Fine-needle aspiration cytology of palpable lesions of the lower female genital tract.

During January 1978 through May 1989, 232 fine-needle aspirations of palpable lesions of the vulva, vagina, inguinal area, and perineum were performed on 209 women. Five samples were considered inadequate for cytologic evaluation. Eighty-seven (38.3%) aspirates were interpreted as malignant, 80 of which were further classified into specific cell types. Most malignant neoplasms represented metastases from other gynecologic organs. Of the 140 (61.7%) nonmalignant aspirates, only 28 (20%) could be categorized into specific pathologic disorders. The false-positive and false-negative rates were 0 and 4.6%, respectively. We conclude that, because of its safety, simplicity, and accuracy, fine-needle aspiration cytology represents a valuable diagnostic tool in the evaluation of palpable lesions of the lower female genital tract. This technique is particularly helpful in the assessment of primary, metastatic, or recurrent malignant neoplasms of this region.

Primary papillary hyperplasia of the gallbladder and cystic and common bile ducts.

A unique case of primary papillary hyperplasia of the gallbladder and cystic and common bile ducts occurring in a young female without calculi, ulcerative colitis, or primary sclerosing cholangitis is reported. The papillary lesion involved the mucosa of the entire gallbladder and of the cystic and common bile ducts. Histologically, the gallbladder mucosal folds were close to one another and taller than normal. They were lined by normal-appearing columnar cells and pencil-like cells. The papillary projections of the common bile duct were lined only by columnar cells with prominent subnuclear vacuoles. No endocrine cells or cytologic atypia were noted. The differential diagnoses, including secondary hyperplasia, multiple adenomas, and papillomatosis of the gallbladder, are discussed.

Toxoplasmosis of the stomach: a cause of antral narrowing.

Radiographs of the stomach showed narrowing of the antrum, caused by toxoplasmosis, in a patient with acquired immunodeficiency syndrome (AIDS). A biopsy specimen demonstrated numerous cysts containing Toxoplasma gondii and many free trophozoites. A subsequent brain scan, obtained with computed tomography, showed multiple enhancing lesions throughout the cerebrum, cerebellum, and basal ganglia that were characteristic of toxoplasmosis. Radiographic abnormalities of the stomach are not uncommon in patients with AIDS. They are associated with infections such as cryptosporidiosis and cytomegalovirus and neoplasms such as Kaposi sarcoma and malignant lymphoma. To the authors' knowledge, this is the first reported case of toxoplasmosis involving the stomach.