IntroductionThis study aimed to discuss smartphone usage in telecytology and determine intraobserver concordance between microscopic cytopathological diagnoses and diagnoses derived via static smartphone images.MethodsThe study was conducted with 172 cytologic material. A pathologist captured static images of the cytology slides from the ocular lens of a microscope using a smartphone. The images were transferred via WhatsApp® to a cytopathologist working in another center who made all the microscopic cytopathological diagnoses 5‐27 months ago. The cytopathologist diagnosed images on a smartphone without knowledge of their previous microscopic diagnoses. The Kappa agreement between microscopic cytopathological diagnoses and smartphone image diagnoses was determined.ResultsThe average image capturing, transfer, and remote cytopathological diagnostic time for one case was 6.20 minutes. The percentage of cases whose microscopic and smartphone image diagnoses were concordant was 84.30%, and the percentage of those whose diagnoses were discordant was 15.69%. The highest Kappa agreement was observed in endoscopic ultrasound‐guided fine needle aspiration (1.000), and the lowest agreement was observed in urine cytology (0.665). Patient management changed with smart phone image diagnoses at 11.04%.ConclusionsThis study showed that easy, fast, and high‐quality image capturing and transfer is possible from cytology slides using smartphones. The intraobserver Kappa agreement between the microscopic cytopathological diagnoses and remote smartphone image diagnoses was high. It was found that remote diagnosis due to difficulties in telecytology might change patient management. The developments in the smartphone camera technology and transfer software make them efficient telepathology and telecytology tools.

Background: The aims of the study are to identify the diagnostic cytological features of subacute granulomatous thyroiditis (SGT), to compare our results with previous literature studies, and to investigate the cytological changes in SGT that mimic other thyroid lesions.Methods: This retrospective study was conducted with 69 cases. The cytology slides were re-evaluated. The diagnostic cytomorphological features of the disease were identified. The results were compared with the literature. Differential diagnosis of the disease is discussed with the results obtained. Results: The diagnostic cytological features consisted of lymphocytes, multinucleated giant cells, loose epithelioid histiocyte groups, granulomas, isolated epithelioid histiocytes, colloid, and neutrophil leukocytes. The highest degree of concordance between our results and the published literature was the presence of giant cells while the lowest was for microfollicles. Some reactive cytological features of SGT were similar to other benign or malignant diseases of the thyroid. Conclusion: SGT is a rare and self-limiting disease. Cytological features are not specific. The diagnosis should be confirmed by clinical and laboratory results. Reactive atypia in the early phase of the disease and microfollicles in the late phase may lead to a false cytological diagnosis, thus resulting in unnecessary resection. To prevent such misdiagnoses, cytopathologists should be aware of the reactive cytological changes in this disorder. K E Y W O R D S cytological features, De Quervain's, differential diagnosis, subacute granulomatous thyroiditis

Background:Management of pancreatic cysts is based on neoplastic–nonneoplastic discrimination. Endoscopic ultrasound (EUS) enables to differentiate neoplastic–nonneoplastic lesions and also allows fine-needle aspiration (FNA). In this study, we aim to assess feasibility and clinical relevance of cytological and biochemical analysis in differential diagnosis of cystic pancreatic lesions in patients who had undergone endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) due to pancreatic cysts.Methods:Participants were 96 patients who had undergone EUS-FNA for differential diagnosis of pancreatic cysts. Pancreatic cysts were classified as benign-mucinous, nonmucinous, and malignant according to patient history, physical examination, EUS appearance, and cystic fluid assessment. Tumor markers (CEA, CA(cancer antigens) 72.4, CA 19-9) , amylase, lipase and cytological assesment were compared between 3 different groups. Receiver-operating characteristics (ROC) curves were constructed to identify appropriate cut-off values.Results:Fluid CEA and CA 72.4 levels for benign-mucinous and malignant cysts were significantly higher than for nonmucinous cysts (P ≤ 0.04). A cut-off CEA level of 207 ng/mL differentiated mucinous etiology with a sensitivity of 72.7%, specificity of 97.7%, and accuracy of 89.5%. The sensitivity, specificity, and accuracy of the CA 72.4 cut-off level of 3.32 ng/mL were 80%, 69.5%, and 73.6%, respectively.Conclusion:Cyst fluid CEA and CA 72.4 levels have a high accuracy in discriminating mucinous from nonmucinous cysts. When combined with cytology their accuracy rate increases.

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Neoplastic proliferation of plasma cells is called plasma cell dyscrasias, and these neoplasms can present as a solitary neoplasm or multiple myeloma. Extramedullary plasmacytoma, in particular pancreatic plasmacytoma, is a rare manifestation of multiple myeloma. Although computerized tomography is useful for the diagnosis of extramedullary plasmacytoma, there are no specific radiologic markers that distinguish it from adenocarcinoma. Histological confirmation by biopsy is necessary for accurate diagnosis and management of the tumor. Endosonography is the most sensitive method for the diagnosis of pancreatic tumors, and the use of fine needle aspiration by endosonography is associated with a lower risk for malignant seeding and complications. Here, we report a case of pancreatic plasmacytoma in newly identified multiple myeloma as diagnosed by endosonography. Endosonography is a reliable and rapid method for the diagnosis of extramedullary plasmacytoma. Therefore, endosonographic fine needle aspiration should be the first choice for histological evaluation when pancreatic plasmacytoma is suspected. Ideally, the pathology would be performed at the same site as endosonographic biopsy.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Plasmacytoma; Endosonography; Pancreatic mass; Multiple myeloma; Fine needle aspiration Core tip: The rare condition extramedullary plasmacytoma involves the gastrointestinal tract, usually liver, in approximately 10% of cases. A role for the pancreas is particularly rare. Pancreatic tumors can be identified radiologically, although it is impossible to discriminate between extramedullary plasmacytoma and adenocarcinoma. The use of endosonographic fine needle aspiration to acquire a histological sample from the pancreatic mass to confirm diagnosis is feasible and informative even in the presence of inoperable mass image.

The common problems seen in CC, such as an excessive number of slides, a haemorrhagic background and air drying artefact in the SP method were not encountered. Through these advantages, the rate of the indeterminate cytopathological diagnosis was low in SP. In addition to those advantages, the increased rates of non-diagnostic cases, the difficulty in evaluating the cytomorphologic features owing to tridimensional structures and the smaller size of the cells and the presence of tridimensional structures uninterpreted microscopically were the disadvantages of SP. The present results showed that SP could be used instead of CC in thyroid cytopathology.

Objective:The aim of the study was to investigate the importance of consumption of the epidermis as an additional diagnostic criteria for malignant melanoma and to evaluate its relationship to clinicopathological findings. Material and Method:The age, gender, localization of the lesion and the histopathological parameters such as tumor type, Breslow thickness, ulceration, Clark's level, mitosis/mm 2 , lymphocytic infiltration were noted in 40 malignant melanoma cases. Consumption of the epidermis was evaluated in tumor sections. Consumption of the epidermis (CoE) due to thinning of the epidermis and loss of rete ridges was noted as (+) or (-). Furthermore, CoE was compared with clinical and histopathological parameters. The Shapiro Wilk and Logistic regression tests were used for statistical analysis. The results were accepted as significant if the p value was <0.05.Results: CoE was detected in 60% (24/40) of malignant melanoma cases. a positive correlation was present between CoE and head and neck localization (p=0,698), superficial spreading melanoma (p=0,341), ulceration (p=0,097) and brisk lymphocytic infiltration (p=0,200) but the results were not statistically significant. CoE was frequently detected in males but the difference was not statistically significant (p=0.796). There was no correlation or significant statistical association between CoE and age, Breslow thickness, Clark's level or the mitotic index. Conclusion:The detection of CoE in most of the patients suggests that CoE could be a histopathological criterion in the diagnosis of malignant melanoma. The frequent association between CoE and the presence of ulceration could also direct attention to CoE as regards prognostic importance.

Objective: The aim of the study was to investigate the importance of consumption of the epidermis as an additional diagnostic criteria for malignant melanoma and to evaluate its relationship to clinicopathological findings. Material and Method:The age, gender, localization of the lesion and the histopathological parameters such as tumor type, Breslow thickness, ulceration, Clark's level, mitosis/mm 2 , lymphocytic infiltration were noted in 40 malignant melanoma cases. Consumption of the epidermis was evaluated in tumor sections. Consumption of the epidermis (CoE) due to thinning of the epidermis and loss of rete ridges was noted as (+) or (-). Furthermore, CoE was compared with clinical and histopathological parameters. The Shapiro Wilk and Logistic regression tests were used for statistical analysis. The results were accepted as significant if the p value was <0.05. Results:CoE was detected in 60% (24/40) of malignant melanoma cases. a positive correlation was present between CoE and head and neck localization (p=0,698), superficial spreading melanoma (p=0,341), ulceration (p=0,097) and brisk lymphocytic infiltration (p=0,200) but the results were not statistically significant. CoE was frequently detected in males but the difference was not statistically significant (p=0.796). There was no correlation or significant statistical association between CoE and age, Breslow thickness, Clark's level or the mitotic index. Conclusion:The detection of CoE in most of the patients suggests that CoE could be a histopathological criterion in the diagnosis of malignant melanoma. The frequent association between CoE and the presence of ulceration could also direct attention to CoE as regards prognostic importance. Bulgular: Epidermal yapısal değişiklikler malign melanom olgularının %60'ında (24/40) mevcuttu. Epidermal yapısal değişiklikler ile baş-boyun yerleşimi (p=0,698), yüzeyel yayılan tümör tipi (p=0,341), ülserasyon varlığı (p=0,097) ve şiddetli lenfositik infiltrasyon (p=0,200) arasında pozitif korelasyon vardı. ancak istatistiksel olarak anlamlı değildi. Epidermal yapısal değişiklikler erkeklerde kadınlara göre daha sık olarak izlendi, ancak aradaki fark istatistiksel olarak anlamlı bulunmadı (p=0,796). Epidermal yapısal değişiklikler ile yaş, Breslow kalınlığı, Clark düzeyi ve mitoz sayısı arasında herhangi bir korelasyon veya anlamlı istatistiksel birliktelik saptanmadı.Sonuç: Epidermal yapısal değişikliklerin olguların çoğunda saptanmış olması, malign melanom tanısında epidermal yapısal değişikliklerin bir histopatolojik kriter olabileceğini düşündürmektedir. ayrıca epidermal yapısal değişikliklerin, ülserasyon varlığı ile olan sık birlikteliği, kötü prognostik gösterge olabilirliği açısından dikkat çekicidir.