Diagnostic Cytopathology最新文献

Multiple myeloma (MM) is a B-cell neoplasm that rounds 15% of all hematological malignancies. The typical clinical presentation of MM includes hypercalcemia, renal failure, anemia and bone lesion (CRAB). Effusions due to MM may occur due to secondary involvement of other organs and rarely are present at the initial diagnosis. Anaplastic myeloma (AMM) is rare morphological variant of multiple myeloma with predisposition of extramedullary affection. Herein, we describe a case of malignant plasmacytic ascites at disease onset of anaplastic multiple myeloma.

Mastocytosis is characterized by the proliferation of neoplastic mast cells in various organs, which can have either cutaneous or systemic presentation. Solitary cutaneous mastocytomas are most commonly seen in the pediatric age group but rarely present in adults. Histopathology of cutaneous mastocytoma is well described in the literature but only a few studies are available describing the cytomorphological features. We present a case of a 19-year-old female who presented with a 6-month history of a right supraclavicular single, 0.5 × 0.5 cm, well-defined, reddish-brown round nodule. The fine needle aspiration cytology (FNAC) smears were highly cellular showing monomorphic cells, predominantly dispersed singly and occasionally in small clusters. The cells were round to oval, with moderate cytoplasm containing coarse metachromatic granules. Toluidine blue stain and CD117 immunocytochemical stain confirmed the presence of mast cell granules. Based on the cytomorphology, staining, clinical history, and examination, a diagnosis of solitary cutaneous mastocytoma was rendered. FNAC plays a pivotal role in diagnosing mast cell tumors and even obviates the need for tissue biopsy in selected cases.

Oral exfoliative cytology has emerged as a valuable tool in the early detection of oral cancer and other systemic diseases. This review comprehensively examines the current applications and recent advancements in oral exfoliative cytology techniques. We analyzed published literature from the past decade, focusing on methodological improvements, diagnostic accuracy, and emerging applications. Key findings include: (1) Enhanced cell collection and preparation methods have significantly improved sample quality and diagnostic reliability. (2) Integration of molecular markers and DNA analysis with traditional cytomorphological assessment has increased diagnostic sensitivity and specificity for oral cancer detection. (3) Novel applications in systemic disease detection, including diabetes and iron overload disorders, demonstrate the expanding utility of this technique. (4) Computer-assisted analysis and deep learning algorithms show promise in improving diagnostic accuracy and efficiency. Despite these advancements, challenges remain in standardization and widespread clinical implementation. This review provides a critical evaluation of oral exfoliative cytology's current status and future potential in oral and systemic disease diagnosis.

Sarcomatous serous effusions are uncommon and diagnostically challenging. Dedifferentiated and pleomorphic liposarcomas are rare tumors in pleural effusions revealing highly pleomorphic tumor cells mimicking carcinoma, mesothelioma, melanoma, and other sarcomas. Hematothoracic effusions further complicate the cytologic diagnosis. Correct cytologic recognition is important. We report pleomorphic liposarcoma cytologically detected in effusion fluid in a 56-year-old man who presented with a massive unilateral pleural effusion. ThinPrep showed hemorrhagic effusion fluid characterized by lysed red blood cells, foamy macrophages, and siderophages intermixed with highly pleomorphic predominantly naked mononuclear and giant nuclei. The aggregated siderophages and vacuolated macrophages could be mistaken for tumor cells, whereas the bare nuclei may be missed as nonspecific degenerate changes. Cellblock sections showed highly pleomorphic mononuclear and multinucleated giant tumor cells with diagnostic lipoblasts, intermixed with foamy macrophages and siderophages. Cellblock immunocytochemistry showed staining for vimentin and S-100 protein in the tumor cells. Other lineage-specific immunomarkers were negative. CD68 and calretinin revealed frequent background macrophages and scarce mesothelial cells. The tumor cells were negative for MDM2 and CDK4. The entertained cytopathologic diagnosis was pleomorphic liposarcoma. Core needle biopsy was procured from the mass. The histopathologic features and immunoprofile of the tissue specimen matched the cytopathologic and immunocytochemical findings confirming the cytologic diagnosis of pleomorphic liposarcoma. Pleomorphic liposarcoma is an unexpected cytologically challenging finding in effusions, particularly when compounded by pitfalls introduced by hemosiderotic fluid. Attention to certain cytologic clues mitigate pitfalls. Cellblock is a valuable diagnostic tool when integrated with relevant negative and positive immunocytochemical markers.

Paragangliomas (PGs) are rare tumors that most commonly occur in the head and neck region and along the sympathetic chain. Fine-needle aspiration cytology is not commonly used for the diagnosis of PG due to the potential risk of hemorrhage and hypertensive crisis. As a result, limited studies describe the cytological features of PGs. In this case series, we will discuss the fine-needle aspiration features of three cases of extra-adrenal PGs. The cellular arrangement in smears was either singly scattered or loosely cohesive clusters. The cells were polygonal with pleomorphic nuclei, abundant granular cytoplasm, and bland chromatin. Cellblock showed two types of cells with focal acinar formation. Immunohistochemistry also confirmed the diagnosis. These results were also in keeping with radiological findings. Fine-needle aspiration cytology, along with clinicoradiological findings, can help in making an accurate preoperative diagnosis of PG.