bluuebunny/crossref_metadata_2025 huggingface dataset:
Fine‐needle aspiration cytology of metastatic breast tumor originating from leukemia
Authors: Miura Hiroyuki , Konaka Chimori , Kawate Norihiko , Kato Harubumi , Miura Reiko , Ebihara Yoshiro
Published: February 2007

Two cases of metastatic breast tumor originating from leukemia are reported. Fine‐needle aspiration (FNA) specimens showed a large number of isolated small‐to‐medium‐sized atypical lymphocytic cells. It is difficult to distinguish metastatic breast tumors and primary breast cancers by physical findings alone. FNA cytology is an effective method for qualitative diagnosis. When atypical lymphocytic cells are obtained in aspiration materials of the breast, past history and general examination are necessary for diagnosis.

In some cases of leukemia with breast involvement, good outcomes are obtained. Therefore, earlier detection is necessary in order to begin suitable therapy earlier and to avoid unnecessary excisional biopsy in patients with leukemia and breast tumors. To achieve this it is also necessary to first take into consideration the possibility of metastasis or infiltration of leukemia, and second to prepare two types of specimen for Papanicolaou stain and Giemsa stain before operation. © 1992 Wiley‐Liss, Inc.
Leiomyosarcoma of the orbit: Diagnosis of its recurrence by fine‐needle aspiration cytology
Authors: Das Dilip K. , Das Jayachandra , Kumar Dileep , Bhatt Naveen C. , Banot Kiran , Natarajan Radha
Published: February 2007

An 8 1/2‐yr‐old boy with proptosis was diagnosed to have low‐grade leiomyosarcoma of the orbit following lateral orbitotomy and histology of an incompletely excised intraconal mass. He received chemotherapy but had recurrence of proptosis at the age of 12 yr. Ultrasonography revealed a solid mass and its fine‐needle aspiration cytology features were consistent with recurrence of leiomyosarcoma. A year later, the cytodiagnosis was confirmed by histology of the excised tumor from a second lateral orbitotomy. Masson 's trichrome stain confirmed the smooth muscle nature of the neoplasm and ultrastructural features were in favor of leiomyosarcoma. The patient received intermittent chemotherapy, and is clinically free from disease at the age of 17 yr. © 1992 Wiley‐Liss, Inc.
Rounded atelectasis: Diagnosis by fine‐needle aspiration cytology
Authors: Miller Wallace T. , Gupta Prabodh K. , Grippi Michael A. , Miller Wallace T.
Published: February 2007

Rounded atelectasis, a rare, benign mass lesion, is most often seen in association with asbestos‐related pleural changes. Often a presumptive diagnosis can be made on the basis of characteristic CT and chest radiographic findings. However, not infrequently radio‐graphic imaging fails to differntiate rounded atelectasis from primary bronchogenic carcinoma, a disease which is seen with increased frequency in patients with asbestos exposure. We describe two cases where the diagnosis of rounded atelectasis was made by fine‐needle aspiration (FNA) cytology. The cytologic features included abundant pulmonary parenchymal material with thickened alveolar walls containing pulmonary macrophages and connective tissue. It is important to realize that this is a useful positive finding indicating rounded atelectasis, rather than a negative finding suggesting the absence of neoplasm. Needles with a cutting action may be necessary to obtain sufficient material to make the diagnosis of rounded atelectasis.
Peritoneal washing cytology in women: Diagnostic pitfalls and clues for correct diagnosis
Authors: Sneige Nour , Fanning Christina V.
Published: February 2007

The significance of peritoneal washing cytology in the management of patients with gynecologic cancer is well established. Its microscopic evaluation, however, is not always straightforward. Previous studies have identified some of the conditions that may result in misinterpretation of cytologic results. This report reviews the literature and describes other sources of diagnostic difficulties and clues for correct diagnosis. In addition, an outline for distinguishing endosalpingiosis from borderline and welt‐differentiated serous carcinoma is proposed.
Fine‐needle aspiration biopsies of metastatic neuroendocrine tumors in liver: Use of transmission electron microscopy and protein A gold technique in diagnosis
Authors: Ravinsky Esther , Quinonez Guillermo E. , Diocee Malkit S.
Published: February 2007

Five fine‐needle aspiration biopsies of liver were studied to evaluate the use of electron microscopy and protein A gold technique in the diagnosis of metastatic neuroendocrine tumors. All five cases had cytologic features suggestive of neuroendocrine tumors and neurosecretory granules on ultrastructural examination.

The aspirates were stained by the immunoperoxidase technique and the postembedding protein A gold technique using the antibody to chromogranin A. Three cases were positive for chromogranin A by both immunoperoxidase and protein A gold techniques. Two cases were positive by protein A gold technique and negative by immunoperoxidase technique.

Confirmation of neurosecretory granules by immunochemistry is ideal, since ultrastructurally they can be mimicked by other electron‐dense inclusions. Advantage of the protein A gold technique is the use of the same material for both ultrastructural evaluation and the protein A gold technique.
Detection and typing of human papillomavirus DNA in the uterine cervix of japanese women by nonradioactive dot blot and southern blot hybridization
Authors: Konno Ryo , Sato Shinji , Yajima Akira
Published: February 2007

HPV infection was examined with Cytobrush in exfoliated cervical cells sampled from 347 women. HPV DNA analysis was conducted in two steps. The presence of HPV DNA was demonstrated by dot blotting and typing of HPV DNA was made by Southern blotting using biotinylated probes. Of 167 cases with cervical intra‐epithelial neoplasia (CIN) and cervical carcinoma, HPV DNA was detected and typed in 25 cases (15.0%). HPV 16, 18, and 33 were found mainly, and no HPV 6 or 11 was detected. The frequency of HPV DNA was 7.1% of CIN I, 28.6% of CIN II, 54.5% of CIN III, and 50.0% of invasive carcinoma. HPV occurred in patients newly diagnosed as CIN at 25.8% and in those of diagnosed as CIN in the past and followed up, 7.6%. Of 180 healthy women, the screening test of F08830 was positive for HPV DNA in four women (2.2%). The present system proved to be useful for facilitating large‐scale clinical research.
Cytopathology of malignant mesothelioma: A study of its patterns and histological bases
Authors: Dibonito Luigi , Falconieri Giovanni , Colautti Isabella , Gori Daniela Bonifacio , Dudine Sandra , Giarelli Luigi
Published: February 2007

We have reviewed the effusion cytology of 51 cases of histologically proven malignant mesothelioma of the pleura (49 cases) and the peritoneum (2 cases). The patient group included 45 males and 6 females, aged 45‐83 yr. A cytological diagnosis of malignancy had been rendered on 43 cases, and in 30 of them it was consistent with, or at least suggestive of, a mesothelioma. Diagnostic clues, especially evident in epithelial and biphasic tumors were hypercellularity and/or morular aggregates of malignant cells showing scalloped borders and nuclei with dense chromatin and evident nucleoli. Cytomegaly with multinucleation was also frequently observed. Reactive mesothelial cells were often present along with other non specific features such as red blood cells, fibrin, necrotic debris. In 13 cases, a diagnosis of malignancy was entertained but mesothelioma, although considered, was not reported out because of scantiness of material. In four cases, adenocarcinoma was erroneously diagnosed for the presence of deceptive cell vacuoles. In eight cases, no diagnostic cells were recovered in repeated effusions. The first diagnosis was a cytologic one in 37 patients. Tissue study was performed on autopsy (35 patients) and surgical material. The latter was the only source of histology in six cases. Immunocytochemical investigation was negative for carcinoembryonic antigen in all but one tested cases (1/21) and positive for human milk fat globulin in about one‐half of the epithelial and biphasic tumors. In 18 of 21 cases, positivity for combined high‐and low‐molecular‐weight keratins was detected. The results of our survey indicate that conventional cytology permits accurate identification of either reactive and neoplastic mesothelial cells. The distinction between mesothelioma and adenocarcinoma may be further attempted using immunocytochemistry, combining a few commonly available markers, although the results should be carefully evaluated in view of their lack of specificity.
Detection of growth fraction in tumors by Ki67 monoclonal antibody in cytologic smears: A prospective study of 40 cases
Authors: Rishi Mazhar , Schwarting Roland , Kovatich Albert J. , Ehya Hormoz , Stanley Michael W.
Published: February 2007

The monoclonal antibody (MAb) Ki67 detects a nuclear antigen in cycling tumor cells. Quantitation of proliferating cells is helpful in predicting the recurrence and metastatic potential of tumors as previously reported. We conducted a prospective study on 40 benign and malignant tumors by performing Ki67 immunocytochemical stains on cytologic smears and their corresponding frozen tissues. Quantitation of Ki67 positive cells was done by counting 300 cells in 5‐7 high‐power fields in cytologic smears and tissues. Only nuclear or nucleolar immunostaining was considered positive for MAb Ki67. The number of Ki67 positive tumor cells in cytologic smears correlated well with Ki67 positive cells from corresponding tissues. On the average, cytologic smears showed 1.9% higher Ki67 positivity in malignant tumors as compared to their corresponding frozen tissues (P < 0.001). The Ki67 positivity in malignant tumors was found to be significantly higher when compared with benign tumors (P < 0.001). We conclude that cytologic smears can be used for the determination of growth potential in tumors by MAb Ki67. Additionally, cytologic preparations can be used during intraoperative consultations when adequate tissue is not available for the above mentioned study.
Fine‐needle aspiration diagnosis of ectopic thyroid: Report of one case
Authors: Stanek Jerzy , Busseniers Anne E.
Published: February 2007

Fine‐needle aspiration (FNA) of a mass of the floor of the mouth in a teenage woman showed many foamy and pigmented histiocytes. cholesterol crystals, and few sheets of follicular cells with paravacuolar granules and cytoplasmic flares. The cytologic findings were consistent with adenomatous thyroid tissue. This was confirmed by subsequent surgical excision and histologic diagnosis of the surgical specimen. The differential diagnosis and value of preoperative diagnosis by FNA of lesions of the floor of the mouth in general and ectopic thyroid in particular, are briefly discussed.
Fine‐needle aspiration cytology of a pancreatic lymphoepithelial cyst
Authors: Cappellari James O.
Published: February 2007

Lymphoepithelial cyst of the pancreas (LECP) is an exceedingly rare nonneoplastic entity of uncertain histogenesis, A case of LECP clinically and radiographically mimicking a pseudocyst in a 44‐yr‐old man is described. Preoperative fine‐needle aspiration cytology was instrumental in correctly identifying the lesion as a benign true cyst, thus permitting appropriate surgical management by local resection. The clinical and pathologic features of all ten previously reported cases of lymphoepithelial cyst of the pancreas are reviewed and current theories regarding its histogenesis are discussed.
Tubal metaplasia: A cytologic study with comparison to other neoplastic and non‐neoplastic conditions of the endocervix
Authors: Ducatman Barbara S. , Wang Helen H. , Jonasson Jon G. , Hogan Christine L. , Antonioli Donald A. , Leiman Gladwyn
Published: February 2007

Tubal metaplasia of the endocervix (TME), a condition that may be con/used morphologically with glandular neoplasia, is frequently found in cone or hysterectomy specimens. To determine the frequency of detecting TME in cytologic smears, we retrospectively reviewed 28 Papanicolaou (Pap) smears from 22 women (mean age 39.1 yr; range 25‐60 yr) with histologically proven TME. Our criteria for TME were the presence of two cell types in addition to endocervical secretory cells, i.e., peg cells (cells with dark and granular cytoplasm and elongate nuclei) and ciliated cells. All women had cervical cytology specimens obtained with an endocervical brush shortly before the procedures in which TME was diagnosed, and five also had at least one post‐procedure smear. Of 20 smears with an adequate, non‐neoplastic endocervical component, TME was found in 2 (10%). In these two, TME cells constituted 10% and < 5% of all the glandular cells, respectively, and the percentage of ciliated cells in the TME was approximately 25% and 75%. In conclusion, TME was noted infrequently (10%) on the cervical cytosmears of women with histologically‐proven TME. This result corresponds to the histologic finding that TME typically involves the upper endocervix and glandular epithelium, with only 13% of the women having TME on the surface of the lower endocervix. Atypical glandular cells on cervical cytology are a problem for clinicians and pathologists alike. The differential diagnosis of such atypia, including TME, cells of the lower uterine segment, squamous intraepithelial lesion in glands and glandular neoplasia, is discussed.
Fine‐needle aspiration biopsy: Dermatofibrosarcoma protuberans
Authors: Powers Celeste N. , Hurt Mark A. , Frable William J.
Published: February 2007

Dermatofibrosarcoma protuberans (DFSP) represents a spectrum of mesenchymal spindle cell tumors that typically involve both dermis and subcutis. Presented herein are six cases of DFSP, four of which were initially diagnosed by FNAB. The cytologic features useful in the identification of this lesion on Papanicolaou‐ and Diff‐Quik‐stained smears are discussed. Chief among these are the storiform stromal fragments, presence of entrapped adipose tissue and the recognition of fibrohistiocytic spindle cells. The potential pitfalls and the differential diagnostic possibilities of spindle‐cell lesions, particularly those of fibrohistiocytic origin are discussed.
Prognostic value of breast cancer cytologic grading: A retrospective study of 213 cases
Authors: Ciatto Stefano , Bonardi Rita , Herd‐Smith Andrea , Cariaggi Paola , Confortini Massimo , Bulgaresi Paolo
Published: February 2007

The authors evaluate 213 consecutive breast cancer cases with positive fine‐needle aspiration cytology. Cytologic smears were reviewed and classified according to a grading system. A correlation between cytologic grading and pathological stage (T and N category) was observed. Univariate analysis of 5‐yr overall survival rate showed a significant negative association with prognosis only for G3 (90%) compared to G1 (72%) cases. Such prognostic correlation was no longer significant at multivariate (Cox) analysis adjusting for potential confounders such as T or N categories. The prognostic value of cytologic grading is limited and dependent on other classic prognostic indicators that are currently determined in breast cancer patients. Its practical value is negligible, as it does not improve the prognostic judgment.
Value of papanicolaou smear in detection of Chlamydia trachomatis infection
Authors: Pandit Ajita A. , Klhilnani Pushpa H. , Powar Harshawardhan S. , Mali B. N. , Joshi Jayashree V. , Krishna Usha
Published: February 2007

This study was undertaken to assess the value of Papanicolaou smear for the diagnosis of Chlamydia trachomatis infection. The study was both retrospective (groups I and II) and prospective (group III). Group I consisted of 41 smears with cytomorphological changes proposed by Gupta, Kiviat, or Shiina. Group II was a control group, consisting of 30 cytologically normal smears. All these smears were subjected to specific immunofluorescent (IF) staining under identical conditions to confirm the diagnosis. In group III, 40 consecutive duplicate cervical smears were collected from patients attending the Sexually Transmitted Disease Clinic. One smear was routinely examined, and the specific IF staining was done on the other smear. The results in all the three groups were analysed. It was concluded that Papanicolaou smear is not useful in the detection of Chlamydia trachomatis infection.
Monoclonal antibody 44‐3A6 as an adjunct in cytodiagnosis of adenocarcinomas in body fluids
Authors: Cajulis Ricardo S. , Szumel Richard , Frias‐Hidvegi Denise , Combs Steven G. , Radosevich James A.
Published: February 2007

Monoclonal antibody (MCA) 44‐3A6 detects a cell‐surface trans‐membrane phosphoprotein frequently expressed by pulmonary adenocarcinoma (AC) and associated with glandular differentiation. This antibody has been found to have utility in assessing routine formalin fixed paraffin‐embedded pulmonary neoplasms, as well as the cytopathological evaluation of sputum and bronchial brushings. Recently, it has been shown to be useful in cytological diagnosis of pleural effusions. This study is directed at evaluating its effectiveness in detecting immunoreactive neoplastic cells in body fluids (BF) arising in other tissues. A retrospective cohort of 57 cases was studied, consisting of 36 pleural, 19 ascitic, and 2 pericardial BF. After evaluation of Papanicolaou‐stained slides, the BF specimens were immunostained with MCA 44‐3A6 using the avidin‐biotin‐peroxidase complex (ABC) method. In 29 cases, tissue sections of the primary tumors, were also available for immunostaining with MCA 44‐3A6. Results showed that 39/42 (93%) of AC BF cases were positive and 28/42 (66%) stained intensely (3‐4+) with 75‐100% of the AC cells staining in each case. All of the 18 benign and non‐AC malignant BF were negative. The staining patterns in the tissue sections of the 29 cases that had corresponding BF samples were similar. We conclude from this study that the MCA 44‐3A6 (1) is useful in detecting cells consistent with AC in BF; (2) does not stain inflammatory cells or reactive mesothelial cells, thus helping distinguish reactive from malignant BF; and (3) frequency and pattern of expression in BF parallels its expression in tissue specimens. This study confirms that this MCA is a useful adjunct tool in the cytopathological evaluation of BF.
Adenoid cystic carcinoma of the breast: Diagnosis by fine‐needle aspiration
Authors: Stanley Michael W. , Tani Edneia M. , Rutquist Lars‐Eric , Skoog Lambert
Published: February 2007

Adenoid cystic carcinoma rarely occurs as a primary breast malignancy. When seen in fine‐needle aspiration (FNA) material, it is identical to its counterpart in the salivary glands. We report six cases diagnosed by aspiration in patients aged 32‐82 yr. The smears were highly cellular and featured extracellular spheres of metachromatic material. These were surrounded by small, uniform cells with bland nuclei and very little cytoplasm. Numerous similar cells occurred singly in the background. The cytologic differential diagnosis of adenoid cystic carcinoma includes other entities that produce extracellular metachromatic spheres including collagenous spherulosis. We describe and illustrate similar material originating in inspissated secretions or stromal fragments from fibrocystic change and fibroadenoma, as well as infiltrating ductal carcinoma. Diagnostic criteria for adenoid cystic carcinoma and the clinical relevance of distinguishing this rare tumor from typical infiltrating ductal carcinoma are discussed.
Unresectable stage IV nephroblastoma: A potential indication for fine‐needle aspiration biopsy in children
Authors: Geisinger Kim R. , Wakely Paul E. , Wofford Marcia M.
Published: February 2007

In the United States, the initial morphologic diagnosis of nephroblastoma is usually determined on a nephrectomy specimen prior to the initiation of any additional therapy. Such an approach, however, is not appropriate in all children; we believe that fine‐needle aspiration biopsies (FNAB) should be the initial diagnostic procedure in a minority of patients with suspected Wilms' tumor. One such group of patients is those who present with stage IV disease, especially when it is considered unresectable. Herein we present two children with advanced Wilms' tumor to support our contention. The initial microscopic diagnosis in each was made by FNAB. Following chemotherapy, predominantly necrotic Wilms' tumors were excised. Both patients are alive with no evidence of residual disease or untoward affects from the aspiration procedure.
Aspiration cytology of maxillary myxoma
Authors: Verma Anand Kumar , Tandon Rajeev , Saxena Sunita , Pandey Jyotsana , Talib Vajahat Hussain
Published: February 2007

Fine‐needle aspiration was used to diagnose a case of maxillary myxoma. Abundant mucoid material was obtained. Microscopic examination showed three‐dimensional fibrillary myxoid fragments entangling spindle‐shaped, stellate, and fusiform cells with round to oval monomorphic nuclei. A striking feature was delicately branching capillaries. The diagnosis was subsequently con‐finned on histology and histochemistry.
Fine‐needle aspiration biopsy of the salivary gland: Problem cases
Authors: Macleod Carla B. , Frable William J. , Cohen Michael B.
Published: February 2007

Among 582 fine‐needle aspiration (FNA) biopsies of major and minor salivary glands performed between 1974 and 1990, lack of cytological histologic correlation was noted in 21 cases. Of these, the cause in 10 FNAs was inadequate cytological sampling of the lesion. [One case of malignant hemangiopericytoma was tentatively diagnosed as a monomorphic adenoma on FNA, a polymorphic T‐cell lymphoma was diagnosed as granulomatous inflammation on aspiration biopsy, a benign lymphoepithelial lesion was diagnosed as a reactive lymph node, a branchial cleft cyst was called benign mixed tumor (BMT), one case of chronic sialoadenitis was called BMT by FNA, two cases of benign lymphoepithelial lesion (BLEL) were diagnosed as cystic Warthin's tumor, two low‐grade mucoepidermoid carcinomas were called BMT, and a BMT was cytologically diagnosed as a Warthin's tumor with squamous metaplasia versus low‐grade mucoepidermoid carcinoma. One case of low‐grade mucoepidermoid carcinoma was diagnosed only as a “cyst.”] Review of these cases identifies constant features that permit differentiation between Warthin's tumor and BLEL, and among BMT, mucoepidermoid carcinoma, and chronic sialoadenitis. Despite a few problem cases, FNA of the salivary gland is accurate in the preoperative diagnosis and classification of salivary gland neoplasms.
Cytologic features of metastatic transitional cell carcinoma
Authors: Johnson Terri L , Kini Sudha R.
Published: February 2007

Cytologic preparations containing metastatic transitional cell carcinoma (MTCC) from 18 sites in 16 patients were renewed to determine characteristic morphologic features. The patient group included 13 males and 3 females with a mean age of 66 years. Primary TCC occurred in the bladder (14), kidney (1) and ureter (1); nearly all the primary tumors were poorly differentiated and most were invasive at the time of diagnosis. The cytologic specimens were derived from lymph nodes (6). liver (4). serous fluids (2), pelvic soft tissue (2), subcutaneous nodules (2), and lung (1). One patient presented with MTCC in Pap smears. Cytologically MTCC presented as loosely cohesive, moderate to markedly pleomorphic cells which occurred singly and in syncytial clusters. The malignant cells were usually large with abundant granular or fibrillar cytoplasm and the cell borders were generally distinct. Most nuclei were large and hyperchromatic with irregularly distributed granular chromatin and prominent nucleoli. The most distinctive features were the presence of spindled, pyramidal, and/or racquet‐shaped malignant cells with eccentric nuclei and cytoplasmic features of both squamous and glandular differentiation including endoplasmic/ectoplasmic interfaces and intracytoplasmic vacuoles. Although clinical history is most useful in the diagnosis of MTCC, these morphologic features in cytologic preparations of malignant epithelial neoplasms may be helpful. In the absence of a known primary TCC. it is doubtful that a definite cytologic diagnosis could be made; however, the characteristic cell shapes and cytoplasmic features may be suggestive of MTCC.
Diagnostic value of electron microscopy on paraffin‐embedded cytologic material
Authors: Young Nancy A. , Naryshkin Sonya , Katz Sheila Moriber
Published: February 2007

Transmission electron microscopy (TEM) is an important adjuvant to light microscopy, but is underutilized in cytopathology because of technical obstacles. One should attempt to obtain properly fixed material for TEM whenever possible. If that is not available, TEM on the cell block requires no preplanning or additional needle passes, and avoids problems of inadequate tissue for diagnosis. However, cell blocks are often not examined because of the perception that their poor ultrastructural preservation precludes their utility. We describe our experience in performing TEM on cell blocks from 15 cytologic specimens. In 13 of 15 cases, the cell block material was adequate for ultrastructural evaluation, and it clarified or extended the diagnosis in seven of these cases. TEM is a useful adjuvant technique to cytodiagnosis and can be successfully performed on cell blocks when gluteraldehyde‐fixed material is not available.
Cytological diagnosis of paget's disease of the nipple by scrape smears: A report of five cases
Authors: Samarasinghe D. , Frost F. , Sterrett G. , Whitaker D. , Ingram D. , Sheiner H.
Published: February 2007

Five cases of mammary Paget's disease were diagnosed by nipple scrape cytology. The neoplastic material obtained was abundant in two cases, moderate in one, but in two, only a few cell aggregates and single malignant cells were obtained. Cell engulfment was a feature in three cases and this, together with dense tumour cell cytoplasm and the background of keratinous debris, may impart a squamous‐like appearance; however, three‐dimensional cell aggregates, papillary‐like groups, acinar‐like collections, and some cells with vacuolated cytoplasm and eccentric nuclei allowed glandular differentiation to be inferred in three cases. In four cases a combination of clinical evaluation, and cytological findings of malignant cells compatible with Paget's disease was used so that mastectomy could proceed, and in one case there was frozen section confirmation of an underlying invasive carcinoma. In the single case in which it was performed, there was positive immunoperoxidase staining for c‐erb B2 oncoprotein. Demonstration of this protein, CEA, or mucin, helps distinguish Paget's disease from melanoma or squamous cell carcinoma in‐situ.
Cytologic detection of herpes simplex virus DNA in nipple discharge by in situ hybridization: Report of two cases
Authors: Kobayashi Tadao K. , Okamoto Hajime , Yakushiji Michiaki
Published: February 2007

Cytologic changes in the smears from nipple discharge of two cases with herpes simplex virus (HSV) infections are described. The cytology revealed the ground‐glass appearance of the nuclei with multinucleated syncytial cells. Subsequently, in situ hybridization (ISH) using a biotinytated DNA probe was applied to identify the HSV DNA in the Papanicolaou‐destained specimens. Positive hybridization was found with intense staining for the HSV DNA in the nuclei of cells having a ground‐glass appearance. Cytologic observation together with ISH procedure may be rapid and valuable tool for the detection and final demonstration of HSV infections. Similar investigations may be carried out in cellular samples from other body sites.
Cytology of thyroglossal cyst papillary carcinoma
Authors: Chen Karl T. K.
Published: February 2007

The cytologic and histologic features of two cases of carcinoma arising in thyroglossal cyst are reported. The carcinoma in both cases was papillary thyroid carcinoma. The aspirated cyst fluid in one case revealed only macrophages and benign squamous epithelial cells, while in the other case the cyst fluid showed cytologic features of papillary carcinoma including psammoma bodies and epithelial cells with papillary clustering, intranuclear cytoplasmic inclusions, and positive immunohistochemical reaction to thyroglobulin.
Nodular fasciitis: Spontaneous resolution following diagnosis by fine‐needle aspiration
Authors: Stanley Michael W. , Skoog Lambert , Tani Edneia M. , Horwitz Charles A.
Published: February 2007

Nodular fasciitis can be histologically mistaken for a sarcoma. Typical cases are less than 5 cm and enlarge rapidly over days or weeks before diagnosis. The natural history of nodular fasciitis is unknown, since the diagnosis is usually based on excised lesions. Fine‐needle aspiration of nodular fasciitis has been described, and features benign‐appearing spindle cells (singly and in groups), collagen, and myxoid material. We describe 11 cases in which nonsurgical observation led spontaneously to complete resolution. Our study includes 7 males and 4 females (24 to 73 years of age; median = 42). Lesions were located in the arm (4), thigh (3), temporal area (2), breast (1) and the parotid (1) and ranged from 0.5 to 5.0 cm. (median = 1.5). They had been present for from less than 1 to 4 weeks (median = 2). In 9 cases, spontaneous resolution occurred in from 3 to 8 weeks (median = 4). Two other patients were lost to follow‐up for up to 11 months, after which resolution was noted. Small palpable masses in the subcutaneous soft tissues which evolve over a short period of time and show the cytologic features of nodular fasciitis should be managed nonsurgically. If resolution does not occur within a few weeks, surgery can then be performed. Diagn Cytopathol 1993;9:322‐324.
Diagnostic pitfalls in thyroid fine‐needle aspiration: A review of 394 cases
Authors: Caraway Nancy P. , Sneige Nour , Samaan Naguib A.
Published: February 2007

To determine the diagnostic pitfalls of thyroid fine‐needle aspiration (FNA), we reviewed 394 thyroid aspirates obtained between January 1986 and December 1990. Surgical follow‐up was available for 150 aspirations. The cytologic diagnoses were categorized into four groups: benign, 57; indeterminate, 51; malignant, 33; and nondiagnostic specimen, nine. There were three false negative diagnoses (3%), which upon review were judged to be inadequate specimens. Three false positive diagnoses (7%) were identified: in the first two cases, follicular adenomas were mistaken for papillary carcinoma: in the third case, atypical Hürthle cells were mistaken for a Hurthle cell carcinoma. Our results showed a sensitivity of 93% and a specificity of 91% for the detection of malignancy. If indeterminate cases were considered positive, the specificity decreased to 50%, while the sensitivity increased to 97%. We conclude that: 1 certain follicular adenomas may display cytologic features mimicking papillary carcinoma; 2 as in follicular neoplasms, aspirates of Hürthle cell adenomas cannot be differentiated from Hurthle cell carcinomas; 3 with adequate sampling, false negative results can be markedly reduced.
Multinodular goiter of the thyroid mimicking malignancy: Diagnostic pitfalls in fine‐needle aspiration biopsy
Authors: Fiorella Russell M. , Isley William , Miller Leslie K. , Kragel Peter J.
Published: February 2007

A case of multinodular goiter with multicentric papillary hyperplasia is presented with cytologic features suggestive of thyroid papillary carcinoma. While the cytologic criteria for papillary thyroid carcinoma is well defined, occasional diagnostic difficulties can arise. Cytologically, the presence of focal papillary aggregates, the presence of a psammoma body within a background of copious colloid and scattered follicular cells led to diagnostic confusion. Histologically, the presence of secondary follicles in the papillae and protrusion of the papillary structures into colloid lakes supported the diagnosis of goiter. It is our opinion that most, if not all, of these difficulties can be circumvented by the incorporation of all major and some minor cytologic criteria for papillary carcinoma in the analysis of such lesions. Single criteria for papillary carcinoma, either major or minor, is not sufficient.
Cytology of mollaret meningitis
Authors: Evans Hilary
Published: February 2007

The diagnosis of Mollaret meningitis was established by cytologic examination of the cerebrospinal fluid (CSF) in a patient with recurrent aseptic meningitis. The characteristic features of the “Mollaret cell,” an activated monocyte, are presented; theories of etiology are reviewed.
Immunocytochemical detection of carcinoembryonic antigen in fine‐needle aspirates from patients with diverse breast diseases
Authors: Alexiev Borislav A. , Valkov Ivan N. , Popov Alexander A. , Marinov Vasil S.
Published: February 2007

Fine‐needle aspirates and paraffin‐embedded tissue sections from 91 cases with diverse breast diseases were immunostained with carcinoembryonic antigen (CEA) monoclonal antibody using a BioGenex StrAviGen kit based on the biotin‐streptavidin amplified methodology. The results were compared with histopathologic tumor type and tumor stage. CEA was not expressed in fibrocystic changes with mild or florid epithelial hyperplasia (n = 23) and fibroadenomas (n = 8). On the other hand, 90% (56/60) of primary breast carcinomas showed positive cytoplasmic staining for CEA. No correlation was found between CEA expression, histopathologic tumor type, and tumor stage. We suggest that CEA immunocytochemistry will help in the accurate diagnosis of primary breast carcinoma in fine‐needle aspirates in addition to the usual cytological criteria.
Specimen adequacy evaluation in gynecologic cytopathology: Current laboratory practice in the college of american pathologists interlaboratory comparison program and tentative guidelines for future practice
Authors: Nielsen Mary L. , Davey Diane D. , Kline Tilde S.
Published: February 2007

Routine specimen adequacy evaluation, as advocated by The Bethesda System (TBS), can play an important role in improving the sensitivity and accuracy of cervical cytopathology screening. The effectiveness of this measure, however, has been limited by the lack of uniform criteria for adequacy. Practice parameters are now emerging, through TBS development of tentative criteria and interlaboratory comparison of adequacy practices. This study reviews 1 nationwide responses to surveys of laboratory practices in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology (CAP PAP); 2 the definitions of adequacy based on TBS; and 3 the results of implementation of these criteria in a private independent laboratory, university hospital laboratory, and private nonprofit hospital laboratory. In the initial CAP PAP survey in 1990, 35% of responding laboratories routinely reported specimen adequacy, increasing to 66% in 1991 and 85% in 1992. Interlaboratory variations in adequacy practices were observed, however, underscoring the need for consensus criteria. The experience in the authors' laboratories indicates that TBS criteria can serve as a sound guideline. Effective implementation of adequacy assessment in the individual laboratory requires careful attention to ensuring the quality of adequacy ratings, correlating clinical and prior laboratory information, issuing clear and concise reports, and giving recommendations judiciously. Through interlaboratory comparison and consistent intralaboratory emphasis on specimen adequacy, greater uniformity of adequacy assessment can be achieved, and adequacy evaluation can achieve its promise of improving the quality of cervical cytopathology.
Reactive change and atypical squamous cells of undetermined significance in papanicolaou smears: A cytohistologic correlation
Authors: Sidawy Mary K. , Tabbara Sana O. , Wilbur David C. , Bonfiglio Thomas A.
Published: February 2007

The purposes of this study were to delineate morphologic criteria for the terms reactive/reparative change (RC) and atypical squamous cells of undetermined significance (ASCUS), which were proposed by the Bethesda System, and to evaluate the impact of the new terminology on patient management. Using criteria defined in this article, 88 cervical smears originally reported as “atypia” were reclassified as RC (57) and ASCUS (31). Correlation with the colposcopically directed biopsies was as follows: 3/57 RC showed condyloma and 19/31 ASCUS had squamous lesions (14 condyloma, four mild, and one moderate dysplasia). The remainder of the cases had either cervicitis or no significant abnormality histologically. Using the proposed criteria, 61.3% of ASCUS correlated with positive biopsies, compared to 5.2% of the RC cases. Our results indicate that patients with smears showing RC are significantly less likely to have a squamous lesion as compared to those showing ASCUS, and therefore may be managed more conservatively.
Helicobacter pylori in gastroduodenal diseases: Rapid identification by endoscopic brush cytology
Authors: Francesco F. , Nicòtina P. A. , Picciotto M. , Martines F. , Ferlazzo G. , D'aquino A.
Published: February 2007

Previous reports showed Helicobacter pylori (H. pylori) in type B gastritis‐affected stomachs. This study was carried out to compare H. pylori staining effectiveness on biopsy to brush cytology. Tissue and brush parallel samples of gastric mucosa with abnormal or normal appearances were examined: 57.6% H. pylori‐positive pieces from the antrum and 19.2% from the body were found, versus 65.3% and 25% H. pylori‐positive brush smears, respectively. H. pylori resembling organisms were mainly related to chronic and acute antral inflammations and were often associated with higher amounts of round‐shaped cocco‐bacteria. In addition, H. pylori direct stain on brushing is proposed as the most rapid and reliable method for the routine diagnosis of Helicobacter pylori infection, in both ulcer or nonulcer gastritis.
Spindle cell lipoma of the breast: A case report and literature review
Authors: Lew W. Y. C.
Published: February 2007

Fine‐needle aspiration cytology (FNA) was performed on a breast lump in a 66‐year‐old female, clinically thought to be a carcinoma. The cytological findings were reported as suspicious of malignancy. Subsequent histological examination showed a tumour macroscopically and microscopically identical with six other cases previously described as benign spindle cell tumours of the breast. This report highlights yet another diagnostic pitfall in FNA cytology of the breast. The presence of floret cells in this case has not been previously reported but supports the concept that this lesion is the same as a spindle cell lipoma, from which it is virtually indistinguishable on light microscopy. The lesion affects both mate and female breast, is predominantly single but may be multiple, and follows a benign course. Local excision is curative.
Primary mucoepidermoid carcinoma of the thyroid: Diagnosis by fine‐needle aspiration biopsy
Authors: Larson Richard S. , Wick Mark R.
Published: February 2007

Fine‐needle aspiration biopsy (FNAB) has been recognized as a safe and reliable procedure in the evaluation of thyroid nodules. We herein report a case of a low‐grade mucoepidermoid carcinoma of the thyroid that was diagnosed with this technique. Examination of an intra‐operative FNAB showed cohesive clusters of polygonal squamoid cells with distinct cellular borders, uniform round nuclei, distinct nucleoli, and homogeneous amphophilic to cyanophilic cytoplasm. Focal keratin “pearl” formation was apparent, along with extracellular, lightly basophilic mucin deposits mantled by squamoid cells. These cytologic features are characteristic of low‐grade mucoepidermoid carcinoma, as seen in other anatomic sites. This impression was confirmed by examination of paraffin sections. Previous reports have indicated that mucoepidermoid thyroid carcinoma is an indolent, locally recurring lesion. However, in spite of low‐grade histology in our case, the neoplasm presented with distant metastases to bones, pleura, and lung.
Histiocytic necrotizing lymphadenitis (kikuchi's disease): Cytologic diagnosis by fine‐needle biopsy
Authors: Greenberg Merle L. , Cartwright Lyn , McDonald David A.
Published: February 2007

A cytologic diagnosis of histiocytic nerotizing lymphadenitis (Kikuchi's lymphadenitis) was made in a 14‐yr‐old female with cervical lymphadenopathy, Fever, neutropenia, and hepatosplenomegaly. A predominance of reticulum cells, foamy macrophages, and karyorrhectic debirs are cluse to the diagnosis in the fine‐needle biopsy smears. Subsequent histology confirmed the diagnosis of Kikuchi's lymphadenitis. The differential diagnoses are discussed including malignant lymphoma, which was excluded by morphology as well as flow cytometry and polymerase chain reaction (PCR) studies.
Fine‐needle aspiration of histiocytic necrotizing lymphadenitis (Kikuchi's disease)
Authors: Hsueh Erh‐Jueng , Ko Wang‐Shen , Hwang Wei‐Shou , Yam Lung T.
Published: February 2007

Fine‐needle aspiration (FNA) of the lymph node was done in five patients with histiocytic necrotizing lymphadenitis (Kikuchi's disease). In four patients, the aspirates were found to have many small and large atypical lymphocytes, some reactive, phagocytic histiocytes, and intense extracellular debris. Neutrophils, plasma cells, or multinucleated giant cells were not seen. These cytologic findings were considered diagnostic for Kikuchi's disease. In one patient, the aspirate did not show significant histiocytosis or tissue necrosis and was considered nondiagnostic. In patients with both typical clinical features and characteristic cytologic findings in the lymph node aspirates, FNA of the lymph node alone will suffice for diagnosis. In those patients with typical clinical features but nondiagnostic findings in the FNA aspirates, the diagnosis of Kikuchi's disease may have to be established either on repeated nodal FNA or on lymph node biopsy.
Nucleolar organiser regions of mesothelial and carcinomatous cells in effusions
Authors: Trevisan Miriam S. , Souza M. InêS , Magna Luís A.
Published: February 2007

The AgNor reaction was performed on effusions and peritoneal washings, and the silver dots were counted on normal or reactive mesothelial cells vs. carcinomatous cells, ascertained by previous HE staining. The mean values were 1.64 for the former (n=20) and 4.90 for the latter (n=10). The intersection between the two group distributions was 2.78, leaving a chance of only 0.65% for a false‐positive result. The method may thus be helpful in the interpretation of doubtful cytological cases.
Cervical cytology findings in women infected with the human immunodeficiency virus
Authors: Henry‐Stanley Michelle J. , Simpson Margaret , Stanley Michael W.
Published: February 2007

It has been suggested that immunocompromised, HIV‐infected patients are at risk of developing HPV infection and SIL. The well documented role of HPV and SIL in cervical carcinogenesis should lead to frequent, careful evaluation of HIV infected women. Forty‐four cervical smears from 23 patients (20 HIV and 3 AIDS) were reviewed. While 11 of the 23 patients produced negative smears, 11 had abnormal cytological findings on at least one occasion. Sixteen smears (36 percent) from 10 patients (43%) showed evidence of HPV and/or SIL Two smears (two patients) were assigned to the benign epithelial atypia category. (One of these showed keratosis which may indicate HPV infection.) Six smears (three patients) represented either a severe Trichomonas, fungal (Candida sp.), or Herpes infection. Three smears were deemed unsatisfactory for diagnosis due to severe acute inflammation or obscuring blood. Five biopsies were available. In four, histologic findings supported the original cytologic diagnosis. One patient with a negative smear had a biopsy showing condyloma. This study further supports an association of HPV and/or cervical dysplasia with HIV. Careful evaluation and follow‐up of HIV‐infected women is essential.
Fine‐needle aspiration of six carotid body paragangliomas
Authors: Fleming Marian V. , Oertel Yolanda C. , Ren Rodríguez E. É , Fidler William J.
Published: February 2007

We report six carotid body paragangliomas diagnosed by fine‐needle aspiration (FNA) in five patients. A total of eight aspirations were performed. The cytologic findings are characteristic: hemorrhagic background, hypo‐ to hypercellular smears (depending on the skill of the aspirator) with cells having delicate, illdefined, vacuolated cytoplasm, pleomorphic nuclei with distinct nucleoli, rare intranuclear cytoplasmic inclusions, and prominent rosette formation. No complications arose in any of the eight aspirations. FNA is a safe, accurate means of diagnosing carotid body paragangliomas. It can provide essential information for treatment planning and patient management.
Utility of BER‐EP4 in the diagnosis of adenocarcinoma in effusions: An immunocytochemical study of 232 cases
Authors: Diaz‐Arias Alberto A. , Loy Timothy S. , Bickel John T. , Chapman Robert K.
Published: February 2007

The usefulness of a new commercially available monoclonal antibody (MoAb) BER‐EP4 was evaluated. This MoAb is directed against a cell surface glycoprotein reported to be present in most epithelial cells and epithelial tumors but not in mesothelial cells. Cell block sections from 103 adenocarcinomatous and 129 benign effusions were studied. Positive staining was seen in 85 of the 103 (83%) malignant effusions. Immunoreactivity was seen in 73‐93% of adenocarcinomas from the ovary, gastrointestinal tract, lung, and breast. Mesothelial cells from 3 of the 129 (2%) benign effusions showed positive staining. It is concluded that immunocytochemical staining with MoAb BER‐EP4 is a sensitive and specific aid in distinguishing reactive mesothelial cells from adenocarcinoma cells in body fluids.
Fine‐needle aspiration cytology of extramedullary hematopoiesis (myeloid metaplasia)
Authors: Raab Stephen S. , Silverman Jan F. , McLeod Darryl L. , Geisinger Kim R.
Published: February 2007

Myeloproliferative disease may be associated with extramedullary hematopoiesis (EH). Clinically, however, the differential diagnosis of solid masses in these patients includes not only EH but also inflammatory lesions and malignant neoplasms, including granulocytic sarcoma. We report the fine‐needle aspiration (FNA) cytology of extramedullary hematopoiesis in five patients with a history of myeloproliferative disease. All of the masses developed subsequent to the diagnosis of myeloproliferative disease. Two of the patients had chronic myelogenous leukemia, one had essential thrombocythemia, and two had an unspecified chronic myeloproliferative disorder. The patients ranged in age from 50 to 88 years, and all presented with solid masses involving the kidney (two aspirates), liver (one aspirate), and lymph nodes (three aspirates). One of the lymph node aspirates was from a paratracheal lymph node. Cytologically, the lesions were composed of varying numbers of hematopoietic cells from all three hematologic cell lines. The Diff‐Quik stain was especially helpful in the recognition of the hematopoietic cells such as granulocytic precursors, eosinophils, and megakaryocytes. In several cases, the megakaryocytic component was particularly prominent. In one case, the Factor VIII immunoperoxidase stain was used to confirm the megakaryocytic lineage of the multinucleated cells. The cytologic differential diagnosis, which includes granulocytic sarcoma, inflammatory disorders, and other lesions containing multinucleated giant cells, is discussed.