ABSTRACT
A 9-year-old girl with a history of a palpable multinodular hard mass in the right lobe of the thyroid gland was biopsied. On diagnosis of a papillary carcinoma, total thyroidectomy and right radical neck dissection were performed. Examination of frozen sections demonstrated metastasis in the right but not the left cervical lymph nodes. Imprint cytology revealed small papillary sheets of neoplastic cells with a high proportion of cytoplasmic inclusions and a few nuclear grooves. These nuclear details allowed a specific diagnosis of metastatic papillary thyroid carcinoma. Papillary thyroid carcinoma can be easily diagnosed by imprint cytology. In places such as small and country hospitals that do not have pathology laboratories, it can also be used successfully as an alternative to frozen section histology. The efficiency, simplicity and rapidity of this method make it a very useful procedure.
Subject(s)
Carcinoma, Papillary/pathology , Carcinoma, Papillary/secondary , Lymph Nodes/pathology , Thyroid Neoplasms/pathology , Biopsy, Needle , Carcinoma, Papillary/surgery , Child , Female , Humans , Immunohistochemistry , Lymphatic Metastasis , Neck , Sensitivity and Specificity , Thyroid Neoplasms/surgery , Thyroidectomy , Treatment OutcomeABSTRACT
A 63-year-old man presented with a three-month history of painless hematuria. A cystoscopic examination revealed a diffuse small nodulopapillary growth of the bladder mucosa. Biopsy resulted in the diagnosis of a transitional cell carcinoma (TCC), grade II. Therefore, total cystectomy with an ileal conduit was performed and the pathologic examination demonstrated a TCC grade II/III apparently confined to the mucosa. However, an ultrasonographic study carried out one year later revealed tumor masses in the pelvic cavity and the liver. FNA and needle biopsy of the liver were carried out and the diagnosis of a metastatic TCC was made from the former. Needle biopsy results pointed to a metastatic undifferentiated carcinoma, most likely originating from the TCC. The advantage of FNA is discussed. It is being used with increasing frequency to diagnose mass lesions in the liver and can identify metastatic tumors which have specific cytologic features that are different from primary liver tumor.
Subject(s)
Carcinoma, Transitional Cell/pathology , Carcinoma, Transitional Cell/secondary , Liver Neoplasms/pathology , Liver Neoplasms/secondary , Urinary Bladder Neoplasms/pathology , Biopsy, Needle , Carcinoma, Transitional Cell/surgery , Cystectomy , Humans , Immunohistochemistry , Magnetic Resonance Imaging , Male , Middle Aged , Sensitivity and Specificity , Urinary Bladder Neoplasms/surgeryABSTRACT
OBJECTIVE: To present experience with the cytologic diagnosis of pulmonary cryptococcosis in bronchial washings and bronchoalveolar lavage in human immunodeficiency virus (HIV)-positive patients in Thailand. STUDY DESIGN: The study group consisted of 54 HIV-positive patients admitted to the Faculty of Medicine, Srinagarind Hospital, during the period January 1992-June 1994. Bronchial washing and bronchoalveolar lavage specimens were studied for Cryptococcus neoformans by routine Papanicolaou and special staining methods. RESULTS: The Cryptococcus organism, an encapsulated yeast with a clear halo on Papanicolaou-stained smears, was found both extracellularly and in histiocytes in 4 of 54 (7.4%) cases. A definitive diagnosis was confirmed by positive staining of the capsular mucopolysaccharides with periodic acid-Schiff and Mayer's mucicarmine stain and of the cell wall with methenamine silver. Lung biopsy was performed in one case and revealed cryptococcosis. CONCLUSION: This study underscores the usefulness of cytologic screening in the detection of this opportunistic pulmonary infection. The cytopathologist and cytotechnologist should be alert for the presence of Cryptococcus in cytologic specimens from HIV-positive patients.
