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The majority of thyroid nodules in pediatric patients appear to be non-cancerous. Thyroid nodules are small, rounded masses that may be either cancerous or non-cancerous. Fine-needle aspiration biopsy was performed on 57 patients younger than 18 years old. Sixty-six samples were taken and evaluated. Seventy-seven percent of the samples were non-cancerous. Twelve percent of the samples were not able to be classified definitively. Eighteen percent of the nodules were cancerous. One cancerous nodule was initially misdiagnosed as non-cancerous. Fine-needle aspiration biopsy appears to be useful in determining whether thyroid nodules are cancerous or non-cancerous., Objective. The prevalence of thyroid nodularity in children has been estimated to be 1.8%. The reported prevalence of specific diseases which comprise these nodules is conflicting as evidenced by a reported range of malignancy of 2 to 50% in solitary nodules. In order to better classify pediatric (

Background: Human papillomavirus (HPV)–related squamous cell carcinoma (SqCC) of the oropharynx is an epidemiologically and clinically distinct form of SqCC that is associated with an improved prognosis. However, HPV‐related small cell carcinoma of the oropharynx is a rare and newly described variant that is associated with aggressive clinical behavior and poor outcomes. To date, fewer than 2 dozen reports of this entity exist in the literature, and there is no discussion of cytopathologic features. This article reports 6 cases and discusses the salient cytomorphologic findings, ancillary studies, and challenges when this entity is encountered. Methods: Anatomic pathology archives were searched to identify patients with a diagnosis of HPV‐related small cell carcinoma of the oropharynx. Medical records were reviewed to document the following: age, sex, smoking status, other relevant clinical history, primary location, treatment, and clinical outcome. Both p16 and high‐risk HPV in situ hybridization (ISH) studies were positive in at least 1 specimen from each patient. The pathologic diagnoses, cytomorphologic characteristics, immunocytochemical stains, and HPV ISH studies were reviewed and recorded for all available cases. Results: Six patients with 11 cytopathology specimens of HPV‐related small cell carcinoma of the oropharynx were identified. The mean age was 61.3 years, and all patients died with widely metastatic disease (mean, 23 months; range, 12‐48 months). Mixed small cell carcinoma and SqCC components were present in half of the cases. Conclusions: The identification of a small cell component can be reliably performed with cytology preparations and is crucial because this (and not the HPV status) determines the prognosis. Human papillomavirus–related small cell carcinoma of the oropharynx is a rare and newly described entity with an aggressive clinical course. This is one of the first studies of human papillomavirus–related small cell carcinoma of the oropharynx in cytology preparations. [ABSTRACT FROM AUTHOR]

Sinonasal tract (SNT) alveolar rhabdomyosarcoma (ARMS) are frequently misdiagnosed, especially in adults. Fifty-two adult (≥18 years) patients with SNT ARMS were reviewed and characterized by immunohistochemistry and molecular studies. Twenty-six females and 26 males (18-72 years; mean 43.2 years), presented after a short duration (mean 2.6 months) with a large (mean 5.5 cm) destructive nasal cavity mass, involving multiple contiguous paranasal sites (n = 46) and with cervical adenopathy (n = 41). The tumors showed an alveolar, nested to solid growth pattern below an intact, but often involved (n = 9) epithelium with frequent necrosis (n = 37), destructive bone invasion (n = 30), and lymphovascular invasion (n = 25). The neoplastic cells were dyshesive and dilapidated, with crush artifacts. Rhabdoid features (n = 36) and tumor cell multinucleation (n = 28) were common. Mitotic counts were high (mean 17/10 HPFs). The neoplastic cells showed the following immunohistochemical positive findings: desmin (100%), myogenin (100%), MYOD1 (100%), MSA (96%), SMA (52%), CAM5.2 (50%), AE1/AE3 (36%); other positive markers included S100 protein (27%), CD56 (100%), synaptophysin (35%), and chromogranin (13%). Overall, 54% show epithelial marker reactivity. Molecular studies showed FOXO1 translocations (81%) with PCR demonstrating PAX3 in 72.7% tested. Patients presented with high stage (IV 24; III 26) and metastatic disease (lymph nodes n = 41; distant metastases n = 25) (IRSG grouping). Surgery (n = 16), radiation (n = 41) and chemotherapy (n = 45) yielded an overall survival of 36.1 months (mean; range 2.4-286); 18 alive without disease (mean 69.6 months); 7 alive with disease (mean 11.0 months); 1 dead without disease (63.7 months); and 26 dead with disease (mean 18.5 months). SNT ARMS frequently present in adults as a large, destructive midline mass of short symptom duration, with high stage disease. The alveolar to solid pattern of growth of cells with rhabdoid-plasmacytoid features suggests the diagnosis, but epithelial immunohistochemistry markers are present in 54% of cases, leading to misdiagnosis as carcinomas if muscle markers are not also performed. Overall survival of 36.1 months is achieved with multimodality therapy, but 64% have incurable disease (16.9 months). Mixed anatomic site (p = 0.02) was a significant adverse prognostic indicator, while stage (0.06) and tumor size >5 cm (0.06) approached marginal significance. [ABSTRACT FROM AUTHOR]

Background: Nodular fasciitis (NF) is a benign, self-limited, fibroblastic/myofibroblastic proliferation that is diagnostically challenging, often mimicking a malignant process due to its rapid growth clinically and its high cellularity, mitotic activity, and variable/nonspecific cytomorphologic findings. Herein, the authors report what to their knowledge is the largest and first multi-institutional study of the cytomorphologic characteristics of NF by fine-needle aspiration (FNA).Methods: The pathology archives at The Johns Hopkins Hospital, The Ohio State University Wexner Medical Center, and Emory University Hospital were searched for soft tissue FNA cytology specimens of masses confirmed to be NF. The clinical history, actual FNA diagnosis, and cytomorphologic features were recorded by the authors.Results: A total of 34 patients were identified, 33 of which had material available for review. The mean age of the patients was 40 years (range, 1-80 years); 18 patients (52.9%) were male. The mean duration of symptoms was 3.75 months. Four cases (11.8%) and 2 cases (5.9%) were signed out as NF and "malignant neoplasm, NOS [not otherwise specified]," respectively. On average, cases were hypercellular (mean, 3.27/4). Thirty cases (90.9%) contained spindled morphology, whereas 30 cases (90.9%) and 28 cases (84.4%) contained cells with unipolar and curved cytoplasmic tails, respectively. Eccentric, ovoid, and spindled/elongated nuclei were observed in 31 cases (93.9%), 30 cases (90.9%), and 29 cases (87.9%), respectively. Nineteen cases (57.6%) lacked atypia.Conclusions: In the current study, the diagnosis of NF was suggested in nearly 40% of cases. Combining the clinical presentation with the most commonly described cytomorphologic features will appropriately triage the majority of cases, although uncertainty will remain in a significant number of cases. Cancer Cytopathol 2017;125:20-29. © 2016 American Cancer Society. [ABSTRACT FROM AUTHOR]