Publications by authors named "Aylin Simsir"
Article Synopsis
- TERT promoter mutations are frequently found in thyroid cancers, but their impact on tumor behavior along with other molecular changes is not fully understood.
- A study of 32 patients revealed that most cases with TERT mutations and additional molecular changes were malignant, particularly high-grade thyroid carcinomas (HGCs).
- Isolated TERT mutations were more likely linked to benign tumors, while cases with multiple mutations were predominantly associated with malignancy, especially high-grade forms.
Article Synopsis
- - The study focuses on the role of fine needle aspiration (FNA) in assessing salivary gland tumors, specifically looking into the “Salivary Gland Neoplasm of Uncertain Malignant Potential” (SUMP) category as defined by the Milan System.
- - Researchers analyzed FNA cases from three academic institutions to determine the risk of neoplasm (RON) and risk of malignancy (ROM) in different SUMP subtypes, finding that overall ROM for SUMP was 20.8%, with clear cell subtype having a high malignancy rate.
- - Results showed variability in ROM across institutions and SUMP subtypes, reinforcing the necessity for precise categorization of SUMP lesions, particularly clear cell types, for effective
Article Synopsis
- The RECOVER-Pathology study focuses on analyzing the long-term effects of SARS-CoV-2 (long COVID) by examining postmortem tissue to better understand the prevalence and types of organ injuries related to PASC.
- The study will involve detailed autopsies of individuals who died at least 15 days after their initial COVID-19 infection, with the aim of linking pathological findings to clinical characteristics and identifying potential causes of ongoing symptoms.
- As the largest autopsy study on long COVID in the U.S., RECOVER-Pathology seeks to contribute significantly to knowledge about the mechanisms behind organ damage and to help guide future treatments.
Article Synopsis
- The 2019 guidelines recommend women with an unsatisfactory Pap test and negative HPV test undergo repeat screening in 2 to 4 months, as a negative HPV result may not be definitive due to potential sample issues.* -
- Our study analyzed data from 1,496 cases with unsatisfactory Pap tests and HPV cotests, finding that a negative HPV test was very predictive of the absence of high-grade lesions.* -
- Despite a low compliance rate for follow-up screenings (45.1%), the results suggest that women with an unsatisfactory Pap test and negative HPV results may not need to return for repeat testing as soon as previously recommended.*
Article Synopsis
- The study investigates outcomes of Pap tests with atypical glandular cells (AGCs) and concurrent squamous cell abnormalities (AGC + Sq) compared to AGCs without squamous cell abnormalities (AGC-alone).
- Data from 287 Pap tests indicated that 55% of AGC + Sq cases tested positive for high-risk human papillomavirus (HR-HPV), in contrast to just 14% in AGC-alone cases, suggesting AGC + Sq is associated with a higher likelihood of significant lesions.
- The findings highlight that while HR-HPV testing and age provide valuable insights, relying solely on HR-HPV to triage patients could lead to overlooking important lesions, especially in AGC + Sq cases
Clonorchis sinensis, a liver fluke parasite, infects humans through ingestion of raw or undercooked fish, crabs, or crayfish in endemic areas where the parasite is found. Clonorchis sinensis infects the liver, gallbladder, and bile duct in humans, causing Clonorichiasis. Although the majority of patients are asymptomatic, long-lasting infections may cause severe disease.
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- The study evaluates the effectiveness of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) compared to the original cytology classification for diagnosing salivary tumors.
- It analyzes the diagnostic performance metrics (sensitivity, specificity, etc.) of both systems using data from 101 resected tumors, finding that MSRSGC has slight advantages in some areas.
- Interobserver agreement was high with MSRSGC, indicating that different cytopathologists are likely to come to similar conclusions when using this system.
Myoepithelial carcinoma (MEC) of soft tissue, also known as malignant myoepithelial tumor, is an uncommon malignancy. Cytologic diagnosis of this entity is challenging due to its rarity and heterogeneous morphology. We report a case of MEC in a 22-year-old man, who presented with a 6.
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- The study investigates the correlation between ACR TI-RADS ultrasound scores and the risk of malignancy in cases with indeterminate thyroid fine needle aspiration cytology.
- A total of 46 cases were analyzed, revealing that most indeterminate cases had higher TI-RADS scores (TR4 and TR5) and that RAS mutations were the most common molecular alteration identified.
- The results suggest that while molecular testing is useful for TR4 and TR5 lesions, lower TI-RADS scores (TR2 and TR3) frequently showed no significant molecular changes, indicating the importance of ultrasound features in evaluating indeterminate cytology.
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for coronavirus disease 2019 (COVID-19), is known to cause severe respiratory infections with occasional accompanying pleural effusion (PE), pericardial effusion (PCE), or peritoneal effusion (PTE). The effect of COVID-19 on effusion cytology is not yet known. This study aimed to examine the cytomorphologic features and workup of effusion fluids in patients with active COVID-19 infection versus those in recovery.
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- The study investigates p16 immunohistochemistry (IHC) in cytology cell blocks from fine-needle aspiration samples of head and neck squamous cell carcinoma, comparing it to surgical pathology results to assess reproducibility.
- Using 40 samples, five cytopathologists independently scored p16 IHC staining, establishing performance metrics such as sensitivity, specificity, and inter-rater reliability (Gwet's coefficient).
- Findings indicate that a positivity threshold of greater than 10% achieves 100% specificity with varying sensitivity, suggesting that this threshold may be suitable for interpreting p16 IHC in cytology compared to surgical pathology standards.
Many state-wide, city-wide, and hospital-wide changes have been implemented due to the ongoing COVID-19 crisis. We describe lessons learned in an anatomic pathology division at a tertiary care center during the peak of the COVID-19 pandemic in the hopes that knowledge of our experiences can benefit other pathology departments as they encounter this pandemic. Five categories that are critical in strategic planning for the COVID-19 pandemic are discussed: workload, departmental policy revisions, impact on faculty, workforce staffing, and impact on educational programs, including residency and fellowship training.
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- The study investigates how well cytopathologists agree on PD-L1 IHC scoring in non-small cell lung carcinoma (NSCLC) cytology cell blocks (CBs).
- It involved scoring 54 NSCLC CBs by seven cytopathologists, focusing on the impact of observer expertise, sample collection methods, and cellularity on agreement.
- Results showed substantial agreement overall, with 48% total agreement and 98% majority agreement, indicating that expertise in pulmonary pathology does enhance scoring agreement but not significantly enough to affect the overall outcome.
Article Synopsis
- The study analyzed changes in guidelines for reporting benign endometrial cells (BECs) in cervical cytology, specifically raising the reporting age from 40 to 45 years under the 2014 Bethesda System (TBS 2014).
- Researchers reviewed follow-up results of Papanicolaou tests in women aged 40 and older, finding that a significant portion showed benign results, particularly in younger age groups, with notable differences observed in women aged 50 and older.
- The findings support the justification for the TBS 2014 revision and suggest that an age threshold of 50 years may be more appropriate for reporting BECs than the current 45 years.
Article Synopsis
- The American College of Radiology (ACR) developed the Thyroid Imaging Reporting and Data System (TI-RADS) to improve thyroid ultrasound evaluations and predict the likelihood of cancer in thyroid nodules using a scoring system from TR1 to TR5 based on various ultrasound features.* -
- An analysis of 361 thyroid nodules with available ACR TI-RADS reports revealed that most nodules fell into the TR4 and TR3 categories, with no nodules classified as TR2 or TR3 corresponding to malignant cytology (Bethesda category VI).* -
- The study found a correlation between TI-RADS categories and cytology results, indicating that higher TI-RADS scores (TR4 and TR5) were associated
Background: Differentiating parathyroid from thyroid lesions can be difficult on fine-needle aspiration (FNA) due to overlapping cytomorphologic features. While the traditional parathyroid hormone (PTH) assays can help in the distinction, these tests may be cumbersome, particularly when the lesion is unexpected clinically and a needle wash is not collected at the time of FNA. Therefore, we chose to investigate the application of immunohistochemical staining (IHC) with GATA 3 and thyroid transcription factor-1 (TTF-1) on air-dried cytology smears to distinguish parathyroid and thyroid lesions.
View Article and Find Full Text PDFObjectives: To evaluate whether non-small cell lung carcinoma (NSCLC) cytology specimens are reliable for programmed death-ligand 1 (PD-L1) immunohistochemical (IHC) testing.
Methods: Fifty-two cell blocks (CBs) with corresponding surgical pathology PD-L1 IHC testing were stained with a Dako PD-L1 pharmDX antibody (clone-22C3). Tumor cellularity was recorded as <100 or ≥100 cells.
Objective: Because of the indolent nature of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) and potential requisite for a more conservative treatment, it is crucial to identify features of this entity preoperatively. Our group recently published findings that there are several cytomorphological features that may be used as clues to distinguish NIFTP, papillary thyroid carcinoma (PTC) and follicular adenoma (FA) on fine needle aspiration. Therefore, we aimed to determine the interobserver reproducibility of these findings.
View Article and Find Full Text PDFObjectives: Recognizing preoperative characteristics of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is important for clinical management. Therefore, we assessed presurgical NIFTP molecular profiles using fine-needle aspiration (FNA) material.
Methods: Presurgical FNA reports of 39 surgically confirmed NIFTP cases from January 2013 through May 2017 were assessed for Afirma and ThyroSeq results.
Objective: Cytomegalovirus (CMV) is a ubiquitous infection typically affecting over 50% of the US population by age 40. We report 8 cases of CMV infections detected in cervical cancer screening tests, the largest series of cases thus far reported in gynecologic cytology specimens.
Methods: A retrospective review of our pathology archival computer database was performed from January 1, 1994 through December 31, 2016 for CMV infections reported in cervical cytology specimens.
Objectives: Noninvasive encapsulated follicular variant of papillary thyroid carcinoma (NEFVPTC) was recently reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Excluding "carcinoma" from the new terminology shifted NIFTP out of the malignant category and altered Bethesda System for Reporting Thyroid Cytopathology (BSRTC) rates of malignancy (ROMs) on thyroid fine-needle aspiration (FNA). Because of potential effects on management guidelines, we examined our ROM data.
View Article and Find Full Text PDFBackground: The success of cell block preparation is crucial for ancillary diagnostic tests in cytology. However, achieving an optimal cell block can be challenging. The current study describes a self-clotting-based technique for fine-needle aspiration (FNA) cell block preparations and evaluates its usefulness in comparison with the conventional needle wash technique.
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