Worrisome Histologic Alterations Following Fine-Needle Aspiration of Benign Parotid Lesions

2000 ◽  
Vol 124 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Shiyong Li ◽  
Zubair W. Baloch ◽  
John E. Tomaszewski ◽  
Virginia A. LiVolsi
Keyword(s):  
Squamous Cell ◽  
Fine Needle Aspiration ◽  
Squamous Metaplasia ◽  
Giant Cells ◽  
Needle Aspiration ◽  
Malignant Neoplasms ◽  
Low Grade ◽  
Fine Needle ◽  
History Of ◽  
Cleft Formation

Abstract Objective.—To describe the histologic changes associated with preoperative fine-needle aspiration biopsies of benign parotid lesions and the features that distinguish these changes from malignant neoplasms. Materials and Methods.—Ten benign parotid lesions with a recent history of preoperative fine-needle aspiration were selected, including pleomorphic adenoma (4 cases), oncocytic adenoma (3 cases), myoepithelioma (1 case), Warthin tumor (1 case), and lymphoepithelial cyst (1 case). Results.—A spectrum of histologic alterations were observed. Alterations included squamous cell metaplasia (8 cases), infarction and necrosis (4 cases), subepithelial stromal hyalinization (3 cases), acute and chronic hemorrhage and inflammation with multinucleated giant cells (all cases), granulation tissue with subsequent fibrosis (all cases), cholesterol cleft formation (1 case), pseudoxanthomatous reaction (1 case), pseudocapsular invasion (1 case), and microcystic degeneration (2 cases). In cases with exuberant squamous metaplasia, necrosis, or subepithelial stromal hyalinization, a diagnosis of squamous cell carcinoma or low-grade mucoepidermoid carcinoma was seriously considered. Conclusions.—Knowledge of a previous fine-needle aspiration procedure and awareness of its effects on histology of the subsequent parotidectomy specimens are necessary to avoid potential misdiagnosis.

scholarly journals Predictive Factors of Malignancy in Cytology of Indeterminate Follicular and Hürthle Cell Neoplasms of the Thyroid Gland

2019 ◽  
Vol 103 (1-2) ◽  
pp. 9-14
Author(s):  
Bahadır Öz ◽  
Serap Doğan ◽  
Ertan Emek ◽  
Muhammed Akyüz ◽  
Alper Akcan ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Family History ◽  
Radiation Exposure ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Cytologic Diagnosis ◽  
Fine Needle ◽  
Solitary Nodule ◽  
History Of

The objective of the current study was to determine the risk of malignancy in patients with thyroid nodules with cytology of indeterminate follicular and indeterminate Hürthle cell neoplasm (HN). The cytologic diagnosis of follicular neoplasm (FN) or HN remains a diagnostic challenge. Often, surgery is recommended for such lesions. A retrospective analysis was performed on 80 patients who underwent thyroid surgery following a diagnosis of indeterminate FN and indeterminate HN in thyroid fine-needle aspiration biopsy. Sex; age; family history of thyroid cancer and radiation exposure; coexisting thyroid conditions, such as solitary nodule; multinodularity; cytologic diagnosis; sonographic features; type of surgical treatment; and histopathologic results were recorded. Of the 80 patients, 52 (65%) had FN on fine-needle aspiration biopsy cytology and 28 (35%) had HN. A total of 23 patients (28.7%) had primary thyroid cancers on surgical pathology, and 57 (71.3%) had benign diagnoses. Univariate analysis showed no differences between the benign and malignant groups by sex, nodule size, family history of thyroid cancer, history of radiation exposure, presence of solitary nodule or multinodularity in the nodular features. In multivariate binary logistic regression analysis, the factors that were statistically significant predictors of malignancy were microcalcification [odds ratio (OR), 10.9; 95% confidence interval (CI), 2.18–54.7; P = 0.004], being older than 45 years (OR, 4.2; 95% CI, 1.25–14.63; P = 0.02]. The independent predictors of malignancy in FN and HN are micorcalcification and being older than 45 years, the use of which may predict the risk of thyroid cancer.

Pitfalls in Salivary Gland Fine-Needle Aspiration Cytology: Lessons From the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology

2005 ◽  
Vol 129 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Jonathan H. Hughes ◽  
Emily E. Volk ◽  
David C. Wilbur
Keyword(s):  
Salivary Gland ◽  
Fine Needle Aspiration ◽  
False Positive ◽  
Interlaboratory Comparison ◽  
False Negative ◽  
Diagnostic Errors ◽  
Poor Performance ◽  
Needle Aspiration ◽  
Low Grade ◽  
Fine Needle

Abstract Context.—We use data from the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology to identify common diagnostic errors in salivary gland fine-needle aspiration (FNA). Objective.—To identify salivary gland FNA cases with poor performance characteristics in the Nongynecologic Cytology Program surveys, so that the most common diagnostic pitfalls can be avoided. Design.—A retrospective review of the College of American Pathologists Nongynecologic Cytology Program's cumulative data from 1999 to 2003 revealed the most common false-positive and false-negative interpretations on FNA for common salivary gland lesions. Slides that performed poorly were then reviewed to identify the cytologic characteristics that may have contributed to their poor performance. Results.—A total of 6249 participant responses with general interpretations of benign (n = 4642) or malignant (n= 1607) were reviewed. The sensitivity and specificity of the participant responses for correctly interpreting the cases as benign or malignant were 73% and 91%, respectively. Benign cases with the highest false-positive rates were monomorphic adenoma (53% false-positive), intraparotid lymph node (36%), oncocytoma (18%), and granulomatous sialadenitis (10%). Malignant cases with the highest false-negative rates were lymphoma (57%), acinic cell carcinoma (49%), low-grade mucoepidermoid carcinoma (43%), and adenoid cystic carcinoma (33%). Selected review of the most discordant individual cases revealed possible explanations for some of the interpretative errors. Conclusions.—These data confirm the difficulty associated with interpretation of salivary gland FNA specimens. Cytologists should be aware of the potential false-positive and false-negative interpretations that can occur in FNAs from this organ site in order to minimize the possibility of diagnostic errors.

Aspiration Cytology of Pediatric Solitary Papillary Hyperplastic Thyroid Nodule

2001 ◽  
Vol 125 (12) ◽  
pp. 1575-1578 ◽  
Author(s):  
Kamal K. Khurana ◽  
Zubair W. Baloch ◽  
Virginia A. LiVolsi
Keyword(s):  
Fine Needle Aspiration ◽  
Giant Cells ◽  
Needle Aspiration ◽  
Cytokeratin 19 ◽  
Intranuclear Inclusions ◽  
Cytologic Diagnosis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
False Positive Diagnosis ◽  
Needle Aspiration Cytology

Abstract Context.—Solitary papillary hyperplastic thyroid nodules (SPHTNs) are frequently encountered in children and teenagers. Although the histologic features are well described, to the best of our knowledge, cytologic findings have not been reported. Objectives.—To review the cytologic features of histologically proven SPHTNs and to identify the potential diagnostic pitfalls in cytologic diagnosis. Materials and Methods.—Fine-needle aspiration cytology of 3 histologically proven SPHTNs was reviewed. Results.—Two girls and 1 boy (ages 11, 12, and 15 years) were affected. The cytologic diagnosis in all 3 cases was suspicious for papillary thyroid carcinoma (PTC). The spectrum of cytologic findings included broad flat sheets and 3-dimensional clusters with fire flares. There was mild to moderate nuclear pleomorphism and nuclear atypia. Short nonbranching papillae with transgressing vessels shown to represent hyperplastic papillae on histologic sections were identified in all cases. The background contained giant cells, histiocytes, and watery and inspissated colloid. Although nuclear grooves were identified in occasional cells, intranuclear inclusions were absent. A cell block section (1 case) and histologic sections of SPHTNs (2 cases) were immunohistochemically negative for cytokeratin 19. Conclusions.—Fine-needle aspiration of SPHTNs may be difficult to interpret accurately and can result in false-positive diagnosis of PTC. Although it shares several cytologic features with PTC, the presence of fire flares and short nonbranching papillae, as well as lack of intranuclear inclusions and watery and inspissated colloid in SPHTN appear to be useful features that are helpful in distinguishing SPHTN from PTC. Negative immunohistochemical staining for cytokeratin 19 is useful in excluding a diagnosis of PTC.

Atypical Hidradenoma Mimicking Primary Mammary Carcinoma on Breast Fine-Needle Aspiration: A Case Report with Long-Term Follow-Up

2016 ◽  
Vol 60 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Lisa M. Rooper ◽  
Jeffrey S. Iding ◽  
Jonathan D. Cuda ◽  
Syed Z. Ali
Keyword(s):  
Differential Diagnosis ◽  
Fine Needle Aspiration ◽  
Mammary Carcinoma ◽  
Needle Aspiration ◽  
Partial Mastectomy ◽  
Low Grade ◽  
Fine Needle ◽  
Nuclear Atypia ◽  
Long Term Follow Up ◽  
Palpable Breast

Background: Fine-needle aspiration (FNA) is well-established as an accurate technique for the diagnosis of palpable breast masses. While the differential diagnosis of such lesions usually focuses on benign or malignant mammary proliferations, a subset of breast neoplasms arises from skin and soft tissue. Skin adnexal neoplasms such as hidradenoma can pose a particular pitfall on breast FNA cytology (FNAC) as epithelial proliferations that are not of ductal or lobular origin. Case: A 59-year-old female presented with a superficial breast mass. FNAC revealed a hypercellular lesion with marked nuclear atypia that was highly suspicious for carcinoma. However, at partial mastectomy, the histological features of the tumor were consistent with atypical hidradenoma. Negativity for estrogen receptor (ER) and progesterone receptor (PR) confirmed the diagnosis. Eighteen years later, the patient remains free of recurrence or metastasis. Conclusions: This report offers the first description of findings of atypical hidradenoma on FNAC. In the breast, its high cellularity and nuclear atypia can mimic a primary mammary carcinoma on FNAC. Although breast and skin adnexal tumors show a immunohistochemical overlap, negative ER and PR stains in a low-grade tumor can suggest a nonmammary lesion. Skin adnexal neoplasms should be considered in the differential diagnosis of superficial breast tumors.

scholarly journals SPOROTRIKOSIS LIMFOKUTAN DIAGNOSIS HISTOPATOLOGI DAN SITOLOGI

2013 ◽  
Vol 2 (1) ◽  
Author(s):  
Poppy M. Lintong ◽  
Inneke V. Sumolang
Keyword(s):  
Skin Lesion ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Histopathological Examination ◽  
Sporothrix Schenckii ◽  
Giant Cells ◽  
Skin Lesions ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Left Hand

Abstract: Diagnosis of sporotrichosis associated with lymphocutaneous nodules was made based on the histopathological examination of skin lesions and the cytology of fine needle aspiration biopsy (FNAB). A case of sporotrichosis in a 63-year-old man was reported with papules and nodules spread along the back of the left hand, forearm, and arm. The histopatho-logical examination showed infiltration of PMNs, granulomas, and giant cells in the dermis and epidermis, along with hyperplasia and microabscesses. Sporothrix schenckii was not found in the skin lesion tissues. However, in the FNAB cytology examination of lymphocutaneus nodules we found spores of Sporothrix schenckii in the cytoplasma of histiocytes besides granuloma and infiltration of PMNs. Key words: sporothrix schenckii, histopathology, FNAB cytology.  Abstrak: Diagnosis sporotrikosis kulit dengan nodul limfokutan ditegakkan melalui pemerik-saan histopatologi pada lesi kulit dan sitologi biopsi aspirasi jarum halus pada nodul limfo-kutan. Kami melaporkan kasus sporotrikosis pada laki-laki berusia 63 tahun dengan papul-papul dan nodul-nodul eritematosa pada dorsum manus, antebrakium, dan brakium sinistra. Pemeriksaan histopatologi jaringan biopsi dari lesi kulit menunjukkan reaksi radang, gambaran granuloma, dan sel datia dalam dermis dan epidermis, dengan mikroabses disertai hiperplasia. Tidak ditemukan jamur Sporothrix schenckii dalam potongan jaringan histopatologi. Hasil pemeriksaan sitologi biopsi aspirasi jarum halus pada nodul limfokutan memperlihatkan adanya spora-spora jamur Sporothrix schenckii dalam sitoplasma sel-sel histiosit disamping  terdapatnya bentuk granuloma dalam infiltrat radang. Kata kunci: sporothrix schenckii, histopatologi, sitologi biopsi aspirasi jarum halus.

scholarly journals Cured primary hyperparathyroidism after fine-needle aspiration biopsy-induced parathyroid disappearance

2017 ◽  
Vol 2017 ◽  
Author(s):  
Elda Kara ◽  
Elisa Della Valle ◽  
Sara De Vincentis ◽  
Vincenzo Rochira ◽  
Bruno Madeo
Keyword(s):  
Primary Hyperparathyroidism ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Complete Disappearance ◽  
List Type ◽  
Fine Needle ◽  
Time Period ◽  
History Of

Summary Spontaneous or fine-needle aspiration (FNAB)-induced remission of primary hyperparathyroidism (PHPT) may occur, especially for cystic lesions. However, the disease generally relapses over a short time period. We present a case of PHPT due to an enlarged hyperfunctioning parathyroid that underwent long-term (almost 9 years) clinical and ultrasonographic remission after the disappearance of the lesion following ultrasound (US)-assisted FNAB. A 67-year-old woman with PHPT underwent biochemical and US examinations that confirmed the diagnosis and showed a lesion suggestive for parathyroid adenoma or hyperplasia. US-FNAB of the lesion confirmed its parathyroid nature by means of elevated levels of parathyroid hormone within the needle washing fluid. At the second visit, the patient referred slight neck swelling that resolved spontaneously in the days after the US-FNAB. At subsequent follow-up, the enlarged parathyroid was not found; it was visible neither with US nor with magnetic resonance imaging. Biochemical remission persists after 9 years. This is the first reported case of cure of PHPT after US-FNAB performed on a hyperfunctioning parathyroid resulting in its complete disappearance over a period of 9 years of negative biochemical and ultrasonographic follow-up. Learning points: Spontaneous or fine-needle aspiration-induced remission of primary hyperparathyroidism can occur. Both circumstances may present disease relapse over a variable time period, but definite remission is also possible even though long-term periodic follow-up should be performed. Parathyroid damage should be ruled out in case of neck symptomatology after parathyroid fine-needle aspiration or spontaneous symptomatology in patients with history of primary hyperparathyroidism.

scholarly journals Squamous Cell Carcinoma in the Third Eyelid of a Dog

2021 ◽  
Vol 49 ◽  
Author(s):  
Beatriz Crepaldi Aléssio ◽  
Juliana Paniago Lordello de Paula ◽  
Gustavo Gomes de Oliveira ◽  
Silvana Marques Caramalac ◽  
Alda Izabel de Souza ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
The Third ◽  
Needle Aspiration Cytology

Background: Squamous cell carcinoma is a malignant neoplasm that originates from the keratinized stratified squamous epithelium and predominantly affect light-skinned animals. In dogs, breeds such as American Staffordshire Terriers, white or speckled Bull Terriers, and Beagles have a higher predisposition. Squamous cell carcinoma presents in the skin, at slightly pigmented or hairy sites, especially in digits, but also may occur in the nasal planum, oral mucosa, and rarely, in the eye. Considering that few reports have been published on eye neoplasms, the aim of this paper is to describe a dog with a lesion in the third eyelid of his right eye which was diagnosticated with squamous cell carcinoma. Case: A 10-year-old male American Staffordshire dog was admitted to the Veterinary Medical Teaching Hospital of the Veterinary Medicine and Zootechnics College, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, Brazil with injury to the right eye. During the physical examination, there was also a non-adhered lump near the foreskin, measuring 1.5 cm in diameter. In addition, there was another lump in the third eyelid of the right eye, approximately 3 mm in diameter. Cytology of the dermal nodule was performed by fine-needle aspiration cytology; however, the sample was insufficient for cytological evaluation. Therefore, the animal was placed under general anesthesia for skin lump excision and for fine-needle aspiration cytology of the third eyelid nodule. The histopathological exam revealed high cellularity of epithelial cells, intense anisocytosis and pleomorphism, cytoplasmic basophilia and vacuolation, multiple evident nucleoli, and anisocariosis and coarse chromatin. These finds were compatible with squamous cell carcinoma, which was the same result suggested by fine-needle aspiration cytology of the third eyelid sample. Based on these results, the dog underwent a surgical procedure for enucleation and subsequent histopathological evaluation of the nodule in the third eyelid, which confirmed the squamous cell carcinoma diagnosis.Discussion: Squamous cell carcinoma is an extremely aggressive tumor with low metastatic potential, characterized by invasion of the dermis by proliferation of malignant epithelial cells from the prickly layer. It is most common in elderly animals, and American Staffordshires are among the breeds that are predisposed to develop this tumor. The clinical presentation is highly variable, depending on the tissue involved. In this case, the dermal nodule was an elevated area on the skin and the third eyelid nodule resembled an ulcerative mass. Cytological examination from the lesion located on the third eyelid, showed malignancies cytoplasmic changes frequently found in carcinomas such as anisocytosis, cytoplasmic basophilia, and cell pleomorphism. In addition, nuclear changes had also occurred, such as crass chromatin, multiple evident nucleoli, and multinucleated cells. A presumptive diagnosis was made based on cytology and was confirmed after biopsy and histopathological examination. Because it is uncommon in dogs, squamous cell carcinoma of the third eyelid may be misdiagnosed, delaying correct treatment, and accelerating the development of the tumor. Currently, various therapeutic approaches are available, such as surgical excision, electrosurgery, cryosurgery, radiation, and hyperthermia. The choice of treatment depends on the location and stage of the lesions. Surgical treatment should be aimed at removing sufficient tissue to leave surgical margins free of neoplastic cells.

Fine-Needle Aspiration Biopsy Features in a Case of Giant Cell Fibroblastoma of the Chest Wall

2001 ◽  
Vol 125 (8) ◽  
pp. 1091-1094
Author(s):  
Anirban Maitra ◽  
Charles F. Timmons ◽  
Momin T. Siddiqui ◽  
M. Hossein Saboorian
Keyword(s):  
Giant Cell ◽  
Chest Wall ◽  
Fine Needle Aspiration ◽  
Soft Tissues ◽  
Fine Needle Aspiration Biopsy ◽  
Giant Cells ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Fine Needle ◽  
Needle Aspiration Biopsy

Abstract Giant cell fibroblastoma is an unusual tumor of childhood, primarily occurring in the superficial soft tissues. We describe the fine-needle aspiration biopsy features of a case of giant cell fibroblastoma of the chest wall in a 3-year-old child. The aspirates comprised bland spindle to oval cells entrapped in a metachromatic matrix, accompanied by rare multinucleated giant cells with wreathlike nuclei. Although we were unable to render a definitive diagnosis on fine-needle aspiration biopsy, surgical resection of the mass established the diagnosis of giant cell fibroblastoma. We review the distinctive cytologic features of some common soft tissue tumors arising in this age group that may give rise to a diagnostic conundrum on fine-needle aspiration biopsy.

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