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Ultrasonically guided needle aspiration biopsy in the diagnosis of advanced superior vena cava syndrome.

From July 1990, 11 cases with advanced superior vena cava (SVC) syndrome were undergone ultrasonically guided needle aspiration or biopsy. Ten cases were diagnosed by thin-needle aspiration cytology. Two cases with cytologic proven lymphoma and one case without cytologic diagnosis were undergone needle biopsy, and two of them were proven to be lymphoma. The diagnostic rate of aspiration cytology was 91.0% (10/11) and of aspiration biopsy was 66.6% (2/3). The diagnostic rate of combination of aspiration cytology and biopsy was 100%. For reducing the incidence of pneumothorax, we strongly recommend this two-stage procedure that needle biopsy was performed only when cytologic diagnosis was not conclusive. Only one case developed pneumothorax in performing needle biopsy. In conclusion, ultrasonically guided needle aspiration biopsy is a safe, convenient, and high-yield diagnostic procedure for selected cases of advanced SVC syndrome.

Adult↗

Breast cyst aspiration.

The breast mass is a clinical problem commonly encountered by family physicians. Fine-needle and core biopsy techniques require training and cytopathologist support. In contrast, breast cyst aspiration using a 21- or 22-gauge needle is a simple, cost-effective, minimally invasive procedure. The technique is easy to learn and can be practiced on a breast model. Breast cyst aspiration may be attempted in many women who present with a palpable, dominant breast mass. If clear fluid is aspirated and the mass resolves, malignancy is unlikely, and breast cyst is the probable diagnosis. In this situation, reevaluation in four to six weeks is appropriate; if the cyst has not recurred, only routine mammographic surveillance is required. Referral for fine-needle or excisional biopsy is indicated if the aspirate is bloody or extremely tenacious, if no fluid can be aspirated, or if there is residual mass after aspiration. Complications such as local discomfort, bruising, and infection are uncommon.

Biopsy, Needle↗

Fine-needle aspiration cytology of the adrenal gland. Fifty biopsies in 48 patients.

Fine-needle aspiration biopsy of 50 adrenal masses from 48 patients was performed between 1984 and 1991. The series consisted of 28 males and 20 females, with an age range of 12 months to 79 years (mean age, 55 years). Clinical and/or pathologic follow-up was available in 37 patients. Fine-needle aspiration was diagnostic in all 29 malignant cases having follow-up, with no false-positive diagnoses. There were six primary malignancies (three neuroblastomas, two pheochromocytomas, and one adrenal cortical carcinoma) and 23 metastatic lesions. Of these, the lung was the most frequent primary malignancy (60%), followed by melanoma and renal cell carcinoma (8.6% each). The remaining nonmalignant fine-needle aspiration diagnoses were adrenal cortical neoplasms (most likely adenoma), adrenal cortical hyperplasia, myelolipoma, benign adrenal tissue, and abscess. Based on clinical follow-up, three other adrenal adenomas were not diagnosed by fine-needle aspiration. Six biopsy specimens (12%) were insufficient for diagnosis. Ancillary studies including electron microscopy and/or immunocytochemistry were performed on 13 malignant aspirates and provided additional confirmation of the cytology diagnosis in 12 cases. This study confirms that fine-needle aspiration is a sensitive and highly specific procedure for the evaluation of primary and metastatic malignancies involving the adrenal gland. The technique is less useful in the workup of benign processes but, in some instances, can provide specific diagnostic information.

Adolescent↗

Fine needle aspiration of unilocular ovarian cysts--a cytohistological correlation.

OBJECTIVE: To assess the diagnostic efficacy of Fine Needle Aspiration Cytology in differentiating neoplastic and non-neoplastic dysfunctional ovarian cysts--cytological findings to be verified with histology of excised cyst. METHODS: In this prospective study fifty-three cases with unilocular nonseptate ovarian cystic masses,detected on ultrasound examination were subjected to ultrasound guided fine needle aspiration of the cyst contents at Department of Pathology, Allama Iqbal Medical College Lahore, from January 1999 - January 2000. Aspirated fluid was examined cytologicaly using Giemsa stain on the smears prepared from centrifuged deposit. The same cyst removed surgically was examined histologicaly and cytohistological correlation was carried out. RESULTS: In this series of 53 cases, histologically confirmed break up of various types of cysts was follicular cysts (n=25), leuteal cysts (n=6), serous cysts (n=15), mucous cysts (N=4) and Endometriotic cysts (n=3). Non-diagnostic fine needle aspirate was obtained in 19/53 cases, majority being the follicular cysts. The cytohistological correlation revealed no false positive but 40% false negative results for follicular cysts on cytological examination of the aspirate. Hence the specificity and sensitivity for cytological diagnosis of follicular cyst was 100% and 60% respectively. For leuteal cysts, false positive and false negative results on cytological examination were 0% and 16.6% respectively with a specificity and sensitivity value of 100% and 83% respectively. For neoplastic serous cysts cytologically false positive and false negative diagnosis was 0% and 46.6% respectively with specificity and sensitivity of 100% and 53%. For mucinous cystadenomas sensitivity and specificity of cytological diagnosis was 100%. For endometriotic cysts a sensitivity of 67% and specificity of 100% was procured with cytological evaluation. CONCLUSION: Guided fine needle aspiration cytology may prove to be one of the most valuable and acceptable tools in the differential diagnosis of ovarian cystic lesions.

Adult↗

Carcinoembryonic antigen assay in fine needle aspirate of pancreas: a diagnostic adjunct to cytology.

Carcinoembryonic antigen (CEA) was measured in 21 consecutive fine needle aspirates (FNA) of solid pancreatic lesions from 20 patients to determine whether elevated levels would predict the presence of pancreatic carcinoma in cytologically negative aspirates. Final diagnoses were correlated with clinical, radiologic, and pathologic (four patients) findings and follow-up. Twenty aspirates had malignancy, and one was benign. FNAs were performed under radiologic guidance with a 22-gauge Chiba needle and a 20-ml syringe. Cytologic examination was rendered on Papanicolaou-stained slides and, when available, hematoxylin and eosin-stained cell blocks. CEA was measured by enzyme immunoassay (Abbott Laboratories). Sensitivity of cytologic diagnosis was 80%; specificity was 100%. With 5 ng/ml as cutoff, the sensitivity of CEA for malignancy was 70% and for adenocarcinoma of pancreas, 78%; the specificity was 100%. The mean CEA in pancreatic carcinoma was 152.1 ng/ml (range 1.4 to greater than 880 ng/ml). The mean CEA for lymphoma, metastatic lung carcinoma, and benign aspirate was 1.0 ng/ml. Elevated CEA was diagnostic of pancreatic carcinoma in three cytologically negative aspirates. Combined sensitivity of CEA and cytology was 95%. Elevated CEA in FNA of pancreas increases the sensitivity of cytologic diagnosis and may suggest carcinoma in cytologically negative aspirates.

Adenocarcinoma↗

Factors predicting early diagnosis of foreign body aspiration in children.

OBJECTIVES: To analyze the clinical spectrum of tracheobronchial foreign bodies in children and explore the clinical features which could facilitate early diagnosis. METHODS: We retrospectively studied pediatric patients who had aspirated foreign bodies over the past 5 years from July 1998 to July 2003 in a tertiary children hospital in northern Taiwan. Patients were divided into 2 groups according to the elapsed time from aspiration to definite diagnosis as early (< or =24 hours after aspiration) and late diagnosis (>24 hours after aspiration). The 2 groups were compared for clinical features, radiological findings, and the influence of morbidity and mortality of early- and late-diagnosed foreign body aspiration (FBA). RESULTS: A total of 53 patients (27 boys, 26 girls) were recruited with a median age of 25.4 +/- 21.3 months. FBA was suspected by the parents in 59% of patients. Sudden onset of cough (72%), dyspnea (64%), and wheeze (60%) were the predominant symptoms and signs. Nuts and peanut (59%) were the most common foreign bodies aspirated. Obstructive emphysema (53%) and normal chest radiograph (34%) were the most frequent radiological findings. Parenchymal consolidation with pneumonia was predominant in the group of late diagnosis (P < 0.05). Bronchial asthma (n = 9), pneumonia (n = 8), and common cold (n = 5) were the most common mistaken diagnoses. Witnessing of choking episode was the most important historical event to pinpoint an early diagnosis of FBA in children (P = 0.002). CONCLUSIONS: In children with an unequivocal choking event while eating even with normal physical and radiographic findings, FBA requires to be excluded by thorough investigations in such instances. Similarly, in toddlers with unexplained persistent cough with refractory parenchymal infiltrates, unrecognized FBA should also be considered. A witnessed choking event is the most important historical information to make an early diagnosis of FBA.

Bronchi↗

[The role of fine-needle aspiration in the diagnosis of thyroid nodules].

The aim of this study was to prospectively evaluate the sensitivity, specificity and accuracy of fine-needle aspiration of thyroid nodules. From January 1978 to December 2003, 497 patients underwent fine-needle aspiration of thyroid nodules and then thyroidectomy. Fine-needle aspiration was performed with a fine 23-25 gauge and the aspirate was fixed and dyed with May-Grounwald-Giemsa method. The results of cytology were divided into four groups: positive for malignancy (77 patients), negative for malignancy (370 patients), suspect for malignancy (34 patients) and not diagnostic (16 patients). Suspect specimens also included follicular neoplasm and Hürthle cell neoplasm. Fine-needle aspiration results were compared with histopathologic analysis after thyroidectomy. There were 2 false-positive (0.5%) and 5 false-negative patients (1%). Sensitivity, specificity and accuracy were respectively 94.7%, 99% and 98.4%. This study confirms that fine-needle aspiration of thyroid nodules can be performed easily with high sensitivity, specificity and accuracy.

Adolescent↗

Ultrasound-guided fine needle aspiration biopsy in differential diagnosis of portal vein tumor thrombosis.

BACKGROUND: Portal vein tumor thrombosis (PVTT) is a serious complication and a major metastatic way of hepatocellular carcinoma(HCC). But portal vein benign thrombosis(PVBT) always appears in patients with hepatocirrhosis, and PVTT should be differentiated from PVBT. The aim of this study was to probe the value of ultrasound-guided fine needle aspiration biopsy in differential diagnosis of PVTT. METHODS: Twenty-two HCC patients with portal vein thrombosis and 8 hepatocirrhosis patients with portal vein thrombosis were studied by ultrasound-guided fine needle aspiration biopsy. Twelve portal vein thrombosis filling portal vein embranchment of the 30 portal vein thrombosis patients were examined by 18G automatic biopsy. The positive rates of aspiration biopsy cytology and histology were calculated and compared with those of automatic biopsy. RESULTS: The positive rates of fine needle aspiration biopsy cytology and histology were 93.3% (28/30) and 90.0% (27/30), respectively. They were not different markedly from that of automatic biopsy 91.7% (11/12). In aspiration biopsy of 22 HCC patients with PVTT, HCC cellular was found in 19 portal vein thrombosis patients (86.4%) by cytology examination and in 18 portal vein thrombosis patients (81.8%) by histology examination. In total, 20 tumor thrombi were detected. The other two were diagnosed as benign thrombosis. No HCC cell and/or tissue was observed in 8 patients with hepatocirrhosis associated with portal vein thrombosis. CONCLUSIONS: Ultrasound-guided fine needle biopsy in detecting PVTT shows a high positive rate and is of diagnostic value. The positive rate is not apparently different from that of automatic biopsy. Hence the case that fails to be diagnosed by color Doppler flow imaging(CDFI) and pulsed Doppler can be detected early by ultrasound-guided fine needle aspiration biopsy.

Biopsy, Needle↗

HCV/PCR positivity in bile and doudenal aspiration of fascioliasis and/or HCV patients.

In this study, three bile aspirates taken from 10 fascioliasis patients (30.0%) showed HCV positivity by PCR/RNA. Also, four duodenal aspirates (66.7%) taken from six HCV/PCR-RNA positive patients and three duodenal aspirates (20%) taken from 15 pure fascioliasis patients showed HCV positivity by PCR/ RNA. This is the first time to demonstrate HCV/PCR-RNA in the bile and duodenal aspirates of fascioliasis patients and in the duodenal aspirates of HCV patients. So, PCR can be used for the detection of HCV in the bile and/or duodenal aspirates of HCV suspected patient. On the other hand, this outcome results may incriminate HCV infection as a concomitant with fascioliasis or incriminate fascioliasis as paving the way to HCV.

Adult↗

Interinstitutional comparison of performance in breast fine-needle aspiration cytology. A Q-probe quality indicator study.

In 1989, the College of American Pathologists, Northfield, Ill, instituted a voluntary quality assurance program, called "Q-Probes," that utilized nationwide interinstitutional peer comparison. One of the anatomic pathology modules retrospectively assessed performance in fine-needle aspiration cytology (FNAC) of the breast from cytohistologic correlations that were made in 294 institutions by 988 pathologists on their own cases that were accessioned during a 6-month period. Of the 13,066 cases of FNAC, 10,751 (82%) were satisfactory for evaluation. Of these satisfactory aspirates, 3471 cases (33%) had histologic correlation, which formed the basis for determining diagnostic accuracy. Of breast aspirates, 2254 (17%) were unsatisfactory for evaluation, with the mean frequency of unsatisfactory aspirates obtained by nonpathologists (18%), ie, more than twice that of unsatisfactory aspirates obtained by pathologists (7.2%). In the diagnosis of breast cancer by FNAC, the following performance results were derived with the use of the aggregate data: 82% sensitivity of the FNAC procedure, 97% sensitivity of diagnosis, 97% specificity, 95% positive predictive value, 86% negative predictive value, and 90% efficiency. No significant difference in performance was detected when institutions were stratified by six peer group characteristics. We made the following conclusions: (1) the aggregate and median breast FNAC performance values obtained from this interinstitutional comparison of data from routine procedures performed in diverse settings in North America compared very favorably with performance from single institutions published in studies of similar design in the literature, and (2) these data may provide a reference point for participant institutions to measure future quality improvement in fine-needle aspiration of breast.

Biopsy, Needle↗

[Evaluation of CT-guided stereotactic hematoma aspiration in mild cases with putaminal hemorrhage].

Reported here is the effectiveness of surgical management in mild cases with putaminal hemorrhage (neurological grading 1 or 2, described by Kanaya, et al.). Ten cases were treated by CT-guided stereotactic hematoma aspiration (aspiration group), and another 10 cases were treated by only medical therapy (conservative group). The mean interval from the onset to operation was 7.2 days. In both groups, serial change in the motor function of the upper extremity was examined and the neuropsychological function was also evaluated at 2 weeks after onset. Perifocal low-density area around the hematoma was estimated on CT scan at 2 weeks after onset. Mean hemispheric cerebral blood flow (mCBF) was measured at 5-days, 2 weeks and 6 months after onset, respectively in each group. The activity of daily life (ADL) was evaluated at 6 months after onset. There was no statistically significant difference in age, neurological grading and CT findings on admission between the 2 groups. At 2 weeks after onset, no case had deteriorated in motor function in the aspiration group. On the other hand, 2 cases had deteriorated in the conservative group. The neuropsychological function was considerably improved in the majority of cases in the aspiration group. Perifocal low area was significantly narrow on CT scan in the aspiration group. At 2 weeks after onset, the mCBF of the affected side was 53.8 +/- 6.0 ml/100g/min in the aspiration group, whereas it was 42.0 +/- 5.7 ml/100g/min in the conservative group. This difference was statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Basal Ganglia Diseases↗

Ultrasonographic findings in relation to ease of aspiration and fluid characteristics in thyroid cyst.

Sixty-six thyroid cysts in 65 patients were studied prospectively using the aspiration method and ultrasonography. The major post-aspiration ultrasonographic change was thyroid tissue enlargement in 95% (62/65) in addition to the decreased size of the thyroid cysts in all. More than double increments of thyroid tissue could be noted in 54% (35/65) of the patients. The color of cystic fluid was related to the duration of the cyst and internal echogenicity (p less than 0.01 and p less than 0.02, respectively). Acute hemorrhage usually had a dark-reddish fluid and an increased echogenicity. The viscosity of the cystic fluid could influence the success rate of aspiration (p less than 0.05). The effect of aspiration was not good if the thyroid cyst had thick gelatinous fluid. Because a cystic goiter may be associated with malignancy, aspiration biopsy should be performed after the fluid is drawn especially if the thyroid tissue is expanded. If there is no evidence of malignancy, aspiration can be tried more than once if the cyst reappears.

Adolescent↗

Myospherulosis. Fine needle aspiration cytologic findings in 19 cases.

An analysis was made of 19 cases of myospherulosis seen on fine needle aspirates of mammary and subcutaneous tissue masses. Myospherulosis, best seen with the Papanicolaou stain, appeared as 4 microns to 7 microns spherules that were homogeneously smooth or contained one or more internal dense bodies. The spherules were dispersed singly or aggregated into sac-like structures. Myospherulosis accompanied 16 benign and 3 malignant conditions. In two aspirates, myospherulosis was seen simultaneously with breast carcinoma; in another, fat necrosis with myospherulosis masked an underlying breast malignancy. In 10 of the 12 aspirates from patients with previous tissue trauma, it accompanied evidence of fat necrosis and mesenchymal repair; in 4 aspirates, no other underlying condition was apparent. These findings indicate that myospherulosis is not an uncommon finding in fine needle aspirates of fatty sites; it often accompanies fat necrosis and mesenchymal repair. The presence of myospherulosis in aspirates of clinically suspicious masses does not exclude an underlying malignancy.

Biopsy, Needle↗

Morphologic and immunocytochemical evaluation of 220 fine needle aspirates of malignant lymphoma and lymphoid hyperplasia.

A total of 220 fine needle aspiration (FNA) specimens from 212 patients with clinically suspected or previously histologically confirmed lymphoma were evaluated by cytology in conjunction with immunophenotyping analysis of the aspirate; the results were compared with the histologic diagnosis made on previous or current accessions of lymph node or extranodal tissue. Smears of the aspirates were stained with the Diff-Quik and Papanicolaou stains while immunoperoxidase staining using antibodies against kappa and lambda immunoglobulin light chains and Leu-4 was routinely performed on Cytospin preparations. Where indicated, additional marker studies (including T-200, Leu-1, Leu-2a, Leu-3a + 3b, Leu-M1, B1, Leu-12, IgM, CALLA and TdT) were performed. For the non-Hodgkin's lymphomas, specimens were classified by the cytologic characteristics of the neoplastic cells according to the International Working Formulation scheme. The combination of cytologic smears and immunoperoxidase studies resulted in a diagnosis of lymphoma in 173 cases (79%). The remaining aspirates were interpreted as suspicious for lymphoma (7%), benign (10%) or inadequate for diagnosis (4%). Of the 15 suspicious aspirates, 5 proved to be Hodgkin's disease and 2 to be T-cell lymphoma by subsequent biopsy. The cause of failure in the nine inadequate aspirates were necrosis (3 cases), sclerosis (2 cases) and faulty technique (4 cases). In the cases that had concurrent tissue biopsies, no false-positive diagnoses were rendered. These results indicate that FNA used in association with immunocytochemistry is a reliable tool for establishing the diagnosis and classification of the majority of cases of lymphoma. Optimal immunoglobulin light-chain ratios for defining monoclonality in FNA specimens of B-cell lymphomas are proposed.

Antigens, Differentiation, B-Lymphocyte↗

[Comparative study of the data of fine-needle aspiration biopsy and echographic aspects of hepatic tumors as a function of the circumstances of discovery. Apropos of 206 patients].

This study was carried out in order to compare the accuracy of ultrasound and ultrasonically guided fine-needle aspiration biopsy in screening for tumoral hepatic syndrome in 206 patients. According to their different clinical presentations, patients were divided into 4 groups: 1: Documented cancer, 2: Hepatic cirrhosis, 3: Fortuitous ultrasonic detection, 4: Clinical hepatic tumor. Cytologic findings were divided into 4 types: benign, primary malignant tumor, secondary malignant tumor (with or without etiologic orientation) non significant result. The ultrasonic and cytologic results were retrospectively compared to definitive diagnosis which was known in 199 patients. No early or delayed complications related to fine-needle aspiration biopsy were recorded. Ultrasonic imaging globally suggested the final diagnosis in 116 patients (diagnostic precision: 58.2 percent) while the cytologic result corresponded to final diagnosis in 183 patients (diagnostic precision: 92.5 percent). Improved results by fine-needle aspiration biopsy with regard to ultrasound was recorded in each group, particularly in group 3; its diagnostic sensitivity was 92 percent for malignant lesions with 100 percent specificity and an excellent value in discriminating between their primitive or secondary nature. Fine-needle aspiration biopsy gave an exact etiologic orientation in half of cases with metastasis and helped to discover the primitive tumor in some patients when this was not known previously. We conclude that fine-needle aspiration biopsy is a simple, moderately invasive and accurate procedure in the diagnosis of hepatic lesions. As ultrasound alone is not suggestive, especially in the case of a fortuitous ultrasonic detection, fine-needle aspiration biopsy improves diagnostic precision.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Stereotactic aspiration using coordinate software for hypertensive intracerebral hematomas].

Stereotactic aspiration for intracerebral hematoma has become widely used due to improvements in computed tomography (CT). CT-guided stereotactic aspiration for hypertensive intracranial hematomas was performed in 46 cases. Stereotactic aspiration with coordinate software was carried out among 16 cases. We compared the clinical results of conventional stereotactic aspiration with results of the new method using coordinate software. Using coordinate software, we can examine the route for the target point, as well as the target point of the hematoma before surgery. Therefore we can avoid obstacles such as ventricles and internal capsules. Further, we can aspirate hematoma by using only this one procedure. Mean hematoma aspiration percentage has risen from 44.9 to 87.2% by using coordinate software. Rate of drainage tube insertion after operation has decreased from 90 to 50%. The period of placement of the drainage tube and the frequency of infection due to the drainage tube has become lower, too. Therefore we can say that the outcome of treatment of hypertensive intracranial hematomas is improved by using coordinate software.

Cerebral Hemorrhage↗

High frequency of elongated platelet forms in guinea pig blood: ultrastructure and resistance to micropipette aspiration.

Elongated cylindric and beaded platelet forms are infrequently observed in the circulation, and have been termed "proplatelets," as presumed precursors to discoid platelets. Some 15% of the blood platelets obtained from the guinea pig by cardiac puncture were elongated forms (1/5 beaded and 4/5 cylindric) under conditions of steady state thrombopoiesis, thus providing an opportunity to contrast the structure and deformability of platelets of potential graded maturation. Ultrastructural studies were consistent with graded maturation. Longitudinal bundles of microtubules in cylindric platelets gave way to the appearance of basket-weave arrays in the nodal thickenings of beaded forms, and, finally, to circumferential coils in a portion of the discoid platelets. Individual platelets were aspirated into micropipettes of 0.8 microns internal diameter by application of incremental pressure up to a maximum pressure of 10 cm water. None of the guinea pig platelets fragmented into smaller forms even when aspiration was performed under physiologic environmental conditions. All the guinea pig platelets passed through the micropipette in aspiration studies performed under conditions minimizing platelet activation and adhesion. Elongated platelets aspirated at the very ends of the cells passed through the pipette at lower pressure than discoid forms, whereas elongated platelets aspirated along the length of the cell were more resistant to deformation and cell passage than were discoid platelets. Beaded forms were similar in deformability to cylindric platelets at low aspiration pressure but were more resistant to deformation at high pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Presurgical determination of estrogen receptor status using immunocytochemically stained fine needle aspirate smears in patients with breast cancer.

We have developed an immunocytochemical staining procedure (ERICA) using a monoclonal antibody to the estrogen receptor (ER) to determine ER status from samples obtained by fine needle aspiration of primary and recurrent breast cancer tissue (cyto-ERICA). ER status was assessable on 214 of 246 smeared aspirates from breast cancer patients. In 143 (66.8%) assessable smears positive nuclear staining was observed but was completely absent in 71 (33.2%) cases. In 107 cases we were able to compare results with those obtained with the quantifiable dextrancoated charcoal (DCC) radioligand binding technique using surgically excised material. We observed qualitative agreement in 53 of 62 (85.5%) of primary specimens and 16 of 16 (100%) recurrent samples compared to the subsequent DCC result on the same sample. Aspirates obtained from new secondary deposits were also assessed and in 16 of 19 (84.2%) cases results agreed with that established previously by DCC on the primary breast tumor. In a further 6 of 10 (60%) cases the cyto-ERICA result obtained from recurrent samples qualitatively agreed with that determined by DCC on a previous recurrent lesion. A comparison of staining of aspirates was also made against frozen tissue sections stained with the monoclonal antibody (tissue-ERICA). Where comparison was made of primary tumor specimens agreement was observed in 40 of 45 (88.9%) of cases while specimens from secondary lesions agreed qualitatively in 14 of 17 (82.3%) of cases. In a small number of samples where tissue-ERICA was performed on an earlier lesion to that aspirated for cyto-ERICA an agreement of 4 of 5 (80%) was observed. This technique shows good sensitivity in demonstrating ER in aspirate specimens, should therefore permit us to determine ER status before surgery for primary breast cancer, and may also mean that surgery for recurrent disease to determine receptor status is no longer necessary.

Antibodies, Monoclonal↗