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Cytologic Examination (cytologic + examination)
Selected AbstractsPapillary thyroid carcinoma with metastasis to the frontal skullDIAGNOSTIC CYTOPATHOLOGY, Issue 7 2009Dian Feng M.D., Ph.D. Abstract Papillary thyroid carcinoma with metastasis to the frontal skull is extremely rare. We report a case of unsuspected papillary thyroid carcinoma with frontal skull metastasis. The patient was a 62-year-old African American woman with presentation of a 4-cm firm, painless, immobile, ill-defined mass at the right forehead. Ultrasound and computer tonography detected a hypervascular and osteolytic tumor involving the skull and overlying skin. Fine-needle aspiration was performed followed by surgical biopsy. Cytologic examination revealed the presence of hypercellular and bloody material. The neoplasm showed glandular features and was composed of clusters of round to oval cells with pinkish squamoid cytoplasm, oval nuclei and inconspicuous nucleoli on smears and sections of cell block. With immunocytochemical stain, the neoplastic cells were positive for pancytokeratin and vimentin and focally positive for EMA, while they were negative for S100, HMB45, Melan-A, CD34, GFAP, CD10, LCA, RCC and CD138. The diagnosis was a metastatic carcinoma. Clinical follow up with surgical biopsy was recommended. Surgical biopsy demonstrated histological and cytological features of papillary thyroid carcinoma including prominent papillae, nuclear overlapping, grooves, and intranuclear pseudoinclusions. Thus, a diagnosis of metastatic papillary thyroid carcinoma was rendered. Though skull metastasis of thyroid carcinoma is rare, it should be considered in the differential diagnosis when a skull mass lesion is encountered. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] Cytology of metastatic cervical squamous cell carcinoma in pleural fluid: Report of a case confirmed by human papillomavirus typingDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2009Roberto G. Gamez M.D. Abstract Cervical squamous cell carcinomas are rarely the cause of malignant effusions. Their identification can be relatively easy when keratinizing atypical squamous cells are present, but may be very difficult when only nonkeratinizing malignant cells are present. We present the case of a 47-year-old woman who presented with a large left pleural effusion after having recently completed chemoradiation therapy for stage IIB cervical squamous cell carcinoma. Cytologic examination of the fluid showed a uniform population of single atypical cells with finely vacuolated cytoplasm, ectoendoplasmic demarcation, cell-in-cell arrangements, and short rows of cells with intervening "windows," all features reminiscent of mesothelial cells. No keratinization or three-dimensional cell clusters were identified. A panel of immunohistochemical stains was performed on the cell block material, and the atypical cells were positive for cytokeratin 5/6, p63, and p16 but not for cytokeratin 7, calretinin, WT1, or Ber-EP4 or TTF1. These findings were consistent with metastatic squamous cell carcinoma. HPV DNA determination and typing by PCR confirmed the presence of HPV16 in an aliquot of pleural fluid. This is to our knowledge the first reported case of pleural fluid involved by metastatic squamous cell carcinoma where HPV DNA testing was used to confirm the origin of the metastasis. Despite its rarity, metastatic nonkeratinizing squamous cell carcinoma should be considered when a single cell population of large atypical cells is found in effusions. Immunoperoxidase stains and HPV testing can be performed to establish the diagnosis and confirm the origin from a cervical primary. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] Cytologic comparison of a primary parathyroid cancer and its metastatic lesions: A case reportDIAGNOSTIC CYTOPATHOLOGY, Issue 1 2006I.A.C., Katsuhide Ikeda C.T. Abstract We describe the fine-needle aspiration cytology features of a primary parathyroid cancer and of the local recurrent and distant metastatic lesions. The presence of prognostic factors Ki-67 and proliferating cell nuclear antigen (PCNA) was compared immunohistochemically between primary parathyroid carcinoma and related metastatic and recurrent foci. Flow cytometric DNA analysis was also performed to investigate any chromosomal abnormality of the parathyroid carcinoma. Cytologic examination of the endocrine tumor showed that it comprised a loose cohesive cluster and tumor cells with granular cytoplasm and mild nuclear atypia, but for purposes of cytodiagnosis, it is difficult to determine whether such a neoplasm is malignant on the basis of morphology alone. Immunohistochemical analysis showed that Ki-67 and PCNA labeling indices were higher in the recurrent and metastasized carcinomas than in the primary cancer, suggesting that neoplastic cells become more malignant in the recurrent and metastasized foci. To our knowledge, this is the first report describing not only cytopathologic but also immunocytologic differences between primary parathyroid cancer and the metastatic lesion. Diagn. Cytopathol. 2006;34:50-55. © 2005 Wiley-Liss, Inc. [source] Preparation Techniques for the Injection of Human Autologous Cartilage: An Ex Vivo Feasibility Study,THE LARYNGOSCOPE, Issue 1 2008J Pieter Noordzij MD Abstract Objectives: To determine the optimum donor site and preparation technique for injecting human autologous cartilage as a potentially permanent implant material for vocal fold medialization. Study Design: Prospective ex vivo experimental model. Methods: Human nasal septal and auricular cartilage was obtained from eight surgical cases after institutional review board approval. The auricle and nasal septum were chosen as potential donor sites because of ease of accessibility, volume of cartilage potentially available, and minimal subsequent cosmetic deformity after the tissue harvesting procedure. Various preparation techniques readily available in most operating rooms were tested for their efficacy in generating an injectable cartilage slurry. The various cartilage slurries were injected through sequentially smaller needles and examined cytologically. Results: The best injection properties for both nasal septal and auricular cartilage were obtained by drilling the cartilage down with a 5 mm otologic cutting bur, which allowed free passage through an 18 gauge needle. Cytologic examination of drilled septal cartilage showed good uniformity of cartilage pieces with a mean largest dimension of 0.44 ± 0.33 mm, and 33% of lacunae contained viable-appearing chondrocytes. Cytologic examination of drilled auricular cartilage was similar, exceptonly 10% of lacunae were occupied by chondrocytes. Other techniques tested (knife, morselizer, and cartilage crusher) did not yield injectable cartilage slurries. Conclusions: Both nasal septal and auricular cartilage can be prepared for injection via an 18 gauge needle using a cutting otologic bur. Further testing of in vivo viability and long-term volume retention is needed. [source] Diagnostic effects of prolonged storage on fresh effusion samples,,DIAGNOSTIC CYTOPATHOLOGY, Issue 1 2007Frances Manosca M.D. Abstract The effects on morphology and diagnostic interpretation of delayed processing of refrigerated effusion samples have not been well documented. The potential for cellular degeneration has led many laboratories to reflexively fix samples rather than submit fresh/refrigerated samples for cytologic examination. We sought to determine if effusion specimens are suitable for morphologic, immunocytochemical, and DNA-based molecular studies after prolonged periods of refrigerated storage time. Ten fresh effusion specimens were refrigerated at 4°C; aliquots were processed at specific points in time (days 0, 3, 5, 7, 10, 14). Specimens evaluated included four pleural (3 benign, 1 breast adenocarcinoma) and six peritoneal (2 ovarian adenocarcinomas, 1 malignant melanoma, 2 mesotheliomas, 1 atypical mesothelial) effusions. The morphology of the cytologic preparations from the 10 effusions was preserved and interpretable after 14 days of storage at 4°C. The immunocytochemical profile of the samples (AE1/AE3, EMA, calretinin, and LCA) was consistent from day 0 to day 14. Amplifiable DNA was present in all samples tested on day 14. We conclude that cytopathologic interpretation of effusion samples remains reliable with refrigeration at 4°C even if processing is delayed. Diagn. Cytopathol. 2007;35:6,11. © 2006 Wiley-Liss, Inc. [source] Diagnostic value of needle aspiration cytology (NAC) in the assessment of palpable inguinal lymph nodes: A study of 210 casesDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2003F.I.A.C., Raj K. Gupta M.D. Abstract The aim of this study was to evaluate the diagnostic value of needle aspiration cytology (NAC) in the assessment of palpable inguinal lymph nodes, which were analyzed in 210 cases. NAC in all the cases were performed by the conventional aspiration method and cytologic examination was done on site after staining smears with the Papanicolaou method. In addition, Diff-Quik-stained air-dried smears, Papanicolaou-stained fixed smears, and filter preparations from needle washings and hematoxylin-eosin-stained sections of cell blocks were studied. The NAC diagnosis was supported by examining cell blocks in 92/210 cases which showed a reliable histologic architecture; further support was also obtained with a tissue biopsy in 9/12 cases of inflammatory lesions, 7/7 cases with a suspicious diagnosis, 20/26 cases of melanomas, 15/15 cases of lymphomas, and/or a comparison with the primary tumor in other cases of metastatic tumors. Additionally, immunoperoxidase and/or histochemical stains were done. Twelve cases were diagnosed as inflammatory lesions and 88 cases were regarded as negative (normal cellular elements n = 40; reactive elements n = 48). In 58 cases a variety of metastatic tumors were diagnosed (melanoma n = 26; others n = 32) and in 15 cases a diagnosis of lymphoma was made. Seven cases were diagnosed as suspicious of malignancy and 30 cases were unsatisfactory due to scanty/acellular samples (despite 2,3 repeat samplings). However, in five of these malignant tumors were later found on a biopsy which was done due to a persistent and continued enlargement of lymph node(s). The sensitivity was 91.7%, specificity 98.2%, positive predictive value (PPV) 97.7.%, and negative predictive value (NPV) was 95.45%. Based on our study we feel that NAC as a first line of investigation is not only useful in the diagnosis of lesions in inguinal lymph nodes, but can also help in deciding on an appropriate management. Also, histologic architecture from cell blocks can be correlated with cytology and such material can be used for histochemical and immunomarker studies. Diagn. Cytopathol. 2003;28:175,180. © 2003 Wiley-Liss, Inc. [source] Septic pericarditis in a Yorkshire TerrierJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 2 2006Amanda Wagner DVM Abstract Objective: To describe a novel case management strategy for a small breed dog diagnosed with septic pericarditis. Case summary: An 8-year-old spayed female Yorkshire Terrier presented for evaluation of pericardial effusion and persistent hypoglycemia. The dog had been hospitalized at a primary care facility for acute onset of vomiting, lethargy, inappetance, and painful abdominal distension. Pericardial effusion was detected and upon referral, cytologic examination revealed a suppurative exudate with Gram-positive and Gram-negative bacteria. The dog was treated with pericardiocentesis and placement of an indwelling pericardial catheter. Subtotal pericardiectomy was performed and a thoracotomy tube was utilized postoperatively. A penicillin-susceptible Bacteroides species was cultured from the pericardial fluid and was treated with a 6-week course of antibiotics. The dog was discharged from the hospital and clinical signs have not recurred in over 2 years. New or unique information provided: Septic pericarditis, an uncommon cause of canine pericardial effusion, has been described primarily in large breed dogs and in association with bacterial infection secondary to Hordeum grass (foxtail) awn migration. This case was unique in that the dog was a small breed with no evidence of foreign body penetration or other precipitating cause for the pericarditis. In a novel management plan, an indwelling pericardial catheter was employed to stabilize the dog before subtotal pericardiectomy. [source] | ||||||||||