bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytodiagnosis of colonic adenoma: Morphology and clinical importance
Authors: Kannan Vaidehi , Masters Charles B.
Published: February 2007

This is a retrospective review of 74 colonic brushings with a view to identiyy colonic adenomas and recognize the cytologic features of villous adenoma (VA) and tubular adenoma (TA). Smears were reviewed for overall field pattern as well as individual cellular changes. The results were tabulated and analyzed for differences and similarities.

The most distinguishing feature of adenoma was the presence of isolated and clustered elongate “needle” and “Yan” cells as first described by Thabet. These were more abundant and in papillary cluster formations in VA as opposed to clusters of more blunted configuration in TA. Another striking feature of VA was an abundance of elongated benign naked needle nuclei in the background. Smears from some cases of TA revealed isolated and clustered needle cells in low numbers but almost no naked nuclei. Tubulovillous adenoma (TVA) showed features of VA on brush cytology. A hemorrhagic diathesis was distinctly more prominent in VA than in TA. However, focally some red cells were noted in smears from TA. The patterns of TA and VA were otherwise essentially similar with regard to cellularity, individual cell sizes, N/C ratios, and nuclear appearance.
Fxine‐needle aspiration biopsy of papillary thyroid carcinoma: Cytologic, histologic, and ultrastructural correlations
Authors: Akhtar Mohammed , Ali Muhammad Ashraf , Huq Mahmuda , Bakry Mohammed
Published: February 2007

Aspiration smears from a series of 21 papillary thyroid carcinomas were studied and a number of morphologic features correlated with the histologic and ultrastructural patterns. These included types of papillary structures, metaplastic cells, grooved and lobulated nuclei, optically clear nuclei, intranuclear inclusions, and macrophages. Generally there was a close correlation between histologic and cytologic findings. The numbers of macrophages and metaplastic cells appeared to be exaggerated in aspiration smears as compared with those seen on histologic sections. Optically clear nuclei were not seen on the air‐dried cytologic smears. Grooved nuclei were somewhat difficult to recognize in the aspiration smears, although lobulated nuclei were identifed easily. We consider the latter to be a significant feature in the diagnosis of papillary carcinoma. Ultrastructurally grooved nuclei showed a deep linear indentation of the nuclear membranes. Lobulated nuclei were characterized by multiple indentations that divided the nucleus into several lobules.
Fine‐needle aspiration biopsy of malignant melanoma: A cytologic and immunocytochemical analysis
Authors: Simmons Thomas J. , Martin Sue Ellen
Published: February 2007

The immunoreactivity of alcohol‐fixed cell blocks from 15 fine‐needle aspiration (FNA) specimens of malignant melanoma was investigated using monoclonal antibodies to keratin and vimentin intermediate filaments, melanoma cytoplasmic antigen (HMB‐45), and S‐100, as well as polyclonal antibodies to S‐100. The results were compared with the immunoprofiles obtained using formalin‐fxed surgical specimens from 10 of the same patients, In all cases, immunostaining for keratin was negative and immunostaining for vimentin was positive. Immunostaining for HMB‐45 was positive in 13/15 aspirates and in 9/10 surgical specimens. Immunostaining for S‐100 protein showed the greatest variability in staining, with 5/15 fine needle aspiration biopsies and 9/10 surgical specimens being positive using the polyclonal antibody and only 1/15 FNA specimens and 7/10 surgical specimens being positive using the monoclonal S‐100 reagent. Our findings indicate that immunocytochemical studies can be very useful as an adjunct in the FNA diagnosis of melanoma. Also included in our series is an unusual variant of malignant melanoma, the so‐called signet ring melanoma. Given the location of the anal verge, the use of immunocytochemical markers was essential in establishing the correct diagnosis in this case. While S‐100 protein is of limited value as a marker of melanoma in alcohol‐fixed FNA specimens, a definitive diagnosis of malignant melanoma can be made using a panel of antibodies including keratin, vimentin, and HMB‐45.
Cryptococcal thyroiditis: Report of a case diagnosed by fine‐needle aspiration cytology
Authors: Vaidya Kamini P. , Lomvardias Stylianos
Published: February 2007

A 54‐yr‐old female diabetic presented with a febrile illness and respiratory distress associated with bilateral alveolar infiltration. The left lobe of the thyroid gland was enlarged and failed to concentrate pertechnetate. The patient was euthyroid. Cryptococcus neoformans was recognized in a fine‐needle aspirate and was confirmed by culture: it was also grown in blood culture. Death was attributed to the respiratory condition. This report emphasizes the emergence of mycotic infections of the thyroid and presents an efficient method for their identification.
Cytologic features of collagenous spherulosis of the breast
Authors: Johnson Terri L. , Kini Sudha R.
Published: February 2007

Collagenous spherulosis is generally classified as a component of benign proliferative breast disease. Previous reports have described the histologic features of collagenous spherulosis, but we are unaware of cytologic descriptions of the condition. In this report, the cytologic features of collagenous spherulosis are described and the differential diagnosis is discussed.
Fine‐needle aspiration cytology of an unusual primary lung tumor, chondrosarcoma: Case report
Authors: Stanfield Barbara L. , Powers Celeste N. , Desch Christopher E. , Brooks James W. , Frable William J.
Published: February 2007

A case of primary chondrosarcoma of the lung diagnosed by fineneedle aspiration biopsy (FNAB) cytology in a 78‐yr‐old male is presented. A mass detected on chest x‐ray and defined by CT scan was subjected to a preoperative percutaneous fine‐needle aspiration under fluoroscopic guidance. The distinctive cytologic features of pleomorphic cells nestled in lacunae surrounded by a chondromyxoid background resulted in a diagnosis of chondrosarcoma. The left upper lobectomy specimen confirmed the FNAB diagnosis and identified the tumor as arising from the left upper lobe bronchus.
Megakaryocytes in fine‐needle aspiration biopsy of breast
Authors: Chen Karl T. K. , Tschang Tai‐Po
Published: February 2007

An unusual case in which megakaryocytes were found in fine needle aspirate of a breast lesion is reported. The megakaryocytes in the smears were initially mistaken to be malignant cells. However, the cell block sections available later showed normal bone marrow particles, indicating that an inadvertent puncture of a rib was the reason for the presence of megakaryocytes in the smears.
Cyto‐histological correlates in a colposcopic clinic: A 1‐year prospective study
Authors: Joseph Mariamma G. , Cragg Frank , Wright V. Cecil , Kontozoglou Theodosios E. , Downing Patricia , Marks Francis R.
Published: February 2007

As part of the Quality Assurance Program, all surgical pathology reports of cervical colposcopic biopsies, cone biopsies, and hysterectomy specimens of 772 consecutive patients were correlated with cytology results for a period of 1 yr. The abnormality in cytology or histology ranged from HPV effect to invasive carcinoma. Cytohistological correlation within one grade of severity was obtained in 662 (86%)cases. On formal review of the remaining 110 (14%) cases, sampling error occurred in 75 cytology smears and in 21 colposcopic biopsies. Screening and interpretation error occurred in 10 smears and four biopsies. In this study the sensitivity of cervical cytology in detecting epithelial abnormalities was 90%, with a positive predictive value of 99.7%. The false‐negative rate of cytology was 11 % and the false‐positive rate 0.26%. The majority (90%) of false negatives were due to sampling error; the rest were due to laboratory error. The sensitivity of colposcopic biopsy was 97% with a positive predictive value of 99.4%. The falsenegative rate of biopsy was 2.7% and the false‐positive rate 0.5%.

Endocervical cells were seen in 48% (370) of smears and absent in 52% (402). However, in both instances the detection rate of squamous abnormality was 90%. Also 43% (33) of smears that showed endocervical cells failed to contain the abnormal cells. Endocervical curettage or cone biopsy in 16 of these 33 cases clearh showed a small CIN‐III lesion high in the endocervical canal. We believe that the value of endocervical cells as an indicator of adequacy is questionable. Our results indicate that smears with HPV effect or CIN‐I would require colposcopic evaluation and cervical biopsy in order to exclude an underlying more severe lesion.
Working formulation of the non‐Hodgkin's lymphomas: A study of cell size and mitotic indices in cytologic subtypes
Authors: Das Dilip K. , Gupta Subhash K. , Datta Bhoopendra N. , Sharma Suresh C.
Published: February 2007

Cell size and mitotic indices were studied in 243 nonHodgkin's lymphomas (NHL) diagnosed cytologically and classified according to the Working Formulation. Low‐, intermediate‐, and high‐grade lymphomas constituted 14.8%, 18.9%, and 61.7% of the cases, respectively. Measurement of the diameter of 100 lymphoid cells in each case showed that in most of the low‐grade malignant lymphomas, 50‐80% of the cells were small (< 10 μm). A majority of the cells (an average of 45‐60%) in intermediate‐ and high‐grade lymphomas were in the range of 11‐15 μm. Only the intermediate‐grade large noncleaved and high‐grade immunoblastic lymphomas had a majority of their cells (> 50%) larger than 15 μm. The mitotic indices (number of mitotic figures per 500 lymphoid cells) showed a highly significant difference between low‐ (0.7±1.14), intermediate‐ (3.0±2.67), and high‐grade (5.4±3.40) lymphomas using the Wilcoxon's signed rank test (P < 0.0001). Nearly two‐thirds of the cases in each grade were within specific ranges of mitotic indices, i.e., < 1 for low‐, 1‐3 for intermediate‐, and > 3 for high‐grade lymphomas.
Fine‐needle aspiration biopsy (FNAB) diagnosis of testicular involvement in acute lymphoblastic leukemia in children
Authors: Akhtar Mohammed , Ali M. Ashraf , Burgess Anwaar , Aur Rhomes J. A.
Published: February 2007

A series of 106 fine‐needle aspiration biopsy specimens obtained from the testes of children with acute lymphoblastic leukemia was reviewed retrospectively. Involvement by leukemia was seen in 34, there was no evidence of disease in 52, and the cellular sample was inadequate in 20, All aspiration smears, except those with leukemic involvement, showed a variable number of Sertoli cells. Testicular leukemia was diagnosed by the presence of numerous leukemic cells and rare or no Sertoli cells. Fine‐needle aspiration biopsy is a simple but effective technique for diagnosing leukemic involvement of the testis in children with acute lymphoblastic leukemia.
Granulomatous prostatitis: A spectrum including nonspecific, infectious, and spindle cell lesions
Authors: Stanley Michael W. , Horwitz Charles A. , Sharer William , Uke Erol , Kaye Keith , Burton Linda
Published: February 2007

Most granulomas of the prostate are nonspecific; infectious, post‐operative, and allergic lesions are much less common. Fine‐needle aspiration findings in the typical case are distinctive and easily recognized. Several series have been reported, but few have included histologic follow‐up. We describe three cases of granulomatom prostatitis (GP) which showed a spectrum of findings confirmed by histologic sections. In all cases, carcinoma was suspected clinically. Case 1 represents typical nonspecific GP with epithelioid and multinucleated histiocytes. In case 2, aggregates of epithelioid histiocytes alternated with areas of necrosis and neutrophils. Histologically, the granulomas showed purulent centers. Silver stains revealed budding yeast in smears and sections. Cultures of FNA material subsequently revealed Cryptococcus. In case 3, the histiocytes were predominantly spindled and occurred singly and in groups. The differential diagnosis included reactive and neoplastic spindle cell lesions. Histologic sections showed GP with spindled histiocytes. Appreciation of the broad cytologic spectrum of GP will facilitate accurate cytologic diagnosis.
Cytology of endobronchial granular cell tumor
Authors: Mermolja Milivoj , Rott Tomaž
Published: February 2007

Cytologic features of four cases of endobronchial granular cell tumor are presented. The diagnostic cells were found in bronchoscopically obtained material. They were arranged in smaller clusters and had finely granular cytoplasm with uniform oval or round nuclei. Frequently the cells are overlooked on regular cytologic examination owing to their benign nature. Nevertheless, there are enough cytomorphologic features that help to distinguish these cells from macrophages and bronchial epithelial cells. It is essential that the possibility of granular cell tumor is considered on cytologic examination. Final diagnosis, however, requires histologic verification.
Echinococcosis (hydatid disease) in Missouri: Diagnosis by fine‐needle aspiration of a lung cyst
Authors: Ingram Ellis A. , Helikson Mary Alice
Published: February 2007

Echinococcus granulosus was diagnosed by fine‐needle aspiration cytology of a lung cyst in a 6‐yr‐old white female in central Missouri. No adverse reaction occurred following the aspiration. The cytologic sample yielded clear fluid containing numerous clearly identifiable protoscoleces diagnostic for echinococcosis using routine PAP staining. Since hydatid disease is extremely uncommon in the Midwest, it had not initially been considered in the differential diagnosis. The infection was probably not indigenous to Missouri, since the patient lived the first 3 ½ yr of life in Alaska, where the organism is endemic. This can only be speculative, however, since echinococcal organisms are found in wildlife in the Midwest.
Occurrence of Pneumocystis carinii organisms in a peritoneal effusion from a patient with the acquired immunodeficiency syndrome
Authors: Magliocco A. , Miller K. , Robertson D. I. , Gill M. J.
Published: February 2007

We describe a unique case of Pneumocystis carinii organisms within a peritoneal effusion of a patient with acquired immunodeficiency syndrome (AIDS). The patient, a 28‐yr‐old homosexual male with profound immunosuppression, presented with splenomegaly and ascites. A peritoneal tap was performed for diagnostic purposes. Cytologic examination of the cytospin specimen showed reactive mesothelial cells along with aggregates of debris reminiscent of the foamy exudates seen in the alveoli of lungs infected with the Pneumocystis carinii organism. A modified methanamine silver stain was performed and revealed the presence of scattered Pneumocystis carinii in the specimen. Extrapulmonary Pneumocystis carinii infection is occasionally seen in AIDS, but we could find no other reports of its detection in peritoneal fluid.
Sources of diagnostic discrepancies in fine‐ needle aspiration of the breast
Authors: Scopa Chrisoula D. , Koukouras Demetrios , Androulakis John , Bonikos Dionysis
Published: February 2007

Fine‐needle aspiration (FNA) is a valuable technique to use in the evaluation of breast lesions; however, inadequate and discrepant diagnoses do occur. To identify the source and nature of inaccuracies related to the method we studied 39 cases in which FNA posed diagnostic problems. These problems could be attributed to sampling errors (71.8%), to the criteria of adequacy we use at our institution (2.5.6%), and to interpretation (2.6%). The nature of the breast lesion (68%) was the most common cause of inadequate sampling, followed by the experience of the aspirator (32%).
Quality assurance in a fine‐needle aspiration biopsy service
Authors: Cohen Michael B. , Sideli Robert V.
Published: February 2007

Fine‐needle aspiration biopsy (FNAB) is an increasingly popular tool for the evaluation of a variety of palpable and nonpalpable masses. Its acceptance has been based on its simplicity, safety, and accuracy. It is its accuracy that is crucial and that requires careful clinical and/or histologic follow‐up. In order to satisfy our own department's quality assurance requirements, we developed a computer‐based searching program that effectively identifies FNAB cases in which there was histologic follow‐up and retrieves the necessary information to produce a meaningful quality assurance report.
Quantitative analysis of sputum cytologic differences between smokers and nonsmokers
Authors: Swan Gary E. , Schumann G. Berry , Roby Tina J. , Sorensen Kent W.
Published: February 2007

An exploratory analysis of sputum cytology was conducted to determine the extent and nature of cytomorphologic differences between smokers and nonsmokers. Specifically, alveolar macrophages, pigmentation of macrophages, neutrophils, mucus, mucous spirals, columnar cells, metaplastic cells, and dysplastic cells were analyzed and compared in 349 smokers and 93 nonsmokers. Results indicate that smokers have significantly higher scores on all components than do nonsmokers. Pigmentation of macrophages, alveolar macrophages, and mucous spirals were the major components discriminating between smokers and nonsmokers. A comparison of the nonsmoking sample with a different group of smokers (n = 466) revealed similar findings. Using the cytomorphologic parameters as the basis for classification, discriminant function analysis was able to classify correctly 94 percent of the nonsmokers and 91% of the smokers, a finding confirmed in the second group of smokers. These data indicate that smokers differ reliably from nonsmokers with respect to their cytomorphologic profile.
Cytologic assessment of tumor cell kinetics: Applications of monoclonal antibody Ki‐67 to fine‐needle aspiration smears
Authors: Henry Michelle J. , Stanley Michael W. , Swenson Bernie , Connolly Joyce E. , Bates Henry
Published: February 2007

Rates of tumor‐cell proliferation often provide prognostic information about a given neoplasm. Previously available methods for accessing cell kinetics are time consuming and expensive, and often require special equipment or radioactive reagents. Monoclonal antibody Ki‐67 binds a nuclear antigen expressed in proliferating but not in resting cells. We studied Ki‐67 immunostaining of fine‐needle aspiration smears from 40 benign and malignant masses. Labeling indices ranged from 0 (thyroid follicular adenoma) to 75 percent (pulmonary oat‐cell carcinoma). Frozen section immunostaining (11 cases) and flow cytometric assessment of cell proliferation (8 cases) were in good agreement with Ki‐67 labeling indices on smear material. We suggest that this method provides a rapid, inexpensive, and dependable means of assessing tumor‐cell kinetics in cytologic preparations.
Gastric carcinoma metastatic to the bone marrow: Immunoperoxidase identification of KMO‐1 antigen in MGG‐destained aspirate
Authors: Kobayashi Tadao K. , Yakushiji Michiaki
Published: February 2007

A case is presented that illustrates the application of the immunoperoxidase technique to the May‐Grünwald‐Giemsa (MGG)‐destained bone marrow aspirate. The cytologic findings in a MGG‐stained smear of the bone marrow suggested a metastatic epithelial tumor. Subsequently, a positive reaction to KMO‐1, a monoclonal antibody raised against a colon carcinoma cell line, was demonstrated in tumor cells in the MGG‐destained smear sample as well as in the paraffin‐embedded section of the primary gastric cancer. The demonstration of the cancer‐associated antigen in the MGG‐destained material may be useful in establishing the diagnosis of metastatic tumor in the bone marrow.
Leydig cell tumor of the testis: A case diagnosed by fine‐needle sampling without aspiration with histologic, immunohistologic, and electron microscopic analysis
Authors: Vielh Philippe , Borghesi Rita , Validire Pierre , Zajdela Antoine
Published: February 2007

Fine‐needle sampling without aspiration was performed in a patient with a testicular mass. The cytologic diagnosis was consistent with Leydig cell tumor. Cytologic features included abundant grey‐blue cytoplasms with spherical or oval nuclei in May‐Grünwald‐Giemsa‐stained smears. Intranuclear inclusions were observed but no Reinke's crystals were detected. Histologic findings confirmed the diagnosis and tumor cells were positive for vimentin. Electron microscopic analysis of the tumor showed abundant smooth endoplasmic reticulum and mitochondria with tubulovesicular cristae but no Reinke's crystals.
Diagnosis of endometriosis by fine‐needle aspiration cytology
Authors: Tabbara Sana O. , Covell Jamie L. , Abbitt Patricia L.
Published: February 2007

Endometriosis is a fairly common disease found in a variety of extrauterine locations. It primarily affects reproductive age women and has symptoms varying from occult to more specific complaints. Occasionally the lesions produce solid nodules and/or cysts that are clinically palpable and easily evaluated by fine needle aspiration (FNA).

We describe three cases of endometriosis diagnosed by FNA. The patients ranged in age from 32 to 38 and reported cyclic symptoms of pain, bleeding, or change in mass size. Two patients presented with subcutaneous masses (one along the upper pubic ramus, the other in the lower abdomen) and had ultrasonically guided FNA. The third patient had a vaginal cuff mass sampled by transvaginal FNA. All cytologic smears contained characteristic sheets of epithelial cells and fragments of loosely arranged spindled stroma. One case also showed mild epithelial atypia and plump stromal cells. Hemosiderin‐laden macrophages were found in only one case. The cytologic diagnoses were confirmed by tissue in all patients.

Endometriotic nodules must be evaluated for possible malignant transformation and differentiated from other benign and malignant masses, especially when clinical symptoms are vague. FNA offers a safe and effective tool for identification of endometriosis and obviates the need for diagnostic surgical procedures in some patients.
Cytologic characteristics of clear‐cell sarcoma of the kidney (CCSK) in fine‐needle aspiration biopsy (FNAB): A report of 4 cases
Authors: Drut Ricardo , Pomar Mabel
Published: February 2007

The cytologic findings observed in fine‐needle aspiration biopsy (FNAB) of four cases of clear‐cell sarcoma of the kidney (CCSK) are reported. Smears contained a monomorphicpopulation of cells exhibiting non‐descriptive cytoplasm and almost nude round to oval nuclei with smooth contour, evenly dispersed fine chromatin granules, and one or two small nucleoli. Some nuclei (approximately 40%) had a bar resulting from grooving or folding of the nuclear membrane. Comparison with smears of classical Wilms' tumor and malignant rhabdoid tumor allowed to recognize a distinctive pattern, different from other tumors of the kidney in in fancy. The recognition of the CCSK cytologic pattern justifies the usage of aggressive preoperative chemotherapy protocols or the indication of surgery avoiding delays.
Pneumocystis carinii in fna of the thyroid
Authors: Walts Ann E. , Pitchon Howard E.
Published: February 2007

We report the diagnosis of Pneumocystis carinii (PC) in a fine‐needle aspirate (FNA) from the thyroid of a human immunodeficiency virus infected (HIV+) male receiving aerosolized pentamidine as prophylaxis for Pneumocystis carinii pneumonia (PCP). The clinical diagnosis prior to FNA was multinodular goiter. The patient did not have pulmonary symptoms nor previous diagnosis of PCP at the time of the aspirate diagnosis. Recently, extrapulmonary Pneumocystis carinii (EPC) has been reported with increasing frequency in HIV+ patients receiving prophylactic aerosolized pentumidine. Awareness of extrapulmonary presentations of Pneumocystis carinii infection is a prerequisite for accurate Cytologic diagnosis.
Role of fine‐needle aspiration biopsy in the assessment of sacrococcygeal masses
Authors: Cristallini Enrico G. , Ascani Stefano , Paganelli Cristina , Peciarolo Antonella , Bolis Giovanni B.
Published: February 2007

While fine‐needle aspiration (FNA) allows the diagnosis of deep masses, it does not always permit histologic classification. In the case of sites such as the sacrococcygeal region, in which a large number of benign or malignant, epithelial or connective, primary or secondary tumors may arise, it is necessary to choose between conservative treatment and radical surgery. This means that preoperative diagnosis must be as certain as possible. In order to increase the diagnostic accuracy of the method, when even immunohistochemistry is of no aid, it is useful to examine the histologic architecture of the specimen by preparing cell blocks from the aspirates. We report the comparative findings from the examination of the histologic architecture of tissue fragments embedded in methacrylate prepared from the aspirates of four cases of tumors: two chordomas, one metastasis of renal clear‐cell carcinoma, and one of mucus‐secreting carcinoma, all of them arising in the sacrococcygeal region.
Intraepithelial neoplasia mimicking microinvasive squamous‐cell carcinoma in endocervical brushings
Authors: Covell Jamie L , Frierson Henry F.
Published: February 2007

The interpretation of endocervical brush specimens requires familiarity with the various benign, atypical, dysplastic, and invasive neoplastic changes in cells located in the endocervical canal There are several pitfalls in the cytologic evaluation of brush specimens that may result in diagnostic difficulty and error. We report seven cases of high‐grade squamous intraepithelial lesions that were sampled by endocervical brushing and confirmed by cone biopsy or hysterectomy in which the cytologic changes in the Papanicolaou smears mimicked those of microinvasive sauamous‐cell carcinoma. The cells in the smears were compared with those in the tissue sections to determine their sites of origin. Results of this study indicate that cells with features fulfilling the criteria for microinvasive carcinoma were found primarily in brushing smears and corresponded with the features of cells involving the endocervical glands rather than those in the surface epithelium. We conclude that the criteria that have been promulgated for the cytologic diagnosis of microinvasive squamous‐cell carcinoma have limited value in the examination of endocervical brush specimens.
Cervicovaginal cytology in carcinosarcoma [malignant mixed mullerian (mesodermal) tumor] of the uterus
Authors: Costa Michael J. , Tidd Cecelia , Willis Dean
Published: February 2007

We examined the cervicovaginal cytology (PAP) findings in a series of 21 endometrial and 2 cervical carcinosarcomas (CS) [malignant mixed mullerian (mesodermal) tumors] (MMMT). Initial cytology diagnosis was positive for cancer in 14 of 23 cases (sensitivity of 61%); however, CS was correctly identified only 2 times. The remaining 12 cancer diagnoses were carcinomas: 10 adenocarcinomas (4 endometrial, 1 cervical, and 5 adenocarcinomas not otherwise specified), 1 squamous carcinoma, and 1 poorly differentiated carcinoma. Seventeen smears were available for review, all 8 false negative, one unsatisfactory, and 8 of 14 true positive smears. One false negative smear showed rare clusters diagnostic of adenocarcinoma. The remaining 7 false negative smears showed 3 high grade squamous dysplasias (two with additional findings: one showed atypical spindle cells and the other showed endometrial stromal cells), 2 extensive repair changes, and 2 negatives. The unsatisfactory smear showed atypical spindle cells. Review of the 8 true positive smears confirmed malignant spindle cells in the two cases originally identified as CS by cytology and in 3 other cases originally identified as adenocarcinoma. Of 9 smears positive for cancer available for review, 4 showed only carcinoma cells. PAP positive for cancer was associated with high stage at presentation (P <.025) and recurrent disease (P <.001) (even among stage I or II patients, P <.025). PAP positive for cancer showed no association with depth of myometrial invasion, size, grade, or histologic type of carcinosarcoma. The results of this study demonstrate the importance of consultative cytology reporting in which recommendations for appropriate biopsy are included in the report. The sensitivity of PAP could be increased to 83% (19/23 of cytologic findings would have led to biopsy recommendations). With consultative reporting, we can communicate that a biopsy is needed to establish a definitive diagnosis in many cases. For this reason, the confusing and potentially clinically damaging discrepancy between cytology and histology is minimized.
Fine‐needle aspiration cytology of multicystic mesothelioma
Authors: Devaney Kenneth , Kragel Peter J. , Devaney Eric J.
Published: February 2007

This report details the cytologic findings from a case of peritoneal multicystic mesothelioma (MCM). Fine‐needle aspiration of a 20 cm abdominal mass in a 31‐year‐old man yielded a specimen which consisted of a monomorphous population of mesothelial cells lacking cytologic atypia which were arranged in three patterns: monolayered sheets, single cells, and two‐cell‐thick strands of mesothelial cells with little or no intervening stroma. The background was clean, without necrotic debris or abundant inflammatory cells. The mesothelial cells were not arranged in prominent papillary formations; mitotic figures were not found. The mesothelial cells were cytokeratin positive and vimentin positive, and negative for carcinoembryonic antigen (CEA) and factor VIII. The FNA findings from MCM should be distinguished from those of a variety of other abdominal lesions, including cystic lymphangioma, ovarian and primary peritoneal epithelial tumors, necrotic tumors with cystic degeneration, developmental cysts, and infectious cysts.
Fine‐needle aspiration cytology in fibromatoses
Authors: Zaharopoulos Paul , Wong Jick Y.
Published: February 2007

Fine‐needle aspiration (FNA) cytology was performed in seven cases of fibromatosis of variable types with tumorous clinical presentation. These included: four cases of musculoaponeurotic fibromatosis, two in posterior neck muscles, one in anterior neck muscles and one in intercostal muscles; one case of fibromatosis of the breast; and two cases of fibromatosis colli in neonates. In all cases the specimens contained connective tissue with many fibroblast‐like cells, lacking features which could indicate a malignant lesion.

The findings in these cases indicate that, although by FNA cytology in fibromatoses a specific diagnosis for each pathologic entity may not be easily reached, in the proper clinical setting the cytologic findings can be of sufficient relevance to offset the need for an open tissue biopsy, where there are valid reasons against a surgical intervention.
Peritoneal cytology of uncommon ovarian tumors
Authors: Valente Philip T. , Daniel Schantz H. , Edmonds Pamela R. , Hanjani Parviz
Published: February 2007

Peritoneal cytology has been well established as a diagnostic and staging tool in the management of the common epithelial tumors of ovary. Germ cell, mesenchymal, and sex‐cord stromal tumors are much less frequently encountered in peritoneal specimens, often with cytologic features that may pose problems in differential diagnosis. This report presents the cytomorphology of the ascitic fluid in cases of endodermal sinus tumor, dysgerminoma, and Sertoli‐Leydig‐cell tumor, and peritoneal washings in a case of ovarian malignant mixed mullerian tumor. The cytologic features of Sertoli‐Leydig‐cell tumors have not been well described. Careful correlation of peritoneal cytologic findings, cell‐block preparations, and immunocytochemistry with the cytohistologic features of these tumors is crucial for correct tumor classification.
Immediate interpretation of FNA smears from the head and neck region
Authors: Sauer Torill , Freng Atle , Djupesland Per
Published: February 2007

FNA smears from 540 patients, investigated for visible and/or palpable lesions in the head and neck, examined immediately during consultation have been compared with the final cytologic diagnoses and, when possible, with histologic results. Preliminary and final cytologic diagnoses differed in 25 cases (4.6%). Major discrepancies as to whether a lesion was benign or malignant occurred in 15 cases (2.8%). Histologic follow‐up was available for 188 lesions (35%). There were 5 false‐positive (2.6%) and 9 false‐negative (4.7%) diagnoses, giving a sensitivity of 90.6% and a specificity of 94.6%. The main diagnostic problem was benign, reactive lymphadenitis versus malignant lymphoma, which was responsible for 11 of 14 erroneous cytologic diagnoses (3 false‐positive and 8 false‐negative smears). © 1992 Wiley‐Liss, Inc.
Two AgNOR counts in fine‐needle aspirates of lymphoproliferative disorders compared with acridine orange flow cytometry
Authors: Mourad Walid A. , Katz Ruth L. , Sembera Doris , Neely Atkinson E. , El‐Naggar Adel K.
Published: February 2007

Studies have shown that argyrophilic nucleolar organizer region‐associated proteins (AgNORs) may correlate with DNA ploidy and/or proliferative activity in neoplastic and non‐neoplastic conditions. However, studies have estimated only the mean AgNOR counts. Here we used two AgNOR counts, one of which may correlate with DNA ploidy and the other with proliferative activity. The mean AgNOR count (mAgNOR) was defined as the mean number of AgNORs/nucleus in 100 cells and may represent DNA or RNA index. The percentage of nuclei exhibiting 5 or more AgNORs/nucleus (pAgNOR) may reflect proliferative activity. These two AgNOR counts were correlated with results from acridine orange flow cyotmetry in 50 fine‐needle aspirate (FNA) smears of nodal and extranodal sites, including three cases of reactive lymphadenopathy and 47 cases of non‐Hodgkin's lymphoma. The mean mAgNOR count in the diploid specimens was 2.03 (±0.74 SD) and 2.62 (±0.73 SD) in the aneuploid tumors (P < 0.0001). Samples with a low RNA index had mean mAgNOR of 1.80 (±0.41 SD), whereas those with high RNA had a mean mAgNOR of 2.93 (±0.86 SD) (P <0.0001). Lesions with low proliferative index, determined by flow cytometry, had a mean pAgNOR of 4%, whereas those with intermediate and high proliferative indices had a mean pAgNOR of 16% (P <0.0001). A similar but less significant correlation existed between RI and pAgNOR (P < 0.005). We conclude that the two AgNOR counting methods may reliably reflect cell kinetics and distinguish ploidy from proliferative activity, making them useful adjuncts to flow cytometry in limited cytology specimens and small biopsy samples. © 1992 Wiley‐Liss. Inc.
The utility of ancillary studies in pediatric FNA cytology
Authors: Marion Gurley A. , Silverman Jan F. , Lassaletta Margarita M. , Wiley John E. , Tate Holbrook C. , Joshi Vijay V.
Published: February 2007

We evaluated the diagnostic contribution of adjunct studies performed on aspirated material in the work‐up of pediatric fine‐needle aspiration (FNA) biopsies. Ancillary studies were performed on 54 of 136 (39.7%) pediatric FNA biopsies during a 5‐year period. In 23 (16.9%) cases, immunocytochemical (ICC) studies, consisting of immunoperoxidase staining of direct smears and/or cell blocks or flow cytometric immunophenotyping, were performed. The studies were adequate in 14 cases (60.9%), suboptimal in five cases (21.7%), and inadequate in four cases (17.4%). Of the adequate and suboptimal cases, the ICC data helped to narrow the differential diagnosis or classify the disease process in eight cases (42.1 %), confirmed cytologic impression in nine cases (47.4%), and gave contradictory results in two cases (10.5%). Adequate material for electron microscopy (EM) was obtained in 14/19 cases (73.7%). Ultrastructural studies were diagnostic, or helped classify the disease process in five cases (35.7%), confirmed the cytologic impression in four cases (28.6%), helped exclude diagnostic considerations in three cases (21.4%), and were judged to be non‐contributory in two cases (14.3%). Cytogenetic studies revealed six of seven cases (all neoplasms) to have abnormal karyotypes. Special stains for organisms performed on smears from 25 cases including Ziehl‐Neelsen, Gomori methenamine silver (GMS), Gram, and Warthin‐Starry (WS) were negative except for 1/10 GMS and 4/9 Gram stains. In summary, we found that with appropriate case selection, ancillary studies performed on aspirated material can provide useful information in pediatric FNA cytology. © 1992 wiley‐Liss, Inc.
Selected monoclonal antibodies can increase the accuracy of cytodiagnosis of neoplastic effusions of cryptic origin expanded in a short term culture
Authors: Mottolese M. , Cianciulli A. , Venturo I. , Perrone Donnorso R. , Salzano M. , Benevolo M. , Bigotti G. , Natali P. G.
Published: February 2007

The use of a selected panel of monoclonal antibodies (MoAb) to tumor associated antigens (TAA) in immunocytochemical (IIC) tests has been shown, in a preliminary study, to be a powerful diagnostic tool for the identification of the primary solid tumor causing metastatic effusion. Despite this improvement in a minority of neoplastic fluids a number of different causes may still determine false negative (FN) immunocytochemical diagnoses. The aim of the present study was to confirm the diagnostic accuracy of this panel of MoAb. This was done by analyzing in IIC tests a larger number of effusions and by evaluating whether the expansion in short term culture of those fluids with an uncertain malignant morphology could provide an adequate cellular substrate for immunocytodiagnosis. The analysis of 314 effusions confirmed the results of the pilot study and demonstrated that the combination of short term culture and immunocytochemical assays can further increase the sensitivity of this novel diagnostic procedure from 84.3% to 95.3%. © 1992 Wiley‐Liss. Inc.
Fine‐needle aspiration biopsy of hepatic papillary cystadenocarcinoma in Caroli's disease
Authors: Tarroch Xavier , Tallada Natalia , Castells Carme , Garcia Magdalena
Published: February 2007

A case of papillary adenocarcinoma arising in Caroli's disease (CD) in a 25‐yr‐old woman is reported. The diagnosis of malignancy was made by ultrasound‐guided, fine‐needle aspiration biopsy (FNAB). As there were no metastasis, a liver transplant was performed and the diagnosis was histologically confirmed. Only 22 cases of malignant transformation of CD have been reported to date, all among middle‐aged subjects (mean age: 52 yr) of both sexes. Most of these reported cases (83%) were found to be bile duct adenocarcinomas with occasional reports of hepatocellular and undifferentiated carcinomas. Our case is the youngest reported to date and the first to be diagnosed cytologically. © 1992 Wiley‐Liss, Inc.
Whipple's disease involving the mesenteric lymph nodes diagnosed by fine‐needle aspiration
Authors: Saleh Husain , Williams Thomas M. , Minda Justina M. , Gupta Prabodh K.
Published: February 2007

Although it traditionally presents with signs and symptoms of small intestine involvement, such as diarrhea and malabsorption, Whipple's disease (WD) can involve many other organs. Typically, WD diagnosis is established by biopsy of the small intestine. A case of WD, established by duodenal biopsy, in a 36‐yr‐old male is presented. This patient developed mesenteric lymphadenopathy, prompting computerized‐tomography guided fine‐needle aspiration (FNA), which showed typical features of WD. Electron microscopy (EM) studies confirmed the diagnosis. To our knowledge, this is the first reported case of lymph‐node involvement in WD diagnosed by FNA biopsy. © 1992 Wiley‐Liss, Inc.
The utility of ancillary techniques in effusion cytology
Authors: Nance Keith V. , Silverman Jan F.
Published: February 2007

(Editor's Note: What are the most appropriate ancillary studies to be used in the workup of a difficult effusion cytology case?).
Supportive role of image analysis and DNA ploidy pattern in the diagnosis of thyroid tumors
Authors: Kashyap V. , Kaushik N. , Bhambhani S. , Das D. K. , Luthra Usha K.
Published: February 2007

To evaluate the supportive role of image cytometry and DNA ploidy pattern in the diagnosis of thyroid tumors, a preliminary study was performed on fine needle aspirates of 30 cases. Of these, 10 cases each were of colloid goiter, follicular neoplasm, and papillary carcinoma. The nuclear area and DNA value of 50 cells in each case were measured. The mean nuclear area in colloid goiter (69.50 + 12.62 sq.μm) was significantly lower than the mean nuclear area in a follicular neoplasm (88.71 + 15.51 sq.μm) (P < 0.05). Similar differences between the mean nuclear area in colloid goiter and papillary carcinoma (124.0 + 12.27 sq μm) was also highly significant (P < 0.001). The results obtained by image cytometry were compared with estimated DNA ploidy pattern of follicular cells from the same cases. All colloid goiter had mean nuclear area below 100sq.μm with diploid DNA value. However, papillary carcinoma showed aneuploid DNA pattern in eight cases (80.0%), but mean nuclear area was above 100 sq. μm. A diagnostically useful finding obtained in two of the 10 cases of follicular neoplasm was the association of aneuploid DNA pattern with mean nuclear area of the follicular cells above 100 sq.μm. indicating a high probability of carcinoma and thus demanding an urgent open biopsy. These cases were readily distinguished from other cases of the same category showing diploid DNA pattern and mean nuclear area of follicular cells below 100 sq.μm. © 1992 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of spindle cell neoplasms of the adrenal gland
Authors: Nance Keith V. , McLeod Darryl L. , Silverman Jan F.
Published: February 2007

Three spindle cell neoplasms were encountered in a series of 46 FNA of the adrenal performed between 1984 and 1991. These neoplasms included a recurrent undifferentiated adrenal cortical carcinoma (ACC) with a predominant spindle cell pattern, a pheochromocytoma (PC), and a metastatic desmoplastic malignant melanoma (DMM), Cytologically, the ACC was characterized by the presence of numerous microtissue fragments composed of spindle‐shaped malignant cells with oval to spindle‐shaped nuclei, one or more nucleoli, and bipolar cytoplasmic processes. In some areas the tumor cells were dissected by vascular channels. The background contained abundant metachromatic stroma as well as individually scattered tumor cells. The PC was composed predominantly of loosely cohesive spindle‐shaped cells along with more polygonal shaped cells with delicate faintly staining granular cytoplasm. The tumor cells exhibited mild anisonucleosis. The tumor fragments were well vascularized by arborizing delicate capillary channels. The DMM was composed of microtissue fragments, interlacing fascicles and loose aggregates of spindle‐shaped malignant cells with hyperchromatic nuclei, small nucleoli, and an absence of cytoplasmic pigment. In each case ancillary studies including immunocytochemistry and electron microscopy (EM) were helpful in the differential diagnosis. The ACC was negative for cytokeratins, neuron‐specific enolase (NSE), and muscle‐specific actin (HHF), but displayed strong positivity for vimentin as welt as characteristic whorls of smooth endoplasmic reticulum by EM. The PC was positive for NSE and chromogranin with no EM performed. The DMM stained for S‐100 and vimentin but was negative for HMB‐45. cytokeratin, and HHF. EM examination revealed rare atypical premelanosomes. A discussion of spindle cell lesions of the adrenal gland encountered in FNA biopsy is presented along with the role of ancillary studies in the work‐up of these cases. © 1992 Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy of ki‐1‐positive anaplastic large‐cell lymphoma
Authors: Akhtar Mohammed , Ali Muhammad Ashraf , Haider Abdulrazzaq , Antonius John , Hainau Bo , Dayel Fouad Al
Published: February 2007

Five cases of Ki‐1‐positive anaplastic large‐cell lymphoma diagnosed by fine‐needle aspiration biopsy are reviewed, and cytologic, histologic, and ultrastructural findings in these cases are correlated. In all cases, the diagnosis of anaplastic large‐cell lymphoma was suggested on the basis of the morphological appearance in aspiration smears. This diagnosis was confirmed by immunohistochemistry, which revealed strong positivity of most of the cells by Ki‐1 antibody. Two of the lymphomas were T‐cell type, one was B‐cell type, and the remaining 2 were composed of null cells. In 2 cases, intracytoplasmic inclusions were seen in some of the tumor cells in aspiration smears. These were ultrastructurally correlated with large lysosomal bodies of variable morphology. Fine‐needle aspiration combined with immunohistochemistry may be an effective technique for diagnosing this neoplasm. © 1992 Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy of pediatric neoplasms: Correlation between electron microscopy and immunocytochemistry in diagnosis and classification
Authors: Akhtar Mohammed , Bedrossian Carlos W. M. , Ali Muhammad Ashraf , Bakry Mohammed
Published: February 2007

A series of fine‐needle aspiration biopsies performed in 635 children were reviewed. The diagnoses rendered in these patients included malignant lymphoma in 139 (21.9%); Hodgkin 's disease, 25 (3.9%); neuroblastoma, 58 (9.1%); Wilms' Tumor, 37 (5.8%); Ewing's sarcoma, 32 (5.0%); rhabdomyosarcoma, 25 (3.9%); retinoblastoma, 22 (3.5%); leukemia infiltrate, 33 (5.2%); and miscellaneous tumors, 52 (8.2%). In 171 patients (26.9%), the biopsy was nondiagnostic. The cytomorphological characteristics of these lesions are briefly described and illustrated. Salient morphological features are further correlated with histological and ultrastructural appearances. Immunocytochemical patterns of these tumors are also discussed briefly. © 1992 Wiley‐Liss, Inc.
The estimation of mean nuclear volume in the diagnosis of breast carcinoma
Authors: Neal Harold J. , Hurst Peter R.
Published: February 2007

Sixty‐two cases of breast pathology were randomly selected From the files of the Dunedin Public Hospital for evaluation of mean epithelial nuclear volume. The cases were comprised of both benign and malignant ductal epithelial disease, diagnosed in cytological smears or in histological sections. Nuclear volume in histological preparations was estimated by the stereological technique of point‐line intercept measurements to derive volume‐weighted mean volumes (vV). An index of the nuclear volume (Vi) of cytology smears was calculated from measurements of nuclear areas by either image analysis Vi(e) or point‐line intercepts Vi(p). By all methods of analysis a clear distinction of nuclear volume was found between the benign [means for the cytology were 148 μm3 (Vi(e)) or 246 μm3 (Vi(p)), and 203 μm3 (Vv) for the histology specimens] and malignant diseased cases [means for cytology: 524 μm3 (Vi(e)) or 886 μm3 (Vi(p)), and 587 μm3 (vV) for the histology specimens]. © 1992 Wiley‐Liss, Inc.