ECP 2023 Abstracts

S101 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 final morphologic scores for cases of NIFTP ranged from 2 to 7 with a mean of 4.33 with those of THY5 PTC ranging from 6 to 8 with a mean of 6.57 giving a significant p value of 0.0109. A comparison of NIFTP cytology scores with scores of surgically proven PTC with THY3 and THY4 preoperative diagnoses was non-significant (P= 0.8442). Conclusion: The morphological detection of NIFTP on FNA is sup- ported by the identification and scoring of key cytological features. The scoring system is most effective at distinguishing NIFTPs from Thy 5 PTCs on FNA. The separation of NIFTPs, predominantly Thy3 and Thy4, from Thy 3 and Thy 4 FNA’s that turned out to be papillary cancer using the scoring system is not possible. Combination with other testing modalities, including molecular, is required. PS-16-004 Spectrum of RAS and BRAF mutational analysis in indeterminate thyroid nodules N. Kumari*, N. Krishnani, R. Paturu *All India Institute of Medical Sciences, Raebareli, India Background & objectives: The role of molecular testing in indetermi- nate thyroid aspirates have become increasingly important in cases of indeterminate cytology (Bethesda category III, IV and V). Molecular testing helps to decide predicting the risk if malignancy and decide about the surgical management. Methods: 135 cases of indeterminate Bethesda cytology were retrieved from the pathology records in 50 months duration. All cases were reviewed by two experienced pathologists. Thirty-one cases were excluded because of inadequate material or reclassification into category II or VI. Remaining 104 cases were included for molecular testing of RAS (NRAS, HRAS, KRAS) and BRAF mutations by real time PCR. Results: Cytomorphologically there were 27.9% Bethesda III, 60.6% IV, and 11.5% category V. Histopathologically malignancy was con- firmed in 35.6% cases. 64.4% cases were benign. RAS was common than BRAF mutation (53.3% vs 7.7%). NRAS was predominant muta- tion (33.7%) followed by HRAS (16.3%) and KRAS (1.9%). Prevalence of mutations in each Bethesda category followed the order of NRAS > HRAS > BRAF > KRAS except in category V where BRAF (25%) was greater than NRAS (16.7%), HRAS (8.3 %) and KRAS (8.3%). Overall risk of malignancy in indeterminate nodules was 35.6%. 66.7% risk highest in category V followed by IV (36.5%) and III (20.7%). NRAS significantly predicted malignancy (p=0.005) in 54% cases. Conclusion: The sensitivity, specificity, positive predictive value, and negative predictive value of NRAS mutations to predict malignancy in indeterminate thyroid nodules is 51.35%, 76.12%, 54.31%, 73.89%, respectively. Despite, predicting malignancy significantly (p=0.005), NRAS had a low diagnostic accuracy of malignancy of 67.3%. PS-16-005 UKNEQAS CPT Cell Block Scheme A. Patterson* *UKNEQAS CPT, United Kingdom Background & objectives: Currently there is no External Quality Assur- ance scheme for assessing the quality of Cell Blocks prepared from cytol- ogy samples. It was decided by UKNEQAS CPT to investigate the need for such a service. Methods: Increase in the number of Haematoxylin and Eosin slides from cell blocks and number of inquiries regarding preparation methods sug- gested a need for such a scheme. A survey UKNEQAS CPT circulated indicated that there is a need for such a scheme. In response to the survey responses it was decided to perform 2 pilots which were well supported. Results: Previously cell block slides were considered to be covered by the Tissue Diagnostics scheme. However, this is not entirely appropri- ate as cytology departments use a variety of preparation methods and fixatives for cell blocks. The 2 pilots were well supported and successful leading to the launch of the new scheme in April 2023. Participants are asked to provide details about the sample types and preparation methods used for the samples they submit for assessment. This presentation will cover the results of the 2 pilots and how the scheme intend to collate the informa- tion gathered and share this with our users. Conclusion: The UKNEQAS CPT Cell Block scheme is not intended to be merely a ’tick box’ exercise for UKAS. or other accreditation bodies. lt will enable enable gathering valuable information about ’best methods’ which can be circulated to laboratories experiencing prob- lems. It will be an advisory service which aims to improve diagnostic practices and therefore be of benefit to patients and clinicians. PS-16-006 High positive predictive value of atypical glandular cells in cytol- ogy for a preneoplastic or neoplastic squamous and/or glandular cervical lesion H. Piña-Giménez*, B. Raposo, R. Granados *Hospital Universitario de Getafe, Spain Background & objectives: Reproducibility of cytological glandular cell atypia (AGC/AGC-H) is low and carries an elevated risk of CIN2+ cervical lesions, warranting immediate colposcopy. This study analyses the positive predictive value (PPV) of the AGC/AGC-H cytological diagnosis in our population for CIN2+ lesions. Methods: A retrospective study with the analysis of liquid-based cytol- ogy (LBC) samples, human papillomavirus (HPV) status, histological correlation and clinical follow-up of women from our archives in the past 10 years. The incidence of AGC/AGC-H in our population and the presence of either glandular, squamous or mixed lesions associated with this diagnosis was reviewed. Statistical analysis of PPV was calculated. Results: From 163.033 LBC samples, 94 (0,06%) showed AGCs (76 AGC and 18 AGC-H). Twenty-two had additional cytological squa- mous atypia. From 81 biopsies, 66,7% showed CIN2+ (average age of 41 years), 27,2% glandular lesions, 11 of them with infiltrating adeno- carcinoma. Mixed squamous/glandular lesions co-existed in 16,7% of cases, but 59,3% of CIN2+ lesions were purely squamous. There were 21 women with negative biopsies, accounting for 25,9% of cases with AGCs. No biopsy was performed in 13 cases, followed-up with cytolo- gies from 1-10 years. The PPV of AGCs in cytology was 66,7% when all, squamous and glandular, CIN2+ lesions were considered. PPV decreased to 27,2% for adenocarcinoma in situ (AIS) or adenocarcinoma. Conclusion: Although a very unusual cytological diagnosis in our population, the presence of AGC or AGC-H poses a high risk (66,7%) for a preneoplastic or neoplastic cervical lesion in women aged 41 years in average. Most associated CIN2+ cases are squamous or mixed squamous/glandular. However, the PPV of atypical glandular cells in cytology for AIS or adenocarcinoma reaches 27,2%, justifying the immediate referral of these women for colposcopy in most cervical cancer screening programmes. PS-16-007 Immunocytochemical determination of hormonal receptor and CerbB2 status in metastatic breast carcinoma in axillary lymph nodes (via SurePath experience) and correlation with synchronous breast mass core needle biopsies S.R. Ramazanoglu*, H. Eren, S. Bagbudar, T. Soylemez Akkurt, H. Izol Ozmen, M.A. Nazli *Başakşehir Çam and Sakura City Hospital, Department of Pathology, Division of Cytopathology, Turkey Background & objectives: Determination of ER and CerbB2 status have pivotal role in patients with breast cancer. We aimed to find out the significance of ER, CerbB2 antibodies’ efficiency and accuracy in metastatic axillary lymph nodes, all of which were diagnosed via FNAC.