A brief review of the WHO reporting system for lung cytopathology

Sule Canberk; Andrew Field; Lukas Bubendorf; Ashish Chandra; Ian A Cree; Marianne Engels; Kenzo Hiroshima; Deepali Jain; Ivana Kholová; Lester Layfield; Ravi Mehrotra; Claire Michael; Robert Osamura; Martha B Pitman; Sinchita Roy-Chowdhuri; Yukitoshi Satoh; Paul VanderLaan; Maureen Zakowski; Fernando C Schmitt

doi:10.1016/j.jasc.2023.04.002

A brief review of the WHO reporting system for lung cytopathology

J Am Soc Cytopathol. 2023 Jul-Aug;12(4):251-257. doi: 10.1016/j.jasc.2023.04.002. Epub 2023 Apr 7.

Authors

Sule Canberk¹, Andrew Field², Lukas Bubendorf³, Ashish Chandra⁴, Ian A Cree⁵, Marianne Engels⁶, Kenzo Hiroshima⁷, Deepali Jain⁸, Ivana Kholová⁹, Lester Layfield¹⁰, Ravi Mehrotra¹¹, Claire Michael¹², Robert Osamura¹³, Martha B Pitman¹⁴, Sinchita Roy-Chowdhuri¹⁵, Yukitoshi Satoh¹⁶, Paul VanderLaan¹⁷, Maureen Zakowski¹⁸, Fernando C Schmitt¹⁹

Affiliations

¹ Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal; Abel Salazar Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal; IPATIMUP, Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal.
² Department of Anatomical Pathology, St Vincent's Hospital, Sydney, and University of New South Wales Sydney and University of Notre Dame, Sydney, Australia.
³ Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland.
⁴ Department of Cellular Pathology, Guy's & St Thomas' NHS Foundation Trust, London, UK.
⁵ International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France.
⁶ Institute of Pathology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁷ Department of Biochemistry and Genetics Chiba University Graduate School of Medicine, Chiba, Japan.
⁸ Department of Pathology-All India Institute of Medical Sciences, New Delhi, India.
⁹ Pathology, Fimlab Laboratories and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland.
¹⁰ Pathology and Anatomic Science Department, University of Missouri, Columbia, Missouri.
¹¹ Indian Cancer Genomic Atlas, Centre for Health, Innovation and Policy Foundation, Pune, India.
¹² Department of Pathology, University Hospitals Cleveland Medical Center/Case, Western Reserve University, Cleveland, Ohio.
¹³ Department of Diagnostic Pathology, Nippon Koukan Hospital, Kawasaki, Japan.
¹⁴ Department of Pathology, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts.
¹⁵ Division of Pathology and Laboratory Medicine, Department of Pathology, Molecular Diagnostics Laboratory, The University of Texas MD Anderson Cancer Center, Houston, Texas.
¹⁶ Department of Thoracic Surgery, Kitasato University School of Medicine, Tokio, Japan.
¹⁷ Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
¹⁸ Mount Sinai Medical Center, New York, New York.
¹⁹ IPATIMUP, Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal; Department of Pathology, Faculty of Medicine of University of Porto, Porto, Portugal; CINTESIS@RISE, Health Research Network, Porto, Portugal. Electronic address: fernando.schmitt@ipatimup.pt.

PMID: 37156705
DOI: 10.1016/j.jasc.2023.04.002

Abstract

The International Academy of Cytology has joined with the International Agency for Research on Cancer to bring together a group of experts in lung cytopathology to develop a WHO Reporting System for Lung Cytopathology (WHO System). This System aims to improve and standardize the reporting of cytopathology, facilitate communication between cytopathologists and clinicians, and improve patient care. The WHO System describes 5 categories for reporting lung cytopathology: 'Insufficient/Inadequate/Nondiagnostic', 'Benign', 'Atypical', 'Suspicious for malignancy', and 'Malignant', each one with a clear descriptive term, a definition, a risk of malignancy, and a suggested management algorithm. The key diagnostic cytopathologic features of each of the lesions within each category have been established by consensus through an Expert Editorial Board, who are also the authors of this review and selected for each reporting system and chosen based on their expertise in the field and/or diversity of geographical representation. Many other co-authors from around the world also contributed. The assignment of writing and editing responsibilities used the same model as that used for the WHO Classification of Tumours (https://whobluebooks.iarc.fr/about/faq/). The WHO System provides the best practice application of ancillary testing, including immunocytochemistry and molecular pathology, and guides in sampling and processing techniques to optimize the handling and preparation of specimens. The WHO System was created by the authors to be applicable globally and is based on cytomorphology with possibilities for additional diagnostic management of the patient. The authors are aware that local medical and pathology resources would differ, especially in low- and middle-income countries. The WHO Tumour Classification for Thoracic Tumors, Fifth Edition, is directly accessible through the online WHO System.

Keywords: EBUS-FNA; IAC; IARC; Lung cytology; Nomenclature; WHO reporting systems for cytopathology; lung FNAB.

Publication types

Review

MeSH terms

Biopsy, Fine-Needle
Cytodiagnosis* / methods
Humans
Lung
Patient Care*
World Health Organization

Grants and funding

001/WHO_/World Health Organization/International