Arteriovenous malformations (AVMs) are type of vascular malformation most relevant to the surgical pathologist. Because their vessels tend to leak and induce gliosis. AVMs can present with seizure disorder and also cause spontaneous hemorrhage. Best seen by trichrome or elastic stains, AVMs manifest artery-vein connections with associated arterialization of veins. Arterialization is thickening of a venous wall to the point where it resembles an artery, possibly due to fibrotic reaction to shunted arterial blood. Arteries show irregular duplication or loss of elastin . Thrombi are common. (Sternberg’s 5th ed)
Hi there, few days ago i stumbled upon this relatively uncommon renal tumor and misdiagnosed it as Conventional renal cell carcinoma on smears. ” seams i got so much to learn ”
So lets review the Cytological Characteristics of this tumor :
- polygonal cells.
- well defined borders.
- granular to light transparent cytoplasm, clear cells are rare.
- accentuation of the granularity at the periphery of the cell.
- central halo giving the cell koilocyte like appearance.
- the nuclei are eccentric with anisonucleosis.
- some of the nuclei are condensed with raisinoid appearance.
Beware of the Eosinophilic Variant of Chromophobe RCC as it very hard to differentiate from Renal Oncocytoma which is a benign tumor.
Ovarian cyst form 40 years old lady. it was 18 C.M in diameter, unilocular and filled with serous fluid.
on Aspirate you can see :
– Simple columnar epithelium ( the red spindly cells ” lets say pseudo-spindly always remember this is not a cross section “).
– the dispersed round cells in between on might think they may represent the intercalated cells and then the diagnosis will be serous cyst But at high magnification you will see that they are full of foamy mucin with pushed nucleus typical of goblet cells.
– the foamy macrophages ” last pic ” indicating the cystic nature of this aspirate
so we have 2 components the serous and mucinous and the proper diagnosis will be seromucinous cyst
please note that we can’t commet on the malignancy of such neoplasm unless we have H & E sections to asses invasion