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At least 685 records · Page 38Linked to original sources
PubMed2000

Fine-needle aspiration biopsy of granulocytic sarcoma: a clinicopathologic study of 27 cases.

BACKGROUND: Because of morphologic similarities, the differential diagnosis of granulocytic sarcoma (GS) in fine-needle aspiration (FNA) specimens includes non-Hodgkin or Hodgkin lymphoma, extramedullary hematopoiesis, poorly differentiated carcinoma, and infection. METHODS: Twenty-six FNAs and 1 pleural effusion fluid specimen of GS obtained from 23 patients were reviewed for cytomorphologic features and clinical characteristics. The cases were categorized as blastic, immature, or mature GS based on the population of the cells present on the smears. RESULTS: The patients included 18 men and 5 women (mean age, 54 years). Aspiration sites included subcutaneous or soft tissue (15 cases), lymph nodes (5 cases), bones (3 cases), testis (1 case), ileum (1 case), and liver (1 case). One sample of pleural effusion fluid also was included. Review of the patients' clinical history revealed that GS was secondary to chronic myelogenous leukemia (CML) in 17 patients, was secondary to chronic myelomonocytic leukemia (CMML) in 2 patients, and was secondary to acute myelogenous leukemia in 2 patients. GS preceded the manifestation of CML in one patient and of CMML in another patient. Based on the proportions of cells, morphologic classification was attempted and revealed blastic GS in 8 aspirates and 1 pleural effusion fluid specimen, immature GS in 13 aspirates, and mature GS in 5 aspirates. Twelve of 22 specimens from extranodal sites (55%) demonstrated lymphoglandular bodies in the background. Five aspirates showed rare eosinophilic myelocytes. Auer rods were not identified in any of the aspirates. Immunophenotypic and histochemical studies confirmed myeloid and/or myelomonocytic differentiation. CONCLUSIONS: GS especially can be confused with non-Hodgkin lymphoma because of morphologic similarities of the blasts to large cell lymphoma, the presence of lymphoglandular bodies, and the rarity of Auer rods and eosinophilic myelocytes. In conjunction with careful cytomorphologic evaluation, knowledge of the patient's clinical history and use of appropriate immunophenotypic studies should lead to a correct diagnosis.

Adult↗
PubMed2001

Role of knee aspiration after resection of the infected total knee arthroplasty.

Recognizing persistent infection after resection arthroplasty and implantation of cement spacers in the infected total knee arthroplasty is often difficult. The purpose of this study was to determine whether aspiration of the knee after resection arthroplasty is valuable for determining the presence of ongoing infection. Thirty-four previously infected knees that were aspirated and cultured after resection arthroplasty, implantation of cement spacers, and intravenous antibiotics for an average of 6.3 weeks were identified. There were 8 cases of persistent infection-none identified on preoperative aspiration. Two preoperative cultures were false positive for Staphylococcus epidermidis. Preoperative cultures were negative in 32 knees, with 8 false-negative results. The antibiotic-free interval among all cases averaged 20 days; the cases with false-negative results from aspiration had an antibiotic-free interval averaging 11.5 days, compared with an average of 26 days among all other cases. Aspiration of knees after resection arthroplasty had sensitivity of 0%, positive predictive value of 0%, and accuracy of 71%. Specificity was 92%, and negative predictive value was 75%. A negative result from joint aspiration after resection arthroplasty does not necessarily rule out the presence of ongoing infection. False-negative results may be observed if joint aspiration is not delayed more than 2 to 3 weeks.

Aged↗
PubMed2001

[Role of echo-guided aspiration of ovarian cysts. Our experience].

BACKGROUND: Ultrasound-guided puncture is a simple and easy to perform procedure. This study was undertaken to verify the role of fine-needle aspiration (FNA) followed by cytological examination as a possible alternative to surgery in case of cystic pelvic masses. Ovarian cysts are conventionally managed by laparoscopy or laparotomy. METHODS: From January 1993 to December 1997, 224 patients with a proven cystic pelvic mass underwent surgical intervention and have been retrospectively analysed for FNA under sonographic guidance. The sediment aspirated was examined by a cytological method and when possible it was also correlated to a histological test. RESULTS: Eight patients (34.8%) had been submitted to one needle cyst aspiration before surgical intervention and 15 (65.2%) to more than one aspiration. Patients with an history of only one aspiration were submitted to surgical intervention with urgency statistically more than the group with an history of more than one aspiration. Anatomo-pathologic examination showed a significative relevance of serous and endometriotic cysts. CONCLUSIONS: We conclude that FNA might be proposed in young women with a unilocular ovarian cyst to avoid a surgical procedure. In all instances the ultrasonographic appearance of the cyst and the characteristics of aspirated fluid are the most important findings.

Female↗
PubMed2000

[Clinical implications of telomerase activity in breast cancer fine-needle aspirates].

OBJECTIVE: To study the telomerase activity in samples of breast fine-needle aspirates, its clinical implications, and possible association with expression of PR, ER, PCNA, c-erbB2 and p53. METHODS: Ninetynine fine needle aspirates from breast cancers in 83 patients, 12 from benign lesions and 4 from inflammation of the breast, were examined for telomerase activity by a PCR-based telomere repeat amplification protocol (PCR-TRAP). In 35 breast cancer tissue specimens, expression of PR, ER, PCNA, c-erbB2 and p53 were examined by immunohistochemical staining. RESULTS: Among 83 fine-needle aspirates from breast cancer, telomerase activity was detected in 61 of 69 cytology-possitive specimens and in 5 of 7 cytology-suspicious specimens and in 4 of 7 cytology-negative specimens, with an overall positive rate of 84.3% (70/83). The concordance rate of telomerase detection and cytologic examination was 77.1% (64/83). Of 12 fine-needle aspirates from patients with benign breast lesions, 4 were telomerase positive, but 4 aspirates from inflammed breast were all negative. Telomerase activity of breast cancer aspirates did not correlate with histologic type, lymph node status, tumor size and clinical stage, nor did it correlate with PR, ER status and PCNA and c-erbB2 expression. However, negative correlation was found between telomerase activity and accumulation of p53 proteins. CONCLUSION: Detection of telomerase in breast fine-needle aspirates complementary to cytological examination is useful in the diagnosis of breast cancer. Its possible association with p53 accummulation needs further study.

Biopsy, Needle↗
PubMed1998

Fine needle aspiration cytology of breast lesions: a clinicocytologic review of 1211 cases.

Fine needle aspiration (FNA) is a widely accepted cytologic technique for the early diagnosis of palpable breast lesions. Early diagnosis and treatment of benign and malignant breast lesions in turn are associated with increased chance of long term survival. Clinical data and results of fine needle aspiration done at the Department of Pathology in Tikur Anbessa Hospital between January 1991 to December 1994 were reviewed to study the cytologic features of breast lesions and to elucidate the clinical use of fine needle aspiration. A total of 9,946 fine needle aspirations were done in the department, out of which 1,211 (12.2%) were from breast lesions. Results from breast lesions were reported as: malignant, benign suspicious and unsatisfactory. Repeat aspiration was performed for all unsatisfactory cases. Fine needle aspiration of the 1,211 breast lesions in the four year period revealed 255 (21%) malignant, 901 (74%) benign, 15 (1.2%) suspicious and 40 (3.3%) unsatisfactory cases. The malignant lesions ranged from small, mobile, firm nodules measuring 4 cm to fixed ulcerated and fungating mass, measuring 20 cm or more. The benign lesions were small and mobile, measuring from 2 cm to 6 cm, mostly fibroadenoma (38%). Biopsy result was found for 20 patients. Out of these 14 were benign lesions and 6 were malignant lesions, confirmed by surgical biopsy. The mean age of patients with malignant lesions was 43 years (range: 24 to 80 years), while it was 27 years (range: 15 to 50 years) for those with benign lesion. There were 1132 (93.5%) females and 79 (6.5%) males. Fine needle aspiration diagnostic technique is recommended to be widely introduced into the health system of Ethiopia in order to ensure timely diagnosis of benign and malignant breast lesions. Furthermore a properly designed study will be beneficial to elucidate the cytologic and clinical characteristics of breast lesions in Ethiopian setting.

Adolescent↗
PubMed2002

Bone marrow trephine biopsy as an adjunct to bone marrow aspiration.

OBJECTIVE: To determine the relative efficacy of bone marrow aspiration as compared to that of trephine biopsy. METHODS: Bone marrow aspiration and bilateral trephine biopsies were performed in 420 consecutive cases. The diagnosis and findings made on bone marrow aspiration were compared with that made on trephine biopsy in each case. RESULTS: Aspiration alone was sufficient in making a diagnosis in 372 (88.6%) cases as it correlated well with the diagnosis made on trephine sections. In the remaining 48 (11.4%) cases trephine biopsy was necessary for making a diagnosis due to incomplete information provided by aspiration or its inability to give a correct diagnosis. These cases were mostly hypoplastic/aplastic marrow, myelofibrosis and marrow involvement by metastatic tumour and lymphomatous infiltration. Often a bilateral marrow biopsy picked up the diagnostic lesion. CONCLUSION: The decision to perform a marrow aspiration alone or in combination with marrow biopsy depends on the diagnosis being considered. In nutritional anaemias, most hematologic malignancies and immune thrombocytopenias, marrow aspiration alone is sufficient, but for detection of disorders with focal marrow involvement bilateral marrow biopsies are a must.

Biopsy, Needle↗
PubMed1984

Volumetric vaginal aspirator may aid in natural family planning.

All natural family planning (NFP) methods are based on the determitnation of a woman's fertile period so that a couple may abstain from sexual relations or use a mechanical means of birth control during that time. Researchers are seeking more accurate methods of predicting the onset of ovulation in order to increase the effectiveness of NFP. A new device developed by Dr. Gebhard F.B. Schumacher, a fertility specialist at the University of Chicago who serves on FHI's Technical Advisory Committee, and Dr. Stepen J. Usala, a former medical student at the University's Pritzker School of Medicine, holds the promise of providing a new, cheap, and relatively simple way of predicting ovulation. Called a volumetric vaginal aspirator, the instrument allows women to measure their own vaginal fluid on a daily basis. In early studies of 7 women carefully studied over 18 menstrual cycles, a striking 3 fold to 30-fold increase in the volume of vaginal fluid occurred a few days before ovulation. Results from 12 more women for a total of 26 cycles confirmed the earlier studies. Blood samples were taken in order to measure the levels of estrogen, known to increase prior to ovulation, and luteinizing hormone, which peaks sharply on the day of ovulation, in the women studied. These confirmed that ovulation typically had occurred after the fluid volume increase. In addition, participants recorded their basal body temperature (BBT) upon awakening. Although the BBT does not predict ovulation, it frequently increases by 1/2-1 degree Fahrenheit after ovulation thus serving as an indicator of the end of the fertile period. The prototype of the vaginal aspirator is a disposable plastic syring marked at .05 milliliter intervals so that fluid levels can be easily measured. After the manufacturing process for the aspirator is perfected so that the instrument can be mass produced, Dr. Schumacher hopes that largescale clinical trials will be initiated in the US and abroad. The larger studies and an endocrine study are needed in order for effective rules to be developed for applying the method in either birth control or fertility enhancement. The vaginal aspirator could be useful not only for preventing unplanned pregnancy but also for aiding couples experiencing infertility to pinpoint the time that conception is most likely to occur. As an aid in birth control, the aspirator should have a success rate similar to or better than that of a diaphragm, Dr. Schumacher believes. Although the women testing the vaginal aspirator were ablet to use it without assistance, Dr. Schumacer emphasizes that some patient education will be necessary if it becomes commercially available. Fertility awareness teachers could incorporate it into their courses. Research on the volumetric vaginal aspirator has been supported by FHI and by Mothers' Aid Research Fund of Chicago Lying-In Hospital.

Clinical Laboratory Techniques↗
PubMed2002

Diagnostic transvitreal fine-needle aspiration biopsy of small melanocytic choroidal tumors in nevus versus melanoma category.

PURPOSE: To report an experience with fine-needle aspiration biopsy of selected small melanocytic choroidal tumors during the interval from April 13, 1983, through January 19, 2001. METHODS: Retrospective descriptive case series report of 34 patients with a small melanocytic choroidal tumor (maximal diameter, < or = 10 mm; thickness, > or = 1.5 mm but < or = 3 mm) evaluated diagnostically by transvitreal fine-needle aspiration biopsy prior to treatment. None of the tumors had invasive features at the time of biopsy. RESULTS: Patients ranged in age from 26 to 73 years (mean, 50.9 years). The evaluated choroidal tumors had a mean maximal basal diameter of 8.0 mm and a mean maximal thickness of 2.4 mm. Eighteen of the 34 tumors (52.9%) had been documented to enlarge prior to biopsy. Biopsy was performed in all cases using a 25-gauge hollow lumen needle and a transvitreal approach via a pars plana puncture site. The biopsy yielded a sufficient aspirate for cytodiagnosis in 22 of 34 cases (64.7%). In these cases, the tumor was classified as malignant melanoma in 16 (47.1% of total), intermediate lesion in 4 (11.8%), and benign nevus in 2 (5.9%). The 12 tumors that yielded an insufficient aspirate and the four lesions that yielded intermediate cells continued to be classified as "nevus versus melanoma" and were monitored periodically for growth or other changes. Four of the 12 tumors that yielded an insufficient aspirate for cytodiagnosis and all four lesions that yielded intermediate cells were eventually reclassified as small choroidal melanomas and treated. The remaining eight tumors that yielded an insufficient aspirate and the two tumors that yielded benign nevus cells were classified as benign nevi at the most recent follow-up evaluation. CONCLUSIONS: Fine-needle aspiration biopsy showed that a substantial proportion of small melanocytic choroidal tumors likely to be classified clinically as small choroidal melanomas in many centers were in fact benign nevi or intermediate lesions.

Adult↗
PubMed2003

[Results of fine needle aspiration biopsy, frozen section diagnosis and definite histological results in thyroid pathology. Report of 163 cases].

INTRODUCTION: In thyroid diseases, the place of fine needle aspiration biopsy still continues to be discussed: the sensibility and specificity vary greatly in the literature. Frozen section diagnosis is necessary to form a diagnostic strategy. The objective of this study was compare the results of fine needle aspiration biopsy, frozen section diagnosis, and definitive histologic results in a population of 163 patients and to draw conclusions about treatment. MATERIAL AND METHOD: From 1994 to 1999, 163 patients (132 females and, 31 males) undergoing thyroid surgery were included in this retrospective study, after a standard preoperative work-up. Those with a single palpable nodule and hypofixation on scintigraphy underwent fine needle aspiration before surgery. These results were compared with the definitive histologic results. RESULTS: A loboisthmectomy was performed in 88 cases (54%), a subtotal thyroidectomy in 34 cases (21%), and a total thyrodectomy in 41 cases (25%). In the latter group, an associated neck dissection was performed in 18 cases (11%); a frozen section diagnosis was obtained in all cases of thyroid nodules. This study demonstrated a single nodule in 97 cases (60%), multiple nodules in 27 cases (17%), multinodular goitre in 34 cases (21%), and 5 Basedow diseases (3%). Sixty-two cases (38%) of thyroid nodules underwent fine needle aspiration before surgery. In 25 cases (15%), definitive pathology showed a malignant lesion. The frozen section diagnosis had a sensitivity of 73% and a specificity of 99%, and the fine needle aspiration biopsy had a sensitivity of 40% and a specificity of 100%. CONCLUSION: The authors propose fine needle aspiration biopsy in the following cases: a single palpable nodule and hypofixation on scintigraphy or a surgical contra indication; and direct surgery in symptomatic thyroid disease or if there are one or several full nodules > 2 cm. In near future, these indications will be modified with the increasing reliability of fine needle aspiration biopsy.

Adolescent↗
PubMed2004

Sensitivity of splenic and bone marrow aspirate study for diagnosis of kala-azar.

Fifty adult patients of kala-azar were included in this prospective study from Medicine Unit-I of Mymensingh Medical College Hospital. Splenic and bone marrow aspiration were done simultaneously to compare the sensitivity and other related merits and demerits of each procedure. Splenic aspiration appeared to be more sensitive procedure than bone marrow aspiration. Leishman - Donovan (LD) bodies were found in 90 percent and 72 percent of the spleen and bone marrow aspirates respectively. Splenic aspiration was found more acceptable to patients (96%) as it was less painful. Both the procedures were hazardless. There was no major complication except mild pain after splenic aspiration; even a few patients had history of epistaxis. Splenic aspiration was also more acceptable by the physicians because of an easy and reliable diagnostic procedure.

Adolescent↗
PubMed2004

[Outcome of follicular aspiration of selection phase in patients with polycystic ovary syndrome undergoing controlled ovarian hyperstimulation].

OBJECTIVE: To assess the effectiveness of follicular aspiration in selection phase of follicle growth of the patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization-embryo transfer (IVF-ET). METHODS: Thirteen infertile patients with PCOS who previously failed IVF-ET associated with ovarian hyperstimulation syndrome (OHSS), served as control group, were asked to undergo new IVF cycles (follicular aspiration group) with ultrasound-guided transvaginal follicular aspirations in the selection phase (diameter 9 - 10 mm) of follicle growth, with a total of 13 cycles both. No more than 10 follicles were selected. Clinical and endocrinological parameters were monitored. RESULTS: In follicular aspiration group, the average number of follicle >or= 12 mm in diameter and serum estradiol level were 16 +/- 4 and (9899 +/- 1431) pmol/L respectively, which were significantly lower than 29 +/- 8 (P < 0.001) and (15,544 +/- 1767) pmol/L (P < 0.001) in control group. No moderate-severe OHSS occurred in follicular aspiration group, while 9 out of 13 (69%) occurred in control group. Oocyte retrieval rate, maturation rate, fertilization rate and cleavage rate in follicular aspiration group were greatly higher than those in control group. CONCLUSIONS: Follicular aspiration in selection phase of follicle growth associates with reduced dominant follicle numbers and estradiol level on the day of hCG injection and moderate-severe OHSS incidence in patients with PCOS undergoing IVF-ET.

Adult↗
PubMedDate not supplied

Carcinoembryonic antigen content in fine needle aspirates of the lung. A diagnostic adjunct to cytology.

Carcinoembryonic Antigen (CEA) was measured in 59 consecutive fine needle aspirates (FNAs) of the lung from 58 patients to determine if the CEA content would enhance the sensitivity of the cytologic diagnosis. Twenty-eight males and 30 females with tumors 1-40 cm in diameter were studied. Final diagnoses were correlated with the clinical history, radiologic studies, tissue (when available) and follow-up. Image-guided FNAs were performed by radiologists using a 22-gauge Chiba needle and 20-mL syringe with one to four passes per specimen. Cytologic examination included rapid assessment in the radiology suite and a final diagnosis in 24 hours. CEA was measured by enzyme immunoassay using monoclonal antibody. Nine benign aspirates and 50 malignant aspirates were diagnosed. The sensitivity of cytology was 86% and specificity, 100%. Using 5 ng/mL as the cutoff, the sensitivity of CEA for malignant aspirates was 50% and specificity, 90%. The combined sensitivity of CEA and cytology was 95%. The mean CEA in malignant aspirates was 131 ng/mL and in benign aspirates, 2.41. The highest mean CEA was seen in adenocarcinoma, 402.6 ng/mL. Lower CEA content was seen in epidermoid carcinoma (58.6 ng/mL), large cell carcinoma (8.09), oat cell carcinoma, metastatic carcinoma of the kidney and breast, thymoma and lymphoma (each less than 1 ng/mL). Elevated CEA alone was diagnostic in two aspirates of bronchioloalveolar carcinoma; carcinoma with an unknown primary source, three; and large cell carcinoma, one. The adjunctive use of CEA in FNAs of the lung enhances the sensitivity of the cytologic diagnosis.

Adult↗
PubMed1992

Bone marrow harvest for marrow transplantation: effect of multiple small (2 ml) or large (20 ml) aspirates.

The aim of this study was to evaluate the yield of nucleated cells and CFU-GM and the T cell composition in bone marrow harvested by means of multiple small (2 ml) or large (20 ml) aspirations. Eleven marrow donors were studied: each donated 1000 ml of bone marrow in two aliquots of 500 ml for an HLA identical sibling transplant. In six cases the first 500 ml were harvested by means of multiple 2 ml aspirations (A) and the second 500 ml by means of 20 ml aspirations (B). In five cases the opposite was done: 20 ml aspirates first (C) and 2 ml afterwards (D). From each 500 ml aliquot a sample was taken for enumeration of nucleated cells and CD3+ lymphocytes and for CFU-GM growth. Small volume aspirations (groups A and D) yielded more nucleated cells (p = 0.02), more CFU-GM (p = 0.03) and fewer CD3+ cells (p = 0.1) when compared with large volume aspirations (groups B and C). This study shows that marrow harvesting by means of multiple small volume aspirations minimizes the dilution with peripheral blood and results in greater numbers of cells and hemopoietic progenitors.

Adult↗
PubMedDate not supplied

Intracellular mechanics and mechanotransduction associated with chondrocyte deformation during pipette aspiration.

The present study utilised pipette aspiration and simultaneous confocal microscopy to test the hypothesis that chondrocyte deformation is associated with distortion of intracellular organelles and activation of calcium signalling. Aspiration pressure was applied to isolated articular chondrocytes in increments of 2 cm of water every 60 seconds up to a maximum of 10 cm of water. At each pressure increment, confocal microscopy was used to visualise the mitochondria and nucleus labelled with JC-1 and Syto-16, respectively. To investigate intracellular calcium signalling, separate cells were labelled with Fluo 4, rapidly aspirated to 5 cm of water and then imaged for 5 minutes at a tare pressure of 0.1 cm of water. Partial cell aspiration was associated with distortion of the mitochondrial network, elongation of the nucleus and movement towards the pipette mouth. Treatment with cytochalasin D or nocodazole produced an increase in cell aspiration indicating that both the actin microfilaments and microtubules provide mechanical integrity to the cell. When the data was normalised to account for the increased cell deformation, both actin microfilaments and microtubules were shown to be necessary for strain transfer to the intracellular organelles. Mitochondria and nucleus deformation may both be involved in chondrocyte mechanotransduction as well as cellular and intracellular mechanics. In addition, pipette aspiration induced intracellular calcium signalling which may also form part of a mechanotransduction pathway. Alternatively calcium mobilisation may serve to modify actin polymerisation, thereby changing cell mechanics and membrane rigidity in order to facilitate localised cell deformation. These findings have important implications for our understanding of cell mechanics and mechanotransduction as well as interpretation and modelling of pipette aspiration data.

Animals↗
PubMed2005

Multi-dimension aspiration control mode in phacoemulsification.

PURPOSE: Multi-dimension aspiration control mode was put forward in this study. Accuracy of multi-dimension aspiration control model was compared to simple traditional pedal control model. METHODS: Induced by high aspiration pressure (200-250 mmHg), hard nucleus (> OR = Grade III ) of senile cataract was chopped before phacoemulsification in 170 patients (174 eyes). Ninety-one patients (94 eyes) accepted multi-dimension aspiration control model in which aspiration direction, distance and targets prevention were adjusted by phaco-tip besides traditional pedal control. Another 79 patients (80 eyes) were compared as reviewed group, aspiration of which was controlled simply by traditional pedal control. Postcapsular rupture rates (PCRR) were compared between two groups. RESULTS: Multi-dimension control model could make the terminal effects cooperate with phacoemulsification more precisely and protect post capsular from damage (chi(2) =5.41, P < 0.02). CONCLUSION: Multi-dimension control model could improve the accuracy of aspiration effects and protect postcapsular from damage.

Humans↗
PubMed1991

[Analysis of tumor DNA by flow cytometry on prostate cyto-aspiration product. Value of routine cytologic evaluation].

In this prospective study, flow cytometry DNA profile of 169 stage D2 prostatic carcinomas were compared with conventional cytologic data. Two transrectal fine-needle aspiration biopsies were performed in each patient. Aspirates were immediately fixed in 2% polyethylene glycol 1500* alcoholic solution (Merck). Suspensions were mixed and studied by a conventional cytologic technique (Papanicolaou) and by flow cytometry (propidium iodide stain on isolated nuclei). A highly significant correlation was found between the DNA profile and the cytologic grade (p less than 0.001). The DNA profile was bimodal in 14% (3/21) of aspirates containing benign or atypical cells, 18% (3/17) of grade I aspirates, 30% (13/43) of grade II aspirates and 71% (24/34) of grade III aspirates. Routine cytologic evaluation of cell suspensions evaluated by flow cytometry is important in clinical practice since both falsely unimodal and falsely bimodal profiles occur. Leukocytes or benign epithelial cells can interfere with the tumor cell population. In fine-needle aspirates, the broad range of non-malignant contaminating cells limits the value of immunocytochemistry and emphasizes the usefulness of routine conventional cytologic evaluation.

Adenocarcinoma↗
PubMedDate not supplied

Fine needle aspiration biopsy of the breast. Influence of the number of passes and the sample size on the diagnostic yield.

The sensitivity of fine needle aspiration (FNA) biopsy of the breast as a function of the number of aspirations performed on any given lesion was investigated. Four separate aspirations each were performed on over 400 lesions of the breast, 93 of which yielded a cytologic diagnosis. The incremental diagnostic yields of each subsequent aspiration were tabulated. The first aspirate of the sequence gave the greatest yield, with smaller incremental yields on the second through the fourth aspirates. Benign and malignant lesions gave similar results, as did palpable and nonpalpable lesions (the latter being usually smaller in size). A mathematical extrapolation of the data indicates that three or four aspirations of any given lesion provide the optimal yield within the limits of practicality. This performance of multiple FNA biopsies is particularly important when the pathologist does not perform the biopsy, or is unable to assist in the immediate interpretation of the specimen to assess its adequacy.

Biopsy, Needle↗
PubMedDate not supplied

Fine needle aspirates of follicular lesions of the thyroid gland. The intermediate-type smear.

In order to evaluate fine needle aspirates of thyroid lesions with features intermediate between those of follicular neoplasms and colloid nodules, 38 aspirates in which a definitive diagnosis had not been made were reviewed. On review, ten aspirates were excluded from the "intermediate" category; seven were reclassified as unsatisfactory and one as a cellular colloid nodule. Two papillary carcinomas showed a complex pattern not identified in smears from other lesions; these aspirates were also classified separately for independent evaluation. The remaining 28 aspirates were characterized by syncytial-type tissue fragments with mild nuclear atypia. The association of syncytial-type tissue fragments and orderly sheets and fragments forming a honeycomb pattern in the same aspirate indicated a colloid nodule, though a two-disease process could not be excluded. Of the aspirates containing only syncytial-type tissue fragments, 50% were from adenomas, 25% were from carcinomas, and 25% were from colloid nodules. Criteria to distinguish between the various follicular lesions were not identified in these smears.

Adenoma↗