The value of molecular testing in the evaluation and management of patients with pancreatic cysts.

Background: Molecular testing aids in the work up and management of patients with pancreatic cysts. This study reports on the value of PancreaSeq® in the evaluation of pancreatic cyst aspirates.

Methods: PancreaSeq® testing at our institution was implemented June 1, 2022.

A simplified molecular method to detect high-risk HPV using the Aptima HPV assay on head and neck FNA smears.

Background: Fine-needle aspiration is used as a diagnostic tool in head and neck oropharyngeal squamous cell carcinoma and its metastases. Prognosis and treatment rely on the presence or absence of the human papilloma virus. The purpose of this study was to validate the performance of the Aptima HPV assay using Hema-Diff stained fine-needle aspiration smears in the diagnosis of human papilloma virus-related oropharyngeal squamous cell carcinoma using a simplified method to obtain tumor cells for testing.

Diagnostic pitfalls and the value of fluorescence in situ hybridization as an adjunct to cytologic evaluation of bile duct brushings in patients with primary sclerosing cholangitis.

Background: Primary sclerosing cholangitis (PSC) can present diagnostic difficulties on bile duct brushings as cytologic features mimicking adenocarcinoma may exist. This study evaluates the role of fluorescence in-situ hybridization (FISH) as an adjunct to cytologic evaluation.

Methods: From January 1, 2020, through December 31, 2021, 308 bile duct brushings were processed of which 34 (11%) were malignant, 25 (8%) were suspicious, 36 (12%) were atypical, 204 (66%) were negative and 10 (3%) were nondiagnostic.

The value of concurrent endoscopic ultrasound-guided fine needle aspirates and needle core biopsies in the diagnosis of pancreatic neoplasms.

Background: Endoscopic ultrasound (EUS) fine needle aspiration (FNA) is highly sensitive and specific in the detection and diagnosis of pancreatic neoplasms. EUS-guided needle core biopsy has been used alone or as an adjunct to maximize diagnostic yield. This study compared the use of FNA versus needle core biopsy in the diagnosis of pancreatic neoplasms.

Busulfan associated pulmonary toxicity: A benign mimic of squamous cell carcinoma diagnosed in a bronchoalveolar lavage specimen.

An uncommon case of iatrogenic cellular changes associated with busulfan therapy in a bronchoalveolar lavage of a 65-year-old woman who underwent bone marrow transplantation is presented and discussed. Chemotherapeutic changes are presented, and pitfalls discussed.

The association of atypical squamous cells, cannot exclude a high grade squamous intraepithelial lesion, hyperchromatic crowded groups and high grade squamous intraepithelial lesions involving endocervical glands.

Background: Hyperchromatic crowded groups (HCGs) are often classified as atypical squamous cells, cannot exclude a high grade squamous intraepithelial lesion (ASC-H) on ThinPrep Pap tests. This study reports on the association of HCG's with high grade squamous intraepithelial lesions (HSIL) involving endocervical glands.

Methods: Over a 3-year period (January 1, 2018-December 31, 2020), 115 (0.

The role of ThyroSeq V3 testing in the management of patients with indeterminate thyroid nodules on fine needle aspiration.

Background: The multigene genomic classifier ThyroSeq V3 has proven to be an effective triage modality in the management of indeterminate thyroid nodules. This study reports on the clinical management of patients with indeterminate thyroid nodules.

Methods: ThyroSeq V3 testing at our institution was implemented April 1, 2019.

Anal Intraepithelial Neoplasia Screening With Anal Pap Tests: Follow-up and Corresponding Histology.

Background: Anal cytology is used as a screening tool in the detection of precancerous anal squamous lesions. Follow-up clinical examination after abnormal anal cytology is recommended. The objective of this study was to determine how often abnormal cytology was followed by a clinical examination at our institution and how often cytology predicted histologic outcome.

The presence of multinucleated giant cells: Noninvasive follicular thyroid neoplasm with papillary-like nuclear features vs the follicular variant of papillary thyroid carcinoma.

Background: Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a newly described entity with an indolent clinical course as compared to the follicular variant of papillary thyroid carcinoma (FVPTC). As the cytologic features of NIFTP overlap those of the FVPTC, distinction between the two on FNA cytology poses diagnostic difficulties. This study analyzes the presence of multinucleated giant cells (MGCs).

Psychological Aspects of Utilizing Telecytology for Rapid On-Site Adequacy Assessments.

Rapid On-Site Evaluation (ROSE) has been well documented in its ability to improve the diagnostic yield and accuracy of fine needle aspirations across many sites, resulting in better quality of patient management and a simultaneous reduction in treatment costs. Telecytology makes it possible for cytology laboratories to offer ROSE in a cost effective manner, whilst employing only a small number of trained cytopathologists to cover many sites from a single connected location. However, the adoption of telecytology for ROSE has been lackluster.

On the job training: an educational program in ROSE of fine needle aspirates and telecytology for cytotechnologists.

Introduction: As the demand for rapid on-site evaluation (ROSE) of fine needle aspirates (FNAs) has continued to increase, the provision of service requires a creative approach to maximize efficiency without compromising patient care. We describe the educational process used to train cytotechnologists in ROSE of FNAs using telecytology.

Materials And Methods: In 2005, the cytopathology division of the University of Wisconsin pathology department developed an on the job training program for cytotechnologists in ROSE of FNAs using telecytology.

FNA smears of pancreatic ductal adenocarcinoma are superior to formalin-fixed paraffin-embedded tissue as a source of DNA: Comparison of targeted KRAS amplification and genotyping in matched preresection and postresection samples.

Background: The current study was conducted to compare DNA yield, including normalization to nuclear area, DNA amplification functionality, and detection of KRAS mutations between matched fine-needle aspiration (FNA) specimens and pancreatic resections diagnostic of pancreatic ductal adenocarcinoma.

Methods: A retrospective sample of 30 matched single FNA smears and macrodissected formalin-fixed, paraffin-embedded (FFPE) curls (2 5-μm curls) were compared by measuring the following: nuclear area (via digital image analysis), DNA yield (via NanoDrop spectrophotometry and Quantus fluorometry), and polymerase chain reaction threshold cycles for KRAS amplifications. Variants in KRAS codons 12/13 and 61 were detected by fluorescent melt curve analyses, followed by Sanger DNA sequencing.

The role of ancillary tests in the evaluation and management of patients with negative and non-diagnostic pancreatic cyst aspirates.

Background: Fine needle aspiration of pancreatic cystic lesions has its limitations as the cytology is often paucicellular to acellular. This study reports on the value of ancillary tests, amylase and carcinoembryonic, in the evaluation and management of patients with negative and non-diagnostic pancreatic cysts.

Methods: From January 1, 2010 through December 31, 2015, the Cytopathology Laboratory processed 119 pancreatic cyst aspirates of which 51(43%) were negative and 52(44%) were non-diagnostic and form the basis of this study.

Glandular epithelial abnormalities on thinprep® pap tests: Clinical and cytohistologic correlation.

Background: Although the incidence of glandular epithelial abnormalities on cervical cytology is low, the clinical and histologic findings are often significant. The laboratory's 12-year experience is reported.

Methods: from January 1, 2003 to December 31, 2014, the Cytopathology Laboratory of the University of Wisconsin Hospital and Clinics processed 191,087 ThinPrep(®) Pap Tests of which 184 (0.

Maximizing the adequacy of Hologic(®) Cervista(®) HPV HR results on ThinPrep(®) Pap samples treated with glacial acetic acid.

Background: Although glacial acetic acid (GAA) treatment of bloody cervical samples has reduced the rate of unsatisfactory Pap Tests, recent studies suggest that it may negatively impact high-risk (hr)-HPV test results. The objectives of this study were to compare the levels of genomic DNA between GAA treated and nontreated ThinPrep(®) samples using the Hologic(®) Cervista(®) HPV-HR assay and to compare the adequacy of the ThinPrep(®) Pap Test between aliquoted and nonaliquoted samples.

Methods: Prior to GAA treatment, 2.

Bile duct brushing cytology: Cytohistologic/fine-needle aspiration correlation and diagnostic pitfalls.

Introduction: Bile duct brushings are a mainstay in the work-up of patients who present with clinical findings of pancreaticobiliary disease. This study presents the University of Wisconsin Hospital and Clinics Cytopathology Laboratory's experience over a 10.5-year period with histologic and fine-needle aspiration (FNA) correlation.

The utility of high-risk HPV testing in the management of women 30 to 64 years of age with low-grade squamous intraepithelial lesions on cervical cytology.

Introduction: The current American Society for Colposcopy and Cervical Pathology guidelines recommend high risk-human papillomavirus testing for patients 30 to 64 years of age with a low-grade squamous intraepithelial lesion on Papanicolaou (Pap) tests. This study presents our experience since the introduction of the new guidelines.

Materials And Methods: From September 1, 2013 through August 31, 2014, 20,014 ThinPrep Pap tests were processed, of which 17,989 (90%) were negative, 863 (4.

Comparison of cytotechnologists' and cytopathologists' ASCUS rates preimplementation and postimplementation of the ThinPrep® imaging system.

Background: The automated ThinPrep® Imaging System assists the cytotechnologists in the primary screening of ThinPrep® Pap Tests. This study compares the concordance of the cytotechnologists and cytopathologists in the interpretation of Pap Tests as Atypical Squamous Cells of Undetermined Significance (ASCUS) before and after implementation of the Imager in our laboratory.

Methods: From January 1-December 31, 2011, 12,853 ThinPrep® Pap Tests were processed on a ThinPrep® 3000 Processor, stained by the Papanicolaou method and screened manually by the cytotechnologists.

Anal-rectal cytology as a screening tool for the detection of anal intraepithelial neoplasia in HIV-positive men.

Introduction: Use of anal-rectal cytology is on the rise as a screening tool for the detection of anal squamous lesions in human immunodeficiency virus (HIV)-positive individuals. The purpose of this 5-year retrospective study was to determine the utility of routine anal-rectal screening for the detection of squamous lesions in HIV-positive patients with histology correlation.

Materials And Methods: From January 1, 2008 through December 31, 2012, 448 anal-rectal Papanicolaou tests were performed on HIV-positive men, of which 133 were referred for high-resolution anoscopy.

Factors contributing to high ThinPrep® Pap test unsatisfactory rates in an academic medical center laboratory.

Specimen adequacy is a key component in the cytologic evaluation of cervical Pap tests. At our institution, yearly unsatisfactory rates continue to be high, placing our laboratory in the 95th percentile for CAP benchmark data for unsatisfactory Pap test rates. Using the 2001 Bethesda System criteria, unsatisfactory Pap test rates were calculated over a ten year period (January 2002 to December 2011) and contributing factors were analyzed.

Kaposi sarcoma herpesvirus/human herpesvirus-8-negative effusion-based lymphoma: report of 3 cases and review of the literature.

Background: Primary effusion lymphoma (PEL) is a rare subtype of large B-cell lymphoma that arises in body cavities without detectable tumor masses. PEL is universally associated with Kaposi sarcoma herpesvirus (KSHV)/human herpesvirus-8 (HHV8). Despite overlapping features, KSHV/HHV8-negative effusion-based lymphoma is a distinct entity from PEL.

Clinical significance of atypical squamous cells cannot exclude high grade squamous intraepithelial lesion with histologic correlation-: a 9-year experience.

Atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion (ASC-H) is a recognized category in the 2001 Bethesda Nomenclature System for cervical cytology. Although current ASCCP guidelines recommend colposcopic follow-up, more recent studies are suggesting prior triage for HPV-DNA analysis. We report on our experience at the University of Wisconsin Hospital and Clinics.

Nondiagnostic fine-needle aspirations of the thyroid: is the risk of malignancy higher?

Background: Nondiagnostic fine-needle aspirations (FNAs) pose a dilemma in the management of patients with thyroid nodules. In most cases, these patients undergo either repeat FNA or surgical resection. However, a significant number of patients will only be observed, assuming that the risk of malignancy is low.

Radiofrequency ablation of liver tumors: quantitative assessment of tumor coverage through CT image processing.

Background: Radiofrequency ablation (RFA) is one of the most promising non-surgical treatments for hepatic tumors. The assessment of the therapeutic efficacy of RFA is usually obtained by visual comparison of pre- and post-treatment CT images, but no numerical quantification is performed.

Methods: In this work, a novel method aiming at providing a more objective tool for the evaluation of RFA coverage is described.

Fine needle aspiration of the thyroid: a contemporary experience of 3981 cases.

Background: Fine needle aspiration (FNA) is an essential tool for the management of thyroid nodules. Recently, several national organizations have recommended FNA of all thyroid nodules >1 cm. With the increase use of imaging in the practice of medicine over the last decade, the number of incidentally discovered thyroid nodules is rising.