We report herein on a case of allergic bronchoalveolar aspergillosis (ABPA) with hyphae and Charcot-Leyden crystals against a necrotic background stained with Papanicolaou stain. Lung carcinoma was initially suspected before bronchoscopic brush cytology. Lung carcinoma or tuberculosis is sometimes suspected first in cases of aspergillosis. The pathological diagnosis is important because the seroprevalence and culture-positive rate are very low, and degenerated or vacuolated Aspergillus hyphae do not stain well with Papanicolaou stain. Careful observation of cytological specimens in a necrotic background is therefore required, considering the possibility of aspergillosis.
Mixed adenoneuroendocrine carcinoma (MANEC) is defined as having morphologically recognizable adenocarcinoma and neuroendocrine carcinoma (NEC) components, and is rare in the bile duct. We report herein on a case of MANEC of the common bile duct diagnosed with brush cytological examination using endoscopic retrograde cholangiopancreatography. It has been reported that the NEC component of MANEC of the bile duct defines the prognosis. Therefore, it is important to detect the NEC component. Careful observation of brush cytological specimens from the bile duct can lead to a cytodiagnosis of MANEC.