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S M Selvaggi

Publications and source records attributed to S M Selvaggi.

49 records · Page 3Linked to original sources
PubMed1986

Cytologic detection of condylomas and cervical intraepithelial neoplasia of the uterine cervix with histologic correlation.

Human papillomavirus (HPV) has been implicated as an important etiologic factor in cervical carcinoma. This study evaluates the efficacy of cytology as a screening tool in the detection of cervical lesions with koilocytotic features. Cervical smears and biopsy specimens from 76 women seen between January 1983 and October 1985 were reviewed. The histologic categories consisted of koilocytotic lesions (flat condylomas) with minimal cellular atypia, CIN I, II, III, with surface koilocytes showing cellular atypia (atypical koilocytosis), CIN III with a contiguous lesion as defined in categories 1 and 2, negative biopsies. Histologically, five cases showed flat condylomas with minimal cellular atypia, 65 showed cervical intraepithelial neoplasia (CIN) with atypical koilocytosis and two showed negative biopsies. Cytologically, in all cases of flat condyloma with minimal cellular atypia (5+5), CIN I with atypical koilocytosis (39/39), and CIN III with a contiguous condylomatous lesion (4/4) both koilocytes and, in the latter two categories, dysplastic cells were identified in the cervical smears. In 7/9 cases of CIN II and 9/17 cases of CIN III with atypical koilocytosis, smears showed both atypical koilocytes and dysplastic cells. In the remaining ten cases, however, there was cytologic underestimation of the histologic diagnosis of CIN, particularly when the lesion was focal. The data suggests that although cytology does detect a high percentage of cervical lesions with koilocytotic features (64/76, 84% in this study), it may not detect focal CIN II, CIN III lesions associated with condylomatous lesions in the same biopsy specimen. Therefore, it is proposed that all women with cytologic evidence of koilocytosis on cervical smears are deserving of a colposcopic examination.

Adolescent↗
PubMed1986

Pulmonary cytology in patients with the acquired immunodeficiency syndrome (AIDS).

Over a 2-yr period, 1982-1984, 181 pulmonary cytology specimens were obtained from 45 patients clinically suspected of having AIDS in an attempt to identify the various organisms and the cytologic atypias present in pulmonary cells. Cytologic correlations with autopsy findings were available for 28 of these cases (62%). Specimens were collected from sputum, bronchial washes and brushes, bronchoalveolar lavages, and pleural fluid. Of the 181 specimens, 121 (67%) were of diagnostic value. Depending on the cytologic technique, Pneumocystis carinii, cytomegalovirus, herpesvirus, and Candida were detected with varying frequency. The bronchial epithelial and glandular cell atypias, ranging from mild inflammatory reactive changes to marked cellular atypia, were noted most often in specimens from patients with pulmonary infections who were concurrently receiving oxygen therapy and/or chemotherapy for Kaposi's sarcoma or central nervous system lymphoma. An awareness of the wide range of AIDS-associated pulmonary cell atypias is required to rule out a diagnosis of malignancy.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Percutaneous fine-needle aspiration biopsy in malignant lymphoma: a case report of an unusual cytologic presentation.

A case of an elderly Hispanic male who presented with clinical findings suspicious for lymphoma and cytologic evidence suggestive of carcinoma is presented and discussed. Percutaneous fine-needle aspiration biopsy of a group of mesenteric lymph nodes and a pleural fluid specimen showed clusters of tumor cells suggestive of carcinoma. Electron microscopic analysis of the pleural fluid showed comparable clusters of tumor cells, which proved to be lymphoma cells enveloped by macrophages. Histologic, electron microscopic, and histocytochemical examination of an enlarged inguinal lymph node confirmed the diagnosis of lymphoma with several alpha-naphthyl acetate esterase-positive macrophages interspersed among the tumor cells. To date, the phenomenon of macrophages enveloping lymphoma cells, so as to simulate tumor cell clustering, has not been reported. It is, however, an important possibility to keep in mind with cytologically distinguishing a lymphoma from a carcinoma.

Aged↗
PubMedDate not supplied

Cytologic diagnosis of peripheral T-cell lymphoma manifesting as ascites. A case report.

BACKGROUND: Patients with malignant lymphoma seldom present with effusions without a known history of malignancy. Because of this, initial diagnosis of malignant lymphoma by effusion cytology is uncommon, with few reported cases. CASE: A 75-year-old male presented with fatigue, decreased appetite and progressively increasing abdominal girth over five weeks. Cytologic examination of ascitic fluid obtained by paracentesis revealed non-Hodgkin's lymphoma with a T-cell phenotype, confirmed by immunophenotypic and molecular studies. Approximately one week later, histologic examination of liver and bone marrow revealed involvement by lymphoma, demonstrating immunophenotypic and molecular profiles identical to those obtained from neoplastic lymphocytes recovered from the ascites fluid. CONCLUSION: This case demonstrates a rare presentation of peripheral T-cell lymphoma, clinically manifesting as ascites. In cases such as ours, where the effusion consists predominantly of small to intermediate-sized lymphocytes, distinguishing lymphoma from reactive lymphocytosis may be difficult. This case not only demonstrates the value of effusion cytology for lymphoma diagnosis but also illustrates how the use of various immunophenotypic and molecular techniques may assist the pathologist in properly diagnosing these difficult cases.

Aged↗
PubMedDate not supplied

Bronchoalveolar lavage in lung transplant patients.

Over a four-month period (November 1991-February 1991), six patients underwent lung transplantation for end-stage pulmonary disease. Twenty-four transbronchial biopsies with concurrent bronchoalveolar lavage were performed at regular intervals to evaluate acute graft rejection and/or infection. A study was performed to evaluate the role of lavage in the cytodiagnosis of acute pulmonary graft rejection. Histologic features of acute rejection were present in 11/24 biopsies (46%), consisting of perivascular and/or peribronchial lymphoid aggregates. Concurrent lavage findings were hyperplastic alveolar lining cells (one specimen, 9%), atypical lymphocytes (one specimen, 9%), and acute and chronic inflammation (nine specimen, 82%). Among the 13 lavages without concurrent histologic evidence of acute graft rejection (54%), atypical lymphocytes were present in one specimen (8%). The majority of the specimens (54%) showed a relative lack of inflammation. Two of the 24 lavages (8%) contained either Candida or cytomegalovirus (CMV), which were not present on the concurrent biopsy, and one biopsy contained CMV, which was absent on the lavage smear. Although a higher percentage of lavages with histologic evidence of acute graft rejection contained acute and chronic inflammatory cells as compared to lavages without concurrent histologic evidence of rejection, the cytodiagnosis of acute graft rejection on bronchoalveolar lavage is indeterminate.

Adult↗
PubMedDate not supplied

Comparison of smears and cell blocks in the fine needle aspiration diagnosis of recurrent gynecologic malignancies.

A retrospective, seven-year study was conducted to evaluate the value of cell blocks as an adjunct to smears in the fine needle aspiration (FNA) diagnosis of recurrent gynecologic malignancies. Eighty-four FNAs were performed on patients with previously diagnosed malignancies of the cervix (39 cases), ovary (27), uterus (14), vulva (2) and vagina (2). Material for the preparation of cell blocks was available in all cases. Smears and cell blocks were reviewed separately, and the findings were categorized as positive, negative, suspicious or unsatisfactory. Identical smear and cell block results were reported in 71 (84.5%) of the 84 cases (45 positive, 20 negative, 1 suspicious and 5 unsatisfactory). In 12 cases (14.3%) the smear was superior to the cell block in detecting malignant cells; while all 12 smears were positive, 8 cell blocks were negative, and 4 were suspicious. In no case was the cell block positive with a negative smear; in one (1.2%) the cell block was positive and the smear suspicious. The results of this study indicate that the additional study of cell blocks is of little benefit in the FNA cytodiagnosis of recurrent disease in patients with documented gynecologic malignancies.

Biopsy, Needle↗
PubMedDate not supplied

Cytologic features of squamous cell carcinoma in situ involving endocervical glands in endocervical cytobrush specimens.

Clinical usage of the cytobrush has led to an increase in cellular yield on endocervical cell samples. In cases of squamous cell carcinoma in situ (CIS) involving endocervical glands, clusters of abnormal cells on endocervical smears can be confused with well-differentiated adenocarcinoma in situ (AIS). The purpose of this retrospective three-year study (January 1988 through December 1990) was to evaluate the cellular features of endocervical gland involvement by CIS on cell samples obtained with the cytobrush. Of the 45 cases of CIS diagnosed on cytology, 25 (56%) had histologic correlation and form the basis of this study. In 10 (40%) of the 25 cases two distinct cell patterns were noted. Pattern A was composed of round to oval clusters of abnormal cells with smooth cell borders. Cells at the periphery were flattened, while those within the center had a spindling or whorling arrangement. The cells showed an increased nuclear/cytoplasmic ratio and contained hyperchromatic nuclei and granular chromatin. Nucleoli were not discernible. Pattern B consisted of sheets of columnar cells with peripheral palisading and nuclear pseudostratification, findings that might be interpreted as AIS. The cellular characteristics were similar to those of pattern A. Histologically all cases (10 cervical cones) showed transformation zone and/or endocervical canal involvement by CIS with extension into endocervical glands. In 8 (32%) of the 25 cases, neither cell pattern was present on cytology. In 7 of these cases (87.5%), 7 cervical cones did not show CIS within endocervical glands; supporting findings for patterns A and B represented gland involvement by CIS. In the remaining 7 cases (28%), 6 (85.7%) showed pattern A, and 1 (14.3%) showed pattern B; of these, 5 (71%) showed CIS within endocervical glands (5 cervical cones). Histologically, none of the 25 cases showed endocervical AIS. Endocervical gland involvement by CIS has characteristic cell patterns on endocervical cell samples obtained with the cytobrush that permit the distinction from well-differentiated AIS.

Adenocarcinoma↗