Exfoliative cytology of angiosarcoma of the pulmonary artery

A case of primary angiosarcoma arising from the pulmonary artery of the left upper lobe is documented. Clinically, the tumor presented as an asymptomatic solitary lung mass. Exfoliated tumor cells in bronchial washing material occurred singly, in irregular clusters and in sheets with focal glandlike arrangement. They showed ill-defined, pale cytoplasm and fairly regular round-to-oval nuclei with irregular chromatin patterns.     

Fine needle aspiration biopsy cytology of renal oncocytoma

The cytologic appearance of cells in fine needle aspiration biopsies of two cases of well-differentiated renal oncocytoma (grade 1) and one case of moderately well differentiated renal oncocytoma (grade 2) is presented. In grade 1 renal oncocytoma, the tumor cells were seen mainly singly or in small clusters; they were round or polygonal, with abundant granular and eosinophilic cytoplasm and small, regular, round, hyperchromatic nuclei. Aspirated cells from the grade 2 renal oncocytoma were seen mainly in large sheets. These cells were polygonal, with eosinophilic, granular cytoplasm and slightly irregular vesicular nuclei with prominent nucleoli.     

Cytopathologic aspects of leiomyoblastoma in fine needle aspiration biopsy. Report of two cases

The cytopathologic features of the fine needle aspiration biopsy of two cases of malignant peripheral leiomyoblastoma are presented. Aspirated tumor cells occurred singly, not in clusters. They were pleomorphic, varying in size and shape and showing eosinophilic to amphophilic cytoplasm. Many tumor cells had a vacuolated cytoplasm. Multinucleated large tumor cells were seen in one case; their nuclei were hyperchromatic and round to oval, with chromatin clumping and prominent nucleoli. The cytologic findings suggested a malignant mesenchymal tumor. Histology demonstrated the diagnosis of leiomyoblastoma.     

Cytology of hyperplastic endocrine cells of the pancreas in fine needle aspiration biopsy

Hyperplastic endocrine cells of the pancreas occurred in small cohesive clusters with focal glandular arrangement in a fine needle aspirate. They showed pale, filmy, ill-defined cytoplasm and round to oval, slightly hyperchromatic nuclei with small nucleoli.     

Sarcoma arising from interdigitating cells. Cytology and cytochemistry

The cytologic features of a highly malignant sarcomatous tumor in a 37-year-old male, arising from interdigitating cells and localized in the mediastinum, lymph nodes and skin, are described. Cytologically this sarcoma was characterized by large cells with ill-defined, faintly basophilic cytoplasm, monocytoid or multilobulated nuclei and a reticular chromatin structure; very prominent nucleoli were seen in some of the cells. Some of the tumor cells were spindle shaped. The ultrastructurally characteristic invaginations of the cell membrane were not obvious in the cytologic smear, although the nuclear membrane showed deep, narrow, channel-like indentations. The specific ultrastructural, immunologic and cytochemical characteristics of the interdigitating cells were recognized in the tumor cells. Adenosine triphosphatase was present in the tumor cells in large amounts, while acid phosphatase, acid alpha-naphthyl acetate esterase and other enzymes were absent. The described tumor must be considered another tumor of the mononuclear phagocyte system; the proposed name is "interdigitating-cell sarcoma."     

Cytology of the human seminiferous epithelium

The appearances in cytologic specimens of the principal cell types in the normal human seminiferous epithelium are described and illustrated. Sertoli cells, which are larger than spermatogenic cells, are characterized by a slightly basophilic, ill-defined cytoplasm of triangular, elongated or columnar shape; the cytoplasm may be vacuolated and may contain spermatozoa. The nuclei of Sertoli cells are round, with a uniformly finely granulated chromatin and a single nucleolus. Spermatogenic cells are round or oval and show scanty cytoplasm with deeper basophilia and well-defined cytoplasmic borders. Multinucleation is common in spermatogenic cells. The Sertoli cells constitute a very homogeneous cell population as compared to the spermatogenic cells, which show several distinct cell types (spermatogonia, primary and secondary spermatocytes, spermatids and spermatozoa) whose nuclear structures depend on the stage of meiosis. Both cell types may occur as naked nuclei. Some problems of cell classification are discussed.     

Fine needle aspiration cytology of an intraductal papilloma originating in a sublingual gland. A case report.

BACKGROUND: Intraductal papilloma of the salivary gland is a very rare tumor; only eight cases have been reported to date. Only histopathology has been used to investigate this tumor to our knowledge. There has not been any reported case of this tumor in a sublingual gland. CASE: A 3-cm oral floor mass with a lanulalike lesion in a 72-year-old female was aspirated. The cytologic features included various cellular smears containing compact clusters of papillary, radial, palisading, trabecular, tubular and buddinglike projected patterns; monomorphic columnar cells with oval-to-spindle nuclei basally located; abundant, finely vacuolar cytoplasm; indistinct nucleoli; and no squamous differentiated cells. A sublingual glandectomy was performed. Cytology, histology, immunohistochemistry and electron microscopy were performed with standard methods. The intraductal papilloma seems to have arisen within an excretory duct and differentiated into acinar cells. CONCLUSION: The cytologic findings of intraductal papilloma are unique and may allow its specific diagnosis on fine needle aspiration.     

Olfactory neuroblastoma. Cytodiagnostic features in a case with ultrastructural and immunohistochemical correlation

In a case of olfactory neuroblastoma, originally misdiagnosed as an undifferentiated carcinoma, cytologic examination of material scraped from the superior nasal vault revealed tumor cells suggestive of neuroblastoma. The most significant cytodiagnostic feature was the presence of a fibrillary cytoplasm with ill-defined borders. Also noteworthy were the smudged hyperchromatic nuclei and structures resembling rosettes or pseudorosettes. The diagnosis was confirmed by electron microscopy, which revealed the presence of dense-core neurosecretory granules, clear vesicles, neurotubules and neurofilaments, and by immunohistochemistry, which showed positive staining for neuron-specific enolase but negative staining for keratin and glial fibrillary acidic protein. Since olfactory neuroblastoma has a relatively good prognosis and aggressive surgical resection may be curative, it is important that this tumor be distinguished from other small cell malignancies arising in the nasal cavity. The present case shows that the diagnosis can be made by the cytologic examination of scrapings from the tumor.     

Pulmonary tumorlet: a case report of a diagnostic pitfall in cytology

BACKGROUND: Pulmonary tumorlets are usually an incidental pathologic curiosity of no clinical importance, but may be mistaken for epithelial and nonepithelial neoplasms. Fine needle aspiration (FNA) of this cell proliferation has rarely been reported. We describe a pulmonary tumorlet associated with bronchocentric granulomatosis presenting as a tumorous consolidation on chest radiograph. CASE: In a hitherto healthy 70-year-old man admitted for acute respiratory infection, a solid consolidation was found on chest radiograph. Medical history was uneventful except right-sided pleurisy in 1949. Computed tomography-guided FNA sample was composed of loose clusters of small columnar cells with cyanophilic cytoplasm and centrally located round to oval nuclei. With a tentative diagnosis of well-differentiated adenocarcinoma, lumpectomy was performed. Intraoperative cytology demonstrated lymphocytes, epithelioid cells, giant cells of Langerhans type and clusters of columnar cells. Definitive histologic examination confirmed the intraoperative diagnosis of necrotizing granulomatosis and tumorlet. Neuroendocrine origin of the cells was confirmed by immunocytochemical and immunohistochemical studies resulting in strong reactivity of the cells to synaptophysin, NSE, chromogranin A and N-Cam. CONCLUSION: Knowledge of the cytomorphologic presentation of tumorlets in FNA and consideration of the appropriate differential diagnoses combined with ancillary studies might have prevented lung resection.     

Exfoliative cytology of multiple endobronchial granular cell tumor

A multicentric endobronchial granular cell tumor (GCT) in a 50-year-old man was diagnosed by the cytologic study of bronchial lavage specimens. The paraffin-embedded sections contained small clusters of medium-sized round tumor cells that had eccentric nuclei without nucleoli and eosinophilic finely granulated cytoplasm, which was positive with the periodic acid-Schiff stain. These cells were distinguishable from the macrophages and bronchial and squamous cells also found in the specimens. The excised tumors histologically mimicked a squamous cell carcinoma. Since 10% of all GCTs occur in the lung, where a multiple presentation can especially mimic a metastatic malignant process, it is important that the possibility of a granular cell tumor be considered in the screening of exfoliative cytologic specimens from the lung.     

Comparative cytomorphology of pituitary adenomas and oligodendrogliomas in intraoperative crush preparations.

Minute fresh tissue fragments from 20 pituitary adenomas and 18 oligodendrogliomas were crushed between two glass slides and stained with hematoxylin and eosin for cytologic examination. These two tumor types displayed distinctive cytologic features that may permit their correct identification. Pituitary adenomas were characterized by single and clustered tumor cells with monomorphic, round or vesicular nuclei that were commonly denuded of cytoplasm. Rare well-preserved tumor cells showed well- or ill-defined, variable and granular cytoplasm. Oligodendrogliomas showed cells with monomorphic or slightly pleomorphic nuclei and scant, fibrillary, wispy cytoplasm, commonly arranged in clusters or around circular and empty spaces.     

Cytologic profile of rhabdoid tumor of the kidney. A report of 3 cases

BACKGROUND: Malignant rhabdoid tumor of the kidney (MRTK) is a rare malignant neoplasm that usually presents as an abdominal mass. The histogenesis is uncertain, and cases outside the kidney have been reported. An association with separate primary tumors of primitive neuroepithelial origin occurring in the midline of the posterior or middle cranial fossa has been reported in approximately 15% of cases. CASES: Three patients, a 7-month-old girl and two boys, aged of 6 and 2 months of age, underwent fine needle aspiration biopsy (FNAB) for the diagnosis of renal masses. In 2 cases the smears revealed round to polygonal cells, singly or arranged in irregularly shaped clusters. The neoplastic cells did not differ much in shape and exhibited clear, empty nuclei with prominent nucleoli; the cytoplasm was abundant and sometimes eosinophilic. In the remaining case the aforementioned characteristics of the nuclei and cytoplasm were not as prominent, and sheets of fibrovascular stroma, with attached neoplastic cells, were seen. Diagnosis of MRTK was suspected in every case based upon morphology and immunocytochemistry; the diagnosis was histologically confirmed in the surgical specimens. CONCLUSION: MRTK may pose diagnostic problems due to its broad morphologic spectrum. Distinction from Wilms' tumor and clear cell sarcoma of the kidney is essential for therapeutic proposes. The results obtained in the FNAB study of these 3 cases demonstrate that diagnosis of MRTK may be proposed from fine needle aspiration smears using conventional methods together with ancillary ones (immunocytochemistry and electron microscopy).     

Basement membrane material and tigroid background in a fine needle aspirate of clear cell adenocarcinoma of the cervix. A case report

BACKGROUND: Although cytologic findings of clear cell adenocarcinoma of the female genital tract have been reported sporadically, the background on the smear has received little attention. CASE: A 16-year-old female had a large, necrotic mass in the cervix. As cervical brushing cytology and a punch biopsy of the mass could not make a definitive diagnosis, fine needle aspiration cytology was performed from the mass. The smears revealed loose, three-dimensional clusters and sheet arrangements of atypical cells. Dispersed atypical cells were also seen. The atypical cells were large and had abundant, weakly stained cytoplasm and round or oval nuclei with large nucleoli. There were a few tumor cells with clear cytoplasm and distinct cell borders in Papanicolaou-stained smears. The background in Diff-Quik-stained smears revealed a tigroid background and basement membrane material. CONCLUSION: The malignant tumor, revealing both a tigroid background and basement membrane material, seems to have been clear cell adenocarcinoma. Both features are diagnostic clues to clear cell adenocarcinoma in the female genital tract. Our case indicates that aspiration cytology is also an effective method of diagnosing a cervical tumor when the tumor is polypoid and the surface is extensively necrotic.     

Cytologic diagnosis of primary adenocarcinoma of Bartholin's gland. A case report.

The cytologic and histologic findings in an extremely rare case of adenocarcinoma of Bartholin's gland are described. The tumor cells in scraping and fine needle aspiration smears were in clusters. The nuclei were oval to oblong, and some cells had a peripherally displaced nucleus. The chromatinic material was slightly increased, and some nuclei had prominent nucleoli. The cytoplasm was basophilic and abundant. Microcalcifications and psammoma bodies were numerous. The tentative diagnosis was primary adenocarcinoma of Bartholin's gland, based on the cytologic findings and location of the tumor. Similar findings were noted in the biopsy and surgical specimens.     

Epithelial-myoepithelial carcinoma of the salivary gland. Fine needle aspiration cytologic findings

A case of epithelial-myoepithelial carcinoma of the salivary gland in a 78-year-old patient is presented. Fine needle aspiration cytologic smears showed a moderate number of tumor cells arranged in three-dimensional, well-outlined clusters reminiscent of the ball-like structures of adenoid cystic carcinoma. The nuclei were small and monotonous, with finely granular chromatin and small nucleoli. A large number of cells showed abundant clear cytoplasm; however, in some of the clusters the cytoplasms were very scant, again mimicking adenoid cystic carcinoma. Fragments of pale homogeneous acellular material, isolated or surrounding the cellular clusters, were another conspicuous finding.     

Ultrastructural characteristics of the vaginal epithelium of neonatally estrogenized mice in response to subsequent estrogen treatment.

Adult mice which had received 10 daily injections of 20 microng estradiol beginning with the day of birth were in a "persistent-estrous" state, showing ovary-independent proliferation and cornification of the vaginal epithelium. Ultrastructural changes of the vaginal epithelium in neonatally estrogenized mice was examined after a single postpuberal injection of 10 microng estradiol and compared with those seen in normal mice to estrogen. In ovariectomized normal mice, the basal cells were round. The nucleus was polygonal and contained peripheral condensed chromatin. After estradiol treatment, the basal cells became columnar. The nucleus was round to oval, containing dispersed chromatin. In neonatally estrogenized ovariectomized mice, the basal layer of vaginal epithelium consisted of round cells with polygonal nuclei, much as in normal ovariectomized mice. The nucleus occupied a large area of the cytoplasm and contained prominent nucleoli. Intercellular spaces were moderately distended. Late estradiol treatment resulted in distended intercellular spaces and in the appearance of the other cell type along with round cells in the basal layers: the columnar cells containing an oval nucleus with dispersed chromatin, resembled the basal cells in normal ovariectomized mice receiving postpuberal estrogen injection. The intercellular spaces between the columnar cells were narrow compared with those between round cells. However, the nuclei of round cells still had prominent nucleoli and peripheral condensed chromatin regardless of subsequent estrogen treatment. This fact suggests that these nuclei do not respond to estrogen. These results clearly show that the vaginal epithelium of neonatally estrogenized mice with ovary-independent persistent cornification consists of a mixed population of cells.     

Papillary neoplasms of the breast: clues in fine needle aspiration cytology

Papillary neoplasms of the breast include a wide spectrum of mammary lesions. The differential diagnosis of benign and malignant lesions can be problematic not only cytologically, but also histopathologically. Aspiration smears can demonstrate that cytological differentiation is feasible. A retrospective study of 30 cases of papillary tumour of the breast, 15 papillary carcinomas and 15 papillomas, was performed to find the cytological differences between the pathologies. Cytological samples of papillary carcinomas were characterized by an abundance of cellular material, three-dimensional papillary clusters without fibrovascular connective tissue cores, small papillae arranged in cell balls, tall columnar cells and isolated naked nuclei. Numerous haemosiderin-laden macrophages were seen. There were no eosinophilic bipolar cytoplasmic granules, bipolar naked nuclei or apocrine metaplasia. In the papillomas there was less material; the papillae had cohesive stalks surrounded by columnar cells in a honeycomb pattern. We also found fewer small papillae and isolated columnar cells. In addition, the presence of apocrine metaplasia and bipolar naked nuclei was noted. We suggest that papillary carcinoma of the breast can be diagnosed by cytology and differentiated from papilloma.     

Fine needle aspiration cytodiagnosis of nasopharyngeal carcinoma in cervical lymph nodes. A study of 40 cases

The cytologic features of fine needle aspiration (FNA) samples of 40 metastatic nasopharyngeal carcinomas in cervical lymph nodes were reviewed. FNA was performed with 21-gauge or 23-gauge needles; the FNA smears were stained with the Papanicolaou stain or with hematoxylin and eosin. Several typical cytologic features were noted. All cases showed the presence of clusters of cohesive tumor cells, most of which were undifferentiated. Medium-sized oval vesicular nuclei were present in 85% of the cases; all cases had prominent nucleoli. The cytoplasm was generally pale, with ill-defined boundaries in 87.5% of the cases. Mitoses were present in 75% of the cases. Mature lymphocytes were intermingled with tumor cells in all cases. The cytologic features correlated with the histologic features in surgical biopsies of the nasopharynx and lymph nodes. The results show that FNA of cervical lymph nodes can aid in the diagnosis of otherwise occult nasopharyngeal carcinoma and in detecting residual or recurrent nodal disease in patients with nasopharyngeal carcinoma who had undergone treatment.     

Sarcomatoid acquired cystic disease-associated renal cell carcinoma

In this article, we report a rare case of hitherto undescribed acquired cystic disease (ACD)-associated renal cell carcinoma (RCC) with sarcomatoid change. A 78-year-old woman had been receiving hemodialysis for fourteen years at the time when a renal tumor was encountered on the follow-up examination of the kidney. Microscopically, oncocytic cuboidal cells proliferated with tubular, cribriform or papillary growth patterns, and atypical columnar cells with abundant cytoplasm proliferated with papillary configuration. Oxalate crystal deposition was observed in the stroma and the tumor focally resembled translocation type (TFE3) RCC. Sarcomatous neoplastic cells were also seen. The cytoplasm of oncocytic and sarcomatous neoplastic cells was diffusely positive for anti-mitochondrial antibody and the ultrastructural examination detected many mitochondria in the cytoplasm of oncocytic carcinoma cells and sarcomatous neoplastic cells. The loss of chromosomes 1p, 2q11-22, 9 and 14 was observed using comparative genomic hybridization analysis. We thus report here a case of hitherto undescribed ACD-associated RCC intermingled with oncocytic cells, translocation type RCC-like area and sarcomatoid change. This is the sixth case of sarcomatoid RCC arising in end-stage kidney disease.