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Most-download articles are from the articles published in 2023 during the last three month.

Review Article
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Multiple sclerosis: a practical review for pathologists
Rachel A. Multz, Pouya Jamshidi, Jared T. Ahrendsen
J Pathol Transl Med. 2025;59(4):203-213.   Published online June 27, 2025
DOI: https://doi.org/10.4132/jptm.2025.05.20
  • 4,108 View
  • 258 Download
  • 1 Crossref
AbstractAbstract PDF
Multiple sclerosis (MS) is an immune-mediated demyelinating disorder of the central nervous system. It is a chronic disorder resulting in neurologic dysfunction that is disseminated both in time (multiple discrete episodes) and space (involving multiple sites). Histologically, MS is characterized by localized loss of myelin with relative preservation of axons. This review will discuss the epidemiology, clinical, laboratory, radiologic, and pathologic features of multiple sclerosis, as well as briefly touch on the differential diagnosis, treatment, and prognosis of the disease, especially as they relate to the pathologic interpretation of tissue specimens.

Citations

Citations to this article as recorded by  
  • White Matter in Crisis: Oligodendrocytes and the Pathophysiology of Multiple Sclerosis
    Mario García-Domínguez
    Cells.2025; 14(18): 1408.     CrossRef
Newsletter
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What’s new in medical renal pathology 2025: Updates on podocytopathy and immunofluorescence staining in medical kidney
Astrid Weins, Ibrahim Batal, Paola Romagnani, Geetika Singh, Rahul Raj, Nicole Andeen, Jonathan Zuckerman, Martina Uzzo, Mariam Priya Alexander, Anjali Satoskar
J Pathol Transl Med. 2025;59(4):269-272.   Published online July 10, 2025
DOI: https://doi.org/10.4132/jptm.2025.06.19
  • 2,550 View
  • 217 Download
AbstractAbstract PDF
Diffuse podocytopathy, including minimal change disease and primary focal segmental glomerulosclerosis, is a common cause of nephrotic syndrome in adults and children. It is increasingly recognized to be autoimmune-mediated associated with anti-nephrin and other emerging anti-slit diaphragm antibodies, and can recur in the kidney allograft. Immunofluorescence is routinely used in evaluation of kidney biopsies, and updates include those on fibrillar diseases, monoclonal staining, lupus-like staining, and use of antibody KM55 in IgA-dominant glomerulonephritis.
Review
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A stepwise approach to fine needle aspiration cytology of lymph nodes
Yosep Chong, Gyeongsin Park, Hee Jeong Cha, Hyun-Jung Kim, Chang Suk Kang, Jamshid Abdul-Ghafar, Seung-Sook Lee
J Pathol Transl Med. 2023;57(4):196-207.   Published online July 11, 2023
DOI: https://doi.org/10.4132/jptm.2023.06.12
  • 37,034 View
  • 2,061 Download
  • 9 Web of Science
  • 10 Crossref
AbstractAbstract PDFSupplementary Material
The cytological diagnosis of lymph node lesions is extremely challenging because of the diverse diseases that cause lymph node enlargement, including both benign and malignant or metastatic lymphoid lesions. Furthermore, the cytological findings of different lesions often resemble one another. A stepwise diagnostic approach is essential for a comprehensive diagnosis that combines: clinical findings, including age, sex, site, multiplicity, and ultrasonography findings; low-power reactive, metastatic, and lymphoma patterns; high-power population patterns, including two populations of continuous range, small monotonous pattern and large monotonous pattern; and disease-specific diagnostic clues including granulomas and lymphoglandular granules. It is also important to remember the histological features of each diagnostic category that are common in lymph node cytology and to compare them with cytological findings. It is also essential to identify a few categories of diagnostic pitfalls that often resemble lymphomas and easily lead to misdiagnosis, particularly in malignant small round cell tumors, poorly differentiated squamous cell carcinomas, and nasopharyngeal undifferentiated carcinoma. Herein, we review a stepwise approach for fine needle aspiration cytology of lymphoid diseases and suggest a diagnostic algorithm that uses this approach and the Sydney classification system.

Citations

Citations to this article as recorded by  
  • Development and Validation of Explainable Artificial Intelligence System for Automatic Diagnosis of Cervical Lymphadenopathy From Ultrasound Images
    Ming Xu, Yubiao Yue, Zhenzhang Li, Yinhong Li, Guoying Li, Haihua Liang, Di Liu, Xiaohong Xu, Mohamadreza (Mohammad) Khosravi
    International Journal of Intelligent Systems.2025;[Epub]     CrossRef
  • Application of the Sydney system for classification and reporting lymph node cytopathology: a retrospective analysis at a tertiary centre
    Ashok Teja Kummari, Pramod Kumar Pamu, Krishna Kiran Ganna, Param Jyothi, Sadashivudu
    International Journal of Research in Medical Sciences.2025;[Epub]     CrossRef
  • Diagnostic approach to FNA biopsy of cystic lesions of the head and neck
    Stefen Andrianus, Olivia Leung, Zubair Baloch
    Cancer Cytopathology.2025;[Epub]     CrossRef
  • Immunocytochemical markers, molecular testing and digital cytopathology for aspiration cytology of metastatic breast carcinoma
    Joshua J. X. Li, Gary M. Tse
    Cytopathology.2024; 35(2): 218.     CrossRef
  • Response to comment on “A stepwise approach to fine needle aspiration cytology of lymph nodes”
    Yosep Chong, Gyeongsin Park, Hee Jeong Cha, Hyun-Jung Kim, Chang Suk Kang, Jamshid Abdul-Ghafar, Seung-Sook Lee
    Journal of Pathology and Translational Medicine.2024; 58(1): 43.     CrossRef
  • Comment on “A stepwise approach to fine needle aspiration cytology of lymph nodes”
    Elisabetta Maffei, Valeria Ciliberti, Pio Zeppa, Alessandro Caputo
    Journal of Pathology and Translational Medicine.2024; 58(1): 40.     CrossRef
  • The Incidence of Thyroid Cancer in Bethesda III Thyroid Nodules: A Retrospective Analysis at a Single Endocrine Surgery Center
    Iyad Hassan, Lina Hassan, Nahed Balalaa, Mohamad Askar, Hussa Alshehhi, Mohamad Almarzooqi
    Diagnostics.2024; 14(10): 1026.     CrossRef
  • Efficiency of Fine-Needle Aspiration (FNA) in Relation to Tru-Cut Biopsy of Lateral Neck Swellings
    Mohammed S Al Olaimat, Fahad S Al Qooz, Zaid R Alzoubi, Elham M Alsharaiah, Ali S Al Murdif, Mohammad O Alanazi
    Cureus.2024;[Epub]     CrossRef
  • Pitfalls in the Cytological Diagnosis of Nodal Hodgkin Lymphoma
    Uma Handa, Rasheeda Mohamedali, Rajpal Singh Punia, Simrandeep Singh, Ranjeev Bhagat, Phiza Aggarwal, Manveen Kaur
    Diagnostic Cytopathology.2024; 52(12): 715.     CrossRef
  • Rapid 3D imaging at cellular resolution for digital cytopathology with a multi-camera array scanner (MCAS)
    Kanghyun Kim, Amey Chaware, Clare B. Cook, Shiqi Xu, Monica Abdelmalak, Colin Cooke, Kevin C. Zhou, Mark Harfouche, Paul Reamey, Veton Saliu, Jed Doman, Clay Dugo, Gregor Horstmeyer, Richard Davis, Ian Taylor-Cho, Wen-Chi Foo, Lucas Kreiss, Xiaoyin Sara J
    npj Imaging.2024;[Epub]     CrossRef
Newsletter
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What’s new in neuropathology 2024: CNS WHO 5th edition updates
Heather Smith, Jared T. Ahrendsen
J Pathol Transl Med. 2024;58(6):346-349.   Published online September 30, 2024
DOI: https://doi.org/10.4132/jptm.2024.09.11
  • 11,408 View
  • 899 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract PDF
The fifth edition of the World Health Organization (WHO) Classification of Central Nervous System (CNS) Tumors was released in 2021, just five years following the updated fourth edition. Advanced molecular testing such as next-generation sequencing, RNA fusion analysis, and DNA methylation profiling has led to more precise grading and classification of pre-existing tumor types as well as the recognition of new ones. Herein, we outline the major updates of the 2021 WHO Classification of CNS tumors, with emphasis on the expanded molecular characterization of CNS tumors.

Citations

Citations to this article as recorded by  
  • Bioinformatics insights into ACSL1 and ACSL5: prognostic and immune roles in low-grade glioma
    Cheng Zhang, Zhonghua Lv, Hongsheng Liang, Fulan Hu, Haoran Bi
    BMC Cancer.2025;[Epub]     CrossRef
  • Current Understanding of the Exosomes and Their Associated Biomolecules in the Glioblastoma Biology, Clinical Treatment, and Diagnosis
    Aghdas Ramezani, Maryam Rahnama, Fatemeh Mahmoudian, Fatemeh Shirazi, Mahmoud Ganji, Shohreh Bakhshi, Bahman Khalesi, Zahra Sadat Hashemi, Saeed Khalili
    Journal of Neuroimmune Pharmacology.2025;[Epub]     CrossRef
  • Diagnostic Utility of Intratumoral Susceptibility Signals in Adult Diffuse Gliomas: Tumor Grade Prediction and Correlation with Molecular Markers Within the WHO CNS5 (2021) Classification
    José Ignacio Tudela Martínez, Victoria Vázquez Sáez, Guillermo Carbonell, Héctor Rodrigo Lara, Florentina Guzmán-Aroca, Juan de Dios Berna Mestre
    Journal of Clinical Medicine.2025; 14(11): 4004.     CrossRef
  • Glioblastoma in Puerto Rico: A 21-year population-based study
    Carlos E Calderon-Valero, Esteban Rivera, Odaly Balasquide, Alejandro E Cedeño-Moran, Aixa De Jesus, Miguel Mayol Del Valle
    Neuro-Oncology Advances.2025;[Epub]     CrossRef
  • Brain Tumors, AI and Psychiatry: Predicting Tumor-Associated Psychiatric Syndromes with Machine Learning and Biomarkers
    Matei Șerban, Corneliu Toader, Răzvan-Adrian Covache-Busuioc
    International Journal of Molecular Sciences.2025; 26(17): 8114.     CrossRef
Review Article
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Recent topics on thyroid cytopathology: reporting systems and ancillary studies
Mitsuyoshi Hirokawa, Ayana Suzuki
J Pathol Transl Med. 2025;59(4):214-224.   Published online June 30, 2025
DOI: https://doi.org/10.4132/jptm.2025.04.18
  • 1,944 View
  • 203 Download
AbstractAbstract PDF
As fine-needle aspiration techniques and diagnostic methodologies for thyroid nodules have continued to evolve and reporting systems have been updated accordingly, we need to be up to date with the latest information to achieve accurate diagnoses. However, the diagnostic approaches and therapeutic strategies for thyroid nodules vary across laboratories and institutions. Several differences exist between Western and Eastern practices regarding thyroid fine-needle aspiration. This review describes the reporting systems for thyroid cytopathology and ancillary studies. Updated reporting systems enhance the accuracy, consistency, and clarity of cytology reporting, leading to improved patient outcomes and management strategies. Although a single global reporting system is optimal, reporting systems tailored to each country is acceptable. In such cases, compatibility must be ensured to facilitate data sharing. Ancillary methods include liquid-based cytology, immunocytochemistry, biochemical measurements, flow cytometry, molecular testing, and artificial intelligence, all of which improve diagnostic accuracy. These methods continue to evolve, and cytopathologists should actively adopt the latest methods and information to achieve more accurate diagnoses. We believe this review will be useful to practitioners of routine thyroid cytology.
Newsletter
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What’s new in thyroid pathology 2024: updates from the new WHO classification and Bethesda system
Andrey Bychkov, Chan Kwon Jung
J Pathol Transl Med. 2024;58(2):98-101.   Published online March 13, 2024
DOI: https://doi.org/10.4132/jptm.2024.03.06
  • 17,044 View
  • 1,716 Download
  • 5 Crossref
AbstractAbstract PDF
In line with the release of the 5th edition WHO Classification of Tumors of Endocrine Organs (2022) and the 3rd edition of the Bethesda System for Reporting Thyroid Cytopathology (2023), the field of thyroid pathology and cytopathology has witnessed key transformations. This digest brings to the fore the refined terminologies, newly introduced categories, and contentious methodological considerations pivotal to the updated classification.

Citations

Citations to this article as recorded by  
  • Cytologic and Clinicopathologic Features of Papillary Thyroid Carcinoma with Prominent Hobnail Features on FNAC
    Deepali Saxena, Ravi Hari Phulware, Prashant Durgapal, Arvind Kumar, Amit Kumar Tyagi
    Indian Journal of Otolaryngology and Head & Neck Surgery.2024; 76(5): 4885.     CrossRef
  • FHL1: A novel diagnostic marker for papillary thyroid carcinoma
    Yeting Zeng, Dehua Zeng, Xingfeng Qi, Hanxi Wang, Xuzhou Wang, Xiaodong Dai, Lijuan Qu
    Pathology International.2024; 74(9): 520.     CrossRef
  • Nouveautés en pathologie thyroïdienne : classification OMS 2022, système Bethesda 2023, biologie moléculaire et testing moléculaire
    Mohamed Amine Bani, Sophie Moog, Voichita Suciu, Livia Lamartina, Abir Al Ghuzlan
    Bulletin du Cancer.2024; 111(10): 10S5.     CrossRef
  • Cytologic hallmarks and differential diagnosis of papillary thyroid carcinoma subtypes
    Agnes Stephanie Harahap, Chan Kwon Jung
    Journal of Pathology and Translational Medicine.2024; 58(6): 265.     CrossRef
  • Surgical and Pathological Challenges in Thyroidectomy after Thermal Ablation of Thyroid Nodules
    Ting-Chun Kuo, Kuen-Yuan Chen, Hsiang-Wei Hu, Jie-Yang Jhuang, Ming-Tsan Lin, Chin-Hao Chang, Ming-Hsun Wu
    Thyroid®.2024; 34(12): 1503.     CrossRef
Original Articles
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Pancreatic cancer in liquid-based cytology: cytological features and cell block utility from 254 fine-needle aspiration samples
Jaeyong Min, Wookjin Oh, Baek-hui Kim
J Pathol Transl Med. 2025;59(4):249-261.   Published online July 3, 2025
DOI: https://doi.org/10.4132/jptm.2025.05.27
  • 1,497 View
  • 154 Download
AbstractAbstract PDFSupplementary Material
Background
Despite the increasing use of liquid-based cytology (LBC) for pancreatic cancer diagnosis, relatively few studies have directly examined such research. This study analyzed the cytopathological features of pancreatic cancer in LBC and demonstrated the utility of cell blocks in diagnosing pancreatic lesions. Methods: A retrospective review identified LBC from 254 pancreatic fine-needle aspirations (FNAs) (221 patients). FNAs were categorized into five subgroups based on cytopathological, clinical, and histopathological findings. Two pathologists evaluated cytological features in LBC samples, cell blocks, and tissue slides. Comparative analysis assessed differences between groups. Results: Compared to benign lesions, LBC of pancreatic cancer more frequently showed a necrotic background, intermediate to high cellularity, mixed architecture, nuclear/cytoplasmic ratio >0.8, anisonucleosis >4:1, irregular and thick nuclear membranes, multinucleated tumor cells, hyperchromatic nuclei, coarse to clumped chromatin, and a prominent single nucleolus. In cases of conventional pancreatic ductal adenocarcinoma, the palliative treatment subgroup showed a higher incidence of necrotic background than the resection subgroup. In the cell block analysis, tumor cells not identified in LBC slides were detected in 16 FNAs. Additionally, 13 FNAs contributed to differential diagnosis: ancillary tests aided diagnosis in 12 FNAs, while histopathological evaluation of the cell block slide alone was helpful in one case. Conclusions: The cytological features of pancreatic cancer in LBC are similar to those observed in conventional smears, with a necrotic background suggesting advanced (unresectable) disease. The cell block methodology minimizes tumor cell loss and facilitates differential diagnosis by enabling ancillary testing.
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AMACR is a highly sensitive and specific immunohistochemical marker for diagnosing prostate cancer on biopsy: a systematic review and meta-analysis
Johannes Cansius Prihadi, Stevan Kristian Lionardi, Nicolas Daniel Widjanarko, Steven Alvianto, Fransiskus Xaverius Rinaldi, Archie Fontana Iskandar
J Pathol Transl Med. 2025;59(4):235-248.   Published online July 3, 2025
DOI: https://doi.org/10.4132/jptm.2025.04.16
  • 2,791 View
  • 147 Download
AbstractAbstract PDFSupplementary Material
Background
Alpha-methylacyl-CoA racemase (AMACR) is the preferred biomarker for distinguishing malignant from benign glands in prostate biopsies, showing high sensitivity and specificity for prostate cancer. A meta-analysis of immunohistochemistry (IHC) for AMACR is essential to further assess its diagnostic accuracy across diverse sample sources. Methods: A systematic search of databases including MEDLINE, ScienceDirect, ProQuest, Google Scholar, and the Cochrane Library was performed, focusing on studies of AMACR to diagnose prostate cancer, particularly in biopsy samples analyzed through IHC over the last 20 years. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool, followed by a meta-analysis of regions and subgroups to calculate summary estimates of diagnostic test accuracy. Results: In the final analysis, 37 studies, with a pooled size of 5,898 samples, were included from the examination of 94 full-text papers. Among them, 27 studies with similar sample sources and testing methodologies underwent meta-analysis, yielding a combined sensitivity estimate of 0.90 (95% confidence interval [CI], 0.86 to 0.93) and specificity of 0.91 (95% CI, 0.83 to 0.95), both with significant heterogeneity (p < .01). The region beneath the hierarchical summary receiver operating characteristic curve was 0.95 (95% CI, 0.93 to 0.97), positive likelihood ratio was 9.6 (95% CI, 5.3 to 17.4), negative likelihood ratio was 0.11 (95% CI, 0.08 to 0.15), and diagnostic odds ratio was 88 (95% CI, 42 to 181). Conclusions: Our meta-analysis findings substantiate AMACR as a highly accurate tool for diagnosing prostate cancer, specifically in biopsy samples, via immunohistochemical staining. Further studies involving diverse samples are needed to enhance our understanding of the AMACR diagnostic accuracy in a range of clinical settings.
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The Automatable Activity–Based Approach to Complexity Unit Scoring as a task-specific model approach to monetizing outcomes of pathology artificial intelligence solutions
Stavros Pantelakos, Martha Nifora, Georgios Agrogiannis
J Pathol Transl Med. 2025;59(4):225-234.   Published online July 3, 2025
DOI: https://doi.org/10.4132/jptm.2025.04.15
  • 2,058 View
  • 117 Download
AbstractAbstract PDF
Background
Cost-containment policies are increasingly affecting decision-making in healthcare. In this context, the need for monetization of digital health interventions has been recently emphasized. Previous studies have attempted to extrapolate cost containment in conjunction with the implementation of digital pathology solutions mostly on the basis of operational cost savings or diagnostic error reduction. However, no study has attempted to link a wider spectrum of potential diagnostic tasks performed by artificial intelligence algorithms to financial figures.
Methods
Herein, we employ a workload measurement tool for the purpose of monetizing particular outcomes associated with the implementation of a pathology artificial intelligence solution. A hundred and thirty-two prostate core biopsy samples were encoded for workload using the Automatable Activity–Based Approach to Complexity Unit Scoring. Subsequently, avoided workload, full-time equivalent gains, and corresponding cost savings were calculated assuming full clinical deployment of a well-developed prostate cancer screening tool.
Results
For a fixed percentage of negative cores and a steady yearly workload of prostate core biopsies, the estimated total avoided workload amounted to 4,291 complexity units per year, with an average avoidance of 16.25 complexity units per ascension number. The calculated full-time equivalent gains were 0.12, whereas projected cost savings were as high as €2,402.34 per year or €0.55 per complexity unit, which in turn would yield an average of €8.93 per ascension number.
Conclusions
The Automatable Activity–Based Approach to Complexity Unit Scoring appears to be a suitable economic evaluation tool for assessing the possible implementation of task-specific artificial intelligence solutions in a given histopathology laboratory or group of laboratories, considering it is a task-specific workload measurement tool per design.
Case Study
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Acquired aberrant partial CD3 expression in recurrent Epstein-Barr virus–negative solitary plasmacytoma of tonsil
Chenchen Niu, Dong Ren, Truc Tran, Ashley Gamayo, Sherif Rezk, Xiaohui Zhao
J Pathol Transl Med. 2025;59(4):262-268.   Published online May 15, 2025
DOI: https://doi.org/10.4132/jptm.2025.04.17
  • 1,660 View
  • 120 Download
AbstractAbstract PDF
The aberrant expression of specific T-cell maker CD3 in B-cell neoplasms can be a potential diagnostic pitfall leading to a misclassification of cell lineage. Here, we report a case of recurrent solitary plasmacytoma with new aberrant expression of CD3. The neoplastic plasma cells of the recurrent tumor were kappa restricted, positive for CD138, MUM1, negative for CD20, cyclin D1, and Epstein-Barr virus. CD79a was positive in majority of the tumor cells, except for a small focus which was strongly positive for CD3, but negative for other T-cell markers (CD2, CD5, CD7, CD4, and CD8) and CD56. The neoplastic plasma cells of the original tumor were negative for CD3. To the best of our knowledge, only one case of recurrent plasmacytoma with aberrant expression of CD3 has been published, which revealed disease progression in the recurrence. However, we did not observe morphologic evidence of disease progression in our case.
Reviews
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A standardized pathology report for gastric cancer: 2nd edition
Young Soo Park, Myeong-Cherl Kook, Baek-hui Kim, Hye Seung Lee, Dong-Wook Kang, Mi-Jin Gu, Ok Ran Shin, Younghee Choi, Wonae Lee, Hyunki Kim, In Hye Song, Kyoung-Mee Kim, Hee Sung Kim, Guhyun Kang, Do Youn Park, So-Young Jin, Joon Mee Kim, Yoon Jung Choi, Hee Kyung Chang, Soomin Ahn, Mee Soo Chang, Song-Hee Han, Yoonjin Kwak, An Na Seo, Sung Hak Lee, Mee-Yon Cho
J Pathol Transl Med. 2023;57(1):1-27.   Published online January 15, 2023
DOI: https://doi.org/10.4132/jptm.2022.12.23
  • 24,345 View
  • 1,384 Download
  • 19 Web of Science
  • 16 Crossref
AbstractAbstract PDFSupplementary Material
The first edition of ‘A Standardized Pathology Report for Gastric Cancer’ was initiated by the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists and published 17 years ago. Since then, significant advances have been made in the pathologic diagnosis, molecular genetics, and management of gastric cancer (GC). To reflect those changes, a committee for publishing a second edition of the report was formed within the Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. This second edition consists of two parts: standard data elements and conditional data elements. The standard data elements contain the basic pathologic findings and items necessary to predict the prognosis of GC patients, and they are adequate for routine surgical pathology service. Other diagnostic and prognostic factors relevant to adjuvant therapy, including molecular biomarkers, are classified as conditional data elements to allow each pathologist to selectively choose items appropriate to the environment in their institution. We trust that the standardized pathology report will be helpful for GC diagnosis and facilitate large-scale multidisciplinary collaborative studies.

Citations

Citations to this article as recorded by  
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    Hye Seung Lee
    Journal of Gastric Cancer.2025; 25(1): 192.     CrossRef
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    Emily E. Stroobant, Seong-Ho Kong, Maria Bencivenga, Takahiro Kinoshita, Tae-Han Kim, Takeshi Sano, Giovanni de Manzoni, Han-Kwang Yang, Yuko Kitagawa, Vivian E. Strong
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    Sujin Oh, Soo Kyung Nam, Keun-Wook Lee, Hye Seung Lee, Yujun Park, Yoonjin Kwak, Kyu Sang Lee, Ji-Won Kim, Jin Won Kim, Minsu Kang, Young Suk Park, Sang-Hoon Ahn, Yun-Suhk Suh, Do Joong Park, Hyung Ho Kim
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    Yeshong Park, Yeon Bi Han, Jinju Kim, MeeYoung Kang, Boram Lee, Eun Sung Ahn, Saemi Han, Haeryoung Kim, Hee-Young Na, Ho-Seong Han, Yoo-Seok Yoon
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    Soomin Ahn, Yoonjin Kwak, Gui Young Kwon, Kyoung-Mee Kim, Moonsik Kim, Hyunki Kim, Young Soo Park, Hyeon Jeong Oh, Kyoungyul Lee, Sung Hak Lee, Hye Seung Lee
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Breast fine-needle aspiration cytology in the era of core-needle biopsy: what is its role?
Ahrong Kim, Hyun Jung Lee, Jee Yeon Kim
J Pathol Transl Med. 2025;59(1):26-38.   Published online January 15, 2025
DOI: https://doi.org/10.4132/jptm.2024.11.01
Correction in: J Pathol Transl Med 2025;59(2):147
  • 6,283 View
  • 340 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Fine-needle aspiration cytology (FNAC) has long been recognized as a minimally invasive, cost-effective, and reliable diagnostic tool for breast lesions. However, with the advent of core-needle biopsy (CNB), the role of FNAC has diminished in some clinical settings. This review aims to re-evaluate the diagnostic value of FNAC in the current era, focusing on its complementary use alongside CNB, the adoption of new approaches such as the International Academy of Cytology Yokohama System, and the implementation of rapid on-site evaluation to reduce inadequate sample rates. Advances in liquid-based cytology, receptor expression testing, molecular diagnostics, and artificial intelligence are discussed, highlighting their potential to enhance the diagnostic accuracy of FNAC. Despite challenges, FNAC remains a valuable diagnostic method, particularly in low-resource settings and specific clinical scenarios, and its role continues to evolve with technology.

Citations

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  • Bulk-lysis protocols as a sensitive method for investigation of circulating CK19 cells in the peripheral blood of patients with breast cancer by flow cytometry
    Daniella Serafin Couto Vieira, Laura Otto Walter, Maria Eduarda Cunha da Silva, Lisandra de Oliveira Silva, Heloísa Zorzi Costa, Chandra Chiappin Cardoso, Fernando Carlos de Lander Schmitt, Maria Cláudia Santos-Silva
    Analytical Methods.2025; 17(23): 4771.     CrossRef
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Cytologic hallmarks and differential diagnosis of papillary thyroid carcinoma subtypes
Agnes Stephanie Harahap, Chan Kwon Jung
J Pathol Transl Med. 2024;58(6):265-282.   Published online November 7, 2024
DOI: https://doi.org/10.4132/jptm.2024.10.11
  • 7,735 View
  • 478 Download
  • 4 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, characterized by a range of subtypes that differ in their cytologic features, clinical behavior, and prognosis. Accurate cytologic evaluation of PTC using fine-needle aspiration is essential but can be challenging due to the morphologic diversity among subtypes. This review focuses on the distinct cytologic characteristics of various PTC subtypes, including the classic type, follicular variant, tall cell, columnar cell, hobnail, diffuse sclerosing, Warthin-like, solid/trabecular, and oncocytic PTCs. Each subtype demonstrates unique nuclear features, architectural patterns, and background elements essential for diagnosis and differentiation from other thyroid lesions. Recognizing these distinct cytologic patterns is essential for identifying aggressive subtypes like tall cell, hobnail, and columnar cell PTCs, which have a higher risk of recurrence, metastasis, and poorer clinical outcomes. Additionally, rare subtypes such as diffuse sclerosing and Warthin-like PTCs present unique cytologic profiles that must be carefully interpreted to avoid diagnostic errors. The review also highlights the cytologic indicators of lymph node metastasis and high-grade features, such as differentiated high-grade thyroid carcinoma. The integration of molecular testing can further refine subtype diagnosis by identifying specific genetic mutations. A thorough understanding of these subtype-specific cytologic features and molecular profiles is vital for accurate diagnosis, risk stratification, and personalized management of PTC patients. Future improvements in diagnostic techniques and standardization are needed to enhance cytologic evaluation and clinical decision-making in thyroid cancer.

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Article image
A review of liver fibrosis and cirrhosis regression
Michael J. Lee
J Pathol Transl Med. 2023;57(4):189-195.   Published online June 20, 2023
DOI: https://doi.org/10.4132/jptm.2023.05.24
  • 18,874 View
  • 742 Download
  • 20 Web of Science
  • 20 Crossref
AbstractAbstract PDF
Cirrhosis has traditionally been considered an irreversible process of end-stage liver disease. With new treatments for chronic liver disease, there is regression of fibrosis and cirrhosis, improvement in clinical parameters (i.e. liver function and hemodynamic markers, hepatic venous pressure gradient), and survival rates, demonstrating that fibrosis and fibrolysis are a dynamic process moving in two directions. Microscopically, hepatocytes push into thinning fibrous septa with eventual perforation leaving behind delicate periportal spikes in the portal tracts and loss of portal veins. Obliterated portal veins during progressive fibrosis and cirrhosis due to parenchymal extinction, vascular remodeling and thrombosis often leave behind a bile duct and hepatic artery within the portal tract. Traditional staging classification systems focused on a linear, progressive process; however, the Beijing classification system incorporates both the bidirectional nature for the progression and regression of fibrosis. However, even with regression, vascular lesions/remodeling, parenchymal extinction and a cumulative mutational burden place patients at an increased risk for developing hepatocellular carcinoma and should continue to undergo active clinical surveillance. It is more appropriate to consider cirrhosis as another stage in the evolution of chronic liver disease as a bidirectional process rather than an end-stage, irreversible state.

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Original Article
Article image
International Academy of Cytology standardized reporting of breast fine-needle aspiration cytology with cyto-histopathological correlation of breast carcinoma
Shweta Pai
J Pathol Transl Med. 2024;58(5):241-248.   Published online September 13, 2024
DOI: https://doi.org/10.4132/jptm.2024.07.14
  • 4,124 View
  • 313 Download
AbstractAbstract PDF
Background
The International Academy of Cytology (IAC) has developed a standardized approach for reporting the findings of breast fine-needle aspiration cytology (FNAC). Accordingly, there are five chief categories of breast lesions, C1 (insufficient material), C2 (benign), C3 (atypical), C4 (suspicious), and C5 (malignant). The prognostication and management of breast carcinoma can be performed readily on the basis of this classification system. The aim of this study was to classify various breast lesions into one of the above-named categories and to further grade the C5 lesions specifically using the Robinson system. The latter grades were then correlated with modified Scarff-Bloom-Richardson (SBR) grades.
Methods
This retrospective study was undertaken in the pathology department of a hospital located in the urban part of the city of Bangalore. All FNAC procedures performed on breast lumps spanning the year 2020 were included in the study.
Results
A total of 205 breast lesions was classified according to the IAC guidelines into C1 (6 cases, 2.9%), C2 (151 cases, 73.7%), C3 (13 cases, 6.3%), C4 (5 cases, 2.5%), and C5 (30 cases, 14.6%) groups. The C5 cases were further graded using Robinson’s system. The latter showed a significant correlation with the SBR system (concordance=83.3%, Spearman correlation=0.746, Kendall’s tau-b=0.736, kappa=0.661, standard error=0.095, p≤.001).
Conclusions
A standardized approach for FNAC reporting of breast lesions, as advocated for by the IAC, improves the quality and clarity of the reports and assures diagnostic reproducibility on a global scale. Further, the cytological grading of C5 lesions provides reliable cyto-prognostic scores that can help assess a tumor’s aggressiveness and predict its histological grade.

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