Flower-like colloid on thyroid fine needle aspiration

No abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60456/1/20857_ftp.pd

Diagnosis of foregut and tailgut cysts by endosonographically guided fine-needle aspiration

Foregut, hindgut, and tailgut cysts are uncommon developmental anomalies. Clinical and radiological diagnosis can present many challenges, especially in adult patients or when the lesions are in unique locations. Thus, diagnosis has traditionally been provided upon surgical resection. We describe the diagnoses of a gastric foregut cyst and a retrorectal tailgut cyst by endosonographically guided fine-needle aspiration in two adults. The common cytologic features of the specimens are ciliated epithelial cells, proteinaceous material with degenerated debris, histiocytes, and benign appearing epithelium of squamous and/or gastrointestinal type that lack cytologic atypia. The identification of ciliated columnar cells is the key finding. Cytologic diagnosis via endosonographically guided fine-needle aspiration of foregut/hindgut cyst is accurate and less traumatic than surgical biopsies. Diagn. Cytopathol. 2007;35:43–46. © 2006 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55921/1/20573_ftp.pd

Fine-needle aspiration cytology of Rosai-Dorfman disease of bone

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) is a rare, benign self-limiting condition of unknown etiology. Less than a quarter of cases have only extranodal involvement and a few cases of skeletal involvement of Rosai-Dorfman disease without associated lymphadenopathy have been reported in the literature. We herein report cytohistologic findings in a case of sole skeletal Rosai-Dorfman disease in a 51-year-old woman who presented with an expansile, heterogeneous lesion at T11 with cord compression and edema. A CT-guided fine-needle aspiration of T-11 lesion was performed and the sample was processed by ThinPrep technique. The ThinPrep smear showed characteristic features of Rosai-Dorfman disease including hypercellularity with moderate number of histiocytes in a background of lymphocytes, plasma cells, and neutrophils. The histiocytes possessed abundant, pale and vacuolated cytoplasm, rounded nuclei with smooth nuclear membranes, fine chromatin, and distinct nucleoli. The histiocytes showed emperipolesis of lymphocytes and neutrophils. The diagnosis was confirmed by concurrent biopsy with immunhistochemical study. Our case highlighted the role of fine-needle aspiration with ThinPrep technique in the diagnosis of Rosai-Dorfman disease. Diagn. Cytopathol. 2008;36:516–518. © 2008 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60237/1/20838_ftp.pd

A metastatic renal carcinoid tumor presenting as breast mass: A diagnostic dilemma

We present clinicopathological and cytological findings of a well-defined breast mass in a patient with history of primary renal carcinoid tumor. Fine-needle aspiration (FNA) cytology showed monotonous tumor cells with plasmacytoid appearance arranged singly and in small clusters. Occasional tumor cells were arranged in acinar architecture resembling glandular differentiation. Tumor cells showed fine speckled chromatin. The unusual location for metastasis of this rare type of carcinoid tumor and overlapping cytological features with primary mammary carcinoma led to an erroneous preliminary cytological diagnosis of primary breast carcinoma with plasmacytoid features. Tumor cells in the corresponding cell block showed strong diffuse positivity for synapthophysin and pan-cytokeratin with weak focal positivity for chromogranin markers. These patterns of immunostaining were similar to the original renal carcinoid tumor. To the best of our knowledge, a few cases of carcinoid tumor metastatic to the breast have been reported in the literature and more than half of these cases were initially misdiagnosed as primary breast carcinoma causing unnecessary surgical treatment. This is a first reported case of metastatic renal carcinoid tumor into breast diagnosed with FNA biopsy. This report highlights the cytological features of well-differentiated neuroendocrine tumor (carcinoid tumor) and its potential diagnostic pitfalls. Diagn. Cytopathol. 2007;35:306–310. © 2007 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/56036/1/20631_ftp.pd

Restoring satisfactory status in ThinPrep Pap test specimens with too few squamous cells and containing microscopic red blood cells

Treatment of specimens that contain excessive blood can effectively reduce the unsatisfactory rate; however, a considerable number of unsatisfactory specimens remain. We evaluated the effectiveness of reprocessing unsatisfactory specimens that had too few squamous cells and contained microscopic red blood cells (TFSQRBC). Out of the 688 unsatisfactory specimens at microscopic screening, 197 (28.63%) were TFSQRBC that were reprocessed by treatment of glacial acetic acid (GAA). Red blood cells were observed clogging the pores in the filter of the ThinPrep device. After reprocessing, 129 (68.48%) yielded a satisfactory diagnosis, which accounted for a reduction of the unsatisfactory rate by 18.25%. In the restored satisfactory specimens, abnormal diagnoses of 1 high-grade squamous intraepithelial lesion (HSIL) (0.78%), 3 atypical glandular cells (AGC) (2.33%), and 13 atypical squamous cells of undetermined significance (ASCUS) (10.08%) were made. The abnormal diagnoses in this group of patients were significantly higher than that in the general population screened. Reprocessing unsatisfactory ThinPrep® (TP) specimens of TFSQRBC can reduce the unsatisfactory rate of the TP Pap test significantly and is a cost-effective measure. The initially unsatisfactory specimens are more likely to represent cases with an abnormal diagnosis, which also justifies the effort of reprocessing this group of specimens. Adjustment of the pore size on the ThinPrep filter device may reduce the interference of red blood cells. Diagn. Cytopathol. 2008;36:696–700. © 2008 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/60992/1/20890_ftp.pd

Computer-assisted image analysis of amyloid deposits in abdominal fat pad aspiration biopsies

Amyloidosis is a heterogeneous group of diseases with a common outcome: deposition of insoluble protein in the visceral organs and tissues. Primary amyloidosis is a consequence of different plasma cell disorders, and it is the most common form of amyloidosis in the United States with an estimated 2,000 new cases annually. Other forms of amyloidosis include chronic inflammatory processes, familial type of amyloidosis, and localized forms like Alzheimer's disease. The diagnosis of amyloidosis is based on the clinical picture and demonstration of amyloid deposit in tissues with Congo-red stain. In our article, we describe a simple methodology for image analysis of fat pad biopsies for amyloidosis using a commercially available software Adobe Photoshop CS3© Extended Edition. The principle is based on calculation of the mean gray value of each blue and green channel and comparison of their ratios. As a negative control, we have used samples from heart, scar tissue, and skin with their representative control. Fibrous tissue often gives a white:blue to blue:green birefringence, which often is confused with the apple: green birefringence of the amyloid stain; however, we were successful in discriminating these colors using the methodology described in this article. We also analyzed 22 patients with at least 2 years follow-up in our institution. The specificity and the sensitivity of the computer-assisted image analysis were calculated to be 75% and 100%, respectively. These results are in agreement with the published papers (references here); however, caution should be exercised before drawing firm conclusions because of the small sample size presented here. Diagn. Cytopathol. 2009. © 2008 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/61453/1/20948_ftp.pd

Nodule heterogeneity as shown by size differences between the targeted nodule and the tumor in thyroidectomy specimen

BACKGROUND. Missed papillary thyroid carcinoma (PTC) diagnoses on fine-needle aspiration (FNA) can result from many causes. To the authors' knowledge, the issue of whether the detection of PTC is correlated with nodule heterogeneity has not been studied to date. METHODS. The authors identified all thyroidectomy specimens with a diagnosis of PTC that had undergone at least 1 prior FNA in the study institution between 1998 and 2003. The tumor size at the time of the resection, the ultrasound (US)-determined nodule size, and other parameters were compared between the 2 groups in which PTC was or was not diagnosed on FNA. RESULTS. Of a total of 89 specimens, 47 were diagnosed on FNA with an average tumor size of 1.7 cm and an US-determined nodule size of 2.1 cm (a difference of 0.4 cm). Forty-two specimens with a smaller average tumor size of 0.9 cm ( P <.0001) and a US-determined nodule size of 2.4 cm (a difference of 1.5 cm) were missed. The differences with regard to the US-determined nodule size and tumor size between the 2 groups were significant (0.4 cm vs 1.5 cm; P < .0001). In the missed group, 29 specimens were found to have PTC foci that measured ≤1.0 cm and 26 had a reasonable size difference (RSD; defined as a PTC size outside the range of ±50% of the US-determined nodule size) as the indicator of the mixed nature of nodules targeted for FNA, whereas in the diagnostic group, 9 foci measured ≤1.0 cm and 6 had RSD. There was no cytologic evidence with which to render a diagnosis of PTC on further review in the missed group. CONCLUSIONS. The major reason for a missed diagnosis of PTC on FNA is because of inadequate tumor sampling due to the heterogeneity of the nodule targeted for FNA. This is illustrated by the RSD noted between the targeted nodule and the actual PTC tumor focus in the resection specimen. Cancer (Cancer Cytopathol) 2008. © 2007 American Cancer Society.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/58022/1/23253_ftp.pd

Incidental giardiasis diagnosed by fine-needle aspiration of a phantom cecal “mass”

No abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48780/1/20351_ftp.pd

Ubc9p and the conjugation of SUMO-1 to RanGAP1 and RanBP2

AbstractThe yeast UBC9 gene encodes a protein with homology to the E2 ubiquitin-conjugating enzymes that mediate the attachment of ubiquitin to substrate proteins [1]. Depletion of Ubc9p arrests cells in G2 or early M phase and stabilizes B-type cyclins [1]. p18Ubc9, the Xenopus homolog of Ubc9p, associates specifically with p88RanGAP1 and p340RanBP2[2]. Ran-binding protein 2 (p340RanBP2) is a nuclear pore protein [3,4], and p88RanGAP1 is a modified form of RanGAP1, a GTPase-activating protein for the small GTPase Ran [2]. It has recently been shown that mammalian RanGAP1 can be conjugated with SUMO-1, a small ubiquitin-related modifier [5–7], and that SUMO-1 conjugation promotes RanGAP1's interaction with RanBP2 [2,5,6]. Here we show that p18Ubc9 acts as an E2-like enzyme for SUMO-1 conjugation, but not for ubiquitin conjugation. This suggests that the SUMO-1 conjugation pathway is biochemically similar to the ubiquitin conjugation pathway but uses a distinct set of enzymes and regulatory mechanisms. We also show that p18Ubc9 interacts specifically with the internal repeat domain of RanBP2, which is a substrate for SUMO-1 conjugation in Xenopus egg extracts

Global wave loads on a damaged ship

A computational tool was applied based on a two dimensional linear method to predict the hydrodynamic loads for damaged ships. Experimental tests on a ship model have also been carried out to predict the hydrodynamic loads in various design conditions. The results of the theoretical method and experimental tests are compared to validate the theoretical method. The extreme wave induced loads have been calculated by short term prediction. For the loads in intact condition, the prediction with duration of 20 years at sea state 5 is used, while for loads in damaged conditions the prediction in 96 hours exposure time at sea 3 is used. The maximum values of the most probable extreme amplitudes of dynamic wave induced loads in damaged conditions are much less than those in intact condition because of the reduced time. An opening could change the distribution of not only stillwater bending moment but also wave-induced bending moment. It is observed that although some cross sections are not structurally damaged, the total loads acting on these cross sections after damage may be increased dramatically compared to the original design load in intact condition