Diagnostic Cytopathology via MedWorm.com

Evaluation of apoptosis in cytologic specimens

Diagnostic Cytopathology — Sat, 13 Mar 2010 00:00:00 +0100

A hallmark of neoplasia is dysregulated apoptosis, programmed cell death. Apoptosis is crucial for normal tissue homeostasis. Dysregulation of apoptotic pathways leads to reduced cytocidal responses to chemotherapeutic drugs or radiation and is a frequent contributor to therapeutic resistance in cancer. The literature pertaining to detection of apoptotic pathway constituents in cytologic specimens is reviewed herein. Virtually all methods for detecting apoptosis, including classic cytomorphologic evaluation, TUNEL assay, immunocytochemistry, and gene sequence analysis, may be applied to cytologic samples as well as tissue. Components of both intrinsic and extrinsic apoptotic pathways have been studied, including many reports examining p53 and bcl-2, as well as studies of caspase inhibitory...

Primary large cell neuroendocrine carcinoma of the vagina: Cytomorphology of previously unreported case

Diagnostic Cytopathology — Thu, 11 Mar 2010 00:00:00 +0100

In this report, we describe a case of LCNEC of the vagina, which is believed to be the first case to date in the English literature. The patient is a 53-year old gravida 3, para 2, African-American woman who had a 4 month history of severe pelvic pain and difficulty voiding and was found to have a firm plate-like mass on the anterior vaginal wall. Thin prep of vaginal swap was interpreted as atypical glandular cells; however, the biopsies showed a large cell neuroendocrine carcinoma which was confirmed by diffuse strong immunoreactivity to AE1/3, CAM5.2, CK7, and CD56 in the tumor cells. Subsequent clinical workup showed that the patient also had numerous metastatic nodules in the bilateral lungs and a vaginal-urethral fistula caused by the tumor. The patient underwent palliative radiation...

Metastasis of colon cancer to the thyroid gland: A case diagnosed on fine-needle aspirate by a combined cytological, immunocytochemical, and molecular approach

Diagnostic Cytopathology — Tue, 09 Mar 2010 00:00:00 +0100

Fine-needle aspiration (FNA) with cytological evaluation reliably diagnoses primary and secondary thyroid neoplasms. However, identifying the primary origin of a metastatic process involving the thyroid gland is challenging. In particular, metastasis of colon cancer to the thyroid gland is very rare. In this case report, a right lobe solid thyroid nodule in a 66-year-old male was aspirated. FNA cytology showed necrosis and atypical tall columnar cells; since, the patient at age 60 had undergone surgery for a sigmoid-rectal cancer metastasizing to the liver and subsequently to the lung, a suspicion of metastasis from colon cancer was raised. This was corroborated by cell-block immunocytochemistry showing a cytokeratin (CK) 7 negative/CK20-positive staining pattern; thyreoglobulin and TTF-1 ...

Melanocytic bronchopulmonary carcinoid tumor in a patient with multiple endocrine neoplasia syndrome type 1: A case report with emphasis on intraoperative cytological findings

Diagnostic Cytopathology — Tue, 02 Mar 2010 00:00:00 +0100

We present the cytological features along with histologic and imaging findings of a melanocytic bronchopulmonary carcinoid tumor in a patient with multiple endocrine neoplasia syndrome type 1 (MEN-1). Intraoperative touch preparations of the lung tumor showed single spindle cells and loosely cohesive aggregates of spindle cells with oval to elongated nuclei, "salt and pepper" chromatin pattern and inconspicuous nucleoli. The spindle cells occasionally contained cytoplasmic pigment, which revealed to be melanin by Fontana Masson stain on permanent processed material. Immunohistochemical stains for both synaptophysin and chromogranin were strongly positive in the spindle cells. The findings were consistent with melanocytic bronchopulmonary carcinoid tumor, which is relatively uncommon in MEN...

Fine-needle aspiration biopsy diagnosis of costal juxtacortical chondrosarcoma presenting as an abdominal mass

Diagnostic Cytopathology — Thu, 25 Feb 2010 00:00:00 +0100

The majority of chondroid tumors arising in the cortex of bone are benign in nature. Juxtacortical chondrosarcoma is a relatively uncommon variant of chondrosarcoma, which by definition, is a malignant cartilaginous tumor that occurs on the surface of bone and measures at least 5 cm.Although the diagnostic value of fine-needle aspiration biopsy is well established, its role in the diagnosis of soft tissue/bone tumors is still not uniformly accepted. Herein, we describe an interesting and controversial case of costal juxtacortical chondrosarcoma presenting as a large intraabdominal mass in a 52-year old female patient, which was diagnosed by fine-needle aspiration biopsy. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

FNA diagnosis of teratoma lung: A case report

Diagnostic Cytopathology — Wed, 24 Feb 2010 00:00:00 +0100

A case of teratoma occurring in the lung of a 27-year-old female, diagnosed by fine-needle aspiration cytology and confirmed by histopathology, is being presented here. Occurrence of teratoma at this site is a rare entity. The authors take this opportunity to report such a rare case, and as to the best of our knowledge, not many cases have been reported in literature till date. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Epithelioid cell granulomas in urine cytology smears: Same cause, different implications

Diagnostic Cytopathology — Wed, 24 Feb 2010 00:00:00 +0100

Tuberculosis of the urinary tract is usually secondary to tuberculosis of the kidney. Multinucleated giant cell histiocytes, often with peripheral nuclei (Langhans' cells), may be identified. Acid-fast bacilli on smear or positive urine cultures confirm the diagnosis. Similar findings can also be seen in patients treated with Bacillus Calmette Guérin (BCG) for transitional cell carcinoma or after bladder surgery. Here, we present two cases showing epithelioid cell granulomas and multinucleated giant cells on urine cytology, and discuss the differentiating features on cytomorphology and their therapeutic implications. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Fine-needle aspiration of metastatic radiation-induced cutaneous epithelioid angiosarcoma of the breast to the liver: A diagnostic dilemma

Diagnostic Cytopathology — Wed, 24 Feb 2010 00:00:00 +0100

We present a case of metastatic radiation-induced cutaneous epithelioid angiosarcoma of the breast to the liver and a review of the literature. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Ancillary testing in liquid based cytology to distinguish cervical glandular neoplasia from tuboendometrial metaplasia in a young woman

Diagnostic Cytopathology — Wed, 24 Feb 2010 00:00:00 +0100

A 33-year old woman had a cervical sample taken at colposcopy clinic. Seven years prior to this, at the age of 26, she had had a cytological diagnosis of cervical glandular neoplasia (cytology descriptor indicated cells suspicious of endocervical neoplasia) and severe dyskaryosis. Confirmation and treatment were by LLETZ and knife cone, and, in keeping with England and Wales National Health Service guidelines, this woman was under follow-up by the colposcopy clinic. Intervening cytological follow-up included a number of negative cytological samples interspaced with one equivocal report. A recent repeat cytology which was rather cellular contained several hyperchromatic crowded cell groups (HCCG's). Careful examination revealed benign endometrial clusters, LUS, TEM and endocervical cells in...

Morphologic features of prostatic adenocarcinoma on ThinPrep® urinary cytology

Diagnostic Cytopathology — Wed, 10 Feb 2010 00:00:00 +0100

Malignant cells of prostatic adenocarcinoma are rarely identified in urine. In most cases, this finding is associated with high stage tumor. Numerous descriptions of the morphology of prostatic adenocarcinoma have been reported using cytocentrifugated specimens. However, no specific morphologic description of prostatic adenocarcinoma in urine using liquid-based cytology has been previously described. Four cases of prostatic adenocarcinoma in urine using ThinPrep® liquid-based preparations were identified between 2002 and 2009 at the University of Wisconsin Hospital and Clinics. Three patients had either high stage tumor or metastatic disease at the time of diagnosis, while the remaining patient had low stage tumor. The morphology of each case was evaluated with specific attention to cell ...

Immunohistochemistry on squash smears: A diagnostic aid

Diagnostic Cytopathology — Tue, 09 Feb 2010 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Podoplanin is a useful marker for identifying mesothelioma in malignant effusions

Diagnostic Cytopathology — Tue, 09 Feb 2010 00:00:00 +0100

In this study, we evaluated the value of immunostaining pattern for podoplanin to differentiate mesothelioma from adenocarcinomas of various origins.Cell blocks from previously collected paraffin-embedded cell blocks of 86 effusions (18 mesothelioma, 35 reactive mesothelium, 9 breast adenocarcinoma, 14 ovarian adenocarcinoma, and 10 lung adenocarcinoma) were retrieved from the file of the Department of Pathology at University of Michigan and Lund University in Sweden and were used for the study. Slides prepared from the cell blocks were stained for podoplanin. The percentage of immunostained cells was recorded as follows: 1+ (5-25%), 2+ (26-50%), and 3+ (>50%). A stain result involving (Source: Diagnostic Cytopathology)

Clinical parameters associated with unsatisfactory specimens of conventional cervical smears

Diagnostic Cytopathology — Thu, 21 Jan 2010 00:00:00 +0100

In conclusion, if any of these parameters are noted prior to obtaining a Pap smear, optimal collecting devices, better sampling techniques, and liquid-based cytology should be considered to decrease the incidence of unsatisfactory smears. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Cytology of sclerosing epithelioid fibrosarcoma in pleural effusion

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

We report a case of sclerosing epithelioid fibrosarcoma focusing on its cytological features in pleural effusion. A 32-year-old man had noticed a tumor in his left buttock 5 years earlier but had not sought treatment because the tumor had been painless. He visited our hospital because the tumor had gradually increased in size. The resected tumor was 12 × 8 × 6 cm in size and had a delineated margin. The histological diagnosis was sclerosing epithelioid fibrosarcoma with a negative surgical margin. Multiple tumor nodules were recognized in both lungs 9 months after the initial surgery, and an excisional biopsy was performed. A histological examination revealed a metastasis of sclerosing epithelioid fibrosarcoma, and chemotherapy was initiated. Pleural disseminations were detected 4 years ...

The use of fine-needle aspiration biopsy samples for the assessment of basal phenotype in triple negative breast cancer patients: A correlative study

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

This study was designed to correlate FNAB samples with corresponding surgical specimens for the assessment of basal phenotype in patients with triple negative breast cancer (TNBC). A total of 198 cases of TNBC with matching FNAB and surgical specimens were identified. Forty-six cases with sufficient tissue in both FNAB cell blocks and surgical specimens were selected. Tissue microarray blocks were prepared and stained with six biomarkers (CK5/6, p63, SMA, EGFR, C-Kit, and p53). For statistical analysis, we used the observed (Gross) percentage of agreement and also calculated the Cohen's Kappa for each biomarker. We found a high agreement between the two groups as shown by the values of Observed (Gross) percentage of agreement (mostly 90% or higher except for the C-Kit which was 78%). In ad...

Cribriform-morular variant of papillary thyroid carcinoma - Cytological and immunocytochemical findings of 18 cases

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

We examined 19 ultrasound-guided fine needle aspiration (FNA) specimens from 18 CMV-PTC patients. Cytologic features of CMV-PTC were as follows, (1) hypercellularity, (2) papillary arrangement composed of tall columnar cells, (3) cribriform pattern, (4) morules, (5) spindle cells, (6) obscure ground-glass nuclei, (7) peculiar nuclear clearing (PNC), (8) foamy or hemosiderin-laden histiocytes, (9) hyaline materials, (10) absence of colloid in the background. The nuclear and cytoplasmic immunoreactivity of beta-catenin and biotin-positive PNC can indicate CMV-PTC. We believe that cytologic diagnosis of CMV-PTC is possible and it may lead to the early detection of polyposis coli. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Role of fine needle aspiration cytology in diagnosis of filarial infestation

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

Filariasis is a tropical disease transmitted by the Culex mosquitoes. The diagnosis of it is conventionally made by demonstrating microfilariae in the peripheral blood smear. However; microfilariae and adult filarial worm have been incidentally detected in fine needle aspirates of various lesions in clinically unsuspected cases. The cases of filariasis diagnosed by fine needle aspiration cytology (FNAC) were retrieved from the archives of the Cytopathology laboratory between the periods of January 1998 to February 2009. Both Papanicolaou- and May-Grunwald-Giemsa-stained smears were available in all the cases. A total of 26 diagnosed cases of filariasis were found, of which 19 were related to funiculo-epididymitis, four presented with breast lump, and three cases with lymphadenopathy. Smear...

Fibroblastic proliferation in chronic cervicitis mimicking epithelioid cell granuloma on cervical cytology

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Diagnosis of sternomastoid tumor of infancy by fine-needle aspiration cytology

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

We report eight cases of sternomastoid tumor of infancy diagnosed by FNAC. The objective of the study is to present the role of FNAC in the diagnosis of sternomastoid tumor with its cytomorphological features. FNA was done by using 23-guage needle and 10 ml disposable plastic syringe. The wet smears were fixed in 95% ethanol and processed for Papanicolaou stain. The dried smears were stained with May-Grünwald-Giemsa stain. The smears were studied for cytomorphologic features. The age of the patients ranged between 2 and 10 weeks. Male: Female ratio was 1.6:1. Six of eight had history of prolonged labor, two had history of breech presentation, and three had history of forceps assisted vaginal delivery. Cytologic findings included singly scattered and loose clusters of benign fibroblasts wi...

Pulmonary zygomycoses in an immunosuppressed patient

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Improving the diagnostic accuracy of thyroid follicular neoplasms: Cytological features in fine-needle aspiration cytology

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

Cytological diagnosis in follicular neoplasms of the thyroid has to surmount some difficulties. Capsular/vascular invasions or metastasis are the histological criteria for follicular carcinoma (FC), and, on fine-needle aspiration (FNA) samples, marked cytological atypias are only observed in moderately to poorly differentiated FC, while they may be completely lacking in well differentiated angio- or capsulo-invasive FC. To clarify the cytological features and to improve the accuracy and reliability of aspiration cytology, 892 follicular adenomas and 82 FCs were reviewed. A macrofollicular pattern or large sheet pattern of follicular cells with thin colloid in the background were found to be indicators of follicular adenoma. Crowding or irregular arrangement of follicular cells were found t...

Pleomorphic (sarcomatoid) carcinoma of lung - Cytohistologic and immunohistochemical features

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Controls in quality assessment in gynecologic cytology

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

Major components of good quality assurance (QA) in cytology laboratories are measuring the screening accuracy of cytotechnologists (CTs) and determining appropriate workload limits for them. Currently, the FDA approved workload limits for image assisted Paps, however, are too high. In addition, the CLIA 88 mandated QA measures, by themselves, are insufficient to accurately measure the screening performance of CTs. Although the use of "controls" is fundamental to good practice in the clinical laboratory; this has not been emphasized in gynecologic cytology. In this review, we underscore the importance of using controls, such as monitoring morning and afternoon abnormal rates, in assessing CT performance and assigning reasonable workload limits. Using controls, however, requires significant ...

The impact of using defined criteria for adequacy of fine needle aspiration cytology of the thyroid in routine practice

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

In this study, we aimed to explore the reasons for high percentage of inadequate thyroid FNAC samples and to reevaluate those samples by applying clearly defined criteria suggested in the literature to reduce the proportion of inadequate aspirates.The results of 550 smears reported as inadequate FNAC samples are presented over a period of 15 years extending from 1986 to 2000 (18.8%). For the purpose of the study, only those patients with subsequent histological or cytological analysis were included (279). The original FNA samples were reviewed by two cytopathologists, unaware of the subsequent repeat cytology or histology results. Specific criteria for adequacy of specimens were used which include the presence of six or more groups of follicular cells, each having more than 10 discernable ...

Fine-needle aspiration diagnosis of a metastatic adult sclerosing rhabdomyosarcoma in a lymph node

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

We report here a 55-year-old woman who presented with a right thigh mass and associated ipsilateral inguinal lymphadenopathy. Biopsy of the mass revealed a uniform population of small, round cells in a dense, sclerotic background. A diagnosis of ASRMS was rendered. Subsequently, the patient underwent FNA of an enlarged inguinal lymph node, which revealed an identical population of small, round cells in a dense, myxoid background. This case highlights the cytologic features of a rare form of rhabdomyosarcoma, and emphasizes the utility of FNA in the assessment of lymphadenopathy in the setting of a soft-tissue sarcoma. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Cytopathologic features of orbital intraosseous chordoid meningioma

Diagnostic Cytopathology — Wed, 20 Jan 2010 00:00:00 +0100

Chordoid meningioma (CM) is characterized by a striking histologic resemblance to chordoma and propensity for aggressive behavior or recurrence (WHO grade II designation). Orbital intraosseous CM is extremely uncommon and only one case report has been documented. A case is presented here in which squash smears of a left orbital tumor in a 53-year-old male revealed small clusters or cord-like structures of bland tumor cells embedded in a myxoid or mucinous background. Whorl-like structures were also identified. The tumor cells possessed uniformly round nuclei with a smooth nuclear outline, fine granular chromatin, and small nucleoli. Occasional intranuclear inclusions, coarse collageneous cytoplasmic filaments were observed. Many spindle-shaped cells with similar nuclear findings were also ...

Merkel cell carcinoma metastatic to the thyroid gland: Aspiration findings and differential diagnosis

Diagnostic Cytopathology — Sat, 16 Jan 2010 00:00:00 +0100

Clinically diagnosed metastasis to the thyroid gland is exceptionally rare and may present diagnostic issues on fine needle aspiration. The most common primary sites of metastases to the thyroid are cancers of the lung, breast, skin (especially melanoma), colon, and kidney. Herein, we report a case of metastatic Merkel cell carcinoma to the thyroid presenting as a 2.1-cm solid nodule in a 50-year-old male with a previous history of Merkel cell carcinoma of the upper extremity. The aspirates were moderately to highly cellular featuring small to intermediate sized cells with scant to no cytoplasm, round-to-oval nuclei with finely dispersed chromatin, and predominantly arranged as scattered single cells. There was focal nuclear molding, numerous mitoses, and karyorrhectic nuclei. The differen...

Fine-needle aspiration biopsy of an invasive ductal carcinoma with medullary features presented with abscess formation

Diagnostic Cytopathology — Fri, 15 Jan 2010 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Liqui-Prep® versus conventional Papanicolaou smear to detect cervical cells abnormality by split-sample technique: A randomized double-blind controlled trial

Diagnostic Cytopathology — Sat, 09 Jan 2010 00:00:00 +0100

To assess the diagnostic performances of LiquiPrep® (LP) to detect cervical cellular abnormality in comparison to Papanicolaou (Pap) smear in 194 women with abnormal cervical cytology who were scheduled for colposcopy at the institution between January 2008 and November 2008. The women were randomized to undergo a repeated cervical cytologic evaluation by Pap smear followed by LP, or the two methods in alternating order. The pathologist was blinded to previous cytologic diagnosis and the pair of slides assigned for each woman. Cytologic results from each method were compared to subsequent histopathology. Mean screening time for each LP and Pap slides were 4.3 ± 1.2 minutes and 5.4 ± 1.1 minutes, respectively (P < 0.001). From 194 cases, ASC or AGC were diagnosed in 72 cases (37.1%) from...

Cytomorphological criteria, subclassifications of endocervical glandular cell abnormalities, and histopathological outcome: A frequency study

Diagnostic Cytopathology — Fri, 08 Jan 2010 00:00:00 +0100

The objective of this study was to evaluate the frequency and the significance of cytomorphological criteria defined in studies as being predictive of neoplasia in cervical smears of women with a cytological diagnosis of atypical glandular cells (AGC) or adenocarcinoma in situ (AIS). Women (n = 103) with cytological findings suggestive of AGC or AIS, whose diagnoses were later established by histopathology, were included in the study. The criteria analyzed and classified as present or absent in cervical smears previously classified as AGC-NOS (not otherwise specified), AGC-FN (favor neoplasia), or AIS were as follows: irregular nuclear membranes; scanty cytoplasm; dyskeratotic cells; increased nuclear/cytoplasmic ratio; nucleoli; overlapping; papillary clusters, feathering; loss of polarit...

Fine-needle aspiration cytology of scar endometriosis: Study of seven cases and literature review

Diagnostic Cytopathology — Fri, 08 Jan 2010 00:00:00 +0100

Endometriosis is defined as the presence of endometrial-like glands and stroma outside the uterine endometrial lining. Endometrial tissue has also been identified in numerous surgical or procedure scars, including cesarean section and laparoscopic trocar tract.A prospective study was conducted at Maternidade-Escola Assis Chateaubriand, Faculty of Medicine, Federal University of Ceara, Brazil in seven patients with abdominal wall mass pathologically proven as scar endometriosis from January 2004 to December 2008. All cases were submitted to fine-needle aspiration cytology (FNAC).Age ranged from 21 to 42 years old (mean: 30) with parity ranging from 0 to 3 (mean: 1.4). The preceding history of pelvic procedures was miomectomy (1 of 7), cesarean section (3 of 7), and diagnostic laparoscopy (3...

Proximal-type epithelioid sarcoma of the maxilla with metastasis to the scalp: Cytologic findings of an unusual malignant tumor

Diagnostic Cytopathology — Thu, 07 Jan 2010 00:00:00 +0100

We describe here the cytological findings of an ESPT metastatic to the scalp in a 14-year-old boy. Cytological preparations showed a discohesive population of pleomorphic ovoid to polygonal cells with large irregular nuclei and prominent nucleoli. Isolated cells with rhabdoid features were noted. These cells had abundant cytoplasm and occasional intracytoplasmic hyaline inclusions. In the light of the patient's clinical history of a known primary ESPT of the maxilla, the cytologic features were distinct enough to render a diagnosis of a metastatic lesion to the skull. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Book review: Histologic Preparations: Common Problems and Their Solutions

Diagnostic Cytopathology — Tue, 05 Jan 2010 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Reed-Sternberg cells in breast FNA of a patient with left breast mass

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

We report a rare case of Hodgkin's lymphoma presented as a breast mass in a 23-year-old woman diagnosed on fine needle aspiration (FNA). At presentation, she had no B symptoms, or palpable lymphadenopathy. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Fine-needle aspiration of follicular patterned lesions of the thyroid: Diagnosis, management, and follow-up according to National Cancer Institute (NCI) recommendations

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

In this study, we report the combined experience from our institutions with thyroid FNA cases that can be placed into NCI-designated thyroid FNA diagnostic categories for follicular patterned lesions.The case cohort comprised of 857 cases in 645 females and 212 males; 509 cases could be classified as FLUS/AUS and 348 as SFON/FON. Histologic follow-up was available in 273/509 (54%) cases diagnosed as FLUS/AUS and 251/348 (72%) cases diagnosed as SFON/FON.RFNA was performed in 203/509 (40%) patients classified as FLUS/AUS. RFNA diagnoses were: benign (125 cases), FLUS (46 cases), SFON/FON (20 cases), suspicious for papillary carcinoma (7 cases), papillary carcinoma (3 cases) and non-diagnostic (2 cases). The malignancy rate on surgical excision in the FLUS/AUS group was 27 and 15% with and w...

Micronucleus in atypical urothelial cells

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

The objective of this study is to evaluate the role of micronuclei (MN) in identifying the atypical urothelial cells urinary cytology. This is a retrospective study of a total of 30 cases of urine samples. Of these, 15 cases were selected where the initial diagnosis was atypical urothelial cell and later turned out as malignant cells on follow-up histopathology. The rest of the 15 cases were reported as normal urothelial cells. The number of MN in 1,000 urothelial cells was counted in all the cases and was expressed as percentage. All the cases diagnosed as atypical urothelial cells show the presence of MN. The mean number of MN was 2.53 ± 0.99%. No MN was noted in any of the normal urothelial cells in control cases. The Student's t-test of MN scoring was highly significant (P < 0.000) in...

Interobserver and intraobserver variability in the calculation of the lipid-laden macrophage index: Implications for its use in the evaluation of aspiration in children

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

The lipid-laden macrophage index (LLMI) is a semiquantitative test used to evaluate aspiration in children. We assessed the reliability and reproducibility of LLMI by calculating interobserver and intraobserver variability among pathologists, with and without expertise in cytopathology. Forty-nine bronchoalveolar washes/lavages were blindly reviewed by four reviewers and assigned an LLMI. Three pathologists (two cytopathologists, one pathology fellow) reviewed slides twice and one cytotechnologist reviewed them once. Intraclass correlation coefficient (ICC) with 95% confidence interval (C.I.) was used to measure overall intraobserver and interobserver agreement. Interobserver agreement was also calculated separately for each pair of reviewers. ICC values did not indicate an acceptable leve...

Fractal dimension of cell clusters in effusion cytology

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

In this study, the fractal dimension (FD) of the ball-like tight clusters of known metastatic adenocarcinoma cells is compared with the tight cell clusters of the benign cells in the effusion fluid to find out the role of FD in differentiating malignant from benign cluster in effusion. A total of 68 and 72 images of cluster of cells from 12 cases of benign and 13 cases of metastatic pleural and peritoneal effusion were studied for FD. The mean FD of the cluster of cells of benign and malignant effusion was 1.4801 ± 0.23260 and 1.7175 ± 0.09006, respectively. Mann-Whitney U-test showed significant difference of FD between the cell clusters of malignant and benign effusion cases (P < 0.0001). Cytological features along with the measurement of FD of cell clusters in effusion cytology may be...

Metastatic peritoneal mesothelioma in the setting of recurrent ascites: A case report

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

Malignant peritoneal mesothelioma is uncommon but rapidly fatal with a median survival of less than 1 year. The diagnosis of this entity is often delayed because of the nonspecific presenting symptoms and nonspecific cytological features of the mesothelial cells in the peritoneal fluids.A 72-year-old man who had no known history of exposure to asbestos and had longstanding refractory ascites thought to be secondary to alcoholic cirrhosis was found to have widespread metastatic malignant mesothelioma involving the lung, liver, pancreas, peritoneal, and pelvic wall, skin and subcutaneous tissue. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Asteroid bodies in lymph node cytology: Infrequently seen and still mysterious

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

Granulomatous inflammation is a relatively common finding in routine aspiration cytology of lymph nodes. However, asteroid bodies are very rarely encountered in cytologic preparations, and most morphologic descriptions result from observations made in histologic tissue sections. This brief report describes the cytologic findings in paratracheal aspirate smears from a 74-year-old Caucasian woman with the history of squamous-cell carcinoma of the right ankle metastasic to a right groin lymph node. At the time of removal of the metastatic tumor, the patient was noted to have multiple small, mildly FDG-avid lymph nodes in the supraclavicular, paratracheal, precarinal, pulmonic hilar, and axillary regions. A transbronchial fine-needle aspiration biopsy (FNAB) of a paratracheal lymph node showed...

KRAS mutation analysis on cytological specimens of metastatic colo-rectal cancer

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

Recent evidences showed that metastatic colorectal cancer (CRC) patients with tumors harboring a KRAS gene mutation do not derive benefit from the administration of epidermal growth factor receptor-directed monoclonal antibodies. Typically, the specimens available for KRAS mutational analysis are formalin-fixed paraffin-embedded (FFPE) primary tumor tissue blocks. However, in patients with rectal tumours undergoing neoadjuvant therapy, the source of FFPE material is limited. In this setting, CRC cytological samples taken from the metastatic site may be exploited. However, these specimens show at least some degree of necrosis; thus, their suitability for the KRAS assay needs to be tested. Here, we show that 18/19 (94.7%) metastatic CRC smears were perfectly adequate for codon 12 and 13 KRAS...

The sensitivity of cytologic evaluation of pleural fluid in the diagnosis of malignant mesothelioma

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

The objective of this study was to provide the current evidence on the role and sensitivity of cytologic examination of pleural fluid in the diagnosis of MM. We reviewed the cytologic findings in pleural effusions of a large series of histologically proven MM (234 cases) diagnosed in our institution between 2001 and 2008. Of all cases, 154 (66%) had cytologic material examined. A specific diagnosis of MM was rendered or suspected in 53% (79 patients). The lowest sensitivity (20%) was noticed in sarcomatoid MM cases. MM was favored over adenocarcinoma in 97% of patients with positive cytologic findings that have been confirmed with immunohistochemistry. In this series, five cases were inadequate and five cases were initially reported as atypical, whereas 65 cases (44%) were reported as nega...

Should fine-needle aspiration cytology be the first choice diagnostic modality for assessment of all nonpalpable breast lesions? The experience of a breast cancer screening center in Alexandria, Egypt

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

In conclusion, aiming to maximize the preoperative diagnosis of cancer, it would be cost efficient and time saving to use FNAC as a first-line investigation to benefit from the wealth of cytological information yielded, followed by CNB in selected cases. Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Book review: Modern Surgical Pathology, 2nd Edition

Diagnostic Cytopathology — Mon, 04 Jan 2010 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Synchronous ipsilateral Warthin tumor encased by a separate mucoepidermoid carcinoma of the parotid gland: A case report and review of the literature

Diagnostic Cytopathology — Tue, 22 Dec 2009 00:00:00 +0100

Fine-needle aspiration (FNA) is a cost effective and low morbidity procedure in the initial assessment of salivary gland tumors. However, cytological assessment of ipsilateral synchronous tumors (which make up less than 0.3% of all salivary gland neoplasms) may pose diagnostic challenges. Therefore, a wholesome approach, including FNA with clinical and radiological correlation, is of utmost importance. Here, we report a unique case of Warthin tumor encased by a separate high-grade mucoepidermoid carcinoma that was first diagnosed on FNA. Another striking feature seen was the presence of chronic sialadenitis in the surrounding nonneoplastic salivary gland. The presence of two different neoplasms in the background of chronic sialadenitis raises the question of a possible causal relationship....

Cystic papillary thyroid carcinoma in fine needle aspiration may represent a subset of the encapsulated variant in WHO classification

Diagnostic Cytopathology — Sat, 19 Dec 2009 00:00:00 +0100

In conclusion, ultrasound-guided FNA, if performed in the manner described, can reliably distinguish cystic PTC from a benign cyst with a mural nodule. Cystic PTC on FNA in this series correlates to a subset of the encapsulated variant of PTC, an entity described in the 1988 WHO Histological Typing of Thyroid Tumours in the good prognostic category. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Thyroid follicular neoplasm: Analysis by fine needle aspiration cytology, frozen section, and histopathology

Diagnostic Cytopathology — Tue, 15 Dec 2009 00:00:00 +0100

In conclusion, our analysis revealed high rates of accuracy when using frozen tissue sections for early diagnosis and treatment of follicular neoplasm; thus, an early decision to extent of surgery prevents a risky follow-up surgery. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Intraoperative cytology - Role in bone lesions

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

This study was undertaken in a view to fill this lacuna.Sixty bone lesions were evaluated intraoperatively with the help of cytology smears prepared by touch, scrape, or crush technique. The diagnosis made on cytological preparation was compared with histopathological diagnosis taking the latter as gold standard. Different parameters like reasons for Intraoperative consultation, best technique for preparation of smear, average time taken to render a diagnosis, and finally the accuracy of IOC was evaluated.Common reasons for the intraoperative consultation were to make or confirm a diagnosis for proper surgical intervention and to evaluate the surgical resection margin. Scrape was found to be the best method for cytological smear preparation. Average time taken to render a diagnosis was 20 ...

Atypical glandular cells (AGC): ThinPrep imaging system (TIS), manual screening (MS), and correlation with Hybrid Capture 2 (HC2) HPV DNA testing

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

The aim of the study was to determine if the ThinPrep Imaging System (T1S) improves the positive predictive value (PPV) of atypical glandular cell (AGC) diagnosis for identifying HPV-related squamous and/or glandular lesions over manual screening (MS), and if human papilloma virus (HPV)-DNA testing improves the diagnostic yield.85 ThinPrep cervical cytology specimens with a diagnosis of AGC by TIS (n = 51) and MS (n = 34) were retrieved. The diagnoses were correlated with corresponding histologic follow-up and high risk (HR)-HPV testing results.The PPV of AGC by TIS and MS for HPV-related squamous lesions were similar. In the MS group, more cases of glandular pathology were identified, however only three represented adenocarcinoma in-situ (AIS), and the remaining ten were endometrial carci...

Sporangia, sporangium-like spherules and mimicking structures in respiratory cytopathology

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Usefulness of NMP22 as an adjunct to a typical urine cytology and low-grade urothelial carcinoma

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

The usefulness of urine cytology combined with NMP22 was evaluated for the primary diagnosis of urothelial carcinoma. Of 53 clinically suspected patients, histopathological diagnoses were low-grade urothelial carcinoma (25), high-grade urothelial carcinoma (13), and inflammatory lesions (15). Cytology was positive in 25 and negative in 14 patients. Fourteen of 25 low-grade urothelial carcinoma and 11/13 high-grade urothelial carcinoma were diagnosed correctly on urine cytology. Atypical cells seen in 14 patients were categorized as inconclusive for malignancy. The overall sensitivity of urine cytology was 65.8%, whereas specificity was 100%. NMP22 was positive in 33 patients. Of these 30, 18 low-grade and 12 high-grade lesions were true positive. Of the 20 NMP22, eight negative cases were ...

Can mobile units improve the strategies for cervical cancer prevention?

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

Cervical cancer is a serious public health problem in women in developing countries because of absence or ineffectiveness of screening programs. Several biases to access medical care and inequity of public health system in a continental country like Brazil limit the implementation of adequate programs to appropriately prevent the cervical cancer. Therefore, the aim of this study was to evaluate the results of applying the mobile unit (MU) for cervical cancer screening. From May 2003 to May 2004, a cervical cancer screening was offered to women aged 20-69 years, residing in 19 municipal districts of the Barretos county region, in São Paulo. Out of the 9,560 examination available, 2,964 (31%) women underwent screening. The medium distance traveled by the MU was 45 km. The medium time spent ...

The prevalence of abnormal cervical cytology in women with infertility

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

The aim of this study was to compare the frequency of abnormal cervical cytology in women with infertility problems with that of fertile women by using ThinPrep® liquid-based Pap TestsTM. A retrospective case-control study for over 2 years was conducted. The cases included all women with infertility problems who had Pap tests during their infertility treatment period. The cases were further subdivided into primary and secondary infertility groups. The control group included all women without infertility problems who had routine Pap tests in the same period. The age and demographic features were adjusted and matched for both groups. Statistical analysis included chi-square test and Fischer exact test. The infertility group (n = 490) showed significantly (P < 0.05) more abnormal cervical sq...

Metastatic signet ring cell carcinoma presenting as a thyroid nodule: Report of a case with fine-needle aspiration cytology

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

Metastatic carcinomas to the thyroid are quite rare in daily cytology practice. However, when present they may produce a diagnostic dilemma, particularly when they share some morphologic similarities with primary thyroid lesions and when occurring in patients with occult malignant history. Herein, we report a case of metastatic gastric signet ring cell carcinoma to the thyroid. Our patient presented with an isolated right thyroid nodule, which was clinically considered to be a primary thyroid neoplasm. Fine-needle aspiration (FNA) cytology of the nodule revealed a cellular specimen with cohesive fragments and scattered individual neoplastic cells. The neoplastic cells had enlarged nuclei, fine chromatin, and inconspicuous nucleoli. Nuclear crowding, molding, and grooving were prominent. In...

Sarcomatoid collecting duct carcinoma of kidney diagnosed with urine and renal pelvic lavage cytology

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

A case of sarcomatoid collecting duct carcinoma (CDC) of kidney is presented, in which the diagnosis was made cytologically with voided urine and renal pelvis lavage. Cytology of hemorrhagic voided urine revealed highly atypical adenocarcinoma cells with reminiscent ductal structure, which suggested CDC as the most likely diagnosis. Computed tomography and magnetic resonance imaging demonstrated a left renal tumor, and selective lavage of left renal pelvis yielded spindle-shaped, highly atypical cells that indicated sarcomatoid carcinoma. The diagnosis of renal cancer with urine cytology is challenging because of small number of tumor cells in the urine, which are often associated with degeneration. As the urinary cytologic findings of sarcomatoid CDC have not been reported, the characteri...

Assessing for primary oropharyngeal or nasopharyngeal squamous cell carcinoma from fine needle aspiration of cervical lymph node metastases

Diagnostic Cytopathology — Mon, 14 Dec 2009 00:00:00 +0100

In fine needle aspirates of cervical lymph nodes with metastatic squamous cell carcinoma (SCC), the site of origin may not be clinically evident. The distinction between oropharyngeal and nasopharyngeal primary SCC has important management consequences. In the current study, we evaluated metastatic SCC for HPV types 16, 18, 31, 33, 51 (by in situ hybridization[ISH]), p16 and ProExC (surrogate HPV markers), and Epstein Barr Virus reported in nasopharyngeal SCC. Forty patients diagnosed between 2004 and 2008, with adequate cell block material were identified. ISH for high risk HPV and EBV (EBER), and immunohistochemistry for p16 and ProExC were performed. Primary site was designated in 31 cases with 26 head and neck including 11 oropharyngeal and 2 nasopharyngeal, and 5 other sites. High ris...

Importance of intraoperative cytology in the definition of cystic solitary brain lesions

Diagnostic Cytopathology — Sat, 12 Dec 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Cytodiagnosis of benign fibrous histiocytoma of rib and diagnostic dilemma: A case report

Diagnostic Cytopathology — Fri, 11 Dec 2009 00:00:00 +0100

Benign fibrous histiocytoma (BFH) of bone is rare in occurrence, and rib is an unusual site. There are limited case reports of this entity in the literature, and cytodiagnosis of this tumor is not described. A 24-year-old man presented with a firm mass and pain in the right lateral chest wall. Radiological investigations (plain radiograph and computed tomography) revealed a lytic bone lesion involving the 5th rib. Radiologically, giant cell tumor (GCT), BFH, and plasmacytoma were suspected. In fine-needle aspiration cytology (FNAC), admixture of benign stromal cells and scattered osteoclast type giant cells were found in the smears. Differential diagnoses of BFH, GCT (non-epiphyseal type), fibrous dysplasia, and aneurysmal bone cyst were made on cytology. Subsequent histologic examination ...

Fine-needle aspiration cytology of subcutaneous toxoplasmosis: A case report

Diagnostic Cytopathology — Fri, 11 Dec 2009 00:00:00 +0100

Toxoplasmosis is a common opportunistic infection in patients with AIDS in whom it typically presents as encephalitis, pneumonia, lymphadenitis, and myocarditis. Skin involvement is very rare and, to our best knowledge, Toxoplasma gondii forming a subcutaneous mass has not been reported. Here, we report the findings of an interesting case of subcutaneous toxoplasmosis with the cytological appearance of an inflammatory fibrovascular lesion in a HIV-positive patient and discuss the differential diagnosis. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

E-Cadherin expression in male urethral smears and correlation with PCR-based detection of human papillomavirus infection

Diagnostic Cytopathology — Wed, 09 Dec 2009 00:00:00 +0100

We performed cytological examination of urethral brushing to study aberrant E-Cadherin expression as a possible marker for papillomavirus in cytological samples.A total of 30 cytobrush male urethral smears were examined E-cadherin expression and human papillomavirus (hpv) was confirmed using PCR-DNA.The age range was 19-36 years (mean: 27 years), 17 (56.7%) cases corresponded to low-risk HPV and 13 (43.3%) cases were high-risk HPV. The mean age ranges were 25.77 ± 5.90 years for high-risk HPV and 26.77 ± 4.31years for low-risk HPV.Pap smears showed dyskeratosis in 23 (76.7%) cases, koilocytes in 13 (43.3%) cases, infection or bacterial background in 14 (43.7%) cases, suggestive changes of Gardnerella infection in 7 (23.3%) cases, and Chlamydia in 3 (10%) cases.Immunohistochemistry was po...

Use of liquid-based preparations in urine cytology: An evaluation of Liqui-PREPTM and BD SurePathTM

Diagnostic Cytopathology — Tue, 01 Dec 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Diagnostic reliability of FNAC for salivary gland swellings: A comparative study

Diagnostic Cytopathology — Mon, 30 Nov 2009 00:00:00 +0100

In conclusion, FNAC is found to be a highly sensitive and specific technique for diagnosis of most of salivary gland swellings, except for malignant neoplastic lesions where its sensitivity is intermediate. We strongly recommend that FNAC should be adopted as an initial investigation for all salivary gland swellings. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Coexistent atypical polypoid adenomyoma and complex atypical endometrial hyperplasia in the uterus

Diagnostic Cytopathology — Mon, 30 Nov 2009 00:00:00 +0100

We report a case of atypical polypoid adenomyoma (APA) concomitantly identified with complex atypical endometrial hyperplasia (CAH) in the uterus. Since an initial endometrial smear revealed atypical endometrial cells, a diagnosis of CAH was made. Even though a concomitantly performed uterine cervical smear contained both atypical epithelial and stromal cells, the diagnosis of APA was not initially made because the cytological criteria for APA had not been established. Histologically, we recognized both CAH in the uterine corpus and APA in the lower uterine segment in the hysterectomy material. Retrospectively, the cells in the first cervical smear were interpreted as part of APA because the same types of cells were observed in the intraoperative cytology sample. Although the APA and CAH l...

Not all unsatisfactory ThinPrep® cervical Pap testsTM are unsatisfactory: Reprocessing improves the satisfactory and detection rates of ThinPrep® cervical cytology

Diagnostic Cytopathology — Mon, 30 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Fine needle aspiration of renal cortical lesions in adults

Diagnostic Cytopathology — Mon, 30 Nov 2009 00:00:00 +0100

The role of fine needle aspiration (FNA) biopsy of renal cortical lesions was controversial in the past because the result of the FNA did not affect clinical management. All renal cortical lesions, except metastasis, were subject to surgical resection. However, with the advances in neoadjuvant targeted therapies, knowledge of the renal cortical tumor histological subtype is critical for tailoring clinical trials and follow-up strategies. At present, there are clinical trials involving the use of novel kinase inhibitors for conventional (clear cell) and papillary renal cell carcinoma. We studied 143 consecutive cases of renal cortical lesions, evaluated after radical or partial nephrectomies over a 2-year period. An air-dried smear and a Thinprep® slide were prepared in all cases. The slid...

Follicular neoplasm of the thyroid gland: Unique cytologic appearances in a fine-needle aspiration biopsy

Diagnostic Cytopathology — Mon, 30 Nov 2009 00:00:00 +0100

We report a case of follicular neoplasm diagnosed on FNA specimen that had a very artistic appearance of the microfollicle formation on both Diff-Quik and Papanicolaou-stained slides. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Enhancing the scope of conventional cervical cytology for detecting HPV infection

Diagnostic Cytopathology — Mon, 30 Nov 2009 00:00:00 +0100

In conclusion, these signs proved useful for identifying HPV infection. Population-based studies are required to corroborate our findings. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

A cell-block preparation using glucomannan extracted from Amorphophallus konjac

Diagnostic Cytopathology — Thu, 26 Nov 2009 00:00:00 +0100

To evaluate a cell-block preparation using glucomannan, which was extracted from Amorphophallus konjac. Ten specimens were centrifuged at 1,500 rpm for 5 minutes, the supernatant was removed; the remnant after the preparation of smear specimens for routine cytological examination was fixed with 20% formalin. The specimen was recentrifuged at 1,500 rpm for 5 minutes, and the supernatant was removed. The residue was resuspended with 2 ml of eosin solution and 1-5 ml of 80% alcohol, and stirred well. After further centrifugation, the supernatant was removed, and one drop of a glucomannan-formalin water solution was added gently. After immersion in methanol for 2 hours, glucomannan is solidified and becomes gelatinous. The obtained cell block was placed in the cassette for the preparation of t...

Anal-rectal cytology: A review

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

The incidence of invasive anal squamous cell carcinoma, a human papilloma virus (HPV) related cancer, is on the rise, especially in HIV positive men who have sex with men (MSM). Like cervical cancer, anal cancer is associated with precursor lesions detectable on exfoliative cytology as squamous intraepithelial lesions and on biopsy as intraepithelial neoplasia. Anal-rectal cytology screening programs, similar to cervical cytology screening programs, have been developed in an effort to detect and to eradicate precursor lesions prior to progression to invasive squamous cell carcinoma. Either conventional or liquid-based anal-rectal cytology specimens are acceptable, but liquid-based specimens are preferred. Specimens may be collected by health care professionals or by patients. A minimum of ...

Cytologic detection of concurrent infectious agents in urines from renal transplant patients

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

Cytology is a well recognized and utilized method for the detection of polyomavirus in urine specimens from renal transplant patients. The purpose of this 5 year 6 month retrospective study (January 1, 2003-June 30, 2008) was to report on the additional infectious agents detected in these specimens. Of the 7,116 urine samples from renal transplant patients that were processed for the detection of polyoma (BK) virus, 1,399 (19.7%) were positive for BK viral inclusions and 5,717 (80.3%) were negative. In addition, 347 specimens (4.8%) contained infectious agents including HPV (1.6%), Candida (3.2%), Herpes virocytes (0.03%), cytomegalovirus (CMV; 0.03%), and trichomonads (0.03%) either alone or in combination. Follow-up cervical, vaginal, and/or vulvar biopsies were available in six (5%) of ...

Angiocentric glioma: A case report and review of the literature

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

We report a case of an AG in the right frontal lobe of a 57-year-old female, emphasizing the cytologic and immunohistochemical features, including confirmation and comparison with the surgical specimen. To our knowledge, this is the first report detailing the cytology of AG, including demonstration of important diagnostic findings that were only appreciated in the cytologic preparations and not in the smears or the surgical specimen. We also compare and contrast AG to other entities in the differential diagnosis and include a review of the literature. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Imprint cytologic features of chromophobe renal cell carcinoma morphologically resembling renal oncocytoma: Is this an oncocytic variant of chromophobe renal cell carcinoma?

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

In this article, we report a case of 76-year-old woman with a rare variant of chromophobe renal cell carcinoma (CRCC). Cytologically, renal tumor cells obtained from imprint cytology were isolated or arranged in small or monotonous population cells with abundant granular cytoplasm. Neoplastic cells showed regular and uniformly shaped small round to oval nuclei with smooth margin. Binucleation was occasionally seen. Immunocytochemically, the cytoplasm of almost all tumor cells was diffusely positive for vimentin and CK 7. Histologically, the cytoplasm was abundant granular eosinophilic and composed of solid cell sheets or pseudoacinar structures. Additionally, tumor cells showed infiltration into some small renal veins covered by a single layer of endothelial cells. These cytological and hi...

ThinPrep Pap test of endocervical adenocarcinoma with lymph node metastasis: Report of a case in a 17-year-old woman

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

Endocervical adenocarcinoma is an uncommon malignancy that is composed of multiple subtypes and accounts for [sim]15% of all cervical cancers. In this article, we describe the cytomorphology and differential diagnosis of an AJCC clinical stage IIIb, FIGO IB2 endocervical adenocarcinoma in a 17-year-old woman in a ThinPrep Pap test.The patient was a 17-year-old G0P0 white woman with no significant past medical history and no prior history of cervical dysplasia. She presented to her physician with a putrid vaginal discharge. A sample was sent to cytology that was interpreted as atypical endocervical cells, favor neoplasia. A subsequent cervical biopsy was diagnosed as endocervical adenocarcinoma with villoglandular features and ultimately, a hysterectomy with lymph node dissection was perfor...

An analysis on the combination expression of HPV L1 capsid protein and p16INK4a in cervical lesions

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

Human papillomavirus (HPV) infection in cervix is the most important reason for cervical cancer, but only 2% cervical HPV infection will develop into cervical cancer. So how to identify patients at risk of progressive cervical lesions from those infected with HPV to avoid over treatment is a big issue in clinic. The aims of this study were to detect the expression of HPV L1 capsid protein and p16INK4a in cervical lesions and to investigate the combination expression of HPV L1 capsid protein and p16INK4a in cervical lesions and its diagnostic efficiency in clinic. Immunochemical method was used to detect the expression of HPV L1 capsid protein and p16INK4a in 169 cases of abnormal cytology. Histopathologic test was performed to identify cervical lesions of all the cases. [chi]2 test and spe...

Adrenocortical carcinoma presenting with a peritoneal effusion

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

In this report, we describe the fine-needle aspiration findings of a case of adrenocortical carcinoma (ACC) that spread to the peritoneal cavity in an 80-year-old female. Cytologically, the peritoneal fluid exhibited clusters and single, small uniform cells with round nuclei and a fine chromatin pattern, which in conjunction with the immunohistochemical stains was diagnostic of ACC. Although ACC is the most common malignant neoplasm of the adrenal gland, its metastatic spread to the peritoneal cavity is exceptionally unusual. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Significance of incidental detection of filariasis on aspiration smears: A case series

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

Filariasis is a major public health problem in tropical and subtropical countries including India. Although there are reports of incidentally diagnosed cases of lymphatic filariasis in the existing literature, the significance of this finding needs to be summarised in one place. The association of filariasis with neoplasms is still debatable.For this series, cases diagnosed as filariasis on aspiration cytology (with or without coexistent pathology) over a period of 1 year were retrieved. The cases with a clinical suspicion of filariasis were excluded. Hence, five cases with incidental diagnosis of filariasis on aspiration cytology were included. The site of aspiration included one case each of thyroid, breast, bone marrow, cervical lymph node, and subcutaneous nodule. Of these, three cases...

Cytologic features and frequency of plasmacytoid dendritic cells in the lymph nodes of patients with histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease)

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

Histiocytic necrotizing lymphadenitis (HNL), also known as Kikuchi-Fujimoto disease, is a benign and self-limiting disease. It is histologically characterized by nodal lesions that show the infiltration of histiocytes, lymphoid cells, myeloid dendritic cells (mDCs), and plasmacytoid dendritic cells (pDCs), along with either apoptotic or karyorrhexic nuclear debris. pDCs have been proposed to be lymphoid early-committed immature DCs which are positive for CD123, CD303, CD68, and HLA-DR but negative for fascin, a mature DC marker, as well as CD13 and CD33,which are mDC markers. In the present study, we analyzed the cytomorphologic features and frequency of pDCs in the lymph nodes of HNL patients. Because the cytologic apprearance of pDCs with Papanicolau staining was quite similar to that of...

Rosette forming glioneuronal tumor pineal gland and tectum: An intraoperative diagnosis on smear preparation

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

We present an extremely rare case of newly described entity called rosette forming glioneuronal tumor (RGNT), involving the pineal gland, tectum, and the adjacent thalamus in a 22-year-old male. Interestingly, the ventricular system was not involved in this case. The tumor was diagnosed intraoperatively on smear preparation on cytomorphology. If sampled adequately, it is fairly easy to diagnose RGNT on smear preparation as it has a very distinctive cytomorphology of being composed of two population of cell. One of the components is pilocytic astrocytoma and the other is composed of small cells with scant cytoplasm, vesicular nuclei, arranged around neuropil-like material forming "neurocytic rosettes." To the best of our knowledge, this is the first case of RGNT in this rare location being ...

Functional biomarkers in cervical precancer: An overview

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

Cervical cancer develops over a long time through precursor lesions that can be detected by cytological screening. Majority of these lesions regress spontaneously. Therefore, the challenge of cervical cancer screening is to detect the lesions that have a high risk of progression. Several promising biomarkers have been described that may improve screening of cervical cancer, but to date, new biomarkers have not been thoroughly validated in high-quality studies.The knowledge about human papillomavirus as a causative agent of cervical cancer has accumulated over the last decades has opened the possibility to improve the existing prevention strategies and screening practices. p16 has amply been applied on cytologic samples and has been shown to be a promising marker especially in identificatio...

Spermiophages in a giant spermatocele

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Rhabdoid meningioma: Rapid intraoperative diagnosis on squash smears

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

Rhabdoid morphology in tumors refers to resemblance of the cells to rhabdomyoblasts without true skeletal muscle differentiation. The cytological features include abundant eosinophilic cytoplasm, eccentric nuclei, and intracytoplasmic hyaline inclusions. Besides the rhabdoid morphology, cytoarchitectural features of atypical meningioma (four or more mitoses per 10 high-power fields, high cellularity, sheeting architecture, nuclear atypia, and necrosis) are seen in most cases. A case is presented here to highlight the appearance of rhabdoid cells on intraoperative squash smears, for most accurate treatment and close follow-up, as rhabdoid morphology is related to aggressive behavior and poor outcomes. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

The equivocal Pap test: Its past, present, and future

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Giardia intestinalis on anal PAP of an HIV-positive male

Diagnostic Cytopathology — Wed, 25 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Human papillomavirus prevalence and cytopathology correlation in young Ugandan women using a low-cost liquid-based Pap preparation

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

Screening for HPV-driven cervical dysplasia and neoplasia is a significant public health concern in the developing world. The purpose of this study was to use a manual, low-cost liquid-based Pap preparation to determine HPV prevalence in HIV-positive and HIV-negative young women in Kampala, Uganda and to correlate cervical cytopathology with HPV-DNA genotype. About 196 post-partum women aged 18-30 years underwent rapid HIV testing and pelvic examination. Liquid-based cervical cytology samples were processed using a low-cost manual technique. A DNA collection device was used to collect specimens for HPV genotyping. HIV and HPV prevalence was 18 and 64%, respectively. Overall, 49% of women were infected with a high-risk HPV genotype. The most common high-risk HPV genotypes were 16 (8.2%), 33...

A rare case of pulmonary cryptococcal inflammatory myofibroblastic tumor diagnosed by fine needle aspiration cytology

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

In a recent outbreak in British Columbia (BC), Canada, Cryptococcus gattii, a rare species of Cryptococcus, was noted to affect primarily immunocompetent hosts and cause limited pulmonary or CNS disease. We herein report a rare case of a pulmonary inflammatory myofibroblastic tumor caused by a Cryptococcus infection, presumed to be of the gattii species, in a 20-year-old immunocompetent college student from Vancouver, BC who presented with a large lung mass. The diagnosis was first made on the fine needle aspirate (FNA) material and was confirmed on the concurrent histologic core biopsy. Cryptococcal inflammatory myofibroblastic tumors have been reported, but neither in the lung nor in the setting of an immunocompetent host. Pulmonary cryptococcosis should therefore be considered in the di...

"Signet-ring" cells - A caveat in the diagnosis of a diffuse peritoneal mesothelioma occurring in a lady presenting with recurrent ascites: An unusual case report

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

We report an unusual case study of a diffuse peritoneal mesothelioma in a 57-years-old lady, with no history of asbestos exposure, presenting with recurrent ascites, diagnosed on ascitic fluid cytology and on histology as an adenocarcinoma, based upon the presence of "signet-ring" cells. On review, clinicopathological correlation with IHC was helpful in forming correct diagnosis. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Amyloid goiter

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Comparison of p16INK4a and ProExTM C immunostaining on cervical ThinPrep® cytology and biopsy specimens

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

ProExTM C and p16INK4a staining of cytology/histology specimens have recently been explored to help distinguish high-grade squamous intraepithelial lesions (HSIL) from benign mimics. The goal of this study was to evaluate the performance characteristics of p16 and ProEx C in tissue and patient matched ThinPrep® liquid-based cytology specimens. Residual cervical ThinPrep cytology specimens and tissue blocks (N = 64) from 63 patients were stained with p16 and ProEx C. Review of immunostained material, Papanicolaou and H&E stained slides was performed by two cytopathologists. The cytology slides were evaluated for the presence or absence of squamous atypia as well as immunoreactivity. Histologic specimens were interpreted as negative, indeterminate, or positive for each immunostain. There wa...

Metastatic retinoblastoma presenting as a left shoulder soft tissue mass: FNA findings and review of the literature

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

Retinoblastoma is a relatively rare malignant pediatric tumor accounting for [sim]3% of childhood cancers and 1% of all cancer deaths in children under 15 years of age. During the clinical course of the disease, a metastasis usually occurs within the first year of diagnosis and is seen in 2% of retinoblastoma patients. Metastases to the intracranial region are common and account for [sim]50% of the metastatic cases. Metastasis to the soft tissue is very rare. Herein, we report a case of metastatic retinoblastoma presenting as a left shoulder soft tissue mass in a 14-year-old female with a 14-year history of familial bilateral retinoblastoma status post radiation therapy. In our case, the FNA cytology shows some features of the small round blue cell tumor group with inconspicuous Flexner-Wi...

Fine needle aspiration cytology of undifferentiated (embryonal) sarcoma of liver in an adult male

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Improving cellularity and quality of liquid-based cytology slides processed from pancreatobiliary tract brushings

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

Cytology has been reported to have suboptimal sensitivity for detecting pancreatobiliary tract cancer in biliary tract specimens partly as a result of low specimen cellularity and obscuring noncellular components. The goal of this study was to determine if the use of a glacial acetic acid wash prior to processing would increase the cellularity and improve the quality of ThinPrep® slides when compared to standard non-gyn ThinPrep processing. Fifty consecutive pancreatobiliary tract specimens containing 20 ml of sample/PreservCyt® were divided equally for standard non-gyn ThinPrep (STP) and glacial acetic acid ThinPrep processing (GATP). A manual drop preparation was also performed on residual STP specimen to determine the number of cells left in the vial during STP processing. Twenty-six ...

Ectopic decidua in abdominal washings found intraoperatively at cesarean section

Diagnostic Cytopathology — Tue, 24 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Sclerosing polycystic adenosis of the parotid gland: Report of one case diagnosed by fine-needle cytology with in situ malignant transformation

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

Sclerosing polycystic adenosis (SPA) is a rare pathological condition affecting the salivary glands, first described by Smith etal. in 1996. Even though this lesion is being increasingly diagnosed, less than 50 cases have been published in the world literature to date. In line with numerous other pathological analogies between breast and salivary gland lesions, SPA shares with fibrocystic disease of the breast many histopathological features, i.e., fibrosis, oncocytic (apocrine) changes, hyperplasia of ductal and acinar epithelium, cystic dilation of ducts, and, often, atypical epithelial changes. Most of the described cases have followed a benign clinical course, despite the frequent possibility of atypical hyperplasia in more than 50% of the cases and of the more than occasional in situ ...

Fine-needle aspiration of classic biphasic pulmonary blastoma: A case report

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Significance of "Signet-ring cells" seen in exfoliative and aspiration cytopathology

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

"Signet ring cell" (SRC) is a phenotypic designation for a cell with a large clear cytoplasmic vacuole displacing the nucleus to the periphery. Our study focuses on the cytopathologic significance of SRCs in the context of diagnostic range, ancillary studies, and clinical prognosis.A retrospective review revealed 83 cases of SRCs diagnosed in a 16-year period (1989-2004). Clinical data and ancillary studies were reviewed.The most common specimen types consisted of abdominal and pleural SCFs (45, 54%). Of the 83 cases, 13 (16%) were benign, 65 (78%) malignant, and 5 (6%) indeterminate. Benign lesions mostly comprised of reactive mesothelial cells (9 cases, 69%). Of the malignant lesions, 47 (72%) were metastases, 14 (22%) were primary cancers and 4 (6%) were local cancer recurrences. Adenoc...

A pseudo-outbreak of yeast in cell blocks associated with the use of human plasma

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Papillary renal cell carcinoma with "Hyaline globules" simulating adenoid cystic carcinoma

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

An algorithmic approach to hemostasis testing: Author: Kandice Kottke-Marchant CAP Press, Northfield, IL, 2008

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Clinical significance of dysplastic squamous cells in exfoliative urine cytology

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Pulmonary neuroendocrine neoplasms: A review of clinicopathologic and cytologic features

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

The objective of this review article is to discuss the diagnostic classifications and the morphologic cytologic-histologic features for the different categories of neuroendocrine tumors of the lung. An accurate characterization of the neuroendocrine tumors of the lung requires knowledge of specific criteria separating the major categories, which is highly essential for determining prognosis and treatment options for these patients. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Papanicolaou tests associated with cervical mucosal endometriosis: An analysis of cellular features and comparison to endocervical adenocarcinoma in situ

Diagnostic Cytopathology — Mon, 23 Nov 2009 00:00:00 +0100

Endometrium directly sampled from endocervical mucosal endometriosis can mimic endocervical adenocarcinoma in situ (AIS) in Papanicolaou (Pap) tests. We analyzed a series of Pap tests to investigate the cellular features of mucosal endometriosis and to assess the utility of stroma and apoptotic bodies in the differential diagnosis with AIS. Pap test samples from patients known to have endocervical mucosal endometriosis were compared with samples containing AIS. Pap tests from patients with mucosal endometriosis had lesional cells in 13 (62%) cases which includes glandular and stromal cells (10 cases), stroma only (two cases), and glandular cells only (one case). Three (23%) cases had gland-stromal aggregates. Three (23%) cases had mitotic figures and two (15%) had apoptotic bodies. By comp...

Clear cell sarcoma: Cytopathologic finding of a "tigroid" background

Diagnostic Cytopathology — Fri, 20 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Polymicrobial lung infection in postrenal transplant recipient diagnosed by fine-needle aspiration cytology

Diagnostic Cytopathology — Thu, 19 Nov 2009 00:00:00 +0100

We report a case of concomitant pulmonary cryptococcosis, aspergillosis, and tuberculosis in a renal transplant recipient diagnosed on FNAC.A 50-year-old renal transplant recipient, asymptomatic for 3 year, presented with intermittent low-grade fever associated with cough, expectoration, and a newly developed cavitatory lesion in the left lung on chest X-ray. Computed tomography-guided FNAC performed on the lung lesion showed fungal profiles with septate hyphae and acute-angled branching consistent with morphology of Aspergillus. In addition, numerous yeast forms of cryptococcus and a few acid-fast mycobacterial tubercle bacilli were seen.Guided FNAC is a useful and reliable technique for the diagnosis of pulmonary infection. One should always keep in mind the possibility of polymicrobial ...

Bursal gouty tophus: Fine-needle aspiration cytology intrabursal tophus on FNAC

Diagnostic Cytopathology — Thu, 19 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Cytological features of cystadenocarcinoma in cyst fluid of the parotid gland: Diagnostic pitfalls and literature review

Diagnostic Cytopathology — Thu, 19 Nov 2009 00:00:00 +0100

We report a case of cystadenocarcinoma causing difficulty in cytological diagnosis. A 23-year-old man presented with an asymptomatic mass in the left parotid gland that had been present for 2 years. The mass was elastic hard, measuring 30 × 35 mm in diameter. Preoperative fine-needle aspiration cytology (FNAC) showed a small number of tumor cell clusters in the cystic fluid. The cluster was arranged in a ball-like structure and was cohesive with overlapping. Tumor cells had a small vacuolated, soap-bubble appearance in the cytoplasm. The papillary-cystic variant of acinic cell carcinoma (ACC-PCV) was suggested from these findings on FNAC. Histologically, the tumor was not encapsulated, but formed large cystic spaces against a background of fibrous connective tissue. The tumor cells in the...

Cervical cytology in patients with postmenopausal bleeding

Diagnostic Cytopathology — Thu, 19 Nov 2009 00:00:00 +0100

In this study, the role of cervical cytology in the diagnosis of post or perimenopausal (PM) bleeding was explored. A total of 135 patients with PM bleeding were selected. In all these cases both conventional cervical cytology and histopathology follow up were available. The commonest causes of postmenopausal (PM) bleeding with abnormal histopathology were squamous cell carcinoma of cervix (14), endocervical polyp (13), endometrial adenocarcinomas (13) and simple hyperplasia without atypia (13). There were a total 13 cases of endometrial adenocarcinoma and cervical smears of these cases were reported as high grade squamous intra epithelial lesion (1), presence of endometrial cells (4), unsatisfactory due to low cellularity (2), and within normal limit (6). In brief, endometrial carcinoma a...

Fine-needle aspiration in myxofibrosarcoma: Experience of Institut Curie

Diagnostic Cytopathology — Sat, 07 Nov 2009 00:00:00 +0100

Myxofibrosarcoma (MFS) is a well-established nosologic entity different from the myxoid variant of malignant fibrous histiocytoma. In an attempt to better define the representative cytologic criteria of MFS, we undertook a review and a reanalysis of a series of 14 cytology samples in 12 patients whose tumors were diagnosed as MFS.Using FNA technique and reviewing the original diagnoses, 11 cases were diagnosed as malignant and three as benign tumors. The cytologic diagnosis of MFS was accurate in seven cases (2 primary tumors, 4 recurrences, and 1 metastasis). Four cases were classified malignant myxoid sarcoma (1 primary and 3 recurrences), whereas three cases (2 primary and 1 recurrence) were false-negative.The smears were cell-rich in 12 cases and cell-poor in two cases. They were const...

Cancer nucleus: Morphology and beyond

Diagnostic Cytopathology — Fri, 06 Nov 2009 00:00:00 +0100

There are many significant morphological alterations of a nucleus of cancer cell that are detectable by light microscopy on routine staining. These changes are often associated with deranged cellular functions of cancer cell. It is difficult to understand the exact relationship between nuclear morphology and alteration of nuclear structural organization in cancer. Herein, the salient visual and subvisual morphological changes of cancer nuclei and their possible etiology and significance have been reviewed. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Fine-needle aspiration cytology in a case of metastatic spindle cell melanoma in liver

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

We present a case of a 62-year-old male, who was found to have multiple space occupying lesions in liver with large central necrotic areas. Fine-needle aspiration cytology yielded cellular material and was diagnostic of a metastatic malignant spindle cell melanoma. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Fine-needle aspiration cytology of extraskeletal myxoid chondrosarcoma: A case report

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

We report a typical case of EMC in left inguinal region of a 71-year-old man, which was first approached by fine-needle aspiration, followed by surgical excision and subsequently diagnosed by microscopic examination and immunohistochemical study. We discuss briefly the differential diagnosis. It is important to separate EMC from other myxoid soft tissue tumors. We point out that although cytologic features may be orientating to a myxoid tumor, may not be completely distinctive. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Cytomorphological diagnosis of tendinous xanthomatosis: A case report

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

Women [ge]30 years of age with low grade squamous intraepithelial lesion (LSIL) have low positivity rates when cotested for high-risk human papillomavirus: Should we reconsider HPV triage for LSIL in older women?

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

High-risk human papillomavirus (HR-HPV) testing for colposcopy triage of low grade squamous intraepithelial lesion (LSIL) is not recommended because of high positive rates in young women. It remains unclear whether HR-HPV testing may be useful for triage of older women. We compiled HR-HPV data for women aged [ge]30 years with LSIL for the period March 1, 2006 to February 28, 2008. Follow-up cervical biopsy information was collected for the period March 1, 2006 to August 15, 2008. We used the Hybrid Capture II test performed on residual material from liquid-based Pap tests. Of 735 women, 254 had HR-HPV testing, and of these 144 had positive HR-HPV results. Among women with positive HR-HPV results 79 underwent biopsy (54.9%) and 11 had cervical intraepithelial neoplasia (CIN) 2 or 3 (13.9% o...

Bilateral adrenal gland enlargement secondary to histoplasmosis mimicking adrenal metastases: Diagnosis with EUS-guided FNA

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

We report a patient with massive bilateral adrenal enlargement due to histoplasmosis that was diagnosed by EUS-FNA. Trans-duodenal and trans-gastric fine needle aspiration biopsy of both adrenal glands was performed. Rapid onsite cytopathologic evaluation (ROSE) revealed epithelioid histiocytes, singly and in clusters consistent with granulomas. Apparent intracytoplasmic inclusions suggestive of organisms were visible. A Gomori Methenamine Silver stain (GMS) revealed abundant small intracellular budding yeasts, morphologically consistent with Histoplasma; the patient was admitted for amphotericin B intravenous infusion. His fever abated on the second day after amphotericin B was started. His urine Histoplasma antigen was positive. Fungal cultures from both adrenal EUS-FNA samples grew Hist...

Vertebral osteomyelitis with a rare etiology diagnosed by fine-needle aspiration cytology

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

We report one such case of vertebral osteomyelitis due to Aspergillus diagnosed by FNAC in a well-controlled diabetic patient who presented with nonspecific symptoms and in whom a clinical and radiological diagnosis of Pott's spine was considered. The present case stresses the importance of early cytologic diagnosis of vertebral Aspergillus osteomyelitis, which in conjunction with appropriate timely medical and surgical treatment, offers good recovery without much sequelae or threat to life. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Fine-needle aspiration biopsy as an initial diagnostic modality in a clinically unsuspected case of invasive maxillary fungal sinusitis: A case report

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

Cases of invasive fungal lesions involving the paranasal sinuses are generally diagnosed either on histologic examination or on fungal culture. Here, we report a case of invasive fungal sinusitis diagnosed primarily by a fine-needle aspiration biopsy (FNAB).Our patient was a 36-year-old male who presented with a history of slowly progressive, painless swelling over the left cheek. The only positive clinical finding was a bony hard swelling in the left maxillary region, which was clinically interpreted as "fibrous dysplasia." A computed tomographic (CT) examination of the paranasal sinuses showed a soft tissue attenuation lesion involving the bilateral maxillae, with the destruction of multiple bones and involvement of multiple sinuses and the bilateral orbits. FNAB of the maxillary swellin...

"Strap cells" in primary prostatic rhabdomyosarcoma in a child

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Osteoclast-rich undifferentiated carcinoma of the urinary tract: Cytologic findings and literature review

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

We report herein, the case of a 63-year-old man who was evaluated at The Johns Hopkins Hospital for gross hematuria of 4 months duration. Urinary cytology displayed high-grade malignant cells with scattered osteoclast-like giant cells in a background of acute inflammation and abundant red blood cells. Subsequently, a transurethral tumor resection was performed, which revealed infiltrating undifferentiated carcinoma with osteoclast-like giant cells. The rarity of this neoplasm and its resemblance to other giant cell-rich processes may pose diagnostic difficulties. A review of the important differential diagnoses is also presented. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Interconnecting cytoplasmic processes on fine-needle aspiration smears of carotid body paraganglioma

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Combining fine-needle aspiration biopsy (FNAB) and high-resolution melt analysis to reduce diagnostic delay in mycobacterial lymphadenitis

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

Tuberculous lymphadenitis is the most common cause of extra-pulmonary tuberculosis (TB) in developing countries. Lymphadenitis caused by non-tuberculous mycobacteria (NTM) requires consideration, particularly in immunocompromised patients and children in developed countries. Fine-Needle Aspiration Biopsy (FNAB) offers a valuable specimen collection technique, but culture confirmation, mycobacterial speciation and drug resistance testing (if indicated) is often unavailable in TB endemic areas and result in unacceptable diagnostic delay.We evaluated the diagnostic value of high-resolution DNA melting (HRM) analysis in the diagnosis of mycobacterial lymphadenopathy using FNAB and an inexpensive transport medium. Specimens were collected from patients referred to the FNAB Clinic at Tygerberg H...

Oral epithelial atypical changes in apparently healthy oral mucosa exposed to smoking, alcohol, peppers and hot meals, using the AgNOR and Papanicolaou staining techniques

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

To evaluate cytological atypical changes in apparently healthy oral mucosa exposed to smoking, alcohol, hot meals, and peppers using the AgNOR and Papanicolaou methods. A total of 180 individuals were evaluated, of which 60 were smokers, 34 were alcohol users, 52 were habitual peppers and hot meal (exposed) consumers, 24 were non-exposed, and 10 were patients with Oral Squamous Cell Carcinoma (OSCC), as an internal control. Cytological materials were obtained by brushing of buccal mucosa, on the border of the tongue and on the floor of the mouth, and participants underwent the Papanicolaou test for cytological changes and AgNOR staining for evaluation of the mean number of AgNOR dots per nucleus. SPSS program was used to perform the Pearson chi-square test. The 95% confidence level, Odds R...

Spontaneous infarction of pleomorphic adenoma: Report of a case simulating malignancy on fine-needle cytology sample

Diagnostic Cytopathology — Thu, 05 Nov 2009 00:00:00 +0100

Ischemic or hemorrhagic infarction has been described as an uncommon but possible complication of fine-needle cytology sampling in numerous organs, more frequently the thyroid, the salivary glands, the breast, the lymph node, and the kidney. In these situations, infarction appears to be directly related to the vascular disturbances caused by needle sampling, though fine this latter might be. One case of a spontaneous infarction of a parotid pleomorphic adenoma in a 46-year-old lady is here described in which the cytopathologic findings, which were related to ischemic infarction, preceded fine-needle cytology sampling and mimicked malignancy.The cytopathologic picture showed a quizzical mixture of necrosis and inflammation coupled to hyperplastic changes of the acinar cells, oncocytic metap...

Minocycline-induced black thyroid

Diagnostic Cytopathology — Wed, 04 Nov 2009 00:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

The diagnostic value of endobronchial ultrasound-guided needle biopsy in lung cancer and mediastinal adenopathy

Diagnostic Cytopathology — Tue, 03 Nov 2009 00:00:00 +0100

Endobronchial ultrasonography (EBUS) has emerged as a new diagnostic tool that allows the bronchoscopist to see beyond the airway, including pulmonary and mediastinal lesion. The real time EBUS-guided transbronchial needle aspiration (TBNA) has advanced the diagnostic yield in primary lung pathology and mediastinal lymph node staging of lung carcinoma. Sixty-four patients (36 males, 28 females, ages ranging from 16 to 86 years) with peribronchial lung lesions and mediastinal and/or hilar lymph node lesions underwent EBUS-TBNA. All patients had intraoperative cytological assessment by smears on aspiration samples or touch preparation on needle core biopsies.The cytological final diagnoses were categorized as negative, suspicious/positive, and non-diagnostic. Forty-nine samples were obtained...

Correlation between morphology and human telomerase gene amplification in bronchial brushing cells for the diagnosis of lung cancer

Diagnostic Cytopathology — Fri, 30 Oct 2009 00:00:00 +0100

The aim of this study was to investigate the frequency of amplification of the human telomerase gene (TERC), as measured by fluorescence in situ hybridization (FISH), in routine liquid-based cytological preparations from bronchial brushing specimens, and to assess the associations between TERC amplification, cytological diagnosis, and cytological morphology, in order to obtain further insight into these associations. Bronchial brushings from 102 patients with lung carcinoma (52 squamous-cell carcinomas, 22 adenocarcinomas, 28 small cell lung carcinomas) and 40 patients with nonmalignant disease were used. Amplification of TERC was performed using a commercially available two-color FISH probe, and slides were prepared for the SurePath liquid-based Pap test (LPT) using the same samples. Ampl...

Modified fine-needle aspiration technique for diagnosis of granulomatous skin lesions with special reference to leprosy and cutaneous tuberculosis

Diagnostic Cytopathology — Wed, 28 Oct 2009 00:00:00 +0100

Skin infections are commonly assessed by slit skin or scrape methods. Fine-needle aspiration biopsy (FNAB) is highly effective especially with blanching of skin to ensure good yield and reduced bleeding. The aim of this study was to assess usefulness of cytology, especially modified FNAB technique, in diagnosis of leprosy and cutaneous tuberculosis and to identify specific cytological characteristics for diagnosis and classification. The study was conducted on 40 patients - 25 cases of leprosy and 15 cases of cutaneous tuberculosis. Smears were prepared using modified FNAB technique, slit skin, and scrape methods (depending on type of lesion). Cytological diagnosis was confirmed by histopathology where the Ridley-Jopling system was used to classify cases of leprosy. A similar attempt was m...

Myoepithelial carcinoma of the parotid gland metastatic to the kidney: Case report and review of the literature

Diagnostic Cytopathology — Mon, 26 Oct 2009 00:00:00 +0100

We describe a case of metastatic myoepithelial carcinoma of the kidney from the parotid gland diagnosed by computed tomography guided fine-needle aspiration biopsy. Immunochemical studies are important to confirm myoepithelial differentiation of the tumor cells. Knowledge of the clinical history, radiographic characterization, andmorphological correlation with the primary tumor are emphasized. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Simultaneous Chlamydia trachomatis and HPV infection in pregnant women

Diagnostic Cytopathology — Mon, 26 Oct 2009 00:00:00 +0100

Pregnancy is associated with HPV infection and with Chlamydia trachomatis (CT) infection mostly due to the natural immunosuppression. In addition, pregnancy associated to CT infection can lead to adverse conditions to the woman and fetus, and CT is also believed to be a co-factor in human immunodeficiency virus infection and HPV-induced cervical cancer. The aim of this study was to establish the odds ratios (OR) of CT infection in to HPV-infected pregnant women and vice versa of women stratified by age ( (Source: Diagnostic Cytopathology)

Respiratory cytology: Differential diagnosis and pitfalls

Diagnostic Cytopathology — Fri, 23 Oct 2009 23:00:00 +0100

Pulmonary cytology can be challenging and has its share of diagnostic pitfalls. Reactive atypia can occasionally be alarming, leading to diagnostic pitfall for a false-positive diagnosis of malignancy, even for experienced cytopathologists (Naryshkin and Young, Diagn Cytopathol 1993;9:89-97). In addition, cytologic preparations can show an absence of architectural clues, leading to diagnostic difficulties. Some conditions can cytologically as well as clinically and radiographically mimic malignancies, making these pitfalls even more frequent (Bedrossian et al., Lab Med 1983;14:86-95). A recent report stated that "no laboratory that aims to make definitive diagnoses in pulmonary cytology can be spared from false-positive results"(Policarpio-Nicolas and Wick, Diagn Cytopathol 2008;36:13-19)....

Living with uncertainty: Equivocal Pap test results and the evolution of ASC terminology

Diagnostic Cytopathology — Thu, 22 Oct 2009 23:00:00 +0100

This article reviews the evolution of terminology for equivocal Pap test findings from the original Papanicolaou classification to the current the Bethesda System 2001 atypical squamous cells terminology, the implication and use of these terms, and the changing landscape of cervical neoplasia screening, which prompted these terminology changes. Emerging issues related to improving risk stratification through the introduction of additional terms and the impact of human papillomavirus testing may alter terminology of equivocal findings in the future. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Combination of MUC5ac and WT-1 immunohistochemistry is useful in distinguishing pancreatic ductal carcinoma from ovarian serous carcinoma in effusion cytology

Diagnostic Cytopathology — Thu, 22 Oct 2009 23:00:00 +0100

Malignant ascites may be the first presentation of an unsuspected cancer. Pancreas and ovary are among the organs that are usually evaluated as a source of primary. The purpose of this study is to investigate a panel of immunohistochemical stains to help differentiate pancreatic from ovarian carcinoma. We evaluated the immunohistochemical staining of eight commercially available antibodies MUC1, MUC2, MUC5ac, Wilm's tumor susceptibility gene 1 (WT1), cytokeratin 7 (CK7), CK20, CA125, and CA19.9 in 25 effusion specimens with evidence of metastatic carcinoma including 14 ovarian serous carcinomas, 9 pancreatic adenocarcinomas, and 2 unknown primaries. Primary ovarian serous carcinomas were positive for WT-1 (100%), CK7 (93%), CK20 (43%), CA125 (100%), CA19.9 (50%), MUC1 (100%), MUC2 (0%), an...

Nephroblastoma is a success of paediatric oncologic therapy. How further can we go?: Results of a cyto-histologic correlation study

Diagnostic Cytopathology — Tue, 20 Oct 2009 23:00:00 +0100

Nephroblastoma is a success of paediatric oncologic therapy, yet, there are still some cases where favourable response to preoperative chemotherapy is not achieved. Fine needle biopsy has the role of diagnostic confirmation and, idyllically of predicting a response to preoperative chemotherapy.To advance in this aim, we retrieved a total of 14 nephroblastomas, (seven male patients and seven female with a mean age of 44.4 months), diagnosed in our department by fine needle biopsy and submitted afterward to chemotherapy and nephrectomy, in the last 10 years.Correlation between cytologic features, (morphology, cell death, and proliferation (Ki-67 labelling index), and post chemotherapy tumour evaluation was done. Cytologic pattern per se was not predictive of histologic tumour classification ...

Two cases of intracranial germinoma showing a cell arrangement mimicking carcinoma

Diagnostic Cytopathology — Mon, 19 Oct 2009 23:00:00 +0100

We report two cases of intracranial germinoma, in which it was necessary to distinguish between intracranial germinoma and metastatic carcinoma in cytological specimens. Cytologically, not only single tumor cells or loosely connective tumor cells but also closely packed clusters of cells and pair cells were recognized. Immunocytochemically, almost all tumor cells were immunoreactive for M2A, placental alkaline phosphatase, and c-kit. Closely packed clusters were also immunoreactive for pan-cytokeratin. Therefore, Cytopathologists should be aware that tumor cell clusters, mimicking carcinoma might appear in cytological specimens of intracranial germinomas. Although immunocytochemical analysis assists in correct diagnosis, some cell clusters showing cytokeratin immunoreactivity does not beco...

Pulmonary crystal-storing histiocytosis diagnosed by computed tomography-guided fine-needle aspiration

Diagnostic Cytopathology — Mon, 19 Oct 2009 23:00:00 +0100

We report the first case of pulmonary CSH diagnosed by fine-needle aspiration biopsy. A patient with a history of urothelial carcinoma developed a lung nodule, which was evaluated by fine-needle aspiration biopsy. Cytologic examination revealed macrophages with abundant cytoplasmic crystals diagnostic of CSH. Based on this cytologic interpretation, additional clinical laboratory evaluation was pursued and revealed a previously unknown monoclonal serum protein. CSH must be differentiated from other non-neoplastic and neoplastic lesions and when diagnosed, should trigger a search for an underlying lymphoproliferative disorder. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Cytopathologist-performed ultrasound-guided fine-needle aspiration of parathyroid lesions

Diagnostic Cytopathology — Mon, 19 Oct 2009 23:00:00 +0100

This study examines cytopathologist-performed ultrasound-guided fine-needle aspiration (UG-FNA) in diagnosis of parathyroid lesions. Between January 1, 2007 and December 31, 2008, seven patients with PHPT or other parathyroid lesions with one or more sonographically-visible thyroid masses underwent cytopathologist-performed UG-FNA with immediate cytological evaluation (ICE). One mass was palpable and nine were nonpalpable. Three parathyroid adenomas, two benign colloid nodules, one papillary carcinoma, three parathyroid cysts, and one thyroid cyst were diagnosed. The nodules in three patients with parathyroid adenomas were identified as follicular lesion/neoplasm on ICE. Additional UG-FNA passes were made to obtain tissue for immunohistochemistry stains, which confirmed parathyroid origin....

Anal pap smear for high risk women

Diagnostic Cytopathology — Mon, 19 Oct 2009 23:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Cytoplasmic vacuoles can occur as an artifact in small cell carcinoma smears

Diagnostic Cytopathology — Mon, 19 Oct 2009 23:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Histiocytic sarcoma with interdigitating dendritic cell differentiation: A case report with fine needle aspiration cytology and review of literature

Diagnostic Cytopathology — Mon, 19 Oct 2009 23:00:00 +0100

A hybrid histiocytic sarcoma-interdigitating dendritic cell sarcoma was found in a small perinephric lymph node of an asymptomatic 80-year-old man, who presented a year ago with two small foci of lung metastasis found during routine chest X-ray. Fine needle aspiration cytology demonstrated interconnecting long and thin cell processes radiating from dendrite-like neoplastic cells with oval, enlongated, reniform, and irregular nuclei with vesicular chromatin and distinct nucleoli. Histology showed spindled epitheliod and histiocytic cells with abundant, slightly eosinophilic cytoplasm with indistinct cell borders and forming fascicles in a vague storiform pattern with interspersed T-lymphocytes. Immunohistochemically, the neoplastic cells were strongly positive for histiocytic markers: CD163...

Significance of cell proliferation markers (Minichromosome maintenance protein 7, topoisomerase II[alpha] and Ki-67) in cavital fluid cytology: Can we differentiate reactive mesothelial cells from malignant cells?

Diagnostic Cytopathology — Fri, 09 Oct 2009 23:00:00 +0100

The aim of this study was to evaluate whether immunocytochemical expressions of proliferation markers, such as minichromosome maintenance protein 7 (MCM 7), topoisomerase II[alpha] (topo II[alpha]), and Ki-67, in reactive mesothelial cells and malignant cells obtained from cavital fluids could be useful for their differential diagnosis. Samples diagnosed as reactive mesothelial cells (14 cases) or malignant tumors (28 cases) in cavital fluids were examined. Immunocytochemical staining of MCM 7, topo II[alpha], and Ki-67 was performed with the universal immunoperoxidase polymer method. In reactive mesothelial cells, MCM 7 was stained in a fine granular pattern and its distribution was uniform in the nuclei. Topo II[alpha] and Ki-67 were stained in a coarse granular pattern and the distribut...

Anal cytology in patients with AIDS

Diagnostic Cytopathology — Wed, 07 Oct 2009 23:00:00 +0100

The objective of the present study was to study the prevalence of abnormal anal cytology in patients with AIDS. Anal smears, obtained with a cytobrush, of 102 HIV-positive patients of the Emilio Ribas Institute (Sao Paulo, Brazil) were collected, and only after that, the patients were submitted to anoscopy. Thirty-two patients had LSIL and 14 others had HSIL. Squamous intra-epithelial lesions were also observed in 38% of the patients without condyloma (18/47): in 9 of the 33 patients without history of condyloma (27%) and in 9 of the 14 patients who had previously treated condyloma (64%). An invasive squamous cell carcinoma was observed in one patient without history of condyloma. In all 13 patients with HSIL, biopsies guided by high resolution anoscopy confirmed high grade dysplasia. Our ...

Cytomorphologic characteristics of fine needle core biopsy of multicystic peritoneal mesothelioma: A case report and review of the literature

Diagnostic Cytopathology — Tue, 06 Oct 2009 23:00:00 +0100

We report a case of MPM in a middle aged female that was diagnosed by fine needle core biopsy and touch preparations, allowing for appropriate clinical management. The cytomorphologic features of needle core biopsy, immunocytochemical studies and differential diagnosis are discussed. Furthermore, despite its infrequency, the current case emphasizes the importance of the inclusion of this entity in the differential diagnosis of cystic lesions of the abdomen and pelvis at the time of on-site evaluation and final diagnosis, in order to avoid misinterpretation of strips of benign mesothelial cells as inadequate for diagnosis. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Comparison of the clinical significance of the Papanicolaou test interpretations LSIL cannot rule out HSIL and ASC-H

Diagnostic Cytopathology — Tue, 06 Oct 2009 23:00:00 +0100

Despite the two-tiered classification of dysplasia in The Bethesda System (TBS), rare cases fall into the category squamous intraepithelial lesion (SIL) of indeterminate grade. These Pap tests are often interpreted as "LSIL/ASC-H" or "LSIL" with a comment indicating the presence of cells with features approaching HSIL. Patients with LSIL/ASC-H have a significant risk of CIN 2 or worse (29-61.5%) on follow-up cervical biopsies, similar to the risk of CIN 2 or worse in patients with ASC-H Pap tests (24-68%). The purpose of this study was to compare patients with ASC-H and LSIL/ASC-H Pap tests. Women with LSIL/ASC-H had a slightly lower incidence of CIN 2 or worse (PPV = 35.6%, 95% CI: 29.8-41.4%) on follow-up cervical biopsy than the control ASC-H group (PPV = 40.2%, 95% CI: 31.9-56.3%); thi...

What's in a name? Evidence that Papanicolaou, not Babes, deserves credit for the PAP test

Diagnostic Cytopathology — Tue, 06 Oct 2009 23:00:00 +0100

The purpose of our study is to elaborate on the ongoing controversy regarding the origination of the Pap test between the supporters of George Papanicolaou and Aurel Babes. We studied the original articles published by Aurel Babes and George Papanicolaou and conducted a comparative evaluation of both methods. Babes' method is radically different from Papanicolaou's method. Differences included the sampling method, the fixation and staining technique, and the interpretation of the results regarding cases of cervical cancer. We conclude that theestablishment of the technique in clinical practice and the ideaof its application as preventive control of cervical cancer belong solely to George Papanicolaou. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. (Source: Diagnostic Cytopathology)

Evidence-based evaluation of the risks of malignancy predicted by thyroid fine-needle aspiration biopsies

Diagnostic Cytopathology — Tue, 06 Oct 2009 23:00:00 +0100

A National Cancer Institute (NCI) "Thyroid Fine-Needle Aspiration (FNA) State of the Science Conference" recently proposed standardized nomenclature and "risks of malignancies" associated with various diagnostic categories. We evaluated the evidence levels of the data used by NCI to predict malignancy risks and whether those estimates had clinical validity in our patient population.Eight hundred seventy-nine patients underwent thyroid FNA during 2006. FNA diagnoses were translated into NCI diagnostic categories, and 2-year follow-up retrospective information was obtained. Four percentages of malignancies were calculated for each diagnostic category using follow-up information from FNA, thyroidectomy, both, and all patients as denominators. 95% confidence intervals (CI) were estimated for a...

Epithelioid angiosarcoma: A neoplasm with potential diagnostic challenges

Diagnostic Cytopathology — Tue, 06 Oct 2009 23:00:00 +0100

In this report, the patient is a 24-year-old man presenting with testicular pain, a pelvic mass, and innumerable liver nodules. Immediate interpretation of the needle core biopsies of the pelvic mass and liver lesions initially favored a poorly differentiated adenocarcinoma. Unusual positive immunohistochemical stains for CD30 and CK7 ultimately led the investigation toward a tumor of mesenchymal origin. Further, immunohistochemical evaluation demonstrated positive CD31 and Factor VIII staining and established the final diagnosis of epithelioid angiosarcoma. The tumor cells were negative for CD34, CK20, alpha-fetoprotein, placental-like alkaline phosphatase, hepatocyte paraffin 1, polyclonal carcinoembryonic antigen, CD10, CA-125, prostate-specific antigen, and prostatic acid phosphatase. ...

Comparison of the sensitivity of conventional cytology and the ThinPrep Imaging System for 1,083 biopsy confirmed high-grade squamous lesions

Diagnostic Cytopathology — Tue, 06 Oct 2009 23:00:00 +0100

We report our experience with ThinPrep Imaging since its introduction into our routine gynecological cytology service. 87,284 split sample pairs reported using the Imaging System demonstrated a decrease in unsatisfactory reports (3.65% for CS and 0.87% for TPI) and an increase in possible high grade and definite high-grade squamous reports (1.57% for CS and 1.62% for TPI).For 1,083 biopsy confirmed high-grade lesions, the correct diagnosis of high grade or possible high-grade squamous disease was made on the ThinPrep imaged slide in 61.0% (661/1,083) of cases and on the CS in 59.4% (643/1,083). This was not statistically significant. When all abnormalities identified on cytology were considered, including possible low grade and definite low-grade abnormalities, the difference in sensitivit...

HPV data can be used as a cytopatholoy laboratory quality indicator

Diagnostic Cytopathology — Wed, 30 Sep 2009 23:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Lipid-rich carcinoma of breast: A case report with fine needle aspiration cytology

Diagnostic Cytopathology — Tue, 29 Sep 2009 23:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

An audit of cervical cytology smear results reported as "Dyskaryosis, difficult to grade; Colposcopy advised"

Diagnostic Cytopathology — Tue, 29 Sep 2009 23:00:00 +0100

No abstract. (Source: Diagnostic Cytopathology)

Inflammatory events as detected in cervical smears and squamous intraepithelial lesions

Diagnostic Cytopathology — Tue, 29 Sep 2009 23:00:00 +0100

This study presents an analysis of 1,008,879 smears. Of each smear, the age of the woman and the reason for smear taking (screening or indication) was available. The cytoscores (per mille) for these codes were calculated. For the screening smears, the cytoscores were for koilocytosis (HPV) 2.6, for Trichomonas vaginalis 1.9, for dysbacteriosis 31.4, for Candida albicans 9.8, for Gardnerella vaginalis 0.7, for Actinomyces 6.9, for Chlamydia 0.8, and for non-specific inflammatory changes 66.4. For the calculation of the Odds Ratio (OR), normal smears were used as a reference. The cytoscores for Chlamydia and Gardnerella covaried with high grade SIL (HSIL), with an OR of 7 and 12, respectively. In addition, the OR for Trichomonas vaginalis, for dysbacteriosis, and for leucocytosis proved to b...

Fine-needle aspiration of primary osseous lesions: A cost effectiveness study

Diagnostic Cytopathology — Tue, 29 Sep 2009 23:00:00 +0100

Fine-needle aspiration (FNA) is not widely used in the work-up of osseous lesions because of concerns regarding its high incidence of nondiagnostic specimens. Although several studies have shown that FNA is less expensive than surgical biopsy, the authors are aware of only one prior study evaluating the cost effectiveness of FNA, which includes the cost of incisional or core needle biopsies necessary to establish a diagnosis when the initial FNA was noncontributory. A computerized search of the pathology records of three medical centers was performed to obtain all FNAs of primary osseous lesions. For each FNA case, all subsequent core needle, incisional or excisional biopsies were recorded as was the result of the definitive operative procedure. The cost of obtaining the definitive diagnos...