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Cytologic features of pulmonary hamartoma. Report of a case
diagnosed by fine needle aspiration cytology.Acta
Cytol. 2001 Mar-Apr;45(2):267-70
BACKGROUND:
Pulmonary hamartoma (PH) is the most common benign tumor of the
lung. It is usually composed of cartilage, fat, smooth muscle and
respiratory epithelium. Its diagnosis is based on imaging methods
(radiography, computed tomography) and cytohistomorphologic study by
means of fine needle aspiration cytology (FNAC). CASE: A 59-year-old
female had a productive cough and lung mass on chest radiography.
Fine needle aspiration of the nodule showed a fusiform tumor cell,
which was diagnosed as consistent with PH. The patient underwent
surgery for the tumor. Histopathologic study confirmed the diagnosis
of PH. CONCLUSION: The fluoroscopically guided FNAC specimen was
adequate in achieving a diagnosis. Cytologic features consisted of a
serosanguineous background in which scant cellular elements of
spindle and stellate cells, as well as fibromyxoid material, enabled
us to make a definitive diagnosis. Since this technique is
relatively noninvasive, it is very useful in diagnosing PH before a
preoperative biopsy.
Fine needle
aspiration biopsy of pulmonary hamartomas. Radiologic, cytologic and
immunocytochemical study of 15 cases.
Acta Cytol.
1995 Nov-Dec;39(6):1167-74.
OBJECTIVE: To
review the radiographic, cytologic and immunocytochemical features
of pulmonary hamartomas (PHs) diagnosed on fine needle aspiration
biopsy (FNAB). STUDY DESIGN: Fifteen consecutive cases of PH,
diagnosed on FNAB between January 1987 and February 1993 and
confirmed by surgery or follow-up, were studied. In two additional
cases PH was offered as a differential diagnosis and was excluded on
follow-up. Clinical notes, radiographs, cytologic smears and cell
block sections stained routinely and with antibody to S-100 protein,
as well as histologic slides, were reviewed. RESULTS: All cases of
PH showed common radiographic features, including peripheral
location, round or oval shape, sharp edges and size < 3 cm.
Cytologic diagnosis of PH was based on recognition of mesenchymal
component, characterized by fibromyxoid stroma, present in 94% of
FNABs. Chondroid material was present in 75% of aspirates. In all
cases of proven PH, fibromyxoid material showed S-100 protein
positivity, characterized by finely granular, brown staining of the
stellate cells. In two cases proven not to be hamartomas, the
material, suspected to be fibromyxoid or chondroid, failed to show
S-100 protein positivity. CONCLUSION: These findings confirm the
value of FNAB in the diagnosis of PH. Immunocytochemical staining
with antibody to S-100 protein is a useful diagnostic tool in
confirming the cartilaginous nature of PH. The cytologic findings
should be correlated with radiologic and clinical findings before a
definitive diagnosis of PH is rendered on FNAB material.
Pulmonary hamartoma: diagnosis by transthoracic needle-aspiration
biopsy.Radiology.
1985 Apr;155(1):15-8.
Hamartomas of
the lung often present as asymptomatic, noncharacteristic masses
that can seldom be differentiated from other lung masses such as
primary cancer or metastases by conventional radiography.
Transthoracic needle-aspiration biopsy (TNAB) has become a popular
and reliable method for the diagnosis of a lung lesion, and it
offers a valuable alternative to diagnostic thoracotomy. In our
study, TNAB established the diagnosis of pulmonary hamartoma in 12
of 14 (86%) patients. In eight patients, one procedure (using one to
three punctures) was sufficient to establish the diagnosis, and, in
four patients, two procedures (using one to two punctures) were
necessary. In two patients, the lesion was missed on second and/or
third biopsy procedures, and the correct diagnosis was obtained at
surgery. Cytologic examination of the material was diagnostic in
five of the 14 patients. Tissue specimens were sent in 13/14
patients, and findings of histologic examination established the
correct diagnosis in 11 of these patients. One of the 12 patients in
whom hamartoma was correctly diagnosed by TNAB underwent resection
of his lesion, and histologic examination confirmed the diagnosis.
In the remaining 11 patients, the lesions have been stable on
follow-up chest examinations.
Pulmonary
hamartomas: cytologic appearances of fine needle aspiration biopsy.Acta
Cytol. 1976 Jan-Feb;20(1):15-9
The cytologic
findings in specimens obtained from pulmonary hamartomas by fine
needle aspiration biopsy are presented. The following are the main
characteristics: 1. In spite of the fact that the lesions are
usually hard and cartilaginous, find needle aspiration is possible
and can obtain diagnostic material. 2. The material obtained usually
has few cells. 3. The cells aspirated include columnar ciliated
cells, lymphocytes, histiocytes as well as fragments of cartilage
which are quite characteristic. 4. The differential diagnosis is
discussed.
Inflammatory pseudotumor: a diagnostic dilemma in
cytopathology.
Diagn
Cytopathol. 2004 Oct;31(4):267-70.
Inflammatory
pseudotumor (IPT) is a rare space-occupying lesion of unknown
etiology that can mimic malignancy on clinicoradiological and
pathological examination. A review of the cytopathology archives at
The Johns Hopkins Hospital identified 12 cases from eight patients
with histologically proven IPT (lung, seven patients; liver, five
patients). There were six men and two women with an age range of
28-84 yr (mean age, 59 yr). Presenting complaints of IPT of the lung
included shortness of breath and hemoptysis, and in cases of IPT of
the liver complaints included abdominal pain and elevated liver
function tests (LFTs). All cases were found to have mass lesions
suspicious for a neoplasm on radiographic examination. Cytological
specimens consisted of fine-needle aspiration (FNA; seven specimens)
and bronchial brush/wash (five specimens). Diagnostic accuracy of
cytology for IPT was low (5/12, 42%). IPT showed hypercellular
smears (on FNA) with an admixture of various cell types including
inflammatory cells with predominance of plasma cells, fibroblastic
proliferation, granulation tissue formation, and atypical-appearing
histiocytes with enlarged nuclei and intranuclear inclusions.
Fibroblastic proliferation with mitoses may mimic mesenchymal
neoplasms. Cytomorphology is nonspecific and IPT usually is a
diagnosis of exclusion.
Pulmonary inflammatory pseudotumor. Its diagnosis by fine-needle
aspiration puncture.Arch
Bronconeumol. 1994 Apr;30(4):215-8.
Cytological
characteristics are reported in the case of a 20-years-old male with
pulmonary inflammatory pseudotumor (PIP) diagnosed by fine-needle
aspiration (FNA) and later confirmed histologically. The patient
presented a large tumor on the lower lobe of the right lung with
hemoptysis, hemothorax and secondary acute anemia. The
clinical-pathological profile of PIP are reviewed, along with
diagnostic problems arising from the morpho-structural
characteristics of the disease.
Fine-needle cytology of inflammatory myofibroblastic tumor of the
lung. Report of a case.Pathologica.
2004 Oct;96(5):430-2
BACKGROUND:
Inflammatory myofibroblastic tumor (IMT) of the lung is a rare
condition that may mimic cancer. CASE: We describe a case of
inflammatory myofibroblastic tumor discovered by a routine chest
X-ray in a 26-year-old male patient, primarily diagnosed by fine
needle aspiration biopsy. The clinical, cytopathological and
differential diagnostic findings of this rare entity are briefly
discussed. CONCLUSION: IMT may be diagnosed accurately on needle
cytology samples, provided that other pseudoneoplastic and
neoplastic entities can be excluded from its differential diagnosis.
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