-Mutated Cytologically Indeterminate Thyroid Nodules: Prevalence of Malignancy and Behavior Under Active Surveillance.

Genomic profiling is now available for risk stratification of cytologically indeterminate thyroid nodules (ITNs). Mutations in genes (, , ) are found in both benign and malignant thyroid nodules, although isolated mutations are rarely associated with aggressive tumors. Because the long-term behavior of -mutant ITNs is not well understood, most undergo immediate surgery.

Active Surveillance of Papillary Thyroid Cancer: Frequency and Time Course of the Six Most Common Tumor Volume Kinetic Patterns.

The change in size of the papillary thyroid cancer (PTC) nodule during active surveillance has traditionally been characterized as either stable, increasing, or decreasing based on changes in maximal tumor diameter or tumor volume. More recently, it has been observed that the changes in tumor size observed during observation are more complex with tumor volume kinetic patterns that can be characterized either as stable (Pattern I), early increase in volume (Pattern II), later increase in volume (Pattern III), early increase in volume followed by stability (Pattern IV), stability followed by an increase in volume (Pattern V), or a decrease in tumor volume (Pattern VI). The frequency, time course, and clinical correlates of these six tumor volume kinetic patterns were analyzed in a cohort of 483 patients with low-risk PTC up to 1.

The Milan System at Memorial Sloan Kettering: Utility of the categorization system for in-house salivary gland fine-needle aspiration cytology at a comprehensive cancer center.

Background: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) provides a standardized reporting system for salivary gland fine-needle aspiration (SGFNA). We review the clinical utility of the MSRSGC at a tertiary care cancer center by assessing the rates of malignancy (ROM) among different categories.

Methods: A retrospective search was performed to retrieve all SGFNA cases performed at our institution between 1/1/07 and 12/31/18.

Cytologic evaluation of p16 staining in head and neck squamous cell carcinoma in CytoLyt versus formalin-fixed material.

Background: The management of high-risk human papillomavirus (HR-HPV)-related oropharyngeal head and neck squamous cell carcinomas (HNSCCs) are distinct from HNSCC linked to smoking and alcohol use. HR-HPV-positive HNSCC frequently presents as a cervical lymph node metastasis. Because fine-needle aspiration (FNA) is often the initial diagnostic procedure, evaluating HR-HPV status in cytology specimens is important.

Genomic comparison of paired primary breast carcinomas and lymph node macrometastases using the Oncotype DX Breast Recurrence Score test.

Purpose: Adjuvant therapy decisions may in part be based on results of Oncotype DX Breast Recurrence Score (RS) testing of primary tumors. When necessary, lymph node metastases may be considered as a surrogate. Here we evaluate the concordance in gene expression between primary breast cancers and synchronous lymph node metastases, based on results from quantitative RT-PCR-based RS testing between matched primary tumors and synchronous nodal metastases.

Unilateral upper extremity lymphedema in metastatic prostate cancer.

Upper extremity lymphedema and cutaneous spread are atypical behavior of prostate disease and should be kept in the differential for selected patients. This presentation in these patients may be underdiagnosed and potentially an ominous sign. Our case adds to our continued learning of possible prostate malignancy behavior.

A Case of Secondary Angiosarcoma of the Breast after Breast-conserving Surgery and Radiation: Review of Radiologic and Pathologic Findings.

Angiosarcoma of the breast is a rare and potentially life-threatening disease. It can present as a palpable mass or subtle erythematous lesion, depending on the predisposing clinical factors. Erythematous skin lesions may be confused for a benign process, which may lead to a delay in diagnosis.

Mammary ductoscopy for evaluation of nipple discharge.

Background: Most breast cancers originate in the ductal epithelium with normal cells progressing to atypia and finally to carcinoma. Ductoscopy enables one to visualize and sample the ductal epithelium and therefore identify early changes cytologically. This report describes our experience with mammary ductoscopy as a tool for evaluation of nipple discharge at Beth Israel Medical Center.

Intraoperative touch preparation cytology for margin assessment in breast-conservation surgery: does it work for lobular carcinoma?

Background: Breast carcinoma is the most frequently diagnosed malignancy in women of the North America. The combination of breast-conservation surgery and radiotherapy has become a standard of treatment for most breast cancers. It is critical to obtain clear margins to minimize local recurrence.

Intra-operative touch preparation cytology; does it have a role in re-excision lumpectomy?

Objective: Breast carcinoma is the most frequently diagnosed malignancy in women of North America. The combination of breast conservation surgery and radiotherapy has become a standard of treatment for the majority of breast cancers. It is critical to obtain clear margins to minimize local recurrence.

Clinical Experience With Mammary Ductoscopy.

Background: Most breast cancers begin in the ductal epithelium with normal cells and progress to atypia and finally to carcinoma. Mammary ductoscopy enables one to directly visualize and sample the ductal epithelium and, therefore, identify early changes cytologically. This article describes our initial experience with mammary ductoscopy at Beth Israel Medical Center.

Association of breast cancer with papillary lesions identified at percutaneous image-guided breast biopsy.

Background: The management of papillary lesions identified on image-guided breast biopsy remains controversial. In the literature, data regarding papillary lesions are limited because of small sample sizes. The purpose of this study was to identify the prevalence of atypical ductal hyperplasia and malignancy associated with papillary lesions identified on image-guided breast biopsy.

Postlactational microcalcifications.

A case of postlactational microcalcifications is reported. A 42-year-old woman presented for screening mammography 2 months after completion of breast-feeding. Comparison to her pregravid screening mammogram revealed the appearance of multiple groups of indeterminate microcalcifications bilaterally (BIRADS IV).

Malignant fibrous histiocytoma, giant cell type, of the breast mimicking metaplastic carcinoma. A case report.

Background: We report a case of malignant fibrous histiocytoma, giant cell type (MFHGC), of the breast. A review of the literature failed to reveal cytology-based reports on this entity. The cytologic similarity of breast MFHGC on fine needle aspiration biopsy (FNAB) to other malignant breast neoplasms, including carcinoma with osteoclastlike giant cells, metaplastic carcinoma and breast sarcomas, as well as benign reactive processes, makes the recognition of this tumor challenging.

Cytology of primary central nervous system neoplasms in cerebrospinal fluid specimens.

Although two-thirds of tumors occurring in the central nervous system (CNS) are primary neoplasms, only 10% of positive cerebrospinal fluid (CSF) specimens are from primary CNS tumors. In this study, we reviewed the cytologic findings of 21 positive CSF specimens from primary CNS tumors. A computer search identified 21 cases of positive CSF specimens from patients with primary CNS tumors from the archives.