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Biomedical subjects

J Waisman

Publications and source records attributed to J Waisman.

At least 127 records · Page 7Linked to original sources

Renal cell carcinoma: correlation of CT findings with nuclear morphologic grading in 100 tumors.

The contrast-enhanced preoperative computed tomographic (CT) scans and microscopic slides of 94 patients with 100 surgically resected renal cell carcinomas (RCCs) were retrospectively and independently reviewed in order to correlate the CT imaging findings of RCC with nuclear grading. As nuclear grade increased, RCCs were more likely to be of higher stage and greater size at presentation, and appeared more heterogeneous and less marginated. Of the features analyzed, tumor margination most closely correlated with nuclear grade. Overlap in the CT appearance of individual tumors limited the potential of CT to differentiate RCCs of varying grade. Small, well-marginated, homogeneous tumors, however, were either grade I or II, and were distinguishable from the more aggressive grade III lesions, which generally displayed irregular margins and greater inhomogeneity.

Adult↗

Nephrotoxicity of epinephrine-assisted venography.

A retrospective study was performed to determined the nephrotoxicity of epinephrine-assisted venography (EAV). The results showed an increase in the serum level of creatinine (sCr) up to five days after EAV in 67% of patients, in comparison with 16% in patients who had other types of renal angiography. Microscopic examination of renal specimens from patients who had undergone EAV showed vacuolization of the epithelial cells of the proximal tubules. Risk factors for acute renal failure that have been described in the literature were not statistically significant in this study. These findings suggest that EAV is a more nephrotoxic procedure than renal angiography without EAV.

Adolescent↗

Plasmacytoma of the breast. A report of two cases diagnosed by aspiration biopsy.

BACKGROUND: Extramedullary plasmacytoma of the breast is an uncommon neoplasm, occurring either as a solitary tumor or as evidence of disseminated multiple myeloma. CASE: Two cases of plasmacytoma of the breast were diagnosed by fine needle aspiration cytology. Aspiration smears showed a dispersed population of plasmacytoid cells with eccentric nuclei, abundant cytoplasm and the characteristic paranuclear hof. CONCLUSION: The clinical, cytologic and immunophenotypic features of plasmacytoma are characteristic, and the importance of distinguishing these neoplasms from primary mammary tumors is important to avoid unnecessary surgery.

ADP-ribosyl Cyclase↗

Apoptotic index from fine needle aspiration cytology as a criterion to predict histologic grade of non-Hodgkin's lymphoma.

OBJECTIVE: To investigate whether the assessment of apoptotic index (AI) from fine needle aspiration (FNA) smears of non-Hodgkin's lymphomas (NHL) is reliable and has potential utility as a criterion to predict histologic grade. STUDY DESIGN: AI was independently determined by four cytopathologists as a percentage from routine FNA smears in 96 NHLs and 15 lymphoid hyperplasias. Working formulation (WF) grades from corresponding surgical biopsies were modified to include mantle zone-derived NHLs as intermediate grade and to make diffuse large cell NHL a separate category called "high" grade, whereas WF high grade NHLs were called "very high" grade. Histologic grades were also derived from the Revised European American Lymphoma (REAL) classification. AI was compared with histologic grade using the unpaired, two-tailed Student t test. These data were used to determine potential thresholds for AI that separate lower from higher grade NHLs. RESULTS: Measurements of AI strongly correlated between cytopathologists (median r = .93). Low and intermediate grade NHLs had indistinguishable AIs, whereas higher grade NHLs had significantly higher AIs. Appropriate potential AI thresholds between low or intermediate grade and higher grade NHLs were in the range of 1.5-2.5% (modified WF) and 1-2% (REAL). CONCLUSION: There is excellent interobserver reliability in the measurement of AI from FNAs of NHLs. Higher AIs distinguish higher from lower grade NHLs. Diffuse large cell NHLs had AIs that were similar to WF high grade NHLs.

Apoptosis↗

A low-power, "architectural," clue to the follicular variant of papillary thyroid adenocarcinoma in aspiration biopsy.

OBJECTIVE: To search for low-power, or "architectural," clues to the diagnosis of the follicular variant of papillary thyroid adenocarcinoma (FVP) in Diff-Quik-stained aspiration biopsy smears in order to aid in the rapid diagnosis of FVP, especially as a complement to frozen sections. STUDY DESIGN: The smears of 23 cases, each with tissue-proven FVP, were compared to those of 23 cases of classic papillary thyroid adenocarcinoma (PTA), 23 cases of tissue-proven follicular neoplasms (FN) (i.e., adenoma or well-differentiated adenocarcinoma) and 23 samples of colloid nodules (CN). The low-power (10x) features of the four groups were studied and compared. RESULTS: Our study showed that FVP exhibited monolayered cellular sheets with branched, irregular contours, which can be distinguished from the uniform microfollicles with smooth contours formed in FN and the large, round or oval monolayered sheets of follicular cells found in CN. FVP shared all of the features of classic PTA except for the larger, complex sheets of epithelial cells and psammoma bodies found in the latter. CONCLUSION: The branched sheets of epithelial cells evident during low-power examination of Diff-Quick-stained smears of thyroid aspirates are a ready first clue to the rapid diagnosis of FVP. The diagnosis can be confirmed by subsequent careful evaluation of nuclei in Papanicolaou-stained smears and sections of tissue.

Adenocarcinoma, Papillary↗

Application of Ultrafast Papanicolaou stain to body fluid cytology.

OBJECTIVE: To investigate the applicability of the Ultrafast Papanicolaou stain to the cytology of fluids and to compare it with other methods. STUDY DESIGN: Over a 30-month period, 528 unfixed fluids (462 serous effusions, 48 pelvic washings, 16 cyst fluids and 2 bile duct drain fluids) were mixed thoroughly and centrifuged. Two Swedish-style air-dried smears were made and stained with Diff-Quik (Mercedes Medical, Inc., Sarasota, Florida, U.S.A.) and Ultrafast Papanicolaou stain (Richard Allan Scientific, Kalamazoo, Michigan, U.S.A.), and the remaining sediment was fixed in CytoRich Red (TriPath Imaging, Inc., Burlington, North Carolina, U.S.A.), centrifuged onto a 17.5-mm circle with a Hettich cytocentrifuge and stained by the Papanicolaou method. RESULTS: For the 115 malignant fluids, Ultrafast Papanicolaou stain was the preferred method in the 94 non-hematopoietic malignant fluids, Diff-Quik was the preferred method in the 9 hematopoietic malignancies, and CytoRich Red was the preferred preparation in 8 bloody effusions containing rare cancer cells and 4 malignant pelvic washings. The diagnostic turnaround time of smears stained by Ultrafast Papanicolaou stain was < 15 minutes, fast enough for intraoperative consultations. CONCLUSION: It seems that Ultrafast Papanicolaou stain improves the resolution of cytoplasmic and nuclear details of nonhematopoietic cells in body fluids. However, to detect cancer in all types of fluids, Diff-Quik and CytoRich preparations are also required. We now examine three slides per fluid sample, one slide by each of the three techniques.

Ascitic Fluid↗

Compact cell blocks. Use for body fluids, fine needle aspirations and endometrial brush biopsies.

OBJECTIVE: To obtain an ideal cell block wherein the maximal number of cells are displayed within the smallest area on the block surface. STUDY DESIGN: Cyto-Rich Red (AutoCyte, Inc., Elon College, North Carolina, U.S.A.) is added to fresh cellular sediment in a centrifuge tube at a ratio of 1:1. After two minutes, three to four drops of plasma and topical thrombin (5,000 U/10 mL) is added. The tube is then gently agitated for two minutes, until a gelatinous clot is obtained. The clot is then slid onto a lens tissue on top of paper towels. The lens tissue is folded once over the clot. By gently squeezing the excess fluid from it through the lens tissue into the paper towels, the clot is transformed into a flat, compact, densely cellular aggregate, which is painted with mercurochrome prior to fixation in formaldehyde. RESULTS: From each of the 495 cases, including 250 body cavity fluids, 170 fine needle aspirates and 75 endometrial brush biopsies, processed with the above protocol, there was a compact cell block containing packed cells or tissue fragments in a clean background devoid of red blood cells. CONCLUSION: The compact cell block is about 10-20% the size of a conventional cell block, yet more cells are on display, thus reducing the need for deeper cuts and screening time while increasing the efficiency of cytodiagnosis. The compact cell block technique is particularly helpful for endometrial brush biopsies.

Biopsy↗

Aspiration cytology of signet-ring cell lymphoma. A case report.

BACKGROUND: Signet-ring cell lymphoma is a rare subtype of non-Hodgkin's lymphoma, composed of vacuolated cells with a signet-ring cell appearance. We found only two cases that had been reported as diagnosed by fine needle aspiration biopsy. CASE: A 61-year-old female had signet-ring cell lymphoma diagnosed by computed tomography-guided aspiration biopsy. Smears of aspirates from her retroperitoneal mass contained a population of small to medium-sized, angular lymphoid cells; lymphoglandular bodies; and an abundance of signet-ring cells. The signet-ring cells were negative for cytokeratin and positive for leukocyte common antigen and CD20, a B-cell marker. Monoclonality for lambda light chain determinant was noted, and a diagnosis of signet-ring cell lymphoma of the B-cell type was made. A core biopsy specimen confirmed the diagnosis. CONCLUSION: Signet-ring cell lymphoma should always be considered in the differential diagnosis of tumors composed of signet-ring cells.

Antigens, CD↗