bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytologic features of prostatic adenocarcinoma in urine: A clinicopathologic and immunocytochemical study
Authors: Varma Vijay A. , Fekete Paul S. , Franks Marla J. , Walther McClellan M.
Published: February 2007

Cells of adenocarcinoma of the prostate (ACP) are infrequently shed in urine. We examined the clinicopathologic features of 22 patients with ACP and tumor cells in urine. Patients typically were clinical stage C or D and had hematuria (13 cases, 59%) and/or obstruction (11 cases, 50%). Prostatic palpation or instrumentation preceded collection of 15 urine specimens. Histologically, tumors were high grade (Gleason score 7‐10) and extensive, with involvement of prostatic ducts and acini (10 cases, 45%) and prostatic urethra (5 cases, 23%). Cytologically, the background was clean, and neoplastic cells appeared singly, in loose clusters, as large “casts,” or, rarely, in papillary structures. The cells were small, round to oval, with a moderate amount of finely granular or vacuolated cytoplasm; nuclei were generally round with a thin, often irregular membrane, finely granular chromatin, and a single prominent nucleolus. Immunoperoxidase staining for prostatic acid phosphatase and prostate‐specific antigen was useful in distinguishing ACP from transitional cell carcinoma.
Immunocytochemical localization of carcinoembryonic antigen in cerebrospinal fluid with metastatic carcinoma of the stomach: Report of four cases
Authors: Iwa Nobuzo , Yutani Chikao , Kobayashi Tadao K.
Published: February 2007

A study was undertaken to evaluate the cellular findings of gastric carcinoma in cerebrospinal fluid (CSF). Immunocytochemical localization of carcinoembryonic antigen (CEA) was performed on four cases of metastatic gastric carcinoma cells in CSF samples. A positive peroxidase‐antiperoxidase (PAP) reaction was obtained in all cases, with intense staining for CEA in the CSF samples as well as in the paraffin‐embedded tissue sections from the primary gastric tumors. Cellular morphology and the results of immunoperoxidase staining can be studied simultaneously. We believe that the PAP method for CEA increases diagnostic accuracy of cytology in the CSF.
Cytology of solid and papillary epithelial neoplasms of the pancreas: A case report
Authors: Stachura Jerzy , Popiela Tadeusz , Pietroń Maria , Tomaszewska Romana , Kulig Jerzy , Nowak Krystyna
Published: February 2007

A case of rare pancreatic tumor in a 39‐yr‐old woman is reported. Fine‐needle aspiration biopsy was performed; frozen sections later allowed definite diagnosis. Cytologic features of the tumor are described, and histogenesis is discussed.
Basal‐cell adenoma of the salivary gland: A benign adenoma that cytologically mimics adenoid cystic carcinoma
Authors: Stanley Michael W. , Horwitz Charles A. , Henry Michelle J. , Burton Linda G. , Lowhagen Torsten
Published: February 2007

We describe the fine‐needle aspiration cytology of two cases of basal‐cell adenoma (BCA) of the parotid gland. Both consisted of groups of small uniform cells with scant cytoplasm and occasional single cells. Small amounts of metachromatic stroma were present in smears from one case. The cytologic and histologic similarities between (BCA) and the solid type of adenoid cystic carcinoma are emphasized. Unequivocal distinction between these two entities may not be possible by cytologic criteria alone.
Aspiration biopsy cytology of mesothelioma
Authors: Tao Liang‐Che
Published: February 2007

From 1977 to 1986, 39 cases at our institution were diagnosed as “consistent with mesothelioma” by percutaneous fine‐needle aspiration biopsy. All were verified clinically andlor histologically, with no false‐positive results. All mesotheliomas except four tumors of peritoneal origin originated from the pleura. On the basis of their cytomorphologic features in correlation with histopathology, the tumors were classified into four types: benign, carcinomatous, sarcomatous, and undifferentiated. Of these 39 cases of mesothelioma diagnosed by aspiration biopsy, nine were benign type; 14, carcinomatous type; 13, sarcomatous type; and three, undifferentiated type. The cytomorphologic features and patterns of different types of mesotheliomas observed in aspirate preparations are presented, and the differential diagnosis is discussed. It appears feasible to investigate pleural‐ or peritoneal‐based lesions with fine‐needle aspiration biopsy, particularly in patients without effusions or with negative results in effusion examinations. It is also possible to make a definitive diagnosis of mesothelioma on the basis of cytologic findings coupled with special and immunoperoxidase staining in combination with roentgenographic findings and clinical history.
Detection of human papillomavirus DNA in fine‐needle aspirations of metastatic squamous‐cell carcinoma of the uterine cervix using the polymerase chain reaction
Authors: Shibata Darryl , Cosgrove Michele , Arnheim Norman , Martin W. John , Martin Sue Ellen
Published: February 2007

Routinely processed fine‐needle aspirations of metastatic squamous‐cell carcinoma (SCC) were analyzed for human papillomavirus type 16 (HPV‐16) using the polymerase chain reaction (PCR), an in vitro DNA amplification method. HPV‐16 DNA was detected in five of seven (71%) metastases from SCC of the uterine cervix. In two cases in which the primary tumor was available for comparison, the HPV‐16 DNA content of the primary tumor and of the metastasis was identical. HPV‐16 was not found in a metastatic SCC from the lung or in a metastatic nasopharyngeal SCC. These findings demonstrate that HPV‐16 DNA sequences can be readily detected in routinely processed fine‐needle aspirations using the polymerase chain reaction. The finding of HPV‐16 DNA in a metastasis may serve to direct a search for a primary site of origin.
Identification of features of metaplastic cells in sputum for the detection of squamous‐cell carcinoma of the lung
Authors: Swank Paul R. , Greenberg S. Donald , Hunter Norwood R. , Spjut Harlan J. , Estrada Rolando , Trahan Elizabeth B. , Montalvo Jorge
Published: February 2007

Digitized images of 1,556 squamous metaplastic cells from the sputum of 15 patients with confirmed squamous‐cell carcinoma of the lung and 13 subjects without apparent neoplasia were analyzed to determine if features existed within these relatively normal cells that could be used to differentiate between the two populations. Results indicate that such marker features do exist. A cross‐validation study using an additional 465 cells confirmed the conclusion that squamous metaplastic cells from patients with squamous‐cell carcinoma of the lung do differ from those of subjects without cancer. While such marker features alone are not reliable enough to assist pathologists in the diagnosis of squamous‐cell carcinoma of the lung, they might, in sufficient numbers, be used to identify patients for whom follow‐up testing would be advised.
Gleason grading of prostatic adenocarcinoma on fine‐needle aspiration
Authors: Jacobs Daniel M. , Vago John F. , Weiss Mark A.
Published: February 2007

We attempted to use the Gleason grading scheme on fine‐needle aspiration (FNA) of the prostate by examining 31 prostate aspirates that had concomitant surgical pathology tissue for correlation. A set of criteria is delineated in which it is proposed that Gleason grading is possible on FNA of the prostate by evaluating aspirated tissue fragments. Cell cytology, including qualitative nucleolar appearance, is not significantly helpful in this approach.
Mucinous breast carcinoma and mixed mucinous‐infiltrating ductal carcinoma: A comparative cytologic study
Authors: Stanley Michael W. , Tani Edneia M. , Skoog Lambert
Published: February 2007

In its pure form, mucinous breast carcinoma (MC) has a much better prognosis than infiltrating ductal carcinoma (IDC). Mixed MC‐IDC has the prognosis of IDC. We compared the fine‐needle aspiration (FNA) cytology and histology of nine cases of pure MC with 13 cases of mixed MC‐IDC. While typical of pure MC, abundant mucin (3−/3+) was noted in smears from three cases of mixed tumor and is thus necessary but not sufficient for a diagnosis of pure MC. Cellular pleomorphism has been said not to be a feature of MC; however, we found occasional large cells markedly different from the typical small uniform cells of MC in four pure and seven mixed tumors. Cytologic features indicative of a mixed tumor include one or more smears totally without mucin, scanty amounts of mucin, or necrosis. A combination of features indicative of pure mucinous carcinoma in FNA included abundant mucin on all smears, no pleomorphism, and no necrosis. Many cases will have smear patterns that are not typical of either profile and should probably be designated as carcinoma with a mucinous component.
Glial fibrillary acid protein immunoreactivity in fine‐needle aspiration of salivary gland lesions: A useful adjunct for the differential diagnosis of salivary gland neoplasms
Authors: Ostrzega Nora , Cheng Lorna , Layfield Lester
Published: February 2007

The value of immunocytochemical staining for glial fibrillary acid protein (GFAP) in salivary gland lesions was investigated in 33 fine‐needle aspiration smears. The study utilized cytologic material from ten pleomorphic adenomas, six normal salivary glands, three cases of chronic sialadenitis, three Warthin's tumors, two adenoid cystic carcinomas, three adenocarcinomas, two malignant mixed tumors, one acinic cell carcinoma, and three mucoepidermoid carcinomas. All tested pleomorphic adenomas stained positively. The adenoid cystic carcinomas and the cases of chronic sialadenitis, along with the low‐grade mucoepidermoid carcinoma, were negative for GFAP immunoreactivity. These results indicate that immunostaining for GFAP may be a valuable aid in the diagnosis of pleomorphic adenoma; GFAP may be especially helpful in distinguishing those cases for which the diferential diagnosis includes the aforementioned salivary gland neoplasms.
Fine‐needle biopsy: Comparison of cellular yield with and without aspiration
Authors: Akhtar Mohammed , Ali Muhammad Ashraf , Huq Mahmuda , Faulkner Carol
Published: February 2007

Fine‐needle biopsies with and without aspiration were performed on 103 lesions, and the cellular yields obtained by the two techniques were compared. A scoring system was devised by which the amount of material obtained in each needle stick was estimated. The mean scorelstick for fine‐needle biopsy with aspiration was 2. 7; for biopsy without aspiration, it was 2. 9. The results of this study indicate that there is no significant difference in the amount of cellular material obtained by the two techniques. It is concluded that needle biopsy without aspiration may be performed routinely with good results.
Fine‐needle aspiration cytology of superficial lymph nodes
Authors: Cardillo Maria Rosaria
Published: February 2007

A series of 244 enlarged superficial lymph nodes was examined by fine‐needle aspiration cytology. Twenty‐nine smears (11.9%) were inadequate for study. Of the remaining 215, 108 were negative, 13 suspicious for malignancy, and 94 positive. Forty‐five excisional biopsies were performed correlating the cytologic and histologic findings. There were two cytologic false‐negative results; both were patients who had been treated for carcinoma and whose aspirates were cytologically negative. Of the 13 samples reported as suspicious for malignancy, there were three epidermoid carcinomas, nine reactive hyperplasias, and one non‐Hodgkin's lymphocytic lymphoma. Of the positive cases, 83 were metastatic tumors, and 11 were malignant lymphomas (two non‐Hodgkin's lymphomas and nine Hodgkin's lymphomas). The criteria used in the interpetration of these aspirates and the problems of differential cytological diagnosis are discussed. In spite of the drawbacks of inadequate and false‐negative smears, fine‐needle aspiration cytology is valuable in preliminary diagnosis of diseased lymph nodes and subsequent management.
Fine‐needle aspiration biopsy of clear‐cell sarcoma of the kidney: Light and electron microscopic features
Authors: Akhtar Mohammed , Ali Muhammad Ashraf , Sackey Kwesi , Burgess Annie
Published: February 2007

Smears from seven fine‐needle aspiration biopsies from three patients with clear‐cell sarcoma of the kidney were reviewed, and the findings were correlated with corresponding histopathologic appearances. In two cases, the tumor cells were polygonal to spindle‐shaped and were loosely arranged in a matrix of mucoid material. The histopathologic examination of the resected tumors in these cases revealed a classic pattern. In the third case, the aspiration smears revealed round to polygonal cells with moderate to abundant cytoplasm but without the mucoid matrix. The predominant histologic appearance of this tumor was an epithelioid trabecular pattern. Electron microscopic findings were similar to those described in published studies.
Papillary carcinoma of prostatic ductal origin: A cytologic case report with immunohistochemical and quantitative dna correlation
Authors: Howell Lydia P. , Teplitz Raymond L.
Published: February 2007

This report describes the aspiration biopsy cytology (ABC) of a case of papillary carcinoma of ductal origin, an uncommon malignant tumor of the prostate. Only one case has been previously reported in the cytology literature. Atypical papillary fragments are the distinctive cytologic findings. Similar to well‐differentiated acinar carcinoma of the prostate, the cytologic features of malignancy in this lesion may be subtle, and diagnosis is based on the presence of the cytologic pattern. Positive immunohistochemical staining with prostate‐specific acid phosphatase confirms the prostatic origin. Application is made of quantitative DNA analysis for prognostic determination.
Argyrophil carcinoma of the breast: A cytologic, histochemical, and ultrastructural study of a case
Authors: Hussein K. A. , Sanders D. S. A. , Preece P. E. , Hunter S. M. , Nicoll S. M.
Published: February 2007

Aspirate from an argyrophil carcinoma (“carcinoid”) of the breast showed malignant dispersed epithelial cells. With Diff‐Quik, the cytoplasm was seen to be abundant, with prominent eosinophilic granularity. The nuclei were fairly uniform, round or oval, and eccentric and had a finely stippled chromatin pattern. On histology, the tumor appeared typical for argyrophil carcinoma, and staining with Grimelius for argyrophilic granules was positive. Membrane‐bound neurosecretory granules were seen on electron microscopy.
Chain of events in papanicolaou smear testing: Impact on quality assurance
Authors: Genack Lorri J. , Schumann G. Berry
Published: February 2007

Quality assurance is defined in this article as a comprehensive program aimed at preventing and controlling errors from the time a test is ordered until test results are reported and utilized in the care of the patient. Quality control is only one facet of a total quality assurance program. Recently, the general public, professional organizations, and regulatory agencies have scrutinized the standards and practice of Papanicolaou smear testing. The components of quality assurance for gynecologic cytology are reviewed, and the chain of events in performing effective cytologic testing is described. The impact of various events on the outcome of Papanicolaou smear testing is thoroughly discussed.
Cytopathological changes in human cervix and endometrium following prolonged retention of copper‐bearing intrauterine contraceptive devices
Authors: Misra Jata S. , Engineer Amy D. , Tandon Prabha
Published: February 2007

Since 1971, cytological evaluation of cervical smears and endometrial aspirates was carried out in 604 women wearing CuT200 intrauterine contraceptive devices (IUDs) for periods ranging from 6 mo to 15 yr. No cases of cervical neoplasia or endometrial carcinoma were encountered, even after continuous use of the device for 15 years. Dysplastic cervical smears were, however, found in 45 postinsertional smears, and endometrial hyperplasia was detected in seven aspirates; in no cases was the dysplasia or hyperplasia higher than of moderate degree. Thirty‐nine of the 45 women with postinsertional dysplastic smears were followed for 3–4 yr; in no case did the lesion progress to a higher grade or to frank malignancy. However, persistence and recurrence of dysplasia were seen in 10 women, necessitating removal of the IUDs. The incidence of cervical dysplasia and endometrial hyperplasia was found to be much higher when the IUDs had been changed than when the original devices were worn continuously. The rate of removal of IUDs because of persistent or recurring dysplasia was also much higher in the former group. Since no pregnancies were reported in any of the women wearing the original device for as long as 15 yr, we do not advocate the practice of changing the device at the end of 3 yr for maintaining contraceptive efficacy as recommended by the manufacturers; instead, we recommend the uninterrupted retention of the original device for periods not longer than 5 yr in view of occurrence of endometrial hyperplasia in two 6‐yr wearers.
Role of culture for mycobacteria in fine‐needle aspiration diagnosis of tuberculous lymphadenitis
Authors: Radhika S. , Gupta S. K. , Chakrabarti A. , Rajwanshi A. , Joshi K.
Published: February 2007

A total of 390 cases of tuberculous lymphadenitis was subjected to fine‐needle aspiration cytology; 100 of the aspirates were subjected to culture for mycobacteria. The overall acidfast bacilli (AFB) positivity in smears was 23.58%. with a maximum positivity of 32.94% in smears with both necrosis and granuloma. The overall rate of isolation of mycobacteria on culture was 35%. Mycobacteria were more frequently isolated from caseating lesions (40%) than noncaseating lesions (9%). Caseating lesions with granuloma had the highest AFB (smear and/or culture) positivity at 52%. Mycobacterium avium infection was diagnosed by culture in one case.
Aspiration cytology of neuroendocrine tumors below the diaphragm
Authors: Leiman Gladwyn , Mair Sharon
Published: February 2007

In a series of 630 transabdominal fine‐needle aspirates, 24 neuroendocrine tumors (NETs) presenting below the diaphragm were encountered. Of these, 10 were classic small‐cell undifferentiated carcinomas (SCUCs). Recognition of SCUC in abdominal aspirates has major directive value, pointing to bronchogenic origin, possibly unsuspected, in most cases (eight of 10 in this series). The other 14 NETs were 10 pancreatic islet‐cell tumors and four intestinal carcinoids, both diagnosed more frequently in metastatic than in primary sites (10 of 14 in the liver in this series). The cytologic presentation of these non‐SCUC neoplasms has received little literature attention, and it is described and differtrated here, with discussion of cytologic pitfalls and differential diagnoses. Diagnostic specificity was 100%, and sensitivity was also 100%, exclusive of two sampling errors. The purpose of this article is to establish a broader view of the range of morphological features of the extended neuroendocrine group of tumors in aspiration cytology.
Fine‐needle aspiration cytology of postirradiation sarcomas, including angiosarcoma, with immunocytochemical confirmation
Authors: Silverman Jan F. , Lannin Donald L. , Larkin Ernest W. , Feldman Philip , Frable William J.
Published: February 2007

Postirradiation sarcomas are an unusual but well‐recognized late effect of cancer therapy. In this article, a fine‐needle aspiration (FNA) series of four cases is presented. There were three female patients and one male patient, with an age range of 28–55 yr (mean, 41). Two of the patients were irradiated for uterine cervical carcinoma while the other two received irradiation for malignant lymphoma. The time interval to the development of the postirradiation sarcoma ranged from 10 to greater than 20 yr. There were a postirradiation synovial sarcoma of the buttock region, malignant fibrous histiocytoma of the bone (femur), and rhabdomyosarcoma and angiosarcoma of the retroperitoneum. A spectrum of cytologic findings was encountered, reflecting the specific types of sarcomas. Immunocytochemical studies performed on the aspirated material from the angiosarcoma demonstrated the utility of immunoperoxidase stains for ULEX europaeus agglutinin‐I (UEA‐I) and, to a lesser degree, factor VIII‐related antigen antibody, confirming the vascular nature of this malignancy. The FNA findings from all four cases demonstrated cytologic features that allowed recognition of this unusual complication of irradiation treatment. This article confirms the utility of FNA cytology in following patients with previous malignancies and differentiating a postirradiation sarcoma from recurrent carcinoma.
Sarcoidosis diagnosed on fine‐needle aspiration cytology of salivary glands: A report of three cases
Authors: Aggarwal Anand Prakash , Jayaram Gita , Mandal Ashish Kumar
Published: February 2007

Three female patients, two presenting with bilateral parotid gland enlargement and one with bilateral submandibular gland enlargement, were subjected to fine‐needle aspiration cytology (FNAC). Smears showed noncaseating epithelioid cell granulomas with or without giant cells and salivary gland acini with varying degrees of degenerative changes. After excluding other granulomatous lesions, sarcoidosis was suggested and was subsequently proved in all three cases. FNAC, therefore, may be considered a useful diagnostic modality in cases of sarcoidosis presenting primarily with head and neck involvement.
Diffuse pigmented villonodular synovitis of the temporomandibular joint diagnosed by fine‐needle aspiration cytology
Authors: Dawiskiba Sigmund , Eriksson Lars , Elner Åke , Johansen Carl Christian , Hansson Lars‐Göran , Westesson Per‐Lennart
Published: February 2007

Diffuse pigmented villonodular synovitis is a rare tumor in the temporomandibular joint region. This article deals with a 32‐yr‐old male who suffered from pain and swelling in the right temporomandibular joint region associated with restricted mouth opening. Computed tomography showed a tumor lateral to the temporomandibular joint. Arthrography revealed a displaced temporomandibular joint disk. Fine‐needle aspiration cytology showed characteristic cellular changes, including rounded or oval cells with abundant cytoplasm and intracytoplasmatic hemosiderin deposits and numerous multinucleated giant cells without nuclear atypia. A benign mesenchymal lesion suggestive for pigmented villonodular synovitis was diagnosed and later verified at histologic examination. Fineneedle aspiration cytology seems to be useful for this diagnosis.
Development and application of immunocytochemical staining techniques: A review
Authors: Myers Joseph D.
Published: February 2007

Since the field of immunocytochemistry was pioneered almost half a century ago, over 30 different immunostaining methods have been developed. Most laboratory investigators, however, are aware of only a few of the more popular techniques. This article, therefore, reviews and places in historical perspective many of the less common methodologies. A discussion of the progression of immunostaining methodology from purely immunologic techniques (employing only antigens, antibodies, and free enzymatic preparations) to procedures that use nonimmunologic substances (such as avidin, biotin, and protein A) is presented. Basic principles of immunostaining, including specimen preparation, fixation, control procedures, interpretation, and problems unique to cytopathology, are also discussed. Schematic diagrams that illustrate the nature and arrangement of the immunochemical reagents employed in most of these techniques are provided in order to demonstrate how various materials can be combined to create a desired staining effect.
The 1988 Bethesda system for reporting cervical/vaginal cytologic diagnoses: Developed and approved at the national cancer institute workshop in Bethesda, MD, December 12–13, 1988
Authors: Soloman Diane
Published: February 2007

The Bethesda System for reporting cervical/vaginal diagnoses, introduced in this article, is a flexible guideline and can be modified as appropriate to meet the needs of cytopathologists, referring physicians, and patients.
The future of cytotechnology
Authors: Hogan Christine L.
Published: February 2007

The future of cytotechnology will reflect the sweeping changes taking place in diagnostic cytology today. These changes affect a variety of issues including the decreasing enrollment in cytotechnology training programs, the growing shortage of qualified technologists, the dilemma of unfavorable publicity, and the implementation of increasing government legislation. Despite these difficulties, this is a technically exciting time in cytology. Many new techniques, including immunocytochemistry, flow cytometry, image analysis, and DNA hybridization, are currently being applied to diagnostic cytology. The need for reform and the prospect of state‐of‐the‐art technology will combine to shape the profession of cytotechnology.
The value of fine‐needle aspiration biopsy in the cytodiagnosis of salivary gland lesions
Authors: Jayaram N. , Ashim Das , Rajwanshi A. , Radhika S. , Banerjee C. K.
Published: February 2007

Fine‐needle aspiration cytology (FNAC) was performed on 195 cases of salivary gland lesions. The smears were technically adequate in 178 cases. Tissue examination was available for subsequent histocytologic correlation in 57 cases. The cytodiagnosis included inflammatory lesions (59) and benign (68) and malignant (51) tumors (total, 119). The accuracy of cytodiagnosis was 87.7% with a sensitivity of 80.9% and a specificity of 94.3%. Exact histologic typing was possible in 61.9% of the malignant tumors. Mucoepidermoid tumors and cellularatypical pleomorphic adenoma posed difficulties in cytodiagnosis.
Ductal carcinoma‐in‐situ of the breast: Fine‐needle aspiration cytology of 12 cases
Authors: Sneige Nour , White Virginia A. , Katz Ruth L. , Troncoso Patricia , Libshitz Herman I. , Hortobagyi Gabriel N.
Published: February 2007

Aspiration specimens from 12 patients with histologically documented ductal carcinoma‐in‐situ (DCIS) of the breast (seven patients) or DCIS with minute foci of stromal invasion (five) were evaluated. Five patients presented with palpable masses, 1.5–4.0 cm, and four patients presented with localized thickening, associated with nipple erosion and discharge in two of them. One patient had nipple inversion, and one patient had bilateral nipple discharge. In one patient, no apparent abnormality of the breast was present. Mammography was either suspicious for or strongly suggestive of carcinoma in 10 patients and negative in two. Aspirates from all patients were composed of fragments of atypical ductal epithelium and numerous single epithelial cells. In nine cases, the smears were hypercellular and similar to aspirates of typical invasive ductal carcinoma. Calcifications were present in six cases. In four of these, associated tumor necrosis was evident. Cytologic features separating DCIS patients from those showing minimal stromal invasion or common types of invasive ductal carcinoma (IDC) were not identified. We conclude that fine‐needle aspiration cytology of DCIS is identical to that of IDC. If preoperative radiotherapy or chemotherapy is considered in the management of invasive breast carcinoma, cutting‐needle biopsy for confirmation of tumor invasion is necessary.
Criteria for aspiration cytology for the diagnosis of seminoma
Authors: Fleury‐Feith J. , Bellot‐Besnard J.
Published: February 2007

Fine‐needle aspiration cytology was performed in two cases of intra‐abdominal tumors, one from retroperitoneal lymph nodes and one from a cryptorchid testis. The cytological diagnosis was consistent with seminoma in both cases. Cytological features included uniform neoplastic malignant cells with round nuclei and nucleoli. The cytoplasm, easily observed on May‐Grünwald‐Giemsa‐stained smears, contained large vacuoles or lacunes filled with glycogen. Alkaline phosphatase activity was strictly located to one cytoplasmic area of the cells. This cytological and cytoenzymatic pattern is different from that observed in other intra‐abdominal tumors, including adenocarcinoma, large‐cell lymphoma, and embryonal carcinoma.
Fine‐needle aspiration cytology of sacrococcygeal chordoma
Authors: Nijhawan Vijay S. , Rajwanshi Arvind , Das Ashim , Jayaram N. , Gupta Subhash K.
Published: February 2007

The fine‐needle aspiration cytology (FNAC) of four cases of chordoma that were diagnosed preoperatively is presented. One of the cases showed anaplastic components along with the classical features of chordoma; this is probably the second case diagnosed with these features on FNAC. The cytologic features of classical chordoma include conspicuous extracellular matrix in the background. Polygonal cells, dissociated and in small groups, were identifed in all cases. Physaliphorous cells were also prominently found in these cases. In addition, the case with anaplastic features showed very bizarre cells with profound multinucleation and the presence of intranuclear cytoplasmic inclusions. The diagnosis of chordoma was possible because of a high index of suspicion on clinical grounds and the use of special staining for confirmation.
Mucinous cystadenocarcinoma of the pancreas: Diagnosis by fine‐needle aspiration cytology
Authors: Gupta Raj K. , Scally John , Stewart Richard J.
Published: February 2007

Two cases of mucinous cystadenocarcinoma of the pancreas are described in which the diagnosis was made from the material obtained by a computed tomography‐guided fine‐needle aspiration cytology examination. It is strongly felt that aspiration cytology, when performed under imaging guidance, is sensitive and specific in the diagnosis of mucinous cystadenocarcinoma and allows for a relatively simple yet confident diagnostic interpretation of this uncommon pancreatic tumour.
False‐positive diagnosis in fine‐needle aspiration of an atypical Warthin's tumor: Histochemical differential stains for cytodiagnosis
Authors: Laucirica Rodolfo , Farnum James B. , Leopold Sophie K. , Kalin George B. , Youngberg George A.
Published: February 2007

Cytologic smears of a Warthin's tumor (WT) typically consist of sheets of oncocytic (oxyphilic) cells and scattered lymphocytes. Reparative foci within this neoplasm can occur, which may give rise to exfoliated, malignant‐appearing, squamouslike cells. A false‐positive diagnosis of squamous carcinoma can occur when these atypical cells dominate the cytologic aspirate. Histochemical and immunoperoxidase stains may aid in diagnosing an atypical WT when the usual cytologic features are absent.
Mites in pulmonary cytology specimens
Authors: Farley Margaret L. , Mabry Linda C. , Hieger Leroy R.
Published: February 2007

Mites were observed in 55 pulmonary specimens examined routinely over a 4.5‐yr period. The 55 specimens included 33 spontaneous and 12 aerosol‐induced sputum samples, nine bronchial washings, and one fine‐needle aspirate. Two specimens contained only fragments of mites; however, in most cases the mites were relatively intact. Many were identified as Tyrophagus sp, but a few were definitely not Tyrophagus sp. Although only a single mite was noted in most instances, eight specimens contained more than one, with the maximum being six. No patient was found to have a mite in more than one specimen. Mite eggs were found in five of the specimens containing mites. One specimen contained adults and a larval form. Mites appeared to be surrounded by acute inflammatory cells in 13 cases. Specimens were processed by the Saccomanno blending technique with smears prepared by pipetting a portion directly onto a slide or by utilizing a cytocentrifuge. No mites were found in nonpulmonary specimens. Both a seasonal variation and an interobserver variability were found. Mites often resemble specimen contaminants, such as food, and may be overlooked on routine screening. Mites are known to represent or produce a respiratory allergen, but the significance of their presence in pulmonary cytology specimens has not been determined.
Fine‐needle aspiration cytology in lymphomas and related disorders
Authors: Pontifex A. H. , Haley L.
Published: February 2007

Fine‐needle aspiration (FNA) is a useful technique in the care of patients with lymphomas and related diseases. It is most effective when the aspiration and interpretation are performed by the same individual and when a Romanowsky stain is the primary stain. Special studies that are applicable to lymph nodes biopsies can also be utilized in specimens obtained by FNA. In the previously undiagnosed patient, where a presumptive diagnosis of lymphoma is made by FNA, a subsequent open biopsy will usually be necessary. At that time, all the measures necessary for the precise classification of the lymphoma can be undertaken under ideal conditions. If a lesion appears reactive by FNA, then a period of clinical observation is required. In the patient with a previously diagnosed lymphoma, FNA is chiefly useful to exclude other coincidental disease and to confirm or exclude transformation of low‐grade lymphoma to a more aggressive phase.
The use of gastric salvage cytology in the diagnosis of malignancy: A review of 731 cases
Authors: Green Linda Kathleen , Zachariah Susan , Graham David Y.
Published: February 2007

Over an 8‐yr period at the Houston Veterans Hospital, 731 endoscopic gastric salvage cytologies were performed in 671 patients, with surgical biopsy also done in 660. Seventy‐six patients subsequently had tissue biopsy‐proven or resection‐proven malignancies. Salvage cytology had a sensitivity of 91 % and a specificity of 100% for the detection of primary adenocarcinoma. Biopsy alone had a sensitivity of 92%; endoscopic gastric salvage cytology and surgical biopsy combined had a sensitivity of 100% in both primary and metastatic neoplasms. This study shows that the combination of endoscopic biopsy and salvage cytology increases the diagnostic accuracy for gastric carcinoma. Gastric salvage cytology requires minimal disruption of the routine endoscopic procedure and is therefore an easier and more rapid cyfologic technique than gastric brushing cytology.
“Thick” cell membranes revealed by immunocytochemical staining: A clue to the diagnosis of mesothelioma
Authors: Leong Anthony s.‐Y. , Parkinson Richard , Milios James
Published: February 2007

The distinction of malignant mesothelioma from metastatic adenocarcinoma in pleural effusions and biopsies is frequently a diagnostic problem. Immunocytochemical staining of 13 malignant mesotheliomas, eight primary adenocarcinomas of the lung, five metastatic adenocarcinomas of the lung, and 20 primary adenocarcinomas in extrapulmonary sites with a monoclonal antibody to epithelial membrane antigen (EMA) revealed ‘thick’ cell membranes in all cases of mesothelioma. This distinctive pattern of staining was seen in the periphery of cell clusters and circumferentially around individual cells in cytologic preparations, cell blocks, and tissue sections. Intracel‐Mar and intercellular acini were also outlined by anti‐EMA, and long intraluminal microvillous projections were demonstrated. Weak cytoplasmic staining was only rarely seen in mesothelioma cells. This membranous staining pattern was not observed in adenocarcinomas, which displayed strong and diffuse cytoplasmic staining. The immunocytochemical demonstration of thick and spiky membranes circumferentially disposed around individual cells corresponds to aberrant microvilli, a diagnostic clue in the recognition of malignant mesothelioma.
Transbronchial needle aspiration biopsy in the diagnosis of pulmonary neoplasms
Authors: Bhat Nalini , Bhagat Pradeep , Pearlman Eugene S. , Kane Gregory , Figueroa William , Kannan Vaidehi , Kline Tilde S.
Published: February 2007

To evaluate the usefulness of transbronchial needle aspiration biopsy (TBNAB) in the primary diagnosis of lung cancer, we undertook a prospective study of this technique, assessing specimens from 124 patients over a 3‐yr period. Cytologic and/or histologic material obtained by an alternate technique was available for 105 (84.7%) of the patients. The diagnostic sensitivity of TBNAB was comparable with that of other bronchoscopic techniques; with the addition of TBNAB, the overall sensitivity of bronchoscopy was increased from 54% to 72% (P < 0.001). Because of its usefulness for diagnosis of submucosal tumors and its safety, we conclude that TBNAB is a useful addition to current methods for the diagnosis of suspicious pulmonary lesions.
Rates of condyloma and dysplasia in papanicolaou smears with and without endocervical cells
Authors: Mauney Marc , Eide David , Sotham Joseph
Published: February 2007

A retrospective study of 36,853 Papanicolaou smears recorded in our laboratory during the latter half of 1988 was undertaken to assess the effect of the absence or presence of columnar endocervical cells on the detection rate of cervical condyloma acuminatum and squamous dysplasia. We found that condyloma was diagnosed only slightly more frequently in smears with endocervical cells than in those without. However, cervical intraepithelial neoplasia was detected 2.3 times more frequently in smears with endocervical cells. The disparity in detection rate increased with higher grades of dysplasia. A significant difference in detection rate was maintained in all age groups except teenagers and patients 60 yr old and above. This suggests that smears lacking endocervical cells are less sensitive in screening for dysplasia and should be repeated when clinically appropriate.
Cytologic features of atypical mesothelial cells in peritoneal dialysis fluid
Authors: Selvaggi Suzanne M. , Migdal Stephen
Published: February 2007

From February 1988 through October 1988, 23 samples of peritoneal dialysis fluid from 20 patients with end‐stage renal disease were cytologically analyzed in an attempt to determine the effect of the dialysate on the mesothelial cells lining the peritoneal cavity. The patients, five female and 15; male, ranging in age from 26 to 75 yr, had been on continuous ambulatory peritoneal dialysis (CAPD) from 1 mo to 6 yr, 4 mo. The patients had no history of cirrhosis, neoplastic disease, radiation and/or chemotherapy, or current findings of infection. Smears and cytosieve filter preparations were made. Smear analysis included the mesothelial cell pattern, the degree of mesothelial cell atypia, and the presence of atypical multinucleated cells and mitoses. In the majority of the fluid samples, reactive mesothelial cells were arranged singly and in sheets. Moderately and severely atypical mesothelial cells were glandular and papillary in configuration. All samples contained at least a few reactive mesothelial cells: in six, the highest degree of cellular atypia was moderate: in 17, it was severe. The development of severe cellular atypia did not appear to be time dependent (a finding noted in samples from patients on dialysis for 6 mo up to 6 yr). When present, multinucleated mesothelial cells showed moderate to severe atypia. In four cases mitotic figures were present. On the basis of these findings, it is proposed that peritoneal dialysis plays a role in the development of mesothelial cell atypia.
Hydatid cyst: Primary diagnosis by fine‐needle aspiration biopsy
Authors: Ascoli Valeria , Teggi Antonella , Gossetti Francesco , Nardi Francesco
Published: February 2007

Two cases of soft‐tissues echinococcosis are presented in which the definitive diagnosis was established by identifying laminated layer remnants on fine‐needle aspiration smears. Large polygonal pieces of acellular material with delicate parallel striations were seen, while neither scolices nor hooklets were found. The cases reported most likely represent the occurrence of sterile hydatid cysts. A diagnosis of echinococcosis should be considered when fragments suggestive of laminated layer are identified on smears, even in unusual sites and without evidence of hooklets and/or scolices.
Mucin production by pleomorphic adenomas of the parotid gland: A cytologic spectrum
Authors: Stanley Michael W. , Lowhagen Torsten
Published: February 2007

Mucinous salivary gland aspirations represent a special diferential diagnostic problem. Considerations include pleomorphic adenoma. Warthin's tumor, chronic obstructive sialadenitis. and low‐grade mucoepidermoid carcinoma. We herein discuss three cases that illustrate a spectrum of mucin production by pleomorphic adenomas. The literature is reviewed, and the possible distinction of pleomorphic adenoma from low‐grade mucoepidermoid carcinoma is considered.
Rapid microwave‐stimulated fixation of fine‐needle aspiration biopsies for transmission electron microscopy
Authors: Gove David W. , Lang Carol A. , Waterhouse Lynette K. , Leong Anthony s.‐Y.
Published: February 2007

A new technique is described in which fine‐needle aspiration biopsies are processed for transmission electron microscopy within 2 hr. This rapid processing method includes exposure of the biopsy in a glutaraldehyde‐formaldehyde mixture to microwaves for 25 sec in a domestic oven. The specimen is then routinely stained, processed through graded ethanol, and embedded in epoxy resin to produce excellent preservation of fine structural features.
Cytology of nonneoplastic cysts of the ovary
Authors: Selvaggi Suzanne M.
Published: February 2007

From March 1986 through September 1988, cytologic material from 13 nonneoplastic ovarian cysts collected at the time of surgical removal of the ovary was compared with the histologic follow‐up of these lesions in an attempt to characterize the cytologic features of benign ovarian cysts. In 22 additional nonneoplastic cysts, cellular material was obtained by the clinician with fine‐needle aspiration, The 32 patients ranged in age from 18 to 64 yr (mean, 36.8; median, 35.5); of these, 24 were premenopausal, 6 were perimenopausal, and 2 were postmenopausal. Cytologically, follicular cysts (two cases) showed clusters of granulosa cells, some containing mitotic figures. Luteinized follicular cysts (11 cases) were composed of granulosa cells admixed with luteinized granulosa cells. Hemorrhagic corpora lutei (five cases) were characterized by fresh blood containing hemosiderin‐laden macrophages and luteinized granulosa cells. Hemorrhagic corpus heal cysts (10 cases) showed the presence of luteinized granulosa cells, fibroblasts, hemosiderin‐laden macrophages, fresh blood, and abundant fibrin. In addition to these findings, regressing corpora lutei (two cases) contained macrophages with yellow hematoidin pigment. Endometriotic cysts (three cases) were composed of fresh blood, hemosiderin‐laden macrophages, and scattered endometrial cells. In two cysts, subclassification was not possible due to scanty cellularity. An understanding of the cytologic features of nonneoplastic ovarian cysts may encourage aspiration as opposed to surgical ovarian removal. This has important implications, particularly in women of child‐bearing age who wish to preserve their fertility.
Chlamydia trachomatisin cervical uterine irradiated cancer patients
Authors: Maeda Marina Yoshiě Sakamoto , Filho Adhemar Longatto , Shih Lai Wun Song , Cavaliere Maria José , Oyafuso Marina Suheko , Marziona Francisco , Santos Donizetti Ramos , Carvalho Manoel InáCio
Published: February 2007

Twenty‐two women with uterine carcinoma with morphological alterations postradiation treatment suggestive ofChlamydia trachomatisinfection were analyzed by direct immunofluorescence. The diagnosis was confirmed in 12 (54.4%) cases. Discussions of the presence ofChlamydiain irradiated cells were not found in the literature. This finding may signify a posttherapeutic morbidity or a preradiation infection.
Fine‐needle aspiration cytology of granulocytic sarcoma and myeloid metaplasia
Authors: Silverman Jan F. , Geisinger Kim R. , Kim Park H. , Strausbauch Paul R. , Frable William J.
Published: February 2007

The fine‐needle aspiration (FNA) cytology of two cases of granulocytic sarcoma involving the breast is reported along with the FNA cytology of one case of myeloid metaplasia (extramedullary hematopoiesis) involving an axillalry lymph node. Two patients had known myeloproliferative disorders, while granulocytic sarcoma of the breast was the initial presentation of an unsuspected acute granulocytic leukemia in the other patient. Diff‐Quik‐stained preparations aided in the diagnosis of all three cases. Immunoperoxidase stains for factor VIII‐related antigen helped confirm the megakaryocytic differentiation of the cells in the FNA cytology of myeloid metaplasia. Electron microscopic (EM) examination performed on the aspirated material also showed megakaryocytic differentiation of the bizarre cells. FNA cytology can make a specific diagnosis of granulocytic sarcoma and myeloid metaplasia. The workup of these unusual extramedullary myeloproliferative masses was aided when immunocytochemistry and EM were performed on the aspirated material.
Malignant rhabdoid tumor of the kidney diagnosed by fine‐needle aspiration cytology
Authors: Drut Ricardo
Published: February 2007

A case of malignant rhabdoid tumor (MRT) of the kidney diagnosed by fine‐needle aspiration cytology (FNAC) in a 4‐mo‐old infant who later developed a left pleural' effusion (also recognized as metastatic disease by cytologic means) is reported. Rhabdoid cells—intermediate‐sized cells with vesicular nuclei and prominent nucleoli, exhibiting a paranuclear, eosinophilic. dense inclusion—seem to be specific enough for this tumor to allow diagnosis by FNAC.
B cell lymphoma of the thyroid in hashimoto's thyroiditis monitored by fine‐needle aspiration cytology
Authors: Jayaram Gita , Rani Sudha , Raina Vinita , Singh Col Harcharan , Chandra Mithilesh , Marwaha Raman Kumar
Published: February 2007

An 80‐yr‐old female with a grade I diffuse goiter was diagnosed on fine‐needle aspiration cytology as having Hashimoto's thyroiditis. Two years later, she developed a hard nodular growth in the right lobe of the thyroid, which was subjected to fine‐needle aspiration and diagnosed as a non‐Hodgkin's lymphoma. Immunocytology demonstrated the monoclonal B cell nature of the lesion. The patient underwent total thyroidectomy and is alive and free of the disease 27 mo after surgery.
Efficacy of fine‐needle aspiration and sampling of lymph nodes in 1,484 chinese patients
Authors: Hsu Chih , Leung Betty S. Y. , Lau Sai‐Kit , Sham Jonathan S. T. , Choy Damon , Engzell Ulf
Published: February 2007

A retrospective study of 1,855 fine‐needle aspirations of the lymph node (LN) from 1,484 Chinese patients in Queen Mary Hospital over a period of 11.5 yr (January 1, 1976, to June 30, 1987) was reviewed and analyzed. Positive cytologic results diagnosed malignancies in 49.3%. Sensitivity and specificity of cytology reached 95% and 96.5%, respectively. The order of frequency of the metastatic tumors according to primary sites was analyzed. The most common metastatic carcinomas in various groups of LNs were nasopharyngeal carcinoma in the cervical LN. breast carcinoma in the axillary LN, and cervical carcinoma in both the groin and pelvic LNs. Tuberculosis (TB) is an important dixerential diagnosis: FNAC showed a sensitivity of 76.9% in the detection of TB lymphadenopathy.