Carcinoid tumor metastatic to breast diagnosed by fine needle aspiration. Case report and literature review.

Fine needle aspiration (FNA) biopsy was used to study a mass in the left breast in a patient with a previous history of an ileal carcinoid tumor and later lymph node metastases who presented with bilateral palpable breast masses. The FNA specimens showed the lesion to be a carcinoid tumor. The metastatic nature of the lesion was proven by positive restaining of FNA smears by both the Sevier-Munger technique (demonstrating abundant argyrophilic cytoplasmic granules) and the Fontana-Masson method (showing argentaffin cytoplasmic granules). The distinction between primary and metastatic carcinoid tumors of the breast is discussed, as is their origin and their differentiation from other malignancies of the breast.

Estrogen receptor determination in fine needle aspirates of the breast. Correlation with histologic grade and comparison with biochemical analysis.

Material obtained by fine needle aspiration (FNA) of 25 surgically removed breast carcinomas was tested for the immunocytochemical localization of estrogen receptor (ER) using the peroxidase-antiperoxidase method and a monoclonal antibody developed against human breast cancer ER. The results were compared to those obtained by the conventional biochemical analysis of cytosol protein. A semiquantitative relationship between the immunoperoxidase stain and the biochemical analysis suggests that cases in which greater than 70% of the cells stain and in which intense staining is present are likely to contain ER in a concentration of greater than 250 fmol/mg of cytosol. Less than 15% stained cells and an absence of intense staining is indicative of a concentration of less than 10 fmol/mg. In only one case was there a significant difference in positivity between the two methods, possibly as a result of a functional heterogeneity of the tumor cell population. Intense staining is strongly suggestive of a tumor of low histologic grade and was never seen in tumors with a high histologic grade or nuclear grade. The immunoperoxidase method of ER detection on material obtained by FNA is a semiquantitative means of selecting patients with breast cancer who are likely to respond to hormonal therapy. The method overcomes many important disadvantages of cytosol analysis and provides clinically significant information regarding the ER content and the degree of tumor differentiation.

Factors determining the degree of endometrial exfoliation and their diagnostic implications in endometrial adenocarcinoma.

Since the degree of endometrial exfoliation largely determines the ability of cytology to diagnose endometrial adenocarcinomas by the study of cervicovaginal smears, five features of their subsequent histologically diagnosed endometrial adenocarcinomas were studied in 28 patients whose smears contained endometrial cells. The surface area occupied by abnormal endometrium was found to be an important determinant in the degree of endometrial exfoliation. The tumor grade, endocervical involvement, pattern of growth and squamous-cell component were all factors that influenced cellular shedding. The extent of myometrial involvement did not affect the likelihood that an endometrial adenocarcinoma would be diagnosed cytologically prior to histologic examination.

Cytopathologic features of adenoid cystic carcinoma. Case report and literature review.

A case of primary bronchial adenoid cystic carcinoma in a 40-year-old white female is reported. Cytologic findings in a bronchial wash specimen obtained at the time of bronchoscopic examination are described, with an emphasis on correlation with the histologic features of the tumor. The literature is briefly reviewed with respect to the occurrence of primary adenoid cystic carcinoma in the bronchial tree.

Hürthle-cell tumor arising in the mediastinal ectopic thyroid and diagnosed by fine needle aspiration. Light microscopic and ultrastructural features.

The light microscopic and ultrastructural features of a Hürthle-cell tumor arising in the ectopic mediastinal ectopic thyroid and diagnosed by fine needle aspiration are presented. Although it lacked clear-cut cytologic features of malignancy, the tumor was clinically malignant, having metastasized to the lungs. Hürthle-cell tumors of the thyroid are unpredictable in their biologic behavior, and the absence of clinical and/or pathologic evidence of malignancy at the time of diagnosis is no guarantee of a benign outcome.

The combined use of cytology and colposcopy in enhancing diagnostic accuracy in preclinical lesions of the uterine cervix.

In an attempt to evaluate the accuracy of cytologic and colposcopic findings (alone and in combination) in detecting preclinical lesions of the uterine cervix, diagnoses made in 170 consecutive patients referred for colposcopic examination at Nassau Hospital because of an abnormal Papanicolaou smear were reviewed. We found that of the investigative methods available prior to biopsy, a combined cytologic and colposcopic evaluation is preferred since it is highly accurate in predicting the degree of severity of a lesion (84.6% of all cases reviewed) and, in our experience, eliminates the problem of false negatives, which are encountered when either method is used to the exclusion of the other.

Metastatic malignant fibrous histiocytoma in lung examined by fine needle aspiration: case report and literature review.

Malignant fibrous histiocytoma appears to be emerging as one of the most common soft tissue sarcomas of late adult life. Cytologic features of a metastatic malignant fibrous histiocytoma in the lung, examined by fine needle aspiration, are reported. Essentially, four cell types in various proportions were observed: spindled cells, pleomorphic giant cells, undifferentiated mesenchymal-type cells and rare signet ring "lipoblast-like" cells. There also were several huge hyperchromatic and often bizarre naked nuclei.