bluuebunny/crossref_metadata_2025 huggingface dataset:
Fine‐needle aspiration biopsy of langerhans histiocytosis (histiocytosis‐x)
Authors: Akhtar Mohammed , Ali Muhammad Ashraf , Bakry Mohammed , Sackey Kwesi , Sabbah Rajeh
Published: February 2007

A series of 14 fine‐needle aspiration biopsies (FNAB) from histologically proven cases of histiocytosis‐x (Hx) were renewed. The smears revealed a variable mixture of Langerhan cells, eosinophils, macrophages, polymorphonuclear cells, and giant cells. Based on the predominant cells present, the cases were further categorized as Langerhan cell predominant (nine cases), eosinophil predominant (two cases), and macrophage predominant (three cases). Langerhan cells were usually polygonal without significant evidence of phagocytosis and frequently contained indented nuclei. In three cases, several Langerhan cells showed prominent dendritic processes. Electron microscopy in 10 cases revealed Langerhan cells with varying degrees of morphologic differentiation. All cases studied revealed Birbeck granules. These findings indicate that FNAB may be an effective technique for diagnosing Hx.
Solid and papillary epithelial tumour of the pancreas: Cytological case study with ultrastructural and flow cytometric evaluation
Authors: Greenberg Merle L. , Rennie Yvonne , Grierson Jean M. , Quin John W. , Boadle Ross A.
Published: February 2007

An intraoperative cytological diagnosis of a rare solid and papillary epithelial tumor of the pancreas was made at laparotomy in a 15‐year‐old Indian female. The characteristic cytological features were the presence of numerous large branching papillary clusters with central vascular stalks lined by multiple layers of uniform bland cells. Perivascular metachromatic material was prominent on Romanovsky stain. Ultrastructural identification of endocrine and exocrine features supports a multipotential cell origin in small pancreatic ductules. DNA analysis, not previously reported for this tumour, demonstrated a diploid population of tumour cells with a low S‐phase fraction (0.4%). This would explain the bland nuclear morphology and favourable prognosis with a high rate of surgical cure for this neoplasm.
Fine‐needle aspiration biopsy of multiple myeloma in a patient with renal‐cell carcinoma: A case report
Authors: Cooper Gary L. , Shaffer Don W. , Raval Hansa B.
Published: February 2007

A case of multiple myeloma diagnosed by fine‐needle aspiration (FNA) biopsy and confirmed by laboratory studies in a patient with a history of renal‐cell carcinoma is presented. The patient was diagnosed with renal‐cell carcinoma of the right kidney and a radical nephrectomy was performed. Eighteen months after this diagnosis was made, the patient developed chest wall pain and was found to have osteolytic bone lesions of the ribs and vertebral bodies. FNA of an osteolytic rib lesion disclosed multiple myeloma. Additional laboratory studies confirmed the diagnosis of multiple myeloma. This case report demonstrates the value of FNA as a diagnostic tool for the follow‐up of cancer patients, the subsequent discrimination between metatastic lesions and a second primary malignancy, and the cytology of multiple myeloma.
Pleomorphic adenoma of the breast: Cytology of fine‐needle aspiration and its differential diagnosis
Authors: Kanter Michael H. , Sedeghi Masood
Published: February 2007

The cytologic findings of a case of pleomorphic adenoma of the breast are presented. This rare tumor appeared identical to pleomorphic adenoma of salivary glands. It presented diagnostic difficulties, however, because of its rarity and the fact that its associated clinical findings suggested a malignancy. The cytologic differential diagnosis includes a phyllodes tumor, fibroadenoma, and metaplastic carcinoma. Awareness of this entity should permit a definitive diagnosis by aspiration biopsy.
Malakoplakia of the vagina diagnosed by fine‐needle aspiration cytology
Authors: Saad A. Joe , Donovan Teresa M. , Truong Luan D.
Published: February 2007

Malakoplakia is an uncommon chronic granulomatous process that most commonly affects the urinary tract, but it may rarely recur in the female genital tract. It appears to result from a defect in macrophage function resulting in an inability to destroy ingested bacteria. We describe the fine needle aspiration cytology of malakoplakia in an 84‐yr‐old woman presenting with a large pelvic mass involving the apex of the vagina. The patient's history was significant for cervical squamous cell carcinoma in the remote past. CT‐guided needle aspiration yielded cellular smears with large numbers of isolated histiocytes, as well as polymorphonuclear leukocytes, lymphocytes, and plasma cells. The histiocytes had central nuclei and abundant granular cytoplasm containing target‐shaped, laminated bodies (Michaelis‐Gutmann bodies). These bodies were PAS positive and focally von Kossa positive. Large numbers of intracellular and extracellular bacteria were also seen on the smears. The characteristic cytologic findings obtained by needle aspiration were diagnostic of malakoplakia with a rare and unusual clinical presentation.
Renal splenic heterotopia, a rare mimic of renal neoplasia: Case report of imaging and fine‐needle aspiration biopsy
Authors: Forino Michael , Davis Gustave L. , Zins Jonathan H.
Published: February 2007

Renal splenic heterotopia, a very rare benign occurrence of splenic tissue within the renal capsule, mimics organizing capsular hemorrhage, adenomyolipoma and renal cortical adenoma or carcinoma. It is found incidentally as a result of imaging assymptomatic kidneys for other reasons or may cause signs and symptoms due to mass effect and hypersplenism. When occurring in patients who had had splenectomy it has been classified as splenosis. When found in patients with intact spleens it is called splenorenal fusion and considered to be a developmental heterotopia. Renal splenic heterotopia can be diagnosed by 99mTc‐sulfur colloid scan and confirmed with fine needle aspiration biopsy cell block preparations. Unnecessary nephrectomy can be avoided if splenic heterotopia is included in the differential diagnosis of renal lesions, particularly in splenectomized patients.
Localized primary amyloid tumor associated with osseous metaplasia presenting as bilateral breast masses: Cytologic and radiologic features
Authors: Lynch Lori A. , Moriarty Ann T.
Published: February 2007

This report details the cytologic features of primary localized amyloid tumor of the breast presenting as bilateral breast masses in a 72‐yr‐old woman. Clinically and radiographically, the masses simulated metastatic or multifocal carcinoma. Fine‐needle aspiration revealed irregular globules of acellular amorphous material and numerous multinucleated giant cells resembling granulomatous inflammation. Histology confirmed amyloid tumors with a foreign‐body giant cell reaction in response to amyloid and foci of osseous metaplasia. Subsequent clinical workup included a serum electrophoresis and immunofixation which showed a small IgG k monoclonal protein. Urine immunofixation was negative for Bence Jones protein. Bone marrow examination revealed no evidence of a plasma cell dyscrasia. To date the patient has not developed clinical or laboratory evidence of systemic amyloidosis or multiple myeloma. Amyloidosis involving the breast and specifically localized primary amyloid tumors of the breast are rare and infrequently reported entities. To our knowledge, osseous metaplasia within isolated primary amyloid tumors of the breast has not been reported. We present this unusual case to illustrate the intratumoral calcification patterns mimicking carcinoma and to characterize the cytologic features. Emphasis is placed on the inclusion of amyloidosis in the differential diagnosis of breast masses.
Fine‐needle aspiration of cutaneous malakoplakia
Authors: Chan Alexander C. L. , Lorentz Theo G. , Ma Lily , Cheung Annie N. Y. , Tse Simon K. M.
Published: February 2007

A 99‐yr‐old Chinese woman with cutaneous malakoplakia and concomitant urinary tract infection was reported. The patient presented with an ulcerated right lower quadrant mass and computerized tomography showed that it was limited to the skin and subcutaneous tissue with no extension to the pelvic or abdominal structures. The patient also suffered from urinary tract infection and was treated with oral norfloxacin. The ulcerated subcutaneous mass disappeared on follow‐up visit 6 months after presentation. The cytologic (fine‐needle aspiration), histologic (trucut biopsy) and ultrastructural features of cutaneous malakoplakia were described. The possible usefulness of fine‐needle aspiration in the diagnosis of this condition was discussed.
Cytometric validation of immunocytochemical observations in developing lung cancer
Authors: Tockman Melvyn S. , Gupta Prabodh K. , Pressman Norman J. , Mulshine James L.
Published: February 2007

Video‐enhanced optical microscopy objectively confirms that immunocytochemical biomarker supplementation of routine cytology permits separation of (1) “pre”‐cancer epithelial cells from JHLP screened individuals who subsequently developed lung cancer from (2) similarly atypical epithelial cells from JHLP participants who did not. The establishment of a bank of sputum cytology specimens along with a data respository of 5‐yr follow‐up and clinical outcome had permitted banked specimens to be immunostained and scored against a gold standard of subsequent histologic lung cancer. A highly skilled cytopathologist, interpreting immunostained screening sputum specimens and blinded to the clinical outcome, originally was able to correctly predict clinical outcome with 88.7% accuracy compared to this “gold standard” (Tockman et al. J Clin Oncol 1988;6:1685‐1693). This study presents an independent confirmation of that earlier immunocytochemical classification through feature extraction of digitally recorded, transmission optical microscope video images of immunostained, moderately atypical sputum cells from the original slides.
Cytology of malignant melanoma of soft parts: Fine‐needle aspirates and exfoliative specimens
Authors: Caraway Nancy P. , Fanning Christine V. , Wojcik Eva M. , Staerkel Gregg A. , Benjamin Robert S. , Ordóñez Nelson G.
Published: February 2007

We describe the morphologic features of 25 cytology specimens (13 fine‐needle aspirates and 12 exfoliative specimens) obtained from nine patients with malignant melanoma of soft parts (MMSP). Analysis of the fine‐needle aspirates and exfoliative specimens revealed primarily a dispersed cell population with occasional cell clustering. Tumor cells were round to polygonal with moderately abundant cytoplasm and had round nuclei with prominent nucleoli. In two cases, an initial definitive diagnosis of MMSP was rendered on material obtained by fine‐needle aspiration with the aid of immunocytochemical and ultrastructural studies.
Diagnosis of pulmonary toxoplasmosis by bronchoalveolar lavage in cardiac transplant recipients
Authors: Gordon Steven M. , Gal Anthony A. , Hertzler Gary L. , Bryan John A. , Perlino Carl , Kanter Kirk R.
Published: February 2007

We report two cases of fatal, clinically unsuspected disseminated toxoplasmosis that developed following orthotopic cardiac transplantation. Toxoplasma gondii trophozoites, pseudocysts, and cysts were best visualized on hematoxylin and eosin and Giemsastained cytospin preparations of bronchoalveolar lavage fluid. Post‐mortem examination in both cases revealed disseminated toxoplasmosis with extensive involvement of the lungs and heart. The patients, who were seronegative for antibody to T. gondii prior to transplantation, received organs from donors whose serology status was unknown. Demonstration of anti‐toxoplasma antibodies post‐transplantation occurred in both cases. Bronchoalveolar lavage may be useful in diagnosis of pulmonary toxoplasmosis. Clinicians, pathologists, and cytopathologists must consider T. gondii in the differential diagnosis of pneumonia in the immunocompromised patient, especially cardiac transplant patients.
Benign and malignant neoplasms of myoepithelial cells: Cytologic findings
Authors: Torlakovic Emina , Ames Elizabeth D. , Manivel J. Carlos , Stanley Michael W.
Published: February 2007

We report two myoepithelial cell neoplasms; a salivary gland tumor was malignant and a breast neoplasm was benign. Both were studied histologically, immunohistochemically, cytologically, and ultrastructurally. The malignant myoepithelioma recurred twice and metastasized to one regional lymph node. This tumor was infiltrative with areas of necrosis and hemorrhage. It was composed of malignant‐appearing spindle and plasmacytoid cells. Both types of cells were immunoreactive to muscle specific actin, S‐100 protein, cytokeratin, vimentin, and neuron‐specific enolase. Ultrastructurally, features of myoepithelial cells were seen. Fine‐needle aspirate smears showed spindle and plasmacytoid cells, numerous mitoses, and malignant‐appearing nuclei.

Spindle‐cell adenomyoepithelioma of the breast, a small well‐circumscribed firm nodule, featured multiple lobules of spindle cells associated with clear‐cell glands at the tabular periphery. Histologically and cytologically, the lesion was cellular but appeared benign. The differential diagnosis of myoepithelial neoplasms is discussed.
Imprint cytology of low‐grade B‐cell lymphoma of mucosa‐associated lymphoid tissue arising in the thymus: A case report
Authors: Nakamura Shigeo , Koshikawa Takashi , Kaba Sadayuki , Tokoro Yoshiro , Suchi Taizan , Kurita Soji
Published: February 2007

Low‐grade B‐cell lymphoma of mucosa‐associated lymphoid tissue (MALT) arising in the thymus is a very rare tumor with characteristic morphologic features. We describe a case of thymic low‐grade B‐cell MALT lymphoma occuring in a 59‐yr‐old woman with Sjögren's syndrome, in whom the definite diagnosis was difficult at the time of surgery. An immunohistologic and genotypic study, however, was diagnostic of lymphoma. A review of cytologic material was undertaken, and it was felt that the cytologic features in Giemsa‐stained preparations in imprint smears were present that initially should have enabled the correct cytodiagnosis and distinction from the other thymic lesions. The findings presented in this study were considered to contribute to the cytodiagnosis of a thymic lesion, which might, in the past, have been erroneously interpreted as another lymphoproliferative disorder.
Leishmania lymphadenitis diagnosed by fine‐needle aspiration biopsy
Authors: Tallada Natàlia , Raventós Antoni , Martinez Salomé , Compañó Carme , Almirante Benito
Published: February 2007

A case of Leishmania lymphadenitis which presented clinically as an isolated left laterocervical lymph node is described. Diagnosis was made by fine‐needle aspiration biopsy (FNAB), as in other cases previously reported. The material obtained yielded abundant histiocytes, multinucleated giant cells, and epithelioid micro‐granulomas with Leishman‐Donovan pathognomic bodies in the cytoplasm of cells, together with free forms of the parasite. This paper comments on the main differential diagnoses to be considered in our region when faced with granulomatous adenitis and the role of FNAB in the identification of this parasite in endemic areas.
Fine‐needle aspiration cytology of diabetic fibrous mastopathy
Authors: Rollins Susan D.
Published: February 2007

Diabetic fibrous mastopathy, also known as lymphocytic mastitis, is an uncommon lesion of the breast that occurs in women with long‐standing insulin‐dependent diabetes mellitus (IDDM). To my knowledge, the fine‐needle aspiration findings of a histologically confirmed case of diabetic fibrous mastopathy have not been previously described and illustrated in the cytology literature.
Fine‐needle aspiration cytology of the male breast in a cancer center
Authors: Sneige Nour , Holder Pamela D. , Katz Ruth L. , Fanning Christina V. , Dekmezian Roupen H. , Shabb Nina S. , Singletary S. Eva
Published: February 2007

All fine‐needle aspirates (FNA) performed on the male breast at The University of Texas M. D. Anderson Cancer Center from 1985 to 1992 were reviewed, totaling 64. The patients' ages ranged from 19 to 86 years, with a mean of 56 years. Thirty‐three patients had a history of an extramammary malignancy. The diagnoses established by FNA were gynecomastia (45), mammary carcinomas (6), neoplasms metastatic to the breast (5), suspicious for carcinoma (1), intra‐mammary lymph node (1), and lipoma (1). In five cases the aspirates were nondiagnostic. Two of these proved to be gynecomastia on subsequent histologic examination. Of the six FNA cases initially thought to represent primary breast carcinomas, two were found to be secondary because of involvement of the underlying chest wall by mesothelioma (1), and mucinous adenocarcinoma, unknown primary (1). No false‐positive diagnosis was rendered. We conclude that fine‐needle aspiration of the male breast is a reliable means of assessment; however, unique problems may be encountered compared with aspiration of the female breast. These include the epithelial hyperplasia frequently associated with gynecomastia, the relatively equal frequency of primary and metastatic breast lesions when a malignant process is discovered, and chest wall lesions masquerading as breast lesions.
Malacoplakia and rosai‐dorfman disease: Two entities of histiocytic origin infrequently localized in the female breast—the cytologic aspect in aspirates obtained via fine‐needle aspiration cytology
Authors: Pérez‐Guillermo M. , Sola‐Pérez J. , Rodríguez‐Bermejo M.
Published: February 2007

We describe one case of Rosai‐Dorfman disease (RDD) localized in the breast and one case of breast malacoplakia (MPK) both diagnosed by fine‐needle aspiration cytology (FNAC). In RDD the cytologic features were lymphocytophagocytosis, large histiocytes with slight nuclear atypia, and lymphohistiocytic aggregates in a polymorphous background which included frequent plasma cells. In MPK the key diagnostic feature was the presence of Michaelis‐Gutmann bodies (M‐G bodies), in various stages of evolution, intermingled with vacuolized medium‐sized histiocytes, other inflammatory cells, and debris. Pap staining is the technique of choice to show lymphocytophagocytosis and M‐G bodies and there is no need to resort to special staining methods.

RDD and MPK share a common cytologic background: the presence of numerous benign reactive histiocytes, either engulfing apparently intact lymphocytes, or phagocytizing M‐G bodies. The cytologic findings seen in both cases suggest that the presence of histiocytes in a breast aspirate is far from being nonspecific and can represent an important lead to disparate diseases such as RDD and MPK.
Low‐grade squamous intraepithelial lesions: Cytologic predictors of biopsy Confirmation
Authors: Hall Scott , Wu T. C. , Soudi Naél , Sherman Mark E.
Published: February 2007

One hundred and seven smears demonstrating a low‐grade squamous intraepithelial lesion (LSIL) were analyzed for features predicting subsequent biopsy confirmation. Twelve (29%) of 41 smears showing few LSIL cells were biopsy confirmed compared to 33 (60%) of 55 containing an intermediate number of LSIL cells and 9 (82%) of 11 displaying many LSIL cells (P < 0.002). Thirty‐seven (47%) of 78 smears showing mainly condylomatous atypia (CA), 7 (54%) of 13 revealing predominantly cervical intraepithelial neoplasia 1 (CIN 1), and 10 (63%) of 16 displaying both CA and CIN 1 were histologically confirmed (N.S.). Biopsy confirmation was obtained in 35 (65%) of 54 women whose repeat smears obtained at colposcopy demonstrated SIL compared to four (15%) of 26 patients whose repeat smears were normal or contained atypical squamous cells of undetermined significance (P < 0.001). These results suggest that the number of diagnostic cells in an LSIL smear predicts biopsy confirmation and affirm the validity of combining CA and CIN 1 under the category of LSIL in the Bethesda System. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of metastatic basal cell carcinoma of the skin to the lung
Authors: Haddad Michel G. , Silverman Jan F.
Published: February 2007

Metastatic basal cell carcinomas of the skin are rare. We present the cytologic features of a metastatic basal cell carcinoma to the lung diagnosed by fine‐needle aspiration biopsy. Cytologic examination revealed syncytial groups of relatively small cells with hyperchromatic, oval to spindle‐shaped nuclei having high nuclear to cytoplasmic ratios. Immunocytochemical studies performed on the cell block sections revealed the malignant cells to be positive for cytokeratin (AE1/3) and negative for neuroendocrine markers, [neuron specific enolase (NSE) and chromogranin (Phe‐5)]. We reviewed the literature related to metastatic basal cell carcinoma of the skin and discuss risk factors and mechanisms of metastatic spread. In addition, a discussion of the other entities that can enter into the differential diagnosis is presented along with the role of ancillary studies. To the best of our knowledge, we believe this is the first case report of the fine‐needle aspiration (FNA) cytology of a basal cell carcinoma metastatic to the lung. © 1994 Wiley‐Liss, Inc.
Cytologic features of papillary‐cystic variant of acinic‐cell adenocarcinoma: A case report
Authors: Sauer Torill , Jebsen Peter Wilhelm , Olsholt Reidar
Published: February 2007

A case of papillary‐cystic variant of acinic‐cell adenocarcinoma is described. The cytologic findings differed significantly from the classic features of this tumor with smears showing large monolayer sheets and small papillary groups, no acinic structures or naked tumor cell nuclei, sparse cell dissociation and many vacuolated cells. © 1994 Wiley‐Liss, Inc.
Cytologic study of renal angiomyolipoma by fine‐needle aspiration biopsy: Report of four cases
Authors: Tallada N. , Martinez S. , Raventos A.
Published: February 2007

Four cases of renal angiomyolipoma (AML) diagnosed by fineneedle aspiration biopsy (FNAB) are reported. One case was associated with the clinical complex of tuberous sclerosis. The tumors were solitary in two cases and multiple and bilateral in the fourth. The cytologic features of the four cases were similar to those described in the literature: smooth muscle cells intermingled with mature fat cells and blood vessels, together with a lipoidic background. These tumors are currently considered benign although they may present characteristics accepted as criteria of malignancy in other tumors: pleomorphism and atypical smooth muscle cells, vascular invasion, capsular rupture, and lymphatic involvement. We conclude that it is important and possible to establish preoperative cytologic diagnosis, since treatment of these tumors is conservative and obviates aggressive nephrectomy. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of myositis ossificans: A case report
Authors: de Almeida Margarida Mendes , Abecassis Nuno , Almeida M. Odette , Mendonça M. Evelina
Published: February 2007

This report describes the cytological findings of a case of myositis ossificans in a 16‐yr‐old girl. Clinically and radiologically she was suspected to have a malignant soft tissue tumor. This was not confirmed by fine‐needle aspiration cytology and a diagnosis of benign lesion, probably myositis, was given. This diagnosis was confirmed by histological examination. © 1994 Wiley‐Liss, Inc.
Malignant rhabdoid tumor of the uterus: Report of a case with findings in a cervical smear
Authors: Niemann Theodore H. , Goetz Steven P. , Benda Jo Ann , Cohen Michael B.
Published: February 2007

Rhabdoid tumors are an uncommon group of neoplasms which share a distinctive morphology. We report the cytologic and histologic findings of a uterine rhabdoid tumor. The presence of rhabdoid cells on a cervical Papanicolaou (Pap) smear raises an intriguing differential diagnosis. Cytologists should be aware of this entity and consider rhabdoid tumor in the differential diagnosis when single malignant cells are noted on cervical Pap smear. © 1994 Wiley‐Liss, Inc.
Comparative assessment of DNA analysis in effusions by lmage analysis and flow cytometry
Authors: Banks Evelyn R. , Jennings C. Darrell , Jacobs Susan , Davey Diane D.
Published: February 2007

Cytologic evaluation of body cavity fluids is useful to detect malignancy within the pleural and peritoneal spaces. A definitive diagnosis cannot always be made on cytologic evaluation alone. As malignant processes may show abnormal DNA content, DNA analysis of effusions may be useful. Therefore, we determined the DNA content of 37 effusions by flow cytometry (FC) and image analysis (IA) using the CAS 200. Of the 37 fluids evaluated, 18 were cytologically malignant, 15 benign, and four atypical. Overall, 22 fluids (60%) showed concordance between FC and IA. None of the benign fluids were aneuploid. All showed diploid histograms or diploidy with increased proliferating cells. Three of four atypical fluids had increased proliferating cells by either FC or IA, whereas one was diploid by both methods. Aneuploidy was detected in 13 malignant fluids: five were aneuploid by both methods and eight by only one method. IA identified aneuploidy in five of those eight cases, while three were identified by FC. Three of the cytologically malignant fluids were diploid by both methods, and two showed increased proliferating cells by IA and diploidy by FC. The specificity of both methods was 100%. However, the sensitivity of identifying a malignant fluid by aneuploidy is low, 44% for FC and 55% for IA. IA appears to identify small aneuploid populations more frequently than FC. The detection of aneuploidy in effusions is highly suggestive of malignancy, and the combination of both techniques gives the highest detection rate (72%). However, neither are as sensitive as traditional cytologic evaluation with the occasional use of additional histochemical stains. © 1994 Wiley‐Liss, Inc.
Dithiothreitol homogenization of prefixed sputum for lung cancer detection
Authors: Tang Cang‐Sing , Tang Cecilia M. C. , Kung Ignatius T. M.
Published: February 2007

The technique of chemical homogenization of sputum for cancer detection was revisited. The mucolytic agent dithiothreitol (DTT) had been used by the authors on fresh specimens. In this study, its effectiveness in homogenizing prefixed sputum was investigated. Fifty‐seven positive samples were examined: 28 were prefixed with 2% carbowax in 60% ethanol and 29 in 3% carbowax in 60% ethanol. Each specimen was divided equally into three parts and homogenized immediately, 3 and 7 days later, respectively, with 0.2% (0.013 mol/L) DTT in the respective prefixative. Five samples were prefixed for 4 wk before homogenization. The homogenization time varied from 30 min to 48 hr. The cellular morphology was compared to directly smeared controls from the same samples. It was found that the cellular morphology was well preserved and best with the 3% carbowax in 60% ethanol. The specimen could be prefixed for up to 4 wk before homogenization and the homogenization process could last from 30 min to 48 hr without any damaging effect on morphology. Furthermore, screening was made easy with the mucus lysed and its obscuring effect removed and the cells concentrated and evenly distributed. The method was versatile and could be of value in enhancing the dettection rate of cancer in sputum. © 1994 Wiley‐Liss, Inc.
Methodological aspects of the immunostaining of proliferating cell nuclear antigen (PCNA) in cytospin preparations of MCF‐7 cell line
Authors: Pelosi Giuseppe , Bresaola Enrica , Menacherry Mary J. , Manfrin Erminia , Lannucci Antonio
Published: February 2007

Cytospins of a human breast cancer cell line (MCF‐7) were studied for the expression of PCNA, a cell cycle‐related protein, using a variety of fixation and immunostaining procedures. The best fixative for PCNA was found to be buffered formaldehyde solution at 4°C followed by methanol at 20°C, whereas alcoholic fixatives decreased greatly the PCNA immunoreactivity. Air‐drying procedures of cytospins prior to and after fixation greatly undermined the PCNA immunostaining. A modified immunoperoxidase method provided a stronger staining of the PCNA‐reactive cells than the alkaline phosphatase anti‐alkaline phosphatase (APAAP) technique. PCNA immunoreactivity could be maintained up to 2 mo, putting slides in methanol at − 2°C. In conclusion, our report indicates that PCNA is a labile antigen, which may critically be affected by temperature and air‐drying procedures. © 1994 Wiley‐Liss, Inc.
Transvaginal sonographic characterization combined with cytologic evaluation in the diagnosis of ovarian and adnexal cysts
Authors: Yee Herman , Greenebaum Ellen , Lerner Jodi , Heller Debra , Timor‐Tritsch Ilan E.
Published: February 2007

A transvaginal sonographic (TVS) scoring system using morphologic features has been developed at our institution to maximize discrimination between benign and malignant ovarian and adnexal cysts. Low (4–7) or intermediate (8–9) scores have been found to correlate with benignity, hence TVS‐guided or laparo‐scopically directed needle aspiration of low‐scoring lesions may safely be performed. High‐scoring lesions (10–14) are often malignant, therefore in situ needle aspiration of such lesions is not recommended. The aim of our study was to correlate the results of TVS characterization of ovarian and adnexal cysts with the aspiration cytologic evaluation.

Twenty‐three of the 43 cysts studied were aspirated in situ from the patient; 20 were aspirated from resected surgical specimens. Thirty‐six benign cysts had TVS scores ranging from 4 to 12, with a median score of 7. All 25 cysts that were benign by TVS and/or histology were also cytologically benign as well as an additional 11 cysts that were not resected (TVS scores: 4 to 9). Seven cytologically and histologically malignant cysts had high TVS scores (TVS scores 10–14; median = 12).

The combination of TVS and needle aspiration cytology is valuable, particularly in the diagnosis of cysts having low or intermediate TVS scores and benign cytology. Aspiration of cysts or masses with high TVS scores is not recommended. This combined evaluation may allow a more limited surgical approach, such as operative laparoscopy, or, in some cases, obviate the need for operative treatment altogether. © 1994 Wiley‐Liss, Inc.
Correlation of two AgNOR counts with Ki‐67 labeling index: A study in fine‐needle aspirates of lymphoproliferative disorders and breast carcinoma
Authors: Mourad Walid A. , Sneige Nour , Katz Ruth L. , Ordóñez Nelson G.
Published: February 2007

The Ki‐67 antibody binds to nonresting cells where Ki‐67 labeling index (KLI) reflects proliferative activity (PA). The argyrophilic nucleolar organizer regions (AgNOR) counts have been correlated to ploidy and/or PA. Two AgNOR counting methods distinguish ploidy from PA. The first count is the mean AgNOR count (mAgNOR) which correlates with ploidy. The second is the percentage of nuclei with ≥ 5 AgNORs/nucleus (pAgNOR) which reflects PA. To explore this relationship, we separately stained smears of 20 fine‐needle aspirates (FNAs) of lymphoproliferative disorders (n = 12) and breast carcinomas (n = 8) for AgNOR and Ki‐67. We also double‐stained 10 of the smears for both AgNOR and Ki‐67. The correlation of pAgNOR counts and KLI was statistically significant (P < 0.0001) whereas it was not between mAgNOR and KLI (P = 0.13). Additionally, using the double stain, the Ki‐67 negative cells had an AgNOR granule range of 1‐3/ nucleus with a mean of 1.33 (± 1.86 SD). The Ki‐67 positive cells showed an AgNOR granule range of 2‐12/nucleus with a mean of 4.15 (± 1.02 SD) (P < 0.0002). We thus conclude that pAgNOR is a more reliable indicator of PA than mAgNOR and that four AgNORs/nucleus is an acceptable number differentiating proliferating from resting cells. © 1994 Wiley‐Liss, Inc.
Tubular carcinoma of the breast: Cytologic features in fine‐needle aspirations and application of monoclonal anti‐α‐smooth muscle actin in diagnosis
Authors: Fischler Diana F. , Sneige Nour , Ordóñez Nelson G. , Fornage Bruno D.
Published: February 2007

Twenty fine‐needle aspirations (FNAs) of histologically proven tubular carcinoma of the breast (TCB) were reviewed, and the staining distribution of α‐smooth muscle actin (SMA) was evaluated to see if this improved FNA sensitivity. In 18 cases, the aspirates were cellular, consisting predominantly of epithelial cells arranged in cohesive tubular structures that appeared angular or twisted. Single epithelial cells were present in varying numbers in 14 cases (70%). Cribriform fragments corresponding to in situ ductal carcinoma were noted in 9 cases (45%). Individual, bare nuclei were present in seven cases (35%). The initial cytologic diagnoses were 10 carcinomas, eight suspicious for carcinoma, and two cases were misinterpreted as fibroadenoma. In 8 of 14 cases, the epithelial fragments stained negatively for SMA, whereas in six cases some fragments (<10%) stained positively. These findings were in contrast to a reticulated staining pattern noted in almost all of the epithelial fragments in nine fibroadenomas and three fibrocystic changes. Eighteen well‐differentiated invasive ductal carcinomas stained negatively, whereas four had occasional positively staining fragments. We conclude that TCB displays distinct cytomorphologic features that can be recognized or at least suggested by FNA. Awareness of the cytologic characteristics—angulated tubular structures with or without single epithelial cells—coupled with mammographic/ultrasound findings, is necessary to avoid a misdiagnosis. Alpha‐smooth muscle actin staining may help in selected cases. © 1994 Wiley‐Liss, Inc.
Diagnosis of umbilical metastasis (sister Mary Joseph's nodule) by fine‐needle aspiration: An immunocytochemical study
Authors: Gupta Raj K. , Naran Sarla , McHutchison Andrew G. R. , Lallu Sharda , Fauck Robert J.
Published: February 2007

During a ten year period, since we introduced needle aspiration cytology at our institution, we have diagnosed five cases of umbilical metastasis (Sister Mary Joseph's nodule). In none of the cases was any false negative or false positive diagnosis rendered and the primary carcinoma was found below the diaphragm. In all the five cases, cell blocks of the aspirate were subsequently prepared, and highlighted the histologic features of the tumour which corresponded with the cytologic diagnosis. Immunohistochemical staining on the aspirate material in all the cases was considered quite useful in substantiating the cytohistologic diagnosis. Based on our findings, we suggest that fine‐needle aspiration cytology as an initial diagnostic procedure in cases suspected of umbilical metastasis should be considered, since it is not only a simple, fast, accurate, and inexpensive diagnostic procedure, but can also save the patient from an invasive surgical procedure, the benefit of which is questionable. © 1994 Wiley‐Liss, Inc.
Cutaneous seeding of a follicular thyroid cancer after fine‐needle aspiration biopsy?
Authors: Panunzi C. , Paliotta D. S. , Papini E. , Petrucci L. , Rinaldi R. , Nardi F.
Published: February 2007

The Authors describe a cutaneous recurrence of a thyroid follicular cancer, immediately above the thyroid nodule, in a 76‐year‐old woman with advanced multiple myeloma, 8 mo after a fine‐needle axpiration biopsy performed with 22‐gauge needles. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of mammary adenomyoepithelioma: Report of a case with intranuclear cytoplasmic inclusions
Authors: Valente Philip T. , Stuckey John H.
Published: February 2007

Adenomyoepithelioma of the breast is an uncommon lesion which may recur and rarely metastasizes. We report the fine‐needle aspiration (FNA) findings in one case of mammary adenomyoepithelioma in which this tumor's unusual cytomorphology led to a cytologic diagnosis of malignancy, possibly metastatic to the breast. Large, atypical, polygonal cells, some with intranuclear cytoplasmic inclusions, were most worrisome cytologically, but corresponded in the biopsied specimen to cells immunohistochemically documented to be of myoepithelial origin. Nests of epithelium and myoepithelial cells sometimes embedded in fibrous, stromal fragments were suggestive of an infiltrating pattern. Recognition of such unusual features in breast FNA is most important since definitive therapy may follow an FNA diagnosis of carcinoma in some clinical settings. In cases with unusual morphology, surgical biopsy should be recommended to clarify the nature of the lesion. © 1994 Wiley‐Liss, Inc.
Guides to clinical aspiration biopsy: Pediatrics authors: Philippe Vielh and Lydia Pleotis Howell, Igaku‐Shoin, New York, 1993
Authors: Davey Diane D.
Published: February 2007

Fine‐needle aspiration biopsy (NAB) continues to be controversial in pediatric medicine, and is probably under‐utilized in many practices. Although there have been several publications dealing with pediatric neoplasms and tumor‐like conditions, there are few books which deal extensively with pediatric cytology. The purpose of this book is to provide both cytologists and clinicians with a systematic guide to cytodiagnosis by NAB in children. It seeks to dispel misconceptions, provide information on the utility of NAB, and summarize the current literature.
On the American scene: Cytology proficiency testing symposium overview
Authors: Davey Diane D.
Published: February 2007

The current and future status of cytology proficiency testing (PT) was the focus of a symposium held in Atlanta November 16–17, 1993. Sponsoring organizations were the Centers for Disease Control and Prevention (CDC), the College of American Pathologists (CAP), and the Cytopathology Education Consortium [American Society of Clinical Pathologists (ASCP), American Society of Cytology (ASC), American Society of Cytotechnology (ASCT)]. The February 28, 1992 Final Rule implementing CLIA 1988 had specified that laboratories evaluating gynecologic cytology specimens had to be enrolled in an approved PT program by January 1994. A contract request had no responses by the April 1993 deadline, however.
Prognostic factors from the fine‐needle aspirate: Breast carcinoma nuclear grade
Authors: Dabbs David J. , Silverman Jan F.
Published: February 2007

Two of the most important microscopically derived morphologic prognostic factors for breast carcinoma patients are histologic type of tumor and nuclear grade. The recent literature stresses the importance of including these parameters in the surgical pathology report, yet there is little information in the cytology literature regarding the reporting of the nuclear grade of breast carcinomas from fine‐needle aspirate biopsies (FNAB). In this retrospective study, we examined 104 ductal carcinomas of the breast in order to determine whether the FNAB derived nuclear grade and morphologic aspects of histological grading such as tubule formation and mitoses could accurately correlate with the same parameters on the tissue specimens.

There was a correlation of 87% between the nuclear grade assigned by FNAB and the nuclear grade assigned to the tissue sample. Both the Diff‐Quik and the Papanicolaou staining methods were assessed in this study and both gave comparable nuclear grade results. Tubule formation was difficult to assess on the cytologic samples and mitoses showed no correlation between cytologic and tissue specimens. The FNAB sample was not representative of the tissue nuclear grade in only 4.8% of the cases. Nuclear grade is especially important in patients treated with chemotherapy prior to definitive therapy for breast carcinoma.

We conclude that the nuclear grading of breast carcinomas is performed with ease, correlates well with tissue nuclear grade, and, as a fundamental cytologic parameter, should be included in the fine‐needle aspirate biopsy report whenever possible. © 1994 Wiley‐Liss, Inc.
Demonstration of fibrils in the hyaline globules of yolk sac tumor with parietal differentiation in fine‐needle aspiration smears
Authors: Yang Grace C. H.
Published: February 2007

Hyaline globules of the yolk sac tumor (YST) have been described as homogeneous pink intracellular globules and intercellular basement membrane material [Akhtar et al.: Diagn Cytopathol 1990;6:184–192]. In Diff‐Quik‐stained air‐dried smears of a lung fine‐needle aspiration (FNA) of YST metastatic from anterior mediastinum, short curvilinear nonbranching fibrils are demonstrated in the metachromatic hyaline substance. The fibril‐containing hyaline substance, which presents as intracellular globules as well as extracellular matrix deposits, is a diagnostic clue for YST with parietal differentiation [Ulbright et al.: Am J Surg Pathol 1986;10:151‐164]. The fibrils are not observed in the translucent homogeneous golden yellow hyaline substance in the Papanicolaou preparation. The fibrils are speculated to be the core protein of proteoglycans. To the best of the author's knowledge, this is the first demonstration of fibrils in the hyaline substance of YST with parietal differentiation. © 1994 Wiley‐Liss, Inc.
Breast solitary schwannoma: Fine‐needle aspiration biopsy and immunocytochemical analysis
Authors: Bernardello Fabio , Caneva Andrea , Bresaola Enrica , Mombello Aldo , Zamboni Giuseppe , Bonetti Franco , Lannucci Antonio
Published: February 2007

A case of intramammary solitary schwannoma (SS) (benign neurilemoma) diagnosed by fine‐needle aspiration biopsy (FNAB) and supported by immunocytochemical study is reported. The tumor arose in the right breast of an 18‐yr‐old woman and was clinically and radiologically considered a fibroadenoma. The smears obtained by FNAB of the lump showed clusters of spindle‐shaped cells and suggested a benign mesenchymal neoplasm. The presence of some structures reminiscent of Verocay bodies and the immunocytochemical reactivity for S‐100 protein antiserum demonstrated the schwannian nature of the tumor and suggested the diagnosis of SS. The final histologic examination confirmed the cytologic diagnosis. © 1994 Wiley‐Liss, Inc.
Psammocarcinoma of the peritoneum
Authors: Chen Karl T. K.
Published: February 2007

The cytologic and histologic features of two cases of psammocarcinoma of the peritoneum are reported. The previously proposed histologic diagnostic criteria for this tumor are expanded in order to accommodate the present two cases. The cytologic features of this tumor have not previously been reported. © 1994 Wiley‐Liss, Inc.
Elastofibroma dorsi: Diagnostic problems and pitfalls
Authors: Pisharodi Latha R. , Cary Donna , Bernacki Edward G.
Published: February 2007

The diagnostic cytomorphologic findings in a case of elastofibroma dorsi are described in this report. The correct diagnosis was initially overlooked on fine‐needle aspiration, and was subsequently made by open biopsy. Review of the FNA material, however, demonstrated scanty but diagnostic material. Cytologic examination revealed a mixture of fibroblasts, adipose tissue, and swollen lightly staining cyanophilic elastic fibers in a background of collagenous matrix. Cross sections of the elastic fibers had the typical serrated and globular appearance. These fibers stained positive with elastin stains. The cytomorphology of elastofibroma dorsi with diagnostic pitfalls and differential diagnostic dilemmas are discussed in this article. © 1994 Wiley‐Liss, Inc.
FNA biopsy of small round cell tumors of childhood: Cytomorphologic features and the role of ancillary studies
Authors: Silverman Jan F. , Joshi Vijay V.
Published: February 2007

Pediatric tumors which are conventionally considered to be small round cell tumors (SRCTs) include the prototypical neuroblas‐toma as well as rhabdomyosarcoma (RMS), Ewing's sarcoma (ES), malignant lymphoma, and primitive neuroectodermal tumor (PNET). Other malignancies may be considered in the differential diagnosis such as small‐cell osteogenic sarcoma, un‐differentiated (anaplastic) hepatoblastoma, granulocytic sarcoma, blastemal type Wilms' tumor, and desmoplastic small‐cell tumor of the peritoneum. The cytomorphologic features of conventional SRCTs is presented as well as the utility of ancillary studies performed on the aspirated material in making a specific and correct diagnosis. The role of the immediate cytologic assessment of the aspirate is stress, since this is a critical step in formulating an initial diagnostic impression that should prompt the need for additional material for pertinent ancillary studies. Although challenging, FNA cytology of SRCTs of childhood can be diagnostic in the majority of cases, allowing specific therapy to be given to patients with unresectable SRCTs without a tissue biopsy as well as documenting recurrent and/or metastatic disease. © 1994 Wiley‐Liss, Inc.
Confocal optical sectioning and three‐dimensional reconstruction of carcinoma fragments in pap smears using sophisticated image data processing
Authors: Boon M. E. , Schut J. J. , Benita E. M. , Kok L. P.
Published: February 2007

Carcinoma fragments found in Pap smears contain important diagnostic information not available to the light microscopist because of their thickness and consequent blurring. Optical sectioning by the confocal microscope allows us to reclaim the mitotic figures, glandular architecture, and abnormal chromatin patterns in the restained original smears. The high spatial resolution of the confocal microscope can be further exploited by processing the digital images with the sophisticated Application Visualization System (AVS) on a CONVEX computer. Serial sections in which fluorescent signals are color coded by this software package and three‐dimensional reconstructions of the nuclei and mitotic figures expand our knowledge of these malignant epithelial fragments. © 1994 Wiley‐Liss, Inc.
Benign cellular changes: Have we inadvertently reinvented the class II cytology sign‐out?
Authors: Luff Ronald D.
Published: February 2007

Beginning in December 1988, a group of highly motivated professionals assembled under NCI sponsorship for the sole purpose of attempting the impossible—namely, attain a national consensus on using standard terms for the sign‐out of cervical/vaginal cytology. What developed was more than many attendees ever expected: a recommended standardized format for cervical/vaginal cytology reports and a lexicon of terms to use in that format that has subsequently become known as The Bethesda System (TBS).1 As expected and anticipated, TBS was criticized for lacking definitions of specimen adequacy and for an absence of diagnostic criteria for some entities. Hence, a second TBS Workshop was held in April 1991, again sponsored by the NCI, with its primary purpose to receive feedback from laboratorians who had been using TBS. From that workshop, changes to the original lexicon were made and disseminated, again after extensive debate and discussion.2 A second communication has just recently been published detailing the criteria of specific entities listed in TBS, including 61 color illustrations for clarification.3 In June 1992, the NCI sponsored a workshop to develop interim guidelines for clinical follow‐up to entities diagnosed utilizing TBS. This had been considered the final “missing piece of the puzzle” in updating cervical/vaginal cytology. Their workshop report is scheduled to be published shortly.
Cytological demonstration of features of Alzheimer's disease using brain smear technique
Authors: McLean Catriona A. , Harney Mary C. , Gonzales Michael F.
Published: February 2007

The major diagnostic histopathological features of moderate to severe Alzheimer's disease (AD) are amyloid rich neurofibrillary tangles (NFTs) and neuritic plaques (NPs) containing beta A4 peptide. As the frequency of stereotactic brain biopsies is increasing, the diagnostic cytological fealures of AD are of relevance. Our study presents the brain smear features of five autopsied patients with moderate to severe AD both clinically and pathologically. NFTs and NPs were identified in 100% of smears. Amyloid neuropil threads (NTs), a more recently identified hallmark of AD, were also seen in all smears. Segmental beta A4 peptide deposition within vessels, clustering of plaques around capillaries, and NTs were more obvious by the smear technique than in histological sections. © 1994 Wiley‐Liss, Inc.