• 대한세포병리학회지
• /
• 제7권2호
• /
• pp.157-162
• /
• 1996

Fine needle aspiration(FNA) is an effective tool in diagnosing mammary carcinoma. We experienced 7 cases of histologically confirmed mammary mucinous carcinoma among 3,052 aspirated cases of breast from 1992 to 1996 in Asan Medical Center. The average age of the patient was 48(33-64) years. The mean size of the lesions was $1.6(0.7{\sim}3)cm$, and they were palpated as well-defined, firm to hard masses. The cytologic features that may be useful in making a FNA diagnosis of mucinous carcinoma of the breast were analysed. Mucinous background and tumor cell clusters with occasional single cells were observed in all cases. Among them, two cases showed abundant scattered single cells, whereas only few single cells were seen in the other two cases. Tumor cells exhibited mild pleomorphism in four cases and moderate pleomorphism in three cases. Nucleoli tended to be not prominent and are observed in three cases, rarely noted in other three cases and not seen in one. There was microcalcification in four cases(57%). In conclusion, mucinous background and clustered tumor cells showing mild to moderate pleomorphism with characteristic clinical findings allow us to diagnose mucinous carcinoma of the breast.

• 대한세포병리학회지
• /
• 제8권1호
• /
• pp.87-92
• /
• 1997

Reports on the cytologic or histopathologic findings of inflammatory pseudotumors are relatively infrequent and most of them have dealt with those involving the lung, liver, genitourinary tract, alimentary tract, spleen, mediastinum, retroperitoneum, etc. Moreover there have not been any cytologic studios of those involving lymph nodes. We present fine needle aspiration cytologic features of inflammatory pseudotumor occurring in a lymph node in a 64 year-old man. The aspirate consisted of proliferating spindle cells and admixed histiocytes, fibroblasts, lymphocytes, and plasma cells. Histiocytes were present either singly or in loosely cohesive small clusters. A few multinucleated giant cells were present as well. However, tuberculosis could be excluded by the absence of typical granuloma, caseation necrosis, or characteristic mixed spindle and inflammatory cell components. Other benign and malignant lymphadenopathies could also be differentiated based on cytologic findings.

• Tuberculosis and Respiratory Diseases
• /
• 제77권4호
• /
• pp.188-192
• /
• 2014

We present a case of an unusual infectious complication of a ruptured mediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which led to malignant pleural effusion in a patient with stage IIIA non-small-cell lung cancer. EBUS-TBNA was performed in a 48-year-old previously healthy male, and a mediastinal abscess developed at 4 days post-procedure. Video-assisted thoracoscopic surgery was performed for debridement and drainage, and the intraoperative findings revealed a large volume pleural effusion that was not detected on the initial radiographic evaluation. Malignant cells were unexpectedly detected in the aspirated pleural fluid, which was possibly due to increased pleural permeability and transport of malignant cells originating in a ruptured subcarinal lymph node from the mediastinum to the pleural space. Hence, the patient was confirmed to have squamous cell lung carcinoma with malignant pleural effusion and his TNM staging was changed from stage IIIA to IV.

• 대한세포병리학회지
• /
• 제15권1호
• /
• pp.45-51
• /
• 2004

It is important to recognize the pathognomonic cytologic findings of chordoma, because of overlapping cytologic features between chordoma, chondrshdosarcoma, myxofilbrillary ependymoma, and metastatic adenocarcinoma. We reviewed the cytomorphologic features of 5 cases of chordoma diagnosed by fine needle aspiration cytology at Korean Cancer Center Hospital from 1987 to 2003. Clinical and radiographic findings of each case were reviewed. Four males and one female (29-54 years) had tumors involving the sacrum. Pain was the presenting symptom in 4 cases. The three cases showed moderate to high cellularity. In all cases, typical physaliferous cells with or without cytoplasmic processes were noted. In two cases, the background was myxoid with single scattered cells. Cell clusters showing cord-like arrangement were occasionally seen. The single or clustered cells showed mild cellular pleomorphism with slightly increased nuclear/cytoplasmic ratio. Mitotic figures were not seen. In our review, the recognition of physaliferous cells is the most important feature to diagnose chordoma and to differentiate it from other lesions mimicking chordoma.

• 대한세포병리학회지
• /
• 제12권2호
• /
• pp.97-103
• /
• 2001

Carcinoma ex pleomorphic adenoma(CXPA) is a rare malignant tumor of the salivary gland, fine needle aspiration cytology(FNAC) of which are rarely reported. We retrospectively reviewed FNAC of five cases of histologically proven CXPA of the salivary glands diagnosed in Seoul National University Hospital to evaluate their cytologic characteristics. Histologically, the carcinoma components were low-grade in three cases and high-grade in two cases. The cytologic diagnosis were malignancy in two cases(40%), suspicious for malignancy in one(20%), and benign(pleomorphic adenoma) in two(40%). All of the high-grade carcinomas were correctly diagnosed by FNAC, however, 2 cases of low-grade carcinomas were diagnosed as benign by FNAC. The low sensitivity in cytologic diagnosis is due to interpretative difficulties in low-grade tumors. The characteristic cytologic features of CXPA were high cellularity, necrotic, bloody, and inflammatory background, marked nuclear overlapping, coarsely granular chromatin, prominent macronucleoli, and atypical mitosis in epithelial component in addition to the typical biphasic pattern of pleomorphic adenoma consisting of epithelial cells admired with spindle-shaped cells and chondromyxoid stroma. Even though low-grade tumors show mild pleomorphism, the cytologic findings of necrotic background, moderate to high cellularity, and nuclear overlapping could lead to an accurate cytodiagnosis of CXPA.

• 대한세포병리학회지
• /
• 제9권2호
• /
• pp.155-159
• /
• 1998

Fine needle aspiration cytology(FNAC) has become a popular method for the diagnosis of a wide variety of both superficial and deep-seated lesions. However, there are few reports about the potential of FNAC for the diagnosis of intraoral lesions. We experienced 44 FNACS from intraoral lesions at Asan Medical Center: 22 from the palate, 6 from the tongue, 5 from the parapharyngeal space, 5 from the lip, 2 from the floor of mouth, 1 from the buccal mucosa, and 3 from other intraoral sites. Histological confirmation was obtained in 32 cases and we analyzed 27 cases excluding 5 cases of inadequate aspirates. Diagnosis was specifically made in 19 of 27 cases(70%) including 1 mucoepidermoid carcinoma, 1 undifferentiated carcinoma, 1 chordoma, 9 pleomorphic adenomas, 1 neurofibroma, and 6 benign lesions. There were three false negative cases(sensitivity, 62.5%) and no false positive cases(specificity, 100%): Two cases diagnosed as "cystic lesion" were confirmed to be mucoepidermoid carcinomas and a case diagnosed as pleomorphic adenoma was proved to be adenoid cystic carcinoma. The results of our study suggest that FNAC is a useful technique in the diagnosis of intraoral lesion.

• 대한세포병리학회지
• /
• 제9권1호
• /
• pp.45-54
• /
• 1998

Fine needle aspiration cytology is considered as a useful diagnostic procedure in management of patients with breast lesions. This study was undertaken to evaluate the scoring system of Masood in the interpretation of breast aspirates, to establish the most useful cytologic criteria for the diagnosis of breast lesions, and to subclassify the benign breast diseases. To assess the feasibility of a cytologic grading system, 57 cases of benign breast disease, 61 cases of malignant breast disease were studied, respectively. The aspirates were evaluated for the cellular arrangement, the degree of cellular pleomorphism and anisonucleosis, and the presence of myoepithelial cells and nuceoli. Values ranging from 1 to 4 were assigned to each criterion and the sum of the individual values was made for each case. The presence of stroma, apocrine metaplasia, foamy histiocytes and inflammatory cells, background of the smear, and cellularity were also evaluated. Cut-off value of the scoring system of Masood between benign and malignant lesion was 15. Among the cytologic criteria, cellular arrangement, presence of myoepithelial cells, nucleoli, and stroma, status of chromatin pattern, and background of smear were useful criteria in the differentiation between benign and malignant lesions. Application of the scoring system of Masood does not always make the accurate diagnosis and the subclassification of benign breast disease.

• 대한세포병리학회지
• /
• 제11권1호
• /
• pp.25-29
• /
• 2000

유방의 분비성 암종은 관 기원으로 통상의 침윤성 관암종보다 예후가 좋은 드문 종양이다. 현재까지 분비성 암종에 대한 세침흡인 세포검사의 세포학적 소견에 대해 보고한 영문보고는 소수이며 국내에는 단 1예의 보고가 있다. 최근 저자들은 세침흡인 세포검사로 진단한 유방의 분비성 암종 1예를 경험하였기에 이를 보고한다. 세포학적 소견은 약호산성의 분비성 물질로 이루어진 배경에 종양세포들이 판상구조를 보이며 개개로 떨어지는 세포는 거의 없었다. 레이스양 세포질의 다공성 변화는 간혹 반지 양 모양을 이루기도 하여 분비성 암종에 합당하였다. 본 증례에서 알 수 있듯이 분비성 도말 배경과 점액으로 채워진 소낭성 공간 및 간혹 관찰할 수 있는 관상피세포의 이형성은 유방의 드문 종양인 분비성 암종의 정확한 세포학적 진단에 매우 유용한 소견이다.

• 대한세포병리학회지
• /
• 제9권1호
• /
• pp.69-78
• /
• 1998

There is a lot of difficulty in the diagnosis of follicular lesions of the thyroid by fine needle aspiration cytology(FNAC). The main purpose of this report is offering more guidance regarding the cytologic appearance to distinguish follicular neoplasm from nodular golfer and laying stress on the presence of mixed group. The histologic and cytologic findings of 23 follicular neoplasms and 13 nodular (adenomatous) getters were reviewed. Histologic specimens were classified into the microfollicular(MIF), mixed(MIX), and nodular getter(NG) groups. The comparison of histologic patterns with histologic diagnosis revealed that all the lesions with predominantly microfollicular, trabecular, or solid pattern were follicular carcinoma and all the lesions with predominantly macrofollicular pattern were nodular goiter. The distinguishing cytologic features for the MIF group were irregular cell arrangement in cell groups(100%, p=0.00001), absence of atrophic follicular cells(100%, p=0.0007), abundant microfollicles(100%, 0=0.002), pleomorphic nuclei(100%, p=0.002), not predominant syncytial smear pattern(100%, p=0.002), heterochromatin(100%, p=0.032), absence of macrofollicles(100%, p=0.038), scant colloid(100%, 0=0.04), clear back-ground(83%, p=0.00006), and uniform sized follicles(83%, p=0.014). And regular cell arrangement(honeycomb appearance) in cell groups(85%, p=0.0000), atrophic change of follicular cells(69%, p=0.0002), syncytial smear pattern(54%, p=0.000), monomorphic nuclei(85%, p=0.008), and hemorrhagic background(100%, p=0.027) were characteristic features of the NG group. Seventeen out of 36 cases(47%) were the MIX group composed of combined cytologic features of the MIF and NG groups. Therefore the frequent presence of the MIX group is considered to be main cause of the difficulty in the diagnosis of follicular lesions by FNAC. The mixed morphologic feature may support the hypothesis of a biologic 'continuum' between nodular goiter and follicular neoplasm of thyroid gland.

• 대한세포병리학회지
• /
• 제16권1호
• /
• pp.47-51
• /
• 2005

Plasmablastic lymphoma (PBL) is a recently described aggressive B-cell neoplasm, which usually manifests as a localized disease of the oral mucosa in individuals infected with human immunodeficiency virus (HIV). Recently we encountered a case of plasmablastic lymphoma manifesting in the left maxillary sinus and cervical lymph node of a previously healthy HIV-negative man, 48 years of age. we conducted a fine-needle aspiration smear of the cervical lymph node, and this was found to be highly cellular with numerous large cells exhibiting eccentrically positioned nuclei, prominent nucleoli, and moderate quantities of basophilic cytoplasm. A biopsy of the mass in the maxillary sinus evidenced diffuse growth of similar plasmablastic cells. These tumor cells were negative for the leukocyte common antigens, CD20, CD3, CD30, and EMA. However, the cells tested positive for CD79a and CD138/syndecan-1. The tumor cells also exhibited L-light-chain restriction. The Ki-67 proliferation index was measured at almost 100%. The patient was diagnosed with plasmablastic lymphoma. After three cycles of combination chemotherapy and radiotherapy, the patient went into complete remission, and currently remains in this state.