1,721,015 research outputs found
Thyroid FNA in the time of coronavirus: The interventional cytopathologist point of view
No full textCirculating tumour cells in predictive molecular pathology: Focus on drug-sensitive assays and 3D culture
No full textMolecular cytopathology is a rapidly evolving field of cytopathology that provides biological information about the response to personalised therapy and about the prognosis of neoplasms diagnosed on cytological samples. Biomarkers such as circulating tumour cells and circulating tumour DNA are increasingly being evaluated in blood and in other body fluids. Such liquid biopsies are non-invasive, repeatable, and feasible also in patients with severe comorbidities. However, liquid biopsy may be challenging due to a low concentration of biomarkers. In such cases, biomarkers can be detected with highly sensitive molecular techniques, which in turn should be validated and integrated in a complex algorithm that includes tissue-based molecular assessments. The aim of this review is to provide the cytopathologist with practical information that is relevant to daily practice, particularly regarding the emerging role of circulating tumour cells in the field of predictive molecular pathology
Histological and fine needle aspiration cytological features of Hashimoto thyroditis-associated 'angiomatoid' papillary thyroid carcinoma.
No full textThe association between Hashimoto thyroiditis (HT) and papillary thyroid carcinoma (PTC) is well known but few reports have described the morphological features of HT-associated PTC.1,2 Di
Pasquale et al.3 described a peculiar histological pattern of HT-associated PTC consisting of anastomosing spaces lined with cells having the characteristic nuclear features of PTC. The authors named this HT-associated variant of PTC as angiomatoid and
emphasized that these cases may be missed if the cells lining the spaces are not examined at high magnification. 3 We describe the fine needle aspiration (FNA) cytological and histological findings n a case of HT-associated PTC in its angiomatoid variant, in which the diagnosis of PTC was more straightforward on cytology than histology. A 16-year- ld girl complained of diffuse enlargement
of the neck. Clinical examination showed a generalized enlargement and increased hardness of the thyroid. Serological data showed high levels of anti-thyroglobulin, anti-thyreoproxidase antibodiesand increased thyroid-stimulating hormone (TSH)levels that were indicative of a HT with subclinical
hypothyroidism. An ultrasonography (US) showed the gland to have irregular borders, diffuse micronodulation and hyperechoic bands in both lobes. Moreover, an irregular, 12-mm-sized hypoechoic nodule was detected at the base of the right lobe; no
cervical lymph nodes were detected. An US-guided, FNA of the nodule was performed. The Diff-Quik stained smears were highly cellular; follicular cells were organized in very large overlapping groups with a branching appearance. In some monolayered
groups, the cells showed plentiful squamoid cytoplasm (Figure 1a); the nuclei were irregular in size and shape, with granular coarse chromatin and inconspicuous nucleoli. Grooves and cytoplasmic intranuclear inclusions were detected (Figure 1a, inset). The background was haemorrhagic, with some lymphoid
cells and tangles intermingled with follicular cells; colloid was absent. The cytological diagnosis was PTC in a background of HT.
The patient underwent a total thyroidectomy. The gland on the cut section was solid and showed a greyreddish colour, with accentuated lobulation. In the right lobe a haemorrhagic, ill-defined 12-mm nodule was detected. The histological sections showed the classic features of HT, with lymphoid follicles and
Hurthle cell metaplasia. The nodule appeared as a haemorrhagic, poorly defined area, and consisted of irregular, spaces, fibrotic bands and inflammatory cells lacking papillary or follicular structures (Figure 1b). The spaces ranged from a roundish to stag-horn pattern and were lined with flat or cuboidal epithelial
cells (Figure 1c). Follicular cells showed plentiful cytoplasm, irregular nuclei, sometimes empty, with grooves and cytoplasmic intranuclear inclusions (Figure 1c, inset); these cells were positive for thyroglobulin and thyroid transcription factor-1 (TTF-1) on immunohistochemistry. Because of the coexistence of
the classic nuclear features of PTC and the histological
features described above, a diagnosis of HT-associated
PTC in its angiomatoid variant was made. There is clinical and pathological evidence of a relationship between HT and PTC ranging between some cytological features and RET-PTC rearrangement. 1 Some studies report that over 90% of thyroids
with HT express RET ⁄ PTC1 and RET ⁄ PTC3 oncogenes.4
Nevertheless, few reports have described the morphological
features of HT-associated PTC
Cytology-based gene mutation tests to predict response to anti-epidermal growth factor receptor therapy: a review.
No full textRecent therapeutic progresses in nonsmall cell lung cancer (NSCLC) and in colorectal cancer (CRC) are based on agents that specifically target the epidermal growth factor receptor (EGFR). To identify the patients most likely to benefit from such therapies, EGFR or KRAS gene mutation tests are mandatory, respectively, in NSCLC and in CRC. In patients with locally advanced or metastatic disease, exploiting cytological samples for these tests avoids not curative surgery. Here, we review the studies that have applied gene mutation assays on cytological samples of NSCLC and CRC to select patients for anti-EGFR therapy. We argue that the standard of quality of gene mutation tests on cytological samples is closely dependent on the extent of the cytopathologist's involvement
Molecular Tests for Risk-Stratifying Cytologically Indeterminate Thyroid Nodules: An Overview of Commercially Available Testing Platforms in the United States
No full textThe past decade has witnessed significant advances in the application of molecular diagnostics for the pre-operative risk-stratification of cytologically indeterminate thyroid nodules. The tests that are currently marketed in the United States for this purpose combine aspects of tumor genotyping with gene and/or microRNA expression profiling. This review compares the general methodology and clinical validation studies for the three tests currently offered in the United States: ThyroSeq v3, Afirma GSC and Xpression Atlas, and ThyGeNEXT/ThyraMIR
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Molecular predictive testing in precision oncology: The Italian experience
No full textIn this review, we describe molecular pathology testing to predict response to targeted treatment of solid tumors, focusing on Italian routine clinical practice. The combination of the universal health care system organized at national, regional, and local levels has led a decentralized model, with a large number of local laboratories performing in-house molecular testing following guidelines issued and external quality assessment organized by the Italian Society of Pathology and Cytopathology–Italian Division of the International Academy of Pathology. In this framework, in the early days of predictive testing, sponsored informatics platforms support to set up national programs that aimed to integrate the activity of oncologists and pathologists to test cancer patients for druggable alterations. More recently, reimbursement for molecular testing is being covered completely by the Italian National Health Service. In the near future, considering the development of complex technologies, we expect that outsourcing samples to next-generation sequencing referral laboratories will take place
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Role of Cytomorphology in the Era of Liquid Biopsy
No full textIn the late stages of non-small cell lung cancer, the detection of sensitizing mutations of the epidermal growth factor receptor (EGFR) is mandatory to select patients' treatment with first- or second-generation tyrosine kinase inhibitors (TKIs). In patients showing progressive disease, the assessment of the EGFR exon 20 resistance point mutation p.T790M is required for third-generation TKI administration. However, molecular analysis does not capture all the different mechanisms of resistance against these molecules. A variety of morphological changes associated with acquired resistance have also been described. Since an altered morphology may be the only clue to acquired resistance, cytopathology still plays a relevant role in this setting. In this comprehensive review, we have focused on the relevance of squamous cell carcinoma, small cell lung cancer and large-cell neuroendocrine carcinoma transitions from adenocarcinoma resistant to TKIs
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