Fine needle aspiration cytology of gastric solitary fibrous tumor: a case report.

BACKGROUND: Solitary fibrous tumors (SFT) occur mainly in the pleura and other serosal sites. However, they have been found in extraserosal sites and should be considered in the differential diagnosis (DDx) of any spindle cell lesion, including those in the gastrointestinal tract. In this report, we describe fine needle aspiration (FNA) cytologic evaluation of a gastric SFT, emphasizing the role of immunocytochemistry in the DDx. CASE: Computerized tomography-guided FNA of a subserosal gastric mass in a 77-year-old female was performed. The moderately cellular smears showed neoplastic cells arranged in interlacing fascicles and in a "patternless" pattern. There was variable collagenous stroma. The cell block revealed a similar pattern, with a single mitotic figure. Nuclear atypia and necrosis were absent. The neoplastic cells were strongly reactive for vimentin and CD34, with weak focal reactivity for smooth muscle actin, suggestive of vessels in tangential section. They were nonreactive for muscle specific actin, desmin, S-100 and pancytokeratin. Other immunocytochemical markers were also studied. CONCLUSION: SFT should be considered in the DDx of spindle cell lesion of the stomach. Cell block and immunocytochemical markers, especially CD34, were extremely useful in the diagnosis of SFT on FNA.

Different tissue responses for iodine and iodide in rat thyroid and mammary glands.

This research describes the effects of short-term elemental iodine (I2) and iodide (I-) replacement on thyroid glands and mammary glands of iodine-deficient (ID) Sprague-Dawley female rats. Iodine deficiency causes atypical tissue and physiologic changes in both glands. Tissue histopathology and the endocrine metabolic parameters, such as serum TT4, tissue and body weights, and vaginal smears, are compared. A moderate reduction in thyroid size from the ID control (IDC) was noted with both I- and I2, whereas serum total thyroxine approached the normal control with both I- and I2, but was lower in IDC. Thyroid gland IDC hyperplasia was reduced modestly with I2, but eliminated with I-. Lobular hyperplasia of the mammary glands decreased with I2 and increased with I- when compared with the IDC; extraductal secretions remained the same as IDC with I2, but increased with I-; and periductal fibrosis was markedly reduced with I2, but remained severe with I-. Thus, orally administered I2 or I- in trace doses with similar iodine availability caused different histopathological and endocrine patterns in thyroid and mammary glands of ID rats. The significance of this is that replacement therapy with various forms of iodine are tissue-specific.

Components of image intensive diagnosis. Codifying visual features for effusion cytology.

Components of visual assessment in the diagnosis of effusions were analyzed using relative operating characteristic. Diagnostic performance in the assessment of malignancy and the specification of metastatic origin was measured for two expert cytologists. The component of performance attributable to feature interpretation was measured in protocols which minimized the effects of clinical information and visual search in the decision process. Feature interpretation, as a process, contributed significantly to the evaluation of malignancy and marginally to the specification of metastatic origin. For each of these diagnostic tasks, the process of feature interpretation was codified in the construction of explicit models. The expert cytologists were asked to define a set of localized visual features that incorporate essential visual elements for diagnosis. These features were evaluated for a set of test cases, and regression models were constructed defining malignancy and metastatic origin. Relative operating characteristic analysis indicated that the predictive value of the models for diagnosis was very similar to the component of human performance attributable to feature interpretation.

Retrorectal cystic hamartoma diagnosed by fine-needle aspiration biopsy.

A 17-yr-old postpartum female presented with a large multicystic mass posterior to the rectum, thought clinically to be an abscess. Fine-needle aspiration biopsy revealed numerous squamous cells. The diagnosis of retrorectal cystic hamartoma was considered and subsequently confirmed by the surgical resection specimen. The cytologic and histologic findings are presented along with a discussion of the entity "retrorectal cystic hamartoma," including a differential diagnosis of presacrococcygeal cysts.