The Bethesda system for reporting thyroid cytopathology: an institutional experience of the outcome of indeterminate categories

ObjectiveIn this study, we investigated the efficacy of the Bethesda system (TBS) for reporting thyroid cytopathology in determining the risk of malignancy for indeterminate cases. These cases comprised atypia or follicular lesion of undetermined significance (AUS/FLUS), follicular neoplasia or suspicious for follicular neoplasia (FN/SFN) and suspicious for malignancy (SM) categories. AUS/FLUS cases were further subcategorized according to their patterns, and the malignancy rate for each subcategory was calculated

Unsupervised Segmentation And Classification Of Cervical Cell Images

The Pap smear test is a manual screening procedure that is used to detect precancerous changes in cervical cells based on color and shape properties of their nuclei and cytoplasms. Automating this procedure is still an open problem due to the complexities of cell structures. In this paper, we propose an unsupervised approach for the segmentation and classification of cervical cells. The segmentation process involves automatic thresholding to separate the cell regions from the background, a multi-scale hierarchical segmentation algorithm to partition these regions based on homogeneity and circularity, and a binary classifier to finalize the separation of nuclei from cytoplasm within the cell regions. Classification is posed as a grouping problem by ranking the cells based on their feature characteristics modeling abnormality degrees. The proposed procedure constructs a tree using hierarchical clustering, and then arranges the cells in a linear order by using an optimal leaf ordering algorithm that maximizes the similarity of adjacent leaves without any requirement for training examples or parameter adjustment. Performance evaluation using two data sets show the effectiveness of the proposed approach in images having inconsistent staining, poor contrast, and overlapping cells. (C) 2012 Elsevier Ltd. All rights reserved.Wo

Prevalence of Epidermal Growth Factor Receptor Mutations in Patients with Non-Small Cell Lung Cancer in Turkish Population

Aims: Epidermal growth factor receptor mutation analysis in non-small cell lung cancer is important for selecting patients who will receive treatment with tyrosine kinase inhibitors. In this study, we aimed to investigate the prevalence of epidermal growth factor receptor mutations and mutation patterns in the Turkish population. Methods: We retrospectively reviewed molecular pathology reports of 959 cases with lung cancer analysed for epidermal growth factor receptor mutations. We analysed all four epidermal growth factor receptor exon mutations using a real-time polymerase chain reaction platform. Results: In this study, the epidermal growth factor receptor mutation rate in the Turkish population was 16.7% (160 of 959). The epidermal growth factor receptor mutation frequency was significantly higher in women (37.1%, n=96) than in men (9.1%, n=64) (p<0.001). In addition, the epidermal growth factor receptor mutation rate was higher in the adenocarcinoma histologic type (p<0.001). Patients with mutations were older than those without mutations (p=0.003). The most frequent mutations were exon 19 deletions (48.8%, 78/160) and exon 21 L858R point mutations (38.1.1%, 61/160). We also detected compound mutation patterns in three cases (1.9%). Conclusion: The prevalence of epidermal growth factor receptor mutations in the Turkish population was slightly higher than that in the Caucasian population and lower than that in the East Asian population. The results of this study may provide guidance in personalized therapy of non-small cell lung cancer in the Turkish population

Akciğer ve Beyin Metastazlı Gestasyonel Trofoblastik Hastalık: Pozitron Emisyon Tomografisi Kranial Metastatik Hastalığı Saptayabiliyor mu?

Gestasyonel Trofoblastik Neoplaziler (GTN) plasenta dokusundan köken alırlar ve erken vasküler invazyon yaptıklarından sıklıkla metastaz yaparlar. Beyin metastazı nadir görülür. Metastatik GTN'nin taranmasında 18-florodeoksiglukoz pozitron emisyon tomografisinin (FDG-PET) etkinliği konusunda veriler yetersizdir. Bu olgu sunumunda, eş zamanlı akciğer ve beyin metastazı olan ve beyin metastazının FDG-PET ile saptanama- dığı bir GTN olgusunu sunuyoruz.Gestational trophoblastic neoplasms (GTN) originate from placental tissue and usually metastasizes because of its propensity for early vascular invasion. Intracranial metastases are relatively uncommon. There are limited data on the efficacy of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in the eva- luation of metastatic GTN. We present a case of GTN with simultaneous pulmonary and cranial metastases in which the cranial metasteses were undetectable with positron emission tomography (PET) scan

Simultaneous Resection Of Thymic And Bronchial Carcinoid Tumors In A Patient Diagnosed With Multiple Endocrine Neoplasia Type 1

Thymic carcinoid tumors are rare tumors which may be associated with multiple endocrine neoplasia type 1. Bronchial carcinoids are also rare tumors and associated with multiple endocrine neoplasia type 1. Coexisting of thymic and bronchial carcinoid tumors in this case is extremely rare. Herein, we report a unique case of coexistence of thymic and bronchial carcinoid tumors which were simultaneously resected via thoracotomy.PubMedWo

Graph convolutional networks for region of interest classification in breast histopathology

Deep learning-based approaches have shown highly successful performance in the categorization of digitized biopsy samples. The commonly used setting in these approaches is to employ convolutional neural networks for classification of data sets consisting of images all having the same size. However, the clinical practice in breast histopathology necessitates multi-class categorization of regions of interest (ROI) in biopsy samples where these regions can have arbitrary shapes and sizes. The typical solution to this problem is to aggregate the classification results of fixed-sized patches cropped from these images to obtain image-level classification scores. Another limitation of these approaches is the independent processing of individual patches where the rich contextual information in the complex tissue structures has not yet been sufficiently exploited. We propose a generic methodology to incorporate local inter-patch context through a graph convolution network (GCN) that admits a graph-based ROI representation. The proposed GCN model aims to propagate information over neighboring patches in a progressive manner towards classifying the whole ROI into a diagnostic class. The experiments using a challenging data set for a 4-class ROI-level classification task and comparisons with several baseline approaches show that the proposed model that incorporates the spatial context by using graph convolutional layers performs better than commonly used fusion rules

HPV types and E6/E7 mRNA expression in cervical samples from Turkish women with abnormal cytology in Ankara, Turkey

Background/aim: Human papillomaviruses have been established as a risk factor for invasive carcinoma of the uterine cervix. HPV E6/ E7 oncogene expression has recently emerged as a promising biomarker to determine the risk for progression to high-grade cervical lesions. The aim of this study was to evaluate HPV mRNA and DNA detection in samples with abnormal cytology. Materials and methods: Cervical specimens were obtained at the Department of Obstetrics and Gynecology via cervical brushes during January–October 2011. Liquid-based cytology slides were evaluated according to the 2001 Bethesda System. Cytology specimens from a total of 81 women with abnormal cytology were included. Real-time PCR and NASBA assays were performed to detect HPV DNA and E6/E7 mRNA, respectively. Results: HPV DNA was identified in 73 samples (90.1%). HPV E6/E7 mRNA expression was observed in 45 samples (55.6%). A statistically significant difference was observed among cytological diagnosis groups. In 25 patients, a biopsy was performed during the follow-up. HPV DNA was detected in all of these patients. HPV E6/E7 expression was present only in CIN I–III diagnosed patients. Conclusion: The E6/E7 mRNA test is a robust indicator of cytological atypia and correlates better with progressive lesions than DNA assays

Tetralogy Of Fallot - Born To Be Bad?

PubMe

Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology

none17To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma(MM). Cytopathologists involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC), who have an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists, who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in cape town. During the previous IMIG biennial meetings, thorough discussions have resulted in published guidelines for the pathologic diagnosis of MM. However, previous recommendations have stated that the diagnosis of MM should be based on histological material only.[1,2] Accumulating evidence now indicates that the cytological diagnosis of MM supported by ancillary techniques is as reliable as that based on histopathology, although the sensitivity with cytology may be somewhat lower.[3-5] Recognizing that noninvasive diagnostic modalities benefit both the patient and the health system, future recommendations should include cytology as an accepted method for the diagnosis of this malignancy.[6,7] The article describes the consensus of opinions of the authors on how cytology together with ancillary testing can be used to establish a reliable diagnosis of MMnoneHjerpe, Anders; Ascoli, Valeria; Bedrossian, Carlos; Boon, Mathilde; Creaney, Jenette; Davidson, Ben; Dejmek, Annika; Dobra, Katalin; Fassina, Ambrogio; Field, Andrew; Firat, Pinar; Kamei, Toshiaki; Kobayashi, Tadao; Michael, Claire; Onder, Sevgen; Segal, Amanda; Vielh, PhilippeHjerpe, Anders; Ascoli, Valeria; Bedrossian, Carlos; Boon, Mathilde; Creaney, Jenette; Davidson, Ben; Dejmek, Annika; Dobra, Katalin; Fassina, Ambrogio; Field, Andrew; Firat, Pinar; Kamei, Toshiaki; Kobayashi, Tadao; Michael, Claire; Onder, Sevgen; Segal, Amanda; Vielh, Philipp

What does the Data of 354,725 Patients from Turkey Tell Us About Cervical Smear Epithelial Cell Abnormalities? - The Epithelial Cell Abnormality Rate is Increasing - Quality Control Studies and Corrective Activity are Musts

Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells/Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed