Xin Jing

Morphologic and immunocytochemical performances of effusion cell blocks prepared using 3 different methods

With increased use of the ThinPrep method for nongynecologic specimens, cell blocks are more commonly prepared by harvesting cells that are fixed in CytoLyt solution. The current study compared morphologic and immunocytochemical performance of effusion cell blocks prepared using CytoLyt-prefixed thrombin clot (CTC) with plasma thrombin clot (PT) and HistoGel (HG) preparation. The study included a total of 25 malignant or benign serous fluids. Three individual cell block materials were simultaneously prepared from each of the 25 effusion specimens using the CTC, PT, or HG method. H&E staining and immunostaining for pancytokeratin (pan-CK), carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), B72.3, HBME-1, estrogen receptor (ER), progesterone receptor (PR), CD45, CD20, and CD3 were then performed. The CTC preparation revealed compatible cellularity and good cellular details. In addition, CTC cell blocks revealed a similar percentage of cells with positive immunostaining along with the strongest intensity and the least background staining. The CTC method can be used reliably as an adjunct to other preparation techniques.

Diagnostic yield of ThinPrep preparation in the assessment of fine‐needle aspiration biopsy of salivary gland neoplasms

Fine‐needle aspiration (FNA) has been widely recognized as an important modality in assessment of salivary gland neoplasms, and specimens are often processed as conventional smears. We conducted the current study to evaluate the diagnostic utility of ThinPrep preparation as an alternative method for assessment of salivary gland neoplasms.

Implementing noninvasive follicular thyroid neoplasm with papillary-like nuclear features may potentially impact the risk of malignancy for thyroid nodules categorized as AUS/FLUS and FN/SFN

Noninvasive encapsulated follicular variant of papillary thyroid carcinoma (PTC) has recently been reclassified as noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP). Implementation of the new terminology may alter the implied risk of malignancy (ROM) across the six categories of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC).

Cytologic Features and Immunocytochemical Profiles of Malignant Effusions with Metastatic Papillary Thyroid Carcinoma: A Case Series from a Single Institution

Objective: Malignant effusions due to papillary thyroid carcinoma (PTC) are rare, but portend a poor prognosis. PTC metastases, although rare, most frequently occur in the lungs and bone. Therefore, differentiating thyroid etiology of malignant effusions from other sites becomes clinically significant in patient management. This study examines morphologic and immunocytochemical findings in 5 cases of malignant effusions with PTC involvement. Study Design: The electronic database at the University of Michigan was searched from January 1, 1995 to December 31, 2014 for malignant pleural effusions with PTC involvement. Clinicopathologic data were obtained from electronic medical records. Cytologic slides were reviewed. Results: Five cases of malignant effusions due to PTC were identified. Characteristic cytologic features of PTC, including ovoid nuclei, irregular nuclear contours, and psammomatous calcifications, were seen. However, the predominant cytologic feature observed was moderate amounts of delicate to vacuolated cytoplasm within the tumor cells. A review of immunocytochemistry demonstrated that all 5 cases showed patchy to diffuse TTF-1 positivity and diffuse positivity for Pax-8. Thyroglobulin only showed focal to patchy positivity in 3 of 5 cases. Conclusion: Given the morphologic features found in our case series, an immunocytochemical workup for the evaluation of involvement of an effusion by a thyroid primary is crucial for accurate diagnosis and appropriate clinical treatment.

Committee II: Guidelines for cytologic sampling techniques of lung and mediastinal lymph nodes

The Papanicolaou Society of Cytopathology has developed a set of guidelines for pulmonary cytology including indications for bronchial brushings, washings, and endobronchial ultrasound guided transbronchial fine‐needle aspiration (EBUS‐TBNA), technical recommendations for cytological sampling, recommended terminology and classification schemes, recommendations for ancillary testing and recommendations for post‐cytological management and follow‐up. All recommendations are based on the expertise of the authors, an extensive literature review and feedback from presentations at national and international conferences. This document selectively presents the results of these discussions. The present document summarizes recommendations regarding techniques used to obtain cytological and small histologic specimens from the lung and mediastinal lymph nodes including rapid on‐site evaluation (ROSE), and the triage of specimens for immunocytochemical and molecular studies.