A man in his 40’s was found to have a right atrial mass, bilateral pulmonary nodules, and pleural effusion. Pleural fluid cytology revealed clusters showing papillary or glandular structure resembling adenocarcinoma, composed of columnar to short-spindle cells. CT-guided needle lung biopsy showed dense proliferation of spindle to oval cells with acinar and glandular structures. The tumor cells were positive for CAM5.2, vimentin, and bcl-2 in immunocytochemistry and immunohistochemistry. RT-PCR detected SYT-SSX1 fusion transcripts in paraffin-embedded tissue. No primary lesions were found except for the cardiac tumor, and a diagnosis of primary cardiac synovial sarcoma was made. The epithelioid clusters in the pleural effusion are a very interesting cytologic feature of synovial sarcomas.
Herein, we report a case of amebic dysentery, focusing on the cytological findings. Emergency surgery was performed on a 48-year-old man with a perforated and hemorrhagic ulcer in the ascending colon of unknown etiology. Touch smear cytology of the resected specimen revealed entamoeba trophozoites. The trophozoites showed strongly positive PAS staining. Characteristically, red blood cells phagocytosed by the trophozoites were found, confirming that the protozoan was Entamoeba histolytica. Smear cytology with PAS staining is useful to identify Entamoeba histolytica in colonic ulcer patients with amebic dysentery.
Inverted papilloma (IP) that is rare benign tumor appears very rarely in urine. A male in his 70’s consulted urology for difficulty in urination. Cystoscopy revealed a papillary tumor, and resected it by TUR-BT. Cytologic examination by spontaneous urine, tall columner shaped cells and cribriform structure by urothelial cells were found on hemorrhagic background. Histologically, the tumor was typical IP. We should be aware of the cytologic features of IP.