Meningioangiomatosis: report of three cases and review of the literature.

Meningioangiomatosis is a rare condition, probably hamartomatous, characterized by proliferation of capillary-sized vessels, meningothelial cells, and fibroblasts within the cortex of the brain. Lesions may be single or diffuse and may be associated with neurofibromatosis type II. Clinically it presents with seizures but may be asymptomatic throughout life. We report 3 cases of meningioangiomatosis, 2 localized and 1 diffuse, all with different clinical manifestations. Differential diagnoses are discussed with a review of the literature. Since this condition is rare, close clinico-pathological correlation is essential. A correct diagnosis avoids further aggressive treatment.

Inflammatory fibroid polyp of the ileum causing intussusception: report of two cases with emphasis on cytologic diagnosis.

Inflammatory fibroid polyp (IFP) of the gastrointestinal tract is a type of inflammatory pseudotumor or inflammatory myofibroblastic tumor that occurs most commonly in the stomach but also in the small and large bowel. Small-bowel IFP usually presents with intussusception. The purpose of the current study is to describe cytological features of this lesion with differential diagnoses since pathologists may be called on to render a diagnosis on fine-needle aspiration. Two cases of IFP are described with diagnostic features on imprint smears. Both were middle-aged obese women with a history of prior intra-abdominal surgical procedures who presented with signs of intestinal obstruction and were found to have a tumor causing intussusception. At intraoperative consult, scrape cytology specimens showed cellular smears with a heterogeneous population of myofibroblasts, inflammatory cells and vessels. The features together with clinical history are sufficient to suggest the diagnosis. IFP is a lesion with a characteristic morphology. The differential diagnosis includes several other lesions, hence triage of cytological specimen for culture, electron microscopy, and immunohistochemistry is important in facilitating a correct diagnosis. Although a surgical procedure may still be necessary once a diagnosis of IFP is made, treatment may be tailored for a less aggressive process.

Role of flow cytometry in the diagnosis of lymphadenopathy in children.

To evaluate the combination of fine-needle aspiration (FNA) and flow cytometric immunophenotyping (FCI) in the diagnosis of lymphadenopathy in children, we reviewed a total of 71 FNA specimens from pediatric patients with persistent lymphadenopathy. Two cases were deemed inadequate. In the remaining 69 cases, 54 (78%) were diagnosed as benign lesions, 9 (13%) as Hodgkin's lymphoma, 4 (6%) as non-Hodgkin's lymphoma or leukemic infiltrate, and 2 as metastatic tumors. Of the 69 cases, 25 cases (38%) were diagnosed based on cytomorphology alone, 30 (43%) by combined cytomorphology and FCI, and 19 (28%) by surgical biopsy. In conclusion, FNA is an easy, safe, and reliable procedure in the diagnosis of lymphadenopathy in children. In difficult cases, FCI can be used to exclude non-Hodgkin's lymphomas.

Atypical glandular cells of undetermined significance: significance of cell type and age on patient management.

OBJECTIVE: To compare the rate, accuracy, and histological correlation of cytological smears reported as atypical glandular cells of undetermined significance (AGUS) in different age groups. MATERIALS AND METHODS: Cervical cytology smears reported as AGUS were reviewed and correlated with histologic follow-up and repeat cytology. RESULTS: A total of 40,464 Pap smears were performed at Long Island Jewish Medical Center between 1996 and 2000. Of those, 163 (0.4%) smears were diagnosed as AGUS, and 62% of the patients with AGUS had either histologic or cytologic follow-up or both. The highest AGUS rates occurred in the fifth (0.6%) and ninth (0.84%) decades of life. Eighty-eight patients had histologic follow-up. Significant endometrial lesions occurred in 15 patients. The mean age was 64 years. Significant cervical lesions occurred in 12 patients. The mean age was 45 years. Among women with AGUS-favor endometrial (AGFEM) cell origin, 9 of 34 women had a significant lesion (8 endometrial and 1 cervical). Four of 12 endometrial carcinomas were identified among women whose cytology suggested cervical origin. CONCLUSIONS: Older women were more likely to have significant endometrial lesions and younger women significant cervical lesions. However, neither cytologic criteria nor the patient's age is perfect in directing the clinician toward the likely origin of the atypical cells.