62 / 366
anti-neutrophil cytoplasmic antibodies were negative, however, pa-
tients were highly suspect of limited GPA because of clinical
presentations and were treated in such a way. Histopathological
revision revealed IgG4-related eosinophilic angiocentric fibrosis in
all three cases.
Conclusion:
These cases confirm eosinophilic angiocentric fibrosis
being part of the spectrum of IgG4-RD. Patients suspected of
limited GPA should be evaluated for IgG4-RD, especially
when diagnosis GPA cannot convincingly be established. The
diagnosis is based on clinical presentation, serum IgG4 and
histology, the gold standard. Proper diagnosis and treatment is
important to prevent manifestation in other organs and to prevent
irreversible fibrosis due to the disease.
OFP-16-001
Performance of ProEx C supplemented with HPV genotypic analysis
in detecting cervical squamous intraepithelial lesions
R. Alaghehbandan
*
, J. Bentley, N. Escott, P. Ghatage, S. Ratnam
*
University of British Columbia, Dept. of Pathology, Vancouver, Canada
Objective:
The clinical usefulness of the ProEx C test (BD) for the de-
tection of cervical intraepithelial neoplasia (CIN) was determined in a
multicentre study carried out in Canada, supplemented with HPV geno-
typic analysis.
Method:
The study population comprised of women representing five of
the ten Canadian provinces referred to colposcopy for further assessment
of cervical cancer risk and follow-up, and those routinely screened.
Cervical specimens were collected in PreservCyt and cytology was per-
formed using the ThinPrep method (Hologic), and were processed for
HPV genotyping using the Linear Array method (Roche Molecular
System). Histology confirmed CIN served as the disease endpoint to
assess the test performance.
Results:
ProEx C was positive in 39 % (634/1625). ProEx C detecting
CIN was best found at CIN2+ with a concordance rate of 73.5 % (95 %
CI: 72.4
–
74.6). The overall positive rate of HR-HPV was 69.8 %
(1135/1625), with a concordance of 54.0 % (95 % CI: 52.8
–
55.3) for
detecting CIN2+. The sensitivities of ProEx C and HR-HPV in detecting
CIN2+ lesions were 74.2 and 95.3 %while the specificities were 73.3 and
39.3 %, respectively. A significant correlation between ProExC and HR-
HPV in terms of detecting CIN2+ lesions was found (
p
= 0.044).
Conclusion:
ProEx C was found to be more specific but less sensitive
than HR-HPV marker in detecting CIN2+ lesions. ProEx C may have the
potential to serve as a useful adjunct test for the detection of CIN2+
lesions in cervical cancer screening.
OFP-16-002
Intra-institutional second opinion diagnosis may reduce unnecessary
surgery for indeterminate thyroid fine-needle aspirates
I. Migliatico
*
, E. Vigliar, N. Serra, G. Troncone, C. Bellevicine
*
Università Federico II, Dipto. de Anatomia Patologica, Napoli, Italy
Objective:
Although fine-needle aspiration (FNA) is a highly cost-
effective diagnostic procedure, a significant proportion of thyroid nodules
are classified as indeterminate. Thus, a second diagnostic opinion given
by an outside expert pathologist is a common practice that facilitates more
appropriate clinical management. Conversely, little is known about the
role of intra-institutional second opinion diagnosis (iSOD) that is usually
informally performed in-house and may improve the diagnosis of inde-
terminate thyroid nodules requiring surgery.
Method:
To assess the contribution of iSOD, a retrospective series of 34
thyroid FNAs diagnosed as follicular neoplasm/suspicious for follicular neo-
plasm (FN/SFN) with matched histological follow-ups and a malignancy rate
of 17.6 % was selected and independently reviewed by two cytopathologists
(CYT1 and 2). Cases with discrepant diagnoses were referred to a third in-
house senior cytopathologist for the iSOD. The malignancy rates obtained
after single independent reviews and iSOD were compared.
Results:
MR obtained after CYT1 and 2 re-screening was similar
(14.28 and 19.04 %, respectively) and did not improve the original MR
(17.64 %). Conversely, after the iSOD of discrepant diagnoses, the overall
malignancy rate increased up to the 27.27 %.
Conclusion:
Intra-institutional second opinion practice potentially avoids
unnecessary surgical procedures and maximizes the detection of malig-
nant cases diagnosed as FN/SFN.
OFP-16-003
Risk stratification of salivary gland lesions on cytology based on the
proposed Milan System for reporting salivary gland cytopathology:
A pilot study
K. Viswanathan
*
, S. Sung, G. Yang, T. Scognamiglio, R. Rao
*
New York Presbyterian, Weill Cornell Pathology, USA
Objective:
Fine-needle aspiration (FNA) is widely used for the initial diag-
nosis of salivary gland nodules. The recently proposed Milan system aims to
standardize the reporting of salivary gland cytopathology. Studies regarding
the risk of malignancy (ROM) for the proposed categories are evolving. Our
retrospective study aims to re-categorize salivary gland lesions using the
proposed Milan system and calculate evidence based ROM.
Method:
186 salivary gland FNAs from 175 patients over 5 years (2011
–
2016) at Weill Cornell Medicine/New York Presbyterian Hospital were
identified. 105 of these FNAs had histologic or flow-cytometry follow up.
The mean age was 59 (range 22
–
99) years, and M:F is 1:1.3. Samples
were processed with liquid-based cytology alone, or in combination with
air-dried Diff-Quik or Ultra fast stained, or alcohol fixed Papanicolaou-
stained smears. Cellblock study was used where available. The final cy-
tology were re-categorized into 6 major categories by two independent
cytopathologists, as 1- Non-diagnostic, 2- Non-neoplastic, 3- Atypia of
undetermined significance, 4a-Neoplastic, benign and 4b- neoplastic, un-
certain malignant potential, 5-suspicious for malignancy, and 6- malig-
nant. The risk of malignancy (ROM) and the overall ROM (OROM) for
each diagnostic category were determined.
Results:
There was near perfect agreement on category assignments. The
results for OROM in the categories 1, 2, and 3, were 5, 9, and 15 %,
respectively. The ROM for neoplastic lesions and above, 4a, 4b, 5 and 6
was approximately 9, 26, 100, and 95 %, respectively.
Conclusion:
Categorization of salivary gland cytology is feasible and can
help standardize reporting and stratifying cases pre-operatively, for effec-
tive patient management.
OFP-16-004
Biochip as a new perspective in cytological diagnostics of serous
effusions
M. Savostikova
*
, E. Furminskaya, E. Fedoseeva, A. Kudaybergenova, S.
Smetanina, S. Zinoviev, O. Utkin
*
N.N. Blokhin RCRC, Moscow, Russia
Objective:
The purpose of this study was to show advantages of appli-
cation of fluorescent immunocytochemistry (FICC) using biochip in se-
rous effusions.
Method:
86 specimens of serous effusions were investigated. At first all
the slides were prepared using Cytospin-3 and evaluated cytologically.
Then immunocytochemical assay was performed using biochip and fluo-
rescent microscope. Biochip is a device with 15 equal individual cells.
Wednesday, 6 September 2017, 14:00
–
16:00, G109
OFP-16 Cytopathology
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S48