Cervical cancer remains a major public health problem particularly in low- and middle-income countries. Systematic screening of at-risk women, detection of oncogenic Human Papillomavirus (HPV) types and vaccination against HPV are essential strategies for reducing the incidence and mortality of this malignancy. This narrative review details publications related to the panorama of cervical cancer in Brazil and highlights major deficiencies as well as advances related to prevention, screening, diagnosis and treatment of this disease. Results - Current Status/Discussion: Cervical cytology, specifically the Papanicolaou test, has been the main method of cervical cancer screening in Brazil. The subsequent implementation of HPV testing, alone or combined with cytology, has been shown to have increased efficacy in the detection and elimination of precancerous lesions. Currently, regional inequities in access to cervical cancer screening, prevention and treatment actions, as well as in expertise in HPV detection protocols, have resulted in large regional differences in the quality of patient care. Vaccination against HPV is available free of charge by the Unified Health System (SUS). However, coverage remains suboptimal due to barriers such as misinformation, resistance from legal guardians, and failures in distribution logistics. State-of-the-art molecular testing and effective screening of at-risk vulnerable populations for cervical lesions and for the presence of HPV still face regional, logistical and infrastructure barriers. To improve cervical cancer prevention, detection and treatment in Brazil, it is necessary to provide upgraded vaccination, screening and treatment strategies, with a focus on an equitable country-wide access to comparable health services.

In the article "Ensuring Quality in Interventional Cytopathology" [Acta Cytologica. https://doi.org/10.1159/000549803] by Bellevicine et al., the 5th author's name should correctly read Martin Harper Hysek.The original online article has been updated to reflect this.

Cytotechnologists have long been central to cervical cancer screening, although their education and job responsibilities differ markedly across countries. The adoption of primary HPV testing has substantially reshaped cytotechnology workforce needs and professional roles. In Sweden, however, no comprehensive overview of these changes exists. This study therefore examined cytotechnologists' training, job tasks, and how HPV testing has affected their daily work and practice patterns. We conducted a nationwide survey of Swedish cytology laboratories using an electronic questionnaire developed by the Board of the Swedish Society of Cytotechnologists. The 84‑item instrument addressed workload, diagnostic tasks, ancillary testing, digital cytology, job satisfaction, and managerial assessments. Responses were summarized descriptively. Screening of gynecologic (86%) and non‑gynecologic specimens (89%) remained widely practiced among cytotechnologists, together with involvement in rapid on‑site evaluation (48%), quality assurance activities (41%), and fine‑needle aspiration assessment (55%). The transition to HPV‑primary screening was associated with reductions exceeding 50% in cervical cytology volumes and contributed to marked workforce pressures; 30% cytotechnologists reported assuming novel responsibilities, 81% of laboratories reported recent cytotechnologist attrition, whereas only 15% anticipated new recruitment. Adoption of digital cytology remained limited (6%), and no laboratory reported the use of artificial intelligence-based tools. Interest in expanded professional roles was high among cytotechnologists (93%) and was substantially supported by managers (88%). Concerns regarding job satisfaction were evident, with 19% of cytotechnologists indicating an intention to leave their position within the forthcoming year. Sustaining cytology services will require proactive workforce planning, competency‑based upskilling, role diversification, and strategic adoption of digital technologies.

Large B-cell lymphoma (LBCL) encompasses a diverse group of aggressive lymphoid neoplasms, the most common of which is diffuse large B-cell lymphoma (DLBCL). A precise diagnosis is critical for determining prognosis and therapeutic strategies, particularly as new molecular subtypes and classification criteria have been introduced in the 5th edition of the World Health Organization (WHO) classification of hematolymphoid tumors (WHO-HAEM5, 2022). Fine needle aspiration (FNA) cytology is a safe and minimally invasive diagnostic tool for assessing lymphadenopathy and extranodal masses. The diagnosis of LBCL and the distinction distinguishing between LBCL subtypes-such as germinal center B-cell (GCB) and activated B-cell (ABC) subtypes of DLBCL, primary mediastinal large B-cell lymphoma (PMBL), anaplastic large cell lymphoma (ALCL), and high-grade B-cell lymphoma (HGBL)-requires the integration of cytomorphologic features with ancillary techniques, including immunocytochemistry, flow cytometry, fluorescence in situ hybridization (FISH), and next-generation sequencing (NGS). This review synthesizes the cytologic features, immunophenotypic profiles, molecular signatures, and clinical implications of LBCL subtypes, highlighting recent advances in cytopathology and classification.

Introduction Treatment of breast cancer is made on ER, PgR, and HER2 results of primary tumor. However, immunoprofile may differ in axillary metastasis, treatment may be inadequate or unsuccessful. The objective of this study was to analyze the results of ER, PgR, and HER2 expression and discordance rates in ThinPrep samples from axillary fine needle aspiration cytology (FNAC) and breast tru-cut biopsies. Methods The study was conducted on 372 cases. Comparative analysis was performed on ER, PgR, and HER2 results of breast tru-cut biopsy and axillary FNAC obtained concurrently. A comprehensive review of literature addressing this subject was carried out. Results The results revealed discrepancies between two specimen in 4, 11, and 5 cases for ER, PgR, and HER2, respectively. All discordant cases in ER and PgR and two cases in HER2 exhibited shift from positive to negative. Notably, in two cases, HER2 was found to be negative in tru-cut biopsy but positive in axillary lymph node FNAC. The HER2 Dual-SISH amplification was identified in a retrospective analysis of breast tru-cut biopsies. The cases examined using ThinPrep method exhibited 98.93%, 97.1%, and 98.7% concordance for ER, PgR, and HER2, respectively, while discordance rates were recorded at 1.07%, 2.9%, and 1.3%. The Kappa values calculated for ER, PgR, and HER2 were 0.97362 (95% CI 0.94791-0. 99932), 0.93443 (95% CI 0.89634-0.97252), and 0.95625 (95% CI 0.91817-0.99432), respectively. Conclusions The ER, PgR, and HER2 results obtained using the ThinPrep in axillary lymph node FNAC had lower discordance and higher concordance than majority of studies in the literature. These results demonstrate that axillary lymph node FNAC and ThinPrep can be safely used for accurate treatment selection and diagnosis.

The interpretation of pediatric thyroid lesion represents a challenging diagnostic tool for fineneedle aspiration cytology (FNAC). As for the adult lesions, it represents the first diagnostic tool for correct characterization of these nodules. Recent data from the National Cancer Institute (NCI) have proven that the incidence of thryoid malignancy has been increasing especially in adolescents. These data are mostly linked to an estimated higher prevalence of well-differentiated cancers with 90% diagnosed as papillary thyroid cancer (PTC), with some specific malignant subtypes, such as diffuse sclerosing subtype, are more frequently diagnosed in children, with, not uncommonly, a more aggressive behavior which justifies the increased number of surgical procedures. For this reason, the American thyroid association (ATA) recommended the performance of neck ultrasonography and FNAC in the evaluation of pediatric thyroid nodules. In this regard, the performance of an FNAC has high sensitivity and diagnostic accuracy in pediatric series, sharing the same problematic issues encountered in adult population, mostly in the diagnosis of the indeterminate lesions. Since 2023, the diagnosis of a pediatric lesion was based on the risk of malignancy used for the adulthood. The introduction of the third edition of The Bethesda system for reporting thyroid cytopathology (TBSRCT)introduced a specific adoption of diagnostic categories combined with their personalized ROM and management in pediatric thyroid lesions. We focused on the analysis of the ROM and data from literature hinged on the evaluation of the adoption of the TBSRTC in pediatric thyroid lesions.

Immunocytochemistry (ICC) on cytospins and cell blocks is usually limited to a single marker per slide, often restricting diagnostic accuracy when sample cellularity is low. Multiplex cryoimmunostaining (mCryo), though not yet used in a routine cytopathology practice, may help overcome these limitations. Our study evaluated the applicability of mCryo compared with standard ICC on routinely prepared cytospins. Residual fine-needle aspiration biopsy (FNAB) and effusion samples from various diseases were used. mCryo staining with antibody panel consisting of EpCAM, CK7, CD56, TTF-1, p40, CD45 and calretinin (X-ZELL, Singapore) was tested on methanol-fixed cytospins, corresponding ICC-stained cytospins served as controls. All slides were reviewed blindly. Forty-two samples were included in the analysis (21 carcinomas, eight lymphomas, five melanomas, eight non-neoplastic). mCryo revealed preserved morphology and no background staining in most of the cases. A 100% of true positivity for EpCAM (21/21), CK7 (21/21) p40 (3/3) and TTF-1 (1/1) in carcinomas matching ICC results. TTF-1 was also true positive in 2/2 benign thyroid nodule samples. CD45 was detected in all samples with both methods, labeling lymphocytes. Calretinin was true positive only in 2/6 effusion samples. CK7 positivity was unexpectedly detected in all melanomas (5/5) by mCryo but not by ICC. Moreover, CD56 was also positive in all carcinomas and melanomas by mCryo (26/26), while only in 9 cases by ICC, raising the question of unspecific staining, antibody cross-reactivity or spectral overlap of fluorochromes. mCryo enables simultaneous evaluation of multiple markers per slide on routinely prepared cytospins, offering potential diagnostic advantages for paucicellular samples. However, further method and panel improvement, and validation are essential for accurate diagnostic implementation into routine practice.

The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is applied widely in reporting salivary gland cytology in adult population; however, there are limited publications on its application in pediatric population and consequently on risk of malignancy (ROM) for each diagnostic category. The aim of this study is to evaluate the ROM for each diagnostic category in the MSRSGC in pediatric patients from different countries using only three published original studies. FNA of the Pediatric salivary gland lesions were assessed from three different studies: 1) Maleki et al., 2) Satturwar et al., and 3) Wang et al and then classified based on the MSRSGC categories: nondiagnostic, non-neoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SM), and malignant. In each study, we reviewed the cases distributed according to the MSRSGC, and recorded the ROM, as well as the available histological follow-up results. The cases across the three different cohort studies showed different distributions using the MSRSGC category. The population of Maleki's cohort study had the highest total patients of around 477 cases. Also, it had the highest number of cases diagnosed as non-neoplastic (34.6%). On the other hand, the paper of Satturwar' s series, had around 32 cases that showed a predominance of benign neoplasms (34.4%). The third research paper by Wang's cohort had around 104 cases that demonstrated a higher proportion of malignant cases (5.8%) relative to total aspirates. The ROM values were also reviewed for each MSRSGC category and showed different outcomes between those three studies. The ROM of "suspicious for malignancy" and "malignant" categories reached 100% in two cohort studies done by Satturwar's and Wang's series versus 60% and 90%, respectively, in Maleki's paper. Histologic follow-up was available for 49.7% of Maleki's, 65.6% of Satturwar' s, and 51.9% of Wang's cases. The ROM for benign neoplasms was consistently low (<5-6%) across studies, while AUS and SUMP categories showed wide interstudy variability (AUS ROM: 20-100%; SUMP ROM: 31.8-67%). This study of 613 salivary gland FNAs in pediatrics confirms that the MSRSGC is applicable on pediatric population with overall high reproducibility. The ROM was lower in benign neoplasm, while it was 100% in SM and malignant categories. Variations on ROM data are most likely due to sample size differences, and patient population and surgical follow-up.