scholarly journals Adult exogenous lipoid pneumonia: A rare and underrecognized entity in cytology – A case series

CytoJournal ◽  
2018 ◽  
Vol 15 ◽  
pp. 17 ◽  
Author(s):  
Simon Sung ◽  
Henry D. Tazelaar ◽  
John P. Crapanzano ◽  
Aziza Nassar ◽  
Anjali Saqi
Keyword(s):  
Case Reports ◽  
Case Series ◽  
Invasive Procedure ◽  
Needle Aspiration ◽  
Definitive Diagnosis ◽  
Imaging Features ◽  
Lipoid Pneumonia ◽  
Fine Needle ◽  
Cytological Features ◽  
Appropriate Therapy

Background:Exogenous lipoid pneumonia (ELP) is a rare benign entity without specific clinical or imaging presentation. Although cytological studies – either bronchoalveolar lavage (BAL) or fine-needle aspiration (FNA) – may be pursued in patients with ELP, a definitive diagnosis is frequently rendered only on histology. The aim of this study is to highlight the cytological features of ELP.Methods:A search of cytopathology (CP) and surgical pathology (SP) diagnoses of ELP was conducted. The corresponding clinical and imaging features were obtained, and the morphology, particularly the presence and size of the intracytoplasmic vacuoles and background, was assessed.Results:Nine cases of ELP were identified, including eight with corresponding CP and SP. A neoplasm was suspected in three based on imaging, but ELP was not in the differential clinically or radiographically in any. Among the cases, six patients had BALs and three FNAs. All of the samples showed multiple large vacuoles within macrophages with at least some equal to or larger than the size of the cell nucleus. Similar vacuoles were noted extracellularly on smears.Conclusions:ELP is typically described in case reports in the clinical or radiological literature. To the best of our knowledge, this represents the largest series of adult ELP in CP. When large vacuoles are present in macrophages in cytology specimens, at least a suspicion of ELP can be suggested to initiate appropriate therapy, identify/remove the inciting agent, and preclude a more invasive procedure.

Ultrasound of Focal Salivary Gland Lesions

Ultrasound ◽  
2009 ◽  
Vol 17 (3) ◽  
pp. 124-130
Author(s):  
Rajat Chowdhury ◽  
Hazel A Pratt ◽  
Keith C Dewbury ◽  
Elizabeth E Rutherford
Keyword(s):  
Salivary Gland ◽  
Imaging Modality ◽  
Needle Aspiration ◽  
Definitive Diagnosis ◽  
Imaging Features ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Diagnostic Uncertainty ◽  
Sensitive Tool ◽  
Initial Imaging

Ultrasound is a sensitive tool for assessing focal salivary gland lesions and is the initial imaging modality of choice for investigating such conditions. Whilst certain lesions have very characteristic ultrasound appearances, many hyperechoic lesions have non-specific imaging features resulting in diagnostic uncertainty based on imaging alone. Here we review the appearances of these lesions on ultrasound and highlight the importance of proceeding to ultrasound-guided fine-needle aspiration for cytology or core biopsy to reach a definitive diagnosis.

scholarly journals Cytomorphological spectrum of epididymal nodules: An institution's experience

CytoJournal ◽  
2017 ◽  
Vol 14 ◽  
pp. 26 ◽  
Author(s):  
Jyotsna Naresh Bharti ◽  
Biswajit Dey ◽  
Jenna Bhattacharya ◽  
Shyama Jain
Keyword(s):  
Fine Needle Aspiration Biopsy ◽  
Case Series ◽  
Needle Aspiration ◽  
Definitive Diagnosis ◽  
Surgical Interventions ◽  
Neoplastic Lesions ◽  
Epidermal Inclusion Cyst ◽  
Cytological Features ◽  
23 Gauge

Background: Epididymal lesions are uncommon in clinical practice. Few case series has been described in the literature documenting the role of cytology in the evaluation of epididymal nodules. This study was undertaken to analyze the cytomorphology of epididymal nodules and to evaluate role of fine-needle aspiration biopsy (FNAB) in early definitive diagnosis of epididymal nodules. Materials and Methods: A total of seventy cases of epididymal nodules were aspirated over a period of 6 years in the Department of Pathology. These cases were taken from the cytology record as a part of this study. The aspiration was performed using 22/23-gauge needle. Smears were stained with May-Grunwald-Giemsa and Papanicolaou stains. Special stains and immunocytochemistry were performed, wherever required. Results: The cytological features were adequate to establish the diagnosis in sixty cases. The lesions diagnosed were tuberculosis 16 (22.85%), spermatoceles 12 (17.14%), benign cystic lesion 8 (11.42%), encysted hydrocele 8 (11.42%), acute suppurative lesion 6 (8.57%), filariasis 4 (5.71%), chronic epididymitis 3 (4.28%), nodular fasciitis 1 (1.42%), epidermal inclusion cyst 1 (1.42%), and cystic adenomatoid tumor 1 (1.42%). Ten cases were inadequate to establish the diagnosis. FNAB was useful in diagnosis of 86% of cases. Infectious lesions of the epididymis were more common than neoplastic lesions. Patients with infection responded well to medical treatment. Conclusions: FNAB is an easily available technique for palpable lesions of epididymis, and it helps in making an early, near definitive diagnosis of epididymal lesions. It also helps to avoid unnecessary surgical interventions and helps in timely management.

scholarly journals Diagnosis of atypical mass-forming chronic pancreatitis mimicking pancreatic carcinoma: A case report

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Han-Yue Wang ◽  
◽  
Hao-Su Huang ◽  
Meng Wang ◽  
Jie Peng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chronic Pancreatitis ◽  
Pancreatic Carcinoma ◽  
Endoscopic Ultrasonography ◽  
Fine Needle Aspiration ◽  
Multimodal Imaging ◽  
Needle Aspiration ◽  
Imaging Features ◽  
Pathological Findings ◽  
Fine Needle

Background: Mass-Forming Chronic Pancreatitis (MFCP) is rare. Moreover, atypical MFCP is difficult to differentiate from Pancreatic Carcinoma (PC) in clinical manifestations, laboratory, and imaging examinations. Diagnosis could be supported by the pathological findings of focal inflammatory fibrosis without evidence of tumor in the pancreas. Case summary: A 52-year-old man had acute pancreatitis twice over 7 months. Amylase and lipase levels were three times higher than the normal range without any clinical symptoms. At the 6th month, the patient lost 15 kg of weight, and abdominal ultrasonography revealed pancreatic head space occupied. All the findings in multimodal imaging including computed tomography image, Magnetic Resonance (MR) imaging with MR cholangiopancreatography, and 18F-FDG positron emission tomography/computed tomography showed an irregular nodule with low density, low signal, and low echo in the head of the pancreas, which were lower than those in the normal pancreatic tissue. The proximal main pancreatic duct was truncated and stenosed, and the distal duct was dilated. Subsequently, he developed progressive painless jaundice, and the specific tumor marker levels were increased. Most of these manifestations were suggestive of the pancreatic malignant tumor; however, multiple specimen pathological findings obtained from laparotomy and endoscopic ultrasonography-guided fine-needle aspiration revealed focal chronic inflammation, fibrosis, and necrosis. Conclusion: This report describes a case of atypical MFCP mimicking PC at clinical presentation and laboratory findings, especially in multimodal imaging. However, the combination of atypical multimodal imaging features, which support MFCP rather than PC, and endoscopic ultrasonography-guided fine-needle aspiration are useful for improving the diagnostic rate of atypical MFCP and avoiding unnecessary surgery.

scholarly journals Transesophageal endoscopic ultrasound fine needle aspiration of vertebral body osteolytic tumors – a novel diagnostic approach. Case series.

2020 ◽  
Author(s):  
Romeo Ioan Chira ◽  
Alina Florea ◽  
Vlad Ichim ◽  
Liliana Rogojan ◽  
Alexandra Chira ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Histopathological Examination ◽  
Traditional Approach ◽  
Case Series ◽  
Lumbar Vertebrae ◽  
Needle Aspiration ◽  
Ct Guided ◽  
Fine Needle

Aims: Vertebral lesions, either primary or more frequently metastasis, are difficult targets for percutaneous guided biopsies and surgical biopsies and are associated with greater risks of complications. We investigated the feasibility of endoscopic ultrasound (EUS) fine needle aspiration (FNA) biopsy in the assessment of vertebral osteolytic tumors as an alternative to CT guided biopsy which is the technique currently used.Material and methods: Four patients with osteolytic tumors of the vertebral bodies identified by imaging methods (CT or MRI) – 3 patients, and one with a tumor detected primarily during EUS procedure were included in order to evaluate the feasibility of the procedure. The lesions were located either at the dorsal or lumbar vertebrae. In all cases we performed EUS FNA of the osteolytic vertebral body lesions with 22G needles using the transesophageal or transgastric approach.Results: In all cases EUS FNA provided enough tissue for an accurate histopathological report, with no procedural complication. We diagnosed lung adenocarcinoma, hepatocarcinoma and a pancreatic adenocarcinoma vertebral metastasis and one case of lymphoma.Conclusions: EUS FNA is a valuable technique which should be considered in selected cases, when a “traditional approach” is not applicable or associated with a higher risk. Treatment guidelines are based on the histology of the tumor, histopathological examination being nowadays mandatory. Therefore, we propose for selected cases a feasible technique, with significantly lower procedural risks, as an alternative for open surgical biopsies or computed tomography guided biopsies

Papillary Thyroid Cancer: A Pediatric Perspective

PEDIATRICS ◽  
1996 ◽  
Vol 98 (3) ◽  
pp. 464-466
Author(s):  
Timothy K. Flannery ◽  
John L. Kirkland ◽  
Kenneth C. Copeland ◽  
Alison A. Bertuch ◽  
Lefkothea P. Karaviti ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Carcinoma ◽  
Fine Needle Aspiration Biopsy ◽  
Case Reports ◽  
Needle Aspiration ◽  
Papillary Thyroid ◽  
Invasive Approach ◽  
Fine Needle ◽  
Less Invasive Approach ◽  
Children And Young Adults

A less-invasive approach to the evaluation of papillary carcinoma in children and adolescents recently has been proposed, based on reports of the accuracy and reliability of fine-needle aspiration biopsy (FNAB) in this population.1-4 Such confidence may be ill-founded, as the following clinical histories will illustrate. Functioning nodules, Hashimoto's thyroiditis (HT), and goiter-associated lymphadenopathy are unusual but significant presentations of papillary carcinoma in children and young adults, likely to be missed by the standard diagnostic approach in adults, which is reliant on FNAB, 123I scintiscans, or clinical response to suppressive doses of L-thyroxine (T4). CASE REPORTS Case 1 A thyroid nodule developed in a 12-year-old girl, first observed 1 month before evaluation in an endocrine clinic.

scholarly journals Utility of NKX3.1 Immunostaining in the Detection of Metastatic Prostatic Carcinoma on Fine-Needle Aspiration Smears

2019 ◽  
Vol 152 (4) ◽  
pp. 495-501 ◽  
Author(s):  
Qiong Gan ◽  
Cicily T Joseph ◽  
Ming Guo ◽  
Miao Zhang ◽  
Xiaoping Sun ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Prostatic Carcinoma ◽  
Specific Antigen ◽  
Prostatic Acid Phosphatase ◽  
Needle Aspiration ◽  
Metastatic Carcinoma ◽  
Small Cell ◽  
Definitive Diagnosis ◽  
Primary Tumors ◽  
Fine Needle

Abstract Objectives NK3 homeobox 1 (NKX3.1) has been increasingly used to diagnose metastatic prostatic carcinoma in histologic samples. However, its utility and reliability in cytologic direct smears have not been studied. Methods A total of 59 fine-needle aspiration (FNA) cases with a definitive diagnosis of metastatic carcinoma from the prostate were included. The cases were grouped based on different Gleason score in their corresponding primary tumors and morphologic variants. For each case, tumor cells were immunostained with NKX3.1, prostate-specific antigen (PSA), and prostatic acid phosphatase (PAP) on cell-transferred smears. Results NKX3.1 was strongly and diffusely positive in all 40 metastatic prostatic adenocarcinomas, including those with ductal features, but negative for the 19 small cell carcinoma (SmCC) cases. NKX3.1 had a better detection rate than PSA (13/50, 26%) and PAP (0/47, 0%). Conclusions NKX3.1 immunostaining on FNA smears is highly reliable for detecting metastatic prostatic carcinomas of conventional and ductal types but not for SmCC.

scholarly journals The Role of Fine Needle Aspiration of Orbital Lesions: A Case Series

2016 ◽  
Vol 60 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Fabio Pagni ◽  
Marta Jaconi ◽  
Andrew James Smith ◽  
Ambrogio Brenna ◽  
Maria Gabriella Valente ◽  
...  
Keyword(s):  
Case Series ◽  
Needle Aspiration ◽  
Lesion Size ◽  
Fine Needle ◽  
Computed Tomography Scans ◽  
The Mean ◽  
The Right ◽  
First Time ◽  
Orbital Lesions

Objective: This paper analyzes a series of ultrasound (US)-guided orbital fine needle aspirations (FNAs) which provide diagnostic information that cytopathologists approaching orbital lesions for the first time can find useful and underlines the importance of teamwork. Study Design: The investigators retrospectively obtained data from 24 consecutive orbital FNAs. For all patients, a complete clinicoradiological database was created. FNAs were performed under US guidance with 25-gauge needles and an aspiration biopsy syringe gun, and sent to the Department of Pathology for examination and data management. Results: The mean age of the patients was 54 years. Imaging studies included US, magnetic resonance imaging and computed tomography scans; 9 lesions involved the right orbit and 15 the left orbit. The mean lesion size was 23.6 ± 7.2 mm. After microscopic examination, 7 smears were labeled as ‘nondiagnostic', while in 17 cases a definitive diagnosis was proposed, which always proved to be correct (70.8%, specificity = 100%). Conclusions: The investigators believe that FNA biopsy of orbital masses is a necessary step; its weaknesses lie in the particularly delicate site of sampling and the extreme heterogeneity of lesions. Nevertheless, when orbital FNA is performed within a well-coordinated multidisciplinary team, it is a powerful tool that can be used to define the most appropriate management of these patients.

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