A patient with bronchiolitis obliterans organizing pneumonia (BOOP) associated with acute Mycoplasma pneumoniae infection is described. Although mycoplasmas have occasionally been associated with bronchiolitis obliterans, to the best of our knowledge, this is the first well-documented case of BOOP associated with M. pneumoniae infection. The diagnosis of BOOP was made by open-lung biopsy after fiberoptic transbronchial biopsy proved nondiagnostic. Corticosteroid therapy was administered and a dramatic improvement was observed; the patient remained without complaints during a 3-year follow-up period.Bronchiolitis obliterans organizing pneumonia (BOOP) is a L (68% and 65%, respectively, of expected values). A highresolution CT scan showed bilateral airspace consolidations in potentially reversible histopathologic condition seen in the lung either as an idiopathic clinical syndrome or as a nonspecific the upper and middle right lobes and in the upper left lobe in association with hilar lymphadenopathies (1 cm in diameter). reaction to injury in a variety of situations, including infections [1]. Mycoplasmas have a wide range of immunomodulatory A 2-week course of therapy with erythromycin and cefonicid was administered. Serological assays revealed no diagnostic effects and have previously been associated with bronchiolitis obliterans (BO) without organizing pneumonia [2 -4]. A causal rise in titers of antibody to Epstein-Barr virus, cytomegalovirus, Legionella pneumophila (serogroups 1 -6), Coxiella burnetii, relationship has also been suggested in experimental studies [5]. However, the component of organizing pneumonia was or Chlamydia. Antibodies to M. pneumoniae were clearly documented by an IgG ELISA: first titer (at admission), 1.05; second lacking in all these reports. To our knowledge, we report the first well-documented case of BOOP associated with Mycotiter (4 weeks later), 2.95; ratio of second-to-first titers, 2.81 (seroconversion is defined by a ratio ú1.64) [6]. plasma pneumoniae infection.Fever (temperature, 37.3ЊC), exertional dyspnea, dry cough, and a high erythrocyte sedimentation rate (80 -92 mm/h) perCase Report sisted. A chest roentgenogram obtained 1 month later revealed the persistence of bilateral, mainly peripheral, migratory patchy A 57-year-old woman was admitted to the hospital because infiltrates in areas that were affected during the first admission of a 10-day history of cough, low-grade fever, and exertional (figure 2). The control WBC count was 7,900/mm 3 , with 948 dyspnea. Physical examination revealed tachypnea, fever (temeosinophils/mm 3 . The patient was admitted again, and fiberopperature, 37.7ЊC), and diffuse crackles in both lungs. Laboratic bronchoscopy was performed. Samples obtained with a teletory studies disclosed the following values: PO 2 , 61 mm Hg; scoping plugged catheter were cultured, but no aerobic bacteria PCO 2 , 36 mm Hg (measured while the patient was breathing or Legionella were isolated. Cytological examination of the room air); hemoglobin, 13.5 g/dL; WBC co...

No abstract

Metaplastic carcinoma (MC) is an uncommon neoplasm of the breast. There are several variants of MC depending on the dominant histologic pattern. The components include overt infiltrating ductal carcinoma, extensive squamous differentiation and spindle cell proliferation with or without chondroid or osseous heterologous elements. In FNA smears, only 57% of cases show both ductal carcinoma and metaplastic component. Thus, in almost one half of the cases, the diagnosis is not possible by FNA. Often it is difficult to define the epithelial or sarcomatous character of malignant cells. We describe a case of metaplastic carcinoma of the breast studied by fine‐needle aspiration cytology in which myxoid ground substance was the dominant feature in the cytology smears. The rest of the material was composed of scanty isolated atypical cells with large and irregular nuclei. It is important to bear in mind the diagnosis of MC and make a careful search for atypical cells when the cytological smears are mainly composed of myxoid ground substance. Diagn Cytopathol 1996;14:325–327. © 1996 Wiley‐Liss, Inc.

~ Dear Dr. Bedrossian: We read with great interest the Grace A.T. Ang et al. article recently published in Diagnostic Cytopathology reporting a case of negative images of mycobacteria in a fine-needle aspirate from a para-aortic lymph node of a patient with AIDS. '