A source of false positives in cytologic interpretation

Milligan, Mildred; Carrow, Leon A.; Eggers, Virginia

doi:10.1016/0002-9378(59)90533-2

Cited by 3 publications

(4 citation statements)

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“…Nonetheless, they are pathologically intriguing since they can be potentially misinterpreted and misdiagnosed as malignancy, viral infection, or other previously described histopathologic structures, such as Bbs or Hbs. Bbbs very closely resemble Bbs, as described first on Papanicolaou-stained vaginal smears in 1959 by Milligan et al [5] and further characterized in 1999 by Abdulla et al [8] Although the two bodies bear close similitude, characteristic location, morphology and staining profile (special and immunohistochemical) allows a clear distinction. For instance, Bbbs reside in lymph node tissue and show higher size variability ranging from 5-30 μ, as opposed to the 8-15 μ described for Bbs, which are found in vaginal smears.…”

Section: Discussionmentioning

confidence: 75%

“…Therefore, characterization of unique structures that could be confused with atypical cells (malignant or virally infected) or known pathologic bodies remains significant. For example, the so-called blue blobs (Bbs) described by Milligan et al [5] may be a source of misdiagnosis in postmenopausal vaginal smears, since they simulate malignancy. Likewise, a few structures such as crystals or Liesegang rings have been confused with parasitic organisms and may be associated with malignancy [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Blue Blob-Like Bodies Mimicking Malignancy

Nava¹

2020

BJSTR

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Background: Incidental morphologic findings in lymph node tissue may represent a diagnostic challenge in surgical pathology. We have characterized, for the first time to our knowledge, dense globular structures that most likely represent degenerated lymphoid cells found in a Mascagni-Lund's lymph node, and resemble Blue Blobs (Bbs) described in vaginal Papanicolaou-stained smears, or Hematoxylin Bodies (Hbs) commonly seen in patients diagnosed with Systemic Lupus Erythematosus (SLE), respectively. These Blue Blob-Like Bodies (Bbbs) are not associated with SLE, and immunohistochemistry may be necessary to rule out malignancy or viral infection.Objective: To characterize Blue Blob-Like Bodies (Bbbs) in a Mascagni-Lund's lymph node from a cholecystectomy specimen performed for acute cholecystitis. Materials and Method:A paraffin-embedded cholecystectomy specimen that included a Mascagni-Lund's lymph node was evaluated by routine microscopy in a busy surgical pathology service. Special stains, immunohistochemistry, and electron microscopy were performed to characterize the unusual structures observed.Results: Many scattered, round-to-oval, dense globular basophilic novel structures with smooth borders were identified and named Blue Blob-Like Bodies (Bbbs). Conclusion:Bbbs mimic malignant (primary or metastatic) or virally infected cells in lymph node tissue. However, they most likely represent degenerated lymphoid cells resulting from reactive lymphadenopathy secondary to acute cholecystitis.Pathologists need to recognize Bbbs and properly distinguish them from other pathological structures, in order to avoid misdiagnosis.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Blue Blob-Like Bodies Mimicking Malignancy

Nava¹

2020

BJSTR

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“…In such instances a simple solution may be to treat with estrogens and repeat the smear after restoration of the epithelium. In a study by Melligan et al, 1 estrogenic stimulation appeared to decrease the number of Bbs or eliminate them. A debatable situation may be clarified by colposcopic evaluation and tissue biopsy.…”

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confidence: 99%

“…A significant number of atrophic smears contain cyanophilic bodies that were colloquially termed "blue blobs" (Bbs) by Melligan et al in 1959. 1 Those authors thought Bbs to be resting or altered forms of trichomonads since trichomonads were seen in 86.6% of the cervicovaginal smears they examined. The origin and precise composition of Bbs is still disputed.…”

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confidence: 99%