Cancer Cytopathology

Cover image for Vol. 122 Issue 4

Early View (Online Version of Record published before inclusion in an issue)

Edited By: Celeste N. Powers, MD, PhD

Impact Factor: 4.434

ISI Journal Citation Reports © Ranking: 2012: 11/77 (Pathology); 45/197 (Oncology)

Online ISSN: 1934-6638

Associated Title(s): Cancer, CA: A Cancer Journal for Clinicians


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  1. Reply to Correspondence

    1. Reply to verification bias in diagnostic accuracy studies for fine-needle aspiration cytology

      Arivarasan Karunamurthy, Guoping Cai, Sanja Dacic, Walid E. Khalbuss, Liron Pantanowitz and Sara E. Monaco

      Article first published online: 18 APR 2014 | DOI: 10.1002/cncy.21432

  2. Original Articles

    1. Evaluation of intraoperative cytological assessment of bone resection margins in patients with oral squamous cell carcinoma

      Markus Nieberler, Patrick Häusler, Enken Drecoll, Mechthild Stoeckelhuber, Herbert Deppe, Frank Hölzle, Andreas Kolk, Klaus-Dietrich Wolff, Marco Rainer Kesting and Gregor Weirich

      Article first published online: 18 APR 2014 | DOI: 10.1002/cncy.21428

      The current study evaluates the intraoperative cytological assessment of bone resection margins to control resection status in patients with bone-infiltrating oral squamous cell carcinomas. The work demonstrates that intraoperative cytological assessment of bone resection margins could supplement the intraoperative assessment of soft tissue margins through the immediate microscopic control of bony resection margins, enabling a guided reresection of positive bone margins during a surgical intervention to optimize surgical concepts, especially for patients with carcinoma, who receive primary reconstruction with osteo-(myo-)cutaneous microvascular transplants.

  3. Correspondence

  4. Original Articles

    1. Targeted multiprobe fluorescence in situ hybridization analysis for elucidation of inconclusive pancreatobiliary cytology

      Tatjana Vlajnic, Gina Somaini, Spasenija Savic, Audrey Barascud, Bruno Grilli, Michelle Herzog, Ellen C. Obermann, Brittany J. Holmes, Syed Z. Ali, Lukas Degen and Lukas Bubendorf

      Article first published online: 18 APR 2014 | DOI: 10.1002/cncy.21429

      This study shows that multitarget fluorescence in situ hybridization (FISH) is diagnostically helpful in cases of inconclusive pancreatobiliary cytology (including atypical and suspicious categories).

    2. Risk stratification in follicular neoplasm: A cytological assessment using the modified bethesda classification

      Berrin Ustun, David Chhieng, Alison Van Dyke, Tobias Carling, Elizabeth Holt, Robert Udelsman and Adebowale J. Adeniran

      Article first published online: 18 APR 2014 | DOI: 10.1002/cncy.21425

      The results of the current study indicate that follicular lesions with even subtle nuclear atypia have high positive predictive value for malignancy and therefore should be distinguished from other follicular lesions because these cases require more aggressive surgical management. The study also raises an important issue concerning the current thyroid classification based on the 2007 Bethesda classification of thyroid cytology. Future thyroid fine-needle aspiration classification schemes should consider subclassifying follicular neoplasms for the purpose of risk stratification.

    3. Molecular testing in lung cancer: Fine-needle aspiration specimen adequacy and test prioritization prior to the CAP/IASLC/AMP Molecular Testing Guideline publication

      Oana C. Rafael, Mohamed Aziz, Harry Raftopoulos, Oana E. Vele, Weisheng Xu and Chiara Sugrue

      Article first published online: 10 APR 2014 | DOI: 10.1002/cncy.21426

      The current study underscores the need for a testing prioritization algorithm in view of the College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology 2013 Molecular Testing Guideline publication to optimize usage of fine-needle aspiration material for both diagnostic and therapy guidance purposes. Implementation of an institution-wide algorithm would serve as a helpful reference for both clinicians and pathologists.

    4. Usefulness of GATA3 and p40 immunostains in the diagnosis of metastatic urothelial carcinoma in cytology specimens

      Tamar C. Brandler, Mohamed S. Aziz, Lisa M. Rosen, Tawfiqul A. Bhuiya and Oksana Yaskiv

      Article first published online: 7 APR 2014 | DOI: 10.1002/cncy.21424

      GATA3 (GATA-binding protein 3) is useful in confirming the diagnosis of metastatic urothelial carcinoma (MUC) in cytology specimens and in distinguishing between MUC and squamous cell carcinoma. p40 is a valuable adjunct to GATA3 in the diagnosis of MUC in cytology specimens.

  5. Correspondence

  6. Help Desk

  7. Original Articles

    1. Focus on technology: How important is resolution in telecytopathology?

      Rachel Q. McMahon, Erin E. McCarthy, Scott J. Hetzel, Kasturi Das and Jimmie Stewart III

      Article first published online: 27 MAR 2014 | DOI: 10.1002/cncy.21404

      Two telepathology systems with differing resolutions are analyzed to determine whether there is a statistical difference in pathologists' ability to give preliminary diagnoses on fine-needle aspiration cases. Evaluation of the data indicates no statistical difference between the 2 systems, but the system with a higher resolution lends itself to greater user satisfaction.

  8. Erratum

    1. You have free access to this content
    2. You have free access to this content
  9. Review Articles

    1. Aggressive variants of follicular cell-derived thyroid carcinomas: A cytopathologist's perspective

      Ricardo R. Lastra, Virginia A. LiVolsi and Zubair W. Baloch

      Article first published online: 24 MAR 2014 | DOI: 10.1002/cncy.21417

      Fine-needle aspiration is the dominant modality for diagnosing thyroid nodules. It has been demonstrated that certain follicular cell-derived thyroid carcinomas have a worse prognosis, and these are termed “aggressive variants” of thyroid carcinomas. The salient cytomorphologic features of these “aggressive variants” are described in this review.

  10. Original Articles

    1. Anaplastic lymphoma kinase gene rearrangements in cytological samples of non-small cell lung cancer: Comparison with histological assessment

      Agnese Proietti, Greta Alì, Serena Pelliccioni, Cristiana Lupi, Elisa Sensi, Laura Boldrini, Adele Servadio, Antonio Chella, Alessandro Ribechini, Federico Cappuzzo, Mario Miccoli and Gabriella Fontanini

      Article first published online: 19 MAR 2014 | DOI: 10.1002/cncy.21418

      Anaplastic lymphoma kinase (ALK) rearrangement is present in 2% to 7% of cases of non-small cell lung cancer. Fluorescence in situ hybridization is currently the elective method for their detection. Although this assay has been approved on histological samples, its usefulness in detecting ALK gene rearrangements in cytological specimens has not been assessed fully. The authors found that ALK gene rearrangement may be easily detected in cytological samples and particularly in direct smears. Moreover, cytological samples may be useful for ALK analysis when insufficient material is available in cell blocks or small biopsy samples.

    2. Fine-needle aspiration in desmoplastic small round cell tumor: A report of 10 new tumors in 8 patients with clinicopathological and molecular correlations with review of the literature

      Jerzy Klijanienko, Pierre Colin, Jérôme Couturier, Réal Lagacé, Paul Fréneaux, Gaëlle Pierron, Marick Laé, Alice Klijanienko, Hervé Brisse, Daniel Orbach and Stamatios Theocharis

      Article first published online: 17 MAR 2014 | DOI: 10.1002/cncy.21415

      The combination of smears showing poorly differentiated round cell morphology, cytoplasmic paranuclear densities, presence of connective fragments, specific clinical context, young adult/pediatric age, intra-abdominal localization, specific immunohistochemical profile, and unique cytogenetic abnormality are highly specific for desmoplastic small round cell tumor and allow an accurate diagnosis.

    3. Analysis of immunocytochemical and molecular BRAF expression in thyroid carcinomas: A cytohistologic institutional experience

      Esther Diana Rossi, Maurizio Martini, Sara Capodimonti, Tonia Cenci, Patrizia Straccia, Basilio Angrisani, Costantino Ricci, Paola Lanza, Celestino Pio Lombardi, Alfredo Pontecorvi, Luigi Maria Larocca and Guido Fadda

      Article first published online: 17 MAR 2014 | DOI: 10.1002/cncy.21416

      BRAF mutation is a strong indicator of papillary thyroid cancer because of its high specificity and positive predictive value, and it can easily be evaluated on thyroid cytologic samples. The new VE1 immunomarker—a monoclonal antibody directed against the mutated BRAF V600E protein—may be a valid alternative to DNA-based methods and produces good results in the presence of moderate and/or strong expression.

  11. Editorials

    1. You have free access to this content
      Should the thyroid AUS/FLUS category be further stratified by malignancy risk?

      Michiya Nishino and Helen H. Wang

      Article first published online: 13 MAR 2014 | DOI: 10.1002/cncy.21412

      Is it time for subcategories within the AUS/FLUS (atypia of undetermined significance/follicular lesion of undetermined significance) category in The Bethesda System for Reporting Thyroid Cytopathology? This editorial summarizes recent reports on risk stratification within the AUS/FLUS subcategory and its implications for patient management.

  12. Original Articles

    1. Thyroid “atypia of undetermined significance” with nuclear atypia has high rates of malignancy and BRAF mutation

      Hyo Jin Park, Jae Hoon Moon, Cha Kyong Yom, Kyu Hyung Kim, June Young Choi, Sang Il Choi, Soon-Hyun Ahn, Woo-Jin Jeong, Won Woo Lee and So Yeon Park

      Article first published online: 11 MAR 2014 | DOI: 10.1002/cncy.21411

      The “atypical of undetermined significance” (AUS) with nuclear atypia subcategory of the Bethesda System for Reporting Thyroid Cytopathology was associated with the highest risk of malignancy and the greatest frequency of BRAF-V600E mutation. The subcategorization of AUS by cytomorphology and BRAF-V600E mutation status is important for predicting the risk of malignancy.

    2. Comparison of urine cytology and fluorescence in situ hybridization in upper urothelial tract samples

      Jordan P. Reynolds, Jesse S. Voss, Benjamin R. Kipp, R. Jeffrey Karnes, Aziza Nassar, Amy C. Clayton, Michael R. Henry, Thomas J. Sebo, Jun Zhang and Kevin C. Halling

      Article first published online: 6 MAR 2014 | DOI: 10.1002/cncy.21414

      When evaluating upper tract urothelial specimens using UroVysion fluorescence in situ hybridization, only hypertetrasomic results (≥ 5 signals) should be interpreted as positive. Samples should be interpreted with caution in patients with a history of bladder carcinoma.

  13. Review Articles

    1. Cytopathology of pediatric malignancies: Where are we today with fine-needle aspiration biopsies in pediatric oncology?

      Sara E. Monaco and Lisa A. Teot

      Article first published online: 6 MAR 2014 | DOI: 10.1002/cncy.21401

      Childhood malignancies are infrequent and differ from adult malignancies clinically and pathologically. This review discusses childhood malignancies, focusing on their frequency in different age groups, representation in cytologic specimens in different geographic regions, the use of cytopathology as a diagnostic tool in the United States, and cytological features of selected tumors using a pattern-based approach.

  14. Original Articles

    1. The prediction of malignant risk in the category “atypia of undetermined significance/follicular lesion of undetermined significance” of the Bethesda System for Reporting Thyroid Cytopathology using subcategorization and BRAF mutation results

      Jiyeon Hyeon, Soomin Ahn, Jung Hee Shin and Young Lyun Oh

      Article first published online: 3 MAR 2014 | DOI: 10.1002/cncy.21396

      The subcategory “AUS” indicates a higher risk of malignancy than the subcategory “FLUS.” Furthermore, BRAF molecular testing is helpful in stratifying the malignant risk of AUS cases into high-risk and low-risk groups.

    2. Cystic pancreatic neuroendocrine tumors: The value of cytology in preoperative diagnosis

      Vicente Morales-Oyarvide, Won Jae Yoon, Thun Ingkakul, David G. Forcione, Brenna W. Casey, William R. Brugge, Carlos Fernández-del Castillo and Martha B. Pitman

      Article first published online: 3 MAR 2014 | DOI: 10.1002/cncy.21403

      Cytopathology is the most accurate test for the preoperative diagnosis of cystic pancreatic neuroendocrine tumors. Endoscopic ultrasound is insufficiently accurate for independent diagnosis, and carcinoembryonic antigen and amylase analyses are noncontributory.

  15. Point/Counterpoint

  16. Original Articles

    1. Measurement of fine-needle aspiration thyroglobulin levels increases the detection of metastatic papillary thyroid carcinoma in cystic neck lesions

      Brittany J. Holmes, Lori J. Sokoll and Qing Kay Li

      Article first published online: 3 MAR 2014 | DOI: 10.1002/cncy.21413

      Measurement of thyroglobulin in fine-needle aspiration material from cystic neck masses improves the detection of metastatic papillary thyroid carcinoma. This ancillary test is particularly useful in cases with inadequate or nondiagnostic cytologic findings.

  17. Clinician's Corner

  18. Original Articles

    1. Reprocessing unsatisfactory ThinPrep Papanicolaou tests using a modified SurePath preparation technique

      Melissa L. Randolph, Howard H. Wu and William N. Crabtree

      Article first published online: 20 FEB 2014 | DOI: 10.1002/cncy.21408

      The modified SurePath processing method was found to be adept at handling nearly all of the challenges that biological and environmental conditions (blood, protein, lubricant, etc) present in unsatisfactory liquid-based filter preparations. A total of 1093 (56%) of 1937 unsatisfactory ThinPrep Papanicolaou tests were converted to a satisfactory state, resulting in the diagnosis of 116 abnormalities (10.6%) that otherwise would have gone undetected.

    2. You have full text access to this OnlineOpen article
      Optimizing detection of RET and PPARg rearrangements in thyroid neoplastic cells using a home-brew tetracolor probe

      Paola Caria, Daniela V. Frau, Tinuccia Dettori, Francesco Boi, Maria L. Lai, Stefano Mariotti and Roberta Vanni

      Article first published online: 7 FEB 2014 | DOI: 10.1002/cncy.21397

      A home-brew tetracolor FISH probe for the simultaneous detection of RET/PTC and PAX8/PPARg alterations in thyroid nodule FNA is reported. Application of the probe on 368 FNA samples demonstrated feasibility, suggesting that this probe may be considered an alternative to the RT-PCR assay when recovery and quality of RNA amplification from FNA is limited.

  19. Review Articles

    1. Growing indication for FNA to study and analyze tumor heterogeneity at metastatic sites

      Francisco Beca and Fernando Schmitt

      Article first published online: 29 JAN 2014 | DOI: 10.1002/cncy.21395

      Metastatic disease is a challenging clinical problem, and due to the increased recognition of cancer phenotypical heterogeneity and evolution, more frequent biopsies may be needed. Presently, because most ancillary studies and molecular techniques can be performed in cytological specimens, cytopathology can become a discipline with a central role in state-of-the-art diagnoses and treatment of metastatic disease.

  20. Original Articles

    1. Isthmic-vaginal smear cytology in the follow-up after radical vaginal trachelectomy for early stage cervical cancer: Is it safe?

      Malgorzata Lanowska, Mandy Mangler, Ulrike Grittner, Gerta Rose Akbar, Dorothee Speiser, Elisabeth von Tucher, Christhardt Köhler, Achim Schneider and Wolfgang Kühn

      Article first published online: 29 JAN 2014 | DOI: 10.1002/cncy.21402

      Isthmic-vaginal cytology is useful in the follow-up of patients after fertility-preserving surgery for early cervical cancer as recurrent dysplasia and malignancy in the remaining cervix may be diagnosed. Improved communication between cytopathologists and clinicians and a modification of the surgical technique may help to achieve more valuable smears.

    2. The role of thyroid fine-needle aspiration cytology in the pediatric population: An institutional experience

      Esther Diana Rossi, Patrizia Straccia, Maurizio Martini, Luca Revelli, Celestino Pio Lombardi, Alfredo Pontecorvi and Guido Fadda

      Article first published online: 28 JAN 2014 | DOI: 10.1002/cncy.21400

      The current study evaluates the authors' pediatric thyroid series with cytohistological control to analyze the distribution of the diagnostic categories and the role of a well-known immunocytochemical panel. The higher incidence of histological malignancies justifies the cytological application of ancillary techniques, thereby enabling a more adequate surgical selection for the categories of follicular/indeterminate neoplasm including atypical cells of indeterminate significance and suspicious for malignancy.

    3. Atypical cytologic diagnostic category in EUS-FNA of the pancreas: Follow-up, outcomes, and predictive models

      Evan Alston, Sejong Bae and Isam A. Eltoum

      Article first published online: 16 JAN 2014 | DOI: 10.1002/cncy.21389

      This study assessed the outcomes of the atypical diagnostic category in EUS-FNA of the pancreas and developed a predictor model to determine which factors are likely to be associated with pancreatic neoplasm or ductal carcinoma following this diagnosis.

  21. Commentary

  22. Original Articles

    1. Malignancy risk associated with diagnostic categories defined by the Papanicolaou Society of Cytopathology pancreaticobiliary guidelines

      Lester J. Layfield, Leslie Dodd, Rachel Factor and Robert L. Schmidt

      Article first published online: 11 DEC 2013 | DOI: 10.1002/cncy.21386

      The diagnostic categories of the Papanicolaou Society of Cytopathology stratify risk of malignancy. An increasing risk of malignancy is associated with progression through the categories “benign,” “atypical,” “suspicious for malignancy,” and “malignant.”

    2. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) contributes to a triple-negative test in preoperative screening of pancreatic cysts

      Roseann I. Wu, Won Jae Yoon, William R. Brugge, Mari Mino-Kenudson and Martha B. Pitman

      Article first published online: 10 DEC 2013 | DOI: 10.1002/cncy.21385

      Endoscopic ultrasound-guided fine-needle aspiration is a screening test that contributes to a triple-negative result for pancreatic cysts—no high-risk stigmata, no worrisome features, and no high-grade atypia on cytology—providing a high negative predictive value for conservative management.


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