Fine needle aspiration cytology of primary non-Hodgkin's lymphoma of the tongue. A case report.

BACKGROUND: Fine needle aspiration cytology (FNAC) of extranodal non-Hodgkin's lymphoma of the tongue has rarely been described. CASE: A 47-year-old male was referred to the cytology laboratory for FNAC of a 3-cm-diameter swelling on the dorsum of the tongue, with a primary clinical diagnosis of soft tissue tumor. FNAC smears showed discrete, monomorphic, round to oval cells with scanty, deep blue cytoplasm. The nuclear margin was regular, with occasional prominent nucleoli and fine nuclear chromatin. The background showed many lymphoglandular bodies. The cells were strongly positive for leukocyte common antigen. A cytologic diagnosis of high grade non-Hodgkin's (NHL) was offered and subsequently confirmed by histopathology. CONCLUSION: Primary NHL of the tongue is relatively rare. As there are no characteristic clinical features of extranodal NHL of the tongue, FNAC may be useful for rapid diagnosis and management of such cases.

Stapes surgery in a residency training program.

OBJECTIVES: Determine parameters for successful stapedectomy and whether this procedure can be performed safely by residents in a teaching hospital. STUDY DESIGN: Retrospective analysis of techniques and results for 71 stapedectomy procedures. MATERIALS AND METHODS: Charts were reviewed for technique, audiological test results, complications, operative time, and anesthetic used. RESULTS: Overall, closure of the air-bone gap at 10 dB was achieved in 87% of patients. Use of general anesthesia and a laser-assisted, small-fenestra technique allowed residents to complete more operations. No severe sensorineural hearing loss was noted. CONCLUSIONS: Residents can safely and successfully perform stapes surgery using a laser-assisted, small-fenestra technique.

Incus and stapes footplate simulator.

Prosthesis placement in stapes surgery is difficult to master. Although temporal bone dissection is an important adjunct to operative experience and anatomic knowledge when training residents to perform this procedure, the high cost and scarcity of temporal bones available for teaching purposes limit their convenience as teaching tools. Therefore, to augment training of residents, the authors developed an inexpensive, easily constructed middle ear simulator made from a disposable drinking cup, toothpicks, and a tongue depressor. The device is used with a microscope and ear instruments to manipulate, place, and crimp stapes prostheses. Improved surgical skills can lead to better surgical results, and this middle ear simulator can help to improve otologic surgical skills by giving residents the opportunity to practice techniques necessary to master stapes surgery.

Fine needle aspiration cytology diagnosis of male breast lesions. A study of 185 cases.

OBJECTIVE: To study the fine needle aspiration (FNA) cytologic features of male breast lesions and to determine the efficacy of FNA cytology in the diagnosis of these lesions. STUDY DESIGN: During a five-year period (July 1988-June 1993), 188 males with breast lesions were investigated by fine needle aspiration cytology (FNAC). Slides were available for review in 185 of these cases. RESULTS: Gynecomastia was the most common lesion (132 cases), followed by benign tumors and cysts (16 cases), carcinoma (6 cases) and inflammatory lesions (5 cases). In 26 cases the smears were considered inadequate. The cytologic features of gynecomastia included cohesive sheets of bland cells (100.0% of cases), bipolar bare nuclei (76.5%) and columnar cells (38.6%). Mild nuclear atypia was observed in seven cases. The cytologic features consisted of dyshesive groups of ductular cells with moderate to severe nuclear atypia and absence of bare nuclei as well as columnar cells. The benign tumors and cysts included lipomatous lesions (10 cases), spindle cell tumors (3 cases) and epidermal inclusion/pilar cysts (3 cases). Histology was done in 25 cases. Diagnostic accuracy of FNAC for gynecomastia, benign tumors and malignancy was 100.0%, 100.0% and 66.7%, respectively. The only discrepant case was a carcinoma, diagnosed as highly suspicious on the cytologic specimen.