The effect of the polyethylene intrauterine device on peritoneal fluid cell distribution of adult female mice

At Hahnemann Medical College and Hospital in Philadelphia, researchers attempted to determine whether uterine cavity IUD-induced inflammation extends into the abdominal cavity. Adult female mice were used. In each experimental animal (14), a piece of polyethylene intramedic tubing (1.3 cm long) was fixed in place by suture within each uterine horn. In the sham-operated controls (15), a silk suture was sutured into each horn. 3 weeks later peritoneal fluid specimens were obtained from the 2 groups and compared. The IUD resulted in significant increases in histiocytes (pl.001) and polymorphonuclear leukocytes (pl.001). Mesothelial cells were significantly decreased (pl.001), but mesothelial cells were somehwat higher in the controls than is usually found. No significant changes in lymphocytes or monocytes were observed. Only experimental animals showed daisy cells. Thus, the IUD resulted in a definite abdominal inflammatory effect. Judging by the spontaneous activity measured on an Electronic Activity Monitor, the IUD produced no animal discomfort. 25% of the IUDs were expelled.     

Fine needle aspiration biopsy in the diagnosis of tuberculosis

Bacteriologic data and aspiration smears obtained by fine needle aspiration (FNA) biopsy for a series of 39 cases of tuberculosis were reviewed. Based on the morphologic features of the aspiration smears, the cases were divided into two groups: 18 cases in which distinct epithelioid granulomas were present and 21 in which no granulomas were found but large amounts of necrotic debris with variable numbers of polymorphonuclear cells, histiocytes and lymphocytes were present. Material from the FNA biopsy specimen was submitted for culture and fluorescence studies in 34 cases (15 with and 19 without granulomas). In the first group, auramine-rhodamine staining of smears was positive in 4 of 15 cases and Mycobacterium tuberculosis was isolated in 12 of 15 cases. In the second group, auramine-rhodamine staining was positive in 9 of 19 cases and culture was positive for M. tuberculosis in 16 of 19 cases. The results indicate that studying FNA smears by light microscopy and bacteriologic culture is an effective way of diagnosing tuberculosis.     

Aspiration cytology of solitary schwannoma

The aspiration cytology of two cases of solitary schwannoma is documented. The first tumor was retroperitoneal and cystic; the aspirated fluid showed single, regular, spindle-shaped cells with cigar-shaped nuclei and scanty wavy cytoplasm in addition to lymphocytes and foamy histiocytes. The second tumor was solid and peripheral; its aspiration smears revealed spindle-shaped cells with cigar-shaped nuclei present singly or in clusters showing nuclei in a palisading pattern.     

Swelling of olecranon bursa in uremic patients receiving hemodialysis.

Three patients with chronic renal failure who received therapy with hemodialysis through arteriovenous fistulas in the forearm had fluctuating swelling over the elbow on the same side as the fistula used for the dialysis. The clinical findings in each case were compatible with olecranon bursitis with effusion. The aspirate obtained from the swellings contained lymphocytes, polymorphonuclear leukocytes and histiocytes, a finding similar to that in cases of uremic pericardial and pleural effusion. Biopsy of the bursa in one case showed hyalinized collagenous tissue with infiltration by histiocytes and lymphocytes, reflecting underlying chronic inflammation. Uremia was believed to be the causative factor. Bursitis with effusion is considered to be one of the clinical aspects of uremic polyserositis.     

Proportional analysis of respiratory cells obtained by bronchoalveolar lavage.

Bronchoalveolar lavage was performed during fibreoptic bronchoscopy in 17 patients with biopsy-proven interstitial lung disease and in 12 control subjects who had focal lesions in the lung. The volume of fluid recovered was unrelated to disease activity or diagnosis. In the control subjects alveolar macrophages represented over 95% of the lavaged cells. The proportion of lymphocytes in the lavaged cells enabled a natural division of the diffuse interstitial lung diseases into two categories: active sarcoidosis, indicated by a large proportion of lymphocytes but a normal proportion of polymorphonuclear leukocytes; and idiopathic pulmonary fibrosis and asbestosis, indicated by a normal proportion of lymphocytes but a variable proportion of polymorphonuclear leukocytes. Bronchoalveolar lavage is a safe and well tolerated method for evaluating the role of alveolitis in diffuse interstitial lung disease through the sampling of respiratory alveolar cells.     

"Collagen balls" in peritoneal washings. Prevalence, morphology, origin and significance.

Peritoneal washings obtained at laparotomy from women undergoing surgery for neoplasms of the genital tract may contain "collagen balls," consisting of tissue fragments composed of collagen covered with mesothelial cells. Collagen balls were found in 19 (4.5%) of 418 peritoneal washings and were more prevalent in specimens labeled pelvic washings (17 of 294, or 5.8%) than in those labeled peritoneal washings (2 of 124, or 1.6%). In 15 of the 19 cases in which we found collagen balls, at least one ovary was available for microscopic examination. In 14 of the 15 cases minute nodular papillary stromal projections covered with mesothelium were found on the surface of the ovaries. We conclude that collagen balls, a nonspecific entity, most probably originate on the surface of the ovaries. Their significance lies in their being mistaken for mucin-distended cells exfoliated from a neoplasm or from detached fragments of a papillary ovarian neoplasm.     

Gonadotropin uptake in genetic and irradiation models of ovarian tumorigenesis

Genetic and irradiation models of ovarian tumorigenesis were investigated for evidence that elevated gonadotropins have a role in tumorigenesis. Wx/Wv mice lack oocytes at birth, develop complex mesothelial adenomas by 6 mo, and additional ovarian tumor types later. Uptake of iodinated human chorionic gonadotropin (125I-hCG) was measured in mice aged 1 to 30 mo, and uptake iodinated human follicle-stimulating hormone (125I-hFSH) was measured in mice aged 1 to 12 mo. Gonadotropin uptake by Wx/Wv ovaries in vivo declined quickly and was undetectable by 6 mo. Irradiated ovaries rapidly lost oocytes and follicular structures, formed mesothelial adenomas by 5 mo, and later formed additional types of ovarian tumors. In the irradiation model, 125I-hCG uptake also declined quickly and was undetectable by 3 mo of age. Neither the surface nor the tubular epithelium of the mesothelial adenoma were consistently labeled by 125I-hCG in autoradiography studies with either model. Although these data do not exclude an acute role for gonadotropins in initiation of preneoplastic events, they do indicate that ovarian cells do not require chronic gonadotropin stimulation during subsequent tumorigenesis. These findings are discussed in relation to additional models of ovarian tumorigenesis.     

Fine needle aspiration cytology of granulomatous mastitis. Report of a case and review of the literature

A case of granulomatous mastitis diagnosed by fine needle aspiration (FNA) cytology alone is reported. A 24-year-old pregnant woman presented with a six-week history of a rapidly enlarging breast mass, considered clinically to be malignant. The FNA smears contained numerous aggregates of epithelioid histiocytes admixed with Langhans' and foreign-body giant cells, lymphocytes, neutrophilic leukocytes and apoptotic debris, leading to a diagnosis of granulomatous mastitis. The features of granulomatous mastitis and its differential diagnoses are discussed.     

In vitro Mesothelial Clearance Assay that Models the Early Steps of Ovarian Cancer Metastasis

Ovarian cancer is the fifth leading cause of cancer related deaths in the United States¹. Despite a positive initial response to therapies, 70 to 90 percent of women with ovarian cancer develop new metastases, and the recurrence is often fatal². It is, therefore, necessary to understand how secondary metastases arise in order to develop better treatments for intermediate and late stage ovarian cancer. Ovarian cancer metastasis occurs when malignant cells detach from the primary tumor site and disseminate throughout the peritoneal cavity. The disseminated cells can form multicellular clusters, or spheroids, that will either remain unattached, or implant onto organs within the peritoneal cavity³ (Figure 1, Movie 1). All of the organs within the peritoneal cavity are lined with a single, continuous, layer of mesothelial cells^4-6 (Figure 2). However, mesothelial cells are absent from underneath peritoneal tumor masses, as revealed by electron micrograph studies of excised human tumor tissue sections^3,5-7 (Figure 2). This suggests that mesothelial cells are excluded from underneath the tumor mass by an unknown process. Previous in vitro experiments demonstrated that primary ovarian cancer cells attach more efficiently to extracellular matrix than to mesothelial cells⁸, and more recent studies showed that primary peritoneal mesothelial cells actually provide a barrier to ovarian cancer cell adhesion and invasion (as compared to adhesion and invasion on substrates that were not covered with mesothelial cells)^9,10. This would suggest that mesothelial cells act as a barrier against ovarian cancer metastasis. The cellular and molecular mechanisms by which ovarian cancer cells breach this barrier, and exclude the mesothelium have, until recently, remained unknown. Here we describe the methodology for an in vitro assay that models the interaction between ovarian cancer cell spheroids and mesothelial cells in vivo (Figure 3, Movie 2). Our protocol was adapted from previously described methods for analyzing ovarian tumor cell interactions with mesothelial monolayers^8-16, and was first described in a report showing that ovarian tumor cells utilize an integrin –dependent activation of myosin and traction force to promote the exclusion of the mesothelial cells from under a tumor spheroid¹⁷. This model takes advantage of time-lapse fluorescence microscopy to monitor the two cell populations in real time, providing spatial and temporal information on the interaction. The ovarian cancer cells express red fluorescent protein (RFP) while the mesothelial cells express green fluorescent protein (GFP). RFP-expressing ovarian cancer cell spheroids attach to the GFP-expressing mesothelial monolayer. The spheroids spread, invade, and force the mesothelial cells aside creating a hole in the monolayer. This hole is visualized as the negative space (black) in the GFP image. The area of the hole can then be measured to quantitatively analyze differences in clearance activity between control and experimental populations of ovarian cancer and/ or mesothelial cells. This assay requires only a small number of ovarian cancer cells (100 cells per spheroid X 20-30 spheroids per condition), so it is feasible to perform this assay using precious primary tumor cell samples. Furthermore, this assay can be easily adapted for high throughput screening.     

Fine needle aspiration (FNA) cytology of Rosai Dorfman disease

deshpande v and verma k. (1998) Cytopathology 9, 329–335
Fine needle aspiration (FNA) cytology of Rosai Dorfman disease
Rosai Dorfman disease (sinus histiocytosis with massive lymphadenopathy (SHML)) is a benign self-limiting disorder that commonly involves the lymph nodes. We reviewed eight cases of this entity aiming to document the cytomorphological features. Of the eight cases, a preoperative diagnosis was suggested in seven cases. Pertinent features included: numerous large histiocytes with prominent emperipolesis (documented by a halo around the cell), fine vacuoles in the cytoplasm and lymphocytes and plasma cells in the background. In some cases the histiocytes showed atypia. In one biopsy-proven case a diagnosis of Hodgkin's was suggested, emphasizing the pitfalls associated with the FNA diagnosis of this lesion.     

Immunohistochemical characterization of the cellular infiltrate in Jorge Lobo's disease

Few studies have been conducted to evaluate the cellular composition of the granulomatous lesions induced by Lacazia loboi. Thus, the objective of the present study was to characterize the mononuclear cell population present in cutaneous lesions obtained from 15 patients with Jorge Lobo's disease. Histological sections were stained with hematoxylin-eosin and methenamine silver and the following mononuclear cells were identified by immunohistochemistry: T lymphocytes (CD3+), helper T lymphocytes (CD4+), cytotoxic T lymphocytes (CD8+), B lymphocytes (CD20+), plasma cells (CD79+), natural killer cells (CD57+) and histiocytes (CD68+). This study showed that the inflammatory infiltrate mainly consists of histiocytes and multinucleated giant cells, in addition to the presence of a large number of fungal cells. The identified inflammatory cells showed the following frequency: CD68+ histiocytes > CD3+ T lymphocytes > CD4+ T > CD8+ T lymphocytes > CD57+ natural killer cells > CD79+ plasma cells > CD20+ B lymphocytes. Based on the findings of a large number of fungal cells in the infected tissues and the disorganized cell arrangement in the granuloma, we hypothesize that patients with Jorge Lobo's disease present immunoregulatory disturbances, which are likely to be specific and perhaps responsible for the lack of containment of the pathogen.     

Pulmonary Hodgkin's disease. Diagnosis by fine needle aspiration

The cytologic manifestations of pulmonary Hodgkin's disease in transthoracic fine needle aspirates from 13 patients with pulmonary radiologic abnormalities and a previous diagnosis of Hodgkin's disease are described. Classic Reed-Sternberg cells and lacunar cells were present in most cases. The so-called "mononuclear" Reed-Sternberg cells were identified in all cases. A cellular background consisting of variable numbers of histiocytes, eosinophilic and neutrophilic leukocytes and lymphocytes was frequently present. Such a background should stimulate a search for cells diagnostic of Hodgkin's disease. We conclude that the cytologic features of Hodgkin's disease are not only characteristic, but are also diagnostic, in patients with a prior history of Hodgkin's disease in whom pulmonary recurrence is suspected.     

Expression of matrix metalloproteinases-2 and -9 by cells isolated from the peritoneal fluid of women with ovarian carcinoma

OBJECTIVE: To investigate the level of expression of matrix metalloproteinases (MMP)-2 and -9 by cells isolated from the peritoneal fluid of women with ovarian carcinoma. STUDY DESIGN: Tumor tissue specimens and cells isolated from peritoneal fluid from 20 patients with epithelial ovarian carcinoma were examined for MMP-2 and -9 expression using immunostaining. Six benign peritoneal effusions containing mesothelial cells were also included in the study. RESULTS: Expression of both MMP-2 and -9 was noted in cancer cells in peritoneal fluid of all cases studied. Peritoneal fluid cancer cells showed increased expression of both MMP-2 and -9 relative to mesothelial cell expression of these MMPs. Positive immunoreactivity of these MMPs in primary tumor tissues was confirmed by immunohistochemistry. CONCLUSION: Our findings suggest that both MMP-2 and -9 are frequently overexpressed in ovarian cancer cells disseminated in the peritoneal cavity and that determination of cellular MMP-2 and -9 expression could be useful in distinguishing cancer cells from mesothelial cells in peritoneal fluid cytologic specimens from women with ovarian epithelial carcinoma.     

Peripheral T-cell lymphoma not otherwise specified vs. Hodgkin's lymphoma on fine needle aspiration cytology

OBJECTIVE: To study the morphologic features of peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) on fine needle aspiration cytology (FNAC) smears and to identify cytomorphologic features that would delineate them from features of cases of Hodgkin's lymphoma (HL). CONCLUSION: Fourteen cases each of PTCL, NOS, and HL with adequate FNAC smears were retrieved. These cases were analyzed for 12 cytomorphologic features: presence of atypical lymphoid cells, percentage of large lymphoid cells, lymphoid cells with cleaved/indented nuclei, typical Reed-Sternberg (RS) cells, mononuclear cells with prominent eosinophilic macronucleoli, mononuclear cells with prominent nucleoli, histiocytes, eosinophils, plasma cells, polymorphonuclear leukocytes, vessels and perivascular clustering of atypical mononuclear/atypical lymphoid cells. Each of these features was evaluated for its presence or absence and was semiquantitated on a scale from 0 to +3. RESULTS: The presence of atypical lymphoid cells with a spectrum ranging from small to intermediate and large was seen exclusively in cases of PTCL. Lymphoid cells with cleaved or indented nuclei, endothelium-lined vessels with perivascular clustering of tumor cells and absence of typical RS cells, and mononuclear cells with prominent eosinophilic macronucleoli emerged as the parameters significant in not only diagnosing cases of PTCL, NOS, but also in their delineation from cases of HL. CONCLUSION: A careful analysis of cytomorphologic features can be useful in at least suggesting a diagnosis of PTCL and help to distinguish that diagnosis from HL, which the features may mimic. Immunophenotyping and molecular studies are important in arriving at a definitive diagnosis.     

Distribution pattern of concanavalin A on carcinoma cells, histiocytes and mesothelial cells from effusions

Fixed and unfixed cancer cells, mesothelial cells and histiocytes were exposed to fluorescein-labeled concanavalin A (ConA-FITC). Cancer cells, whether fixed or unfixed, showed a similar pattern of fluorescence, as a continuous layer over the whole periphery of the cell. This pattern of ConA-FITC distribution was also obtained on fixed mesothelial cells and fixed histiocytes. Redistribution of ConA-FITC in form of "caps" and "patches" was recorded on unfixed mesothelial cells and unfixed histiocytes. Of the three cell types studied, only the histiocytes were lysed by the incubation with ConA-FITC.     

In situ lymphophagocytosis by nonlymphoreticular neoplasms

Lymphophagocytosis by nonlymphoreticular neoplasms has been observed. Twenty cancer patients having either adenocarcinoma or epidermoid carcinoma were the subjects of our study. Malignant cells were found to phagocytize autologous lymphocytes, polymorphonuclear cells (PMNs) and red blood cells (RBCs). Papanicolaou smears from cancer patients revealed that 30% (6/20) of the patients had phagocytic malignant cells in situ, the mean phagocytosis for this group was 3.7%. Different cellular elements showed differences in their susceptibility towards phagocytic activity of tumor cells: 2.6% for lymphocytes, 0.7% for PMNs and 0.4% for RBCs. The patients having phagocytic malignant cells showed complete absence of monocytes in their peripheral blood. In contrast, other patients had peripheral blood monocyte percentages within the limits of control values (7.2). However, there was no correlation between development of phagocytic activity of malignant cells and age and sex of patients or type of tumor. This study further confirms that phagocytic activity of nonlymphoreticular neoplasms is a general phenomenon which can be directed against erythroid elements. In addition, we have demonstrated that these tumor cells also phagocytize autologous leukocytes.     

Bronchoalveolar lavage fluid differential cell count. How many cells should be counted?

OBJECTIVE: To investigate the number of cells to be counted in cytocentrifuged bronchoalveolar lavage (BAL) fluid preparations in order to reach a reliable enumeration of each cell type. STUDY DESIGN: A total of 136 BAL fluid samples for patients with suspected pneumonia or interstitial lung disease were investigated. Differential cell counts were performed on May-Grünwald-Giemsa-stained cytocentrifuged preparations by 2 observers, each differentiating 500 cells. Reliability for the enumeration of each cell type was expressed as phi value, as calculated in generalizability theory. RESULTS: For polymorphonuclear neutrophils (PMNs), alveolar macrophages, lymphocytes and eosinophils, an acceptable phi value of > or = .95 was reached at a count of 300 cells by 1 observer. Mast cells reached a phi value of only .674 at a count of 500 cells by 1 observer, precluding a reliable count. At a count of 500 cells by 1 observer, squamous epithelial cells, bronchial epithelial cells and plasma cells displayed phi values of .868, .903 and .816, respectively. CONCLUSION: At a count of 300 cells, PMNs, alveolar macrophages, lymphocytes and eosinophils are reliably enumerated in cytocentrifuged BAL fluid samples.     

Inflammatory myofibroblastic tumor of the breast. A case report

BACKGROUND: Inflammatory myofibroblastic tumor (IMT) of the breast is a very rare tumor like lesion with only 6 previously reported cases. Very little is known about the cytology of IMT. We present the fine needle aspiration (FNA) cytology of a case of recurrent, bilateral IMT of the breast and detail the clinical course, radiologic findings, morphologic appearances and immunohistochemical profile of the lesion. CASE: A 79-year-old female was initially seen in 1991 because of a suspicious mammographic abnormality in her right breast. Ultrasound-guided FNA cytology showed an unusual "inflammatory" lesion with occasional aggregates of cellular connective tissue fragments, sheets of uniform ductal epithelial cells with myoepithelial cells, spindle cells, lymphocytes and histiocytelike cells. The lesion was excised, and histology confirmed a benign process with spindle cells, lymphocytes and histiocytes. No malignant features were noted. During follow-up many new lesions appeared in both breasts, and after several FNA procedures and local excisions, bilateral mastectomy was performed at the patient's urging. She remained disease free. CONCLUSION: Although IMT of the breast has benign cytology and histology, clinically and on imaging, it resembles carcinoma. Awareness of the condition may help prevent a false diagnosis of carcinoma.     

Ghrelin ovarian cell expression in patients with polycystic ovary syndrome: an immunohistochemical evaluation.

INTRODUCTION: The influence of ghrelin on different organs has been studied recently, e.g. in the regulation of pituitary hormone release, regulation of energy homeostasis, glucose metabolism and insulin secretion, cell proliferation, and reproductive function. However, the etiology of polycystic ovary syndrome has not been fully explained. The aim of our study was to estimate the presence of ghrelin in polycystic ovaries cells and evaluation of the relationship between ghrelin occurrence and cells proliferation. METHODS: In the present work we have compared ten polycystic ovaries with ovaries without pathology as the control group. We used immunohistochemical method to detect ghrelin. The cells proliferation was evaluated by Ki 67 proliferation index. RESULTS: Ghrelin immunostaining was demonstrated in cytoplasm of ovarian secondary interstitial cells and in atretic corpus luteum. The cell nuclei were ghrelin positive in granulosa, theca layers of follicular cyst in both groups as well as in luteal cells of young corpus luteum in healthy ovaries. Ki 67 immunostaining was observed in granulosa and theca layers of follicular cyst in polycystic and healthy ovaries. CONCLUSIONS: It is possible that local ghrelin expression plays an important role in the direct control of ovarian development and function and ghrelin may participate in patomechanism of PCOS.