• Issue

    Cytopathology: Volume 31, Issue 4

    i, 253-363
    July 2020

COVER IMAGE

Free Access

Cover Image

  • Page: i
  • First Published: 21 July 2020
Cover Image

Cover Illustration: The cover image is based on the Original Article Cancer-associated fibroblasts are a useful cytological finding for diagnosing pancreatic ductal adenocarcinoma by Tsubasa Saika et al., https://doi.org/10.1111/cyt.12868.

ISSUE INFORMATION

Free Access

Issue Information

  • Page: 253
  • First Published: 21 July 2020

INSIDE THIS MONTH’S CYTOPATHOLOGY

REVIEWS

Open Access

The early detection of cervical cancer. The current and changing landscape of cervical disease detection

  • Pages: 258-270
  • First Published: 17 April 2020

The article describes the merits and limitations of current approaches for cervical screening, focusing on future developments that should allow a better specificity in the identification of clinically important precancerous lesions. HPV DNA, RNA and biomarker tests are discussed, alongside their ability to stratify disease according to severity and to help locate its position at colposcopy.

Role of fine needle aspiration cytology in the diagnosis of soft tissue tumours

  • Pages: 271-279
  • First Published: 16 April 2020

Despite several reviews on the cytologic diagnosis of soft tissue tumors, the role of cytological examinations compared to histological examination in evaluating soft tissue tumors remains controversial. This review discussed the role and value of FNAC in the evaluation and treatment of soft tissue tumors.

ORIGINAL ARTICLES

Cytomorphological spectrum, including immunohistochemical results of 16 cases of clear cell sarcoma of soft tissue, along with positive EWSR1 gene rearrangement result in two cases

  • Pages: 280-287
  • First Published: 30 April 2020

The present study describes the cytomorphological spectrum of clear cell sarcoma of soft parts in a series of 16 cases. Immunohistochemical stains are necessary and molecular testing is helpful in reinforcing a diagnosis in some cases, which has treatment implications.

The newly proposed International Endocervical Adenocarcinoma Criteria and Classification and its relevance to cervical cytology screening assessed in a prospective 2-year study of 118 cases

  • Pages: 288-291
  • First Published: 14 April 2020

The new IECC classification of endocervical adenocarcinomas (EA) is based on tumor HPV-status. HPV testing of cervical smears allows the cytology samples presenting with a high grade glandular lesion to be divided into two groups: (1) robust diagnosis of HPV-associated EA and (2) non-HPV associated glandular lesions of heterogeneous origin requiring further clinical preoperative diagnostic workup.

Assessment of micronuclei counts as tumour marker in cervical carcinogenesis: A follow-up study

  • Pages: 292-297
  • First Published: 28 April 2020

Micronuclei counts were carried out in 100 low grade (LSIL) cases to assess their potential as tumor marker in cervical carcinogenesis. The study revealed a correlation between high micronuclei counts and persistance of LSIL. The HPV postivity was also found to be higher in persistent LSIL cases.

Is bacterial vaginosis associated with autoimmune antibody positivity?

  • Pages: 298-302
  • First Published: 02 May 2020

Bacterial vaginosis (BV) is a common vaginal infection in women but the mechanisms behind its pathogenesis and recurrence are not clearly understood. This first study investigating the association between BV and autoimmune antibodies found BV to be more frequent in autoimmune antibody positive women. The authors recommend further studies to determine if autoimmunity increases the risk of BV, or if BV is a risk factor for autoantibody positivity.

Interobserver agreement between pathologist, pulmonologist and molecular pathologist to estimate the tumour burden in rapid on-site evaluation smears from endosonography and guided bronchoscopy

  • Pages: 303-309
  • First Published: 28 May 2020

This study assessing interobserver agreement between pathologist, pulmonologist and molecular pathologist for the tumor burden in ROSE smears reaches the following conclusions: a trained pulmonologist can reliably identify malignancy and estimate tumor burden in ROSE smears; estimation of tumor burden is easier in smears prepared from lymph nodes than from pulmonary nodules; correct estimation of tumor burden in ROSE smears improves specimen triage for molecular profiling.

Cancer-associated fibroblasts are a useful cytological finding for diagnosing pancreatic ductal adenocarcinoma

  • Pages: 310-314
  • First Published: 30 May 2020

Cancer-associated fibroblasts in pancreatic ductal brush cytological specimens could be distinguished from the normal fibrous stroma by large nuclear size (over 10.22 µm) and prominent nucleoli. Cancer-associated fibroblasts were a powerful cytological finding for the diagnosis of pancreatic ductal adenocarcinoma.

Differences in cytopathologist thyroid nodule malignancy rate

  • Pages: 315-320
  • First Published: 25 April 2020

In this retrospective study we compared the sensitivity, specificity, negative and positive predictive values malignancy rates, and accuracy between two cytopathologists who evaluated thyroid nodules. There was a similar frequency of use of all thyroid Bethesda system categories with the exception of category 3, and as a consequence, the malignancy rate was different in this category.

CASE REPORTS

Anaplastic large cell lymphoma diagnosed from ascitic and pleural fluid effusion cytology in a paediatric patient

  • Pages: 321-324
  • First Published: 05 May 2020

Anaplastic large cell lymphoma is commonly diagnosed on biopsy or fine needle aspiration but it is very rarely reported in fluid cytology. However, this tumor can be easily diagnosed and confirmed from the cytosmears of serous effusion samples.

Large-cell lymphoma with features intermediate between Hodgkin’s, primary mediastinal B-cell and grey-zone lymphoma: a conundrum on fine needle aspiration cytology

  • Pages: 325-328
  • First Published: 17 May 2020

Gray zone lymphoma (GZL) is a rare B-cell lymphoma with features intermediate between diffuse Large B-Cell Lymphoma and classical Hodgkin Lymphoma. The fine-needle cytology of a GZL observed in a cervical lymph node is described and compared to the corresponding histological features. This case highlights the cytological and histological diagnostic difficulties and the need of a timely and accurate diagnosis.

Cytological diagnosis of a rare synchronous non-small cell lung cancer metastatic to the thyroid gland

  • Pages: 329-332
  • First Published: 14 April 2020

A rare case of synchronous metastatic lung adenocarcinoma to the thyroid gland, diagnosed on routine fine-needle aspiration cytology, is described. The combined use of morphological features associated with immunocytochemical analysis on smeared specimens as well as on cell-block material, is a feasible tool to achieve a definitive diagnosis and it also permits determination of the required biomarkers.

CYTOPATHOLOGY CURIOSITIES

Unexpected finding of inflammatory myofibroblastic tumour in two cytological specimens

  • Pages: 333-337
  • First Published: 16 May 2020

Diagnosing inflammatory myofibroblastic tumor (IMT) on cytology remains challenging, and the cytological features of IMT have been reported only in a limited number of studies to date. Two cases are described which were unexpected clincially. IMT in urine cytology has not previously been reported and IMT in the urogenital tract is very rare.

ENIGMA PORTAL

Dedicated to teaching and education for all staff working in cytology laboratories worldwide

Blurred vision in a young man: Eyeball fluid cytopathology

  • Pages: 338-340
  • First Published: 24 April 2020

A 23-year-old male presented with progressive blurred vision in his right eye for three weeks. Ocular examination by a slit-lamp demonstrated an accumulation of a turbid cream-colored material at the bottom of the anterior chamber (AC) of the eyeball. An AC paracentesis was carried out, obtaining 0.5 ml of non-transparent fluid,and a diagnosis was made.

Rare parotid tumour presenting with facial nerve palsy diagnosed on fine needle aspiration cytology

  • Pages: 341-344
  • First Published: 01 May 2020

Rarely Lymphoma of the parotid gland can result in facial nerve palsy however these patients can be easily correctly diagnosed accurately categorized with the help of FNAC and cell block. This can help to avoid the unnecessary sacrifice of the facial nerve and surgical management.

Bulky cervical tumour showing mixed unique cell clusters in cervical cytology

  • Pages: 345-347
  • First Published: 16 May 2020

The cytological features of synchronous mucinous signet-ring cell carcinoma and squamous cell carcinoma of the cervix have not been reported before. A case is described to emphasise that these two distinct carcinoma types can occur simultaneously in a high-risk HPV infected cervix.

An inguinal mass in an elderly man with ipsilateral lower limb oedema

  • Pages: 348-350
  • First Published: 16 May 2020

Venous leiomyoma is an extremely rare entity. A case of femoral vein leiomyoma accurately diagnosed pre-operatively based on fine needle aspiration cytology supplemented by immunocytochemistry.

Dedicated to teaching and education for all staff working in cytology laboratories worldwide

An infant with an abdominal mass

  • Pages: 351-354
  • First Published: 23 April 2020

Mesoblastic nephroma, also known as congenital mesoblastic nephroma or fetal renal hamartoma, is a rare renal mesenchymal tumor with low malignant potential, occurring most commonly in infants. A case is presented which could be diagnosed on fine needle aspiration cytology complemented with cell-block immunocytochemistry. The cytopathologists need to be aware of the cytologic and immunocytochemical features of this entity, to accurately diagnose these cases pre-operatively, so as to avoid unnecessary administration of chemotherapy to these infants.

An adolescent with an abdominal mass

  • Pages: 355-358
  • First Published: 03 April 2020

Hepatoblastoma, is a rare primary hepatic malignancy, most commonly seen in infants and children less than 3 years of age. We present a rare case of mixed fetal-embryonal hepatoblastoma.

CORRESPONDENCES

The cytological evaluation of ascitic fluid led to the diagnosis of mediastinal T-lymphoblastic lymphoma: A simplified algorithmic approach to diagnosis of lymphoid cell-rich effusion

  • Pages: 359-361
  • First Published: 18 April 2020

Ascitic fluid involvement by mediastinal T lymphoblastic lymphoma is very unusual. These cases can easily be differentiated from their morphological mimickers with the help of immunocytochemistry or flow cytometry on the fluid sample. T lymphoblastic lymphoma can present with superior vena cava syndrome which needs an early diagnosis for accurate management.

Appendiceal adenocarcinoma diagnosed by fine needle aspiration cytology

  • Pages: 362-363
  • First Published: 24 April 2020

This report describes a case of appendiceal adenocarcinoma presenting as an appendiceal mucocele which was diagnosed on fine needle aspiration cytology despite biopsies being non-diagnostic.