Diagnosis of Lymphoma Using Fine-Needle Aspiration Biopsy and Core-Needle Biopsy: A Single-Institution Experience.

OBJECTIVE: The objective is to study the efficacy of fine-needle aspiration biopsy (FNAB) and core-needle biopsy (CNB) in the diagnosis of lymphoma in a single institution. STUDY DESIGN: We retrospectively reviewed 635 FNAB/CNB cases performed in our institution to rule out lymphoma during a 4-year period and collected the relevant clinical and pathological information for statistical analysis. RESULTS AND CONCLUSIONS: This cohort comprised 275 males and 360 females, with a median age of 57 years. Among the 593 cases with adequate diagnostic materials for lymphoma work-up, 226 were positive for lymphoma, 286 were negative for lymphoma, and 81 were nondiagnostic. Each case had an FNAB, and 191 cases also underwent a CNB. The subclassification rate according to the WHO (2008) was 67% overall, 81% for the FNAB with CNB group, and 40% for the FNAB group. In the FNAB with CNB group, the subclassification rates for cases with and without a history of lymphoma were not significantly different. A definitive diagnosis of lymphoma relied on ancillary studies, but was not affected by location, or the needle gauge of CNB. Follow-up data revealed a high diagnostic accuracy of FNAB with CNB. In conclusion, the use of FNAB and CNB with ancillary studies is effective in providing a definitive diagnosis of lymphoma in our experience at the Northwell Health System.

Two-tiered subdivision of atypia on urine cytology can improve patient follow-up and optimize the utility of UroVysion.

BACKGROUND: The annual incidence of urothelial carcinoma continues to increase, and it is projected that greater than 70,000 new cases will occur in the year 2015. However, as much as 23% of cytologic specimens will demonstrate some degree of atypia without meeting the criteria for urothelial carcinoma and thus will be reported as atypical. METHODS: The authors conducted 2 laboratory information searches and 1 survey. In total, 311 patients who had atypical cytology-biopsy pairs available were identified from the initial data search. The second data search identified 942 patients who had fluorescence in situ hybridization (FISH) results available. RESULTS: There was fair agreement between FISH results and cytology results (κ = 0.34; 95% confidence interval, 0.27-0.41). The analysis did not reveal any benefits of using additional atypical subcategories beyond the 2 suggested in the literature. It was determined that 2 strategies would provide an optimal balance: standardizing patient management and facilitating the adoption of universally recognized templates. CONCLUSIONS: When combining cytology and the 2-tiered atypical classification system with FISH testing, a marked increase in sensitivity and an accompanying decrease in specificity were observed compared with either test individually. Thus, highly sensitive FISH testing may help to identify high-risk patients among those in the group with uncertain atypical findings.

Laryngeal myxoma: a case report and review of the literature.

Myxomas are a rare benign neoplasm of uncertain mesenchymal cell origin, typically involving the heart. Laryngeal myxomas are uncommon, and are usually misdiagnosed as laryngeal polyp. To the best of our knowledge, there are only nine reported cases in the English literature. We report a case of a laryngeal myxoma presenting clinically as a left vocal cord polyp in a 77 year old male, and review the literature related to this rare entity.

Malignant rhabdoid tumor of the kidney in a child: report of a case with recurrence in the contralateral kidney.

BACKGROUND: Malignant rhabdoid tumor (MRT) of the kidney is a rare and aggressive neoplasm with a controversial histogenesis. Although their immunohistochemistry may be diverse, the rhabdoid phenotype and mutations of the INI1 gene are consistently exhibited by MRTs regardless of their location. CASE: MRT recurred in the contralateral kidney in a 12-month-old child within 6 months after the initial histologic diagnosis, nephrectomy and autologous stem cell transplant. The presence of widespread metastases at the time of the recurrence precluded any further chemical and surgical diagnostic or therapeutic intervention. CONCLUSION: To the best of our knowledge, only a few cases describing the cytologic diagnosis of MRT of the kidney in a child have been reported. This case illustrates the usefulness of cytologic diagnosis in an MRT recurrence.

Rosai-Dorfman disease. Report of a case presenting as a midline thyroid mass.

To the best of our knowledge, this is the only reported case of isolated involvement by Rosai-Dorfman disease (RDD) of small, anterior cervical-midline lymph nodes, clinically presenting as a thyroid mass. Thyroid parenchymal involvement by RDD has been reported in only 3 cases in the literature. The present case shows involvement of RDD of a pretracheal and thyroid isthmic lymph node in a 38-year-old woman. The progressively enlarging, anterior neck mass was diagnosed as "lymph node" on a fine-needle aspiration biopsy specimen and subsequently interpreted to be an isthmic cyst on ultrasonography. A magnetic resonance imaging scan revealed foci of nodularity in the thyroid isthmus and pretracheal lymph node. Excisional biopsy of the 2 masses revealed typical features of sinus histiocytosis with massive lymphadenopathy in the lymph node. Review of the patient's previous fine-needle aspiration biopsy specimens also revealed the presence of similar features. Currently, the patient is well and has no other manifestation or recurrence of RDD.