Reliability of assessing morphologic features with prognostic significance in cytology specimens of epithelioid diffuse pleural mesothelioma and implications for cytopathology reporting Journal Article

   

Authors:	Li, Y.; Salama, A. M.; Baine, M. K.; Bodd, F. M.; Offin, M. D.; Rekhtman, N.; Zauderer, M. G.; Travis, W. D.; Adusumilli, P. S.; Sauter, J. L.
Article Title:	Reliability of assessing morphologic features with prognostic significance in cytology specimens of epithelioid diffuse pleural mesothelioma and implications for cytopathology reporting
Abstract:	Background: The World Health Organization incorporates morphologic features with prognostic significance in the 2021 classification of epithelioid diffuse pleural mesothelioma (E-DPM). Although cytology specimens are often the first and occasionally the only specimen available for patients with DPM, these features have not yet been investigated in cytology. Methods: Nuclear atypia, pleomorphic features, necrosis, and architectural patterns were retrospectively assessed in 35 paired cytology and concurrent/consecutive surgical pathology specimens of E-DPM. Agreement between pairs was determined via unweighted κ scores. Discordant cases were re-reviewed to determine the reasons for disagreement. Results: Interpretation of nuclear atypia in cytology was concordant with histology in all cases (κ = 1.000; p <.001). The presence of pleomorphic features and necrosis was concordant in 97.1% (κ = 0.842; p <.001) and 85.7% (κ = 0.481; p =.001) of paired cases, respectively. Assessment of architectural patterns in cytology showed only slight agreement with histology (κ = 0.127; p =.037). In cytology cases (n = 23) with cell block material available, assessment of nuclear atypia and the presence of pleomorphic features showed perfect agreement (κ = 1.000; p <.001, each), the presence of necrosis showed moderate agreement (κ = 0.465; p =.008), and assessment of architectural patterns showed slight agreement (κ = 0.162; p =.15) in paired specimens. Most disagreements were due to sampling differences between cytology and histology specimens. Conclusions: Although complete nuclear grading of E-DPM is not possible given the unreliability of mitotic counts in cytology, assessment of nuclear atypia in cytology specimens is shown to be reliable. Identification of pleomorphic features and necrosis is also reliable despite occasional sampling issues. Assessment of architectural patterns is more limited in cytology. © 2023 American Cancer Society.
Keywords:	adult; clinical article; controlled study; human tissue; aged; retrospective studies; human cell; histopathology; reproducibility; reproducibility of results; cytology; cohort analysis; pathology; retrospective study; necrosis; correlation analysis; scoring system; malignant mesothelioma; pleura mesothelioma; mesothelioma; pleura tumor; cell nucleus; cancer tissue; pleural neoplasms; cytopathology; sampling; epithelioid mesothelioma; pleomorphic; nuclear atypia; cancer prognosis; humans; prognosis; human; male; female; article; mesothelioma, malignant; diffuse pleural mesothelioma; epithelioid diffuse pleural mesothelioma
Journal Title:	Cancer Cytopathology
Volume:	131
Issue:	8
ISSN:	1934-662X
Publisher:	John Wiley & Sons
Date Published:	2023-08-01
Start Page:	495
End Page:	506
Language:	English
DOI:	10.1002/cncy.22705
PUBMED:	37127928
PROVIDER:	scopus
PMCID:	PMC11037265
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85158010629&doi=10.1002%2fcncy.22705&partnerID=40&md5=f4398bcc949242c780a087bfa58bd450
Notes:	The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Jennifer L. Sauter -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/208871