Xanthogranulomatosis is an idiopathic, rare process in which lipid-laden histiocytes may deposit in various locations in the body, which if systemic is called Erdheim-Chester disease. A rare case of isolated retroperitoneal, bilateral perinephric xanthogranulomatosis is reported. The diagnosis was suspected on cross-sectional imaging and was confirmed by CT-guided percutaneous core biopsy.

Aged↗

PubMedDate not supplied

The challenge of Pneumocystis carinii culture.

Published and unpublished data on the cultivation of P. carinii were reviewed by a panel of investigators convened by the National Institutes of Health. Although several cell culture systems allow propagation of P. carinii for a limited time with modest rates of replication, these have not proved adequate for isolation of P. carinii in sufficient quantity to explore important basic biological investigation. Attempts at cell-free culture have yielded only transient proliferation. Because much of the unsuccessful work on cultivation of the organism has been unpublished, the panel agreed that these data may be useful to other investigators in designing experimental strategies for cultivation. Therefore, the purpose of this report is to make available this information to researchers, lest others unknowingly repeat unsuccessful methods. It is hoped that by documenting the history and the complexities of Pneumocystis culture, renewed interest and efforts will be directed toward this fundamental scientific challenge.

Animals↗

PubMedDate not supplied

Comparison of aspiration, touch and scrape preparations simultaneously obtained from surgically excised specimens. Effect of different methods of smear preparation on interpretive cytologic features.

OBJECTIVE: To determine whether three commonly used methods of obtaining and preparing cells for cytologic evaluation--touch preparation (TP), fine needle aspiration (FNA) and scrape preparation--yield essentially comparable material for evaluation or whether important differences exist between them that may influence interpretation. STUDY DESIGN: FNA, TP and scrape preparations were made simultaneously on surgically excised specimens. Thirty breast, 6 lung and 12 colon lesions were studied. Each slide was assessed for qualitative and quantitative features. Cellularity was semiquantitatively scored. RESULTS: Scrape preparations were the most cellular (P < .0001). Scrape and TPs often had larger tissue fragments than FNA. However, fragmentation of epithelial groups into smaller clusters and single cells was often noted on scrape preparations. FNAs tended to have cleaner backgrounds than the other two methods. CONCLUSION: Most often, there are few differences between smears prepared by the three techniques studied. However, scrape preparations may yield smears with smaller clusters and single cells as compared to the other two methods; that is a potential source of diagnostic confusion, particularly with respect to benign breast lesions. Scrape preparations uniformly yield more cellular smears. To the extent that cellularity is an interpretive factor in assessing cytologic specimens, it is important to be aware of the increased cellularity of scrape preparations as compared to the other two techniques.

Adenoma↗

PubMedDate not supplied

Correlation of cytologic and histologic findings in fibrosing thyroiditis. A case report.

BACKGROUND: Fibrous thyroiditis is the rarest form of thyroiditis. Consequently, needle aspiration biopsy experience is limited. Aspirates generally yield paucicellular smears with, at the most, only occasional, small fragments of connective tissue. CASE: A 35-year-old man presented with a firm right thyroid mass. Aspiration yielded cellular smears with round and irregularly shaped, cellular aggregates. Coarse cytoplasmic granules and intranuclear inclusions were also noted. The lesion was surgically excised, and pathologic examination was consistent with fibrous thyroiditis. CONCLUSION: As confirmed by histopathologic examination, the aspirated atypical cellular aggregates represented thyroid follicular units that were distorted by entrapment within fibrous tissue. Fibrosing thyroiditis may yield an atypical smear pattern.

Adult↗

PubMedDate not supplied

In vitro aggregation of macrophages around human-derived Pneumocystis carinii.

Interaction between human monocyte-derived macrophages with human Pneumocystis carinii was examined in this study. Macrophages formed aggregates around P. carinii in the presence of heat-inactivated, but not native serum. This interaction is distinct from phagocytosis and appears to be analogous to granuloma formation.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Diagnosis of histoplasmosis in bronchoalveolar lavage fluid by intracytoplasmic localization of silver-positive yeast.

A case of histoplasmosis in a patient with acquired immunodeficiency syndrome is presented. Intracytoplasmic organisms were found in Diff-Quik- and Papanicolaou-stained bronchoalveolar lavage fluid sediment. Budding yeasts were found in the silver methenamine-stained material. It was initially thought that the yeasts might represent another infecting organism, especially in view of the patient's history of esophageal candidiasis. When the silver-stained material was counterstained with hematoxylin and eosin, simultaneous demonstration of cytologic detail and silver positivity showed that the silver-positive yeasts were intracellular, confirming that they were Histoplasma capsulatum. Counterstaining with hematoxylin and eosin allows localization of argyrophilic organisms to either intracellular or extracellular sites and is technically simple to perform. It is useful in acquired immunodeficiency syndrome patients and other immunocompromised hosts, in whom multiple organisms are often found.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Histiocytes and the detection of endometrial adenocarcinoma.

Histiocytes have long been recognized as part of the milieu of endometrial carcinoma in gynecologic smears. In an effort to determine whether a quantitative assessment of histiocytes, especially in the absence of endometrial cells, could increase the effectiveness of the cervicovaginal smear for diagnosis of endometrial carcinoma, smears obtained prior to a tissue diagnosis of endometrial adenocarcinoma were evaluated from 44 postmenopausal women. Smears from 97 age-matched patients in the same clinic were also evaluated and used as a control group for the endometrial carcinoma patients. All smears were evaluated for the presence of histiocytes and for the presence of benign or malignant endometrial cells, with the histiocytes quantitated as minimal (less than 5 per high-power field [HPF]), moderate (5 to 10/HPF) or heavy (greater than 10/HPF). Sensitivity and specificity were calculated to assess the role of histiocytes in the presence and in the absence of endometrial cells using cytologic findings. Our data indicate that the presence of moderate or heavy numbers of histiocytes on cervicovaginal smears of postmenopausal women increased the cytologic sensitivity from 61% to 82% when considered a marker of disease along with endometrial cells. These results suggest that attention to the presence of histiocytes on cervicovaginal smears may increase the utility of cytology for the diagnosis of endometrial lesions and may be a useful guideline for the cancer-related gynecologic examination.

Adenocarcinoma↗

PubMedDate not supplied

Fine needle aspiration of abdominal fat for the diagnosis of amyloidosis.

Amyloidosis is a dysproteinemia characterized by extracellular deposition of amyloid fibrils. Its diagnosis depends on the demonstration of the characteristic apple-green birefringence in tissue stained with Congo red. Aspiration of subcutaneous fat as a means of procuring tissue has received attention in the internal medicine literature. However, this application of fine needle aspiration biopsy has not been investigated extensively by cytopathologists. We therefore report our experience. Over the past two years we performed 18 aspirations of subcutaneous fat on 17 patients in whom amyloidosis was clinically suspected. Eight aspirates were positive for amyloid, and nine were negative. There were no known false-negative results. False positives were more problematic, occurred early in our experience and were due to overinterpretation of occasional long, slender, green strands representing collagen. The true positives were all characterized by large numbers of short, apple-green strands intimately associated with the fat, oriented in multiple directions and occurring in much, if not all, of the aspirated fat. Attention to details of the aspirated material other than the presence or absence of apple-green birefringence can lead to a correct distinction between amyloid and collagen. We conclude that abdominal fat pad aspiration is useful in the workup of suspected amyloidosis, especially since it is a safe, easily performed procedure.

Abdomen↗