bluuebunny/crossref_metadata_2025 huggingface dataset:
Fine‐needle aspiration cytology of juvenile papillomatosis of breast: A case report
Authors: Ostrzega Nora
Published: February 2007

The cytologic findings of juvenile papillomatosis (JP) have been rarely described. The clinical and cytologic findings were suggestive of a fibroadenoma, but due to the presence of 2 cc of clear fluid during the aspiration, fibrocystic change was in the differential diagnosis. Operation and subsequent examination of the mass identified a case of JP (so‐called Swiss cheese disease of the breast). Because JP is a marker for breast carcinoma for the patients' families, and the patients may themselves be at increase risk for malignancy, it is important that this entity be considered in the differential diagnosis.

The observations in this case indicate that it is difficult to diagnose JP only by cytology, but the combination of clinical findings—a well‐circumscribed mass in a young patient with cystic fluid, but with a residual mass after aspiration due to the multicystic nature of JP—with the cytologic findings—sheets of hyperplatic breast epithelium with areas resembling fibroadenoma, macrophages, and apocrine cells—that appear to be sufficiently characteristic to suggest the diagnosis of JP.
Needle aspiration cytology, immunocytochemistry, and electron microscopic study in a case of carcinoid of the male breast
Authors: Gupta Raj K. , Holloway Linda J. , Johnwakefield St.
Published: February 2007

The diagnosis of a primary carcinoid of breast in a 68‐yr‐old male was initially made from a sample of needle aspirate. The cytodiagnosis was supported by histochemical and immunocytochemical studies which showed positivity for argyrophilic granules by Grimelius stain and positive staining for chromogranin. A subsequent cell block of the aspirate and biopsy of the tumour confirmed the cytodiagnosis. Electron microscopic study of the material further demonstrated the presence of neurosecretory granules in the malignant cells. Mastectomy with axillary node dissection was performed and showed no residual or metastatic tumour. No primary tumour was found elsewhere. This case illustrates the importance of needle aspiration cytology in the diagnosis of carcinoid tumour which is very rare in the male breast.
Pericellular lacunae in effusions
Authors: McNeely T. Bruce D.
Published: February 2007

Pericellular lacunae are reported to be characteristic of adenocarcinoma cell clusters in cell block preparations of serous effusions. We examined the incidence of lacunae in cell blocks from 24 benign and 31 malignant effusions. The cases were classified as follows: group A with no pericellular lacunae, group B with <50% of cell clusters in lacunae, and group C with >50% of cell clusters in lacunae. Of the malignant effusions, 5% were in group A, 67% were in group B and 29% were in group C. Of the benign effusions, 50% were in group A, 50% were in group B, and 0% were in group C.

The pericellular lacuna by itself is not a reliable diagnostic criterion. It could assist, however, in the overall evidence when evaluating a case, particularly if either there are no lacunae seen or the majority of cells are in lacunae. Furthermore, since lacunae are easily visible at low magnification, their recognition may help in screening cell blocks, using their presence to locate cell groups worthy of special attention. Diagn Cytopathol 1993;9:503‐507. © 1993 Wiley‐Uss, Inc.
Negative images due to clofazimine crystals simulating mai infection in a bronchoalveolar lavage specimen
Authors: Silverman Jan F. , Holter John F. , Berns Lisa A. , Benning Timothy L. , Neill James S. A.
Published: February 2007

“Negative images” of bacilli in mycobacterial infections have been recently described in air‐dried, Romanovsky‐stained cytologic material. We report a case of negative images due to crystalline deposition of clofazimine, a drug used to treat Mycobacterium avium‐intracellulare complex infection in AIDS patients. The negative images of clofazimine crystals seen in bronchoalveolar lavage (BAL) macrophages resemble the negative images of mycobacterial infection due to the pseudogaucher appearance of the cells. Crystals are distinguished by their refractile reddish appearance in unfixed, unstained smears, and by their birefringence on polarization. Crystals were found in both Pap‐stained and Diff‐Quik‐stained smears and were negative with Ziehl‐Neelsen stains. Clofazimine crystals in BAL specimens must be distinguished from the pseudogaucher type cells of mycobacterial infection in this patient population. We believe that this is the first report of clofazimine crystal deposition diagnosed in a BAL specimen along with electron microscopic examination of the cytologic material.
Adenomyoepithelioma of the breast: Report of a case initially examined by fine‐needle aspiration
Authors: Birdsong George G. , Bishara Hany M. , Costa Michael J.
Published: February 2007

This report describes the morphologic features of an adenomyoepithelioma of the breast that was first examined by fine‐needle aspiration. On retrospective review of the cytology, the stromal elements of this adenomyoepithelioma showed extensive metachromasia on Diff‐Quik stain, had elongated nuclei, and on Papanicolaou stain showed elongated, pale, wispy cytoplasm. Clusters of stromal cells were usually intimately associated with epithelial elements. While the main differential consideration, cystosarcoma phylloides, can show similar features, it may be possible to distinguish the two lesions in some instances.
Nodular pulmonary amyloidosis: Diagnosis by fine‐needle aspiration cytology and a review of the literature
Authors: Dundore Paul A. , Aisner Seena C. , Templeton Philip A. , Krasna Mark J. , White Charles S. , Seidman Jeffrey D.
Published: February 2007

Solitary nodular pulmonary amyloid tumor is an uncommon benign lesion which is seldom diagnosed prior to surgical extirpation. We present a case of unsuspected nodular pulmonary amyloid tumor diagnosed by fine needle aspiration cytology. A 52‐yr‐old‐black woman presented with a 3‐cm right middle lobe mass. Percutaneous fine‐needle aspiration cytology (FNA) of the mass revealed waxy amorphous material that demonstrated apple green birefringence on Congo Red Stain. Thoracotomy for diagnosis may be avoided by using FNA to diagnose these unusual lesions.
“Cellular adenomatoid nodules” of the thyroid: Review of 219 fine‐needle aspirates
Authors: Busseniers Anne E. , Oertel Yolanda C.
Published: February 2007

We reviewed 219 consecutive thyroid aspirates previously diagnosed as “cellular adenomatoid nodule.” applying the criteria presented in this paper and reclassifying them as 146 adenomatoid nodules (AN), 31 cellular adenomatoid nodules (CELL‐AN), 29 cellular adenomatoid nodules vs. follicular neoplasms (CELL‐AN vs. FN), 5 follicular neoplasms (FN), 2 FN of oxyphilic cell type, 4 papillary carcinomas, and 2 chronic lymphocytic (Hashimoto's) thyroiditis.

Of the 146 adenomatoid nodules, 14 occurred in multinodular goiters on histologic examination. Of the 31 CELL‐AN, five had surgery: two were follicular adenomas, one was papillary carcinoma, and two were multinodular goiters. Of the 29 CELL‐AN vs. FN, 11 had surgery: six were follicular adenomas, two were follicular carcinomas, two were multinodular goiters, and one was Hashimoto's thyroiditis. Surgery on four FN showed follicular adenomas (a fifth patient was lost to follow‐up). Of the two FN of oxyphilic cell type, one was a multinodular goiter and the other a follicular adenoma with oxyphilic cells. Three of the four papillary carcinomas were confirmed histologically (one patient was lost to follow‐up). Of the two cases showing Hashimoto's thyroiditis, one was diagnosed as FN on repeat aspiration and follicular carcinoma at surgery. After review, we identified 40 patients at higher risk of harboring a neoplasm and 31 with cellular adenomatoid nodules. Twenty‐five underwent surgery with the above results. In the classification of follicular lesions of the thyroid by FNA, adherence to strict cytologic criteria helps identify those patients who will benefit most from surgery.
Diagnosis of palpable breast cancer by FNA: A changing role?
Authors: Howell Lydia Pleotis
Published: February 2007

Editorial Comments: A vital topic that will impact on cytopathologists doing fine‐needle aspiration is discussed in the following two editorials: “Diagnosis of Palpable Breast t Cancer by FNA: A Changing Role?” by Lydia P. Howell, M.D., and “Occult Breast Lesions and Aspiration Biopsy: A New Challenge” by Shahla Masood, M.D. One concerns the aspiration of palpable lesions and the second, occult; but, the problem is the same in both. Will aspiration biopsy of the breast be replaced by core biopsy? This is already the case in prostatic biopsies. To many, this represents a step backward, particularly in view of the tremendous progress made by aspiration biopsy of the breast. This progress is especially evident in this issue of Diagnostic Cytopathology with an additional six articles covering the cytology of reactive, proliferative, and neoplastic breast diseases in both sexes. To prevent the premature demise of aspiration biopsy of the breast, cytopathologists must firstly, be aware of the situation; secondly, be comfortable in the interpretation of aspiration biopsy; and thirdly, be knowledgeable in the advantages of each procedure. During the coming months, a number of papers will address this critical issue. Let us hear from our readership.
Fine‐needle aspiration cytology diagnosis of non‐hodgkin lymphoma of thyroid: A report of four cases
Authors: Das Dilip K. , Gupta Subhash K. , Francis Issam M. , Ahmed Mahmoud Sayed
Published: February 2007

Four cases of non‐Hodgkin lymphoma of thyroid, diagnosed by fine‐needle aspiration (FNA) cytology during a period of 3% yr constituted 0.2% of 1,716 thyroid FNAs and 3.4% of 118 thyroid neoplasms. The age of the patients ranged from 42 to 78 yr with an average of 63 yr and all were females. Three cases had thyroid swellings, and one case had cervical lymphadenopathy and fullness in the thyroid region. The lymphomas were categorized as mixed small and large cell lymphomas, large cell lymphoma, small noncleaved lymphoma (non‐Burkitt‐type), and plasmacytoid lymphoma. Histopathology as well as immunohistochemistry confirmed the cytodiagnosis of lymphoma in the first and fourth cases. In the second case where possibility of anaplastic carcinoma could not be ruled out altogether at initial cytotogic examination, the histopathology report was undifferentiated carcinoma but immunohistochemically it was proved to be a B‐cell neoplasm.
Value of repeat cervical smears at the time of colposcopic biopsy
Authors: Young Nancy A. , Naryshkin Sonya , Bowman Richard L.
Published: February 2007

At our institution, gynecologists perform Pap smears not only as an initial screening procedure but also at the time of colposcopy and biopsy. We compared the results of initial Papanicolaou (Pap) smears with those taken at colposcopic biopsy to determine if repeating the Pap smear at the time of colposcopy contributed to patient management. We found that repeat colposcopic smears often agreed with the referral smears and biopsies. When there was disagreement, the colposcopic smear was more often a lower grade than the referral smear and correlated best with the biopsy. Both referral and colposcopic smears underestimated the severity of cervical lesions with the same frequency. We could document only 5/414 (1.2%) colposcopic smears that contributed to patient care.
Cytology of cardiac myxomas: Presence of ulex europaeus agglutinin‐I (UEA‐I) lectin by immunoperoxidase staining
Authors: Iwa Nobuzo , Yutani Chikao
Published: February 2007

Cytological findings are presented of seven cases of cardiac myxomas. Avidin‐biotin‐peroxidase complex (ABC) method was employed to demonstrate Ulex europaeus agglutinin‐I (UEA‐I) lectin in imprint smears as well as in paraffin‐embedded tissue sections in cardiac myxomas.

The cytology was characterized by tumor cells with polyhedral or stellate and mucinous background with lymphocytes, neutrophilles, and hemosiderin‐laden machrophages.

In smears as well as tissue sections, UEA‐I lectin was detected throughout the cytoplasm of myxoma cells.

This study established the applicability of the immunoperoxidase staining for cardiac myxoma as an aid in cytopathological diagnosis.
Fine‐needle aspiration of epithelioid sarcoma
Authors: Goswitz Joseph J. , Kappel Timothy , Klingaman Kathy
Published: February 2007

The cytologic appearance of epithelioid sarcoma in fine‐needle aspiration biopsy (FNAB) has not been extensively described. The authors report the cytologic findings in one case that metastasized to a lymph node. The cells are characterized by irregular nuclei, nuclear folds, macronucleoli, and a high nucleus‐cytoplasm ratio. The cells vary in shape and occur singly and in clusters where intercellular spaces are uncommon. The findings allow the diagnosis of malignancy but are nonspecific. History, immunocytochemistry, and tissue cores are helpful in the differential diagnosis.
Quantitative analysis of mast cells in testicular aspiration cytology smears in azoospermic males
Authors: Dey Pranab , Ray Ruma
Published: February 2007

Quantitative estimation of mast cells was done in testicular aspiration cytology smears of 90 azoospermic males. Cases included normal spermatogenesis (32), Sertoli cell only (38), late maturation arrest (16), and early maturation arrest (4). The pooled number of mast cells in 20 standard fields in Sertoli cell only and late maturation arrest cases were significantly higher than that of normal spermatogenesis (P < .001 and P < .01 respectively). Aggregates of mast cells were found around the seminiferous tubules in Sertoli cell only cases. The findings suggest that increased number of mast cells may be the cause or effect of testicular damage in idiopathic male infertility.
Aspiration cytology of clear‐cell lesions of the parotid gland: Morphologic features and differential diagnosis
Authors: Layfield Lester J. , Glasgow Ben J.
Published: February 2007

Clear‐cell lesions of the parotid gland are uncommon but when studied by fine‐needle aspiration may result in a clinically important but cytologically difficult differential diagnosis. Clear‐cell lesions involving the parotid include acinic cell neoplasm, clear cell oncocytoma, mucoepidermoid carcinoma, primary clear‐cell carcinoma, epithelial‐myoepithelial carcinoma, and metastatic renal cell carcinoma. Accurate diagnosis is achieved by assessment of nuclear features, other cell populations present, and clinical data including radiographic studies.
Quality control study on negative gynecological cytology in Mexico
Authors: Lazcano‐Ponce Eduardo Cesar , de Ruiz Patricia Alonso , Lopez‐Carrillo Lizbeth , Vazquez‐Manriquez Maria Eugenia , Hernandez‐Avila Mauricio
Published: February 2007

An external evaluation of the quality of diagnosis of gynecological cytology specimens (Papanicolaou or “Pap” tests) in the Cytopathological Laboratory at the Mexico General Hospital was performed, with evaluation of 6,011 Pap tests randomly selected from 31,378 Pap studies previously reported as negative during 1988–1989. These tests were part of the early detection program for cervical cancer run by the Ministry of Health of Mexico City. A quality index for specimens was constructed based on the presence of endocervical cells, mucus, and squamous metaplastic cells. The index of false negatives for the diagnosis of cervical neoplasm in this sample which correspond to diagnostic error by the examiner was 0.18% (11). The constructed quality index revealed that 64.1% of specimens were low quality. The correlation between diagnostic error and low quality was .87. Results indicate that laboratories participating in early detection programs for cervical cancer in developing countries need to implement (1) external evaluation programs for Pap diagnosis; (2) permanent training programs in registration; and (3) monitoring procedures for collection, fixation, and transportation of cytologic materials. © 1994 Wiley‐Liss, Inc.
Papillary‐cystic tumor of the pancreas in a young woman: Fine‐needle aspiration cytology, ultrastructure and DNA analysis
Authors: Skarda Janet S. , Honick Arnold B. , Gibbins Carl S. , Josselson Arnold R. , Rishi Mazhar
Published: February 2007

A case of papillary‐cystic tumor (PCT) of the pancreas in a young woman is reported. Fine‐needle aspiration (FNA) was done preoperatively under ultrasound guidance. The aspirate showed numerous delicate papillary fragments, dyscohesive and monomorphic tumor cells with folded nuclear membranes, and foamy macro‐phages. A diagnosis of PCT of the pancreas was made based on clinical, radiologic, and cytologic findings. The patient underwent distal pancreatectomy without complications. The histopathologic examination of the surgical tissue confirmed the diagnosis of PCT of the pancreas. The tumor cells were faintly positive with mucicarmine and periodic acid‐schiff (PAS) stains. Immunocytochemistry using Ki67 monoclonal antibody showed a cycling index of 0.1 percent, supporting the clinical observation of low metastatic and recurrence rates of this rare tumor. DNA analysis of the tumor showed a DNA index of 1.09 (diploid) and an S‐phase fraction of 5.38%. The tumor cells were positive for progestrone receptors (> 15 fmol/mg protein) but negative for estrogen receptors (< 15 fmol/mg protein). Abundant mitochondria, prominent endoplasmic reticulum and few junctional complexes were noted on electron microscopy. Emphasis is placed on accurate diagnosis based on preoperative FNA cytology in order to maximize cure rates while minimizing surgical risk and complications. © 1994 Wiley‐Liss, Inc.
Clue helping to distinguish hyalinizing trabecular adenoma from carcinoma of the thyroid in fine‐needle aspirates
Authors: Bondeson Lennart , Bondeson Anne‐Greth
Published: February 2007

Fine‐needle aspirates from four hyalinizing trabecular thyroid adenomas stained with May‐Grünwald‐Giemsa showed a distinctive component of purplish red stromal deposits corresponding to accumulations of basement membrane material occurring in such tumors. Recognition of these deposits helps to prevent cytologic overdiagnosis of malignancy in this rare benign tumor, which has a number of traits in common with both papillary and medullary carcinoma of the thyroid. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology as a tool for the early detection of testicular relapse of acute lymphoblastic leukemia in children
Authors: de Almeida Margarida Mendes , Chagas Mário , de Sousa J. Valen Ça , Mendonça M. Evelina
Published: February 2007

Fine‐needle aspiration cytology (FNAC) of the testis was done in 31 children (33 aspirates) with acute lymphoblastic leukemia (ALL) either as part of an end‐therapy protocol (Group I, n = 20) or because of clinical suspicion of testicular relapse (Group II, n = 13). In Group I, none of the smears showed evidence of leukemic cells. However, two of these patients developed subsequent testicular relapse within 1 yr and were considered false‐negative cases. Blast cells were present in nine patients of Group II; in the remaining four patients no neoplastic cells were observed in the smears and none experienced a relapse after a mean follow‐up of 18 mo. Our findings indicate that FNAC can be a valuable method to evaluate clinically suspected testicular infiltration in children with ALL, and can be considered as an alternative procedure to surgical biopsy for screening testicular recurrence of childhood ALL. © 1994 Wiley‐Liss, Inc.
Metastatic myxopapillary ependymoma: Report of a case with fine‐needle aspiration findings
Authors: Bardales Ricardo H. , Porter Maria C. , Sawyer Jeffrey R. , Mrak Robert E. , Stanley Michael W.
Published: February 2007

A case of recurrent and metastasizing myxopapillary ependymoma of the sacral region in a 35‐yr‐old man is reported. Fifteen years after the original diagnosis, he presented with an abdominal mass, subcutaneous nodules in the previous surgical excirion line, and bilateral inguinal lymph node enlargement. FNA cytology of the inguinal lymph nodes showed a poorly cohesive, highly cellular smear pattern exhibiting papillary formations and rosette‐like structures composed of slim columnar cells having cytoplasmic processes without evidence of atypia. Histologic and ultrastructural findings confirmed the diagnosis. Chromosomal analysis was also done. © 1994 Wiley‐Liss, Inc.
Monoclonal antibody Ber‐EP4: Its use in the differential diagnosis of malignant mesothelioma and carcinoma in cell blocks of malignant effusions and FNA specimens
Authors: Maguire Brigid , Whitaker Darrel , Carrello Salvatore , Spagnolo Dominic
Published: February 2007

Formal sublimate‐fixed cell blocks derived from 129 malignant pleural (and some peritoneal) effusions, 8 benign effusions with reactive mesothelial cells, and 23 FNA specimens, were immunostained with monoclonal antibody Ber‐EP4 to assess its ability to distinguish malignant mesothelioma (MM) from carcinoma.

Only 2 of 44 (4%) well‐characterized MM were Ber‐EP4+, while none of 8 benign mesothelial proliferations reacted with the antibody. Fifty‐seven percent of 23 pulmonary adenocarcinomas (AC) and 60% of 43 pulmonary carcinomas of all other histological types were Ber‐EP4+. Of 40 metastatic AC originating from breast, gastrointestinal tract, ovary, endometrium, and kidney, 80% were Ber‐EP4+. The predictive value of positive Ber‐EP4 staining in distinguishing AC from MM was 96%. The predictive value of a negative Ber‐EP4 in excluding MM was 70%, when the differential diagnosis was adenocarcinoma. These results suggest that Ber‐EP4 is helpful in differentiating MM and AC if used together with other discriminating antibodies. © 1994 Wiley‐Liss, Inc.
Merkel cell tumor of the eyelid and the cytologic aspect in fine‐needle aspirates: Report of a case
Authors: Pérez‐Guillermo M. , Sola‐Pérez J. , Abad‐Montaño C. , Quirante F. A. Pastor , Montalb Romero M. S. Án
Published: February 2007

We describe one case of Merkel cell tumor (MCT) of the eyelid diagnosed by fine‐needle aspiration (FNA). The main cytologic features were: isolated cells, loose cohesive sheets, and rosette‐like structures in a hematic background. The cells were round to ovoid and very uniform. Chromatin was finely granular and frequent mitotic figures were observed. Under close scrutiny small faintly stained juxtanuclear “caps” were seen. A strong dot‐like positivity for CK22 and NFP was observed in the position corresponding to the “caps.” NSE positivity was diffuse, although a weak dot‐like positivity was seen in some cells. S‐100 was negative. Both the cytologic features and the immunocytologic profile of Merkel cell turmor are very characteristic. FNA enables an early and confident diagnosis of this aggressive tumor and an early planning of surgery. © 1994 Wiley‐Liss, Inc.
Small cell anaplastic carcinoma of the prostate: Report of a case with positive urine cytology
Authors: Nguyen‐Ho Phong , Nguyen Gia‐Khanh , Villanueva Ricci R.
Published: February 2007

A case of small‐cell anaplastic carcinoma of the prostate, occurring in an 82‐year‐old man with prior prostatic adenocarcinoma, is reported. The exfoliated tumor cells in the urine were seen singly or in loose aggregates with molding. They showed scant cytoplasm and slightly pleomorphic, hyperchromatic nuclei with inconspicuous nucleoli. By electron microscopy the tumor consisted of primitive epithelial cells without glandular or neuroendocrine diffrentiation. The tumor pursued a highly aggressive course, and the patient died of metastatic disease 4 mo after the diagnosis. © 1994 Wiley‐Liss, Inc.
Role of fine‐needle biopsy in an atypical case of lupus lymphadenopathy
Authors: Loo Christine K. C. , Greenberg Merle L.
Published: February 2007

Necrotizing lymphadenitis dominated by individual cell necrosis with tingible body macrophages and karyorrhectic nuclear debris is an unusual appearance in smears from fine‐needle biopsies (FNB) of lymph nodes (Greenberg et al., Diagn Cytopathol 1993; 9:443‐447). These features together with a polymorphous population of lymphocytes, absent epithelioid histiocytes and neutrophils, suggest a possible diagnosis of either histiocytic necrotizing lymphadenitis (HNL) (syn. Kikuchi's Disease) or systemic lupus erythematostis (SLE). These were the cytologic features found in a FNB of a cervical lymph node in a 43‐year‐old female, treated for a mixed connective tissue disease. A presumptive diagnosis of an acute lupus lymphadenitis was made, based on the above features, and was subsequently confirmed by the presence of raised antinuclear antibodies as well as resolution of the lymphadenopathy on high dose steroids. © 1994 Wiley‐Liss, Inc.
Cytomegalovirus sialadenitis in patients with the acquired immunodeficiency syndrome: A potential diagnostic pitfall with fine‐needle aspiration cytology
Authors: Wax Tim D. , Layfield Lester J. , Zaleski Sue , Bhargara Vivek , Cohen Michael , Lyerly Herbert K. , Fisher Samuel R.
Published: February 2007

We report three cases of cytomegalovirus (CMV) sialadenitis which presented as parotid gland nodules in patients infected with the human immunodeficiency virus. While CMV is known to widely infect patients with the acquired immunodeficiency syndrome (AIDS), we are aware of only a single report of CMV sialadenitis in a patient with AIDS (Pialoux et al.: Rev Infect Dis 1991;13:338). Utilizing fine‐needle aspiration (FNA) cytology as the initial investigative modality, two cases were correctly diagnosed preoperatively while the third case displayed atypical features and was interpreted erroneously as carcinoma leading to surgical intervention. Upon review of these cases of CMV sialadenitis, the characteristic intranuclear inclusions are best identified with Papanicolaou (Pap) staining. CMV sialadenitis should be considered in the differential diagnosis of painless salivary gland enlargement in patients with AIDS. We believe this lesion can be diagnosed preoperatively with FNA and the interpretation is aided by evaluating both Pap‐ and Giemsa‐stained material. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of suture granulomas of the breast: A potential pitfall in the cytologic diagnosis of recurrent breast cancer
Authors: Maygarden Susan J. , Novotny Debra B. , Johnson Danna E. , Powers Celeste N. , Frable William J.
Published: February 2007

The fine‐needle aspirates of three cases of suture granulomas of the breast area following mastectomy, lumpectomy, or axillary node dissection were reviewed. The original histologic diagnoses were mucinous (colloid) carcinoma, intraductal carcinoma, and low‐grade phyllodes tumor. In two patients a new nodule developed in the surgical scar, and in the third a nodule developed in the axilla 2 cm away from the scar. The cellularity of the aspirates ranged from low to moderate, and all three cases contained variable numbers of spindled cells and fragments of cellular stroma. Multinucleated giant cells characteristic of suture granulomas were absent in all cases. Abundant metachromatic amorphous background material was present in one case, which was interpreted as recurrent mucinous carcinoma. The remaining cases were interpreted as suspicious for recurrent neoplasm. Upon excision, all were suture granulomas with fibroblastic proliferation. Suture granulomas can both clinically and cytologically mimic recurrent malignancy. The predominance of spindled cells and dissimilarity to the original tumor appear to be the most helpful features to cytologically distinguish suture granuloma from recurrent carcinoma in the absence of the characteristic multinucleated giant cells. © 1994 Wiley‐Liss, Inc.
Women in the early days of cytology: A personal recollection
Authors: Koprowska Irena
Published: February 2007

The fight for the acceptance of the validity of cytopathology has been fought by a group of individuals associated with George N. Papanicolaou. The common effort to convince the skeptics that Papanicolaou's method of diagnosing cancer was the best way to detect its presence at an early stage became a bond linking all of us. When we taught cytology, we felt more like preaching a gospel than like teaching a subject. Those of us who became involved in original research experienced an additional excitement from expanding the frontiers of our new specialty. This uniquely stimulating experience has been shared by women and men in most of the early cytology teaching centers throughout the world. This was diffrent from the enthusiasm with which people enter the field of cytopathology today. All of us had to constantly prove the validity of what we were doing, whereas now the value of cytologic diagnosis is fully recognized and taken for granted. © 1994 Wiley‐Liss, Inc.
Polyomavirus in the urine: Follow‐up study
Authors: Minassian Haig , Schinella Roger , Reilly Jane C.
Published: February 2007

This study was undertaken to determine the significance of polyomavirus nuclear inclusions in urine cytology specimens. Thirty‐two such cases were identified and patient follow‐up was instituted. We have determined that there is no detectable urologic damage in such patients. In a minority of cases inclusions were found in subsequent urines but they ultimately disappeared within 3 mo. In a minority of the patients (35 percent) there was evidence of diseases associated with immunosuppression or administration of immunosuppressive drugs. © 1994 Wiley‐Liss, Inc.
Paranuclear blue inclusions in small cell undifferentiated carcinoma: A diagnostically useful finding demonstrated in fine‐needle aspiration biopsy smears
Authors: Walker William P. , Wittchow Richard J. , Bottles Kent , Layfield Lester J. , Hirschowitz Sharon , Cohen Michael B.
Published: February 2007

In a study of bone marrow aspiration smears. Wittchow et al. (Mod Pathol 1992;5:555–558) described a highly characteristic finding, paranuclear blue inclusions (PBIs), found almost exclusively in cases of metastatic small cell undifferentiated carcinoma (SCUC). PBIs are 1–4 μm, light blue, cytoplasmic inclusions best visualized with Romanowsky‐type stains. These inclusions are most easily found indenting the nuclei within clusters of closely opposed tumor cells. In the current study air‐dried fine‐needle aspiration biopsy (FNAB) smears from 146 primary and meta‐static small cell and non‐small cell adult and childhood malignancies were reviewed. PBIs were found in 28/32 (88%) of SCUC but were observed in only 4/44 (9%) non‐small cell carcinomas, 2/21 (9.5%) lymphomas, 1/8 (12.5%) melanomas, 0/14 sarcomas, and 6/27 (22%) small round cell neoplasms. These results suggest that the presence of PBIs in air‐dried FNAB smears of adult neoplasms, while not pathognamonic of SCUC, are a diagnostically useful finding. PBIs may be seen in a variety of different childhood small round cell neoplasms which limits their utility in this setting. The recognition of PBIs is most important to the cytologist who may not have access to ancillary studies, such as immunohistochemistry and electron microscopy. © 1994 Wiley‐Liss, Inc.
Paragonimiasis in a cystic breast mass: Case report and implications for examination of aspirated cyst fluids
Authors: Fogel Steven P. , Chañdrasoma Parakrama T.
Published: February 2007

We report a case of paragonimiasis diagnosed by fine‐needle aspiration of a breast mass in a middle‐aged Korean female with a history of breast silicone injections. Although parasitoses have been discovered by aspiration of cyst fluid in otherwise sterile sites (i.e., liver and lung), the cystic presentation in the breast of a middle‐aged female complicated the diagnosis in this case. Some authors have argued against the routine cytologic examination of non‐bloody cyst fluids in premenopausal women, but this protocol may lead to a false negative diagnosis in the rare instance of a parasitic cyst. While microscopic examination of breast cyst fluid is probably not warranted in every patient, it may be useful in patients at risk for unusual cystic lesions, especially if clinical and mammo‐graphic signs of fibrocystic change are absent. © 1994 Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy: Pitfalls in the diagnosis of spindle‐cell lesions
Authors: Powers Celeste N. , Berardo Melora D. , Frable William J.
Published: February 2007

Seven cases of spindle‐cell proliferations in which fine‐needle aspiration biopsy (FNAB) did not correlate with subsequent histology are presented. Three cases were considered low‐grade sarcoma, one a dermatofibrosarcoma protuberans (DFSP), one a spindle‐cell tumor with malignancy not excluded, and one a rhab‐domyosarcoma vs. a fibrosarcoma. Two of the these three were histologically nodular fasciitis and one an inflammatory pseudotumor. Two cases were diagnosed cytologically as fibromatosis or nodular fasciitis (NF). One of these histologically was an intramuscular hemangioma, the other a DESP. The last two cases were diagnosed by FNAB as spindle‐cell lesion, undetermined if benign or malignant, and malignant fibrous histiocytoma (MFH). Histologically both of these case were leiomyosarcoma. The cyto‐logic features of each case, differential diagnosis, and potential pitfalls are discussed. In the evaluation of FNAB smears dominated by spindle cells, cellullarity, individual cells and cell patterns,and background stromal features coupled with a precise clinical history may allow a narrow differential diagnosis with a focus on whether the lesion is benign or malignant. Caution is warranted in the exact classification of spindle‐cell tumors from FNAB as this may have a major impact on patient management. © 1994 Wiley‐Liss, Inc.
Immunocytochemical typification of mesothelial cells in effusions: In vivo and in vitro models
Authors: Ferrandez‐lzquierdo A. , Navarro‐Fos S. , Gonzalez‐Devesa M. , Gil‐Benso R. , Llombart‐Bosch A.
Published: February 2007

We have performed immunocytochemical, immunoelectron microscopy. Western blot, and culture techniques using monoclonal antibodies against cytokeratin, vimentin, and desmin on 17 benign and 20 malignant effusions of pleural and ascitic origin. Triple coexpression of these three antigens was observed in benign reactive mesothelial cells as well as in one case of mesothelioma. All metastatic adenocarcinoma cells were consistently negative to desmin and positive to cytokeratin and vimentin. Present results were helpful to distinguish reactive and malignant mesothelioma from metastatic carcinoma cells in effusions. © 1994 Wiley‐Liss, Inc.
Prognostic and diagnostic implications of estrogen and progesterone receptor assays in cytology
Authors: Masood Shahla
Published: February 2007

Scientific evidence suggests that cancer is a consequence of genetic changes that result in uncontrolled cellular growth, tissue invasion, and metastasis. This concept has led to a great deal of excitement in the medical community in the hope that precise identification of genes involved in human cancer could potentially facilitate our understanding of human malignancies. It may also be possible to apply this information directly to different clinical settings. Many technologies are now available which offer opportunities for pathologists to not only expand their diagnostic abilities, but also to assess the prognosis of a given tumor in a specific patient. These include immunocytochemistry, flow cytometry, cell image analysis, and molecular genetic studies. In this review, the role of immunocytochemical hormone receptor assay as an aid in tumor prognosis and in prediction of tumor response to endocrine therapy will be discussed. Emphasis will be placed on the use of hormone receptor assay as an adjunct in diagnostic pathology and in assessment of metastatic tumors of unknown origin. The potential value of assessment of hormone receptors in different cytologic preparations will also be discussed. © 1994 Wiley‐Liss, Inc.
Prevalence of HPV 16 and 18 DNA sequences in CIN III lesions of adults and adolescents
Authors: Johnson Terri L. , Joseph Christine L. M. , Caison‐Sorey T. Jann , Smith Richard E. , Bedrossian Carlos W. M. , Sarkar Fazlul H.
Published: February 2007

Adolescents may be more susceptible to cervical human papillomavirus (HPV) infections and may have more rapid progression of cervical intraepithelial neoplastic (CIN) lesions than adults. We evaluated Papanicolaou (Pap) smears and cervical tissue specimens from a consecutive series of 25 adolescent (age 15‐20 yr) and 17 adult (age 35‐40 yr) patients with a histologic diagnosis of CIN III. The study patients were all Detroit residents enrolled in a health maintenance organization (HMO) affliated with Henry Ford Hospital. The cervical tissue specimens were evaluated for HPV 6b/11, HPV 16, and HPV 18 using agarose gel electrophoresis and Southern hybridization following polymerase chain reaction (PCR) DNA amplification. While the small sample size precluded testing for statistical significance, HPV 16 and/or HPV 18 DNA was detected in specimens from 21/25 (84%) adolescents compared to 12/17 (71%) adults (odds ratio [OR] = 2.2; 95% confidence interval [CI] = 0.49‐9.74). The relationship between adolescence and HPV infections appears to be stronger for HPV 18 and mixed HPV 16/18 infections (OR = 5.6; 95% CI = 0.7‐42.4) than for HPV 16 infections (OR = 1.93; 95% CI = 0.4‐8.8). None of the cervical specimens contained HPV 6b/11 DNA. Oral contraceptive (OC) use was associated with HPV infection in patients with CIN III, but there was no association between cigarette smoking and HPV infection. The effect of OC use on the relationship of age and HPV could not be evaluated due to small sample size. The effects of previous sexually transmitted disease (STD) on the relationship of age and HPV were assessed. Among women with a history of STD, there was a strong association between HPV and adolescent age (OR = 18.0; 95% CI = 1.2‐260.0). Our data suggest that among women with CIN III, adolescents have a higher prevalence of certain high‐risk types of HPV infections than adults. The excess is due predominantly to the higher rates of HPV 18 and mixed HPV 16/18 infections in adolescents. The positive relationship between high‐risk HPV infections and young age was most evident in adolescents with a history of STD. The results from this study suggest that differences in HPV type infections may be related to the more aggressive clinical course of CIN in adolescents. © 1994 Wiley‐Liss, Inc.
DNA adduct assay in cervical epithelium
Authors: Simons Andrew M. , Phillips David H. , Coleman Dulcie V.
Published: February 2007

Numerous epidemiological studies have shown that there is an association between smoking and cervical cancer. However, the essential evidence to show whether this relationship is casual or causal is lacking. The demonstration of DNA modification by tobacco components in the cervical epithelium would provide biochemical evidence to support a causal role. In this study, DNA from 39 cervical biopsies was analysed for the presence of DNA adducts using the 32P‐postlabelling technique. A questionnaire on smoking habit and a urinary cotinine assay were used to identify smokers and nonsmokers. DNA samples from smokers [identified from questionnaire] were found to have significantly higher adduct levels than nonsmokers (Mann‐Whitney one‐tailed U‐test, 95% CI > 0.339, P = 0.024). Exclusion of the women whose urinary cotinine levels did not confirm their self‐reported smoking status (smoker or nonsmoker) increased this significance (95% CI > 0.508, P = 0.01). Women who had abnormal cervical smears hadsignificantly higher DNA adduct levels than those with normal smears (95% CI > 0.439, P = 0.015). Monitoring of women with high DNA adduct levels may be a way of identifying women at risk of cervical cancer.

These findings demonstrate that tobacco smoking by women leads to elevated levels of DNA adducts in cervical epithelium and provides the biochemical evidence to support the concept that smoking is a cause of cervical cancer. © 1994 Wiley‐Liss, Inc. Published 1994 Wiley‐Liss, Inc. © 1994 Wiley‐Liss, Inc.
Transthoracic fine‐needle aspiration biopsy cytology of pulmonary neoplasms
Authors: Hayes Malcolm M. M. , Zhang Dong Yue , Brown William
Published: February 2007

The experience with 212 transthoracic fine‐needle aspiration biopsy cytology specimens of mass lesions of the lung at a small Canadian hospital is reviewed. The technique showed a sensitivity of 78.0%, a specificity of 85.7%, a positive predictive value of 98.5%, and a negative predictive value of 25.0% when the cytological diagnoses were compared with the final clinicopathological diagnoses listed in the patients' charts. There was only one false positive diagnosis of malignancy. Diagnoses based on cytology of the aspirates were compared with histological diagnoses in 127 cases and the accuracy of typing of the major groups of carcinoma was assessed. Distinction between small‐cell carcinoma and non‐small‐cell carcinoma was usually accurate and fairly good correlation was achieved for all major types of carcinoma. The results for typing of the neoplasm are not as good as those from larger centres in the world. The technique is considered to be useful even in the setting of a small hospital. © 1994 Wiley‐Liss, Inc.
Paranuclear blue inclusions: An aid in the cytopathologic diagnosis of primary and metastatic pulmonary small‐cell carcinoma
Authors: Mullins Rejeana K. , Thompson Sophie K. , Coogan Philip S. , Shurbaji M. Salah
Published: February 2007

Accurate diagnosis of small‐cell carcinoma of the lung (SCLC) is clinically important because of the therapeutic implications. SCLC must be distinguished from non‐small‐cell carcinoma (NSCLC) and lymphoma. Paranuclear blue inclusions (PBIs) were recently described as a feature of metastatic SCLC on air‐dried Wright‐stained bone marrow aspirate smears. To determine the utility of PBIs in distinguishing SCLC from NSCLC and lymphoma, we evaluated air‐dried Diff‐Quik‐stained smears from 103 fine‐needle aspiration (FNA) specimens and 14 touch imprint specimens. PBIs were identified in 24 (89%) of 27 cases of SCLC, in 6 (9%) of 64 non‐small‐cell carcinomas (P < 0.00001), and in two (8%) of the 26 lymphoma cases (P < 0.00001). No PBIs were seen on any of the alcohol‐fixed Papanicolaou or hematoxylin‐eosin (H&E) stained smears examined. In conclusion, PBIs appear to be a feature of SCLC on air‐dried cytologic material stained with Romanowsky type stains. In the presence of cytologic features of SCLC, the identification of PBIs provides a useful diagnostic feature for diferentiating between SCLC and NSCLC carcinomas, and between SCLC and lymphomas in FNA specimens and touch imprints from surgical specimens. © 1994 Wiley‐Liss, Inc.
Potassium permanganate resistant amyloid in fine‐needle aspirate of the liver
Authors: Srinivasan Radhika , Nijhawan Raje , Gautam Upasana , Bambery Pradeep
Published: February 2007

A case of primary amyloidosis, initially detected by fine‐needle aspiration of the liver, is reported here. Amorphous acellular metachromatic material was seen extracellularly in between the hepatocytic cords compressing them. This material showed typical apple‐green birefringence under crossed bipolars after alkaline Congo‐red staining proved its amyloid nature. It was resistant to potassium permanganate pretreatment, indicating it to be of the AL type. © 1994 Wiley‐Liss, Inc.
Cervicovaginal cytology and the diagnosis of Chlamydia Trachomatis: A comparison with immunofluorescent results
Authors: Caudill Jill L. , Humphrey Sandra K. , Goellner John R.
Published: February 2007

To evaluate the accuracy of a Chlamydia diagnosis in our laboratory, cytologic Chlamydia diagnoses for the years 1990 and 1991 were compared with immunofluorescent studies for Chlamydia for the same period. Only one of 22 cases diagnosed cytologically as suggestive of Chlamydia had a positive immunofluorescent result. On rescreen of 110 cervicovaginal smears taken within I mo of a positive fluorescent antibody test, 11 cases were found to contain criteria suggestive of Chlamydia. These correlations represent a 4.5% specificity and 10% sensitivity rate, suggesting that our current efforts in cytology are not effective in determining the presence of Chlamydia. Diagn Cytopathol 1994; 11:20–22. © 1994 Wiley‐Liss, Inc.
Lymphoglandular bodies in lymphoid lesions and non‐lymphoid round cell tumors: A quantitative assessment
Authors: Francis Issam M. , Das Dilip K. , Ai‐Rubah Nawal A. R. , Gupta Subhash K.
Published: February 2007

Lymphoglandular bodies (cytoplasmic fragments) were counted in 10 high power fields (HPF) of the smears in 35 cases of non‐Hodgkin lymphoma (NHL), 26 Hodgkin's disease (HD), 36 reactive lymphadenitis, 24 non‐lymphoid round cell tumors, and 20 cases of secondaries in lymph nodes. The number of lymphoglandular bodies in both May‐Grünwald‐Giemsa (MGG) and hematox‐ylin‐eosin (H&E) stained smears in NHL, HD, and reactive lymphadenitis were significantly higher compared to non‐lymphoid round cell tumors (P < 0.001). In H&E stained smear 92.5% of NHL, 86.2% of reactive lymph nodes, and 66.7% of HD cases had > 100 lymphoglandular bodies per 10 HPF. In MGG stained smears 100% NHL, 89.7% of reactive lymphadenitis, and 66.7% of HD cases contained > 100 lymphoglandular bodies per 10 HPF. On the other hand only 4.8% of non‐lymphoid round cell tumors crossed this level in both H&E stained and MGG stained smears. Number of lymphoglandular bodies was also significantly higher in MGG stained smears compared to H&E stained smears (P < 0.05 to < 0.01) and in fine‐needle aspiration (FNA) smears compared to imprint smears (P < 0.01 to < 0.001) in cases of NHL, HD, and reactive lymphadenitis. Diagn Cytopathol 1994; 11:23–27. © 1994 Wiley‐Liss, Inc.
HPV typing of cervical squamous lesions by in situ HPV DNA hybridization: Influence of HPV type and therapy on the follow‐up of low‐grade squamous cervical disease
Authors: Raisi Orville , Ghirardini Carla , Aloisi Piero , Cermelli Claudio , Portolani Marinella
Published: February 2007

Papanicolaou (Pap)‐stained cervical specimens from 160 squamous lesions were processed for the detection of human papillomavirus (HPV) DNA by an in situ hybridization (ISH) assay. Three biotinylated HPV DNA probes were employed, each containing HPV genotypes 6/11, HPV genotypes 16/18, or HPV genotypes 31/35/51. The HPV etiology of 86 lesions was ascertained (53.8%). In 74 out of 135 (58.8%) HPV‐typed low‐grade squamous intraepithelial lesions (SILs), HPV 6/11 was found in nine (6.6%), HPV 16/18 in 46 (34.2%), and HPV31/35/51 in 19 lesions (14.1%); in 11 out of 18 HPV‐typed high‐grade SILs (61.1%), seven lesions (38.9%) were typed for HPV 16/18 and four (22.2%) for HPV 31/35/51. Of seven invasive carcinomas, only one (14.3%) reacted with the HPV 16/18 DNA probe. A cohort of 124 low‐grade SILs was followed cytologically for a year. The results of this study are discussed in light of HPV type association and therapy. Diagn Cytopathol 1994; 11:28–32. © 1994 Wiley‐Liss, Inc.
Matrix crystals in cytologic urine specimens: Observations on their mineral composition by energy dispersive X‐ray microanalysis and morphologic scanning electron microscopy
Authors: Zaharopoulos Paul , Wen Julie W. , Wong Jick
Published: February 2007

Crystals consisting by light microscopy of organic matrix (matrix crystals) encountered in cytologic urine specimens of 8 patients were examined for mineral phase components by scanning electron microscopy with energy dispersive X‐ray microanalysis (SEM‐EDX) and by morphologic scanning electron microscopy (SEM) performed separately in four of the eight cases. Whenever possible (three cases) mineralized crystals present in these specimens were examined separately by SEM‐EDX for comparison of mineral phase composition with that of the corresponding matrix forms. Although by SEM‐EDX components of matrix, glass and slide preparation media interfere with the precise estimation of the mineral phase components, the results of this method supported by the SEM morphology suggest that crystals consisting of organic matrix include a mineral phase, the lattice structure of which provides them from the early stages of formation with the characteristic morphology of the fully mineralized forms. This also suggests that organic matrix plays a role in the nucleation of minerals during the formation of certain urinary crystals. Diagn Cytopathol 1994; 11:38–46. © 1994 Wiley‐Liss, Inc.