• 대한세포병리학회지
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• 제6권1호
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• pp.48-53
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• 1995

Kimura's disease is a chronic Inflammatory disorder of unknown etiology, presenting usually as a painless subcutaneous swelling in the head and neck region or in the lymph nodes. We experienced a case of Kimura's lymphadenitis with characteristic Warthin-Finkeldey type polykaryocytes by fine needle aspiration cytology. The patient was a 10-year old male with two enlarged lymph nodes in the postauricular area. Fine needle aspiration cytology from the lymph nodes disclosed hypercellular smears with some scattered eosinophils and polykaryocytes in a polymorphous lymphoid background. There were also fragmented vessel wails and activated endothelial cell clusters in the slightly necrotic background. The Warthin-Finkeldey type polykaryocytes had three to thirty nuclei and prominent nucleoli with cytoplasmic borders. Their nuclei were arranged in grapevine or ring shaped clusters. As these polykaryocytes could also be found in lymph nodes and extranodal tissues of both reactive and neoplastic lymphoid disorders, polykaryocytes themselves are clinically nonspecific. However, the morphologic features of the Warthin-Finkeldey type giant cells are quite different from the foreign body type or Langhans' type giant cells. When the characteristic cytologic features of Kimura's disease such as significant number of eosinophils in a background of lymphoid cells asd proliferation of vessels and endothelial cells are also observed in the smear, it is possible to suggest this diagnosis in the appropriate clinical setting.

• 대한세포병리학회지
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• 제10권1호
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• pp.43-53
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• 1999

We retrospectively reviewed the results of 1,850 fine needle aspiration cytology(FNAC) of thyroid nodules performed from 1990 to 1991 in the Department of Pathology, Seoul National University Hospital. Among 1,528 cases and 322 cases aspirated by clinicians and a pathologist, 465 cases(30.4%) and 13 cases(4.0%) of the aspirates were inadequate, respectively. In 227 cases, correlation of the FNAC diagnosis and histologic diagnosis was done. Excluding the inadequate cases, the sensitivity nor the detection of neoplasm(malignancy together with follicular adenoma) was 86.4% and the specificity was 70.7%. The overall diagnostic accuracy was 79.0%. There were 16 false-positive cases(7.0%), and 19 false-negative cases(8.4%). The predictive value of each cytologic diagnosis was 92% in papillary carcinoma, and 100%, in Hashimoto's thyroiditis. The expectancy of malignancy was 52.8% in "suspicious malignancy" and 26.7% in "atypical lesion".

• 대한세포병리학회지
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• 제10권1호
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• pp.91-96
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• 1999

Sometimes a pilomatrixoma on upper neck can be misdiagnosed as primary salivary gland tumor, skin adnexal tumor or metastatic carcinoma. On fine needle aspiration cytology(FNAC), characteristic features are ghost cells, basaloid cells, and calcium deposits, among which presence of ghost cells seems to be the key to recognize it. Here we present a cytologically misdiagnosed case of pilomatrixoma. A 32-year-old man presented a subcutaneous mass on the right posterior neck. It has grown slowly for 1 year, and was nontender, well circumscribed, hard, and movable mass. An Initial FNAC yielded only monomorphic population of highly mitotic basaloid cells, without anucleated ghost cells, chronic inflammatory cells or foreign-body giant cells, suggestive of a poorly differentiated carcinoma. However, that was inconsistent with patient's clinical findings. For further correct diagnosis, FNAC was repeated, which yielded the basaloid cells and foreign-body giant cells. The diagnosis of pilomatrixoma could be made and the mass was excised. This case demonstrates that the pilomatrixoma should be considered in the differential diagnosis of subcutaneous aspirates containing not ghost cells but a dominant population of basaloid cells.

• 대한세포병리학회지
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• 제10권2호
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• pp.179-184
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• 1999

The columnar cell variant of papillary carcinoma is a rare tumor of the thyroid, associated with aggressive behavior, early metastasis, and a rapidly fatal course. We present the fine needle aspiration cytologic(FNAC) findings of columnar ceil variant of papillary carcinoma with cytohistologic correlation. In the smears, the tumor fragments showed mainly papillary pattern and a few scattered individual cells were present around the papillary fragments. The tumor cells were columnar or cuboidal and exhibited pseudostratification of the nuclei. The nuclei were oval to elongated with finely stippled chromatin and inconspicous nucleoli. Neither nuclear grooves nor intracytoplasmic inclusion was found. The FNAC diagnosis was consistent with papillary carcinoma. Total thyroidectomy was done and the histologic finding of the mass showed a predominantly papillary and focal solid proliferation of columar cells with marked nuclear pseudostratification. The unique histopathologic features and highly aggressive nature of columnar ceil variant of papillary carcinoma require that this variant should be differeniated from common papillary carcinoma of the thyroid.

• 대한세포병리학회지
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• 제10권2호
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• pp.185-189
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• 1999

The diagnosis of peripheral T cell lymphoma is difficult due to the varying size and shape of the neoplastic lymphoid cells and the frequent admixture of nonneoplastic mature lymphyocytes, histiocytes, eosinophils, and plasma cells. We report a case of peripheral T cell lymphoma, lymphoepithelioid ceil type, which was difficult to differentiate from tuberculous lymphadenitis due to the aggregates of epithelioid histlocytes mimicking granuloma and the past history of pulmonary tuberculosis. Fine needle aspiration cytology of the inguinal lymph node in a 63-year-old male was characterized by hypercellular aspirates composed of a mixture of small and intermediate-size lymphoid cells and large lymphoid cells with background of confluent epithelioid histiocytes. The neoplastic lymphocytes demonstrated significant nuclear irregularity with protrusion and indentations of the nuclear membrane, prominent nucleoli, and frequent mitotic figures. The diagnosis of peripheral T cell lymphoma was confirmed by histological and immunohistochemical studios.

• 대한세포병리학회지
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• 제4권2호
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• pp.166-170
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• 1993

We describe the cytologic features of metastatic ameloblastoma which presented as multiple bilateral lung nodules. The patient was a 22-year-old male who had recurrent ameloblastoma of the mandible 7 years after the diagnosis of primary lesion. Fine needle aspiration of one of the pulmonary nodules revealed patchy arrangement of cell clusters with outer palisading columnar cells and inner irregular loose polygonal cells. Most of tumor cells had plenty cytoplasm and ovoid nuclei which lacked either pleomorphism or hyperchromatism. The cytologic findings corresponded with histologic features of the primary site which was also benign looking ameloblastoma.

• 대한두경부종양학회지
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• 제8권2호
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• pp.91-96
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• 1992

The efficacy of the fine needle aspiration biopsy and cytological examination(FNABC) under ultrasonographic(US) guides for the diagnosis of cervical tuberculous lymphadenitis was assessed. There were one hundred and one patients whose neck masses were proven to be tuberculous lymphadenites with cytologic and/or histologic diagnosis. The physical characteristics shown by US revealed that all the cases were multiple lesions. Multiregional lesions were found in 80 cases(79.1%) and 19 cases(18.8%) were the bilateral lesion. The region V was the most prevalent site(n=69, 68.3%). US findings revealed 92 cases(90.9%) showed hypoechoic lesions and 9(9.1%) showed mixed echo patterns. There was no hyperechoic lesion (p<0.05). The sensitivity of FNABC was 77.2% and specificity was 99.0%. Diagnostic accuracy was 85.0%. There was no complication during the procedures. FNABC for the diagnosis of cervical tuberculous lymphadenitis is a safe, convinient procedure and has a high specificity. The pitfall of FNABC the low sensitivity, seemed to be compensated by US evaluations.

• 대한세포병리학회지
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• 제16권2호
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• pp.88-92
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• 2005

Mucious cystic neoplasm of pancreas is a cystic neoplasm composed of columnar, mucin-producing epithelium and is supported by ovarian-type stroma. The key to the cytologic evaluation of pancreatic cystic lesions is to recognize the cytologic components as being diagnostic of a mucin-producing cystic neoplasm, as all of these neoplasms need to be resected. We report the use of fine needle aspiration cytology in the diagnosis of an invasive mucinous cystic carcinoma confirmed by partial pancreatectomy. The cytologic specimen showed a abundant mucin background and sheets or papillae of neoplastic cells. There are mucin-containing columnar cells that show a variable degree of cytologic atypia.

• 대한세포병리학회지
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• 제13권1호
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• pp.28-32
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• 2002

Malignant myoepithelioma (myoepithelial carcinoma), is a very rare malignant epithelial accounting for less than 1% of all salivary gland tumors and has an intermediate malignant potential. We report a case of malignant myoepithelioma arising in the left parotid giand in a 54-year-old man, which was difficult to differentiate from pleomorphic adenoma and other malignant salivary gland neoplasms. Fine needle aspiration cytology of the parotid gland showed cellular smear, composed of overlapped sheets and clusters or individually scattered tumor cells without any acinic or ductal structures. The tumor cells were rather uniform, with distinct cell borders and moderate amount of cytoplasm. The eccentrically located nuclei were oval to round and pleomorphic and showed prominent nucleoli. A few clear cells were noted in the cellular aggregates Metachromatic matrix was seen between individual tumor cells in a lacelike fashion, resembling pleomorphic adenoma. According to the immunohistochemical staining, we recognized that the component cells are myoeplthelial in nature, showing reactivity for the S-100 protein, vimentin, and actin.

• 대한세포병리학회지
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• 제13권1호
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• pp.42-46
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• 2002

Epithelial-myoepithelial carcinoma(EMC) is a rare, low grade malignant tumor of the salivary glands. The EMC has a distinctive histological appearance comprising ductal structures with an inner epithelial cell component and an outer layer of myoepithelial cells which show plump clear cytoplasm. The cytologic features of the EMC have been rarely described. A correct cytological diagnosis to this rare tumor is difficult with high false negative rate. We report a case of EMC in which fine needle aspiration cytologic findings were misinterpreted as a pleomorphic adenoma.