RESUMO
BACKGROUND: Yolk sac tumor (YST) of the ovary is a rare neoplasm typically affecting children and young women. We describe the cytomorphology of this tumor in ascitic fluid and discuss its differential diagnosis from other neoplasms. CASE: Smear preparations of the ascitic fluid showed a predominance of clusters of malignant cells with vacuolated cytoplasm, mimicking a mucinous adenocarcinoma, and fewer syncytial-like and glandular structures. Hyaline globules were extremely rare. Immunocytochemistry was positive for alpha-fetoprotein. CONCLUSION: The diagnosis of YST in ascitic fluid specimens may be challenging and requires the use of immunocytochemistry and the correlation of cytology with the remaining clinical and laboratory data.
Assuntos
Líquido Ascítico/patologia , Tumor do Seio Endodérmico/diagnóstico , Tumor do Seio Endodérmico/patologia , Neoplasias Ovarianas/patologia , Adulto , Agregação Celular , Feminino , Humanos , Reação do Ácido Periódico de Schiff , alfa-Fetoproteínas/metabolismoRESUMO
BACKGROUND: Primary effusion lymphoma (PEL) is a rare type of lymphoma that presents as an effusion, seldom with evidence of a solid neoplasm elsewhere; thus, cytology is the basic diagnostic method. It usually occurs in HIV-positive males with a history of Kaposi's sarcoma (KS), and DNA sequences of human herpesvirus 8 (HHV-8) are detected by molecular analysis. The distinct morphologic, immunophenotypic, molecular and clinical characteristics render this neoplasm a new pathologic entity. CASE: A 57-year-old, HIV-positive man presented to the hospital with ascites and absence of neoplasm on radiologic investigation. Cytologic evaluation of the ascitic fluid revealed the presence of highly atypical, pleomorphic lymphoid cells. Immunocytochemistry of the lymphoma cells was positive for CD45 (leukocyte common antigen), CD30 and epithelial membrane antigen antigens and negative for panB, panT and cytokeratin antigens. DNA sequences of HHV-8 were identified by polymerase chain reaction (PCR), and DNA ploidy analysis showed aneuploidy. The patient died 5 months after the diagnosis. CONCLUSION: Conventional and ThinPrep (Cytyc Corp., Boxborough, Massachusetts, U.S.A.) cytology, in combination with immunocytochemistry and PCR for HHV-8 DNA sequences, can lead to an accurate diagnosis of PEL. DNA ploidy analysis confirms the aggressive nature of this neoplasm.
Assuntos
Líquido Ascítico/patologia , Infecções por HIV/complicações , Linfoma/patologia , Infecções Oportunistas/patologia , Líquido Ascítico/etiologia , Biomarcadores Tumorais/metabolismo , Herpesvirus Humano 8/genética , Humanos , Imuno-Histoquímica , Imunofenotipagem , Antígeno Ki-1/metabolismo , Antígenos Comuns de Leucócito/metabolismo , Linfócitos/patologia , Linfoma/virologia , Masculino , Pessoa de Meia-Idade , Mucina-1/metabolismo , Infecções Oportunistas/etiologia , Ploidias , Sarcoma de Kaposi/complicaçõesRESUMO
Strongyloidiasis is an opportunistic infection which may result in a fatal hyperinfection syndrome in immunocompromised patients. We report the case of a pulmonary infection with Strongyloides stercoralis in a 61-year-old male with a history of a long-term administration of corticosteroids. Cytologic examination of a bronchial washing specimen, processed both as conventional and as Thin-Prep smears, revealed an abundance of the typical larvae of Strongyloides stercoralis, amidst a cellular population comprising several acute inflammatory cells as well as bronchial epithelial cells with features of basal cell hyperplasia or regenerative atypia. To the best of our knowledge there is only one previous report describing Strongyloides stercoralis in thin-layer smears, and there are no previous studies comparing its morphology in conventional and thin-layer preparations.