Fine needle aspiration diagnosis of neuroendocrine tumors in the liver

Ten neuroendocrine tumors (NET) in the liver are presented, in which the diagnosis was made on fine needle aspiration cytology and cell blocks from the aspirate. In seven of the patients with liver metastasis, a biopsy-proven extrahepatic primary NET had been previously diagnosed, while in three patients no extrahepatic neoplasm could be identified, suggesting that the NET may have been a primary in the liver. Based on cytomorphological findings the cases were typed as either round cell type, spindle cell type or polygonal cell type. In all cases, immunopositivity for neuroendocrine markers provided reliable evidence of the cell of origin and distinguished them from well-differentiated hepatocellular carcinoma, adenocarcinomas and other neoplasms, which sometimes may present a diagnostic dilemma.     

Fine needle aspiration biopsy of the liver

The liver is a commonly targeted deep-seated organ in which fine-needle aspiration biopsy (FNAB) is performed. By far, the most frequently encountered lesions on FNAB of the liver are metastases; however, a wide variety of other lesions have been described and are likely to be encountered. Because of this wide variety, attention to architectural as well as cytologic features on smears and cell block preparations, ancillary techniques, and special studies are often required. In the setting of proper specimen handling and judicious use of ancillary procedures, FNAB of hepatic lesions can be an accurate diagnostic procedure.     

Fine needle aspiration in the diagnosis of subcutaneous cysticercosis

Human cysticercosis commonly manifests as subcutaneous and intramuscular nodules. The current study highlights the role of fine needle aspiration cytology (FNAC) in the diagnosis of subcutaneous cysticercosis. One hundred and twenty two patients with subcutaneous swellings, diagnosed as cysticercus or suspicious of parasitic inflammation on FNAC, were included in the present study. The relevant clinical data, cytomorphological findings, and histopathological findings, wherever available were evaluated. In 57 cases, a definite evidence of cysticercus was obtained in the form of fragments of parasite bladder wall, hooklets, or intact larva. Out of these, biopsy correlation was available in 10 cases, eight of which failed to reveal any parasite. In 65 cases, larval fragments could not be identified on aspirates, and the diagnosis of parasitic inflammation was suggested on the basis of other cytomorphological findings, which are discussed. In 22 of these cases, a biopsy correlation was available, which revealed definite parasitic elements in six cases and the remaining 16 cases were reported as suggestive of parasitic cysts. Thus, to conclude, FNAC is a reliable and cost effective procedure for the diagnosis of subcutaneous parasitic nodules. It obviates the need for a subsequent histopathological examination, as the parasite may not be demonstrated even on biopsy specimens.     

Fine needle aspiration cytology of liver tumors

Fine needle aspiration cytology has undergone increasing utilization in the evaluation of hepatic neoplasms. Experience with liver aspirates has demonstrated that problems in differential diagnosis require thorough understanding of criteria for distinguishing different tumor types. The present report describes the cytologic presentation of primary and metastatic hepatic tumors with emphasis on characteristic nuclear and cytoplasmic features encountered in fine needle aspiration biopsy specimens.     

Fine needle aspiration diagnosis of tuberculous mastitis

Fine needle aspiration cytology has become the first choice in diagnostic procedures in the management of a variety of breast diseases. The technique can be successfully used to diagnose granuloma in breast aspirates and to demonstrate the presence of acid-fast bacilli. Tuberculosis is rampant in developing countries and patients are prescribed antituberculous therapy on the basis of finding granuloma in breast aspirates without a culture report. In our practice, this principle has been followed with excellent results. In our experience, this technique was reliable and reproducible in diagnosing tuberculous mastitis. We report on the cytomorphological findings of this uncommon but important disorder.     

Transbronchial needle aspiration biopsy in the diagnosis of pulmonary neoplasms

To evaluate the usefulness of transbronchial needle aspiration biopsy (TBNAB) in the primary diagnosis of lung cancer, we undertook a prospective study of this technique, assessing specimens from 124 patients over a 3-yr period. Cytologic and/or histologic material obtained by an alternate technique was available for 105 (84.7%) of the patients. The diagnostic sensitivity of TBNAB was comparable with that of other bronchoscopic techniques; with the addition of TBNAB, the overall sensitivity of bronchoscopy was increased from 54% to 72% (P less than 0.001). Because of its usefulness for diagnosis of submucosal tumors and its safety, we conclude that TBNAB is a useful addition to current methods for the diagnosis of suspicious pulmonary lesions.     

Fine needle aspiration of thymic epithelial neoplasms and non-neoplastic lesions

Thymic epithelial neoplasms are rare as these tumors represent less than 1% of all human tumors. In addition, thymic hyperplasia and thymic cysts can also present as anterior or less often superior mediastinal masses. Fine needle aspirates and core biopsies of thymic epithelial neoplasms are rarely encountered in routine pathology practices. Histologic classification of these lesions requires microscopic examination of the entire lesion as a significant number of tumors can have more than one histologic type and the status of invasion into adjacent soft tissues or organs is needed for accurate staging. Therefore, it is important to understand the limitations of the information these biopsy methods can provide. The accuracy of the diagnosis can be improved by using ancillary techniques like immunohistochemistry and flow cytometry. In this review, we are summarizing the clinical, histologic and cytologic characteristics of thymic cysts, thymic hyperplasia and thymic epithelial neoplasms including different types of thymoma and thymic carcinoma.     

Fine needle aspiration cytology of liver: a study of 202 cases

From January 1990 to December 2000, 202 patients with clinical evidence of liver disease underwent fine needle aspiration cytology of the liver. Of these, 102 patients were diagnosed as non-neoplastic lesions. These include diffuse parenchymal disease of liver, liver abscess, hepatitis, and granulomas. There were 100 patients with malignancies of the liver. Out of the above, 64 were due to metastatic carcinoma, 31 were primary hepatocellular carcinoma, 1 hepatoblastoma and in 4 patients the diagnosis of non-Hodgkin's lymphoma was made. By comparing with clinical and biochemical parameters, the diagnostic accuracy of the fine needle aspiration cytology, in this study, was found to be more accurate in malignant nodules of the liver as compared to other pathological lesion. The findings of fine needle aspiration cytology of the liver reported by other authors are discussed and it is concluded that this diagnostic method is a safe, useful and economic procedure with minimum complication and can be routinely done for assisting diagnosis of liver diseases in our clinical set up.     

Fine needle aspiration cytology diagnosis of aneurysmal bone cyst: a case report

Aneurysmal bone cyst is a relatively rare tumour accounting 1 to 6% of all primary bone tumours. The involvement of clavicle is even rare with incidence of only 3% of all cases of aneurysmal bone cyst. Aneurysmal bone cyst is an expanding osteolytic lesion occurring mostly at metaphyseal ends of the long bones. Although excisional biopsy is diagnostic for aneurysmal bone cyst and FNAC (fine needle aspiration cytology) is mostly inconclusive. Still FNAC can be helpful in pre-operative diagnosis of aneurysmal bone cyst.     

白血病髓外浸润的针吸细胞病理学诊断

目的 探讨对白血病髓外浸润行针吸细胞病理学(FNAc)诊断和鉴别诊断的要点。方法 对65例白血病髓外浸润的临床及FNAc诊断结果进行了分析总结。为确诊,对疑为白血病者,用油镜观察细胞形态并做外周血涂片镜检以助确诊,部分病例做了髓过氧化物酶(MPO)、氯醋酸AS-D奈酚酯酶(CE)、酸性非特异性酯酶(ANAE)及糖原(PAS)染色。部分病例做了组织病理学、免疫细胞化学及流式细胞仪检查。结果 65例髓外浸润中急性淋巴细胞性白血病(ALL)24例、急性髓细胞性白血病(AML)25例、慢性淋巴细胞性白血病(CLL)6例、慢性髓细胞性白血病(CML)10例。各部位中以淋巴结浸润最多,占73．8％。结论 白血病髓外浸润的FNAC诊断应紧密结合临床及有关实验室检查,特别是以局部肿块为首发症状而就诊的初诊白血病。各类白血病髓外浸润以原始细胞增生为主者,需与非霍奇金淋巴瘤(NHL)鉴别。FNAC拟诊为NHL者均应及时用油镜观察细胞形态并做外周血涂片镜检。     

Fine needle aspiration cytology of undifferentiated embryonal sarcoma of the liver: a case report

The cytological features of a rare case of undifferentiated (embryonal) sarcoma of the liver are presented. The cytology smears showed singly dispersed polygonal and spindle cells as well as loose clusters of cells held together in myxoid material. Neoplastic cells were generally large with round, oval or lobulated nuclei. The cytoplasm was variable in amount with ill-defined borders. Occasional multinucleated cells were also present. Hyaline globules were present on sections of the cell block. Immunohistochemical studies performed showed positivity for vimentin, cytokeratin and alpha-1-antitrypsin (AAT) in the tumour cells.     

Fine needle aspiration cytology in the diagnosis of uncommon types of lymphoma

AIMS: Fine needle aspiration (FNA) cytology is an accepted means of diagnosing and typing common forms of lymphoma, particularly small lymphocytic lymphoma, follicular lymphoma, and large B cell lymphoma. However, its usefulness for diagnosing less common forms of lymphoma is not clearly established and this study was designed to examine this. METHODS: The study reviewed the FNAs of suspected lymphomas collected over a period of approximately five years. RESULTS: FNA samples were available for 138 definite lymphomas; most were common forms of B cell lymphoma. However, there was also one Burkitt lymphoma (BL), two Burkitt-like large B cell lymphomas, 15 classic Hodgkin lymphomas (HLs), two nodular lymphocyte predominant Hodgkin lymphomas, four mantle cell lymphomas, two mediastinal (thymic) large B cell lymphomas (MLBCLs), 11 peripheral T cell lymphomas (PTCLs), and five T cell rich large B cell lymphomas (TCRLBCLs). CONCLUSIONS: FNA diagnosis of BL was possible with immunoflow cytometry (IFC), cell block immunohistochemistry (IHC), and cell block fluorescent in situ hybridisation for c-myc alteration. It was difficult to make a definite diagnosis of HL and MLBCL on FNA alone. Both tend to be sclerotic tumours and FNA tends to yield scanty neoplastic cells. The FNA diagnosis of PTCL depended on cell block IHC; IFC was not usually useful. TCRLBCL did not show light chain restriction on IFC of FNA samples, probably because of frequent reactive B cells in the tumour. Thus, HL, MLBCL, and TCRLBCL are often difficult to diagnose accurately on FNA cytology, even when using IFC and cell block IHC.