Disseminated histoplasmosis diagnosed by fine needle aspiration biopsy of the adrenal gland. A case report

A case of disseminated histoplasmosis diagnosed by fine needle aspiration (FNA) biopsy of the adrenal gland is reported for a 60-year-old man who presented with a 40-pound weight loss and abdominal computed tomography showing bilateral adrenal enlargement. FNA biopsy of the adrenal gland revealed clusters of macrophages with abundant cytoplasm containing the yeast forms of Histoplasma capsulatum. This case emphasizes that FNA is effective in diagnosing infectious as well as neoplastic conditions of the adrenal glands.     

Pulmonary dirofilariasis diagnosed by fine needle aspiration biopsy. A case report

A case of pulmonary dirofilariasis in a 62-year-old female was diagnosed by fine needle aspiration biopsy. A review of the literature revealed this to be the first reported case diagnosed by this method. The presence of bilateral lesions in this patient is an uncommon finding for this entity.     

Dermal analogue tumor of the salivary gland diagnosed by fine needle aspiration cytology. A case report

BACKGROUND: Dermal analogue tumor of the salivary gland is a rare form of salivary gland adenoma. Cytologic and histologic findings of 1 case are presented. CASE: A 74-year-old-female had a dermal analogue tumor in the parotid gland diagnosed by fine needle aspiration cytology (FNAC). Aspiration smears were characterized by aggregates of uniform epithelial cells, and cell groups bordered on thick, basement membrane-like material. The tumor was excised, and the histologic sections confirmed the cytologic diagnosis. CONCLUSION: Dermal analogue tumor of the salivary gland has a distinctive cytomorphologic appearance, and diagnosis of this neoplasm by FNAC is possible. Preoperative FNAC of salivary gland lesions is important in planning the most appropriate type of treatment.     

Subcutaneous metastasis from transitional cell carcinoma of the bladder diagnosed by fine needle aspiration biopsy. A case report

BACKGROUND: Metastasis of transitional cell carcinoma (TCC) of the bladder to the skin and subcutaneous tissue is an uncommon finding. CASE: A 58-year-old man with a known case of high grade TCC of the bladder, presented with a right paraspinal mass. Clinically an abscess was suspected. Fine needle aspiration (FNA) showed many clusters and isolated malignant cells in an inflammatory background. The smears were diagnosed as positive for malignancy. CONCLUSION: It is essential to differentiate tumors metastatic to the skin and subcutaneous tissue from inflammatory lesions. FNA helped with the diagnosis in this case and prevented unnecessary biopsy.     

Primary retroperitoneal seminoma diagnosed by fine needle aspiration biopsy. A case report

A fine needle aspiration biopsy specimen of a retroperitoneal mass was submitted for cytologic evaluation. Malignant cells were found, and the cytologic appearance was consistent with seminoma although the clinical possibilities included lymphoma and adenocarcinoma of the pancreas. Cytologic features of the needle biopsy specimen included uniform neoplastic malignant cells with round nuclei and nucleoli and clear or pale-staining cytoplasm. The cells were found singly or in groups of two or three cells. Lymphocytes were intermingled with the neoplastic cells.     

Malignant islet-cell tumor of the pancreas diagnosed by fine needle aspiration biopsy. A case report

A case of malignant islet-cell tumor of the pancreas diagnosed by preoperative percutaneous fine needle aspiration biopsy and confirmed by tissue examination is reported. The cytologic presentation of this neoplasm is described, and the differential diagnosis is discussed.     

Hepatic actinomycosis diagnosed by fine needle aspiration. A case report

A 43-year-old woman, a long-term intrauterine contraceptive device (IUD) wearer with a history of Actinomyces organisms seen in cervicovaginal smears, developed hepatic actinomycosis 13 months after removal of the IUD. The liver involvement was diagnosed by fine needle aspiration (FNA) cytology and the use of immunocytochemical techniques. Histopathologic examination of a right pelvic mass removed at surgical exploration revealed an Actinomyces tuboovarian abscess, the primary lesion in this case. The importance of cytologic detection of Actinomyces in cervicovaginal smears for the prevention of IUD-related pelvic inflammatory disease (PID) is discussed, as is the usefulness of FNA cytology in the diagnosis of systemic actinomycosis.     

Malignant phyllodes tumor of the breast metastatic to the parotid gland diagnosed by fine needle aspiration biopsy. A case report

BACKGROUND: Phyllodes tumor (cystosarcoma phyllodes) is a rare fibroepithelial neoplasm of the breast. Malignant phyllodes tumor is characterized by an infiltrative border and marked degree of hypercellular stromal overgrowth with > 5 mitoses per 10 high-power fields. Distant metastasis occurs in 10-20% of patients with malignant phyllodes tumor. The most common sites of distant metastases are the lungs, bone and abdominal viscera. Although theoretically any organ may have metastasis, the parotid gland has not been documented before in the English-language literature. CASE: A 40-year-old, Caucasian woman with a history of malignant phyllodes tumor of the left breast presented with a mass on the right side of the parotid gland. Fine needle aspiration biopsy of the mass revealed abundant discohesive spindle cells showing moderate nuclear pleomorphism with occasional mitoses. No epithelial elements were seen. A diagnosis of malignant spindle cell tumor consistent with metastatic malignant phyllodes tumor was made. Histology confirmed the cytologic diagnosis. CONCLUSION: Fine needle aspiration biopsy is accurate and efficient in conjunction with clinical information in the diagnosis of malignant phyllodes tumor of the breast metastatic to the parotid gland.     

Nodular sarcoid myositis of skeletal muscle diagnosed by fine needle aspiration biopsy. A case report

BACKGROUND: Symptomatic striated muscle involvement in sarcoidosis is rare. Muscle biopsy is usually required for the diagnosis. Fine needle aspiration biopsy (FNAB) has been successfully used in diagnosing soft tissue lesions. To the best of our knowledge, FNAB of sarcoid myositis has not been reported. CASE: A 31-year-old, black female with a history of sarcoidosis presented with an enlarging, painful, left calf mass. Infected thrombi were suspected. FNAB showed numerous loosely arranged epithelioid histiocytes, multinucleated giant cells and skeletal muscle cells. The overall cytologic picture was that of granulomatous myositis. The cytologic features coupled with the patient's history and magnetic resonance imaging findings suggested sarcoid myositis. Subsequent muscle biopsy showing noncaseating granulomata and negative stains for organisms confirmed the diagnosis of nodular sarcoid myositis. CONCLUSION: Nodular sarcoid myositis can be suggested by FNAB cytology in a patient with a past history of sarcoidosis.     

Oral metastasis of breast carcinoma diagnosed by fine needle aspiration cytology. A case report

BACKGROUND: Fine needle aspiration cytology (FNAC) is an important technique in the diagnosis of oral and maxillofacial conditions. The purpose of the present paper is to report a case of oral metastasis of breast carcinoma diagnosed by FNAC. CASE: A 45-year-old, black woman was referred for evaluation of symptomatic swelling in the left mandible. The medical history revealed that the patient had undergone extensive surgery to remove a lobular carcinoma. She had finished chemotherapy treatment about 5 months earlier. Due to the main diagnostic considerations of metastatic and inflammatory disease, FNAC was performed. The cytologic picture was consistent with a metastatic glandular neoplasm. CONCLUSION: FNAC is a safe, reliable, cost-effective and easy procedure and sometimes eliminates the need for open biopsy.     

Mediastinal pleomorphic liposarcoma diagnosed by fine needle aspiration biopsy: a case report

BACKGROUND: Progress in radiology and pathology for diagnosing mediastinal tumors has R been made in recent decades, thanks to the use of fine needle aspiration biopsy (FNAB) guided by computed tomography, which has replaced mediastinoscopy and open biopsies. CASE: A 66-year-old male had a history o productive coughing with mucopurulent expectoration, progressive dyspnea, arthralgias, myalgias, astenia and adynamia for the previous 3 months. A CT scan and magnetic resonance imaging revealed a poorly limited tumor mass ofheterogeneous den sity in the anterior mediastinum. FNAB of the tumor mass showed malignant cells compatible with liposarcoma. CONCLUSLON: Of the several types of mesenchymal mediastinal neoplasms, liposarcoma is the most important. Many of them are seen in adults, and <10 cases have been diagnosed in children. The symptoms are related to compression of the nearby airways. Usually liposarcomas are yellow, lobed tumors without capsules that infiltrate adjacent organs and tissues. Microscopically, they have the same histologic spectrum as tumors originating in other sites. Thus, it is common to observe all the histologic varieties of soft tissue liposarcomas. The identification of lipoblasts is the key to the correct diagnosis in FNAB material.     

Intraductal papilloma of the salivary gland. A report of two cases with diagnosis by fine needle aspiration biopsy

BACKGROUND: Intraductal papillomas are rare, benign tumors most commonly encountered in minor salivary glands. They are cystic, solitary neoplasms that arise from ductal epithelium and produce painless swellings. CASES: Two cases arose in major salivary glands. The first case was a superficial, firm mass at the superior edge of the parotid, cytologically evocative of an adnexal tumor. A firm, submandibular mass in the second case was diagnosed as a papillary neoplasm. Fluid was aspirated from both cases. Three-dimensional epithelial clusters, some with a papillary configuration and histiocytes, were the main cellular components. The majority of cells showed oncocytic differentiation; however, benign-appearing ductal cells in honeycomb sheets were also present. The first case also had occasional cells suggestive of sebaceous differentiation. The excised lesions were unilocular cystic papillary neoplasms consistent with intraductal papilloma; focal sebaceous differentiation was noted in the first case. CONCLUSION: Awareness of the cytologic features of intraductal papilloma of the salivary glands should prompt its inclusion in the differential diagnosis of papillary lesions of the head and neck.     

Pulmonary mucormycosis diagnosed by fine needle aspiration cytology. A case report

BACKGROUND: The usefulness of fine needle aspiration cytology (FNAC) in the diagnosis of lung lesions is well documented. Fungal lesions are among nonneoplastic lesions of the lung in which FNAC has proven a useful technique in both immunocompromised and immunocompetent patients. These include cryptococcosis, aspergillosis, histoplasmosis and coccidiodomycosis. Pulmonary mucormycosis, an aggressive fungal infection, is rarely diagnosed on FNAC. We report a case of isolated pulmonary mucormycosis diagnosed on FNAC. CASE: A 62-year-old renal transplant recipient with diabetes mellitus and hypertension, asymptomatic for four months, presented with tachypnea, generalized malaise and weakness. Radiologic studies showed an enlarging, cavitating lesion in the right lung. Computed tomography-guided fine needle aspiration performed on the lung lesion showed fungal profiles with broad, ribbonlike, aseptate hyphae with right-angled branching consistent with the Zygomycetes class of fungi, which includes Rhizopus and Mucor species. Fungal cultures confirmed the presence of Rhizopus. The patient underwent right pneumonectomy, was placed on liposomal amphotericin B therapy and discharged with good pulmonary status and stable kidney function. CONCLUSION: FNAC is a useful technique in the diagnosis of pulmonary mucormycosis.     

Langerhans cell histiocytosis of the thyroid diagnosed by fine needle aspiration cytology. A case report

BACKGROUND: Langerhans cell histiocytosis rarely involves the thyroid gland even in patients with multifocal disease. Unifocal disease apparently confined to the thyroid is even more rare. CASE: A 30-year-old woman presented with a 6-cm mass in the right and a 3-cm mass in the left lobe of the thyroid. Fine needle aspiration cytology showed isolated, loose aggregates and histiocytelike cells with grooved or contorted nuclei mixed in varying proportions with many mature eosinophils, scattered and small lymphocytes, multinucleated giant cells and foamy histiocytes. CONCLUSION: The cytologic features of Langerhans cell histiocytosis are characteristic. A fine needle aspiration cytology diagnosis is confirmed by histopathologic studies, imunohistochemical staining and ultrastructural studies.     

Cementifying fibroma diagnosed by fine needle aspiration cytology. A case report.

A case of cementifying fibroma in the right lateral mandible was diagnosed by fine needle aspiration (FNA) cytology. The aspirate was a cellular specimen composed of clusters of oval and spindle-shaped fibroblasts with no atypical features. These cells were admixed with spherical, calcified structures. A diagnosis of "consistent with benign fibroosseous lesion, suggestive of cementoossifying fibroma" was made, and subsequent histologic examination confirmed this cytologic diagnosis. The clinical, cytologic and histologic findings in the case are presented, and the value of FNA cytology in the diagnosis of jaw lesions is discussed.     

Fine needle aspiration cytology of dedifferentiated acinic cell carcinoma of the parotid gland: a case report

BACKGROUND: Dedifferentiation of acinic cell carcinoma (ACC) to undifferentiated carcinoma occurs rarely and entails a poor prognosis. Most cases of dedifferentiation occur as recurrences of a previously excised ACC. More rarely the neoplasm presents with areas of well-differentiated ACC coexisting with dedifferentiated ones. CASE: An 85-year-old man presented with 2 nodular areas in the right parotid area. Fine needle aspiration of both nodules was performed. In both cases cytology revealed a double epithelial component in similar proportions. The first one corresponded to cohesive groups of small to intermediate-sized, polygonal cells with round, monomorphic nuclei. They were distributed in small and larger, branching groups with acinic morphology. Intermixed with this population, irregular groups of larger, pleomorphic cells with irregular nuclei, prominent nucleoli and scarce cytoplasm were present. In addition, smears showed an abundant lymphoid background. A cytologic diagnosis of "salivary carcinoma with coexisting areas of acinic cell differentiation and high grade, undifferentiated carcinoma" was given. Histopathology revealed a well-differentiated ACC with areas of high grade undifferentiated carcinoma (dedifferentiated ACC). CONCLUSION: The current case expands the cytomorphologic spectrum of ACC. Cytology may permit the preoperative recognition of dedifferentiation, allowing a more sound therapeutic approach.