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Biomedical subjects

G B Schumann

Publications and source records attributed to G B Schumann.

67 records · Page 4Linked to original sources
PubMedDate not supplied

Reliability of a quantitative interpretation of sputum cytology slides.

A sputum cytology method has been developed in which eight cytologic components associated with stimulation of the bronchial airways are quantified. The extent to which cytotechnologists could reliably and consistently utilize this system was measured. In an initial study (study A), four cytotechnologists had an overall intraobserver agreement of 90.2% and an interobserver agreement of 76.3%. There was an overall agreement with the laboratory standard of 85.6%. The most difficult components to consistently rate were mucous spirals and metaplastic, dysplastic and columnar cells. Study B was initiated after the implementation of a training program designed to better define both cytologic criteria and our system of quantitation. Two of the original cytotechnologists and a newly trained cytotechnologist participated in study B. The overall intraobserver agreement increased to 97.8% while the overall interobserver agreement increased to 97.5%. The overall agreement with the laboratory standard was 98.3%. These results indicate that a cytologic rating system employed for quantitative sputum cytology can be taught and applied reliably and consistently.

Bronchi↗
PubMedDate not supplied

Discriminant analysis of lower respiratory tract components associated with cigarette smoking, based on quantitative sputum cytology.

Cigarette smoking is the major contributor to chronic bronchial irritation, and tobacco smoke is the most common bronchial carcinogen. A newly developed quantitative sputum cytology test was applied to three-day-pooled, spontaneously produced sputa collected from 349 cigarette smokers and 93 patients who had never smoked; the samples were processed by the Saccomanno technique. In addition to identifying malignant and precancerous cells in sputum, this test identifies eight morphologic parameters of bronchial irritation. Cross-sectional analysis of the cytologic data indicated that, within a 99% confidence interval, cigarette smokers had statistically significantly higher levels of all eight components, producing a unique profile. Discriminant analysis revealed that pigmentation of macrophages, alveolar macrophages and mucous spirals (in that order) were the leading components differentiating smokers from nonsmokers. This new quantitative sputum cytology test correlates with the model of lung carcinogenesis. The detection of proliferative cellular alterations, such as benign and early atypical metaplasia, represent the detection of chronic persistent irritation, which is considered to be a reversible change. The ability to monitor individual responses to toxic inhalants (before the development of irreversible disease) by utilizing a noninvasive test represents a unique opportunity to impact the historic course of lung carcinogenesis.

Adult↗
PubMedDate not supplied

Primary cytodiagnosis of dually differentiated lung cancer by transthoracic fine needle aspiration.

The cytologic features are described in a case of squamous cell carcinoma and small cell cancer of the lung concurrently diagnosed by a single transthoracic fine needle aspiration specimen. The value of diagnostic cytology in the detection of dually differentiated lung malignancies is discussed, and the importance of identifying the small cell component in order to direct appropriate therapy is emphasized.

Aged↗
PubMedDate not supplied

Cytologic diagnosis of acanthamoebic keratitis.

A case of acanthamoebic keratitis was identified from a corneal scraping stained with a modified Papanicolaou stain. The characteristic double-walled cyst forms were easily identified. Corneal scraping cytology provides a rapid, noninvasive means of diagnosis and follow-up for this serious disease.

Acanthamoeba↗
PubMedDate not supplied

Cystoscopic biopsy supernate. A new cytologic approach for diagnosing urothelial carcinoma in situ.

The examination of cystoscopic biopsy supernates is a new cytologic procedure that can aid the urologist in the differential diagnosis of urothelial carcinoma in situ (CIS) and cystitis. Within the past two years, the Cytodiagnostic Urinalysis Laboratory has received 79 cystoscopic biopsy supernate specimens from 29 patients; these were prepared using a membrane filtration technique and stained with a modified Papanicolaou method. Positive diagnoses were rendered on 17 (21.5%) specimens, including 7 (41%) CIS and 10 (59%) papillary neoplasms. An 87% cytohistologic correlation was seen. Of the 17 cases with biopsy specimens that were denuded and thus nondiagnostic, 11 had negative supernate cytologies and 6 had positive cytologic diagnoses. Half of these positive specimens were diagnosed as CIS. Because urothelial CIS is often a friable lesion that yields denuded bladder biopsies, the cytologic examination of cystoscopic biopsy supernates offers a valuable adjunctive method for diagnosing urothelial CIS on otherwise lost cellular material.

Biopsy↗
PubMedDate not supplied

Primary cytodiagnosis of synchronous small-cell cancer and squamous-cell carcinoma of the respiratory tract.

Report is made of the first primary cytodiagnosis of a synchronous small-cell cancer of the lung and squamous-cell carcinoma of the larynx, which were histologically confirmed. Sputum cytology should be used in the detection and surveillance of multiple primary malignancies of the respiratory tract, which have been observed with increasing frequency.

Carcinoma, Small Cell↗
PubMedDate not supplied

Sputum cytodiagnosis of disseminated histiocytic lymphoma. A case report.

Cytohistologic evidence of pulmonary involvement with histiocytic lymphoma was discovered in a patient nine years after the original clinical diagnosis was made. The positive sputum cytologic diagnosis confirmed the radiologic impression of pulmonary involvement, which was substantiated by an open lung biopsy. This case report demonstrates the value of periodic sputum cytology in the diagnosis and management of histiocytic lymphoma. Sputum cytology should be utilized more frequently in the monitoring of pulmonary histiocytic lymphoma.

Biopsy↗
PubMedDate not supplied

Urinary cytodiagnosis of renal involvement in disseminated histiocytic lymphoma.

Two cases of patients with disseminated histiocytic lymphoma are presented in which positive urine cytology provided evidence of renal involvement. In addition to malignant cells, the urine sediment characteristics included renal tubular epithelial cell exfoliation, renal epithelial fragments and pathologic cast formation, which distinguished renal from lower urinary tract involvement. Such cytologic observations may be useful in differentiating among the various causes of renal disease in patients with malignant lymphomas.

Aged↗
PubMedDate not supplied

Osmotic effects on neutrophil segmentation. An in vitro phenomenon.

Segementation of the nucleus is an important morphologic characteristic of mature neutrophils and is a useful parameter for their identification in various body fluids. From our studies, we have demonstrated that when mature neutrophils are placed in low specific gravity urine, cellular enlargement and a loss of nuclear segmentation occur, resulting in inaccurate identification. Both cytotechnologists and investigators involved in neutrophil research should be aware of the effects of tonicity on morphologic characteristics.

Cell Nucleus↗
PubMedDate not supplied

Renal epithelial fragments in urine sediment.

In this cytomorphologic study, the diagnostic criteria for recognizing renal epithelial fragments are given based upon urine sediment examinations with histologic correlation. The study included individuals without urine system disease and patients with acute allograft rejection, acute tubular necrosis, papillary necrosis and renal infarction. Exfoliated renal epithelial fragments are accurately identified by th following configurational characteristics: (1) epithelium attached to or molded by renal casts, (2) epithelial encasement of casts, (3) cylindrical ("sleevelike") epithelium, (4) epithelial sheets with "honeycomb" arrangement and (5) epithelium containing spindle or elongate cells.

Cytodiagnosis↗
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Cytodifferentiation of urinary epithelial fragments: papillary transitional cell carcinoma in a renal allograft recipient.

Exfoliated epithelial fragments found in urinary sediment may originate in renal parenchymal or lower urinary tract epithelium. Cytologists must be aware of situations or diseases that frequently exfoliate epithelial fragments from these sites. In this case report, cytodiagnoses of both renal ischemic necrosis and low-grade papillary transitional cell carcinoma were made. Exfoliated renal epithelial fragments were accurately identified by their morphologic features and distinguished from exfoliated urothelial fragments of a low-grade bladder neoplasm.

Carcinoma, Transitional Cell↗