Fine needle aspiration of sclerosing lymphocytic lobulitis of the breast. A report of two cases.

BACKGROUND: Sclerosing lymphocytic lobulitis (SLL) was described in 1948 by Soler and Khardori as fibrotic disease of the breast with histologic features similar to those of Hashimoto's thyroiditis. Associations of this process with thyroiditis, artropathy and diabetes mellitus have been seen. CASES: We report the fine needle aspiration biopsy (FNAB) findings of two cases of SLL seen in our service. Both patients showed a breast nodule suspicious for malignancy. The cytologic changes vary according to the stage of the disease, from abundant lymphocytes and scanty fibrosis (case 1) to the presence of a few lymphocytes, epithelioid fibroblasts and significant sclerosis (case 2). CONCLUSION: The cytologic changes seen in FNAB are sufficient to indicate the diagnosis of SLL. The differential diagnosis has to be made with primary breast lymphoma, periductal or perilobular inflammation and different types of sclerosing breast lesions, depending on the stage of the disease.

Percutaneous fine needle aspiration biopsy cytology of the liver for staging small cell lung carcinoma. Comparison with other methods.

Fine needle aspiration biopsy (FNAB) is used routinely in the diagnosis of primary, benign, malignant and metastatic hepatic tumors. At our hospital, the staging protocol for small cell lung carcinomas and lymphomas requires biochemical determination of liver function, hepatic radionuclide analysis with 99Tc and abdominal echography (used also for FNAB guidance). We analyzed the effectiveness of these methods in 16 patients with a previous diagnosis of small cell lung carcinoma. They represented 22.5% of 71 patients on whom 142 FNABs of the liver were performed. Biochemistry was normal in 1 case of tumor and abnormal in 19 others in which all other determinations were normal. Echography was positive in 12 of the 16 cases; gammagraphy was abnormal in 11. FNAB of the liver therefore increased the sensitivity of the other procedures.

Fine needle aspiration cytology of granulomatous prostatitis.

The fine needle aspiration (FNA) cytologic findings are presented for 18 cases of granulomatous prostatitis (12 nonspecific, 5 tuberculous and 1 eosinophilic cases). These cases represented 19% of all prostatitis cases and 2% of all prostatic aspirates examined from January 1986 to December 1987. The cytomorphologic differences between the three types of granulomatous prostatitis are described, with emphasis on the differentiation between the nonspecific and specific varieties. The differential diagnostic features between reactive changes and well-differentiated adenocarcinomas of the prostate are also presented. The findings in these cases indicate that FNA cytology is a reliable procedure for the morphologic diagnosis of granulomatous prostatitis, which can clinically mimic prostatic carcinoma when it presents as a diffuse or nodular enlargement with increased consistency.

Fine needle aspiration cytology of soft-tissue lesions.

The use of fine needle aspiration (FNA) cytology was reviewed in 117 cases of soft-tissue lesions: 23 non-neoplastic lesions, 34 benign mesenchymal tumors and 60 histologically proven soft-tissue sarcomas. The soft-tissue sarcoma aspirates were classified according to their cytomorphology into five groups of possible histologic diagnoses. Difficulties were experienced in the correct diagnoses. Difficulties were experienced in the correct assessment of aspirates from low-grade malignancies. On the other hand, in high-grade malignant sarcomas and in recurrent or metastatic soft-tissue sarcoma, FNA cytology was useful in both the initial diagnosis of a new lesion (22 patients) and in the confirmation or exclusion of a suspected treatment failure (38 patients with recurrence or metastases). In the latter, FNA cytology supported the clinical data and reduced the number of repeat open biopsies. However, the final diagnosis of soft-tissue sarcomas should be based upon the histologic study of tissue sections.