Publications
Highlighted Publications
2026
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Navigating the International System for Reporting Serous Fluid Cytopathology in pericardial effusion: A meta-analysis
CONCLUSIONS: TIS effectively stratifies pericardial effusion cytology samples by malignancy risk. The progressive increase in the risk of malignancy across categories supports its diagnostic utility. However, substantial heterogeneity, particularly in the negative for malignancy and malignant categories, highlights the need for standardized reporting and further prospective validation of TIS. -
International Consensus Guidelines for Diagnostic Criteria and Checklist for Future Studies for Minimally Invasive Carcinoma ex Pleomorphic Adenoma: An HN CLEAR Initiative
A variety of factors, including the extent of invasion, determine the clinical outcome in patients with carcinoma ex pleomorphic adenoma (Ca ex PA). A Head and Neck Consensus Language for Ease of Reproducibility (HN CLEAR) Steering Committee organized a working group (WG) to harmonize diagnostic and research approaches for assessing invasion in Ca ex PA.WG of head and neck pathologists and a radiation oncologist conducted 6 iterative rounds of online voting (Modified Delphi), using Google Forms,... -
Genotype and age shape the risk of persistent high-risk human papillomavirus infections
CONCLUSION: Persistent infections with human papillomavirus 16, 58, 33, and 52 were associated with the highest risks of progression, whereas Group 3 genotypes frequently persisted without leading to precancerous lesions. Younger women demonstrated an approximately 3-fold higher progression rate compared with older women. These findings suggest that persistence alone may not uniformly reflect oncogenic potential. Incorporating genotype-specific and age-specific risk stratification into screening... -
Cellularity of Routinely Prepared Cell Blocks: Insights From an International Study
CONCLUSIONS: The study revealed marked variability in the proportion of poorly cellular CBs among preparation methods and laboratories, highlighting the need for improved processing and monitoring of CB adequacy. -
Multiplex Cryoimmunostaining in Fine-Needle Aspiration Biopsies and Effusion Samples: Preliminary Results
CONCLUSIONS: mCryo enables simultaneous evaluation of multiple markers per slide on routinely prepared cytospins, offering potential diagnostic advantages for paucicellular samples. However, further method and panel improvement, and validation are essential for accurate diagnostic implementation into routine practice. -
Choice of fixative affects programmed death-ligand 1 expression in cell blocks from pleural effusions with metastatic pulmonary adenocarcinoma
CONCLUSIONS: PD-L1 ICC expression in CBs depends on the fixative and antibody used. Alcohol-based fixatives, particularly with low cutoffs, risk underestimating PD-L1 positivity, and may contribute to false-negative results. ICC protocol optimization is essential before diagnostic use. -
Clinical relevance of partial HPV genotyping in cervical cancer screening
Partial human papillomavirus (HPV) genotyping is increasingly used to triage high-risk (HR)-HPV-positive women in national cervical cancer screening. This study evaluated whether separate triage for HPV genotypes 16 and 18 could enhance the effectiveness of Finland's program. Data from 76,482 women participating in primary HPV screening in Tampere and surrounding municipalities (2012-2023) were analyzed. Partial genotyping identified HPV16, HPV18, and 12 other HR-HPV-types, and the association... -
ThinPrep® Whole-Slide Digital Images versus Conventional Microscopy in Negative for Intraepithelial Lesion or Malignancy, Atypical Squamous Cells of Undetermined Significance, and Low-Grade Squamous Intraepithelial Lesion Cervical Lesions: European Federation of Cytological Societies (EFCS) Study
CONCLUSION: This study illustrated that despite overall better agreement in WSI, ASC-US results were less favourable in WSI than LM, according to Fleiss's kappa test, but not other tests. -
Recommendations for optimizing cytology and small biopsy specimen processing for ancillary techniques by the American Society of Cytopathology taskforce: Reflection by European Federation of Cytological Societies
No abstract -
Hyperthyroidism-Related Epithelial Hyperplasia as a Potential Pitfall of Thyroid Cytology: Institutional Cytomorphological Analysis of Histologically Verified Cases
CONCLUSION: Fine-needle aspiration referrals with clinical data and thyroid function test results can facilitate the interpretation of cytomorphological features and reduce the use of undetermined categories in cases of hyperthyroidism-related epithelial hyperplasia. -
Special Issue: Quality Assurance/Quality Control in Cytopathology
No abstract -
Not Enough Cells: How Insufficient Cytological Specimens Are Mirrored by Reporting Systems - Journey from the Bethesda to the WHO Reporting Systems
Background: Pap classes have been replaced by organ-specific reporting systems in recent decades; however, part of the cytological specimens is insufficient. The present review summarizes how different organ-specific systems define the insufficient category: both quantitative and qualitative criteria are used. In addition, the sample volume may be evaluated in certain specimens. Summary: The reasons for an insufficient sample may vary and depend either on the lesion itself or the sampling...
2025
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Recommendations for optimizing cytology and small biopsy specimen processing for ancillary techniques by the American Society of Cytopathology taskforce: Reflection by European Federation of Cytological Societies
No abstract -
Cytological Features of Spindle Cell Lesions of the Head and Neck and Review of the Literature
CONCLUSION: FNA is a valuable, cost-effective tool for evaluating spindle cell lesions in the head and neck. While morphological overlap poses diagnostic limitations, ancillary techniques and molecular studies enhance its accuracy and clinical utility. -
Dr. Leena Krogerus: A Grand Old Lady of the Finnish Cytopathology and My Cytopathology Mum
The communication introduces former President of the Finnish Society of Clinical Cytology and organizer of the European Congress of Cytology in Rovaniemi, Dr. Leena Krogerus. She played an important role in the formation of my cytopathology career as she led my path in cytopathology education, research, and leadership. -
Hyperthyroidism-Related Epithelial Hyperplasia as a Potential Pitfall of Thyroid Cytology: Institutional Cytomorphological Analysis of Histologically Verified Cases
CONCLUSION: Fine-needle aspiration referrals with clinical data and thyroid function test results can facilitate the interpretation of cytomorphological features and reduce the use of undetermined categories in cases of hyperthyroidism-related epithelial hyperplasia. -
Special Issue: Quality Assurance/Quality Control in Cytopathology
No abstract -
Severity of Ascending Aortic Degeneration in Patients With Chronic Obstructive Pulmonary Disease
Background Ascending aortic dilatation is associated with increased susceptibility to aortic events. Chronic obstructive pulmonary disease (COPD) may add to tissue degeneration and inflammation associated with the risk of increased aortic dilatation. We studied the characteristics and aortic wall degeneration of patients with COPD during ascending aortic dilatation. Methodology We enrolled 35 consecutive patients who underwent elective surgery for ascending aortic dilatation between February... -
Microvascular over-dilation and hypoxia: a potential mechanism for pressure ulcer pathogenesis
No abstract -
Diabetes Mellitus Is Associated with Distinctive Aortic Wall Degeneration During Acute Type A Aortic Dissection
Background: Non-adjustable patient characteristics such as diabetes mellitus may influence surgical decision-making and outcome after acute type A aortic dissection (ATAAD). The aim of this study was to compare the degree of aortic wall atherosclerosis and surgical solutions in patients with diabetes mellitus versus those without during ATAAD. Methods: Altogether, 123 consecutive patients undergoing surgery for ATAAD at Tampere University Heart Hospital were evaluated. The ascending aortic wall... -
CMKLR-1 Expression in Human Aorta Is Dominated by Smooth Muscle Cell Positivity
Chemokine-like receptor 1 (CMKLR-1) is a G-protein-coupled receptor that functions as the binding site of chemerin. It induces chemotaxis in various immune cells, and it has recently been linked to vascular remodeling in inflammation. In this study, we investigated CMKLR-1 expression in human aorta samples, focusing on its distribution across different cell types and its potential association with clinical and histomorphological data, particularly concerning aortic dissection and aneurysms. We... -
Not Enough Cells: How Insufficient Cytological Specimens Are Mirrored by Reporting Systems - Journey from the Bethesda to the WHO Reporting Systems
Background: Pap classes have been replaced by organ-specific reporting systems in recent decades; however, part of the cytological specimens is insufficient. The present review summarizes how different organ-specific systems define the insufficient category: both quantitative and qualitative criteria are used. In addition, the sample volume may be evaluated in certain specimens. Summary: The reasons for an insufficient sample may vary and depend either on the lesion itself or the sampling...
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Increased angiogenesis and lymphangiogenesis in rheumatic mitral valves
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) create a global burden in the field of cardiovascular medicine due to significant morbidity and mortality, particularly in low- and middle-income countries and the underprivileged population. Sequential surgical specimens of mitral valves excised from 19 patients with moderate to marked rheumatic mitral stenosis were included in this study and compared to eight sequential surgical myxomatous degenerative valves (control). The study... -
The Milan System SUMP Category: 5-Year Diagnostic Performance
CONCLUSIONS: The 5-year analysis of SUMP category performance showed a lower ROM in our practice than the MSRSGC reference value. The oncocytic/oncocytoid subtype presented a higher ROM than the basaloid subtype. The ROMs were highest in the male population and in the age group of 30-69 years. -
Systematic Morphological Assesment of the Ascending Aorta Dissection: Application of Cardiovascular Pathology Consensus Statement in Tertiaty Care Hospital in Finland
This study investigated the distinguishing characteristics between acute type A aortic dissection (ATAAD) and aortic wall dilatation. Utilizing systematic histopathology criteria from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology consensus statement, the analysis focused on degeneration, atherosclerosis, and inflammation in patients undergoing surgery in a Finnish tertiary care hospital. The study included 156 patients, those undergoing... -
Warthin's Tumour Diagnostic Outcome in the Milan System Era and Cytomorphological Pitfalls
CONCLUSION: The MSRSGC is useful in WT diagnostics, and it improves communication between cytopathologists and clinicians. In this study, the most useful cytomorphological feature that led to accurate WT diagnoses was papillary architecture in cell block specimens and the most significant pitfall was necrosis followed by diffuse hypercellularity. -
InterobServer AgreeMent in Pd-l1 evaLuatIoN on cytoloGical samples-SAMPLING project: A multi-institutional, international study
CONCLUSIONS: The overall moderate agreement observed showed that there is still room for improvement in inter-pathologist agreement for PD-L1 evaluation on cytological samples, highlighting the need for standardization in sample preparation, focused training in PD-L1 evaluation on cytological material, and the integration of machine learning tools to improve interobserver consistency. -
Intimal sarcoma of the lower pulmonary vein diagnosed by Endobronchial Ultrasound-Guided Fine-Needle Aspiration (EBUS-FNA): A case report and comprehensive literature review
Intimal sarcoma of blood vessels is a rare, aggressive tumor originating from vascular endothelial cells. This report presents a 22-year-old male diagnosed with an intimal sarcoma of the lower pulmonary vein, detailing diagnosis, treatment, and prognosis information. Additionally, this report explores the application application of Endobronchial Ultrasound-Guided Fine-Needle Aspiration (EBUS-FNA) alongside with Rapid Remote Online Evaluation (ROLE) for identifying a mass-like lesion in the... -
The International System for Serous Fluid Cytopathology (TIS) survey in preparation for TIS 2.0
CONCLUSIONS: This survey examines acceptance of TIS and advice for future directions. -
Squamous Cells in Thyroid Cytology and Their Clinical Significance: A Multi-Institutional Study
CONCLUSION: Squamous cells in thyroid FNAs carry a broad differential diagnosis with variable prognoses. It is crucial to interpret squamous cells in the context of clinical and radiographic findings for optimal patient care. -
Interplay of atherosclerosis and medial degeneration in human ascending aorta
The previous understanding has been that atherosclerosis tends to increase distally from the ascending aorta, but recent studies and practical experience have indicated that atherosclerosis occurs in the ascending aorta more than previously thought. Medial degeneration is linked to aortic aneurysms, dissection and dilatation and has been related to increased mortality. There is a lack of data on the coexistence of atherosclerosis and medial degeneration in the ascending aorta and its outcome to... -
Practical Approach to Reporting Based on the International System for Serous Fluid Cytopathology
The International System for Serous Fluid Cytopathology (TIS) is intended for reporting cytological specimens from serous cavities: pleural, abdominal and pericardial cavities. TIS is being adopted into practice in cytology laboratories worldwide. In this system, there are six diagnostic categories: non-diagnostic, negative for malignancy, atypia of undetermined significance, suspicious for malignancy, malignant-primary and malignant-secondary. Malignant-primary category almost always implies...
2024
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The International System for Serous Fluid Cytopathology (TIS) survey in preparation for TIS 2.0
CONCLUSIONS: This survey examines acceptance of TIS and advice for future directions. -
Squamous Cells in Thyroid Cytology and Their Clinical Significance: A Multi-Institutional Study
CONCLUSION: Squamous cells in thyroid FNAs carry a broad differential diagnosis with variable prognoses. It is crucial to interpret squamous cells in the context of clinical and radiographic findings for optimal patient care. -
Interplay of atherosclerosis and medial degeneration in human ascending aorta
The previous understanding has been that atherosclerosis tends to increase distally from the ascending aorta, but recent studies and practical experience have indicated that atherosclerosis occurs in the ascending aorta more than previously thought. Medial degeneration is linked to aortic aneurysms, dissection and dilatation and has been related to increased mortality. There is a lack of data on the coexistence of atherosclerosis and medial degeneration in the ascending aorta and its outcome to... -
Practical Approach to Reporting Based on the International System for Serous Fluid Cytopathology
The International System for Serous Fluid Cytopathology (TIS) is intended for reporting cytological specimens from serous cavities: pleural, abdominal and pericardial cavities. TIS is being adopted into practice in cytology laboratories worldwide. In this system, there are six diagnostic categories: non-diagnostic, negative for malignancy, atypia of undetermined significance, suspicious for malignancy, malignant-primary and malignant-secondary. Malignant-primary category almost always implies... -
The proximal extension of acute type A aortic dissection is associated with ascending aortic wall degeneration
CONCLUSIONS: Histopathology of the ascending aorta during ATAAD reveals distinctive aortic wall degeneration in patients with aortic root involvement vs. not. The degree of mucoid extracellular matrix accumulation assessed postoperatively is associated with the choice of surgical procedure in many patients. -
Multi-Tissue Controls and Multiplex Immunocytochemistry in Pulmonary Cytology
CONCLUSION: Multiplex IHC/ICC emerges as a transformative force in biomedical diagnostics and research. Beyond simultaneous marker detection, it unravels complexities within tissues - unveiling co-localization nuances, deciphering expression patterns, and enhancing understanding of cellular populations. As personalized treatments gain prominence, the study emphasizes the heightened importance of diagnostic tools and sample adequacy. The present methodological study, encapsulating an automated... -
The Milan system atypia of undetermined significance: 5-year performance data
CONCLUSIONS: The results indicated higher percentages of AUS cases compared with the reference value, which may be attributed to the impact of the coronavirus disease 2019 pandemic. The risk of malignancy calculated in this study was closer to the reference value from the first edition of the Milan System for Reporting Salivary Gland Cytopathology compared with the second edition. -
The World Health Organization Reporting System for Lung Cytopathology-A Review of the First Edition
The World Health Organization Reporting System for Lung Cytopathology is the first international system that was developed to standardize the reporting of lung cytopathology specimens across all settings of cytopathology practice. The system is composed of five diagnostic categories, which apply to all lung cytopathology specimen types. Each category contains cytomorphologic criteria, an estimated risk of malignancy, and clinical management recommendations. International uniformity in the... -
BRAF mutation, selected miRNAs and genes expression in primary papillary thyroid carcinomas and local lymph node metastases
Mutations in cancer-related genes are now known to be accompanied by epigenetic events in carcinogenesis by modification of the regulatory pathways and expression of genes involved in the pathobiology. Such cancer-related mutations, miRNAs and gene expression may be promising molecular markers of the most common papillary thyroid carcinoma (PTC). However, there are limited data on their relationships. The aim of this study was to analyse the interactions between BRAF mutations, selected... -
Segmental arterial mediolysis leading to spontaneous rupture of splenic artery and fatal hemorrhage in pregnancy
We report an unexpected death of a 22-year-old primigravida who was admitted to the hospital with sudden abdominal pain two days before a scheduled delivery. During an emergency caesarean section due to intrauterine asphyxia, intraabdominal bleeding was observed with no apparent source of bleeding. Newly formed blood clots in the subdiaphragmatic space and arterial bleeding near the splenic hilum required a surgery on the next day. Hemorrhagic shock led to multiple organ failure on the fourth... -
The 1000 Mitoses Project: A Consensus-Based International Collaborative Study on Mitotic Figures Classification
Introduction. The identification of mitotic figures is essential for the diagnosis, grading, and classification of various different tumors. Despite its importance, there is a paucity of literature reporting the consistency in interpreting mitotic figures among pathologists. This study leverages publicly accessible datasets and social media to recruit an international group of pathologists to score an image database of more than 1000 mitotic figures collectively. Materials and Methods.... -
How the Milan System for Reporting Salivary Gland Cytopathology works in cytopathology practice: Meta-analysis of prospective studies and comparison with retrospective studies
CONCLUSIONS: This meta-analysis indicated that the MSRSGC works well in FNA cytopathology practice and improves diagnostic accuracy in all diagnostic categories. The ROMs of prospective studies were in concordance with the MSRSGC reference values. -
The autonomic nerves around the vein of Marshall: a postmortem study with clinical implications
This study aims to analyze the vein of Marshall (VOM) in human autopsy hearts and its correlation with clinical data to elucidate the morphological substrates of atrial fibrillation (AF) and other cardiac diseases. Twenty-three adult autopsy hearts were studied, assessing autonomic nerves by immunohistochemistry with tyrosine hydroxylase (sympathetic nerves), choline acetyltransferase (parasympathetic nerves), growth-associated protein 43 (neural growth), and S100 (general neural marker)... -
Updates in head and neck cytopathology: Insights from European Congress of Pathology Short Course
Cytological specimens play a pivotal role in head and neck nodule/mass work up and diagnoses. The specimens´ importance has grown with the onset of personalized medicine and the routine use of molecular markers in the diagnostic work up. The Updates in Head and Neck Cytopathology Short Course ran during the 35th European Congress of Pathology held in Dublin, Ireland, in 2023 and brought together experts in cytopathology, pathology, and related fields to share their expertise and experience in... -
Insufficient endobronchial ultrasound-guided transbronchial needle aspiration specimens. When and why? The analysis of criteria and reasons behind the insufficient specimens
CONCLUSION: Insufficient EBUS-TBNA samples raise challenges in diagnosis and management. This study identified the root cause of insufficient samples, including factors related to humans, diagnostic methods, sampling, and laboratory processing. By understanding the root causes, diagnostic recommendations can be developed to improve the diagnostic process. The findings emphasize the importance of standardized classification and terminology systems for clear communication among healthcare... -
Aortic elastic fiber degeneration during acute type a aortic dissection and reverse aortic remodeling
CONCLUSIONS: According to this exploratory study, histopathology reveals distinctive aortic wall degeneration during ATAAD. Reverse aortic remodeling after ATAAD is associated with the presence of ascending aortic wall elastic fiber fragmentation, loss and disorganization during ATAAD. -
Cell block practices in European cytopathology laboratories
CONCLUSIONS: There is a great variability in CB practices in European laboratories with low cellular CBs as the main issue. Additional studies are mandatory to evaluate and improve performance and cellular yield of CBs. -
Histopathology reveals concealed aortic valve inflammation
CONCLUSIONS: Aortic valve tissue analysis reveals severe inflammation that may require postoperative treatment. The association of severe but local aortic valve inflammation with patient outcome after aortic valve surgery merits further investigation. -
Detailed study of collagen, vasculature, and innervation in the human cardiac conduction system
CONCLUSIONS: Our results provide new insights into the unique morphology of the human CCS collagen, fat, vasculature, and innervation. A deeper understanding of the CCS anatomical components and morphologic substrates' role will help in elucidating the causes of cardiac arrhythmias and provide a basis for further therapeutic interventions. -
Myth-Busting the Zone-of-Injury Concept: A Prospective Study on the Vascular Response to High-Energy Lower Extremity Trauma
CONCLUSIONS: These findings support the validity of the zone-of-injury concept by providing a novel histologic basis for this phenomenon. Intimal thickening and arterial intimal fibrosis are prominent histologic features of vessels affected by major lower extremity trauma.
2023
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Kari J. Syrjänen, MD, PhD, FIAC: A Tribute to Our Editor on His 75th Birthday
No abstract -
Detailed study of collagen, vasculature, and innervation in the human cardiac conduction system
CONCLUSIONS: Our results provide new insights into the unique morphology of the human CCS collagen, fat, vasculature, and innervation. A deeper understanding of the CCS anatomical components and morphologic substrates' role will help in elucidating the causes of cardiac arrhythmias and provide a basis for further therapeutic interventions. -
Myth-Busting the Zone-of-Injury Concept: A Prospective Study on the Vascular Response to High-Energy Lower Extremity Trauma
CONCLUSIONS: These findings support the validity of the zone-of-injury concept by providing a novel histologic basis for this phenomenon. Intimal thickening and arterial intimal fibrosis are prominent histologic features of vessels affected by major lower extremity trauma. -
False-Positive Atypical Endocervical Cells in Conventional Pap Smears: Cyto-Histological Correlation and Analysis
CONCLUSION: Additional methods besides cytomorphology are required to reliably distinguish smears with AEC, NOS harbouring only benign histological changes from those exhibiting endocervical glandular malignancy. -
Atypical urothelial cells classified according to the Paris System for Reporting Urinary Cytology: A 2-year experience with histological correlation from a Finnish tertiary care center-low rate and high risk of malignancy
CONCLUSIONS: The performance of 5.5% AUC cases is considered good and within the limits proposed by TPS. TPS is widely accepted by cytotechnologists, cytopathologists, and clinicians; it improves communication and patient management. -
A brief review of the WHO reporting system for lung cytopathology
The International Academy of Cytology has joined with the International Agency for Research on Cancer to bring together a group of experts in lung cytopathology to develop a WHO Reporting System for Lung Cytopathology (WHO System). This System aims to improve and standardize the reporting of cytopathology, facilitate communication between cytopathologists and clinicians, and improve patient care. The WHO System describes 5 categories for reporting lung cytopathology:... -
Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study
BACKGROUND: Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours. -
Ectopic thyroid in EBUS: experience from a quality assurance programme
A diagnostic challenge is presented: Distinguishing ectopic thyroid tissue from metastatic well-differentiated follicular carcinoma in cytological material. Two cases of thyroid tissue in mediastinal lymph nodes were sampled by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Later, the cases were presented in Labquality's nongynecological external quality scheme rounds in the years 2017, 2019, and 2020. The same case was presented two times, both in the 2017 and in... -
Comments to: Nationwide differences in cytology fixation and processing methods and their impact on interlaboratory variation in PD-L1 positivity
No abstract -
The diagnostic accuracy of pleomorphic adenoma in fine needle aspiration: Features leading to false positive and false negative diagnoses and the utility of cell blocks
CONCLUSION: The present study showed diagnostic accuracy of 96.5% for FNA in PA diagnosis. Sensitivity, specificity, positive predictive value and negative predictive value were 94.4%, 98.2%, 97.7%, and 95.6%, respectively. The benefit of CBs was more evident in true-positive cases (85%). -
The World Health Organization Reporting System for Lung Cytopathology
The International Academy of Cytology has joined with the International Agency for Research on Cancer (IARC) to bring together a group of experts in lung cytopathology to develop a WHO Reporting System for Lung Cytopathology (WHO System). This WHO System defines five categories for reporting lung cytopathology, that is, "Insufficient"/"Inadequate"/"Non-diagnostic," "Benign," "Atypical," "Suspicious for malignancy," and "Malignant," each with a clear descriptive term for the category, a...
2022
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The World Health Organization Reporting System for Lung Cytopathology
The International Academy of Cytology has joined with the International Agency for Research on Cancer (IARC) to bring together a group of experts in lung cytopathology to develop a WHO Reporting System for Lung Cytopathology (WHO System). This WHO System defines five categories for reporting lung cytopathology, that is, "Insufficient"/"Inadequate"/"Non-diagnostic," "Benign," "Atypical," "Suspicious for malignancy," and "Malignant," each with a clear descriptive term for the category, a... -
Human Pulmonary Vein Myocardial Sleeve Autonomic Neural Density and Cardiovascular Mortality
Myocardial sleeves around pulmonary veins (PVs) are highly innervated structures with heterogeneous morphological and electrophysiological characteristics. Autonomic nerve dysfunction in the myocardium may be associated with an increased risk of cardiovascular morbidity and mortality. This article studied autonomic neural remodeling in myocardial sleeves around PVs and atrial-PV ostia with immunohistochemical and morphometric methods with clinicopathological correlations. PVs were collected from... -
Cytohistological findings in HPV-negative cases from HPV primary screening programme: quality assurance study
To evaluate the risk of false HPV-negative results and possible related morphological abnormalities in HPV primary cervical cancer screening. Out of 53,661 HPV-negative cases, 5469 (10.2%) randomly selected cytology slides were evaluated as a part of the quality assurance protocol. The Bethesda category negative for intraepithelial lesion or malignancy (NILM) in the HPV-negative cases given was present in 95.4%. Due to cytology other than NILM, 0.4% of cases were referred to colposcopy and 4.2%...
2021
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INSM1, a Novel Biomarker for Detection of Neuroendocrine Neoplasms: Cytopathologists' View
Insulinoma-associated protein 1 (INSM1) has been considered as a novel immunostain for neuroendocrine tumors (NETs) and is hypothesized to be more reliable than first-generation NET biomarkers, such as CGA (chromogranin A), SYP (synaptophysin) and CD56 (neural cell adhesion molecule). In this review, we summarize existing literature on INSM1's reliability as an immunostain for detection of various NETs, its results in comparison to first-generation NET biomarkers, and its expression in both... -
Detection and Outcome of Endocervical Atypia in Cytology in Primary HPV Screening Programme
Most endocervical adenocarcinomas (EAC) are associated with high-risk HPV (hrHPV) infection, with HPV genotypes 16, 18 and 45 accounting for >90% of the cases. Among endocervical glandular lesions, screening with hrHPV test has previously shown to predict the outcome better than cytology, although around one-fifth of the EAC remain negative both in hrHPV testing and cytology. The study consists of two consecutive HPV-primary screening rounds, conducted in 2012-2015 and 2017-2020. Of the 87 women... -
Code of practice for medical autopsies: a minimum standard position paper for pathology departments performing medical (hospital) autopsies in adults
The medical autopsy (also called hospital or clinical autopsy) is a highly specialised medical procedure, which requires professional expertise and suitably equipped facilities. To ensure high standards of performance, the Working Group of Autopsy Pathology of the European Society of Pathology (ESP) suggests a code of practice as a minimum standard for centres performing medical autopsies. The proposed standards exclusively address autopsies in adults, and not forensic autopsies, perinatal/or... -
Non-Invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features Is Not a Cytological Diagnosis, but It Influences Cytological Diagnosis Outcomes: A Systematic Review and Meta-Analysis
CONCLUSIONS: Based on our results, NIFTP remains a histological diagnosis. Although cytomorphological features cannot be used in differentiating NIFTP from FVPTC, they may guide in separating NIFTP from PTC. Features such as papillae, microfollicles, giant cells, psammoma bodies, and the amount of papillary-like nuclear features should be taken into account when suspicious of NIFTP. NIFTP should not have papillae or psammoma bodies, and giant cells were rarely observed. -
The Contributory Role of Cell Blocks in Salivary Gland Neoplasms Fine Needle Aspirations Classified by the Milan System for Reporting Salivary Gland Cytology
(1) Background: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced in 2018, bringing an organ-specific classification system for salivary gland cytopathology. The aim of present study is to evaluate the MSRSGC prospectively, based on a two-year experience in the tertiary care center pathology department, and evaluate the role of routine cell block (CB) preparation in salivary gland cytopathological diagnostics. (2) Methods: In our institution, the Department of... -
Follicular Epithelial Dysplasia as Hashimoto Thyroiditis-Related Atypia: a Series of 91 Specimens
Follicular epithelial dysplasia (FED) is described as Hashimoto thyroiditis-related atypia and is thought to be a possible precancerous lesion. Dysplasia as an interface between normal state and carcinoma is described in a wide range of diseases and carcinogenesis chains. On the other hand, inflammation-related atypia and cancerogenesis is also widely studied. In this study, we retrospectively analyzed 91 specimens of thyroid gland surgical resections with FED during a 10-year-period at the... -
The Role of Cell Blocks and Immunohistochemistry in Thyroid Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance Bethesda Category
CONCLUSION: In conclusion, CB cellularity is essential for successful immunohistochemistry application and further diagnostic workup of AUS/FLUS cases. -
The role of Pap smear in the diagnostics of endocervical adenocarcinoma
In the high-income countries, the amount of cervical adenocarcinomas is on the rise. The pap smear sampling has a low sensitivity and a low specificity for endocervical malignancies, and there are only a few cytomorphological features, that are specifically associated with glandular atypia. In this study, 298 pap smears of 60 patients with endocervical adenocarcinoma or adenocarcinoma in situ (AIS) and 30 patients with high-grade intraepithelial lesion (HSIL) in histology were reviewed. The pap... -
Autopsy examination in sudden cardiac death: a current perspective on behalf of the Association for European Cardiovascular Pathology
In sudden cardiac death, an autopsy is an essential step in establishing a diagnosis of inherited cardiac disease and identifying families that require cardiac screening. To evaluate aspects of post-mortem practice in Europe, a questionnaire was designed and circulated to both clinical and forensic pathologists. There was a 48% response rate and information was obtained from 17 countries. The results showed a wide variety in the management of sudden cardiac death, with a general tendency towards... -
Primary HPV screening for cervical cancer: Results after two screening rounds in a regional screening program in Finland
CONCLUSIONS: In the setting of routine organized cervical cancer screening, the initially high colposcopy rate associated with primary HPV screening seems to level off at the second screening round in women who were screened twice with an hrHPV test. -
FNA diagnostics of secondary malignancies in the salivary gland: Bi-institutional experience of 36 cases
CONCLUSIONS: FNA is a reliable technique in the diagnosis of salivary gland secondary malignancies. The knowledge of the personal history of malignancy is essential for the successful immunocytochemical targeted diagnosis without any delay. -
Assessing the diagnostic accuracy for pleomorphic adenoma and Warthin tumor by employing the Milan System for Reporting Salivary Gland Cytopathology: An international, multi-institutional study
CONCLUSIONS: The diagnostic accuracy for PA and WT on FNA is high. Furthermore, these findings highlight the difference in the ROMs associated with 2 specific differential diagnoses in the SUMP category: basaloid neoplasms and oncocytoid neoplasms.
2020
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Ascending aortic estrogen receptor positivity and aortic valve stenosis
No abstract -
Autopsy examination in sudden cardiac death: a current perspective on behalf of the Association for European Cardiovascular Pathology
In sudden cardiac death, an autopsy is an essential step in establishing a diagnosis of inherited cardiac disease and identifying families that require cardiac screening. To evaluate aspects of post-mortem practice in Europe, a questionnaire was designed and circulated to both clinical and forensic pathologists. There was a 48% response rate and information was obtained from 17 countries. The results showed a wide variety in the management of sudden cardiac death, with a general tendency towards... -
Global impact of the COVID-19 pandemic on cytopathology practice: Results from an international survey of laboratories in 23 countries
CONCLUSIONS: The COVID-19 pandemic resulted in a drastic reduction in the total number of cytology specimens regardless of anatomic site or specimen type. The rate of malignancy increased, reflecting the prioritization of patients with cancer who were considered to be at high risk. Prospective monitoring of the effect of delays in access to health services during the lockdown period is warranted. -
Primary HPV screening for cervical cancer: Results after two screening rounds in a regional screening program in Finland
CONCLUSIONS: In the setting of routine organized cervical cancer screening, the initially high colposcopy rate associated with primary HPV screening seems to level off at the second screening round in women who were screened twice with an hrHPV test. -
FNA diagnostics of secondary malignancies in the salivary gland: Bi-institutional experience of 36 cases
CONCLUSIONS: FNA is a reliable technique in the diagnosis of salivary gland secondary malignancies. The knowledge of the personal history of malignancy is essential for the successful immunocytochemical targeted diagnosis without any delay. -
Multifunctional Roles of miR-34a in Cancer: A Review with the Emphasis on Head and Neck Squamous Cell Carcinoma and Thyroid Cancer with Clinical Implications
MiR-34a belongs to the class of small non-coding regulatory RNAs and functions as a tumor suppressor. Under physiological conditions, miR-34a has an inhibitory effect on all processes related to cell proliferation by targeting many proto-oncogenes and silencing them on the post-transcriptional level. However, deregulation of miR-34a was shown to play important roles in tumorigenesis and processes associated with cancer progression, such as tumor-associated epithelial-mesenchymal transition,... -
Reply to letter to the editor "The role of fine-needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls"
No abstract -
Assessing the diagnostic accuracy for pleomorphic adenoma and Warthin tumor by employing the Milan System for Reporting Salivary Gland Cytopathology: An international, multi-institutional study
CONCLUSIONS: The diagnostic accuracy for PA and WT on FNA is high. Furthermore, these findings highlight the difference in the ROMs associated with 2 specific differential diagnoses in the SUMP category: basaloid neoplasms and oncocytoid neoplasms. -
IgG4-positive plasma cells in Hashimoto thyroiditis: IgG4-related disease or inflammation-related IgG4-positivity?
Despite the interest of researchers in IgG4-related disease (IgG4-RD), many questions still remain unanswered regarding the thyroid gland. We aimed to clarify the relationship between IgG4-positive plasma cells and the histopathological pattern in the Hashimoto thyroiditis (HT) in a Finnish series. HT specimens (n = 280) were retrieved from the Department of Pathology, Fimlab Laboratories. After re-evaluation, 82 (29%) cases (72 females and 10 males, 52 ± 17 years) with significant fibrosis were... -
Insulinoma-associated protein 1 (INSM-1) expression in medullary thyroid carcinoma FNA: a multi-institutional study
CONCLUSIONS: INSM-1 nuclear positivity is a reliable marker of MTC neuroendocrine differentiation on cytology material from both primary tumor and metastases. INSM-1 can also discriminate MTC from other primary and secondary thyroid carcinomas when there are cytomorphologic overlaps. -
The role of fine-needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls
CONCLUSION: Our results confirm the significant role of FNAB in the diagnostic algorithm of parotid gland lesions. -
Combined use of galectin-3 and thyroid peroxidase improves the differential diagnosis of thyroid tumors
The differential diagnosis of well-differentiated tumors of follicular cell origin remains the most problematic task in thyroid pathology. Specific morphologic criteria (capsular and/or vascular invasion, nuclear characteristics) are crucial in the diagnosis of these neoplasms. However, the assessment of malignant features is inconclusive in some cases. Moreover, oncocytic thyroid tumors remain controversial in a respect to their pathobiology, behavior and management. Therefore, the useful... -
Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification
Ischemic heart disease is one of the leading causes of morbidity and death worldwide. Consequently, myocardial infarctions are often encountered in clinical and forensic autopsies, and diagnosis can be challenging, especially in the absence of an acute coronary occlusion. Precise histopathological identification and timing of myocardial infarction in humans often remains uncertain while it can be of crucial importance, especially in a forensic setting when third person involvement or medical... -
New Cell Block Method to Enhance the Cellular Yield in Mucous and/or Bloody Samples
CONCLUSIONS: The newly described method showed a better cellular yield in mucous and/or bloody cytological specimens.