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S R Kini

Publications and source records attributed to S R Kini.

33 records · Page 2Linked to original sources
PubMed1984

Orbital metastasis from prostatic carcinoma. Identification by immunocytology.

We report a case in which the diagnosis of prostatic carcinoma, metastatic to the orbit, was confirmed using an immunoperoxidase technique on cytologic specimens obtained by fine-needle aspiration. Computed tomography was valuable in localizing the tumor for biopsy and subsequent radiation therapy. The results of these studies correlated with the clinical history and other evidence of widespread metastatic disease. Ironically, the first evidence of malignancy in this patient was possibly also ophthalmologic, manifesting 14 months earlier with hemorrhagic retinopathy associated with thrombocytopenia. To our knowledge, this is the first report describing the combination of an immunoperoxidase technique with the fine-needle aspiration biopsy of an orbital tumor.

Adenocarcinoma↗
PubMed1984

Cytopathologic features of medullary carcinoma of the thyroid.

Medullary carcinoma of the thyroid (MCT) presents a varied but characteristic cytologic pattern in cellular samples obtained by fine-needle aspiration (FNA) biopsy. In our experience with 17 cases of MCT, ten were identified by cytologic examination. One was acellular. The remaining six were typed as undifferentiated carcinoma (three cases), follicular variant of papillary carcinoma (one case), and cellular adenoma (two cases). Four Hürthle cell tumors and four papillary carcinomas were incorrectly typed as MCT. There was one false positive. Careful consideration of the listed cytologic features should make the FNA biopsy diagnosis of MCT of satisfactory sensitivity for the evaluation of "cold" thyroid nodules. Specificity may be considerably improved by using immunoperoxidase stain for calcitonin granules and/or by large-needle biopsy.

Adenocarcinoma↗
PubMed1983

Lymphoma of the thyroid.

In 24 of 30 patients with lymphoma of the thyroid, the diagnosis was made preoperatively or without surgery; undifferentiated or poorly differentiated carcinoma was suspected in 3 other patients. Thirteen patients were under 60 years of age; 7 were under 40. An increase in the ratio of men to women was seen among younger patients. At presentation, a discrete nodule was found in 19 patients, and multinodular or diffuse goiters in 11. Seventy-six percent of patients with solitary nodules had enlargement of extranodular tissue. Imaging showed "cold" nodules, cold areas in diffuse goiters, or patchy uptake. Nine patients had obstructive complaints; 12 patients had subnormal thyroid function; 24 patients had coexistent Hashimoto's thyroiditis. Lymphoma of the thyroid was suggested by fine-needle biopsy results in 17 of 28 patients (undifferentiated carcinoma was suspected in 2); and by large-needle biopsy results in 21 of 23 (undifferentiated or poorly differentiated carcinoma was suspected in 2). Biopsy of diffuse Hashimoto's goiters is indicated for cold imaging defects, enlarging tender goiter, or goiter enlarging on thyroid hormone. Early diagnosis may improve prognosis for lymphoma of the thyroid, so that surgery or chemotherapy can be avoided.

Adult↗
PubMed1981

The needle biopsy diagnosis of papillary thyroid carcinoma.

One hundred five cases of papillary thyroid carcinoma (PTC) were studied by needle biopsy and surgically confirmed in a 30-month period. Eight years were required to diagnose the same number of cases without the use of needle biopsies. Identification of clinically unsuspected cancer and confirmation of clinical "possible" cancer diagnoses accounted for 30% of this change. Seventy percent was accounted for by the increase in nodules referred for evaluation. The accuracy of fine-needle biopsy (FNB) improved with experience. Positive diagnoses of PTC were made in 19 of the first 35 PTCs and in 33 of the last 35. False-negative and unsatisfactory FNBs decreased from seven in the first third of the study to zero in the last third. Large-needle biopsy (LNB), initially used to check FNB, became less necessary as experience increased. Both FNB and LNB were more specific when papillary areas were included in the biopsy procedure, and approached the specificity of surgical biopsy. The increase in identifying PTC may require modification of the therapeutic implications of this diagnosis.

Adolescent↗
PubMedDate not supplied

Cytopathology of follicular lesions of the thyroid gland.

Fine needle biopsy is generally considered unreliable in the differential diagnosis of follicular lesions of the thyroid gland. To test this hypothesis, we correlated fine needle biopsy diagnoses with surgical diagnoses in 379 follicular lesions. From nuclear characteristics (especially size) and the architectural pattern of tissue fragments, the following observations were made. Differentiation of goiters (including hyperplastic ones) from neoplastic thyroid disease is quite accurate and no more than 1 to 2% of cancers should be missed. The specific cytologic diagnosis of follicular carcinoma is 75% accurate, and that of follicular variant of papillary carcinoma is over 95% accurate. Of histologically proved follicular carcinomas, almost three-quarters should be diagnosed as such or strongly suspected by fine needle biopsy. The remainder will be identified as cellular follicular adenomas, reaffirming the overlap of cytologic features of benign and malignant neoplastic disease. From cytologic and surgical pathologic data for each fine needle biopsy diagnosis of follicular lesion, a probability of cancer can be stated that is useful in management decisions.

Adenocarcinoma↗
PubMedDate not supplied

Cells of squamous cell carcinoma in pleural, peritoneal and pericardial fluids. Origin and morphology.

The records of two cytopathology laboratories, covering an aggregate of 33 years, were searched for pleural, peritoneal and pericardial fluids reported as containing cells of squamous cell carcinoma (SCC). This search embraced 9,297 serous fluids from 7,389 patients. Cells of SCCs were found in the fluids from only 46 patients, illustrating the infrequency of such a finding, with most of the SCC cells originating in primary neoplasms of the lung (16), female genital tract (8) or larynx (6). All of the recognized types of SCC cells were found in these fluids. Even so, SCC cells may be mistaken for cells of other neoplasms, such as adenocarcinoma and malignant mesothelioma. SCC cells in serous fluids should be identifiable if careful attention is paid to the morphologic features characteristic of SCC.

Body Fluids↗
PubMedDate not supplied

Cytopathology of Hürthle cell lesions of the thyroid gland by fine needle aspiration.

The increasing use of fine needle aspiration biopsy of the thyroid has refocused attention on Hürthle cell lesions. From 2,317 cytologic studies on "cold" nodules, 70 diagnoses of Hürthle cell tumor were made. Of 49 thought to be cytologically benign, 37 were confirmed histologically; 3 others were carcinoma, 5 were autoimmune thyroiditis, and 4 were nodular goiter. Of eight considered to be cytologically malignant, histology confirmed six carcinomas and two benign tumors. Identification of nonneoplastic Hürthle cell lesions required experience. Differentiation of benign and malignant Hürthle cell tumors with a high degree of accuracy is probably not possible cytologically with the present state of our knowledge.

Biopsy, Needle↗
PubMedDate not supplied

Cytopathology of papillary carcinoma of the thyroid by fine needle aspiration.

To delineate the cytologic presentation of papillary carcinoma of the thyroid, the fine needle aspiration smears were studied from 87 surgically proven cases. Six diagnostically useful findings were identified: papillary fronds, monolayered sheets, tissue fragments, intranuclear cytoplasmic inclusions, psammoma bodies and multinucleated giant cells. From 1,500 smears on "cold" nodules of the thyroid, 6 known false-negative and 4 false-positive diagnoses for papillary carcinoma were made. The estimated accuracy of the fine needle aspirate diagnosis of papillary carcinoma is 94%.

Biopsy, Needle↗
PubMedDate not supplied

Problems in the cytologic diagnosis of the "cold' thyroid nodule in patients with lymphocytic thyroiditis.

The cytologic diagnosis of the coexistence of lymphocytic thyroiditis (LT) and thyroid neoplasms presented certain problems. Fine needle aspirations of 117 "cold' nodules were reviewed because they were or should have been diagnosed as LT. Of five cases of LT plus lymphoma, two were correctly diagnosed and three were diagnosed as LT only. All seven cases of LT plus papillary carcinoma were correctly identified, as were four of those in patients operated upon for LT plus a cellular neoplasm. From a total of 1,600 biopsies, 7 "probable' and 5 "possible' cancers were LT at operation. The causes of diagnostic error were identified as: (1) similarity of epithelial cell nuclear atypia in LT and cellular neoplasm, (2) inexperience and (3) inadequate sampling. The presence of diffuse thyroid abnormality, of significant titers of antithyroglobulin and antimicrosomal antibodies and of chemical evidence of thyroid insufficiency should alert the examiner to the possibility of LT. Large needle biopsy may clarify difficult cases.

Adenoma↗
PubMedDate not supplied

Fine needle aspiration and endoscopic brush cytology: comparison of direct smears and rinsings.

When cellular samples obtained by endoscopic brushings and by fine needle aspirations were prepared by the direct smear thechnique, 22% were unsatisfactory due to scantiness of the cellular sample, air drying of the cells or bloodiness of the specimens. To improve diagnostic accuracy, an additional specimen was prepared by rinsing the brush or needle in a balanced salt solution, from which cells were recovered by membrane filtration. The combination of direct smears and rinsings decreased our unsatisfactory rate to 2% and increased our diagnosis rate for malignant neoplasms by 24%.

Biopsy, Needle↗