Seminal vesicle epithelium as a potential pitfall in the cytodiagnosis of presacral masses. A report of two cases

BACKGROUND: Whenever abdominoperineal resection is performed because of a rectal adenocarcinoma, the prostate and seminal vesicles may be displaced backward to the presacral space, giving rise to a false radiologic image of a presacral tumor. Due to cytologic atypia associated with the epithelium of seminal vesicles, there is a real possibility, in fine needle aspiration biopsy (FNAB), of erroneously giving a malignant diagnosis. CASES: Two men, aged 53 and 57 years, presented with presacral masses three months and six years, respectively, after abdominoperineal resection for rectal adenocarcinoma. In both cases, FNAB smears showed some groups and single cells with large and irregular nuclei. These cells suggested a recurrence of carcinoma. The presence of cytoplasmic coarse pigment and a background with spermatozoa and blobs of inspissated secretory product were sufficient to determine that these presacral masses represented the seminal vesicles. CONCLUSION: Awareness that seminal vesicles may give rise to a radiologic impression of presacral tumor after abdominoperineal resection of the rectum will avoid unnecessary FNAB and a cytologic false positive diagnosis of colorectal adenocarcinoma.     

Cells from the seminal vesicles: contaminants of the V-C-E smear.

Cells originating in the seminal vesicles are occasionally observed on routing gynecologic smears. Sometimes, these cells may display large hyperchromatic dense nuclei, which conceivably may produce diagnostic problems. The identification of these cells is therefore of practical significance in order to avoid one more pitfall in gynecologic cytodiagnosis.     

Neuroendocrine (Merkel-cell) carcinoma of the skin. Cytology, intermediate filament typing and ultrastructure of tumor cells in fine needle aspirates

The light and transmission electron microscopic findings and the intermediate filament typing of tumor cells from fine needle aspirates of primary, recurrent and metastatic neuroendocrine (Merkel-cell) carcinoma of the skin are described. The tumor cells in the smears coexpressed keratins and neurofilaments and were characterized by "intermediate filament buttons," i.e., buttonlike fragments of cytoplasm of tumor cells, which could be observed either by staining with intermediate filament-specific antibodies using immunofluorescence or by their appearance in hematoxylin-and-eosin-stained smears. These features may help in the differential diagnosis of fine needle aspirates of neuroendocrine carcinomas of the skin.     

Aspiration cytology of breast cysts

A cytologic evaluation was made of 57 samples of fluid aspirated from cystic breast masses during the past 12 years in our hospital. The cytologic diagnosis of the cyst aspirates from 17 cancer cases was positive in 10 cases, suspicious in 2 and negative in 5. No false-positive cytologic diagnosis was made in 40 cases of benign cystic disease. Blood-tinged aspirates were observed in 14 of the 17 cases of malignant cystic disease but in only 2 of 40 benign cases. Ductal cell clusters were detected in aspiration smears from 16 of the cases of malignant cystic disease and 15 of the cases of benign cystic disease. Apocrine cells were seen in the aspiration smears from 12 of the cases of benign cystic disease but in none of the aspirates from the 17 cancer cases.     

Necrotic Debris In Thyroid Aspirates: A Feature of Follicular Carcinoma of the Thyroid

Fine needle aspirates from 44 follicular thyroid tumours (30 adenomas, 14 carcinomas) have been studied. All aspirates contained neoplastic cells in follicular and trabecular arrangements. The individual tumour cells showed varying degrees of anisonucleosis and nuclear pleomorphism. Colloid was scanty or absent from all smears. Granular or filamentous necrotic material was observed in both biopsies and smears from one moderately and two poorly differentiated follicular carcinomas, but in none of the adenomas. This suggests that necrotic debris may be a feature of follicular carcinoma of the thyroid.     

Ontogenesis and ultrastructure of seminal vesicles of the catfish,Clarias gariepinus

The ontogenesis and structural characteristics of the seminal vesicles in Clarias gariepinus (sharptooth catfish) were studied by light and electron microscopy and are described in detail. The seminal vesicles, beginning as simple protrusions from the vas efferentia, becomes more complex with age. Their distal ends become fingerlike and the bases form palm-like extensions. Juvenile male organs do not reveal any signs of seminal vesicles although spermatogenic tissue is already well delineated. The developing gonads contain clusters of large cells, close to the sperm duct and cysts of the testis, from which seminal vesicles are formed. Secretory epithelium lines the tubules of the seminal vesicles and becomes columnar as the tissue matures. Electron micro-graphs of these epithelial cells reveal two types of cells: opaque cells and cells with very vacuolized cytoplasm. Dense pinocytotic vesicles are present between the membranes of neighbouring seminal tubules and apical cell membranes facing the lumen. Maturation and onset of secretion by the secretory cells is accompanied by morphological changes. Protruding cylindrical cells become shortened, modified to cuboidal, rounded cells that send tubular extensions into the lumen. In the final stage of differentiation, only connective tissue membranes supporting the tubule walls remain intact. At the points of contact between the testis, seminal vesicles, and sperm duct, the epithelia of these organs often become confluent. The distal parts of the seminal vesicles, rarely contain sperm; during spawning sperm accumulated in the proximal tubules of the vesicles. © 1994 Wiley-Liss, Inc.     

Immunocytochemical Detection of the Androgen Receptor In Fine Needle Aspirates From Benign and Malignant Human Prostate

A monoclonal antibody to the androgen receptor was applied to fine needle aspirates from patients with benign and malignant prostatic disease. The series includes six patients with benign hyperplasia and 24 patients with prostatic carcinomas. The androgen receptor was detected in most nuclei of both benign and malignant epithelial cells. The intensity of immunostaining varied. No obvious relation was observed between the intensity of the staining in benign versus malignant cells. In addition no clear differences were found in the proportion of androgen receptor positive cells in benign aspirates as compared with aspirates from well differentiated or moderately well differentiated prostatic carcinomas. The relative number of androgen receptor positive cells was highest in smears from poorly differentiated prostatic carcinomas.     

Increase in epithelial cell growth by hyperprolactinemia induces delay of castration-induced involution of mouse seminal vesicle

Male (C57BL/6 x DBA)F1 hybrid mice were castrated on day 60 after birth; two pituitaries from 60-day-old female mice were immediately grafted under the capsule of the left kidney in half of the castrated mice to induce hyperprolactinemia. The seminal vesicles in the absence of androgen treatment were examined 15, 22, 30 and 60 days after castration with or without grafting. Significant increases in the weight (1.3-1.4-fold), DNA content (1.2-1.3-fold) and labeling index of epithelial cells (4-10-fold) of the seminal vesicles were found in mice with pituitary grafts compared to mice without grafts on days 15-30 after castration but not on day 60 after castration. Such stimulatory effects of hyperprolactinemia on mouse seminal vesicle cells were also observed on day 15 after castration plus adrenalectomy. Cell loss from the seminal vesicles was found to be similar in castrated mice with and without the grafts. The present findings demonstrate that hyperprolactinemia induces an increase in DNA synthesis of epithelial cells in the seminal vesicles until 30 days after castration and results in a significant delay of castration-induced involution of the weight and DNA content of the seminal vesicles for 1 month. However, the delay with increased epithelial cell growth by hyperprolactinemia disappeared 60 days after castration.     

Decisive role of intermediate filament typing of tumor cells in the differential diagnosis of difficult fine needle aspirates

Thirty-six diagnostically difficult fine needle aspirates from enlarged lymph nodes and malignant soft tissue tumors, containing tumor cells with scanty or no obvious light microscopic features indicative of their differentiation, were assessed by a panel of six cytopathologists. Their diagnoses were recorded and then compared with the definitive diagnosis established by combining the cytologic findings with the results of intermediate filament typing of tumor cells in the smears using monoclonal antibodies specific for each filament type. The results show that use of these antibodies can markedly improve the accuracy of the cytologic diagnosis of tumor type as well as revise or prevent erroneous cytologic diagnoses in difficult cases. This pertains especially to the differential diagnoses of carcinoma versus malignant lymphoma, carcinoma versus malignant melanoma, carcinoma versus sarcoma and squamous carcinoma versus carcinoma of simple epithelia. Intermediate filament typing of tumor cells in aspirates as an objective histogenetic criterium makes the differential diagnosis of the difficult aspirates much more reliable and reproducible, provided that appropriate questions are asked, monoclonal antibodies with well-defined specificities are used and the antigenicity of the intermediate filaments in smears is preserved.     

Growth related changes in the content of heparin and 5-hydroxytryptamine of mast cells

Summary Fine structural changes of testicular interstitial cells of Leydig and secretory cells of seminal vesicles were studied in golden hamsters under different functional states of the pineal gland. Experiments were performed in the reproductive season (summer months). In the hamsters blinded for 8 weeks the testes and the seminal vesicles were markedly atrophic, and the Leydig cells and the secretory cells of seminal vesicles were extremely involuted. By contrast, both types of cells in the pinealectomized or superior cervical ganglionectomized hamsters exhibited cytological features suggestive of an enhanced secretory activity. This study shows that functional activity of Leydig cells as well as secretory cells of seminal vesicles in the hamster may be depressed or augmented by stimulating or inhibiting the pineal antigonadal function, respectively, without performing hypophysectomy or hormonal administration.Dedicated to Professor Shu Yeh on the occasion of his 70th birthday. This study was supported in part by a grant from the National Science Council, the Republic of China     

Chondroblastoma in fine needle aspirates.

The cytologic features of smears of fine needle aspirates from four chondroblastomas were studied. In an ideal fine needle aspiration biopsy sample of chondroblastoma, all the diagnostic details can be found: chondroid matrix surrounding individual round to oval mononuclear cells, calcifications among cells and multinucleate osteoclasts. Chondroid matrix, which we believe to be the decisive feature, and calcifications are seen better in Giemsa-than in Papanicolaou-stained smears.     

Fine needle aspirates of follicular lesions of the thyroid gland. The intermediate-type smear

In order to evaluate fine needle aspirates of thyroid lesions with features intermediate between those of follicular neoplasms and colloid nodules, 38 aspirates in which a definitive diagnosis had not been made were reviewed. On review, ten aspirates were excluded from the "intermediate" category; seven were reclassified as unsatisfactory and one as a cellular colloid nodule. Two papillary carcinomas showed a complex pattern not identified in smears from other lesions; these aspirates were also classified separately for independent evaluation. The remaining 28 aspirates were characterized by syncytial-type tissue fragments with mild nuclear atypia. The association of syncytial-type tissue fragments and orderly sheets and fragments forming a honeycomb pattern in the same aspirate indicated a colloid nodule, though a two-disease process could not be excluded. Of the aspirates containing only syncytial-type tissue fragments, 50% were from adenomas, 25% were from carcinomas, and 25% were from colloid nodules. Criteria to distinguish between the various follicular lesions were not identified in these smears.     

Histological examination of clots from cytological specimens: is this a worthwhile procedure?

A comparison of conventional cytology and clot histology was made on 174 serous fluids, fine needle aspirates (FNA) and other non‐gynaecological specimens. In eight cases (4.5%) this clot material contained malignant cells or cells suspicious of malignancy despite the absence of suspicious or malignant cells in conventionally prepared smears from the same specimen. In 11 cases (6.3%) the clot was negative, although conventional smears contained malignant or suspicious cells. A χ² test showed that there was no statistically significant difference between the number of positive diagnostic scores in each group with χ² of 0.223 (degrees of freedom=1), P=0.637. Examination of clot material from serous fluids and FNA aspirates is as effective as examination of conventional cytological preparations. Processing of clots from cytological aspirates for histological examination should be more widely adopted, and is applicable in all cytopathology laboratories.     

Cytologic characteristics and origin of naked nuclei in breast aspirate smears

To elucidate the origin of "naked nuclei" in breast aspiration smears, 17 cases of fibroadenoma were studied by light and electron microscopy. The ATPase reaction was also studied at both levels. The aspirates contained two types of naked nuclei: denuded degenerated nuclei and oval to spindle-shaped nuclei with very scanty cytoplasm. The cytoplasm of the latter was rich in free ribosomes and rough-surfaced endoplasmic reticulum but was devoid of cytoplasmic filaments and dense bodies. These cells were negative for ATPase activity. Stromal cells, not myoepithelial cells, characteristically demonstrated such cellular features in the aspirates and tissue sections studied. We conclude that most naked nuclei are derived from stromal cells.     

Fine needle aspiration cytologic findings in four cases of pilomatrixoma (calcifying epithelioma of Malherbe).

Four cases of pilomatrixoma studied by fine needle aspiration (FNA) biopsy prior to resection and histologic diagnosis were reviewed to identify the cytologic features useful in making the FNA cytodiagnosis. Cytopathology had initially correctly diagnosed two cases while misdiagnosing one as a carcinoma and one as a suspected carcinoma. The aspirates from all cases contained either clustered or isolated basaloid cells, with variably sized nuclei and prominent nucleoli. "Ghost cells" were also present in most smears stained with the Giemsa stain and could thus be very helpful for making the FNA diagnosis of pilomatrixoma. The occurrence of either foreign-body giant cells or calcium deposits in the aspirates could also contribute to suggesting the correct diagnosis of pilomatrixoma in some cases.     

Identification of aneuploid cells in cytological specimens by combined in situ hybridization and immunocytochemistry

The purpose of our study was the application of non-isotopic in situ hybridization with chromosome-specific repetitive DNA probes for the determination of cytogenetically aberrant cells in routine cytological materials, such as cervical smears and breast tumour aspirates. Hyperdiploid cells in fine needle aspirates (FNA) of breast tumours could be visualized by in situ hybridization with a chromosome l-specific repetitive DNA probe. However, for the evaluation of a specific cell type in heterogeneous cell populations, i.e. cervical smears, a procedure combining immunocytochemistry and in situ hybridization can be required. Therefore, we developed a combination protocol using β-galactosidase/ ferri-ferrocyanide (blue-green) for immunocytochemistry and peroxidase/DAB (brown-black) for detection of the DNA probe. the described protocol enabled us to distinguish squamous epithelial cells within heterogeneous cell populations. By combining the chromosome 1 DNA probe with a specific cytokeratin marker it was possible to identify the chromosomal abnormal cells within cervical smears.     

Immunocytochemistry of fine needle aspirates. A tactical approach

To maximize the potential of immunocytodiagnosis for fine needle aspiration (FNA) samples, it is necessary to be aware of the pitfalls and limitations of these techniques and to formulate a strategy to deal with the many variables involved. Five cases are presented to illustrate some of these variables, which include determining the adequacy of the FNA specimen, selecting tactics for cytologic and immunocytochemical studies, selecting methods for processing the FNA sample, preparing smears to enrich and preserve cells of interest, selecting enzyme labeling methods to optimize sensitivity and specificity, selecting monoclonal antibodies to make the study efficient and pertinent and interpreting the study results. The adequacy of the FNA specimen could be determined by an immediate cytologic assessment of the aspirate as it was obtained. Alcohol-fixed smears and formalin-fixed tissue sections prepared from the aspirate were used for diagnosis; the immunocytochemical studies were used as a diagnostic adjunct for accurate cell identification. Immunocytochemical studies were done on air-dried cytocentrifuge smears of pre-washed cells. While both immunoperoxidase and immunoalkaline phosphatase methods were suitable, we recommend the immunoperoxidase method for the study of aspirates from nonhemopoietic tissues and the immunoalkaline phosphatase method for the study of aspirates with many blood cells present. The proper selection of monoclonal antibodies and the interpretation of the results are best made in the context of the cytologic characteristics of the FNA sample and the clinical features of the patient.     

Cytologic diagnosis of adenovirus bronchopneumonia

The recognition of adenovirus-induced cytopathic changes in tracheal aspirates of two 7-month-old infants is reported. The smears showed cells containing nuclear inclusions with radiated strands ("rosette" cells), large homogeneously-staining nuclei ("smudge" cells) and nuclei with a "honeycomb" appearance. These findings appear to be distinctive for bronchopulmonary adenovirus infection, suggesting that the cytologic examination of tracheal aspirates may be a simple and cost-saving method for making an accurate diagnosis of this disease.     

Morphology of the male system and spermatophores of the arrowworm Ferosagitta hispida (Chaetognatha)

Transmission electron microscopy reveals that the somatic testicular tissues and sperm ducts are elaborations of the epithelial lining of the tail coelom. The testes consist of closely packed spermatogonia embedded between specialized lateral field cells. These cells contain few organelles and appear to function mainly as a compartment boundary. Masses of spermatogenic cells are released into the tail coelom from the anterior end of the testes. The sperm ducts, lined by simple cuboidal ciliated epithelium, collect mature spermatozoa from the tail coelom and convey them to the blindly ending seminal vesicles. The sperm ducts also modify coelomic fluid entering them along with the spermatozoa. The seminal vesicles consist of a simple glandular lining epithelium embedded in the stratified epidermis. Secretions of the lining epithelium surround the enclosed sperm mass and correspond in position to a noncellular spermatophore coat visible by light microscopy around released sperm masses. Spermatophores leave the seminal vesicles through a temporary split that forms between microfilament-containing suture cells. Maturation of spermatozoa and filling of the seminal vesicles is cyclical, occurring late each day. © 1994 Wiley-Liss, Inc.     

Age-related changes in the seminal vesicles of a Brazilian (Nelore) zebu.

Age changes in the structure of the seminal vesicles and in the rate of production of fructose and citric acid have been studied in a Brazilian (Nelore) zebu, from the fetal period to 36 months of age. At 3 and 6 months, the microscopic anatomy of the gland resembled that of the fetus; the tubules of the seminal vesicles had a reduced diameter and a low epithelial layer; only a few presented traces of secretion, and tissue contents of fructose and citric acid were accordingly low. At 12 months, the tubules were more ramified and had a larger diameter. In the 18-month-old animals the seminal vesicles presented substantial modifications; the tubules were large, with irregular lumina and surrounded by narrow stroma, the epithelial layer was higher than that of previous stages and its columnar cells had nuclei located basally. Tissue levels of fructose increased rapidly between 12 and 18 months. At 24 months, the seminal vesicles had reached the adult condition characterized by intense proliferation of tubules with irregular lumina and abundant secretory material. Numerous dark columnar cells were found in the epithelium. Seminal vesicles of Nelore zebus contain less fructose and citric acid than those of taurine bulls of comparable age.