ECP 2023 Abstracts

S176 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 Background & objectives: Cat scratch disease (CSD) is clinically characterized by subacute painful lymphadenopathy. Histopathology is commonly nonspecific, and serology often necessary. The main objec- tive is to describe the diagnostic approach of CSD in the Pathology Department of the University Hospital of Cruces. Methods: Descriptive, retrospective, and cross-sectional study of 25 patients with painful lymphadenopathy diagnosed with CSD by compatible cytology and positive serology, evaluated in the Pathol- ogy Department of the University Hospital of Cruces between 1999-2020. Patients with indeterminate or negative serology were excluded. Medical records were reviewed. Qualitative data were expressed in percentages and absolute values and quantitative data as mean (range). Results: 60% were men (n=15) with a mean age of 33 years (16-65). The location of lymphadenopathies was predominantly cervical (n=20) followed by inguinal (n=4) and axillary (n=1). Regarding cytological smears, 9 samples presented inflammatory characteristics, 4 included in their cytological spreads heterogeneous lymphohistiocytic cellularity with frequent apoptotic bodies in a context of abscess-forming necrotic material, and in the remaining 11, mononuclear cells were evident at different maturation stages embedded in a reticular network. No sam- ples presented cytological atypia. Conclusion: The differential diagnosis of suppurative granulomatous lymphadenitis is broad and should include CSD. The epidemiological history of contact with cats should be questioned. In the case of clinical suspicion of CSD, we recommend the systematic use of fine-needle aspiration cytology in the absence of rapid on-site evaluation and rou- tine infectious serology. E-PS-04-008 Audit of thyroid fine needle aspiration cytology reporting over a two-year period (2019-2020) E. Joslin*, S. Appukutty, A. Paterson, M. O’Donovan, J. Chan, A. Duckworth, N. Patel, A. Marker *Cambridge University Hospital, United Kingdom Background & objectives: Calculate the proportion of thyroid fine needle aspiration (FNA) cytology and core needle biopsy (CNB) cases in each Thy and C categories compared to RCPath standards. To determine the proportion of Thy3 cases that were double-reported with MDT meeting discussion. Methods: All consecutive thyroid FNA and CNB samples received for reporting at Addenbrooke’s Hospital, Cambridge from January 2019-December 2020. The Thy and C categories were compared to RCPath standards, as well as associated malignancy rates. Results: 401 thyroid FNA samples were received and categorised as follows: Thy1 22%, Thy1c 13%, Thy2 5%, Thy2c 6%, Thy3a 26%, Thy3f 17%, Thy4 1%, Thy5 9%, no category 1%. 88% Thy3a and 69% Thy3f samples were double reported. MDT discus- sion documented in 92% Thy3a, 94% Thy3f, 100% Thy4 and 92% Thy5. The subsequent histology showed the malignancy risk in each cat- egory to be Thy1 6%, Thy2 0%, Thy3a 12%, Thy3f 28%, Thy4 100% and Thy5 100%. 89 cases of thyroid core needle biopsies were received and categorised as follows: C1 3%, C2 11%, C3 68%, C4 1% and C5 17%. 100% of C5 cases were malignant on subsequent resection. Conclusion: The use of the Thy2/Thy2C category is lower than expected; likely to reflect local clinical practice where cases which appear benign on clinical and radiological assessment, and have no symptomatic cystic component, are often not sampled. The Thy3a category is used more than expected; however, the risk of malignancy determined on subsequent histology meets RCPath standards. The lower-than-expected double reporting of Thy3 specimens as per local protocol is likely due to changing working practices secondary to the COVID-19 pandemic. E-PS-04-009 The incidence of leptomeningeal metastasis from solid tumours on the cerebrospinal fluid smear L. Lozneanu*, I.D. Căruntu, C. Amalinei, R. Balan, S.E. Giu ș că, B. Manole, E.R. Avadanei *U.M.F. "Grigore T. Popa" Iasi, Romania Background & objectives: The aim of our study was to analyse the presence of tumour cells in the cerebrospinal fluid (CSF) taken from patients with clinical meningeal syndrome and pleocytosis. Methods: We analysed 55 CSF smears from patients who presented to the Infectious Diseases Hospital in Iasi with meningeal syndrome, who underwent lumbar puncture. At the direct microscopic examination (cytobacteriological smear) they were diagnosed with pleocytosis and negative bacterioscopy. Consequently, the cytodiagnostic examination of the smears was carried out by a pathologist. Results: We identified, in 4 cases (7.27%), the presence of atypical tumour cells with different morphology, as follows: immature hematogenous cells of the blastic type were predominant in one case, atypical cells with a mor- phology similar to breast cancer cells were identified in one case, which has previously diagnosed with primary breast cancer, lymphocytes with a mature appearance, but in very large numbers were seen in one case, which had history of ALL and cells with a morphology suggestive of microcel- lular bronchopulmonary carcinoma, were identified in another case. In the latter case, the cytological diagnosis was further on certified by imagistic investigation (CT), followed by a biopsy. Conclusion: The routine cytological examination of the CSF obtained through lumbar punctures is inexpensive and facile to carry out in suspected cases of inflammatory meningeal diseases, as a useful tool for diagnosis of aggressive diseases. E-PS-04-010 Ten years of experience in endoscopic ultrasound-guided fine-nee- dle aspiration cytology in a tertiary referral hospital V. Macarrón Aguilera*, M.M. Petrino, P. Puente López, I. de la Peña Navarro, A.M. Rodríguez-García, P. López-Ferrer *La Paz University Hospital, Spain Background & objectives: The endoscopic ultrasound-guided fine- needle aspiration cytology (EUS-FNAC) is a technique that involves obtaining cytological samples from lesions close to the digestive tract via endoscopy. The objective is to evaluate EUS-FNAC results from a tertiary referral centre from 2013 to 2022. Methods: A search was made of all EUS-FNAC performed from March 2013 to December 2022, most of them executed by rapid on- site evaluation (ROSE) method. The results were subdivided according to location (pancreas, lymph node, stomach, liver, bile duct/ ampulla, duodenum, retroperitoneum, oesophagus, rectum and others). Based on the bibliography, the following variables were extracted: gender, age and cytological result. Results: The total of EUS-FNAC performed was 988. Pancreatic lesions were 750 (75.9%) (527 solid, 182 cystic and 41 solid-cystic) with the fol- lowing diagnoses: 338 positive (45,1%), 43 suspected (5.7%), 229 nega- tive (30.5%) and 140 insufficient (18.7%). Lymph node samples were 104 (10.6%), with results of 32 positive (30.8%), 44 negative (42.3%), 7 sus- pected (6.7%) and 21 insufficient (20,2%). Gastric lesions were 44 (4.5%), with 24 positive (54.5%), 11 negative (25%) and 9 insufficient (20.5%) results. The remaining EUS-FNAC samples were distributed in 20 liver (2%), 19 bile duct/ampulla (1.9%), 17 duodenum (1,7%), 7 retroperitoneum (0.7%), 7 oesophagus (0.7%), 7 rectum (0.7%) and 13 others (1.3%). Conclusion: The main sample obtained by EUS-FNAC is the pancreas, in which has been observed to have a good efficiency with 81,3% sat- isfactory results. The yield in the other two most frequent locations (lymph node and stomach) is similar to pancreatic samples. This reveals that EUS-FNAC is an efficient minimally invasive technique for obtain- ing samples of lesions accessible by digestive ultrasound.