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Biomedical subjects

M E Boon

Publications and source records attributed to M E Boon.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Diagnostic accuracy of squamous cervical lesions studied in spatula-cytobrush smears.

The cytologically positive cases found in 25,300 cervical smears of spatula samples and 6,168 smears prepared by combined spatula-Cytobrush sampling were analyzed. The diagnostic accuracy (the correlation between the cytologic and histologic diagnoses) was the same for both types of sampling. As to the histologic diagnosis, the rates of severe dysplasia, carcinoma in situ and squamous carcinoma in the spatula-Cytobrush group were more than twice as high as in the spatula group. In the spatula group, the majority of abnormal cells was of the mature type. In the spatula-Cytobrush group, the majority of smears contained a mixture of immature and mature abnormal cells. The more immature lesions, which are often located higher in the endocervical canal, seem to be better sampled by the Cytobrush. The results indicate that the Cytobrush reaches areas that a spatula cannot reach, resulting in a higher diagnostic efficiency.

Carcinoma in Situ↗
PubMedDate not supplied

Carcinoma in situ of the urinary bladder. Clinical presentation, cytologic pattern and stromal changes.

The clinical presentation, cytologic pattern and stromal changes in the cystectomy specimen were studied in a group of 26 patients with carcinoma in situ of the urinary bladder who underwent cystectomy. Only cases in which the nuclear area of the carcinoma in situ cells was over 80 sq micron (large-cell type) were included in this study. The results indicate that the cells from large-cell carcinoma in situ of the bladder exfoliate easily, resulting in a cytologic pattern of predominantly single, highly abnormal cancer cells. Due to the increased exfoliation of the affected epithelium, the bladder stroma is focally denuded; therefore, while cytology may be strongly positive for malignancy in these cases, the histologic diagnosis can be falsely negative when only denuded stroma is biopsied. The edematous stroma causes complaints of "cystitis." The neoplastic urothelium may involve contiguously related epithelial surfaces. When the lesion extends into the prostatic ducts, the patient can have "pseudoprostatitis" complaints. Urethral extension may give penile voiding pain. In one female patient, involvement of the vagina and vulva was found. Carcinoma in situ may develop in patients with papillary low-grade bladder carcinoma during follow-up, with a concomitant shift in the cytologic and clinical patterns; this deserves the consideration and attention of the cytologist and the clinician due to its serious clinical implications.

Adult↗
PubMedDate not supplied

Consequences of the introduction of combined spatula and Cytobrush sampling for cervical cytology. Improvements in smear quality and detection rates.

One of the most important yardsticks for evaluating sampling for the detection of premalignant and malignant cervical lesions is the percentage of smears that contain cells from the transformation zone. Until February 1985, all smears made by around 500 different general practitioners were taken with a modified Ayre spatula. In the period February to October 1985, 24,496 smears of spatula samples and 5,716 smears prepared by combined spatula-Cytobrush sampling were analyzed. With the introduction of the combined spatula-Cytobrush method, the rate of smears containing cells from the transformation zone (adequate smears) rose from 84% to 98%. With the spatula-alone method, there were large differences between the rates of adequate smears from the various doctors; with the combined spatula-Cytobrush method, all participating doctors were without exception highly successful. The positive cytology rate was significantly higher in the combined spatula-Cytobrush smears (0.75%) as compared with the spatula-alone smears (0.38%). There was also a change in the diagnostic pattern in that more premalignant changes of the glandular epithelium of the endocervix were detected. One case of early invasive adenocarcinoma of the endocervix, in which the combined spatula-Cytobrush smears was positive and the repeat spatula-alone smear made by the gynecologist was negative, is discussed in detail. We anticipate that, with the large-scale introduction of the Cytobrush sampling method, fewer repeat smears will be required and, in addition, the observed relative increase of endocervical adenocarcinoma of the endocervix will be halted. In addition, there will be fewer false-negative smears.

Adenocarcinoma↗
PubMedDate not supplied

Manipulating the Papanicolaou staining method. Role of acidity in the EA counterstain.

The role of phosphotungstic acid as the main pH-controlling agent in Papanicolaou's EA stain was analyzed, including its effect on the competition between eosin Y and light green, the principal components of EA solutions, and this acid was compared with HCl as an acidifying agent. The amount of phosphotungstic acid in the solution determined the color of the cytoplasm. Our study led to a better understanding and a simplification of the staining procedure. With the acquired knowledge, the Papanicolaou counterstain can be standardized to suit the taste of the individual cytologist and can add to the predictability of the results.

Buffers↗
PubMedDate not supplied

Significance of the morphology of anucleated squames in the cytologic diagnosis of vulvar lesions. A new approach in diagnostic cytology.

Vulvar smears from 80 patients with various vulvar lesions were analyzed. In each case, 10 anucleated horny squames were identified and the perimeters measured by a graphic tablet (digitizing board) equipped with a camera lucida system. The internal computer of the system calculated areas and shape factors, with the latter characterizing the degree of cellular pleomorphism.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Role of the air bubble in increasing cell recovery using cytospin I and II.

The Shandon Cytospin II cytocentrifuge invariably produces greater cell recovery than does the Cytospin I due to the persistence of an automatically formed air bubble created between the cell suspension and the slide by the new design of the head of the centrifuge. Similar results were achieved with the Cytospin I when care was taken to produce such an air bubble while introducing the sample into the chamber. The instructions for creating such an air bubble in the sample chambers of the Cytospin I are given. The protective role of an albumen solution for cells on slides to be air dried for Giemsa staining, which is particularly valuable for many cytocentrifuged preparations, is also discussed.

Air↗
PubMedDate not supplied

Qualitative distinctive differences between the vacuoles of mesothelioma cells and of cells from metastatic carcinoma exfoliated in pleural fluid.

The qualitative features of the intracytoplasmic vacuoles occurring in the cells of pleural malignant mesothelioma and of metastatic carcinoma exfoliated in pleural fluid were studied. There were important differences in the two types of vacuoles. In mesotheliomas, the vacuoles were centrally situated, small and regular in size; these vacuoles stained positively with fat stains and always negatively with the periodic acid-Schiff stain. In routine cytology, these lipid-containing vacuoles can best be seen in air-dried May-Grünwald-Giemsa-stained smears and are almost invisible in wet-fixed Papanicolaou-stained smears. In metastatic carcinoma, the vacuoles were irregular in size, noncentral in location and often positive with mucin stains. Electron microscopy was used in one case to further elucidate the staining patterns of the vacuoles. This study proves that the analysis of the qualitative features of vacuoles of malignant cells exfoliated in pleural fluid can be of great value in the distinction between metastatic carcinoma and mesothelioma.

Histocytochemistry↗
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Cost effectiveness of population screening and rescreening for cervical cancer in the Netherlands.

In a screening program for cervical cancer held in the western part of the Netherlands in 1978, it was shown that the incidence of positive cases dropped from 8.0% to 1.4% when repeat screening was performed within two years; however, the incidence of mild dysplasia remained the same (13.0%). Forty percent of the allocated funds were used for canvassing. Recanvassing of the no-response group did not result in the finding of positive cases. Of the ten positive cases in the rescreened group, four had had inadequate negative smears previously, and two had had adequate negative smears; in two cases the previous smears were reclassified as dysplasias, and in the two remaining cases endocervical carcinoma cells were found in the additional endocervical smear. In light of the high canvassing costs of population screening and the low detection rate of positive cases in the rescreened group, as described in this paper, it appears overly costly to repeat population screening with two years.

Adult↗
PubMedDate not supplied

A comparison of the efficiency of diagnosis of early cervical carcinoma by general practitioners and cytology screening programs in the Netherlands.

The efficiency of general practitioners and cytology screening programs in the Netherlands in diagnosing neoplasia by means of cervical cytology was investigated. For all age groups of women living in rural or urban areas, the general practitioners were almost twice as successful in detecting cases of cervical neoplasia. No reason could be found why the general practitioners were relatively more successful. The important role of the general practitioner and his or her ability to encourage the high-risk group of women to have early and regular smears is stressed.

Adult↗
PubMedDate not supplied

Simultaneous condyloma acuminatum and dysplasia of the uterine cervix.

A population of 116,090 asymptomatic women between the ages of 20 and 40 was examined for the cytologic presence of dysplasia and koilocytosis presumably resulting from condyloma acuminata of the uterine cervix. Subpopulations of 50 women with severe dysplasia and 50 with severe dysplasia and koilocytosis (= condyloma) were selected for a short-term study of progression to carcinoma or carcinoma in situ. The cytologic preparations examined by morphometry to determine the quantitative morphologic characteristics of the epithelial populations in the two groups showed that patients with condyloma and dysplasia had a different population of cells than those with dysplasia alone. Histologic studies showed that there were significantly more mitotic abnormalities in the condylomatous lesions, consistent with viral alterations of mitosis. While short-term follow-up (three to four years) failed to show that patients with both dysplasia and condyloma were at higher risk of developing cancer than patients with dysplasia alone, patients with condyloma of the cervix should be closely followed clinically since they have a higher risk of other cervical abnormalities.

Adult↗
PubMedDate not supplied

Discrimination between primary pleural and primary peritoneal mesotheliomas by morphometry and analysis of the vacuolization pattern of the exfoliated mesothelial cells.

Cells exfoliated from primary pleural mesotheliomas differ significantly from those from primary peritoneal tumors. In a quantitative study, it was shown that the pleural cells have larger nuclei, a more pronounced anisokaryosis and a higher nuclear-cytoplasmic ratio and, therefore, appear more malignant than the peritoneal cells, which have abundant cytoplasma and small nuclei. The differences in quantitative parameters were due to a more extensive vacuolization and consequent cytoplasmic distension, combined with nuclear compression in the case of peritoneal mesotheliomas. The morphometric parameters and the vacuolization patterns of cell populations in cases with both pleural and peritoneal involvement correlated with the data of the primary tumor regardless of the fluid in which the cells were found. This finding indicates the transcoelomic metastatic properties of malignant mesothelioma.

Ascitic Fluid↗
PubMedDate not supplied

Atypical indifferent (reserve) cells in the cervical epithelium and their exfoliative pattern.

The ultrastructure of light microscopically selected atypical indifferent (reserve) cells in cervical smear preparations is described and compared with their ultrastructure in histologic sections. These atypical indifferent cells have a blastlike chromatin pattern and an intact nuclear membrane. The cytoplasm, however, was often damaged or absent; if present, it showed no sign of differentiation. In the histologic sections, these atypical indifferent cells were found in reserve-cell hyperplasia, in small numbers in squamoid dysplasia and as basally located cells in atypical endocervical epithelium. In contrast to the indifferent cells, the squamoid dysplastic cells and atypical endocervical cells in smear preparations had intact cytoplasm; however, the nuclear membrane of the squamoid dysplastic cells was often interrupted. This study indicates that atypical indifferent (reserve) cells can be recognized by light microscopy in smear preparations and that the fact that the cytoplasm is often damaged or absent is probably due to its undifferentiated nature. These cells can originate in pure atypical reserve-cell hyperplasia, dysplasia or atypical endocervical epithelium. In view of the great importance of these cells in the morphogenesis of squamoid and adenomatous carcinoma of the cervix, it seems of paramount importance that they be identified in cervical smears.

Cell Nucleus↗
PubMedDate not supplied

Carcinoembryonic antigen in sputum cytology.

Carcinoembryonic antigen (CEA) activity was studied in exfoliated cells in sputum from patients with carcinoma of the lung and its precursor lesions. For this purpose, immunohistochemical techniques were applied on paraffin-embedded cell blocks of sputum. In the cancer patients, not only the morphologically malignant cells were CEA positive, but squamous cells that lacked the cytologic features of malignancy also were CEA positive. Some of these CEA-positive cells originated in morphologically benign squamous epithelium. In high-risk patients without clinical evidence of neoplasm, some benign squamous cells were CEA positive, possibly indicating the presence of an undetected or developing cancer.

Adenocarcinoma↗
PubMedDate not supplied

Quantitative and qualitative differences between benign and malignant mesothelial cells in pleural fluid.

Quantitative as well as qualitative cellular parameters were investigated in 20 cases of reactive mesothelial proliferations and 40 cases of primary pleural mesotheliomas. The two groups showed statistically significant differences in the nuclear areas, cytoplasmic areas and standard deviations. In the mesotheliomas, the mean nuclear area and the mean cytoplasmic area were larger than in the reactive proliferations. Nine cases could not be properly classified with these quantitative parameters alone. Qualitative analysis revealed highly characteristic features in the mesotheliomas. Morula formation as well as irregular and coarse reticular chromatin patterns were strongly indicative of mesothelioma. The location and shape of the nucleus and the type and amount of cytoplasmic vacuolization gave additional information for distinguishing between the two groups.

Diagnosis, Differential↗
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Planimetric studies on fine needle aspirates from follicular adenoma and follicular carcinoma of the thyroid.

A planimetric study was performed on fine needle aspiration biopsy smears from 21 follicular thyroid adenomas, 13 follicular thyroid carcinomas and 7 nontoxic goiters. The nuclear and the cytoplasmic projected areas were measured in each smear on 50 cells with intact nuclei. The nuclear-cytoplasmic area was calculated. Significant differences in mean nuclear area were found between benign and malignant follicular neoplasms and between neoplastic cells and cells from nontoxic goiter. Planimetry of cells aspirated from follicular neoplasms permitted differentiation between carcinomas and adenomas with a high degree of statistical probability.

Adenocarcinoma↗