Risk of malignancy associated with the diagnostic categories proposed by the Papanicolaou Society of Cytopathology for pancreaticobiliary specimens: An institutional experience

2021 ◽  
Author(s):  
Miguel S. Gonzalez‐Mancera ◽  
Saman S. Ahmadian ◽  
Carmen Gomez‐Fernandez ◽  
Jaylou Velez‐Torres ◽  
Merce Jorda ◽  
...  
Keyword(s):  
Diagnostic Categories ◽  
Risk Of Malignancy ◽  
Institutional Experience

scholarly journals The Milan System, from Its Introduction to Its Current Adoption in the Diagnosis of Salivary Gland Cytology

2021 ◽  
Vol 2 (2) ◽  
pp. 114-122
Author(s):  
Esther Diana Rossi
Keyword(s):  
Salivary Gland ◽  
Daily Practice ◽  
Needle Aspiration ◽  
Classification Systems ◽  
Diagnostic Categories ◽  
International Group ◽  
The Everyday ◽  
Neoplastic Process ◽  
Risk Of Malignancy ◽  
Well Differentiated

Salivary gland masses are often encountered in the everyday practice of cytopathology. It is commonly known that the cytologic interpretation of these lesions can pose diagnostic problems due to overlapping cytomorphologic features. Fine needle aspiration (FNA) of salivary lesions shows good to excellent sensitivity and specificity in differentiating a neoplastic from a non-neoplastic process and in diagnosing common tumors such as pleomorphic adenoma. However, its value is limited in diagnosing specific neoplastic entities especially those with well-differentiated morphology. In light of this gap, an international group of pathologists has proposed a management-oriented, tiered classification for reporting salivary gland FNA specimens, “The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC)”. Similar to other classification systems, the MSRSGC scheme comprises six diagnostic categories, which were linked with a specific risk of malignancy (ROM) and management. In this review article, the author evaluated the published literature on FNA in diagnosing salivary gland lesions with the adoption of the Milan system since its introduction in the daily practice of salivary cytopathology.

scholarly journals Malignancy Rate in Thyroid Nodules with Atypia or Follicular Lesion of Undetermined Significance

2020 ◽  
Vol 24 (02) ◽  
pp. e221-e226
Author(s):  
Hamdan Ahmed Pasha ◽  
Rahim Dhanani ◽  
Ainulakbar Mughal ◽  
Kaleem S. Ahmed ◽  
Anwar Suhail
Keyword(s):  
Thyroid Nodules ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Diagnostic Categories ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Undetermined Significance

Abstract Introduction Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) is one of the six diagnostic categories of the Bethesda System for Reporting Thyroid Cytopathology. The prevalence of malignancy among Bethesda category III cytology is variable, ranging from 5% to 37% in the literature. Objective To determine the rate of malignancy in thyroid nodules reported as Bethesda category III. Methods A total of 495 patients underwent surgical intervention for thyroid nodules from January 2015 to December 2017. The present study included 81 cases reported as Bethesda category III, and their medical records were reviewed. Results Out of 495 fine-needle aspiration cytology samples, 81 (16.4%) samples were labeled as AUS/FLUS. Among these 81 patients, the mean age was 43.0 years (± 13.9), with only 11 (14%) patients older than 55 years of age. Most of our patients were female (n = 69; 85.2%), and the rest were male. The rate of malignancy based on the final histology was of 33.3% (n = 27). The majority were 17 cases (21%) of papillary carcinoma, followed by follicular carcinoma (n = 6) (7.4%). Conclusion The risk of malignancy can be higher than it is commonly believed, and guidelines should be based on the data from the institutions themselves for a better assessment of the outcomes.

Risk of malignancy in “atypia of undetermined significance” category of salivary gland fine‐needle aspiration: A bi‐institutional experience

2019 ◽  
Vol 48 (2) ◽  
pp. 138-143 ◽  
Author(s):  
Fatimah Alruwaii ◽  
Jen‐Fan Hang ◽  
Bao‐Rung Zeng ◽  
Harvey M. Cramer ◽  
Chiung‐Ru Lai ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Risk Of Malignancy ◽  
Institutional Experience ◽  
Undetermined Significance

Pleureaergüsse: Zytohistologie als wesentliche Option zum Ausschluss oder zur Bestätigung einer bösartigen Ursache

2021 ◽  
pp. 1-3
Author(s):  
Franz Stanzel
Keyword(s):  
International System ◽  
The Body ◽  
Future Research ◽  
Pleural Effusions ◽  
Serous Fluid ◽  
Pleural Biopsy ◽  
Diagnostic Categories ◽  
Unknown Significance ◽  
Risk Of Malignancy ◽  
Fluid Cytology

The International System for Reporting Serous Fluid Cytology (TIS) was recently developed. Given its novelty, most studies looking into the risk of malignancy (ROM) of serous effusion diagnostic categories were published before the development of TIS. We searched the database of our department for pleural effusions diagnosed in the last five years, excluding those without a corresponding pleural biopsy. Cases were reviewed and reclassified according to the TIS. A cytohistological correlation was performed. In total, 350 pleural effusion specimens with one or more corresponding pleural biopsies were included. After reclassification, 5 (1.43%) were nondiagnostic (ND), 253 (72.29%) were negative for malignancy (NFM), 7 (2.00%) had atypia of unknown significance (AUS), 14 (4.00%) were suspicious for malignancy (SFM), and 71 (20.57%) were malignant (MAL). Calculated ROM was 40% for ND, 20.16% for NFM, 42.86% for AUS, 78.57% for SFM, and 100% for MAL. Effusion cytology sensitivity and specificity were 60.29% and 98.56%, respectively. This is the first publication looking into the cytohistological correlation of a retrospective cohort of pleural effusions based on the TIS. We add to the body of data regarding the ROM for TIS categories, highlighting areas of potential future research.

RISK STRATIFICATION UTILIZING THE MILAN SYSTEM OF CLASSIFICATION FOR SALIVARY GLAND CYTOLOGY : A CYTOHISTOLOGICAL CORRELATION STUDY IN TERTIARY CARE HOSPITAL IN HIMACHAL PRADESH

2021 ◽  
pp. 22-24
Author(s):  
Monica Sarohi ◽  
Kavita Mardi
Keyword(s):  
Salivary Gland ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Management ◽  
Care Hospital ◽  
Conventional System ◽  
Diagnostic Categories ◽  
Risk Of Malignancy

Introduction- Milan system is an evidence based system derived from the literature which correlates diagnostic categories with risk of malignancy and clinical management strategies. The goals of this system were to standardize salivary gland cytology reporting across institutions and provide a framework for guiding clinical management. It is a tier based classication having six diagnostic categories. The conventional system was used for diagnosis before the advent of Milan system. In this study, FNAC done for all sa Material and methods- livary gland lesions over a period of two years from 2018 - 2020 in department of pathology, IGMC Shimla are included. All cases are categorized according to MSRSGC and correlated with histopathological follow up wherever available. We calculated the sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy of FNA using the Milan system. We also calculated the ROM was for each category. All the cases were Results: categorized as per MSRSGC and were 14%, 45.4%, 0%, 31.4%, 0.6%, 0.6% and 8% in category I, II, III, IVA, IVB, V and VI respectively. ROM for category I, II, IVA, IVB, V and VI was 0%, 0%, 2.6%, 0%, 100% and 87.5% respectively. The sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy was 98.51%, 66.67%, 98.51%, 66.67% and 97.14% respectively. Milan system is an Discussion: effective tool for diagnosing salivary gland lesions. It offers advantages over the conventional system such as risk of malignancy, management options for each category and a better communication both institute wise and between clinicians and cytopathologists.

Application of the Bethesda Classification for Thyroid Fine-Needle Aspiration: Institutional Experience and Meta-analysis

2016 ◽  
Vol 140 (10) ◽  
pp. 1121-1131 ◽  
Author(s):  
Elliot A. Krauss ◽  
Megan Mahon ◽  
Jean M. Fede ◽  
Lanjing Zhang
Keyword(s):  
Fine Needle Aspiration ◽  
Meta Analysis ◽  
Needle Aspiration ◽  
Data Sources ◽  
Follicular Neoplasm ◽  
Fine Needle ◽  
Diagnostic Categories ◽  
Risk Of Malignancy ◽  
Thyroid Fna ◽  
Undetermined Significance

Context.—Fine-needle aspiration (FNA) biopsies have been an important component in the preoperative evaluation of thyroid nodules. Until the introduction of the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) in 2008, individual institutions had developed their own diagnostic categories. The BSRTC proposed 6 categories in an attempt to standardize reporting of thyroid FNA. Objective.—To present a 15-year experience of thyroid FNA at one institution, including data before and after introduction of the BSRTC. The risk of malignancy is compared with the meta-analysis of high-quality published data. Data Sources.—Data sources were PubMed, a manual search of references, and institutional data. Conclusions.—The diagnostic categories developed at our institution were similar to those proposed by the BSRTC, with best fit into the 6 categories easily accomplished and reported in the final 2 years of the study. Significant differences were noted in the frequencies of cases in diagnostic categories Benign (II; P = .003), Suspicious for follicular neoplasm/Follicular neoplasm (IV; P < .001), and Malignant (VI; P = .003) after the introduction of the BSRTC. Eighteen published articles met the criteria for inclusion in the meta-analysis. The risk of malignancy in each category in our institution was similar to that determined in the meta-analysis, except for Insufficient for diagnosis (I; 20% versus 9%–14%). Meta-analysis showed an overlapping 95% CI of risk of malignancy between Atypia of undetermined significance/Follicular lesion of undetermined significance (III; 11%–23%) and Suspicious for follicular neoplasm/Follicular neoplasm (IV; 20%–29%), suggesting similar risks of malignancy. The use of newer molecular tests for these indeterminate cases may further refine risk assessment.

scholarly journals Accuracy and risk of malignancy for diagnostic categories in urine cytology at a large tertiary institution

2014 ◽  
Vol 123 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Karen Chau ◽  
Lisa Rosen ◽  
Constantinos Coutsouvelis ◽  
Maly Fenelus ◽  
Ryan Brenkert ◽  
...  
Keyword(s):  
Urine Cytology ◽  
Tertiary Institution ◽  
Diagnostic Categories ◽  
Risk Of Malignancy

scholarly journals Performance of the Bethesda System for Reporting Thyroid Cytology in Multi-Institutional Large Cohort of Pediatric Thyroid Nodules: A Detailed Analysis

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 179
Author(s):  
Sule Canberk ◽  
Helena Barroca ◽  
Inês Girão ◽  
Ozlem Aydın ◽  
Aysun Uguz ◽  
...  
Keyword(s):  
Task Force ◽  
Paediatric Population ◽  
High Rate ◽  
Histologic Diagnosis ◽  
Thyroid Cytology ◽  
Risk Of Malignancy ◽  
Institutional Experience ◽  
Bethesda System ◽  
Sensitivity Specificity ◽  
The Bethesda System

Background: To evaluate the performance of TBSRTC through multi-institutional experience in the paediatric population and questioning the management recommendation of ATA Guidelines Task Force on Paediatric Thyroid Cancer; Methods: A retrospective search was conducted in 4 institutions to identify consecutive thyroid FNAC cases in paediatric population between 2000 and 2018. Following the 2nd TBSRTC, the risk of malignancy ratios (ROMs) was given in ranges and calculated by 2 different ways. Sensitivity, specificity, PPV, NPV and DA ratios were calculated using histologic diagnosis as the gold standard; Results: Among a total of 405 specimens, the distribution of cases for each category was, 44 (11%) for ND, 204 (50%) for B category, 40 (10%) for AUS/FLUS, 36 (9%) for FN/SFN, 24 (6%) for SFM and 57 (14%) for M categories. 153 cases have a histological diagnosis. The ratio of surgery was 23% in ND, 16% in the B, 45% for AUS/FLUS, 75% for SFN/FN and 92% for SFM and 75% in M categories; Conclusions: The data underlines the high ROM values in paediatric population which might be clinically meaningful. The high rate of malignancy of the cohort of operated patients (50%) also underlines the need of better preoperative indicators for stratification. Considering that more than half of the nodules in AUS/FLUS category were benign, direct surgery recommendation could be questionable as proposed in ATA 2015 guidelines.

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