bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurement of CA125, carcinoembryonic antigen, and alpha‐fetoprotein in ovarian cyst fluid: Diagnostic adjunct to cytology
Authors: Pinto Marguerite M. , Bernstein Larry H. , Brogan Dennis A. , Parikh Firuza , Lavy Gaby
Published: February 2007

This study used CA125, carcinoembryonic antigen (CEA), and alpha‐fetoprotein (AFP) to classify ovarian cysts by measuring the levels of the three antigens; this information was useful when fluid obtained through laparoscopic puncture of ovarian cysts was submitted for cytologic examination from patients for whom tissue was unavailable for classification. We studied 136 consecutive cyst fluids (108 benign, 28 malignant) and correlated the findings with the tissue diagnosis. All three antigens were very low (CEA, < 0.5 ng/ml; CA125, 55‐2,143 μ/ml; and AFP, <4.8 ng/ml) in follicular and lutein cysts. Markedly elevated CA125 (296‐1,950,000 μ/ml) and low CEA (0.5‐220 ng/ml) and AFP (<4.8 ng/ml) levels were seen in patients with serous neoplasms, both benign and malignant. Elevated CEA (>600 ng/ml) and CA125 (56‐65.330 μ/ml) levels were seen in primary mucinous cystadenoma and cystad‐enocarcinoma. Two patients with colonic carcinoma met astatic to the ovary had an elevated CEA (>600 ng/ml) and a normal CA125. Only one patient, with a malignant teratoma, had an elevated AFP. The adjunctive use of CEA and CA125 is recommended for the classification of ovarian cysts.
Liesegang rings in renal cyst fluid
Authors: Katz Laurie B. K. , Ehya Hormoz
Published: February 2007

Peculiar ring‐like structures identifed as Liesegang rings (LRs) were found in renal cyst fluid from three patients with benign renal cysts. They ranged in size from 5 to 820 μ. Most had a double‐layer outer wall with equally spaced radial cross‐striations and an amorphous central nidus. Special stains were performed in one case, and the results are discussed. Reports of LRs in cystic or inflamed tissues have recently appeared in the literature. Some LRs have been mistaken for eggs or mature components of the giant kidney worm, Dioctophyma renale. We propose that cytologic assessment of renal cyst fluid in conjunction with histologic examination decreases the likelihood of misdiagnosis of LRs.
Cytology of pseudomyxoma peritonei: Report of two cases arising from appendiceal cystadenomas
Authors: Costa Michael , Oertel Yolanda C.
Published: February 2007

Pseudomyxoma peritonei is the clinical term for the diffuse deposition of mucus within the peritoneal cavity secondary to a mucinous tumor of the ovary or appendix. This gelatinous ascites, or ‘jelly‐belly’ may result in death from loss of intestinal function and intestinal obstruction caused by peritoneal implants rather than visceral invasion. Microscopic evaluation of peritoneal fluid is frequently an initial diagnostic test: however, in a search of the recent literature we were surprised to find only one case report of the cytologic features. This prompted us to report the cytologic findings in the peritoneal fluid of two cases of pseudomyxoma peritonei arising from appendiceal mucinous cystadenomas.
Detection of human papillomavirus in reprocessed routine papanicolaou smears by dna hybridization
Authors: Rakoczy P. , Hutchinson L. , Kulski J. K. , Sterrett G. F. , Pixley E. C.
Published: February 2007

DNA dot blot hybridization was used for the detection of human papillomavirus (HPV) types 6, 11, 16, anti 18 in reprocessed routinely collected Papanicolaou smears. DNA was extracted from the smears with alkaline lysis and applied onto a nitrocellulose jilter. The specificity and sensitivity of the dot blot hybridization on reprocessed Papanicolaou smears were confirmed by Southern blot analysis of selected samples, using CaSki, SiHa cell lines as positive controls and HF 32 as negative controls. From 42 normal smears and 44 abnormal smears with koilocytosis present, 9 (21W) and 43 (98 %), respectively, were positive for HPV6/11/16 or 18. These results show that reprocessed Papanicolaou smears in combination with DNA hybridization have potential application in retrospective studies on the prevalence and distribution of HPV infection.
Identification of Campylobacter pylori by endoscopic brush cytology
Authors: Schnadig Vicki J. , Bigio Eileen H. , Gourley William K. , Stewart Georgia D. , Newton Grace A. , Shabot J. Marc
Published: February 2007

To investigate the value of Papanicolaou‐stained endoscopic brush samples in the diagnosis of Campylobacter pylori infection of the upper gastrointestinal tract, 138 brush and biopsy samples from the esophagus, stomach, and duodenum, taken concomitantly, were reviewed retrospectively. In 35 cases, Campylobacter‐like organisms (CLOs) were found in both cytology and biopsy samples. In 15 cases, CLOs were seen in biopsy material only, and in 8 cases, CLOs were found in cytology material only. CLOs were found in 49% of the gastric specimens and 33% of the Barrett's esophagus specimens by histologic or cytologic examination or by both methods. CLOs were found by at least one method in 64% of the gastric samples with active gastritis, 40% with borderline gastritis, 15% without gastritis, and in 64% with adenocarcinoma. Cytologic examination of endoscopic brush samples is a valuable technique for the diagnosis of gastric Campylobacter infections and can be performed easily in cytopathology laboratories.
Intraoperative cytologic diagnosis: Evaluation of 370 consecutive intraoperative cytologies
Authors: Guarda Luis A.
Published: February 2007

Three‐hundred and seventy intraoperative cytologies are presented and compared with synchronously performed frozen sections. Cytologic smears and frozen sections were misinterpreted in 1.6% and 0.8% of cases, respectively; the rate of diagnostic errors between the two techniques is comparable given the lack of experience with intraoperative cytology at the beginning of the study. Intraoperative cytology is a suitable technique for a variety of lesions, but it is most helpful in the field of neuro‐oncological pathology, certain infectious diseases, lesions of the hematopoietic system, and most epithelial tumors. Cytologic smears afford better morphologic preservation and detail than frozen sections. Techniques are outlined and discussed. Diagnostic criteria of selected cases are presented, and pitfalls are analyzed.
Radiation changes in endocervical cells in brush specimens
Authors: Frierson Henry F. , Covell Jamie L. , Andersen Willie A.
Published: February 2007

Although the cytologic changes in cervical and vaginal squamous cells after radiation therapy were well‐described decades ago, alterations in endocervical cells in response to radiation therapy have not been delineated in detail. We studied the effect of radiation therapy (usually combined linear accelerator beam and radium insertion) on endocervical cells as seen in endocervical brush specimens from 24 patients treated for cervical cancer. Of the 40 smears examined, 45 % were taken 3–6 mo after the completion of radiotherapy, 28% at 10–14 mo, and 20% at 18–34 mo. Endocervical cells appeared as single cells and in clusters and had lavender, mucin‐filled cytoplasm. When present in clusters, they lacked the honeycomb appearance of normal endocervical cells. In smears taken at 3–6 mo. the majority of endocervical cells were enlarged (100% of smears) but they usually had normal nuclear/cytoplasmic ratios. Their nuclei were enlarged (100% of smears); varied in size (100%); had some coarse chromatin (67%) and large nucleoli (78%); and were multinucleated (89%). Repair cells and multinucleated histiocytes were seen in 83% and 61% of smears, respectively, Each of these cytologic findings was less apparent in follow‐up smears taken more than 6 mo after the completion of radiation therapy. Awareness of these cytologic changes in endocervical cells after radiation therapy precludes the overdiagnosis of cancer in follow‐up endocervical brush specimens.
Diagnosis of squamous‐cell carcinoma of the lung by sputum cytology: With special reference to correlation of diagnostic accuracy with size and proximal extent of resected tumor
Authors: Matsuda Minoru , Horai Takeshi , Doi Osamu , Kodama Ken , Tateishi Ryuhei
Published: February 2007

Sputum cytology was performed in 179 cases of squamlous‐cell carcinoma of the lung; 134 cases were diagnosed as positive. There were no significant differences in diagnostic accuracy of sputum cytology between tumors sizes. In cases with tumors extending proximally into the main, lobar, or segmental bronchi, the diagnostic accuracy of sputum cytology was significantly higher than in cases where the proximal invasion of tumor was limited to the peripheral bronchi. In cases with tumors 3 cm or less in diameter, when tumors extended proximally into main, lobar, or segmental bronchi, the diagnostic accuracy of sputum cytology was significantly higher than in cases with tumors extending proximally into subsegmental or subsubsegmental bronchi. In peripherally located squamous‐cell carcinoma, in cases in which the tumor arose in subsegmental or subsubsegmental bronchi, carcinoma could be detected by sputum cytology even when it was roentgenographically occult.
Fine‐needle aspiration cytology of hematopoietic lesions from multiple sites
Authors: Silverman Jan F. , McLeod Darryl L. , Park H. Kim
Published: February 2007

We reviewed 130 fine‐needle aspiration (FNA) biopsies from 118 patients with a variety of benign and malignant hematopoietic lesions. There were 74 (57%) malignant, 45 (35%) benign, and 11 (8%) atypical diagnoses. Immunocytochemistry of the aspirated material was performed in 47 (36%) and electron microscopy in 4 (3%) of the cases. FNA cytology was utilized to make a primary hematopoietic malignant diagnosis in approximately half of the cases and to confirm recurrence in the remainder. The malignant cases included non‐Hodgkin's lymphoma, Hodgkin's disease, medullary and extramedullary plasmacytoma, and granulocytic sarcoma. Forty‐two malignant cases had either previous or follow‐up surgical biopsy with no false‐positive diagnoses. Of the 11 atypical cases, seven had surgical confirmation with five malignant and two benign diagnoses. The benign hematopoietic lesions correctly identified included acute and chronic lymphadenitis, granulomatous processes, and eosinophilic granuloma. Only 5 of the 45 benign FNA biopsies had surgical pathology follow‐up, with no false‐negative diagnoses. The most commonly aspirated sites were lymph nodes (71 %), although hematopoietic lesions were correctly identified in a number of extranodal locations, including soft tissue (8%), abdominal viscera (6%), lungs (5%), mediastinum (2.5%), bone (3%), and thyroid, salivary gland, and breast (1.5% each). This study demonstrates the clinical utility and diagnostic accuracy of FNA cytology in the evaluation of benign and malignant hematopoietic disorders from multiple sites. Ancillary studies performed on the aspirated material aided in making a specific and accurate diagnosis.
Cytologic diagnosis of fibrolamellar carcinoma of the liver by fine‐needle aspiration
Authors: Davenport Robertson D.
Published: February 2007

Two cases in which the diagnosis of fibrolamellar carcinoma of the liver was made by fine‐needle aspiration are presented. The cytologic findings were characteristic and permitted these tumors to be differentiated from the usual hepatocellular carcinoma. Since fibrolamellar carcinoma has unique clinical and pathologic features, and is much more likely to be resectable. making this diagnosis is important.
Silver staining of interphase nucleolar organizer regions in cytologic smears previously stained by the papanicolaou and may‐Grünwald‐Giemsa Techniques
Authors: Batsotti Paola , Ascoli Valeria , Nardi Francesco , Marinozri Vittorio
Published: February 2007

Malignant cells are known to display a distinctive argyrophilic nucleolar organizer region (Ag‐NOR) protein distribution compared with distribution in their benign counterparts. In this study, Ag‐NOR staining was applied to smears from reactive and malignant serous effusions. The smears were either unstained or had been previously stained with the Papanicolaou or May‐Grünwald‐Giemsa (MGG) technique. The purpose of this study was to assess the feasibility and usefulness of Ag‐NOR staining in diagnostic cytopathology and to set up a procedure that could be used on prestained smears in retrospective studies. The one‐step silver staining method was applied to prestained smears after a weak destaining step in trichloroacetic acid and to unstained smears after a postfixation step in Carnoy's fluid. Positive results were observed on both destained and unstained preparations, MGG‐stained smears showing a better visualization of the silver deposits than Papanicolaou‐stained smears. Major differences in size, shape, and distribution patterns of the Ag‐NOR‐positive granules were observed between neoplastic and reactive cells. Furthermore, the mean number of silver‐stained dots per cell was significantly higher in malignant cells (33.32 ± 2.23) than in reactive mesothelial cells (9.71 ± 0.66). These data indicate that this Ag‐NOR technique can be profitably applied to prestained cytologic smears to assist in the diagnosis of malignancy and that the technique has the advantage that cellular morphology and silver staining can be evaluated on the same slide.
Aspiration cytology diagnosis of echinococcosis
Authors: Kapila Kusum , Verma Kusum
Published: February 2007

We report five cases of echinococcosis diagnosed on material obtained by fine‐needle aspiration. The sites were the liver in three cases, the thigh in one case, and the retroperitoneum in one case. No complications were observed.
Intraoperative imprint cytology: Its significance as a diagnostic adjunct
Authors: Kim Kitai , Phillips Edwin R. , Paolino Michael
Published: February 2007

We retrospectively evaluated 664 specimens submitted for intraoperative frozen‐section analysis for which cytologic imprints or smears were also prepared; 238 (36%) were malignant neoplasms. These preparations were retrospectively evaluated independently by three reviewers of varied experience in the detection of malignancy. The number of false‐positive and false‐negative results were recorded, and various assessment parameters (sensitivity, specificity, efficiency, and predictive value) were calculated. The imprint was of chief value as an adjunct to the frozen section, particularly in avoiding false‐positive and, to a lesser extent, false‐negative interpretations. Experience with the use of intraoperative cytology demonstrated the technique to be of value in providing abbreviated preparation time (3‐5 min); supportive diagnostic information when frozen section was equivocal: diagnostic information when frozen‐section evaluation could not be done (e.g., excessively small sample); contributory information for final diagnosis on difficult cases; and excellent teaching material for cytopathology.
Lung cancer treated on the basis of cytologic findings: An analysis of 112 patients
Authors: Caya James G. , Gilles Lynn , Tieu Thu Minh , Murray Kevin , Clowry Lawrence J. , Wollenberg Nancy J.
Published: February 2007

The authors studied 112 patients who received definitive radiotherapy/chemotherapy solely on the basis of positive cytologic findings in the appropriate clinical context. Eighty patients (71.4%) were treated on the basis of one or more positive sputum studies, while the remainder had at least one positive bronchial cytologic preparation. Eighty‐six patients (76.3%) received radiotherapy alone; 19 received both radiotherapy and chemotherapy: only 7 were exclusively given chemotherapy. The utilization of stringent verification criteria revealed that none of our patients was falsely positive for malignancy. For those patients categorized as having malignant disease by verification criteria I‐IV, there were no significant disparities between histologic and cytologic diagnoses. This study demonstrated, in a systematic fashion, that patients can be reliably and definitively treated for lung cancer on the basis of positive respiratory cytology findings without tissue corroboration.
Fine‐needle aspiration of lymph nodes in patients with acute infectious mononucleosis
Authors: Stanley Michael W. , Steeper Theresa A. , Horwitz Charles A. , Burton Linda G. , Strickler John G. , Borken Stuart
Published: February 2007

We studied lymph node fine‐needle aspirations from 10 patients with primary Epstein‐Barr virus (EBV) infections (infectious mononucleosis). There were five males and five females, aged 15‐54yr. The diagnoses were confirmed by blood morphology and heterophil antibody (HA) and EBV‐specific serologic studies. Nine patients were HA‐positive, nine were viral capsid antigen (VCA)‐IgM‐positive, and all 10 were VCA‐IgG‐positive and anti‐EBV nuclear antigen (EBNA)‐negative. Five patients were referred for fine‐needle aspiration biopsies for clinically suspected malignant lymphoma (ML). Four of these patients had been tested for HA prior to fine‐needle aspiration, with negative results in three cases. The heterophil‐positive patient was referred for fine‐needle aspiration due to very impressive unilateral cervical adenopathy. Cytologically, all cases showed atypia consisting of greater numbers of large immunoblastic lymphocytes than are usually seen in the reactive lymph node. Two cases were cytologically suspicious for malignant lymphoma but included a considerable background of polymorphic immunoblasts. We suggest that polymorphic immunoblastic proliferations in lymph node cytology are suggestive of infectious mononucleosis. Since several reactive and neoplastic processes mimic this pattern, cases not followed by both confirmatory serologic studies and resolution of adenopathy should be pursued by excisional lymph node biopsy.
Recurrent multifocal adult rhabdomyoma diagnosed by fine‐needle aspiration cytology: Report of a case and review of the literature
Authors: Walker William P. , Laszewski Michael J.
Published: February 2007

The fine needle aspiration (FNA) cytology of a recurrent multifocal extracardiac adult rhabdomyoma is described, and the literature is reviewed. The patient presented with dysphagia and bilateral palpable neck masses 21 yr after resection of a rhabdomyoma of the tongue. The clinical differential diagnoses included ptotic submandibular glands and lymphadenopathy. The aspiration smears and cytospin preparations contained large polygonal cells with abundant granular cytoplasm with indistinct borders and uniform, peripherally located nuclei. Cross‐striations were identified within the cytoplasm of some cells on Papanicolaou and modified Wright‐Giemsa stains. This case represents only the fourth description of the cytology of this entity and the first reported case of a recurrence diagnosed by FNA. The characteristic cytomorphologic features enabled a definitive diagnosis to be made 21 yr after the original resection, sparing a poor‐risk patient a debilitating surgical procedure for a benign, slow‐growing neoplasm.
Fine‐needle aspiration of fibroadenomas of the breast with atypia: A spectrum including cases that cytologically mimic carcinoma
Authors: Stanley Michael W. , Tani Edneia M. , Skoog Lambert
Published: February 2007

We herein report the cytologic and histotogic findings in 11 cases of cytologically atypical fibroadenoma (FA). These ranged from cases recognizable as FA but showing epithelial atypia to cases that, even on review, completely mimicked the needle aspiration picture of ductal breast carcinoma. A retrospective review of 45 cases of previously excised FA showed that focal atypia is common (27%). Possible physiologic explanations for atypia in FA, along with strategies for avoiding false diagnoses of malignancy in aspiration smears, are discussed.
Light and electron microscopic examination of fine‐needle aspirates in the preoperative diagnosis of cartilaginous tumors
Authors: Walaas Lisa , Kindblom Lars‐Gunnar , Gunterberg Björn , Bergh Peter
Published: February 2007

Twenty‐eight patients with chondrogenic tumors—2 chondroblastomas, 4 chondromas, 18 chondrosarcomas, 1 clear‐cell chondrosarcoma, and 3 mesenchymal chondrosarcomas—underwent fine‐needle aspiration biopsy (FNAB) in the preoperative investigation. The cytologic features in smears were compared with the histopathologic findings in the surgical specimens; in 14 cases they were also compared with the light and electron microscopic findings in resin‐embedded fine‐needle aspirates. The smears of the vast majority of the classical chondrosarcomas presented features that made possible the FNAB diagnosis of a chondrogenic tumor to be made. In the case of the low‐grade chondrosarcomas in particular, which were poorly or moderately cellular in smears and showed chondroblastic cells often in lacunary structures of hyaline matrix, consideration of the clinical presentation, size, location, and roentgenographic appearance was essential for the diagnosis of chondrosarcoma. On the other hand, the high‐grade chondrosarcomas presented cytologic features that clearly indicated their malignancy and they usually had a myxoid matrix. The possible differential diagnoses that may arise from the FNAB diagnosis of cartilaginous tumors are discussed. The resin‐embedding technique for the light and electron microscopic examination of FNABs. along with the histochemical analysis for the demonstration of sulphated glucosaminoglycans and the immunocytochemistry applied to smears, was found to be of value in the definite diagnosis, especially in the distinction of chondrogenic tumors from chordoma and metastatic mucous‐producing carcinoma.
Lipid‐rich metastatic balloon‐cell melanoma: Diagnosis by a multimodal approach to aspiration biopsy cytology
Authors: Martinez Felix , Merenda Gloria , Bedrossian Carlos W. M.
Published: February 2007

Fine needle aspirates from one of multiple liver nodules revealed a large number of discohesive malignant cells with abundant vacuolated cytoplasm. The patient had had left eye enucleation the year before, for a melanoma with focal areas of clear cell change. Pap stained preparations from the liver FNA displayed well the nuclear features of balloon cell melanoma, including anisonucleosis, prominent nucleoli and intranuclear inclusions. Diff‐Quik stain demonstrated best the cytoplasmic features such as distinct cell margins and finely dispersed and sharply delineated clear vacuoles. No pigmentation was noted but melanoma was suspected after the history prompted comparison with the enucleated specimen resected a year previously. A multimodal battery of ancillary methods including electron microscopy (EM) and immunocytochemistry (ICC) allowed the confirmation of balloon‐cell melanoma, a rare variant not previously described in the eye. By EM, abundant lipids were identified along with melanin‐containing structures resembling melanosomes. S‐100 positivity along with negativity for epithelial, lymphohistiocyte and germ cell markers was compatible with melanoma, These findings are consistent with the view that cytologic detection of poorly cohesive, hypervacuolated cells does not exclude the possibility of melanoma. This rare example of a lipid‐containing melanoma stresses the value of obtaining good clinical history, comparing FNAs to any pre‐existing material and utilizing a multimodal approach to cytologic diagnosis in select cases.
Fine‐needle aspiration cytology in azoospermic males
Authors: Rajwanshi A. , Indudhara R. , Goswami A. K. , Radhika S. , Das A. , Sharma S. K. , Vaidyanathan S. , Datta B. N.
Published: February 2007

Bilateral testicular fine‐needle aspiration cytology (FNAC) was performed in 100 males, including 10 controls with normal fertility and 90 infertile azoospermic males. The various seminiferous tubular cells were easily identified in smears. It was possible to give a cytological diagnosis in histologic terms by analysis of the combinations of various cell types. The cytohistologic correlation in 25 cases was nearly 100%. FNAC is particularly useful in cases of obstructive azoospermia, where mature spermatozoa are seen in smears.
Cytological typing of primary lung cancer: Study of 100 cases with autopsy confirmation
Authors: Dibonito Luigi , Colautti Isabella , Patriarca Silvia , Falconieri Giovanni , Barbazza Renzo , Vielh Philippe
Published: February 2007

In order to assess the accuracy of bronchial aspiration cytology in typing lung cancer, tissue sections from 100 autopsy cases of lung cancer were compared with the cytology features observed in the same patients prior to death. There was 100% accuracy in the cytology of small‐cell carcinoma; 90% in squamous‐cell carcinoma; 70% in adenocarcinoma; and 50% in undifferentiated large‐cell carcinoma. The observed discrepancies probably reject intrinsic tumor properties rather than problems attributable to either the bronchial aspiration method or cytology interpretation, especially in cases involving advanced lung carcinoma. Because the highest accuracy rate was in detecting small‐cell carcinoma, it is recommended that only the distinction between small‐cell and non‐small‐cell forms be made on cytologic grounds and that further categorizations only be rendered in cases with unquestionable cytomorphological features.
Carcinoembryonic antigen in fine‐needle aspirate of liver: A diagnostic adjunct to cytology
Authors: Pinto Marguerite M. , Monteferrante Mark , Kaye Alan D.
Published: February 2007

Carcinoembryonic antigen (CEA) was measured in 50 consecutive fine‐needle aspirates of liver to determine whether elevated levels could predict the presence of carcinoma in cytologically negative aspirates. There were 44 malignant and 6 benign lesions. The highest mean CEA values (591–672 ng/ml) were obtained in metastatic adenocarcinoma of the colon, stomach, and pancreas; lower levels (13.5–151 ng/ml) were found in metastatic carcinoma from the breast and lung. Carcinoid, hepatoma, Hodgkin's disease, and benign liver aspirates had low (<5 ng/ml) CEA levels. Cytologic diagnosis of malignancy was 96% sensitive and 100% specific. Using 5 ng as a cutoff for malignancy, the overall sensitivity of CEA for detection of malignancy was 77%; for detection of adenocarcinoma alone, sensitivity was 85%. Specificity was 100%. The CEA content of fine‐needle aspirates generally exceeded serum values by 10–100‐fold. Although CEA content did not enhance the sensitivity of cytologic diagnosis, it may suggest metastatic carcinoma of the GI tract in patients presenting with adenocarcinoma of an unknown primary source.
Clinical prevalence of glomerular hematuria: A nine‐year retrospective study
Authors: Pellet Hélène , Buenerd Annie , Minaire Eliette , Lacavalerie BÉAtrice , Donne Chantal
Published: February 2007

The authors evaluated red blood cell (RBC) morphology by phase contrast microscopy and identified casts and lipidic material in 4,448 urine sediments (US). Microhematuria was discovered on systematic examination in 1,186 apparently healthy patients (group I). Another 4,362 patients (group II) with microscopic or gross hematuria were being treated or evaluated for various renal or extrarenal diseases (renal transplantation excepted). Glomerular hematuria (GH) was observed in 93.1% of group I patients and in 58.0% ofgroup II patients. GH and non‐GH were observed together in 0.6% of cases. The origin of hematuria remained uncertain in 11.6% of cases, In GH, the other cytological findings were as follows: RBC casts were seen in 5.3% of group I and 20.5% of group I; granular and/or cellular casts were seen in 12.8% of group I and 39.6% ofgroup II; and lipidicmaterial was seen in 0.6% of group I and 8.8% of group II. Both groups showed a higher frequency of RBC casts, granular and/or cellular casts, and lipidic material in patients under 20. This method of investigation of urine, which is simple, rapid, inexpensive, and noninvasive, provides useful information for the clinician and avoids unnecessary investigations.
Cytology of treated and minimal Pneumocystis carinii pneumonia and a pitfall of the grocott methenamine silver stain
Authors: Naryshkin Sonya , Daniels Joan , Freno Elaine , Cunningham Larry
Published: February 2007

To clarify the role of foamy alveolar casts (FACs) in the diagnosis of Pneumocystis carinii pneumonia (PCP), we retrospectively reviewed Papanicolaou (Pap)‐ and Grocott methenamine silver (GMS)‐stained slides from 205 bronchial specimens submitted for suspected opportunistic lung infection. FACs containing sporozoites were seen in 86 cases, all with positive GMS. FACs were absent in 119 cases with negative GMS. In patients previously treated for PCP, Pap showed FAC‐like material which lacked sporozoites. GMS demonstrated clumped degenerated Pneumocystis carinii (PC) cysts. In 17 GMS‐positive cases there were no FACs on Pap due to sampling error and low burden of organisms. Morphologic features of macrophages in these cases can suggest the presence of PC. When FACs are lacking, a special stain is required. When GMS is used, the control must contain PC to avoid a false negative GMS. The inconsistent uptake of GMS by PC is a pitfall which is distinct from sampling error and which to our knowledge has not been previously reported.
Fine‐needle aspiration cytology in a case with features of chronic granulomatous disease
Authors: Drut Ricardo
Published: February 2007

Fine‐needle aspiration cytology (FNAC) of enlarged cervical lymph nodes of a 9‐yr‐old boy complaining of progressive weight loss showed a combination of a necrotizing granulomatous process and pigmented histiocytes. The diagnosis of chronic granulomatous disease (CGD) of childhood was proposed, and it was later confirmed by histology. Although the NBT test was negative, the patient responded well to prolonged bactericidal therapy with trimethoprim‐sulfamethoxazole associated with parenteral nutrition, indicating a rare case of CGD with a negative Nitro‐Blue Tetrazolium (NBT) test. The cytologic findings appear to be unique for this disease.
Papillary carcinoma of the thyroid with anaplastic transformation: Diagnostic pitfalls in fine‐needle aspiration biopsy
Authors: Vinette Danielle S. J. , Macdonald Laurie L. , Yazdi Hossein M.
Published: February 2007

A case of coexistent papillary and anaplastic carcinoma of the thyroid is presented. The diagnosis of papillary carcinoma was made by fine‐needle aspiration biopsy (FNAB); however, it did not correspond to the aggressive clinical behavior of the tumor. Subsequent biopsies revealed anaplastic carcinoma in the thyroid and pretracheal tissue. This case most likely represents anaplastic transformation in a pre‐existing papillary carcinoma. The limitations of diagnosing this entity by FNAB as well as some possible solutions are discussed.
Diagnosis of pulmonary blastoma by fine‐needle aspiration biopsy: Cytologic and immunocytochemical findings
Authors: Cosgrove Michele M. , Chandrasoma Parakrama T. , Martin Sue Ellen
Published: February 2007

A preoperative diagnosis of pulmonary blastoma was established by fine‐needle aspiration (FNA) cytology in a patient who presented with a pulmonary mass discovered incidentally on chest x‐ray. At the time of computed tomography‐guided FNA, an on‐site preliminary diagnosis of poorly differentiated carcinoma was made after examination of a rapid hematoxylineosin (H a E)‐stained smear. Malignant epithelial and stromal elements could be demonstrated on smears subsequently stained with the H&E, Papanicolaou, and Diff‐Quik methods. The cell block preparation showed a distinctly biphasic malignant tumor with classic morphologic features of pulmonary blastoma. We present the clinical, cytologic, immunocytochemical, and histologic findings of this case and re‐emphasize the valuable contribution of adequate cell block preparations to accurate diagnosis of fine‐needle aspiration material.
Diagnosis of hepatic actinomycosis by fine‐needle aspiration
Authors: Granger John K. , Houn Houn‐Yee David
Published: February 2007

A 48‐yr‐old white female with a 20‐yr history of intrauterine device use presented with signs and symptoms suggestive of a disseminated neoplasm with a pelvic primary. A definitive diagnosis of disseminated actinomycosis was made on the basis of computed tomography‐guided fine‐needle aspiration of a liver lesion. Subsequent laparotomy revealed involvement of the endometrium and of the ovaries and uterine tubes bilaterally. This article indicates the usefulness offine‐needle aspiration in the diagnosis of actinomycosis in this case.
Malignant lymphoma in pleural effusions: An immunocytochemical cell surface analysis
Authors: Guzman Josune , Bross Klaus J. , Costabel Ulrich
Published: February 2007

Nine malignant pleural effusions due to lymphoma were immunocytochemically analyzed with the peroxidase‐antiperoxidase adhesive slide assay for detection of cell surface antigens using a broad panel of monoclonal antibodies. The study population included one case of hairy‐cell leukemia; four cases of B cell non‐Hodgkin's lymphoma (B‐NHL), low malignant grade; two cases of B‐NHL, high malignant grade; one case of Hodgkin's disease; and one case of plasmacytoma. In the cases of B cell lymphoma, high percentages of B cells with monoclonal staining for kappa were found. In hairy‐cell leukemia, the hairy cells reacted with the monoclonal antibodies CD20, CD25, HLA‐DR, CD45, and HLA‐1. In Hodgkin's disease, the Hodgkin cells reacted with CD15, CD20, CD25, CD30, Tü9, and OKT9. The plasmacytoma case showed tumor cells negative for CD20, HLA‐DR, and CD45; partially positive for CD38; positive for HLA‐1; rnonoclonally positive for lambda; and negative for heavy‐chain immunoglobulins. The analysis of nonmalignant lymphocyte subpopulations revealed CD4/CD8 ratios similar to those in effusions of other etiologies. The percentages of natural killer cells (Leu‐7‐positive and CD16‐positive) were small and also similar to percentages in effusions of other etiologies. We conclude that immunocytochemical analysis of pleural effusions allows a clear recognition of B lymphoma cells and also of Hodgkin and hairy cells and that the distribution of nonmalignant lymphocyte subsets is indistinguishable from those found in other malignant and nonmalignant effusions.
Fine‐needle cytology of the breast: A controlled study of aspiration versus nonaspiration
Authors: Ciatto Stefano , Catania Salvatore , Bravetti Patrizia , Bonardi Rita , Cariaggi Paola , Pacifico Emma
Published: February 2007

We report on 534 breast masses examined by fine‐needle aspiration cytology. Two samples were obtained from each mass, one with aspiration and the other without. Aspiration, equivalent to that obtained by a 20‐ml syringe on full aspiration, was obtained by an automatic aspirator. The two sampling modalities did not differ apart from aspiration and were compared in terms of inadequate sampling rates. The inadequacy rate was the same in 166 cancers (6.6%), whereas a signifcant difference was recorded in favor of aspiration (13.6 versus 24.4%) in 368 benign masses. When inadequate results were excluded, the accuracy of the two modalities was almost the same. Sensitivity was 97.4% and 96.7% and specificity was 99.4% and 99.3% for sampling with and without aspiration, respectively. Reducing the rate of inadequate sampling from benign masses seems to be the major advantage of aspiration. Double sampling, independent of the specific techniques, reduced inadequacy rates to very low levels (1.2% for cancers; 5.9% for benign masses) and may be useful as a routine policy.
Fine‐needle aspiration cytology of a renal cell adenocarcinoma with massive intracellular hemosiderin accumulation
Authors: Weaver Michael G. , Al‐Kaisi Nadia , Abdul‐Karim Fadi W.
Published: February 2007

The cytologic findings of a fine‐needle aspiration biopsy of a renal cell adenocarcinoma with massive intracellular hemosiderin accumulation are described. These findings have not been previously illustrated in the cytology literature. These features could also be observed in fine‐needle aspiration biopsies of renal cell adenocarcinoma metastases.
Rhabdomyosarcomatous differentiation in a neuroblastoma: A potential pitfall in the cytologic diagnosis of small round‐cell tumors of childhood
Authors: Layfield Lester J. , Glasgow Ben J.
Published: February 2007

Rhabdomyoblasts demonstrating immunoreactivity for musclespecific actin, desmin, and myoglobin were identified in smears obtained by aspiration from a large retroperitoneal mass in a 14‐mo‐old girl. Following a tentative diagnosis of a rhabdomyogenous neoplasm, retroperitoneal exploration and adrenalectomy demonstrated a stromal poor neuroblastoma with extensive rhabdomyogenous differentiation. The presence of a subpopulation of rhabdomyoblasts was not diagnostic of rhabdomyosarcoma when obtained by fine‐needle aspiration from a retroperitoneal tumor composed predominantly of primitive small round cells.
An approach to fine‐needle aspiration biopsy diagnosis of hepatic masses
Authors: Bottles Kent , Cohen Michael B.
Published: February 2007

After reviewing collection techniques and the cytology of normal and reactive hepatocytes, a systematic approach to the evaluation of fine‐needle aspiration biopsy smears of hepatic mass lesions is presented. One of the main problems facing the cytopathologist is the differentiation of cirrhosis from well‐differentiated hepatocel‐Mar carcinoma. Smears from patients with cirrhosis often contain clusters of bile duct epithelial cells and chronic inflammatory cells, while properly sampled hepatocellular carcinoma smears should contain no bile duct epithelial cells and few inflammatory cells. Key criteria which favor the diagnosis of hepatocellular carcinoma over cirrhosis are: increased nuclear to cytoplasmic ratio, trabecular pattern, and atypical naked hepatocytic nuclei. Key criteria which favor the diagnosis of primary hepatocellular carcinoma over metastatic disease include polygonal cells with centrally placed nuclei, cells separated by sinusoidal capillaries, and bile. This systematic approach to the evaluation of hepatic fine‐needle aspiration biopsies must be used with the realization that other uncommon mass lesions of the liver do exist vocal nodular hyperplasia, adenoma, hepatoblastoma, bile duct carcinoma, vascular tumors, mesenchymal tumors, and lymphomas).
Cytomorphologic features of sputum samples from marijuana smokers
Authors: Roby Tina J. , Hubbard Gayle , Swan Gary E.
Published: February 2007

Histopathologic evidence in recent literature suggests that habitual, heavy marijuana smoking causes changes in the bronchial airways similar to changes seen in older, habitual cigarette smokers. The cytologic effects of marijuana smoking on the bronchial airways were investigated utilizing a quantitative analysis of sputum. Levels of macrophages (pigmented and nonpigmented), neutrophils, mucus, mucous spirals, and columnar and benign metaplastic cells were measured. The presence or absence of dysplasia, “purse” cells, eosinophils, reactive bronchial lining cells, and benign bronchial hyperplasia was noted. Results were compared across three groups of 25 subjects each: never cigarette or marijuana smokers; marijuana only smokers; and in cigarette only smokers. Results indicate that cytomorphologic changes observed in habitual marijuana smokers are similar to changes observed in tobacco smokers and much different than those observed in nonsmokers. These cytologic findings are similar to those described in other studies from specimens obtained at bronchoscopy.
Cytologic interpretation of fine‐needle aspiration biopsies from clinically occult breast masses
Authors: Howell Lydia P. , Lindfors Karen K. , Russell Liisa A.
Published: February 2007

Fine‐needle aspiration biopsy (FNAB) was performed on 39 occult breast masses of soft tissue density using standard mammographic guidance. All malignant tumors were diagnosed as either positive or suspicious for carcinoma, and there were no false‐positive or false‐suspicious diagnoses. These excellent results can be attributed to accurate cytologic interpretation based on consideration of problems unique to these lesions and the sampling method, such as scantier cellularity, potentially less confidence in needle placement, and the nature of the occult mass itself. The team approach between pathologist, radiologist, and clinician is emphasized.
Intraocular fine‐needle aspiration biopsy of coronal adenomas
Authors: Glasgow Ben J.
Published: February 2007

The cytologic findings from intraocular biopsy of coronal adenomas of three previously surgically enucleated eyes were studied. Cohesive clusters of nonpigmented epithelial cells were observed. Clusters of epithelial cells were surrounded by characteristic intercellular matrix material. Coronal adenomas have been clinically mistaken for intraocular melanomas. It is important for pathologists to be familiar with the aspiration cytology of the coronal adenoma to avoid unnecessary enucleation or iridocyclectomy.
Cytologic findings in microglandular hyperplasia of the cervix
Authors: Yahr Laura J. , Lee Kenneth R.
Published: February 2007

A case of florid microglandular hyperplasia of the uterine cervix that contained cells with severe atypia suggesting malignancy on a Papanicolaou smear is reviewed. Findings from 25 additional smears from patients with microglandular hyperplasia are reported. These sometimes contained glandular cells with varying degrees of atypia, but demonstrated no features specific for microglandular hyperplasia. The distinction between markedly atypical endocervical cells sometimes exfoliated from microglandular hyperplasia and those of adenocarcinoma is discussed.
Diagnosis of salivary gland tumors by fine‐needle aspiration cytology: A review of clinical utility and pitfalls
Authors: Layfield Lester J. , Glasgow Ben J.
Published: February 2007

Fine‐needle aspiration cytology has become a frequently used technique for the diagnosis of neoplasms of the head and neck. While the method has a high sensitivity and specificity for the diagnosis of salivary gland lesions, important pitfalls for the cytologic diagnosis of these lesions exist. This paper discusses the diagnostic pitfalls and investigates strategies for the evaluation of salivary gland masses.
Aspiration cytology and immunocytochemistry of sacral chordoma with liver metastases: A case report
Authors: Perasole Antonio , Infantolino Domenico , Spigariol Francesco
Published: February 2007

We present the cytologic features and immunocytochemical profile of a case of sacrococcygeal chordoma metastatic to the liver. Cytologic diagnosis was suspected from the aspiration biopsy smears of the primary sacrococcygeal tumor and confirmed by histology. Further aspirates failed to reveal diagnostic physaliferous cells, and only undifferentiated spindle cells were obtained. Chordoma may lack physaliferous cells; in such cases, immunocytochemistry studies can greatly facilitate the diagnosis. This study confirms the utility of irnmunocytochemistry in the differential diagnosis of chordoma and tumors with similar cytologic characteristics.
Granulomatous mastitis secondary to histoplasmosis: Report of a case diagnosed by fine‐needle aspiration biopsy
Authors: Houn Houn‐Yee David , Granger John K.
Published: February 2007

A case of unilateral histoplasmal “granulomatous” mastitis diagnosed by fine‐needle aspiration biopsy (FNAB) is presented. The clinical presentation and mammographic findings were strongly suspicious for carcinoma. FNAB cytology showed a picture of necrotizing granuloma secondary to histoplasmosis. The lesion was treated with surgical excision and appropriate antifungal therapy. The differential diagnosis of granulomatous mastitis is discussed.
Fine‐needle aspiration of a solitary pulmonary nodule following treatment of metastatic giant‐cell tumor of bone
Authors: Powers Celeste N. , Bull Joan M. , Raval Pramila , Schmidt Waldemar A.
Published: February 2007

Giant cell tumor (GCT) of bone is a local, variably aggressive neoplasm with high local recurrence and occasional pulmonary metastases. Radiographically guided fine‐needle aspiration (FNA) plays a large role in establishing a tissue diagnosis of lung metastases prior to therapeutic intervention. We present a patient with histologically proven pulmonary metastases from a femoral grade II GCT. These lesions were obliterated with combination HT‐CT (hyperthermia and chemotherapy). The patient subsequently developed another pulmonary nodule at a site previously occupied by a GCT metastatic deposit. Radiographically guided FNA revealed that this new lesion was an adenocarcinoma, apparently of pulmonary origin. We suggest that this second neoplasm arose within a scar that developed after HT‐CT ablation of one of the metastases. Additional intriguing features of this case are the effective HT‐CT therapy of GCT metastatic to lung and the extended temporal course (some 16 yr from initial diagnosis to death).
Solitary pleural amyloid nodules occurring as coin lesions diagnosed by fine‐needle aspiration biopsy
Authors: Kaw Yao Tek , Esparza Alfredo R.
Published: February 2007

Solitary pleural amyloid nodule is rare and radiologically can mimic neoplastic lesions. This report describes two cases of this entity diagnosed by fine‐needle aspiration biopsy in patients without systemic amyloid deposits. The histologic, ultrastructural, and cytologic features are described.
Vaginocervical cytology in victims of sexual assault
Authors: Costa Michael J. , Tadros Talaat , Tackett Eva , Naib Zuher
Published: February 2007

To investigate the role of vaginocervical smears in alleged victims of rape, we reviewed the findings in 4,220 consecutive rape victims between the years 1982 and 1989. These rape victims showed a slight increase in cellular abnormalities (1.18% vs .93%) when compared to a group of 17,187 routine smears from an indigent population in 1989. While the differences in the spectrum of cellular abnormalities were not statistically significant, the increase in abnormal smears is remarkable because of the younger age distribution and lower risk factors for cervical cancer in this group of rape victims (41% of the victims were never seen at our institution before their evaluation for alleged rape and were most probably of higher socioeconomic status and at lower risk for cervical cancer than the indigent population served at our hospital). This finding may reflect the low incidence of vaginocervical cytology screening among the general population of which rape victims are a random sample. Fifty‐seven percent of the rape victims with cellular abnormalities who were also regular patients at our hospital returned for follow‐up by appropriate repeat smears or biopsies. This was lower than the 95% general follow‐up rate of vaginocervical smear abnormalities among the rest of the population screened at our hospital. We detected spermatozoa in 56% of the smears from victims who were examined within three days of the alleged sexual assault. Cytology adds to the criminal investigation of rape cases as we detected spermatozoa in four of 16 semen‐negative cases from a random sample of 53 cases evaluated by the state crime lab.
Needle aspiration cytology and lmmunocytochemical study in a case of angiosarcoma of the breast
Authors: Gupta Raj K. , Naran Sarla , Dowle Carl
Published: February 2007

A case of angiosarcoma of breast diagnosed by needle aspiration cytology (NAC) is documented. The signifcant features which enabled the NAC diagnosis included presence of spindly to polygonal malignant endothelial lining cells appearing as papillary tufts merging with solid areas, branching effects, and presence of microacinar structures lined with abnormal spindly to polygonal cells indicative of vasoformative structures.

Immunostaining for factor VIII and vimentin was strongly positive in the malignant spindly polygonal endothelial cells and further supported the NAC diagnosis. Similar findings were also seen in sections of cell blocks from aspirate and excised biopsy tissue from the breast tumor in hematoxylin‐eosin stained sections and on immunostaining. Despite the rarity of occurrence of angiosarcoma in the breast it was felt that its cytologic diagnosis is possible especially in cases in which the lesion is extensive because of a good chance of getting a cellular sample on aspiration. This can be of considerable value for deciding an appropriate management and as a possible guide to prognosis.