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This report of the Editorial Advisory Board of Cytopathology gives the results of a survey of medical practitioners in cytopathology, which aimed to find out their views on the current situation in undergraduate and postgraduate training in their institutions and countries. The results show that training in cytopathology and histopathology are largely carried out at postgraduate level and tend to be organized nationally rather than locally. Histopathology was regarded as essential for training in cytopathology by 89.5% of respondents and was mandatory according to 83.1%. Mandatory cytopathology sections of histopathology were reported by 67.3% and specific examinations in cytopathology by 55.4%. The main deficiencies in training were due to its variability; there were insufficient numbers of pathologists interested in cytology and a consequent lack of training to a high level of competence. Pathologists without specific training in cytopathology signed out cytology reports according to 54.7% of responses, more often in centres where training was 3-6 months or less duration. Although 92.2% of respondents thought that specialist cytology should not be reported by pathologists without experience in general cytopathology, that practice was reported by 30.9%, more often in centres with small workloads. The survey report recommends that 6-12 months should be dedicated to cytopathology during histopathology training, with optional additional training for those wanting to carry out independent practice in cytopathology. Formal accreditation should be mandatory for independent practice in cytopathology. When necessary, temporary placements to centres of good practice should be available for trainees intending to practise independently in cytopathology. There should be adequate numbers of pathologists trained in cytopathology to a high level of competence; some of their time could be released by training cytotechnologists and trainee pathologists to prescreen cytology slides and assess adequacy of fine-needle aspiration samples when immediate diagnosis was not required. The survey demonstrated a clear need for European and international guidelines for training in cytopathology.

PubMedID: 21054822 G. Kocjan, B. Cochand-Priollet, P. P. de Agustin, C. Bourgain, A. Chandra, Y. Daneshbod, A. Deery, J. Duskova, C. Ersoz, G. Fadda, A. Fassina, P. Firat, B. Jimenez-Ayala, P. Karakitsos, O. Koperek, N. Matesa, D. Poller, L. Thienpont, A. Ryska, U. Schenck, T. Sauer, F. Schmitt, E. Tani, T. Toivonen, M. Tötsch, G. Troncone, L. Vass and P. Vielh Diagnostic terminology for reporting thyroid fine needle aspiration cytology: European Federation of Cytology Societies thyroid working party symposium, Lisbon 2009 A European Federation of Cytology Societies (EFCS) working party of 28 members from 14 European countries met at the European Congress of Cytology in Lisbon in September 2009, with two observers from the USA, to discuss the need for standardising thyroid FNA nomenclature in the light of the National Institute of Cancer (NCI) recommendations resulting from the State of the Science conference in Bethesda in 2007. The data were obtained through two questionnaires sent by email and a transcript of the live discussion at the congress, which is presented in full. The surveys and discussion showed that there were currently no national terminologies for reporting thyroid FNA in the different European countries except in Italy and the UK. Personal, 'local', surgical pathology and descriptive terminologies were in use. All but one of the working party members agreed that thyroid FNA reporting should be standardised. Whilst almost a third would adopt the NCI Bethesda terminology, which offers the advantages of a 'risk of cancer' correlation and is linked to clinical recommendations, more than half favoured a translation of local terminology as the first step towards a unified nomenclature, as has been done recently in the UK. There was some disagreement about the use of: a) the six-tiered as opposed to four or five-tiered systems, b) the use of an indeterminate category and c) the 'follicular neoplasm' category, which was felt by some participants not to be different from the 'suspicious of malignancy' category. The conclusions will be passed to the different national societies of cytology for discussion, who will be asked to map their local terminologies to the Bethesda classification, observe its acceptance by clinicians and audit its correlation with outcome. © 2010 Blackwell Publishing Ltd.

G. Kocjan, B. Cochand-Priollet, P. P. de Agustin, C. Bourgain, A. Chandra, Y. Daneshbod, A. Deery, J. Duskova, C. Ersoz, G. Fadda, A. Fassina, P. Firat, B. Jimenez-Ayala, P. Karakitsos, O. Koperek, N. Matesa, D. Poller, L. Thienpont, A. Ryska, U. Schenck, T. Sauer, F. Schmitt, E. Tani, T. Toivonen, M. Tötsch, G. Troncone, L. Vass and P. Vielh Diagnostic terminology for reporting thyroid fine needle aspiration cytology: European Federation of Cytology Societies thyroid working party symposium, Lisbon 2009 A European Federation of Cytology Societies (EFCS) working party of 28 members from 14 European countries met at the European Congress of Cytology in Lisbon in September 2009, with two observers from the USA, to discuss the need for standardising thyroid FNA nomenclature in the light of the National Institute of Cancer (NCI) recommendations resulting from the State of the Science conference in Bethesda in 2007. The data were obtained through two questionnaires sent by email and a transcript of the live discussion at the congress, which is presented in full. The surveys and discussion showed that there were currently no national terminologies for reporting thyroid FNA in the different European countries except in Italy and the UK. Personal, 'local', surgical pathology and descriptive terminologies were in use. All but one of the working party members agreed that thyroid FNA reporting should be standardised. Whilst almost a third would adopt the NCI Bethesda terminology, which offers the advantages of a 'risk of cancer' correlation and is linked to clinical recommendations, more than half favoured a translation of local terminology as the first step towards a unified nomenclature, as has been done recently in the UK. There was some disagreement about the use of: a) the six-tiered as opposed to four or five-tiered systems, b) the use of an indeterminate category and c) the 'follicular neoplasm' category, which was felt by some participants not to be different from the 'suspicious of malignancy' category. The conclusions will be passed to the different national societies of cytology for discussion, who will be asked to map their local terminologies to the Bethesda classification, observe its acceptance by clinicians and audit its correlation with outcome. © 2010 Blackwell Publishing Ltd.

The objective of this study was to perform a comparative investigation of the capability of various classifiers in discriminating benign from malignant thyroid lesions. Using May Grunvald-Giemsa-stained smears taken by fine needle aspiration (FNA) and a custom image analysis system, 25 nuclear features describing the size, shape and texture of the nuclei were measured in each case. A statistical pre-processing of features revealed that only 4 of the 25 features are important when discriminating benign from malignant thyroid lesions, which were transformed and fed to four classifiers for subsequent analysis. The cases were divided into one set used for the training of classifiers, a second set used as the test set, and the remaining cases with no clear classification formed an ambiguous test set. Classification was performed at the nuclear and patient level. The technique described in this study produced encouraging results and promises to be a helpful tool in the daily cytological laboratory routine.

A 83-year-old woman with chronic lymphoid leukemia--well controlled for 14 years with chemotherapy--was admitted for ascitis due to portal hypertension. Liver biopsy showed major portal infiltration with monomorphic little lymphocytes. Portal hypertension during chronic lymphoid leukemia might be caused by this periportal lymphoid infiltration or by intraportal venous thrombosis due to thrombophilia or by increasing of hepatic blood flow. Our observation showed that hepatic localizations of the disease may induce acute symptoms even when the lymphoid leukemia seems to be under control both in terms of blood parameters and lymphadenopathy.