We encountered a case of bronchial carcinoid in which the brushing cytology diagnosis was assisted by the presence of a capillary network. An atelectatic X-ray shadow in the left lung field of a 52-year-old man was identified as a nodule obliterating the B8 bronchus. Brushing cytology of the nodule revealed numerous tufts of a capillary network along with small round cells with mild nuclear atypia. Although biopsy was non-contributory, an assumption of carcinoid was made. The diseased lobe with the nodule was resected and typical carcinoid was diagnosed histologically. In cytological diagnosis, supporting components of the disease morphology may also provide important clues to the diagnosis.
The imprint cytologic features of a myelolipoma of the adrenal glands are reported. The patient, a 42-year-old man, noticed abdominal fullness and pain in the left upper quadrant. The imprint smear of the surgically resected tumor consisted of loosely cohesive groups of mature adipose tissues and isolated hematopoietic tissues containingerythroid, granulocytic and megakaryocytic elements. Histologic sections revealed a mass composed largely of mature adipose tissue with scattered hematopoietic tissue containing erythroid, granulocytic and megakaryocytic elements. Cytological examination of the megakaryocytic elements confirmed the diagnosis of myelolipoma of the adrenal gland, emphasizing the usefulness of cytology.
A 61-year-old female was found to have a nodule in the left lobe of the thyroid. FNA smears showed several clusters of atypical polygonal cells, some of which had bizarre nuclei and intranuclear inclusions. DPP IV staining was negative for these tumor cells. It was difficult to make a diagnosis of this thyroid tumor based only on the cytological findings. Histologically the tumor was encapsulated and composed of follicular and solid proliferation of atypical cells with frequent bizarre nuclei and intranuclear inclusions. These findings were compatible with those of atypical adenoma of the thyroid. Careful examination is recommended when making a cytological diagnosis of this type of tumor.
Cytologic features of a case of inverted papilloma of the urinary bladder are described. A 33-year-old man presented with gross hematuria. Endoscopic examination revealed a pedunculated, non-papillary lesion measuring 15×10 mm near the left ureteral opening in the urinary bladder. Cytologic examination of the spontaneous urine exhibited small and intermediate-sized clusters of spindled-shaped cells with benign-looking oval nuclei with fine chromatin on a hemorrhagic background. Focal arrangement of tall columnar cells was observed. Histologically, the tumor was typical inverted papilloma. We should be aware of the cytologic features of this tumor in spontaneous urine samples.
A case of NSOC syndrome revealed by cervical smear screening in mass surveys was presented. The patient was a 50-year-old woman who had not complained of any problem. In cytology, tumor cells could be seen as a cohesive and overlapping cluster in a clean background and papillary adenocarcinoma originating from ovary or Fallopian tube was considered. We would like to emphasize that the rare NSOC syndrome always should be considered in the examination of cervical smears.