5 research outputs found
Diagnóstico citológico de las recidivas tumorales de ameloblastoma: presentación de dos casos clínicos
Introducción: Los ameloblastomas son los tumores odontogénicos
más frecuentes del maxilar. A pesar de su aspecto citohistológico
de benignidad, se comportan como tumores invasivos,
recidivantes y con posibilidad de metastatizar.
La P.A.A.F. es una prueba rápida e incruenta que proporciona
un diagnóstico prequirúrgico evitando, en ocasiones, tomas
biópsicas destinadas al diagnóstico.
Presentamos las características citológicas de dos casos de
recidiva yugal de ameloblastoma de rama mandibular diagnosticados
por PAAF, así como su correlación citohistológica.
Casos clínicos: Dos pacientes, una mujer de 36 años y un varón
de 62 años, que acuden por tumoración mandibular de escasos
meses de evolución. En ambos casos, la primera aproximación
diagnóstica fue junto a los estudios radiológicos el estudio
histológico de la masa tumoral. Tras la extirpación terapeútica,
ambos casos recidivaron. El diagnóstico de las recidivas fue
establecido citológicamente mediante PAAF.
Las extensiones citológicas mostraron un fondo granular con
aislados macrófagos y células multinucleadas gigantes y una
abundante celularidad epitelial de aspecto basaloide dispuesta
en grupos cohesivos configurando imágenes de empalizada
periférica, así como pequeños grupos de células de metaplasia
escamosa.
Discusión: La PAAF se considera como un método diagnóstico rápido, incruento y fiable en el diagnóstico del ameloblastoma.
La citología de estos tumores revela los componentes de la lesión
que, en general, son suficientes para llegar al diagnóstico de
ameloblastoma, especialmente en casos de recidiva.Introduction: Ameloblastomas are the most frequent odontogenic
tumors of the maxilla. In spite of their benign cytohistological
appearance, they behave as invasive recurring tumors, with the
possibility of metastasis.
FNAB is a rapid, bloodless test that provides a pre-surgical
diagnosis, thus, on occasions avoiding the need for diagnostic
biopsies.
We present the cytological characteristics of two cases of jugal
recurrences of mandibular ameloblastomas diagnosed by FNAB,
as well as their cytohistological correlation.
Clinical cases: Two patients, a 36-year-old woman, and a 62-
year-old male who both attended with mandibular swelling
of a few months evolution. In both cases the first diagnostic
approximation was the histological study of the tumoral mass,
together with the radiological studies. Following therapeutic
extirpation both cases recurred. The diagnosis of the recurrences
was established cytologically by means of FNAB.
The cytologic smears revealed a granular background with isolated
macrophages and giant multinucleate cells and an abundant
epithelial cellularity of basaloid appearance arranged in cohesive
groups forming images of peripheral palidasing, as well as small
groups of squamous metaplastic cells.
Discussion: FNAB is considered to be a rapid, bloodless and reliable
method for the diagnosis of ameloblastoma. The cytology of these tumors reveals components of the lesion that, in general,
are sufficient for the diagnosis of ameloblastoma, especially in
cases of recurrence
Características citopatológicas del carcinoma de células acinares (CCA) de glándula salival: a propósito de cuatro observaciones
Objetivo: Presentar las características citopatológicas del carcinoma
acinar (CCA), así como su correlación cito-histológica,
comentando los problemas de diagnóstico diferencial de esta
entidad en base a cuatro observaciones estudiadas mediante
PAAF.
Casos clínicos: Dos varones de 52 y 53 años, una mujer de
79 años, y una niña de 12 años que presentaron tumoraciones
localizadas en territorio parotídeo (casos 1, 2 y 4), y a nivel
laterocervical (caso 3).
En tres pacientes, la PAAF fue, junto a los estudios de imagen,
la primera aproximación diagnóstica; correspondiendo el caso
3 a una punción de adenopatías laterocervicales metastásicas en
una paciente con antecedentes de CCA de parótida.
Hallazgos citológicos: Las extensiones citológicas mostraron
abundante celularidad tumoral dispuesta en pequeñas placas
monocapa, formando estructuras acinares, o como células aisladas.
Es de destacar la abundancia de núcleos desnudos en el
fondo de los frotis, y la ausencia de grasa y de epitelio ductal.
Las células poseían núcleos monomorfos redondeados u ovales,
nucleólo poco evidente y abundante citoplasma granular o
finamente vacuolado.
Discusión: La PAAF proporciona información esencial en la
actuación diagnóstico-terapeútica de las tumoraciones de la
glándula salival, resultando esta metodología muy sensible
en su eficacia diagnóstica. La identificación de los CCA frecuentemente
presenta dificultades, debido a la gran similitud citológica de las células tumorales con el componente acinar
normal propio de la glándula salival. El diagnóstico diferencial
se plantea, fundamentalmente, con carcinomas de células claras,
con carcinomas mucoepidermoides, con el tumor de Warthin
y con los oncocitomas. Nuestras observaciones confirman la
validez de la PAAF en una primera aproximación diagnóstica
de estas lesiones tumorales accesibles a la punción directa.Objective: To present the cytopathological characteristics of
acinic cell carcinoma (ACC) as well as its cyto-histological
correlation, commenting on the differential diagnostic problems
of this entity based on four observations studied using fine-needle
aspiration biopsy (FNAB).
Clinical Cases: Two males of 52 and 53 years of age, one 79
year-old woman and a girl of 12 years of age, who presented
tumors located in the parotid area (cases 1, 2 and 4) and at the
laterocervical level (case 3).
In 3 patients, the FNAB was, together with the image studies,
the first diagnostic indication; case 3 corresponding to a puncture
of metastatic laterocervical adenopathies in a patient with
a history of parotid ACC.
Cytological findings: The cytologic smears revealed abundant
tumoral cellularity arranged in small monolayered sheets,
forming acinar structures or isolated cells. The abundance of
bare nuclei at the background of the smears, and the absence of
adipose tissue and ductal epithelium are highlighted. The cells
possessed round or oval monomorphic nuclei, few nucleoli and
abundant granular or finely vacuolate cytoplasm.
Discussion: FNAB provides essential information on the diagnostic-
therapeutic management of salivary gland tumors; this
methodology is highly sensitive in its diagnostic efficacy. The
diagnosis of ACCs frequently presents difficulties, owing to
the great cytologic similarity of the tumor cells with the normal
acinar component of the salivary gland. The differential diag-nosis is considered, fundamentally, with clear cell carcinomas,
mucoepidermoid carcinomas, Warthin's tumor, and oncocytomas.
Our observations confirm the validity of FNAB in a first
diagnostic approximation for those lesions accessible to direct
puncture
Thyroid papillary carcinoma infarction after fine needle aspiration
Complications following fine needle aspiration (FNA) are very infrequent and generally resolve spontaneously without treatment. The appearance of necrosis or infarction after FNA of the thyroid gland is an exceptional finding. An 83-year-old woman with a thyroid nodule was subjected to diagnostic FNA using a G23 needle. The patient noted a decrease in nodule size after FNA. A total thyroidectomy was performed 36 days after FNA. The cytological diagnosis was papillary carcinoma. Histology revealed massive coagulation necrosis affecting 80% of the tumor mass; the cytological diagnosis was confirmed. Iron pigment deposits were observed in the vicinity of the necrotic areas together with interstitial fibrosis; this suggested a mechanism of ischemic necrosis but no vascular thrombosis was observed. Post-FNA tumour regression of a thyroid lesion is an infrequent finding thet should be made known to clinicians and pathologist, since final diagnosis may be difficult by the massive necrosis
Aplicacion de la PAAF en el diagnostico de masas mediastinicas. Correlación cito-histologica
Fine needle aspiration (FNA) is found to be a useful and non invasive technique in the presurgical diagnosis of intrathoracic masses. In the present study we report our findings from a total of 33 mediastinal aspiration punctures, performed over the past 24 months. In 24 of the 33 puntures, the lesion was either previously biopsied or surgically removed, which allowed for the corresponding cytohistological correlations. The cytological diagnosis demonstrated 12 cases of malignancy, 2 cases of benign lesions and 5 cases of negative tumours. It was possible to establish the cellular lineage in only 8 cases without specifying the benignity or malignancy of the lesion (2 neural tumours, 2 thymomas, 2 spindle cell mesenchymall tumours and 2 with a lymphoproliferative process), while 6 cases were insufficient for diagnosis. The sensitivity and specificity obtained using this diagnostic methodology was 79% and 100% respectively, where the diagnostic accuracy was 83%. The positive and negative predictive value was 100% and 53% respectively. In 2 of the 9 cases that were not operated on, the cytological diagnosis was benign, showing 2 brochogenic cysts that were evacuated during the process thus resolving the situation. Our findings and the adequate cytohistological correlation obtained confirm the effectiveness of FNA in the diagnosis of mediastinal masses