Fine needle aspiration diagnosis of pilomatrixoma. A case report

BACKGROUND: Fine needle aspiration (FNA) diagnosis of pilomatrixoma is rare. The cytologic presentation can be mistaken for squamous cell carcinoma because of high cellularity, high nuclear/cytoplasmic ratio and presence of anucleate squames. CASE: A 25-year-old male presented to Cook County Hospital with a slowly enlarging neck mass of three months' duration. FNA was interpreted as consisted with pilomatrixoma. Subsequently the patient had the mass removed. Histology confirmed the diagnosis of pilomatrixoma. CONCLUSION: The wide range of cell differentiation in conjunction with pertinent clinical findings, absence of nuclear atypia, tumor diathesis, mitotic figures and awareness of the entity lead to the correct diagnosis of pilomatrixoma.     

Fine needle aspiration cytology of adenoma of the nipple. A case report

BACKGROUND: Adenoma (papillary adenoma, florid papillomatosis, subareolar duct papillomatosis, erosive adenomatosis) of the nipple is an uncommon lesion and can be mistaken clinically for Paget's disease and pathologically be misinterpreted as an adenocarcinoma. CASE: A case of adenoma of the nipple was studied by cytology and histopathology. CONCLUSION: Recognition of this benign lesion on cytology will prevent unnecessary radical surgery. Local excision alone suffices.     

Fine needle aspiration cytology of lipid-secreting carcinoma of the breast. A case report

A renotropic factor was partially purified by sequential gel filtration and anion exchanger chromatography from plasma of human kidney transplantation donors and a renal cancer patient after uninephrectomy. This activity increased the rate of [3H]thymidine incorporation into DNA in rat cortical tubules, but not in rat liver cells, within the range of 100-200 ng/ml protein. The renotropic activity was detected between 7 and 12 days after uninephrectomy, and at least in 1 case decreased thereafter. This activity was undetected in gel-filtrated plasma of patients after a nonurological surgical procedure. The potency of this renotropic activity and its elution by gel filtration are similar to those displayed by a renal growth factor activity isolated from uninephrectomized rat plasma, as recently reported.     

Fine needle aspiration of secretory breast carcinoma resembling lactational changes. A case report

The purpose of the study was to determine if exhaled nitric oxide levels in children varied according to their asthmatic and atopic status. Exhaled nitric oxide was measured in a sample of 93 children attending the North West Lung Centre, Manchester, United Kingdom, for the clinical evaluation of a respiratory questionnaire being developed as a screening tool in general practice. The clinical assessment included full lung function, skin prick testing, and exercise challenge. Children were said to be asthmatic either by consensus decision of three independent consultant pediatricians, who reviewed all the clinical results except the nitric oxide measurements, or by positive exercise test. Atopic asthmatic children had higher geometric mean exhaled nitric oxide levels (consensus decision, 12.5 ppb [parts per billion] 95% CI, 8.3 to 18. 8; positive exercise test, 12.2 ppb 95% CI, 7.6 to 19.7) than did nonatopic asthmatic children (3.2 ppb 95% CI, 2.3 to 4.6; 3.2 ppb 95% CI, 2.0 to 5.0), atopic nonasthmatic children (3.8 ppb 95% CI, 2. 7 to 5.5; 5.7 ppb 95% CI, 4.1 to 8.0), or nonatopic nonasthmatic children (3.4 ppb 95% CI, 2.8 to 4.1; 3.5 ppb 95% CI, 3.0 to 4.1). Thus, exhaled nitric oxide was raised in atopic asthmatics but not in nonatopic asthmatics, and these nonatopic asthmatics had levels of exhaled nitric oxide similar to those of the nonasthmatics whether atopic or not.     

Fine needle aspiration of poorly differentiated rhabdomyosarcoma presenting with quadriparesis. A case report

BACKGROUND: The diagnosis of metastatic poorly differentiated rhabdomyosarcoma (RMS) in lymph node specimens by fine needle aspiration presents a difficult problem since it is virtually indistinguishable from other small round cell neoplasms. CASE: Fine needle aspiration was performed under radiologic guidance on an extradural, space-occupying lesion of unknown etiology in the region of the C-6 and C-7 vertebrae in a 20-year-old male who was hospitalized with quadriparesis. Cytologic examination suggested a metastatic tumor consistent with the diagnosis of rhabdomyosarcoma. A subsequent search for the primary tumor site revealed a soft tissue swelling in the right calf muscle. Light microscopic, ultrastructural and immunocytochemical examination of multiple Tru-cut biopsy specimens from the swelling in the right calf muscle confirmed the diagnosis of poorly differentiated embryonal rhabdomyosarcoma. CONCLUSION: Immunostaining is useful for muscle proteins in the detection of poorly differentiated forms of embryonal rhabdomyosarcoma. Electron microscopy is of limited use in such cases.     

Fine needle aspiration cytology of clear cell sarcoma of the kidney. A case report

BACKGROUND: Fine needle aspiration cytology is an established method for cytodiagnosis. Its application is particularly suited to the pediatric age group. A correct cytodiagnosis of especially large tumors can result in timely cytoreductive chemotherapy, thereby facilitating surgery. While the cytomorphology of Wilms' tumor is well documented, there is a paucity of literature concerning other uncommon pediatric renal tumors. CASE: A 2-year-old female underwent surgery for a renal mass following aspiration cytology. The histologic diagnosis was clear cell sarcoma of the kidney (CCSK). The cytologic smears were cellular and pleomorphic. The main feature of cytologic interest was the presence of deep nuclear indentations and grooves in many of the tumor cells. CONCLUSION: The cytologic features of CCSK are distinct and different from those of other renal tumors in children. Its recognition in cytology is important because its behavior is more aggressive than that of Wilms' tumor. A correct diagnosis can result in the institution of appropriate treatment.     

Fine needle aspiration diagnosis of aggressive giant cell tumor of bone. A case report

Giant cell tumors of bone are neoplasms with potential local and systemic aggressiveness. A case of giant cell tumor with radiologic and histologic features suggestive of locally aggressive behavior is reported. Cytologic material was obtained by fine needle aspiration from an intraosseous tumor that destroyed the cortex and from the invaded, adjacent soft tissues. The smears from the osseous aspirate showed the typical cytologic features of giant cell tumor, whereas the invaded tissues had a prominent loss of cohesiveness between mononucleate and giant cells. In addition, mitotic figures in the mononucleate component were noticeable. The differential diagnosis based on clinical and cytologic findings is discussed.     

Congenital ulcerated subcutaneous fat necrosis of the newborn

Teloscopy, a method of suprapubic cystoscopy, involves placing a telescope into the dome of a full bladder to examine the bladder interior. A 5-mm Dexide cannula was pierced through the dome of the bladder and a telescope was inserted through it. This specialized cannula sleeve maintained bladder distention and allowed an excellent wide-angle view of the interior of the bladder and ureteral orifices. In a retrospective analysis, 103 consecutive women with stress urinary incontinence who underwent retropubic urethropexy were placed into one of three categories: Burch laparotomy (13), Burch laparoscopy (44), or laparoscopy with mesh and staples (46). Teloscopy was performed and indigo carmine was given intravenously at the end of the procedure in 90 patients. Of these, seven (8%) were positive. In all seven a suture was seen through the bladder mucosa, and in five an additional obstructed ureter was observed. In all seven women the suture was removed and replaced, and all obstructed ureters were patent before the end of the procedure. Average time required was 4 minutes. No complications, short- or long-term, occurred in the 90 women. Our results support the view that cystoscopy should be performed at the end of bladder neck suspension.     

Fine needle aspiration cytology of malignant chondroid syringoma: a case report

BACKGROUND: Chondroid syringoma, a tumor of the eccrine glands, was previously called mixed tumor of skin as it has both mesenchymal and epithelial elements. Malignancy in this tumor is extremely rare. Although there are a few reports describing the cytomorphologic features of chondroid syringoma, the cytologic findings of its malignant counterpart have not been described. CASE: A 40-year-old female presented with a recurrent swelling on the scalp of one year's duration. Fine needle aspiration yielded blood-mixed gelatinous material. May-Grünwald-Giemsastained smears showed epithelial cells arranged in cordlike structures and ill-formed glands against a myxomatous background. The epithelial cells had scanty cytoplasm and markedly pleomorphic nuclei with prominent nucleoli. A few cells in the stroma had a halo around them and a resemblance to cartilage cells. A preoperative diagnosis of malignant chondroid syringoma was made. The tumor was excised, and the cytologic diagnosis was confirmed on histopathology. CONCLUSION: Cytomorphologic features of a rare case of malignant chondroid syringoma are reported for the first time. The presence of malignant epithelial cells against a myxoid background with a few chondroid foci helped in making a correct preoperative diagnosis.     

Fine needle aspiration cytology of amyloid goiter. A report of four cases

To understand the mechanisms of telomere maintenance in human gliomas, telomerase activity, telomerase RNA expression and telomere length of surgically excised glioma samples were analyzed. Sixty-five percent of gliomas exhibited telomerase activity, the occurrence of which was not related to their histological malignancy scale. Not only the telomerase-positive gliomas, but also the telomerase-negative gliomas and normal brain expressed telomerase RNA, suggesting that the presence of telomerase RNA component does not indicate the presence of telomerase activity. Compared with telomerase-positive gliomas, telomerase-negative gliomas had long heterogeneous telomeric terminal restriction fragments. These data suggest that in addition to the telomerase-dependent mechanism, a telomerase-independent mechanism for telomere maintenance may be present in human gliomas.     

Fine needle aspiration diagnosis of a pulmonary metastasis from a cutaneous adenoid cystic carcinoma. A case report

Ficolins are characterised by the presence of collagen-like and fibrinogen-like (FBG) sequences. Human L-ficolin is synthesised in the liver and secreted into blood circulation. In previous studies, it was shown to bind to N-acetyl-D-glucosamine (GlcNAc). In the present study, its detailed sugar specificity and binding site have been investigated. It was found to bind to GlcNAc and GalNAc (N-acetyl-D-galactosamine) while showing no significant affinity for the precursor sugars. The structure in these molecules which is recognised by L.-ficolin has been deduced to include an amide (-CO-NH-) or similar group. L-Ficolin was digested with collagenase and the collagenase resistant FBG domain was shown to bind to GlcNAc. Its levels in adult and cord blood-derived human plasma were also determined and showed that adult plasma contains approximately three times more L-ficolin than that of newborn babies.     

Leukemia cutis. Fine needle aspiration findings

OBJECTIVE: To aspirate, for cytologic study, skin nodules from known cases of leukemia during full remission. STUDY DESIGN: The study group consisted of nine leukemia patients in full remission who developed skin nodules on the head, face, chest and upper extremities. RESULTS: The size of the nodules ranged between 1 and 3.5 cm. The nodules were aspirated with 21-gauge needle. Four were diagnosed as acute lymphoblastic leukemia, 1 as chronic lymphocytic leukemia, 1 as acute myeloblastic leukemia, 2 as acute monocytic leukemia and 1 as acute promyelocytic leukemia. Histologic sections were diagnosed as lymphoma-leukemia. The patients developed leukemia again three to four months after excision of the skin nodules. CONCLUSION: Fine needle aspiration cytology is useful in the diagnosis of leukemia cutis.     

Diagnosis of renal malacoplakia by fine needle aspiration cytology. A case report

Talc administration into the pleural cavity induces pleurodesis. To obtain further insight into the inflammatory process that causes pleurodesis, the cellular kinetics in the pleural space after the administration of talc was studied, along with its relation to chemokine concentrations in the pleural fluid. Thirteen consecutive patients with idiopathic spontaneous pneumothorax and eight patients with malignant pleural effusions received talc pleurodesis. The first group was treated with talc poudrage, whereas the second group was treated with talc slurry. Pleural fluids were isolated before talc administration as well as 3, 6, 24, 48 and 72 h afterwards. The talc induced a rapid polymorphonuclear neutrophil (PMN) influx followed by an accumulation of macrophages. In addition, increased production of interleukin (IL)-8 and monocyte chemotactic protein (MCP)-1 was observed. The talc-induced PMN influx reached its maximum after 3-24 h, and was related to the IL-8 concentration. In contrast, the MCP-1 was not related to the macrophage accumulation. Talc-induced inflammation in patients with idiopathic spontaneous pneumothorax and malignant pleural effusion is characterized by an influx of polymorphonuclear neutrophils related to interleukin-8, followed by an accumulation of monocytes.     

Fine needle aspiration of sclerosing lymphocytic lobulitis of the breast. A report of two cases

We quantified telomerase activities in thyroid tumors by a telomeric-repeat-amplification-protocol-based assay in an attempt to determine its clinical significance. Telomerase activity was detected in 10 of 18 (55.6%) malignant tumors, but in none of the four benign lesions, and the level of telomerase activity correlated significantly with the progression of the clinical stages. High activity was determined in 4 (80%) of 5 metastatic lesions in the lymph nodes. Five (45.5%) of 11 non-tumoral specimens from malignant cases showed telomerase activity, while none of the four from benign cases did. In conclusion, the determination of telomerase activity might be useful in determining the existence and progression of thyroid cancer.     

Fine needle aspiration cytology of the thyroid osteosarcoma. Report of a case

The histologic changes in the white pulp of the spleens collected from thirty women died of widespread adenocarcinoma of the breast were assessed by using the standardized reporting system previously introduced. As a control material, the same number of age-matched women died of myocardial infarction or cerebrovascular accident without signs of any malignancy was used. Special attention was focused on the evaluation of the lymphocyte populations (T- and B-cells) responsible for immunological reactivity. Histological characteristics suggested to reflect the activity of both the cell-mediated and humoral immune reactions were found to be within normal range in the control patients, whereas in the cancer series both these elements seemed to be profoundly deranged. The significance of these observations was discussed with regard to the background of the previously demonstrated immunological reactivity against the cells of human breast carcinoma, and the conclusion was drawn that an impairment of both the humoral and cell-mediated immune responses must exist in women dying of widespread adenocarcinoma of the breast. The applicability of the standardized reporting system used in the assessment of spleen white pulp morphology was emphasized.     

Fine needle aspiration of osteogenic sarcoma metastatic to the lung. A report of four cases

Autosomal recessive juvenile parkinsonism (AR-JP) is a distinct clinical and genetic entity characterized by selective degeneration of nigral neurons. Recently, the parkin gene responsible for AR-JP has been identified. To date, we found two different deletional mutations including single and multiple exonic deletions. In the present study, we identified two types of point mutations (Thr240Arg and Gln311Stop) involving exons 6 and 8 in the parkin gene of the AR-JP patients from two Turkish families. This is the first report on point mutations for the parkin gene. Furthermore, the Thr240Arg mutation was located on a consensus sequence for the site of phosphorylation by casein kinase II. Identification of its mutation provides an important clue as to the role of the Parkin protein in degeneration of the substantia nigra in the brain of AR-JP patients.     

Testicular leukemia relapse. Fine needle aspiration findings

Calcification and/or ossification of the ligamenta flava is a well reported clinicopathologic entity causing narrowing of the spinal canal cord compression. It has been described almost exclusively in Japanese people. The authors present the case of a non Japanese patient with thoracic myelopathy caused by ossification of the ligamentum flavum.