{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:39:41Z","timestamp":1780393181942,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T00:00:00Z","timestamp":1634774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Nuclear protein in testis (NUT) carcinoma (NC) is an aggressive type of poorly differentiated carcinoma with a variable degree of squamous differentiation. NC is defined by the presence of BRD\u2010NUT fusion oncogenes, the most common fusion form being the BRD4\u2010NUTM1 gene. Variant rearrangements involving the BRD3 and NSD3 genes. Variant rearrangements involving the BRD3 and NSD3 genes occur in approximately one\u2010third of the cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This is the first case regarding the study of cytological features of NC of the lung with BRD3\u2010NUTM1 fusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A 36\u2010year\u2010old female with chest heaviness and shortness of breath was found to have a right\u2010sided pleural effusion; she was non\u2010smoker and denied any significant past medical illness. CT\u2010chest revealed an 8.5 cm heterogeneous mass in the right and mid\u2010upper lung. She underwent endobronchial ultrasound\u2010guided (EBUS) transbronchial fine\u2010needle aspiration (FNA) of the lung mass. Thoracocentesis was performed, and pleural fluid was sent to the laboratory for cytological evaluation<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cytopathological findings showed atypical squamoid cells with variably prominent single or multiple nucleoli. Monotonous\u2010looking cells with high nuclear to cytoplasmic ratio and hyperchromasia were also present. The atypical squamoid cells showed abundant clear to eosinophilic cytoplasm with rare individual cell keratinization and focal keratin pearl formation. The atypical cells were positive for CK7, p40, p63, mCEA and equivocal for NUT\u2010specific antibody. The cytopathological findings were consistent with squamous cell carcinoma with focal keratinization. The Fusion Panel\u2010Solid Tumor (50 genes) revealed BRD3\u2010NUTM1 fusion gene. Diagnosis was amended to pulmonary NC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>NC is a diagnostic challenge for pathologists as it can morphologically mimic undifferentiated carcinoma, squamous cell carcinoma, or neuroendocrine carcinoma. The challenge is not how to diagnose NC but rather determining when to include it in the differential diagnosis and perform the diagnostic molecular tests (FISH or NGS) or IHC study for NUT\u2010specific antibody.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When a specimen demonstrates a dual cell population of squamoid cells and primitive\u2010looking tumor cells in the wrong clinical context (i.e., young patient with no smoking history), further molecular profiling is warranted to include the differential of a primary NC of the lung. The cytological features of NC itself have rarely been documented and moreover, that of a primary NC of the lung with BRD3\u2010NUTM1 fusion has never been reported. We herein report cytological findings of a primary NC of the lung with BRD3\u2010NUTM1 fusion gene.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.24885","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T07:08:41Z","timestamp":1634800121000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["<scp>BRD3\u2010NUTM1<\/scp>\u2010expressing <scp>NUT<\/scp> carcinoma of lung on endobronchial ultrasound\u2010guided transbronchial needle aspiration cytology, a diagnostic pitfall"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7203-7951","authenticated-orcid":false,"given":"Sameer Chhetri","family":"Aryal","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Zia","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1530-5005","authenticated-orcid":false,"given":"Shannon","family":"Rodgers","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulei","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5935-2073","authenticated-orcid":false,"given":"Lisi","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,21]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","first-page":"304","article-title":"BRD4\u2010NUT fusion oncogene: a novel mechanism in aggressive carcinoma","volume":"63","author":"French CA","year":"2003","journal-title":"Cancer Res"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/onc.2013.126"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31815a3900"},{"issue":"9","key":"e_1_2_7_5_1","first-page":"1243","article-title":"The 2015 World Health Organization classification of lung tumors: Impact of 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