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BACKGROUND: The identification of BRAF mutations in thyroid cancer has prognostic and therapeutic implications. Although the gold standard for identifying BRAF mutations is molecular testing, the ability to perform BRAF p.V600E immunostaining on fine‐needle aspiration (FNA) samples can facilitate the rapid triaging of patients to treatment options. METHODS: A total of 50 thyroid carcinoma FNA samples, including papillary (29 samples), poorly differentiated (10 samples), anaplastic (9 samples), and Hurthle cell (2 samples) carcinomas, with a known BRAF p.V600E mutation status were selected for the current study. Immunostaining was performed on smears and cell block sections using an anti‐BRAF p.V600E antibody (clone VE1). The results were compared with the known mutation status obtained by molecular testing and/or immunostaining of surgical pathology material from the same patient. RESULTS: Of the total of 50 cases, 26 cases had smears available for the evaluation of BRAF p.V600E immunostaining; positive immunostaining was noted in 16 samples and negative immunostaining was noted in 4 samples, whereas 6 cases were equivocal. Of the 34 cases for which cell blocks were available for evaluation, BRAF p.V600E immunostaining was positive in 17 cases, negative in 16 cases, and equivocal in 1 case. The overall sensitivity and specificity of BRAF p.V600E immunostaining on the cell block preparation was 94.4% and 100%, respectively, whereas for the smears it was 80% and 63.6%, respectively. CONCLUSIONS: BRAF p.V600E immunostaining can be performed reliably on thyroid FNA cell block preparations. However, false‐positive results on direct smears limit their utility and therefore need to be interpreted with caution. Cancer Cytopathol 2018;126:406‐13. © 2018 American Cancer Society. [ABSTRACT FROM AUTHOR]

Fine-needle aspiration cytology (FNAC) is used as a valuable method for examining suspected salivary gland lesions. It is a simple, cost-effective, and minimally invasive procedure with high specificity and sensitivity. Due to the cellular heterogeneity and overlapping architectural features, it can be difficult to distinguish between non-neoplastic processes, benign lesions, and/or malignancies in salivary glands on routine stains. Cell block methods are currently replacing surgical biopsy-based diagnostic methods on the basis of utilizing aspirates from FNAC with a rapid and reliable potential for reaching a conclusive diagnosis. Ancillary investigations including a panel of immunohistochemical markers are frequently applied on cytology specimens in the era of precision diagnostics to offer a specific diagnosis and even prognostic information for optimal patient care. [ABSTRACT FROM AUTHOR]

Objective: To determine the value of calretinin and cytokeratin (CK) 5/6 in discriminating mesothelioma from adenocarcinoma in serous effusion specimens. Methods: A total of 101 recent, histologically or clinically confirmed malignant effusions with immunostained cell block preparations were reviewed. The cases consisted of 34 mesotheliomas and 67 adenocarcinomas. This included 17 ascitic fluid and 84 pleural fluid samples. The adenocarcinomas included metastatic carcinomas from the breast (12), lung (19), stomach (3), colon (1), pancreas (2), ovary (6) endometrium (1) and 23 histologically confirmed metastases from unknown primary sites. The cases were assessed as negative or positive (>5% of cells stained). The staining pattern was recorded as cytoplasmic, cell membrane, nuclear or cytoplasmic and nuclear staining. Results: Calretinin staining was present in 97% (33/34) of the mesothelioma cases with a majority of them showing both cytoplasmic and nuclear staining (29/33). Only 3% (2/67) of adenocarcinomas were positive for calretinin, one being a lung adenocarcinoma and the other an adenocarcinoma of unknown primary site in an ascitic fluid. Cytokeratin 5/6 staining was also present in 33/34 (97%) of mesothelioma cases. Six (9%) adenocarcinomas were positive, including metastases from the lung (1), breast (1), ovary (2) and unknown primary site (2). Four of the six adenocarcinoma cases positive for CK5/6 were in ascitic fluids. No cases of mesothelioma were negative for both calretinin and CK5/6. Only one adenocarcinoma case, (which was from unknown primary site in an ascitic fluid sample), was positive for both markers. Conclusions: The results confirm that calretinin and CK 5/6 are useful markers for mesothelioma in effusion specimens. CK5/6 staining may be less useful for peritoneal fluid specimens where metastatic adenocarcinomas may be more likely to express the antigen. Further study of ascitic/peritoneal specimens is warranted. However, positive staining, particularly for both antigens, is highly indicative of a mesothelial origin for cells. The two markers make a useful addition to EMA and the panel of adenocarcinoma markers routinely applied to effusion specimens. [ABSTRACT FROM AUTHOR]

Our findings showed that Cyclin D1 immunohistochemical staining was not helpful to differentiate between mesothelioma and carcinoma in cell block preparations from fluid cytology cases. B Aims: b To determine if Cyclin D1 immunohistochemical staining on fluid cytology cell block preparations can help differentiate between mesothelioma and carcinoma. [Extracted from the article]

Introduction: Conventional cytology smear method and cell block method are two important methods used for cytological diagnosis. Limitations of conventional smears have to be dealt with daily while reporting cytology. Despite the many advantages of the cell block method, it has been an underestimated diagnostic tool. The purpose of this study is to compare conventional smears and cell block preparations with different parameters and find out which one is more effective in evaluating body fluids. Materials and Methods: Sixty body fluids were studied by the conventional smear method and cell block method. Data were tabulated and analyzed. Results: The cell block method showed a significant increase in cellularity (83.3%) compared to the conventional method (50%) [P = 0.0001, significant]. The limitation of low cellularity was significantly reduced by the cell block method (8.3%) as compared to conventional smears (33.3%) [P = 0.0007, significant]. Morphology preservation was significantly more by cell block method (95%) versus conventional smears (60%) [P = 0.00001, significant]. The yield of malignancy increased by 3.33% in the present study. Suspicious cases on conventional smears could be confidently segregated as malignant or benign by the cell block method. Conclusion: The cell block technique should be routinely used along with conventional smears to improve diagnostic accuracy and resolve diagnostic dilemmas on conventional smears. [ABSTRACT FROM AUTHOR]

Endobronchial ultrasound-guided transbronchial needle aspiration has demonstrated its accuracy in the diagnostic workup of enlarged mediastinal lymph nodes. In addition to conventional smears, the use of liquid-based cytology (LBC) and cell block preparations (CBP) has been introduced more recently. The aim of our study was to determine the performance of each of the different techniques, separately and combined, in terms of diagnostic yield and sensitivity. A total of 290 consecutive patients were included. The pathological examination was based on smear cytology, LBC, and CBP. Adequate sampling was defined by the presence of pathological material or lymphocytes. The global diagnostic yield was 82.7 % and the sensitivity was 89.1 %. The diagnostic yield was 72.8 % for smears, 78.8 % for LBC, and 69.9 % for CBP. The combination of smears with CBP significantly increased diagnostic yield ( p = 0.01) and sensitivity ( p = 0.006), but not the combination of smears with LBC (yield: p = 0.07; sensitivity: p = 0.13). The combination of the three techniques further increased yield ( p = 0.007) and sensitivity ( p = 0.006), compared with smears alone. CBP were more sensitive than smears for both diagnoses of carcinoma ( p = 0.01) and granulomatous inflammation ( p = 0.048). Conversely, LBC was less sensitive than smears for granulomatous inflammation ( p = 0.004), but the difference was not significant for carcinoma ( p = 0.42). CBP, as a complement to smears, increases diagnostic yield and sensitivity for both diagnoses of carcinoma and granulomatous inflammation. LBC, if used alone, increases the risk of a false-negative result. [ABSTRACT FROM AUTHOR]

AIMS: To review consecutive cell block preparations of cytological specimens in a large general hospital. METHODS: 50 cell blocks were made over an 18 month period in which about 1900 fine needle aspirations (FNAs) were performed. The aspirator was a cytologist or, for image guided FNAs, a radiologist with a cytologist at hand to collect the specimen. Forty eight cell blocks were from FNAs and two were from serous fluids. RESULTS: The cellularity of the cell blocks was inadequate in only four preparations. The main motive for making cell blocks was to obtain tissue for immunohistochemistry. This was performed on 28 cases and a total of 107 immunostained sections were produced. The most common diagnostic dilemma was between carcinoma and melanoma, and the second most common between carcinoma and lymphoma. Consequently cytokeratin, S-100, and LCA were the most frequently used antibodies. At least one of these three antibodies was positive in 17 cases. Five cases were immunostained only for prognostic breast markers. CONCLUSIONS: The use of cell block immunohistochemistry is a reliable and technically unsophisticated aid in the cytological examination of tumours other than lymphomas. Success depends on having highly experienced aspirators that reliably obtain sufficiently cellular material. [ABSTRACT FROM PUBLISHER]

Background: Fine‐needle aspiration cytology (FNAC) is generally the initial sampling method for salivary gland neoplasms. The cytomorphologic features of acinic cell carcinoma (AciCC) of salivary gland can overlap with other neoplastic and nonneoplastic entities. AciCCs harbor a recurrent t(4;9) rearrangement with upregulation of nuclear receptor subfamily 4 group A member 3 (NR4A3). NR4A3 protein overexpression has been shown to be highly sensitive and specific for the diagnosis of AciCC in histologic specimens and cell block preparations. However, data on NR4A3 immunocytochemistry (ICC) on conventional smears or liquid‐based cytology are limited. Methods: The authors identified 18 FNAC of histologically proven AciCC cases between 2013 and 2019. FNAC samples of diagnostic mimickers were likewise retrieved and included in the study cohort for comparison. The NOR1/NR4A3 mouse monoclonal antibody was applied directly to FNAC slides using a standard ICC technique. Results: The cohort included ethanol‐fixed Papanicolaou‐stained cytologic smears and liquid‐based preparations from 18 AciCC, one secretory carcinoma, four mucoepidermoid carcinomas, four salivary duct carcinomas, five pleomorphic adenomas (PA), five Warthin tumors, five oncocytomas, one oncocytic hyperplasia, and five nonneoplastic salivary gland cases. Strong nuclear staining for NR4A3 was present in all AciCC, weak nuclear staining was present in one PA, and all other non‐AciCC were negative (sensitivity, 100%; specificity, 97%). Conclusions: NR4A3 ICC can be used directly on FNAC conventional smears and liquid‐based cytology to reliably distinguish AciCC from its mimickers. This marker may be useful in cases where a cell block preparation is unavailable or inadequate. NR4A3 immunocytochemistry can be used directly on fine‐needle aspiration cytology conventional smears and liquid‐based cytology to reliably distinguish acinic cell carcinoma from its mimickers. This may be useful in cases where a cell block preparation is unavailable or inadequate. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cell block (CB) preparation during the endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS-TBNA) procedure plays an important role in the diagnosis of lung cancer and recovery of cellular material for molecular characterization of the tumor. However, the efficiency of the conventional method of CB preparation is suboptimal. METHODS: In the current study, the 'tissue coagulum clot' cell block (TCC-CB) method was used to prepare the CBs and its efficiency was compared with that of the conventional saline rinse cell block (NR-CB) method. A total of 84 consecutive TCC-CBs (106 lymph nodes [LNs] and 14 lung lesions) and 28 consecutive cases of NR-CB (39 LNs and 3 lung lesions) obtained within the same time period were included in the current study. RESULTS: In the TCC-CB specimens, 94 of 106 LN cases (88.7%) yielded sufficient diagnostic material, as did 11 of 14 lung lesions (78.6%). In the NR-CB group, which was used as the control, 22 of 39 LN specimens (56.4%) and none of 3 lung specimens (0%) were found to provide sufficient diagnostic material. Although the average size of the LNs in the study group were not significantly different from those in the control group (1.76 cm vs 1.82 cm; P > .05), the overall nondiagnostic rates in the TCC-CB and NR-CB groups were 11.2% and 43.6%, respectively ( P < .001). The nondiagnostic rates of the lung specimens were 15.4% in the TCC-CB group and 100% in the NR-CB group ( P < .05). In addition, immunohistochemistry studies and epidermal growth factor receptor ( EGFR)/ KRAS mutational analyses were performed in 26 and 14 TCC-CB cases, respectively. With the exception of 1 case, all of them had satisfactory results. CONCLUSIONS: The data from the current study demonstrate that the TCC-CB method significantly increases the cellular yield of CB preparations without compromising cytomorphological characterization of tumor cells. Cancer (Cancer Cytopathol) 2012;. © 2011 American Cancer Society. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the diagnostic accuracy of the cell block (CB) method and clinical features affecting it in patients with vitreoretinal lymphoma (VRL). Methods: This study enrolled 38 eyes in 33 VRL patients, and 7 eyes in 7 patients with idiopathic uveitis who underwent diagnostic vitrectomy. Medical records including the results of CB cytology, interleukin (IL)-10/-6 concentrations, and immunoglobulin heavy chain gene (IgH) rearrangement were retrospectively searched. Results: Patients with VRL comprised 16 women and 17 men, and the age of onset ranged from 44 to 85 years (mean: 70 years). CB preparations detected large malignant cells in 35 eyes (92%), whereas the other 3 VRL eyes were negative. Two of the latter three eyes showed subretinal infiltrates, which existed in 7 of 35 CB-positive eyes. Intravitreal IL-10 and -6 concentrations were 1866 ± 4088 pg/mL and 98 ± 139 pg/mL, respectively, and the rate of IL-10/-6 >1 was 86.9%. The presence of IgH monoclonality was 63.2%. In patients with uveitis, CB specimens revealed no atypical but small inflammatory cells. IL-6 concentration was 311.1 ± 240 pg/mL, whereas IL-10 was undetectable in six eyes, and the IL-negative rate was 85.7%. Six eyes (85.7%) with uveitis showed no IgH monoclonality. Conclusions: Diagnostic accuracy of CB preparations in VRL could achieve an equivalent outcome to IL ratio calculation and IgH monoclonality detection. The appearance of subretinal infiltrates may diminish the CB positivity. [ABSTRACT FROM AUTHOR]

Background: The development of high‐throughput drug screening (HTS) using primary cultures provides a promising, clinically translatable approach to tailoring treatment strategies for patients with cancer. However, this has been challenging for solid tumors because of often limited amounts of tissue available. In most cases, in vitro expansion is required before HTS, which may lead to overgrowth and contamination by non‐neoplastic cells. Methods: In this study, hematoxylin and eosin staining and immunohistochemical staining were performed on 129 cytopathology cases from 95 patients. These cytopathology cases comprised cell block preparations derived from primary tumor specimens or patient‐derived xenografts as part of a pediatric precision oncology trial. Cytopathology cases were compared with the morphology and immunohistochemical staining profile of the original tumor. Cases were reported as tumor cells present, equivocal, or tumor cells absent. The HTS results from cytopathologically validated cultures were incorporated into a multidisciplinary tumor board report issued to the treating clinician to guide clinical decision making. Results: On cytopathologic examination, tumor cells were present in 77 of 129 cases (60%) and were absent in 38 of 129 cases (29%), whereas 14 of 129 cases (11%) were equivocal. Cultures that contained tumor cells resembled the tumors from which they were derived. Conclusions: Cytopathologic examination of tumor cell block preparations is feasible and provides detailed morphologic characterization. Cytopathologic examination is essential for ensuring that samples submitted for HTS contain representative tumor cells and that in vitro drug sensitivity data are clinically translatable. Routine cytopathology is able to establish the presence or absence of tumor cells in primary cultures derived from patients with pediatric cancer. Cytopathologic examination ensures the clinical relevance of in vitro drug sensitivity profiling in a pediatric precision oncology platform. [ABSTRACT FROM AUTHOR]

Background: High‐risk human papillomavirus (HR‐HPV) status is critical for the diagnosis, prognosis, and treatment of patients with oropharyngeal squamous cell carcinoma (OPSCC). Patients often present with enlarged cervical nodes, and fine‐needle aspiration cytology (FNAC) is frequently the initial diagnostic procedure. Although p16 is the most widely used surrogate marker, problems with interpretation can limit its utility in FNAC. HR‐HPV RNA in situ hybridization (ISH) has emerged as a specific way to assess HPV status on cell block preparations of cervical nodes. The authors evaluated the utility of HR‐HPV ISH in conventional smears and liquid‐based cytology (LBC) preparations of metastatic head and neck squamous cell carcinoma (SCC). Methods: Thirty‐one aspirates of proven, HPV‐related SCC (confirmed by p16 and/or HR‐HPV ISH in corresponding surgical specimens) were selected. Ten aspirates of HPV‐negative SCC were also retrieved. HR‐HPV ISH was performed on 27 smears and 14 LBC preparations. All results were scored as positive, equivocal, or negative. Results: Eighty‐four percent of metastatic, HPV‐related SCCs were positive for HR‐HPV RNA ISH, with high number of signals (n = 19) and low number of signals (n = 7), whereas five HPV‐related SCCs were equivocal. All metastatic, HPV‐negative SCCs were negative for HR‐HPV ISH. Conclusions: HR‐HPV ISH can be reliably performed on smears or LBC preparations, particularly when cell blocks are unavailable or paucicellular. Results were easy to interpret when high numbers of signals were present but were challenging in aspirates with low or rare number of signals. The current study suggests that HR‐HPV ISH could be used as the initial testing modality for determining HPV status in FNAC specimens of metastatic SCC. High‐risk human papillomavirus RNA in situ hybridization can be reliably performed on conventional smears or liquid‐based cytology. It could also be used as the initial testing modality for determining human papillomavirus status in patients with metastatic head and neck squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Introduction: Metastatic cancers are frequently detected on fine-needle aspiration (FNA) cytology, and confirmation of metastatic breast cancer often requires immunocytochemistry. Tissue provisioning for FNA specimens is important. In this study, GATA3, gross cystic disease fluid protein-15 (GCDFP15), mammaglobin (MMG), and SOX10 were performed on cell block preparations from aspirates of histologically confirmed metastatic breast cancers. The diagnostic performance of single markers and combinations of these markers were investigated with the aim to construct a tissue-efficient immunopanel. Methodology: Aspirates of metastatic breast cancer with corresponding histology and biomarker (estrogen receptor (ER), progesterone receptor (PR), HER2 and ki67) profile were retrieved. ER, GATA3, GCDFP15, MMG and SOX10 immunostains were performed on cell block sections and their expressions were assessed and compared. Results: Immunostaining was performed on a total of 115 aspirates. GATA3 showed the highest expression, followed by MMG, GCDFP15 and SOX10. Twenty-three, five and five cases expressed GATA3, MMG and SOX10 only. The five cases expressing SOX10 only were ER negative, and SOX10 expression was negatively associated with ER (p = 0.001), MMG (p = 0.001), GCDFP15 (p = 0.010) and GATA3 (p = 0.002), whereas GATA3 expression showed positive correlation with ER positivity (p < 0.001). MMG and GCDFP15 showed association with high Ki67 (p < 0.05), and no correlations were found with HER2 expression. Conclusion: In this cohort, GATA3 was the most sensitive single marker. The addition of MMG and SOX10 increases the sensitivity for detection of ER positive and ER negative breast cancers, respectively. These findings support the use of a combination of GATA3/MMG/SOX10 for confirmation of metastatic breast cancer. [ABSTRACT FROM AUTHOR]

Background: Fluid cytology plays an important role in delineating benign from malignant effusions, tumor staging, and also in diagnosing recurrences. Various methods are used in cytology for the preparation of smears. As the accurate diagnosis of the fluids aids in clinical decisions, the method of preparation of cytology smears, it is very important. Cytospin preparation of smears is one of the methods which provide higher cellular yield with better preservation of cellular morphology and is less time consuming. On the other hand, cell block method gives superior architectural details and provides options for immunocytochemistry. Aims and Objectives: The aim of this study was to assess the diagnostic utility of cytospin in comparison to cell block method in peritoneal and pleural fluid cytology. The study is done to determine the sensitivity, specificity, predictive values, and diagnostic accuracy of cytospin preparations with cell block method which is considered as the gold standard. Materials and Methods: This was a diagnostic test evaluation study done at the Department of Pathology, Government Medical College, Kottayam. The sample size was 240 which included all pleural and peritoneal fluids received in our cytology laboratory during the study period. Cytospin prepared smears of peritoneal and pleural fluids were compared with the tissue sections prepared by cell block method, to evaluate the diagnostic utility of cytospin. Tissue sections prepared from the cell blocks of effusions were considered as the gold standard for comparison. Results: A diagnostic test evaluation of cytospin preparation was done with cell block preparations. The sensitivity of cytopsin preparations in pleural and peritoneal fluid cytology is 94%. The specificity of cytopsin preparations in pleural and peritoneal fluid cytology is 100%. The positive predictive value of cytopsin preparations in pleural and peritoneal fluid cytology is 100% and the negative predictive value of cytopsin preparations in pleural and peritoneal fluid cytology is 96.8%. Hence, accuracy of the test is 97.9%. Conclusion: There is only minimal statistical difference between the results obtained by the cytospin and cell block methods. Cytospin method is less time consuming along with the advantage of higher cellular yield. Hence, the incorporation of cytospin along with the cell block technique is beneficial for augmenting the results of effusion cytology. [ABSTRACT FROM AUTHOR]

Background: Acinic cell carcinoma (AcCC) is diagnostically challenging on fine‐needle aspiration because it can mimic several other neoplasms or even normal acinar tissue. Immunopositivity for DOG1, especially circumferential membranous staining, can support the diagnosis of AcCC but is not entirely specific, and it is prone to technical and interpretive challenges on small specimens. NR4A3 (nuclear receptor subfamily 4 group A member 3) translocation and nuclear NR4A3 overexpression were recently described in the majority of AcCCs. Here, the authors evaluate the performance of NR4A3 immunohistochemistry (IHC) and NR4A3 break‐apart fluorescence in situ hybridization (FISH) on cell block preparations and compare them with DOG1 IHC in distinguishing AcCC from other entities in the differential diagnosis. Methods: The authors identified 34 cytology cell blocks with lesional cells, including 11 specimens of AcCC (2 of which derived from 1 patient and showed high‐grade transformation) as well as 2 secretory carcinomas, 7 salivary duct carcinomas, 4 mucoepidermoid carcinomas, 3 oncocytomas, 3 renal cell carcinomas, and 6 specimens containing nonneoplastic salivary gland tissue. NR4A3 IHC, DOG1 IHC, and NR4A3 FISH were attempted for all cases. Results: NR4A3 IHC had 81.8% sensitivity and 100% specificity for AcCC, whereas NR4A3 FISH had 36.4% sensitivity and 100% specificity, although 4 cases (3 mucoepidermoid carcinomas and 1 salivary gland tissue sample) could not be analyzed because of low cellularity. Notably, no normal acinar tissue specimens showed NR4A3 positivity by IHC or FISH. In addition, DOG1 IHC had 72.7% sensitivity and 92% specificity. Conclusions: NR4A3 IHC is highly specific for the diagnosis of AcCC and is more sensitive than DOG1 IHC and NR4A3 FISH. In addition, NR4A3 IHC performance is not improved by the inclusion of DOG1 IHC. Finally, NR4A3 positivity resolves the perennial problem of distinguishing AcCC from normal acinar tissue. Nuclear receptor subfamily 4 group A member 3 (NR4A3) immunohistochemistry (IHC) is sensitive and specific for the diagnosis of acinic cell carcinoma in cytology cell block preparations, with better performance than DOG1 IHC. NR4A3 fluorescence in situ hybridization is also specific for acinic cell carcinoma but is less useful with limited tissue and is less sensitive than NR4A3 IHC. [ABSTRACT FROM AUTHOR]

Urothelial carcinoma represents a diverse group of tumours with distinct histologic subtypes, each exhibiting unique cytomorphologic features, architectural growth patterns, and/or well‐developed aberrant differentiation. In fact, there are more than 13 subtypes of urothelial carcinoma recognized in the 2022 WHO classification of tumours in the urinary tract. The identification of these subtypes is crucial for an accurate diagnosis of urothelial carcinoma, and many have important clinical implications. Variant/divergent features may coexist with conventional high‐grade urothelial carcinoma (HGUC) or present with 100% variant morphology. In urinary tract cytology (UTC), urothelial carcinoma can display divergent differentiation, such as squamous, glandular, or small cell carcinoma differentiation. The use of cell block preparations and immunohistochemistry with available residual urine can enhance diagnostic accuracy. On the other hand, identifying urothelial carcinoma variants, including nested, micropapillary, and plasmacytoid subtypes, poses significant challenges in UTC. Many cases of these variants are only detected retrospectively after variant histology has been established from resection specimens. Moreover, some variants exhibit features inconsistent with the diagnostic criteria for HGUC according to the Paris System for Reporting Urinary Tract Cytology. Nevertheless, the rarity of pure variant morphology and the occurrence of some false negatives for these variant cases are essential to maintain the specificity of UTC overall. This review covers the histology, cytomorphology, and important clinical aspects observed in urothelial carcinoma exhibiting divergent differentiation and various urothelial carcinoma variants detected in UTC. [ABSTRACT FROM AUTHOR]

Pulmonary actinomycosis is an uncommon infectious disease. Although the gold standard for diagnosis is histological examination with bacterial culture of lung tissue, cytology samples offer a fast and low-cost alternate diagnostic procedure. The cytology literature on this topic is limited to mostly case reports. Therefore, the aim of this study was to review cytological material in a series of patients with a diagnosis of pulmonary actinomycosis to characterize the main cytomorphological findings. Different cytological respiratory samples including sputum smears, bronchoalveolar lavages (BALs), transthoracic or endobronchial fine needle aspiration cytology (FNAC) and cell block preparations were used for retrospective examination. For all cases patient age, gender, symptoms, and radiological chest findings were recorded. A total of 26 cytological respiratory samples (14 sputum smears, 9 FNAC, two BALs) including direct smears and 6 cell blocks from 9 patients were examined. In sputum smears the most remarkable findings were the presence of dark cotton ball masses with projections like spider legs and/or mouse tails (75% of the samples). Sulfur granules were observed in 4 (40%) of the sputum smears and within FNAC cases. Various respiratory cytology samples including sputum smears, FNAC and BALs can reveal cytomorphological findings diagnostic of pulmonary actinomycosis. Characteristic cytological findings compatible with a diagnosis of this infection include cotton ball masses and less frequently sulfur granules. [ABSTRACT FROM AUTHOR]

Cytology specimens play an important role in the diagnosis and predictive testing of lung cancer. While morphological characterisation of small cell and non‐small cell lung carcinomas (NSCLC) on cytology is possible, further subtyping of NSCLC into adenocarcinoma and squamous cell carcinoma morphology is also mandatory in the current era of personalised medicine. Notably, cytology specimens in different forms (fine needle aspiration, exfoliative, and cell block) with or without immunocytochemistry are reliable sources for accurate diagnosis of adenocarcinoma and squamous cell carcinoma as evidenced by numerous studies present in the literature. However, there are instances where subtyping of NSCLC based on morphology alone is challenging on cytology samples, especially non‐cell block preparations. In this paper, we will discuss current concepts, advances, and challenges of subtyping NSCLC in cytology specimens. [ABSTRACT FROM AUTHOR]

Background: The recently introduced monoclonal V600E antibody (clone VE1) is likely to be an alternative strategy for detecting this mutation in thyroid lesions. Although VE1 immunostaining and molecular methods used to assess papillary thyroid carcinoma in surgical specimens are in good agreement, evaluation of VE1 in cytology and cell block samples is rarely performed, and its diagnostic value in cytology has not been well established. In this study, we sought to determine if VE1 is suitable for fine needle aspiration (FNA) and cell block methods. Methods: A total of 86 patients who had BRAF V600E mutations were investigated with molecular and immunocytochemical (ICC) analysis in 45 FNA and 41 cell blocks. In total, 83 (96.5%) patients underwent surgical treatment. Assessment of BRAF V600E mutation status was performed in 72 (83.7%) cases. Results: Among the 72 cases analysed, 54 cases agreed (ICC+/BRAF+ or ICC−/BRAF−), seven cases were false positive (ICC+/BRAF−) and 11 cases were false negative (ICC−/BRAF+). False negative cases were not detected in the cell block method. The statistical analysis showed that sensitivity and specificity of ICC for detecting the BRAF V600E mutation were 61% and 77% in FNA samples and 100% and 73% in cell block. Conclusion: The use of antibody VE‐1 is a reliable method and a negative result of VE1 immunostaining might help to save time and money, restricting the molecular test to antibody‐positive cases only. The identification of the aggressive variants of papillary carcinoma might be enabled by the expression of the antibody in neoplastic cells with tall cell features. BRAFV600E staining (VE‐1) is showing promising results in identifying aggressive variants of papillary thyroid carcinoma. It can be performed reliably on thyroid FNA cell block preparations. The current study supports the role of FNA assessment in thyroid carcinomas emphasising the importance of cell block preparations in providing a tool for the preoperative assessment of BRAF V600E mutation status. [ABSTRACT FROM AUTHOR]

Background: To report two cases with idiopathic unilateral diffuse opacification of the posterior hyaloid membrane (PHM) completely separated from the retina, the mechanism of which is possibly due to glial cell proliferation and migration.Case Presentation: Two Japanese women at age 75 and 84 with no systemic or ocular history developed diffuse opacification in one eye resembling a ground glass sheet almost all over the surface of the PHM, but not within the vitreous gel or fluid. The retinas were funduscopically normal; however, optical coherence tomography demonstrated hyperreflective icicle-like anterior protrusions from the surface of the fovea. The patients received pars plana vitrectomy, resulting in visual improvement. Cell block preparations of the vitreous in one case revealed a cluster of cells immunoreactive for glial fibrillary acidic protein in consistence with gliosis, while denying vitreoretinal lymphoma from lack of atypical cells and vitreous amyloidosis due to no staining for Congo red or direct fast scarlet. The lesions did not recur during follow-up with no new funduscopic abnormalities.Conclusions: To our knowledge, this is the first to demonstrate such peculiar cases of vitreous opacity with idiopathic and unilateral onset. Histological assessments revealed the possible pathogenesis of gliotic opaque PHM separation to cause its ground-glass-sheet appearance. [ABSTRACT FROM AUTHOR]

Cell-block preparations have become an essential part of integrated cytology diagnosis. They are essentially microbiopsies that are formalin fixed and embedded in paraffin. This has become more prevalent with greater sample procurement due to the advent of newer biopsy techniques and needles. Cell-blocks allow retrieval of small tissue fragments from cytology specimens that sometimes cannot be processed by alternate cytologic techniques. They represent concentrated, cell-enriched preparations that provide cytologists with the opportunity to evaluate cellular architecture, as well as to perform ancillary testing. A cell-block compatible sample may thus obviate the need for a more invasive procedure such as a tissue biopsy. Microscopic examination of cell-blocks is quick, avoids obscuring material, permits cells to be evaluated in one focal plane, and allows the histologic architecture such as glandular differentiation, papillary formations, and sometimes invasion to be easily identified. This new era of "cytohistology" accordingly requires practicing cytologists to become more familiar with histopathology. This review article discusses the benefit of various architectural patterns identifiable in cell-blocks employed as an adjunct to Pap tests, exfoliative fluid specimens, and fine-needle aspirations. [ABSTRACT FROM AUTHOR]

Introduction: Conventional cell blocks (CCB) prepared from cytological specimens are very useful but the method is relatively time‐consuming. Suitable modifications in cell‐block techniques are beneficial for improving the turnaround time. We share our experience of a rapid microwave cell‐block (MCB) technique. Aim and objectives: To study the quality of routine and immunohistochemical (IHC) staining of cell‐block sections from serous body fluids prepared by the MCB technique compared with the CCB technique. Method: A total of 177 serous body fluid samples were processed by routine centrifugation technique, and the sediments were used for cell‐block preparations by both conventional and rapid microwave methods. Cell‐block sections were stained with haematoxylin and eosin stain. Haematoxylin and eosin staining quality was analysed using three parameters (cellularity, morphology and staining intensity). IHC for epithelial membrane antigen and calretinin were also performed, and the quality of staining was evaluated on 62/177 samples. Results were analysed using appropriate statistical tests. Results: The time taken for processing cell blocks by the MCB method was 1 hour and 18 minutes compared to 13 hours and 45 minutes by CCB. The quality of sections by both methods showed good agreement for cellularity and intensity of staining, and moderate agreement for morphology. A 100% concordance was noted for distinguishing benign and malignant samples on morphology as well as with IHC stain results. Conclusion: Although the techniques are comparable in terms of quality of routine and IHC staining, we recommend using the MCB technique due to its short turnaround time. Cell blocks are useful in supplementing information provided by cytology smears. However, the preparation of a conventional cell block is time consuming. The authors describe an equally good rapid cell‐block method (microwave cell‐block technique) which can reduce turnaround time of reporting. [ABSTRACT FROM AUTHOR]

Background: Early detection of pancreatic adenocarcinomas is essential for improving survival. In this regard, endoscopic ultrasound-guided fine-needle aspiration cytology (EUS-FNAC) has established itself as the method of choice for its ability to target lesions smaller than those which could be targeted by the traditional imaging methods like transabdominal ultrasound. Identifying these tumors correctly on FNA may be challenging because pancreatic adenocarcinomas may show a wide range of morphological features and the presence of contaminants from the gastrointestinal tract may show up as potential pitfalls. This study presents detailed cytomorphological analyses of 59 cases reported as pancreatic adenocarcinomas on smears and cell blocks. The clinical and histopathology follow-up data wherever available have also been presented. Materials and Methods: EUS-FNAC smears and cell blocks from cases reported as pancreatic adenocarcinomas were retrospectively evaluated with individual assessments of a range of features related to cellularity, cellular arrangement, cytoplasmic qualities, and nuclear features. Aspirates from peripancreatic lymph nodes, histopathology sections, and clinical records were reviewed wherever available. Results: Nonneoplastic cells like pancreatic ductal cells and acinar cells, duodenal, and gastric epithelia were detected along with neoplastic cells showing a wide range of variations in different cytomorphological characters. Often, a mixture of features was noted in the same case. Cell block preparations served as useful adjuncts since they made it possible to render unequivocal diagnoses of malignancies in cases where smears were hypocellular. Conclusion: The study creates a useful knowledge base of cytomorphological features of pancreatic adenocarcinomas. [ABSTRACT FROM AUTHOR]

Breast cancer is the leading cause of cancer-related mortality among women worldwide. MicroRNAs (miRNAs), short non-coding RNAs, have been implicated in cancer-related processes such as tumor development, metastasis, angiogenesis, and drug resistance. Circulating miRNA-373 demonstrates higher relative exosomal serum levels in breast cancer patients compared to healthy women, making it a potential non-invasive biomarker. Separately, vascular endothelial growth factor (VEGF) is crucial for angiogenesis, and is elevated in breast cancer. In this case–control study, we aimed to investigate the diagnostic accuracy of miRNA-373 and VEGF as biomarkers for early-stage breast cancer detection. Serum samples were collected from 120 participants, comprising 30 breast cancer patients, 30 benign breast tumor patients, and 60 healthy controls, over the period of April 2022 to January 2023. MiRNA-373 expression was analyzed by reverse transcription-quantitative PCR with GAPDH normalisation, while VEGF levels in serum samples were measured by ELISA. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of both biomarkers. MiRNA-373 expression (∆Ct) differed significantly between the three groups (breast cancer: − 12.20 ± 1.11; benign tumors: − 12.79 ± 1.09; controls: − 13.64 ± 0.93). ROC analysis revealed moderate discriminative power for miRNA-373 (specificity = 76.7%; sensitivity = 70.0%; AUC = 0.839) and excellent discriminative power for VEGF (specificity = 85.0%; sensitivity = 90.0%; AUC = 0.944) in distinguishing early-stage breast cancer patients from healthy controls. In summary, this study demonstrates the promising potential of miRNA-373 as an early diagnostic biomarker for breast cancer detection, requiring further validation in larger cohorts. Our findings also reinforce the diagnostic value of circulating VEGF levels for breast cancer screening. [ABSTRACT FROM AUTHOR]

The presence of Paracoccidioides brasiliensis was determined in sputum samples from 50 patients with paracoccidioidomycosis using four different techniques: (a) cell-block preparations stained with silver methenamine, (b) direct microbiologie examination, (c) smears stained with Shorr, and (d) smears stained with silver methenamine. Overall, cell-block preparations and smears stained with silver methenamine proved to be the most sensitive techniques, followed by smears stained with Shorr and direct microbiologic examination in decreasing order of sensitivity. Sputum cytology tended to be less positive in patients with interstitial pulmonary lesions as determined by chest X-ray than in patients with alveolar lesions. In addition to its high sensitivity, cell-block preparation technique allows storage of blocks and slides for further studies. [ABSTRACT FROM AUTHOR]

Background: Cell blocks are alternative preparations of fluid cytological specimens. They can be used for immunochemical studies as complementary tools or when other techniques (eg, immunocytochemistry, flow cytometry) are not available. Objectives: We aimed to provide comparative morphologic, immunohistochemical, and technical features of agar‐based cell blocks (ACBs) and cell tube blocks (CTBs) from cavitary effusions. Methods: Agar‐based cell blocks and CTBs were obtained from canine and feline effusions with neoplastic/atypical cells or with packed cell volumes ≥3%. Cellularity, RBC separation, and cellular features were evaluated on digitalized H&E slides with evaluators blinded to the method. The immunohistochemical intensity and nonspecific background were assessed on pan‐cytokeratin and vimentin‐stained slides. Overall yield was calculated, and morphologic and immunohistochemical features were compared among paired samples. Technical and cellular features were also described. Results: Agar‐based cell blocks and CTBs yielded evaluable sections in 100% (52/52) and 98% (51/52) of the cases, respectively. Cellularity and RBC separation scores were significantly higher in CTBs. Similar staining intensities were observed, and background staining was more frequently seen in pan‐cytokeratin‐stained ACBs. Only basic materials and equipment were required for both methods. Agar‐based cell block preparations were more operator dependent and difficult to standardize, whereas CTBs were easier to prepare, but laboratory processing was more demanding. Conclusions: Both methods can be used to produce good sections for immunohistochemistry staining with no significant differences. Cell tube blocks are beneficial for RBC‐rich samples, and little additional training is required to prepare the blocks. Both types of cell blocks are reliable, cost‐effective methods that could be introduced in diagnostic laboratories to further characterize canine and feline effusions. [ABSTRACT FROM AUTHOR]

Background: A peritheliomatous pattern (PP) in tumors is characterized by a sheath of viable tumor cells closely surrounding a central blood vessel. In the authors' cytology practice, such a PP has been recognized in several metastatic melanoma specimens. The aim of this study was to evaluate the frequency of a PP in cytology samples of melanoma in comparison with other tumors. Methods: Eighty archival fine‐needle aspiration (FNA) cases of metastatic melanoma were compared with 65 control cases (35 poorly differentiated/metastatic carcinomas, 15 lymphomas, and 15 recurrent/metastatic/high‐grade sarcomas). Cytologic findings were correlated with corresponding histologic specimens, which were available for 44 cases (55%) in the melanoma group and for 23 cases (35.38%) in the control group. All slides were examined for a PP and were semiquantitatively graded for comparison. Results: A PP was present in 51.3% of the cytologic preparations (n = 41) among the melanoma group cases, whereas in the control group, a PP was present in only 3.1% of the cases (n = 2). A PP was present in 65.9% of melanomas with available histologic sections (n = 29) and in 8.7% of tissue samples from the control group (n = 2). A PP was seen more often in cell blocks than direct smear preparations (51.3% vs 40.0%) from patients with melanoma. Conclusions: The presence of a characteristic PP can be helpful in diagnosing melanoma in FNA samples because it was present in almost half of the metastatic melanoma cases in this study and was rarely present in other tumor types. A PP is easier to recognize and more often presents in cell blocks than aspirate smears. Ancillary studies such as immunohistochemistry are helpful for excluding other entities that may exhibit a PP. In this study, the presence of a peritheliomatous pattern of tumor cells is shown to be helpful in diagnosing melanoma in fine‐needle aspiration smears and cell block preparations. This characteristic growth pattern is present in almost half of the metastatic melanoma cases in this study, and this highlights it as an important morphologic feature to recognize in fine‐needle aspirates of melanoma. [ABSTRACT FROM AUTHOR]

Aim: To explore the cytological spectrum of the gastrointestinal stromal tumour (GIST) including its metastatic sites. Material and methods: A total of 42 patients (45 sites) diagnosed with GIST or its metastases on fine needle aspiration cytology were studied over a period of 5 years. May‐Grünwald Giemsa‐ and haematoxylin and eosin‐stained smears were reviewed and analysed for the cytomorphological spectrum of GIST. Results: Primary GIST alone was seen in 24 cases, E‐GIST in eight cases and metastasis in 11 cases (one patient showing metastasis at two distinct sites), whereas concurrent primary and metastatic lesions were noted in two cases. Amongst primary sites, the most commonly affected location was stomach (n = 22), followed by ileum (n = 2), duodenum (n = 1) and rectum (n = 1). Extra‐GIST was seen in retroperitoneum and pelvis (n = 3 each), omentum and mediastinum (n = 1 each). Fine needle aspiration cytology was done from 11 metastatic sites of GIST which included liver, gall bladder fossa, chest wall, and thigh. The classic spindle cell arrangement was the predominant cytological pattern. About 8.8% cases showed predominant epithelioid cell morphology and 15.5% cases had a mixed cytomorphology comprising of both spindle cell and epithelioid cell patterns. Nuclear pseudoinclusions, perinuclear vacuoles and multinucleation were seen in four cases. Immunocytochemistry on cell‐block sections for confirmation was performed in 18 cases and all these cases showed strong c‐KIT positivity. Conclusion: In this largest case series of cytomorphological diagnosis of GIST, we describe the cytomorphology and immunocytochemistry of primary and metastatic GIST. GISTs with predominant epithelioid cell morphology may pose a diagnostic dilemma therefore in all suspected cases of GIST, immunocytochemistry for c‐KIT and/or DOG1 should be employed on cell‐block preparations to confirm the diagnosis of GIST. This is the largest reported series on the cytomorphology of gastrointestinal stromal tumour (GIST). The details of cytomorphology and immunocytochemistry of GIST have been described. [ABSTRACT FROM AUTHOR]

Background/Aim: Masquerade syndrome is characterized by uveitis-like manifestations caused by tumor cell infiltration into the ocular tissues. The aim of the study was to report a lung cancer patient with persistent unilateral vitreous opacity, who was eventually diagnosed with masquerade syndrome using cell block preparation. Case Report: An 82-year-old female complained of blurred vision in her left eye (OS). Because of pulmonary adenocarcinoma, she had previously received anticancer drug treatment at another Hospital and achieved partial remission. Ophthalmic examinations revealed anterior chamber inflammation and vitreous opacity OS. Corticosteroid eye drops were administered, but the inflammation did not improve, and was referred to the Hokkaido University Hospital. The left bestcorrected visual acuity was 0.1 with normal intraocular pressure. Anterior chamber inflammation was 2+ cells, and vitreous haze was 4+ OS. B-mode ultrasonography showed diffuse heterogeneous high echoic changes in the vitreous cavity. She underwent vitrectomy, and cell block preparation of the vitreous infusion fluids was performed. Cytopathology revealed adenocarcinoma cells with a high nuclear/cytoplasmic ratio and glandular formation. The immunocytochemical study showed that tumor cells were positive for thyroid transcription factor-1 (TTF-1), napsin A, and CK7, therefore diagnosis of masquerade syndrome due to intraocular metastasis of pulmonary adenocarcinoma was reached. Chemoradiotherapy was administered, and the eye got phthisis bulbi after irradiation 2 years after diagnosis. Conclusion: Cell block preparation using vitreous humor may be useful in the diagnosis and management of intraocular metastasis of pulmonary adenocarcinoma in patients with prolonged vitreous opacity. [ABSTRACT FROM AUTHOR]

We compared the diagnostic performances of conventional smears and cell block preparations of tissue samples obtained with endobronchial ultrasound-guided transbronchial needle aspiration. We retrospectively analysed 451 patients (926 lymph nodes) who had undergone endobronchial ultrasound and for whom both smears and cell blocks were available and compared the diagnostic performances of these techniques when used alone and combined. Cell block preparations showed higher diagnostic performance over smears, but the combination was superior to either alone. The combination of smear and cell block techniques achieved a sensitivity, specificity and positive and negative predictive values of 92.5, 100, 100, 97.7 and 99.4, 95.0, 98.6, and 97.9 % for malignant and benign diseases, respectively. We recommend cell block preparations during endobronchial ultrasound-guided transbronchial needle aspiration. [ABSTRACT FROM AUTHOR]

BACKGROUND: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal (GI) tract, and the majority contain KIT or PDGFRA activating mutations. Fine-needle aspiration biopsy (FNAB) is a valuable technique in the diagnosis of GIST and may allow for preoperative therapy with tyrosine kinase inhibitors (TKI). Because of the morphologic diversity of these tumors, routine diagnosis of GIST often relies on C-Kit immunohistochemical staining in addition to morphologic findings. However, up to 15% of GISTs are C-Kit negative. Antibodies with increased sensitivity and specificity for detection of C-Kit-negative GIST cases may be of value, especially because some of these cases may also benefit from TKI therapy. METHODS: Immunohistochemical staining for DOG-1, C-Kit (CD117) and protein kinase C theta (PKCθ) was performed on FNA cell-block preparations representing 30 GISTs, 17 leiomyosarcomas, 16 melanomas, 16 schwannomas, 11 adenoid cystic carcinomas, and 8 leiomyomas. RESULTS: DOG-1 was found to have 100% sensitivity and 100% specificity in diagnosis of GIST. C-Kit demonstrated 70% sensitivity and 76% specificity, and PKCθ showed 40% sensitivity and 86% specificity. When only spindle-cell neoplasms were considered (adenoid cystic carcinomas excluded), the specificity of C-Kit increased to 89%. Of interest, all C-Kit-negative cases showed DOG-1 positivity. CONCLUSIONS: DOG-1 was the most sensitive and specific of the 3 markers for the diagnosis of GIST in cell-block preparations and may be of particular use in the diagnosis of C-Kit-negative GIST. Cancer (Cancer Cytopathol) 2011;. © 2011 American Cancer Society [ABSTRACT FROM AUTHOR]

Objective: To assess the diagnostic value of clot examination for satisfactory processing and confirmation of malignancy in serous effusions in routine cytological evaluation and compare the results with those of conventional smear and cell block preparations. Methodology: Body cavity fluids ( n = 600) received in our laboratory were processed according to a pre-designed protocol for the study as follows: Day1: on receipt of the specimen, smears were made and a cell block was prepared from the sediment. Day2: after overnight sample storage of the remaining specimen at 2–8 °C all fluids were examined for the presence of a clot at the bottom of the container. Fluids in which clot had formed were fixed in formalin. The clot was then placed on a lens paper, wrapped and processed routinely. Diagnostic yields were compared. Results: In this study, we included 600 cases of serous fluids from pleural, pericardial and peritoneal effusions. In 73% ( n = 437) of samples, clot formation was seen, while in 27%, ( n = 163) no clot had formed. Routine smear and cell block preparations showed malignant cells in 9.6% ( n = 42). However, with the addition of the clot preparation, the number of cases in which atypical/malignant cells were seen increased from 42 to 85 (19.4%), with a P < 0.001. Special stains and immunohistochemistry (IHC) were also performed on clot preparations in 10 difficult cases. Conclusion: Clot preparation from body cavity fluids on the second day can be used as an adjunct to smear and routine cell block preparation to improve the accuracy and yield of the cytological diagnosis and may also be of great help for special studies such as IHC staining. [ABSTRACT FROM AUTHOR]

Background: Vitreoretinal lymphoma (VRL) is a life- and sight-threatening disorder. The aim of this study was to analyze the usefulness of the cell block method for diagnosis of VRL. Methods: Sixteen eyes in 12 patients with VRL, and 4 eyes in 4 patients with idiopathic uveitis presenting with vitreous opacity were enrolled in this study. Both undiluted vitreous and diluted fluids were isolated during micro-incision vitrectomy. Cell block specimens were prepared in 19 eyes from diluted fluid containing shredding vitreous. These specimens were then submitted for HE staining as well as immunocytological analyses with antibodies against the B-cell marker CD20, the T-cell marker CD3, and cell proliferation marker Ki67. Conventional smear cytology was applied in 14 eyes with VRL using undiluted vitreous samples. The diagnosis of VRL was made based on the results of cytology, concentrations ofinterleukin (IL)-10 and IL-6 in undiluted vitreous, and immunoglobulin heavy chain gene rearrangement analysis. Results: Atypical lymphoid cells were identified in 14 out of 15 cell block specimens of VRL (positive rate: 93.3 %), but in 5 out of 14 eyes in conventional smear cytology (positive rate: 35.7 %). Atypical lymphoid cells showed immunoreactivity for CD20 and Ki67. Seven cell block specimens were smear cytology-negative and cell block-positive. The cell block method showed no atypical lymphoid cells in any patient with idiopathic uveitis. Conclusions: Cell block specimens using diluted vitreous fluid demonstrated a high diagnostic sensitivity and a low pseudo-positive rate for the cytological diagnosis of VRL. The cell block method contributed to clear differentiation between VRL and idiopathic uveitis with vitreous opacity. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the effectiveness of thyroid fine needle aspiration cytology (FNAC) using a novel-cell preserving matrix called Cytomatrix in improving diagnostic accuracy for thyroid nodules. Materials and Methods: Fifty patients undergoing thyroidectomy were enrolled and FNAC was performed on the excised thyroid glands, with the collected sample being placed on the Cytomatrix. The results were compared with histopathological analysis, and diagnostic performance was assessed statistically. Results: Cytomatrix demonstrated an accuracy of 96%, sensitivity of 84.61%, and specificity of 100%. Concordance between cytological and histopathological findings highlighted Cytomatrix's potential to enhance thyroid FNAC accuracy. Conclusion: FNAC using Cytomatrix shows promise in improving diagnostic accuracy for thyroid nodules. Its application, marked by faster processing and efficient resource utilization, coupled with the preservation of cellular architecture, holds considerable potential in enhancing cytological diagnosis, thus optimizing patient management strategies. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the effectiveness of thyroid fine needle aspiration cytology (FNAC) using a novel-cell preserving matrix called Cytomatrix in improving diagnostic accuracy for thyroid nodules. Materials and Methods: Fifty patients undergoing thyroidectomy were enrolled and FNAC was performed on the excised thyroid glands, with the collected sample being placed on the Cytomatrix. The results were compared with histopathological analysis, and diagnostic performance was assessed statistically. Results: Cytomatrix demonstrated an accuracy of 96%, sensitivity of 84.61%, and specificity of 100%. Concordance between cytological and histopathological findings highlighted Cytomatrix's potential to enhance thyroid FNAC accuracy. Conclusion: FNAC using Cytomatrix shows promise in improving diagnostic accuracy for thyroid nodules. Its application, marked by faster processing and efficient resource utilization, coupled with the preservation of cellular architecture, holds considerable potential in enhancing cytological diagnosis, thus optimizing patient management strategies. [ABSTRACT FROM AUTHOR]

Introduction : Cytological diagnosis of sarcomas requires detailed cytomorphological assessment and integration of immunocytochemistry and/or molecular testing. The role of exfoliative cytology, as compared to aspiration cytology, is less understood. This case series describes well-differentiated/dedifferentiated liposarcomas in effusions, with cytomorphological features, ancillary test results and clinical outcomes detailed. Methods : A computerized search of the department pathology archives was performed for sarcomatous effusions with histological diagnosis or clinical history of well-differentiated/dedifferentiated liposarcoma. Clinical progress, cytology slides, immunocytochemistry and molecular test results were reviewed. Results : Six patients were identified. In 5 patients with clinical follow up, 4 (80%) were deceased within 5 months of malignant effusion. One patient was alive with 12 years disease-free survival after radical resection with adjuvant radiotherapy. Three patients showed dedifferentiation on histology, and high-grade (dedifferentiated) tumor cells were present in effusion cytology of 2 patients. Two showed well-differentiated components only on biopsy, but high-grade (dedifferentiated) tumor cells were identified in cytology. The high-grade tumor cells displayed marked nuclear irregularity, enlargement, size variation, with macronucleoli and multinucleation. Well-differentiated lipomatous components were demonstrated in 4 patients (66.7%), comprising of multivacuolated lipoblasts and atypical lipocytes. CDK4 and MDM2 immunoreactivity in all 3 cases with cell blocks, and CDK4 and MDM2 amplification in one were successfully demonstrated. Conclusion : Lipomatous and dedifferentiated components can be sampled and cytomorphologically identified on effusion fluids of liposarcomas, with sufficient cellularity for immunocytochemistry and molecular testing. Although generally associated with poor prognosis, long disease-free survival with sarcomatous effusion is possible with radical surgery and adjuvant treatment. [ABSTRACT FROM AUTHOR]

Introduction: Fine Needle Aspiration Cytology (FNAC) of the lymph node is a simple tool in the diagnosis of suspected and unsuspected primary and secondary lymph node malignancy. It is a useful first-line investigation to distinguish between infective and malignant lymphadenopathy, especially in a low-resource setting like our country. Aim: To study the utility of FNAC in the diagnosis of lymph node malignancy and to evaluate the efficacy of cytology in diagnosing the primary site of malignancy in case of metastasis. Materials and Methods: A cross-sectional retrospective and prospective study was conducted for a five-year period from July 2015 to June 2020, in the pathology department of Dr. RN Cooper Municipal General Hospital, Mumbai, Maharashtra, India. A total of 112 patients diagnosed with malignancy on FNAC of lymph nodes were studied. The FNAC procedure was performed by cytopathologists using a 23/24G needle attached to a 10 ml syringe. The alcohol-fixed smears were stained with Haematoxylin & Eosin (H&E) stain and Papanicolaou (PAP) stains, while the airdried smears were stained with Giemsa stain. Diagnosis was based on cytomorphological features and clinical presentation. Results: A total of 112 patients were diagnosed with malignancy on FNAC, of which 90 were males and 22 were females, with a male-to-female ratio of 4:1. Cytological analysis of these nodes revealed metastasis in 98 cases (87.50%) and lymphoma in 14 cases (12.50%). The maximum number of patients were in the 51-60 years age group, with 38 cases (33.92%). The most common site of involvement was cervical lymph nodes, with 75 cases (66.96%). The most common cytological diagnosis was metastatic squamous cell carcinoma in 65 cases (58.02%), followed by metastatic un-differentiated carcinoma in 26 cases (23.20%). Conclusion: Fine Needle Aspiration (FNA) is a simple, safe, accurate, cost-effective, and valuable tool in the evaluation of malignant lymphadenopathy. Malignant diseases were easily diagnosed by this simple diagnostic procedure. In the case of a diagnosis of lymphoma, surgery can be completely avoided. It helps in planning further surgical management for metastatic disease, where definitive operative intervention can be performed in one session. In the case of an un-detected primary tumour, FNAC directs further investigations towards the possible primary site. [ABSTRACT FROM AUTHOR]