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Zhu Y, Meng Z, Wu H, Fan X, Lv W, Tian J, Wang K, Nie F. Deep learning radiomics of multimodal ultrasound for classifying metastatic cervical lymphadenopathy into primary cancer sites: a feasibility study. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2024; 45:305-315. [PMID: 38052240 DOI: 10.1055/a-2161-9369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
PURPOSE To investigate the feasibility of deep learning radiomics (DLR) based on multimodal ultrasound to differentiate the primary cancer sites of metastatic cervical lymphadenopathy (CLA). MATERIALS AND METHODS This study analyzed 280 biopsy-confirmed metastatic CLAs from 280 cancer patients, including 54 from head and neck squamous cell carcinoma (HNSCC), 58 from thyroid cancer (TC), 92 from lung cancer (LC), and 76 from gastrointestinal cancer (GIC). Before biopsy, patients underwent conventional ultrasound (CUS), ultrasound elastography (UE), and contrast-enhanced ultrasound (CEUS). Based on CUS, DLR models using CUS, CUS+UE, CUS+CEUS, and CUS+UE+CEUS data were developed and compared. The best model was integrated with key clinical indicators selected by univariate analysis to achieve the best classification performance. RESULTS All DLR models achieved similar performance with respect to classifying four primary tumor sites of metastatic CLA (AUC:0.708~0.755). After integrating key clinical indicators (age, sex, and neck level), the US+UE+CEUS+clinical model yielded the best performance with an overall AUC of 0.822 in the validation cohort, but there was no significance compared with the basal CUS+clinical model (P>0.05), both of which identified metastasis from HNSCC, TC, LC, and GIC with 0.869 and 0.911, 0.838 and 0.916, 0.750 and 0.610, and 0.829 and 0.769, respectively. CONCLUSION The ultrasound-based DLR model can be used to classify the primary cancer sites of metastatic CLA, and the CUS combined with clinical indicators is adequate to provide a high discriminatory performance. The addition of the combination of UE and CEUS data is expected to further improve performance.
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Affiliation(s)
- Yangyang Zhu
- Medical Center of Ultrasound, Lanzhou University Second Hospital, Lanzhou, China
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Zheling Meng
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- School of Artificial Intelligence, University of the Chinese Academy of Sciences School, Beijing, China
| | - Hao Wu
- Medical Center of Ultrasound, Lanzhou University Second Hospital, Lanzhou, China
| | - Xiao Fan
- Medical Center of Ultrasound, Lanzhou University Second Hospital, Lanzhou, China
| | - Wenhao Lv
- Medical Center of Ultrasound, Lanzhou University Second Hospital, Lanzhou, China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- School of Artificial Intelligence, University of the Chinese Academy of Sciences School, Beijing, China
| | - Kun Wang
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
- School of Artificial Intelligence, University of the Chinese Academy of Sciences School, Beijing, China
| | - Fang Nie
- Medical Center of Ultrasound, Lanzhou University Second Hospital, Lanzhou, China
- Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China
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Shahab J, Ahuja S, Singh M, Verma P, Ranga S. Comparison of liquid based cytology and conventional smears on lymph node aspirates: A cytomorphological study. Cytojournal 2024; 21:7. [PMID: 38469400 PMCID: PMC10927237 DOI: 10.25259/cytojournal_22_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 04/06/2023] [Indexed: 03/13/2024] Open
Abstract
Objective In an era of minimally invasive and rapid diagnostic technologies, fine-needle aspiration cytology (FNAC) is most useful when it comes to patients with lymphadenopathies especially of the cervical region. Liquid-based cytology (LBC) is an alternative processing method which is used for both gynecological and non-gynecological samples. Because of the remarkable advantages of LBC smears in gynecological samples, nowadays, many studies have been done to assess its utility in various other lesions. Hereby, with the help of this study, we would like to evaluate the efficiency of LBC smears in comparison to conventional FNAC smears conventional smears (CS) on lymph node aspirates. Material and Methods A retrospective study was done over a 1-year period in which 253 cases of lymph node aspirates were included in the study. The slides were prepared using standard conventional and LBC techniques and compared for adequacy, cellularity, cell architecture, necrosis, background debris, presence of cells in monolayer sheets, and nuclear/cytoplasmic details. Results Of the total 253 cases, 171 (67.6%) were and 67 (26.5%) were diagnosed as non-neoplastic and malignant, respectively. Although the LBC smears were useful in the diagnosis of malignant cases, they did pose some challenges especially in the non-neoplastic lymph node aspirates due to loss of the background necrosis. In addition, the cellular yield in LBC smears was low in comparison to CS. Conclusion LBC smears from lymph node aspirates results in better diagnostic accuracy for malignant cases due to better cellular and nuclear details. However, for non-neoplastic etiology, it should not be considered better than CS as loss of the background necrosis and inflammation may result in an incorrect diagnosis.
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Affiliation(s)
- Juhi Shahab
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sana Ahuja
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Mukul Singh
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Pooja Verma
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sunil Ranga
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Jiang Z, Yuan F, Zhang Q, Zhu J, Xu M, Hu Y, Hou C, Liu X. Classification of superficial suspected lymph nodes: non-invasive radiomic model based on multiphase contrast-enhanced ultrasound for therapeutic options of lymphadenopathy. Quant Imaging Med Surg 2024; 14:1507-1525. [PMID: 38415137 PMCID: PMC10895124 DOI: 10.21037/qims-23-1182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/29/2023] [Indexed: 02/29/2024]
Abstract
Background Accurate determination of the types of lymphadenopathy is of great importance in disease diagnosis and treatment and is usually confirmed by pathological findings. Radiomics is a non-invasive tool that can extract quantitative information from medical images. Our study was designed to develop a non-invasive radiomic approach based on multiphase contrast-enhanced ultrasound (CEUS) images for the classification of different types of lymphadenopathy. Methods A total of 426 patients with superficial suspected lymph nodes (LNs) from three centres were grouped into a training cohort (n=190), an internal testing cohort (n=127), and an external testing cohort (n=109). The radiomic features were extracted from the prevascular phase, vascular phase, and postvascular phase of the CEUS images. Model 1 (the conventional feature model), model 2 (the multiphase radiomics model), and model 3 (the combined feature model) were established for lymphadenopathy classification. The area under the curve (AUC) and confusion matrix were used to evaluate the performance of the three models. The usefulness of the models was assessed in different threshold probabilities by decision curve analysis. Results There were 139 patients (32.6%) with benign LNs, 110 patients (25.8%) with lymphoma, and 177 patients (41.5%) with metastatic LNs in our population. Finally, twenty features were selected to construct the radiomics models for these three types of lymphadenopathy. Model 2 integrating multiphase images of the CEUS yielded the AUCs of 0.838, 0.739, and 0.733 in the training cohort, internal testing cohort, and external testing cohort, respectively. After the combination of conventional features and radiomic features, the AUCs of model 3 improved to 0.943, 0.823 and 0.785 in the training cohort, internal testing cohort, and external testing cohort. Besides, model 3 had an accuracy of 81.05%, sensitivity of 80%, and specificity of 90.43% in the training cohort. Model performance was further confirmed in the internal testing cohort and external testing cohort. Conclusions We constructed a combined feature model using a series of CEUS images for the classification of the lymphadenopathies. For patients with superficial suspected LNs, this model can help clinicians make a decision on the LN type noninvasively and choose appropriate treatments.
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Affiliation(s)
- Zhenzhen Jiang
- Department of Ultrasound, Shaoxing People's Hospital, Shaoxing, China
| | - Fang Yuan
- Department of Ultrasound, Shaoxing People's Hospital, Shaoxing, China
| | - Qi Zhang
- Department of Ultrasound, Shaoxing People's Hospital, Shaoxing, China
| | - Jianbo Zhu
- Department of Ultrasound, Shaoxing People's Hospital, Shaoxing, China
| | - Meina Xu
- Department of Ultrasound, Xiamen Hospital, Beijing University of Chinese Medicine, Xiamen, China
| | - Yanfeng Hu
- Department of Ultrasound, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Chuanling Hou
- Department of Pathology, Shaoxing People's Hospital, Shaoxing, China
| | - Xiatian Liu
- Department of Ultrasound, Shaoxing People's Hospital, Shaoxing, China
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Kimura J, Narita N, Imamura Y, Tokunaga T, Mori M, Matsukawa H, Furuichi K, Ito Y, Imoto Y, Takabayashi T, Fujieda S. Liquid-based cytology (LBC) with immunocytochemical staining improves fine-needle aspiration cytology (FNA) performance for salivary gland tumors. Pathol Res Pract 2023; 248:154582. [PMID: 37267770 DOI: 10.1016/j.prp.2023.154582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/28/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Liquid-based cytology (LBC), now used globally for the head and neck region, has been used at our hospital since 2011. This study was designed to analyze the efficacy of LBC with immunocytochemical staining on preoperative diagnosis of salivary gland tumors. METHODS This retrospective analysis of fine-needle aspiration (FNA) performance for salivary gland tumors was conducted at Fukui University Hospital. Salivary gland tumor operations conducted during April 2006 - December 2010 (84 cases) were classified as the Conventional Smear (CS) group, which were diagnosed morphologically by Papanicolaou and Giemsa staining. Those done during January 2012 - April 2017 (112 cases) were classified as the LBC group, which were diagnosed using LBC samples with immunocytochemical staining. The FNA results and pathological diagnosis of both groups were analyzed to calculate the FNA performance. RESULTS Compared to the CS group, cases of inadequate and indeterminate FNA sample were not reduced significantly by LBC with immunocytochemical staining. As for FNA performance, the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CS group were, respectively, 88.7%, 53.3%, 100%, 100%, and 87.0%. Those of LBC group were all 100%, representing significant improvement over the CS group. CONCLUSIONS Analysis results indicated the usefulness of LBC with immunocytochemical staining for preoperative diagnosis of salivary gland tumors.
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Affiliation(s)
- Junya Kimura
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan; Division of Diagnostic Pathology / Surgical Pathology, University of Fukui Hospital, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Norihiko Narita
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan.
| | - Yoshiaki Imamura
- Division of Diagnostic Pathology / Surgical Pathology, University of Fukui Hospital, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Takahiro Tokunaga
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Masaki Mori
- Division of Diagnostic Pathology / Surgical Pathology, University of Fukui Hospital, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Haruka Matsukawa
- Division of Diagnostic Pathology / Surgical Pathology, University of Fukui Hospital, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Kazumi Furuichi
- Division of Diagnostic Pathology / Surgical Pathology, University of Fukui Hospital, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Yumi Ito
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Yoshimasa Imoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Tetsuji Takabayashi
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
| | - Shigeharu Fujieda
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medical Sciences, University of Fukui, 23 Shimoaizuki, Matsuoka, Eiheiji, Fukui 910-1193, Japan
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Zhu Y, Meng Z, Fan X, Duan Y, Jia Y, Dong T, Wang Y, Song J, Tian J, Wang K, Nie F. Deep learning radiomics of dual-modality ultrasound images for hierarchical diagnosis of unexplained cervical lymphadenopathy. BMC Med 2022; 20:269. [PMID: 36008835 PMCID: PMC9410737 DOI: 10.1186/s12916-022-02469-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Accurate diagnosis of unexplained cervical lymphadenopathy (CLA) using medical images heavily relies on the experience of radiologists, which is even worse for CLA patients in underdeveloped countries and regions, because of lack of expertise and reliable medical history. This study aimed to develop a deep learning (DL) radiomics model based on B-mode and color Doppler ultrasound images for assisting radiologists to improve their diagnoses of the etiology of unexplained CLA. METHODS Patients with unexplained CLA who received ultrasound examinations from three hospitals located in underdeveloped areas of China were retrospectively enrolled. They were all pathologically confirmed with reactive hyperplasia, tuberculous lymphadenitis, lymphoma, or metastatic carcinoma. By mimicking the diagnosis logic of radiologists, three DL sub-models were developed to achieve the primary diagnosis of benign and malignant, the secondary diagnosis of reactive hyperplasia and tuberculous lymphadenitis in benign candidates, and of lymphoma and metastatic carcinoma in malignant candidates, respectively. Then, a CLA hierarchical diagnostic model (CLA-HDM) integrating all sub-models was proposed to classify the specific etiology of each unexplained CLA. The assistant effectiveness of CLA-HDM was assessed by comparing six radiologists between without and with using the DL-based classification and heatmap guidance. RESULTS A total of 763 patients with unexplained CLA were enrolled and were split into the training cohort (n=395), internal testing cohort (n=171), and external testing cohorts 1 (n=105) and 2 (n=92). The CLA-HDM for diagnosing four common etiologies of unexplained CLA achieved AUCs of 0.873 (95% CI: 0.838-0.908), 0.837 (95% CI: 0.789-0.889), and 0.840 (95% CI: 0.789-0.898) in the three testing cohorts, respectively, which was systematically more accurate than all the participating radiologists. With its assistance, the accuracy, sensitivity, and specificity of six radiologists with different levels of experience were generally improved, reducing the false-negative rate of 2.2-10% and the false-positive rate of 0.7-3.1%. CONCLUSIONS Multi-cohort testing demonstrated our DL model integrating dual-modality ultrasound images achieved accurate diagnosis of unexplained CLA. With its assistance, the gap between radiologists with different levels of experience was narrowed, which is potentially of great significance for benefiting CLA patients in underdeveloped countries and regions worldwide.
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Affiliation(s)
- Yangyang Zhu
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, 730030, China.,CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Zheling Meng
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Xiao Fan
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, 730030, China
| | - Yin Duan
- Department of Ultrasound, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Yingying Jia
- Department of Ultrasound, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Tiantian Dong
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, 730030, China
| | - Yanfang Wang
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, 730030, China
| | - Juan Song
- Department of Ultrasound, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China.,Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine and Engineering, Beihang University, Beijing, China
| | - Kun Wang
- CAS Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China. .,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China.
| | - Fang Nie
- Ultrasound Medical Center, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, 730030, China. .,Gansu Province Clinical Research Center for Ultrasonography, Lanzhou, China. .,Gansu Province Medical Engineering Research Center for Intelligence Ultrasound, Lanzhou, China.
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Suzuki S, Bandoh N, Goto T, Kubota A, Uemura A, Kono M, Sato R, Takeda R, Sakaue S, Yamaguchi-Isochi T, Nishihara H, Takei H, Harabuchi Y. A retrospective study of parotid gland tumors at a single institution. Oncol Lett 2022; 24:207. [PMID: 35720490 PMCID: PMC9178697 DOI: 10.3892/ol.2022.13328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
The aim of the present study was to analyze the clinical characteristics, surgical treatments and clinical outcome of patients with parotid gland tumors and to compare the results with those cited in the literature. A retrospective study was conducted in 140 patients (male, n=77; female, n=63) with parotid gland tumors who underwent parotidectomy at Hokuto Hospital Department of Otolaryngology-Head and Neck Surgery (Obihiro, Japan) between April 2007 and December 2021. Of the 140 patients enrolled, 118 (84.3%) patients had benign tumors, including 63 (45%) patients with pleomorphic adenomas and 43 (30.7%) patients with Warthin tumors, and 22 patients (15.7%) had parotid carcinoma. Comparison of the three groups of patients with parotid gland tumors indicated that pack years as an indicator of smoking status were significantly higher in patients with Warthin tumors than in those with parotid carcinomas (P=0.011) or pleomorphic adenoma (P<0.001). Fine-needle aspiration cytology (FNAC) was non-diagnostic for only 6 (4.3%) of 140 patients. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNAC by both conventional smear and liquid-based cytology (LBC) for parotid carcinomas were 70, 99, 93.3, 94.4 and 82.9%, respectively. Among the 22 patients with parotid carcinoma, extended total/total and superficial parotidectomy were performed in 10 (45%) and 11 (50%) cases, respectively. Total and selective neck dissection of the area from level II to I, II and III were performed in 6 (24%) and 7 (32%) patients, respectively. Postoperative radiotherapy (50 Gy) was performed in 15 (68%) patients. The overall survival (OS) and disease-free survival (DFS) rates at 5 years were 51.5 and 76.4%, respectively. Univariate analysis revealed that age >65 years was significantly associated with poorer 5-year OS (P<0.001) and DFS (P<0.001). Multivariate analysis revealed that an age of more than 65 years combined with high-grade histologic malignancy was associated with worse DFS (P=0.02; hazard ratio, 3.628; 95% confidence interval, 1.283-9.514). In conclusion, the clinical characteristics and treatment outcomes of parotid gland tumors were consistent with the results of previous reports. Smoking may be closely related to the pathogenesis of Warthin tumors. LBC potentially provides improved accuracy in FNAC.
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Affiliation(s)
- Shiori Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan.,Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
| | - Nobuyuki Bandoh
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan
| | - Takashi Goto
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan
| | - Akinobu Kubota
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan.,Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
| | - Akihiro Uemura
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan
| | - Michihisa Kono
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan.,Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
| | - Ryosuke Sato
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan.,Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
| | - Ryuhei Takeda
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan.,Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
| | - Shota Sakaue
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan.,Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
| | | | - Hiroshi Nishihara
- Genomics Unit, Keio Cancer Center, Keio University School of Medicine, Shinjukuku, Tokyo 160-8582, Japan
| | - Hidehiro Takei
- Department of Pathology and Translational Pathobiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA
| | - Yasuaki Harabuchi
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan.,Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
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Cheng PC, Chang CM, Liao LJ, Cheng PW, Lo WC. The outcomes and decision-making process for neck lymph nodes with indeterminate fine-needle aspiration cytology. PLoS One 2021; 16:e0246437. [PMID: 33539457 PMCID: PMC7861456 DOI: 10.1371/journal.pone.0246437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 01/19/2021] [Indexed: 12/05/2022] Open
Abstract
Objectives This study aims to propose a cytological classification, to evaluate predictive factors of the final malignancy, and to suggest a proper management strategy for neck lymph nodes (LNs) with indeterminate cytology. Methods Patients who had neck lymphadenopathy with indeterminate cytology between 2007 and 2017 were analyzed retrospectively in a tertiary medical center. Cytological classification was conducted according to the cytological descriptions. We examined the clinical characteristics according to the final diagnosis of the neck lymphadenopathy. Results According to the final diagnoses, there were 142 malignant and 95 benign neck LNs among 237 patients. Multivariate analyses using a stepwise logistic regression model showed that cytological classification [p < 0.001, OR = 5.67 (3.48–9.23)], prior history of malignancy [p = 0.01, OR = 2.97 (1.26–6.99)], long axis [p = 0.01, OR = 3.06 (1.33–7.06)], short-to-long axis (S/L) ratio [p = 0.047, OR = 2.15 (1.01–4.57)] and internal echogenicity [p = 0.01, OR = 2.72 (1.26–5.86)] were independent predictors of malignancy. Conclusions In patients who have neck LNs with indeterminate cytology, a cytological classification and four other predictors (prior history of malignancy, long axis ≥ 1.93 cm, S/L ratio ≥ 0.64 and heterogeneity of internal echogenicity) are statistically associated with the risk of malignancy and helpful in guiding further management.
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Affiliation(s)
- Ping-Chia Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Chih-Ming Chang
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan (R.O.C.)
| | - Li-Jen Liao
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.)
- Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Po-Wen Cheng
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
| | - Wu-Chia Lo
- Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.)
- * E-mail:
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Choudhury M, Pahwa AR. Comparison of liquid-based cytology with conventional cytology in the evaluation of abdominal masses. INDIAN J PATHOL MICR 2020; 63:73-77. [PMID: 32031126 DOI: 10.4103/ijpm.ijpm_363_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Liquid-based cytology. Aims Utility of liquid-based cytology (LBC) was compared to conventional smear cytology in ultrasound-guided fine-needle aspirates of abdominal masses. Settings and Design This was a prospective comparative study conducted in collaboration with surgery and pediatrics surgery departments of our institute. Subjects and Methods Thirty patients presenting with evidence of abdominal mass were enrolled for the study and underwent fine-needle aspiration cytology. The material was processed for the preparation of conventional smears and residual material was rinsed into cytolyt for LBC by Thin Prep method and into cell block fluid. The smears prepared from both the methods were compared by two independent and experienced pathologists for adequacy, cellularity, architectural pattern, cytoplasmic preservation, nuclear preservation, and background. Results : Cellularity was frequently higher in the conventional smears than on Thin Prep slides (P value = 0.025). Recognition of architecture was better on the conventional smears (P value = 0.001). Cytoplasm was better preserved on the conventional smears (P value = 0.001) but difference in the preservation of nuclear details was not statistically significant on slides prepared from both the techniques. The background of Thin Prep slides is significantly cleaner than direct smears (P value = 0.001). Non epithelial elements such as mucin and neurofibrillary tangles were better preserved on direct smears (P value = 0.001) but diagnostic accuracy of both the methodologies showed no statistically significant difference (P value = 0.226). Conclusions The Thin Prep technique utilizes expensive equipment and reagents. It also generates certain morphological artefacts in slides with which a cytologist needs to get familiar. When used in isolation, it may not consistently provide any added advantage in the diagnosis of such lesions and should be used as an adjunct to conventional smears. It may be preferred in situations where material has to be transported for processing or is required for ancillary tests.
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Affiliation(s)
- Monisha Choudhury
- Department of Pathology, Sharda Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
| | - Archna R Pahwa
- Department of Pathology, Army College of Medical Sciences, New Delhi, India
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Budhwar A, Kataria SP, Kumar S, Singh G, Kaushik N, Sen R. Fine needle aspiration cytology of cervical lymph nodes: Comparison of liquid based cytology (SurePath) and conventional preparation. Diagn Cytopathol 2020; 49:18-24. [PMID: 32841545 DOI: 10.1002/dc.24589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 07/03/2020] [Accepted: 08/03/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND Fine needle aspiration cytology (FNAC) is the first diagnostic step in patient with cervical lymphadenopathy because of its simplicity, safety and early availability of the results. Liquid-based cytology (LBC) is an alternative processing method which is used for both gynecological and nongynecological samples. Literature reviewed show few studies comparing LBC with conventional preparation (CP). AIM The present study was undertaken to evaluate the efficacy of LBC and comparison of LBC and CP in cervical lymphadenopathy. MATERIALS AND METHODS In this prospective study, a total of 75 cases of FNAC with cervical lymphadenopathy were included. The first pass was used for CP followed by LBC with the use of SurePath (SP) technique. Both the smears were compared for cellularity, background containing blood, cell debris, lymphoglandular bodies, stromal fragments, cytoarchitectural pattern, etc., by semiquantitative scoring system. RESULTS There was no statistical difference in the cellularity, cell architecture, and monolayer cells (P > .05). On the basis of background containing blood, cell debris, lympho-glandular bodies, stromal fragments (P < .001), nuclear, and cytoplasmic details (P < .05), LBC was found to be superior to CP. CONCLUSION LBC is a relatively simple technique and superior to CP in respect of better nuclear and cytoplasmic details with loss of background blood and debris. It has a diagnostic accuracy equivalent to that of CP. However, use of both LBC and CP can result in better diagnostic accuracy.
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Affiliation(s)
- Archana Budhwar
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Sant Prakash Kataria
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Sanjay Kumar
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Gajender Singh
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Nidhi Kaushik
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Rajeev Sen
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
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Choy B, Venkataraman G, Biernacka A, Lastra RR, Mueller J, Setia N, Reeves W, Antic T. Correlation of cytopathology with flow cytometry and histopathology for the diagnosis of hematologic malignancies in young adults presenting with cervical lymphadenopathy. Diagn Cytopathol 2019; 47:579-583. [PMID: 30794347 DOI: 10.1002/dc.24157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 12/19/2018] [Accepted: 01/31/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Fine-needle aspiration (FNA) is frequently utilized in the diagnostic workup of lymphadenopathy. We evaluated the correlation of cytopathology with flow cytometry and tissue biopsy results and assessed the prevalence of specific malignancies in young adults presenting with cervical lymphadenopathy. METHODS Database was searched for cervical lymph node FNA performed by a cytopathologist in patients aged 18-30 years from 2005 to 2017. RESULTS Cervical lymph node FNA was performed on 48 patients without prior history of malignancy. Nineteen patients had cytology results only, of which all were interpreted as benign reactive lymph node. None developed subsequent malignancies. The remaining 29 patients had cytology with flow cytometry and/or tissue biopsy results. A benign reactive cytology diagnosis was rendered in 18 (62%) cases, of which 11 had concordant diagnosis on flow cytometry, 2 had tissue biopsy, and 3 had both. Eleven (38%) patients had cytology results concerning for a hematologic malignancy, of which 7 were confirmed by flow cytometry and 3 by both flow cytometry and tissue biopsy. Cervical lymph node FNA has 94.1% sensitivity, 83.3% specificity, 88.9% positive predictive value, and 90.9% negative predictive value. The most common hematologic malignancy in our young adult population presenting with cervical lymphadenopathy was Hodgkin lymphoma. CONCLUSION FNA is a useful first-line diagnostic procedure for assessing cervical lymphadenopathy in young adults to allow for better triage of specimens for flow cytometry and/or tissue biopsy concerning for a hematologic malignancy and potentially avoid invasive excisional biopsy in a proportion of cases.
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Affiliation(s)
- Bonnie Choy
- Department of Pathology, University of Chicago, Chicago, Illinois.,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Anna Biernacka
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Ricardo R Lastra
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Jeffery Mueller
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Namrata Setia
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Ward Reeves
- Department of Pathology, University of Chicago, Chicago, Illinois
| | - Tatjana Antic
- Department of Pathology, University of Chicago, Chicago, Illinois
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Barroca H, Bode-Lesniewska B, Cozzolino I, Zeppa P. Management of cytologic material, preanalytic procedures and biobanking in lymph node cytopathology. Cytopathology 2018; 30:17-30. [DOI: 10.1111/cyt.12609] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 06/06/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Helena Barroca
- Serviço de Anatomia Patológica; Hospital S João-Porto; Porto Portugal
| | - Beata Bode-Lesniewska
- Institute of Pathology and Molecular Pathology; University Hospital; Zurich Switzerland
| | - Immacolata Cozzolino
- Dipartimento di Salute Mentale e Fisica e Medicina; Università degli studi della Campania Luigi Vanvitelli; Napoli Italy
| | - Pio Zeppa
- Dipartimento di Medicina e Chirurgia; Università di Salerno; Salerno Italy
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