A summary of the XIII Molecular Cytopathology Congress

9-10 December, 2024 – Naples, Italy

Dear reader,

In its 13th edition, in December 2024 and under the direction of Dr. Giancarlo Troncone, Head of the Department of Public Health, University of Naples Federico II, The Congress of Molecular Cytopathology was held for the first time in a majestic and imposing venue “Church of Saints Marcellinus and Festo”.

The convent building is the result of the union of two neighboring Basilian monasteries dating back to the early Middle Ages. With a Baroque architectural style, it has no waste and every angle is worthy of admiration. From the facade designed by Di Conforto and D’Apuzzo, at the beginning of the 17th century, passing through the dome of the Di Conforto, concluded in 1645, and the interior with a Latin cross plan, a single nave and six side chapels decorated with polychrome marble and carved wood.

This international event, besides being a product of collaboration between cytopathologists from Europe and the United States, provides the opportunity to share and exchange experiences and to learn from the path that others have already passed.

Cytology molecular techniques and testing have rapidly evolved over the years, not only for predictive or prognostic purposes but also for treatment. Due to this, molecular testing must be included in our routine daily practice in which the convergence of a multidisciplinary team (cytopathologists, clinicians: pneumologists, endocrinologists, oncologists, radiologists, among others, as well as technical personnel and molecular biologists), is also essential to obtain adequate and optimal results.

Small specimens are increasingly used for diagnostic and predictive biomarker testing. There is a wide variability in the sampling modality based not only in the clinical presentation and in the access ‘way to the lesion, but also on the infrastructure, logistic and financial particularities of each laboratory. Being the expertise of the clinicians and the cytotechnologists or cytopathologists to evaluate and judicious monetize the sample in the most effective and efficient way possible, an important factor.

Another particularity of this meeting has been the emphasis on the need to homogenize our nomenclatures and reporting systems. To establish quality criteria in all phases of the process, being the pre-analytical phase the one that has more impact on the results with entirely dedicated sessions to acquisition, handling/processing and storage (collection/ transport’s media and fixation) of samples in order to ensure nucleic acids’ preservation.

I n our daily practice, samples are subject to several uncontrolled, unknown and undocumented factors that may alter their molecular quality and composition and therefore the results. As for today, there are currently no requirements to control or record pre-analytical variables nor international guides to follow.

There is a need to properly evaluate sample processing and develop standardize recommendations for optimizing pre-analytical variables and ancillary testing in order to assure the quality and reliability of the analysis avoiding skew data.

This last congress edition, was mainly focused in two organs, thyroid and lung, it was structured in 9 sessions, distributed in two days, full of information, bibliography, experiences, new educational resources among many other things, providing an opportunity to obtain the necessary tools to improve the outcome for cancer patients worldwide based on a better pathology and molecular diagnosis.

With its very particular microphone, icon of the event, we are looking forward to the next edition later this year.

Cioly Rivero Colmenarez, MD, MIAC.

EFCS Residents and Young Cytopathologists Committee Co-chair.

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Case of the Month

A 79-year-old male presented with a peri-rectal tumour measuring 20×16 mm without any additional clinical data. Endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA) of the tumour was performed. The sample was stored in the cell medium and cytospins were prepared.

QUESTIONS

  1. Describe what you see.
  2. What does it represent?
  3. What is its significance?
Fig. 1. May-Grunwald-Giemsa stain (MGG), x200
May-Grunwald-Giemsa stain (MGG), x400
Fig. 3.May-Grunwald-Giemsa stain (MGG), x400
Fig. 4. Papanicolaou stain (PAP), x400

Fig. 5. Papanicolaou stain (PAP), x600

Fig. 6. Immunocytochemical reaction (ICC) PAX8, x400

Fig. 7. Immunocytochemical reaction (ICC) GATA3, x400

Fig. 8. Immunocytochemical reaction (ICC) CK5.6, x400

Fig. 9. Immunocytochemical reaction (ICC) CK7, x400

ANSWERS

a)

  • predominantly dissociated cells forming discrete, small, poorly cohesive clusters
  • moderately abundant, dense cytoplasm, focal coarse golden-brown pigment (Papanicolaou stain)
  • oval and round nuclei, pronounced anisonucleosis, nuclear hyperchromasia, nucleoli
  • abundant, thick proteinaceous material, sperms with long tails in the background

b) The cytomorphological picture and positive PAX8, GATA3, CK7, CK5.6 results and negative NKX3.1 and SATB2 immunocytochemical reactions were consistent with the diagnosis of a seminal vesicle.

c) Imaging studies prior to EUS-FNA showed that the most likely diagnosis was a peri-rectal soft tissue tumour. When a neoplastic process is suspected, and the epithelioid cell atypia is so pronounced, the differential diagnosis should include carcinoma, e.g., primary colon cancer, but also carcinoma arising from the surrounding organs, e.g., prostate, bladder, and kidney. The immunocytochemical reactions performed certainly excluded metastases of primary colon cancer and prostate cancer but not kidney or bladder cancer. While the cells were quite atypical, the presence of spermatozoa in the background of the sample, in combination with the coarse-grained golden-brown pigment (lipofuscin) in the cytoplasm were the key to the correct diagnosis.

Comment:

The EUS-FNA diagnosis of seminal vesicle raised the question of whether the sample was diagnostic, so comparison with the results of imaging studies was essential. In our case, after re-evaluation of the imaging studies, it was concluded that the peri-rectal lesion was a seminal vesicle because the imaging studies showed an association with the prostate.

Seminal vesicle sampling is infrequent in contemporary cytopathological practice. It may occur in patients with a history of previous abdominoperineal pelvic surgery or colorectal surgery because the seminal vesicles may be displaced posteriorly after abdominoperineal resection, giving the false appearance of a peri-rectal mass on radiologic imaging. However, our patient had no information about any previous surgeries, but this does not exclude them. The cytomorphology corresponding to the seminal vesicle may be very similar to residual colon adenocarcinoma after neoadjuvant chemoradiotherapy and resection. However, a negative SATB2 immunocytochemistry and a positive CK7 immunocytochemistry in combination with the cytomorphological picture can exclude the possibility of a primary colon adenocarcinoma.

Satturwar S, Monaco SE, Xing J, Brand RE, Pantanowitz L. Bizarre benign cells in peri-rectal endoscopic ultrasound-guided fine-needle aspiration due to seminal vesicle sampling. Diagn cytopathol. 2020;48(6):586-8.

Liaquat S, Idowu MO, Hatfield BS. Seminal vesicle adherent to rectal wall following neoadjuvant chemoradiotherapy: a potential false-positive diagnostic pitfall. Int J Surg Pathol. 2020;28(4):406-9.

Clinical case and pictures provided by:

Damjana Cimerman,

YEFCS co-chair

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A Glimpse into the #IACcongress 2025: Embrace the Future of Cytology | 11 – 15 May 2025, Florence, Italy

Dear colleagues and friends,

As we approach the 22nd International Congress of Cytology (#IACcongress) in
Florence
, it is mygreat pleasure to extend a warm welcome to all cytopathologists,
cytologists, cytotechnologists, pathologists, researchers and allied health professionals
from around the globe. From May 11th to 15th, 2025, we will converge to celebrate the
latest advancements, share cutting-edge research, and foster collaborations that will
shape the future of cytology.

Our program is rich and diverse. Leading experts from all continents will share their
knowledge and experience, ensuring the representation of perspectives from every
corner of the cytopathology and cytology landscape. This diversity is a cornerstone of
the IAC’s mission, and it ensures that we learn from and inspire one another, no matter
where and how long we practice.

Scientific Highlights

The Congress will cover an impressive range of topics, ensuring there is something for
everyone, whether you’re just starting your journey in cytology or looking to explore
cutting-edge advancements. Key themes include:

• Updates in the WHO Reporting Systems for Cytopathology
• The Evolution of Cytology: A Historical Journey through the International

Academy of Cytology
• Insights into the application of Artificial Intelligence (AI) in cytology
• Groundbreaking discussions on Liquid Biopsy and molecular techniques.
• Core topics in diagnostic cytology, from head and neck lesions to gynaecological cytology.

Interactive and Engaging Activities

Whether you’re a seasoned expert or a budding enthusiast, there will be ample
opportunities to expand your knowledge, exchange ideas, and network with peers.

The #IACcongress features an exciting lineup of keynotes, workshops and seminars, such as:

• Whole-slide imaging with AI-powered Analysis
• Workshops on Thyroid Cytopathology, focusing on the Bethesda classification system and real-world diagnostic challenges.
• Digital Cytology for Non-Gynaecological Specimens
• Cytology Preanalytics and Digital Pathology
• Liquid-based Cytology
• Interventional Cytopathology
• HPV and Cervical Cancer Screening Programs

These sessions will allow participants to engage directly with cases, tools, and experts,
bridging theory and practice in a collaborative setting.

Support for Young Cytologists

Recognizing the importance of nurturing future leaders, the IAC Foundation offered
grants to support participation, making it easier for young professionals to access this
invaluable experience.

Why Florence?

The beautiful city of Florence offers a perfect setting for reflection and inspiration,
blending historic charm and modern vitality. It is a fitting venue for a Congress that
bridges our field’s illustrious history with its promising future.

Whether you are passionate about advancing your diagnostic skills, exploring new
technologies, or connecting with the international cytopathology and cytology family,
#IACcongress 2025 is the place to be. I encourage you to take advantage of this unique
opportunity to learn, grow, and contribute to the vibrant global cytopathology
community.

Join us in Florence as we embark on a transformative journey in our field. Together, let us
chart new frontiers, ignite innovation, and pave the way for a brighter future in
cytopathology and cytology.

Warm regards,

Fernando Schmitt, MD, PhD, FIAC

President, International Academy of Cytology
President, 22nd International Congress of Cytology

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