Journal of Pathology and Translational Medicine

Review & Perspective

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; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.5.405

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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.

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Telecytology for rapid on-site evaluation: current status
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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
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Original Article

Fine Needle Aspiration Cytology of Kikuchi's Lymphadenitis: with Emphasis on Differential Diagnosis with Tuberculosis.: Kang Min Han, Jai Hyang Go, Na Hye Myong, Wonae Lee; Korean J Pathol. 2011;45(6):626-631.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.6.626

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Abstract PDF

BACKGROUND
Although Kikuchi's lymphadenitis (KL) has been known to have characteristic cytological features, pathologists encounter difficulties in making a diagnosis with fine needle aspiration cytology (FNAC). The objective of this study was to assess the diagnostic pitfalls of KL with FNAC, particularly with emphasis on differential diagnosis with tuberculosis.
METHODS
FNAC of 10 patients with a histological diagnosis of KL and tuberculosis was reviewed.
RESULTS
Acidophilic cells were observed in all the 10 KL cases, even if the smears were insufficient. Crescentic histiocytes were seen in 8, granular background in 7, and karyorrhectic debris in 3 cases. Epithelioid histiocytes or neutrophils were not seen in any of the KL cases. Of the 10 cases of tuberculosis, acidophilic cells were observed in 6 cases, crescentic histiocytes in none of them, cheese-like background in 9, karyorrhectic debris in 8, epithelioid histiocytes in 4, and neutrophils in 8 cases.
CONCLUSIONS
The acidophilic cell could be the most sensitive but not the specific marker of KL with FNAC. The crescentic histiocytes might be the sensitive and considerably specific marker of KL. The cytological features distinguishing tuberculosis from KL may be cheese-like necrosis admixed with neutrophils and epithelioid histiocytes.

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Kikuchi–Fujimoto disease in the Eastern Mediterranean zone
Abdel Rahman Al Manasra, Hamzeh Al-Domaidat, Mohd Asim Aideh, Doaa Al Qaoud, Majd Al Shalakhti, Sohaib Al khatib, Jehad Fataftah, Raed Al-Taher, Mohammad Nofal
Scientific Reports.2022;[Epub] CrossRef
The fine-needle aspiration cytology and clinical findings of Kikuchi–Fujimoto disease in pediatric patients: a retrospective clinical study
Yuto Naoi, Tomoyasu Tachibana, Yoji Wani, Machiko Hotta, Katsuya Haruna, Yasutoshi Komatsubara, Kazunori Kuroda, Soichiro Fushimi, Tami Nagatani, Yuko Kataoka, Kazunori Nishizaki, Yasuharu Sato, Mizuo Ando
Acta Oto-Laryngologica.2022; 142(3-4): 340. CrossRef
Identification of Torque Teno Virus/Torque Teno-Like Minivirus in the Cervical Lymph Nodes of Kikuchi-Fujimoto Lymphadenitis Patients (Histiocytic Necrotizing Lymphadenitis): A Possible Key to Idiopathic Disease
Yosep Chong, Ji Young Lee, Chang Suk Kang, Eun Jung Lee
Biomedicine Hub.2020; 5(1): 1. CrossRef
Morphology quiz: Enigma of a cervical lymph node
Sudha Sharma
Cytopathology.2019; 30(6): 676. CrossRef
Kikuchis lymphadenitis: Is biopsy necessary in managing these patients
Hemalatha Anantharamaiah, Sagayaraj Arokiyaswamy, ChinaiahS. B. R. Prasad
International Journal of Medicine and Public Health.2015; 5(1): 115. CrossRef
Causative agents of Kikuchi–Fujimoto disease (histiocytic necrotizing lymphadenitis): A meta-analysis
Yosep Chong, Chang Suk Kang
International Journal of Pediatric Otorhinolaryngology.2014; 78(11): 1890. CrossRef

Case Report

Cytologic Findings of Alveolar Soft Part Sarcoma Presenting with Multiple Pulmonary Masses: A Case Report with Review of Literature.: Na Rae Kim, Jae Y Ro, Eun Kyung Cho, Mi Jin Kim, Jungsuk An, Seung Yeon Ha; Korean J Pathol. 2011;45(1):119-124.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.119

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Abstract PDF

Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor of uncertain origin, and it has a strong propensity for metastasis to the lungs, bones and brain. We report upon an unusual case of ASPS, presenting as multiple lung nodules with no other detectable primary site, in a 44-year-old man. A fine needle aspiration of the nodules yielded scattered, discohesive cells, each containing an eccentrically displaced nucleus and prominent nucleolus, on a granular background. Tumor cells with numerous bared nuclei, and occasional sheets of epithelioid cells were also found. Under the cytological diagnosis of an unclassified epithelioid malignant tumor, resection of the lung nodules was performed. The histologic findings were consistent with ASPS, showing positive TFE3-nuclear immunoreactivity. There is limited literature concerning cytological findings associated with pulmonary ASPS: especially in cases where the primary site is unknown. Here, we present a cytological review of pulmonary ASPS, investigating the significance of TFE3 staining in the diagnosis of ASPS.

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Alveolar soft part sarcoma: A case report with emphasis on some unusual cytological features
Neelam Sood, Minakshi Gulia
Diagnostic Cytopathology.2018; 46(2): 170. CrossRef

Original Article

The Analysis of Indeterminate Category in Thyroid Fine Needle Aspiration.: Soo Kee Min, Jinwon Seo, Sun Young Jun, Kwangseon Min, Hye Rim Park; Korean J Pathol. 2010;44(6):657-661.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.657

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Abstract PDF

BACKGROUND
Descriptive diagnosis reports have been causing some problems in communication. Our institution decided to use the category diagnosis system since June, 2008. So we evaluated the effectiveness of this change.
METHODS
The category system is composed of unsatisfactory, suboptimal for diagnosis but suggestive of, most probably benign, indeterminate, suspicious for malignancy and malignancy. We evaluated 1,525 cases from June, 2008 to September, 2009. We analyzed 159 cases of the indeterminate category.
RESULTS
Among the 159 cases, 21 were re-aspirated and 63 underwent an operation. The diagnoses of the re-aspirated cases were 2 positive for malignancy, 5 indeterminate, 13 most probably benign, and 1 unsatisfactory. The surgical diagnoses were 39 malignancies, 2 follicular adenomas and 1 Hurthle cell adenoma, and 21 benign lesions. Re-aspiration for the indeterminate cases could help decide whether the lesions need to be operated or not at above 70%. The indeterminate category could predict the surgical diagnosis of the thyroid nodule with statistical significance when the subcategories were indicated (p < 0.001).
CONCLUSIONS
The category diagnosis is replacing the descriptive diagnosis for the thyroid fine needle aspiration. The indeterminate category is useful and effective for making the decision to operate and especially when the indeterminate subcategories are used.

Citations

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Fine Needle Aspiration Cytology of Thyroid Follicular Neoplasm: Cytohistologic Correlation and Accuracy
Changyoung Yoo, Hyun Joo Choi, Soyoung Im, Ji Han Jung, Kiouk Min, Chang Suk Kang, Young-Jin Suh
Korean Journal of Pathology.2013; 47(1): 61. CrossRef

Case Report

Fine Needle Aspiration Cytology of Pulmonary Epithelioid Hemangioendothelioma with Prominent Hyaline Degeneration: A Case Report.: Kang Min Han, Dong Hoon Kim, Na Hye Myong; Korean J Pathol. 2010;44(5):554-557.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.554

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Abstract PDF

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor of low to intermediate malignant potential, and PEH can mimic other more common tumor entities pathologically as well as clinically. Compared to its well-recognized histological features, its cytological findings have been reported rarely to be plasmacytoid or epithelioid cells with abundant dense or finely granular cytoplasm, cytoplasmic vacuoles, round nuclei and prominent nucleoli.We report here on the fine needle aspiration cytologic findings of a 38-year-old woman with EH of the lung, that showed in addition to its classical cytomorphology, a somewhat peculiar cytologic finding such as big twig-like rosettoid structures with prominent hyalinized stroma. This tumor was histologically and immunohistochemically proven to be PEH by primary antibodies for CD31, CD34 and vimentin. We emphasize that the accuracy of making a cytologic diagnosis of this rare tumor can be increased by recognizing the peculiar cytologic finding that we report on here.

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Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies
Gi Tark Noh, Kyoung Ju Lee, Hee Jung Sohn, Kyung Han Lee, Won Seok Heo, Byung Sung Koh, Un Mi Han, Young A Bae
Yeungnam University Journal of Medicine.2016; 33(1): 72. CrossRef
Fine needle aspiration cytology of epithelioid hemangioendothelioma of soft tissue
Shelly Sehgal, Reena Agarwal, Sarika Verma, Ajay Kumar Verma, Sompal Singh
Diagnostic Cytopathology.2013; 41(2): 179. CrossRef

Original Article

Galectin-3 Expression and BRAF Mutation in Cases of Cytologically Suspicious Papillary Thyroid Carcinoma.: Dokyung Kim, Hyunki Kim, Jinyoung Kwak, Minju Kim, Hyung Jae Jung, Ja Seung Koo, Beom Jin Lim, Chankwon Jung, SoonWon Hong; Korean J Pathol. 2010;44(2):191-198.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.2.191

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Abstract PDF: BACKGROUND
Fine needle aspiration, which is known as the most accurate and cost-effective method for diagnosis of thyroid nodule, still may result in indeterminate cases that are pauci-cellular and show minor nuclear atypia, but most cases are associated with suspicion of papillary thyroid carcinoma (PTC). A B-type Raf kinase (BRAF) mutation was found in about half of PTCs and galectin-3 was expressed by malignant tumors, helping us to differentiate malignancies from benign lesions.
METHODS
Cases studied included histologically 44 confirmed PTC cases and 18 benign cases previously diagnosed as suspicious of PTC using cytologic examination. Cases were analyzed for galectin-3 expression by immunohistochemical staining and BRAF mutation by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with a new restriction enzyme.
RESULTS
All 44 cases of PTC and 8 of 18 benign controls expressed galectin-3. BRAF mutations were found in only 9 of the 44 PTC cases. Assessment of galectin-3 expression demonstrated high sensitivity but low specificity. Evaluation of BRAF mutation revealed high specificity and low sensitivity.
CONCLUSIONS
This study suggests that the combined application of these two methods for PTC of suspicious cytology is complementary.

Case Report

Cytology of Plasmacytoid Type Myoepithelioma: Report of Two Cases.: Na Rae Kim, Hyun Yee Cho, Seung Yeon Ha; Korean J Pathol. 2009;43(5):489-493.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.489

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Abstract PDF

Myoepithelioma is a rare benign tumor of salivary gland myoepithelial cells, most commonly as a spindle subtype. Here, we present two cases of fine needle aspiration cytology of plasmacytoid myoepithelioma arising from a parotid gland and a hard palate. Aspirates showed plasmacytoid cells with pink-staining, homogeneous, abundant eosinophilic cytoplasm eccentrically displacing the nucleus in cohesive and dissociated forms. Rarely, nuclear grooves and intranuclear cytoplasmic inclusions were evident. These unfamiliar cytologic findings of uncommon myoepithelioma often cause diagnostic difficulties in preoperative aspiration cytology. Recognition of those rare findings provides a reliable diagnostic clue.

Citations

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Plasmacytoid myoepithelioma: Diagnostic algorithm and a tailored therapeutic protocol for a geriatric individual
Pratik N. Patel, Aatish Thennavan, Venkadasalapathy Narayanaswamy, Raghu Radhakrishnan
Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology.2015; 27(5): 737. CrossRef
Imprint Cytology of Soft Tissue Myoepithelioma: A Case Study
Seok Ju Park, Ae Ri Kim, Mi Jin Gu, Joon Hyuk Choi, Duk Seop Shin
Korean Journal of Pathology.2013; 47(3): 299. CrossRef
Fine Needle Aspiration Cytology of Benign Salivary Gland Tumors with Myoepithelial Cell Participation: An Institutional Experience of 575 Cases
Soomin Ahn, Yuil Kim, Young Lyun Oh
Acta Cytologica.2013; 57(6): 567. CrossRef
Plasmacytoid Myoepithelioma of the Palate: Case Report
Matina T. Zormpa, Asimina S. Sarigelou, Anna N. Eleftheriou, Anthoula S. Assimaki, Alexandros E. Kolokotronis
Head and Neck Pathology.2011; 5(2): 154. CrossRef

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