bluuebunny/crossref_metadata_2025 huggingface dataset:
Behavioral problems in relation to intelligence in children with 22q11.2 deletion syndrome: A matched control study
Authors: Jansen P.W. , Duijff S.N. , Beemer F.A. , Vorstman J.A.S. , Klaassen P.W.J. , Morcus M.E.J. , Heineman‐de Boer J.A.
Published: February 2007

The 22q11.2 deletion syndrome (22q11DS) is a genetic disorder associated with palatal abnormalities, cardiac defects, a characteristic facial appearance, learning difficulties, and delays in speech and language development. Various behavioral disorders and psychiatric illnesses have also been reported. There is much debate as to whether the behavioral problems are caused by factors such as medical discomfort, facial abnormalities or a lower intelligence, or whether they are independently related to the genetic abnormality (“behavioral phenotype”). We examined the relationship between intelligence level and behavioral problems. A group of 69 children with 22q11DS was compared with 69 children with craniofacial anomalies (CFA) using the child behavior checklist (CBCL). The matches between individual children were based on their total IQ scores. Use of the CBCL norm scores covered the corrections for age and sex. The group of 22q11DS children showed significantly more behavioral problems than the CFA group: this was especially apparent on the CBCL subscales “withdrawn,” “anxious/depressed,” “delinquent behavior,” “aggressive behavior,” “somatic complaints,” and “social problems.” We found no correlation between IQ score and behavioral problems in the 22q11DS group, which was remarkable because, comparable with the general population, intellectual disabilities were a predictor of behavioral problems in the CFA group. 22q11DS children with relatively higher IQs showed more problems of an internalizing than an externalizing nature, whereas the 22q11DS children with lower IQs showed various behavioral problems. The absence of a statistically significant correlation between intelligence and behavior problems in the group of 22q11DS children is tentative evidence for a 22q11DS behavioral phenotype. © 2007 Wiley‐Liss, Inc.
Intractable diarrhea with “phenotypic anomalies” and tricho‐hepato‐enteric syndrome: Two names for the same disorder
Authors: Fabre Alexandre , André Nicolas , Breton Anne , Broué Pierre , Badens Catherine , Roquelaure Bertrand
Published: February 2007

Tricho‐hepato‐enteric syndrome and syndromic diarrhea are quite rare conditions with only 15 patients described to date. Both include severe diarrhea requiring total parenteral nutrition, facial dysmorphism, immunity defect, and hair abnormalities (mostly trichorrhexis nodosa). A definite clear clinical description of the two syndromes is lacking; the outcome is also poorly known. Here, we report on two additional patients. Analysis of our observations together with a review of previously published cases suggests that patients with tricho‐hepato‐enteric syndrome and/or syndromic diarrhea actually have the same heterogeneous disease that has been incorrectly and confusingly separated into different entities. The acknowledgment that these two syndromes represent the same disease is a crucial step toward a better description of this syndrome and its outcome toward studies of the underlying genetic cause. © 2007 Wiley‐Liss, Inc.
Randomized clinical trial of radiofrequency-assistedversusclamp-crushing liver resection
Authors: Lupo L , Gallerani A , Panzera P , Tandoi F , Di Palma G , Memeo V
Published: February 2007

Background

Surgical resection remains the treatment of choice for primary and secondary liver cancer. Complications are mainly related to blood loss. Radiofrequency-assisted liver resection (RF-R) has been proposed for parenchymal division as an alternative to clamp crushing in order to reduce blood loss.

Methods

Fifty patients (median age 62 (range 30–82) years) undergoing hepatectomy were randomized to RF-R (24 patients) or the clamp-crushing method (26). In the RF-R group the resection plane was precoagulated by multiple insertion of a planar triple-cooled radiofrequency ablation needle, and then the parenchyma was sectioned using a scalpel.

Results

The two groups were well matched in terms of age, sex, liver disease and type of resection. There were no deaths. Eight in the RF-R group developed complications (abscess in six, biliary fistula in three and biliary stenosis in one) compared with none of those who had resection by the crush method (P < 0·001). Two patients with cirrhosis in each group developed decompensation. Blood transfusion was required in eight of 24 patients in the RF-R group and 13 of 26 in the clamp-crushing group (P = 0·079).

Conclusion

RF-R allows parenchymal resection in a clean surgical field but is associated with a higher rate of postoperative complications than the clamp-crushing technique.
Chemotherapy-associated hepatotoxicity and surgery for colorectal liver metastases
Authors: Zorzi D , Laurent A , Pawlik T M , Lauwers G Y , Vauthey J-N , Abdalla E K
Published: February 2007

Background

Preoperative systemic chemotherapy is increasingly used in patients who undergo hepatic resection for colorectal liver metastases (CLM). Although chemotherapy-related hepatic injury has been reported, the incidence and the effect of such injury on patient outcome remain ill defined.

Methods

A systematic review of relevant studies published before May 2006 was performed. Studies that reported on liver injury associated with preoperative chemotherapy for CLM were identified and data on chemotherapy-specific liver injury and patient outcome following hepatic resection were synthesized and tabulated.

Results

Hepatic steatosis, a mild manifestation of non-alcoholic fatty liver disease (NAFLD), may occur after treatment with 5-fluorouracil and is associated with increased postoperative morbidity. Non-alcoholic steatohepatitis, a serious complication of NAFLD that includes inflammation and hepatocyte damage, can occur after treatment with irinotecan, especially in obese patients. Irinotecan-associated steatohepatitis can affect hepatic reserve and increase morbidity and mortality after hepatectomy. Hepatic sinusoidal obstruction syndrome can occur in patients treated with oxaliplatin, but does not appear to be associated with an increased risk of perioperative death.

Conclusion

Preoperative chemotherapy for CLM induces regimen-specific hepatic changes that can affect patient outcome. Both response rate and toxicity should be considered when selecting preoperative chemotherapy in patients with CLM.
A unified particle model for fluid–solid interactions
Authors: Solenthaler Barbara , Schläfli Jürg , Pajarola Renato
Published: February 2007

We present a new method for the simulation of melting and solidification in a unified particle model. Our technique uses the Smoothed Particle Hydrodynamics (SPH) method for the simulation of liquids, deformable as well as rigid objects, which eliminates the need to define an interface for coupling different models. Using this approach, it is possible to simulate fluids and solids by only changing the attribute values of the underlying particles. We significantly changed a prior elastic particle model to achieve a flexible model for melting and solidification. By using an SPH approach and considering a new definition of a local reference shape, the simulation of merging and splitting of different objects, as may be caused by phase change processes, is made possible. In order to keep the system stable even in regions represented by a sparse set of particles we use a special kernel function for solidification processes. Additionally, we propose a surface reconstruction technique based on considering the movement of the center of mass to reduce rendering errors in concave regions. The results demonstrate new interaction effects concerning the melting and solidification of material, even while being surrounded by liquids. Copyright © 2007 John Wiley & Sons, Ltd.
Regio‐ and Stereoselective Intermolecular Oxidative Phenol Coupling in Kotanin Biosynthesis by Aspergillus Niger
Authors: Hüttel Wolfgang , Müller Michael
Published: February 2007

The intermolecular, regio‐ and stereoselective phenol coupling for the biosynthesis of the bicoumarin kotanin in Aspergillus niger has been investigated. Feeding experiments with singly and doubly 13C‐labeled monomeric precursors clearly proved that it is not the coumarin siderin but its hydroxy derivative, demethylsiderin, that undergoes phenol coupling. However, siderin is demethylated regioselectively to demethylsiderin and it is the latter that is coupled to the corresponding dehydrodimer, orlandin. The product is subsequently O‐methylated in a stepwise fashion to demethylkotanin and kotanin. Crude extracts were analysed by HPLC with chemically synthesized bicoumarins as reference compounds. This and a stereochemical analysis of the isolated bicoumarins revealed that A. niger produces exclusively the (P)‐atropisomers of the three 8,8′‐bicoumarins, kotanin, demethylkotanin, and orlandin. The absence of other monomeric or dimeric coumarins strongly suggests an intermolecular, regio‐ and stereoselective mode for the phenol‐coupling step.
Detection of herpesvirus cervicovaginitis by a sequential papanicolaou‐immunoperoxidase technique
Authors: Lozano Eloisa A. , Arce De , Bedrossian Carlos W. M. , Bedrossian Ursula K. , Reitmeyer William , Burgeois Paul Le
Published: February 2007

Herpes simplex virus (HSV) infection constitutes an immediate threat to the neonate of pregnant women who deliver vaginally, and thus requires a rapid, specific means of diagnosis that is easily applicable to cervicovaginal smears. We applied the peroxidase‐antiperoxidase technique to variously fixed, previously stained Papanicolaou smears from 60 women with HSV and 18 negative controls using an HSV‐2 antibody and either diaminobenzidine (DAB) or aminoethylcarbazol (AEC) as the chromogen and Mayer's, Gill's, or Lillie‐Mayer's hematoxylin as the counterstain. With Papanicolaou stain alone, there was adequate cytologic demonstration of either single cells in aggregates (11%), syncytial giant cells (40%), or both (49%) that displayed a ground‐glass appearance (68%), discrete nuclear inclusions (5%), or both (28%). With the peroxidase‐antiperoxidase technique, 57 of the 60 HSV specimens (95%) stained moderately or strongly positive for HSV‐2, as did sections of herpetic encephalitis and esophagitis. There was no false‐positive staining in any of the 18 control smears revealing koilocytosis, Chlamydia, or nonspecific vaginitis. Positivity of the immunostain was more vivid and evenly dispersed throughout the cytoplasm with AEC than with DAB, but tended to wash away with alcohol‐based counterstaining. In contrast, DAB was more stable, but was positive predominantly at the cell periphery and cytoplasmic processes. Lillie‐Mayer's stain provided the best counterstaining for the cytologic visualization of virocytes and accompanying inflammatory and epithelial cells, which revealed a minimal degree of atypia. The fixative used had no influence on the frequency or degree of immunopositivity of virocytes, but wet fixation with 95% alcohol or Carbowax led to less background staining than Spray‐Cyte®. The technique is sensitive, specific, reproducible, more cost‐effective, and less time‐consuming than the alternate methods of immunofluorescence, viral culture, and electron microscopy.
Smearing techniques for the concentration of particles from fine needle aspiration biopsy
Authors: Abele John S. , Miller Theodore R. , King Eileen B. , Lowhagen Torsten
Published: February 2007

Fine needle aspiration biospy of palpable masses yields a variety of specimens. Some are fluid, whereas others are semisolid; some contain numerous particles, whereas others contain no identifiable particulate fragments. Not surprisingly, no single smearing technique can reasonably be expected to provide good results with such a variety of specimens. This article describes a family of techniques, of which one or more are applicable to virtually any fine needle aspiration biopsy specimen. The techniques described and illustrated include the two‐step, one‐step, absorption, and watch‐glass techniques.
Cytopathology of follicular lesions of the thyroid gland
Authors: Kini Sudha R. , Miller J. Martin , Hamburger Joel I. , Smith‐Purslow M. Jane
Published: February 2007

Fine needle biopsy is generally considered unreliable in the differential diagnosis of follicular lesions of the thyroid gland. To test this hypothesis, we correlated fine needle biopsy diagnoses with surgical diagnoses in 379 follicular lesions. From nuclear characteristics (especially size) and the architectural pattern of tissue fragments, the following observations were made. Differentiation of goiters (including hyperplastic ones) from neoplastic thyroid disease is quite accurate and no more than 1 to 2% of cancers should be missed. The specific cytologic diagnosis of follicular carcinoma is 75% accurate, and that of follicular variant of papillary carcinoma is over 95% accurate. Of histologically proved follicular carcinomas, almost three‐quarters should be diagnosed as such or strongly suspected by fine needle biopsy. The remainder will be identified as cellular follicular adenomas, reaffirming the overlap of cytologic features of benign and malignant neoplastic disease. From cytologic and surgical pathologic data for each fine needle biopsy diagnosis of follicular lesion, a probability of cancer can be stated that is useful in management decisions.
Chondroid chordoma of the skull base diagnosed by squash‐smear technique
Authors: Nguyen Gia‐Khanh , Johnson Edward S. , Mielke Bruce W.
Published: February 2007

Squash‐smears of tissue from a chondroid chordoma arising from the skull base of a 26‐year‐old white man showed numerous single and clustered physaliferous cells with multiple intracytoplasmic vacuoles, and atypical cartilaginous cells in an amorphous myxoid background.
Effective use of bronchoscopy and sputa in the diagnosis of lung cancer
Authors: Bender Bruce L. , Cherock Maryann , Sotos Steven N.
Published: February 2007

The records of 134 patients who underwent bronchoscopy at the Forbes Health System hospitals between January 1, 1982 and December 31, 1983 were reviewed. The number of pre‐ and postbronchoscopy sputa obtained on each patient, final diagnosis, and follow‐up for 6 to 30 months were obtained. Tissue obtained at bronchoscopy yielded a diagnosis of malignancy in 71 of 84 (84.5%) patients who received that final diagnosis. Addition of postbronchoscopy sputa examination increased the yield to 73 of 84 (86.9%). Prebronchoscopy sputa contributed no diagnoses beyond those made by bronchoscopically obtained material. The cost to the patient of examining pre‐ and postbronchoscopy sputa in addition to bronchoscopically obtained cytologic and biopsy material is 70% higher than that of examining bronchoscopically obtained material alone. Indirect costs of increased hospital stay may also be significant. We propose early bronchoscopy without prebronchoscopy sputa in cases where there is clinical suspicion of lung cancer. Postbronchoscopy sputa should be obtained, but only processed for microscopic examination if the bronchoscopically obtained material does not yield a diagnosis.
Psammoma bodies and optically clear nuclei in bronchiolo‐alveolar cell carcinoma. Diagnosis by fine needle aspiration biopsy with histologic and ultrastructural confirmation
Authors: Silverman Jan F. , Finley James L. , Park H. Kim , Norris H. Thomas , Strausbauch Paul H.
Published: February 2007

The fine needle aspiration cytology of two cases of bronchiolo‐alveolar cell carcinoma of the lung having unusual features is reported. One case demonstrated numerous psammoma bodies in the cytologic smears, whereas the other case showed an abundance of cells with optically clear nuclei. Both peripherally located tumors were resected and confirmed as primary bronchiolo‐alveolar cell carcinoma by histologic and ultra‐structural examination. We believe this to be the first report describing these unusual features of bronchiolo‐alveolar cell carcinoma diagnosed by fine needle aspiration cytology. Presented is a discussion of psammoma bodies and optically clear nuclei seen in primary and metastatic tumors of the lung. This will aid in the diagnosis of these cases. Diagn Cytopathol 1985;1:205–15.
Cytologic diagnosis of extravesical malacoplakia
Authors: Chalvardjian Ara , Carydis Bessie , Cohen Sandra
Published: February 2007

Malacoplakia, a rare form of chronic granulomatous inflammation, most frequently involves the urinary tract of middleaged women. The disease represents an unusual inflammatory response to bacteria, most commonly Escherichia coli, and probably reflects some dysfunction in the immune system of the host. We describe two cases of malacoplakia involving in one patient the vagina and in the other the perianal subcutaneous tissue and lung. In both cases, the diagnosis was made concurrently by cytology and histologic examination of tissue sections. This, in turn, led to the institution of appropriate therapy with complete resolution of the disease. In smears, the characteristic von Hansemann histiocytes are larger than alveolar macrophages. They have a reticulated granular cytoplasm that is caused by excessive accumulation of lysosomal bodies, some of which upon mineralization give rise to the pathognomonic Michaelis‐Gutmann body. The latter, which is usually intracel‐lular, can be distinguished readily from psammoma bodies and should not be confused with yeasts. Diagn Cytopathol 1985;1:216–20.
Transthoracic fine needle aspiration of primary and metastatic sarcomas
Authors: Crosby John H. , Høeg Kari , Hager Bjarne
Published: February 2007

Sarcomas, excluding lymphomas, are relatively uncommon targets of transthoracic fine needle aspiration. This paper presents a series of 11 adult patients with a variety ofhistologically documented sarcomas that were positive on transthoracic fine needle aspiration. Most tumors were metastatic from extrathoracic primary sites. We summarize the cytologic appearances of the aspirates and the clinical roles of fine needle aspiration in this setting. The aspirates resembled the corresponding histologic sections in cellular morphology. Nine different histologic types of sarcomas therefore produced a wide variety of cytologic appearances. Two findings, though not specific for sarcomas, were common and are suggested as clues to the recognition of sarcomas: (1) poor cohesion of cells and (2) numerous spindle cells. Transthoracic fine needle aspiration confirmed a strongly suspected clinical diagnosis in 7 cases, and it clarified a more obscure clinical diagnosis in 4 cases. Suggestions are presented for differential diagnosis. Diagn Cytopathol 1985;1:221–7.
Functional parathyroid carcinoma cytology, histology, and ultrastructure of a case
Authors: de la Garza Sergio , de la Garza Estela Flores , Batres Francisco Hernández
Published: February 2007

A case of a functional parathyroid carcinoma that recurred 1 year after being resected is presented. The clinical and laboratory data and the histologic structure are presented with confirmatory electron microscopy. The preoperative aspiration biopsy showed findings suggestive of parathyroid carcinoma although simultaneous core biopsy results were reported as parathyroid adenoma. The differential cytologic diagnosis with thyroid neoplasms is discussed.
Gastric epithelial atypia following hepatic arterial infusion chemotherapy
Authors: Choi Hong Yul , Takeda Misao
Published: February 2007

A case of a gastric ulcer with epithelial atypia following hepatic arterial infusion chemotherapy (mitomycin C and 5‐fluoro‐2‐deoxyuridine) for a metastatic carcinoid tumor in the liver was observed. The gastric ulcer was endoscopically detected about 2 months after the initiation of the hepatic arterial infusion chemotherapy. The gastric epithelial atypia was severe enough to cause erroneous cytologic interpretation of the smear as a carcinoma. The cytologic and histologic appearance of chemotherapy‐induced epithelial atypia is described with special emphasis on possible diagnostic pitfalls in gastric cytology. Diagn Cytopathol 1985;1:241–4.
Clinician perception of fine needle aspiration cytology
Authors: Bottles Kent , Cohen Michael B. , Sacks Susan T.
Published: February 2007

Private practitioners in San Francisco were surveyed about their perceptions of fine needle aspiration cytology. The overall response rate was 60% (369/614). The responding group was uncertain about the utility of fine needle aspiration cytology in several specific clinical settings, but 83% (307/369) believed fine needle aspiration cytology will be used more extensively in the future. Diagn Cytopathol 1985;1:249–54.
Ultrastructural studies of malignant cells in fluids
Authors: Herrera Guillermo A. , Wilkerson James A.
Published: February 2007

An ultrastructural study was performed on 104 sequential fluids in which more than eight malignant cells per ten highpower fields were found by routine light microscopy. The study included fluids associated with mesotheliomas, melanomas, lymphomas, squamous‐cell carcinomas, small‐cell anaplastic (oat‐cell) carcinomas, and adenocarcinomas. Electron microscopic examination reliably separated lymphoid from epithelial malignancies and benign from reactive and malignant mesothelial cell proliferations. It also suggested or identified a primary site for the adenocarcinomas. Ultrastructural examination of fluids can be a valuable adjunct to routine light microscopy of cytology specimens. No false‐positive diagnoses were encountered. Sampling was the most significant limitation for this technique.
Application of monoclonal antibody 44‐3A6 in the cytodiagnosis and classification of pulmonary carcinomas
Authors: Banner Barbara F. , Gould Victor E. , Radosevich James A. , Ma Yixing , Lee Inchul , Rosen Steven T.
Published: February 2007

Thirty‐five pulmonary carcinomas were studied retrospectively with monoclonal antibody (MCA) 44‐3A6 raised against a human adenocarcinoma cell line. The antibody was applied to cytologic smears of bronchial brushings originally stained with the Papanicolau method, and to conventional tissue sections. Ten of 12 adenocarcinomas (ADC) immunostained strongly in sections and smears, as did five of seven large‐cell „undifferentiated”︁ carcinomas (LCUC). Eight neuroendocrine carcinomas (NEC) and eight squamous‐cell carcinomas (SCC) were negative, except for rare weakly positive foci. We conclude that MCA 44‐3A6 can be effectively applied on cytologic smears, and that it could be valuable in the precise classification of pulmonary carcinomas. The immunoreactivity of the ADC and SCC was predictable. Positive immunostaining in some LCUC confirms that these constitute a heterogeneus tumor class that includes cases that are phenotypically ADC despite the absence of obvious glands. Occasional immunostaining in NEC suggests focal exocrine differentiation as previously noted by electron microscopy. Diagn Cytopathol 1985;1:300–7.
Cytologic findings in peritoneal fluids from patients with ovarian serous adenocarcinoma
Authors: Kashimura Masamichi , Matsukuma Keita , Kamura Toshiharu , Matsuyama Toshitaka , Tsukamoto Naoki
Published: February 2007

The cytomorphotogic observations of peritoneal fluid from seven patients with ovarian serous adenocarcinomas are presented. Some different cytologic findings, including smaller cell and nuclear size, larger relative nuclear area, fewer cells with large discrete cytoplasmic vacuoles and macronucleoli, more frequent multinucleolation, and larger closely packed clusters of cells, were shown in serous adenocarcinoma of the ovary as compared with those in other types of ovarian malignant neoplasms. Although the materials of nonserous tumors are too limited for a valid comparative study, prediction of histologic types by the peritoneal fluid cytology will be possible if the close cytomorphologic studies are performed. Diagn Cytopathol 1985;1:13‐16.
Cytologic diagnosis of orbital and periorbital palpable tumors using fine‐needle sampling without aspiration
Authors: Zajdela A. , Maublanc De , Schlienger P. , Haye C.
Published: February 2007

Sixty‐two cases of orbital and periorbital palpable neoplasms were analyzed cytologically. The material was obtained by our technique of simply introducing a fine injection needle in the tumor mass without aspiration. Fifty‐six of these tumors had a subsequent histologic diagnosis by surgical procedure or biopsy. Forty‐nine of the 56 cytologic diagnoses (87%) were concordant with the histologic findings with regard to malignancy and its variety. In three other cases the diagnosis of malignancy was only achieved by surgical procedure or biopsy (5%). In two cases, there were false‐malignant results (4%), one corresponding to a meningioma and the other related to a reactive lymphoid hyperplasia. There was one false‐benign (2%) result in a case of non‐Hodgkin's lymphoma. In one patient, the cytologic material was insufficient for diagnosis (2%). In six other cases, the initial cytologic examination was ultimately confirmed either by biochemical studies or by biopsies of nodal metastases. No orbital hemorrhage was observed after fine‐needle sampling. This outpatient technique is highly accurate and permits diagnosis in a few minutes. Diagn Cytopathol 1986;2:17‐20.
Fine‐needle aspiration versus large‐needle biopsy or cutting biopsy in evaluation of thyroid nodules
Authors: Silverman Jan F. , West R. Lee , Finley James L. , Larkin Ernest W. , Park H. Kim , Swanson Melvin S. , Fore William W.
Published: February 2007

This report describes our experience with both fine‐needle aspiration (FNA) biopsies and large‐needle biopsies (LNB) or core biopsies (CB) performed at the same time on 23 patients out of a series of 309 patients examined by the FNA technique. There was no significant differences in diagnostic accuracy of tissue obtained with the FNA technique when compared with the LNB or CB biopsy technique. While FNA always yielded tissue adequate for diagnosis, the LNB, and/or CB technique yielded tissue insufficient for diagnosis in four of 26 biopsies (15.4%). We believe that the FNA is better able to sample a mass with fewer insufficient specimens. Using FNA, the diagnosis can be rendered more rapidly, at lower cost, and with decreased potential for complications. The adequacy of the FNA biopsies can be assessed immediately using a modified Wright stain (Diff‐Quik®). Repeat biopsies can be performed that better sample the lesions with increased patient acceptance. Diagn Cytopathol 1986;2:25‐30.
Diagnosis of cystic lesions of the pancreas: A biochemical and cytologic analysis of material obtained utilizing radiographic or intraoperative technique
Authors: Pinto Marguerite M. , Kaye Alan D. , Brogan Dennis A. , Criscuolo Elaine H.
Published: February 2007

The widespread use of imaging modalities may detect clinically unsuspected “pancreatic cysts” in which the differential diagnoses include pseudocysts, cystic neoplasms, necrotic carcinomas, abscesses, and, uncommonly, islet cell tumors. Accurate preoperative diagnosis requires clinical, radiologic, microbiologic, cytologic, and biochemical studies. Material obtained by fine‐needle aspiration from cysts can be triaged for cytology, amylase, and carcinoembryonic antigen (CEA) studies. The four cases described suggest that an elevated fluid CEA is specific for carcinoma, and an elevated amylase and negative CEA suggests pseudocysts, while both amylase and CEA are negative in abscesses. Thus, “cystic lesions of pancreas” can be accurately diagnosed in cases in which radiologic and cytologic studies are inconclusive. The routine inclusion of these tests with cytologic study should be encouraged to obviate unnecessary surgery for diagnostic purposes. Diagn Cytopathol 1986;2:40‐45.
A correlative cytologic and histologic study of malignant fibrous histiocytoma: An analysis of 40 cases examined by fine‐needle aspiration cytology
Authors: Walaas Lisa , Angervall Lennart , Hagmar Björn , Säve‐Söderbergh Johan
Published: February 2007

A correlative cytologic and histologic study of 40 cases of histologically highly pleomorphic malignant fibrous histiocytoma (MFH) is presented. The fine‐needle aspiration biopsy was performed preoperatively, and a diagnosis of malignant soft‐tissue tumor could be established in all cases. The cytologic and histologic features corresponded well with each other. The two main cell types were mono‐ and multinucleated, large polymorphic, often bizarre, histiocyte‐like cells and atypical fibroblast‐like cells. For a correct diagnosis of pleomorphic MFH, it is important to recognize atypical large polymorphic tumor cells showing signs of phagocytosis: prominent cytoplasmic vacuolization, cell debris or even well‐preserved cells within the tumor cell cytoplasm. Phagocytic activity was easily demonstrated in air‐dried and May‐Grünwald Giemsa‐stained material. The differential diagnosis of MFH as opposed to other soft‐tissue sarcomas and pleomorphic carcinomas is discussed. Diagn Cytopathol 1986;2:46‐54.
Parathyroid cytopathology
Authors: Davey Diane Davis , Giant Michael D. , Berger Eric K.
Published: February 2007

Cytologic criteria for diagnosing parathyroid adenomas and hyperplasia have not been elucidated. This report will present the cytomorphology of parathyroid tissue in the spectrum of normal, hyperplastic, and neoplastic states. We examined clinical needle aspirates from three patients with parathyroid lesions as well as 15 needle aspirations or touch preparations from surgical specimens. The series included three with hyper‐parathyroidism secondary to chronic renal failure, four with primary chief cell hyperplasia, nine with typical adenomas, and two with atypical adenomas. Normal parathyroid glands were also studied. Most parathyroid lesions could be distinguished from thyroid lesions by frequent thick fragments of cohesive cells with frayed edges and typical nuclear features. In general, the nuclei were small (6‐8 μ) and round with regular coarse granular chromatin. Occasional larger nuclei (10‐30 μ) with similar chromatin were observed in some cases. Oxyphil cells with abundant granular cytoplasm were present in some cases; one case with mostly oxyphil cells was difficult to differentiate from a thyroid neoplasm. Pseudocolloid was found in seven cases. Criteria for the differentiation between parathyroid hyperplasia and adenomas were not discovered. In addition, the cytology and differential diagnosis of atypical parathyroid adenomas are described and illustrated. Diagn Cytopathol 1986;2:76‐80.
Diagnosis of primary hepatic neoplasms by fine‐needle aspiration cytology
Authors: Suen Kenneth C.
Published: February 2007

This article describes the cytologic features of various primary hepatic neoplasms as seen in fine‐needle aspirates. Hepatocellular carcinoma can be differentiated from metastatic carcinoma by its tendency to recapitulate the characteristics of normal hepatocytes, namely, resemblance of the neoplastic cells to liver cells, growth in trabeculae, and bile production. Fibrolamellar hepatocellular carcinoma is characterized by larger, polygonal tumor cells with clearly defined cell outline, deeply eosinophilic granular cytoplasm, and extremely large solitary nucleoli. Lamellae of fibrocytes are seen dividing the tumor cells into small groups. Hepatocellular adenoma and focal nodular hyperplasia exhibit cells that are benign‐appearing or minimally atypical. Cholangiocarcinoma is an adenocarcinoma and cannot be differentiated from metastatic adenocarcinoma on purely morphologic grounds. Primary hepatic sarcoma is exceptionally rare and shows malignant spindle cells. Some inflammatory conditions such as abscess, cysts, and tuberculoma often present as space‐occupying lesions and should be included in the differential diagnosis of hepatic neoplasm. Diagn Cytopathol 1986;2:99‐109.
Malignant thymic neoplasms: Diagnosis by fine‐needle aspiration biopsy with histologic, immunocytochemical, and ultrastructural confirmation
Authors: Finley James L. , Silverman Jan F. , Strausbauch Paul H. , Dabbs David J. , West Robert L. , Weaver Michael D. , Norris H. Thomas
Published: February 2007

Two cases of malignant thymic neoplasms diagnosed by trans‐thoracic fine‐needle aspiration (FNA) biopsy under fluoroscopic and computerized axial tomography (CT) guidance with histologic, immunocytochemical, and ultrastructural confirmation are presented. The clinical and cytomorphologic features of the first case were typical of a malignant thymoma. A characteristic biphasic cell population of benign epithelial cells and mature lymphocytes was seen in Diff‐Quik‐ and Papanicolaou‐stained smears from the anterior mediastinal mass and the paravertebral metastasis and was confirmed by histologic examination. Immunoperoxidase studies for T and B cell subsets demonstrated lymphocytes with the thymic lymphocyte phenotype (Leu 6). Electron microscopic (EM) examination revealed epithelial cells with desmosomal attachments, tonofilaments, and extended cell processes along with mature lymphocytes. FNA biopsy of the second case demonstrated features of a thymic carcinoma. Individually scattered and loosely clustered small groups of markedly anaplastic and pleomorphic large cells were seen both in the Diff‐Quik‐ and Papanicolaou‐stained smears. EM performed on the FNA specimen demonstrated the poorly differentiated epithelial nature of the malignancy. The mediastinal mass was partially resected and demonstrated an undifferentiated carcinoma staining positively for low‐molecular‐weight cytokeratin. Ultrastructure demonstrated cell attachments and relationships consistent with carcinoma. The tack of a lung or other extrapulmonary primary tumor was consistent with a thymic carcinoma. These cases demonstrate the value of performing EM and immunocytochemistry on material obtained by fine‐needle aspiration, which can aid in establishing the correct diagnosis and facilitate the clinical management of patients with malignant thymic neoplasms. Diagn Cytopathol 1986;2:118‐125.
Exfoliative cytology of clear‐cell sarcoma metastases in pleural fluid
Authors: Nguyen Gia‐Khanh , Shnitka Theodor K. , Jewell Laurence D. , Wroblewski Julius A.
Published: February 2007

Two cases of clear‐cell sarcoma arising from the leg with widespread metastasis were reported. Exfoliated tumor cells in pleural effusions were round, oval, and slightly pleomorphic. They were seen singly or in clusters of variable size with marked cellular cohesiveness and molding. Their cytoplasm was well‐defined, clear, or finely granular, and contained S‐100 protein and periodic acid‐Schiff positive material that was digestible by diastase. Tumor‐cell nuclei were round and hyperchromatic with irregular chromatin clumping, and showed conspicuous nucleoli. Diagn Cytopathol 1986;2:144‐149.
Malignant melanoma in effusions: A source of false‐negative cytodiagnoses
Authors: Walts Ann E.
Published: February 2007

Melanoma, a not uncommon tumor, is associated with variable cytomorphology and unpredictable metastatic potential. Although most cytologic diagnoses of malignant melanoma represent metastatic disease, the diagnosis is frequently unsuspected clinically. Three effusions in which cells from metastatic melanomas were not diagnosed are described. Clinical factors that may have contributed to the erroneous cytodiagnoses are illustrated. Cytologic features and adjunctive studies that are helpful in identifying melanoma cells are discussed. Diagn Cytopathol 1986;2:150‐153.
Semiquantitative approach to csf cytopathology
Authors: Schumann G. Berry , Crisman Linda G.
Published: February 2007

During the past two years, our laboratory has introduced a semiquantitative membrane filter approach to cerebrospinal fluid (CSF) cytology. Five hundred and thirty‐five CSF specimens, averaging 3 ml in volume, were placed over 25‐mm diameter Milliporer̀ filters (5‐μ pore size) and stained using a modified Papankolaou method. Each microscopic evaluation consisted of a cell count per milliliter, a 100‐cell differential, and a diagnostic or interpretive statement. Seventy‐four (13.8%) positive, 17 (3.2%) atypical, 439 (82%) negative, and 4(1%) unsatisfactory specimens were evaluated. Seventy‐four percent of the positive or atypical CSF specimens had mononuclear cell counts within the medically accepted normal range of five mononuclear cells per cubic millimeter (chamber count method) or 5,000 cells per milliter (cytologic method). The small‐filter technique offered advantages because it maximized cell retrieval, localized cells, and shortened the time required for microscopic evaluation. Diagn Cytopathol 1986;2:194‐197.
The cytology of the normal cyclic endometrium
Authors: Coscia‐Porrazzi Luigi O. , Maiello Francesco M. , de Falco Maria L.
Published: February 2007

Endometrial cytologic samples obtained with Cohen's endocyte from 501 normally menstruating women were studied and correlated with histologic sections from cell blocks. In this article, the cytologic diagnostic criteria for normal cyclic endometrium are pointed out. The diagnostic accuracy of normal cyclic endometrium has been 92%. A possibility of a cytologic dating is discussed. The diagnostic accuracy was 71.8% for early proliferative endometria, 82% for late proliferative, 93% for early secretory, 81% for midsecretory, and 60% for late secretory endometria. Diagn Cytopathol 1986;2:198‐203.
Hyperplastic and neoplastic endocrine cells of the pancreas in aspiration biopsy
Authors: Nguyen Gia‐Khanh , Rayani Nargis A.
Published: February 2007

Aspiration biopsy of four primary endocrine tumors of the pancreas showed single and large sheets of tumor cells. Tumor cells were polygonal in shape with ill‐defined, filmy or granular cytoplasm and regular round nuclei containing a finely granular chromatin pattern and inconspicuous or prominent nucleoli. Focal gland‐like arrangement was seen in several sheets of tumor cells. Aspirate from liver metastases of an endocrine tumor of the pancreas showed single and clustered oval cells with granular cytoplasm and eccentrically located round and hyperchromatic nuclei. Smears prepared from aspirates of three fibrotic pancreata containing nodules of hyperplastic endocrine cells showed smaller fragments of endocrine‐cell epithelium with focal gland‐like arrangement. Individual hyperplastic endocrine cells displayed granular, filmy, and ill‐defined cytoplasm and round to oval hyperchromatic nuclei showing a finely granular chromatin pattern. Nuclear pleomorphism was noted in some cell groups. Diagn Cytopathol 1986;2:204–211.
Immunodetection of neuron‐specific enolase and keratin in cytological preparations as an aid in the differential diagnosis of lung cancer
Authors: Kyrkou Kalliopi A. , Latridis Sotirios G. , Athanassiadou Pauline P. , Lambropoulou Sofia , Liossi Anna
Published: February 2007

The results of neuron‐specific enolase (NSE) and keratin immunodetection in cytological specimens of sputum secured from 41 patients with lung cancer are presented. All 19 cases of small‐cell carcinoma showed intense immunoreactivity for NSE. No such immunoreactivity was found in 21 of 22 cases of non‐small‐cell carcinoma. The single positive result was from a case of large‐cell undifferentiated carcinoma. All 10 cases of squamous‐cell carcinoma showed immunoreactivity for keratin. The 19 cases of small‐cell carcinoma showed no such reactivity. Our findings indicate that immunostaining for NSE and keratin is a valuable aid when a definite diagnosis of small‐cell carcinoma of the lung can not be made on the basis of conventional cytologic features. Diagn Cytopathol 1986;2:217‐220.
Percutaneous fine‐needle aspiration biopsy of the pancreas
Authors: Bret Patrice M. , Nicolet Viviane , Labadie Michel
Published: February 2007

Percutaneous fine needle aspiration biopsy of the pancreas allows to obtain without surgery a tissue proven diagnosis of focal lesions of the pancreas. Ultrasound (US), computed tomography (CT), or fluoroscopy are used to guide the positioning of the needle in the lesion. Various benign and malignant lesions can be diagnosed and the cytologic features of them are presented. The average sensitivity of the technique in the diagnosis of pancreatic carcinoma is 80.5% in the literature. The use of percutaneous fine needle biopsy of the pancreas decreases the number of investigations to be done in a patient with pancreatic disease. Diagn Cytopathol 1986;2:221‐227.
Primary cytodiagnosis of peritoneal extramedullary hematopoiesis
Authors: Stephenson Robert W. , Britt Dawn A. , Schumann G. Berry
Published: February 2007

Cytologic examination of peritoneal fluid in a patient with known myelofibrosis and previous splenectomy revealed mega‐karyocytes along with erythroid and myeloid precursors. These findings were consistent with extramedullary hematopoietic (EMH) implants of the peritoneum. A few similar cases have been occasionally reported in the literature. This case represents an additional example of a primary diagnosis of peritoneal EMH in which therapy was based on the cytologic findings and sequential cytologic observations were made. Diagn Cytopathol 1986;2:241 243.
Ancient neurilemoma: A pitfall in the cytologic diagnosis of soft‐tissue tumors
Authors: Ryd Walter , Mugal Sanjida , Ayyash Khalid
Published: February 2007

A case of ancient neurilemoma (Schwannoma) is presented that, owing to a severe cell pleomorphism, was falsely interpreted as a malignant spindle‐cell sarcoma by fine‐needle aspiration cytology. Cytological features of the tumor are given together with its histopathology and electron microscopy findings. The usefulness of electron microscopy on material obtained by fine‐needle aspiration biopsies in the diagnosis of soft‐tissue tumors is discussed. Diagn Cytopathol 1986;2:244‐247.
Fine‐needle aspiration of metastatic sacrococcygeal myxopapillary ependymoma
Authors: Wahl Robert W.
Published: February 2007

A 45‐yr‐old white woman with a 24‐yr history of sacrococcygeal myxopapillary ependymoma developed a large metastasis of scalp and skull diagnosed as metastatic ependymoma on fine‐needle aspiration, based on cytologic features, histotogic pattern in cell block fragments, and a positive reaction with the glial fibrillary acidic protein immunoperoxidase study. The fine‐needle study obviated the need for biopsy in this case, for which a surgical approach was considered to be inappropriate due to the extent of the process demonstrated by various imaging techniques. Diagn Cytopathol 1986;2:261–263.
Transthoracic needle biopsy in neoplastic and nonneoplastic pathology: Experience in a general hospital
Authors: Alonso Patricia , Sánchez Susana , Ramírez Ernestina , Cicero Raúl
Published: February 2007

Transthoracic needle biopsy (TNB) was performed in 344 cases of intrathoracic pathology. In 60 of them, the material obtained was inadequate. In the remaining 284, the possibilities of TNB to identify malignant cells were evaluated. Of them, 202 had neoplastic lesions and 82 had nonneoplastic processes. Among the neoplastic cases, malignant cells were found in 188, (true positive), and in 14 the results were false negative. In the group of nonneoplastic processes, there were 80 without malignant cells (true negative), and two were diagnosed as malignant, (false positive). In these 284 cases with cytologic diagnosis, the global sensitivity was 0.93, and the specificity was 0.97; however, including all cases and the inadequate samples as false negatives, the sensitivity is lower—0.71. TNB required some skill, the use of fine needles, and the colaboration of an expert cytopathologist. TNB is an important method with which to explore intrathoracic pathology. Diag Cytopathol 1986;2:284‐289.
Cytology of hepatocellular carcinoma
Authors: Gupta Subhash K. , Das Dilip K. , Rajwanshi A. , Bhusnurmath S. R.
Published: February 2007

Twenty‐five cases of cytologically and histologically confirmed hepatocellular carcinoma (HCC) were cytomorphologically analyzed using May‐Grünwald‐Giemsa (MGG)‐stained aspiration smears and supplemented with special stains. The cell types were categorized as well differentiated (18 cases), vacuolated (four cases), giant cell (one case), and poorly differentiated (two cases). Glycogen staining was positive in 80% of the cases and hence served as a reliable parameter of diagnostic importance in HCC. Cytoplasmic hyaline bodies (14.6%) and bile pigment (17%), when present, were other important features supporting the diagnosis of HCC. Vacuolation of the cell cytoplasm (80%) was possibly related to glycogen accumulation. The cause of nuclear vacuolation (60%) and the significance of nuclear argyrophilia as markers of abnormal cell growth remain to be studied. Diagn Cytopathol 1986;2:290‐294.
Immunocytochemical localization of human papilloma virus and cytomorphologic correlation in smears and biopsies of cervical flat condylomata
Authors: Deligeorgi‐Politi H. , Mui K. K. , Trotta K. , Safaii H. , An‐Foraker S. H. , Wolfe H. , Hutchinson M.
Published: February 2007

The cytomorphologic features in cervical biopsies and smears associated with human papilloma virus antigen (Ag) expression as demonstrated by immunoperoxidase staining techniques are presented. There was good concordance between cytology and biopsy results with respect to immunoperoxidase staining for human papilloma virus Ag. Cytomorphologic scoring of low‐grade lesions (cervical intraepithelial neoplasias, grades 0 and I) showed atypical mitoses, macronucleated koilocytes, superficial cell keratohyaline granules, and multinucleation to be more frequent in Ag+ biopsy specimens. Chronic inflammation was more evident in Ag‐ biopsy specimens (P < 0.05). Parakeratosis was more frequent in Ag+ cytologic specimens. Koilocytosis was not a reliable indicator of Ag expression in either preparation. Human papilloma virus (HPV) Ag testing by immunoperoxidase techniques appears to be a useful adjunct for screening low‐grade atypias of the cervix. Diagn Cytopathol 1986;2:320‐325.
Cytomegalovirus infection of the lung: Cytomorphologic diagnosis by fine‐needle aspiration cytology
Authors: Buchanan Andrew J. , Gupta Raj K.
Published: February 2007

Cytomegalovirus (CMV) infection of the lung was diagnosed by fine‐needle aspiration cytology (FNAC) in a patient who underwent renal transplantation due to end‐stage renal failure. This case illustrates that CMV can be diagnosed by FNAC and, when seen, must be reported in an immunocompromised host. Diagn Cytopathol 1986;2:341‐342.
The role of routine outpatient cytological screening for early detection of carcinoma of the cervix in India
Authors: Engineer Amy D. , Misra Jata S.
Published: February 2007

Cytological evaluation of cervical smears has been carried out in 4,338 women attending the Gynecology and Obstetrics Department and Family Planning Clinic of Queen Mary's Hospital, Lucknow, India, since April 1971. The incidence of cervical dysplasia was found to be 4.6% (205 out of 4,338) in the series, while malignant smears were detected in 54 patients (1.2%). In five cases, malignant smears were encountered in women with apparently normal cervices, highlighting the advantage of exfoliative cytology in screening subjects without cervical pathology. The remaining 49 cases with malignant smears had lesions on the cervix that had been clinically diagnosed as carcinoma. The diagnosis of malignancy was confirmed by biopsy in all 54 cases showing malignant smears; however, in 10 cases clinically diagnosed as carcinoma of the cervix, and subsequently confirmed histologically, the diagnosis was missed by cytology, the smears being reported as inflammatory in seven and inadequate in three. Cytological evidence of herpes simplex infection was seen in the smears in 23 out of 54 cases of carcinoma, and trichomonal infection was present in 15, indicating some relationship of these infections with the development of neoplastic changes in the cervical epithelium. Eleven of the total 54 cases of carcinoma of the cervix were in the age group of 26‐35 yr, and four were in subjects with only two children. This emphasizes the need for the routine cytologic screening of all child‐bearing women with parities of two and above, regardless of their age, if any meaningful results are to be obtained in a cancer‐screening program in India in view of the prevailing custom of early marriage. Diagn Cytopathol 1987;3:30–34.