Fine needle aspiration cytology diagnosis of cutaneous leishmaniasis in a 6-month-old child: a case report.

BACKGROUND: Skin biopsy and scrape smear examination are the two most commonly employed investigatory techniques in the diagnosis of cutaneous leishmaniasis. Although cases Leishmania lymphadenitis are reliably diagnosed with fine needle aspiration (FNA) cytology, it has not attained popularity in the diagnosis of cutaneous leishmaniasis, and only a few reports are available. CASE: A 6-month-old Kuwaiti child presented with a skin lesion on her left forearm of five months' duration. Both scrape smears and FNA were performed from the lesion. FNA cytology smears showed a rich population of inflammatory cells predominating in lymphocytes and histiocytes and epithelioid cell granulomas. The amastigote forms of Leishmania were noted on the smears. The scrape smears were nondiagnostic. CONCLUSION: FNA cytology can be reliably used in the diagnosis of cutaneous leishmaniasis, especially in dry lesions, where scrape smears are likely to be nondiagnostic.     

Fine needle aspiration cytology of adenomatoid tumor. A case report.

BACKGROUND: Adenomatoid tumor is a benign neoplasm of the male and female genital tract. The epididymis is the most common site. CASE: A 25-year-old male presented with a swelling in the left side of the epididymis. Cytology showed monotonous cells arranged in sheets, cords and glandular patterns. The cell showed eccentric vesicular nuclei with fine chromatin and abundant, vacuolated cytoplasm. CONCLUSION: With the help of fine needle aspiration cytology, an accurate diagnosis of adenomatoid tumor is possible and can relieve anxiety and uncertainty in both the patient and physician.     

Fine needle aspiration cytology of desmoplastic small round cell tumor. A case report.

BACKGROUND: Intraabdominal desmoplastic small round cell tumor (DSRCT) is a recently recognized type of primitive sarcoma characterized by a predilection for young males, a usually very aggressive course and generally unsuccessful therapy. A primitive histologic appearance with prominent desmoplasia and striking divergent multilineage differentiation are well-described morphologic features of this tumor, along with a consistent fusion of the EWS and WT1 genes at the molecular level. The cytologic literature contains only scattered references to this type of neoplasm. Detailed information on the clinical and fine needle aspiration (FNA) biopsy and the immunocytochemical and ultrastructural findings in a patient with DSRCT is presented. CASE REPORT: A 23-year-old male had a firm abdominal mass with multiple secondary lesions of the liver. An FNA biopsy was performed under ultrasonographic guidance. CONCLUSION: FNA of the liver nodules showed cohesive groups of small cells with hyperchromatic nuclei and inconspicuous nucleoli; immunocytochemically vimentin and desmin showed characteristic perinuclear globular positivity. FNA cytology is an effective means of diagnosing deeply located lesions. The cytologic features of DSRCT need to become familiar to pathologists and must be considered in the differential diagnosis of liver metastasis.     

Fine needle aspiration cytology in malignant Sertoli cell tumor of the testis. A case report.

A rare case of malignant Sertoli cell tumor of the testis occurred in which the diagnosis was initially suggested on fine needle aspiration cytology. Smears of the testicular, inguinal and cervical lymph node aspirates showed cells resembling normal Sertoli cells arranged in nests and tubules. Histopathology of the orchidectomy specimen confirmed the diagnosis. The literature is briefly reviewed.     

Fine needle aspiration cytology of neurothekeoma. A case report

BACKGROUND: Neurothekeoma (NT) is a rare, benign neoplasm of soft parts with a distinctive histologic appearance. To our knowledge, the cytologic findings have not been described before. We present a case of NT with the cytologic features on fine needle aspiration cytology (FNAC). CASE: A 54-year-old female presented with a circumscribed nodule in the left breast. The lesion was evaluated by FNAC. The smears showed an abundant, metachromatic, myxoid matrix with fusiform and epithelioid cells, some binucleated or multinucleated, loose or in groups and sometimes forming concentric whorls. The lesion was removed, and the diagnosis of NT was made after histopathologic study. CONCLUSION: NT is an extremely rare neoplasm in the mammary region. Fusiform and epithelioid cells arranged in concentric whorls in a myxoid tumor of soft tissue are a distinctive characteristic of this neoplasm and can suggest the diagnosis.     

Fine needle aspiration cytology of follicular dendritic cell sarcoma. A case report

BACKGROUND: Follicular dendritic cell (FDC) sarcoma is a rare, recently described neoplasm that shows differentiation similar to that of follicular dendritic cells. It must be differentiated from metastatic neoplasms and other rare, nonlymphoid nodal lesions. CASE REPORT: A 76-year-old man underwent fine needle aspiration of a recurrent laterocervical mass. Sixteen months earlier, the original tumor was excised and proved to be an FDC sarcoma. Smears exhibited a dual cell population composed of large cells with abundant cytoplasm and a lymphoid component that consisted mainly of lymphocytes and plasma cells. Large cells were atypical and distributed in ill-defined groups and as single cells. Nuclei were round to oval and pleomorphic, with irregular contours and nucleoli. Binucleation and multinucleation were occasionally seen. After the cytologic diagnosis, the tumor was excised and showed typical histologic and immunophenotypic features of FDC sarcoma. CONCLUSION: The morphologic features of FDC sarcoma seem characteristic enough to permit its preoperative recognition. Its cytologic definition increases our knowledge of rare, nonlymphoid, primary nodal tumors, allowing better differentiation from metastatic neoplasms.     

Fine needle aspiration cytology of a skeletal metastasis of adult Wilms' tumor. A case report

BACKGROUND: Nephroblastoma (Wilms' tumor) is the most common malignant tumor of the kidney in children but is rare in adults. The stage and histopathology of the tumor are the most important prognostic indicators. The common sites of metastasis are lung, liver and lymph nodes. Skeletal metastasis is exceedingly rare in both pediatric and adult nephroblastoma. We report an unusual case of a skeletal metastasis of adult nephroblastoma that developed nine years after the diagnosis of a typical nephroblastoma of favorable histology and that was diagnosed by computed tomography (CT)-guided fine needle aspiration cytology. CASE: Following a right radical nephrectomy for adult nephroblastoma and two local recurrences two and three years later, a 74-year-old woman presented with low back pain. CT and magnetic resonance imaging revealed lytic lesions in the 10th and 12th thoracic vertebrae. Smears prepared from specimens obtained through CT-guided fine needle aspiration biopsy were moderately cellular, with small, round cells arranged singly and in loosely cohesive clusters. These cells had inconspicuous nucleoli and scanty to moderate amounts of cytoplasm. The cells were also positive for cytokeratin and vimentin and appeared similar to areas of blastema in the original tumor. CONCLUSION: A definitive diagnosis of metastatic adult nephroblastoma in thoracic vertebrae was made possible by CT-guided fine needle aspiration cytology in conjunction with clinical and radiologic findings and by using ancillary modalities, such as immunohistochemical studies.     

Fine needle aspiration cytology of metastatic lymphoepithelioma. A case report

A case is presented of lymphoepithelioma (undifferentiated nasopharyngeal carcinoma) metastatic to the cervical lymph nodes in a 12-year-old boy for whom material was obtained by fine needle aspiration (FNA) for the primary diagnosis as well as for ancillary studies. Papanicolaou-stained smears demonstrated the characteristic cytopathologic features of Regaud-type lymphoepithelioma; the diagnosis was substantiated by immunocytochemical and electron microscopic studies. This report discusses the reliability and rapidity of FNA in definitively diagnosing undifferentiated metastatic malignancies as well as providing superior material for ancillary studies demanded by lesions with complicated and difficult differential diagnoses.     

Fine needle aspiration cytology of intranodal myofibroblastoma. A case report

BACKGROUND: Intranodal myofibroblastoma is a rare, primitive, mesenchymal neoplasm of the lymph nodes first described in 1989. It behaves in a benign fashion and has a great predilection for the inguinal region. CASE REPORT: A 56-year-old man was referred for fine needle aspiration cytology of an inguinal lymph node. Smears were moderately cellular, with a predominant population of single, small spindle cells with no atypia. Most neoplastic cells were distributed as dissociated, single cells, with few groups. The cells showed metachromatic stromal material with a fibrillary quality. Nuclei were elongated, with pointed ends and occasional twisted forms. A remarkable finding on Papanicolaou-stained smears was hemosiderin granules. After a cytologic report of low grade spindle cell tumor, the node was excised, and a histologic and immunohistochemical diagnosis of intranodal myofibroblastoma was established. CONCLUSION: Intranodal myofibroblastoma should always be considered when aspirating solitary inguinal lymph nodes. The presence of a low grade spindle cell pattern of variably dissociated cells with hemosiderin granules should lead to immunocytochemical studies. Muscle-specific actin expression in the absence of S-100 protein and vascular markers permits a more specific diagnosis.     

Fine needle aspiration cytology in lupus lymphadenopathy. A case report.

This case report describes the aspiration cytologic characteristics of histologically proven acute lupus lymphadenitis. The aspirate contained numerous lymphoid cells and many amorphous, basophilic, hematoxylin-stained bodies dispersed in a granular, necrotic background that lacked polymorphonuclear leukocytes. The lymphadenopathy was diagnosed cytologically as necrotizing lymphadenitis and histologically as acute lupus lymphadenitis.     

Fine needle aspiration cytology of an ovarian luteinized follicular cyst mimicking a granulosa cell tumor. A case report

BACKGROUND: Fine needle aspiration is a valuable tool in the diagnosis of ovarian cysts, especially in the young and when a nonneoplastic cyst is suspected. High cellularity, epitheliallike clusters and cellular atypia in aspirates from functional cysts are known features that may lead to an erroneous diagnosis of malignancy. Granulosa cells in ovarian cystic fluids may originate in follicular cysts or cystic granulosa cell tumors. In luteinized follicular cysts the cells usually have ample cytoplasm and tend to form clusters. This report draws attention to a case where abundant, dispersed cells lacking cytoplasm led to the incorrect diagnosis of a granulosa cell tumor. CASE: In an ovarian cystic aspirate from a 34-year-old woman, the fluid was highly cellular, with a striking predominance of cells interpreted as granulosa cells. Granulosa cells are often found in aspirates from functional cysts, but striking cellularity, prominent nuclear grooves and lack of luteinization made us consider a granulosa cell tumor rather than a follicle-derived cyst. Surgery was performed, and histology revealed a benign serous cystadenoma but also numerous maturing follicles and follicular cysts with thick layers of granulosa cells. The aspirate obviously did not represent the cystadenoma but one of the prominent follicular cysts. CONCLUSION: An understanding of the cytologic features of functional ovarian cysts, including the pitfalls, is necessary to avoid a false diagnoses of a neoplastic lesion. For a correct interpretation of the cytologic findings, close communication with the clinician and with the radiologist performing the aspiration is of vital importance.     

Fine needle aspiration cytology of mesoblastic nephroma. A case report.

A case of congenital mesoblastic nephroma of the left kidney was diagnosed in a 4-month-old child by fine needle aspiration cytology. The smears consisted of clustered and dyshesive spindle cells with minimal nuclear atypia and mitosis. No epithelial, tubular or glomeruloid differentiation was noted. Considering the age and cytomorphology, a diagnosis of mesoblastic nephroma was made. Histopathology of the nephrectomy specimen showed a tumor with features of atypical mesoblastic nephroma. Cytologic diagnosis of mesoblastic nephroma is important because the tumor has an excellent prognosis, and unlike Wilms' tumor, requires only surgery.     

Fine needle aspiration cytology diagnosis of renal medullary carcinoma: a case report

BACKGROUND: Renal medullary carcinoma is a recently described, highly aggressive neoplasm that affects predominantly young African American males with a history of sickle cell trait. To the best of our knowledge, this is the first report of fine needle aspirate cytology (FNAC) findings of renal medullary carcinoma. CASE: A 14-year-old, African American male with a history of sickle cell trait presented with the sudden onset of third cranial nerve palsy. Radiographic examination demonstrated possible tumor masses in the brain, thorax and left kidney. Ultrasound-guided fine needle aspiration was performed on the left kidney, and a cytologic diagnosis of "suspect renal medullary carcinoma" was rendered. The cytologic diagnosis was confirmed by tissue examination. CONCLUSION: The cytologic features of renal medullary carcinoma include loosely cohesive clusters and single epithelioid cells with cytologic atypia, including high nuclear/cytoplasmic ratios, hyperchromasia, prominent nucleoli and cytoplasmic vacuolation. These cytologic findings, coupled with clinical findings (young black male with sickle cell trait), allow recognition of this rare renal neoplasm.     

Fine needle aspiration diagnosis of lymphangiomyomatosis. A case report

BACKGROUND: Lymphangiomyomatosis is a rare disease of females, usually of reproductive age. There is a proliferation of lymphatic smooth muscle in mediastinal, retroperitoneal and often pulmonary lymphatics and lymph nodes. CASE: A 45-year-old female presented with a right pleural effusion and increasing retroperitoneal adenopathy with palpable left inguinal adenopathy. Three months previously she had undergone a right salpingo-oophrectomy for an ovarian fibroma with concomitant left ovarian wedge biopsy, myomectomy for leiomyomas and partial omentectomy. Three years previously, at age 42, she had experienced two transient episodes of chylous pleural effusion with no sequelae. She underwent computed tomography-guided fine needle aspiration of a 4-cm inguinal lymph node to rule out lymphoma. CONCLUSION: Fine needle aspiration of lymphangiomyomatosis yields distinctive cytologic morphology. This characteristic morphology, in combination with the appropriate history, permits a minimally invasive, timely and in this particular case, entirely unexpected diagnosis.     

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 alveolar soft-part sarcoma. A case report

A fine needle aspiration specimen from a mass in the thigh of a 25-year-old woman was submitted for cytologic examination. Malignant cells were found singly and in well-defined nests, resulting in an alveolar pattern. Individual cells were large, with moderate amounts of granular cytoplasm and vesicular nuclei with prominent nucleoli. The aspiration cytology findings plus the clinical setting suggested an alveolar soft-part sarcoma. Histologic and electron microscopic examination of the tumor mass confirmed the diagnosis.     

Fine needle aspiration cytology of primary pulmonary paraganglioma. A case report

BACKGROUND: Primary pulmonary paragangliomas are rare tumors. To our knowledge, there is no prior report on fine needle aspiration cytology (FNAC) in pulmonary paraganglioma. CASE: A 34-year-old man presented with an incidentally found solitary pulmonary mass. FNAC showed papillarylike clusters of epithelioid cells with round to oval nuclei, evenly dispersed chromatin, micronucleoli and occasional anisonucleosis. These cytologic features were suggestive of a sclerosing hemangioma or bronchioloalveolar carcinoma. A right lower lobectomy revealed a primary pulmonary paraganglioma. CONCLUSION: The possibility of pulmonary paraganglioma should be considered in the differential diagnosis of FNAC showing pseudopapillary clusters of epithelioid cells.