BACKGROUND. In 1996, the National Cancer Institute (NCI) recommended five categories for the diagnosis of breast aspiration cytology: benign, atypical, suspicious, malignant, and unsatisfactory. The authors evaluated the usefulness of separating inconclusive diagnoses into the aforementioned atypical and suspicious categories. The current study examined the correlation between cytologic and histologic findings made in breast aspiration cytology specimens that were categorized in accordance with these NCI guidelines. METHODS. From 1992 to 2000, 7727 breast aspirations were performed at the University of Miami/Jackson Memorial Medical Center (Miami, FL). Aspirates were classified using criteria similar to the NCI recommendations. Four hundred eightynine aspirates (6%) were classified as being cytologically 'atypical' or 'suspicious'. Of those, 225 'atypical' aspirates and 162 'suspicious' aspirates had available histologic follow-up data and were included in the study. RESULTS. Among the 'atypical' aspirates, 118 (52%) yielded malignant findings on histologic evaluation. Infiltrating ductal carcinoma (n ϭ 87; 74%) was the most common malignant diagnosis, followed by infiltrating lobular carcinoma (n ϭ 12; 10%). Among 'suspicious' aspirates, 135 (83%) yielded malignant findings on histologic analysis. The most common benign diagnosis in both 'atypical' and 'suspicious' aspirates was proliferative fibrocystic changes with or without atypia, followed by fibroadenoma. CONCLUSIONS. Most aspirates that yielded suspicious findings on cytologic examination proved to be malignant, as did Ͼ 50% of aspirates that yielded atypical findings. Infiltrating lobular carcinoma commonly was underdiagnosed as being atypical on cytologic examination. Benign lesions with atypical or suspicious cytologic diagnoses included certain cases of atypical ductal hyperplasia. The authors concluded that the distinction between the atypical and suspicious categories, as recommended by the NCI, is not warranted. Therefore, they suggest the use of a single term, such as 'equivocal', to describe inconclusive diagnoses on breast fine-needle aspiration cytology. Cancer (Cancer Cytopathol) 2004;102:164-7.

Up to 30-50% of melanomas arise in association with a nevus. Accurately defining, the nevus from the melanoma can significantly affect microstaging. Recently, we showed that a targeted fluorescence in situ hybridization (FISH) assay could distinguish between benign nevi and melanoma with a sensitivity of 87% and specificity of 95%. In this study, we evaluated the potential of this same assay for use in the microstaging of melanoma. We performed FISH on 36 cases of melanoma occurring in association with a nevus and 6 cases of nevoid melanoma with deep dermal involvement. In the melanomas with associated benign nevi, FISH enumeration was performed separately on the histologically malignant and benign components. In the nevoid melanomas, FISH was performed on the deep dermal areas. On the basis of the criteria developed in our earlier studies, we determined the sensitivity of the assay within the malignant areas and the specificity within the benign areas of melanomas with associated nevi. In addition, we evaluated the sensitivity and specificity within a group of six nevoid melanomas with deep dermal involvement. Among melanomas with associated nevi, 28 of 36 cases (78%) tested positively in the histologically malignant areas. The benign nevus components were uniformly negative for all criteria. Six of six nevoid melanomas (100%) tested positively in the deep dermal area. FISH analysis with probes targeting 6p25, 6q23, 11q13 and CEP6 can effectively discriminate the malignant and benign components of melanomas with associated nevi and can be used as an adjunctive tool for microstaging. The assay has high sensitivity for the malignant areas of nevus-associated melanomas and outstanding specificity for the benign areas. The sensitivity is independent of the morphological features, and the assay performs well in nevoid melanoma cases.

To our knowledge, this is the first case of cutaneous leishmaniasis in a kidney transplant patient residing in the US in an area known to be non-endemic for leishmaniasis, probably after reactivation of a previously dormant infection acquired outside of the US at least 9 months prior to developing clinical symptoms.