Publications by authors named "Susan A Alperstein"

Introduction: Current literature lacks data regarding the influence of serous fluid volume (SFV) on next-generation sequencing (NGS) performed on malignant cases. In this study, we highlight the impact of SFV and other parameters influencing the outcome of NGS analysis.

Materials And Methods: We evaluated 827 samples of serous fluids from 607 patients.

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Article Synopsis
  • The report summarizes the November 2022 ASC/IAC Cytology Education Symposium, focusing on educational practices and opportunities for cytology students and other learners in anatomic pathology.
  • It discusses recruitment strategies for cytology programs, shares teaching resources, and highlights the role of virtual microscopy and online learning.
  • Additionally, the report addresses student wellness in schools of cytology, emphasizing the importance of mental health and support systems in educational settings.
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This report highlights information and outcomes from the November 2022 ASC/IAC joint Cytology Education Symposium, an annual conference organized by the Cytology Programs Review Committee. The manuscript provides information on shared educational opportunities and practices for cytology students and other learners in anatomic pathology, discusses recruitment strategies for schools of cytology, conveys teaching resources, introduces perspectives on virtual microscopy and online learning, and transmits information about wellness of students in schools of cytology.

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Introduction: Detection of malignant cells in serous fluids is an indicator of advanced stage of malignancy and is critical in clinical management decisions and prompt treatment initiation. The minimum volume which is ideal for detecting malignancy in serous fluid is not well established. In this study, we aim to identify optimal volume that will be ideal for adequate cytopathological diagnosis.

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Background: Whole slide imaging (WSI) adoption has been slower in cytopathology due, in part, to challenges in multifocal plane scanning on 3-dimensional cell clusters. ThinPrep and other liquid-based preparations may alleviate the issue by reducing clusters in a concentrated area. This study investigates the use of Z-stacked images for diagnostic assessment and the experience of evaluating urine ThinPrep WSI.

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Background: Molecular testing (MT) of thyroid fine-needle aspiration (FNA)-derived genetic material is commonly used to assess malignancy risk for indeterminate cases. The Bethesda System for Reporting Thyroid Cytopathology (TBS) provides limited guidance for the appropriate use of category III (atypia of undetermined significance [AUS]). The authors combined MT with cytomorphology to monitor AUS diagnoses in a cytopathology laboratory.

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  • Cell-free DNA (cfDNA) from pleural effusion supernatant (PES) is being studied for its potential in molecular tumor profiling for metastatic non-small cell lung carcinoma (NSCLC).
  • The study involved collecting pleural effusion specimens, extracting DNA, and comparing results with DNA from formalin-fixed paraffin-embedded (FFPE) samples using targeted next-generation sequencing (NGS).
  • Challenges were observed in the extraction and sequencing processes, yet the findings suggest that PES is still a valuable source of cfDNA for genetic analysis despite certain limitations in mutation detection and sample variation.
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Background: Tumor sample quality and quantity determine the success of somatic mutation analysis. Thus, a rapid on-site evaluation (ROSE) tumor cytology adequacy assessment was incorporated into the workflow of precision oncology at Weill Cornell Medicine in New York City. Optimal samples were obtained from 68 patients with metastatic cancer.

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Objectives: To identify less readily identifiable patterns of high-grade squamous intraepithelial lesions (HSIL) in negative human papillomavirus (HPV)-positive Papanicolaou (Pap) tests on ThinPrep preparations.

Methods: Of all HPV-positive Pap tests that were negative for intraepithelial lesion or malignancy (NILM) from July 2013 to June 2018, those with HSIL on subsequent histology within 6 months were identified. ThinPrep slides from the latter group (group 1) and from NILM HPV-negative Pap tests with negative follow-up (group 2) were reviewed independently by 4 participants.

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Introduction: Cerebral spinal fluid (CSF) cytomorphologic analysis remains the gold standard in the evaluation of malignant leptomeningeal involvement. However, collection of optimal volumes for adequate cytomorphologic evaluation is not standardized. Our study investigated optimal CSF volumes that result in a significant diagnostic result.

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Objectives: To evaluate the impact of implementing the dual interpretation of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and low-grade squamous intraepithelial lesion (LSIL) after the Bethesda System 2014 and to compare it with other indeterminate interpretations.

Methods: Rates of high-risk human papillomavirus (HPV) positivity and histologic follow-up and the proportion of women with high-grade squamous intraepithelial lesion on histologic follow-up were compared for the combined interpretation of ASC-H and LSIL (ASCHL) and the categories of LSIL, cannot exclude high-grade squamous intraepithelial lesion (LSIL-H) and ASC-H.

Results: The percentage of ASCHL HPV-positive cases (86.

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Article Synopsis
  • The study evaluates how preanalytic variables, like cellularity and storage time, influence the quality and quantity of nucleic acids extracted from thyroid fine-needle aspiration specimens.
  • Data from 56 samples showed a correlation between the Bethesda classification of nodules and cellularity, along with variations in nucleic acid concentrations based on storage duration.
  • The findings indicate that higher cellularity generally yields better quality nucleic acids, and prolonged storage may negatively impact DNA and RNA integrity, suggesting a need for further research into these factors.
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Background: High-risk human papillomavirus (HPV) test ordering has evolved since the 2006 ASCCP guidelines. In light of the availability of the HPV test results for most women ≥30 y, regardless of the Pap test diagnosis; we examined their value in assessing the overall performance of cytopathologists (CPs).

Methods: Data were derived for six CPs for Pap test interpretations over 4 y.

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Background: Bile duct brushing (BDB) cytology, for the characterization of bile duct strictures, can be challenging to interpret when associated with a stent. Our study aims to identify the cytologic criteria for the diagnosis of adenocarcinoma in BDBs in the presence of a stent.

Methods: A database search (January 2010-December 2015) identified three groups of BDBs-negative with stent, malignant with stent, malignant without stent.

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Background: Pericardial effusions can cause considerable morbidity and potentially may lead to mortality. Malignant pericardial effusions are uncommon, and data on malignancies encountered in pericardial effusion cytology specimens are limited.

Methods: Relevant records of all pericardial effusions from January 2008 to September 2014 were examined and compared with pericardial biopsy results when performed.

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Women ≥30 years of age with negative (-) Pap tests and positive (+) HPV co-test results have a higher prevalence and cumulative risk of developing high-grade cervical intraepithelial neoplasia (CIN 2+). Thus, the current management in these women is to repeat co-test in 12 months or immediate reflex genotyping for HPV16 or HPV 16/18. If genotyping is not an option, timely quality assurance (QA) rescreen of such Pap tests may be a valuable alternative.

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