False-positive case. (A) Areas with low cellularity and a highly atypical cell with irregular nucleus (Papanicolaou [PAP], 200×). (B) Areas with low cellularity and occasional highly atypical cells with hyperchromatic irregular nuclei (PAP, 400×). (C) Hypercellular cluster with nuclear overlapping, hyperchromasia, and moderate nuclear pleomorphism (PAP, 400×). (D) The subsequent adrenalectomy shows adrenal cortical adenoma with marked endocrine atypia (H & E, 400×).