Journal of Pathology and Translational Medicine

Case Study

Intravascular schwannoma as an extremely unusual cause of vein obstruction: a case report: Luis Miguel Chinchilla-Tábora, Beatriz Segovia Blázquez, José María Sayagués, Marta Rodríguez González, Joaquín González-Rivero, José Antonio Muñoz León, Andrea Beatriz Jiménez Pérez, Idalia González Morais, Diego Bueno-Sacristán, María Dolores Ludeña; J Pathol Transl Med. 2024;58(5):249-254. Published online July 3, 2024; DOI: https://doi.org/10.4132/jptm.2024.05.15

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Abstract PDF: The blood vessel lumen is an extremely rare location for a benign peripheral nerve sheath tumor like schwannoma. Less than 10 cases have been previously reported. In this report, we present a case of a 68-year-old woman who had a soft tissue nodule at the posterior calf of her left leg during a physical examination. Pathological examination was performed after complete surgical excision. The patient underwent follow-up for 12 months after surgery without evidence of recurrence or any other complication. This is the first case of intravascular schwannoma reported as a cause of vein obstruction. Microscopically, the tumor was composed of Schwann spindle cells that were immunoreactive for S100 protein and SOX10. This tumor was surrounded by a well-defined vascular smooth muscle wall. Prospective series are required to improve the knowledge on the underlying mechanisms of intravascular schwannoma development.

Original Articles

Postmortem lung and heart examination of COVID-19 patients in a case series from Jordan: Maram Abdaljaleel, Isra Tawalbeh, Malik Sallam, Amjad Bani Hani, Imad M. Al-Abdallat, Baheth Al Omari, Sahar Al-Mustafa, Hasan Abder-Rahman, Adnan Said Abbas, Mahmoud Zureigat, Mousa A. Al-Abbadi; J Pathol Transl Med. 2023;57(2):102-112. Published online March 14, 2023; DOI: https://doi.org/10.4132/jptm.2023.01.30

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Abstract PDF: Background
Coronavirus disease 2019 (COVID-19) has emerged as a pandemic for more than 2 years. Autopsy examination is an invaluable tool to understand the pathogenesis of emerging infections and their consequent mortalities. The aim of the current study was to present the lung and heart pathological findings of COVID-19–positive autopsies performed in Jordan.
Methods
The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples.
Results
Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings.
Conclusions
The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.

A machine-learning expert-supporting system for diagnosis prediction of lymphoid neoplasms using a probabilistic decision-tree algorithm and immunohistochemistry profile database: Yosep Chong, Ji Young Lee, Yejin Kim, Jingyun Choi, Hwanjo Yu, Gyeongsin Park, Mee Yon Cho, Nishant Thakur; J Pathol Transl Med. 2020;54(6):462-470. Published online August 31, 2020; DOI: https://doi.org/10.4132/jptm.2020.07.11

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Abstract PDF Supplementary Material

Background
Immunohistochemistry (IHC) has played an essential role in the diagnosis of hematolymphoid neoplasms. However, IHC interpretations can be challenging in daily practice, and exponentially expanding volumes of IHC data are making the task increasingly difficult. We therefore developed a machine-learning expert-supporting system for diagnosing lymphoid neoplasms.
Methods
A probabilistic decision-tree algorithm based on the Bayesian theorem was used to develop mobile application software for iOS and Android platforms. We tested the software with real data from 602 training and 392 validation cases of lymphoid neoplasms and compared the precision hit rates between the training and validation datasets.
Results
IHC expression data for 150 lymphoid neoplasms and 584 antibodies was gathered. The precision hit rates of 94.7% in the training data and 95.7% in the validation data for lymphomas were not statistically significant. Results in most B-cell lymphomas were excellent, and generally equivalent performance was seen in T-cell lymphomas. The primary reasons for lack of precision were atypical IHC profiles for certain cases (e.g., CD15-negative Hodgkin lymphoma), a lack of disease-specific markers, and overlapping IHC profiles of similar diseases.
Conclusions
Application of the machine-learning algorithm to diagnosis precision produced acceptable hit rates in training and validation datasets. Because of the lack of origin- or disease- specific markers in differential diagnosis, contextual information such as clinical and histological features should be taken into account to make proper use of this system in the pathologic decision-making process.

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Revolutionizing Pathology with Artificial Intelligence: Innovations in Immunohistochemistry
Diana Gina Poalelungi, Anca Iulia Neagu, Ana Fulga, Marius Neagu, Dana Tutunaru, Aurel Nechita, Iuliu Fulga
Journal of Personalized Medicine.2024; 14(7): 693. CrossRef
Enhanced Immunohistochemistry Interpretation with a Machine Learning-Based Expert System
Anca Iulia Neagu, Diana Gina Poalelungi, Ana Fulga, Marius Neagu, Iuliu Fulga, Aurel Nechita
Diagnostics.2024; 14(17): 1853. CrossRef
Optimization of diagnosis and treatment of hematological diseases via artificial intelligence
Shi-Xuan Wang, Zou-Fang Huang, Jing Li, Yin Wu, Jun Du, Ting Li
Frontiers in Medicine.2024;[Epub] CrossRef
Real-Life Barriers to Diagnosis of Early Mycosis Fungoides: An International Expert Panel Discussion
Emmilia Hodak, Larisa Geskin, Emmanuella Guenova, Pablo L. Ortiz-Romero, Rein Willemze, Jie Zheng, Richard Cowan, Francine Foss, Cristina Mangas, Christiane Querfeld
American Journal of Clinical Dermatology.2023; 24(1): 5. CrossRef
Validation of a Machine Learning Expert Supporting System, ImmunoGenius, Using Immunohistochemistry Results of 3000 Patients with Lymphoid Neoplasms
Jamshid Abdul-Ghafar, Kyung Jin Seo, Hye-Ra Jung, Gyeongsin Park, Seung-Sook Lee, Yosep Chong
Diagnostics.2023; 13(7): 1308. CrossRef
Clinical approaches for integrating machine learning for patients with lymphoma: Current strategies and future perspectives
Dai Chihara, Loretta J. Nastoupil, Christopher R. Flowers
British Journal of Haematology.2023; 202(2): 219. CrossRef
Current Trend of Artificial Intelligence Patents in Digital Pathology: A Systematic Evaluation of the Patent Landscape
Muhammad Joan Ailia, Nishant Thakur, Jamshid Abdul-Ghafar, Chan Kwon Jung, Kwangil Yim, Yosep Chong
Cancers.2022; 14(10): 2400. CrossRef
Recent Application of Artificial Intelligence in Non-Gynecological Cancer Cytopathology: A Systematic Review
Nishant Thakur, Mohammad Rizwan Alam, Jamshid Abdul-Ghafar, Yosep Chong
Cancers.2022; 14(14): 3529. CrossRef
Diagnosis prediction of tumours of unknown origin using ImmunoGenius, a machine learning-based expert system for immunohistochemistry profile interpretation
Yosep Chong, Nishant Thakur, Ji Young Lee, Gyoyeon Hwang, Myungjin Choi, Yejin Kim, Hwanjo Yu, Mee Yon Cho
Diagnostic Pathology.2021;[Epub] CrossRef

A retrospective cytohistological correlation of fine-needle aspiration cytology with classification by the Milan System for Reporting Salivary Gland Cytopathology: Ji Hyun Park, Yoon Jin Cha, Ja Yeong Seo, Jae Yol Lim, Soon Won Hong; J Pathol Transl Med. 2020;54(5):419-425. Published online July 8, 2020; DOI: https://doi.org/10.4132/jptm.2020.06.09

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Abstract PDF

Background
Before publication of the new classification system named the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) in 2018, there was no standard classification for salivary gland lesions obtained by fine-needle aspiration (FNA). We therefore aimed to evaluate the diagnostic utility of this system by retrospectively reviewing FNA samples using the MSRSGC and to determine their risk of developing into neoplasms and becoming malignant.
Methods
Retrospective slide review and classification of salivary gland FNAs obtained over a 6-year period (2013–2018) at a single center were performed by two pathologists. The risks of neoplasm and malignancy for each category also were calculated.
Results
This study surveyed 374 FNAs (371 patients) performed over a six-year period and selected 148 cases that included documented surgical follow-up (39.6%). Among the surgically treated cases, the distributions of FNA categories were as follows: non-diagnostic (ND; 16.9%), non-neoplastic (NN; 2.7%), atypia of undetermined significance (AUS; 3.4%), benign (BN; 54.7%), salivary gland neoplasm of uncertain malignant potential (SUMP; 10.1%), suspicious for malignancy (SM; 6.8%), and malignant (M; 5.4%). The risk of malignancy (ROM) was 24.0% for ND, 0% for NN, 40.0% for AUS, 2.5% for BN, 46.7% for SUMP, 100% for SM, and 87.5% for M. The overall diagnostic accuracy was 95.9% (142/148 cases).
Conclusions
The newly proposed MSRSGC appears to be a reliable system for classification of salivary gland lesions according to the associated ROM.

Citations

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Salivary gland fine-needle aspiration biopsy: quality assurance results from a tertiary cancer center
Fanni Ratzon, Dominique L. Feliciano, Nora Katabi, Bin Xu, Oscar Lin, Xiao-Jun Wei
Journal of the American Society of Cytopathology.2023; 12(3): 206. CrossRef
Cytohistological correlation and risk stratification of salivary gland lesions using the Milan System for Reporting Salivary Gland Cytopathology: A tertiary care centre experience
Tarun Kumar, Prerna Tewari, Jitendra Singh Nigam, Shreekant Bharti, Surabhi, Ruchi Sinha, Punam Prasad Bhadani
Cytopathology.2023; 34(3): 225. CrossRef
Assessment of Risk of Malignancy of Fine-needle Aspiration Cytology in Salivary Gland Lesions Using the Milan System for Reporting Salivary Gland Cytopathology Categorization: A Systematic Review and Meta-analysis
Amit Kumar, Subhash Chandra, Bishnupati Singh, Swati Sharma, Ankita Tandon, Ajoy Kumar Shahi
The Journal of Contemporary Dental Practice.2023; 23(10): 1039. CrossRef
Milan Sınıflandırma Sistemi’ne Göre Değerlendirilen Tükürük Bezi İnce İğne Aspirasyon Sitolojilerinin Histopatolojik Tanı Uyumu
Özlem SARAYDAROĞLU, Selin YİRMİBEŞ
Uludağ Üniversitesi Tıp Fakültesi Dergisi.2023; 49(3): 285. CrossRef
Milan system for reporting salivary gland cytopathology: Adoption and outcomes in a community setting
Samih J. Nassif, Ali R. Sasani, Garrey T. Faller, Jennifer L. Harb, Jagdish K. Dhingra
Head & Neck.2022; 44(6): 1462. CrossRef
Nondiagnostic salivary gland FNAs are associated with decreased risk of malignancy compared with “all‐comer” patients: Analysis of the Milan System for Reporting Salivary Gland Cytopathology with a focus on Milan I: Nondiagnostic
Shu K. Lui, Troy Tenney, Patrick C. Mullane, Kartik Viswanathan, Daniel J. Lubin
Cancer Cytopathology.2022; 130(10): 800. CrossRef
Application of the Milan System for Reporting Salivary Gland Cytopathology: A systematic review and meta‐analysis
Zhaoyang Wang, Huan Zhao, Huiqin Guo, Changming An
Cancer Cytopathology.2022; 130(11): 849. CrossRef
Multiplexed single‐cell analysis of FNA allows accurate diagnosis of salivary gland tumors
Juhyun Oh, Tae Yeon Yoo, Talia M. Saal, Lisa Tsay, William C. Faquin, Jonathan C.T. Carlson, Daniel G. Deschler, Sara I. Pai, Ralph Weissleder
Cancer Cytopathology.2022; 130(8): 581. CrossRef
Cytologic analysis of vitreous fluids: A retrospective review of our 24 years of experience
Gabriel L. Collins, Elizabeth W. Hubbard, Christopher T. Clark, Lisa D. Duncan, Laurentia Nodit
Diagnostic Cytopathology.2021; 49(10): 1122. CrossRef

Adjunctive markers for classification and diagnosis of central nervous system tumors: results of a multi-center neuropathological survey in Korea: Yoon Jin Cha, Se Hoon Kim, Na Rae Kim; J Pathol Transl Med. 2020;54(2):165-170. Published online February 20, 2020; DOI: https://doi.org/10.4132/jptm.2020.02.04

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Abstract PDF Supplementary Material

Background
The revised 4th 2016 World Health Organization (WHO) classification of tumors of the central nervous system (CNS) classification has adopted integrated diagnosis encompassing the histology and molecular features of CNS tumors. We aimed to investigate the immunohistochemistry, molecular testing, and testing methods for diagnosis of CNS tumors in pathological labs of tertiary centers in Korea, and evaluate the adequacy of tests for proper diagnosis in daily practice.
Methods
A survey, composed of eight questions concerning molecular testing for diagnosis of CNS tumors, was sent to 10 neuropathologists working in tertiary centers in Korea.
Results
For diagnosis of astrocytic and oligodendroglial tumors, all 10 centers performed isocitrate dehydrogenase mutations testing and 1p/19q loss of heterozygosity. For glioneuronal tumors, immunohistochemistry (IHC) assays for synaptophysin (n = 9), CD34 (n = 7), BRAF(VE1) (n = 5) were used. For embryonal tumors, particularly in medulloblastoma, four respondents used IHC panel (growth factor receptor bound protein 2-associated protein 1, filamin A, and yes-associated protein 1) for molecular subclassification. Regarding meningioma, all respondents performed Ki-67 IHC and five performed telomerase reverse transcriptase promoter mutation.
Conclusions
Most tertiary centers made proper diagnosis in line with 2016 WHO classification. As classification of CNS tumors has evolved to be more complex and more ancillary tests are required, these should be performed considering the effect of necessity and justification.

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Exploring the role of epidermal growth factor receptor variant III in meningeal tumors
Rashmi Rana, Vaishnavi Rathi, Kirti Chauhan, Kriti Jain, Satnam Singh Chhabra, Rajesh Acharya, Samir Kumar Kalra, Anshul Gupta, Sunila Jain, Nirmal Kumar Ganguly, Dharmendra Kumar Yadav, Timir Tripathi
PLOS ONE.2021; 16(9): e0255133. CrossRef

Case Study

Frozen Cytology of Meningeal Malignant Solitary Fibrous Tumor/Hemangiopericytoma: Myunghee Kang, Na Rae Kim, Dong Hae Chung, Gie-Taek Yie; J Pathol Transl Med. 2019;53(3):192-197. Published online April 11, 2019; DOI: https://doi.org/10.4132/jptm.2019.03.20

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Abstract PDF

A 51-year-old woman presented with severe dizziness. The brain magnetic resonance image revealed a 5.5 cm multiloculated mass with a thick rim in the left temporal lobe. Cytological examination of frozen diagnosis of the mass showed hypercellular sheets of round and rhabdoid cells in a hemorrhagic background, and two mitotic figures were observed. Histologically, the excised dura-based mass consisted of predominantly round cells with small foci of rhabdoid tumor cells in a pseudoalveolar pattern in a hemorrhagic background, and the cells showed nuclear positivity for signal transducer and activator of transcription 6 as well as frequent mitosis. The mass was diagnosed as a grade 3 solitary fibrous tumor (SFT)/hemangiopericytoma (HPC). The cytological diagnosis of SFT/HPC is challenging because of the heterogeneous cytological findings, such as histological heterogeneity, and because there are no standardized cytological criteria for malignant SFT/HPC. Cytological findings, such as singly scattered small cells, hypercellularity, rare ropy collagen, and round and rhabdoid cells with pseudoalveolar pattern, may assist in the diagnosis of malignant SFT/HPC.

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Cytologic features of mesenchymal, melanocytic and haematolymphoid tumours of the central nervous system and metastases
Carmen Bárcena, José A. Jiménez‐Heffernan
Cytopathology.2024; 35(5): 590. CrossRef
A Hemangiopericytoma in the External Auditory Canal: A Rare Clinical Presentation and Management
Vaibhavi Patil, Prasad Deshmukh, Sagar S Gaurkar , Ayushi Ghosh Moulic, Jasleen Kaur
Cureus.2024;[Epub] CrossRef
Scoring system for intraoperative diagnosis of intracranial schwannoma by squash cytology
Hirotaka Fujita, Takuma Tajiri, Tomohisa Machida, Nozomi Nomura, Suguru Toguchi, Hitoshi Itoh, Shinichiro Hiraiwa, Tomoko Sugiyama, Chie Inomoto, Masaaki Imai, Shinri Oda, Masami Shimoda, Naoya Nakamura
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Occurrence of a solitary fibrous tumor adjacent to the resection bed of a high-grade meningioma: A case report
Coby Cunningham, Rocco Dabecco, Justin Davanzo
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A case of solitary fibrous tumor arising in the meninge
Saori NAKANISHI, Naoto KURODA, Toshiko TAKAI, Mari KOJIMA, Misato OONOGI
The Journal of the Japanese Society of Clinical Cytology.2021; 60(4): 224. CrossRef
Intraoperative frozen cytology of intraosseous cystic meningioma in the sphenoid bone
Na Rae Kim, Gie-Taek Yie
Journal of Pathology and Translational Medicine.2020; 54(6): 508. CrossRef

Original Article

Intraoperative Frozen Cytology of Central Nervous System Neoplasms: An Ancillary Tool for Frozen Diagnosis: Myunghee Kang, Dong Hae Chung, Na Rae Kim, Hyun Yee Cho, Seung Yeon Ha, Sangho Lee, Jungsuk An, Jae Yeon Seok, Gie-Taek Yie, Chan Jong Yoo, Sang Gu Lee, Eun Young Kim, Woo Kyung Kim, Seong Son, Sun Jin Sym, Dong Bok Shin, Hee Young Hwang, Eung Yeop Kim, Kyu Chan Lee; J Pathol Transl Med. 2019;53(2):104-111. Published online January 14, 2019; DOI: https://doi.org/10.4132/jptm.2018.11.10

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Abstract PDF

Background
Pathologic diagnosis of central nervous system (CNS) neoplasms is made by comparing light microscopic, immunohistochemical, and molecular cytogenetic findings with clinicoradiologic observations. Intraoperative frozen cytology smears can improve the diagnostic accuracy for CNS neoplasms. Here, we evaluate the diagnostic value of cytology in frozen diagnoses of CNS neoplasms.
Methods
Cases were selected from patients undergoing both frozen cytology and frozen sections. Diagnostic accuracy was evaluated.
Results
Four hundred and fifty-four cases were included in this retrospective single-center review study covering a span of 10 years. Five discrepant cases (1.1%) were found after excluding 53 deferred cases (31 cases of tentative diagnosis, 22 cases of inadequate frozen sampling). A total of 346 cases of complete concordance and 50 cases of partial concordance were classified as not discordant cases in the present study. Diagnostic accuracy of intraoperative frozen diagnosis was 87.2%, and the accuracy was 98.8% after excluding deferred cases. Discrepancies between frozen and permanent diagnoses (n = 5, 1.1%) were found in cases of nonrepresentative sampling (n = 2) and misinterpretation (n = 3). High concordance was observed more frequently in meningeal tumors (97/98, 99%), metastatic brain tumors (51/52, 98.1%), pituitary adenomas (86/89, 96.6%), schwannomas (45/47, 95.8%), high-grade astrocytic tumors (47/58, 81%), low grade astrocytic tumors (10/13, 76.9%), non-neoplastic lesions (23/36, 63.9%), in decreasing frequency.
Conclusions
Using intraoperative cytology and frozen sections of CNS tumors is a highly accurate diagnostic ancillary method, providing subtyping of CNS neoplasms, especially in frequently encountered entities.

Citations

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Intraoperative Integrated Diagnostic System for Malignant Central Nervous System Tumors
Takahiro Hayashi, Kensuke Tateishi, Shinichiro Matsuyama, Hiromichi Iwashita, Yohei Miyake, Akito Oshima, Hirokuni Honma, Jo Sasame, Katsuhiro Takabayashi, Kyoka Sugino, Emi Hirata, Naoko Udaka, Yuko Matsushita, Ikuma Kato, Hiroaki Hayashi, Taishi Nakamur
Clinical Cancer Research.2024; 30(1): 116. CrossRef
A multicenter proof-of-concept study on deep learning-based intraoperative discrimination of primary central nervous system lymphoma
Xinke Zhang, Zihan Zhao, Ruixuan Wang, Haohua Chen, Xueyi Zheng, Lili Liu, Lilong Lan, Peng Li, Shuyang Wu, Qinghua Cao, Rongzhen Luo, Wanming Hu, Shanshan lyu, Zhengyu Zhang, Dan Xie, Yaping Ye, Yu Wang, Muyan Cai
Nature Communications.2024;[Epub] CrossRef
Advancements in Neurosurgical Intraoperative Histology
Ali A. Mohamed, Emma Sargent, Cooper Williams, Zev Karve, Karthik Nair, Brandon Lucke-Wold
Tomography.2024; 10(5): 693. CrossRef
Unveiling the potential application of intraoperative brain smear for brain tumor diagnosis in low-middle-income countries: A comprehensive systematic review
Muhammad Shakir, Ahmed Altaf, Hawra Hussain, Syed Muhammad Aqeel Abidi, Zoey Petitt, Mahnoor Tariq, Ahmed Gilani, S. Ather Enam
Surgical Neurology International.2023; 14: 325. CrossRef
A Comparative Study of Squash Smear Cytology Diagnosis and Radiological Diagnosis with Histopathology in Central Nervous System Lesions
B N Kumarguru, G Santhipriya, S Kranthi Kumar, R Ramesh Kumar, A S Ramaswamy, P Janakiraman
Journal of Cytology.2022; 39(1): 1. CrossRef
Intraoperative squash cytology provides a qualitative intraoperative diagnosis for cases in which frozen section yields a diagnosis of equivocal brain tumour
Hirotaka Fujita, Takuma Tajiri, Tomohisa Machida, Nozomi Nomura, Suguru Toguchi, Hitoshi Itoh, Shinichiro Hiraiwa, Tomoko Sugiyama, Masaaki Imai, Shinri Oda, Masami Shimoda, Naoya Nakamura
Cytopathology.2020; 31(2): 106. CrossRef
Intraoperative frozen cytology of intraosseous cystic meningioma in the sphenoid bone
Na Rae Kim, Gie-Taek Yie
Journal of Pathology and Translational Medicine.2020; 54(6): 508. CrossRef
Use of 5-Aminolevulinic Acid for Confirmation of Lesional Biopsy Sample in Presumed High-Grade Glioma
Victoria L. Watson, Jeffrey W. Cozzens
World Neurosurgery.2019; 132: 21. CrossRef

Case Study

Primary Peripheral Gamma Delta T-Cell Lymphoma of the Central Nervous System: Report of a Case Involving the Intramedullary Spinal Cord and Presenting with Myelopathy: Jeemin Yim, Seung Geun Song, Sehui Kim, Jae Won Choi, Kyu-Chong Lee, Jeong Mo Bae, Yoon Kyung Jeon; J Pathol Transl Med. 2019;53(1):57-61. Published online October 1, 2018; DOI: https://doi.org/10.4132/jptm.2018.08.21

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Abstract PDF

Primary central nervous system lymphoma of T-cell origin (T-PCNSL) is rare, and its clinicopathological features remain unclear. Peripheral T-cell lymphoma of γδ T-cell origin is an aggressive lymphoma mainly involving extranodal sites. Here, we report a case of γδ T-PCNSL involving the intramedullary spinal cord and presenting with paraplegia. A 75-year-old Korean woman visited the hospital complaining of back pain and lower extremity weakness. Magnetic resonance imaging revealed multifocal enhancing intramedullary nodular lesions in the thoracic and lumbar spinal cord. An enhancing nodular lesion was observed in the periventricular white matter of the lateral ventricle in the brain. There were no other abnormalities in systemic organs or skin. Laminectomy and tumor removal were performed. The tumor consisted of monomorphic, medium-to-large atypical lymphocytes with pale-to-eosinophilic cytoplasm. Immunohistochemically, the tumor cells were CD3(+), TCRβF1(-), TCRγ(+), CD30(-), CD4(-), CD8(-), CD56(+), TIA1(+), granzyme B(+), and CD103(+). Epstein-Barr virus in situ was negative. This case represents a unique T-PCNSL of γδ T-cell origin involving the spinal cord.

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B-Cell Lymphoma Intramedullary Tumor: Case Report and Systematic Review
Daniel Gregório Gonsalves, Paulo Eduardo Albuquerque Zito Raffa, Gabriela Gerenutti de Sousa, Melissa Esposito Gomes Rigueiral, Iracema Araújo Estevão, Cesar Cozar Pacheco, Roger Thomaz Rotta Medeiros, Paulo Roberto Franceschini, Paulo Henrique Pires de A
Asian Journal of Neurosurgery.2023; 18(02): 231. CrossRef
Primary intramedullary spinal cord lymphoma misdiagnosed as longitudinally extensive transverse myelitis: a case report and literature review
Huizhen Ge, Li Xu, Huajie Gao, Suqiong Ji
BMC Neurology.2023;[Epub] CrossRef
Clinicopathologic and Genetic Features of Primary T-cell Lymphomas of the Central Nervous System
Jeemin Yim, Jiwon Koh, Sehui Kim, Seung Geun Song, Jeong Mo Bae, Hongseok Yun, Ji-Youn Sung, Tae Min Kim, Sung-Hye Park, Yoon Kyung Jeon
American Journal of Surgical Pathology.2022; 46(4): 486. CrossRef
Peripheral T-Cell Lymphomas Involving the Central Nervous System: A Report From the Czech Lymphoma Study Group Registry
Heidi Mocikova, Robert Pytlík, Katerina Benesova, Andrea Janikova, Juraj Duras, Alice Sykorova, Katerina Steinerova, Vit Prochazka, Vit Campr, David Belada, Marek Trneny
Frontiers in Oncology.2022;[Epub] CrossRef

Original Article

Cytologic Diagnosis of Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features and Its Impact on the Risk of Malignancy in the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience: Milim Kim, Joung Eun Kim, Hyun Jeong Kim, Yul Ri Chung, Yoonjin Kwak, So Yeon Park; J Pathol Transl Med. 2018;52(3):171-178. Published online April 3, 2018; DOI: https://doi.org/10.4132/jptm.2018.04.03

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Abstract PDF

Background
This study was performed to analyze cytologic diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) and its impact on the risk of malignancy (ROM) in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC).
Methods
Five thousand five hundred and forty-nine cases of thyroid fine-needle aspiration cytology (FNAC) diagnosed between 2012 and 2014 were included in this study. Diagnostic categories based on TBSRTC were compared with final surgical diagnoses, and the ROM in each category was calculated both when NIFTP was included in malignant lesions and when excluded from malignant lesions.
Results
Of the 5,549 thyroid FNAC cases, 1,891 cases underwent surgical resection. In final diagnosis, 1,700 cases were revealed as papillary thyroid carcinoma (PTC), and 25 cases were reclassified as NIFTP. The cytologic diagnoses of NIFTP were non-diagnostic in one, benign in five, atypia of undetermined significance (AUS) in 14, follicular neoplasm in two, and suspicious for malignancy in three cases. Collectively, NIFTP/encapsulated follicular variant of PTC (EFVPTC) were more frequently classified as benign, AUS, or follicular neoplasm and less frequently categorized as malignant compared to conventional PTCs. Exclusion of NIFTP from malignant diagnoses resulted in a slight decrease in malignancy rates in non-diagnostic, benign, AUS, follicular neoplasm, and suspicious for malignancy categories without any statistical significance.
Conclusions
The decrease in the ROM was not significant when NIFTP was excluded from malignant lesions. In thyroid FNACs, NIFTP/EFVPTCs were mostly classified into indeterminate categories. Therefore, it might be feasible to separate NIFTP/EFVPTC from conventional PTC on FNAC to guide clinicians to conservative management for patients with NIFTP/EFVPTC.

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Clinical and Translational Medicine.2024;[Epub] CrossRef
Cytological Features of “Non-invasive Follicular Tumour with Papillary Like Nuclear Features” – A Single Institutional Experience in India
K Amita, HB Rakshitha, M Sanjay, Prashantha Kalappa
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Detailed fine needle aspiration cytopathology findings of noninvasive follicular thyroid neoplasm with papillary‐like nuclear features with nuclear grading correlated to that of biopsy and Bethesda category and systematic review
Sevgiye Kaçar Özkara, Gupse Turan
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Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features Is Not a Cytological Diagnosis, but It Influences Cytological Diagnosis Outcomes: A Systematic Review and Meta-Analysis
Elina Haaga, David Kalfert, Marie Ludvíková, Ivana Kholová
Acta Cytologica.2022; 66(2): 85. CrossRef
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Soon-Hyun Ahn
Clinical and Experimental Otorhinolaryngology.2021; 14(1): 116. CrossRef
Comprehensive DNA Methylation Profiling Identifies Novel Diagnostic Biomarkers for Thyroid Cancer
Jong-Lyul Park, Sora Jeon, Eun-Hye Seo, Dong Hyuck Bae, Young Mun Jeong, Yourha Kim, Ja Seong Bae, Seon-Kyu Kim, Chan Kwon Jung, Yong Sung Kim
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Noninvasive follicular neoplasm with papillary like nuclear features: A comprehensive analysis with a diagnostic algorithm
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Did Introducing a New Category of Thyroid Tumors (Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features) Decrease the Risk of Malignancy for the Diagnostic Categories in the Bethesda System for Reporting Thyroid Cytopathology?
Janusz Kopczyński, Agnieszka Suligowska, Kornelia Niemyska, Iwona Pałyga, Agnieszka Walczyk, Danuta Gąsior-Perczak, Artur Kowalik, Kinga Hińcza, Ryszard Mężyk, Stanisław Góźdź, Aldona Kowalska
Endocrine Pathology.2020; 31(2): 143. CrossRef
High risk of malignancy in cases with atypia of undetermined significance on fine needle aspiration of thyroid nodules even after exclusion of NIFTP
Sevgiye Kaçar Özkara, Büşra Yaprak Bayrak, Gupse Turan
Diagnostic Cytopathology.2020; 48(11): 986. CrossRef
The importance of risk of neoplasm as an outcome in cytologic‐histologic correlation studies on thyroid fine needle aspiration
Yu‐Hsin Chen, Kristen L. Partyka, Rae Dougherty, Harvey M. Cramer, Howard H. Wu
Diagnostic Cytopathology.2020; 48(12): 1237. CrossRef
Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
PLOS ONE.2020; 15(11): e0241597. CrossRef
How is noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) shaping the way we interpret thyroid cytology?
Michiya Nishino
Journal of the American Society of Cytopathology.2019; 8(1): 1. CrossRef
Cytological Diagnoses Associated with Noninvasive Follicular Thyroid Neoplasms with Papillary-Like Nuclear Features According to the Bethesda System for Reporting Thyroid Cytopathology: A Systematic Review and Meta-Analysis
Massimo Bongiovanni, Luca Giovanella, Francesco Romanelli, Pierpaolo Trimboli
Thyroid.2019; 29(2): 222. CrossRef
Preoperative Diagnostic Categories of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features in Thyroid Core Needle Biopsy and Its Impact on Risk of Malignancy
Hee Young Na, Ji Won Woo, Jae Hoon Moon, June Young Choi, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park
Endocrine Pathology.2019; 30(4): 329. CrossRef
Papillary Thyroid Microcarcinoma: Reclassification to Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP): a Retrospective Clinicopathologic Study
Khurram Shafique, Virginia A. LiVolsi, Kathleen Montone, Zubair W. Baloch
Endocrine Pathology.2018; 29(4): 339. CrossRef

Reviews

Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand: Somboon Keelawat, Samreung Rangdaeng, Supinda Koonmee, Tikamporn Jitpasutham, Andrey Bychkov; J Pathol Transl Med. 2017;51(6):565-570. Published online November 15, 2017; DOI: https://doi.org/10.4132/jptm.2017.08.12

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Abstract PDF

Thyroid carcinoma is one of the leading malignancies in Thailand increasingly prevalent in the female population. Fine-needle aspiration (FNA) cytology is a widely used diagnostic tool for evaluation of thyroid nodules and thyroid cancer. Thyroid FNA is a routine procedure universally performed in Thai hospitals by a variety of clinical specialists. Manual guidance is the first-line choice complemented by ultrasound assistance in selected cases. Despite national guidelines recommendations, the diagnostic criteria and terminology of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was slowly adopted in the local settings. Currently, the Bethesda system is actively promoted by the local professional societies as a uniform reporting system. Experience with thyroid FNA has been rarely reported to date—only a handful of publications are available in local journals. Our review, in addition to presenting various aspects of thyroid FNA in Thailand, established for the first time national references for a certain statistical outputs of TBSRTC based on the original multi-institutional cohort. The risk of malignancy in 2,017 operated thyroid nodules collected from three tertiary thyroid cancer centers was 21.7%, 14.7%, 35.9%, 44.4%, 76.7%, and 92.6% for categories I to VI, respectively. The malignancy risk in several diagnostic categories (II to IV) was higher than the risk estimated by TBSRTC and recent meta-analysis studies. We endorse the use of uniform terminology of the Bethesda system in Thailand, which will help facilitate communication among diverse medical professionals involved in the management of patients with thyroid nodules, to share local experience with the international audience.

Citations

Citations to this article as recorded by

The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Application of the Bethesda system for reporting thyroid cytopathology for classification of thyroid nodules: A clinical and cytopathological characteristics in Bhutanese population
Sonam Choden, Chimi Wangmo, Sushna Maharjan
Diagnostic Cytopathology.2021; 49(11): 1179. CrossRef
Patient Discomfort in Relation to Thyroid Nodule Fine-Needle Aspiration (FNA) Performed with or without Parenteral and/or Topical Anesthetic
Chenxiang Cao, Sina Jasim, Amrita Cherian, Aziza Nassar, Ana-Maria Chindris, Ana Marcella Rivas, Stephanie Bonnett, Melanie Caserta, Marius N. Stan, Victor J. Bernet
Endocrine Practice.2020; 26(12): 1497. CrossRef
Incidence and malignancy rates classified by The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) – An 8-year tertiary center experience in Thailand
Yotsapon Thewjitcharoen, Siriwan Butadej, Soontaree Nakasatien, Phawinpon Chotwanvirat, Sriurai Porramatikul, Sirinate Krittiyawong, Nampetch Lekpittaya, Thep Himathongkam
Journal of Clinical & Translational Endocrinology.2019; 16: 100175. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef

Thyroid Cytology: The Japanese System and Experience at Yamashita Thyroid Hospital: Shinya Satoh, Hiroyuki Yamashita, Kennichi Kakudo; J Pathol Transl Med. 2017;51(6):548-554. Published online October 11, 2017; DOI: https://doi.org/10.4132/jptm.2017.09.29

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Abstract PDF

In Japan, fine-needle aspiration (FNA) cytology is the most important diagnostic modality for triaging patients with thyroid nodules. A clinician (endocrinologist, endocrine surgeon, or head and neck surgeon) generally performs FNA cytology at the outpatient clinic, and ultrasound (US)-guided FNA is widespread because US is extremely common and most clinicians are familiar with it. Although almost all FNA thyroid samples are examined by certified cytopathologists and pathologists, some clinicians assess cytological specimens themselves. In Japan, there are two clinical guidelines regarding the management of thyroid nodules. One is the General Rules for the Description of Thyroid Cancer (GRDTC) published by the Japanese Society of Thyroid Surgery (JSTS) in 2005, and the other is the national reporting system for thyroid FNA cytology published by the Japan Thyroid Association in 2013 (Japanese system). Although the Bethesda System for Reporting Thyroid Cytopathology (Bethesda system) is rarely used in Japan, both the GRDTC and Japanese system tried to incorporate the Bethesda system so that the cytological diagnoses would be compatible with each other. The essential point of the Japanese system is stratification of follicular neoplasm (FN) into three subgroups based on cytological features in order to reduce unnecessary diagnostic thyroidectomy, and this system has been successful in stratifying the risk of malignancy in FN patients at several high-volume thyroid surgery centers. In Japan, the measurement of thyroglobulin and/or calcitonin in FNA needle washings is often used as an adjunct for diagnosis of possible cervical lymph node metastasis when FNA cytology is performed.

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Thyroid FNA cytology: The Eastern versus Western perspectives
Mitsuyoshi Hirokawa, Manon Auger, Chan Kwon Jung, Fabiano Mesquita Callegari
Cancer Cytopathology.2023; 131(7): 415. CrossRef
The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Criteria for follow‐up of thyroid nodules diagnosed as follicular neoplasm without molecular testing – The experience of a high‐volume thyroid centre in Japan
Mitsuyoshi Hirokawa, Ayana Suzuki, Makoto Kawakami, Takumi Kudo, Akira Miyauchi
Diagnostic Cytopathology.2022; 50(5): 223. CrossRef
The Significance of RAS-Like Mutations and MicroRNA Profiling in Predicting Malignancy in Thyroid Biopsy Specimens
Nicole A. Cipriani, Daniel N. Johnson, David H. Sarne, Peter Angelos, Ward Reeves, Tatjana Antic
Endocrine Pathology.2022; 33(4): 446. CrossRef
Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada
Mohannad Rajab, Richard J. Payne, Véronique-Isabelle Forest, Marc Pusztaszeri
Cancers.2022; 14(17): 4140. CrossRef
Impact of Molecular Testing on the Management of Indeterminate Thyroid Nodules Among Western and Asian Countries: a Systematic Review and Meta-analysis
Hanh Thi Tuyet Ngo, Truong Phan Xuan Nguyen, Trang Huyen Vu, Chan Kwon Jung, Lewis Hassell, Kennichi Kakudo, Huy Gia Vuong
Endocrine Pathology.2021; 32(2): 269. CrossRef
The Incidence of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: A Meta-Analysis Assessing Worldwide Impact of the Reclassification
Chanchal Rana, Huy Gia Vuong, Thu Quynh Nguyen, Hoang Cong Nguyen, Chan Kwon Jung, Kennichi Kakudo, Andrey Bychkov
Thyroid.2021;[Epub] CrossRef
Ultrasound-guided Fine Needle Aspiration Cytological Examination of Thyroid Nodules: A Practical Guideline (2019 edition)

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Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis
Huy Gia Vuong, Hanh Thi Tuyet Ngo, Andrey Bychkov, Chan Kwon Jung, Trang Huyen Vu, Kim Bach Lu, Kennichi Kakudo, Tetsuo Kondo
Cancer Cytopathology.2020; 128(4): 238. CrossRef
Exploring the Inter-observer Agreement Among the Members of the Italian Consensus for the Classification and Reporting of Thyroid Cytology
Anna Crescenzi, Pierpaolo Trimboli, Fulvio Basolo, Andrea Frasoldati, Fabio Orlandi, Lucio Palombini, Enrico Papini, Alfredo Pontecorvi, Paolo Vitti, Michele Zini, Francesco Nardi, Guido Fadda
Endocrine Pathology.2020; 31(3): 301. CrossRef
The Current Histologic Classification of Thyroid Cancer
Sylvia L. Asa
Endocrinology and Metabolism Clinics of North America.2019; 48(1): 1. CrossRef
Clinical Impact of Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features on the Risk of Malignancy in the Bethesda System for Reporting Thyroid Cytopathology: A Meta-Analysis of 14,153 Resected Thyroid Nodules
Huy Gia Vuong, Thao T.K. Tran, Andre y. Bychkov, Chan Kwon Jung, Tadao Nakazawa, Kennichi Kakudo, R yohei Katoh, Tetsuo Kondo
Endocrine Practice.2019; 25(5): 491. CrossRef
A Multi-institutional Study of Prevalence and Clinicopathologic Features of Non-invasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP) in Korea
Ja Yeong Seo, Ji Hyun Park, Ju Yeon Pyo, Yoon Jin Cha, Chan Kwon Jung, Dong Eun Song, Jeong Ja Kwak, So Yeon Park, Hee Young Na, Jang-Hee Kim, Jae Yeon Seok, Hee Sung Kim, Soon Won Hong
Journal of Pathology and Translational Medicine.2019; 53(6): 378. CrossRef
Noninvasive follicular thyroid neoplasm with papillary‐like nuclear features (NIFTP) in thyroid tumor classification
Kennichi Kakudo, Adel K. El‐Naggar, Steven P. Hodak, Elham Khanafshar, Yuri E Nikiforov, Vania Nosé, Lester D. R. Thompson
Pathology International.2018; 68(6): 327. CrossRef
Diagnostic value of HBME‐1, CK19, Galectin 3, and CD56 in the subtypes of follicular variant of papillary thyroid carcinoma
Haeyon Cho, Ji‐Ye Kim, Young Lyun Oh
Pathology International.2018; 68(11): 605. CrossRef
The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
Hyunseo Cha, Ju Yeon Pyo, Soon Won Hong
Journal of Pathology and Translational Medicine.2018; 52(6): 404. CrossRef
Impact of the modification of the diagnostic criteria in the 2017 Bethesda System for Reporting Thyroid Cytopathology: a report of a single institution in Japan
Miyoko Higuchi, Mitsuyoshi Hirokawa, Risa Kanematsu, Aki Tanaka, Ayana Suzuki, Naoki Yamao, Toshitetsu Hayashi, Seiji Kuma, Akira Miyauchi
Endocrine Journal.2018; 65(12): 1193. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef

Thyroid Cytology in India: Contemporary Review and Meta-analysis: Shipra Agarwal, Deepali Jain; J Pathol Transl Med. 2017;51(6):533-547. Published online October 5, 2017; DOI: https://doi.org/10.4132/jptm.2017.08.04

9,401 View
206 Download
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Abstract PDF

Fine-needle aspiration cytology (FNAC) is a screening test for triaging thyroid nodules, aiding in subsequent clinical management. However, the advantages have been overshadowed by the multiplicity of reporting systems and a wide range of nomenclature used. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was formulated in 2007, to give the world a uniform thyroid cytology reporting system, facilitating easy interpretation by the clinicians. Here, we review the status of thyroid FNAC in India in terms of various reporting systems used including a meta-analysis of the previously published data. An extensive literature search was performed using internet search engines. The reports with detailed classification system used in thyroid cytology were included. The meta-analysis of published data was compared with the implied risk of malignancy by TBSRTC. More than 50 studies were retrieved and evaluated. TBSRTC is currently the most widely used reporting system with different studies showing good efficacy and interobserver concordance. Ancillary techniques have, as of now, limited applicability and acceptability in thyroid cytology in India. Twenty-eight published articles met the criteria for inclusion in the meta-analysis. When compared with TBSRTC recommendations, the meta-analysis showed a higher risk of malignancy for categories I and III. Thyroid FNAC is practiced all over India. TBSRTC has found widespread acceptance, with most institutions using this system for routine thyroid cytology reporting. However, reasons for a high malignancy risk for categories I and III need to be looked into. Various possible contributing factors are discussed in the review.

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Incidence and Malignancy Rates in Thyroid Nodules in North-East Indian Population by Bethesda System: A Single Institutional Experience of 3 Years
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Evaluation of Concordance of Ultrasound, Cytology, and Histopathology in Solitary Thyroid Nodules
Sunil Chumber, Surabhi Vyas, Kamal Kataria, Shipra Agarwal, Yashwant S Rathore, Gopal Puri, Sushma Yadav, Kanika Sharma, Amit Patidar
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The Asian Thyroid Working Group, from 2017 to 2023
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Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Cytomorphological Categorization of Thyroid Lesions according to The Bethesda System for Reporting Thyroid Cytology and Correlation with their Histological Outcome
Meenakshi Kamboj, Anurag Mehta, Sunil Pasricha, Gurudutt Gupta, Anila Sharma, Garima Durga
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Pushkar Chaudhary, Naseem Noorunnisa
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Effect of the Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Nomenclature Revision on Indian Thyroid Fine-Needle Aspiration Practice
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American Journal of Clinical Pathology.2021; 156(2): 320. CrossRef
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Differentiated Thyroid Cancer
Anita M. Borges
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Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef

Thyroid Fine-Needle Aspiration Practice in the Philippines: Agustina D. Abelardo; J Pathol Transl Med. 2017;51(6):555-559. Published online October 5, 2017; DOI: https://doi.org/10.4132/jptm.2017.07.14

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Abstract PDF

Fine-needle aspiration (FNA) is a well accepted initial approach in the management of thyroid lesions. It has come a long way since its introduction for nearly a century ago. In the Philippines, FNA of the thyroid was first introduced 30 years ago and has been utilized until now as a mainstay in the diagnosis of thyroid malignancy. The procedure is performed by pathologists, endocrinologists, surgeons, and radiologists. Most pathologists report the cytodiagnosis using a combination of the aspiration biopsy cytology method that closely resembles the histopathologic diagnosis of thyroid disorders and the six-tier nomenclature of The Bethesda System for Reporting Thyroid Cytopathology. Local endocrinologists and surgeons follow the guidelines of the 2015 American Thyroid Association in the management of thyroid disorders. There is still a paucity of local research studies but available data deal with cytohistologic correlations, sensitivity, specificity, and accuracy rates as well as usefulness of ultrasound-guided FNA. Cytohistologic correlations have a wide range of sensitivity from 30.7% to 73% and specificity from 83% to 100%. The low sensitivity can be attributed to poor tissue sampling since a majority of the thyroid FNA is done by palpation only. The reliability can be improved if FNA is guided by ultrasound as attested in both international and local studies. Overall, FNA of the thyroid has enabled the diagnosis of thyroid disorders with an accuracy of 72.8% to 87.2% and it correlates well with histopathology.

Citations

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Combining radiomics and molecular biomarkers: a novel economic tool to improve diagnostic ability in papillary thyroid cancer
Qingxuan Wang, Linghui Dai, Sisi Lin, Shuwei Zhang, Jing Wen, Endong Chen, Quan Li, Jie You, Jinmiao Qu, Chunjue Ni, Yefeng Cai
Frontiers in Endocrinology.2024;[Epub] CrossRef
Agreement between Sonographic Features and Fine Needle Aspiration Cytology in the Diagnosis of Thyroid Nodules in a Tertiary Hospital
Danette Pabalan, Ricardo Victorio Quimbo
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The Asian Thyroid Working Group, from 2017 to 2023
Kennichi Kakudo, Chan Kwon Jung, Zhiyan Liu, Mitsuyoshi Hirokawa, Andrey Bychkov, Huy Gia Vuong, Somboon Keelawat, Radhika Srinivasan, Jen-Fan Hang, Chiung-Ru Lai
Journal of Pathology and Translational Medicine.2023; 57(6): 289. CrossRef
Application of the Bethesda System for Reporting Thyroid Cytopathology in the Pediatric Population
Huy Gia Vuong, Ayana Suzuki, Hee Young Na, Pham Van Tuyen, Doan Minh Khuy, Hiep Canh Nguyen, Tikamporn Jitpasutham, Agustina Abelardo, Takashi Amano, So Yeon Park, Chan Kwon Jung, Mitsuyoshi Hirokawa, Ryohei Katoh, Kennichi Kakudo, Andrey Bychkov
American Journal of Clinical Pathology.2021; 155(5): 680. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef
The Use of Fine-Needle Aspiration (FNA) Cytology in Patients with Thyroid Nodules in Asia: A Brief Overview of Studies from the Working Group of Asian Thyroid FNA Cytology
Chan Kwon Jung, SoonWon Hong, Andrey Bychkov, Kennichi Kakudo
Journal of Pathology and Translational Medicine.2017; 51(6): 571. CrossRef

Case Study

An Autopsy Case of Epstein-Barr Virus–Associated Diffuse Large B-Cell Lymphoma of the Central Nervous System in an Immunocompromised Host: Sun-Young Park, Seong Ik Kim, Hannah Kim, Yoojin Lee, Sung-Hye Park; J Pathol Transl Med. 2018;52(1):51-55. Published online August 4, 2017; DOI: https://doi.org/10.4132/jptm.2017.01.23

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Abstract PDF

Lymphomas arising in the central nervous system (CNS) of immunocompromised hosts are most commonly non-Hodgkin’s lymphomas and are highly associated with Epstein-Barr virus (EBV). Here we report an autopsy case of EBV-associated CNS diffuse large B-cell lymphoma (DLBCL) in a host suffering from systemic lupus erythematosus who underwent immunosuppressive therapy. After autopsy, EBV-associated CNS DLBCL as well as pulmonary mixed aspergillosis and Pneumocystis jirovecii pneumonia were added to the cause of clinical manifestations of complicated pneumonia and cerebral hemorrhage in this immunocompromised patient. In conclusion, complex disease processes were revealed by autopsy in this case, indicating that the clinicopathological correlations observed through autopsy can improve our understanding of disease progression and contribute to the management of similar patients in the future.

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Primary central nervous system lymphoma in neuropsychiatric systemic lupus erythematosus: case-based review
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Original Article

The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea: A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists: Mimi Kim, Hyo Jin Park, Hye Sook Min, Hyeong Ju Kwon, Chan Kwon Jung, Seoung Wan Chae, Hyun Ju Yoo, Yoo Duk Choi, Mi Ja Lee, Jeong Ja Kwak, Dong Eun Song, Dong Hoon Kim, Hye Kyung Lee, Ji Yeon Kim, Sook Hee Hong, Jang Sihn Sohn, Hyun Seung Lee, So Yeon Park, Soon Won Hong, Mi Kyung Shin; J Pathol Transl Med. 2017;51(4):410-417. Published online June 14, 2017; DOI: https://doi.org/10.4132/jptm.2017.04.05

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Abstract PDF

Background
The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has standardized the reporting of thyroid cytology specimens. The objective of the current study was to evaluate the nationwide usage of TBSRTC and assess the malignancy rates in each category of TBSRTC in Korea.
Methods
Questionnaire surveys were used for data collection on the fine needle aspiration (FNA) of thyroid nodules at 74 institutes in 2012. The incidences and follow-up malignancy rates of each category diagnosed from January to December, 2011, in each institute were also collected and analyzed.
Results
Sixty out of 74 institutes answering the surveys reported the results of thyroid FNA in accordance with TBSRTC. The average malignancy rates for resected cases in 15 institutes were as follows: nondiagnostic, 45.6%; benign, 16.5%; atypical of undetermined significance, 68.8%; suspicious for follicular neoplasm (SFN), 30.2%; suspicious for malignancy, 97.5%; malignancy, 99.7%.
Conclusions
More than 80% of Korean institutes were using TBSRTC as of 2012. All malignancy rates other than the SFN and malignancy categories were higher than those reported by other countries. Therefore, the guidelines for treating patients with thyroid nodules in Korea should be revisited based on the malignancy rates reported in this study.

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CD56 Expression in Papillary Thyroid Carcinoma Is Highly Dependent on the Histologic Subtype: A Potential Diagnostic Pitfall
Uiju Cho, Yourha Kim, Sora Jeon, Chan Kwon Jung
Applied Immunohistochemistry & Molecular Morphology.2022; 30(5): 389. CrossRef
Malignancy rates in thyroid nodules: a long-term cohort study of 17,592 patients
M Grussendorf, I Ruschenburg, G Brabant
European Thyroid Journal.2022;[Epub] CrossRef
Subclassification of the Bethesda Category III (AUS/FLUS): A study of thyroid FNA cytology based on ThinPrep slides from the National Cancer Center in China
Huan Zhao, HuiQin Guo, LinLin Zhao, Jian Cao, Yue Sun, Cong Wang, ZhiHui Zhang
Cancer Cytopathology.2021; 129(8): 642. CrossRef
Effect of the Noninvasive Follicular Thyroid Neoplasm With Papillary-Like Nuclear Features (NIFTP) Nomenclature Revision on Indian Thyroid Fine-Needle Aspiration Practice
Chanchal Rana, Pooja Ramakant, Divya Goel, Akanksha Singh, KulRanjan Singh, Suresh Babu, Anand Mishra
American Journal of Clinical Pathology.2021; 156(2): 320. CrossRef
Comprehensive DNA Methylation Profiling Identifies Novel Diagnostic Biomarkers for Thyroid Cancer
Jong-Lyul Park, Sora Jeon, Eun-Hye Seo, Dong Hyuck Bae, Young Mun Jeong, Yourha Kim, Ja Seong Bae, Seon-Kyu Kim, Chan Kwon Jung, Yong Sung Kim
Thyroid.2020; 30(2): 192. CrossRef
Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis
Huy Gia Vuong, Hanh Thi Tuyet Ngo, Andrey Bychkov, Chan Kwon Jung, Trang Huyen Vu, Kim Bach Lu, Kennichi Kakudo, Tetsuo Kondo
Cancer Cytopathology.2020; 128(4): 238. CrossRef
Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic
Butheinah A. Al-Sharafi, Jamila A. AlSanabani, Ibraheem M. Alboany, Amani M. Shamsher
Thyroid Research.2020;[Epub] CrossRef
Is Bethesda classification sufficient to predict thyroid cancer in endemic regions?
Gamze ÇITLAK, Bahar CANBAY TORUN
Journal of Surgery and Medicine.2020; 4(9): 794. CrossRef
Preoperative diagnostic categories of fine needle aspiration cytology for histologically proven thyroid follicular adenoma and carcinoma, and Hurthle cell adenoma and carcinoma: Analysis of cause of under- or misdiagnoses
Hee Young Na, Jae Hoon Moon, June Young Choi, Hyeong Won Yu, Woo-Jin Jeong, Yeo Koon Kim, Ji-Young Choe, So Yeon Park, Paula Soares
PLOS ONE.2020; 15(11): e0241597. CrossRef
Nuclear features of papillary thyroid carcinoma: Comparison of Core needle biopsy and thyroidectomy specimens
Jae Yeon Seok, Jungsuk An, Hyun Yee Cho, Younghye Kim, Seung Yeon Ha
Annals of Diagnostic Pathology.2018; 32: 35. CrossRef
Clinical utility of EZH1 mutations in the diagnosis of follicular-patterned thyroid tumors
Chan Kwon Jung, Yourha Kim, Sora Jeon, Kwanhoon Jo, Sohee Lee, Ja Seong Bae
Human Pathology.2018; 81: 9. CrossRef
The History of Korean Thyroid Pathology
Soon Won Hong, Chan Kwon Jung
International Journal of Thyroidology.2018; 11(1): 15. CrossRef
Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas
K. Kakudo, M. Higuchi, M. Hirokawa, S. Satoh, C. K. Jung, A. Bychkov
Cytopathology.2017; 28(6): 455. CrossRef
Thyroid Fine-Needle Aspiration Cytology Practice in Korea
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Journal of Pathology and Translational Medicine.2017; 51(6): 521. CrossRef
Current Practices of Thyroid Fine-Needle Aspiration in Asia: A Missing Voice
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Journal of Pathology and Translational Medicine.2017; 51(6): 517. CrossRef
Current Status of Thyroid Fine-Needle Aspiration Practice in Thailand
Somboon Keelawat, Samreung Rangdaeng, Supinda Koonmee, Tikamporn Jitpasutham, Andrey Bychkov
Journal of Pathology and Translational Medicine.2017; 51(6): 565. CrossRef

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