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PubMedDate not supplied

Aspiration cytology and E2 content in ovarian tumors.

This study demonstrates the reasonable reliability of fine needle aspiration cytology in ovarian tumors: 91% of benign and 84.5% of malignant tumors were diagnosed correctly by aspiration cytology. The concentration of estradiol-17 beta in cyst fluid may be helpful in distinguishing follicle cysts from neoplastic cysts. Cytologic differentiation of aspirated ovarian tumors was reasonably accurate. With respect to the approximately 1.6% of severe pelvic inflammations in our patients, we suggest that there are few indications for the use of aspiration cytology in ovarian tumors. In spite of a worldwide trend towards cytologic diagnoses by means of aspiration biopsy, there are still few studies on the aspiration biopsy of ovarian tumors. This is surprising because fine needle puncture of ovarian tumors is neither more trouble-some nor more complicated than the well-established cytologic biopsy of the prostate. This paper reports on the reliability of this method and its capability in the differentiation of various types of ovarian tumors. The differentiation of ovarian cysts is of particular interest.

Adolescent↗
PubMedDate not supplied

Aspiration cytology of breast cysts.

A cytologic evaluation was made of 57 samples of fluid aspirated from cystic breast masses during the past 12 years in our hospital. The cytologic diagnosis of the cyst aspirates from 17 cancer cases was positive in 10 cases, suspicious in 2 and negative in 5. No false-positive cytologic diagnosis was made in 40 cases of benign cystic disease. Blood-tinged aspirates were observed in 14 of the 17 cases of malignant cystic disease but in only 2 of 40 benign cases. Ductal cell clusters were detected in aspiration smears from 16 of the cases of malignant cystic disease and 15 of the cases of benign cystic disease. Apocrine cells were seen in the aspiration smears from 12 of the cases of benign cystic disease but in none of the aspirates from the 17 cancer cases.

Breast Diseases↗
PubMed1982

[Cancer of the ovary: the usefulness of Cul-de-sac aspiration and the level of carcino-embryonic antigen in the peritoneal fluid].

While it is useful to carry out aspiration from the Pouch of Douglas for screening for cancer of the ovary, the technique is irreplaceable for the follow-up of tumours that have been operated on or irradiated or treated with chemotherapy. We have carried out 1,353 aspirations: 189 of these which were done routinely have been equivocal. 380 aspirations that were carried out because of abnormal symptoms led to the discovery of 26 cancers of which 2 were very early ones. 784 aspirations were carried out for follow-up. There were in all 4.8% blank aspirations, 0.5% false positives and 1.6% false negatives, which is an indication of the reliability of the method so long as certain points in the technique are carefully followed. These figures, which are quoted as a percentage of the total number of aspirations, however, become more important when considered as a percentage of the number of cancers that were diagnosed (5.5% false positive and 18% false negatives). Furthermore, the level of C.E.A. in peritoneal fluid is a method which can be added to cytology in following up the progress of the disease which is not to be dismissed.

Adolescent↗
PubMed1982

[Endometrial cytology by endocyte and by Masubuchi's aspiration technic --a comparative study--].

Lately there is a tendency for an increase in the incidence of endometrial cancer both in this country and other industrialized countries such as the United States. The routine cervicovaginal smear method is generally poor for the detection of endometrial carcinoma as compared to that used for the diagnosis of early cervical neoplasms. The principal reason for the poor detection rate is that the cells are not obtained directly from the lesion as is the case with disease of the cervix. Various techniques for obtaining endometrial cells directly from the lesions have been described, but none has enjoyed wide acceptance by the clinicians. The patients for this study consisted of 138 women who were referred to us for diagnostic curettage. We employed the new disposable device, the Endocyte, and Masubuchi's endometrial aspiration and compared the results. After obtaining specimens with both methods curettage was performed on all patients. In addition, the Endocyte was employed on 8 patients with endometrial carcinoma in another hospital, and the following results were obtained. 1. With the Endocyte it is possible to obtain a larger volume of cells than by aspiration. 2. Although a certain amount of difficulty is encountered in the insertion of the Endocyte in some cases, it is much easier than the brush method used heretofore. 3. No significant difference in the amount of bleeding after insertion could be observed between the two methods. 4. In patients with bleeding in the endometrium and pyometra it is easier to obtain specimens from the endometrium with the Endocyte than by aspiration. 5. With the Endocyte contamination of the cells of the cervix was less than after aspiration. 6. Although pain during collection of cells with the Endocyte was somewhat stronger than during aspiration, analgesics were not necessary in any one of the cases. 7. The Endocyte was used on 13 patients with endometrial carcinoma, and all specimens were positive for carcinoma. From the results of our study we conclude that for endometrial cytology the Endocyte is as useful as the aspiration method. Furthermore, it should pose no difficulty to the gynecologists to use the Endocyte because the Endocyte resembles IUD structurally.

Adult↗
PubMed1981

A comparison between simple aspiration, marker correction, and marker perfusion techniques in the estimation of pancreatic function.

Results of pancreatic function tests, using simple aspiration, simple aspiration with marker correction and marker perfusion methods were compared. With simple aspiration alone, approximately one-third of the marker was not recovered. Yet with the marker correction method the volume (and consequently other measurements), appeared to be greatly overcorrected, probably owing to poor mixing of marker and endogenous secretions. In contrast, the marker perfusion method yielded data which were 8-24% higher than those for simple aspiration for the various outputs; this difference was not statistically significant. It is concluded, firstly, that marker correction of a simple aspiration technique is inaccurate because of poor mixing; secondly, that because marker perfusion methods yield arithmetically but not statistically greater outputs than simple aspirations tests, the latter are probably adequate for diagnostic tests of pancreatic function.

Carbon Radioisotopes↗
PubMedDate not supplied

A one-year audit of fine needle aspiration cytology of breast lesions. Factors affecting adequacy and a review of delayed carcinoma diagnoses.

OBJECTIVE: To compare the rate of inadequate specimens in a triple-diagnosis breast clinic with that of specimens taken by clinicians. STUDY DESIGN: Breast aspirates obtained in 1993, 2,923 specimens, were reviewed. Of these, 1,515 (51.9%) were taken in a specialist clinic with a triple approach (clinical examination, imaging and aspiration cytology). Palpable lesions were aspirated by a cytopathologist and nonpalpable lesions by a cytopathologist and radiologist in cooperation using imaging techniques. The rate of inadequate specimens was determined and compared with the rate of the remaining specimens, which were sent to the laboratory by clinicians. RESULTS: In the breast clinic, the inadequacy rate was 3.8% (n = 58). The inadequacy rate for the 1,408 mailed breast aspirates was 14.8% (n = 209). A cancer diagnosis was recorded in 13.5% (n = 395). Six carcinomas were diagnosed late because of inadequate specimens. CONCLUSION: The inadequacy rate was lower in cytology samples taken in a specialized breast clinic than in samples mailed to the laboratory by clinicians. In order to increase the detection rate of malignancies, clinicians performing fine needle aspiration should be trained in the aspiration technique and smear preparation.

Biopsy, Needle↗
PubMed1995

[Fine needle aspiration cytology in screening of prostatic cancer].

Between October 1990 and June 1993, 112 patients underwent fine needle aspiration cytology and core needle biopsy of the prostate under transrectal ultrasonographic guidance. They were suspected of having prostatic cancer from the prostatic antigen level, digital rectal examination and/or transrectal ultrasonography. Twenty seven of the 112 cases (24%) were diagnosed with prostatic cancer. Their cytological diagnoses showed 22 class IV or V, 2 class III, and 3 class I or II. Efficiency, false negative rate and false positive rate were 86%, 11% and 0% in fine needle aspiration cytology. We could obtain sufficient samples for fine needle aspiration cytology in all cases. No severe complication was observed. However, we missed 3 patients, in fine needle aspiration cytology, who were strongly suspected of having prostatic cancer, and reexamination or additional core needle biopsy would have been necessary on 15 of the 112 patients (13%) who showed false negative or class III cytological results, if we had screened prostatic cancer only by fine needle aspiration cytology. In conclusion, fine needle aspiration cytology may not be as useful as core needle biopsy to screen prostatic cancer.

Adenocarcinoma↗
PubMed1994

[Fine needle aspiration cytology and influencing factors in breast cancer].

The results of 200 women with primary breast cancer who had fine needle aspiration cytology prior to definitive surgery at the Peking Union Medical College Hospital were presented. Among them, aspiration cytology was positive and suspicious in 87% (174/200) and pseudonegative in 13% (26/200). Clinical factors relating to the success of these aspiration were evaluated. The most significant factor was which physician performed the aspiration. Size of the lesion and type of the cancer were also important influences on the aspiration. Experiences in aspiration cytology were introduced by author.

Adenocarcinoma↗
PubMed1994

[Epididymal fine needle aspiration replacing vasography].

Epididymal fine needle aspirations (EFNA) were performed on 29 epididymides of 17 infertile, azoospermic men in whom testicular cytology revealed adequate spermatogenesis. Sonograms confirmed the presence of all the excretory male organs. EFNA was performed to diagnose and locate the site of genital tract occlusion. The presence of cuboidal epithelial cells in the aspirate was the sole indication that epididymal content was aspirated. In 10 (34%) of the 29 aspirates there were only cuboidal epithelial cells and no spermatozoa, indicating proximal occlusion in the rete testis, in the canaliculi efferents or in the most proximal segment of the epididymis itself. Occlusion in the distal segments of the epididymis or in the vas deferens was diagnosed in 13 epididymal aspirates (45%) which contained both cuboidal cells and spermatozoa. In 6 epididymides (21%) no conclusion could be reached because of failed aspirations. There are a variety of treatment modalities available for male genital tract obstruction, such as reconstructive surgery or IVF. The success rate of treatment is mainly dependent on the site of obstruction. Since vasography has its own limitations and hazards, diagnostic EFNA should be performed before treatment in men in whom genital obstruction is suspected.

Biopsy, Needle↗
PubMedDate not supplied

Fine needle aspiration cytology of the breast. A review of 1,868 cases using the Cytospin method.

The Cytospin method of fine needle aspiration cytology includes flushing the aspirate into 10 mL of Cytospin fluid; the cytocentrifuge preparations are then safely and conveniently prepared in the laboratory. Slides are stained with Papanicolaou stain and hematoxylin and eosin. From November 1989 through October 1992, 1,868 breast aspirates from palpable lumps were examined by this method at our institution. The method detected 398 of 441 cancers (90.2%); of the 43 that were undetected, 16 had inadequate aspirates, and 27 were falsely reported as negative (for a false-negative rate of 6.0%). There were no false positives; the positive predictive value for malignancy was 100%. The inadequacy rate was 14.8%. Excluding inadequate samples, the complete sensitivity was 95.2%, with 96.5% specificity. The Cytospin method of processing breast aspirates from palpable breast lumps is an acceptable alternative to conventional fine needle aspiration using direct smears. It is also highly convenient as an outpatient procedure, obviating the need for skillful preparation of direct smears.

Biopsy, Needle↗
PubMedDate not supplied

Pneumonia in the neonatal intensive care unit. Diagnosis by quantitative bacterial tracheal aspirate cultures.

Growth of > or = 10(5) colonies of bacteria per milliliter obtained at bronchoscopy in children and adults correlates with bacterial pneumonia. To determine whether quantitative tracheal aspirate cultures aid in diagnosis of pneumonia in the neonatal intensive care unit setting, tracheal aspirates were obtained from 25 infants who had recently undergone endotracheal intubation; 15 of the infants had suspected pneumonia and 10 control infants had undergone intubation for suspected apnea of prematurity (4 infants) or elective surgery (6 infants). Studies also were performed to detect Mycoplasma, Ureaplasma, viruses, and Pneumocystis. Tracheal aspirates from 2 of 15 infants with suspected pneumonia grew > or = 10(5) bacteria, and 1 was positive for respiratory syncytial virus. These infants were considered to have pneumonia. In 12 infants whose tracheal aspirates grew < 10(5) bacteria, respiratory decompensation later was explained by other causes in 11 infants, and there was one false-negative culture. There were three false-positive tracheal aspirates in the control group. We conclude that tracheal aspirates of infants who have recently had an endotracheal tube placed may be useful for diagnosing pneumonia and for identifying the causative agent.

Bacteria↗
PubMed1993

Management of severe ovarian hyperstimulation syndrome by ascitic fluid aspiration and intensive intravenous fluid therapy.

OBJECTIVE: To assess the value of intensive intravenous (IV) fluid therapy and ascitic fluid aspiration in the management of severe ovarian hyperstimulation syndrome. METHODS: Forty-two women with severe ovarian hyperstimulation syndrome were treated by ultrasonically guided transvaginal aspiration of ascitic fluid and IV fluid infusion. Ten women with the same condition treated conservatively constituted a comparison group. The main outcome measures included percentage change in hematocrit, creatinine clearance, and urine output before and after aspiration. The duration of hospital stay was compared between the groups. RESULTS: Marked improvement of symptoms and general condition followed soon after aspiration. Hematocrit readings decreased by 22%, creatinine clearance increased by 79.3%, and urine output increased by 220.7%. The average volume of aspirated fluid was 3900 mL. The average duration of hospital stay was 3.8 days in the treated women. In the comparison group, severe symptoms and electrolyte imbalance continued for an average of 9 days, and the average hospital stay was 11 days. CONCLUSION: Intensive IV fluid therapy and transvaginal aspiration of ascitic fluid are safe and effective in improving symptoms, preventing complications, and shortening the hospital stay in severe ovarian hyperstimulation syndrome.

Ascites↗
PubMed1993

[Peritonsillar abscess--a comparison of treatment by needle aspiration and incision].

To compare the efficacy of permucosal needle aspiration with that of incision and drainage in the management of peritonsillar abscess, we reviewed the charts of 32 patients, diagnosed as having peritonsillar abscess, who had been admitted to the Central Hospital of Social Health Insurance from June 1987 to December 1991. Twelve patients, 9 males and 3 females, were managed with incision and drainage. Their average age was 34 years, with a range of 23 to 69 years. Permucosal needle aspirations were performed in 20 patients, including 14 males and 6 females. Their age ranged from 16 to 65 with a mean of 36 years. All patients received parenteral antibiotics. The duration of fever over 37.0 degrees C averaged 2.0 hospital days (range, 0 to 8 days) in patients treated with incision and drainage, and 2.1 hospital days (range, 0 to 4 days) in patients treated with needle aspiration. The average postoperative time elapsed until the patient could eat solid food with ease was 3.8 hospital days with a range of 1 to 9 days in patients treated with incision and drainage, and 3.2 hospital days with a range of 1 to 7 days in patients treated with needle aspiration. The hospital stay ranged from 3 to 9 days with an average of 5.4 days in patients treated with incision and drainage, and from 4 to 10 days with an average of 5.5 days in patients treated with needle aspiration. These data indicate that permucosal needle aspiration of peritonsillar abscess provides symptomatic relief and cure which are as rapid as those of incision and drainage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

[Diagnostic value of ultrasonically guided lung aspiration in pneumonia].

To determine the diagnostic value of ultrasonic lung aspiration for patients with pneumonia, 60 patients with a tentative diagnosis of pneumonia were included in this study. After recording ultrasonographic findings, lung aspiration was done with a spinal needle and aspirated specimens were sent for Papanicolaou, May-Giemsa, acid fast, and Gram stains. The remaining specimens were sent for bacterial, mycobacterial and fungal culture. Twelve patients were excluded from the study because of the final diagnosis of non-infectious pulmonary diseases. In 28 cases of bacterial pneumonia, the diagnostic sensitivity of smear was 50% and culture 61%. The overall sensitivity of needle aspiration and culture was 71%. In 11 cases of bacterial pneumonia with a negative bacterial culture result, 7 cases were afebrile at the time of examination. To increase the diagnostic yield, needle aspiration should be performed at the acute stage of bacterial pneumonia. In 15 cases of pulmonary tuberculosis, the diagnostic rate of acid-fast smear was 47% and mycobacterial culture was 46%. The overall sensitivity of smear and culture was 60%. The diagnostic rate of needle biopsy was 75% and cytologic examination was 77%. Needle biopsy and cytologic examination enhanced the diagnostic rate of sputum-negative pulmonary tuberculosis. Cryptococcosis was documented by smear and needle biopsy in all of the five cases of cryptococcosis. Cryptococcosis is not easily detected by routine cytologic examination, and clinical information is still necessary to enhance the diagnostic rate. Our results show that ultrasonically guided lung aspiration is a technique with a high diagnostic yield and a low complication rate for various types of pneumonia. It is especially useful for patients without satisfactory clinical responses or without accurate microbiologic diagnosis.

Adult↗
PubMed1996

[Quantitative analysis of spermatogenesis in fine-needle aspirates of the testicle].

It was shown recently that testicular fine-needle aspiration (TFNA) can replace biopsy as a diagnostic tool in male infertility. The aim of this study was to determine whether a method of quantitative analysis of spermatogenesis can be developed based on the cytological elements in the aspirates. TFNA aspirates from markedly oligospermic and azoospermic patients were studied. All spermatogenic cells (spermatogonia, spermatocytes, spermatids and spermatozoa, as well as Sertoli cells) in the aspirates were identified and counted. It was found that: 500 consecutive cells were needed to reach conclusions about the spermatogenic process; the number of Sertoli cells in aspirates was constant in each individual's smears; each spermatogenic cell type could therefore be related to the number of Sertoli cells; the cell type index (CTI: the ratio between the number of cells of each given cell type and the number of Sertoli cells in the count of 500 consecutive cells) indicated the relative appearance of each cell type in the spermatogenic process. Determination of a spermatogenic process index (SPI), reflecting the ratio of the CTI for a given spermatogenic stage to its previous one, may be used in a flow sheet of the spermatogenic process. Assessing these indices for all the spermatogenic cell types in testicular aspirates provides a method for quantitative evaluation of the process of spermatogenesis. It enables expression of testicular pathology quantitatively and it defines various testicular fertility disorders. It can also be used as a guide for surveillance of therapy.

Biopsy, Needle↗
PubMed1996

[Successful treatment of diffuse aspiration bronchiolitis by cricopharyngeal myotomy].

A 62-year-old man was admitted to our hospital with complaints of coughing and fever. He had poliomyelitis at the age of 4 years, and had experienced difficulty in swallowing and chronic aspiration for the past 3 years. A chest roentgenogram and a high-resolution CT scan obtained on admission showed many small nodular shadows in the lower lung fields. Cricopharyngeal myotomy was done to decrease aspiration. The patient was then able to eat without aspiration, and the chest-roentgenographic and CT findings improved. Diffuse aspiration bronchiolitis was diagnosed from the clinical course and the radiographic findings. Cricopharyngeal myotomy can reduce the risk of aspiration in patients with diffuse aspiration bronchiolitis.

Bronchiolitis↗
PubMed1997

Combined use of micropipette aspiration and perifusion for studying red blood cell volume regulation.

We combined micropipette aspiration with a new technique of perifusion to study volume behavior of single red blood cells (RBCs) during anisotonic conditions. Other techniques have suggested that RBC volume changes are complete within 1 s, but our pipette data indicate a slower volume response of 5-10 s. This difference appears to be due to the partial aspiration of the cell into the pipette, which in part prevents exposure of the membrane area to the anisotonic medium. However, we found that medium will pass the aspirated RBC (-20 mm H2O aspiration pressure) and enter the pipette at a volume rate of 0.3 micron3/s; this rate was measured by introducing a flow marker, a separate RBC or a cell fragment, into the pipette. The osmotic balance across the RBC also affected the flow: if the outside fluid was made hypertonic, the pipette flow decreased, but a hypotonic conditions, the flow increased and contributed to the exposure of the aspirated portions of the RBC. However, after the initial 10 s, the RBC geometry can be precisely monitored; at 200 mOsm, the RBC swelled by 41.0 +/- 0.9% and then demonstrated a small but significant (P < 0.001) regulatory volume decrease. We suggest that this technique is very precise in measuring the dynamics of geometric regulation, although acute changes are affected by the partial cell aspiration and pipette flow.

Adult↗
PubMed1997

Molecular cytogenetic analysis of cytokeratin 20-labeled cells in primary tumors and bone marrow aspirates from colorectal carcinoma patients.

BACKGROUND: Low frequency epithelial cells in bone marrow from colorectal carcinoma patients are associated with an increased risk of recurrence and decreased survival. Current immunohistochemical approaches to detect epithelial cells in bone marrow aspirates rely on antibodies against cytokeratin 18 (CK18). The predictive value of CK18-based detection strategies is limited by false-positives that occur in approximately 30% of cases. Cross-reactivity of anti-CK18 antibodies with nontumor cells may contribute to the false-positive rate. Cytokeratin 20 (CK20) shows more restricted expression than CK18 and labels cells in colorectal tumors. METHODS: Immunofluorescence assays were used to quantify CK20-labeled cells in bone marrow aspirates and tumors from 18 Dukes stage C and D colorectal carcinoma patients to determine whether CK20 is useful in detecting micrometastases. Fluorescent in situ hybridization was used to determine whether CK-labeled subpopulations carried genomic aberrations associated with colorectal carcinoma. RESULTS: CK20-labeled cells occurred at frequencies approximately 5 x 10(-5) in control bone marrow aspirates from patients without colorectal carcinomas. Approximately 10(-4) CK20-labeled cells were present in 4 of 11 bone marrow aspirates (45%) from patients with Dukes stage D colon carcinoma. The mean frequency (5 x 10(-5) of CK20-labeled cells in Dukes stage C and D rectal carcinoma patients was statistically similar to control values. CONCLUSIONS. A subset of CK20-labeled cells in primary tumors and hepatic metastases are aneusomic. CK20-labeled cells in bone marrow aspirates are cytogenetically normal. These data demonstrate that CK20 cells in solid tumors may be cytogenetically aberrant, but suggest caution in the use of CK20 to detect micrometastases in bone marrow aspirates.

Adult↗