Abstract:
Background: In recent decades, various standardized classification systems for reporting cytopathology have been implemented, which have revolutionized the management of patients with cancerous and non-cancerous conditions by establishing effective communication between clinicians and cytopathologists. The present study evaluates the merits of the Sydney System of reporting lymph node cytopathology.
Study Design: A comparison between the conventional and the recently proposed ‘Sydney systems of reporting lymph node cytopathology’ was carried out in the present study with 355 cases in each group. The fine needle aspiration cytological (FNAC) diagnoses and interpretations in both study groups were made as per the established criteria for each of the diagnostic entities, documented in the standard textbooks and literature, with the use of appropriate ancillary techniques, whenever possible. An algorithmic approach designed in one of our previous studies was stringently applied for all hematolymphoid neoplasms in both groups.
Results: There was no significant variation in terms of interpretative categories and the final diagnoses between the two groups. Both groups showed high sensitivity, specificity, positive and negative predictive values, as well as, diagnostic accuracy for lymph node FNAC. There was a slight decline in the rate of non-diagnostic aspirates, due to the consistent use of the ROSE technique in the Sydney group.
Conclusions: Though no significant differences were noted between the two systems of reporting, our study immensely contributed to implementing and streamlining the new system of reporting in our institute, with a more rigid and meticulous approach and the use of relevant ancillary techniques.
Keywords: Sydney system, lymph node, cytopathology, fine needle aspirates, neoplastic, non-neoplastic, ancillary studies.
Audience Take Away Notes:
As mentioned in the abstract, the standardized cytological reporting systems improve not only the pre-therapeutic diagnostic accuracy but also the effective follow-up of patients with improved communication between clinicians and cytopathologists
The algorithmic approach used in the study for diagnosing a variety of hematolymphoid malignancies would be of great practical value, especially for budding pathologists in general and cytopathologists in particular
The paper also emphasizes the importance of a meticulous approach to sampling, interpretation, and effective use of ancillary techniques such as immunocytochemistry and flow cytometry in the diagnosis and distinction of hematolymphoid malignancies. The aspects dealt with here are not just good teaching material but also have scope for further research
