Utility of rapid staining of fine needle aspiration smears at the University Hospital of the West Indies

In a prospective study at the University Hospital of the West Indies, 187 fine needle aspiration cytology (FNAC) specimens, comprising 100 breast, 75 head and neck, and 12 miscellaneous specimens, were subjected to rapid Papanicolaou staining and immediate assessment. Inadequate aspirates were repeated, and all cases were also evaluated after routine Papanicolaou staining. Histologic and clinical follow-up data were obtained. The overall concordance between rapid and routine cytologic diagnoses ranged from 79 to 87 for the three specimen cohorts. Sensitivity and specificity values were similar for rapid and routine-stained slides and ranged from 80 to 100. There were no false positive or false negative diagnoses in the cases for which the outcome was known. Rapid staining of cytologic smears is a useful adjunct to the evaluation of aspirated material, improving adequacy rates and overall performance of the FNAC service, and should also result in significant savings in time and cost to patients

Angiomatosis of the breast in a male child. A case report with immunohistochemical analysis

Angiomatosis is a benign vascular lesion that has been described rarely in the breast. We describe a case in a seven-year-old boy of African descent who presented with progressively increasing, unilateral breast enlargement, the first such report in a male child. The patient underwent excisional biopsy of the breast mass followed by mastectomy. Pathologic examination revealed a diffuse proliferation of variably-sized, thin-walled vascular channels lined by flattened endothelium that showed negative immunohistochemical staining for von Willebrand factor, factor VIII-related antigen, CD34 and S-100 protein. There is no evidence of recurrence after 24 months of follow-up

Scleroderma with cardiac tamponade, hyperthyroidism and incidental papillary thyroid carcinoma

Cardiac tamponade and malignancy are associated with a poor prognosis in Progressive Systemic Sclerosis (PSS). We present the case of a 31-year-old African-Jamaican woman with PSS and a thyroid neoplasm who presented with cardiac tamponade requiring pericardiocentesis. Despite the presence of two poor prognostic markers, she has had a favourable postoperative course.

Granulomatous lobular mastitis. A case report and review of the literature

Granulomatous lobular mastitis is a rare, benign, inflammatory breast condition of unknown aetiology that can clinically mimic breast cancer. Awareness of this condition is important, as the appropriate specimens must be taken to confirm the diagnosis and to rule out an infectious aetiology. While surgical excision has been the traditional therapeutic modality, the most appropriate therapy seems to involve the use of corticosteroids, even in the case of recurrence.

Massive ascites secondary to severe endometriosis

Massive ascites is an unusual association with endometriosis. This case report is of such a condition in an Afro-Jamaican woman. The diagnosis was made at laparotomy and conservative treatment was adopted allowing for retention of reproductive function. Postoperative therapy was Goserelin, a Gonadotropin Releasing Hormone (GnRH) agonist, for six months. This relieved all of her symptoms. However, long term follow-up is needed, as recurrence is possible.

Malignant lymphoma of gastric mucosa-associated lymphoid tissue in Jamaica

The recently appreciated concept of Mucosa-Associated Lymphoid Tissue (MALT) and the characteristics of the lymphomas arising therein are discussed with reference to the clinical, histological and immunohistochemical features of the first four cases of gastric MALT lymphomas diagnosed at the University Hospital of the West Indies. These tumours are low-grade B-cell lymphomas, which may undergo high-grade transformation. They are aetiologically associated with Helicobacter pylori (H pylori) infection in the stomach and may be cured in the early stages with antibiotics. Our cases were diagnosed from gastrectomy specimens removed for suspected carcinoma. All were high-grade, and associated with H pylori; 3 cases presented as advanced disease. Documentation of the features of these lymphomas will increase awareness and earlier recognition.