Biomedical subjects

A Dekker

Publications and source records attributed to A Dekker.

156 records · Page 9Linked to original sources

PubMedDate not supplied

Fine needle aspiration of pleomorphic adenoma and adenoid cystic carcinoma of salivary gland origin.

OBJECTIVE: To determine the cytologic similarities, distinctive features and diagnostic problems on fine needle aspiration in patients with pleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) of salivary gland origin. STUDY DESIGN: We reviewed the preoperative cytology and histologic sections in 22 patients in whom the resected specimens were diagnosed as PA (17 cases) or ACC (5 cases) of salivary gland. RESULTS: Concordant results were noted between cytologic and histologic diagnoses in 20 cases (91%) and discordant results in 2 cases (9%). Both discordant aspirates had been diagnosed as PA; however, their resected specimens were diagnostic of ACC. Although there were cytologic features common to both tumors, each had a unique relationship of epithelial cells to stroma. Aspirates in PA showed cell clusters with a "sunburst" appearance caused by peripheral spindled cells streaming into a fibrillar myxoid stroma. In ACC well-delineated, tightly cohesive, basaloid cells surrounded mucoid/hyaline globules or clear spaces in a honeycomb pattern. CONCLUSION: The cytologic distinction between PA and ACC in most cases was easily made on adequately cellular aspirates. In the two aspirates with discordant results, diagnostic difficulty resulted when the distinctive relationship between epithelial cells and extracellular matrix was not recognized in sparsely cellular specimens, in part due to lack of observer familiarity with the different patterns.

Adenoma, Pleomorphic↗

PubMedDate not supplied

Significance of positive bronchial cytology in presence of squamous cell carcinoma of upper aerodigestive tract.

The otolaryngologic literature reflects the high incidence if second primary neoplasms found in patients with a squamous cell carcinoma of the upper aerodigestive tract. Most commonly the second tumor is bronchogenic in origin. Routine panendoscopy (direct laryngoscopy, bronchoscopy, esophagoscopy) has been recommended in patients presenting with a squamous cell carcinoma primary in the upper aerodigestive tract. We have questioned the usefulness of obtaining bronchial washings during bronchoscopy in a patient who has an established primary in the upper aerodigestive tract. Perhaps false-positives would occur due to desquamation of tumor cells into the tracheobronchial tree. The authors address the incidence of false-positive washings encountered in a prospective evaluation of bronchial cytology encountered in 100 consecutive patients with primary squamous cell carcinoma of the upper aerodigestive tract who do not have primary bronchogenic carcinoma. A single false-positive (1%) was encountered. It is concluded that epithelial carcinoma of the larynx and upper aerodigestive tract rarely shed identifiable tumor cells into the tracheobronchial tree. When malignant cells are found with bronchial washings, every effort should be made to localize a second primary tumor in the lung.

Aged↗

PubMedDate not supplied

The occurrence of sickle cells in pleural fluid: report of a patient with sickle cell disease.

A 20 year old patient seen in sickle cell crises who presented clincally with pleural effusion, presumably on the basis of pulmonary infarction with subsequent infection, had many sickled red cells in the fluid. This occurrence has not hitherto been reported. Its importance from a diagnostic standpoint is pointed out, particularly in patients where the primary disease process is unsuspected.

Adult↗

PubMedDate not supplied

A comparison of modified methenamine silver and toluidine blue stains for the detection of Pneumocystis carinii in bronchoalveolar lavage specimens from immunosuppressed patients.

Pneumonia due to Pneumocystis carinii is an increasingly frequent occurrence; a prompt, accurate diagnosis is important to successfully manage this infection. Methenamine silver and toluidine blue stainings of material recovered by bronchoalveolar lavage (BAL) have been the most widely employed techniques for detecting Pneumocystis organisms. The value of these two staining techniques for the detection of Pneumocystis organisms was prospectively compared in 220 BAL specimens obtained from 186 immunosuppressed individuals. The patients included those with disease-related and therapy-related immunosuppression; half of the BAL specimens came from organ transplant recipients. The results indicate that neither method is superior to the other and that both will correctly identify almost all Pneumocystis infections if a sufficient aliquot of BAL material is examined systematically by trained individuals. The toluidine blue method is somewhat simpler to perform, however. The reasons for discrepant results between the two staining methods were analyzed.

False Negative Reactions↗

PubMedDate not supplied

A comparative cytologic study of 100 urine specimens processed by the slide centrifuge and membrane filter techniques.

An evaluation of cytology preparations made by the slide centrifuge and membrane filter techniques was made on 100 consecutive urine specimens from 46 patients. The membrane filter technique gave better cellular recovery and produced slides qualitatively superior to those prepared by the slide centrifuge technique. The former, therefore, is the recommended method. The slide centrifuge might be of greater value with urine of low cellularity where the membrane filter has provided only a few to practically no cells. The diagnostic accuracy on clinical follow-up of the patients included in this study is 94% for both methods, with no false positive cases and a 6% false negative rate. This high degree of accuracy indicates that these concentrating methods may lead to clinically valuable information if used routinely in the cytology laboratory.

Adult↗

PubMedDate not supplied

Tissue culture of cells in serous effusions. Evaluation as an adjunct to cytology.

Cell pellets from peritoneal, pleural and pericardial effusions from thirty-six patients were incubated in tissue culture medium. Both the culture supernatants and the cell monolayers in the flasks were examined for malignant cells. Of the ten cases diagnosed as positive for malignant cells by the conventional cytologic smears, eight were positive on examination of the tissue culture supernatants and only six were positive by analysis of the monolayers. All the cases diagnosed as positive from the culture supernatants and from the monolayers were also positive by the conventional smear method. Hence, tissue culture of cells in serous effusions is not helpful as an adjunct to routine diagnostic cytology techniques.

Ascitic Fluid↗

PubMedDate not supplied

Diagnostic significance of carcinoembryonic antigen levels in serous effusions. Correlation with cytology.

Carcinoembryonic antigen (CEA) determinations were performed in 86 malignant and 103 benign serous fluids submitted for routine cytologic examination. Cytology alone identified 54 (63%) of the malignant fluids. The remaining 32 (37%) had elevated CEA levels but no detectable malignant cells. In nearly half of 67 effusions with CEA greater than 2.5 ng/ml and negative cytology, elevated CEA concentrations were confirmed to be associated with malignancy. Most (92.5%) cytologically positive serous fluids also had elevated levels of CEA. Elevated CEA assay may raise the suspicion of malignancy in serous fluids that are negative cytologically. Increased CEA concentrations alone, however, cannot be used for confirming malignancy because CEA levels greater than 2.5 ng/ ml (mean, 10.5 +/- 8.2) were found in 50% of the fluids proven to be nonmalignant. Fluid CEA was more consistently elevated in tumors of gastrointestinal tract (greater than 25 ng/ml), lung (11.2 +/- 8.9) and breast (11.6 +/- 7.7) than in lymphomas or sarcomas (3.6 +/- 1). Paired plasma and fluid CEA levels may be particularly helpful in confirming a clinical diagnosis of malignancy in cases with negative fluid and biopsy findings.

Carcinoembryonic Antigen↗

PubMedDate not supplied

Fine needle aspiration cytology of the pancreas. An analysis of its use in 52 patients.

An experience with fine needle aspiration cytology of the pancreas over a five-year period in 52 patients is described. It was a highly specific test (93%), with a 100% predictive value for a positive test, regardless of the method used to obtain the cytologic sample. On the other hand, the sensitivity was relatively low, especially for percutaneous biopsies (58%). These results are similar to those reported by others. The complication rate was low (less than 1%). FNA cytology is now the procedure of choice in establishing a definitive diagnosis of pancreatic carcinoma in our institution.

Adenocarcinoma↗

PubMedDate not supplied

Cytology of serous effusions: a comparative study of two slightly different preparative methods.

A prospective study of 100 serous effusions was made by two slightly different technics of smearing cells from the centrifuged sediment onto glass slides. Those made with the cotton swab had greater cell concentration and better cell morphology than matching slides prepared by the pipette-"hematologic" two-slide technic. Exclusive use of the cotton swab, therefore, is recommended in making these preparations. On follow-up, in this series of 72 patients, there was a false positive rate of zero per cent, and a false negative rate of 29%.

Adult↗

PubMedDate not supplied

Orbital aspergillosis. Report of a case diagnosed by fine needle aspiration biopsy.

Presentation is made of a case of orbital aspergillosis, a rare condition that may clinically mimic nonspecific orbital inflammatory disease. It can be a subacute or chronic disease that develops in otherwise healthy individuals. Fine needle aspiration biopsy, which has been useful in the diagnosis of a variety of orbital diseases, provided the initial diagnosis in this case.

Aged↗

PubMedDate not supplied

Occurrence of benign glandular tissue in orbital aspirates. Importance of recognizing its lacrimal gland origin.

In the course of performing approximately 100 orbital aspirates, glandular epithelial inclusions were seen in three specimens from three patients. These inclusions, now recognized as benign and normal structures, initially led to false-positive cytologic results in two of the three cases. On the basis of reconstructing the clinical events, they appear to have been derived from the minor lacrimal glands in two cases and from the major lacrimal glands in the third. The potential hazard of regarding these glandular inclusions as indicating metastatic neoplasm is emphasized.

Adult↗

PubMedDate not supplied

Hairy cell leukemia (leukemic reticuloendotheliosis) in serous effusions.

The cytology of two cases of hairy cell leukemia (leukemic reticuloendotheliosis) involving pleural and ascitic fluids is described. With the Papanicolaou stain, the cells have a "lymphoid" appearance. The presence of these cells plus knowledge of the clinical history might help the cytologist and/or hematologist in their identification. A tartrate resistant acid phosphatase (TRAP) stain will confirm the true nature of such cells and establish the clinical diagnosis of hairy cell leukemia. Unlike the other members of the leukemia-malignant lymphoma group, the body cavities are rarely involved.

Acid Phosphatase↗