Division of Diagnostic Pathology, Kyushu University Hospital, Fukuoka, Japan.
Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Cancer Cytopathol. 2024 Nov;132(11):696-706. doi: 10.1002/cncy.22888. Epub 2024 Jul 29.
A standardized reporting system for bone and soft tissue tumor cytopathology has not yet been established. The objective of this study was to explore the potential utility of a classification modified from the Milan System for Salivary Gland Cytopathology and compared it with the upcoming World Health Organization (WHO) system for fine-needle aspiration of soft tissue lesions.
The authors reviewed 285 cytology cases of bone/joint (n = 173) and soft tissue (n = 112) lesions, scoring each within diagnostic categories. The results were compared with histologic diagnoses and the risk of malignancy (ROM) for each category, and diagnostic reliability was analyzed.
All 285 cases were successfully classified into one of the following categories: nondiagnostic (6.3%), non-neoplastic (11.9%), atypia of uncertain significance (11.9%), benign neoplasm (5.6%), bone and soft tissue neoplasm of uncertain malignant potential (25.3%), suspicious for malignancy (1.4%), and malignant (37.5%). The ROM was 44.4% (eight of /18 cases) in nondiagnostic, 0% (zero of 34 cases) in non-neoplastic, 32.4% (11 of 34 cases) in atypia of uncertain significance, 0% (zero of 16 cases) in benign neoplasm, 16.7% (12 of 72 cases) in bone and soft tissue neoplasm of uncertain malignant potential, 75.0% (three of four cases) in suspicious for malignancy, and 100% (107 of 107 cases) in malignant categories. Using the WHO system, the proportion and ROM of the benign category (non-neoplastic and benign neoplasm) was 17.5% and 0%, respectively. Among benign and malignant lesions, the diagnostic accuracy, sensitivity, and specificity for detecting malignancy were 99.4%, 100%, and 98.0%, respectively.
The modified Milan system as well as the WHO system may be a useful cytopathologic classification tool for both bone and soft tissue lesions.
骨和软组织肿瘤细胞病理学的标准化报告系统尚未建立。本研究的目的是探讨从米兰涎腺细胞学分类系统修改后的分类方法的潜在应用，并将其与即将出台的软组织病变细针抽吸的世界卫生组织（WHO）系统进行比较。
作者回顾了 285 例骨/关节（n=173）和软组织（n=112）病变的细胞学病例，对每个病例进行了诊断类别评分。将结果与组织学诊断和每个类别的恶性风险（ROM）进行比较，并分析诊断可靠性。
285 例病例均成功分为以下类别之一：非诊断性（6.3%）、非肿瘤性（11.9%）、意义不明确的非典型性（11.9%）、良性肿瘤（5.6%）、骨和软组织交界性肿瘤（25.3%）、疑似恶性（1.4%）和恶性（37.5%）。非诊断性的 ROM 为 44.4%（18 例中的 8 例），非肿瘤性的为 0%（34 例中的 0 例），意义不明确的非典型性的为 32.4%（34 例中的 11 例），良性肿瘤的为 0%（16 例中的 0 例），骨和软组织交界性肿瘤的为 16.7%（72 例中的 12 例），疑似恶性的为 75.0%（4 例中的 3 例），恶性的为 100%（107 例中的 107 例）。使用 WHO 系统，良性类别的比例和 ROM 分别为 17.5%和 0%。在良性和恶性病变中，检测恶性的诊断准确性、敏感性和特异性分别为 99.4%、100%和 98.0%。
改良的米兰系统和 WHO 系统可能是一种有用的骨和软组织病变的细胞病理学分类工具。
