bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytologic atypia associated with microglandular hyperplasia
Authors: Valente Philip T. , Schantz H. Daniel , Schultz Monica
Published: February 2007

Although it has long been known that microglandular hyperplasia (MGH) may be associated with cytologic atypia in cervical smears, the cytomorphology of MGH has not been described in great detail. To clarify its cytomorphology, Pap smears obtained from biopsy proven cases of MGH over a 3‐yr period were reviewed. Of 122 smears containing endocervical cells, 34 (28%) showed striking glandular abnormalities. In two cases, adenocarcinoma and adenocarcinoma in situ were falsely suggested and a high grade squamous intraepithelial lesion (HGSIL‐CIN III) was not confirmed in a conization specimen which showed only low grade SIL and MGH. Review of six cytologic diagnoses of HGSIL (CIN III) unconfirmed on biopsy suggested overcalls related to MGH related atypia in five. Cytologic features of MGH, therefore, may occasionally result in erroneous interpretations of HGSIL as well as glandular neoplasia. Although these changes may be striking, comparison with glandular atypia not associated with MGH shows that they are not entirely specific. © 1994 Wiley‐Liss, Inc.
Papillary neoplasms of the breast: Fine‐needle aspiration findings in cystic and solid cases
Authors: Bardales Ricardo H. , Suhrland Mark J. , Stanley Michael W.
Published: February 2007

Papillary neoplasms of the breast are uncommon; at the time of needle aspiration, the diagnostic yield from such lesions can be initially classified as cystic or solid. We describe the fine‐needle aspiration findings in four cystic papillary neoplasms (three intracystic papillary carcinomas and one intracystic papilloma) and three solid masses (two sclerosing ductal lesions and one infiltrating ductal carcinoma with prominent papillary component). The smears were examined with respect to the following features: cellularity, architectural pattern in cell groups, cytologic pleomorphism, degree of cohesiveness, morphology and size of individual cells, anisonucleosis, nuclear‐cytoplasmic ratio, irregularity of nuclear contour, chromatin texture, macronucleoli, the presence of bipolar nuclei, apocrine cells, and multinucleated giant cells. A combination of cytologic and clinical characteristics may be helpful in distinguishing benign from malignant papillary lesions. © 1994 Wiley‐Liss, Inc.
FNA of extraskeletal myxoid chondrosarcoma: Cytomorphologic, EM, and X‐ray microanalysis features
Authors: Gordon Melissa D. , Vetto John , Meshul Charles K. , Schmidt Waldemar A.
Published: February 2007

Extraskeletal myxoid chondrosarcoma, an unusual soft tissue lesion which preferentially affects the extremities, is a prime candidate for “pathologist performed” fine‐needle aspirates (FNA) because it preferentially affects the extremities [Enzinger and Shiraki, Hum Pathol 1972;3:421‐435] and is usually an accessible lesion. Cytomorphologically, the neoplasm consists of clusters of fairly uniform cells, lacking cartilaginous differentiation, with a metachromatic matrix when stained with Diff‐Quik (DQ). While subtle, this neoplasm has distinct features and must be distinguished for other neoplasms in the differential diagnosis because patient evaluation, prognosis, and therapy will vary greatly. We present a case characteristic of this tumor in which FNA derived material was subjected to light microscopy, X‐ray microanalysis, and immunohistochemical studies; each modality provided data essential to the correct diagnosis. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology in locally advanced breast adenocarcinoma: A case with complete response to preoperative chemotherapy in association with granulomatous inflammatory reaction
Authors: Costa Michael J. , Stewart Glen , Perez Edith A. , Goodnight James E.
Published: February 2007

Preoperative chemotherapy for locally advanced breast carcinoma (stage IIIA,B) is increasingly utilized demonstrating a 70 to 95% objective response and 15 to 35% complete response. A 70‐yr‐old woman presented with a 9 cm left upper outer quadrant breast mass associated with overlying skin redness and a 2.5 cm left axillary mass. Fine‐needle aspiration cytology (FNA) showed a pleomorphic adenocarcinoma in both the breast and axilla. Following three courses of chemotherapy with cyclophosphamide, methotrexate, and 5‐fluorouracil (CMF), the patient had a dramatic clinical reduction of tumor, reduction of serum CA 15‐3 from 161 to 64 U/ml, and underwent a modified radical mastectomy and axillary dissection. The specimen showed no viable tumor in association with an extensive granulomatous response in both the breast and axillary lymph nodes. This case illustrates two points concerning preoperative chemotherapy for locally advanced breast cancer: (1) The role of FNA v. tissue biopsy is examined. Positive cytology must be conclusive since, as in this case, no viable carcinoma may be present after therapy. (2) Chemotherapy induced host tissue reaction has not been extensively studied. This case showed a remarkable granulomatous reaction in association with tumor elimination. Since this reaction was not present on the original aspiration cytology slides, the chemotherapy treatment must have induced this reaction. Mechanisms for creating this effective host response need further investigation. © 1994 Wiley‐Liss, Inc.
Needle aspiration cytology of acinar‐cell carcinoma of the pancreas: Report of a case with diagnostic pitfalls and unusual ultrastructural findings
Authors: Villanueva Ricci R. , Nguyen‐Ho Phong , Nguyen Gia‐Khanh
Published: February 2007

A case of histologically and ultrastructurally confirmed acinarcell carcinoma of the pancreas examined by needle aspiration cytology is reported. The aspirate showed isolated and loosely clustered cells with variable granular cytoplasm, and central or eccentrically located oval hyperchromatic nuclei dysplaying prominent nucleoli, suggesting a pancreatic neuroendocrine tumor. Numerous intracytoplasmic zymogen granules and several microtubules within cisternae of rough endoplasmic reticulum (MCRER) were found by electron microscopic study of metastatic tumor tissue. Cytodiagnostic pitfalls of this rare pancreatic cancer are discussed as well as the diagnostic value of MCRERs. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy of pilomatrixoma: Still a diagnostic trap for the unwary
Authors: Wong Maria Pik , Yuen Siu Tsan , Collins Robert John
Published: February 2007

Of the 16 cases of fine‐needle aspiration biopsy (FNAB) of pilomatrixomas reported since 1982, only 25% were correctly diagnosed prior to excision. The most common pitfall encountered was a false‐positive or suspicious diagnosis of a carcinoma. All the reported cases had a polymorphous cellular and noncellular composition on low‐power examination, including numerous basaloid cells, ghost cells, squamoid cells, foreign body giant cells, mixed inflammatory cells, keratin clumps, and granular debris which might be easily mistaken for a malignant necrotic background. Amongst these, ghost cells were the critical pathognomonic feature. This paper reported a further finding that had been under‐emphasized in the literature: masses of refractile orangeophilic keratin clumps representing compact sheets and stacks of ghost cells. Their presence should alert the observer to search for the more diagnostic dispersed forms which otherwise might be inconspicuous and easily overlooked. © 1994 Wiley‐Liss, Inc.
Preoperative diagnostic accuracy of fine‐needle aspiration in the management of breast lesions: Comparison of specificity and sensitivity with clinical examination, mammography, echography, and thermography in 249 patients
Authors: Negri Stefano , Bonetti Franco , Capitanio Arrigo , Bonzanini Mariella
Published: February 2007

Two hundred and forty‐nine women suffering from breast problems underwent a complete series of tests including clinical examination, mammography, echography, thermography, and fine‐needle aspiration (FNA). Ninety‐four of these patients were shown to be positive or to have suspected malignancy. Accordingly, they underwent surgical excision followed by histologic examination, while the remaining patients were re‐examined after 12 to 18 mo in order to exclude false negatives.

The analysis of specificity and sensitivity of every single procedure showed that FNA describes the best degree of sensitivity and specificity but no procedure allows, by itself, the detection of all carcinomas. When considered in combination, clinical examination, mammography, and fine‐needle aspiration have a sensitivity of 100% and a specificity of 49%, and are the best diagnostic tests for a correct assessment of mammary lesions. Thermography and echography showed a low degree of sensitivity and should not be included in the routine diagnostic procedure of breast lesions. Diagn Cytopathol 1994; 11:4–8. © 1994 Wiley‐Liss, Inc.
Occult breast lesions and aspiration biopsy: The lankenau experience
Authors: Zemba‐Palko Vlasta , Minkowitz Gerald , Kline Tilde S.
Published: February 2007

With the increased use of screening mammography, many occult lesions are being identified. Despite the availability of ultrasonography and stereotaxis, their use in conjunction with fine‐needle aspiration biopsy for further examination of these lesions, at the time when cost containment is a serious consideration, must be evaluated. Consequently, the role of cytopathologist becomes important in identifying lesions requiring timely follow‐up and surgical treatment.

To assist the clinicians in evaluating the best approach to occult lesions, we reviewed the results from ultrasonographic guided aspiration biopsies (100) and stereotactic guided aspiration biopsies (61) at our institution. Our findings and review of the literature suggest that the former should only be used sparingly. By contrast, stereotactic biopsies interpreted as a part of an interdisciplinary approach can provide critical information for decision‐making. Diagn Cytopathol 1994; 11:15–19. © 1994 Wiley‐Liss, Inc.
Efficacy of thinprep® preparation of cervical smears: A 1,000‐case, investigator‐sponsored study
Authors: Awen Charles , Hathway Stephen , Eddy William , Voskuil Roy , Janes Charmayne , Hutchinson Martha
Published: February 2007

The diagnoses of 1,000 pairs of conventional Papanicolaou (Pap) smears and ThinPrep® preparations were compared. Cervical cells were collected using an Ayre spatula and endocervical brush. The conventional smear was made first, the collection devices were rinsed into PreservCyt® solution, and the slides were prepared using the ThinPrep® Processor. The diagnoses of the paired smears agreed in 988 of the 1,000 cases (98.8%), including 949 negatives, 28 atypicals, 9 low grade squamous intraepithelial lesions (LGSIL), and 2 high grade squamous intraepithelial lesions (HGSIL). Five cases where LGSIL or HGSIL was found on the ThinPrep® slide were negative or atypical on the conventional smear. No conventional smear abnormalities were missed on the ThinPrep® slide. Although not statistically significant, this difference indicates that the ThinPrep® method gives a better diagnosis of abnormalities than the conventional method. The ThinPrep® method was acceptable to participating physicians and ThinPreps® were easier and faster to screen than conventional smears. Diagn Cytopathol 1994; 11:33–37. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of salivary duct carcinoma
Authors: Elsheikh Tarik M. , Bernacki Edward G. , Pisharodi Latha
Published: February 2007

Salivary duct carcinoma (SDC) is an extremely rare and highly aggressive primary epithelial neoplasm of the salivary glands associated with increased tendency for lymph node and vascular metastases. Histologically, this lesion resembles intraductal cribri‐form and comedo carcinoma of the breast. Fine‐needle aspiration (FNA) cytology of SDC in two patients with parotid masses (ages 65 and 67) is presented. The aspirates were sparsely to richly cellular and contained predominantly broad flat and branching sheets of large polygonal epithelial cells with abundant eosinophilic cytoplasm, round to oval nuclei, finely granular chromatin and prominent nucleoli. Few sheets showed cribriforming and papillary configuration. The cytologic differential diagnosis included oncocytoma, acinic cell carcinoma, muco‐epidermoid carcinoma, and melastatic adenocarcinoma. To the best of our knowledge, this is the first report to describe a spectrum of cytologic features that may allow a specific FNA diagnosis of SDC. Preoperative diagnosis of this neoplasm may warrant a more extensive radiologic workup and therapy including radical surgery and neck dissection followed by radiation therapy. Diagn Cytopathol 1994; 11:47–51. © 1994 Wiley‐Liss, Inc.
Hypersegmentation of neutrophils in the cerebrospinal fluid: Report of a case with hematologic correlation and review of the literature
Authors: Lodge‐Rigal R. Daniel , Novotny Debra B.
Published: February 2007

Hypersegmented neutrophils can occasionally be seen in the cere‐brospinal fluid (CSF) of patients with acute pyogenic meningitis, and rarely as an artifact of cytocentrifugation. We report a case of florid neutrophil hypersegmentation in cytocentrifuged CSF specimens from a patient presenting with anemia and mental status changes. Megaloblastic anemia was excluded by a thorough hematologic evaluation, and the patient was later found to have an epidural abscess. The striking hypersegmentation is attributed to the combined effects of meningeal infection and cytocentrifugation, and a review of the available limited literature on cytomorphologic alterations in CSF cells, specifically neutrophils, is presented. Diagn Cytopathol 1994; 11:56–59. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy of pituitary carcinoma with cervical lymph node metastases: A report of two cases and review of the literature
Authors: Cartwright David M. , Miller Theodore R. , Nasr Anthony J.
Published: February 2007

Metastases from pituitary carcinomas are rare lesions that can mimic other tumors on fine‐needle aspiration biopsies. Two patients with primary pituitary neoplasms developed cervical lymph node metastases, which were sampled and diagnosed correctly using the fine‐needle aspiration biopsy technique. These two cases demonstrate the varied cytologic patterns of pituitary neoplasms, ranging from uniform bland cells to cells with striking anaplastic features. The time period between the onset of symptoms and subsequent metastases is unpredictable as well, underscoring the need for an accurate clinical history before a meaningful cytologic interpretation is made. Diagn Cytopathol 1994; 11:68–73. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy of renal collecting duct carcinoma
Authors: Layfield Lester J.
Published: February 2007

The fine‐needle aspiration biopsy (FNA) findings in a case of collecting duct (ducts of Bellini) carcinoma of the kidney are described. The cytologic smears were modestly cellular and contained individual and small clusters of round to oval cells with small to moderate amounts of well‐defined cytoplasm. The nuclei were large and hyperchromatic with prominent single nucleoli and focal chromatin clearing. The findings were distinct from those of the usual clear or granular cell renal‐cell carcinomas and were more similar to adenocarcinomas arising in the breast, ovary, or pancreas. Because collecting duct carcinomas need to be distinguished from metastatic deposits and are believed to have a poorer prognosis than the majority of renal‐cell carcinomas, preoperative diagnosis may have important therapeutic implications. The distinction of collecting duct carcinoma from the more common variants of renal‐cell carcinoma and transitional‐cell carcinoma is discussed. Diagn Cytopathol 1994; 11:74–78. © 1994 Wiley‐Liss, Inc.
Artifactual endocervical atypia induced by endocervical brush collection
Authors: Fiorella Russell M. , Casafrancisco Don , Yokota Susan , Kragel Peter J. , Davey Diane D.
Published: February 2007

The cytologic distinctions between artifactual atypia induced by endocervical brush collection, endocervical glandular repair, and endocervical glandular dysplasia or neoplasia are often difficult. This difficulty is amplified by the lack of accepted cytologic criteria for endocervical glandular dysplasia, and the fact that earlier studies defining the significant cytologic features of endocervical adenocarcinoma in situ and endocervical adenocarcinoma (endocervical neoplasia) utilized a swab for endocervical cell retrieval. With the almost universal adoption of the endocervical brush, it is important to redefine those cytologic characteristics that differentiate true endocervical glandular dysplasia or neoplasia from reactive or reparative processes and instrument artifact.

From our data, it appears that the classically described cytologic discriminators between a negative smear and smears of endocervical dysplasia or neoplasia are basically unchanged with some minor modifications for endocervical brush‐collected samples. Diagn Cytopathol 1994; 11:79–84. © 1994 Wiley‐Liss, inc.
Laboratory compliance with federal government and professional society recommendations
Authors: Layfield Lester J. , Zaleski Sue , Bottles Kent , Cohen Michael B.
Published: February 2007

Quality assurance issues have assumed growing importance in the cytology laboratory. The 1988 Clinical Laboratories Improvement Amendment (CLIA '88) (United States Department of Health and Human Services, Federal Register: U.S. Government Printing Office 1990;55:9495) regulates the patient identifiers and clinical data on the requisition form but does not mandate physician compliance to provide the information. We investigated the use of patient identifiers and clinical data by laboratories as specimen acceptance/rejection criteria. We surveyed 81 board certified cytopathologists and 235 randomly selected cytology laboratories for acceptance criteria of cytology specimens and received responses from 104. Approximately two thirds of all responding laboratories had specific criteria for rejecting specimens on the basis of inadequate identification or clinical data. While the vast majority required the specimens to be identified with patient name, collection date, and specimen source, a minority of laboratories required clinical information such as LMP, prior atypical cytologic/histologic specimens, and history of previous therapy. Little correlation was found between practice setting and the use of rejection criteria. Diagn Cytopathol 1994; 11:85–92. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration of plasma cell disorders: Special emphasis on plasma cell subtype
Authors: Karmakar Tarun , Dey Pranab
Published: February 2007

Fine‐needle aspiration cytology and clinical presentations of 16 cases of plasma cell dyscrasias (PCD) have been studied in a period of 6 yr. There were seven cases of solitary plasmacytomas of bones, two cases of extramedullary plasmacytomas, and seven cases of multiple myelomas. Differential counts of mature and immature plasma cells along with presence of cell clumps, mitosis, and bi/multinucleations were studied. The cytological findings revealed no correlation with the different subtypes of PCDs; however, it was helpful in the differential diagnosis. Bone narrowing findings, immunological parameters, available histopathology, and X‐ray appearances were analysed. Clinical diagnosis of PCDs were made in only three cases. Thus fine‐needle aspiration biopsy was considered as an important diagnostic modality in tissue diagnosis of plasma cell tumors, particularly in solitary plasmacytoma of bone and extramedullary plasmacytoma. Diagn Cytopathol 1994; 11:119–123. © 1994 Wiley‐Liss, Inc.
Comparative study of interphase cytogenetics, flow cytometric analysis, and nuclear grade of fine‐needle aspirates of breast carcinoma
Authors: Cajulis Ricardo S. , Kotliar Sophia , Haines George K. , Frias‐Hidvegi Denise , O'Gorman Maurice
Published: February 2007

The correlation between DNA ploidy and S‐phase fraction (SPF) by flow cytometry (FCM) and the detection of numerical chromosomal abnormalities (NCA) by interphase cytogenetics (IC) involving chromosomes 8 and 12 was studied in 20 human breast lesions (17 breast carcinomas, 2 fibroadenomas, and 1 sclerosing adenosis). Initial diagnosis was performed on fine‐needle aspiration biopsy (FNAB) material with subsequent histologic confirmation. FCM was performed on formalin‐fixed paraffin‐embedded tissue while IC by fluorescence in situ hybridization (FISH) was done on alcohol fixed FNAB materials. Sixteen (80%) cases showed concordance between FCM and IC with respect to the presence or absence of aneuploidy. The remainder of the cases (20%), which were all malignant neoplasms, showed discrepancies between the two methods, all four were DNA‐diploid with low SPF by FCM but showed various NCA by IC. Nuclear grades (NG) of all the malignant samples were also evaluated and correlated with both FCM and IC studies. Although a good correlation was observed between NG and FCM, a better correlation was seen between NG and IC. This study shows that although IC by FISH correlated well with FCM analysis, it can detect NCA in DNA‐diploid, low SPF tumors. It also correlates well with the NG of the tumor. The increased sensitivity provided by IC in detecting aneuploidy may be of great prognostic significance in low stage, DNA‐diploid, low SPF breast carcinomas. Diagn Cytopathol 1994; 11:151–158. © 1994 Wiley‐Liss, Inc.
Small round cell tumor with divergent differentiation: Cytologic, histologic, and ultrastructural findings
Authors: Akhtar Mohammed , Ali Muhammad Ashraf , Sabbah Rajeh , Bakry Mohammed , Al‐Dayel Fouad
Published: February 2007

A case study of desmoplastic small round cell tumor with divergent differentiation in a 13‐yr‐old boy is presented. Clinical, cytologic, histologic, immunohistochemical, and ultrastructural findings are reported. There was a close correlation between the various histologic and cytologic patterns. Immunohistochemical studies revealed strong positivity of many of the tumor cells for cytokeratin, vimentin, and desmin. Ultrastructurally, some of the tumor cells contained aggregates of cytoplasmic intermediate filaments. Fine‐needle aspiration biopsy may suggest the diagnosis of desmoplastic small round cell tumor. Confirmation of the diagnosis may be provided by immuhistochemistry and electronmicroscopy. Diagn Cytopathol 1994; 11:159–164. © 1994 Wiley‐Liss, Inc.
Expression of the pS2 protein and correlation with estrogen receptor status in fine‐needle aspirates from breast carcinomas
Authors: Sauer Torill , Naess Oddvar
Published: February 2007

A series of 36 cases of breast carcinomas diagnosed by fine‐needle aspiration were investigated for the presence of estrogen receptors (ER) and the estrogen‐induced pS2 protein. Immunocytochemically ER could be demonstrated in 28 aspirates, whereas eight were negative. These eight were also negative for the pS2 protein. In addition three aspirates with a low score for ER and five with a high score for ER were found negative for pS2. Thus, of the 36 cases, 20 were found to express the pS2 protein. The presence of the pS2 protein in the tumor cells is believed to be a marker of a functional estrogen regulatory system and its demonstration may therefore predict clinical responsiveness to hormonal therapy. Diagn Cytopathol 1994;11:165–167. © 1994 Wiley‐Liss, Inc.
Cytodiagnosis of a primary non‐Hodgkin's lymphoma of bone
Authors: Ascoli Valeria , Facciolo Francesco , Nardi Francesco
Published: February 2007

We report fine‐needle aspiration cytology and histologic findings of a primary non‐Hodgkin's lymphoma of bone involving the rib and iliac bones. Smears contained abnormal lymphoid cells and abundant lymphoglandular bodies, suggesting a malignant lymphoproliferative disease. However, histologic sections showed nests of tumor cells with extensive cytoplasmic clearing surrounded by sclerosis, thus mimicking a carcinoma. Clinical data, radiographic findings, and cytohistological correlation led to a final diagnosis of primary non‐Hodgkin's lymphoma of the bone, confirmed by immunopositive staining for leukocyte common antigen CD45 and B‐cell associated antigen CD20. It is concluded that finding numerous lymphoglandular bodies in bone tumor specimens allows an accurate diagnosis of lymphoid tissue. The rarity of bone lymphoma and the misleading histologic features can cause considerable difficulty in diagnosing this entity. The importance of identifying lymphoglandular bodies and the appropriate use of immunochemistry are emphasized. Diagn Cytopathol 1994;11:168–173. © 1994 Wiley‐Liss, Inc.
Infarcted intraduct papilloma diagnosed by fine‐needle biopsy: A cytologic, clinical, and mammographic pitfall
Authors: Greenberg Merle L. , Middleton Pip D. , Bilous A. Michael , Wilbur David C.
Published: February 2007

Necrosis is a worrisome cytologic feature in breast aspirates which, when paired with suspicious clinical and mammographic findings, could potentially result in a false positive diagnosis. A 66‐yr‐old female presented with clinical evidence of stage 1 breast carcinoma supported by the mammographic and ultrasound findings. A fine‐needle biopsy (FNB) revealed extensive necrosis with scattered degenerate columnar cells, occasional clusters of hyperchromatic epithelial cells, and a few sheets of ductal cells. A cytologic diagnosis of an infarcted intraduct papilloma was made. This uncommon diagnosis was subsequently confirmed by open biopsy. Cytologic features to distinguish infarcted, necrotic, and papillary breast lesions are discussed. Diagn Cytopathol 1994;11:188–194. © 1994 Wiley‐Liss, Inc.
Morphologic and morphometric features of low grade serous tumours of the ovary
Authors: Gurley A. Marion , Hidvegi Denise F. , Cajulis Ricardo S. , Bacus Sarah
Published: February 2007

Peritoneal washings from twelve patients with serous tumours of the ovary were studied. Six patients had borderline serous tumours (BSTs), and six had grade one adenocarcinomas. Papanicolaou stained slides were assessed for nine morphologic parameters; background, single cells, size of papillary fragments, contour of papillary fragments, psamomma bodies, cytoplasmic vacuoles, nuclear pleomorphism, nuclear membrane contour, and nucleoli The slides were destained and restained by the Feulgen method for assessment, with a computer based image analysis system (CAS100, Cell Analysis Systems, Inc., Elmhurst, IL), of DNA content, nuclear size, and nuclear roundness.

The contour of the papillary fragments (P = 0.004) and the presence of nuclear pleomorphism (0.019) were distinguishing characteristics. All six BSTs were diploid while three of the six adenocarcinomas had aneuploidy. Two exhibited polyploid DNA distribution and one exhibited diploid DNA distribution. The pooled data for the nuclear size and roundness showed little difference in the modal values, although the nuclei of the adenocarcinoma cells were slightly larger than those of the borderline cells (54 sq. μm vs. 46 sw. μm). However, the coefficients of variation (CVs) for each of these parameters were larger in the adenocarcinoma group than in the borderline group (59.7 vs. 36.4% for size and 33.5 vs. 17.8% for roundness).

Although the sample size is small, the data suggest that aneuploidy is rare in borderline tumours. In addition, the presence of papillary groups with irregular contours and nuclear pleomorphism (reflected in higher CVs for nuclear size and roundness) both occur more commonly in adenocarcinomas than in borderline tumours and may be of predictive value in distinguishing the two groups. Diagn Cytopathol 1994; 11:220–225. © 1994 Wiley‐Liss, Inc.
Immunocytochemical staining of c‐erbB‐2 oncogene in fine‐needle aspirates of breast carcinoma: A comparison with tissue sections and other breast cancer prognostic factors
Authors: Corkill Mary E. , Katz Ruth
Published: February 2007

The role of fine‐needle aspiration (FNA) in breast cancer management is expanding to include prognostic in addition to diagnostic studies. This study was undertaken to compare the immunohistochemical staining of c‐erbB‐2, a breast cancer prognostic factor, on cytologic FNA smears of breast cancer with that on corresponding formalin‐fixed, paraffin‐embedded tissue sections of the same tumor and to correlate the c‐erbB‐2 expression with other known breast cancer prognostic factors. FNA smears (destained, alcoholfixed, Pap‐stained direct smears) and corresponding tissue sections (formalin‐fixed, paraffin‐embedded, unstained sections) from 36 primary breast carcinomas were stained immunohistochemically with c‐erbB‐2 antibody using an avidin‐biotin procedure. Ten tumors (28%) showed strong positive staining for c‐erbB‐2 on the FNA smear and, of those ten, seven were positive on the corresponding tissue section and three were negative. In several of the cytology and tissue positive cases, staining on the tissue section was significantly weaker than on the FNA smear. Two cases involved treatment with preoperative chemotherapy; in one of those cases, tissue staining was weaker than cytologic staining, and, in the other case, both were negative. Correlation of c‐erbB‐2 staining with other prognostic factors showed an association between positive c‐erbB‐2 staining and high nuclear grade. Our results indicate that immunohistochemical staining for c‐erbB‐2 can be performed on destained FNA smears of breast carcinomas and may be more sensitive on the cytologic specimens than on formalin‐fixed, paraffin‐embedded tissue sections. Diagn Cytopathol 1994;11:250–254. © 1994 Wiley‐Liss, Inc.
Diagnosing intramuscular myxoma by fine‐needle aspiration: A multidisciplinary approach
Authors: Caraway Nancy P. , Staerkel Gregg A. , Fanning Christina V. , Varma Datla G. , Pollock Raphael E.
Published: February 2007

The gross and microscopic appearances of aspirates from ten intramuscular myxomas are reported. The specimens were obtained from seven women and three men, ages 43 to 75, who had tumors involving the muscles of the thigh (7), upper arm (2), and forearm (1). Magnetic resonance (MR) imaging performed in six of the ten cases revealed well‐defined, sharply demarcated tumors exhibiting low signal intensity relative to muscle on the T1‐weighted images. The tumors were hyperintense to muscle on T2‐weighted images. All aspirated tissues were clear, tenacious, and viscous. Smears contained few spindled and histiocytoid cells in an abundant mucoid background. Spindle cells demonstrated long cytoplasmic processes that in areas intertwined to form fibrillar tangles. Nuclei were oval to spindled with fine chromatin and inconspicuous nucleoli. Capillaries were sparse with simple (nonplexiform) branching. The differential diagnosis of myxoid lesions of the extremities includes benign entities such as myxoid schwannoma and neurofibroma, mesenchymal repair, and ganglion cyst, as well as malignant neoplasms such as myxoid liposarcoma, fibrosarcoma, malignant fibrous histiocytoma, and extraskeletal chondrosarcoma. The findings of this study revealed that, although the cytologic features were suggestive of intramuscular myxoma, a definitive diagnosis was often difficult, owing to scant cellularity and lack of distinctive cytologic features. The MR imaging findings may be utilized as an adjunct to the cytologic features to more confidently suggest a diagnosis of intramuscular myxoma. Diagn Cytopathol 1994;11:255–261. © 1994 Wiley‐Liss, Inc.
Retrospective c‐erbB‐2 immunostaining in aspiration cytology of breast cancer
Authors: Jorda M. , Ganjei P. , Nadji M.
Published: February 2007

Fifty fine‐needle aspiration cytologies of breast that were diagnosed as carcinomas were retrieved from the files and retrospectively evaluated for the expression of c‐erbB‐2 oncoprotein using standard immunocytochemical methods. Corresponding histologic sections of all tumors were similarly studied.

Seventeen fine‐needle aspirates (34%) reacted positively for the presence of c‐erbB‐2 oncoprotein. All but one (32%) of the corresponding tissue sections were also positive for c‐erbB‐2 by immunohistochemistry. All positive cases were infiltrative ductal carcinomas with a preponderance of the comedo type. Positive reactions were localized in the cytoplasmic membrane of tumor cells. The staining was either present in all cells throughout a tumor, or it was completely absent. We conclude that immunocytochemistry for c‐erbB‐2 oncoprotein can be performed on fine‐needle aspiration cytology samples that are previously fixed and stained with the Papanicolaou technique. Furthermore, the sensitivity of immunostaining results are comparable to that obtained in histologic sections. Diagn Cytopathol 1994; 11:262–265. © 1994 Wiley‐Liss, Inc.
Small‐cell carcinoma of the ovary in peritoneal fluid
Authors: Selvaggi Suzanne M.
Published: February 2007

Two cases of small‐cell carcinoma of the ovary in the ascitic fluid and peritoneal/pelvic washings of a 30‐ and 28‐yr‐old woman, respectively, are presented and discussed. Smear preparations from the ascitic fluid showed loose clusters and single malignant cells with scant cytoplasm and nuclei with smooth to irregular nuclear membranes, granular chromatin, and small nucleoli. In the second case peritoneal/pelvic washing specimens contained clusters and single malignant cells with a moderate amount of cytoplasm and nuclei with smooth nuclear membranes, granular, clumped chromatin, and prominent nucleoli. Histology confirmed the diagnosis of small‐cell carcinoma of the ovary. These are the first reported cases of this rare ovarian neoplasm present on fluid cytology. Its differentiation from other small‐cell neoplasms on peritoneal fluid cytology from young women is discussed. Diagn Cytopathol 1994; 11:266–270. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy of salivary gland mycoses
Authors: Raab Stephen S. , Thomas Patricia A. , Cohen Michael B.
Published: February 2007

This report details the fine‐needle aspiration biopsy (FNAB) cytomorphologic features of two cases of salivary gland mycosis. Both patients had acquired immunodeficiency syndrome (AIDS) and presented with parotid gland masses. The first patient had Histoplasmosis with secondary infection by Candida. Cytopathologically, the FNAB smears showed classic features of a deep‐seated mycosis characterized by necrosis and scattered fungal forms. The second patient had a colonizing sialadenitis caused by either Asperigillus or Fusarium. Cytopathologically, the findings were similar to those seen in aspergillomas of the lung orparanasal sinuses with numerous hyphal forms and an absence of an inflammatory response. Because mycotic disease can induce a wide spectrum of pathogenic change, other benign or malignant, solid or cystic lesions enter into the differential diagnosis. Diagn Cytopathol 1994; 11:286–290. © 1994 Wiley‐Liss, Inc.
Melanocytic schwannoma: The cytologic aspect in fine‐needle aspiration cytology (FNAC): Report of a case located in the spinal cord
Authors: Sola‐Pérez J. , Pérez‐Guillermo M. , Bas‐Bernal A. , Giménez‐Bascuñana A. , Montes‐Clavero C.
Published: February 2007

We describe a case of intramedullary melanocytic schwannoma (MS) studied by means of fine‐needle aspiration cytology (FNAC).

The main cytologic features were (1) large three‐dimensional clusters overshadowed by heavy pigment deposits which tested positive for Fontana Masson (and bleached with potassium permanganate), HMB‐45, Vimentin, and S‐100 protein; (2) loose syncytial monolayered sheets with very little pigment deposit; and (3) isolated spindle cells with polarized nucleus and tapered, thin cytoplasmic ends.

Both the cytologic features and the immunophenotypic profile were nonspecific and on their own were insufficient to allow the diagnosis of MS to be reached. Clinical data and the magnetic resonance image (MRI) in conjuction with the cytologic findings did suggest the diagnosis of intramedullary MS. Diagn Cytopathol 1994;11:291–296. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of recurrent and metastatic mixed mesodermal tumors
Authors: Mourad Walid A. , Sneige Nour , Katz Ruth L. , Caraway Nancy P. , Fanning Tina V.
Published: February 2007

We report the cytological and clinical findings of 16 fine‐needle aspirates (FNAs) performed on recurrent (n = 6) and metastatic (n = 10) mixed mesodermal tumors (MMMTs). The median interval between the primary diagnosis and FNA was 16 mo. Primary sites were the endometrium (n = 11), the ovary (n = 3), the cervix (n = 1), and pelvic soft tissue (n = 1). Primary tumors showed carcinoma with homologous mesenchymal components in 13 cases and focal heterologous elements in three (two chondrosarcomas and one rhabdomyosarcoma). The FNAs showed carcinoma in all 16 cases, with adenocarcinoma differentiation in three, Mesenchymal elements were identified in aspirates of three recurrent and two metastatic lesions. They were all homologous. No heterologous mesenchymal elements were identified in the aspirates. We conclude that mesenchymal components in FNAs of MMMTs are less likely to be seen in metastatic lesions, and that heterologous mesenchymal components are rarely seen in these aspirates even in recurrent disease. These findings confirm that the epithelial component is responsible for the malignant behavior of MMMTs, and suggest that these lesions may need to be classified as sarcomatoid carcinomas rather than true carcinosarcomas. Diagn Cytopathol 1994;11:328–332. © 1994 Wiley‐Liss, Inc.
Comparative studies of the same adenocarcinoma cells, macrophages, and mesothelial cells by light microscopy, scanning electron microscopy, and transmission electron microscopy
Authors: Kaneko Chiyuki , Niimi Hajime , Shinzato Masanori , Shamoto Mikihiro
Published: February 2007

The identification of cells in body cavities of cancer patients is sometimes difficult to make. In order to make a definite cytological diagnosis, we observed the same cells by using light microscopy (LM)‐scanning electron microscopy (SEM)‐transmission electron microscopy (TEM). In this study we first stained cells by the Papanicolaou method after fixation in 1% glutaraldehyde for LM, and then attempted to observe them successively by SEM‐TEM after fixation in 1% paraformaldehyde and 1.25% Os04. Our method and procedures in examining successively one and the same cells in body cavity fluids by using LM, SEM, and TEM ensured accurate discrimination among adenocarcinoma cells, mesothelial cells, and macrophages. The results of this study suggest that LM‐SEM‐TEM may be of diagnostic value in distinguishing among mesothelial cells, macrophages, and adenocarcinoma cells. This method also succeeded in disclosing differences between the ultrastructure of the cell surfaces, and those of the cytoplasm, and of the nuclei It is desirable that LM‐SEM‐TEM observation can be introduced into various aspects in order to obtain an improvement in the diagnosis by cytologic examination, the judgment of therapeutical effects, drug selection, and prognostic presumption. Diagn Cytopathol 1994; 11:333–342. © 1994 Wiley‐Liss, Inc.
Interobserver variability of cervical smears with squamous‐cell abnormalities: A philadelphia study
Authors: Young Nancy A. , Naryshkin Sonya , Atkinson Barbara F. , Ehya Hormoz , Gupta Prabodh K. , Kline Tilde S. , Luff Ronald D.
Published: February 2007

The reproducibility of reporting squamous lesions by the Bethesda System (TBS) was evaluated by distributing 20 slides to be classified among 5 panelists considered experts in the field of cytopathology. Four cases were chosen for their classic morphology and the remainder were foreseen to produce possible discrepancies within one diagnostic category. For 7/20 (35%) cases there was unanimous agreement. Participants disagreed within one category of magnitude for seven (35%) cases. In six (30%) cases there was a range of more than one category disagreement. However, additional written comments modifying TBS diagnoses often diminished the clinical significance of these discrepancies. We conclude that despite the important role of TBS in standardization of Pap smear reports, a great degree of subjectivity exists in classifying squamous abnormalities without “classic” morphology. The lack of reproducibility should be taken into account in cytology proficiency testing. Diagn Cytopathol 1994;11:352–357. © 1994 Wiley‐Liss, Inc.
Utility of polyclonal and monoclonal antibodies against carcinoembryonic antigen in hepatic fine‐needle aspirates
Authors: Rishi Mazhar , Kovatich Albert , Ehya Hormoz , Davila Rosa M.
Published: February 2007

To assess the usefulness of polyclonal and monoclonal antibodies against carcinoembryonic antigen (CEA) in the differential diagnosis of hepatocellular carcinoma (HCC) vs. metastatic adenocarcinoma (MA), we studied 25 cases of fine‐needle aspirates (FNA) of hepatic lesions. The material consisted of 9 primary HCCs, 8 MAs, and 8 benign hepatic aspirates. For immunostaining, the avidin‐biotin complex technique was performed on paraffin sections of cell blocks, using a standardized automatic immunostainer. Specific bile canalicular immunostaining with polyclonal CEA (pCEA) antibody was present in five of eight (5/8) benign hepatic aspirates and eight of nine (8/9) HCCs. Diffuse cytoplasmic immunostaining with pCEA antibody was present in four of eight (4/8) MAs. None of the aspirates showed any positive immunostaining with monoclonal CEA (mCEA) antibody. We conclude that: (1) pCEA antibody is useful in the evaluation of hepatic FNAs. Diffuse cytoplasmic staining is seen in MAs, whereas canalicular immunostaining pattern is an indication of benign or malignant hepatocytes. (2) Paraffin‐embedded cell blocks made from hepatic aspirate material are suitable for immunostaining with polyclonal CEA antibody. (3) mCEA antibody has no value in the diagnosis of HCC. Diagn Cytopathol 1994; 11:358–362. © 1994 Wiley‐Liss, Inc.
Nocardiosis diagnosed by lung FNA: A case report
Authors: Busmanis Inny , Harney Mary , Hellyar Andrew
Published: February 2007

A 63‐yr‐old woman with systemic lupus erythematosus (SLE) diagnosed 12 mo previously and treated with prednisolone and cyclophosphamide presented with recent fever and dyspnoea. the etiology of a 3 cm diameter centrally cystic coin lesion in the lower lobe of the left lung was obscure. Blood cultures and sputum examination had been non‐contributory, and the diagnosis of Nocardia asteroidesinfection was initially made by cytologic examination of material obtained by lung fine‐needle aspiration (FNA). It is notoriously difficult to detect this organism by conventional sputum examination or with histologic sections, and it has rarely been detected by lung FNA. If this organism is demonstrated, appropriate microbiologic cultures for confirmation and susceptibility testing should be instituted. Long‐term antimicrobial therapy is needed. in this case, complete resolution of the lung lesion followed 5 mo of therapy.
Diagnosis of metastatic appendiceal adenocarcinoid in liver by fine‐needle aspiration cytology
Authors: Argani Pedram , Van Hoeven Karen H. , Artymyshyn Renee L.
Published: February 2007

A 70‐yr‐old woman presented with symptoms clinically attributed to acute appendicitis. An adenocarcinoid tumor of the appendix was resected, followed by right hemicolectomy with negative lymph nodes. Seven years later, a fine‐needle aspiration biopsy was performed on one of multiple hepatic nodules, revealing metastatic adenocarcinoid. the cytopathologic features of the metastatic tumor are described.
Calcium oxalate crystals in benign breast cyst fluid
Authors: Mihaescu A. , Burri G.
Published: February 2007

We have recently observed a strongly birefringent material of varying shapes and sizes in a benign breast cyst fluid specimen from a 52‐yr‐old woman with suspicious mammographic microcalcifications. the finding of calcium oxalate crystals in the breast cyst fluid should be regarded as a recognition of a particular type of calcification, easily overlooked with the conventional light microscopy. to date, we are unaware of any cytologic reports of this type of calcification in the breast.
Calcifying epithelial odontogenic tumor (Pindborg's tumor) on fine‐needle aspiration biopsy smears: A case report
Authors: Fulciniti Franco , Vetrani Antonio , Zeppa Pio , Califano Luigi , Palombini Lucio
Published: February 2007

A 44‐yr‐old woman with a long‐standing history of painful mandibular swelling was hospitalized for the diagnostic evaluation of an osteolytic mandibular lesion in the premolar‐canine area. Fineneedle aspiration biopsy (FNAB) was performed and cytologic smears were characterized by clusters, sheets, and rare isolated pleomorphic cells of the squamoid type, blocks of amorphous material encircled by fibroblasts, and occasional calcifications. A cytological diagnosis of Pindborg's tumor was made, which was confirmed by histopathological examination. Evaluation of DNA ploidy by semiautomated image cytometry produced an aneuploid histogram. the patient is free of residual neoplasm at a 12‐mo post‐operative interval. the cytological differential diagnosis of this rare odontogenic neoplasm is discussed briefly.
Transtracheal needle aspiration
Authors: Roche David H. , Wilsher Margaret L. , Marion Gurley A.
Published: February 2007

A series of 27 transtracheal needle aspiration biopsies performed on 25 patients were reviewed. A rigid bronchoscope and rigid needle were used. the biopsies were performed as staging procedures in patients with bronchogenic carcinoma, or to obtain diagnoses in patients with mediastinal adenopathy. A cytopathologist attended 11 biopsies and microscopically examined a direct smear to determine adequacy. Repeat biopsies were taken at the time if necessary. A diagnosis was obtained in 9/11 (81%) of these cases. Only 3/16 biopsies (18.8%) performed in the absence of a pathologist were diagnostic. All negative cases were subsequently found to have disease (2 sarcoidosis, 13 cancer) by other methods including mediastinoscopy in 5 cases. in the patient group sampled, the technique of rigid needle and rigid bronchoscope with a cytopathologist in attendance resulted in a much higher sensitivity for the test than has been previously reported. © 1995 Wiley‐ Liss, Inc.
Benign spindle and inflammatory lesions of the breast: Diagnosis by fine‐needle aspiration
Authors: Bardales Ricardo H. , Stanley Michael W.
Published: February 2007

We describe fine‐needle aspiration (FNA) findings in 7 patients with breast masses showing numerous spindle cells in smear material. the benign nature of these lesions was confirmed by clinical follow‐up (n = 4) or surgical excision with histologic examination (n = 3). the final diagnosis included one case each of myofibroblastoma, juvenile hypertrophy, post‐FNA reactive stromal proliferation, stromal induction in proliferative fibrocystic disease, and subareolar abscess. There were two instances of granulation tissue. the case of stromal induction was initially felt to be suspicious for phyllodes tumor. the post‐FNA stromal reaction was considered sufficiently atypical to warrant histologic investigation. the importance of historical and physical examination findings in accurate interpretation of these uncommon cases is emphasized. Some will require histologic assessment for final diagnosis. © 1995 Wiley‐ Liss, Inc.