Cytological Aspects Research Articles

Cytologic and Clinicopathologic Features of Papillary Thyroid Carcinoma with Prominent Hobnail Features on FNAC.

The hobnail variation of papillary thyroid cancer (PTC) is an uncommon, aggressive variety with hobnail characteristics on more than 30% of the tumour cells. Because of the entity's rarity, the clinical behaviour and pathologic characteristics of these tumours are still unknown. The purpose of this case study was to look at the cytologic, clinical, and pathological aspects of the hobnail variant of PTC, because of its severe clinicopathologic features and poor outcome, the unusual hobnail type of PTC may necessitate more aggressive treatment than traditional PTCs. The cytologic features of the hobnail variety are distinctive, and FNAC specimens can be used to provide a preoperative diagnosis. Diagnostic parameters for proportion of hobnail morphology need to be refined further. More research is needed to understand how detection of this high-risk variation affects clinical treatment.

New edition of the Paris classification 2022: What is new?

As an internationally accepted diagnostic system, the Paris classification has achieved aglobal breakthrough in the standardization of diagnoses in urine cytology. Based on experience over the past few years since its first publication, the new edition of the Paris classification refines the diagnostic criteria and discusses diagnostic pitfalls. While the detection of high-grade urothelial carcinoma remains the main focus, other aspects of urine cytology, including cytology of the upper urinary tract and the associated challenges, have also been addressed. Low-grade urothelial neoplasia is no longer listed as aseparate category but is now included in the category "negative for high-grade urothelial carcinoma" (NGHUC). Essentially, the Paris classification provides an important basis for estimating the risk of malignancy and further clinical management.

Bethesda Category III thyroid nodules: descriptive cytological aspects of a series

BackgroundThe Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is used for cytopathological diagnosis of fine needle aspiration (FNA) of thyroid nodules (TN). Diagnosis of Bethesda Category III (CIII) has estimated malignancy rates of around 10%-30%, which vary between different institutions. Objective. To review cases of FNA interpreted as CIII thyroid nodules. To evaluate cytopathological criteria used to interpret FNA for CIII thyroid nodules and the associations between cytological and radiological aspects. To determine the malignancy rate of thyroid nodules classified as CIII, based on the correlation with surgical procedure. Methods. Retrospective study of FNA’s cytologic criteria of TN classified as CIII, carried out between 2010 and 2016. The patients included in the study were those who underwent the first FNA in the service and who were diagnosed with CIII. The patients had their cytological slides and medical records reviewed to detect the conduct flow followed after the CIII diagnosis. All cases that had histological slides available of their thyroidectomy products, total or partial, reviewed. The associations between clinical, histological and cytological findings were statistically studied. Results. Among 63 patients with resected nodules, 17 (27%) were malignant, 13 of which were papillary thyroid carcinomas. Among the benign cases, 18 patients (28.1%) had chronic lymphocytic thyroiditis/Hashimoto’s thyroiditis. Papillae (p = .004) was the criterion best associated with the diagnosis of malignancy. Conclusion. The malignancy rate was consistent with the rate of malignancy predicted in the TBSRTC. It is important to point out that the sample of this study is relatively small, which compromises specific evaluations and reduces the robustness of the observed data. CIII is extensively studied in the literature, however there is still a need for more precise studies regarding the correlations between cytological findings and other parameters. Probably, more than other categories, CIII may require a combination of cytological, radiological and clinical interpretation, with pathology leading role in this diagnosis process.

Cytological and microbiotic aspects of the diagnosis of otitis externa in dogs

The purpose of the study was to compare cytological samples from two consecutive swabs obtained from ear canals of dogs with otitis externa and to determine the minimum number of samples required to obtain up-to-date information on the degree of microbiological contamination of the affected ear canals. Samples were obtained using sterile applicators with a cotton tip, which were sequentially inserted into ear canal until slight resistance (the junction between vertical and horizontal parts of ear canal), after making a circular motion, the applicator was removed and the material from the tip was applied to the glass slide with rolling movements so that on each slide there were four single parallel smears - two from each ear of the dog. The slides were air dried for one hour and stained using the standard Diff-Quick method. The actual counting was carried out at 1000 magnification (at a high magnification field). Bacteria were differentiated according to their shape into cocci and bacilli. The numbers of bacteria and fungi in the two samples were compared using the Wilcoxon matched pair test. Qualitative agreement between two consecutive swabs was determined using the k-test. Among the studied animals, a breed predisposition to otitis externa was revealed in Cocker Spaniels and French Bulldogs, and an anatomical predisposition in animals with drooping auricles. There was no significant difference in the number of microorganisms present in two ear cytology samples taken consecutively from the same ear at the same site in the external auditory canal, and there was significant agreement between the results of two consecutive smears for the presence of cocci and rods. For yeast, the agreement was only moderate. The data obtained indicate that in cases of otitis externa in dogs, reproducibility of cytological pattern with a single sample of material, as a rule, reflects current stage of pathogenesis of the disease and provides the best opportunity to detect local proliferative activity of opportunistic microbiota and corresponding inflammatory response of the macroorganism.

Concordance of in vivo reflectance confocal microscopy and horizontal-sectioning histology in skin tumours.

In vivo reflectance confocal microscopy (RCM) enables the study of architectural and cytological aspects in horizontal sections, which closely correlate with histologic features. However, traditional histopathological vertical sections cannot totally reproduce the image of the in vivo RCM horizontal section. To evaluate the concordance between in vivo RCM and histopathologic transverse sections for melanocytic lesions, basal cell carcinoma and seborrheic keratoses. Prospectively collected benign melanocytic and non-melanocytic tumours diagnosed by dermoscopy were evaluated for common RCM features and compared to histopathology in horizontal sections with haematoxylin and eosin staining. A total of 44 skin tumours including 19 melanocytic lesions (nine compound, five junctional and five intradermal nevi), 12 basal cell carcinomas and 13 seborrheic keratoses were collected in the Department of Dermatology of Hospital Clinic of Barcelona. The RCM features that had statistically significant agreement with the histopathological horizontal sections were the preserved and visible honeycomb pattern, well defined DEJ, small bright particles, dermal nests, tumour islands and dark silhouettes, clefting, collagen bundles, thickened collagen bundles and cytologic atypia. Histopathology evaluation of horizontal sections of skin tumours can be correlated with main RCM findings. The results of this study have improved the understanding and interpretation of RCM features in relation to skin tumours, thus reinforcing the utility of RCM as a diagnostic tool.

A Triple-Targeted Rutin-Based Self-Assembled Delivery Vector for Treating Ischemic Stroke by Vascular Normalization and Anti-Inflammation via ACE2/Ang1-7 Signaling.

Changes in the cerebral microenvironment caused by acute ischemic stroke-reperfusion are the main obstacle to the recovery of neurological function and an important cause of stroke recurrence after thrombolytic therapy. The intracerebral microenvironment after ischemia-reperfusion reduces the neuroplasticity of the penumbra and ultimately leads to permanent neurological damage. To overcome this challenge, we developed a triple-targeted self-assembled nanodelivery system, which combines the neuroprotective drug rutin with hyaluronic acid through esterification to form a conjugate, and then connected SS-31, a small peptide that can penetrate the blood brain barrier and target mitochondria. Brain targeting, CD44-mediated endocytosis, hyaluronidase 1-mediated degradation, and the acidic environment synergistically promoted the enrichment of nanoparticles and drug release in the injured area. Results demonstrate that rutin has a high affinity for ACE2 receptors on the cell membrane and can directly activate ACE2/Ang1-7 signaling, maintain neuroinflammation, and promote penumbra angiogenesis and normal neovascularization. Importantly, this delivery system enhanced the overall plasticity of the injured area and significantly reduced neurological damage after stroke. The relevant mechanism was expounded from the aspects of behavior, histology, and molecular cytology. All results suggest that our delivery system may be an effective and safe strategy for the treatment of acute ischemic stroke-reperfusion injury.

Review on tapetal ultrastructure in angiosperms

The appearance of new cellular structures and characteristics in the tapetum suggests that there is still much to discover that would help to better understand the tapetum functions. The ultrastructure of the tapetum provides important information for the understanding of the functions performed by this tissue. Since there are no reviews on the subject, we aim to collect all the detailed information about the tapetum ultrastructure present until this moment in order to lay the foundations for future research. Detailed information on the tapetal ultrastructure of 80 species from 45 different families: 2 species with invasive non-syncytial tapetum, 11 with plasmodial and 67 with a secretory tapetum was collected. These studies allowed to establish (a) the most usual cytological characteristics of this tissue, (b) unique characteristics and/or cellular structures in tapetum cells, (c) the ultrastructural changes that occur in different types of tapetum, during the progress of microsporogenesis and microgametogenesis, and (d) the most recognized ultrastructural traits of the tapetum that cause androsterility. The structure of these cells is related to their function in each developmental stage. Since most species present their particular ultrastructure and may sometimes, share some traits within families, there is not a model plant on tapetum ultrastructure. However, knowing the general cytological aspect of the tapetum may help distinguish between patterns of cytoplasmic disorganization due to tapetum degeneration from technical failures of the preparation. Moreover, as the amount of species analyzed increases, unknown tapetal organelles or traits may be identified that might be associated to particular functions of this tissue. On the other hand, different ultrastructural changes may be related to the metabolisms and the regulation of normal/abnormal tapetum development.

An emerging era of computational cytology.

The significant advancement in digital imaging, data management, advanced computational power, and artificial neural network have an immense impact on the field of cytology. The amalgamation of these areas has generated a newer discipline known as computational cytology. In To discuss the various important aspects of computational cytology. We reviewed the different studies published in English during the last few years on computational cytology. Computational cytology is a newer and emerging discipline in pathology that deals with the patient's meta-data and digital image data to make a mathematical model to produce diagnostic interpretations and predictions. The role of the cytologist is now changing from a simple observational scientist and slide interpreter to a dynamic and integrated multi-parametric prediction-based scientist. In the current stage, the cytologist must understand the situation and should have a vision of the complete scenario on computational cytology.

The use of multilayer perceptron and radial basis function: an artificial intelligence model to predict progression of oral cancer.

The use of multilayer perceptron and radial basis function: an artificial intelligence model to predict progression of oral cancer.

Atypical cytologic mantle cell lymphoma presentation.

A 61-year-old patient presents with monoclonal B lymphocytosis diagnosed in 2014 with initial moderate splenic involvement without any clinical symptoms. In 2021, during a follow-up workup, a Positron Emission Tomography scan is performed objectifying homogeneous splenic involvement with moderate colonic hypermetabolism. Cytology showed a monoclonal lymphocytosis composed of small lymphocytes with mature chromatin and high nucleocytoplasmic ratio regularly displaying small cytoplasmic expansions (A: May-Grunwald-Giemsa stain, 50× objective, B: May-Grunwald-Giemsa stain, 100× objective). Immunophenotyping brought to light a monoclonal population that is CD19+ CD20+ CD5+ CD23− CD43− CD10− CD200− CD38− with a Matutes score at 1/5. Furthermore, cytogenetic analysis was performed showing an IGH/CCND1 translocation (11;14) with loss of TP53 in all nuclei analyzed. These elements are all in favor of mantle cell lymphoma diagnosis. However, this cytological presentation is very atypical, the presence of small cells with blebs not being classical in this lymphoma but more in prolymphocytic leukemia for example. This case thus presents a very particular cytological aspect of mantle cell lymphoma blood dissemination and the importance of cytogenetic analysis and immunophenotyping in addition to cytology (Figure 1). The data that support the findings of this study are available on request from the corresponding author. The authors received no specific funding for this work. No research on human was performed on this study. Dr Chea Mathias wrote the manuscript and took pictures. Dr Loyens helped with cytometry analysis. No new data were created or analyzed in this study. The data that support the findings of this study are available on re-quest from the corresponding author.

The cytological Aspect of Clinically Concerned Supraclavicular lymphadenopathy- a Prospective Study

Aims: The purpose of the study was to find out the distribution of various diseases in supraclavicular lymphadenopathy by fine-needle aspiration cytology (FNAC) and to study cytomorphological findings in detail.
 Study Design: The present study was a prospective study.
 Place and Duration of Study: Department of Pathology, Dr. DY Patil medical college and research centre, DY Patil Vidyapeeth, Pune, Maharashtra, India. The study was conducted over a period of 2 years (i.e., September 2019 to August 2021).
 Methodology: Fine needle aspirations (FNA) were performed in 50 cases of supraclavicular lymphadenopathy after obtaining written consent. The cytomorphological features of stained smears were studied in detail.
 Results: A total of 50 aspirates were studied. The male to female ratio found was 2:3. The age of the patients ranged from 9 yrs to 81 yrs. The maximum number of cases were found in the elderly (>60 yrs). A predominance of right-sided lymphadenopathy was seen. Diagnosis based on FNAC findings were categorized as metastatic deposits (34% cases), tubercular lymphadenitis (16% cases), reactive lymphadenitis (14% cases), granulomatous lymphadenitis (14% cases), acute suppurative lymphadenitis (12% cases), necrotizing lymphadenitis (8% cases) and one NHL (2% case).
 Squamous cell carcinoma (14% cases) was the most commonest metastatic lesion followed by adenocarcinoma (10% cases). Common primary sites were the breast, lung, and gall bladder for adenocarcinoma, whereas the oesophagus and tongue for squamous cell carcinoma.
 Conclusion: Supraclavicular node was well known for metastasis but non-malignant cause like tuberculosis is frequently found in developing countries. Enlarged supraclavicular nodes suggest some underlying pathology and chances of malignancy increase with the age of the patient. FNAC can be used as a first-line investigation for diagnosis because of its simplicity, cost-effectiveness, and efficacy to rule out metastasis.

Comparative Transcriptome Analysis of Anthocyanin Biosynthesis in Pansy (Viola × wittrockiana Gams.)

Pansy (Viola × wittrockiana Gams.) is an important and attractive ornamental plant with a wide variety of flower colors. To date, the molecular genetic understanding of its colorful petal pigment patterns remains largely unknown. In this study, we analyzed the bicolor petals of “Mengdie” in cytological, physiological, and transcriptomic aspects. Results showed that the difference of flower colors was mainly determined by the pigment distribution in the epidermal cells. Pigment analysis indicated that anthocyanins had strong correlations with color parameters, which acted as the main factor in flower coloration. Comparative transcriptome analysis found a total of 43,908 unigenes with the mean length of 682 bp. There were 24,323, 16,668, 8507, and 7680 unigenes annotated in the Nr, Swiss-Prot, KOG, and KEGG databases, respectively. Differential expression genes (DEGs) showed that the expression of anthocyanin late biosynthesis genes (LBGs), VwF3′H, VwF3′5′H, and VwUFGT, would be likely to play a major role in the color formation of pansy. The expression patterns of selected DEGs were verified by qRT-PCR. This study contributes an excellent insight into molecular mechanism of pigment biosynthesis and provides some useful information for flower color modification in pansy.

New aspects in fine needle biopsies of the lymph nodes

The cytology of lymph nodes is acost-effective method with ashort turnaround time and low risk to patients that delivers valuable information on the cause of the lymphadenopathies. To discuss the value of lymph node cytology in the diagnosis of lymph node swellings. Analysis of the causes of the controversially discussed aspects of lymph node cytology. Presentation of the diagnostic groups of lymph node cytology according to the Sydney system. The technical aspects of lymph node sampling during fine needle biopsy, as well as the subsequent preparation of the correctly fixed direct smears and the triage of the sample for the auxiliary studies, may pose asignificant challenge for some puncturers. The whole spectrum of modern pathologic auxiliary studies can be applied to correctly triaged cytologic samples. The diagnoses of fine needle biopsies of the lymph nodes can be divided into five groups according to the recently proposed Sydney reporting system: insufficient/non-diagnostic, benign, atypical, suspicious, and malignant. Further details concerning the diagnosis as well as recommendations on how to proceed are additionally included in cytologic reports. The improvement of lymph node sampling as well as the technical aspects of the sample handling, including the application of auxiliary studies, considerably increase the diagnostic value of fine needle biopsy of the lymph nodes. Wide implementation of the usage of the diagnostic groups for reporting fine needle biopsies of the lymph nodes can standardize reporting and improve communication with other clinical specialists.

Cytological aspects of an endometrial dedifferentiated carcinoma that was associated with a highly aggressive clinical course

背景：子宮内膜脱分化癌は分化傾向の不明瞭な癌腫である未分化癌に低異型度の類内膜癌が混在するまれな腫瘍である．われわれは術前の子宮頸部細胞診にて未分化癌由来の細胞，内膜細胞診にて分化型腺癌と未分化癌由来の細胞を認めた子宮内膜脱分化癌の 1 例を経験したので報告する．

A clear cell hepatocellular carcinoma in an obese dog with hyperlipidemia: a case report

An 11-year-old obese dog was referred for a liver mass. Cytologic examination revealed vacuolated hepatocytes with mild pleomorphism. A partial liver lobectomy was performed. On histopathologic examination, the mass was diagnosed as hepatocellular carcinoma composed of hepatocytes with clear vacuoles. These findings were consistent with clear cell hepatocellular carcinoma (CCHCC). The CCHCC is a rare subtype of hepatocellular carcinoma in dogs, and clinical features are poorly defined. This is the first report on the cytological, histological and clinical aspects of CCHCC, suggesting that obesity and hyperlipidemia are potential risk factors for CCHCC in dogs.

Recherche de cellules de surcharge dans le sang : enquête de pratique

AbstractIdentification in blood films of storage cells and/or vacuolated lymphocytes is a precious usefulness to diagnose lysosomal storage disease. However, this screening is fully prescribed and cytological aspects sometimes not well known. The French Cellular Hematology Group (GFHC) has decided to investigate members’ practices through a survey. Because of the important variability in screening storage cells on blood film examination, the GFHC, aimed to establish recommendations for practical harmonization.

Epidemiological and cytological aspects of cervical dystrophies in SENEGAL using cervico-uterine smears

To identify the different types of cervical dystrophy in the DAKAR region and make a comparison between the epidemiological and cytological aspects. 2391 cases of significant cervico-uterine smears performed in the period from August 1, 2014 to June 1, 2016. Data collection was performed at the laboratory of Cytology, Cytogenetics and Reproductive Biology of the CHU Aristide Le Dantec. The average age of the patients was 47.72 years. Patients referred for routine check-ups with no apparent clinical manifestations represented 43.16 %. The women with more than 5 children were 8.67 %, sometimes with multiple abortions. Infectious dystrophies accounted for 54.37 %. Cervical dystrophy are benign lesions that could, by their persistence, lead to low-grade epithelial lesions.

Epidemiological and cytological aspects of the cervix in women from the Diourbel region (Senegal) cervical smear screening

To record the results of uterine cervical smear tests of women in the Diourbel region to compare epidemiological data with the results of uterine cervical smear tests. This is a retrospective study of 201 satisfactory cervical smears performed in the period from 01 December 2018 to 01 December 2019 at the laboratory of the regional hospital Henrich Lubcke of Diourbel. All women with a satisfactory smear were included in our study, so we classified patients according to age and parity. The mean age of the patients was 38.41 years with a standard deviation of 11.51 years. The extremes were 15 and 64 years. The age group [30-40 years] was in the majority at 32.34%. Multiparous patients were in the majority, accounting for 43.28%. The cervix was macroscopically healthy in 61.19% of patients and inflammatory in 12.94%. There was 18.41% LSIL, HSIL accounted for 1% of smears. A statistically significant relationship existed between parity and smear result with P ˂ 0.01. Cervical cancer is one of the most fatal cancers in women and the smear remains the safest and most effective means of prevention.

AML-215: Successful Management of an Unusual Fournier’s Gangrene Secondary to Post-Transplant AML

Fournier's Gangrene is known to be one of the rarest and potentially lethal necrotizing infections of the perineum and genital region with high mortality. We report an unusual case of a 34-year-old male presenting to Saint Antoine Hospital in June 2020 after 6 months of severe pain, a mass in the anal and perineal area with blackish discoloration, and painful swelling of the scrotum and the penis. A likely diagnosis of necrotizing fasciitis associated with high-grade fever and sepsis was made. An immediate surgical debridement, colostomy, and suprapubic catheter were done, along with broad-spectrum antibiotics. Per medical history, in 1999, he had an amputation of the left foot after diagnosis with osteosarcoma and lung metastasis, followed by chemotherapy. A new evaluation was done in 2003 and showed progressive lung lesions treated with right lobectomy. In January 2010, the patient presented a blood test with pancytopenia and 14% of circulating blasts. Bone marrow aspiration (BMA) was done and showed an AML secondary to chemotherapy (t-AML) with complex karyotype of chromosome 5 and chromosome 17. Induction chemotherapy with 4 cycles of Vidaza + Revlimid from January 2010 to April 2010 led to partial response. In May 2010, bone marrow biopsy showed signs of dysmyelopoiesis with young elements of a dispersed blastic appearance of myeloid origin without excess blasts and no signs of osteosarcoma. In June 2010, the patient had a successful haploidentical allotransplant from his brother. After presenting with Fournier's Gangrene in June 2020, his blood tests showed anemia (Hb 8.6g/dL), thrombocytopenia (127g/L), and blast cells (12%). Biopsies of the genital mass showed diffuse proliferation of malignant cells, and immunohistochemistry tests came back as CD34+, CD117+, MPO-, Glycophorine +/-, CD68-/+, ACL-/+, CD163-, AE1/AE3-, Ki67%, and EBER-. BMA showed a rich marrow invaded by 50% of blasts with a cytologic aspect of AML. After controlling the Fournier's Gangrene by surgery and antibiotics, the patient was started on a new line of treatment with Vidaza/Venetoclax (July 2020). A new BMA done in September showed a complete biologic response with 1% blasts. The decision was made to continue 4 cycles of chemotherapy. The recovery phase was uneventful with satisfactory cosmetic results.

Testicular seminoma in a dog and its clinical, ultrasonographic, cytological and histopathological aspects: case report

Neoplasms are amongst the main death causes in dogs, with the testis as the second most affected tissue in non-neutered male dogs and seminoma as one of the most common type. In this study, a 12-years-old non-neutered male teckel dog was attended with no perceived clinic. The ultrasound examination revealed a hypoechogenic nodule of ellipsoid shape and slightly heterogeneous echotexture in right testis. The animal was referred for bilateral orchiectomy and histopathological evaluation confirmed the presence of diffuse seminoma in the right testicle and testicular degeneration in both testes. Prognostic factors evaluated in histopathology designated resolution with orchiectomy.