Fernando Schmitt

Glassy Cell Carcinoma of the Uterine Cervix

BACKGROUND: Glassy cell carcinomas of the uterine cervix are poorly differentiated carcinomas composed of cells with a large, round to oval nucleus containing one or multiple prominent nucleoli, finely vacuolated eosinophilic to amphophilic cytoplasm and distinct cell borders. These cells occur in sheets and chords, with fibrovascular septae presenting a mixed inflammatory infiltrate. This neoplasm has a poor response to radiotherapy and a worse prognosis than the usual types of adenocarcinoma and squamous cell carcinoma. There are few reports on the cytologic and histopathologic features of this neoplasm. CASE: A 56-year-old woman presented with a large, exophytic cervical tumor. Exfoliative cytology showed clusters of cells and single cells with large, round to oval nuclei, with one or multiple nucleoli and moderate to large, finely granulated cytoplasm with distinct cell borders. The background of the smears had a polymorphous inflammatory infiltrate, necrotic debris and proteinaceous material. A high mitotic rate was observed, as were rare bizarre and atypical multinucleated cells. There was no evidence of koilocytes. These findings were highly suggestive of glassy cell carcinoma and were confirmed by the histologic and immunocytochemical findings, with positivity for cytokeratin (MNF116), vimentin and carcinoembryonic antigen and negativity for HMB-45. CONCLUSION: Glassy cell carcinoma of the cervix presents a cytologic picture that can be highly suggestive of the diagnosis in typical cases; however, in difficult cases ancillary techniques, such as immunocytochemistry, as well as histologic findings might confirm the diagnosis.

Ancillary Studies in Urinary Cytology

In the last two decades, different markers and diagnostic assays have been developed to overcome limitations of urinary cytology and improve the timely detection of urothelial carcinoma (UC). Among ancillary tests that can be used on cytological preparations, namely cell-based tests UroVysion® Fluorescence in situ Hybridization (U-FISH; Abbott Laboratories, Abbott Park, IL, USA) and ImmunoCyt/UCyt+® (uCyt; Diagnocure Inc, Quebec, Canada) have been approved by the U.S. Food and Drug Administration (FDA) for diagnosis of UC in patients with hematuria and/or monitoring for tumor recurrence in patients previously diagnosed with UC. The pre-analytical procedures, technique, and evaluation of U-FISH including imaging and automation are described, followed by discussion on the performance of the assay. U-FISH is used for the determination of neoplasia after an interpretation of atypical urinary cytology or finding residual neoplastic cells after intravesical bacillus Calmette-Guerin (BCG) treatment. This seems to be the most important indication. uCyt is another promising diagnostic assay; however, further validation studies are needed.

Ancillary Studies for Salivary Gland Cytology

A precise cytological classification of salivary gland tumors based on cytomorphology alone is possible for many of the commonly encountered lesions. However, there are challenges for the cytologic diagnosis of some entities. Ancillary tests have become invaluable tools that assist in refining our cytologic diagnoses, and recent advances have improved the diagnostic accuracy of salivary gland fine-needle aspiration (FNA), leading to better patient management. A subset of tumors has been characterized cytogenetically by the presence of specific and recurrent translocations. These translocations and their resulting fusion oncogenes and oncoproteins can be used as diagnostic markers in salivary gland FNA. In this chapter, we describe the ancillary techniques and several currently available ancillary markers for salivary gland FNA.

Contents Vol. 58, 2014

M.A. Al-Abbadi, Dammam U. Baandrup, Hjoerring Z.W. Baloch, Philadelphia, Pa. G.G. Birdsong, Atlanta, Ga. B. Bode-Lesniewska, Zurich J.-P. Bogers, Antwerp A. Bondi, Bologna M.E. Boon, Lieveren L. Chen, Phoenix, Ariz. D. Chhieng, New Haven, Conn. B. Cochand-Priollet, Paris B.T. Collins, St. Louis, Mo. P. Dalquen, Basel D.K. Das, Safat L. Di Bonito, Triest C.U.S. Dinesh, Dharwad J. Dušková, Prague H. Ehya, Philadelphia, Pa. G. Fadda, Rome W.C. Faquin, Boston, Mass. A. Farnsworth, North Ryde, N.S.W. P. Firat, Istanbul B.T. Fitzpatrick, Camden, N.J. K.R. Geisinger, Winston-Salem, N.C. R. González-Cámpora, Seville S.E. Greening, Philadelphia, Pa. P.K. Gupta, Philadelphia, Pa. M. Henry, Rochester, Minn. Y. Huang, Philadelphia, Pa. P. Ip, Hong Kong K. Kapila, Kuwait W.E. Khalbuss, Pittsburgh, Pa. I. Kholova, Tampere B. Knight, Carlton, Vic. T.K. Kobayashi, Shiga J.F. Krane, Boston, Mass. G. Leiman, Burlington, Vt. O. Lin, New York, N.Y. V.A. Livolsi, Philadelphia, Pa. B.-M. Ljung, San Francisco, Calif. V. Mahovlic, Zagreb P.M. Michelow, Johannesburg D.R. Mody, Houston, Tex. M. Nasioutziki, Th essaloniki J.F. Nasuti, Bridgeport, Conn. R. Nayar, Chicaco, Ill. B. Önal, Ankara M. Pusztaszeri, Geneva T. Sauer, Nordbyhagen S. Savic, Basel I. Shabalova, Moscow M.T. Siddiqui, Atlanta, Ga. J.F. Silverman, Pittsburgh, Pa. J.H.F. Smith, Sheffi eld L. Şkoog, Stockholm E. Szekely, Budapest E.M. Tani, Stockholm G. Tse, Hong Kong L. Vass, Kistarcsa D.C. Wilbur, Boston, Mass. B. Yang, Cleveland, Ohio G.C.H. Yang, New York, N.Y. M.F. Zakowski, New York, N.Y. Editor-in-Chief