Appearance of mesothelioma cells in sputum. A case report.

A case in which mesothelioma cells appeared in sputum is reported. There has been only one earlier reported case of the exfoliation of mesothelioma cells into sputum. A postmortem examination in our case disclosed a lepidic growth of mesothelioma cells along the alveolar wall of the lung, suggesting that this mode of spread in the lung was probably responsible for the shedding of tumor cells in sputum. Cytopathologists should be aware of this possibility in differentiating this entity from adenocarcinoma involving the pleura.     

Mycosis fungoides with pulmonary involvement. Cytopathologic findings

In order to define the cytologic features of pulmonary involvement by mycosis fungoides, 15 respiratory cytology specimens from four patients with biopsy-proven pulmonary mycosis fungoides were reviewed. The presence in sputum smears of occasional small or large cerebriform mononucleated cells against a background of numerous atypical lymphocytic cells permitted an antemortem cytologic diagnosis of probable or definite dissemination of mycosis fungoides with pulmonary involvement. Similar cells were seen in aspiration smears. The lymphocytic infiltrates were similar to those in corresponding skin biopsies in each case. The distinctive cytologic findings in these cases may therefore help to determine the underlying etiology of pulmonary lesions and may contribute to the antemortem diagnosis of visceral dissemination of mycosis fungoides.     

Mycosis fungoides. The importance of pulmonary cytology in the diagnosis of a case with systemic involvement

A patient with cutaneous mycosis fungoides developed pulmonary lesions while under radiation therapy. Bronchial cytologic specimens demonstrated malignant lymphocytes, which open lung biopsy confirmed to be mycosis cells. We believe this is the first report to document pulmonary involvement of mycosis fungoides by the use of bronchial cytology.     

TCR基因重排在蕈样肉芽肿诊断中的应用

T细胞在成熟过程中通过T细胞表面受体基因重排,从而具有特异性识别抗原的能力,在这一过程中的任何失调都会导致疾病。蕈样肉芽肿是由于淋巴细胞的恶性增殖所导致的,病变组织表现出T细胞受体基因重排克隆性。通过Southern印迹分析技术和PCR技术来检测T细胞受体基因重排。T细胞受体基因重排的检测在蕈样肉芽肿的诊断的应用上有重要的参考价值。     

Inverted papilloma of the nasal cavity presenting with massive amounts of squamous metaplastic cells in sputum. A case report

BACKGROUND: Squamous metaplasic cells are rarely seen in sputum of female nonsmokers. CASE: A 47-year-old female nonsmoker presented with massive amounts of squamous metaplasic cells in sputum and an elevated level of squamous cell carcinoma (SCC) antigen in serum present for months, while no causative lesion was detected either by lung computed tomography or bronchoscopy. The patient was eventually diagnosed as having inverted papilloma in the right nasal cavity. Resection of the tumor brought about disappearance of squamous metaplastic cells in sputum and return of serum SCC antigen to the normal range. CONCLUSION: This case clearly demonstrates that squamous metaplastic cells in sputum can originate in lesions in the nasal cavity, although they are rare. It should be kept in mind that the nasal cavity is a potential site producing squamous metaplastic cells in sputum.     

Circulating cancer cells in peripheral blood. A case report

BACKGROUND: Carcinocythemia, the presence of circulating cancer cells in peripheral blood, is a rare complication of solid neoplasms. When the number of such cells is very high, they can be detected during routine laboratory tests. They are associated with a dismal prognosis. CASE REPORT: Carcinocythemia occurred in a patient with disseminated breast cancer. Eighteen cases were identified from a review of the literature. The most common neoplasms associated with circulating cancer cells in peripheral blood were breast adenocarcinoma, small cell lung carcinoma and rhabdomyosarcoma. All the patients had stage IV disease at the time of diagnosis, and all had involvement of the reticuloendothelial system. Patients survived for an average of a few days or weeks. CONCLUSION: Circulating cancer cells in peripheral blood are an unusual manifestation of disseminated neoplasms that occurs as a terminal event.     

Pulmonary blastoma. A case report.

Pulmonary blastoma occurred in a 71-year-old man. Bronchial brushing specimens showed numerous epithelial cells and only a few mesenchymal cell clusters. The epithelial cells were round to oval, more uniform and smaller than ordinary adenocarcinoma cells. The nuclear:cytoplasmic ratio of these cells was increased, with an even chromatin distribution, and nucleoli were inconspicuous. Mesenchymal cell clusters were markedly hypercellular and consisted of small and short spindle-shaped cells with hyperchromatic nuclei. Although it is very difficult to diagnose pulmonary blastoma correctly by cytology, the possibility of pulmonary blastoma should be considered when small, nonsquamous neoplastic cells are observed, particularly in association with small and short spindle-shaped cells reminiscent of mesenchymal origin.     

X-Y translocation. A case report

Summary A translocation of genetic material involving the long arm of the X chromosome and the heterochromatic portion of the Y chromosome is reported in a young woman. The phenotypic effect of this translocation and loss of almost half of the long arm of the X chromosome is described.     

Extradural spinal meningioma as a source of plasmacytoid cells. A case report

BACKGROUND: Meningiomas, tumors that often affect middle-aged and elderly people, occasionally arise in the spine, typically at the thoracic level. The cytologic findings in meningiomas include whorls and syncytial clusters of bland-looking cells with scattered, psammomatous calcifications and intranudclear cytoplasmic inclusions. However, in many cases, not all these findings are seen, and in rare cases, unusual cytomorphologic features are observed. CASE: A case of spinal meningioma was located in the extradural compartment and composed predominantly of singly scattered cells with a plasmacytoid appearance, demonstrated on fine needle aspiration biopsy smear preparations. The cell block showed more typical features of meningioma, and the diagnosis was supported by the results of immunohistochemical staining. CONCLUSION: The diagnosis of spinal meningioma is readily made by employing magnetic resonance imaging. The diagnosis can be difficult to confirm pathologically when atypical histologic findings are present, as in this case, with prominent plasmacytoid features. Sections from the cell block and immunohistochemical stains as well as clinical and radiologic findings were extremely helpful in arriving at the final diagnosis.     

Gynecomastia in a mortician. A case report

The fine needle aspiration (FNA) observations in a case of gynecomastia occurring in a mortician are described. The FNA smear showed cytomorphologic features typical of a gynecomastia. Morticians use an embalming cream that contains estrogens or estrogenlike compounds; these substances may be absorbed percutaneously and cause the development of gynecomastia. The mortician should be made aware of the potential risk of such an occupational exposure and development of the "embalmer's curse. "Recognition by the clinicians and cytopathologists of such an occurrence and its implications can help with the proper management.