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PubMed2005

Flow cytometry in breast cancer: cell yield using two different fine needle aspiration devices.

The aim of the study was to compare the quality of breast aspirates obtained by two methods of fine needle aspiration cytology (FNAC): the auto-vacuum device and the syringe pistol holder, using flow cytometry. Both techniques were used in 44 fresh surgical specimens. Subsequently, these specimens were fixed and mounted in paraffin. Both the aspirates and the de-waxed histology material were prepared for flow cytometry using a FACScan. Flow cytometry showed that the means for DNA index and S-phase fraction were similar for aspirates obtained with both techniques. Mean aneuploidy was significantly higher in the auto-vacuum device aspirates than in the surgical specimen (43.4 SD +/- 23 vs. 27.9 SD +/- 17; p = 0.04). Mean DNA index and S-phase fraction were similar in cells from aspirates and surgical specimens. It is concluded that both FNAC methods are of similar efficacy in collecting aspirates for flow cytometry.

Aneuploidy↗
PubMed1997

Effects of follicular aspiration and flushing, and the genotype of the fetus on circulating progesterone levels during pregnancy in the mare.

When aspirating ovarian follicles in pregnant mares to obtain oocytes for in vitro fertilisation (IVF), the effect of the manipulation on circulating concentrations of progesterone may be an important consideration in terms of the maintenance of pregnancy. The object of this study was to compare the effects of 3 different forms of transvaginal ultrasound-guided follicle aspiration (Treatment 1, no aspiration, n = 4; Treatment 2, aspirate only follicles > or =20 mm in diameter, n = 7; Treatment 3, aspirate all visible follicles, n = 7) on peripheral plasma progesterone concentrations between Days 21 and 150 of gestation in 9 mares carrying intraspecies horse and 9 mares carrying interspecies mule conceptuses. The 3 follicle aspiration treatments were applied at the peak of each follicular wave as determined by follicular mapping by means of transrectal ultrasonography on alternate days. The plasma progesterone profile in mares undergoing Treatment 1 was in close agreement with those reported previously in pregnant mares. A decline in plasma progesterone levels occurred after Day 53 of gestation in Treatments 2 and 3 mares, indicating that the follicular aspiration procedures did interfere with the formation of secondary corpora lutea. However, the levels in individual mares never dropped low enough to endanger the pregnancy. Mares carrying mule pregnancies exhibited higher mean plasma progesterone concentrations between Days 39 and 45 of gestation than mares carrying horse pregnancies, equivalent levels between Days 46 and 66 despite the lower circulating concentrations of chorionic gonadotrophin (mule CG) in their blood during this period and lower progesterone levels between Days 67 and 150 of gestation. The results indicate that the primary corpus luteum in the pregnant mare may be more sensitive to mule CG than horse CG. Furthermore, the earlier disappearance of CG from the circulation in mares carrying mule fetuses is reflected by an earlier decline in plasma progesterone concentrations in this type of equine pregnancy.

Animals↗
PubMed1999

Lesion localization in acute stroke patients with risk of aspiration.

The objective of this prospective study was to determine whether specific neuroanatomical sites were associated with increased risk of aspiration in acute stroke patients. Videofluoroscopic swallow studies (VSS) and computed tomography or magnetic resonance imaging scans were completed on consecutive male stroke patients (n = 54). Videofluoroscopic swallow studies were scored on a scale from 0 (normal swallowing) to 4 (severe dysphagia). Patients with scores of 0-1 were grouped together as having no risk of aspiration, and patients with scores of 2-4 were grouped together as having a risk of aspiration. Lesion analyses revealed that location appeared to be more critical than hemisphere or lesion size in predicting patients at risk of aspiration. Anterior locations and subcortical periventricular white matter sites were commonly lesioned in patients with risk of aspiration, whereas patients without risk of aspiration were more likely to have posterior lesions and lesions to subcortical gray matter structures. These data demonstrate that swallowing appears to be mediated by a distributed neural network that involves both cerebral hemispheres with descending input to the medulla; however, specific lesion locations may put patients at a greater risk of aspiration.

Acute Disease↗
PubMed2006

The usefulness of bone marrow aspiration in the diagnosis of Niemann-Pick disease type C in infantile liver disease.

BACKGROUND: Niemann-Pick disease type C (NPC) is a fatal, autosomal recessive lysosomal storage disease which may present in infancy with cholestatic jaundice and/or hepatosplenomegaly. In cholestatic patients with splenomegaly, a bone marrow aspirate has been advocated as a relatively accessible tissue to demonstrate storage phenomena. Typically in patients with NPC, macrophages with abnormal cholesterol storage, so called foam cells, can be detected in the bone marrow. AIM: To review our experience of bone marrow aspiration in children with NPC presenting with infantile liver disease. METHODS: A retrospective analysis of 11 consecutive children (8 males) from Birmingham Children's Hospital with NPC presenting with infantile liver disease was undertaken. The diagnosis of NPC was confirmed in all cases by demonstrating undetectable or low rates of cholesterol esterification and positive filipin staining for free cholesterol in cultured fibroblasts. RESULTS: The median age at presentation was 1.5 months (range 0.5-10). Bone marrow aspirates showed storage cells in only 7/11 cases. Bone marrow aspirates which had storage cells were undertaken at a median age of 11 months while those with no storage cells were undertaken at median age 2.3 months. The overall sensitivity of bone marrow aspirates for detecting storage cells in children presenting with infantile liver disease was 64%; however, for children who had bone marrow aspirates in the first year of life it was only 57%. CONCLUSIONS: The sensitivity of bone marrow aspirate for the diagnosis of NPC disease in patients presenting with infantile liver disease was lower than previously reported. Where NPC is suspected clinically, definitive investigations should be undertaken promptly. There is a need to develop sensitive screening methods for NPC in children presenting with infantile liver disease.

Age Factors↗
PubMed1990

Management of isolated thyroid swellings: a prospective six year study of fine needle aspiration cytology in diagnosis.

OBJECTIVE: To audit the accuracy and impact on the frequency of operation of fine needle aspiration cytology of isolated thyroid swellings. DESIGN: Prospective analysis over six years of cytological predictions compared with histological findings. SETTING: Thyroid clinic serving the Grampian region. PATIENTS: 395 Consecutive patients presenting with an isolated thyroid swelling, 307 of whom underwent surgical excision. Analysis was confined to a subgroup of 283 patients with satisfactory aspirates who were operated on. RESULTS: The positive predictive value of aspiration cytology for detecting malignant disease was 100% and the sensitivity 83%. The sensitivity for the detection of neoplasia (frank malignancy together with follicular adenomas) was 76%. The specificity was 58% and the overall accuracy 69%. Recalculation of data in previous papers with strict criteria showed the accuracy of aspiration cytology to be variable and lower than is widely accepted. Since the introduction of aspiration cytology 21% fewer operations for isolated thyroid swellings have been performed. CONCLUSIONS: As a basis of selection for surgical excision of isolated thyroid swellings according to prediction of neoplasia fine needle aspiration cytology is less reliable than is widely accepted. It is an adjunct to management rather than a definitive test, and negative cytological results do not exclude neoplastic disease. Further study should take account of the implications of repeated clinic attendances for review and aspiration as these may culminate in delayed surgical treatment.

Biopsy, Needle↗
PubMed1991

Endoscopic fine needle aspiration cytology in the diagnosis of gastro-oesophageal and colorectal malignancies.

In a prospective study we compared the diagnostic accuracy of endoscopic fine needle aspiration cytology with that of brush cytology and forceps biopsy in relation to gross tumour pattern and site in 265 confirmed consecutive cases of malignancy of the oesophagus, stomach, colon, and rectum. Aspiration cytology gave the highest diagnostic accuracy (94%), which was significantly better than that of brush cytology (84.9%) and biopsy (87.2%) (p less than 0.005). The difference was mainly related to tumour pattern. When compared to brush cytology and biopsy aspiration cytology was significantly better in submucosal tumours (92.9% v 7.1% and 14.3%, p less than 0.001); in infiltrative malignancies (95.8% v 90.1% and 78.9%, p less than 0.01), and in ulceronecrotic malignancies (90.9% v 36.4% and 45.4%, p less than 0.05). In polypoid malignancies there was a significant trend (p less than 0.05) in favour of forceps biopsy, with a diagnostic yield of 100% compared with 95% for aspiration cytology and 93.3% for brush cytology. The accuracy of the different techniques was not significantly related to the site of the tumour. The cumulative accuracy of aspiration cytology and biopsy was significantly better than that of biopsy and brush cytology (98.5% v 90.9%, p less than 0.005). Aspiration cytology was diagnostic in 21 of 24 lesions that were negative with both brush cytology and biopsy. There were no false positive cytology or histology results. We conclude that aspiration cytology is a simple, safe, and reliable technique with a high diagnostic yield and is of particular value in submucosal, infiltrative, and ulceronecrotic tumours.

Biopsy↗
PubMed1997

Predictive value of clinical indices in detecting aspiration in patients with neurological disorders.

OBJECTIVES: (1) To evaluate the predictive value of a detailed clinical screening of aspiration in patients with neurological diseases, both with and without symptoms of dysphagia taking videofluoroscopy as the gold standard; (2) to assess the existence of risk factors for silent aspiration, measuring the cost-benefit ratio of radiological examination. METHODS: 93 consecutive patients meeting the diagnostic criteria for a neurological disease with a risk of swallowing dysfunctions (cerebrovascular accidents, brain injury, Parkinson's disease, multiple sclerosis, amyotrophic lateral sclerosis, myotonic dystrophy, and abiotrophic diseases) underwent a detailed clinical assessment using a 25 item form to check for symptoms of dysphagia and impairment of the oropharyngeal swallowing mechanism. The 3 oz water swallow test was also performed to assess the aspiration risk. Sensitivity, specificity, positive predictive, and negative predictive values (NPV) of dysphagia, history of cough on swallowing, and 3 oz test positivity, versus videofluoroscopy documented aspiration, taken as the gold standard, were measured in all the patients and in subgroups with different neurological disorders. RESULTS: Non-specific complaints of dysphagia showed a very poor predictive value, whereas the symptom "cough on swallowing" proved to be the most reliable in predicting the risk of aspiration, with 74% sensitivity and specificity, 71% positive predictive, and 77% negative predictive value. The standardised 3-oz test had a higher predictive potential than the clinical signs, but had low sensitivity. The association of cough on swallowing with the 3 oz test gave a positive predictive of 84%, and an negative predictive value of 78%. In cases where the clinical tests failed to detect any impairment, videofluoroscopy documented only a low risk (20%) for mild aspiration. CONCLUSIONS: The association of two clinical items (such as history of cough on swallowing and 3 oz test positivity) provides a useful screening tool, the cost:benefit ratio of which seems very competitive in comparison with videofluoroscopy in aspiration risk evaluation.

Adolescent↗
PubMed1982

Cytological sampling at fibreoptic bronchoscopy: comparison of catheter aspirates and brush biopsies.

A prospective study was undertaken to compare bronchial brushings with dry catheter aspiration for the cytological diagnosis of lung cancer at fibreoptic bronchoscopy. Duplicate samples taken by aspirate and brush were obtained at 103 consecutive routine bronchoscopies. Aspirate and brush samples were reported on separately by two cytologists. At the end of the study a 30% sample, including the 19 cases with different findings by the two methods, were subjected to a blind crossover review, and then an open review. Forceps biopsy specimens for routine histological assessment were taken in 94 cases (92%). Ninety-eight of 103 (95%) aspirates and 99 of 103 (96%) brush specimens were technically satisfactory. Carcinoma was diagnosed at bronchoscopy on cytological or histological evidence or both in 57 cases. Fifty-five of these tumours (96%) were recognised by either the aspirate or the brush method, 52 (91%) by brush, and 50 (88%) by aspirate. Thirty-four cases (60%) could be diagnosed from histological specimens. The order of cytological sampling did not systematically affect yield. It is concluded that fine-catheter aspirates, permitting smears to be prepared in the laboratory, are a satisfactory alternative to brush smears for the cytological diagnosis of lung cancer at bronchoscopy. The routine use of both techniques at bronchoscopy will increase diagnostic yield by about 5%. Duplicate sampling may be especially useful in obtaining diagnostic material from upper-lobe or apical-segment tumours.

Biopsy↗
PubMed1993

Diagnosis of pulmonary cryptococcosis by ultrasound guided percutaneous aspiration.

BACKGROUND: Ultrasound is useful for locating thoracic lesions and guiding biopsy procedures. The use of sonographic appearances and ultrasound guided needle aspiration has led to the diagnosis of pulmonary cryptococcosis at this hospital. METHODS: Six hundred and eight patients who had ultrasound guided lung aspirations were reviewed retrospectively and nine with documented pulmonary cryptococcosis were collected. All patients had nodules or infiltrates on the chest radiograph. The needle aspirates obtained under ultrasound guidance were stained by Riu's or Papanicolaou's method or with India ink, and six were sent for culture. Five patients also underwent bronchoscopy and biopsy. RESULTS: The nine patients had 18 pulmonary lesions, of which 15 were nodules and three infiltrates. Fifteen lesions were detectable by ultrasound, which showed the nodules to be hypoechoic with eccentrically located air echoes. In eight of the nine cases cryptococci were detected after the lung aspirates had been stained with Riu's or Papanicolaou stain or with India ink. In five of the six aspirates sent for fungal culture Cryptococcus neoformans was isolated. The diagnostic yield was higher than that of bronchoscopy. None developed post-aspiration pneumothorax or any evidence of late dissemination. CONCLUSIONS: Because they tend to be subpleural pulmonary cryptococcal lesions seem to be identifiable by ultrasound. Ultrasound guided lung aspiration is an effective, rapid, and safe method for diagnosis.

Adult↗
PubMed1992

Uncomplicated amebic liver abscess: prospective evaluation of percutaneous therapeutic aspiration.

The performance of therapeutic aspiration in the treatment of amebic liver abscess, advocated and practiced in many centers, is controversial. Previously, this practice has been evaluated in retrospective analyses. To test the potential benefit of therapeutic aspiration, the authors undertook a prospective randomized trial in 57 patients admitted for suspected amebic liver abscess during a 15-month period. Sixteen patients were excluded from the trial. The remaining 41 patients were randomly included in one of two study groups to receive amebicidal therapy alone or amebicidal therapy coupled with image-guided percutaneous therapeutic aspiration. All patients in the trial recovered. No statistically significant benefit was demonstrated in the aspiration group for the two objective parameters evaluated: length of hospitalization and duration of time to becoming afebrile. Subjective improvement in symptoms after aspiration was greater in the aspiration group at a marginally statistically significant level. These data do not support the adjunctive performance of percutaneous therapeutic aspiration in the treatment of uncomplicated amebic liver abscess. Amebicidals alone were equally efficacious in treating the group studied.

Humans↗
PubMed2003

Relative contribution of various airway protective mechanisms to prevention of aspiration during swallowing.

Deglutitive airway protective mechanisms include glottal closure, epiglottal descent, and anterosuperior displacement of the larynx. Aspiration of swallowed material may occur during the pre-, intra-, or postpharyngeal phase of swallowing. Our objectives were to determine the relative contribution of the airway protective mechanisms during each phase of swallow in 14 decerebrated cats before and after suprahyoid myotomy, epiglottectomy, and unilateral cordectomy. After myotomy, superior excursions of the hyoid, thyroid, and cricoid cartilages and anteroposterior diameter of maximum upper esophageal spincter (UES) opening were significantly diminished, but the incidence of pharyngeal residue significantly increased (P < 0.05). No aspiration was observed in the predeglutitive period. After myotomy, the incidence of aspiration significantly increased in both intra- and postdeglutitive periods. Epiglottectomy did not alter aspiration incidence, but unilateral cordectomy resulted in a 100% incidence of intra- and postdeglutitive aspiration. In conclusion, glottal closure constitutes the primary mechanism for prevention of intra- and postdeglutitive aspiration, but laryngeal elevation may assist this function. Bolus pulsion without laryngeal distraction can open the UES, but at risk of aspiration due to decreased pharyngeal clearance. The epiglottis provides no apparent airway protection during any phase of swallowing.

Animals↗
PubMed1992

Factors predicting successful stereotactic aspiration of colloid cysts.

Stereotactic aspiration is a valuable surgical alternative for colloid cysts, but due to cyst heterogeneity, it is not uniformly successful as the sole treatment in all patients. Since 1981, we performed CT-guided stereotactic aspiration as the initial procedure in 25 patients with colloid cysts. We retrospectively reviewed our experience in the first 22 patients and found that preoperative CT imaging studies accurately determined size and predicted cyst viscosity. The preoperative CT appearance of a hypodense or isodense cyst correlated favorably with successful aspiration. Preoperative MRI provided excellent anatomic definition of the cyst and its relationship to other structures, but failed to correlate successful aspiration. Unsuccessful aspiration was related to the high viscosity of the intracystic material or deviation of the cyst away from the aspiration probe. These factors were used prospectively in 3 additional patients to accurately predict success of cyst aspiration.

Cerebral Ventricle Neoplasms↗
PubMedDate not supplied

A simple intraductal aspiration method for cytodiagnosis in nipple discharge.

OBJECTIVE: To increase cytodiagnostic accuracy for women with spontaneous nipple discharge using a simple intraductal aspiration method. STUDY DESIGN: We compared the cytodiagnostic accuracy of the conventional squeezing collection method and intraductal aspiration by intravenous catheter in a total of 146 women with spontaneous nipple discharge in a single duct without a mass; they had been pathologically identified at Kaohsiung Medical University Hospital. RESULTS: Adequate specimens were collected in 96.6% (141/146 cases) of the sample by the intraductal aspiration method as compared to 76.0% collected by the conventional squeezing method (P < .05). An adequate specimen should consist, at a minimum, of six cohesive clusters of well-preserved epithelial cells, with each cluster composed of at least five cells other than foam cells. The cytologic diagnosis was divided into five categories: positive in 9 cases, suspicious in 10, negative with atypical findings in 59, negative in 33 and inadequate specimens in 35 cases that employed the squeezing method. These results were less satisfactory than with the intraductal aspiration method: the smears were positive in 17 cases, suspicious in 14, negative with atypical findings in 78, negative in 32 and inadequate specimens in 5. Our results showed a sensitivity of 92.3% and specificity of 93.9% for the intraductal aspiration method as compared to a sensitivity of 52.9% and specificity of 89.3% for the squeezing method. Among the 27 cancers in this series, correct cytodiagnosis, including suspicious cases, was made in 24 cases by intraductal aspiration, with an accuracy of 88.9%, as compared to the 33.3% (9/27) accuracy of the squeezing method (P < 0.5). CONCLUSION: For patients with spontaneous nipple discharge, the intraductal aspiration method provides much more accurate cytodiagnosis than does the conventional squeezing method.

Adolescent↗
PubMedDate not supplied

Diagnosis of small non-cleaved cell lymphoma by fine needle aspiration utilizing cytomorphologic features combined with cytogenetic analysis.

OBJECTIVE: To determine the utility of cytogenetic studies in the diagnosis of small non-cleaved cell lymphoma by fine needle aspiration. STUDY DESIGN: Cases of suspected lymphoma were identified in a prospective fashion by an immediate examination of the fine needle aspirate material by the pathologist. In these instances, additional material was aspirated directly into RPMI 1640 medium for cytogenetic studies. RESULTS: Four cases of suspected small non-cleaved cell lymphoma were identified on fine needle aspirate material, and the diagnosis was confirmed in all cases by the presence of the characteristic (8;14) translocation or associated variant translocation in cytogenetic studies from the aspirated material. CONCLUSION: Cytogenetic analysis is useful as an additional ancillary technique applicable to fine needle aspiration material. In the case of suspected small non-cleaved cell lymphoma, the finding of a translocation (8;14) or associated variant translocation, along with the characteristic cytomorphology, allows a definitive diagnosis by fine needle aspiration and may alleviate the need for biopsy.

Aged↗
PubMed1977

Retrospective analysis of 645 simultaneous perineal punch biopsies and transrectal aspiration biopsies for diagnosis of prostatic carcinoma.

Transrectal aspiration biopsy of the prostate has been recommended as method of choice for morphological diagnosis of prostatic malignancies. It is less inconvenient to the patient and with hardly any complications. A retrospective analysis of 645 simultaneous perineal punch biopsies and transrectal aspiration biopsies was carried out in order to elicit whether prostatic carcinoma can be detected with transrectal aspiration biopsy as frequently as with perineal punch biopsy, and whether a cytological diagnosis of prostatic cancer is reliable. Carcinoma of the prostate was found in a total of 39.1% either with both techniques or with only one of them. A concordant diagnosis has been obtained in only 25.1%. Prostatic carcinoma was diagnosed more often by perineal punch biopsy (36.1%) than by transrectal aspiration biopsy (27.7%). However, the diagnosis has been missed by perineal punch biopsy in 2.6% of the cases. Doubtful results and unsatisfactory preparations have been observed more frequently after transrectal aspiration biopsies. Definite 'false-positive' cystological findings have not been detected. Thus, cytological evaluation of aspirated prostatic cells appears reliable. A definite morphological diagnosis can be expected with this technique. Simultaneous application of perineal punch biopsy and transrectal aspiration biopsy can be recommended in order to diagnose prostatic carcinoma with a higher frequency.

Biopsy↗
PubMed1983

Transbronchial needle aspiration of peripheral masses.

Transbronchial needle aspiration through a flexible fiberoptic bronchoscope was performed on peripheral lung masses in 42 consecutive patients with bronchogenic carcinoma using a 20-gauge by 1-cm prototype needle. The aspiration was preceded by routine washings and brushings and followed by transbronchial forceps biopsy. Adding transbronchial needle aspiration to the standard combination of transbronchial biopsy, brush, and wash significantly improved the diagnostic yield (48 to 69%, p = 0.046). Considering only lesions 2 cm or greater in diameter, the combination of transbronchial needle aspiration, brush, and wash was superior to transbronchial biopsy, brush, and wash (76 versus 52%, p = 0.041). No complications occurred with either transbronchial needle aspiration or transbronchial biopsy, but transbronchial needle aspiration produced less bleeding than did transbronchial biopsy. We conclude that transbronchial needle aspiration of peripheral mass lesions is a safe procedure that can increase the diagnostic yield of flexible fiberoptic bronchoscopy.

Aged↗
PubMed1994

Peritonsillar abscess: repeated needle aspiration versus incision and drainage.

The study evaluates the management of peritonsillar abscess (PTA) by comparing needle aspiration versus incision and drainage of the abscess. Twenty-four of 86 patients treated by needle aspiration underwent a single aspiration, and 38 had 2, 19 had 3, and 5 had 4 aspirations before the abscess resolved. A significant amount of pus, up to 8, 5, and 3 mL, respectively, was detected in the subsequent aspirations. Recurrent PTA was noted in 20 patients (23.26%). In 9 of these patients (10.47%) the recurrent episode occurred immediately (in less than 1 month) and was considered residual disease. Seventy-four patients were treated by incision and drainage, and none had an immediate recurrence. Only 3 (4.05%) patients developed a late recurrent episode. The difference in the recurrence rate between the two groups is statistically significant. A history of recurrent tonsillitis prior to abscess formation did not show a significant influence on the recurrence rate. A high incidence of streptococcal infections was noted in both groups, with anaerobes detected in only 15% of samples. There was a good response to penicillin-resistant organisms. Although needle aspiration is a tempting modality for treating PTA in community clinics, one should be aware of the risks of a higher incidence of residual and recurrent disease in comparison to incision and drainage, as well as the need for repeated aspirations.

Adolescent↗
PubMed2005

Fine needle aspiration diagnosis of extracranial glioblastoma multiforme: Case report and review of the literature.

BACKGROUND: Hitherto uncommon, the incidence of extracranial metastases of primary brain malignancies may increase, with improved treatment methods and longer patient survival. Fine needle aspiration biopsy is a simple, safe and reliable method to diagnose metastatic malignancy. It has definite advantages over tissue biopsy, which is more invasive and is of higher risk to the patient. Ours is a case of glioblastoma multiforme, which metastasized to the scalp and was diagnosed on fine needle aspiration biopsy. Only a few articles document the cytological features of extracranial glioblastoma multiforme, diagnosed by fine needle aspiration biopsy. CASE PRESENTATION: We report the case of an elderly female who presented with focal neurological symptoms. She was diagnosed radiologically with an intracranial lesion in the left temporal region, which was subsequently resected. Histology revealed a glioblastoma multiforme confirmed by immunohistochemistry. The tumor recurred subsequently and the patient was treated with chemotherapy, intraoperatively. At a later stage, she presented with a scalp mass on which fine needle aspiration biopsy was performed. The cytomorphological features aided by immunohistochemistry supported a diagnosis of metastatic glioblastoma multiforme. The mass was later resected and histology confirmed the fine needle aspiration diagnosis of glioblastoma multiforme. CONCLUSION: Reports of extracranial metastases of primary brain tumors are few. When they do occur, the primary cause is implantation during surgery or biopsy. However, spontaneous metastases to other organs do occur rarely. We believe fine needle aspiration biopsy to be very useful in the diagnosis of metastatic glioblastoma multiforme. The ability to use a cellblock for immunohistochemical studies is greatly advantageous and helpful in differentiating this tumor, from other malignancies that can occur in the scalp. A detailed discussion of the material obtained from fine needle aspiration biopsy of metastatic glioblastoma multiforme is presented, as well as a review of previous accounts in the literature.

Journal Article↗