• The Korean Journal of Cytopathology
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• v.8 no.2
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• pp.109-114
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• 1997

Transbronchial fine needle aspiration(TBNA) is one of the cytologic methods in diagnosing lung cancers. TBNA can be used in cases of hilar, mediastinal or lung masses adjacent to the bronchi. We analyzed and compaired the findings of 27 cases of TBNA and bronchial washing and brushing(BW/BB) in lung cancers confirmed by either biopsy or surgical resection between Jun, 1996 and May, 1997 in Asan Medical Center. They were 18 cases of non-small cell carcinomas(eight squamous cell carcinomas, nine adenocarcinomas, and one large cell undifferentiated carcinoma), eight cases of small cell carcinomas, and one case of metastatic hepatocellular carcinoma. The sensitivity of TBNA was 37%(10/27) and false negative was 63%(17/27). Although the sensitivity of BW/BB w3s 56%(15/27), it was not different statistically from that of TBNA(Chi square, p=0.38). Overall sensitivity of TBNA and BW/BB in this series was 70%(19/27). Forty-seven percent of false negative TBNA(8/17) were positive in BW/BB. The findings suggest that the addition of TBNA to the standard BW/BB increases diagnostic yield in cytologic diagnosis of lung cancer.

• The Korean Journal of Cytopathology
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• v.7 no.1
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• pp.44-50
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• 1996

Small cell carcinoma of the lung is characterized by cells with finely stippled chromatin and scanty cytoplasm as well as a particularly aggressive clinical course and favorable response to the chemotherapy. Recently percutaneous fine needle aspiration (FNA) biopsy has become both widely established and highly respected for the diagnosis of lung cancer. However metastatic small cell carcinoma of lymph node should be cytologically differentiated from the small round cell tumor of particular sites, especially malignant lymphoma, because small ceil carcinoma of classic oat cell type nay simulate small cell non-Hodgkin's lymphoma. We report five cases of metastatic small cell carcinoma of in-termediate cell type diagnosed by FNA of the enlarged lymph nodes of the neck and axilla. The cytologic smears contained diffuse small neoplastic cells larger than lymphocytes with dense, pyknotic nuclei and extremely scanty cytoplasm. Apparently viable large tumor cells have vesicular nuclei with granular, sometimes very coarse chromatin. The characteristic cytologic features of small cell carcinoma as compared to malignant lymphoma were as follows.: 1) small cells with dense pyknotic nuclei are evenly distributed in the background of apparently viable larger tumor cells, admixed with mature lymphocytes and phagocytic macrophages. 2) small loose aggregates of cells with nuclear melding are indicative of small cell carcinoma rather than non-Hodgkin's lymphoma. 3) the cytoplasmic and nuclear fragments of tumor necrosis are more dominant in the smears of small cell carcinoma. 4) nuclear membrane and nucleoli are generally indistinct in small cell carcinoma due to condensation of chromatin.

• The Korean Journal of Cytopathology
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• v.14 no.2
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• pp.53-59
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• 2003

Fine needle aspiration cytology (FNAC) has been known as a very sensitive and effective method for preoperative diagnosis. We studied cases preoperatively diagnosed by FNAC and confirmed by the histopathologic examination to define the effectiveness of FNAC. A total of 567 cases including breast, thyroid gland, lymph node, and soft tissue confirmed histologically after FNAC were enrolled, among 2,844 FNAC cases from January 1996 to March 2000. Overall sensitivity and specificity of FNAC were 93% and 100%, respectively. Sensitivity and specificity of FNAC by sites or organs were 91% and 100% in breast, 100% and 100% in thyroid, 97% and 100% in lymph node, and 71% and 100% in soft tissue, respectively. Nine cases showed diagnostic discrepancy; eight cases of sampling error and one case of interpretation error. Five cases, diagnosed as fibrocystic change at FNAC but invasive ductal carcinoma after the histopathologic examination, were categorized as sampling error due to the presence of diffuse fibrosis or deep seated location. One case of breast, diagnosed descriptively as atypical ductal and stromal cells suggesting invasive ductal carcinoma at FNAC but malignant phyllodes tumor histologically, was categorized as interpretation error. Other cases of sampling errors were two cases of soft tissue, a case of lymph node, and a case of salivary gland.

• The Korean Journal of Cytopathology
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• v.15 no.2
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• pp.126-130
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• 2004

Granular cell tumor is characterized by large eosinophilic cells with granular appearances. These are mostly benign. Approximately $1\sim2%$ are malignant, and establishment of reliable criteria for diagnosing malignant granular cell tumor has been difficult to establish because oi the rarify. Reports on the cytologic features of this neoplasm are hardly found in Korea. We report a case of rarely-occurring granular cell tumor in the lower leg of a 40-year-old male, diagnosed on fine needle aspiration cytology, together with a review of the literature regarding significant adverse histology and prognostic factors. The aspirates revealed cellular smears of isolated cells, syncytial clusters, and occasionally stripped nuclei in a nine, bluish-purple, granular background. Tumor cells were polygonal, rounded, or slightly spindled, and showed ill-defined granular cytoplasm. Nuclei were small and round or oval, with inconspicuous or small, prominent nucleoli. The nuclei showed rare intranuclear cytoplasmic invagination. Occasionally, there were mild to moderate nuclear pleomorphisms with vesicular nuclei, with large, prominent nucleoi, but no mitosis. The immunocytochemical stain for S-100 was strongly positive in the cytoplasm of tumor cells with occasional nuclei.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1583-1588
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• 2012

Fine needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimal invasive and cost-effective method for diagnosis of salivary gland lesions. This study evaluated the accuracy and diagnostic performance of FNA cytology in Thailand. A consecutive series of 290 samples from 246 patients during January 2001-December 2009 were evaluated from the archive of the Anatomical Pathology Department of our institution and 133 specimens were verified by histopathologic diagnoses, obtained with material from surgical excision or biopsy. Cytologic diagnoses classified as unsatisfactory, benign, suspicious for malignancy and malignant were compared with the histopathological findings. Among the 133 satisfactory specimens, the anatomic sites were 70 (52.6%) parotid glands and 63 (47.4 %) submandibular glands. FNA cytological diagnoses showed benign lesions in 119 cases (89.5 %), suspicious for malignancy in 3 cases (2.2 %) and malignant in 11 cases (8.3%). From the subsequent histopathologic diagnoses, 3/133 cases of benign cytology turned out to be malignant lesions, the false negative rate being 2.2 % and 1/133 case of malignant cytology turned out to be a benign lesion, giving a false positive rate was 0.8%. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 97.0% (95% CI, 70.6%-99.4%), 81.3% (95% CI, 54.4%-96.0%), 99.1% (95% CI, 95.4%-100%), 92.9% (95% CI, 66.1%-99.8), 97.5% (95% CI, 92.8%-99.5%), respectively. This study indicated that FNA cytology of salivary gland is a reliable and highly accurate diagnostic method for diagnosis of salivary gland lesions. It not only provides preoperative diagnosis for therapeutic management but also can prevent unnecessary surgery.

• The Korean Journal of Cytopathology
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• v.6 no.1
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• pp.18-26
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• 1995

In order to compare cytologic findings ol breast carcinoma in fine needle aspiration cytology (FANC) with histologic findings and prognostic factors including histologic grading, lymph node metastasis and stage, 79 cases of infiltrating ductal carcinoma diagnosed by FANC and confirmed by histology were analysed. We especially attempted to col relate nuclear grade, cellularity and smear pattern with histologic grade, type, status of lymph node metastasis and stage. The results are as fellows. 1. High nuclear grade was correlated with high histologic grade, lymph node metastasis and advanced stage. 2. Individual cell pattern was more frequently identified in high histologic grade and scirrhous or solid-tubular type than in low histolgic grade and papillotubular type. 3. Cellularity increased with higher histologic grade and lymph node metastsis. However cellularity was low in scirrhous type. 4. There is no relationship between nuclear grade and histologic type, between smear pattern and lymph node metastasis or stage, and between cellularity and stage. These results suggest that cytologic findings of breast carcinoma such as nuclear grade, cellularity and smear pattern are indicative of histologic findings in relation to histolgic grade and type. Especially, nuclear grade of FANC may yield valuable prognostic information.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.193-198
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• 1995

The increased use of thyroid fine needle aspiration(FNA) has re-focused on $H\"{u}rthle$ cell lesions. The cytologic diagnosis of $H\"{u}rthle$ cell tumor is a challenge due to the presence of $H\"{u}rthle$ cells in non-neoplastic lesions and the inability to differentiate between benign and malignant $H\"{u}rthle$ cell tumor. We report a case of $H\"{u}rthle$ cell adenoma(HCA) un a 68-year old woman, with review of the cytopathologic findings. FNA revealed loosely cohesive or sheets of large oval to polygonal $H\"{u}rthle$ cells containing abundant granular cytoplasm. The hustopathologic examination confirmed the diagnosis of HCA with follicular growth pattern. Ultrastructurally, the cytoplasm was packed with variable sized mitochondria.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.156-162
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• 1995

Fine needle aspiration of the breast is an important diagnostic tool in malignant lesions, but is also useful in differentiation of inflammatory breast diseases mimicking carcinoma clinically and radiologically. Recently, the authors have experienced eight biopsy-proven cases of chronic inflammatory diseases of the breast, which consisted of 4 cases of duct ectasia, 2 cases of fat necrosis, and a case of tuberculous mastitis and granulomatous mastitis respectively. Their cytologic features mainly based on the components and the relative frequency of inflammatory cells were evaluated for differential diagnosis of chronic inflammatory breast diseases. The results are as follows; 1. In cases of duct ectasia, varying amount of neutrophils, mononuclear leukocytes, histiocytes and multinucleated giant cells were intermixed with benign epithelial cell clusters. 2 Abundant fat tissue fragments were diagnostic for fat necrosis. Histiocytes and mononuclear cells were main components but not rich, and neutrophils and giant cells were infrequently observed. 3. Characteristic granulomas composed of epithelioid cells, mononuclear leukocytes and Langhans' type giant cells and lymphocytic infiltrates were conspicuous in tuberculous mastitis, and occasionally neutrophils, necrotic materials and epithelial cell clusters were found 4. In granulomatous mastitis, epithelioid cell granulomas were also noted but numerous neutrophils and histiocytes were intermingled within or outside the granulomas.

• The Korean Journal of Cytopathology
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• v.10 no.2
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• pp.163-167
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• 1999

Primary small cell carcinoma of the salivary gland is a rare neoplasm that accounts for approximately 1.8% of all primary major salivary gland malignancies. Because of its rarify, it is difficult to diagnose small cell carcinoma of the parotid gland by fine needle aspiration cytology(FNAC). We experienced a case of primary small cell carcinoma of the parotid gland in a 72-year-old woman who presented with two palpable masses of the left infraauricular and ocular legions of two to three month's duration, respectively. Aspirate smears from the left infraauricular area were highly cellular on necrotic and lymphocytic background and showed individually dispersed cells or three-dimensional clusters of small cells. The tumor cells were round to oval with a very high nucleocytoplasmic ratio. Nuclei were about two times the size of lymphocytes and had uniformly dispersed but hyperchromatic to pyknotic chromatin. Nucleoli were occasionally visible but were generally inconspicuous. Numerous mitotic figures were detected. The clusters of these small tumor cells exhibited angular nuclear molding, irregular nuclear outlines, and occasionally rosette like arrangement. The tumor was confirmed by histology and immunohistochemistry.

• The Korean Journal of Cytopathology
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• v.10 no.1
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• pp.35-42
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• 1999

The accuracy of fine needle aspiration cytology(FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases(43.6%) were diagnosed as tuberculosis, 4(10.3%) as granulomatous lymphadenitis, 3(7.7%) as necrotizing lymphadenitis, and 15(38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.