Chondroid syringoma diagnosed by fine needle aspiration cytology

Chondroid syringoma is a rare benign skin adnexal tumor of eccrine/apocrine origin affecting commonly the head and neck region. It used to be previously called as mixed tumor of skin because of the presence of both the epithelial and mesenchymal components. There are only few case reports describing the fine needle aspiration cytologic features of chondroid syringoma for diagnosis. We studied a 20‐year‐old male case from Taplejung district of Nepal came to Otorhinolaryngology out patient department with the complaints of painless, progressively enlarging swelling on the dorsum of nose. On examination, 2.0 × 2.0 cm, firm, non‐tender swelling was seen on the right side of dorsum of nose. Overlying skin was normal, and the swelling was fixed to the skin but freely mobile over underlying structure. A clinical diagnosis of dermoid cyst was entertained, and the case was subjected to FNAC. FNA yielded mucoid material which on microscopy showed clusters of round cells with moderate to abundant cytoplasm embedded in chondromyxoid ground substance. The nuclei were monomorphic, centrally to eccentrically located and had fine chromatin. On the basis of these cytologic features, a diagnosis of chondroid syringoma was made. We concluded that Chondroid syringoma may be considered as a rare differential diagnosis in the swelling of head and neck region and the diagnosis can be easily confirmed or ruled out by means of fine needle aspiration cytology. Diagn. Cytopathol. 2010. © 2009 Wiley‐Liss, Inc.     

Diagnostic utility of fine needle non-aspiration cytology versus fine needle aspiration cytology in breast masses

Fine needle aspiration cytology (FNAC) and fine needle non-aspiration cytology (FNNAC) techniques were studied in 145 cases of breast masses. All the needle-sampling procedures were done by single operator. The samples were assessed cytologically and evaluated using five parameters i.e. background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture. Differences between all the individual parameters as observed in FNAC and FNNAC smears were insignificant. After evaluation of FNNAC and FNAC on the basis of these scores, greater number of diagnostically superior samples were obtained by FNNAC; however by FNAC more number of diagnostically adequate smears were observed. This difference was statistically significant. The number of unsuitable smears were also more by FNNAC technique.     

Cutaneous granular cell tumor clinically mimicking ectopic breast diagnosed on fine needle aspiration cytology

Granular cell tumor (GCT) is a rare benign neoplasm of Schwannian origin which accounts of 0.5% of soft tissue tumors. Although the most common site for GCT is tongue, it can occur at any site. GCT presenting as cutaneous nodule is rare, however cases have been reported in literature. We hereby document a case of 30 year female with a hyper‐pigmented cutaneous nodule of anterior chest wall on the milk‐line mimicking as an ectopic breast, diagnosed as GCT on fine needle aspiration cytology. We also add a note on the differential diagnoses of GCT with differentiating cytological features to emphasize on the correct diagnosis of GCT pre‐operatively.     

Hepatocellular carcinoma metastasizing to the orbit diagnosed by fine needle aspiration cytology

Hepatocellular carcinoma (HCC) rarely metastasizes to the orbit. We report a case of a 78-year-old man with a past history of HCC, who presented with a periorbital mass, which was diagnosed as metastatic HCC by fine needle aspiration cytology (FNAC) and subsequently confirmed on excision biopsy. The cytological, histopathological and immunohistochemical findings are presented and the differential diagnosis is discussed. To our knowledge there has been no previously reported case of HCC metastatic to the orbit diagnosed by FNAC.     

Mammography-guided stereotactic fine needle aspiration cytology of breast lesions

The purpose of the present study was to evaluate the efficacy of mammographic guided stereotactic fine needle aspiration cytology in 136 patients with breast lesions including mammographic features, cytomorphological findings and nuclear grading in malignant cases. Majority of the cases were predictable correctly by combination of the three modalities of diagnosis viz, clinical examination, mammography and cytology.     

Follicular thyroid carcinoma with metastasis to skin diagnosed by fine needle aspiration cytology

In April 2006, a 55-year-old female presented with a thyroid mass and multiple skin nodules on scalp, forehead and neck. Fine needle aspiration cytology of thyroid mass and multiple skin nodules show tumor cells clusters in a repetitive microfollicular pattern on May-Grunwald-Giemsa stain suggestive of follicular thyroid carcinoma with metastasis to skin. Although follicular carcinoma have a propensity for vascular invasion and hematogenous dissemination, skin is not commonly involved. Only a few cases of cutaneous metastasis from follicular thyroid carcinoma are reported in the English language literature.     

Breast lesions diagnosed by fine needle aspiration

Fine needle aspiration (FNA) of the breast offers patient and clinican a rapid, non-morbid, inexpensive, and highly accurate means of diagnosing both benign and malignant breast lesions. Breast FNA can replace frozen section diagnosis, and in fact has the advantage of providing a known diagnosis before the time that operations are performed. This situation enables the patient and surgeon to discuss and plan therapeutic alternatives in a rational atmosphere. As with any other technique, experience of the aspirator and diagnostician minimizes false positive and false negative rates.     

Breast filariasis diagnosed by needle aspiration cytology.

A case of nodular lesion of the breast in a 37 year old female caused by filariasis is described. The case is instructive since the diagnosis was made by fine-needle aspiration cytology.     

细针吸取细胞学的进展

自从上世纪80年代开始,细针吸取活检（fine needle aspiration biopsy,FNAB）,又称细针吸取细胞学（fine needle aspiration cytology,FNAC或称FNA）以其具有快捷、损伤少、经济及准确率高的优点,深受临床医生及患者的欢迎,使其应用非常广泛,几乎涉及全身所有的器官。但是,也因其取材较少导致的取材不满意率和假阴性率高,造成对组织结构观察不满意,分型不够细致和确定等缺点而局限了其应用。此方法对操作人员的技术要求也较高。未经细胞病理学专业训练的病理医生,应用FNA的效果并不理想,引发的医疗纠纷较多（美国的医疗纠纷中以FNA引发最多）,使得部分病理科医生对FNA并不十分热衷。相反粗针穿刺活检（core needle biopsy,CNB）取材较多,吸出的组织与手术切除的标本相近,病理科医生容易诊断。影像学的发展使定位准确,     

Intramuscular myxoma report of a case diagnosed on fine needle aspiration cytology

Intramuscular myxoma is a relatively rare soft tissue tumour. Here we present a case which was diagnosed as intramuscular myxoma on cytology and confirmed on histopathology. This is the first such reported case from this country.     

Primary tibial adamantinoma diagnosed by fine needle aspiration

Adamantinoma is one of the rarest primary bone tumors and is almost exclusively found in the tibia. Because of its scarcity, there are only a handful of reported cases of adamantinoma diagnosed by fine needle aspiration (FNA). We report a case of a 30‐year‐old woman seen at The Johns Hopkins Hospital for a 2.5‐cm lytic lesion in the distal diaphysis of the tibia. A computed tomography‐guided FNA of the lesion revealed a moderately cellular lesion consisting of a biphasic admixture of epithelioid cells seen singly and in fragments. These cells had round to oval nuclei with pale chromatin and well‐formed nuclear grooves. The other population had more elongated nuclei and spindled appearance. An immunostain for cytokeratin was positive, supporting the diagnosis of adamantinoma. Due primarily to its rarity, the diagnosis of adamantinoma on FNA can be challenging and must be made in the context of its characteristic clinical and radiographic setting. Diagn. Cytopathol. 2010. © 2009 Wiley‐Liss, Inc.     

A computer-based training system for breast fine needle aspiration cytology.

Fine-needle aspiration (FNA) cytology is a rapid and inexpensive technique used extensively in the diagnosis of breast disease. To remove diagnostic subjectivity, a diagnostic decision support system (DDSS) called CytoInform has been developed, based on a Bayesian belief network (BBN) for the diagnosis of breast FNAs. In addition to acting as a DDSS, the system implements a computer-based training (CBT) system, providing a novel approach to breast cytology training. The system guides the trainee cytopathologist through the diagnostic process, allowing the user to grade each diagnostic feature using a set of on-screen reference images as visual clues. The trainee positions a slider on a spectrum relative to these images, reflecting the similarity between the reference image and the microscope image. From this, an evidence vector is generated, allowing the current diagnostic probability to be updated by the BBN. As the trainee assesses each clue, the evidence entered is compared with that of the expert through the use of a defined teaching file. This file records the relative severity of each clue and a tolerance band within which the trainee must position the slider. When all clues in the teaching case have been completed, the system informs the user of inaccuracies and offers the ability to reassess problematic features. In trials with two pathologists of different experience and a series of ten cases, the system provided an effective tool in conveying diagnostic evidence and protocols to trainees. This is evident from the fact that each pathologist only misinterpreted one case and a total of 86%/88% (experienced/inexperienced) of all clues assessed were interpreted correctly. Significantly, in all cases that produced the correct final diagnostic probability, the route taken to that solution was consistent with the expert's solution.     

Role of fine needle aspiration cytology in breast cancer screening.

In a six year period up to the end of December 1985 fine needle aspiration cytology specimens of the breast were obtained from 562 apparently healthy women invited to participate in a breast cancer screening programme. Of these, 397 had a biopsy and 173 cancers were confirmed histologically. For the diagnosis of cancer, the procedure was less successful than in symptomatic cases. The main factors influencing success were the aspirator, the small size of many cancers, and the occult nature of the lesions seen only on mammography. Retrospective analysis of the figures shows that combining the results of FNA cytology in a triple assessment with physical and mammographical findings for restricted selection means that the number of benign biopsy specimens could be reduced considerably.     

An unusual localization of mucormycosis diagnosed by fine needle aspiration cytology: a case report

Mucormycosis is an uncommon fungal infection, occurring mainly in patients with acidosis, chronic illnesses and malignancies. The most frequent site of involvement in patients of hematological malignancies is the respiratory tract. Isolated subcutaneous localization of mucormycosis in such patients is extremely rare. We report a case of a young patient of non-Hodgkin's lymphoma on chemotherapy who presented with a subcutaneous swelling on the anterior aspect of right thigh. Fine needle aspiration cytology (FNAC) smears from the swelling revealed numerous characteristic broad, irregularly contoured and pleomorphic hyphae of mucormycosis. This fungus seldom grows in culture and confirmation of the diagnosis depends on cytological or histological examination of infected tissues. Our case report documents a rare site of isolated mucormycosis infection and emphasizes the role of FNAC as a simple, rapid, accurate, and useful method of diagnosing fungal infections.     

Decidualized endometrioma diagnosed by fine needle aspiration cytology: A case report with immunocytochemical confirmation

Endometriosis is defined as ectopic endometrial tissue which can respond to hormonal stimulation. Cutaneous endometriosis is a rare pathologic entity that can represent a clinical diagnostic challenge. We report a case of a decidualized endometrioma in a 24‐year old pregnant African American woman diagnosed by fine needle aspiration cytology and confirmed by immunocytochemistry using CD10, ER, and Calretinin. The awareness of the pathologist of the cytologic characteristics of this uncommon entity is important to avoid diagnostic pitfalls and unnecessary diagnostic interventions during pregnancy. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

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

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 differential diagnosis of a lung mass, even in an immunocompetent host, especially if the clinical history reveals recent travel to British Columbia where Cryptococcus gattii is endemic. Diagn. Cytopathol. 2010. © 2009 Wiley‐Liss, Inc.     

Juvenile ossifying fibroma diagnosed on fine needle aspiration cytology: A diagnostic challenge

Preoperative diagnosis of jaw lesions is not always possible on the basis of clinico‐radiological findings alone and needs to be confirmed before attempting any surgical intervention. Fibro‐osseous lesions of the jaw comprise a spectrum of diseases which include cement‐osseous dysplasia, fibrous dysplasia, and ossifying fibroma. The cytomorphological distinction between these individual entities is difficult. We present a case of maxillary fibro‐osseous lesion in an adolescent girl diagnosed and categorized as juvenile ossifying fibroma preoperatively on cytology and confirmed on histopathology. Although aspirates are usually paucicellular in fibro‐osseous lesions, certain cytological features if present in cellular cytosmears can offer further categorization and a definitive diagnosis may be possible in light of clinico‐radiological correlation. Diagn. Cytopathol. 2015;43:75–79. © 2014 Wiley Periodicals, Inc.