Specific criteria for the diagnosis of fine-needle aspiration (FNA) of Hürthle Cell Carcinoma (HCC) have rarely been discussed in the literature. A retrospective review of 35 FNA cases with the diagnosis of Hürthle cell lesion or Hürthle cell neoplasm was performed. In each case, there was a subsequent surgical excision. The FNA specimens were divided according to histologic diagnoses as HCC (12 cases), Hürthle cell adenoma (HCA) (14 cases), and benign nonneoplastic Hürthle cell lesions (BNHCL) (9 cases). Each case was examined using a semiquantitative scoring system for the following 11 features: presence or absence of colloid, lymphocytes, and transgressed blood vessels (each scored 0 or 1); the percentage of nuclear enlargement, small cell dysplasia, large cell dysplasia, nuclear crowding, and cellular dyshesion (each scored 0-3); and age, gender, and size of lesion. When diagnosed by FNA as either Hürthle cell neoplasm or Hürthle cell lesion, males were much more likely to have malignant tumors than females. Statistically significant cytologic features that favored malignant (HCC) over benign lesions (HCA and BNHCL) included small cell dysplasia, large cell dysplasia, nuclear crowding, and cellular dyshesion. The presence of colloid and lymphocytes favored a benign lesion. Nuclear enlargement and large tumor size are significantly more common in neoplasms than BNHCL.

Electrochemical treatment (EChT) with direct current delivered through implanted electrodes has been used for local control of solid tumors in humans. This study tested the hypothesis that rat breast cancer responses to EChT are dependent on electrode spacing and dose, and explored suitable parameters for treating breast cancers with EChT. Rat breast cancers were initiated by injecting 1 Â 10 6 MTF-7 cells to the right mammary gland fat pad of Fisher 344 female rats. The rats were randomly divided into designated experimental groups when the tumors grew to approximately 2 Â 2 Â 2 cm. One hundred and thirty rats were used for a survival study and 129 for a pathology study. A 4-channel EChT machine was used to administer coulometric doses. The survival study indicated that local tumor control rate is less than 40% in the 40 coulomb (C) and 60 C groups and more than 70% in the 80 and 100 C groups. Sixty six rats died of primary tumors, including all 10 rats in the control group. Once a rat's primary tumor was controlled, no recurrence was found. The main reason for terminating the primary tumor-free rats (51) was lymph node metastasis. Thirteen tumor-free rats survived for more than 6 months. The pathology study showed a signi®cant dose effect on EChT induced tumor necrosis. At 10, 20, 40, and 80 C, the fraction showing necrosis were 39.7, 52.3, 62, and 77.7%, respectively (P 0.001). Electrodes spacing was not an important factor within a given range. At 5, 10, and 15 mm spacing, the fraction showing the necrosis were 54.1, 60.4, and 59.2%, respectively (P 0.552). The overlap rate of necroses was similar in the 5 and 10 mm groups (82.5 and 85%) and lower in the 15 mm group (65%). We conclude that the tumor responses to EChT, local control, survival rates, and necrosis percentages were signi®cantly increased with increasing dose. The changes in electrode spacing (3, 5, and 10 mm) did not signi®cantly affect the tumor responses to EChT within the same dose. For a diameter of 2.0± 2.5 cm rat breast cancer, EChT should be applied with 5±10 mm spacing and a minimum dosage of 80 C.

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Follicular dendritic cell sarcoma (FDCS) is an uncommon neoplasm derived from FDCs in lymphoid tissue. Metastatic FDCS to the liver is rare. We present a case of a 65-yr-old woman who was referred to our institution 1 mo after splenectomy for FDCS of the spleen. An abdominal CT scan revealed a 2.0-cm liver lesion, which led to fine-needle aspiration (FNA) biopsy. Smears of the aspiration obtained were hypercellular showing a pleomorphic population of large oval to spindle-shaped tumor cells against a background of small mature lymphocytes, plasma cells, and necrotic debris. Tumor cells were arranged singly, in syncytial or fascicular patterns, and had a moderate amount of cytoplasm and indistinct cell borders. Nuclei had irregular nuclear membranes, finely granular to vesicular chromatin, and prominent nucleoli. Multinucleated and binucleated cells resembling Reed-Sternberg cells were noted occasionally. Mitotic figures, including atypical forms, were frequently identified. The diagnosis of "pleomorphic malignant spindle-cell neoplasm consistent with metastatic FDCS" was rendered and later confirmed by histological review and immunohistochemical staining of the subsequent liver resection specimen. Although cytological features of FDCS are characteristic, they are overlapping with those of many other tumors. We review the literature on this entity with emphasis on FNA cytomorphology, differential diagnosis, and immunohistochemical findings.

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