Ultrafast Papanicolaou (Pap) stain, a 90-second preparation originally designed for the immediate assessment of fine-needle aspiration (FNA) smears (Yang and Alvarez, Acta Cytol 1995;39:55-60), can also be adapted for permanent FNA smears. It involves the addition of three simple steps prior to the conventional Pap procedure: the first step is to make the cells appear larger, thus increasing the resolution for analysis of cellular details; the second step is to hemolyse the background blood, thus unmasking tumor cells; and the third step is to bring out the vibrant colors in the cells and the nucleoli, which stain red.
Sir, Granular cell tumours (GCTs) are uncommon tumours that occur at a wide range of sites (1) and are characterized by granular, acidophilic cytoplasm that contains abundant lysosomes upon ultrastructural examination (2). Although they vary considerably in cellular and nuclear morphology, tumour cells tend to cluster into aggregates, with some situated between bands of collagen. The nuclei are small, round and centrally located, with no mitoses. GCTs are shown to express S-100 protein upon immunohistochemical examination and to contain numerous pleomorphic secondary lysosomes, including occasional angulate forms upon ultrastructural examination. We describe an atypical GCT with a histological architecture resembling that of a dermatofibroma. CASE REPORTA 48-year-old man presented with a solitary, round, dome-shaped hard nodule, 1.061.0 cm in size, and slightly yellow in colour in the pubic area which had grown over a period of 4 years (Fig. 1). The nodule was slow-growing, fixed and painful when subjected to pressure. Examination of haematoxylin and eosinstained sections revealed that the tumour was situated in the reticular dermis with extension into the papillary dermis and associated with mild hyperplasia of the overlying epidermis with elongation of the rete ridges and hyperpigmentation of the basal layer (Fig. 2 top). The tumour was made up of sheets of cells arranged singly and in nests or lobules separated by thin delicate collagen bundles. At the periphery of the lesion, tumour cells were arranged in a whorled pattern, and appeared to be infiltrating the surrounding tissue. The tumour cells were oval, polygonal to spindle-shaped with distinct cellular borders. The majority of cells had abundant eosinophilic granular cytoplasm and small, bland, eccentrically placed nuclei, and considerable variation in cellular and nuclear size was noted. The tumour cell nuclei showed prominent nucleoli, pleomorphism and nuclear contour irregularities (Fig. 2 bottom); however, no mitosis or necrosis was seen. Immunohistochemical staining revealed that tumour cells showed immunoreactivity for S-100, vimentin, neuron-specific enolase and CD68. No immunopositivity for desmin, smooth muscle actin, CD34, CD57, alpha-1-antitrypsin, MAC387, factor VIII and factor XIIIa was observed. Electron microscopy revealed that the tumour was composed of Fig. 2. (top) Hyperplasia of the overlying epidermis and hyperpigmentation of the basal layer (haematoxylin and eosin, original magnification 640). (bottom) Tumour cells show nuclear pleomorphism and prominent nucleoli (6200).Fig. 1. A dome-shaped, hard nodule in the pubic area. Acta Derm Venereol 85 Letters to the Editor
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