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ArticleCancer cytopathology2025

Fine-needle aspiration and effusion cytology of thoracic SMARCA4-deficient undifferentiated tumor and SMARCA4-deficient non-small cell lung carcinoma: A multi-institutional experience with 27 patients.

Nicole Zalles, Sanjay Mukhopadhyay, Swati Satturwar, Sigfred Lajara, Samer Khader, Liron Pantanowitz, Tarik M Elsheikh

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer cytopathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. ThoracicJournal of thoracic disease · 2026
    Article
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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nicole ZallesDepartment of Pathology, Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Sanjay MukhopadhyayDepartment of Pathology, Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Swati SatturwarDepartment of Pathology, The Ohio State University, Columbus, Ohio, USA.ORCID 0000-0003-1960-9847
Sigfred LajaraDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.ORCID 0000-0003-2828-532X
Samer KhaderDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Liron PantanowitzDepartment of Pathology, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0001-8182-5503
Tarik M ElsheikhDepartment of Pathology, Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0001-8249-9009

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThoracic switch/sucrose nonfermentable-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 4 (SMARCA4)-deficient (SD) malignancies, including SD undifferentiated tumor (SD-UT) and SD non-small cell lung carcinoma (SD-NSCLC), have been recently described. The cytologic features of these neoplasms in fine-needle aspiration (FNA) and effusion specimens have rarely been reported in the literature. This study aimed to describe and compare the spectrum of cytologic, immunohistochemical, and clinical features of these high-grade malignancies recently encountered at the participating institutions.

methodsThis study documented clinical and imaging characteristics of tumors from 27 patients. Sixteen cytomorphologic features and immunohistochemical findings were compared between SD-UT and SD-NSCLC samples.

resultsTwenty three FNAs, two bronchial brushings, and two pleural fluids were evaluated, including 17 SD-UT cases (mean patient age, 70 years) and 10 SD-NSCLC cases (mean patient age, 62 years). Both malignancies presented with large thoracic masses and/or hilar/mediastinal lymphadenopathy. All SD-UT cytologic samples had a discohesive or mixed cohesive-discohesive architecture, and most (13 of 17) showed predominant rhabdoid or mixed rhabdoid-epithelioid features. Most SD-NSCLC cytologic samples (nine of 10) were either cohesive or mixed cohesive-discohesive and had a predominantly epithelioid morphology (eight of 10). Keratins and claudin-4 were negative or focally positive in SD-UT samples, whereas they were diffusely positive in SD-NSCLC samples. Both malignancies were negative for TTF-1 and p40/p63 and showed loss of expression of SMARCA4.

conclusionsAlthough there is considerable clinical and cytopathologic overlap between SD-UT and SD-NSCLC, some key features allow for their distinction. SD-UT is mostly discohesive with rhabdoid or mixed rhabdoid-epithelioid features, whereas SD-NSCLC often has cohesive epithelioid morphology. The combination of clinical presentation, cytomorphology, and immunohistochemistry is essential for a definitive diagnosis.

Indexed as

Carcinoma, Non-Small-Cell LungDNA HelicasesLung NeoplasmsNuclear ProteinsTranscription FactorsAdultAgedAged, 80 and overBiomarkers, TumorBiopsy, Fine-NeedleCytodiagnosisFemaleHumansMaleMiddle AgedPleural Effusion, MalignantBiomarkers, TumorDNA HelicasesNuclear ProteinsSMARCA4 protein, humanTranscription Factorscytologyeffusionfine‐needle aspirationimmunohistochemistrynon–small cell carcinomaSMARCA4–deficientundifferentiated tumor

Identifiers

PMID39555952
PMCPMC11695706

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