Search

The purpose of the present investigation was to report the presence of cervicovaginal microorganisms most frequently found in cervicovaginal exfoliative smears (Papanicolaou) of patients with type 2 diabetes. Cervical-vaginal exfoliative cytologist was performed on an open population to all patients who attended from March 2010 to March 2020 in the within the framework of the early cancer detection program, gynecological interrogations were applied to 1587 patients who, after taking cell samples, were processed using the Papanicolaou staining technique modified by the same for subsequent microscopic diagnosis. Of the results obtained from the 1587 patients studied, 148 (9.32%) suffer from type 2 diabetes mellitus and of these only 130 (87.83%) showed at least one microorganism under microscopic observation, being Candida spp., the most found microorganism in samples from patients with type 2 diabetes. In conclusions, type 2 diabetes is a disease that predisposes to the appearance of microorganisms and cervicovaginal infections, particularly by Candida spp., therefore, there is a need for surveillance guidelines and efforts to reverse this disease and its complications.

Introduction: The consumption of Alcohol has been increasing now-a-days and the same has been attributed to the development and progression of oral and Mucosal diseases. Meanwhile, the dangers of drinking alcohol to human body as well as the influence on oral mucosa remains unknown to the general public. Exfoliative Cytology is a rapid diagnostic method which depends on scrapings obtained from the mucosa. Objectives: The aim of the study was to determine the changes in the exfoliative cytology of the cells of the buccal mucosa in people who consume alcohol chronically. Materials and Methods: The study was carried out among 18 individuals, out of which 10 were known to chronically consume alcohol and the other 8 participants had no habits and were chosen as the control category. Once the consent was obtained, the scrapping was collected. The smears were then stained and observed under the microscope for cytological and cytomorphometric assessment. Results: On cytological analysis it was also observed that various slides showed the presence of micro nuclei which reveals that the cells have an increased replicative potential which in itself might be due to dysplasia. On cytomorphometricanalysis a change in the nuclear cytoplasmic ratio was also observed. Conclusion: There are buccal mucosal changes which are present in people who chronically consume alcohol and awareness about the same should be brought about to reduce the incidence of such diseases.

Background/aim Quantification of oral mucositis that progresses during concomitant chemo-radiotherapy (CCRT) is essential for its management. It is important to determine the methods that are simple, reliable and beneficial in foreseeing mucositis at earlier stages of treatment. Materials and methods A prospective study was conducted on 100 oral cancer patients receiving CCRT following the inclusion criteria. Patients were evaluated for mucositis i.e. erythema and ulcers by using the World Health Organization (WHO) scale and the oral mucositis assessment scale (OMAS), whereas mature and immature cells were identified by exfoliative cytology. Clinical examination and procedure of oral cavity were performed before, on days 5, 17, and at the end of treatment. Results Oral mucositis was observed in all oral squamous cell carcinoma (OSCC) patients receiving CCRT on different days with noteworthy increase from day 5 of CCRT to the end of treatment. For OMAS grading related to ulceration and erythema, Grade 1 (7.2%; 34%) was most commonly seen on the 5th day of CCRT, Grade 2 (29%; 19%) and Grade 3 (19%) were most frequently seen at the 17th day and end of CCRT, accordingly. With respect to WHO scale grades 1 and 2 (18.3%; 21.5%) was most frequently observed at the 17th day of CCRT, whereas grades 3 and 4 (12.5%; 2%) was noted at the end of CCRT. There was statistically significant increase in the percentage of immature cells at the end of CCRT (99%). A significant association (P < 0.0000) was observed among the days of smear and maturation stages of epithelial cells as well as among WHO mucositis grading, OMAS and types of epithelial cells, respectively. Conclusion According to the findings of the study, oral mucositis grade is directly proportional to the progressing days of CCRT. Oral mucositis is frequently related to adverse clinical outcomes, affecting the patient’s quality of life. It is essential to develop methods that can be employed for the assessment of CCRT associated oral mucositis.

Introduction: Ethanol is a traditional cytofixative which is widely used for oral exfoliative cytology. Due to its limitations, a search of better, eco-friendly, and cost-effective fixative was explored. The present study was conducted to evaluate the efficacy and reliability of 10%, 20%, and 30% processed honey as a cytofixatives, and was compared with that of 95% ethanol. Materials and Methods: Four oral smears were obtained from each individual (n = 80) by gently scraping the buccal mucosa. One slide was fixed in ethanol (95%) and the other in various grades of processed honey (10%, 20%, and 30%), and stained with Papanicolaou stain. Two separate pathologists who were kept in blind for the fixative used evaluated the slides based on the five parameters (cell morphology, nuclear and cytoplasmic staining, clarity, and uniformity of staining). Results: In the present study, it was observed that 20% of processed honey showed overall good results, followed by (95% alcohol) and (10% honey). However, poor results were observed in (30% honey). When compared, no statistically significant difference was observed between the groups. Conclusion: The present study offers an innovative application using honey as a cytofixative. Honey in lower concentration is an excellent alternative to ethanol as a cytofixative.

Introduction: Incidence of oral epithelial dysplasia and oral squamous cell carcinoma (SCC) is very high in south Asian countries as compared to western population owing to a greater use of tobacco in these regions. While visual examination and exfoliative cytology are the most common screening and diagnostic modalities at present, it is a subjective analysis. Quantitative analyses such as nuclear size, cell size, and nuclear-to-cytoplasmic ratio may provide an accurate diagnosis and improve reproducibility. The aim of the study was to evaluate the role of morphometry as a diagnostic adjunct to exfoliative cytology and to derive a significant cutoff to identify the population at risk for development of SCC among chronic tobacco users. Material and Methods: This was an outpatient-based prospective study done in a tertiary hospital over a period of 2 years. Hundred and fifty cases with a history of chronic tobacco use for a minimum period of 5 years were evaluated. Visual inspection using acetic acid was done. Oral scrapes were taken for cytological and morphometric analysis followed by incision biopsy for histopathological evaluation, wherever possible. Results: On morphometrical analysis, mean nuclear area and nuclear:cytoplasmic (N:C) ratio increased, while the cytoplasmic area decreased from smears with normal cytology to oral dysplasia to SCC. Analysis of variance and post hoc Tukey’s honest significant difference test showed a statistically significant difference among the 3 groups (p value Conclusion: In high-risk cases, morphometry can be a useful adjunct to exfoliative cytology and visual examination for an early and accurate diagnosis and timely intervention in oral potentially malignant and malignant lesions, thereby improving the prognosis.

Accurate identification of the murine estrous cycle using vaginal exfoliative cytology is the initial and crucial step for controlled reproduction of this species. However, it is generally difficult to discriminate each stage of the cycle, and thus to select pro-estrous mice for mating. To increase the accuracy of identification of the pro-estrous stage, we re-evaluated the vaginal fold histology and modified the method of exfoliative cytology. Tissue fixation using methanol in Carnoy’s solution but not paraformaldehyde, combined with Alcian blue staining but not the conventional Giemsa staining, resulted in better manifestation of mucosal cell layers in the vaginal epithelium just above the keratinized layer. This mucous layer in the fold histology was found to form specifically in the pro-estrous and late di-estrous stages, and the mucous cells exfoliated in smear samples only in the pro-estrous stage. This novel method was found, by a blinded test, to increase the rate of accurate identification of the pro-estrous stage compared to the conventional method (80% vs 50%). Consistent with this finding, the mating experiment with “pro-estrous” females selected by the novel method revealed a significantly higher success rate than that with the conventional method (78.0% vs 47.5%). Thus, our study demonstrates vaginal exfoliative mucous cells as a better potential marker to detect the “receptive” state of female mice that leads to an improved success rate of mating.

Purpose To calculate the diagnostic accuracy of nipple aspirate fluid (NAF) cytology. Background Evaluation of NAF cytology in asymptomatic patients conceptually offers a non-invasive method for either screening for breast cancer or else predicting or stratifying future cancer risk. Methods Studies were identified by performing electronic searches up to August 2019. A meta-analysis was conducted to attain an overall pooled sensitivity and specificity of NAF for breast cancer detection. Results A search through 938 studies yielded a total of 19 studies. Overall, 9308 patients were examined, with cytology results from 10,147 breasts [age (years), mean ± SD = 49.73 ± 4.09 years]. Diagnostic accuracy meta-analysis of NAF revealed a pooled specificity of 0.97 (95% CI 0.97–0.98), and sensitivity of 0.64 (95% CI 0.62–0.66). Conclusions The diagnostic accuracy of nipple smear cytology is limited by poor sensitivity. If nipple fluid assessment is to be used for diagnosis, then emerging technologies for fluid biomarker analysis must supersede the current diagnostic accuracy of NAF cytology.

Oral mucosa experiences ceaseless peeling of epithelial cells which can be assessed for the determination of specific illnesses. Exfoliative cytology is the infinitesimal assessment of shed or desquamated cells from the epithelial surface generally the mucous film. A few recolouring methodologies have been utilized for investigation of smears however PAP stain despite everything stays as the stain of decision. Since exfoliative cytology is an easy, bloodless, and insignificantly intrusive methodology, it is all around acknowledged by the patients and has different applications. In this review, we will see how it can be used for the purpose related to dentistry. Keywords: Exfoliative cytology, Pap smear, Oral malignancy, Nuclear stain, Haematoxylin.

For a long time, oral exfoliative cytology (OEC) has been implemented as an effective preliminary diagnostic tool for pathological lesions and various methods for fixation of the cytology specimens have been studied. The present study was undertaken to compare the efficacy between the wet and spray type of fixation methods for Papanicolaou (PAP) stained oral cytosmears. The study comprised of 45 healthy subjects in the age group of 20-25 yrs. For each subject, two smears were collected from the buccal mucosa and subjected to wet and spray fixation methods respectively. Both the smears were stained using a commercial Rapid Pap Kit. Smears were observed microscopically and evaluated for cytomorphological features involving uniformity of staining, cellular morphology, nuclear morphology, cellular staining, nuclear staining and presence of impurities. Comparisons were made between the two methods of fixation and statistically analysed using McNemar non-parametric test. Cells were evenly distributed in wet-fixed smears (n=38, 95%) compared to spray fixed smears (n=19, 47.5%). Wet-fixed smears showed lesser impurities (n=13, 32.5%) than spray fixed smears (n=27, 67.5%). However, other parameters such as cytological and nuclear morphology, staining of cytoplasm and nucleus were found to be not significant when compared between the two methods of fixation (p

Highlights • Microfilaria detection on exfoliative and fluid cytology is extremely rare. • 45-year-old nulliparous female presented with complaints of lower abdominal swelling and pain. • Ascitic fluid cytology showed 3-dimensional clusters of cells along with microfilaria. • On histopathology, a diagnosis of Mucinous cystadenocarcinoma of ovary was made., Introduction Filariasis is a major health problem in certain parts of India. Microfilaria detection on exfoliative and fluid cytology is extremely rare and it is even very rare to find microfilaria coexistent with neoplastic lesions. Presentation of case A 45-year-old nulliparous female, who presented with complaints of lower abdominal swelling and pain. Initially, a clinical diagnosis of cystadenoma was made. Ascitic fluid cytology of the patient showed 3-dimensional clusters of cells along with an occasional microfilaria. On histopathology, a diagnosis of Mucinous cystadenocarcinoma of ovary was made. Discussion Most common cause of lymphatic filariasis is W. bancrofti followed by Brugia species and it affects young adults. The adult form of the filaria lodge in lymph vessels, and due to lymphatic blockage in neoplasms they appear in tissue fluid or on surface material. It is the first case report of microfilaria being detected in ovarian cystic fluid cytology in a patient of Mucinous cystadenocarcinoma of ovary. Conclusion Filaria is an incidental finding in most of the cases, hence, cytopathologist should be vigilant and careful screening of all the slides should be done, especially in a country like India, where it is highly endemic.

Background: Tobacco consumption is the major cause of oral cancer. Early detection of cytomorphometrical changes in the buccal mucosa of smoker by the use of exfoliative cytology could help in picking early premalignant changes and thereby reduce morbidity in oral cancer patients. Aim: To assess and compare the cytomorphometrical changes in the buccal mucosa cells among smoker and nonsmoker group and assess these findings in smokers with a duration of exposure to smoking by dividing them as per pack year groups. Materials and Methods: This study was carried out on 51 male cases (Cigarette or Bidi smoking) and 51 controls as per the inclusion and exclusion criteria. For finding the effect of smoking exposure severity, smokers were divided into three groups based on pack year like Group 1 with pack year 10. Sample was taken from the buccal mucosa and stained with Papnicoalaou stain. Images were analyzed by Image J software and nuclear area (NA), cytoplasmic area, and nuclear/cellular ratio (N/C ratio) data collected and analyzed. Results: There was a significant difference for the mean values of NA and N/C ratio in the buccal mucosa of smokers. Significantly increased NA and N/C ratio were found with increased pack year. Conclusion: Cytomorphometrical findings such as NA and N/C ratio are observed in increased severity in premalignant conditions such as leukoplakia. Hence, it is possible to pick up these findings earlier by noninvasive method such as exfoliative cytology, and it can be used as an adjunct tool for mass screening.

Background: Liquid-based cytology (LBC) is a method of manufacturing cyto-diagnostic specimens. Improved accuracy is expected from standardizing specimen production and use of this method is rapidly spreading in oral cytology. On the other hand, LBC reportedly requires training to show peculiar cell findings compared to those of conventional smear cytology (CVC). Few studies have compared detailed cell findings for oral CVC and LBC. Objectives: The aim of this study was to compare cytological findings between CVC and LBC using cytomorphological image analysis. Materials and Methods: Cytological specimens were collected from 20 patients (negative for squamous neoplasia in 10, dysplasia in 5, squamous cell carcinoma in 5) and 5 controls of the tongue between January 2017 and December 2018. Two different preparation techniques were investigated cytomorphologically for CVC and LBC (BD CytorichTM). Results: LBC showed significantly higher cell numbers than CVC for all lesions. LBC-to-CVC ratio ranged from 9.52 (hyperkeratosis) to 1.87 (deep cells in oral squamous cell carcinoma (OSCC)). Nuclear area of normal, hyperkeratosis, and inflammation were significantly higher in LBC than those of CVC. Hyperchromasia was significantly more frequent with CVC than with LBC for hyperkeratosis, inflammation, dysplasia and OSCC. There was no significant difference in circularity between CVC and LBC among all lesions. Conclusion: Only one cytomorphological disadvantage was seen with LBC, in the form of decreased hyperchromasia. Further clarification of the advantages and disadvantages of LBC is needed, including management of precision and screening practices.

The gynecological interrogations, clinical impressions and results obtained from 1587 patients who attended the Department of Cellular Biology of the Faculty of Medicine of the Benemérita Universidad Autónoma de Puebla, México, for cervicovaginal exfoliative cytology sampling (Papanicolaou) were analyzed. Within the framework of the early cancer detection program from March 2010 to March 2021. From the 1587 patients studied, 302 reported smoking during the gynecological examination. Of the total number of patients with a smoking habit 178 (58.94%) showed cervicovaginal lesions on microscopic observation and/or physical examination. Smoking is considered a predisposing factor in the appearance of cervicovaginal lesions, and there is a need to carry out more detailed studies on the secondary effects of tobacco in patients with an active sexual life and a smoking habit in Mexico.

This chapter covers the principle of flow cytometry (FCM), the techniques and clinical applications of it. FCM provides us very quick assessment of cell surface antigens, DNA content and intracellular proteins. The instrument is now used not only for research but also for routine clinical activities. Both histology and cytology samples can be processed for FCM. However cytology samples are easy to process due to less effort for disaggregation. The chapter describes the positive and negative control of FCM, steps of sample preparation, acquisition and data interpretation. The sub-classification of lymphomas and other diagnostic use of FCM in exfoliative cytology also have been discussed. FCM is one of the important technologies to detect the apoptotic cell death. Quantitation of the apoptotic cell is possible with the help of light scatter (a loss in forward light scatter), plasma membrane changes and DNA content (a sub-diploid peak). The steps of FCM for the detection of apoptosis are also described here.

The removal of tissue from a living organism for the purposes of diagnosis and therapy is referred to as a biopsy. A proper biopsy process necessitates adequate training and decent hand skills. There are different biopsy processes, each with its own set of benefits and drawbacks. As a result, the dental practitioner must select the right biopsy process in order to obtain a confirmed diagnosis.

Background: We aimed to present a minimally invasive clinical approach to collect a suitable sample for the laboratory diagnosis of desquamative gingivitis. Materials and Methods: The proposed technique involves Nikolsky's test for the collection of tissue samples. It consists of the histopathological analysis of the bullous membrane formed in cases with positive Nikolsky's sign (NS). Three patients without a previous diagnosis of the disease agreed to undergo this protocol before a biopsy. Results: The diagnoses of the three cases reported here were mucous pemphigoid (MP), pemphigus vulgaris (PV), and lichen planus (LP). The tissue samples collected using this technique were sufficient to microscopically observe partial-thickness epithelium (diagnosing PV) or full-thickness epithelium (diagnosing MP). The diagnosis of LP was only possible by conventional biopsy. Conclusion: We observed, for different cases, some advantages of the proposed technique: minimally invasive, potentially superior to exfoliative cytology, easily performed, and with low costs.

Introduction: Exfoliative cytological study of body fluids is easy, simple, rapid, cost effective and patient compliant investigation that helps in characterizing the disease into their varying subtypes. These presumptive and sometimes definitive diagnoses are in most cases the cornerstone which helps in staging and prognosis of the patient Objective: To determine the spectrum of malignant and non-malignant lesions in exfoliative cytology Methodology: This was a quantitative retrospective cross sectional study conducted at Birat Medical College Teaching Hospital from 24th December 2014 to 24th December 2018. All the exfoliative samples received at the lab were accepted in our study. Results: Of the 300 samples received, the maximum number were those of sputum followed by pleural fluid and ascitic fluid. Peritoneal fluid, Cerebrospinal fluid, synovial fluid, fluid from suspected abscess and breast fluid were also received. Malignancy was found in 1.67% of the samples studies. Conclusion: A study of different cytomorphological features of exfoliative cytology samples will help in establishing the role of cytology as an important diagnostic tool in improving the effectiveness of diagnosis , treatment & prognosis of the patient in the medical field.

Carcinoma of the urinary bladder affects men more often than women and occurs in patients over the age of 50 years. Transitional cell carcinoma (TCC) comprises about 90% of all primary tumor of urinary bladder. In this study a total of 57 cases were taken. The aim of the study was to establish diagnostic role of voided urine cytology, ultrasonography and cystoscopy in urothelial cancers. Out of 57 cases, cytological diagnosis was positive in 53 cases (93%) and negative in 4 cases (7%). There were no atypical or suspicious cases. Of the total cases, cytology was negative only in 7% cases. Among 42 invasive carcinomas 14 (33%) grade III invasive flat carcinoma, one (2%) invasive papillary adenocarcinoma and two (5%) invasive squamous cell carcinoma, each of them gave 100% positive cytology. Of the remaining 25 (60%) invasive papillary TCC, 21 were in grade II and 4 were in grade III. They gave 90% and 100% positive cytologic results. Ultrasonogram of urinary bladder gave 95% (approx.) positive results and out of 57 cases, 3 cases failed to give positive results in ultrasonogram (USG) of the urinary tract. Cystoscopy detected tumor mass in 98% cases and it gave false negative result in 2% cases. Fifty-two tumors had a diameter ranging 1.1- 6 cm. Single lesions were seen in 40 cases, double lesion in one case and multiple in 13 cases. The probability of later invasive carcinomas nearly tripled in-patients with multiple lesions on presentation (13.6%) compared with those who presented with a single lesion (4.6%). Consistent with previously published data, this study showed the highest diagnostic accuracy with high-grade tumors and lowest with low-grade tumors. So in a proper clinical setting, non-invasive technique like voided urine cytology and ultrasonography could be done as a first line cost effective method in the diagnosis of urothelial cancers.TAJ 2017; 30(2): 39-46

Aim: To investigate the effect of tobacco smoking and chewing on the buccal mucosa using cytomorphometry. Materials and Methodology: Oral mucosal cells were collected from 45 subjects divided into three groups: smokers, chewers, and nonsmokers.The cells were stained with Papanicolaou stain and examined under a high magnification microscope. Image J analysis software was used to perform cytomorphometric analyses on the cells in the captured image to determine the Cellular Diameter, Nuclear Diameter, and Nuclear Cytoplasmic Ratio. The statistical test used was ANOVA and p Results: From controls to smokers and chewers, cellular diameter decreases while nuclear diameter and nuclear cytoplasmic ratio increase. Conclusion: The findings indicated that chewing tobacco changed the cytomorphology of normal buccal mucosa, and that the degree of change was greater in chewers than in smokers.Oral smears can be analysed cytomorphometrically on a regular basis to detect changes in cellular and nuclear dimensions, particularly among tobacco users.

AIM We aimed to explore the application of PAX1 methylation and human papillomavirus (HPV) E6/E7 mRNA detection in cervical cancer screening and to compare the efficacy with high-risk (HR)-HPV detection. PATIENTS AND METHODS The cervical exfoliative cytology samples of 337 patients were collected, including 70 cases of cervical inflammation, 72 cases of low-grade squamous intraepithelial lesions, 97 cases of high-grade squamous intraepithelial lesions, and 98 cases of cervical carcinoma. The PAX1 gene methylation (PAX1) status was detected by multiple quantitative PCR, HPV E6/E7 mRNA (E6/E7) was detected by QuantiVirus detection, and HR-HPV (HPV) was detected by the Cobas 4800 detection system. The sensitivities, specificities, and accuracies were validated in the testing set. RESULTS The sensitivities of the HPV, HPV E6/E7, and PAX1 testing were 89.23%, 84.10%, and 86.67%, respectively, which all maintained a high level. In contrast, the specificities of the HPV, E6/E7, and PAX1 testing were only 19.10%, 37.32%, and 97.18% (in pairwise comparisons, p = 0.000). The AUC of PAX1 (0.919) was significantly larger than that of HPV (0.541) and E6/E7 detection (0.607) (p

Objective: Oral cancer accounts for 50–70% of total cancer mortality. VIA screening has drastically changed the morbidity and mortality related to cervical cancer. In present study, we assessed the role of 5% Acetic Acid as a vital stain in oral mucosa of chronic tobacco chewers, to know if it can help in early diagnosis and improved prognosis of oral malignancies and to assess the sensitivity and specificity of VIA and exfoliative cytology for screening of Oral premalignant and malignant lesions in high risk population with limited health care infrastructure. Methods: This was an outpatient department based prospective study done in a tertiary hospital over a period of two years. 150 cases with a history of chronic tobacco use were evaluated. Visual inspection (VI) followed by VIA using 5% Acetic acid was done. Oral scrapes were taken for cytological examination followed by biopsy for histopathological evaluation, wherever possible. Results: Sensitivity, specificity, PPV, NPV and accuracy of VIA and Exfoliative cytology was 71%, 65%, 83%, 48%, 69% and 98%, 65%, 89%, 92%, 88% respectively keeping histology as gold standard. Conclusion: Acetic acid along with exfoliative cytology can be used as simple, cost effective and convenient methods for mass screening of OPMDs and OSCC in high risk population where biopsy is not possible.

Introduction: Occupational exposure to petrol derivatives possesses an increased risk of various cancers including that of the oral mucosa. Scientific studies have shown the correlation of micronuclei assay (MN) with the cytogenotoxic changes in petrol station attendants. However, very few have reported the use of MN assay as a promising tool for assessing the impact of smoking in these workers. Aim: To explore the cytogenotoxic damage in exfoliated buccal cells obtained from petrol station attendants and control subjects using the MN assay along with additional effects due to smoking. Materials and Methods: The study comprised 60 males who were divided into Group I–IV with each having 15 subjects. These subjects were categorized as exposed smokers, exposed nonsmokers, unexposed smoker group, and unexposed nonsmokers. The MN and additional nuclear abnormalities (karyorrhexis [KH], binucleation [BN], pyknosis [P], and karyolysis [KL]) were calculated in PAP-stained slides. Results: Statistically higher mean frequencies of overall nuclear anomalies were observed in petrol pump workers in comparison with the control group. Petrol pump smokers carry the highest nuclear anomalies followed by non-exposed smokers than exposed non-smokers and the count was the least among unexposed non-smoker workers. Discussion and Conclusion: The present study indicated that the petrol pump workers are under higher cytogenotoxic damage. Also, smoking added to the frequency of damage. Thus, MN and other nuclear anomalies are in-vitro reliable biomarker assays available and should be routinely employed as a screening tool in their periodic medical evaluation.

Introduction: the variation of microorganisms of the vaginal canal is reported in patients with the presence of modified cervicovaginal polyps from the city of Puebla, Mexico; describing the vaginal microbiota and pathogenic microorganisms in order to analyze the possible association of these with the formation of cervicovaginal polyps. Methods: the clinical impressions and samples obtained from the patients who attended the Department of Cell Biology of the Faculty of Medicine of the Benemérita Universidad Autónoma de Puebla were analyzed within the framework of the Early Cancer Detection (DOC) program of the years 2001 to 2019, to the taking of cervicovaginal exfoliative cytology (PAP). Results: Of the 2,671 patients who met the inclusion criteria when presenting with cervicovaginal polyp, 82.14% reported the presence of microorganisms, beingcocoid flora,the most frequent microorganism found in patients with cervicovaginal polyps, thus, the need for more studies deep and extensive in Mexico, due to the null reviews reported in the scientific literature.

Cytology is a modern, fast, secure, and cost-effective method to render a diagnosis of neoplastic processes throughout the body, including neuroendocrine neoplasms. Fine-needle aspiration and exfoliative cytology specimens show a good sensitivity and specificity in detecting neuroendocrine neoplasms. Increased imaging has led to an increased and earlier detection of neuroendocrine neoplasms. In addition, the easy accessibility of both endoscopic procedures and a fast-diagnostic workup by cytology allow for earlier diagnoses on less invasively obtained material, increasingly in an outpatient setting. Thus, cytology has contributed to the decrease in the mortality of neuroendocrine neoplasms. This chapter focuses on general and site-specific cytology of neuroendocrine neoplasms to make the reader familiar with the spectrum of the cytology of neuroendocrine neoplasms. In addition, differential diagnoses and the use of ancillary techniques such as immunocytochemisty and immunohistochemistry are discussed. Finally, the widely accepted organ system-based, specific classification systems to facilitate the conversation among members of multidisciplinary endocrine oncology team are discussed.

Objective Inhalational drugs used in treating asthma have several side effects including those on oral tissues. We therefore designed a study to analyze the effects of inhalational drugs on the buccal mucosal cells of the oral cavity. Methods Smears were obtained from clinically normal buccal mucosa of 20 randomly selected asthmatic patients who had been under inhalational therapy for at least 6 months. The Papanicolaou-stained smears were then analyzed for average nuclear area, average cytoplasmic area, and average nuclear area:cytoplasmic area ratio for each patient, and the values were compared with those of 10 healthy controls. Results A statistically significant decrease in cytoplasmic area (P

Background: Discovery of methylated DNA markers (MDM) of esophageal squamous cell carcinoma (ESCC) has sparked interest in assessing these markers in tissue. We evaluated MDMs in ESCC from three geographically and ethnically distinct populations, and explored the feasibility of assaying MDMs from DNA obtained by swallowed balloon devices. Methods: MDMs were assayed in ESCC and normal tissues obtained from the populations of United States, Iran, and China, and from exfoliative cytology specimens obtained by balloons in a Chinese population. Areas under the receiver operating curve (AUC) of MDMs discriminating ESCC from normal tissues were calculated. Random forest prediction models were built, trained on U.S. cases and controls, and calibrated to U.S.-only controls (model 1) and three-country controls (model 2). Statistical tests were used to assess the relationship between dysplasia and MDM levels in balloons. Results: Extracted DNA from 333 ESCC and 322 normal tissues was analyzed, in addition to archival DNA from 98 balloons. For ESCC, model 1 validated in Iranian and Chinese tissues with AUCs of 0.90 and 0.87, and model 2 yielded AUCs of 0.99, 0.96, and 0.94 in tissues from the United States, Iran, and China, respectively. In Chinese balloons, MDMs showed a statistically significant trend of increasing levels with increasing grades of dysplasia (P < 0.004). Conclusions: MDMs accurately discriminate ESCC from normal esophagus in tissues obtained from high- and low-incidence countries. Preliminary data suggest that levels of MDMs assayed in DNA from swallowed balloon devices increase with dysplasia grade. Larger studies are needed to validate these results. Impact: MDMs coupled with minimally invasive collection methods have the potential for worldwide application in ESCC screening.

espanolDe 1990 a 2012, el Instituto de Salubridad y Enfermedades Tropicales experimento los cambios mas importantes. En 1989 modifico su nombre y orientacion a Instituto Nacional de Diagnostico y Referencia Epidemiologicos. Poco antes se habia formalizado como cuspide de la Red Nacional de Laboratorios en Salud Publica y habia incorporado los laboratorios de pro- gramas preventivos como el de citologia exfoliativa y los de diagnostico de rabia, paludismo, tuberculosis; posteriormente incorporaria otras redes que surgieron como parte de la respuesta a brotes epidemicos y al nuevo panorama epidemiologico. En este periodo, 27 algoritmos diagnosticos se definieron y organizaron en 18 redes, algunas de las cuales comenzaron a colaborar con redes globales. En 2001, en el Instituto se empezo a trabajar con patogenos relacionados con el bioterrorismo. Para entonces, las restricciones del edificio sede fueron evidentes; en 2008, se decidio construir nuevas instalaciones. El Instituto y sus redes diagnosticas constituyen un hito en la salud publica latinoamericana del siglo XXI. EnglishFrom 1990 to 2012, the Sanitary and Tropical Diseases Institute experienced the most important changes. In 1989, its name and orientation were modified to become the National Institute of Epidemiological Diagnosis and Reference (InDRE). Short- ly before, it had been formalized as the apex of the National Network of Public Health Laboratories and had incorporated laboratories for preventive programs such as exfoliative cytology and rabies, malaria and tuberculosis diagnosis; subse- quently, it would incorporate other networks that emerged as part of the response to major epidemic outbreaks and to the new epidemiological outlook. In this period, 27 priority diagnostic algorithms were defined and organized in 18 networks, some of which began to collaborate with global networks. In 2001, the Institute started working with pathogens related to bioterror- ism. By then, space restrictions of the headquarters’ building were evident; in 2008, starting the construction of new facilities was decided. The institute and its diagnostic networks constitute a milestone in Latin American public health of the 21st century.

Background Oral exfoliative cytology is simple, non-invasive, inexpensive tools prone to subjective bias. Objective computer-based quantitative cytomorphometry technique was developed in last few decades to overcome its limitation. However, there is no consensus about the utility of cytomorphometry as a routine screening tool for early detection of dysplastic changes. Objectives To review the utility of cytomorphometry in OPMDs in the detection of dysplasia changes. Method A scoping review was undertaken focusing on cytomorphometric analysis in exfoliative cells for detection of oral epithelial dysplasia and cytomorphometric parameter denoting dysplasia. The systematic search was carried out in the online journal databases (Scopus, Google Scholar, PubMed, Web of Science) using keywords until December 2019 for the studies evaluated the cytomorphometry in the detection of dysplastic changes in OPMDs. Three authors independently extracted data using collection forms. Result The search strategy found seven analytical cross-sectional studies for scoping review after eliminating 8940 out of 8947 initial results. The scoping review showed that cytomorphometry is useful tool in detecting the dysplastic changes in OPMDs. In addition, decrease in mean cellular area, increase in mean nuclear area, and decrease in mean cell diameter, increase mean nuclear diameter, increase in mean nuclear and cytoplasmic area ratio, associated with development of dysplastic changes in OPMDs. Conclusion Cytomorphometry is promising tool, yet there is currently no-good evidence to support role of cytomorphometry in detecting the dysplastic changes in OPMDs in this setting. More research is required for refinement of cytomorphometry as a screening tool.

Orientador: Pablo Agustin Vargas Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba Resumo: O objetivo desse estudo foi realizar um levantamento dos casos submetidos para o diagnóstico citopatológico para demonstrar as diversas aplicações desse exame complementar na região oral e maxilofacial. Uma análise retrospectiva foi realizada no Laboratório de Patologia Oral da Faculdade de Odontologia de Piracicaba num período de 18 anos. Informações clínicas e citológicas foram coletadas. Associações entre as variáveis clínicas e citológicas foram realizadas através do teste do qui-quadrado de Pearson ou teste de Fisher, com um nível de significância de 5%. Quando disponível, o diagnóstico histopatológico foi comparado com o diagnóstico citológico para identificar a porcentagem de concordância entre esses exames e foram calculadas a especificidade, sensibilidade e acurácia da citopatologia em identificar neoplasias malignas. 1.082 casos foram identificados compreendendo 65 diferentes diagnósticos. A citologia esfoliativa (CE) foi realizada em 312 casos (29,1%) e a punção aspirativa por agulha fina (PAAF) em 770 casos (70.9%). CE foi empregada principalmente para diagnóstico de lesões infecciosas e PAAF para diagnósticos do grupo de neoplasias, lesões císticas, reacionais e de patologia variada. Cell Block (CB) foi realizado em 555 casos (51.3%) derivados da PAAF. Colorações de Panótico, Papanicolaou e hematoxilina-eosina foram realizadas na PAAF e Ácido periódico de Schiff na EC. Em 211 casos (19.5%) o diagnóstico histopatológico estava disponível e a porcentagem de concordância com o diagnóstico citopatológico foi de 40.3%. Sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e acurácia da citologia em identificar neoplasias malignas foi 84.6%, 100%, 77.8% e 90.0%, respectivamente. Em conclusão, a Citopatologia forneceu diferentes diagnósticos de lesões da região de cabeça e pescoço. A CE foi realizada principalmente para o diagnóstico de lesões infecciosas e a PAAF para o diagnóstico de tumores de glândula salivar, lesões odontogênicas, lesões reacionais e rastreamento de metástases cervicais Abstract: The aim of this study was to perform a survey of oral and maxillofacial specimens submitted for cytologic diagnosis to verify the importance of this complementary exam. A retrospective analysis of our institutional cytopathology database was performed over an 18-year period. Clinical information and cytological data were collected. Associations between independent variables and outcomes were assessed using the Pearson chi-square test or Fisher's test, with a 5% significance level. When available, the histologic diagnosis was compared with cytologic diagnosis to identify the percentage of agreement and the specificity, sensitivity and accuracy of cytology in identifying malignant neoplasms. A total of 1,082 cases were identified that comprised 65 different cytological diagnoses. Exfoliative cytology (EC) was performed in 312 cases (29.1%) and fine-needle aspiration cytology (FNAC) in 770 cases (70.9%). EC was mainly employed to diagnose oral infectious diseases and FNAC to diagnose neoplasms, cystic, reactive and miscellaneous lesions. Cell block was performed in 555 FNAC cases (51.3%). Panoptic, Papanicolaou and hematoxylin-eosin staining was performed in FNAC and periodic acid-Schiff in EC. In 211 cases (19.5%), the histologic diagnosis was available and the percentage agreement with the cytologic diagnosis was 40.3%. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy to identify malignant neoplasms were 84.6%, 100%, 100%, 77.8% and 90.0%, respectively. In summary, the cytology provided several different diagnoses of lesions of the oral and maxillofacial region. EC was mainly performed for diagnosis of infectious diseases and FNAC for diagnosis of salivary gland tumours, odontogenic lesions, reactional lesions and cervical metastasis Mestrado Patologia Mestra em Estomatopatologia CAPES

Exfoliated cell are one of the most patient compliant specimens, hence are workhorse of successful screening programs in cancers like cervix. Raman exfoliative cytology (REC), even on cell pellets using Raman microprobe, has demonstrated ∼80% specificity, comparable to conventional screening programs. Objective of this study is to further evaluate Raman spectroscopy, which is sensitive to biochemical composition, vis-a-vis conventional morphology based cytology that differentiates cell-type but not the origin. Exploration of this kind further corroborates utility and efficacy of REC as screening tool, also can pave way to prospective multi-cancer screening by a multi-group model. Therefore, the present study explores REC in a stringent two-cancer, four-group model for classification of 44 oral [29, tumor (OT), 15 normal (ON)] and 66 cervical (38 tumor (CT), 28 normal (CN)] exfoliated cell specimens. Spectra were acquired from cell pellets using Raman microprobe. Spectra were analyzed in two approaches, spectra-wise and subject-wise to circumvent inherent heterogeneity due to co-localization of normal cells in malignant specimens. In the first approach, PCA and LDA yielded a classification efficiency of 82% for OT and 77% for CT. A slightly higher classification (OT, 86% and CT, 84%) was achieved for the subject-wise approach. Thus findings of this study demonstrate similar efficacy and specificity to that of individual cancer-based models reported earlier. These findings are quite encouraging especially for resource deprived and under privileged countries where these two cancers are more prevalent and could be useful for prospective centralized REC facility.

Ninety years ago, at the Battle Creek conference, Papanicolaou introduced cervical exfoliative cytology. Since then, the "Pap test" has come a long way. The discovery of a causal relationship between cervical carcinoma and HPV infection opened the door for molecular testing and immunomarkers for HPV. The Clinical Laboratory Improvement Amendments, 1988, established quality assurance and quality control programs to monitor performance of cytology laboratories. The Bethesda System for reporting cervical cytology laid the foundations for cervical cytology education, implementation of management guidelines, and further research on cervical carcinogenesis. HPV vaccine penetration in both genders remains 62% or less.

Hatice Kose Ozlece,1 Gulname Findik Guvendi,2 Nergiz Huseyinoglu,1 Yusuf Ehi,3 Yuksel Kivrak4 1Department of Neurology, Acibadem Kayseri Hospital, Kayseri, Turkey; 2Department of Pathology, Medical Faculty, Kafkas University, Kars, Turkey; 3Department of Neurology, Medical Faculty, Kafkas University, Kars, Turkey; 4Department of Psychiatry,Medical Faculty, Kafkas University, Kars, Turkey Background: Alzheimer’s disease (AD) and Parkinson’s disease (PD) are the two most common neurodegenerative diseases. Recent studies have sought to identify precursor symptoms of AD and PD that occur before the onset of the disease. We evaluated changes in the oral mucosa of patients with AD and PD using a stereological method. Patients and methods: The study included 29 patients with AD, 30 patients with idiopathic PD, and 30 healthy volunteers. Brush biopsies were obtained from all participants, and the nucleator method was used to estimate the volume of cells obtained from the buccal mucosa. Results: Cytomorphometric analysis revealed that the nuclear volume was 484.39±117.10 µm3 in the AD group, 509.71±132.26 µm3 in PD patients, and 509.30±100.21 µm3 in the control group. The cytoplasmic volume was 115,456.60±30,664.98 µm3 in the AD group, 103,097.93±25,034.65 µm3 in PD patients, and 109,528.45±28,381.43 µm3 in the control group. The nuclear and cytoplasmic volumes were not significantly different among groups (P>0.05). Conclusion: The cytomorphometric analysis revealed no significant differences in the cytoplasmic and nuclear volumes of buccal cells obtained from patients with AD and PD and healthy volunteers. Keywords: Alzheimer’s disease, Parkinson’s disease, exfoliative cytology, stereology, oral mucosa

Diabetes mellitus (DM) is one of the most prevalent endocrine metabolic disorders. It has damaging effects on the oral cavity and is reported to be a risk factor for periodontal disease. The aim of the study was to describe the periodontal status of patients with type 2 DM and to evaluate the multiple demographic, behavioral, medical and dental factors that may be associated with periodontal disease and DM. Material and Methods: Demographic data and medical and dental histories were reviewed, periodontal assessments (loss of attachment, bleeding on probing, presence of supragingival calculus) and cytomorphometric analysis were made. Results: 160 subjects participated in the study, age of 64.2 (±0.2) years, duration of DM 23.6 (±0.39) years and HbA1c 8.70% (±0.45). Severe loss of attachment and calculus were more present in older patients. Bleeding on probing was consistent among subjects in each age group. Cytomorphometric analysis revealed larger nuclear area values in older subjects. Factors possibly associated with advanced periodontal disease included in the regression analysis were: age (P

Background: Bidi smoking is a serious health hazard which is common throughout South Asia and parts of the Middle East. It has been strongly implicated to various benign and malignant lesions of oral cavity and oropharynx. These tobacco-filled leaves deliver more than three times the amount of nicotine, carbon monoxide, and tar as cigarettes which exert injurious effects on cells reflected in terms of accelerated proliferative activity in normal oral mucosal cells. Aim: This study aimed to compare the exfoliated cells from the oral mucosa of bidi smokers and nonsmokers, with emphasis on proliferative activity. Materials and Methods: Exfoliative smears were obtained from the oral mucosa of forty participants (twenty nonsmokers and twenty smokers) with age group ranging from 30-80 years, in and around Barwala (Haryana). The cytologic smears were evaluated using Papanicolaou (PAP) stain and AgNOR in order to evaluate the presence of cytological alterations suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. Only PAP Class I and Class II smears were observed. Results: Comparison of the mean number of AgNORs showed a significant difference between nonsmokers and smokers. Inflammatory alterations were found in 70% of smokers and 55% of nonsmokers. A significant difference in proliferative activity was observed between smokers and nonsmokers classified as PAP Class II. Conclusion: A significant difference of AgNORs/nucleus was observed between bidi smokers and nonsmokers.

Amalgam is a filler material containing toxic mercury. One of the main risks comes from the mercury vapor released in the mouth. The presence of amalgams in the oral cavity changes the metabolism of epithelial cells in the oral mucosa. Exfoliative cytology is a fast and easy method because the examination is only performed on the surface of the oral mucosa, and epithelial cells can be released without anesthesia. The research method was an analytical descriptive with a cross-sectional design. Epithelial cells from oral mucosa were collected from 32 samples using the cytobrush method. The epithelial cells were collected on the closest buccal mucosa of the amalgam restoration. The number of epithelial cells in the oral mucosa was seen through micrographs from a microscope with 100x magnification. The data were analyzed using the Mann Whitney U test to determine the number of epithelial cells released. The Mann Whitney U test results showed that there was a significant difference in the number of oral mucosal epithelial cells obtained ​​between subjects with amalgam and subjects without amalgam with p

BACKGROUND The incidence of anal carcinoma has risen in recent decades. Exfoliative cytology screening of selected high risk patients is performed in many centers. Unsatisfactory cytology results are frustrating to patients, clinicians, and laboratorians. The aim of this study is to ascertain outcomes of patients with non-diagnostic anal cytology. METHODS A retrospective review of anal cytology testing performed at the Cleveland Clinic between 01/01/2001 and 12/31/2015 was performed. All cases were received as liquid-based samples and processed as ThinPreps (Hologic, Marlborough, MA). Co-testing for HR-HPV DNA was performed using Hybrid Capture 2® (Qiagen, Germantown, MD) in the majority of patients. RESULTS Of 1,276 ThinPrep anal cytology samples, 130 (10%) were deemed unsatisfactory. 77% of patients were HIV positive. 85% were males. Of the unsatisfactory cases, 116 (89%) were co-tested for HR-HPV DNA. Of those, 40 patients (34%) had a simultaneous positive HR-HPV DNA. Adequate follow up cytology within a one year and a two year period revealed that 18/130 (14%) and 26/130 (20%) of patients had ASC or SIL respectively. Histologic follow-up within one and two years showed 3 patients (2%) and 8 patients (6%) with HSIL or worse. CONCLUSIONS High risk patients with unsatisfactory anal cytology are not "negative". At least one-third proved to be concomitantly HR-HPV DNA positive with one-fifth showing subsequent cytologic squamous abnormalities and with more than 5% being diagnosed with a high grade intraepithelial lesion within two years. Prompt repeat cytology and/or HR-HPV DNA is recommended for high risk patients with non-diagnostic cytology.

Objective To evaluate if dental students with the habit of smoking exhibit alterations in the epithelial cells of the cheek mucosa on the nuclear area (NA), cytoplasmic area (CA) or in the nucleus/cytoplasm ratio (NA/CA), when compared to non-smokers. Methods This is a descriptive, experimental study using a control group. The sample comprised 40 dental undergraduates (20 smokers and 20 non-smokers). Individuals who smoked at least 5 or 6 cigarettes a day were deemed to be smokers, while non-smokers were those who reported having no experience of any form of smoking. The samples of epithelial cells were obtained from the oral mucosa using the liquid-based exfoliative cytology technique. The slides were processed in the laboratory, stained using the Papanicolau technique and were analyzed via an image analysis system (analySIS getIT). A structured questionnaire was applied with the aim of measuring independent variables related to personal characteristics, health and lifestyle behavior. Results The values obtained in the group of smokers were as follows: NA (169.4 µm² ± 17.0), CA (1240.1 µm² ± 128.9) and NA/CA ratio (0.1375 ± 0.01743). The results did not evidence significant differences when compared to the control group: NA (170.7 µm² ± 20.0), CA (1255.3 µm² ± 174.5) and NA/CA (0.1380 ± 0.01436). Conclusion It was not possible to observe significant cell alterations in the NA, CA or the NA/CA ratio of epithelial cells of the oral mucosa. Other risk factors associated with tobacco should be studied, principally the length of exposure to the properties of the causative agent. RESUMO Objetivo Avaliar se os estudantes de odontologia que possuem hábitos tabagistas apresentam alterações celulares nas células epiteliais da mucosa jugal sobre as áreas nucleares (AN), citoplasmáticas (AC) e na relação núcleo/citoplasma (AN/AC) quando comparados a não fumantes. Métodos Trata-se de um estudo experimental, descritivo com grupo controle. A amostra foi composta por 40 estudantes de graduação em odontologia (20 fumantes e 20 não fumantes). Consideraram-se fumantes aqueles indivíduos que fumavam diariamente, no mínimo, cinco a seis cigarros do tipo industrializado; e não fumantes aqueles indivíduos que relataram a não experiência com qualquer tipo de fumo. As amostras de células epiteliais foram obtidas da mucosa oral pela técnica de citologia esfoliativa em meio líquido. As lâminas foram processadas em laboratório, coradas pela técnica de Papanicolau e analisadas através de um sistema de análise de imagens (Analysis getlt). Um questionário estruturado foi aplicado com o intuito de mensurar variáveis independentes referentes às características pessoais, comportamentos em saúde e estilo de vida. Resultados Os valores obtidos no grupo dos fumantes para a AN (169,4 µm² ± 17,0), AC (1240,1 µm² ± 128,9) e na relação AN/AC (0,1375 ± 0,01743) não apresentaram resultados com diferenças expressivas quando comparados ao grupo controle AN (170,7 µm² ± 20,0), AC (1255,3 µm² ± 174,5) e na AN/AC (0,1380 ± 0,01436). Conclusão Não foi possível observar alterações celulares significantes nas AN, AC e na relação AN/AC de células epiteliais da mucosa oral. Outros fatores de risco associados ao tabaco devem ser estudados, principalmente o tempo de exposição às propriedades do agente causador.

Liquid-based cytology (LBC), since its inception in the 1990s, has shown significant advantages over conventional exfoliative cytology. LBC gives better results than conventional method as it not only enhances both sensitivity and specificity, but also provides material for further investigations. However, LBC requires expensive automated devices and materials, which might not be affordable for many cytopathology laboratories in countries with poor resources. In order to formulate an economic cytological procedure with the accuracy of LBC, smears made out of manual liquid based cytology (MLBC) technique was followed in this study and the results were compared with respective conventional cytology smears. To the authors’ knowledge, this is the first comparative study between MLBC and conventional method done for oral cavity in normal buccal mucosa. One hundred apparently normal subjects who reported to the outpatient department were selected after obtaining informed consent from all the subjects. Two Scrapings were made in each patient from the clinically normal appearing buccal mucosa. Both conventional and MLBC smears were stained by routine Papanicolaou technique and evaluated by three independent observers for specimen adequacy, thickness of the smear, uniformity of cell distribution, clarity or resolution of the cells, presence of background artifacts, and staining characteristics of the cells. Each parameter was graded as satisfactory; satisfactory but limited; or unsatisfactory. Number of satisfactory results obtained in MLBC smears was significantly higher than that by conventional smears. After comparison of smears prepared from conventional cytology and manual liquid-based cytology, we conclude that manual liquid-based cytology is both cost effective and also technically sound method with specific and clear results.

Background: Cytological study of body fluids a non-invasive, simple procedure, relatively inexpensive, and helps in faster reporting that has high population acceptance. The present study aims to determine the proportion of malignant and non malignant lesions. Methods: A total of 1129 specimens of exfoliative cytology were examined during the period over five years from year January 2011 to December 2016 at Department of Pathology at Chitwan Medical College Teaching Hospital, Nepal. The fluid received was centrifuged at 3000 revolutions per minute for five minutes. Smears were made from the sediment. Two to three slides were air dried and stained with Giemsa stain. One slide was immediately fixed in 95% alcohol and stained with Papanicolaou (Pap) stain for cytological evaluation. Results: Pleural fluid was most common specimen (49.3%) with peritoneal fluid (32%), pericardial fluid (1%), BAL (7.8%), CSF (4%), sputum (3.4%), synovial fluid (2%) and urine (0.5%) specimens. Male to female ratio was 1.33:1. Maximum cases belonged to age group of 50-69 years. Only (5.8%) 67 cases were neoplastic. The maximum cases of malignant neoplasm were detected in pericardial fluid and pleural fluid, each 21 (1.8%) cases, and 20 (1.7%) cases BAL. Malignant effusions were detected in 46 (4%) cases. Maximum malignant cases were adenocarcinoma (71.6%), followed by squamous cell carcinoma (20.8%). Conclusion: Exfoliative cytology should be suggested in all cases of effusion and suspected malignancies which helps in reaching at a particular diagnosis and aids in further management.

// Yao Liu 1, * , Yicheng Li 2, * , Yue Fu 1 , Tong Liu 1 , Xiaoyong Liu 3 , Xinyan Zhang 4 , Jie Fu 1 , Xiaobing Guan 1 , Tong Chen 5 , Xiaoxin Chen 2 and Zheng Sun 1 1 Department of Oral Medicine, Beijing Stomatological Hospital, Capital Medical University, Beijing, China 2 Cancer Research Program, Julius L. Chambers Biomedical Biotechnology Research Institute, North Carolina Central University, Durham, North Carolina, USA 3 Department of Pathology, Beijing Stomatological Hospital, Capital Medical University, Beijing, China 4 Beijing Institute of Dental Research, School of Stomatology, Capital Medical University, Beijing, China 5 Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio, USA * These authors have contributed equally to this work Correspondence to: Xiaoxin Chen, email: lchen@nccu.edu Zheng Sun, email: zhengsun12@vip.126.com Keywords: exfoliative cytology, oral cancer risk, oral leukoplakia, oral squamous cell carcinoma, quantitative prediction Received: January 13, 2017 Accepted: February 28, 2017 Published: May 02, 2017 ABSTRACT Exfoliative cytology has been widely used for early diagnosis of oral squamous cell carcinoma. We have developed an oral cancer risk index using DNA index value to quantitatively assess cancer risk in patients with oral leukoplakia, but with limited success. In order to improve the performance of the risk index, we collected exfoliative cytology, histopathology, and clinical follow-up data from two independent cohorts of normal, leukoplakia and cancer subjects (training set and validation set). Peaks were defined on the basis of first derivatives with positives, and modern machine learning techniques were utilized to build statistical prediction models on the reconstructed data. Random forest was found to be the best model with high sensitivity (100%) and specificity (99.2%). Using the Peaks-Random Forest model, we constructed an index (OCRI2) as a quantitative measurement of cancer risk. Among 11 leukoplakia patients with an OCRI2 over 0.5, 4 (36.4%) developed cancer during follow-up (23 ± 20 months), whereas 3 (5.3%) of 57 leukoplakia patients with an OCRI2 less than 0.5 developed cancer (32 ± 31 months). OCRI2 is better than other methods in predicting oral squamous cell carcinoma during follow-up. In conclusion, we have developed an exfoliative cytology-based method for quantitative prediction of cancer risk in patients with oral leukoplakia.

Viral lower respiratory tract infections (VLRTI) remain one of the most common causes of morbidity and mortality worldwide. For many years, the diagnosis of VLRTI was based on laboratory techniques such as viral isolation in cell culture, antigen detection by direct fluorescent antibody staining, and rapid enzyme immunoassay. Radiological imaging and morphology also play an important role in diagnosing these infections. Exfoliative cytology provides a simple, rapid, inexpensive, and valuable means to diagnose and manage VLRTI. Here we review viral-associated cytomorphological changes seen in exfoliated cells of the lower respiratory tract. Diagn. Cytopathol. 2017;45:614-620. © 2017 Wiley Periodicals, Inc.

Viral lower respiratory tract infections (VLRTI) remain one of the most common causes of morbidity and mortality worldwide. For many years, the diagnosis of VLRTI was based on laboratory techniques such as viral isolation in cell culture, antigen detection by direct fluorescent antibody staining, and rapid enzyme immunoassay. Radiological imaging and morphology also play an important role in diagnosing these infections. Exfoliative cytology provides a simple, rapid, inexpensive, and valuable means to diagnose and manage VLRTI. Here we review viral-associated cytomorphological changes seen in exfoliated cells of the lower respiratory tract. Diagn. Cytopathol. 2017;45:614-620. © 2017 Wiley Periodicals, Inc.

Objectives: To compare the cytological findings of preoperative buccal smears with their histopathological types in oral cavity tumors. Materials and Methods: This study investigated 45 patients with oral tumors who had undergone preoperative buccal smears of oral lesions and were diagnosed by postoperative histopathological examination. Two samples were taken from patients that were clinically diagnosed with oral squamous cell carcinoma (OSCC): smears for cytological examination and biopsies for histopathological diagnosis. Results: Of the 45 cases studied, histopathology showed the presence of OSCC (n = 39 [86.7%]), verrucous carcinoma (n = 2 [4.4%]), and hyperkeratosis (n = 4 [8.9%]). OSCC cases predominantly occurred in males, with a ratio of 3.8:1 (P = 0.000); the majority of OSCC cases, in both males (27; 87%) and females (6; 75%), were older than 50 years. Most OSCC cases, 32 (82.1%), were toombak dippers, and 28 out of the 32 were males (87.5%). In addition, the labiogingival, a common site of toombak dipping, was a prevalent lesion site of OSCC (13 patients, 33.3%) (P = 0.004). The cytological findings showed good diagnostic concordance with the histopathological findings; in 39 cases of OSCC, 31 patients had positive smears and biopsies and eight patients had negative smears but positive biopsies, for an overall sensitivity of 79.5% and specificity of 100%. Conclusion: Despite the small number of cases in this study, we realized that the diagnostic accuracy of preoperative buccal smear cytology for oral lesions was high and that it is a safe, easy-to-perform, and clinically useful diagnostic procedure.