Nodular fasciitis initially diagnosed by aspiration cytology.

A case of nodular fasciitis diagnosed by fine needle aspiration cytology is described. The cytologic findings included fusiform cells, mitoses, macrophages, multinucleated giant cells and mesenchymal elements in a characteristic granular background substance. The cytopathologic diagnosis was subsequently confirmed by the histopathologic study of the tumor and by electron microscopy.

Fine needle aspiration cytologic findings in four cases of pilomatrixoma (calcifying epithelioma of Malherbe).

Four cases of pilomatrixoma studied by fine needle aspiration (FNA) biopsy prior to resection and histologic diagnosis were reviewed to identify the cytologic features useful in making the FNA cytodiagnosis. Cytopathology had initially correctly diagnosed two cases while misdiagnosing one as a carcinoma and one as a suspected carcinoma. The aspirates from all cases contained either clustered or isolated basaloid cells, with variably sized nuclei and prominent nucleoli. "Ghost cells" were also present in most smears stained with the Giemsa stain and could thus be very helpful for making the FNA diagnosis of pilomatrixoma. The occurrence of either foreign-body giant cells or calcium deposits in the aspirates could also contribute to suggesting the correct diagnosis of pilomatrixoma in some cases.

[Skin metastasis of long-course prostatic cancer]. / Metástasis cutáneas de cáncer de próstata de larga evolución.

OBJECTIVE: To present a case of prostate cancer of long evolution and follow up time, in the one which has been evidenced the appearance of skin metastases at hypogastrium level, inferior extremities root and inguinal zone. METHODS: Patient diagnosed of prostate cancer, treated with radical prostatectomy and followed in conferences during ten years by the neoplasica disease. RESULTS: Appearance of skin metastases of a prostate cancer, after ten years of a radical surgery, in the one which the pathological anatomy demonstrated the local infiltration at seminal bladders level. CONCLUSIONS: The skin metastases of a prostate cancer are extremely uncommon, appearing in most of the occasions in process of very long evolution and in those which the disease has not been able be controlled.

DNA quantification as a prognostic factor in prostatic adenocarcinoma.

OBJECTIVE: To determine if DNA quantification on fine needle aspiration (FNA) has a predictive value in cancer of the prostate. STUDY DESIGN: Fifty-four patients with cancer of the prostate during the years 1979-1989 were selected; all were diagnosed by FNA. The smears were studied using image cytometry. RESULTS: With the type of histogram and value of entropy, two large groups with high and low degrees of malignancy were obtained. Survival was utilized as a variable of interest. Kaplan-Meier survival curves for both groups were formulated, and the results were supported with statistical data. CONCLUSION: The survival differences between both groups were statistically significant (P < .001), thus demonstrating the predictive value of DNA quantification.

Cytologic differentiation grade and malignancy DNA index in prostatic adenocarcinoma.

OBJECTIVE: To compare the predictive value of cytologic differentiation grades traditionally used for adenocarcinoma of the prostate with the malignancy grades obtained by DNA quantification. STUDY DESIGN: Of a total number of 156 cases of cancer of the prostate, 54 were selected for DNA quantification by image cytometry. They were studied cytologically, separating well, moderately and poorly differentiated cases. We obtained Kaplan-Meier survival times based on the cytologic grade. Then DNA quantification was carried out, and cases were selected on the basis of their different malignancy grades. The relative survival curves were obtained. Survival times based on cytologic grade were compared with those from DNA quantification. RESULTS: There was no statistically significant difference in survival times between moderate and poorly differentiated cases, so they were included in the same group. Between well and moderately differentiated cases there were differences related to survival that were significant at P < .01. With respect to DNA quantification, a survival difference between low and high grade malignancy occurred at P < .001. CONCLUSION: DNA quantification clearly allows better prediction of survival than does cytologic grading alone.

Prognostic value from DNA quantification by static cytometry in breast cancer.

OBJECTIVE: To determine if DNA quantification on fine needle aspiration (FNA) has predictive value in breast cancer. STUDY DESIGN: Forty-nine patients with breast cancer were selected for this study because of their common characteristics. The smears were studied using image cytometry. RESULTS: With the type of histogram and value of entropy, two large groups, with high and low degrees of malignancy, were obtained. Survival was utilized as a variable of interest. Kaplan-Meier survival curves for both groups were formulated, and the results were supported with statistical data. CONCLUSION: The survival differences between both groups were statistically significant (P < .001), thus demonstrating the predictive value of DNA quantification.

DNA quantification as a prognostic factor in gastric adenocarcinoma.

OBJECTIVE: To determine if DNA quantification, studied in cytologic samples obtained by fiberendoscopy, has predictive value in gastric adenocarcinoma. The survival times of patients in whom the tumor was the cause of death were considered variables of interest. STUDY DESIGN: Twenty-nine patients with gastric cancer, diagnosed by cytology, endoscopy and microbiopsy, were selected. The study was done over more than 10 years. Smears were stained with progressive hematoxylin and processed by computer for DNA evaluation by image cytometry. RESULTS: Four different types of histograms that directly relate to tumoral malignancy were obtained. These histograms were characterized by the value of entropy. We established four grades of aggressiveness. Then we obtained two large groups: high and low grade of malignancy. We studied the survival times in both groups and constructed a Kaplan-Meier survival curve for the high grade of malignancy group. We confirmed the results statistically and found that there was a significant relationship, with P < .05. CONCLUSION: The use of DNA quantification by image cytometry is strongly advised in daily surgery as a prognostic indicator of survival time in gastric adenocarcinoma patients.

DNA quantification as a prognostic factor in colorectal adenocarcinoma.

OBJECTIVE: To determine if DNA quantification, studied in cytologic samples obtained by fiberendoscopy, has predictive value in colorectal adenocarcinoma. STUDY DESIGN: Thirty patients with colorectal cancer diagnosed by cytology, endoscopy and microbiopsy, were selected. The study covered > 10 years. Smears were stained with progressive hematoxylin and processed by computer for DNA evaluation by image cytometry. RESULTS: Four different types of histograms that directly related to malignancy were obtained. These histograms were characterized by the value of entropy, and we established four grades of aggressiveness. Finally, we obtained two large groups: high and low grade of malignancy. We studied the survival times in both groups and used a Kaplan-Meier survival curve for the high grade group. We confirmed the results statistically and found that there was a significant relationship, with P < .05. CONCLUSION: We strongly advise the use of DNA quantification by image cytometry in daily surgery as a prognostic indicator of survival time in colorectal cancer.

Papillary neoplasms of the breast: clues in fine needle aspiration cytology.

Papillary neoplasms of the breast include a wide spectrum of mammary lesions. The differential diagnosis of benign and malignant lesions can be problematic not only cytologically, but also histopathologically. Aspiration smears can demonstrate that cytological differentiation is feasible. A retrospective study of 30 cases of papillary tumour of the breast, 15 papillary carcinomas and 15 papillomas, was performed to find the cytological differences between the pathologies. Cytological samples of papillary carcinomas were characterized by an abundance of cellular material, three-dimensional papillary clusters without fibrovascular connective tissue cores, small papillae arranged in cell balls, tall columnar cells and isolated naked nuclei. Numerous haemosiderin-laden macrophages were seen. There were no eosinophilic bipolar cytoplasmic granules, bipolar naked nuclei or apocrine metaplasia. In the papillomas there was less material; the papillae had cohesive stalks surrounded by columnar cells in a honeycomb pattern. We also found fewer small papillae and isolated columnar cells. In addition, the presence of apocrine metaplasia and bipolar naked nuclei was noted. We suggest that papillary carcinoma of the breast can be diagnosed by cytology and differentiated from papilloma.

Fine needle aspiration cytology of mammary hamartoma: a review of nine cases with histological correlation.

Mammary hamartoma is a breast lesion rarely reported by fine-needle aspiration cytology (FNAC). We report on our experience of FNAC in nine cases confirmed by biopsy. We searched hospital case files for mammary hamartoma or similar lesions (fibrolipomas, lipomas, fibromas, etc.), and cases included were only those in which both FNAC and a histopathological study had been performed. The cytological features that were analysed included epithelial components, mesenchymal fragments and isolated cells dispersed in the background. The patients ranged in age from 25 to 58 years (mean 40 years), and the lesions were predominantly in the right breast and upper outer quadrant. The duration varied from 1 to 20 years. Mammographic features were characteristic revealing well-circumscribed masses of heterogeneous radiodensity and by ultrasonography were hypoechoic without calcification. Grossly, these lesions were oval to round, well-demarcated masses, ranging in diameter from 10 to 80 mm. The tumours were firm, rubbery and white, consisting largely of dense fibroconnective tissue with variable amounts of adipose tissue and glandular elements. Cytological samples showed two components, epithelial and mesenchymal. The cellularity was variable and was composed of lobular cells forming acini, ductal cells, occasional apocrine and foamy cells; myoepithelial cells and isolated naked nuclei were also observed. Adipose tissue and dense fibrous tissue were observed, occasionally with epithelial cells attached, and this finding was an important feature for diagnosis. We considered that the cytological findings could help to diagnose mammary hamartoma, FNAC making a rapid and very important technique for the diagnosis of this pathology.

Metástasis cutáneas de cáncer de próstata de larga evolución / Sin metastases in a long follow-up prostatic cancer

OBJETIVO: Presentar un caso de cáncer de próstata de largo tiempo de evolución y seguimiento, en el cual se ha evidenciado la aparición de metástasis cutáneas a nivel de hipogastrio, raíz de extremidades inferiores y zona inguinal. MÉTODOS: Paciente diagnosticado de cáncer de próstata, tratado con prostatectomía radical y seguido en consultas de urología durante diez años de evolución de la enfermedad neoplásica. RESULTADOS: Aparición de metástasis cutáneas de un adenocarcinoma de próstata, tras diez años de una cirugía radical, en la cual la anatomía patológica demostró la infiltración local a nivel de vesículas seminales. CONCLUSIONES: Las metástasis cutáneas del adenocarcinoma de próstata son extremadamente infrecuentes, apareciendo en la mayoría de las ocasiones en procesos de muy larga evolución, y en los cuales la enfermedad neoplásica no ha podido ser controlada (AU)