Fine needle aspiration cytology of malignant mesothelioma

The results of fine needle aspiration (FNA) cytology in 19 cases of malignant mesothelioma are presented. Adequate material for a diagnosis of malignancy was obtained in 17 cases, and in 8 cases a specific diagnosis of mesothelioma could be made. In four other cases, the findings were either consistent with or suggestive of mesothelioma; in four, accurate distinction from other neoplasms was not possible, and in two cases, adenocarcinoma was suggested. The spectrum of cytologic findings ranged from neoplasms of purely epithelial appearance through more pleomorphic biphasic neoplasms to anaplastic tumors. A combination of epithelial-like cell clusters, pavement-like sheets of epithelial cells with well-defined cell borders and prominent cell separation, dispersed angular cells with dense cytoplasm and some spindle-cell forms was the most specific cytologic pattern for mesothelioma. In four neoplasms, ultrastructural examination of aspirated material provided the additional evidence for a definitive diagnosis. The identification of hyaluronic acid within intracytoplasmic vacuoles, either in smears or in cell blocks, confirmed the diagnosis in three tumors. Only in one case, with a strong clinical background suggesting mesothelioma, was the cytologic preparation sufficient for diagnosis without ancillary diagnostic methods. FNA is of particular value in the diagnosis of pleural mesothelioma in patients who do not present with a pleural effusion. Obtaining material for cell block preparations, cytochemistry or ultrastructural study is generally necessary for definitive tumor typing.     

Fine needle aspiration cytology of myxoid metastatic malignant melanoma

The macroscopic and microscopic findings in a fine needle aspirate of a myxoid metastatic malignant melanoma are presented. The macroscopically mucoid material and the microscopically normal appearance of the cells in the myxomatous background were pitfalls while the presence of a melanin-positive pigment was a clue to the correct diagnosis.     

Fine needle aspiration cytology of metastatic malignant rhabdoid tumor

The diagnosis and management of pediatric neoplasms using fine needle aspiration (FNA) has been neglected as compared to neoplasms occurring in adults. A case of metastatic malignant rhabdoid tumor diagnosed by FNA cytology is presented, and the cytologic morphology, which to our knowledge has not previously been reported, is described. The ultrastructural findings in the histologic specimen are also depicted. This case demonstrates the feasibility and need for further exploration of the use of FNA in pediatric oncology.     

Fine needle aspiration cytology of malignant schwannoma metastatic to the breast

A case of malignant schwannoma metastatic to the breast is reported. The tumor was found as a solitary breast lump in a 43-year-old woman and was clinically considered to be a primary tumor. Fine needle aspiration (FNA) smears of the mass were interpreted cytologically as a malignant neurogenic tumor, compatible with a malignant schwannoma. The patient did not have multiple neurofibromatoses. Eight months previously, an excision of a solitary nodule located in the left axilla had been performed in another hospital. Comparison of the histologic section from that excision with the FNA confirmed that the breast tumor was a metastatic malignant schwannoma, and the patient was treated accordingly.     

Fine needle aspiration cytology in extramedullary plasmacytoma

OBJECTIVE: Extramedullary plasmacytoma is a rare plasma cell neoplasm. It can occur as the sole manifestation of plasma cell neoplasm, as a metastasis from another extramedullary plasmacytoma, as a solitary plasmacytoma of the bone or as a consequence of multiple myeloma. These plasma cell tumors can occur anywhere and have to be differentiated from other neoplasms, infectious processes and chloroma. STUDY DESIGN: We report the findings of fine needle aspiration cytology (FNAC) in 18 patients with extramedullary plasmacytoma. In six patients extramedullary plasmacytoma was the initial presentation of plasma cell neoplasm. In the remaining 12 patients the tumors occurred under or after treatment of plasma cell disease. RESULTS: Eleven lesions were located in the skin, seven in the lymph nodes, one in the liver and another in the spleen. Two patients with known diagnoses of plasma cell disease were thought, before FNAC, to have an infection, and two had a histologic diagnosis of non-Hodgkin's lymphoma. In 13 of 18 patients, cytologic smears showed anaplastic plasma cells. CONCLUSION: FNAC is a front-line investigative procedure in diagnosing extramedullary plasmacytoma.     

Fine needle aspiration cytology of rare malignant tumors of the breast.

This report describes the fine needle aspiration (FNA) cytologic findings in 17 rare malignant breast tumors. The series consisted of invasive cribriform carcinoma, papillary carcinoma, apocrine carcinoma, carcinoma with pseudosarcomatous metaplasia, carcinosarcoma, fibrosarcoma, malignant phyllodes tumors, primary malignant lymphomas, plasmocytoma, metastatic melanoma and metastatic renal clear cell carcinoma. Besides cytomorphology, the results of immunostaining in eight cases are presented, as is a review of the literature. It is important for rare primary malignancies, as well as for metastatic tumors, to be diagnosed, or at least have the diagnosis suggested, preoperatively by FNA and immunocytochemistry, permitting better therapy planning.     

Fine needle aspiration cytology of desmoplastic malignant melanoma. A case report

The cytologic features of a recurrent desmoplastic malignant melanoma (DMM) examined by fine needle aspiration biopsy are reported. Cytologic examination revealed multiple microtissue fragments as well as smaller, dissociative aggregates composed predominantly of spindle-shaped neoplastic cells with hyperchromatic nuclei, small but prominent nucleoli and no cytoplasmic pigment or intranuclear pseudoinclusions. The tumor cells exhibited weak cytoplasmic staining for S-100 protein. To the best of our knowledge, this is the first reported case report describing the cytologic findings of DMM. Problems in differential diagnosis are discussed.     

Fine needle aspiration cytology of metastatic malignant schwannoma. A case report

A metastatic malignant schwannoma diagnosed by fine needle aspiration (FNA) biopsy in a 56-year-old man is reported. Cytologic examination of smears and cell blocks prepared from aspirates of a vertebral mass suggested the presence of metastases from a previously excised malignant schwannoma on the right leg. Electron microscopic and immunocytochemical studies on the aspirate supported the diagnosis, as did the patient's clinical history and previous pathology and the radiographic demonstration of metastatic lesions in the lung. The cytologic findings (cells with oval-to-spindled nuclei and ill-defined cellular borders suspended within a delicately fibrillar eosinophilic matrix) are discussed in light of the histologic diversity of this lesion and the problems of distinguishing it from other sarcomas. The ability to diagnose metastatic malignant schwannoma by FNA emphasizes the value of this technique.     

Fine needle aspiration cytology of bursal cyst

OBJECTIVE: To evaluate the cytomorphology of bursal cyst and assess the efficacy of aspiration cytology in its diagnosis and treatment. STUDY DESIGN: Nineteen cases of bursal cyst seen over four years were studied. Material was obtained by fine needle aspiration. The smears were stained with May-Grünwald-Giemsa stain and hematoxylin and eosin. RESULTS: Eight cysts were in the popliteal fossa, 4 on the elbow, 3 on the knee, 2 on the shoulder and 2 in the calf. Gelatinous material was aspirated in all the cases. In some cases the cyst collapsed after aspiration. The key diagnostic features were hypocellular smears in a mucoid background. Histiocytelike (synovial) cells were seen lying in all cases and as pseudopapillary structures in two. CONCLUSION: The presence of a cyst at a classic location with aspiration of gelatinous material and the presence of singly occurring histiocytelike cells in a mucoid background in smears is diagnostic of bursal cyst. The procedure is therapeutic in some cases.