Fine Needle Aspiration Cytology of Superficial Organs and Body Sites.

Abstract

Department of Pathology Yale University School of Medicine New Haven, Connecticut, U.S.A. This multiauthored book is primarily an atlas of the cytomorphology of superficially occurring lesions readily amenable to fine needle aspiration (FNA) as an adjunct to diagnosis. The authors advocate the combination of pattern recognition at low magnification as well as detailed high-power examination of cytomorphologic attributes, and assume a practical working knowledge of the histopathologic basis for cytomorphologic findings in Diff-Quik and Papanicolaou stain aspiration smears. Precise diagnosis may be rendered at times with a proper integration of the clinical, radiographic, and cytomorphologic features. They subscribe to the “quick read” examination, not only to provide a rapid diagnosis, but also to indicate the procurement of additional material for immunocytochemical, electromicroscopic, molecular biologic, cytogenetic, and microbiologic examination. Six anatomic areas, lymph nodes, breast, thyroid and parathyroid, salivary gland and other head and neck masses, bone and skin and superficial soft tissues, are described. The format features the description of the techniques involved followed by a listing of the possible diagnoses starting with benign and reactive and progressing to malignant. The description is accompanied by high-quality color photographs approximately 2 × 4 inches in size with up to eight per page stained with both Romanowsky and Papanicolaou techniques. Graphs of flow cytometric analyses for surface markers are given in association with the morphology of lymphoid neoplasms. The chapter on breast FNA describes the technique, philosophy of reporting, a listing of the entities and a description, as well as abundant illustrations of the cytomorphology. The authors favor precise diagnosis, grading, and estimation of ploidy, S-phase, steroid hormone receptors, and C-ERB 2 on the cytologic material. The chapter on thyroid and parathyroid features an algorithm which includes clinical, cytomorphologic, and therapeutic data. Perhaps the most unusual chapter is that on FNA of bone in which a limited number of entities amenable to diagnosis by FNA are listed. These include nonossifing fibroma, fibrous histiocytoma, fibrous dysplasia, osteofibrous dysplasia, hemangioma, osteochondroma, enchondroma, osteoid osteoma, osteoblastoma, low-grade central osteosarcoma, and low-grade chondrosarcoma. The authors stress that interpretation must be closely linked to clinical and radiographic data, but information of value in therapy can be provided. This atlas is placed somewhere between a treatise on localized disease and a comprehensive atlas of fine needle aspirate cytomorphology. The authors are experienced, the illustrations are abundant and of high quality, and the suggestions for reporting are timely. All of these suggest that this book would be of value not only to the cytopathologist, but also to the surgical pathologist with an interest in obtaining diagnostic material from a variety of techniques.