Pinar Firat

Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology.

To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma (MM). Cytopathologists involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC), who have an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists, who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in cape town. During the previous IMIG biennial meetings, thorough discussions have resulted in published guidelines for the pathologic diagnosis of MM. However, previous recommendations have stated that the diagnosis of MM should be based on histological material only.[12] Accumulating evidence now indicates that the cytological diagnosis of MM supported by ancillary techniques is as reliable as that based on histopathology, although the sensitivity with cytology may be somewhat lower.[345] Recognizing that noninvasive diagnostic modalities benefit both the patient and the health system, future recommendations should include cytology as an accepted method for the diagnosis of this malignancy.[67] The article describes the consensus of opinions of the authors on how cytology together with ancillary testing can be used to establish a reliable diagnosis of MM.

The Bethesda system for reporting thyroid cytopathology: an institutional experience of the outcome of indeterminate categories

In this study, we investigated the efficacy of the Bethesda system (TBS) for reporting thyroid cytopathology in determining the risk of malignancy for indeterminate cases. These cases comprised atypia or follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasia or suspicious for follicular neoplasia (FN/SFN) and suspicious for malignancy (SM) categories. AUS/FLUS cases were further subcategorized according to their patterns, and the malignancy rate for each subcategory was calculated.

Effect of neostigmine on organ injury in murine endotoxemia : Missing facts about the cholinergic antiinflammatory pathway

Electrical and pharmacologic stimulation of the efferent cholinergic antiinflammatory pathway suppress the systemic inflammatory response and can prevent lethal endotoxemia. Neostigmine, a cholinergic agent, has not been tested to determine if it can prevent histopathologic organ injury in endotoxemia. In the present study, the effects of neostigmine treatment on the histopathologic organ injury inflicted by Escherichia coli endotoxin in a mouse model of septic shock was investigated. Endotoxemia in mice caused weight loss and increased spleen, liver, and lung weight. When the organs were examined for histopathologic injury, endotoxemia increased interstitial inflammation in the lungs, liver injury, and organ injury in general terms; neostigmine, at a dose of 0.1 mg/kg, failed to attenuate these effects. Although the simultaneous administration of neostigmine at a dose of 0.3 mg/kg and endotoxin decreased interstitial inflammation in the lungs, vacuolar degeneration in the liver, and total liver injury, mortality was increased with this dose in the presence of endotoxemia. We conclude that neostigmine at a dose of 0.1 mg/kg was not protective against histopathologic organ injury in mice with endotoxemia, and a higher dose (0.3 mg/kg) was not tolerated probably owing to nonspecific parasympathetic action including cardiovascular effects. Further studies are required to determine the contribution of sites in the cholinergic antiinflammatory pathway.

The diagnostic yield of transbronchial needle aspiration in superior vena cava syndrome

Superior vena cava syndrome (SVCS) requires a timely histopathological diagnosis for appropriate management. We prospectively evaluated the diagnostic yield and complications of transbronchial needle aspiration (TBNA) among patients with SVCS in a tertiary care university hospital. From February 1996 to April 2000, 27 consecutive patients referred with clinical SVCS without a prior diagnosis underwent flexible bronchoscopy and TBNA. The ultimate diagnoses were small cell carcinoma (SCLC) in 15 patients, non-small cell lung carcinoma (NSCLC) in 11, and non-Hodgkin lymphoma in one patient. TBNA was diagnostic in all 26 patients with bronchogenic carcinoma, but not in lymphoma, which was subsequently diagnosed via thoracotomy. The overall diagnostic yield of TBNA was 96%, and the 95% confidence interval (CI) of diagnostic yield was 80-100%. TBNA solely provided the diagnosis in nine patients with NSCLC (82%), and in seven with SCLC (47%), and confirmed the diagnosis established via forceps biopsy in ten patients. Age, gender, radiological involvement and TBNA site were comparable in cases with and without forceps biopsy. There was no major complication related to either flexible bronchoscopy or TBNA. We concluded that TBNA is safe and has a high diagnostic yield in SVCS caused by bronchogenic carcinoma.

Guidelines for the Cytopathologic Diagnosis of Epithelioid and Mixed-Type Malignant Mesothelioma

Objective: To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma. Data Sources: Cytopathologists with an interest in the field involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC) contributed to this update. Reference material includes peer-reviewed publications and textbooks. Rationale: This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in Cape Town.

Guidelines for the cytopathologic diagnosis of epithelioid and mixed-type malignant mesothelioma: Complementary Statement from the International Mesothelioma Interest Group, Also Endorsed by the International Academy of Cytology and the Papanicolaou Socie: IMIG Guidelines for the Pathologic Diagnosis of MM

To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma.

Cystic lesions of the head and neck: cytohistological correlation in 63 cases

Objective:  To investigate the accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of cystic masses of the head and neck (H&N), excluding thyroid lesions.

Sclerosing angiomatoid nodular transformation (SANT) of spleen: a case report describing cytology, histology, immunoprofile and differential diagnosis

Benign splenic lesions are frequently vascular or inflammatory in origin. These lesions may pose diagnostic difficulties pre-operatively because they may mimic malignant tumours both clinically and radiologically. In such conditions, a splenectomy is often performed for diagnostic and ⁄ or therapeutic purposes. Sclerosing angiomatoid nodular transformation (SANT) is such a lesion that has been recently described as a reactive condition rather than a true neoplasm. The aim of this report is to describe the cytology, histopathology and immunohistochemical features of SANT from a splenectomy that was carried out for a radiological suspicion of angiosarcoma. Cytological smears were carried out postoperatively from the excised fresh specimen for an educational purpose. To our knowledge, this is the first report of cytological features of SANT in the literature.

Fine-needle aspiration cytology of solitary thyroid nodules: how far can we go in rendering differential cytologic diagnoses?

Fine-needle aspiration cytology (FNAC) is a diagnostic tool used in the clinical workup of solitary thyroid nodules; however, differential cytologic diagnosis of these nodules often is challenging. With the goal of identifying cytologic findings that could improve predictions regarding the presence of neoplastic lesions, the authors performed a retrospective review of cases in which FNAC led to diagnoses of solitary cellular nodules or cellular microfollicular lesions at two university hospitals. FNAC smears associated with cases for which surgical specimens subsequently were obtained were reviewed. FNAC accurately detected follicular neoplasms in 76% of cases at one hospital and in 67% of cases at the other. In the current report, the cytologic findings made in these cases are reevaluated, and the potential diagnostic contribution of available clinical data is discussed. Cancer (Cancer Cytopathol) 2004.

Mammographic features of nonpalpable spiculated lesions

OBJECTIVE To evaluate the mammographic features of nonpalpable spiculated lesions in order to find differentiating findings between malignant and benign pathologies. MATERIALS AND METHODS Standard mammograms of 27 patients with 28 nonpalpable spiculated lesions were evaluated retrospectively. Two dimensions of dense centre of the spiculated lesions were measured and the mean dimensions were compared in analysing the malignant and benign features. Fine radiolucent lines between dense spicules were noted. RESULTS Thirteen spiculated lesions (46.4%) were malignant and 15 were benign. Eleven malignant lesions (84.6%) have dense centre larger than 5 mm, whereas only four benign lesions (26.7%) had a dense core larger than 5 mm. There were fine radiolucent lines parallel to dense spicules in 5 malignant lesions (38.5%) and in 13 benign lesions (86.7%). Only one invasive carcinoma and one radial scar with florid ductal epithelial hyperplasia and papillomatosis had punctate calcifications. The sensitivity and specificity of the dense core larger than 5 mm for malignancy were 84.6% and 73.3%, respectively. The sensitivity of radiolucent lines for benign lesions was 86.7% and the specificity was 61.5%. CONCLUSION When the dense centre of a nonpalpable spiculated lesion is larger than 5 mm, the probability of malignant pathology increases. The fine radiolucent lines between dense spicules may indicate benign etiology. However, there is no reliable mammographic feature differentiating benign spiculated lesions from carcinomas. Therefore, all of them should be diagnosed pathologically unless they are postsurgical.