Diagnostic utility of ThinPrep Imaging System® for detecting atypical glandular cells in cervical smear samples.

INTRODUCTION: The ThinPrep Imaging System® (TIS) is an automated system that has now been used for over 20 years in the primary screening of ThinPrep liquid-based cervical samples. Although there are a lot of publications about the diagnostic utility of this method in squamous cell lesions, which has advantages such as time-saving and standardization, there are only a few publications on this issue in glandular cell lesions in the literature. We aimed in this study to investigate the diagnostic utility of the system in the detection of premalignant and malignant glandular lesions in cervical smears. MATERIAL AND METHOD: Our study was conducted retrospectively, and a total of 126 cervical smear samples between 2010 and 2022 that have histological confirmation of endometrial adenocarcinoma (EAC), endocervical adenocarcinoma (ECAC), or adenocarcinoma in situ (AIS), were included. These samples were re-evaluated by manual and TIS by two experienced pathologists, and the results were compared in terms of sensitivity. RESULTS: We found out that 70 of the 126 smear samples have atypical glandular cells. We detect 48 cases (48/70) (sensitivity 68.5%) in manual examination, however TIS successfully determined 66 cases (66/70) (sensitivity 94.3%). In 4 cases (5.7%) TIS could not detect the atypical cells within the 22 areas. CONCLUSION: TIS is quite an effective method with a high sensitivity for detecting atypical glandular cells in cervical smears, like detecting squamous cell anomalies. Imposing this system in our laboratory and using them appropriately, save us time and help to ensure standardization. Additionally, it may be a good way to adopt artificial intelligence and digital pathology in today's world.

An extremely rare case of thyroid malignancy from the non-Alpine region: Angiosarcoma.

INTRODUCTION: Thyroid angiosarcoma is a rather rare malignancy featuring a poor prognosis, and which may interfere with other aggressive thyroid tumors; it is usually seen in the Alpine region. CASE PRESENTATION: A 74-year-old male was referred to our center with complaints of progressive neck swelling and dyspnea. He had multiple nodules featuring cystic degeneration and calcifications in the thyroid gland, together with multiple lymphadenopathies of the neck region. Fine-needle aspiration cytology (FNAC) confirmed the presence of anaplastic carcinoma. A total thyroidectomy was performed. During the postoperative period, multiple drainage were performed for recurrent hematomas, but hematoma development could not be prevented. On postoperative day 7, the patient died due to multiple-system failure. Histopathological investigation of the thyroidectomy specimen indicated that the lesion was an angiosarcoma. DISCUSSION: The cytological diagnosis of thyroid angiosarcoma is quite difficult. Extracapsular invasion and distant organ metastasis during surgery are known as strong and negative prognostic factors for thyroid angiosarcoma. Treatment is quite difficult, since this tumor is locally aggressive, destructive, and features a high recurrence rate. In this case, since extracapsular invasion, as well as lymph node and lung metastasis were present at the time of surgery; the expected survival time was quite short. CONCLUSION: This case shows that during differential diagnosis, patients initially diagnosed with anaplastic carcinoma via FNAC may actually present with angiosarcoma. It may be helpful to review the treatment modalities for this cancer type, which has a rather poor prognosis and features severe bleeding, as well as local and distant metastasis.