Search

A study of the clinico-cytologic findings of 62 primary palpable lesions located in the scalp is reported. Trichilemmal cyst (16 cases) followed by lipoma (8 cases) and benign melanocytic proliferation (4 cases) were the most frequent benign conditions (n = 45); basal-cell carcinoma (6 cases) and squamous-cell carcinoma (5 cases) were the most frequently aspirated malignant tumors (n = 17). In the cytologic category of benign lesions (n = 45), cytohistologic correlation was carried out in 19 cases and the cytohistologic agreement was 100%, except for the three actinic keratosis cases that were diagnosed as atypical epidermal lesions. Cytohistologic agreement was 100% in the 16 malignant lesions in which excisional biopsy was performed. Based on the findings reported here, fine-needle aspiration is indicated as the first-choice technique for the clinical evaluation of primary scalp lesions. Experience with cutaneous cytopathology is essential in order to be able to carry out this task., (Copyright 2001 Wiley-Liss, Inc.)

Various types of superficial and deep-seated lesions may occur in the hand, causing concern to the patient and posing diagnostic dilemmas to the clinician. A study was undertaken to evaluate the utility of fine-needle aspiration (FNA) or scraping for the diagnosis of palpable lesions located in the hand. From a clinico-cytologic point of view, lesions were classified as superficial (n = 41) or deep-seated (n = 66), and aspirates were categorized into five groups: benign without specific cytohistologic diagnosis, benign with specific cytohistologic diagnosis, atypical, malignant without specific cytohistologic diagnosis, and malignant with specific cytohistologic diagnosis. Out of 107 cases with aspirates adequate for cytologic evaluation, 85 had histologic correlation; in 22 cases, histologic confirmation was deemed unnecessary because of unequivocal cytologic findings and/or clinical workup. Sensitivity was 90.9%, specificity 100%, and efficacy 98%. Based on these findings, we believe that FNA or scraping may help in the clinical workup of patients with either superficial or deep-seated lesions located in this anatomic region., (Copyright 2000 Wiley-Liss, Inc.)

A retrospective reappraisal is made of the smears of 29 testicular germ cell tumors (TGCT) studied by FNA in which both orchiectomy specimens and histologic diagnoses were available. In 22 cases (75.86%) the yield was sufficient and contained cells suitable for cytologic diagnosis; in these 22 cases a diagnoses of malignancy was reached. In four cases (13.79%) the yield was sparse and a diagnostic cells were partially obscured by haemorrhage and necrosis; these cases were categorized as suspicious of malignancy. In these cases (10.34%) the yield was not suitable for cytologic evaluation because haemorrhage and necrosis hampered evaluation of diagnostic cells. The cytologic findings that enable a reliable diagnosis of TGCT are described and those cytologic features that may lead the less experienced cytopathologist into an erroneous diagnosis are discussed. Pure TGCT can be confidently diagnosed with FNA and mixed TGCT can be successfully diagnosed, although it is difficult to recognized every cytologic subtype observed in the histologic sections. Despite the advantages of FNA for the prompt diagnosis of TGCT, FNA can not fully replace the histologic diagnosis and should rather be considered as a helpful tool in the work-up of testicular tumours.

This is a retrospective reassessment of the most important cytopathologic features of 23 FNA smears with a cytologic diagnosis of panniculitis (PN). Patients were sent by clinicians. Clinical diagnoses were as follows: 16 suspicious of PN; three cutaneous metastases of an extracutaneous primary neoplasm; four with no clinical diagnosis. Thirteen cases were subsequently submitted to histopathologic study. The following cytoarchitectural patterns were found to be very useful for the cytologic diagnosis of PN: adipocytes intermingled with foamy histiocytes, donut-like granulomas, aggregates of adipocytes intermingled with plump histiocytes, a granular basophilic background forming a lattice-like pattern, and well-formed granulomas with or without multinucleated giant cells. Inflammatory cells could be seen combined with any of these cytoarchitectural patterns. FNA does not pretend to replace excisional biopsy as the diagnostic procedure for these entities but it is a very useful diagnostic tool in certain cases: for confirming the recurrence of PN previously diagnosed by histology, for evaluating the onset of subcutaneous nodules in patients with a non-cutaneous malignant primary neoplasm, for evaluating cutaneous nodules with no clinical suspicion, and for confirming a clinical diagnosis of PN and differentiating it from other entities that mimic PN clinically.

The smears of fine-needle aspirates corresponding to 137 histologically proven basal-cell carcinomas (BCCs) were reviewed. Satisfactory for evaluation were 127 smears; the remaining 10 were unsatisfactory. In 124 cases (97.6%), the cytologic diagnoses coincided with the histologic ones. The remaining 3 were false negatives, and the subsequent histologic correlation demonstrated superficial BCC missed by the needle. The cytologic criteria that permitted a diagnosis of BCC were: variable-sized and irregular-shaped cohesive epithelial clusters, round to oval monomorphic nuclei, bland chromatin pattern, and sparse cytoplasm. In 35 cases, a panel of antibodies was used in the smears and in the respective histologic sections. Epithelial clusters of BCC showed an intense and diffuse positivity for AE-3 and BerEP4, while UEAI and AE-1 were negative. Although HMB45 and S100-A tested negative in the epithelial clusters, a faint and sparse focal positivity for HMB45 and S-100A was seen in some clusters. This positivity is believed to correspond to just a few normal melanocytes and Langerhans cells trapped in the neoplastic epithelial clusters. In the histologic correlates, the same results were obtained, although HMB45 positivity was more conspicuous at the periphery of the neoplastic nests.