{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:12:06Z","timestamp":1792599126971,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Thoracic switch\/sucrose nonfermentable\u2013related, matrix\u2010associated, actin\u2010dependent regulator of chromatin, subfamily A, member 4 (SMARCA4)\u2013deficient (SD) malignancies, including SD undifferentiated tumor (SD\u2010UT) and SD non\u2013small cell lung carcinoma (SD\u2010NSCLC), have been recently described. The cytologic features of these neoplasms in fine\u2010needle 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\u00a0these high\u2010grade malignancies recently encountered at the participating institutions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study documented clinical and imaging characteristics of tumors from 27 patients. Sixteen cytomorphologic features and immunohistochemical findings were compared between SD\u2010UT and SD\u2010NSCLC samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty three FNAs, two bronchial brushings, and two pleural fluids were evaluated, including 17 SD\u2010UT cases (mean patient age, 70 years) and 10 SD\u2010NSCLC cases (mean patient age, 62 years). Both malignancies presented with large thoracic masses and\/or hilar\/mediastinal lymphadenopathy. All SD\u2010UT cytologic samples had a discohesive or mixed cohesive\u2013discohesive architecture, and most (13 of 17) showed predominant rhabdoid or mixed rhabdoid\u2013epithelioid features. Most SD\u2010NSCLC cytologic samples (nine of 10) were either cohesive or mixed cohesive\u2013discohesive and had a predominantly epithelioid morphology (eight of 10). Keratins and claudin\u20104 were negative or focally positive in SD\u2010UT samples, whereas they were diffusely positive in SD\u2010NSCLC samples. Both malignancies were negative for TTF\u20101 and p40\/p63 and showed loss of expression of SMARCA4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although there is considerable clinical and cytopathologic overlap between SD\u2010UT and SD\u2010NSCLC, some key features allow for their distinction. SD\u2010UT is mostly discohesive with rhabdoid or mixed rhabdoid\u2013epithelioid features, whereas SD\u2010NSCLC often has cohesive epithelioid morphology. The combination of clinical presentation, cytomorphology, and immunohistochemistry is essential for a definitive diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.22919","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T09:10:16Z","timestamp":1731921016000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Fine\u2010needle aspiration and effusion cytology of thoracic <i>SMARCA4<\/i>\u2013deficient undifferentiated tumor and <i>SMARCA4<\/i>\u2010deficient non\u2013small cell lung carcinoma: A multi\u2010institutional experience with 27 patients"],"prefix":"10.1002","volume":"133","author":[{"given":"Nicole","family":"Zalles","sequence":"first","affiliation":[{"name":"Department of Pathology Pathology &amp; Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Mukhopadhyay","sequence":"additional","affiliation":[{"name":"Department of Pathology Pathology &amp; Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1960-9847","authenticated-orcid":false,"given":"Swati","family":"Satturwar","sequence":"additional","affiliation":[{"name":"Department of Pathology The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2828-532X","authenticated-orcid":false,"given":"Sigfred","family":"Lajara","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Khader","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8182-5503","authenticated-orcid":false,"given":"Liron","family":"Pantanowitz","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Pathology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8249-9009","authenticated-orcid":false,"given":"Tarik M.","family":"Elsheikh","sequence":"additional","affiliation":[{"name":"Department of Pathology Pathology &amp; Laboratory Medicine Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2021.06.001"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/MCB.24.1.362\u2010376.2004"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3399"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.1500447"},{"key":"e_1_2_7_6_1","volume-title":"WHO Classification of Tumours: Thoracic Tumours","author":"Yoshida A","year":"2021"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells10081920"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22709"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2019.10.023"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.21037\/med\u201020\u201015"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2017.11"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010020\u201003011\u20103"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000510323"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000493335"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000500684"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2022.04.001"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22581"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1066896919870866"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2016.230"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001188"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2019\u20100633\u2010OA"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010017\u20102148\u20105"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22342"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/cyt.13056"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019\u2010509X.180822"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001262"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001606"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001556"},{"key":"e_1_2_7_29_1","volume-title":"WHO Classification of Tumours: Thoracic Tumours","author":"Chirieac LR","year":"2021"},{"key":"e_1_2_7_30_1","volume-title":"Thoracic Tumours. 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