bluuebunny/crossref_metadata_2025 huggingface dataset:
Acquired gluteal myospherulosis secondary to intramuscular injections of petrolatum‐based hormones: A case report diagnosed by fine‐needle aspiration cytology
Authors: Vuong Phat N.
Published: February 2007

A case of acquired myospherulosis of the right gluteal region diagnosed by FNA cytology is reported in a woman who had received a series of intramuscular injections of petrolatumbased hormones. The lesion is characterized by inflammatory pseudocystic nodules containing saccular formations with erythrocytes or “bags of marbles.” It results from a physical process similar to the emulsion phenomenon between nonresorbent oily material and plasma. This process gives rise to sequestration of blood corpuscles by oily materials and thus development of foreign body granulomas.
Fine‐needle aspiration cytology of histiocytosis X: A case report
Authors: Layfield Lester J. , Bhuta Sunita
Published: February 2007

The cytologic features of a case of histiocytosis X diagnosed by fine‐needle aspiration biopsy of a right cervical lymph node in a 15‐mo‐old girl are reported. Characteristic reticuloendothelial cells with abundant cytoplasm and grooved nuclei were observed. Electron microscopy of the aspiration‐derived specimen revealed Birbeck granules. The cytologic pattern and electron microscopic demonstration of Birbeck granules allowed definite diagnosis of lymph node involvement by histiocytosis X, negating the need for open biopsy. The cytologic differential diagnosis and current diagnostic criteria for histiocytosis X are discussed.
Fine‐needle aspiration cytology of chondromyxoid fibroma: A case report
Authors: Layfield Lester J. , Ferreiro Jorge A.
Published: February 2007

The cytologic presentation of a case of chondromyxoid fibroma studied by fine‐needle aspiration in a 17‐yr‐old black male is described. The cytologic features of chondromyxoid fibroma are presented, and the differential diagnosis of intraosseous cartilaginous neoplasms is reviewed, emphasizing the cytomorphologic differentiation of chondromyxoid fibroma from chondrosarcoma, enchondroma, and chondroblastoma.
Fine‐needle aspiration cytology of an adult rhabdomyoma of the head and neck
Authors: Bertholf Marsha F. , Frierson Henry F. , Feldman Philip S.
Published: February 2007

The cytologic features of a multifocal adult rhabdomyoma of the head and neck, as observed in a fine‐needle aspiration specimen, are described. Cross‐striations and characteristic cytoplasmic “crystals” were conspicuous in the cytologic preparations and also during ultrastructural examination. The cytologic features of adult rhabdomyoma are distinctive, allowing a rapid specific diagnosis.
The fine‐needle aspiration appearance of the follicular variant of thyroid papillary carcinoma: A report of three cases
Authors: Hugh Judith C. , Duggan Máire A. , Chang‐Poon Vivien
Published: February 2007

The follicular variant of thyroid papillary carcinoma (FVTPC) is an uncommon neoplasm with the architectural features of a follicular lesion and the nuclear characteristics of a papillary carcinoma. The fine‐needle aspiration (FNA) appearance is underreported in the literature. Three cases of histologically confirmed FVTPC that were aspirated prior to surgery are presented. Although the cytological features were suspicious or confirmatory of a low‐grade thyroid carcinoma, they did not convey a specific diagnosis of the FVTPC. We suggest that this variant is recognizable as a neoplasm requiring surgical excision on FNA, but that the cytological appearance does not allow its specific diagnosis.
Fine‐needle aspiration cytology of breast: Its impact on surgical practice with an emphasis on the diagnosis of breast abnormalities in young women
Authors: Gupta Raj K. , Naran Sarla , Buchanan Andrew , Fauck Robert , Simpson John
Published: February 2007

Fine‐needle aspiration cytology (FNAC) of the breast is a minimally invasive yet maximally diagnostic method, often precluding the need of an open biopsy. In young women, in whom breast cancer is a rare disorder, it is also important that carcinoma is recognized without delay so that an appropriate plan of management can be adopted. In this study, we reviewed our experience in a total of 3,226 needle aspirates of breast with particular emphasis on the diagnosis of carcinoma in women under the age of 30. Diagn Cytopathol 1988;4:206–209.
Nephrogenic adenoma of the urinary bladder: A comparison of its cytologic and histopathologic features in ten cases
Authors: Rutgers Joanne L. , Young Robert H.
Published: February 2007

We studied the cytologic features of ten cases of nephrogenic adenoma, a benign proliferative lesion of urothelium that is typically associated with prior trauma or urothelial irritation. The typical cytologic features consisted of numerous vacuolated polygonal cells, including signet‐ring‐like cells, that were isolated or formed papillae or loose groups. Columnar cells and occasional glandular structures were also seen. The cells typically exhibited no or only mild nuclear atypia. There was often a background of acute inflammation. The differential diagnosis of urinary cytologic specimens with these features includes degenerative changes, changes induced by instrumentation, and, most importantly, adenocarcinoma and low‐grade papillary transitional‐cell carcinoma. Diagn Cytopathol 1988;4:210–216.
Epithelial repair versus carcinoma in esophageal brush cytology
Authors: Hoover Lola , Berman Jules J.
Published: February 2007

The distinction between repair atypia and carcinoma in esophageal brushings is often difficult. To establish criteria for making this distinction, the cytologic smears from 121 consecutive esophageal brushings and the companion biopsies were reviewed. The most reliable criteria for malignancy included sharply angulated nuclear rims, a high nuclear/cytoplasmic ratio, and coarsely granular chromatin. Nuclei bearing these features were not numerous and had to be carefully sought. Nuclear pleomorphism was a more consistent feature, but it showed considerable overlap with epithelial repair. Cytologic features of multiple nucleoli, macronucleoli, and loss of polarity were common to both repair and carcinoma. Adherence to the criteria established in this study permits the distinction between repair atypia and carcinoma in almost all cases; however, there are lesions of the esophagus with such overlap between the features of repair and carcinoma that it may not be possible to reach a definitive diagnosis. Specific examples, with illustrations, are discussed as diagnostic guides.
Immunocytochemical staining of different cell types in vaginal smears by monoclonal anti‐DNA methylase antibodies
Authors: Naujoks H. , Siracky J. , Drahovsky D. , Pfeifer G. P.
Published: February 2007

Enzymatic methylation of mammalian DNA is closely related to the replication process; also, the synthesis of DNA meth‐ylase, an enzyme that is responsible for this process, is cell cycle related. A monoclonal antibody against DNA methylase recognizes proliferatively active cells in the heterogenous population. We used this antibody to identify the proliferative state of different cell types in normal vaginal smears and in smears of patients with precancerous lesions and cervical cancer. In all preparations, the normal epithelial cells remained unstained. The majority of cancer cells gave a positive immunocytochemical signal indicating the presence of DNA methylase antigen and the proliferative state. Staining was also observed in dyskaryotic cells, particularly in nuclei of parabasal‐type cells. Diagn Cytopathol 1988;4:230–233.
Primary spindle‐cell sarcomas of the breast: Diagnosis by fine‐needle aspiration
Authors: Stanley Michael W. , Tani Edneia M. , Horwitz Charles A. , Tulman Scott , Skoog Lambert
Published: February 2007

Primary breast sarcomas (excluding cystosarcoma phyllodes and its sarcomatous recurrences) are rare neoplasms. Few have been described in the aspiration cytology literature. We report the cytologic features of two cases of stromal sarcoma (both with the pattern of malignant fibrous histiocytoma) and two cases of angiosarcoma. The dominant cytologic features included individual atypical spindle cells and fragments of collagenous stroma. Tumor giant cells were present in one stromal sarcoma. Features of possible significance in the diagnosis of angiosarcoma include obvious vessel formation by atypical spindle cells, bridging of adjacent tumor fragments by spindle cells, and microacinar structures lined by atypical spindle cells. The differential diagnostic considerations in spindle‐cell breast aspirations are discussed.
Fine‐needle aspiration of metastatic atrial myxoma
Authors: Moriarty Ann T. , Nelson William A. , George Kathryn , Waller Bruce F.
Published: February 2007

Atrial myxoma is the most common primary neoplasm of the heart, but “metastatic” or embolic phenomena are rare. The first reported case of “metastatic” atrial myxoma diagnosed by fine‐needle aspiration biopsy is presented. It occurred in a 54‐yr‐old woman with multiple metastatic lesions. The cytologic and histologic findings of the fine‐needle aspiration biopsy and subsequent surgical excision are presented as is a discussion of the incidence, origin, and clinical findings of atrial myxoma and the characteristics of its emboli. Diagn Cytopathol 1988;4:250–253.
A history of aspiration biopsy with special attention to prostate biopsy
Authors: Johenning Paul W.
Published: February 2007

The history of needle biopsy is outlined from the early 19th century when the first use of needles for biopsy was recorded. The development of aspiration biopsy, largely at Memorial Hospital in New York in the 1930s, followed by its virtual disappearance in the 1940s and 1950s, and its reemergence in the 1960s, is traced. Special attention is given to the history of aspiration biopsy of the prostate from its origins up to the present day. Diagn Cytopathol 1988;4:265–268.
Fluorescence of blastomyces and other fungi in papanicolaou‐stained pulmonary cytology preparations: Comparison with light microscopy
Authors: Subramony Charu , Cason Zelma , Gong Jody C. , Evers Carl G.
Published: February 2007

In this study, 152 Papanicolaou‐stained pulmonary cytologic smears from 15 known cases of pulmonary fungal infection were randomly mixed with 194 control pulmonary smears. All slides were examined for fungi by three observers, first by light microscopy and then by fluorescent microscopy. The results of the light and fluorescent microscopy were compared. It was concluded that when both methods were used for fungal detection, the yield of positive results was higher.
Aspiration cytology of retinoblastoma: Light and electron microscopic correlations
Authors: Akhtar Mohammed , Ali M. Ashraf , Sabbah Rajeh , Sackey Kwesi , Bakry Mohammed
Published: February 2007

A series of 16 cases of retinoblastoma diagnosed by fine‐needle aspiration biopsy (FNAB) and confirmed by histologic examination is reviewed, and the salient cytomorphologic features are described. Two types of cells were encountered in the aspiration smears; type I cells were undifferentiated while type II cells showed more differentiation and frequently revealed cytoplasmic processes that are probably indicative of early photoreceptor differentiation. Flexner‐Wintersteiner rosettes characteristic of retinoblastoma were found in 10 of 16 cases. These findings were further correlated with ultrastructural examination of the tumors in nine cases. It is concluded that the presence of rosettes and type II cells with cytoplasmic processes are the two features that are most helpful in the FNAB diagnosis of retinoblastoma.
Pleomorphic carcinoma of the pancreas with osteoclast‐like giant cells expressing an epithelial‐associated antigen detected by monoclonal antibody 44‐3A6
Authors: Combs S. G. , Hidvegi D. F. , Ma Y. , Rosen S. T. , Radosevich J. A.
Published: February 2007

This article describes a case of pleomorphic adenocarcinoma of the pancreas, metastatic to the adrenal glands and liver, that has unique cytological and histological features. Cytology demonstrated numerous mononuclear and multinucleated tumor giant cells as well as numerous osteoclast‐like giant cells. These features were also seen in the histological sections, as were numerous clear cells. Electron microscopy demonstrated features suggesting an epithelial origin of the epulis cells. Prominent immunoreactivity with the monoclonal antibody (MCA) 44‐3A6 of these cellular constituents was seen in the aspirate and in the tissue sections. These data provide further evidence to support the epithelial origin of these cellular components.
Aspiration cytology of neuroblastoma: Light microscopy with transmission and scanning electron microscopic correlations
Authors: Akhtar Mohammed , Ali Muhammad Ashraf , Sackey Kwesi , Sabbah Rajeh , Bakry Mohammed
Published: February 2007

Fine‐needle aspiration biopsies from three patients with neuroblastoma were studied by light microscopy, and the morphologic findings were correlated with those from transmission and scanning electron microscopy. Light microscopic examination of the aspiration smears from all three cases revealed small and large round cells with variable numbers of intertwining cytoplasmic processes. Transmission electron microscopy confirmed the light microscopic finding of cytoplasmic processes; in addition, it revealed the presence of other diagnostic morphologic features, including neurosecretory granules, microtubules, and synaptic cell junctions. Scanning electron microscopy demonstrated that the tumors were composed of a mixture of undifferentiated round cells and more differentiated cells with long cytoplasmic processes. The morphologic spectrum of these processes and their interrelationships with one another and with other cells could be studied in detail. These findings indicate that scanning electron microscopy may be used effectively in the morphologic evaluation and pathologic diagnosis of neuroblastoma.
Cytodiagnosis of extrahepatic biliary duct tumors from specimens obtained during cholangiography
Authors: Howell Lydia Pleotis , Chow Hsi‐Chao , Russell Liisa A.
Published: February 2007

Two cases of cholangiocarcinoma of the extrahepatic biliary ducts, one case of bile duct adenoma, and one case of pancreatic carcinoma involving the common bile duct are presented to illustrate cytologic diagnoses from specimens obtained during endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography. Obtaining specimens during these procedures can be advantageous because the cells retrieved are well‐preserved, surgery is not required, and patients with advanced disease can be managed conservatively once a diagnosis is rendered. Cytologic diagnosis can be difficult, since malignancies of the extrahepatic bile ducts are often well‐differentiated. Cytologic findings with histologic correlation are presented to emphasize the subtle cellular features of these uncommon lesions.
Cervical schwannoma with intranuclear vacuoles by fine‐needle sampling without aspiration
Authors: Vendraminelli R. , Fiorentino R. , Collazzo R. , Di Filippo L. , Delendi N.
Published: February 2007

In a 49‐yr‐old woman who presented with a cervical mass, a fine‐needle specimen without aspiration was suggestive of paraganglioma; there were spindle‐shaped cells with pseudoacinar structures and prominent intranuclear vacuoles. Subsequent examination of a mass removed from the vagus nerve clearly identified a schwannoma. The differential diagnosis is discussed, particularly in relation to the presence of intranuclear vacuoles, and it is concluded that this cytological characteristic should not in itself define the diagnosis.
Special stains in cytology: A technique using one half of a previously stained slide
Authors: Dhurandhar Nina R. , Zorrilla Olivia
Published: February 2007

We describe a technique for performing special stains on one half of a slide previously stained by the Papanicolaou or Diff‐Quick method. The technique varies depending on whether incubation is required during the staining procedure. For stains that do not require incubation, the portion of the slide to be preserved is covered with liquid paraffin. For stains that do require incubation, the area to be preserved is coverslipped with mounting medium and dried overnight prior to staining. The technique is easy, rapid, inexpensive, and enhances diagnostic accuracy.
Bronchoalveolar lavage in the diagnosis of lipoid pneumonia
Authors: Silverman Jan F. , Turner Robert C. , West R. Lee , Dillard Thomas A.
Published: February 2007

Lipoidpneumonia (LP) is an uncommon entity with the characteristic radiographic features and histologic findings of alveoli filled with vacuolated, lipid‐laden histiocytes. We questioned whether bronchoalveolar lavage (BAL) could be useful in the confirmation of LP. We examined lipid stains (oil‐red O) in BAL specimens from 18 cases, representing a variety of pulmonary disease states, and compared them with an index case of confirmed LP. The index case of LP had a history of chronic intranasal use of mentholated petrolatum with subsequent x‐ray findings of progressive air bronchograms. Positive histochemical confirmation (oil‐red O) performed on frozen sections of transbronchial lung biopsy was obtained. Eleven of the non‐LP cases had no intracellular staining of BAL macrophages with oil‐red O stain, whereas the index case of LP exhibited markedly positive intracytoplasmic staining of macrophages for lipid. The remaining seven cases showed minimal to mild lipid staining with only one other case having moderate staining. This study demonstrates that BAL macrophages from patients with a variety of pulmonary states and without suspected LP do not demonstrate significant staining for intracellular lipids, in contrast with the expected strong positivity of LP. Lipid staining of BAL specimens, although not entirely specific may be a preferred method for confirming the diagnosis of LP. thereby avoiding more invasive procedures.
Urine and semen cytomorphology in patients with testicular tumors
Authors: Rojewska Jadwiga , Pykafo Roman , Czaplicki Maciej
Published: February 2007

Our original technique of preparing urinary and seminal sediment was modified in order to identify neoplastic cells in cases of testicular malignancies. In a series of 24 patients with testicular tumor‐like conditions, 18 tumors were diagnosed, 12 cytologically. In one case, the result of cytological examination was falsely positive since histopathology revealed necrosis of the testicle only. The morphology of neoplastic cells in the seminal sediment is demonstrated.
Cystosarcoma phyllodes of the breast: A cytologic and clinicopathologic study of 23 cases
Authors: Stanley Michael W. , Tani Edneia M. , Rutqvist Lars E. , Skoog Lambert
Published: February 2007

Twenty‐three cases of cystosarcoma phyllodes of the breast were studied clinically and by fine‐needle aspiration (FNA) cytology as well as by tumor histology. The median patient age was 52 yr. The total actuarial survival at 5 yr was 90%, and the recurrence‐free survival was 70%. A combination of stromal elements (tissue fragments and/or single spindle cells) and epithelial tissue was required to make the diagnosis on smear material. In FNA smears, stromal elements were absent in two cases, and ductal elements were not seen in three. Thus, the dimorphic pattern essential to this diagnosis was not present in five (22%) cases. An evaluation of tumor factors reported to be of prognostic significance was performed on histologic sections of resected tumors. Comparison of these data with FNA results indicates that little prognostic information can be obtained from FNA alone in most cases.
Fine‐needle aspiration of the liver: Out of the ivory tower and into the community
Authors: Leiman Gladwyn , Leibowitz C. Bruce , Dunbar Fiona
Published: February 2007

This study of 160 consecutive fine‐needle aspirates of localized hepatic masses analyzed the efficacy of the technique when extended into a multicenter setting. The aspirates were processed and interpreted by a single cytology service, but they were performed, under radiographic imaging, in eight different hospitals by at least 20 radiologists, few of whom had had the opportunity to acquire long‐term experience. of 108 malignancies, 101 were correctly sampled (sensitivity, 93.5%), including 30 primary hepatocellular carcinomas, 70 metastatic tumors, and I lymphoma. Specific benign pathologic lesions in 12 cases were amenable to cytodiagnosis. The problem of the remaining 47 samples, which contained exclusively blood, necrotic material, or normal and reactive hepatic constituents, was addressed at length. These were considered “nondiagnostic” samples in the context of aspirating focal masses. The majority had benign lesions on further study, but tumors were found in seven, all of which had been sampling errors, resulting in a negative predictive value of 82.5%. Fine‐needle sampling of localized lesions, particularly neoplasms, can thus perform well in transition from single‐center studies to more widespread usage in daily practice. Confident reliance on the procedure can be maintained if appropriate radiologic and cytologic facilities exist, provided that the limitations of nonneoplastic aspirates are fully understood.
A review of pulmonary cytopathology in the acquired immunodeficiency syndrome
Authors: Strigle Stephen M. , Gal Anthony A.
Published: February 2007

Over the past 6 yr, we have observed an increase in cytologic specimens from the respiratory tract in patients suspected or known to have AIDS, from 7 of 81,031 cases in 1982 to 1,231 of 55,333 in 1987. Based on our experience with 1,140 patients, this article reviews the technical and morphologic evaluation of pulmonary cytologic specimens from AIDS patients.
Fine‐needle aspiration cytology of pheochromocytoma‐ganglioneuroma of the organ of zuckerkandl
Authors: Tanaka Takuji , Yoshimi Naoki , Iwata Hitoshi , Sugie Shigeyuki , Kato Kazuo , Sakamoto Hirofumi , Mori Hideki
Published: February 2007

Fine‐needle aspiration (FNA) cytologic and immunocytochemical findings of a rare combined pheochromocytoma‐ganglio‐neuroma developing in a 48‐yr‐old Japanese man in the organ of Zuckandl are described. This is the first report of a combined pheochromocytoma‐ganglioneuroma of the organ of Zuckerkandl. FNA cytology showed typical cytologic findings of these two components similar to those described individually in fine‐needle aspirates of these neoplasms. The neoplastic cells showed positive reactions for vasoactive intestinal polypeptide, neuron‐specific enolase, and S‐100.
Mesenteric fibromatosis: Cytologic, histologic, and ultrastructural findings in a case
Authors: Lin B. P. C. , Scott G. S. , Loughman N. T. , Newland R. C.
Published: February 2007

The cytologic findings in a case of mesenteric fibromatosis initially suggested the diagnosis of a benign spindle‐cell softtissue tumor. Subsequent histology and electron microscopy were performed on the resected mass, and the definitive diagnosis was established. The patient had a history of previous abdominal surgery, but no features of Gardner's syndrome. The dificulties associated with the diagnosis of mesenteric fibromatosis and the cytologic diagnosis of benign and spindlecell soft‐tissue tumors and low‐grade sarcomas in general are discussed.
Epithelioid hemangioendothelioma: Cytomorphology and histological features of a case
Authors: Nowels Kent W. , Burford‐Foggs Adrienne , Benson Al B. , Hidvegi Denise F.
Published: February 2007

A case of epithelioid hemangioendothelioma involving the left lung, the 10th thoracic vertebra, and paravertebral soft tissues is presented. Preoperative sputum cytology was thought to show adenocarcinoma. Histologic examination demonstrated an intravascular bronchioloalveolar tumor; immunohistochemical staining for factor VIII‐related antigen revealed strongly positive tumor cells. The cytomorphology of this rare neoplasm is discussed.
Fine‐needle aspiration cytology of angiolymphoid hyperplasia with eosinophilia: A case report with electron microscopy and immunohistochemistry
Authors: Pettinato Guido , Insabato Luigi , De Chiara Annarosaria , Ruocco Vincenzo , Bucci Luigi
Published: February 2007

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon vascular inflammatory lesion usually involving the dermis or subcutaneous tissue of the head‐neck region of middle‐aged women. Histologically, this lesion shows a florid proliferation of vessels lined by particular endothelial cells and an inflammatory infiltrate composed of lymphocytes and eosinophils. The fine‐needle aspiration (FNA) cytology of a nodular lesion in the retroauricolar region of a 18‐yr‐old woman showed spindle‐shaped and polygonal cells with vesicular nuclet and deeply eosinophilic cytoplasm containing welldefined vacuoles in a background of eosinophils and lymphocytes. These features were consistent with a proliferation of epithelioid endothelial cells, and a diagnosis of ALHE was suggested. The histology confirmed the preoperatory diagnosis, and ultrastructural and immunohistochemical studies further demonstrated the endothelial nature of epithelialappearing cells. Because the clinical appearance of the lesion may mimic a large number of benign and malignant diseases, a preoperatory diagnosis of ALHE is rarely made. The FNA cytology may represent a simple and reliable method with which to study and diagnose proliferations of epithelioid endothelial cells.
Difficulties in evaluating urinary specimens after local mitomycin therapy of bladder cancer
Authors: Koshikawa T. , Leyh H. , Schenck U.
Published: February 2007

In order to describe the cytological changes induced by mitomycin in urinary specimens, we re‐examined cytological specimens from patients with recurring bladder cancer treated by long‐term intravesical mitomycin therapy after transurethral resection. Local mitomycin therapy causes an increase of leukocytes and urothelial cells, especially of the umbrella‐cell type, in urinary specimens. During and after the application of mitomycin, the nucleus and the cytoplasm of urothelial cells are enlarged, usually proportionally. Urothelial cells frequently show a giant nucleus, multiple prominent nucleoli, and an enlarged foamy cytoplasm of the umbrella‐cell type. Anisokaryosis is also seen. Such cytological changes are more remarkable later in the course of therapy and after the end of therapy, and they often confuse cytological interpretation. However, the nuclei of urothelial cells are usually translucent and not hyperchromatic, and there is rarely a coarse chromatin pattern. On the other hand, in positive specimens during or after local mitomycin therapy, usually a number of tumor cells showing nuclear enlargement, hyperchromatic nuclei, coarse chromatin pattern, and/or increased nuclear‐cytoplasmic ratio are found beside the atypical cells changed by mitomycin.
Tuberculous pleural effusions: Lymphocyte phenotypes in comparison with other lymphocyte‐rich effusions
Authors: Guzman Josune , Bross Klaus J. , Würtemberger Gebhard , Freudenberg Nikolaus , Costabel Ulrich
Published: February 2007

This study investigated whether the analysis of T cell subsets and of activation markers on T cells in pleural fluids can be helpful for diagnostic purposes in tuberculous pleurisy and other lymphocyte‐rich pleural effusions. Pleural effusion fluids were obtained from 18 patients with tuberculous pleurisy (TB), 21 with effusions following radiotherapy (RT) for a malignant disease, and 11 with congestive heart failure (CHF). Lymphocyte subsets were analyzed by a battery of monoclonal antibodies using an immunoperoxidase method. The majority of the lymphocytes were CD3‐positive T cells (TB, 86 ± 7% of lymphocytes; RT, 81 ± 8%; CHF, 84 ± 12%). The ratios of CD4‐positive helper‐inducer to CD8‐positive suppressor‐cytotoxic T cells were higher than those reported for the peripheral blood but not significantly different between the study groups (TB, 3.3 ± 1.9; RT, 2.8 ± 1.1). The activation marker studies revealed that only a few pleural T cells were positive for CD38, CD25 (interleukin‐2 receptor), HLA‐DR antigen, and OKT9 (transferrin receptor), the proportion of CD25‐positive T cells being higher in TB and in RT than in CHF and the proportion of HLA‐DR‐positive T cells being higher in TB than in CHF (P < 0.05). Significant differences were not observed relative to the natural killer‐cytotoxic phenotypes staining positive for Leu‐7 or for CD16. Thus, we concluded that phenotypic analysis of lymphocytes is of limited diagnostic usefulness to differentiate tuberculous from other nonmalignant effusions.
Mucinous metaplasia to neoplastic lesions in endometrial samples with cytohistologic correlation
Authors: Galera‐Davidson H. , Fernandez A. , Navarro J. , Parrilla A. , Salguero M. , Rivera F.
Published: February 2007

Seven cases of endometrial mucinous metaplasia and five of well‐differentiated mucinous adenocarcinoma of the endometrium were studied. Cytologic specimens were obtained by Isaacs endometrial sampler, avoiding endocervical contamination. The histologic diagnosis between the intermediate type of mucinous metaplasia and the well‐differentiated mucinous adenocarcinoma posed no problems. DNA analyses of the histologic samples showed a euploid pattern in benign and intermediate types of metaplasia, while well‐differentiated mucinous adenocarcinoma showed a hyperdiploid pattern. The cytologic diagnosis of benign mucinous metaplasia should be suggested in the presence of abundant mucinous cells in endometrial samples in the absence of nuclear abnormalities.
Ultrastructural histochemistry of mesotheliomas and adenocarcinomas in malignant effusions
Authors: Barsotti Paola , Muda Andrea Onetti , Ascoli Valeria , Casareale Paola , Nardi Francesco
Published: February 2007

The results of electron microscopic examination of cytologic specimens from six cases of mesothelioma and 10 cases of metastatic carcinoma of different origins are presented. The formation of cell clusters in malignant effusions from the two neoplasms has been thoroughly investigated: in mesotheliomas, ctdls had longer, more slender microvilli than in carcinomas and more abundant bundles of intermediate filaments; the central cavity often seen in the clusters frequently contained collagen and showed basement membrane production. The application of periodic acid‐silver methenamine (PASM) and phosphotungstic acid (PTA) demonstrated a peculiar ultrastructural difference in cell coat staining in the two tumor types: in mesotheliomas, PTA and PASM were consistently negative along the outer surface of the cell aggregates, while carcinomas displayed a positive reaction either on the outer surface or on both inner and outer surfaces of the clusters. The diagnostic significance of the above‐mentioned difference between the two neoplasms will require further investigation in a larger number of cases.
The aspiration cytology of pulmonary hamartomas
Authors: Dunbar Fiona , Leiman Gladwyn
Published: February 2007

Cytodiagnosis of pulmonary hamartomas (PHs) by transthoracic fine‐needle aspiration (FNA), successful in II of a series of 14 cases, has been found to rely less on the presence of mature cartilage than on the recognition of fibromyxoid fragments. These fragments, wispy yet discrete, consisting of variable numbers of fibroblasts embedded in fibrillary ground substance, can be distinguished from fibrous tissue and mucus, both of which they may resemble. Mature cartilage is distinctive when present, but it is seen in a minority of cases. Bronchial rrlls and adipocytes, integral components of PHs, are of no diagnostic value unless associated with fibromyxomatous tissue or cartilage. Chest wall “contaminants” that may cause pitfalls in diagnosis, such as bone, skeletal muscle, and fibrous tissue, are described and illustrated. The differential diagnosis of biphasic lesions containing epithelial cells and mesenchyme, including dermoids and blastomas, is discussed. With knowledge of the radiologic appearance of target lesions, confident cytodiagnosis of PHs is possible if attention is paid to subtle, yet specific. background features in aspirated material.
A simple method for estrogen receptor antigen preservation in cytologic specimens containing breast carcinoma cells
Authors: Redard Mireille , Vassilakos Pierre , Weintraub Jonathan
Published: February 2007

We report a modified method to prepare cytologic specimens for the evaluation of estrogen receptors by immunocytochemistry. Cytologic samples were obtained by needle aspiration of tumor masses (nine patients) and body cavity fluids (nine patients). The cytologic material was divided, and slides for immunostaining were prepared according to two different techniques: (1) fixation of cells in suspension (modified method); and (2) fixation of cells adherent to slides (standard method). The results after immunostaining demonstrated that the number of cells adhering to slides prepared according to the modified method was greatly increased as compared with the number of cells remaining attached to slides prepared according to the standard method. There was no loss of cell groups or aggregates using the modified method. The antigenicity of estrophilin and the cell morphology were well‐preserved for up to 30 days. With this modified method, cytologic samples may be stored and conveniently processed in batches, thereby improving the utilization of laboratory resources.
Undifferentiated small round‐cell tumors of childhood: The immunocytochemical demonstration of myogenic differentiation in fine‐needle aspirates
Authors: Pettinato Guido , Swanson Paul E. , Insabato Luigi , De Chiara Annarosaria , Wick Mark R.
Published: February 2007

The recognition of myogenic differentiation is not always possible using routine light or electron microscopic techniques. In this article, we describe our experience with two small round‐cell neoplasms occurring in young children, each of which exhibited an undifferentiated light microscopic appearance. In both cases, myogenic features were revealed by immunocytochemical methods applied to fine‐needle aspiration (FNA) biopsies. Each was immunoreactive for desmin and vimentin and failed to react with antibodies to leukocytecommon antigen. Moreover, formalin‐fixed tissue sections of one case were negative for cytokeratin and epithelial membrane antigen. Sporadic reactivity for neuron‐specific enolase and Leu‐7 antigen was observed in occasional cells in FNA specimens, but synaptophysin was not identified. The rapidity of the method and the reliability of the immunocytochemical findings, when compared with routine cytologic evaluation, emphasize the diagnostic utility of immunocytochemical analysis when FNAs of pediatric soft‐tissue tumors are obtained.
Marginal vacuoles in metastatic thyroid carcinoma: A case report
Authors: Pitts William C. , Berry Gerald J.
Published: February 2007

A case of metastatic follicular carcinoma to the iliac bone in a 78‐yr‐old woman is presented. Fine‐needle aspiration biopsy (FNAB) smears showed numerous, cohesive tumor cell groups with moderately abundant cytoplasm and distinctive, peripherally situated pink‐staining vacuoles on May‐Grünwald‐Giemsa stain. The presence of marginal vacuoles strongly suggested the possibility of metastatic thyroid carcinoma. Immunohistochemical studies performed on a concomitant needle core biopsy showed immunoreactivity for thyroglobulin, supporting a thyroid derivation for this metastasis. To our knowledge, this is the first reported case in which marginal vacuoles (“flame cells”) have been identified in a malignant thyroid condition.
Epithelioid hemangioendothelioma: Report of a case diagnosed by fine‐needle aspiration
Authors: Gambacorta Marcello , Bonacina Edgardo
Published: February 2007

A case of epithelioid hemangioendothelioma suggested by fine‐needle aspiration biopsy is reported. The clinical, cytological, histopathological, and postmortem findings are described. The diagnosis was confirmed by cyto‐histoimmunochemical studies.
Male breast lesions: Gynecomastia and its distinction from carcinoma by aspiration biopsy cytology
Authors: Russin Victoria L. , Lachowicz Carolyn , Kline Tilde S.
Published: February 2007

Gynecomastia is a benign proliferative lesion of the male breast. It may present as a diffuse bilateral process or a unilateral, discrete mass, clinically suggestive of carcinoma. We examined the aspiration biopsy cytology of 50 cases of gynecomastia to define the cytologic criteria and to distinguish it from carcinoma. The parameters of cellularity, architecture, single columnar cells, naked nuclei, nuclear and cell size, nuclear and cytoplasmic characteristics, and extraneous cells were accessed. Diagnostic confusion with carcinoma may occur because of cellularity with loose groups and single cells; however, the mixed cell population, composed of cohesive sheets or groups of bland cells, bipolar naked nuclei, and single tall columnar cells, delineates gynecomastia from carcinoma of the male breast.
Aspiration cytology of Wilms' tumor: Correlation of cytologic and histologic features
Authors: Akhtar Mohammed , Ali Mohammed Ashraf , Sackey Kwesi , Sabbah Rajeh , Burgess Annie
Published: February 2007

We examined the cytomorphologic features of fine‐needle aspiration biopsy (FNAB) specimens from 23 Wilms' tumor patients. The findings were correlated with histopathologic patterns from these tumors. The study revealed a close resemblance between the cytologic and histopathologic appearance of various cellular elements in Wilms' tumors. The major cellular patterns seen in Wilms' tumor include blastemal cells, blastemal cells with epithelial differentiation, blastemal cells with tubular differentiation, and stromal elements. It is hoped that recognition of these cellular components in aspiration smears will be helpful in establishing an FNAB diagnosis of Wilms' tumor.
Human papovavirus in a routine urine specimen of a four‐year‐old boy
Authors: Braza Frank , Johnson Kathleen A. , Grigg Lois M. , Lopez Victor F. , Kavirajan Vadakkekara
Published: February 2007

Cellular changes produced by viruses can be readily identified using light microscopy and Papanicolaou stain of a fixed specimen. These findings can then be confirmed by viral culture and/or electron microscopy studies. Human polyomavirus, common in transplant recipients or otherwise immunocompromised patients, is one virus that can be identified using these methods. The following is a case study of a 4‐yr‐old boy with no known immune impairment who exhibited human papovavirus (polyomavirus) on a routine urine examination. The diagnosis was confirmed by electron microscopy.
Fine‐needle aspiration of subcutaneous phaeohyphomycosis caused by Wangiella dermatitidis
Authors: Crosby John H. , O'Quinn Mary H. , Steele John C. H. , Rao R. N.
Published: February 2007

Two cases of subcutaneous phaeohyphomycosis, first recognized by fine‐needle aspiration (FNA), were confirmed with culture, excision, and histologic study. Both patients had debilitating medical problems and a solitary mass on the left leg. Pigmented hyphae and other fungal elements, numerous in both aspirates, assumed a variety of forms that did not permit specific identification. Culture grew Wangiella dermatitidis in both cases. FNA also yielded purulent exudate, multinucleated giant cells, and, in one case, epithelioid histiocytes. Both excised lesions were abscesses, with associated granulomatous inflammation, fibrosis, and plant splinters. Fungi in sections resembled those seen in the aspirates.
Adrenal myelolipoma: Preoperative diagnosis by fine‐needle aspiration cytology
Authors: Katsuta Koji , Nakabayashi Hiroshi , Kuroda Yuzuru , Liu Paul I.
Published: February 2007

Fine‐needle aspiration (FNA) was performed under ultrasonographic guidance on a suprarenal mass in a 52‐yr‐old Japanese man. Preoperatively, the diagnosis of adrenal myelolipoma was easily established from the cytologic findings of the aspirates. FNA is a very useful technique for the differential diagnosis of this tumor, and it is particularly valuable for many hospitals that are not equipped with computed tomography.
Variations in interpretation of gynecologic cytology photomicrographs
Authors: Maguire Nancy Council
Published: February 2007

This was a study of variations in interpretations of photomicrographs of gynecologic cytology specimens. Two photomicrographs from each of 20 gynecologic cytology specimens were examined by 10 cytotechnologists and 10 pathologists. In only two cases was there agreement among all participants regarding the primary entity illustrated. The greatest agreement in interpretation was for benign entities such as repair reaction, koilocytotic changes, benign endocervical cells, and herpes simplex. There was little uniformity in the recognition of intraepithelial neoplasia and invasive carcinoma, or these lesions are difficult to illustrate using photomicrographs. Most abnormal cases were identified at least as atypical, but in many cases the range of responses was great—for example, atypical squamous metaplasia to squamous carcinoma. There was more uniformity among cytotechnologists than pathologists in the recognition of the cytologic entities presented. The results of this study illustrate the difficulty of selecting photomicrographs for testing purposes and the lack of uniformity in the interpretation of such photomicrographs.
Cytology of primary versus secondary genital herpesvirus infection
Authors: Naib Zuher M. , McNeill William F. , Crowder Susan , Fekete Paul
Published: February 2007

Certain authors state that primary genital herpes infections mainly produce cells with ground‐glass nuclei, whereas secondary infections produce a higher percentage of multinucleated or single cells with prominent intranuclear inclusions. The cervicovaginal smears of 11 patients with primary genital herpes infection and 16 patients with secondary infection were studied to determine the validity of this differentiation. The percentage per patient of virally infected cells containing distinct inclusions ranged from 0% to 35% in the primary herpes group and 0% to 100% in the secondary herpes group. In eight additional patients, the initial herpes simplex virus (HSV)‐positive smear was compared with recurrent positive smears taken from 2 to 120 mo later. No statistical difference in the incidence of distinct inclusions in the infected cells was detected. Finally, primary rabbit kidney and the heteroploid A549 cell cultures were inoculated with herpes viruses and followed by fixation with several agents at various time intervals. Alcohol and Bouin's fixative favored the recognition of distinct inclusions, as did the duration of the infection.
Lymphocytic thyroiditis in fine‐needle aspirates: Differential diagnostic aspects
Authors: Tseleni‐Balafouta Sofia , Kyroudi‐Voulgari Aspasia , Paizi‐Biza Penelopi , Papacharalampous N. X.
Published: February 2007

This study assessed the morphological criteria for the diagnosis of various types of lymphocytic thyroiditis in fine‐needle aspirates. Of 950 aspirates, 121 revealed lymphocytic thyroiditis, including Hashimoto's thyroiditis (partly confirmed by serological or histological examination) and focal thyroiditis adjacent to neoplasms. The diagnosis of Hashimoto's thyroiditis was easy when the aspirated material was adequate and contained oxyphilic cells: in the fibrous type, diagnosis was rather dificult. Focal thyroiditis may be confused with Hashimoto's thyroiditis, especially when adjacent to neoplasm. Surgical exploration should be performed in cases of severe lymphocytic thyroiditis revealed by fine‐needle aspiration with repeatedly negative antibody titers in order to exclude neoplasm.
Role of fine‐needle aspiration cytology in childhood malignancies
Authors: Rajwanshi A. , Rao K. L. N. , Marwaha R. K. , Nijhawan V. S. , Gupta S. K.
Published: February 2007

During the last 4 yr. fine‐needle aspiration cytology (FNAC) has been employed in 1,474 patients in 0‐15‐yr age group at our institute. Of these, 245 patients were found to have malignant disease, including primitive neuroectodermal tumors, hepatoblastoma, nephroblastoma, sarcoma, and epithelial malignancies. Four metastases from medulloblastoma and two each from astrocytoma and meningioma were confirmed without open biopsy. FNAC interpretation was easy when cytologic findings were correlated with relevant clinical and radiologic data.
Significance of giant cells in fine‐needle aspiration biopsies of benign and malignant lesions of the pancreas
Authors: Silverman Jan F. , Finley James L. , Berns Lisa , Unverferth Marsha
Published: February 2007

The cytologic results of 44 consecutive fine‐needle aspiration (FNA) biopsies of the pancreas are reported. The series consisted of 27 women and 17 men with an age range of 31–89 yr (mean, 61.5), Excluding insufficient cases, the sensitivity of the procedure was 88%. specificity was 100%, positive predicative value (PV) was 100%, negative PV was 69%, and efficiency of the test was 90%, There were 29 true‐positive, four false‐negative, and nine true‐negative diagnoses. Two specimens were insuficient for diagnosis. Giant cells of varying types were seen in both the malignant and benign cases. Two of the benign cases demonstrated rare multinucleated foreign body‐type giant cells, most likely representing the changes seen in pancreatitis. In 13 malignant cases, multinucleated tumor cells were present, while six additional cases had multinucleated benign histioeytes reflecting the associated pancreatitis. Two malignant cases each had tumor giant cells and benign multinucleated histiocytes. Three of the malignant cases had numerous multinucleated tumor giant cells arranged in a dissociative fashion with evidence of cytophagocytosis consistent with a pleomorphic giant‐cell carcinoma of the pancreas. One additional case demonstrated numerous multinucleated osteoclastic‐like cells consistent with an osteoclastic tumor of the pancreas. This article documents the accuracy of FNA biopsy of the pancreas and notes that giant cells of varying types can be found in pancreatic FNA biopsies. Appreciation of the various types of giant cells in pancreatic FNA biopsy is important for diagnostic accuracy and prognosis.
Transthoracic needle aspiration biopsy in inflammatory pseudotumors of the lung
Authors: MacHicao Carlos N. , Sorensen Kelly , Abdul‐Karim Fadi W. , Somrak Theresa M.
Published: February 2007

The cytologic findings on transthoracic needle aspiration biopsy in four patients with pulmonary inflammatory pseudotumor are described. These findings have not been previously illustrated in the literature. The main cytologic components of this lesion are histiocytes, lymphocytes, fibroblasts, pneumocytes, and plasma cells. Familiarity with these features is essential to avoid misdiagnosis and possible overtreatment.
Morphometric analysis of hyperthermia‐induced nuclear and nucleolar size modifications in a human melanoma cell line
Authors: Delpino Andrea , De Santis Maurizio , Sudano Luigi , Donnorso Raffaele Perrone , Ferrini Umberto
Published: February 2007

Although no prominent morphologic alterations were observed by light microscopy in a human melanoma cell line (M‐14) exposed at 42°C for 4 hr. the computerized image analysis demonstrated a significant enlargement of both nuclei and nucleoli. The mean nuclear and nucleolar areas were found to be 32% and 94% increased, respectively, in comparison with normal controls. The gaussian distribution of absolute frequency of the measures demonstrated that this nuclear and nucleolar enlargement was distributed among the whole cell population, taking place in clonogenic cells and in “sterilized” cells, ultimately doomed to die. This finding, not previously described in the context of the heat shock response, may be regarded as morphological evidence of an increase in the protein content of the nuclei of heat‐treated cells, as determined by biochemical methods.