Biomedical subjects
Publications and source records attributed to E Malberger.
In seven patients with orbital lesions, fine-needle aspiration (FNA) was performed. No complications were seen in performing this procedure. FNA proved to be an important adjuvant method in the diagnosis of orbital lesions, especially in their pre-operative cytologic definition.
In a pilot study, 21 patients underwent transbronchial fine needle aspiration (TBFNA) using a 45 cm-22 gauge needle guided by means of a semi-rigid metal sleeve, which was introduced through a standard rigid bronchoscope. A total of 33 aspirations were performed from main carina (15), paratracheal (five), and lobar carinal (13) foci. Six aspirations yielded malignant cellular samples, 22 aspirations presented only normal cells, and in five no adequate cellular sample was obtained. Fifteen patients underwent surgical exploration (mediastinoscopy with or without thoracotomy). Four of the cytologically malignant cases were explored and in three the aspiration site was confirmed histologically. In the remaining patients where the site of aspiration was explored, no tumour was demonstrated in the cytologically negative or cytologically inadequate cases. There were no complications from TBFNA. We suggest that TBFNA is useful in determining mediastinal malignant involvement rapidly and with lesser invasion than with current techniques.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Salivary flow rate and sIgA were measured in twenty-one patients suffering from recurrent aphthous stomatitis (RAS). Out of this group ten volunteered for continuous study. In these patients salivary IgA and serum IgA and IgG were measured every 3 days for 3 weeks. All parameters were in the physiologic range of healthy people. No correlation with the clinical condition of the patients was found.
Auto and homo transplantation of the uterus and ovaries was studied in 40 bitches divided into four groups. Group A served as a control. In group B the omentopexy technique of auto-transplantation was used. This method did not prove very rewarding and all 12 grafts were found to have degenerated and were non-functioning when relaparotomy was performed, 3 months after transplantation. In group C, auto transplantation with vascular anastomosis was performed in 12 dogs, yielding satisfactory results including one successful pregnancy and the delivery of 3 healthy puppies. In group D homotransplantation of the internal genital organs was performed in two sets of twin dogs. No immunosuppressive treatment was used. These grafts survived for a limited period as proved by the functional tests and X-ray examination but after 3 months were found to be necrotic and degenerated. Graft function and viability was established by: X-ray examination, cytology of vaginal smears, the effect of gonadotropins on the grafted ovaries and finally relaparotomy undertaken after 3 weeks and 3 months.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: To improve the accuracy of cytologic diagnosis in breast lesion aspirates that are cytologically suggestive of fibroadenoma (FA), exhibiting proliferating epithelial elements and bare nuclei but devoid of the typical stroma. STUDY DESIGN: A retrospective study was conducted. All available cases (89) that were aspirated and reported as suggestive of FA between 1981 and 1991 and were later biopsied were studied, and various morphologic criteria were analyzed in each smear. A control group consisted of 43 cases that were cytologically diagnosed as FA and confirmed histologically. RESULTS: Two criteria contributed to the cytologically suggestive diagnosis of FA. The presence of numerous "multilayered" fragments of proliferating glandular epithelium improved the positive predictive value (PPV) for FA on the suggestive smear from 67.4% to 88.3%, and the presence of numerous bare nuclei in the background improved it to 88.9%. The combined presence of both criteria improved the PPV even further, to 91.7%. CONCLUSION: When an aspirate from a breast lesion is cytologically suggestive of FA despite the absence of the typical stroma, a PPV of 91.7% can be achieved, provided that the epithelial elements include many "multilayered" fragments and that the background consists of numerous bare nuclei.
Hematopoietic elements were found in breast aspirates from nine women. A complete hematologic work-up did not disclose any hematologic disorder. It was concluded that these findings represent microfoci of extramedullary hematopoiesis without any pathologic significance.
While examining fine needle aspirates of lesions, it became evident that preovulatory aspirates differed from postovulatory ones. Proliferation activity was noted in cells and in fragments aspirated during the luteal phase. In order to verify this observation, pairs of smears obtained during different phases of the menstrual cycle from eight fertile women were studied by computer image analysis. Using discriminant analysis based on nuclear features extracted from the digitized cell images, 84.87% of all cells were correctly classified as preovulatory or postovulatory, according to the smear of origin. When the classification was restricted to only the cells from each woman, a 100% correct identification of cell types was obtained, which supports the visual observation that there are cellular changes in the mammary epithelium correlated to the menstrual cycle. Since some proliferative changes may mimic atypia or malignancy, these findings suggest that it is advisable to perform needle aspirations of breast lesions during the preovulatory phase of the cycle.
A comparative cytologic-histologic study of 107 lesions clinically suspected of being basal-cell carcinomas was conducted. Good correlation was found in 94.3% of the cases. This study indicated that needle aspiration cytology could be utilized for the preoperative and follow-up diagnosis of skin lesions clinically suspected of being basal-cell carcinoma. Cellular as well as structural diagnostic criteria are suggested.
Our existing cytologic and radiologic service enabled us to introduce transthoracic fine needle aspiration cytology (FNAC). The results of 301 aspirations on 221 patients during the first three years and the histologic, hematologic or clinical correlations are presented. Cytologically, 127 cases were reported positive for malignancy. No false-positive diagnosis was made. Most cases reported as suspicious for or suggestive of malignancy were also found to be malignant. In 23 cases (18%), the cytologic diagnosis of malignancy was made only upon repeated aspiration. Half of the cases reported as "insufficient" or "negative" on the first aspiration attempt were subjected to repeat aspirations, yielding representive samples in 57% of theses cases. FNAC helped to isolate cases of small-cell undifferentiated carcinoma and lymphoma as well as metastases from a group of patients presenting radiologic and clinical symptoms of malignancy and thus was instrumental in establishing proper treatment and preventing contraindicated surgery. It is suggested that in cases considered inoperable, where exfoliative cytology has failed, transthoracic FNAC, rather than bronchoscopy, mediastinoscopy or thoracotomy, should be applied.
During an 18-mo period, 760 palpable mammary lesions were examined and aspirated. When indicated, mammography was performed in addition. Three separate aspirations were performed in each lesion utilizing 23 gauge (0.6 mm) needles. Biopsies were performed following aspiration in 206 lesions; and 470 of the cases in whom biopsies were not performed were followed up clinically for periods of 10 to 26 mo (mean period 15 mo). Accuracy and sensitivity of the cytological examination were found to be far higher than that of clinical evaluation or mammography. Aspiration cytology resulted in only 1.5% false negative, no false positive, and only 1.65% inconclusive reports. On the other hand, clinical evaluation and mammography yielded 35 and 29% false negative, 0.3 and 0.8% false positive, and 6.75 and 8.8% inconclusive findings, respectively. Eleven malignant cases that were considered to be benign both clinically and mammographically, were correctly diagnosed cytologically. Aspiration cytology was found to be the most accurate of the preoperative diagnostic methods.