Tag Archives: cytology

Lung Nodule , 15 years old boy

 

 

 

 

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Case of metastatic Osteosarcoma to the lung

  • cellular smear composed of plasmacytoid cells
  • pleomorphism
  • osteoid matrix strands
  • mitosis

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Another Chromophobe RCC :-)  

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Things to note :

  • well defined cell border
  • fluffy , moth-eaten cytoplasm
  • accentuation at the periphery
  • dark irregular nuclear membranes ( rasinoid)
  • inconspicuous nucleoli

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Renal Rhabdoid Tumor, Case of 2 Years Old Infant with Large Right Renal Mass

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Renal Rhabdoid Tumor :
Touch Imprints:
   -Hyper cellular.
   -Vesicular nuclei with reniform indented contour.
   -Prominent nucleolus.
   -Abundant pink cytoplasm.
   – Frequent mitotic figures.
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H & E Sections:
INI immunostain is negative
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The rhabdoid tumor is an exceedingly rare renal tumor that occurs predominantly in infants and young children. The tumor is highly aggressive and has a poor prognosis (Weeks et al, 1989, 1991). The histogenesis is unknown. Rhabdoid tumors have now been reported in all age groups and in sites other than the kidney (Parham et al, 1994; Fanburg-Smith et al, 1998; Ogino et al, 2000).
In tissue sections, the tumor is composed of a single population of cells that may vary in size and configuration from round or oval to spindly. The characteristic feature of these tumors is the presence of large, eosinophilic cytoplasmic inclusions that displace the nucleus of the cell to the periphery. On electron microscopy, the inclusions are composed of intermediate filaments. There is no evidence that the cytoplasmic inclusions represent an accumulation of myoglobin, but it is the appearance that gave the tumor its name. Similar cytoplasmic inclusions that stain with an antibody to myoglobin may be observed in cells of rhabdomyosarcoma. From time to time, similar cytoplasmic inclusions may be observed in other tumors, including undifferentiated large-cell lung cancer. To our knowledge, there is only one published description of the cytologic findings in FNA biopsies of rhabdoid renal tumors. In three patients, Akhtar (1991) observed large polygonal cells with abundant dense pink cytoplasm, large intracytoplasmic eosinophilic inclusions, and large nuclei with macronucleoli.   “Koss’ Diagnostic Cytology and Its Histopathologic Bases, 5th Edition”

Giant Cell Tumor Of Tendon Sheath, Aspirate

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GCTTS  is a very common Benign tumor usually affecting the digits  in females ( 2x more common) grossly it is a lobulated small (2-3 Cm.) yellowish mass.

Here in our case we can see :

  • osteoclast like gaint cells with many bland looking nuclei.
  • many mononuclear cells in the back ground.
  • Not much inflammatory cells or hemosidren.

The differential here:

  • pigmented villonodualr tenosynovitis – usually in large joints like knee with lots of hemosidren.
  • other granulomatous lesions – many inflammatory cells.

Pitfalls:

  • mononuclear cells stain with Desmin
  • you may see necrosis , tumor thrombi on paraffin sections.

Neoplastic vs reactive nature is still one of the questions to be solved.

 

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A Cause and Effect

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This patient underwent total abdominal hysterectomy and bilateral oopherectomy  due to endometrial complex hyperplasia with atypia, the left ovary showed a  mass ” couldn’t resist the temptation of taking a smear for fast pap stain” which showed this spindle tumor with fasicular arrangement. the tumor later proved to be a fibrothecoma quit known to screte lots of estrogen that may lead to hyperplastic endometrium. strangly the cells on smears showed many grooves as on sections a feature seen in estrogen secreting  granulosa cell tumor.

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Adrenal Cyst Aspirate , A Case of Pheochromocytoma

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  • The smears are hyper cellular.
  • cells appear singly or in loose groups or pseudo rosettes.
  • Three types of cell have been described:
  1.           The first type is small to moderate-sized polygonal cells with finely granular cytoplasm and uniform roundor oval nuclei with granular chromatin and prominent chromocenters. These cells are the prototypic cells of neuroendocrine tumors.
  2.            The second type is spindle cells with abundant cytoplasm, elongated nuclei, and coarse granular chromatin.
  3.            large, myoid-like cells with eccentric large nuclei, prominent nucleoli, and abundant pale, finely granular cytoplasm.

The smears may be composed of a mixture of these cell types or one cell type may predominate.   “M.BIBO 3rd ed”

Aspirating a pheochromocytoma is dangerous as it may precipitate a hypertensive crisis.

Remember the rule of 10% and multiple endocrine neoplasia association.

 

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Follicular Neoplsm , Thyroid lesion

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  • Hyper cellular smears
  • Micro follicles
  • Absent macrophages
  • little to no colloid

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Renal Cell Carcinoma, Chromophobe Type “ChRCC”

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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.

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Schwannoma, presents as Intra Abdominal mass

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-Long slender tapering nuclei sometimes bend and form hooks and comma shapes.

– Fibrillari back ground.

– Watch out from degenerative changes which including  pleomorphism.

– If you find verocay bodies you are lucky

This case is dedicated to our dear colleague and friend Ahmed AboSolb, leaving us soon. your case is solved from the very first day  🙂


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Liver Cyst

 

 

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Cytology of the cystic fluid revealed many Hooks and scolex typical  of  Hydatid Cyst ”  Echinococcus Granulosus infestation”

 

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