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Sample records for biopsy fine-needle

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

    Science.gov (United States)

    ... Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy ... Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration ...

  2. Fine-needle aspiration biopsy. When is it most beneficial?

    Science.gov (United States)

    Peterson, I M; Brink, W J

    1990-09-01

    When fine-needle aspiration biopsy is done skillfully, it is an accurate, efficient, and cost-effective method for diagnosing many diseases in selected patients. This article describes its uses for palpable masses of the thyroid, breast, and peripheral lymph nodes and some nonpalpable lesions. The authors also discuss its advantages and disadvantages and technical considerations that affect accuracy. PMID:2399196

  3. Fine needle aspiration biopsy of fibromatoses.

    Science.gov (United States)

    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.

  4. Low coherence interferometry approach for aiding fine needle aspiration biopsies

    Science.gov (United States)

    Chang, Ernest W.; Gardecki, Joseph; Pitman, Martha; Wilsterman, Eric J.; Patel, Ankit; Tearney, Guillermo J.; Iftimia, Nicusor

    2014-11-01

    We present portable preclinical low-coherence interference (LCI) instrumentation for aiding fine needle aspiration biopsies featuring the second-generation LCI-based biopsy probe and an improved scoring algorithm for tissue differentiation. Our instrument and algorithm were tested on 38 mice with cultured tumor mass and we show the specificity, sensitivity, and positive predictive value of tumor detection of over 0.89, 0.88, and 0.96, respectively.

  5. MRI-guided biopsy and fine needle aspiration biopsy (FNAB) in the diagnosis of musculoskeletal lesions

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    Kerimaa, Pekka, E-mail: pekka.kerimaa@ppshp.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Marttila, Antti, E-mail: antti.marttila@ppshp.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Hyvönen, Pekka, E-mail: pekka.hyvonen@ppshp.fi [Department of Surgery, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Ojala, Risto, E-mail: risto.ojala@ppshp.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Lappi-Blanco, Elisa, E-mail: elisa.lappi-blanco@ppshp.fi [Department of Pathology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Tervonen, Osmo, E-mail: osmo.tervonen@ppshp.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland); Blanco Sequeiros, Roberto, E-mail: roberto.blanco@oulu.fi [Department of Radiology, Oulu University Hospital, P.O. Box 50, 90029 OYS (Finland)

    2013-12-01

    Objectives: The purpose of this study was to evaluate the diagnostic performance of magnetic resonance imaging (MRI) guided musculoskeletal biopsy and the value of fine needle aspiration biopsy (FNAB) when combined with histologic biopsy. Materials and methods: A total of 172 biopsies were performed under MRI guidance, 170 were histologic biopsies. In 112 cases, a fine needle aspiration biopsy was also performed. In two cases, a stand-alone FNAB was performed. The diagnostic performance was evaluated retrospectively by comparing the histopathologic and cytologic diagnosis with the current or final diagnosis after at least one year of clinical and imaging follow-up. A 0.23 T open MRI scanner with an interventional stereotactic guidance system was used. Results: The overall diagnostic accuracy of MRI guided biopsy was 0.95, sensitivity 0.91, specificity 0.98, positive predictive value (ppv) 0.97 and negative predictive value (npv) 0.93. The diagnostic accuracy of trephine biopsy alone was 0.93, sensitivity 0.89, specificity 0.98, ppv 0.97 and npv 0.91 and accuracy for FNAB alone was 0.85, sensitivity 0.80, specificity 0.90, ppv 0.89 and npv 0.82. Conclusions: MRI guidance is a feasible and accurate tool in percutaneous musculoskeletal biopsies. Fine needle biopsy is a useful low-cost supplement to histologic biopsy.

  6. Fine needle aspiration biopsy of intraoral and oropharyngeal mass lesions

    Directory of Open Access Journals (Sweden)

    Saleh Husain A

    2008-03-01

    Full Text Available Abstract Background Fine needle aspiration (FNA biopsy has been rarely used in oral and oropharyngeal lesions. The goal of this study was to assess the value and accuracy of FNA biopsy in the diagnosis of oral and oropharyngeal lesions particularly in regards to discriminating benign from malignant tumors. Methods Sixteen cases of FNA biopsies obtained of various intraoral and oropharyngeal masses or lesions performed at our institution during the eight-year period from 1998 to 2006 were retrospectively reviewed. The aspiration cytologic diagnoses were correlated with the histologic examination of the corresponding resected lesions. Results Sixteen cases of intraoral lesions evaluated by FNA biopsies during the period of 1998–2006 were reviewed. The sites of involvement were: lip 1, maxillary sinus 3, pharynx/oropharynx 5, floor of mouth 4, buccal mucosa 2 and peritonsillar area 1. Patients' age ranged from 30 to 87 with an average of 54 years. Male to female ratio was 1:3. Cytologically, 7 cases were diagnosed as suspicious/malignant, and 9 cases as benign (including 6 benign neoplasm, 1 atypical, and 2 reactive or "descriptive". Fifteen cases had corresponding surgical resection for histologic examination, of these, 9 cases were interpreted as malignant, and 6 as benign. There were no false positive diagnoses of malignancy on FNA. Two cases were interpreted as benign or atypical cytologically, but were found to be malignant on histologic examination. Conclusion FNA biopsy of intraoral and oropharyngeal masses is a valuable procedure for the initial evaluation of various lesions. It provides helpful information about these lesions and avoids hasty or unnecessary surgical biopsy. It is a rapid and relatively noninvasive procedure. Furthermore, aspiration biopsy is an important tool in the diagnosis and management of these lesions, both neoplastic and non-neoplastic, and can be sometimes complemented by ancillary studies for more accurate

  7. Usefulness of Core Needle Biopsy for Thyroid Nodules with Macrocalcifications: Comparison with Fine-Needle Aspiration

    OpenAIRE

    Yi, Kyung Sik; Kim, Ji-Hoon; Na, Dong Gyu; Seo, Hyobin; Min, Hye Sook; Won, Jae-Kyung; Yun, Tae Jin; Ryoo, Inseon; Kim, Su Chin; Choi, Seung Hong; Sohn, Chul-Ho

    2015-01-01

    Background: This study was performed to determine the benefits of core needle biopsy (CNB), as compared with fine-needle aspiration (FNA), for the diagnosis of thyroid nodules with macrocalcifications.

  8. 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

  9. Primary amyloidosis presenting as an isolated mediastinal mass: diagnosis by fine needle biopsy.

    OpenAIRE

    Hiller, N.; FISHER, D.; Shmesh, O.; Gottschalk-Sabag, S.; Dollberg, M.

    1995-01-01

    Intrathoracic amyloidosis affecting the lungs or mediastinum is rare, and mediastinal lymphadenopathy in the absence of pulmonary involvement is even more rare. The case history is presented of a previously healthy man who developed nodular mediastinal amyloidosis without pulmonary involvement. Diagnosis was made by percutaneous fine needle biopsy.

  10. [Clarification of breast lesions using core-cut, drill and fine needle biopsy].

    Science.gov (United States)

    Junkermann, H; Anton, H W; Krapfl, E; Harcos, A; von Fournier, D

    1993-05-01

    Interest in needle biopsy methods (core cut-, drill-, and fine-needle biopsy) has recently increased considerably because of the rise in screening mammography and new developments in the therapy of breast cancer. In order to achieve adequate results using needle biopsy and to avoid complications, certain technical details must be strictly adhered to. An experienced surgeon can achieve a sensitivity of above 90% in the diagnosis of breast carcinoma with all three methods. Considering the advantages and disadvantages of these three methods of needle biopsy, we prefer--based on our own experience--high-speed core-cut biopsy for the morphological evaluation of breast lesions. PMID:8516437

  11. Preparation and Using Phantom Lesions to Practice Fine Needle Aspiration Biopsies

    OpenAIRE

    Shidham, Vinod B.; Varsegi, George M.; D'Amore, Krista; Shidham, Anjani

    2009-01-01

    Currently, health workers including residents and fellows do not have a suitable phantom model to practice the fine- needle aspiration biopsy (FNAB) procedure. In the past, we standardized a model consisting of latex glove containing fresh cattle liver for practicing FNAB. However, this model is difficult to organize and prepare on short notice, with the procurement of fresh cattle liver being the most challenging aspect. Handling of liver with contamination-related problems is also a signifi...

  12. Ultrasonography and ultrasonoguided percutaneous fine needle aspiration biopsy of pancreatic cancer

    International Nuclear Information System (INIS)

    Ultrasonography of pancreas has been already established to be a effective method in the evaluation of pancreatic mass lesion. In addition to ultrasonography, ultrasonoguided percutaneous fine needle aspiration biopsy of pancreatic mass has been known to be a safe method of obtaining tissue diagnosis in patients with pancreatic cancer without operation. From March, 1984 to June, 1986 ultrasonography and ultrasonoguided percutaneous fine needle aspiration biopsy were performed in 40 patients who had been finally diagnosed as pancreatic cancer at the Department of Radiology, Yonsei University College of Medicine. The results were summarized as follows: In ultrasonographic findings of pancreatic cancer, (1) The location of pancreatic mass is 19 cases in head, 3 in head and body, 7 in body, 4 in body and tail, 5 in tail and 2 diffuse type. (2) The size of tumor ranged under 2cm in 2 cases, between 2.1-4cm in 21, between 4.1-6cm in 13 and over 6cm in 4 cases. (3) The other ultrasonographic findings were 6 cases common bile duct dilatation, 4 pancreatic duct dilatation, 10 peripancreatic node enlargement, 16 liver metastasis and 3 stomach involvement. In ultrasonoguided percutaneous fine needle aspiration biopsy of total 40 cases of pancreatic cancer.

  13. Nonimage-guided fine needle aspiration biopsy of palpable axillary lymph nodes in breast cancer patients.

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    Marti, Jennifer L; Ayo, Diego; Levine, Pascale; Hernandez, Osvaldo; Rescigno, John; Axelrod, Deborah M

    2012-01-01

    We report the utility of office-based, nonimaged guided fine needle aspiration of palpable axillary lymph nodes in breast cancer patients. We examine the sensitivity and specificity of this procedure, and examine factors associated with a positive fine needle aspiration biopsy result. Although the utility of ultrasound-guided fine needle aspiration biopsy (FNA) of axillary lymph nodes is well established, there is little data on nonimage guided office-based FNA of palpable axillary lymphadenopathy. We investigated the sensitivity and specificity of nonimage-guided FNA of axillary lymphadenopathy in patients presenting with breast cancer, and report factors associated with a positive FNA result. Retrospective study of 94 patients who underwent office-based FNA of palpable axillary lymph nodes between 2004 and 2008 was conducted. Cytology results were compared with pathology after axillary sentinel node or lymph node dissection. Nonimage-guided axillary FNA was 86% sensitive and 100% specific. On univariate analysis, patients with positive FNA cytology had larger breast tumors (p = 0.007), more pathologic positive lymph nodes (p benefits select patients, permitting avoidance of axillary ultrasound, sentinel lymph node biopsy, or delay in receiving neoadjuvant therapy. This results in time and cost savings for the health care system, and expedites definitive management. PMID:22098412

  14. 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. PMID:24597324

  15. Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions.

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    Douville, Nicholas J; Bradford, Carol R

    2013-11-01

    Ultrasound-guided core biopsy provides many benefits compared with fine-needle aspiration cytology and has begun to emerge as part of the diagnostic work-up for a salivary gland lesion. Although the increased potential for tumor-seeding and capsule rupture has been extensively discussed, the safety of this procedure is widely accepted based on infrequent reports of tumor-seeding. In fact, a review of the literature shows only 2 cases of salivary tumor seeding following biopsy with larger-gauge needle characteristics, with 2 reported cases of salivary tumor seeding following fine-needle aspiration cytology. However, the follow-up interval of such studies (benefits of ultrasound-guided core biopsy over fine-needle aspiration biopsy, which include both improved consistency and diagnostic accuracy, current studies lack adequate patient numbers and follow-up duration to confirm comparable safety profile to currently accepted fine-needle aspiration cytology. In this report we: (1) compare the relative benefits of each procedure, (2) review evidence regarding tumor seeding in each procedure, (3) discuss time course and patient numbers necessary to detect tumor recurrence, and (4) describe how these uncertainties should be factored into clinical considerations. PMID:23109044

  16. A portable, low coherence interferometry based instrument for fine needle aspiration biopsy guidance

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    Iftimia, Nicusor V.; Bouma, Brett E.; Pitman, Martha B.; Goldberg, Brian; Bressner, Jason; Tearney, Guillermo J.

    2005-06-01

    A portable, low coherence interferometry (LCI) based instrument for fine-needle aspiration biopsy guidance is presented. The instrument consists of a fiber-based low coherence interferometer, a data acquisition, processing and display unit, and a probe. The probe, consisting of a 250μm diameter single-mode optical fiber inserted within the bore of a fine needle, is used to illuminate tissue and collect light from tissue at the tip of the needle. Light returning out of the probe is detected by the LCI system, which is capable of measuring depth-resolved information (reflectivity, spectra, birefringence) with a spatial resolution of 10μm over a depth range of approximately 1.4mm. The LCI based instrument can be used to guide the fine needle during biopsy procedures to potentially diagnose neoplasms, infections, inflammations, or infiltrations. The design and performance of the instrument, as well as preliminary measurements on excised breast tissue specimens, are presented in detail.

  17. Diagnostic value of fine needle aspiration biopsy in 'cold' thyroid nodules

    International Nuclear Information System (INIS)

    In this study fined needle aspiration (FNA) was performed to ascertain a preoperative diagnosis in patients with cold thyroid nodules. A brief clinical history comprising of general physical and local examination was recorded on a proforma. Fine needle aspiration of thyroid nodules were performed with 5 ml disposable syringe (22g needle). Local anesthesia was not used. Four slides were prepared in each case, two were fixed in 95% alcohol for Pananicolau's stain and the Haematoxylin and Eosin while other two slides were air dried for May Grunwald Giemsa stains. Surgical specimens were received at the Department of Pathology and processed as per routine. Cytological and histological reporting was done separately and independently. Special stains were performed when required. A total of 91 patients were studied, in 14 cases aspirate was unsatisfactory and in 21 cases surgery was not performed. In 56 patient, histological correlation was available. Forty were reported benign, out of which 37 proved correct on histological examination. Of the eleven smears reported as follicular neoplasm, 9 proved correct and 2 reported as 'suspicious' and 3 as 'malignant' also proved malignant on histological examination. Sensitivity was 86.36% and specificity was 100%. Efficiency of the test was 94.9%. Fine needle aspiration biopsy was found to be simple and valuable technique for a reliable preoperative diagnosis of thyroid nodules. (author)

  18. Diagnosing a parotid lump: fine needle aspiration cytology or core biopsy?

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    Howlett, D C

    2006-04-01

    Fine needle aspiration cytology (FNAC) has been widely adopted for the cytological diagnosis of parotid lumps. FNAC does have drawbacks, even under optimum conditions and may be associated with poor levels of diagnostic accuracy, particularly outside the specialized clinic environment. Ultrasound-guided core biopsy (USCB) is a relatively recently described technique in the parotid gland which has been well tolerated and has demonstrated a high degree of diagnostic accuracy in several studies. This article discusses the merits and pitfalls of FNAC, together with the technique of USCB and also highlights the potential advantages benefit provided by USCB in parotid diagnosis. PMID:16585720

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Core needle biopsy versus fine needle aspiration biopsy in breast--a historical perspective and opportunities in the modern era.

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    Nassar, Aziza

    2011-05-01

    Breast fine-needle aspiration biopsy (FNAB) by palpation is on the decline, due to its limitations in diagnostic accuracy, decreased sensitivity, and its replacement with core needle biopsy (CNB). Despite its decreasing utility, superficial fine-needle aspiration (FNA) in breast is still the main modality for evaluating metastatic lesions, recurrence, and axillary lymph node metastasis. New modalities including proteomic pattern expression and methylation profiling of breast lesions are other promising techniques that can be used as ancillary tests for refining the diagnosis of breast lesions using FNAB. Image-guided breast FNA proves to be a successful alternative with high sensitivity and specificity. In this review, the advantages, disadvantages, and inherent limitations of breast FNA and CNB, and new advanced techniques are discussed. PMID:20949457

  1. Diagnosis of peritoneal mesothelioma: computed tomography, sonography, and fine-needle aspiration biopsy

    International Nuclear Information System (INIS)

    The diagnosis of peritoneal mesothelioma was made prospectively and noninvasively in four patients with the use of sonography, computed tomography, and sonographically guided fine-needle aspiration biopsy. The imaging methods revealed information similar to the operative findings, with clear superiority of computed tomography over sonography. These noninvasive methods may be used as screening tools, especially among groups or in regional areas with a high risk for asbestos exposure. The findings included soft-tissue masses with invariable involvement of the omentum; small intraperitoneal nodules; thickened peritoneum, mesentery, and bowel wall; pleural plaques; and usually minimal, if any, ascites. Since the differential diagnosis from peritoneal carcinomatosis may be difficult, sonographically (or CT) guided aspiration biopsy is needed to produce diagnostic cytologic specimens. The use of this type of biopsy should obviate surgical exploration

  2. 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.

  3. 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

    to incorrect handling of the specimen. The biopsy procedures lasted 16.3 minutes (range 10-20 minutes) and no complications were seen. CONCLUSIONS: LUS-guided fine-needle aspiration or Trucut biopsy is possible using this newly developed biopsy system. These preliminary data suggest that LUS-guided biopsy may......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...

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

    International Nuclear Information System (INIS)

    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)

  5. 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)

  6. Guided fine needle absorption biopsy in the diagnosis of cysts in maritime workers.

    Science.gov (United States)

    Bartelik, W; Jaremin, B; Smolińska, D; Głombiowski, P

    Cysts in the organs of the abdominal cavity revealed in ultrasonographic examinations in patients with none or with unclear clinical symptoms cause diagnostic and fitness for work assessment problems. The aim of the study was to evaluate the usefulness of ultrasonography of cysts, combined with biochemical, bacteriological, cytological examinations and analysis of markers CEA and AFP of the fluid collected with fine needle aspiration biopsy (FAB). The study material examined were maritime workers who were submitted to these examinations for diagnostic purposes and/or previous to issue of certificate of health for work at sea. Examinations results provided support for usefulness of the method discussed in diagnosis and differentiation of inflammatory and neoplastic processes with simple cysts. This was crucial for final diagnosis, for decision about treatment and recognizing fitness for work at sea. It was concluded that the method FAB is safe both in hospital as well as in ambulatory conditions. PMID:7580347

  7. Image-Directed Fine-needle Aspiration Biopsy of the Thyroid with Safety-engineered Devices

    International Nuclear Information System (INIS)

    Purpose: The purpose of the present study was to integrate safety-engineered devices into outpatient fine-needle aspiration (FNA) biopsy of the thyroid in an interventional radiology practice. Materials and Methods: The practice center is a tertiary referral center for image-directed FNA thyroid biopsies in difficult patients referred by the primary care physician, endocrinologist, or otolaryngologist. As a departmental quality of care and safety improvement program, we instituted integration of safety devices into our thyroid biopsy procedures and determined the effect on outcome (procedural pain, diagnostic biopsies, inadequate samples, complications, needlesticks to operator, and physician satisfaction) before institution of safety devices (54 patients) and after institution of safety device implementation (56 patients). Safety devices included a patient safety technology—the mechanical aspirating syringe (reciprocating procedure device), and a health care worker safety technology (antineedlestick safety needle). Results: FNA of thyroid could be readily performed with the safety devices. Safety-engineered devices resulted in a 49% reduction in procedural pain scores (P < 0.0001), a 56% reduction in significant pain (P < 0.002), a 21% increase in operator satisfaction (P < 0.0001), and a 5% increase in diagnostic specimens (P = 0.5). No needlesticks to health care workers or patient injuries occurred during the study. Conclusions: Safety-engineered devices to improve both patient and health care worker safety can be successfully integrated into diagnostic FNA of the thyroid while maintaining outcomes and improving safety.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Ultrasound guided fine needle aspiration cytology versus core biopsy in the preoperative assessment of non-palpable breast lesions

    International Nuclear Information System (INIS)

    Background: Breast screening is a method of detecting breast cancer at a very early stage. Most of the lesions detected by screening are not malignant. Objective of this study was to compare ultrasound guided fine needle aspiration cytology and core biopsy in the preoperative assessment of non-palpable breast lesions. Methods: The study was conducted prospectively at Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan from March 2004 to February 2005. All the patients underwent fine needle aspiration cytology and core biopsy. Later on, all of them had excision biopsy/ mastectomy. Prospectively 80 patients were studied; information was collected on a specifically designed form according to inclusion criteria. The patient age, sex, medical record number and side of lesion were recorded. Clinical history of duration of lump was also taken. Informed consent was obtained. Results: The age of patients were ranges from 20-71 years, with mean of 44.31+- 11.002 and the maximum number of patients 28 (35.3%) was between the ages 50 - 59 years. The sensitivity of FNAC was 92.85%, while the specificity of was 90% and the accuracy rate was 92.1%. The sensitivity of core biopsy was 94.64%, specificity 91.30% and accuracy rate was 94.87%. Conclusion: Fine Needle Aspiration has been found to be an extremely useful method for the diagnosis of lumps of breast. The accuracy and the sensitivity of diagnosis on fine needle aspiration cytology were high. (author)

  10. Fine-needle aspiration cytology and biopsy in hepatic masses: A minimally invasive diagnostic approach

    Directory of Open Access Journals (Sweden)

    Jitendra G Nasit

    2013-01-01

    Full Text Available Aims and Objective: To evaluate the diagnostic sensitivity, usefulness and limitations of fine-needle aspiration cytology (FNAC and fine-needle aspiration biopsy (FNAB in the diagnosis of hepatic masses. Materials and Methods: FNAC was performed on 150 cases of hepatic masses under guidance of ultrasound or computed tomography (CT scan. Adequate diagnostic aspirates were obtained in 147 cases (98.0%. Smears were stained with hematoxylin and eosin (H and E, and Papanicolaou stains. FNAB was obtained from the same 149 cases (except one and stained with HE stain. The hepatic masses were categorized into benign, malignant and inflammatory groups. Results: Out of 150 hepatic masses, 3.3% were benign, 94.26% were malignant and 2% were inflammatory lesions. FNAC and FNAB were unsatisfactory for evaluation in 3 out of the 150 cases (2% and 6 out of 149 cases (4.02%, respectively. Correct cytological diagnoses were achieved in 129 out of the 150 cases (diagnostic sensitivity: 86%. FNAB gave satisfactory results in 143 out of 149 cases (diagnostic sensitivity: 95.77%. Cytological diagnoses of 21 cases were not consistent with histology (false negativity: 14%. Cyto-histological correlation showed 87.32% diagnostic sensitivity of FNAC for malignant tumors, whereas benign tumors posed maximum diagnostic problems, with sensitivity of 40%. This difference was statistically significant (P < 0.05. FNAB showed a statistically significant difference (P < 0.05 compared with FNAC in the diagnosis of benign and malignant hepatic masses. FNAC showed 100% diagnostic sensitivity for inflammatory lesions. Conclusion: Malignant tumors of liver can be confidently diagnosed on FNAC. However, FNAC has a few limitations and diagnostic challenges in benign lesions, well-differentiated and poorly differentiated hepatocellular carcinoma, and metastatic carcinoma. Microhistology by FNAB allows architectural, cellular and immunohistochemical evaluation. To obtain maximum

  11. Role of fluoroscopic guided fine needle aspiration biopsy in spinal pathologies

    Directory of Open Access Journals (Sweden)

    Chauhan Vijendra

    2006-01-01

    Full Text Available Background: The presence of vertebral lesion, whether symptomatic or not presents a diagnostic challenge. Open biopsy of spine is associated with considerable clinical morbidity. Hence it was decided to evaluate the efficacy of fluoroscopic guided fine needle aspiration biopsy (FGFNAB in providing a definitive diagnosis in pathologies of the spine and to determine the degree of co-relation between the histopathological diagnosis and the presumptive clinicoradiological diagnosis. Methods: A prospective study of 103 patients in whom a presumptive diagnosis was made by available imaging techniques (including magnetic resonance imaging was undertaken. All patients underwent histopathological /cytological examination for confirmation of the presumptive diagnosis, using material obtained through FGFNAB. Results: A definitive diagnosis was established, through FGFNAB, in 76 (73.8% patients. Non concordant diagnosis was seen in 13(12% of patients. In 27 (26.2% patients the results of FGFNAB were inconclusive. Conclusion: FGFNAB is a minimally invasive, technically easy, quick and cost-effective procedure. It can be done on an outpatient basis, under local anaesthesia and often eliminates the need for an open biopsy. FGFNAB can clinch the diagnosis early and helps institute definitive therapy. Hence we strongly recommend FGFNAB as a basic investigation in all pathological lesions of the spine.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Ultrasonography-Guided Fine-Needle Aspiration Biopsy of Predominantly Cystic Thyroid Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Hye Jin; Kim, Dong Wook [Busan Paik Hospital, Busan (Korea, Republic of)

    2010-02-15

    The aim of this study is to present our biopsy technique and to determine the efficacy of the ultrasound- guided fine-needle aspiration biopsy (US-FNAB) for predominantly cystic thyroid nodules (PCTNs). This study included patients that underwent US-FNABs on PCTNs, and were sampled for the solid component following the aspiration of a cystic component through one needle puncture between January to December of 2008. We retrospectively reviewed the cytopathology results as well as any complication associated with the procedure. Of the 76 PCTNs (range of maximal diameter: 0.4 cm-6.1 cm, mean: 2.39 cm) observed in the 75 patients (females: males = 63: 12, age range: 19-72, mean: 45.3 years old), the incidence rate of adequate and inadequate samples was 90.8% (69/76) and 9.2% (7/76) in the first US-FNAB, respectively. Further, 23 PCTNs were surgically removed in 22 patients, of which 15 PCTNs were benign and 8 were confirmed malignant nodules. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for USFNAB of PCTNs were 95.2%, 100%, 100%, 76.9%, and 95.8%, respectively. The data suggest that our technique for US-FNAB of PCTNs was effective and accurate.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Similar changes of gene expression in human skeletal muscle after resistance exercise and multiple fine needle biopsies.

    Science.gov (United States)

    Friedmann-Bette, Birgit; Schwartz, Fides Regina; Eckhardt, Holger; Billeter, Rudolf; Bonaterra, Gabriel; Kinscherf, Ralf

    2012-01-01

    Repeated biopsy sampling from one muscle is necessary to investigate muscular adaptation to different forms of exercise as adaptation is thought to be the result of cumulative effects of transient changes in gene expression in response to single exercise bouts. In a crossover study, we obtained four fine needle biopsies from one vastus lateralis muscle of 11 male subjects (25.9 ± 3.8 yr, 179.2 ± 4.8 cm, 76.5 ± 7.0 kg), taken before (baseline), 1, 4, and 24 h after one bout of squatting exercise performed as conventional squatting or as whole body vibration exercise. To investigate if the repeated biopsy sampling has a confounding effect on the observed changes in gene expression, four fine needle biopsies from one vastus lateralis muscle were also taken from 8 male nonexercising control subjects (24.5 ± 3.7 yr, 180.6 ± 1.2 cm, 81.2 ± 1.6 kg) at the equivalent time points. Using RT-PCR, we observed similar patterns of change in the squatting as well as in the control group for the mRNAs of interleukin 6 (IL-6), IL-6 receptor, insulin-like growth factor 1, p21, phosphofructokinase, and glucose transporter in relation to the baseline biopsy. In conclusion, multiple fine needle biopsies obtained from the same muscle region can per se influence the expression of marker genes induced by an acute bout of resistance exercise. PMID:22052872

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

    Science.gov (United States)

    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.

  17. Thyroid cancer detected by ultrasound-guided fine-needle aspiration biopsy.

    Science.gov (United States)

    Yokozawa, T; Fukata, S; Kuma, K; Matsuzuka, F; Kobayashi, A; Hirai, K; Miyauchi, A; Sugawara, M

    1996-09-01

    A greater percentage of thyroid cancers can be detected by ultrasound-guided fine-needle aspiration biopsy (UG-FNAB) than by ordinary FNAB. A group of 678 patients were selected sequentially as having been diagnosed with benign nodules by the conventional FNAB method. We reexamined these patients by UG-FNAB and investigated the types of thyroid cancer that were missed by the conventional FNAB. Of the 678 patients diagnosed with benign nodules (using conventional FNAB), 571 (84.2%) demonstrated the same diagnosis when UG-FNAB was used. The remaining 107 patients (15.8%) studied were suspected of having a malignancy after UG-FNAB had been performed. Surgical specimen histology proved thyroid cancer in 99 of the 107 patients: 93 had papillary carcinoma, 4 had follicular carcinoma, 1 had medullary carcinoma and 1 had anaplastic carcinoma. Two drawbacks were noted when conventional FNAB was used: (1) cancer lesions difficult to palpate (n = 55) (e.g., small cancers with or without benign lesions or cancers associated with Hashimoto's thyroiditis or Graves' disease); and (2) palpable cancers with insufficient cell material for analysis (n = 44) (e.g., cystic carcinoma and cancers with calcified lesions. UG-FNAB is a powerful technique for detecting microcancers, cystic carcinomas, cancers associated with benign nodules, Hashimoto's thyroiditis, or coarse calcifications. PMID:8678961

  18. Diagnosing breast lesions by fine needle aspiration cytology or core biopsy: which is better?

    Science.gov (United States)

    Tse, Gary M; Tan, Puay-Hoon

    2010-08-01

    Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) are widely used in diagnosing breast lesions, with both achieving high sensitivity and specificity. Whether FNAC or CNB is better remains highly controversial. In this review, the advantages and disadvantages of each of these methods are discussed, especially in relation to specific problematic groups of breast lesions. In general, CNB has a slight advantage with lower inadequate and suspicious rates, allowing easier grade assessment and ancillary testings (hormome receptors, HER2) in cases of cancers. FNAC cannot reliably predict invasion in a malignant aspirate, whereas CNB, although useful in confirming invasion in carcinomas, has a much lower efficacy in predicting invasion when only in situ carcinoma is detected. The other problematic areas are papillary breast lesions and fibroepithelial lesions, notably phyllodes tumors. In papillary lesions, FNAC diagnosis is inaccurate, but with CNB, one can confidently diagnose papillary lesion, although there is still significant false positive and false negative rates, even with immunohistochemistry. For fibroepithelial lesions, using either FNAC or CNB to differentiate between a phyllodes tumor from fibroadenoma is also inaccurate. As management of breast diseases necessitates the triple approach (clinical, imaging and pathological), an awareness of the limitations of these very useful diagnostic modalities by all specialists is prudent, especially when dealing with these specific groups of breast lesions. PMID:20526738

  19. Preparation and using phantom lesions to practice fine needle aspiration biopsies.

    Science.gov (United States)

    Shidham, Vinod B; Varsegi, George M; D'Amore, Krista; Shidham, Anjani

    2009-01-01

    Currently, health workers including residents and fellows do not have a suitable phantom model to practice the fine- needle aspiration biopsy (FNAB) procedure. In the past, we standardized a model consisting of latex glove containing fresh cattle liver for practicing FNAB. However, this model is difficult to organize and prepare on short notice, with the procurement of fresh cattle liver being the most challenging aspect. Handling of liver with contamination-related problems is also a significant draw back. In addition, the glove material leaks after a few needle passes, with resulting mess. We have established a novel simple method of embedding a small piece of sausage or banana in a commercially available silicone rubber caulk. This model allows the retention of vacuum seal and aspiration of material from the embedded specimen, resembling an actual FNAB procedure on clinical mass lesions. The aspirated material in the needle hub can be processed similar to the specimens procured during an actual FNAB procedure, facilitating additional proficiency in smear preparation and staining. PMID:19893483

  20. 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.

  1. Multiparametric analysis of fine needle aspirate biopsies from parotid tumors by laser scanning cytometry (LSC)

    Science.gov (United States)

    Gerstner, Andreas O.; Machlitt, Julia; Mueller, Anne-Kathrin; Tarnok, Attila; Oeken, Jens; Bootz, Friedrich

    2002-06-01

    In order to minimize hospitalization and morbidity with optimized therapy for a patient with a tumor of the parotid gland a malignancy must be confirmed or excluded as soon as possible. Up to now, non- and minimal-invasive methods do not yield this information. For fine needle aspirate biopsies (FNABs), analysis by a specialized cytologist yields subjective and qualitative but not objective and quantitative data. LSC is a semi-automated microscope-based technology and offers ideal prerequisites for the analysis of specimens fixed on a slide. We have established an assay for FNABs from parotid gland tumors. Cells are stained for cytokeratin and DNA. The analysis quantitatively determines the ploidy of the cells and the degree of condensation of the DNA; on this basis the percentage of cells undergoing mitosis can be determined. Subsequently the cells are stained by H&E and are re-localized on the slide at their fixed position. Micrographs are taken for objective documentation of the cells' morphology. Using this assay FNABs from parotid gland tumors were analyzed; tumors that were diagnosed as benign by routine histopathology showed no aneuploidy whereas malignant tumors were aneuploid. This preliminary study demonstrates the capacities of LSC for minimal-invasive assays yielding quantitative and objective data.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    OpenAIRE

    Giusti, Massimo; Dolcino, Mara; Vera, Lara; Ghiara, Carla; Massaro, Francesca; Fazzuoli, Laura; Ferone, Diego; Mussap, Michele; Minuto, Francesco

    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 hyperparathyroidism (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, scintigr...

  4. CT-Guided Pancreatic Percutaneous Fine-Needle Biopsy in Differential Diagnosis between Pancreatic Cancer and Chronic Pancreatitis

    OpenAIRE

    Michele Carlucci; Alessandro Zerbi; Danilo Parolini; Sandro Sironi; Angelo Vanzulli; Carlo Staudacher; Agostino Faravelli; Paola Garancini; Alessandro del Maschio; Valerio di Carlo

    1989-01-01

    Differential diagnosis between pancreatic cancer and chronic pancreatitis is still difficult to establish. In 63 patients with suspected pancreatic neoplasm we performed: serum CA 19-9 assessment, abdominal ultrasound, CT scan and CT-guided pancreatic percutaneous fine-needle biopsy. The conclusive diagnosis was pancreatic cancer in 40 patients and chronic pancreatitis in 23 patients. With regard to the differential diagnosis, sensitivity and specificity were respectively 80% and ...

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  9. Risk factors of pneumothorax in percutaneous fine needle aspiration biopsy of the lung

    International Nuclear Information System (INIS)

    Percutaneous fine needle aspiration biopsy is known to be a useful diagnostic method for the diagnosis of various pulmonary diseases. Its diagnostic yield is high, and it is safe, but complications such as pneumothorax can occasionally occur. We reviewed the complications arising after needle aspiration biopsy and analyzed the risk factors of pneumothorax. The medical records and radiographic studies of 157 patients with various pulmonary diseases who underwent needle aspiration biopsy of the lung between 1990 and 1996 were retrospectively reviewed. The clinical features, treatment, and courses of complications were reviewed, and risk factors of pneumothorax such as depth and size of lesion, diameter of needle, number of punctures, and obstructive pulmonary abnormalities were analyzed. Complications occurred in 40 of 157cases(25.5%), namely pneumothorax in 26(16.6%), hemoptysis in 11(7%), hemothorax in two(1.3%), and recurrence of malignancy at the site of aspiration in one(0.6%). When the patients were divided into three groups according to depth of lesion, there were significant difference in the incidence of pneumothorax;the results were as follows:less than 2cm, 12.9%;between 2 and 4cm, 24.1%;and larger than 4cm, 57.1%(p<0.05). In pulmonary function testing, FVC(Forced Vital Capacity) of patients with pneumothorax was less than that of patients without(2.6±0.9L vs 3.1±0.8L, p<0.05), but FEV1(Forced Expiratory Volume in 1 second), FEV1%(percentage of predicted FEV1), FEV1/FVC, and FVC% (percentage of predicted FVC) were not different between the two groups. The incidence of pneumothorax in patients with pleura-at-tached lesion (9%) was lower than that of those with non-attached lesion(26%, p=3D0.01). The age of patients, size of lesion, diameter of the needle, guidance methods and number of aspirations showed no significant relationship with pneumothorax. In needle aspiration biopsy of the lung, depth of lesion and passage of a needle through aerated lung are

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

    Science.gov (United States)

    Kalogeraki, Alexandra; Papadakis, Georgios Z; Tamiolakis, Dimitrios; Karvela-Kalogeraki, Iliana; Karvelas-Kalogerakis, Mihailos; Segredakis, John; Papadakis, Michael; Moustou, Eleni; Datseri, Galateia; Tzardi, Maria

    2016-01-01

    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 such as tumors

  11. Ultrasound-Guided Fine-Needle Aspiration Biopsy in Infracentimetric Thyroid Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang Su; In, Hyun Sin; Eun, Choong Ki [Busan Paik Hospital, Inje University School of Medicine, Busan (Korea, Republic of)

    2010-03-15

    The aim of this study is to determine the efficacy of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) of thyroid nodules that are equal to or less than 1 cm at the maximum diameter. The US-FNABs performed on thyroid nodules from March to August 2009 were included in this study. We retrospectively evaluated the cytopathologic results as well as any complications associated with the procedure. Of the 241 thyroid nodules (range: 0.1 - 1.0 cm, mean size: 5.8 mm) in 184 patients (female: male = 164:20, mean age: 49.0 years, age range: 18 - 77 years old), the incidence of an inadequate sample was 14.1% (34/241) for the US-FNABs. Eighty six nodules were surgically removed in 62 patients, of which 15 were confirmed to be benign nodules and 71 were confirmed to be malignant nodules. The number of true positive, false positive, true negative and false negative results for US-FNAB were 59, 0, 10 and 3%, respectively, and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 95.2%, 100%, 100%, 76.9% and 95.8%, respectively. All the false negative cases were less than 3 mm at the maximal diameter. There were no serious complications in all the patients. US-FNAB was effective for the cases of thyroid nodule under 1 cm at the maximal diameter. However, a false negative result of US-FNAB should be considered for the cases of very small nodules that are less than 3 mm at the maximal diameter

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  13. Fine Needle Aspiration Biopsy and/or Tissue Biopsy for Avoiding Surgery Complication in Patients with Peripancreatic Tuberculosis

    Directory of Open Access Journals (Sweden)

    Enver Ilhan

    2009-05-01

    Full Text Available Dear Sir, Peripancreatic tuberculosis is rarely seen. It is more widespread in countries with high endemicity for tuberculosis than in developed countries and the immunocompromized population. It may mimic a carcinoma of the pancreas, acute pancreatitis or chronic pancreatitis, or present with biliary obstruction [1, 2]. Diagnosing pancreatic tuberculosis is often difficult. Histopathological or microbiological evaluation can confirm the etiology. Ultrasound, CT scan and endoscopic ultrasound (EUS, guided aspiration and definitive tissue diagnosis are feasible techniques. Image-guided FNA biopsy of the pancreas, a safe procedure, has an overall sensitivity of 64-98%, a specificity of 80-100% and a positive predictive value of 98.4-100%. When fine needle aspiration cytology (FNAC and polymerase chain reaction (PCR were combined, the sensitivity and specificity increased to 84% and 100%, respectively. EUS is today considered to be the most suitable investigative tool for differentiating a benign from a malignant pancreatic lesion. EUS provides an accurate and safe diagnosis without the risk, cost and time delay involved in an open biopsy or laparotomy. When not available, expensive investigations such as CECT and MRI with guided biopsy have to be resorted to. Exploratory laparotomy may be required in technically difficult cases due to the risk of injury to vessels in the vicinity of the mass [3, 4].

  14. K-ras gene mutation in the diagnosis of ultrasound guided fine-needle biopsy of pancreatic masses

    Institute of Scientific and Technical Information of China (English)

    Min Zheng; Lian-Xin Liu; An-Long Zhu; Shu-Yi Qi; Hong-Chi Jiang; Zhu-Ying Xiao

    2003-01-01

    AIM: To investigate the utility of K-ras mutation analysis ofultrasound guided fine-needle aspirate biopsy of pancreaticmasses.METHODS: Sixty-six ultrasound guided fine-needle biopsieswere evaluated by cytology, histology and k-ras mutation.The mutation at codon 12 of the k-ras oncogene wasdetected by artificial restriction fragment lengthpolymorphisms using Bst NI approach.RESULTS: The presence of malignant cells was reported in40 of 54 pancreatic carcinomas and K-ras mutations weredetected in 45 of the 54 FNABs of pancreatic carcinomas. Thesensitivity of cytology and k-ras mutation were 74 % and 83%, respectively. The speciality of cytology and k-ras mutationwere both 100 %. The sensitivity and speciality of k-ras mutationcombined with cytology were 83 % and 100 %, respectively.CONCLUSION: High diagnostic accuracy with acceptablediscomfort of FNAB make it useful in diagnosis of pancreaticcarcinoma. Ultrasound guided fine-needle biopsy is a safeand feasible method for diagnosing pancreatic cancer.Pancreatic carcinoma has the highest K-ras mutation rateamong all solid tumors. The mutation rate of k-ras is about80-100 %. The usage of mutation of codon 12 of k-rasoncogene combined with cytology is a good alternative forevaluation of pancreatic masses.

  15. Ultrasound guided fine needle aspiration biopsy of parathyroid gland and lesions

    Directory of Open Access Journals (Sweden)

    Dimashkieh Haytham

    2006-03-01

    Full Text Available Abstract Background Parathyroid gland and their tumors comprise a small proportion of non-palpable neck masses that are investigated by ultrasound (US guided fine needle aspiration biopsy. We reviewed our institution's cases of US guided FNAB of parathyroid gland and their lesions to determine the role of cytology for the preoperative diagnosis of parathyroid gland and their lesions. Method All cases of FNAB of parathyroid gland and lesions in the last 10 years were reviewed in detail with respect to clinical history and correlated with the histopathologic findings in available cases. The cytologic parameters that were evaluated included cellularity assessed semiquantitatively as scant, intermediate or abundant (500 cells, cellular distribution (loose clusters, single cells/naked nuclei, rounded clusters, two- and three-dimensional clusters, and presence of prominent vascular proliferation, cellular characteristics (cell size, nuclear shape, presence/absence of a nucleolus, degree of mitosis, amount of cytoplasm, and appearance of nuclear chromatin, and background (colloid-like material and macrophages. Immunostaining for parathyroid hormone (PTH was performed on selected cases using either destained Pap smears or cell block sections. Results Twenty cases of US-guided FNAB of parathyroid glands and their lesions including 13 in the expected locations in the neck, 3 in intrathyroid region, 3 in thyroid bed, and 1 metastatic to liver were studied. Majority of the cases showed intermediate cellularity (51–500 cells with round to oval cells that exhibited a stippled nuclear chromatin, without significant pleomorphism or mitotic activity. The cells were arranged in loose two dimensional groups with many single cells/naked nuclei around the groups. Occasionally macrophages and colloid like material was also encountered. There was no significant difference in the cytomorphologic features between normal gland, hyperplasia adenoma, or carcinoma

  16. Sparing sentinel node biopsy through axillary lymph node fine needle aspiration in primary breast cancers

    OpenAIRE

    Cheng, Yu-Shu; Kuo, Shou-Jen; Chen, Dar-Ren

    2013-01-01

    Background Axillary lymph node status is an important staging and prognostic factor in breast cancer. This study aimed to evaluate the efficacy of axilla fine needle aspiration cytology (FNAC) in primary breast cancer without a palpable node and even without image characteristics of a metastatic node. Methods From June 2008 to January 2012, 77 patients met the inclusion criteria of having received a FNAC procedure during the diagnostic protocol of primary breast cancer with the characteristic...

  17. The role of fine-needle aspiration biopsy in the dynamic monitoring of patients with nodular goiter

    Directory of Open Access Journals (Sweden)

    G Semkina

    2012-09-01

    Full Text Available Review of the literature devoted to the relevance of fine-needle aspiration biopsy in the diagnosis of thyroid nodules. Application of the new classification system, the interpretation of FNA can significantly increase the reproducibility of the method and reduce the number of false-negative results. This review summarizes recent data on the epidemiology of thyroid nodules, new system of the interpretation of FNA cytology findings, the role of FNA in the dynamic monitoring of benign tumors of thyroid gland.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature.

    Science.gov (United States)

    Mitra, Suvradeep; Dey, Pranab

    2016-01-01

    In recent times, the diagnosis of breast lesions has mostly become dependent on core needle biopsies (CNBs) with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). Both the procedures have their pros and cons and outsmart each other taking into account different parameters. Both the methods are found to be fraught with loopholes, taking into account different performance indices, diagnostic accuracy and concordance, patient benefit, and cost-effectiveness. Unlike the popular belief of an absolute superiority of CNB over FNAC, the literature review does not reveal a very distinct demarcation in many aspects. We recommend judicious use of these diagnostic modalities in resource-limited settings and screening programs taking into account parameters such as palpability and availability of an experienced cytopathologist. PMID:27651820

  20. 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

  1. 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.

  2. Tumour seeding after fine-needle aspiration and core biopsy of the head and neck--a systematic review.

    Science.gov (United States)

    Shah, Keval S V; Ethunandan, Madan

    2016-04-01

    Although fine-needle aspiration cytology (FNAC) and core needle biopsy are essential diagnostic investigations of lumps in the head and neck, seeding along the needle track has long been a concern, and various factors have been implicated. We therefore searched the Medline database for relevant English language papers published between 1970 and 2014, excluding those on the thyroid and parathyroid, and systematically reviewed them to assess the risk. In the 610 articles reviewed we found only 7 reports of seeding (5 after FNAC and 2 after core needle biopsy). Tumours were found between 3 months and 3 years after the procedure in 4 cases, and in 3, tumour cells were found along the needle track between 0 and 33 days after the procedure. The needles varied in size from 18 - 22 gauge (G) and there were 3 to 4 passes. Four cases occurred after investigation of a mass in the salivary glands, and 3 after assessment of a cervical lymph node. Disease was benign in one and malignant in 6. Seeding along the needle track after FNAC or core needle biopsy of a lump in the head and neck is rarely reported, and an accurate estimate of its incidence is difficult to ascertain. Crude estimates suggest 0.00012% and 0.0011% after FNA and core needle biopsy, respectively. A distinction should be made between seeding that is seen shortly after the procedure and the development of tumour along the needle track. PMID:26837638

  3. 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...

  4. 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.

  5. Fine-Needle Aspiration Followed by Core-Needle Biopsy in the Same Setting: Modifying Our Approach.

    Science.gov (United States)

    Joudeh, Amani A; Shareef, Sameera Q; Al-Abbadi, Mousa A

    2016-01-01

    Fine-needle aspiration biopsy (FNAB) is a well-established initial diagnostic tool. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis. Consequently, patients have to undergo another diagnostic procedure. The second procedure is either repeat FNAB, core-needle or open biopsy, and can be inconvenient and costly. In some centers, the FNAB is immediately followed by core-needle biopsy (CNB) in the same setting after assuring adequacy on the initial FNAB utilizing rapid on-site specimen evaluation (ROSE). It is argued that implementing such an approach will eventually have additional critical advantages that include the following: (a) it is more convenient to patients to have both procedures in one visit, (b) the tissue procured by both procedures will be more adequate, enabling cytopathologists to reach an accurate diagnosis, and (c) it is ultimately a cost-effective approach if we take into consideration the avoidance of a potential second more invasive diagnostic procedure. Since we are living in an era of patient-centered medicine coupled with cost-cutting strategies, we present here a brief review of the topic with analysis of this alternative approach, review of the pertinent literature and shed light on a few scenarios that justify this approach. PMID:26963594

  6. Diagnostic accuracy of fine needle biopsy in the management of thyroid pathology in the Hospital Mexico in 2011-2012

    International Nuclear Information System (INIS)

    The nodule has been a very common thyroid pathology; through palpation is located in a 5% of the population and through ultrasound this figure has increased by almost 50%. The thyroid nodule has been the shape of presentation of thyroid cancer; the majority of times asymptomatic and most recently has shown without relation to the size of the nodule, 5 to 15% of thyroid nodules are malignant. This requires to classify clinically, to decide which patient requires surgical management. In Costa Rica, and especially in the CCSS (Caja Costarricense de Seguro Social); It has had two tools for perform differentiation: ultrasound and FNA (fine needle aspiration biopsy). The diagnostic accuracy of these tests has allowed minimize thyroid surgeries in patients with benign nodules and sift patients with thyroid nodules into search for cancer of thyroid. Previous to routine use of FNA was resected only 14% of malignant nodules, now are resected more than 50%. The diagnostic accuracy of these tests is related to technical aspects and also with the structural and histological features of the lesions valued. The limitations and scope described have allowed to optimize the utilization of direct and indirect costs related to the management of patients with thyroid nodules and decrease morbidity in the management of thyroid pathology. The sensitivity and specificity of fine needle biopsy varies, as is noted in various publications, according to the reference center, has been quite reliable between 0.3 and 3 cm and is highly specific in the case of papillary carcinoma. The diagnostic accuracy of the test has never been studied in the Hospital Mexico. Of the total population for the period 2011-2012, it is documented that the FNA is a study of high specificity (95,5%), with value predictive negative and positive appropriate (>75%) and with an intermediate sensitivity (55,6%). The analysis of ultrasound and FNA as parallel testing has allowed greater sensitivity. The use of ultrasound

  7. CT-guided fine-needle biopsy (FNB) in histological characterization of mediastinum and lung lesions

    International Nuclear Information System (INIS)

    CT-guided percutaneous thin-needle biopsy is the method of choice in the histological characterization of mediastinum and lung lesions in which a diagnosis could not be reached trough non-invasive methods such as cytology of the sputum, or biopsy during bronchoscopy. FNB represents an alternative to diagnostic thoracotomy: it is, in fact, less invasive, it can be carried out with no need for hospitalization, and has low incidence of complicatios. FNB diagnostic accuracy 89,6%, sensitivity 87,6% and specificity 98%. Our series includes 419 percataneous fineneedle biopsies

  8. Management issues in breast lesions diagnosed by fine-needle aspiration and percutaneous core breast biopsy.

    Science.gov (United States)

    Levine, Pascale; Simsir, Aylin; Cangiarella, Joan

    2006-06-01

    The use offine-needle aspiration biopsy or percutaneous core needle biopsy to diagnose breast lesions has increased during the past few decades. Although the benefits of these procedures are well known, controversies remain about the management of certain categories of breast lesions detected by these methods. This article discusses the management issues in categories of breast lesions, including papillary lesions, atypical lobular hyperplasia and lobular carcinoma in situ, and mucinous lesions diagnosed by the preoperative techniques of aspiration or core biopsy. PMID:16830962

  9. 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

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

    International Nuclear Information System (INIS)

    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 pulmonary

  11. Establishing an accurate diagnosis of a parotid lump: evaluation of the current biopsy methods - fine needle aspiration cytology, ultrasound-guided core biopsy, and intraoperative frozen section.

    Science.gov (United States)

    Howlett, D C; Skelton, E; Moody, A B

    2015-09-01

    The optimum technique for histological confirmation of the nature of a parotid mass remains controversial. Fine needle aspiration cytology (FNAC), which has traditionally been used, is associated with high non-diagnostic and false negative rates, and ultrasound (US)-guided core biopsy and frozen section have been explored as alternatives. US-guided core biopsy is more invasive than FNAC, but is safe, well-tolerated, and associated with improved diagnostic performance. Although frozen section offers better specificity than FNAC, it has a number of important drawbacks and cannot be considered as a primary diagnostic tool. US-guided core biopsy should be considered as the initial diagnostic technique of choice, and in units where the accuracy of FNAC is good it can be used when FNAC is equivocal or non-diagnostic. PMID:25886878

  12. Comparison of fine needle aspiration biopsy and paraffin embedded tissue sections for measuring AgNOR proteins.

    Science.gov (United States)

    Tasdemir, S; Eroz, R; Cucer, N; Oktay, M; Türkeli, M

    2015-07-01

    Paraffin embedded tissue sections and fine needle aspiration biopsy (FNAB) are important methods for diagnosis. We compared thyroid tissue obtained by FNAB to paraffin embedded sections to determine whether there were differences in detection of the amounts of argyrophilic nucleolar organizing region (AgNOR) proteins. Twenty-two patients with papillary thyroid carcinoma were included in the study. Slides were prepared with both FNAB tissue and 3 μm sections of paraffin embedded tissue, and stained for AgNOR. One hundred nuclei per individual were evaluated; total AgNOR number/nucleus (TAn/TNn) and total AgNOR area/nuclear area (TAa/TNa) of individual cells were determined. Mean TAn/TNn and TAa/TNa values were 4.800 ± 1.118 and 13.382 ± 2.612, respectively, for FNAB samples; corresponding values were 2.406 ± 0.649 and 8.49 ± 0.893, respectively, for paraffin embedded sections. The differences between FNAB materials and paraffin embedded tissue sections were significant for the mean TAn/TNn and TAa/TNa values. Significant differences in the amounts of AgNOR protein detected were found between FNAB and paraffin embedded tissue sections.

  13. 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.

  14. 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

  15. Fine needle aspiration of the thyroid

    Science.gov (United States)

    Thyroid nodule fine needle aspirate biopsy; Biopsy - thyroid - skinny-needle; Skinny-needle thyroid biopsy ... cleaned. A thin needle is inserted into the thyroid, and a sample of thyroid cells and fluid ...

  16. Tissue Harvester with Functional Valve (THFV): Shidham's device for reproducibly higher specimen yield by fine needle aspiration biopsy with easy to perform steps

    OpenAIRE

    Basir Zainab; Rao R Nagarjun; Pandit Ashwini W; Shidham Vinod B; Shidham Anjani

    2007-01-01

    Abstract Background Fine needle aspiration biopsy (FNAB) cytology has been a highly effective methodology for tissue diagnosis and for various ancillary studies including molecular tests. In addition to other benefits, FNAB predominantly retrieves the diagnostic loosely cohesive cells in the lesion as compared to the adjacent supporting stroma with relatively higher cohesiveness. However, FNAB procedure performed with currently available resources is highly skill dependent with inter-performe...

  17. Fine needle aspirating and cutting is superior to Tru-cut core needle in liver biopsy

    Institute of Scientific and Technical Information of China (English)

    Guo-Ping Li; Gao-Quan Gong; Xiao-Lin Wang; Yi Chen; Jie-Min Cheng and Chang-Yu Li

    2013-01-01

    BACKGROUND: Liver  biopsy  is  the  "gold  standard"  for evaluating liver disorders, but controversies over the potential risk of complications and patient discomfort still exist. Using a 21G fine needle, we developed a new biopsy procedure, fine needle aspirating and cutting (FNAC). Our procedure obtains enough  tissue  for  pathological  examination  and  meanwhile, reduces the risk of biopsy complications. The present study was to determine the safety and efficiency of 21G FNAC compared with 18G Tru-cut core needle (TCN) in liver tumor biopsies. METHODS: Ninety-four patients with unresectable malignant tumors were included in this study. Patients were divided into 2 groups: 18G TCN and 21G FNAC. The total positive rate (TPR) and safety of both groups were compared. RESULTS: TPR was not different between the two groups. Liver puncture  track  subcapsular  hemorrhage  and  arteriovenous shunt  were  reported  with  18G  TCN  but  not  with  21G  FNAC. The incidence of pain caused by biopsy was higher for the 18G TCN group compared to the 21G FNAC group (P0.5  cm,  but  52.1%  in  the  21G  FNAC  group  (P CONCLUSIONS: TPR is not different between the 21G FNAC and 18G TCN biopsy procedures, but the safety of 21G FNAC is superior to that of 18G TCN. Tissues obtained by either of these two procedures are sufficient for a pathological diagnosis.

  18. 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.

  19. Pros and cons of fine needle aspiration biopsy in ocular tumors%眼内肿瘤细针穿刺活检的利与弊

    Institute of Scientific and Technical Information of China (English)

    魏文斌; 屠颖

    2012-01-01

    Fine-needle aspiration biopsy (FNAB) is an important method of intraocular tumors biopsy and often used in diagnosis of choroids tumors and primary intraocular lymphoma. The sensibility and specificity'of FNAB will increase with technique improvement of biopsy and handling the samples. Compared with other methods of intraocular biopsy, FNAB shows more convenient, quickly and safer. However, dissemination of tumor cells may still be the potential risk of FNAB. Indication of FNAB should be correctly selected before used. (Ophthalmol CHN, 2012, 21: 217-221)%细针穿刺眼内活检(fine-needle aspiration biopsy,FNAB)是眼内肿瘤诊断性活检的重要方法,常用于脉络膜肿瘤以及原发性眼内淋巴瘤的诊断.随着穿刺技术以及标本处理方法的改进,FNAB的诊断敏感性和特异性逐渐增加.与其他眼内活检方法相比,FNAB具有方便、快捷、安全的优点,但肿瘤的播散依然是其潜在的风险.临床应用FNAB需严格掌握其适应证.

  20. CT-guided fine-needle biopsy of focal lung lesions as the method for reducing the number of invasive diagnostic procedures

    International Nuclear Information System (INIS)

    Background: CT-guided fine-needle biopsy (FNB) of focal lung lesions is one of the possibilities of obtaining histopathological diagnosis in pulmonary diseases. Its place in the algorithm is determined by the invasiveness. In case of no diagnosis after bronchoscopy or endobronchial ultrasonography (EBUS) guided biopsy, CT-guided FNB can become an alternative for more invasive procedures, such as open lung biopsy - thoracotomy. Material/Methods: Since January 2009 until February 2010, we performed 37 CT-guided FNB in 34 patients aged 31 to 76 (mean age 60.9). Among them, there were 16 women and 18 men. All patients underwent a standard chest CT with contrast medium injection. They were diagnosed with focal lesions and they were rejected from surgery as the primary method of treatment. During biopsy, the patient was positioned prone or supine, depending on the location of lesions. After performing a scout image and initial slices, we marked the level of biopsy, using a metal marker. Next, the biopsy needle was introduced under local anesthesia. When the obtained position of the needle in the lesion was correct, the specimen was taken. After needle removal, the patient was controlled for the presence of complications (i.e. pneumothorax). Biopsy time ranged from 10 to 50 minutes. Results: In 94.6% of biopsies, the specimens for histopathological and cytological examinations were obtained. In 22 (64.7%) patients, histopathological diagnoses (in 14 cases this was the non-small cell cancer and in 8, inflammatory lesions) were established which allowed us to resign from invasive thoracotomy and to introduce an appropriate treatment. In the remaining 12 patients, no diagnosis was established. Complications in the form of a minor pneumothorax occurred in 2 patients. Conclusions: Fine-needle biopsy of the focal lung lesions is an affective and a relatively safe method, which can replace the more invasive diagnostic thoracotomy in the majority of patients. (authors)

  1. 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. 

  2. Significance of fine-needle aspiration biopsy of peripheral lymph nodes upon the initial presentation of patients with lymphadenopathy of unknown etiology

    Directory of Open Access Journals (Sweden)

    Mihaljević Biljana

    2006-01-01

    Full Text Available Fine-needle aspiration biopsy is safe, simple, cost-effective and efficient technique providing rapid information and, therefore, directing further approach to a patient. Its findings are especially beneficial for verification of lymphoid origin of the enlarged growth, diagnostics and differentiation of metastatic, infectious, reactive and lymphomatous conditions; determination of the extent of tumor; detection of recurrence; monitoring of the course of disease; obtaining of material for special studies such as microbiological cultures, immunological or genetic studies as well as electron microscopy; in addition, for encouragement of patient in case of benign nature of the disease. At the Institute of Hematology, in three-year period, a total of 193 fine-needle aspiration biopsies were performed in 172 patients with the enlarged peripheral lymph nodes. Technically, aspiration biopsy was successful in 175/193 attempted interventions (91%. Punctates were analyzed by cytomorphology and subsequently compared with histopathological findings. In indistinguishable cases, additional immunocytochemical streptavidin-biotin peroxidase staining was carried out. In our studies, immunocytochemical analysis was performed in 63 out of 81 patients (78%, and diagnostic accuracy was 93.6% what was compatible with the results of other authors. It significantly corrected the earlier cytomorphological-histological congruence that used to be 83%. Immunocytochemistry has contributed to diagnostic value of cytological analysis of punctate, before all, in view of its higher diagnostic accuracy, which, according to majority of authors, is about 90%.

  3. Histological diagnosis of gastric submucosal tumors: A pilot study of endoscopic ultrasonography-guided fine-needle aspiration biopsy vs mucosal cutting biopsy

    Institute of Scientific and Technical Information of China (English)

    Hisatomo; Ikehara; Zhaoliang; Li; Jiro; Watari; Masato; Taki; Tomohiro; Ogawa; Takahisa; Yamasaki; Takashi; Kondo; Fumihiko; Toyoshima; Tomoaki; Kono; Katsuyuki; Tozawa; Yoshio; Ohda; Toshihiko; Tomita; Tadayuki; Oshima; Hirokazu; Fukui; Ikuo; Matsuda; Seiichi; Hirota; Hiroto; Miwa

    2015-01-01

    AIM: To compare the usefulness of endoscopic ultrasonography-guided fine-needle aspiration biopsy(EUS-FNAB) without cytology and mucosal cutting biopsy(MCB) in the histological diagnosis of gastric submucosal tumor(SMT).METHODS: We prospectively compared the diagnostic yield, feasibility, and safety of EUS-FNAB and those of MCB based on endoscopic submucosal dissection. The cases of 20 consecutive patients with gastric SMT ≥1 cm in diameter. who underwent both EUS-FNAB and MCB were investigated.RESULTS: The histological diagnoses were gastrointestinal stromal tumors(n = 7), leiomyoma(n =6), schwannoma(n = 2), aberrant pancreas(n = 2), and one case each of glomus tumor, metastatic hepatocellular carcinoma, and no-diagnosis. The tumors’ mean size was 23.6 mm. Histological diagnosis was made in 65.0% of the EUS-FNABs and 60.0% of the MCBs, a nonsignificant difference. There were no significant differences in the diagnostic yield concerning the tumor location or tumor size between the two methods. However, diagnostic specimens were significantly more frequently obtained in lesions with intraluminal growth than in those with extraluminal growth by the MCB method(P = 0.01). All four SMTs with extraluminal growth were diagnosed only by EUSFNAB(P = 0.03). No complications were found in either method.CONCLUSION: MCB may be chosen as an alternative diagnostic modality in tumors showing the intraluminal growth pattern regardless of tumor size, whereas EUSFNAB should be performed for SMTs with extraluminal growth.

  4. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  6. Core-needle biopsy under CT fluoroscopy guidance and fine-needle aspiration cytology: Comparison of diagnostic yield in the diagnosis of lung and mediastinum tumors. Analysis of frequency and types of complications

    International Nuclear Information System (INIS)

    Patients with pathological tissue mass in thoracic cage found with imaging require histopathological or cytological confirmation of malignancy before treatment. The tissue material essential for patomorphological evaluation can be acquired with fine-needle aspiration biopsies (FNAB) controlled with CT and core-needle biopsy (CNB) under real-time CT fluoroscopy guidance. The purpose of this work is to carry out a retrospective analysis of the two methods with regards to their informativity, frequency and the kind of complications. From January, 2012 to May 2013, 76 core-needle biopsies of lung and mediastinum tumors were conducted and compared with 86 fine-needle aspiration biopsies(FNAB) of lung and mediastinum tumors, including 30 patients who underwent FNAB and were referred to CNB in order to specify the diagnosis. Complete histopathological diagnosis was made in 91% with the use of CNB and in 37% when FNAB was the chosen method. Early complications were observed in 32% patients who underwent BG and in group of 11% who underwent FNAB. Late complications, however, appeared in 29% patients after CNB and 13% after FNAB. In 24 cases CNB specified the complete diagnosis. Core-needle biopsy in comparison to fine-needle aspiration biopsy has more frequent rate of negligible complications, however, it offers higher diagnostic yield for diagnostic of lung and mediastinum neoplastic disease and allows for more precise diagnosis of focal lesions

  7. Sonographically guided fine-needle biopsy of thyroid nodules: the effects of nodule characteristics, sampling technique, and needle size on the adequacy of cytological material

    Energy Technology Data Exchange (ETDEWEB)

    Degirmenci, B. [Department of Radiology, Faculty of Medicine, University of Kocatepe, Afyonkarahisar (Turkey)]. E-mail: bumin.degirmenci@gmail.com; Haktanir, A. [Department of Radiology, Faculty of Medicine, University of Kocatepe, Afyonkarahisar (Turkey); Albayrak, R. [Department of Radiology, Faculty of Medicine, University of Kocatepe, Afyonkarahisar (Turkey); Acar, M. [Department of Radiology, Faculty of Medicine, University of Kocatepe, Afyonkarahisar (Turkey); Sahin, D.A. [Department of General Surgery, Faculty of Medicine, University of Kocatepe, Afyonkarahisar (Turkey); Sahin, O. [Department of Pathology, Faculty of Medicine, University of Kocatepe, Afyonkarahisar (Turkey); Yucel, A. [Department of Radiology, Faculty of Medicine, University of Kocatepe, Afyonkarahisar (Turkey); Caliskan, G. [Department of Radiology, Faculty of Medicine, University of Kocatepe, Afyonkarahisar (Turkey)

    2007-08-15

    Aim: To evaluate the effects of sonographic characteristics of thyroid nodules, the diameter of needle used for sampling, and sampling technique on obtaining sufficient cytological material (SCM). Materials and methods: We performed sonography-guided fine-needle biopsy (FNB) in 232 solid thyroid nodules. Size-, echogenicity, vascularity, and localization of all nodules were evaluated by Doppler sonography before the biopsy. Needles of size 20, 22, and 24 G were used for biopsy. The biopsy specimen was acquired using two different methods after localisation. In first method, the needle tip was advanced into the nodule in various positions using a to-and-fro motion whilst in the nodule, along with concurrent aspiration. In the second method, the needle was advanced vigorously using a to-and-fro motion within the nodule whilst being rotated on its axis (capillary-action technique). Results: The mean nodule size was 2.1 {+-} 1.3 cm (range 0.4-7.2 cm). SCM was acquired from 154 (66.4%) nodules by sonography-guided FNB. In 78 (33.6%) nodules, SCM could not be collected. There was no significant difference between nodules with different echogenicity and vascularity for SCM. Regarding the needle size, the lowest rate of SCM was obtained using 20 G needles (56.6%) and the highest rate of adequate material was obtained using 24 G needles (82.5%; p = 0.001). The SCM rate was 76.9% with the capillary-action technique versus 49.4% with the aspiration technique (p < 0.001). Conclusion: Selecting finer needles (24-25 G) for sonography-guided FNB of thyroid nodules and using the capillary-action technique decreased the rate of inadequate material in cytological examination.

  8. Ultrasonography and fine-needle aspiration cytology can spare breast cancer patients unnecessary sentinel lymph node biopsy

    NARCIS (Netherlands)

    M.C. van Rijk; E.E. Deurloo; O.E. Nieweg; K.G.A. Gilhuijs; J.L. Peterse; E.J.T. Rutgers; R. Kroger; B.B.R. Kroon

    2006-01-01

    Background: Some 30% to 40% of the breast cancer patients scheduled for sentinel node biopsy have axillary metastasis. Pilot studies suggest that ultrasonography is useful in the preoperative detection of such nodes. The aims of this study were to evaluate the sensitivity of preoperative ultrasonogr

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  10. 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.

  11. A COMPARATIVE STUDY OF FINE NEEDLE ASPIRATION CYTOLOGY AND OPEN BIOPSY IN THE DIAGNOSIS OF CERVICAL LYMPHADENOPATHY IN RURAL TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Karunamoorthy

    2016-04-01

    Full Text Available ABSTRACT Lymphadenopathy is a very common clinical manifestation of many diseases, defined as an abnormality in the size or character of lymph nodes, caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node. The clinical examination may be inaccurate in differentiating benign from neoplastic enlargement of the lymph node. Surgical excision of a palpable peripheral lymph node is relatively simple; it does require anaesthesia, strict sterility and theatre time and it leaves behind a scar. Fine needle aspiration cytology offers the advantages of an immediate with little cost and trauma. The present study is being undertaken to evaluate its accuracy in the diagnosis of tuberculosis and malignancy of the cervical lymph nodes. AIM AND OBJECTIVE To assess the usefulness of FNAC in the diagnosing cervical lymph node enlargement and cytological features of common pathological conditions affecting the lymph nodes and to evaluate the diagnostic accuracy of FNAC and open biopsy in cervical lymphadenopathy. MATERIALS AND METHODS A total of 100 patients were subjected for the study at CMCH and RC, Irungalur. FNAC was performed under aseptic precaution of the cervical lymph nodes using a 22G needle and HPE correlation was obtained for these patients remaining. These patients were subjected to surgical excision for radical dissection and the HPE correlation for specimen was obtained. RESULTS The result shows that the age wise distribution of patient with benign lesions were within 21-25 age groups and those with malignant lesion were in 31-50 age groups. Among the incidence of male-to-female ratio was 107:93. The duration of symptom was <6 months (<3 cm 50%/3-6 months 45%. The gross morphology shows that TB adenitis patient with positive matting nodes were 18 out of 25 patients were positive for matted nodes (94.47%. According to AJCC cancer staging the size of the nodes were assessed, which shows most of the nodes <3

  12. Should fine needle aspiration biopsy be the first pathological investigation in the diagnosis of a bone lesion? An algorithmic approach with review of literature

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    Mehrotra Ravi

    2007-01-01

    Full Text Available Abstract Background Fine needle aspiration biopsy (FNAB is gaining increasing popularity in the diagnosis of musculoskeletal lesions; and in many patients, a definitive diagnosis can be rendered from aspiration smears alone. Its applicability in bone pathology, however, has been controversial due to a high percentage of inadequate smears, difficulty in evaluation of tissue architecture and nonspecific results in the diagnosis of primary bone lesions. In this study, the value of aspiration as the first pathological investigation in the diagnosis of a bone lesion was evaluated. Methods 91 cases of clinically suspected cases of bone lesions were aspirated over a period of two years. Direct or cytospin smears were fixed in 95% alcohol and stained by Hematoxylin and Eosin or air-dried and later fixed in methanol for May Grŭnwald Giemsa staining. Results Of the 91 patients who were subjected to FNAB, 81 were considered satisfactory and 10.9 % (10 were inadequateinconclusive for diagnosis. Cyto-histological concordance was obtained in 78.5 % (51/65 patients. Positive and negative predictive values were 87.5% and 97.2 % respectively. Sensitivity as a preliminary diagnostic technique was 93.3%, whereas specificity was 94.5 %. Overall, diagnostic accuracy was 94.2 %. Metastatic lesions were detected with 100% accuracy. Two cases were reported as false positive and one case as false negative. Conclusion Cytology provides valuable information to the clinician to make an informed decision regarding appropriate therapy. We conclude that time-consuming and costly investigations may be reduced by choosing FNAB as the initial pathological diagnostic method for skeletal lesions of unknown origin. The choice of radiological examinations, laboratory tests and surgical biopsies can be determined after the FNAB diagnosis.

  13. [Fine needle aspiration cytology of mammography screening

    DEFF Research Database (Denmark)

    Engvad, B.; Laenkholm, A.V.; Schwartz, Thue W.;

    2009-01-01

    diagnostic classes were introduced. The aim of this study was to evaluate the quality assurance programme in a screening population to determine whether fine needle aspiration cytology (FNAC) as first choice remains a useful tool in the preoperative diagnostics, or if needle core biopsy should be the first...

  14. 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.

  15. Ultrasound-Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules Smaller Than 5 mm in the Maximum Diameter: Assessment of Efficacy and Pathological Findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Wook; Park, Auh Whan; Lee, Eun Joo; Choo, Hye Jung; Kim, Sang Hyo; Lee, Sang Hyub; Eom, Jae Wook [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2009-10-15

    The aim of this study was to determine the efficacy of the use of an ultrasound-guided fine-needle aspiration biopsy (US-FNAB) to diagnose thyroid nodules smaller than 5 mm in the maximum diameter and to evaluate pathological findings of small thyroid malignancies. From May 2007 to April 2008, we evaluated the findings of US-FNABs of small thyroid nodules less than 5 mm in the maximum diameter. The cytopathological findings were retrospectively reviewed and the diagnostic performance of the use of an US-FNAB was examined in all patients. Of 201 small thyroid nodules in 180 patients, there were 162 adequate specimens (81%). Among 180 patients, 75 patients underwent thyroid surgery and 50 malignant and 33 benign nodules were identified based on a pathological examination. All small malignant thyroid nodules were identified as papillary thyroid microcarcinomas (PTMCs). There were 34 (55%) true positive, 0 (0%) false positive, 23 (37%) true negative and five (8%) false negative results for malignancy after performing a first US-FNAB in 62 surgically confirmed nodules. The sensitivity (87%), specificity (100%), positive predictive value (100%), negative predictive value (82%), accuracy (92%), false positive rate (0%) and false negative rate (8%) for an US-FNAB were determined. In 23 patients with a primary PTMC, capsular invasion (9%, 2 of 23), a perithyroidal lymph node metastasis (30%, 7 of 23), the rate of multifocality (9%, 2 of 23) and bilaterality (4%, 1 of 23) were also determined. An US-FNAB of thyroid nodules smaller than 5 mm in the maximum diameter is an effective diagnostic procedure.

  16. Histopathologic Findings Related to the Indeterminate or Inadequate Results of Fine-Needle Aspiration Biopsy and Correlation with Ultrasonographic Findings in Papillary Thyroid Carcinomas

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    Jung, So Lyung; Jung, Chan Kwon; Kim, Sung Hun; Kang, Bong Joo; Ahn, Kook Jin; Kim, Bum Soo; Ahn, Myeong Im; Im, Dong Jun; Bae, Ja Sung; Chung, Soo Kyo [Seoul St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of)

    2010-04-15

    To determine histopathologic findings related to the indeterminate or inadequate result of fine-needle aspiration biopsy (FNAB) in papillary thyroid carcinomas (PTCs) and to correlate histopathological findings with ultrasonographic features of tumors. We retrospectively reviewed the medical records of FNAB, histopathologic characteristics, and sonographic findings of the solid portion of 95 PTCs in 95 patients. All cases were pathologically confirmed by surgery. Histopathologic characteristics were analyzed for tumor distribution, microcystic changes, fibrosis, and tumor component. We assumed several histopathologic conditions to be the cause of indeterminate or inadequate results of FNAB, including: 1) an uneven tumor distribution, 2) > 30% microcystic changes, 3) > 30% fibrosis, and 4) < 30% tumor component. Ultrasonographic findings of each PTC were evaluated for echotexture (homogeneous or heterogeneous), echogenicity (markedly hypoechoic, hypoechoic, isoechoic, or hyperechoic), and volume of the nodule. We correlated histopathologic characteristics of the PTC with results of the FNAB and ultrasonographic findings. From 95 FNABs, 71 cases (74%) were confirmed with malignancy or suspicious malignancy (PTCs), 21 (22%) had indeterminate results (atypical cells), and three (4%) were negative for malignancy. None of the assumed variables influenced the diagnostic accuracy of FNAB. Tumor distribution and fibrosis were statistically correlated with ultrasonographic findings of the PTCs (p < 0.05). Uneven tumor distribution was related with small tumor volume, and fibrosis over 30% was correlated with homogeneous echotexture, markedly hypoechoic and hypoechoic echogenicity, and small tumor volume (p < 0.05). No histopathologic component was found to correlate with improper results of FNAB in PTCs. In contrast, two histopathologic characteristics, uneven distribution and fibrosis, were correlated with ultrasonographic findings.

  17. Tissue Harvester with Functional Valve (THFV: Shidham's device for reproducibly higher specimen yield by fine needle aspiration biopsy with easy to perform steps

    Directory of Open Access Journals (Sweden)

    Basir Zainab

    2007-03-01

    Full Text Available Abstract Background Fine needle aspiration biopsy (FNAB cytology has been a highly effective methodology for tissue diagnosis and for various ancillary studies including molecular tests. In addition to other benefits, FNAB predominantly retrieves the diagnostic loosely cohesive cells in the lesion as compared to the adjacent supporting stroma with relatively higher cohesiveness. However, FNAB procedure performed with currently available resources is highly skill dependent with inter-performer variability, which compromises its full potential as a diagnostic tool. In this study we report a device overcoming these limitations. Methods 'Tissue Harvester with Functional Valve' (THFV was evaluated as part of a phase 1 National Institute of Health (NIH research grant under Small Business Technology Transfer (STTR Program. Working prototypes of the device were prepared. Each of the four cytopathologists with previous cytopathology fellowship training and experience in performing FNAB evaluated 5 THFV and 5 hypodermic needles resulting in 40 specimens (20 with THFV, 20 with hypodermic needles. A piece of fresh cattle liver stuffed in latex glove was used as the specimen. Based on these results a finished design was finalized. Results The smears and cell blocks prepared from the specimens obtained by THFV were superior in terms of cellularity to specimens obtained with hypodermic needles. The tissuecrit of specimens obtained with THFV ranged from 70 to 100 μl (mean 87, SD 10, compared to 17 to 30 μl (mean 24, SD 4 with conventional hypodermic needles (p Conclusion The specimen yield with the new THFV was significantly higher when compared to hypodermic needles. Also, the FNAB procedure with THFV was relatively easier in comparison with hypodermic needles. The final version of Shidham's THFV device would improve the FNAB specimen yield by eliminating the skill factor. The increased specimen yield by this device would also facilitate wider application of

  18. 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.

  19. Cytological and sonographic correlation of the biopsies by fine needle aspiration (FNAB) of thyroid nodules in the Hospital San Rafael de Alajuela of July 1, 2006 to February 28, 2007

    International Nuclear Information System (INIS)

    The importance of the use of aspiration biopsy with ultrasonic-guided fine needle is recognized as screening method for diagnosis of thyroid nodules. Thyroid nodules are very common, the prevalence of palpitation has been estimated by 4% and 6% by ultrasound. The prevalence in autopsy data of patients with no history of thyroid pathology has been up to 50%. The use set of advanced imaging techniques and modified techniques of biopsy is implemented in order to increase the diagnostic security of thyroid lesions. The incidental finding of thyroid nodules or incidentalomas has soared dizzily, since the advent of ultrasound as an element in the valuation of thyroid disease and thyroid in the neck. Incidence has been reported even up to 40%. A growing number of endocrinologists are using aspiration biopsy with ultrasound guided fine needle of thyroid nodules as initial diagnostic procedure to identify discrete nodules with a direct location. The percentage of malignant nodules or that require surgery by size or symptomatology, generally, is very low, had to be established a systematic approach to reducing morbidity and mortality associated with major surgery of the neck and reduce costs. The biopsy by fine needle aspiration has been a well established diagnostic technique for preoperative evaluation of thyroid nodules, which has led a significant reduction in the number of unnecessary surgeries in most centers has been between 35-75%. This biopsy has been a specific method, sensitive and inexpensive. The sonographic guidance for biopsy by fine needle aspiration offers the following benefits: is safe and inexpensive, able to reduce costs in 25%, minimally invasive and highly effective, this guidance has increased the detection of malignancy of 14 to 39%. Among the complications that can occur is the formation of hematoma and pain, which are rare. On the other hand, the sonographic guidance is essential for biopsy nonpalpable nodules helping to ensure proper placement of

  20. Ultrasound guided Core Biopsy, Fine Needle Aspiration Cytology and Surgical Excision Biopsy in the diagnosis of metastatic squamous cell carcinoma in the head and neck: An eleven year experience

    International Nuclear Information System (INIS)

    Introduction: This study aims to review our 11 year experience of diagnosing metastatic squamous cell carcinoma presenting as head and neck lumps. The techniques of Ultrasound guided Core Biopsy (USCB), Fine Needle Aspiration Cytology (FNAC) and Surgical Excision Biopsy (SEB) are compared. Materials and methods: All patients with metastatic squamous cell carcinoma (SCC) involving the lymph nodes of the head and neck or parotid gland, diagnosed at Eastbourne District General Hospital between January 1998 and November 2009 were identified. The following data items were collated: biopsy location (e.g. cervical lymph node or parotid), any history of likely primary SCC and site, type of biopsy used to establish a conclusive diagnosis (index diagnostic technique), previous biopsies, the technique and their results, subsequent histology results. Results: A total of 90 patients were diagnosed with metastatic squamous cell carcinoma. The index diagnostic technique was USCB in 48 patients, FNAC in 29 and SEB in 13. In 72 (80%) patients the index biopsy was the sole tissue sample taken prior to surgery or other treatment. The remaining 18 patients underwent a total of 22 previous biopsies prior to the index biopsy. 95% (21/22) of these previous biopsies were non-definitive FNAC and 5% (1/22) was a non-definitive USCB. FNACs also demonstrated the highest non-diagnostic rate (42%). The accuracy of USCB and FNAC in correlating with final histopathology was 97% and 85% respectively. Conclusions: USCB demonstrates excellent results in the diagnosis of metastatic SCC in the head and neck with higher accuracy and greater reliability than FNAC.

  1. 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.

  2. 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

  3. 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.

  4. Should fine needle aspiration cytology in breast assessment be abandoned?

    Energy Technology Data Exchange (ETDEWEB)

    Litherland, Janet C

    2002-02-01

    Fine needle aspiration cytology (FNAC) has been used extensively in the U.K. for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy has been used to address many of the problems which have been encountered with fine needle aspiration. This paper reviews the evolution of the use of these procedures and the advantages and disadvantages of each. In considering whether to abandon the use of fine needle aspiration cytology in breast assessment, each individual unit should make a decision based upon their own audited results. However, even if FNAC is retained, it is important to be able to complement cytological diagnosis with core biopsy as there are indisputable advantages, e.g. in the diagnosis of mammographically detected microcalcification. As always, a multi-disciplinary approach is ultimately essential for effective patient management. Litherland, J.C. (2002)

  5. Should fine needle aspiration cytology in breast assessment be abandoned?

    Science.gov (United States)

    Litherland, Janet C

    2002-02-01

    Fine needle aspiration cytology (FNAC) has been used extensively in the U.K. for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy has been used to address many of the problems which have been encountered with fine needle aspiration. This paper reviews the evolution of the use of these procedures and the advantages and disadvantages of each. In considering whether to abandon the use of fine needle aspiration cytology in breast assessment, each individual unit should make a decision based upon their own audited results. However, even if FNAC is retained, it is important to be able to complement cytological diagnosis with core biopsy as there are indisputable advantages, e.g. in the diagnosis of mammographically detected microcalcification. As always, a multi-disciplinary approach is ultimately essential for effective patient management. PMID:11977938

  6. 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

  7. Comparative analysis of fine-needle aspiration cell block biopsy, cells smear and postoperative pathological diagnosis in 118 patients with breast lumps%118例乳腺肿块细胞块活检、细胞涂片和术后病理诊断对比分析

    Institute of Scientific and Technical Information of China (English)

    卞铁荣; 邢宏运; 唐利; 李燕; 陈庄; 吴云飞

    2013-01-01

    Objective:To evaluate the diagnostic value of the fine-needle aspiration cell block biopsy in breast lumps.Methods:One hundred and eighteen patients with breast lumps were examined by fine-needle aspiration cells smear,fine-needle aspiration cell block biopsy and postoperative histological pathology diagnosis,then the resuits were analyzed.Results:Compared with fine-needle aspiration ceils smear,fine-needle aspiration cell block biopsy showed higher sensitivity,specificity,overall diagnostic coincidence rate,negative accuracy rate,positive accuracy rate,and lower false positive rate and false negative rate.Especially for the negative accuracy rate,fine-needle aspiration cell block biopsy was 77.27% (17/22),while fine-needle aspiration cells smear was 65.38%(17/26).Conclusion:The results of comparative analysis suggested that fine-needle aspiration cell block biopsy had unique value for breast lumps.This method was not only fast,simple and relatively accurate,but also the related diagnosis indexes of fine-needle aspiration cell block biopsy were superior to the fine-needle aspiration cells smear.And the characteristics of fine-needle aspiration cell block biopsy in the initial diagnostic procedure can provide important reference for clinic doctors.%目的:探讨针吸细胞块活检确诊乳腺肿块的诊断价值.方法:对118例乳腺肿块患者经针吸细胞涂片检查、针吸细胞块活检与术后组织学病理诊断对比分析.结果:针吸细胞块活检与针吸细胞学涂片的的诊断结果比较,前者的敏感性、特异性、总体诊断符合率、阴性准确率、阳性准确率均要高出后者,假阳性率及假阴性率亦低于后者.尤其阴性准确率,针吸细胞块活检为77.27%(17/22),针吸细胞学涂片为65.38%(17/26),高出近12%.结论:细胞块活检对乳腺癌肿块诊断有独特价值,该方法不仅快速、简便,较为准确,而且综合之相关诊断指标优于细胞涂片的结果,并能弥补细

  8. 超声引导下细针穿刺对浅表淋巴结转移癌的诊断价值%Value of Ultrasound-guided Fine Needle Biopsy in Diagnosis of Superficial Lymph Nodes Metastatic Carcinoma

    Institute of Scientific and Technical Information of China (English)

    徐继业; 徐克友; 左彩莹; 董萍

    2016-01-01

    目的:探讨超声引导下细针穿刺病理对诊断浅表淋巴结转移癌的准确性和安全性。方法对52例原发部位病理已确诊为癌症同时合并CT或超声检查存在浅表淋巴结转移的患者,行超声引导下浅表淋巴结细针穿刺病理检查,对细胞病理结果进行回顾性分析。结果52例患者均一次性穿刺成功,且未出现严重并发症,穿刺取材成功率为100%,细胞病理诊断为恶性的阳性率为92.3%。结论超声引导下细针穿刺病理对颈部淋巴结转移癌诊断准确率高,可以作为诊断的首选方法。%Objective To investigate the accuracy and safety of ultrasound-guided fine needle biopsy in the diagnosis of superficial lymph nodes metastatic carcinoma. Methods 52 cases of superficial lymph node metastasis patients examined by CT or ultrasound,at the same time primary pathology diagnosed with cancer,were given ultrasound-guided needle biopsy pathologic examination,the cel pathological results were retrospectively analyzed. Results 52 patients are one-time puncture success,and no serious complications occurred. The achievement ratio of puncture sampling was 100%. The positive rate of pathological diagnosis of malignant cel s was 92.3%. Conclusion Ultrasound guided fine needle biopsy for the diagnosis of cervical lymph node metastasis carcinoma has the characteristic of high accuracy rating,can be used as the preferred methods.

  9. 背景音乐在甲状腺细针穿刺抽吸活检术中的应用%Application of background music for patients undergoing thyroid fine needle aspiration biopsy

    Institute of Scientific and Technical Information of China (English)

    胡蒙; 张杰; 胡芳; 唐万斌

    2015-01-01

    [目的]探讨背景音乐对行甲状腺细针穿刺抽吸活检术病人手术过程中焦虑状态、疼痛及术后并发症的影响。[方法]选择在天津某三级甲等医院行甲状腺细针穿刺活检术的病人120例,采用随机数字表法随机分成干预组及对照组各60例。手术过程中,对照组病人只接受常规护理,干预组在常规护理基础上播放背景音乐,分别应用状态焦虑量表和疼痛数字评分表法对两组病人的焦虑和疼痛程度进行评定,并观察病人术后虚脱及手术24 h后疼痛的情况。[结果]手术前两组的焦虑状态评分差异无统计学意义(t=0.300,P>0.05)。手术后干预组焦虑状态评分、疼痛评分及术后虚脱的发生率均明显低于对照组,差异有统计学意义(P0.05)。[结论]甲状腺细针穿刺抽吸活检术中播放背景音乐能降低病人的焦虑程度和对疼痛的敏感性,缓解其紧张情绪,并能减少术后并发症的发生。%Objective:To probe into the influence of background music on anxiety,pain and postoperative compli-cations in patients undergoing thyroid fine needle aspiration biopsy.Methods:A total of 120 patients receiving thyroid fine needle aspiration biopsy in a three grade A hospital in Tianjin were selected and randomly divided into intervention group and control group by using random number table,60 cases in each.During surgery,the patients in control group only received routine care,the background music was played for patients in interven-tion group in addition to routine care.Then the State Anxiety Inventory (SAI)scale and Numerical Rating Scale (NRS)were used for assessment of anxiety and pain of two groups of patients,and to observe the pa-tients’postoperative exhaustion and pain after 24 hours after surgery.Results:The results showed that there was no statistically significant difference in SAI score between both groups before operation (t=0.300,P>0.05). After operation,the SAI,NRS scores and the

  10. 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.

  11. 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.

  12. Evaluation of shear wave elastography for guiding real-time fine-needle aspiration biopsy of superficial organs%剪切波弹性成像引导浅表器官细针穿刺活检的实时性评价

    Institute of Scientific and Technical Information of China (English)

    邢晋放; 乔晓慧; 金宇飚; 高峰; 张佳杰

    2015-01-01

    目的:评价剪切波弹性成像(SWE)引导浅表器官细针穿刺活检的实时性。方法随机选取浅表器官细针穿刺活检患者41例,其中男性22例,女性19例;年龄26~68岁,中位年龄46岁。选用法国SuperSonic Imagine公司生产的Aixplorer超声诊断仪(配备SWE),启动SWE成像模式实时引导浅表器官细针穿刺。结果患者均可耐受,在探头扫查切面保持不变的情况下,利用SWE可以成功完成穿刺全程的实时监视引导,可以将穿刺部位精确地定位于病灶内硬度最高区域,穿刺针尖显示清晰。结论应用剪切波弹性成像可以实时引导浅表器官细针穿刺活检,但图像帧频需要进一步提高。%Objective To probe into the feasibility of using shear wave elastography (SWE) for guiding re-al-time fine-needle aspiration biopsy of superficial organs. Methods Forty-one patients, including 22 males and 19 females, aged 26~28 years old (46 years old in mean), who need fine-needle aspiration biopsy for their superficial or-gans, were randomly selected. The special ultrasonic diagnosis system Aixplorer (SuperSonic Imagine Company, France) was applied. SWE imaging model was used for real-time fine-needle aspiration biopsy. Results All patients could tolerate the treatment. With the scanning plane of probe remained unchanged, using SWE could successfully complete the real-time monitoring of the whole guided fine-needle aspiration of superficial organs. The site of fine-needle aspiration could be accurately positioned to the highest hardness region of SWE. The puncture needle dis-played clearly. Conclusion Using shear wave elastography can guide real-time fine-needle aspiration biopsy of su-perficial organs, but the image frame rate of SWE needs to be further improved.

  13. Usefulness of Ultrasound and Ultrasound-guided Fine-Needle Aspiration Biopsy for Axillary Staging in Breast Cancer: Analysis of 327 patients at a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Mi Jung; Kim, Sun Mi; Lyou, Chae Yeon; Kang, Eun Young; Kim, Sung Won; Park, So Yeon; Kim, Jee Hyun; Kim, Yu Jung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Moon, Woo Kyung; Cho, Nariya [Seoul National University Hospital, Seoul (Korea, Republic of)

    2010-12-15

    Aspiration biopsy (FNAB) for the diagnosis of metastasis in the axillary lymph node (LN) of patients with breast cancer. A retrospective review of the data was performed on 327 breast cancer patients that underwent axillary US from Jun 2006 to July 2008. US guided FNAB was performed when a LN indicated suspicious findings. Results of FNAB were compared with those of subsequent surgery. Of the 327 patients, 111 showed suspicious findings on US and underwent FNAB. Among the 111 cases, 73 (66%) were positive for cancer, while 38 (34%) were negative results. A Total of 254 patients who had normal findings on US (n=216) and negative results on FNAB (n=38) underwent SNB, of which 56 (22%) were proven to have metastasis. Sensitivity and specificity of US were 61.9% and 81.8%, respectively, with a positive predictive value (PPV) of 65.8% and negative predictive value (NPV) of 79.2%. Sensitivity and specificity of US-guided FNAB were 86.9% and 100%, respectively, with a PPV of 100% and a NPV of 71.7%. US and US-guided FNAB performed for axillary staging are useful methods with a high specificity and positive predictive value in invasive breast cancer patients

  14. Fine needle aspiration cytology in leprosy

    Directory of Open Access Journals (Sweden)

    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.

  15. 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.

  16. 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

  17. Punção aspirativa por agulha fina guiada por ultra-sonografia de nódulos tireoidianos: estudo de 63 casos Ultrasound-guided fine needle aspiration biopsy of thyroid nodules: study of 63 cases

    Directory of Open Access Journals (Sweden)

    Daniel Andrade Tinoco de Souza

    2004-10-01

    Full Text Available Neste trabalho foi revisada a técnica empregada na execução da punção aspirativa por agulha fina guiada por ultra-sonografia, e são descritos os seus benefícios no diagnóstico de nódulos tireoidianos. Foram realizadas punções aspirativas por agulha fina em 63 pacientes do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, encaminhados ao Serviço de Radiodiagnóstico, no período de agosto de 2001 a junho de 2002. Dos 63 pacientes estudados, 58 (92% eram do sexo feminino e cinco (8% eram do sexo masculino, com uma relação mulher/homem de cerca de 11:1. Trinta e um pacientes (49% se situaram na quinta e sexta décadas de vida. Oitenta e nove por cento dos pacientes apresentaram-se com nódulos múltiplos ao exame ecográfico; apenas 11% dos pacientes tinham nódulo único. Em relação aos laudos citológicos dos nódulos puncionados, 47% foram benignos, 31%, suspeitos, 17%, inadequados e apenas 5%, malignos. Todos os nódulos malignos (três pacientes tiveram o diagnóstico citológico de carcinoma papilífero. Dos nódulos benignos, 93% foram diagnosticados como hiperplasia nodular e apenas 7% tiveram diagnóstico de tireoidite. Dos laudos considerados inadequados, 70% foram considerados hemorrágicos, sendo 30% considerados hipocelulares. Os dados encontrados no nosso trabalho estiveram de acordo com os encontrados na literatura médica.In this study we reviewed the technique for ultrasound-guided fine needle aspiration biopsy and its benefits in the diagnosis of thyroid nodules. Ultrasound-guided fine needle aspiration was performed in 63 patients referred to the Department of Radiology of "Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro", Rio de Janeiro, Brazil, between August 2001 and June 2002. Fifty-eight (92% of the patients were female and five patients (8% were male; 11:1 female/male ratio. Thirty-one patients (49% had 50-60 years of age and 89

  18. [Technic of fine needle aspiration cytology of the thyroid gland: coagulation inhibiting and stabilizing additives].

    Science.gov (United States)

    Schröder, F; Poley, F

    1988-04-01

    In the fine needle aspiration cytology of the thyroid gland by the moistening of cannule and syringe with heparin or citric sodium rather disadvantages for the evaluation are the result. Artificial changes are most clearly to be seen in heparin. ACD-buffer does indeed not bring about any artefacts, does, however, also not show any provable advantages. In the fine needle biopsy the additives mentioned are entirely avoidable. PMID:3388921

  19. Fine-Needle Aspirate CYFRA 21-1, an Innovative New Marker for Diagnosis of Axillary Lymph Node Metastasis in Breast Cancer Patients

    OpenAIRE

    Choi, Ji Soo; Han, Kyung Hwa; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung

    2015-01-01

    Abstract To compare the value of cytokeratin fragment 21-1 (CYFRA 21-1) concentration in the fine-needle biopsy aspirates (fine needle aspirate [FNA] CYFRA 21-1) with cytopathology of fine-needle aspiration biopsy (FNA cytology) and to assess whether CYFRA 21-1 concentrations from ultrasound-guided fine-needle aspiration biopsy (US-FNAB) specimens (FNA CYFRA 21-1) is not inferior to FNA cytology in the diagnosis of axillary lymph node (ALN) metastasis of breast cancer patients. This study rec...

  20. 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.

  1. Fine-needle aspiration biopsy for thyroid nodules: a clinical and pathological study of 782 patients%甲状腺结节细针穿刺检查782例临床病理分析

    Institute of Scientific and Technical Information of China (English)

    蔡晓频; 王瑶; 佟杰; 杨兆军; 张金苹; 何一凡; 李光伟

    2010-01-01

    目的 分析甲状腺结节细针穿刺(FNAB)检查的诊断结果及其应用价值.方法 回顾性分析782例行FNAB检查患者的临床病理资料.细胞病理诊断分为6类,为未诊断、良性病变、滤泡性病变、滤泡性肿瘤、可疑恶性和恶性.对其中手术治疗的76例患者的组织病理与细胞病理进行对比,判断细针穿刺的准确性.结果 782例行FNAB检查患者中,良性病变占74.4%(582/782),恶性诊断只占2.6%(20/782),滤泡性肿瘤占5.6%(44/782),滤泡性病变、可疑恶性分别为3.2%(25/782)和2.9%(23/782),未诊断者占11.3%(88/782).76例手术患者中,组织病理诊断良性疾病占65.8%(50/76),恶性肿瘤占28.9%(22/76),良性肿瘤占5.3%(4/76).在细胞病理诊断为良性和恶性两大类中,与组织病理的符合率较高,分别为16/16和16/17.结论 甲状腺细针穿刺是甲状腺结节诊断和鉴别诊断的可靠方法.%Objective To evaluate clinical application of thyroid fine-needle aspiration biopsy (FNAB) and its diagnostic value.Methods FNAB was performed for 782 cases during 2005-2009 at China-Japan Friendship Hospital,Beijing and their clinical pathological data were retrospectively analyzed.Cytopathological diagnoses by FNAB were classified as unsatisfactory,benign,atypical cellular lesions,follicular neoplasm,suspicious malignancy and definite malignancy.Results of thyroid cytological and histological examinations of 76 patients with subsequent thyroidectomies were compared to those with FNAB to evaluate its diagnostic accuracy.Results Of 782 FNAB specimens,74.4 % (582/782) were classified as benign,2.6 % (20/782) as malignant,5.6 % (44/782) as follicular neoplasm,3.2 % (25/782) as atypical cellular lesion,2.9% (23/782) as suspicious malignancy and 11.3 % (88/782) as unsatisfactory.Among 76 patients with thyroidectomies,65.8 % of them (50/76) were histologically diagnosed as benign lesion,28.9 % (22/76) as definite malignancy and only 5.3 % (4/76) as benign follicular

  2. DSA Innova CT重建在体表区域定位经皮肺穿刺活检术的应用价值%The application of body surface localization by virtue of Innova CT reconstruction combined with DSA guidance in performing percutaneous fine needle biopsy of lung lesions

    Institute of Scientific and Technical Information of China (English)

    王嵇; 朱炯; 池嘉昌; 沈加林; 许建荣

    2009-01-01

    目的 探讨DSA结合Innova CT重建在体表区域定位经皮肺穿刺活检术的临床应用价值.方法 选取肺占位性病变患者21例,作体表区域定位后行旋转DSA采集,重建Innova CT图像,制订精确穿刺方案,在DSA导向下行经皮肺穿刺活检术.结果 经皮肺穿刺活检取材41次,40牧标本取得组织病理结果,阳性率97.6%,其中1例术中发生气胸,发生率4.8%.结论 DSA结合Innova CT重建引导体表区域定位经皮肺穿刺活检术定位准确,操作简便,安全性高,在诊断肺占位性病变中具有重要的应用价值.%Objective To evaluate body surface localization by virtue of lnnova CT reconstruction combined with DSA guidance in performing percutaneous fine needle biopsy of lung lesions. Methods Twenty-one patients with solid lung lesions were enrolled in this study. Before percutaneous lung needle biopsy, DSA rotation scanning was performed. Based on the reconstructed lnnova CT images, precise puncture scheme was formulated. Then, under DSA guidance, pereutaneous fine needle biopsy of lung lesions was carried out. Results A total of 41 percutaneous fine needle biopsies was made, of which definite pathologic diagnosis was obtained in 40, with a positive rate of 97.6%. Pneumothorax occurred in one patient (4.8%). Conclusion Percutaneous lung needle biopsy with the help of body surface localization, which is determined by Innova CT reconstruction images, and DSA guidance is a safe and technically-simple procedure with high accuracy in localization. It is of great value in the diagnosis of pulmonary space-occupying lesions.

  3. 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

  4. Can elastography replace fine needle aspiration?

    DEFF Research Database (Denmark)

    Popescu, Alexandru; Săftoiu, Adrian

    2014-01-01

    Endoscopic ultrasound (EUS) is one of the best diagnostic methods for diseases of the digestive tract and surrounding organs. Whereas EUS-guided fine needle aspiration (FNA) has been very useful for providing histological confirmation for previously hard to reach lesions, elastography is aiming...

  5. 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 ...

  6. Granzyme expression in fine-needle aspirates from liver allografts is increased during acute rejection

    NARCIS (Netherlands)

    Kuijf, M L; Kwekkeboom, Jaap; Kuijpers, Marianne A; Willems, Marc; Zondervan, Pieter E; Niesters, Hubert G M; Hop, Wim C J; Hack, C Erik; Paavonen, Timo; Höckerstedt, Krister; Tilanus, Hugo W; Lautenschlager, Irmeli; Metselaar, Herold J; Kuijf, Mark M L

    2002-01-01

    We investigated whether determination in fine-needle aspiration biopsy (FNAB) specimens of cells expressing granzymes (Grs) and Fas ligand would provide a reliable, easy, and quantitative measure of rejection activity in the transplanted liver. Retrospectively, 13 FNAB specimens obtained during clin

  7. Pulmonary actinomycosis in fine needle aspiration cytology

    OpenAIRE

    Patel Keyuri; Gupta Gurudutt; Shah Menka; Patel Purvesh

    2009-01-01

    Pulmonary actinomycosis is a rare bacterial lung disease caused by one of two types of bacteria, Actinomyces or Propioni. Pulmonary actinomycosis in the lung causes lung cavities, lung nodules, and pleural effusion. We report here a case of pulmonary actinomycosis that was diagnosed by fine needle aspiration cytology (FNAC). A 45 year-old male with a history of smoking and alcohol abuse, presented with complaints of cough with hemoptysis, right-sided chest pain, and fever of two months′...

  8. Fine-needle aspiration cytology of superficial lymph nodes.

    Science.gov (United States)

    Cardillo, M R

    1989-01-01

    A series of 244 enlarged superficial lymph nodes was examined by fine-needle aspiration cytology. Twenty-nine smears (11.9%) were inadequate for study. Of the remaining 215, 108 were negative, 13 suspicious for malignancy, and 94 positive. Forty-five excisional biopsies were performed correlating the cytologic and histologic findings. There were two cytologic false-negative results; both were patients who had been treated for carcinoma and whose aspirates were cytologically negative. Of the 13 samples reported as suspicious for malignancy, there were three epidermoid carcinomas, nine reactive hyperplasias, and one non-Hodgkin's lymphocytic lymphoma. Of the positive cases, 83 were metastatic tumors, and 11 were malignant lymphomas (two non-Hodgkin's lymphomas and nine Hodgkin's lymphomas). The criteria used in the interpretation of these aspirates and the problems of differential cytological diagnosis are discussed. In spite of the drawbacks of inadequate and false-negative smears, fine-needle aspiration cytology is valuable in preliminary diagnosis of diseased lymph nodes and subsequent management. PMID:2776599

  9. Diagnostic Challenges in the Fine Needle Aspiration Biopsy of Chronic Sclerosing Sialadenitis (Küttner's Tumor) in the Context of Head and Neck Malignancy: A Series of 4 Cases.

    Science.gov (United States)

    Leon, Marino E; Santosh, Neetha; Agarwal, Amit; Teknos, Theodoros N; Ozer, Enver; Iwenofu, O Hans

    2016-09-01

    Chronic sclerosing sialadenitis (CSS) is a benign chronic inflammatory condition of the salivary gland. Clinically, CSS patients may present with a neck mass, often suggesting a neoplastic process. Fine-needle aspiration (FNA) is frequently used to evaluate these lesions. We present a series of 4 patients with CSS, in whom all but one had history of squamous cell carcinoma. The previous diagnosis of malignancy appeared to influence the interpretation of the cytologic preparations. Four patients who had undergone resection of a neck nodule that eventually was diagnosed as CSS were identified. FNA was performed in all 4 cases, and the final cytologic diagnosis in these cases included squamous cell carcinoma, basaloid neoplasm, and salivary gland neoplasm. During intraoperative consultation, the lesions were identified as benign, atrophic salivary gland with chronic inflammation, or sialadenitis with atypical glands. All resected specimens were submitted for histopathological examination and were considered diagnostic for CSS. CSS is a potential pitfall in the FNA interpretation of salivary gland lesions, especially if there is a previous history of head and neck malignancy. Awareness of this entity, adherence to strict cytologic criteria, and careful clinicopathologic correlation are helpful in preventing misinterpretation and unnecessary surgical intervention. PMID:26909791

  10. Fine Needle Aspiration Cytology in Diagnosis of Pure Neuritic Leprosy

    Directory of Open Access Journals (Sweden)

    Bipin Kumar

    2011-01-01

    Full Text Available Leprosy is a chronic infection affecting mainly the skin and peripheral nerve. Pure neuritic form of this disease manifests by involvement of the nerve in the absence of skin lesions. Therefore, it can sometimes create a diagnostic problem. It often requires a nerve biopsy for diagnosis, which is an invasive procedure and may lead to neural deficit. Fine needle aspiration cytology (FNAC of an affected nerve can be a valuable and less invasive procedure for the diagnosis of such cases. We report five suspected cases of pure neuritic Hansen's disease involving the common and superficial peroneal, ulnar, and median nerve, who underwent FNAC. Smears revealed nerve fibers infiltrated by chronic inflammatory cells in all cases, presence of epithelioid cells granulomas, and Langhans giant cells in three cases, and acid fast bacilli in two cases. In conclusion, FNAC is a safe, less invasive, and time saving procedure for the diagnosis of pure neuritic leprosy.

  11. 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.

  12. 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.

  13. Pulmonary actinomycosis in fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Patel Keyuri

    2009-01-01

    Full Text Available Pulmonary actinomycosis is a rare bacterial lung disease caused by one of two types of bacteria, Actinomyces or Propioni. Pulmonary actinomycosis in the lung causes lung cavities, lung nodules, and pleural effusion. We report here a case of pulmonary actinomycosis that was diagnosed by fine needle aspiration cytology (FNAC. A 45 year-old male with a history of smoking and alcohol abuse, presented with complaints of cough with hemoptysis, right-sided chest pain, and fever of two months′ duration. A chest radiograph and computed tomography (CT of the thorax showed a right upper lobe mass lesion with hilar lymphadenopathy. CT-guided FNAC revealed colonies of Actinomyces surrounded by polymorphs. The disease is commonly confused with other chronic suppurative lung diseases and malignancy. An early diagnosis by FNAC prevents difficulties in the management of the disease, as well as considerable physiological and physical morbidity, including unwarranted surgery.

  14. 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.

  15. [Management of pulmonary masses by guided transthoracic fine needle biopsy under computed tomography. Contribution from the Pathology and Radiology Departments of the Percy Military Hospital (Clamart, France) over 10 years].

    Science.gov (United States)

    Harket, A; Weber-Donat, G; Tériitéhau, C; Saint-Blancard, P

    2010-09-01

    Examining 260 samples of pulmonary nodules obtained by percutaneous biopsy under tomodensitometric control from the departments of radiology and pathology over 10 years, the authors note the advantages and disadvantages of this technique, provide the results of their experience and emphasise the importance of these biopsies in malignant pathology. The results of this series can be superposed with those found in the literature. Malignant tumours account for 75 % of the cases, with a clear prevalence of primitive adenocarcinoma. Benign pathology (approximately, 14 % of the cases) was represented by necrosis without any specificity, fibrous reaction and infectious causes. The act had to be repeated for the false negatives (7 %). PMID:20933168

  16. Fine-needle aspiration cytology in the management of salivary gland tumors: an Australian experience.

    Science.gov (United States)

    Stow, Nicholas; Veivers, David; Poole, Alan

    2004-02-01

    We conducted a retrospective study of 104 cases of salivary gland tumors that were initially assessed by fine-needle aspiration biopsy (FNAB). Based on subsequent histopathologic analysis of excised specimens, we found that preoperative FNAB was highly sensitive and specific for both benign and malignant tumors-including the most common, pleomorphic adenomas and squamous cell carcinomas, respectively. Despite its possible drawbacks, we conclude that preoperative FNAB is a useful tool in the management of salivary gland tumors. PMID:15008447

  17. Fuzzy method for pre-diagnosis of breast cancer from the Fine Needle Aspirate analysis

    OpenAIRE

    Sizilio Gláucia RMA; Leite Cicília RM; Guerreiro Ana MG; Neto Adrião D Dória

    2012-01-01

    Abstract Background Across the globe, breast cancer is one of the leading causes of death among women and, currently, Fine Needle Aspirate (FNA) with visual interpretation is the easiest and fastest biopsy technique for the diagnosis of this deadly disease. Unfortunately, the ability of this method to diagnose cancer correctly when the disease is present varies greatly, from 65% to 98%. This article introduces a method to assist in the diagnosis and second opinion of breast cancer from the an...

  18. Fine-Needle Aspiration Cytology of Soft Tissue Sarcoma: Benefits and Limitations

    OpenAIRE

    Måns Åkerman

    1998-01-01

    Purpose. Examine the benefits and limitations of fine-needle aspiration cytology (FNA) used as the definitive diagnostic method before treatment. Method. Review of the 25 year experience at a multidisciplinary musculo-skeletal centre where FNA is the primary diagnostic approach to soft tissue sarcoma in the extremities and trunk wall and the experience of various experts in the field. Results. FNA has several benefits compared with coarse needle or open surgical biopsy. The most important are...

  19. 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...

  20. Diagnosis by endoscopic ultrasound guided fine needle aspiration of tuberculous lymphadenitis involving the peripancreatic lymph nodes: A case report

    Institute of Scientific and Technical Information of China (English)

    Joseph D Boujaoude; Khalil Honein; Cesar Yaghi; Claude Ghora; Gerard Abadjian; Raymond Sayegh

    2007-01-01

    Pancreatic tuberculosis is an extremely rare form of extrapulmonary disease. The diagnosis preoperatively is difficult because clinical, laboratory and radiologic findings are nonspecific. Published data indicate that these lesions mimic cystic neoplasms of the pancreas and the confirmation of clinical suspicion could only be obtained by an open surgical biopsy. Recently, fine needle aspiration cytology has been shown to be a safe,reliable and cost-effective alternative. We report a new case of a peripancreatic tuberculosis in a 52 year old woman and review the relevant literature, paying special attention to the usefulness of endoscopic ultrasound guided-fine needle aspiration in the diagnosis of abdominal tuberculosis.

  1. 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.

  2. Diagnosis of foregut and tailgut cysts by endosonographically guided fine-needle aspiration.

    Science.gov (United States)

    Hall, Diane A; Pu, Robert T; Pang, Yijun

    2007-01-01

    Foregut, hindgut, and tailgut cysts are uncommon developmental anomalies. Clinical and radiological diagnosis can present many challenges, especially in adult patients or when the lesions are in unique locations. Thus, diagnosis has traditionally been provided upon surgical resection. We describe the diagnoses of a gastric foregut cyst and a retrorectal tailgut cyst by endosonographically guided fine-needle aspiration in two adults. The common cytologic features of the specimens are ciliated epithelial cells, proteinaceous material with degenerated debris, histiocytes, and benign appearing epithelium of squamous and/or gastrointestinal type that lack cytologic atypia. The identification of ciliated columnar cells is the key finding. Cytologic diagnosis via endosonographically guided fine-needle aspiration of foregut/hindgut cyst is accurate and less traumatic than surgical biopsies. PMID:17173292

  3. 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.

  4. Fine Needle Aspiration Cytology of Pediatric Thyroid Nodules

    OpenAIRE

    Ayper KAÇAR; İrem PAKER; Gülşah KABAÇAM BAYRAM; Fatma DEMİREL; Şenel, Emrah; Murat KIZILGÜN

    2010-01-01

    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 major...

  5. Endoscopic and endosonography guided fine-needle aspiration.

    Science.gov (United States)

    Antillon, M R; Chang, K J

    2000-10-01

    Endoscopic ultrasound-guided fine-needle aspiration is emerging as the preferred technique for the cytologic diagnosis of various gastrointestinal lesions. This technique may not be routinely available, but there is still a role for endoscopic or endoscopic ultrasound-assisted fine-needle aspiration. This article provides an overview of the evolution of these various techniques and discusses the advantages, disadvantages, indications, and contraindications of each. PMID:11036536

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

    OpenAIRE

    Hongming Song; Chuankui Wei; Dengfeng Li; Kaiyao Hua; Jialu Song; Niraj Maskey; Lin Fang

    2015-01-01

    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, We...

  7.  A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules

    OpenAIRE

    Prathvi Shetty; Divakar Shenoy; P. Sathyamoorthy Aithala; Celine George; Hilda Fernandes; Lobo, Geover J.; Leo F. Tauro

    2012-01-01

     Objectives: Fine needle aspiration cytology (FNAC/FNA) is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC) is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis.Methods: This prospective study was conducted on 50 patients attending the FR Muller Medical College ...

  8. A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules

    Science.gov (United States)

    Tauro, Leo F.; Lobo, Geover J.; Fernandes, Hilda; George, Celine; Aithala, P. Sathyamoorthy; Shenoy, Divakar; Shetty, Prathvi

    2012-01-01

    Objectives Fine needle aspiration cytology (FNAC/FNA) is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC) is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis. Methods This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules (diagnosed by palpation) were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available (38 cases). Results The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88% diagnostic superiority and adequate specimens compared to 94% by FNA. Sensitivity was 50% for FNC and 100% for FNA while specificity was 100% for both techniques; accuracy score was 97.4% for FNC and 100% for FNA in predicting malignancy. While sensitivity was 75% for FNC and 100% for FNA; specificity was 100% for both techniques, and accuracy score was 97.4% for FNC and 100% for FNA in the prediction of neoplasia. Conclusion The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC. PMID:22496942

  9. Cytogenetics of fine needle aspiration biopsies of sarcomas

    NARCIS (Netherlands)

    Molenaar, WM; vandenBerg, E; Dolfin, AC; Zorgdrager, H; Hoekstra, HJ

    1995-01-01

    Chromosomal analysis has become an adjunct in the classification of soft tissue and bone sarcomas and may provide indications of tumor progression. Since it is not always possible or desirable to obtain fresh tumor tissue, the current study analyzed the feasibility to obtain karyotypes from fine nee

  10. 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.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 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

    Directory of Open Access Journals (Sweden)

    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.

  16. Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

    Institute of Scientific and Technical Information of China (English)

    Ghassan; M; Hammoud; Ashraf; Almashhrawi; Jamal; A; Ibdah

    2014-01-01

    Endoscopic ultrasound(EUS)-guided fine needle aspira-tion(FNA) of the liver is a safe procedure in the diag-nosis and staging of hepatobiliary malignancies with a minimal major complication rate. EUS-FNA is useful for liver lesions poorly accessible to other imaging modali-ties of the liver. EUS-guided FNA of biliary neoplasia and malignant biliary stricture is superior to the con-ventional endoscopic brushing and biopsy.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Cytological diagnosis usefulness (PAAF) (Fine needle puncture and Aspiration) in radiotherapy

    International Nuclear Information System (INIS)

    The discovery of palpable lesions (adenopathy, subcutaneous, breast and thyroid nodes, etc.) in patients with malignancies of various locations referred for radiotherapy, poses diagnostic problems which should be promptly resolved since it may result in changes in the anticipated therapeutic regime. Likewise, the presentation of such lesions in previously irradiated patients raises the differential diagnosis between a progression of the disease and a non-malignant condition. Given the experience and the ease with which fine needle puncture and aspirations is carried out, previding-according to published data a diagnostic accuracy of 76% to 100% in palpable nodules, the usefulness of this procedure was assessed in 35 patients who presented with palpable lesions among a total of 428 new patients seen at the Radiotherapy Department of the Hospital Clinico Universitario, Valencia, in 1985. Out of the 35 lesions, 17 were adenopathies. In 63% of cases, the patients had head and neck malignancies; 14% had breast tumors; 11% had lung cancer and the remaining 11% of patients had malignancies located elsewhere. 43% were discovered before radiotherapy was administered, 14% during the treatment and 43% after this, in routine follow-up visits. Cytological diagnosis was achieved in 89% of cases. An overall clinical and pathological correlation was obtained in 58% of cases. Then out of 20 positive fine needle aspirations determined changes in the therapeutic regime (7 out of 15 prior to radiotherapy and 5 out of 5 during this). After radiotherapy, the clinical and pathological correlation is worse, in 33% of cases, than prior to or during this treatment. In four cases in which fine needle puncture and aspiration was negative but clinical suspicion of tumor involvement was high, open biopsy proved to be negative. (Author). 9 refs

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

    Directory of Open Access Journals (Sweden)

    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

  20. Thyroid gland biopsy (image)

    Science.gov (United States)

    ... a sample of cells is needed from the thyroid gland a fine needle biopsy can be performed. During ... procedure, a skinny needle is inserted into the thyroid gland, and a sample of thyroid cells and fluid ...

  1. 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

  2. Fine needle aspiration cytology of cervical lymph node involvement by ovarian serous borderline tumor.

    Science.gov (United States)

    Chen, Longwen; Butler, Kristina A; Bell, Debra A

    2016-01-01

    Serous borderline tumor (SBT) involving a cervical lymph node is extremely rare. In addition, fine needle aspiration (FNA) cytology of the involved cervical lymph node shares tremendous morphologic similarity with other low-grade papillary carcinomas. Thus, it can be easily misdiagnosed as metastatic carcinoma. A 42-year-old female had a history of bilateral SBT and postbilateral salpingo-oophorectomy. She presented with left cervical lymphadenopathy 6 months later. FNA cytology showed a low-grade papillary neoplasm with psammoma bodies. Needle core biopsy along with immunostains was diagnostic of cervical lymph node involvement (LNI) of SBT. although extremely rare, cervical LNI can be found in patients with SBTs. FNA cytology, sometimes, is indistinguishable from metastatic papillary adenocarcinoma. Cell block or needle core biopsy is essential to make the correct diagnosis. PMID:27563339

  3. Reasons for False-Negative and False-Positive Diagnosis in Fine Needle Aspiration Cytology of the Breast: 286 Cases with Cyto-Histopathologic Correlation

    Directory of Open Access Journals (Sweden)

    Nilüfer Onak KANDEMİR

    2010-09-01

    Full Text Available Objective: Fine needle aspiration cytology is the first step in the diagnosing breast lesions. This study evaluated factors causing falsenegative and false-positive diagnoses when evaluating breast lesions using this technique.Material and Method: In this study, we retrospectively examined 511 breast diagnoses, based on Fine needle aspiration cytology specimens, made in the Medical School of Zonguldak Karaelmas University, Department of Pathology, between 2002 and 2009. Factors affecting the reliability of fine needle aspiration cytology were evaluated by comparing the cytological and biopsy diagnoses and using the clinical parameters in the diagnosis of breast lesions.Result: In our series, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of fine needle aspiration cytology were 77%, 99%, 95%, 93%, and 95%, respectively. The falsenegative diagnosis rate was 4% and the false-positive diagnosis rate was 1%.Conclusion: Sampling errors and erroneous interpretation of cellular monomorphism are the most important reasons for false-negative diagnosis results in the evaluation of breast lesions with fine needle aspiration cytology. Increased cellularity and reactive cell atypia in benign proliferative breast lesions are the most frequent reasons for false-positive diagnosis.

  4. Fine Needle Aspiration Cytology of Pediatric Thyroid Nodules

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. 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.

  7. Intranuclear Pseudo-inclusions and Grooves in Fine Needle Aspiration Cytology of Pulmonary Carcinoid Tumor.

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    Mokhtari, Maral; Kumar, Perikala Vijayananda

    2016-02-01

    Cytologic findings of pulmonary carcinoid have been well described. We report new cytological findings in a case of carcinoid tumor. The patient is a 36-year-old man presenting with hemoptysis of about six months in duration. Chest CT scans showed a well-defined round polypoid lesion measuring 1 × 1 cm within the right upper lobe of the bronchus with hyperinflation of the right upper lobe. Trans-bronchial fine needle aspiration and biopsy were done. Cytologic smears showed isolated and loose clusters of uniform round to spindle shape cells with round centrally located nuclei, fine granular (salt and pepper) chromatin and pale cytoplasm. Intranuclear pseudo-inclusions and grooves were seen in some tumor cells. No mitotic figures or necrosis were evident. A cytological diagnosis of carcinoid tumor was made and histopathologic examination and subsequent immunohistochemical study confirmed the diagnosis. Carcinoid tumor may be reliably diagnosed on fine needle aspiration cytology smears. Intranuclear pseudo-inclusions and grooves may be evident in tumor cells. PMID:26838088

  8. 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.

  9. Basic technique in endoscopic ultrasound-guided fine needle aspiration for solid lesions: How many passes?

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    Petrone, Maria Chiara; Arcidiacono, Paolo Giorgio

    2014-01-01

    Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has evolved to become an indispensable tool for tissue acquisition in patients with luminal and extra luminal gastrointestinal cancers. Despite the extensive use of EUS-FNA, there still exists a wide variation in the number of samples required to ensure acquisition of diagnostic material from different kind of lesions. There are several factors that may influence the number of fine needle passes made during EUS-FNA, but the main factor seems to be the presence of a Cytopathologist during the EUS procedure. The diagnostic yield of EUS-FNA with rapid on-site evaluation (ROSE) in most studies exceeds 90%. Nevertheless, ROSE is not available in many centers. Various studies have investigated the adequate number of needle passes that should be performed if ROSE is not used. Differences exist based on the nature of the target lesion: Five to seven passes for pancreatic masses, three passes for lymphnodes, only one pass for pancreatic cystic lesions. Consider using a core biopsy needle or a 19-G FNA needle for histology could improve the diagnostic yield. Even though EUS-FNA is widely available, some patients still do not receive conclusive diagnoses upon initial EUS-FNA. One way to maximize the benefits for patients might be to centralize cases to several well-equipped, high-volume centers with experienced endosonographers that have universal availability of ROSE. PMID:24949407

  10. Acurácia da punção aspirativa por agulha fina e da punção por agulha grossa no diagnóstico de lesões mamárias Diagnostic accuracy of the fine needle aspiration cytologyand core needle biopsy as a diagnostic method for breast lesions

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    Patrícia Pontes Frankel

    2011-03-01

    Full Text Available OBJETIVO: avaliar a acurácia da punção aspirativa por agulha fina (PAAF e da punção por agulha grossa (PAG no diagnóstico da lesão mamária e do câncer de mama. MÉTODOS: trata-se de um estudo transversal, retrospectivo e descritivo, baseado na busca em prontuários médicos. A PAAF e a PAG foram realizadas sequencialmente, como rotina do serviço de Mastologia. Os dois procedimentos percutâneos foram realizados em 233 pacientes, no período de março de 2005 a fevereiro de 2007. Foram incluídas mulheres com idade igual ou superior a 18 anos, com alterações no exame clínico e/ou de imagem das mamas ou com histórico familiar de câncer de mama e/ou ovário. A PAAF e a PAG foram realizadas de acordo com as recomendações técnicas do Instituto Nacional de Câncer. Foram calculados o percentual de concordância, o coeficiente Kappa de Cohen, a sensibilidade, a especificidade, os valores preditivos positivo e negativo e a acurácia da PAAF e da PAG, considerando como padrão-ouro a biópsia cirúrgica. RESULTADOS: a média de idade das pacientes foi de 49 anos (±12,7, os tumores mediam em média 26,9 mm (±23,1, e em 47,2% dos casos, tinham mais de 20 mm. A sensibilidade, a especificidade, os valores preditivos positivo e negativo e a acurácia foram maiores na PAG do que na PAAF, independentemente do tamanho da lesão mamária, tendo a PAG uma acurácia diagnóstica de 97,5% e a PAAF de 77,5%. CONCLUSÃO: apesar de a PAG mostrar maiores valores de sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e acurácia que a PAAF, tanto para as lesões palpáveis quanto para as impalpáveis, o método permanece útil no diagnóstico minimamente invasivo das lesões mamárias, sobretudo quando seus resultados são analisados em conjunto com o exame clínico e de imagem.PURPOSE: to determine the accuracy of fine-needle aspiration biopsy (FNAB and of core-needle biopsy (CNB in diagnosing breast lumps and breast

  11. 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.

  12. Value of CT-guided fine needle aspiration in solitary pulmonary nodules with negative fiberoptic bronchoscopy

    International Nuclear Information System (INIS)

    The usefulness of fine needle aspiration (FNA) with CT-guidance was evaluated in the diagnosis of solitary pulmonary nodules (SPN) following negative fiberoptic bronchoscopy in 84 patients. The records were analyzed for all patients with SPN who had undergone chest FNA in the years 1988 to 1990, showing previous nondiagnostic fiberoptic bronchoscopy. A final diagnosis was made by biopsy (transbronchial, thoracotomy or necropsy), response to therapy or follow-up of the lesions. The patients had medium-sized lesions, 2.87 ± 1.11 cm, adherent to the pleura in 62%. In the diagnosis of malignancy FNA showed 76% sensitivity, 100% specificity, 100% positive predictive value, 52% negative predictive value and 81% accuracy. These results were correlated with histology in 84% of the cases. One pulmonary hemorrhage, which resolved spontaneously, and 12 cases of pneumothorax, requiring a thoracic tube in 4 patients, were noted. (orig.)

  13. Advances in head and neck fine-needle aspiration and ultrasound technique for the pathologist.

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    Jakowski, Joseph D; DiNardo, Laurence J

    2015-07-01

    The success of fine-needle aspiration (FNA) biopsy in the evaluation of head and neck (H&N) masses has already been established. Herein we outline the most recent advancement for the pathologist who performs traditional palpation-guided FNA (PGFNA) in the H&N while also incorporating ultrasound-guided FNA (UGFNA) into their practice. We provide an overview of the educational and training opportunities in H&N ultrasound and UGFNA with emphasis on the advantages and limitations for the pathologist. Throughout are useful clinical and technical pearls, many of which may also interest those who practice PGFNA, including local anesthesia use and FNA procedures in pediatric patients. PMID:25677264

  14. 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.

  15. Metastatic Chordoma: A Diagnostic Challenge on Fine Needle Aspiration

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    Ghassan Tranesh

    2016-01-01

    Full Text Available Chordomas are primary low grade malignant tumors of bone that usually arise within both ends of axial skeleton. The Notochord is a midline, ectoderm-derived structure that defines the phylum of chordates. Chordomas may pose difficult diagnostic challenges when encountered in secondary locations, such as lungs or other parenchymatous organs. We report the cytologic findings of a metastatic chordoma sampled through CT-scan guided fine needle aspiration (FNA of lower lobe lung nodule in a 54-year-old man diagnosed with recurrent chordoma involving the lumber spine and paraspinal region.

  16. Metastatic Chordoma: A Diagnostic Challenge on Fine Needle Aspiration

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    Tranesh, Ghassan; Nassar, Aziza

    2016-01-01

    Chordomas are primary low grade malignant tumors of bone that usually arise within both ends of axial skeleton. The Notochord is a midline, ectoderm-derived structure that defines the phylum of chordates. Chordomas may pose difficult diagnostic challenges when encountered in secondary locations, such as lungs or other parenchymatous organs. We report the cytologic findings of a metastatic chordoma sampled through CT-scan guided fine needle aspiration (FNA) of lower lobe lung nodule in a 54-year-old man diagnosed with recurrent chordoma involving the lumber spine and paraspinal region. PMID:26881166

  17. Secondary B-cell lymphoma diagnosed by fine-needle aspiration cytology and flow cytometry following penile carcinoma: A case report

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    WANG, HUAN; QIU, LIAN-NV; WU, MAO; CHEN, WAN-YUAN; REN, LI-GANG; HE, XIANG-LEI; ZHOU, YONG-LIE

    2016-01-01

    The number of studies reporting lymphoma as a secondary tumor has gradually increased. However, few studies have reported that occurrence of lymphoma as a secondary tumor following treatment for penile carcinoma, particularly cases in which the lymphoma was diagnosed by fine-needle aspiration cytology and flow cytometry. The present study reports the case of a 62-year-old male patient who was troubled with frequent urination and repeated chest tightness for 5 years. The diagnosis upon admission was penile carcinoma. Two months subsequent to the tumor removal surgery, enlarged lymph nodes were extracted from the patient using fine-needle biopsy, to be analyzed using light microscopy and flow cytometry. Smear results indicated a large number of abnormal cells scattered in the right axillary lymph node. Flow cytometry immunophenotyping of fine-needle aspiration samples indicated the increased expression of cluster of differentiation (CD)79a, CD19, CD20, CD38, κ chain and human leukocyte antigen-DR, which supported a diagnosis of B-cell lymphoma. Thus, the patient was diagnosed with B-cell lymphoma based on the results of the fine-needle aspiration biopsy and flow cytometry. The method of diagnosis and causes of therapy-related leukemia are discussed in the present report. PMID:27073496

  18. 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.

  19. 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

  20. 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.

  1. Pure choriocarcinoma of ovary diagnosed by fine needle aspiration cytology

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    Naniwadekar M

    2009-07-01

    Full Text Available Pure ovarian choriocarcinoma is extremely rare and can develop as a germ cell tumor or as a metastasis from uterine or tubal gestational choriocarcinoma or rarely from an ovarian pregnancy. The cytomorphologic findings have been reported previously in different sites. However, this is the first case of pure ovarian choriocarcinoma diagnosed on cytology to the best of our knowledge. The distinction between a gestational and nongestational choriocarcinoma is difficult. A 19-year-old female patient presented with an irregular per-vaginal bleeding and a mass in lower abdomen. Fine needle aspiration cytology smears of the mass were hypocellular and showed large, multinucleated giant cells and malignant mononucleated cells. Background was hemorrhagic. Serum β hCG level was 3,80,000 mIU/ml. A diagnosis of choriocarcinoma was offered which was later confirmed by histopathology. The diagnosis of choriocarcinoma on fine needle aspiration cytology is based on the presence of large, multinucleated giant cells and malignant mononucleated cells. A high index of suspicion should be maintained and estimation of serum β hCG plays a key role in supporting the diagnosis.

  2. 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.

  3. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of kidney lesions: A review.

    Science.gov (United States)

    Lopes, Roberto Iglesias; Moura, Renata Nobre; Artifon, Everson

    2015-03-16

    Traditionally, treatment of renal lesions is indicated based only on imaging features. Although controversy exists about tissue sampling from small renal masses, renal biopsy is indicated in some cases. In this review, we discuss the rationale for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and summarize the recent advances in this field, providing recommendations for the practicing clinician. The use of EUS-FNA appears to be a safe and feasible means of confirming or excluding malignancy. EUS allows assessment and biopsy of masses or lesions within both kidneys and related complications are rare. The main advantages of EUS-FNA are that it can be done as an outpatient procedure, with good results, minimal morbidity and a short hospital stay. Nevertheless, EUS-FNA of renal masses should be indicated only in selected cases, in which there is potential to decrease unnecessary treatment of small renal masses and to best select tumors for active surveillance and minimally invasive ablative therapies. Additionally, some renal lesions may be ineligible for EUS-guided biopsy because of anatomical limitations. EUS-FNA renal biopsy will probably be best applied to central anterior renal masses, while tumors on the posterior aspect of the kidney, percutaneous access will probably be superior. PMID:25789096

  4. 超声引导下穿刺粗针病理学和细胞学及细针细胞学在甲状腺微小结节中的诊断价值%Evaluation of the efficacy and the limitation of ultrasound-guided core-needle biopsy, core-needle aspiration and fine-needle aspiration in micro-nodules of thyroid

    Institute of Scientific and Technical Information of China (English)

    张少航; 牛丽娟

    2014-01-01

    目的 研究超声引导下粗针病理学检查(ultrasound-guided core-needle biopsy,USCNB)、粗针细胞学检查(ultrasound-guided core-needle aspiration,US-CNA)及细针细胞学检查(ultrasound-guided fine-needle aspiration,US-FNA)在甲状腺微小结节诊断中的价值.方法 对92例超声诊断为可疑恶性的甲状腺微小结节患者的92个结节进行穿刺.所有病例经手术治疗有病理证实.其中52例行US-CNB及US-FNA;另外40例行US-CNA及US-FNA.结果 52例行US-CNB和US-FNA患者中,41例US-CNB取材不满意,11例取材满意,且诊断与术后病理符合;52例US-FNA取材均满意,均有明确诊断,6例与术后病理不符,46例与术后病理符合.40例行US-CNA、US-FNA的患者中,26例US-CNA取材成功,14例取材失败或欠满意;36例US-FNA取材成功,4例取材失败或欠满意.92例US-FNA对于鉴别甲状腺微小良、恶性结节的敏感度、特异度、阳性预测值、阴性预测值、符合率分别为93.4%、86.7%、97.3%、72.2%、92.3%.结论 US-FNA是甲状腺微小结节的术前穿刺最有价值的活检方式.%Objective To evaluate the efficacy and the limitation of ultrasound-guided core-needle biopsy,ultrasound-guided core-needle aspiration and ultrasound-guided fine-needle aspiration in micronodules of thyroid.Methods A retrospective was performed in 92 patients with suspectable malignent micro-nodules in thyroid.Of them,52 patients underwent US-CNB and US-FNA and 40 patients underwent US-CNA and US-FNA.The diagnoses for the micro-nodules were identified by histopathlogical examination after surgery.Result Among 52 cases with both US-CNB and US-FNA,41 got nondiagnostic US-CNB and 11 cases successfully got the correct diagnoses of US-CNB ; 6 cases got the incorrect diagnosis of US-FNA and 46 cases got the correct diagnosis of US-FNA.Of 40 cases with US-CNA and US-FNA,unsatisfactory specimen of US-CNA occurred in 14 cases and satisfactory specimen of US-CNA were got in 26 cases

  5. ROLE OF FINE NEEDLE CYTOLOGY IN THE DIAGNOSIS OF HEAD & NECK MASS LESIONS

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    Rifat

    2015-03-01

    Full Text Available CONTEXT: Although head and neck masses are fairly common clinical presentation, it may be the only, or one of several nonspecific findings in serious illnesses like lymphoma or metastatic cancer. Thus, the need to efficiently differentiate patients with serious illness from those with self - limited disease arises. Fine Needle Aspiration Cytology (FNAC helps in the early and accurate diagnosis especially where approach for interventional biopsy is limited. AIMS: To diagnose various head and neck mass lesions via FNAC and correlating the results with clinical and histo pathological diagnosis. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa ( MP, on 406 patients who presented with head and neck swellings . METHODS & MATERIAL: A complete general and systemic examination was carried out. FNAC was carried out on 406 subjects while biopsy was done for 123 lesions. The predictive value for FNAC was retrospectively correlated with biopsy results. RESULTS: In the current study, 372 diagnoses clinically correlated to 406 cytological diagnoses. The most common head and neck swellings were Cervical Lymph Node lesions (346 followed by Salivary Gland lesions(37, while the remaining 23 were other head and neck lesions. Out of the 123 biopsies performed, 111 were correctly diagnosed by FNAC itself. Inflammatory lesions ( 301 accounted for 86.99% of all cervical lymph node lesions. Demographic profile revealed a higher tendency of malignant lymph node lesions in Males (68.9% and in the older (>50years age group (55.6%; benign lesions were more common in the young (<20years [26.2%]. Similarly, Salivary Gland lesions ( 37 were mostly benign (32 and had a male predilection. 100% accuracy was achieved in the diagnosis of adenomas. Among other head and neck lesions, Lipomas were most common ( 30.4% achieving a cytological accuracy of 80%. Through this study, the Sensitivity ( 76

  6. A comparative analysis of fine-needle capillary cytology vs. fine-needle aspiration cytology in superficial lymph node lesions.

    Science.gov (United States)

    Sajeev, Suraj; Siddaraju, Neelaiah

    2009-11-01

    Fine-needle capillary cytology (FNCC) has been attempted in various organs and studies have shown this procedure to yield qualitatively superior material compared with fine-needle aspiration cytology (FNAC). Studies evaluating the efficacy of this technique in lymph nodes are rare. The present study has attempted to assess the relative advantages and disadvantages of the FNCC technique in comparison to the more widely applied FNAC technique.Thirty enlarged lymph nodes from 26 patients were sampled by both the FNCC and FNAC techniques. The smears obtained were routinely stained by May-Grünwald-Giemsa (MGG) and Papanicolaou staining. The quality of smears was evaluated using an objective scoring system originally devised by Mair et al., for various organs. The score of individual parameters in each case as well as the total scores for FNAC and FNCC procedures were calculated separately and Mann-Whitney's test was performed; a P-value of less than 0.05 was considered significant. Statistical results showed smears obtained by FNCC to be qualitatively better than those obtained by FNAC. Though, individual parameters were not statistically significant, FNCC smears showed better scores as compared with those of FNA smears. Also, the technique was found to be easier to perform and less apprehensive to the patient.Our study convincingly proved the technical superiority of the FNCC technique in cellular lymph node lesions, emphasizing the need for this less publicized procedure to be more widely applied. PMID:19526570

  7. A PROSPECTIVE STUDY OF FINE NEEDLE ASPIRATION CYTOLOGY OF INTRAORAL LESIONS

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    Harish S

    2015-10-01

    Full Text Available Fine needle aspiration cytology (FNAC is an important diagnostic tool for swellings in the thyroid, salivary gland, breast lump and enlarged lymph nodes. Very few studies have been done to explore the potential of FNAC in the diagnoses of intraoral lesions. Hence the present study was done to find out the efficacy of FNAC in the diagnosis of intraoral lesions. AIMS/OBJECTIVES : To determine the efficacy of Fine Needle Aspiration Cytology in the diagnosis of intraoral lesions . MATERIALS & METHODS: A prospective study on 88 cases presented with intraoral lesions was done from August 2010 to July 2012. Cases of intraoral Cases having both FNACs along with biopsy correlation were included. OBSERVATIONS/RESULTS: The age group ranged from 12 - 83 years with male: female ratio of 1.6:1. The most common sites of aspiration were tongue in 28 cases, followed by buccal mucosa in 24 and other sites 42 cases. The lesions rep orted on FNAC were malignant tumors in 44(50%, benign lesions 39 (44.31% and suspicious for malignancy 5(5.69% cases. False negative and false positive were 6 and 2 cases respectively. Squamous cell carcinoma was the common malignant tumor. Overall sens itivity of 88%, specificity 95.6% and diagnostic accuracy of 91.6% was obtained in our study. CONCLUSION: We conclude that FNAC is one of the important diagnostic tool in the diagnosis of intraoral lesions. The results of our study suggest, it should be co nsidered as first line of investigation, especially in clinically suspected malignant tumors.

  8. 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.

  9. Fine needle aspirate flow cytometric phenotyping characterizes immunosuppressive nature of the mesothelioma microenvironment

    Science.gov (United States)

    Lizotte, Patrick H.; Jones, Robert E.; Keogh, Lauren; Ivanova, Elena; Liu, Hongye; Awad, Mark M.; Hammerman, Peter S.; Gill, Ritu R.; Richards, William G.; Barbie, David A.; Bass, Adam J.; Bueno, Raphael; English, Jessie M.; Bittinger, Mark; Wong, Kwok-Kin

    2016-01-01

    With the emergence of checkpoint blockade and other immunotherapeutic drugs, and the growing adoption of smaller, more flexible adaptive clinical trial designs, there is an unmet need to develop diagnostics that can rapidly immunophenotype patient tumors. The ability to longitudinally profile the tumor immune infiltrate in response to immunotherapy also presents a window of opportunity to illuminate mechanisms of resistance. We have developed a fine needle aspirate biopsy (FNA) platform to perform immune profiling on thoracic malignancies. Matching peripheral blood, bulk resected tumor, and FNA were analyzed from 13 mesothelioma patients. FNA samples yielded greater numbers of viable cells when compared to core needle biopsies. Cell numbers were adequate to perform flow cytometric analyses on T cell lineage, T cell activation and inhibitory receptor expression, and myeloid immunosuppressive checkpoint markers. FNA samples were representative of the tumor as a whole as assessed by head-to-head comparison to single cell suspensions of dissociated whole tumor. Parallel analysis of matched patient blood enabled us to establish quality assurance criteria to determine the accuracy of FNA procedures to sample tumor tissue. FNA biopsies provide a diagnostic to rapidly phenotype the tumor immune microenvironment that may be of great relevance to clinical trials. PMID:27539742

  10. Interpretation of negative results in fine needle aspiration of discrete pulmonary lesions.

    Science.gov (United States)

    Winning, A J; McIvor, J; Seed, W A; Husain, O A; Metaxas, N

    1986-01-01

    A retrospective analysis was carried out on a consecutive series of 181 percutaneous fine needle aspiration biopsies of discrete pulmonary lesions, in which the outcome was established in 95%. In primary bronchial carcinoma the technique had a sensitivity of 86%. There was no relationship between the size, location, or radiological appearance of the lesion and the incidence of false negative results. The principal reason for failure to diagnose malignancy was inadequacy of the material provided for cytological examination. For metastatic neoplasms of non-bronchial origin the procedure had a sensitivity of 42% and a significantly greater false negative rate than for primary bronchial malignancy. For the entire series 72 (40%) of the procedures failed to produce a definite diagnosis, 29 (40%) of these cases subsequently proving to be malignant. A positive diagnosis was established in only 16% of patients with benign conditions. Review of published reports and consideration of the role of this and other biopsy techniques in the investigation of discrete pulmonary lesions lead to the conclusion that needle aspiration biopsy seems particularly appropriate in the investigation of inoperable patients with probable bronchial carcinoma in whom sputum cytology and bronchoscopy do not yield a diagnosis. PMID:3824273

  11. Fine needle aspirate flow cytometric phenotyping characterizes immunosuppressive nature of the mesothelioma microenvironment.

    Science.gov (United States)

    Lizotte, Patrick H; Jones, Robert E; Keogh, Lauren; Ivanova, Elena; Liu, Hongye; Awad, Mark M; Hammerman, Peter S; Gill, Ritu R; Richards, William G; Barbie, David A; Bass, Adam J; Bueno, Raphael; English, Jessie M; Bittinger, Mark; Wong, Kwok-Kin

    2016-01-01

    With the emergence of checkpoint blockade and other immunotherapeutic drugs, and the growing adoption of smaller, more flexible adaptive clinical trial designs, there is an unmet need to develop diagnostics that can rapidly immunophenotype patient tumors. The ability to longitudinally profile the tumor immune infiltrate in response to immunotherapy also presents a window of opportunity to illuminate mechanisms of resistance. We have developed a fine needle aspirate biopsy (FNA) platform to perform immune profiling on thoracic malignancies. Matching peripheral blood, bulk resected tumor, and FNA were analyzed from 13 mesothelioma patients. FNA samples yielded greater numbers of viable cells when compared to core needle biopsies. Cell numbers were adequate to perform flow cytometric analyses on T cell lineage, T cell activation and inhibitory receptor expression, and myeloid immunosuppressive checkpoint markers. FNA samples were representative of the tumor as a whole as assessed by head-to-head comparison to single cell suspensions of dissociated whole tumor. Parallel analysis of matched patient blood enabled us to establish quality assurance criteria to determine the accuracy of FNA procedures to sample tumor tissue. FNA biopsies provide a diagnostic to rapidly phenotype the tumor immune microenvironment that may be of great relevance to clinical trials. PMID:27539742

  12. 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

  13. 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.

  14. 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.

  15. Fine-needle aspiration detects primary neuroendocrine carcinoma of the breast in a patient with breast implants.

    Science.gov (United States)

    Malowany, Janet I; Kundu, Uma; Santiago, Lumarie; Krishnamurthy, Savitri

    2015-01-01

    Breast augmentation with implantation represents a challenge for subsequent radiographic imaging and pathological sampling. Fine-needle aspiration biopsy (FNAB) is an excellent technique to sample suspicious lesions that are adjacent to fragile implants. We report a case of a 51-year-old woman with breast implants presenting with an initial diagnosis of fibroadenoma by imaging studies. A definite diagnosis of mammary carcinoma with plasmacytoid cells was made on ultrasound (US)-guided FNAB of the breast mass with rapid on-site evaluation which initiated core needle biopsy of the mass and subsequent mastectomy with sentinel lymph node biopsy. Our case exemplifies the role of US-guided FNAB for the initial investigation of breast masses in patients with implants. In addition, the case illustrates the cytomorphological features of the tumor cells in primary neuroendocrine carcinoma of the breast.

  16.  A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules

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    Prathvi Shetty

    2012-03-01

    Full Text Available  Objectives: Fine needle aspiration cytology (FNAC/FNA is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis.Methods: This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules (diagnosed by palpation were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available (38 cases.Results: The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88�0diagnostic superiority and adequate specimens compared to 94�0by FNA. Sensitivity was 50�0for FNC and 100�0for FNA while specificity was 100�0for both techniques; accuracy score was 97.4�0for FNC and 100�0for FNA in predicting malignancy. While sensitivity was 75�0for FNC and 100�0for FNA; specificity was 100�0for both techniques, and accuracy score was 97.4�0for FNC and 100�0for FNA in the prediction of neoplasia.Conclusion: The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC.

  17. [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.

  18. Endoscopic Ultrasound Fine Needle Aspiration in the Diagnosis of Lymphoma

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    Koen Creemers

    2011-01-01

    Full Text Available In recent years, endoscopic ultrasound techniques with Fine Needle Aspiration (FNA have become an increasingly used diagnostic aid in the differentiation of mediastinal lymphadenopathy. Endobronchial ultrasound (EBUS and endoesophageal ultrasound (EUS are now available for clinicians to reach mediastinal and paramediastinal masses using a minimally invasive approach. These techniques are an established component for diagnosing and staging lung cancer and their benefit in the diagnosis of lymphoma's has been highlighted in a number of case studies. However, the lack of tissue architecture obtained by cytological FNA specimens decreases the diagnostic accuracy for benign causes of thoracic lymphadenopathies, lymphomas, and histopathological subtyping of lung cancer. Accordingly, our study group have adapted the FNA sampling technique, resulting in tissue fragments that can be used for histopathological examinations. As an illustration, we report a case of follicular non-Hodgkin lymphoma, diagnosed on tissue fragments obtained by adjusted EUS FNA. We believe that this relatively simple adjustment to routine FNA sampling can help to overcome the diagnostic limitations inherent in cytology obtained by routine FNA.

  19. Guided fine needle aspiration cytology of retroperitoneal masses - Our experience

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    Mimi Gangopadhyay

    2011-01-01

    Full Text Available Background : Early pathological classification of retroperitoneal masses is important for pin-point diagnosis and timely management. Aims : This study was done to evaluate the usefulness and drawbacks of guided fine needle aspiration cytology (FNAC of retroperitoneal masses covering a period of two years with an intention to distinguish between neoplastic and non-neoplastic lesions and to correlate with histologic findings. Materials and Methods : FNAC was done under radiological guidance in all cases using long needle fitted with disposable syringe. Appropriate staining was done and cytology was correlated with histology which was taken as the gold standard for comparison. Results : Fifty-one patients who presented with retroperitoneal masses were studied. Forty-four lesions were malignant cytologically and 7 were inflammatory (tuberculous. According to radiological and cytologic findings, we classified our cases into four groups: renal tumors, retroperitoneal lymphadenopathy, germ cell tumors, soft tissue tumors. Except for cases of non-Hodgkin lymphoma (NHL and metastatic lesions, we had sensitivity and specificity of 100%. In NHL the sensitivity and specificity were both 50%. In cases of metastatic adenocarcinoma, the sensitivity and specificity were 84.6% and 81.8%, respectively. Conclusions : Ignoring the pitfalls, guided FNAC is still an inexpensive and reliable method of early diagnosis of retroperitoneal lesions.

  20. Ultrasound-guided percutaneous thoracoabdominal biopsy.

    Science.gov (United States)

    Ojalehto, M; Tikkakoski, T; Rissanen, T; Apaja-Sarkkinen, M

    2002-03-01

    This review will discuss the benefits and disadvantages of ultrasound-guided percutaneous fine-needle aspiration and cutting needle biopsies. Clinical efficacy, cost-effectiveness, some controversies and safety will be reviewed. PMID:12010294

  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. Fine-needle aspiration cytology of soft tissue lesions: diagnostic challenges.

    Science.gov (United States)

    Domanski, Henryk A

    2007-12-01

    Clinical and radiographic data provide important information in the evaluation of soft tissue lesions/neoplasms. Morphologic tissue and cytologic examination is considered to be a necessary part of the diagnostic work-up. The standard procedure for obtaining tumor tissue for morphologic evaluation has been incisional (open) or core needle biopsy. An increasing use of minimally invasive diagnostic procedures has resulted in better acceptance of fine-needle aspiration cytology (FNAC) in the diagnosis of soft tissue lesions. This article discusses challenges in FNAC of soft tissue lesions based on the experience at a multidisciplinary referral sarcoma center. Obtaining sufficient specimens from deeply seated small and necrotic/cystic lesions is technically a potential pitfall and misdiagnosis of cells from reactive zones surrounding the tumor as well as the correct evaluation of spindle cell lesions, rare soft tissue neoplasms, and "new entities" lacking reproducible cytological criteria are other important challenges in FNAC of soft tissues. The successful cytological evaluation of soft tissue lesions requires the application of strict, reproducible morphological criteria in the context of the clinical findings as well as ancillary techniques. The minimal criteria for diagnostic intervention in various clinical settings and the relative advantages and disadvantages of FNAC must be understood. FNAC of soft tissue lesions is facilitated when limited to specialized orthopedic-oncologic centers with a well-integrated multidisciplinary team and experience in the evaluation and therapy of soft tissue lesions. PMID:18008345

  4. MR-guided fine needle aspiration of breast lesions: Initial experience

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    Wald, D.S.; Weinreb, J.C.; Newstead, G.; Flyer, M.; Bose, S. [New York Univ. Medical Center, NY (United States)

    1996-01-01

    Fine needle aspiration (FNA) is a minimally invasive procedure that is used to obtain cytologic specimens of suspicious lesions in the breast. The goal of this study was to evaluate the logistics and limitations of MR-guided FNA using a prototype breast localization coil. MR-guided FNAs were attempted on 18 lesions (detected on mammography and/or palpation) in 16 patients. Patients were prone with their compressed mediolaterally between two plates in a circularly polarized RF coil. Lesion position was determined by reference to fiducial makers that corresponded to a grid of holes placed at 5 mm intervals in compression plate. FNA was performed with a 22G non-ferromagnetic needle. FNA was successful for 11 of 18 lesions (61%). Of the seven unsuccessful cases, there were four in which the lesions were too posteriorly placed to be accessed through the compression plate by the needle. Three cases were too anteriorly placed to be effectively immobilized and, although successfully localized, were insufficiently sampled by the FNA technique. MR-guided FNA is possible using a prototype breast localization device in a select group of patients. Current coil design limits its use in performing MR-guided FNA on the most anteriorly and posteriorly placed breast lesions. Unique requirements of FNA under MR guidance as compared to needle localization and biopsy have been identified. Modifications in localization hardware and cytology aspiration needles should overcome these restrictions. 15 refs., 3 figs.

  5. Comparison of Ultrasonography and Fine Needle Aspiration Cytology in the Diagnosis of Malignant Breast Lesions

    OpenAIRE

    Takhellambam, Yumjaobabu Singh; Lourembam, Sunil Singh; Sapam, Opendro Singh; Kshetrimayum, Raju Singh; Ningthoujam, Bhubon Singh; Khan, Tousif

    2013-01-01

    Introduction: Breast cancer is the most common cancer of women worldwide and usually presents as lump in the breast. Ultrasonography and Fine Needle Aspiration Cytology (FNAC) are two investigational tools often used to differentiate malignant breast lump from benign one.

  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. 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

  8. Comparison of ThinPrep and conventional smears in head and neck fine needle aspiration cytology

    OpenAIRE

    Fulya KÖYBAŞIOĞLU; Önal, Binnur; Gülçin Güler ŞİMŞEK; Yilmazer, Demet; Han, Ünsal

    2008-01-01

    Aim: The ThinPrep Processor has gained popularity as a collection and preparation technique for fine needle aspiration cytology in addition to Papanicolaou smear test. The aim of this study was to compare the various cytologic features of ThinPrep and conventional smear in head and neck masses.Material and Methods: We reviewed 71 consecutive fine needle aspiration cytology specimens and the conventional smear and ThinPrep slides diagnosed without knowledge of histopathologic diagnosis. Statis...

  9. Basic technique in endoscopic ultrasound-guided fine needle aspiration for solid lesions: How many passes?

    OpenAIRE

    Petrone, Maria Chiara; Arcidiacono, Paolo Giorgio

    2014-01-01

    Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has evolved to become an indispensable tool for tissue acquisition in patients with luminal and extra luminal gastrointestinal cancers. Despite the extensive use of EUS-FNA, there still exists a wide variation in the number of samples required to ensure acquisition of diagnostic material from different kind of lesions. There are several factors that may influence the number of fine needle passes made during EUS-FNA, but the main fa...

  10. Fine needle aspiration cytology: a tool to diagnose cervical and vaginal endometriosis in low-income places.

    Science.gov (United States)

    Oliveira-Filho, Manoel; Rao, Vietla S; Eleutério, José; Medeiros, Francisco C

    2013-01-01

    Regarded as infrequent, vaginal and cervical endometriosis is probably more common than is generally realized. The apparent rarity of the lesion may be ascribed to the limited awareness of its clinical appearance, combined with technical difficulty in obtaining suitable biopsy material for confirmation. Thus, clinical recognition and tissue confirmation become essential. This paper focuses on vaginal and cervical endometriosis, documenting the clinical, macroscopic, cytological and colposcopic findings in 4 cases seen at a single physical vaginal examination. Diagnosis in these patients was facilitated and improved by fine needle aspiration cytology and confirmed by histology. This technique, which is not used for the diagnosis of endometriosis, could be an option in low-income areas. PMID:23406608

  11. 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.

  12. Does large needle aspiration biopsy add pain to the thyroid nodule evaluation?

    Directory of Open Access Journals (Sweden)

    Angelo Carpi

    Full Text Available Thyroid large needle aspiration biopsy is disregarded because it is thought to be associated with pain. This is in contrast with our 32 years long experience. We surveyed reports of pain in patients examined with fine needle aspiration biopsy (78, 87.2% women, mean age 59 years or FNAB+large needle aspiration biopsy (48, 87.5% women, mean age 60 years. Each patient was questioned regarding a no unpleasant sensation (score "0"; b unpleasant sensation ("1"; c mild pain (no analgesic used; "2"; or d pain (analgesic used; "3". The mean size of the needle used was for FNAB 22.3±0.7 or 20.8±1 gauge in the fine needle aspiration or fine needle aspiration plus large needle aspiration biopsy group, respectively (p<.0001. The number of percutaneous punctures was higher in the fine needle aspiration plus large needle aspiration biopsy group. However, the pain score in the fine needle aspiration biopsy or fine needle aspiration biopsy plus large needle aspiration biopsy group was not significantly different. Large needle aspiration biopsy after fine needle aspiration biopsy does not add any discomfort or pain and therefore in light of the demonstrable benefits, should be included in clinical algorithms for the evaluation of thyroid nodules.

  13. Biopsies

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Biopsies - Overview A biopsy is the removal of tissue ... What are the limitations of biopsies? What are biopsies? A biopsy is the removal of tissue in ...

  14. [The role of fine-needle aspiration in the diagnosis of thyroid nodules].

    Science.gov (United States)

    Marrazzo, Antonio; Casà, Luigi; David, Massimo; Lo Gerfo, Domenico; Noto, Antonio; Taormina, Piera

    2005-01-01

    The aim of this study was to prospectively evaluate the sensitivity, specificity and accuracy of fine-needle aspiration of thyroid nodules. From January 1978 to December 2003, 497 patients underwent fine-needle aspiration of thyroid nodules and then thyroidectomy. Fine-needle aspiration was performed with a fine 23-25 gauge and the aspirate was fixed and dyed with May-Grounwald-Giemsa method. The results of cytology were divided into four groups: positive for malignancy (77 patients), negative for malignancy (370 patients), suspect for malignancy (34 patients) and not diagnostic (16 patients). Suspect specimens also included follicular neoplasm and Hürthle cell neoplasm. Fine-needle aspiration results were compared with histopathologic analysis after thyroidectomy. There were 2 false-positive (0.5%) and 5 false-negative patients (1%). Sensitivity, specificity and accuracy were respectively 94.7%, 99% and 98.4%. This study confirms that fine-needle aspiration of thyroid nodules can be performed easily with high sensitivity, specificity and accuracy. PMID:15832740

  15. Ultrasonographic criteria for fine needle aspiration of nonpalpable thyroid nodules 1–2 cm in diameter

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    Kim, Ji Yang, E-mail: j0kim040@louisville.edu [Department of Radiology, University of Louisville, 530 South Jackson Street, Louisville, KY 40242 (United States); Department of Healthcare System Gangnam Center, Department of Radiology, Seoul National University Hospital, 737 Star tower, 40 floor, Yeoksam-dong, Gangnam-gu, Seoul 135-080 (Korea, Republic of); Kim, Soo Young; Yang, Ki Ra [Department of Healthcare System Gangnam Center, Department of Radiology, Seoul National University Hospital, 737 Star tower, 40 floor, Yeoksam-dong, Gangnam-gu, Seoul 135-080 (Korea, Republic of)

    2013-02-15

    Purpose: To investigate the ultrasonographic (US) characteristics for nonpalpable thyroid nodules 1–2 cm in diameter and to evaluate the guideline for fine needle aspiration (FNA) in terms of US findings. Materials and methods: Between June 2005 and November 2006, FNA was performed in 919 thyroid nodules by radiologists. Of these nodules, 51 malignant nodules and 72 benign nodules were finally included. All 123 nodules were analyzed by 3 radiologists if there were the following US characteristics: marked hypoechogenecity, hypoechogenecity, isoechogenecity, hyperechogenecity, microcalcification, coarse calcification, rim calcification, spiculated margin, taller-than-wide shape, irregular shape, hypoechoic rim and honeycomb appearance. The maximum diameters of nodules and thickness of hypoechoic rim were measured. US characteristics relevant as predictors were identified using a Chi-square or Fisher's exact test and odds ratio. We compared the diagnostic efficacy of 3 US criteria for FNA indication. Results: Microcalcification, taller-than-wide shape, marked hypoechogenecity, hypoechogenecity, coarse calcification, irregular shape and spiculated margin were significant characteristics of malignant nodules. Isoechogenecity, hypoechoic rim and honeycomb appearance was significant characteristics of benign nodules. Rim or arc calcification, hyperechogenecity and thickness of hypoechoic rim were insignificant. Among 3 US criteria for FNA indication, NFI showed the highest diagnostic efficacy, 98.0% in sensitivity, 75.0% in specificity and 150.0 in odds ratio. Conclusion: As for nonpalpable thyroid nodules 1–2 cm in diameter, US characteristics are useful for differentiating between malignant and benign nodules. Malignant US characteristics and honeycombing appearance have significant value in selecting nodules for biopsy and reducing the frequency of the FNA procedure.

  16. 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.

  17. 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.

  18. Lymph node fine needle Cytology in the staging and follow-up of Cutaneous Lymphomas

    International Nuclear Information System (INIS)

    Lymph nodal involvement is an important clinical-pathological sign in primary cutaneous lymphoma (PCL), as it marks the transformation/evolution of the disease from localized to systemic; therefore the surveillance of lymph nodes is important in the staging and follow up of PCL. Fine needle cytology (FNC) is widely used in the diagnosis of lymphadenopathies but has rarely been reported in PCL staging and follow-up. In this study an experience on reactive and neoplastic lymphadenopathies arisen in PCL and investigated by FNC, combined to ancillary techniques, is reported. Twenty-one lymph node FNC from as many PCL patients were retrieved; 17 patients had mycosis fungoides (MF) and 4 a primary cutaneous B-cell lymphoma (PBL). In all cases, rapid on site evaluation (ROSE) was performed and additional passes were used to perform flow cytometry (FC), immunocytochemistry (ICC) and/or polymerase chain reaction (PCR) to assess or rule out a possible clonality of the corresponding cell populations. FNC combined with FC, ICC, and PCR identified 12 cases of reactive, non specific, hyperplasia (BRH), 4 dermatopathic lymphadenopathy (DL), 4 lymph nodal involvement by MF and 1 lymph nodal involvement by cutaneous B-cell lymphoma. FNC coupled with ancillary techniques is an effective tool to evaluate lymph node status in PCL patients, provided that ROSE and a rational usage of ancillary techniques is performed according to the clinical context and the available material. The method can be reasonably used as first line procedure in PCL staging and follow up, avoiding expensive and often ill tolerated biopsies when not strictly needed

  19. Is fine-needle aspiration diagnosis of malignancy adequate prior to major lung resections including pneumonectomy?

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    Khorsandi, Maziar; Shaikhrezai, Kasra; Wallace, William; Brackenbury, Edward

    2012-08-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether a fine-needle aspiration (FNA) diagnosis is of sufficient reliability for the diagnosis of lung cancer prior to a major lung resection. Altogether, 112 papers were found using the reported search, of which 13 papers presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The tabulated studies include two meta-analyses, one systematic review, one randomized controlled trial (RCT) and nine cohort studies. The specificity reported for FNA in the diagnosis and staging of lung cancer ranged from 96.2 to 100%. One meta-analysis reported a specificity of 97%. Another meta-analysis reported a specificity of 98.8%. A systematic review reported a specificity of 97%. An RCT reported a specificity of 96.2-100%. We conclude that the FNA for lung cancer is reported to be highly specific prior to major lung resection with a very low false positive rate. However, although a false positive may occasionally be acceptable in lobectomies, where the lobes are often removed without histology, all steps should be taken to avoid a false positive result in pneumonectomy considering the serious consequences of embarking upon such an operation in the small number of patients with a false positive result, and we recommend that a positive FNA result should be confirmed by means of alternative sampling methods. We also acknowledge that obtaining an additional biopsy specimen would add to the risk of morbidity and costs; therefore, any benefits should be weighed against risks and additional costs. PMID:22611184

  20. Fine-Needle Aspirates CYFRA 21-1 is a Useful Tumor Marker for Detecting Axillary Lymph Node Metastasis in Breast Cancer Patients

    OpenAIRE

    Jung Hyun Yoon; Kyung Hwa Han; Eun-Kyung Kim; Hee Jung Moon; Min Jung Kim; Young Joo Suh; Ji Soo Choi; Byeong-Woo Park

    2013-01-01

    INTRODUCTION: To assess whether the value of CYFRA21-1 in the aspirates of ultrasonography-guided fine-needle aspiration biopsy (US-FNAB) can contribute to improving the performances of US-FNAB in the diagnosis of axillary lymph node (LN) metastasis in breast cancer patients. METHODS: US-FNAB was performed in 156 axillary LNs in 152 breast cancer patients (mean age: 51.4 years, range: 17-92 years). Concentrations of CYFRA21-1 were measured from washouts of the syringe used during US-FNAB. Tum...

  1. Fine-needle aspirate CYFRA 21-1, an innovative new marker for diagnosis of axillary lymph node metastasis in breast cancer patients.

    Science.gov (United States)

    Choi, Ji Soo; Han, Kyung Hwa; Kim, Eun-Kyung; Moon, Hee Jung; Yoon, Jung Hyun; Kim, Min Jung

    2015-05-01

    To compare the value of cytokeratin fragment 21-1 (CYFRA 21-1) concentration in the fine-needle biopsy aspirates (fine needle aspirate [FNA] CYFRA 21-1) with cytopathology of fine-needle aspiration biopsy (FNA cytology) and to assess whether CYFRA 21-1 concentrations from ultrasound-guided fine-needle aspiration biopsy (US-FNAB) specimens (FNA CYFRA 21-1) is not inferior to FNA cytology in the diagnosis of axillary lymph node (ALN) metastasis of breast cancer patients.This study received institutional review board approval, and written informed consent was obtained from all patients. US-FNAB was performed in 373 ALNs from 358 patients with invasive breast cancer. Concentrations of CYFRA 21-1 were measured from washouts of the syringe used during US-FNAB (FNA CYFRA 21-1), and ALN metastasis was determined using a cutoff value of 1.93 ng/mL. FNA cytology, intraoperative sentinel lymph node biopsy, and surgical pathology results were reviewed and analyzed. The noninferiority margin for the difference in accuracies between FNA cytology and FNA CYFRA 21-1 was set as 5%.Among 373 ALNs, 136 (36.5%) were benign, and 237 (63.5%) were metastatic. The mean FNA CYFRA 21-1 was significantly higher in metastatic ALNs compared to that in benign ALNs (P = 0.001). For the diagnosis of ALN metastasis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA CYFRA 21-1 (cutoff value 1.93 ng/mL) were not significantly different from those of FNA cytology (P > 0.05). FNA CYFRA 21-1 reached statistical noninferiority to FNA cytology in terms of diagnostic accuracy for ALN metastasis. Of the 20 ALNs (8 metastasis, 12 benign) that showed insufficient results on FNA cytology, FNA CYFRA 21-1 accurately diagnosed 15 ALNs (4 metastasis, 11 benign).The diagnostic performance of FNA CYFRA 21-1 is comparable with that of FNA cytology for breast cancer ALN metastasis. Our results indicate that FNA CYFRA 21-1, using an US-FNAB specimen

  2. Indication and diagnostic value of roentgenguided fine-needle puncture of space-occupying renal lesions

    International Nuclear Information System (INIS)

    Roentgen-guided fine needle puncture of spaceoccupying renal lesions as an important additive radiologic procedure is able to solve differential diagnostic problems of liquid or solid renal lesions in a quick, accurate and safe way. It rules out a solid neoplasm, provides the surgeon with a maximum of preoperative information and helps to avoid operations on aged and other poor-risk patients. After description of the puncture technique we reports the results of 217 fine needle punctures of the kidney over 13 years. (orig.)

  3. ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF INTRA ABDOMINAL LUMPS

    OpenAIRE

    Sanjay Kumar; Umesh; Nitu

    2014-01-01

    Fine needle aspiration cytology has gained recognition in the last decade as valuable diagnostic technique. Its benefits have been demonstrated in large series of patients and in almost all tumor types. Aim of this study was to establish role of fine needle aspiration cytology in the diagnosis of intra-abdominal lumps. Most commonly involved organ in our study was liver (30.4%) followed by G.I.T (21.7%) and Gall Bladder (17.4%). Maximum numbers of cases were in sixth decade followed by fifth ...

  4. 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

  5. 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

  6. Correlation between Fine-Needle Aspiration Cytology and Histology for Palpable Breast Masses in a Nigerian Tertiary Health Institution

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    Adetola Olubunmi Daramola

    2015-01-01

    Full Text Available Background. Management of breast lumps can be challenging in resource poor settings. Fine-needle aspiration cytology (FNAC especially when used with cell block can help improve affordability for the patients. Objective. To determine the diagnostic accuracy of FNAC of palpable breast lesions within a 5-year period. Methods. The findings obtained from FNAC of palpable breast lumps seen at the FNAC clinic of our department from January 2007 to December 2011 were retrieved and correlated with findings on histology of excisional biopsies. Results. A total of 1790 patients had FNAC of breast lumps during the 5-year period; 436 of them subsequently had biopsies. Our results compare favourably with the measures of test performance of the UK NHS Breast Screening Programme shown in brackets: absolute sensitivity 95.4% (>70%, complete sensitivity 99.2% (>90%, full specificity 88.9% (>65%, positive predictive value 99.6% (>99%, false-negative rate 0.8% (<4%, false-positive rate 0.4% (<0.5%, inadequate rate 3.2% (<15%, and suspicious rate 10.2% (<15%. Conclusion. Breast FNACs compare very well with histology of excisional biopsies and in experienced hands are extremely useful in the management of breast lumps. Further studies assessing the diagnostic accuracy of FNAC and cell blocks in our setting are recommended.

  7. 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.

  8. To fine needle aspiration or not? An endosonographer's approach to pancreatic cystic lesions

    NARCIS (Netherlands)

    D.Y.-K. But (David Yiu-Kuen); J.-W. Poley Dr (Jan-Werner)

    2014-01-01

    textabstractEndoscopic ultrasound (EUS) guided fine needle aspiration (FNA) is an established diagnostic tool in the management of pancreatic cystic lesions (PCLs). Due to the proximity to the target lesion, the fine diagnostic needle travels through only minimal normal tissues. The risks of bleedin

  9. 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.

  10. Practical significance of utilizing fine needle aspiration cytology as an adjunct diagnostic aid in the preoperative presumptive diagnosis of ameloblastoma

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    Sriram Kaliamoorthy

    2013-01-01

    Full Text Available Background: Cytological reports of ameloblastoma are relatively rare in the literature. Appropriate cytologic diagnosis may play a significant role in its preoperative presumptive diagnosis, especially when incisional biopsy findings are inadequate. Aim: To systematically study the detailed cytomorphologic features of ameloblastoma and to evaluate the role of fine needle aspiration cytology (FNAC in its preoperative diagnosis. Materials and Methods: In this study, FNAC was done on 26 cases of intra-osseous jaw lesion, clinically diagnosed as odontogenic tumor or developmental odontogenic cysts and detailed cytopathological interpretation was carried out and the results were correlated with the corresponding histopathology. Results: Of the 26 cases, 15 were found to be ameloblastoma and sensitivity of FNAC in the diagnosis of ameloblastoma was found to be 86.6%. None of the intra-osseous jaw lesion was false positively diagnosed as ameloblastoma in FNAC and hence the specificity was found to be 100%. Conclusion: Presence of cohesive epithelial cell clusters exhibiting smaller basaloid cells with peripherally placed tall columnar cells and occasional large squamous cells either adjoining the basaloid epithelial clusters or in isolated group aids in the specific cytological diagnosis of ameloblastoma and FNAC offers an excellent diagnostic aid that may play a significant role in preoperative presumptive diagnosis of ameloblastoma along with incisional biopsy.

  11. Does large needle aspiration biopsy add pain to the thyroid nodule evaluation?

    Science.gov (United States)

    Carpi, Angelo; Rossi, Giuseppe; Nicolini, Andrea; Iervasi, Giorgio; Russo, Matteo; Mechanick, Jeffrey

    2013-01-01

    Thyroid large needle aspiration biopsy is disregarded because it is thought to be associated with pain. This is in contrast with our 32 years long experience. We surveyed reports of pain in patients examined with fine needle aspiration biopsy (78, 87.2% women, mean age 59 years) or FNAB+large needle aspiration biopsy (48, 87.5% women, mean age 60 years). Each patient was questioned regarding a) no unpleasant sensation (score "0"); b) unpleasant sensation ("1"); c) mild pain (no analgesic used; "2"); or d) pain (analgesic used; "3"). The mean size of the needle used was for FNAB 22.3±0.7 or 20.8±1 gauge in the fine needle aspiration or fine needle aspiration plus large needle aspiration biopsy group, respectively (pfine needle aspiration plus large needle aspiration biopsy group. However, the pain score in the fine needle aspiration biopsy or fine needle aspiration biopsy plus large needle aspiration biopsy group was not significantly different. Large needle aspiration biopsy after fine needle aspiration biopsy does not add any discomfort or pain and therefore in light of the demonstrable benefits, should be included in clinical algorithms for the evaluation of thyroid nodules. PMID:23536779

  12. 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.

  13. Fuzzy method for pre-diagnosis of breast cancer from the Fine Needle Aspirate analysis

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    Sizilio Gláucia RMA

    2012-11-01

    Full Text Available Abstract Background Across the globe, breast cancer is one of the leading causes of death among women and, currently, Fine Needle Aspirate (FNA with visual interpretation is the easiest and fastest biopsy technique for the diagnosis of this deadly disease. Unfortunately, the ability of this method to diagnose cancer correctly when the disease is present varies greatly, from 65% to 98%. This article introduces a method to assist in the diagnosis and second opinion of breast cancer from the analysis of descriptors extracted from smears of breast mass obtained by FNA, with the use of computational intelligence resources - in this case, fuzzy logic. Methods For data acquisition of FNA, the Wisconsin Diagnostic Breast Cancer Data (WDBC, from the University of California at Irvine (UCI Machine Learning Repository, available on the internet through the UCI domain was used. The knowledge acquisition process was carried out by the extraction and analysis of numerical data of the WDBC and by interviews and discussions with medical experts. The PDM-FNA-Fuzzy was developed in four steps: 1 Fuzzification Stage; 2 Rules Base; 3 Inference Stage; and 4 Defuzzification Stage. Performance cross-validation was used in the tests, with three databases with gold pattern clinical cases randomly extracted from the WDBC. The final validation was held by medical specialists in pathology, mastology and general practice, and with gold pattern clinical cases, i.e. with known and clinically confirmed diagnosis. Results The Fuzzy Method developed provides breast cancer pre-diagnosis with 98.59% sensitivity (correct pre-diagnosis of malignancies; and 85.43% specificity (correct pre-diagnosis of benign cases. Due to the high sensitivity presented, these results are considered satisfactory, both by the opinion of medical specialists in the aforementioned areas and by comparison with other studies involving breast cancer diagnosis using FNA. Conclusions This paper presents an

  14. Repeat endoscopic ultrasound fine needle aspiration after a first negative procedure is useful in pancreatic lesions

    Science.gov (United States)

    Téllez-Ávila, Félix I.; Martínez-Lozano, Jorge Adolfo; Rosales-Salinas, Anamaría; Bernal-Méndez, Ambrosio Rafael; Guerrero-Velásquez, Camilo; Ramírez-Luna, Miguel Ángel; Valdovinos-Andraca, Francisco

    2016-01-01

    Background and Objectives: There is no consensus about the ideal method for diagnosis in patients who have already undergone endoscopic ultrasound fine needle aspiration (EUS-FNA), and the inconclusive material is often obtained. The aim was to evaluate the diagnostic yield of the second EUS-FNA of pancreatic lesions. Materials and Methods: A retrospective analysis of prospectively collected data of patients with EUS-FNA of pancreatic lesions is performed. All patients who underwent more than one EUS-FNA for the evaluation of suspected pancreatic cancer over a 7-year period were included in the analysis. Results: A total of 296 EUS-FNAs of the pancreas were performed in 257 patients. The diagnostic yield with the first EUS-FNA was 78.6% (202/257). Thirty-nine (13.3%) FNAs were repeated in 34 patients; 17 (50%) patients were women. The mean ± standard deviation (SD) age was 58.8 ± 16.1 years. The location of the lesions in the pancreatic gland, from which the second biopsies were taken, was head of the pancreas, n = 28 (82.4%), body of the pancreas, n = 3 (8.8%), and tail, n = 3 (8.8%). The mean ± SD of the size of the lesion was 36.3 ± 14.6 mm. The second EUS-FNA was more likely to be positive for diagnosis in patients with an “atypical“ histological result in the first EUS-FNA (odds ratio [OR]: 4.04; 95% confidence interval [CI]: 0.9–18.3), in contrast to patients with a first EUS-FNA reported as “normal” (OR: 0.21; 95% CI: 0.06–0.71). Overall, the diagnostic yield of the second EUS-FNA was 58.8% (20/34) with an increase to 86.3% overall (222/257). Conclusion: Repeat EUS-FNA in pancreatic lesions is necessary in patients with a negative first EUS-FNA because it improves the diagnostic yield. PMID:27503159

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    1997 to 2006, were reviewed with special reference to its value in the clinical treatment of patients. RESULTS: Cytologic as well as histologic diagnoses of 382 patients were available. In these diagnoses, the sensitivity of malignancy was 83% and specificity was 99%. The positive predictive value...

  17. A comparative study of fine-needle aspiration and fine-needle non-aspiration techniques in head and neck swellings

    Directory of Open Access Journals (Sweden)

    S Srikanth

    2014-01-01

    Full Text Available Aims and Objective: The present study was undertaken to compare the fine-needle aspiration cytology (FNAC and the fine-needle non-aspiration cytology (FNNAC techniques in head and neck swellings and to study the cytology features of various head and neck swellings. Materials and Methods: A total of 138 cases of head and neck swellings were sampled by a single operator, using both FNAC and FNNAC techniques. The two techniques were compared for the five objective parameters, amount of background blood or clots, amount of cellular material present, retention of appropriate architecture, degree of cellular degeneration and degree of cellular trauma, using Mair′s point scoring system. Results: Blood contamination was similar in FNNAC as compared to FNAC in all cases. The difference was not statistically significant. Cellular yield was more in FNNAC in Thyroid and salivary gland lesions, with a significant statistical difference being noted in both. Better retention of architecture with a statistically significant difference was seen in FNNAC smears from lymph node lesions. There was no significant difference between the two techniques in degree of background blood. More number of FNNAC smears was diagnostically superior. Conclusion: The FNNAC technique provides an adequate cellular yield for a definite diagnosis in all head and neck swellings, except in cystic and fibrotic swellings where FNAC is a better technique.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Diagnosis of cryptococcal lymphadenitis in HIV infected patient on fine needle aspiration Cytology: A Case Report

    OpenAIRE

    Amit H Agravat; Gharia, Amit A; Gauravi A Dhruva

    2014-01-01

    Cryptococcal infection most commonly affects the lung, meninges and skin. The involvement of lymph node in cryptococcosis is considered to be rare and is usually observed in cases where the disease is very widely disseminated. Disseminated cryptococcosis is a life threatening disease seen more commonly in patients with acquired immunodeficiency syndrome (AIDS) or other forms of immune suppression. We report a case of AIDS with cryptococcal lymphadenitis, diagnosed by fine needle aspiration cy...

  1. A Tailgut Cyst Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration

    OpenAIRE

    Rathinamanickam, Harini; Pawa, Swati

    2015-01-01

    Tailgut cysts are rare developmental cysts. Surgery has been the primary method of diagnosis and treatment of these cysts, but endoscopic ultrasound (EUS) has recently been used to establish diagnosis. Only 2 cases of tailgut cyst diagnosed by EUS-guided FNA have been reported. We present a woman in her fourth decade who presented for evaluation of perirectal mass. EUS-guided fine-needle aspiration (FNA) helped establish the diagnosis of tailgut cyst. The patient opted for observation rather ...

  2. Endoscopic Ultrasound-Guided Fine Needle Aspiration in Cystic Pancreatic Lesions

    OpenAIRE

    Hawes, Robert H.; Clancy, James; Hasan, Muhammad K.

    2012-01-01

    Incidental pancreatic cysts are being increasingly recognized recently with incremented concern about health and frequent health check-up. Endoscopic ultrasound (EUS) has emerged as the principal modality for imaging pancreas for various pancreatic diseases including pancreatic cyst. But imaging alone cannot accurately identify the exact nature of the pancreatic cyst. EUS-guided fine needle aspiration is a useful adjunctive procedure to differentiate pancreatic cystic lesions. Cystic fluid an...

  3. The safety of endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions

    OpenAIRE

    Yoon, Won Jae; Brugge, William R

    2015-01-01

    Endoscopic ultrasound (EUS) is widely used in the evaluation of various pancreatic diseases including pancreatic cystic lesions (PCLs). EUS-guided fine-needle aspiration (EUS-FNA) of PCLs provides cyst fluid, which is used for the differentiation of PCLs. EUS-FNA of PCLs is a safe procedure with a low complication rate. Contrary to the concerns expressed by some investigators, preoperative EUS-FNA of mucinous PCLs is unlikely to increase the frequency of postoperative peritoneal seeding.

  4. Clinical analysis of 250 cases of ultrasound-guided percutaneous fine needle aspiration of pancreatic mass

    Institute of Scientific and Technical Information of China (English)

    王仕迎

    2014-01-01

    Objective To assess the accuracy and safety of cytopathological diagnosis of ultrasound guided fine needle aspirated(US-FNA)pancreatic masses.Methods From January 2008 to February 2013,250 pancreatic mass cases underwent US-FNA and with cytopathological diagnosis were retrospectively analyzed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were calculated.The stratified analysis of

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

    OpenAIRE

    Jashnani, Kusum D.; Heena M Desai; Shetty, Jyothi B; Inshita Pandey

    2016-01-01

    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 parasi...

  6. Fine needle aspiration cytology of Hashimoto′s thyroiditis - A diagnostic pitfall with review of literature

    OpenAIRE

    B N Gayathri; Kalyani, R; M L Harendra Kumar; Krishna Prasad, K

    2011-01-01

    Hashimoto's thyroiditis is the second most common thyroid lesion next to goiter diagnosed on fine needle aspiration cytology (FNAC). It is also an important cause for hypothyroidism. FNAC plays a significant role in the diagnosis of thyroid lesions due to its simplicity and low cost. It can accurately diagnose Hashimoto's thyroidits in most patients. However, a small percentage of cases may be missed due to the inherent limitations of this procedure and the varied cytomorphology of this lesio...

  7. Significance of eosinophils in diagnosing Hashimoto′s thyroiditis on fine-needle aspiration cytology

    OpenAIRE

    Ekambaram Maheswari; Kumar Bipin; Chowdhary Nitlotpal; Siddaraju N; Kumar Surendra

    2010-01-01

    Background: Hashimoto′s thyroiditis (HT) is the most common cause of hypothyroidism in those areas of the world where iodine levels are sufficient. Fine-needle aspiration cytology (FNAC) can accurately diagnose this lesion in most of the patients. However, a small percentage of cases may be missed due to inherent limitations of this procedure. Therefore, cytologic clues to increase sensitivity of diagnosis need to be searched for. Aims: To assess whether an eosinophilic infiltration of...

  8. Fine needle aspiration cytology in the management of head and neck masses.

    Science.gov (United States)

    Slack, R W; Croft, C B; Crome, L P

    1985-04-01

    Fine needle aspiration cytology is a useful technique in the management of patients with masses in the head and neck, which is usually performed in co-operation with a specialized cytopathologist. It has not until recently been an investigation used frequently by British otolaryngologists. This study shows that an aspiration cytology service may be run with the aid of a general histopathologist and demonstrates that it is a valuable aid to diagnosis even without the services of a specialized cytopathologist. PMID:4028473

  9. Role of fine needle aspiration cytology in diagnosing filarial arm cysts

    OpenAIRE

    Tandon, Nishi; Bansal, Cherry; Sharma, Richa; Irfan, Sumaiya

    2013-01-01

    Filariasis is prevalent in tropical and subtropical areas and is endemic in regions of India. Lymphatic filariasis in India is caused mainly by two species of nematodes: Wuchereria bancrofti and Brugia malayi, which invade the human lymphatic system. We report two cases of superficial cystic lesions of the upper limb revealed on fine needle aspiration (FNA) to be clinically unsuspected filariasis. Despite similar aetiologies, both cases revealed variations in aspirate nature, smear morphology...

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

    OpenAIRE

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

    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 mandator...

  11. Fine needle aspiration cytology of lesions of liver and gallbladder: An analysis of 400 consecutive aspirations

    OpenAIRE

    Mustafa Barbhuiya; Shushruta Bhunia; Manisha Kakkar; Braj Shrivastava; Pramod K Tiwari; Sanjiv Gupta

    2014-01-01

    Background: Patients presenting with mass lesions of liver and gallbladder are a common occurrence in a cancer hospital in north central part of India. Fine-needle aspiration cytology (FNAC) serves as first line of pathological investigations, but there are pros and cons involved. Aim: The main objective of the present study was to establish adequacy of the procedure and to find out diagnostic pitfalls. An attempt was made to analyze inconclusive and inadequate aspirations. Materials ...

  12. How good is fine needle aspiration? What results should you expect?

    OpenAIRE

    Eisendrath, Pierre; Ibrahim, Mostafa

    2014-01-01

    Tissue acquisition plays a key role before treatment decision in most of oncological pathologies but also in several benign diseases. By offering tissue sampling, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become an essential tool in the diagnostic processes. One of the reasons for the success of the technique is related to its excellent diagnostic performance. The diagnostic accuracy of EUS-FNA is above 80% for most of the usual indications. These performances are howe...

  13. Is fine-needle aspiration diagnosis of malignancy adequate prior to major lung resections including pneumonectomy?

    OpenAIRE

    Khorsandi, Maziar; Shaikhrezai, Kasra; Wallace, William; Brackenbury, Edward

    2012-01-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether a fine-needle aspiration (FNA) diagnosis is of sufficient reliability for the diagnosis of lung cancer prior to a major lung resection. Altogether, 112 papers were found using the reported search, of which 13 papers presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, releva...

  14. Fine-Needle Aspiration Cytology of Pleomorphic Carcinomas of the Lung

    OpenAIRE

    Choi, Hee Seung; Seol, Hyesil; Heo, Il Yeong; Jung, Chang Won; Cho, Soo Youn; Park, Sunhoo; Koh, Jae Soo; Lee, Seung-Sook

    2012-01-01

    Background Pleomorphic carcinoma (PC) is a rare pulmonary malignancy. Because of its rarity and histological heterogeneity, cytopathologists might suspect PC only rarely on the basis of its cytological specimen. In addition, cytological findings from fine needle aspiration (FNA) specimens have rarely been described. Hence, we investigated the cytological features of FNA in the cases of PC. Methods We reviewed 7 FNA specimens of PC. The patients had undergone surgical resection at the Korea Ca...

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Rotational fluoroscopy and fine needle antegrade pyelography for determining kidney access in percutaneous nephrostomy

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical value of fine needle antegrade pyelography combined with rotational fluoroscopy in determining the puncture track of percutaneous nephrostomy. Methods: A total of 543 patients with upper ureter calculus had percutaneous nephrostomy guided by C-arm fluoroscopy. After rotating fluoroscopy from anterior to lateral positions, fine needle percutaneous antegrade pyelography was performed under fluoroscopic guidance, which allowed three-dimensional mapping of the calculi, renal pelvis and their relationship. Using the nephroscope to select the optimal skin and calyceal puncture site by a 19G EV needle, the hydrophilic guide wire with or without a catheter was introduced and passed though the ureteric obstruction into the bladder. The punctured track was dilated and a nephrostomy tube was inserted. Results: Successful nephrostomy was performed on 542 patients. The nephrostomy tube was inserted into the ureter or renal pelvis in 539 cases and inserted into renal calices in 3 cases, with complications of renal pelvic tear in 5, pleura injury in 3, mild post-operative hemorrhage in 3 and delayed massive hemorrhage in 1. One patient died of heart failure after nephrolithotomy.. The total stone-free rate was 88% after the first nephrolithotomy. Conclusion: The use of fine needle antegrade pyelography combined with rotational fluoroscopy to determine the kidney access improves the success rate and reduces the incidence of complication. (authors)

  17. Fine needle aspiration cytology of swellings of head and neck region

    Directory of Open Access Journals (Sweden)

    Gunvanti B Rathod

    2012-01-01

    Full Text Available Head and neck mass lesions are frequently found in clinical practice. A spectrum of pathological lesions ranging from simple benign lesion to highly malignant manifestation is observed. Objectives: To make clinicopathological correlation of head and neck lesions and to assess the frequency of incidences of different sites, age groups, sex, and distribution among inflammation and neoplastic lesion. Materials and Methods: A retrospective study was conducted from January 2011 to April 2012. Fine-needle aspiration diagnosis was correlated with details of relevant clinical findings and investigations. Patients aged between 1 and 70 years were included in the study. A total of 200 patients with the swellings of head and neck underwent fine-needle aspiration cytology (FNAC. Results: Out of 200 fine-needle aspiration procedures, 52% were of thyroid, 28.50% were of lymph node, 11% from salivary gland, and 4% from soft tissue and miscellaneous swellings. There were 4.5% cases in which diagnosis was not possible. In inflammatory swelling (33%, tuberculous lymph node (42.12% involvement is common than all other sites with male preponderance (55%. Conclusion: FNAC is a simple, quick, inexpensive, and minimally invasive technique to diagnose different types of head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries. Thus, FNAC can be recommended as a first line of investigation in the diagnosis of head and neck swellings.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Transesophageal endoscopic ultrasound-guided fine-needle aspiration for the mediastinal staging of extrathoracic tumors: a new perspective.

    NARCIS (Netherlands)

    Peric, R.; Schuurbiers, O.C.J.; Veselic, M.; Rabe, K.F.; Heijden, H.F.M. van der; Annema, J.T.

    2010-01-01

    BACKGROUND: Several extrathoracic tumors metastasize to the mediastinum. Mediastinoscopy is the standard method to obtain tissue proof of mediastinal spread, but drawbacks are its invasiveness, requirement for general anesthesia and costs. Transesophageal endoscopic ultrasound-guided fine-needle asp

  20. Endoscopic Ultrasound-Guided Fine Needle Aspiration of Suspected Pancreatic Adenocarcinoma: Yield of the First and Repeat Procedure

    OpenAIRE

    Faming Zhang; Vivek Kumbhari; Alan H Tieu, Mohamad H El Zein; Ahmed Messallam; Singh, Vikesh K.; Anne Marie Lennon; Canto, Marcia I.; Kalloo, Anthony N.; Khashab, Mouen A.

    2016-01-01

    Background and study aims There is no consensus on how to manage patients with a high probability of pancreatic cancer, based on their clinical presentation and imaging, but have a non-diagnostic endoscopic ultrasound - fine needle aspiration. Our aim was to evaluate the yield of a single or if necessary multiple endoscopic ultrasound - fine needle aspiration procedures for the cytological diagnosis of a pancreatic mass. Patients and methods Retrospective review of patients undergoing endosco...

  1. Evaluation of large-needle biopsy for the diagnosis of cancer.

    Science.gov (United States)

    Roussel, F; Nouvet, G

    1995-01-01

    The arguments for a choice between a large or fine needle in the diagnosis of tumors are still unclear. This paper reviews the advantages and disadvantages of large-needle biopsy and fine needle aspiration. Reports indicate that although the procedures have the same diagnostic efficacy, the risk of tumor seeding is far higher following large-needle biopsy. For this reason it should be avoided for the diagnosis of cancer. The risk of tumor seeding after fine needle aspiration may be reduced by performance through a cover of normal parenchyma, by maintaining suction during withdrawal of the needle and by examining samples for quality during the procedure. PMID:7762331

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Mucinous tubular and spindle cell carcinoma of the kidney: Diagnosis by fine needle aspiration and review of the literature

    Directory of Open Access Journals (Sweden)

    Jiang Huimiao

    2015-01-01

    Full Text Available Renal mucinous tubular and spindle cell carcinoma (MTSCC was recently described as a distinct subtype of renal cell carcinoma (RCC in the 2004 World Health Organization classification of kidney tumors. MTSCC is a rare low grade malignancy with < 100 cases reported in the literature. To the best of our knowledge, there are 5 case reports with a total of 6 patients describing its diagnosis by fine needle aspiration (FNA. All of these cases were diagnosed as conventional RCC on FNA. Subsequent excisions proved them to be MTSCC. We herein report a case in a 67-year-old male. He presented with abdominal pain and was found to have a new colon adenocarcinoma with metastasis to the liver and lungs. The extent of disease made the patient ineligible for surgical excision, and he received chemotherapy. Work-up also revealed a kidney mass which was later biopsied by FNA and core biopsy. The tumor was composed of epithelial and spindled cell components embedded in a myxoid background. It was positive for CK7, AMCAR, vimentin, and epithelial membrane antigen. The tumor was diagnosed as MTSCC. One year later the kidney mass remained stable. However, the patient developed new metastasis to the liver from colonic primary. The kidney mass was not resected. Although rarely encountered in FNA cytology of the kidney, we believe the cytologic features of this tumor are distinctive and are different from conventional and other subtypes of RCC. Therefore, its accurate diagnosis on FNA is possible once pathologists are aware that MTSCC should be considered in the differential diagnosis of kidney tumors.

  5. Biopsy of soft-tissue tumors.

    Science.gov (United States)

    Shives, T C

    1993-04-01

    Biopsy is an integral part of the overall management of patients with soft-tissue sarcoma. The types of biopsy are fine needle, trocar, open incision or en bloc excision. There are advantages and disadvantages of each. Open biopsy requires strict adherence to a number of surgical principles. Proper execution requires determination of appropriate biopsy site, meticulous technique, and close collaboration with an experienced pathologist. Failure to adhere to these principles may result in untoward consequences for patients. PMID:8472430

  6. Discussion on further diagnostic method with immunohistochemical detection in specimens of cell blocks by fine needle aspiration%针吸标本细胞块在免疫组化染色方法的探讨

    Institute of Scientific and Technical Information of China (English)

    陈书媛; 王卫东; 余小蒙

    2014-01-01

    Objective To explore the further diagnostic method with immunohistochemical detection in specimens of cell blocks by fine needle aspiration. Methods The application of combined cell block preparation method and immunohistochemical staining had been carried out for further analysis. Results There was no significant difference in immunohistochemical staining between cell blocks by fine needle aspiration and biopsy. Conclusion The application of immunohistochemical staining method for cell block is feasible,and it can effectively raise the diag-nostic rate of pathological examination of specimens obtained by fine needle aspiration,and it may become an useful cytological method.%目的:探讨针吸标本细胞块通过免疫组化方法进行进一步诊断的方法。方法将细胞块制作方法与免疫组化染色方法相结合。结果细胞块行免疫组化染色其效果与活检标本完全相同。结论细胞块行免疫组化染色方法可行,明显提高了针吸病理的诊断率,已成为细胞学检查非常实用的实验技术。

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

    Directory of Open Access Journals (Sweden)

    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

  8. [Up-to-date experience with the international classification system Bethesda 2010 for thyroid fine-needle aspirate: a review].

    Science.gov (United States)

    Ludvíková, Marie; Kholová, Ivana

    2014-07-01

    The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) was introduced in thyroid fine needle aspiration cytology (FNAC) in 2010. A six-tier system is generally accepted. Bethesda categories include morphologic description, risk of malignancy and follow-up suggestions in each group. The system has its advantages and disadvantages, that are discussed. The most problematic are the categories of "Atypia of undetermined significance" or "Follicular lesion of undetermined significance" (AUS/FLUS). The group is heterogenous and overused thus far. The possibilities of its improvement are discussed. The Bethesda system does not include any prognostic and predictive markers. However, they represent the promising direction in the improved version of the BSRTC. Novel molecular methods and alternative techniques such as core needle biopsy are briefly discussed. PMID:25186598

  9. 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

    Directory of Open Access Journals (Sweden)

    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.

  10. Differential Diagnosis Value of Fine Needle Aspiration Cytology on Thyroid Nodules%细针穿刺细胞学在甲状腺结节鉴别诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    张颖; 邓建平

    2015-01-01

    目的:评价细针穿刺细胞学在甲状腺结节鉴别诊断中的价值。方法选取2010年1月~2013年1月我院收治的患有甲状腺结节者95例,对比分析甲状腺结节细针穿刺后行手术治疗患者的细胞病理学与组织病理学诊断结果,评价细针穿刺细胞学检查对甲状腺结节的诊断价值。结果甲状腺结节穿刺细胞学检查与病理组织学检查的符合率分别为93.75%、84.21%、90.9%。结论细针穿刺细胞学检查在甲状腺结节诊断中有很高的价值。%Objective To evaluate the dif erential diagnosis value of fine needle aspiration cytology on thyroid nodules. Methods From January 2010 to January 2010, 95 cases patients with thyroid nodule were accepted by our hospital, after thyroid nodule fine needle puncture, cel pathology and histopathological diagnosis of thyroid nodule patients who were carried out surgerical treatment, were compared and analyzed, evaluating diagnostic value of fine needle aspiration cytology on thyroid nodule. Results The coincidence rate of thyroid nodule biopsy cytology and histologic examination was 93.75%, 84.21%and 90.9%respectively. Conclusion Fine needle puncture cytological examination has a high value in the diagnosis of thyroid nodule.

  11. FINE NEEDLE ASPIRATION CYTOLOGY AS A DIAGNOSTIC TOOL IN HEAD AND NECK LESIONS

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    Yogesh

    2014-09-01

    Full Text Available INTRODUCTION: Palpable masses of head and neck regions are quite common, affecting all age groups. The lumps are worrisome for both, clinicians and patients as the diagnostic spectrum ranges from innocuous inflammation to life threatening malignancies. Fine needle aspiration cytology plays a vital role in solving all this issues, and fine needle aspiration cytology is now being recognized as a rapid diagnostic technique because of its simplicity and high accuracy. AIM: This retrospective study was carried out at the Department of Pathology, BSR Hospital and diagnostic Centre Rajnandgaon (C.G. for a period of one year from April 2013 to March 2014. The aim was to know the pattern and frequency of head and neck swelling in rural Indian population, and also to know the distribution of these lesions in relation to age and sex. RESULT: A total of 241cases of head and neck swelling were observed during this period. Age of presentation varied from 1 year to 82 years with male to female ratio of 1 to 1.23. Lymph node enlargement was the commonest cause (48.54%, followed by thyroid lesions (23.65%. Salivary gland lesions comprised 5.8% of all lesions. Tuberculosis/Granulomatous lymphadenitis and Non-specific lymphadenitis were the most common lesion observed constituting 22.4 %( n=54 each. Other common cause of swelling in region observed were due to Colloid goiter n=44 (18.25%, Cystic lesion n=20 (8.29% and Abscess/inflammatory lesion n=16 (6.63%. CONCLUSION: During the first three decades, most of the swelling of the head and neck region was either due to Tuberculosis/Granulomatous lymphadenitis or due to Reactive lymphadenitis. Among thyroid swellings both colloid goiter and thyroditis were found to be common in females. Fine needle aspiration cytology is useful in diagnosis and differentiating Neoplastic and Non Neoplastic lesions.

  12. Utility of Fine Needle Aspiration Cytology in Diagnosis of Soft Tissue Lesions with Histopathological Correlation

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    Rasool Zubaida

    2013-05-01

    Full Text Available 100 cases of Soft tissue lesions were studied by Fine Needle Cytology (FNAC and subsequently correlated by Histopathological examination and Immunohistochemical staining. The study revealed that 55% of the cases were benign soft tissue tumour masses, 34% were benign soft tissue tumour like masses and 11% were malignant soft tissue lesions. The accuracy determined by the histopathological examination for benign soft tissue masses was 94.38% and in 100%malignant soft tissue lesions. The discordance of 5.62% in the benign soft tissue masses was due to aspiration of inadequate material and loss of architectural pattern. Hence, excision with histopathological examination is mandatory in such cases.

  13. Fine needle aspiration cytology and cell block in the diagnosis of seminoma testis

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    Abhishant Pandey

    2011-01-01

    Full Text Available Testicular neoplasms which show a wide variety of morphologic types, comprise a small proportion of malignancies. Early identification and treatment is essential for achieving long term survival. The cytologic findings in fine needle aspiration smears from left testicular swelling of a 49 year old male suggestive of a germ cell tumor was complimented by cell block preparation as seminoma. This was confirmed by histopathologic studies. We are presenting this case to emphasize that cell block can be used for diagnosis of testicular tumors.

  14. 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.

  15. Needle Fracture during Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspicious Thoracic Lymph Nodes

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    Bartosz Adamowicz

    2016-01-01

    Full Text Available Endoscopic ultrasound fine-needle aspiration (EUS-FNA is used to make a cytopathologic diagnosis of suspicious lesions located around the gastrointestinal tract. It is a safe technique with few complications. The most common complications of EUS-FNA are related to pancreatic lesions (pancreatitis, bleeding, and abdominal pain. Rare complications have been noted such as stent malfunction, air embolism, infection, neural and vascular injuries, and tumor cell seeding. There are very few studies examining equipment malfunctions. We report a case of needle fracture during the EUS-FNA of suspicious thoracic lymph nodes in a 79-year-old man investigated for unexplained weight loss.

  16. A Tailgut Cyst Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration.

    Science.gov (United States)

    Rathinamanickam, Harini; Pawa, Swati

    2015-10-01

    Tailgut cysts are rare developmental cysts. Surgery has been the primary method of diagnosis and treatment of these cysts, but endoscopic ultrasound (EUS) has recently been used to establish diagnosis. Only 2 cases of tailgut cyst diagnosed by EUS-guided FNA have been reported. We present a woman in her fourth decade who presented for evaluation of perirectal mass. EUS-guided fine-needle aspiration (FNA) helped establish the diagnosis of tailgut cyst. The patient opted for observation rather than surgery. PMID:26504874

  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. 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.

  19. 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.

  20. 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.

  1. Fine needle aspiration of head and neck masses in the operating room: accuracy and potential benefits.

    Science.gov (United States)

    Arabi, Haitham; Yousef, Nida; Bandyopadhyay, Sudeshna; Feng, Jining; Yoo, George H; Al-Abbadi, Mousa A

    2008-06-01

    Fine needle aspiration (FNA) in the operating room is a convenient optional diagnostic approach. Our objective of this study was to evaluate the accuracy and study the potential benefits of fine needle aspiration in the operating room. Retrospective review of all intraoperative FNA that were requested and performed by pathologists over 20-month period was carried out. Immediate smears were interpreted by the cytopathology team after staining with Diff Quik stain. All cases were reviewed and correlation with subsequent tissue diagnosis was done. Accuracy was calculated and potential benefits were discussed. The number of aspirates was 32. Adequate material for immediate and final interpretation was achieved in 31 cases (sensitivity 97%). In 20 cases (63%), malignancy was diagnosed while a benign diagnosis was rendered in 12 (37%). All cases had a follow up tissue diagnosis. No false-positive cases were identified (specificity 100%). The information gained from this approach was considered helpful to the surgeons. We concluded that FNA of head and neck masses in the operating room is an accurate and sensitive diagnostic approach. The service provides helpful information to surgeons and is an additional optional diagnostic approach. PMID:18478613

  2. Rapid Mycobacterium tuberculosis DNA Detection on Fine Needle Aspirates from Extra Pulmonary Lymph Nodes

    International Nuclear Information System (INIS)

    Objective: To evaluate the diagnostic efficacy of two rapid methods i.e. Mycobacterium tuberculosis (MTB) Polymerase Chain Reaction (PCR) on Fine Needle Aspiration (FNA) samples by comparing with cytology of respective site sample. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan, from July 2010 through November 2013. Methodology: A total of 105 extra pulmonary lymph nodes aspirates obtained through fine needle aspiration were processed. Cytology and PCR were done on each specimen. Cytology was taken as gold standard. Results: Out of the total 105 samples, 71 (67.6 percentage) were positive for the MTB PCR while 34 (32.4 percentage) showed negative status. According to FNA cytology (FNAC) results, 72 (68.6 percentage) cases were positive for the disease while 33 (31.4 percentage) were negative. Sensitivity of PCR was 90.3 percentage, specificity 81.8 percentage, positive predictive value (PPV) 91.5 percentage, negative predictive value (NPV) 79.4 percentage, with diagnostic accuracy of 87.6 percentage. Area under the curve was 0.860 (p < 0.001). Conclusion: PCR is a sensitive tool for detection of MTB on FNA samples from EPTB cases. The results are available within few hours which is helpful for the clinicians to initiate therapy. (author)

  3. Endoscopic ultrasound and endobronchial ultrasound-guided fine-needle aspiration of deep-seated lymphadenopathy: Analysis of 1338 cases

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    Amberly L Nunez

    2012-01-01

    Full Text Available Background: We retrospectively studied 1338 samples of lymph nodes obtained by endoscopic and endobronchial ultrasound-guided fine needle aspiration biopsy (EUS and EBUS-FNAB with an objective of characterizing the utility of this diagnostic modality in the assessment of deep-seated lymphadenopathy. The secondary aims were to establish the utility in the diagnosis of lymphoma and to determine the number of passes required to obtain adequate cellularity for flow cytometric analysis. Materials and Methods: On-site assessment was performed by a cytopathologist using Diff-Quik (American Scientific Products, McGraw Park, IL stain. In addition, Papanicolaou and immunohistochemical stains were performed and additional samples were sent for flow cytometric analyses (n = 145. The final cytologic diagnosis was correlated with surgical pathology diagnosis and/or clinical follow-up. In select cases, fluorescence in situ hybridization analysis with specific probes was performed on Diff-Quik smears. Results: Both morphology as well as ancillary studies (flow cytometry or immunohistochemical stain and/or fluorescence in situ hybridization show that EUS and EBUS-FNA are effective techniques to detect and stage intrathoracic and intra-abdominal tumors. Operating characteristics show that these are highly sensitive (89% and specific (100% techniques for the diagnosis of lymphoma. At least two passes provided an average of 5.66 million cells (range, 0.12-62.32 million for lymphoma cases. Conclusions: EUS and EBUS-FNA are powerful modalities to stage malignancies and at least two passes can provide adequate cells for flow cytometric analysis. We also demonstrate that fluorescence in situ hybridization analysis can be performed on Diff-Quik-stained and mounted smears.

  4. Randomized controlled trial of endoscopic ultrasound-guided fine-needle sampling with or without suction for better cytological diagnosis

    DEFF Research Database (Denmark)

    Puri, Rajesh; Vilmann, Peter; Saftoiu, Adrian;

    2009-01-01

    OBJECTIVE: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a highly accurate method to obtain specific diagnosis in various diseases. The optimal method of EUS-guided sampling of material for pathologic diagnosis has not been clearly established. The aim of our study was to compare....... RESULTS: EUS-guided fine-needle sampling with suction of solid masses increased the number of pathology slides (17.8+/-7.1 slides for suction as compared with 10.2+/-5.5 for non-suction, p=0.0001), without increasing the overall bloodiness of each sample. Sensitivity and the negative predictive values...... were higher when suction was applied, as compared to the non-suction group (85.7% as compared with 66.7%, p=0.05). CONCLUSIONS: This prospective randomized study showed that EUS-guided fine-needle sampling of solid masses using suction yields a higher number of slides without increasing bloodiness...

  5. 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.

  6. Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

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    Baldini Enke

    2013-02-01

    Full Text Available Abstract Background Measurement of thyroglobulin (Tg protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN metastasis from well-differentiated thyroid cancer (TC. In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp, Tg mRNA (FNAB-Tgm and calcitonin (CT mRNA (FNAB-CTm in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN. Methods In this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC in 26 CLN, metastatic medullary TC (MTC in 3 CLN, metastatic anaplastic TC (ATC in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers. Results The overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters. Conclusions We demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters.

  7. Thin needle aspiration biopsy of endocrine organs.

    Science.gov (United States)

    Koss, L G

    1979-01-01

    The purpose of this paper is to summarize the advantages and disadvantages of the fine needle aspiration technique in reference to the endocrine organs. The principles of technique and interpretation are presented. The application of aspiration biopsies to the breast, the prostate, the pancreas and the thyroid are briefly discussed. PMID:485094

  8. 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

  9. 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.

  10. A technique to improve diagnostic information from fine-needle aspirations: immunohistochemistry on cytoscrape

    DEFF Research Database (Denmark)

    Skov, Birgit Guldhammer; Kiss, Katalin; Ramsted, Julie;

    2009-01-01

    BACKGROUND: Cytologic examination of fine-needle aspiration (FNA) material is being used increasingly for the diagnosis of pulmonary lesions. Accurate distinction between nonsmall cell lung cancer (NSCLC), including subgroups, and small cell lung cancer and between primary lung cancer....... METHODS: Aspirates from 47 patients who had possible malignant infiltrates identified on computed tomography scans of the chest were included. Smears were stained by May-Grunwald-Giemsa and Diff-Quick for diagnostic purposes. CS material was obtained by gently scraping cells off the slides. Clots were......: Malignant tumor cells in the CS material were identified in 43 aspirates (91%). Both the sensitivity and the specificity for TTF-1 were 100%. The sensitivity for mucin was 60%, and the specificity for mucin was 100%. The diagnoses made on smears were improved by CS in 31 patients (72%), in that more precise...

  11. 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.

  12. Diagnosis and fine needle aspiration of pancreatic pseudocysts: the role of endoscopic ultrasound.

    Science.gov (United States)

    Breslin, Niall; Wallace, Michael B

    2002-10-01

    Pseudocysts are localized collections of pancreatic fluid surrounded by nonepithelialized granulation tissue that occur following an insult to the pancreas. High image resolution and the ability sample in real-time by fine needle aspiration permit accurate distinction between various cystic lesions in the pancreas by endoscopic ultrasound (EUS). Other cyst characteristics and background pancreatic changes detectable at EUS assist in the diagnostic process. The use of Doppler flow ultrasound allows diagnosis of important pseudocyst complications such as pseudoaneurysms and varices. Endoscopic approaches to the drainage of symptomatic lesions previously relied on the use of cross-sectional imaging studies such as computed tomography scanning in combination with stent placement using a duodenoscope in the presence of an endoscopically visible cyst bulge. EUS facilitates this process allowing accurate imaging of the lesion prior to stent placement via the echoendoscope and overcomes many of the drawbacks and pitfalls of other endoscopic techniques. PMID:12607787

  13. Fine needle aspiration cytology of Hashimoto′s thyroiditis - A diagnostic pitfall with review of literature

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    B N Gayathri

    2011-01-01

    Full Text Available Hashimoto′s thyroiditis is the second most common thyroid lesion next to goiter diagnosed on fine needle aspiration cytology (FNAC. It is also an important cause for hypothyroidism. FNAC plays a significant role in the diagnosis of thyroid lesions due to its simplicity and low cost. It can accurately diagnose Hashimoto′s thyroidits in most patients. However, a small percentage of cases may be missed due to the inherent limitations of this procedure and the varied cytomorphology of this lesion. Therefore thorough cytological evaluation and an integrated approach are necessary to pick up correct diagnosis and to avoid unnecessary surgery. We present a 56-year-old female with solitary thyroid nodule diagnosed as Hurthle cell neoplasm on FNAC, but subsequent histopathological diagnosis following resection revealed Hashimoto′s thyroiditis with marked Hurthle cell change.

  14. 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...

  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. Primary subcutaneous inguinal hydatid cyst: diagnosis by fine needle aspiration cytology.

    Science.gov (United States)

    Bagga, Permeet Kaur; Bhargava, Satish Kumar; Aggarwal, Neema; Chander, Yogesh

    2014-08-01

    Hydatid disease or human cystic echinococcosis, recognized by ancient scholars such as Hippocrates, Galen and Rhazes, is one of the oldest diseases known to man. Though hydatid cyst may develop in almost any part of the body, a solitary primary subcutaneous localization is an extremely rare entity. We herein report a case of primary subcutaneous inguinal hydatid cyst which was diagnosed by fine needle aspiration cytology. Radiological examination done subsequently corroborated with the cytodiagnosis of Hydatid cyst and did not show involvement of any other organ or site. Histopathological examination of surgically removed cyst confirmed the diagnosis of Hydatid cyst. Hydatid disease should be considered in the differential diagnosis of all unusual swellings in soft tissues, especially in regions where the disease is endemic. PMID:25302206

  17. Determination of oestrogen receptors with monoclonal antibodies in fine needle aspirates of breast carcinoma.

    Science.gov (United States)

    Marrazzo, A.; La Bara, G.; Taormina, P.; Bazan, P.

    1989-01-01

    Fifty patients with operable breast carcinoma underwent fine needle aspiration for cytological examination. The smears were prepared by means of the immunocytochemical method using monoclonal antibodies for the determination of the oestrogen receptors (ER). After surgery the contents of the ER were determined with the traditional biochemical technique. The results of the immunocytochemical method showed 31 positives, two of which disagreed with the biochemical results, 15 negatives and four cases which could not be assessed due to the absence of adequate numbers of cells. The ICA staining for ER was expressed on a semiquantitative basis; there was a significant correlation between this and the values expressed by the biochemical technique, with a coefficient of 0.83, P less than 0.000006. PMID:2930709

  18. 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).

  19. Penile metastasis of urothelial carcinoma diagnosed by fine-needle aspiration

    Directory of Open Access Journals (Sweden)

    Santos Gilda

    2009-01-01

    Full Text Available Penile neoplasms are rare and can be primary or represent metastasis or local recurrence. The most common primary cancer of the penis is squamous cell carcinoma, accounting for 95% of all cancers. In spite of the rich vascularity of the organ, penile metastases are uncommon. Cutaneous metastasis of urothelial carcinoma (UC is extremely rare and generally accepted as the late manifestation of a systemic spread. By 1998, approximately 500 cases of penile metastasis had been reported worldwide. However, only few case reports and series of fine-needle aspiration cytology (FNAC of penile tumors have been documented. We report a case of penile metastasis from UC diagnosed by FNAC and describe the cytomorphological findings with an emphasis on cercariform cells. Although not commonly used, FNA of penile nodules can be effective in diagnosing recurrence or metastasis and avoiding surgical procedures, thus being an excellent initial procedure in the diagnostic approach.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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. PMID:27011442

  4. Ultrasound-Guided Fine Needle Aspirations of Thyroid Nodules: Assessment of Nondiagnostic Samples

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Min Ho; Lee, Ji Hye; Bae, Il Hun; Han, Gi Seok; Cha, Sang Hoon; Kim, Sung Jin; Park, Kil Sun; Koong, Sung Soo [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2005-06-15

    To determine the frequency of malignancy among the nondiagnostic specimens by ultrasound-guided, fine needle aspiration (US-FNA) and to analyze the factors which cause the nondiagnostic specimens of thyroid nodules. Data were collected from 425 patients (58 male, 367 female) who underwent US-FNA of the thyroid nodule between February, 2002 and October, 2003. The study included 784 nodules from 425 patients. US-FNA was performed 1 to 3 times by two radiologists using a 10MHz linear probe and a 21-gauge fine needle. The percentage of total nondiagnostic specimens was obtained and the percentage of nondiagnostic specimens according to the thyroid nodule's size and nature was analyzed. Thyroid nodules were classified according to their sizes and natures. The nodules were divided by size as either 1cm or more, or less than 1cm in diameter. Each nodule was classified as cystic (pure cystic), mixed (solid portion of nodule<2/3) or solid (solid portion of nodule >2/3). The percentage of malignancy among nondiagnostic specimens was determined and compared to the malignancy rate among diagnostic specimens. Chi-square test and Fisher's exact test were used for statistical significance. Among the 784 nodules, 95 (12.1%) were nondiagnostic. The percentage of nondiagnostic specimens increased as the cystic content increased (p<0.0001). The malignancy rate of the diagnostic specimens was higher than that of the nondiagnostic specimens, but the difference was not significant. The cystic content of each nodule was the only significant predictor of nondiagnostic specimens. There was no significant difference in malignancy rate between nondiagnostic and diagnostic specimens. It is suggested that when evaluating an initially nondiagnostic US-FNA, repetitive US-FNA or follow-up USG should be performed

  5. ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF INTRA ABDOMINAL LUMPS

    Directory of Open Access Journals (Sweden)

    Sanjay Kumar

    2014-03-01

    Full Text Available Fine needle aspiration cytology has gained recognition in the last decade as valuable diagnostic technique. Its benefits have been demonstrated in large series of patients and in almost all tumor types. Aim of this study was to establish role of fine needle aspiration cytology in the diagnosis of intra-abdominal lumps. Most commonly involved organ in our study was liver (30.4% followed by G.I.T (21.7% and Gall Bladder (17.4%. Maximum numbers of cases were in sixth decade followed by fifth and fourth decade (19.56% and 17.4% respectively. Malignant lesions were more common in this study compared to benign lesions. Reason behind this was inclusion of patients of higher age group in the study. Out of 46 cases only 23 cases were subjected for histopathological correlation. Amongst all such cases there were more number of malignant lesions. 100% accuracy was observed in cases of liver, intestine, ovary and kidney lesions. In other organs less accuracy obtained and probably it was due to less number of cases subjected to histological correlation. FNAC being a safe and OPD procedure can be used as important diagnostic tool for any abdominal lump. Present study had adequacy of material in 93.4% of cases and this study carries an overall accuracy ranging from 75-100% with sensitivity of 91.3%. The aspirated material can be subjected to other modalities of study like immunological, cytogenetic and microbiological depending as per need of cases, which adds to diagnostic accuracy of FNAC. Overall role of FNAC in intra-abdominal lumps is of great value and its use should be encouraged in the diagnosis of intra-abdominal lumps.

  6. A simple procedure for routine RNA extraction and miRNA array analyses from a single thyroid in vivo fine needle aspirate

    DEFF Research Database (Denmark)

    Rossing, Maria; Kaczkowski, Bogumil; Futoma-Kazmierczak, Ewa;

    2010-01-01

    microRNA (miRNA) expression profiling and classification of tissue obtained from fine-needle aspirates (FNA) could be a major improvement of the preoperative diagnosis of thyroid nodules.......microRNA (miRNA) expression profiling and classification of tissue obtained from fine-needle aspirates (FNA) could be a major improvement of the preoperative diagnosis of thyroid nodules....

  7. Ultrasound-guided fine-needle aspiration of suspicious nodes in breast cancer patients; selecting patients with extensive nodal involvement.

    NARCIS (Netherlands)

    Wely, B.J. van; Wilt, J.H.W. de; Schout, P.J.; Kooistra, B.; Wauters, Carla; Venderinck, D.; Strobbe, L.J.

    2013-01-01

    The aim of this study was to evaluate the value of Ultrasonography (US) guided fine-needle aspiration (FNA) of the axilla to identify breast cancer patients with extensive nodal involvement. A prospective database of breast cancer patients who underwent US-guided FNA of suspicious nodes, diagnosed b

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Non-imaging-guided fine-needle aspiration of liver lesions: a retrospective study of 279 patients

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    AIM To determine the value of nonimaging-guided (direct) fine-needle aspiration cytology in diagnosing liver lesions.METHODS Detection by technetium-99m, ultrasound or computed tomographic scanning of the liver was made in 279 patients with 332 aspirations.RESULTS Based on histologic, cytologic and clinical findings, final liver diagnoses were reached in 265 patients, of whom 171 had malignant and 94 benign liver disease. Among the 171 patients with malignant liver disease, the cytologic findings indicated suspected malignancy in 8 patients, suggested definite malignancy in 130, but failed to disclose malignancy in 33 patients. In 93 of the 94 patients with benign liver disease, the cytologic findings were reported as benign, while in one patient the report of malignancy was false. The overall sensitivity, specificity, and positive and negative predictive values for cytologic results were 80.7%, 98.9%, 99.3% and 73.8%, respectively. The diagnostic accuracy of fine-needle aspiration cytology was 87.2%. The only major complication attributable to the procedure consisted of one case of pneumothorax.CONCLUSION Direct fine-needle aspiration of palpable liver mass and blind fine-needle aspiration of non-palpable liver lesions for cytodiagnosis are simple, safe, and cost-effective diagnostic method for evaluating the nature of liver lesions. The aspiration procedure including potential complications could be cut short by early finding of abnormal cells.

  10. Endoscopic Ultrasound and Fine Needle Aspiration in Chronic Pancreatitis: Differential Diagnosis between Pseudotumoral Masses and Pancreatic Cancer

    OpenAIRE

    José Celso Ardengh; César Vivian Lopes; Antônio Dorival Campos; Luiz Felipe Pereira de Lima; Filadélfio Venco; José Luiz Pimenta Módena

    2007-01-01

    Context Pseudotumoral chronic pancreatitis can be difficult to differentiate from pancreatic carcinoma. Objective To evaluate the role of endoscopic ultrasound and fine needle aspiration in differentiating between inflammatory masses and malignancies in chronic pancreatitis. Design Retrospective study. Setting Tertiary care endoscopy unit. Patients and interventions Between February 1997 and December 2006, 69 pancreatic head masses from patients with alcoholic chronic pancreatitis underwent E...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. 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.

  13. 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...

  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. 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...

  16. 针吸浅表淋巴结细胞学检查诊断肺癌的意义%THE SIGNIFICANCE OF FINE NEEDLE ASPIRATION CYTOLOGY OF SUPERFICIAL LYMPH NODES IN DIAGNOSIS OF LUNG CANCER

    Institute of Scientific and Technical Information of China (English)

    张桂蓉

    2001-01-01

    目的探讨针吸细胞学检查(fine needle aspiration cytology,FNAC)在诊断肺癌时的价值.方法回顾分析210例临床病例,并结合文献复习.结果针吸细胞学检查在肺癌诊断中阳性率高于其他检查方法且结果可靠;针吸检查与外科活检联合检测可提高肺癌诊断率.结论肺部疾病伴有浅表淋巴结肿块者应尽早做针吸或活组织检查.%Objective To elucidate the value of fine needle aspiration cytology (FNAC) in diagnosis of lung cancer.Methods Report of 210 cases and literature were reviewed.Results The positive rates of FNAC were greater than those of other methods and the positive results were believable.To unite FNAC and biopsy can improve the rates of diagnosis.Conclusions Those of accompanying with superficial lymph node would be done FNAC and biopsy as soon as possible.

  17. Techniques for thyroid FNA: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference.

    Science.gov (United States)

    Pitman, Martha Bishop; Abele, John; Ali, Syed Z; Duick, Dan; Elsheikh, Tarik M; Jeffrey, R Brooke; Powers, Celeste N; Randolph, Gregory; Renshaw, Andrew; Scoutt, Leslie

    2008-06-01

    The National Cancer Institute (NCI) sponsored the NCI Thyroid fine-needle aspiration (FNA) State of the Science Conference on October 22-23, 2007 in Bethesda, MD. The 2-day meeting was accompanied by a permanent informational website and several on-line discussion periods between May 1 and December 15, 2007 (http://thyroidfna.cancer.gov). This document summarizes matters addressing manual and ultrasound guided FNA technique and related issues. Specific topics covered include details regarding aspiration needles, devices, and methods, including the use of core needle biopsy; the pros and cons of anesthesia; the influence of thyroid lesion location, size, and characteristics on technique; the role of ultrasound in the FNA of a palpable thyroid nodule; the advantages and disadvantages of various specialists performing a biopsy; the optimal number of passes and tissue preparation methods; sample adequacy criteria for solid and cystic nodules, and management of adverse reactions from the procedure. (http://thyroidfna.cancer.gov/pages/info/agenda/) PMID:18478608

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

    Directory of Open Access Journals (Sweden)

    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

  19. HER2 expression in fine needle aspirates of lymph nodes detected by preoperative axillary ultrasound in breast cancer patients.

    Directory of Open Access Journals (Sweden)

    Ji Soo Choi

    Full Text Available The purpose of this study was to assess the usefulness of HER2 levels in ultrasonographically guided fine-needle aspiration biopsy (US-FNA aspirates of axillary lymph nodes (ALNs in the determination of lymph node metastasis or the characterization of primary breast cancer, and to correlate the HER2 levels in US-FNA aspirates (FNA-HER2s of metastatic ALNs with the HER2 statuses of corresponding primary breast cancers. An institutional review board approved the study. Between January and October 2010, 164 patients with 167 ALNs examined by US-FNA were included. FNA-HER2s of ALNs were measured by chemiluminescence immunoassay, and they were correlated with cytologic/final diagnoses. Receiver operating characteristics (ROC curve analysis was performed to evaluate the diagnostic ability to differentiate benign and metastatic ALNs. Additionally, FNA-HER2s of metastatic ALNs were correlated with HER2 status and other clinicopathologic variables of the primary breast cancers. Among the 167 ALNs, 138 were metastatic and 29 were benign. The mean FNA-HER2 (6.3 ng/ml of metastatic ALNs was higher than that of benign ALNs. All 29 benign ALNs showed no measurable value of FNA-HER2 (0.0 ng/ml. The area under the ROC curves of FNA-HER2 of ALNs was 0.679 for the diagnosis of ALN metastasis. The FNA-HER2 statuses of 108 metastatic ALNs (79.4% were concordant with the HER2 statuses of the corresponding primary breast cancers. In a subgroup analysis of HER2-positive cancers with ALN metastasis, distant metastasis was significantly associated with FNA-HER2-negativity of metastatic ALNs (P = 0.04. Although FNA-HER2 of ALNs did not improve the diagnostic performance of FNA cytology in preoperative diagnosis of ALN metastasis of overall patients, FNA-HER2-positive metastatic ALNs were significantly associated with HER2-positivity of primary breast cancers. Additionally, FNA-HER2 analysis of ALN may help to develop more personalized treatment protocol for breast

  20. Egg and larvae of filarial worm in fine-needle aspiration smears of lymph node

    Directory of Open Access Journals (Sweden)

    Jitendra Singh Nigam

    2013-01-01

    Full Text Available Filariasis is a major health problem in tropical countries like India. Detection of egg with or without larva in fine-needle aspiration cytology (FNAC is very unusual despite the high incidence of this parasite in endemic zone. Early diagnosis and treatment prevent the more severe manifestations of disease. A 6-year-old male from eastern Uttar Pradesh presented with the complaints of axillary swelling, fever and loss of appetite. On examination, swelling was 3 cm × 2 cm in size, freely mobile, firm and non-tender. FNA was performed and air-dried smears were stained with Giemsa stain. Smears showed many short and blunt larvae without any distinct sheath and nuclei. Numerous round to oval eggs with short coiled larvae inside them were also seen. A diagnosis of filarial lymphadenopathy was made. The case was considered worth documentation to highlight the finding of filarial eggs in FNA of lymph node, which can be missed or misdiagnosed by an unexperienced pathologist leading to delayed or wrong treatment of a curable disease.

  1. Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration

    Institute of Scientific and Technical Information of China (English)

    Kazuya Akahoshi; Takashi Nagaie; Yorinobu Sumida; Noriaki Nlatsui; Masafumi Oya; Rie Akinaga; Masaru Kubokawa; Yasuaki Motomura; Kuniomi Honda; Masayuki Watanabe

    2007-01-01

    AIM: to evaluate the role of endoscopic ultrasonographyguided fine needle aspiration (EUS-FNA) in the preoperative diagnosis of gastrointestinal stromal tumor (GIST).METHODS: From September 2002 to June 2006, Fiftythree consecutive EUS-FNAs of GI tract subepithelial hypoechoic tumors with continuity to proper muscle layer suspected as GIST by standard EUS were evaluated prospectively. The reference standards for the final diagnosis were surgery (n = 31), or clinical follow-up (n = 22). Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens were compared.RESULTS: In 2 cases puncture was not performed because of anatomical problems. The collection rate of adequate specimens from the GI tract subepithelial hypoechoic tumor with continuity to proper muscle layer was 82% (42/51). The diagnostic rate for the tumor less than 2 cm, 2 to 4 cm, and 4 cm or more were 71% (15/21), 86% (18/21), and 100% (9/9),respectively. In 29 surgically resected cases, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EUS-FNA using immunohistochemical analysis of GIST were 100%(24/24), 80% (4/5), 96% (24/25), 100% (4/4), and 97% (28/29), respectively. No major complications were encountered.CONCLUSION: EUS-FNA with immunohistochemical analysis is a safe and accurate method in the pretherapeutic diagnosis of GIST. It should be taken into consideration in decision making, especially in early diagnosis following minimal invasive surgery for GIST.

  2. Simultaneous endoscopic ultrasound fine needle aspiration and endoscopic retrograde cholangio-pancreatography:Evaluation of safety

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To investigate the rate of complications of endoscopic retrograde cholangio-pancreatography (ERCP)performed immediately after endoscopic ultrasound fine needle aspiration (EUS-FNA) in a large series of patients.METHODS: Patients with the following conditions were considered candidates for EUS-FNA and ERCP: diagnosis of locally advanced or metastatic pancreatic lesion not eligible for surgery, and patients with pancreatic lesion of unknown nature causing jaundice. Data were prospectively collected on the following parameters:indication for FNA, EUS findings, pathological diagnosis,procedure duration of EUS-FNA and combined EUS-FNA and ERCP, and immediate and late complications.RESULTS: From January 2004 to October 2006, 72 patients were deemed eligible for combined EUS and ERCP. In 25/72 EUS-FNA was performed to obtain a pathology diagnosis of lesions causing biliary obstruction,and ERCP sequentially performed to drain the biliary system. No immediate complications occurred except for two mild bleeding episodes post sphincterotomy. No late complications were recorded except for one patient who experienced fever, promptly recovered with antibiotic therapy.CONCLUSION: Simultaneous approach appears to be feasible and safe. When possible, this can be considered the reference standard to avoid double sedation and reduce duration of the procedure and hospital stay.

  3. 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.

  4. Significance of eosinophils in diagnosing Hashimoto′s thyroiditis on fine-needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Ekambaram Maheswari

    2010-07-01

    Full Text Available Background: Hashimoto′s thyroiditis (HT is the most common cause of hypothyroidism in those areas of the world where iodine levels are sufficient. Fine-needle aspiration cytology (FNAC can accurately diagnose this lesion in most of the patients. However, a small percentage of cases may be missed due to inherent limitations of this procedure. Therefore, cytologic clues to increase sensitivity of diagnosis need to be searched for. Aims: To assess whether an eosinophilic infiltration of the thyroid gland has a higher association with HT than colloid goiter. Materials and Methods: The study was a case-control study. Smears obtained by FNAC of 50 case, each of HT (which served as cases and colloid goiter (which served as controls were observed. The number of eosinophils and neutrophils per high-power field (HPF was counted in all the smears. The eosinophil-neutrophil ratio in the smears, diagnosed as HT, was then compared with that of colloid goiter using unpaired t-test. Results: Smears diagnosed as HT was found to have a significantly higher eosinophil-neutrophil ratio than smears diagnosed as colloid goiter (P value 0.0001. Conclusion: Eosinophilic infiltration of the thyroid gland has higher association with Hashimoto thyroiditis.

  5. The Clinical Usefulness of Ultrasound-Guided Fine Needle Aspiration Cytology in Thyroid Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young [Dept. of Diagnostic Radiology, Dankook University Hospital, Yongin (Korea, Republic of); Park, Young Sun [Dept. of Radiological Technology, Daejeon Health Science College, Daejeon (Korea, Republic of)

    2008-06-15

    Thyroid nodules are a common disease in clinical practice. Fine needle aspiration (FNA) is an accurate and safe method for the diagnosis of thyroid nodules. One of the limitations of FNA is the variable rate of unsatisfactory specimens, especially in small sized, deep seated or complex cystic nodules. To overcome this problem, ultrasound-guided FNA (US-FNA) has been widely used. In this study, the clinical usefulness of US-FNA cytology in thyroid nodules was investigated. Female to male ratio was 6.58:1. The incidence of nodules were 157 (43.1%) cases on the right, 130 (35.7%) cases on the left and 9 (2.5%) cases in isthmus. Total 139 cases (38.2%) belong to less than 1 cm and 225 cases (61.8%) belong to more than 1 cm. As for the echo type in the nodules, solid types were 255(70.1%), cystic type 39 (10.7%) cases, and the percentage of mixed type was 19.2%. The results show that US-FNA reduces the possibility of unsatisfactory cytologic specimens and the rate of false-negative diagnosis, and improves the diagnostic accuracy in investigation thyroid nodules.

  6. When Morphology Meets Somatic Mutations: The New Possible Scenario in Thyroid Fine-Needle Aspiration.

    Science.gov (United States)

    Rossi, Esther Diana; Schmitt, Fernando

    2016-01-01

    This study points to the analysis of the morphological features suggestive of somatic mutations, mostly the BRAFV600E mutation, on cytological samples of thyroid carcinomas. According to the literature, the application of ancillary techniques on cytology comes in handy as a challenging aid in ruling out a malignant outcome on both conventional and liquid-based cytological preparations. However, the evaluation of somatic mutations, including BRAFV600E, usually performed by DNA techniques, may have some limitations in a worldwide diffusion. In this perspective, few authors emphasized the morphological search for BRAFV600E mutations harbored in papillary thyroid carcinoma (PTC) and characterized by specific architectural and cellular findings (i.e. eosinophilic cells defined as 'plump cells' and sickle-shaped nuclei). Hence, the detection of eosinophilic cytoplasm of mutated PTC cells seems to suggest the possible involvement of the 'Warburg effect' pioneering the ability of cancer cells to convert glucose into lactic acid. The recent yields of immunohistochemical expression of monocarboxylate transporters in mutated PTCs may suggest the accumulation of lactate in these plump cells. Equally importantly, the detection of these morphological findings using fine-needle aspiration cytology may be helpful in triaging thyroid lesions and limiting costs. Additionally, it may lead to the stratification of the malignant risk and personalized management in cases with multifocal lesions. PMID:27288325

  7. Cytologic findings and diagnostic yield in 92 dogs undergoing fine-needle aspiration of the pancreas.

    Science.gov (United States)

    Cordner, Amy P; Sharkey, Leslie C; Armstrong, P Jane; McAteer, Kaitlyn D

    2015-03-01

    The diagnosis of pancreatic disease in small animal veterinary patients is complicated by nonspecific clinical signs and the limitations of diagnostic testing. Pancreatic cytology is a potential diagnostic tool, but safety and diagnostic yield are not well characterized in large patient cohorts. We hypothesized that pancreatic fine-needle aspiration (FNA) in dogs would frequently generate diagnostic-quality samples and subsequent adverse medical events would be uncommon. Ninety-two client-owned dogs undergoing pancreatic FNA for clinical diagnostic evaluation were identified retrospectively by a computer search for pancreatic cytology submissions. Archived slides were reviewed by a single board-certified clinical pathologist using a predetermined descriptive scheme. Medical records were reviewed for adverse events 48 hr following FNA, for concurrent procedures and diagnosis in patients with adverse events and for histology results. Diagnostic yield was calculated as the % cases in which a cytologic diagnosis could be achieved; correlation with histology or other confirmatory testing was determined when possible. Diagnostic yield was 73.5%, and the major pathologic process identified cytologically correlated with confirmatory testing in 10 out of 11 cases. There were 7 adverse events, all in dogs with significant comorbidities or undergoing other invasive procedures. Pancreatic FNA in dogs has a good diagnostic yield and a low rate of clinical complications in a large case series of dogs. Correlation of cytology and histology results was high in a limited number of cases. PMID:25776547

  8. Malignancy risk analysis in patients with inadequate fine needle aspiration cytology (FNAC of the thyroid.

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    Talib Al Maqbali

    Full Text Available BACKGROUND: Thyroid fine needle aspiration cytology (FNAC is the standard diagnostic modality for thyroid nodules. However, it has limitations among which is the incidence of non-diagnostic results (Thy1. Management of cases with repeatedly non-diagnostic FNAC ranges from simple observation to surgical intervention. We aim to evaluate the incidence of malignancy in non-diagnostic FNAC, and the success rate of repeated FNAC. We also aim to evaluate risk factors for malignancy in patients with non-diagnostic FNAC. MATERIALS AND METHODS: Retrospective analyses of consecutive cases with thyroid non diagnostic FNAC results were included. RESULTS: Out of total 1657 thyroid FNAC done during the study period, there were 264 (15.9% non-diagnostic FNAC on the first attempt. On repeating those, the rate of a non-diagnostic result on second FNAC was 61.8% and on third FNAC was 47.2%. The overall malignancy rate in Thy1 FNAC was 4.5% (42% papillary, 42% follicular and 8% anaplastic, and the yield of malignancy decreased considerably with successive non-diagnostic FNAC. Ultrasound guidance by an experienced head neck radiologist produced the lowest non-diagnostic rate (38% on repetition compared to US guidance by a generalist radiologist (65% and by non US guidance (90%. CONCLUSIONS: There is a low risk of malignancy in patients with a non-diagnostic FNAC result, commensurate to the risk of any nodule. The yield of malignancy decreased considerably with successive non-diagnostic FNAC.

  9. Pancreatic Leak After Endoscopic Ultrasound Guided Fine Needle Aspiration Managed by Transpapillary Pancreatic Duct Stenting

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    Savio Reddymasu

    2011-09-01

    Full Text Available Context Endoscopic ultrasonography guided fine needle aspiration (EUS-FNA is a front line test used for the diagnosis of solid as well as cystic lesions of the pancreas. This procedure is fairly well tolerated and associated with minimal complications. Local complications such as perforation and pancreatitis have been reported with EUS-FNA, albeit rarely. Although pancreatic duct injury can occur during EUS-FNA, symptomatic pancreatic duct leak as a complication of this procedure has never been reported. Case report We present a 67-year-old patient who developed symptomatic ascites after EUS-FNA of a pancreatic neck lesion that required several paracenteses. Analysis of the ascitic fluid revealed that the fluid amylase and lipase levels were very high consistent with pancreatic ascites. An endoscopic retrograde pancreatography was subsequently performed that documented the presence of a pancreatic duct leak in the neck. The pancreatic duct leak and the ascites resolved after placing a pancreatic duct stent. Conclusion A clinically significant pancreatic leak can occur as a rare complication of EUS-FNA that can be effectively managed by endoscopic retrograde pancreatography and placement of a transpapillary pancreatic duct stent.

  10. Assessment of SPAG9 Transcript in Fine Needle Aspirates of Thyroid Nodules

    Science.gov (United States)

    Volard, Bertrand; Krieger, Sophie; Planchard, Gaétane; Hardouin, Agnès; Vaur, Dominique; Rame, Jean-Pierre; Bardet, Stéphane

    2012-01-01

    Objectives Sperm-associated antigen 9 (SPAG9) has been suggested as a possible biomarker in several malignancies including thyroid cancer. We investigated the expression of SPAG9 mRNA in fine needle aspiration (FNA) material from papillary thyroid carcinoma (PTC) and benign thyroid nodules. Study Design SPAG9 expression was assessed in 36 FNA samples corresponding to 16 PTC and 20 benign nodules using the original method detecting the SPAG9 transcript containing intron 21 (NCBI X91879). The presence of the BRAF V600E point mutation was also analyzed by pyrosequencing. Results Six of 16 (38%) PTC samples were positive for X91879 SPAG9 transcript compared to 8 of 20 (40%) benign samples (p = 0.88). Out of 12 BRAF-positive PTC, 3 (25%) also expressed the SPAG9 transcript compared to 3 out of 4 BRAF-negative PTC (75%; p = 0.12). Conclusions The X91879 SPAG9 transcript originally described does not appear to be overexpressed in FNA material from PTC or to be clinically relevant in the diagnosis of thyroid nodules. PMID:24783006

  11. 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

  12. 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.

  13. 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.

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Psammoma bodies in fine needle aspiration cytology of the breast: a clinicopathological study of 30 cases.

    Science.gov (United States)

    Pillai, K Raveendran; Mani, K S; Jayalal, K S; Preethi, T R; Somanathan, Thara; Jayasree, K

    2013-05-01

    Psammoma bodies (PBs) in breast lesions are rare and little is known about the role of these structures in breast pathology. This study has looked in to the diagnostic significance of PBs in fine needle aspiration (FNAC) of breast lesions. Over a 5-year period, FNACs of the breast were done in 4,563 subjects, of which 1,678 were diagnosed to be malignant. On review of all breast aspirates including non-neoplastic lesions, 30 cases showed PBs to be associated with breast carcinoma (BC). Cytological features were correlated with clinical, radiological, histological, and immunohistochemical findings. All 30 aspirates and their corresponding histological sections showed varying number of PBs and nonpsammomatous bodies (NPBs). For comparison, 31 cases of age-matched BC without PBs and NPBs in both aspirates and sections were studied. Statistical analysis using Chi-square test was done to compare BC with and without PBs. BC with PBs was characterized by papillary pattern of malignant cells, mucin in the background, infiltration by macrophages, cellular degeneration, overexpression of estrogen receptor (ER), and progesterone receptor (PR) and moderate positivity (2+) for Her2/neu. Calcium deposition has long been implicated in the pathogenesis of many degenerative diseases; hence the formation of PBs may be relevant in breast oncology. The presence of PBs in FNAC of clinically suspected breast lesions which are cytologically negative for malignancy warrants further histological confirmation. PMID:22144226

  17. [Cytologic diagnosis of abdominal lesions with fine needle aspiration guided by ultrasound].

    Science.gov (United States)

    Candia, P; Rojas, M; Alvarado, M; Garassini, M A; Römer, M A

    1990-01-01

    The purpose of this work was to analyse the advantages and disadvantages of puncture-aspiration with fine needle, guided by ultrasonography, trying to determine its usefulness in our hospitals and its reliability in the diagnosis of intraabdominal lesions of different locations. 29 punctures were practiced on 19 patients, 9 women and 10 men of ages comprised between 34 and 94 years, with lesions in different organs of the abdominal cavity diagnosed by ultrasonography with real time equipment and lineal 3.5 and 5 MHz transducers. After cleaning and antisepsis a Chiba needle is introduced under ultrasonographic vision, up to the location of the lesion, the guide is removed and under a negative pressure, the sample is taken, which is later dried into the air and coloured using the May-Grünwald-Giemsa Technique. Only in one case it was not possible to obtain adequate material for the cytological study. There were 11 positive cases for malignity and 7 negative, one of which was a false negative. The sensibility of the method was of 91.6% with a specificity of 100% and a reliability of 89.4%. We definitely believe that the method is practical, very easy to carry out in our hospitals with a minimum amount of risk, and most of all, dependable to clarify certain diagnoses. PMID:2152268

  18. How good is fine needle aspiration? What results should you expect?

    Science.gov (United States)

    Eisendrath, Pierre; Ibrahim, Mostafa

    2014-01-01

    Tissue acquisition plays a key role before treatment decision in most of oncological pathologies but also in several benign diseases. By offering tissue sampling, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become an essential tool in the diagnostic processes. One of the reasons for the success of the technique is related to its excellent diagnostic performance. The diagnostic accuracy of EUS-FNA is above 80% for most of the usual indications. These performances are however dependent on some factors related to both the disease and patient's medical history but also related to medical staff expertise. Endoscopist needs to know how to reach a lesion but also how to efficiently acquire good tissue samples. This review aims to report general recommendations available in the literature for high quality EUS-FNA. Sample processing and sample interpretation also influence diagnostic accuracy of FNA. This paper includes a discussion on sample processing and benefits of the on-site pathology examination. It also provides the results reported in the literature of sample adequacy and diagnostic performance of EUS-FNA for most common indications: Pancreatic diseases, sub-mucosal lesion, mucosal thickenings, lymph nodes, cystic lesion and free fluids. PMID:24949404

  19. 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.

  20. Value of biomedical scientists providing on-site specimen adequacy assessment for fine-needle aspirations.

    Science.gov (United States)

    Narine, N; Rana, D N; Perera, D M; Irshad, A

    2012-01-01

    Fine-needle aspiration (FNA) is accepted as a first-line investigation in patients with superficial or deep-seated mass lesions. One of the fundamental principles of successful aspiration is harvesting sufficient numbers of cells that are representative of the lesion being investigated. Central Manchester University Hospitals NHS Foundation Trust provides FNA services to Christie Hospital, including non-attended and biomedical scientist-attended aspirations, some of which are assessed on-site for specimen adequacy. This study audits the FNA coverage provided to Christie Hospital by exploring the contribution of biomedical scientist on-site specimen adequacy assessment to successful aspirations and identifies potential areas for service improvement such that unsatisfactory sampling is reduced. Satisfactory sampling rates varied between biomedical scientist-attended (79%) and non-attended (70%) procedures. Within the former group, 100% satisfactory sampling was achieved with on-site assessment, falling to 77% without on-site assessment. The highest unsatisfactory sampling rate was identified at 33% for thyroid aspirations in endocrinology, while rates elsewhere varied between 21% and 23%. This audit demonstrated the value of on-site specimen adequacy assessment as the ultimate goal of any FNA is to negate the need for more invasive procedures. In terms of flexibility and economic value, having adequately trained biomedical scientists to perform on-site assessment is quite feasible. Extending this biomedical scientist-led service to other departments would reduce unsatisfactory sample rates and the requirement for more invasive procedures. PMID:23057157

  1. 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.

  2. 1731例乳腺肿块细针穿刺诊断的临床应用分析%Clinical value on fine needle aspiration cytology in the diagnosis of 1 731 patients with breast lumps

    Institute of Scientific and Technical Information of China (English)

    王晓洁

    2011-01-01

    目的:探讨乳腺肿块细针穿刺细胞学检查(FNAC)的临床应用价值.方法:对2006~2010年的1 731例乳腺肿块细针穿刺细胞学检查结果进行对比分析.结果:1 731例乳腺细针穿刺病例,2009~2010年的病例及阳性病例明显高于2006~2008年,其中924例做了活检对照,恶性肿瘤敏感性为96.68%(233/241),假阴性率为3.32%(8/241),无假阳性.FNAC诊断的总准确率为 97.29%(899/924).结论:乳腺肿块细针穿刺诊断技术,操作简易、快速、安全、可靠、价格低廉,可在基层医院及乳腺癌筛查中大力推广.%Objective: To explore the clinical value of fine needle aspiration cytology (FNAC) in the diagnosis of breast lumps.Methods: A total of 1 731 patients with breast lumps from 2006 to 2010 were diagnosed by fine needle aspiration cytology.The results were compared and analyzed.Results: 1 731 cases were given fine needle aspiration cytology, the number of cases and positive cases from 2009 to 2010 were obviously higher than that from 2006 to 2008.924 patients were diagnosed with biopsy.The results showed that the diagnostic sensitivity of malignant tumor was 96.68% (233/241),the false negative rate was 3.32% (8/241), arid the false positive cases were of rot existing.The accurate rate of FNAC diagnostic technology was 97.29% (899/924).Conclusion; The fine needle aspiration cytology (FN AC) in diagnosing breast lumps,which is simple, fast, secure and reliable, cou ld be largely promoted in the primary hospitals and the screening of breast cancer.

  3. Fine-needle aspiration diagnosis of breast neoplasms based on random forests%基于随机森林的乳腺肿瘤细针穿刺辅助诊断

    Institute of Scientific and Technical Information of China (English)

    孙伟; 张俊升; 邢培锐

    2015-01-01

    Fine needle aspiration cytology diagnosis is the most commonly used method for early diagnosis of breast neoplasms. In order to improve the accuracy rate of fine-needle aspiration breast neoplasms diagnosis, this paper proposed the methods for fine-needle aspiration diagnosis of breast neoplasms based on Random Forests ( RF) and Support Vector Machine ( SVM) . Using breast tumor fine needle biopsy cases database, RF and SVM classification algorithms were trained to get the classification model for breast neoplasms diagnose. The simulation results show that by using RF classifier, the average classification accuracy rate of ten times six-fold cross validation reaches 95. 96%, which is better than the 94. 71% of SVM classifier, the 91. 51% of Learning Vector Quantization ( LVQ) neural network and the 91. 25% of artificial neural network. Furthermore, the stability of RF classifier accuracy is better than that of SVM classifier. The final results show that RF classifier improves the accuracy and reliability of fine-needle aspiration diagnosis of breast neoplasms and provides advanced and effective method for clinical fine-needle aspiration diagnosis of breast neoplasms.%细针穿刺细胞学诊断是乳腺肿瘤早期诊断最常用的方法。为提高乳腺肿瘤细针穿刺诊断的准确率,提出了基于随机森林( RF)和支持向量机( SVM)的乳腺肿瘤细针穿刺辅助诊断方法。该方法利用乳腺肿瘤细针穿刺病例数据库,分别对随机森林( RF)、支持向量机( SVM)两种分类算法进行训练,并利用训练得到的分类模型对乳腺肿瘤进行诊断。仿真结果表明,采用RF分类器时,乳腺肿瘤诊断准确率达到95.96%,高于SVM分类器的94.71%,也高于学习向量化(LVQ)神经网络的91.51%及中人工神经网络的91.25%,且RF分类器准确率的稳定性优于SVM分类器,可靠性高。最终结果证明:采用RF分类器提高了乳腺肿瘤细针穿刺诊断的正确率和

  4. 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. PMID:25914148

  5. High risk of acute pancreatitis after endoscopic ultrasound-guided fine needle aspiration of side branch intraductal papillary mucinous neoplasms

    OpenAIRE

    Siddiqui, Ali A.; Shahid, Haroon; Shah, Apeksha; Khurana, Tanvi; Huntington, William; Ghumman, Saad S.; Loren, David E; Kowalski, Thomas E; Laique, Sobia; Hayat, Umar; Eloubeidi, Mohamad A

    2015-01-01

    Background and Objectives: Data on the risk of acute pancreatitis following endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic cystic lesions are limited. The aim of our study was to evaluate the frequency of acute pancreatitis after EUS-FNA of pancreatic cysts and solid lesions, and determine whether there was a difference in pancreatitis risk in patients with side branch intraductal papillary mucinous neoplasms (SB-IPMN). Patients and Methods: A retrospective review...

  6. 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.

  7. Endoscopic ultrasound-guided fine-needle aspiration of metastases to the pancreas: A study of 25 cases

    OpenAIRE

    Gilbert, Christopher M.; Monaco, Sara E.; Cooper, Scott T.; Khalbuss, Walid E.

    2011-01-01

    Background: Metastases to the pancreas are an uncommon cause of pancreatic masses seen on endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). The purpose of this study is to retrospectively review the cytomorphology, clinical findings, and results of ancillary studies in a large series of these unusual cases. Materials and Methods: We searched our institution′s pathology database for EUS-guided FNAs of the pancreas that were diagnostic of metastatic tumor over a 5-year period. Th...

  8. Image-Guided Fine Needle Cytology with Aspiration Versus Non-Aspiration in Retroperitoneal Masses: Is Aspiration Necessary?

    OpenAIRE

    Misra, Rajiv Kumar; Mitra, Shaila; Jain, Rishav Kumar; Vahikar, Shilpa; Bundela, Archana; Misra, Purak

    2015-01-01

    Background: Although using fine needle cytology with aspiration (FNC-A) for establishing diagnoses in the retroperitoneal region has shown promise, there is scant literature supporting a role of non-aspiration cytology (FNC-NA) for this region. We assessed the accuracy and reliability of FNC-A and FNC-NA as tools for preoperative diagnosis of retroperitoneal masses and compared the results of both techniques with each other and with histopathology. Methods: Fifty-seven patients with retroperi...

  9. How to improve the success of endoscopic ultrasound guided fine needle aspiration cytology in the diagnosis of pancreatic lesions

    OpenAIRE

    Antonio Z Gimeno-García; Elwassief, Ahmed

    2012-01-01

    Endoscopic ultrasonography (EUS) is highly accurate for assessing the pancreatic parenchyma and ductal system. Currently, it is the most sensitive imaging procedure for detecting small solid pancreatic masses. EUS-guided fine needle aspiration cytology (EUS-FNA) is a safe and highly accurate tool for the diagnosis of pancreatic malignancy. Prior to perform an EUS-FNA one should wonder whether the benefits outweigh the potential risks of the procedure. Therefore, it is important to take into a...

  10. 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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Endoscopic ultrasound-guided fine-needle aspiration cytology in the evaluation of suspected tuberculosis in patients with isolated mediastinal lymphadenopathy

    DEFF Research Database (Denmark)

    Puri, R.; Vilmann, P.; Sud, R.;

    2010-01-01

    Patients with suspected tuberculosis without pulmonary lesions and with mediastinal lymphadenopathy often pose a diagnostic challenge. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) cytology is an established modality to evaluate mediastinal and abdominal lesions. The aim...

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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Fine needle aspiration of secondary synovial sarcoma of the thyroid gland.

    Science.gov (United States)

    Murro, Diana; Slade, Jamie Macagba; Syed, Sahr; Gattuso, Paolo

    2015-11-01

    Synovial sarcomas (SS) of the head and neck region are extremely rare and arise in only 5% of cases. We present a case of secondary SS of the thyroid originally diagnosed as medullary carcinoma on fine needle aspiration (FNA). A 41-year-old man presented with several weeks of dysphonia and a left thyroid mass. FNA of the thyroid nodule showed a cellular smear composed of loosely cohesive oval to spindle-shaped cells with irregular nuclear borders, finely granular chromatin, and inconspicuous nucleoli. The patient was diagnosed with medullary carcinoma and underwent a total thyroidectomy. Intro-operatively, the mass was found to arise from the tracheoesophageal groove with spread to the left thyroid. Microscopic examination of the thyroid tumor revealed a dense spindle cell proliferation with abundant mitoses, scant cords and nests of epithelial cells and foci of necrosis. The spindle cells were positive for bcl2 and vimentin and the epithelial cells were positive for cytokeratin 8/18 and epithelial membrane antigen (EMA). Both spindle and epithelial cells were negative for thyroglobulin, calcitonin, synaptophysin and chromogranin. Fluorescence in situ hybridization (FISH) demonstrated translocation (X;18)(p11;q11), confirming the diagnosis of SS. The patient underwent a total laryngopharyngoesophagectomy with subsequent adjuvant therapy and is currently disease free. Only 6 cases of histologically confirmed primary SS of the thyroid have been reported. To the best of our knowledge, this is the first case of FISH-confirmed secondary SS of the thyroid and also the first case of SS arising from the tracheoesophageal groove.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  16. Diagnostic Yield of Fine-Needle Aspiration for Axillary Lymph Nodes During Screening Breast Ultrasound.

    Science.gov (United States)

    Youn, Inyoung; Kim, Eun-Kyung; Yoon, Jung Hyun; Moon, Hee Jung; Kim, Min Jung

    2016-06-01

    The purpose of our study was to assess the positive predictive value (PPV) of ultrasound (US)-guided fine-needle aspiration (FNA) and the cancer detection rate for incidentally detected abnormal axillary lymph node (LN) in patients who underwent screening US. We retrospectively reviewed 72 LNs of 69 patients (mean age, 44.9 years) who underwent US-FNA for incidentally detected abnormal axillary LNs on 50,488 screening US from January 2005 to December 2011. The PPV of US-FNA and the cancer detection rate were calculated. We evaluated US images for lymph node size, abnormal findings (hilum loss, eccentric cortical thickening, round shape, extranodal extension, or marked hypoechoic cortex), and mammography for the identification of abnormal LNs. The PPV of each finding was also calculated. The PPV of US-FNA and the cancer detection rate were 2.8% (2/72) and 0.004% (2/50,488), respectively. The mean (SD) measurements for long-axis, short-axis, and cortical thickening of the LNs were 14.9 (5.9) mm, 8.5 (3.5) mm, and 5.8 (2.8) mm, respectively. Of the positive LNs, US findings of hilum loss, eccentric cortical thickening, and extranodal extension were found, and each corresponding PPV was 6.3% (1/16), 1.8% (1/56), and 14.3% (1/7), respectively. The PPV of mammography was 14.3% (1/7). Our results suggest that the PPVs of US-FNA and the cancer detection rate for incidentally detected abnormal axillary LNs during screening US are too low to recommend axillary US during breast US screening and that follow-up is acceptable for abnormal LNs detected during screening breast US that do not have extranodal extension or are negative on mammography. PMID:27054655

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

    International Nuclear Information System (INIS)

    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. CORRELATION OF FINE NEEDLE ASPIRATION CYTOLOGY WITH BRONCHOALVEOLAR LAVAGE AND BRUSH SMEAR CYTOLOGY IN PULMONARY LESIONS

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    Surabhi

    2014-06-01

    Full Text Available BACKGROUND: Fine Needle Aspiration Cytology (FNAC, Bronchoalveolar Lavage (BAL and Brush Cytology are important diagnostic tools for evaluation of pulmonary lesions. Considering the limitations of these procedures correlation of these cytological techniques may help in improving accuracy and increasing the diagnostic yield. AIM: To determine the role of FNAC, Brush and BAL Cytology in pulmonary lesions and to correlate the efficacy of FNAC with Brush and BAL Cytology. MATERIALS AND METHODS: This prospective study was conducted on 78 patients with radiologically demonstrable pulmonary lesions in the department of pathology and Dr ML Chest Hospital, GSVM Medical College, Kanpur over a period from nov2011-july2013. The cases selected had to give consent for the procedure. Bronchoalveolar lavage, bronchial brush sample were taken and FNAC was done in the cases. RESULTS: In present study 78 cases of pulmonary lesions were subjected to FNAC and/ or Bronchoalveolar lavage and brush cytology. Among them 49 cases were selected in which all three procedures were done. The sensitivity and specificity for detecting lung tumors by FNAC was 96.29% and 95.45% which was more than that of BAL cytology (84.61%, 91.30% and Brush cytology (81.48%, 95.45%. FNA correlates with Brush and BAL cytology in 78.57% of malignant lesions. Among malignant lesions 84.61% of BAL and Brush cytology correlates with FNA for diagnosis of squamous cell carcinoma. FNA correlates with 66.67% of brush and 83.37% of BAL fluid cytology for diagnosis of adenocarcinoma. BAL and Brush both correlates with FNA in 83.33% cases of small cell carcinoma. Overall 85.71% of BAL and 82.14% of brush smear cytology correlates with FNA cytology for diagnosis of lung cancers. CONCLUSIONS: FNA, BAL and Brush cytology provide a high yield for evaluation of pulmonary lesions. BAL fluid and brush cytology correlated well with FNAC for diagnosis of lung cancers.

  19. Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration

    Institute of Scientific and Technical Information of China (English)

    José Celso Ardengh; César Vivian Lopes; Luiz Felipe Pereira de Lima; Juliano Rodrigues de Oliveira; Filadelfio Venco; Giulio Cesare Santo; Jose Luiz Pimenta Modena

    2007-01-01

    AIM: To evaluate the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic solid tumors larger or smaller than 3 cm, and cystic lesions.METHODS: From January/1997 to December/2006, 611 patients with pancreatic tumors were subjected to EUS-FNA. The final diagnosis was obtained either by surgery (356 cases) or after a mean clinical follow-up of 11.8 mo in the remaining patients.RESULTS: There were 405 solid tumors, 189 cystic lesions and 17 mixed. Pancreatic specimens for cytological assessment were successfully obtained by EUS-FNA in 595 (97.4%) cases. There were 352 (57.6%) malignancies and 259 (42.4%) benign tumors. Among the malignancies, pancreatic adenocarcinomas accounted for 67% of the lesions. Overall, the sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA were, respectively, 78.4%, 99.2%, 99.3%, 77.2% and 87.2%. Specifically for solid tumors, the same parameters for neoplasms larger and smaller than 3 cm were, respectively, 78.8% vs 82.4%, 100% vs 98.4%, 100% vs 99%, 54.8% vs 74.1% and 83.1% vs 87.8%. For cystic lesions, the values were, respectively, 72.2%, 99.3%, 97.5%, 91% and 92.2%.CONCLUSION: EUS-FNA can be used to sample pancreatic tumors in most patients. Even though the negative predictive value is inadequate for large solid tumors, the results are rather good for small solid tumors, especially concerning the sensitivity, negative predictive value and diagnostic accuracy. Among all pancreatic lesions, EUS-FNA for cystic lesions can reveal the best negative predictive value and diagnostic accuracy, both higher than 90%.

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

    Science.gov (United States)

    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.

  1. Papillary thyroid carcinoma: How much should the surgeon read from Fine needle aspiration cytology reports?

    Directory of Open Access Journals (Sweden)

    Das Dilip

    2010-10-01

    Full Text Available Objective: During routine fine needle aspiration cytodiagnosis of papillary thyroid carcinoma (PTC, a number of cases are diagnosed as suspicious; or it is suggested that PTC or a neoplasm be ruled out by histopathology. Since these diagnostic labels are likely to put the clinicians in a difficult situation while planning the management, this study aims to find out how much the surgeon should read from these reports. Materials and Methods: The patients were divided into two groups. Group A included 38 cases diagnosed as PTC or suspicious of PTC. Group B included 40 cases in which it was suggested that PTC/a neoplasm to be ruled out and non-neoplastic lesions with one or more cytologic features of PTC. The two groups were compared with clinical, imaging and cytomorphologic features. Results: A significant difference was observed with respect to age between Group A and Group B (P<0.001. The frequency of the following five cytologic features was significantly higher in Group A: papillary formation (P<0.001, psammoma bodies (P=0.054, fine nuclear chromatin (P=0.010, frequent nuclear grooves (P<0.001 and intra-nuclear cytoplasmic inclusion (P<0.001. Three or more of the five cytologic features were also reported in significantly higher number of Group A cases (P<0.001. Majority (81.8% of the cases with subsequent histology in Group A were confirmed as PTC as opposed to 7.7% in Group B (P<0.001. Conclusions: Thus, cases with definitive cytodiagnosis of PTC and suggestive of PTC (Group A should be taken much more seriously by the surgeons as compared to Group B cases.

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

    Directory of Open Access Journals (Sweden)

    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

  3. Fine-needle aspiration and Mammotome Comparison before T1 operative diagnosis of breast cancer%细针穿刺与麦默通在 T1期乳腺癌术前诊断中应用比较

    Institute of Scientific and Technical Information of China (English)

    张苗; 童艳兰; 李扬; 李子国; 刘增亮

    2016-01-01

    Objective To investigate the effect of fine needle aspiration with the Mammotome breast cancer surgery in T1 before diagnosis, provide the basis for the diagnosis of breast cancer. Methods A hospital in April 2012~April 2015 admitted to surgical indications and T1 diagnosed 130 cases of breast cancer patients were analyzed, all patients underwent preopera-tive fine needle aspiration with the Mammotome minimally invasive biopsy system inspection, inspection method to observe two disadvantages. Results In the real-time performance and accuracy of diagnosis of breast cancer T1, Mammotome significantly better than fine-needle aspiration biopsy examination, the difference was significant; and Mammotome biopsy success rate and positive were significantly higher than fine-needle aspiration, the difference was significant; but Mammotome biopsy hematoma and subcutaneous congestion were significantly higher than fine-needle aspiration, the difference was significant. Conclusion Fine needle aspiration method is simple, safe, minimally invasive, the disadvantage of low positive rate, high rate of misdiag-nosis; and Mammotome biopsy method has high sensitivity, high specificity, the advantages of minimally invasive breast mass. Mammotome minimally invasive biopsy system is a safe breast lumps qualitative difficulties (including fine-needle aspiration were negative) when effective diagnostic method.%目的:探讨细针穿刺与麦默通在 T1期乳腺癌术前诊断中的效果,为乳腺癌的诊断提供依据。方法:选择本院2012年4月-2015年4月收治的有手术指征并确诊的 T1期乳腺癌患者130例进行分析,所有患者术前均进行细针穿刺与麦默通微创活检系统进行检查,观察两组检查方法的优缺点。结果:在一次性确诊 T1期乳腺癌的实际效果和准确性上,麦默通活检显著优于细针穿刺检查,差异具有统计学意义;且麦默通穿刺成功率及穿刺阳性率均显著高于细针穿

  4. Scenario of Fine Needle Aspiration Cytology of Neck Masses in a Tertiary Care Hospital

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    Md Atiqur Rahman

    2011-01-01

    Full Text Available Background: Masses in the neck are very common and these may range from inflammatory to neoplastic lesions. Fine needle aspiration cytology (FNAC is a simple, quick and minimally invasive procedure that is well recognized and widely accepted diagnostic tool in separating inflammatory lesions from cystic and neoplastic lesions of the neck. We designed this study in our populations for evaluation of FNAC of different neck masses and that might facilitate the diagnosis and management of these lesions. Objectives: To find out the frequency of different pathological conditions detected on FNAC, to determine the prevalence of neck masses with respect to age and sex and to assert their organs of origin and the nature of the lesions. Materials and Methods: This study was conducted in the Department of Pathology, Enam Medical College, Savar, Dhaka from January 2009 to August 2010. The patients of any age and either sex with neck masses were included. Total 526 patients with neck swellings were included in this study. Among these 60.6% were females and 39.4% were males with male to female ratio of 1:1.54. The age of the patients ranged from 10 months to 85 years with mean age of 32.52 ±17.01 years. Results: Of the 526 cases 341 (64.8% were from lymph nodes, 127 cases (24.2% from thyroid glands, 32 cases (6.1% from salivary glands, 14 cases (2.7% from cysts and 12 cases (2.2% from soft tissues. FNAC revealed that 86.2% of the lesions were non-malignant which included 60.5% of inflammatory lesions and 25.7% of other benign lesions. Malignant lesions were found in 8% of cases and 5.9% of the cases were categorized as indeterminate follicular neoplasm of the thyroid gland. Conclusion: Reactive lymphadenitis is the commonest condition in the neck swellings followed by tuberculous lymphadenitis, nodular goiter and malignant neoplasm, especially metastatic carcinoma.

  5. 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.

  6. Fine needle aspiration cytology of lesions of liver and gallbladder: An analysis of 400 consecutive aspirations

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    Mustafa Barbhuiya

    2014-01-01

    Conclusion: FNAC can be used successfully for the diagnosis of liver and gallbladder lesions, thus avoiding open biopsy. Study indicates the potential of using FNAC in clinical intervention where the incidence of gall-bladder and liver cancer is very high and open biopsy and surgery are not an option.

  7. Assessment of pancreatic neoplasms: review of biopsy techniques.

    Science.gov (United States)

    Goldin, Steven B; Bradner, Michael W; Zervos, Emmanuel E; Rosemurgy, Alexander S

    2007-06-01

    Pancreatic cancer is the 4th leading cause of cancer death annually. Recent technological advances in imaging have led to non-uniformity in the evaluation of pancreatic neoplasms. The following article describes the history behind various biopsy techniques and the rationale for obtaining a biopsy of a pancreatic neoplasm and discusses the benefits and disadvantages of the various pancreatic biopsy techniques, including fine needle aspiration biopsy, Tru-cut needle biopsy, endoscopic brushings/cytology, and endoscopic ultrasound guided biopsies. A treatment algorithm for pancreatic neoplasms is then presented. PMID:17562121

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

    International Nuclear Information System (INIS)

    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.

  9. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  11. Diagnosis of Rosai-Dorfman Disease in Elderly Female on Fine Needle Aspiration Cytology: A Case Report

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    Meher Aziz

    2012-01-01

    Full Text Available Rosai-Dorfman disease (RDD is a rare benign disorder of histiocytic proliferation that usually presents with bilateral cervical lymphadenopathy in children. We describe the case of a 50-year-old lady suffering from this disease who presented with generalized lymphadenopathy and a left sided chest wall lump. Fine needle aspiration cytology (FNAC from all the lesions showed abundant benign histiocytes with lymphophagocytosis which was compatible with the diagnosis of RDD. This case is being reported for its rarity in presentation in an elderly female with both generalized nodal as well as extranodal manifestations.

  12. 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.

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

    OpenAIRE

    Nalini Gupta; Tarak Banik; Arvind Rajwanshi; Bishan D Radotra; Naresh Panda; Pranab Dey; Radhika Srinivasan; Raje Nijhawan

    2012-01-01

    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% ca...

  14. 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.

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

    Institute of Scientific and Technical Information of China (English)

    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

  16. 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.

  17. Internal mammary lymph node biopsy guided by computed tomography

    OpenAIRE

    Irving, Henry C; Hardy, Graham J.

    1982-01-01

    Internal mammary lymph node enlargement may be demonstrated using computed tomography (CT), and a confirmatory tissue diagnosis of metastatic involvement may be obtained using fine needle aspiration biopsy with needle tip placement guided by the CT scanner. A case history is described to illustrate how a patient presented 9 years after mastectomy with an internal mammary lymph node metastasis and how cytopathological diagnosis of this metastasis was achieved by CT guided biopsy.

  18. Biopsy of parotid masses: Review of current techniques

    OpenAIRE

    Haldar, Sananda; Sinnott, Joseph D; Tekeli, Kemal M; Turner, Samuel S; Howlett, David C.

    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 goog...

  19. Is ultrasound-guided fine-needle aspiration cytology of adequate value in detecting breast cancer patients with three or more positive axillary lymph nodes?

    Science.gov (United States)

    Kramer, G M; Leenders, M W H; Schijf, L J; Go, H L S; van der Ploeg, T; van den Tol, M P; Schreurs, W H

    2016-04-01

    This study evaluated the accuracy of ultrasound-guided fine-needle aspiration cytology of the sonographically most suspicious axillary lymph node (US/FNAC) to select early breast cancer patients with three or more tumour-positive axillary lymph nodes. Between 2004 and 2014, a total of 2130 patients with histologically proven early breast cancer were evaluated and treated in the Noordwest Clinics Alkmaar. US/FNAC was performed preoperatively in all these patients. We analysed the results of US/FNAC retrospectively. Pathological axillary node status (sentinel node biopsy and/or axillary lymph node dissection) was used as reference standard. A total of 634 (29.8 %) of 2130 patients had axillary lymph node metastases on final histology. 248 node positive patients (11.6 %) had three or more positive lymph nodes. The accuracy of US/FNAC to detect three or more positive lymph nodes was 89.8 %, sensitivity was 44.8 %, specificity was 95.7 %, PPV was 58.1 %, and NPV was 92.9 %. This study shows a more than adequate accuracy of preoperative US/FNAC to detect three or more positive lymph nodes (89.8 %). However, when US/FNAC was chosen as the only axillary staging method, 6.4 % of all patients (false negative group) would have been undertreated and 3.8 % of all patients (false positive group) would have been overtreated according to the ACOSOG Z0011 criteria. PMID:26995283

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

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    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.

  1. 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.

  2. Biopsy pathology in uveitis

    Directory of Open Access Journals (Sweden)

    Jyotirmay Biswas

    2011-01-01

    Full Text Available Uveitis is fraught with speculations and suppositions with regard to its etiology, progress and prognosis. In several clinical scenarios what may be perceived as due to a systemic infection may actually not be so and the underlying etiology may be an autoimmune process. Investigations in uveitis are sometimes the key in identification and management. Invasive techniques could be of immense value in narrowing down the etiology and help in identifying the cause. This article updates one on the invasive techniques used in biopsy such as anterior chamber paracentesis, vitreous tap and diagnostic vitrectomy, iris and ciliary body biopsy, choroidal and retinochoroidal biopsy and fine needle aspiration biopsy (FNAB. In populations where certain infections are endemic, the clinical scenario does not always respect a known presentation and the use of biopsy is resorted to as a sure way of confirming the etiology. Biopsies have a role in diagnosis of several inflammatory and infectious conditions in the eye and are pivotal in diagnosis in several dilemmas such as intraocular tumors and in inflammations. Appropriate and timely use of biopsy in uveitis could enhance the diagnosis and provide insight into the etiology, thus enabling precise management.

  3. Image-guided breast biopsy: state-of-the-art

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    O' Flynn, E.A.M., E-mail: lizoflynn@doctors.org.u [South East London Breast Screening Programme and National Breast Screening Training Centre, Kings College Hospital NHS Foundation Trust, London SE5 9RS (United Kingdom); Wilson, A.R.M.; Michell, M.J. [South East London Breast Screening Programme and National Breast Screening Training Centre, Kings College Hospital NHS Foundation Trust, London SE5 9RS (United Kingdom)

    2010-04-15

    Percutaneous image-guided breast biopsy is widely practised to evaluate predominantly non-palpable breast lesions. There has been steady development in percutaneous biopsy techniques. Fine-needle aspiration cytology was the original method of sampling, followed in the early 1990s by large core needle biopsy. The accuracy of both has been improved by ultrasound and stereotactic guidance. Larger bore vacuum-assisted biopsy devices became available in the late 1990s and are now commonplace in most breast units. We review the different types of breast biopsy devices currently available together with various localization techniques used, focusing on their advantages, limitations and current controversial clinical management issues.

  4. Image-guided breast biopsy: state-of-the-art.

    Science.gov (United States)

    O'Flynn, E A M; Wilson, A R M; Michell, M J

    2010-04-01

    Percutaneous image-guided breast biopsy is widely practised to evaluate predominantly non-palpable breast lesions. There has been steady development in percutaneous biopsy techniques. Fine-needle aspiration cytology was the original method of sampling, followed in the early 1990s by large core needle biopsy. The accuracy of both has been improved by ultrasound and stereotactic guidance. Larger bore vacuum-assisted biopsy devices became available in the late 1990s and are now commonplace in most breast units. We review the different types of breast biopsy devices currently available together with various localization techniques used, focusing on their advantages, limitations and current controversial clinical management issues. PMID:20338392

  5. Image-guided breast biopsy: state-of-the-art

    International Nuclear Information System (INIS)

    Percutaneous image-guided breast biopsy is widely practised to evaluate predominantly non-palpable breast lesions. There has been steady development in percutaneous biopsy techniques. Fine-needle aspiration cytology was the original method of sampling, followed in the early 1990s by large core needle biopsy. The accuracy of both has been improved by ultrasound and stereotactic guidance. Larger bore vacuum-assisted biopsy devices became available in the late 1990s and are now commonplace in most breast units. We review the different types of breast biopsy devices currently available together with various localization techniques used, focusing on their advantages, limitations and current controversial clinical management issues.

  6. Needle core biopsy for breast lesions: An audit of 467 needle core biopsies

    OpenAIRE

    Selvi Radhakrishna; Anu Gayathri; Deepa Chegu

    2013-01-01

    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...

  7. Progression of Infection after Surgical CT Navigation-Assisted Aspiration Biopsy of a Vertebral Abscess

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    Vasiliki Spyropoulou

    2016-01-01

    Full Text Available Background Context. Computed tomography- (CT- guided fine-needle aspiration biopsy of the vertebral body is an important tool in the diagnostic evaluation of vertebral osteomyelitis. The procedure is considered simple to perform and it is considered a safe procedure with few complications. Purpose. The purpose of this study was to describe an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, to better understand the relationship between surgical procedure and complication, and to reflect on how to avoid it. Study Design/Setting. Case report and literature review. Methods. The medical records, laboratory findings, and radiographic imaging studies of an 11-year-old boy, with an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, were reviewed. Results. We report a case of vertebral osteomyelitis of L3 caused by methicillin-sensitive Staphylococcus aureus (MSSA. Following a computed tomography-guided aspiration biopsy of the vertebral body of L3, vertebral osteomyelitis rapidly progressed into the vertebral body of L4 as well as the L3-L4 disk. Conclusions. Based on the present case, one should consider that a CT-guided fine-needle aspiration biopsy of the vertebral body may be complicated by a progression of a vertebral osteomyelitis into both the intervertebral disk and also the adjacent vertebral body.

  8. Clinical and pathological analysis of fine needle aspiration cytology of lymph nodes%淋巴结细针穿刺细胞学检查的临床病理分析

    Institute of Scientific and Technical Information of China (English)

    万宇; 万礼仪; 陆忠鸣

    2011-01-01

    目的 探讨淋巴结细针穿刺细胞学(fine needle aspiration cytology,FNAC)检查的病理特点及临床价值.方法 采用回顾性分析方法,研究640例淋巴结FNAC病理特点,并结合临床诊断及病理组织学诊断结果进行比较分析.结果 640例中良性病变388例,特异性为93.3%;恶性肿瘤252例,敏感性为86.3%.假阴性率为4.1%,无假阳性病例出现,总准确率94.1%,穿刺成功率100%.结论 FNAC操作安全简便,对淋巴结病变具有较高的诊断价值,为临床诊断及治疗提供了可靠依据.%Objective To discuss pathological features and diagnostic value of fine needle aspiration cytology (FNAC) of lymph nodes. Methods The pathological features of 640 cases of FNAC of lymph nodes were analyzed and compare with clinical diagnosis and biopsy diagnosis. Results Of the 640 samples.388 were benign lesions.the specificity were 93. Z%. 252 were cancer,the sensitivity were 86. 3%. The false negative rate were 4.1% .no false positive diagnosis was found, the overall accuracy of diagnosis were 94. 1%, the success rates of the operation were 100%. Conclusion The operation of FNAC is simple and safe. FNAC has high accuracy in diagnosing pathological changes of lymph nodes, it could provide the reliable evidence for clinical diagnosis and treatment.

  9. 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.

  10. Pancreatic Hepatoid Carcinoma Mimicking a Solid Pseudopapillary Neoplasm: A Challenging Case on Endoscopic Ultrasound-guided Fine-needle Aspiration.

    Science.gov (United States)

    Akimoto, Yutaka; Kato, Hironari; Matsumoto, Kazuyuki; Harada, Ryo; Oda, Shinsuke; Fushimi, Soichiro; Mizukawa, Shou; Yabe, Shuntaro; Uchida, Daisuke; Seki, Hiroyuki; Tomoda, Takeshi; Yamamoto, Naoki; Horiguchi, Shigeru; Tsutsumi, Koichiro; Yagi, Takahito; Okada, Hiroyuki

    2016-01-01

    A 59-year-old man was admitted to our hospital for treatment of a 45 mm pancreatic mass found during a medical examination. Endoscopic ultrasound-guided fine-needle aspiration cytology showed polygonal cells with pseudopapillary structures. The tumor cells were positive for nuclear/cytoplasmic β-catenin and CD10, and negative for chromogranin A. After a tentative diagnosis of a solid pseudopapillary neoplasm, middle pancreatectomy was performed. Histologically, polygonal cells with abundant eosinophilic cytoplasm formed in the trabeculae and were immunohistochemically positive for HepPar1 and protein induced by vitamin K absence or antagonist-II. The tumor was finally diagnosed to be pancreatic hepatoid carcinoma. No recurrence occurred for 12 months, even without adjuvant chemotherapy. PMID:27580541

  11. Fine-needle aspirates CYFRA 21-1 is a useful tumor marker for detecting axillary lymph node metastasis in breast cancer patients.

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    Jung Hyun Yoon

    Full Text Available INTRODUCTION: To assess whether the value of CYFRA21-1 in the aspirates of ultrasonography-guided fine-needle aspiration biopsy (US-FNAB can contribute to improving the performances of US-FNAB in the diagnosis of axillary lymph node (LN metastasis in breast cancer patients. METHODS: US-FNAB was performed in 156 axillary LNs in 152 breast cancer patients (mean age: 51.4 years, range: 17-92 years. Concentrations of CYFRA21-1 were measured from washouts of the syringe used during US-FNAB. Tumor marker concentrations, US-FNAB, intraoperative sentinel node biopsy (SNB, and surgical pathology results were reviewed and analyzed. For comparison, the values of CEA and CA15-3 were also measured from washouts. RESULTS: Among the 156 LNs, 75 (48.1% were benign, and 81 (51.9% were metastases. Mean concentrations of CYFRA21-1 were significantly higher in metastasis compared to benign LNs (P<0.001. US-FNAB combined to CYFRA21-1 showed significantly higher sensitivity, NPV, and accuracy compared to US-FNAB alone (all values P<0.05. All diagnostic indices of US-FNAB combined to CYFRA21-1 were significantly higher compared to US-FNAB combined with CEA or CA15-3 (all P<0.001. Of the 28 metastatic LNs which showed metastasis on SNB, CYFRA21-1 showed higher positive rate of 75.0% (CEA or CA15-3∶60.7%, P = 0.076. CONCLUSION: Measuring CYFRA 21-1 concentrations from US-FNAB aspirates improves sensitivity, NPV, and accuracy of US-FNAB alone, and may contribute to reducing up to 75.0% of unnecessary intraoperative SNB. Compared to CEA or CA15-3, CYFRA21-1 shows significantly higher performances when combined to US-FNAB in the preoperative diagnosis of LN metastasis in breast cancer patients.

  12. Advances of fine needle aspiration cytology%细针吸取细胞学的进展

    Institute of Scientific and Technical Information of China (English)

    王念黎

    2006-01-01

    自从上世纪80年代开始,细针吸取活检(fine needle aspiration biopsy,FNAB),又称细针吸取细胞学(fine needle aspiration cytology,FNAC或称FNA)以其具有快捷、损伤少、经济及准确率高的优点,深受临床医生及患者的欢迎,使其应用非常广泛,几乎涉及全身所有的器官。但是,也因其取材较少导致的取材不满意率和假阴性率高,造成对组织结构观察不满意,分型不够细致和确定等缺点而局限了其应用。此方法对操作人员的技术要求也较高。未经细胞病理学专业训练的病理医生,应用FNA的效果并不理想,引发的医疗纠纷较多(美国的医疗纠纷中以FNA引发最多),使得部分病理科医生对FNA并不十分热衷。相反粗针穿刺活检(core needle biopsy,CNB)取材较多,吸出的组织与手术切除的标本相近,病理科医生容易诊断。影像学的发展使定位准确,

  13. Ultrasound guided fine needle aspiration cytology in the diagnosis of retroperitoneal masses: A study of 85 cases

    Directory of Open Access Journals (Sweden)

    Mangal Nidhi

    2009-01-01

    Full Text Available Background: The diagnosis of retroperitoneal lesions is one of the most difficult areas in surgical pathology. The retroperitoneal space allows both primary and metastatic tumors to grow silently before the appearance of clinical signs and symptoms. Fine needle aspiration cytology has shown promising role in establishing the diagnosis in this region. Objectives: This study was undertaken to evaluate the reliability of ultrasonography (USG-guided fine needle aspiration cytology (FNAC in distinguishing between benign and malignant lesions in the retroperitoneum, and to correlate the diagnosis by cytology of retroperitoneal masses with the results obtained by histology. Materials and Methods: The study was carried out on 85 patients presenting over the last five years with retroperitoneal masses on ultrasound. Results: Out of 85 cases, 32 were of kidney, 27 of lymph nodes, 24 of retroperitoneal soft tissues, and two were of the adrenals. Malignant lesions (47 were more common than nonmalignant lesions (38. In the kidney, the maximum number of cases were of renal cell carcinoma (12-38%, followed by Wilm′s tumor (6-19%, pyonephrosis (5-16%, renal cyst (4, angiomyolipoma (2, cortical pseudotumor (2, and tuberculosis (1. Out of 27 cases of retroperitoneal lymphadenopathy, 12 cases (44% were of metastatic carcinoma followed by non-Hodgkin′s lymphoma (8-30%, tuberculosis (6-22%, and Hodgkin′s lymphoma (1. The two cases of the adrenals were of angiomyolipoma and metastatic carcinoma. Among the 24 soft tissue tumors in the study, seven (29% were malignant and 17 (71% were benign (lipoma being the most common benign neoplasm. Results from histopathological investigations were available in 47 cases, out of which 45 were consistent with the FNAC-based diagnoses. Two cases for which the histopathological results were inconsistent with the FNAC diagnoses, were of renal cell carcinoma, which had been diagnosed as renal cysts on cytology. Conclusions: USG

  14. 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)

  15. Diagnostic accuracy of percutaneous cytodiagnosis of hepatic masses, by ultrasound guided fine needle aspiration cytology

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    Objective: To evaluate the diagnostic accuracy, usefulness and limitations of ultrasound guided FNAC of hepatic masses. Design: Cross - sectional analytical (comparative study). Place and Duration: Department of histopathology, Sheikh Zayed Hospital, Lahore. Study period 1 year. Material and Methods: A total of 32 patients with solitary or multiple hepatic masses underwent FNAC from March 1999 to March 2000. Adequate aspirates were obtained in all these cases. Smears were stained with May-Grunwald Giemsa, Haematoxylin and Eosin and Papanicolaou stain. Needle biopsies from the same cases were also obtained and processed. These were stained with routine Haematoxylin and Eosin staining. The blood clots obtained during FNAC were fixed in 10% neu-tral buffered formalin. The histopathology of these blood clots was used for cases whose needle core biopsy was not available. The screened FNAC smears were divided into 3 categories i.e., benign (group - I), malignant (group - II), non-neoplastic / inflammatory lesions (including cysts and abscesses) (group - III). Results: Out of 32 cases, 6 were categorized as benign, 18 as malignant, and 8 as non-neoplastic inflammatory lesions. Three false negative diagnoses, including 1 for malignant tumour and 2 for benign tumours was obtained. There was 1 false positive diagnosis for malignancy. FNAC - histological correlation showed a 94.2% sensitivity and 92.3% diagnostic accuracy for malignant tumours, while benign tumours posed maximum diagnostic problems, giving a 66.67% sensitivity and 85.7% diagnostic accuracy. FNAC picked up correctly all the non-neoplastic lesions giving a 100% sensitivity and diagnostic accuracy. Conclusion: Majority of the malignant tumours can be categorized on FNAC, with a high degree of accuracy, while benign tumours should be subjected to biopsy, as there is a relatively greater possibility of false negative diagnosis. (author)

  16. Reliable and valid assessment of competence in endoscopic ultrasonography and fine-needle aspiration for mediastinal staging of non-small cell lung cancer

    DEFF Research Database (Denmark)

    Konge, L.; Vilmann, P.; Clementsen, P.;

    2012-01-01

    Fine-needle aspiration (FNA) guided by endoscopic ultrasonography (EUS) is important in mediastinal staging of non-small cell lung cancer (NSCLC). Training standards and implementation strategies of this technique are currently under discussion. The aim of this study was to explore the reliability...

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

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    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.

  18. 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...

  19. Rapid KRAS, EGFR, BRAF and PIK3CA Mutation Analysis of Fine Needle Aspirates from Non-Small-Cell Lung Cancer Using Allele-Specific qPCR

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    Schrumpf, Melanie; Talebian Yazdi, Mehrdad; Ruano, Dina; Forte, Giusi I.; Nederlof, Petra M.; Veselic, Maud; Rabe, Klaus F.; Annema, Jouke T.; Smit, Vincent; Morreau, Hans; van Wezel, Tom

    2011-01-01

    Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA) and Trans-esophageal Ultrasound Scanning with Fine Needle Aspiration (EUS-FNA) are important, novel techniques for the diagnosis and staging of non-small cell lung cancer (NSCLC) that have been incorporated into lung cancer staging guidelines. To guide and optimize treatment decisions, especially for NSCLC patients in stage III and IV, EGFR and KRAS mutation status is often required. The concordance rate of the mutation analysis between these cytological aspirates and histological samples obtained by surgical staging is unknown. Therefore, we studied the extent to which allele-specific quantitative real-time PCR with hydrolysis probes could be reliably performed on EBUS and EUS fine needle aspirates by comparing the results with histological material from the same patient. We analyzed a series of 43 NSCLC patients for whom cytological and histological material was available. We demonstrated that these standard molecular techniques can be accurately applied on fine needle cytological aspirates from NSCLC patients. Importantly, we show that all mutations detected in the histological material of primary tumor were also identified in the cytological samples. We conclude that molecular profiling can be reliably performed on fine needle cytology aspirates from NSCLC patients. PMID:21408138

  20. Rapid KRAS, EGFR, BRAF and PIK3CA mutation analysis of fine needle aspirates from non-small-cell lung cancer using allele-specific qPCR.

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    Ronald van Eijk

    Full Text Available Endobronchial Ultrasound Guided Transbronchial Needle Aspiration (EBUS-TBNA and Trans-esophageal Ultrasound Scanning with Fine Needle Aspiration (EUS-FNA are important, novel techniques for the diagnosis and staging of non-small cell lung cancer (NSCLC that have been incorporated into lung cancer staging guidelines. To guide and optimize treatment decisions, especially for NSCLC patients in stage III and IV, EGFR and KRAS mutation status is often required. The concordance rate of the mutation analysis between these cytological aspirates and histological samples obtained by surgical staging is unknown. Therefore, we studied the extent to which allele-specific quantitative real-time PCR with hydrolysis probes could be reliably performed on EBUS and EUS fine needle aspirates by comparing the results with histological material from the same patient. We analyzed a series of 43 NSCLC patients for whom cytological and histological material was available. We demonstrated that these standard molecular techniques can be accurately applied on fine needle cytological aspirates from NSCLC patients. Importantly, we show that all mutations detected in the histological material of primary tumor were also identified in the cytological samples. We conclude that molecular profiling can be reliably performed on fine needle cytology aspirates from NSCLC patients.

  1. Potential value and disadvantages of fine needle aspiration cytology in diagnosis of ameloblastoma.

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    Perić, Marija; Milicić, Valerija; Pajtler, Marija; Marjanović, Ksenija; Zubcić, Vedran

    2012-11-01

    Ameloblastoma is a benign, slow growing but locally aggressive tumor that is clinically manifested as swelling in a jaws. Prone to relapse (30%) even 30 years after inadequate primary operation. The most important cytological features of this tumor are small bazaloid cells in clusters, and single spindle and stellate shaped cells. We report on a case of 79-year-old patient, who was hospitalized due to tumor formation in the buccal region. FNA was performed and liquid material that contained only fagocites was collected. The conclusion was--cyst, while biopsy finding--adenoma baseo-cellulare, pointed to the salivary gland tumor. Patient refused the proposed surgical treatment. Four years later, the patient was urgently hospitalized due heavy bleeding from the tumor in the same region. It affected the crest portion of the upper jaw and a section of hard palate, and was bleeding on palpation. In second FNA we found phagocytes and a few small clusters of basaloid cells with palisade arrangement at the edges. Because of uniform and benign cytomorphological features it was concluded that it was a cystic tumor. On biopsy pattern the diagnose of ameloblastoma was determinated. The patient underwent surgery, however due to postoperative complications he died. Preoperative diagnosis is usually set on the basis of clinical and often nonspecific radiological findings. As it is very important to get the correct diagnose before planning an adequate surgical procedure, we would like to point out the potential value and disadvantages of FNA cytology in the diagnosis of ameloblastoma. PMID:23397775

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

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    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.

  3. CT-guided percutaneous automated gun biopsy of pulmonary lesions : complications and diagnostic accuracy

    International Nuclear Information System (INIS)

    To determine the frequency of complications and diagnostic accuracy of CT-guided percutaneous automated gun biopsy, and to compare the results with those reported for fine needle aspiration. using automated biopsy devices, 118 CT-guided percutaneous biopsies of pulmonary lesions were performed. An 18-gauge needle was used. Final diagnosis was made with operation or other methods. We retrospectively analyzed the frequency of complications and diagnostic yields of 118 biopsies. Four of 118(3.3%) patients developed pneumothorax and two of these required chest tube insertion. Other complications were resolved spontaneously. 106 biopsies (89.8%) yielded sufficient tissue for pathologic evaluation. For cases of malignant and of benign disease, sensitivity was 91.8% and 87.7% respectively ; the corresponding figures for diagnostic accuracy were 88.5% and 78.9%. CT-guided automated gun biopsy of the pulmonary lesions is safe, with a pneumothorax rate comparable to that of fine needle aspiration. In tne absence of a trained cytologist at the time of biopsy, the diagnostic accuracy of automated gun biopsy of pulmonary lesions compared favorably with the reported accuracy of fine needle aspiration

  4. Lung adenocarcinoma and its thyroid metastasis characterized on fine-needle aspirates by cytomorphology, immunocytochemistry, and next-generation sequencing.

    Science.gov (United States)

    Bellevicine, Claudio; Vigliar, Elena; Malapelle, Umberto; Carelli, Emanuele; Fiorelli, Alfonso; Vicidomini, Giovanni; Cappabianca, Salvatore; Santini, Mario; Troncone, Giancarlo

    2015-07-01

    Lung adenocarcinoma and papillary thyroid carcinoma (PTC) share a number of microscopic and immunophenotypical features. Thus, patients presenting with thyroid and lung synchronous neoplasms may be difficult on fine-needle aspiration (FNA) samples to define the site of origin of the malignancy. In the case reported here, inherent to a 57-years-old man presenting with a right lung mass and a large (44 mm) thyroid nodule, an integrated cytological, immunocytochemical and molecular approach enabled to clarify the primary nature of the neoplasm. FNA cytology showed in both sites papillary structures and nuclear changes reminiscent of PTC. The lung origin of the neoplasm was suggested on cell-block immunocytochemistry showing thyroid transcription factor-1 positive and PAX8 and TGB negative neoplastic cells. Next generation sequencing performed on the Ion Torrent platforms by the Ion Ampliseq Colon and Lung Cancer panel showed a similar genomic profile in both neoplastic sites with a concurrent KRAS G12C mutation. An integrated approach on FNA biospecimen is safe, cost effective, and may be coupled effectively with modern ancillary molecular techniques that may be useful, besides their predictive value, as a adjunctive diagnostic tool when the synchronous occurrence of lesions featuring overlapping morphologies challenge the cytopathologist.

  5. 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.

  6. Differential diagnosis between pancreatic neuroendocrine and solid pseudopapillary neoplasms on endoscopic ultrasound-guided fine-needle aspiration

    Science.gov (United States)

    Raddaoui, Emad M.; Almadi, Majid A.; Aljebreen, Abdulrahman M.; Alsaif, Faisal A.; AlShedoukhy, Ahlam A.; Al-Lehibi, Abed H.; Almohameed, Khalid A.; Tsolakis, Apostolos V.; AlAbbadi, Mousa A.; Almutrafi, Amna R.

    2016-01-01

    Objectives: To evaluate the role of applying a limited panel of immunohistochemical stains on the cellblock preparation from samples obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the aim of differentiating solid pseudopapillary neoplasms (SPNs) from neuroendocrine tumors (NETs). Methods: We retrospectively retrieved all the EUS-FNAs of the pancreas that have a diagnosis of NET or SPN that were performed at 2 tertiary care hospitals in Riyadh, Kingdom of Saudi Arabia from May 2004 to December 2014. Diff-Quik, Papanicolaou, and Immunohistochemistry stains on cellblock preparations were performed. Results: Twenty cases were available (16 pancreatic neuroendocrine tumors (pNETs) and 4 SPNs). The pNETs were immunoreactive for synaptophysin, chromogranin A and CD56 while E-cadherin was diffusely to focally cytoplasmic positive. β-catenin was negative or showed focal cytoplasmic immunoreactivity. In comparison, SPNs were positive for vimentin, CD10, CD-56, focally positive for progesterone receptors and synaptophysin, and revealed nuclear immunostaining for β-catenin. They were negative for chromogranin A and E-cadherin. Conclusion: Based on EUS-FNA samples, nuclear immunoreactivity for β-catenin with loss of membranous immunostaining for E-Cadherin can potentially facilitate differentiating SPNs from pNETs. PMID:27381533

  7. ROLE OF FINE NEEDLE ASPIRATION CYTOLOGY (FNAC IN THE DIAGNOSIS OF SKIN AND SUBCUTANEOUS LESIONS: A RETROSPECTIVE ANALYSIS

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    Gautam

    2016-01-01

    Full Text Available BACKGROUND Cytopathology of skin has been established to be useful in the diagnosis of several skin lesions. This study aims to evaluate cytopathology as a quick non-invasive method for early diagnosis of different skin conditions including neoplastic and non-neoplastic. Fine Needle Aspiration Cytology (FNAC is a simple and rapid diagnostic technique. The present study is a retrospective analysis of 356 patients who were cytologically evaluated for various skin and superficial soft tissue lesions over a period of four years (W. E. F. January 2012 to December 2015 in the Department of Dermatology and Pathology of Tripura Medical College and Dr. BRAM Teaching Hospital. Amongst the 356 cases reported, 170 cases were non-neoplastic and 186 were reported as neoplastic skin lesions. Out of 186 neoplastic lesions, 134 (72.04% were benign in nature and rest of the cases were malignant, i.e. only 52 cases (27.95%. Commonest non-neoplastic lesion epidermal inclusion cyst followed by acute suppurative lesions. Other lesions which were commonly reported in our study were Granulomatous lesions. It has been observed that FNAC performed carefully, skilfully with proper selection of cases leads to an early diagnosis in majority of the skin lesions.

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

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    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.

  9. Small cell mesothelioma: A rare entity and diagnostic pitfall mimicking small cell lung carcinoma on fine-needle aspiration.

    Science.gov (United States)

    Zhang, Yanhong; Afify, Alaa; Gandour-Edwards, Regina F; Bishop, John W; Huang, Eric C

    2016-06-01

    Small cell mesothelioma (SCM) is an extremely rare variant of epithelioid mesothelioma that can be mistaken for other forms of small round blue cell tumors, particularly small cell lung carcinoma (SCLC). Here, we describe a fine-needle aspiration (FNA) from a pleural lesion in a 75-year-old man with a history of known asbestos exposure. The FNA revealed cohesive clusters of uniform small round blue cells with high nuclear-to-cytoplasmic ratio, finely powdery chromatin, small inconspicuous nucleoli, and scant amount of cytoplasm. Mitoses were infrequent and nuclear molding was absent. Immunochemical profile supported a mesothelial origin, which was later confirmed by pleurectomy with a diagnosis of SCM. This report demonstrates the difficulties in cytologic evaluation of lung FNAs in differentiating SCM from SCLC or other small round blue cell tumors. As therapy differs for SCM, early recognition of the cytologic features is essential in making the correct diagnosis needed for appropriate clinical management. Diagn. Cytopathol. 2016;44:526-529. © 2016 Wiley Periodicals, Inc. PMID:26952387

  10. Molecular Biologic Approach to the Diagnosis of Pancreatic Carcinoma Using Specimens Obtained by EUS-Guided Fine Needle Aspiration

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    Kiyohito Kato

    2012-01-01

    Full Text Available We review the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA, a rapid, safe, cost-effective, and accurate diagnostic modality for evaluating pancreatic tumors. EUS-FNA is currently used for the diagnosis and staging of pancreatic tumors. The sensitivity of EUS-FNA for pancreatic malignancy ranges from 75% to 94%, and its specificity approaches 100% in most studies. However, EUS-FNA has some limitations in the diagnosis of well-differentiated or early-stage cancers. Recent evidence suggests that molecular biological analysis using specimens obtained by EUS-FNA improves diagnostic sensitivity and specificity, especially in borderline cytological cases. It was also reported that additional information regarding patient response to chemotherapy, surgical resectability, time to metastasis, and overall survival was acquired from the genetic analysis of specimens obtained by EUS-FNA. Other studies have revealed that the analysis of KRAS, MUC, p53, p16, S100P, SMAD4, and microRNAs is helpful in making the diagnosis of pancreatic carcinoma. In this paper, we describe the present state of genetic diagnostic techniques for use with EUS-FNA samples in pancreatic diseases. We also discuss the role of molecular biological analyses for the diagnosis of pancreatic carcinoma.

  11. Histopathological Correlation of Atypical (C3 and Suspicious (C4 Categories in Fine Needle Aspiration Cytology of the Breast

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    Prashant Goyal

    2013-01-01

    Full Text Available Introduction. According to the National Cancer Institute (NCI guidelines in 1996, breast lesions are categorized as C1 to C5 on fine needle aspiration (FNA cytology. Very few studies are available in the English literature analyzing histopathology outcome of C3 (atypical, probably benign and C4 (suspicious, probably malignant lesions. Our study aims to correlate FNA cytology of breast lump diagnosed as C3 and C4 lesion with histopathological examination. Methods. During a period of 2 years, 59 cases of C3 and 26 cases of C4 were retrieved from total 1093 cases of breast FNA. All the cases were reviewed by two cytopathologists independently. The final 24 cases of C3 and 16 cases of C4 categories were correlated with histopathological diagnosis. Result. Among C3 category, 37.5% revealed malignant findings, whereas of C4 category, 87.5% were malignant on histopathology. This difference was statistically significant (P=0.0017. Sensitivity, specificity, positive predictive values, and negative predictive value of C4 category in diagnosing breast malignancy were 60.8%, 88.2%, 87.5%, and 62.5%, respectively. Conclusion. Although FNAC is simple, safe, cost-effective and accurate method for diagnosis of breast masses, one must be aware of its limitations particularly in C3 and C4 categories. Also, since both these categories carry different probabilities of malignancy and thus different management, we therefore, support maintaining C3 and C4 categories.

  12. A Case of Adenomatous Goiter Involving Diffuse, Acute, and Painful Thyroid Enlargement after Fine-Needle Aspiration Cytology

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    Toshiro Shimo

    2014-01-01

    Full Text Available The patient was a 44-year-old woman who exhibited a diffuse goiter during health screening. Her medical history did not include any significant medication-based treatment. An echographic examination detected a solid cystic tumor, which measured 21 × 14 × 10 mm, in her right thyroid lobe; however, she displayed normal thyroid function. After fine-needle aspiration cytology had been performed with a 22 G injection needle, the patient immediately complained of compression and pain extending from the front of her neck to her lower chin, which was not accompanied by dyspnea. A second echographic examination revealed diffuse and edematous enlargement and increased internal blood flow in the bilateral thyroid lobes as well as a thyroid nodule. We immediately iced the patient’s neck and administered 125 mg methylprednisolone via an intravenous infusion. Within one hour, her symptoms had markedly improved, but acute pain remained. Thus, we continued the steroid (prednisone treatment, but the dose was gradually reduced from 10 mg/day to 5 mg/day at 1 week after the patient’s symptoms disappeared. The mechanism responsible for the patient’s condition remains unclear.

  13. 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

  14. 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.

  15. CT-guided transthoracic fine-needle aspiration versus transbronchial fluoroscopy-guided needle aspiration in pulmonary nodules

    International Nuclear Information System (INIS)

    Purpose: To evaluate the diagnostic yield of CT-guided (CTNAB) and fluoroscopy-guided transbronchial (TBNA) fine-needle aspiration cytology in pulmonary nodules and to compare their complications. Material and Methods: Thirty patients with pulmonary nodules not abutting upon the chest wall and inaccessible to bronchoscopy were randomised for CTNAB or TBNA. Eighteen patients underwent CTNAB and 16 TBNA. Four patients underwent both procedures. Results: In the CTNAB group, a definitive diagnosis could be made in 14 (78%) out of 18 patients whereas in the TBNA group, a definitive diagnosis was made in 11 (69%) out of 16 patients. This difference was not statistically significant (p>0.05). The final diagnosis in 29 out of 30 patients comprised primary bronchogenic carcinoma in 14 patients, metastases in 5 patients, and benign lesions in 10 patients (34%) of which 3 lesions (30%) were of tuberculous aetiology. There were 2 asymptomatic pneumothoraces in the CTNAB group and no complication was observed in the TBNA group. Conclusion: Both techniques were safe and effective in the diagnosis of peripheral pulmonary lesions. TBNA was best suited for lesions larger than 3 cm and located in the middle and lower lobes while CTNAB could be used for any lesions. (orig.)

  16. A case of Langerhans' cell histiocytosis associated with Hodgkin's lymphoma: Fine-needle aspiration cytologic and histopathological features.

    Science.gov (United States)

    Das, Dilip K; Sheikh, Zafar A; Alansary, Taiba A; Amir, Thasneem; Al-Rabiy, Fatma N; Junaid, Thamradeen A

    2016-02-01

    Langerhans cell histiocytosis (LCH) can be associated with a variety of malignant neoplasms, the most common being malignant lymphoma, especially Hodgkin's lymphoma (HL). In this report, we describe the fine needle aspiration (FNA) cytologic features of a case with concurrent LCH and HL in a lymph node. A 20-year-old man presented with an enlarged left upper cervical lymph node. FNA smears from the swelling revealed numerous CD1a+ and S-100+ Langerhans-type cells (LCs) along with many eosinophils, neutrophils, and lymphocytes; there were also large atypical cells with enlarged nuclei having prominent nucleoli. The cytodiagnosis was LCH and the possibility of association with or trans-differentiation into a lymphoma was suggested. The histopathological diagnosis of the excised left cervical lymph node was classical HL-nodular sclerosis type (CHL-NS) with LCH. The lacunar type Reed-Sternberg (RS) cells were positive for CD30 and CD15, and the LCs were positive for CD1a and S-100 protein. PET/CT imaging demonstrated hypermetabolic lymph nodes in neck, abdomen, thorax and pelvis as well as pulmonary nodules and a splenic mass. The patient received 13 courses of chemotherapy and two years later, the enhanced CT revealed regressive course of the disease. PMID:26608102

  17. 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.

  18. 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.

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Recurrence of a Pancreatic Cystic Lymphangioma After Diagnosis and Complete Drainage by Endoscopic Ultrasound with Fine-Needle Aspiration

    Directory of Open Access Journals (Sweden)

    Nabil M Mansour

    2013-05-01

    Full Text Available Context Lymphangiomas are uncommon benign neoplasms that result from a blockage of the lymphatic system. Pancreatic cystic lymphangiomas are extremely rare. Pancreatic cystic lymphangiomas have been classically diagnosed on histopathologic examination following surgical excision, but recent reports have demonstrated successful diagnosis using endoscopic ultrasound with fine-needle aspiration (EUS-FNA. Data on the natural history of these lesions following drainage via EUS-FNA are lacking. We present a case of successful initial diagnosis and drainage of a pancreatic cystic lymphangioma using EUS-FNA, with unfortunate recurrence of the lesion four months later. Case report A 50-year-old female was evaluated for epigastric abdominal pain and nausea. CT scan revealed a 4 cm retroperitoneal cystic lesion. EUS-FNA was performed with complete drainage of the lesion using a 22-gauge needle. Twenty-five mL of chylous white fluid was obtained with laboratory analysis consistent with a pancreatic cystic lymphangioma. The patient was symptom-free for 4 months following drainage, but eventually had symptoms again with a CT scan confirming recurrence. Conclusions While EUS-FNA is effective for the diagnosis of pancreatic cystic lymphangiomas, its role in the management of these lesions is questionable. Temporary relief of symptoms can be achieved after EUS-guided drainage, but recurrence is a concern. Definitive cure likely requires complete surgical excision.

  2. 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.

  3. 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

  4. How to improve the success of endoscopic ultrasound guided fine needle aspiration cytology in the diagnosis of pancreatic lesions.

    Science.gov (United States)

    Gimeno-García, Antonio Z; Elwassief, Ahmed

    2012-01-01

    Endoscopic ultrasonography (EUS) is highly accurate for assessing the pancreatic parenchyma and ductal system. Currently, it is the most sensitive imaging procedure for detecting small solid pancreatic masses. EUS-guided fine needle aspiration cytology (EUS-FNA) is a safe and highly accurate tool for the diagnosis of pancreatic malignancy. Prior to perform an EUS-FNA one should wonder whether the benefits outweigh the potential risks of the procedure. Therefore, it is important to take into account whether the procedure will influence patient management. The diagnostic yield and success rate of EUS-FNA in pancreatic lesions varies greatly depending on many factors including: the characteristics of the lesion itself (location of the mass and consistency of the lesion), technical factors (type of needle size, use of stylet, use of suction and number of needle passes performed) and the availability of immediate cytological assessment of the specimen. The aim of this review is to analyze all these factors for optimizing specimen collection and diagnostic efficiency in dealing with solid pancreatic masses. PMID:22586548

  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. 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. PMID:27261491

  7. Preoperative Ultrasound Guided Fine Needle Aspiration Cytology of Ovarian Lesions- Is It a Rapid and Effective Diagnostic Modality?

    Science.gov (United States)

    Datta, Saikat; Chaudhuri, Snehamay; Paul, Prabir Chandra; Khandakar, Binny; Mandal, Sonali

    2016-01-01

    Introduction The deep seated ovarian lesions unapproachable by unguided aspiration cytology were easily done under ultrasound guidance. It gave a before hand cytological diagnosis of the lesion to the surgeon determining the modality of treatment for the patient. Aim To find the diagnostic accuracy of the method of ultrasound guided cytological assessment of ovarian lesion. Materials and Methods The study was conducted as a prospective observational study over a period of one year, in hospital setting, where ultrasound guided fine needle aspiration had been used to aspirate ovarian lesions, giving a rapid cytological diagnosis. In 43 sample cases, aspiration of fluid done from ovarian lesions were followed by cyto-centrifugation and staining by May-Grunwald-Giemsa (MGG) and Papanicolaou (Pap) stain providing a cytological opinion regarding benign/malignant nature of the lesion and further categorization. Later the cytological diagnosis was compared with final histopathological diagnosis, taking it as a gold standard. Results The overall sensitivity, specificity, and diagnostic accuracy of ultrasound guided aspiration and cytological analysis were high, 96%, 76.92% and 89.47% respectively as calculated by comparing the cytological diagnosis with histological diagnosis, taking it as gold standard. Conclusion This method has evolved as a highly sensitive, rapid, simple and effective modality for screening and as well as accurate preoperative diagnosis of ovarian lesions. PMID:27134878

  8. Utility of Fine Needle Aspiration as a Diagnostic Technique in Lymphoma%细针穿刺对淋巴瘤诊断技术的价值

    Institute of Scientific and Technical Information of China (English)

    李甘地; 胡皓; 李文瑜

    2010-01-01

    @@ 1 文献来源 Hehn ST,Grogan TM,Miller TR.Utility of fine needle aspiration as a diagnostic technique in lymphoma[J].J Clin Oncol,2004,22(15):3046-3052. 2证据水平 2b. 3背景 20世纪80年代至90年代早期,细针穿刺(fine needle aspiration,FNA)技术常用于诊断确认淋巴瘤复发的病例和既往有淋巴瘤病史的患者,从20世纪90年代末期开始,FNA已经越来越多地用于诊断初诊的淋巴瘤患者.

  9. Accuracy of fine needle aspiration cytology in the diagnosis of bone lesions with radiological assistance: Experience from the National Cancer Institute, Cairo University, Egypt

    OpenAIRE

    Ahmed Mohamed Aly; Hebatallah M. Shaaban; Iman Abou-Sinna

    2014-01-01

    Aim: To evaluate the accuracy of fine needle aspiration cytology in the diagnosis of bone lesions with radiological assistance. Patients and methods: 85 cases of FNAC of bone lesions were included. Sixty two procedures were performed by the radiologist and 23 procedures by the histopathologists. The aspirates were immediately fixed in 95% ethanol alcohol for Papanicolaou staining. If there was sufficient material, cell block was prepared. Diagnosis was established in 81 cases (95.3%), clas...

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

    Directory of Open Access Journals (Sweden)

    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. Pitfalls in diagnosing specific subtypes of carcinoma breast on fine needle aspiration cytology: A report of two cases with review of literature

    OpenAIRE

    Hemalatha Anantharamaiah; Kalyani Raju; Shruthi Pannayanapalya Suresh; Udaya Kumar Manikyam

    2012-01-01

    Fine needle aspiration cytology (FNAC) is a useful procedure that can be conveniently performed in the outpatient department (OPD) and can be used in the subtyping of breast carcinomas. However, some specific subtypes can cause a hindrance to that. We present two such cases, one of tubulolobular carcinoma breast and the other of squamous cell carcinoma breast that were missed on FNAC, and subsequently diagnosed on histopathology and by immunohistochemistry. A thorough knowledge of the cytolog...

  12. Core biopsy as a simple and effective diagnostic tool in head and neck focal myositis.

    Science.gov (United States)

    Tan, Chun Yee; Chong, Sheldon; Shaw, Chi-Kee Leslie

    2015-12-01

    Most unilateral head and neck masses are benign, although malignancy is a possibility in some cases. However, there are other rare causes of unilateral neck masses, such as focal myositis, which is a rare, benign condition belonging to the family of inflammatory pseudotumors of the skeletal muscles, with rare presentations in the head and neck region. Focal myositis presents as a rapidly enlarging neck mass that can be misdiagnosed by fine-needle aspiration biopsy and/or radiologic imaging as either an infective or a neoplastic process. To date, there are only 5 reported cases of adult focal myositis of the sternocleidomastoid muscle in the medical literature. In this article, the authors present 2 cases involving patients with focal myositis of the sternocleidomastoid muscle that were successfully diagnosed with core-needle biopsy and managed conservatively. The pros and cons of fine-needle aspiration biopsy and core-needle biopsy are discussed. Based on the authors' results, fine-needle aspiration biopsy universally fails to provide the diagnosis of focal myositis. In contrast, core-needle biopsy successfully diagnosed focal myositis in both of our patients. Both of them had complete resolution with conservative management. PMID:26670758

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

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    Pinki Pandey

    2013-12-01

    Full Text Available 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 examination.Results: Among non- neoplastic group, the most frequently encountered lesion was colloid goiter in 231 (67.94% cases followed by thyroiditis in 68 (20% cases, five (1.47% adenomatous goiter and four (1.17% thyroglossal cysts. Among the neoplasticgroup, twelve (3.52% cases were reported as follicular neoplasm, seven (2.05% cases as Hürthle cell neoplasm and four (1.17% as malignant tumors. The cytological and histological concordance was determined. A false positive cytologic diagnosis of neoplasms was made in five cases. Presence of Hürthle cell metaplasia, hyperplastic nodules and papillary hyperplasia were responsible for the false positive diagnoses. For the entire series, the false negative rate was 8.57% and the false positive rate was 7.14%. FNA revealed a sensitivity of 62.5%, a specificity of 90.74%, a positive predictive value of 66.66% and a negative predictive value of 89.09%.Conclusion: FNAC is thus an accurate, cost- effective, minimally invasive and reliable diagnostic tool for assessment of patients with thyroid lesions and their management.

  15. 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.

  16. Gene expression profiles derived from fine needle aspiration correlate with response to systemic chemotherapy in breast cancer

    International Nuclear Information System (INIS)

    Drug resistance in breast cancer is a major obstacle to successful chemotherapy. In this study we used cDNA microarray technology to examine gene expression profiles obtained from fine needle aspiration (FNA) of primary breast tumors before and after systemic chemotherapy. Our goal was to determine the feasibility of obtaining representative expression array profiles from limited amounts of tissue and to identify those expression profiles that correlate with treatment response. Repeat presurgical FNA samples were taken from six patients who were to undergo primary surgical treatment. Additionally, a group of 10 patients who were to receive neoadjuvant chemotherapy underwent two FNAs before chemotherapy (adriamycin 60 mg/m2 and cyclophosphamide 600 mg/m2) followed by another FNA on day 21 after the first cycle. Total RNA was amplified with T7 Eberwine's procedure and labeled cDNA was hybridized onto a 7600-feature glass cDNA microarray. We identified candidate gene expression profiles that might distinguish tumors with complete response to chemotherapy from tumors that do not respond, and found that the number of genes that change after one cycle of chemotherapy was 10 times greater in the responding group than in the non-responding group. This study supports the suitability of FNA-derived cDNA microarray expression profiling of breast cancers as a comprehensive genomic approach for studying the mechanisms of drug resistance. Our findings also demonstrate the potential of monitoring post-chemotherapy changes in expression profiles as a measure of pharmacodynamic effect and suggests that these approaches might yield useful results when validated by larger studies

  17. UTILITY OF CELL BLOCK TECHNIQUE BY MICROWAVE PROCESSING FOR RAPID DIAGNOSIS IN FLUIDS AND FINE NEEDLE ASPIRATES

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    Shailaja

    2014-11-01

    Full Text Available : INTRODUCTION: The present study was carried out to evaluate the cell block technique prepared out of the residue of fluids and fine needle aspirate (FNA samples after routine cytological processing. In addition it was processed in a microwave to facilitate early reporting. Aims and OBJECTIVES: The aim of the present study was to correlate the cytological findings with those of cell block sections and to establish the microwave processing technique in preparation of paraffin blocks. MATERIALS AND METHODS: A total of 100 samples were studied over a two year period. They comprised of 64 fluids and 36 FNA samples. In 88 cases, both cytology and histology were available for correlation. For cell block preparation, the modified plasma-thrombin technique and for microwave processing, the modified Bellotti’s technique were used respectively. RESULTS: Positive correlation between cell block and cytology for malignant and benign lesions in fluid specimens was seen in 21.87% and 51.56% cases respectively. Positive correlation between cell block and cytology for malignant and benign lesions in FNA specimens was seen in 47.22% and 33.33% cases respectively. The sensitivity and specificity of cell blocks and cytology smears were calculated. Also the use of microwave processing allowed us to give report on the same day without affecting the quality of sections and staining. CONCLUSIONS: The present study indicates that even after cytological processing of fluids and FNA specimens, some residue is left behind which may contain valuable diagnostic material which can be processed further as a cell block. In addition, microwave processing gives the added benefit of rapid reports without compromise in the quality of reports.

  18. A STUDY OF CORRELATION OF PREOPERATIVE FINE NEEDLE ASPIRATION CYTOLOGY (FNAC WITH HISTOPATHOLOGICAL EXAMINATION (HPE IN GOITRE

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    Srirangaprasad

    2015-11-01

    Full Text Available BACKGROUND: FNAC is a simple, cost effective, readily repeated and quick to perform procedure, with excellent patient compliance. It is, however, not without limitations related to specimen adequacy, sampling techniques, and overlapping cytological features between benign and malignant follicular neoplasm. Here arises the need for Histopathological examination (HPE, as it is considered the final diagnostic test. OBJECTIVE: This study aims at correlating the cytological diagnosis with the final histopathological diagnosis to evaluate the sensitivity, specificity and positive predictive value of smears and thereby its role in the preoperative diagnosis of thyroid swellings. METHODS: Data for the study was collected from patients undergoing thyroidectomy in Department of ENT, Head and Neck Surgery at Raja Rajeswari Medical College and Hospital, Bangalore. The study period was from 1st October 2013 –30th September 2014. Fine needle aspiration cytology of the swelling was done on OPD basis for all patients presenting with goitre. Thyroidectomy specimens preserved in 10% formalin was sent for histopathology examination. RESULTS: A total of 157 patients was evaluated, out of which 118 patients underwent FNAC. 15 were unsatisfactory aspirates. A total of 57 cases were operated specimens were available for histopathologic examination. The mean age of patients were 36.9 years. The ratio between female to males was 7.1:1. The sensitivity of FNAC was 87.5%, the Specificity was 100%, accuracy was 98.2%, and the positive predictive value of a positive test for malignancy was 100%. CONCLUSION: FNAC of thyroid lesions has been shown to be safe, simple, cost effective and accurate method for management of palpable thyroid lesions. It not only facilitates the communication among cytopathologists, surgeons, radiologists, and endocrinologists but also facilitate research into the epidemiology, molecular biology, pathology and diagnosis of thyroid diseases.

  19. 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.

  20. Endoscopic ultrasound-guided fine-needle aspiration of metastases to the pancreas: A study of 25 cases

    Directory of Open Access Journals (Sweden)

    Christopher M Gilbert

    2011-01-01

    Full Text Available Background: Metastases to the pancreas are an uncommon cause of pancreatic masses seen on endoscopic ultrasound (EUS-guided fine-needle aspiration (FNA. The purpose of this study is to retrospectively review the cytomorphology, clinical findings, and results of ancillary studies in a large series of these unusual cases. Materials and Methods: We searched our institution′s pathology database for EUS-guided FNAs of the pancreas that were diagnostic of metastatic tumor over a 5-year period. The final cytologic diagnosis, results of ancillary studies, corresponding histological material, and clinical follow-up data were reviewed in these cases. Results: A total of 1172 pancreatic EUS-guided FNAs were identified, of which 25 cases (2.1% had a confirmed diagnosis of a pancreatic metastasis. This included 12 (48% cases of renal cell carcinoma, 3 (12% melanomas, 3 (12% small cell carcinomas, and 7 (28% other malignancies. In these metastatic tumors involving the pancreas, 20 (80% of the lesions were solitary. Four (16% cases had no prior history of malignancy. The average time to diagnosis of pancreatic metastasis was 5.3 years. Immunohistochemistry and special stains were performed in 22 (88% and 9 (36% cases, respectively. Conclusions: Our data shows that although metastases to the pancreas are rare, they can present as a solitary mass many years after the primary malignancy is diagnosed and can even be the first manifestation of an extrapancreatic primary in a small number of cases. It is important to consider the possibility of a metastatic lesion in the pancreas because this may require a different management than a primary pancreatic tumor.

  1. On-site evaluation of percutaneous CT-guided fine needle aspiration of pulmonary lesions. A study of 321 cases

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to assess the usefulness of having a cytopahologist present during percutaneous CT-guided fine needle aspiration (FNA) of pulmonary lesions. Materials and methods: Three hundred and twenty-one FNAs of lung lesions were performed in 312 patients (218 males, 94 females; age range 20-86 years; means age: 66yrs). Nodule size ranged from 0.5 to 8 cm. The sampling was performed by a radiologist under CT-guidance; the calibre of the needle used was 20-25G. Smears were prepared in the Radiology Department and stained using a quick method by a cytopathologist: the sample adequacy was assessed and, if possible, a preliminary diagnosis was made. An additional FNA was requested if the first aspirate was considered diagnostically inadequate. The diagnostic accuracy was examinated by reviewing the clinical data and by correlating with the histological material and the clinical outcome.Results: Satisfactory diagnostic material was obtained in 275 of the 321 FNA (86%): 231 were malignant (72%), 8 suspicious (3%) and 36 were negative for malignancy (11%). Forty-six of the 321 specimens (14%) were considered inadequate for any diagnostic verification. An additional FNA was performed immediately in 60 cases (19%). Forty-two subjects developed pneumothorax: 21 patients (50%) of these required thoracic drainage. Blood effusion around the lesion site or adjacent to the needle path was observed in 39 patients (12%). Sensitivity was 99%, specificity was 95% and diagnostic accuracy was 99%. Conclusions: CT-guided aspiration cytology can be a safe and fast procedure for lung nodule characterization. On-site immediate evaluation of FNA specimens can be beneficial in determining the adequacy of the aspirate and in providing accurate preliminary diagnoses of the specimens, thus allowing for rapid clinical decisions

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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 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-income economies had a definite edge over the developing nations in the absolute number of publications from each and every site/organ. However, when the frequency of publications on various organs

  4. 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

  5. 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...

  6. Fine Needle Aspiration Cytology of Breast Lesions:Analysis of 323 Cases%323例乳腺肿块针吸细胞学诊断分析

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qin; 张勤; NIE Shigui; 聂世贵; CHEN Yuhua; 陈玉华; ZHOU Limei

    2004-01-01

    Objective: 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.

  7. 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].

  8. [Detection of numerical aberrations in chromosomes by fluorescence in situ hybridization in fine needle aspirates in the preoperative diagnosis of cancer].

    Science.gov (United States)

    Noguchi, S; Tsukamoto, F; Miyoshi, Y; Inaji, H; Watatani, M; Sasa, M; Inazawa, J; Takami, S

    1999-12-01

    Fine needle aspiration (FNA) samples were obtained from 176 breast tumors suspected of malignancy, which were then subjected to conventional cytological and fluorescence in situ hybridization (FISH) analyses using the centromeric probes for chromosomes 1, 11, and 17. Histological examination revealed 157 breast cancers and 19 benign diseases (ten fibroadenomas, six intraductal papillomas, one intracystic papilloma, and two ADH). Sensitivity, specificity, and diagnostic accuracy were 85.4% 94.7%, and 86.4%, respectively, for cytology and 90.4%, 100%, and 91.5%, respectively, for FISH. These results demonstrate that FISH diagnosis of FNA samples has a diagnostic accuracy comparable to that of conventional cytology. PMID:10635294

  9. Pitfalls in diagnosing specific subtypes of carcinoma breast on fine needle aspiration cytology: A report of two cases with review of literature

    Directory of Open Access Journals (Sweden)

    Hemalatha Anantharamaiah

    2012-01-01

    Full Text Available Fine needle aspiration cytology (FNAC is a useful procedure that can be conveniently performed in the outpatient department (OPD and can be used in the subtyping of breast carcinomas. However, some specific subtypes can cause a hindrance to that. We present two such cases, one of tubulolobular carcinoma breast and the other of squamous cell carcinoma breast that were missed on FNAC, and subsequently diagnosed on histopathology and by immunohistochemistry. A thorough knowledge of the cytological features of the subtypes and the use of immunocytochemistry can appropriately make FNAC a standard, accurate, and simple OPD procedure, thus helping us in arriving at specific diagnosis.

  10. Combined applications of fine needle aspiration cytology and Flow cytometric immunphenotyping for diagnosis and classification of non Hodgkin Lymphoma

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    Al Quallaf Aisha

    2006-01-01

    Full Text Available Abstract Aims and objectives In this present study we have evaluated the feasibility of sub-classification of non-Hodgkin's lymphoma (NHL cases according to World Health Organization's (WHO classification on fine needle aspiration cytology (FNAC material along with flow cytometric immunotyping (FCI as an adjunct. Materials and methods In this five years study, only cases suggested or confirmed as NHL by FNAC were selected and FCI was performed with a complete panel of antibodies (CD3, CD2, CD 4, CD5, CD8, CD7, CD10, CD19, CD20, CD23, CD45, κ and λ by dual color flow cytometry. Both cytologic findings and FCI data were interpreted together to diagnose and sub-classify NHL according to WHO classification. Wherever possible the diagnoses were compared with cytology. Results There were total 48 cases included in this study. The cases were classified on FNAC as predominant small cells (12, mixed small and large cells (5 and large cells (26. In five cases a suggestion of NHL was offered on FNAC material and these cases were labeled as NHL not otherwise specified (NHL-NOS. Flow cytometry could be performed in 45 cases (93.8% and in rest of the three cases the material was inadequate because of scanty blood mixed aspirate. Light chain restriction was demonstrated in 30 cases out of 40 cases of B-NHL (75%. There were 15 cases each of κ and λ light chain restriction in these 30 cases. With the help of combined FCI and FNAC, it was possible to sub-classify 38 cases of NHL (79% according to WHO classification. Combined FNAC and FCI data helped to diagnose 9 cases of small lymphocytic lymphoma (SLL, 2 cases of mantle cell lymphoma (MCL, 4 cases of follicular lymphoma (FL, 17 cases of diffuse large B lymphoma (DLBL and 6 cases of lymphoblastic lymphoma. Histopathology diagnosis was available in 31 cases of NHL out of which there were 14 recurrent and 17 cases of primary NHL. Out of 15 DLBL cases diagnosed on FCI and FNAC, histology confirmed 14 cases and

  11. Evaluation of the Value of Fine Needle Aspiration in the Treatment of Breast Cancer%细针穿刺技术在乳腺癌手术治疗中的应用价值评价

    Institute of Scientific and Technical Information of China (English)

    李响; 王玉倩; 石庆宇

    2015-01-01

    ObjectiveTo investigate the value of fine needle aspiration in the treatment of breast cancer.Methods 140 cases of breast cancer patients were selected,all patients were treated with fine needle aspiration technique,and then breast cancer radical mastectomy,and pathological analysis, observation of fine needle aspiration examination results. ResultsAll patients were examined by fine needle aspiration technique,the accuracy rate was 94.29%.ConclusionFine needle aspiration technique is a very good assistant diagnostic technique for the examination of breast cancer with high accuracy.%目的:探讨细针穿刺技术在乳腺癌手术治疗中的应用价值。方法选取我院收治的乳腺癌患者140例,所有患者均采用细针穿刺技术检查,然后行乳腺癌根治术,并进行病理学分析,观察细针穿刺检查结果。结果所有患者经细针穿刺技术检查后,检查准确率为94.29%。结论细针穿刺技术用于检查乳腺癌准确率高,是一种很好的辅助诊断技术。

  12. Malignant Pancreatic Extra-Gastrointestinal Stromal Tumor Diagnosed by Ultrasound Guided Fine Needle Aspiration Cytology. A Case Report with a Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ram Nawal Rao

    2011-05-01

    Full Text Available Context Pancreatic extra-gastrointestinal stromal tumors are extremely uncommon neoplasm. To the best of our knowledge, only eleven cases have been reported in the literature. All the case reports published mostly involve diagnoses made on surgical pathology. Case report A 40-year-old male patient presented with asthenia, mild abdominal pain, severe anemia and weight loss. Contrast-enhanced computed tomography of the abdomen revealed a heterogeneously enhancing mass (6.5x6.0 cm in the body and head of the pancreas. Ultrasound-guided fine needle aspiration (US-FNA was performed on the mass of the pancreas before a pancreaticoduodenectomy. A cytological diagnosis of pancreatic malignant mesenchymal neoplasm was made. The final diagnosis of primary pancreatic extra-gastrointestinal stromal tumor was confirmed by histopathological examination and immunohistochemical findings (CD117 positivity. This case was diagnosed by percutaneous transabdominal ultrasound, rather than endoscopic ultrasound-guided fine needle aspiration (EUS-FNA which had been used in three previous cases. Conclusion We report a very unusual case of pancreatic extra-gastrointestinal stromal tumor which was diagnosed by US-FNA cytology. Although this is uncommon in the pancreas, extra-gastrointestinal stromal tumors should be considered in the differential diagnosis of solid and cystic pancreatic masses on cytology.

  13. Application of B -ultrasonic Guided Fine Needle Aspiration Cytology in the Diagnosis of Tuberculous Lymphadenitis%经B超引导FNAC在淋巴结结核诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    余琦; 杨江辉; 李宁

    2011-01-01

    To explore the value of B-ultrasonic guided fine needle aspiration cytology (FNAC) in the diagnosis of tuberculous lymphadenitis (TB). The patients were carried out FNAC under B-ultrasonic guidance to distinguish the tuberculosis lymphadenitis. With the FNAC diagnosis of lymphoglandulae and reactive hyperplasia lesions of 80 cases, 41 cases were confirmed by histopathology. With FNAC diagnosed tuberculosis 36 cases,granulomatous lymphadenitis 2 cases and reactive hyperplasia 3 cases. FANC is one of efficient method to diagnosis the tuberculous tymphadenitis. This method has some limitations, but it could be overcome by biopsy or polymerase chain reaction.%探讨经B超引导针吸穿刺细胞学检查(FNAC)对淋巴结结核(TB)的诊断价值.在B超引导下对淋巴结进行FNAC,以鉴别淋巴结结核.FNAC诊断淋巴结肉芽肿及反应性增生病变80例,41例经病理组织学证实.FNAC诊断结核36例,肉芽肿性淋巴结炎2例,反应性增生3例.结论:经B超引导FNAC是淋巴结结核病理诊断的有效方法之一,但也存在一定的局限性,可以通过活检或聚合酶链反应(polymerase chain reaction,PCR)等方法解决.

  14. Biopsy techniques for intraocular tumors

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi

    2016-01-01

    Full Text Available Biopsy involves the surgical removal of a tissue specimen for histopathologic evaluation. Most intraocular tumors are reliably diagnosed based on the clinical evaluation or with noninvasive diagnostic techniques. However, accurately diagnosing a small percentage of tumors can be challenging. A tissue biopsy is thus needed to establish a definitive diagnosis and plan the requisite treatment. From fine-needle aspiration biopsy (FNAB to surgical excision, all tissue collection techniques have been studied in the literature. Each technique has its indications and limitations. FNAB has been reported to provide for 88-95% reliable and safe ophthalmic tumor diagnosis and has gained popularity for prognostic purposes and providing eye conserving treatment surgeries. The technique and instrumentation for biopsy vary depending upon the tissue involved (retina, choroid, subretinal space, vitreous, and aqueous, suspected diagnosis, size, location, associated retinal detachment, and clarity of the media. The cytopathologist confers a very important role in diagnosis and their assistance plays a key role in managing and planning the treatment for malignancies.

  15. Biopsy techniques for intraocular tumors.

    Science.gov (United States)

    Rishi, Pukhraj; Dhami, Abhinav; Biswas, Jyotirmay

    2016-06-01

    Biopsy involves the surgical removal of a tissue specimen for histopathologic evaluation. Most intraocular tumors are reliably diagnosed based on the clinical evaluation or with noninvasive diagnostic techniques. However, accurately diagnosing a small percentage of tumors can be challenging. A tissue biopsy is thus needed to establish a definitive diagnosis and plan the requisite treatment. From fine-needle aspiration biopsy (FNAB) to surgical excision, all tissue collection techniques have been studied in the literature. Each technique has its indications and limitations. FNAB has been reported to provide for 88-95% reliable and safe ophthalmic tumor diagnosis and has gained popularity for prognostic purposes and providing eye conserving treatment surgeries. The technique and instrumentation for biopsy vary depending upon the tissue involved (retina, choroid, subretinal space, vitreous, and aqueous), suspected diagnosis, size, location, associated retinal detachment, and clarity of the media. The cytopathologist confers a very important role in diagnosis and their assistance plays a key role in managing and planning the treatment for malignancies. PMID:27488148

  16. 脊索瘤针吸细胞学诊断探讨%The Approach of Fine Needle Aspiratiopn Biopsy of Chordoma

    Institute of Scientific and Technical Information of China (English)

    潘秦镜; 张询

    1999-01-01

    8例脊索瘤(1例骶尾部,2例颈部,5例颅底部)治疗前经针吸细胞学诊断.所有病例都有共同的细胞学表现:有两种细胞成份:一种是有丰富泡沫状或空泡状胞浆的圆形、卵圆形或多边形液滴状细胞,另一种是无胞浆空泡的小圆形、短梭形或星形细胞;多数细胞核圆形或卵圆形无明显异型,核染色质轻度增多、分布均匀,核浆比例不高;细胞单个散在或排列为松散的细胞群;涂片背景中有多少不等的粘液状物.本资料分析表明针吸细胞学结合临床及X线所见可以诊断脊索瘤.

  17. Importance and value of a preoperative diagnosis in oat cell carcinoma by radiography and its verification by Fine Needle Biopsy (FNB)

    International Nuclear Information System (INIS)

    Surgical resection currently offers the best hope of cure in Non Small Cell Lung Cancer (NSCLC), while chemotherapy and/or radiotherapy is the primary choice for Small Cell Lung Cancer (SCLC). The preoperative diagnosis of small cell anaplastic carcinoma (oat cell carcinoma) therefore is extremely important for adequate patient management treatment and prognosis. The patients history, clinical findings and radiographic patterns are all important for the differential diagnosis of SCLC (oat cell cancer) constituting a clinical, radiological and histopathological entity. FNB is a minor, fast, safe, inexpensive procedure, which is easy to perform, not uncomfortable for the patient and which, due to high accuracy may confirm or exclude SCLC (oat cell cancer). Major surgery with its inherent risk of morbidity/mortality may such be avoided allowing to choose the optimal and most appropriate form of alternative treatment permitting a high quality of life during the course of the disease. In a series of 2726 patients with 5300 FNB, of which 1264 (46%) showed evidence of malignancy SCLC (oat cell carcinoma) was cytologically diagnosed in 54 cases (6%). No serious complication occurred. (orig.)

  18. Analysis of the behavior and characteristics of thyroid lesions identified by biopsy fine needle aspiration and gammagraphic diagnosis: Hospital Calderon Guardia: period 2004-2006

    International Nuclear Information System (INIS)

    Thyroid lesions have meant one of the most important pathological entities in the Costa Rican population for many years, which have been increased by new diagnostic examinations and early detection and timely thanks to the preventive medicine that is exerted on the security of the country. After the nuclear accident Chernobyl in the former Soviet Union for several decades ago has shown an increase in neoplastic lesions as well as was appreciated after the implementation of the first atomic bomb in World War II, this behavior is the interest to see how thyroid pathology develops in the environment and what have been the Costa Rican experiences in correlation with the expected time to the global statistics. The behavior pattern observed of the lessons of the thyroid gland and based on clinical findings and in some cases together with scintigraphy have allowed to study the development seen through the ultrasound and cytopathological result. The behavior of the patients was similar to global statistics, being most frequent the benign lesions than malignant, and the scintigraphy correlation with lesions were found to be cold was significant for determination of malignant or suspicious for malignancy. Some of these lesions that were suspicious for malignancy scintigraphy and ultrasound were benign have been found to fall within the expected rate for this type of injury. The study consisted of sampling in 2023 noted that the prevalence was 9:1 in women compared with men, which agrees as thyroid diseases are more common in women than in men as well as the expected results in malignant lesions that remained the same behavior. As expected in the age ranges of suffering from thyroid lesions remained between the fifth and sixth decade of life, which has allowed to observe the frequency of different benign and malignant lesions that occurred during this study in the decades and periods covered. While before the study of thyroid lesions was occupied by scintigraphy and endocrinological management has been viewed that incidentalomas appreciated by the teams high-resolution ultrasound bring a benefit in the care of the patient early and fast like its minimally invasive intervention to characterize the thyroid lesions that are suspicious of malignancy or indeterminate by clinical and other diagnostic methods, a fact that increases in the routine study of thyroid pathology. In fact in the cost benefit study of FNA for early patient care is relatively cheap with a great evaluation of lesions and is important for determination of injury, because if there were suspected, sonographically, it is easier to seek the consent from patient and treating physician to take the sample and lead to better clinical guidance, histological and radiological, fact that will allow the patient a concise definition of your case. (author)

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

    International Nuclear Information System (INIS)

    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

  20. 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.

  1. Needle biopsy of the breast.

    Science.gov (United States)

    Millis, R R

    1984-01-01

    Recently, there has been a considerable increase in the use of both fine-needle aspiration biopsy (aspiration cytology) and tissue-core needle biopsy of the breast. In patients with suspected breast cancer, needle biopsy is frequently used to confirm the diagnosis before treatment is planned. This allows a more thoughtful approach to the patient and full screening for possible metastatic disease prior to definitive surgery. Needle biopsy techniques are simple, rapid, can be performed in the doctor's office, and save time, equipment, and hospital beds. Complications are few. Aspiration cytology has the advantage that it is quick to perform, the preparation can be examined almost immediately and, in the event of an unsatisfactory smear, the procedure can be repeated. However, the diagnosis is based on purely cytological evaluation, and the information obtained is somewhat limited. Reported accuracy rates range from 42 to 96%. False positive reports are rare but have occurred in most centers, and a high degree of accuracy will only be obtained by experienced practitioners. Tissue-core needle biopsy has the advantage that the diagnosis is based on histopathological assessment, but the procedure is slightly more time consuming, is more traumatic for the patient, and the equipment is more expensive. Accuracy rates range from 67 to 98.5%. During the past 4 years, 329 tissue-core (Tru-Cut) biopsies have been performed in the Guy's Hospital Breast Unit, with an accuracy rate of 83% in the diagnosis of carcinoma. The procedure has been acceptable to most patients, and complications have been minimal. Studies comparing the use of aspiration cytology and tissue-core needle biopsy in the diagnosis of mammary carcinoma have produced variable results. Both methods have advantages and disadvantages, and the choice of technique must depend on the clinical situation and the preferences and skills of the practitioners involved in the management of the patient. PMID:6377049

  2. Rectal palpation and transrectal fine needle aspiration of the prostate in the monitoring of prostate cancer: a study of 59 patients during treatment with estramustine phosphate or estrogens.

    Science.gov (United States)

    Hedlund, P O; Das, D; Löwhagen, T; Esposti, P

    1989-01-01

    Fifty-nine hormonally treated prostatic carcinoma patients were prospectively followed by rectal palpation and fine needle aspiration cytology (FNAC) at 6 month intervals for periods ranging from 6 to 120 months (median follow-up, 48 months). The cytologic impressions and palpatory findings were divided into four categories, respectively, ranging from benign to clearly malignant. Cytologic material and palpatory descriptions suitable for evaluation were available for 306 follow-up examinations, with a mean number of follow-up examinations per patient of five (range, 1-13). Tumor relapse was noted in 26 patients and was diagnosed at the same time by FNAC and palpation in six patients. In 16 of the patients tumor progression was first noted by cytology, and in four patients relapse was first detected by rectal palpation. Different patterns of cytologic and palpatory findings during the development of remission and progression of the tumors and drawbacks of the methods are discussed. PMID:2594583

  3. 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

    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......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...... with cancer in only 12% and 50% of samples, respectively. In the indeterminate group 4 of 25 carcinomas were identified by molecular FNA screening, which increased the sensitivity from 67% (cytology alone) to 75% (cytology plus molecular screening). Conclusion: Molecular screening for point mutations...

  4. 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.

  5. 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.

  6. 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.

  7. EVALUATION OF MALIGNANT SKIN LESIONS ON FINE NEEDLE ASPIRATION CYTOLOGY AND THEIR CLINICOPATHOLOGICAL CORRELATION IN A TERTIARY CARE HOSPITAL IN NORTH - EAST INDIA

    Directory of Open Access Journals (Sweden)

    Partha Kamal

    2015-09-01

    Full Text Available BACKGROUND: Malignant lesions of skin often come to clinical attention. Fine needle aspiration cytology (FNAC is an easy and commonly used technique to diagnose them . Basal cell carcinoma (BCC , squamous cell carcinoma (SCC and malignant melanoma predominant the picture. AIM: To evaluate the malignant skin lesions by FNAC and their clinicopathological correlation . MATERIAL AND METHODS : FNAC from patients with the suspected malignant skin lesions coming to the department of pathology is done . Their MGG stained sections are studied and clinic - pathological correlation is done. RESULTS: Out of the 21 malignant skin lesions 85.7% cases accurately diagnosed by FNAC in our study. This is similar to other studies done on malignant skin lesions.

  8. Diagnosis of Hepatocellular Carcinoma Complicating Liver Cirrhosis: Utility of Repeat Ultrasound-Guided Biopsy after Unsuccessful First Sampling

    International Nuclear Information System (INIS)

    Purpose: To evaluate the utility of a second ultrasound-guided fine-needle biopsy of liver nodules thought to be hepatocellular carcinoma when the original biopsy has failed to provide a reliable diagnosis. Methods: Thirty-seven cirrhotic patients underwent ultrasound-guided fine-needle biopsy of liver nodules that were subsequently diagnosed as hepatocellular carcinoma. Each biopsy involved a single puncture with a 20 G cutting needle, which yielded pathologic material used both for cytologic and histologic studies. In 23 cases (mean diameter of nodules 48 mm) the biopsy furnished exclusively necrotic material (non-diagnostic subgroup); in the other 14 cases (mean diameter 26 mm) the biopsy yielded no neoplastic elements (false-negative subgroup). All 37 nodules were subjected to repeat biopsies performed in the same manner. Results: The repeat biopsies provided a diagnosis of hepatocellular carcinoma in six of the 23 patients from the non-diagnostic subgroup and in seven of the 14 in the false-negative subgroup. Overall, repeat biopsy produced a diagnostic gain of 35.1%. Conclusion: The chance of success with repeat biopsy of hepatocellular carcinoma is limited and may depend to some extent on the characteristics of the lesions (i.e., areas of necrosis in large nodules, well-differentiated cellular populations in small ones)

  9. Postoperative Prognosis of Breast Cancer Patients Predicted by p53 Gene Mutation in Cancer Cells Obtained by Aspiration Biopsy

    OpenAIRE

    Takashi, SATO; Hideji, Masuoka; Kazunori, Toda; Kosho, Watabe; Yukio, Nakamura; Tatsuya, Ito; Makoto, Meguro; Masaaki, Yamamoto; Tousei, Ohmura

    2007-01-01

    The method of cytological examination by fine needle aspiration biopsy (FNAB) was developed clinically in breast cancer and enabled us to prepare cancer cell nuclei for the detection of p53 gene mutation. In the expectation that this method would improve the prediction of postoperative prognosis, the observation of 10 year survival for breast cancer patients with p53 gene mutations was done. The DNA of the aspirated cells was examined preoperatively for gene alterations in 53 patients with br...

  10. Bone Biopsy

    Science.gov (United States)

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

  11. 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.

  12. 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.

  13. 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.

  14. [Preoperative biopsy diagnosis in suspicion of breast cancer].

    Science.gov (United States)

    Rasmussen, Birgitte Bruun; Bak, Martin; Rank, Fritz E

    2007-09-01

    The golden standard in non-operative breast cancer diagnosis is the triple test, a combination of clinical evaluation, mammography/ultrasound and needle biopsy, either fine needle aspiration cytology (FNAC) or histological core biopsy. FNAC and core biopsy both have advantages and disadvantages but neither of them can act as a decisive diagnostic procedure on its own. The final diagnosis should always be a consensus between the three diagnostic modalities in the triple test. Quality assurance of the pathological diagnosis is a must. The number of uncertain diagnoses i.e. atypia or suspicion of malignancy should be kept at a minimum. These diagnostic categories call for additional diagnostic procedures and thereby cause a delay in reaching the final diagnosis leading to definitive treatment. PMID:17953876

  15. Methods for Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    M. Ghafoori

    2008-01-01

    Full Text Available Prostate cancer is currently the most prevalent form of cancer in men and the second leading cause of can-cer death in the United States, and the third most common cancer in men worldwide. Increasing mor-tality rates due to prostate carcinoma have been ob-served worldwide. This disease usually progresses im-perceptibly; thus, patients are unlikely to seek medi-cal help during the early stages. For these reasons, screening programs aimed at early detection have been developed. The prostate-specific antigen (PSA test is among the best screening tools available in medicine today and is recognized as the best marker for its early detection. Prostate cancers detected by DRE method alone are clinically localized only 50% to 60% of the time, whereas PSA-detected tumors are clinically localized 90% of the time and pathologi-cally confined to the prostate as determined at prostatectomy about two thirds of the time. Recently, the detection of localized prostate cancers has improved, owing to the development of various new biopsy methods. However, a standard biopsy method, including number of cores, has not yet been established at present. When screening results indi-cate the possibility of prostate cancer, a pathologic diagnosis may be pursued by ultrasound guided trans-rectal needle biopsy. Prostate biopsy is usually ad-vised if serum PSA is >4 ng/mL, and this procedure remains the gold standard for prostate cancer diagno-sis. Fine needle biopsy is less painful than core bi-opsy, but also less diagnostically accurate. Systematic biopsy protocols: In 1989, Hodge et al. coined the sextant biopsy method that is still the standard of reference in prostate cancer detection. The prostate is bilaterally divided into three regions (apex, midgland, and base, all of which are system-atically biopsied once. Although Hodge et al. first proposed sextant biopsy under transrectal ultrasound guidance, some recent reports have indicated that systematic sextant biopsy

  16. Fine-needle aspiration diagnosis of squamous cell carcinoma in a lymph node involved with small lymphocytic lymphoma: case report and review of the literature.

    Science.gov (United States)

    McElroy, Clinton; Velilla, Rowena; Chaudhary, Humera; Al-Abbadi, Mousa A

    2009-01-01

    Diagnosis of two distinct malignant entities existing concurrently and at the same location (synchronous malignancy) by fine- needle aspiration (FNA) is unusual but may occur. Small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) in particular is associated with an increased incidence of secondary tumor, likely due to associated immunodeficiency. Co-occurrence of some carcinomas such as squamous cell carcinoma (SCC), may show especially aggressive behavior. A 57-year-old Caucasian male presented with recurrent upper extremity lymphedema and diffuse lymphadenopathy of the axillary and cervical regions. FNA of a large cervical lymph node was diagnostic for both atypical lymphocytic proliferation and SCC. Flow cytometric analysis showed the atypical lymphocytic proliferation to be positive for CD5, CD23, CD19, CD20, HLA-DR, CD38, and the population was kappa light chain restricted. These cells were negative for CD-10 and FMC-7 antigens, suggesting a phenotype of B-cell SLL/CLL. We report a rare occurrence of metastatic SCC to a lymph node infiltrated by SLL/CLL. The diagnosis was achieved by a combination of cytomorphologic examination of FNA smears, immunohistochemical staining of cell block material, and flow cytometry on the sample obtained by FNA. To the best of our knowledge, only three cases of SCC metastasis to SLL/CLL diagnosed by FNA have been reported in the English literature. Though rare, awareness of such a possibility and careful cytological examination under the appropriate clinical conditions is warranted. PMID:18973126

  17. Diagnóstico de criptococose canina pela citologia aspirativa por agulha fina Diagnosis of canine cryptococcosis by fine-needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Danieli Brolo Martins

    2008-06-01

    Full Text Available Relata-se um caso de criptococose canina de caráter sistêmico e neurológico diagnosticado com o auxílio da citologia aspirativa por agulha fina (CAAF. O paciente, da raça Labrador, 1 ano e 5 meses, macho, apresentava sinais de depressão/estupor, hiporexia, presença de uma massa cervical delimitada entre os dois linfonodos submandibulares e aumento de linfonodos. A punção aspirativa da massa cervical e dos linfonodos poplíteo, pré-escapular e submandibular revelaram presença de fungos compatíveis com Cryptococcus neoformans, o qual foi então confirmado pela cultura fúngica, e classificado como sorotipo D. A CAAF mostrou ser um método rápido, seguro e eficaz em casos de criptococose canina com presença de linfoadenomegalia.This paper aimed to described a 1.5 year-old Labrador male, diagnosed with cryptococcosis using fine-needle aspiration cytology (FNAC. The dog was showing signs of depression and hyporexia. Peripheral lymph nodes and a mass situated between the submandibular lymph nodes were aspirated. The cytology showed yeast-like structures resembling Cryptococcus sp. in all samples examined. These findings were confirmed by culture (C. neoformans, serotype D. The FNAC technique allowed a quick, safe and easy diagnosis in this case.

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

    International Nuclear Information System (INIS)

    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/mm2) 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 -3 mm2/s and 1.93 x 10-3 mm2/s, respectively (P -3 mm2/s) and carcinoma. An ADC value of 2.25 x 10-3 mm2/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.

  19. Ultrasonography-Guided Fine Needle Aspiration Cytology of Cervical Lymphadenopathy: Comparative Study of the Cytological Adequacy Using of 21- and 23- Gauge Needles

    Energy Technology Data Exchange (ETDEWEB)

    Beak, Jin Wook; KIm, Dong Wook; Kim, Bo Mi [Busan Paik Hospital, Inje University School of Medicine, Busan (Korea, Republic of)

    2011-05-15

    To assess the difference in the cytological adequacy of ultrasonography (US)-guided fine needle aspiration cytology (US-FNAC) for cervical lymphadenopathy using 21 and 23 gauge needles. US-FNACs were separately performed on two cervical lymph nodes and in each patient using 21 gauge (group A) and 23 gauge (group B) needles, respectively. We used 4 grade classifications for the cytological analysis of each slide and compared the cytological adequacy of US-FNAC for cervical lymphadenopathy in the two groups. We performed US-FNACs on 58 cervical lymph nodes from 29 patients, with a cytological adequacy of 69.0%. The number of adequate cytological results was 19 (65.5%) in group A and 21 (72.4%) in group B, and the diagnostic adequacy did not differ significantly between the two groups (Mann-Whitney test, p = 0.574). There was no statistically significant difference in the cytological adequacy of US-FNAC for cervical lymphadenopathy according using of 21 and 23 gauge needles.

  20. Repeat Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Patients with Suspected Pancreatic Cancer: Diagnostic Yield and Associated Change in Access to Appropriate Care.

    Science.gov (United States)

    Mitchell, Robert A; Stanger, Dylan; Shuster, Constantin; Telford, Jennifer; Lam, Eric; Enns, Robert

    2016-01-01

    Background. There is a high incidence of inconclusive cytopathology at initial EUS-FNA (endoscopic ultrasound-guided fine-needle aspiration) for suspected malignant pancreatic lesions. To obtain appropriate preoperative or palliative chemotherapy for pancreatic cancer, definitive cytopathology is often required. The utility of repeat EUS-FNA is not well established. Methods. A retrospective cohort study was conducted evaluating the yield of repeat EUS-FNA in determining a cytological diagnosis in patients who had undergone a prior EUS-FNA for diagnosis of suspected malignant pancreatic lesions with inconclusive cytopathology. The wait times to the second procedure and to decisions regarding therapy were calculated. Results. Overall, 45 repeat EUS-FNA procedures were performed over seven years for suspected malignant pancreatic lesions. Cytopathological class (I to IV) changed between first and second EUS-FNA in 32 patients (71%). Of 34 patients with an initially nonconclusive diagnosis, 20 had a conclusive diagnosis (59%) on repeat EUS-FNA. The cumulative yield after repeat EUS-FNA for definite pancreatic adenocarcinoma was 7 (16%). The median time interval between first and second EUS-FNA was 31 (7-175) days. Conclusions. A substantial number of patients had a definitive diagnosis of adenocarcinoma on repeat FNA and were, therefore, subsequently able to access appropriate care. PMID:27648440

  1. Putting an eye on cytological specimens: an audit of the clinical impact of thyroid fine-needle aspiration in different health care settings.

    Science.gov (United States)

    Pereira, Bernardo Dias; Gerhard, Renê; Schmitt, Fernando

    2014-12-01

    There is published evidence showing less cost-benefit approaches in the evaluation of thyroid nodules. We performed an institutional audit of the cytologic diagnosis of thyroid fine-needle aspiration (FNA) in an attempt to perceive the clinical impact of this technique on the management of thyroid nodules and to compare it in two different types of health care: Primary Care Medicine and Endocrinology. We performed a retrospective analysis to the electronic records of patients referred from General Practitioners (GP) and Endocrinologists (E) for thyroid FNA between 2010 and 2012. Request forms for cytological reports where retrieved for analysis of clinical and cytological data. The database search retrieved 1655 patients (female gender: 88.2%; GP references: 51.8%). Preprocedure clinical information was available from 157 out of 2005 nodules (7.8%). Significant differences in cytological diagnosis were seen in "Nondiagnostic" (GP: 11.6%; E: 7.5%, χ(2)  = 0.002) and "Benign" categories (GP: 75%; E: 81.8%, χ(2)  limitations of FNA, the international recommendations for better cost-benefit approaches and the importance of a well-informed cytopathologist for better cytological diagnostic results. PMID:24678022

  2. 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.

  3. Fine-needle aspiration cytology in nonpalpable mammographic abnormalities in breast cancer screening: results from the breast cancer screening programme in Oslo 1996-2001.

    Science.gov (United States)

    Sauer, Torin; Myrvold, Kristina; Lømo, Jon; Anderssen, Karin Yvonne; Skaane, Per

    2003-10-01

    Fine-needle aspiration cytology (FNAC) of nonpalpable mammographic lesions has been under attack from two sides for some years. There has been much discussion and controversy as to the ability to differentiate between in situ and invasive carcinomas in cytological material. A further issue is that of optimal sampling to obtain adequate cell material in sufficient quantity. We present the results of FNAC from 832 nonpalpable mammographic abnormalities detected in the course of the breast cancer screening programme in Oslo during 1996-2001. In 11.6% of cases the smears were inadequate, and there were 7% false negatives (FN) and 1.3% false positives. Of the FN, 64% represented microcalcifications and 86% were due to sampling errors. Absolute sensitivity was 74%, complete sensitivity 88% and specificity 88%. In 255 carcinomas a cytological diagnosis of them as in situ or invasive was made. In 93% of the invasive cases (190/205) these had been correctly identified as invasive on FNAC. In 78% of cases proper follow-up could be resolved by cytology/radiology alone. Suboptimal sampling and localization remains the main cause of FN FNAC results. Problems in differentiating between in situ and invasive breast carcinomas can be significantly reduced by applying strict criteria for in situ lesions. PMID:14659146

  4. 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

  5. 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.

  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. Useless and dangerous--fine needle aspiration of hepatic colorectal metastases%结直肠癌肝转移细针穿刺--无用而且危险

    Institute of Scientific and Technical Information of China (English)

    M S Metcalfe; F H G Bridgewater; E J Mullin; G J Maddern; 邓瑞雪; 陆星华

    2004-01-01

    @@ 细针穿刺细胞学检查(fine needle aspiration cytology,FNAC)是一种成熟的诊断肝脏肿瘤的方法.但这种方法有其公认的并发症,用于腹部肿瘤诊断时可导致0.006%~0.031%的患者死亡1,2.

  8. The Role of Fine Needle Aspiration Cytology for Thyroid Tumor%细针吸取细胞学对甲状腺肿物的诊断价值

    Institute of Scientific and Technical Information of China (English)

    张文杰; 毕丽荣; 魏立静

    2001-01-01

    [ Purpose ] To investigate the role of fine needle aspiration cytology for the diagnosis of thyroid tumor. [ Method ] Fine needle aspiration from 386 cases with pathologically proved thyroid tumor was analysed. [ Results ] Of 386 cases, the cytologic diagnosis was consistent with pathologic diagnosis in 359 cases(93.0% ). [ Conclusion] Fine needle aspiration cytology can accurately diagnose thyroid tumor majority.%[目的]探讨细针吸取细胞学检查对甲状腺肿物的诊断价值。[方法]对有组织学证实的386例甲状腺肿物细针穿刺涂片进行分析。[结果]386例甲状腺肿物细胞学检查结果与组织学检查结果相符359例,准确率为93 0%。[结论]大多数甲状腺肿物在细针穿刺细胞学上可作出明确诊断。

  9. 甲状腺结节细针穿刺细胞学检查评估%Fine-needle aspiration cytology of thyroid nodules:a clinical evaluation

    Institute of Scientific and Technical Information of China (English)

    张永侠; 张彬; 张智慧; 郭会芹; 王勇; 徐震纲; 唐平章

    2011-01-01

    Objective To investigate the clinical application of fine needle aspiration ( FNA )cytology of thyroid nodules.Methods A retrospective review was performed of 474 consecutive cases of FNA cytology of thyroid nodules from October 2005 to January 2011.Two hundred and eighteen patients underwent ultrasound-guided FNA,and 256 patients experienced palpation-guided FNA.Cytologic diagnoses were classified as unsatisfactory,benign,atypical cellular lesion,follicular neoplasm,suspicious for malignancy,and positive for malignancy.The discrepancies between initial cytologic diagnoses and histologic diagnoses were evaluated in 157 surgical specimens.Results According to the cytological categories,the rates for histologically confirmed malignancy in the 157 patients were as follows:2/7 of unsatisfactory results,16.7% (9/54) of benign lesion,3/9 of atypical cellular lesion,1/3 of follicular neoplasm,83.3%(35/42) of suspicious for malignancies,and 97.6% (41/42) of positive for malignancies.The sensitivity,specificity and positive predictive value of thyroid FNA for the diagnosis of malignancy were 85.4%,86.9%and 90.5%,respectively.Conclusions FNA can provide an accurate diagnosis of thyroid malignancy preoperatively.The 6 diagnostic categories were beneficial for either clinical follow-up or surgical management of the patients with thyroid nodules.%目的 探讨甲状腺细针穿刺细胞学(fine-needle aspiration,FNA)检查的临床价值.方法 回顾性分析中国医学科学院肿瘤医院2005年10月至2011年1月行甲状腺细针穿刺的474例连续病例资料.B超引导下穿刺218例(46.0%),触诊穿刺256例(54.0%).细胞学诊断结果分为六级:无法诊断、良性、不典型细胞、滤泡样肿瘤、可疑恶性及恶性.将其中157例手术患者术前细胞学诊断结果与术后组织病理学诊断结果进行比较.结果 157例手术治疗患者中91例为恶性,术前FNA诊断为无法诊断2/7、良性16.7% (9/54)

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

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    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.

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

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    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

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

    International Nuclear Information System (INIS)

    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

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

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    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.

  14. 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.

  15. 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.

  16. 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.

  17. Role of Fine Needle Aspiration Cytology in Salivary Gland Pathology and its Histopathological Correlation: A Two Year Prospective Study in Western India.

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    Amit H Agravat

    2012-10-01

    Full Text Available Background and objectives: Salivary gland lesions account for 2-6.5% of all the neoplasms of the head and neck. Fine needle aspiration cytology (FNAC is being increasingly used in the diagnosis of salivary gland lesions. The objective of this study was to evaluate the diagnostic accuracy and the sensitivity and specificity of FNAC in various salivary gland lesions in correlation with their histopathology, which helps in the appropriate therapeutic management. Methods: A total of 120 FNACs were done on salivary gland tumours from July 2010 to June 2012 in the Department of Pathology, P.D.U. Government Medical College, Rajkot (Gujarat, India. Formalin fixed (10%, surgically resected specimens were received, they were processed and slides were prepared for histopathological diagnosis. The stained cytological and histopathological slides were studied, analyzed and correlated. Results: The cytomorphological features were studied and analyzed and the following lesions were observed: Pleomorphic adenoma (88, Warthin’s tumour (2, Cystic lesion (4, Mucoepidermoid carcinoma (6, Acinic cell carcinoma (2, Primary lymphoma (2, Carcinoma EX pleomorphic adenoma(4, metastatic malignancy deposits (2, benign parotid tumour (8 and malignant tumour (unspecified(2. A histopathological correlation was available in 78 cases. Out of these, 71 cases were true positive, 1 was false positive, 2 were false negative and 4 were true negative. Interpretation and conclusion: The overall sensitivity, specificity and the diagnostic accuracy were 97%, 80% and 92% respectively. Hence, the appropriate therapeutic management could be planned earlier. This study documents that FNAC of the salivary gland tumours is accurate, simple, rapid, inexpensive, well tolerated and harmless for the patient.

  18. 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.

  19. Skin Biopsy

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    ... skin condition cannot be diagnosed by the patient's history and what the physician finds on examination alone. Confirming a clinical diagnosis may also be necessary prior to starting therapy. Skin biopsy types are as follows: Shave biopsies Punch biopsies ...

  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 ...