PART TWO
Diagnostic Cytology
A
B
Fig. 29.2 (A) Colloid goiter. Thyroid follicles with variability in the size of the acini and absence of cellular atypia. Cell block (H&E x HP). (B) Papillary
carcinoma. Complex papillary arrangement of follicular atypical cells. Cell block (H&E x HP). (C) Medullary carcinoma. Nests of large polygonal atypical cells
and a fibrous stroma (H&E x MP). (D) Medullary carcinoma. Non cohesive plasmocytoid cells. Fine-needle aspiration (Papanicolaou x OI).
located in s o ft tissues o f th e a n te rio r cervical reg ion, and w ith
o r w ith o u t in filtra tio n to w a rd th e th y ro id gland. T h e y are also
ty p ic a lly soft, cystic and th e y m easure several centim eters in
d iam eter. M icroscop ically, m atu re teratom as have a p re d o m i-
nance o f th e ectoderm ic c om p on en t, w h ile im m a tu re te ra to -
m as sh o w an im m a tu re n e u ro e p ith e liu m o r a n eu ro b lastic
appearance. Fine-need le aspirates sho w variab le a m o un ts o f
sebum , corneous flakes, a n d /o r sq uam ous e p ith e lia l cells,
in fla m m a to ry cells, h a ir fragm ents, and e p ith e lia l cells o f
sebaceous glands and th e re sp ira to ry and m a tu re in te s tin a l
systems.
Other M alignant Tum ors
N o n-H od g kin's lym p h om as o r Langerhans cell histiocytoses
rarely orig inate in the th y ro id gland, and the fin d in g o f th y ro id
in filtra tio n by acute lym p h ob lastic leukem ia, lym p hom as, o r a
m etastatic neoplasm is very infreq uent.
Lung Tumors
In children, b o th benign and m alig nant tum ors as w e ll as pseudo-
tu m o ra l lesions o f the lungs are rare, and the m ost frequent is the
in fla m m a to ry pseudotum or. A m ong benign lesions, leiom yom as,
chondrom atous ham artom as, b ronchial chondrom as, teratomas,
and granular cell m yoblastom as can be observed, w h ile m alig nant
lesions include the b ronchial carcinoma, fibrosarcom a, rhab-
dom yosarcom a, leiom yosarcom a, and p u lm on ary blastom a.12,13
Benign Tumors
Inflammatory Pseudotum or
In fla m m a to ry p seud otum or (sclerosing hem ang iom a o r m yo fi-
b rob lastic in fla m m a to ry tu m o r) is the m ost freq uent p u lm o -
nary tu m o r o f child ren (~ 8 4% ), especially in those old er than
920
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