One blinded observer (C.D.S.) retrospectively reviewed 76 previously diagnosed and biopsy-confirmed malignant bronchial brush and wash specimens, 46 non-small cell and 30 small cell carcinomas, obtained from 55 patients. Each case was scored for the presence or absence of 36 standard criteria (architectural, cytoplasmic, and nuclear). Logistic regression analysis was used to determine which criteria were most useful for separating small cell from non-small cell lesions. Although no single criterion displayed 100% sensitivity and specificity for small cell cancer, univariate statistical analysis indicated that 3 individual criteria (nuclear molding, finely granular or "salt and pepper" chromatin, and scant delicate cytoplasm) were more than 90% sensitive and specific in cases of small cell carcinoma. The presence of nuclear molding alone provided the best fit for the logistic regression model. When nuclear molding was present, the odds of a small cell diagnosis increased more than 300-fold. Nuclear molding, finely granular or salt and pepper chromatin, and scant, delicate cytoplasm are the 3 most sensitive and specific cytomorphologic features traditionally used to separate small cell from non-small cell carcinoma. Nuclear molding alone represents the most significant cytomorphologic feature for distinguishing between these malignant lesions.

Objective: We identified unique vegetable cell-like structures in urinary diversion specimens. This study aimed to describe their cytomorphology and prevalence and to investigate the possible origin of these contaminants. Study Design: A 10-year retrospective review of urinary diversion urine specimens with reported vegetable cell-like structures was performed. Data regarding patient demographics, previous history and specimen cytomorphology were recorded. To determine their prevalence, 100 urinary diversion cases were screened. Stoma materials were evaluated as possible contaminant sources. Results: A total of 11 urine cases from 7 patients (mean age 64 years; male/female ratio 2.5:1; all with ileal conduits) were identified with contaminating vegetable cell-like structures. These thick-walled cells contained dense, smudged cores and pericentral clearing. In 27% of cases, the specimens were less than optimal or unsatisfactory for evaluation due to low cellularity and associated lubricant material. No contaminating vegetable cell-like structures were found in the 100 screened cases. Stoma care products tested did not yield any morphologically similar structures. Conclusion: Vegetable cell-like structures may rarely be identified as a contaminant in urinary diversion specimens, possibly from stoma care material. Associated lubricant may affect specimen adequacy. These vegetable cell-like structures must be distinguished from true pathologic structures such as koilocytes or parasitic ova.

Ocular and periocular hematolymphoid diseases are a diverse group of lesions affecting various soft tissue structures within the orbital cavity. Lymphoid proliferations in particular are among the most commonly diagnosed entities in orbital pathology. When noninvasive techniques fail to confirm or rule out the suspicion of orbital neoplasia, fine‐needle aspiration (FNA) may be of use in establishing a diagnosis in a reliable, timely, cost‐effective and safe manner. From 1986 to 1999, 79 orbital/ocular needle aspiration biopsies were conducted by staff ophthalmologists at Allegheny General Hospital. Slides from these cases and corresponding reports were pulled from the cytology files and grouped into the two broad categories of hematolymphoid and other. Specimens came from patients ranging in age from 14 to 88 years (mean, 64 years) with eight patients having known histories of hematolymphoid disorders. Immunocytochemical (ICC) studies were performed in 33% of the cases (14/43). Review of the diagnoses for the 79 aspiration specimens revealed 30 cases diagnosed as lymphoma/atypical lymphocytic infiltrate, cases diagnosed as inflammation or abscess, three cases diagnosed as plasmacytoma, three cases called suboptimal with scant inflammatory cells, and one case of Langerhans' cell histiocytosis. Hematolymphoid diagnoses accounted for 54% (43/79) of all diagnoses. Histologic correlation was available in 33% (14/43) of the cases (nine cases diagnosed as cytologically atypical/malignant and five cases called cytologically benign/suboptimal) with 100% correlation. Hematolymphoid lesions of the orbit are readily diagnosed by FNA. Because many hematolymphoid malignancies are treated as systemic or multiorgan system diseases and because ocular lymphomas may also involve the central nervous system, nonsurgical attempts at diagnosis have the potential to spare the patient procedural morbidity which may be associated with open biopsy. Our experience indicates that the combination of FNA, judicious use of immunocytochemical studies, and correlation with pertinent clinical information and imaging studies allows for reliable and effective classification and diagnosis of orbital hematolymphoid lesions. Diagn. Cytopathol. 2000;23:314–317. © 2000 Wiley‐Liss, Inc.

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