Ana María Colino Gallardo

Introduction: Pathology requires the integration of macroscopic and microscopic findings for an accurate diagnosis. Fine needle aspiration biopsy (FNA) traditionally became the domain of radiologists with the introduction of ultrasound; however, its increased accessibility has allowed other specialists, including pathologists, to incorporate it into their daily practice. Both ultrasound-guided FNA and core needle biopsy (CNB) performed by interventional pathologists have proven valuable tools in the diagnosis of lymph node lesions. Materials and Methods: An observational, descriptive, retrospective study was conducted at Hospital Universitario del Henares, analysing 134 FNABs and 31 CNBs of lymph node lesions between 2023 and 2024. The diagnostic yield of both techniques and their correlation were evaluated. Results: Ultrasound facilitated better lesion characterization. FNA demonstrated a diagnostic yield of 98%, with a 94% correlation with CNB results. The Sydney system 2020 was applied to FNA reporting in lymphatic node. An equivalent classification system for CNB is proposed. Conclusion: The performance of FNA and CNB by pathologists optimizes diagnosis, reduces time and costs, and strengthens their role in minimally invasive diagnostics. Adoption of a unified classification system for CNB lesions would facilitate communication between specialists.

Introduction: Accurate staging is essential in pancreatic adenocarcinoma due to its aggressive nature and poor prognosis. The 8th edition of the AJCC TNM staging system introduced changes in tumor size criteria and nodal classification. This study compares the prognostic performance of the 7th and 8th editions in resected patients. Material and Methods: A retrospective analysis was conducted on 214 patients with pancreatic adenocarcinoma who underwent curative surgery. TNM staging was assigned according to both AJCC editions. Kaplan–Meier analysis and multivariate Cox regression, stratified by adjuvant therapy, were used to assess disease-free survival (DFS) and overall survival (OS). Results: The 8th edition TNM staging was significantly associated with lower risk of recurrence, with TNM stages I and II independently predicting better DFS (p < 0.05). In contrast, the 7th edition TNM stage I remained the only independent predictor of OS (HR = 0.376; p = 0.023). Reclassification between editions altered stage distribution, particularly within stage II. Conclusions: The 8th edition improves early recurrence stratification, while the 7th edition retains stronger prognostic value for overall survival. Both systems offer complementary insights, supporting outcome-specific staging use.

Introduction: Pancreatic adenocarcinoma has a poor prognosis, underscoring the need for accurate staging systems. The 8th edition of the AJCC TNM classification introduced key changes, including size-based T staging and the N2 category for ≥4 positive lymph nodes. This study compares the prognostic value of the 7th and 8th editions. Methods: A retrospective cohort of 214 patients with resected pancreatic adenocarcinoma was analyzed. TNM staging was applied using both editions. Associations with disease progression and overall survival were assessed using chi-square tests and Kaplan-Meier survival analysis. Results: The 8th edition led to significant reclassification, especially within Stage II and Stage III. Both editions showed significant association with disease recurrence. However, only the 7th edition was significantly associated with overall survival. Conclusions: The 8th edition improves disease progression stratification through refined T and N criteria but shows limited ability to predict overall survival compared to the 7th edition. These findings support the use of updated TNM staging while highlighting the need for complementary prognostic tools.

Introduction: The new ‘WHO Reporting System for Lung Cytopathology’ (2022) includes an ‘Insufficient’/‘Inadequate’/‘Non‐diagnostic’ category. Although they recommend that each laboratory should choose one term to report this diagnostic category, they do not recommend one term over the others. Our aim was to evaluate the use of these three terms in pulmonary FNACs among Spanish pathologists.Methods: A web‐based survey among Spanish pathologists using Google Forms was performed. It included 14 yes/no and multiple‐choice questions, the latter with an open‐text option where it was possible to give a different answer from the ones given. Some questions inquired about their daily practice routine whilst others proposed different cytological examples with the intention of knowing how they would report those particular cases.Results: Twenty‐eight participants (18 cytopathologists, two general pathologists and seven residents) from 17 different Spanish hospitals completed the survey. Most of the respondents use more than one term of this diagnostic category, and there is a lack of reproducibility on the criteria to use one specific term.Conclusion: There is a need to clearly define this category to reduce variability between pathologists.

Corneal dystrophies are hereditary diseases affecting the corneal tissue; they are bilateral, symmetrical and unrelated to environmental or systemic conditions. Congenital corneal stromal dystrophy is a very rare autosomal dominant dystrophy that is caused by a mutation in the DCN gene that encodes decorin (a proteoglycan of the extracellular matrix). We herein report 4 cases of congenital stromal corneal dystrophy in 2 families, highlighting the previously undescribed histopathologic features, the possible differential diagnosis of this entity and the key role played by decorin staining in its diagnosis.

Objectives: The hyalinizing trabecular tumor (HTT) is a rare benign neoplasm of the thyroid gland. This neoplasm has overlapping cytological features with Papillary Thyroid Carcinoma, Medullary Carcinoma and Follicular Neoplasm with Nuclear Features of Papillary Carcinoma. This can lead to misdiagnosis of malignancy in fine needle aspiration (FNA) cytology specimens with unnecessary total thyroidectomy. The aim of this study is to determine if there are some cytological features that could help us to suspect HTT on FNA specimens and avoid radical surgery. Material and Methods: With this purpose we have collected 6 cases diagnosed of HTT in Hospital Clínico San Carlos of Madrid (Spain) in the last 10 years and reviewed the cytological specimens. Result: We conclude that the presence of hyaline material in FNA specimens of HTT is a constant feature being a diagnostic clue. We must be cautious not to confuse it with dense colloid or amyloid material, the latter seen in Medullary Carcinoma. Papillary architecture and fibrovascular cores are not present in a HTT. Special stains as ki-67, calcitonin and Congo Red staining could help us in achieving the correct diagnosis. Conclusion: We feel the cytopathologists must be aware of the distinguishing features of this lesion, mainly the typical hyaline material to achieve a proper diagnosis and be able to reduce unnecessary aggressive management of these patients.