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S Naryshkin

Publications and source records attributed to S Naryshkin.

33 records · Page 2Linked to original sources
PubMed1991

Clear-cell change in follicular adenoma mimicking Hürthle-cell tumor on thyroid aspiration biopsy cytology.

We present a case of follicular adenoma with clear-cell change, which on fine-needle aspiration biopsy mimicked a Hürthle-cell tumor. Papanicolaou-stained smears revealed a monomorphic pattern of loosely cohesive groups of cells with abundant cytoplasm and centrally placed round nuclei with single prominent nucleoli. The cytoplasm was granular or finely vacuolated with occasional intracytoplasmic brown pigment. Subsequent surgical histology of the partial thyroidectomy specimen revealed a follicular adenoma composed of macro- and microfollicles. The microfollicular areas showed clear-cell change: these cells appeared identical to those seen on cytology. No Hürthle-cell change was present in the surgical specimen. Follicular cells with clear-cell change of the granular type must be added to the list of differential diagnoses when cells with Hürthle-like features are seen on aspiration biopsy of the thyroid.

Adenoma↗
PubMed1991

Acute renal failure secondary to carcinomatous lymphatic metastases to kidneys.

We report a rare case of acute renal failure secondary to bilateral renal parenchymal metastases from carcinoma. Despite clinical investigation the cause of the renal failure remained undiagnosed and was discovered only upon microscopy at autopsy, which revealed metastatic gastric adenocarcinoma. The pattern of tumor infiltration was predominantly lymphatic involvement limited to the vascular bundles at the corticomedullary junction, and the lymphatics adjacent to the calices and pelves. The significance of lymphatic obstruction in the pathogenesis of renal failure is discussed. Renal parenchymal metastases should be considered in the differential diagnosis of acute renal failure in patients with carcinoma.

Acute Kidney Injury↗
PubMed1991

Intraoperative pancreatic fine needle aspiration biopsy. Results in 166 patients.

Intraoperative fine needle aspiration biopsy (NAB) of undiagnosed pancreatic masses was studied in 166 patients over a 17-year period. The cytologic diagnoses were correlated with histologic specimens, autopsy results, or clinical follow-up (benign disease was documented if the patient was alive without malignancy at least 2 years after laparotomy). Aspirates were interpreted as benign, suspicious, malignant, or unsatisfactory. Malignant disease was the final diagnosis in 109 patients; the cytology was concordant in 101 and was interpreted as suspicious in four. Four patients with benign cytology later proved to have malignant disease--a false-negative rate of 2.5 per cent. A total of 57 patients had benign disease; 51 of these had benign cytology. The remaining patients had "unsatisfactory" cytology reports. A 93 per cent sensitivity, 100 per cent specificity, and 0 per cent complication rate are reported. There were no false-positive cytology reports. Complications are rare and represent case reports, thus, additional sampling is at minimal risk. Intraoperative pancreatic NAB is a safe, easy, more accurate biopsy technique than historical wedge or core needle biopsies. It is the biopsy method of choice for pancreatic masses found at laparotomy.

Adult↗
PubMed1991

Differential diagnosis of cystic neoplasms of the pancreas by fine-needle aspiration.

Fine-needle aspiration biopsy of pancreatic lesions is becoming widespread. Pathologists need to be familiar with the cytologic features of pancreatic tumors, of which cystic neoplasms are a distinct subset. Of our 31 pancreatic aspirates diagnostic of neoplasia, six were diagnosed as cystic by radiographic imaging. These cases were compared. Similar symptoms were experienced by all of these patients, although those with malignant tumors lost the most weight. Loss of border definition, ascites, and liver metastases were the only radiologic clues to malignancy. Each entity had distinguishing cytologic features. These cases illustrate the importance of knowing the clinical, radiologic, and cytologic features of pancreatic cystic neoplasms to arrive at a preoperative diagnosis and determine proper treatment.

Adult↗
PubMed1987

Milk of calcium bile. Evidence that gallbladder stasis is a key factor.

Milk of calcium bile is a rare disorder in which the gallbladder lumen is filled with a semisolid radiopaque material composed primarily of calcium carbonate. The etiology is unknown, although gallbladder stasis is believed to be a prerequisite. We report a case of milk of calcium bile in which preexisting gallbladder stasis was retrospectively evaluated by reviewing plain abdominal films and by using iodide as a marker for retained contrast. This latter approach was validated by demonstrating that obstructed gallbladders do not physiologically sequester iodide and that following oral cholecystography functioning gallbladders do not retain significant iodide for prolonged periods. In the case described, we propose that gallbladder stasis was present as long as 2 1/2 years prior to the diagnosis of milk of calcium bile.

Adult↗
PubMed1987

Prototheca zopfii isolated from a patient with olecranon bursitis.

Prototheca zopfii was isolated from a patient with olecranon bursitis. Olecranon bursitis caused by Prototheca is a distinct clinical entity. Recognition of this infection was made by observing characteristic organisms in tissue and subsequent isolation of the organism.

Aged↗
PubMed1985

Comparison of the performance of serum and urine hCG immunoassays in the evaluation of gynecologic patients.

We conducted a study to compare the performance of serum and urine pregnancy tests in the evaluation of gynecologic patients presenting to our ED. The overall efficiency of the two tests was very similar: 99.5% for the serum test, and 97.6% for the urine test. In patients proven to have ectopic pregnancies, however, the serum test was positive in 100%; the urine test was positive in only 60%. The serum test misclassified (gave false-negative or false-positive results) in three of 607 patients (0.5%). The urine test misclassified 14 of 607 patients (2.3%). Moreover there were 18 inconclusive or invalid urine test results. Thus the urine test provided misinformation or no information in 32 of 607, or 5.3%, of the total study population.

Chorionic Gonadotropin↗
PubMedDate not supplied

Calcium homeostasis during therapeutic plasma exchange.

Because the removal of substantial quantities of plasma calcium during plasma exchange is rarely attended by clinically significant hypocalcemia, we evaluated calcium homeostasis during this procedure. Twenty-one procedures were performed on 10 patients with various neurological disorders. The reduction by plasma exchange in the serum concentrations of total calcium, ionized calcium, magnesium, and phosphate was significantly less than predicted (p less than 0.001) based on plasma volume of the patient and size of the exchange. However, N-terminal parathomone (PTH) levels increased to 242 +/- 120 percent midway into the procedure and were 207 +/- 84 percent after plasma exchange; urinary cyclic adenosine monophosphate (cAMP) levels rose by 165 +/- 35 percent. These data demonstrate a rapid compensatory response in N-terminal PTH and urinary cAMP to the reduction by plasma exchange of serum concentrations of total calcium, ionized calcium, and phosphate. The routine administration of supplemental calcium during plasma exchange may therefore be unnecessary in patients with normal parathyroid function.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Obligations to provide appropriate patient management.

The Pap test is a successful method of preventing cervical cancer, but it does have significant false negative and false positive rates. The main aim of screening is the detection of precursor lesions, both regression and progression of which may occur, making it difficult to decide upon follow-up and further therapy. Around the world there are many differences, as a far as the frequency of the disease, the organization and economic background of the health care system, the use of different additional diagnostic tools and even the terminology considered. All these factors underline the importance of a consensus on a "minimum level" of obligations to provide appropriate patient management. The screening interval should be two to five years, in some cases even annually. The cytopathologist has an obligation to recommend repeat smears in cases of cytologic abnormalities likely to regress. We recommend the use of standard terminology and stress the importance of a "common language" in cervical cytology. Colposcopy and biopsy are obligatory in cases of HSIL and cancer. We suggest that in severe cases women should be provided with detailed written and verbal information.

Adult↗
PubMedDate not supplied

Quality assurance and risk reduction guidelines.

Cervical cancer continues to be a major cause of death in women worldwide. The major problem facing most women is the unavailability of screening Pap tests in poor and underdeveloped countries. While rates of cancer deaths have decreased 60-80% in developed countries since the Pap test became available, the accuracy of Paps was challenged recently. In order to instill public confidence and promote optimal patient care, measures to improve the quality of the entire screening process should be undertaken. Continuous quality improvement processes are more appropriate than traditional quality assurance monitors. Although no standards can be defined that are applicable to all laboratory settings and nations, this document provides current views on universal quality procedures and risk reduction. Procedure/policy manuals, workload assessment, hierarchic/peer review, discrepancy analysis, rescreening studies and cytohistologic correlation are examples of universally applicable quality tools. The variability in practices in different parts of the world is also discussed.

Female↗