CYTOPATHOLOGY

Navigating the Diagnostic Challenges in Lymph Node Cytology: The Case of Reactive Hyperplasia
Vigliar E, Acanfora G, Buono M, Bellevicine C, Picardi M and Troncone G
Fine needle cytology (FNC) is a pivotal diagnostic tool for distinguishing between benign and malignant lymphadenopathies mainly because of its minimal invasiveness, cost-effectiveness and accuracy. A major requirement for maximising diagnostic accuracy is proper sample management of aspirated cellular material. In this diagnostic process, the morphological evaluation of adequate smears is paramount, guiding cytopathologists in the selection of appropriate ancillary tests through the recognition of cell size and patterns of distribution. Here, we describe a peculiar 'concentric ovals distribution pattern', frequently observed in the FNC of benign reactive lymph nodes, which may represent an aid in the cytological diagnosis of reactive hyperplasia.
Plasmablastic Lymphoma in the Submandibular Region Diagnosed by FNAC: A Case Report and Literature Review
de Aquino SN, de Cáceres CVBL, Bezerra HKF, Vargas PA and Lopes MA
This study aims to provide a literature review of FNAC-diagnosed plasmablastic lymphoma (PBL) cases and present a case of PBL in an HIV patient diagnosed by FNAC.
Infantile Fibromatosis Colli: Cytological Diagnosis of a Rare Entity
Mohamedali R, Kaur M, Kumar P and Handa U
Cytology Is No Longer 'Just Cytology': The Clear Message of the XII. Congress of Molecular Cytopathology in Naples
Ryška A
Evaluation of Diagnostic Accuracy of the Paris System (TPS 2.0) in Urine Cytology Specimens: An Institutional Experience From a Large Cohort of a Tertiary Care Centre
Jangir H, Narwal A, Adhikari SS, Batra A, Nayak B, Seth A and Kaushal S
The objective of this study is to evaluate the diagnostic performance of urine cytology using The Paris System (TPS 2.0) in comparison with TPS 1.0, and the Four-Tier Reporting System (FTRS) of our institute for identifying high-grade urothelial carcinoma (HGUC).
Myoepithelial-Rich Pleomorphic Adenoma With Novel PLAG1 Inversion on Chromosome 8, and LRP1B, PBRM1 and TCF3 Mutations
Gonzalez MF, Pei J, Rong Y and Seth A
Pleomorphic adenoma (PA) is the most common salivary gland neoplasm worldwide (50%-70%). Most cases of PA are straightforward diagnoses. However, the diagnosis may be challenging due to the morphological diversity of PAs, which in many cases is caused by the predominance of one of the three components or the presence of metaplastic epithelium. We present the case of a 64-year-old male with a history of prostate cancer and right submandibular gland excision 16 years ago with an unknown previous diagnosis and recent regrowth of his mass in the surgical bed. The tumour showed a predominant spindle cell morphology, cytokeratin-positivity, variable expression of myoepithelial markers in the cytology and surgical pathology specimens, and novel inversion of the chromosome 8, and LRP1B, PBRM1 and TCF3 mutations.
Practical Approach to Reporting Based on the International System for Serous Fluid Cytopathology
Viljanen E, Kholová I and Chandra A
The International System for Serous Fluid Cytopathology (TIS) is intended for reporting cytological specimens from serous cavities: pleural, abdominal and pericardial cavities. TIS is being adopted into practice in cytology laboratories worldwide. In this system, there are six diagnostic categories: non-diagnostic, negative for malignancy, atypia of undetermined significance, suspicious for malignancy, malignant-primary and malignant-secondary. Malignant-primary category almost always implies malignant mesothelioma and malignant-secondary usually refers to metastasis from carcinoma but also to involvement of serous cavity by haematolymphoid and other malignancies. When evaluating effusion cytological specimen adequacy, the factors that must be considered are sample volume, cellular content and cellular preservation. In the diagnostic analysis and interpretation, it is helpful to consider systematically all basic cytomorphological components in a sample. The basic components are architecture, cell populations, cell size, cytoplasm, nuclei and background elements. One important requirement for a successful evaluation of an effusion cytological specimen is sufficient clinical and radiological information in a referral. Clinical information may guide ancillary testing. In the present review, we provide a practical and educational approach to reporting serous effusion cytology based on the TIS.
Detecting Cholangiocarcinoma in the Setting of Primary Sclerosing Cholangitis: Is Biliary Tract Fluorescence In Situ Hybridization Helpful?
Miller LJ, Holmes IM, Chen-Yost HI, Smola B, Lew M and Pang J
Biliary brushing cytology (BB) to detect cholangiocarcinoma (CCA) is integral in the surveillance of patients with primary sclerosing cholangitis (PSC). Since reactive changes can mimic carcinoma, indeterminant results are frequent. Fluorescence in situ hybridization (FISH) using the UroVysion probe set has been advocated to enhance the detection of CCA. This study evaluates the performance of FISH for detecting CCA in patients with and without PSC.
Lymphocytic-rich effusion
Townsend J and Perez-Machado M
Neonatal Mimicker Cells in Cerebrospinal Fluid
Alexander CM and Carrillo LF
Fine Needle Aspiration of CD20-Negative Diffuse Large B Cell Lymphoma Presenting as an Anterior Neck Mass
Hartzell C, Mason EF and O'Conor C
Malignant melanoma diagnosed by fine-needle aspiration in cases presenting with parotid mass
Turcan D, Yilmaz E, Acu B and Acikalin MF
One of the most common malignancies that metastasize to the parotid glands and associated lymph nodes is cutaneous melanoma. Although fine-needle aspiration (FNA) is well established for diagnosing primary salivary gland tumours, there is limited literature on its role in diagnosing metastatic lesions.
Amelanotic melanoma arising from a giant congenital melanocytic nevus - A novel entity diagnosed by fine needle aspiration
Gangadaran N, Narayanan A, Ravi S, Gochhait D and Chandrashekar L
Striated duct adenoma: The cytological description of a rare entity
De La Torre Serrano M, Alarcón García L, Colino Gallardo AM, Vega-Gonzalez J, Bergillos Giménez MR, Hernandez Martinez D, Garcia Egido A, Iglesias Moreno MC, Pérez-Alonso P, Plaza Hernandez JC and Fernández-Aceñero MJ
Striated duct adenoma is a benign salivary gland tumour recently recognized by the World Health Organization. To date, no report has described the cytological features of this entity.
An unusual cyst at an unusual site in an adult
Sharma S, Dadwal M and Chandran VA
Bronchogenic cysts are usually seen in the intrathoracic region in children. The authors describe the cytologic features of a case of a bronchogenic cyst in the cervical region in an adult and discuss its differential diagnoses.
Cytopathological findings of granular cell glioblastoma in intraoperative squash smear preparations: A case report
López-Muñoz S, Sánchez-Cordon B, Taravilla-Loma M and Esteban-Rodríguez I
Incidental finding in urine cytology in a patient with chronic renal disease
Vega-Gonzalez J, de la Torre Serrano M, Colino Gallardo AM, Rodriguez Moreno A and Fernández-Aceñero MJ
An incidental finding in urine smears from a patient with a presumptive diagnosis of an IgA mesangial nephropathy is presented. A possible example of the potential value of urine cytology in functional renal disorders. We report a case of an incidental finding in urine cytology from a patient with a presumptive diagnosis of an IgA mesangial glomerulonephritis, previously diagnosed as atypical urothelial cells.
Higher sensitivity of pericardial fluid cytology than biopsy in malignant effusions with potential explanation of false-negative cytology: A multi-institutional analysis
Takeda K, Gereg C, Liu X, Ma W, Bearse M, Tang H, Delfino I, Huang E, Lin X, Chandler JB and Wang H
Malignant pericardial effusions are associated with a poor prognosis. Pericardial fluid cytology and pericardial biopsy are the primary methods for diagnosis. This study aimed to conduct a multi-institutional analysis to compare the diagnostic sensitivity of cytology and biopsy, and to investigate potential explanations for false-negative results in cytology.
Adenosquamous carcinoma arising within a long-standing intrapulmonary bronchogenic cyst in an adult presenting with hyponatraemia
Akinsanya A, Segura S, Cramer H and Mesa H
A 74-year-old woman's persistent hyponatraemia led to the discovery of an adenosquamous carcinoma within an intrapulmonary bronchogenic cyst (IPBC), diagnosed 59 years prior. This is the first reported case of such a transformation in an IPBC. An adenosquamous carcinoma, originating from an intrapulmonary bronchogenic cyst identified 59 years prior, was discovered during the workup for a patient's unexplained, persistent hyponatraemia.
Rare case of stromal predominant Wilm's tumour with rhabdomyoblastic differentiation in FNAC smears
Gupta A, Srinivasan R, Rohilla M, Kakkar N and Peters NJ
The FNAC smear and histopathology of stromal predominant Wilm's tumour with rhabdomyoblastic Differentiation along with immunostaining in a 7-year-old male. In this paper, the diagnostic potential of FNAC in identifying rare histological variants of paediatric renal tumours is highlighted.
Metastatic Medullary Thyroid Carcinoma Presenting as an Incidental Posterior Mediastinal Mass
Goldberg C, Diaz D and Brandler T
Medullary thyroid carcinoma (MTC) is an uncommon neuroendocrine tumour that is usually asymptomatic at its onset and therefore may not present clinically until the patient has developed advanced or metastatic disease. Common metastatic sites include cervical lymph nodes, liver, bone and lung. This is the case of a patient who presented with an incidental posterior mediastinal mass. Because the posterior mediastinum is an unusual location for MTC, MTC was not a consideration and preliminary histopathological testing did not include calcitonin, which would have been diagnostic. This case highlights the importance of testing for calcitonin more regularly when encountering a mass of unknown origin with neuroendocrine morphology, which may lead to earlier detection of MTC and thus improved prognosis.