ECP 2023 Abstracts

S175 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 Background & objectives: Although effective chemotherapy is avail- able for tuberculosis, compliance of the patient is a major challenge. The aim of this study was to describe cytomorphological features of drug defaulters on lymph node FNAC and compare it with newly diag- nosed cases. Methods: A cross-sectional study was done for a period of 18 months in which all patients having tuberculous lymphadenitis were taken for study after taking detail history regarding previous anti-tuberculosis drug intake. Cytomorphological findings in drug defaulters were evalu- ated and compared with newly diagnosed cases. Results: There were a total of 150 cases with 120 newly diagnosed and 30 drug defaulters. Splintered epithelioid cell granuloma was seen in 40% of drug defaulters while it was absent in case of newly diagnosed cases (p value< 0.0001). Well-formed epithelioid cell granuloma was most commonly seen in newly diagnosed cases (65.83%) followed by poorly formed granuloma (26.67%). Another significant finding was distribution of eosinophils were significantly high in case of drug defaulters (56.67%) (p value <0.0001). Conclusion: Cytomorphological findings can help in identification of the drug defaulters on FNAC and thus plan further line of treatment. E-PS-04-002 Milan System and its efficacy in salivary gland cytology A. Uğuz, M. Aksin*, B.N. Ateş, E. Onan *Cukurova University Faculty of Medicine, Department of Pathology, Turkey Background & objectives: The aims of this study is to evaluate the risk of malignancy (ROM) of ‘’Milan System for Reporting Salivary Gland Cytopathology (MSRSGC)” in each categories, to compare ROMs with the previous descriptive diagnoses, and to analyse the effects on management. Methods: Our database was searched for patients who had salivary gland fine needle aspiration between 2011-2020. Each specimen was re-evaluated, and cases were reclassified according to the MSRSGC diagnostic categories. Cytopathological diagnoses were correlated with the follow-up histopathologies. ROM was calculated for each category. The overall sensitivity, spesificity, positive predictive value, negative predictive value and the diagnostic accuracy were evaluated. Results: A total of 605 salivary gland fine needle aspiration speci- mens were evaluated and histologic follow-up was available for 247 specimens. The calculated ROMs for each categories was as follows: 1- 14.2%, 2- 6.2%, 3- 56.5%, 4A- 1.03%, 4B- 24.4%, 5- 26.3%, 6- 82.7%. The sensitivity, specificity, positive predictive value, and nega- tive predictive value of the MSRSGC-based classification were 91.6%, 93.7%, 78.5% and 97.8%, respectively. Conclusion: The present results confirm the usefullnes of the MSRSGC in clinical practice, providing prognostic information and suggestions for management strategies. In addition, it creates a com- mon language between pathologists and the clinicians in the approach to salivary gland lesions. E-PS-04-003 Clinicopathologic characteristics of HPV-negative/cytology-positive cervical lesions: results from a 5-year study Y. Chun*, J.Y. Park, Y. Kim * Korea University Guro Hospital, Republic of Korea Background & objectives: With increasing cervical cancer screen- ing and human papillomavirus (HPV) vaccination, the importance of HPV-independent cervical cancer is anticipated to increase. This study examined the clinicopathologic characteristics of HPV-negative/ cytology-positive cervical lesions. Methods: Over 5 years from 2017, 30,950 HPV tests were conducted using the HPV 28 Anyplex Real-time Detection kit. Of these, 25,088 cases (81%) were also tested for liquid-based cytology. Out of 1506 cases with abnormal cytology and negative HPV test results, the his- tological results of 52 cases with high-grade squamous intraepithelial lesion or worse (HSIL+) on cytology were reviewed. Results: Histological examination of the 52 cases revealed that 33 cases had a diagnosis of HSIL+, including 30 cases of carcinoma and 3 cases of HSIL. The 30 cases of carcinoma included 11 cases of endometrial carcinoma, 9 cases of cervical carcinoma, 8 cases of metastatic carcinoma, 1 case of anal carcinoma, and 1 case of vulvar Paget disease. A case of carcinoma and 3 cases of HSIL were found to be HPV-positive by p16 immunostaining and HPV DNA in situ hybridization. Conclusion: The results suggest that HPV-negative and cytology-pos- itive cases can present with various types of cervical cancer, including HPV-independent and HPV-associated cancer, HSIL, endometrial can- cer, and metastatic cancer in extrauterine organs. Also, it is important to consider the possibility of false negative HPV test results. Thus, relying solely on HPV screening may result in missing these different types of lesions, which has significant implications for the management and treatment of cervical cancer. E-PS-04-004 Investigation of common stoma adhesive powder, paste and tapes: Identification of guar cell contamination may prevent diagnostic pitfalls O.C. Eren*, E. Orak, S. Ilme, E. Koseoglu, E. Eren, T. Keskin, D. Ertoy Baydar, P. Fırat *Koç University Hospital, Department of Pathology, Turkey Background & objectives: A 75-year-old male patient with ileal con- duit after radical cystectomy submitted a urostomy-bag urine sample during his annual evaluation. Cytologic examination revealed non- atypical urothelial cells, intestinal epithelial cells and vacuolated plant cells, initially mimicking an intestinal fistula. Methods: To investigate the possibility of a contamination from urostomy adhesives, smears were made from commonly used, com- mercially available stoma adhesive pastes (Coloplast® and Con- vatec®), powder (Brava®), and hard/soft tapes (Coloplast® Alterna). Simultaneously, cell blocks were prepared and histologic sections of 3 micrometer thickness were made for hematoxylin-eosin staining. Separately, unstained sections were deparaffinized for further use in immunofluorescence. Results: Cytologic evaluation of Coloplast® paste revealed plant cells with vacuolar cytoplasm and rigid borders, identical to what was observed in patient’s sample. Sections from Coloplast® adhesive confirmed similar cells, further demonstrated to be auto-fluorescent in fluorescence microscopy. The patient was later confirmed to use the same stoma adhesive paste and was found to have no signs or symp- toms suggesting an intestinal fistula. Cytopathologic examination of the remaining stoma adhesives were acellular, displaying merely inorganic material. Conclusion: Stoma adhesives should be acknowledged as potential contaminators of urine samples, especially in circumstances where sampling is made directly from urostomy bags. Although most adhe- sives are devoid of organic material, Coloplast® stands out due to its plant-based component. Guar gum, found in stoma adhesives such as the latter, is characterized by auto-fluorescent, rigid-walled, vacuolar plant cells. Recognition of morphologic features may prevent pathol- ogists misinterpreting Guar cells as contents of intestinal fistula or uncommon parasites. E-PS-04-006 Diagnostic approach to cat scratch disease: a cross-sectional study K. Goncalves Villarreal*, E. Oliva Dominguez, S. Gamba Torrez, I. Garcia Miranda, S. Fernandez Sole, J.D. Solano Iturri *MD, University Hospital of Cruces, Spain