Shelley I. Odronic

Solid tumor metastases to the pancreas diagnosed by FNA: A single-institution experience and review of the literature

Pancreatic fine‐needle aspiration (FNA) is useful for diagnosing pancreatic masses. This article describes the experience of a single institution with metastases to the pancreas sampled by FNA and provides a review of the literature.

Cytologic features of parathyroid fine-needle aspiration on ThinPrep preparations: Cytology of Parathyroid FNA on ThinPrep

Previous studies have provided cytologic criteria that aid in the recognition of parathyroid tissue on aspirate smears, including high cellularity, the presence of naked nuclei, loose 2‐dimensional clusters, and papillary architecture. However, to the authors knowledge, the cytomorphologic features of parathyroid fine‐needle aspiration (FNA) on liquid‐based preparations have not been previously described.

Primary gastric extra-uterine endometrial stromal sarcoma.

Endometrial stromal sarcoma (ESS) is an uncommon uterine neoplasm, but its occurrence as an extra-uterine primary (EESS) is exceedingly unusual, and the fine-needle aspiration (FNA) cytopathology of EESS is rarely described. We hereby present 2 women with primary gastric EESS whereby the FNA cytopathology of this rare entity showed a population of cytologically monotonous oval-spindle shaped cells. This cytopathology is correlated with the subsequent histopathology. EESS is another, albeit rare, diagnostic consideration along with gastrointestinal stromal tumor, schwannoma, glomus tumor, and leiomyoma of cytologically bland neoplasms of the stomach that can be encountered using endoscopic ultrasound-guided FNA biopsy.

Cocaine-induced microangiopathic hemolytic anemia mimicking idiopathic thrombotic thrombocytopenic purpura: a case report and review of the literature.

Our understanding of the pathogenesis of idiopathic thrombotic thrombocytopenic purpura (TTP) has increased, but remains incomplete, particularly with respect to cases of suspected TTP that are either unresponsive to therapeutic plasma exchange (TPE) or have normal ADAMTS13 (a disintegrin‐like and metalloprotease with thrombospondin type 1 motif 13) activity. A 53‐year‐old woman presented with severe anemia (hemoglobin 1.8 g/dL) and clinical and laboratory findings consistent with TTP in conjunction with acute cocaine use. The patient was treated with TPE until the pre‐treatment ADAMTS13 activity was reported as normal without evidence of an inhibitor. TPE was stopped and the patient continued to improve without treatment. This patients microangiopathic hemolytic anemia (MAHA) appeared to be secondary to cocaine use. The proposed pathogenesis is likely a combination of cocaine‐induced vasoconstriction, vascular damage, platelet activation, and procoagulation. This is the fifth published report of cocaine‐induced MAHA and to our knowledge the first with ADAMTS13 testing. J. Clin. Apheresis 29:284–289, 2014.

Pulmonary capillary hemangiomatosis associated with connective tissue disease: a report of 4 cases and review of the literature

Pulmonary hypertension (PHTN) can be seen in patients with connective tissue disease (CTD). The typical pathology associated with CTD is interstitial fibrosis and hypertensive pulmonary arteriopathy. We describe 4 patients with CTD and PHTN unexpectedly found to have pulmonary capillary hemangiomatosis (PCH) at explant after lung transplantation or autopsy. Pulmonary capillary hemangiomatosis is defined as a proliferation of capillaries in alveolar walls and can clinically cause PHTN. We detail the pathologic findings of PCH, describe the differential diagnosis, and present a review of the literature on the possible association of PCH with CTD. Although PCH may present clinically as PHTN, it is critical to differentiate between the typical CTD-associated interstitial fibrosis with hypertensive pulmonary arteriopathy and PCH because the treatment is different. We provide the largest case series to date and highlight the need for pathologists to have a high level of suspicion for PCH in patients with CTD.