bluuebunny/crossref_metadata_2025 huggingface dataset:
Fine‐needle aspiration cytology in pancreatic endocrine tumors
Authors: Sneige Nour , Ordonez Nelson G. , Veanattukalathil Susan , Samaan Naguib A.
Published: February 2007

Pancreatic endocrine tumors (PETs) are relatively uncommon neoplasms. Although their histologic patterns have been widely studied, their cytologic features as they appear in fine‐needle aspiration (FNA) specimens have rarely been reported. In this study, aspirates of seven PETs, four primary and three metastatic lesions (two to liver and one to bone), are described. The tumors occurred in seven men ranging in age from 37 to 72 yr. Six tumors presented as nonfunctioning masses and one produced Zollinger‐Ellison syndrome. Three were located in the head of the pancreas and four in the body and tail. The pancreatic and liver aspirations were performed under computed tomographic guidance and the bone lesion, under fluoroscopy. The aspiration specimens were hypercellular. The tumor cells occurred singly and in small clusters. In three cases, there was a tendency toward acinar formations. In two cases, there were prominent, thin‐walled, branching blood vessels with tumor cells attached to the vascular walls. The cells were round or polygonal with a moderate amount of finely granular, well‐defined cytoplasm. The nuclei were eccentrically located and round‐to‐oval—with one or two small nucleoli and finely granular, evenly‐dispersed chromatin. The diagnosis was confirmed by immunocytochemistry (two cases) and electron microscopy (four cases) of the aspirated material and histology sections of the resected tumors (two cases). The results of this study demonstrate that FNA is a useful method to establish the diagnosis of PETs. Diagn Cytopathol 1987;3:35–40.
Epithelial membrane antigen in the cytodiagnosis of effusions and aspirates: Immunocytochemical and ultrastructural localization in benign and malignant cells
Authors: Walts Ann E. , Said Jonathan W. , Shintaku I. Peter
Published: February 2007

Immunoreactivity for epithelial membrane antigen (EMA) was evaluated in exfoliated benign and malignant cells using immunoperoxidase and immunogold techniques. In addition, protein A‐colloidal gold was used for ultrastructural localization of EMA. Our results suggest that EMA is useful in distinguishing adenocarcinoma cells (strongly positive) from reactive mesothelial cells (negative or weakly positive), lymphoid cells (negative), and a variety of nonepithelial neoplasms (negative) with which they may be confused. Exfoliated cells from two mesotheliomas were also strongly positive for EMA. Ultrastructurally, EMA was distributed in a dense, even, linear pattern along the cell membrane and microvillous surface processes of adenocarcinoma cells. A similar but sparse distribution pattern was observed in reactive mesothelial cells. These observations reflect the increased sensitivity and higher resolution of the immunogold technique. Diagn Cytopathol 1987;3:41–49.
Similarities and variations among lobular carcinoma cells
Authors: Antoniades Kristina , Spector Harvey B.
Published: February 2007

A cytomorphological description of lobular carcinoma of the breast is given based on imprints, paraffin‐embedded 5‐μ sections, and plastic‐embedded 2‐μ sections in nine patients. Both nuclear and cytoplasmic features are illustrated and tabulated. A basic lobular carcinoma cell is depicted. Cytoplasmic vacuolization is demonstrated in all tumors. Transitions from one lobular cell variation to another are demonstrated. It is suggested that more precise knowledge of the similarities and the variations in the morphology of the lobular carcinoma cell will help in both cytolagical and histological diagnosis. Diagn Cytopathol 1987;3:55–59.
Neuron‐specific enolase‐positive rosettes in nephroblastoma: A possible diagnostic pitfall in aspiration cytology
Authors: Drut Ricardo
Published: February 2007

Neuron‐specific enolase‐positive cells, some arranged in rosettes, were identified in smears obtained in fine‐needle aspiration of a left retroperitoneal tumor found in a 3‐yr‐old boy. Nephrectomy showed a typical nephroblastoma with a prominent blastemic component revealing a positive reaction for neuron‐specific enolase in blastemic and tubular components. Neuron‐specific, enolase‐positive, small malignant cells are not diagnostic of neuroblastoma when coming from a tumor of the retroperitoneum even if rosettes are present. Diagn Cytopathol 1987;3:74–76.
Retroperitoneal lymph node aspiration biopsy in staging of pelvic cancer: A cytological study of 228 consecutive cases
Authors: Cochand‐Priollet B. , Roger B. , Boccon‐Gibod I. , Ferrand J. , Faure B. , Blery M.
Published: February 2007

Knowledge of the status of the pelvic lymph nodes is important for accurate staging and adequate treatment of patients with genitourinary tract cancer (bladder and prostatic carcinoma, testicular tumors, and uterine carcinoma). A total of 228 consecutive patients underwent preoperative evaluation of the lymph node status by lymphangiography combined with fine‐needle aspiration biopsy. A lymphadenectomy was performed in 94 patients. The overall diagnostic accuracy was 93%. There were 5% false‐negative results and no false‐positive diagnoses. Fine‐needle aspiration biopsy is an inexpensive method with which to detect the presence of metastatic lymph nodes visualized by bipedal lymphangiography. It is also a safe and well‐tolerated method, with a low morbidity and no mortality. The various cytological features are described as are some possible pitfalls. Diagn Cytopathol 1987;3:102–107.
The use of immunoperoxidase panels for the cytologic diagnosis of malignancy in serous effusions
Authors: Silverman Jan F. , Nance Keith , Phillips Beth , Norris H. Thomas
Published: February 2007

The diagnostic value of an immunoperoxidase panel composed of antisera to carcinoembryonic antigen (CEA), epithelial membrane antigens (EMA), and high‐ and low‐molecular‐weight cytokeratins was evaluated on 39 consecutive pleural and peritoneal fluid specimens and correlated with routine cytologic and histochemical studies. The cases were classified into two groups: malignant (epithelial and small‐cell undiffer‐entiated carcinomas) and benign effusions. We found that the CEA and EMA antisera identified 91% and 100% of the epithelial malignancies, respectively. Mucin stains were positive in only 41% (mucicarmine) and 59% (Alcian blue) of these cases. The battery of cytokeratin markers identified malignant cells from 45%‐100% of the case but showed considerable positive staining of mesothelial cells. A selective review of the literature is presented along with recommendations for technical improvement in immunoperoxidase studies. We believe that an immunoperoxidase panel can be of considerable value in the cytologic diagnosis of epithelial malignancies in effusions. The panel composed of CEA and EMA can prove helpful in a routine cytology practice. Although the cytokeratin marker identified malignant cells, the concomitant immunostaining of mesothelial cells limits its utility. The commercially available panel can be a potential aid in improving the accuracy of serous fluid cytologic examination by decreasing both false‐positive and false‐negative diagnoses and thereby helping to prevent delays in diagnosis and treatment. Diagn Cytopathol 1987;3:134–140.
Fine‐needle aspiration cytology of terminal duct carcinoma of minor salivary gland
Authors: Frierson Henry F. , Covell Jamie L. , Mills Stacey E.
Published: February 2007

The cytologic features of terminal duct carcinoma of the palate, as observed in a fine‐needle aspiration specimen, are described and contrasted with the cytologic features reported for benign mixed tumor, basal‐cell adenoma, and adenoid cystic carcinoma. Terminal duct carcinoma, at times, may be difficult, if not impossible, to distinguish from adenoid cystic carcinoma in fine‐needle aspiration specimens. In most instances, this distinction may not be important. Diagn Cytopathol 1987;3:159–162.
Fine‐needle aspiration cytology of prostatic embryonal rhabdomyosarcoma: A case report
Authors: Henkes David N. , Stein Neil
Published: February 2007

Fine‐needle aspiration of the prostate has recently gained popularity as a reliable technique in the evaluation of prostatic nodules for malignancy. The cytologic features of adenocarcinoma have been described, but the features of other more unusual tumors have not been widely publicized. We report a case of embryonal rhabdomyosarcoma of the prostate gland with epithelioid cytologic features. Diagn Cytopathol 1987;3:163–165.
Meningeal metastasis of squamous‐cell carcinoma of the uterine cervix: Case report and review of the literature
Authors: Weithman Angela M. , Morrison Gideon , Ingram Ellis A.
Published: February 2007

Cervical squamous carcinoma metastatic to the central nervous system is an uncommon occurrence. Only eight such cases are reported in the literature. This is a case report of such a metastasis with emphasis on the cytologic features seen in the tumor cells found in the spinal fluid, along with a review of the literature. Diagn Cytopathol 1987;3:170–172.
Endometrial cytology: Six years of experience
Authors: Mencaglia Luca
Published: February 2007

This article deals with a 6‐yr mass screening program for the early detection of endometrial cancer, which took place 1978‐1983. The diagnostic accuracy of endometrial cytology and the possibility of integrating this technique with the hysteroscopy and endometrial biopsy were studied. The authors analyzed 2,504 outpatients, all over the age of 45. The results of endometrial cytology were compared with those found using hysteroscopy and endometrial biopsy. Endometrial cytology showed high sensitivity in diagnosing endometrial cancer (97.7%) and high specificity in diagnosing true negatives. However, this technique was not adequate in identifying benign endometrial pathology, e.g., endometrial hyperplasia, polyps, or submucous fibromas. Epidemiological and clinical data in our series were fundamental in establishing mass screening for the early detection of endometrial cancer using integrated techniques. These data should be taken into consideration for creating new projects. The significantly high prevalence of endometrial neoplasia even in asympomatic women over 45 years of age (4 per 1000) and the possibility of improving the accuracy of endometrial diagnosis using hysteroscopy and endometrial biopsy were the cornerstones of this project.
The cytological features and DNA content of cervical adenocarcinoma
Authors: Kudo Ryuichi , Sagae Satoru , Hayakawa Osamu , Kusanagi Tetsuya , Hashimoto Masayoshi
Published: February 2007

The relationship among cytological features, DNA content, and degree of histological differentiation of cervical adenocarcinoma was investigated in an attempt to discover a more accurate means of screening for this cancer. In highly differentiated adenocarcinoma (so‐called adenoma malignum), the nuclei were only somewhat more irregular in size and shape than those of normal columnar epithelial cells. The cells were arranged in slightly multilayered clusters. The cells of well‐differentiated adenocarcinoma were usually columnar in shape, and they exfoliated side by side in clusters. In moderately differentiated adenocarcinoma, solitary cells with markedly atypical nuclei were combined with multilayered cell clusters. The cells from poorly differentiated adenocarcinoma were roundish, occurred as solitary cells or irregularly overlapping cell clusters, and showed markedly atypical nuclei. As the degree of histological differentiation decreased, as determined by measurement of the DNA content of the cells, the DNA distribution covered a wider range in terms of ploidy, and the number of cells exceeding tetraploid DNA content increased.
Malignant carcinoid of the pancreas: A cytologic, ultrastructural, and immunocytochemical study of a case diagnosed by fine‐needle aspiration of a supraclavicular node metastasis
Authors: Khorsand Jila , Katz Ruth L. , Savaraj Niramol
Published: February 2007

Carcinoid tumor of the pancreas is extremely rare. This article describes the case of a 22‐yr‐old woman who manifested a typical carcinoid syndrome; a definitive diagnosis of a metastatic carcinoid tumor was made from needle aspiration of a supraclavicular lymph node using morphologic, immunocytochemical, and ultrastructural criteria. The carcinoid tumor was subsequently shown to be of pancreatic origin.
Subepithelial organisms in trichomonal cervicitis
Authors: Gardner William A. , Culberson Donald E. , Stafford Jesse R.
Published: February 2007

Trichomonas vaginalis is usually described as a surfacedwelling, noninvasive organism. Most studies of the pathogenicity of this organism have been derived from cytologic studies of uterine cervical epithelium. We employed specific immunoperoxidase techniques that allow the identification of organisms in cytologic and histologic specimens. In a case of trichomonal cervicitis these organisms were demonstrated both on the epithelial surface and in subepithelial tissues. Interpretations and implications of these findings are discussed.
Fine‐needle aspiration cytology of neoplastic cysts of the pancreas
Authors: Jones Edward C. , Suen Kenneth C. , Grant Dennis R. , Chan Norman H.
Published: February 2007

Herein is reported the cytologic features of four cases of cystic neoplasms of the pancreas as seen in fine‐needle aspirates. Cytologically, the cases fall into two distinct groups: mucinous cystic neoplasm and serous cystadenoma. The aspirates from the mucinous cystic neoplasms characteristically showed columnar mucus‐secreting epithelial cells, some of which were arranged in a papilloglandular pattern, with abundant mucous material in the background. The aspirates from the serous cystadenoma yielded small sheets of cuboidal cells with small nuclei and clear cytoplasm, without a background of mucous material. This cytologic division corresponds closely to the histologic classification proposed by Compagno and Oertel and hence is of prognostic and therapeutic value. The diagnostic challenges confronted by the cytopathologist are (1) to differentiate neoplastic cysts from the inflammatory pseudocysts; (2) to differentiate neoplastic epithelium from the normal epithelium of the bowel and pancreatic ducts; and (3) to differentiate mucinous cystic neoplasms from serous cystadenomas.
Fine‐needle aspiration biopsy in the diagnosis of metastases in the liver
Authors: Bizjak‐Schwarzbartl Marija
Published: February 2007

During the years 1975–1985, fine‐needle aspiration biopsy of the liver was performed in 655 patients. The procedure entailed no complications. In 302 (46%) cases, the samples contained malignant cells; in 238 (36%), liver cells; in 46 (7%), cells suspected of malignancy; in 69 (11%) of cases, the samples were unsatisfactory. The medical records of 242 patients were reviewed. Based on the results of different examinations, it was established that 149 patients had liver metastases and 62 did not. In 31 patients, evaluation could not be done owing to insufficient data. The cytological findings were compared with the results of liver scintiscan. Alcaline phosphatase, serum gamma‐glutamyltranspeptidase, and histological diagnoses. There were no false‐positive cytological diagnoses. False‐negative diagnoses were found in 14% of cases. Cytologically positive samples from known primaries were reviewed. It has been established that pallisade‐like formations are characteristic for metastases of intestinal carcinoma; usually in these cases, necrotic material and inflammatory cells were found as well. Diagn Cytopathol 1987;3:278‐83.
Aspiration cytology of lipomatous tumors: A 10‐year experience at an orthopedic oncology center
Authors: Åkerman Måns , Rydholm Anders
Published: February 2007

The cytodiagnoses of preoperative fine‐needle aspirate smears from 72 histologically proven lipomatous tumors (52 lipomas and 20 liposarcomas of varying type) collected during the 10‐yr period 1972–1981 were correlated to the corresponding histopathologic diagnoses. Three out of 52 lipomas were erroneously diagnosed as low‐grade malignant liposarcomas, and one out of 20 liposarcomas was falsely diagnosed as a benign soft‐tissue tumor. Of the 20 liposarcomas, 15 were cytologically diagnosed as such, and the majority of the myxoid and the pleomorphic liposarcomas were correctly diagnosed as to type. Important differential diagnostic problems were, on one hand, the separation of lipoma with regressive changes and histiocytic reaction and lipoma with chondroid metaplasia from low‐grade malignant liposarcoma and, on the other hand, liposarcoma from intramuscular myxoma, myxofibrosarcoma, and malignant fibrous histiocytoma. The differential diagnosis of liposarcoma as opposed to other soft‐tissue sarcomas is discussed, and it is concluded that preoperative fine‐needle aspiration of lipomatous tumors is of value in the management of these tumors. Diagn Cytopathol 1987;3:295–302.
Cytostructural localization of peanut lectin binding in fine‐needle aspirates of benign and malignant breast lesions
Authors: Henry Michelle J. , Horwitz Charles A. , Stanley Michael W.
Published: February 2007

Numerous studies have employed lectin binding patterns to investigate alterations in cell surface polysaccharide expression associated with malignant transformation. Cytostructural relocalization of peanut lectin (Arachis hypogaea) binding sites from the cell surface to the cytoplasm has been described in breast carcinomas. To investigate the possible utility of peanut lectin binding patterns in the diagnosis of breast fine‐needle aspirations, the PNA immunoperoxidase method was applied to smears from a group of 15 benign and malignant breast lesions. Cytostructural relocalization of PNA binding was seen in both benign and malignant breast lesions, indicating that it is of little diagnostic utility in the assessment of malignancy. This finding was noted in both cytologic and histologic preparations. Diagn Cytopathol 1987;3:310‐3.
Gangliocytic paraganglioma of the duodenum: Report of cytologic, histologic, immunohistochemical, and ultrastructural features of a case
Authors: Guarda Luis A. , Ordóñez Nelson G.
Published: February 2007

A case of gangliocytic paraganglioma of the duodenum is reported, including light microscopic, ultrastructural, and immunohistochemical characteristics. The cytologic appearance, as might be seen in fine‐needle aspiration smears, indicates a neoplasm with three cellular components (epithelioid, ganglion, and spindle cells) seen histologically by light and electron microscopy. Diagn Cytopathol 1987;3:314‐9.
Fine‐needle aspiration of fibromatosis of the breast
Authors: El‐Naggar Adel , Abdul‐Karim Fadi W. , Marshalleck Josephine J. , Sorensen Kelly
Published: February 2007

Percutaneous fine‐needle aspiration of breast fibromatosis yielded clusters of uniform spindle cells. The differential diagnosis of spindle stromal cells obtained by fine‐needle aspiration of the breast is discussed. This includes a wide spectrum of both benign and malignant breast lesions that have to be considered prior to suggesting the diagnosis of fibromatosis. Diagn Cytopathol 1987;3:320‐2.
Cytodiagnosis and monitoring of acute lymphocytic leukemia and eosinophilia in cerebrospinal fluid
Authors: Coleman Anne , Schumann G. Berry
Published: February 2007

A case of adult aleukemic leukemia with an isolated CNS relapse diagnosed by cytologic examination of the CSF is reported. CSF hypereosinophilia of uncertain significance was documented. Immunologic marker studies (CALLA, HTA, Tdt) were performed on the CSF and showed a null cell acute lymphocytic leukemia. Sequential CSF specimens were obtained to determine the continued presence of lymphoblasts. Cytologic monitoring of the CSF in acute leukemia is a useful technique to determine disease status and efficacy of therapy. We advocate the use of cell morphology for monitoring, reserving the use of cell markers for initial identification of malignant cells and for use when the cell morphology is altered. Diagn Cytopathol 1987;3:330‐4.
Aspiration biopsy cytology of mammary myoepithelioma
Authors: Nguyen Gia‐Khanh , Shnitka Theodor K. , Jewell Laurence D.
Published: February 2007

A case of ultrastructurally confirmed myoepithelioma of the breast studied by fine‐needle aspiration biopsy is reported. Aspirated tumor cells were spindle‐shaped with well‐defined cytoplasm and oval nuclei showing no remarkable nuclear pleomorphism. They were seen mainly in irregular bundles with strong cellular cohesiveness. Their cytoplasm contained S‐100 protein demonstrated by the peroxidase antiperoxidase staining technique. Diagn Cytopathol 1987;3:335‐8.
Cytomorphologic changes in split‐course radiation‐treated bronchogenic carcinomas
Authors: Albright Craig D. , Hafiz Mohammad A.
Published: February 2007

The cellular changes produced by radiation therapy were studied in cytologic specimens from seven patients with bronchogenic carcinoma: squamous‐cell carcinoma (four patients), adenocarcinoma (two patients), and small‐cell undifferentiated carcinoma (one patient). Cytologic samples were obtained from sputum and bronchoscopic examination in patients before and after they received a course of radiation. The cells were studied by light microscopy. An increase in the percentage of columnar cells was detected in five of seven patients independent of the latency of cytologic sampling posttherapy. The percentage of macrophages was unchanged in patients sampled at 15, 18, and 24 mo after the last radiation dose; leukocytes were decreased in relative frequency in the majority of patients studied. Following irradiation, moderately atypical and severely atypical metaplastic cells were increased in relative frequency (48% versus 15% and 19% versus 3%, respectively) and malignant cells were decreased (40% versus 22%) or absent in all patients, irrespective of the type of carcinoma. Nuclear vacuolation, nuclear enlargement, loss of chromatin texture, and rupture of the chromatinic rim were seen in atypical and cancer cells. Infiltration of cancer cells by leukocytes was observed in two of four patients with squamous‐cell carcinoma. In all treated patients, morphologic observations indicated that irradiation produces similar damage to “normal” bronchial epithelial cells although such changes are less apparent at longer time intervals following therapy.
Semiquantitative criteria for fine‐needle biopsy diagnosis: Reduced false‐negative diagnoses
Authors: Hamburger Joel I. , Husain Mujtaba
Published: February 2007

Adequate sampling is important to minimize the risk of false‐negative fine‐needle biopsy (FNB) diagnoses. This article reports a prospective study of the following criteria for adequacy of sampling for FNB benign diagnoses: at least six aspirates, at least two of which each contain at least six clusters of benign cells. Of 888 patients studied with FNB, 60 had FNB diagnoses of malignancy; 58 were surgically confirmed, and there was one false positive. Seven of eight nodules with diagnoses of suspected malignancy were excised; three were malignant. Fifty‐seven nodules had diagnoses of cellular or Hurthle‐cell adenomas; 35 were excised, and four were malignant. All 33 nodules excised after benign diagnoses (including Hashimoto's thyroiditis) were benign. Five of 23 FNBs with small numbers of benign cells were malignant, but false‐negative FNB diagnoses were avoided because of adherence to the proposed criteria for adequacy of sampling.
Cytologic diagnosis of papillary carcinoma of the breast in needle aspirates
Authors: Naran Sarla , Simpson John , Gupta Raj K.
Published: February 2007

Eleven cases of rare papillary carcinoma of the breast diagnosed by fine‐needle aspiration cytology (FNAC) are reported. Five of these were pure papillary carcinomas and six were mixed papillary and ductal, lobular, or mucinous carcinomas. In each case, cytological material was collected by washing the needle and syringe contents into 30% alcohol in saline, and the Gelman cytosieve method was used for the cytological preparations. In this article, the cytological features of these tumors are described, including the presence of single papillae and papillary clusters, tall columnar cells, diathesis of blood with hemosiderin‐laden macrophages, naked nuclei, and high cell recovery.
Immunocytological demonstration of HSV‐II antigen on exfoliated cells from precancerous and cancerous lesions of the uterine cervix
Authors: Gupta M. M. , Sharma B. K. , Singh Veena , Luthra Usha K.
Published: February 2007

Cancer of the uterine cervix is the most common malignancy among Indian women. Evidence has shown that cervical cancer is preceded by dysplastic, or precancerous, lesions. HSV‐II has been associated with this process of cervical carcinogenesis. We collected 167 cervical smears that had been diagnosed as normal, dysplastic, or carcinoma‐in‐situ and found a significantly high positivity of HSV‐II antigen in women with cervical dysplasia (38.8%) and carcinoma‐in‐situ (33.3%) versus women with normal cytology (17.02%). Latent HSV‐II infection of cervical epithelium may be considered of prognostic value to identify a population at high risk for cervical cancer.
Fine‐needle aspiration cytology of mesenchymal tumors of the breast
Authors: Silverman Jan F. , Geisinger Kim R. , Frable William J.
Published: February 2007

This report describes the fine‐needle aspiration (FNA) cytologic findings of 15 cases of sarcomas involving the breast out of a combined series of 2,064 breast FNA biopsies, including 580 malignancies, thereby accounting for 2.6% of all the malignant breast tumors. The series consisted of 14 women and one man with a mean age of 48.4 yr (range, 29‐63). There were eight cases of cystosarcoma phyllodes, including one malignant cystosarcoma phyllodes. Three benign cystosarcoma phyllodes had a significant concomitant atypical epithelial hyperplasia, which lead to a misdiagnosis of carcinoma in two of the cases. The third case was correctly identified as recurrent cystosarcoma phyllodes. In retrospect, features suggestive for cystosarcoma phyllodes and unusual for breast carcinoma include increased numbers of naked nuclei and hypercellular stromal fragments. Sarcomatous patterns in our four metaplastic carcinomas included chondrosarcoma (two cases), malignant fibrous histiocytoma (MFH) (one case), and fibrosarcoma (one case). Two additional pure primary MFHs (both of which had electron microscopic confirmation) and one metastatic fibrosarcoma to the breast were encountered. Recognition of unusual cytologic patterns for breast carcinoma should suggest the possibility of a primary or metastatic sarcoma to the breast. Potential pitfalls for misdiagnosis include the presence of atypical epithelial hyperplasia in some cases of cystosarcoma phyllodes, along with occasional cases having patterns indistinguishable from a fibroadenoma. The pleomorphic and bizarre cellular features can suggest the diagnosis of metaplastic and pure sarcomas of the breast, although the potential exists for confusion with very poorly differentiated carcinoma. FNA diagnosis of sarcomatous lesions of the breast is essential in order to insure proper surgical treatment.
Aspiration cytology and immunohistochemistry of an orbital aspergilloma
Authors: Oneson Ruth H. , Feldman Philip S. , Newman Steven A.
Published: February 2007

The results of fine‐needle aspiration (FNA) cytology combined with immunohistochemical staining of an orbital aspergilloma are presented. The cytologic findings included a tangled mass of hyphal elements and acute inflammation consistent with fungal disease. The slides were stained by the peroxidaseantiperoxidase method for Aspergillus sp. Positive staining confirmed the diagnosis of an orbital aspergilloma, and appropriate therapy was started.
Cytology of pleural effusions in rheumatoid arthritis
Authors: Montes Silvia , Guarda Luis A.
Published: February 2007

Rheumatoid pleural effusions are relatively uncommon. The cytologic examination of such effusions can be diagnostic of the underlying disease; this is of great clinical significance when the rheumatoid condition has not been diagnosed prior to the pleural involvement. The diagnostic cytologic abnormalities include large elongated and multinucleated giant cells and macrophages in a background of granular and necrotic debris. The cytologic characteristics parallel the histologic features of pleural rheumatoid nodules.
Immunocytochemical demonstration of glial fibrillary acidic protein in imprint smears of human brain tumors
Authors: Iwa Nobuzo , Yutani Chikao , Ishibashi‐Ueda Hatsue , Katayama Yoshiaki
Published: February 2007

Papanicolaou‐destained imprint smears from 24 brain tumors were investigated by means of avidin‐biotin‐peroxidase complex method (ABC) with the use of monoclonal antibodies against glial fibrillary acidic protein (GFAP). Positive staining reaction to GFAP antibody has been demonstrated in cells from the following tumors: astrocytoma, anaplastic astrocytoma, glioblastoma multiforme, mixed glioma, and ependymoma. The reaction for GFAP was negative for the following tumors: medulloblastoma, neurilemmoma, melanoma, hemangioblastoma, and metastatic tumors. In astrocytoma, the cell bodies and processes were positive with delicate fibrillary patterns; in anaplastic astrocytoma, cytoplasm and the processes were intensively stained. In glioblastoma multiforme, the staining patterns were also mixed, and the short, thickened processes were characteristic. Use of both a smear preparation and the immunoperoxidase staining technique is of great value in diagnosis of tumors of the central nervous system.
Nasal cytology in allergic processes and other syndromes caused by hyperreactivity
Authors: Rivasi Francesco , Bergamini Giuseppe
Published: February 2007

The spontaneous nasal secretions from about 128 patients with the symptomatic triad of rhinorrhea, sneezing, and nasal obstruction were studied. The cytological examination consisted of a morphological evaluation and a semiquantitative evaluation. Noncellular and nonliving presences in the smears have been considered, including mucus, Charcot‐Layden crystals, and pollen grains, as well as fungi and bacilli. We found a net increase in eosinophils, goblet cells, and cellular debris in secretions of atopic patients. Pollen grains and vegetative fragments were present in the nasal smears of pollinosis. The presence of fungi was observed in five cases of allergic rhinopathy. The exfoliative cytology represents a valuable means for the differential diagnosis of rhinitis. In particular, the presence of noncellular elements has value regarding rhinocytology.
Diagnosis of Pneumocystis carinii pneumonia by cytologic evaluation of papanicolaou‐stained bronchial specimens
Authors: Dugan John M. , Avitabile Ann M. , Rossman Milton D. , Ernst Carolyn S. , Atkinson Barbara F.
Published: February 2007

To evaluate the sensitivity and specificity of diagnosing Pneumocystis carinii pneumonia (PCP) by Papanicolaou‐stained bronchial brushing and wash/lavage specimens obtained by fiberoptic bronchoscopy, the cytologic preparations and clinical records from 58 immunocompromised patients were reviewed. Bronchial brushings and wash/lavage specimens were examined using methenamine silver (Grocott) and Papanicolaou stains. Pneumocystis carinii pneumonia was recognized with Papanicolaou stain by identifying distinctive alveolar casts, which frequently contained collections of encysted sporozoites. Thirty cases of PCP were identified, and Grocottstained bronchial wash/lavage specimens were positive in 29 instances (97%). Grocott staining of the transbronchial biopsy was positive for PCP in 18 of 22 specimens (82%). Bronchial brushings were insensitive, yielding a positive specimen in only 30% of cases of PCP. Alveolar casts of PCP were identified by Papanicolaou‐stained slides of wash/lavage specimens in 83% of cases of Pneumocystis pneumonia. These proteinaceous alveolar casts were not seen in other pulmonary disorders. Encysted sporozoites were found in 56% of cases in which Papanicolaou‐stained alveolar casts were identified. We conclude that the diagnosis of PCP can be made rapidly and reliably on the Papanicolaou‐stained bronchial wash/lavage or bronchial brush specimens by detecting the characteristic alveolar casts, which contain P. carinii–encysted sporozoites. The presence of encysted sporozoites within alveolar casts is pathognomonic for PCP, and methenamine silver stains can be eliminated in those cases in which encysted sporozoites are identified.
Foamy alveolar casts: Diagnostic specificity for Pneumocystis carinii pneumonia in bronchoalveolar lavage fluid cytology
Authors: Stanley Michael W. , Henry Michelle J. , Iber Conrad
Published: February 2007

Pneumocystis carinii pneumonia (PCP) is a major infectious complication of immunodeficiency states, including the acquired immunodeficiency syndrome (AIDS). Bronchoalveolar lavage (BAL) is a safe and effective procedure for making this diagnosis. In addition to the characteristic organisms, both histologic and cytologic material often reveals exudate in the form of foamy alveolar casts (FACs). To test the diagnostic utility of FACs in BAL fluids, we compared 20 PCP‐positive and 28 PCP‐negative fluids as assessed by silver stains. All PCP‐positive fluids contained FACs on Papanicolaou‐stained material. Only one PCP‐negative lavage contained FACs, and transbronchial biopsy in this case revealed PCP. We suggest that FACs in BAL fluids are highly sensitive and specific for the diagnosis of PCP.
Familial hemophagocytic lymphohistiocytosis
Authors: Lachman Mary F. , Vogel Edward H. , Kim Kitai
Published: February 2007

The cytologic features of familial hemophagocytic lymphohistiocytosis in two infant siblings were reviewed and compared to the histopathologic features in the same cases. The cytologic features of familial hemophagocytic lymphohistiocytosis in imprint smears from the spleen, lymph nodes, and liver were distinct, with proliferation of benign histiocytes engulfing erythrocytes and platelets. Hemophagocytic activity was more readily identifiable in imprint smears than in paraffin‐embedded histologic sections. The differential diagnosis of histiocytic proliferative syndromes is also discussed.
Cytologic diagnosis of adenoid cystic carcinoma in tracheal wash specimens
Authors: Buchanan Andrew J. , Fauck Robert , Gupta Raj K.
Published: February 2007

Two examples of primary adenoid cystic carcinoma of the trachea are described in which the cytologic diagnosis was made from tracheal washings. It is easy to confuse adenoid cystic carcinoma with the more common small‐cell neoplasms of the respiratory tract; however, if differential features are kept in mind, such a distinction can be made in the cytologic material. Differential features include cohesive, globular, honeycomb‐like arrangements of cells lacking nuclear molding, three‐dimensional cell groups with ball‐like formations, and clusters of uniform cells with cystic spaces, some containing mucus. These features in both of our cases resulted in unequivocal cytologic diagnoses.
Metastatic transitional‐cell carcinoma to the mandible: A case report
Authors: Weithman Angela M. , Morrison Gideon , Hurt Mark A.
Published: February 2007

Transitional‐cell carcinoma to the mandible is an uncommon occurrence. Only three cases have been reported in the literature. This is a case report of such a metastasis, the first diagnosed by fine‐needle aspiration. Emphasis is placed on the cytologic features of the tumor cells.
Fine‐needle aspiration of spleen: Diagnosis of a solitary ovarian metastasis
Authors: Nosanchuk Jerome S. , Tyler William S. , Terepka Raymond H.
Published: February 2007

We report a patient in whom a solitary splenic lesion detected by computed tomography (CT) was successfully diagnosed by fine‐needle aspiration biopsy under CT guidance. The ability to distinguish metastatic carcinoma from lymphoma in the spleen assisted the clinician in making therapeutic decisions. Fine‐needle aspiration of spleen is a reasonable diagnostic approach that has been underutilized.
Fine‐needle aspiration cytology of pediatric patients with primary hepatic tumors: A comparative study of two hepatoblastomas and a liver‐cell carcinoma
Authors: Dekmezian Roupen , Sneige Nour , Popok Steven , Ordóñez Nelson G.
Published: February 2007

The cytologic features of fine‐needle aspirates (FNA) of two hepatoblastomas (HBs) and a liver‐cell carcinoma (LCC) occurring in three children, ages 1, 3, and 14 yr, are presented. Electron microscopic features of one of the HBs and the LCC are also included. The HBs displayed single or small aggregates or larger clusters of cells with a high nuclear‐cytoplasmic ratio and usually round, hyperchromatic nuclei with single, and occasionally double, prominent nucleoli. In addition, one patient had extramedullary hematopoiesis; both had osteoid‐like material. These findings were very helpful in differentiating the HB cases from the LCC case, which had features similar to those of adult hepatocytes, including the presence of abundant, finely granular cytoplasm. Ultrastructural studies showed an absence of differentiation into adult hepatocytes in the HB, with scant organelles, rare bile canaliculi, lakes of glycogen, and rare lysosomal bodies. In contrast, the LCC showed features similar to adult hepatocytes, such as abundant cytoplasmic organelles, lysosomes, and bile canaliculi. In addition, intranuclear pseudoinclusions caused by cytoplasmic invagination were present in the LCC but not in the HB. Fine‐needle aspiration of hepatic masses in children is a useful technique for rendering a diagnosis, especially in unresectable tumors. Ultrastructural studies on FNA material may be important in differentiating hepatoblastoma from hepatocellular carcinoma.
Clinical utility of head and neck aspiration cytology
Authors: Karayianis Sharon L. , Francisco Gary J. , Schumann G. Berry
Published: February 2007

Over the past 3.5 yr, we have examined 195 head and neck fine‐needle aspiration (FNA) specimens from three diverse medical settings. Specimens were collected in saline solution or Saccomanno fixative and processed using cytocentrifugation or membrane filtration. This allowed us simultaneously to perform cytologic evaluations, special stains, and immunologic marker studies from a single specimen. Good correlation between clinical experience with FNA and obtaining satisfactory specimens was demonstrated. Our sensitivity (89%) and specificity (94%) reflect problems associated with specimen collection in a training environment where clinician experience with the procedure is low. A definitive diagnosis was possible in most cases, and the treatment plan was often based on the FNA results. In patients without a history of a primary malignancy, a FNA done early in the clinical course helped direct the initial workup of the patient, saving time and expense.
The diagnosis of pulmonary small‐cell anaplastic carcinoma by cytologic means: A 13‐year experience
Authors: Caya James G. , Wollenberg Nancy J. , Clowry Lawrence J. , Tieu Thu M.
Published: February 2007

This article reports on a series of 432 patients with positive respiratory (sputum and bronchial) cytology and proven malignant respiratory tract disease as corroborated by detailed verification criteria; 54 of these patients were diagnosed as having small‐cell anaplastic carcinoma (SCAC). None of the 31 patients with autopsy‐and/or biopsy‐proven disease had false‐positive results for SCAC. Typing accuracy for SCAC versus non‐SCAC was 97.7% in the 263 patients with histologic confirmation of their respiratory tract disease. Twenty‐three of the 54 patients (42.6%) were treated for SCAC solely on the basis of positive cytology in the context of compatible clinical data. This finding underscores the great importance of proper specimen preparation, quality control procedures, and diligent clinical follow‐up in an era of heightened cost‐containment awareness when many patients with pulmonary SCAC will be treated on the basis of positive cytology not immediately confirmed by histologic methods. Diagn Cytopathol 1988;4:202–205.
Cytopathologic detection of chlamydia trachomatis in vaginopancervical (fast) smears
Authors: Gupta Prabodh K. , Shurbaji Muhammad S. , Mintor Lori Jo , Ermatinger Susan V. , Myers Joseph , Quinn Thomas C.
Published: February 2007

The value of the Papanicolaou‐stained vaginopancervical (Fast) smear in the detection of chlamydial infection has been disputed. We examined 116 satisfactory Fast smears from 203 women enrolled in the Johns Hopkins Fertility Control Clinic and compared tissue‐culture results with cytopathologic detection using various published morphologic criteria. All Chlamydia culture‐positive cases were reviewed, and certain cytologic features considered helpful in the detection of chlamydial infection in cervical smears obtained from this selected high‐risk population were identified. The changes that had the highest correlation with tissue culture included fine vacuolation ofmetaplastic endocervical cells, giving their cytoplasm a rarefied “moth‐eaten” appearance. Using these criteria, cytopathologic changes of chlamydial infection were observed in 24 of 28 cases of tissue‐culture‐positive cases and in 8 of 88 tissue‐culture‐negative cases. The sensitivity and specificity of the Fast‐smear cytodiagnosis of Chlamydia infection utilizing these morphologic changes and compared with tissue culture were 86% and 91%, respectively. Other cytologic features, including inflammatory background and intracytoplasmic structures consistent with initial and intermediate chlamydial bodies within the metaplastic cells, were found to be useful although less specific and less sensitive. The implications of these diagnostic features, the conditions to be considered in their differential diagnosis, and the pitfalls of chlamydial cytodiagnosis and the chlamydia culture studies have been critically reviewed. Study design and the high unsatisfactory cervical smear rate are discussed. Diagn Cytopathol 1988;4:224–229.
Fine‐needle aspiration cytology of pulmonary carcinosarcoma with immunocytochemical and ultrastructural observations
Authors: Finley James L. , Silverman Jan F. , Dabbs David J.
Published: February 2007

The cytologic, immunocytochemical, and ultrastructural features of a pulmonary carcinosarcoma diagnosed by fine‐needle aspiration biopsy are presented. Both malignant epithelial groups and bizarre spindle‐shaped cells arranged in loose groups, microtissue fragments and in a dissociate fashion showed dual immunoperoxidase staining with cytokeratins and vimentin. Although the immunocytochemical staining pattern is typical of this neoplasm, it does not allow differentiation in all cases from the more common primary large‐cell undifferentiated carcinoma, which can also show dual staining for cytokeratin and vimentin. However, the presence of poorly differentiated epithelial groupings associated with a malignant mesenchymal component set in a myxoid stroma should suggest the correct diagnosis. Cytologically, differentiating carcinosarcoma, a poorly differentiated malignancy showing dual staining for cytokeratin and vimentin, from a large‐cell carcinoma is important, since the former may pursue a more indolent clinical course.
Medullary thyroid carcinoma metastatic to breast diagnosed by fine‐needle aspiration biopsy
Authors: Ordóñez Nelson G. , Katz Ruth L. , Luna Mario A. , Samaan Naguib A.
Published: February 2007

We report a patient with a 22‐yr history of medullary thyroid carcinoma in whom fine‐needle aspiration biopsy of a breast mass, clinically suspected of being a primary mammary carcinoma, established the diagnosis of metastasis. This article demonstrates the importance of the use of immunocytochemical methods on fine‐needle aspirates to diagnose metastases to the breast.
Fine‐needle aspiration cytology of meningiomas with unusual presentations
Authors: Bose Shikha , Kapila Kusum , Sarkar Chitra , Verma Kusum
Published: February 2007

Meningiomas are not often aspirated unless they erode the skull, occur intraorbitally, or present as swelling in the head and neck region. We describe the cytologic findings of fine‐needle aspiration cytology (FNAC) in four cases of meningioma that presented with swellings in the head and neck region. The patients underwent surgery, and the diagnosis of meningioma was confirmed. Three of the four cases were reported as aggressive meningiomas on histopathology.
Malignant fibrous histiocytoma of bone: Initial diagnosis by aspiration biopsy cytology
Authors: Kannan Vaidehi , Ruden David Von
Published: February 2007

Aspiration biopsy cytology by fine needle is becoming a popular diagnostic procedure for soft‐tissue lesions; it also can be used successfully to diagnose some lesions from bone. The value of this procedure for making the initial diagnosis is illustrated by a case in which a malignant fibrous histiocytoma from a skull bone afflicted with Paget's disease was aspirated and interpreted as a sarcoma. This was later confirmed and subclassi‐fied by histology and electron microscopy from the tissue. Diagn Cytopathol 1988;4:262–264.
Cytologic indicators of condylomatous lesions of the uterine cervix with histologic correlation: An outpatient laboratory's experience
Authors: Selvaggi Suzanne M.
Published: February 2007

Human papillomavirus (HPV) is widely implicated as a primary etiologic factor in cervical carcinoma. Cytology plays an important role as the initial screening tool in the early detection of cervical lesions with koilocytotic features. The purpose of this study was to describe the various cytologic indicators of condylomatous lesions of the uterine cervix with histologic correlation. Cervical smears and biopsy specimens from 278 women seen in an outpatient clinical setting between January 1, 1985; and January 1, 1987, were reviewed. The histologic categories consisted of (1) flat condylomas with minimal cellular atypia; and (2) cervical intraepithelial neoplasia (CIN), I, II, or III with atypical koilocytosis. Cytologically in 57 cases, flat condylomas were composed predominately of koilocytes containing large perinuclear halos and dyskeratotic cells. In the 221 cases of CIN with atypical koilocytosis, the cervical smears were composed predominantly of atypical koilocytes with large hyperchromatic nuclei and small perinuclear halos; a variable number of koilocytes with large perinuclear halos; pleomorphic dyskeratotic cells; and abnormal multinucleated cells. Mild, moderate, or severely dysplastic/carcinoma‐in‐situ cells (CIS) were also present. An understanding of the cytologic features associated with condylomatous lesions of the cervix will enable the cytopathologist to alert the clinician of the need to perform colposcopy with the appropriate follow‐up treatment.
Cytology of embryonal rhabdomyosarcoma: A cytologic, light microscopic, electron microscopic, and immunohistochemical study of seven cases
Authors: Seidal Tomas , Walaas Lisa , Kindblom Lars‐Gunnar , Angervall Lennart
Published: February 2007

A correlated cytologic and histologic study of seven cases of embryonal rhabdomyosarcoma is presented. The diagnosis of rhabdomyosarcoma was established by light and electron microscopy and immunohistochemistry of the operative specimens. The cytologic appearance of the smears corresponded well with the histopathologic findings. Cytologically, two main cell types were distinguished: a predominant primitive, small round cell with scant cytoplasm and a large cell with an abundant cytoplasm, sometimes tadpole‐ or ribbon‐shaped. The tumor cells were often enclosed in a background of mucosubstances. The lack of cytologic features proving rhabdomyoblastic differentiation, such as cross‐striation, necessitates the use of additional methods in the cytologic diagnosis of embryonal rhabdomyosarcoma. The value of the embedding technique for ultrastructural analysis and immunohistochemistry in the demonstration of desmin in aspirates is emphasized in the diagnosis of embryonal rhabdomyosarcoma.