology samples from very small amounts of DNA. Fluorescence in situ hybridization assays on cytology specimens, including stained direct smear, offer some distinct advantages over their histologic counterpart, and are used to detect ALK and ROS1 rearrangements in NSCLC. Cytology specimens allow assessment of the entire tumor cell nucleus, avoiding signal loss from truncation artifacts. The use of cytology samples for assessing programmed death ligand-1 protein expression is currently being developed. Protocols for bisulfite conversion and DNA droplet digital polymerase chain reaction assays have been optimized for cytology smear to investigate aberrant DNA methylation of several NSCLC-related genes.
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GV, Chaithra, Debarshi Saha, Richa Yadav, Deepa S. Adiga, Flore D. Lobo, Apurv Ghosh, and Jyoti Kini. "The Role of Crush Cytology in the Diagnosis of Large-Intestine Lesions with Correlation on Histopathology." Acta Cytologica 62, no. 3 (2018): 215–22. http://dx.doi.org/10.1159/000487628.
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Objective: To study the efficacy of colonoscopic crush cytology as a convenient and near-accurate method to evaluate colonic neoplasms. Study Design: Retrospective and cross-sectional. The original cytologic diagnoses were correlated with a histology report on 100 cases sent to the cytology laboratory over 2 years. Results: Of the 100 cases, 25 were nonmalignant. Of the 75 malignant lesions, 72 could be identified as positive for malignancy on cytology. The false-positives consisted of 6 adenomas and 1 case of ulcerative colitis. Thus, sensitivity and specificity of cytology are 96 and 63.2%, respectively. Of the 6 adenomas diagnosed as malignant, 4 showed high-grade dysplasia, and the other 2 showed superficial ulceration with low-grade dysplasia on histopathology. The ulcerative colitis case showed widespread ulcers and regenerative/reparative features on biopsy. The 3 adenocarcinomas diagnosed s benign on cytology showed an occasional malignant cell with thickened nuclear borders and prominent central nucleoli. Conclusions: With careful attention to the cytomorphology, coupled with good clinical and endoscopic correlation, crush cytology of the large intestine is a reliable diagnostic tool. It categorizes lesions as malignant and benign with a high sensitivity, positive predictive value, and negative predictive value. Adenomas and reparative/regenerative changes seen in inflammatory bowel disease are major pitfalls in the cytology diagnosis of malignancy that may be averted by informing the endoscopic findings and clinical history. Cytology diagnosis saves time and gives proper feedback to the gastroenterologist.
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Jones, Bruce A., and David A. Novis. "Follow-up of Abnormal Gynecologic Cytology." Archives of Pathology & Laboratory Medicine 124, no. 5 (May 1, 2000): 665–71. http://dx.doi.org/10.5858/2000-124-0665-fuoagc.
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Abstract Objectives.—To measure the percentage of women with abnormal gynecologic cytology who have follow-up within 1 year and to identify patient and laboratory characteristics associated with higher percentages of follow-up. Design and Setting.—Retrospective identification of patients with abnormal cervicovaginal cytology and identification of the initial clinical follow-up activity during the 12 months following the cytologic diagnosis. Main Outcome Measure.—Percentage of women receiving follow-up. Results.—Three hundred six laboratories reported follow-up information on 16 132 patients with gynecologic cytology diagnoses of carcinoma, high-grade squamous intraepithelial lesion, low-grade squamous intraepithelial lesion, or glandular intraepithelial lesion. The following percentages of women received follow-up within 1 year: 85.6% of patients with cytologic diagnoses of carcinoma, 87.2% with diagnoses of high-grade squamous intraepithelial lesion, 82.7% with diagnoses of low-grade squamous intraepithelial lesion, and 84.9% with diagnoses of glandular intraepithelial lesion. Within 6 months, 82.2% of patients with cytologic diagnoses of carcinoma, 82.4% with diagnoses of high-grade squamous intraepithelial lesion, 71.9% with diagnoses of low-grade squamous intraepithelial lesion, and 74.7% with diagnoses of glandular intra-epithelial lesion received follow-up. Overall, 90.8% of patients who received follow-up within the 1-year time frame of this study had their follow-up completed within 6 months. Specific follow-up activities and their frequencies are listed for each diagnostic category. Patients 30 years old or younger and pregnant patients had lower follow-up percentages. Conclusions.—With less than 83% of patients with high-grade squamous intraepithelial lesion or carcinoma cytology findings having available documentation of follow-up within 6 months, and less than 88% within 1 year, there is room for improvement in this area of health care. Monitoring and critical analysis of the follow-up process is a starting point for improvement.
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Desai, Pankaj, Mayank Kabrawala, Chintan Patel, Priya Arora, Rajiv Mehta, Subhash Nandwani, Parika Kalra, Ritesh Prajapati, Nisharg Patel, and Krishna Parekh. "Crush cytology: an expeditious diagnostic tool for gastrointestinal tract malignancy." Endoscopy International Open 09, no. 05 (April 22, 2021): E735—E740. http://dx.doi.org/10.1055/a-1388-6479.
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Abstract Background and study aims Crush cytology is a simple and rapid method used for diagnosis of central nervous system lesions. We have evaluated the diagnostic accuracy of crush cytology for gastrointestinal tract lesions. Patients and methods This was a prospective, cross-sectional, single center study, conducted on the patients who had suspected malignant lesions between August 2018 and March 2020. The crush cytologic diagnoses were correlated with histology to determine the diagnostic accuracy. Results During the period of interest, a total of 451 patients (26.4 % esophagus & GE junction, 16.6 % stomach, 5.9 % ampulla & duodenum, and 50.9 % colorectal) had a suspected malignant lesion on endoscopic examination. Histology confirmed 92.9 % cases as malignant lesions and 7.1 % as nonmalignant. On crush cytology, 84.5 % were positive for malignancy, 8.9 % were negative for malignancy and 6.6 % were reported as suspicious for malignancy. The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of crush cytology were 97.3 %, 90 %, 99.2 %, 72.5 % and 96.9 %, respectively. Conclusions Crush cytology is a highly sensitive, specific, rapid and cost effective technique to diagnose gastrointestinal malignancies in endoscopically suspected malignant lesions. However, it cannot entirely substitute histopathological examination for definite tumor typing, grading, confirming invasion and in cases in which cytology is suspicious. Crush cytology is an added asset to the histology to maximize diagnostic accuracy and accelerating decision making for the management of lesions.
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Bak, Mihály, Judit Hidvégi, Judit Andi, Mária Bahéry, Eszter Kovács, Ferenc Schneider, Szilárd Kostic, et al. "Quality assurance of rapid on-site evaluation of CT-guided fine-needle aspiration cytology of lung nodules." Orvosi Hetilap 154, no. 1 (January 2013): 28–32. http://dx.doi.org/10.1556/oh.2013.29519.
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Introduction: The methods available for the diagnosis of lung cancer include radiologic, cytologic and pathologic procedures. Aims: The aim of this study was to determine the quality assurance of CT guided fine needle aspiration cytology of lung nodules. Methods: Cytology results were rated to 4 categories (positive; suspicious; negative; not representative). All cytology reports were compared with the final histology diagnosis. Results: A total of 128 patients underwent CT-guided percutaneous fine-needle aspiration biopsy cytology (63 males; 65 females; mean age 62.8 years). Smears were adequate in 99 cases and inadequate in 29 cases. The average diameter of the nodules was 3.28 cm. Thirty three (25.6%) of the cases were histologically verified and 2 falsely negative and 2 falsely positive cases were detected. The sensitivity and the positive predictive value were 88.8% and 88.8%, respectively. Pneumothorax developed in 7 (5.4%) cases. Conclusion: These results suggest that CT-guided transthoracic fine needle aspiration cytology has a high diagnostic accuracy and an acceptable complication rate. The auditing valves of the results meet the proposed threshold values. Orv. Hetil., 2013, 154, 28–32.
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Itsuki, Hiroshi, Masahiro Serikawa, Tamito Sasaki, Yasutaka Ishii, Ken Tsushima, Yoshinari Furukawa, Yoshiaki Murakami, Koji Arihiro, and Kazuaki Chayama. "Indication and Usefulness of Bile Juice Cytology for Diagnosis of Gallbladder Cancer." Gastroenterology Research and Practice 2018 (2018): 1–6. http://dx.doi.org/10.1155/2018/5410349.
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Aim. We examined the effectiveness of bile juice cytology for distinguishing between benign and malignant gallbladder lesions of the protruding type with various sampling points, sampling methods, and macroscopic forms in order to discuss the effectiveness of the endoscopic transpapillary gallbladder drainage (ETGD) cytology. Methods. We studied 162 cases of patients with a lesion localized within the gallbladder. At first, we examined the effectiveness for diagnosis of ETBD cytology using ERC and then that of the first ETGD cytology after placing the ETGD. Next, we examined the diagnostic effectiveness of the washed ETGD cytology by using the ETGD. Finally, we examined complications. Results. In the final diagnoses, we identified 33 cases of adenocarcinoma, 10 cases of adenoma, 63 cases of ADM, 35 cases of nonneoplastic polyp, and 21 cases of chronic cholecystitis. It was found that the sensitivity of ETBD cytology was 3.6% and that of ETGD cytology was 59.1%. In the comparison of diagnostic effectiveness of cytologic diagnosis using samples of bile juice from the gallbladder collected by different methods, the sensitivities were 38.9% and 73.3% for the first and washed ETGD cytologies, respectively. In the comparison of the diagnostic effectiveness of gallbladder bile juice cytology using samples collected for different forms of lesion and by different methods, the sensitivities were 38.9% and 73.3%, respectively, for the first and washed ETGD cytologies for flat gallbladder wall thickening, while it was impossible to diagnose for lesions of GB polyp. Conclusion. For diagnosis of gallbladder cancer, we consider that the ETGD cytology should be taken into consideration for lesions of flat gallbladder wall thickening, for which it is difficult to distinguish between benign and malignant lesions.
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Wang, Shaohua, Dan Li, Jieqiong Wang, Yu Wan, Conggai Huang, Bo Yang, Xiaoqin Tang, Gang Tian, and Zhihui Yang. "A Comparative Study of Liquid-Based Cytology and DNA Image Cytometry in the Diagnosis of Serous Effusion." Technology in Cancer Research & Treatment 19 (January 1, 2020): 153303382094229. http://dx.doi.org/10.1177/1533033820942298.
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Background: Liquid-based cytology is one of the most useful methods to diagnose a patient with serous effusion, especially when malignancy is suspected. As an alternative to the use of liquid-based cytology only, the serous effusion can be further processed using the technique of DNA image cytometry, which may augment diagnostic utility. The aim of this study was to compare the diagnostic yields of liquid-based cytology, DNA image cytometry, and both in combination, regardless of serous-effusion etiology. Methods: We conducted a descriptive study on patients with serous effusions from July 2016 to June 2018. All samples were submitted for liquid-based cytology and DNA image cytometry techniques. We compared the results of cytopathological studies to the final diagnoses. Results: For a total of 798 samples, final diagnoses included 412 (51.6%) malignancies, 280 (35.1.%) inflammatory diseases, and 106 (13.3%) transudative serous effusions. Liquid-based cytology had a more sensitive diagnostic yield than DNA image cytometry did (38.8% vs 30.7%; P < .05), but the combination of both had a higher yield (43.7%; P < .05) compared with that of liquid-based cytology alone. For the 412 malignant serous effusions, diagnostic yields of liquid-based cytology and DNA image cytometry were 73.8% and 59.5%, respectively. The difference in sensitivity was significant ( P < .05). Combined liquid-based cytology + DNA image cytometry improved diagnostic yield to 83.3% ( P < .05). However, both liquid-based cytology and DNA image cytometry had low diagnostic yields for inflammatory diseases and transudative serous effusions. Conclusion: In serous effusion, liquid-based cytology’s diagnostic performance is better than that of DNA image cytometry. Application of both techniques can significantly increase diagnostic yield.
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Badruddoza, SM, FA Azim, AJE Nahar Rahman, M. Kamal, AR Barua, KH Khan, and T. Chowdhury. "Cytohistologic Correlation of Urothelial Cancers– A study of 57 Cases." TAJ: Journal of Teachers Association 30, no. 1 (December 3, 2018): 1–10. http://dx.doi.org/10.3329/taj.v30i1.39114.
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Transitional cell carcinoma (TCC) comprises about 90% of all primary tumors of urinary bladder. The accuracy of multiple voided urine cytology justifies its continued use as a first line diagnostic and detection technique, particularly for high grade invasive cancers and clinically unsuspected case of carcinoma particularly carcinoma in-situ. In this study 57 cases were taken to see correlation of cytology, histology, stage, morphological pattern and sensitivity and specificity of urothelial cancers. Out of 57, 53 (92.99)% were positive for malignancy and 4(7.01%) were negative. There were 14 (24.56%) non-invasive papillary tumors, 1(1.76%) carcinoma in-situ and 42 (76.68%) invasive carcinoma of all grades and types. Of 14 grade-II non-invasive papillary tumors, 12 (85.72%) were cytologically positive. With only two exceptions, out of 39 all of the invasive carcinomas of all grades and types were identified by cytology as cancerous. A 100% positive cytology was noted in the detection of flat carcinoma in-situ, papillary adenocarcinoma and squamous cell carcinoma of the urinary bladder. Of the total 57 cases of malignant lesions of urinary tract, 53 (92.99%) were positive on cytological examination. The two TCC of the renal pelvis also gave a 100% positive cytologic results. Among invasive carcinoma, stage B1 and B2 urothelial cancers yield highest positive cytologic diagnosis rather than stage 0 and stage A urothelial cancers. For all tumors the sensitivity was 92.99%. The specificity was 100% since there were no false positive cases. The diagnostic accuracy was 93% (approximately). Comparison with previously published data this study showed highest diagnostic accuracy, sensitivity, specificity of voided urine cytology, good correlation with cytology histology and stage of tumor. So voided urine cytology, a very cheap and purely non invasive technique, can be done as an effective method to diagnose urothelial cancers in a developing country like Bangladesh where facilities for other investigations are practically limited.TAJ 2017; 30(1): 1-10
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Pausawasdi, Nonthalee, Penprapai Hongsrisuwan, Wipapat Vicki Chalermwai, Amna Subhan Butt, Kotchakon Maipang, and Phunchai Charatchareonwitthaya. "The diagnostic performance of combined conventional cytology with smears and cell block preparation obtained from endoscopic ultrasound-guided fine needle aspiration for intra-abdominal mass lesions." PLOS ONE 17, no. 3 (March 23, 2022): e0263982. http://dx.doi.org/10.1371/journal.pone.0263982.
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Background/Aim Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the primary method for tissue acquisition of intra-abdominal masses. However, the main limitation of cytology alone is the lack of tissue architecture and inadequate samples. This study aimed to evaluate the diagnostic performance of combined conventional cytology and cell block preparation obtained from EUS-FNA of intra-abdominal masses without Rapid On-site Evaluation (ROSE). Methods Cytologic smears and cell block slides of 166 patients undergoing EUS-FNA during 2010–2015 were reviewed by an experienced cytopathologist blinded to clinical data. Results 125 patients had neoplastic lesions. Pancreatic adenocarcinoma was the most common etiology (35.5%), followed by lymph node metastasis (27.7%). The mean mass size was 2.5±1.3 cm. The mean number of passes was 1.9±1.28. Tissue adequacy for conventional cytology and cell block preparation was 78.9% and 78.1%, respectively. Factors associated with tissue adequacy were assessed. For cytology, lesions of > 2.1 cm, masses in the pancreatic body or tail, malignancy, and pancreatic cancer were positively associated with adequate cellularity. For cell block preparation, lesions of > 3 cm and malignancy were associated with increased tissue adequacy. The conventional cytology alone had a sensitivity of 68.5%, a specificity of 95.7%, and an area under the receiver operating characteristics (AUROC) of 0.821. The cell block preparation alone had a sensitivity of 65.4%, a specificity of 96%, and an AUROC of 0.807. The combined conventional cytology and cell block preparation performed significantly better than either method alone (p<0.05), as demonstrated by an increased AUROC of 0.853. Furthermore, cell block detected malignancy in 9.3% of cases where the cytologic smears failed to identify malignant cells. Conclusions The combined conventional cytology and cell block preparation increased the diagnostic accuracy of EUS-FNA compared to either method alone. This approach should be implemented in routine practice, especially where ROSE is unavailable.
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Garma-Aviña, Armando. "The Cytology of Squamous Cell Carcinomas in Domestic Animals." Journal of Veterinary Diagnostic Investigation 6, no. 2 (April 1994): 238–46. http://dx.doi.org/10.1177/104063879400600216.
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A series of 40 tumors with a proven diagnosis of squamous cell carcinoma for which both histology and cytology were available were classified according to their histologic appearance as well differentiated, moderately differentiated, and poorly differentiated. The Romanowsky-stained cytology specimens were reviewed. When available, Papanicolaou-stained smears were included. The cytologic findings for each of the 3 groups are described, and the most significant findings are photographically illustrated.
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Barkan, Güliz A., Eva M. Wojcik, Ritu Nayar, Spasenija Savic-Prince, Marcus L. Quek, Daniel F. I. Kurtycz, and Dorothy L. Rosenthal. "The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology." Acta Cytologica 60, no. 3 (2016): 185–97. http://dx.doi.org/10.1159/000446270.
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The main purpose of urine cytology is to detect high-grade urothelial carcinoma (HGUC). With this principle in mind, The Paris System (TPS) Working Group, composed of cytopathologists, surgical pathologists, and urologists, has proposed and published a standardized reporting system that includes specific diagnostic categories and cytomorphologic criteria for the reliable diagnosis of HGUC. This paper outlines the essential elements of TPS and the process that led to the formation and rationale of the reporting system. The Paris System Working Group, organized at the 2013 International Congress of Cytology, conceived a standardized platform on which to base cytologic interpretation of urine samples. The widespread dissemination of this approach to cytologic examination and reporting of urologic samples and the scheme's universal acceptance by pathologists and urologists is critical for its success. For urologists, understanding the diagnostic criteria, their clinical implications, and the limitations of TPS is essential if they are to utilize urine cytology and noninvasive ancillary tests in a thoughtful and practical manner. This is the first international/inclusive attempt at standardizing urinary cytology. The success of TPS will depend on the pathology and urology communities working collectively to improve this seminal paradigm shift, and optimize the impact on patient care.
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Alagappan, Muthuraman, Natasha Darras, Lauren Yang, Paul Vanderlaan, Meir Mizrahi, Mandeep Sawhney, Douglas Pleskow, and Tyler Berzin. "Yield of biliary stent cytology: Is it time to think lean?" Endoscopy International Open 07, no. 04 (April 2019): E545—E550. http://dx.doi.org/10.1055/a-0829-6216.
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Abstract Background and study aims During evaluation of pancreaticobiliary strictures, it is common practice to send biliary stents for cytologic analysis. However, in recent years, complementary tissue acquisition techniques ranging from cholangioscopy to fine-needle biopsy have improved the ability to acquire tissue and diagnose malignancy. Data are limited on the current diagnostic yield and cost effectiveness of biliary stent analysis. Patients and methods We performed a retrospective study of all pancreaticobiliary stents sent for analysis in a tertiary care academic medical center from June 2013 to September 2016. Patient demographics, stent information, and final diagnosis history were collected through chart review. Costs were determined using published reimbursement rates for Medicare. Results Two hundred thirty-one stents from 175 patients were sent for cytologic analysis during the study period. Of the 62 stents obtained from patients ultimately diagnosed with malignancy, only one (1.6 %) had positive cytology for malignant cells, while the others were acellular/non-diagnostic (2/62, 3.2 %), negative (48/62, 77.4 %), or atypical (11/62, 17.7 %). The sensitivity of stent cytology for diagnosis of malignancy was 1.6 % (1/62). No cases were identified in which stent cytology changed clinical management. From a payer perspective, the mean estimated cost for each stent cytologic analysis is greater than $ 70.00. Conclusions While stent cytologic analysis is a common clinical practice, the diagnostic yield and cost effectiveness of the practice must be reevaluated. With the rise of newer diagnostic technologies such as digital cholangioscopy and endoscopic ultrasound-guided fine-needle biopsy, it may be time to “think lean” and acknowledge a sunset for biliary stent cytology.
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Cecchini, Silvia, Rita Bonardi, Antonia Mazzotta, Grazia Grazzini, Anna Iossa, and Stefano Ciatto. "Testing Cervicography and Cervicoscopy as Screening Tests for Cervical Cancer." Tumori Journal 79, no. 1 (February 1993): 22–25. http://dx.doi.org/10.1177/030089169307900104.
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Aims and Background Suboptimal sensitivity is currently reported for Pap test in screening for cervical cancer. Colposcopy is known to be more sensitive than cytology but its use as a screening test is not possible due to costs and complexity. Screening by cervicography has been suggested as a compromise being less costly and feasible. The present study evaluates the feasibility of screening by cervicography and cervicoscopy (naked eye examination of the cervix after acetic acid lavage) on a consecutive screening series. Methods Cervicography and cervicoscopy were performed by the smear taker in subjects consecutively attending a screening clinic. Women with abnormal cytology (atypia or more severe lesion) and/or abnormal cervicography or cervicoscopy (acetowhite lesion) underwent colposcopic assessment. The three screening methods were compared according to positivity rate, CIN 2-3 detection rate and positive predictive value. Results 2105 consecutive subjects were screened. Positivity rate was 3.8 %, 15.3 % or 25.4 % for cytology, cervicography or cervicoscopy, respectively, 486 of 555 women attended the assessment phase, 281 directed biopsies were performed and 8 CIN 2-3 lesions were detected. Cytology, cervicography and cervicoscopy, detected 5.5, or 7 of 8 CIN 2-3 lesions, respectively. The positive predictive value was 0% for cytologic atypia, 25 % for cytologic SIL, 1.75 % for cervicography and 2.05% for cervicoscopy. Detecting one CIN 2-3 lesion at cytology cost $ 5,543. The cost per each additional cytologically negative CIN 2-3 lesion detected at cervicography or cervicoscopy was $ 12,947 or $ 3,916, respectively. Conclusions The study confirms the limited sensitivity of cytology for CIN 2-3. The association of cervicography was not cost effective. Cervicoscopy was poorly specific but increased the detection rate of CIN 2-3 at relatively low costs. Cervicoscopy is worth further evaluation as a screening test.
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Putra, M. Afif Heldian, Gama Satria, Dini Rizkie Wijayanti, Legiran, Bermansyah, Ahmat Umar, and Aswin Nugraha. "Sensitivity and Specificity Sputum Cytology Examination to Histopathology Examination of Lung Malignancy Suspect Patient in Dr. Mohammad Hoesin General Hospital Palembang." Sriwijaya Journal of Surgery 4, no. 1 (April 12, 2021): 195–203. http://dx.doi.org/10.37275/sjs.v4i1.46.
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Introduction: Incidence of lung cancer highest in Indonesia and the fifth most abundant in female after breast cancer. Lung cancer is first cause of cancer related mortality in male (21.8%) and second cause of cancer related mortality in female (9.1%) after breast cancer (21.4%). The result of study in 100 hospitals in Jakarta showed that lung cancer was the most abundant in male and forth in female. The sputum cytology in lung cancer is an initial examination for diagnosis. The sputum cytology examination is a simple, accurate, cheap and non-invasive for initial diagnosis of lung disease including lung cancer.
Methods: This study targeted lung malignancy suspect patient with sputum cytology examination in Dr. Mohammad Hoesin Hospital Palembang. The inclusion criteria were patients who will have a surgery and histopathology examination, patient >17 years old, patient that willingly take part in this research. The exclusion criteria were patient with sputum that can’t be retrieved. This study was using Cross Sectional method. The measurement of sensitivity and specificity of sputum cytology to histopathology examination calculated with Thornier-Remain formula.
Results: The lung cancer patient found most in category of > 40 years (63.6%), male and smoking (77.3%). The sputum cytology’s result highest in non-malignancy (86.4%) and the histopathology examination’s result highest in malignancy (72.7%). Sensitivity of sputum cytology in this study is 28.75% and the specificity 100%
Conclusion: The sensitivity of sputum cytology in 28.75% shown accuracy of sputum cytology method and specificity in 100% shown how often the sputum cytology method diagnoses the malignancy
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Neihaus, Steven A., Jennifer E. Locke, Anne M. Barger, Luke B. Borst, and Robert L. Goring. "A Novel Method of Core Aspirate Cytology Compared to Fine-Needle Aspiration for Diagnosing Canine Osteosarcoma." Journal of the American Animal Hospital Association 47, no. 5 (September 1, 2011): 317–23. http://dx.doi.org/10.5326/jaaha-ms-5676.
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There is little information in veterinary literature regarding the diagnostic accuracy of aspirate cytology for the diagnosis of canine osteosarcoma (OSA). The authors compared the diagnostic accuracy of a novel method of cytologic collection, termed core aspirate cytology (CA), with fine needle aspiration (FNA) and histopathology in 27 dogs with lytic and/or proliferative bone lesions. Alkaline phosphatase (ALP) staining was performed to confirm the diagnosis of OSA cytologically. OSA was accurately diagnosed in 85% and 95% of FNA and CA, respectively. ALP staining was 100% sensitive for the diagnosis of OSA. CA using a bone marrow biopsy needle allowed for penetration of cortical bone and aspirate cytology with a larger bore needle than FNA; however, there was no significant difference in diagnostic accuracy between techniques. Aspirate cytology with ALP staining was a safe, accurate, and minimally invasive diagnostic test for the evaluation of suspected OSA lesions in dogs.
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SAKAMOTO, Hirofumi, Makiyo TAKENAKA, Kazuki USHIMARU, and Takuji TANAKA. "Cytologic features of endometrial Liquid-Based Cytology." Journal of the Japanese Society of Clinical Cytology 52, no. 1 (2013): 8–11. http://dx.doi.org/10.5795/jjscc.52.8.
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Zhao, J., L. Ding, P. Fung, E. Mathews, and P. Sullivan. "Accuracy of prior cytology versus intraoperative consultation in predicting the final diagnosis of thyroid specimens." American Journal of Clinical Pathology 160, Supplement_1 (November 1, 2023): S24. http://dx.doi.org/10.1093/ajcp/aqad150.053.
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Abstract Introduction/Objective The aim of this study was to assess the accuracy of preoperative cytology and the additional contribution of intraoperative frozen section in predicting the final diagnosis of thyroid surgical specimens. Methods/Case Report A retrospective search was conducted for cases that underwent pre-surgical cytology of thyroid surgical specimens received from January 2017 to June 2022. A total of 99 cases were evaluated which were grouped into six categories according to the Bethesda system. The cytology results were compared with the corresponding frozen section and permanent section diagnoses. Indeterminate and discordant cases were further evaluated with molecular tests. Results (if a Case Study enter NA) Among the 99 cases, preoperative cytologic diagnoses were as follows: 1 was nondiagnostic, 9 were benign, 7 were AUS/FLUS, 3 were FN/SFN, 7 were suspicious for malignancy, and 72 were malignant. Using Bethesda categories V and VI as cytology “positive” cases and Bethesda category II as cytology “negative” cases, the sensitivity and specificity of cytology were 99% and 100%, respectively. The positive predictive value was 100%. The negative predictive value was 89%, which was affected by sampling error. Intraoperative frozen section was performed on 31 cases. In 4 indeterminate cytology cases (Bethesda III, IV), frozen section diagnosis was benign in 1 (confirmed on final) and remained indeterminate in 3 cases (3 benign on final). All 3 dual indeterminate cases showed a follicular pattern; molecular tests were predictive of the final diagnosis in these cases. All 21 malignant frozen section diagnoses had positive cytology. Conclusion Cytology has high sensitivity and specificity, making it a valuable preoperative tool in thyroid surgery. Practically, intraoperative frozen section has limited value in thyroid nodules classified as Bethesda categories V and VI. Additional evaluation may be helpful for cases classified as uncertain Bethesda categories. For follicular patterned lesions, frozen section may have less value.
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Moore, Kathleen N., and Joan L. Walker. "High Risk Human Papillomavirus Testing: Guidelines for Use in Screening, Triage, and Follow-up for the Prevention and Early Detection of Cervical Cancer." Journal of the National Comprehensive Cancer Network 2, no. 6 (November 2004): 589–96. http://dx.doi.org/10.6004/jnccn.2004.0049.
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The changes in cervical cytology characterization agreed on by the Bethesda committee meeting in 2001 created a category of atypical findings that has caused some management confusion. By description, the characterization of cervical cytology as only atypical implies a less worrisome prognosis. However, more than 40% of high-grade (CIN II or III or cancer) will be discovered within this category. The development and Food and Drug Administration approval of the Hybrid Capture 2 (HC-2; Digene Corporation, Gaithersburg, MD) for detecting high-risk human papillomavirus (HR-HPV) subtypes and the subsequent level I evidence supporting use of this test in the triage of women with atypical cytology has revolutionized the management of this cytology. With this success has come numerous additional uses for HR-HPV testing in the treatment and follow-up of women with a variety of cytologic abnormalities. This article reviews the literature on uses of HR-HPV testing in this population, with reference to currently accepted guidelines.
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Thapa, Suman, R. Parajuli, T. Limbu, and R. Bhandari. "Parotid oncocytoma: diagnostic vs surgical dilemma." Nepalese Journal of ENT Head and Neck Surgery 5, no. 1 (February 28, 2017): 22–23. http://dx.doi.org/10.3126/njenthns.v5i1.16873.
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Oncocytomas are rare benign tumors of salivary gland origin, most often seen involving the parotid gland. They should be considered as a possible diagnosis in elderly patients with slow growing, nontender and mobile parotid swelling. We report here a middle aged female with left parotid swelling that was misdiagnosed on fine needle aspiration cytology and confirmed with histopathology report. Rarity of the disease with frequent cytologic overlaps and interpreter’s inexperience account for the majority of aspiration cytology pitfalls. Therefore, aspiration cytology alone may be misguiding at times, leading to surgical over-correction and further potential complications. The ever-changing trends of mucoepidermoid carcinoma (pre-operative, fine needle aspiration cytology), pleomorphic adenoma (intraoperative) and oncocytoma (post-operative, histopathology) have created diagnostic dilemma, confusion and challenged the surgical rationale. In cases with discrepancy between clinical, cytological and pathological reports, diagnostic as well as surgical dilemma exists wherein a thorough diagnostic re-assessment and a proper surgical revision is warranted.
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Eltoum, Isam A., Evans A. Alston, and Janie Roberson. "Trends in Pancreatic Pathology Practice Before and After Implementation of Endoscopic Ultrasound-Guided Fine-Needle Aspiration: An Example of Disruptive Innovation Effect?" Archives of Pathology & Laboratory Medicine 136, no. 4 (April 1, 2012): 447–53. http://dx.doi.org/10.5858/arpa.2011-0218-oa.
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Context.—Little has been reported on changes in pancreatic pathology practice after implementation of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Objectives.—We assessed the impact of EUS-FNA on cytologic diagnosis replacing histologic diagnosis for pancreatic disease and determined whether it fulfills Christensen criteria of a disruptive innovation effect. Design.—Pattern of utilization during 20 years, diagnostic categories, and diagnostic accuracy of pancreatic cytology were compared before and after implementation of EUS-FNA. The disruptive effect of cytology relevant to biopsy was assessed by comparing the utilization trends and the accuracy of diagnosis over time. Results.—The mean annual volume (standard deviation) of cytologic specimens increased from 24 (11) to 231 (10) after implementation of EUS-FNA, and that of histologic specimens increased from 97 (42) to 377 (148). The average percentage of annual cases managed by following cytology alone was 19% (10) before versus 51% (8) after implementation. The percentage managed by histology alone was 56% before versus 23% after implementation. Non–endoscopic ultrasound-guided fine-needle aspiration cytology decreased from 36% to 1%. Needle biopsies decreased from 7% to 1%, and other biopsy types from 29% to 9%. Unsatisfactory (7% versus 1%), atypical (16% versus 4%), and suspicious (16% versus 3%) diagnoses were significantly reduced. The accuracy of cytologic diagnosis significantly improved: the sensitivity (confidence interval) and specificity (confidence interval) for cancer diagnosis were 55% (38%–70%) and 78% (58%–89%) before versus 88% (84%–91%) and 96% (93%–98%) after implementation, respectively. Conclusions.—Endoscopic ultrasound-guided fine-needle aspiration improved the accuracy of cytologic diagnosis, reduced the number of indeterminate diagnoses, and replaced the need for tissue biopsy. Given its cost and simplicity as compared with tissue biopsy, this trend represents a disruptive innovation effect.
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Ma, Cao, and Lihua Zhang. "Comparison of small biopsy and cytology specimens: Subtyping of pulmonary adenocarcinoma." Cytojournal 20 (February 8, 2023): 5. http://dx.doi.org/10.25259/cytojournal_45_2022.
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Objectives: The aims of this study was to investigate the use of cytologic samples for subclassification of lung adenocarcinoma and the cytologic-histologic correlation in lung adenocarcinoma subtypes using small samples. Methods and Methods: Cytological characteristics of lung adenocarcinoma subtypes were summarized by a literature review. Cytology samples from 115 patients with lung adenocarcinoma confirmed by small biopsies were classified by subtype. The diagnostic concordance of subtypes between biopsy and cytology samples was assessed. Results: Among the 115 cases, 62 (53.9%) had acinar predominant pattern, 16 (13.9%) were papillary predominant pattern, 29 (25.2%) had solid predominant pattern, 3 (2.6%) had lepidic predominant pattern, and 5 (4.3%) had micropapillary predominant pattern. All corresponding cytologic samples were classified into five subtypes based on cytomorphology features, with concordance rates of 74.2% (46 patients) in c-acinar subtype, 56.3% (nine patients) in c-papillary subtype, 24.1% (seven patients) in c-solid subtype, 66.7% (two patients) in c-lepidic subtype, and 40% (two patients) in c-micropapillary subtype. Collectively, the cytology and small biopsy concordance rate was approximately 57.4%. Conclusion: Subtyping of lung adenocarcinoma using cytologic specimens is challenging and the consistency rate varies with the subtype. Acinar predominant tumors have an excellent cytologic-histologic correlation compared to tumors with predominant solid or micropapillary pattern. Evaluating cytomorphologic features of different lung adenocarcinoma subtypes can reduce the false-negative rate of lung adenocarcinoma, particularly for the mild, atypical micropapillary subtype, and improve diagnostic accuracy.
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Martini, Maurizio, Sara Capodimonti, Tonia Cenci, Mirna Bilotta, Guido Fadda, Luigi Maria Larocca, and Esther Diana Rossi. "To Obtain More With Less: Cytologic Samples With Ancillary Molecular Techniques—The Useful Role of Liquid-Based Cytology." Archives of Pathology & Laboratory Medicine 142, no. 3 (March 1, 2018): 299–307. http://dx.doi.org/10.5858/arpa.2017-0148-ra.
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Context.— Fine-needle aspiration cytology has been increasingly used as the first tool in the evaluation of several diseases. Although cytology has a relevant role in the discrimination between benign and malignant lesions, conventional slides cannot lead to 100% conclusive results. It was hoped that the introduction of liquid-based cytology (LBC) would improve the efficacy of cytology through standardization, quality improvement, and the possibility of carrying out ancillary techniques on the residual stored material. In recent decades, the application of genomic alterations has been studied on cytologic samples with feasible and reliable results. The molecular analysis offers a powerful aid to define the best clinical or surgical approaches and follow-up for patients. In recent years, the application of different ancillary techniques has been carried out on conventional slides even though LBC represents a useful additional and alternative method for molecular testing. Objective.— To demonstrate the relevance of LBC as a valid aid to overcoming the difficulties encountered in the application of ancillary techniques on conventional slides. Data Sources.— We examined and reviewed our experience with the application of ancillary techniques on LBC performed on different body sites. Conclusions.— We emphasize that LBC achieves significant and accurate results. It represents a valid method for cytologic evaluation and it provides highly reproducible and informative molecular yields.
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Schnadig, Vicki J., Claudia P. Molina, and Judith F. Aronson. "Cytodiagnosis in the Autopsy Suite: A Tool for Improving Autopsy Quality and Resident Education." Archives of Pathology & Laboratory Medicine 131, no. 7 (July 1, 2007): 1056–62. http://dx.doi.org/10.5858/2007-131-1056-citasa.
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Abstract Context.—Despite several publications attesting to its accuracy and value, cytology is rarely used for preliminary autopsy diagnosis in the United States. Postmortem cytodiagnosis has the potential to increase the accuracy and specificity of the provisional and final autopsy diagnoses, increase resident interest in cytodiagnostic techniques, and direct pathologists to request pertinent special studies, such as microbial cultures and special stains. Objective.—To assess and illustrate the value of cytodiagnostic techniques for improving autopsy quality assurance and resident education. Design.—Eighty-five samples were evaluated from 49 nonconsecutive autopsies. Sixty-five focal lesions were sampled by direct scraping. Diffuse lung consolidation was sampled by fine-needle aspiration (20 samples). Smears and cytocentrifuge preparations of fine-needle aspirations were routinely stained by both Papanicolaou and Romanowski methods. Cytologic diagnoses were compared with final autopsy diagnoses, and both cytology and pertinent histology were reviewed. Results.—Clinical or radiographic antemortem site-specific diagnoses had been made in 28 (33%) of the 85 samples. A definite diagnosis was made by postmortem cytology in 68 (80%) of 85 samples, and these diagnoses could contribute to provisional autopsy diagnosis in 46 instances (68%). Resident and faculty enthusiasm for the use of cytology in the autopsy suite has increased during the 7 years following the study. Case examples illustrating the benefits of postmortem cytology are provided. Conclusions.—Postmortem cytology benefits both autopsy quality and resident education.
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Dimitrov, Goran, Elena Dzikova, Gligor Dimitrov, Saso Panov, Irena Aleksioska, and Gjorgji Babusku. "The role of human papillomavirus (HPV) testing in the follow-up of patients after treatment for cervical intraepithelial neoplasia (CIN)." Journal of Health Sciences 3, no. 2 (September 15, 2013): 117–22. http://dx.doi.org/10.17532/jhsci.2013.75.
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Introduction: The aim of this study was to examine the role of human papillomavirus testing in the follow-up after treatment for CIN, as a prognostic sign for residual/recurrent cervical precancerous lesions.Methods: A hospital-based analysis was performed on 460 patients previously treated for CIN with cold knife conization, at the University Clinic for Gynecology and Obstetrics and General Hospital Remedika, in Skopje, Republic of Macedonia, in a period of 3 years. The patients were followed-up with HPV testing in addition to cytology, colposcopy and/or biopsy. The first after treatment HPV testing was performed8 months after cold knife conization, proceeded by follow-up within 24 months after treatment, at 4 months intervals.Results: Among 460 treated patients, at the fi rst HPV and cytologic testing, 8 months after treat-ment, 69 (15%) were HPV+, and 391 (85%) HPV negative. From the 69 HPV+ patients, 41 (59.4%) were withcytologic abnormalities and 28 (40.6%) without abnormalities. 12 months after treatment, the number of HPV+ patients developing cytologic abnormalities raised to 45/70 (64.29%). Within the 24 months aftertreatment, the number of patients who had recurrent/ residual CIN from the HPV+ patients reached 50/71 (70.42%); which was 10.87% from all 460 treated patients.Conclusion: Persistence or clearance of HPV especially 8 months after treatment even in patients with normal cytology, is an early valid prognostic marker of treatment failure, and is more accurate than cytologyat the same follow-up intervals.
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Laucirica, Rodolfo, and Mary L. Ostrowski. "Cytology of Nonneoplastic Occupational and Environmental Diseases of the Lung and Pleura." Archives of Pathology & Laboratory Medicine 131, no. 11 (November 1, 2007): 1700–1708. http://dx.doi.org/10.5858/2007-131-1700-conoae.
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Abstract Context.—Cytologic examination of the respiratory tract has been a useful diagnostic tool when evaluating neoplastic lesions of the respiratory tract. However, we have limited experience in the application of this technique in the management of nonneoplastic occupational and environmental diseases of the lung and pleura. This review focuses on the cytologic characteristics of a variety of occupational lung diseases, grouping them into 2 broad diagnostic categories: reactive cellular changes and noncellular elements. The former includes entities such as reactive mesothelial proliferation, goblet cell metaplasia, Creola bodies, and reserve cell hyperplasia, and the latter encompasses Curschmann spirals, Charcot-Leyden crystals, and asbestos bodies. Objective.—To illustrate the cytologic features of several nonneoplastic occupational and environmental diseases and correlate the cytology with various etiologic agents. Data Sources.—Case-derived material and literature review. Conclusions.—The role of cytology in the diagnosis of nonneoplastic occupational and environmental lung diseases is limited. This may be because more than one agent can elicit a similar host reaction and/or the offending agent can be associated with more than one pathologic process. However, in the appropriate clinical and radiographic setting, the cytology can render valuable diagnostic information. Examples include pulmonary alveolar proteinosis in patients with acute silicoproteinosis and asbestos bodies in bronchoalveolar lavage samples of patients with asbestos exposure.
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Umar, Ahmed M., Uzodimma E. Onwuasoanya, Emmanuel U. Oyibo, Adamu Dahiru, and Ismaila A. Mungadi. "The pattern of urine cytology among patients with clinical diagnosis of bladder tumor in a tertiary hospital northwest Nigeria." International Surgery Journal 6, no. 10 (September 26, 2019): 3521. http://dx.doi.org/10.18203/2349-2902.isj20194402.
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Background: Urine cytology is a simple, safe, non-invasive and cheap investigation that is used as adjunct to cystoscopy in the diagnosis of bladder cancer. Its low sensitivity is a major limitation against its use as a sole diagnostic test for bladder cancer. The objective of this study was to determine the pattern of urine cytology seen in patients with clinical diagnosis of bladder tumour in our practice.Methods: This is a retrospective study of patients with clinical diagnosis of bladder tumour that had urine cytology in our centre. The age and gender of the patients, number of urine cytology per patient per year and cytologic diagnosis were analysed using the SPSS 20.Results: During the period under review, a total of 512 urine cytology was done for patients with clinical diagnosis of bladder tumour. The age range of the patients was 6 to 90 years with modal age of 60 years. 457 (89.3%) were males while 54 (10.5%) were females and 1 (0.2%) was unspecified. Male to female ratio was 8.5:1. The highest number of urine cytology was done in 2013 with 64 (12.5%) while the least number was 1 (0.2%) recorded in 2001 and 2003. Only 68 (13.3%) specimens were reported to be malignant while 245 (47.9%) were reported as negative representing the most common cytological diagnosis in the study.Conclusions: Although urine cytology is useful in the diagnostic workup of patients with bladder mass, it is unlikely it would supplant cystoscopy and biopsy in the diagnosis of bladder cancer.
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Sulaieva, Oksana, Pavlina Botsun, Olena Koshyk, Iryna Omelianenko, Mariia Burkatska, Igor Panko, Tetyana Meged, Svitlana Pischanska, Valentyna Korpachova, and Oleksandr Dudin. "The impact of war on cytopathological practice in Ukraine." St open 4 (April 5, 2023): 1–9. http://dx.doi.org/10.48188/so.4.1.
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Aim: To investigate the impact of Russian invasion on Ukrainian healthcare services related to cytopathology screening and diagnostics.Methods: The workload and output of the cytopathological laboratory located in Kyiv before and during 8 months of Russian invasion were analyzed. The laboratory performance was assessed by the total number of cytologic cases, the turn-around time (TAT) index, and the percentage of timely reported test results. The geographic distribution of cases was also analyzed.Results: There was a significant decline in the workload of the laboratory during the first two months of the war, and the numbers of cytopathology specimens fell to less than one third of prewar levels, and the TAT was prolonged. Since May 2022, the efficiency and quality of cytopathologic testing has been largely restored in most parts of Ukraine, only to be affected again by increased Russian bombardment toward the end of summer 2022. The number of cytology specimens was reduced and the source of cytology specimens changed from the prewar conditions reflecting the relocation of the CSD Lab to western Ukraine.Conclusion: Cytolopathological screening and diagnostics were seriously disrupted in Ukraine during the Russian invasion resulting in a decreased volume of cytology specimens received in the CSD Lab during the early months of the war. By adapting to the war conditions and reorganizing the cytology services, CSD Lab has continued providing cytology services at a level of efficiency similar to those of the prewar period. However, the volume of cytology specimens remains much smaller than before war, indicating that the cytology services have been adversely affected by the war.
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Kulai, T., T. Arnason, E. Filter, and S. E. Gruchy. "A328 FACTORS PREDICTIVE OF MALIGNANCY IN PATIENTS WITH BILIARY BRUSHINGS OBTAINED BY ERCP." Journal of the Canadian Association of Gastroenterology 1, suppl_1 (February 2018): 570–71. http://dx.doi.org/10.1093/jcag/gwy008.329.
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Abstract Aims Biliary brushings for cytology obtained during endoscopic retrograde cholangiopancreatography (ERCP) are the most commonly used method of evaluating patients with biliary strictures for potential underlying malignancy. Patients generally proceed to a pancreatoduodenectomy if there is concern for pancreatic or peripancreatic neoplasm and the patient is an operable candidate. Some patients undergo pancreatoduodenectomy for what is eventually determined to be benign disease. We sought to analyze ERCP brushings to determine predictive factors for malignancy at our centre and whether brushing results influenced decision for pancreatoduodenectomy. Methods Retrospective review was conducted on adult patients who underwent ERCP with biliary duct brushings for cytology at the QEII Health Sciences Centre in Halifax, NS, from 2013–2014. Bile duct brushing cytology reports were identified by electronic search of hospital pathology archives (Cerner Millenium, Cerner, Kansas City, MO). Information on gender, age, symptoms, biliary stricture location and endoscopic impression, presence of pancreatic mass, cytologic impression of brushings, CA 19-9 level, CEA level, surgical intervention and clinical outcome was collected. Abnormal cytology was defined as samples reported as suggestive of malignancy or positive for malignant cells. Basic descriptive statistics and qualitative analysis were performed. Results A total of 185 ERCP patients had biliary brushings for cytology during the study time period. Patients who received biliary brushings were more likely to be between ages 60 to 79 (56%) with a mean age of 66. Presenting symptoms included elevated liver enzymes (82%), jaundice (75%) and pain (48%). Location of biliary stricture, age and gender were not associated with abnormal cytology results. Endoscopic impression of the biliary stricture was malignant in 53% of cases and associated with increased likelihood of abnormal cytology (39/92; p < 0.001). Pancreatic mass on imaging, seen in 38%, was associated with abnormal cytology (25/69, p = 0.001). Elevated CEA, but not CA 19-9, was associated with abnormal cytology (13/23; p = 0.008). Patients who received a pancreatoduodenectomy were not more likely to have abnormal cytology (5/18, p = 0.051). Patients eventually diagnosed with malignancy were more likely to have abnormal cytology on biliary brushing (49/120, p < 0.001). Conclusions Age, gender, location of stricture and elevated CA 19-9 were not associated with abnormal cytology suggestive of malignancy. The presence of a pancreatic mass, elevated CEA and eventual diagnosis of cancer were associated with abnormal cytology. Patients who received a pancreatoduodenectomy were not more likely to have abnormal cytology, which may reflect the scarcity of surgical candidates due to advanced disease at diagnosis. Funding Agencies None
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Jorda, M., F. Mousavi, C. Gomez-Fernandez, Z. Maleki, G. Walker, and P. Ganjei-Azar. "P63 in cytologic material is helpful for detection of squamous differentiation in non-small cell carcinomas of lung and treatment selection." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 18052. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.18052.
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18052 Background: Bevacizumab in combination with carboplatin and paclitaxel improves overall response and survival in patients with advanced or recurrent non-small cell lung carcinoma. However, this drug is not recommended in patients with carcinomas with squamous differentiation. Therefore, identification of squamous cell component is desirable. In many instances, cytology is the diagnostic tool of choice; however, routine cytomorphology is limited in classification of non small-cell carcinomas into squamous and non-squamous subtypes. The aim of this study is to identify the value of immunocytochemistry for p63 in this distinction. Methods: Review of cytology records identified 51 consecutive pulmonary specimens with the diagnosis of non-small cell carcinoma (9 squamous cell carcinomas and 42 carcinomas without squamous differentiation). Histologically, they proved to be 26 squamous cell carcinomas and 25 non-small cell carcinomas without squamous differentiation. P63 immunocytochemical stain was performed on archival alcohol-fixed Papanicolaou stained cytology slides, using standard immunocytochemical methods. Results: Twenty-three (88 %) of the 26 histologically proven squamous cell carcinomas were positive for p63 on cytologic smears. Using p63, we detected 14 carcinomas with squamous differentiation not identified by cytomorphology. Smears from all carcinomas with squamous differentiation were positive for p63. Sensitivity of cytology for the detection of squamous differentiation increased from 35% to 88% using p63 immunocytochemistry (p=0.001, McNemar’s test). Four carcinomas with squamous differentiation were detected only in cytologic and not in corresponding histologic samples. Conclusions: 1- p63 is a useful marker for the detection of squamous differentiation in cytologic pulmonary samples; 2- p63 immunocytochemistry significantly increases the sensitivity for the identification of squamous cell carcinomas of lung from 35% to 88% (p=0.001); 3- p63 immunocytochemistry should be used in all pulmonary cytologic samples with a diagnosis of non-small cell carcinoma to improve therapeutic selection of patients; 4- Cytologic sampling may provide better representation of tumor subtypes. No significant financial relationships to disclose.
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Ismaeel, Amina, Safa Al-Shaikh, Aalaa Mubarak, and Rawan Ismaeel. "Atypical squamous cells of undetermined significance cervical cytology in Bahrain: Reporting rates, high-risk HPV testing, and cytologic and histopathologic follow-up findings." Cytojournal 21 (March 18, 2024): 11. http://dx.doi.org/10.25259/cytojournal_84_2023.
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Objective: Atypical squamous cells of undetermined significance cytology (ASC-US) is a challenging and equivocal diagnosis for pathologists in cervical Pap smears. The data on ASC-US cervical cytology in Bahrain are deficient. This study reviewed and identified the reporting rates, high-risk human papillomavirus (HPV) testing results, histopathologic follow-up findings, and the cytologic progression of patients diagnosed with ASC-US in Bahrain. Material and Methods: A retrospective chart review was conducted on the medical records of 23,888 women who had Pap smear test results between January 2019 and March 2022 at the main referral tertiary hospital in Bahrain to identify the ASC-US cases. High-risk HPV (hrHPV) genotype was identified, and the histopathological results of the cervical biopsy was recorded. In addition, cytologic follow-up Pap smear tests conducted within 1 year of ASC-US diagnosis were tracked to monitor the progression or regression of ASC-US. Results: In this study, 259 out of 23,888 women reported to have ASC-UC cytology results with a reporting rate of 1.1%. The mean age of the ASC-US cases was 43 ± 11.6. Thirty percent of the ASC-US cases tested positive for hrHPV, and they were predominantly infected with the other hrHPV genotype (75%). When the histopathological changes of the cervix were analyzed, 82.1% had normal histopathologic findings. However, low-grade cervical intraepithelial neoplasia-1 was reported in 2 cases (7.1%), and high-grade cervical lesions (cervical intraepithelial neoplasia-2 and higher) were reported in 3 cases (10.7%). Regarding the cytologic follow-up, most of the ASC-US cases were negative for intraepithelial lesion or malignancy (NILM) (73.8%) or had persistent ASC-US (17.9%). The remaining minority of cases progressed into either low-grade squamous intraepithelial lesions (6%) or high-grade squamous intraepithelial lesions (2.4%). There was a statistically significant and relatively strong association between the cytology follow-up findings and the hrHPV test results (χ2 [2] = 8.869, P < 0.012, Cramer’s V = 0.417). Conclusion: This is the first and largest study to characterize the ASC-US cytology cases in Bahrain. The reporting rates of ASC-US fell within the worldwide reported range. Although most of the ASC-US cases regressed into NILM, ASC-US showed progression into more advanced cervical cytologic diagnoses or contributed to the malignant transformation of cervical tissue, especially in the presence of hrHPV infection which was positive in 30% of the ASC-US cases. This emphasizes the role of cotesting (combination of hrHPV genotyping and Pap smear test) and the importance of colposcopic evaluation of those women with cytologic follow-up tests at 1 year of diagnosis. Implementing these recommendations in the cervical cancer screening practice in Bahrain will help in having a better management plan for women diagnosed with ASC-US cervical cytology.
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Apiwattanasevee, Warangkana, Nida Jareemit, and Boonlert Viriyapak. "Spontaneous Regression Rate of Low Grade Cervical Intraepithelial Lesions Diagnosed from Colposcopy." Journal of Health Science and Medical Research 36, no. 3 (August 20, 2018): 233. http://dx.doi.org/10.31584/jhsmr.2018.36.3.16.
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Objective: To evaluate the spontaneous regression rate and its associated factors of low grade intraepithelial lesionsafter colposcopy in Thai women.Material and Methods: A retrospective study of the data of Thai women, not younger than 21 years old with liquidbased cervical cytology of atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL), who had received colposcopic examination with histologically proven cervical intraepithelial neoplasia grade 1 (CIN1) or human papillomavirus (HPV) infection. All patients underwent cytologic tests as the follow-up method for at least 2 years at the Gynecology Clinic, Siriraj Hospital. Analyzed data included patient characteristics, cervical cytological and pathological results, colposcopic findings and evidence of cytological regression. The correlations between each variable and regression status were then measured.Results: Data of a total of 154 patients who completed 2 years of follow-up were reviewed. One hundred and two patients had cytologic regression, showing a regression rate of 66.2%. There was 31.8% persistent abnormal cytology, and 2.0% progressed to high-grade cervical intraepithelial lesions. All patients with persistence or progression of cervical cytology had no invasive lesion. The only factor significantly related to cytologic regression was the pattern of colposcopic findings (p-value=0.041). The HPV-specific lesion on the colposcopy showed the significant pattern with an odds ratio of 3.5 (95% confidence interval=1.2-10.1, p-value=0.028).Conclusion: Women who had initial cervical cytology of ASC-US or LSIL with colposcopic histological confirmation of CIN1 or HPV infection had spontaneous regression, about two-thirds within 2 years of follow-up time. Thus, conservative management in these patients should be considered.
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Mendoza, R. P., T. Haidary, and R. Gupta. "Paris System Has A Higher Cytohistologic Correlation And Reproducibility Than Traditional Urine Cytology Method." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S94. http://dx.doi.org/10.1093/ajcp/aqaa161.206.
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Abstract Introduction/Objective The major limitation of urine cytology is the lack of consensus regarding the terminology and diagnostic criteria that should be used for urothelial atypia. The main goal of the newly proposed Paris System for Reporting Urine Cytology is to concentrate primarily on the detection of high grade urothelial carcinoma while minimizing the detection of low grade lesions. This study aimed to apply the criteria and categories of the Paris system in retrospectively collected urine cytology specimens and assess histologic correlation and reproducibility. Methods Two senior pathologists independently reviewed retrospectively collected urine cytology specimens strictly following the Paris system criteria for categorization. Cytologic diagnosis were compared with previous cytology result and histologic diagnosis. Results A total of 67 patients were included in the study. The mean age is 65.8 years (36-89 years), majority were males (73.1%) and African American (89.6%). Urine cytology using traditional method showed mostly atypical results (58.2%), followed by reactive (26.9%), high-grade urothelial carcinoma (11.9%) and suspicious (3.0%). On the other hand, the Paris system had more negative results (62.7%), followed by atypical (19.4%), high-grade urothelial carcinoma (11.9%) and lastly suspicious (6.0%). All of negative cases (18 out of 18) and majority of HGUC cases (7 out of 8) were concordant between the two cytology methods. Traditional urine cytology method only yielded 71.4% histologic concordance, while 100% Paris system results were concordant with bladder histology. Majority of the atypical cases using traditional method were converted to negative, and a few atypical cases were converted to suspicious and high-grade. All results using Paris system were concordant between two general pathologists. Conclusion Using the Paris system in analyzing urine cytology resulted to higher cytohistologic concordance than traditional method. Majority of atypical cases from traditional method were converted to more definitive categories. The cytopathologic analyses from two general pathologists applying the criteria of Paris system had superior reproducibility. Applying the Paris system, therefore, can significantly improve the performance of urine cytopathology.
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Kurian, A. W., V. B. Sharma, E. J. Schwartz, M. A. Mills, A. D. Staton, N. M. Chun, K. E. Kingham, and J. M. Ford. "A phase II breast cancer chemoprevention study of lovastatin in high-risk women: Initial feasibility data." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 1502. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.1502.
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1502 Background: More than 250,000 U.S. women have high inherited breast cancer risk; many develop hormone-receptor negative (ER/PR-) tumors, for which no chemoprevention exists. Pre-clinical data suggest that hydrophobic HMG-CoA reductase inhibitors (statins) may reduce risk of ER/PR- breast cancers. We report initial feasibility results of a phase II study of lovastatin for breast cancer chemoprevention. Methods: Study Design: Single-arm, non-randomized phase II study. Agent: Lovastatin 80 mg daily for 6 months. Primary Endpoint: Change in proportion of women with atypical cytology on 2-quadrant random periareolar fine needle aspiration (rpFNA) of breast duct cells before and after lovastatin. Secondary Endpoints: Changes in Ki-67, ER/PR, and elevated levels of oxidative DNA damage (ODD) measured by single-cell gel electrophoresis (Comet) assay of breast duct cells; changes in mammographic density; breast cancer incidence. Eligibility: BRCA1/2 mutation carrier, or estimated lifetime risk = 20% due to family history. Statistical Considerations: Planned sample size of 60, yielding 90% power to detect 50% change in proportion with atypia. Results: Twenty participants enrolled in Year 1; 15 have pre-study rpFNA and 5 have post-study rpFNA results to date. Pre-Study Cytology: N=15: 1 (7%, 95% confidence interval 0–32%) had insufficient, 11 (73%, 48–90%) had normal, and 3 (20%, 6–46%) had atypical cytology. Pre-Study Comet Assay: N=4 to date, 2 with atypical and 2 with normal pre-study cytology: 2 with atypical cytology (100%, 29–100%) had a positive Comet assay for elevated ODD, but 0 with normal cytology (0%, 0–71%) had a positive Comet assay. Post-Study Cytology: N=5, 1 with atypical cytology pre-study: 5 (100%, 51–100%) were normal post-study. Post-Study Comet Assay: N=1 to date, with atypical cytology and positive Comet assay pre-study: cytology was normal and Comet assay negative post-study. The study has been well-tolerated, with no drop-out. Conclusions: An early-stage chemoprevention study of lovastatin for 6 months, including 2 rpFNAs, appears feasible in high-risk women. Early results suggest a correlation between cytologic atypia and elevated levels of ODD, and the possibility that lovastatin might reverse these abnormalities. Accrual is ongoing. No significant financial relationships to disclose.
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Asaturova, Aleksandra, Darya Dobrovolskaya, Alina Magnaeva, Anna Tregubova, Guldana Bayramova, and Gennady Sukhikh. "Cervical Cytology–Histology Correlation Based on the American Society of Cytopathology Guideline (2017) at the Russian National Medical Research Center for Obstetrics, Gynecology, and Perinatology." Diagnostics 12, no. 1 (January 15, 2022): 210. http://dx.doi.org/10.3390/diagnostics12010210.
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Recent evidence suggests that a cytology–histology correlation (CHC) with discrepancy detection can both evaluate errors and improve the sensitivity and specificity of the cytologic method. We aimed to analyze the errors in cytologic–histologic discrepancies according to the CHC protocol guideline of the American Society of Cytopathology (2017). This retrospective study included 273 patients seen at the National Medical Research Center of Obstetrics, Gynecology and Perinatology (Moscow, Russia) between January 2019 and September 2021. The patients’ mean age was 34 ± 8.1 years. The cytology–histology agreement was noted in 158 cases (57.9%). Major discrepancies were found in 21 cases (7.6%), while minor discrepancies were noted in 93 cases (34.1%). The reason for 13 (4.8%) discrepancies was a colposcopy sampling error and, in 46 (16.8%) cases, the reason was a Papanicolaou (PAP) test sampling error. The discrepancy between primary and reviewed cytology was due interpretive errors in 13 (4.8%) cases and screening errors in 42 (15.4%) cases. We demonstrated that the ASC guidelines facilitate cervical CHC. A uniform application of these guidelines would standardize cervical CHCs internationally, provide a scope for the inter-laboratory comparison of data, and enhance self-learning and peer learning.
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Cowell, Rick L. "Cytology:." Veterinary Clinics of North America: Small Animal Practice 32, no. 6 (November 2002): xi—xii. http://dx.doi.org/10.1016/s0195-5616(02)00054-2.
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