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At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

Fine needle aspiration of the thyroid. Distinction between colloid nodules and follicular neoplasms using cell blocks and 21-gauge needles.

Although fine needle aspiration (FNA) of the thyroid has been found to be useful in selecting patients for surgery in most cases, the cytologic differentiation of cellular colloid nodules from follicular neoplasms has not been possible because of the scanty amount of tissue obtained by this technique and because of the infrequent preparation of cell blocks, thus precluding appreciation of the tissue architecture. Review of the histology of nodular goiters and follicular neoplasms and comparison of their morphology in smears and cell blocks from FNA specimens with the histology of the surgically excised specimens in 74 cases revealed the presence of hyperplastic papillae and fragments of dilated follicles in the aspirates of most cases of colloid nodules. These two features appear to be specific for colloid nodules and are useful for distinguishing colloid nodules from follicular neoplasms. The merits of using a 21-gauge needle and of preparing cell blocks in thyroid studies are also discussed.

Adenocarcinoma↗
PubMedDate not supplied

[Percutaneous pulmonary needle biopsy using thin-needle aspiration. Experience with 302 patients].

Percutaneous aspiration biopsy of the lung was performed in 302 patients, following the method of examination and the criteria of patient selection already reported in the literature. A fine (22-gauge) needle was always employed, each patient receiving an average of two needle placements. Sensitivity was 88.4%; the false negatives being mainly related to the aspiration of inadequate material. Specificity was 96.9% and overall accuracy 89.4%. A histological diagnosis was obtained in 84% of the primary neoplasms. Adverse reactions were observed in 9.6% of the patients; the most frequent complication was pneumothorax which required treatment in two cases. The usefulness of the method in the diagnosis of pulmonary nodules is emphasized.

Adolescent↗
PubMed1994

Prospective study of the incidence of ultrasound-detected hepatic hematomas due to percutaneous Menghini needle liver biopsy and laparoscopy-guided Silverman needle biopsy.

Recently, a high incidence of sonographically detected hepatic hematomas following percutaneous liver biopsy and laparoscopy-guided liver biopsy has been reported. For this reason a prospective study in 178 patients was performed. The patients were examined by ultrasound before and 24 hours after percutaneous liver biopsy using the 1.4 mm-Menghini needle (n = 107) and by laparoscopically-guided biopsy with the 2.5 mm-Silverman needle (n = 71). Four of the 107 patients (4%) who underwent percutaneous Menghini biopsy displayed hepatic hematoma on ultrasonography, and in 2 of these cases the hematoma was > 6 cm in diameter and persisted for more than seven months. In the group of patients who underwent laparoscopy-guided Silverman biopsy (n = 71) a liver hematoma occurred twice (3%). Both hematomas were small and disappeared within several days. There was no need for special therapeutic interventions due to complications. In contrast to recent data about Tru-cut and JAM-Shidi biopsy, the results of this study indicate that percutaneous Menghini biopsy and laparoscopy-guided Silverman biopsy are relatively safe diagnostic procedures.

Adult↗
PubMed1998

The cost-effectiveness of fine-needle aspiration cytology and 14-gauge core needle biopsy compared with open surgical biopsy in the diagnosis of breast carcinoma.

BACKGROUND: Judicious utilization of fine-needle aspiration cytology (FNAC) and 14-gauge core needle biopsy (CB) theoretically should result in greater accuracy in breast carcinoma diagnosis and fewer unnecessary open surgical biopsies (OSBs), thus lowering health care costs. METHODS: In 1995 in Rochester, New York, the ratio of open surgical breast biopsies per each verified breast carcinoma (OSB/Ca) in a freestanding breast clinic (EWBC) was compared with the OSB/Ca ratio of all physicians in the remainder of the city. The EWBC differs from all other diagnostic facilities in Rochester in that it routinely performs FNAC and CB. RESULTS: The EWBC recommended 462 OSBs resulting in 310 verified carcinomas, for a OSB/Ca ratio of 1.5. The physicians in the remainder of the city recommended 2036 OSBs resulting in 513 verified carcinomas, for a OSB/Ca ratio of 4.0. If the EWBC OSB/Ca ratio had been identical to the remainder of the city, the number of extra OSBs recommended by the clinic would have been 778, resulting in an additional cost of $1,712,082. When the added cost of the 2594 FNACs ($256,285) and 403 CBs ($252,278) performed by the clinic was subtracted from the $1,712,082, the freestanding breast clinic cost savings was $1,203,519. The lymph node metastasis rate of 19% for the breast carcinomas diagnosed in clinic patients was identical to that of the women with breast carcinoma in the remainder of the city. CONCLUSIONS: Utilization of FNAC and CB allows radiologists to lower their OSB/Ca ratio without sacrificing early detection. In this study, these less expensive procedures result in lowered medical costs for the health care system.

Biopsy, Needle↗
PubMed1998

Percutaneous core cutting needle biopsy compared with fine-needle aspiration in the diagnosis of peripheral lung malignant lesions: results in 156 patients.

BACKGROUND: The authors attempted to determine the utility of percutaneous core needle biopsy (PCNB) compared with fine-needle aspiration (FNA) in the diagnosis of peripheral lung carcinoma. METHODS: A retrospective review was undertaken of 156 computed tomography (CT)-guided PCNBs and FNAs of malignant lung lesions between 1988-1996. Both CT-guided FNA and PCNB biopsies were performed sequentially at the same visit for each subject. RESULTS: The authors reviewed 156 malignant lesions whose specific diagnosis was obtained by FNA in 133 cases (85.3%) and by PCNB in 121 cases (77.6%) (P < 0.05). PCNB confirmed the FNA diagnosis in 90 patients (57.7%), provided additional information in 17 patients (10.9%), and was less informative than FNA in 35 patients (22.4%), mostly those with nonsmall cell carcinoma. The PCNB was marginally superior to FNA only in cases of metastatic carcinoma. The only significant complication encountered was a 24% rate of pneumothorax, which is comparable to the reported rate for FNA alone-induced complications. CONCLUSIONS: PCNB offers no substantial advantage over FNA in the evaluation of peripheral malignant lung lesions. Therefore, the authors recommend the use of FNA biopsy as the initial diagnostic procedure in all cases of suspected malignancy. The use of the PCNB technique is recommended when the diagnosis of malignancy by FNA is uncertain, or when a more detailed characterization of the lesion is required.

Adult↗
PubMed1996

Preoperative assessment of proliferative activity and hormonal receptor status in carcinoma of the breast: a comparison of needle aspiration and needle-core biopsies to the surgical specimen.

The applicability and reliability of estimates of proliferative activity in breast carcinomas using fine-needle aspiration (FNA) and needle-core biopsies (NC) was evaluated in 98 breast carcinoma patients. The Ki-67, Estrogen receptor (ER), and progesteron receptor (PR) immunolabelling of FNA and NC was compared with that of the surgical specimen. A statistically significant consistency between labelling was found in the Ki-67-NC (kappa = 0.474), ER-FNA (kappa = 0.318), ER-NC (kappa = 0.518), and PR-FNA (kappa = 0.404) groups. The consistency in the Ki-67-FNA group was less significant (kappa = 0.182), and there was no consistency in the PR-NC group (kappa = 0.062). There was a positive correlation of Ki-67 labelling in FNA and NC biopsies (Spearman rank, rho = 0.4; P = 0.0007), and also in ER labeling (Spearman rank rho = 0.6; P = 0.0001). These results indicate that NC and FNA can be used for preoperative assessment of proliferative activity and hormonal status in breast carcinoma.

Adult↗
PubMed1994

Randomized comparison of fine-needle aspiration cytology and Biopty-Cut needle biopsy after unsatisfactory initial cytology of discrete breast lesions.

In a minority of patients with a discrete breast lump the initial cytological assessment is either unsatisfactory or at variance with the results of other methods of diagnosis. A randomized comparison of repeat cytology and needle-core biopsy provided clinically useful information in 14 of 31 patients receiving repeat cytology and in 26 of 29 randomized to core biopsy. Nineteen patients had carcinoma: ten who received repeat cytology, which indicated malignancy in only three (diagnostic of malignancy in one, suspicious in two), while all nine patients who underwent core biopsy had a correct diagnosis (only suspicious of malignancy in one). The sensitivity for the definitive diagnosis of carcinoma on repeat cytology and core biopsy was 10 and 89 per cent respectively. Patients with a discrete breast lump and unclear cytology results require needle-core biopsy. This has more diagnostic value than repeat cytology.

Adult↗
PubMed2003

Is core needle biopsy superior to fine-needle aspiration biopsy in the diagnosis of papillary breast lesions?

Since the 1980s core needle biopsy (CNB) has gained remarkable popularity and in many institutions it has replaced fine-needle aspiration biopsy (FNAB). However, similar to FNAB, limitation remains in the ability of this procedure to reliably diagnose a small, but prognostically significant, number of breast lesions. These include entities such as atypical ductal hyperplasia, fibro-epithelial tumors, radial scar, papillary lesions, and lobular neoplasia. To assess the diagnostic accuracy of CNB vs. FNAB in the same breast lesions, we reviewed our cases of papillary lesions of the breast. In a retrospective study, we identified 36 cases of FNAB and 11 cases of CNB diagnosed as papillary lesions and compared the results with their corresponding surgical specimen. Interpretation ranged from papillary vs. atypical papillary lesions favoring benign vs. malignant tumors, respectively. Occasionally, definitive diagnosis of papillary carcinoma was entertained. Immunohistochemical staining with smooth muscle actin was used to evaluate the presence or absence of a myoepithelial cell layer. FNAB had benign findings in 21 lesions, atypical in 10, and malignant in five. Of the five lesions yielding malignant features, four had invasive carcinoma and one had micropapillary ductal carcinoma in situ (DCIS). Surgery revealed invasive carcinoma in three of the cases interpreted as atypical papillary lesions and invasive cancer and micropapillary DCIS in three of the cases diagnosed as benign lesions. Similar results were obtained with CNB. DCIS was found in one out of six of the cases diagnosed as papilloma. Out of the four cases that were interpreted as atypical papillary lesion, surgery revealed invasive carcinoma in one case and one case had micropapillary DCIS. Diagnosis of malignancy was confirmed by histology in one case interpreted as papillary carcinoma by CNB. This study suggested that both FNAB and CNB share similar diagnostic challenges and a follow-up surgical excision is indicated when diagnosis of a papillary lesion is entertained by both procedures.

Biopsy, Needle↗
PubMed2004

How stereotactic core-needle biopsy affected breast fine-needle aspiration utilization: an 11-year institutional review.

To determine the effect of stereotactic core-needle biopsy (SCNB) on the utilization of breast fine-needle aspirate (FNA) biopsy, we retrospectively reviewed 1,568 cases of breast FNAs that were obtained from 1,188 patients between the years 1990 and 2000. There were 378 positive and atypical cases and 497 negative and unsatisfactory cases in the pre-SCNB group (between 1990 and 1996; 7 years); and 225 positive and atypical cases and 468 negative and unsatisfactory cases in the post-SCNB group (between 1997 and 2000; 4 years). The average number of cases per year in the pre- and post-SCNB groups was 125 and 173, respectively. While the average positive/atypical cases per year in both groups remained relatively constant, the average negative/unsatisfactory cases per year were significantly increased in the post-SCNB group (117 in the post-SCNB vs. 71 in the pre-SCNB). The increase in this group was due to a true increase in the negative diagnoses, since unsatisfactory rate decreased in the post-SCNB group (12.6% in the post-SCNB vs. 9.3% in the pre-SCNB). The sensitivity, specificity, positive predictive value, and negative predictive value were 90%, 79%, 92%, and 82% in the pre-SCNB group and 93%, 86%, 91%, and 90% for the post-SCNB group, respectively. In conclusion, the implementation of SCNB did not result in a decrease in the total number of breast FNAs; however, the distribution of cases changed. FNA is increasingly used to complete the triple test in clinically and radiographically negative cases.

Biopsy, Fine-Needle↗
PubMedDate not supplied

Fine-needle aspiration versus large-needle biopsy or cutting biopsy in evaluation of thyroid nodules.

This report describes our experience with both fine-needle aspiration (FNA) biopsies and large-needle biopsies (LNB) or core biopsies (CB) performed at the same time on 23 patients out of a series of 309 patients examined by the FNA technique. There was no significant differences in diagnostic accuracy of tissue obtained with the FNA technique when compared with the LNB or CB biopsy technique. While FNA always yielded tissue adequate for diagnosis, the LNB, and/or CB technique yielded tissue insufficient for diagnosis in four of 26 biopsies (15.4%). We believe that the FNA is better able to sample a mass with fewer insufficient specimens. Using FNA, the diagnosis can be rendered more rapidly, at lower cost, and with decreased potential for complications. The adequacy of the FNA biopsies can be assessed immediately using a modified Wright stain (Diff-Quik). Repeat biopsies can be performed that better sample the lesions with increased patient acceptance.

Adenoma↗
PubMed1996

Use of a 22-gauge Whitacre needle to reduce the incidence of side effects after lumbar myelography: a prospective randomised study comparing Whitacre and Quincke spinal needles.

In a prospective study lumbar iohexol myelography was performed in 107 consecutive patients, randomised for lumbar puncture with a Quincke or Whitacre spinal needle. All patients answered a questionnaire about possible side effects. Data from 100 patients (58 men, 42 women) were evaluated. In the Quincke group (n = 53), 23 (43%) reported no side effects. In the 30 patients who reported various side effects, post-dural puncture headache (PDPH) occurred in 22 (42%), of whom 9 had mild, 6 moderate and 7 (13%) severe cephalalgia, 18 (34%) reported increased low back pain/sciatica, 5 nausea and 7 dizziness. In the Whitacre group (n = 47), 33 (70%) had no side effects. PDPH was reported by 9 patients (19%), of whom 2 had mild, 6 moderate and only 1 (2%) severe cephalalgia, 4 (9%) reported increased low back pain/sciatica, 5 nausea and 4 dizziness. The conclusion drawn from this study is that lumbar myelography performed with the Whitacre spinal needle reduces postspinal side effects.

Adult↗
PubMedDate not supplied

Fibrin glue for sealing the needle track in fine-needle percutaneous lung biopsy using a coaxial system: Part II--Clinical study.

PURPOSE: Following percutaneous lung biopsy (PLB), we used fibrin glue as a sealant in 26 patients for the purpose of decreasing the incidence of pneumothorax. METHODS: All 26 patients (group A) had chronic obstructive pulmonary disease (COPD). The results for group A were compared with a control group of 32 patients (group B), also with COPD and in whom fibrin glue was not used. All biopsies were conducted under computed tomography (CT) using a coaxial needle system consisting of 19-gauge and 22-gauge needles. RESULTS: Pneumothorax developed in five patients (19.2%) in group A and in one instance, drainage was required (3.8%). In group B, pneumothorax developed in 13 patients (40.6%) and in six instances (18.8%) drainage was required. Comparing the use of chest-tube drainage in the two groups, a statistical significance was observed, p < 0.0025). No adverse reactions related to the fibrin glue were observed. CONCLUSION: Our results indicate that fibrin glue is a safe sealing material for lung PLB and serves to decrease the incidence and, in particular, the severity of pneumothorax, especially in high-risk patients.

Aged↗
PubMed1999

Ultrasound-guided biopsy of abdominal and pelvic lesions in children. A comparison between fine-needle aspiration and 1.2 mm-needle core biopsy.

BACKGROUND: Tissue diagnosis is mandatory prior to treatment of an abdominal or pelvic lesion in a child. OBJECTIVES: To compare the diagnostic yield and complications of fine-needle aspiration biopsy (FNAB) and 1.2-mm needle core biopsy (NCB) for abdominal and pelvic lesions in children using US guidance. MATERIAL AND METHODS: Ninety consecutive abdominal or pelvic US-guided biopsies in 61 children; 53 FNAB procedures in 43 children and 37 NCB procedures in 34 children were retrospectively analysed. Fifty-seven biopsies were performed on malignant lesions and 33 on benign lesions. In 15 children, both FNAB and NCB were performed at the same occasion. RESULTS: FNAB was diagnostic in 41 (77 %) of 53 biopsies while NCB provided a correct diagnosis in 35 (95 %) of 37 biopsies. Results were similar in both malignant and benign conditions. Clinically important bleeding complicated three biopsies (3.3 %); in two after FNAB and in one after combined FNAB and NCB. CONCLUSION: If FNAB were to be replaced with 1.2-mm NCB using an automatic gun, the diagnostic yield for abdominal and pelvic focal lesions in children would improve significantly (P < 0.05) while the complication rate would remain low. NCB may reduce the need for diagnostic and staging surgery and repeated procedures.

Abdominal Neoplasms↗
PubMed1993

Ultrasonographically guided fine needle aspiration cytology and core-needle biopsy in the diagnosis of breast tumors.

The present study was designed to assess the performance of fine needle aspiration cytology (FNAC) and core-needle biopsy (CNB) of breast lesions when these procedures are performed under sonographic guidance. The results obtained in 1142 FNAC procedures and 180 CNB procedures were analysed. The study took place in a University Hospital and a private practice clinic. The patients eligible for this study were a series of women, in whom at least one hypoechoic, limited mass was found at breast ultrasonography. Cystic masses were excluded from the study. Each individual mass was investigated using either FNAC or CNB under sonographic guidance. Accuracy characteristics to suspect or diagnose malignant and pre-malignant breast lesions, such as sensitivity and specificity, were calculated. The cytological results were classified into four categories according to standard criteria: benign; atypical and/or suspicious for cancer (hyperplasia with atypia); malignant; and unsatisfactory for diagnosis specimen. Tissue specimens were classified according to the W.H.O. The 1142 lesions submitted to FNAC included 66 invasive carcinomas, 4 intraductal carcinomas, and 4 atypical hyperplasias. FNAC led to 6 false-negative examinations, equally distributed between small (volume < or = 1 cm3), and larger lesions, and 1 false-positive examination. There were 12.9% (147/1142) inadequate smears. Only 3 inadequate samples were obtained in the presence of a discrete pathologic lesion (3/363, or 0.1%). All 3 corresponded to invasive carcinomas. The majority of inadequate samples (144/147, or 98.0%) were obtained in the normal/dystrophic group. Overall, the sensitivity is 92.1%, and the specificity is 84.8%. The 180 lesions submitted to CNB included 31 invasive carcinoma, 5 intraductal carcinomas, and 17 atypical hyperplasias. CNB, in this series, had an accuracy rate of 100%. In conclusion, US guidance increases the accuracy of breast tissue sampling procedures. This is of particular importance as the number of suspicious images to be investigated steadily increases, as the result of mass screening.

Biopsy, Needle↗
PubMed2001

Magnetic resonance imaging-guided core needle biopsy and needle localized excision of occult breast lesions.

BACKGROUND: Breast magnetic resonance imaging (MRI) has been reported to be twice as sensitive and three times more specific in detecting breast cancer. We report a series of MRI-guided stereotactic breast biopsies (SCNBB) and needle localized breast biopsies (NLBB) to evaluate MRI as a localization tool. METHODS: Forty-one breast lesions were identified in 39 patients who subsequently had SCNBB or NLBB. Suspicious areas of enhancement were stereotactically biopsied with 16-G core biopsy needles or localized with 22-G wires for excision under laser guidance. RESULTS: Forty-one breast lesions were identified from 1,292 breast MRIs. SCNBB identified three malignancies and two areas of atypia. Two additional cancers were found after NLBB. In patients having NLBB alone, five cancers and two areas of atypia were identified. CONCLUSIONS: In this initial series, breast MRI-guided SCNBB and NLBB were valuable tools in the management of patients with suspicious abnormalities seen only on MRI.

Adult↗
PubMed1993

Percutaneous needle biopsy of the renal allograft using the automated needle system: evaluation of 87 procedures.

Between April 1991 and February 1992 we obtained 87 percutaneous core needle biopsy specimens from 60 patients with the automatic biopsy gun. In 78 cases (89.7%) enough renal tissue was obtained for histological analysis. Acute rejection was present on 35 biopsies (40.3%) indicating antirejection therapy. No pathological signs of rejection were detected on 43 biopsies (49.4%). In 38 instances (43.7%) biopsy diagnosis differed from clinical presumptive diagnosis, affecting patient management, while in the remainder it was helpful to confirm clinical impressions. The only complication of the procedure was gross hematuria (requiring vesical irrigation in 1 patient). Due to its simplicity and low morbidity rate, renal biopsy with the automated needle system is the procedure of choice for evaluation and management of renal allograft dysfunction.

Adolescent↗