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Sample records for biopsy fine-needle

  1. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

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    ... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid ... Needle Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? ...

  2. Fine needle aspiration biopsy of fibromatoses.

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    Raab, S S; Silverman, J F; McLeod, D L; Benning, T L; Geisinger, K R

    1993-01-01

    Fibromatoses form a spectrum of clinicopathologic entities characterized by the infiltrative proliferation of fibroblasts that lack malignant cytologic features. Fibromatoses present as nodular soft tissue masses almost anywhere in the body and thus are often amenable to fine needle aspiration (FNA). This report describes the FNA cytologic findings of fibromatosis in six patients ranging in age from 7 1/2 weeks to 36 years. Two of the lesions arose in the abdominal wall (musculoaponeurotic fibromatosis or extra-abdominal desmoid), and one each involved the plantar surface (Ledderhose's disease), the shoulder and the sternocleidomastoid muscle (Fibromatosis coli). The FNA of the shoulder was initially interpreted as nodular fasciitis due to the clinical presentation of a rapidly growing mass; an aspirate from the deep musculoaponeurotic region was believed to reveal a low grade sarcoma. The FNA diagnosis of musculoaponeurotic fibromatosis in a patient with familial polyposis coli suggested the diagnosis of Gardner's syndrome. Cytologically the aspirates consisted of groups of loosely cohesive, bland-appearing, spindle-shaped cells having oval to elongated nuclei and cytoplasmic tags. Individual spindle cells and rare inflammatory cells were also present. The aspirate of fibromatosis coli also contained degenerating skeletal muscle cells. Tissue confirmation was obtained in four cases. We believe that FNA is a useful procedure for the initial and recurrent diagnosis of fibromatoses and in the separation of fibromatoses from other benign and malignant soft tissue lesions. A discussion of other entities that enter into the cytologic differential diagnosis, such as mesenchymal repair, fasciitis and spindle cell types of sarcoma, is presented. From our experience we believe that the clinicopathologic features can suggest the diagnosis of fibromatosis, but histologic confirmation is recommended.

  3. Fine-needle aspiration biopsy: a historical overview.

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    Rosa, Marilin

    2008-11-01

    Fine needle aspiration biopsy is a safe, inexpensive and accurate technique for the diagnosis of benign and malignant conditions. Its increase in popularity in the present days has made it a technique used on daily basis in the majority of medical centers in United States and around the world. However, the situation was not always like this. In its beginnings the procedure suffered from all kinds of criticism and attacks. The purpose of this manuscript is to provide an overview about the development of this technique from its birth to our days.

  4. Inadequate fine needle aspiration biopsy samples: Pathologists versus other specialists

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    Gomez-Macias G

    2009-01-01

    Full Text Available Background: Fine needle aspiration biopsy (FNAB is a simple, sensitive, quick and inexpensive method in which operator experience is essential for obtaining the best results. Methods: A descriptive study in which the aspiration biopsy cases of the Pathology and Cytopathology Service of the University Hospital of the UANL (2003-2005 were analyzed. These were divided into three study groups: Group 1, FNAB performed by a pathologist; Group 2, FNAB performed by specialists who are not pathologists, Group 3, FNAB guided by an imaging study with immediate evaluation by a pathologist. The samples were classified as adequate and inadequate for diagnosis, the organ, the size and characteristics of the lesions were taken into consideration. Results: A total of 1905 FNAB were included. In Group 1: 1347 were performed of which 1242 (92.2% were adequate and 105 (7.7% were inadequate. Of the 237 from Group 2, 178 were adequate (75.1% and 59 inadequate (24.8%; in Group 3 there were 321 of which 283 (88.1% were adequate and 38 (11.8% inadequate. A statistically significant difference was found between FNAB performed by Group 1 (p< 0.001 and the other groups. A multivariate analysis was done where the organ punctured, the study groups, the size and characteristics of the lesion by study group were compared, finding that the most important variable was the person who performed the procedure. Conclusion: The experience and training of the person performing the aspiration biopsy, as well as immediate evaluation of the material when it is guided, substantially reduces the number of inadequate samples, improving the sensitivity of the method as well as reducing the need for open biopsies to reach a diagnosis.

  5. Feasibility of fine-needle aspiration biopsy and its applications in superficial cervical lesion biopsies.

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    Xu, Dong; Xu, Hai-Miao; Li, Ming-Kui; Chen, Li-Yu; Wang, Li-Jing

    2014-01-01

    The aim of the study was to investigate the feasibility and value of clinical application of fine-needle aspiration histological biopsy via ultrasound-guided thyroid nodule and enlarged cervical lymph node fine-needle aspiration histological biopsy. Fine-needle aspiration cytological and histological biopsies and surgical treatments were performed on 982 patients with thyroid nodule and 1435 patients with enlarged cervical lymph nodes. A comparative study of the histological and cytological examination results and post-surgical etiology results was subsequently conducted. Among the 982 thyroid nodule patients, the acquisition rates were 89.8% (882/982) for fine-needle aspiration histological biopsy and 96.2% (945/982) for cytological biopsy, while among the 1435 patients with enlarged cervical lymph nodes, the acquisition rate for fine-needle aspiration cytological biopsy was slightly higher than that for histological biopsy, with values of 95.7% (1374/1435) and 91.4% (1312/1435), respectively. For the thyroid nodule patients, when the acquired histological and cytological biopsy results were compared with the post-surgical etiology results, the sensitivity, specificity, and accuracy of the histological results were 98.5%, 100%, and 98.9%, respectively, whereas those of the cytological results were 86.8%, 82.9%, and 85.6%, respectively; the differences between the 2 biopsy methods were statistically significant (P < 0.05). For the patients with enlarged cervical lymph nodes, when the acquired histological and cytological biopsy results were compared with the post-surgical etiology results, the sensitivity, specificity, and accuracy of the histological results were 96.3%, 99.8%, and 97.6%, respectively, whereas the those of the cytological results were 76.8%, 92.1%, and 82.2%, respectively; again, the differences between the 2 methods were statistically significant (P < 0.05). In conclusion, Fine-needle aspiration histological biopsy is a reliable and highly

  6. Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy

    OpenAIRE

    2013-01-01

    PURPOSE: Determine whether cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy (FNAB) is a significant prognostic factor for death from metastasis. METHODS: Retrospective analysis of cases of clinically diagnosed uveal melanoma evaluated by fine-needle aspiration biopsy from 1980 to 2006. Main outcome evaluated was death from metastasis. Associations between baseline clinical variables and cytopathologic classification were evaluated using cros...

  7. False Negative Fine Needle Aspiration Biopsy Results in Primary Thyroid Lymphoma

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    Kim, In Joong; Kim, Eun Kyung; Koh, Myoung Ju; Kwak, Jin Young; Moon, Hee Jung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography-guided fine needle aspiration biopsy (US-FNA) is one of the methods used to diagnose thyroid lymphoma, but it has a relatively high false-negative rate. The authors report a case of a primary thyroid lymphoma associated with underlying lymphocytic thyroiditis that was initially misdiagnosed as lymphocytic thyroiditis based on US-FNA findings

  8. Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy

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    James Jay Augsburger

    2013-04-01

    Full Text Available PURPOSE: Determine whether cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy (FNAB is a significant prognostic factor for death from metastasis. METHODS: Retrospective analysis of cases of clinically diagnosed uveal melanoma evaluated by fine-needle aspiration biopsy from 1980 to 2006. Main outcome evaluated was death from metastasis. Associations between baseline clinical variables and cytopathologic classification were evaluated using cross-tabulation. Prognostic significance of cytopathologic classification was evaluated by Kaplan-Meier and Cox proportional hazards analysis. RESULTS: Of 302 studied biopsies, 260 (86.1% yielded sufficient cells for cytopathologic classification. Eighty of the 260 patients who had a sufficient specimen have already died (P=0.021, 69 from metastatic uveal melanoma. Cell type assigned by cytopathology was strongly associated with metastasis/metastatic death in this series (P=0.0048. Multivariate analysis showed cytopathologic classification to be an independently significant prognostic factor for metastatic death (P=0.0006. None of the 42 patients whose tumor yielded insufficient aspirates (sampled in at least two sites have developed metastasis or died of metastasis thus far. CONCLUSION: In this series, cytopathology of fine-needle aspiration biopsy samples obtained from uveal melanomas was strongly prognostic of death from metastasis. Insufficiently aspirates (2 or more sites sampled proved to be prognostic of a favorable outcome (i.e., not developing metastasis.

  9. Fine needle aspiration biopsy to reestablish cell culture in an animal model of uveal melanoma

    OpenAIRE

    Correa, Zelia Maria da Silva; Marshall,Jean-Claude; Souza Filho,João Pessoa de; Odashiro, Alexandre Nakao; Burnier, Jr.,Miguel Noel

    2009-01-01

    PURPOSE: To access the reliability of fine-needle aspiration biopsy in harvesting a sufficient amount of viable melanoma cells to establish a cell culture and maintain a melanoma cell line from an animal model of uveal melanoma. METHODS: For this study, fifteen male New Zealand albino rabbits had their right eye surgically inoculated with uveal melanoma cell line 92.1. The animals were immunosupressed with cyclosporine A using a dose schedule previously published. The animals were followed fo...

  10. Fine needle biopsy of abdominal organs in dogs -- indications, contraindications and performance technique.

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    Glińska-Suchocka, K; Jankowski, M; Kubiak, K; Spuzak, J; Dzimira, S; Nicpoń, J

    2013-01-01

    Recent years have seen in both human and veterinary medicine the development of numerous techniques allowing for evaluation and classification of changes in individual organs and tissues. Despite introduction of such techniques into diagnostics as among others, CT, MRI, CEUS or elastography, biopsy is still considered a "golden standard" and it is a procedure performed in order to obtain a final diagnosis. There are many biopsy techniques, such as fine needle aspiration biopsy, core biopsy as well as methods of performing a procedure, e.g. blind biopsy, biopsy under USG control and biopsy during laparotomy. In the article usefulness of biopsy techniques in relation to diagnostics of individual abdominal organ, as well as the procedure technique, contraindication and complications are discussed.

  11. Endoscopic ultrasound-guided fine needle aspiration cytology and biopsy in the evaluation of lymphoma

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    Gimeno-García, Antonio Z.; Elwassief, Ahmed; Paquin, Sarto C.; Sahai, Anand V.

    2012-01-01

    Accurate diagnosis and subtyping of lymphoma have important prognostic implications and are generally required for treatment planning. Histological assessment, immunophenotyping, and genetic studies are usually necessary. Endoscopic ultrasound guided-fine needle aspiration cytology (EUS-FNAC) is a minimally invasive technique widely used for the evaluation of deep-seated benign and malignant lesions. However, the value of cytological samples in lymphoma diagnosis is still a matter of debate. Endoscopic ultrasound guided-fine needle biopsy (EUS-FNAB) can provide tissue core samples that may help overcome the limitations of cytology. The aim of this review is to summarize the available literature regarding EUS-FNAC and EUS-FNAB for the diagnosis and subtyping of lymphoma. In addition, we discuss its usefulness in the management of primary extra-nodal lymphomas, as well as technical issues that may influence sample quality. PMID:24949331

  12. Value of fine-needle aspiration biopsy of salivary gland lesions

    DEFF Research Database (Denmark)

    Christensen, Rikke Kølby; Bjørndal, Kristine; Godballe, Christian;

    2010-01-01

    BACKGROUND: The aim of this study was to assess the utility of fine-needle aspiration biopsy (FNAB) in the diagnosis and treatment planning of the lesions of the salivary gland. METHODS: Eight hundred seventy-nine aspiration biopsies of the lesion of the salivary gland over a 10-year period, from...... was 98%, and the negative predictive value was 97%. The overall accuracy was 93%. The correct subtyping of the benign lesions was 97%, and the exact type-specific concordance of the malignant lesions was 71%. CONCLUSION: Considerable benefit to the patient may result from the cautious use of FNAB...

  13. Fine-needle aspiration biopsy of cervical lymph nodes: factors in predicting malignant diagnosis.

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    Aribaş, B K; Arda, K; Ciledağ, N; Cetindağ, M F; Doğan, K; Sahin, G; Yoloğlu, Z; Aktaş, E

    2011-01-01

    The objective of the study was to determine the predicting factors in malignant diagnosis in ultrasonography guided fine-needle aspiration biopsy of cervical lymph nodes. Design is retrospective follow-up study. Ultrasonography guided fine-needle aspiration biopsies of cervical lymph nodes were performed in 290 patients. The mean age was 45.5 ± 14.4 years (range; 15-85). 207 (71.4%) and 83 (28.6%) were women and men, respectively. Cytopathologist was not present in any biopsy procedure. Factors in predicting malignancy were age, gender, presence of primary malignancy, localization (Level 1-6), hypoechogenicity with loss of echogenic hilum, microcalcification, cystic feature, minimum and maximum sizes, and index value (minimum size/maximum size). Factors were analyzed by univariate and multivariable tests. The mean minimum size and index value of the lymph nodes were 10.4 ± 5.5 mm and 0.58 ± 0.18, respectively. Age, gender, microcalcification, cystic feature, minimum size, and index value were poor predictors in malignancy. Predictors were presence of primary malignancy (p-hypoechogenicity (p-hypoechogenicity. Malignancy rate was relatively low in patients with thyroid malignancy than those with non thyroid malignancies in Level 5. Level 6 was the most difficult area for biopsy due to postoperative changes. Microcalcification was specific only in thyroid carcinoma, whereas cystic parts were more specific in the other malignancies

  14. Percutaneous Fine Needle Biopsy in Pancreatic Tumors: A Study of 42 Cases

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    Piotr Lewitowicz

    2012-01-01

    Full Text Available The technological progress within the range of methods of pancreas imaging and their more common accessibility selects a group of patients requiring a microscopic diagnosis. Percutaneous fine needle aspiration biopsy under the control of ultrasonography (PCFNA/USG is the method commonly used in determining the character of a focal pancreatic lesion. Aim of the Work. An assessment of the accessibility of PCFNA biopsy in the assessment of solid and cystic changes in a pancreas and the correlation of the results of imaging examination, cytological smear and concentration of a serous marker CA19-9. Material and Methodology. In our material we analysed 43 cases of tumors of the pancreas among the patients who were at the average age of 59 ± 10.4 (14 women, 28 men diagnosed by PCFNA biopsy. Results. In a group we are 23 cases of cancer, 12 cases of inflammation and 7 cases of cellular atypia for which 2 cases of IPMN were included. The sensitivity of the method was 92.5% but specificity was 68%. In our opinion PCFNA/USG is a method of the comparable sensitivity and specificity with fine needle aspiration biopsy with EUS control and its efficiency depends to a considerable degree on experience and interdisciplinary collaboration.

  15. Fine needle aspiration biopsy diagnosis of metastatic neoplasms of the breast. A three-case report

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    Raquel Garza-Guajardo

    2005-09-01

    Full Text Available Abstract Metastases to the breast are unusual lesions that make up approximately 2% of all malignant mammary neoplasms and may mimic both benign and malignant primary neoplasms from a clinical point of view, as well as in imaging studies. Arriving at a correct diagnosis is therefore essential in order to establish appropriate management. We present three cases of metastatic neoplasms diagnosed through fine needle aspiration biopsy and immunocytochemistry. The cytological diagnoses were: medulloblastoma in an 18-year-old woman, melanoma in a 26-year-old man, and an exceptional case of ovarian sarcoma originating from a granulosa cell tumor with metastases to both breasts. A metastatic disease should be considered in the differential diagnosis of a palpable mass in the breast, especially if there is a history of an extramammary malignant neoplasm. Fine needle aspiration biopsy is the method of choice for the management of these cases. Whenever possible the exam of the material obtained should be compared to the previous biopsy, which is usually enough to arrive at a correct diagnosis, thus preventing unnecessary surgical procedures.

  16. Mixed germ cell tumor of mediastinum/lung masquerading as hemangioma in fine needle biopsy

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    Rathna Nuti

    2013-01-01

    Full Text Available The histological predominance of one component in a germ cell tumor can lead to a mistaken diagnosis. Here, we describe a mediastinal teratoma with predominant vascular proliferation (>90% which on fine needle biopsy was diagnosed as a pulmonary hemangioma. Later, resection specimen revealed other components constituting ~4%, changing the diagnosis while illustrating theimportance of careful evaluation. A 37-year-old Caucasian male with shortness of breath, weight loss, and history of recently resolved pneumonia was diagnosed with hemangioma, after a computed tomography guided fine needle biopsy of a -16.3-cm mediastinal pulmonary mass revealed abundant benign vascular elements. Following tumor excision, ~94% of the sample exhibited predominant vascular elementsThe mass also exhibited rare focal areas of malignant epithelium in a reticular arrangement and undifferentiated pleomorphic cells associated with vascular invasion. These atypical epithelial cells were positive for CD30, pan CK, AFP, β-HCG and CD 117, thusprocuring a diagnosis of mediastinal mixed germ cell tumor. Although mixed germ cell tumors consist of various tissue types, diagnosis can be easily overlooked if one component dominates. Therefore, obtaining adequate representative neoplasm samples, and sectioning the samples thoroughly, searching for coexisting tissue types is critical for accurate diagnosis.

  17. Lymphography and percutaneous fine needle node aspiration biopsy in the staging of bladder carcinoma.

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    Boccon-Gibod, L; Katz, M; Cochand, B; Le Portz, B; Steg, A

    1984-01-01

    Forty-two patients with infiltrating bladder tumor were submitted to pedal lymphography with percutaneous fine needle node aspiration biopsy on an out patient basis. Of 41 evaluable patients, 59% had a positive lymphangiogram. Adequate material was obtained in 81% of the patients. Of 12 patients with a normal lymphography, none had a positive aspiration whereas 40% of the positive lymphangiograms correlated with a positive aspiration. The high rate of positive lymphangiogram negative aspirate is attributed to inflammatory changes due to previous TUR of the tumor. Twenty-one patients were submitted to radical cystectomy: 12 negative aspirations correlated with 11 negative lymphadenectomies, and 4 positive aspirations with 4 positive lymphadenectomies. There was no mortality and only mild morbidity in this series. Lymphography with fine needle percutaneous node aspiration biopsy has a role in the pre-operative staging of bladder carcinoma. Positive pelvic wall lymph nodes upgrade bladder carcinoma from a local to a systemic disease that is no longer amenable to any form of local treatment. Nodal assessment is therefore critical to treatment planning in order to spare the N+ patients unnecessary radical surgery. Pelvic lymph nodes have been evaluated, in the past, radiologically by bipedal lymphography or C.A.T. scanning. The high false positive and negative rates of these procedures (Benson et al., 1981; Boccon-Gibod et al., 1982) preclude their routine use (Correa 1982; Walsh et al., 1980).(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Mixed germ cell tumor of mediastinum/lung masquerading as hemangioma in fine needle biopsy.

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    Nuti, Rathna; Bodhireddy, Surender; Thirumala, Seshadri

    2013-01-01

    The histological predominance of one component in a germ cell tumor can lead to a mistaken diagnosis. Here, we describe a mediastinal teratoma with predominant vascular proliferation (>90%) which on fine needle biopsy was diagnosed as a pulmonary hemangioma. Later, resection specimen revealed other components constituting ~4%, changing the diagnosis while illustrating theimportance of careful evaluation. A 37-year-old Caucasian male with shortness of breath, weight loss, and history of recently resolved pneumonia was diagnosed with hemangioma, after a computed tomography guided fine needle biopsy of a -16.3-cm mediastinal pulmonary mass revealed abundant benign vascular elements. Following tumor excision, ~94% of the sample exhibited predominant vascular elementsThe mass also exhibited rare focal areas of malignant epithelium in a reticular arrangement and undifferentiated pleomorphic cells associated with vascular invasion. These atypical epithelial cells were positive for CD30, pan CK, AFP, β-HCG and CD 117, thusprocuring a diagnosis of mediastinal mixed germ cell tumor. Although mixed germ cell tumors consist of various tissue types, diagnosis can be easily overlooked if one component dominates. Therefore, obtaining adequate representative neoplasm samples, and sectioning the samples thoroughly, searching for coexisting tissue types is critical for accurate diagnosis.

  19. Results and complications of CT-guided transthoracic fine-needle aspiration biopsy of pulmonary lesions

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    Lima, Cristiano Dias de; Nunes, Rodolfo Acatauassu; Saito, Eduardo Haruo; Higa, Claudio; Cardona, Zanier Jose Fernando; Santos, Denise Barbosa dos, E-mail: cristianodiaslima@gmail.co [Hospital Universitario Pedro Ernesto (HUPE/UERJ), Rio de Janeiro, RJ (Brazil). Dept. Cirurgia Toracica

    2011-03-15

    Objective: to analyze the cytological findings of CT-guided percutaneous fine-needle aspiration biopsies of the lung, to demonstrate the diagnostic feasibility of the method in the investigation of pulmonary lesions, and to determine the complications of the procedure, evaluating its safety. Methods: a retrospective analysis of 89 patients with various types of pulmonary lesions who underwent 97 procedures over a period of five years. The patients were divided into groups regarding the indication for the procedure: suspicion of primary lung cancer (stages IIIB or IV); suspicion of lung cancer (stages I, II, or IIIA) and clinical contraindications for surgery; suspicion of pulmonary metastasis from other organs; and pulmonary lesions with benign radiological aspect. All of the procedures were performed with 25-gauge needles and were guided by spiral CT. The final diagnosis was confirmed by surgical biopsy and clinical/oncological follow-up. For the analysis of complications, the total number of procedures was considered. Results: the main indication for the procedure was suspicion of advanced stage primary lung cancer. The accuracy of the method for malignant lesions was 91.5%. The lesion was confirmed as cancer in 73% of the patients. The major complication was pneumothorax (27.8%), which required chest tube drainage in 12.4% of the procedures. Conclusions: the principal indication for CT-guided fine-needle biopsy was suspicion of primary lung cancer in patients who were not surgical candidates. The procedure has high diagnostic feasibility for malignant pulmonary diseases. The most prevalent complication was pneumothorax. However, in most cases, chest tube drainage was unnecessary. No deaths were related to the procedure. (author)

  20. Thyroid fine-needle aspiration biopsy and thyroid cancer diagnosis: a nationwide population-based study.

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    Li-Ying Huang

    Full Text Available Thyroid cancer is the most common endocrine gland malignancy and fine-needle aspiration biopsy is widely used for thyroid nodule evaluation. Repeated aspiration biopsies are needed due to plausible false-negative results. This study aimed to investigate the overall relationship between aspiration biopsy and thyroid cancer diagnosis, and to explore factors related to shorter diagnostic time.This nationwide retrospective cohort study retrieved data from the Longitudinal Health Insurance Database in Taiwan. Subjects without known thyroid malignancies and who received the first thyroid aspiration biopsy after 2004 were followed-up from 2004 to 2009 (n = 7700. Chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards model were used for data analysis.Of 7700 newly-aspirated patients, 276 eventually developed thyroid cancer (malignancy rate 3.6%. Among the 276 patients with thyroid cancer, 61.6% underwent only one aspiration biopsy and 81.2% were found within the first year after the initial aspiration. Cox proportional hazards model revealed that aspiration frequency (HR 1.07, 95% CI 1.06-1.08, ultrasound frequency (HR 1.02, 95% CI 1.01-1.03, older age, male sex, and aspiration biopsies arranged by surgery, endocrinology or otolaryngology subspecialties were all associated with shorter time to thyroid cancer diagnosis.About 17.4% of thyroid cancer cases received more than two aspiration biopsies and 18.8% were diagnosed one year after the first biopsy. Regular follow-up with repeated aspiration or ultrasound may be required for patients with clinically significant thyroid nodules.

  1. Extrapleural paravertebral CT guided fine needle biopsy of subcarinal lymph nodes

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    Tantawy, Wahid H., E-mail: tantawyw@yahoo.com [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt); El-Gemeie, Emad H. [Pathology Department, National Cancer Institute, Fom El Khalige Faculty of Medicine, Cairo University (Egypt); Ibrahim, Ahmed S., E-mail: asibrahima@gmail.com [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt); Mohamed, Mona A. [Radiology Department, Faculty of Medicine, Ain Shams University, Egypt Abbassyia square, Cairo (Egypt)

    2012-10-15

    Purpose: To report our experience in CT guided extrapleural paravertebral subcarinal lymph biopsy using a thin 25 gauge (25 G) thin needle without the need of injection of saline to widen the mediastinum. Materials and methods: Biopsy was performed using a 25 G needle which was advanced lateral to the vertebral body between the endothoracic fascia and the parietal pleura to gain access to subcarinal lymph nodes. One hundred and forty one patients were included in the study (74 females, 57 males). No artificial widening of the mediastinum using saline injection was required. The study was performed in the presence of a cytopathologist; sensitivity and specificity rates were calculated. Complications were documented for each case especially for pneumothorax and haemorrhage. Results: Cytopathological diagnosis was reached in all cases. All re-aspirations were done in the same session to reach a primary diagnosis at the time of the biopsy. Imunophenotyping study was done in 94 cases to confirm the primary diagnosis and to classify the malignant lesions. No pneumothorax was encountered. Small haematomas were noted in 5 cases (3.5%). Cytopathology showed a sensitivity of 97.2% and specificity of 100%. By adding immunophenotyping a 100% sensitivity and specificity was achieved. Conclusion: Fine needle aspiration cytology (FNAC) using a 25 gauge needle for subcarinal lymph nodes via a percutaneous extrapleural paravertebral CT guided approach is a safe, minimally invasive, and tolerable procedure yielding a high sensitivity and specificity rates without the need of artificial widening.

  2. APPLICATION OF LIQUID-BASED CYTOLOGY TO FINE-NEEDLE ASPIRATION BIOPSIES OF THE THYROID GLAND

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    Guido eFadda

    2012-05-01

    Full Text Available FNAB (fine-needle aspiration biopsy is regarded as an important tool for diagnosing thyroid lesions because of its simplicity, safety and cost-effectiveness. Its role in correctly characterizing the group of indeterminate lesions or follicular-patterned neoplasms (FN might be more decisive. LBC (Liquid-based cytology is a technique based on the use of a semi-automated device that has gained popularity as a method of collecting and processing both gynecologic and non-gynecologic cytologic specimens. It achieves a diagnostic sensitivity as accurate as conventional preparations especially for its excellent cell preservation and for the lack of background which decrease the amount of inadequate diagnoses. Moreover, the cellular material which has been stored in the preservative solution could be effectively used for the application of immunocytochemical and molecular techniques used especially for the Follicular proliferations . In many cases the cytologic features are similar in both methods but the colloid film and the lymphocytic component are more easily evaluated on direct smears whereas nuclear details and colloid globules are better evaluated in LBC slides. The LBC processed biopsies represent a valid alternative to conventional cytology. The possibility of applying special techniques enhance the efficacy of the cytological diagnosis of thyroid lesions.

  3. Micromachined bulk PZT tissue contrast sensor for fine needle aspiration biopsy.

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    Li, Tao; Gianchandani, Roma Y; Gianchandani, Yogesh B

    2007-02-01

    This paper describes a micromachined piezoelectric sensor, integrated into a cavity at the tip of a biopsy needle, and preliminary experiments to determine if such a device can be used for real-time tissue differentiation, which is needed for needle positioning guidance during fine needle aspiration (FNA) biopsy. The sensor is fabricated from bulk lead zirconate titanate (PZT), using a customized process in which micro electro-discharge machining is used to form a steel tool that is subsequently used for batch-mode ultrasonic micromachining of bulk PZT ceramic. The resulting sensor is 50 microm thick and 200 microm in diameter. It is placed in the biopsy needle cavity, against a steel diaphragm which is 300 microm diameter and has an average thickness of 23 microm. Devices were tested in materials that mimic the ultrasound characteristics of human tissue, used in the training of physicians, and with porcine fat and muscle tissue. In both schemes, the magnitude and frequency of an electrical impedance resonance peak showed tissue-specific characteristics as the needle was inserted. For example, in the porcine tissue, the impedance peak frequency changed approximately 13 MHz from the initial 163 MHz, and the magnitude changed approximately 1600 Omega from the initial 2100 Omega, as the needle moved from fat to muscle. Samples including oils and saline solution were tested for calibration, and an empirical tissue contrast model shows an approximately proportional relationship between measured frequency shift and sample acoustic impedance. These results suggest that the device can complement existing methods for guidance during biopsies.

  4. Diagnostic utility of endoscopic ultrasound-guided fine-needle aspiration biopsy for glomus tumor of the stomach.

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    Kato, Shin; Kikuchi, Kaoru; Chinen, Kenji; Murakami, Takahiro; Kunishima, Fumihito

    2015-06-14

    A 52-year-old man was referred for further investigation of a gastric submucosal tumor on the greater curvature of the antrum. Endoscopic ultrasonography demonstrated a hypoechoic solid mass, which was primarily connected to the muscular layer of the stomach. We performed endoscopic ultrasound-guided fine-needle aspiration biopsy. The pathological examination showed proliferation of oval-shaped cells with nest formation, which stained strongly positive for muscle actin, and negative for c-kit, CD34, CD56, desmin, S-100, chromogranin, and neuron-specific enolase. Therefore, we performed laparoscopy and endoscopy cooperative surgery based on the preoperative diagnosis of glomus tumor of the stomach. The final histological diagnosis confirmed the preoperative diagnosis. Although preoperative diagnosis of glomus tumor of the stomach is difficult with conventional images and endoscopic biopsy, endoscopic ultrasound-guided fine-needle aspiration biopsy is an essential tool to gain histological evidence of glomus tumor of the stomach for early diagnosis.

  5. Endoscopic ultrasound with fine needle aspiration and biopsy in lung cancer and isolated mediastinal lymphadenopathy.

    LENUS (Irish Health Repository)

    Nadarajan, P

    2010-03-01

    Endoscopic ultrasound with fine-needle aspiration and biopsy (EUS-FNAB) is well established in diagnosing and staging lung cancer in patients with mediastinal adenopathy. EUS-FNAB is highly sensitive, less invasive and has lower complication rates when compared to surgical staging of mediastinal nodes. In this study we describe our experience of EUS-FNAB in lung cancer and other causes of mediastinal lymphadenopathy. EUS-FNAB was performed for assessment of PET positive mediastinal lymph nodes between January 2007 and March 2009 in AMNCH. The endpoints of our study were sensitivity and specificity of EUS-FNAB, morbidity and length of hospital stay. Thirty four patients underwent EUS-FNAB during the study period for both diagnosis and staging. Thirty patients had positive lymph node invasion and 4 had no evidence of malignant invasion. In these 4 patients negative cytology was confirmed on mediastinoscopy giving EUS-FNAB a sensitivity and specificity of 100%. EUS-FNAB upstaged the disease in 12 patients. EUS-FNAB is a reliable tool for mediastinal staging in lung cancer, significantly reducing the need for surgical staging procedures in patients with suspected mediastinal involvement.

  6. Diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy in cavitary pulmonary lesions

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    Zhuang, Yi-Ping, E-mail: yipingzhuang2010@sina.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Wang, Hai-Yan, E-mail: mycherishgirl@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Jin, E-mail: yari_zj@hotmail.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Feng, Yong, E-mail: fengyong119@sohu.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China); Zhang, Lei, E-mail: motozl163@163.com [Department of Radiology, Jiangsu Cancer Institute and Hospital, No. 42 Baiziting Road, Nanjing 210009, Jiangsu (China)

    2013-01-15

    Objective: CT-guided transthoracic biopsy is a well-established method in the cytologic or histologic diagnosis of pulmonary lesions. The knowledge of its diagnostic performance and complications for cavitary pulmonary lesions is limited. The purpose of this study was to determine the diagnostic accuracy and safety of CT-guided fine needle aspiration biopsy (FNAB) in cavitary pulmonary lesions. Materials and methods: 102 consecutive patients with pulmonary cavitary lesions received CT-guided FNAB with use of an 18-gauge (n = 35) or 20-gauge (n = 67) Chiba for histology diagnosis. The sensitivity, specificity, and diagnostic accuracy of FNAB were calculated as compared with the final diagnosis. Complications associated with FNAB were observed. The diagnostic accuracy and complications were compared between patients with different lesion sizes and different cavity wall thickness. Results: The overall sensitivity, specificity, and accuracy of FNAB were 96.3%, 98.0%, and 96.1%, respectively. The sensitivity, specificity, and diagnosis accuracy in different lesion size (<2 cm vs ≥2 cm), or different cavity wall thickness (<5 mm vs ≥5 mm) were not different (P > 0.05; 0.235). More nondiagnostic sample was found in wall thickness <5 mm lesions (P = 0.017). Associated complications included pneumothorax in 9 (8.8%) patients and alveolar hemorrhage in 14 patients (13.7%) and hemoptysis in 1 patient (1%). No different rate of complications was found with regard to lesion size, wall thickness, length of the needle path and needle size (P > 0.05). Conclusion: CT-guided FNAB can be effectively ad safely used for patients with pulmonary cavitary lesions.

  7. Cancer incidence of larger thyroid nodules and the diagnostic value of palpation and ultrasound guided fine needle aspiration biopsy

    OpenAIRE

    Umut Rıza Gündüz; Arif Aslaner; Rojbin Karakoyun Demirci; Hasan Çalış; Osman Zekai Öner; Nurullah Bülbüller

    2014-01-01

    In this prospective study, we aimed to determine the cancer incidence of thyroid nodules larger than 3cm and compare the efficacy of palpation and ultrasound guided fine needle aspiration biopsy (FNAB). The study was conducted at General Surgery Departments of Istanbul Okmeydanı and Antalya Training and Research Hospitals of Turkey from March 2008 to December 2011. In our clinics, between the years 2008 and 2011, both palpation and ultrasound guided FNAB were performed in all 55 patients havi...

  8. Pleomorphic rhabdomyosarcoma of the heart metastatic to bone. Report of a case with fine needle aspiration biopsy findings.

    Science.gov (United States)

    Ali, S Z; Smilari, T F; Teichberg, S; Hajdu, S I

    1995-01-01

    Pleomorphic rhabdomyosarcoma is an extremely rare and highly malignant neoplasm. We report an unusual case of a 14-year-old boy with skeletal metastases from a primary cardiac tumor. Fine needle aspiration biopsy of a lytic lesion in the right iliac wing showed a pleomorphic population of clusters and single cells with hyperchromatic nuclei; granular, pink cytoplasm; and isolated, large cells with whiplike or globoid cytoplasmic processes and occasional striations. Histologic, ultrastructural and radiologic features are also presented.

  9. Diagnosis of multiple myeloma on based the material obtained by fine needle aspiration biopsy of the lungs

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    Bokun Radojka

    2004-01-01

    Full Text Available The patient presented in this paper was admitted to the hospital for the evaluation of radiologically revealed shadow in both lungs. In the course of diagnostic procedures, fine needle aspiration biopsy of the intrathoracic mass was performed. Cytologic analysis of the smear was performed because of clinical suspicion of plasma cell proliferative disease that was confirmed by bone marrow aspiration. Thus, the cytologic finding of intrathoracic lesion preceded the diagnosis of multiple myeloma.

  10. A 5-year-old girl with a congenital ganglioneuroma diagnosed by fine needle aspiration biopsy: a case report

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    Ponce-Camacho Marco

    2008-01-01

    Full Text Available Abstract Introduction Ganglioneuroma is a rare, benign, neuroblastic tumor arising mainly from the central or peripheral autonomic nervous system, especially the sympathetic system. The most affected anatomical sites are the posterior mediastinum, retroperitoneum, adrenal gland and head and neck soft tissue. In the current literature, reports of ganglioneuroma diagnosed by fine-needle aspiration and its cytological appearance are scarce. Case Presentation A 5-year-old girl presented with a mass in the cervical region since birth. Laboratory routine tests were within normal limits, ultrasonography demonstrated a solid and well-circumscribed lesion in the soft tissues of the cervical region. Fine needle aspiration biopsy was carried out, and the obtained smears showed a mixture of mature ganglion cells and groups of spindle cells suggestive of schwann cell origin. A diagnosis of ganglioneuroma was suggested. Core biopsy and surgical resection confirmed this diagnosis. Conclusion Congenital ganglioneuroma of the cervical region is an uncommon soft tissue benign neoplasm of neuroblastic origin, and it should be considered in the differential diagnosis of head and neck pediatric soft tissue tumors. Fine needle aspiration biopsy technique is a reliable method that can be used with confidence when dealing with pediatric soft tissue tumors.

  11. EUS – Fine- Needle Aspiration Biopsy (FNAB in the Diagnosis of Pancreatic Adenocarcinoma: A Review

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    Kalogeraki Alexandra

    2016-03-01

    Full Text Available Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS is a relatively new technology that employs endoscopy and high-frequency ultrasound (US. EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP brushing, CT-guided biopsies, and transabdominal ultrasound (US have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities

  12. Initial experience with new dedicated needles for laparoscopic ultrasound-guided fine-needle aspiration and histological biopsies

    DEFF Research Database (Denmark)

    Mortensen, M B; Durup, J; Pless, T;

    2001-01-01

    BACKGROUND AND STUDY AIMS: Laparoscopic ultrasonography (LUS) is an important imaging modality during laparoscopic staging of intra-abdominal malignancies, but LUS-assisted biopsy is often difficult or impossible. We report a newly developed inbuilt biopsy system for direct LUS-guided fine......-needle aspiration (FNA) and Tru-cut biopsies. PATIENTS AND METHODS: LUS-guided biopsy was performed in 20 patients with upper gastrointestinal tract tumors. The biopsied lesions had either not been previously detected by other imaging modalities or had been inaccessible, or the biopsy sample had been inadequate....... Primary diagnosis, duration of biopsy procedure, needle monitoring (visibility, penetration, and deviation), complications, technical failures, and pathological findings were prospectively recorded. RESULTS: 44 biopsies were performed with 25 needles (19, 20, and 22-G). Needle monitoring and penetration...

  13. Thyroid fine needle aspiration biopsy: Do we really need an on-site cytopathologist?

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    Cengic, Ismet, E-mail: ismetcengic@yahoo.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Tureli, Derya, E-mail: deryatureli@yahoo.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Ahiskali, Rengin, E-mail: renginiara@gmail.com [Department of Pathology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Bugdayci, Onur, E-mail: onurbug@hotmail.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Aydin, Hilal, E-mail: hilalaltasaydin@gmail.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey); Aribal, Erkin, E-mail: earibal@gmail.com [Department of Radiology, Marmara University, School of Medicine, Fevzi Cakmak Mahallesi Mimar Sinan Caddesi No: 41, 34899 Ust Kaynarca Pendik, Istanbul (Turkey)

    2014-04-15

    Purpose: The aim of this single center study is to evaluate the effectiveness of performing ultrasound-guided thyroid fine-needle aspiration biopsies (FNAB) performed by the radiologist alone without an on-site cytopathologist. Materials and methods: In this prospective randomized study, 203 patients with single nodules measuring 10 mm or more underwent ultrasound-guided FNAB: 102 patients underwent FNAB performed by the radiologist accompanied by a cytopathologist (control group); 101 patients underwent FNAB by the radiologist alone (study group). In both groups biopsy time, specimen adequacy ratio, total aspiration number, cytopathologist's cytological diagnosis time (t1), cytopathologist's total time consumption (t2) were evaluated. Results: Mean total biopsy time was 8.74 ± 2.31 min in the study group and was significantly shorter than the control group's 11.97 ± 6.75 min (p = 0.004). The average number of aspirations per patient in the study group was 4.00 ± 0; compared to the control group's 3.56 ± 1.23 this was significantly higher (p = 0.001). t1 of the study group was 307.48 ± 226.32 s; compared to 350.14 ± 247.64 s in the control group, there was no statistically significant difference (p = 0.137). t2 of the study group was 672.93 ± 270.45 s; compared to the control group (707.03 ± 258.78 s) there was no statistically significant difference (p = 0.360). Diagnostic adequacy of aspirated specimens was reassessed in the pathology laboratory. In the study group, 84 out of 101 aspirations and in the control group 89 out of 102 aspirations was determined as adequate with no statistically significant difference (p = 0.302). Conclusions: We believe that in centers where a cytopathologist is not available, ultrasound-guided thyroid FNAB can be adequately performed by an experienced radiologist who was effectively trained in smear preparation.

  14. Concurrent fine needle aspirations and core needle biopsies: a comparative study of substrates for next-generation sequencing in solid organ malignancies.

    Science.gov (United States)

    Roy-Chowdhuri, Sinchita; Chen, Hui; Singh, Rajesh R; Krishnamurthy, Savitri; Patel, Keyur P; Routbort, Mark J; Manekia, Jawad; Barkoh, Bedia A; Yao, Hui; Sabir, Sharjeel; Broaddus, Russell R; Medeiros, L Jeffrey; Staerkel, Gregg; Stewart, John; Luthra, Rajyalakshmi

    2017-01-13

    Minimally invasive procedures, such as fine needle aspiration and core needle biopsy, are commonly used for the diagnosis in solid organ malignancies. In the era of targeted therapy, it is crucial for molecular testing to be performed on these limited volume specimens. Although several recent studies have demonstrated the utility of small biopsy specimens for molecular testing, there remains debate as to whether core needle biopsy specimens are more reliable than fine needle aspiration for molecular studies. In this study, we reviewed concurrently acquired fine needle aspiration and core needle biopsy samples (n=24), and compared overall cellularity, tumor fraction, and the results of next-generation sequencing. All somatic mutations detected in core needle biopsy samples were also detected in fine needle aspiration samples. The estimated tumor fraction was significantly higher in fine needle aspiration smears than core needle biopsy samples (P=0.003), whereas the overall DNA yield from smears was significantly lower than that obtained from the core needle biopsy specimens (P=0.01). The normalized average amplicon coverage for the genes analyzed was significantly higher in cytology smears than paired core needle biopsy samples, with lower numbers of failed amplicons and higher overall mutation allelic frequencies seen in the former. We further evaluated 100 malignant fine needle aspiration and core needle biopsy samples, acquired concurrently, for overall cellularity and tumor fraction. Overall cellularity and tumor fraction of fine needle aspiration samples was significantly higher than concurrently acquired core needle biopsy samples (Pcore needle biopsy samples. Cytologic specimens, therefore, should be better integrated into routine molecular diagnostics workflow to maximize limited tissues for clinically relevant genomic testing.Modern Pathology advance online publication, 13 January 2017; doi:10.1038/modpathol.2016.228.

  15. Comparison of Different Techniques of Ultrasound-Guided Fine Needle Biopsy of Liver in a Swine Model

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    Hamidian Jahromi

    2015-06-01

    Full Text Available Background The quality of liver biopsy specimens obtained with different fine needle biopsy (FNB techniques has not been compared. Objectives This study was performed to evaluate the diagnostic quality of three different liver FNB biopsy techniques. Materials and Methods Two sequential biopsy series were performed on piglets. Three biopsy techniques were compared: capillary-FNB, core-FNB (CFNB and vacuum-assisted CFNB (VACFNB in a swine model. Initially, 30 liver biopsies were performed (ten for each technique. The cellularity and quantity of blood in specimens were measured and compared. In the second series, 54 additional biopsies using CFNB and VACFNB techniques (27 each in a separate piglet were evaluated in the same fashion. Results In the first series, cellularity and blood levels were significantly lower in capillary-FNB compared with CFNB (P < 0.001 and P = 0.011, respectively. There was no significant difference between CFNB and VACFNB in cellularity and blood (P = 0.15 and P = 0.1, respectively. In the second series, cellularity was significantly higher in CFNB compared with VACFNB (P < 0.001 with no significant difference in blood (P = 0.5. Conclusions Among these three different FNB techniques, CFNB technique provided the greatest cellularity. Capillary-FNB technique was inferior among all with the lowest quality of obtained material for cytopathological interpretation.

  16. Endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of pancreatic masses.

    Science.gov (United States)

    Jinga, Mariana; Gheorghe, Cristian; Dumitrescu, Marius; Gheorghe, Liana; Nicolaie, Tudor

    2004-03-01

    Endoscopic ultrasound (EUS) represents a highly sensitive method for the detection of pancreatic masses. When available, EUS-guided fine needle aspiration (FNA) is the best technique for the diagnosis and staging of pancreatic cancer due to its ability to obtain tissue for diagnosis. The standardized indications for pancreatic EUS-FNA comprise the definite diagnosis of malignancy and histopathological confirmation of adenocarcinoma before surgical resection, chemo/radiotherapy, or celiac plexus neurolysis. The technique of performing EUS-FNA is described in detail, from the vizualization of the target lesion and adequate placement of the transducer to allow optimal needle access, to needle penetration and sampling of the targeted lesion. We report a series of 9 patients who underwent EUS-FNA and shortly review the indications, technique, results and impact of EUS-FNA on the management of these patients.

  17. Use of Core Needle Biopsy rather than Fine-Needle Aspiration Cytology in the Diagnostic Approach of Breast Cancer

    Science.gov (United States)

    Pagni, Paola; Spunticchia, Flaminia; Barberi, Simona; Caprio, Giuliana; Paglicci, Carlo

    2014-01-01

    Background and Aims In the following study case, we reviewed breast ultrasound-guided core needle biopsy (CNB), using Mammotome (vacuum-assisted breast biopsy) and Tru-cut, carried out on palpable and nonpalpable uncertain breast lumps or malignant large lesions to be submitted to neoadjuvant chemotherapy. Material and Methods Examinations were conducted during a 4-year period of clinical activity in a highly specialized center, from December 2009 to December 2013, in 712 patients previously subjected to fine-needle aspiration cytology (FNAC). Results The results demonstrated that among the 712 breast biopsies, in many cases FNAC was not conclusive, and therefore we proceeded with the echo-guided biopsy, through which we were able to collect sufficient material for the histological examination in order to direct patients to surgery or follow-up. Conclusions CNB is far superior to FNAC, especially in cases of uncertainty, where it is preferable to proceed directly with CNB, which may also determine additional prognostic and predictive markers. Initially FNAC is less expensive, but the actual costs involved tend to be higher for FNAC as it is less accurate and a CNB is often required. In accordance with recent publications, we can confirm the full validity of CNB in the diagnostic approach of breast lesions. PMID:25120471

  18. Use of Core Needle Biopsy rather than Fine-Needle Aspiration Cytology in the Diagnostic Approach of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Paola Pagni

    2014-07-01

    Full Text Available Background and Aims: In the following study case, we reviewed breast ultrasound-guided core needle biopsy (CNB, using Mammotome (vacuum-assisted breast biopsy and Tru-cut, carried out on palpable and nonpalpable uncertain breast lumps or malignant large lesions to be submitted to neoadjuvant chemotherapy. Material and Methods: Examinations were conducted during a 4-year period of clinical activity in a highly specialized center, from December 2009 to December 2013, in 712 patients previously subjected to fine-needle aspiration cytology (FNAC. Results: The results demonstrated that among the 712 breast biopsies, in many cases FNAC was not conclusive, and therefore we proceeded with the echo-guided biopsy, through which we were able to collect sufficient material for the histological examination in order to direct patients to surgery or follow-up. Conclusions: CNB is far superior to FNAC, especially in cases of uncertainty, where it is preferable to proceed directly with CNB, which may also determine additional prognostic and predictive markers. Initially FNAC is less expensive, but the actual costs involved tend to be higher for FNAC as it is less accurate and a CNB is often required. In accordance with recent publications, we can confirm the full validity of CNB in the diagnostic approach of breast lesions.

  19. Comparison of palpation-versus ultrasound-guided fine-needle aspiration biopsies in the evaluation of thyroid nodules

    Directory of Open Access Journals (Sweden)

    Peker Kamil

    2008-05-01

    Full Text Available Abstract Background The aim of this study was to compare the results of palpation-versus ultrasound-guided thyroid fine-needle aspiration (FNA biopsies. Findings Clinical data, cytology and histopathology results were retrospectively analyzed on all patients who underwent thyroid FNA biopsy in our outpatient endocrinology clinic between January 1998 and April 2003. The same investigators performed all thyroid FNAs (ASC and cytological evaluations (KP. Subjects in the ultrasound-guided group were older, otherwise there were no differences in baseline characteristics (gender, thyroid function, the frequency of multinodular goiter, nodule diameter and nodule location between groups. Cytology results in nodules aspirated by palpation (n = 202 versus ultrasound guidance (n = 184 were as follows: malignant 2.0% versus 2.7% (p = 0.74, benign 69.8% versus 79.9% (p = 0.02, indeterminate 1.0% versus 4.9% (p = 0.02, inadequate 27.2% versus 12.5% (p Conclusion We demonstrate that ultrasound guidance for thyroid FNA significantly decreases inadequate for evaluation category. We also confirm the high sensitivity and specificity of thyroid FNA biopsy in the diagnosis of thyroid cancer. Where available, we recommend universal application of ultrasound guidance for thyroid FNA biopsy as a standard component of this diagnostic technique.

  20. Reliability of fine needle aspiration and ex tempore biopsy in the diagnosis of salivary glands lesions

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    Gajanin Radoslav

    2014-01-01

    Full Text Available Background/Aim. Interpretation of cytological material obtained by fine needle aspiration (FNA of salivary glands is one of the most challenging areas in cytopathology. FNA is performed easily, it is minimally invasive, inexpensive, fast, reliable and provides valuable information to clinicians about the nature of the lesion and therapeutic modalities. Ex tempore diagnosis, frozen section (FS is a diagnostic tool that is essential in determining the modalities of surgical treatment of lesions of the salivary glands. Today this method is used in determining the status of resection margins and infiltration of adjacent anatomical structures. The aim of this study was to present our experiences in the application of FNA and FS in the diagnosis of salivary gland lesions and to determine the sensitivity, specificity, predictive value, and diagnostic reliability of these methods. Methods. The study included 36 patients. In all the patients, cytological analysis was done before surgery and histological analysis of the surgical material. In 23 of the patients the FS diagnostics was done. Then we compared FNA and FS findings with histopathological findings. Results. Correlation of cytological and histological diagnosis showed sensitivity of 83.3%, specificity 96.67%, positive predictive value 83.3%, negative predictive value of 96.77% and diagnostic accuracy of 97.2%. Based on the relationship between FS diagnosis and histopathological diagnosis, the sensitivity was 100%, specificity 96.67%, while positive predictive value and diagnostic accuracy were 100% each. Conclusion. The study confirmed that FNA is a sensitive, reliable diagnostic method for differentiation of lesions of the salivary glands. In cases with no posibility to definite differentiation in FNA samples, and with the need to assess the resection margins and invasion of anatomical structures, it is recommended to use FS diagnostics.

  1. Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses

    Institute of Scientific and Technical Information of China (English)

    Julio Iglesias-Garcia; Enrique Dominguez-Munoz; Antonio Lozano-Leon; Ihab Abdulkader; Jose Larino-Noia; Jose Antunez; Jeronimo Forteza

    2007-01-01

    AIM: To evaluate the diagnostic accuracy of histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) material in the differential diagnosis of pancreatic solid masses.METHODS: Sixty-two consecutive patients with pancreatic masses were prospectively studied. EUS was performed by the linear scanning Pentax FG-38UX echoendoscope. Three FNAs (22G needle) were carried out during each procedure. The materials obtained with first and second punctures were processed for cytological study. Materials of the third puncture were recovered into 10% formol solution by careful injection of saline solution through the needle, and processed for histological study.RESULTS: Length of the core specimen obtained for histological analysis was 6.5 + 5.3 mm (range 1-22 mm).Cytological and histological samples were considered as adequate in 51 (82.3%) and 52 cases (83.9%), respectively. Overall sensitivity of both pancreatic cytology and histology for diagnosis of malignancy was 68.4%. Contrary to cytology, histology was able to diagnose tumours other than adenocarcinomas, and all cases of inflammatory masses. Combination of cytology and histology allowed obtaining an adequate sample in 56 cases (90.3%),with a global sensitivity of 84.21%, specificity of 100%and an overall accuracy of 90.32%. The complication rate was 1.6%.CONCLUSION: Adequate pancreatic core specimens for histological examination can be obtained by EUS-guided FNA. This technique is mainly useful for the diagnosis of different types of pancreatic tumours and evaluation of benign diseases.

  2. Diagnosis and typing of systemic amyloidosis: The role of abdominal fat pad fine needle aspiration biopsy

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    Halloush Ruba

    2009-01-01

    Full Text Available Introduction: Systemic amyloidosis (SA has a broad nonspecific clinical presentation. Its diagnosis depends on identifying amyloid in tissues. Abdominal fat pad fine needle aspiration (FPFNA has been suggested as a sensitive and specific test for diagnosing SA. Materials and Methods: Thirty-nine FPFNA from 38 patients (16 women and 20 men, age range 40-88 years during a 15-year period were reviewed. Smears and cell blocks were stained with Congo red (CR. A panel of antibodies (serum amyloid protein, serum amyloid A, albumin, transthyretin, kappa light chain and lambda light chain was used on six cell blocks from five patients. The FNA findings were correlated with clinical and histological follow-up. Results: FPFNAs were positive, confirmed by CR in 5/39 (13%, suspicious in 1/39 (3%, negative in 28/39 (72%, and insufficient for diagnosis in 5/39 (13% of cases. In all the positive cases, SA was confirmed within 2-16 weeks. Among the 28 negative cases, SA was diagnosed in 21, the rest were lost to follow-up. Among the insufficient cases, SA was diagnosed in four and one was lost to follow-up. Specificity was 100%, whereas sensitivity was 19%. SA typing using cell block sections was successful in three, un-interpretable in one, and negative in two cases. Conclusion: FPFNA for SA is not as good as previously reported. This may be due to different practice setting, level of experience, diagnostic technique, or absence of abdominal soft tissue involvement. A negative result of FPFNA does not exclude SA. Immune phenotyping of amyloid is possible on cell block.

  3. [Hepatic fine needle aspiration biopsy. Experience in the study of hepatic masses at the Salvador Zubiran National Institute of Nutrition].

    Science.gov (United States)

    Angeles-Angeles, A; Gamboa-Domínguez, A; Velázquez Fernández, D; Muñoz-Fernández, L

    1994-01-01

    The results of 114 fine-needle aspiration biopsies (FNAB) of the liver performed during six years (1987-1992) at the Departament of Pathology of the Instituto Nacional de la Nutrición Salvador Zubirán are presented. All were done by radiologists under ultrasonographic (three cases) or computerized tomographic guidance (111 cases). In order to determine the diagnostic accuracy, diagnoses made by FNAB were compared with those made by histological examination (coarse biopsies or surgical specimens) and/or by other diagnostic procedures including the clinical follow-up. Six cases were excluded because clinical information was not available. In 92 cases (85.2%) a correct diagnosis was made, in six (5.5%) the sample was inadequate and in 10 (9.3%) the diagnosis made by FNAB was incorrect. The diagnoses made were as follows: hepatocarcinoma 44, metastatic carcinoma 27, inflammatory lesions 12, regeneration 10, normal eight, unclassified carcinoma five, and lymphoma two. The sensitivity was 96.2, specificity 93.1, positive predictive value 97.4, negative predictive value 90.0, accuracy 95.3 and prevalence 73.1. There were three false negative and two false positive for carcinoma. These figures are similar to those found by other authors. No relevant complications were observed. It is concluded that FNAB of the liver is a safe, inexpensive and reliable method in the diagnoses of liver masses.

  4. Predisposing factors of pneumothorax in percutaneous transthoracic fine needle aspiration biopsy: comparison between CT emphysema score and pulmonary function test

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang Ho; Park, Kyung Joo; Park, Dong Won; Jung, Kyung Il; Suh, Jung Ho [Ajou Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-11-01

    To compare the CT emphysema score with various factors of pulmonary function test by simple spirometry and to use the result as a predictor of pneumothorax in percutaneous transthoracic fine needle aspiration biopsy. The CT scans of 106 patients who had undergone percutaneous transthoracic fine needle aspiration biopsy of lung lesions within the previous 18 months were retrospectively reviewed. In 75 of these 106 cases, the results of the pulmonary function test were also reviewed. On plain chest radiography, pneumothorax was noted in 20 cases (19%). Emphysema was blindly evaluated. We divided each lung into four segments and determined the severity and involved volume of emphysema, as seen on CT. Severity was classified as one of four grades, as follow : absence of emphysema=0 ; low attenuation area of less than 5mm=1 ; low attenuation area of more than 5mm, and vascular pruning with normal lung intervening=2 ; and diffuse low attenuation without intervening normal lung, and larger confluent low attenuation with vascular pruning and distortion of branching pattern occupying all or almost all the involved parenchyma=3. The involved area was also classified as one of four grades : less than 25%=1 ; 25 - 49%=2 ; 51 - 74%=3 ; and more than 75%=4. The CT emphysema score was defined as the average of the grade of severity multiplied by the grade of involved area. Pulmonary function tests, consisting of simple spirometry and a pulmonologist's interpretation, were evaluated. We also evaluated depth and size of lesion as known predisposing factors in postbioptic pneumothorax. Statistical analysis was performed using the chi-square test, Wilcoxon ranks sum W test and the student t test. A comparison between the two groups of occurrence(with or without pneumothorax) showed the emphysema scores to be 1.69{+-}2.0 and 1.11{+-}2.9, respectively ; there was thus no significant difference between the two groups (z= - 0.048, p>0.10). Nor were differences revealed by the

  5. Fine needle biopsy with cytology in paediatrics: the importance of a multidisciplinary approach and the role of ancillary techniques.

    Science.gov (United States)

    Barroca, H; Bom-Sucesso, M

    2014-02-01

    Fine needle biopsy (FNB) with cytology has long been regarded as an excellent technique as the first choice for diagnosing adult tumours. Being an inexpensive minimally invasive technique with high accuracy and diagnostic immediacy through rapid on-site evaluation, it is also ideal for implementation in the paediatric setting, particularly in developing countries. Furthermore, it allows complementary and advanced procedures such as flow cytometry, polymerase chain reaction (PCR) or fluorescence in situ hybridization (FISH), among others, which enhances the diagnostic capacity of this technique and gives it a key role in risk stratification and therapeutic decision-making for several tumours. The advantages of FNB are optimized in the setting of a multidisciplinary team where cytologist, clinician and radiologist play leading roles. Paediatric tumours are rare and most ancillary techniques are cost-effective but complex to be implemented in small centres with limited experience in paediatric pathology. Therefore reference centres are essential, in order to establish teams with extensive experience and expertise. Hence, any child with a suspected malignancy should be directly referred to a paediatric oncology unit. Focusing on a practical approach to the assessment of paediatric lymphadenopathies and non-central nervous system solid tumours we review the effectiveness of FNB as applied concurrently with ancillary techniques in a multidisciplinary approach to the diagnosis, prognosis and therapeutic decisions of paediatric tumours and tumour-like lesions.

  6. The reliability of fine-needle aspiration biopsy in terms of malignancy in patients with Hashimoto thyroiditis.

    Science.gov (United States)

    Kapan, Murat; Onder, Akin; Girgin, Sadullah; Ulger, Burak Veli; Firat, Ugur; Uslukaya, Omer; Oguz, Abdullah

    2015-02-01

    The aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives.

  7. Stromal tissue as an adjunct tool in the diagnosis of follicular thyroid lesions by fine-needle aspiration biopsy

    Science.gov (United States)

    Mai, Kien T.; Hogan, Kevin

    2016-01-01

    Background: The stroma in fine-needle aspiration biopsy (FNAB) of thyroid lesions has not been well investigated. Design: We studied 256 consecutive cases of thyroid FNAB prepared with traditional smear technique. The stroma was categorized: Type 1a consisted of long (more than 3 mm), broad bands composed of mesh containing collagen fibrils thickened by entrapped blood components and follicular cells. Type 1b consisted of dense strands/bands. Type 2 was similar to Type 1a but with shorter (papillary architectures or fragments of capsule. Type 1b stroma likely represented thick/collagenized fibrous septae. Incomplete or complete rings of small encapsulated tumor were occasionally identified. These frameworks of stroma were frequently associated with multinodular goiters (MNGs) which are often hypocellular and follicular neoplasms/papillary thyroid carcinoma with increased cellularity. Type 2 was associated with microfollicles in encapsulated neoplasms or with macrofollicles in MNG. Follicular lesions of unknown significance (n = 41) either negative (n = 26) or positive (n = 15) for carcinoma in subsequent follow-up were frequently associated with stroma characteristic of MNG and carcinoma, respectively. Conclusion: The preservation of the in vivo architecture of Type 1 is likely due to its elasticity. Recognition of the stromal architecture will likely facilitate the diagnosis. PMID:27651822

  8. Thyroid Fine Needle Aspiration Biopsies in Children: Study of Cytological-Histological Correlation and Immunostaining with Thyroid Peroxidase Monoclonal Antibodies

    Directory of Open Access Journals (Sweden)

    Bauer Andrew

    2010-05-01

    Full Text Available Context. There is limited data comparing results of fine needle aspiration biopsies (FNABs to histological diagnosis in children. Design. FNABs were performed in 707 children and cytological results were compared to histology in 165 cases. The usefulness of immunostaining with anti-TPO monoclonal antibodies (MoAb47 on FNAB samples was examined in 54 operated patients. Results. Among unsatisfactory, benign, suspicious, and malignant FNAB, the histological diagnoses were benign in 12/12 (100%, 69/70 (98.5%, 40/50 (80.0%, and 0/33 (0%, respectively. After surgery, malignancy was established in 44/165 (26.6% cases. The sensitivity, specificity, and positive and negative predictive values were 95.4%, 55.8%, 61.7%, and 95% with standard FNAB; and 100%, 75%, 73.3, and 100% with MoAb47. Among suspicious FNAB, positive MoAb47 staining was a reliable marker for exclusion of malignancy. Conclusion. Benign and malignant FNAB accurately predict histological diagnosis. In suspicious FNAB, MoAb47 immunostaining may be a useful adjunct to standard cytology.

  9. Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue

    Institute of Scientific and Technical Information of China (English)

    Massimo GIUSTI; Mara DOLCINO; Lara VERA; Carla GHIARA; Francesca MASSARO; Laura FAZZUOLI; Diego FERONE; Michele MUSSAP; Francesco MINUTO

    2009-01-01

    Assaying parathyroid hormone (PTH) in the washing liquid after fine-needle aspiration biopsy (FNAB) seems to be a valid approach to locate parathyroid tissue. PTH-FNAB was evaluated in 47 patients with a clinical picture of primary hyper-parathyroidism (PHP) and ultrasonography (US) suggestive of parathyroid lesion. The patients were subdivided into two groups on the basis of the absence or presence of US thyroid alterations. The result of PTH-FNAB was compared with those of cytology, scintigraphy and, in 24 patients, surgical outcome. PTH-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid tissue. Cytology proved diagnostic for benign thyroid lesions, non-diagnostic for thyroid lesions, hyperplastic parathyroid tissue, undetermined or malignant thyroid lesions and other lesions in 45%, 30%, 17%, 4%, and 4% of cases, respectively. In 47% of cases, PTH-FNAB indicated that the sample had been taken in parathyroid tissue. In patients without US alterations, the diagnostic accuracy of PTH-FNAB was greater than that of scintigraphy. After surgery, comparison between the results of PTH-FNAB and scintigraphy, in terms of positive predictive value (PPV), revealed the superiority of PTH-FNAB; PPV was 94% for FNAB and 71% for scintigraphy, while sen-sitivity was 83% and 69%, respectively. PTH-FNAB evaluation after FNAB appears to be more diagnostic than cytology and scintigraphy. Of all the procedures used, PTH-FNAB appears to be the method of choice when the target is US suggestive and reachable. PTH-FNAB appears to be a useful method of guiding surgical intervention.

  10. The triage efficacy of fine needle aspiration biopsy for follicular variant of papillary thyroid carcinoma using the Bethesda reporting guidelines.

    Science.gov (United States)

    Kurian, Elizabeth M; Dawlett, Marilyn; Wang, Jianping; Gong, Yun; Guo, Ming

    2012-05-01

    Diagnosis of follicular variant of papillary thyroid carcinoma (FVPTC) by ultrasound-guided fine-needle aspiration (FNA) is challenging. In this retrospective review, we evaluated triage efficacy (i.e., potential for triggering surgical intervention) in 44 archived FNA biopsies of surgically confirmed FVPTC obtained between December 2006 and December 2008. We compared the original FNA diagnoses with reclassified diagnoses based on 2007 National Cancer Institute (NCI)/Bethesda recommendations, and reviewed FNA cytologic features. Original FNA diagnoses included colloid nodule (7%, 3/44), atypical follicular cells (5%, 2/44), follicular lesion (11%, 5/44), follicular neoplasm (16%, 7/44), suspicious for malignancy/PTC (27%, 12/44), and papillary thyroid carcinoma (34%, 15/44). Reclassified diagnoses included indeterminate (5%, 2/44), colloid nodule (7%, 3/44), atypical cells of undetermined significance [ACUS] (7%, 3/44), Hurthle cell neoplasm (2%, 1/44), follicular neoplasm (7%, 3/44), suspicious for malignancy/PTC (25%, 11/44), and PTC (48%, 21/44). Triage efficacy was 77% (34/44) for original diagnoses versus 82% (36/44) for reclassified FNA diagnoses. We frequently observed cytologic features of PTC, such as nuclear grooves and fine chromatin; conversely, intranuclear inclusions, though present in 77% cases, were scant. Our review findings suggest that lack of characteristic cytologic features of PTC,coexistence with other thyroid lesions, and small tumor size arethe major obstacles to FNA diagnosis of FVPTC. Reclassification of thyroid FNA diagnoses does not significantly improve triage efficacy. Furthermore, FNA diagnoses of follicular neoplasm and suspicious for malignancy are valuable in patients with FVPTC because they trigger triage toward surgical intervention.

  11. Thyroid nodules with isolated macrocalcification: Malignancy and diagnostic efficacy of fine-needle aspiration and core needle biopsy

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    Na, Dong Gyu; Kim, Dae Sik; Kim, Soo Jin [Dept. of Radiology, Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Ryoo, Jae Wook [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Jung, So Lyung [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-07-15

    This study was performed to determine the malignancy risk of thyroid nodules with isolated macrocalcification and to evaluate the diagnostic efficacy of fine-needle aspiration (FNA) and core needle biopsy (CNB). From May 2008 to December 2014, a total of 44 patients with isolated macrocalcifications were enrolled from 4,081 consecutive patients who underwent FNA or CNB at a single institution. We assessed the malignancy risk of nodules with isolated macrocalcification. We compared the diagnostic results between FNA and CNB, and the diagnostic efficacy of each procedure was evaluated by the rate of inconclusive results. We compared the diagnostic performance for malignancy between FNA and CNB with a criterion of malignant or atypia/follicular lesion of undetermined significance (indeterminate) diagnostic results. We investigated whether the ultrasonographic feature of isolated macrocalcification was predictive of malignancy. The malignancy risk of nodules with isolated macrocalcification was 16.1% in 31 nodules with final diagnoses and 11.4% in all nodules. CNB demonstrated a significantly lower rate of nondiagnostic and inconclusive results than FNA (7.7% vs. 53.8%, P=0.002 and 15.4% vs. 57.7%, P=0.003, respectively) in 26 nodules that underwent both FNA and CNB. CNB showed a marginally higher diagnostic performance for identifying malignancy than FNA (P=0.067). The ultrasonographic features of the anterior margin of isolated macrocalcification were not predictive of malignancy (P>0.999). Thyroid nodules with isolated macrocalcification had a low to intermediate malignancy risk and should not be considered benign nodules. CNB showed a higher diagnostic efficacy than FNA in these nodules.

  12. Metastatic renal cell carcinoma from a native kidney of a renal transplant patient diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA biopsy

    Directory of Open Access Journals (Sweden)

    Yaseen Alastal

    2015-04-01

    Full Text Available Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA biopsy sampling of enlarged lymph nodes is increasingly used to diagnose metastatic tumors, especially of the gastrointestinal tract and the lungs. Herein, we describe the diagnosis of metastatic renal cell carcinoma from a native kidney of a 54 year-old male patient, who had a 5-years history of renal transplant, by EUS-FNA of mediastinal and celiac lymph nodes. Histological and immunohistochemical findings confirmed the origin of metastatic tumor. EUS-FNA with proper cytological evaluation can be useful in the diagnosis of metastatic renal cell carcinoma in renal transplant patients. 

  13. Fine needle aspiration cytology of rectal masses.

    Science.gov (United States)

    Kochhar, R; Rajwanshi, A; Wig, J D; Gupta, N M; Kesiezie, V; Bhasin, D K; Malik, A K; Gupta, S K; Mehta, S K

    1990-01-01

    This paper describes the results of transproctoscopic fine needle aspiration cytology in the diagnosis of rectal lesions. Fifty one consecutive patients referred with a presumptive diagnosis of rectal mass were subjected to proctoscopic examination when fine needle aspiration cytology, brush cytology and biopsy samples were taken. Of the 30 patients of malignancy of rectum in whom all the three sampling techniques were applied, the biopsy was positive in 27 (90%), brush cytology in 25 (83.3%) and fine needle aspiration cytology in 29 (96.6%). A combination of fine needle aspiration cytology with brush cytology gave a positive yield in 96.6% while that fine needle aspiration cytology with brush cytology gave a yield of 100%. Fine needle aspiration cytology was most helpful in infiltrative tumours. All 10 patients with secondaries in the pouch of Douglas or rectovesical pouch, and the single patient with submucosal rectal carcinoma were correctly diagnosed at fine needle aspiration cytology. There were no false positive results with fine needle aspiration cytology and no complications were encountered with the procedure. Images Figure 1 Figure 2 Figure 3 PMID:2323600

  14. Evaluation the Relationship Between Thyroid Nodule Size with Malignancy and Accuracy of Fine Needle Aspiration Biopsy (FNAB)

    Science.gov (United States)

    Godazandeh, Gholamali; Kashi, Zahra; Zargarnataj, Sadegh; Fazli, Mehran; Ebadi, Robab; Kerdabadi, Ensiyeh Hajializadeh

    2016-01-01

    Introduction: Some studies have shown largest thyroid nodule size, especially ≥4cm that can predict malignancy and reduce fine needle aspiration biopsy (FNAB) accuracy. Therefore, this study is designed to evaluate relationship between thyroid nodule sizes with malignancy and its effect on FNBA accuracy. Materials and Methods: a retrospective analytical study design aims to investigate all patients with thyroid nodules who referred to surgery department of Imam-Khomeini Hospital of Mazandaran University of Medical Sciences in Sari from 20 March 2008 to 22 March 2014. We collected patient’s demographic data, nodules size, FNAB reports and final pathology (after surgery) reports from their medical records. All data were analyses performed by SPSS18. Results: 167 patients (153 women) with mean age of 41.56±13.24 years old were enrolled for this study. In final pathology; 38 patients (22.8%) had malignant nodules. The mean age of patients with or without malignant nodules were 34.93±11.86 and 42.37±12.26 years old, respectively (P=0.002). The mean size of benign and malignant nodules were 2.91±1.29 cm and 3.38±1.86 cm, respectively (P=0.15). 25.2% of <4 cm nodules and 17.9% of ≥4 cm nodules were diagnosed as a malignant (P=0.29). FNAB was done on 95 patients that reported benign in 60 patients (63.2%), malignant in 18 patients (18.9%) and suspicious in 17 patients (17.9%). Positive and negative results of FNAB in all nodules were 3.5% and 6.3%, in <4cm nodules were 5.8% and 6.2% and in ≥4cm nodules were zero and 6.7%, respectively. The sensitivity, specificity, Positive predict value (PPV), negative predict value (NPV) and overall accuracy (OA) of FNAB in all nodules were 76.19%, 96.49%, 88.88%, 91.66% and 91.02%, and in <4cm nodules were 78.57%, 94.11%, 84.61%, 91.42% and 89.58%, and in ≥4cm nodules were 71.4%, 100%, 100%, 92% and 93.33%, respectively. Conclusion: the results of this study revealed that the size of the thyroid nodules is not reliable at

  15. Combined use of fine-needle aspiration biopsy, MIBI scans and frozen section biopsy offers the best diagnostic accuracy in the assessment of the hypofunctioning solitary thyroid nodule

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    Hurtado-Lopez, Luis Mauricio; Arellano-Montano, Sara; Torres-Acosta, Evelyn Migdalia; Zaldivar-Ramirez, Felipe Rafael; Duarte-Torres, Reyna Margarita; Alonso-de-Ruiz, Patricia; Martinez-Duncker, Ivan [Thyroid Clinic, General Hospital of Mexico, Mexico City (Mexico); Martinez-Duncker, Carlos [Thyroid Clinic, General Hospital of Mexico, Mexico City (Mexico); Molecular Nuclear Medicine, Hospital Infantil de Mexico, Mexico (Mexico)

    2004-09-01

    The probability of malignancy is increased in hypofunctioning solitary thyroid nodules (HFNs). Fine-needle aspiration biopsy (FNA), {sup 99m}Tc-methoxyisobutylisonitrile (MIBI) and frozen section biopsy (FS) have limited independent diagnostic accuracy for the differential diagnosis of HFNs. The goal of this study was to assess the accuracy of the three independent diagnostic methods in distinguishing between benign and malignant disease. A total of 130 patients with an HFN on the {sup 99m}Tc-pertechnetate scan were included in this study. FNA, MIBI scans, FS, thyroidectomy and histological analysis of surgical specimens for final diagnosis were performed in all patients. Of the 130 patients, 80 (61.54%) had benign lesions and 50 (38.46%), malignant lesions. FNA was diagnostic in 78/130 (60%) patients and non-diagnostic in 52/130 (40%) patients. None of the patients with a negative MIBI scan had a final histological diagnosis of malignancy, and MIBI scans were negative in 38.46% of patients with non-diagnostic FNA results. FS was diagnostic in 104/130 (80%) patients and non-diagnostic in 26/130 (20%) patients. Sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios were 81.3%, 97.8%, 96%, 88%, 36.95 and 0.19 respectively for FNA; 100%, 61.3%, 61.7%, 100%, 2.58 and 0 respectively for MIBI; and 80.5%, 100%, 100%, 89%, 0 and 0.2 respectively for FS. Use of both MIBI scans and FS in patients with non-diagnostic FNA rendered a specificity and sensitivity of 100%. MIBI scans exclude malignancy in a significant proportion of patients with non-diagnostic FNAs (38% in this study). Cystic nodules with a positive MIBI scan should be further investigated even when the FNA result indicates a benign lesion. Combined use of FNA, MIBI and FS offers the best diagnostic accuracy. (orig.)

  16. Clinical impact of endoscopic ultrasound-guided fine needle aspiration biopsy in patients with upper gastrointestinal tract malignancies. A prospective study

    DEFF Research Database (Denmark)

    Mortensen, M B; Pless, T; Durup, J;

    2001-01-01

    BACKGROUND AND STUDY AIMS: Several studies have evaluated the accuracy of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) in the upper gastrointestinal tract, but so far no studies have specifically evaluated the clinical impact of EUS-FNAB in upper gastrointestinal tract......% in esophageal, gastric, and pancreatic cancer, respectively. The staging-related clinical impact was similar for all three types of cancer (11-12.5%), whereas the diagnosis-related impact was highest in pancreatic cancer patients (86%). EUS-FNAB was inadequate in 13% and gave false-negative results in 5......%. The overall sensitivity, specificity and accuracy for EUS-FNAB were 80%, 78% and 80%, respectively. No complications related to the biopsy procedure were seen. CONCLUSIONS: If EUS-FNAB was performed only in cases where a positive malignant result would change patient management, then approximately one out...

  17. Post-brushing and fine-needle aspiration biopsy follow-up and treatment options for patients with pancreatobiliary lesions: The Papanicolaou Society of Cytopathology Guidelines

    Directory of Open Access Journals (Sweden)

    Daniel F. I. Kurtycz

    2014-01-01

    Full Text Available The Papanicolaou Society of Cytopathology (PSC has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS guided fine-needle aspiration (FNA biopsy, techniques of EUS-FNA, terminology and nomenclature for pancreatobiliary cytology, ancillary testing and post-procedure management. All documents are based on the expertise of the authors, a review of the literature and discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the PSC web site (www.papsociety.org. This document selectively presents the results of these discussions and focuses on the follow-up and treatment options for patients after procedures performed for obtaining cytology samples for the evaluation of biliary strictures and solid and cystic masses in the pancreas. These recommendations follow the six-tiered terminology and nomenclature scheme proposed by committee III.

  18. Comparison of power Doppler and thermography for the selection of thyroid nodules in which fine-needle aspiration biopsy is indicated

    Directory of Open Access Journals (Sweden)

    Maria Lucia D'Arbo Alves

    Full Text Available Abstract Objective: To compare two methods-power Doppler and thermography-for the analysis of nodule vascularization and subsequent selection of nodules to be biopsied. Materials and Methods: A total of 510 subjects with thyroid nodules were analyzed by power Doppler and submitted to fine-needle aspiration biopsy (FNAB. Thirty-seven patients were submitted to nodule excision (29 due to carcinoma or suspected carcinoma and 8 by patient choice. Among those patients, power Doppler had raised the suspicion of malignancy in 39 lesions, compared with 48 for FNAB. Another group, comprising 110 patients, underwent thermography, which raised the suspicion of malignancy in 124 thyroid nodules, as did FNAB. Malignant nodules were excised in all 110 of those patients (95 underwent nodulectomy and 15 underwent thyroidectomy, malignancy being confirmed by intraoperative examination of frozen biopsy samples. Results: In relation to the FNAB findings, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of power Doppler were 95.16%, 23.52%, 96.22%, 16.70%, and 89.51%, respectively, compared with 100%, 58.06%, 87.73%, 100%, and 89.51%, respectively, for thermography. Conclusion: Thermography was more precise than was power Doppler for the selection of thyroid nodules to be biopsied.

  19. Comparison of power Doppler and thermography for the selection of thyroid nodules in which fine-needle aspiration biopsy is indicated*

    Science.gov (United States)

    Alves, Maria Lucia D'Arbo; Gabarra, Manoel Henrique Cintra

    2016-01-01

    Objective To compare two methods-power Doppler and thermography-for the analysis of nodule vascularization and subsequent selection of nodules to be biopsied. Materials and Methods A total of 510 subjects with thyroid nodules were analyzed by power Doppler and submitted to fine-needle aspiration biopsy (FNAB). Thirty-seven patients were submitted to nodule excision (29 due to carcinoma or suspected carcinoma and 8 by patient choice). Among those patients, power Doppler had raised the suspicion of malignancy in 39 lesions, compared with 48 for FNAB. Another group, comprising 110 patients, underwent thermography, which raised the suspicion of malignancy in 124 thyroid nodules, as did FNAB. Malignant nodules were excised in all 110 of those patients (95 underwent nodulectomy and 15 underwent thyroidectomy), malignancy being confirmed by intraoperative examination of frozen biopsy samples. Results In relation to the FNAB findings, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of power Doppler were 95.16%, 23.52%, 96.22%, 16.70%, and 89.51%, respectively, compared with 100%, 58.06%, 87.73%, 100%, and 89.51%, respectively, for thermography. Conclusion Thermography was more precise than was power Doppler for the selection of thyroid nodules to be biopsied. PMID:27818545

  20. Use of CT-guided fine needle aspiration biopsy in epidermal growth factor receptor mutation analysis in patients with advanced lung cancer

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    Zhuang, Yi-Ping; Wang, Hai-Yan; Zhang, Jin; Feng, Yong (Dept. of Radiology, Jiangsu Cancer Inst. and Hospital, Nanjing, Jiangsu (China)), email: yipingzhuang2010@sina.com; Shi, Mei-Qi (Dept. of Chemotherapy, Jiangsu Cancer Inst. and Hospital, Nanjing, Jiangsu (China))

    2011-12-15

    Background. The safety of using a cutting needle when performing a core-needle biopsy is of major concern, in particular for small lung tumors or tumors near the hilum. Purpose. To investigate the usefulness of CT-guided fine needle aspiration biopsy (FNAB) of the lung in obtaining tumor tissue for epidermal growth factor receptor (EGFR) mutation analysis in advanced lung cancer patients. Material and Methods. Forty-three patients with stage IIIB-IV lung cancer were enrolled. In all patients, CT-guided FNAB was performed using an 18-gauge or 20-gauge Chiba aspiration needle for histology diagnosis and EGFR mutation analysis. Complications associated with CT-guided FNAB were observed, and the specimen mutational assessments were recorded. Results. The obtained tumor samples ranged from 0.5-1.5 cm in length and were adequate for histological and DNA analyses in all patients. No patient had a pneumothorax or hemoptysis. Minor needle tract bleeding appeared in eight patients. Mutation analysis was satisfactorily demonstrated in 23 mutations and 20 non-mutations. Ten and 13 mutations were identified by 18-gauge and 20-gauge needle biopsies, respectively. EFGR mutations, including 12 cases of EGFR exon 19 deletion and 11 cases of exon 21 point mutation, were present in 21 patients with adenocarcinomas, one with squamous cell carcinoma, and one with undifferentiated carcinoma. Conclusion. CT-guided FNAB is a feasible and safe technique for obtaining lung tumor tissues for EGFR gene mutation analysis

  1. Metastatic pancreatic acinar cell carcinoma in a younger male with marked AFP production: A potential pitfall on fine needle aspiration biopsy.

    Science.gov (United States)

    Valente, Kari; Yacoub, George; Cappellari, James O; Parks, Graham

    2017-02-01

    A 30-year-old male presented to his doctor with complaints of abdominal pain and was found to have retroperitoneal as well as multiple hepatic masses. A serum alpha-fetoprotein (AFP) level was significantly elevated (17,373 ng mL(-1) ), raising suspicions for a metastatic germ cell tumor. Fine needle aspiration biopsy of the pancreatic lesion revealed atypical epithelioid cells with round nuclei, large prominent nucleoli, and granular cytoplasm. The morphologic differential diagnosis included pancreatic neoplasm, metastatic germ cell tumor, other metastatic carcinoma, and melanoma. An extensive panel of immunohistochemical stains confirmed the diagnosis of acinar cell carcinoma. The diagnosis of acinar cell carcinoma could be confounded by the markedly increased AFP level, particularly in the setting of a retroperitoneal mass in a younger male. The increased AFP level in the setting of an acinar cell tumor is a potential pitfall to correct diagnosis by cytology. As the treatment for these two entities differs considerably, acute awareness of the phenomenon is important. We present a case of pancreatic ACC with an increased AFP level diagnosed on a cytology specimen. Diagn. Cytopathol. 2017;45:133-136. © 2016 Wiley Periodicals, Inc.

  2. CXCR3, CCR5, and CRTH2 Chemokine Receptor Expression in Lymphocytes Infiltrating Thyroid Nodules with Coincident Hashimoto’s Thyroiditis Obtained by Fine Needle Aspiration Biopsy

    Directory of Open Access Journals (Sweden)

    Jan Jiskra

    2016-01-01

    Full Text Available Objective. To determine the expression of chemokine receptors in lymphocytes from thyroid nodules and peripheral blood in patients with and without Hashimoto’s thyroiditis (HT. Patients and Methods. The study included 46 women with thyroid nodules and HT and 60 women with thyroid nodules without HT (controls who underwent a fine needle aspiration biopsy (FNAB. Expression of chemokine receptors CXCR3, CCR5, and CRTH2 was assessed by flow cytometry in lymphocytes from FNAB samples and from peripheral blood. Results. The percentage of CRTH2+ lymphocytes was higher in nodules with HT in comparison with controls, both in FNAB samples (13.95 versus 6.7%, p=0.008 and in peripheral blood (6.7 versus 5.13%, p=0.047, and positively correlated with serum antibodies to thyroid peroxidase (r=0.243; p=0.026 and negatively correlated with thyroid volume (r=-0.346; p=0.008. Lymphocytes from neoplastic nodules showed a higher expression of both CXCR3 and CCR5 than those from hyperplastic ones. Conclusion. Flow cytometry performed in FNAB samples may serve as a good tool in investigation of intrathyroidal expression of immunological parameters. In our study, the CRTH2 expression on thyroid-infiltrating lymphocytes as well as on lymphocytes from peripheral blood was increased in HT as compared to controls.

  3. CXCR3, CCR5, and CRTH2 Chemokine Receptor Expression in Lymphocytes Infiltrating Thyroid Nodules with Coincident Hashimoto's Thyroiditis Obtained by Fine Needle Aspiration Biopsy

    Science.gov (United States)

    Antošová, Marie; Krátký, Jan; Vítková, Hana; Límanová, Zdeňka; Marečková, Helena; Potluková, Eliška

    2016-01-01

    Objective. To determine the expression of chemokine receptors in lymphocytes from thyroid nodules and peripheral blood in patients with and without Hashimoto's thyroiditis (HT). Patients and Methods. The study included 46 women with thyroid nodules and HT and 60 women with thyroid nodules without HT (controls) who underwent a fine needle aspiration biopsy (FNAB). Expression of chemokine receptors CXCR3, CCR5, and CRTH2 was assessed by flow cytometry in lymphocytes from FNAB samples and from peripheral blood. Results. The percentage of CRTH2+ lymphocytes was higher in nodules with HT in comparison with controls, both in FNAB samples (13.95 versus 6.7%, p = 0.008) and in peripheral blood (6.7 versus 5.13%, p = 0.047), and positively correlated with serum antibodies to thyroid peroxidase (r = 0.243; p = 0.026) and negatively correlated with thyroid volume (r = −0.346; p = 0.008). Lymphocytes from neoplastic nodules showed a higher expression of both CXCR3 and CCR5 than those from hyperplastic ones. Conclusion. Flow cytometry performed in FNAB samples may serve as a good tool in investigation of intrathyroidal expression of immunological parameters. In our study, the CRTH2 expression on thyroid-infiltrating lymphocytes as well as on lymphocytes from peripheral blood was increased in HT as compared to controls. PMID:27872865

  4. An analysis of of the ultrasound findings of false negative cases for an initial ultrasound-guided fine needle aspiration biopsy (FNAB)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jee Young; Jung, So Lyung; Kim, Bum Soo; Ahn, Kook Jin; Hahn, Seong Tae [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-09-15

    To analyze the ultrasonographic (US) findings of thyroid nodules that yielded false negative results after an initial ultrasound-guided fine needle aspiration biopsy (FNAB). Between August 2003 and February 2006, 389 patients with 405 thyroid nodules received a repeat US-guided FNAB. We retrospectively reviewed the US findings, cytology results and postsurgical pathological results. The cytology diagnoses were classified as benign, a suspicious malignancy, a follicular neoplasm, a papillary carcinoma, and a non-diagnostic result. The US findings of the thyroid nodules were analyzed with regard to size, internal content, shape, margin, echogenecity, and calcification pattern. Of the 405 thyroid nodules, 17 nodules were false negative. The major US findings of these nodules were a solid internal component in 16 nodules, hypoechogenicity or marked hypoechogenicity in 14 nodules, microcalcifications in 12 nodules, an ovoid to round shape in 9 nodules and a well-defined smooth margin in 9 nodules. An repeat US-guided FNAB should be performed if the thyroid nodules have one of the malignant US features such as hypoechogenecity or marked hypoechogenecity, a microcalcification, a taller than wide shape or a well-defined spiculate margin although the cytology results indicated a benign lesion. In addition, thyroid nodules with findings of a well-defined smooth margin, ovoid to round shape, and solid internal component might also be subject to a repeat US-guided FNAB to exclude a malignancy.

  5. Diagnostic accuracy and complication rate of CT-guided fine needle aspiration biopsy of lung lesions: A study based on the experience of the cytopathologist

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    Massimiliano Priola, Adriano; Priola, Sandro Massimo; Cataldi, Aldo; Paze, Francesco (Dept. of Diagnostic and Interventional Radiology, Univ. of Turin, S. Luigi Gonzaga Hospital, Turin (Italy)), e-mail: adriano.priola@inwind.it; Di Franco, Marisa (Dept. of Pharmacology, S. Luigi Gonzaga Hospital, Orbassano, Turin (Italy)); Marci, Valerio (Dept. of Pathology, S. Luigi Gonzaga Hospital, Orbassano, Turin (Italy)); Berruti, Alfredo (Dept. of Oncology, S. Luigi Gonzaga Hospital, Orbassano, Turin (Italy))

    2010-06-15

    Background: CT-guided transthoracic needle biopsy is a well-established technique for the diagnosis of focal lung lesions. Fine needle aspiration biopsy (FNAB) requires the presence of a cytopathologist on-site to assess the adequacy of samples. For this reason FNAB is less and less used, and core biopsy is the first-line procedure when an experienced cytopathologist is not immediately available. Purpose: To evaluate the accuracy and complication rate of CT-guided FNAB of lung lesions according to the experience of the cytopathologist on-site. Material and Methods: A total of 321 consecutive biopsies were considered. Immediate cytological assessment was performed by an experienced cytopathologist for the first 165 procedures (group A) and by two training pathologists for the remaining 156 biopsies (group B). At the time of FNAB the pathologist assigned a semiquantitative score (0-3) to each specimen to assess its diagnostic quality. All variables between the two groups were analyzed by chi-square and Student's t test. A P value <0.05 was considered statistically significant. Results: For all procedures, overall diagnostic accuracy was 80% for cytology alone, with no statistical difference between the two groups for diagnostic accuracy and sample score assigned. In all, 75% of the cytological samples (75% group A, 74% group B) obtained a higher score with a specific diagnosis of histotype. A post biopsy pneumothorax was detected in 27% of biopsies (25% group A, 28% group B). Thirteen patients (4.0%) required chest tube insertion for treatment. For all cases, the pneumothorax rate was significantly affected by the number of samples obtained (P=0.02), but not by the pleural punctures (P=0.15). There was no statistically significant difference between the two groups concerning the number of needle passes and complication rate (P>0.05). Conclusion: The efficacy and safety of CT-guided FNAB is not significantly affected by the training level of the cytopathologist

  6. Restricting ultrasound thyroid fine needle aspiration biopsy by nodule size: which tumors are we missing? A population-based study.

    Science.gov (United States)

    Brito, Juan P; Singh-Ospina, Naykky; Gionfriddo, Michael R; Maraka, Spyridoula; Espinosa De Ycaza, Ana; Rodriguez-Gutierrez, Rene; Morris, John C; Montori, Victor M; Tuttle, R Michael

    2016-03-01

    Clinicians use nodule size to determine which thyroid nodules should receive cytological evaluation. The American Thyroid Association (ATA) has recommended against cytological evaluation for nodules thyroid cancers that would not be diagnosed if a strict 1 cm size cut off is used as the threshold for biopsy of intrathyroidal nodules are not well established. Using the Rochester Epidemiology Project, a population-based cohort, we identified all thyroid nodules in Olmsted County residents from 2003-2006. To assess the presence of favorable or unfavorable features for each nodule size cutoff, each patient found to have thyroid cancer was risk-stratified using the ATA risk score, which predicts risk of recurrence and persistent disease. Thyroid cancer cases in which a biopsy was done for factors other than thyroid nodule size or suspicious ultrasound features were excluded. We identified 485 thyroid nodules, 46 (9.5%) harbored thyroid cancer. Of the 46 thyroid cancers, 37 (7.6%) had ATA low risk; 8 (1.6%) had intermediate, and only 1 (0.2%) had an ATA high risk scores. The frequency of thyroid cancer and the distribution of ATA risk scores were similar across tumor sizes. In thyroid nodules of thyroid cancer patients, no cases of persistent disease were found after a median follow-up of 7 years. In this population-based study, we showed that high risk thyroid cancers are rare; indeed, in this highly selected cohort of patients, the ATA's recommendation to avoid cytologic evaluation in thyroid nodules less than 1 cm would not miss any thyroid cancer with high risk features. However, thyroid nodule size at presentation did not accurately discriminate between tumors with favorable versus unfavorable clinicopathologic features. Thus, if further discrimination is desired, for example, to avoid overdiagnosis, features other than size at presentation need to be evaluated.

  7. Implante subcutáneo de un carcinoma hepatocelular tras la punción aspiración con aguja fina Subcutaneous seeding of hepatocellular carcinoma after fine-needle percutaneous biopsy

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    D. Martínez Ramos

    2007-06-01

    Full Text Available Los implantes subcutáneos son una complicación rara tras la punción aspiración con aguja fina de los carcinomas hepatocelulares. Los autores describen un caso de implante subcutáneo neoplásico en una mujer de 70 años con cirrosis hepática por virus C complicada con un carcinoma hepatocelular. Se efectuó una punción aspiración con aguja fina en el segmento II hepático. El implante tumoral se desarrolló en el trayecto de la punción aspiración. La tumoración subcutánea fue extirpada quirúrgicamente y el estudio anatomopatológico confirmó que se trataba de un carcinoma hepatocelular bien diferenciado.Subcutaneous tumor seeding after fine-needle percutaneous biopsy for hepatocellular carcinoma is a rarely seen complication. The authors describe a case of subcutaneous neoplastic seeding in a 70-year-old woman with chronic hepatitis C virus complicated by hepatocellular carcinoma. Ultrasonically guided fine-needle aspiration biopsy was performed in segment II of the liver. The neoplastic seeding developed along the needle track used to carry out the fine-needle biopsy. The subcutaneous tumor was excised, and histological examination revealed a well-differentiated hepatocellular carcinoma.

  8. Comparison of Thin-Prep and cell block preparation for the evaluation of Thyroid epithelial lesions on fine needle aspiration biopsy

    Directory of Open Access Journals (Sweden)

    Hammoud Jamal

    2008-01-01

    Full Text Available Abstract Background The objective of this study was to compare the utility of Thin-Prep (TP cytologic preparation with that of Cell Block (CB preparation in the diagnosis of thyroid lesions, mainly follicular epithelial lesions, by fine needle aspiration biopsy (FNAB. Feasibility of using the TP slides for immunocytochemical stains is also discussed. Methods A total of 126 consecutive cases of thyroid FNAB with TP slides and 128 consecutive cases of thyroid FNAB with CB slides were reviewed blindly by two cytopathologists. The presence of colloid, follicular cells, macrophages and lymphocytes/plasma cells were recorded and scored 0–4 on each case based on TP or CB slide review. The cytologic diagnoses were grouped as follows: cyst, colloid nodule, colloid nodule with cystic change, chronic thyroiditis, atypical/neoplastic and non-diagnostic. Results The TP slides had higher diagnostic rate than CB slides. The diagnostic yield was 68% of the TP slides whereas only 24% of the CB slides were diagnostic. Also, only 4 atypical/neoplastic lesions were diagnosed on the TP slides and the corresponding direct smears, while 5 cases of atypical/neoplastic lesions were diagnosed on the smears but could not be diagnosed on the corresponding CB slides. Additionally, the TP slides revealed cytologic features that were not observed on the direct traditional smears of the same case. Conclusion In thyroid FNAB cases, TP slide preparation is superior to CB slide preparation and is more likely to have greater cellularity for diagnosis and detect atypical/neoplastic thyroid lesions, particularly those of follicular cell origin. Furthermore, TP slides appear to detect helpful diagnostic cytologic features and should be considered complementary to, rather than replacing, direct smears.

  9. The Validity of Ultrasonography-Guided Fine Needle Aspiration Biopsy in Thyroid Nodules 4 cm or Larger Depends on Ultrasonography Characteristics

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    Jin Hwa Kim

    2014-12-01

    Full Text Available BackgroundThe objective of this study was to evaluate the validity of fine needle aspiration biopsy (FNAB according to ultrasonography (US characteristics in thyroid nodules 4 cm and larger.MethodsWe retrospectively reviewed the cases of 263 patients who underwent thyroid surgery for thyroid nodules larger than 4 cm between January 2001 and December 2010.ResultsThe sensitivity of US-FNAB was significantly higher in nodules with calcifications (micro- or macro- than those without (97.9% vs. 87.% P<0.05. The accuracy of US-FNAB was higher in large thyroid nodules with US features suspicious of malignancy, such as a solid component, ill-defined margin, hypoechogenicity or marked hypoechogenicity, or any calcifications (micro- or macro- compared to thyroid nodules with none of these features. Furthermore, the accuracy improved as the number of these features increased. The overall false negative rate (FNR was 11.9%. The FNR of thyroid nodules that appeared benign on US, such as mixed nodules (7.7% or nodules without calcification (9.8%, trended toward being lower than that of solid nodules (17.9% or nodules with any microcalcification or macrocalcification (33.3%. In nodules without suspicious features of malignancy, the FNR of US-FNAB was 0% (0/15.ConclusionWe suggest individualized strategies for large thyroid nodules according to US features. Patients with benign FNAB can be followed in the absence of any malignant features in US. However, if patients exhibit any suspicious features, potential false negative results of FNAB should be kept in mind and surgery may be considered.

  10. Predictive value of intratumoral heterogeneity of F-18 FDG uptake for characterization of thyroid nodules according to Bethesda categories of fine needle aspiration biopsy results.

    Science.gov (United States)

    Kim, Seong-Jang; Chang, Samuel

    2015-12-01

    The current study was aimed to investigate the clinical value of intratumoral heterogeneity of F-18 FDG uptake for characterization of thyroid nodule (TN) with inconclusive fine-needle aspiration biopsy (FNAB) results. The current study enrolled 200 patients who showed F-18 FDG incidentaloma and were performed FNAB. The intratumoral heterogeneity of F-18 FDG uptake was represented as the heterogeneity factor (HF), defined as the derivative (dV/dT) of a volume-threshold function for a primary tumor. The diagnostic and predictive values of HF and F-18 FDG PET/CT parameters were evaluated for characterization of inconclusive FNAB results. Among F-18 FDG PET/CT parameters, SUVmax, MTV, and TLG of malignant group were statistically higher than those of Bethesda category of suspicious malignant group. However, HF values were not statistically different between the groups of Bethesda categories (Kruskal-Wallis statistics, 9.924; p = 0.0774). In ROC analysis, when HF > 2.751 was used as cut-off value, the sensitivity and specificity for prediction of malignant TN were 100 % (95 % CI 69.2-100 %) and 60 % (95 % CI 42.1-76.1 %), respectively. The AUC was 0.826 (95 % CI 0.684-0.922) and standard error was 0.0648 (p F-18 FDG uptake represented by HF could be a predictor for characterization of TN with inconclusive FNAB results. Additional large population-based prospective studies are needed to validate the diagnostic utility of HF of F-18 FDG PET/CT.

  11. Real-Time PCR Assay Using Fine-Needle Aspirates and Tissue Biopsy Specimens for Rapid Diagnosis of Mycobacterial Lymphadenitis in Children

    Science.gov (United States)

    van Coppenraet, E. S. Bruijnesteijn; Lindeboom, J. A.; Prins, J. M.; Peeters, M. F.; Claas, E. C. J.; Kuijper, E. J.

    2004-01-01

    A real-time PCR assay was developed to diagnose and identify the causative agents of suspected mycobacterial lymphadenitis. Primers and probes for the real-time PCR were designed on the basis of the internal transcribed spacer sequence, enabling the recognition of the genus Mycobacterium and the species Mycobacterium avium and M. tuberculosis. The detection limit for the assay was established at 1,100 CFU/ml of pus, and the specificity tests showed no false-positive reaction with other mycobacterial species and other pathogens causing lymphadenitis. From 67 children with suspected mycobacterial lymphadenitis based on a positive mycobacterial skin test, 102 samples (58 fine-needle aspirates [FNA] and 44 tissue specimens) were obtained. The real-time PCR assay detected a mycobacterial infection in 48 patients (71.6%), whereas auramine staining and culturing were positive for 31 (46.3%) and 28 (41.8%) of the patients. The addition of the real-time PCR assay to conventional diagnostic tests resulted in the recognition of 13 more patients with mycobacterial disease. These results indicate that the real-time PCR is more sensitive than conventional staining and culturing techniques (P = 0.006). The M. avium-specific real-time PCR was positive for 38 patients, and the M. tuberculosis-specific real-time PCR was positive for 1 patient. Analysis of 27 patients from whom FNA and tissue biopsy specimens were collected revealed significantly more positive real-time PCR results for FNA than for tissue biopsy specimens (P = 0.003). Samples from an age-matched control group of 50 patients with PCR-proven cat scratch disease were all found to be negative by the real-time PCR. We conclude that this real-time PCR assay with a sensitivity of 72% for patients with lymphadenitis and a specificity of 100% for the detection of atypical mycobacteria can provide excellent support for clinical decision making in children with lymphadenitis. PMID:15184446

  12. Patterns of Lymph Node Pathology; Fine Needle Aspiration Biopsy as an Evaluation Tool for Lymphadenopathy: A Retrospective Descriptive Study Conducted at the Largest Hospital in Africa.

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    Denasha Lavanya Reddy

    Full Text Available Lymphadenopathy is a common clinical presentation of disease in South Africa (SA, particularly in the era of Human Immunodeficiency Virus (HIV and tuberculosis (TB co-infection.Data from 560 lymph node biopsy reports of specimens from patients older than 12 years at Chris Hani Baragwanath Academic Hospital (CHBAH between 1 January 2010 and 31 December 2012 was extracted from the National Health Laboratory Service (NHLS, division of Anatomical Pathology. Cytology reports of lymph node fine needle aspirates (FNAs performed prior to lymph node biopsy in 203 patients were also extracted from the NHLS. Consent was not obtained from participants for their records to be used as patient information was anonymized and de-identified prior to analysis.The majority of patients were female (55% and of the African/black racial group (90%. The median age of patients was 40 years (range 12-94. The most common indication for biopsy was an uncertain diagnosis (more than two differential diagnoses entertained, followed by a suspicion for lymphoma, carcinoma and TB. Overall, malignancy constituted the largest biopsy pathology group (39%, with 36% of this group being carcinoma and 27% non-Hodgkin lymphoma. 22% of the total sampled nodes displayed necrotizing granulomatous inflammation (including histopathology and cytology demonstrating definite, and suspicious for mycobacterial infection, 8% comprised HIV reactive nodes; in the remainder no specific pathology was identified (nonspecific reactive lymphoid hyperplasia. Kaposi sarcoma (KS accounted for 2.5% of lymph node pathology in this sample. Concomitant lymph node pathology was diagnosed in four cases of nodal KS (29% of the subset. The co-existing pathologies were TB and Castleman disease. HIV positive patients constituted 49% of this study sample and the majority (64% of this subset had CD4 counts less than 350 cells/ul. 27% were HIV negative and in the remaining nodes, the HIV status of patients was unknown

  13. SUPRACLAVICULAR LYMPH-NODE METASTASES IN CARCINOMA OF THE ESOPHAGUS AND GASTROESOPHAGEAL JUNCTION - ASSESSMENT WITH CT, US, AND US-GUIDED FINE-NEEDLE ASPIRATION BIOPSY

    NARCIS (Netherlands)

    VANOVERHAGEN, H; LAMERIS, JS; BERGER, MY; VANDERVOORDE, F; TILANUS, HW; KLOOSWIJK, AIJ; ZONDERLAND, HM; VANPEL, R

    1991-01-01

    The preoperative assessment of supraclavicular lymph node metastases was prospectively studied in 100 patients with carcinoma of the esophagus and gastroesophageal junction. Findings at computed tomography (CT), ultrasound (US), and palpation were compared, and US-guided fine-needle aspiration biops

  14. Assessment of RET/PTC1 and RET/PTC3 rearrangements in fine-needle aspiration biopsy specimens collected from patients with Hashimoto's thyroiditis

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    Cyniak-Magierska Anna

    2011-01-01

    Full Text Available Abstract Background RET/PTC rearrangements are the most frequent molecular changes in papillary thyroid carcinoma (PTC. So far, 15 main RET/PTC rearrangements have been described, among which RET/PTC1 and RET/PTC3 are the most common in PTC - especially in radiation-induced tumours. RET/PTC1 and RET/PTC3 are the result of intrachromosomal paracentric inversions in chromosome 10, where RET and the activating genes (H4 and ELE1, respectively are located. Recently, RET/PTC rearrangements have been shown not only in PTC but also in benign thyroid lesions, including Hashimoto's thyroiditis (HT. The aim of study was an assessment of RET/PTC1 and RET/PTC3 rearrangements in patients with Hashimoto's thyroiditis. Materials and methods Thyroid aspirates, eligible for the study, were obtained from 26 patients with Hashimoto's thyroiditis by fine-needle aspiration biopsy (FNAB. Each aspirate was smeared for conventional cytology, while its remaining part was immediately washed out of the needle. The cells, obtained from the needle, were used in further investigation. Total RNA from FNAB was extracted by use of an RNeasy Micro Kit, based on modified Chomczynski and Sacchi's method and reverse transcription (RT-PCR was done. Quantitative evaluation of RET/PTC1 and RET/PTC3 rearrangements by real-time PCR was performed by an ABI PRISM® 7500 Sequence Detection System. In the study, PTC tissues with known RET/PTC1 and RET/PTC3 rearrangements served as a reference standard (calibrator, while β-actin gene was used as endogenous control. Results Amplification reactions were done in triplicate for each examined sample. No RET/PTC1 and RET/PTC3 rearrangements were found in the examined samples. Conclusions Our results indicate that RET/PTC1 and RET/PTC3 rearrangements in Hashimoto's thyroiditis, if any, are rather rare events and further investigations should be conducted in order to determine molecular changes, connecting Hashimoto's thyroiditis with PTC.

  15. Preoperative Diagnosis of Solitary Fibrous Tumor of the Kidney with Percutaneous Fine Needle Biopsy and Management with Laparoscopic Partial Nephrectomy:One Case Report and Llteratnres ReVleW

    Institute of Scientific and Technical Information of China (English)

    Liaoyuan Li; Yadi He; Xin Gao; Ming rang; Haibin Zhang; Yuanyuan Xu; WenfengXu

    2008-01-01

    @@ Solitary fibrous tumor(SFT)of the kidney is a rare spindle cell neo-plasm and all reported SFTs of the kidney were diagnosed throughpathological examination and immunohistochemical study after opennephrectomy or open radical nephrectomy[1-3].We present a case ofSFT of the kidney diagnosed through fine needle core biopsy pre-operatively in a 50-year-old female and managed with laparoscopicpartial nephrectomy.Due to the difficulty in discriminating betweenmalignant and benign growth paRem of this tumor entity,a regularfollow-up after conservative treatment iS mandatory.

  16. Concordance between HER-2 status determined by qPCR in Fine Needle Aspiration Cytology (FNAC) samples compared with IHC and FISH in Core Needle Biopsy (CNB) or surgical specimens in breast cancer patients.

    Science.gov (United States)

    Rodriguez, Claudia; Suciu, Voichita; Poterie, Audrey; Lacroix, Ludovic; Miran, Isabelle; Boichard, Amélie; Delaloge, Suzette; Deneuve, Jacqueline; Azoulay, Sandy; Mathieu, Marie-Christine; Valent, Alexander; Michiels, Stefan; Arnedos, Monica; Vielh, Philippe

    2016-11-01

    Determining the status of HER2-neu amplification and overexpression in breast cancer is crucial for prognosis but mostly for treatment purposes. Standard techniques include the determination of IHC in combination with in situ hybridization techniques to confirm a HER2-neu amplification in case of IHC2+ using either a core-needle biopsy or a surgical specimen. qPCR has been also demonstrated to be able to determine HER2 status, mostly in core biopsies or in surgical specimens. Fine-needle aspiration is a reliable, quicker and less invasive technique that is widely used for diagnosis of invasive breast cancer. In this study, we assessed the performance of qPCR in invasive breast carcinomas to determine HER2-neu status by using fine-needle aspiration samples and comparing to standard IHC and FISH. From a total of 154 samples from patients who had nodular breast lesions and attended the 1-day-stop clinic at the Gustave Roussy from March 2013 to October 2014, qPCR was able to determine the HER2 status in a mean of 3.7 days (SD 3.1). The overall concordance with standard HER2-testing was very high: 97% (95% CI 0.94 to 0.99); sensitivity was 96% (0.87-1), specificity 98% (0.95-1) and positive and negative predictive values 88% (0.75-1) and 99% (0.98-1), respectively. In conclusion, our study demonstrates that qPCR performed using fine-needle aspiration samples from a primary tumour is a reliable and fast method to determine HER2/neu status in patients with early breast cancer.

  17. Ultrasound guided fine-needle aspiration cytology of breast lesions

    OpenAIRE

    C. Pagani; Coscia, D. R.; Dellabianca, C.; Bonardi, M.; Alessi, S.; Calliada, F.

    2011-01-01

    Breast biopsy consists in the collection of cells or tissue fragments from a breast lesion and their analysis by a pathologist. There are several types of breast biopsy defined on the basis of the type of needle used: fine-needle aspiration and biopsy performed with a spring-based needle. This article focuses on fine-needle aspiration performed under sonographic guidance.

  18. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

    Energy Technology Data Exchange (ETDEWEB)

    Eun, Na Lae; Chang, Hang Seok; Gweon, Hye Mi; Kim, Jeong Ah; Youk, Ji Hyun; Son, Eun Jun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Yoo, Mi Ri [Dept. of Radiology, Dongjak Kyunghee Hospital, Seoul (Korea, Republic of); Park, Ah Young [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Moon, Hee Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules.

  19. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

    Science.gov (United States)

    2016-01-01

    Purpose: The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. Methods: This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. Results: The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Conclusion: Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules. PMID:27068131

  20. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

    Directory of Open Access Journals (Sweden)

    Na Lae Eun

    2016-07-01

    Full Text Available Purpose: The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US-guided fineneedle aspiration biopsy (FNAB according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. Methods: This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. Results: The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Conclusion: Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules.

  1. Percutaneous transthoracic biopsy for thoracic lesions: comparison of the utility of fine needle aspiration (FNA), percutaneous curring needle biopsy (PCNB) and combination of both methods

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Won Sang; Choi, Young Hi; Kim, Tae Hoon; Seo, Jae Cheol; Na, Hye Myong; Ha, Mina Ha [College of Medicine, Dankook Univ., Chonan (Korea, Republic of)

    2002-03-01

    To assess the diagnostic role of FNA, PCNB, and a combination of both methods in patients who underwent percutaneous transthoracic biopsy for a malignant or benign intrathoracic lesion. We retrospectively reviewed the findings of 213 patients with an intrathoracic mass or consolidation who underwnt FNA (Group A, n=98), PCNB(Group B, n=31) or a combination of both methods (Group C, n=84). Under fluoroscopic guidance, diagnoses were based on the findings of surgery, biopsy at another site or clinical and radiologic follow-up. In the differential diagnosis of benign and malignant disease, and in the diagnosis of small-cell lung cancer, pulmonary tuberculosis, non-tuberculous infectious disease and benign mass, sensitivity, specificity and accuracy were statistically analysed in each group. Among 213 patients, lesions were malignant in 134 and benign in 79. In group A, sensitivity and specificity were 90.1% and 100% for malignant lesions, and 91.5% and 90.1% for benign, while in group B, the corresponding findings were 90.4% and 100% and 90.0% and 90.1 %. In group C, corresponding rates of 95.1% and 100% (p<0.05) and 100% and 92% (p<0.05) were recorded. In group C, accuracy and sensitivity were higher than in group A or (p<0.05). Post-procedural pneumothorax occurred in 15.3% of group A, 13.3% of group B, and 20.6% of group C, while hemoptysis was found in 7.1% of group A, 13.3 % group B, and 2.9% of group C. Among the three groups, the complication rate showed no statistically significant variation (p<0.05). In the specific diagnosis of small-cell lung cancer, the sensitivity and specificity of FNA and PCNB were, respectively, 100%, and 98.5%, and 90.0% and 98.0% (p<0.05); for tuberculosis, the corresponding figures were 35.0% and 100%, and 20.0% and 97.2 (p<0.05). FNA was better in the diagnosis of non-tuberculous infectious disease, while PCNB was better in the specific diagnosis of benign masses, without statistical significance. FNA is superior to PCNB in the

  2. Abdominal masses in the pediatric age. Characterization by CT guided fine needle aspiration biopsy; Masse addominali nell'eta' pediatrica. Caratterizzazione mediante biopsia computerizzata con ago sottile guidata con Tomografia Computerizzata

    Energy Technology Data Exchange (ETDEWEB)

    Marano, I.; Soscia, E.; Salvatore, M. [Naples Univ. Federico 2. (Italy). Dipt. di Scienze Biomorfologiche e Fuzionali, Cattedra di Radiologia

    1999-04-01

    CT-guided fine needle aspiration biopsy (FNAB) is known to improve diagnosis of expansive abdominal lesions, especially relative to more invasive procedure like explorative laparotomy. FNAB in not commonly use in pediatric patients because of their poor collaboration and of associated risks. The authors investigated the feasibility of FNAB in the pediatric age. [Italian] Sono noti i vantaggi che la biopsia percutanea con ago sottile guidato con TC puo' apportare per la diagnosi delle lesioni espansive addominali, soprattutto se confrontata con procedure piu' invasive come la laparatomia esplorativa. Questo tipo di metodica e' attalmente poco utilizzato nel caso di pazienti pediatrici a causa della scarsa collaborazione e dei rischi associati. Gli autori valutano l'applicabilita' di tale procedura nell'eta' pediatrica alla luce delle propria esperienza.

  3. Prospective validation of microRNA signatures for detecting pancreatic malignant transformation in endoscopic-ultrasound guided fine-needle aspiration biopsies

    Science.gov (United States)

    Frampton, Adam E.; Krell, Jonathan; Prado, Mireia Mato; Gall, Tamara M.H.; Abbassi-Ghadi, Nima; Del Vecchio Blanco, Giovanna; Funel, Niccola; Giovannetti, Elisa; Castellano, Leandro; Basyouny, Mohamed; Habib, Nagy A.; Kaltsidis, Harry; Vlavianos, Panagiotis; Stebbing, Justin; Jiao, Long R.

    2016-01-01

    Background Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. Novel biomarkers are required to aid treatment decisions and improve patient outcomes. MicroRNAs (miRNAs) are potentially ideal diagnostic biomarkers, as they are stable molecules, and tumour and tissue specific. Results Logistic regression analysis revealed an endoscopic-ultrasound fine-needle aspiration (EUS-FNA) 2-miRNA classifier (miR-21 + miR-155) capable of distinguishing benign from malignant pancreatic lesions with a sensitivity of 81.5% and a specificity of 85.7% (AUC 0.930). Validation FNA cohorts confirmed both miRNAs were overexpressed in malignant disease, while circulating miRNAs performed poorly. Methods Fifty-five patients with a suspicious pancreatic lesion on cross-sectional imaging were evaluated by EUS-FNA. At echo-endoscopy, the first part of the FNA was sent for cytological assessment and the second part was used for total RNA extraction. Candidate miRNAs were selected after careful review of the literature and expression was quantified by qRT-PCR. Validation was performed on an independent cohort of EUS-FNAs, as well as formalin-fixed paraffin embedded (FFPE) and plasma samples. Conclusions We provide further evidence for using miRNAs as diagnostic biomarkers for pancreatic malignancy. We demonstrate the feasibility of using fresh EUS-FNAs to establish miRNA-based signatures unique to pancreatic malignant transformation and the potential to enhance risk stratification and selection for surgery. PMID:27086919

  4. Cell morphology observation of breast cancer on fine needle aspiration biopsy%乳腺癌细针穿刺的细胞形态学观察

    Institute of Scientific and Technical Information of China (English)

    付春林; 凌象红; 李军川; 张昱

    2011-01-01

    目的 总结乳腺癌细针穿刺的细胞形态学特点及鉴别诊断.方法 观察175例乳腺癌细针穿刺的细胞学涂片与76例乳腺增生症、93例乳腺纤维腺瘤对照分析;同时观察20例细胞学漏诊和低诊乳腺癌细胞学涂片与13例细胞学过诊病例对照分析.结果 175例乳腺癌:细胞排列杂乱无极性96.6%(169/175),核间疏松排列71.4%(125/175),以散在或小细胞群为主34.3%(60/175),核中等大小以上81.1%(142/175),圆形细胞核占绝大多数88.6%(155/175),核边缘不整齐28.6%(50/175),核质比明显增大60%(105/175)、明显减小8.6%(15/175),大核仁28%(49/175),核大小差异明显77.7%(136/175),未见肌上皮细胞96%(168/175),可见坏死13.7%(24/175),散在细胞圆形核占绝大多数89.7%(157/175)、胞质完整66.9%(117/175),均明显高于乳腺增生症、乳腺纤维腺瘤的相对病例数,差异均有统计学意义(P<0.05);细胞数量多的、散在细胞中等量以上的分别为52.6%(92/175)、55.4%(97/175),均明显高于乳腺增生症的5.3%(4/76)、14.5%(11/76),均P<0.05.20例细胞学漏诊、低诊乳腺癌:圆形核细胞占绝大多数、胞质完整均为70%(14/20),易见腺腔、腺管、炮竹、栅栏、单列纵队等特殊排列为35%(7/20),均明显高于13例细胞学过诊病例相对病例数,差异有统计学意义(P<0.05).结论 乳腺癌细针穿刺的细胞形态学特点有:细胞数量较多,呈松散、紊乱样排列,以散在和(或)小细胞群为主;胞质完整;核增大,呈圆形或不规则圆形,边缘不整齐,核质比明显增大或减小,核仁增大,核大小差异明显;易见散在细胞,未见肌上皮细胞,可见坏死;与乳腺增生症、乳腺纤维腺瘤可以鉴别.圆形核细胞占绝大多数,细胞质完整,易见腺腔、腺管、炮竹、栅栏、单列纵队样特殊排列的细胞学特点,对疑难病例的鉴别诊断有帮助.%Objective To summarize the cytological features of breast carcinoma by fine needle aspiration

  5. Flow cytometry of fine-needle-aspiration biopsies : a new method to monitor the intrahepatic immunological environment in chronic viral hepatitis

    NARCIS (Netherlands)

    Sprengers, D; van der Molen, R G; Kusters, J G; Kwekkeboom, J; van der Laan, L J W; Niesters, H G M; Kuipers, E J; De Man, R A; Schalm, S W; Janssen, H L A

    2005-01-01

    SUMMARY: Information about the character and grade of the intrahepatic immune response in viral hepatitis is important for the evaluation of disease stage and effect of therapy. Complications like haemorrhage limit the frequent performance of tissue-needle biopsies (TB), and the cells of peripheral

  6. Clinical Application of Fine Needle Aspiration Biopsy in Diagnosis of Thyroiditis%甲状腺细针穿刺活检在甲状腺炎性疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    王全胜; 李骏; 刘晓丽; 倪卫慧; 吴静; 邵晓丽; 祝保艳

    2011-01-01

    探讨甲状腺细针穿刺活检(FNAB)在甲状腺炎性疾病诊断中的应用.分析行甲状腺FNAB并符合甲状腺炎性疾病共120例患者的临床资料.结果:甲状腺FNAB能准确诊断甲状腺炎性疾病;亚急性甲状腺炎和无痛性甲状腺炎发病时年龄较慢性淋巴细胞性甲状腺炎低;甲状腺炎性疾病女性发病率远高于男性,特别是自身免疫性甲状腺疾病(AIT);甲状腺FNAB对不同类型的甲状腺炎性疾病的诊断有确诊意义.%To investigate the value of fine needle aspiration biopsy (FNAB) in diagnosis of thyroiditis. The clinical data from 120 thyroiditis patients diagnosed with FNAB were analyzed. It was found that FNAB can accurately diagnose the disease of thyroiditis. The patients' age of subacute thyroiditis and silent thyroiditis was younger than that chronic lymphocytic thyroiditis. The incidence of thyroiditis in women was higher than that in men, espiecially for the autoimmune thyroiditis ( AIT). FNAB has the significance of diagnosing the different types of thyroiditis,

  7. Relative quantification of PIK3CA gene expression level in fine-needle aspiration biopsy thyroid specimens collected from patients with papillary thyroid carcinoma and non-toxic goitre by real-time RT-PCR

    Directory of Open Access Journals (Sweden)

    Wojciechowska-Durczyńska Katarzyna

    2010-08-01

    Full Text Available Abstract Background Recent studies have shown that the phosphatidylinositol 3-kinase (PI3K signaling pathway is important regulator of many cellular events, including apoptosis, proliferation and motility. PI3K pathway alterations (PIK3CA gene mutations and/or amplification have been observed in various human tumours. In the majority of diagnosed cases, mutations are localized in one of the three "hot spots" in the gene, responsible for coding catalytic subunit α of class I PI3K (PIK3CA. Mutations and amplification of PIK3CA gene are characteristic for thyroid cancer, as well. Methods The aim of our study was to examine a gene expression level of PIK3CA in fine-needle aspiration biopsy (FNAB thyroid specimens in two types of thyroid lesions, papillary thyroid carcinoma (PTC and non-toxic goitre (NTG. Following conventional cytological examination, 42 thyroid FNAB specimens, received from patients with PTC (n = 20 and NTG (n = 22, were quantitatively evaluated regarding PIK3CA expression level by real-time PCR in the ABI PRISM® 7500 Sequence Detection System. Results Significantly higher expression level (RQ of PIK3CA in PTC group has been noted in comparison with NTG group (p Conclusion These observations may suggest role of PIK3CA alterations in PTC carcinogenesis.

  8. Fine-needle aspiration cytology in fibromatoses.

    Science.gov (United States)

    Zaharopoulos, P; Wong, J Y

    1992-01-01

    Fine-needle aspiration (FNA) cytology was performed in seven cases of fibromatosis of variable types with tumorous clinical presentation. These included: four cases of musculoaponeurotic fibromatosis, two in posterior neck muscles, one in anterior neck muscles and one in intercostal muscles; one case of fibromatosis of the breast; and two cases of fibromatosis colli in neonates. In all cases the specimens contained connective tissue with many fibroblast-like cells, lacking features which could indicate a malignant lesion. The findings in these cases indicate that, although by FNA cytology in fibromatoses a specific diagnosis for each pathologic entity may not be easily reached, in the proper clinical setting the cytologic findings can be of sufficient relevance to offset the need for an open tissue biopsy, where there are valid reasons against a surgical intervention.

  9. Fine needle aspiration cytology in leprosy

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    Prasad PVS

    2008-01-01

    Full Text Available Background: Laboratory diagnosis of leprosy by slit skin smear and skin biopsy is simple but both techniques have their own limitations. Slit skin smear is negative in paucibacillary cases whereas skin biopsy is an invasive technique. Fine needle aspiration cytology (FNAC from skin lesions in leprosy with subsequent staining with May-Grunwald-Giemsa (MGG stain has been found useful. Aim: To evaluate the possible role of cytology in classifying leprosy patients. Methods: Seventy-five untreated cases of leprosy attending the outpatient department were evaluated. Smears were taken from their skin lesions and stained using the MGG technique. Skin biopsy was also done from the lesions, which was compared with cytology smears. Results: A correlation of clinical features with FNAC was noticed in 87.5% of TT, 92.1% of BT, 81% of BL, and 66% of LL cases. Correlation of clinical with histopathological diagnoses revealed 12.5% specificity in TT leprosy, 55.3% in BT, 52.4% in BL and 50% in LL, and 100% in neuritic and histoid leprosy cases. Both correlations were found to be statistically significant by paired t test analysis. Thus, it was possible to distinguish the tuberculoid types by the presence of epithelioid cells and the lepromatous types by the presence of lymphocytes and foamy macrophages. Conclusion: FNAC may be used to categorize the patients into paucibacillary and multibacillary types, but is not a very sensitive tool to classify the patients across the Ridley-Jopling spectrum.

  10. Accuracy of fine-needle aspiration in early detection of breast cancer

    Directory of Open Access Journals (Sweden)

    Jamali Zavarehei M

    1999-08-01

    Full Text Available Fine-needle aspiration biopsy for the diagnosis of breast lesions has been used for more than six decades and has been established as an effective procedure in Europe for many years. In order to evaluate the accuracy of fine-needle aspiration with histopathologic confirmation, a retrospective study was performed in Iranian Center for Breast Cancer, using a computer database over one year period. All women who had had fine-needle aspiration breast biopsy with histopathologic diagnosis included open excisional biopsy or mastectomy specimen. A total of 49 patients fulfilled the criteria. The test had a 93% sensitivity, 73% specificity, 65% positive predictive value, and 95% negative predictive value. Fine-needle aspiration is a sensitive test that Van be useful as an adjuct in the diagnosis of breast cancer.

  11. Analysis of the BRAFV600E Mutation in Thyroid Nodules: the Preoperative Diagnostic Role of Fine-needle Aspiration Biopsy for Patients with Papillary Thyroid Cancer and Its Impact on Patient Care

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Ji Yeon; Hong, Hyun Sook; Lee, Eun Hye; Kim, Chul Hee; Kwak, Jeong Ja; Lee, Seung Won; Kim, Jae Wook [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2011-06-15

    We wanted to evaluate the frequency of BRAFV600E mutations on the preoperative fine-needle aspiration biopsies (FNAB) of thyroid nodules and the effect of this on the accuracy of diagnosing papillary thyroid cancer (PTC). We also wanted to evaluate the influence of BRAFV600E analysis on patient care. The results of cytology and BRAFV600E mutation analysis of 190 thyroid nodules were retrospectively reviewed. The results of the cytology and BRAFV600E analysis were compared with the histopathological diagnosis for the surgically confirmed cases, and we calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the diagnostic accuracy of FNAB and combining the modalities of FNAB and BRAFV600E mutation. The frequency of BRAFV600E mutation according to age and the influence of BRAFV600E analysis on patient care were studied. The nodule size was compared between the malignant and other categories of BRAFV600E positive nodules. Seventy four percent of the PTC were BRAFV600E positive. BRAFV600E analysis increased the sensitivity, NPP and diagnostic accuracy of FNAB. Fifty percent of the BRAFV600E positive nodules with other than malignant cytology received surgery and these were confirmed to be PTC. The frequency of BRAFV600E mutation increased with age, which was statistically significant. There was a statistically significant difference in the nodule size between the cytologically malignant nodules and the other nodules. BRAFV600E analysis increased the diagnostic accuracy of FNAB and it should be considered as being complementary to cytological analysis. The frequency of the BRAFV600E mutation increased with age. The size of the malignant nodules was larger than that of the benign nodules

  12. Punção aspirativa por agulha fina no diagnóstico de linfadenopatias e tumores sólidos em crianças e adolescentes Fine needle aspiration biopsy in the diagnosis of lymphadenopathies and solid tumors in children and adolescents

    Directory of Open Access Journals (Sweden)

    Wallace Acioli Freire de Gois

    2008-02-01

    Full Text Available OBJETIVO: Avaliar a importância diagnóstica da punção aspirativa por agulha fina (PAAF em crianças e adolescentes portadores de linfadenopatias e tumores sólidos. MÉTODOS: Análise retrospectiva dos pacientes com idade igual ou inferior a 18 anos, atendidos no Centro de Pediatria Cirúrgica do Hospital Universitário de Brasília, Universidade de Brasília, no período de julho de 2000 a julho de 2005. Foram calculados: sensibilidade, especificidade, precisão (acurácia diagnóstica, valor preditivo positivo e valor preditivo negativo. RESULTADOS: Em 50 pacientes estudados, os resultados da PAAF mostraram sensibilidade de 90,9%; especificidade de 100%, precisão diagnóstica de 95% e valores preditivos positivo e negativo de 100% e 90%, respectivamente. CONCLUSÃO: Em nossa experiência, a PAAF é um método preciso, simples e seguro, útil no diagnóstico de linfadenopatias e tumores sólidos em crianças e adolescentes.BACKGROUND: To evaluate the diagnostic value of the fine needle aspiration biopsy in children and adolescents with solid tumors or lymphadenopathy. METHODS: 18 years old or less patients were observed since July 2000 to July 2005. We observed: sensibility, specificity, diagnostic accuracy and predictive value. RESULTS: In 50 studied patients the fine needle aspiration biopsy we found 90.9% sensibility, 100% specificity, 95% diagnostic accuracy, 100% positive predictive value and 90% negative predictive value. CONCLUSION: The fine needle aspiration biopsy is a easy, safe and accurate diagnostic method for solid tumors and lymphadenopathies.

  13. Prospective study of fine needle aspiration cytology of clinically palpable breast lump with histopathological correlation

    Directory of Open Access Journals (Sweden)

    Ashwin K. Hebbar

    2013-06-01

    Full Text Available Background and objectives: This study was conducted to compare the diagnostic accuracy of fine needle aspiration cytology in differentiating the benign and malignant lesions of palpable breast lump with histopathological correlation and also to study the accuracy of the needle tip localizing the tumor during fine needle aspiration cytology procedure. Methods: Two years prospective study was conducted in our institution and in that 100 patients underwent fine needle aspiration cytology of the palpable breast lump after thorough physical examination. The cytological diagnosis was classified in to 3 groups benign, suspicious and malignant. After this reporting all the patients were later subjected to open/excision biopsy and its histopathological confirmation. Later diagnostic accuracy of cytology reporting was compared with that of histopathology. Accuracy of the needle tip in localizing the tumor in fine needle aspiration cytology was also studied by comparing the normal glandular cell aspirate with tumor cell aspirate. Repeat cytology was carried out before open/excision biopsy if the pathologist reports the cytology slide as “inadequate”. Results: We had accuracy rate of 100% for benign lesion and 93.10% for malignant lesion with false negative rate of 6.9% and false positive rate of zero with fine needle aspiration cytology in the diagnosis of palpable breast lump. The overall sensitivity of fine needle aspiration in diagnosing the palpable breast lump is 93.10%, specificity is 100%, positive predictive value is 100% and negative predictive value is 90.47%. Since inadequate sampling rate is 2% in our study, the accuracy rate of needle tip in localizing the tumor in fine needle aspiration cytology is 98%. Conclusion: Since our diagnostic accuracy rate and predictive values are very high and comparable to any other published series it can be advised that the patients in which fine needle aspiration cytology is unequivocally diagnostic for

  14. Lymph node biopsy

    Science.gov (United States)

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... A lymph node biopsy is done in an operating room in a hospital. Or, it is done at an outpatient surgical center. The ...

  15. Catheterisation of the biliary tract and portal vein by Seldinger-technique following ultrasonic guided fine needle puncture

    Energy Technology Data Exchange (ETDEWEB)

    Elgeti, H.; Luska, G.; Kleine, P.

    1981-11-01

    The article describes an easier technique of biliary tract and portal vein catheterisation following fine needle puncture. Special biopsy equipment has been compiled for this purpose by the authors. Initial experiences revealed a considerable simplification of hepatic duct and portal vein puncture using a real time biopsy applicator. The procedure is explained by two characteristic cases.

  16. O diagnóstico do carcinoma metastático de coróide pela biópsia aspirativa com agulha fina (BAAF: relato de caso The diagnosis of metastatic carcinoma of the choroid using fine-needle aspiration biopsy (FNAB: case report

    Directory of Open Access Journals (Sweden)

    Zélia Maria da Silva Corrêa

    2003-01-01

    male, while being treated for a solitary pulmonary condensation, reported sudden loss of vision, pain, discharge and red eye (right eye for 10 days. During the ophthalmic examination a nonregmatogenous retinal detachment as well as multiple choroidal tumors were confirmed by diagnostic ocular ultrasound. Fine-needle aspiration biopsy (FNAB was suggested to diagnose a possible metastatic disease. Fine-needle aspiration biopsy was performed under peribulbar anesthesia with sedation. A transvitreous route was chosen through a sclerotomy 4 mm from the limbus. The procedure was monitored via binocular indirect ophthalmoscopy. Two sample aspirates were obtained from different tumour foci. After fine-needle aspiration biopsy, the aspirates were sent for processing, fixation and stained with Papanicolaou and HE. RESULTS: Cytology confirmed the diagnosis of multiple metastatic tumors. Immunocytochemistry of ocular and lung aspirates revealed a common cell origin by a pankeratin (AE1/AE3 positive test. Regardless of systemic treatment with chemotherapy and improvement of the ocular status, the patient died 4 months after cytological diagnosis of metastatic carcinoma of the choroid. CONCLUSIONS: Fine-needle aspiration biopsy was efficient to diagnose and correlate ocular cytology with the primary tumor by imunohistochemical methods in this case. Fine-needle aspiration biopsy should still be used only in selected cases and further research will be necessary for it to become a standard diagnostic procedure in ophthalmology.

  17. Fine-needle aspiration cytology in children with superficial lymphadenopathy

    Directory of Open Access Journals (Sweden)

    F. De Corti

    2014-04-01

    Full Text Available Introduction: In pediatric population Fine-Needle Aspiration Citology (FNAC is slowly gaining acceptance in clinical management of Superficial Lymphadenopathy (SL. Our experience adds some data about the usefulness of this technique in diagnosing the cause of a SL and therefore guiding further treatment. Patients and Methods: 238 FNAC were performed in 217 patients with SL, observed at our Institution from 2002 to 2006. The neck was the most frequent localization. The results were available within few hours. In cases of granulomatous findings, the samples were processed for microbiological and PCR test, in order to identify Mycobacteria. Results: 174 were reactive lesions, 38 granulomatous lymphadenopathies, 24 malignant lesions, 2 specimens inadequate for diagnosis. Among the 174 reactive SL, 22 required an incisional biopsy after 1 month follow-up. Among the granulomatous lymphadenopathies, 13 children with Cat-Scratch Disease recovered, 25 with Mycobacteria infection underwent surgical excision. For 24 malignant lesions, the diagnosis was confirmed by further biopsy. Two false negative and no false positive were detected (sensitivity 92%, specificity 100%. No complications were encountered. Conclusions: In our experience FNAC, performed by experienced cytopathologist, has revealed to be a fast, safe, non invasive and inexpensive method to achieve diagnosis in persistent SL. The use of FNAC gave us the possibility to select patients for further investigation and/or surgical treatment. Incisional biopsy remains necessary to confirm the diagnosis in case of malignancy or doubtful lesions.

  18. Analysis of estrogen and progesterone receptors on preoperative fine-needle aspirates.

    Science.gov (United States)

    Frigo, B; Pilotti, S; Zurrida, S; Ermellino, L; Manzari, A; Rilke, F

    1995-01-01

    For 56 cases of carcinoma of the breast, results of the immunocytochemical assay for estrogen and progesterone receptors performed on preoperative fine-needle aspirates were compared with those obtained on scraping material from the same tumors. The value and usefulness of this last analysis was demonstrated in a previous study. The level of agreement between the two cytological techniques was assessed by the k statistic. A high level of agreement was found, with k values of 0.909 and 0.889 for estrogen and progesterone receptors, respectively. The results reported here revealed the reliability of steroid receptor determination on fine-needle aspiration biopsies, provided that sufficient cellularity was available. This technique can replace the open biopsy procedure, in as much as it represents a rapid, almost painless, and easily repeated method for the assessment of the receptor status, and is useful for treatment decisions at any time during the course of the disease.

  19. Diagnostic accuracy and pitfalls of fine needle aspiration cytology and scrape cytology in oral cavity lesions

    OpenAIRE

    Nesreen H. Hafez; Mohamed I. Fahim

    2014-01-01

    Background — The oral cavity can be home for a wide variety of lesions. To date, biopsy has remained the gold standard for diagnosing these lesions. Purpose — This study was carried out to assess the diagnostic accuracy of cytology in the oral lesions and to address the cytologic-histologic correlation. Patients and Methods — This prospective study included 72 patients with intraoral lesions. Fine needle aspiration cytology (FNAC) or scrap cytology was performed. The smears were immediate...

  20. Fine needle aspiration cytology of dermal cylindroma

    Directory of Open Access Journals (Sweden)

    Parikshaa Gupta

    2014-01-01

    Full Text Available In this paper, we have described fine needle aspiration cytology (FNAC of a rare case of dermal cylindroma. A 40-year-old female presented with a lateral mid-cervical swelling fixed to the skin. FNAC smears showed multiple clusters of small, round to oval cells with hyperchromatic nuclei, inconspicuous nucleoli and scant cytoplasm. In addition, the background showed deposits of basement membrane type material. This was dark magenta colored pinkish globular material. The globules were occasionally surrounded by the basal type of cells. Occasional cells with elongated nuclei were also noted. Cytological diagnosis of skin adnexal tumor possibly cylindroma was offered. Subsequent histopathology of the swelling showed sheets and clusters of cells in a jigsaw puzzle-like fashion. Deposition of abundant basement membrane-like material was noted in between the tumor cells. A diagnosis of cylindorma was offered. FNAC along with the subcutaneous location of the tumor and absence of primary salivary gland tumor may help to diagnose such rare case.

  1. Percutaneous transhepatic cholangiography using fine needle

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Kyoo Byung; Kim, Yun Hwan; Lee, Nam Joon; Suh, Won Hyuck [College of Medicine, Korea University, Seoul (Korea, Republic of)

    1980-12-15

    In recent years, percutaneous transhepatic cholangiography (PTC) using fine needle has become widely employed as the procedure of choice for direct opacification of the biliary trees because of its high success rate, easy performance and relative low complication rate. Authors present the clinical and PTC findings of experienced cases during last four years, from May 1976 to June 1980, at the Department of Radiology, Korea University Hospital. We tried to study of PTC in 44 cases, 32 males and 12 females, and succeeded in visualization of bile ducts in 41 cases, but the other three cases were failed to visualize the bile ducts. Final confirmative diagnosis was achieved in 29 cases by operation, laparoscopy and other clinical methods. The PTC diagnosis was correct in 24 of 29 cases, and the others were incorrect. The 29 final diagnosis was including 13 cases of biliary stones, 6 cases of biliary cancer, 3 cases of pancreatic cancer, 3 cases of clonorchiasis, one case of CBD ascariasis and 3 cases of others. Incorrect PTC diagnosis was made in five cases. They were one case of nonvisualized intrahepatic stones, one case of hepatoma PTC diagnosed as cholangiocarcinoma, one case of pancreatic cancer diagnosed as cholangiocarcinoma, one case of clonorchiasis diagnosed as biliary stones and one case of normal CBD which was diagnosed as distal CBD cancer. And we experienced one case of bile peritonitis as complication, who was 35 year-old female patient with multiple CBD stones, and aspirated about 500ml of bile stained ascites during operation.

  2. Harmonic Contrast-Enhanced Endoscopic Ultrasonography for the Guidance of Fine-Needle Aspiration in Solid Pancreatic Masses

    DEFF Research Database (Denmark)

    Seicean, A; Badea, R; Moldovan-Pop, A;

    2015-01-01

    Purpose: The global accuracy of fine-needle aspiration guided by endoscopic ultrasound (EUS-FNA) for pancreatic adenocarcinoma is about 85 %. The use of contrast agents during EUS to highlight vessels and the necrotic parts of pancreatic masses may improve biopsy guidance. Our aim was to assess w...

  3. Diagnostic pitfalls in fine needle aspiration of solitary pulmonary nodules: two cases with radio-cyto-histological correlation

    Directory of Open Access Journals (Sweden)

    Burbridge Brent

    2003-09-01

    Full Text Available Abstract Background Fine needle aspiration is an important tool for diagnosis and preoperative evaluation of solitary nodules of the lung. It provides a definitive diagnosis in most patients at low cost with minimal trauma. However, because of the nature of the study and the presentation of the cells in a more distorted and incomplete tissue structure than a histological slide, false positive results can occur. Prior detailed clinical knowledge about the patient, procedures and methods of radiology in obtaining the aspirate specimen is extremely useful in the accurate interpretation of fine needle cytological specimens. Case presentation We report two cases of solitary pulmonary nodules in two elderly females, which were initially diagnosed as malignant by fine needle aspiration biopsy. Both cases subsequently underwent pulmonary lobectomy in which, one turned out to be a pulmonary hamartoma and the other appeared to be a middle lobe syndrome of the right lung with liver tissue contamination at the time of fine needle aspiration of the lung. Conclusions We are now strong believers that much care must be taken in the interpretation of fine needle aspiration of solitary nodules of the lung. Complete study of the entire specimen, including the cell block, is warranted, since what one interprets as malignant, could have different features in another part of the sample. Last but not the least, prior knowledge of the complete clinical history of the patient together with the salient radiological findings would greatly facilitate the cytopathologist to reach an accurate diagnosis.

  4. Toward improving fine needle aspiration cytology by applying Raman microspectroscopy

    Science.gov (United States)

    Becker-Putsche, Melanie; Bocklitz, Thomas; Clement, Joachim; Rösch, Petra; Popp, Jürgen

    2013-04-01

    Medical diagnosis of biopsies performed by fine needle aspiration has to be very reliable. Therefore, pathologists/cytologists need additional biochemical information on single cancer cells for an accurate diagnosis. Accordingly, we applied three different classification models for discriminating various features of six breast cancer cell lines by analyzing Raman microspectroscopic data. The statistical evaluations are implemented by linear discriminant analysis (LDA) and support vector machines (SVM). For the first model, a total of 61,580 Raman spectra from 110 single cells are discriminated at the cell-line level with an accuracy of 99.52% using an SVM. The LDA classification based on Raman data achieved an accuracy of 94.04% by discriminating cell lines by their origin (solid tumor versus pleural effusion). In the third model, Raman cell spectra are classified by their cancer subtypes. LDA results show an accuracy of 97.45% and specificities of 97.78%, 99.11%, and 98.97% for the subtypes basal-like, HER2+/ER-, and luminal, respectively. These subtypes are confirmed by gene expression patterns, which are important prognostic features in diagnosis. This work shows the applicability of Raman spectroscopy and statistical data handling in analyzing cancer-relevant biochemical information for advanced medical diagnosis on the single-cell level.

  5. Fine needle aspiration cytology: a useful technique for diagnosis of invasive fungal rhinosinusitis.

    Science.gov (United States)

    Singhal, Niti; Raghubanshi, Gunjan; Handa, Uma; Punia, R P S; Singhal, Surinder

    2013-09-01

    Mycotic infections are on the rise globally. Patients with invasive fungal infection of the paranasal sinuses often present with destructive mass lesions and mimic malignancy clinically and radiologically. To assess the utility of Fine needle aspiration cytology for early diagnosis of invasive fungal rhinosinusitis. Fine needle aspiration cytology was performed from the maxillary/ethmoid sinus in patients with a destructive mass lesion in the maxilla. Differential diagnoses were malignancy and fungal rhinosinusitis. In eight cases fungi were detected on initial examination whereas in a single case that was initially reported as giant cell lesion, hyphae could be identified within giant cells, on review. Smears showed inflammatory cells with variable numbers of eosinophils with neutrophils and histiocytes. Foreign body giant cells were seen in all cases. The fungi conformed to morphology of aspergillus in seven cases (77.78%); in two cases (22.22%), typing could not be done. Periodic acid Schiff and Grocott stains highlighted the fungi in all the cases. Fine needle aspiration is a simple technique that can be useful for diagnosis of fungal rhinosinusitis and to exclude malignancy. Search for fungus may be more aggressive in smears with many foreign body giant cells and inflammatory cells and in cases with a high clinical suspicion. Differentiation between aspergillus and mucor can be made with help of special stains. Aspergillus is the commonest agent isolated. Preoperative cytological diagnosis obviates the need for biopsy, saves time and helps to plan proper treatment.

  6. Eccrine porocarcinoma: cytologic diagnosis by fine needle aspiration biopsy (FNAB).

    Science.gov (United States)

    Kalogeraki, Alexandra; Tamiolakis, Dimitrios; Tsagatakis, Thomas; Geronatsiou, Katerina; Haniotis, Vrettos; Kafoussi, Maria

    2013-01-01

    Introdução: O porocarcinoma écrino (PE) é um tumor maligno pouco comum dos anexos cutâneos. Trata-se de um adenocarcinoma da glândula sudorípara écrina com propensão para recorrer localmente e para originar metástases ao longo dos gânglios linfáticos regionais. Este artigo apresenta um diagnóstico por citologia aspirativa com agulha fina (CAAF) de um PE, associado ao exame histológico e de imunocito/histoquímica.Caso Clínico: São descritos os achados da citologia de um porocarcinoma écrino numa doente de 76 anos de idade, bem como as características histológicas do tumor cutâneo. A citologia aspirativa revelou que o tumor se caracterizava pela presença de células atípicas malignas com citoplasma basófilo, núcleos hipercromáticos e nucléolos proeminentes. O diagnóstico citológico foi confirmado pela histologia.Conclusões: É crucial obter um diagnóstico pré-operatório preciso de modo a desencadear um plano cirúrgico curativo. A CAAF possibilita uma abordagem pouco invasiva, segura e efectiva, de modo a esclarecer um diagnóstico diferencial exigente.

  7. Fine needle aspiration analysis of misdiagnosis of 2 cases with skin singular leiomyoma%针吸细胞学皮肤奇异型平滑肌瘤误诊2例分析

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    Lei Wang; Hua Zhang

    2009-01-01

    @@ This article reported that 2 cases with skin singular leiomyoma confirmed by pathology were misdiagnosed by fine needle aspiration biopsy, and the combination analysis of clinical history and pathological features of cells was as follows.

  8. Scalp Melanoma Diagnosed by Fine Needle Aspiration Cytology in a Tertiary Health Center

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    A. B. Zarami

    2015-01-01

    Full Text Available Melanoma is one of the most aggressive malignant skin neoplasms worldwide with more than 20% of world melanoma seen in black Africa and Asia. Late presentation due to ignorance, poverty, and lack of adequate health facility in Nigeria is always the norms. We present this case report because of precision in diagnosis, using fine needle aspiration cytology (FNAC to reemphasize that the technique is cheap, cost effective, and quick that can reduce the burden of incisional biopsy before definitive surgery and improve early detection of the disease especially in developing countries.

  9. Diagnostic approach using endosonography guided fine needle aspiration for lymphadenopathy in primary sclerosing cholangitis

    Institute of Scientific and Technical Information of China (English)

    Shintaro Tsukinaga; Hisao Tajiri; Hiroo Imazu; Yujiro Uchiyama; Hiroshi Kakutani; Akira Kuramoti; Masayuki Kato; Keisuke Kanazawa; Tsuyoshi Kobayashi; Yasuyuki Searashi

    2007-01-01

    We report a case of primary sclerosing cholangitis (PSC) with benign lyphadenopathy which was diagnosed with endosonography guided fine needle aspiration (EUS-FNA).A 65-year-old woman was admitted to Jikei University Hospital with severe jaundice. Although endoscopic retrograde cholangiography and liver biopsy revealed the findings consistent with PSC, abdominal computed tomography revealed numerous large perihepatic lymph nodes with a maximum diameter of more than 3 cm.Therefore, EUS-FNA was done in order to exclude malignant lymphadenopathy, and adequate specimens obtained by EUS-FNA showed reactive hyperplasia of lymphnode. The patients were scheduled to undergo liver transplantation.

  10. INITIAL EXPERIENCE WITH ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF RENAL MASSES: indications, applications and limitations

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    Renata Nobre MOURA

    2014-12-01

    Full Text Available Context Tissue sampling of renal masses is traditionally performed via the percutaneous approach or laparoscopicaly. The utility of endoscopic ultrasound to biopsy renal lesions it remains unclear and few cases have been reported. Objectives To evaluate the feasibility and outcome of endoscopic ultrasound fine needle aspiration of renal tumors. Methods Consecutive subjects undergoing attempted endoscopic ultrasound fine needle aspiration of a kidney mass after evaluation with computerized tomography or magnetic resonance. Results Ten procedures were performed in nine male patients (median age 54.7 years on the right (n = 4 and left kidney (n = 4 and bilaterally (n = 1. Kidney masses (median diameter 55 mm ; range 13-160 mm were located in the upper pole (n = 3, the lower pole (n = 2 and the mesorenal region (n = 3. In two cases, the mass involved more than one kidney region. Surgical resection confirmed renal cell carcinoma in six patients in whom pre-operative endoscopic ultrasound fine needle aspiration demonstrated renal cell carcinoma. No complications were reported. Conclusions Endoscopic ultrasound fine needle aspiration appears as a safe and feasible procedure with good results and minimal morbidity.

  11. Etiology of Subclinical Thyroid Dysfunction in Patients Performed by Thyroid Fine - Needle Aspiration Biopsy%亚临床甲状腺功能异常在甲状腺细针穿刺患者中的病因构成

    Institute of Scientific and Technical Information of China (English)

    蔡晓频; 何一凡; 张金苹; 王瑶; 邢小燕

    2011-01-01

    目的 探讨亚临床甲状腺功能异常患者的病因构成.方法 回顾性分析2326例患者甲状腺细针穿刺的临床资料及其细胞病理诊断结果,临床资料包括甲状腺功能及甲状腺自身抗体检测、甲状腺超声检查等.结果 亚临床甲状腺功能异常的患者274例,占11.8%,其中,亚临床甲状腺功能亢进患者112例,占4.8%,亚临床甲状腺功能减退患者162例,占7.0%.桥本甲状腺炎是亚临床甲状腺功能减退最常见的病因,而结节性甲状腺肿是亚临床甲状腺功能亢进最常见的病因.结论 在亚临床甲状腺功能异常的患者中,桥本甲状腺炎和结节性甲状腺肿是主要的两大病因,甲状腺细针穿刺对于亚临床甲状腺功能异常病因的诊断具有重要的临床价值.%Objective To determine the etiolgy of subclinical thyroid dysfunction in patients performed by fine - needle aspiration biopsy ( FNAB) . Methods 2326 FNABs were performed between 2005 - 2011 and related clinical records were retrospectively evaluated. Clinical data included thyroid function tests, immunological studies and ultrasound of the thyroid. Results We identified 274 cases with subclinical thyroid dysfunction, a prevalence of 11. 8% , including 112 subclinical hyperthyroidism cases (4.8%) and 162 subclinical hypothyroidism cases (7.0%). Hashimoto' s thyroiditis was the moat common cause of subclinical hypothyroidism and multinodular goiter was the most common cause of subclinical hyperthyroidism. Conclusion Hashimoto' s thyroiditis and multinodular goiter were the most common causes of subclinical thyroid dysfunction. FNAB is a very reliable diagnostic method for the evaluation of etiology of subclinical thyroid dysfunction.

  12. Punção aspirativa por agulha fina: desempenho no diagnóstico diferencial de nódulos mamários palpáveis Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses

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    Orlando José de Almeida

    1998-09-01

    Full Text Available Objetivo: avaliar, de forma prospectiva, o desempenho da punção aspirativa por agulha fina (PAAF no diagnóstico diferencial de nódulos mamários palpáveis. Método: avaliaram-se a sensibilidade, a especificidade, os valores preditivos e a acurácia deste teste em 102 mulheres com idade superior a 30 anos, com nódulos mamários palpáveis, atendidas na Universidade Estadual de Campinas. As punções foram realizadas por um único examinador. Resultados: o procedimento teve sensibilidade de 97%, especificidade de 87%, valor preditivo positivo de 94% e negativo de 93%. A taxa de material insuficiente ou insatisfatório foi de 16% na primeira punção, diminuindo para 2% com uma nova PAAF. Conclusões: Este teste mostrou-se altamente sensível e específico no diagnóstico diferencial de nódulos mamários palpáveis, reafirmando-se a sua grande importância na abordagem clínica de nódulos palpáveis.Purpose: to evaluate, in a prospective way, the performance of the fine needle aspiration biopsy in the differential diagnosis of palpable breast masses. Method: the sensitivity, specificity, positive and negative predictive values for this test were evaluated in 102 women with age above 30 years and a palpable breast mass, who were attended at the University of Campinas. All punctures were performed by the same examiner. Results: the procedure had a sensitivity of 97%, specificity of 87%, positive predictive value of 94% and negative predictive value of 93%. The insufficient or unsatisfactory sample rate was 16% for the first aspiration, decreasing to 2% with a new procedure. Conclusions: this test showed to be highly sensitive and specific for the differential diagnosis of palpable breast masses, reassuring its great importance for the clinical approach of palpable masses.

  13. Diagnosis of Langerhans Cell Histiocytosis on Fine Needle Aspiration Cytology: A Case Report and Review of the Cytology Literature

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    Neeta Kumar

    2011-01-01

    Full Text Available A case of multifocal Langerhans cell histiocytosis in a two-year-old child is presented where fine needle aspiration was helpful in achieving a rapid and accurate diagnosis in an appropriate clinical and radiological setting. This can avoid unnecessary biopsy and guide the management especially where access to histopathology is limited. The highly characteristic common and rare cytological features are highlighted with focus on differential diagnoses and causes of pitfalls.

  14. ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE EVALUATION OF MALE INFERTILITY

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    Prasad

    2015-03-01

    Full Text Available BACKGROUND: Male infertility is a common problem and needs a minimally invasive method to arrive at the appropriate diagnosis . Alternative to open testicular biopsy the fine needle aspiration cytology of the testis is being increasingly used as a minimally invasive method of evaluating testicular function . AIM OF THE STUDY: To know whether FNAC of testes is as informative as biopsy in cases of male infertility . To establish that FNAC is cost effective , safe , out p atient investigation with no complications . METHODOLOGY: Fifty patients with primary male infertility in the age group of 20 - 40 years were included in the study . All the cases with oligospermia and azoospermia were subjected for Doppler study to rule out varicocele . Cord block was achieved with 1% lignocaine and aspiration was done with 23 gauge 1 . 5 inch needle . Smears were made on albuminised slides and stained with Leishman Stain . Forresta et al scoring system was adopted to analyse the smears . In the same sitting testicular biopsy was taken , fixed in Bouins fluid , routinely processed and stained with H&E stain . RESULTS: The commonest group with infertility were in the age group 21 - 30 years . On semen analysis 78% were azoospermic and 22% were oligozoospermic . The testicular size was normal in 90 % of subjects and 10% had small testis . Out of fifty subjects with infertility , 40% subjects had varicocele . Varicocele was commonly associated with duct obstruction . The commonest patterns observed on cytology were; normal spermatogenesis ( 14/50 , 28 % , duct obstruction ( 8/50 , 16 % , maturation arre st ( 7/50 , 14 % and testicular atrophy ( 7/50 , 14 % . In the present study diagnostic accuracy was 93 . 4% . CONCLUSION: Fine needle aspiration cytology is as informative as biopsy and can be done as a routine procedure . It is a simple and cost effective . In cases where FNAC shows normal spermatogenesis with azoospermia and oligospermia , biopsy and doppler study

  15. Fine Needle Aspiration and Medullary Thyroid Carcinoma: The Risk of Inadequate Preoperative Evaluation and Initial Surgery When Relying Upon FNAB Cytology Alone

    NARCIS (Netherlands)

    Essig, G.F.; Porter, K.; Schneider, D.; Debora, A.; Lindsey, S.C.; Busonero, G.; Fineberg, D.; Fruci, B.; Boelaert, K.; Smit, J.W.A.; Meijer, J.A.M.; Duntas, L.; Sharma, N.; Costante, G.; Filetti, S.; Sippel, R.S.; Biondi, B.; Topliss, D.J.; Pacini, F.; Maciel, R.M.; Walz, P.C.; Kloos, R.T.

    2013-01-01

    Objectives: To evaluate the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) to preoperatively diagnose medullary thyroid cancer (MTC) among multiple international centers and evaluate how the cytological diagnosis alone could impact patient management.Methods: We performed a retrospectiv

  16. Fine-needle aspiration cytology in Hodgkin’s lymphoma

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    Nedeljkov-Jančić Ružica

    2005-01-01

    Full Text Available Background. Cell composition of tumor tissue in Hodgkin’s lymphoma is considered to be specific. According to some authors, precise cytomorphological analysis of the specimen obtained by fine needle enables the diagnosis of the histologically well-defined form of lymphoma in a high percentage of cases. However, other authors consider the precise diagnosis of HL based on cytological analysis of a lymph node puncture specimen extremely difficult. The aim of this study was to a assess the diagnostic accuracy of cytomorphological analysis, as well as the possibility of application of this method in establishing the preliminary or even final diagnosis of this form of lymphoma. Methods. Thirty four samples were analyzed, obtained by fine needle aspiration, in patients examined and treated at the Institute of Hematology, Clinical center of Serbia, Belgrade. Smears were stained by May-Grünvald-Giemsa and Papanicolau methods. Results. The finding of typical multinucleate Reed-Sternberg cells in the smears of lymph node puncture specimen was diagnostically significant, as well as the finding of mononuclear variances of the neoplastic cells of anunusual morphology (Hodgkin’s cells. The cell environment in the background of the above-mentioned tumor cells was heterogeneous. It was composed of small lymphocytes, plasma cells, eosinophils and reticular cells. These cell forms, found in cell preparations, resembled those seen in the tissue sections of the relevant extirpated lymph nodes. The comparison of the cytological findings in the fine needle specimen to the subsequently established histological diagnoses of HL revealed a high correlation of 85.2%. Conclusion. Cytological examination of fine needle lymph node specimens is still significant for the diagnosis of HL in spite of the development of more sophisticated methods used for verification of the diagnosis of this neoplasm.

  17. Fine Needle Aspiration Cytology of Pediatric Thyroid Nodules

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    Ayper KAÇAR

    2010-05-01

    Full Text Available Objective: The objectives were to evaluate fine needle aspiration cytology results of 39 pediatric patients, and the pathologies that cause childhood thyroid nodules, and to review the literature on the subject.Material and Method: Thyroid fine needle aspiration cytology results of 39 pediatric patients were retrospectively reviewed. Associated diseases, thyroid functions, anti-thyroid antibody levels, ultrasonographic findings and number of nodules were also evaluated.Results: The vast majority of patients with thyroid nodules were cytopathologically diagnosed as benign (97.3%. Of these patients, 64.8% (24 patients were diagnosed as nodular goiter and 35.2% (13 patients as lymphocytic thyroiditis. Thyroid malignancy was found in two patients; one was diagnosed as follicular neoplasm/ minimal invasive follicular carcinoma on surgical evaluation while the other was a secondary tumor (Burkitt's lymphoma. The majority of our subjects were females (66.6%: the female/male ratio was 2:1 for nodular goiter and 3.3:1 for thyroiditis. Surgical resection was performed in 5 patients (4 cases of nodular goiter, 1 suspicious for malignancy and cytological diagnoses were confirmed by histology.Conclusion: Our study confirmed the utility of fine needle aspiration cytology in childhood thyroid disorders along with a possible higher incidence of nodular thyroiditis in childhood. Nodular autoimmune thyroiditis, focal thyroiditis and thyroid cancer in children are discussed and attention is drawn to some special subtypes of thyroid cancer and some benign lesions that can cause difficulty in interpreting fine needle aspiration cytology and frozen sections at this age.

  18. Riedel thyroiditis: Fine needle aspiration findings of a rare entity.

    Science.gov (United States)

    Weidner, Anna-Sophie; Molina, David; DeSimone, Robert A; Cohen, Marc A; Giorgadze, Tamar; Scognamiglio, Theresa; Hoda, Rana S

    2015-09-01

    Riedel thyroiditis is a rare fibrosing disorder characterized by extension of the fibroinflammatory process beyond the thyroid capsule. Due to the nature of this lesion, fine-needle aspiration often yields scant material and may be interpreted as non-diagnostic. In this report, we describe cytologic features that allow the cytopathologist to favor a diagnosis of Riedel thyroiditis, thereby guiding appropriate further work-up and management.

  19. Fine needle aspiration cytology findings in cases diagnosed as oropharyngeal tularemia lymphadenitis (Erratum was published in Vol 24 Number 1, 2008

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    Banu DOĞAN GÜN

    2007-01-01

    Full Text Available Francisella tularensis is a gram-negative coccobacilus that causes zoonotic disease tularemia. Histopathological examination of lymph node biopsy in tularemia reveals suppurative granulomatous inflammation potentially associated caseous necrosis. Diagnosis is mainly made on the evidence of elevated agglutinating antibodies against F. Tularensis. In this study we aimed to evaluate the cytological features of ulceroglandular tularemia cases and to demonstrate the role of fine needle aspiration cytology in the diagnosis of tularemia.Fine needle aspiration cytology findings of six cervical lymphadenopaties that had established diagnoses of tularemia both clinically and serologically, were evaluated and the cytomorphological features were described.All of the cases revealed suppurative inflammation and some caseous necrosis and in four cases epithelioid histiocytes and multinuclear giant cells were observed additionally.The differential diagnosis of tularemia principally from tuberculosis and other types of bacterial lymphadenitis was made and the place of fine needle aspiration cytology among other diagnostic laboratory tests for tularemia was evaluated.

  20. Diagnostic assessment of enlarged superficial lymph nodes by fine needle aspiration.

    Science.gov (United States)

    Pilotti, S; Di Palma, S; Alasio, L; Bartoli, C; Rilke, F

    1993-01-01

    Two hundred eighty-five consecutive outpatients with enlarged superficial lymph node either clinically suspicious (152) or with a previous diagnosis of a malignant tumor (133) underwent fine needle aspiration (FNA) followed by excisional biopsy. Cytologic and/or cytologic-immunophenotypic diagnoses made on direct smears were compared with subsequent histologic findings. The comparison demonstrated (1) a high rate of conclusive cytologic diagnoses in the assessment of metastatic malignancies, with an overall accuracy rate of 99.1% and a typing accuracy rate of 96.5%; (2) a high rate of conclusive diagnoses in the assessment of high grade non-Hodgkin's lymphomas and Hodgkin's disease, with the exception of the lymphocytic predominance variant of the latter; and (3) significant limitations in the assessment of low grade non-Hodgkin's lymphomas because of the high rate of false-negative diagnoses in cases with a substantial nonmalignant cell component. This was particularly evident in follicular centroblastic-centrocytic lymphomas. Immunocytochemistry appeared to be of limited value in the distinction between centroblastic-centrocytic follicular lymphomas and reactive follicular hyperplasia. The results confirmed the diagnostic value of fine needle aspiration as the first step in the workup of patients with nodal enlargement suspicious for malignancy. In the area of low grade non-Hodgkin's lymphomas, morphologic and immunocytochemical methods need to be supplemented by molecular techniques in order to achieve conclusive diagnoses.

  1. Comparison of Fine Needle Aspiration and Fine Needle Nonaspiration Cytology of Thyroid Nodules: A Meta-Analysis

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    Hongming Song

    2015-01-01

    Full Text Available Background. Fine needle aspiration cytology (FNAC and fine needle nonaspiration cytology (FNNAC are useful cost-effective techniques for preoperatively assessing thyroid lesions. Both techniques have advantages and disadvantages, and there is controversy over which method is superior. This meta-analysis was performed to evaluate the differences between FNAC and FNNAC for diagnosis of thyroid nodules. Methods. Primary publications were independently collected by two reviewers from PubMed, Web of Science, Google Scholar, EBSCO, OALib, and the Cochrane Library databases. The following search terms were used: fine needle, aspiration, capillary, nonaspiration, sampling without aspiration, thyroid, and cytology. The last search was performed on February 1, 2015. Results. Sixteen studies comprising 1,842 patients and 2,221 samples were included in this study. No statistically significant difference was observed between FNAC and FNNAC groups with respect to diagnostically inadequate smears, diagnostically superior smears, diagnostic performance (accuracy, sensitivity, specificity, negative predictive value, and positive predictive value, area under the summary receiver operating characteristic curve, average score of each parameter (background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma, and retention of appropriate architecture, and total score of five parameters. Conclusion. FNAC and FNNAC are equally useful in assessing thyroid nodules.

  2. Myofibromatosis: Utility of fine needle aspiration cytology in the diagnosis of an underreported entity

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    Poflee, Sandhya V; Bode, Anjali N; Chavarkar, Sneha; Umap, Pradeep S

    2017-01-01

    Myofibromatosis (MFS) was recognized as a distinct form of childhood fibromatosis. Infantile myofibromatosis (IMF) is now identified as a solitary or multicentric tumor that predominantly occurs in neonates and infants. The adult counterpart of IMF, though of rare occurrence, is identified and is known as MFS. Morphological diagnosis of MFS is made by histopathological examination of the biopsy or surgically excised mass and confirmed on the basis of specific immunoprofile. We report a case of multicentric MFS occurring in an adolescent in whom diagnosis was suggested on the basis of fine needle aspiration cytology (FNAC) that avoided surgical excision of multiple nodules. The diagnosis was later confirmed on histopathological study and contributory immunohistochemical markers. Details of the clinical features and cytological diagnosis of the case are provided to diminish the paucity of available literature on FNAC diagnosis of the rare disease. PMID:28182064

  3. Fine-needle aspiration cytology of subcutaneous cysticercosis: A series of five cases

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    Kusum D Jashnani

    2016-01-01

    Full Text Available Taenia solium, a potentially dangerous parasite, causes human cysticercosis that can cause a gamut of manifestations affecting the various systems of the body. Sometimes, parasitic infestations present as only superficial palpable subcutaneous or intramuscular nodules that are usually mistaken for lymph nodes or benign tumors like lipoma, neurofibroma, or epidermal inclusion cysts. Fine-needle aspiration cytology (FNAC has emerged as a useful tool in the diagnosis of these superficial parasitic lesions. It also helps in avoiding unnecessary open biopsy to obtain a diagnosis. We, herein, report a series of five cases of subcutaneous cysticercosis at different sites (axilla, chest wall, abdominal wall, lateral neck, and cheek misdiagnosed as lipomas and lymph nodes and finally diagnosed on FNAC.

  4. Fine needle aspiration cytology of thymic carcinoid tumor.

    Science.gov (United States)

    Wang, D Y; Kuo, S H; Chang, D B; Yang, P C; Lee, Y C; Hsu, H C; Luh, K T

    1995-01-01

    Carcinoid tumors of the thymus are very rare, and their cytologic findings have not been reported previously in English. Retrospective study of fine needle aspiration (FNA) cytologic features in four histopathologically verified thymic carcinoid tumors are described here in detail. The FNA cytology of thymic carcinoids is characterized by predominantly single and some loose clusters of small, round to oval cells with scanty cytoplasm, interspersed with some larger cells with moderate to abundant, granular cytoplasm. The differential diagnosis of the cytologic features between carcinoid tumor and other mediastinal tumors is also discussed.

  5. Nódulos de tireóide: valor da ultra-sonografia e da biópsia por punção aspirativa no diagnóstico de câncer Cancer in thyroid nodules: evaluation of ultrasound and fine-needle aspiration biopsy

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    Simone Peccin

    2003-06-01

    equipamento, são necessários estudos em diferentes centros para o seu uso na prática clínica.BACKGROUND: Thyroid nodules are a very common clinical problem and fine-needle aspiration biopsy (FNAB is its main diagnostic test. Recently, it has been shown that some ultrasonographic features are associated to an increased risk of cancer, but a comparison between FNAB and ultrasonography (US or its combination is not available. The aim of this study was to evaluate FNAB and US performance, isolated or combined, for cancer diagnosis in thyroid nodules. METHODS: Eighty patients, with palpable solitary thyroid nodules or multinodular goiters, who were to undergo surgery, were selected among 289 patients seen in our clinic between March, 1995 and July, 1997. US and FNAB were performed by one of us. US was considered positive for cancer when microcalcifications, absent halo or hypoechogenicity were seen. FNAB was considered positive for cancer when it was either suspicious or compatible with malignancy. Both methods (FNAB and US were evaluated in parallel combination (positive when FNAB or US was positive and in serial combination (positive when both, FNAB and US, were positive. RESULTS: Sensitivity and specificity of FNAB and US for cancer diagnosis in thyroid nodules were, respectively, 87% and 62%, and 81% and 70%. Serial combination of FNA and US had sensitivity of 69% and specificity of 91%, and parallel combination resulted in sensitivity of 94% and specificity of 52%. CONCLUSION: The US had good accuracy in the evaluation of thyroid nodules, and can help us take some decisions in the clinical practice, supplementary to FNA. Nevertheless, the quality of the ultrasound examination depends on the experience of the examiner and on the characteristics of the equipment, so new studies are necessary to evaluate these factors to the current usage of ultrasonographic characteristics in the evaluation diagnostic of thyroid nodules.

  6. Preoperative assessment of thyroid nodules: role of ultrasonography and fine needle aspiration biopsy followed by cytology Avaliação preoperatória de nódulos thireóides: papel da ultrassonografia e da biópsia de aspiraçào por agulha fina, seguida de citologia

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    Rosalinda YA Camargo

    2007-01-01

    Full Text Available PURPOSE:To evaluate the preoperative assessment of thyroid nodules using ultrasound studies and cytology of nodular aspirates. SUBJECTS AND METHODS: 2,468 patients with thyroid nodules were examined from 1999 to 2005. All patients were clinically examined and underwent ultrasonography followed by fine-needle aspiration biopsy (FNAB and cytology. RESULTS:Nodules larger than 10 mm were classified ultrasonographically in a 4-tier system and received a score according to the criterion of possible malignancy. Cytological examinations were conducted independently by 2 cytologists and classified as benign (score 1, indeterminate (score 2, suspicious (score 3, and malignant (score 6. Combining both scores, an index was generated that would indicate a higher probability of malignancy (benign, doubtful, suspicious, and malignant. Thyroid surgery was performed in 274 patients. Of those, 115 patients had a score of 2 to 5 and only 8 had a histological diagnosis of thyroid cancer (6.9%. For patients with a score of 5 (n = 51, 11.5% had a malignant lesion, and 51% of the 61 patients with a score of 6 had confirmed thyroid cancer. Of the 98 patients with a combined score of 7 to 10, 99% had a histological confirmation of malignancy. CONCLUSIONS: The index score had a sensitivity of 94.1% and specificity of 77.5%. The overall accuracy was 85.8%. Therefore, we concluded that this methodology may improve the preoperative diagnosis of thyroid cancer in nodules larger than 10 mm. Association with other methods such as color Doppler echography, serum TSH concentration, galectin-3 expression analysis, and FDG/PET scan would be useful in avoiding the higher costs of thyroid surgical procedures.OBJETIVO: Avaliar a possibilidade de diagnóstico pré-operativo de nódulos da tireóide (de diâmetro superior a 10mm usando ultra-sonografia da glândula tireóide e citologia de punção aspirativa por agulha fina guiada pela ultra-sonografia. CASUÍSTICA E MÉTODOS: N

  7. Diagnostic Efficacy of Fine Needle Aspiration in Parotid Mass

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    Ebrahim Razmpa

    2010-10-01

    Full Text Available Introduction: The preoperative diagnostic evaluation of the parotid lesion is a valuable aid in planning the operation and the approach to intervention. Among different diagnostic tools, Fine Needle Aspiration has a key role. However, the exact efficacy of this technique in our center had not been thoroughly investigated. Materials and Methods: Between January 2000 and June 2007 a subset of 64 patients who had agreed to undergo preoperative FNAB was selected. The FNAB diagnoses were compared with those of the surgical specimens as the gold standard. Then, sensitivity, specificity, predictive value, and pertinent characteristics of the patients were evaluated. Finally, the results were analyzed with SPSS version14. Results: During the study period, 81 patients underwent parotidectomy, only 64 of whom had the FNA before surgery, so only the data collected from 64 patients were evaluated. The most common clinical presentation 75% (48 patients was a parotid mass. The second common presentation was facial paralysis at 17.2% (11 patients, followed by pain at 7.8%.  The result of FNA sensitivity was 82.5% and specificity was 93.3%. The accuracy of the test was 87.5%. Positive predictive value was 93.3% and negative predictive value was 82.35%. Conclusion: Fine-needle aspiration cytology is a reliable method in the evaluation of parotid tumors with a fairly high specificity and sensitivity rate.

  8. Endoscopic ultrasound-guided fine-needle aspiration for thediagnosis of kidney lesions: A review

    Institute of Scientific and Technical Information of China (English)

    Roberto Iglesias Lopes; Renata Nobre Moura; Everson Artifon

    2015-01-01

    Traditionally, treatment of renal lesions is indicatedbased only on imaging features. Although controversyexists about tissue sampling from small renalmasses, renal biopsy is indicated in some cases. Inthis review, we discuss the rationale for endoscopicultrasound-guided fine needle aspiration (EUS-FNA) andsummarize the recent advances in this field, providingrecommendations for the practicing clinician. The useof EUS-FNA appears to be a safe and feasible meansof confirming or excluding malignancy. EUS allowsassessment and biopsy of masses or lesions withinboth kidneys and related complications are rare. Themain advantages of EUS-FNA are that it can be doneas an outpatient procedure, with good results, minimalmorbidity and a short hospital stay. Nevertheless,EUS-FNA of renal masses should be indicated only inselected cases, in which there is potential to decreaseunnecessary treatment of small renal masses and tobest select tumors for active surveillance and minimallyinvasive ablative therapies. Additionally, some renallesions may be ineligible for EUS-guided biopsy becauseof anatomical limitations. EUS-FNA renal biopsy willprobably be best applied to central anterior renalmasses, while tumors on the posterior aspect of thekidney, percutaneous access will probably be superior.

  9. Fine Needle Aspiration Diagnosis of Isolated Pancreatic Tuberculosis: A Case Report and Review of Literature

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    D'Cruz S

    2003-07-01

    Full Text Available CONTEXT: Tuberculosis is a common disease in the developing world and its incidence is slowly increasing in developed countries where a resurgence has been seen subsequent to the AIDS epidemic. Tuberculosis, in its extrapulmonary form, though emerging as a clinical problem, rarely affects the pancreas. The pancreas is biologically protected from being infected by Mycobacterium tuberculosis. Pancreatic tuberculosis presents with a wide spectrum of symptoms such as abdominal pain, constitutional symptoms, obstructive jaundice, iron deficiency anemia, pancreatic abscess, massive gastro-intestinal bleeding, acute/chronic pancreatitis, secondary diabetes, splenic vein thrombosis and a pancreatic mass mimicking malignancy. It should be suspected clinically in patients having a pancreatic mass, particularly if the patient is young, not jaundiced, coming from an area of high tuberculosis endemicity and having a normal endoscopic retrograde cholangio-pancreatography. Its indolent course and vague symptomatology along with non-specific laboratory and radiological findings call for greater vigilance. CASE REPORT: We report a case of pancreatic tuberculosis which presented with pancreatic pain. Imaging techniques revealed a mass located in the head of the pancreatic gland. Fine needle aspiration cytology revealed caseating granulomas. The diagnosis of pancreatic tuberculosis was made and the patient was put on anti-tubercular therapy. Five months later, a repeat CT scan of the abdomen revealed resolution of the pancreatic lesion. CONCLUSION: The diagnosis of pancreatic tuberculosis is usually not suspected prior to laparotomy. Most patients have been diagnosed at laparotomy, thus fine needle aspiration cytology/biopsy is useful in obviating the need for major surgery with its accompanying morbidity. Exploratory laparotomy may be required in technically difficult cases due to risk of injury to the vessels in the vicinity of the mass.

  10. Fine needle cytology of Kaposi's sarcoma in heterosexual male

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    Anjali R. Dhote

    2014-04-01

    Full Text Available Kaposi's sarcomas the most common malignancy associated with Human Herpesvirus-8 (HHV8 infection. Though name is sarcoma but it is low grade vascular neoplasm. It is the tumour which arises from endothelial lining of vessels as well as lymphatic channels. So it involved all sites such as skin, Gastro intestine, lungs along with lymph nodes. We are presenting one such case of 65 year immunocompromised Indian male presented with multiple non blanching reddish bluish nodules on all extremities, chest, back with submandibular and cervical lymphadenopathy. Fine needle aspiration cytology (FNAC was performed and diagnosis was given low grade spindle cell neoplasm consistent with Kaposi's sarcoma which was confirmed on histopathology as Kaposi's sarcoma. [Int J Res Med Sci 2014; 2(2.000: 789-791

  11. Fine-needle aspiration of the thyroid: an overview

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    Nguyen Gia-Khanh

    2005-06-01

    Full Text Available Abstract Thyroid nodules (TN are a common clinical problem. Fine needle aspiration (FNA of the thyroid now is practiced worldwide and proves to be the most economical and reliable diagnostic procedure to identify TNs that need surgical excision and TNs that can be managed conservatively. The key for the success of thyroid FNA consists of an adequate or representative cell sample and the expertise in thyroid cytology. The FNA cytologic manifestations of TNs may be classified into seven working cytodiagnostic groups consisting of a few heterogenous lesions each to facilitate the differential diagnosis. Recent application of diagnostic molecular techniques to aspirated thyroid cells proved to be useful in separating benign from malignant TNs in several cases of indeterminate lesions.

  12. Incisional endometriosis: Diagnosed by fine needle aspiration cytology

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    P Veda

    2010-01-01

    Full Text Available Incisional endometriosis (IE is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC. Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  13. Incisional endometriosis: diagnosed by fine needle aspiration cytology.

    Science.gov (United States)

    Veda, P; Srinivasaiah, M

    2010-07-01

    Incisional endometriosis (IE) is a rare entity reported in 0.03-1.08% of women following obstetric or gynecologic surgeries. Most cases reported in literature have appeared after cesarean sections and were often clinically mistaken for hernia, abscess, suture granuloma or lipoma. We hereby report a case of IE following a second trimester hysterotomy, which was diagnosed by fine needle aspiration cytology (FNAC). Our patient was 26 years old, presenting with a mass over anterior abdominal wall, associated with incapacitating pain during each menstrual cycle. FNAC showed epithelial cells, stromal cells and hemosiderin laden macrophages. Based on the typical history, clinical and cytological features, the diagnosis of IE was established. Wide surgical excision was done and the resulting rectus sheath defect was repaired. Patient was followed for 6 months during which time she was symptom free. This article also reviews the spectrum of cytological features and the rare possibility of malignant transformation that can occur in IE.

  14. Endoscopic ultrasound-fine needle injection for oncological therapy

    Institute of Scientific and Technical Information of China (English)

    Jeremy; Kaplan; Amaara; Khalid; Natalie; Cosgrove; Ayesha; Soomro; Syed; Mohsin; Mazhar; Ali; A; Siddiqui

    2015-01-01

    The minimal invasiveness and precision of endoscopicultrasound(EUS) has lead to both its widespread use as a diagnostic and staging modality for gastrointestinal and pancreaticobiliary malignancies, and to its expand-ing role as a therapeutic modality. EUS-guided celiac plexus neurolysis is now a well-accepted modality for palliation of pain in patients with pancreatic cancer. EUS-guided ablation, brachytherapy, fiducial marker placement, and antitumor agent injection have been described as methods of performing minimally invasive oncological therapy. EUS-fine needle injection may be performed as adjunctive, alternative, or palliative treatment. This review summarizes the studies to date that have described these methods. A literature search using the Pub Med/MEDLINE databases was performed. While most published studies to date are limited with disappointing outcomes, the concept of a role of EUS in oncological therapy seems promising.

  15. BRMS1 and Cx43 expression in fine needle aspiration thyroid cancer tissue and their correlation with tumor malignancy

    Institute of Scientific and Technical Information of China (English)

    Jian-Guo Sheng; Bin Wang; Zong-Ping Diao; Kun-Kun Cao; Sai Zhang; Zheng-Guo Pu

    2016-01-01

    Objective:To study the BRMS1 and Cx43 expression in fine needle aspiration thyroid cancer tissue and their correlation with tumor malignancy.Methods:Patients undergoing thyroid fine needle aspiration biopsy in our hospital from April 2012 to October 2015 were selected for study, 60 patients with thyroid cancer and 60 patients with benign thyroid tumor were screened after pathological diagnosis, biopsy tissue was collected to determine the expression of BRMS1 and Cx43, and serum specimens were collected to determin Gal-3, CEACAM1, MMP2 and MMP9 content.Results: mRNA levels and positive expression rate of BRMS1 andCx43in thyroid cancer tissue were significantly lower than those in benign thyroid tumor tissue; mRNA levels ofBRMS1andCx43in thyroid cancer tissue with different pathological types and tumor diameters were not different, mRNA level ofCx43in thyroid cancer tissue with TNM III-IV stage was significantly lower than that in thyroid cancer tissue with TNM I-II stage, mRNA levels ofBRMS1 in thyroid cancer tissue with different TNM stages were not different, and mRNA levels ofBRMS1andCx43in thyroid carcinoma tissue with lymph node metastasis were significantly lower than those in thyroid carcinoma tissue without lymph node metastasis; serum Gal-3, CEACAM1, MMP2 and MMP9 levels in patients with positive BRMS1 and Cx43 expression in thyroid cancer tissue were significantly lower than those in patients with negative BRMS1 and Cx43 expression in thyroid cancer tissue.Conclusions:Lower expression of BRMS1 and Cx43 in fine needle aspiration thyroid cancer tissue is associated with the distant metastasis and malignant degree of tumor, and lower expression of Cx43 is also associated with the growth of tumor and cancer cell proliferation.

  16. Analysis of ultrasound-guided fine needle aspiration in percutaneous biopsy of nodular goitre%超声引导下结节性甲状腺肿穿刺活检与病理组织学检查对比分析

    Institute of Scientific and Technical Information of China (English)

    崔西振; 程印蓉; 马晓娟; 刘述益

    2011-01-01

    目的 通过对超声引导下穿刺活检和病理组织学检查与超声诊断结节性甲状腺肿进行对照分析,提高超声诊断结节性甲状腺肿的准确性.方法 对49例超声诊断结节性甲状腺肿患者的86个结节行超声引导下细针穿刺,抽取结节组织做病理学检查,将超声诊断与病理检查结果进行比较.结果 每个结节抽取组织2~3条,穿刺取材成功率为100%;超声检查结果与组织活检和细胞学病理诊断比较,结节性甲状腺肿病理诊断42例,符合率为85.7%.超声误诊7例,其中病理诊断桥本氏病2例、亚急性甲状腺炎1例、甲状腺乳头状癌2例、甲状腺腺瘤2例,误诊率14.3%.结论 超声引导下穿刺病理学结果对结节性甲状腺肿的检查具有很高的诊断价值,准确、可靠、安全、方便,能为临床医生提供可靠的诊断依据.%Objective To analyze the efficacy of ultrasound diagnosis and results of ultrasound-guided fine-needle aspiration(US-FNA). Methods US-FNA was performed for 86 thyroid nodes in 49 patients. The diagnostic data obtained from US-FNA were compared with the ultrasound diagnosis. Results Two pieces of tissue were obtained from one nodule and the success ratio were 100%. Among these 86 thyroid nodules, US-FNA showed that 42 nodular goiter and the coincidence rate were 85. 7%. 7 cases were misdiagnosed (misdiagnosis rate 14. 3%), among those were 2 Hashimoto 's disease, 1 subacute thyroiditis, 2 thyroid papillary carcinoma and 2 thyroid adenoma. Post-puncture bleeding was not observed in all nodules. Conclusion Ultrasound-guided fine-needle aspiration (US-FNA) is accurate and reliable in diagnosing thyroid nodules. The US-FNA results can provide more information to the clinic.

  17. Fine needle aspiration cytology of salivary gland lesions: Our experience

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    Pooja K Suresh

    2016-01-01

    Full Text Available Introduction: Fine needle aspiration cytology (FNAC of salivary glands is one of the most commonly done first line investigations in the head and neck region. Objectives: To study the cytological features of various salivary gland lesions and to correlate with histopathological diagnosis wherever possible. Materials and Methods: All the FNAC slides of salivary gland lesions received at cytology lab of a tertiary hospital for a period of 3 years that is, from January 2011 to December 2013 were reviewed retrospectively. Histopathological correlation was done for cases wherever available. Results: During the study period salivary gland FNAC was done for 100 cases. Among them, 51 (51% were reported as nonneoplastic and 49 as neoplastic (49%. Histopathological correlation was available in 18 cases (18%. The accuracy of salivary gland cytology is 77.7% (14/18 cases. The mean age of presentation of all the salivary gland lesions ranged from 12 years to 92 years with the mean age being 47.7 years. The male:female ratio was 1.5:1. Parotid gland was involved in 74 cases and submandibular gland in 26 cases. Bilateral involvement was noted in 1 case (1%. Conclusion: Being a minimally invasive procedure, FNA of salivary glands continues to be an important diagnostic tool in the preoperative diagnosis of salivary gland lesions in spite of few pitfalls in diagnosing due to cytomorphological overlapping.

  18. [The immediate interpretation for fine-needle aspiration cytology].

    Science.gov (United States)

    Chang, M C; Ho, W L

    1993-11-01

    From December 1990 to November 1992, 2005 cases of immediate interpretation for fine-needle aspiration (FNA) cytology were performed, of which 727 cases were confirmed by surgical pathology. A mobile cytologic laboratory (a cart loaded with a dual viewing microscope, Liu's staining solutions, hair dryer, and slides) can be moved to the Out-patient Department, wards and Computed Tomography room, where clinicians perform aspiration and pathologists read smears. Immediate verbal diagnoses are documented to patients' charts and listed in cytopathologic files. Immediate interpretation in this entire series yielded a sensitivity 92.5%; specificity, 98.1%; false-positive rate, 1.1%; false-negative rate, 3.2%; positive predictive value (PV), 97.3%; negative PV, 94.7% and efficiency, 95.7%. The cause of false-negative results in the 23 cases probably came from the hesitation in making an immediate diagnosis. Most of these cases were malignant lymphoma or breast carcinoma. The roles of immediate cytodiagnosis are (1) to decrease the inadequate rate of FNA specimens; (2) to render preliminary diagnosis for clinicians to make decisions; (3) to provide on-site teaching material for both clinicians and pathology residents to better understand clinicopathological correlations; (4) to act as the initial diagnostic procedure in the evaluation of a superficial palpable mass. This study shows that immediate interpretation for FNA cytology is a simple, rapid, accurate and noninvasive diagnostic procedure that can be routinely used for superficial palpable masses.

  19. Intratumor genetic heterogeneity of breast carcinomas as determined by fine needle aspiration and TaqMan low density array

    DEFF Research Database (Denmark)

    Lyng, Maria B.; Laenkholm, Anne-Vibeke; Pallisgaard, Niels

    2007-01-01

    BACKGROUND: Gene expression profiling is thought to be an important tool in determining treatment strategies for breast cancer patients. Tissues for such analysis may at a preoperative stage be obtained, by fine needle aspiration (FNA) allowing initiation of neoadjuvant treatment. To evaluate...... the extent of the genetic heterogeneity within primary breast carcinomas, we examined whether a gene expression profile obtained by FNA was representative of the tumor. METHODS: Tumors from 12 consecutive cases of early predominantly estrogen receptor positive (ER+) breast cancer patients undergoing primary...... by statistical analysis. High correlations between the gene profiles of tumor FNAs and tissue biopsies from the same patient were observed for all patients. A cluster analysis identified clustering of both the two FNAs and the tissue biopsy of the same 9 patients. CONCLUSION: The overall genetic heterogeneity...

  20. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients

    Science.gov (United States)

    GUDMUNDSSON, Jens Kristjan; AJAN, Aida; ABTAHI, Jahan

    2016-01-01

    ABSTRACT Objective Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses. Material and Methods Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed. The results of FNAC and final histological diagnosis were compared and the accuracy of FNAC was determined. Results Final histological evaluation revealed 11 malignant tumors and 103 benign lesions. Pleomorphic adenoma was the most common neoplasm (63%), followed by Warthin’s tumor (17.5%). The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Positive predictive value (PPV) was 73% and negative predictive value (NPV) was 97%. The overall accuracy of FNAC in detecting parotid masses was 95%. False-negative diagnosis was found in mucoepidermoid carcinoma, acinic cell carcinoma, and epithelial-myoepithelial carcinoma whereas there was false-positive diagnosis in cases of pleomorphic adenoma and normal parotid gland tissue. Conclusion FNAC is a reliable minimally invasive diagnostic method with a high sensitivity in diagnosis of lesions in parotid glands. The sensitivity of detection of malignant tumors in parotid glands was low due to the biopsy technique used, and depended on tumor location. Postoperative complications decreased after superficial parotidectomy. PMID:28076460

  1. The Utility of Endoscopic Ultrasound Guided Fine Needle Aspiration in the Diagnosis of Infectious Diseases—Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Mauro Ajaj Saieg

    2013-01-01

    Full Text Available Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA is a fast and minimally invasive methodology with a crucial impact on patients’ management. It has an important and established role in the diagnosis and staging of mediastinal and abdominal malignancies, but little is discussed in the literature on the usefulness of this technique in the diagnosis of infectious diseases. In the current report, we present three different cases where EUS was essential for reaching the diagnosis of tuberculosis and paracoccidiodomicosis in cases otherwise seen as malignant. In conclusion, EUS was successful not only in obtaining enough cells for morphological analysis, but also for the production of cell blocks and assessment of the presence of the microorganisms by special stains. EUS allied to fine needle biopsy was an important tool in determining diagnoses of enlarged lymph nodes, revealing the diagnosis of infectious diseases in cases otherwise seen as malignant. The wide use of this methodology in cases such as those reported here cannot only rule out malignancy, but also aid critically ill patients by installing early proper therapy without the need for aggressive interventions.

  2. The experience with fine needle aspiration cytology in the management of palpable breast lumps in the University Hospital Kuala Lumpur.

    Science.gov (United States)

    Yip, C H; Jayaram, G; Alhady, S F

    2000-09-01

    A total of 676 palpable breast lumps seen in the Breast Clinic, University Hospital, Kuala Lumpur from August 1993 to August 1994 were subjected to fine needle aspiration cytology. Fifty-four were reported as inadequate, 501 benign, 95 malignant and 26 suspicious. One hundred and eighty-seven aspirates had histological correlation, while 34 of the malignant aspirates had clinical correlation. The majority of the other 455 patients were followed up for a period of 60 to 72 months without any malignancies becoming apparent. For analysis, only the 221 cases with histological or clinical correlation were included, (the suspicious category was included into the positive group and the inadequate cases were excluded), giving a sensitivity of 91.7%, a specificity of 91.7% and a diagnostic accuracy of 91.7%. Breast cytology was an accurate and rapid method of diagnosis of breast diseases, and in a busy surgical unit with limited operating time, it allowed for the triage of patients with breast complaints in deciding which cases needed early open biopsy. A negative cytology does not exclude the possibility of cancer, as there was a false negative rate of 11%. However by utilising a diagnostic triad of clinical examination, radiological assessment and fine needle aspiration cytology, the risk of missing a malignancy is small.

  3. The accuracy of fine-needle aspiration cytology for diagnosis of parotid gland masses: a clinicopathological study of 114 patients

    Directory of Open Access Journals (Sweden)

    Jens Kristjan GUDMUNDSSON

    Full Text Available ABSTRACT Objective Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC in the diagnosis of parotid gland masses. Material and Methods Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed. The results of FNAC and final histological diagnosis were compared and the accuracy of FNAC was determined. Results Final histological evaluation revealed 11 malignant tumors and 103 benign lesions. Pleomorphic adenoma was the most common neoplasm (63%, followed by Warthin’s tumor (17.5%. The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Positive predictive value (PPV was 73% and negative predictive value (NPV was 97%. The overall accuracy of FNAC in detecting parotid masses was 95%. False-negative diagnosis was found in mucoepidermoid carcinoma, acinic cell carcinoma, and epithelial-myoepithelial carcinoma whereas there was false-positive diagnosis in cases of pleomorphic adenoma and normal parotid gland tissue. Conclusion FNAC is a reliable minimally invasive diagnostic method with a high sensitivity in diagnosis of lesions in parotid glands. The sensitivity of detection of malignant tumors in parotid glands was low due to the biopsy technique used, and depended on tumor location. Postoperative complications decreased after superficial parotidectomy.

  4. Repeated fine-needle aspiration cytology for the diagnosis and follow-up of thyroid nodules

    Directory of Open Access Journals (Sweden)

    Agnaldo José Graciano

    2014-10-01

    Full Text Available INTRODUCTION: The recently-proposed Bethesda reporting system has offered clinical recommendations for each category of reported thyroid cytology, including repeated fine-needle aspiration (FNA for non-diagnostic and atypia/follicular lesions of undetermined significance, but there are no sound indications for repeated examination after an initial benign exam. OBJECTIVE: To investigate the clinical validity of repeated FNA in the management of patients with thyroid nodules. METHOD: The present study evaluated 412 consecutive patients who had repeated aspiration biopsies of thyroid nodules after an initial non-diagnostic, atypia/follicular lesion of undetermined significance, or benign cytology. RESULTS: The majority of patients were female (93.5% ranging from 13 to 83 years. Non-diagnostic cytology was the most common indication for a repeated examination in 237 patients (57.5%, followed by benign (36.8%, and A/FLUS (5.6% cytology. A repeated examination altered the initial diagnosis in 70.5% and 78.3% of the non-diagnostic and A/FLUS patients, respectively, whereas only 28.9% of patients with a benign cytology presented with a different diagnosis on a sequential FNA. CONCLUSIONS: Repeat FNA is a valuable procedure in cases with initial non-diagnostic or A/FLUS cytology, but its routine use for patients with an initial benign examination appears to not increase the expected likelihood of a malignant finding.

  5. Clinicopathological characteristics of thyroid cancer misdiagnosed by fine needle aspiration

    Science.gov (United States)

    Maeda, Hideki; Kutomi, Goro; Satomi, Fukino; Shima, Hiroaki; Mori, Mitsuru; Hirata, Koichi; Takemasa, Ichiro

    2016-01-01

    Fine-needle aspiration (FNA) is commonly used as a preoperative assessment to diagnose thyroid cancer. However, misdiagnosis of malignancy by FNA is not rare, even if image examination suggests the possibility of thyroid cancer. In the present study, the clinicopathological factors of patients whose preoperative FNA examination had not led to a diagnosis of thyroid cancer were examined. In total, 125 patients with thyroid cancer who underwent FNA and surgery (total thyroidectomy, subtotal thyroidectomy or hemithyroidectomy) at the Department of Surgery, Surgical Oncology and Science of the Sapporo Medical University Hospital between 2006 and 2013 were retrospectively analyzed. The patients were divided into two groups: Group A, malignancy determined by FNA, and group B, no malignancy. The groups were then compared by gender, age, tumor size, stage, tumor stage, lymph node metastasis, histology, surgical procedure methods, presence or absence of calcification and thyroglobulin levels. The mean age of the patients in group A (5 males and 59 females) was 53.0 years. The mean age in group B (11 males and 49 females) was 54.2 years. The mean tumor size in both groups was 1.6 cm. The mean thyroglobulin levels were 82.7 ng/ml in Group A and 525.5 ng/ml in group B. There were also significant differences between the groups for tumor stage (P=0.046), histological type (P=0.024) and thyroglobulin levels (P=0.035). The results of the present study suggested that it may be difficult to diagnose thyroid cancer by FNA in cases with non-papillary carcinoma and higher thyroglobulin levels. PMID:27698782

  6. Salivary gland anlage tumor: cytologic features in a case examined by fine-needle aspiration.

    Science.gov (United States)

    Bondeson, L; Andreasson, L; Olsson, M; Rausing, A

    1997-06-01

    The cytologic features in fine-needle aspirates from a rare benign nasopharyngeal salivary gland anlage tumor in a newborn boy are described and commented on, regarding therapeutically important differential diagnoses.

  7. Fine Needle Aspiration Cytology: A Useful Technique for Diagnosis of Invasive Fungal Rhinosinusitis

    OpenAIRE

    2013-01-01

    Mycotic infections are on the rise globally. Patients with invasive fungal infection of the paranasal sinuses often present with destructive mass lesions and mimic malignancy clinically and radiologically. To assess the utility of Fine needle aspiration cytology for early diagnosis of invasive fungal rhinosinusitis. Fine needle aspiration cytology was performed from the maxillary/ethmoid sinus in patients with a destructive mass lesion in the maxilla. Differential diagnoses were malignancy an...

  8. Pancreatic metastasis in a case of small cell lung carcinoma: Diagnostic role of fine-needle aspiration cytology and immunocytochemistry

    Directory of Open Access Journals (Sweden)

    Dilip K Das

    2011-01-01

    Full Text Available Small cell lung carcinoma represents a group of highly malignant tumors giving rise to early and widespread metastasis at the time of diagnosis. However, the pancreas is a relatively infrequent site of metastasis by this neoplasm, and there are only occasional reports on its fine needle aspiration (FNA cytology diagnosis. A 66-year-old man presented with extensive mediastinal lymphadenopathy and a mass in the pancreatic tail. Ultrasound-guided FNA smears from the pancreatic mass contained small, round tumor cells with extensive nuclear molding. The cytodiagnosis was metastatic small cell carcinoma. Immunocytochemical staining showed that a variable number of neoplastic cell were positive for cytokeratin, chromogranin A, neurone-specific enolase and synaptophysin but negative for leukocyte common antigen. The trans-bronchial needle aspiration was non-diagnostic, but biopsy was suspicious of a small cell carcinoma. This case represents a rare metastatic lesion in the pancreas from small cell lung carcinoma, diagnosed by FNA cytology.

  9. Subcutaneous metastases of sarcomatoid mesothelioma with its differential diagnosis on fine needle aspiration--a case report.

    Science.gov (United States)

    Patel, Trupti; Bansal, Rimpi; Trivedi, Priti; Modi, Lopa; Shah, M J

    2005-10-01

    Metastasis of mesothelioma of the pleura, to the skin and subcutis is an extremely rare occurrence. A 25 year old woman, who had undergone chemotherapy, partial excision of tumor followed by radiotherapy of sarcomatoid mesothelioma of the pleura, presented three months later with painless widespread subcutaneous nodules. FNAC of these nodules reveled pleomorphic malignant spindle shaped cell with epithelioid morphology. The subcutis is a particularly rare site of metastatic sarcomatoid mesothelioma. It is essential to differentiate neoplasm metastatic to the skin and subcutis from primary and benign lesions of the same region. FNAC is accurate and efficient, in conjugation with clinical history, and it also prevents surgical biopsy in the diagnosis of metastatic subcutaneous lesion. To our knowledge, this is the first case, reported till date, in which the sarcomatoid mesothelioma metastasized to the subcutaneous tissue and was diagnosed by fine needle aspiration cytology (FNAC).

  10. Accuracy of fine needle aspiration cytology of salivary gland lesions: routine diagnostic experience in Bangkok, Thailand.

    Science.gov (United States)

    Nguansangiam, Sudarat; Jesdapatarakul, Somnuek; Dhanarak, Nisarat; Sosrisakorn, Krittika

    2012-01-01

    Fine needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimal invasive and cost-effective method for diagnosis of salivary gland lesions. This study evaluated the accuracy and diagnostic performance of FNA cytology in Thailand. A consecutive series of 290 samples from 246 patients during January 2001-December 2009 were evaluated from the archive of the Anatomical Pathology Department of our institution and 133 specimens were verified by histopathologic diagnoses, obtained with material from surgical excision or biopsy. Cytologic diagnoses classified as unsatisfactory, benign, suspicious for malignancy and malignant were compared with the histopathological findings. Among the 133 satisfactory specimens, the anatomic sites were 70 (52.6%) parotid glands and 63 (47.4 %) submandibular glands. FNA cytological diagnoses showed benign lesions in 119 cases (89.5 %), suspicious for malignancy in 3 cases (2.2 %) and malignant in 11 cases (8.3%). From the subsequent histopathologic diagnoses, 3/133 cases of benign cytology turned out to be malignant lesions, the false negative rate being 2.2 % and 1/133 case of malignant cytology turned out to be a benign lesion, giving a false positive rate was 0.8%. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 97.0% (95% CI, 70.6%-99.4%), 81.3% (95% CI, 54.4%-96.0%), 99.1% (95% CI, 95.4%-100%), 92.9% (95% CI, 66.1%-99.8), 97.5% (95% CI, 92.8%-99.5%), respectively. This study indicated that FNA cytology of salivary gland is a reliable and highly accurate diagnostic method for diagnosis of salivary gland lesions. It not only provides preoperative diagnosis for therapeutic management but also can prevent unnecessary surgery.

  11. Lung malignancy: Diagnostic accuracies of bronchoalveolar lavage, bronchial brushing, and fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Rateesh Sareen

    2016-01-01

    Full Text Available Background: Early diagnosis of lung cancer plays a pivotal role in reducing lung cancer death rate. Cytological techniques are safer, economical and provide quick results. Bronchoscopic washing, brushing and fine needle aspirations not only complement tissue biopsies in the diagnosis of lung cancer but also comparable. Objectives: (1 To find out diagnostic yields of bronchioalveolar lavage , bronchial brushings, FNAC in diagnosis of lung malignancy. (2 To compare relative accuracy of these three cytological techniques. (3 To correlate the cytologic diagnosis with clinical, bronchoscopic and CT findings. (4 Cytological and histopathological correlation of lung lesions. Methods: All the patients who came with clinical or radiological suspicion of lung malignancy in two and a half year period were included in study. Bronchoalveolar lavage was the most common type of cytological specimen (82.36%, followed by CT guided FNAC (9.45% and bronchial brushings (8.19%. Sensitivity, specificity, positive and negative predictive value for all techniques and correlation with histopathology was done using standard formulas. Results: The most sensitive technique was CT FNAC – (87.25% followed by brushings (77.78% and BAL (72.69%. CT FNAC had highest diagnostic yield (90.38%, followed by brushings (86.67% and BAL (83.67%. Specificity and positive predictive value were 100 % each of all techniques. Lowest false negatives were obtained in CT FNAC (12.5% and highest in BAL (27.3%. Highest negative predictive value was of BAL 76.95 % followed by BB 75.59% and CT FNAC 70.59%. Conclusion: Before administering antitubercular treatment every effort should be made to rule out malignancy. CT FNAC had highest diagnostic yield among three cytological techniques. BAL is an important tool in screening central as well as in accessible lesions. It can be used at places where CT guided FNAC is not available or could not be done due to technical or financial limitations

  12. Fine needle aspiration cytology in symptomatic breast lesions: still an important diagnostic modality?

    LENUS (Irish Health Repository)

    Smith, Myles J

    2012-01-01

    The objective of this study was to make an assessment of the utility of fine needle aspiration cytology (FNAC), in a "one-stop" symptomatic breast triple assessment clinic. Controversy surrounds the optimal tissue biopsy methodology in the diagnosis of symptomatic breast cancer and the identification of benign disease. FNAC in the context of a Rapid Assessment Breast Clinic (RABC) allows the same day diagnosis and early treatment of breast cancer, with the immediate reassurance and discharge of those with benign disease. We analyzed prospective data accrued at a RABC, over a 4-year period from 2004 to 2007. All patients were triple assessed, with FNACs performed on site by two consultant cytopathologists. Investigations were reported immediately, and clinical data were captured via a database using compulsory data field entry. There were 4487 attendances at our RABC, with 1572 FNACs were performed. The positive predictive value of FNAC with a C5 cancer diagnosis was 100%, 95.6% for a C4 report, with a complete sensitivity of 94%. The full specificity of correctly identified benign lesions was 77.4%, with a false negative rate of 3.85%. This enabled 66% of patients attending the RABC to receive a same day diagnosis of benign disease and discharge. FNAC is highly accurate in the diagnosis of symptomatic breast cancer in an RABC. FNAC allows accurate diagnosis of benign disease and immediate discharge of the majority of patients. In this era, when a large majority of patients have benign disease, we believe that FNAC provides an equivalent, if not better, method of evaluation of patients in a triple assessment RABC.

  13. Diagnostic accuracy and pitfalls of fine needle aspiration cytology and scrape cytology in oral cavity lesions

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    Nesreen H. Hafez

    2014-10-01

    Full Text Available Background — The oral cavity can be home for a wide variety of lesions. To date, biopsy has remained the gold standard for diagnosing these lesions. Purpose — This study was carried out to assess the diagnostic accuracy of cytology in the oral lesions and to address the cytologic-histologic correlation. Patients and Methods — This prospective study included 72 patients with intraoral lesions. Fine needle aspiration cytology (FNAC or scrap cytology was performed. The smears were immediately fixed in 95% alcohol for Papanicolaou staining. If there was sufficient material, cell block was prepared. When indicated immunocytochemical study was ordered. Final cytologic results were then compared with the definitive histopathological diagnoses which were considered the gold standard. Results — Cytologically, 28 patients (38.9% were diagnosed as benign/atypical and 44 (61.1% as malignant/suspicious. The most common benign cytologic diagnosis was inflammation (42.9% of benign cases. The most common malignant cytologic diagnosis was squamous cell carcinoma (36.4%. Cytologic diagnoses were compared with histopathologic ones. There were 3 false negative cases and one false positive case. The sensitivity was 93.5%; specificity was 96.2%; positive predictive value (PPV was 97.7%; negative predictive value (NPV was 89.3% with a diagnostic accuracy of 94.4%. P-value was <0.001. Kappa was 0.882. Conclusion — FNAC was found to be highly accurate in the diagnosis of oral lesions. Detailed cytomorphologic examination coupled with clinical data and appropriate immunocytochemical study, in some cases, can lead to an accurate diagnosis. Overlapping features of some tumors, especially in minor salivary gland, as well as limitation of sampling, were responsible for the inaccurate diagnoses.

  14. Hydronephrotic Kidney Previously Treated for Tuberculosis: Rare Primary Squamous Cell Carcinoma of Renal Pelvis Diagnosed by Fine-needle Aspiration Cytology

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    Dragica Obad-Kovačević

    2015-09-01

    Full Text Available Primary squamous cell carcinoma (SCC of the renal pelvis is a very rare tumor often associated with renal calculi and chronic infections. There are only a few articles in literature which report renal pelvis SCC in kidneys treated for renal tuberculosis, diagnosed after nephrectomy. We report the case of SCC in a hydronephrotic kidney previously treated for tuberculosis, diagnosed by ultrasound (US-guided fine-needle aspiration cytology (FNAC, prior to core biopsy and nephrectomy. Our report highlights the utility of FNAC and the need for a careful search for renal collecting system tumors, in patients previously treated for renal tuberculosis.

  15. A rare case of myxoid liposarcoma of the adult foot diagnosed using fine needle aspiration cytology (FNAC

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    Kure S

    2014-12-01

    Full Text Available Shoko Kure,1 Wei-Xia Peng,1 Mitsuhiro Kudo,1 Miyuki Matsubara,2 Takashi Tsunoda,3 Zenya Naito1,21Department of Integrated Diagnostic Pathology, Nippon Medical School, 2Department of Pathology, Nippon Medical School Hospital, 3Department of Orthopedics, Nippon Medical School Department of Orthopedics, Nippon Medical School, Tokyo, JapanAbstract: Liposarcoma is categorized as a soft tissue sarcoma that most commonly appears in the lower extremities during adulthood, but rarely in the feet. We present a rare case of a primary myxoid liposarcoma in the foot of a 63-year-old man that was diagnosed by fine needle aspiration cytology (FNAC. The patient presented to our hospital with a 10-year history of a slow-growing mass on the left lateral ankle. On physical examination, the 60 mm ×60 mm mass, was found to be soft and elastic, causing poor mobility without pain. Magnetic resonance imaging of the mass revealed high signal intensity on T1-weighted images and heterogeneously high signal intensity on T2-weighted images without fat suppression. As a result of the physical examination and imaging, the mass was suspected to be a lipoma or ganglion cyst. However, the FNAC procedure revealed atypical small, round, short spindle cells, or foamy cells with a myxoid background, suggesting myxoid liposarcoma. Histology using an open biopsy showed a proliferation of atypical spindle and asteroid cells with a few foamy lipoblasts in a capillary-rich and myxoid background. The atypical lipoblasts were slightly positive for S-100. These findings were consistent with myxoid liposarcoma. The patient was treated with a resection of the mass. Liposarcoma is considered to be the second most common soft-tissue sarcoma. It usually involves the lower extremities, particularly the thigh, and is very rare in the adult foot. Our case was a rare occurrence of myxoid liposarcoma of the foot diagnosed preoperatively using FNAC.Keywords: myxoid liposarcoma, foot, fine needle

  16. Biopsia por aspiración y supresión con hormonas tiroideas en el diagnóstico de cáncer tiroideo: comparación con la cirugía en 77 nódulos hipocaptantes Fine-Needle aspiration biopsy and suppression with thyroid hormone in the diagnosis of thyroid carcinoma

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    Humberto Aristizábal

    1992-01-01

    Full Text Available Se estudiaron 77 pacientes con nódulos tiroideos hipocaptantes, demostrados por gamagrafía, por medio de biopsia tiroidea por aspiración y terapia supresiva con hormonas tiroideas durante 6 meses o más. Se realizó estudio ecográfico del nódulo antes de iniciar la terapia y seis meses después de estarla administrando. Todos fueron intervenidos porque en ninguno desapareció el nódulo con la terapia, a pesar de que se obtuvo supresión de la tirotrofina en plasma. La biopsia tiroidea por aspiración (BT A fue Interpretada en todos los pacientes como bocio coloide o nodular o neoplasia folicular. En contraste, en el estudio de la pieza quirúrgica 52 pacientes presentaron bocio nodular, multinodular o coloide; 16 tenían carcinomas (12 papilares y 4 foliculares y 9 tiroiditis de Hashimoto. Contrariamente a lo esperado se observó que 5 de loS carcinomas (31.3% disminuyeron de volumen durante el tratamiento hormonal; de acuerdo a la ecografía la disminución promedio fue 0.41 cm3. En cambio 4 de los 52 nódulos benignos (7.7% aumentaron de volumen, en promedio 3.7 cm3. Estos hallazgos sugieren que la prueba de supresión con hormonas tiroideas no es confiable para definir si una lesión es benigna o maligna. En el estudio quirúrgico se demostró que 20.8% (16/77 de los nódulos eran carcinomas. A la luz de estos datos la biopsia por aspiración no estableció por lo general el diagnóstico de carcinoma; por ello se debe recurrir a la cirugía aunque la biopsia sea negativa.

    Seventy-seven patients with cold thyroid nodules were studied with flne-needle aspiration biopsy and suppression with thyroid hormone. The volume of the nodule was calculated ultrasonographycally at the beginning of the study and after six months of oral therapy with thyroglobulin, at doses sufficient to maintain TSH at the low limits of the normal

  17. Technical description of endoscopic ultrasonography with fine-needle aspiration for the staging of lung cancer

    NARCIS (Netherlands)

    Kramer, H; van Putten, JWG; Douma, WR; Smidt, AA; van Dullemen, HM; Groen, HJM

    2005-01-01

    Background: Encloscopic ultrasonography (EUS) is a novel method for staging of the mediastinum in lung cancer patients. The recent development of linear scanners enables safe and accurate fine-needle aspiration (FNA) of mediastinal and upper abdominal structures under real-time ultrasound guidance.

  18. Rapid on-site evaluation of axillary fine-needle aspiration cytology in breast cancer.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2012-06-01

    Axillary ultrasonography (AUS) and fine-needle aspiration cytology (FNAC) can establish axillary lymph node status before surgery, although this technique is hampered by poor adequacy rates. To achieve consistently high rates of FNAC adequacy, rapid on-site evaluation (ROSE) of FNAC samples was introduced.

  19. A STUDY OF HISTOPATHOLOGICAL CORRELATION WITH FINE NEEDLE ASPIRATION CYTOLOGY OF CERVICAL LYMPHADENOPATHY

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    Bobby Duarah

    2016-07-01

    histopathology gives the final definite diagnosis in most of the cases, it is hoped that the diagnostic error in fine needle aspiration cytology can be minimized to a negligible degree by acquiring skill and experience in performing the technique with thorough clinical knowledge and judgment.

  20. Thyroglobulin measurement in the fine-needle aspiration washout for diagnosing cervical lymph node metastasis in the patients with differentiated papillary thyroid cancer

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    Kim, Byung Moon [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Kim, Eun Kyung; Kim, Min Jung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2006-11-15

    We wanted to evaluate the utility of thyroglobulin measurement in the washout of the needle (FNA-Tg) used for fine needle biopsy for detecting lymph node metastasis in patients with differentiated papillary thyroid carcinoma (DPTC). We performed ultrasonography-guided fine-needle aspiration cytology (FNAC) and FNA-Tg for 50 ultrasonographically suspicious lymph nodes in 45 DPTC patients. Eighteen patients underwent thyroidectomy before FNA and the remaining 27 patients underwent fine-needle aspiration prior to surgery. The final diagnoses were determined based on the results of histological examination of the excised specimens (n = 21) or on the follow-up examination that was done least 12 months after surgery. Lymph node metastases were confirmed in 19 patients. FNAC detected 14 metastatic lymph nodes in 14 patients, and FNA-Tg detected 18 metastatic lymph nodes in 18 patients. While none of 3 cystic lymph nodes metastasis was detected via FNAC, they all revealed positive results via FNA-Tg. One patient with a negative result on both methods had one metastatic lymph node among 9 excised lymph nodes, and this one node had not been sampled via FNAC or Tg. The sensitivities and specificities of FNAC and FNA-Tg were 73.6% (14/19) and 100% (27/27), and 94.7% (18/19) and 96.2% (26/27), respectively. FNA-Tg is a useful technique for the early detection of lymph node metastasis, and especially for detecting cystic lymph node metastasis in patients with DPTC.

  1. CT-guided fine needle aspiration cytology diagnosis of extra-adrenal pheochromocytoma

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    Rangaswamy M

    2010-01-01

    Full Text Available Pheochromocytoma is a rare tumor, accounting for <0.1% of the hypertensive population. Extra-adrenal pheochromocytomas (EAPs are rarer still, accounting for 10% of all pheochromocytomas. Pheochromocytomas are functional catecholamine-secreting tumors of the paraganglionic chromaffin cells found in the adrenal medulla and the extra-adrenal paraganglia cells. EAPs are readily detected by computed tomography (CT as soft tissue masses closely associated with the entire length of the abdominal aorta. Here, we present a rare case of EAP in a 45-year-old male hypertensive patient diagnosed by CT-guided fine needle aspiration cytology. The smears showed loosely cohesive tumor cells with prominent anisokaryosis and abundant eosinophilic, granular cytoplasm. The diagnosis was later confirmed by histopathology. The present case also highlights the fact that fine needle aspiration of pheochromocytoma is not necessarily contraindicated.

  2. CT-guided fine needle aspiration cytology diagnosis of extra-adrenal pheochromocytoma.

    Science.gov (United States)

    Rangaswamy, M; Kumar, Sandeep P; Asha, M; Manjunath, Gv

    2010-01-01

    Pheochromocytoma is a rare tumor, accounting for accounting for 10% of all pheochromocytomas. Pheochromocytomas are functional catecholamine-secreting tumors of the paraganglionic chromaffin cells found in the adrenal medulla and the extra-adrenal paraganglia cells. EAPs are readily detected by computed tomography (CT) as soft tissue masses closely associated with the entire length of the abdominal aorta. Here, we present a rare case of EAP in a 45-year-old male hypertensive patient diagnosed by CT-guided fine needle aspiration cytology. The smears showed loosely cohesive tumor cells with prominent anisokaryosis and abundant eosinophilic, granular cytoplasm. The diagnosis was later confirmed by histopathology. The present case also highlights the fact that fine needle aspiration of pheochromocytoma is not necessarily contraindicated.

  3. Diagnostic problems in fine needle aspiration cytology of fat necrosis within a subcutaneous lipoma

    OpenAIRE

    2008-01-01

    Fat necrosis in subcutaneous lipomas is very unusual and has been reported only occasionally. Literature regarding fine needle aspiration cytology of such a lesion is lacking although fat necrosis is well described in the breast. We came across a case of a large subcutaneous lipoma in the anterior abdominal wall with a well encapsulated area of fat necrosis. The aspiration smears showed an unusual picture which was misinterpreted as the fragments of the hydatid cyst wall. They were actually e...

  4. FINE NEEDLE ASPIRATION CYTOLOGY OF RETROPERITONEAL GANGLIONEUROBLASTOMA – A CASE REPORT

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    Rajshekhar

    2013-01-01

    Full Text Available ABSTRACT: Ganglioneuroblastoma is an uncommon peripheral neurob lastic tumor. They have intermediate malignant potential, in between that of neuroblastomas and ganglioneuromas. Histologically, they are considered to have interme diate malignant potential because they contain primitive neuroblasts along with mature gang lion cells. In literature, reports of this entity being diagnosed by fine needle aspiration and its cytological appearance are scarce. KEY WORDS: Ganglioneuroblastoma, FNA, Neuroblastoma

  5. Cytomorphology of nipple discharge and fine needle aspiration of duct papilloma

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    H B Bannur

    2012-01-01

    Full Text Available The primary role of fine needle aspiration (FNA of the breast is the distinction between benign and malignant lesions; but in many cases, additional information may be obtained. The major breast lesions that yield papillary fragments on FNA are papillary carcinoma, papilloma, fibroadenoma, and invasive ductal carcinoma that have a papillary component. We present cytomorphological features of nipple discharge and FNA of breast lump in a 32-year female.

  6. Osseous differentiation in cystosarcoma phyllodes - diagnosed by fine needle aspiration cytology

    OpenAIRE

    Krishnamurthy Jayashree

    2010-01-01

    Osseous differentiation within a phyllodes tumor is extremely rare. Cytological and histological findings of a case of malignant phyllodes tumor with osseous differentiation are presented. A 45-year-old female had a malignant phyllodes tumor with osseous stroma diagnosed by fine needle aspiration cytology. The cytological findings were representative of the histological features. The diagnosis of these tumors preoperatively is important in planning the most appropriate treatment. It is also i...

  7. DSA by means of fine-needle puncture for excluding vascular complications in haemodialysis shunts

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    Alart, I.P.; Merk, J.; Eichner, H.

    1985-06-01

    The article on hand presents the experience gained with examinations of Cimino haemodialysis shunts using digital substraction angiography (DSA). Angiographic results after arterial and venous fine-needle puncture show - particularly in arterial DSA - the advantage of excellent contrasting of the afferent arterial vessel, of the arterio-venous anastomosis and of the venous return while allowing safe diagnosis. This examination procedure is low in complications for the patient, is suitable for outpatients and has numerous advantages over transvenous shunt DSA.

  8. Bilateral recurrent auricular pseudocyst: Importance of fine-needle aspiration cytology and lactate dehydrogenase estimation

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    Kalyan Khan

    2013-01-01

    Full Text Available Auricular pseudocyst or Idiopathic cystic chondromalacia is a rare, benign condition characterized by a focal noninflammatory cystic swelling on the pinna, occurring usually in young male patients. Bilaterality and recurrence have been reported rarely. We report a case of bilateral, recurrent auricular pseudocyst in a young male patient, where fine needle aspiration cytology coupled with fluid lactate dehydrogenase level estimation was diagnostic. Repeated surgery was avoided and conservative treatment was proved to be effective.

  9. Targeted, high-depth, next-generation sequencing of cancer genes in formalin-fixed, paraffin-embedded and fine-needle aspiration tumor specimens.

    Science.gov (United States)

    Hadd, Andrew G; Houghton, Jeff; Choudhary, Ashish; Sah, Sachin; Chen, Liangjing; Marko, Adam C; Sanford, Tiffany; Buddavarapu, Kalyan; Krosting, Julie; Garmire, Lana; Wylie, Dennis; Shinde, Rupali; Beaudenon, Sylvie; Alexander, Erik K; Mambo, Elizabeth; Adai, Alex T; Latham, Gary J

    2013-03-01

    Implementation of highly sophisticated technologies, such as next-generation sequencing (NGS), into routine clinical practice requires compatibility with common tumor biopsy types, such as formalin-fixed, paraffin-embedded (FFPE) and fine-needle aspiration specimens, and validation metrics for platforms, controls, and data analysis pipelines. In this study, a two-step PCR enrichment workflow was used to assess 540 known cancer-relevant variants in 16 oncogenes for high-depth sequencing in tumor samples on either mature (Illumina GAIIx) or emerging (Ion Torrent PGM) NGS platforms. The results revealed that the background noise of variant detection was elevated approximately twofold in FFPE compared with cell line DNA. Bioinformatic algorithms were optimized to accommodate this background. Variant calls from 38 residual clinical colorectal cancer FFPE specimens and 10 thyroid fine-needle aspiration specimens were compared across multiple cancer genes, resulting in an accuracy of 96.1% (95% CI, 96.1% to 99.3%) compared with Sanger sequencing, and 99.6% (95% CI, 97.9% to 99.9%) compared with an alternative method with an analytical sensitivity of 1% mutation detection. A total of 45 of 48 samples were concordant between NGS platforms across all matched regions, with the three discordant calls each represented at <10% of reads. Consequently, NGS of targeted oncogenes in real-life tumor specimens using distinct platforms addresses unmet needs for unbiased and highly sensitive mutation detection and can accelerate both basic and clinical cancer research.

  10. Axillary ultrasound and fine-needle aspiration in preoperative staging of axillary lymph nodes in patients with invasive breast cancer*

    Science.gov (United States)

    Rocha, Rafael Dahmer; Girardi, André Ricardo; Pinto, Renata Reis; de Freitas, Viviane Aguilera Rolim

    2015-01-01

    Objective To propose an algorithm to determine the necessity for ultrasonography-guided fine-needle aspiration (US-FNA) in preoperative axillary lymph node staging of patients with invasive breast cancer. Materials and Methods Prospective study developed at National Cancer Institute. The study sample included 100 female patients with breast cancer referred for axillary staging by US-FNA. Results The overall US-FNA sensitivity was set at 79.4%. The positive predictive value was calculated to be 100%, and the negative predictive value, 69.5%. The US-FNA sensitivity for lymph nodes with normal sonographic features was 0%, while for indeterminate lymph nodes it was 80% and, for suspicious lymph nodes, 90.5%. In the assessment of invasive breast tumors stages T1, T2 and T3, the sensitivity was respectively 69.6%, 83.7% and 100%. US-FNA could avoid sentinel node biopsy in 54% of cases. Conclusion Axillary ultrasonography should be included in the preoperative staging of all patients with invasive breast cancer. The addition of US-FNA in cases of lymph nodes suspicious for malignancy may prevent more than 50% of sentinel lymphadenectomies, significantly shortening the time interval to definitive therapy. PMID:26811550

  11. The value of preoperative ultrasound guided fine-needle aspiration cytology of radiologically suspicious axillary lymph nodes in breast cancer

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    Torill Sauer

    2014-01-01

    Full Text Available Background: Preoperative ultrasound (US and eventually US-guided fine-needle aspiration cytology (FNAC of suspicious axillary lymph nodes (ALN is a standard procedure in the work-up of suspicious breast lesions. Preoperative US FNAC may prevent sentinel node biopsy (SNB procedure in 24-30% of patients with early stage breast carcinoma. The aim of this study was to evaluate the institutional results of this preoperative diagnostic procedure. Materials and Methods: A total of 182 cases of preoperative FNAC of suspicious ALN where retrieved from the pathology files. The results were compared with the final histology and staging. False negative (FN FNAC cases were reviewed and possibly missed metastatic cases (2 were immunostained with the epithelial marker AE1/AE3. Results: There were no false positives, whereas 16 cases were FN. In all but one case the FN′s represented sampling error. Half of the 16 FN cases in this series were macrometastases. Discussion: About 83% of the preoperatively aspirated cases were N+, indicating that a radiologically suspicious ALN has a very high risk of being metastatic. Preoperative US guided FNAC from radiologically suspicious ALN is highly efficient in detecting metastases. Depending on national guidelines, a preoperative, positive ALN FNAC might help to stratify the patients as to SNB and/or ALN dissection.

  12. "A fine needle aspiration cytology in time saves nine" - cutaneous phaeohyphomycosis caused by Exophiala jeanselmei in a renal transplant patient: Diagnosis by fine needle aspiration cytology

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    Prashant Joshi

    2016-01-01

    Full Text Available Infections by dematiaceous fungi are an emerging group of infectious diseases worldwide with a variety of clinical presentations. Though generally localized, they can disseminate in immunocompromised settings, therefore, early diagnosis and prompt therapy can prevent significant morbidity and mortality in these patients. Fungi of genus Exophiala are common causative organisms; however, Exophiala jeanselmei (E. jeanselmei has not yet been reported from environmental sources in India. We present here the case of a renal transplant recipient who presented with an innocuous lesion on the foot, diagnosed on fine needle aspiration cytology (FNAC as phaeohyphomycosis, and promptly treated with excision and antifungal therapy. To the best of our knowledge, this is the first case report from India of E. jeanselmei causing phaeohyphomycosis in a transplant recipient and highlights the role a cytopathologist can play in the timely management of such cases.

  13. Fine needle aspiration cytology of bone tumours- the experience from the National Orthopaedic and Lagos University Teaching Hospitals, Lagos, Nigeria

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    Nnodu Obiageli E

    2006-06-01

    Full Text Available Abstract Background Due to difficulty in confirming clinical suspicions of malignancy in patients presenting with bone tumours, the cost of surgical biopsies where hospital charges are borne almost entirely by patients, competition with bone setters and healing homes with high rate of loss to follow up; we set out to find if sufficient material could be obtained to arrive at reliable tissue diagnosis in patients with clinical and radiological evidence of bone tumours in our hospitals. Methods After initial clinical and plain radiographic examinations, patients were sent for fine needle aspirations. Aspirations were carried out with size 23G needles of varying lengths with 10 ml syringes in a syringe holder (CAMECO, Sebre Medical, Vellinge, Sweden. The aspirates were air dried, stained by the MGG method and examined microscopically. Histology was performed on patients who had subsequent surgical biopsy. These were then correlated with the cytology reports. Results Out of 96 patients evaluated, [57 males, 39 females, Mean age 31.52 years, Age Range 4–76 years,] material sufficient for diagnosis was obtained in 90 patients. Cytological diagnosis of benign lesions was made in 40 patients and malignant in 47. Of these, 27 were metastases, osteogenic sarcoma 16, giant cell tumour 19, infection 11. Histology was obtained in 41 patients. Correct diagnosis of benignity was made in 17 out of 18 cases, malignancy in 21 out of 22 cases. One non-diagnostic case was malignant. The accuracy of specific cytological diagnosis was 36/41 (87.8% and incorrect in 5/41 (12.2%. Conclusion We conclude that FNAC can be useful in the pre-operative assessment of bone tumours especially where other diagnostic modalities are unavailable.

  14. Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.

    LENUS (Irish Health Repository)

    Hayes, Brian D

    2012-02-01

    INTRODUCTION: Fine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes. METHODS: 161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. RESULTS: FNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4). CONCLUSIONS: FNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.

  15. Use of fine needle aspirate from peripheral nerves of pure-neural leprosy for cytology and PCR to confirm the diagnosis: A pilot study

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    Abu Hena Hasanoor Reja

    2013-01-01

    Full Text Available Background: The diagnosis of pure neural leprosy (PNL remained subjective because of over-dependence of clinical expertise and a lack of simple yet reliable diagnostic tool. The criteria for diagnosis, proposed by Jardim et al., are not routinely done by clinicians in developing country as it involves invasive nerve biopsy and sophisticated anti-PGL-1 detection. We conducted a study using fine needle aspiration cytology (FNAC coupled with Ziehl Neelsen staining (ZN staining and Multiplex- Polymerase Chain Reaction (PCR specific for M. leprae for an objective diagnosis of pure neural leprosy (PNL, which may be simpler and yet reliable. Aim: The aim of the study is to couple FNAC with ZN staining and multiplex PCR to diagnose pure neural leprosy patients rapidly, in simpler and yet reliable way. Methods: Thirteen patients of PNL as diagnosed by two independent consultants were included as case, and 5 patients other than PNL were taken as control in the study. Fine needle aspiration was done on the affected nerve, and aspirates were evaluated for cytology, ZN staining and multiplex- PCR. Results: Out of the 13 cases where fine needle aspiration was done, M. leprae could be elicited in the nerve tissue aspirates in 5 cases (38.4% with the help of conventional acid-fast staining and 11 cases (84.6% with the help of multiplex PCR. On cytological examination of the aspirates, only 3 (23% cases showed specific epithelioid cells, whereas 8 (61.5% cases showed non-specific inflammation, and 2 (15.3% cases had no inflammatory cells. Conclusion: Our study demonstrates that in the field of laboratory diagnosis of PNL cases, FNAC in combination with ZN staining for acid-fast bacilli (AFB and Multiplex-PCR can provide a rapid and definitive diagnosis for the majority of PNL cases. FNAC is a less-invasive, outdoor-based and simpler technique than invasive nerve biopsy procedure. Thus, this study may enlighten the future path for easy and reliable diagnosis of

  16. Clinical evaluation, imaging studies, indications for cytologic study and preprocedural requirements for duct brushing studies and pancreatic fine-needle aspiration: The Papanicolaou Society of Cytopathology Guidelines

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    Douglas Adler

    2014-01-01

    Full Text Available The Papanicolaou Society of Cytopathology has developed a set of guidelines for pancreaticobiliary cytology including indications for endoscopic ultrasound (EUS and fine-needle aspiration (FNA biopsy, techniques for EUS-FNA, terminology and nomenclature to be used for pancreaticobiliary disease, ancillary testing and postbiopsy management. All documents are based on expertise of the authors, literature review, discussions of the draft document at national and international meetings and synthesis of online comments of the draft document. This document selectively presents the results of these discussions. This document summarizes recommendations for the clinical and imaging work-up of pancreatic and biliary tract lesions along with indications for cytologic study of these lesions. Prebrushing and FNA requirements are also discussed.

  17. Primary lymphoma of the liver. Report of a case with diagnosis by fine needle aspiration.

    Science.gov (United States)

    Netto, D; Spielberger, R; Awasthi, S; Balaban, E P; Nowak, J A; Demian, S D

    1993-01-01

    In a 69-year-old man with hepatomegaly, a diagnosis of primary non-Hodgkin's lymphoma (NHL) of the liver was made by fine needle aspiration (FNA). At the time of presentation there was no evidence of involvement of the lymph nodes, bone marrow or any other organ. Although hepatic involvement is common in advanced stages of Hodgkin's disease and NHL, primary lymphoma of the liver is rare. The purpose of this paper is to report a rare occurrence of primary lymphoma of the liver and to demonstrate the possibility of making this diagnosis by FNA.

  18. ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC IN DIAGNOSIS OF ASYMPTOMATIC MICROFILARIASIS

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    Reena

    2015-05-01

    Full Text Available Filariasis is a tropical and subtropical disease caused by Wuchereria Bancrofti and Brugia Malayi and transmitted by Culex mosquito. Lymphatic Filariasis is a major health problem in countries like India, China, Indonesia, and Africa. Diagnosis of Filari a is done by conventional methods like peripheral blood smear examination, Fluorescent capillary method and filarial antigen detection by Rapid card method. Here we present four unusual cases with swellings presented in surgical outdoor and referred for FN AC. Our aim is to evaluate and emphasize the utility and importance of Fine Needle Aspiration in diagnosing Microfilarasis in clinically unsuspected cases.

  19. Leiomyosarcoma metastatic to the thyroid diagnosed by fine needle aspiration cytology.

    Science.gov (United States)

    Nemenqani, Dalal; Yaqoob, Nausheen; Khoja, Hatem

    2010-04-01

    The thyroid gland is a known but an unusual site for metastatic tumours from various primary sites. Primary smooth muscle tumours of thyroid are rare. Leiomyosarcoma of the thyroid gland whether of primary or metastatic origin should be distinguished from anaplastic carcinoma. Few cases of leiomyosarcoma metastatic to thyroid, diagnosed by fine needle aspiration cytology (FNAC) have been documented. We are reporting this case to highlight the importance of FNAC as a tool for diagnosing sarcomas and to plan further management accordingly. Ancillary techniques can be applied on FNAC and give comparative results to tissue sections.

  20. Fine needle aspiration diagnosis of bilateral dysgerminoma with syncytiotrophoblastic giant cells

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    Chakrabarti Indranil

    2009-01-01

    Full Text Available Dysgerminoma accounts for only 1-3% of ovarian cancers and about 30-40% of all ovarian germ cell malignant tumors. Literature states that about 2% of nonpregnant patients with dysgerminomas present with elevated serum or urine levels of human chorionic gonadotropin (hCG. Here, we report a 34 year-old multiparous woman presenting with an abdominal lump, ascites, and abdominal pain with elevated urinary and serum hCG levels. An abdominal ultrasound showed bilateral ovarian mass. An ultrasound-guided, transabdominal fine needle aspiration revealed dysgerminoma with syncytiotrophoblastic giant cells. Bilateral oophorectomy was done and the diagnosis was confirmed on histopathology.

  1. Paraganglioma with unusual presentation in parotid gland: A diagnostic dilemma in fine needle aspiration

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    Anagh A Vora

    2012-01-01

    Full Text Available Paragangliomas (PGLs are uncommon tumors. Although PGLs are known to occur in the head and neck region, especially the carotid body, middle ear, and larynx, involvement of the parotid glands has not been reported. In this article, we report the fine needle aspiration features of tumor in an unusual location, presenting as a parotid gland mass, submitted to pathology for initial diagnosis. The clinical presentation, cytomorphology, and the immunohistochemical features for the diagnosis are described. To our knowledge, this is the first case of paraganglioma of the parotid gland reported in the literature.

  2. Fine needle aspiration diagnosis of cryptococcal lymphadenitis: A window of opportunity

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    Suchitha S

    2008-01-01

    Full Text Available Cryptococcal meningitis is the most common, life-threatening, opportunistic, fungal disease in human immunodeficiency virus (HIV-infected individuals. An expeditious diagnosis is of utmost importance because once a cryptococcal infection disseminates, it becomes life-threatening. Pulmonary, intestinal, bone marrow, and retinal involvement have been described. There are very few reports, however, of lymphadenopathy along with cryptococcal meningitis. We report here a case of cryptococcal meningitis with lymphadenitis, which was diagnosed by fine needle aspiration cytology of the involved lymph nodes.

  3. Osseous differentiation in cystosarcoma phyllodes - diagnosed by fine needle aspiration cytology

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    Krishnamurthy Jayashree

    2010-01-01

    Full Text Available Osseous differentiation within a phyllodes tumor is extremely rare. Cytological and histological findings of a case of malignant phyllodes tumor with osseous differentiation are presented. A 45-year-old female had a malignant phyllodes tumor with osseous stroma diagnosed by fine needle aspiration cytology. The cytological findings were representative of the histological features. The diagnosis of these tumors preoperatively is important in planning the most appropriate treatment. It is also important to follow up these patients postoperatively for long periods for recurrence and metastasis.

  4. Fine Needle Aspiration Cytology of Breast Lesions:Analysis of 323 Cases

    Institute of Scientific and Technical Information of China (English)

    ZHANGQin; NIEShigui; CHENYuhua; ZHOULimei

    2004-01-01

    To compare the fine needle aspiration cytology (FNAC) diagnostic accuracy of breast lesions with that of histopathology. Methods: The FNAC results of 323 cases of breast lesions were analyzed and compared with those of histological diagnosis. Results: In this group, the FNAC sensitivity, specificity, false-positive rate, false-negative rate and the rate of diagnostic coincidence was 97.1%, 97.3%, 2.7%, 2.9% and 97.2%, respectively. Conclusion: FNAC was a useful method with high value for breast lesions.

  5. Fine-needle aspiration diagnosis of extranodal non-Hodgkin′s lymphoma of the tongue

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    Srinivasa Murthy

    2011-01-01

    Full Text Available Primary non-Hodgkin′s lymphoma (NHL of the oral region is rare. Oral manifestation is present in 3-5% of cases of NHL and oral lesions are rarely the initial manifestations. We describe primary NHL, diffuse, mixed, small and large cell type in a 50-year-old female, who presented with mass lesion primarily involving the base of the tongue; initially diagnosed by fine needle aspiration cytology and later confirmed by histopathology and immunohistochemistry. Pertinent literature is being reviewed.

  6. Testicular fine-needle aspiration for the assessment of intratesticular hormone concentrations

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    Ada P Lee

    2016-01-01

    Full Text Available Measurement of intratesticular sex steroid concentrations in men informs both the development of male hormonal contraceptives and the understanding of male infertility. Given the challenges of using invasive techniques to measure testicular hormone physiology, our group has used a minimally-invasive fine-needle aspiration technique to measure intratesticular hormones in normal healthy men. Herein, we present a post-hoc analysis of the safety and efficacy of testicular fine-needle aspiration (FNA completed as part of six clinical trials. From 2001 through 2011, a total of 404 procedures were conducted among 163 research volunteers, 85.9% of which were successful in obtaining sufficient fluid for the measurement of intratesticular steroid concentrations. Pain was the most common side effect, with 36.8% of procedures associated with moderate procedural pain and 4.7% with severe procedural pain. Postprocedural pain was uncommon and abated within a few days. Mild local bruising occurred with 14.9% of procedures. Two serious adverse events (0.5% required surgical intervention. The risk of an adverse event was not associated with age, body mass index, testicular size, or the volume of fluid aspirated. Testicular FNA to obtain fluid for measurement of intratesticular steroid concentrations frequently causes mild to moderate procedural pain, but serious adverse events occur rarely. Testicular FNA has been instrumental for defining human intratesticular hormone physiology and is a minimally-invasive, safe, effective method for obtaining fluid for research on testicular physiology and pathology.

  7. Role of AgNORs in thyroid lesions on fine needle aspiration cytology smears

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    Asotra Sarita

    2008-01-01

    Full Text Available Background: Fine needle aspiration has an important role in diagnosis of thyroid neoplasm. However, it is difficult to differentiate between follicular adenoma and follicular carcinoma by cytology alone. Recently, silver staining has been performed for nucleolar organizer regions (AgNORs to differentiate various tumors. Aims: The present study was undertaken to see if the AgNOR technique could distinguish between benign and malignant lesions, particularly, follicular neoplasm. Materials and Methods: One hundred forty cases of thyroid lesions were examined, which included colloid goiter (n = 36, multinodular goiter (n = 38, subacute thyroiditis (n = 6, Hashimoto′s thyroiditis (n = 17, lymphocytic thyroiditis (n = 3, follicular neoplasm (n = 18, Hurthle cell neoplasm (n = 3, papillary carcinoma (n = 16, and medullary carcinoma (n = 3. Diagnosis was confirmed by histopathology in 80 cases. The usual one-step silver colloidal reaction was performed at room temperature for 35 minutes and intranuclear dots of silver deposits were counted in 100 cells. Results: AgNOR counts of benign and malignant lesions were compared and were found to be statistically significant (P < 0.001. The mean AgNOR counts were higher in neoplastic lesions. Conclusions: AgNOR counting in fine needle aspiration smears is a simple, sensitive, and cost-effective method for differentiating benign from malignant thyroid follicular neoplasms.

  8. Amylase Crystalloids on Fine-Needle Aspiration of the Salivary Gland

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    İrem PAKER

    2010-05-01

    Full Text Available Amylase crystalloids is one of the several types of crystalline structures that can be seen in non-neoplastic and neoplastic salivary gland lesions. Here, a 60-year-old woman with an infraauricular mass existing for two years is presented.On ultrasound a cystic mass, 1 cm in diameter was detected in the tail of right parotid gland. Clear and mucoid fluid was obtained from the mass by fine-needle aspiration. Smears showed numerous rhomboid, rectangular or rod-shaped, non-birefringent crystalloid structures and a few acinar cell groups in a mucoid background rich in polymorphonuclear leucocytes and lymphoctes. It was reported as cystic sialadenitis with amylase crystalloids. In the four-month follow-up, there was no recurrence of the mass.Since encountered only in benign salivary gland lesions in the literature as in our case, observation of amylase crystalloids on fine-needle aspiration smears indicates a benign lesion and avoids unnecessary surgery.

  9. Accuracy of ultrasound-guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter

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    Saif Al-Yaarubi

    2011-01-01

    Full Text Available Background: Fine-needle aspiration (FNA is a useful method for evaluating multinodular goiter; however, its role is still controversial. The aim of this study was to assess the utility of ultrasound-guided thyroid FNA in detecting malignancy in patients with multinodular goiter in Oman. Materials and Methods: This was a retrospective study where all patients with multinodular goiter seen at the Sultan Qaboos University Hospital endocrinology clinic in Oman in 2005 were evaluated. The thyroid FNA results were grouped into either malignancy (positive result or others (negative result. They were compared to those of final histopathological examination in order to calculate the value of the test in diagnosing malignancy. Analyses were evaluated using descriptive statistics. Results: A total of 272 patients were included in the study. The mean age was 39΁13 years with an age range from 5 to 85 years. The majority of the patients were females (n=236; 87%. The results of thyroid FNA revealed that 6% (n=15 of the patients had malignancies while histopathological results showed that the proportion of subjects with malignancies was 18% (n=49. Out of the 15 cases identified to have malignances by thyroid FNA, only 53% (n=8 of the subjects were confirmed to have malignancy by biopsy. Overall, the results of the tests were poor, revealing a sensitivity of 16%, specificity of 97% and a diagnostic accuracy of 82%, with a positive predictive value of 53% and a negative predictive value of 84%. Conclusion: Thyroid FNA is not a useful test in differentiating multinodular goiter from malignancy, as more than 80% of the malignancies go unnoticed.

  10. Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?

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    Do Hoon Koo

    2016-01-01

    Full Text Available Background. Fine-needle aspiration cytology (FNAC is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy. Methods. All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system were compared to pathological diagnosis. The nodules were categorized into groups A–E on the basis of maximal diameter on ultrasound (≤0.5, >0.5–1, >1-2, >2–4, and >4 cm, resp.. Results. There were 502 cases with 690 nodules. Overall FNAC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.4%, 98.2%, 99.4%, 86.4%, and 96.0%, respectively. False-negative rates (FNRs of groups A–E were 3.2%, 5.1%, 1.3%, 13.3%, and 50%, respectively. Accuracy rates of groups A–E were 96.8%, 94.8%, 99%, 94.7%, and 87.5%, respectively. Conclusion. Although accuracy rates of FNAC in thyroid nodules smaller than 0.5 cm are comparable to the other group, thyroid nodules larger than 4 cm with benign cytology carry a higher risk of malignancy, which suggest that those should be considered for intensive follow-up or repeated biopsy.

  11. Fine-needle aspiration diagnosis of primary hydatid disease of the thyroid; first reported case in the USA.

    Science.gov (United States)

    Dissanayake, Pavithra Irushi; Chennuri, Rohini; Tarjan, Gabor

    2016-04-01

    Echinococcosis or hydatid disease (HD) is a parasitic disease caused by species of the Echinococcus genus. Since the incidence of HD in the USA is very low and the primary HD of the thyroid is extremely rare even in endemic regions, the occurrence of primary thyroid HD is exceptional in the USA. Thyroid HD is rarely diagnosed by fine-needle aspiration (FNA). Our literature review revealed less than ten cases of primary HD of thyroid diagnosed by FNA worldwide. Hereby, we report the first case of a primary thyroid HD diagnosed by fine-needle aspiration in the USA.

  12. Segmentation of ultrasound images of thyroid nodule for assisting fine needle aspiration cytology.

    Science.gov (United States)

    Zhao, Jie; Zheng, Wei; Zhang, Li; Tian, Hua

    2013-01-01

    The incidence of thyroid nodule is very high and generally increases with the age. Thyroid nodule may presage the emergence of thyroid cancer. Most thyroid nodules are asymptomatic which makes thyroid cancer different from other cancers. The thyroid nodule can be completely cured if detected early. Therefore, it is necessary to correctly classify the thyroid nodule to be benign or malignant. Fine needle aspiration cytology is a recognized early diagnosis method of thyroid nodule. There are still some limitations in the fine needle aspiration cytology, such as the difficulty in location and the insufficient cytology specimen. The accuracy of ultrasound diagnosis of thyroid nodule improves constantly, and it has become the first choice for auxiliary examination of thyroid nodular disease. If we could combine medical imaging technology and fine needle aspiration cytology, the diagnostic rate of thyroid nodule would be improved significantly. The properties of ultrasound, such as echo, shadow, and reflection, will degrade the image quality, which makes it difficult to recognize the edges for physicians. Image segmentation technique based on graph theory has become a research hotspot at present. Normalized cut (Ncut) is a representative one, whose biggest advantage is not prone to small region segmentation but suitable for segmentation of feature parts of medical image. However, how to solve the normalized cut has become a problem, which needs large memory capacity and heavy calculation of weight matrix. It always generates over segmentation or less segmentation which leads to inaccurate in the segmentation. The speckle noise produced in the formation process of B ultrasound image of thyroid tumor makes the quality of the image deteriorate. In the light of this characteristic, we combine the anisotropic diffusion model with the normalized cut in this paper. After the enhancement of anisotropic diffusion model, it removes the noise in the B ultrasound image while

  13. [Endoscopic ultrasound-guided fine-needle aspiration in pulmonary medicine].

    Science.gov (United States)

    Claussen, M; Annema, J T; Welker, L; Rabe, K F

    2004-06-01

    Endoscopic ultrasound-guided fine-needle aspiration has significantly increased the capacity of pulmonary diagnostic procedures. Since this method was introduced, 1212 examinations have been performed at two centres of pulmonary medicine. Data on indications, procedures, findings, diagnostic yield and complications have been recorded. This paper describes the experiences thus gained regarding the possibilities and limitations of the method and assesses the current significance of the technique in pulmonary medicine according to previous studies. In primary diagnosis of mediastinal tissue alterations and in staging of malignant diseases the method offers a low-complication diagnostic measure which has a seminal impact on therapy in many cases, even though in daily practise the diagnostic accuracy of published studies is not always attained.

  14. Hypercalcemic crisis due to a mediastinal parathyroid cyst diagnosed by ultrasound-guided fine needle aspiration

    Institute of Scientific and Technical Information of China (English)

    ZHU Yan; MENG Yun-xiao; LI Nai-shi; LU Lin; CHEN Shi; XING Xiao-ping; MENG Xun-wu; GUAN Heng; TAN Li; LU Ke

    2010-01-01

    @@ Hypercalcemic crisis, generally accepted as serum calcium concentration greater than 3.5 mmol/L,constitues a life-threatening endocrinologic emergency,and is most frequently caused by either primary hyperparathyroidism (PHPT) or malignant diseases.Parathyroid cysts are uncommon lesions, most of that are located in the low part of the neck. By routine neck ultrasound scan investigation in a large series of 6621 patients, only 5 parathyroid cysts were detected, yielding a prevalence of 0.075% in setting of unselected patients.The parathyroid cysts in the mediastinum are much less frequently encountered, with only 106 cases reported in English literature.2,3 Moreover, less than half of these cases presented as functional with elevated serum calcium and parathyroid hormone, and only 10 cases were associated with hypercalcemic crisis.3 Herein, we present a rare case of mediastinal parathyroid cyst associated with recurrent hypercalcemic crisis, which diagnosed by ultrasound-guided fine needle aspiration (FNA).

  15. Fine needle aspiration cytology of primary thyroid lymphoma: a report of ten cases

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    Gupta Nalini

    2005-12-01

    Full Text Available Abstract Primary lymphoma is an uncommon malignancy of the thyroid, comprising of 0.6 to 5 per cent of thyroid cancers in most series. Primary thyroid lymphomas (PTL occur most commonly in elderly women and are commonly of B- cell origin. These frequently present in clinical stage IE and IIE. We report here ten cases of PTL diagnosed over a period of about 7 years in our institute. Out of these ten cases, nine were diagnosed on fine needle aspiration cytology (FNAC and one case was misdiagnosed as lymphocytic thyroiditis. This case was diagnosed as Non- Hodgkin's lymphoma on surgical specimen. Five patients are disease free and doing well, while two died of disease and the other two were lost to follow-up. One patient is currently on chemotherapy. The salient clinical, biochemical, radiological features, FNA findings along with diagnostic difficulties are discussed.

  16. Fine-needle aspiration cytology of granular cell tumor: A report of two cases

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    Pampa Ch. Toi

    2013-01-01

    Full Text Available Granular cell tumors (GCTs are uncommon soft tissue tumors, which are difficult to diagnose merely on clinical examination. Being an effective first-line investigation, the fine-needle aspiration cytology (FNAC plays a significant role in its pre-operative recognition. However, as the tumor is likely to mimic certain other lesions, a cytopathologist needs to be aware of its characteristic cytomorphology. We report two cases of GCT who presented with subcutaneous swellings in the left lower back and the right-sided anterior abdominal wall for 6 and 2 months, respectively. Both the patients had a clinical diagnosis of lipoma/neurofibroma. FNAC was done in both. In the first case a cytodiagnosis of xanthogranuloma was suggested and GCT in the second. Subsequent histologic examination of both showed features of GCT. FNAC would aid in presumptive diagnosis of GCT.

  17. Fine-needle aspiration cytology of granular cell tumor: A report of two cases.

    Science.gov (United States)

    Toi, Pampa Ch; Siddaraju, Neelaiah; Basu, Debdatta

    2013-07-01

    Granular cell tumors (GCTs) are uncommon soft tissue tumors, which are difficult to diagnose merely on clinical examination. Being an effective first-line investigation, the fine-needle aspiration cytology (FNAC) plays a significant role in its pre-operative recognition. However, as the tumor is likely to mimic certain other lesions, a cytopathologist needs to be aware of its characteristic cytomorphology. We report two cases of GCT who presented with subcutaneous swellings in the left lower back and the right-sided anterior abdominal wall for 6 and 2 months, respectively. Both the patients had a clinical diagnosis of lipoma/neurofibroma. FNAC was done in both. In the first case a cytodiagnosis of xanthogranuloma was suggested and GCT in the second. Subsequent histologic examination of both showed features of GCT. FNAC would aid in presumptive diagnosis of GCT.

  18. Diagnostic problems in fine needle aspiration cytology of fat necrosis within a subcutaneous lipoma

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    Kavishwar Vikas

    2008-01-01

    Full Text Available Fat necrosis in subcutaneous lipomas is very unusual and has been reported only occasionally. Literature regarding fine needle aspiration cytology of such a lesion is lacking although fat necrosis is well described in the breast. We came across a case of a large subcutaneous lipoma in the anterior abdominal wall with a well encapsulated area of fat necrosis. The aspiration smears showed an unusual picture which was misinterpreted as the fragments of the hydatid cyst wall. They were actually enlarged, nonnucleate, single adipocytes showing laminations, along with calcification and paucity of inflammation. Histopathology confirmed the diagnosis of fat necrosis within the lipoma. Such lesions can be mistaken on radiology for malignancy.

  19. Fine-needle aspiration cytology of myoepithelial carcinoma of salivary gland: Diagnostic challenge to cytopathologist

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    Shelly Sehgal

    2013-01-01

    Full Text Available Myoepithelial carcinoma (MC is rare malignant salivary gland neoplasm and its cytologic features have been rarely described in the literature. Furthermore, MC shows varied cell types and patterns leading to the wide range of differential diagnosis on cytology. Histopathology and immunohistochemistry (IHC are necessary to make a definite diagnosis. A 37-year-old female presented with painless, progressive swelling in the infra-auricular region since 2 years. Fine-needle aspiration cytology was performed and cytological possibilities of cellular pleomorphic adenoma and myoepithelial cell neoplasm were rendered and patient was advised excision and histopathologic examination for final diagnosis and subtyping. Final diagnosis of MC was made on hematoxylin and eosin sections and IHC. MC is rare malignant salivary gland tumor showing a clinic-pathologic diversity. The cytological features of MC are diverse and may lack overt feature of malignancy. Pathologists should be aware of this entity while evaluating cytological smears of salivary gland mass.

  20. Evaluation of pancreatic tissue fluid pressure measurements intraoperatively and by sonographically guided fine-needle puncture

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Bülow, J;

    1990-01-01

    pressure measurements via direct puncture. Furthermore, no significant difference was seen between pancreatic duct and tissue fluid pressure. The technical evaluation was performed by repeated pressure measurements in human pancreatic autopsy specimens and living rats in a pressure chamber at various...... external pressure levels. The basic calibration of the method evaluated by means of this pressure chamber study showed sufficient precision and accuracy of the needle technique for clinical and investigative purposes. In conclusion, our results suggest that pancreatic tissue fluid pressure can be reliably......The aim of the present study was to evaluate the needle method for pancreatic tissue fluid pressure measurements. Clinical evaluation was performed in 24 patients with chronic pancreatitis, comparing repeated pressure measurements via sonographically guided fine-needle puncture and intraoperative...

  1. Pituitary carcinoma diagnosed on fine needle aspiration: Report of a case and review of pathogenesis

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    Yakoushina Tatiana

    2010-01-01

    Full Text Available Pituitary carcinoma (PC is a very rare entity (0.2% of all pituitary tumors, with only about 140 cases reported in English literature. There are no reliable histological, immunohistochemical or ultrastructural features distinguishing pituitary adenoma (PA from PC. By definition, a diagnosis of PC is made after a patient with PA develops non-contiguous central nervous system (CNS or systemic metastases. To date, only three cases of PC have been reportedly diagnosed on fine needle aspiration (FNA. Two of the reported cases were diagnosed on FNA of the cervical lymph nodes and one on FNA of the vertebral bone lesion. Herein, we present a case of PC, diagnosed on FNA of the liver lesion. In this case, we describe cytologic features of PC and compare them to histologic features of the tumor in the pituitary. Clinical behavior of tumor, pathogenesis of metastasis and immunochemical and prognostic markers will also be described.

  2. Fine needle aspiration cytology in the diagnosis of cysticer-cosis cases

    Institute of Scientific and Technical Information of China (English)

    Anshu Agarwal; OPMurty; Meenakshi Jain

    2009-01-01

    Objective:To document the value of Fine Needle Aspiration Cytology (FNAC)in the diagnosis of cysticerco-sis.Methods:Aspirates smears of 102 cases of cysticercosis from different sites like extremities,head,neck, forearm,arm,chest wall and abdominal wall were studied in the Department of Pathology,BPKIHS,Dharan, Nepal.Results:In 7 cases (9.73%)lingual cysticercosis was diagnosed.Involvement of breast was seen in 4 cases (5.56%)which is a rare presentation.On cytomorphological examination,parts of cysticercus cellu-lose were seen in (97.22%)cases.Conclusion:The characteristic cytomorphological features of parasitic tegument,parenchymatous portion,presence of giant cells and inflammatory cells in cytological smears help di-agnose the cases of cysticercosis.FNAC provides safe and rapid tool for diagnosis of cysticercosis.In endemic areas,cysticercosis should be considered one of the differential diagnosis of the swellings.

  3. Fine Needle Aspiration Cytology Evaluation for Classifying Breast Cancer Using Artificial Neural Network

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    Nor A.M.   Isa

    2007-01-01

    Full Text Available Thirteen cytology of fine needle aspiration image (i.e. cellularity, background information, cohesiveness, significant stromal component, clump thickness, nuclear membrane, bare nuclei, normal nuclei, mitosis, nucleus stain, uniformity of cell, fragility and number of cells in cluster are evaluated their possibility to be used as input data for artificial neural network in order to classify the breast pre-cancerous cases into four stages, namely malignant, fibroadenoma, fibrocystic disease, and other benign diseases. A total of 1300 reported breast pre-cancerous cases which was collected from Penang General Hospital and Hospital Universiti Sains Malaysia, Kelantan, Malaysia was used to train and test the artificial neural networks. The diagnosis system which was developed using the Hybrid Multilayered Perceptron and trained using Modified Recursive Prediction Error produced excellent diagnosis performance with 100% accuracy, 100% sensitivity and 100% specificity.

  4. Evaluation of pancreatic tissue fluid pressure measurements intraoperatively and by sonographically guided fine-needle puncture

    DEFF Research Database (Denmark)

    Ebbehøj, N; Borly, L; Bülow, J;

    1990-01-01

    The aim of the present study was to evaluate the needle method for pancreatic tissue fluid pressure measurements. Clinical evaluation was performed in 24 patients with chronic pancreatitis, comparing repeated pressure measurements via sonographically guided fine-needle puncture and intraoperative...... pressure measurements by direct puncture of pancreatic tissue and duct. In patients with chronic pancreatitis we found small week-to-week variations in sonographically guided percutaneous pressure measurements and good agreement between preoperative percutaneous pressure measurements and intraoperative...... external pressure levels. The basic calibration of the method evaluated by means of this pressure chamber study showed sufficient precision and accuracy of the needle technique for clinical and investigative purposes. In conclusion, our results suggest that pancreatic tissue fluid pressure can be reliably...

  5. Huge pelvic parachordoma: fine needle aspiration cytology and histological differential diagnosis

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    Mona A. Kandil

    2012-10-01

    Full Text Available Parachordoma is an extremely rare soft tissue tumor of unknown lineage. Parachordoma develops most often on the extremities. Only 2 cases have been reported as pelvic parachordoma. A 46-year old Egyptian woman with a huge painful pelvic mass was found to have a parachordoma with ectopic pelvic right kidney. There is only one report in the literature of fine needle aspiration cytology in this setting. The microscopic picture of parachordoma is not new to pathologists but the gross picture of this rare tumor has not previously been published; not even in the World Health Organization classification of soft tissues tumors. Diagnosis was confirmed by immuno-histochemistry. The patient is in good clinical condition without any evidence of recurrence or metastasis after 84 months of follow up.

  6. Silicone lymphadenopathy: presentation of a further case containing asteroid bodies on fine-needle cytology sample.

    Science.gov (United States)

    Malzone, Maria Gabriella; Campanile, Anna Cipolletta; Gioioso, Antonella; Fucito, Alfredo; D'Aiuto, Giuseppe; Botti, Gerardo; Fulciniti, Franco

    2015-01-01

    Silicone lymphadenopathy is a recognized complication of breast augmentation. It is thought to occur when silicone droplets migrate from breast implants to lymph nodes. We report the cytologic findings in axillary and inguinal lymph node aspirate smears from a 35-year-old Italian woman, who came to our observation 10 years after bilateral cosmetic breast augmentation. A fine-needle cytology of the axillary lymph node showed extensive granulomatous inflammation, numerous histiocytes, and multinucleated giant cells containing star-shaped structures known as "asteroid bodies." The inguinal lymph node aspirate simply showed an aspecific reactive hyperplasia. No evidence of malignancy was present in any of the smears as well as in the excised axillary lymph node.

  7. Fine needle aspiration cytology of chondroblastoma: A report of two cases with brief review of pitfalls.

    Science.gov (United States)

    Krishnappa, Amita; Shobha, S N; Shankar, S Vijay; Aradhya, Sushma

    2016-01-01

    Chondroblastoma is a rare, giant cell-rich, benign neoplasm of bone. Since the past few decades fine needle aspiration cytology (FNAC) has gained momentum in preoperative diagnosis of bone lesions. At cytology, other giant cell-rich tumors and tumorlike lesions such as aneurysmal bone cyst (ABC), giant cell tumor, and chondromyxoid fibroma fall under the differential diagnosis of chondroblastoma. Due to the difference in the treatment protocol and prognosis, preoperative diagnosis is mandatory. We describe the cytomorphology in two cases of chondroblastoma diagnosed at FNAC and confirmed by histopathology. At cytology, the presence of giant cells, chondroid matrix, mononuclear cells with nuclear indentation, and grooving along with glassy, vacuolated cytoplasm are characteristic of chondroblastoma. In addition to this, the presence of chicken wire calcification is a useful clue to the accurate diagnosis of chondroblastoma at FNAC.

  8. Fine needle aspiration cytology of chondroblastoma: A report of two cases with brief review of pitfalls

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    Amita Krishnappa

    2016-01-01

    Full Text Available Chondroblastoma is a rare, giant cell-rich, benign neoplasm of bone. Since the past few decades fine needle aspiration cytology (FNAC has gained momentum in preoperative diagnosis of bone lesions. At cytology, other giant cell-rich tumors and tumorlike lesions such as aneurysmal bone cyst (ABC, giant cell tumor, and chondromyxoid fibroma fall under the differential diagnosis of chondroblastoma. Due to the difference in the treatment protocol and prognosis, preoperative diagnosis is mandatory. We describe the cytomorphology in two cases of chondroblastoma diagnosed at FNAC and confirmed by histopathology. At cytology, the presence of giant cells, chondroid matrix, mononuclear cells with nuclear indentation, and grooving along with glassy, vacuolated cytoplasm are characteristic of chondroblastoma. In addition to this, the presence of chicken wire calcification is a useful clue to the accurate diagnosis of chondroblastoma at FNAC.

  9. Diagnosis of metastatic fibrolamellar hepatocellular carcinoma by endoscopic ultrasound-guided fine needle aspiration

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    Amanda Crowe

    2011-01-01

    Full Text Available The fibrolamellar variant of hepatocellular carcinoma (FL-HCC is distinguished from other hepatocellular carcinomas (HCC by its unique clinical and pathologic features. Cytological features for this tumor on fine needle aspiration (FNA of primary tumors have been described earlier. We present here a unique case of metastatic FL-HCC diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA of mediastinal adenopathy. A 32-year-old woman with a history of oral contraceptive use presented with nausea and severe abdominal pain but no ascites or stigmata of cirrhosis. She had a past history of resection of a liver lesion. Serial computed tomography scans revealed mediastinal lymphadenopathy and the patient was referred for endoscopic ultrasound (EUS. A transesophageal EUS-FNA was performed and tissue was collected for cytological evaluation by an on-site pathologist with no knowledge of prior history. Based on morphology correlated with prior history received later, a final diagnosis of metastatic FL-HCC in the retrocardiac lymph node was rendered on the EUS-FNA samples. There are very few reports in the literature where a diagnosis of FL-HCC is rendered at unusual sites. This case highlights that EUS-FNA is a relatively non-invasive, rapid, accurate and effective modality in obtaining tissue from otherwise hard-to-reach areas. It also suggests that metastasis of FL-HCC can be observed in mediastinal nodes and that diagnosis based on cytological features can be rendered even when the tumor is identified at unusual locations.

  10. Sensory cutaneous nerve fine-needle aspiration in Hansen′s disease: A retrospective analysis of our experience

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    Dev Prasoon

    2015-01-01

    Conclusion: Sensory cutaneous nerve fine-needle aspiration (FNA is a feasible, viable, effective, and safe procedure. It adds to diagnostic FNA yield in patients with concomitant skin involvement and offers a way to evaluate patients with only nerve involvement. Calculation of morphological index allows prognostication and may have a role in assessing response to therapy and/or relapse.

  11. Selective fine needle aspiration of parotid masses. FNA should be performed in all patients older than 60 years.

    LENUS (Irish Health Repository)

    Kieran, S M

    2012-02-01

    OBJECTIVES: The exact role of fine needle aspiration in the pre-operative assessment of patients presenting with parotid masses is controversial. Some surgeons propose that fine needle aspiration be performed only selectively in those patients with likely malignant disease, whilst others recommend it for all patients presenting with such a mass. Intuitively, one would expect older patients to be more likely to suffer from primary malignant parotid tumours and secondary deposits of malignant skin tumours. Therefore, we hypothesised that older patients with a parotid mass should undergo fine needle aspiration regardless of their medical history. DESIGN: We retrospectively reviewed 197 consecutive parotidectomies to test this hypothesis. RESULTS: One hundred and twenty-one patients (61.4 per cent) were diagnosed with benign disease, whilst 76 (38.6 per cent) were diagnosed with malignant disease. Eighty-three per cent of patients aged 60 years or younger had benign disease, as opposed to 35.6 per cent of patients aged more than 60 years. Malignant disease occurred more commonly in patients older than 60 years (odds ratio 8.962, 95 per cent confidence interval 4.607-17.434). CONCLUSION: In patients with a parotid mass, fine needle aspiration should be performed on all those aged 60 years or older.

  12. Aspergillus thyroiditis: first antemortem case diagnosed by fine-needle aspiration culture in a pediatric stem cell transplant patient.

    Science.gov (United States)

    Badawy, S M; Becktell, K D; Muller, W J; Schneiderman, J

    2015-12-01

    Aspergillus thyroiditis (AT) has historically been considered a postmortem diagnosis in immunocompromised patients; most have disseminated disease. This report summarizes the clinical challenge of diagnosing AT. It also highlights the value of the early use of thyroid fine-needle aspiration culture and the need for a high index of suspicion to reach the final diagnosis before disease dissemination.

  13. Diagnosis of Parathyroid Adenoma Detected during Thyroid Ultrasound: The Role of Parathormone Measurement in Fine-Needle Aspiration Washout

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    Ahn, Sung Soo; Kim, Eun Kyung; Kwak, Jin Young; Kim, Min Jung [Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2009-03-15

    With the widespread use of thyroid ultrasound, the detection rate of parathyroid incidentalomas as well as thyroid nodules has been on the increase. The differentiation between thyroid nodules and parathyroid nodules is occasionally difficult due to considerable overlap in terms of the sonographic findings. A case of parathyroid adenoma diagnosed with a measured parathyroid hormone level after fine needle aspiration washout is presented

  14. Fine-needle aspiration cytology as a diagnostic modality for cysticercosis: A clinicocytological study of 137 cases

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    Pooja Kala

    2014-01-01

    Conclusion: Fine-needle aspiration cytology in cysticercosis is a low-cost outpatient procedure. The cytological diagnosis is quite straightforward in cases where the actual parasite structures are identified in the smears. In other cases, a cytological diagnosis of suspicious of cysticercosis can be given if the cytological findings suggest the same.

  15. Endoscopic Ultrasound Fine-Needle Aspiration Characteristics of Primary Adenocarcinoma versus Other Malignant Neoplasms of The Pancreas

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    Veronika Gagovic

    2012-01-01

    Full Text Available BACKGROUND: Endoscopic ultrasound (EUS with fine-needle aspiration (FNA is often used to assist in the evaluation of pancreatic lesions and may help to diagnose benign versus malignant neoplasms. However, there is a paucity of literature regarding comparative EUS characteristics of various malignant pancreatic neoplasms (primary and metastatic.

  16. Pre-analytic steps for molecular testing on thyroid fine-needle aspirations: The goal of good results

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    Esther Diana Rossi

    2013-01-01

    Full Text Available Fine-needle aspiration cytology (FNAC represents a valid alternative to biopsy in a variety of clinical settings mainly based on its simplicity and less invasive clinical approach. In some cases, morphology evaluation alone is not sufficient to manage the patients, so that the application of ancillary techniques can contribute to diagnosis, prognosis and prediction of tumor behavior. These techniques include polymerase chain reaction (PCR, fluorescence in situ hybridization (FISH, in situ PCR, direct Sequencing, microarrays and proteomic methodologies. Although several recent experiences underline the superior value of deoxyribonucleic acid (DNA quality mainly for advanced genomic high throughput platforms, very scant literature studied the role of the pre-analytical or analytical phases. Despite the high specificity of molecular techniques as a support for diagnosis, there is a need for an increased standardization of pre-analytical/analytical steps such as providing appropriate clinical history, proper collection of laboratory specimens and proper preparation of samples, adequate fixative/reagent concentrations and technical equipments. All these requirements are crucial according to the results from 42 American laboratories, which reported 0.33% of significant molecular errors with 60% of them in the pre-analytical phase. The most common error is to forget that cytological preparation requires specific molecular variables, which are different from histological specimens. Cytological samples offer the advantage of a well preserved DNA, readily extractable and reasonably stable (from 6 months to 5 years avoiding pitfalls due to formalin-fixation. Freshly prepared, unstained direct, alcohol-fixed papanicolaou, air-dried diff-quick smears are all suitable for DNA extraction and preservation. In the specific field of thyroid FNAC, molecular analysis has been supported by the growing evidence that papillary thyroid carcinoma (PTC, the most common

  17. Pre-analytic steps for molecular testing on thyroid fine-needle aspirations: The goal of good results.

    Science.gov (United States)

    Rossi, Esther Diana; Schmitt, Fernando

    2013-11-28

    Fine-needle aspiration cytology (FNAC) represents a valid alternative to biopsy in a variety of clinical settings mainly based on its simplicity and less invasive clinical approach. In some cases, morphology evaluation alone is not sufficient to manage the patients, so that the application of ancillary techniques can contribute to diagnosis, prognosis and prediction of tumor behavior. These techniques include polymerase chain reaction (PCR), fluorescence in situ hybridization (FISH), in situ PCR, direct Sequencing, microarrays and proteomic methodologies. Although several recent experiences underline the superior value of deoxyribonucleic acid (DNA) quality mainly for advanced genomic high throughput platforms, very scant literature studied the role of the pre-analytical or analytical phases. Despite the high specificity of molecular techniques as a support for diagnosis, there is a need for an increased standardization of pre-analytical/analytical steps such as providing appropriate clinical history, proper collection of laboratory specimens and proper preparation of samples, adequate fixative/reagent concentrations and technical equipments. All these requirements are crucial according to the results from 42 American laboratories, which reported 0.33% of significant molecular errors with 60% of them in the pre-analytical phase. The most common error is to forget that cytological preparation requires specific molecular variables, which are different from histological specimens. Cytological samples offer the advantage of a well preserved DNA, readily extractable and reasonably stable (from 6 months to 5 years) avoiding pitfalls due to formalin-fixation. Freshly prepared, unstained direct, alcohol-fixed papanicolaou, air-dried diff-quick smears are all suitable for DNA extraction and preservation. In the specific field of thyroid FNAC, molecular analysis has been supported by the growing evidence that papillary thyroid carcinoma (PTC), the most common thyroid cancer

  18. Langerhans cell histiocytosis in children diagnosed by fine-needle aspiration

    Science.gov (United States)

    Handa, Uma; Kundu, Reetu; Punia, Rajpal Singh; Mohan, Harsh

    2015-01-01

    Background: Langerhans cell histiocytosis (LCH) is a rare intricate pediatric neoplasm with varied clinical manifestations and multiple treatment modalities. Aim: To study the cytological features of LCH and the differential diagnoses on fine-needle aspiration (FNA). Materials and Methods: FNA was performed using a 23-gauge needle fitted to a 10 mL syringe mounted on syringe holder. LCH was diagnosed on FNA smears in seven cases confined to the head and neck region, which included three cases of lymphadenopathy, three cases of scalp swelling, and one case of orbital swelling. Results: The age of the patients ranged from 25 days to 11 years and male-to-female ratio was 1:1.3. Clinically, the diagnoses suggested were tuberculosis, inflammatory lesion, abscess, and malignancy. The cytologic findings included high cellularity, isolated Langerhans cells (LCs) with prominent nuclear indentation, grooves and abundant vacuolated cytoplasm, multinucleated giant cells, eosinophils, and lymphocytes. Areas of necrosis were noted in one case. Histopathology, along with positive S-100 immunohistochemistry, confirmed the diagnosis of LCH. Conclusions: LCH is a rare disease occurring predominantly in children and can be diagnosed with ease on FNA cytology by the presence of characteristic Langerhans cells. The S-100 positivity aids in suggesting a diagnosis of LCH. PMID:26811572

  19. Hyalinizing trabecular tumor of the thyroid gland: A puzzling entity on fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Jitendra Nasit

    2014-01-01

    Full Text Available Hyalinizing trabecular tumor (HTT is a rare unique but controversial thyroid neoplasm, characterized by prominent trabecular growth pattern and stromal hyalinization. Whether HTT is a benign tumor or a variant of papillary thyroid carcinoma (PTC is still unclear. Cytology findings of HTT have been described in few reports. Cytological features of HTT frequently overlap with those of PTC and medullary thyroid carcinoma, which can lead to frequent misdiagnosis. In order to avoid overtreatment like total thyroidectomy, pathologist should be aware of cytological features of HTT. We present a case of 35-year-old female with a right-side thyroid swelling for three years. Fine needle aspiration cytology was performed. According to The Bethesda System for Reporting Thyroid Cytopathology, cytological diagnosis of benign thyroid neoplasm was made. Histopathology of the right thyroidectomy specimen showed HTT. Accurate preoperative diagnosis of HTT requires a very meticulous and cautious approach in the evaluation of cytological features. Trabecular pattern of cells, vague curved nuclear palisading, radiating arrangement of cells around hyaline material, spindled to elongated cells, filamentous cytoplasmic processes with ill-defined cell border and yellow bodies are important diagnostic features of HTT. Nuclear features alone are insufficient for the diagnosis of HTT. Any suspicious cytology of thyroid lesion should follow hemithyroidectomy and histopathological evaluation.

  20. Metastatic renal cell carcinoma of spleen diagnosed by fine-needle aspiration.

    Science.gov (United States)

    McGregor, Douglas H; Wu, Yaping; Weston, Allan P; McAnaw, Mary P; Bromfield, Cecil; Bhattatiry, Manu M

    2003-07-01

    Splenic metastases are infrequent, and determination of the primary site by fine-needle aspiration (FNA) can be complex. We report the case of a 65-year-old man who was found to have a large heterogeneously enhancing 8 x 7-inch splenic mass by abdominal computed tomography (CT). FNA by transesophageal endoscopic ultrasonography demonstrated atypical cells conclusive for malignancy and consistent with metastatic renal cell carcinoma based on cytomorphology, histochemical lipid positivity, and immunohistochemical positivity for cytokeratin, vimentin, and renal cell carcinoma marker. Repeat CT with and without arteriovenous contrast demonstrated bilateral renal cysts, including a 0.9 x 0.8-cm lesion on the left with significant enhancement. Splenectomy confirmed the radiological and cytological findings, and left kidney exploration and nephrectomy demonstrated a small (1.5 cm) lower pole renal cell carcinoma of chromophil (papillary) type, histologically similar to the splenic metastasis. This case demonstrates the diagnostic importance of interdisciplinary involvement (oncology, radiology, gastroenterology, pathology, and general and urologic surgery); cytomorphology; histochemistry, including fat stain on frozen cell block; and immunohistochemistry, including the recently developed renal cell carcinoma marker.

  1. Lymph node and lymphoid organs fine needle aspiration cytology: historical background.

    Science.gov (United States)

    Cozzolino, Immacolata; Vigliar, Elena; Vetrani, Antonio; Zeppa, Pio

    2012-01-01

    Lymph node has probably been the first target of Fine Needle Cytology (FNC) and among the latest to be accepted as an affordable diagnostic procedure. In 1912, dr. Hirschfeld performed FNC to diagnose cutaneous lymphomas and other tumours. Subsequently FNC was used to diagnose lymphoblastoma and splenic FNC to diagnose leishmaniasis on Romanowsky-stained smears. One of the first systematic study on lymph node FNC was then performed at John Hopkins Hospital, in Baltimore (USA) using FNC and Romanowsky stain on air-dried smears. In the twenties, two independent groups from Memorial Hospital (New York, USA), worked on FNC of a large scale of different human pathologies. One of this study reported 1,405 diagnoses of cancer and other diseases by means of FNC, mainly performed on lymph nodes (662 cases). In the sixties, at the Karolinska Hospital (Stockholm, Sweden) a group of cytopathologists started a Cytopathology Service available to the whole Institution, which exploited all fields of FNC. Since then, the procedure spread all over the word and nowadays it is routinely used for the diagnosis of different organs and pathologies including lymph node. Distinguished cytopathologists have worked on lymph nodal FNC producing significant advances and highlighting advantages and inevitable limitations of the technique. Despite some persistent criticism, FNC is a generally accepted procedure in the first diagnosis of lymph nodes enlargement. Moreover, numerous studies have demonstrated that vital cells obtained by FNC are excellent samples suitable for molecular evaluation, offering new challenging application to lymph node FNC.

  2. Diagnosis and reporting of follicular-patterned thyroid lesions by fine needle aspiration.

    Science.gov (United States)

    Faquin, William C

    2009-03-01

    Over the past 3 decades, fine needle aspiration (FNA) has developed as the most accurate and cost-effective initial method for guiding the clinical management of patients with thyroid nodules. Thyroid FNA specimens containing follicular-patterned lesions are the most commonly encountered and include various forms of benign thyroid nodules, follicular carcinomas, and the follicular variant of papillary thyroid carcinoma. Based primarily upon the cytoarchitectural pattern, FNA is used as a screening test for follicular-patterned lesions to identify the majority of patients with benign nodules who can be managed without surgical intervention. The terminology and reporting of thyroid FNA results have been problematic due to significant variation between laboratories, but the recent multidisciplinary NCI Thyroid FNA State of the Science Conference has provided a seven-tiered diagnostic solution. A key element of this approach is the category "atypical cells of undetermined significance" (ACUS) which is used for those aspirates which cannot be easily classified as benign, suspicious, or malignant. Lesions in this category represent approximately 3-6% of thyroid FNAs and have a risk of malignancy intermediate between the "benign" category and the "suspicious for a follicular neoplasm" category. The recommended follow-up for an ACUS diagnosis is clinical correlation and in most cases, repeat FNA sampling.

  3. Papillary thyroid carcinoma, a diagnostic approach in fine needle aspiration: Review of literature

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    Shirish S Chandanwale

    2013-01-01

    Full Text Available Background: Despite well-defined cytology features of papillary thyroid carcinoma (PTC in fine needle aspiration (FNA, diagnostic difficulties do exist while making decision in respect to papillary thyroid carcinoma (PTC cases. Aims: The aim of this study is to clarify diagnostic significance of various cytology features of PTC and to identify possible diagnostic pitfalls. Materials and Methods: FNA cytology (FNAC features and clinical findings of 17 PTC cases diagnosed on histology were retrieved. A retrospective review of these cases was performed. Results: The frequency and number of papillary formations, intranuclear cytoplasmic inclusions (INCI, and nuclear grooves (NG was more in PTC cases as compared to suggestive/suspicious of (S/O and rule out (R/O PTC cases. Cyst macrophages forming clusters were seen in six cases. Multinucleated giant cells (MGC were seen in seven cases. Large MGC with dense cytoplasm and more nuclei were seen in four PTC and one S/O PTC cases. Conclusion: FNAC features of PTC in FNA smears are neither constant nor specific. All the cytology features of PTC should be reported in proper context which allows endocrine specialist to treat and urgent histological verification.

  4. Role of preoperative endoscopic ultrasound-guided fine-needle tattooing of a pancreatic head insulinoma

    Institute of Scientific and Technical Information of China (English)

    Pornchai; Leelasinjaroen; Wuttiporn; Manatsathit; Richard; Berri; Mohammed; Barawi; Frank; G; Gress

    2014-01-01

    Although insulinomas are rare, they are the most com-mon pancreatic neuroendocrine tumor, with an inci-dence of four cases per million population. Insulinomas are generally benign indolent intrapancreatic tumors. Surgical resection remains the main option for treat-ment. However, up to 67% of a pancreatic head insu-linomas are nonpalpable, thus surgical resection of the nonplapable insulinoma in this area could become prob-lematic resulting in prolonged surgical time, increased risk of pancreatic duct injury and need for pancreati-coduodenectomy. Endoscopic ultrasound-guided fine- needle tattooing(EUS-FNT), has been shown to have a crucial role for localization of pancreatic body and tail lesions, facilitating laparoscopic distal pancreatectomyand helping surgeons identify the location of the tumor. EUS-FNT might have a role for preoperative localiza-tion of pancreatic head insulinomas which are likely to be nonpalpable. We report a case of preoperative EUS-FNT for localization of a nonplapable pancreatic head insulinoma. This report demonstrates that EUS-FNT of pancreatic head insulinomas may facilitate surgical resection, reduce operative time and decrease surgical complications.

  5. Fine-Needle Aspiration Cytology of Parathyroid Carcinoma Mimic Hürthle Cell Thyroid Neoplasm

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    Chutintorn Sriphrapradang

    2014-01-01

    Full Text Available Background. Fine-needle aspiration (FNA can cause misdiagnosis of cytomorphological findings between parathyroid and thyroid lesions. Case Presentation. A 31-year-old man presented with a palpable neck mass on the right thyroid lobe. FNA cytology was reported as intrathyroidal lymphoid hyperplasia. After 5 years, repeated FNA was done on the enlarged nodule with result of Hürthle cell lesion. Prior to right lobectomy, laboratories revealed elevated serum calcium and parathyroid hormone (PTH. Careful history taking revealed chronic knee pain and ossifying fibroma at the maxilla. Ultrasonography showed a 2.8 cm mass inferior to right thyroid lobe. Pathology from en bloc resection was parathyroid carcinoma and immunohistochemical study revealed positivity for PTH. Genetic analysis found somatic mutation of CDC73 gene in exon1 (c.70delG which caused premature stop codon in amino acid 26 (p.Glu24Lysfs2*. The final diagnosis was hyperparathyroidism-jaw tumor syndrome. Conclusions. FNA cytology of parathyroid can mimic thyroid lesion. It is important to consider and correlate the entire information from clinical history, laboratory, imaging, and FNA.

  6. Fine-needle aspiration study of cystic papillary thyroid carcinoma: Rare cytological findings

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    Maral Mokhtari

    2016-01-01

    Full Text Available Background: Cystic papillary thyroid carcinoma (CPTC is a variant of papillary carcinoma that has many mimickers in cytological grounds. Aim: To study the cytomorphologic features of CPTC and compare them to those of other cystic thyroid lesions using fine-needle aspiration cytology (FNAC. We also aimed to identify the cytomorphologic features that distinguish CPTC from other cystic thyroid lesions. Materials and Methods: Seventy-three cases of CPTC were included in the study. The cytomorphologic features of these cases were analyzed. The FNA smears of other thyroid lesions with cystic changes (300 colloid goiters, 290 adenomatoid nodules, 11 follicular neoplasms, and 9 hurtle cell neoplasm were also studied. Results: The smears in CPTC revealed isolated follicular cells, small groups of cells with scalloped margins, cell swirls, small clusters with a cartwheel pattern, papillary clusters, intranuclear inclusions, nuclear grooves, sticky colloid, intracellular colloids, psammoma bodies, multinucleated giant cells, and foamy and hemosiderin laden macrophages. Small groups of cells with scalloped borders, cellular swirls, and small clusters with a cartwheel pattern were seen in CPTC, but not in other cystic lesions. Interestingly, mesothelial-like cells and hemophagocytic cells were seen in five and three cases of CPTC, respectively, but not in other cystic lesions. Conclusion: Mesothelial-like cells and hemophagocytic cells were observed in five and three cases of CPTC, respectively. Similar finding have not been previously reported in the literature.

  7. Artificial neural network in breast lesions from fine-needle aspiration cytology smear.

    Science.gov (United States)

    Subbaiah, R M; Dey, Pranab; Nijhawan, Raje

    2014-03-01

    Artificial neural networks (ANNs) are applied in engineering and certain medical fields. ANN has immense potential and is rarely been used in breast lesions. In this present study, we attempted to build up a complete robust back propagation ANN model based on cytomorphological data, morphometric data, nuclear densitometric data, and gray level co-occurrence matrix (GLCM) of ductal carcinoma and fibroadenomas of breast cases diagnosed on fine-needle aspiration cytology (FNAC). We selected 52 cases of fibroadenomas and 60 cases of infiltrating ductal carcinoma of breast diagnosed on FNAC by two cytologists. Essential cytological data was quantitated by two independent cytologists (SRM, PD). With the help of Image J software, nuclear morphomeric, densitometric, and GLCM features were measured in all the cases on hematoxylin and eosin-stained smears. With the available data, an ANN model was built up with the help of Neurointelligence software. The network was designed as 41-20-1 (41 input nodes, 20 hidden nodes, 1 output node). The network was trained by the online back propagation algorithm and 500 iterations were done. Learning was adjusted after every iteration. ANN model correctly identified all cases of fibroadenomas and infiltrating carcinomas in the test set. This is one of the first successful composite ANN models of breast carcinomas. This basic model can be used to diagnose the gray zone area of the breast lesions on FNAC. We assume that this model may have far-reaching implications in future.

  8. Testicular fine needle aspiration as a diagnostic tool in non-obstructive azoospermia

    Institute of Scientific and Technical Information of China (English)

    A. Bettella; A. Ferlin; M. Menegazzo; M. Ferigo; I. M. Tavolini; P. F. Bassi; C. Foresta

    2005-01-01

    Aim: To report the fine needle aspiration cytology (FNAC) of the testes used as a diagnostic tool in non-obstructive azoospermic patients. Methods: One hundred and twenty-five non-obstructive azoospermic male candidates to intracytoplasmic sperm injetion (ICSI) were analysed for follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and inhibin B plasma levels. They were classified into three groups on the basis of FNAC: 1) Sertoli cell-only syndrome (SCOS) (70); 2) severe hypospermatogenesis (42); and 3) maturation arrest (13). Then, all men underwent testicular sperm extraction (TESE) for sperm recovery for ICSI. Results: Mature spermatozoa were detected by FNAC in 24 of 42 men with severe hypospermatogenesis and nine of 13 men with maturation arrest;while they were retrieved by TESE in 29 of 70 men with SCOS, 35 of 42 men with severe hypospermatogenesis (including the 24 by FNAC) and 10 of 13 men with maturation arrest (including the nine by FNAC). The sensitivity and specificity of FNAC were 44.6 % and 100 %, respectively. There was no difference on testicular volume and hormonal parameters in men with and without sperm retrieved. Conclusion: These findings suggest that FNAC may be a simple and valid diagnostic parameter in non-obstructive azoospermic men and it may represent a valid positive prognostic parameter for sperm recovery at TESE.

  9. Fine-Needle Aspiration, Touch Imprint, and Crush Preparation Cytology for Diagnosing Thyroid Malignancies in Thyroid Nodules

    OpenAIRE

    Ahmadinejad, Mojtaba; Aliepour, Asghar; Anbari, Khatereh; Kaviani, Mojhgan; Ganjizadeh, Hasan; Nadri, Sedigheh; Foroutani, Niloufar; Meysami, Masoumeh; Almasi, Vahid

    2013-01-01

    Several methods are used to evaluate the thyroid nodules. The aim of this study was to determine the sensitivity, specificity, false positive and negative rates, positive predictive value (PPV), and negative predictive value (NPV) of touch imprint, crush preparation, and fine-needle aspiration (FNA) methods. This cross-sectional study was done in Shohada-ye Ashayer University Hospital in Khorramabad. All the patients who underwent thyroid surgery due to thyroid nodules in this hospital betwee...

  10. Benign chondroblastoma on fine-needle aspiration smears: A seven-case experience and review of the literature.

    Science.gov (United States)

    Cozzolino, Immacolata; Zeppa, Pio; Zabatta, Assunta; Merolla, Francesco; Vetrani, Antonio; Sadile, Francesco

    2015-09-01

    We report seven cases of chondroblastoma (CB) of bone, diagnosed by Fine-Needle Aspiration Cytology (FNAC), and confirmed by histomorphological examination. The concurrence of some cytomorphologic findings - mononucleated cells, multinucleated cells, and intercellular chondroid substance - unequivocally suggested the cytological diagnosis of CB. We also reviewed the literature on this topic in order to discuss morphological criteria and the importance of needle size. The differential diagnosis between CB, Giant Cell Tumor of Bone, and Eosinophilic Granuloma is further discussed.

  11. Usefulness of fine-needle aspiration in the diagnosis of thyroid lesions: an institutional experience of 340 patients

    OpenAIRE

    2013-01-01

    Objective: To evaluate the results of fine needle aspiration cytology (FNAC) in the diagnosis, its correlation with histology, to highlight its limitations and diagnostic pitfalls as well as the impact of FNAC on the decreased rate of surgery in clinically suspect thyroid lesions.Study design: FNAC was performed on 340 patients with thyroid enlargement over a period of six years. The cytological results were correlated with clinical features, thyroid function tests and histopathological exami...

  12. Ultrasound criteria and guided fine-needle aspiration diagnostic yields in small animal peritoneal, mesenteric and omental disease.

    Science.gov (United States)

    Feeney, Daniel A; Ober, Christopher P; Snyder, Laura A; Hill, Sara A; Jessen, Carl R

    2013-01-01

    Peritoneal, mesenteric, and omental diseases are important causes of morbidity and mortality in humans and animals, although information in the veterinary literature is limited. The purposes of this retrospective study were to determine whether objectively applied ultrasound interpretive criteria are statistically useful in differentiating among cytologically defined normal, inflammatory, and neoplastic peritoneal conditions in dogs and cats. A second goal was to determine the cytologically interpretable yield on ultrasound-guided, fine-needle sampling of peritoneal, mesenteric, or omental structures. Sonographic criteria agreed upon by the authors were retrospectively and independently applied by two radiologists to the available ultrasound images without knowledge of the cytologic diagnosis and statistically compared to the ultrasound-guided, fine-needle aspiration cytologic interpretations. A total of 72 dogs and 49 cats with abdominal peritoneal, mesenteric, or omental (peritoneal) surface or effusive disease and 17 dogs and 3 cats with no cytologic evidence of inflammation or neoplasia were included. The optimized, ultrasound criteria-based statistical model created independently for each radiologist yielded an equation-based diagnostic category placement accuracy of 63.2-69.9% across the two involved radiologists. Regional organ-associated masses or nodules as well as aggregated bowel and peritoneal thickening were more associated with peritoneal neoplasia whereas localized, severely complex fluid collections were more associated with inflammatory peritoneal disease. The cytologically interpretable yield for ultrasound-guided fine-needle sampling was 72.3% with no difference between species, making this a worthwhile clinical procedure.

  13. Efficacy of an in-house polymerase chain reaction assay for rapid diagnosis of Mycobacterium tuberculosis in patients with tubercular lymphadenitis: Comparison with fine needle aspiration cytology and conventional techniques

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    Sharma Meera

    2010-10-01

    Full Text Available Introduction: Tubercular lymphadenitis (TB-L is the most common manifestation of extrapulmonary tuberculosis. Excisional biopsy with histopathological examination, Ziehl-Neelsen staining (ZNS and culture and fine needle aspiration (FNA cytology, although useful in the diagnosis of TB-L, cannot diagnose a substantial proportion of cases. We investigated the role of an in-house polymerase chain reaction (PCR assay targeting the IS6110 gene from the FNA material in the diagnosis of the disease. Materials and Methods: The clinical profile of 150 patients with lymphadenopathy was noted and the fine needle aspirate was collected. After cytological processing, ZNS and culture on Lowenstein-Jensen media, mycobacterial DNA was isolated from the residual aspirate material and IS6110 gene PCR was performed. Results of cytology, ZNS, culture and IS6110 gene PCR were compared. Results: There were 49 confirmed patients of TB-L based on laboratory parameters (either culture isolation of Mycobacterium tuberculosis or any two of cytology, ZNS, PCR positive and clinical response to therapy. Sensitivity and specificity of FNA was 89.8% and 96%, of ZNS was 40.8% and 99%, of culture was 40.8% and 100% and of IS6110 gene PCR test was 100% and 92.1%. Conclusion: IS6110 PCR can be considered a valuable adjunct to cytology, ZNS and culture techniques in the diagnosis of TB-L.

  14. The Relevance of CD117-Immunocytochemistry Staining Patterns to Mutational Exon-11 in c-kit Detected by PCR from Fine-Needle Aspirated Canine Mast Cell Tumor Cells

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    A. Sailasuta

    2014-01-01

    Full Text Available Canine cutaneous mast cell tumors (MCT are the lethal skin tumors. The biological behavior of the MCT cells is quite varied and unpredictable. Almost MCT dogs usually require a rapid diagnosis and therapy. However, MCT diagnosis and prognosis are still dependent on histopathology which is rather inconvenient, time-consuming, painful, and harmful for some cases. Indeed, MCT can be easily accessible using fine-needle aspiration (FNA. In this study, our biopsy specimens were classified as low- and high-grade MCT based on the novel 2-tier histopathologic grading system. We have demonstrated the usage of fine-needle aspirated MCT cells (FNA-MCT cells from these specimens as a primary cell source to study the distribution of CD117-immunocytochemistry (CD117-ICC staining patterns and the frequency of internal tandem duplication- (ITD- mutant exon-11 of c-kit. The result has substantially shown that there were three staining patterns identified in the cells. Only paranuclear pattern was significantly increased in the cells from high-grade MCT. Altogether, the ITD-mutant exon-11 was also detectable only in these cells. Therefore, the result has supported our hypothesis that there was an increased opportunity to observe a higher CD117-ICC staining pattern and exon-11 mutation in high-grade MCT; even these two parameters may not precisely indicate a histopathological grade.

  15. Renal Tumor Biopsy Technique

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2016-01-01

    Objective:To review hot issues and future direction of renal tumor biopsy (RTB) technique.Data Sources:The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on RTB technique in English,with no limitation of study design.Results:Computed tomography and ultrasound were usually used for guiding RTB with respective advantages.Core biopsy is more preferred over fine needle aspiration because of superior accuracy.A minimum of two good-quality cores for a single renal tumor is generally accepted.The use of coaxial guide is recommended.For biopsy location,sampling different regions including central and peripheral biopsies are recommended.Conclusion:In spite of some limitations,RTB technique is relatively mature to help optimize the treatment of renal tumors.

  16. A standardized cytological and immunochemical method for the analysis of fine-needle spleen aspirates: assessment of leukocyte population changes in canine visceral leishmaniosis.

    Science.gov (United States)

    Barrouin-Melo, Stella Maria; Larangeira, Daniela Farias; Santos, Silvana Ornelas; Chagas-Júnior, Adenizar Delgado; Paixão, Mariza; Aguiar, Paulo Henrique Palis; dos-Santos, Washington Luís Conrado; Pontes-de-Carvalho, Lain

    2006-06-15

    A method for the evaluation of splenic cellularity using samples collected by fine-needle aspirative biopsy was standardized in this work. The procedure includes erythrocyte lysing, preparation of cytospin films and staining by histochemical and immunocytochemical techniques. The cellular profiles of spleen preparations were compared with those observed in peripheral blood samples subjected to the same procedure. Two groups were compared, one consisting of 14 healthy uninfected and the other of 15 polysymptomatic Leishmania chagasi/infantum-infected dogs, from an endemic area for visceral leishmaniosis. Cell populations were identified by conventional hematoxilin-eosin and Wright' stainings, and by immunocytochemistry using monoclonal antibodies against canine CD45RA and CD45RB, phagocytes and a pan-leukocyte antigen. Larger neutrophil (P < 0.0001) and monocyte/macrophage (P = 0.0036) relative counts and lower lymphocyte relative counts (P < 0.0001) were found in the spleen, and not in the blood, of the animals with leishmaniosis than in those of the healthy animals. The proportions of CD45RB+ cells were higher, and of CD45RA+ cells were lower, both in the spleen and in the blood of animals with leishmaniosis than in those of healthy dogs (P < 0.05). Additionally, hematoxilin-eosin-stained cytospins of spleen aspirates from Leishmania-infected animals permitted the easy visualization of amastigote forms inside phagocytes, under light microscopy.

  17. Sonographic features and ultrasonography-guided fine-needle aspiration of metastases to the thyroid gland

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    Yoon, Jung Hyun; Kim, Eun Kyung; Kwak, Jin Young; Moon, Hee Jung; Kim, Ga Ram [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-03-15

    To evaluate the characteristic ultrasonographic (US) features of metastatic carcinoma to the thyroid, and how accurate US features and ultrasonography-guided fine-needle aspiration (US-FNA) are for the diagnosis of thyroid metastases. Twenty-three thyroid lesions in 23 patients (mean age, 66.7 years; range, 46 to 85 years) that had been diagnosed as thyroid metastases were included. The composition, echogenicity, margin, shape, presence of calcifications, underlying parenchymal echotexture, and vascularity were analyzed in US images of the thyroid metastases. Final US assessments were categorized into probably benign and suspicious malignancy. The presence of suspicious metastatic cervical lymph nodes was noted. The medical records, US-FNA cytology, and pathology reports of these patients were retrospectively reviewed. Of the 23 thyroid lesions, the general US appearance was mass-forming in 21 (91.3%) and non-mass-forming in 2 (8.7%). All 23 lesions showed a solid tumor composition. Common US features among the 21 mass-forming thyroid metastases were hypoechogenicity (81.0%), non-circumscribed margins (90.5%), no calcifications (76.2%), and parallel shape (81.0%). Suspicious cervical lymph nodes were present in 18 patients (78.3%). Of the 23 lesions, 21 (91.3%) were classified as suspicious malignancy, and 2 (8.7%) as probably benign. US-FNA showed diagnostic results specific for metastases in 21 of the 22 patients (95.5%) who had undergone US-FNA. Common US features in thyroid metastasis were hypoechogenicity, non-circumscribed margins, no calcifications, parallel shape, and the presence of suspicious cervical lymph nodes. US-FNA can be effectively used in the diagnosis of thyroid metastasis, preventing unnecessary surgery.

  18. Assessing RET/PTC in thyroid nodule fine-needle aspirates: the FISH point of view.

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    Caria, Paola; Dettori, Tinuccia; Frau, Daniela V; Borghero, Angela; Cappai, Antonello; Riola, Alessia; Lai, Maria L; Boi, Francesco; Calò, Piergiorgio; Nicolosi, Angelo; Mariotti, Stefano; Vanni, Roberta

    2013-08-01

    RET/PTC rearrangement and BRAF(V600E) mutation are the two prevalent molecular alterations associated with papillary thyroid carcinoma (PTC), and their identification is increasingly being used as an adjunct to cytology in diagnosing PTC. However, there are caveats associated with the use of the molecular approach in fine-needle aspiration (FNA), particularly for RET/PTC, that should be taken into consideration. It has been claimed that a clonal or sporadic presence of this abnormality in follicular cells can distinguish between malignant and benign nodules. Nevertheless, the most commonly used PCR-based techniques lack the capacity to quantify the number of abnormal cells. Because fluorescence in situ hybridization (FISH) is the most sensitive method for detecting gene rearrangement in a single cell, we compared results from FISH and conventional RT-PCR obtained in FNA of a large cohort of consecutive patients with suspicious nodules and investigated the feasibility of setting a FISH-FNA threshold capable of distinguishing non-clonal from clonal molecular events. For this purpose, a home brew break-apart probe, able to recognize the physical breakage of RET, was designed. While a ≥3% FISH signal for broken RET was sufficient to distinguish nodules with abnormal follicular cells, only samples with a ≥6.8% break-apart FISH signal also exhibited positive RT-PCR results. On histological analysis, all nodules meeting the ≥6.8% threshold proved to be malignant. These data corroborate the power of FISH when compared with RT-PCR in quantifying the presence of RET/PTC in FNA and validate the RT-PCR efficiency in detecting clonal RET/PTC alterations.

  19. Correlation of fine needle aspiration cytology findings with thyroid function test in cases of lymphocytic thyroiditis.

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    Sood, Neelam; Nigam, Jitendra Singh

    2014-01-01

    Background. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC is reliable tool in the diagnosis of thyroid lesion. Objective. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. Methods. 175 patients with thyroid swellings were referred for FNAC as well as TFT during 2011-2013. Fine needle aspiration cytology was performed using non-aspiration or aspiration techniques and TFT performed on Beckman culter access 2. Results. Lymphoid infiltrate was seen in 55 cases. The commonest age group of lymphocytic thyroiditis was 21-30 years with male : female ratio being 1 : 10. Anti-TPO and TSH were elevated in 96.16% (25/26) of cases with grade 3 lymphoid infiltrate, 94.12% (16/17) of cases with grade 2, and 91.67% (11/12) of cases with 1 grade. Increased anti-TPO with raised TSH without any lymphoid infiltrate was seen in 5 cases and 5 cases showed only raised TSH without raised anti-TPO and without any lymphoid infiltrate. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. We also observed that anti-TPO and TSH together are significant even if no lymphocytic infiltration is present. Conclusion. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Anti TPO was adjunct to TSH in grade 3. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis.

  20. Correlation of Fine Needle Aspiration Cytology Findings with Thyroid Function Test in Cases of Lymphocytic Thyroiditis

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    Neelam Sood

    2014-01-01

    Full Text Available Background. Chronic lymphocytic thyroiditis is the second most common thyroid lesion diagnosed on FNAC after goiter. FNAC is reliable tool in the diagnosis of thyroid lesion. Objective. To correlate FNAC cytologic findings with TFT in the lymphocytic thyroiditis. Methods. 175 patients with thyroid swellings were referred for FNAC as well as TFT during 2011–2013. Fine needle aspiration cytology was performed using non-aspiration or aspiration techniques and TFT performed on Beckman culter access 2. Results. Lymphoid infiltrate was seen in 55 cases. The commonest age group of lymphocytic thyroiditis was 21–30 years with male : female ratio being 1 : 10. Anti-TPO and TSH were elevated in 96.16% (25/26 of cases with grade 3 lymphoid infiltrate, 94.12% (16/17 of cases with grade 2, and 91.67% (11/12 of cases with 1 grade. Increased anti-TPO with raised TSH without any lymphoid infiltrate was seen in 5 cases and 5 cases showed only raised TSH without raised anti-TPO and without any lymphoid infiltrate. We observed that grade 3 lymphocytic infiltration has correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. We also observed that anti-TPO and TSH together are significant even if no lymphocytic infiltration is present. Conclusion. Grade 3 lymphocytic infiltration has statistical correlation with anti-TPO and TSH together or TSH alone but not with anti-TPO alone. Anti TPO was adjunct to TSH in grade 3. The presence of Hurthle cell change, giant cells, and granulomas has no statistical correlation with lymphocytic thyroiditis.

  1. The diagnostic evaluation of fine needle aspiration cytology of thyroid and its clinical application

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    Jiayu Zhang; Jian Wang

    2012-01-01

    Objective: The aim of the study was to investigate the diagnostic value of fine needle aspiration cytology (FNAC) and its clinical application. Methods: From April 2009 to February 2011, thyroid FNAC were performed in a total of 186 patients with thyroid nodule or mass in our hospital and 78 of those 186 patients subsequently underwent thyroidectomy. The FNAC findings were compared with the results of the corresponding histological diagnosis. Results: The results of thyroid FNAC for 186 patients showed that, (1) 166 cases of benign lesions, the detection rate was 89.24% (166/186), including 96 cases of nodular colloid goiter (51.61 %), 28 cases of simple colloid goiter (15.05%), 38 cases of Hashimoto's thyroiditis (HT) (20.43%) and 4 cases of thyroid adenoma (2.15%); (2) 4 cases of suspicious malignant lesion, the detection rate was 2.15% (4/186); (3) 16 cases of malignant tumor, the detection rate was 8.60% (16/186). Seventy eight patients including malignant (16), suspicious malignant (4), HT (20) and nodular colloid goiters (38) cases diagnosed by FNAC were performed operation with thyroidectomy and the postoperative histopathologic results showed that there were 2 cases HT combined thyroid papillary carcinoma in HT 20 cases by FNAC, 15 cases of thyroid papillary carcinoma and 1 case of follicular carcinoma in 16 cases of malignant tumor by FNAC and 4 case of thyroid papillary carcinoma in 4 cases of suspicious malignant by FNAC. Conclusion: Thyroid FNAC is a valuable and reliable method for the diagnosis of the thyroid nodules or mass or even most diffuse thyroid diseases. Diagnosis of HT and thyroid papillary carcinoma can be made by thyroid FNAC. There was larger hint value for nodular colloid goiter and simple colloid goiter according to thyroid FNAC.

  2. FINE NEEDLE ASPIRATION CYTOLOGY IS A DIAGNOSTIC TOOL IN THE THYROID LESION

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    Mani

    2015-12-01

    Full Text Available Thyroid nodules the main indication for FNAC, and the goal of this diagnostic procedure is to detect thyroid neoplasm for surgical resection and to identify non-neoplastic lesions that may be managed conservatively. MATERIAL AND METHOD Three hundred and fourteen patients with thyroid nodules diagnosed on physical examination underwent fine-needle aspiration with 23-gauge needle and 10ml syringe. FNAC results were classified into non-neoplastic lesion and neoplastic lesion for diagnosis. RESULT AND ANALYSIS We included 314 cases; 37 were male and 277 were female with female-to-male ratio of 7.48:1. The age ranged from 8 to 87 years with a median age of 47.5 years. Maximum number of patients were found in age group of 41-50 years. In the present study we found 285(90.76% non-neoplastic lesion and 29(9.23% neoplastic lesions. Out of 285 non-neoplastic lesion, most commonly encountered were colloid goiter 178(56.68% and second most common thyroiditis 100(31.84%. Out of 314,29(9.23% neoplastic lesions, most commonly encountered neoplasm were papillary carcinoma 14(4.45% followed by 9(2.86% follicular neoplasm, Hurthle cell neoplasm 2(0.63%, medullary carcinoma 4(1.27%. AIMS AND OBJECTIVES  To study the distribution of various thyroid lesions among the age and sex groups.  To study the cytomorphological, clinical and biochemical correlation. CONCLUSION Clinical features and serum findings when used alone to diagnose thyroid lesion, diagnosis will be missed in many cases.

  3. Subacute granulomatous (De Quervain's) thyroiditis: Fine-needle aspiration cytology and ultrasonographic characteristics of 21 cases

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    Vural, Çigdem; Paksoy, Nadir; Gök, Nazlı D; Yazal, Kadri

    2015-01-01

    Background: Subacute granulomatous thyroiditis (SGT) is an inflammatory disease that presents with different clinical and cytological characteristics. Although the diagnosis is generally made clinically, imaging methods and fine-needle aspiration (FNA) may provide assistance, particularly in atypical cases. The objective of this study is to reveal the ultrasonographic (USG) and cytological characteristics of SGT. Materials and Methods: The clinical, USG and cytological findings of 21 cases diagnosed with SGT were reviewed. Results: Ultrasonographic data was available in 20 cases. A hypoechoic thyroid nodule with irregular margins was detected in 12 of the 20 total cases. Of these, 9 cases complained about pain in the thyroid lodge and generally had unilateral lesions, heterogeneous and hypoechoic areas with indistinct margins, rather than nodular lesions, which were seen in 7 cases. Cytologically, the multinuclear giant cells (MNGCs) found in all cases were accompanied by a dirty background containing varying numbers of granulomatous structures, including isolated epithelioid histiocytes, proliferated/regenerated follicle epithelium cells and inflammatory cells and colloid. Conclusion: Though hypoechoic and heterogeneous areas with irregular margins are strongly associated with thyroiditis, SGT may also appear as painful or painless hypoechoic, solid nodules and generate challenges in differential diagnosis. Although the most remarkable characteristic observed in FNA cytology was the presence of multiple MNGCs with cytoplasm, a dirty background accompanied by mild-moderate cellularity, degenerated-proliferated follicular epithelium cells, rare epithelioid granulomas and mixed type inflammatory cells are characteristic for SGT. The assessment of these radiological and cytological findings in conjunction with clinical findings will assist in the achievement of an accurate diagnosis. PMID:26085833

  4. Cytological grading of breast carcinoma on fine needle aspirates and its relation with histological grading

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    Jyoti Prakash Phukan

    2015-01-01

    Full Text Available Background: Grading of breast carcinoma on fine needle aspiration cytology (FNAC is beneficial for selecting patients for neoadjuvant chemotherapy. Aims: To grade the breast carcinoma on FNAC using Robinson grading system and to assess the concordance of cytological grading (CG with histological grading (HG using Elston-Ellis modification of Scarff-Bloom-Richardson grading system. Materials and Methods: The study was conducted for 1-year, comprising of 50 female patients attending outpatient departments (OPD as well as admitted in various surgical wards of a teaching hospital, diagnosed as breast carcinoma. FNAC smears were stained with May-Grunwald-Giemsa and Papanicolaou (Pap stains and CG was done using Robinson system on Pap stained smears. The results were compared with HG system after resection of tumors. Results: Of 50 cases, 14 (28% cases were graded as grade I, 24 (48% grade II, and 12 (24% grade III by CG, whereas 9 (18%, 28 (56% and 13 (26% cases were graded as grade I, II and III by HG. The result showed overall 72% concordance of CG with HG, with grade II and grade III showing highest degree of concordance (83.33%, which is comparable to previous studies. Kappa measurement showed a higher degree of agreement in high-grade tumors compared with low-grade tumors (0.73 in grade III, 0.53 in grade II and 0.39 in grade I. Conclusion: Cytological grading is comparable to HG in majority of cases. Because neoadjuvant chemotherapy is becoming increasingly popular as primary treatment modality of breast cancer, CG could be a useful parameter in selecting the mode of therapy and predicting tumor behavior.

  5. Immunocytochemistry versus nucleic acid amplification in fine needle aspirates and tissues of extrapulmonary tuberculosis

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    Madhu Mati Goel

    2012-01-01

    Full Text Available Background: Immunocytochemistry (ICC is an established routine diagnostic adjunct to cytology and histology for tumor diagnosis but has received little attention for diagnosis of tuberculosis. Aims: To have an objective method of direct visualization of mycobacteria or their products in clinical extrapulmonary tuberculosis (EPTB specimens, immunocytochemical localization of M. tuberculosis antigen by staining with species specific monoclonal antibody to 38-kDa antigen of Mycobacterium tuberculosis complex. Materials and Methods: Immunostaining with specific monoclonal antibody to 38-kDa antigen of Mycobacterium tuberculosis complex was done in fresh and archival fine needle aspirates and tissue granulomata of 302 cases of extrapulmonary tuberculosis and was compared with the molecular diagnostic i.e., nucleic amplification and conventional [Cytomorphology, Ziehl Neelsen (ZN staining and culture] tests and 386 controls. Results: Diagnostic indices by Bayesian analysis for all types of archival and fresh material varied from 64 to 76% in nucleic acid amplification (NAA and 96 to 98% in ICC. There was no significant difference in the diagnostic indices of ZN staining and/ or ICC in fresh or archival material whereas the sensitivity of NAA differed significantly in fresh versus archival material both in cytology (71.4% vs 52.1% and histology (51.1% vs 38.8%. ICC can be easily used on archival smears and formalin-fixed paraffin-embedded tissue sections with almost equal sensitivity and specificity as with fresh material, in contrast to NAA which showed significant difference in test results on archival and fresh material. Conclusions: Low detection sensitivity of MTB DNA in archival material from known tuberculous cases showed the limitation of in-house NAA-based molecular diagnosis. ICC was found to be sensitive, specific and a better technique than NAA and can be used as an adjunct to conventional morphology and ZN staining for the diagnosis of

  6. Investigation of scanning parameters for thyroid fine needle aspiration cytology specimens: A pilot study

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    Maheswari S Mukherjee

    2015-01-01

    Full Text Available Background: Interest in developing more feasible and affordable applications of virtual microscopy in the field of cytology continues to grow. Aims: The aim of this study was to investigate the scanning parameters for the thyroid fine needle aspiration (FNA cytology specimens. Subjects and Methods: A total of twelve glass slides from thyroid FNA cytology specimens were digitized at ×40 with 1 micron (μ interval using seven focal plane (FP levels (Group 1, five FP levels (Group 2, and three FP levels (Group 3 using iScan Coreo Au scanner (Ventana, AZ, USA producing 36 virtual images (VI. With an average wash out period of 2 days, three participants diagnosed the preannotated cells of Groups 1, 2, and 3 using BioImagene′s Image Viewer (version 3.1 (Ventana, Inc., Tucson, AZ, USA, and the corresponding 12 glass slides (Group 4 using conventional light microscopy. Results: All three raters correctly identified and showed complete agreement on the glass and VI for: 86% of the cases at FP Level 3, 83% of the cases at both the FP Levels 5 and 7. The intra-observer concordance between the glass slides and VI for all three raters was highest (97% for Level 3 and glass, same (94% for Level 5 and glass; and Level 7 and glass. The inter-rater reliability was found to be highest for the glass slides, and three FP levels (77%, followed by five FP levels (69.5%, and seven FP levels (69.1%. Conclusions: This pilot study found that among the three different FP levels, the VI digitized using three FP levels had slightly higher concordance, intra-observer concordance, and inter-rater reliability. Scanning additional levels above three FP levels did not improve concordance. We believe that there is no added benefit of acquiring five FP levels or more especially when considering the file size, and storage costs. Hence, this study reports that FP level three and 1 μ could be the potential scanning parameters for the thyroid FNA cytology specimens.

  7. Flow cytometry immunophenotyping (FCI) of fine needle aspirates (FNAs) of lymph nodes.

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    Paro, Mirjana Mariana Kardum; Siftar, Zoran; Kardum-Skelin, Ika; Sustercić, Dunja; Nazor, Aida; Flegar-Mestrić, Zlata; Jaksić, Branimir

    2010-06-01

    Flow cytometry immunophenotyping (FCI) has an important role in the clinic work-up of fine needle aspirates (FNAs) of lymph nodes. Its standardization has been defined by proposed analytical protocols and procedures used to assure proper analytical results also in those non-routine samples. In Institute of Clinical Chemistry, "Merkur" University Hospital, FCI is accredited method according to laboratory accreditation standard ISO 15189. According to this laboratory accreditation standard, participation in external quality assessment (EQA) programs is a prerequisite for assuring integrity and quality of the entire laboratory process. A critical analysis of our institutional experience in the feasibility of FCI of the material obtained by FNA of lymph nodes with suspected lymphoma represented the purpose of the study. During an eight-year period in Institute of Clinical Chemistry, "Merkur" University Hospital, a total of 1295 FNA analysis was done, 245 of them with a possible diagnosis of B-cell Non-Hodgkin lymphomas (B-NHL) formed the basis of the study. Lymphocytes were isolated on density gradient according to Boyum et al. The average feasibility of FNAs for FCI analysis was 86% (ranged 78-93%). An acceptable total cell number in FNAs for FCI analysis (4257) was established. In total population of respondents statistical significances in expressions of cellular antigens CD3, CD5, CD22, CD23, CD19 and CD5 on B-cells (CD5+CD19+) between patient's with final diagnosis of benign, reactive lymphoid proliferations and patient's with diagnosis of B-NHL were found. EQA results analysis showed that all results were either inside target values (X +/- 1SD) or inside accepted values (X +/- 2SD). Compatibility of the restriction of immunoglobulins light chains determinated by FCI and cytomorphology diagnosis depends on the choice of criterion values of the light chains ratio which determine the monoclonality. According to the matrix of shares of all classified data of retained

  8. Breeding soundness evaluation of bulls by semen analysis, testicular fine needle aspiration cytology and trans-scrotal ultrasonography

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    Chapwanya A

    2008-05-01

    Full Text Available Abstract The aim of this study was to evaluate the usefulness of trans-scrotal ultrasonography and testicular fine needle aspiration cytology in assessing bulls for breeding suitability. These two techniques were also compared with semen analysis. Bulls presented for breeding soundness evaluation were assessed using all three techniques. The findings of each technique were compared. There was agreement in classification of fertile bulls using all three techniques, suggesting that the combined use of these techniques enhances routine breeding soundness examination. Use of the three techniques also enhances detailed investigation of suspected sub-fertile bulls while accurately identifying testicular cause(s of sire sub-fertility.

  9. Ultrasound-guided fine needle aspiration of thyroid nodules: A consensus statement by the Korean Society of Thyroid Radiology

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    Lee, Young Hen; Baek, Jung Hwan [Dept. of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Jung, So Lyoung [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Kwak, Jin Young [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Ji Hoon [Dept. of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Shin, Jung Hee [Dept. of Radiology, and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-04-15

    Ultrasound (US)-guided fine needle aspiration (US-FNA) has played a crucial role in managing patients with thyroid nodules, owing to its safety and accuracy. However, even with US guidance, nondiagnostic sampling and infrequent complications still occur after FNA. Accordingly, the Task Force on US-FNA of the Korean Society of Thyroid Radiology has provided consensus recommendations for the US-FNA technique and related issues to improve diagnostic yield. These detailed procedures are based on a comprehensive analysis of the current literature and from the consensus of experts.

  10. Role of fine needle aspiration cytology and cell block in diagnosis of scar endometriosis: A case report

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    Sashibhusan Dash

    2015-01-01

    Full Text Available Presence of endometrial glands and stroma in places other than the uterus is called endometriosis. It can be pelvic or extra-pelvic. Abdominal scar endometriosis is an extra-pelvic endometriosis that can occur after surgery involving the uterus. Post-caesarean section, scar endometriosis is a rare event. The diagnosis is frequently made only after excision of disease tissue. We present a case of post-caesarean section abdominal scar endometriosis presenting as a tumor on the abdominal wall, which was diagnosed by fine needle aspiration cytology and confirmed by cell block preparation.

  11. Extramedullary plasmacytoma of thyroid - a mimicker of medullary carcinoma at fine needle aspiration cytology: A case report

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    Vidya Bhat

    2014-01-01

    Full Text Available A rare case of extra medullary plasmacytoma (EMP of thyroid gland in a 60 year old male, occurring against a background of Hashimoto′s thyroiditis is reported. The fine needle aspiration cytology (FNAC initially done as an outpatient procedure, showed atypical epithelial cells on a background of amyloid. Considering these findings we gave a diagnosis of medullary carcinoma. Histology of the total thyroidectomy specimen showed an extensive infiltration of neoplastic plasma cells against a background of Hashimoto′s thyroiditis, with a bizarre Hurthle cell change. Immunohistochemistry on the histology sections confirmed the diagnosis of solitary plasmacytoma of thyroid against a background of Hashimoto′s thyroiditis.

  12. Endoscopic ultrasonography-guided fine needle aspiration:Relatively low sensitivity in the endosonographer population

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    Jean-Marc Dumonceau; Thibaud Koessler; Jeanin E van Hooft; Paul Fockens

    2012-01-01

    AIM:To assess the characteristics and quality of endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) in a large panel of endosonographers.METHODS:A survey was conducted during the 13th annual live course of endoscopic ultrasonography (EUS)held in Amsterdam,Netherlands.A 2-page questionnaire was developed for the study.Content validity of the questionnaire was determined based on input by experts in the field and a review of the relevant literature.It contained 30 questions that pertained to demographics and the current practice for EUS-FNA of responders,including sampling technique,sample processing,cytopathological diagnosis and sensitivity of EUS-FNA for the diagnosis of solid mass lesions.One hundred and sixty-one endosonographers who attended the course were asked to answer the survey.This allowed assessing the current practice of EUS-FNA as well as the self-reported sensitivity of EUS-FNA for the diagnosis of solid mass lesions.We also examined which factors were associated with a self-reported sensitivity of EUS-FNA for the diagnosis of solid mass lesions > 80%.RESULTS:Completed surveys were collected from 92 (57.1%) of 161 endosonographers who attended the conference.The endosonographers had been practicing endoscopy and EUS for 12.5 ± 7.8 years and 4.8 ± 4.1 years,respectively; one third of them worked in a hospital with an annual caseload > 100 EUS-FNA.Endoscopy practices were located in 29 countries,including 13 countries in Western Europe that totaled 75.3% of the responses.Only one third of endosonographers reported a sensitivity for the diagnosis of solid mass lesions > 80% (interquartile range of sensitivities,25.0%-75.0%).Factors independently associated with a sensitivity > 80% were (1) > 7 needle passes for pancreatic lesions or rapid on-site cytopathological evaluation (ROSE) (P < 0.0001),(2) a high annual hospital caseload (P =0.024) and (3) routine isolation of microcores from EUS-FNA samples (P =0

  13. PANCREATIC SPLENOSIS MIMICKING NEUROENDOCRINE TUMORS: microhistological diagnosis by endoscopic ultrasound guided fine needle aspiration

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    José Celso ARDENGH

    2013-03-01

    Full Text Available Context Pancreatic splenosis is a benign condition which can mimic a pancreatic neoplasm. Objective To describe the role of the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA of pancreatic nodules suspicious for pancreatic splenosis. Method From 1997 to 2011, patients with pancreatic solid tumors suspicious for splenosis by computed tomography and/or magnetic resonance imaging were referred to EUS-FNA. Those cases with pancreatic splenosis confirmed by EUS-FNA or surgery were included. Endosonographic findings and clinicopathologic features were also analysed. Results A total of 2,060 patients with pancreatic solid tumors underwent EUS-FNA. Fourteen (0.6% cases with pancreatic splenosis were found. After applying exclusion criteria, 11 patients were selected. Most patients were male (7, young (mean age: 42 years and asymptomatic (8. Endoscopic ultrasound imaging alone suspected pancreatic splenosis in 6 cases, and neuroendocrine tumors in 5 cases. Pancreatic splenosis was found most commonly in the tail, was round, hypoechoic, with homogeneous pattern, regular borders, and with scintigraphy negative for somatostatin receptors. The average diameter of these nodules identified by endoscopic ultrasound was 2.15 cm. Microhistology obtained by EUS-FNA confirmed the diagnosis in 9/10 patients. Conclusion Pancreatic splenosis can be diagnosed by EUS-FNA. Microhistology prevents unnecessary surgeries, and reassures asymptomatic patients with hypoechoic, homogeneous, and well circumscribed pancreatic nodules. Contexto A esplenose pancreática é uma afecção benigna que pode mimetizar uma neoplasia pancreática. Objetivo Descrever o papel da ecoendoscopia associada à punção aspirativa com agulha fina ecoguiada (EE-PAAF dos nódulos de pâncreas suspeitos de esplenose pancreática. Método De 1997 a 2011, pacientes com tumores sólidos de pâncreas sugestivos de esplenose pancreática, conforme achados de exames de imagem por

  14. Diagnosis of Aelurostrongylus abstrusus verminous pneumonia via sonography-guided fine-needle pulmonary parenchymal aspiration in a cat

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    Jennifer Gambino

    2016-04-01

    Full Text Available Case summary A 9-year-old, male neutered, indoor–outdoor domestic shorthair cat from the northern Alabama countryside presented for a 3 week history of coughing, lethargy and an episode of self-resolving dyspnea that occurred 1 week prior to presentation. Three-view thoracic radiographs revealed a moderate-to-severe, diffuse, mixed bronchial to structured interstitial (miliary-to-nodular pulmonary pattern in all lung lobes with peribronchial cuffing and multifocal areas of mild patchy alveolar opacity. Ultrasound-guided evaluation and fine-needle aspiration of the caudodorsal lung parenchyma was performed with sedation. Cytology revealed many widely scattered Aelurostrongylus abstrusus larvae and ova. Upon the confirmed diagnosis of A abstrusus verminous pneumonia, treatment with fenbendazole and selamectin resulted in complete resolution of clinical signs within 6 weeks of the initial diagnosis. Relevance and novel information We report herein the first documented case in the Americas of A abstrusus verminous pneumonia diagnosed via cytologic evaluation of an in vivo, percutaneous ultrasound-guided fine-needle aspirate of affected lung. Additionally, to our knowledge, we offer the first account of the sonographic (pulmonary features of the disease.

  15. Primary hydatid cyst of the supraspinatus muscle: complete removal of the germinal layer and cytodiagnosis by fine-needle aspiration.

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    Das, Dilip K; El-Sharawy, Maha; Ayyash, Emad H; Al-Enezi, Nadia A; Iqbal, Jamshed R; Madda, John P

    2014-03-01

    Primary hydatid disease of the skeletal muscle without systemic involvement is rare. The purpose of this report is to document the novel clinical presentation and the interesting facets of fine-needle aspiration in a case of hydatid disease. It was a case of primary hydatid cyst of the left supraspinatus muscle in an Indian woman living in Kuwait, which was clinically diagnosed as a lipoma. Fine-needle aspiration (FNA) yielded 2 ml of clear fluid with white particulate material. The cytocentrifuged smears prepared from the aspirated fluid showed many scolices, occasional laminated cyst wall fragments and numerous hooklets. The laminated cyst wall and scolices were PAS positive. Trichrome staining imparted a demon-head-like appearance to the scolices. The cytodiagnosis of hydatid cyst was corroborated by histopathological examination of an excised whitish membrane and an irregular cystic fragment, which showed parallel laminations without germinal layer, and skeletal muscle with granulomas and a dense eosinophilic infiltration, respectively. Quantitative serological (indirect hemagglutination) test on blood sample collected 9 days after the excision of the cyst showed insignificant antibody titer to Echinococcus sp. and after 6 weeks the antibodies were completely absent. CT scan of the chest and abdomen performed 7 weeks after removal of cyst showed no evidence of visceral hydatid cyst.

  16. Going beyond "Basaloid neoplasm": Fine needle aspiration cytology of epithelial-myoepithelial carcinoma of the parotid gland.

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    Molnar, Stacy L; Zarka, Matthew A; De Las Casas, Luis E

    2016-05-01

    Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland malignancy with variable cytologic findings. Its rarity, variable morphologic findings, and similarities with more common salivary gland entities make it a difficult cytologic diagnosis. As the name signifies, the key feature of this tumor is presence of an epithelial and myoepithelial component. However, when one of these two components is scant on the fine needle aspiration (FNA) smears, it may be overlooked. We present a case from a 62 year-old female who presented to the clinic with a parotid nodule and episodes of sharp, throbbing pain. A fine needle aspiration was performed which revealed a highly cellular specimen comprised primarily of aggregates of cells with small, round nuclei and scant to absent cytoplasm. Abundant hyaline stromal material was also noted. The case was signed out as basaloid neoplasm with a recommendation for surgical resection. The subsequent resection specimen revealed EMC. By reviewing the FNA specimen following the surgical resection of the tumor, we were able to utilize the benefit of hindsight to more clearly identify the subtle, biphasic components of the tumor.

  17. Endoscopic ultrasound-guided fine-needle aspiration cytology diagnosis of solid pseudopapillary tumor of the pancreas:A case report and literature review

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We describe the clinical, imaging and cytopathological features of solid pseudopapillary tumor of the pancreas (SPTP) diagnosed by endoscopic ultrasoundguided (EUS-guided) fine-needle aspiration (FNA). A 17-year-old woman was admitted to our hospital with complaints of an unexplained episodic abdominal pain for 2 mo and a short history of hypertension in the endocrinology clinic. Clinical laboratory examinations revealed polycystic ovary syndrome, splenomegaly and low serum amylase and carcinoembryonic antigen (CEA)levels. Computed tomography (CT) analysis revealed a mass of the pancreatic tail with solid and cystic consistency. EUS confirmed the mass, both in body and tail of the pancreas, with distinct borders, which caused dilation of the peripheral part of the pancreatic duct (major diameter 3.7 mm). The patient underwent EUS-FNA. EUS-FNA cytology specimens consisted of single cells and aggregates of uniform malignant cells,forming microadenoid structures, branching, papillary clusters with delicate fibrovascular cores and nuclear overlapping. Naked capillaries were also seen. The nuclei of malignant cells were round or oval, eccentric with fine granular chromatin, small nucleoli and nuclear grooves in some of them. The malignant cells were periodic acid Schiff (PAS)-Alcian blue (+) and immunocytochemically they were vimentin (+), CA 19.9 (+), synaptophysin (+), chromogranin (-), neuro-specific enolase (-), a1-antitrypsin and a1-antichymotrypsin focal positive.Cytologic findings were strongly suggestive of SPTP.Biopsy confirmed the above cytologic diagnosis. EUS-guided FNA diagnosis of SPTP is accurate. EUS findings,cytomorphologic features and immunostains of cell block help distinguish SPTP from pancreatic endocrine tumors,acinar cell carcinoma and papillary mucinous carcinoma.

  18. Unusual, metastatic, or neuroendocrine tumor of the pancreas: A diagnosis with endoscopic ultrasound-guided fine-needle aspiration and immunohistochemistry

    Directory of Open Access Journals (Sweden)

    Mohamad A Eloubeidi

    2012-01-01

    Full Text Available Background/Aim: To determine the yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA in combination with immunostains in diagnosing unusual solid pancreatic masses (USPM in comparison with pancreatic adenocarcinoma (ACP. Patients and Methods: All EUS-FNA of solid pancreatic masses performed with a 22-gauge needle were included. Data on clinical presentations, mass characteristics, presence of pancreatitis, yield of tissue, and final diagnosis were compared between the two groups. On site cytopathology was provided and additional passes were requested to perform immunostains. Results : Two hundred and twenty-nine cases with either adenocarcinoma or USPM were included. The median age of the cohort was 65 years. ACP (210/229, 92% accounted for the majority of the cases. The USPM included neuroendocrine (NET masses (n=13, metastatic renal carcinoma (n=3, metastatic melanoma (n=1, lymphoma (n=1, and malignant fibrous histiocytoma (n=1. Subjects with ACP were significantly more likely to present with loss of weight (P=0.02 or obstructive jaundice (P<0.001. Subjects with ACP were more likely to have suspicious/atypical FNA biopsy results as compared with USPM (10% vs 0%. The sensitivity of EUS-FNA with immunostains was 93% in ACP as compared with 100% in USPM. Diagnostic accuracy was higher in USPM as compared with ACP (100% vs 93%. Conclusions: EUS-FNA using a 22-gauge needle with immunostains has excellent diagnostic yield in patients with USPMs, which is comparable if not superior to the yield in pancreatic adenocarcinoma.

  19. Subtyping of Non-Small Cell Lung Carcinoma in Fine Needle Aspiration Specimens: A Study of 252 Patients with Surgical Correlations

    Directory of Open Access Journals (Sweden)

    Beyhan Varol Mollamehmetoğlu

    2016-12-01

    Full Text Available Objective: Fine-needle aspiration (FNA cytology performed by either transthoracic or transbronchial procedures is an important approach to obtain tumor tissue for histological diagnosis. We investigated the accuracy of FNA in differentiating NSCLCs of adenocarcinoma from squamous cell carcinoma histological types to correlate cytological findings with histological features and immunohistochemistry confirmation in some cases. Methods: From 2010 to 2015, a total of 635 transbronchial needle aspirations or transthoracic needle aspirations were performed. 332 cases were diagnosed as NSCLC, with or without an indication of a specific subtype, while 303 cases were not diagnosed as NSCLC. Out of 332 cases diagnosed as NSCLC, 252 had a histological follow-up. Subsequently, histological samples included 161 surgical resections and 91 biopsies. In cases with histopathological diagnosis accompanied by FNA cytology, an immunohistochemical study was carried out and the diagnostic results of the two methods were compared to each other. Results: The specific subtype of NSCLC was provided in 217 cases (86% based on cytomorphology which included 115 adenocarcinomas (46% and 102 squamous cell carcinomas (40%. The diagnosis NSCLC-NOS by FNA was set in 35 cases. At histology, 251 cases (99.6% were sub-classified: 122 adenocarcinomas (48%, 104 squamous cell carcinomas (41%, 11 large cell carcinomas (4% , and 14 adenosquamous carcinomas (6%. Agreement between cytological and histological typing was found in 181 of 197 cases (92% (K=0.837; p<0.001. Conclusion: Our study proved that most NSCLC can be sub-classified as adenocarcinoma or squamous cell carcinoma by FNA through cytomorphology and the application of immunocytochemistry.

  20. Endoscopic ultrasound-guided fine-needle aspiration plus KRAS and GNAS mutation in malignant intraductal papillary mucinous neoplasm of the pancreas

    Science.gov (United States)

    Bournet, Barbara; Vignolle-Vidoni, Alix; Grand, David; Roques, Céline; Breibach, Florence; Cros, Jérome; Muscari, Fabrice; Carrère, Nicolas; Selves, Janick; Cordelier, Pierre; Buscail, Louis

    2016-01-01

    Background: KRAS and GNAS mutations are common in intraductal papillary mucinous neoplasia of the pancreas (IPMN). The aims of this study were to assess the role of pre-therapeutic cytopathology combined with KRAS and GNAS mutation assays within cystic fluid sampled by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to predict malignancy of IPMN. Patients and methods: We prospectively included 37 IPMN patients with clinical and/or imaging predictors of malignancy (men: 24; mean age: 69.5 years). Cytopathology (performed on cystic fluid and/or IPMN nodules), KRAS (Exon 2, codon 12) and GNAS (Exon 8, codon 201) mutations assays (using TaqMan® allelic discrimination) were performed on EUS-FNA material. The final diagnosis was obtained from IPMN resections (n = 18); surgical biopsies, EUS-FNA analyses, and follow-up (n = 19): 10 and 27 IPMN were benign and malignant, respectively. Results: Sensitivity, specificity, positive and negative predictive values, and accuracy of cytopathology alone to diagnose IPMN malignancy were 55 %, 100 %, 100 %, 45 %, and 66 %, respectively. When KRAS-mutation analysis was combined with cytopathology these values were 92 %, 50 %, 83 %, 71 %, and 81 %, respectively. GNAS assays did not improve the performances of cytopathology alone or those of cytopathology plus a KRAS assay. Conclusions: In patients with a likelihood of malignant IPMN at pre-therapeutic investigation, testing for KRAS mutations in cystic fluid sampling by EUS-FNA improved the results of cytopathology for the diagnosis of malignancy whereas GNAS mutation assay did not. PMID:27995180

  1. Two-miRNA classifiers differentiate mutation-negative follicular thyroid carcinomas and follicular thyroid adenomas in fine needle aspirations with high specificity

    DEFF Research Database (Denmark)

    Stokowy, Tomasz; Wojtas, Bartosz; Jarzab, Barbara

    2016-01-01

    Diagnosis of thyroid by fine needle aspiration is challenging for the "indeterminate" category and can be supported by molecular testing. We set out to identify miRNA markers that could be used in a diagnostic setting to improve the discrimination of mutation-negative indeterminate fine needle...... aspirations. miRNA high-throughput sequencing was performed for freshly frozen tissue samples of 19 RAS and PAX8/PPARG mutation-negative follicular thyroid carcinomas, and 23 RAS and PAX8/PPARG mutation-negative follicular adenomas. Differentially expressed miRNAs were validated by quantitative polymerase...... chain reaction in a set of 44 fine needle aspiration samples representing 24 follicular thyroid carcinomas and 20 follicular adenomas. Twenty-six miRNAs characterized by a significant differential expression between follicular thyroid carcinomas and follicular adenomas were identified. Nevertheless...

  2. “A fine needle aspiration cytology in time saves nine” — cutaneous phaeohyphomycosis caused by Exophiala jeanselmei in a renal transplant patient: Diagnosis by fine needle aspiration cytology

    Science.gov (United States)

    Joshi, Prashant; Agarwal, Shipra; Singh, Geetika; Xess, Immaculata; Bhowmik, Dipankar

    2016-01-01

    Infections by dematiaceous fungi are an emerging group of infectious diseases worldwide with a variety of clinical presentations. Though generally localized, they can disseminate in immunocompromised settings, therefore, early diagnosis and prompt therapy can prevent significant morbidity and mortality in these patients. Fungi of genus Exophiala are common causative organisms; however, Exophiala jeanselmei (E. jeanselmei) has not yet been reported from environmental sources in India. We present here the case of a renal transplant recipient who presented with an innocuous lesion on the foot, diagnosed on fine needle aspiration cytology (FNAC) as phaeohyphomycosis, and promptly treated with excision and antifungal therapy. To the best of our knowledge, this is the first case report from India of E. jeanselmei causing phaeohyphomycosis in a transplant recipient and highlights the role a cytopathologist can play in the timely management of such cases. PMID:27011447

  3. Use of fine needle aspiration cytology in the diagnosis of cutaneous leishmaniasis: a comparison with the conventional scraping method.

    Science.gov (United States)

    Hosseinzadeh, Massood; Omidifar, Navid; Lohrasb, Mohamad Hosein

    2012-04-01

    Cutaneous leishmaniasis is endemic in Iran. Scraping smears are widely used and fine needle aspiration (FNA) cytology is now attracting more attention. Both methods were performed on the clinically suspected cases in our study. Smears were stained using Giemsa. We compared the sensitivity, specificity and some other aspects of these two methods. Of our 400 patients, 346 had specimens that were positive for leishman body, and of these 328 were detected using both methods. However, 42 cases were confirmed positive by FNA cytology and 18 as a result of scraping smears. There was a significant difference between the two methods in the detection of leishman body and microgranuloma, slide background and patient comfort. The sensitivity of FNA cytology was greater even though the specificity was the same. Our study confirmed the advantages of FNA cytology as a reliable method for the diagnosis of cutaneous leishmaniasis.

  4. PAX8/PPARG and RET/PTC rearrangement detection is feasible in routine air dried fine needle aspiration (FNA) smears

    DEFF Research Database (Denmark)

    Ferraz, Carolina; Rehfeld, Christian; Krogdahl, Annelise;

    2012-01-01

    Background: The diagnostic limitations of fine needle aspiration (FNA), like the "indeterminate" category, can be partially overcome by molecular analysis. As PAX8/PPARG and RET/PTC rearrangements have been detected in follicular carcinomas (FTC) and papillary carcinomas (PTC), their detection...... as generally not suitable for testing these rearrangements in a clinical setting. Therefore, the objective of the present study was to investigate the feasibility of extracting RNA from routine-air-dried FNA smears for the detection of these rearrangements with RT-PCR. Methods: A new method for RNA extraction......). Similarly, RET/PTC was found in 3 of 96 FFPEs and in 4 of 96 FNAs. Two of 21 PTC samples and 3 of 42 FA samples carried this rearrangement. Conclusion: These data are the first to show the feasibility of extracting RNA from routine air dried FNA smears for the detection of PAX8/PPARG and RET...

  5. Identification of second malignancies on effusions and fine-needle aspirates using a panel of monoclonal antibodies.

    Science.gov (United States)

    Mottolese, M.; Venturo, I.; Rinaldi, M.; Lopez, M.; Bigotti, G.; Benevolo, M.; Natali, P. G.

    1997-01-01

    The longer survival of neoplastic patients achieved through improvements of therapeutic regimens has increased the relative risk of developing a second primary tumour (SPT). In this context, conventional cytopathology can define tumour histotype only in a small fraction of cases. In this study, we have evaluated whether selected combinations of monoclonal antibodies (MAbs) to tumour-associated antigens (TAAs) can increase the accuracy of conventional morphology in detecting second primary tumours (SPTs) in two particularly difficult areas of cytodiagnosis, namely that of effusions and pulmonary fine-needle aspirates (FNAs). The immunocytochemical (ICC) analysis of 334 cytological specimens demonstrated that the use of our selected panel of MAbs could allow a more efficient identification of SPTs in comparison with conventional morphology. This diagnostic improvement was statistically significant (P < 0.0001). The present findings show that the immunophenotyping of effusions and FNAs, providing a more accurate and objective identification of SPTs, may have significant therapeutic and epidemiological relevance. PMID:9052413

  6. Methods specification for diagnostic test accuracy studies in fine-needle aspiration cytology: a survey of reporting practice.

    Science.gov (United States)

    Schmidt, Robert L; Factor, Rachel E; Affolter, Kajsa E; Cook, Joshua B; Hall, Brian J; Narra, Krishna K; Witt, Benjamin L; Wilson, Andrew R; Layfield, Lester J

    2012-01-01

    Diagnostic test accuracy (DTA) studies on fine-needle aspiration cytology (FNAC) often show considerable variability in diagnostic accuracy between study centers. Many factors affect the accuracy of FNAC. A complete description of the testing parameters would help make valid comparisons between studies and determine causes of performance variation. We investigated the manner in which test conditions are specified in FNAC DTA studies to determine which parameters are most commonly specified and the frequency with which they are specified and to see whether there is significant variability in reporting practice. We identified 17 frequently reported test parameters and found significant variation in the reporting of these test specifications across studies. On average, studies reported 5 of the 17 items that would be required to specify the test conditions completely. A more complete and standardized reporting of methods, perhaps by means of a checklist, would improve the interpretation of FNAC DTA studies.

  7. Fine-needle percutaneous transhepatic parenchymal portal venography by using carbon dioxide: a pilot study in pigs

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Fei; Hernandez, Javier; Crisostomo, Veronica; Pineda, Luis-Fernando; Lima, Juan Rafael; Uson, Jesus [Minimally Invasive Surgery Centre, Campus Universitario, Avenida de la Universidad, s/n, 10071 Caceres (Spain); Maynar, Manuel [Department of Radiology, Faculty of Medicine, Las Palmas University, 35016 Las Palmas de Gran Canaria (Spain)

    2003-02-01

    Our purpose was to evaluate the feasibility and safety of carbon dioxide (CO{sub 2}) in fine-needle percutaneous transhepatic parenchymal portal venography and its potential clinical applications. Three Belgian landrace pigs received fine-needle percutaneous transhepatic parenchymal portal venography by using CO{sub 2} as a contrast agent. Under fluoroscopic and B-mode ultrasonic guidance, right or left lobe of liver was punctured with a 22-G Chiba needle, through which CO{sub 2} was injected with a dedicated CO{sub 2} injector at injection rate of 20 ml/s for 20 ml, 40 ml/s for 40 ml, 40 ml/s for 60 ml, and 40 ml/s for 80 ml, respectively. The portal venograms were obtained by use of digital subtraction angiography (DSA) system with animal in supine position. In one pig transarterial portal venography was performed, in addition, using iodinated contrast agent. The portal vein was visualized in each run of venography. Optimal images of portal tree structure up to four-order branches were obtained in all those with CO{sub 2} injection rate of 40 ml/s, which appeared much better in quality than those obtained by cranial mesenteric arteriography with iodinated contrast agent. No extravasation of CO{sub 2}, liver laceration, or any other complication occurred during the procedures. The technique we proposed demonstrated optimal portography, which appeared to be safe, minimally invasive, less time-consuming, cost-effective, and easy to perform, with great potential in clinical applications. (orig.)

  8. Predictors of Malignancy and Recommended Follow-Up for Patients with Negative Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspected Pancreatic Lesions

    Directory of Open Access Journals (Sweden)

    Bret J Spier

    2009-01-01

    Full Text Available BACKGROUND: Endoscopic ultrasound (EUS with fine-needle aspiration (FNA can characterize and diagnose pancreatic lesions as malignant, but cannot definitively rule out the presence of malignancy. Outcome data regarding the length of follow-up in patients with negative or nondiagnostic EUS-FNA of pancreatic lesions are not well-established.

  9. Thyroid ultrasound-guided fine-needle aspiration : The positive influence of on-site adequacy assessment and number of needle passes on diagnostic cytology rate

    NARCIS (Netherlands)

    de Koster, Elizabeth J.; Kist, Jakob W.; Vriens, Menno R.; Rinkes, Inne H M Borel; Valk, Gerlof D.; De Keizer, Bart

    2016-01-01

    Objective: Nondiagnostic cytology is the most important limitation of thyroid ultrasound-guided fine-needle aspiration (US-FNA). This study aimed to identify factors associated with the adequacy rate of thyroid US-FNA. Study Design: Consecutive thyroid US-FNAs (2006-2013) were retrospectively includ

  10. Fusion of freehand SPECT and ultrasound to perform ultrasound-guided fine-needle aspiration cytology of sentinel nodes in head and neck cancer

    NARCIS (Netherlands)

    De Bree, R.; Pouw, B.; Heuveling, D. A.; Castelijns, J. A.

    2015-01-01

    BACKGROUND AND PURPOSE: Criteria for ultrasound-guided fine-needle aspiration cytology (USgFNAC) for the detection of occult lymph node metastasis in patients with clinically negative head and neck cancer are based on the morphology of cervical lymph nodes. To improve the selection of lymph nodes fo

  11. Diagnostic Yield and Safety of Endoscopic Ultrasound Guided Fine Needle Aspiration of Central Mediastinal Lung Masses

    Directory of Open Access Journals (Sweden)

    Enrique Vazquez-Sequeiros

    2013-01-01

    Full Text Available Background and Aims. EUS-FNA is an accurate and safe technique to biopsy mediastinal lymph nodes. However, there are few data pertaining to the role of EUS-FNA to biopsy central lung masses. The aim of the study was to assess the diagnostic yield and safety of EUS-FNA of indeterminate central mediastinal lung masses. Methods. Design: Retrospective review of a prospectively maintained database; noncomparative. Setting: Tertiary referral center. From 10/2004 to 12/2010, all patients with a lung mass located within proximity to the esophagus were referred for EUS-FNA. Main Outcome Measurement: EUS-FNA diagnostic accuracy and safety. Results. 73 consecutive patients were included. EUS allowed detection in 62 (85% patients with lack of visualization prohibiting FNA in 11 patients. Among sampled lesions, one patient (1/62 = 1.6% had a benign lung mass (hamartoma, while the remaining 61 patients (61/62 = 98.4% had a malignant mass (primary lung cancer: 55/61 = 90%; lung metastasis: 6/61 = 10%. The sensitivity, specificity, and accuracy of EUS-FNA were 96.7%, 100%, and 96.7%, respectively. The sensitivity was 80.8% when considering nonvisualized masses. One patient developed a pneumothorax (1/62 = 1.6%. Conclusions. EUS-FNA appears to be an accurate and safe technique for tissue diagnosis of central mediastinal lung masses.

  12. Computed tomography guided needle biopsy: experience from 1,300 procedures

    Energy Technology Data Exchange (ETDEWEB)

    Chojniak, Rubens; Isberner, Rony Klaus; Viana, Luciana Marinho; Yu, Liao Shin; Aita, Alessandro Amorim; Soares, Fernando Augusto [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Radiologia e Patologia

    2006-01-15

    Context and objective: computed tomography (CT) guided biopsy is widely accepted as effective and safe for diagnosis in many settings. Accuracy depends on target organ and needle type. Cutting needles present advantages over fine needles. This study presents experience from CT guided biopsies performed at an oncology center. Design and setting: retrospective study at Hospital do Cancer A. C. Camargo, Sao Paulo.Methods: 1,300 consecutive CT guided biopsies performed between July 1994 and February 2000 were analyzed. Nodules or masses were suspected as primary malignancy in 845 cases (65%) or metastatic lesion in 455 (35%). 628 lesions were thoracic, 281 abdominal, 208 retroperitoneal, 134 musculoskeletal and 49 head/neck. All biopsies were performed by one radiologist or under his supervision: 765 (59%) with 22-gauge fine-needle/aspiration technique and 535 (41%) with automated 16 or 18-gauge cutting-needle biopsy. Results: adequate samples were obtained in 70-92% of fine-needle and 93-100% of cutting-needle biopsies. The specific diagnosis rates were 54-67% for fine-needle and 82-100% for cutting-needle biopsies, according to biopsy site. For any site, sample adequacy and specific diagnosis rate were always better for cutting-needle biopsy. Among 530 lung biopsies, there were 84 pneumothorax (16%) and two hemothorax (0.3%) cases, with thoracic drainage in 24 (4.9%). Among abdominal and retroperitoneal biopsies, there were two cases of major bleeding and one of peritonitis. Conclusion: both types of needle showed satisfactory results, but cutting-needle biopsy should be used when specific diagnosis is desired without greater incidence of complications. (author)

  13. Use of core biopsy in diagnosing cervical lymphadenopathy: a viable alternative to surgical excisional biopsy of lymph nodes?

    Science.gov (United States)

    Allin, D; David, S; Jacob, A; Mir, N; Giles, A; Gibbins, N

    2017-03-01

    OBJECTIVES Lymphoma often presents with a neck mass and while fine-needle aspiration cytology may be suggestive, tissue biopsy is required for reliable diagnosis and classification of a lymphoma that is sufficient to deliver the correct treatment for the patient. Traditionally, excisional biopsy of a lymph node has been the standard method of tissue sampling, providing ample tissue for assessment. However, this requires theatre time, and preceding fine-needle aspiration cytology, which may incur a delay. With careful use of tissue, coupled with advances in immunohistochemical and molecular investigative techniques, core biopsy provides a possible alternative to traditional fine-needle aspiration and excisional biopsy. In this study, we aimed to determine the efficacy of diagnosing neck masses. METHOD A retrospective analysis was performed of patients being investigated for a neck mass who were undergoing ultrasound-guided core biopsies of cervical lymph nodes over a 17-month period. The final histology report was scrutinised to assess whether adequate tissue was obtained to allow for full tissue diagnosis. RESULTS Over the 17-month period analysed, 70 patients with cervical lymphadenopathy underwent core biopsy. Of these, 63 (90%) were diagnostic for either lymphoma or other pathology and did not require further tissue sampling. Overall, 19 patients were diagnosed with lymphoma, of which only 1 required further biopsy due to inconclusive initial core biopsy. CONCLUSIONS Current guidelines for investigating lymphomas require that excisional biopsy be performed to obtain ample tissue to allow full nodal architecture assessment and ancillary investigation to reach an accurate histological classification. Within our head and neck multidisciplinary team, however, it is considered that results from core biopsies can be obtained in a more timely fashion and with histological accuracy equal to those of open biopsy. The results obtained demonstrate that core biopsy is an

  14. Solitary metastatic cancer to the thyroid: a report of five cases with fine-needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Batoroev Yuri

    2007-01-01

    Full Text Available Abstract Three men and 2 women with ages ranging from 37 to 70 years, clinically and histologically confirmed solitary, palpable metastatic cancers to the thyroid (SMCT and preoperative cytologic investigation of their thyroid lesions by fine-needle aspiration (FNA, were reviewed. Four patients were known to have a solid cancer treated by radical surgery 1 to 4 years prior [1 bronchogenic squamous cell carcinoma, 1 parotid adenoid cystic carcinoma, 1 renal cell carcinoma (RCC and 1 cutaneous melanoma], and 1 patient had no past history of cancer. Direct smears prepared from the patients' thyroid FNAs were fixed in 95% ethanol and stained with the Papanicolaou method. In 3 cases, immunostaining of the aspirated tumor cells with thyroglobulin antibody was performed, and in 1 case an aspiration smear was stained with commercial HMB-45 antibody. A correct cytodiagnosis of metastatic cancer to the thyroid was made in all 5 cases. In 1 patient the thyroid FNA revealed a metastatic RCC that led to the discovery of a clinically occult RCC. All 5 patients died of metastatic disease 27 to 40 months after surgical resection of their SMCTs.

  15. Combined use of fine needle aspiration cytology and full field digital mammography in preoperative assessment of breast masses

    Institute of Scientific and Technical Information of China (English)

    Yanan Zhang; Junsheng Li; Zhenling Ji; Wenhao Tang

    2008-01-01

    Objective: To evaluate the accuracy of these two methods and focus on the analysis and management of the false-negative cases.Methods: Results of full field digital mammography (FFDM) and fine needle aspiration cytology (FNAC)were obtained and analyzed from a consecutive of 102 women with palpable breast masses, results were correlated with the histopathological findings.Results: Of the 102 cases, malignancy was confirmed in 43 cases (42.16%) by final pathological examination, the sensitivity and specificity of cancer detection with FNA cytology was 90.7% (39/43) and 89.8% (53/59), respectively, the whole accuracy was 90.2% (92/102), with a positive predictive value of 86.7% (39/45) and a negative predictive value of 93.0% (53/57).FFDM gave a sensitivity of 88.4% (38/43), specificity of 83.1% (49/59), and whole accuracy 85.3% (87/102), the positive predictive value and negative predictive value was 79.2% (38/48) and 90.7% (49/54), respectively.All the FNAC-negative cancer cases were suggestive of malignancy by FFDM findings, however, the benign cases which presentas equivocal finding by FNA cytology, could not be ruled out the presence of malignancy.Conclusion: FNAC and FFDM both are accurate, effective and economical diagnostic modalities, combined use of these two methods can reduced the misdiagnosis rate of breast masses.

  16. Limits of fine-needle aspiration cytology in diagnosing pilomatrixoma: A series of 25 cases with clinico-pathologic correlations

    Directory of Open Access Journals (Sweden)

    A Ieni

    2012-01-01

    Full Text Available Background: Pilomatrixoma (PMX is a benign, quite uncommon, skin neoplasm, which is frequently misdiagnosed by clinicians. Aim: We have analyzed 25 PMX to determine the agreement between clinical diagnosis, preoperative FNA characteristics, and corresponding histopathological specimens; moreover, reliable cytologic criteria for PMX and the differential diagnosis to avoid cytological pitfalls have been emphasized. Materials and Methods: By fine-needle aspiration (FNA cytology a series of consecutive cases of PMX collected during last 5 years were studied. Smears were stained by Papanicolau and May-Grünwald-Giemsa. Results: Patients affected by PMX were 11 males, 14 females (ratio 1:1.27; the mean age was 32.72 years with age range 3-78 years, being 72% (18/25 of patients 40 years or less. PMX was mainly distributed in the head-neck region (52%, scalp (16%, upper/lower arms (28%, and chest (4%. The observed diagnostic cytological features were represented by clusters of basaloid epithelial cells, shadow or ghost cells, inflammatory background, calcification, and giant cells. Unfortunately, not all these morphological aspects were always disclosed in smears, thus making the cytological preoperative diagnosis questionable and problematic. Conclusions: The experience of a well-trained cytopathologist should distinguish the relevant FNA features in terms of smear background, architecture, and cell morphology. The most dangerous mistake in FNA diagnosis of PMX regards a diagnosis of primary malignant or metastatic cutaneous lesions.

  17. University of Pennsylvania aspiration cart (Penn-A-Cart): an innovative journey in fine needle aspiration service.

    Science.gov (United States)

    Gupta, Prabodh K

    2010-01-01

    On-site evaluation of fine needle aspiration specimens is now considered the standard of care. The procedure is performed at the bedside and at various other locations within the hospital using a mobile cart fitted with essentials, including a microscope, stains and supplies. Earlier, an open specimen cart was used with various supplies and a binocular microscope. The mobile cart during the past 25 years has been variously modified. A second-generation cart containing 2 folding pods, a double-headed microscope, supplies and stains had been used for the past 20 years; it did not meet the current regulatory standards and needs, and little attention was paid to meet the Joint Commission on the Accreditation of Healthcare Organizations, Health Insurance Portability and Accountability Act and infection control standards. Also, the repeated lifting of the microscope resulted in much wear and tear. We have designed Penn-A-Cart, which has a pneumatic lift for the microscope, a high-definition camera with a TV screen and access to the Internet. It has a sharps container and storage space for supplies, stains and slides. This cart meets the various regulatory agency standards. It is user friendly and valuable for multiviewing. The cart is valuable for remote access, telecytopathology and improved patient care.

  18. Applying machine learning approaches to improving the accuracy of breast-tumour diagnosis via fine needle aspiration

    Institute of Scientific and Technical Information of China (English)

    YUAN Qian-fei; CAI Cong-zhong; XIAO Han-guang; LIU Xing-hua

    2007-01-01

    Diagnosis and treatment of breast cancer have been improved during the last decade; however, breast cancer is still a leading cause of death among women in the whole world. Early detection and accurate diagnosis of this disease has been demonstrated an approach to long survival of the patients. As an attempt to develop a reliable diagnosing method for breast cancer, we integrated support vector machine (SVM), k-nearest neighbor and probabilistic neural network into a complex machine learning approach to detect malignant breast tumour through a set of indicators consisting of age and ten cellular features of fine-needle aspiration of breast which were ranked according to signal-to-noise ratio to identify determinants distinguishing benign breast tumours from malignant ones. The method turned out to significantly improve the diagnosis, with a sensitivity of 94.04%, a specificity of 97.37%, and an overall accuracy up to 96.24% when SVM was adopted with the sigmoid kernel function under 5-fold cross validation. The results suggest that SVM is a promising methodology to be further developed into a practical adjunct implement to help discerning benign and malignant breast tumours and thus reduce the incidence of misdiagnosis.

  19. Next-generation sequencing for molecular diagnosis of lung adenocarcinoma specimens obtained by fine needle aspiration cytology

    Science.gov (United States)

    Qiu, Tian; Guo, Huiqin; Zhao, Huan; Wang, Luhua; Zhang, Zhihui

    2015-06-01

    Identification of multi-gene variations has led to the development of new targeted therapies in lung adenocarcinoma patients, and identification of an appropriate patient population with a reliable screening method is the key to the overall success of tumor targeted therapies. In this study, we used the Ion Torrent next-generation sequencing (NGS) technique to screen for mutations in 89 cases of lung adenocarcinoma metastatic lymph node specimens obtained by fine-needle aspiration cytology (FNAC). Of the 89 specimens, 30 (34%) were found to harbor epidermal growth factor receptor (EGFR) kinase domain mutations. Seven (8%) samples harbored KRAS mutations, and three (3%) samples had BRAF mutations involving exon 11 (G469A) and exon 15 (V600E). Eight (9%) samples harbored PIK3CA mutations. One (1%) sample had a HRAS G12C mutation. Thirty-two (36%) samples (36%) harbored TP53 mutations. Other genes including APC, ATM, MET, PTPN11, GNAS, HRAS, RB1, SMAD4 and STK11 were found each in one case. Our study has demonstrated that NGS using the Ion Torrent technology is a useful tool for gene mutation screening in lung adenocarcinoma metastatic lymph node specimens obtained by FNAC, and may promote the development of new targeted therapies in lung adenocarcinoma patients.

  20. Comparative Study of US Features, US-guided Fine Needle Aspiration Cytology, and Pathology Results for Eggshell Calcified Thyroid Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Yoon Nae; Kim, Dong Wook [Dept. of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2011-06-15

    The aim of this study was to investigate ultrasound (US) findings of eggshell calcified thyroid nodules associated with thyroid malignancy and the diagnostic usefulness for US-guided fine-needle aspiration cytology (US-FNAC) of eggshell calcified thyroid nodules. We analyzed 36 eggshell calcified thyroid nodules in 35 patients who underwent thyroid US and US-FNAC from January to December of 2009. We compared the US findings and US-FNAC results with the pathologic results confirmed by surgery. Twenty eggshell calcified nodules were surgically removed in 19 patients, from which 8 papillary thyroid carcinomas and 12 hyperplasia nodules were confirmed. The sensitivity, specificity, positive, and negative predictive values, as well as accuracy for US diagnosis and US-FNAC of eggshell calcified nodules were 100% and 20%, 25% and 100%, 43.8% and 100%, 100% and 63.6%, and 55% and 66.7%, respectively. The results of this study indicate that thick peripheral hypoechoic rim and thickening of eggshell calcified nodules are significantly related to malignancy, but focal disruption of eggshell calcification is not.

  1. The concordance between thyroid nodules ultrasound, based on thyroid Imaging reporting and data systems, and fine needle aspiration

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    Nazanin Farshchian

    2016-03-01

    Full Text Available Background: Thyroid nodules are solid or cystic lumps within the thyroid gland. The purpose of this study was to evaluate the concordance between thyroid nodules ultrasound reports, based on Thyroid Imaging Reporting and Data (TIRAD System and results of ultrasound guided Fine Needle Aspiration (FNA. Methods: In this cross-sectional study, 144 patients with thyroid nodules who referred to the radiology department of Imam Reza Hospital of Kermanshah at the request of endocrinologist were evaluated. Data were analyzed by SPSS-21software using descriptive statistics. Results: The age range of patients was 15 to 78, with mean age 44.86±13.27 years. Of the sample, 141 cases (97.9 % were female and 3 cases (2.1 % were male. Based on the results of pathology, 130 (90.2% were benign and 14 (9.8% were malignant lesions and sonography result 129 cases (89.6% were benign and 15 cases (10.4% were malignant. There was a significant difference between the results of sonography and FNA and Kappa agreement test showed a significant concordance (96% between the sonographic reports of thyroid nodules, based on TIRAD system, and pathological findings. Conclusion: The results of this study indicated a high concordance between sonographic reports of thyroid nodules, based on TIRAD category, and FNA findings. Thus, TIRAD-based ultrasound can play a key role in determining thyroid nodules, thereby facilitating patient's management.

  2. Gene Methylation and Cytological Atypia in Random Fine-Needle Aspirates for Assessment of Breast Cancer Risk.

    Science.gov (United States)

    Stearns, Vered; Fackler, Mary Jo; Hafeez, Sidra; Bujanda, Zoila Lopez; Chatterton, Robert T; Jacobs, Lisa K; Khouri, Nagi F; Ivancic, David; Kenney, Kara; Shehata, Christina; Jeter, Stacie C; Wolfman, Judith A; Zalles, Carola M; Huang, Peng; Khan, Seema A; Sukumar, Saraswati

    2016-08-01

    Methods to determine individualized breast cancer risk lack sufficient sensitivity to select women most likely to benefit from preventive strategies. Alterations in DNA methylation occur early in breast cancer. We hypothesized that cancer-specific methylation markers could enhance breast cancer risk assessment. We evaluated 380 women without a history of breast cancer. We determined their menopausal status or menstrual cycle phase, risk of developing breast cancer (Gail model), and breast density and obtained random fine-needle aspiration (rFNA) samples for assessment of cytopathology and cumulative methylation index (CMI). Eight methylated gene markers were identified through whole-genome methylation analysis and included novel and previously established breast cancer detection genes. We performed correlative and multivariate linear regression analyses to evaluate DNA methylation of a gene panel as a function of clinical factors associated with breast cancer risk. CMI and individual gene methylation were independent of age, menopausal status or menstrual phase, lifetime Gail risk score, and breast density. CMI and individual gene methylation for the eight genes increased significantly (P breast cancer risk biomarker, warranting larger prospective studies to establish its utility for cancer risk assessment. Cancer Prev Res; 9(8); 673-82. ©2016 AACR.

  3. Primary small cell carcinoma of the parotid: Fine needle aspiration and immunohistochemical features of a neuroendocrine variant

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    Serdar Altinay

    2016-01-01

    Full Text Available Salivary gland small cell carcinoma (SGSmCC is extremely rare, accounting for less than 1% of salivary gland tumors. A 42-year-old female patient came to the outpatient clinic due to a mass localized in the left submandibular space and that had been growing since 3-4 months. The fine needle aspiration cytology (FNAC matched with small cell carcinoma (SmCC. As no other focus was detected by computerized tomography (CT, it was accepted as a primary neoplasm of the parotid gland. The histopathological assessment of the excised material and immunohistochemical staining demonstrated a neuroendocrine differentiation of SmCC. No recurrence was observed during the 54-month follow-up period. We believe this to be the second case of SmCC with neuroendocrine differantiation of the parotid glands reported in Turkύsh medical literature and will be added to the english database as one of the favorable SmCC cases.

  4. CORRELATION OF HIGH RESOLUTION ULTRASOUND AND COLOR DOPPLER FINDINGS OF THYROID NODULES WITH FINE NEEDLE ASPIRATION CYTOLOGY

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    Rajendra Kumar

    2015-07-01

    Full Text Available The objective of this study was to assess the utility of gray scale and color Doppler Ultrasonographic (US findings in characterization of benign and malignant thyroid nodules in correlation with the pathological diagnosis. METHODS: From January 2013 through December 2013, a total of 70 patients with solitary thyroid nodule underwent thyroid US with 7.5 – 12 MHz, linear array transducer of ESOATE MYLAB 40 . The following characteristics of each nodule were determined: Nodule diameter, Shape , Margins, Internal Contents , Echo texture, Halo, Presence and pattern of calcification, Pattern of vascularity, resistive index (RI of Intranodular/Peripheral vessels, and Association of cervical lymphadenopathy. Sensitivity, specificity, and positive and negative predictive values were obtained. The results were then compared to the fine needle aspira tion (FNA/Histopathological diagnosis. Diagnostic accuracy of US was determined using multiple logistic regression analysis. RESULTS: Statistically significant ( P peripheral pattern of vascularity and associated cervical lymphadenopathy. The overall diagnostic accuracy of thyroid US for differentiating a malignant lesion from a benign one was found to be 84.3%. CONCLUSION: Taller - than - wide shape, Lobulated/poorly defined margins, Hypoechogenicity and Marked hypoechogenicity, Microcalcifications and Central/central >peripheral pattern of vascularity are helpful criteria for the discrimination of malignant from benign nodules. Thyroid US achieved a good overall diagnostic accuracy in the categorization of benign and malignant thyroid nodules.

  5. The use of computerised tomography guided percutaneous fine needle aspiration in the evaluation of solitary pulmonary nodules.

    LENUS (Irish Health Repository)

    Khan, K A

    2012-02-01

    The evaluation of a solitary pulmonary nodule (SPN) has changed over the years with increased access to percutaneous computerised tomography (CT) guided fine needle aspiration (FNA), where bronchoscopy is unhelpful. The aim of our study was to evaluate the sample adequacy, diagnostic and complication rate of CT-FNA of a SPN at our academic teaching hospital over an 18 month period. CT-FNA was performed by a radiologist, with a cytopathologist in attendance to confirm the adequacy of the sample obtained. The size of the nodule, sample material and adequacy, diagnosis and complications were recorded. A total of 101 patients were included, 54 male and the mean age was 68 +\\/- 11 years. The mean size of the SPN was 2.3 cm (range 1-11 cm). 56 (56%) patients had a right SPN, 45 (45%) had a left SPN. CT-FNA was diagnostic in 80 (80%) patients and non-diagnostic in 21 (20%) patients. The sample was insufficient for immunocytochemistry, although the morphological appearance was diagnostic in 20 (25%) of the 80 patients. Pneumothorax occurred in 26\\/101 (26%) patients post CT-FNA, of these 7 (27%) required chest drain insertion, while 19 (73%) were managed conservatively. CT FNA is a useful tool for the diagnosis of a SPN, with our diagnostic accuracy comparable to that reported in the literature. However, CT-FNA may not provide adequate sample volume to perform ancillary testing and has a moderate complication rate.

  6. Utility of manual liquid-based cytology and conventional smears in the evaluation of various fine-needle aspiration samples

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    P Arul

    2016-01-01

    Full Text Available Background: Liquid-based cytology (LBC preparation is a way to improve and refine the fine-needle aspiration (FNA samples. There are a few studies comparing LBC with conventional smear (CS. Aim: The present study was undertaken to evaluate the utility of manual LBC (MLBC and CS preparations in various FNA samples. Materials and Methods: In this cross-sectional study, a total of 100 FNA samples from various anatomical sites were evaluated using MLBC and CS preparations. Cellularity, blood, informative background, monolayers, cell architecture, cytoplasmic, and nuclear preservation were compared with MLBC and CS preparations by Wilcoxon signed rank test. P < 0.05 is considered statistically significant. Results: MLBC preparations were superior to CS preparations in view of absence of blood and debris (P = 0.001, presence of monolayers (P < 0.001, and preservation of cytoplasmic (P = 0.001 and nuclear details (P = 0.001. However, no statistically significant differences were found between MLBC and CS preparations with regard to cellularity (P = 0.157, informative background (P = 0.083, and architecture (P = 0.739. Conclusion: MLBC preparations in FNAC are a safe, easy, and less time-consuming procedure, and it may have promising diagnostic value in the evaluation of FNA samples from various anatomical sites. However, the use of both MLBC and CS preparations is recommended to achieve optimal diagnostic yield.

  7. Correlation of fine needle aspiration cytology with histopathology findings in cases of thyroid lesions in Bir Hospital

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    PB Thapa

    2014-01-01

    Full Text Available Aims: To correlate the findings of fine needle aspiration cytology (FNAC with the histopathology( HPE of the excised nodule or specimen and to assess the accuracy and efficacy of FNAC in the diagnosis of the thyroid nodules. Materials and methods: This is a prospective study conducted at the Department of Ear Nose Throat (ENT & Head & NecK Surgery( HNS, National Academy of Medical Sciences, Bir Hospital, Kathmandu from 2nd January 2009 to 29th December 2011. One hundred patients with thyroid nodule were included in the study. Results: Out of 100 patients 77 were females and 23 males. The age ranged from 11-60 years. Statistical analysis of results for Benign Thyroid lesion showed 98.6% sensitivity, 75 % specificity. Likewise, results for Malignant thyroid lesions showed 75 % sensitivity, 98.6 % specificity . Conclusion: FNAC has high accuracy in the diagnostic evaluation of thyroid lesions. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 23-29 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9670

  8. Detection of TP53 mutation, loss of heterozygosity and DNA content in fine-needle aspirates of breast carcinoma.

    Science.gov (United States)

    Lavarino, C.; Corletto, V.; Mezzelani, A.; Della Torre, G.; Bartoli, C.; Riva, C.; Pierotti, M. A.; Rilke, F.; Pilotti, S.

    1998-01-01

    Recent preclinical and clinical data suggest that TP53 status and TP53 mutations may be important in determining tumour aggressiveness and therapy response. In this study we investigate the feasibility of a structural and quantitative analysis of TP53 on fine-needle aspiration (FNA) material obtained from 31 consecutive female patients with breast carcinoma, enrolled in a primary chemotherapy protocol. Tumours were screened for p53 protein overexpression and TP53 mutations (exons 5-8) using immunocytochemistry, polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) and DNA sequencing analyses, and finally using fluorescence in situ hybridization (FISH) analysis. Positive nuclear staining was identified in six cases whereas mutations were detected in nine. Although the immunoreactive pattern fitted fully with the characterized TP53 mutation type, the considerable number of null p53 mutations (i.e. four) coupled with the lack of information regarding the localization of TP53 mutations make immunocytochemistry an inadequate indicator of TP53 function deregulation. Combining molecular and FISH analyses, we detected three cases with TP53 deletion and one case with deletion and mutation. Finally, DNA static-image analysis performed on 29 cases showed aneuploidy in 26 cases, which included all TP53-mutated cases. The present results show that FNA may assist clinical decisions by allowing the evaluation of a variety of biological parameters relevant for prognosis and treatment planning. Images Figure 1 PMID:9459157

  9. Cutaneous metastasis of testicular choriocarcinoma, diagnosed by fine-needle aspiration cytology: A rare case report and review of the literature

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    Bita Geramizadeh

    2012-01-01

    Full Text Available Skin metastasis of testicular choriocarcinoma is very rare. Until now about nine cases have been reported in the English literature; however, only one of them has been diagnosed by fine-needle aspiration (FNA cytology. Herein, we report our experience with FNA cytology diagnosis of a metastatic testicular choriocarcinoma to the skin of chin. The combination of highly atypical mononuclear cells (cytotrophoblasts and multinucleated malignant cells (syncytiotrophoblasts are characteristic of metastatic tumor in a known case of choriocarcinoma of testis.

  10. Diagnosis of sebaceous lymphadenoma by fine needle aspiration in a patient with Cowden syndrome: Case report and review of the literature

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    Tarek Jazaerly

    2014-01-01

    Full Text Available Sebaceous lymphadenoma (SLA is a rare benign tumor of the salivary gland that commonly arises in the parotid gland in adults. It is rarely diagnosed correctly preoperatively. In addition, to the best of our knowledge, SLA has not been described yet in the literature in association with Cowden′s syndrome (CS. We present an extremely rare case of parotid SLA that was diagnosed preoperatively by fine needle aspiration in a patient with CS.

  11. Sentinel lymph node biopsy in clinically N0 T1-T2 staged oral cancer: the Dutch multicenter trial

    NARCIS (Netherlands)

    Flach, G.B.; Bloemena, E.; Klop, W.M.C.; van Es, R.J.J.; Schepman, K.P.; Hoekstra, O.S.; Castelijns, J.A.; Leemans, C.R.; de Bree, R.

    2014-01-01

    Objectives Results of the Dutch multi-institutional trial on sentinel lymph node (SLN) biopsy in oral cancer. Patients and methods Patients were consecutively enrolled from 4 institutions, with T1/T2 oral cancer and cN0 neck based on palpation and ultrasound guided fine needle aspiration cytology. L

  12. Avoidance of unnecessary fine-needle aspiration with the use of the Thyroid Imaging Reporting Data System classification and strain elastography based on The Bethesda System for Reporting Thyroid Cytopathology

    Science.gov (United States)

    Erkan, Murat; Canberk, Sule; Kilicoglu, Gamze Z.; Onenerk, Mine; Uludokumaci, Atay; Gunes, Pembegul; Atasoy, Tugba

    2016-01-01

    Thyroid fine-needle aspiration (FNA) biopsy has been widely accepted as an accurate and cost-effective tool in the management of thyroid nodules. To avoid unnecessary FNAs and provide appropriate management, patient evaluation should be based on a multidisciplinary approach. For this purpose, the Thyroid Imaging Reporting and Data System (TI-RADS) and strain elastography (SE) were proposed as tools for the risk assessment of malignancy in thyroid nodules. The aim of the present study was to analyze the utility of TI-RADS system and SE, along with FNA, and prospectively evaluate 369 consecutive patients referred for FNA of a thyroid nodule. TI-RADS was tested against The Bethesda System for Reporting Thyroid Cytopathology to determine whether there was an agreement between the two classification systems; statistically, some agreement was observed. Medians of the maximum SE values (E-max) were obtained for benign and malignant FNA results and found to be 1.97 [interquartile range (IQR): 1.87] and 2.8 (IQR: 3.42), respectively (P=0.004). The number of studies investigating the utility of TI-RADS and SE along with TBSRCT is currently limited. Our study demonstrated that a multidisciplinary approach with the use of TI-RADS and SE may mildly improve the management of thyroid nodules. PMID:27900100

  13. Subacute granulomatous (De Quervain′s thyroiditis: Fine-needle aspiration cytology and ultrasonographic characteristics of 21 cases

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    Çigdem Vural

    2015-01-01

    Full Text Available Background: Subacute granulomatous thyroiditis (SGT is an inflammatory disease that presents with different clinical and cytological characteristics. Although the diagnosis is generally made clinically, imaging methods and fine-needle aspiration (FNA may provide assistance, particularly in atypical cases. The objective of this study is to reveal the ultrasonographic (USG and cytological characteristics of SGT. Materials and Methods: The clinical, USG and cytological findings of 21 cases diagnosed with SGT were reviewed. Results: Ultrasonographic data was available in 20 cases. A hypoechoic thyroid nodule with irregular margins was detected in 12 of the 20 total cases. Of these, 9 cases complained about pain in the thyroid lodge and generally had unilateral lesions, heterogeneous and hypoechoic areas with indistinct margins, rather than nodular lesions, which were seen in 7 cases. Cytologically, the multinuclear giant cells (MNGCs found in all cases were accompanied by a dirty background containing varying numbers of granulomatous structures, including isolated epithelioid histiocytes, proliferated/regenerated follicle epithelium cells and inflammatory cells and colloid. Conclusion: Though hypoechoic and heterogeneous areas with irregular margins are strongly associated with thyroiditis, SGT may also appear as painful or painless hypoechoic, solid nodules and generate challenges in differential diagnosis. Although the most remarkable characteristic observed in FNA cytology was the presence of multiple MNGCs with cytoplasm, a dirty background accompanied by mild-moderate cellularity, degenerated-proliferated follicular epithelium cells, rare epithelioid granulomas and mixed type inflammatory cells are characteristic for SGT. The assessment of these radiological and cytological findings in conjunction with clinical findings will assist in the achievement of an accurate diagnosis.

  14. A cell pattern approach to interpretation of fine needle aspiration cytology of thyroid lesions: A cyto-histomorphological study

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    Bommanahalli Basavaraj

    2010-01-01

    Full Text Available Aim: Our study aimed at a cell pattern approach to interpret thyroid cytology and to demonstrate diagnostic accuracy of fine needle aspiration cytology (FNAC with an emphasis on diagnostic pitfalls. Materials and Methods: A total number of 218 goitre cases, from the year 2000 to 2004, were reviewed retrospectively from the cytology files, without considering the previous cytological diagnosis. Four cases with inadequate aspirate were excluded. The predominant cell pattern, such as macro/normofollicular, microfollicular, papillary, syncytial, dispersed and cystic pattern, was noted in each case. The final diagnosis was arrived by observing the cellular details and background elements. Cytological diagnosis was correlated with histopathology in 75 cases. The sensitivity and specificity were computed. Results: Normo/macrofollicular pattern was seen in 71.96% of nodular goitre and 6.9% of follicular neoplasms. Around 86.2% of follicular neoplasms and 17.6% of papillary carcinoma had microfollicular pattern. The papillary pattern was seen in 47% of papillary carcinoma. Syncytial pattern was noticed in 72.3% of chronic lymphocytic thyroiditis and 29.4% of papillary carcinoma. Cytological diagnosis was concordant with histopathological diagnosis in 65 cases. Overall sensitivity and specificity of FNAC in diagnosing neoplastic lesions of thyroid were 83.33 and 95.55%, respectively. Conclusion: FNAC is more sensitive and specific in triaging neoplastic from non-neoplastic thyroid lesions. Identification of the predominant cell pattern would be complementary to analysis of cell morphology and background details in cytological diagnosis of thyroid lesions. This approach helps to diagnose follicular neoplasm and follicular variant of papillary thyroid carcinoma.

  15. Endoscopic ultrasound-guided fine-needle aspiration diagnosis of secondary tumors involving the pancreas: An institution′s experience

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    Ahmed K Alomari

    2016-01-01

    Full Text Available Background: Pancreatic masses may seldom represent a metastasis or secondary involvement by lymphoproliferative disorders. Recognition of this uncommon occurrence may help render an accurate diagnosis and avoid diagnostic pitfalls during endoscopic ultrasound-guided fine needle aspiration (EUS-FNA. In this study, we review our experience in diagnosing secondary tumors involving the pancreas. Materials and Methods: The electronic database of cytopathology archives was searched for cases of secondary tumors involving the pancreas at our institution and a total of 31 cases were identified. The corresponding clinical presentations, imaging study findings, cytological diagnoses, the results of ancillary studies, and surgical follow-up, if available, were reviewed. Results: Nineteen of the patients were male and 12 female, with a mean age of 66 years. Twenty-three patients (74% had a prior history of malignancy, with the latency ranging from 6 months to 19 years. The secondary tumors involving the pancreas included metastatic carcinoma (24 cases, metastatic sarcoma (3 cases, diffuse large B-cell lymphoma (2 cases, and plasma cell neoplasm (2 cases. The most common metastatic tumors were renal cell carcinoma (8 cases and lung carcinoma (7 cases. Correct diagnoses were rendered in 29 cases (94%. The remaining two cases were misclassified as primary pancreatic carcinoma. In both cases, the patients had no known history of malignancy, and no ancillary studies were performed. Conclusions: Secondary tumors involving the pancreas can be accurately diagnosed by EUS-FNA. Recognizing uncommon cytomorphologic features, knowing prior history of malignancy, and performing ancillary studies are the keys to improve diagnostic performance and avoid diagnostic pitfalls.

  16. Liu-stain quick cytodiagnosis of ultrasound-guided fine needle aspiration in diagnosis of liver tumors

    Institute of Scientific and Technical Information of China (English)

    Chi-Sin Changchien; Jing-Houng Wang; Sheng-Nan Lu; Chao-Hung Hung; Chien-Hung Chen; Chuan-Mo Lee

    2007-01-01

    AIM: To combine ultrasound-guided fine-needle aspiration (US-FNA) and Liu (Riu) stain to make a quick study on liver tumor lesions.METHODS: Two hundred and twenty-eight aspirations from 232 patients were completely studied. The operator himself made the quick cytodiagnosis of US-FNA smear stained by Liu method within thirty minutes. The US-FNA specimen was also sent to the pathological department for cytological study and cellblock histology. The result of our Liu-stain quick cytodiagnosis in each patient was confirmed by the final cytopathological diagnosis from pathological report.RESULTS: Among 228 samples, the quick cytodiagnosis revealed 146 malignancies, 81 benign lesions and one inadequate specimen. Cytopathological diagnosis from the pathological department revealed 150 malignancies,and 78 benign lesions. Four well-differentiated hepatocellular carcinomas (HCCs) were under-diagnosed by quick cytodiagnosis as benign and 3 benign lesions were over-diagnosed as well-differentiated HCCs. Compared with cytopathological diagnosis, quick cytodiagnosis correctly diagnosed 143 malignancies and 77 benign lesions. Except for the one inadequate specimen in quick cytodiagnosis, the accuracy of quick cytodiagnosis was 96.9% (220/227), and its sensitivity, specificity and positive and negative predictive values were 97.9%, 95.1%,97.3% and 96.3%, respectively.CONCLUSION: Liu-stain quick cytodiagnosis is a fast,convenient, safe and effective method for hepatologists in clinic practice to diagnose liver tumor. In few cases of well-differentiated HCC, Liu-stain quick cytodiagnosis has its limitation.

  17. Incidental detection of filaria in fine-needle aspirates: a cytologic study of 14 clinically unsuspected cases at different sites.

    Science.gov (United States)

    Mondal, Santosh Kumar

    2012-04-01

    Filariasis is a major health problem in tropical countries like India. Detection of microfilariae or adult worm or egg in FNAC is very unusual despite the high incidence of this parasite in endemic zone. The aim of this study was to document the value of fine-needle aspiration cytology (FNAC) in diagnosis of filaria at all possible sites presenting as mass or swelling. Fourteen patients (nine males and five females) in the age range of 14-61 years were subjected to FNAC. FNA from swellings was done using 22-gauge needles fitted with 10 or 20 ml disposable plastic syringes. The slides were stained with May-Grunwald-Giemsa stain, Haematoxylin and Eosin (H&E) stain, and Papanicolaou (Pap) stain. In total, 14 cases of filariasis were detected, which included subcutaneous swellings (six cases), epididymis/spermatic cord nodules (four cases), breast lumps (two cases), lymph nodes (one case), and thyroid swelling (one case). Larvae (microfilariae), eggs, and adult worms were detected in cytological smears. Microfilaria was present in all 14 cases whereas adult worm was found in three cases only. In four cases, eggs were seen in the smears. None of the patients was microfilariaemic and significant eosinophilia (>10%) was seen seen in two patients. Filarisis should be considered as one of the differential diagnosis of swelling in endemic area. Identification of the parasite, Wuchereria bancrofti, in FNA smears and accurate diagnosis of filaria is important to employ proper treatment. Early diagnosis and treatment prevents the more severe manifestation of the disease, lymphatic filariasis.

  18. The utility of p16 immunostaining in fine needle aspiration in p16-positive head and neck squamous cell carcinoma.

    Science.gov (United States)

    Xu, Bin; Ghossein, Ronald; Lane, Jason; Lin, Oscar; Katabi, Nora

    2016-08-01

    Many patients with human papillomavirus (HPV)-related head and neck squamous cell carcinoma present initially with cervical nodal metastasis. Fine needle aspiration (FNA) of the nodal disease might be the only diagnostic material available for p16 immunohistochemistry (IHC) and HPV testing. The current study aims to evaluate p16 IHC in FNA and establish guidelines for its interpretation. The percentage and intensity of p16 IHC staining were examined in 60 matched FNA and surgical cases. Cytomorphologic features were included in the analysis. p16 IHC staining was correlated with the results seen in the surgical specimens and with HPV in situ hybridization (ISH). Analysis of different thresholds demonstrated that the threshold of 10% p16 tumor cell positivity had the best overall concordance rate with surgical p16 IHC (κ = 0.650) and with FNA HPV-ISH (κ = 0.714). Applying the recommended p16 positivity threshold for surgical specimens (70%) on FNA materials resulted in low sensitivity (39%) and low negative predictive value (26%). In comparison with p16 IHC in surgical specimens, 6/46 FNA cases (13%) were falsely negative for p16. All 6 cases were associated with necrotic background, two (33%) lacked large tumor clusters, and one (17%) had low cellularity. The recommended threshold for p16 IHC on surgical specimens should not be used in cytology materials. The cutoff value for p16 immunostain in FNA specimens showing best results in our series is 10%. When p16 IHC is negative in FNA specimens, a repeat stain on a surgical specimen is recommended to avoid a false-negative diagnosis.

  19. Risk factors for aggressive nonfunctional pancreatic neuroendocrine tumors and the role of endoscopic ultrasound guided fine-needle aspiration

    Science.gov (United States)

    Ende, Alexander R.; Sedarat, Alireza; Shah, Pari; Jhala, Nirag; Fraker, Douglas L.; Drebin, Jeffrey A.; Metz, David C.; Kochman, Michael L.

    2016-01-01

    Background: Nonfunctional pancreatic neuroendocrine tumors (NF-pNETs) are increasingly being diagnosed but management, especially of small tumors, remains a clinical dilemma. Endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) is now routinely used for diagnosis of pancreatic neuroendocrine tumors (pNETs) but has not been well studied as a tool for identifying aggressive disease. Materials and Methods: A systematic search of the cytology database identified all patients at our center who underwent EUS-FNA from 1999 through 2011 and were diagnosed with NF-pNET. Results: A total of 50 patients were identified. Though patients with metastatic disease had a mean tumor size of 40 mm compared to 25 mm in patients without metastatic disease (P = 0.04), we also identified several patients with tumors 20 mm (P = 0.13). Using receiver operating characteristic (ROC) analysis, we found that using a cutoff point of 20 mm only led to a sensitivity of 85% in screening for metastases, while lowering the cutoff point to 18 mm allowed for a sensitivity of 95%. Conclusion: Currently, guidelines suggest that only patients with tumors greater than 20 mm undergo surgical resection, as tumors less than this size are thought to have low risk of metastases. Our analysis suggests that these recommendations could lead to undertreating patients with small tumors. Tumor size alone may be inadequate as a marker for aggressive NF-pNETs. Given this, other risk factors for aggressive pNETs should be studied to help identify the patients most likely to benefit from surgery. PMID:26879167

  20. Fine needle aspiration cytology of oral and oropharyngeal lesions with an emphasis on the diagnostic utility and pitfalls

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    Nalini Gupta

    2012-01-01

    Full Text Available Aim: This study was undertaken to evaluate the diagnostic utility and pitfalls of fine needle aspiration cytology (FNAC in oral and oropharyngeal lesions. Materials and Methods: This was a retrospective audit of oral and oropharyngeal lesions diagnosed with FNAC over a period of six years (2005-2010. Results: Oral/oropharyngeal lesions [n=157] comprised 0.35% of the total FNAC load. The age ranged 1-80 years with the male: female ratio being 1.4:1. Aspirates were inadequate in 7% cases. Histopathology was available in 73/157 (46.5% cases. Palate was the most common site of involvement [n=66] followed by tongue [n=35], buccal mucosa [n=18], floor of the mouth [n=17], tonsil [n=10], alveolus [n=5], retromolar trigone [n=3], and posterior pharyngeal wall [n=3]. Cytodiagnoses were categorized into infective/inflammatory lesions and benign cysts, and benign and malignant tumours. Uncommon lesions included ectopic lingual thyroid and adult rhabdomyoma of tongue, and solitary fibrous tumor (SFT, and leiomyosarcoma in buccal mucosa. A single false-positive case was dense inflammation with squamous cells misinterpreted as squamous cell carcinoma (SCC on cytology. There were eight false-negative cases mainly due to sampling error. One false-negative case due to interpretation error was in a salivary gland tumor. The sensitivity of FNAC in diagnosing oral/oropharyngeal lesions was 71.4%; specificity was 97.8% with diagnostic accuracy of 87.7%. Conclusions: Salivary gland tumors and squamous cell carcinoma (SCC are the most common lesions seen in the oral cavity. FNAC proves to be highly effective in diagnosing the spectrum of different lesions in this region. Sampling error is the main cause of false-negative cases in this region.

  1. Fine-needle aspiration cytology: its origin, development, and present status with special reference to a developing country, India.

    Science.gov (United States)

    Das, Dilip K

    2003-06-01

    Fine-needle aspiration cytology (FNAC) was performed on a large scale at Memorial Hospital, New York, during the 1930s, but during the ensuing years, it did not gain much encouragement in United States. The technique had a resurgence in Scandinavia during the 1950s and 1960s, where it flourished before spreading to other parts of the world. It had also a revival in the United States, which contributed enormously to this tool in each and every aspect. The status of FNA during 1966-2002 was assessed through review of MEDLINE search data on FNA and its correlation with World Bank website data on classification of countries. A total of 849 journals published 5,609 articles on FNA over a period of 37 years. Both the number of publishing journals and the number of published articles on FNA were low during the 1960s (3.5 +/- 0.58 and 4.0 +/- 0.82, respectively) and 1970s (20.3 +/- 14.72 and 25.0 +/- 20.54, respectively), but their number increased sharply from the 1980s onward (78.2 +/- 25.65 and 147.2 +/- 66.89, respectively, during the 1980s, 126.2 +/- 11.94 and 301.4 +/- 35.99, respectively, during the 1990s, and 113.3 +/- 36.46 and 287.3 +/- 85.93, respectively, during the 2000s). The difference between the decades of 1960s-2000s, with respect to the number of publishing journals and published articles, was highly significant (P published 2,448 (43.6%) of the total articles on FNA. During 1987-2002, 46 (29.7%) of the 155 developing nations published articles on FNA, whereas 28 (52.8%) of the developed (high-income economies) countries did so, the difference being highly significant (P = 0.0044). The total number of publications from high-income economies was 3,124 (195.3 per year), as opposed to 772 (48.3 per year) from the developing world. The number of articles published from the developing nations (16.8 +/- 52.21) was significantly lower as compared with that from the high-income economies (111.6 +/- 242.03) (P = 0.005). Except for infectious diseases, the high

  2. Diagnostic difficulties and pitfalls in rapid on-site evaluation of endobronchial ultrasound guided fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Monaco Sara

    2010-01-01

    Full Text Available Background: One of the novel techniques utilizing fine needle aspiration (FNA in the diagnosis of mediastinal and lung lesions is the endobronchial ultrasound (EBUS-guided FNA. In this study, we describe five cases which had a discrepancy between on-site evaluation and final diagnosis, or a diagnostic dilemma when rendering the preliminary diagnosis, in order to illustrate some of the diagnostic difficulties and pitfalls that can occur in EBUS FNA. Methods: A total of five EBUS FNA cases from five patients were identified in our records with a discrepancy between the rapid on-site evaluation (ROSE and final diagnosis, or that addressed a diagnostic dilemma. All of the cases had histological confirmation or follow-up. The cytomorphology in the direct smears, cell block, and immunohistochemical stains were reviewed, along with the clinical history and other available information. Results: Two cases were identified with a nondefinitive diagnosis at ROSE that were later diagnosed as malignant (metastatic signet-ring cell adenocarcinoma and metastatic renal cell carcinoma (RCC on the final cytological diagnosis. Three additional cases were identified with a ROSE and final diagnosis of malignant (large cell neuroendocrine carcinoma (LCNEC and two squamous cell carcinomas, but raised important diagnostic dilemmas. These cases highlight the importance of recognizing discohesive malignant cells and bland neoplasms on EBUS FNA, which may lead to a negative or a nondefinitive preliminary diagnosis. Neuroendocrine tumors can also be difficult due to the wide range of entities in the differential diagnosis, including benign lymphocytes, lymphomas, small and nonsmall cell carcinomas, and the lack of immunohistochemical stains at the time of ROSE. Finally, the background material in EBUS FNAs may be misleading and unrelated to the cells of interest. Conclusions: This study illustrates the cytomorphology of five EBUS FNA cases that address some of the

  3. 1201例甲状腺细针穿刺术的护理%Nuring care of 1 201 cases accepting fine needle aspiration on thyroid gland

    Institute of Scientific and Technical Information of China (English)

    李瑛; 张华; 赵芳

    2011-01-01

    @@ 甲状腺细针穿刺术(fine needle aspiration,FNA)是安全、经济、简便的检查手段,可准确评估甲状腺结节[1].甲状腺细针穿刺细胞学检查能够为甲状腺结节的诊断提供可靠的细胞病理学依据,有经验的穿刺和细胞学检查其敏感性和特异性均可达95%以上[2].

  4. Sentinel lymph node biopsy in breast cancer--experience with the combined use of dye and radioactive tracer at Aarhus University Hospital

    DEFF Research Database (Denmark)

    Lauridsen, Mette Cathrine; Garne, Jens Peter; Sørensen, Flemming Brandt;

    2004-01-01

    One hundred and twenty-four patients with palpable tumours underwent sentinel lymph node biopsy (SLNB) and subsequent axillary lymph node dissection. Ultrasound of the axilla was used as part of the diagnostic work-up on all patients and those with lymph node metastasis verified by fine-needle as...

  5. The role of endoscopic ultrasound guided fine needle aspiration (EUS-FNA in non small cell lung cancer (NSCLC patients: SEED-SEPD-AEG Joint Guideline

    Directory of Open Access Journals (Sweden)

    Enrique Vázquez-Sequeiros

    2013-04-01

    Full Text Available Lung cancer is one of the most frequent neoplasms in our environment, and represents the first cause of cancer related death in western countries. Diagnostic and therapeutic approach to these patients may be complicated, with endoscopic ultrasound guided fine needle aspiration (EUS-FNA, classically performed by gastroenterologists, playing a very important role. As this disease is not closely related to the "digestive tract", gastroenterologists have been forced to update their knowledge on this field o adequately diagnose this significant group of patients. The recent advent of modern and promising techniques like endobronchial ultrasound guided fine needle aspiration (EBUS-FNA have prompted new approaches for diagnosis and staging of this type of patients. In this clinical guideline, the "Sociedad Española de Endoscopia Digestiva" (SEED, "Sociedad Española de Patología Digestiva" (SEPD and the "Asociación Española de Gastroenterología", have jointed efforts to update the existing knowledge on the field and provide their members with evidence based recommendations.

  6. Comparison of sample adequacy, pain-scale ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience.

    Science.gov (United States)

    Lee, Yoo Jin; Kim, Dong Wook; Jung, Soo Jin

    2013-12-01

    This study aimed to assess and compare the sample adequacy, patient pain ratings, and complications associated with ultrasound-guided fine-needle aspiration of thyroid nodules between two radiologists with different levels of experience. From March 2012 to May 2012, two radiologists performed ultrasound-guided fine-needle aspiration to diagnose thyroid nodules in consecutive patients using the same techniques. 157 patients were divided into two groups: group 1 consisted of 75 patients who underwent ultrasound-guided fine-needle aspiration by an experienced radiologist and group 2 consisted of 82 patients who underwent ultrasound-guided fine-needle aspiration by a less experienced radiologist. The sample adequacy, pain-scale ratings, and complications related to ultrasound-guided fine-needle aspiration were compared between the two groups. There was no statistical difference in sex, age, nodule size, or location between the two groups. There was no statistical difference (p = 0.710) in the prevalence of adequate cytology between group 1 (94.7 % [71/75]) and group 2 (96.3 % [79/82]). The mean ± standard deviation of pain-scale ratings was 1.99 ± 1.68 in group 1 and 2.30 ± 1.83 in group 2, but there was no statistical difference (p = 0.326). There were no significant complications related to the procedure and no sonographic changes on follow-up ultrasound for either group. The study results demonstrated good outcomes for ultrasound-guided fine-needle aspiration of thyroid nodules and no statistically significant differences in sample adequacy, pain-scale ratings, or complication rates between two radiologists with different levels of experience.

  7. Percutaneous computed tomography-guided biopsy of the lung: data from a hospital; Biopsia pulmonar percutanea guiada por tomografia computadorizada: dados de um hospital

    Energy Technology Data Exchange (ETDEWEB)

    Carazzai, Emilio Humberto; Rossi, Marcelo D' Andrea [Maximagem Diagnosticos por Imagem, Sao Paulo, SP (Brazil); Andreosi, Maristela [Hospital Beneficencia Portuguesa, Sao Paulo, SP (Brazil); Gonzalez, Fabio Mota; Tornin, Olger de Souza [Hospital Heliopolis, Sao Paulo, SP (Brazil)]. E-mail: olger1@uol.com.br; Gonzalez, Sandra de Quadros Uzeda [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil)

    2006-07-15

    Objective: to present the experience of Santa Cecilia Hospital (Sao Paulo, SP, Brazil) radiology service in the handling of computed tomography-guided fine-needle aspiration biopsy and percutaneous core biopsy of pulmonary lesions, analyzing their importance and associated complications. Materials and methods: one hundred and sixty-eight computed tomography-guided biopsies were performed in 84 men and 84 women. Sixty-four patients underwent fine-needle aspiration biopsy, 68 underwent percutaneous core biopsy and 36 patients underwent both techniques. Results: pneumothorax occurred in 38 patients, and pulmonary hemorrhage in then cases. The biopsied lesions ranged in size from 0.5 to 15 cm. The diagnosis was achieved at the first attempt in 132 cases and at the second attempt, in ten cases. Conclusion: the accuracy of fine-needle aspiration and percutaneous core biopsies depends both on the size of the lesion and the patient's cooperation. These techniques are relatively safe and present a high diagnostic accuracy when performed by an experienced professional. (author)

  8. Disseminated histoplasmosis in an immunocompetent haweli dweller: A diagnosis and follow-up by endoscopic ultrasound-guided fine-needle aspiration

    Directory of Open Access Journals (Sweden)

    Ruth Shifa Ecka

    2015-01-01

    Full Text Available Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA is nowadays widespread minimally invasive procedure for diagnosing a large number of benign as well as malignant lesions. We report a case of a 62-year-old immunocompetent elderly male, who presented with high-grade fever, hepatosplenomegaly and mediastinal and intra-abdominal lymph nodes. He was residing in an old haweli with bats infestation. EUS-FNA of the subcarinal and the preaortic lymph node clinched the diagnosis. A rapid on-site evaluation of the cytology material revealed organisms conforming to the morphology of Histoplasma capsulatum. The patient was immediately started on amphotericin B and itraconazole and responded well. In this case, we found the role of EUS-FNA not only in diagnosis, but also in the follow-up of the patient.

  9. Impact of Molecular Screening for Point Mutations and Rearrangements in Routine Air-Dried Fine-Needle Aspiration Samples of Thyroid Nodules

    DEFF Research Database (Denmark)

    Eszlinger, Markus; Krogdahl, Annelise; Münz, Sina

    2014-01-01

    Background: The diagnostic limitations of thyroid fine-needle aspiration (FNA), such as the indeterminate category, can be partially overcome by molecular analyses. However, until now, rearrangements have only been detected in fresh FNA material and the number of follicular thyroid carcinomas (FTCs...... formalin-fixed paraffin-embedded tissue (156 follicular adenomas [FAs], 32 FTCs, 44 papillary thyroid carcinomas [PTCs], 9 follicular variant PTCs, and 69 goiters). PAX8/PPARG and RET/PTC rearrangements were detected by qPCR, BRAF and RAS mutations by high-resolution melting PCR and by pyrosequencing....... Results: Forty-seven mutations were detected in the FNAs: 22 BRAF, 13 NRAS, and 3 HRAS mutations, 8 PAX8/PPARG, and one RET/PTC-rearrangement. While the presence of a BRAF and RET/PTC mutation was associated with cancer in 100% of samples each, the presence of a RAS and PAX8/PPARG mutation was associated...

  10. Detection of PAX8/PPARG and RET/PTC Rearrangements Is Feasible in Routine Air-Dried Fine Needle Aspiration Smears

    DEFF Research Database (Denmark)

    Ferraz, Carolina; Rehfeld, Christian; Krogdahl, Annelise;

    2012-01-01

    Background: The diagnostic limitations of fine needle aspiration (FNA), like the indeterminate category, can be partially overcome by molecular analysis. As PAX8/PPARG and RET/PTC rearrangements have been detected in follicular thyroid carcinomas (FTCs) and papillary thyroid carcinomas (PTCs...... as generally not suitable for testing these rearrangements in a clinical setting. Therefore, the objective of the present study was to investigate the feasibility of extracting RNA from routine air-dried FNA smears for the detection of these rearrangements with real-time polymerase chain reaction (RT......-PCR). Methods: A new method for RNA extraction from routine air-dried FNA smears was established, which allowed analysis for the presence of four variants of PAX8/PPARG and RET/PTC 1 and RET/PTC 3, which were analyzed in 106 routine FNA smears and the corresponding surgically obtained FFPE tissues using real...

  11. Combined papillary and mucoepidermoid carcinoma of the thyroid gland: a possible collision tumor diagnosed on fine-needle cytology. Report of a case with immunocytochemical and molecular correlations.

    Science.gov (United States)

    Fulciniti, Franco; Vuttariello, Emilia; Calise, Celeste; Monaco, Mario; Pezzullo, Luciano; Chiofalo, Maria Grazia; Di Gennaro, Francesca; Malzone, Maria Gabriella; Campanile, Anna Cipolletta; Losito, Nunzia Simona; Botti, Gerardo; Chiappetta, Gennaro

    2015-05-01

    Fine-needle cytology (FNC) is frequently used to diagnose thyroid nodules discovered by palpation or imaging studies. Molecular tests on FNC material may increase its diagnostic accuracy. We report a case of a classic papillary thyroid carcinoma combined with a mucoepidermoid carcinoma correctly identified on FNC. The papillary component had a classic immunophenotype (CK19+, TTF1+), while the mucoepidermoid one was only focally CK19+. Point mutations (BRAF and RAS) and rearrangements (RET/PTC) of the papillary component have been also investigated on FNC samples, with resulting concurrent rearrangements of RET/PTC1 and RET/PTC3, but no point mutations. The histogenesis of combined papillary and mucoepidermoid carcinoma of the thyroid still remains partly unsettled, and further genomic studies are needed to shed some more light on this peculiar neoplasm.

  12. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of pancreatic cysts by combined cytopathology and cystic content analysis

    Institute of Scientific and Technical Information of China (English)

    Amanda; K; Martin; Zhongren; Zhou

    2015-01-01

    Recent advances in imaging technology have resulted in an increase in incidental discoveries of pancreatic cystic lesions. Pancreatic cysts comprise a wide variety of lesions and include non-neoplastic cysts and neoplastic cysts. Because some pancreatic cysts have more of a malignant potential than others, it is absolutely essential that an accurate diagnosis is rendered so that effective care can be given to each patient. In many centers, endoscopic ultrasound(EUS)-guided fine-needle aspiration(FNA) has emerged as the modality of choice that enables one to distinguish between mucinous and non-mucinous lesion, diagnose malignancy and collect cyst fluid for further diagnostic studies, such as pancreatic enzyme levels, molecular analysis and other tumor biomarkers. The current review will focus on EUSguided FNA and the cytological diagnosis for pancreatic cysts.

  13. Unsuspected pheochromocytoma: Risk of blood-pressure alterations during percutaneous adrenal biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Casola, G.; Nicolet, V.; van Sonnenberg, E.; Withers, C.; Bretagnolle, M.; Saba, R.M.; Bret, P.M.

    1986-06-01

    Four unsuspected pheochromocytomas were discovered during percutaneous fine-needle biopsy of the adrenal gland under ultrasound (n = 1) and computed tomographic (n = 3) guidance. One patient suffered an acute episode of alternating hypertension and hypotension during the procedure. A second patient had no alterations in vital signs during the procedure but had a severe hypertensive crisis during induction of anesthesia at surgery. Neither biopsy nor surgery affected the vital signs in the other two patients. During biopsy study of adrenal lesions, the possibility of unsuspected pheo-chromocytoma should be considered, and the interventional radiologist must be familiar with the emergency treatment of hypotensive or hypertensive crises that may occur.

  14. Outcome of patients with early stage oral cancer managed by an observation strategy towards the N0 neck using ultrasound guided fine needle aspiration cytology: No survival difference as compared to elective neck dissection

    NARCIS (Netherlands)

    Flach, G.B.; Tenhagen, M.; de Bree, R.; Brakenhoff, R.H.; van der Waal, I.; Bloemena, E.; Kuik, D.J.; Castelijns, J.A.; Leemans, C.R.

    2013-01-01

    Objectives Management of the clinically N0 neck in oral cancer patients remains controversial. We describe the outcome of patients with T1-T2 oral cancer and N0 neck based on ultrasound guided fine needle aspiration cytology (USgFNAC) who were treated by transoral excision and followed by a ‘wait an

  15. Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Lesions: A Systematic Review of Technical and Procedural Variables.

    Science.gov (United States)

    Jani, Bhairvi S; Rzouq, Fadi; Saligram, Shreyas; Lim, Diego; Rastogi, Amit; Bonino, John; Olyaee, Mojtaba

    2016-01-01

    Endoscopic ultrasound (EUS)-guided tissue acquisition has emerged over the last decade as an invaluable diagnostic tool in approaching the different pancreatic lesions. Given the safety and minimal invasiveness of this approach combined with the high diagnostic yield, it became the standard of care when dealing with different pancreatic pathologies. However, some variables regarding this procedure remain not fully understood. These can influence the diagnostic yield of the procedure and include the presence of the on-site cytopathologist, the type and size of the needle used as well as obtaining aspiration versus core biopsy, the number of passes and the sampling technique, and the role of suction and stylet use among others. We performed a comprehensive literature search using PubMed, Google Scholar, and Embase for studies that assessed these variables. Eligible studies were analyzed using several parameters such as technique and procedure, with the aim of reviewing results from an evidence-based standpoint.

  16. Endoscopic ultrasound-guided fine-needle aspiration of pancreatic lesions: A systematic review of technical and procedural variables

    Directory of Open Access Journals (Sweden)

    Bhairvi S Jani

    2016-01-01

    Full Text Available Endoscopic ultrasound (EUS-guided tissue acquisition has emerged over the last decade as an invaluable diagnostic tool in approaching the different pancreatic lesions. Given the safety and minimal invasiveness of this approach combined with the high diagnostic yield, it became the standard of care when dealing with different pancreatic pathologies. However, some variables regarding this procedure remain not fully understood. These can influence the diagnostic yield of the procedure and include the presence of the on-site cytopathologist, the type and size of the needle used as well as obtaining aspiration versus core biopsy, the number of passes and the sampling technique, and the role of suction and stylet use among others. We performed a comprehensive literature search using PubMed, Google Scholar, and Embase for studies that assessed these variables. Eligible studies were analyzed using several parameters such as technique and procedure, with the aim of reviewing results from an evidence-based standpoint.

  17. Punção Aspirativa por Agulha Fina Orientada por Ultra-Sonografia em Lesões Não-palpáveis Fine Needle Aspiration Cytology Guided by Ultrasound in Nonpalpable Lesions

    Directory of Open Access Journals (Sweden)

    Cláudio Kemp

    2001-06-01

    (cystic or solid masses with the ultrasound and histopathological features of the biopsy lesions. Methods: a total of 617 nonpalpable lesions were analyzed by ultrasound. Fine needle aspiration cytology was guided by ultrasonography and the cysts were distinguished from the solid masses by comparing the biopsies. The cytologic results were compared with the histological results in the case surgical biopsy was carried out. Results: of the 617 nonpalpable lesions 471 were cysts (451 simple cysts with 100% negative cytology and 20 cases were considered complex cysts; 3 (15% of these had a positive or suspected cytology and in 2 cases malignancy was confirmed. There were 105 solid masses, 63 of them with negative cytology. Fifty-nine cases had a negative biopsy, and 4 cases (0.3% were false-negative but all of them presented disagreement between the cytological and image features; in 14 cases (13% there was a suspected cytology and in 5 of them carcinoma was confirmed; in 14 cases (13%, the samples were insufficient, 1 case was carcinoma and in 51 cases, a triple diagnosis was concordant and the lesions were followed-up. Conclusion: cytological analysis of simple cysts is not required, but when they are complex, cytological analysis is mandatery. In the case of nonpalpable solid masses, cytology must be correlated with ultrasound and mammography features. If the results are discordant, the lesion should be followed-up.

  18. Bone Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  19. Metastasis of colon cancer to the thyroid gland: a case diagnosed on fine-needle aspirate by a combined cytological, immunocytochemical, and molecular approach.

    Science.gov (United States)

    Cozzolino, Immacolata; Malapelle, Umberto; Carlomagno, Chiara; Palombini, Lucio; Troncone, Giancarlo

    2010-12-01

    Fine-needle aspiration (FNA) with cytological evaluation reliably diagnoses primary and secondary thyroid neoplasms. However, identifying the primary origin of a metastatic process involving the thyroid gland is challenging. In particular, metastasis of colon cancer to the thyroid gland is very rare. In this case report, a right lobe solid thyroid nodule in a 66-year-old male was aspirated. FNA cytology showed necrosis and atypical tall columnar cells; since, the patient at age 60 had undergone surgery for a sigmoid-rectal cancer metastasizing to the liver and subsequently to the lung, a suspicion of metastasis from colon cancer was raised. This was corroborated by cell-block immunocytochemistry showing a cytokeratin (CK) 7 negative/CK20-positive staining pattern; thyreoglobulin and TTF-1 were both negative. Since KRAS codon 12/13 mutations frequently occur in colon cancer, whereas they are extremely uncommon in primary thyroid tumors, DNA was extracted from the aspirated cells, and KRAS mutational analysis was carried out. The codon 12 G12D mutation was found; the same mutation was evident in the primary cancer of the colon and in its liver and lung metastasis. Thus, a combined cytological, immunocytochemical and molecular approach unquestionably correlated metastatic adenocarcinoma cells aspirated from the thyroid to a colo-rectal origin.

  20. Individual and combined diagnostic accuracy of ultrasound diagnosis, ultrasound-guided fine-needle aspiration and polymerase chain reaction in identifying tuberculous lymph nodes in the neck.

    Science.gov (United States)

    Kim, Dong Wook; Jung, Soo Jin; Ha, Tae Kwun; Park, Ha Kyoung

    2013-12-01

    The aim of this study was to assess the efficacy of, both individually and in combination, ultrasound (US) diagnosis, US-guided fine-needle aspiration (US-FNA) and polymerase chain reaction (PCR) in diagnosing tuberculous lymph nodes in the neck (i.e., tuberculous cervical lymph nodes [TCLs]). Eighty-two patients who underwent US diagnosis, US-FNA and PCR for clinical suspicion of TCLs were enrolled. Of the 82 patients, 31 were confirmed as having TCLs. The sensitivity, specificity, positive and negative predictive values and accuracy of US diagnosis, US-FNA and PCR were 93.5%, 76.5%, 70.7%, 95.1% and 82.9%; 64.5%, 98.0%, 95.2%, 82.0% and 85.4%; and 100%, 96.1%, 93.9%, 100% and 97.6%, respectively. The diagnostic values of PCR alone and in combination with US-FNA were found to be higher than those of other methods. No US feature with high sensitivity and specificity was identified.

  1. BRAF(V600E) assessment by pyrosequencing in fine needle aspirates of thyroid nodules with concurrent Hashimoto's thyroiditis is a reliable assay.

    Science.gov (United States)

    Guerra, Anna; Di Stasi, Vincenza; Zeppa, Pio; Faggiano, Antongiulio; Marotta, Vincenzo; Vitale, Mario

    2014-03-01

    Detection of BRAF mutation in cytology specimens has been proposed as a diagnostic adjunctive tool in evaluation of thyroid nodules with indeterminate cytology findings. Concurrent papillary thyroid carcinoma and Hashimoto's thyroiditis (HT), a disease characterized by thyroid lymphocytic infiltration, is a frequent occurrence. A large lymphocytic infiltrate might reduce the sensitivity of methods employed to detect BRAF mutation in thyroid cytology specimens. To determine whether testing for BRAF mutational status in fine needle aspirates (FNA) is reliable also in the presence of HT lymphocytic infiltration, we assessed the BRAF status by direct sequencing and pyrosequencing in a series of FNAs with and without concomitant HT lymphocytic infiltration. We also performed the same assessment by pyrosequencing in the corresponding tissue samples. Pyrosequencing demonstrated to be more sensitive than direct sequencing. The percentage of mutant BRAF(V600E) alleles was higher in FNAs than in the corresponding tissues, probably because of the lower stromal contamination in FNA than in the sections. In the presence of lymphocytic infiltration, the percentage of mutant BRAF(V600E) alleles determined by pyrosequencing was higher in FNAs than in the corresponding tissue samples (P lymphocytic contamination in FNA. The diagnostic value of BRAF(V600E) in inconclusive FNAs was not hampered by thyroid lymphocytic infiltration. These results indicate that BRAF(V600E) assessment by pyrosequencing is a reliable assay useful to refine inconclusive cytology of thyroid nodules also in the presence of concurrent HT.

  2. Tibial bone metastasis as an initial presentation of endometrial carcinoma diagnosed by fine-needle aspiration cytology: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Sarag Aboujafar Boukhar

    2015-01-01

    Full Text Available Endometrial cancer is the most common gynecologic malignancy in the United States. However, bony metastasis is infrequent and exceptionally rare as the initial presentation. We report a case of a 77-year-old female with a clinically silent endometrial carcinoma who presented with a left tibial metastasis as the first manifestation of her disease. Ours is only the third case diagnosed by fine-needle aspiration (FNA cytology, and the first to detail the cytomorphologic features of metastatic endometrial cancer to bone. These microscopic findings, including three-dimensional cohesive clusters with cellular overlapping and cuboidal to columnar cells exhibiting low nuclear: cytoplasmic ratios and partially vacuolated cytoplasm, differ significantly from those of endometrial carcinoma on a Papanicolaou test. The tumor bore similarity to the more commonly encountered metastatic colon cancer, but immunohistochemical staining enabled reliable distinction between these entities. A review of osseous metastases of endometrial cancer demonstrates a predilection for bones of the lower extremity and pelvis with a predominance of the endometrioid histologic subtype. In about a quarter of the cases, the bony metastasis was the first manifestation of the cancer. FNA was an effective diagnostic modality for this unusual presentation of a common malignancy. Awareness of this entity and its differential diagnosis is essential for accurate and timely diagnosis.

  3. Fine Needle Aspiration of Thyroid Nodules Using the Bethesda System for Reporting Thyroid Cytopathology: An Institutional Experience in a Rural Setting

    Science.gov (United States)

    Kaminoh, Yuuki; Forward, Terra; Schwartz, Frank L.; Jenkinson, Scott

    2017-01-01

    Background. Fine needle aspiration (FNA) remains the first-line diagnostic in management of thyroid nodules and reduces unnecessary surgeries. However, it is still challenging since cytological results are not always straightforward. This study aimed to examine the results of thyroid FNA using the Bethesda system for reporting thyroid cytopathology (TBSRTC) to establish the level of accuracy of FNA procedures in a rural practice setting. Method. A retrospective chart review was conducted on existing thyroid FNA performed in a referral endocrine center between December 2011 and November 2015. Results. A total of 159 patients (18–88 years old) and 236 nodule aspirations were performed and submitted for evaluation. 79% were benign, 3% atypia/follicular lesion of unknown significance (AUS/FLUS), 5% follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), 4% suspicious for malignancy (one case was indeed an atypical parathyroid neoplasm by surgical pathology), 2% malignant, and 7% nondiagnostic. Two cases also had advanced molecular analysis on FNA specimens before thyroidectomy. Conclusion. The diagnostic yield of FNA cytology from our practice in a rural setting suggests that accuracy and specificity are comparable to results from larger centers. PMID:28280507

  4. Ultrasound-guided fine-needle aspiration for solid thyroid nodules larger than 10 mm: correlation between sonographic characteristics at the needle tip and nondiagnostic results.

    Science.gov (United States)

    Wu, Hongxun; Zhang, Bingjie; Zang, Yaping; Wang, Jun; Zhu, Beilin; Cao, Yuelong; Liu, Qianyun

    2014-06-01

    The objective of this study was to investigate the effect of the ultrasonographic (US) characteristics and ultrasound elastography (UE) patterns on the probability of a nondiagnostic result when performing ultrasound-guided fine-needle aspiration (UG-FNA) cytological sampling of solid thyroid nodules larger than 10 mm, to determine the efficacy of needle tip localization in UG-FNA. We retrospectively reviewed the cytological results of 710 samples from 355 patients. We compared the US characteristics and UE patterns between nodules with nondiagnostic and diagnostic results, using univariate and multivariate analyses. Among the 710 samples, 81 samples (11.4 %) from 41 patients had nondiagnostic results. According to multivariate analysis, the combinations of hypoechogenicity with avascularity [odds ratio (OR) = 2.42; 95 % confidence interval (CI) 1.37-3.72; p hypoechogenicity with the "hard pattern" (OR = 2.12; 95 % CI 1.58-4.59; p hypoechogenicity with avascularity and the hard pattern (OR = 2.61; 95 % CI 1.40-5.21; p hypoechogenicity and avascularity in US and the hard pattern in UE.

  5. c-erbB2/neu gene and chromosome 17 analysis in breast cancer by FISH on archival cytological fine-needle aspirates

    Science.gov (United States)

    Mezzelani, A; Alasio, L; Bartoli, C; Bonora, M G; Pierotti, M A; Rilke, F; Pilotti, S

    1999-01-01

    The detection of specific genetic alterations in breast cancer is useful for diagnosing, predicting prognosis and planning preoperative treatment. c-erbB2/neu overexpression is usually detected by immunocytochemistry (ICC), although this technique is neither completely reproducible nor highly reliable, owing to specimen and methodologic variability and antibody sensitivity. Here, we combine two well-established techniques, fine-needle aspiration (FNA) and fluorescence in situ hybridization (FISH), to detect c-erbB2/neu amplification in patients candidate to primary chemotherapy and, in part, previously analysed for c-erbB2/neu overexpression. Sixty smears from FNA were used to simultaneously detect c-erbB2/neu and chromosome 17 centromere. FISH was successful in 58 cases and detected 24 amplified cases, three of which were negative by immunophenotyping, 28 negative cases, with evidence of two normal c-erbB2/neu/ signals, two cases with deletion of c-erbB2/neu, and four cases with polysomy, thus providing more reliable and informative results than ICC. This study underlines the advantages offered by the FNA and FISH combination which are two rapid, reliable, simple and informative techniques, to analyse one of the most important genetic markers for predicting prognosis and chemotherapy planning for breast carcinoma in particular in the light of the recently proposed trials of primary chemotherapy. © 1999 Cancer Research Campaign PMID:10408862

  6. Gum biopsy

    Science.gov (United States)

    Biopsy - gingiva (gums) ... used to close the opening created for the biopsy. ... to eat for a few hours before the biopsy. ... Risks for this procedure include: Bleeding from the biopsy site Infection of the gums Soreness

  7. Molecular testing guidelines for lung adenocarcinoma: Utility of cell blocks and concordance between fine-needle aspiration cytology and histology samples

    Directory of Open Access Journals (Sweden)

    Jonas J. Heymann

    2014-01-01

    Full Text Available Background: Lung cancer is a leading cause of mortality, and patients often present at a late stage. More recently, advances in screening, diagnosing, and treating lung cancer have been made. For instance, greater numbers of minimally invasive procedures are being performed, and identification of lung adenocarcinoma driver mutations has led to the implementation of targeted therapies. Advances in molecular techniques enable use of scant tissue, including cytology specimens. In addition, per recently published consensus guidelines, cytology-derived cell blocks (CBs are preferred over direct smears. Yet, limited comparison of molecular testing of fine-needle aspiration (FNA CBs and corresponding histology specimens has been performed. This study aimed to establish concordance of epidermal growth factor receptor (EGFR and Kirsten rat sarcoma (KRAS virus homolog testing between FNA CBs and histology samples from the same patients. Materials and Methods: Patients for whom molecular testing for EGFR or KRAS was performed on both FNA CBs and histology samples containing lung adenocarcinoma were identified retrospectively. Following microdissection, when necessary, concordance of EGFR and KRAS molecular testing results between FNA CBs and histology samples was evaluated. Results: EGFR and/or KRAS testing was performed on samples obtained from 26 patients. Concordant results were obtained for all EGFR (22/22 and KRAS (17/17 mutation analyses performed. Conclusions: Identification of mutations in lung adenocarcinomas affects clinical decision-making, and it is important that results from small samples be accurate. This study demonstrates that molecular testing on cytology CBs is as sensitive and specific as that on histology.

  8. Identification of biomarkers of human pancreatic adenocarcinomas by expression profiling and validation with gene expression analysis in endoscopic ultrasound-guided fine needle aspiration samples

    Institute of Scientific and Technical Information of China (English)

    Henrik Laurell; Louis Buscail; Michèle Bouisson; Philippe Berthelémy; Philippe Rochaix; Sébastien Déjean; Philippe Besse; Christiane Susini; Lucien Pradayrol; Nicole Vaysse

    2006-01-01

    AIM: To compare gene expression profiles of pancreatic adenocarcinoma tissue specimens, human pancreatic and colon adenocarcinoma and leukemia cell lines and normal pancreas samples in order to distinguish differentially expressed genes and to validate the differential expression of a subset of genes by quantitative real-time RT-PCR (RT-QPCR) in endoscopic ultrasound-guided fine needle aspiration (EUS-guided FNA) specimens.METHODS: Commercially dedicated cancer cDNA macroarrays (Atlas Human Cancer 1.2) containing 1176 genes were used. Different statistical approaches (hierarchical clustering, principal component analysis (PCA) and SAM) were used to analyze the expression data. RT-QPCR and immunohistochemical studies were used for validation of results.RESULTS: RT-QPCR validated the increased expression of LCN2 (lipocalin 2) and for the first time PLAT (tissue-type plasminogen activator or tPA) in malignant pancreas as compared with normal pancreas.Immunohistochemical analysis confirmed the increased expression of LCN2 protein localized in epithelial cells of ducts invaded by carcinoma. The analysis of PLAT and LCN2 transcripts in 12 samples obtained through EUS-guided FNA from patients with pancreatic adenocarcinoma showed significantly increased expression levels in comparison with those found in normal tissues, indicating that a sufficient amount of high quality RNA can be obtained with this technique.CONCLUSION: Expression profiling is a useful method to identify biomarkers and potential target genes.Molecular analysis of EUS-guided FNA samples in pancreatic cancer appears as a valuable strategy for the diagnosis of pancreatic adenocarcinomas.

  9. Metastatic ductal carcinoma of the breast to the thyroid gland diagnosed with fine needle aspiration: A case report with emphasis on morphologic and immunophenotypic features.

    Science.gov (United States)

    Magers, Martin J; Dueber, Julie C; Lew, Madelyn; Pang, Judy C; Davenport, Robertson D

    2016-06-01

    Metastases to the thyroid are uncommon [thyroid fine needle aspirations (FNA)]. Of metastases to the thyroid, breast carcinoma is relatively common. The diagnosis of metastasis to the thyroid has important therapeutic and prognostic implications. To our knowledge, a morphologic and immunophenotypic comparison of metastatic ductal carcinoma of the breast and primary thyroid carcinomas has not been reported. Here, we report the case of a 37-year-old female with a history of metastatic ductal carcinoma of the breast (modified Bloom-Richardson grade 2; ER+, PgR+, HER2+) diagnosed 6 years prior. She developed hoarseness, prompting a CT scan. Multiple thyroid nodules were found, including a 1.5 cm hypoechoic, solid, irregularly-shaped nodule. On FNA, cells were arranged singly and in crowded groups, varied in size and degree of pleomorphism, and exhibited rare nuclear grooves, inconspicuous nucleoli, and rare intracytoplasmic lumina with no nuclear pseudoinclusions or colloid (Figs. 1A and B). These findings raised the differential of papillary thyroid carcinoma (Fig. 1C), follicular neoplasm (Fig. 1D), medullary carcinoma (Fig. 1E), parathyroid (Fig. 1F), and metastatic breast carcinoma. Immunostaining for GATA-3 (+), ER (+), PAX-8 (-), and TTF-1 (-) was consistent with metastatic breast carcinoma (Fig. 2). We conclude that metastatic breast carcinoma to the thyroid may morphologically mimic primary thyroid carcinoma on FNA; a panel of immunomarkers, such as GATA-3, hormonal marker(s), PAX-8, and TTF-1, may be useful in some cases. GATA-3 immunostaining for metastatic breast carcinoma was helpful in our case and has not been previously reported in a thyroid metastasis sampled by FNA. Diagn. Cytopathol. 2016;44:530-534. © 2016 Wiley Periodicals, Inc.

  10. Fine-needle aspiration cytology of extra mammary metastatic lesions in the breast: A retrospective study of 36 cases diagnosed during 18 years

    Directory of Open Access Journals (Sweden)

    Sauer Torill

    2010-01-01

    Full Text Available Background: Metastatic tumors in the breast require treatment according to origin and type of tumor. It is important to recognize these lesions in fine-needle aspiration cytology (FNAC in order to avoid unnecessary mastectomy or non-relevant chemotherapy. The aim of this study was to evaluate the cytological features of metastatic tumors and possible criteria that could alert us as to the possibility of a metastasis from an extra mammary malignancy. Methods: The material included 36 confirmed or suspected metastases in the breast registered in the pathology files at Oslo University Hospital, Ulleval, during 1990-2007. There were a total of 6,325 cases of malignant breast FNAC, representing 30 men and 6,295 women. Smears were evaluated for the amount of material, presence or absence of myoepithelial cells, microcalcifications, mitoses and necrotic material. All carcinomas were graded. Results: There were seven men (7/30 = 23.3% and 29 women (29/6,295 = 0.46%. The primary tumor was known in 22 cases (22/36 = 61.1%. No other primary tumor was known and metastatic lesion was not initially suspected in 14 cases (14/36 = 38.9%. The most common origin was lung (15/36 = 41.7%. In five cases (5/36 = 13.9%, the origin remained uncertain. Conclusions: Metastases from extra mammary sites are (relatively common in males (23.3%. In women, metastatic lesions are rare (0.46%. A large proportion of them (88% are high-grade adenocarcinomas and poorly differentiated carcinomas that may resemble grade 3 ductal carcinomas. Unusual clinical and/or radiological presentation in combination with high-grade malignant cells should alert us to consider the possibility of a metastasis.

  11. Diagnostic value of sonography, ultrasound-guided fine-needle aspiration cytology, and diffusion-weighted MRI in the characterization of cold thyroid nodules

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    Schueller-Weidekamm, Claudia [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)], E-mail: claudia.schueller-weidekamm@meduniwien.ac.at; Schueller, Gerd [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kaserer, Klaus [Department of Pathology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Scheuba, Christian [Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Ringl, Helmut; Weber, Michael; Czerny, Christian; Herneth, Andreas M. [Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2010-03-15

    Introduction: The purpose of this prospective study was to assess the diagnostic value of different modalities for the characterization of cold thyroid nodules. Methods: In 35 patients with cold nodules, thyroid carcinoma was suspected on scintigraphy. These patients were prospectively investigated with sonography, ultrasound-guided fine-needle aspiration (USgFNA), and quantitative diffusion-weighted imaging magnetic resonance imaging (DWI) (navigated echo-planar imaging; maximum b-value 800 s/mm{sup 2}) prior to surgery. The sonographic findings, USgFNA cytology, and the apparent diffusion coefficient (ADC) values of DWI were correlated with the postoperative histology of benign and malignant lesions. Statistical analysis was performed with the Kruskal-Wallis test and the Fisher's exact test. P < .05 denoted statistical significance. Results: The accuracy of sonography and USgFNA was 64% and 68.8%, respectively. The sensitivity was 86.7% and 80%, respectively. Specificity was only 57.2% and 50%, respectively. The median ADC values for carcinoma and adenoma were 2.73 x 10{sup -3} mm{sup 2}/s and 1.93 x 10{sup -3} mm{sup 2}/s, respectively (P < .001). There was no significant difference between the median ADC value for Hashimoto thyroiditis (3.46 x 10{sup -3} mm{sup 2}/s) and carcinoma. An ADC value of 2.25 x 10{sup -3} mm{sup 2}/s or higher was proven to be the cut-off value for differentiating between benign and malignant cold thyroid nodules, with an accuracy of 88%, a sensitivity of 85%, and a specificity of 100%. Conclusions: These results show that quantitative DWI is a more reliable diagnostic method for differentiation between benign and malignant thyroid lesions than sonography or USgFNA. However, further studies including a larger study population are necessary to confirm our study results.

  12. Performance of K-ras mutation analysis plus endoscopic ultrasound-guided fine-needle aspiration for differentiating diagnosis of pancreatic solid mass: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Xu Ying; Hu Duanmin; Zhu Qi; Sun Yunwei

    2014-01-01

    Background Difficulties persist in differentiating pancreatic ductal adenocarcinomas (PDAC) from pancreatic inflammatory masses (PIM).Auxiliary diagnostic techniques which enhance the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) diagnostic yield have been attempted,for example,K-ras mutation analysis.We aimed to evaluate the accuracy of K-ras mutation analysis combined with EUS-FNA for the differential diagnosis of PDAC and PIM by pooling data of existing trials.Methods We systematically searched the Medline,PubMed,Web of Science,Embase,and Cochrane Central Trials databases for relevant published studies.Meta-analysis was performed.Pooling was conducted in fixed-effect model or random-effect model.Results In total eight studies,with 696 cases of PDAC and 138 cases of PIM,met our inclusion criteria.The pooled sensitivity,specificity,positive likely ratio and negative likely ratio of K-ras mutation analysis combined with cytopathology for diagnosis of PDAC versus PIM were 90%,95%,13.45,and 0.13,respectively.Especially,among total 123 patients whose EUS-FNA results were inconclusive or negative,fifty-nine had K-ras mutations and were finally diagnosed with PDAC (48%,59/123).Publication bias was not present.Conclusions Combining K-ras mutation analysis with routine cytology moderately improves the ability of EUS-FNA to differentially diagnose between PDAC and PIM,especially for patients with suspected PDAC yet inconclusive EUS-FNA findings,and may prove to be a valuable supplemental method to EUS-FNA.

  13. Qualitative elastography can replace thyroid nodule fine-needle aspiration in patients with soft thyroid nodules. A systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nell, Sjoerd; Kist, Jakob W. [Department of Surgery, University Medical Center Utrecht (Netherlands); Debray, Thomas P.A. [Julius Center for Health Sciences and Primary Care Utrecht (Netherlands); Keizer, Bart de [Department of Radiology and Nuclear Medicine, University Medical Center Utrecht (Netherlands); Oostenbrugge, Timotheus J. van; Borel Rinkes, Inne H.M. [Department of Surgery, University Medical Center Utrecht (Netherlands); Valk, Gerlof D. [Department of Endocrinology, University Medical Center Utrecht (Netherlands); Vriens, Menno R., E-mail: mvriens@umcutrecht.nl [Department of Surgery, University Medical Center Utrecht (Netherlands)

    2015-04-15

    Context: Only a minority of thyroid nodules is malignant; nevertheless, many invasive diagnostic procedures are performed to distinguish between benign and malignant nodules. Qualitative ultrasound elastography is a non-invasive technique to evaluate thyroid nodules. Objective: To investigate the diagnostic value of qualitative elastography in distinguishing benign from malignant thyroid nodules in patients referred for fine-needle aspiration (FNA). Data sources: A systematic literature search (PubMed, Embase and Cochrane Library) was performed. Study selection: Included studies reported thyroid nodule elastography color scores and the related cytologic or histologic findings in patients with a thyroid nodule referred for FNA. Data extraction: Two independent reviewers extracted study data and assessed study quality. Pooled sensitivities and specificities of different populations were calculated using a bivariate Bayesian framework. Data Synthesis: Twenty studies including thyroid nodules were analyzed. Pooled results of elastography indicate a summary sensitivity of 85% (95% confidence interval [CI], 79–90%) and specificity of 80% (95% CI, 73–86%). The respective pooled negative predictive and positive predictive values were 97% (95% CI, 94–98%) and 40% (95% CI, 34–48%). The pretest probability of a benign nodule was 82%. Only 3.7% of the false-negative nodules was a follicular thyroid carcinoma. A pooled negative predictive value of 99% (95% CI, 97–100%) was found when only complete soft nodules (Asteria elastography 1) were classified as benign, which included 14% of the studied population. Conclusions: Elastography has a fair specificity and sensitivity for diagnostic accuracy. Its major strength entails the detection of benignity, especially when only completely soft nodules are qualified as benign. The outcomes of our analysis show that FNA could safely be omitted in patients referred for analysis of their thyroid nodule when elastography shows it

  14. Molecular Testing for miRNA, mRNA, and DNA on Fine-Needle Aspiration Improves the Preoperative Diagnosis of Thyroid Nodules With Indeterminate Cytology

    Science.gov (United States)

    Shifrin, Alexander; Busseniers, Anne E.; Lupo, Mark A.; Manganelli, Monique L.; Andruss, Bernard; Wylie, Dennis; Beaudenon-Huibregtse, Sylvie

    2015-01-01

    Context: Molecular testing for oncogenic mutations or gene expression in fine-needle aspirations (FNAs) from thyroid nodules with indeterminate cytology identifies a subset of benign or malignant lesions with high predictive value. Objective: This study aimed to evaluate a novel diagnostic algorithm combining mutation detection and miRNA expression to improve the diagnostic yield of molecular cytology. Setting: Surgical specimens and preoperative FNAs (n = 638) were tested for 17 validated gene alterations using the miRInform Thyroid test and with a 10-miRNA gene expression classifier generating positive (malignant) or negative (benign) results. Design: Cross-sectional sampling of thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) or follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN) cytology (n = 109) was conducted at 12 endocrinology centers across the United States. Qualitative molecular results were compared with surgical histopathology to determine diagnostic performance and model clinical effect. Results: Mutations were detected in 69% of nodules with malignant outcome. Among mutation-negative specimens, miRNA testing correctly identified 64% of malignant cases and 98% of benign cases. The diagnostic sensitivity and specificity of the combined algorithm was 89% (95% confidence interval [CI], 73–97%) and 85% (95% CI, 75–92%), respectively. At 32% cancer prevalence, 61% of the molecular results were benign with a negative predictive value of 94% (95% CI, 85–98%). Independently of variations in cancer prevalence, the test increased the yield of true benign results by 65% relative to mRNA-based gene expression classification and decreased the rate of avoidable diagnostic surgeries by 69%. Conclusions: Multiplatform testing for DNA, mRNA, and miRNA can accurately classify benign and malignant thyroid nodules, increase the diagnostic yield of molecular cytology, and further improve

  15. Transrectal EUS-guided FNA biopsy of a presacral chordoma-report of a case and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Klaus Gottlieb; Paul H Lin; David M Liu; Karl Anders

    2008-01-01

    Chordomas are rare tumors which originate from the remnants of the notochord.These tumors are locally aggressive and have a predilection for the ends of the axial skeleton.An important prerequisite for optimal management of these tumors is a correct preoperative diagnosis.The present case is the first report of the use of endoscopic ultrasound to obtain transrectal fine needle aspiration biopsy of a presacral chordoma.A review of the prior computer tomography (CT) scans allowed us to calculate the tumor volume doubling time (18.3 mo).Transrectal biopsy of chordomas is controversial,however we believe that such concerns are not justified.

  16. Evaluation of biopsy methods in the diagnosis of submandibular space pathology.

    Science.gov (United States)

    Olubaniyi, B O; Chow, V; Mandalia, U; Haldar, S; Gok, G; Michl, P; Ramesar, K; Sellon, E; Williams, M; Howlett, D C

    2014-03-01

    The aim of this study was to evaluate the performance of fine needle aspiration cytology (FNAC), ultrasound-guided core needle biopsy (USCNB), punch biopsy, and surgical excision biopsy in neoplasms presenting within the submandibular space. A retrospective analysis of all patients with a pathological diagnosis of a submandibular space neoplasm within a 12-year period (February 1999 to June 2011) was performed. Biopsy results were compared to histopathological diagnosis obtained from surgical excision biopsy. Eighty-one specimens from 44 patients met the search criteria (15 FNAC, 24 USCNB, 7 punch biopsy, and 35 surgical excision biopsy). The final diagnosis was established by USCNB, punch biopsy, or surgical excision biopsy and not by FNAC alone. Surgical excision biopsy was performed as a primary diagnostic (n = 8), secondary diagnostic (n = 15), or as a post-diagnostic therapeutic procedure (n = 12). Non-diagnostic results were: FNAC 11/15, USCNB 2/24, and punch biopsy 1/7. Diagnostic results were: FNAC 2/15, USCNB 20/24, and punch biopsy 5/7. No complications were reported. Although punch biopsy demonstrated good yield and accuracy, its use is restricted to a small cohort of patients. USCNB is a safe and accurate technique in the submandibular space, with a low non-diagnostic rate.

  17. Dual color multiplex TTF-1 + Napsin A and p63 + CK5 immunostaining for subcategorizing of poorly differentiated pulmonary non-small carcinomas into adenocarcinoma and squamous cell carcinoma in fine needle aspiration specimens

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    Seema Sethi

    2012-01-01

    Full Text Available Background: The distinction of lung adenocarcinoma (ADC from squamous cell carcinoma (SCC has important therapeutic implications. Napsin A is a recently developed marker, which has shown high specificity for lung tissue in the surgical pathology specimens. In this study, we have evaluated whether the use of a panel of novel multiplex cocktails of TTF-1 + Napsin A and p63 + CK5 for dual color immunostaining will improve the diagnostic accuracy of lung adenocarcinoma and squamous cell carcinoma in fine needle aspiration (FNA specimens, usually with relatively scant microfragments of diagnostic material. Materials and Methods: Formalin-fixed, paraffin-embedded, adequately cellular FNA cell blocks with a confirmed diagnosis of either ADC (n = 22, SCC (n = 20 or poorly differentiated carcinoma (PDC; n = 7, from a total of 49 consecutive cases, were studied. All these cases had subsequently confirmed diagnosis in biopsies or resection specimens. The sections were immunostained with two color methods of TTF-1 + Napsin A and p63 + CK5 multiplex cocktails. The presence of one or more unequivocal individual tumor cells with convincing brown nuclear TTF-1 and red cytoplasmic Napsin A staining, and cells with brown nuclear p63 and membranous / cytoplasmic CK5 staining were interpreted as ′positive′. Results: All 20 FNA cell blocks from SCC cases were positive for dual stain p63 + CK5 and negative for dual stain TTF-1 + Napsin A. The sensitivity and specificity of the dual immunoexpressions of p63 + CK5 for SCC of lung FNAs were both 100%. All 22 ADC cases were positive with dual stain of TTF-1 + Napsin A and negative for dual stain of p63 + CK5. On follow-up of the surgical pathology specimens, 22 cases were confirmed as ADC. The sensitivity of the dual immunoexpression of TTF-1 + Napsin A for ADC of lung FNAs was 100% and the specificity was also 100%. Of the seven PDC cases, five cases that were positive for dual stain p63 + CK5 and negative for dual

  18. Selection and validation of miRNAs as normalizers for profiling expression of microRNAs isolated from thyroid fine needle aspiration smears

    Science.gov (United States)

    Titov, Sergei E.; Demenkov, Pavel S.; Ivanov, Mikhail K.; Malakhina, Ekaterina S.; Poloz, Tatiana L.; Tsivlikova, Elena V.; Ganzha, Maria S.; Shevchenko, Sergei P.; Gulyaeva, Lyudmila F.; Kolesnikov, Nikolay N.

    2016-01-01

    Fine needle aspiration cytology (FNAC) is currently the method of choice for malignancy prediction in thyroid nodules. Nevertheless, in some cases the interpretation of FNAC results may be problematic due to limitations of the method. The expression level of some microRNAs changes with the development of thyroid tumors, and its quantitation can be used to refine the FNAC results. For this quantitation to be reliable, the obtained data must be adequately normalized. Currently, no reference genes are universally recognized for quantitative assessments of microRNAs in thyroid nodules. The aim of the present study was the selection and validation of such reference genes. Expression of 800 microRNAs in 5 paired samples of thyroid surgical material corresponding to different histotypes of tumors was analyzed using NanoString technology and four of these (hsa-miR-151a-3p, -197-3p, -99a-5p and -214-3p) with the relatively low variation coefficient were selected. The possibility of use of the selected microRNAs and their combination as references was estimated by RT-qPCR on a sampling of cytological smears: benign (n=226), atypia of undetermined significance (n=9), suspicious for follicular neoplasm (n=61), suspicious for malignancy (n=19), medullary thyroid carcinoma (MTC) (n=32), papillary thyroid carcinoma (PTC) (n=54) and non-diagnostic material (ND) (n=34). In order to assess the expression stability of the references, geNorm algorithm was used. The maximum stability was observed for the normalization factor obtained by the combination of all 4 microRNAs. Further validation of the complex normalizer and individual selected microRNAs was performed using 5 different classification methods on 3 groups of FNAC smears from the analyzed batch: benign neoplasms, MTC and PTC. In all cases, the use of the complex classifier resulted in the reduced number of errors. On using the complex microRNA normalizer, the decision-tree method C4.5 makes it possible to distinguish between

  19. The pathobiology diagnosis of breast carcinoma using fine needle aspiration cytology%乳腺癌细针吸取细胞病理学诊断探讨

    Institute of Scientific and Technical Information of China (English)

    付春林; 夏波; 任红兵; 陈庭煊; 李军川

    2011-01-01

    Objective To explore the diagnostic characteristics of fine needle aspiration cytology(FNAC) in breast carcinoma and the differential diagnosis of breast carcinoma with cyclomastopathy and fibroadenoma of breast. Methods 160 cases of patients with breast carcinoma were enrolled and analyzed for clinical manifestation and FNAC characteristics,and compared with 71 cases with cyclomastopathy and 85 case with fibroadenoma of breast. Results The percentage of patients at least 45 years old, with fixed,vague tumor,crisp paracentesis feeling and easier to suck out material, with more loosely and disorderly arrayed cells, which were with integrated cytoplasm, round or irregular round,large nucleus with rough edge, obviously increased or reduced nuclear-cytoplasmic ratio,large nucleoli,obvious size difference of nuclei,with more scattered cells,or without myoepithelial cells in 160 cases with breast carcinoma were significantly higher than cases with cyclomastopathy or fibroadenoma of breast (P<0.05). Conclusion There are special FNAC characteristics of breast carcinoma, which could be distinguished from cyclomastopathy and fibroadenoma ofbreast.%目的 探讨乳腺癌细针吸取细胞病理学诊断要点及其与乳腺增生症、乳腺纤维腺瘤的鉴别诊断.方法 分析160例乳腺癌临床表现、细针吸取和细胞学特点,与71例乳腺增生症和85例乳腺纤维腺瘤比较.结果 160例乳腺癌中,具备年龄大于或等于45岁;肿块固定、欠清,脆样穿刺针感,易吸出物质;细胞数量多,呈松散、紊乱样排列;胞质完整;核大,呈圆或不规则圆形,边缘不整齐,核质比明显增大或减小,核仁增大,核大小差异明显;易见散在细胞,未见肌上皮细胞等特点的相对病例数明显多于乳腺增生症和乳腺纤维腺瘤,差异有统计学意义(P<0.05).结论 乳腺癌细针吸取细胞病理学表现特殊,可与乳腺增生症和乳腺纤维腺瘤进行鉴别.

  20. Liver biopsy

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    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  1. Synovial biopsy

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    Biopsy - synovial membrane ... fluid in and out of the area. A biopsy grasper is inserted through the trocar and turned ... Synovial biopsy helps diagnose gout and bacterial infections, or rule out other infections. It can be used to diagnose ...

  2. Nerve biopsy

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    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  3. Bladder biopsy

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    Biopsy - bladder ... A bladder biopsy can be done as part of a cystoscopy . Cystoscopy is a telescopic examination of the inside of the ... informed consent form before you have a bladder biopsy. In most cases, you are asked to urinate ...

  4. Biopsy - polyps

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    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  5. Current Concepts in the Biopsy of Musculoskeletal Tumors

    Directory of Open Access Journals (Sweden)

    Costantino Errani

    2013-01-01

    Full Text Available In the management of bone and soft tissue tumors, accurate diagnosis, using a combination of clinical, radiographic, and histological data, is critical to optimize outcome. On occasion, diagnosis can be made by careful history, physical examination, and images alone. However, the ultimate diagnosis usually depends on histologic analysis by an experienced pathologist. Biopsy is a very important and complex surgery in the staging process. It must be done carefully, so as not to adversely affect the outcome. Technical considerations include proper location and orientation of the biopsy incision and meticulous hemostasis. It is necessary to obtain tissue for a histological diagnosis without spreading the tumor and so compromise the treatment. Furthermore, the surgeon does not open compartmental barriers, anatomic planes, joint space, and tissue area around neurovascular bundles. Nevertheless, avoid producing a hematoma. Biopsy should be carefully planned according to the site and definitive surgery and should be performed by an orthopedic surgeon with an experience in musculoskeletal oncology who will perform the definitive surgery. Improperly done, it can complicate patient care and sometimes even eliminate treatment options. Different biopsy techniques are suitable: fine-needle aspiration, core-needle biopsy, and incisional biopsy. The choice of biopsy depends on the size, the location of the lesion, and the experience of the pathologist.

  6. Value of the Fine Needle Aspiration Cytological Examination in Diagnosis of Child Thyroiditis%细针吸取细胞学检查在儿童甲状腺炎诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    高莉莉; 方先勇

    2001-01-01

    Objective To study the value of the fine needle aspirationin cytological examination for child thyroiditis. Methods The fine needle aspiration was performed in cytological examination for 100 patients with child thyroiditis. Results In 98 patients (98%) the clinical treatment coincided with other laboratory examinations. Two patients (2%) were misdiagnosed by typing. The sensitivity of serology (T3, T4, TG, TM, TSH) examination was lower. The hashimoto's thyroiditis diagnostic rate was 63.1%~73.6%, lymphocytic thyroiditis was 26.0%~84.7%, and other serological examinations showed no significance. Conclusions The fine needle aspiration can obtain enough tissues for diagnosis.%目的 探讨细针吸取细胞学(FNAC)检查对儿童甲状腺炎的诊断价值。方法 采用FNAC检查法诊断儿童甲状腺炎。结果 经细胞学诊断为甲状腺炎共计100例,经临床治疗及其它实验室检查结果相符的98例(98%),只有2例(2%)在分类上出现误差,而血清学(T3,T4,TG,TM,TSH)检查敏感性则相对较低,桥本氏甲状腺炎为63.1%~73.6%,淋巴细胞性甲状腺炎为26.0%~84.7%,其它血清学检查均无意义。结论 FNAC检查法吸出细胞成分充足,几乎不含血液成分,有利于甲状腺炎的诊断及分类。

  7. The value of B ultrasound-guided fine needle aspiration cytology to the diagnosis of renal carcinoma%B超引导下细针吸取细胞学涂片对肾癌的诊断价值

    Institute of Scientific and Technical Information of China (English)

    马广贞; 滕玲玲; 周莉; 王敏; 梁凤泉; 陈冰; 解建军

    2010-01-01

    目的 探讨细针穿刺细胞学涂片对肾癌的诊断价值.方法 选取有病理组织学对照的59例肾癌病例.每一病例术前均行细针穿刺细胞学涂片(FNAC),分析细胞学涂片对肾癌诊断的准确率.结果 FNAC诊断准确率为83.1%(49/59).对恶性肿瘤分型中,FNAC 诊断准确率为66.1%(39/59),差异显著(P<0.05).结论 细针吸取细胞学对肾癌的诊断准确性较高,但对组织分型诊断特异性较差.%Objective To investigate the diagnostic value of fine needle aspiration(FNA)cytology to the renal carcinoma.Methods A total of 59 samples from kidney maglignant tumor with matched histological diagnosis were studied.Every case was diagnosised by fine needle aspiration cytology(FNAC).The diagnostic accuracy of cell cytology was analyzed in comparing retrospectively with the smear cytology in the renal carcinoma.Results The diagnostic accuracy of FNAC was 83.1%(49/59) in sensitivity.For kidney malignant tumors,the histological typing accuracy was 66.1%(39/59),which had significant difference(P<0.05).Conclusion The diagnostic accuracy of fine needle aspiration cytology is higher in kidney malignant tumors.But FNAC diagnosis of histological type-specific lower.

  8. Pediatric lymphoma diagnosis: role of FNAC, biopsy, immunohistochemistry and molecular diagnostics.

    Science.gov (United States)

    Iyer, Venkateswaran K

    2013-09-01

    Peripheral lymphadenopathy in the pediatric age group is screened using fine needle aspiration cytology (FNAC). Cases found to have features suspicious for lymphoma on FNAC need to undergo biopsy with immunohistochemistry for characterization and typing. In pediatric age group, peripheral lymph nodes are common in Hodgkin's lymphoma for which biopsy is needed for subtyping. Distinction of classical Hodgkin's lymphoma of lymphocyte rich type from nodular lymphocyte predominant Hodgkin's lymphoma needs biopsy evaluation and a panel of immunostains. T lymphoblastic lymphomas and Burkitt's lymphoma are the common types of non Hodgkin's lymphoma seen in the pediatric age group. All lymphomas require a biopsy evaluation with immunohistochemistry and analysis of molecular genetic markers for proper characterization and selection of optimal treatment which are discussed in detail in this review.

  9. Three cases of systemic amyloidosis successfully diagnosed by subcutaneous fat tissue biopsy of the hip

    Directory of Open Access Journals (Sweden)

    Arahata M

    2016-08-01

    Full Text Available Masahisa Arahata,1 Shigeru Shimadoi,1 Satosi Yamatani,1 Shin-ichi Hayashi,2 Shigeharu Miwa,2 Hidesaku Asakura,3 Shinji Nakao4 1Department of Internal Medicine, Nanto Municipal Hospital, Nanto, 2Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, 3Department of Internal Medicine (III, 4Department of Cellular Transplantation Biology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan Abstract: Fine-needle aspiration biopsy of the abdominal fat pad is considered to be a minimally invasive procedure for diagnosing systemic amyloidosis. However, this procedure is sometimes difficult and can be dangerous for elderly patients whose abdominal fat layer is thin because of malnutrition. In such cases, alternative diagnostic methods are required. We report three elderly patients with heart failure complicated by malnutrition. In all cases, electrocardiogram showed low voltage in the limb leads and a pseudoinfarct pattern in the chest leads, and echocardiography showed left ventricular wall thickening with granular sparkling appearance. These patients were suspected of having amyloid cardiomyopathy but could not undergo myocardial biopsies because of their poor conditions. After failed attempts at biopsy of the abdominal fat pad or the other organs, subcutaneous fat tissue biopsy over the hip led to the diagnosis of systemic amyloidosis with cardiomyopathy. The resultant diagnosis guided us to choose the appropriate treatment for the patients. This article illustrates that subcutaneous fat tissue biopsy of the hip could be a useful procedure for diagnosing systemic amyloidosis in elderly patients, particularly when a fat tissue biopsy of the abdomen is associated with a high risk of complications because of malnutrition. Keywords: systemic amyloidosis, amyloid cardiomyopathy, fine-needle aspiration biopsy, subcutaneous fat tissue, hip

  10. A study of pathology and clinical findings in cervical lymph node biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Asakawa, Takeshi; Yoshida, Shinya; Yoshikawa, Takuma; Kishida, Satoru [Tachikawa Hospital, Tokyo (Japan)

    2003-02-01

    We investigated the pathology, age groups, blood test, CT image, isotope findings and fine-needle aspiration biopsy (FNAB) diagnosis in 92 cervical lymph node biopsies. There were 31 cases of benign causes and 61 cases of malignant cases. 18 patients had been treated for malignant disease previously. Of these 18, 17 had had a recurrence of a previous malignant disease. Eleven of the 15 cases that showed an enhancement in the CT examination were malignant. Sensitivity and specificity for malignant etiology in the gallium isotope examination were 91.4% and 37.5%. The hot spot for scintigraphy with {sup 67}Ga was helpful for diagnosis of malignancy. In a total of 8 cases of malignant lymphoma and metastatic lymphoepithelial carcinoma, 5 cases were diagnosed as Class I or II by fine-needle aspiration biopsy. However, there was a hot spot for scintigraphy with {sup 67}Ga in these 5 cases. Therefore, we concluded that the indications of operation in cervical lymph node biopsy are the following: elderly patients with lymphadenopathy that have shown no spontaneous regression for a long time, patients who have been treated for malignant disease previously except for class IV or V, patients who were found to have an enhancement in their CT besides a hot spot for scintigraphy, and suspicion of malignant lymphoma, a hot spot for scintigraphy but in Class I or II. We also investigated 9 cases, 4 men and 5 women aged 13-34 years, with necrotizing lymphadenitis that were correctly diagnosed by biopsy. Antibiotics were not effective in all cases. These patients were improving by taking prednisone after their biopsy. We considered a biopsy necessary in cases where it is difficult to distinguish malignant lymphoma from the effects of prednisone. (author)

  11. Tongue biopsy

    Science.gov (United States)

    Biopsy - tongue ... A tongue biopsy can be done using a needle. You will get numbing medicine at the place where the ... provider will gently stick the needle into the tongue and remove a tiny piece of tissue. Some ...

  12. Complication rates of CT-guided transthoracic lung biopsy: meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Heerink, W.J.; Vliegenthart, R. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Radiology, University of Groningen, Groningen (Netherlands); Bock, G.H. de [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Epidemiology, University of Groningen, Groningen (Netherlands); Jonge, G.J. de [University Medical Center Groningen, Department of Radiology, University of Groningen, Groningen (Netherlands); Groen, H.J.M. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands); University Medical Center Groningen, Department of Pulmonary Medicine, University of Groningen, Groningen (Netherlands); Oudkerk, M. [University Medical Center Groningen, Center for Medical Imaging-North East Netherlands, University of Groningen, Groningen (Netherlands)

    2017-01-15

    To meta-analyze complication rate in computed tomography (CT)-guided transthoracic lung biopsy and associated risk factors. Four databases were searched from 1/2000 to 8/2015 for studies reporting complications in CT-guided lung biopsy. Overall and major complication rates were pooled and compared between core biopsy and fine needle aspiration (FNA) using the random-effects model. Risk factors for complications in core biopsy and FNA were identified in meta-regression analysis. For core biopsy, 32 articles (8,133 procedures) were included and for FNA, 17 (4,620 procedures). Pooled overall complication rates for core biopsy and FNA were 38.8 % (95 % CI: 34.3-43.5 %) and 24.0 % (95 % CI: 18.2-30.8 %), respectively. Major complication rates were 5.7 % (95 % CI: 4.4-7.4 %) and 4.4 % (95 % CI: 2.7-7.0 %), respectively. Overall complication rate was higher for core biopsy compared to FNA (p < 0.001). For FNA, larger needle diameter was a risk factor for overall complications, and increased traversed lung parenchyma and smaller lesion size were risk factors for major complications. For core biopsy, no significant risk factors were identified. In CT-guided lung biopsy, minor complications were common and occurred more often in core biopsy than FNA. Major complication rate was low. For FNA, smaller nodule diameter, larger needle diameter and increased traversed lung parenchyma were risk factors for complications. (orig.)

  13. Laryngeal chondrosarcoma diagnosed by core-needle biopsy.

    Science.gov (United States)

    Miyamaru, Satoru; Haba, Koichi

    2014-01-01

    We report a case of chondrosarcoma of the larynx, diagnosed by a percutaneous core-needle biopsy (CNB). Cartilaginous tumors of the larynx are usually diagnosed by biopsy with direct laryngomicroscopy under general anesthesia. However, patients find it difficult to undergo a biopsy under general anesthesia, for physical, economic, and social reasons. Instead, we can readily detect and sample tumors of the larynx using ultrasound under local anesthesia with reduced stress. Concerning needle-puncture biopsies, including fine-needle aspiration cytology (FNAC) and CNB, some studies have reported needle track dissemination, a possible complication in patients with malignant tumors. Thus, in the head and neck region, we generally use FNAC for biopsies, not CNB. However, it can be difficult to diagnose bone tumors by cytology alone. Regarding primary bone tumors, only one study has reported needle track dissemination by CNB, in osteosarcoma of the femur. Additionally, this complication has not been reported before with chondrosarcoma anywhere in the body. To our knowledge, this is the first report concerning chondrosarcoma of the larynx diagnosed by percutaneous CNB. We recommend CNB as a useful and safe diagnostic technique for primary bone tumors in the head and neck region.

  14. Hashimoto's thyroiditis ultrasound manifestation under fine needle aspiration%桥本甲状腺炎超声声像图分析

    Institute of Scientific and Technical Information of China (English)

    李传红; 宋修芹; 张良岩; 王允芹; 张忠英; 史少华

    2012-01-01

    Objective To discuss the ultrasound manifestation of Hashimotos thyroiditis by using ultrasonic guided fine needle aspiration( U-FNA )as the gold standard of Hashimotos thyroiditis. Methods The ultrasound images of 216 patients with Hashimoto's thyroiditis were retrospectively investigated, with observation of the following indexes: the size of two lateral lobes, the thickness of isthmus, the echo pattern, blood flow distribution, superior thyroid artery flow velocity and enlarged lymph nodes. According to the throid function,all Hashimotos thyroiditis were divided in to the hyperthyroidism group,the hypothyroidism group and the euthroidism group, and the superior thyroid artery flow velocity was compared among the three groups. Results Sonographic features of typical Hashimotos thyroiditis were only showed in 38. 9% cases ( 84/216 ). Sonographic characteristics of atypical Hashimoto s thyroiditis included normal thyroid volume, coarse parenchyma echo,partial hypoechoic area,25. 0%( 54/216 )with solid nodules, and 2. 8% ( 6/216 ) associated with thyroid carcinoma. Blood flow distribution was more abundant in Hashimotos thyroiditis than in normal thyroid. The superior thyroid artery mean flow velocity was( 39. 0 ± 20. 5 ) cm/s in the hyperthyroidism group,it was( 41. 1 ±21.4 )cm/s in the hypothyroidism group and it was( 35.6 ± 17. 1 )cm/s in the euthroidism group. There was no significant difference among the three groups( F = 0. 39,P = 0. 68 ). 93. 1%( 201/216 ), enlarged lymph nodes were detected in the lower pole area of Hashimoto's thyroiditis cases. Conclusions Only a small portion of Hashimoto s thyroiditis cases presented the typical sonographic features. Attention should be paid to those with atypical sonographic features to avoid misdiagnosis. Blood flow velocity of thyroid artery in Hashimoto's thyroiditis is not well-correlated with thyroid function; detection of lymph nodes at thyroid lower pole area might be helpful for diagnosis.%目的 以超声

  15. [Correlation of cytologic and pathohistologic findings in ultrasonically-guided thin-needle biopsy of abdominal and retroperitoneal organs].

    Science.gov (United States)

    Bokun, R; Tatomirović, Z; Lakić-Trajković, Z; Lisanin, L; Pesić, V; Zica, D; Lukac, S; Kupresanin, S; Spasić, V; Ilić, S; Dimitrijević, J

    1997-01-01

    The ultrasonically guided fine needle biopsy is cheap, very sensitive and specific method for the diagnosis of nonpalpable deep-seated lesions. During 1992 in the institute of Radiology of Military Medical Academy in Belgrade 87 biopsies of abdominal and 81 biopsies of retroperitoneal organs were performed for the cytological and histopathologic analysis. Deficient material was obtained in 15.4% of the cases. A good correlation between cytologic and histopathologic findings was observed, with diagnostic concordance in 90.8%. In 9 cases with falsely positive cytological diagnosis at the first examination, the diagnosis of malignancy was later confirmed by other diagnosis procedures. Diagnostic difficulties and the significance of adequate biopsy were particularly stressed.

  16. Punção aspirativa por agulha fina para diagnóstico de mastocitoma em cães Fine needle aspiration for diagnosis of mast cell tumors in dogs

    Directory of Open Access Journals (Sweden)

    G.E. Lavalle

    2003-08-01

    Full Text Available Fine needle aspiration (FNA associated with the cytological diagnosis mast cell tumor is a widely employed technique in human medicine, but it is still underused in veterinary medicine. The aim of this study was to demonstrate the efficacy of FNA technique for the diagnosis of mast cell tumors in dogs. Over one year period all dogs referred to the Veterinary Hospital of the Universidade Federal de Minas Gerais with tumor-like formations of the skin were submitted to FNA. In order to detect metastasis, both skin lesions and the regional lymph nodes were subjected to FNA. After surgical removal of the lesions, histological examination indicated a complete agreement with the cytological diagnosis. In conclusion, FNA technique is a good choice for diagnosis of mast cell tumors in dogs. In addition, FNA allows an adequate and early therapeutic planning.

  17. Biopsy of parotid masses:Review of current techniques

    Institute of Scientific and Technical Information of China (English)

    Sananda Haldar; Joseph D Sinnott; Kemal M Tekeli; Samuel S Turner; David C Howlett

    2016-01-01

    Definitive diagnosis of parotid gland masses is required optimal management planning and for prognosis. There is controversy over whether fine needle aspiration cytology(FNAC) or ultrasound guided core biopsy(USCB) should be the standard for obtaining a biopsy. The aim of this review is to assess the current evidence available to assess the benefits of each technique and also to assess the use of intra-operative frozen section(IOFS). Literature searches were performed using pubmed and google scholar. The literature has been reviewed and the evidence is presented. FNAC is an accepted and widely used technique. It has been shown to have variable diagnostic capabilities depending on centres and experience of staff. USCB has a highly consistent diagnostic accuracy and can help with tumour grading and staging. However, the technique is more invasive and there is a question regarding potential for seeding. Furthermore, USCB is less likely to be offered as part of a one-stop clinic. IOFS has no role as a first line diagnostic technique but may be reserved as an adjunct or for lesions not amenable to percutaneous biopsy. On balance, USCB seems to be the method of choice. The current evidence suggests it has superior diagnostic potential and is safe. With time, USCB is likely to supplant FNAC as the biopsy technique of choice, replicating that which has occurred already in other areas of medicine such a breast practice.

  18. Kidney Biopsy

    Science.gov (United States)

    ... Care Provider People should talk with their health care provider about medical conditions they have and all prescribed and over- ... biopsy, a person should talk with their health care provider about medical conditions and allergies they have and all medications ...

  19. Computed tomography guided needle biopsy in the head and neck region

    Directory of Open Access Journals (Sweden)

    Aris NTOMOUCHTSIS, Maria PANAGIOTOPOULOU, Kostas PARASKEVOPOULOS,

    2011-08-01

    Full Text Available SUMMARY: Introduction: The search for new methods of diagnostic identification of lesions and diseases in cases posing differential diagnostic challenges, as well as the objective of creating the least possible discomfort for patients, have led to the application and use of new technologies. Guided biopsy is a technique used to obtain biopsy samples, avoiding open biopsy and by extension, the possibility of tumour dissemination. Aim: In this paper, we seek to present the experience we have gained from using computed tomography guided needle biopsy in cases involving differential diagnostic difficulties. Material-Method: This technique was applied in cases of lesions in the head and neck region,where neither fine needle aspiration cytology (FNAC nor open biopsy could be used to establish diagnosis. In areas where post-operation or post-radiation scars are present,imaging is necessary, especially when suspicion of recurrence is raised. The identification of benign lesions or local recurrence of malignant tumours can help prevent surgical interventions or malpractices. Results: The diagnostic accuracy of computed tomography guided needle biopsy was very high, since in 90% of the cases presented here it helped establish the correct diagnosis. Conclusions:Computed tomography guided needle biopsy is a safe technique in the hands of experienced interventional radiologists and maxillofacial surgeons.

  20. 小细胞类乳腺癌细针穿刺细胞形态学观察%Cell morphological observation of small cell breast cancer by fine needle puncture

    Institute of Scientific and Technical Information of China (English)

    付春林; 李军川; 胡艳; 凌象红

    2012-01-01

    目的:探讨小细胞类乳腺癌细针穿刺的细胞形态学特点及鉴别诊断.方法:观察33例小细胞类乳腺癌细针穿刺细胞学涂片与93例乳腺纤维腺瘤和76例乳腺增生症并进行对照分析.结果:小细胞类乳腺癌中,细胞排列紊乱、松散,以散在或小细胞群为主,易见腺腔样、腺管样、炮竹式、栅栏状、单列纵队样排列,圆形核细胞占绝大多数,核质比明显减小,散在细胞易见、圆形核占多数、胞质完整,未见肌上皮细胞的相对病例数,均明显高于乳腺纤维腺瘤、乳腺增生症的相对病例数,差异均有统计学意义(P<0.05);细胞量中等以上的相对病例数,明显高于乳腺增生症,差异有统计学意义(P<0.05);纤维间质及其与乳腺上皮细胞混杂的相对病例数,明显低于乳腺纤维腺瘤,差异均有统计学意义(P<0.05).结论:小细胞类乳腺癌具有不同于乳腺纤维腺瘤和乳腺增生症的细针穿刺细胞形态学特点,与乳腺纤维腺瘤、乳腺增生症可以鉴别.%Objective; To explore the cell morphological characteristics and differential diagnosis of small cell breast cancer by fine needle puncture. Methods: The cytological smears of 33 cases with small cell breast cancer were observed, then the results were compared with those of 93 cases with breast fibroadenoma and 76 cases with breast hyperplasia. Results: The cytological smears of 33 cases with small cell breast cancer showed that the distribution of cells was disorder and loose, diffuse cells and small cell mass dominated, the glandular cavities , glandular tubes, firecrackers, fences, and single columns arranged, most of the cells were round nucleic cells, the nucleoplasm reduced significantly, diffuse cells were easily to be found, most of the cells had round nuclei, and cytoplasm was intact, the relative number of cases without myoepithelial cells was statistically significantly higher than those of cases with breast

  1. Fine needle aspiration cytology diagnosis of ductal lesions of breast%应用细针吸取细胞技术诊断乳腺导管病变的细胞学指标

    Institute of Scientific and Technical Information of China (English)

    狄方; 王念黎

    2010-01-01

    Objective To find out the most effective and combined cytomorphologic criteria trying to set up an effective diagnostic model for breast ductal lesion in fine needle aspiration cytology (FNAC).Methods A total of 400 breast FNAC cases were collected with follow-up information of more than six years. A retrospective analysis including 104 non-proliferative breast diseases,163 proliferarive breast diseases and 133 carcinomas basing on the diagnostic results of surgical biopsies. Altogether,60 cytomorphologic variables were counted for the evaluation of each case,including 4 main categories: the cellularity and components,natures of background,cellular arrangements and the cellular features. According to the quantity or the classification stage,the variables were semi-quantitatively scored. Multiple step-wise logistic regression (SPSS)and classification tree model (SAS)were performed to determine the significant and combined variables predictive for the diagnosis of non-proliferative lesion,proliferative breast diseases and carcinoma,respectively. Results (1)Among 400 benign and malignant cases studied,and basing on the result of analyses of multiple step-wise logistic regression system,intermingling of myoepithelial cells within the epithelial cluster (P < 0. 05 ),presence of large epithelial cell cluster (P < 0. 05),presence of small epithelial cell cluster (P < 0. 05),cytoplasmic vacuoles (P < 0.05)and figures of "progressive intussusception" of cells (P <0. 1)were selected as the effectively differential diagnostic criteria for the benign and malignant lesions. However,according to the classification tree model,the most useful variable selected associating with the benign lesion was intermingling of myoepithelial cells within epithelial cluster. The diagnostic accuracy will be increased to 94. 4% ,if another criterion,presence of a big amount of large epithelial clusters,was used as the second useful variable in combination. Presence of a moderate to large amount

  2. Needle core biopsy for breast lesions: An audit of 467 needle core biopsies

    Directory of Open Access Journals (Sweden)

    Selvi Radhakrishna

    2013-01-01

    Full Text Available Background: Breast cancer is the commonest cancer among women in urban India. Triple assessment includes clinical, radiological and cytological assessment of breast lesions. Guided core needle biopsy has replaced fine needle aspiration cytology in most of the western countries. In resource poor countries FNAC is still a very valuable and cost effective method to diagnose breast lesions. Pitfalls include increased rates of non diagnostic smears, and inadequate smears. Further procedures may be required and this increases the cost, anxiety and delay in diagnosis. Aims: The aim of this study is to analyze the concordance of radiological and histopathology findings in BI-RADS category 3,4,5 lesions following a core biopsy. Materials and Methods: Data was retrospectively collected from consecutive symptomatic and opportunistic screen detected patients with abnormalities who underwent ultrasound guided interventional procedures from Jan 2010 to Aug 2011. Symptomatic patients underwent clinical examination, mammogram and breast ultrasound. Women under 35 years of age had only breast ultrasound. Core biopsy was performed under ultrasound guidance or clinically by a breast surgeon/ radiologist for BI-RADS category 3,4,5 lesions. Statistical Methods: Chi square test was done to show the strength of association of imaging findings and histopathology results of core biopsy. Results: 437 patients were symptomatic and 30 patients had screen detected abnormalities. The positive predictive value for BI-RADS 5 lesions for malignancy is 93.25% and the negative predictive value of BI-RADS category 3 lesions for cancer is 98.4%. False negative diagnosis on core biopsy was 0.85%. We were able to defer surgery in 60% of the patients with a clear radiological and pathological benign diagnosis. Conclusion: The PPV and NPV for cancer is high with needle core biopsy in BI-RADS 3,4,5 lesions. Where there is no discordance between clinical, radiology and pathology findings

  3. Fine-needle aspiration of the diffuse sclerosing variant of papillary thyroid carcinoma masked by florid lymphocytic thyroiditis; A potential pitfall: A case report and review of the literature.

    Science.gov (United States)

    Bongiovanni, Massimo; Triponez, Frederic; McKee, Thomas A; Kumar, Neeta; Matthes, Thomas; Meyer, Patrick

    2009-09-01

    The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is a rare tumor with aggressive behavior that requires aggressive treatment. Despite characteristic clinical and histological features that easily permit diagnosis, pre-operative fine-needle aspiration cytology (FNAC) diagnosis is often challenging and thus delays diagnosis. We describe the cytological features of a case of DSV-PTC diagnosed by FNAC in a 30-year-old woman presenting with an ill-defined mass in her neck lasting for 2 months. Ultrasonograpy revealed a heterogeneous enlargement of both thyroid lobes suspicious for a lymphoproliferative syndrome. Flow cytometry showed a suspect B-lymphocyte population. FNAC showed in five out of six slides an overwhelming presence of slightly atypical monomorphic small lymphocytes. The remaining slide showed syncytial tissue fragments of follicular cells with nuclear enlargement and pleomorphism, irregular nuclear membrane, grooves with scattered intranuclear inclusions, squamous metaplastic epithelium, and abundant psammoma bodies. A diagnosis of DSV-PTC was rendered and confirmed by total thyroidectomy and lymph node dissection. Our report supports the possibility of obtaining a preoperative diagnosis of DSV-PTC by FNAC. In the case of diffuse thyroid enlargement, adequate sampling of the thyroid and the presence of the combination of features described in our case permitted the diagnosis of this PTC variant.

  4. A case of composite classical and nodular lymphocyte predominant Hodgkin lymphoma with progression to diffuse large B-cell non-Hodgkin lymphoma: Diagnostic difficulty in fine-needle aspiration cytology.

    Science.gov (United States)

    Das, Dilip K; Sheikh, Zafar A; Al-Shama'a, Mariam H; John, Bency; Alawi, Abdulla M S; Junaid, Thamradeen A

    2017-03-01

    A small percentage of nodular lymphocytic predominant Hodgkin lymphoma (NLPHL) progresses to diffuse large B-cell lymphoma (DLBCL). There have also been rare reports of gray zone lymphoma with features intermediate between classical Hodgkin lymphoma (CHL) and DLBCL. We report a very rare case of composite lymphoma (CHL and NLPHL) progressing to DLBCL, and highlight the diagnostic difficulty faced during its fine-needle aspiration (FNA) cytology diagnosis. A 65-year-old woman presented with a right axillary swelling which was subjected to FNA cytology. The routine FNA cytology diagnosis was anaplastic large cell lymphoma (ALCL) but immunocytochemistry did not support this diagnosis completely. The histopathological diagnosis of the excised lymph node was NLPHL with progression to DLBCL in our hospital but in a hospital abroad where the patient was treated, the reviewed diagnosis was CHL. The patient had a rapid downhill course with development of terminal pleural effusion and died approximately one year from initial diagnosis.The review of the cyto-histologic material along with additional immunocyto/histochemical studies and the clinical course of the disease support the diagnosis of a composite lymphoma (CHL and NLPHL) with progression to DLBCL. It is suggested that all the three lesions were clonally related. Diagn. Cytopathol. 2017;45:262-266. © 2016 Wiley Periodicals, Inc.

  5. Diagnostic efficacy of cell block immunohistochemistry, smear cytology, and liquid-based cytology in endoscopic ultrasound-guided fine-needle aspiration of pancreatic lesions: a single-institution experience.

    Directory of Open Access Journals (Sweden)

    Shan-Yu Qin

    Full Text Available The diagnostic efficiency of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA cytology varies widely depending on the treatment method of the specimens. The present study aimed to evaluate the diagnostic efficacy of cell block (CB immunohistochemistry, smear cytology (SC, and liquid-based cytology (LBC in patients with pancreatic lesions without consulting an on-site cytopathologist.This study prospectively enrolled 72 patients with pancreatic lesions. The EUS-FNA specimens were examined by SC, LBC, and CB immunohistochemistry. The diagnostic efficacy of the 3 methods was then compared. Patients' final diagnosis was confirmed by surgical resection specimens, diagnostic imaging, and clinical follow-up.Our results included 60 malignant and 12 benign pancreatic lesions. The diagnostic sensitivity (90%, negative predictive value (66.7%, and accuracy (91.7% of CB immunohistochemistry were significantly higher than those of SC (70.0%, 30.0%, and 75.0%, respectively and LBC (73.3%, 31.6%, and 77.8%, respectively (all P<0.05. The combination of CB and SC, or CB and LBC, did not significantly increase the efficacy compared to CB immunohistochemistry alone.Our findings suggest that in the absence of an on-site cytopathologist, CB immunohistochemistry on EUS-FNA specimens offers a higher diagnostic efficacy in patients with pancreatic lesions than does SC and LBC.

  6. Three cases of systemic amyloidosis successfully diagnosed by subcutaneous fat tissue biopsy of the hip.

    Science.gov (United States)

    Arahata, Masahisa; Shimadoi, Shigeru; Yamatani, Satosi; Hayashi, Shin-Ichi; Miwa, Shigeharu; Asakura, Hidesaku; Nakao, Shinji

    2016-01-01

    Fine-needle aspiration biopsy of the abdominal fat pad is considered to be a minimally invasive procedure for diagnosing systemic amyloidosis. However, this procedure is sometimes difficult and can be dangerous for elderly patients whose abdominal fat layer is thin because of malnutrition. In such cases, alternative diagnostic methods are required. We report three elderly patients with heart failure complicated by malnutrition. In all cases, electrocardiogram showed low voltage in the limb leads and a pseudoinfarct pattern in the chest leads, and echocardiography showed left ventricular wall thickening with granular sparkling appearance. These patients were suspected of having amyloid cardiomyopathy but could not undergo myocardial biopsies because of their poor conditions. After failed attempts at biopsy of the abdominal fat pad or the other organs, subcutaneous fat tissue biopsy over the hip led to the diagnosis of systemic amyloidosis with cardiomyopathy. The resultant diagnosis guided us to choose the appropriate treatment for the patients. This article illustrates that subcutaneous fat tissue biopsy of the hip could be a useful procedure for diagnosing systemic amyloidosis in elderly patients, particularly when a fat tissue biopsy of the abdomen is associated with a high risk of complications because of malnutrition.

  7. Pitfalls in the biopsy diagnosis of intraoral minor salivary gland neoplasms: diagnostic considerations and recommended approach.

    Science.gov (United States)

    Turk, Andrew T; Wenig, Bruce M

    2014-01-01

    Among the more common types of intraoral minor salivary gland neoplasms are pleomorphic adenoma, basal cell adenoma, polymorphous low-grade adenocarcinoma, and adenoid cystic carcinoma. These minor salivary gland neoplasms share similar morphologic features and to a large extent immunohistochemical findings. Differentiation between these benign and malignant neoplasms is often predicated on the presence or absence of invasion. As such, in the presence of limited tissue sampling that typifies the initial testing modalities, including fine needle aspiration biopsy and/or incisional biopsy, it often is not possible to differentiate a benign from malignant minor salivary gland neoplasm. The diagnostic difficulties arise from the absence in needle or incisional biopsy of the tumor's periphery to determine whether infiltrative growth is or is not present. In this manuscript we discuss limitations and considerations associated with evaluation of incisional biopsies of intraoral minor salivary gland tumors. We offer a diagnostic approach to evaluating these biopsies, and suggest diagnostic terminology for biopsy specimens in which distinction between benignancy and malignancy is not feasible. The pathologist's approach to this distinction is critical, as treatment of benign neoplasms is generally conservative, whereas malignant lesions may warrant more aggressive management.

  8. Endoscopic ultrasound guided biopsy performed routinely in lung cancer staging spares futile thoracotomies

    DEFF Research Database (Denmark)

    Larsen, Soeren S; Vilmann, Peter; Krasnik, Mark;

    2005-01-01

    BACKGROUND: Up to 45% of operations with curative intent for non-small-cell lung cancer (NSCLC) can be regarded as futile, apparently because the stage of the disease is more advanced than expected preoperatively. During the past decade several studies have evaluated the usefulness of endoscopic...... ultrasound guided fine needle aspiration biopsy (EUS-FNA) in lung cancer staging with promising results. However, no randomised trials have been performed, in which a staging strategy with EUS-FNA performed in all patients is compared with a conventional workup. METHODS: Before surgery (i.e. mediastinoscopy.......3 years (range 0.2-2.4 years). Thoracotomy was regarded as futile if the patient had an explorative thoracotomy without tumour resection or if a resected patient had recurrent disease or died from lung cancer during follow-up. Analysis was by intention to treat. RESULTS: Fifty-three patients were randomly...

  9. Small renal mass biopsy--how, what and when: report from an international consensus panel.

    Science.gov (United States)

    Tsivian, Matvey; Rampersaud, Edward N; del Pilar Laguna Pes, Maria; Joniau, Steven; Leveillee, Raymond J; Shingleton, William B; Aron, Monish; Kim, Charles Y; DeMarzo, Angelo M; Desai, Mihir M; Meler, James D; Donovan, James F; Klingler, Hans Christoph; Sopko, David R; Madden, John F; Marberger, Michael; Ferrandino, Michael N; Polascik, Thomas J

    2014-06-01

    To discuss the use of renal mass biopsy (RMB) for small renal masses (SRMs), formulate technical aspects, outline potential pitfalls and provide recommendations for the practicing clinician. The meeting was conducted as an informal consensus process and no scoring system was used to measure the levels of agreement on the different topics. A moderated general discussion was used as the basis for consensus and arising issues were resolved at this point. A consensus was established and lack of agreement to topics or specific items was noted at this point. Recommended biopsy technique: at least two cores, sampling different tumour regions with ultrasonography being the preferred method of image guidance. Pathological interpretation: 'non-diagnostic samples' should refer to insufficient material, inconclusive and normal renal parenchyma. For non-diagnostic samples, a repeat biopsy is recommended. Fine-needle aspiration may provide additional information but cannot substitute for core biopsy. Indications for RMB: biopsy is recommended in most cases except in patients with imaging or clinical characteristics indicative of pathology (syndromes, imaging characteristics) and cases whereby conservative management is not contemplated. RMB is recommended for active surveillance but not for watchful-waiting candidates. We report the results of an international consensus meeting on the use of RMB for SRMs, defining the technique, pathological interpretation and indications.

  10. Is DOG1 really useful in the diagnosis of salivary gland acinic cell carcinoma? - A DOG1 (clone K9 analysis in fine needle aspiration cell blocks and the review of the literature

    Directory of Open Access Journals (Sweden)

    Sule Canberk

    2015-01-01

    Full Text Available Introduction: DOG1 is a transmembrane protein originally "discovered on gastrointestinal stromal tumors," works as a calcium-activated chloride channel protein. There is a limited number of studies on the potential usage of this antibody in the diagnosis of salivary gland tumors on routine practice in cell blocks. The aim of this study was to search for the usefulness of K9 clone in oncocytic type tumors and review of the literature. Materials and Methods: Sixty-nine fine needle aspiration (FNA cytologic materials of predominantly oncocytic morphology salivary gland tumors; acinic cell carcinoma (AciCC (n = 8, adenoid cystic carcinoma (n = 2, pleomorphic adenoma (PA (n = 22, Warthin tumor (WT (n = 20, myoepithelioma (ME (n = 5, benign oncocytoma (BeO (n = 3, mucoepidermoid carcinoma (MEC (n = 7, mammary analog salivary gland carcinoma (n = 2 were immunostained with DOG1 (clone K9 stain. Results: Of the 8 AciCCs, 7 were observed apical-luminal positive staining, demonstrating 1-3 + intensity, and involving 40-70% of the tumor cells. One MEC of 7 (14%, 1 ME of 5 (20%, and 4 PA of 22 (18% showed weak (1+ cytoplasmic granular staining in 5-10% of the tumor cells. Pure oncocytic neoplasms (WT, BeO showed no expression with DOG1-K9. Conclusions: FNA is a common tool in the diagnosis and management of salivary gland tumors. DOG1-K9 clone was very useful with a unique staining pattern of apical-luminal positivity in the differential diagnosis of AciCC from other oncocytic salivary gland tumors.

  11. Combined {sup 99m}Tc-methoxyisobutylisonitrile scintigraphy and fine-needle aspiration cytology offers an accurate and potentially cost-effective investigative strategy for the assessment of solitary or dominant thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Wale, Anita [Brighton and Sussex University Hospitals NHS Trust, Department of Nuclear Medicine, Brighton (United Kingdom); Royal Sussex County Hospital, Department of Nuclear Medicine, Brighton (United Kingdom); Miles, Kenneth A. [University College London, London (United Kingdom); Young, Barnaby [Tan Tock Seng Hospital, Novena (Singapore); Zammit, Charles [Brighton and Sussex University Hospitals NHS Trust, Department of Surgery, Brighton (United Kingdom); Williams, Anthony [Brighton and Sussex University Hospitals NHS Trust, Department of Pathology, Brighton (United Kingdom); Quin, John [Brighton and Sussex University Hospitals NHS Trust, Department of Endocrinology and Diabetes, Brighton (United Kingdom); Dizdarevic, Sabina [Brighton and Sussex University Hospitals NHS Trust, Department of Nuclear Medicine, Brighton (United Kingdom)

    2014-01-15

    Fine-needle aspiration (FNA) has revolutionised the care of patients with thyroid nodules and is the initial investigation of choice. However, as a result of nondiagnostic (Thy1) and nonneoplastic (Thy2) specimens, it remains an imperfect sole solution with a range of sensitivities and a high inadequate ratio. Therefore the British Thyroid Association (BTA) guidelines recommend a second FNA immediately for Thy1 specimens and 3-6 months later for Thy2 specimens. Patients must be followed up to exclude malignancy. In this study we assessed the performance of MIBI scintigraphy for diagnosing thyroid malignancy and the cost-effectiveness of a combined FNA/MIBI investigative strategy for the management of thyroid nodules. The diagnostic performance of MIBI scintigraphy was calculated from a retrospective review of local data combined with a meta-analysis of the published literature. Decision tree analysis was used to calculate the cost-effectiveness of a combined FNA/MIBI investigative strategy compared to the BTA guidelines. From 712 patients, the sensitivity, specificity, PPV and NPV of MIBI scintigraphy for the diagnosis of malignancy were 96 %, 46 %, 34 % and 97 %, respectively. MIBI-based strategies were more accurate and associated with lower cost per patient (pound 1,855/EUR2,125 vs. pound 2,445/EUR2,801) and lower cost per cancer diagnosed (pound 1,902/EUR2,179 vs. pound 2,469/EUR2,828) with negligible change in life expectancy. Due to its high NPV, MIBI scintigraphy can usefully exclude malignancy for Thy1 and Thy2 lesions. Its low specificity means MIBI scintigraphy cannot be recommended as a first-line investigation, but as a second-line investigation MIBI scintigraphy may lead to a lower rate of unnecessary thyroidectomies. Combined FNA/MIBI strategies are potentially cost-effective in the management of solitary or dominant thyroid nodules. (orig.)

  12. Ultrasonography-guided Fine-needle Aspiration for Solid Thyroid Nodules Less than 5 mm in the Largest Diameter: Comparison in Diagnostic Adequacy and Accuracy According to Nodule Size

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jang Hee; Kim, Dong Wook; Baek, Seung Hun [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2012-03-15

    This study assessed the adequacy and accuracy of ultrasonography (US)-guided fine-needle aspiration (US-FNA) of solid thyroid nodules, less than 5 mm in maximum diameter. From January to December 2009, US-FNA was performed for small solid thyroid nodules in 201 patients. Each thyroid nodule was classified into group A and B according to the largest diameter (1 mm {<=} group A < 3 mm and 3 mm {<=} group B < 5 mm). The adequacy and accuracy of US-FNA in two groups were compared using the histopathological results as a reference standard. Of the 227 thyroid nodules in 201 patients, the inadequacy of US-FNA in group A and B was 24.3% (18/74) and 13.1% (20/153), respectively, showing a statistically significant difference between the two groups (p = 0.0333, chi-square test). Eighty nodules were removed surgically in 72 patients, from which papillary thyroid carcinoma (n = 52), follicular thyroid carcinoma (n = 1), nodular hyperplasia (n = 26), and pseudonodule related to thyroiditis (n = 1) were confirmed. Based on the histopathological results of the 80 surgical nodules, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US-FNA in group A and B were 55.0% and 79.4%, 81.8% and 100%, 84.6% and 100%, 50% and 68.2%, and 64.5% and 85.7%, respectively. The adequacy and accuracy of US-FNA for solid thyroid nodules, {>=} 3 mm in the largest diameter, were higher than those of US-FNA for very small nodules, < 3 mm in the largest diameter

  13. Chromogenic in situ hybridization to detect HER-2/neu gene amplification in histological and ThinPrep-processed breast cancer fine-needle aspirates: a sensitive and practical method in the trastuzumab era.

    Science.gov (United States)

    Vocaturo, Amina; Novelli, Flavia; Benevolo, Maria; Piperno, Giulia; Marandino, Ferdinando; Cianciulli, Anna Maria; Merola, Roberta; Donnorso, Raffaele Perrone; Sperduti, Isabella; Buglioni, Simonetta; Mottolese, Marcella

    2006-09-01

    The increasing evidence of trastuzumab efficacy in breast cancer (BC) patients means that an accurate and reproducible evaluation of HER-2 statusis of paramount importance in histological and in cytological samples. Currently, the two main methods used to analyze HER-2 amplification or overexpression are fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC). Although the two methods are strongly correlated for histological tissue, the evaluation of tumor morphology through FISH may be difficult and fluorescence fades quickly. These limitations can be overcome by chromogenic in situ hybridization (CISH), which can visualize the amplification product along with morphological features. In view of this, in the present study, we analyzed the usefulness of CISH on formalin-fixed, paraffin-embedded (FFPE) BC specimens and investigated whether CISH can be a valid technique in the determination of HER-2 status for fine-needle aspirates (FNAs) processed by liquid-based cytology. The results we obtained in a retrospective series of 111 FFPE BC specimens demonstrated good concordance between CISH and IHC and between CISH and FISH. The former concordance was comparable with that observed between FISH and IHC. When CISH was applied to a prospective series of 53 FNAs, from surgically removed BC, our data showed evidence of a higher concordance of results between liquid-based cytology and the companion FFPE tissues using CISH rather than HercepTesttrade mark. Therefore, CISH analysis, which is avaluable and reproducible alternative to FISH for selecting breast cancer patients for trastuzumab therapy, can lower false-positive immunocytochemistry findings in ThinPrep-processed FNAs.

  14. Fine-needle aspiration with measurement of parathyroid hormone levels in thyroidectomy%甲状腺术中应用抽吸组织测定甲状旁腺激素的临床意义

    Institute of Scientific and Technical Information of China (English)

    黄海燕; 李浩; 林少建; 邓维叶; 李秋梨; 陈艳峰; 杨安奎; 张诠; 郭朱明

    2013-01-01

    Objective Hypoparathyroidism is one of the most serious complications of thyroidectomy.It is important to identify the parathyroid glands during thyroidectomy.In order to find an economic,simple and less traumatic way to identify the parathyroid glands and testify its feasibility,fineneedle aspiration of suspected parathyroid tissue was used to measure the parathyroid hormone (PTH) levels during the surgical procedure.Methods From Nov.2011 to Apr.2012,50 patients were recruited for thyroid surgery in the Sun Yat-sen University Cancer Centre.During surgery,fine-needle aspiration of suspected tissues,including parathyroid gland,thyroid gland,muscle,fat tissue,and lymph node,was performed,the PTH levels were measured.In addition,the tissues above-mentioned were taken to pathological examination.Statistical processing was adopted to determine the sensitivity and specificity of intraoperative fine-needle aspiration with measurement of PTH level in finding the pathology of the parathyroid gland.Results There were 237 tissues from 50 patients in total,and 45 of them were certified as the parathyroid glands by pathology.Intra-operative PTH (ioPTH) of the tissues in forty-four cases were higher than 600 ng/L,ioPTH of the tissues in one case was lower than 600 ng/L,and it was 160 ng/L.The highest ioPTH in other cases was 537.7 ng/L.The sensitivity was 97.8%.The specificity was 100%.The difference between the sensitivity and the specificity of two groups was not statistically significant,and P > 0.05.The level of PTH of parathyroid gland were much higher than other tissues,and P < 0.001.Conclusions The level of ioPTH of parathyroid gland were far higher than thyroid,muscle,fat,lymph node.It is an economic,fast and less traumatic way to identify the parathyroid gland by using the fine-needle aspiration of the parathyroid tissue with measurement of PTH levels.The sensitivity and the specificity are high.It can be used in the thyroidectomy to identify the parathyroid

  15. Biopsy - biliary tract

    Science.gov (United States)

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  16. Nasal mucosal biopsy

    Science.gov (United States)

    Biopsy - nasal mucosa; Nose biopsy ... to fast for a few hours before the biopsy. ... Nasal mucosal biopsy is usually done when abnormal tissue is seen during examination of the nose. It may also be done ...

  17. [Fine needle aspiration cytology of mammography screening

    DEFF Research Database (Denmark)

    Engvad, B.; Laenkholm, A.V.; Schwartz, Thue W.

    2009-01-01

    -choice treatment. MATERIAL AND METHODS: 767 women had FNAC performed from a total of 783 lesions at the Mammography Clinic, University Hospital Odense. All FNACs were compared with the final histology diagnosis. Nine statistical parameters were calculated according to the European guidelines. RESULTS: A total...

  18. Standards of the Polish Ultrasound Society - update. Ultrasound examination of thyroid gland and ultrasound-guided thyroid biopsy.

    Science.gov (United States)

    Trzebińska, Anna; Dobruch-Sobczak, Katarzyna; Jakubowski, Wiesław; Jędrzejowski, Maciej

    2014-03-01

    Ultrasonography is a primary imaging technique in patients with suspected thyroid disease. It allows to assess the location, size and echostructures of the thyroid gland as well as detect focal lesions, along with indication of their size, echogenicity, echostructure and vascularity. Based on these features, ultrasound examination allows to predict abnormal focal lesions for biopsy and monitor the biopsy needle track. This paper presents the standards of thyroid ultrasound examination regarding ultrasound apparatus technical requirements, scanning techniques, readings, measurements, and the description of the examination. It discusses the ultrasound features of increased malignancy risk in focal lesions (nodules) found in the thyroid gland. It presents indications for fine needle aspiration biopsy of the thyroid gland for the visibility of single nodules (focal lesions) and numerous lesions as well as discusses contraindications for thyroid biopsy. It describes the biopsy technique, possible complications and rules for post-biopsy monitoring of benign lesions. The paper is an update of the Standards of the Polish Ultrasound Society issued in 2011. It has been prepared on the basis of current literature, taking into account the information contained in the following publications: Thyroid ultrasound examination and Recommendations of the Polish Ultrasound Society for the performance of the FNAB of the thyroid.

  19. Punção biópsia aspirativa (PBA com agulha fina no diagnóstico diferencial de patologias da mama Fine-needle aspiration cytology (FNAC in the differential diagnosis of breast pathology

    Directory of Open Access Journals (Sweden)

    Francisco José Candido dos Reis

    1998-05-01

    Full Text Available A punção biópsia aspirativa (PBA é um método simples e isento de complicações, de grande valor em mastologia. Sua acurácia diagnóstica pode sofrer a influência de diversos fatores, dos quais podemos destacar a experiência do médico que a realiza. Com o objetivo de verificar a eficácia da PBA realizada por ginecologistas gerais, foram estudadas 341 pacientes correlacionando-se os resultados da PBA com o diagnóstico histopatológico da lesão mamária. Obtivemos sensibilidade de 70,87%, especificidade de 70,58%, valor preditivo positivo de 92,40%, valor preditivo negativo de 89,36% e acurácia de 70,67%. Concluímos que a PBA é de grande auxílio na abordagem das lesões mamárias e pode ser realizada adequadamente por ginecologistas gerais. O método, contudo, pode apresentar erros de diagnóstico. Não recomendamos, portanto, o uso do resultado da PBA como diagnóstico definitivo, devendo este resultado ser interpretado no contexto do diagnóstico clínico e mamográfico da lesão mamária.Fine-needle aspiration cytology (FNAC is a simple method and free from complications, among great value in mastology. Its accuracy can suffer the influence of several factors, among which we can highlight the experience of the physician who performs it. With the objective of verifying the effectiveness of FNAC performed by general gynecologists, 341 patients were studied concerning the relationship between the results of FNAC and the histology of the breast lesion. We obtained sensitivity of 70.87%, specificity of 70.58%, predictive positive value of 92.40%, predictive negative value of 89.36% and accuracy of 70.67%. We concluded that FNAC is of great value in handling breast lesions and can be appropriately performed by general gynecologists. The method, however, may lead to errors of diagnosis. We do not recommend, therefore, the use of the result of FNAC as a definitive diagnosis; instead this result must be interpreted in the context of the

  20. Estimation of hormone receptor status in fine-needle aspirates and paraffin-embedded sections from breast cancer using the novel rabbit monoclonal antibodies SP1 and SP2.

    Science.gov (United States)

    Cano, Guillerma; Milanezi, Fernanda; Leitão, Dina; Ricardo, Sara; Brito, Maria José; Schmitt, Fernando Carlos

    2003-10-01

    We describe a method of immunocytochemical assessment of estrogen receptor (ER) status on alcohol-fixed smears obtained by fine-needle aspiration (FNA) from breast cancer patients, using a commercially available rabbit monoclonal antibody anti-ER (SP1) without any antigen retrieval. A series of 40 aspirates were analyzed and the results of ER status were compared with the respective formalin-fixed tissue using the same procedure and with assessment by the classical method using the mouse monoclonal antibody 6F11 (anti-ER) with antigen retrieval on paraffin sections. Twenty-four out of the 40 cases examined were positive at least by two methods and 16 were negative for all three determinations. The results obtained in the ER immunocytochemical assay on aspirates and paraffin sections using the antibody SP1 and those obtained on paraffin sections using the antibody 6F11 were quite similar. In one case the material was insufficient to interpret the reaction in the cytological specimen and only one case, with focal positivity reaction on paraffin sections, was negative in the cytological specimen. The intensity of nuclei staining in cytological smears of breast cancer cells was stronger than that observed by traditional methods. We also assessed progesterone receptor (PR) status on 40 paraffin-sections from breast cancer patients, using a commercially available rabbit monoclonal antibody anti-PR (SP2), with the same characteristics described for anti-ER (SP1). The results were compared with assessment by the classic method with mouse monoclonal antibody 1A6 (PR) on paraffin sections and total agreement was observed. Of the 40 cases examined, 18 were positive and 22 were negative for the two determinations. We conclude that the application of the ER method on alcohol-fixed smears/paraffin sections with the rabbit monoclonal antibody SP1, and the PR method on paraffin sections with the rabbit monoclonal antibody SP2, provide several advantages, such as high sensitivity

  1. Padrão citológico de punção aspirativa do tecido tireoidiano morfologicamente normal Cytologic pattern for fine-needle aspiration among morphologically normal thyroids

    Directory of Open Access Journals (Sweden)

    Daysi Maria de Alcântara Jones

    2006-02-01

    Full Text Available Nódulos tireoidianos pequenos com diagnóstico citológico de padrão folicular causam muita inquietação porque, se por um lado podem representar uma lesão que exige muito rigor no acompanhamento, por outro poderão representar material aspirado do tecido tireoidiano normal. OBJETIVO: Verificar o padrão citológico do tecido tireoidiano normal obtido através de punções aspirativa e não-aspirativa em cadáveres. MÉTODOS: Estudo observacional em que se procedeu a dissecção anatômica da tireóide normal e se efetuou a citoaspiração da glândula, em 38 casos. Dois patologistas cegos para a metodologia do estudo, sem conhecer a correspondência entre citologia e histologia, analisaram os esfregaços e os cortes histológicos. RESULTADOS: As tireóides normais forneceram diagnóstico citológico de bócio adenomatoso em 70,4% das vezes para um observador e 92,6% para o outro. Houve uma concordância regular entre os observadores, com kappa de 0,51 (p Small thyroid nodules, which are diagnosed as follicular pattern for fine-needle aspiration, are a cause of great worry. They may present a lesion requiring rigorous follow up, or on other hand, there is a risk that some normal thyroid tissue is removed during the procedure. OBJECTIVE: To verify the cytology of a normal thyroid tissue, for aspiration and non-aspiration puncture, in autopsy material. METHODS: Observational study involving the anatomical dissection and cytoaspiration of normal thyroid glands in 38 cadavers. Two blind pathologists, unaware of the cytology and histology, analyzed the smears and the histological cuts. RESULTS: One of pathologists identified a diagnostic cytology of adenomatous goiter in 70.4% of the 38 normal glands found, while the other observed it in 92.4%. There was regular agreement between them, with Kappa of 0.51 (p < 0.0001. Contrary to what was expected, follicular patterns were not found among the cytological samples. RESULTS: The cytological aspect of

  2. Is an increase in CD4/CD8 T-cell ratio in lymph node fine needle aspiration helpful for diagnosing Hodgkin lymphoma? A study of 85 lymph node FNAs with increased CD4/CD8 ratio

    Directory of Open Access Journals (Sweden)

    Hernandez Osvaldo

    2005-01-01

    Full Text Available Abstract Background An elevated CD4/CD8 T-cell ratio on flow cytometry (FCM analysis has been reported in the literature to be associated with Hodgkin lymphoma (HL. The purpose of our study was to determine the diagnostic significance of an elevated CD4/CD8 ratio in lymph node fine needle aspiration (FNA specimens. Design Between 1996 and 2002, out of 837 lymph node FNAs submitted for flow cytometry analysis, 85 cases showed an elevated CD4/CD8 ratio, defined as greater than or equal to 4, without definitive evidence of a lymphoproliferative disorder. The cytologic diagnoses of these 85 cases were grouped into four categories: reactive, atypical, Hodgkin lymphoma (HL, and non-Hodgkin lymphoma (NHL. Histologic follow-up was available in 17/85 (20% of the cases. Results 5 of the 64 cases in which FCM and cytology did not reveal evidence of a lymphoproliferative disease had tissue follow-up because of persistent lymphadenopathy and high clinical suspicion. 3/5 (60% confirmed the diagnosis of reactive lymphadenopathy. The two remaining cases (40% were positive for lymphoma (1HL, 1NHL. 8/15 cases called atypical on cytology had histologic follow-up. 7/8 (87.5% cases were positive for lymphoma (3HL, 4NHL. 3/4 cases called HL on cytology had tissue follow-up and all 3 (100% confirmed the diagnosis of HL. One case diagnosed as NHL on cytology was found to be a diffuse large B-cell lymphoma. In summary, out of 17 cases with histologic follow-up 4/17 (24% were reactive with CD4/CD8 T-cell ratio of 4.1–29, 7/17 (41% were HLs with CD4/CD8 T-cell ratio of 5.3 – 11, and 6/17 (35% were NHLs with CD4/CD8 T-cell ratio of 4.2 – 14. Conclusion An elevated CD4/CD8 ratio on FCM is a nonspecific finding which may be seen in both reactive and lymphoproliferative disorders. The cytomorphologic features of the smear are more relevant than the sole flow cytometric finding of an elevated CD4/CD8 ratio.

  3. Pathological analysis of liquid-based cytological diagnosis in fine needle aspiration of thyroid lesion%甲状腺病变的液基细胞学诊断病理分析

    Institute of Scientific and Technical Information of China (English)

    王玉欣; 武卫国; 韩艳华; 宋忠海

    2012-01-01

    目的 探讨液基细胞学方法处理标本在甲状腺病变针吸细胞学诊断的应用价值.方法 采用利普液基细胞学(liquid-PRER,LPT)和传统手工制片方式对229例甲状腺病变患者细针穿刺细胞学诊断结果,并对两种制片方法进行比较.结果 应用LPT技术保存标本和制片,诊断性细胞数量明显增多,背景清洁,分布均匀,玻片中较少见到甲状腺胶质,而核细节更容易观察.LPT制片甲状腺癌的阳性诊断率6.55%(15/229),传统涂片3.93%(9/229).结论 LPT技术用于甲状腺细针穿刺能明显提高标本质量和甲状腺癌阳性诊断率,为诊断甲状腺病变提供了一种可靠而有前景的诊断方法.%Objective To evaluate the liquid - based cytology in the diagnosis of thyroid diseases. Methods Two hundred cases of thyroid lesion in outpatient and inpatient departments underwent liquid - based cytological examinations to compare the quality and diagnosis of traditional manual smear preparation. Results The preserved specimens and smears made with liquid - PREP showed an increased number of valuable cells, a cleaner background, uniform distribution, less thyroid colloid in the smear and clear nuclei. The positive rate of thyroid cancer was 6. 55% ( 15/229) in liquid - PREP and 3. 93% (9/229) in traditional manual smear preparation. Conclusions Liquid - PREP improves the smear quality and positive rate of cancer in thyroid fine needle aspiration cytology and can serve as a promising diagnostic method for thyroid lesion.

  4. Diagnostic value of guided fine needle aspiration accompanied by CFTR detection in chronic pancreatitis%内镜超声引导下穿刺联合CFTR基因检测对慢性胰腺炎的诊断价值

    Institute of Scientific and Technical Information of China (English)

    郑著家; 李长福; 韩继武

    2011-01-01

    Objective To evaluate significance of diagnosis with endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) accompanied by cystic fibrosis transmembrane conductance regulator (CFTR) detection in chronic pancreatitis. Methods Endoscopic ultrasonography guided fine needle aspiration was performed in 120 patients with chronic pancreatitis at our hospital and the Fourth Affiliated Hospital of Harbin Medical University from August 2003 to December 2005. At the same time. CFR was detected. Results In EUS-FNA specimens of patients, the contents of CFTR were significantly higher than that in blood ( P < 0. 05 ), 20% of the patients were dignosed as pancreatic cancer. Conclusion EUS-FNA accompanied by CFTR detection is important in diagnosis of chronic pancreatitis.%目的 探讨内镜超声引导下细针穿刺活检(endoscopic ultrasonography guided fine needle aspiration,EUS-FNA )联合囊性纤维化转膜传导调节因子(cystic fibrosis transmembrane conductance regulator,CFTR)基因检测对慢性胰腺炎的诊断价值.方法 对本院及哈尔滨医科大学附属第四医院120例慢性胰腺炎患者进行超声内镜引导下穿刺活检,并采用免疫印迹方法检测CFTR基因表达情况.结果 活检物中的CFTR检测阳性率明显高于血清中的浓度,其中小胰腺癌检出率为20%.结论 EUS-FNA联合CFTR基因检测对慢性胰腺炎的诊断具有重要价值.

  5. Needle-in-Needle Technique for Percutaneous Retrieval of a Fractured Biopsy Needle during CT-Guided Biopsy of the Thoracic Spine.

    Science.gov (United States)

    Shaikh, Hamza; Thawani, Jayesh; Pukenas, Bryan

    2014-10-31

    Common complications related to CT-guided percutaneous thoracic bone biopsy procedures include pneumothorax and muscular hematoma. Serious, but rare complications include paralysis, nerve injury, CSF leak, and aortic injury. Device failure has not been well documented in the literature. We discuss our experience with biopsy needle breakage during retrieval of a core specimen and the technique used to help retrieve an embedded needle using a CT fluoroscopic-guided, needle-in-needle approach. A 43 year-old man with Stage IIIa NSCLC was found to have a T11 vertebral body lesion as seen on PET, CT, and MR imaging. The patient underwent a CT-guided biopsy in the prone position. The T11 vertebral body was localized and cannulated using the percutaneous Bonopty(®) (Apriomed, Upsala, Sweden) needle device. After fine needle aspiration samples were obtained, a core needle biopsy was attempted with a 16-gauge device. The needle fractured 4 cm deep to the skin during removal of a sclerotic lesion, leaving a retained portion within the pedicle and vertebral body. Using CT-guided fluoroscopy, a large diameter Murphy M2 needle was advanced over the distal portion of the fractured Bonopty needle. The Murphy M2 needle was advanced distal to the tip of the Bonopty needle and removed, capturing the broken Bonopty penetration needle along with a core specimen. Larger-bore biopsy needle systems and/or a coaxial system should be used to perform core biopsies in sclerotic lesions to prevent device fracture. If there is device fracture, a larger-bore needle may be used to help capture the fractured needle and prevent open surgery.

  6. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  7. Muscle biopsy (image)

    Science.gov (United States)

    A muscle biopsy involves removal of a plug of tissue usually by a needle to be later used for examination. Sometimes ... there is a patchy condition expected an open biopsy may be used. Open biopsy involves a small ...

  8. Skin lesion biopsy

    Science.gov (United States)

    ... procedure will leave a small indented area. This type of biopsy is often done when a skin cancer is ... may have stitches to close the area. This type of biopsy is often done to diagnose rashes . EXCISIONAL BIOPSY ...

  9. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... needle is gently pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  10. 免疫学标记在细针穿吸甲状腺桥本病诊断中的应用%Diagnosis application of immunological markers in thyroid fine needle aspiration cytology

    Institute of Scientific and Technical Information of China (English)

    刘邦荣; 陆军; 张伟; 蒋艳; 张岩; 陈媛媛

    2014-01-01

    目的:探讨免疫学标记在甲状腺细针穿吸细胞学诊断中应用的价值。方法应用免疫细胞化学技术,观察CD45 RO、Vimentin、HLA-DR、CK/Pan在60例桥本氏甲状腺炎(Hashimot′s thyroiditis,HT)和10例结节性甲状腺细胞的表达。结果(1)CD45RO、HLA-DR在其T淋巴细胞阳性率表达上HT高于结节性甲状腺肿,有显著差异(P<0.05);(2)甲状腺滤泡上皮细胞(TEC)的DR和Vimentin表达程度HT明显高于结节性甲状腺肿,有显著差异(P<0.05);(3)CK/Pan在不典型增生17例中,阳性表达10例(10/17),细胞学确诊甲状腺癌3例均阳性表达,在细胞无异型中1例强表达。结论细针穿刺加做CD45 RO、Vimentin、HLA-DR、CK/Pan有助于桥本甲状腺炎的分型及与其他甲状腺疾病的鉴别、判断疾病的发展程度,且能筛检出变异细胞为临床治疗诊断提供可靠依据。%Objective Explortion the application of immunological markers in thyroid fine needle aspiration cytology.Methods Appli-cation of immunocytochemical technique,observes the expression of CD45RO,Vimentin,HLA-DR,CK/Pan in 60 cases of HT and 10cases of nodular Thyroid cells.Results (1)The T lympholytes positive expression of CD45RO,HLA-DR,HT is significantly higherthan normal nodular goiter(P <0.05).(2)The expression of DR and Vimentin in thyroid follicular epithelial,HT is significantly higherthan normal nodular goiter(P <0.05).(3)In 17 cases atypicalhyperplasia cases,the CK/Pan positive expression were 10 cases,cyto-logical diagnosis 3 thyroid carcinoma cases were positive expression,1 strong expression case in no abnormal cell morphology.Conclu-sions Cell puncture cooperate with CD45RO,Vimentin,HLA-DR,CK/Pan contribute to the types of thyroiditis,identification of otherthyroid diseases,determins disease severity,and screens variant cells could provide celiable basis for clinical diagnosis and treatment.

  11. Approach to the Solitary Liver Lesion: Imaging and When to Biopsy.

    Science.gov (United States)

    Pang, Emily H T; Harris, Alison C; Chang, Silvia D

    2016-05-01

    The characterization and management of focal liver lesions is a commonly encountered problem in radiology. While the imaging findings will often be diagnostic, in equivocal cases the decision of how to proceed may be challenging. The primary modalities for liver lesion characterization are multiphase contrast-enhanced computed tomography and magnetic resonance imaging. Most lesions have typical imaging features, and when taken in conjunction with patient demographics and biochemistry the diagnosis can usually be made. Ancillary imaging modalities such as contrast-enhanced ultrasound and hepatobiliary specific contrast agents are also useful. Cirrhotic livers present a challenge due to the spectrum of benign, dysplastic, and malignant nodules that can occur. The report should include information necessary for accurate staging, and published standardized reporting guidelines should be taken into consideration. A decision to proceed to biopsy should be made only after multidisciplinary review of the case. If biopsy is required, fine needle aspiration is usually sufficient, though core needle biopsy may be required in certain circumstances.

  12. Successful mucosal incision-assisted biopsy for the histological diagnosis of duodenal lymphoma: A case report

    Science.gov (United States)

    MORISHITA, ASAHIRO; MORI, HIROHITO; KOBARA, HIDEKI; NISHIYAMA, NORIKO; FUJIHARA, SHINTARO; YACHIDA, TATSUO; AYAKI, MAKI; MATSUNAGA, TAE; SAKAMOTO, TEPPEI; MAEDA, EMIKO; NOMURA, TAKAKO; TANI, JOJI; MIYOSHI, HISAAKI; YONEYAMA, HIROHITO; HIMOTO, TAKASHI; KAGAWA, SEIKO; HABA, REIJI; MASAKI, TSUTOMU

    2016-01-01

    Tissue sampling of primary duodenal lymphoma is essential for its histological diagnosis. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), which is frequently used for submucosal tumor (SMT)-like duodenal tumors, is adequate for cytological diagnosis, but not for histological diagnosis. Therefore, in the present study, a mucosal incision-assisted biopsy (MIAB) was performed in an 81-year-old woman for the diagnosis of an SMT-like duodenal mass, as tissue sampling for histological analysis using a regular endoscopic biopsy had failed to establish a definite diagnosis of malignant lymphoma. EUS-FNA had also led to poor tissue sampling due to the difficult location of the duodenal tumor. The pathological examination of biopsy samples using MIAB revealed the presence of a diffuse proliferation of atypical lymphocytes, and the expression of cluster of differentiation (CD)20 and CD79a, but no expression of CD3 in the tumor specimens. The patient was diagnosed with diffuse large B-cell lymphoma. To the best of knowledge, this is first report of a case using MIAB as a sampling method for the histological diagnosis of SMT-like primary duodenal lymphoma. This case suggests that MIAB may be an essential method for obtaining tissue samples from SMT-like duodenal tumors. PMID:26870243

  13. Biopsy with the New Essen Biopsy Forceps

    Directory of Open Access Journals (Sweden)

    Peter G. Traine

    2013-01-01

    Full Text Available Purpose. To present initial experience with a novel biopsy method, the Essen biopsy forceps. Therefore, two patients with diagnostic suspicion of uveal melanoma underwent biopsy for histopathological confirmation. Case Presentation. Two patients presented with painless unilateral vision reduction. Ultrasound revealed the diagnostic suspicion of uveal melanoma. Therefore, biopsy with the Essen biopsy forceps using a sutureless 23-gauge three-port vitrectomy system was performed. The specimens were then submitted to a pathologist and processed. Histopathology of the obtained specimen confirmed the diagnostic suspicion of choroid melanoma in both patients. Conclusion. Essen biopsy forceps is a very practicable alternative method to the FNAB, allowing a combined histopathological and immunohistochemical examination for achieving high diagnostic accuracy at minimal risk.

  14. Skin biopsy: Biopsy issues in specific diseases.

    Science.gov (United States)

    Elston, Dirk M; Stratman, Erik J; Miller, Stanley J

    2016-01-01

    Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders. Understanding these potential pitfalls can result in improved diagnostic yield and patient outcomes.

  15. Improved Accuracy of Percutaneous Biopsy Using “Cross and Push” Technique for Patients Suspected with Malignant Biliary Strictures

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Prashant, E-mail: p.patel@bham.ac.uk [University of Birmingham, School of Cancer Sciences, Vincent Drive (United Kingdom); Rangarajan, Balaji; Mangat, Kamarjit, E-mail: kamarjit.mangat@uhb.nhs.uk, E-mail: kamarjit.mangat@nhs.net [University Hospital Birmingham NHS Trust, Department of Radiology (United Kingdom)

    2015-08-15

    PurposeVarious methods have been used to sample biliary strictures, including percutaneous fine-needle aspiration biopsy, intraluminal biliary washings, and cytological analysis of drained bile. However, none of these methods has proven to be particularly sensitive in the diagnosis of biliary tract malignancy. We report improved diagnostic accuracy using a modified technique for percutaneous transluminal biopsy in patients with this disease.Materials and MethodsFifty-two patients with obstructive jaundice due to a biliary stricture underwent transluminal forceps biopsy with a modified “cross and push” technique with the use of a flexible biopsy forceps kit commonly used for cardiac biopsies. The modification entailed crossing the stricture with a 0.038-in. wire leading all the way down into the duodenum. A standard or long sheath was subsequently advanced up to the stricture over the wire. A Cook 5.2-Fr biopsy forceps was introduced alongside the wire and the cup was opened upon exiting the sheath. With the biopsy forceps open, within the stricture the sheath was used to push and advance the biopsy cup into the stricture before the cup was closed and the sample obtained. The data were analysed retrospectively.ResultsWe report the outcomes of this modified technique used on 52 consecutive patients with obstructive jaundice secondary to a biliary stricture. The sensitivity and accuracy were 93.3 and 94.2 %, respectively. There was one procedure-related late complication.ConclusionWe propose that the modified “cross and push” technique is a feasible, safe, and more accurate option over the standard technique for sampling strictures of the biliary tree.

  16. Sentinel node biopsy (image)

    Science.gov (United States)

    Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastasized), or is contained locally. When a ... is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, ...

  17. Nerve biopsy (image)

    Science.gov (United States)

    Nerve biopsy is the removal of a small piece of nerve for examination. Through a small incision, a sample ... is removed and examined under a microscope. Nerve biopsy may be performed to identify nerve degeneration, identify ...

  18. Percutaneous liver biopsy.

    Science.gov (United States)

    Rustagi, Tarun; Newton, Eric; Kar, Premashish

    2010-01-01

    Percutaneous liver biopsy has been performed for more than 120 years, and remains an important diagnostic procedure for the management of hepatobiliary disorders. Modern biochemical, immunologic, and radiographic techniques have facilitated the diagnosis and management of liver diseases but have not made liver biopsy obsolete. This comprehensive review article will discuss the history of development of percutaneous liver biopsy, its indications, contraindications, complications and the various aspects of the biopsy procedure in detail.

  19. Ultrasound-Guided Breast Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound-Guided Breast Biopsy An ultrasound-guided breast biopsy ... limitations of Ultrasound-Guided Breast Biopsy? What is Ultrasound-Guided Breast Biopsy? Lumps or abnormalities in the ...

  20. Analysis of bone biopsies.

    Science.gov (United States)

    Goodrich, J A; Difiore, R J; Tippens, J K

    1983-11-01

    The orthopedic surgeon is frequently confronted with the decision of when to perform a bone biopsy and whether to do a needle biopsy or an open biopsy. Frequently consultations are received from other services requesting bone biopsies with questionable indications. The indications and contraindications for performing bone biopsies are discussed as well as advantages and disadvantages of either closed or open technique. Four selective cases are discussed with illustrations. The challenge of undiagnosed osseous lesions is best met by rational evaluation of each individual case and coordinated with the team effort of the primary care physician, surgeon, pathologist, and radiologist. The decision for either an open or closed biopsy technique must be based on the experience and skills of the surgeon and pathologist.

  1. Appropriateness of Liver Biopsy

    OpenAIRE

    Thierry Poynard; Vlad Ratziu; Pierre Bedossa

    2000-01-01

    This review aims to discuss the appropriateness of liver biopsy in two frequent liver diseases, hepatitis C and alcoholic liver disease. The medical literature, published between 1965 and 1999, was reviewed by using MEDLINE. Only 0.1% of the publications were devoted specifically to the appropriateness of liver biopsy. Not all studies observed a significant agreement among doctors on the decision to use liver biopsy. Therefore, there is a possibility that hepatologists have significant, heter...

  2. Open lung biopsy

    Science.gov (United States)

    ... CT scan Disseminated tuberculosis Granulomatosis with polyangiitis Lung cancer - small cell Lung disease Lung needle biopsy Malignant mesothelioma Pulmonary tuberculosis Rheumatoid lung disease Sarcoidosis Simple pulmonary eosinophilia ...

  3. Needle biopsy of histoplasmosis

    Energy Technology Data Exchange (ETDEWEB)

    Sinner, W.N.

    1980-12-01

    A case of histoplasmosis, simulating a bronchogenic carcinoma, was needle biopsied. Histoplasma capsulatum organisms were found in great numbers. Needle biopsy established an accurate diagnosis making an exploratory thoracotomy unnecessary and preventing the patient from an already planned lobectomy. Specific treatment with Amphotericin B healed the lesion.

  4. Lung needle biopsy

    Science.gov (United States)

    ... biopsy Lung tissue biopsy References Ettinger DS. Lung cancer and other pulmonary neoplasms. In: Goldman L, Schafer AI, eds. Goldman's ... 2010:chap 47. Read More Aspiration ... by: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, ...

  5. Ureteral retrograde brush biopsy

    Science.gov (United States)

    ... biopsy URL of this page: //medlineplus.gov/ency/article/003906.htm Ureteral retrograde brush biopsy To use ... minutes. A cystoscope is first placed through the urethra into the bladder. Cystoscope is a tube with a ... results may show cancer cells ( carcinoma ). This test is often used to ...

  6. Diagnostic application and value of the fine needle aspiration cytology in HIV positive patients with lymphadenopathy and superficial mass%细针吸取细胞学在HIV感染者体表肿大淋巴结和肿块诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    孙磊; 张亮; 王玉光; 余小蒙; 滕晓英; 赵红心; 李兴旺; 王鹏

    2011-01-01

    Purpose To study the diagnostic value of fine needle aspiration cytology ( FNA ) in AIDS patients with lymphadenopathy and superficial mass.Methods 72 cases HIV positve patients with superficial masses were done by fine needle aspiration, samples were obtained by Youyi Type FNA aspirators, specimens were prepared into cell smears, HE staining and special staining such as Acid-fast, Grocott-Gomori, PAS were stained and cell blocks were made if required.Bacterial culture , immunohistochemistry and PCR assay were used for specific diseases.Results Among 72 cases of HIV patients , there were 65 paracentesis lymph node( 90.3% ) and 7 superficial masses( 9.7% ).These patients with lymphadenopathy included 30 cases of tuberculosis, 5 cases of MAC, 14 cases of reactive lymphadenitis, 7 cases of lymphoma, 5 cases of suppurative lymphadenitis,2 case of Cryptococcus, 2 cases of Penicillium marneffei.Superficial masses were located at skin and soft tissues ( 4 cases ), hreast( 2 cases ) and thyroid ( 1 case ) which there were 2 cases of malignant tumour including 1 hreast lymphoma and 1 thyroid papillary carcinoma.Conclusions FNA is one simple and effective diagnostic method for those HIV positive patients with lymphadenopathy, which is important valuable in determining pathogen for HIV positve patients with lymphadenopathy.The tuberculosis is the most common cause of lymphadenopathy in our study.%目的 探讨细针吸取细胞学(fine needle aspiration cytology,FNA)对HIV感染者体表肿大淋巴结和肿块诊断的应用价值.方法 采用"友谊式"细针穿刺器,对72例HIV感染者进行FNA检查.获得组织用于制备涂片或细胞块,进行HE染色、抗酸染色、六胺银染色、PAS染色,特殊病例进行细菌培养、免疫组织化学染色和PCR检测.结果 在72例HIV感染者中,穿刺淋巴结65例(90.3%)和体表肿物7例(9.7%).淋巴结病例包括:结核30例(42%),非结核分支杆菌感染5例(7%)、HIV相关性反应性增生14例(19%)

  7. O papel da expressão de Bcl-2 em material obtido por PAAF no diagnóstico de doenças linfoproliferativas B The role of Bcl-2 expression in fine needle aspiration specimens for the diagnostic accuracy in lymphoproliferative diseases

    Directory of Open Access Journals (Sweden)

    Carolina Escaramuzi Lourenço

    2008-12-01

    Full Text Available INTRODUÇÃO: O diagnóstico das doenças linfoproliferativas (DLP tradicionalmente baseia-se no estudo histológico dos linfonodos (LN acrescido de imuno-histoquímica. A imunofenotipagem (IFT pela citometria de fluxo (CF é uma ferramenta sensível e rápida, que pode ser aplicada nas DLP, em material obtido por punção aspirativa por agulha fina (PAAF de LN. O Bcl-2 é um proto-oncogene que se expressa em várias DLP, porém em níveis especialmente elevados no linfoma folicular (LF. OBJETIVOS: Diagnosticar DLP, através de morfologia e imunofenotipagem por CF, em amostras obtidas por PAAF de LN. MATERIAL e MÉTODO: Amostras de 25 pacientes com adenopatias e de duas tonsilas reacionais foram analisadas pela morfologia e IFT, utilizando um painel inicial de AcMo (CD3, CD4, CD8, CD19, anti-kappa; e anti-lambda;, ampliado conforme a necessidade (CD5, CD10, CD11c, CD23, CD79b, sIgM, FMC-7 e Bcl-2. Os resultados foram comparados com a histologia. RESULTADOS:Dos 25 casos, quatro foram classificados como reacionais e 21 como DLP-B, havendo concordância com resultados histológicos em todos os casos. A intensidade média de fluorescência (IMF da Bcl-2 no LF (19,92 foi maior que em outras DLP-B (11,93 e que nos controles (3,49 (p = 0,032. CONCLUSÃO:A PAAF de LN combinada com a citomorfologia e a IFT por CF permite uma rápida diferenciação entre os processos reacionais e linfoproliferativos B. A elevada expressão da Bcl-2 nos LFs pela citometria mostra sua utilidade no diagnóstico do tipo mais freqüente das DLP-B. A obtenção de células por PAAF requer treinamento e recomendamos mais de uma punção.BACKGROUND: The diagnosis of lymphoproliferative disorders (LPD is routinely made through histological and immunohistochemical analysis of lymph nodes. Immunophenotyping by flow cytometry (FC is a sensitive and fast tool, which may be applied in samples obtained through fine needle aspiration for the diagnosis of LPD. Bcl-2 is a proto

  8. Malignant-looking thyroid nodules with size reduction: Core needle biopsy results

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ha Young; Baek, Jung Hwan; Ha, Eun Jun; Park, Jee Won; Lee, Jeong Hyun; Song, Dong Eun; Shong, Young Kee [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-08-15

    The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years) who underwent core needle biopsy (CNB), and whose thyroid nodules had malignant ultrasonographic (US) features, although they showed size reduction (>20% decrease in maximum diameter) during the follow-up period (mean, 37±27 months). The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo. All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12) and hemorrhage (8/12) and that the isoechoic rim was composed of follicular cells. In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery.

  9. Malignant-looking thyroid nodules with size reduction: core needle biopsy results

    Directory of Open Access Journals (Sweden)

    Ha Young Lee

    2016-10-01

    Full Text Available Purpose The aim of this study was to evaluate whether malignant-looking thyroid nodules with size reduction were malignant or not. Methods From November 2010 to July 2011, we retrospectively enrolled 16 patients with 16 nodules (11 females and five males; mean age, 55 years who underwent core needle biopsy (CNB, and whose thyroid nodules had malignant ultrasonographic (US features, although they showed size reduction (>20% decrease in maximum diameter during the follow-up period (mean, 37±27 months. The histologic findings of the CNB specimen were reviewed and correlated with the US findings. US studies were analyzed for their internal content, shape, margin, echogenicity, the presence of microcalcification and macrocalcification, inner isoechoic rim, and low-echoic halo. Results All nodules were confirmed as benign by CNB. Pathologic analysis was available for 12 CNB specimens. US imaging showed central hypoechogenicity or marked hypoechogenicity in all cases and a peripheral isoechoic rim in 15 nodules. US-pathologic correlation showed that the central hypoechoic area was primarily composed of fibrosis (12/12 and hemorrhage (8/12 and that the isoechoic rim was composed of follicular cells. Conclusion In our study, the CNB results of all of the malignant-looking thyroid nodules with size reduction were benign and were primarily composed of internal fibrosis and hemorrhage. Understanding these US and pathologic features could prevent repeated fine-needle aspiration or unnecessary diagnostic surgery.

  10. Initial research for the cytoactive of the fibroblast in the dermis of SD mice after treatment by fine-needle electrocoagulation%小针电凝对SD大鼠真皮成纤维细胞活性影响的初步研究

    Institute of Scientific and Technical Information of China (English)

    于海生; 陈石海; 刘庆丰; 韦强; 廖明德; 蒙旭昌

    2011-01-01

    目的:研究小针电凝对SD大鼠真皮成纤维细胞生长活性的影响,并探讨其可能的发生机制.方法:应用小针高频电凝分别在6J/H、8J/H、10J/H、12J/H功率下对SD大鼠真皮进行选择性电热解作用2s,然后分别在术后第14天、第35天取标本制成病理切片光镜下观察成纤维细胞和胶原纤维的数量变化.结果:经小针高频电凝作用后第35天的SD大鼠真皮中胶原纤维数量明显增加(P<0.05).结论:小针高频电凝的适度选择性电热解作用可增加SD大鼠真皮中成纤维细胞的活性,增加其对胶原纤维的分泌,从而提示小针高频电凝对人体皮肤有非剥脱性除皱的作用.%Objective To research the effects of the cytoactive of the Fibroblast in the dermis of SD Mice after selectional treatment by Fine-needle electrocoagulation,and infer the mechanism that results in the effects. Methods Using Fineneedle,the Dermis of SD Mice were electrolyzed selectionally at 6J/H、8J/H、10J/H、and 12J/H power. Then the specime,electrolyzed with Fine-needle,were made into the pathological sections on 14 and 35 days after electrocoagulation,the change of the fibroglia fibrils and the fibroblast would be observeed in photon microscope. Results The quantity of the fibroglia fibrils in the the dermis of SD mice were more incremental on 35 days after electrocoagulation than before that (P<0.05). Conclusions The quantity of the fibroglia fibrils that secreted by the Fibroblast,were increase in the dermis of the SD mice after moderately selectional electrocoagulation,and what manifest that the effects of nonablative skin rejuvenation can be obtained by electrocoagulation.

  11. The Role of Negative Pressure Fine Needle Aspiration Cytology in the Diagnosis of Fibroadenoma of Breast and Breast Cancer%负压针穿刺细胞学在诊断乳腺纤维腺瘤与乳腺癌中的意义

    Institute of Scientific and Technical Information of China (English)

    郑平; 杨霞; 彭柳英; 王影

    2015-01-01

    目的:探讨负压针穿刺对乳腺纤维腺瘤与乳腺癌的诊断应用价值及细胞病理学特征表现。方法回顾性分析本院2014年4月至8月87例可触及乳腺肿块行一次性10mL负压注射器穿刺细胞学检查结果,结合术后病理检查,比较分析乳腺纤维腺瘤与乳腺癌的细胞病理学特征。结果本组87例患者一次穿刺成功率100%。确诊乳腺癌患者40例,纤维腺瘤患者47例,负压针吸细胞学与术后活检的诊断符合率95.4%,负压针吸细胞学对乳腺癌诊断的敏感性为100%,假阳性4.6%,漏诊率为0。结论负压针穿刺细胞学安全无痛苦,创伤小,单人操作,简单方便,对乳腺纤维腺瘤和乳腺癌的术前的诊断和鉴别诊断具有重要的应用价值。%Objective To study the application value of negative pressure fine needle aspiration cytology in breast fibro-adenoma and breast cancer and compare with their cytological features. Methods 87 cases of breast lumps received negative pressure fine needle aspiration cytology and compared the cytological features between breast fibroadenoma and breast cancer. Re-sults All cases were proved by postoperative patholgy. 40 cases were breast cancer,and 47 cases were fibroadenoma of breast. The diagnose accordance rate was 95. 4%. The sensitivity of diagnosis of malignant tumor was 100%, and the false positive rate was 4. 6%, the misdiagnosis rate was 0. Conclusion Negative pressure needle aspiration cytology is safe without pain, small trauma, single operation, simple and convenient, It has important application value in the diagnosis and differential diagnosis of breast fi-broadenoma and breast cancer before operation.

  12. A Case of Gastrointestinal Stromal Tumor That Underwent Endoscopic Ultrasound-Guided Aspiration with a 25-Gauge Biopsy Needle

    Directory of Open Access Journals (Sweden)

    Minoru Tomizawa

    2016-05-01

    Full Text Available Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA is performed to obtain specimens for pathological analysis. For this procedure, 19-gauge (19G, 22-guage (22G, and 25-guage (25G needles are available. The needles are classified into aspiration type and biopsy type. A 56-year-old woman underwent upper gastrointestinal endoscopy that showed a 38-mm-diameter submucosal tumor. The elevated lesion was diagnosed as a submucosal tumor of the stomach. Contrast-enhanced computed tomography showed a low-density area on the luminal surface of the gastric wall, which was covered with a thin layer of gastric mucosa. EUS showed a hypoechoic lesion in the submucosal layer. Color Doppler image showed a pulsating vascular signal extending into the center of the hypoechoic lesion from the periphery. EUS-FNA was performed with a 25G biopsy needle. The specimen tissue consisted of spindle-shaped cells. The cells were positive for CD117 and CD34. The submucosal tumor was diagnosed as a gastrointestinal stromal tumor.

  13. A Case of Gastrointestinal Stromal Tumor That Underwent Endoscopic Ultrasound-Guided Aspiration with a 25-Gauge Biopsy Needle.

    Science.gov (United States)

    Tomizawa, Minoru; Shinozaki, Fuminobu; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2016-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is performed to obtain specimens for pathological analysis. For this procedure, 19-gauge (19G), 22-guage (22G), and 25-guage (25G) needles are available. The needles are classified into aspiration type and biopsy type. A 56-year-old woman underwent upper gastrointestinal endoscopy that showed a 38-mm-diameter submucosal tumor. The elevated lesion was diagnosed as a submucosal tumor of the stomach. Contrast-enhanced computed tomography showed a low-density area on the luminal surface of the gastric wall, which was covered with a thin layer of gastric mucosa. EUS showed a hypoechoic lesion in the submucosal layer. Color Doppler image showed a pulsating vascular signal extending into the center of the hypoechoic lesion from the periphery. EUS-FNA was performed with a 25G biopsy needle. The specimen tissue consisted of spindle-shaped cells. The cells were positive for CD117 and CD34. The submucosal tumor was diagnosed as a gastrointestinal stromal tumor.

  14. Improved transvenous liver biopsy needle

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Matzen, P; Christoffersen, P;

    1979-01-01

    A modified type of the standard transvenous cholangiography biopsy needle is described. The modified tranvenous liver biopsy needle caused only minimal artefactual changes of the liver biopsy specimens. The new type of biopsy needle is a modified Menghini needle. The conventional Menghini needle...... should be avoided for transvenous catheter biopsies because of risk of leaving catheter fragments in the liver....

  15. A utilidade da citologia por punção com agulha fina aliada a imunofenotipagem no diagnóstico dos linfomas não-Hodgkin Diagnosis of non-Hodgkin's lymphoma combining immunophenotyping and fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Flávia P. S. Costa

    2005-03-01

    biopsy. In 85% of cases, cytology combined with immuno-phenotyping and percentage of Phase S cells allowed the correct diagnosis. In the remaining cases it was possible to differentiate T or B lymphomas and estimate their aggressiveness. The panel, although small, was sufficient in all cases except for anaplastic lymphoma. S-phase fraction was important for the diagnosis of large B-cell NHL vs. Follicular NHL. In cases of T-cell lymphomas a reliable diagnosis was only possible for lymphoblastic lymphomas. In conclusions, combined cytology and cytophotometric diagnosis of lymph node aspirations is a good alternative to histologic examination, except for T-cell lymphomas. In contrast to biopsy this method is less invasive and may be repeated if necessary.

  16. Diagnostic Accuracy of PET/CT-Guided Percutaneous Biopsies for Malignant Peripheral Nerve Sheath Tumors in Neurofibromatosis Type 1 Patients.

    Directory of Open Access Journals (Sweden)

    Mehdi Brahmi

    Full Text Available Malignant peripheral nerve sheath tumors (MPNST are one of the most frequent causes of death in patients with neurofibromatosis type 1 (NF1. Early detection is crucial because complete surgical resection is the only curative treatment. It has been previously reported that an 18F-fluorodeoxyglucose (FDG positron emission tomography/computed tomography (PET/CT image with a T/L (Tumor/Liver SUV max ratio > 1.5 provides a high negative predictive value; however, it is not specific enough to make a NF1-related MPNST diagnosis. A formal proof of malignant transformation from a histological analysis is necessary before surgical excision because the procedure can cause mutilation. The objective of the present work was to investigate the effectiveness of and complications associated with PET/CT-guided percutaneous biopsies for an NF1-related MPNST diagnosis.PET/CT-guided percutaneous biopsy procedures performed on 26 NF1 patients with a clinical suspicion of MPNST and a suspect lesion from a PET/CT scan (T/L SUV max ratio > 1.5 were retrospectively evaluated. The localization of the suspected malignant site was determined using PET/CT. A stereotactic (ultrasonic and CT control core biopsy technique was used with a local anesthesia.The first PET/CT-guided percutaneous biopsies enabled a pathological diagnosis for all of the patients (no "inconclusive " results were obtained, and no secondary procedures were needed. Among the 26 patients, the histopathological results from the biopsy were malignant in 17 cases and benign (BPNST with atypical cells in nine cases. No complications from the diagnostic procedure were observed. A surgical resection was performed in 18 patients (seven benign and 11 malignant biopsies, removing the fine needle biopsy scar. In addition, six locally advanced/metastatic MPNST were treated with chemo/radiotherapy, and two BPNST had no progression after a follow-up of 14 and 39 months, respectively. The PET/CT-guided percutaneous

  17. No need for biopsies

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Skindersoe, Mette E; Christensen, Jens Jørgen;

    2011-01-01

    The aim of the study was to compare three sampling techniques used in routine diagnostics to identify the microbiota in chronic venous leg ulcers. A total of 46 patients with persisting venous leg ulcers were included in the study. At inclusion, swab, biopsy and filter paper pad samples were...... collected. After 4 weeks, additional biopsy and filter paper pad samples were collected. Bacteria were isolated and identified at species level by standard methods. The most common bacterial species detected was Staphylococcus aureus found in 89% of the ulcers. No methicillin-resistant S. aureus isolates...... species present in chronic wounds, thus avoiding complications during and after biopsy sampling....

  18. 桥本甲状腺炎甲状腺细针穿刺两种细胞学亚型临床特点比较%Patients with Hashimoto's thyroiditis confirmed by fine-needle aspiration cytology:comparison of clinical features of two subtypes

    Institute of Scientific and Technical Information of China (English)

    刘丽; 高燕明; 卢桂芝; 袁振芳; 高莹; 惠岩; 郭晓蕙; 唐素恩; 高妍

    2010-01-01

    Three hundred and ninety-seven patients of Hashimoto's thyroiditis(HT)confirmed by fine-needle aspiration cytology(FNAC)were investigated retrospectively.Between oxyphil cell subtype(OC,n=181)and lymphocytic cell subtype(LC,n=186),there were no significant differences in clinical manifestation and levels of thyroglobulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb).However,compared with lymphocytic cell subtype,the patients with oxyphil cell subtype had the tendency to develop hypothyroidism,suggesting advanced stage of Hashimoto's thyroiditis.%回顾性分析397例经甲状腺细针穿刺细胞学(FNAC)确诊桥本甲状腺炎患者的临床特点.发现嗜酸细胞型(n=181)及淋巴细胞型(n=186)桥本甲状腺炎临床表现、抗甲状腺自身抗体(甲状腺球蛋白抗体、甲状腺过氧化物酶抗体)水平无差异.嗜酸细胞型较淋巴细胞型更倾向进展为甲状腺功能减退,可能为疾病进程中晚期阶段.

  19. Biopsy in Musculoskeletal Tumors

    Directory of Open Access Journals (Sweden)

    Mohammad Gharehdaghi

    2014-09-01

    Full Text Available Diagnosis of bone tumors is based on careful evaluation of clinical, imaging and a pathologic findings. So the biopsy of bone and soft tissue sarcomas is the final step in evaluation and a fundamental step in the diagnosis of the lesion. It should not be performed as a shortcut to diagnosis (1. The biopsy should be performed in order to confirm the diagnosis and differentiate among few diagnoses after careful staged studies. Real and artificial changes in imaging studies will be superimposed after performing biopsy, which may alter the interpretation if done after biopsy is taken (1. The correct management of a sarcoma depends on the accurate diagnosis. Inadequate, inapprppriate, or inaccurate non-representative biopsy leads to poorer outcome in terms of survivorship and limb salvage. An incorrect, unplanned incision and biopsy may unnecessarily contaminate uninvolved compartments which may convert a salvageable limb to amputation. Anatomic approach along with the proper biopsy techniques may lead to success or catastrophe. It is clear that in patients with inappropriate biopsy, the chance of the need to change the treatment to more radical than would originally be expected is significantly higher. Also it is more probable to need to  convert curative to palliative treatment and to require adjuvant radiotherapy in patients with inappropriate biopsies. Patients with sarcoma are best served by early referral to a specialized center where staged investigations and biopsy can be performed with minimal morbidity (3. Open biopsy is still considered the gold standard; however, recent studies suggest comparable results with percutaneous core needle biopsy. Our study on 103 consecutive CNB and open biopsy showed comparable results as well. Surgeons need to answer to two questions prior to performing a biopsy: 1-          Where is the best part of the lesion to be biopsied? 2-          What is the safest route without contaminating

  20. The Terry Biopsy Needle

    Science.gov (United States)

    Bond, Alan F.; Murphy, Fergus A.; Nanson, Eric M.

    1963-01-01

    Six illustrative cases are reported to demonstrate the versatility of the Terry biopsy needle as a useful instrument for obtaining satisfactory biopsy specimens from the liver and from other tissues as well. The apparatus and method of use are described and illustrated. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6aFig. 6bFig. 7Fig. 8Fig. 9Fig. 10Fig. 11 PMID:13968726

  1. Corpus vitreum, retina og chorioidea biopsi

    DEFF Research Database (Denmark)

    Scherfig, Erik Christian Høegh

    2002-01-01

    oftalmology, biopsy, choroid, corpus vitreum, retina, malignant melanoma, biopsy technic, retinoblastoma......oftalmology, biopsy, choroid, corpus vitreum, retina, malignant melanoma, biopsy technic, retinoblastoma...

  2. Biological characteristics of HCC by ultrasound-guided aspiration biopsy and its clinical application

    Institute of Scientific and Technical Information of China (English)

    Li-Wu Lin; Xue-Ying Lin; Yi-Mi He; Shang-Da Gao; Xiao-Dong Lin

    2003-01-01

    AIM: To probe the pathological biological characteristics of hepatocellular carcinoma (HCC) by the ultrasound-guided aspiration biopsy and assess the clinical application value of this method.METHODS: The biopsy and DNA analysis by flow cytometry (FCM) were taken in 46 cases with HCC nodules, including 26 cases and 20 cases with nodules ≤3 cm and >3 cm in diameters respectively, and 12 cases with intrahepatic benign hyperplastic nodules. They were taken in 22 cases of 46cases with HCC before and after the therapy. Fine-needles and automatic histological incised biopsy needles were used.The fresh biopsy tissue was produced into the single cell suspension, which was sent for DNA detection and ratio analysis of cell period. The ratio of each DNA period of cell proliferation of each group was calculated and compared with each other. The DNA aneuploid (AN) and apoptosis cell peak were observed and their percentages were calculated.RESULTS: The ratios of S and G2/M periods of DNA, which reflect cell hyperproliferation, in the group with HCC tumors >3 cm in diameter were markedly higher than those of the group with HCC nodules ≤3 cm in diameter and the group with the benign hyperplastic nodules (P<0.01 except A:B of S period, P<0.05). The ratios of the middle group were also apparently higher than those of the latter group (P<0.01).The ratio of DNA AN of 46 cases with HCC nodules was 34.8 % (16/46). None of the cases with the intrahepatic hyperplastic nodules appeared AN. The DNA AN appeared more apparently with the growth of the tumors. The AN ratio of the group with tumors >3 cm in diameter was 55 %(11/20), markedly higher than that of the group with tumors ≤3 cm in diameter which was 19.2 % (5/26) (P<0.01). The FCM DNA analysis of 22 specimens of hepatic carcinoma tissue before therapy showed that the aneuploid peaks appeared in 5 cases (22.7 %). The ratio of G1 period rose after therapy while the S period and G2/M ratios fell (P<0.01).The

  3. Breast Biopsy System

    Science.gov (United States)

    1994-01-01

    Charge Coupled Devices (CCDs) are high technology silicon chips that connect light directly into electronic or digital images, which can be manipulated or enhanced by computers. When Goddard Space Flight Center (GSFC) scientists realized that existing CCD technology could not meet scientific requirements for the Hubble Space Telescope Imagining Spectrograph, GSFC contracted with Scientific Imaging Technologies, Inc. (SITe) to develop an advanced CCD. SITe then applied many of the NASA-driven enhancements to the manufacture of CCDs for digital mammography. The resulting device images breast tissue more clearly and efficiently. The LORAD Stereo Guide Breast Biopsy system incorporates SITe's CCD as part of a digital camera system that is replacing surgical biopsy in many cases. Known as stereotactic needle biopsy, it is performed under local anesthesia with a needle and saves women time, pain, scarring, radiation exposure and money.

  4. PERCUTANEOUS PLEURAL BIOPSY

    Directory of Open Access Journals (Sweden)

    M. Bahadori

    1966-01-01

    Full Text Available I have carried out 22 biopsies in 20 Patients, in fifteen I used a Vim _ Silverman Needle, and in the remainder a curetting type Needle, In 12 cases (60% the diagnosis that was made; in 3 cases, inadequate tissue, was obtained; in two cases a fibromuscular tissue, in one case a fatty tissue and in one case the specimen was of hepatic tissue. Even with the small biopsy specimen obtained with the Needle it is easy to recognize malignant tissue if present.

  5. Transjugular liver biopsy.

    Science.gov (United States)

    Ble, Michel; Procopet, Bogdan; Miquel, Rosa; Hernandez-Gea, Virginia; García-Pagán, Juan Carlos

    2014-11-01

    Liver biopsy is still the gold standard for evaluation of acute and chronic liver diseases, despite achievements regarding noninvasive diagnosis and staging in liver diseases. Transjugular liver biopsy (TJLB) has proved a good option when ascites and/or significant coagulopathy precludes a percutaneous approach. Because diagnostic hemodynamic procedures can be performed during the same session, it is useful in many clinical settings, regardless of the absence of percuteaneous contraindications. TJLB is a safe technique able to provide good-quality specimens with a low rate of complications. This article presents an overview of TJLB that discusses the technique, applicability, indications, contraindications, complications, and diagnostic accuracy.

  6. Biópsia pulmonar percutânea guiada por tomografia computadorizada: dados de um hospital Percutaneous computed tomography-guided biopsy of the lung: data from a hospital

    Directory of Open Access Journals (Sweden)

    Emílio Humberto Carazzai

    2006-08-01

    Full Text Available OBJETIVO: Apresentar a experiência do serviço de radiologia do Hospital Santa Cecília, São Paulo, SP, no manejo das biópsias pulmonares por aspiração através de agulha fina e biópsias por fragmentos guiadas por tomografia computadorizada e a análise de sua importância e associação com suas complicações. MATERIAIS E MÉTODOS: Foram analisadas 168 biópsias guiadas por tomografia, sendo 84 em homens e 84 em mulheres. Utilizou-se a técnica de biópsia por aspiração por agulha fina em 64 pacientes, a técnica de biópsia por fragmento em 68 pacientes e ambas as técnicas em 36 pacientes. RESULTADOS: Pneumotórax ocorreu em 38 pacientes e a hemorragia pulmonar, em dez pacientes. As dimensões das lesões biopsiadas variaram de 0,5 cm até 15 cm. O diagnóstico foi realizado na primeira tentativa em 132 casos e na segunda tentativa em dez casos. CONCLUSÃO: A acurácia das biópsias aspirativas por agulha fina e por fragmento de lesões pulmonares depende do tamanho da lesão e da colaboração do paciente. Essas técnicas são relativamente seguras e têm acurácia diagnóstica elevada quando feitas por um profissional experiente.OBJECTIVE: To present the experience of Santa Cecília Hospital (São Paulo, SP, Brazil radiology service in the handling of computed tomography-guided fine-needle aspiration biopsy and percutaneous core biopsy of pulmonary lesions, analyzing their importance and associated complications. MATERIALS AND METHODS: One hundred and sixty-eight computed tomography-guided biopsies were performed in 84 men and 84 women. Sixty-four patients underwent fine-needle aspiration biopsy, 68 underwent percutaneous core biopsy and 36 patients underwent both techniques. RESULTS: Pneumothorax occurred in 38 patients, and pulmonary hemorrhage in then cases. The biopsied lesions ranged in size from 0.5 to 15 cm. The diagnosis was achieved at the first attempt in 132 cases and at the second attempt in ten cases. CONCLUSION: The

  7. Percutaneous renal tumour biopsy.

    Science.gov (United States)

    Delahunt, Brett; Samaratunga, Hemamali; Martignoni, Guido; Srigley, John R; Evans, Andrew J; Brunelli, Matteo

    2014-09-01

    The use of percutaneous renal tumour biopsy (RTB) as a diagnostic tool for the histological characterization of renal masses has increased dramatically within the last 30 years. This increased utilization has paralleled advances in imaging techniques and an evolving knowledge of the clinical value of nephron sparing surgery. Improved biopsy techniques using image guidance, coupled with the use of smaller gauge needles has led to a decrease in complication rates. Reports from series containing a large number of cases have shown the non-diagnostic rate of RTB to range from 4% to 21%. Re-biopsy has been shown to reduce this rate, while the use of molecular markers further improves diagnostic sensitivity. In parallel with refinements of the biopsy procedure, there has been a rapid expansion in our understanding of the complexity of renal cell neoplasia. The 2013 Vancouver Classification is the current classification for renal tumours, and contains five additional entities recognized as novel forms of renal malignancy. The diagnosis of tumour morphotype on RTB is usually achievable on routine histology; however, immunohistochemical studies may be of assistance in difficult cases. The morphology of the main tumour subtypes, based upon the Vancouver Classification, is described and differentiating features are discussed.

  8. Optimizing prostate biopsy for repeat transrectal prostate biopsies patients

    Institute of Scientific and Technical Information of China (English)

    Xiaojun Deng; Jianwei Cao; Feng Liu; Weifeng Wang; Jidong Hao; Jiansheng Wan; Hui Liu

    2014-01-01

    Objective:Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re-mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for patients who need repeat prostate biopsy. Methods:In this prospective, non-randomized phase-I clinical trial, the prostate cancer detection rate of initial detection scheme was compared with optimizing prostate biopsy scheme. The number of punctures of initial detection scheme was the same as that of optimizing prostate biopsy scheme. The puncture direction of optimizing prostate biopsy was a 45° angle to the sagittal plane from front, middle, and back. The two cores from each lateral lobe were horizontal y inwardly inclined 45°. Results:A total of 45 patients with initial negative biopsy for cancer were received the optimizing prostate biopsy scheme. The cancer detection rate was 17.8%(8/45), and prostate intraepithelial neoplasm (PIN) was 6.7%(3/45). The pa-tients receiving repeat transrectal prostate biopsies were pathological y diagnosed as lower Gleason grade prostate cancers. Conclusion:The cancer detection rate of repeat biopsy prostate cancer is lower than that of initial biopsy. Our study showed that the optimizing prostate biopsy is important to improve the detection rate of repeat transrectal prostate biopsies patients.

  9. Optically clearing tissue as an initial step for 3D imaging of core biopsies to diagnose pancreatic cancer

    Science.gov (United States)

    Das, Ronnie; Agrawal, Aishwarya; Upton, Melissa P.; Seibel, Eric J.

    2014-02-01

    The pancreas is a deeply seated organ requiring endoscopically, or radiologically guided biopsies for tissue diagnosis. Current approaches include either fine needle aspiration biopsy (FNA) for cytologic evaluation, or core needle biopsies (CBs), which comprise of tissue cores (L = 1-2 cm, D = 0.4-2.0 mm) for examination by brightfield microscopy. Between procurement and visualization, biospecimens must be processed, sectioned and mounted on glass slides for 2D visualization. Optical information about the native tissue state can be lost with each procedural step and a pathologist cannot appreciate 3D organization from 2D observations of tissue sections 1-8 μm in thickness. Therefore, how might histological disease assessment improve if entire, intact CBs could be imaged in both brightfield and 3D? CBs are mechanically delicate; therefore, a simple device was made to cut intact, simulated CBs (L = 1-2 cm, D = 0.2-0.8 mm) from porcine pancreas. After CBs were laid flat in a chamber, z-stack images at 20x and 40x were acquired through the sample with and without the application of an optical clearing agent (FocusClear®). Intensity of transmitted light increased by 5-15x and islet structures unique to pancreas were clearly visualized 250-300 μm beneath the tissue surface. CBs were then placed in index matching square capillary tubes filled with FocusClear® and a standard optical clearing agent. Brightfield z-stack images were then acquired to present 3D visualization of the CB to the pathologist.

  10. Prospective Study for Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using 25- and 22-Gauge Core Biopsy Needles in Solid Pancreatic Masses.

    Directory of Open Access Journals (Sweden)

    Se Woo Park

    Full Text Available Although thicker needles theoretically allow more tissue to be collected, their decreased flexibility can cause mechanical damage to the endoscope, technical failure, and sample blood contamination. The effects of needle gauge on diagnostic outcomes of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB of pancreatic mass lesions remain unknown. This study compared procurement rates of histologic cores obtained from EUS-FNB of pancreatic masses using 25- and 22-gauge core biopsy needles.From March 2014 to July 2014, 66 patients with solid pancreatic mass underwent EUS-FNB with both 25- and 22-gauge core biopsy needles. Among them, 10 patients were excluded and thus 56 patients were eligible for the analyses. Needle sequences were randomly assigned, and two passes were made with each needle, consisting of 10 uniform to-and-fro movements on each pass with 10 mL syringe suction. A pathologist blinded to needle sequence evaluated specimens for the presence of histologic core.The mean patient age was 65.8 ± 9.5 years (range, 44-89 years; 35 patients (62.5% were men. The mean pancreatic mass size was 35.3 ± 17.1 mm (range 14-122.3 mm. Twenty-eight patients (50% had tumors at the pancreas head or uncinate process. There were no significant differences in procurement rates of histologic cores between 25-gauge (49/56, 87.5% and 22-gauge (46/56, 82.1%, P = 0.581 needles or diagnostic accuracy using only histologic cores (98% and 95%. There were no technical failures or procedure-related adverse events.The 25-gauge core biopsy needle could offer acceptable and comparable outcomes regarding diagnostic performance including histologic core procurement rates compared to the 22-gauge core biopsy needle, although the differences were not statistically significant.ClinicalTrials.gov NCT01795066.

  11. Optimizing Endoscopic Ultrasound Guided Tissue Sampling of the Pancreas

    Directory of Open Access Journals (Sweden)

    Pujan Kandel

    2016-03-01

    Full Text Available Endoscopic ultrasound is an important innovation in the field of gastrointestinal endoscopy and allows evaluation of many organs in the vicinity of the gastrointestinal tract. Endoscopic ultrasound-fine needle aspiration has been established to be an important tool in the management of pancreaticobiliary disease and is used for screening, staging, biopsy confirmation, and palliation. The accuracy of endoscopic ultrasound-fine needle aspiration is affected by several factors such as different needle sizes and types and fine needle aspiration techniques. Several comparative studies have been published on various techniques, such as the use of a stylet and suction during fine needle aspiration. Although most studies demonstrate high accuracy across techniques and equipment, various fine needle biopsy histology needles have been studied to compare the advantage of fine needle biopsy over fine needle aspiration. Although fine needle biopsy needles provide better tissue architecture and require fewer numbers of passes, there is no significant evidence of the superiority of fine needle biopsy over fine needle aspiration with regard to diagnostic yield and core tissue procurement. The main aim of this article is to review the various methodologies for improving the practice of endoscopic ultrasound-fine needle aspiration and endoscopic ultrasound- fine needle biopsy tissue sampling for cytological and histological analysis.

  12. No need for biopsies

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Skindersoe, Mette E; Christensen, Jens Jørgen;

    2011-01-01

    The aim of the study was to compare three sampling techniques used in routine diagnostics to identify the microbiota in chronic venous leg ulcers. A total of 46 patients with persisting venous leg ulcers were included in the study. At inclusion, swab, biopsy and filter paper pad samples were...... collected. After 4 weeks, additional biopsy and filter paper pad samples were collected. Bacteria were isolated and identified at species level by standard methods. The most common bacterial species detected was Staphylococcus aureus found in 89% of the ulcers. No methicillin-resistant S. aureus isolates...... were found. We did not find any significant differences regarding the bacterial species isolated between the three sampling techniques. However, using multiple techniques led to identification of more species. Our study suggests that it is sufficient to use swab specimens to identify the bacterial...

  13. Can we confidently diagnose pilomatricoma with fine needle aspiration cytology?

    Science.gov (United States)

    Wong, Yin-Ping; Masir, Noraidah; Sharifah, Noor Akmal

    2015-01-01

    Pilomatricomas can be confidently diagnosed cytologically due to their characteristic cytomorphological features. However, these lesions are rarely encountered by cytopathologists and thus pose a diagnostic dilemma to even experienced individuals, especially when the lesions are focally sampled. We describe two cases of histologically confirmed pilomatricoma. The first case is of a 13-year-old boy with posterior cervical 'lymphadenopathy', and the second one is of a 12-year-old girl with a lower cheek swelling. Both aspirates comprised predominantly atypical basal-like cells, with prominent nucleoli. 'Ghost cells' were readily identified by cell block in case two, but cell block in case one yielded no diagnostic material. In case two, pilomatricoma was accurately diagnosed pre-operatively. A cytological suspicion of a neoplastic process was raised in case one. Despite being diagnostically challenging, pilomatricoma can be diagnosed with careful observation of two unique cytological features of the lesions: (1) pathognomonic 'ghost cells' and (2) irregular, saw-toothed, loosely cohesive basaloid cells, with prominent nucleoli. The role of thorough sampling of the lesion, with multiple passes of various sites, cannot be overemphasized.

  14. Fine needle aspiration cytology of chondroblastoma of the fibula

    Directory of Open Access Journals (Sweden)

    Kamal Malukani

    2014-01-01

    Full Text Available Chondroblastoma is a rare benign cartilaginous tumor typically seen in long bones, especially femur, tibia and proximal humerus. Extracortical soft tissue invasion or metastasis is rarely seen. We report here a unique case of chondroblastoma of the fibula with extracortical soft tissue invasion. Differential diagnosis on cytology is discussed.

  15. Fine needle aspiration cytology of chondroblastoma of the fibula.

    Science.gov (United States)

    Malukani, Kamal; Nandedkar, Shirish S; Yeshwante, Prashant; Rihal, Preeti

    2014-01-01

    Chondroblastoma is a rare benign cartilaginous tumor typically seen in long bones, especially femur, tibia and proximal humerus. Extracortical soft tissue invasion or metastasis is rarely seen. We report here a unique case of chondroblastoma of the fibula with extracortical soft tissue invasion. Differential diagnosis on cytology is discussed.

  16. Insight to neoplastic thyroid lesions by fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    M Rangaswamy

    2013-01-01

    Conclusions: FNAC is a rapid, efficient, cost-effective, relatively painless procedure with a high diagnostic accuracy. It has high rate of sensitivity and positive predictive value in diagnosing thyroid neoplastic lesions. Hence, it is a valuable tool in the diagnosis and management of patients.

  17. Breast Cancer Biomarkers Based on Nipple and Fine Needle Aspirates

    Science.gov (United States)

    2005-05-01

    Concentrations of 18S gene were compared with those of the breast epithelium specific genes fat milk globule membrane antigen and whey acidic protein (Table 2...354, 1994. 45. Quenby, M, Farquharson, R. Human chorionic gonadotropin supplementation in recurring pregnancy loss: a controlled trial. Fertil . Steril...compared with those of the breast epithelium specific genes fat milk globule membrane antigen and whey acidic protein. Our results led us to conclude that RT

  18. Utility of Fine Needle Aspiration Cytology in Diagnosing Bone Tumors

    Directory of Open Access Journals (Sweden)

    Sonal Mahajan

    2015-01-01

    Results: A total of 36 cases were studied, of which diagnostic material was adequately obtained in 32 cases (88.88%. The sensitivity (92.85% and specificity (94.44% of FNAC were high, with an accuracy of 93.75%, which is similar to findings in other studies. Conclusion: FNAC plays a vital role in diagnosing bone tumors. It is a rapid, easy, cheap, and minimum invasive outpatient department procedure. However histopathology is still important in diagnosing bone tumors that are unclear or undiagnosed on FNAC since histopathology gives a complete architectural pattern of tissue.

  19. Ultrasound-guided renal biopsy with automated biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Pil Yeob; Kwon, Jae Soo [Masan Samsung Hospital, Masan (Korea, Republic of)

    1998-01-01

    To elevate the diagnostic yield and complications of percutaneous ultrasound-guided renal biopsy using a biopsy gun in patients with diffuse renal disease. Using an automated biopsy gun mounted with a 16 G needle, biopsies were performed on 90 patients with diffuse renal disease. In a total of 95 biopsies, diagnostic yield, the mean number of glomeruli and frequency of complication were retrospectively analysed. Tissue adequate for histological diagnosis was obtained in 92 % of procedures. Mean glomerular yield was 8.3, and complications were seen in 26% of the procedures, 25 % of these were minor, and 1% were major. For the diagnosis of diffuse renal disease, ultrasound-guided percutaneous renal biopsy using an automated biopsy gun is accurate and safe. (author). 25 refs., 1 tab.

  20. Punción pancreática ecodirigida: estudio multicéntrico Ultrasound-guided biopsy of the pancreas: A multicenter study

    Directory of Open Access Journals (Sweden)

    M. C. Garre Sánchez

    2007-09-01

    Full Text Available Objetivo: en el seno de la Asociación de Ecografía Digestiva se decidió realizar un estudio retrospectivo multicéntrico sobre la punción-aspiración con aguja fina (PAAF de lesiones ocupantes de espacio pancreáticas, mediante control ecográfico y por vía percutánea, con el objetivo de valorar el rendimiento de dicha técnica y poder compararla con la punción mediante ultrasonografía endoscópica. Participantes: en el estudio han participado 10 hospitales con 222 pacientes con lesiones pancreáticas entre 8 y 120 mm, sospechosas de malignidad. Resultados: el análisis de los resultados muestra una sensibilidad del 89%, especificidad 98%, valor predictivo positivo 99% y negativo 74%, con precisión diagnóstica global 91%. No encontramos ninguna complicación significativa. Conclusión: la PAAF de lesiones pancreáticas por vía percutánea es de alta rentabilidad diagnóstica y con pocas y leves complicaciones.Objective: members of "Asociación de Ecografía Digestiva" decided to carry out a multicenter retrospective study on fine-needle aspiration biopsy for pancreatic space-occupying lesions under ultrasonographic guidance and via the percutaneous route in order to assess this technique's performance versus endoscopic ultrasound-guided biopsy. Subjects: 10 hospitals for a total of 222 patients with suspiciously malignant, 8-120-mm pancreatic lesions were included in the study. Results: the analysis of results shows a sensitivity of 89%, a specificity of 98%, a positive predictive value of 99%, and a negative predictive value of 74%, for an overall diagnostic accuracy of 91%. No major complications occurred. Conclusion: percutaneous fine-needle aspiration for pancreatic lesions is highly cost-effective and has few and mild complications.

  1. Different Methods for Prostate Biopsy and Biopsy Protocols

    Directory of Open Access Journals (Sweden)

    Mahyar Ghafoori

    2011-05-01

    Full Text Available Prostate carcinoma is one of the most common"nmalignancies among men. Increasing mortality rates due"nto prostate carcinoma have been observed worldwide."nThis disease usually progresses imperceptibly, for this"nreason; screening programs aimed at early detection"nhave been developed. The prostate specific antigen"n(PSA test is among the best screening tools available"nin medicine today because it is recognized as the best"nmarker for its early detection."nIn case of abnormal rise in PSA, the patient usually"nrefers for prostate biopsy under the guide of trans"nrectal ultrasonography (TRUS. Different methods are"nrecognized for prostate biopsy that may be divided"ninto two main categories namely, systematic biopsy"nand targeted biopsy."nIn systematic biopsy we divide the prostate gland"nrandomly to different sections and obtain biopsy"nspecimens from each section.The protocol of systematic biopsy is different among"ndifferent institutions. The number of biopsy specimens"ncould be started from less than 6 to more than 20"nbiopsies in some institutions. Increasing the number"nof biopsy specimens increases the detection rate for"nprostate cancer increasing the complications such"nas post biopsy prostatitis and septicemia, which are"nthe most important, as well. In scheduling a biopsy"nprotocol with high number of biopsies it is preferred"nto hospitalize the patient and prescribe intravenous"nantibiotics."nTargeted biopsy of the prostate means obtaining biopsy"nspecimens from a pathologic lesion that is suspicious"nfor prostate cancer. Different modalities could be"nused for detecting prostate cancer within the prostate"ngland. Transrectal ultrasonography, ultrasonography"nwith the use of ultrasound contrast agents, MRI of the"nprostate with the use of endorectal coil, dynamic MR"nstudy with contrast agent, diffusion weighted imaging"nof the prostate and MR spectroscopy all could help"nin the detection of a suspicious tumoral mass in the

  2. The accuracy of colposcopic biopsy

    DEFF Research Database (Denmark)

    Stoler, Mark H; Vichnin, Michelle D; Ferenczy, Alex;

    2011-01-01

    We evaluated the overall agreement between colposcopically directed biopsies and the definitive excisional specimens within the context of three clinical trials. A total of 737 women aged 16-45 who had a cervical biopsy taken within 6 months before their definitive therapy were included. Per......-protocol, colposcopists were to also obtain a representative cervical biopsy immediately before definitive therapy. Using adjudicated histological diagnoses, the initial biopsies and the same day biopsies were correlated with the surgically excised specimens. The overall agreement between the biopsies taken within 6...... degree of variance in the correlation, the overall agreement was 92% for CIN2-3/AIS. The overall agreement between the same day biopsy and definitive therapy specimen was 56% (weighted kappa = 0.41) (95% CI: 0.36-0.47), and the underestimation of CIN2-3/AIS was 57%. There were significant associations...

  3. 超声介导下细针穿刺活检在腮腺肿瘤术前诊断中的应用价值%The value of ultrasonography guided fine-needle aspiration cytology in the preoperative diagnosis of parotid tumors

    Institute of Scientific and Technical Information of China (English)

    刘丽华; 王庆红

    2014-01-01

    目的 分析超声介导下细针穿刺活检(USFNA)在腮腺肿瘤术前诊断中应用的价值.方法 回顾性分析2011年10月至2013年10月间外科就诊的腮腺肿瘤患者120例,所有患者术前均行USFNA诊断,并与术后病理学诊断比较.结果 USFNA定性诊断总相符率为92.5%,与病理学诊断完全一致的总准确率为74.2%.其中良性肿瘤定性诊断相符率为92.9%,准确率为77.4%;恶性肿瘤定性诊断相符率为91.7%,准确率为66.7%.结论 USFNA鉴别良恶性腮腺肿瘤安全快速,准确率高,临床并发症少,是术前重要的常规检查之一.%Objective To evaluate the value of ultrasound-guided fine-needle aspiration (USFNA)in the preoperative diagnosis of parotid tumors.Methods 120 cases with parotid tumors admitted to our department of oral and maxillofacial surgery were analyzed retrospectively.Preoperative USFNA findings were compared with the final pathologic diagnosis of the surgically resected specimen.Results The total coincidence rate of distinction of benign and malignant tumors by USFNA was 92.5%,and the overall agreement of the cytologic and pathologic diagnosis was 74.2%.Those of benign lesions were 92.9% and 77.4%,and of malignant tumors were 91.7% and 66.7%.Conclusion USFNA is a safe and effective examination with higher accuracy and fewer complications in differencing the malignant and benign tumor of the parotid region,which is an important routine test before operation.

  4. Biopsy of the transplanted kidney--role of protocol biopsies.

    Science.gov (United States)

    Masin-Spasovska, J; Spasovski, G

    2012-01-01

    Traditionally, renal allograft biopsies were performed mainly in the setting of acute graft dysfunction. Recently, there has been a change of paradigms. Several reports suggested that acute rejection of the graft and chronic allograft nephropathy are often subclinical without any deterioration in the graft function. This raises the issue of biopsies in functionally stable allografts (e.g. protocol biopsies) and the clinically useful information they provide. Namely, recent reports provide evidence in favour of treating biopsy-proven subclinical rejections. Moreover, by early identification of chronic histological lesions, protocol biopsies give an opportunity for individualized immunosuppressive regimen and use of targeted therapeutic strategies, in order to prevent chronic allograft dysfunction and improve long-term graft outcome. In this review, diagnostic, therapeutic and research benefit information on protocol biopsies performed in stable kidney recipients are described.

  5. Morbidity after percutaneous liver biopsy.

    OpenAIRE

    Lichtman, S; Guzman, C; Moore, D.; Weber, J L; Roberts, E.A.

    1987-01-01

    The safety of percutaneous liver biopsy with a 1.2 mm Menghini needle in infants aged one year or less was investigated. One hundred and eighty four procedures performed from 1975 to 1985 were reviewed. There were no deaths or major complications within 48 hours associated with the procedure. In five instances specific complications occurred: a drop in haemoglobin concentration (three), transient hypotension (one), and haematoma at the biopsy site (one). The result of liver biopsy was diagnos...

  6. Analysis of Testicular Cytology by Fine Needle Aspiration and Reproductive Endocrine Hormone for 38 Infertile Patients with Klinefelter's Syndrome%38例Klinefelter综合征不育患者睾丸细针穿刺吸液细胞学检查

    Institute of Scientific and Technical Information of China (English)

    邱毅; 王作立; 王磊光; 杨丹彤; 贾颐舫

    2007-01-01

    目的:探讨Klinefelter(Klinefelter's Syndrome,KS)综合征不育患者睾丸生精功能及生殖内分泌激素水平.方法:临床应用化学发光法测定已经染色体核型分析确诊的38例KS患者血清中的FSH、LH和T水平;B超测量睾丸体积;睾丸细针穿刺吸液(Fine Needle Aspiration,FNA)细胞学检查了解KS患者睾丸生精功能.32例已婚且至少生育过一个子女的成年健康男性作为对照组.结果:38例男性不育患者染色体核型均为47,XXY,38例KS不育患者占就诊男性的1.8%(38/2132),在无精子症患者中占12.6%(38/302);血清中FSH、LH、E2及PRL水平明显增高,而T水平明显降低,分别为FSH平均36.7±10.2 IU/L、LH平均31.2±9.5 IU/L(明显高于对照组,p<0.001)、PRL平均16.9±2.3ng/ml、E2平均59.8±12.1pg/ml(明显高于对照组,p<0.01)及T平均0.62±0.5nmol/L(明显低于对照组,p<0.001);睾丸体积明显小于正常成年人,平均为2.2±1.3ml,差异非常显著(p<0.001);睾丸细针穿刺吸液细胞学检查显示,5例可见到少量不成熟精子(13.2%,5/38),28例仅见少量生精细胞(73.7%,28/38),其余5例仅见支持细胞(13.2%,5/38),未见生精细胞及精子.结论:KS不育患者睾丸体积明显小于正常成年男性,T值低于正常值下限水平,而FSH、LH值明显高于正常值,睾丸生精功能极差或无生精功能.

  7. Influence of different sample processing methods on yield of endoscopic ultrasound-guided fine needle aspiration%内镜超声引导下细针穿刺抽吸术不同处理标本方法对诊断结果的影响

    Institute of Scientific and Technical Information of China (English)

    赵航; 湛先保; 李兆中; 金震东; 邹多武; 满晓华

    2009-01-01

    Objective To compare the yield of endoscopic ultrasonography guided fine needle aspira-tion (EUS-FNA) with 3 different sample processing methods. Methods The clinical data of 118 patients, who underwent EUS-FNA performed by one physician from February 2005 to September 2008, were retrospectively analyzed. The FNA sample processing methods included liquid-based cytology, on-site cytology and smear method. The pathological diagnosis was classified as definite, suspicious malignancy, dissatisfying sampling and indefinite. Results The success rate of obtaining samples through on-site cytological procedure was 95.2% (40/42), which was significantly higher than that of conventional smear (32/47, 68%, P 0.05). The yield of definite diagnosis with liquid-based cytology and on-site cytology were 82.8% (24/29) and 78. 6% (33/42), respectively, which were both significantly higher than that of smear method (57. 4%, 27/47, P 0. 05). Conclusion Compared with conventional smear method, an-site cytology and liquid-based cytology yield more results from EUS-FNA.%目的 探讨内镜超声引导下细针穿刺抽吸术(EUS-FNA)不同处理标本方法对诊断结果的影响.方法 回顾分析2005年2月-2008年9月间由同一内镜超声医师行EUS-FNA检查118例患者的临床资料.依据病理报告将诊断结果分为明确良恶性诊断、可疑恶性、取材不满意3类,比较液基细胞学、现场细胞学和传统细胞学方法的穿刺成功率及诊断敏感性、特异性和准确性.结果 现场细胞学方法的穿刺成功率为95.2%(40/42),显著高于传统细胞学方法的68.0%(32/47)(P0.05).液基细胞学和现场细胞学方法获得明确良恶性的诊断率分别为82.8%(24/29)和78.6%(33/42),显著高于传统细胞学方法的57.4%(27/47)(P0.05).结论 现场细胞学方法和液基细胞学方法较传统细胞学方法提高了穿刺成功率,且液基细胞学方法更易于获得明确良恶性的诊断结论.

  8. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... Resources Professions Site Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI-guided prostate ... MRI-guided Prostate Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI-guided prostate ...

  9. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI- ... Ultrasound-and MRI-guided Prostate Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI- ...

  10. 28 CFR 79.26 - Proof of medical condition.

    Science.gov (United States)

    2010-07-01

    ... cytology; (E) Fine needle aspirate; (F) Pleural biopsy; or (G) Sputum cytology; (ii) Autopsy report; (iii... surgical resection; (ii) Autopsy report; (iii) Report of otolaryngology or oral maxillofacial...

  11. Endoscopic duodenal biopsy in children

    Directory of Open Access Journals (Sweden)

    El Mouzan Mohammad

    2006-01-01

    Full Text Available Background: Biopsy of the small bowel is frequently obtained by endoscopic forceps instead of the classical suction capsule, yet reports from developing countries are scarce. Aim of the study: to report our experience on the diagnostic value of this procedure in our community. Patients and methods: A retrospective analysis of all endoscopic duodenal biopsies (EDB, performed on all patients below 18 years of age. Data retrieved from the records included age, gender, nationality, indication for biopsy, the endoscopic findings, and the results of histopathology. Results: From 1993 to 2002, 241 endoscopic biopsies were performed on 241 consecutive children. Most of the children (96% were Saudi nationals, the age range between six weeks to 18 years, and male to female ratio was 0.7: 1. All of the biopsy material was adequate for routine histopathology. The commonest indications for biopsy were short stature and chronic diarrhea in 116/241 (48% and 102/241 (43% of the children respectively. Refractory rickets accounted for 11/241 (5% of the indications. The prevalence of villous atrophy was highest in children presenting with chronic diarrhea (40%, compared to short stature (22%. Other less common, but important findings were villous atrophy in three unusual conditions (one refractory rickets, one unexplained anemia, and one polyendocrinopathy, two cases of intestinal Giardia lamblia infestation, three cases of intestinal lymphangiectasis and one case of Mycobacterium avium intracellulare. Unexpected endoscopic findings were documented in 34/241 (14% of the children. Conclusions: Endoscopic duodenal biopsy is adequate not only for the diagnosis of villous atrophy, but also for the detection of other gastroenteropathies. Accordingly, when expertise and equipments are available, EDB should be the procedure of choice not only in industrialized but also in developing countries.

  12. 内镜超声引导下细针穿刺抽吸术在诊断上消化道及其周围占位病变中的价值%Endoscopic ultrasonography guided fine needle aspiration for diagnosis of occupying lesions in upper digestive tract and its peripheral areas

    Institute of Scientific and Technical Information of China (English)

    彭海霞; 杨大明; 褚以忞; 蒯榕; 李吉; 陶琨; 金云菲; 王赛玉

    2015-01-01

    目的:探讨内镜超声引导下细针穿刺抽吸术( EUS-FNA)对上消化道及其周围实质性占位病变诊断的准确性及其临床应用价值。方法回顾性分析2011年11月至2014年5月我院行超声内镜检查及超声内镜引导下的细针穿刺检查的87例患者的临床资料,对比细胞学和(或)病理学检查与术后病理结果及随访结果。结果本组86例患者成功进行了EUS-FNA,穿刺成功率98.85%。其中,病灶位于食管9例(10.35%),胃39例(44.83%),十二指肠球部10例(11.49%),胰腺18例(20.69%),腹腔10例(11.49%)。74例患者细胞学检查结果为阳性,阳性率85.06%。39例患者获得组织碎片或组织细条行病理学检查,组织获得率44.83%;其中,20例病理学检查结果为阳性,阳性率51.28%。与术后病理结果及术后随访结果对照,EUS-FNA对上消化道及其周围占位病变诊断的准确率为89.65%。对于病灶直径大小(>3 cm及≤3 cm)、穿刺针针号(19G及22G)及抽吸负压(5 ml负压及10 ml负压),两两比较发现,EUS-FNA诊断准确率差异均无统计学意义(P>0.05)。穿刺过程中无明显并发症发生。结论在上消化道及周围实质性占位病变中,EUS-FNA是一项安全、有效、准确的诊断及鉴别诊断方法,穿刺诊断的准确性与病灶的大小,穿刺针的针号及穿刺抽吸负压大小无明显相关性。%Objective To evaluate the accuracy and clinical application of endoscopic ultrasound guided fine needle aspiration ( EUS-FNA) in diagnosis of occupying lesions in upper digestive tract and its peripheral areas. Methods Forty-six patients under-went endoscopic ultrasonagraphy and EUS-FNA between November 2011 and May 2014. The result of cytology and/or pathology was compared with that of surgical finding and follow-up study. Results EUS-FNA was successfully performed on 86 patients,with a success rate of 98. 85%. In all 86 patients,lesions were located in oesophagus(9 cases),stomach(39 cases

  13. Clinical significance of fine-needle cathter jejunostomy on enteral nutrition support for esophageal carcinoma patients after operation%穿刺导管空肠造口术对食管癌患者术后肠内营养支持的临床意义

    Institute of Scientific and Technical Information of China (English)

    曹子昂; 潘文标; 梁而慷; 钱晓哲

    2013-01-01

    Objective To investigate the mechanism of improving nutrition status via enteral nutrition(EN) in esophageal carcinoma patients after radical surgery so that they can undergo chemotherapy and radiotherapy safety. Methods From April 2011to April 2012,80 patients with esophageal carcinoma were divided into two groups randomly, EN group 40 cases and control group 40 cases. Their physical condition and illness status were comparable and no serious perioperative complication. EN group patients received fine-needle cathter jejunostomy (FKJ) enteral nutrition support (Fresubin Diebetes 1000 ml per day) at least 2 months after surgery. There was no enteral or paraenteral support in control group before operation or out-patient. Results The content of serum total protein and albumin in EN group was higher than that in control group at 3 month after operation(P<0.05). The content was similar in two groups at 6 month after operation. The content of NK cell, IgM, IgG in EN group was a bit higher than that in control group, however, was not statistically significant. 89.65%patients of EN group and 75%patients of control group completed the adjuvant therapy successfully, but 3 cases of pneumonia and 7 cases of diarrhea occurred in EN group, 4 cases of pneumonia and 2 cases of diarrhea occurred in control group. Conclusion FKJ is a long-term effective treatment for improving the nutritional status of patient and helping them completing postoperative adjuvant therapy successfully.%目的:研究食管癌患者经过重大手术以后,如何通过肠内营养改善机体营养状态,安全接受辅助放、化疗。方法2011年4月至2012年4月对40例(EN组)食管癌患者采取了针刺导管空肠造口(FKJ)模式的营养支持,并设立40例对照组。入组患者符合下述条件:(1)两组患者的基本情况和疾病病程有可比较性;(2)术中及术后无严重并发症;(3)EN组术后FKJ提供肠内营养≥2个月;(4

  14. Computed tomography-guided needle aspiration and biopsy of pulmonary lesions - A single-center experience in 1000 patients

    Energy Technology Data Exchange (ETDEWEB)

    Poulou, Loukia S.; Tsagouli, Paraskevi; Thanos, Loukas [Dept. of Medical Imaging and Interventional Radiology, General Hospital of Chest Diseases ' Sotiria' , Athens (Greece)], e-mail: ploukia@hotmail.com; Ziakas, Panayiotis D. [Program of Outcomes Research, Div. of Infectious Diseases, Warren Alpert Medical School, Brown Univ., RI, and Div. of Infectious Diseases, Rhode Island Hospital, Rhode Island (United States); Politi, Dimitra [Dept. of Cythopathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece); Trigidou, Rodoula [Dept. of Pathology, General Hospital of Chest Diseases ' Sotiria' Athens (Greece)

    2013-07-15

    Background: Computed tomography (CT)-guided fine needle aspiration (FNA) and biopsies are well-established, minimally invasive diagnostic tools for pulmonary lesions. Purpose: To analyze retrospectively the results of 1000 consecutive lung CT-guided FNA and/or core needle biopsies (CNB), the main outcome measures being diagnostic yield, and complication rates. Material and Methods: Patients considered eligible were those referred to our department for lung lesions. The choice of FNA, CNB, or both was based upon the radiologist's judgment. Diagnostic yield was defined as the probability of having a definite result by cytology/histology. Results: The study included 733 male patients and 267 female patients, with a mean (SD) age of 66.4 (11.4) years. The mean (SD) lesion size was 3.7 (2.4) cm in maximal diameter. Six hundred and forty-one (64%) patients underwent an FNA procedure, 245 (25%) a CNB, and 114 (11%) had been subjected to both. The diagnostic yield was 960/994 (96.6%); this decreased significantly with the use of CNB only (odds ratio [OR] 0.32; 95% CI 0.12 - 0.88; P = 0.03), while it increased with lesion size (OR 1.35; 95% CI 1.03 - 1.79; P = 0.03 per cm increase). In 506 patients (52.7%), a malignant process was diagnosed by cytopathology/histology. The complication rate reached 97/1000 (9.7%); complications included: hemorrhage, 62 (6.2%); pneumothorax, 28 (2.8%); hemorrhage and pneumothorax, 5 (0.5%); and hemoptysis, 2 (0.2%). It was not significantly affected by the type of procedure or localization of the lesion. The overall risk for complications was three times higher for lesions <4 cm (OR 3.26; 95% CI 1.96 - 5.42; P < 0.001). Conclusion: CT-guided lung biopsy has a high diagnostic yield using FNA, CNB, or both. The CNB procedure alone will not suffice. Complication rates were acceptable and correlated inversely with lesion size, not localization or type of procedure.

  15. Treatment strategies for patients with negative biopsy for pancreatic head mass%胰头肿块组织活检阴性的处理对策

    Institute of Scientific and Technical Information of China (English)

    张太平; 李建; 赵玉沛

    2012-01-01

    The special anatomy around the head of pancreas leads to difficulties in arriving at a definitive diagnosis for a pancreatic head mass,the management of which has recently become a hot topic and a challenge for clinicians.Despite recent advances in tumor markers,ultrasound,CT,PET/CT and MRI,some of these pancreatic head masses cannot be diagnosed with certainty.A fine needle aspiration biopsy can be used before operation; however,false negative results not infrequently happen.Based on the reports from domestic and foreign medical literatures published recently,this paper reviewed and discussed the proper treatment strategies when biopsy results from a pancreatic head mass turn out negative.%由于胰头解剖部位的特殊性,该部位肿块的鉴别诊断是目前临床外科学界的难点和热点问题之一.近年来,虽然血清肿瘤标记物检查、超声、CT、PET/CT、MRI、内镜逆行胆胰管造影等各种影像学方法能为鉴别诊断提供帮助,但仍有部分病例不能通过非手术方法获得确诊.手术前穿刺加病理虽然有助于确诊,但仍有部分患者存在假阴性可能.该文综合近年国内外文献,就胰头肿块组织如果活检阴性,如何恰当地进一步处理,以使患者最大获益进行讨论.

  16. Protocol biopsies for renal transplantation

    Directory of Open Access Journals (Sweden)

    Rush David

    2010-01-01

    Full Text Available Protocol biopsies in renal transplantation are those that are procured at predetermined times post renal transplantation, regardless of renal function. These biopsies have been useful to study the natural history of the transplanted kidney as they have detected unexpected - i.e. "subclinical" pathology. The most significant subclinical pathologies that have been detected with protocol biopsies have been acute lesions, such as cellular and antibody mediated rejection, and chronic lesions, such as interstitial fibrosis and tubular atrophy, and transplant glomerulopathy. The potential benefit of early recognition of the above lesions is that their early treatment may result in improved long-term outcomes. Conversely, the identification of normal histology on a protocol biopsy, may inform us about the safety of reduction in overall immunosuppression. Our centre, as well as others, is attempting to develop non-invasive methods of immune monitoring of renal transplant patients. However, we believe that until such methods have been developed and validated, the protocol biopsy will remain an indispensable tool for the complete care of renal transplant patients.

  17. SATURATION BIOPSY OF THE PROSTATE (REVIEW

    Directory of Open Access Journals (Sweden)

    A. V. Sadchenko

    2014-07-01

    Full Text Available Prostate biopsy is the principal method of diagnois of prostate cancer, allowing to start the adequate treatment. The tactics of the patients, which have negative initial biopsy, is a subject of discussion. Saturation biopsy is a “gold standard„ of diagnostics of PCA with repeat biopsy. Saturation biopsy of the prostate is not a primary procedure, usually apply in patients with negative biopsies in anamnesis, patients with multifocal PIN and ASAP. Saturation biopsy allows to more precisely predict the volume and degree of malignancy of PCA, that can be used for planning tactics of active surveillance and focal therapy.

  18. Spectrum of pediatric skin biopsies

    Directory of Open Access Journals (Sweden)

    Grace D′costa

    2007-01-01

    Full Text Available Background: Skin diseases are common in childhood and they are common reasons for pediatric visits to the hospital. In spite of this high occurrence, there are very few prospective studies addressing this issue. Aims: The present study was directed at determining the spectrum of dermato-pathological lesions encountered in a large general tertiary care hospital, over a two-year period. Materials and Methods: 107 cases formed the total sample studied, in a part prospective and part retrospective study. A detailed clinical history was recorded on a proforma prepared for the purpose and gross photographs were taken wherever possible. Results: Skin biopsies accounted for 7.29% of the total surgical pathology load, 55.44% of the total pediatric biopsies and 10.82% of the total number of skin biopsies. The age and sex distribution pattern revealed that the maximum number of biopsies (62.61% were of older children, with a male preponderance (57.94%. The anatomic distribution pattern indicated predominant involvement of the limbs (59.82%. The maximum numbers of cases were of infectious nature (24.29%; the most frequently encountered being borderline tuberculoid Hansen′s disease (8.4%. A positive correlation with the clinical diagnosis was obtained in 56.07% cases. Conclusions: Histopathology contributed to the diagnosis in a significant number of (82.23% cases, indicating its importance and utility.

  19. Vacuum enhanced cutaneous biopsy instrument

    Science.gov (United States)

    Collins, Joseph

    2000-01-01

    A syringe-like disposable cutaneous biopsy instrument equipped with a tubular blade at its lower end, and designed so that a vacuum is created during use, said vacuum serving to retain undeformed a plug of tissue cut from a patient's skin.

  20. Retroperitoneoscopic renal biopsy in children

    Directory of Open Access Journals (Sweden)

    Carlos M. Jesus

    2007-08-01

    Full Text Available OBJECTIVE: We present our experience in a series of 17 consecutive pediatric patients submitted to retroperitoneal laparoscopic renal biopsy. MATERIALS AND METHODS: Retroperitoneal laparoscopic renal biopsy (LRB was performed in 5 boys and 12 girls. Mean age was 8.1 years and age range from 2 to 12. Two or three trocars were used to expose the inferior pole of the kidney, remove enough cortical parenchymal specimen and fulgurate the biopsy site. Assessment included surgical time, estimated blood loss, hospitalization period, analgesia requirements, complications and number of glomeruli present in the specimen. RESULTS: LRB was successfully performed in all 15 patients (88%. In two cases, LRB was not possible to be performed. One patient was converted to a transperitoneal laparoscopy due to tear in the peritoneum. The other patient had had previous abdominal surgery and, during retroperitoneal balloon dilation, the peritoneum was opened and the open biopsy was performed. A third patient had postoperatively a perirenal hematoma, which was solved spontaneously. Complication rate was 17.6% (3/17 cases. Mean operative time was 65 minutes, while mean estimated blood loss was 52 mL, mean hospital stay was 2.2 days and mean analgesic requirement was 100 mg of tramadol. The mean number of glomeruli present in the specimen was 60. CONCLUSION: Retroperitoneal laparoscopic renal biopsy in children is a simple, safe. Bleeding is still the most common complication. However, direct vision usually allows a safe control of this drawback. In our institution, laparoscopic approach is the chosen procedure in pediatric patients older than one - year - old.

  1. Improving the Prediction of Prostate Cancer Overall Survival by Supplementing Readily Available Clinical Data with Gene Expression Levels of IGFBP3 and F3 in Formalin-Fixed Paraffin Embedded Core Needle Biopsy Material.

    Directory of Open Access Journals (Sweden)

    Zhuochun Peng

    Full Text Available A previously reported expression signature of three genes (IGFBP3, F3 and VGLL3 was shown to have potential prognostic value in estimating overall and cancer-specific survivals at diagnosis of prostate cancer in a pilot cohort study using freshly frozen Fine Needle Aspiration (FNA samples.We carried out a new cohort study with 241 prostate cancer patients diagnosed from 2004-2007 with a follow-up exceeding 6 years in order to verify the prognostic value of gene expression signature in formalin fixed paraffin embedded (FFPE prostate core needle biopsy tissue samples. The cohort consisted of four patient groups with different survival times and death causes. A four multiplex one-step RT-qPCR test kit, designed and optimized for measuring the expression signature in FFPE core needle biopsy samples, was used. In archive FFPE biopsy samples the expression differences of two genes (IGFBP3 and F3 were measured. The survival time predictions using the current clinical parameters only, such as age at diagnosis, Gleason score, PSA value and tumor stage, and clinical parameters supplemented with the expression levels of IGFBP3 and F3, were compared.When combined with currently used clinical parameters, the gene expression levels of IGFBP3 and F3 are improving the prediction of survival time as compared to using clinical parameters alone.The assessment of IGFBP3 and F3 gene expression levels in FFPE prostate cancer tissue would provide an improved survival prediction for prostate cancer patients at the time of diagnosis.

  2. Freehand biopsy guided by electromagnetic needle tracking

    DEFF Research Database (Denmark)

    Ewertsen, C; Nielsen, Marie Kristina Rue; Nielsen, M Bachmann

    2011-01-01

    To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking.......To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking....

  3. Tissue Biopsies in Diabetes Research

    DEFF Research Database (Denmark)

    Højlund, Kurt; Gaster, Michael; Beck-Nielsen, Henning

    2007-01-01

    Type 2 diabetes is characterized by insulin resistance in major metabolic tissues such as skeletal muscle, liver and fat cells, and failure of the pancreatic ß-cells to compensate for this abnormality (1,2). Skeletal muscle is the major site of glucose disposal in response to insulin, and insulin...... resistance of glucose disposal and glycogen synthesis in this tissue are hallmark features of type 2 diabetes in humans (2,3). During the past two decades, we have carried out more than 1200 needle biopsies of skeletal muscle to study the cellular mechanisms underlying insulin resistance in type 2 diabetes....... Together with morphological studies, measurement of energy stores and metabolites, enzyme activity and phosphorylation, gene and protein expression in skeletal muscle biopsies have revealed a variety of cellular abnormalities in patients with type 2 diabetes and prediabetes. The possibility to establish...

  4. Testicular biopsy in prepubertal boys

    DEFF Research Database (Denmark)

    Faure, Alice; Bouty, Aurore; O'Brien, Mike

    2016-01-01

    in undervirilized patients with 46,XY disorders of sexual development. Testicular histology is also of considerable value in the prediction of both fertility potential and risk of cancer in individuals with undescended testes, particularly those with intraabdominal undescended testes. New possibilities......No consensus exists regarding the precise role of testicular biopsy in prepubertal boys, although it is considered useful for assessing the potential consequences of undescended testes on fertility. Current scientific knowledge indicates that surgeons should broaden indications for this procedure...... for the preservation of fertility after gonadotoxic chemotherapy - even for prepubertal boys - are emerging. Cryopreservation of testicular tissue samples for the preservation of fertility - although still an experimental method at present - is appealing in this context. In our opinion, testicular biopsy...

  5. Breast magnetic resonance imaging guided biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Bo La; Kim, Sun Mi; Jang, Mi Jung [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Cho, Nariya; Moon, Woo Kyung [Dept. of Radiology, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Hak Hee [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-06-15

    Despite the high sensitivity of breast magnetic resonance imaging (MRI), pathologic confirmation by biopsy is essential because of limited specificity. MRI-guided biopsy is required in patients with lesions only seen on MRI. We review preprocedural considerations and the technique of MRI-guided biopsy, challenging situations and trouble-shooting, and correlation of radiologic and pathologic findings.

  6. Freehand biopsy guided by electromagnetic needle tracking

    DEFF Research Database (Denmark)

    Ewertsen, C; Nielsen, Marie Kristina Rue; Nielsen, M Bachmann

    2011-01-01

    To evaluate the overall accuracy and time spent on biopsy guided by electromagnetic needle tracking in a phantom compared with the standard technique of US-guided biopsy with an attached steering device. Furthermore, to evaluate off-plane biopsy guided by needle tracking....

  7. 20 CFR 718.106 - Autopsy; biopsy.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Autopsy; biopsy. 718.106 Section 718.106... PNEUMOCONIOSIS Criteria for the Development of Medical Evidence § 718.106 Autopsy; biopsy. (a) A report of an autopsy or biopsy submitted in connection with a claim shall include a detailed gross macroscopic...

  8. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Pijpe, J.; Kalk, W. W. I.; van der Wal, J. E.; Vissink, A.; Kluin, Ph. M.; Roodenburg, J. L. N.; Bootsma, H.; Kallenberg, C. G. M.; Spijkervet, F. K. L.

    2007-01-01

    Objective. To assess the value of the parotid biopsy as a diagnostic tool for primary Sjogren's syndrome ( pSS), and to compare the parotid biopsy and the labial biopsy with regard to diagnostic value and biopsy-related morbidity. Methods. In 15 consecutive patients with pSS and 20 controls, the par

  9. Immunohistochemistry for BRAF(V600E) antibody VE1 performed in core needle biopsy samples identifies mutated papillary thyroid cancers.

    Science.gov (United States)

    Crescenzi, A; Guidobaldi, L; Nasrollah, N; Taccogna, S; Cicciarella Modica, D D; Turrini, L; Nigri, G; Romanelli, F; Valabrega, S; Giovanella, L; Onetti Muda, A; Trimboli, P

    2014-05-01

    BRAF(V600E) is the most frequent genetic mutation in papillary thyroid cancer (PTC) and has been reported as an independent predictor of poor prognosis of these patients. Current guidelines do not recommend the use of BRAF(V600E) mutational analysis on cytologic specimens from fine needle aspiration due to several reasons. Recently, immunohistochemistry using VE1, a mouse anti-human BRAF(V600E) antibody, has been reported as a highly reliable technique in detecting BRAF-mutated thyroid and nonthyroid cancers. The aim of this study was to test the reliability of VE1 immunohistochemistry on microhistologic samples from core needle biopsy (CNB) in identifying BRAF-mutated PTC. A series of 30 nodules (size ranging from 7 to 22 mm) from 30 patients who underwent surgery following CNB were included in the study. All these lesions had had inconclusive cytology. In all cases, both VE1 and BRAF(V600E) genotypes were evaluated. After surgery, final histology demonstrated 21 cancers and 9 benign lesions. CNB correctly diagnosed 20/20 PTC and 5/5 adenomatous nodules. One follicular thyroid cancer and 4 benign lesions were assessed at CNB as uncertain follicular neoplasm. VE1 immunohistochemistry revealed 8 mutated PTC and 22 negative cases. A 100% agreement was found when positive and negative VE1 results were compared with BRAF mutational status. These data are the first demonstration that VE1 immunohistochemistry performed on thyroid CNB samples perfectly matches with genetic analysis of BRAF status. Thus, VE1 antibody can be used on thyroid microhistologic specimens to detect BRAF(V600E)-mutated PTC before surgery.

  10. Stereotactic breast biopsy: pitfalls and pearls.

    Science.gov (United States)

    Huang, Monica L; Adrada, Beatriz E; Candelaria, Rosalind; Thames, Deborah; Dawson, Debora; Yang, Wei T

    2014-03-01

    Stereotactic breast biopsies have become indispensable and the standard of care for patients in whom screening mammography or tomosynthesis reveals breast lesions suggestive of malignancy. A variety of stereotactic biopsy systems and needle types are now available, which allow more accurate sampling of lesions as well as successful biopsy of lesions in difficult locations in patients of all body habitus. We discuss how to plan, perform, and follow up stereotactic biopsies. Most importantly, we offer suggestions on how to avoid problems and complications and detail how to achieve technical success even in the most challenging cases. Stereotactic biopsy has proven over time to be an accurate and acceptable alternative to surgical biopsy for histopathologic diagnosis of breast abnormalities. Successful performance of this minimally invasive procedure spares women from undergoing potentially deforming and expensive procedures to diagnose breast disease.

  11. Photoacoustic biopsy: a feasibility study

    Science.gov (United States)

    Xu, Guan; Tomlins, Scott A.; Siddiqui, Javed; Davis, Mandy A.; Kunju, Lakshmi P.; Wei, John T.; Wang, Xueding

    2015-03-01

    Photoacoustic (PA) measurements encode the information associated with both physical microstructures and chemical contents in biological tissues. A two-dimensional physio-chemical spectrogram (PCS) can be formulated by combining the power spectra of PA signals acquired at a series of optical wavelengths. The analysis of PCS, or namely PA physio-chemical analysis (PAPCA), enables the quantification of the concentrations and the spatial distributions of a variety of chemical components in the tissue. The chemical components and their distribution are the two major features observed in the biopsy procedures which have been regarded as the gold standard of the diagnosis of many diseases. Taking non-alcoholic fatty liver disease and prostate cancer for example, this study investigates the feasibility of PAPCA in characterizing the histopathological changes in the diseased conditions in biological tissue. A catheter based setup facilitating measurement in deep tissues was also proposed and tested.

  12. Needle muscle biopsy and its application

    Directory of Open Access Journals (Sweden)

    Meng-long CHEN

    2015-07-01

    Full Text Available Needle muscle biopsy is a straightforward and reliable minimally-invasive technique. During the past century, the needle biopsy can provide adequate samples and the technique has gradually gained wider acceptance. Compared with open biopsy, needle biopsy is less traumatic, with low rate of complications, and is suitable for the identifications and evaluations of muscular dystrophy, inflammatory myopathies and systemic diseases involving muscles, specially for infants and young children. Domestic insiders should be encouraged to apply this technique. DOI: 10.3969/j.issn.1672-6731.2015.06.003 

  13. Nerve Biopsy In The Diagnosis Of Leporsy

    Directory of Open Access Journals (Sweden)

    Hazra B

    1997-01-01

    Full Text Available Skin and nerve biopsies were done in 33 cases of different clinical types of leprosy selected from Dermatology OPD of Medical College and Hospitals, Calcutta during 1994-95. Histopathological results were compared with emphasis on the role of nerve biopsies in detection of patients with multibacillary leprosy. The evident possibility of having patients with multibacillary leprosy in peripheral leprosy with multiple drugs. It is found that skin and nerve biopsy are equally informative in borderline and lepromatour leprosy and is the only means to diagnose polyneuritic leprosy. Nerve biopsy appears to be more informative in the diagnosis of all clinical types of leprosy.

  14. Surface staining of small intestinal biopsies

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1977-01-01

    Small intestinal biopsies are most often by routine examined under a stereo-microscope, prior to embedding for histological examination. This is done in order to get a view of the appearance of the mucosal pattern, especially villus configuration. The distinctness of the surface pattern however......, is improved considerably if the biopsies are stained with Alcian Green and/or PAS before they are examined. In the present paper a detailed description is given of staining of small intestinal biopsies as whole mounts. The difference between the unstained and the stained biopsies is illustrated by a few...

  15. Técnicas de biopsia para el diagnóstico de lesiones mamarias no palpables Biopsy techniques for the diagnosis of non-palpable mammary lesions

    Directory of Open Access Journals (Sweden)

    L. Pina

    2004-12-01

    (basically in cases of microcalcifications, echography (above all in the nodules, and magnetic resonance (for lesions not made visible through the previous systems. The next step is to select the most suitable biopsy technique. The most classical and reliable technique is the surgical biopsy with prior marking using a metallic harpoon, but, besides its high cost, it has the drawback of being an aggressive technique for the diagnosis of a benign pathology. Numerous systems of puncture have been developed as alternatives. Puncture with a fine needle is technically simple to carry out and can provide good results in the mammary nodules, but the existence of positive and negative false results has progressively limited its use. As an alternative, the systems of biopsy with a broad needle have made it possible to obtain multiple cylinders with a high diagnostic reliability, above all in the case of mammary nodules. However, their use in microcalcifications continues to show negative false results. The arrival of systems of vacuum-assisted biopsy has made it possible to obtain cylinders of greater quality, above all in cases of microcalcifications. Finally, the systems of percutaneous resection biopsy by means of cannulas with a diameter of 22mm make it possible to completely extract lesions of a size below that of the cannula, with a reliability similar to that of the surgical biopsy.

  16. Pain and Anxiety During Bone Marrow Biopsy

    NARCIS (Netherlands)

    Tanasale, Betty; Kits, Jenne; Kluin, Philip M.; Trip, Albert; Kluin-Nelemans, Hanneke C.

    2013-01-01

    A bone marrow biopsy is considered to be painful, often causing anxiety. We observed large differences between patients and wondered which factors cause pain and anxiety. In a prospective study, 202 patients were analyzed. Experienced hematologists and fellows in training (17% of biopsies) performed

  17. 'Microerosions' in rectal biopsies in Crohn's disease

    DEFF Research Database (Denmark)

    Poulsen, Steen Seier

    1984-01-01

    Small (less than 1 mm), superficial erosions ('microerosions') have been observed stereo-microscopically in surface-stained rectal biopsies in Crohn's disease (CD). Biopsy specimens from 97 patients with CD, 225 with ulcerative colitis (UC), and a control material of 161 patients were investigated...

  18. Evaluation of Stress Scores Throughout Radiological Biopsies

    Directory of Open Access Journals (Sweden)

    Turkoglu

    2016-06-01

    Full Text Available Background Ultrasound-guided biopsy procedures are the most prominent methods that increase the trauma, stress and anxiety experienced by the patients. Objectives Our goal was to examine the level of stress in patients waiting for radiologic biopsy procedures and determine the stress and anxiety level arising from waiting for a biopsy procedure. Patients and Methods This prospective study included 35 female and 65 male patients who were admitted to the interventional radiology department of Kartal Dr. Lütfi Kirdar training and research hospital, Istanbul between the years 2014 and 2015. They filled out the adult resilience scale consisting of 33 items. Patients who were undergoing invasive radiologic interventions were grouped according to their phenotypic characteristics, education level (low, intermediate, and high, and biopsy features (including biopsy localization: neck, thorax, abdomen, and bone; and the number of procedures performed, 1 or more than 1. Before the biopsy, they were also asked to complete the depression-anxiety-stress scale (DASS 42, state-trait anxiety inventory scale (STAI-I, and continuous anxiety scale STAI-II. A total of 80 patients were biopsied (20 thyroid and parathyroid, 20 thorax, 20 liver and kidney, and 20 bone biopsies. The association between education levels (primary- secondary, high school and postgraduate and the number of biopsies (1 and more than 1 with the level of anxiety and stress were evaluated using the above-mentioned scales. Results Evaluation of sociodemographic and statistical characteristics of the patients showed that patients with biopsy in the neck region were moderately and severely depressed and stressed. In addition, the ratio of severe and extremely severe anxiety scores was significantly high. While the STAI-I and II scores were lined up as neck > bone > thorax > abdomen, STAI-I was higher in neck biopsies compared to thorax and abdomen biopsies. Regarding STAI-I and II scales, patients

  19. Biopsy needle detection in transrectal ultrasound.

    Science.gov (United States)

    Ayvaci, Alper; Yan, Pingkun; Xu, Sheng; Soatto, Stefano; Kruecker, Jochen

    2011-01-01

    Using the fusion of pre-operative MRI and real time intra-procedural transrectal ultrasound (TRUS) to guide prostate biopsy has been shown as a very promising approach to yield better clinical outcome than the routinely performed TRUS only guided biopsy. In several situations of the MRI/TRUS fusion guided biopsy, it is important to know the exact location of the deployed biopsy needle, which is imaged in the TRUS video. In this paper, we present a method to automatically detect and segment the biopsy needle in TRUS. To achieve this goal, we propose to combine information from multiple resources, including ultrasound probe stability, TRUS video background model, and the prior knowledge of needle orientation and position. The proposed algorithm was tested on TRUS video sequences which have in total more than 25,000 frames. The needle deployments were successfully detected and segmented in the sequences with high accuracy and low false-positive detection rate.

  20. Delayed culture of Leishmania in skin biopsies.

    Science.gov (United States)

    Dedet, J P; Pratlong, F; Pradinaud, R; Moreau, B

    1999-01-01

    Between January 1997 and October 1998, 16 skin biopsies collected from 13 patients with cutaneous leishmaniasis in French Guiana were inoculated in culture medium after travel for 3-17 days from the place of biopsy to the culture laboratory in France. Each biopsy fragment was introduced near the flame of a Bunsen burner into the transport medium (RPMI medium supplemented with 10% fetal calf serum) which was maintained at ambient temperature during postal delivery to France. In France the biopsies were ground in sterile saline before being inoculated into NNN culture tubes. The cultures were incubated at 25 degrees C and subcultured every week until the 5th week. The cultures were positive in 9 cases, remained negative in 4, and were contaminated in 3 cases. Positive results were obtained at all seasons and for 3 different Leishmania species. The study indicates that delayed culture can yield useful results from biopsies taken in field conditions.

  1. Transjugular liver biopsy: indications, technique and results.

    Science.gov (United States)

    Dohan, A; Guerrache, Y; Boudiaf, M; Gavini, J-P; Kaci, R; Soyer, P

    2014-01-01

    Transjugular liver biopsy is a safe, effective and well-tolerated technique to obtain liver tissue specimens in patients with diffuse liver disease associated with severe coagulopathies or massive ascites. Transjugular liver biopsy is almost always feasible. The use of ultrasonographic guidance for percutaneous puncture of the right internal jugular vein is recommended to decrease the incidence of local cervical minor complications. Semiautomated biopsy devices are very effective in obtaining optimal tissue samples for a precise and definite histological diagnosis with a very low rate of complication. The relative limitations of transjugular liver biopsy are the cost, the radiation dose given to the patient, the increased procedure time by comparison with the more common percutaneous liver biopsy, and the need of a well-trained interventional radiologist.

  2. Computed tomography-guided biopsy. I. Overview.

    Science.gov (United States)

    Haaga, J R; Reich, N E; Havrilla, T R; Alfidi, R J; Meaney, T F

    1978-03-01

    The authors are preparing a series of communications on CT-guided biopsy procedures to be published in future issues of this journal. The present article, which previously appeared in the Cleveland Clinic Quarterly, is intended to serve as an introduction to the concept of CT-guided biopsies. Because the principles of the biopsy procedure remain the same, we do not believe that a "rewrite" of the previously published article would be required. We hope that by presenting this article and subsequent articles concerning the use of CT-guided biopsies, the reader will acquire an appreciation of the proper role of this exciting new technique in comparison to the available imaging modalities. We believe that as individuals become more experienced with the imaging capabilities of these CT devices, they will want to develop the technique of obtaining biopsy confirmation of the imaging diagnosis.

  3. US-guided biopsy of renal allografts using 18G biopsy gun: analysis of 200 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Kyung; Lee, Jong Tae; Kim, Myeong Jin; Yoo, Hyung Sik; Kim, Ki Whang; Park, Ki Ill; Chung, Hyun Joo [Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    1995-05-15

    We evaluated the effectiveness and safety of 18G biopsy gun with US guidance in the transplanted kidneys. We performed 200 US-guided percutaneous biopsies using 18G biopsy gun. Diagnostic efficacy and complication of the biopsy in these patients were analyzed. Biopsy specimens were adequate for histologic diagnoses in 193 patients(96.5%). The mean of the biopsy frequency was 3, the mean of total glomerular number was 21.64 and the mean glomerular number per one biopsy was 6.93. Major complications occurred in 3 (1.5%) of the 200 biopsies; hematuria developed in two patients, AV fistula in one. These complications were successfully controlled either by only transfusion or by coil embolization. There were no statistical differences in blood pressure, hemoglobin, BUN/Cr between pre-and post-renal biopsies. US-guided percutaneous biopsy of renal allograft with 18G biopsy gun is simple, safe, and accurate method in evaluating the renal allograft dysfunction.

  4. Detecting and Treating Thyroid Nodules and Cancer Before, During, and After Pregnancy

    Science.gov (United States)

    ... thyroid nodules relies mainly on the results of thyroid ultrasound imaging and fine-needle aspiration biopsy . A biopsy ... small sample of the nodule for further testing. Thyroid ultrasound uses the same safe technique of high- frequency ...

  5. 21 CFR 876.1075 - Gastroenterology-urology biopsy instrument.

    Science.gov (United States)

    2010-04-01

    ... generic type of device includes the biopsy punch, gastrointestinal mechanical biopsy instrument, suction... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology biopsy instrument. 876... Gastroenterology-urology biopsy instrument. (a) Identification. A gastroenterology-urology biopsy instrument is...

  6. GoM Coastal Biopsy Surveys - NRDA

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Small vessel surveys were conducted within estuarine and nearshore coastal waters of Barataria Bay, LA and Mississippi Sound, MS to collect tissue biopsy samples...

  7. Prostate biopsy tracking with deformation estimation

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Troccaz, Jocelyne

    2011-01-01

    Transrectal biopsies under 2D ultrasound (US) control are the current clinical standard for prostate cancer diagnosis. The isoechogenic nature of prostate carcinoma makes it necessary to sample the gland systematically, resulting in a low sensitivity. Also, it is difficult for the clinician to follow the sampling protocol accurately under 2D US control and the exact anatomical location of the biopsy cores is unknown after the intervention. Tracking systems for prostate biopsies make it possible to generate biopsy distribution maps for intra- and post-interventional quality control and 3D visualisation of histological results for diagnosis and treatment planning. They can also guide the clinician toward non-ultrasound targets. In this paper, a volume-swept 3D US based tracking system for fast and accurate estimation of prostate tissue motion is proposed. The entirely image-based system solves the patient motion problem with an a priori model of rectal probe kinematics. Prostate deformations are estimated with ...

  8. Salivary Gland Biopsy for Sjogren's Syndrome

    NARCIS (Netherlands)

    Delli, Konstantina; Vissink, Arjan; Spijkervet, Fred K. L.

    2014-01-01

    Salivary gland biopsy is a technique broadly applied for the diagnosis of Sjogren's syndrome (SS), lymphoma accompanying SS, sarcoidosis, amyloidosis, and other connective tissue disorders. SS has characteristic microscopic findings involving lymphocytic infiltration surrounding the excretory ducts

  9. Navigation-guided endoscopic biopsy for intraparenchymal brain tumor.

    Science.gov (United States)

    Tsuda, Kyoji; Ishikawa, Eiichi; Zaboronok, Alexander; Nakai, Kei; Yamamoto, Tetsuya; Sakamoto, Noriaki; Uemae, Yoji; Tsurubuchi, Takao; Akutsu, Hiroyoshi; Ihara, Satoshi; Ayuzawa, Satoshi; Takano, Shingo; Matsumura, Akira

    2011-01-01

    To evaluate the efficacy of intraparenchymal brain tumor biopsy using endoscopy and a navigation system (navigation-guided endoscopic biopsy) as a diagnostic tool, a case series of intraparenchymal tumor biopsies was reviewed. Navigation-guided endoscopic biopsy was applied in 9 cases, stereotactic needle biopsy in 16 cases, and open biopsy with or without navigation system in 34 cases. In all biopsy cases, 84.7% of biopsy points were sampled accurately, and 93.2% of diagnoses by biopsy were correct. Comparison of each type of biopsy showed that the resected volumes in navigation-guided endoscopic biopsy and open biopsy tended to be larger than those in stereotactic biopsy, and the mean operation time for the open biopsy procedure was the longest. To define the most applicable device or examination method to increase sampling accuracy, various factors were analyzed in 59 procedures. Navigation-guided endoscopic biopsy was the most accurate of the three types of biopsy, although the statistical difference was not significant. Older patients, histological diagnosis of high-grade glioma or malignant lymphoma, positive photodynamic diagnosis, and positive intraoperative pathology were significant factors in improving the sampling accuracy. Navigation-guided endoscopic biopsy could provide a larger sample volume within a relatively short operation time. The biopsy can be easily combined with both photodynamic diagnosis and intraoperative pathology, significantly improving the histological diagnostic yield.

  10. Testicular biopsy: clinical practice and interpretation

    Institute of Scientific and Technical Information of China (English)

    Gert R Dohle; Saad Elzanaty; Niels J van Casteren

    2012-01-01

    Testicular biopsy was considered the cornerstone of male infertility diagnosis for many years in men with unexplained infertility and azoospermia.Recent guidelines for male infertility have limited the indications for a diagnostic testicular biopsy to the confirmation ofobstructive azoospermia in men with normal size testes and normal reproductive hormones.Nowadays,testicular biopsies are mainly performed for sperm harvesting in men with non-obstructive azoospermia,to be used for intracytoplasmic sperm injection.Testicular biopsy is also performed in men with risk factors for testicular malignancy.In a subgroup of infertile men,there is an increased risk for carcinoma in situ of the testis,especially in men with a history of cryptorchidism and testicular malignancy and in men with testicular atrophy.Ultrasonographic abnormalities,such as testicular microlithiasis,inhomogeneous parenchyma and lesions of the testes,further increase the risk of carcinoma in situ (CIS) in these men.For an accurate histological classification,proper tissue handling,fixation,preparation of the specimen and evaluation are needed.A standardized approach to testicular biopsy is recommended.In addition,approaches to the detection of CIS of the testis testicular immunohistochemistry are mandatory.In this mini-review,we describe the current indications for testicular biopsies in the diagnosis and management of male infertility.

  11. Treatment Option Overview (Thyroid Cancer)

    Science.gov (United States)

    ... filled. When a thyroid nodule is found, an ultrasound of the thyroid and a fine-needle aspiration biopsy are often ... This procedure can show the size of a thyroid nodule and whether it is solid or a fluid-filled cyst . Ultrasound may be used to guide a