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Biomedical subjects

N Sneige

Publications and source records attributed to N Sneige.

At least 109 records · Page 6Linked to original sources
PubMed1990

Comparison of immunocytochemical and biochemical assays for estrogen receptor in fine needle aspirates and histologic sections from breast carcinomas.

An immunocytochemical assay using a monoclonal antibody specific for estrogen receptor (ER-ICA) was performed on needle aspirates and on histologic sections (mastectomy and biopsy specimens) from 55 patients with breast cancer. A total of 82 ER-ICAs were performed, with matched cytologic and histologic specimens in 27 patients, cytology alone in 15, and histology alone in 13. ER-ICA results were described by a histochemical score (H score) based on intensity-weighted percentages of staining cells. The H scores were compared with results of sucrose density gradient (SDG) analysis of histologic specimens (mastectomy, resection, or biopsy). An H score greater than or equal to 10 and an SDG value greater than or equal to 10 fmol/mg protein were considered positive. The sensitivity of cytologic ER-ICA was 94%, the specificity 100%. The sensitivity of histologic ER-ICA was 67%, the specificity 90%. Correlating cytologic H score with Black's nuclear grade showed that grade 1 (the most anaplastic) carcinomas demonstrated the lowest H scores (mean, 7.3 +/- 29.8), whereas the highest H scores were noted in grade 3 tumors (mean, 150.0 +/- 88.1). Both SDG and ER-ICA showed ER values to be lower in premenopausal than postmenopausal women. There was no correlation between H score and presence of axillary nodal metastases or tumor size. An overall good correlation was demonstrated between immunohistochemical methods and biochemical analysis.

Biopsy, Needle↗
PubMed1990

Fine-needle aspiration cytology and flow cytometry of intracystic papillary carcinoma of breast.

To define criteria for cytologic diagnosis of intracystic papillary carcinoma (ICPC), the authors retrospectively reviewed the fine-needle aspiration (FNA) cytologic specimens of eight cases of histologically proven ICPC of breast. The patients were five black and three white women, 56-87 years of age. The FNA specimen was cyst fluid in four cases (bloody in three, clear in one). All the aspirates showed cellular smears with small and large clusters of cells with papillary and/or cribriform configurations and numerous single epithelial cells. The cells were cuboidal to columnar with minimal atypia. ICPC was suggested by FNA in each case, and all the patients underwent surgical excision or mastectomy. Flow cytometry, performed on fresh FNA specimen in one case and on paraffin-embedded surgical tissue in all eight cases, showed seven tumors to be aneuploid and one to be diploid. The authors contend that ICPCs of breast have distinct cytomorphologic features that can be recognized by FNA. Because ICPC may present in cyst fluid, either bloody or clear, all breast cyst fluids from postmenopausal women should be examined cytologically. Flow cytometric demonstration of an aneuploid population may assist in confirming malignancy in this lesion.

Aged↗
PubMed1990

Sonographic appearance and ultrasound-guided fine-needle aspiration biopsy of breast carcinomas smaller than 1 cm3.

The purpose of this study was to review the sonographic appearance and the results of ultrasound-guided fine-needle aspiration biopsies of a series of 49 breast carcinomas smaller than 1 cm3. No tumor was found to be hyperechoic. Contours were irregular in 69% of cases. In 53%, an echogenic rim was present, and the echotexture was nonhomogeneous in 41%. Sound beam attenuation was present in 39%. The ratio of longitudinal diameter to anteroposterior diameter ranged from 0.67 to 2.25 (mean, 1.08 +/- 0.28). Fine-needle aspiration biopsy under continuous real-time sonographic guidance was performed on 36 patients and yielded 30 positive and four suspicious results (sensitivity, 94%), one inadequate specimen, and one false-negative result. With high-resolution hand-held transducers, breast sonography can depict small carcinomas and provides accurate, cost-effective guidance for fine-needle aspiration biopsy.

Adult↗
PubMed1989

Ductal carcinoma-in-situ of the breast: fine-needle aspiration cytology of 12 cases.

Aspiration specimens from 12 patients with histologically documented ductal carcinoma-in-situ (DCIS) of the breast (seven patients) or DCIS with minute foci of stromal invasion (five) were evaluated. Five patients presented with palpable masses, 1.5-4.0 cm, and four patients presented with localized thickening, associated with nipple erosion and discharge in two of them. One patient had nipple inversion, and one patient had bilateral nipple discharge. In one patient, no apparent abnormality of the breast was present. Mammography was either suspicious for or strongly suggestive of carcinoma in 10 patients and negative in two. Aspirates from all patients were composed of fragments of atypical ductal epithelium and numerous single epithelial cells. In nine cases, the smears were hypercellular and similar to aspirates of typical invasive ductal carcinoma. Calcifications were present in six cases. In four of these, associated tumor necrosis was evident. Cytologic features separating DCIS patients from those showing minimal stromal invasion or common types of invasive ductal carcinoma (IDC) were not identified. We conclude that fine-needle aspiration cytology of DCIS is identical to that of IDC. If preoperative radiotherapy or chemotherapy is considered in the management of invasive breast carcinoma, cutting-needle biopsy for confirmation of tumor invasion is necessary.

Adult↗
PubMed1989

Fine-needle aspiration cytology of metastatic neoplasms in the breast.

Twenty cases of metastatic neoplasms in the breast were identified in a series of 1,034 fine-needle aspirations (FNAs) of the breast, of which 389 were malignant. Patients with breast carcinomas in whom metastasis to the contralateral breast developed were excluded from this study. This series consisted of 17 women and 3 men, ranging in age from 28 to 63 years (mean, 49 years). The tumors included oat cell carcinoma (three), melanoma (three), ovarian serous carcinoma (one), bronchogenic adenocarcinoma and squamous carcinoma (four and two, respectively), lymphoma (two), carcinoid (two), transitional cell carcinoma (one), plasma cell myeloma (one), and rhabdomyosarcoma (one). In two patients, the breast mass was the first manifestation of an extramammary cancer (two adenocarcinoma of the lung). Eleven patients died of disseminated cancer shortly after the breast metastasis was diagnosed. In most cases, the aspirates displayed the cytologic features characteristic of the primary tumors, thereby establishing the metastatic nature of the neoplasm. In four cases (two carcinoids, one myeloma, and one rhabdomyosarcoma), the cytologic features were difficult to differentiate from a primary breast carcinoma; however, the final diagnosis was established by electron microscopic examination and immunocytochemical studies on the aspirates. One case (adenocarcinoma of the lung) was misdiagnosed as primary breast carcinoma on both FNA and mastectomy specimen. Because metastatic neoplasms in the breast may mimic primary breast tumors, the authors recommend the following: (1) Evaluation of FNA of breast should be done with complete knowledge of the patient's clinical history. (2) The possibility of metastasis should be suspected in lesions with unusual cytologic patterns. (3) Ancillary studies on FNA can be helpful in interpreting selected cases.

Adult↗
PubMed1989

Sinus histiocytosis with massive lymphadenopathy.

Sinus histiocytosis with massive lymphadenopathy is a lymphoreticular disorder of obscure pathogenesis with extranodal lesions and a variable clinical course. Clinical manifestations are most often in the head and neck, with 97% of patients showing cervical lymphadenopathy and a significant but lesser number having lesional infiltrates in the upper aerodigestive tracts, particularly the nasal cavity and salivary glands.

Humans↗
PubMed1989

Parapharyngeal and retropharyngeal space diseases.

The involvement by a disease process of the parapharyngeal and retropharyngeal spaces poses significant diagnostic and therapeutic problems. Neoplasms, the majority histologically benign, comprise the greatest number of parapharyngeal space lesions. Inflammatory lesions and metastases to lymph nodes are the preponderant disorders affecting the retropharyngeal space.

Child↗
PubMed1989

Ewing's sarcoma of bone and soft tissues.

Ewing's sarcoma is a distinctive clinical and pathologic entity that may be intraosseous or of soft-tissue origin. In the facial bones, the incidence of the sarcoma is estimated at 2.5% of all Ewing's sarcoma of bone. The soft tissue of the head and neck account for 11% of extraskeletal sites of the neoplasm. Combined modality treatment has modified its high-grade malignancy.

Bone and Bones↗
PubMed1989

The prognostic significance of peritoneal cytology for stage I endometrial cancer.

A retrospective study of 567 patients treated for surgical stage I endometrial cancer was undertaken to resolve the controversy over the significance of malignant peritoneal cytology findings in early-stage disease. Twenty-eight women (4.9%) had peritoneal cytology positive for malignant cells. Comparisons were made between the groups with positive and negative cytology. Subgroups used in analysis included stage according to the International Federation of Gynecology and Obstetrics, treatment regimen, histology, grade, depth of myometrial invasion, and cervical Papanicolaou smear results. Cervical smear status was the only subgroup in which a statistically significant difference was found, with the positive peritoneal cytology patients having a higher incidence of positive Papanicolaou smears (P = .01). Forty-nine women (8.6%) developed recurrent tumor, 7% of the negative-cytology group and 32% of the positive-cytology group (P = .0002). The progression-free survival rate was lowered significantly by positive peritoneal cytology (P less than .0001); patients with negative peritoneal cytology had a significantly better 5-year survival rate, 96 versus 84% (P = .0001). When multivariate analysis was performed on the 477 cases that had no missing values, peritoneal cytology remained significant for both survival rate (P = .01) and progression-free interval (P = .002). Positive peritoneal cytology is a poor prognostic factor for patients with surgical stage I endometrial cancer.

Adenocarcinoma↗
PubMed1988

Fine-needle aspiration cytology of pediatric patients with primary hepatic tumors: a comparative study of two hepatoblastomas and a liver-cell carcinoma.

The cytologic features of fine-needle aspirates (FNA) of two hepatoblastomas (HBs) and a liver-cell carcinoma (LCC) occurring in three children, ages 1, 3, and 14 yr, are presented. Electron microscopic features of one of the HBs and the LCC are also included. The HBs displayed single or small aggregates or larger clusters of cells with a high nuclear-cytoplasmic ratio and usually round, hyperchromatic nuclei with single, and occasionally double, prominent nucleoli. In addition, one patient had extramedullary hematopoiesis; both had osteoid-like material. These findings were very helpful in differentiating the HB cases from the LCC case, which had features similar to those of adult hepatocytes, including the presence of abundant, finely granular cytoplasm. Ultrastructural studies showed an absence of differentiation into adult hepatocytes in the HB, with scant organelles, rare bile canaliculi, lakes of glycogen, and rare lysosomal bodies. In contrast, the LCC showed features similar to adult hepatocytes, such as abundant cytoplasmic organelles, lysosomes, and bile canaliculi. In addition, intranuclear pseudoinclusions caused by cytoplasmic invagination were present in the LCC but not in the HB. Fine-needle aspiration of hepatic masses in children is a useful technique for rendering a diagnosis, especially in unresectable tumors. Ultrastructural studies on FNA material may be important in differentiating hepatoblastoma from hepatocellular carcinoma.

Adolescent↗
PubMed1988

Pseudoparasitic (Liesegang) bodies in paranasal sinus.

The end product of the Liesegang precipitation phenomenon can produce microscopic bodies that can be and have been mistaken for parasites in human tissues. The Liesegang bodies have been recently described and defined in and about hemorrhagic and cystic lesions of the kidney. The present authors report the first instance of these bodies in the paranasal sinuses.

Chemical Precipitation↗
PubMed1988

Pseudoparasitic Liesegang structures in perirenal hemorrhagic cysts.

Periodic structures with equally spaced radial striations identified as Liesegang-like rings were seen in two male patients' hemorrhagic perirenal cysts. The patients, one 48 and the other 60 years old, had acute right-flank pain and anemia; both had nephrectomy. The rings, initially believed to represent parasites (Dioctophyma renale), were from 8 to 500 micron in diameter and had uniform, pink-tan, radially striated double walls. Multiple small rings within a larger ring predominated in one case. Morphologically, the rings differed from D. renale when compared with specimens from animals infected naturally or experimentally with the giant kidney worm. Histochemical and immunoperoxidase tests for iron, calcium, mucopolysaccharides, amyloid, keratin, and hemoglobin had negative results. Energy-dispersive x-ray elemental analysis demonstrated no detectable elements; ultrastructurally, however, the rings displayed a fine fibrillary composition with a concentric and radial pattern. These rings are believed to be an end product of a phenomenon resembling or are, in fact, the Liesegang phenomenon. Because these Liesegang-like structures may be mistaken for parasites on fine-needle aspiration or surgical specimens of hemorrhagic areas, pathologists should be aware of them.

Cysts↗
PubMed1988

The significance of müllerian inclusions found at second-look laparotomy in patients with epithelial ovarian neoplasms.

When no visible tumor is identified at second-look laparotomy, selected biopsy specimens or cytologic washings may reveal microscopic tumor or benign pathologic atypia. The pathology material from 311 patients with epithelial ovarian carcinoma who had no macroscopic tumor at second-look laparotomy was evaluated for psammoma bodies, müllerian inclusions (benign glandular inclusions), microscopic tumor, and either inflammation or fibrosis. Progression-free intervals and survival rates were influenced by the presence of müllerian inclusions (favorably), tumor or positive cytology (unfavorably), and inflammation or fibrosis (unfavorably). Multivariate analysis (proportional hazards model) demonstrated that both the progression-free interval and survival rates were influenced significantly by the presence of microscopic tumor and tumor grade. Of 51 patients with müllerian inclusions and no microscopic tumor, 23 received additional treatment after second-look laparotomy. No differences were noted in the progression-free interval or survival rates when these patients were compared with the 28 nontreated patients. Of the treated patients, three died from chemotherapy toxicity, whereas there were no chemotherapy-related deaths in the nontreated group. These findings indicate that the presence of müllerian inclusions at second-look laparotomy does not justify treatment, and that further treatment after misinterpretation of these benign pathologic entities may lead to harmful results.

Antineoplastic Agents↗
PubMed1987

Fine-needle aspiration cytology in pancreatic endocrine tumors.

Pancreatic endocrine tumors (PETs) are relatively uncommon neoplasms. Although their histologic patterns have been widely studied, their cytologic features as they appear in fine-needle aspiration (FNA) specimens have rarely been reported. In this study, aspirates of seven PETs, four primary and three metastatic lesions (two to liver and one to bone), are described. The tumors occurred in seven men ranging in age from 37 to 72 yr. Six tumors presented as nonfunctioning masses and one produced Zollinger-Ellison syndrome. Three were located in the head of the pancreas and four in the body and tail. The pancreatic and liver aspirations were performed under computed tomographic guidance and the bone lesion, under fluoroscopy. The aspiration specimens were hypercellular. The tumor cells occurred singly and in small clusters. In three cases, there was a tendency toward acinar formations. In two cases, there were prominent, thin-walled, branching blood vessels with tumor cells attached to the vascular walls. The cells were round or polygonal with a moderate amount of finely granular, well-defined cytoplasm. The nuclei were eccentrically located and round-to-oval--with one or two small nucleoli and finely granular, evenly-dispersed chromatin. The diagnosis was confirmed by immunocytochemistry (two cases) and electron microscopy (four cases) of the aspirated material and histology sections of the resected tumors (two cases). The results of this study demonstrate that FNA is a useful method to establish the diagnosis of PETs.

Adenoma, Islet Cell↗
PubMed1987

Carcinoid metastatic to breast diagnosed by fine-needle aspiration biopsy.

We report a patient in whom fine-needle aspiration biopsy of a breast mass, clinically suspected to be a mammary adenocarcinoma, established the diagnosis of a carcinoid metastatic to breast. The aspirate smears resembled a primary breast carcinoma; however, subtle cytomorphologic differences were present. Ultrastructural and immunohistochemical studies of the aspirate material confirmed the diagnosis of metastatic carcinoid.

Biopsy, Needle↗
PubMed1987

Cervical carcinoma DNA content, S-fraction, and malignancy grading. I. Interrelationships.

The flow cytometric measured DNA content (i.e., DNA index), S-fractions, and histopathologic malignancy grades were studied for ninety uterine cervical squamous cell carcinomas using tissue biopsies taken prior to radiotherapy. The DNA aneuploidy frequency for low S-phase tumors (%S less than 14) was only 9/29 (31%) compared to 22/30 (73%) for intermediate (%S 15-23) and 30/31 (97%) for high (%S greater than 24) tumors. An overall mean %S of 20 +/- 7 (range 2-45%) was observed for these cervical cancers, with the S-fraction significantly increasing (P = less than 0.01) from 12 +/- 5, to 18 +/- 8, and 26 +/- 7 for diploid/near diploid, low-degree DNA aneuploidy, and high-degree DNA aneuploidy tumors, respectively. Broad heterogeneity was observed for the microscopic scored malignancy grades within DNA index and the cell-cycle S-fraction subgroups. Generally, multifactorial histopathology scoring was not significantly correlated with either the tumor DNA index or %S variables. Based on statistical analysis, the malignancy grades more closely reflected the tumor proliferative activity than the DNA index, with nuclear polymorphism, mitotic frequency, and the invasion pattern showing the lowest P values (which were not significant at P = 0.05). High tumor S-fraction was associated with high malignancy grade, as evidenced by 19/25 (75%) of high S-fraction, high degree DNA aneuploidy tumors having greater than average malignancy grade compared to only 2/14 (14%) low to moderate S-fraction tumors having similar DNA index. The results indicate that more reliable identification of biologically different cervical cancers can be achieved by evaluating the tumor DNA index in relationship to the cell-cycle %S and malignancy grading.

Biopsy↗
PubMed1987

Cervical carcinoma DNA content, S-fraction, and malignancy grading. II. Comparison with clinical staging.

In an attempt to achieve more biologically meaningful subclassification of squamous cell cervical cancers and ultimately more reliable prediction of tumor behavior, we have studied the tumor pretreatment DNA content (i.e., DNA index), cell-cycle S-fraction, and histomorphologic malignancy grading properties for tumors having similar and different clinical staging. The tumor DNA index, %S-phase cells, and average malignancy grades were statistically tested against known clinical predictive variables for 90 primary squamous cell carcinomas of the uterine cervix studied prior to radiotherapy. We observed that the biological and morphological tumor properties of cervical cancers broadly overlapped between different stages of disease and for other clinical criteria including the gross morphology, lymph node status, and intravenous positivity. No significant differences were detected in the DNA indices, %S, or malignancy grades between the stages of disease or the other clinical criteria. It was concluded that: the gross clinical staging criteria inadequately reflected the tumor biological properties; and that the possibility exists for refining prognosis by use of the biological and morphological noncodependent tumor parameters to supplement staging criteria; and the use of cell-cycle cytokinetic and malignancy grading criteria in addition to tumor DNA index is superior to DNA index (or DNA content) alone for identifying biologically different cervical cancers.

Carcinoma, Squamous Cell↗