• 대한세포병리학회지
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• 제7권2호
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• pp.111-121
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• 1996

Fine needle aspiration cytology(FNAC) is preferred because of simplicity, safety, and reliability in the evaluation of patients with thyroid nodule or hyperplasia. However, there are a few limitations such as false-negative or false-positive cases and non-diagnostic material. To evaluate the usefulness of FNAC in thyroid lesions, we reviewed 704 FNAC cases of thyroid nodules from 1988 to 1994 at Soonchunhyang University Hospital. The results are as follows. 1. Among 704 FNAC cases of thyroid gland, 571(81.1%) cases were benign, 12(1.7%) were suspicious, 71(10.1%) were malignancy, and 50(7.1%) were material insufficiency. The cytologic diagnoses of the benign lesions included 168 cases of follicular neoplasm, 139 cases of adenomatous goiter, 162 cases of follicular lesion such as follicular neoplasm or adenomatous goiter, 61 cases of Hashimoto's thyroiditis, 13 cases of subacute thyroiditis, and 28 cases of colloidal nodule or benign nodule. The malignant lesions included 68 cases of papillary carcinona, two medullary carcinomas and a case of metastatic colon cancer. 2. The average number of cytologic smear slides was $4.12{\pm}1.81$ in material insufficiency and $5.63{\pm}1.79$ in diagnostic cases. This difference was statistically significant(p<0.00001). 3. Histological assessment of 150 cases revealed 2 false negative and 1 false positive cases. The false negative cases were a case of marked sclerosis in papillary carcinoma and an occult case of papillary carcinoma. The false positive case resulted from pseudo-ground glass nuclei due to marked dry artifact. 4. Comparison between the FNAC and the histologic diagnosis revealed that FNAC had a sensitivity of 93.5%, a specificity of 99.2%, a false negative rate of 6.6%, a false positive rate of 0.8%, and an overall diagnostic accuracy of 98.0%. Therefore, FNAC of thyroid gland is a very reliable diagnostic method with excellent accuracy rate.

• 대한세포병리학회지
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• 제8권1호
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• pp.11-19
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• 1997

Clinical lymphadenopathies are subjected to fine needle aspiration cytology(FNAC) for diagnosing not only benign lesions but also malignant ones, as the first diagnostic procedure. While the diagnostic reliability in metastatic carcinoma is high, it is difficult to differentiate malignant lymphoma from reactive conditions. We evaluated the diagnostic reliability of FNAC in lymphadenopathy, and discuss the diagnostic limitation and its place in clinical practice in this study, Over 8 years from January 1988, FNAC of 1,216 lymphadenopathies were analyzed and among them 170 cases were compared with histopathology. The results are as follows. 1. Of ail the cases, 890 cases(73.2%) were diagnosed cytologically as benign, 312 cases(25.7%) as malignant, and 14 cases(1.1%) as unsatisfactory material. Reactive hyperplasia was diagnosed in 585 cases(65.7%) of the benign lesions, and among the malignant diseases, metastatic carcinoma was diagnosed in 248 cases(79.5%), and malignant lymphoma in 62 cases(19.9%). 2. The overall diagnostic accuracy was 89.2%, and no false positive case and 9 false negative results were observed among 170 cases which were proven by histopathology. Six cases of sampling error of false negative diagnoses included 3 of metastatic carcinomas and 3 of malignant lymphomas. The causes were difference between aspiration and biopsy site, poor fixation, or scanty cellularity with bloody smear. All 3 cases of misinterpretation error were malignant lympliomas, one of mixed type on biopsy which was diagnosed as reactive hyperplasia cytologically. In summary, FNAC technique is thought to be useful in the initial diagnosis of lymphadenopathies as well as in the follow-up of patients with known malignancy. Although the results of malignant lymphoma was less accurate than other malignant lesions, the application of strict cytologic criteria or lymphoid marker studies of aspiration material will reduce the false negative rate.

• 대한세포병리학회지
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• 제9권2호
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• pp.221-225
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• 1998

Malignant tumors of the breast with stromal multinucleated giant cells are rare entity of uncertain clinical significance. There have been few reports on the fine needle aspiration cytologic(FNAC) findings about these rare tumors. We report a FNAC case of invasive mammary carcinoma with osteoclast-like giant cells not only for its rare occurrence but in particular for its distinctive cytologic picture on aspirated material. The patient was a 40-year-old woman who presented with a right breast mass for one month. Mammography showed a well-demarcated rounded mass density without calcification. The aspirates of FNAC were highly cellular and two main cell types were seen; malignant epithelial cells and osteoclast-like multinucleated giant cells. The carcinoma cells occurred singly or arranged in loose clusters with ill-defined cytoplasm, oval nuclei, coarse chromatin and small but distinct nucleoli. The multinucleated giant cells showed variable number of nuclei with prominent nucleoli and abundant dense oxyphilic cytoplasm. The immunocytochemical studies suggested that osteoclast-like giant cells were not of epithelial origin, but rather of histlocytic origin.

• 대한세포병리학회지
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• 제13권2호
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• pp.60-65
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• 2002

The accuracy of fine needle aspiration cytology (FNAC) for the diagnosis of follicular lymphoma was investigated by a review of 13 FNAC specimens from 10 patients. All patients Included in this study were confirmed by surgical biopsy preceded by FNAC. Three aspirates were unsatisfactory because of scanty cellularity. Among the remaining 10 cases, 5(50%) were diagnosed as lymphoma, 3(30%) as reactive hyperplasia, one (10%) as metastatic small cell carcinoma, and one (10%) as granulomatous inflammation. Cytologic distinction between follicular lymphoma and reactive hyperplasia is very difficult with cytomorphology alone. Compared to reactive hyperplasia, the characteristic cytologic features such as relatively homogeneous cellular constituent, paucity of tingible body macrophages and lymphohistiocytic aggregates, and less mitotic activity in follicular lymphoma are important findings to prevent false negative diagnosis. In addition, lymphoglandular bodies are useful in distinguishing malignant epithelial tumor from lymphoid lesion.

• 대한세포병리학회지
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• 제9권1호
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• pp.95-98
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• 1998

Papillary renal cell carcinoma (RCC) is an uncommon subtype of RCC that has distinctive gross, histologic, and cytogenetic features. The cytologic features of FNA are abundant papillary clusters and relatively few single cells. The cells are usually small and contain uniform nuclei; numerous macrophages with foamy cytoplasm are often found in the background. We describe a case of papillary renal cell carcinoma evaluated by fine needle aspiration cytology(FNAC) in a 42 year-old man. The smear showed a few papillary clusters and numerous macrophages with foamy cytoplasm in the background. With adequate cellularity, papillary RCC can be distinguished reliably from non-papillary RCC by FNAC.

• 대한세포병리학회지
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• 제10권1호
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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.

• 대한세포병리학회지
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• 제3권2호
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• pp.67-74
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• 1992

Apocrine carcinoma is a rare form of breast malignancy and is composed of entirely or predominantly of apocrine type epithelial cells. Apocrine metaplastic cells are frequently noted in fine needle aspiration cytology(FNAC) of breast lesions, especially fibrocystic disease. These apocrine cells may occasionally be atypical, to make a diagnostic difficulty. Two cases of apocrine carcinoma of the breast diagnosed by FNAC are described, and differential cytologic points between apocrine metaplasia and apocrine carcinoma are discussed. The first case is a right breast mass of a 37-year-old woman for 20 days. The smears show many single or sheets of large cells on bloody background. Each cell has a large vesicular nuclei with multiple macronucleoli and abundant eosinophilic granular cytoplasm. The second case is a left breast mass of a 35-year-old woman for one month. The smears show similar findings as seen in the first one. Histopathologic findings of both cases are typical of apocrine carcinoma. Electron microscopy demonstrates variable numbers of large osmiophilic granules in diameter of $200\sim600nm$ in both cases.

• 대한세포병리학회지
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• 제15권2호
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• pp.112-115
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• 2004

Lymphoproliferative disorders, manifesting either as a primary lesion or as part of a generalized process, rarely involve the breast. The primary malignant lymphoma of the breast is rare. The cytologic features of this neoplasm have not been reported in Korea thus far. We described a case of primary malignant lymphoma of the breast, as diagnosed by fine needle aspiration cytology (FNAC) in an 84-year-old female. FNAC smears showed high cellularity. The main cytologic feature observed was a carpeting of monotonous, atypical, enlarged lymphoid cells. These lymphocytes showed relatively round elliptical nuclei with some indentation. One or more prominent nucleoli were seen. Biopy from the breast mass revealed diagnostic features of non-Hodgkin's lymphoma, diffuse large B-cell type.

• 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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• 제17권1호
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• pp.56-62
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• 2006

Salivary duct carcinoma (SDC) is a rare primary salivary gland malignancy characterized by histological features similar to those of ductal carcinomas of the breast. It is regarded as a high-grade malignancy associated with frequent local recurrences and early distant metastases that require aggressive treatment. The typical fine needle aspiration cytology (FNAC) findings in SDC include cellular smears showing tumor cells with eccentric pleomorphic nuclei and a granular cytoplasm arranged in flat sheets or cribriform patterns against a necrotic background. However, the presence of mucin-containing cells in SDC has been rarely described. We report the FNAC findings in a patient with histologically confirmed SDC that demonstrated numerous mucin-containing cells and was subsequently misdiagnosed as a high-grade mucoepidermoid carcinoma. Here we discuss the problems involved in distinguishing SDC from high-grade mucoepidermoid carcinoma on the basis of cytologic findings alone.