Fine needle aspiration of metastatic adult granulosa cell tumor of the ovary: a case report.

BACKGROUND: Granulosa cell tumors (GCTs) of the ovary are low grade ovarian malignancies with a predilection for late recurrences in the pelvic cavity and occasionally distant metastases. Fine needle aspiration (FNA) can be used to detect such recurrences accurately based on unique cytologic and immunohistochemical features. CASE: A 5-cm, retrocaval mass at the level of the kidneys was detected in a 63-year-old woman who had a diagnosis of adult GCT (AGCT) of the ovary 18 years earlier and a local recurrence 5 years prior to this admission. The FNA of the retrocaval mass displayed small tumor cells with scant cytoplasm arranged in small aggregates and isolated cells. Coffee bean-like longitudinal nuclear grooves and microfollicular structures with amorphous material resembling Call-Exner bodies were not readily identified. Cytohistologic correlation with the patient's previous biopsies and positive immunohistochemical staining reaction with estrogen receptor, progesterone receptor and inhibin confirmed the recurrence of AGCT, thus avoiding unnecessary surgical interventions for diagnostic purposes. CONCLUSION: For accurate interpretation of cytologic findings of recurrent GCT, proper clinical history, cytohistologic correlation with prior biopsies and a positive immunohistochemical reaction with inhibin are of vital importance.

Iron pill-induced tumefactive mucosal injury of the hypopharynx.

Iron pill-induced mucosal injury of the airways with massive necrosis and stricture of the lower airways is known to occur, but symptomatic injury of the hypopharyngeal mucosa secondary to therapeutic oral iron ingestion has not been described. We report iron-sulfate-induced mucosal injury of the hypopharynx in a patient receiving therapeutic oral iron supplementation. The patient presented with dysphagia when swallowing pills, but not when eating or drinking. Imaging studies and clinical examination revealed an ulcerated and protuberant hypopharyngeal mass. Histology showed mucosal ulceration with deposits of extracellular crystalline iron particles. The histologic changes were identical to those seen in patients with "iron pill" gastritis.

Fine needle aspiration cytology of ALK1(-), CD30+ anaplastic large cell lymphoma post renal transplantation: a case report and literature review.

Post transplant lymphoproliferative disorders (PTLD) complicates the course of 0.3 to 3% of renal transplant patients receiving immunosuppression. Epstein-Barr virus (EBV) related non-Hodgkin's lymphomas of B-cell type is more common than those of T-cell origin. CD30 positive Anaplastic Large Cell Lymphoma (ALCL) is a Non-Hodgkin's lymphoma (B or T cell type) that accounts for a small percentage of PTLD's. ALCL of T-cell type are a spectrum of disease ranging from primary cutaneous to systemic nodal ALCL. The systemic nodal ALCL is further subdivided into anaplastic lymphoma kinase-1 (ALK-1) positive or negative. ALK-1 protein is a gene fusion product of translocation (2;5) and carries prognostic implications. We present an unusual manifestation of ALK-1 negative CD30 positive ALCL in a post renal transplant patient in FNA cytology with all supportive adjuvant studies and differential diagnoses and review the cytology literature on this topic.

Verrucous carcinoma of the endometrium: case history, pathologic findings, brief review of literature and discussion.

BACKGROUND: Verrucous carcinoma is a rare condition. A defined disease of the oral cavity, larynx, esophagus, skin, vulva, vagina and cervix. But a verrucous carcinoma arising from the endometrium without evidence of cervical malignancy or endometrial adenocarcinoma is extremely rare. CASE: A 67-year-old G2P2 menopausal patient that was referred for consultation 1 year after presenting with vaginal bleeding to her gynecologist who subsequently underwent several endometrial biopsies where the pathological findings were repetitively similar: papillary squamous proliferation, cytologically bland with low mitotic activity but extensive proliferation. A hysterectomy with bilateral salpingo-oophorectomy was performed. The final histologic examination revealed a squamous cell carcinoma of endometrium, verrucous and well differentiated, and there was no cervical invasion identified. CONCLUSION: This is a rare form of endometrial cancer with apparent favorable prognosis that must be considered when squamous cells are identified on endometrial samplings.