Bahiyah E. Haji

Cytomorphological spectrum in scar endometriosis: a study of eight cases

Objective:  Endometriosis due to ectopic endometrial tissue that responds to hormonal stimulation and is extremely rare in a surgical scar appearing in 0.1% of women who have undergone Caesarean section. Fine needle aspiration cytology (FNAC) can be a valuable diagnostic aid in the evaluation of these subcutaneous abdominal masses.

Hodgkin's lymphoma: Diagnostic difficulties in fine-needle aspiration cytology

It is commonly believed that cytodiagnosis of Hodgkins lymphoma (HL) is much easier than that of non‐Hodgkin lymphoma (NHL). However, recognition of certain NHL subtypes with Reed‐Sternberg (R‐S)‐like cells and results of immunohistochemical studies point to the contrary. To study the limitations of cytology in diagnosis of HL, fine‐needle aspiration (FNA) smears of 130 lymphoma or suspected lymphoma cases were reviewed. Initial and reviewed cytodiagnoses were compared with histopathology in 89 cases. Immunocytochemical and immunohistochemical studies were performed in 56 and 59 cases, respectively. Among histologically diagnosed HL cases, definitive cytodiagnosis of HL (initial as well as reviewed) was significantly less frequent than cytodiagnosis of NHL among histologically diagnosed NHL cases (P = 0.0328 and = 0.0001, respectively). On the other hand, cytologically diagnosed HL/NHL cases were significantly more frequent in the former group (P = 0.0001 and = 0.0018, respectively). ALCL and TCRBCL were the two NHL subtypes which created confusion with HL in FNA smears. Twenty‐one cytohistological concordant HL cases and equal number of discordant cases were compared. When compared with discordant group, the patients in concordant group were significantly younger (P = 0.045). Hodgkin/Hodgkin‐like cells and typical R‐S cells were significantly more frequent in FNA smears of the concordant group (P = 0.0478 and = 0.0431, respectively). Immunocytochemical and immunohistochemical studies showed good correlation with histological diagnosis of HL. It is suggested that proper interpretation of cytologic features, together with use of immunocytochemical parameters can help in reducing the margin of error in cytodiagnois of HL. Diagn. Cytopathol. 2009.

Cytomorphology of hyaline-vascular Castleman's disease: A diagnostic challenge

Objective:  Hyaline‐vascular Castlemans disease (CD) is difficult to diagnose on fine needle aspiration and may be mistaken to be a lymphoreticular malignancy because of the presence of large cells having nuclei showing atypical features. The cytomorphological findings in three histopathologically documented cases of hyaline‐vascular CD were evaluated to a set of cytomorphological criteria which could help in the identification of this condition on aspirate smears.

Cytomorphological features of metastatic mammary lobular carcinoma in cervicovaginal smears: report of a case and review of literature

The most common extragenital tumours metastasizing to the female genital tract are breast and gastrointestinal carcinomas. The ovaries are commonly affected (75–80%) while the uterus is less often involved (10%) and in the rare case where the uterus is affected, it is not uncommon to find co-existing ovarian disease. Malignant cells of extragenital origin are found only exceptionally in cervicovaginal (CV) smears and when present usually indicate widespread metastasis. Ng et al. in a review of 600 000 cellular samples from the female genital tract found 66 cases of extrauterine malignancy – the primary site was predominantly ovarian (42.1%) followed by gastrointestinal tract (19.8%), fallopian tube (7.5%), pancreas (6.1%), urethra (4.5%), breast (4.5%) and peritoneal mesothelium (3.0%). In a retrospective analysis of 33 extrauterine carcinomas with positive Pap smears the ovary and fallopian tube (46%) dominated as the primary site followed by breast and gastrointestinal tract (17% each). Scattered reports of metastatic melanoma, transitional cell carcinoma, myeloma, leukaemia and lymphoma have also been reported. Review of the literature revealed 19 reported cases of breast carcinoma detected on CV smears of which five were reported as lobular carcinoma. At the time of detection of metastasis in the CV smear the breast primary was known in three cases and detected subsequently in two cases. The aim of this paper is to report the cytopathological features of metastatic lobular carcinoma of the breast first detected in a CV smear and review the findings of the five previously reported cases.

Cytomorphological and immunocytochemical study of non‐Hodgkin's lymphoma in pleural effusion and ascitic fluid

Introduction:  Non‐Hodgkins lymphoma (NHL) is often complicated by pleural effusion and ascites. The present study is an attempt to categorize the lymphomatous effusions according to the WHO classification, using archival material.

Fine Needle Aspiration Cytology of Breast Masses in Children and Adolescents

Objective To study the distribution and efficacy of fine needle aspiration cytology (FNAC) in the diagnosis of breast lesions in pediatric and adolescent patients. Study Design From January 1993 to December 2006, the cytology reports of 1,404 breast aspirates (178 males and 1,226 females) performed on children and adolescents (ranging from 1 to 21 years) were reviewed. Of these 41, 179, 506 and 678 aspirates belonged to the age group 1-<12, 12-<16, 16-< 19 and 19-21 years, respectively. Results The morphologic spectrum seen in females was inflammatory lesions (4%), benign ductal cells (20%), ductal hyperplasia (0.6%), papillary lesions (0.7%), benign neoplasms (69%), suspicious cytology (0.3%) and cancer (0.3%). Of the benign neoplasms, 98% (831 of 851) were fibroadenomas, with 12 cases of phyllodes (benign), 5 cases of lipoma and 3 cases of adenoma. There were 3 cases of malignancy (2 adenocarcinoma and 1 non-Hodgkins lymphoma). Only 3% of the male breast aspirates provided a diagnostic challenge, while 89% of them showed benign ductal cells. Conclusion FNAC of children and adolescent breast masses is helpful and can reduce the need for open surgery to prevent later deformity. The aspirates are mostly benign and can be managed conservatively.

T-cell-rich B-cell lymphoma (TCRBCL): limitations in fine-needle aspiration cytodiagnosis.

Exclusive reports on fine needle aspiration (FNA) cytodiagnosis of T‐cell‐rich B‐cell lymphoma (TCRBCL) are scarce in literature. This report reflects the diagnostic difficulties associated with cytodiagnosis of this rare variant of diffuse large B‐cell lymphoma. The study is based on 11 cases with age ranging from 16 to 63 years and a median of 50 years. Male to female ratio was 6:5. Ten cases presented with lymphadenopathy and one had lymphadenopathy as well as extranodal solid tumor. The initial cytodiagnosis was suggestive of TCRBCL in one case, TCRBCL/Hodgkins lymphoma (HL) in three cases, TCRBCL/HL/anaplastic large cell lymphoma (ALCL) in two cases, TCRBCL/ALCL in one case, and TCRBCL/non‐Hodgkin lymphoma (NHL) T‐cell/ALCL in one case. There was also a cytologically diagnosed HL case, which on review turned out to be HL/TCRBCL. Histopathological diagnosis was HL in all these nine cases. There were two histologically diagnosed TCRBCL cases during this period, with cytodiagnoses of NHL other than TCRBCL in one and HL in the other. While highlighting the difficulties associated with the cytodiagnosis of TCRBCL, this study conveys a word of caution that adequate immunocytochemical studies should be performed before diagnosing this rare neoplasm with a varied cytomorphology. Diagn. Cytopathol. 2012.

Subject Index Vol. 52, 2008

Analytical and Quantitative Cytology and Histology: Volume 29, Number 6 (December 2007), 2008; 52:114–116 Analytical and Quantitative Cytology and Histology: Volume 30, Number 1 (February 2008), 2008;52: 255–258 Analytical and Quantitative Cytology and Histology: Volume 30, Number 2 (April 2008), 2008;52: 373–376 Analytical and Quantitative Cytology and Histology: Volume 30, Number 3 (June 2008), 2008;52:505– 508 Analytical and Quantitative Cytology and Histology: Volume 30, Number 4 (August 2008), 2008;52: 631–634 Analytical and Quantitative Cytology and Histology: Volume 30, Number 5 (October 2008), 2008;52: 736–738 Acid-fast bacilli Role of Modified Bleach Method in Staining of Acid-Fast Bacilli in Lymph Node Aspirates. (Gangane et al), 2008;52:325–328 Adenocarcinoma CK5/6 in Effusions: No Difference Between Mesothelioma and Pulmonary and Nonpulmonary Adenocarcinoma. (Dejmek), 2008;52: 579–583 Cytology of Pseudomyxoma Peritonei Associated with Well-Differentiated Appendiceal Adenocarcinoma. (Siddaraju et al), 2008;52:391–394 (Letter) Diagnosis of Linitis Plastica–Type Gastric Adenocarcinoma by Endoscopic Ultrasound-Guided Fine Needle Aspiration: A Case Report. (Carter et al), 2008;52:725–728 Improved Identification of Malignant Cells in Serous Effusions Using a Small, Robust Panel of Antibodies on Paraffin-Embedded Cell Suspensions. (Grefte et al), 2008;52:35–44 Adenocarcinoma, clear cell Clear Cell Carcinoma in a Background of Endometriosis: Case Report of a Finding in a Midline Abdominal Scar 5 Years After a Total Abdominal Hysterectomy. (Rust et al), 2008;52: 475–480 Adenoma Cytologic Features of Pulmonary Alveolar Adenoma. (González et al), 2008;52:739–740 (Letter) Adenoma, microcytic Preoperative Fine Needle Aspiration Cytology Diagnosis of Microcystic Adenoma of the Pancreas: Fact or Fiction? A Report of 2 Cases. (Fitzhugh et al), 2008;52:240–246 Adenoma, pleomorphic Chondromyxoid Fibroma of the Mandible: A Diagnostic Pitfall on Aspiration Cytology of Parotid. (Daneshbod and Khademi), 2008;52:636–638 (Letter) Fine Needle Aspiration Biopsy of Pleomorphic Adenoma and Adenoid Cystic Carcinoma of the Lacrimal Gland. (Siddaraju et al), 2008;52:515– 517 (Letter) Adenoma, pleomorphic metastazing Pleomorphic Adenoma of the Parotid Gland Metastasizing to the Scapular Region: A Case Report. (Ghosh et al), 2008;52:733–735 Adnexa Cytologic Features of Primary Malignant Tumors of Skin and Adnexae. (Prayaga et al), 2008;52: 702–709 Adolescent Fine Needle Aspiration Cytology of Breast Masses in Children and Adolescents: Experience with 1,404 Aspirates. (Kapila et al), 2008;52:681–686 Adult T-cell leukemia/lymphoma Diagnostic Considerations in Prolymphocytes in Pleural Fluid: A Case Report. (Anand et al), 2008; 52:251–254 Africa Into Africa: Cytology for One World. (Kaminsky), 2008;52:399 Alcian blue Cytology of Pseudomyxoma Peritonei Associated with Well-Differentiated Appendiceal Adenocarcinoma. (Siddaraju et al), 2008;52:391–394 (Letter) Analytical and Quantitative Cytology and Histology

Contributors Index Vol. 52, 2008

Abascal-Agorreta M (see Vera-Alvarez et al). 2008;52: 264–266 (Letter) Abdali K (see Shamsi et al). 2008;52:187–190 Abdul-Karim FW (see Farag et al). 2008;52:294–296 Abnet CC (see Pan et al). 2008;52:14–23 Abraham EK (see Ramadas et al). 2008;52:396–398 (Letter) Adán A (see Saro et al). 2008;52:87–90 Afarid M (see Mostaghni et al). 2008;52:597–601 Aisner S (see Fitzhugh et al). 2008;52:240–246 Akbulut M, Zekioglu O, Kapkac M, Erhan Y, Ozdemir N. Fine Needle Aspiration Cytology of Glycogen-Rich Clear Cell Carcinoma of the Breast: Review of 37 Cases with Histologic Correlation. 2008;52:65–71 Akbulut M, Zekioglu O, Ozdemir N, Kapkac M. Fine Needle Aspiration Cytology of Mammary Carcinoma with Choriocarcinomatous Features: A Report of 2 Cases. 2008;52:99–104 Aktepe F (see Tokyol et al). 2008;52:235–239 Al-Abbadi M (see Vella et al). 2008;52:377–378 (Letter) Al-Abbadi MA (see Feng et al). 2008;52:434–438 Al-Agha OM, Khader SN, Cajigas A, Blank W, Grafstein N, Seymour AW. Fine Needle Aspiration of Urethral Recurrence of Urothelial Carcinoma After Radical Cystectomy Presenting as a Perineal Mass: A Case Report. 2008;52:94–98 Al-Ayadhy B (see Kapila et al). 2008;52:681–686 Al-Mosawy FA (see Kapila et al). 2008;52:681–686 Al-Sebeih K (see Palmieri et al). 2008;52:691–696 Aledavud A (see Daneshbod et al). 2008;52:387–389 (Letter) Ales A (see Terčelj et al). 2008;52:584–590 Almeida JD, Lima CF, Brandão AAH, Cabral LAG. Evaluation of Staining Methods for Cytologic Diagnosis of Oral Lesions. 2008;52:697–701 Altay M (see Demir et al). 2008;52:309–312 Alvarez-Santín C. Endometrial Adenocarcinoma: Prevention and Early Diagnosis. 2008;52:748 (Book Review) Amadori PL (see Bonzanini et al). 2008;52:541–548 Amano S (see Komatsu et al). 2008;52:591–596 Ambaye AB (see Sherman et al). 2008;52:659–664 Anand M, Sharma S, Kumar R, Raina V. Diagnostic Considerations in Prolymphocytes in Pleural Fluid: A Case Report. 2008;52:251–254 Ang L-C (see Keith et al). 2008;52:260–263 (Letter) Angeloni C (see Maccallini et al). 2008;52:568–574 Anshu (see Gabhane et al). 2008;52:354–356 Anshu (see Gangane et al). 2008;52:325–328 Anshu (see Gangane et al). 2008;52:619–622 Antonelli C (see Maccallini et al). 2008;52:568–574 Apice G (see Fulciniti et al). 2008;52:612–618 Arabi MA (see Daneshbod et al). 2008;52:268–270 (Letter) Argüelles M (see González et al). 2008;52:490–494 Armbruster C, Bernhardt K, Setinek U. Pulmonary Tumorlet: A Case Report of a Diagnostic Pitfall in Cytology. 2008;52:223–227 Aron M (see Mathur et al). 2008;52:740–743 (Letter) Arora VK (see Mathur et al). 2008;52:740–743 (Letter) Arundhati (see Garbyal et al). 2008;52:204–206 Arundhati (see Ghosh et al). 2008;52:733–735 Ashfaq R (see Patino et al). 2008;52:718–720 Ashraf MJ (see Azarpira et al). 2008;52:220–222 Ashraf MJ, Azarpira N, Vasei M, Tavakol MH, Khademi B. Thyroid Paraganglioma: Diagnostic Pitfall in Fine Needle Aspiration Biopsy. 2008;52: 745–747 (Letter) Assiri AH (see Mokhtar et al). 2008;52:169–177 Asthana AK (see Ghosh et al). 2008;52:733–735 Athanassiadou P, Grapsa D. Value of Endoscopic Retrograde Cholangiopancreatography–Guided Brushings in Preoperative Assessment of Pancreaticobiliary Strictures: What’s New? 2008;52:24–34 Azarpira N (see Ashraf et al). 2008;52:745–747 (Letter) Azarpira N, Ashraf MJ, Shishegar M. Fine Needle Aspiration Findings in Angiofollicular Hyperplasia with Eosinophilia: A Case Report. 2008;52:220–222