The solid variant of papillary thyroid carcinoma comprises a heterogeneous group of tumors.The tumors that have cytomorphologic patterns of cohesive, syncytial-type tissue fragments or microfollicules/trabeculae are circumscribed and indolent, whereas tumors that have dyshesive single cells are infiltrative and potentially aggressive.
The past 20 years in cytopathology have demonstrated tremendous growth and evolution in the cytopathology of organs located below the diaphragm, with much of the progress centering on the pancreas.Cancer Cytopathology has been at the forefront of reporting advances in the field of pancreaticobiliary cytology, especially for the diagnosis of pancreatic cysts.
Abstract Objective Malignant pericardial effusions are associated with a poor prognosis. Pericardial fluid cytology and pericardial biopsy are the primary methods for diagnosis. This study aimed to conduct a multi‐institutional analysis to compare the diagnostic sensitivity of cytology and biopsy, and to investigate potential explanations for false‐negative results in cytology. Methods A retrospective review of pericardial fluid cytology cases with concurrent biopsy was conducted across four different institutions. Results were compared using standard statistical methods with attention to sensitivity and histologic distribution. False‐negative cytology cases were investigated for further exploration. Results A total of 309 cases were collected, of which 99 (32.0%) were confirmed malignant through repeat sampling or clinical history. Pericardial fluid cytology and biopsy identified 84 and 64 malignant cases, respectively. Our findings confirmed significantly higher sensitivity of cytology compared to biopsy (84.8% vs 65.7%). The most common sites of origin were lung, breast, and gastrointestinal, with adenocarcinoma being the most prevalent histologic subtype. Histologic review of 12 false‐negative cytology cases revealed three key explanations; lymphoma was the most common missed diagnosis (33.3%); fibrinous pericarditis obscures neoplastic cells on the pericardial surface; and pericardial involvement can be seen without extension into the pericardial space. Conclusion This study demonstrated diagnostic superiority of pericardial fluid cytology over biopsy in the evaluation of malignant pericardial effusions. We identified several limitations in fluid cytology causing false negatives. In the context of an underlying malignancy with pericardial effusion, pathologists should consider immunohistochemistry studies to aid on the diagnosis.
Primary retroperitoneal serous adenocarcinoma (PRSA) is an extremely uncommon malignancy exclusively reported in females. Due to the rarity of the disease, it is difficult to establish a standardized treatment. We describe a unique case of PRSA in a 71-year-old male who presented with right-sided lower back pain and numbness. Magnetic resonance imaging identified a mass invading the adjacent psoas muscle and twelfth rib. Tissue biopsy confirmed poorly differentiated PRSA. Patient was initially treated with neoadjuvant carboplatin and paclitaxel chemotherapy regimen. This resulted in complete radiological resolution of the tumor. However, 12 weeks later, rapid recurrence was noted on follow-up CT scan. The patient was then treated with external radiotherapy with concurrent nivolumab, an anti-PD-1 antibody. The patient displayed a positive response to treatment with reduction in primary tumor and metastases and had a sustained disease control. Treatment with radiotherapy in combination with anti-PD-1 antibody could be an effective modality of management for PRSA.
Abstract The molecular landscape in non-muscle-invasive bladder cancer (NMIBC) is characterized by large biological heterogeneity with variable clinical outcomes. Here, we performed a large integrative multi-omics analysis of patients diagnosed with NMIBC (n=834). Transcriptomic analysis identified four classes (1, 2a, 2b and 3) reflecting tumor biology and disease aggressiveness. Both transcriptome-based subtyping and the level of chromosomal instability provided independent prognostic value beyond established prognostic clinicopathological parameters. High chromosomal instability, p53-pathway disruption and APOBEC-related mutations were significantly associated with transcriptomic class 2a and poor outcome. RNA-derived immune cell infiltration was associated with chromosomally unstable tumors and enriched in class 2b. Spatial proteomics analysis confirmed the higher infiltration of class 2b tumors and demonstrated an association between higher immune cell infiltration and lower recurrence rates. Finally, a single-sample classification tool was built and the independent prognostic value of the transcriptomic classes was documented in 1306 validation samples. The classifier provides a framework for novel biomarker discovery and for optimizing treatment and surveillance in next-generation clinical trials.
Cancer Cytopathology, a journal of the American Cancer Society, provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines.The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content.The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.
Objective To investigate the bacterial drug resistance and utilization of antibiotic drugs in the intensive care unit(ICU)of The Fifth Affiliated Hospital of Xinjiang Medical University;to guide appropriate antibiotic drug use.Methods Retrospective investigation method was used to statistically analyze the frequency and results of drug resistance test,the consumption,and defined daily dose system(DDDS) of antibiotic drugs in the ICU of hospital during 2011-2012.Results In 2011,constituent ratio of gramnegative bacteria is 78.33%(788/1 006),gram-positive:18.29%(184/1 006),fungus:3.38%(34/1 006).Pseudomonas aeruginosa(17.99%),Escherichia colil(16.40%),klebsiella pneumonial(15.71%),Acinetobacter baumannii(15.21%),staphylococcus aureus(6.06%)were the top five species of isolates.In 2012,constituent ratio of Gram Negative bacteria is 82.68%(659/797),Gram positive:11.29%(90/ 797),fungus:6.02%(48/797).Acinetobacter baumannii(22.21%),klebsiella pneumonia(20.70%),Pseudomonas aeruginosa(18.82%),Escherichia coli(6.90%),Proteus mirabilis(6.40%)were the top five species of isolates.β-lactams+enzyme inhibitors,Antifungal Agents,cephalosporins,Carbapenems,Quinolones were the top five categories of antibiotics in the list of DDDs drugs from 2011 to 2012.Cefoperazone/Sulbactam DDDs ranked first in all used antibiotics from 2011 to 2012.Conclusions The majority of pathogenic bacteria in the ICU of The Fifth Affiliated Hospital of Xinjiang Medical University are non-zymogenic bacteria,klebsiella pneumonia,staphylococcus aureus and Escherichia coli.Bacterial drug resistance is still a severe problem that requires effective manipulation.
