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PubMed1989

Aspiration cytology in the diagnosis of head and neck masses: the early Christchurch experience.

Fine needle aspiration cytology has been performed on patients presenting with head and neck masses in Christchurch since mid-1985. The results of an initial 120 aspirations were reviewed. Histology was available to compare with the cytology result in 58% of cases. Clinical review was used to assess the accuracy of the cytology result in the remaining cases. The majority of the masses aspirated were of benign origin (72%). The cytological diagnosis was accurate in 79% of cases. Of the remaining aspirates, 13% were inaccurate and 8% nondiagnostic. The sensitivity for malignant lesions was 100%, with 86% specificity (for benign lesions). Particular diagnostic difficulty was found in the differentiation between some salivary gland tumours, and the assessment of aspirates from neck masses after combined therapy (radiotherapy and surgery). Fine needle aspiration cytology is of considerable value in the management of head and neck masses.

Adolescent↗
PubMed1989

Fine needle aspiration biopsy cytology of superficial lymph nodes: comparative with histopathology.

Fine needle aspiration biopsy cytology was done in 215 lymph nodes involving cervical, submandibular, supraclavicular, axillary and inguinal regions. One hundred and forty of these were diagnosed by histopathology after excisional biopsy or surgery, including 46 cases of metastatic tumor, 57 of lymphoma (46 were non-Hodgkin's lymphoma and 11 were Hodgkin's disease), and 37 of benign lymphadenopathy. Diagnosis of metastatic malignancy was easily made by aspiration biopsy cytology with a total sensitivity of 95.7% (44/46). The diagnosis of lymphoma was less satisfactory with a total sensitivity of 82.5% (47/57). The specificity for diagnosis of benign lymphadenopathy was 97.3% (36/37) with one false positive. The concordance of cell type in aspiration biopsy cytology and histopathology was 75% (33/44) in metastatic malignancy, and 73.5% (28/38) in lymphoma. Typical Reed-Sternberg giant cells were detected in 4 of 11 cases of Hodgkin's disease by aspiration cytology. Out of the 37 cases of benign lymphadenopathy diagnosed by aspiration cytology, 7 were cases of tuberculous lymphadenitis, of which typical Langhans' giant cells were found in 2, and acid fast stain bacilli in 3 cases. There was no complication or needle tract spreading throughout the procedure. We concluded that aspiration biopsy cytology is a simple, safe, reliable, and quick diagnostic method.

Adolescent↗
PubMed1989

Transrectal fine-needle aspiration and truecut needle biopsy of the prostate: a blinded comparison of accuracy.

Transrectal needle aspiration biopsy and core biopsy of the prostate were performed simultaneously on 88 men with prostatic nodules. Cytologic and histologic assessments were made in a blinded, independent fashion, and the results were compared. All patients with positive findings on aspiration also had positive findings on core biopsy, for a positive predictive value for aspiration of 100%. However, five negative and six "insufficient" results obtained by aspiration were positive on core biopsy, for a negative predictive value for aspiration of 88%. This experience support the use of needle aspiration as an initial diagnostic maneuver in the assessment of prostatic nodules.

Biopsy, Needle↗
PubMed1989

[A new apparatus using the Micro Ultra-Sonic Aspirator (MUSA) system for microneurosurgery].

Matsumoto was the first to present the NIIC UltraSonic Aspirator for CT guided stereotactic aspiration of intracerebral hematoma. Based on the NIIC Aspirator, the authors have developed a useful tool for microsurgery by adapting conventional ultrasonic aspirators. This was done by making the aspirator lighter and more handy for use during microsurgical procedures. A newly devised apparatus using the Micro Ultra-Sonic Aspirator (MUSA) was applied clinically to surgical treatment for brain tumors, arterio-venous malformations (AVMs) and intracerebral hematomas. Using the MUSA system, it became easier to remove successfully tumorous mass and the nidus of AVM, because it minimized the risk of injury to the normal structures such as the surrounding brain tissue, vascular systems and the cranial nerves.

Brain Diseases↗
PubMed1989

Aspiration of middle ear effusions prior to grommet insertion an etiological factor in tympanosclerosis.

Fifty-five children with bilateral middle ear effusions were entered into a prospective randomized double blind trial to determine whether aspiration of middle ear effusions prior to ventilation tube insertion influences ventilation tube extrusion time or the development of tympanosclerosis. Following myringotomy, aspiration of the left or right ear only was performed randomly prior to ventilation tube insertion. The tympanic membranes were inspected six-monthly to determine whether ventilation tube extrusion had occurred, and at 24 months after surgery for the presence of tympanosclerosis. Results showed no significant difference in extrusion time between aspirated and non-aspirated ears. Aspiration was found to be a factor in the development of tympanosclerosis. We conclude that routine aspiration of the middle ear effusion prior to ventilation tube insertion is associated with an increased risk of tympanosclerosis.

Child↗
PubMedDate not supplied

Value of fine needle aspiration cytology in the diagnosis of testicular neoplasms.

In 403 patients with a clinical suspicion of a testicular neoplasm, fine needle aspiration (FNA) was performed on the scrotal mass in 380 cases and on an extrascrotal swelling in 23 cases. There were 109 unsatisfactory aspirates. Fluid was aspirated in 50 cases, and only normal testicular elements were obtained in 82 cases. The aspirate showed an inflammatory lesion in 104 cases. A diagnosis of malignancy or suspicious for malignancy was given in 52 and 6 cases, respectively. Histopathologic confirmation of malignancy was available for 30 cases, for which the aspirate had been reported as malignant in 23, suspicious for malignancy in 3, unsatisfactory in 2 and negative for malignancy in 2. There were no false-positive FNA cytodiagnoses. No local seeding of tumor by the FNA procedure was observed. Typing of the testicular tumors on the aspirates showed a problem in classifying teratocarcinomas.

Biopsy, Needle↗
PubMed1989

[Transmission electron microscopy in the differential diagnosis of malignant neoplasms using fine-needle aspirates].

The results of application of transmission electron microscopy to the differential diagnosis of malignant tumors in needle aspirates are summarized. The analysis is based on the personal experience of the authors with 117 cases and the review of 223 cases published in the literature. The following four topics are discussed in detail: 1. Preparation of aspirates for transmission electron microscopic examination-limitations and advantages of various technical approaches. 2. Ultrastructural characteristics of malignant cells aspirated from various types of human tumors. 3. The diagnostic significance of ultrastructural examination of tumor cells in aspirates. 4. Transmission electron microscopy as compared to immunocytochemistry and to other methods used to aid differential diagnosis of needle aspirates. It is concluded that transmission electron microscopy when properly introduced into the diagnostic process helps to resolve many difficult problems of differential diagnosis of tumors in needle aspirates.

Biopsy, Needle↗
PubMedDate not supplied

Aspiration of ovarian cysts: laparoscopy or echography?

The authors present their experience from 1970 to the present on the laparoscopic aspiration of ovarian cysts and compare it with the more recent echographic aspiration technique. Since the risks of the aspiration of neoplastic masses cannot yet be evaluated, a strict selection of patients was carried out in order to perform the diagnostic and therapeutic aspiration of presumably benign masses. In addition, endometrial cysts were not included in the follow-up since these will be the object of a future communication, nor were dermoid cysts, removed during surgery itself. Out of 45 cases of laparoscopic aspiration with a follow-up ranging from 6 months to 4 years, 5 recurrences were observed, while the 15 cases of echographic aspiration (follow-up from 6 to 18 months) had 8 recurrences. We therefore believe that the latter, less invasive method, should be employed for diagnostic purposes only, while the laparoscopic method, which is more invasive and more traumatic, should be used when it is desirable to obtain also a therapeutic result.

Adult↗
PubMedDate not supplied

Ultrasonically guided fine needle aspiration of suggested enlarged parathyroid glands.

Ultrasonically guided fine needle aspiration from 22 ultrasonically suspect enlarged parathyroid glands was performed in 21 consecutive patients with biochemically confirmed hyperparathyroidism. Histologic examination revealed parathyroid tissue in 20 and thyroid tissue in 2 of the 22 ultrasonically suspect parathyroid glands. The aspirated material (21 patients) was analysed for PTH content and compared with the PTH content in aspirates from corresponding thyroid tissue. In all but one, a higher PTH content was found in aspirates from parathyroid glands. Further, the aspirated material (16 patients) was cytologically examined for parathyroid cells. In 10 of 14 histologically confirmed parathyroid glands cells of parathyroid origin were found, but in 4 cases only cells of endocrine origin were seen. The results and the use of fine needle aspiration in relation to the ultrasonic findings are discussed.

Adult↗
PubMed1988

[Aspiration cytology. New method in the diagnosis of cancer of the colon].

The method of cytologic samples by aspirative punction was successfully used in lesions that are accessible with common needles. The digestive tract's lesions are of more difficult access, and that is the reason why we do not known any antecedent with this method in the literature. Since 1978 we have thought about some way of taking the sample by fiberoptic devices in endoscopic explorations, adjusting to a polyethylene tube of suitable measure, as to exceed the colonoscopy, in the distal extreme, a little trocar and on its proximal extreme the adjustable part of the trocar for the adaptation of the syringe that makes the aspiration. It crosses through the biopsy channel of the colonoscope, puncturing the lesion and extracting the material by aspiration to prepare the cytologic smear, and fixing it for its further coloration and microscopic observation. We present the result of the aspirative cytology in 100 cases of tumoral or elevated lesions detected in the course of a colonoscopy, performing a comparative study with the exfoliative cytology and biopsy of the same cases, to compare the diagnostic positivity index between all the tree methods. We have studied 77 adenocarcinomas, 9 villous adenomas or polyps, 5 elevated lesions in long-evolution idiopathic ulcerative colitis and 3 inflammatory lesions. The aspirative cytology had greater positivity than the exfoliative one, complementing the judgement of biopsy studies in cases of malign neoplasia with great necrotic component. It must be underlined the utility of aspirative cytology method due to its simplicity, innocuousness and diagnostic security.

Adenocarcinoma↗
PubMed1988

Aspiration in rehabilitation patients: videofluoroscopy vs bedside clinical assessment.

This paper reports the results of a blinded study comparing videofluoroscopy with bedside clinical evaluations by speech/language pathologists in the diagnosis of aspiration. One hundred and seven inpatients from a general rehabilitation hospital were evaluated over a four-month period. Of the total patient population, 43 (40%) aspirated at least one consistency of food during videofluoroscopy. Bedside evaluation identified only 18 (42%) of these patients. The positive predictive value of bedside assessment was 0.75; negative predictive value was 0.70. Aspirators on videofluoroscopy were more likely to have brainstem or multilobe central nervous system involvement than nonaspirators. However, there was no statistically significant difference in lesion sites between clinically detected and "silent" aspirators. While the significance of aspiration noted on videofluoroscopy is debatable, it is clear that bedside evaluation alone underestimates the frequency of aspiration in patients with neurologic dysfunction.

Adult↗
PubMedDate not supplied

Fine needle aspiration biopsy of metastatic melanoma. A morphologic analysis of 174 cases.

The prognostic and therapeutic decisions in cases of metastatic melanoma depend upon the morphologic documentation of metastatic disease, which may rapidly and accurately be done by fine needle aspiration (FNA) biopsy of clinically suspicious lesions. The tumor cells derived from malignant melanomas demonstrate a wide range of appearances, however, and other neoplasms may be mimicked. Furthermore, additional neoplasms of other types are more frequent in melanoma patients: the possibility of a new primary tumor must be considered if the morphology of the tumor cells is uncharacteristic. Therefore, a study was undertaken to analyze the morphologic changes seen in FNA biopsy specimens from metastatic malignant melanoma and to determine which features could be the most useful in establishing a definitive diagnosis. A total of 174 consecutive cases, comprising 151 malignant aspirates and 23 inconclusive aspirates, were reviewed. The most significant features for identification of melanoma over other tumor types were the cell shape and nuclear position, the presence of numerous isolated neoplastic cells and occasional binucleated or multinucleated cells. Intracellular melanin in neoplastic cells was diagnostic when present, but it was absent in 60% of the cases. Macronucleoli and/or intranuclear cytoplasmic invaginations were characteristic but variable features. Morphology was also found to vary by site and cell type. Lung aspirates were less cellular and more likely to contain melanin. Aspirates of subcutaneous nodules were more often composed of spindle-shaped cells or of other variant cell types. Lymph node aspirates more often yielded epithelioid cells with macronucleoli and/or intranuclear invaginations. Spindle-cell melanomas usually demonstrated inconspicuous nuclei and rarely showed enlarged nucleoli. Epithelioid-cell tumors contained multinucleated cells and areas of cell wrapping more frequently than did spindle-cell tumors. The findings in this study emphasize that a full awareness of the spectrum of morphologic presentations of metastatic melanoma as well as of the clinical history are needed for greater precision in its diagnosis and for avoidance of the pitfall of misdiagnosing nonmelanomas with similar appearances.

Biopsy, Needle↗
PubMed1987

Percutaneous aspiration of peripancreatic fluid collections: a safe method to detect infection.

During the past 5 years, we have used percutaneous aspiration of peripancreatic fluid collections guided by computed tomography (CT) or ultrasonography (US) to facilitate diagnosis of infection in selected cases. Fifteen of 18 patients undergoing guided needle aspiration had persistent fevers (greater than 38.3 degrees C). The three afebrile patients all had abdominal pain and leukocytosis, and two of the three also had elevated serum amylase levels. Percutaneous aspiration was guided by CT in 14 patients and by US in four. On the basis of aspirate Gram stains and cultures, as well as surgical (15) and percutaneous drainage (1) findings, the final diagnosis was pancreatic abscess in nine patients, infected pseudocyst in four, uninfected pseudocyst in four, and cystadenoma in one. Diagnosis based on percutaneous aspiration was correct in 17 of 18 patients (94%), and no complications could be directly attributed to the procedure. We conclude that CT- or US-guided percutaneous aspiration is a safe and accurate diagnostic procedure for patients with peripancreatic fluid collections in whom secondary infection is suspected.

Abscess↗
PubMed1987

Flow cytometric determination of ploidy and proliferative activity on isolated bone marrow particles and on total bone marrow aspirate.

The nuclear DNA content distribution of peripheral blood (PB) and bone marrow (BM) cells was determined by propidium iodide flow cytometry in 33 patients who underwent BM aspiration for diagnostic purposes. Two types of BM samples were taken during every aspiration procedure: whole BM aspirate, composed of BM particles contaminated by PB cells; isolated BM particles. Proliferative activity was calculated as the percentage of cells with DNA content intermediate between the diploid (2n) and the tetraploid (4n) values (2n-4n%). Ploidy was expressed as the ratio between the modal channel of the G0-G1 peak of the probe and that of an internal reference standard (DNA index, DI). The 2n-4n% was very close to zero in all PB samples. It was significantly greater in BM particles (21.2 +/- 6.6%) than in whole BM aspirate (16.6 +/- 5.5%, p less than .0005), with a close correlation (r2 = 66; p less than .0001) between the two values. Aneuploid stem lines were found in BM but not in PB. The DI of BM stem lines were similar in whole BM aspirate and BM particles, but the percentage of aneuploid cells was usually higher in BM particles. The reduced proliferative activity and the lower percent of aneuploid cells found in whole BM aspirates, with respect to BM particles, can be attributed to the contamination of BM tissue by PB, which had a very low proliferative activity and did not show aneuploidy. BM particles are therefore an easily obtained and reliable sample for routine evaluation of proliferative activity and ploidy of BM cells by DNA flow cytometry.

Aneuploidy↗
PubMed1987

Evaluation of a filter aspiration technique to determine membrane deformability.

A filter aspiration technique for the measurement of red cell membrane deformability described by Brailsford et al. (Blood Cells 1977;3:25) was evaluated. Pore diameters of 0.6 and 1.0 micron were used. Portions of red cells were aspirated with various hydrostatic pressures between 1 and 9 mm H2O. After fixation the filter was removed and the length and radius of the pressure-induced tongues measured by scanning electron microscopy. One to several tongues per cell were observed. The number of tongues had no influence on the measurements at pressures less than or equal to 7 mm H2O. The elastic modulus of the red cell membrane was calculated; it yielded 2.9 (+/- 0.4) X 10(-3) dynes/cm. Data obtained with filter aspiration were compared with the results obtained concurrently with the micropipette technique. A good correlation was found for normal red cells (r = 0.74, P less than 0.001). Stomatocytes produced by chlorpromazine in vitro had an increased elastic modulus with both methods. For echinocytes produced by salicylate or adenosine triphosphate depletion, the elastic modulus as determined by filter aspiration was normal, but the modulus as measured by micropipette aspiration was increased. Possible reasons for the difference are discussed. We conclude that the filter aspiration is a valid technique to measure elastic properties of red cell membranes, except when there are surface irregularities, such as those in the echinocytes.

Erythrocyte Deformability↗
PubMedDate not supplied

Bronchial submucosal needle aspiration performed through the fiberoptic bronchoscope.

Retrospective review of 251 bronchial submucosal needle aspirations obtained from 171 patients with unsuspected pulmonary malignancy showed that adequate cytologic material was obtained in 87.6% of the aspirations. Eighty-one patients were found to have primary bronchogenic carcinomas (with a visible endobronchial tumor in 39), and 21 had secondary pulmonary metastases. The overall diagnostic accuracy of bronchial submucosal aspiration was 81%, with only four definite false-negative and no false-positive results. The diagnostic accuracy was 82% for bronchial brushing, 71% for forceps biopsy, 67% for postbronchoscopy sputum cytology and 46% for bronchial washing. The major advantage of the submucosal aspiration technique was in evaluating mural mucosal lesions, especially those covered with intact mucosa, that were not readily accessible to forceps biopsy or successful brush sampling. Negative results from a needle aspiration must be interpreted with caution because of the small area a single sample represents. Multiple sequential submucosal aspirations may be helpful in assessing the resectability of bronchial neoplasms. No complications have been encountered with this technique.

Biopsy, Needle↗
PubMed1983

Efficacy of preoperative hip aspiration performed in the radiology department.

The results of 148 preoperative hip aspirations performed in the radiology department were analyzed and compared with those of preoperative aspirations done in the operating room in another group of patients. The aspirations were performed in a standard fluoroscopic room used only for "clean procedures"; strict aseptic precautions were used. The majority of patients had undergone prosthetic hip arthroplasty. The results were comparable, i.e., the sensitivity for the radiologic aspirations was 0.88, as compared with 1.00 for intraoperative aspirations; the specificities were 0.83 and 0.78, respectively. The advantages of aspirations done in the radiology department include lower cost, shorter hospitalization, and simultaneous performance of arthrography, if indicated. Important aspects of technique include meticulous aseptic precautions, avoidance of local anesthetics, and prompt transportation of the specimen to the laboratory.

Adolescent↗
PubMed1983

Diagnostic endometrial aspiration with the Karman cannula.

Endometrial aspiration with the Karman cannula can be used to detect endometrial pathology. To document the feasibility and accuracy of endometrial aspiration with this cannula, 49 women were evaluated by this technique prior to diagnostic dilation and curettage (D&C). Completion rates for both endometrial aspiration and D&C were 96%. Endometrial aspiration yielded tissue adequate for histologic evaluation in 82% of cases as compared with 76% of D&C cases. Three cases of cancer (two endometrial and one endocervical) were identified by both techniques. A majority of patients expressed a preference for endometrial aspiration over D&C. Endometrial aspiration with the Karman cannula appears to be a convenient, accurate and acceptable method of detecting endometrial pathology.

Biopsy, Needle↗