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Syed Z. Ali 3 Articles
Cytotechnologists and On-Site Evaluation of Adequacy
Jennifer A. Collins, Anna Novak, Syed Z. Ali, Matthew T. Olson
Korean J Pathol. 2013;47(5):405-410.   Published online October 25, 2013
  • 9,345 View
  • 64 Download
  • 22 Citations
AbstractAbstract PDF

While fine needle aspiration (FNA) is certainly not a new biopsy technique, recent developments in advanced imaging techniques, molecular testing, and targeted therapies have coincided with a rapid increase in the number of FNA procedures being performed. Concurrently, the demand for on-site evaluation of adequacy (OSEA) has also increased, outstripping the capacity of available cytopathologists at some institutions. Among the several alternatives to cytopathologist-performed OSEA, cytotechnologist-attended OSEA stands out because it preserves the representation of the pathology service at the time of the procedure. Herein, we review the current literature about OSEA and the necessity of cytotechnologists to expand access of this useful pathology service to a broader patient population. We also examine how cytotechnologists are likely to fit into the emerging practice of telecytology.


Citations to this article as recorded by  
  • Performance of Rapid On-Site Evaluation in Breast Fine-Needle Aspiration Biopsies: Identifying Areas of Diagnostic Challenge
    Vanda F. Torous, Silvia Huerta Lopez, Christine Xu, Brenda J. Sweeney, Martha B. Pitman
    Acta Cytologica.2022; 66(1): 1.     CrossRef
  • Role of cytotechnologists in rapid onsite adequacy assessment of cytology materials for diagnostic workup and specimen allocation for ancillary testing using a standardized protocol
    Russel Fetzer, Michelle Duey, Valerie Pena, Dana Wanzer, James Kirkpatrick, Donnie Chau, Venetia R. Sarode
    Journal of the American Society of Cytopathology.2020; 9(2): 67.     CrossRef
  • Review of different platforms to perform rapid onsite evaluation via telecytology
    Keluo Yao, Zaibo Li
    Cytopathology.2020; 31(5): 379.     CrossRef
  • Results from the 2019 American Society of Cytopathology survey on rapid onsite evaluation (ROSE)–part 2: subjective views among the cytopathology community
    Jennifer L. Sauter, Yigu Chen, Deepu Alex, Ronald Balassanian, Jackie Cuda, Melina B. Flanagan, Christopher C. Griffith, Peter Illei, Daniel N. Johnson, Cindy M. McGrath, Melissa L. Randolph, Jordan P. Reynolds, Amy J. Spiczka, Annemieke van Zante, Paul A
    Journal of the American Society of Cytopathology.2020; 9(6): 570.     CrossRef
  • Comparison of Number of Passes and Cytopathological Specimen Adequacy for Thyroid Fine-Needle Aspiration Biopsy in the Absence of an On-Site Pathologist
    Taha Yusuf Kuzan, Ceren Canbey Goret
    European Thyroid Journal.2020; 9(1): 49.     CrossRef
  • Rapid on-site evaluation using telecytology: A major cancer center experience
    Oscar Lin, Dorota Rudomina, Rusmir Feratovic, S. Joseph Sirintrapun
    Diagnostic Cytopathology.2019; 47(1): 15.     CrossRef
  • ROSE: Alternative for Cancelled and Inconclusive Cytopathologic Examinations, as Well as Professional Training at the UNESP-Botucatu Veterinary Hospital
    Fabiane Andrade Correia Neiva, Eduardo Eburnio, Paula de Sanctis, Nayara Maria Gil Mazzante, Noeme Sousa Rocha
    Open Journal of Veterinary Medicine.2019; 09(09): 121.     CrossRef
  • Endosonographer-driven dynamic telecytopathology of pancreatic lesions—a pilot study
    Benjamin Tharian, Konrad Krall, Xiang Zhu, Nayana George, Michael Chambers, Shyam Varadarajulu, Shantel Hebert-Magee
    Journal of the American Society of Cytopathology.2018; 7(2): 86.     CrossRef
  • Telecytology for rapid on-site evaluation: current status
    Oscar Lin
    Journal of the American Society of Cytopathology.2018; 7(1): 1.     CrossRef
  • Rapid On-Site Evaluation of Fine-Needle Aspiration by Non-Cytopathologists: A Systematic Review and Meta-Analysis of Diagnostic Accuracy Studies for Adequacy Assessment
    Lauren Pearson, Rachel E. Factor, Sandra K. White, Brandon S. Walker, Lester J. Layfield, Robert L. Schmidt
    Acta Cytologica.2018; 62(4): 244.     CrossRef
  • Fine needle aspiration biopsy cytology of phyllodes tumour and fibroadenoma: A cytomorphological study of 104 cases
    Xue Yu Wang, Hema Mahajan, Nicole Dickinson, Carol Cox, Karen Byth, Angela Bayly, Michael A. Cahill, Nirmala Pathmanathan
    Diagnostic Cytopathology.2018; 46(11): 927.     CrossRef
  • Chapter 7 Image-Guided Fine-Needle Aspiration and Core Needle Biopsy of Neck Lymph Nodes: Techniques, Pearls, and Pitfalls
    Amir A. Borhani, Sara E. Monaco
    Seminars in Ultrasound, CT and MRI.2017; 38(5): 531.     CrossRef
  • Cytologic rapid on-site evaluation of transthoracic computed tomography–guided lung needle biopsies: who should perform ROSE? A cross-institutional analysis of procedural and diagnostic outcomes
    Jonathan D. Marotti, Kavitha P. Rao, Kathriel J. Brister, Edward J. Gutmann, Michael J. Tsapakos, Robert Sheiman, Helen H. Wang, Paul A. VanderLaan
    Journal of the American Society of Cytopathology.2015; 4(3): 160.     CrossRef
  • When Is Rapid On-Site Evaluation Cost-Effective for Fine-Needle Aspiration Biopsy?
    Robert L. Schmidt, Brandon S. Walker, Michael B. Cohen, Fernando Schmitt
    PLOS ONE.2015; 10(8): e0135466.     CrossRef
  • Cytotechnologist Performance for Screening Hürthle Cell Atypia in Indeterminate Thyroid Fine-Needle Aspirates
    Christopher J. VandenBussche, Christina Adams, Syed Z. Ali, Matthew T. Olson
    Acta Cytologica.2015; 59(5): 377.     CrossRef
  • Xylazine-ketamine immobilization and propofol anesthesia for surgical excision of sebaceous adenoma in a jaguar (Panthera onca)
    M. Bharathidasan, R. Thirumurugan, B. Justin William, R. S. George, A. Arunprasad, T. A. Kannan, S. Viramuthu
    Veterinary World.2014; 7(11): 986.     CrossRef
  • Inexpensive telecytology solutions that use the Raspberry Pi and the iPhone
    Radu Dudas, Christopher VandenBussche, Alex Baras, Syed Z. Ali, Matthew T. Olson
    Journal of the American Society of Cytopathology.2014; 3(1): 49.     CrossRef
  • Everything's Coming Up R.O.S.E.s
    Brian T. Collins
    Journal of the American Society of Cytopathology.2014; 3(2): 57.     CrossRef
  • A minimum fluid volume of 75 mL is needed to ensure adequacy in a pleural effusion: A retrospective analysis of 2540 cases
    Lisa M. Rooper, Syed Z. Ali, Matthew T. Olson
    Cancer Cytopathology.2014; 122(9): 657.     CrossRef
  • Cytotechnologist-attended on-site evaluation of adequacy for fine-needle aspiration of bone and soft tissue neoplasms
    Matthew T. Olson, Anna Novak, Thiraphon Boonyaarunnate, Hinna Shahid, John Kirby, Syed Z. Ali
    Journal of the American Society of Cytopathology.2014; 3(2): 60.     CrossRef
  • Accuracy of Cytotechnologist Evaluation of Specimen Adequacy and Screening Interpretation of Malignancy in Fine-Needle Aspiration of the Liver
    Aadil Ahmed, Anna B. Novak, Aisha Farhat Sheerin, Thiraphon Boonyaarunnate, Syed Z. Ali, Matthew T. Olson
    Acta Cytologica.2014; 58(4): 367.     CrossRef
  • Cytotechnologist Performance for Screening Microfollicular Atypia in Indeterminate Thyroid Fine-Needle Aspirates
    Christopher J. VandenBussche, Matthew T. Olson, Christina Adams, Syed Z. Ali
    Acta Cytologica.2014; 58(5): 432.     CrossRef
Aspiration Cytopathology of Peripancreatic Space: A Clinicoradiologic and Cytopathologic Analyses of 42 Cases
Justin Bishop, Wei Zhang, Olga B. Ioffe, Syed Z. Ali
Korean J Pathol. 2013;47(3):258-264.   Published online June 25, 2013
  • 7,673 View
  • 38 Download
AbstractAbstract PDF

The pancreas is surrounded by soft tissue known as the peripancreatic space (PPS). Pathologic lesions of the PPS are infrequent and have only rarely been reported in the cytopathology literature.


A retrospective review of cytopathology files at two large institutions revealed 42 cases of PPS lesions obtained by transabdominal fine needle aspiration (FNA) or endoscopic ultrasound-guided FNA over a 16-year period. Clinicoradiologic findings and follow-up information were also reviewed.


Patients ranged in age from 23-83 years (mean, 60 years) with an equal gender distribution. The major clinical presentations included pain, jaundice, nausea/vomiting, and abnormal liver enzymes. Radiographic characteristics included lymphadenopathy and cystic/solid soft tissue masses with a size range of 1.5 to 8 cm. Cytologically, 4 (9.5%) cases were nondiagnostic, 9 (21.5%) were diagnosed as benign, 4 (9.5%) were atypical or suspicious for cancer, and 25 (59.5%) were malignant. Six of 25 (24%) patients had metastasis of a prior known malignancy.


FNA of PPS masses is a rare occurrence. The majority of lesions are metastatic carcinomas from a variety of primary sites. Flow cytometry and immunoperoxidase studies are useful adjuncts to determine the tumor origin. The sensitivity of PPS aspiration for a malignant diagnosis is 90% with a positive predictive value of 100%.

Acinar Cell Carcinoma of the Pancreas: Clinical and Cytomorphologic Characteristics
Adam D. Toll, Ralph H. Hruban, Syed Z. Ali
Korean J Pathol. 2013;47(2):93-99.   Published online April 24, 2013
  • 13,190 View
  • 77 Download
  • 17 Citations
AbstractAbstract PDF

Acinar cell carcinoma is a rare malignant epithelial neoplasm with predominantly exocrine acinar differentiation and is seen primarily in older men (mean age, 62 years). The presenting symptoms are usually non-specific, and jaundice is often not present. Symptoms relating to the overproduction and release of lipase into the circulation are present in 10-15% of patients. Characteristic cytomorphologic features include a population of cells with minimal pleomorphism, eccentrically placed nuclei with a single prominent nucleoli and moderate hyperchromasia. The cytoplasm is finely granular, and the background may contain granular debris secondary to cytolysis. A significant proportion of the cases also have a minor neuroendocrine component or scattered neuroendocrine cells. Approximately 50% of patients have metastatic disease at presentation, often restricted to the regional lymph nodes and liver. The prognosis is poor, only slightly better than that of pancreatic ductal adenocarcinoma.


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    Manuela Cuoghi, Cinzia Baccaro, Noemi Zorzetti, Adele Fornelli, Francesco Ferrara, Vincenzo Cennamo, Giuseppe Giovanni Navarra
    Surgeries.2023; 4(1): 73.     CrossRef
  • Pancreatic acinar cell carcinoma: A comprehensive review
    Luis Fernando Calimano-Ramirez, Taher Daoud, Dheeraj Reddy Gopireddy, Ajaykumar C Morani, Rebecca Waters, Kazim Gumus, Albert Russell Klekers, Priya R Bhosale, Mayur K Virarkar
    World Journal of Gastroenterology.2022; 28(40): 5827.     CrossRef
  • Germline BRCA2 variants in advanced pancreatic acinar cell carcinoma: A case report and review of literature
    Cha Len Lee, Spring Holter, Ayelet Borgida, Anna Dodd, Stephanie Ramotar, Robert Grant, Kristy Wasson, Elena Elimova, Raymond W Jang, Malcolm Moore, Tae Kyoung Kim, Korosh Khalili, Carol-Anne Moulton, Steven Gallinger, Grainne M O’Kane, Jennifer J Knox
    World Journal of Gastroenterology.2022; 28(45): 6420.     CrossRef
  • Germline BRCA2 variants in advanced pancreatic acinar cell carcinoma: A case report and review of literature
    Cha Len Lee, Spring Holter, Ayelet Borgida, Anna Dodd, Stephanie Ramotar, Robert Grant, Kristy Wasson, Elena Elimova, Raymond W Jang, Malcolm Moore, Tae Kyoung Kim, Korosh Khalili, Carol-Anne Moulton, Steven Gallinger, Grainne M O’Kane, Jennifer J Knox
    World Journal of Gastroenterology.2022; 28(45): 6421.     CrossRef
  • Pancreatic Acinar Cell Carcinoma with Germline BRCA2 Mutation and Severe Pancreatic Panniculitis: A Case Report
    Lena Dreikhausen, Nadine Schulte, Sebastian Belle, Philip Weidner, Johannes Moersdorf, Christoph Reissfelder, Matthias P. Ebert, Tianzuo Zhan
    Visceral Medicine.2021; 37(5): 447.     CrossRef
  • The Unusual Suspects of the Pancreas—Understanding Pancreatic Acinar Cell Carcinomas and Adenomas
    Andreas Minh Luu, Tim Fahlbusch, Johanna Munding, Waldemar Uhl, Chris Braumann
    Journal of Gastrointestinal Cancer.2020; 51(1): 172.     CrossRef
  • The contemporary trend in worsening prognosis of pancreatic acinar cell carcinoma: A population-based study
    Nie Duorui, Bin Shi, Tao Zhang, Chuyao Chen, Chongkai Fang, Zhijun Yue, Peng Wu, Zhiming Wu, Xuewu Huang, Meng Li, Girijesh Kumar Patel
    PLOS ONE.2020; 15(12): e0243164.     CrossRef
  • Metastatic pancreatic acinar cell carcinoma in a younger male with marked AFP production: A potential pitfall on fine needle aspiration biopsy
    Kari Valente, George Yacoub, James O. Cappellari, Graham Parks
    Diagnostic Cytopathology.2017; 45(2): 133.     CrossRef
  • Establishment and characterization of a new human acinar cell carcinoma cell line, Faraz-ICR, from pancreas
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JPTM : Journal of Pathology and Translational Medicine