{"doi":"10.1002/cncy.22681","title":"Diagnostic features of low‐ and high‐grade mucinous neoplasms in pancreatic cyst FNA cytology","abstract":"BACKGROUND: Pancreatic cyst cytology evaluates for neoplastic mucin and epithelial grade. This study describes cytological features of low- and high-grade mucinous neoplasms (MNs) using gastrointestinal contaminants for comparison. METHODS: Histologically confirmed pancreatic cystic neoplasms were reviewed by a panel of cytopathologists to identify which, among 26 selected cytologic features, correlate significantly with low- and high-grade MN. A test for greater than or equal to four of eight high-grade features (three-dimensional architecture, high nuclear:cytoplasmic ratio, moderate nuclear membrane abnormalities, loss of nuclear polarity, hyperchromasia, >4:1 nuclear size variation in one cluster, karyorrhexis, and necrosis) was assessed for identifying a high-grade neoplasms. Additional characteristics of the cohort such as cyst fluid carcinoembryonic antigen results, molecular testing, Papanicolaou Society of Cytopathology classification, and select high-risk clinical features are described. RESULTS: Endoscopic ultrasound fine-needle aspirations from 134 MN and 17 serous cystadenomas containing gastrointestinal contaminants were included. The MN consisted of 112 (84%) intraductal papillary MNs (low-grade = 69, 62%; high-grade = 24, 21%; and invasive = 19, 17%) and mucinous cystic neoplasms (low-grade = 20, 90%; high-grade = 2, 10%). Half had greater than five clusters of epithelium for analysis. Compared with gastrointestinal contaminants, mucin from MN was thick and colloid-like (40% vs. 6%, p < .01), covered >20% of the smear area (32% vs. none, p < .01), and contained histiocytes (46% vs. 18%, p = .04). Greater than or equal to four of eight select high-grade features was present in 36% of high-grade MN with sensitivity 37% and 98% specificity. CONCLUSION: Colloid-like features, >20% of smear, and histiocytes correlated with MN. Testing for greater than or equal to four high-grade features had low sensitivity and high specificity for high-grade MN.","journal":"Cancer Cytopathology","year":2023,"id":369744,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9616,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1117397,"name":"Xiao‐Jun Wei","orcid":"0000-0002-0550-7244","position":1,"is_corresponding":false},{"id":250489,"name":"Narasimhan P. Agaram","orcid":"0000-0002-6991-2310","position":2,"is_corresponding":false},{"id":104268,"name":"Keith Sigel","orcid":"0000-0002-4051-4861","position":3,"is_corresponding":false},{"id":1129028,"name":"Roshan Raza","orcid":null,"position":4,"is_corresponding":false},{"id":1129029,"name":"Rebecca Andrade","orcid":null,"position":5,"is_corresponding":false},{"id":711819,"name":"Rema Rao","orcid":"0000-0003-2462-0004","position":6,"is_corresponding":false},{"id":561533,"name":"Pari Shah","orcid":"0009-0005-6211-2862","position":7,"is_corresponding":false},{"id":300972,"name":"Kevin C. Soares","orcid":"0000-0002-0406-017X","position":8,"is_corresponding":false},{"id":1128661,"name":"Abha Goyal","orcid":"0000-0002-8876-4894","position":9,"is_corresponding":false},{"id":277369,"name":"Carlie Sigel","orcid":"0000-0001-6276-3968","position":0,"is_corresponding":true}],"reference_count":18,"raw_metadata":null,"created_at":"2026-07-19T01:15:32.670954Z","pmid":"36650420","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}