My Top 5 Picks from The 59th American Society of Cytopathology Meeting

In case you weren’t able to attend the 59th Annual ASC meeting in November 2011, CytoJournal has published abstracts from the finalized poster-platform sessions. I am sharing my top 5 picks from this list which peaked my interest. Please feel free to post a particular abstract you found interesting by posting a comment.

Selected Abstracts from CytoJournal 2011 8(1):16-16

These are peer-reviewed poster-platform submissions finalized by the Scientific Program Committee. A total of 153 abstracts (14 Platforms [PP1 through PP14] & 139 Posters [1 through 139]) were selected from 161 submissions to be considered for presentation during November 4 – 8, 2011, at the Hilton Baltimore Hotel, to pathologists, cytopathologists, cytotechnologists, residents, fellows, students, and other members of cytopathology-related medical and scientific fields.

1. The Tahoe Study: Bias in interpretation of Pap tests when HPV …: This is a CAP Cytopathology Committee group study, written by Moriarty, et. al. evaluating the what impact, if any, known HPV status has on Pap smear interpretations. The study found that known HPV status does affect the Pap test interpretation, and was statistically significant. The authors concluded that “[i]f molecular testing is used as a primary screening test and Pap tests are used as secondary or reflex tests, it is more likely that the Pap test will be interpreted as abnormal, as compared to when a Pap test is used as a primary screening test.
2. An Analysis of Fine Needle Aspirations with Atypical Diagnoses: This study from Virginia Commonwealth University by Cahill, et. al. evaluated superficial (SFNA) and Image guided (IGFNA) to determine factors precluding definitive interpretation. The authors found that most often, atypical diagnoses were made when there was no useful cell block, although additional factors, such as low cellularity, bland morphology, and insufficient material for ancillary studies, such as with flow cytometry in suspected hematologic cases. Low cellularity was often associated with a difficult FNA procedure. The authors conclude that atypical FNA diagnoses are “unavoidable”, and are usually secondary to low cellularity. Although the authors’ atypia rate was low, 1.8%, they were frequently associated with subsequent malignancy in nearly 80% of the cases. The authors suggest that additional peer-review of adequately sampled atypical interpretations may improve the final interpretation and reduce and avoiding unnecessary followup.
3. Combined cytomorphological and immunophenotypic analysis enhances the fine needle aspiration diagnosis of lymphoproliferative disorders involving the thyroid: This retrospective Yale study, conducted by Levy, et. al., reported their experience with lymphoproliferative disorders (LPD) of the thyroid. The authors report that LPD of the thyroid are rare lesions, with diffuse large B-cell lymphoma being the most common type. Clinical history is important for directing proper patient followup and additional workup. Flow cytometry is the ancillary study of choice for definitive diagnosis, although fluorescence in-situ studies may be helpful in identifying chromosomal translocations useful for subtyping LPD’s.
4. Thyroid fine needle aspiration cytology: Performance data of malignant and neoplastic cases as identified from the ASCP NonGYN assessment program: This study from the ASCP by Eilers, et. al. reports the performance data from the ASCP Non-GYN Assessment Program, specifically evaluating the categories of malignant and neoplastic. “In summary, thyroid aspirates of Papillary carcinoma, Medullary carcinoma, Anaplastic carcinoma, and hurthle cell neoplasm, showed diagnostic sensitivity rates (Group A + Group C) of 92 – 100%, which was similar to the reported rates of around 95%. The follicular neoplasm presented as the most challenging diagnosis, with a 22% false negative rate.”
5. CINtec^® PLUS as a triage tool for anorectal  Pap smears with atypical squamous cells of undetermined significance (ASC-US) / low- grade squamous intraepithelial lesions: A pilot study: A study by Walts and Bose from Cedars-Sinai, was “…designed to assess the utility of CINtec ® for the detection of the underlying or subsequent (U / S) anal high-grade squamous intraepithelial lesions (AIN2 / 3) in individuals with ASC-US / LSIL, on anorectal Pap smear.” The authors found that CINtec^®PLUS staining on prepared and previously stained LBP did not affect cytomorphologic detail. They also found it to be: less expensive and time-consuming than conventional HPV testing, with a shorter turn-around time (TAT); could help stratify ASC-US/LSIL cases for clinical management; in LSIL cases, a positive result was less sensitive but slightly more specific than HR-HPV for identification of underlying or subsequent AIN2/3+ . The authors request a large prospective study be performed to confirm their findings. 
   

(Abstracts for the 59^th Annual Scientific Meeting (November 2011) by American Society of Cytopathology (ASC) at Baltimore, MD, USA. CytoJournal 2011;8:16)