Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas diagnosed by endoscopic ultrasonography-guided fine-needle aspiration

Undifferentiated carcinoma with osteoclast-like giant cells, also formerly known as osteoclast-like giantcell tumor, is a rare neoplasm of the pancreas and usually diagnosed after pancreatectomy. The presence of non-neoplastic osteoclast-like giant cells is the histological hallmark of this tumor and the diagnosis is usually not difficult on tissue sections. However there have been relatively few reports regarding the cytological features of this type of tumor in literatures.1-4 Here we.     

Vitamin A status of socio-economically backward children

A comprehensive survey was carried out to asses the Vitamin A status of pre-school (0–6 yrs.) and school age (6–12 yrs.) children of socio-economically backward families from slums of Bombay and its suburbs. The Vitamin A, protein, calories and iron from the rice and dal based diet was found to be below recommended dietary allowances (RDA). Among the 1956 children surveyed 20% of the children showed low (<20 μg/dl) serum vitamin A levels. 4.8% of the children were suffering from one or the other signs of Vitamin A deficiency. Rose Bengal stain test (RBST) and conjuctival impression cytology (CIC) indicted the signs of mild conjuctival xerosis and of early epithelial changes which were correlated with serum vitamin A levels. Serum iron, PCV, Hb and RBC levels were below normal. The anthropometric measurements of these children were below 50th percentile of Indian Council of Medical Research (ICMR) standards. Due to lack of proper nutrition, the overall growth of children is either retarded or not upto the standard levels as was noted in majority of the children.     

Influence of age and human papillomavirus-infection on reliability of cervical cytopathology

The aim of the present study was to evaluate the effect of age and human papillomavirus (HPV) infection associated cellular changes on the predictive value of cervical cytology. In a group of 671 women with Papanicolaou smears suggesting low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) or invasive cervical cancer, cervical cytology was correlated with the histological finding. Predictive values were calculated and related to severity of the lesion, age and HPV associated changes. The predictive values of Papanicolaou (cervical) smears suggesting LSIL, HSIL and invasive carcinoma were 40%, 86%, and 78%, respectively. A poor predictive value of smears suggesting LSIL was found among older women. HPV associated changes were diagnosed in 80% of women 25 years of age, 66% in the age group 26 to 35 years, 51% in the age group 36 to 45 years and 38% in women aged 46 years (P = 0.03). The presence of HPV associated cellular changes led to a significantly higher number of overdiagnoses (9% with HPV infection compared to 4% without HPV infection) and HPV negative cases were more frequently associated with underdiagnosis (15% without HPV infection compared to 8% with HPV infection,P = 0.0011). This result remained significant after adjustment for age (P = 0.004). Cellular changes associated with HPV infection most frequently occurred in young women. HPV infection should therefore be acknowledged as source of overdiagnosis in the cytological evaluation of SIL especially in woung women.Supported by the Research Grant of the Mayor of Vienna (no. 1045 [to Dr. Kainz])     

The Value of Fine Needle Aspiration Cytology in Breast Fibromatosis: Study of Two New Cases and Review of the Literature

▪ Abstract: We report two new cases of breast fibromatosis studied by needle aspiration cytology observed in a 32-year-old man and a 49-year-old woman. The lesions manifested as palpable, painless, and firm masses of the para-areolar breast soft tissues. Preoperative fine needle cytology revealed scant cellularity, featuring oval and spindle cells with bland nuclei and occasional larger polygonal cells with high nuclear:cytoplasmic ratio. Histologically, interwoven fascicles of spindle cells with bland nuclei, infiltrating the adjacent breast fat, were recognized. Based on available reports in the literature, we concluded that needle aspiration cytology, although not entirely specific, may be a source of important information in patients with breast fibromatosis. In particular, it confidently allows the exclusion of breast cancer and other more common diseases and is useful in planning a surgical approach to the lesion. ▪     

Prediction of survival and recurrence in bladder carcinoma

Summary We have followed a large population of patients receiving radiation treatment for bladder carcinoma with respect to survival and recurrence-free survival. Bivariate and multivariate life table analyses have been performed using a set of independent variables. The most important were T class, grade (G), urinary carcinoembryonic antigen (U-CEA) taken before treatment and cytological analysis 4 months after treatment. We compared the usual way of classifying a patient (T+G) with the combination of U-CEA and cytology since the latter two variables seemed to have great prognostic importance. The analyses show that T+G gives the best significance for survival (P=0.0003) while U-CEA and cytology is better for recurrence-free survival (=0.0002). 0.0002).     

Diagnosis of cerebral Whipple's disease by cerebrospinal fluid cytology

Summary In a case of Whipple's disease the diagnosis was made by careful cytologic evaluation of the cerebrospinal fluid (CSF), identifying Sieracki cells. A basal granuloma invaded the hypothalamus, diencephalon, and rostral parts of the brainstem. An exploration in the initial stage led to misdiagnosis as a granular cell tumor. Diagnosis was then confirmed by intestinal biopsy.

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Zusammenfassung Es wird über einen Fall mit Morbus Whipple berichtet, der bei sorgfältiger Untersuchung des Liquor cerebrospinalis durch den Nachweis von Sieracki-Zellen diagnostiziert wurde. Die Exploration eines basalen Granuloms, das in den Hypothalamus, das Diencephalon und die rostralen Anteile des Hirnstamms eingewachsen war, hatte im Frühstadium zur Fehlinterpretation eines Granularzelltumors geführt. Die Diagnose wurde schließlich durch Dünndarmbiopsie bestätigt.

     

婴幼儿手术损伤与外周血淋巴细胞凋亡的关系

目的　手术应激可引起细胞介导的免疫受到抑制 ,包括淋巴细胞数量减少 ,导致感染并发症增加 ,确切的原因尚不清楚 ,本研究探讨婴幼儿大手术损伤和淋巴细胞凋亡的关系。方法　 1 2例择期大手术婴幼儿和 6例严重感染的婴幼儿 ,择期手术患儿包括先天性胆总管囊肿 7例和先天性巨结肠 5例 ,其中男 8例 ,女 4例 ,年龄 6个月～ 3岁 ;6例正常婴幼儿作为对照 ,抽取外周血 ,用Boyum描述的方法借助梯度离心分离淋巴细胞 ,用AnnexinV/PI双染色法来分析淋巴细胞早期凋亡情况 ,流式细胞仪测定淋巴细胞Fas的表达。结果　术后患儿外周血淋巴细胞明显下降 ,术后 1d为最低 ,术后 3d仍处于低值。大手术组患儿淋巴细胞凋亡率为 (1 4 .1± 1 .1 ) % ,严重感染组为 (1 2 .3±2 .0 ) % ,与正常对照组 (5 .1± 0 .3) %相比有统计学意义 (P <0 .0 5) ;Fas阳性淋巴细胞百分数术毕为(50 .3± 6 .3) % ,术后 1d为 (49.3± 4 .3) % ,与术前 (36 .3± 1 .1 % )相比有统计学意义 (P <0 .0 5)。结论　经历大手术的患儿循环淋巴细胞呈现凋亡的早期征象 ,可能是全身炎症反应中免疫细胞低反应的原因     

单纯腹腔细胞学阳性子宫内膜癌Ⅲ a期患者的预后

目的　研究不同子宫内膜癌Ⅲa期患者的预后 ,为临床治疗提供依据。方法　对 1988～ 2 0 0 1年在我院收治的子宫内膜癌Ⅰ期、Ⅲ期患者共 191例进行回顾性分析。患者共分为四组 :第一组为Ⅰ期患者 ,共134例 ;第二组为单纯腹腔细胞学阳性的子宫内膜癌Ⅲa期患者 ,共 2 3例 ;第三组为伴有浆膜浸润或附件转移的子宫内膜癌Ⅲa期患者 ,共 16例 ;第四组为子宫内膜癌Ⅲb期 Ⅲc期患者 ,共 18例。采用Kaplan -Meier法对四组的平均生存时间进行计算 ,并进行比较。结果　①第一组与第二组的平均生存时间差异无显著性 ,P >0 0 5 ;②第二组与第三组的平均生存时间差异有明显统计学意义 ,P <0 0 1;③第三组与第四组的平均生存时间差异无显著性 ,P >0 0 5。结论　尽管腹腔细胞学阳性、浆膜浸润及附件转移均被定为子宫内膜癌Ⅲa期 ,但单纯腹腔细胞学阳性的患者其预后明显好于伴有浆膜层浸润或附件转移者。对她们应采取不同的后续治疗     

宫颈细胞学和电子阴道镜在宫颈病变早期诊断中的应用研究

目的进一步评价细胞学和电子阴道镜在宫颈病变的早期诊断中的价值.方法回顾性分析431例宫颈涂片和阴道镜检的结果,与活检组织病理学的结果进行对比研究.结果 431例中检出宫颈上皮内瘤变(CIN)Ⅰ 39例、CIN Ⅱ 36例、CIN Ⅲ 32例、宫颈鳞癌11例和宫颈湿疣27例,其余286例为慢性宫颈炎.宫颈涂片检出了93.5%宫颈病变,阴道镜检出了95.9%宫颈病变,细胞学与阴道镜下活检联合应用无漏诊.结论细胞学与阴道镜下活检联合应用能提高宫颈病变的检出率,阴道镜检查能明显提高宫颈湿疣的检出率.     

骨髓增生异常综合征细胞形态学观察

目的：观察骨髓增生异常综合征(MDS)骨髓细胞形态学病态改变。方法：用瑞氏-姬姆萨混合染液染色，进行骨髓及外周血细胞学分析。结果：粒、红、巨核三系都有不同程度的病态造血。粒系主要以细胞核浆发育不平衡，内外浆、中性粒细胞核分叶不能或Pelger-Huet样畸形。结论：MDS三系均有不同程度的病态改变，患者以中老年居多，分型主要以RA为主。