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Endobronchial ultrasound‐guided fine‐needle aspiration cytology of bronchial low‐grade mucoepidermoid carcinoma: Rapid on‐site evaluation of cytopathologic findings
Author(s) -
Dyhdalo Kathryn S.,
Chen Longwen
Publication year - 2013
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.22928
Subject(s) - medicine , cytopathology , cytology , mucoepidermoid carcinoma , fine needle aspiration , radiology , biopsy , pathology , nodule (geology) , lung , carcinoma , paleontology , biology
Bronchial mucoepidermoid carcinoma (MEC) is rare, comprising about 0.2% of primary lung tumors. Endobronchial ultrasound (EBUS) guided fine‐needle aspiration (FNA) cytology is an integral tool in the diagnosis and staging of malignant lung tumors. Rapid on‐site evaluation (ROSE) has been proven useful as a guide for assessing the adequacy and accuracy of the FNA samples. Therefore, comprehensive knowledge of diagnostic cytomorphologic findings of MEC is critical for ROSE. We reported a 46‐year‐old woman with 6 weeks of cough productive of yellow sputum that did not improve on antibiotics. A chest CT demonstrated a well‐circumscribed nodule in the right lower lobe bronchus that extended into the lung parenchyma. EBUS‐guided FNA was performed to obtain diagnostic materials. The ROSE of cytology specimen revealed numerous tight clusters of cells with well‐defined, but scant cytoplasm. These cells were relatively small and bland with high N/C ratio, resembling benign ductal cells. Neither cilia nor intranuclear inclusions were noted. Focal extracellular metachromatic mucinous materials were also noted. A preliminary diagnosis of “low‐grade epithelial neoplasm, favor low grade MEC” was rendered. The definitive diagnosis was confirmed by both cytology and core biopsy. EBUS‐guided FNA cytology can be a reliable method for the diagnosis of bronchial low grade MEC. The cyto‐morphology of ROSE can indicate the diagnosis of low grade MEC and direct the appropriate follow‐up triage of the specimen.Diagn. Cytopathol. 2013;41:1096–1099. © 2012 Wiley Periodicals, Inc.