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Singh S, Chaudhari JP, Kothari K. Castleman Disease: Diagnosis on Cytology. J Cytol 2023; 40:105-106. [PMID: 37388404 PMCID: PMC10305901 DOI: 10.4103/joc.joc_1_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 07/01/2023] Open
Affiliation(s)
- Suneet Singh
- Department of Pathology, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Jayashri P. Chaudhari
- Department of Pathology, Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr. R. N. Cooper Hospital, Mumbai, Maharashtra, India
| | - Kanchan Kothari
- Department of Pathology, Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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Singh N, Chowdhury N, Pal S, Goyal JP, Bhakhri BK, Rao S. Hyaline Vascular Type of Castleman Disease: Diagnostic Pitfalls on Cytology and Its Clinical Relevance. Cureus 2021; 13:e17174. [PMID: 34532195 PMCID: PMC8436830 DOI: 10.7759/cureus.17174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 11/30/2022] Open
Abstract
Castleman disease (CD) is an uncommon cause of lymphadenopathy. The role of fine-needle aspiration cytology (FNAC) as a diagnostic modality in this disease is not well established. Cytological features of CD have a considerable overlap with many reactive conditions. It has subtle morphological features; which if overlooked, may miss the diagnosis. A two-year-old girl presented with cervical lymphadenopathy. FNAC of the cervical lymph node showed features of granulomatous lymphadenitis. Excision biopsy revealed the hyaline vascular type of CD. Cytological smears were reviewed carefully and revealed indicators of CD. These included capillary fragments with adherent reactive lymphoid cells, plump endothelial cells and pale pink material admixed with germinal center cells. The collections of plump endothelial cells had been misinterpreted as granulomas previously. This report highlights the subtle cytomorphological pointers of CD. Careful scrutiny for these features could aid the cytologist in differentiating CD from other reactive and neoplastic disorders, thus avoiding cytodiagnostic pitfalls. This case study reiterates an important fact that for a lymph node lesion, histopathology plays a crucial role in differentiating mimickers and renders an accurate diagnosis.
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Affiliation(s)
- Neha Singh
- Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Nilotpal Chowdhury
- Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Shweta Pal
- Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Jagdish P Goyal
- Pediatrics, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Bhanu Kiran Bhakhri
- Pediatric Endocrinology, Super Speciality Paediatric Hospital & Post Graduate Teaching Institute, Noida, IND
| | - Shalinee Rao
- Pathology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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Affiliation(s)
- Rajendra Prasad Takhar
- Department of Respiratory Medicine, Government Medical College, Kota, Rajasthan, India. E-mail:
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Malzone MG, Campanile AC, Sanna V, Ionna F, Longo F, De Chiara A, Setola SV, Botti G, Fulciniti F. Castleman's disease of a submandibular mass diagnosed on Fine Needle Cytology: Report of a case with histopathological, immunocytochemical and imaging correlations. Intractable Rare Dis Res 2016; 5:36-41. [PMID: 26989647 PMCID: PMC4761582 DOI: 10.5582/irdr.2016.01006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Castleman's disease (CD) is an unusual inflammatory lymphoproliferative disorder of uncertain aetiology, mainly involving lymphatic tissue in the mediastinum, but also occurring in the neck, lung, abdomen, pelvis, skeletal muscle and retroperitoneum. Fine Needle Cytology (FNC) is a quick, cost-effective and safe diagnostic modality to investigate on organs involved by CD, also providing a guide to treatment and management of patients with lymphoadenopathy. We report a case of a 44-year-old man who underwent FNC of a submandibular mass with subsequent surgical excision. Cytology revealed an atypical lymphoproliferative process, which arose the suspicion of CD. Histopathological study of the excised masses combined with immunhistochemistry and imaging of the submandibular and neck areas, confirmed the suspicion. A final diagnosis of Unicentric Castleman's disease, hyaline-vascular type, was made.
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Affiliation(s)
- Maria Gabriella Malzone
- S.S.D. di Citopatologia e S.C. di Anatomia Patologica, Istituto Nazionale Tumori “Fondazione G. Pascalea”, Napoli, Italy
- Address correspondence to: Dr. Maria Gabriella Malzone, S.S.D. di Citopatologia e S.C. di Anatomia Patologica, Istituto Nazionale Tumori “Fondazione G. Pascale”, via Mariano Semmola, 80131 Napoli, Italy. E-mail:
| | - Anna Cipolletta Campanile
- S.S.D. di Citopatologia e S.C. di Anatomia Patologica, Istituto Nazionale Tumori “Fondazione G. Pascalea”, Napoli, Italy
| | - Veronica Sanna
- S.S.D. di Citopatologia e S.C. di Anatomia Patologica, Istituto Nazionale Tumori “Fondazione G. Pascalea”, Napoli, Italy
| | - Franco Ionna
- S.C. Maxillo Facciale - Otorinolaringoiatria, Istituto Nazionale Tumori “Fondazione G. Pascale”, Napoli, Italy
| | - Francesco Longo
- S.C. Maxillo Facciale - Otorinolaringoiatria, Istituto Nazionale Tumori “Fondazione G. Pascale”, Napoli, Italy
| | - Annarosaria De Chiara
- S.S.D. di Citopatologia e S.C. di Anatomia Patologica, Istituto Nazionale Tumori “Fondazione G. Pascalea”, Napoli, Italy
| | - Sergio Venanzio Setola
- S.C. Radiodiagnostica 1, Dipt. Diagnostica per immagini - Terapia Radiante e Metabolica, Istituto Nazionale Tumori “Fondazione G. Pascale”, Napoli, Italy
| | - Gerardo Botti
- S.S.D. di Citopatologia e S.C. di Anatomia Patologica, Istituto Nazionale Tumori “Fondazione G. Pascalea”, Napoli, Italy
| | - Franco Fulciniti
- Servizio di Citopatologia Clinica, Istituto Cantonale di Patologia, Locarno, Switzerland
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Murro D, Agab M, Brickman A, Loew J, Gattuso P. Cytological features of Castleman disease: a review. J Am Soc Cytopathol 2015; 5:100-106. [PMID: 31042489 DOI: 10.1016/j.jasc.2015.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/17/2015] [Accepted: 08/17/2015] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Castleman disease (CD) is a benign lymphoproliferative disorder with hyaline vascular (HVCD), plasma cell (PC-CD), and mixed subtypes. Only HVCD lymph node cytomorphology has been described, mainly as case reports. We reviewed all CD subtypes. To the best of our knowledge, our case series is the largest and most comprehensive yet published. MATERIALS AND METHODS We searched our institution's database for histologically confirmed CD cytology cases (fine needle aspiration, touch preps) for the past 23 years. Two independent pathologists evaluated cytomorphology. We then reviewed touch preps from 6 histologically confirmed, non-CD reactive lymph node excisions. RESULTS 8 patients (5 women, 3 men) had the following subtypes: HVCD (5 patients), PC-CD (2), and mixed (1). All cases had a heterogenous background population composed predominantly of small lymphocytes with single and clustered follicular dendritic cells (FDCs). The FDCs had delicate pale cytoplasm with indistinct borders showing lymphocyte emperipolesis. They were often binucleated or multinucleated with fine chromatin, regular nuclear borders, large nuclei, and small nucleoli. HVCD cases had traversing, frequently hyalinized capillaries. PC-CD cases had increased plasma cells, including binucleate forms, and tingible body macrophages with fewer FDC clusters. Human herpes virus-8 immunostain was negative in all cases. Non-specific follicular hyperplasia cases had abundant tingible body macrophages, rare hyalinized capillaries, and no lymphocyte emperipolesis. CONCLUSIONS CD is distinguished by background lymphocytes and cohesive FDC clusters with lymphocyte emperipolesis. HVCD has traversing, hyalinized capillaries and PC-CD has increased plasma cells and tingible body macrophages. Knowledge of these features can prevent a lymphoma misdiagnosis.
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Affiliation(s)
- Diana Murro
- Department of Pathology, Rush University Medical Center, 1750 W Harrison St, Ste 573 Jelke, Chicago, Illinois.
| | - Mohamed Agab
- Department of Pathology, Rush University Medical Center, 1750 W Harrison St, Ste 573 Jelke, Chicago, Illinois
| | - Arlen Brickman
- Department of Pathology, Rush University Medical Center, 1750 W Harrison St, Ste 573 Jelke, Chicago, Illinois
| | - Jerome Loew
- Department of Pathology, Rush University Medical Center, 1750 W Harrison St, Ste 573 Jelke, Chicago, Illinois
| | - Paolo Gattuso
- Department of Pathology, Rush University Medical Center, 1750 W Harrison St, Ste 573 Jelke, Chicago, Illinois
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Sancheti SM, Midha D, Zameer MAL, Arun I. Benign monsters. Int J Surg Pathol 2015; 23:207-8. [PMID: 25782733 DOI: 10.1177/1066896915576405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Temirbekov D, Yazici ZM, Ergelen R, Turgut H, Kayhan FT. Castelman disease of the parotid gland: An unusual entity. Otolaryngol Pol 2014; 68:208-11. [PMID: 24981305 DOI: 10.1016/j.otpol.2013.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 09/24/2013] [Indexed: 10/26/2022]
Abstract
Castleman disease (CD) is a benign lymphoepithelial disorder characterised by abnormal growth of a lymph node. This disease may be seen anywhere along the lymphatic chain but it usually occurs in the mediastinum. Two clinical types (localised and generalised) and three histopathological types (hyaline vascular, plasma cell, and mixed) have been described. We present a case of a 35-year-old female patient with parotid CD of the hyaline-vascular type as an extremely rare entity. We also discuss recent updates on this disease.
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Affiliation(s)
- Dastan Temirbekov
- Department of Otolaryngology - Head and Neck Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
| | - Zahide Mine Yazici
- Department of Otolaryngology - Head and Neck Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Rabia Ergelen
- Department of Otolaryngology - Head and Neck Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Hurriyet Turgut
- Department of Otolaryngology - Head and Neck Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Fatma Tulin Kayhan
- Department of Otolaryngology - Head and Neck Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Frisch NK, Nathan R, Ahmed YK, Shidham VB. Authors attain comparable or slightly higher rates of citation publishing in an open access journal (CytoJournal) compared to traditional cytopathology journals - A five year (2007-2011) experience. Cytojournal 2014; 11:10. [PMID: 24987441 PMCID: PMC4058908 DOI: 10.4103/1742-6413.131739] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 03/31/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The era of Open Access (OA) publication, a platform which serves to better disseminate scientific knowledge, is upon us, as more OA journals are in existence than ever before. The idea that peer-reviewed OA publication leads to higher rates of citation has been put forth and shown to be true in several publications. This is a significant benefit to authors and is in addition to another relatively less obvious but highly critical component of the OA charter, i.e. retention of the copyright by the authors in the public domain. In this study, we analyzed the citation rates of OA and traditional non-OA publications specifically for authors in the field of cytopathology. DESIGN We compared the citation patterns for authors who had published in both OA and traditional non-OA peer-reviewed, scientific, cytopathology journals. Citations in an OA publication (CytoJournal) were analyzed comparatively with traditional non-OA cytopathology journals (Acta Cytologica, Cancer Cytopathology, Cytopathology, and Diagnostic Cytopathology) using the data from web of science citation analysis site (based on which the impact factors (IF) are calculated). After comparing citations per publication, as well as a time adjusted citation quotient (which takes into account the time since publication), we also analyzed the statistics after excluding the data for meeting abstracts. RESULTS Total 28 authors published 314 publications as articles and meeting abstracts (25 authors after excluding the abstracts). The rate of citation and time adjusted citation quotient were higher for OA in the group where abstracts were included (P < 0.05 for both). The rates were also slightly higher for OA than non-OA when the meeting abstracts were excluded, but the difference was statistically insignificant (P = 0.57 and P = 0.45). CONCLUSION We observed that for the same author, the publications in the OA journal attained a higher rate of citation than the publications in the traditional non-OA journals in the field of cytopathology over a 5 year period (2007-2011). However, this increase was statistically insignificant if the meeting abstracts were excluded from the analysis. Overall, the rates of citation for OA and non-OA were slightly higher to comparable.
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Affiliation(s)
- Nora K. Frisch
- Address: Department of Pathology, Wayne State University School of Medicine, Karmanos Cancer Center and Detroit Medical Center, Old Hutzel Hospital, Detroit, MI 48201, USA
| | - Romil Nathan
- Address: Department of Pathology, Wayne State University School of Medicine, Karmanos Cancer Center and Detroit Medical Center, Old Hutzel Hospital, Detroit, MI 48201, USA
| | - Yasin K. Ahmed
- Address: Department of Pathology, Wayne State University School of Medicine, Karmanos Cancer Center and Detroit Medical Center, Old Hutzel Hospital, Detroit, MI 48201, USA
| | - Vinod B. Shidham
- Address: Department of Pathology, Wayne State University School of Medicine, Karmanos Cancer Center and Detroit Medical Center, Old Hutzel Hospital, Detroit, MI 48201, USA
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Aguilar-Rodriguez R, Milea SL, Demirci I, Herold S, Flasshove M, Klosterhalfen B, Kinkel H, Janßen H. Localized retroperitoneal Castleman's disease: a case report and review of the literature. J Med Case Rep 2014; 8:93. [PMID: 24612848 PMCID: PMC3977947 DOI: 10.1186/1752-1947-8-93] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 02/11/2014] [Indexed: 12/11/2022] Open
Abstract
Introduction Castleman’s disease, also known as angiofollicular lymph node hyperplasia, is a rare disease with two known expansion types, unicentric and multicentric, which play a major role in determining therapy. We focus here on the unicentric type, which can be treated and cured by surgery. To date, approximately 1000 cases of Castleman’s disease have been reported in the literature. Case presentation A 50-year-old Caucasian woman presented to our Department of Hematology and Internal Oncology with increasing fatigue as her sole symptom. Diagnostic investigations including laboratory studies, ultrasound, computed tomography and magnetic resonance imaging were performed. These revealed an interaortocaval, retroperitoneal tumor mass in her upper abdomen as the only manifestation of the disease. No enlarged lymph nodes were detected. We conducted a laparotomy with radical extirpation of the tumor mass (10×9×5.7cm). Complete tumor resection with clear margins was achieved. A pathological analysis of the resected sample showed atypical lymphoid tissue of small to medium cells with some clearly visible nucleoli, enlarged sinusoidal vessels, pleomorphic calcifications and focally preserved germinal-center-like structures. Histological and immunohistochemical analysis confirmed the diagnosis of Castleman’s disease: staining for CD3, CD5, CD10, CD20, CD23, CD79 and Ki-67 was strongly positive in the germinal-center-like structures. Histological findings clearly showed the disease to be the hyaline vascular subtype. Staining for cyclin D1 and CD30 was negative. Expression of CD15 was positive in the enlarged sinusoidal vessels. A supplementary clonality analysis was without pathological findings. Tests for human immunodeficiency virus and human herpes virus 8 were negative and results from a bone marrow biopsy were normal. Our patient recovered well from surgery and was discharged from our hospital. To date, no recurrence of the disease has been detected. Conclusion Castleman’s disease is a rare disorder that remains a diagnostic challenge. Radical surgical resection is considered to be the gold standard for treating the unicentric variant of this disease.
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Affiliation(s)
| | | | - Ilhan Demirci
- Department of General, Visceral, Vascular and Thoracic Surgery, Hospital of Düren, Düren, Germany.
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Gill MK, Suri V, Dubey VK, Makkar M. Cytological diagnosis of Castleman's disease of the soft tissue. J Cytol 2013; 30:213-5. [PMID: 24130419 PMCID: PMC3793364 DOI: 10.4103/0970-9371.117653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Castleman's disease (CD), a rare benign disease is characterized by lymphoid hyperplasia of uncertain etiology that may present as a nodal or extranodal mass. We describe herein a rare case of CD occurring in the soft-tissue of right arm in a 55-year-old woman. The present case is instructive in the differential diagnosis of primary soft-tissue tumors, for which the possibility of CD should be considered. On clinical examination as well as gross examination, this disease mimics lymphomas and tuberculosis. Since cytological appearances vary depending on the type and extent of hyperplasia, fine needle aspiration cytology findings may not always be conclusive in all cases. We studied aspirates which revealed reactive hyperplasia with increased vascularity. Excision confirmed the diagnosis.
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Affiliation(s)
- Manmeet Kaur Gill
- Department of Pathology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
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Chen YF, Zhang WD, Sun CZ, OuYang D, Chen WK, Luo RZ, Wu MW. Clinical Features and Outcomes of Head and Neck Castleman Disease. J Oral Maxillofac Surg 2012; 70:2466-79. [DOI: 10.1016/j.joms.2011.12.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 12/01/2011] [Accepted: 12/01/2011] [Indexed: 11/29/2022]
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Abstract
Castleman’s disease (CD), also called giant lymph nodal hyperplasia, is a lymphoproliferative disorder secondary to lymphoid follicle hyperplasia and marked capillary proliferation with endothelial hyperplasia. It presents as enlarged lymph nodes in the mediastinum, neck, groin, axilla and other sites. On clinical examination as well as gross examination, this disease mimics lymphomas and tuberculosis. Since cytological appearances vary depending on the type and extent of hyperplasia, fine needle aspiration cytology (FNAC) findings may not always be conclusive in all cases. We studied aspirates in two cases of CD, one of which presented with multiple enlarged axillary lymph nodes and the other with enlarged cervical lymph node. Cytology revealed reactive lymphadenitis with hyalinized capillaries and other features. Lymph node excision in both cases confirmed the diagnosis.
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Affiliation(s)
- Ayyagari Sudha
- Consultant Pathologist, Medwin Hospitals, Hyderabad, India
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Lang TU, Khalbuss WE, Monaco SE, Michelow P, Pantanowitz L. Review of HIV-Related Cytopathology. PATHOLOGY RESEARCH INTERNATIONAL 2011; 2011:256083. [PMID: 21559199 PMCID: PMC3090088 DOI: 10.4061/2011/256083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 02/15/2011] [Indexed: 11/28/2022]
Abstract
Exfoliative and aspiration cytologies play a major role in the management of patients with human immunodeficiency virus infection. Common cytology samples include cervicovaginal and anal Papanicolaou tests, fine needle aspirations, respiratory specimens, body fluids, Tzanck preparations, and touch preparations from brain specimens. While the cytopathologists need to be aware of specific infections and neoplasms likely to be encountered in this setting, they should be aware of the current shift in the pattern of human immunodeficiency virus-related diseases, as human immunodeficiency virus patients are living longer with highly active antiretroviral therapy and suffering fewer opportunistic infections with better antimicrobial prophylaxis. There is a rise in nonhuman immunodeficiency virus-defining cancers (e.g., anal cancer, Hodgkin's lymphoma) and entities (e.g., gynecomastia) from drug-related side effects. Given that fine needle aspiration is a valuable, noninvasive, and cost-effective tool, it is frequently employed in the evaluation and diagnosis of human immunodeficiency virus-related diseases. Anal Papanicolaou tests are also increasing as a result of enhanced screening of human immunodeficiency virus-positive patients for cancer. This paper covers the broad spectrum of disease entities likely to be encountered with human immunodeficiency virus-related cytopathology.
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Affiliation(s)
- Tee U. Lang
- Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA
| | - Walid E. Khalbuss
- Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA
| | - Sara E. Monaco
- Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA
| | - Pam Michelow
- Cytology Unit, Department of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Johannesburg 2192, South Africa
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA
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