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203. Preoperative next-generation sequencing of pancreatic cyst fluid is highly accurate in cyst classification and detection of advanced neoplasia

Author

Singhi, Aatur D, primary, McGrath, Kevin, additional, Brand, Randall E, additional, Khalid, Asif, additional, Zeh, Herbert J, additional, Chennat, Jennifer S, additional, Fasanella, Kenneth E, additional, Papachristou, Georgios I, additional, Slivka, Adam, additional, Bartlett, David L, additional, Dasyam, Anil K, additional, Hogg, Melissa, additional, Lee, Kenneth K, additional, Marsh, James Wallis, additional, Monaco, Sara E, additional, Ohori, N Paul, additional, Pingpank, James F, additional, Tsung, Allan, additional, Zureikat, Amer H, additional, Wald, Abigail I, additional, and Nikiforova, Marina N, additional

Published
2017
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210. Rapid On-Site Evaluation of Endobronchial Ultrasound–Guided Transbronchial Needle Aspirations for the Diagnosis of Lung Cancer: A Perspective From Members of the Pulmonary Pathology Society

Author

Jain, Deepali, primary, Allen, Timothy Craig, additional, Aisner, Dara L., additional, Beasley, Mary Beth, additional, Cagle, Philip T., additional, Capelozzi, Vera Luiza, additional, Hariri, Lida P., additional, Lantuejoul, Sylvie, additional, Miller, Ross, additional, Mino-Kenudson, Mari, additional, Monaco, Sara E., additional, Moreira, Andre, additional, Raparia, Kirtee, additional, Rekhtman, Natasha, additional, Roden, Anja Christiane, additional, Roy-Chowdhuri, Sinchita, additional, da Cunha Santos, Gilda, additional, Thunnissen, Erik, additional, Troncone, Giancarlo, additional, and Vivero, Marina, additional

Published
2017
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212. Integrating next-generation sequencing to endoscopic retrograde cholangiopancreatography (ERCP)-obtained biliary specimens improves the detection and management of patients with malignant bile duct strictures.

Author

Singhi, Aatur D., Nikiforova, Marina N., Chennat, Jennifer, Papachristou, Georgios I., Khalid, Asif, Rabinovitz, Mordechai, Das, Rohit, Sarkaria, Savreet, Ayasso, M. Samir, Wald, Abigail I., Monaco, Sara E., Nalesnik, Michael, Ohori, N. Paul, Geller, David, Tsung, Allan, Zureikat, Amer H., Zeh, Herbert, Marsh, J. Wallis, Hogg, Melissa, and Lee, Kenneth

Subjects
BILE ducts, ENDOSCOPIC retrograde cholangiopancreatography, CHOLANGITIS, NUCLEOTIDE sequencing, BILIARY tract cancer, INTRAHEPATIC bile ducts
Published
2020
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214. HPV‐associated neuroendocrine carcinomas of the head and neck in FNA biopsies: Clinicopathologic features of a rare entity.

Author

Jo, Vickie Y., Krane, Jeffrey F., Pantanowitz, Liron, and Monaco, Sara E.

Abstract

Background: The majority of human papillomavirus (HPV)–associated oropharyngeal carcinomas are squamous cell carcinomas; however, there are rare reports of HPV–associated neuroendocrine carcinomas (HPV‐NECs) in the upper aerodigestive tract. The aim of this study was to characterize the diagnostic features of fine‐needle aspiration (FNA) cases of head and neck HPV‐NEC. Methods: Cytology cases of HPV‐NEC were identified over a 3‐year period from 2 institutions. Clinical, cytomorphologic, and ancillary test results were evaluated. Results: Five FNA cases of HPV‐NEC were identified from 4 patients with cervical lymph node metastases with primaries in the oropharynx (n = 2), nasopharynx (n = 1), and larynx (n = 1). Three cases showed mixed small cell and large cell neuroendocrine morphologies; 1 case was a small cell carcinoma, and the last case appeared as a large cell neuroendocrine carcinoma. All tumors were strongly positive for synaptophysin and p16 and negative for p63/p40. Two cases tested for INSM1 showed diffuse nuclear staining. HPV was confirmed by in situ hybridization in 4 cases, and HPV‐18 was detected by polymerase chain reaction in the fifth case. Retinoblastoma (Rb) staining was moderate to weak (5/5), and p53 was weakly positive (5/5). Conclusions: Head and neck HPV‐NEC is a rare, aggressive entity that can show mixed small and large cell features and p16 upregulation; p53 and Rb are variable with limited diagnostic utility. Because p16 positivity can be nonspecific, confirmatory HPV testing is required and may be helpful in determining the primary site for neuroendocrine carcinoma of an unknown primary. The accurate diagnosis of HPV‐NEC is also important because of its worse prognosis in comparison with HPV‐associated squamous cell carcinoma. HPV‐associated neuroendocrine carcinoma is an aggressive neoplasm that frequently shows mixed features of small cell carcinoma and large cell neuroendocrine carcinoma, and may pose diagnostic challenges in cytologic samples. Tumors show p16 overexpression, which may be nonspecific in the differential diagnosis; thus, confirmatory testing for high‐risk human papillomavirus is helpful, HPV especially for tumors presenting as cervical lymph node metastases with an unknown primary. [ABSTRACT FROM AUTHOR]

Published
2019
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235. Molecular Characterization of Sporadic Pediatric Thyroid Carcinoma with the DNA/RNA ThyroSeq v2 Next-Generation Sequencing Assay

Author

Picarsic, Jennifer L., primary, Buryk, Melissa A., additional, Ozolek, John, additional, Ranganathan, Sarangarajan, additional, Monaco, Sara E., additional, Simons, Jeffrey P., additional, Witchel, Selma F., additional, Gurtunca, Nursen, additional, Joyce, Judith, additional, Zhong, Shan, additional, Nikiforova, Marina N., additional, and Nikiforov, Yuri E., additional

Published
2016
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236. Preoperative next-generation sequencing of pancreatic cyst fluid is highly accurate in cyst classification and detection of advanced neoplasia.

Author

Singhi, Aatur D., Mcgrath, Kevin, Brand, Randall E., Khalid, Asif, Zeh, Herbert J., Chennat, Jennifer S., Fasanella, Kenneth E., Papachristou, Georgios I., Slivka, Adam, Bartlett, David L., Dasyam, Anil K., Hogg, Melissa, Lee, Kenneth K., Marsh, James Wallis, Monaco, Sara E., Ohori, N. Paul, Pingpank, James F., Tsung, Allan, Zureikat, Amer H., and Wald, Abigail I.

Subjects
PANCREATIC cysts, PREOPERATIVE period, NUCLEOTIDE sequencing, PANCREATIC intraepithelial neoplasia, GENETIC mutation
Published
2018
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237. Utility of The Paris System for Reporting Urinary Cytology in upper urinary tract specimens.

Author

Xing, Juan, Monaco, Sara E., and Pantanowitz, Liron

Abstract

Introduction Diagnosing upper urinary tract (UUT) lesions using cytology has been historically difficult because of a lack of standardized terminology, cytomorphologic criteria, and the presence of instrumentation artifact. The goal of The Paris System for Reporting Urinary Cytology (TPSRUC) was to provide standardized terminology and cytomorphologic criteria. The aim of this study was to evaluate the utility of TPSRUC in UUT cytology specimens at our institution. Materials and Methods Single ThinPrep archival slides from 30 UUT cytology cases with corresponding histological follow-up were reviewed using TPSRUC. Those results were compared with the original cytology diagnoses. Results The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for high-grade urothelial carcinoma (HGUC) using TPSRUC were 71%, 100%, 100%, and 71%. Conclusions The TPSRUC was reliable at identifying HGUC. These data showed that this system had a lower sensitivity (71% versus 100%) and NPV (71% versus 100%) for UUT specimens compared with original cytology diagnoses. TPSRUC had a sensitivity and specificity that were comparable to reported overall sensitivity and specificity of UUT cytology for detection of HGUC. A major cause of discrepancy with TPSRUC was the classification of urine samples (n = 8) from histologically proven HGUC cases as only atypical (n = 6) or negative (n = 2), mainly owing to nuclear hypochromasia rather than hyperchromasia. Thus, hyperchromasia, a criteria used in TPSRUC, may not be as relevant in UUT specimens. [ABSTRACT FROM AUTHOR]

Published
2018
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239. Cell block preparation in urine cytology: examination of utility and workflow in an academic practice

Author

Dantey, Kossivi, Pantanowitz, Liron, Xing, Juan, Cuda, Jackie, Nestler, Rick, and Monaco, Sara E.

Abstract

Urine cytology is a common non-invasive test to screen for urothelial carcinoma. Urine cell blocks may sometimes be prepared as a diagnostic aid (eg, to characterize architecture or perform immunohistochemistry). The aim of this study was to determine whether routinely preparing cell blocks on urine specimens improves diagnostic sensitivity.

Published
2024
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240. Cytopathology fellowship recruitment: historical context, current state, and future considerations

Author

Torous, Vanda F., Wu, Roseann I., Monaco, Sara E., and Staats, Paul N.

Abstract

Fellowship recruitment and retention of a skilled workforce is one of the biggest challenges that not only cytopathology is facing but that the field of pathology in general is being confronted with. There have long been issues with the fellowship recruitment process for both applicants and fellowship directors, including pressure to move the application process earlier and earlier and frustrations stemming from applicants needing to determine different individual timelines and program requirements. The unified timeline for fellowship recruitment was established as an attempt to standardize the recruitment process and to address the key issues of the push for earlier and earlier decision-making, which placed significant anxiety on trainees, as well as the burden on programs of more unexpected openings. While institution of the unified timeline has had many successes, there have been problems as well. Here, we discuss the multifaceted and intertwined factors that affect fellowship recruitment with a review of the historical context and the current setting and with an eye towards future directions. In the end, the issues we are currently facing are complex and there is likely no perfect solution to fixing an inherently broken system. However, the ultimate goal should be in better supporting our trainees’ development and promoting a more fair and equitable recruitment process. Only by working together can we optimize the process for both applicants and programs alike.

Published
2024
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241. Benchmarking cytology support for ROSE during endoscopic and bronchoscopic procedures

Author

Anderson, Alayna, Monaco, Edward A., Udoeyo, Idorenyin F., Cuda, Jackie, Zelonis, Michele, Khader, Samer N., Pantanowitz, Liron, and Monaco, Sara E.

Abstract

There has been an increase in endoscopic and bronchoscopic biopsies as minimally invasive methods to obtain specimens from gastrointestinal (GI) or pancreatobiliary lesions and thoracic or mediastinal lesions, respectively. As hospitals undertake more of these procedures, it is important to consider the staffing implications that this has on cytopathology laboratories with respect to support for rapid on-site evaluation (ROSE).

Published
2024
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242. Adding the “US” in FNA: Pearls for starting a pathologist-performed ultrasound-guided fine needle aspiration service (USG FNA)

Author

Lynn, Terrance J. and Monaco, Sara E.

Abstract

•Initiating a pathologist-performed ultrasound-guided fine needle aspiration (USG-FNA) biopsy clinic is a challenging task that requires consideration of multiple factors.•Some of the key considerations include training, certification, privileges, equipment, documentation, information technology (IT) issues, and the overall business plan or financial component..

Published
2024
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243. Determination of appropriate urine volume cutoff values for voided urine specimens to assess adequacy

Author

Xing, Juan, Qi, Yan, Monaco, Sara E., and Pantanowitz, Liron

Abstract

Incorporating urine volume into adequacy assessment was recommended by The Paris System for Reporting Urinary Cytology. The concept was relatively new, however, and supportive studies were sparse. We accordingly aimed to determine the role of urine volume in adequacy assessment and cutoff values for urine samples using ThinPrep (Hologic, Inc, MA) processing.

Published
2024
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244. Review of HIV-Related Cytopathology

Author

Lang, Tee U., Khalbuss, Walid E., Monaco, Sara E., Michelow, Pam, and Pantanowitz, Liron

Subjects
Article Subject
Abstract

Exfoliative and aspiration cytologies play a major role in the management of patients with human immunodeficiency virus infection. Common cytology samples include cervicovaginal and anal Papanicolaou tests, fine needle aspirations, respiratory specimens, body fluids, Tzanck preparations, and touch preparations from brain specimens. While the cytopathologists need to be aware of specific infections and neoplasms likely to be encountered in this setting, they should be aware of the current shift in the pattern of human immunodeficiency virus-related diseases, as human immunodeficiency virus patients are living longer with highly active antiretroviral therapy and suffering fewer opportunistic infections with better antimicrobial prophylaxis. There is a rise in nonhuman immunodeficiency virus-defining cancers (e.g., anal cancer, Hodgkin's lymphoma) and entities (e.g., gynecomastia) from drug-related side effects. Given that fine needle aspiration is a valuable, noninvasive, and cost-effective tool, it is frequently employed in the evaluation and diagnosis of human immunodeficiency virus-related diseases. Anal Papanicolaou tests are also increasing as a result of enhanced screening of human immunodeficiency virus-positive patients for cancer. This paper covers the broad spectrum of disease entities likely to be encountered with human immunodeficiency virus-related cytopathology.

Published
2011
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