Showing papers in "Acta Cytologica in 1985"

Diagnostic value of cytology of voided urine.

Abstract: Cytologic examination of the sediment of voided urine is the only noninvasive method of detection, diagnosis and follow-up of tumors of the bladder and other anatomic components of the lower urinary tract. In order to assess the value of cytology of voided urine, we analyzed the diagnostic yield in 203 episodes, each composed of three sediments of voided urine obtained on consecutive days. For each one of these episodes, histologic material was available and was reviewed. Of special interest were 181 instances of primary or recurrent bladder tumors; in 37 of these patients, random biopsies of the bladder were also available for review. The concept of intraurothelial neoplasia (IUN), graded I, II or III, was introduced to describe degrees of atypia in flat urothelium, with IUN grade III corresponding to nonpapillary carcinoma in situ. The results documented that cytology of voided urine is highly reliable in the diagnosis of high-grade tumors, with a sensitivity of 94.2%. In primary flat carcinoma in situ (IUN III), the sensitivity was 100%. The method failed in the recognition of grade I papillary tumors and in about one-third of grade II tumors. There were no false-positive results in this study. In the 151 positive cases, the cytologic diagnosis was established on the first specimen in 79%, on the second specimen in an additional 14% and on the third specimen in 7% of cases. These results justify the use of three consecutive daily urine specimens for optimal diagnostic results. There is a remarkable similarity between the presence of cancer cells in voided urine and the DNA ploidy of bladder tumors, as established by Tribukait. The observations reported herein suggest that positive urine cytologies may correspond to aneuploid tumors and hence be not only of diagnostic but also of prognostic value. A direct proof of this hypothesis is under investigation; the results of this study justify the need for a field trial of an automated image analysis diagnostic system that was developed in this department.

False-negative results in cervical cytologic studies.

Abstract: The appropriate interval between cervical cytologic screening studies is a matter of considerable controversy, with a major consideration being the problem of false-negative results. To determine the rate of false-negative cervical cytologic results in our laboratory and to determine how these failures occur, tissue-proven cases of carcinoma in situ, invasive squamous-cell carcinoma, endocervical adenocarcinoma and lymphoid malignancy involving the cervix with negative Papanicolaou smears obtained within one year prior to the tissue diagnosis were reviewed. Over the four-year period from 1980 through 1983, 339 patients had tissue-proven cervical malignancies. Of these, 66 had false-negative Papanicolaou smears, representing a 20% overall false-negative rate. These false-negative smears were rescreened. For all types of cervical malignancy, the majority of errors were due to sampling. No malignancy was missed disproportionately by either cytotechnologists or cytopathologists. We plan to utilize these data for quality control purposes and for continued review of future performance.

Fine needle aspiration biopsy cytology of major salivary glands.

Abstract: Fine needle aspiration biopsy of the major salivary glands was performed on 160 patients. In 146 patients with satisfactory samples, the cytologic diagnosis was correlated with clinical follow-up and histologic findings. There were 122 benign lesions, including 47 tumors. There were 24 malignant lesions, 10 of which were primary and 14 metastatic. The overall accuracy was 98%. The sensitivity of the technique was 87.5%. There was no false-positive diagnosis. There were three false-negative diagnoses due to sampling errors and inexperience during the initial period of the study. This study documents that needle aspiration biopsy cytology of the salivary glands is accurate, simple, rapid, inexpensive, well tolerated and harmless to the patient.

Relationship between the diagnosis of epithelial abnormalities and the composition of cervical smears.

Abstract: The significance of endocervical columnar cells as a high-quality parameter of cervical smears was studied. In a cohort of women with two successive screenings, the consistency of the cellular composition of the cervical smears and the relation between the cellular composition of the smears and the frequency of the diagnosis of abnormal epithelial changes was investigated. At the first screening, a significantly higher number of epithelial abnormalities was found in smears with endocervical columnar cells than in smears without endocervical columnar cells. A significantly higher number of abnormal epithelial changes was found on the second screening in smears from women whose smears from the first screening did not contain endocervical columnar cells than in smears from women whose smears from the first screening did contain endocervical columnar cells. The presence of endocervical cells should be considered a very important indicator of the quality of cervical smears. The chance of missing an abnormal epithelial change is increased in smears without endocervical columnar cells. When endocervical columnar cells are absent, the smear should be considered to be of unreliable quality and a repeat smear should be taken after a short interval, unless the absence of columnar cells can be satisfactorily explained.

Sensitivity and specificity of fine needle aspiration cytology in the diagnosis of tumors of the thyroid gland.

Abstract: A study of the preoperative fine needle aspiration cytologies in consecutive patients with primary malignant tumors (203 cases) or benign thyroid tumors (217 cases) showed a sensitivity of 0.57 and a specificity of 0.98. The sensitivity of FNA cytology in medullary and undifferentiated carcinomas was 0.82 and 0.84, respectively; none of these were microscopically misdiagnosed. The sensitivity was only 0.58 for papillary carcinomas (excluding occult carcinoma) and 0.42 for follicular carcinoma. Four reasons for these low sensitivities were identified: tumors missed at aspiration, microscopic misinterpretations, diagnoses of cellular atypia and indeterminate diagnoses. Reevaluation of the false diagnoses once more emphasized the problem of distinguishing follicular adenomas from follicular carcinomas. Microscopically undiagnosed papillary carcinomas were either the result of misinterpretations of the characteristic cytomorphologic features or of the smears being misdiagnosed as showing cellular atypia when papillary formations were missing and only one or two of the other cellular criteria were evident. The specificity of FNA cytology of thyroid tumors was found to be high enough to permit surgical intervention after a cytodiagnosis of malignancy.

Fine needle aspiration cytologic study of the solitary thyroid nodule. Profile of 308 cases with histologic correlation

Abstract: The cytologic features and diagnoses of 308 solitary thyroid nodules subjected to fine needle aspiration (FNA) are presented and correlated with the histopathology. The findings reconfirmed the overall utility of FNA cytology in the differentiation of benign from neoplastic lesions and in the specific diagnosis of most types of thyroid lesions. The difficulty in the diagnosis of follicular carcinoma and in its differentiation from follicular adenoma is highlighted. Of note was the finding of Hurthle-cell populations in several types of lesions, which represents a potential diagnostic problem; this potential difficulty was lessened by sampling two or three areas within a nodule, thus obtaining a more truly representative specimen.

Fine needle aspiration biopsy in the diagnosis of tuberculosis.

Abstract: Bacteriologic data and aspiration smears obtained by fine needle aspiration (FNA) biopsy for a series of 39 cases of tuberculosis were reviewed. Based on the morphologic features of the aspiration smears, the cases were divided into two groups: 18 cases in which distinct epithelioid granulomas were present and 21 in which no granulomas were found but large amounts of necrotic debris with variable numbers of polymorphonuclear cells, histiocytes and lymphocytes were present. Material from the FNA biopsy specimen was submitted for culture and fluorescence studies in 34 cases (15 with and 19 without granulomas). In the first group, auramine-rhodamine staining of smears was positive in 4 of 15 cases and Mycobacterium tuberculosis was isolated in 12 of 15 cases. In the second group, auramine-rhodamine staining was positive in 9 of 19 cases and culture was positive for M. tuberculosis in 16 of 19 cases. The results indicate that studying FNA smears by light microscopy and bacteriologic culture is an effective way of diagnosing tuberculosis.

Diagnosis and typing of lung carcinomas by cytopathologic methods. A review of 108 cases.

Abstract: A correlative review was made of the type of cytology specimens (sputum, bronchial washing and bronchial brushing) together with the corresponding histopathologic specimens of 108 patients. One hundred patients had primary pulmonary carcinomas diagnosed histopathologically (84) or clinically (16); 5 had carcinomas metastatic to the lungs and 3 had apparently false-positive cytologic results for lung cancer. The correlative review was used to determine the diagnostic reliability of pulmonary cytopathologic techniques in the detection and classification of lung carcinomas (i.e., the sensitivity and accuracy). The overall sensitivities of sputum, bronchial washing and bronchial brushing cytology were 60%, 66% and 77%, respectively (p less than 0.05). Bronchial brushing had a higher sensitivity (80%) for peripheral and metastatic lesions than did sputum (37%) or bronchial washing (60%). The overall accuracies of sputum, bronchial washing and bronchial brushing cytology were 79%, 75% and 76%, respectively, which is not statistically different. Regardless of the sampling methods, cytologic typing of squamous-cell and small-cell carcinomas was highly accurate but was less satisfactory for the other types of lung carcinomas. In the 16 cases in which endoscopic biopsies were either not attempted or gave negative results, one or more pulmonary cytologic specimens showed malignant cells. It is concluded that: (1) pulmonary cytopathologic techniques have excellent sensitivity and accuracy in the diagnosis of lung carcinomas; (2) they may establish the diagnosis of pulmonary carcinomas when endoscopic biopsies give negative results; and (3) they are particularly helpful in cases in which endoscopic biopsies suffer from a low yield (peripheral lesions) or create a considerable danger to the patients (iatrogenic hemorrhage).

Subcutaneous endometriosis diagnosed by fine needle aspiration cytology.

Abstract: The fine needle aspiration cytology (FNAC) of two patients manifesting cutaneous/subcutaneous endometriosis is presented. Endometrial tissue sampled by the aspiration technique manifested different cytologic characteristics as compared to those of endometrial tissue obtained by standard exfoliative methods. A primary difference was the appearance of the endometrial cells in syncytial clusters in the aspirate, in contrast to the three-dimensional clusters seen in exfoliated material. These cases emphasize the need to include endometriosis in the differential diagnosis of palpable lesions of the abdominal wall, especially in women with healed surgical scars, and the role of FNAC in diagnosing such lesions.

Fine needle aspiration diagnosis of malignant lymphoma with confirmation by immunoperoxidase staining.

Abstract: Cytospin preparations of fine needle aspirates in 14 cases of suspected lymphoma were studied by immunoperoxidase techniques. The combination of cytologic smears and immunoperoxidase studies resulted in a working diagnosis in 13 of the 14 cases. The immunologic markers in conjunction with the cytologic appearance of the aspirates were reliable and consistent in differentiating between malignant and benign lymphoproliferative lesions and in determining the B-cell or T-cell nature of the process.

Cell population obtained by bronchoalveolar lavage in Pneumocystis carinii pneumonitis.

Abstract: In the course of bronchoalveolar lavages performed in 115 immunocompromised patients in order to investigate the occurrences of pneumonitis, Pneumocystis carinii pneumonia was diagnosed by demonstration of cysts in bronchoalveolar lavage specimens from 11 patients. The cellular phenomena associated with P. carinii infection at the level of the alveolar space were evaluated. Differential cell counts on bronchoalveolar lavage preparations stained by the May-Grunwald-Giemsa method were performed in immunocompromised patients and in ten nonimmunocompromised patients without any respiratory disease. A decrease in the alveolar macrophage count associated with an increase in the polymorphonuclear neutrophil count and the presence of plasma cells and/or immunoblasts was highly suggestive of P. carinii pneumonia. These cellular changes in bronchoalveolar lavage specimens are discussed in relation to the pathologic features usually described in P. carinii pneumonia.

Fine needle aspiration cytology smear patterns of malignant melanoma.

Abstract: The 23 cases of malignant melanoma diagnosed by fine needle aspiration (FNA) cytology from the years 1974 to 1983 were reviewed. The smears showed an abundance of melanin pigment overshadowing the tumor cells in six cases, a pleomorphic cytology in six, a round-cell morphology in four, an epithelial-like appearance in six and a spindle-cell pattern in one. Melanin pigment was readily seen in the May-Grunwald-Giemsa-stained smears in all cases except two, in one of which it was apparent after use of the Schmorl stain for melanin. An interesting observation was the presence of multiple, well-defined clear vacuoles in the cytoplasm of many cells and similar nuclear vacuolization in some cells in smears from ten cases. These cells could be regarded as intermediate forms between the nonvacuolated cells and the hypervacuolated balloon cells. The cause of this vacuolization is probably the result of degeneration and coalescence of melanosomes due to abnormal melanogenesis. These vacuoles were prominent in May-Grunwald-Giemsa-stained smears but were only faintly visible in Papanicolaou-stained smears, which may be the reason why this observation had not received emphasis in earlier reports of the FNA cytologic diagnosis of melanoma, in which the Papanicolaou stain was primarily used.

Salivary duct carcinoma of the parotid gland. Cytologic and histopathologic study.

Abstract: Ductal carcinoma is an uncommon tumor of the salivary glands. Histopathologically, it is characterized by the presence of intraductal and infiltrative neoplastic components, morphologically resembling mammary carcinoma. A case of ductal carcinoma of the parotid gland, in which preoperative fine needle aspiration biopsy was performed, is presented. Cytologic examination of the aspirate revealed naked nuclei featuring anisokaryosis, chromatin clumps and clear vacuolar zones.

Fine needle aspiration cytology of the breast. A review of 321 cases with statistical evaluation.

Abstract: To assess the accuracy of fine needle aspirations of the breast performed at our institution, all patients undergoing this procedure between the years 1973 and 1982 were evaluated. Correlation was made between the cytologic and histologic diagnoses whenever possible. Correlations were made with mammography results or clinical impressions when biopsies were not obtained. Our results for sensitivity, specificity, predictive value of a positive diagnosis and predictive value of a negative diagnosis were 65.0%, 100%, 100% and 89.6%, respectively. The data indicate that when adequate, well-prepared samples are submitted to the laboratory, accurate cytologic diagnoses can be made. The high specificity and predictive value of a positive result allow for the early diagnosis, treatment and management of breast cancer.

Peritoneal washings in ovarian tumors. Potential sources of error in cytologic diagnosis.

Abstract: Peritoneal washings were performed on 48 patients with suspected or known ovarian carcinoma. The procedure was part of the initial surgical staging in 27 patients with presumed stage I and II ovarian cancer and was performed during second-look operations in 21 other cases with proven ovarian malignancy. This paper presents the microscopic features of the washings, with particular emphasis on the cytologic differentiation between benign and malignant findings outside of the ovary. Thirty-four cases showed benign or reactive mesothelial cells and no evidence of peritoneal disease. The washings of six patient showed malignant cells, which were confirmed histologically. Notable atypia that mimicked ovarian carcinoma was found in eight patients who had benign or borderline lesions. These findings included papillary and glandlike epithelial structures, with varying degrees of cellular atypia and psammoma bodies. The histologic counterparts of these atypicalities were Mullerian inclusions, mesothelial proliferations and borderline serous tumors. The differential diagnosis between these entities is essential because false-positive cytologic diagnoses may alter postoperative treatment in some patients.

Identification of types and primary sites of malignant tumors by examination of exfoliated tumor cells in serous fluids. Comparison with the diagnostic accuracy on small histologic biopsies.

Abstract: The accuracy of identification of tumor type and primary site of malignant tumors by examination of exfoliated tumor cells was cytologically studied in 448 malignant effusions from 366 patients for whom the primary tumor site had been confirmed by histology. Ninety-seven corresponding small biopsies from metastases were separately reviewed histopathologically. In four fluids, the cells were too scanty or too poorly preserved for tumor typing. The cytologic tumor typing was performed with nearly 100% accuracy in the remaining 444 fluids, except for those of intermediate-cell anaplastic carcinomas (0 of 3) and poorly differentiated squamous (epidermoid) carcinomas (1 of 5). Adenocarcinoma was correctly identified in 98% of 285 fluids, large-cell carcinoma in 97% of 108 fluids, oat-cell carcinoma in 94% of 16 fluids, well-differentiated (keratinizing) squamous carcinoma in 100% of 3 fluids, malignant lymphoma in 100% of 22 fluids and sarcoma in 100% of 2 fluids. The criteria and the failures are discussed at length. In the investigation of the accuracy of cytologic and histologic diagnoses with respect to the primary tumor site, tumors with variable sites of origin (sarcomas and lymphomas) and those with usually singular sites of origin (e.g., small-cell anaplastic carcinoma of the lung) were excluded, leaving 387 cytologic and 83 histologic specimens available for review. The breast as a primary site was correctly identified in 70% of both the cytologic and histologic specimens; the primary cytodiagnostic criteria included a uniform cell pattern, finely granular chromatin, dense cytoplasm and cell balls with smooth borders. Ovarian primaries were correctly identified in 70% of the fluids and 83% of the biopsy samples on the basis of very irregular clusters of large pleomorphic tumor cells, large nucleoli and psammoma bodies. Lung primaries, identified in 50% of the fluids and 29% of the biopsy samples, showed quite variable cell patterns, most often including large pleomorphic cells with or without mucus formation and prominent multinucleation. Gastric cancers of the diffuse type were accurately identified in 52% of the corresponding fluids, which showed mainly isolated cells with dense cytoplasmic rims, occasional signet-ring cells, "embryo-shaped" nuclei, marked hyperchromasia and densely granular chromatin.(ABSTRACT TRUNCATED AT 400 WORDS)

Cytodiagnosis of bone tumors by fine needle aspiration.

Abstract: A retrospective study was undertaken of bone lesions examined by preoperative fine needle aspiration (FNA) cytology in our hospital during the ten-year period from 1970 to 1979. The 430 cytologically examined lesions were classified into three groups: inflammatory lesions, tumorlike lesions and tumors. A total of 54 patients had undergone surgery, with most of the lesions in those cases proven to be tumors or tumorlike by histologic study. Correlation between the histologic and FNA cytologic findings showed complete compatibility in 76% of the cases, partial compatibility in 13% and incompatibility in 11%. It is concluded that FNA biopsy is appropriate for identifying bone tumors and tumorlike lesions if sufficient numbers of tumor cells are obtained for morphologic examination. Although aspiration cytodiagnosis can be of considerable value in the recognition of certain bone lesions, it cannot replace formal tissue biopsy in the diagnosis of primary bone neoplasms. The morphology of several common bone tumors is described in detail and their differential diagnosis is discussed.

Cytologic diagnosis of primary tubal cancer.

Abstract: A study was made of the 128 cases of primary tubal cancer reported to date in Japan, especially of the 61 cases with a preoperative cytologic examination, which was positive for malignancy in 28 cases (45.9%). A positive cytologic diagnosis was made on the cervicovaginal smear in 37.9% of the 58 cases so examined and on the endometrial smear in 80.0% of the 15 cases so examined. Of the 12 cases with positive endocervical smear cytologies, 11 were without endometrial invasion and 4 had no cancer cells in the cervicovaginal smear. Histologic examination of endometrial curettage specimens was positive for cancer in 8 (23.5%) of 34 cases so examined. Endometrial invasion by cancer cells was seen in 11.1% of the surgically extirpated endometrial specimens. The results of this study suggest that cytologic diagnosis is one of the most reliable methods for detecting primary tubal cancer before a surgical operation is undertaken. Its efficacy might be improved by more careful sampling and study in patients suspected of having primary tubal cancer.

Fine needle aspiration cytology of bronchioloalveolar-cell carcinoma of the lung.

Abstract: The fine needle aspiration cytology features of twelve peripherally located bronchioloalveolar cell carcinomas of the lung diagnosed by fine needle aspiration biopsy are described. A spectrum of cytomorphologic changes was appreciated, including classic groups showing uniform malignant cells having prominent depth of focus with a lack of significant nuclear molding. Other cells showed features of atypical alveolar macrophages and bronchial-lining cells. The smears demonstrated malignant cells arranged along alveolar septae and possessing hobnail-shaped nuclei. Two cases had associated psammoma bodies, and one case demonstrated optically clear nuclei in the malignant cells. This series stresses the fine needle aspiration features that aid in the recognition of this specific lung neoplasm and its differentiation from benign reactive pulmonary lesions, other primary lung cancers and metastatic tumors.

Fine needle aspiration cytology of the pancreas. An analysis of its use in 52 patients.

Abstract: An experience with fine needle aspiration cytology of the pancreas over a five-year period in 52 patients is described. It was a highly specific test (93%), with a 100% predictive value for a positive test, regardless of the method used to obtain the cytologic sample. On the other hand, the sensitivity was relatively low, especially for percutaneous biopsies (58%). These results are similar to those reported by others. The complication rate was low (less than 1%). FNA cytology is now the procedure of choice in establishing a definitive diagnosis of pancreatic carcinoma in our institution.

Crush preparations of lesions of the central nervous system. A useful adjunct to the frozen section.

Abstract: A series of 32 cases in which crush preparations were used in addition to frozen sections for the rapid diagnosis of lesions of the central nervous system (CNS) is presented. The cytopathologic features in crush preparations of astrocytomas, glioblastomas multiforme and a pituitary adenoma are described. Excellent preservation of cellular detail was seen in the crush preparations. Frozen sections lacked cytologic detail but provided a better view of the tissue architecture. The crush preparations yielded the correct diagnosis in 29 of the 32 cases. In the other three, a secondary component of the neoplasms (oligodendroglioma and fibrosarcoma) was identified only in the paraffin sections. Use of both frozen sections and crush preparations is recommended for all cases in which an immediate diagnosis of a CNS lesion is required.

Crystals occurring in pulmonary cytology specimens. Association with Aspergillus infection.

Abstract: Birefringent needlelike crystals in rosette or wheat-sheaf-like arrangements were found in pulmonary cytology specimens from 11 of 65 patients who had either sputum cultures positive for Aspergillus or histologically confirmed pulmonary aspergilloma No crystals were found in specimens from 60 control patients with and without known fungal disease The crystals were most often associated with A niger infection (454%), followed by A flavus (16%) Crystals were also observed in one case of A fumigatus infection and in one case in which the species was not determined In two cases, crystals were found more than one year before sputum cultures became positive; in one of these patients, a fungus ball was not identified by X ray until five years after the first appearance of the crystals in the sputum Sixty-four percent of the patients with crystals also showed moderate to severe cytologic atypia The crystals are thought to be calcium oxalate We conclude that the presence of birefringent needlelike crystals with rosette or wheat-sheaf-like arrangements in pulmonary cytology specimens is a reliable marker for the presence of Aspergillus infection, which may be detected before cultures are positive or a fungus ball is evident on X ray

Criteria for the cytologic assessment of hyperplasias in endometrial samples obtained by the Endopap Endometrial Sampler.

Abstract: The Endopap Endometrial Sampler was used in 1,465 women, either just before endometrial biopsy or curettage (in 760 symptomatic patients) or as an office procedure (in 705 women) The samples were inadequate for interpretation in only 87% of the cases Although all malignant lesions were identified by this screening technique, about one-fourth were initially classified cytologically as hyperplasia Endometrial hyperplasias presented the greatest difficulties in interpretation, with only slightly over half of the proven cases correctly assessed on the endometrial sample In an attempt to improve the accuracy of the cytologic diagnosis of hyperplasias, ten morphologic features were examined retrospectively in 207 cases Five of the criteria were shown to provide an increased probability of correctly diagnosing endometrial hyperplasias on the cytologic sample: (1) the overlapping of cells in the glandular clusters or sheets, (2) the presence of nucleoli, (3) anisokaryosis, (4) granularity of chromatin and (5) the presence of sheets of stromal cells The more of these criteria observed in a given case, the better was the chance of cytologically identifying a hyperplasia in the Endopap sample

Cytologic and histologic correlation in primary lung cancer. A study of 154 cases with resectable tumors.

Abstract: The accuracy of cytologic diagnosis and typing was examined in 154 patients, 113 males and 41 females, who underwent radical surgery during the past six years. There were 42 central and 112 peripheral lesions: 6 adenocarcinomas and 28 squamous-cell carcinomas were centrally located and 69 adenocarcinomas and 27 squamous-cell carcinomas were peripherally located. Repetition of sputum sampling at least three times was preferred, especially in central lesions, which were detected in 57% to 64% of the cases by either three-day-pooled or aerosol-induced specimens. Peripheral lesions required brushing to enhance the accuracy. The overall typing accuracy was 64.3%, ranging from 83.6% in squamous-cell carcinoma to 25.0% in large-cell carcinoma. Cytologic positivity correlated well with the finding of tumors more than 3 cm in diameter. Adenocarcinoma and squamous-cell carcinoma showed no significant difference in frequency of regional lymph nodal metastases. The value of judging the accuracy of cytologic diagnosis and typing on the histologic evaluation of the entire resected lesion, rather than on biopsy specimens, is emphasized.

Possible spread of bronchogenic carcinoma to the chest wall after a transthoracic fine needle aspiration biopsy. A case report.

Abstract: Spread of tumor along the needle tract following aspiration biopsy with the so-called "fine" needles (thinner than 18 gauge) is recognized to be an extremely uncommon complication of this technique. A case is presented in which such a spread appears to have occurred to the chest wall 13 months after a transthoracic aspiration biopsy of a bronchogenic tumor.

Pulmonary dirofilariasis diagnosed by fine needle aspiration biopsy. A case report.

Abstract: A case of pulmonary dirofilariasis in a 62-year-old female was diagnosed by fine needle aspiration biopsy. A review of the literature revealed this to be the first reported case diagnosed by this method. The presence of bilateral lesions in this patient is an uncommon finding for this entity.

Primary amyloid tumor of the breast. Case report and literature review.

Abstract: An example of localized amyloid deposition in the breast of an elderly woman is reported. Fine needle aspiration biopsy yielded clumps of amorphous material, which stained violet with the May-Grunwald-Giemsa technique. The amyloid appeared to be of the AA type on histochemical analysis. The lesion was clinically associated, probably coincidentally, with a stage II carcinoma of the cervix. The nature and classification of amyloid is briefly reviewed, and the role of fine needle aspiration cytology in its diagnosis is discussed.

Clear-cell adenocarcinoma of the female urethra.

Abstract: Malignant cells were found in the urine of a 54-year-old woman. The papillary tumor subsequently removed from the posterior wall of the urethra proved to be a clear-cell adenocarcinoma. The cytologic, histologic and ultrastructural features of this tumor were very similar to clear-cell adenocarcinomas arising in the female genital tract, suggesting a possible Mullerian origin of this neoplasm.

Neuroblastoma diagnosed by fine needle aspiration biopsy.

Abstract: Small-cell malignancies of childhood are a source of diagnostic difficulty, both in cytology and histology. Four cases of neuroblastoma are presented that were diagnosed by fine needle aspiration cytology. The importance of a complete history, physical examination and laboratory evaluation is stressed. In addition to the usual description of cytologic detail obtained by routine methods, a new method of study is introduced: the potential use of plastic embedding and histochemical studies in small-cell tumors is discussed.

Diagnosis of radiolucent lesions of the jaw by fine needle aspiration biopsy.

Abstract: Radiolucent lesions of the jaw, representing a variety of metabolic, inflammatory, developmental, neoplastic and other disorders, may be quite variable in appearance. Fine needle aspiration biopsy, performed on 57 patients who presented with oral abnormalities, was used in an attempt to differentiate the pathologic processes in the 23 patients with radiolucent changes resulting from bony involvement. Most aspirations were performed on an outpatient basis, and the cytologic findings were correlated with the clinical course and subsequent surgical findings. The entities encountered included ameloblastoma, a variety of odontogenic cysts and inflammatory and infectious processes, such as actinomycosis and giant-cell and eosinophilic granulomas. An unusual salivary gland lesion was also observed. The aspiration biopsy proved to be a valuable adjunct method for the preoperative diagnosis of radiolucent lesions of the jaws. A discussion of the differential diagnostic considerations is presented.