Diagnóstico citológico de las recidivas tumorales de ameloblastoma: Presentación de dos casos clínicos / Ameloblastoma. Diagnosis by means of FNAB. Report of two cases

Introducción: Los ameloblastomas son los tumores odontogénicos más frecuentes del maxilar. A pesar de su aspecto citohistológico de benignidad, se comportan como tumores invasivos, recidivantes y con posibilidad de metastatizar. La P.A.A.F. es una prueba rápida e incruenta que proporciona un diagnóstico prequirúrgico evitando, en ocasiones, tomas biópsicas destinadas al diagnóstico. Presentamos las características citológicas de dos casos de recidiva yugal de ameloblastoma de rama mandibular diagnosticados por PAAF, así como su correlación citohistológica. Casos clínicos: Dos pacientes, una mujer de 36 años y un varón de 62 años, que acuden por tumoración mandibular de escasos meses de evolución. En ambos casos, la primera aproximación diagnóstica fue junto a los estudios radiológicos el estudio histológico de la masa tumoral. Tras la extirpación terapeútica,ambos casos recidivaron. El diagnóstico de las recidivas fueestablecido citológicamente mediante PAAF.Las extensiones citológicas mostraron un fondo granular con aislados macrófagos y células multinucleadas gigantes y una abundante celularidad epitelial de aspecto basaloide dispuesta en grupos cohesivos configurando imágenes de empalizada periférica, así como pequeños grupos de células de metaplasia escamosa. Discusión: La PAAF se considera como un método diagnóstico rápido, incruento y fiable en el diagnóstico del ameloblastoma. La citología de estos tumores revela los componentes de la lesión que, en general, son suficientes para llegar al diagnóstico de ameloblastoma, especialmente en casos de recidiva

Introduction: Ameloblastomas are the most frequent odontogenic tumors of the maxilla. In spite of their benign cytohistological appearance, they behave as invasive recurring tumors, with the possibility of metastasis. FNAB is a rapid, blood less test that provides a pre-surgical diagnosis, thus, on occasions avoiding the need for diagnostic biopsies. We present the cytological characteristics of two cases of jugal recurrences of mandibular ameloblastomas diagnosed by FNAB, as well as their cytohistological correlation. Clinical cases: Two patients, a 36-year-old woman, and a 62-year-old male who both attended with mandibular swelling of a few months evolution. In both cases the first diagnostic approximation was the histological study of the tumoral mass,together with the radiological studies. Following therapeuticextirpation both cases recurred. The diagnosis of the recurrences was established cytologically by means of FNAB. The cytologic smears revealed a granular background with isolated macrophages and giant multinucleate cells and an abundant epithelial cellularity of basaloid appearance arranged in cohesive groups forming images of peripheral palidasing, as well as small groups of squamous metaplastic cells. Discussion: FNAB is considered to be a rapid, blood less and reliable method for the diagnosis of ameloblastoma. The cytology of these tumors reveals components of the lesion that, in general, are sufficient for the diagnosis of ameloblastoma, especially incases of recurrence

Ameloblastoma. Diagnosis by means of FNAB. Report of two cases.

INTRODUCTION: Ameloblastomas are the most frequent odontogenic tumors of the maxilla. In spite of their benign cytohistological appearance, they behave as invasive recurring tumors, with the possibility of metastasis. FNAB is a rapid, bloodless test that provides a pre-surgical diagnosis, thus, on occasions avoiding the need for diagnostic biopsies. We present the cytological characteristics of two cases of jugal recurrences of mandibular ameloblastomas diagnosed by FNAB, as well as their cytohistological correlation. CLINICAL CASES: Two patients, a 36-year-old woman, and a 62-year-old male who both attended with mandibular swelling of a few months evolution. In both cases the first diagnostic approximation was the histological study of the tumoral mass, together with the radiological studies. Following therapeutic extirpation both cases recurred. The diagnosis of the recurrences was established cytologically by means of FNAB. The cytologic smears revealed a granular background with isolated macrophages and giant multinucleate cells and an abundant epithelial cellularity of basaloid appearance arranged in cohesive groups forming images of peripheral palidasing, as well as small groups of squamous metaplastic cells. DISCUSSION: FNAB is considered to be a rapid, bloodless and reliable method for the diagnosis of ameloblastoma. The cytology of these tumors reveals components of the lesion that, in general, are sufficient for the diagnosis of ameloblastoma, especially in cases of recurrence.

Psammomatous melanotic schwannoma localized in the mediastinum: diagnosis by fine-needle aspiration cytology.

The cytological characteristics are presented in a case of psammomatous melanotic schwannoma localized in the mediastinum, diagnosed by fine-needle aspiration cytology (FNAC), with later histological confirmation. This lesion affected a 38-year-old male, with a tumor measuring 5 cm in diameter located in the posterior mediastinum in contact with the spinal cord, with erosion of the adjacent vertebra (T5), that caused constant pain localized in the right scapular region with an evolution of several weeks. The cytological characteristics of psammomatous melanotic schwannoma are discussed, along with the histological and immunohistochemical features of this infrequent neural tumor, which aid in establishing a differential diagnosis. The importance of a correct histological diagnosis of this tumor is of particular clinical relevance after having been identified as one of the possible components of Carney's complex. This possibility demands a meticulous patient exploration in search of any other components that make up this complex, given the aggressive character of some of them. These lesions could, if not detected early enough, produce fatal consequences for the patient, fundamentally in those patients with cardiac myxomas. In this case, following an exhaustive clinical examination there was no pathology associated with this complex. It is therefore considered to be an isolated psammomatous melanotic schwannoma, and not a part of Carney's complex.

[The diagnostic value of liver aspiration puncture with echographic control]. / Valor diagnóstico de la punción aspiración hepática con control ecográfico.

OBJECTIVE: To correlate liver fine needle aspiration (FNA) diagnosis with histopathological diagnosis and clinical evolution. DESIGN: Retrospective analysis of liver FNA validity, evaluating sensitivity, specificity and predictive value of the method in correlation with the clinical evolution and biopsy results. RESULTS: Malignancy was diagnosed in 46 cases (20 hepatocarcinomas and 26 liver metastases), and benign lesions in 24 patients. Ten additional cases were excluded on the grounds of insufficient material or the impossibility of establishing clinico-histological correlation. There were 6 false-negatives and one false-positive. The overall accuracy of the method was 90% with a sensitivity of 88.2% and specificity of 94%. The positive and negative predictive values of the method were 97.8 and 75%, respectively. CONCLUSIONS: Liver FNA is efficient in cases of suspected liver tumoration. The technique proved particularly useful in the present series in diagnosing liver metastases, often allowing the establishing of tumor origin.

[Pulmonary inflammatory pseudotumor. Its diagnosis by fine-needle aspiration puncture]. / Seudotumor inflamatorio pulmonar. Diagnóstico mediante PAAF.

Cytological characteristics are reported in the case of a 20-years-old male with pulmonary inflammatory pseudotumor (PIP) diagnosed by fine-needle aspiration (FNA) and later confirmed histologically. The patient presented a large tumor on the lower lobe of the right lung with hemoptysis, hemothorax and secondary acute anemia. The clinical-pathological profile of PIP are reviewed, along with diagnostic problems arising from the morpho-structural characteristics of the disease.