Analysis of this survey of 244 responding cytotechnologists shows that a high percentage still suffer from musculoskeletal disorders commonly associated with poor ergonomic design in the workplace, despite the variety of ergonomically designed microscopes that have been introduced into the market. Although Kalavar and Hunting surveyed a small group of cytotechnologists in the Washington, DC, area in 1996, no broad-based study has focused specifically on these professionals. The landmark study of microscope ergonomics, published by Soderberg in 1980, documented widespread musculoskeletal complaints in the electronics industry. This article identifies and discusses the types of musculoskeletal discomforts experienced by cytotechnologists. We propose that both practicing and student cytotechnologists receive training in ergonomic principles and appropriate interventions, such as improved work practices, proper ergonomic aids, well-designed workstations, and ergonomically designed equipment. More than 85% of respondents reported some musculoskeletal discomfort. Among the symptoms presented are headache, neck pain and stiffness, pain of the lower and upper back, and upper-extremity discomfort. Neurological symptoms, such as numbness, tingling, and/or pain in the hand and fingers, are often associated with repetitive motion. More than one-third reported numbness, tingling, and/or pain in the left-hand fingers, usually used for the fine-focus control knob. Almost one-half of respondents reported such symptoms for the right hand and fingers, normally used to manipulate the mechanical stage controls. Only 9% of the respondents were left-handed. Most (91%) were right handed. Although just over one-third (34.4%) of respondents worked for an employer with an ergonomics program, ergonomic assessments had been performed for only about one-half (17.6%) of these. In addition, approximately 10% of respondents indicated that ergonomics assessments had been performed on their workstations, even though the employer did not have an ergonomics program. Because of the high prevalence of reported symptoms, we recommend that all cytologists be trained in basic ergonomic principles and the proper use of ergonomic aids. These interventions should reduce the prevalence of musculoskeletal discomfort in medical microscopists.

Accurate diagnosis of small-cell carcinoma of the lung (SCLC) is clinically important because of the therapeutic implications. SCLC must be distinguished from non-small-cell carcinoma (NSCLC) and lymphoma. Paranuclear blue inclusions (PBIs) were recently described as a feature of metastatic SCLC on air-dried Wright-stained bone marrow aspirate smears. To determine the utility of PBIs in distinguishing SCLC from NSCLC and lymphoma, we evaluated air-dried Diff-Quik-stained smears from 103 fine-needle aspiration (FNA) specimens and 14 touch imprint specimens. PBIs were identified in 24 (89%) of 27 cases of SCLC, in 6 (9%) of 64 non-small-cell carcinomas (P < 0.00001), and in two (8%) of the 26 lymphoma cases (P < 0.00001). No PBIs were seen on any of the alcohol-fixed Papanicolaou or hematoxylin-eosin (H&E) stained smears examined. In conclusion, PBIs appear to be a feature of SCLC on air-dried cytologic material stained with Romanowsky type stains. In the presence of cytologic features of SCLC, the identification of PBIs provides a useful diagnostic feature for differentiating between SCLC and NSCLC carcinomas, and between SCLC and lymphomas in FNA specimens and touch imprints from surgical specimens.

This is a report of a case of Ki‐1–positive large‐cell anaplastic lymphoma in an 87‐year‐old man diagnosed on pleural and peritoneal fluids by cytomorphologic and immunohistochemical examination. Papanicolaou‐stained smears revealed many single, large neoplastic cells containing one or two nuclei with occasional multinucleated cells having a wreath‐like nuclear arrangement. The tumor cells expressed Ki‐1 antigen and epithelial membrane antigen. This is the first known report of Ki‐1 lymphoma diagnosed initially on cytologic examination of pleural and peritoneal fluids. Diagn. Cytopathol. 17:134–137, 1997. © 1997 Wiley‐Liss, Inc.

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