Aylin Simsir

Glandular cell atypia on Papanicolaou smears: Interobserver variability in the diagnosis and prediction of the cell of origin

The 2001 Bethesda System recommended qualification of atypical glandular cells (AGC) to indicate the site of origin and separated endocervical adenocarcinoma in situ (AIS) from “AGC favor neoplastic” as a specific diagnostic category. To the authors knowledge, the literature evaluating the reproducibility of Papanicolaou (Pap) smear diagnosis of glandular cell abnormalities with emphasis on the cell of origin is limited. The aim of the current study was to investigate whether a variety of benign to neoplastic glandular lesions can be reliably classified on Pap smear with regard to diagnosis and cell of origin.

Mammary lesions diagnosed as papillary by aspiration biopsy: 70 cases with follow-up

The authors reviewed smears from fine‐needle aspiration biopsies (FNAB) diagnosed as “papillary lesions” and correlated the cytologic findings with the final diagnoses at excision. The objective of the current study was to determine the accuracy of FNAB diagnosis of a papillary lesion in distinguishing true papillary from nonpapillary proliferations and to evaluate cytologic criteria for the distinction of papillomas from true papillary malignancies and their cytologic look‐alikes.

Challenging breast lesions: pitfalls and limitations of fine-needle aspiration and the role of core biopsy in specific lesions.

Core biopsy rapidly replaced fine needle aspiration (FNA) over the past decade in evaluation of diseases of the female breast in many centers in the USA. We continue to heavily utilize FNA for the initial evaluation of breast masses in our institution. In this article, we discuss the cytologic and core biopsy findings in challenging breast lesions such as papillary and mucinous proliferations, fibroepithelial neoplasms, and low grade cancers. We specifically focus on the pitfalls and limitations of both diagnostic modalities in these selected specific lesions. Diagn. Cytopathol. 2012

Goblet cell carcinoid in ascitic fluid

Dear Dr. Bedrossian, Goblet cell carcinoid (GCC) is a rare appendiceal tumor exhibiting both neuroendocrine and glandular differentiation. This entity is also referred to as ‘‘adenocarcinoid,’’ ‘‘mucinous carcinoid,’’ ‘‘microglandular goblet cell carcinoma,’’ and ‘‘mixed adenocarcinoma carcinoid.’’ It is considered a separate entity from the classic appendiceal endocrine tumor and appendiceal adenocarcinoma in its behavior and prognosis. Medical literature is sparse in cytologic description of GCC both in effusion and fine-needle aspiration (FNA) cytology. The diagnosis of metastatic GCC in body cavity fluids may be especially challenging. Not only unfamiliarity with its cytologic features due to its rarity but also overlapping morphology with benign reactive mesothelial cells and histiocytes may cause difficulties in arriving at an accurate diagnosis. Here, we present a case of GCC in a 67-year-old female who complained of abdominal and rectal pain, and bloating. Abdominal and pelvic CT showed minimally enlarged left ovary, pelvic ascites and multiple small omental nodules measuring up to 3 mm consistent with carcinomatosis. The preoperative laboratory tests demonstrated an elevated cancer antigen (CA) 125 and carcinoembryonic antigen (CEA). With a preoperative diagnosis of probable ovarian cancer, the patient underwent a laparoscopy. On laparoscopy, there was carcinomatosis involving the anterior abdominal wall, omentum, mesentery, liver, small bowel, and bilateral fallopian tubes and ovaries. The appendix was large, firm, and bulky suggesting an appendiceal primary. An appendectomy and bilateral salpingoophorectomy along with staging biopsies were done. Ascitic fluid was drained. Surgical specimen and the drained ascitic fluid were submitted for pathologic examination. Cytologic Findings