Performance of the forward-viewing linear echoendoscope for fine-needle aspiration of solid and cystic lesions throughout the gastrointestinal tract: a large single-center experience.

BACKGROUND: A newly developed forward-viewing linear echoendoscope (FV-EUS) has recently become available. To date, however, only scanty data on the performance of the FV-EUS scope for fine-needle aspiration (FNA) of lesions throughout the gastrointestinal (GI) tract are available. This study aimed to evaluate the technical performance of the FV-EUS scope for FNA of solid and cystic lesions located throughout the GI tract in a large cohort of patients referred to a tertiary care center. METHODS: All patients who underwent endoscopic ultrasound (EUS)-guided FNA using the FV-EUS scope between January 2007 and December 2008 were included in this retrospective study. The performance of the FV-EUS scope for FNA was evaluated. RESULTS: During the study period, 285 patients with solid or cystic lesions throughout the GI tract underwent the procedure with the FV-EUS scope. A total of 300 FNAs were attempted, 6 (2%) of which could not be performed. Of the 294 successful EUS-FNA procedures, 130 (44.2%) were performed using a 22-gauge needle, 89 (30.3%) using a 25-gauge needle, and 75 (25.5%) using a 19-gauge needle. In all 67 cases of pancreatic cyst or dilated pancreatic duct, a specimen for cystic fluid analysis or cytologic examination could be obtained. Among the remaining 217 patients with solid lesion, a definitive diagnosis could be established for 211 patients (97.2%). The FV-EUS scope had a sensitivity of 74.7% (95% confidence interval [CI] 68.1-80.6%), a specificity of 100% (95% CI 89.9-100%), a positive likelihood ratio of infinity, and a negative likelihood ratio of 0.251 (95% CI 0.196-0.323). CONCLUSIONS: The FV-EUS scope is highly effective for FNA of solid and cystic lesions throughout the GI tract. Prospective studies comparing the FV-EUS scope and a curved linear scope are needed.

An international outreach from the American Society of Cytopathology: Worldvision Cytopathology Contest.

In an effort to be more inclusive and embrace the international cytology community, the American Society of Cytopathology formed the International Liaison and Membership (ILM). The Worldvision Cytopathology Contest was designed by the co-chairs of this committee (Drs. Güliz A. Barkan and Esther Diana Rossi) as an opportunity of scientific exchange in the international cytology community. The idea took its inspiration from the well-known song contest, the "Eurovision Song Contest" a competition among international singers, which started as a "light entertainment" in the 1950's to bring together a war-torn Europe. The goals of this session were to bring the worldwide cytology community together, to increase the international participation to the ASC, to attract a younger generation of pathology professionals to cytopathology, to provide education on interesting cases for the participants, and to provide training for international contestants on how to give good public presentations. The contest was successfully done at the 2019 annual meeting, and the winner was Dr. Elena Vigliar from Italy. The Worldvision Cytopathology Contest will be performed again in future meetings.

Milan Interobserver Reproducibility Study (MIRST): Milan System 2018.

INTRODUCTION: Prior to the 2018 publication of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC), a Web-based interobserver study was performed to evaluate MSRSGC reporting categories, identify cytomorphologic features that represent poor sources of agreement, and establish a baseline for future studies. MATERIAL AND METHODS: Study participants evaluated 75 images chosen from the MSRSGC image set, prior to the release of the Milan Atlas. Images spanned all diagnostic categories including typical and borderline cytomorphology. Participant demographics were collected on level of training, practice patterns, and experience. RESULTS: A total of 647 persons attempted access to the survey. Of these, 555 correctly answered the qualifying questions. Participants included: 16.5% ASCP Certified Cytotechnologists, 2.8% Specialist Cytotechnologists, 5.8% IAC Certified individuals, 14.3% Anatomic (AP) Certified Pathologists, 38.9% AP and Cytopathology Certified Pathologists, and 15.3% pathology trainees. Length of participant practice varied from 0 to 54 years. In our sample, 43.4% of participants came from academic centers, 17.6% from private hospitals; and 13.3% from commercial/private laboratories. Overall, 42% of respondents agreed with the reference interpretations of salivary gland lesions. The best agreement was seen in cytopathology certified pathologists. Among the MSRSGC categories, best agreement was found in Neoplasm-Benign (58.9%) and Non-Diagnostic (49.2%) categories, followed by Malignant (48.4%). The agreement rates for Salivary Gland Lesion of Uncertain Malignant Potential (SUMP) and Suspicious For Malignancy (SFM) were 23.6% and 22.7%, respectively. CONCLUSIONS: Similar to the reproducibility studies conducted for gynecologic and urinary cytopathology, the most important factor in diagnostic reproducibility was a priori classification of image difficulty, although people with higher certifications performed better.