Impact of COVID-19 pandemic on functioning of cytopathology laboratory: Experience and perspective from an academic centre in New York

COVID‐19 has extraordinarily impacted every facet of the health care facilities’ operations. Various strategies and policies were implemented promptly to preserve resources, not only to provide medical care to the expected massive numbers of COVID‐19 patients, but also to mitigate the contagion spread at the workplace to ensure safety of healthcare workers. All routine, non‐essential medical services and procedures were ramped down and workers deemed non‐essential were directed to work remotely from home to reduce the number of people at hospital premises and preserve much needed personal protective equipment that were in short supply at the outset of the pandemic. The laboratories did not remain unscathed and were under immense pressure to maintain workplace safety while being operational and provide best patient care with limited resources. In this paper, we share our experience and challenges that we faced in a cytopathology laboratory at a major academic centre in New York, USA during the peak of infection.

This study reviews the impact of COVID‐19 on cytopathology specimen numbers during the peak of pandemic in New York City. Most specimens decreased in number and proportion except for effusion cytology which almost doubled. The rate of malignant and indeterminate diagnostic categories significantly increased while the benign category decreased, and the non‐diagnostic category remained the same. Adaptations to staffing and clinical operations to provide continuous patient care and trainee education while maintaining workplace safety are described.

Cytomorphology of Recurrent Osseous Extracranial Meningioma of Right Pubic Ramus:: Report of a Case and Literature Review

Meningiomas are well-recognized neoplasms of the central nervous system. Primary extracranial meningiomas (ECMs) are extremely rare and arise in various anatomic sites. We present a 56-year-old female with 13-year history of primary grade I meningothelial meningioma of right pubic symphysis, orthotopic heart transplant, and right total hip arthroplasty, who presented with progressive right hip pain for 3 weeks. Primary intracranial, intraspinal and other tumors were excluded. Imaging revealed a destructive lytic lesion at right superior and inferior pubic rami and body, associated with extensive bone destruction and soft tissue mass. Touch imprint (TI) cytology of computed tomography (CT)-guided core biopsy from the right pubic ramus (PRA) lesion showed a spindle cell neoplasm, with classical syncytial, lobular, and whorling cellular arrangement, composed of spindle, oval or round nuclei with occasional pseudoinclusions, consistent with known history of osseous meningioma. Tumor was further characterized by histopathology as grade 1 meningioma with meningothelial features. To our knowledge, primary osseous ECM arising specifically at the PRA has not been reported previously. ECM at this site may pose a diagnostic challenge for cytologists as its features may resemble other more commonly observed lesions. Accurate diagnosis requires awareness of occurrence of ECM at PRA and recognition of its characteristic cytomorphology. TI cytological features of our case are presented and previously described cytology of ECMs and diagnostic pitfalls are reviewed. Diagn. Cytopathol. 2016;44:618-622. © 2016 Wiley Periodicals, Inc.

Acute pancreatitis in a patient treated for alcoholic hepatitis. The hypothesis of supranormal ecbolic stimulation of the pancreon

A 33-yr-old white woman treated for alcoholic hepatitis developed acute pancreatitis during her hospital stay. At autopsy, two major pathological processes were found: alcoholic cirrhosis and chronic pancreatitis. In both, there was evidence of an acute episode, i.e., acute alcoholic hepatitis and acute hemorrhagic pancreatitis superimposed on the chronic alcoholic lesions. The sequence of events would indicate that the acute pancreatic pathology was precipitated by supranormal ecbolic stimulation of the acinar segment of the "pancreon" units, triggered as a result of a high protein and fat diet.