scholarly journals Cytology Reporting System for Lung Cancer from the Japan Lung Cancer Society and the Japanese Society of Clinical Cytology: An Extensive Study Containing More Benign Lesions

2021 ◽  
pp. 1-10
Author(s):  
Akihiko Yoshizawa ◽  
Kenzo Hiroshima ◽  
Akemi Takenaka ◽  
Reiji Haba ◽  
Kunimitsu Kawahara ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Interobserver Agreement ◽  
Japanese Society ◽  
Reporting System ◽  
Sputum Sample ◽  
Extensive Study ◽  
Low Grade ◽  
Benign Lesions ◽  
Cancer Society ◽  
Universal System

<b><i>Introduction:</i></b> The Japan Lung Cancer Society (JLCS) and the Japanese Society of Clinical Cytology (JSCC) have proposed a new four-tiered cytology reporting system for lung carcinoma (JLCS-JSCC system). Prior to the proposal, the Papanicolaou Society of Cytopathology (PSC) had proposed a revised reporting system (PSC system), which comprises the “neoplastic, benign neoplasm, and low-grade carcinoma” category (N-B-LG category), in addition to the 4 categories of the JLCS-JSCC system. This study aimed to evaluate the interobserver agreement of the JLCS-JSCC system with an additional dataset with more benign lesions in comparison with the PSC system. <b><i>Methods:</i></b> We analyzed 167 cytological samples, which included 17 benign lesions, obtained from the respiratory system. Seven observers classified these cases into each category by reviewing one Papanicolaou-stained slide per case according to the JLCS-JSCC system and PSC system. <b><i>Results:</i></b> The interobserver agreement was moderate in the JLCS-JSCC (<i>k</i> = 0.499) and PSC (<i>k</i> = 0.485) systems. Of the 167 samples, 17 samples were benign lesions: 7 pulmonary hamartomas, 5 sclerosing pneumocytomas, 2 squamous papillomas, one solitary fibrous tumor, one meningioma, and one lymphocytic proliferation. There were diverse sample types as follows: 11 touch smears, 3 brushing smears, 2 aspirations, and one sputum sample. Fourteen samples (82.3%) were categorized into “negative” or “atypical” by more than half of the observers in the JLCS-JSCC system. Conversely, 3 samples were categorized as “suspicious” or “malignant” by more than half of the observers in the JLCS-JSCC system. On the other hand, 11 samples (64.7%) were categorized into the N-B-LG category by more than half of the observers in the PSC system. <b><i>Conclusions:</i></b> The concordance rate in the JLCS-JSCC system was slightly higher than that in the PSC system; however, the interobserver agreement was moderate in both the JLCS-JSCC and PSC systems. These results indicate that both the JLCS-JSCC and PSC systems are clinically useful. Therefore, both systems are expected to have clinical applications. It may be important to integrate the 2 systems and construct a universal system that can be used more widely in clinical practice.

scholarly journals Cytology Reporting System for Lung Cancer from the Japan Lung Cancer Society and Japanese Society of Clinical Cytology: An Interobserver Reproducibility Study and Risk of Malignancy Evaluation on Cytology Specimens

2020 ◽  
Vol 64 (5) ◽  
pp. 452-462 ◽  
Author(s):  
Kenzo Hiroshima ◽  
Akihiko Yoshizawa ◽  
Akemi  Takenaka ◽  
Reiji  Haba ◽  
Kunimitsu  Kawahara ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Carcinoma ◽  
Japanese Society ◽  
Reporting System ◽  
Interobserver Reproducibility ◽  
Cancer Society ◽  
Reproducibility Study ◽  
Reporting Systems ◽  
Atypical Cells ◽  
Risk Of Malignancy

Introduction: The classification of lung carcinoma is based on small biopsies and/or cytology in 80% of patients with non-small cell carcinoma. However, there is no widely accepted classification system for respiratory cytology. The Japan Lung Cancer Society (JLCS) and Japanese Society of Clinical Cytology (JSCC) have proposed a new four-tiered cytology reporting system for lung carcinoma with the following categories: (1) “negative for malignancy,” (2) “atypical cells,” (3) “suspicious for malignancy,” and (4) “malignancy.” Objective: The aim of this work was to perform an interobserver reproducibility study to confirm the utility of the four-tiered reporting system on respiratory cytological samples. Methods: We analyzed 90 cytological samples obtained with bronchoscopy. Seven observers classified these cases into each category by reviewing one Papanicolaou-stained slide per case according to the three-, four-, and five-tiered reporting systems. Results: The interobserver agreement was fair in the three- (κ = 0.50), four- (κ = 0.45), and five-tiered (κ = 0.45) reporting systems. However, the four-tiered reporting system provided more precise information than the three-tiered reporting system in patient management. The risk of malignancy in the four-tiered reporting system was also stratified well: 19.3% for “negative for malignancy,” 45.6% for “atypical cells,” 74.7% for “suspicious for malignancy,” and 88.1% for “malignancy.” Conclusions: The reporting system proposed by the JLCS and JSCC was designed to enhance the communication between clinicians and pathologists and among different institutions. It is simple and applicable to cytological diagnosis of any respiratory diseases. We propose establishing an international classification for respiratory cytology, harmonizing the reporting systems proposed by different countries.

scholarly journals The Japan Lung Cancer Society–Japanese Society for Radiation Oncology consensus-based computed tomographic atlas for defining regional lymph node stations in radiotherapy for lung cancer

2017 ◽  
Vol 58 (1) ◽  
pp. 86-105 ◽  
Author(s):  
Tomoko Itazawa ◽  
Yukihisa Tamaki ◽  
Takafumi Komiyama ◽  
Yasumasa Nishimura ◽  
Yuko Nakayama ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Radiation Oncology ◽  
Japanese Society ◽  
International Association ◽  
Regional Lymph Node ◽  
Cancer Society ◽  
Project Group ◽  
Computed Tomographic ◽  
The Board Of Directors

Abstract The purpose of this study was to develop a consensus-based computed tomographic (CT) atlas that defines lymph node stations in radiotherapy for lung cancer based on the lymph node map of the International Association for the Study of Lung Cancer (IASLC). A project group in the Japanese Radiation Oncology Study Group (JROSG) initially prepared a draft of the atlas in which lymph node Stations 1–11 were illustrated on axial CT images. Subsequently, a joint committee of the Japan Lung Cancer Society (JLCS) and the Japanese Society for Radiation Oncology (JASTRO) was formulated to revise this draft. The committee consisted of four radiation oncologists, four thoracic surgeons and three thoracic radiologists. The draft prepared by the JROSG project group was intensively reviewed and discussed at four meetings of the committee over several months. Finally, we proposed definitions for the regional lymph node stations and the consensus-based CT atlas. This atlas was approved by the Board of Directors of JLCS and JASTRO. This resulted in the first official CT atlas for defining regional lymph node stations in radiotherapy for lung cancer authorized by the JLCS and JASTRO. In conclusion, the JLCS–JASTRO consensus-based CT atlas, which conforms to the IASLC lymph node map, was established.

Implementation of a Lung Cancer Screening Program in Two Federally Qualified Health Centers

2021 ◽  
pp. 003335492097171
Author(s):  
Lesley Watson ◽  
Megan M. Cotter ◽  
Shauna Shafer ◽  
Kara Neloms ◽  
Robert A. Smith ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Screening Program ◽  
Lung Cancer Screening ◽  
Pilot Project ◽  
Health Centers ◽  
Smoking History ◽  
Federally Qualified Health Centers ◽  
Cancer Society ◽  
Improved Outcomes

Using low-dose computed tomography (LDCT) to screen for lung cancer is associated with improved outcomes among eligible current and former smokers (ie, aged 55-77, at least 30-pack–year smoking history, current smoker or former smoker who quit within the past 15 years). However, the overall uptake of LDCT is low, especially in health care settings with limited personnel and financial resources. To increase access to lung cancer screening services, the American Cancer Society partnered with 2 federally qualified health centers (FQHCs) in Tennessee and West Virginia to conduct a pilot project focused on developing and refining the LDCT screening referral processes and practices. Each FQHC was required to partner with an American College of Radiology–designated lung cancer screening center in its area to ensure high-quality patient care. The pilot project was conducted in 2 phases: 6 months of capacity building (January–June 2016) followed by 2 years of implementation (July 2016–June 2018). One site created a sustainable LDCT referral program, and the other site encountered numerous barriers and failed to overcome them. This case study highlights implementation barriers and factors associated with success and improved outcomes in LDCT screening.

The reporting of anal cytology and histology samples: establishing terminology and criteria

Sexual Health ◽  
2012 ◽  
Vol 9 (6) ◽  
pp. 562 ◽  
Author(s):  
Jennifer Margaret Roberts ◽  
Deborah Ekman
Keyword(s):  
Reporting System ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Classification Systems ◽  
Low Grade ◽  
Evidence Based ◽  
High Grade ◽  
Anal Neoplasia ◽  
Anal Cytology ◽  
Bethesda System

Our understanding of the human papillomavirus (HPV) related cytomorphology and histopathology of the anal canal is underpinned by our knowledge of HPV infection in the cervix. In this review, we utilise cervical reporting of cytological and histological specimens as a foundation for the development of standardised and evidence-based terminology and criteria for reporting of anal specimens. We advocate use of the Australian Modified Bethesda System 2004 for reporting anal cytology. We propose the use of a two-tiered histological reporting system for noninvasive disease – low-grade and high-grade anal intraepithelial neoplasia. These classification systems reflect current understanding of the biology of HPV and enhance diagnostic reproducibility. Biomarkers such as p16INK4A may prove useful in further improving diagnostic accuracy. Standardisation is important because it will increase the value of the data collected as Australian centres develop programs for screening for anal neoplasia.

scholarly journals IMP3 Protein Overexpression Is Linked to Unfavorable Outcome in Laryngeal Squamous Cell Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4306
Author(s):  
Diana Maržić ◽  
Blažen Marijić ◽  
Tamara Braut ◽  
Stefan Janik ◽  
Manuela Avirović ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Protein Expression ◽  
Cell Carcinoma ◽  
Cyclin D1 ◽  
Squamous Cell ◽  
Expression Patterns ◽  
Low Grade ◽  
Benign Lesions ◽  
Ki 67 ◽  
Neck Node

Background: The aim of this study was to (i) determine IMP3 protein expression in benign and malignant laryngeal lesions, (ii) compare its expression to Ki-67, p53, cyclin D1, and (iii) finally, to examine the prognostic power of IMP3 in squamous cell carcinomas of the larynx (LSSC). Methods: IMP3 protein expression was evaluated in 145 patients, including 62 LSCC, 45 dysplasia (25 with low and 20 with high-grade dysplasia), and 38 benign lesions (vocal cord polyps and nodules). Results: IMP3 was significantly higher expressed in LSCC compared to dysplasia and benign lesions (p < 0.001; p < 0.001, respectively). Similarly, higher expression patterns were observed for Ki-67 and p53, whereas cyclin D1 was equally distributed in all three lesions. IMP3 (p = 0.04) and Ki-67 (p = 0.02) expressions were significantly linked to neck node positivity, and IMP3 overexpression to worse disease-specific survival (p = 0.027). Conclusion: Since IMP3 showed significantly higher expression in laryngeal carcinomas, but not in high- or low-grade dysplasia, it serves as a useful marker to differentiate between invasive and noninvasive lesions. Higher IMP3 expression represented a significantly worse prognosticator for clinical outcomes of patients with squamous cell carcinoma of the larynx.

Diagnostic Performance and Reliability of the Standardized Computed Tomography Reporting System for Acute Appendicitis: Experience in a Tertiary Care Academic Center

2021 ◽  
Vol 104 (7) ◽  
pp. 1102-1108
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Interobserver Agreement ◽  
Reporting System ◽  
Lower Quadrant ◽  
Suspected Appendicitis ◽  
Diagnostic Certainty

Background: Computed tomography (CT) is generally accepted as a modality of choice for imaging workup in patients with suspected appendicitis. A standardized CT reporting system, CT certainty score, has been proposed to improve diagnostic accuracy and to reduce ambiguous CT reports. Objective: To assess the diagnostic performance and the reliability of the standardized CT reporting system for acute appendicitis in Thai adults. Materials and Methods: The present study was a retrospective data review of 421 adult patients who had CT scans of the appendix between January 2016 and December 2017. The clinical and imaging data were extracted and analyzed. The pathological result was used as a standard of reference. The diagnostic performance and interobserver agreement of the standardized CT reporting system were estimated. Results: One hundred sixty-three patients, with a mean age of 41.7 years, had clinical diagnoses of acute appendicitis. Using standardized CT report, radiologists were highly accurate at diagnosing appendicitis [area under curve (AUC) 0.988 (95% CI 0.98 to 1.00); p<0.001]. The estimated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.1% (95% CI 90.6 to 97.9), 95.7% (95% CI 92.5 to 97.9), 93.4% (95% CI 88.7 to 96.2), 96.9% (95% CI 93.0 to 97.2), 95.5% (95% CI 93.0 to 97.3), respectively. The interobserver agreement was greater than 80% for all binary objective findings and more than 90% agreement on the presence or absence of greater-than-3-mm wall thickness, appendicolith, periappendiceal air, and right lower quadrant fluid collection. The use of CT certainty score had interobserver agreement of 78% (κ=0.69; 95% CI 0.62 to 0.77). Conclusion: Using a standardized CT reporting system yielded a high diagnostic accuracy and high reproducibility of supportive CT findings for appendicitis in at-risk patients. The standardized CT reporting system can improve diagnostic certainty, accuracy, and guide patient management. Keywords: Appendicitis; Certainty score; Computed tomography; Standardized reporting system

Diagnosis and management of cold agglutinin disease associated with low-grade B-cell lymphoma in a patient receiving pembrolizumab for lung cancer

2021 ◽  
Vol 14 (8) ◽  
pp. e243751
Author(s):  
Nabin Raj Karki ◽  
Peyton McElhone ◽  
Natasha Savage ◽  
Nagla Abdel Karim
Keyword(s):  
Lung Cancer ◽  
B Cell ◽  
Marginal Zone ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
High Titre ◽  
Cold Agglutinin ◽  
Low Grade ◽  
Cold Agglutinin Disease ◽  
Cold Room

A 65-year-old with non-small cell lung cancer developed autoimmune haemolytic anaemia while receiving pembrolizumab containing chemoimmunotherapy. Initially thought to be due to pembrolizumab induced haemolysis, he was treated with steroids, and pembrolizumab was held. Haemolysis was refractory to steroids and blood was observed to agglutinate in cold room temperatures. Cold agglutinins in high titre and monoclonal serum IgM kappa protein were detected. Bone marrow biopsy showed marginal zone lymphoma confirming low grade B-cell lymphoma causing cold agglutinin disease. B-cell depletion by rituximab stopped haemolysis, and pembrolizumab was safely continued for lung cancer.

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