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931.
Yaxia Zhang M.D. Ph.D. Carmen R. Gomez‐Fernandez M.D. Merce Jorda M.D. Ph.D. Parvin Ganjei‐Azar M.D. 《Diagnostic cytopathology》2009,37(11):828-831
Lesions that contain abundant benign myoepithelial cells, including pleomorphic adenomas of salivary gland origin, may present a diagnostic challenge in fine‐needle aspiration (FNA) specimens. Benign metastasizing pleomorphic adenoma is a rare neoplasm, in which the benign appearing pleomorphic adenoma, without any histological evidence of malignancy, metastasizes to distant sites including lung. In the absence of clinical history of a pre‐existing myoepithelial neoplasm, the presence of myoepithelial cells in the lung or any other organs besides salivary glands may create diagnostic difficulty. Here we present the cytologic findings of such a metastatic tumor found in the lung FNA and pleural fluid specimens from a 64‐year‐old woman, with a history of local recurrent salivary gland pleomorphic adenomas, who presented with multiple bilateral pulmonary nodules and pleural effusion. The diagnosis of benign metastasizing pleomorphic adenoma was made based on clinical information and cytomorphology, and confirmed by immunocytochemistry. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc. 相似文献
932.
Kenan Sauder M.D. David C. Wilbur M.D. Linda Duska M.D. Rosemary H. Tambouret M.D. 《Diagnostic cytopathology》2009,37(6):437-442
Radical trachelectomy (RT) is the surgical amputation of the uterine cervix with paracervical lymphadenectomy, performed in reproductive age women to treat invasive squamous‐cell carcinoma or endocervical adenocarcinoma while preserving the uterine corpus for potential child bearing. Post‐RT patient monitoring includes isthmic‐vaginal cytology. This study reviews our experience with liquid based preparation of post‐RT cytology samples. Fifty‐four post‐RT vaginal‐isthmic cytology specimens were reviewed from nine patients, seven with adenocarcinoma, and two with squamous‐cell carcinoma. Five patients had normal (NILM) or normal with reactive changes on all cytology samples. Two patients had isolated squamous abnormalities (atypical squamous‐cells of uncertain significance (ASC‐US) and low‐grade squamous intraepithelial lesion (LSIL)); both follow‐up biopsies were negative. Two patients had repeatedly abnormal specimens interpreted as atypical glandular cells (AGC), one of whom also had a concurrent ASC‐US. Only one sample was tested for high risk human papilloma virus (hrHPV), with negative results. All patients with abnormal cytology went on to have biopsies which were interpreted as benign. The cytology specimens most often interpreted as AGC contained many groups of hyperchromatic crowded glandular cells and/or stromal cells derived from direct sampling of the lower uterine segment. The crowding often limits visualization of all the cells in a group, plus sampled endometrium may harbor mitoses, adding to the atypical appearance. Cytologists should become familiar with the spectrum of changes in the post‐RT cytology. Testing for hrHPV should be considered for use in the management of abnormal cytology results. Post RT cytology should be compared with presurgical cytology since one would anticipate similarities in post‐RT true positive cases. In particular, a primary diagnosis of adenocarcinoma makes differentiating benign reactive glandular cells from recurrence a critical issue. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc. 相似文献
933.
This small prospective study compared the time cytologists spend reviewing cervical cytology slides processed by the ThinPrep Imager (TPI) with screening times for conventional cytology slides (CS), to determine the effect, if any, of the TPI on productivity in our department. Some possible factors affecting TPI reading times, such as individual screener's experience with both specimen types, were also studied. We recorded the time taken to screen approximately 2,140 corresponding CS and TPI slides. The CS slides were screened by 22 cytologists, of whom 14 also read the TPI slides. The time taken to screen the slides at the conventional or review microscope was recorded, including any full reviews. Administrative duties including history checks and result entry were not included. Overall, the mean CS reading time was 5.6 minutes, (or 10.7 slides/hour) while the mean screening time for TPI was 2.9 minutes (20.6 slides/hour), a productivity increase of 92%. For the 14 cytologists who read both types of specimen, individual productivity increases ranged from 38.9 to 252%. Screener experience had little or no effect on TPI times, but slower CS readers were found to have greater increase in speed and productivity when using the TPI. This study has demonstrated a significant decrease in screening times for TPI when compared with CS (P = 0.001), resulting in significantly increased productivity (P = 0.001). Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc. 相似文献
934.
Seema Aggarwal D.N.B. Vinod K. Arora M.D. Sanjay Gupta M.D. Navjeevan Singh M.D. Arati Bhatia MD 《Diagnostic cytopathology》2009,37(3):174-177
The aim of this study were (1) To correlate koilocytosis with high risk HPV(HrHPV) DNA in urinary bladder carcinoma and (2) To compare detection of koilocytosis on tissue sections and urine cytology. Biopsy and cytologic specimens from 33 patients of urinary bladder carcinoma were analyzed. HPV DNA was detected by PCR on biopsy specimens using consensus primers MY09 and MY11. Koilocytosis was assessed both on tissue sections and urine cytology. HrHPV DNA was found in 14 of 33 bladder carcinoma. Koilocytosis was seen in tissue sections from 13 patients. Eleven of these were HrHPV DNA positive (positive predictive value 84.6%). Koilocytosis was seen in urine cytology in three patients. All three were positive for HrHPV DNA. To conclude koilocytosis is a good morphological marker for HrHPV DNA in the urothelium. Tissue sections are better than cytologic smears for detection of koilocytes. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc. 相似文献
935.
Diagnosis of two distinct malignant entities existing concurrently and at the same location (synchronous malignancy) by fine- needle aspiration (FNA) is unusual but may occur. Small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) in particular is associated with an increased incidence of secondary tumor, likely due to associated immunodeficiency. Co-occurrence of some carcinomas such as squamous cell carcinoma (SCC), may show especially aggressive behavior. A 57-year-old Caucasian male presented with recurrent upper extremity lymphedema and diffuse lymphadenopathy of the axillary and cervical regions. FNA of a large cervical lymph node was diagnostic for both atypical lymphocytic proliferation and SCC. Flow cytometric analysis showed the atypical lymphocytic proliferation to be positive for CD5, CD23, CD19, CD20, HLA-DR, CD38, and the population was kappa light chain restricted. These cells were negative for CD-10 and FMC-7 antigens, suggesting a phenotype of B-cell SLL/CLL. We report a rare occurrence of metastatic SCC to a lymph node infiltrated by SLL/CLL. The diagnosis was achieved by a combination of cytomorphologic examination of FNA smears, immunohistochemical staining of cell block material, and flow cytometry on the sample obtained by FNA. To the best of our knowledge, only three cases of SCC metastasis to SLL/CLL diagnosed by FNA have been reported in the English literature. Though rare, awareness of such a possibility and careful cytological examination under the appropriate clinical conditions is warranted. 相似文献
936.
Massimo Bongiovanni M.D. Frederic Triponez M.D. Thomas A. McKee M.D. Neeta Kumar M.D. Thomas Matthes M.D. Patrick Meyer M.D. 《Diagnostic cytopathology》2009,37(9):671-675
The diffuse sclerosing variant of papillary thyroid carcinoma (DSV–PTC) is a rare tumor with aggressive behavior that requires aggressive treatment. Despite characteristic clinical and histological features that easily permit diagnosis, pre‐operative fine‐needle aspiration cytology (FNAC) diagnosis is often challenging and thus delays diagnosis. We describe the cytological features of a case of DSV–PTC diagnosed by FNAC in a 30‐year‐old woman presenting with an ill‐defined mass in her neck lasting for 2 months. Ultrasonograpy revealed a heterogeneous enlargement of both thyroid lobes suspicious for a lymphoproliferative syndrome. Flow cytometry showed a suspect B‐lymphocyte population. FNAC showed in five out of six slides an overwhelming presence of slightly atypical monomorphic small lymphocytes. The remaining slide showed syncytial tissue fragments of follicular cells with nuclear enlargement and pleomorphism, irregular nuclear membrane, grooves with scattered intranuclear inclusions, squamous metaplastic epithelium, and abundant psammoma bodies. A diagnosis of DSV–PTC was rendered and confirmed by total thyroidectomy and lymph node dissection. Our report supports the possibility of obtaining a preoperative diagnosis of DSV–PTC by FNAC. In the case of diffuse thyroid enlargement, adequate sampling of the thyroid and the presence of the combination of features described in our case permitted the diagnosis of this PTC variant. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc. 相似文献
937.
Haitham Arabi M.D. Mahendra Shah M.D. Husain Saleh M.D. M.B.A. 《Diagnostic cytopathology》2009,37(10):715-719
Extragonadal germ cell tumors are uncommon and such tumors originating from the lung parenchyma are extremely rare. This is a case of 68‐year‐old female who was admitted with complaints of right‐sided weakness, inability to maintain her balance, right‐sided headache, and bloody sputum. Her workup revealed two enhancing brain lesions and large lung mass involving the left lower lobe. Fine‐needle aspiration (FNA) of the lung followed by craniotomy was performed and the patient was initially diagnosed with lung adenocarcinoma metastatic to the brain based on the cytomorphology of the lung FNA and histology of the brain mass. However, retrospective investigation revealed markedly elevated alpha fetoprotein (AFP) of which the cytopathologist was unaware at the time of diagnosis. A review of the cytology and surgical specimen slides, as well as immunohistochemistry (IHC) on the brain tumor and FNA cell block were preformed. On the basis of the slides review, clinical findings, and immunostaining results, a diagnosis of primary pulmonary mixed germ cell tumor, containing choriocarcinoma and yolk sac elements, with brain metastases, was retrospectively made. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc. 相似文献
938.
Fine-needle aspiration (FNA) biopsy of the salivary gland is a sensitive and specific diagnostic tool. However, diagnostic problems are sometimes encountered in interpreting some cases, not only in differentiating benign from malignant cases but also in the specific classification of these neoplasms. We report a case of a pleomorphic adenoma with predominant plasmocytoid myoepithelial cells arising in minor salivary glands from the hard palate in a 78-year-old patient, which was falsely diagnosed as a carcinoma on liquid-based cytology (ThinPrep (TP)). The differential diagnosis of salivary gland tumors with predominant myoepithelial cells on FNA biopsy is discussed. 相似文献
939.
Nalini Gupta M.D. Ruchi Gupta M.D. Jaimanti Bakshi M.S. D.N.B. M.N.A. M.S. Arvind Rajwanshi M.D. F.R.C.Path. 《Diagnostic cytopathology》2009,37(12):920-922
Fibro‐osseous lesions of the jaw comprise of a spectrum of diseases which include osseous dysplasia, fibrous dysplasia, and ossifying fibroma. The differentiation amongst these individual pathological lesions is difficult and a combined clinico‐radiological and histological correlation is essential for exact categorization. Fine needle aspiration cytology (FNAC) is frequently carried out to distinguish between benign and malignant lesions of the jaw as is a quick and reliable modality of investigation which guides in further management. We report, a case of a jaw swelling in a young male, diagnosed as fibrous dysplasia on FNAC. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc. 相似文献
940.
Dimitra Grapsa M.D. Efthalia Petrakakou M.D. Ph.D. Efi Botsoli‐Stergiou M.D. Panagiota Mikou M.D. Pauline Athanassiadou M.I.A.C. Athina Karkampasi M.D. Anna Ioakim‐Liossi M.I.A.C. 《Diagnostic cytopathology》2009,37(12):903-905
Strongyloidiasis is an opportunistic infection which may result in a fatal hyperinfection syndrome in immunocompromised patients. We report the case of a pulmonary infection with Strongyloides stercoralis in a 61‐year‐old male with a history of a long‐term administration of corticosteroids. Cytologic examination of a bronchial washing specimen, processed both as conventional and as Thin‐Prep smears, revealed an abundance of the typical larvae of Strongyloides stercoralis, amidst a cellular population comprising several acute inflammatory cells as well as bronchial epithelial cells with features of basal cell hyperplasia or regenerative atypia. To the best of our knowledge there is only one previous report describing Strongyloides stercoralis in thin‐layer smears, and there are no previous studies comparing its morphology in conventional and thin‐layer preparations. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc. 相似文献