Significance of bizarre cells in cervical screening liquid-based cytology: A prospective study of 15 cases.

OBJECTIVE: The aim of this study was to assess the significance of bizarre cells (cells of squamous origin with a superficial squamous cell-type cytoplasm and characterised by multinucleation that produces bizarre nuclear shapes) in liquid-based cytology (LBC) Papanicoaou (pap) smears with clinical and histological follow-up correlation. METHODS: Fifteen patients, all with LBC samples containing bizarre cells, were identified in routine ThinPrep® LBC workload. HPV testing was performed in each case using residual LBC material. Cytological-histological correlations were reviewed. RESULTS: All 15 LBC samples contained bizarre cells and tested positive for high-risk HPV types. Ten of the 15 cases were identified as atypical squamous cells - cannot exclude an HSIL (ASC-H) with secondary diagnosis of low-grade squamous intraepithelial lesion (LSIL), while five cases were identified as high-grade squamous intraepithelial lesion (HSIL), and a subsequent biopsy was recommended. Additionally, 13/15 cases underwent cone biopsy or hysterectomy within 1-11 months, of which 10 showed histologically confirmed HSIL end-points. LSIL was present in three cases. Bizarre cells were identified in the HSIL epithelium of five cone biopsies. CONCLUSIONS: Identification of bizarre cells in LBC is straightforward and may facilitate diagnosis. The cytology of bizarre cells is associated with HSIL in cone biopsies. We recommend assigning LBC samples containing bizarre cells as ASC-H with secondary diagnosis of LSIL.

[Sarcomatous chromophobe cell renal carcinoma. 2 case reports]. / Sarkomatoidní chromofobocelulární karcinom ledviny. Popis dvou prípadu.

Chromophobe cell renal carcinoma is a relatively rare primary tumour of the kidney. We present two cases of sarcomatoid transformation in this type of renal cell carcinoma. Described transformation in chromophobe renal cell carcinoma has been reported previously only in four publications. We present a very unusual aggressive recurrence of one of our cases and introduce the first case of sarcomatoid carcinoma arising from chromophobe cell renal carcinoma of the kidney with rhabdomyoblastic differentiation.

[Extensive metastases in the thoracic wall as an unusual manifestation of malignant hepatoma]. / Rozsáhlá metastáza hrudní steny jako neobvyklý príznak maligního hepatomu.

In a 53-year-old man an extensive tumour of the thoracic wall was extirpated. It was examined histologically and identified as a secondary of a malignant hepatoma. In the second stage a primary hepatic tumour was removed by extended right-sided lobectomy. The case-history provides evidence of a remote secondary of a malignant hepatoma and a successful palliative approach.

[Segmental mediolytic arteriopathy]. / Segmentální mediolytická arteriopatie.

Three cases of segmental mediolytic arteriopathy occurring in abdominal muscular arteries are presented. This unusual arterial lesion is noted for cytoplasmic vacuolar degeneration of the arterial smooth muscle cells, intercellular vacuoles of various sizes, and focal arterial wall defects designated "arterial gaps". This spectrum of histologic changes can progress to formation of aneurysms with rupture of the vascular wall. The extensive intraabdominal haemorrhage led to the death of all our patients. Pathogenesis and differential diagnosis of this lesion is discussed.