A 63-yr-old woman with systemic lupus erythematosus (SLE) diagnosed 12 mo previously and treated with prednisolone and cyclophosphamide presented with recent fever and dyspnoea. The etiology of a 3 cm diameter centrally cystic coin lesion in the lower lobe of the left lung was obscure. Blood cultures and sputum examination had been non-contributory, and the diagnosis of Nocardia asteroides infection was initially made by cytologic examination of material obtained by lung fine-needle aspiration (FNA). It is notoriously difficult to detect this organism by conventional sputum examination or with histologic sections, and it has rarely been detected by lung FNA. If this organism is demonstrated, appropriate microbiologic cultures for confirmation and susceptibility testing should be instituted. Long-term antimicrobial therapy is needed. In this case, complete resolution of the lung lesion followed 5 mo of therapy.

At the queen victoria medical centre between 1981 and 1984. 2920 fine needle aspirates of the breast were examined with an overall diagnostic accuracy of 97% and a sensitivity of 80%. This high diagnostic accuracy combined with the ease and complication‐fm nature of the procedure has meant that fine needle aspiration (fna) has become an important p˜tl of the investigation and management of breast disease within the breast service of the queen victoria medical centre.

The major diagnostic histopathological features of moderate to severe Alzheimer's disease (AD) are amyloid rich neurofibrillary tangles (NFTs) and neuritic plaques (NPs) containing beta A4 peptide. As the frequency of stereotactic brain biopsies is increasing, the diagnostic cytological features of AD are of relevance. Our study presents the brain smear features of five autopsied patients with moderate to severe AD both clinically and pathologically. NFTs and NPs were identified in 100% of smears. Amyloid neuropil threads (NTs), a more recently identified hallmark of AD, were also seen in all smears. Segmental beta A4 peptide deposition within vessels, clustering of plaques around capillaries, and NTs were more obvious by the smear technique than in histological sections.

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