Cytologic findings in postpartum and postabortal smears

A study was undertaken to evaluate the cytologic features of pregnancy-induced cell patterns (PIP) observed in postpartum and postabortal cervicovaginal smears. A total of 3,000 PIP were evaluated and studied by an indirect immunofluorescent technique using human chorionic gonadotropin (HCG). Three characteristic types of PIP were demonstrated. In type I PIP, the cells had a sheetlike arrangement with a fine chromatin pattern and were thought to be of decidual origin. Type II PIP were shed in clumps and had round nuclei, cytoplasmic vacuoles and coarse chromatin. They were thought to originate in the endometrium with the Arias-Stella reaction. Type III PIP were large and had large nuclei with marked atypism. They were thought to be cytotrophoblasts. Almost all of the type III PIP were positive with the anti-HCG stain. It is concluded that this classification and analysis is significant and could reduce the number of false-positive cytology reports on postpartum and postabortal smears.     

Cytologic findings of medulloblastoma in crush smears

OBJECTIVE: To describe the cytologic findings of medulloblastomas on intraoperative crush preparation smears and compare them with the findings of other central nervous system tumors. STUDY DESIGN: The intraoperative crush preparation smears of 19 cases of medulloblastoma were studied (6 undifferentiated type and 13 well-differentiated type). The findings were compared with those of a control group consisting of 31 astrocytomas, 22 ependymomas, 18 oligodendrogliomas, 27 meningiomas, 17 schwannomas, 17 pituitary adenomas, 3 lymphomas, 5 hemangioblastomas, 5 chordomas and 11 metastatic tumors. RESULTS: Medulloblastomas revealed clusters and isolated small, round malignant cells with hyperchromatic nuclei and indistinct cytoplasm. Typical Homer-Wright rosettes were seen in the well-differentiated type, but they were poorly formed in the undifferentiated type. Tumor cannibalism, target inclusions, cytoplasmic vacuoles and prominent multiple nucleoli were noticed frequently in the undifferentiated type. The control group (metastatic tumors and high grade astrocytomas) rarely showed tumor cannibalism or multiple nucleoli. CONCLUSION: Smears of the undifferentiated type of medulloblastomas frequently revealed tumor cannibalism, cytoplasmic vacuoles, target inclusions and prominent multiple nucleoli. These findings have been rarely reported. The prognosis of the undifferentiated type of medulloblastoma was poor.     

Cytologic appearance of esthesioneuroblastoma in a fine needle aspirate

Esthesioneuroblastoma (olfactory neuroblastoma) is a rare malignant neoplasm derived from the olfactory epithelium. It was diagnosed by cytologic study of fine needle aspiration biopsy smears of a tumor situated in the nasopharynx in a 57-year-old man.     

Cytologic grading and DNA image cytometry of breast carcinoma on fine needle aspiration cytology smears

OBJECTIVE: To correlate the cytologic grade of breast carcinoma with DNA image cytometry (ICM) and nuclear area on fine needle aspiration cytology (FNAC) smears. STUDY DESIGN: In this prospective study, FNAC material from 28 breast carcinomas were studied for cytologic grade and DNA ICM. Breast carcinomas were classified as grade 1-3 (low to high). DNA histograms were classified by the modified Auer method. Degree of hyperploidy (DH), ploidy balance (PB) and nuclear area (NA) were measured on Feulgen-stained smears by a CAS 200 image cytometer. Cytologic grade was correlated with DNA ICM findings and NA. RESULTS: There were 3 cytologic grade 1, 13 grade 2 and 12 grade 3 breast carcinomas. Seven of eight cases of hypertetraploid aneuploidy were grade 3 tumors. All cytologic grade 1 tumors were diploid. There were significant differences in DH, PB and NA in different grades of breast carcinoma (one-way ANOVA). CONCLUSION: DNA image cytometry in combination with cytologic grading might offer additional information for the characterization of breast carcinomas diagnosed by FNAC. These observations are of particular interest with the introduction of preoperative chemotherapy.     

Cytologic findings in pap smears with Actinomyces-like organisms

OBJECTIVE: To detect whether there is a relationship between the presence ofActinomyces-like organisms (ALOs) and cytologic findings. STUDY DESIGN: Papanicolaou-stained smears from 2290 women were examined cytologically. Nineteen (0.83%) of the 2290 were diagnosed with ALOs and became the study group. Patients without infectious agents (n=1792) were the control group. Statistical analyses were conducted with the chi2 test using the SPSS program (Chicago, Illinois, U.S.A.). RESULTS: The study and control groups were compared statistically. There was a significant correlation between the presence of ALOs and other cytologic findings, such as Trichomonas vaginalis, cocci, pseudoeosinophilia, endocervical cells, superficial cells, lactobacilli and polymorphonuclear leukocytes (p < 0.05), but there was no statistically significant difference between the presence of ALOs and metaplastic cells, parabasal cells or nuclear changes (p > 0. 05). CONCLUSION: ALOs in cervicovaginal smears might provide a milieu for growing some infectious agents, such as Trichomonas vaginalis and cocci. Lactobacilli were less plentiful in these cases. Vaginal discharge and abdominal pain were also important clinicalfindings for the detection ofALOs. Another finding was long-term usage of intrauterine contraceptive devices, which can cause the overgrowth of ALOs in vaginal mucosa.     

Pheochromocytoma. Cytologic findings on intraoperative scrape smears in five cases

BACKGROUND: There have been few studies describing the cytology of adrenal pheochromocytoma (PC). Although fine needle aspiration (FNA) for a preoperative diagnosis of PC is generally considered a contraindication, this tumor can be an unsuspected finding in adrenal FNA performed for other reasons. STUDY DESIGN: Scrape cytology smears prepared in five cases of PC were examined for different cytomorphologic features. The results were correlated with the corresponding permanent histologic sections. RESULTS: Previously described features, like cellular smears showing cells with abundant, poorly defined fragile cytoplasm, bare nuclei, anisonucleosis, "salt and pepper" chromatin, variable nucleoli and few ganglion cell-like cells, were noted. In addition, several previously unreported cytologic features were observed: (1) loosely cohesive PC cells along a ramifying, delicate central core; (2) intracytoplasmic microvesicular (not hyaline/homogeneous) globules; and (3) different arrangements of capillary-stroma and PC cells (Zellballen pattern; empty capillary rings; stroma with adherent, intact PC cells or fragments of disrupted PC cell cytoplasm). CONCLUSION: The cytologic appearance of PC may resemble that of other neuroendocrine tumors; however, it can be diagnostic when combined with proper clinical data and ancillary tests.     

Cytologic characteristics of subependymal giant cell astrocytoma in squash smears: morphometric comparisons with gemistocytic astrocytoma and giant cell glioblastoma

OBJECTIVE: To evaluate the squash smear features of subependymal giant cell astrocytoma (SEGA) in comparison with gemistocytic astrocytoma and giant cell glioblastoma. STUDY DESIGN: We compared the squash smear features of 3 cases of SEGA, 9 cases of gemistocytic astrocytoma and 3 cases of giant cell glioblastoma with the morphometric findings. RESULTS: SEGA had, on average, a 15.84 +/- 5.03-microm nucleus, 33.22 +/- 12.05-microm cytoplasm and 0.50 +/- 0.12 nuclear/cytoplasmic ratio in squash smears. In addition, SEGA showed hairlike processes distributed along the squash direction like strap cells. While the gemistocytic astrocytoma had several tumor cells showing a vertically located nucleus, the tumor cells of SEGA showed nuclei oriented mainly in parallel. CONCLUSION: These squash cytologic features of SEGA can be very helpful in the differential diagnosis by excluding mimics.     

Microglandular hyperplasia of the uterine cervix. Cytologic diagnosis in cervical smears

OBJECTIVE: To identify cytomorphologic features specific to microglandular hyperplasia (MGH) in cervical cytologic smears. STUDY DESIGN: Twenty-four cervical smears from 24 patients obtained before the histologic diagnosis of MGH made on colposcopically directed biopsies during a period of two years (1995-1997) were evaluated. RESULTS: Of cases with MGH, 13/24 (54%) showed the presence of bidimensional or tridimensional cellular clusters made up of cubic or cylindrical glandular cells with vacuolated cytoplasm; cells with dense cytoplasm, basaloid in appearance, corresponding to immature squamous metaplasia; and subcylindrical reserve cells with small, round nuclei and scant cytoplasm. Clusters showed microlumina or fenestrated spaces, preserved polarity and absence of nuclear peripheral dispersion. In the control group these cellular clusters were found in 6/100 (6%). Statistical analysis (chi 2) showed a strong, highly significant association (P < 0.001) of the cytologic parameters selected and the histologic diagnosis of MGH. CONCLUSION: Until now, no specific cytologic parameters were described for MGH. This study underscored the value of cytomorphologic parameters described for typical cellular clusters showing microlumina or fenestrated spaces with shared party walls and an admixture of glandular cells, and immature squamous metaplastic and subcylindrical reserve cells in the cytologic diagnosis of MGH.     

Cytologic characteristics of endocrine ductal carcinoma in situ of the breast. A case report

BACKGROUND: Endocrine ductal carcinoma in situ is a rare form of ductal carcinoma in situ. It is regarded as a distinct subgroup of mammary carcinoma. However, the cytologic features of endocrine ductal carcinoma in situ have not been previously reported. CASE: A case of endocrine ductal carcinoma in situ exhibited characteristic cytologic findings on a specimen obtained by the scrape method (stained with hematoxylin and eosin and Diff-Quik). CONCLUSION: The cytologic criteria for endocrine ductal carcinoma in situ are sufficiently distinct and are useful for making the diagnosis on fine needle aspiration.     

Nonfluorescent Y chromosomes. Cytologic evidence of origin

Summary Twelve presumptive structurally altered Y chromosomes were studied with Q-, G-, G-11, C-, Cd, and lateral asymmetric banding techniques and were compared with normal X and Y chromosmes and with an abnormal [i(Yq)] Y chromosome that exhibited intact fluorescence. Significant to this work is the fact that the Y chromosome has a small block of Giemsa-11 heterochromatin adjacent to the centromere on the long arm, while the X chromosome does not, which allows a distinction between the X-and Y-derived chromosomes. Two of the twelve altered chromosomes of either X or Y origin are small nonfluorescent rings. Each ring has a G-11-positive band of heterochromatin at the centromere, confirming Y origin. Each of the normal-length nonfluorescent presumed Ys and a Y with a fluorescent band in the center have one G-11 band at the centromere and another at an equal distance from the end of the long arm, the bands also being Cd positive, indicating that these chromosomes are pseudodicentric. The likely mechanism of origin is a break at the distal bright heterochromatin/ euchromatin junction (or within the bright segment in the chromosome with the bright center band), fusion of the sister chromatids at the breakpoints, and loss of the distal segment.     

Measurements of cell nuclei in blood smears from frogs]

In the blood-spread of frog size and extinction of nuclei of erythrocytes, thrombocytes and neutrophile leucocytes with segmental nucleus were investigated. The substance of nucleus was made visible by means of colouring in according to May-Grünwald and the DNA-content in according to Feulgen-reaction. The thickeness of layer and relief of the spread were recorded and measured with a touch-equipment. The nuclei and segments of nucleus, which are flat disks in the dry spread (nuclei of thrombocytes are about 0.75 mum thick), are considered to be rotational ellipsoids in the fluid blood; volume, surface and quantity of DNA are calculated. The erythrocytes have the smallest. the leucocytes the largest quantity of DNA in the nucleus. The concentration of the substance of nucleus and of the DNA increases with the dryness of the spread, to about the sixfold value at the nuclei of thrombocytes.     

Cytologic features of seminal vesicle epithelium in aspiration biopsy smears of the prostate.

To determine the rate of occurrence of cells derived from seminal vesicles in routine needle aspirates of the prostate, the smears of 853 aspirates were reviewed. The cytologic features of cells originating from the seminal vesicles were described using air-dried smears stained by the May-Grünwald-Giemsa method. The differential diagnosis with malignancy is discussed.     

Cytologic evaluation of prognostic markers in breast carcinoma

To type breast carcinomaon on fine needle aspiration cytology (FNAC) material and correlate the results with histologic typing, to grade breast carcinoma on FNAC material and correlate the findings with Bloom-Richardson histologic grading, and to determine the estrogen receptor (ER) status in cases of breast carcinoma by immunocytochemical (ICC) staining of FNA cytologic material and correlate the findings with ER status, as determined by immunohistochemical (IHC) staining of tissue sections. STUDY DESIGN: Seventy-seven cases of breast carcinoma diagnosed on FNAC formed the basis of this study. Typing was done in all cases on the basis of cytologic features and grading in 62. (Fifteen cases were special types of breast carcinoma). In all cases, ER status was determined by immunostaining of cytologic smears. Results of tumor typing, grading and ER status on cytologic material were compared with the results of histologic typing, grading and immunostaining of histologic material obtained from mastectomy or wide excision specimens. RESULTS: Tumor typing was accurate in 73 of 77 cases (94.8%). Fifteen of 18 cases that were cytologically grade 3 were confirmed on histology, while 3 proved to be grade 2. Of 40 cytologic grade 2 cases, 26 were confirmed on histology, while 14 cases were grade 3. Three of 4 cytologically grade 1 cases were confirmed on histology while 1 was grade 2. The overall accuracy for cytologic grading was 71% (44 of 62 cases). Thirty-seven of 40 ER-positive cases (92.5%) were labeled ER positive on ICC. One case was ER negative on cytology, while in 2 cases the cellularity of the cytologic smear was insufficient to assess ER expression. Thirty-seven cases were negativefor ER on IHC. Nine of these showed ER positivity on ICC, 26 were negative, and 2 had cellularity that was inadequate for assessment of ER. Sensitivity and specificity rates for ER detection on ICC were 97.4% and 74.3%, respectively. CONCLUSION: Tumor typing, grading and evaluation of ER status on FNA C material in breast carcinomas are simple, quick and moderately reliable techniques that compare and correlate favorably with histologic typing, grading and ER status on IHC.