Frequency and characterization of celiac ganglia diagnosed on fine-needle aspiration

Introduction: Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) is frequently used to sample intra-abdominal lesions and lymph nodes. Celiac ganglia normally located near the celiac artery may be sampled during these procedures. The aim of this study was to determine the frequency of detection and cytologic findings of celiac ganglia diagnosed on FNA. Materials and Methods: A 14-year retrospective review of radiologic and endoscopic FNA cases involving the celiac region was performed. Cases in which ganglia were reported were further analyzed and slides reviewed. Results: A total of 354 patients underwent FNA of a suspected celiac lymph node (334 patients) or celiac mass (20 cases). In 9 of these patients (2.5%), ganglion cells were identified. These were identified in cases only after 2008 via EUS-guided FNA. Aspirates were hypocellular and bloody. Large ganglion cells were either sparsely dispersed or present in clusters. Ganglion cells had a low N: C ratio, granular cytoplasm with neuromelanin, and eccentric small round nucleus with a prominent nucleolus. One specimen had concomitant pancreatic adenocarcinoma. None of these cases had a false positive on-site adequacy assessment or final misdiagnosis. Conclusions: These data show that celiac ganglia may be infrequently encountered, especially with intra-abdominal EUS-guided FNA targeting nodes or masses near the celiac region. Therefore, cytologists should be aware of the possibility of finding ganglionic cells in EUS-guided FNA samples.

Cytomorphologic consideration in malignant ascites with renal cell carcinoma: A report of two cases

Effusions, especially peritoneal, are seen in less than 2% of patients with renal cell carcinoma (RCC). Since the tumor cells in RCC are bland and nondescript, the involvement of serous effusions is difficult to diagnose. An accurate recognition of malignant effusion and differentiation from reactive mesothelial cells is imperative. A 55-year-old male presented with gradually progressive ascites. Cytospin preparations from ascitic fluid showed reactive mesothelial cells admixed with few smooth-contoured clusters of cells with moderate cytoplasm, vesicular nuclei with prominent nucleolus. He had undergone nephrectomy for papillary RCC two years earlier. Another 36-year-old man underwent left nephrectomy for suspected RCC. Intra-operative ascitic fluid was sent for cytologic examination and showed numerous reactive mesothelial cells along with few clusters of cells with scant to moderate amount of cytoplasm, vesicular nucleus and a small nucleolus. Considering the histomorphology of the primary renal tumor in both cases, a cytologic diagnosis of malignant peritoneal effusion, morphologically compatible with RCC was rendered. RCC, due to its bland cytologic features, is easily overlooked in effusions. In a known patient, the cytopathologist must be extra vigilant to pick up the few cell clusters present in the fluid preparations and differentiate them from reactive mesothelial cells. A close inspection of the cytologic features and comparison with the histopathology of the primary tumor helps in making an accurate diagnosis.

Topical Review: Activated Remodeling and N-Methyl-D-Aspartate (NMDA) Receptors in Cortical Dysplasia

Cortical dysplasia is now recognized as one of the major etiologies causing intractable epilepsy in childhood. Dysplastic cortex displays cortical dyslamination, which is often associated with dysmorphic large neurons and less frequently with balloon cells. The dysmorphic large neurons are commonly located in the subcortical white matter and cerebral cortex, with enlarged nuclei with a single prominent nucleolus and showing aberrant cytoskeletal changes. I have shown that dysmorphic large neurons have several immature types of cytoskeletal proteins, such as the low-molecular-weight form of microtubule-associated protein 2 (MAP2) and MAP1B, which are involved in the outgrowth and modeling of neuronal processes in the immature brain. I have also reported that dysmorphic large neurons also have enhanced gene expression of growth-associated protein GAP43, which is a phosphoprotein enriched at presynaptic nerve terminals and is thought to be involved in axonal outgrowth and plasticity in synaptic connections. Finally, I have shown that the N-methyl-D-aspartate acid (NMDA) receptor R1 gene is up-regulated in the dysmorphic large neurons and nearly normal-sized neurons located in the dysplastic cortex. This evidence suggests that growth of neuronal processes and activated excitatory synaptic remodeling exist in the epileptic conditions of cortical dysplasia. ( J Child Neurol 2005;20:303—307).

Hairy Cell Leukemia Variant Developing in a Background of Polycythemia Vera

We report a case of hairy cell leukemia variant developing in a background of polycythemia vera in a 77-year-old man who presented with lymphocytosis and splenomegaly. Classic hairy cell leukemia in a patient with polycythemia vera has been reported previously, but hairy cell leukemia variant arising in a patient with polycythemia vera has never been described to the best of our knowledge. Initial testing of the peripheral blood showed circulating medium to large leukemic cells with large, centrally placed nuclei, each containing a prominent nucleolus, and some cells showed cytoplasmic projections. A bone marrow biopsy had marked myeloid and erythroid hyperplasia and interstitially distributed cells with a fried-egg appearance. We verified a monoclonal B-cell population by flow cytometric analysis, which revealed expression of bright CD11c, CD22, and CD103 expression, and a lack of CD25 expression. The patient received a 5-day course of cladribine and subsequently had a complete remission. Approximately 2 months later, he had a relapse and was treated with pentostatin; however, he had no clinical response and died.

Ultrastructure of cellular components of human trophoblasts during early pregnancy

Two cell types, the cyto- and syncytio-trophoblasts, were identified in human chorionic villi of 6-10 weeks' gestation. The intracellular organization of these cells was examined. Ultrathin sections of small pieces of chorionic villi revealed the presence of a multinucleate syncytiotrophoblastic layer, whose surface was covered with microvilli. The cytotrophoblasts, however, had a single large nucleus with a prominent nucleolus. An interesting feature of the basement membrane of these cells was the presence of aggregates of dark granules in samples of the earlier gestational age (6-8 weeks) and granular bodies having a dense outer ring and a translucent inner ring with a lucid central area in samples of 8-10 weeks' gestation. Both types of granules are mineralized and are assumed to perform a buffering role for maintaining the neutrality of the layer.

Die histologie en ultrastruktuur van die hepatopankreas van die bloukurper Oreochromis mossambicus

The histology and ultrastructure of the hepatopancreas of the Mozambique tilapia O. mossambicus are described. The liver is surrounded by a thin connective tissue capsule. The hepatocyte arrangement shows as lobules, with the hepatocyte cords that radiate and anastomose from a central vein. Borders of individual liver lobules do not show clearly, as do the few triads found in the liver of O. mossambicus. Each hepatocyte contains a single round nucleus with a prominent nucleolus. The rough endoplasmic reticulum appears in two or more rows around the nuclei and in close proximity to the plastnalemma of the hepatocytes. The remaining cytoplasmic organelles are scattered throughout the hepatocyte cytoplasm. The exocrine pancreas cells are centred around the portal veins. The nuclei of these cells are spherical and hasally situated in the cubiform to cylindriform cells. Well developed rough endoplasmic reticula - vesicular, tubular and circular in appearance - as well as secretory granules, apically situated in the cells, are present.

MDX mouse myopathy II: Degenerative changes in centronucleated fibers from mice of different ages

Ultrastructural features of centronucleated (regenerating) fibers of ‘mdx’ mice have been reported in three different papers and in all three, different features of these fibers were described in some detail. Thus, in one paper “abortive attempts at regeneration” in very young fibers, in another early degeneration of regenerating fibers and in the third paper “healthy” regenerating fibers, as well as degenerating myotubes were shown. We show the probable pathogenesis of degeneration of centronucleated fibers in ‘mdx’ mice.METHODS: Tibialis anterior muscles from 22-, 25-, 41-, 61- and 99-days-old C57BL/10ScSn/MDX mice were pinned on corkboard in a relaxed state, prefixed for 30 minutes in glutaraldehyde followed by routine processing for TEM.RESULTS: In a 41-days-old ‘mdx’ mouse a fiber which had apparently fully regenerated from a previous episode of necrosis is shown in FIG. 1. Since there are no pathological changes in this fiber, it will serve as a control. The nucleus has a fairly prominent nucleolus and there are no lesions in the myofibrils and the rest of the sarcoplasm.

The clinical significance of the morphological subdivision of diffuse "histiocytic" lymphoma: a study of 162 patients treated by the Southwest Oncology Group

We grouped 162 patients wtih advanced, diffuse histiocytic lymphoma (DHL) into various morphological subtypes to ascertain whether there were any significant differences in survival among them. These patients were staged and treated from 1972 to 1977 according to the protocols of the Southwest Oncology Group. Of the 159 patients on whom a consensus on the diagnosis was reached, 115 were classified morphologically as having large non-cleaved, 26 as B-immunoblastic, 9 as large cleaved, and 6 as T-immunoblastic. The 3 remaining patients did not fit any of these subtypes, but each had a single prominent nucleolus in most tumor cells (“prominent nucleolus” type). Morphological subdivision of DHL did not identify any subgroup of patients with a significantly longer survival, but clinical parameters such as stage, symptoms, and type of treatment significantly influenced survival times.

The clinical significance of the morphological subdivision of diffuse "histiocytic" lymphoma: a study of 162 patients treated by the Southwest Oncology Group

We grouped 162 patients wtih advanced, diffuse histiocytic lymphoma (DHL) into various morphological subtypes to ascertain whether there were any significant differences in survival among them. These patients were staged and treated from 1972 to 1977 according to the protocols of the Southwest Oncology Group. Of the 159 patients on whom a consensus on the diagnosis was reached, 115 were classified morphologically as having large non-cleaved, 26 as B-immunoblastic, 9 as large cleaved, and 6 as T-immunoblastic. The 3 remaining patients did not fit any of these subtypes, but each had a single prominent nucleolus in most tumor cells (“prominent nucleolus” type). Morphological subdivision of DHL did not identify any subgroup of patients with a significantly longer survival, but clinical parameters such as stage, symptoms, and type of treatment significantly influenced survival times.

Ultrastructural Studies on L1210 Cells Sensitive or Resistant to Actinomycin-D.

The L1210(V)gln- cell line, which requires glutamine for growth, was established as a suspension culture by Hutchison et al. (1) from an ascites tumor maintained in BD2F1 mice (C57BL X DBA/2). A variety of particles having the morphology of intracytoplasmic-A, type-B and type-C oncornaviruses have been observed in the solid, ascitic (2;3) and tissue culture forms(4;5;6) of the L1210 cells. A subline of the L1210(V)gln- line, 2000-fold resistant to actinomycin-D exhibits low tumorigenicity and is immunogenic inBD2F1 mice.Cells of the parent, drug-sensitive line are primarily of lymphoid morphology, i.e. spherical with a large central nucleus. Occasionally they have lobulated or multiple nuclei, marginated heterochromatin, and a single prominent nucleolus. Although some rough endoplasmic reticulum is visible in sensitive cells, the majority of polysomes are found free in the cytoplasm.