Cytopathology in the diagnostic appraisal of uncommon malignant neoplastic lesions.

Cytology and fine needle aspiration (FNA) cytology are accepted means of diagnosing and typing of common forms of malignant tumors. However, their usefulness for diagnosing less common neoplasms is not clearly established and this study was designed to examine this. We report four unusual cases of patients with malignant neoplasms in which cytology and fine needle aspiration cytology or aspiration biopsy (FNAC, FNAB) contributed significantly in establishing the diagnosis. These cases facilitate the diagnostic capabilities of cytology over a wide spectrum of neoplasms including rare lymphoproliferative disorders and carcinomas.

THE PROGNOSTIC SIGNIFICANCE OF P53, BCL2 AND MIB1 EXPRESSIONS RELATED WITH OTHER CLINICOPATHOLOGICAL VARIABLES IN SEROUS OVARIAN CARCINOMAS. A CLINICOPATHOLOGICAL STUDY IN PERITONEAL FLUIDS.

OBJECTIVE: The first cytological study examining the expression of P53, BCL2 and MIB 1 expressions in correlation with other clinicopathological parameters in ascitic fluids of patients with serous ovarian carcinomas. MATERIALS AND METHODS: Fifty women 35-75 years old were diagnosed cytologically and confirmed histologically after operation in the University Hospital of Crete. All carcinomas were serous type and eight(8) of grade I, eighteen (18) of grade II and twenty two (22) of grade III. All carcinomas were staged according to the Figo criteria. Fifteen (15) were of Figo stage III and thirty five (35) were of Figo stage IV. For p53 and bcl-2, staining was evaluated on a semiquantitative scale depending on the number of cells showing positivity. For MIB1, the percentage of positive nuclei was calculated. Main outcome measure(s): The expression of P53, BCL2 and MIB 1 (Ki 67) correlated with tumor grade and Figo stages were estimated by chi-square (χ2). RESULTS: The expression of P53 and MIB1 were found to be statistically significant (p < 0.005) correlated with Figo stage and tumor grade. A statistical significant correlation was also found between BCL2 expression and tumor Grade ( p < 0.005) but not between BCL2 expression and Figo Stage. The study found a high expression of P53 (64%) and MIB1 (72%) and an expression of BCL2 (48%) in ascitic fluid of patients with ovarian carcinoma. A statistically significant correlation between P53 and MIB1 expression correlated with tumor grade and Figo stage (p < 0.005) and a statistically significant correlation between BCL2 expression and tumor grade but no with the Figo stage was found (p < 0.005). There was a positive correlation between P53 and MIB1. No significant association was found between P53 and BCL2 expression or MIB1 labeling index. CONCLUSION(S): Our data show significant differences in the expression of these markers in ovarian tumors and suggest a possible role for these tumor-associated genes as supplemental tools in prognosis and further definition of the biologic potential of these tumors.

Primary effusion lymphoma with aberrant T-cell phenotype in an iatrogenically immunosuppressed renal transplant male: cytologic diagnosis in peritoneal fluid.

Primary effusion lymphoma (PEL) is an unusual class of non-Hodgkin's lymphoma that develops in body cavities, without associated mass lesions. It has been linked to human herpes virus 8 (HHV-8), an etiological factor of Kaposi's sarcoma. Although PEL is a B-cell lymphoma, the neoplastic cells are usually of the "null" phenotype by immunocytochemistry. The relative infrequency of this entity, the absence of wide casuistic allowing a better characterization, and its unfavorable outcome, strongly support the need of a deeper knowledge. We report the clinico-biological findings of a 49-year-old male who was iatrogenically suppressed patient for 29 years because of renal transplantation. This case was diagnosed cytologically as peritoneal PEL and confirmed histologically on peritoneal biopsies. The immune status for both HHV-8 and Epstein-Barr virus (EBV) was evaluated and showed positive immunostaining only for the former. The combination of the immunocytochemistry results with the existence of a clonal rearrangement in the immunoglobulin heavy chain gene (identified by PCR) was compatible with the diagnosis of PEL. The presence of T-cell markers was consistent with the diagnosis of PEL with an aberrant T-cell phenotype.