Background:Granular cell tumors (GCT) formerly known as Abrikossoff tumor or granular cell myoblastoma, are rare neoplasms encountered in the fine needle aspiration (FNA) service. Named because of their highly granular cytoplasm which is invariably positive for the S-100 antibody, the classic GCT is thought to be of neural origin. The cytomorphological features range from highly cellular to scanty cellular smears with dispersed polygonal tumor cells. The cells have abundant eosinophilic granular cytoplasm, eccentric round to oval vesicular nuclei with small inconspicuous nucleoli. The fragility of the cells can result in many stripped nuclei in a granular background. The differential diagnosis occasionally can range from a benign or reactive process to features that are suspicious for malignancy. Some of the concerning cytologic features include necrosis, mitoses and nuclear pleomorphism.Methods:We identified 6 cases of suspected GCT on cytology within the last 10 years and compared them to their final histologic diagnoses.Results:Four had histologic correlation of GCT including one case that was suspicious for GCT on cytology and called atypical with features concerning for a malignant neoplasm. Of the other two cases where GCT was suspected, one showed breast tissue with fibrocystic changes, and the other was a Hurthle cell adenoma of the thyroid.Conclusions:These results imply that FNA has utility in the diagnosis of GCT, and should be included in the differential diagnoses when cells with abundant granular cytoplasm are seen on cytology. Careful attention to cytologic atypia, signs of reactive changes, use of immunohistochemistry, and clinical correlation are helpful in arriving at a definite diagnosis on FNA cytology.
Anaerobiospirillum succiniciproducens is an uncommon yet potentially lethal gram-negative bacterium typically affecting patients with comorbidities. We report a case of A. succiniciproducens infection in an autopsy patient who had hepatitis C and type 2 diabetes and describe the difficulties in the laboratory identification of this pathogen.
Myeloproliferative neoplasms (MPNs) are traditionally separated into BCR-ABL-positive chronic myeloid leukemia (CML), and BCR-ABL-negative MPNs including primary myelofibrosis (PMF), essential thrombocythemia (ET), and so forth. One of the diagnostic requirements for PMF and ET is the absence of the Philadelphia chromosome, while its presence is almost universally indicative of CML. However, a diagnostic dilemma arises when Philadelphia chromosome-positive MPNs lack the majority of the typical features seen in CML. Some of these classic CML features include basophilIa, marked leukocytosis, neutrophils left-shift with myelocytes bulge, and “dwarf” megakaryocytes. Presented here is a case of a 32-year-old pregnant patient who did not have typical morphologic findings for CML, and yet the Philadelphia chromosome was positive. The patient demonstrated some pathologic features that are commonly presented in PMF that included bone marrow reticulin fibrosis, leukoerythroblastosis, splenomegaly, and increased serum lactate dehydrogenase.
Hepatitis C virus (HCV) involves both the liver and extra hepatic organs. The aim of this study was to retrospectively evaluate the association between HCV genotypes and lymphomas. Lymphoma cases were retrieved from our surgical pathology and hematopathology archives from January 2005 to April 2012. Patients who had positive HCV serology with subsequent viral genotyping were selected. Patients with positive Human immunodeficiency virus (HIV)serology were excluded. We identified 17 lymphoma cases with associated HCV infection. Eleven out of 14 (79%) patients had genotype 1 HCV. Diffuse large B cell lymphoma (DLBCL) was the most common lymphoma (6 out of 17 cases) and all cases of DLBCL had genotype 1. Genotype 2 was detected in only three patients (21%) with the diagnoses of follicular lymphoma, splenic marginal zone lymphoma, and classical Hodgkin lymphoma (CHL). CHL was diagnosed in three cases and peripheral T-cell lymphoma in one case.Twelve of 17 (71%) patients were incarcerated in the Texas Department of Criminal Justice system. All 11 genotype 1 patients were male, 4 of 11 (36%) were African American, 4 of 11 (36%) were Caucasian and 3 of 11 (27%) were Hispanic.We concluded that HCV genotype 1 was more common than genotype 2 while no other genotype was detected.
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