bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytopathology of fine‐needle aspiration biopsy of the brain and spinal cord
Authors: Silverman Jan F.
Published: February 2007

The cytomorphologic findings of 37 intraoperative fine‐needle aspiration (FNA) biopsies are presented. Thirty‐two of the biopsies were performed at the time of craniotomy, and five were performed through a burr‐hole. All cases used direct smear preparations stained with Papanicolaou and modified Wright stain (Diff‐Quik®). Immediate evaluation of the Diff‐Quik‐stained smears was performed for assessment of the adequacy of the specimen, and in most cases, a rapid preliminary diagnosis (similar to a frozen‐section report) was rendered in the operating room. Cytopathologic features of anaplastic astrocytomas, glioblastoma multiforme, pituitary adenoma, meningioma, metastatic carcinoma, epidermoid cyst, herniated disc, hemangioblastoma, cerebral hemorrhage, and malignant lymphoma are described and illustrated. The cytologic preparation demonstrated superior cellular detail, which served as a considerable aid for diagnosis, and lacked the artifactural distortion often seen in the frozen‐section preparations. Reliance on the fine‐needle aspiration biopsy specimen enabled better triage of the small amount of tissue often available for permanent sections and special studies including electron microscopy and immunohistochemistry. Although not meant to replace tissue biopsy, FNA of the central nervous system through burr holes under radiologic guidance can be advantageous in selective cases. Diagn Cytology 1986;2:312‐319.
Cytopathology of extramedullary hemopoiesis in effusions and peritoneal washings: A report of three cases with immunohistochemical study
Authors: Yazdi Hossein M.
Published: February 2007

The clinical, cytopathologic, and immunohistochemical features of three cases of extramedullary hemopoiesis are presented. Differentiation of megakaryocytes from malignant cells can be difficult in cytologic material; we believe familiarity with cytologic features of megakaryocytes, along with factor VIII‐related antigen immunoreactivity, is helpful in providing an accurate diagnosis. Diagn Cytopathol 1986;2:326‐329.
Chordoma: Diagnosis by fine‐needle aspiration biopsy with histologic, immunocytochemical, and ultrastructural confirmation
Authors: Finley James L. , Silverman Jan F. , Dabbs David J. , West Robert L. , Dickens Allen , Feldman Philip S. , Frable William J.
Published: February 2007

Five cases of chordoma, diagnosed by fine‐needle aspiration (FNA) biopsy, are presented. Four cases were histologically confirmed, and in one, immunocytochemical and ultrastructural studies were performed on both the aspirate and tissue specimen. Four cases presented as sacral masses, while in the fifth case, a destructive lesion of the clivus extended into the soft tissues of the lateral neck. A spectrum of cytomorphologic features was encountered including the presence of abundant microtissue fragments and cells in a dissociate pattern, often with abundant metachromatic extracellular matrix. Stellate and cuboidal cells often contained intracytoplasmic vacuoles of varying sizes. Intranuclear inclusions, mitotic figures, and anisonucleosis were prominent features of several cases. Immunoperoxidase studies on a single case demonstrated cytoplasmic staining for low‐ and high‐molecular‐weight cytokeratins, vimentin, and epithelial membrane antigen, while glial fibrillary acidic protein and carcinoembryonic antigen were negative. Ultrastructural features included the presence of mitochondrial endoplasmic reticulum complexes, occasional desmosome‐like junctions, and abundant extracellular matrix adherent to the tumor cells. We believe the cytomorphologic findings are characteristic and, when taken in concert with immunocytochemical and ultrastructural studies, allow differentiation of chordoma from other primary or metastatic neoplasms occurring in bone. As demonstrated in our series, chordoma is often an unsuspected diagnosis. We believe that FNA biopsy of these lesions can lead to a correct preoperative diagnosis and may also be utilized to document recurrence and thus facilitate the evaluation and management of patients with these lesions. Diagn Cytopathol 1986;2:330–337.
Carcinoid tumors of the lung: Cytologic differential diagnosis in fine‐needle aspirates
Authors: Kim Kitai , Mah Chonggi , Dominquez Justo
Published: February 2007

Pulmonary carcinoid tumors presenting as peripheral or coin lesions are rare and radiologically may resemble other primary or metastatic neoplasms in the lung. This study consisted of the cytologic evaluation of fine‐needle aspirates from five peripheral carcinoid tumors of the lung with particular reference to the differences between the cytologic manifestations of this neoplasm and of small‐cell carcinoma and well‐differentiated adenocarcinoma. Aspirates of typical carcinoid tumors are characterized by (1) isolated cells and loose aggregates of cells; (2) spindle‐ and oval‐shaped cells of uniform size with scanty, pale eosinophilic cytoplasm; and (3) nuclei with evenly dispersed finely granular chromatin and usually prominent single micronucleoli with occasional macronucleoli. In contrast, the cells of small‐cell carcinoma are pleomorphic and arranged in noncohesive loose aggregates, their cytoplasm is scanty, and they show nuclear molding. Their nuclei are hyperchromatic with fine to coarsely granular chromatin. The cells of well‐differentiated adenocarcinoma are arranged in three‐dimensional clusters or loose aggregates of relatively uniform cells with a columnar configuration. The nuclei are uniformly round and hyperchromatic with finely granular chromatin. Macronucleoli are usually prominent. This study demonstrates that cytologic analysis of fine‐needle aspirates can play a significant role in the evaluation and management of peripheral lung tumors. Diagn Cytopathol 1986;2:343–346.
The reliability of fine‐needle aspiration biopsy in the diagnosis of deep lesions of the lung and mediastinum: Experience with 250 cases using a modified technique
Authors: Young Geraldine P. , Young Irving , Cowan Daniel F. , Blei Rebecca L.
Published: February 2007

Two‐hundred and fifty discrete lesions of the lung and mediastinum were sampled by a modified fine‐needle aspiration biopsy (FNAB) technique. Aspirates were collected directly into 15 ml of Saccomanno's fixative, and all preparative work was carried out in the cytopathology laboratory. Only seven aspirates were “insufficient for diagnosis,” giving a productivity rate of 97%. Five insufficient aspirates later proved to be neoplasms. Of the 243 cases with a primary FNAB diagnosis, 21 had insignificant disease, 29 had benign neoplasms or nonneoplastic disease, and 193 had malignant tumors. Most malignancies could be assigned to a specific histologic type by FNAB; those that proved difficult by FNAB were usually difficult on histopathologic examination. There were no false‐positive diagnoses of malignancy and only eight false‐negative results. Of 12 results interpreted as “Suspicious,” 10 proved to be malignant on follow‐up. This modified method has proven to have a low complication rate and to be both highly productive and reliable in the diagnosis of malignant and nonmalignant disease. Diagn Cytopathol 1987;3:1–7.
Cytologic detection of malignancy in pleural effusion: A review of 5,255 samples from 3,811 patients
Authors: Hsu Chih
Published: February 2007

A retrospective analysis of 5,255 pleural effusion specimens from 3,811 patients was undertaken to determine the accuracy of cytopathologic correlation with pleural biopsy, the detection rate of malignancy by cytology, and the frequency distribution of malignant effusions according to age group. The cytopathologic correlation was 96.5% accurate, with 0.1% false‐positive results and 0.18% false‐negative results by cytology. The sensitivity of cytologic detections was 6.7% higher than that of pleural biopsy. Frequency analysis showed that the incidence of carcinoma of the lung, the most common cause of malignant effusion, is not sex based. Adenocarcinoma of the lung was the most frequent type of malignancy found in pleural effusions. It represented 79% of lung carcinomas that metastasized to pleura, accounting for 40% of all malignant pleural effusions. In young adults, lymphoreticular malignancies were the most common cause of malignant effusions. Diagn Cytopathol 1987;3:8–12.
Fine‐needle aspiration cytology diagnosis of tuberculosis
Authors: Rajwanshi Arvind , Bhambhani Suresh , Das Dilip K.
Published: February 2007

Fine‐needle aspiration cytology of lymph nodes and extranodal swellings in 160 cases showed granulomatous reaction with or without caseation necrosis in 83%. The material was acellular or predominantly composed of necrotic material, polymorphs, and lymphocytes in 17%. The age of the patient ranged from 1.5 to 72 yr. The male to female ratio was 1:1.3. Acid‐fast bacilli (AFB) could be demonstrated in 40.6% of cases. In cases associated with cellular reaction and necrosis, AFB positivity was 50.0%, while it was 66.7% in cases with acellular necrotic material. Diagn Cytopathol 1987;3:13–16.
Cytology and hormonal receptors in breast cancer
Authors: Lampertico P. , Stagni F.
Published: February 2007

Even in advanced tumors of the breast, it may be interesting to know the steroid receptor status (RS) for therapeutic and prognostic purposes. When, for clinical reasons, surgical biopsy is not advisable, a morphologic technique may be attempted on cytological material. In the past few years, we have employed the cytochemical method described by Lee (RSf) on cytological material obtained from 31 primary and 34 secondary tumors; adequate material and follow‐up were available in 42 cases. Patients with positive results (strong and diffuse fluorescence of neoplastic cells) usually had better prognosis and longer disease‐free interval and total duration of disease. The majority of patients responded to endocrine manipulation. In contrast, weak positivity or negative results were associated with a poorer prognosis. If these results are confirmed in larger series of cases and for longer periods of observation, the morphological evaluation of RS on cytological material could significantly contribute to the management of breast cancer patients. Diagn Cytopathol 1986;2:17–23.
Nuclear and cell area measurements in the cytological evaluation of pleural effusions: A study of subjective assessments and morphometric measurements
Authors: Christensen Jan A. , Skaarland Elsa
Published: February 2007

Morphometric measurements of cellular area, nuclear area and nuclear:cytoplasmatic ratio were performed on single cells in pleural effusions from 15 patients with effusion caused by bronchial, ovarian, or mammary carcinoma. The results were compared with corresponding measurements on mesothelial cells in pleural effusions from 15 patients without malignant disease. Significant differences were found between the mean values from cellular area, nuclear area, and nuclear:cytoplasmatic ratios in mesothelial cells from benign effusion versus malignant cells from effusions associated with metastatic growth. Such morphometric measurements are, however, of little value in routine diagnostic work as more than 90% of the cells in the two groups showed similar values. Diagn Cytopathol 1987;3:50–54.
Morphometric evaluation of histological sections of the thyroid gland in benign and malignant follicular lesions
Authors: De Santis M. , Sciarretta F. , Sudano L. , Donnorso R. Perrone
Published: February 2007

A morphometric analysis was made on histological sections of thyroid tissue in various aspects of follicular cell pathologies (goiter, adenoma, and carcinoma) and in normal follicular cells. Three cases of each aspect and 150 cells of each case were measured. The results obtained demonstrate the importance of the nuclear area in the differential diagnosis of normal thyroid, goiter, adenoma, and carcinoma. The other parameters considered, i.e., perimeter, maximum diameter, and nuclear form factor, proved to be able to exclusively distinguish between benign lesions (normal thyroid, goiter and, adenoma) and malignant ones (carcinoma). Diagn Cytopathol 1987;3:60–67.
Methodological aspects and application of the immunoperoxidase staining technique in diagnostic fine‐needle aspiration cytology
Authors: Gustafsson Bertil , Manson Jan‐Christer
Published: February 2007

The immunoperoxidase method was modified and adapted for use on cells obtained by fine‐needle aspiration biopsy for routine diagnostic cytology. Combinations of different modes of fixation and graded trypsinisation were tested. Best results were obtained with fixation in formol‐acetone followed by enzyme digestion for 3‐6 min; exact times were adjusted for the individual antigen. With optimal conditions as to fixation and prateolytic digestion, the method was found to be sensitive and reproducible and without artifactual background staining. Various intracytoplasmic antigens of diagnostic importance such as immunoglobulins, prostate‐specific antigen, keratin, thyreoglobulin, S‐100, α‐1‐antitrypsin, and lysozyme in lymphoid cells, bone marrow cells, and tumor cells of epithelial and mesenchymal origin were detected. Staining of newly prepared or up to 2‐yr‐old specimens gave equally good results. Both cellular morphology and the results of immunoperoxidase staining can be studied simultaneously. The method is considered valuable for increasing accuracy of diagnostic cytology. Diagn Cytopathol 1987;3:68–73.
Myoepithelial cells in needle aspirations of two cases of unusual breast lesions: An aid in differential diagnosis
Authors: Whitlatch Stephen P. , Panke Thomas W.
Published: February 2007

The observation of myoepithelial cells bordering abnormal epithelial cells in fine‐needle aspiration smears of two unusual breast lesions helped to prevent misdiagnosis of these lesions as malignant. The presence of myoepithelial cells has been a well‐established criterion for histologically benign lesions. Their presence or absence appears to be equally valuable in fine‐needle aspiration smears of breast lesions. Diagn Cytopathol 1987;2:77–81.
Adrenal myelolipoma: Fine‐needle aspiration of an asymptomatic retroperitoneal mass
Authors: Neumann M. Paula , Manivel Carlos , Dehner Louis P.
Published: February 2007

We report a case of myelolipoma of the adrenal gland diagnosed by ultrasound‐guided fine‐needle aspiration in a patient with bronchogenic carcinoma who was noted to have a 5‐cm adrenal mass on computerized tomography during evaluation for metastatic disease. The cytologic features are characteristic and consist of mature adipocytes and bone marrow elements that are most clearly demonstrated on Wright‐stained cytospin material. This case illustrates the importance of fine‐needle aspiration in the evaluation of radiologically detected adrenal masses in patients with known malignancies. A cytologic diagnosis of benign or metastatic disease can eliminate the need for formal surgical exploration in selected cases. Diagn Cytopathol 1987;3:82–84.
A morphologic, immunologic, and cytometric approach to the classification of non‐Hodgkin's lymphoma in effusions
Authors: Katz Ruth L. , Raval Pramila , Manning John T. , McLaughlin Peter , Barlogie Bart
Published: February 2007

The biologic and clinical heterogeneity of the various subtypes of non‐Hodgkin's lymphoma is related to differences in morphologic, immunologic, and kinetic properties. Comprehensive studies characterizing these features in lymphomatous effusion have yet to be reported. We recently studied 27 effusion specimens from 26 patients with clinically suspected or confirmed lymphoma. Wright‐Giemsa‐ and Papanicolaou‐stained cytologic preparations, acridine orange nucleic acid flow cytometry, and immunoperoxidase staining of cell suspensions using antibodies to a battery of T and B cell markers were evaluated and compared with prior histologic accessions. Specimens were classified by cytologic characteristics according to the International Working Formulation Scheme and by acridine orange nucleic acid flow cytometry using the parameters of DNA, RNA, and proliferative activity. Correlation of the cytometric and morphologic data demonstrated that with increasing cytologic grade of lymphoma, the proliferative activity increased progressively and distinguished between grades (P < 0.01). Immunologic studies identified B cell phenotype in 16 specimens, T cell in three, and true histiocytic lymphoma in one; one lymphoma had no cell markers (null cell). Six effusons proved to be inflammatory and reactive according to surface marker studies. Classification by cytologic characteristics showed good correlation with histologic classification performed previously. Immunologic study of cytologic specimens gave results identical to those achieved by frozen‐section immunohistologic examination. Thus, immunologic and cytometric parameters can be readily performed on effusion specimens and aid in the diagnosis and classification of lymphomas. Diagn Cytopathol 1987;3:91‐101.
Cytological grading of therapy‐induced tumor regression in prostatic carcinoma: Proposal of a new system
Authors: Böcking Alfred , Auffermann Wolfgang
Published: February 2007

Proposed in this article is a new system for the cytological grading of therapy‐induced regression of prostatic carcinoma. Reversible and irreversible criteria in cytoplasm, nuclei, and nucleoli are distinguished and rated independently of each other on a scale of 0 to 2; the cellular regression grades r1‐r3 are the sum of rating numbers. Criteria that are invalid for grading regression are pointed out. Results of the clincial testing of this grading system are presented. Diagn Cytopathol 1987;3:108‐111.
The cytologic diagnosis of amniotic fluid embolism: A critical reappraisal
Authors: Giampaolo Casimiro , Schneider Volker , Kowalski Brenda H. , Bellaver Lynn A.
Published: February 2007

In an attempt to assess the extent to which contamination by exogenous squamous cells contributes to false‐positive results in the cytologic diagnosis of amniotic fluid embolism, blood sampled from the right heart or from the pulmonary artery of 42 nonpregnant cardiac patients was processed and examined for squames. Despite a variety of precautions, it proved impossible to eliminate contamination in any of these specimens. In addition, two of three blank slides that were stained with maximal precaution also demonstrated squames. The authors conclude that cytologic techniques are not helpful in the diagnosis of amniotic fluid embolism and should no longer be utilized. Diagn Cytopathol 1987;3:126–128.
Fine‐needle aspiration biopsy of abdominal and retroperitoneal tumors in infants and children
Authors: Valkov Ivan , Bojikin Boris
Published: February 2007

Fine‐needle aspiration biopsy has been employed to establish morphologic diagnoses in abdominal and retroperitoneal tumors in 54 infants and children. A 0.4‐0.7‐mm gauge needle was used; the puncture was performed through the anterior abdominal wall in the abdominal tumors and by the lateral approach in the retroperitoneal tumors. Malignant tumors were discovered in 51 cases (94.4%). The nature of the lesion was recognized in 96.2%, and correct cell typing was achieved in 90.2%. The most frequent lesion was non‐Hodgkin's malignant lymphoma, followed by neuroblastoma, nephroblastoma, and individual cases of other epithelial and mesenchymal tumors. Using parallel bone marrow examination, half of the neuroblastoma cases and five of 28 lymphoma cases showed bone marrow involvement. We observed no complications caused by the fine‐needle aspiration technique. Due to the safety and efficacy of this technique, it can often be used instead of explorativie laparatomy. Diagn Cytopathol 1987;3:129–133.
Cytologic examination of synovial fluid
Authors: Villanueva Thelma G. , Schumacher H. Ralph
Published: February 2007

Cytologic study of synovial fluid has been relatively neglected both by cytologists and rheumatologists. Currently identified implications of cytologic findings include definitive diagnoses of a variety of joint diseases such as those due to malignancies, infections, or pathogenic crystals. Diagnoses can also be strongly suggested, for example, by visualization of lupus erythematosus cells formed in vivo. Immunocytochemistry is being explored for diagnostic and pathogenetic implications. We propose that complementary techniques used in our cytology and rheumatology laboratories may provide new insights into the clinical significance of cellular changes in joint fluids. Diagn Cytopathol 1987;3:141–147.
Diagnosis of central nervous system Toxoplasma gondii from the cerebrospinal fluid in a patient with acquired immunodeficiency syndrome
Authors: Dement Samuel H. , Cox M. Catherine , Gupta Prabodh K.
Published: February 2007

The cytologic diagnosis of central nervous system (CNS) Toxoplasma gondii was established from the cerebrospinal fluid (CSF) in a patient with acquired immunodeficiency syndrome (AIDS) who presented with obstructive hydrocephalus and progressive obtundation. Free extracellular tachyzoites, phagocytized tachyzoites, and cyst forms were identified with Wright staining of cytocentrifuge preparations. Diagnosis was confirmed with indirect immunofluorescent antibody studies. Initial CSF examination was remarkable for low cellularity (24 wbc/mm3) with 42% neutrophils and 58% mononuclear cells on differential examination. Subsequent differential counts of CSF showed persistence of a mixed inflammatory pattern until day 10 at which time a mononuclear pleocytosis was observed. Cerebrosphinal chemistries were notable for a low glucose (20 mg/dl), which persisted for 10 days. The cytocentrifuge Wright stain preparation was found to be superior to routine millipore filter Papanicolaou stain preparation for the identification of free tachyzoites and is recommended in the setting of immunodeficient patients with suspected CNS roxoplasmosis. Diag Cytopathol 1987;3:148–151.
Fine‐needle aspiration cytology of juvenile hemangioma of the parotid gland: A case report
Authors: Hilborne Lee H. , Glasgow Ben J. , Layfield Lester J.
Published: February 2007

A 4‐mo‐old child presented with a 20‐day history of swelling of the left cheek. Fine‐needle aspiration (FNA) biopsy revealed a spindle‐cell neoplasm with a bloody background. Subsequent surgical excision confirmed the presence of a juvenile hemangioma (juvenile hemangioendothelioma). The FNA biopsy and surgical pathology findings are presented along with a discussion of the differential diagnosis of this relatively rare neoplasm. Diagn Cytopathol 1987;3:152–155.
Teflon granuloma mimicking a thyroid tumor
Authors: Wilson Roma A. , Gartner William S.
Published: February 2007

An unusual case is presented of a patient who developed a “thyroid” nodule following injection of Polytef into the left posterior vocal cord for impaired phonation. Fine‐needle aspiration cytology was interpreted as suspicious for malignant cells. Histological evaluation revealed a benign granulomatous lesion with numerous Teflon particles. Review of the literature relating to Teflon injections is presented. Diagn Cytopathol 1987;3:156–158.
Short‐term estrogen test for cytodiagnosis in postmenopausal women
Authors: Kashimura Masamichi , Baba Shinji , Nakamura Shuji , Matsukuma Keita , Kamura Toshiharu
Published: February 2007

A short‐term estrogen test was used to obtain a correct cytologic diagnosis in 73 patients with an equivocal atrophic cellular pattern. Overestimation in cytodiagnosis was markedly eliminated, and the correct cytologic diagnosis was made in 81 % of the cell samples after the estrogen test. The purpose of this study was not only to confirm the usefulness of the short‐term estrogen test, but also to observe the cytomorphologic changes before and after the test. Thick cytoplasm, vacuoles in the cytoplasm, and a distinct cell border increased, while the amorphous chromatin pattern was eliminated after the estrogen test. Maturation of atypical cells in cases of dysplasia, carcinoma in situ, and invasive squamous‐cell carcinoma was investigated before and after the estrogen test. Although malignant cells were not influenced by estrogen, maturation of dysplastic cells was induced after the test.
The diagnostic cytology of nonspecific vaginitis
Authors: Giacomini Giuseppe , Reali Daniela , Vita Daniela , Barahmandpour Siamak , D'Acunto Antonio
Published: February 2007

Diagnostic cytology has not kept pace with the general growing interest in nonspecific vaginitis (NSV). This study on 114 patients compares Papanicolaou vaginal smears with bacteriologic cultures, whiff test, gram‐stained vaginal smears, and vaginal pH in the evaluation of nonspecific vaginitis. Cytology is a valid practical test for diagnosis of nonspecific vaginitis; however, it must be emphasized that the coccoid morphotype is the same as the Gardnerella morphotype. Perhaps the Gardner‐ella morphotype is the most typical of all the inflammatory typologies found in vaginal smears, and it was indeed one of the first to be described in the history of diagnostic cytology–albeit with a slight misnomer. The question is of considerable importance since NSV is the most frequent and persistent of all collapses of the vaginal ecosystem. Cases of NSV must be screened to prevent more serious diseases of the female genital tract.
The role of an immunoperoxidase technique in the diagnosis of oral herpes simplex virus infection in patients with leukemia
Authors: Epstein J. B. , Page J. L. , Anderson G. H. , Spinelli J.
Published: February 2007

Laboratory techniques are often used to confirm a clinical diagnosis of oral herpes simplex virus (HSV) infection in patients with leukemia. In the present study, an immunoperoxidase technique (IPT) was used to examine smears taken from the oral mucosa of 44 patients with leukemia at Vancouver General Hospital. It was found that the IPT was as sensitive and specific as viral culture in confirming the presence of HSV. The IPT was found to be more predictive of symptomatic oral HSV disease than viral culture because it did not give positive results if there was only viral shedding in the absence of clinical disease. As the IPT is rapid and inexpensive as well as being specific, sensitive, and predictive, it has a definite role in the laboratory confirmation of oral HSV lesions in leukemics.
Intermediate filaments in cytological specimens of thyroid tumors
Authors: Altmannsberger Michael , Dralle Henning , Weber Klaus , Osborn Mary , Droese Manfred
Published: February 2007

Cytological specimens of thyroid carcinomas and follicular adenomas obtained by fine‐needle aspiration biopsies or touch imprints were investigated with antibodies to keratin, vimentin, and neurofilaments. All tumors were keratin positive. In follicular adenomas as well as in papillary thyroid carcinomas, a coexpression of keratin and vimentin was detected; in follicular carcinomas, only some tumors showed coexpression of keratin and vimentin; and in medullary thyroid carcinomas, positive staining of all six tumors studied was seen with the keratin and neurofilament antibodies, with some tumors also showing coexpression of vimentin. The mechanism of such coexpression is unclear.
Value of immunocytochemistry in the study of malignant effusions
Authors: Mason Maria R. , Bedrossian Carlos W. M. , Fahey Colleen A.
Published: February 2007

Recognition of malignant effusion relies heavily on cytologic examination despite the difficulty of distinguishing atypical mesothelial hyperplasia from metastatic carcinoma. The combination of CEA, EMA, vimentin, keratin, high‐molecular‐weight cytokeratin (HMWK), low‐molecular‐weight cytokeratin (LMWK), and Alcian blue was tested in 51 cytologic specimens of pleural, peritoneal, and pericardial effusions. These showed metastatic carcinoma in 38 cases (ovary, 14; lung, 8; breast, 7; GI, 4; endometrium, 4; bladder, 1) and mesothelial processes in 13 (hyperplasia, 9; mesothelioma, 4). Strong positivity for EMA (92%), CEA (90%), and Alcian blue (71 %) was noted in metastatic carcinoma but not in the mesothelial processes. Keratin was positive in all cases of mesothelioma but occurred also in mesothelial hyperplasias (44%) and metastatic carcinomas (47%). In mesothelial cells, HMWK was consistently stronger than LMWK, whereas in adenocarcinoma the reverse was true. There was no difference in the degree or distribution of positivity of any of the markers among the various primary sites of the neoplasms. Our findings are consistent with the view that immunocytochemistry with a battery of antibodies is useful in the recognition of malignant effusions but cannot, as yet, determine the site of origin of metastatic neoplasms.
Carcinoid metastatic to breast diagnosed by fine‐needle aspiration biopsy
Authors: Landon Gene , Sneige Nour , Ordóñez Nelson G. , Mackay Bruce
Published: February 2007

We report a patient in whom fine‐needle aspiration biopsy of a breast mass, clinically suspected to be a mammary adenocarcinoma, established the diagnosis of a carcinoid metastatic to breast. The aspirate smears resembled a primary breast carcinoma; however, subtle cytomorphologic differences were present. Ultrastructural and immunohistochemical studies of the aspirated material confirmed the diagnosis of metastatic carcinoid.
Aspiration biopsy cytology of secretory carcinoma of the breast
Authors: Nguyen Gia‐Khanh , Neifer Roy
Published: February 2007

Aspirate from a secretory carcinoma of the breast showed malignant epithelial cells present singly or in large sheets with strong cellular cohesiveness. Tumor cells displayed ill‐defined, granular, or vacuolated cytoplasm. Intracytoplasmic globular material was periodic acid‐Schiff positive and resistant to prior diastase digestion. The cytologic differential diagnosis with other breast cancers is briefly discussed.
Fine‐needle aspiration cytology of malignant lymphoma of the thyroid
Authors: Matsuda Minoru , Sone Hiroko , Koyama Hiroki , Ishiguro Shingo
Published: February 2007

Our experience with fine‐needle aspiration cytology in five cases of malignant lymphoma of the thyroid is reported. Only one case was correctly diagnosed as malignant lymphoma from the original cytologic reports. Three cases were misdiagnosed as anaplastic carcinoma of small‐cell type and two of these three cases were subsequently revised as malignant lymphoma after a second aspiration. The final case was misdiagnosed as chronic thyroiditis at both the first and second aspirations; following a third aspiration, 8 mo later, it was correctly diagnosed as malignant lymphoma. Cytological findings of malignant lymphoma are as follows: many malignant cells are distributed as isolated cells and show monotonous features. Malignant cells are slightly larger than normal lymphocytes. Sometimes cleaved cells or large nucleoli are visible. The differential diagnosis of cytologic findings of malignant lymphoma and the other thyroid diseases is discussed in detail.
Sensitivity of the cytologic diagnosis of cervical condyloma in comparison with HPV‐DNA hybridization studies
Authors: Schneider Achim , Meinhardt Gabriele , De‐Villiers Ethel‐Michele , Gissmann Lutz
Published: February 2007

The cytologic diagnosis of cervical condyloma is based on criteria developed over the last 10 years. It has now become possible to document the presence of human papilloma virus (HPV) DNA directly in cervical swabs by the highly sensitive technique of DNA filter hybridization in situ. The purpose of this article is to evaluate critically the empirically established cytologic criteria of condyloma by comparing them with HPV‐DNA hybridization studies in the same material. The results of this study indicate that ‘classic’ koilocytosis and dyskeratocytosis are not highly sensitive criteria for the presence of HPV infection, identifying only 15% of the HPV‐DNA‐positive cases correctly. In an attempt to improve the sensitivity of the cytologic diagnosis of HPV infections, a panel of nine ‘nonclassic’ criteria was evaluated. The five most valuable signs were ‘mild koilocytosis,’ mild dyskeratocytosis, hyperchromatic nuclei, bi‐ and multinucleation, and cleared cytoplasm. Using these criteria in combination, statistically discriminant analysis could correctly identify 84% of the HPV‐positive group.
The influence of the wet‐fixed papanicolaou and the air‐dried giemsa techniques on nuclear parameters in breast cancer cytology: A cytomorphometric study
Authors: Schulte E. , Wittekind Chr.
Published: February 2007

The influence of fixation and staining on morphometric nuclear parameters in cytologic samples of breast lesions has been investigated with respect to the wet‐fix and the air‐dry techniques. Aspiration biopsy material from 55 benign and malignant breast lesions was smeared onto slides and stained with a routine Papanicolaou technique (after wet fixation) or with the Azur B‐eosin Y stain (after air drying). Tumors were grouped according to both histological grade and lymph node status. Nuclear area, diameter, and perimeter were measured from each specimen with an image analyzer and correlated to grade and stage of the disease. All nuclear parameters were significantly smaller in wet‐fixed slides. The coefficient of variation was smaller in air‐dried samples, which allowed better discrimination between different groups. Nuclear perimeter had the highest discriminative power. Unintentional air drying in wet‐fixed smears increased the coefficient of variation for all nuclear parameters. Air drying of cytologic smears is recommended for morphometric investigations if chromatin texture is of minor importance.
Frequency of “blue bodies” in pulmonary cytology specimens
Authors: Kung I. T. M. , Hsu C. , Chan S. C. W. , Leung B. S. Y. , Ng D. W. H.
Published: February 2007

To determine the frequency of occurrence of “blue bodies” (BBs), 2,010 pulmonary cytology specimens (1,403 sputum and 607 bronchial specimens) from 1985 were reviewed. The smears were examined microscopically by transmitted and polarized light. BBs were extracellular structures, occurring most commonly in clusters but sometimes conglomerated. With Papani‐colaou stain, they had a characteristic birefringent laminated brown core and a nonbirefringent blue rim. Chemical microanalysis and energy‐dispersive x‐ray analysis revealed that their chemical composition was calcium carbonate. A total of 233 specimens contained BBs, with a frequency of 10.5% in bronchial specimens and 12% in sputum. Only 8.6% of the BBs had co‐existent pulmonary malignancy. We concluded that BBs were common structures in pulmonary cytology and were not associated with pulmonary malignancy or pulmonary fibrosis in our series. They must be distinguished from contaminants, staining artifacts, and parasitic ova. Diagn Cytopathol 1987;3:284‐6.
Immunocytochemical confirmation of oral and respiratory herpesvirus infection by the immunoperoxidase method
Authors: Gupta Raj K. , Buchanan Andrew J. , Fauck Robert
Published: February 2007

Recognition of diagnostic viral changes in general, and due to herpesvirus infection (HVI) in particular, from a variety of materials examined cytologically has added a new dimension to diagnostic cytology. Such recognition provides valuable information to the clinician when no infection is suspected. Previously, the diagnosis of HVI of the respiratory tract was only possible at postmortem, tissue culture, or diagnostic rise in antibody titer. This study describes our experience in the diagnosis of HVI of the respiratory tract initially suggested by sputum cytology and later confirmed by the immunoperoxidase method. The importance of sputum cytology in the diagnosis of HVI is emphasized. Diagn Cytopathol 1987;3:287‐90.
Nuclear crease as a cytodiagnostic feature of papillary thyroid carcinoma in fine‐needle aspiration biopsies
Authors: Deligeorgi‐Politi Helen
Published: February 2007

Nuclear crease or grooving was found to be a diagnostic feature of papillary thyroid carcinoma (PTC) in fine‐needle aspiration (FNA) biopsies. The FNA biopsies of 37 cases of PTC, 50 cases of multinodular goiter, and 50 cases of follicular neoplasms (45 follicular adenomas and five follicular carcinomas) were examined. The diagnosis was histologically verified in all the cases. The nuclear crease was found to be present in 34 of 37 cases of PTC and in two of five cases of follicular carcinoma. There was no nuclear crease in any of the other cases examined. Thus, it is concluded that the nuclear crease is a fairly constant and characteristic feature of PTC in FNA biopsies and can be used as a valuable diagnostic criterion. Diagn Cytopathol 1987;3:307‐10.
Cytologic diagnosis and monitoring of Hodgkin's disease in cerebrospinal fluid: A case report
Authors: Shenoy Uma A. , Kushner James P. , Schumann G. Berry
Published: February 2007

Central nervous system (CNS) involvement in Hodgkin's disease is rare, but when the tumor extends into the CNS the route of tumor spread is similar to that seen in non‐Hodgkin's lymphoma. Reed‐Sternberg cells were identified in the cerebrospinal fluid (CSF) of a patient with Hodgkin's disease involving the CNS. Sequential cytologic examination of the CSF proved valuable in evaluating the efficacy of therapy. The ability to identify Reed‐Sternberg cells in the CSF makes CSF cytology a useful adjunct in the management of patients with established or suspected CNS involvement of Hodgkin's disease. Diagn Cytopathol 1987;3:323‐5.
Cytodiagnosis of hibernoma: A case report
Authors: Hashimoto Claire H. , Cobb Camilla J.
Published: February 2007

Cytologic examination of material obtained by fine‐needle aspiration of a supraclavicular mass revealed features that were consistent with a hibernoma. Subsequent histologic study following resection of the mass confirmed the cytologic impression. The clinical, histologic, and cytologic features of this rare tumor along with the differential diagnosis and pitfalls in the cytologic diagnosis are discussed in this article. Diagn Cyto‐pathol 1987;3:326‐9.
Fine‐catheter aspiration cytology of peritoneal cavity: A new system with potential for oncologic diagnosis
Authors: Stewart Richard J. , Gupta Raj K.
Published: February 2007

Fine‐catheter aspiration cytology of the peritoneal cavity is a new system for obtaining a sample of peritoneal cells in the absence of fluid or the need for lavage. Its potential use in the diagnosis of peritoneal malignancy is illustrated by two case reports. Diagn Cytopathol 1987;3:339‐41.
The diagnosis of chlamydial infection in a cytology laboratory: Ten months' experience using immunofluorescence with and without previous cytologic prediction
Authors: Lindner Luther E. , Nettum John A.
Published: February 2007

A Chlamydiadiagnostic service has been established as part of a cytology laboratory, combining prediction of possible infection by routine cytology with definitive testing by immunofluorescence. The first 10 mo of operation have had good clinician acceptance with 527 specimens submitted and 128 reported as positive (24.3%). Routine cytology was more accurate in predicting chlamydial infection than was clinical evaluation (32.8% of cytologically suspected cases were positive versus 20.2% of clinically suspected cases); however, both failed to identify many infected women. The patient selection for testing must be improved since only about 22% of infected women in our population were tested. Nevertheless, the service identified a large number of patients infected with an important sexually transmitted pathogen. Chlamydial diagnosis has become a major component of the laboratory's workload and has been cost‐effective. Diagn Cytopathol.
Nasal eosinophilia in children: Its use in the nasal allergen provocation test
Authors: Jean René , Lellouch‐Tubiana Arielle , Brunet‐Langot Denise , Scheinmann Pierre , Pfister André
Published: February 2007

This pediatric cytological and clinical study aimed at assessing the value of nasal eosinophilia during nasal provocation tests for identifying an offending allergen. The population studied comprised 50 children aged from 4 to 18 yr; 39 of these had well‐characterized allergic rhinitis, which in 21 cases was combined with asthma, and the remaining 11 had nonatopic chronic rhinitis. Nasal secretions, collected by nose blowing, were stained with May‐Grünwald‐Giemsa or Wright stain. The percentage of nasal eosinophils was obtained by examining the cells in the whole slides. Counts were carried out on secretions collected before challenge, after insufflation of saline solution (for verification), and 40 min after insufflation into each nostril of an allergen (housedust mite extract). The nasal provocation test was considered positive when insufflation of the allergen increased nasal eosinophilia by more than 10%, provided that the prechallenge proportion of eosinophils was less than 50%. No increase in specific bronchial resistance was noted. These results indicate that nasal provocation tests are safe, even in asthmatic children.
Respiratory cytopathology in chlorine gas toxicity: A study in 28 subjects
Authors: Shroff Chandralekha P. , Khade Megha V. , Srinivasan Mahalaxmi
Published: February 2007

Bronchial brushings to evaluate cytopathologic changes were collected from 28 patients exposed to a toxic atmospheric level (66 parts/million) of chlorine gas. Postexposure smears collected on day 5 showed basal‐cell and goblet‐cell hyperplasia, acute inflammation, and chromatolysis of columnar epithelial cells. Columnar epithelial cell syncytia were observed in 15 (53.57%) smears. Nine (32.14%) smears showed abundant nonpigmented alveolar macrophages. Seven (25%) smears from mucosal erosions showed proliferating fibroblasts and capillary fragments; on day 15 and day 25 repeat smears from these seven cases showed evidence of epithelial regeneration and repair byfibrosis. This latter feature could lead to chronic ventilatory incapacitation in patients exposed to toxic levels of chlorine gas.
The potential value of imprint cytology in cytochemical localization of steroid hormone receptors in ovarian cancer
Authors: Masood Shahla
Published: February 2007

Steroid hormone receptors were studied in 45 patients with primary, recurrent, or metastatic ovarian cancer in cryostat‐frozen sections and imprint preparations. The ligands, 17 B‐estradiol‐6‐carboxymethyloxine‐bovine serum albumin fluorescein isothiocyanate (FITC‐BSA estradiol) and hydroxypro‐gesteronehemisuccinate bovine serum albumin tetramethylrho‐damine isothiocyanate (TMRITC‐BSA progesterone) were used in the fluorescent cytochemical method. Results were compared with standard dextran‐coated charcoal (DCC) biochemical assay. An overall significant correlation between biochemical values and cytochemical results was found. However, the imprint results were more sensitive and more specific than the frozen section results. A statistically significant difference (P < 0.05) was observed between touch preparation material and frozen section specimens by the fluorescent method.
Fine‐needle aspiration biopsy of tibial adamantinoma: A case report
Authors: Hales Martha S. , Ferrell Linda D.
Published: February 2007

Adamantinoma of long bones is a rare, primary bone tumor of controversial histogenesis, usually arising in the anterior mid‐shaft of the tibia. This slowly growing, radiolucent, expansile tumor eventually causes thinning or destruction of overlying cortical bone. Fine‐needle aspiration biopsy (FNAB) is a rapid, safe, and relatively painless means of obtaining diagnostic material from bone tumors, provided the mass has eroded through or markedly attenuated the overlying cortex. A case is presented of primary adamantinoma of the tibia which was sampled first by FNAB and subsequently by surgical biopsy.
Nuclear grooves: A useful criterion in the cytopathologic diagnosis of papillary thyroid carcinoma
Authors: Shurbaji Muhammad S. , Gupta Prabodh K. , Frost John K.
Published: February 2007

A recent report emphasized the usefulness of the grooved nucleus as a diagnostic criterion of papillary thyroid carcinoma (PTC) in histopathologic material. The present study was undertaken to evaluate whether grooved nuclei can serve as an additional diagnostic criterion for PTC in cytologic material obtained by fine‐needle aspiration (FNA). Slides from 124 consecutive thyroid FNAs were reviewed. Specimens included 11 PTCs, one follicular carcinoma, six follicular adenomas, eight follicular neoplasms not otherwise specified, 10 cases of chronic thyroiditis, and 88 colloid nodules/adenomatous goiters. Among the PTC cases, grooved nuclei were found in all 11 (100%), intranuclear inclusions in nine (82%), papillary fragments in seven (64%), and psammoma bodies in two (18%). Nuclear grooves were also observed in two of the 113 non‐PTC cases (1.8%), both of which were colloid nodules, one with extensive Hurthle‐cell change. The grooved nuclei were best identified on Papanicolaou‐stained material. They were inconspicuous and difficult to identify in air‐dried Diff‐Quik‐stained material. It appears that the recognition of grooved nuclei among tumor cells is a valuable diagnostic feature of PTC in cytologic material stained with polychromatic Papani‐colaou stain.
Immunocytochemical presentation of alpha‐fetoprotein‐producing gastric cancer in ascitic fluid: A case study
Authors: Kobayashi Tadao K. , Gotoh Takechika , Kamachi Masahiro , Watanabe Shinsuke , Sawaragi Isamu
Published: February 2007

A case of primary gastric cancer without hepatic metastasis showing extremely high alpha‐fetoprotein (AFP) levels is reported. This case illustrates the application of the immunoperoxidase technique to ascitic fluid cytology. Papanicolaoustained smears of the ascites permitted the diagnosis of a metastatic carcinoma. A positive reaction to AFP was demonstrated in the tumor cells in the ascitic fluid cellular samples as well as in the paraffin‐embedded tissue section of the primary gastric carcinoma. Rising AFP levels were also detected in ascitic fluid. AFP fractionation using lectin‐affinity‐crossed‐line immunoelectrophoresis showed the hepatic rather than yolk sac type. Reports of such occurrences are few; no study, to the best of our knowledge, has previously documented cytological and immunocytochemical diagnosis in ascitic fluid. AFP‐producing gastric cancer should be considered in the differential diagnosis.
Renal‐cell carcinoma with intranuclear inclusions metastatic to thyroid: A diagnostic problem in aspiration cytology
Authors: Gritsman Andrey Y. , Popok Steven M. , Ro Jae Y. , Dekmezian Roupen H. , Weber Randal S.
Published: February 2007

A case of renal‐cell carcinoma (RCC) exhibiting prominent intranuclear inclusions in a metastasis to the thyroid is presented. RCC had been treated in this patient by right nephrectomy 7 yr earlier and by left partial nephrectomy 5 yr earlier; the patient had also received radiation to the neck 4 yr earlier for carcinoma in situ of the left true vocal cord. Aspiration performed on a rapidly enlarging mass in the left lobe of the thyroid revealed both clusters of tumor cells and single tumor cells with prominent intranuclear inclusions. Definitive distinction between a primary and metastatic neoplasm was difficult on the aspiration specimen. Subsequent thyroidectomy confirmed the diagnosis of metastatic renal‐cell carcinoma with intranuclear inclusions by histologic, immunohistochemical, and ultrastructural analysis. The differential diagnosis by aspiration cytology of thyroid neoplasms that contain intranuclear inclusions is discussed.
Cytologic detection of amyloid in duodenal and ureteral brushings
Authors: Korat Orly , Yachnis Anthony T. , Ernst Carolyn S.
Published: February 2007

Two cases of amyloidosis diagnosed on cytology brush specimens are described. Gastrointestinal involvement in a patient with primary amyloidosis and renal involvement in a patient with multiple myeloma were diagnosed on duodenal and ureteral brush specimens, respectively. Familiarity with the staining characteristics of amyloid should increase it as a consideration in the differential diagnosis of certain specimen types.