Swati Dighe

Cytology of Ileal Conduit Urine in Bladder Cancer Patients

OBJECTIVE To study the cytomorphology of urine obtained from the ileal conduit and to determine its utility and identify the pitfalls. STUDY DESIGN Urine specimens from 469 cases of suspected or proven bladder cancer received over a period of 5 years were analyzed in the cytology laboratory. In 35 cases, total bladder resection was followed by ileal conduit reconstruction. The follow-up cytologic analysis of these 35 ileal conduit cases formed the basis of this study. RESULTS There was absence of urothelial cells in all but 2 cases. The smear predominantly showed small, scattered intestinal mucosal cells with pyknotic nuclei, extensive karyorrhexis and numerous bacteria. In 2 cases, cytology proved superior to endoscopy and radiology in detecting recurrent disease. We had 2 false negative cases, and the negativity was attributed to sampling errors. There was 1 false positive case in which 3-dimensional clusters of intestinal columnar cells were erroneously diagnosed as adenocarcinoma. CONCLUSION Urine obtained from ileal conduit specimens shows a smear picture that is different from that of specimens from the bladder. Thus, it is imperative to understand the difference between the cytomorphology of bladder urine and ileal conduit urine, to minimize the pitfalls and increase diagnostic utility.

Has Urine Cytology a Role to Play in the Era of Fluorescence in Situ Hybridization

OBJECTIVE To determine the efficacy of urine cytology as a diagnostic tool and in follow-up of patients with urinary bladder cancer. STUDY DESIGN From 951 cases, 1,831 urine specimens were collected in a 5-year period (2000-2004). Six hundred fifty-two cases were suspected to have primary bladder cancer and formed the basis of the study. The final diagnosis was based on histology. When histology was not available, clinical or radiologic findings formed the basis for the final diagnosis. RESULTS We had 173 false negative and 6 false positive cases in our series, giving an overall sensitivity of 82% and specificity of 96%. The main reason for false negativity was screening error, noticed in low grade urothelial carcinoma. False positivity was due to inflammatory atypia and polyomaviral cytopathic changes. CONCLUSION The sensitivity and specificity in our study compared well with those in the world literature. Urine cytology can be successfully used as a primary diagnostic tool and also as a follow-up modality as the cystoscopically occult malignancy can be detected easily.

Pulmonary non-Hodgkin's lymphoma (NHL) of diffuse large B-cell type with simultaneous humeral involvement in a young lady: an uncommon presentation with cytologic implications.

A bronchogenic carcinoma, almost invariably, presents as a lung mass. Primary pulmonary lymphomas are rare. We report an unusual case of a pulmonary non‐Hodgkins lymphoma (NHL) with simultaneous involvement of the right humerus in a 37 year old lady. Bronchial lavage smears showed atypical cells with irregular nuclear membranes raising a suspicion of a hematolymphoid tumor, over a small cell carcinoma that was the closest differential diagnosis. Biopsy from the lung mass and from the lesion in the humerus showed an identical malignant round cell tumor with prominent apoptosis. On immunohistochemistry (IHC), tumor cells were diffusely positive for leukocyte common antigen (LCA), CD20 and MIB1 (70%), while negative for cytokeratin (CK), epithelial membrane antigen (EMA) synaptophysin, chromogranin, neuron specific enolase (NSE), CD3, and CD10. Diagnosis of a pulmonary NHL of diffuse large B‐cell type with involvement of the humerus was formed.

Collection devices for cervicovaginal cytology: a comparison.

OBJECTIVE To compare cervicovaginal smears obtained by a cotton-tipped swab with those obtained by cervix brush and modified Ayre spatula. STUDY DESIGN A combined cervicovaginal smear was collected from 100 women using 3 different collection devices: cotton-tipped swab, cervix brush, and modified Ayre spatula. In each patient a set of 3 smears was collected by the same cytotechnologist using all 3 devices in random order. Smears were evaluated using parameters mandatory for an optimal smear: evenly dispersed, well-preserved, adequate cells from the transformation zone. The cost and availability of the collection devices were also considered. RESULTS The swab was the most effective device in obtaining thin, evenly spread, adequate, well-preserved smears as against the cervix brush and Ayre spatula. The pickup of abnormal cells was similar with the cotton-tipped swab and cervix brush, while the Ayre spatula failed to yield high grade squamous intraepithelial lesions, atypical glandular cells of undetermined significance and adenocarcinoma cells. The cotton-tipped swab proved to be the most cost effective. CONCLUSION A properly prepared cotton-tipped swab is an inexpensive, readily available, nontraumatic collection device that yields smear of optimal quality.

Scrape cytology in ophthalmology: Our experience with three cases

The aim was to describe the use of scrape cytology as a procedure for the preliminary diagnosis of suspicious lesions in case of three patients. The first patient was diagnosed with sebaceous gland carcinoma of the upper lid, second patient had squamous cell carcinoma (SCC) of the bulbar conjunctiva, and the third patient had SCC of the skin of medial canthus of eye. In this article, we have discussed the history of evolution of cytology briefly. Different types of cytology procedures as well as advantages and disadvantages of each procedure have also been discussed. We have described the procedure of taking scrape specimen and further processing in brief. The article emphasizes the role of scrape cytology in initial diagnosis, treatment plan, prognosis, and subsequent follow-ups in patients of ocular surface tumor.

Reviewers And Consultants, Vol. 54, 2010

Fadi W. Abdul-Karim Pedro P. de Agustín Måns Åkerman Mousa A. Al-Abbadi Syed Z. Ali Patricia Alonso de Ruiz Karen M. Atkison Silvana Audy-Jurkovic R. Marshall Austin Ulrik Baandrup Zubair W. Baloch Markus Bangerter Oralia Barboza Quintana Aasmund Berner George G. Birdsong Thomas A. Bonfiglio Mathilde E. Boon Lukas Bubendorf Jorge Campos R. de C. Tien-Chun Chang Guangchun Chen Edmund S. Cibas Terence J. Colgan Luiz Martins Collaco Brian T. Collins William N. Crabtree Yahya Daneshbod Dilip K. Das Mina Desai Pranab Dey Wenancjusz M. Domagala Liu Dongge Antonio Ducrot-Schinini Jaroslava Dus̆ková Hormoz Ehya Yener S. Erozan Canan Ersöz Guido Fadda Annabelle Farnsworth Peter N. G. Fitzgerald Brendan T. Fitzpatrick Daniel Fontaine Kim R. Geisinger Claude Gompel Ricardo González-Cámpora Zenon Gonzalez-Romero Roberta M. Goodell Mai Gu Prabodh K. Gupta Raj K. Gupta Xhevdet Harasani Amanda Herbert Anders Hjerpe Yajue Huang Lucrecia T. Illescas Rohit Jain Matías Jiménez-Ayala So-Young Jin William W. Johnston David B. Kaminsky Kusum Kapila Harubumi Kato Ruth L. Katz Karim Khetani Ui-Soon Khoo Bryan Knight Tadao K. Kobayashi Leopold G. Koss Helen A. Koutselini Rainer Kraft Leena Krogerus Sow-Hsong Kuo Hiroyuki Kuramoto Gladwyn Leiman Marianne Lidang Oscar Lin Virginia A. LiVolsi Britt-Marie Ljung The editors and publisher are grateful to the following individuals for their assistance in evaluating manuscripts for publication in the journal. It is only through their efforts that Acta Cytologica is able to maintain the high scientific standards for which it is known.