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PubMedDate not supplied

Exfoliative cytology of invasive neuroendocrine small cell carcinoma in a cervical cytologic smear. A case report.

BACKGROUND: Neuroendocrine small cell carcinoma of the cervix (NSC) is cytologically identical to its counterparts at other sites, such as the lung, and can be suspected on a cervical cytologic smear. It has to be distinguished from poorly differentiated nonkeratinizing squamous small cell carcinoma, adenocarcinoma with carcinoid features, embryonal neuroblastoma, embryonal rhabdomyosarcoma, stromal sarcoma and non-Hodgkin's lymphoma. CASE: An 18-year-old woman had invasive NSC. Exfoliative cytology of the cervix showed tumor cells, single or in small clusters and files, with darkly staining nuclei. The chromatin pattern was coarse, with small, prominent chromocenters, and the nuclei were often invisible. The cytoplasm was so reduced as to be barely discernible. Mutual molding of adjacent nuclei was frequent. Immunohistochemistry showed positive staining for pancytokeratin and neuron-specific enolase. Flow cytometry showed aneuploidy, with a DNA index of 1.93. CONCLUSION: The cytologic appearance of NSC in a cervical cytologic smear is characteristic. The diagnosis, nevertheless, has to be proven by the identification of neuroendocrine differentiation.

Adolescent↗
PubMed2000

[Reliability of the interpretation of lymph node cytology by investigators with little cytologic experience--a study with students of veterinary medicine].

The aim of this study was to calculate the reliability of the examination of lymph node cytologies by individuals with little experience in the field of cytology. After an introduction comparable to the content of a cytology seminar, 11 students of veterinary medicine were asked to assess 20 slides with different lymphadenopathies (hyperplasia: n = 4, lymphadenitis: n = 4, malignant lymphoma: n = 4, different other neoplasias: n = 8). A correct classification according to these categories was achieved on the average (median value) in 18 of the 20 cases (minimum: 16, maximum: 20). The majority of the investigators also found a correct further differentiation for some slides, particularly with respect to the type of non-lymphatic neoplasia. The results of this study emphasize that the experience gained in a single cytology seminar enables only few individuals to reliably differentiate lymphadenopathies. The error rate, which was 10 to 20% for the majority of the investigators, however, has to be assessed critically due to the clinical consequences of misdiagnosis. This emphasizes the necessity of experience even for interpretation of lymph node cytology.

Animals↗
PubMed2005

Preliminary study concerning the cytoscreen system importance (liquid based cytology) in gynecologic cytology.

Our study aims to present the principal and the advantage of using the Liquid Based Cytology method by Cytoscreen system, as an alternative to the conventional Babes-Papanicolaou test, by reducing the false negative results frequency due to the poor quality of the smears and the epithelial cell screening by the blood elements, mucus or inflammatory exudates. A set of 1 054 female patients was available to be investigated during 2002-2004 both in the Clinical Gynaecology of The Clinical Hospital Filantropia and the Clinic of Oncology of the Clinical County Emergency Hospital of Craiova; the patients were from the rural and urban places as well; they underwent cytologic screening by Cytoscreen method. We simultaneously performed the cytologic exam by using both the Cytoscreen and the conventional Papanicolaou methods in 220 patients; the rest of them, namely 834 patients, were examined just by Cytoscreen method. The samples were processed in the Laboratory of Pathology and Cytology of the Clinical County Emergency Hospital of Craiova. The smears were fixed in the absolute ethanol for minimum five minutes than was performed the Papanicolaou stain. The diagnosis was according to Bethesda System 2001. Most of the patients (85.87%) were 21-50 aged. For the group of those tested by Cytoscreen, the rate of the "satisfactory smears" was significant increase (82.27% compared to 65.45% of the patients examined by using only the conventional method). The positive results were 5.44% compared to 2.27%. More accurate diagnosis of high degrees squamous intraepithelial lesions (1.36% compared to one case --0.45%), of low degree lesions (4 cases--1.81% compared to 2 cases--0.91%) and the atypical squamous cells with undetermined significance (1.36%Cytoscreen tested compared with 0.91%). Cytologic diagnosis was enforced by biopsy with histopathologic exam for 4 of 10 cases; the rest of the patients did not present for biopsy to be performed. In one case, HSIL diagnosis was false negative as the biopsy result was well-differentiated invasive squamous carcinoma. Both the diagnosis sensitivity and the smears feasibility were significantly improved by using Cytoscreen method.

Adolescent↗
PubMedDate not supplied

Frequency of cytologic features in fine needle aspirates from histologically and cytologically diagnosed fibroadenomas.

Identification of key cytologic criteria for various lesions by means of stepwise logistic regression is common today and is often claimed to facilitate cytologic diagnosis. As can be expected, there usually is good agreement between the selected criteria and those given in the cytologic literature. In a study by Bottles et al based on 64 fibroadenomas, stroma, antler horn clusters and honeycomb sheets differentiated fibroadenoma from ductal carcinoma. We applied Bottles's criteria to our fibroadenoma material in order to test their value in clinical cytologic practice. In fine needle aspirates from histologically (cytologically) diagnosed fibroadenomas, stroma was found in 41 (57%), antler horn clusters in 59 (90%) and honeycomb sheets in 62 (81%), which reduced the clinical value of the criteria.

Adenofibroma↗
PubMed1985

[Exfoliative cytology of mixed mesodermal tumors of the uterus--review of cytologic smears sampled prior to therapy].

Nine cases of mixed mesodermal tumor of the uterus were reviewed cytologically. Abnormal cytologic findings were seen in all cases, but malignant cells were detected in only 17 of 30 cytologic smears sampled prior to the therapy (2 of 7 pool smears, 2 of 3 portio rubbing-smears, 6 of 8 endocervical smears and 7 of 12 tumor-rubbing smears). The most commonly encountered cellular components were epithelial malignant cells which showed a close resemblance to those derived from uterine carcinomas, but tended to have multiple nuclei. In other cytologic components, a rhabdomyosarcoma was characterized by large, isolated, round or strap-shaped malignant cells with granular cytoplasms, bizarre and eccentric nuclei and one or more prominent nucleoli. Another infrequent cellular component was a fibrogenic sarcomatous cell which had an illdefined lacy cytoplasm and single or multiple nuclei containing rather finely granular chromatin, and occasionally formed a cluster. In several cytologic specimens, there were also seen multinucleated giant cells which were not in keeping with their histologic origins.

Adenocarcinoma↗
PubMed1986

Fine needle aspiration cytology and exfoliative biliary cytology in the diagnosis of hilar cholangiocarcinoma.

Nineteen patients with suspected malignant obstruction at the confluence of the bile ducts had exfoliative biliary cytology and fine needle aspiration cytology performed. Of these patients 14 cases were histologically proven to be cholangiocarcinoma, and 3 others followed a clinical course which was clearly malignant. Fine needle aspiration cytology gave a true positive result in 14 patients (87.5%), whereas exfoliative cytology was positive in 11 (73%). There were no false positive results and no complications from either procedure. Both the cytological procedures are rapid and safe and are useful for preoperative planning of surgical and intraoperative diagnosis.

Adenoma, Bile Duct↗
PubMed1982

[Cytology in the detection and followup of urothelial tumors. Critical review of 500 cytologic investigations (authors transl)].

500 cytologic studies were performed in patients who underwent urological explorations. Sensitivity is defined as the ability to identify correctly those patients who have tumoral disease of urothelium: urine cytology is ineffective in detecting benign papilloma, but sensitivity is more than 66% in low grade carcinoma and 80% in high grade carcinoma; cytology was able to detect 4/6 transitional cell carcinomas of the upper urinary tract. Specificity, which is defined as the ability to identify correctly those patients who do not have tumoral disease, is extremely high; thus, careful urological examination must be completed when cytology is positive. Urinary cytology is needed in every urological exploration concerned with urinary tract.

Carcinoma, Papillary↗
PubMed1995

[Post-operative peritoneal washing cytology in cases of stage IIIa endometrial carcinoma with positive peritoneal cytology].

According to the new FIGO staging of corpus cancer, the cases with positive peritoneal cytology alone belong in stage IIIa. The authors previously reported, however, good prognosis of IIIa cases with only positive peritoneal cytology. In order to assess the potential of malignant cells in the peritoneal cavity to metastasize, post-operative peritoneal washing cytology was undertaken. This study was conducted on a total of 115 consecutive patients with endometrial carcinoma who underwent primary surgical therapy at the Cancer Institute Hospital during the 25-month period from December, 1991 to December, 1993. Fifteen cases were included in stage IIIa with positive intraoperative peritoneal cytology alone. In 12 cases with endometrioid adenocarcinoma, a Silascon tube was indwelt in the abdominal cavity before closure of the abdomen. The peritoneal cavity was washed with 500 ml of physiological saline through the indwelt tube 14 days after the operation. The cytology of recovered washings was negative in all cases. Only two cases received postoperative chemotherapy owing to other prognostic factors. These 12 cases are alive with no evidence of disease after 12 to 36 months. The present study demonstrated that malignant cells in the peritoneal cavity appear to have a very low potential for implantation into the peritoneum.

Adult↗
PubMedDate not supplied

Aspiration biopsy cytology of smooth muscle tumors. A cytologic approach to the differentiation between leiomyosarcoma and leiomyoma.

From 1970 to 1991, 51 cases of smooth muscle tumors were diagnosed by fine needle aspiration biopsy. All were verified histologically and/or clinically, with no false-positive results. Of the 51 tumors, 41 were leiomyosarcoma and 10 leiomyoma. Among the 41 cases of leiomyosarcoma, 29 were the well-differentiated type; 8, poorly differentiated type; and 4, epithelioid type. Of the 10 cases of leiomyoma, 2 were the epithelioid type. The cytomorphologic features and cytologic patterns of various types of smooth muscle tumors observed in aspirate preparations are presented and compared in order to establish the cytologic criteria for differentiating malignant from benign smooth muscle tumors. Cytomorphologically the various types of smooth muscle tumors were different, and their cytologic features were sufficiently distinctive to distinguish one from the others. It appears possible to differentiate a well-differentiated leiomyosarcoma from a leiomyoma on the basis of cytologic findings observed in aspirate preparations. The recognition of different cytomorphologic features of various types of smooth muscle tumors is important in establishing an accurate cytologic diagnosis, which may be of practical significance to clinical management.

Biopsy, Needle↗
PubMed1988

Is cytology capable of adequately grading prostate carcinoma? Matched series of 50 cases comparing cytologic and histologic pattern diagnoses.

A perceived disadvantage of fine-needle aspiration biopsy of the prostate is that aspiration biopsies cannot be correlated with current tissue-grading systems. We compared patterns of cellular arrangement among 50 cases of prostate carcinoma studied in histologic and cytologic specimens obtained simultaneously. Cell patterns were independently scored in a semiquantitative fashion on both histologic and cytologic material, and "predicted Gleason scores" were assigned to the cytologic specimens. When carcinomas were classified as well differentiated (Gleason score 2 to 4), moderately differentiated (Gleason score 5 to 7), or poorly differentiated (Gleason score 8 to 10), there was 84 per cent agreement between histology and cytology. In no instance was there overlap between well-differentiated and poorly differentiated adenocarcinoma in the matched specimens. We believe that it is possible to accurately predict tissue patterns of prostate carcinoma and to estimate Gleason scores in aspiration biopsy specimens.

Adenocarcinoma↗
PubMed2007

HPV triage for low grade (L-SIL) cytology is appropriate for women over 35 in mass cervical cancer screening using liquid based cytology.

In the experimental arm of a randomised trial, women were tested both for liquid-based cytology and human papillomavirus (HPV) DNA and referred for colposcopy if cytology was ASCUS (atypical cells of undetermined significance) or more severe. We considered those with ASCUS (757) or LSIL (low-grade squamous intraepithelial lesions) (485) and a valid HPV test who received colposcopy. We computed sensitivity, specificity and ROC curves with different values of relative light units (RLU, that are related to viral load) as cut off, using cervical intraepithelial neoplasia grade 2 or more severe (CIN2+) at blind histology review as the endpoint. The area under the receiver operating characteristic (ROC) curve was significantly less among women aged 25-34 years than in those older, both considering ASCUS/AGUS (atypical glandular cells of undetermined significance) (p=0.0355) and LSIL (p=0.0009). At age 35-60 the curves for ASCUS and LSIL were similar, while at age 25-34 the area under the curve for LSIL was significantly less than for ASCUS (p=0.0084). With LSIL cytology, specificity of Hybrid Capture 2 with 2 RLU cut-off was 35.0% (95%CI 28.4-42.1) at age 25-34 and 64.5% (95%CI 58.3-70.3) at age 35-60. In conclusion, triaging by HPV testing performed better in women aged over 35 years than those younger. For older women, HPV triaging should also be considered for managing those with LSIL cytology.

Adult↗
PubMed1996

Invasive cytology of internal organs. Cytology of the thorax and abdomen.

Invasive cytology of the thoracic and abdominal cavities can provide diagnostic information in a timely manner for the practitioner. The information depends on obtaining a quality sample followed by thorough cytologic evaluation. Diagnostic imaging can enhance the sampling process and minimize the risk. As an adjunct to the historic and clinical information, cytology is valuable in establishing a diagnosis or list of differentials and directing future diagnostics or therapy. The application of cytology of internal organs opens a new window for the differential diagnosis of disease.

Abdomen↗
PubMed1998

Applications of the microbiopsy technique in non-cervical cytology: where cytology and histology meet.

AIM: To evaluate a recently developed technique allowing the removal and processing for histology of thick tissue fragments, called microbiopsies, from noncervical cytology specimens. METHODS AND RESULTS: Forty-five non-cervical smears from malignant tumours which contained microbiopsies were selected and processed. Sufficient sections could be cut in most cases for haematoxylin and eosin and an extensive panel of immunostaining. Seventy-one per cent of histological slides from the microbiopsies were representative of the tumour and confirmed the diagnosis. In 29% of the cases they were too small, contained non-representative tissue or showed extensive necrosis. Surprisingly, immunostaining results were at least the same and often better than those observed in routine formalin-fixed, paraffin-embedded tissue. Immunostaining profiles allowed distinction of tumour subtypes. Antigen retrieval techniques could be avoided in all cases. CONCLUSIONS: Application of the microbiopsy technique in routine cytology smears containing microbiopsies is helpful, particularly in those cases in which the diagnosis is not clear on the basis of the cytology smear and in cases in which there are not enough cytology slides for immunohistochemical examination.

Biomarkers, Tumor↗
PubMed1989

Non-exfoliative canine cytology: the value of fine needle aspiration and scraping cytology.

The results of the cytological and histological examination of 348 canine lesions, localised in various organs, were compared with respect to the tumourous or non-tumour nature of the lesions and the malignancy or benignancy of tumours. The retrieval rate was 92.5%. Regarding the distinction between tumourous and non-tumourous lesions, the cytological examination showed a diagnostic accuracy of 83.9%, a sensitivity of 95.6%, a specificity of 65.4% and a predictive value for the presence of tumour of 93.5%. The diagnostic accuracy of cytology concerning the differentiation in malignancy and benignancy of the neoplasms was 83.7%, with a sensitivity of 86.8%, a specificity of 79.4% and a predictive value for the presence of malignant tumour of 85.6%. These results confirm the value of non-exfoliative cytology as a diagnostic method, providing rapid and valuable information with regard to diagnosis and prognosis and, consequently, for therapeutic handling. An eventual histological diagnosis remains indicated, especially in case of soft-tissue and mammary lesions.

Animals↗
PubMed1991

Fine needle aspiration cytology, imprint cytology and tru-cut needle biopsy in breast lumps: a comparative evaluation.

Fine needle aspiration cytology, imprint cytology and tru-cut needle biopsy were performed in 86 patients with breast lump and the results of these techniques were finally compared with the incisional or excisional biopsy in all the patients. Fine needle aspiration cytology had the sensitivity of 96.8% and specificity of 100%, the imprint cytology had the sensitivity of 98.4% and specificity of 100%. While the tru-cut needle biopsy had the sensitivity and specificity of 100% though in this technique 15 of 86 (17.4%) specimens were rejected as insufficient for any diagnosis.

Biopsy, Needle↗
PubMed2004

Fine-needle aspiration cytology of solitary thyroid nodules: how far can we go in rendering differential cytologic diagnoses?

Fine-needle aspiration cytology (FNAC) is a diagnostic tool used in the clinical workup of solitary thyroid nodules; however, differential cytologic diagnosis of these nodules often is challenging. With the goal of identifying cytologic findings that could improve predictions regarding the presence of neoplastic lesions, the authors performed a retrospective review of cases in which FNAC led to diagnoses of solitary cellular nodules or cellular microfollicular lesions at two university hospitals. FNAC smears associated with cases for which surgical specimens subsequently were obtained were reviewed. FNAC accurately detected follicular neoplasms in 76% of cases at one hospital and in 67% of cases at the other. In the current report, the cytologic findings made in these cases are reevaluated, and the potential diagnostic contribution of available clinical data is discussed.

Adult↗
PubMed2002

Cytologic features of high-grade squamous intraepithelial lesions involving endocervical glands on ThinPrep cytology.

Usage of liquid-based cytology has resulted in better cellular preservation with enhancement of nuclear features. The purpose of this retrospective 2-yr study (January 1999 through December 2000) was to evaluate the cellular features of endocervical gland involvement by a high-grade squamous intraepithelial lesion (HSIL) vs. endocervical adenocarcinoma in situ (AIS) on cell samples processed by the ThinPrep method as compared to conventional smears. Of the 97 cases of CIN III diagnosed on cytology, 52 (54%) showed surface endocervical gland involvement by CIN III and form the basis of this study. There were also six cases of endocervical AIS diagnosed on histology with prior cytology. The architectural features of HSIL involving endocervical glands and AIS were similar to those previously reported on conventional smears. A consistent finding of HSIL involving endocervical glands was the loss of central cell polarity and piling within cell groups, a finding not present in AIS. Central cell polarity was maintained in cellular groupings of AIS. In addition to the cellular feature present on conventional smears, micronucleoli were clearly visualized in cells of HSIL involving endocervical glands and prominent nucleoli were present in AIS. Apoptosis and mitoses were clearly visualized in both entities. Endocervical gland involvement by HSIL has characteristic cell patterns and features on liquid-based/thin-layer cytology that permit their distinction from AIS.

Adenocarcinoma↗
PubMed2002

Cytologic findings of myxoid neurothekeoma: case report based on fine-needle aspiration cytology, immunohistochemistry, and correlating histopathology.

Myxoid neurothekeomas (nerve sheath myxomas) are rare benign cutaneous neoplasms that may morphologically mimic other myxoid neoplasms of skin and soft tissue. The cytologic and histopathologic features of this lesion may resemble various myxoid sarcomas, chordoma, myxoid neurofibroma, dermal cutaneous mucinosis, and cutaneous myxoma as well as other myxoid or chondroid neoplasms. In this study, a myxoid neurothekeoma was analyzed using multiple techniques. We found that myxoid neurothekeomas reveal a nonspecific pattern by fine-needle aspiration, including stellate cells embedded within an abundant metachromatic myxoid stromal matrix. These are cytologic features shared by various other subcutaneous neoplasms and thus may not be helpful in forming a definitive diagnosis. Histopathologically, the tumor is composed of nodules of myxoid stroma containing interspersed bland spindled and stellate cells. Immunohistochemical studies show tumor cell positivity for S-100 protein and vimentin, a profile shared by other neoplasms with similar cytologic features and therefore of little diagnostic value. The histologic and cytologic differential of subcutaneous and soft tissue myxomatous lesions is broad and, therefore, is of unique value to the cytopathologist to consider myxoid neurothekeomas among the differential of other myxomatous neoplasms.

Biopsy, Needle↗