Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ASPIRATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,153 records · Page 64Linked to original sources
PubMed1998

Tracheal aspirate surface tension in babies with hyaline membrane disease: effects of synthetic surfactant replacement.

Our objective was to determine changes in surface tension of tracheal aspirate over the first 4-5 days of life in babies with hyaline membrane disease, with and without synthetic surfactant replacement. Tracheal aspirates were collected prior to and for 96-108 hr after initiation of a randomized double-blind trial of synthetic surfactant (EXOSURF Neonatal) or air-treated control patients. Using the captive bubble technique, we measured minimum surface tension (initial adsorption, first quasi-static compression, dynamic cycling at 30 cpm, second quasi-static compression and 5 min after quasi-static compressions) in 39 surfactant-treated and 44 control babies. We also compared minimum surface tension with the respiratory support provided. Twelve hours after one dose of synthetic surfactant, minimum surface tension on first quasistatic compression decreased significantly from 20.9+/-1.4 to 17.6+/-1.3 mN/m compared to air-treated babies, who did not show any change. Reduction in minimum tracheal aspirate surface tension on first quasi-static compression and during dynamic cycling over 48-60 hr occurred more rapidly in surfactant-treated babies. Ventilator support did not correlate with minimum tracheal aspirate surface tension. We conclude that treatment of babies with synthetic surfactant improved tracheal aspirate minimum surface tension within 12 hr of the first dose and for the next 48-60 hr.

Double-Blind Method↗
PubMed1976

The role of bone marrow aspiration and biopsy in detecting marrow involvement by nonhematologic malignancies.

A review of the records of the Memorial Sloan-Kettering Cancer Center identified 291 adult patients with nonhematologic malignancies who had undergone simultaneous bone marrow aspiration and biopsy from the same anatomic site. In 236 cases both samples were negative for tumor whereas in 39 both were positive. The biopsy was positive in three patients with a negative aspirate whereas in three others to aspirate was positive with a negative biopsy. The higher rate of tumor detection on aspirate in comparison with previous reports may be due to a thorough initial screening provided by technologists. Both aspiration and biopsy appear to be indicated for full evaluation of bone marrow in cancer patients.

Adult↗
PubMed1980

Appraisal of aspiration cytology in management of Hodgkin's disease.

The value of aspiration cytology in the management of Hodgkin's disease is shown in this study of 228 patients and 403 aspirations; 385 from lymph nodes and 18 from extranodal masses. In all patients the initial diagnosis was established on surgical biopsy. Aspirates were helpful in staging, defining extension of unusual radiation fields, and in recognizing residual disease and relapses after therapy. Adequate material was obtained in 80% of aspirations. The diagnosis of Hodgkin's disease could not be established in the adequate cytologic sample in 9.9% of cases. In 5.5%, the diagnosis was that of benign reactive hyperplasia and in 4.4%, non-Hodgkin's lymphoma. Unsatisfactory material was usually obtained from nodes less than 1 cm in diameter or from residual lesions following radiation or chemotherapy. Only 14 of 93 such lesions proved to have active disease during follow up. There were no significant complications. Characteristics of the varied aspects of aspirated tumor cells found in Hodgkin's disease are described.

Adolescent↗
PubMed1983

Fluoresceinated estrone binding by cells from human breast cancers obtained by needle aspiration.

Despite widespread use there are disadvantages associated with biochemical methods for ER determination. Since there is increasing emphasis on earlier detection of primary breast cancers there is clearly a need for a method which requires only small numbers of tumor cells. A variety of other clinical situations exist in which the availability of a technic that could supply information regarding tumor ER from a small cell population would be helpful. This report presents our experience with 17-fluoresceinated estrone (17-FE) binding for detecting the proportion of estrone binding cells in samples obtained by fine-needle aspiration of tumors prior to their removal. The findings from the aspirated cells employing 17-FE were compared with results obtained from aliquots of the same tumors following their removal using both cytochemical (17-FE) and biochemical (3H-estradiol binding) methods for ER determination. When biochemically determined ER values (fmol/mg cytosol protein) were compared to the proportion of fluorescent cells observed either in cells from needle aspirates prior to tumor removal or in cells from the removed tumor there was no direct quantitative relationship. That lack of correlation is to be expected and does not indicate that one or the other method is inappropriate. It was found, however, that 100% of tumors having ER levels greater than or equal to 10 fmol had greater than or equal to 10% marker positive cells. Fifty-four percent of tumors with a negative or borderline (less than 10 fmol) ER level had less than 10% marker positive cells. The less satisfactory correlation in biochemically ER negative tumors may be related to false negative biochemical determinations. The better correlation between results from the biochemical method and those with 17-FE binding using needle aspirates than between the former and the latter when cells from fragments of removed tumor were used for cytochemical analysis, and the lack of concordance in 17-FE binding by the two cell suspensions (from needle aspirates and from parts of the removed tumor) may be related to the heterogeneity of the cellular composition of a tumor as regards ER content and consequently to the methods of sampling. The authors' experience in this and previous studies using 17-FE for determination of the proportion of putatively ER positive cells indicate that the method is worthy of further evaluation and consideration for experimental and clinical use.

Adult↗
PubMed1984

Application of aspiration biopsy cytology to lymphomas.

Fine needle aspiration diagnosis is a well established technique. However, its application to lymphomas has been quite limited. From September 1977 to January 1981, the Lymphoma Group at the CCABC performed 213 aspirates. Of the 213, 180 were considered to be diagnostically useful, with 33 being unsatisfactory or no action was taken. Of the 180 considered useful, 170 were positive, and prompted institution of therapy (84), provided guide to appropriate treatment (84), provided rapid solution to clinical situation (65), provided improved understanding of clinical situation (78), and prevented invasive procedure [minor (local anesthetic), 31; intermediate (general anesthetic), 88; major (laparotomy or thoracotomy), 18]. Ten negative results delayed therapy (3), led to unnecessary or inappropriate investigation (1), led to incorrect therapy, (4), and were a source of confusion (10). In most circumstances, the authors tried to avoid fine needle aspirations as the only basis for an initial diagnosis. In a previously diagnosed lymphoma, aspiration aided in staging, in confirming recurrence, in the diagnosis of new and unrelated malignancy or undiagnosed infection and in assessing the evolution of a lymphoma to a more aggressive form. Aspiration diagnosis was considered to be a useful adjunct in the care of patients with lymphoma and it is especially suited to use by a closely working team of clinicians, radiologists, and pathologists.

Biopsy, Needle↗
PubMed1985

Aspiration cytology in the staging of urologic cancer.

Knowledge of the status of the pelvic lymph nodes is vital for accurate staging and adequate treatment of patients with urologic cancer. Noninvasive techniques for assessing the lymphatic spread of urologic neoplasms have proved to be of limited value. Bipedal lymphangiography and percutaneous fine needle aspiration cytology under fluoroscopic guidance were performed for staging purposes in 71 patients with clinically localized bladder, prostatic and penile cancer from 257 nodal chains. The overall diagnostic accuracy was 93% and the correct aspiration of 186 lymph nodes was surgically confirmed. There were 11 (6%) false-negative biopsy results and no false-positive diagnoses. Aspiration cytology is a safe, well tolerated, accurate, and rapid method of determining the presence of metastatic disease in lymphangiographically visualized pelvic nodes. In the management of prostatic carcinoma, positive cytologic results are diagnostic of nodal metastatic involvement and spare the patients unnecessary surgical staging. Negative cytologic findings may be considered diagnostic of localized disease in the patients with well differentiated prostatic carcinoma (2-4 Gleason's sum). Since most surgeons are reluctant to perform a staging lymphadenectomy in the management of invasive bladder carcinoma, aspiration cytology can provide accurate staging, thus permitting an appropriate treatment plan. In patients with carcinoma of the penis, a positive aspirate permits an early and even curative lymphadenectomy in cases with clinically negative but pathologically positive nodes.

Biopsy, Needle↗
PubMed1989

Fine needle aspiration biopsy in the management of children and young adults with peripheral lymphadenopathy.

To determine the effectiveness of fine needle aspiration (FNA) of the lymph node in the management of young patients with peripheral lymphadenopathy, all patients 30 years of age and under who had a lymph node aspirate and who then had subsequent excisional biopsy, autopsy, or clinical follow-up for a minimum of one year were examined. One hundred twenty-seven aspirates from one hundred twenty-six patients fulfilled the criteria of the study. Diagnoses of eighty-three benign and thirty-seven malignant lymphadenopathies were confirmed. There were three false negative and four false positive diagnoses. Sensitivity, specificity, and positive and negative predictive values were 0.93, 0.95, 0.90, and 0.97%, respectively. Of the one hundred twenty-six patients, twenty-five had a previous history of malignancy. Results of aspiration biopsy in this group were examined to determine FNA ability to predict recurrent disease. In this group the sensitivity, specificity and positive and negative predictive values were 0.95, 0.80, 0.95, and 0.80 respectively. Finally, the group of patients with clinically suspicious primary lymphadenopathy without an antecedent history of malignancy were examined to determine the effectiveness of the technique for selecting patients for surgical biopsy. This group included a total of one hundred two patients. Sensitivity, specificity, and positive and negative predictive values were 0.93, 0.96, 0.90, and 0.97, respectively. Based on the data from this retrospective study, we conclude that fine needle aspiration provides a useful tool in the management of young patients with peripheral lymphadenopathy, both in monitoring recurrent disease and in triaging patients with clinically suspicious primary lymphadenopathy to determined the next appropriate step in management.

Adolescent↗
PubMed1989

Immunodetection in fine-needle aspirates and multiparametric (SAMBA) image analysis. Receptors (monoclonal antiestrogen and antiprogesterone) and growth fraction (monoclonal Ki67) evaluation in breast carcinomas.

Immunocytochemical assays (ICA) using monoclonal antiestrogen receptors (ER ICA), antiprogesterone receptors (PR ICA), and monoclonal antibody Ki67 (Ki67 ICA) were performed in 127 breast carcinomas. The immunostaining procedures were applied on frozen tissue sections, tumour imprints, and fine-needle aspirates in order to compare the variations in the distribution of the antigens detected in the three different types of preparations. Positive reactions detected with peroxidase-antiperoxidase and avidinbiotin-peroxidase, and alkaline phosphatase-antialkaline phosphatase complexes were evaluated through a computerized system of image analysis referred to as SAMBA 200 (SAMBA TITN, Grenoble, France). Application programs specifically developed for the analysis of tissue sections and of cytologic preparations were applied. This system allowed a multiparametric, accurate, reliable, reproducible and automatized evaluation of the heterogeneity of the antigenic sites in tumors. For each markers positive cell surface (PS), and integrated and mean optical densities (IOD, MOD) and IOD histograms were compared. It was shown that (1) there was no significant variation in optical densities in cell imprints and aspirates whereas PS significantly (P less than 0.01) differed in both preparations; (2) there were significant differences of the optical densities between tissue sections and cytological preparations, either imprints or aspirates, likely due to randomly cut nuclei in tissue sections; and (3) there was a significant difference between the PS of tissue sections and aspirates but no significant difference between tissue sections and imprints. It is concluded that fine-needle aspiration constitutes a convenient method for cell sampling, reliable for the diagnosis of malignancies. However, it may not reflect the heterogeneity of cell subpopulations in tissue.

Antibodies, Monoclonal↗
PubMed1990

The male breast and malignant neoplasms. Diagnosis by aspiration biopsy cytology.

Fine-needle aspiration biopsy is now an established procedure for the evaluation of breast masses in women. On the other hand, there are only occasional reports of aspirates from male breast masses. During the past 19 years from more than 14,000 mammary aspirates, the authors examined the aspiration biopsy cytology (ABC) from 14 cases of malignant mammary tumors in men. There were ten infiltrating ductal carcinomas, one mucinous carcinoma, two metastatic carcinomas, and one leiomyosarcoma. The cytologic and clinicopathologic feature of these cases are presented. Because these specimens can be readily differentiated from gynecomastia, aspiration biopsy is recommended as the initial procedure for all breast masses in men.

Adenocarcinoma, Mucinous↗
PubMed2000

Fine-needle aspiration cytology: a survey of current utilization in relationship to hospital size, surgical pathology volume, and institution type.

Fine-needle aspiration cytology has become an accepted technique for the preoperative diagnosis of palpable and radiographically detected lesions at a wide variety of body sites. Little information exists regarding the degree of utilization of the technique in the general medical community. The present study investigated the number of fine-needle aspirations (FNAs) performed in relationship to hospital size, surgical pathology caseload, and type of hospital. Six hospitals from each state were selected at random (total of 300), and a survey was sent which requested the following information: hospital size, surgical pathology caseload, FNA volume, most common sites aspirated, change in FNA utilization over the last 5 years, and who was performing the needle aspirates. Usable responses were received from 133 institutions. The survey revealed that in 63% of institutions, FNAs were performed predominantly or exclusively by clinicians. An increase in number of FNAs performed was reported in 73% of institutions, while 11% reported a net decrease in FNA volume. The breast was the most common organ undergoing needle aspiration, followed by the thyroid and lung. For all hospitals, irrespective of size and type, FNA volume represented about 2.5% of the total surgical pathology volume. For nonacademic tertiary-care institutions, FNA represented approximately 1.2% of the surgical pathology caseload, and for academic tertiary-care institutions, FNA volume was approximately 3.6% of cases. The survey indicated that utilization of FNA continues to increase, is predominantly performed by clinicians, and represents a greater percentage of tissue examinations in academic tertiary-care institutions than in either community general hospitals or nonacademic tertiary-care institutions.

Biopsy, Needle↗
PubMed2001

Fine-needle aspiration for the diagnosis of primary epithelial tumors of the lacrimal gland and ocular adnexa.

Results of fine-needle aspiration (FNA) of solid-tissue neoplasms arising in the periocular glands are infrequently reported in the literature. To our knowledge, no previous series relating to this topic exist. Neoplastic processes that arise in the semiconfined area of the orbit behave as space-occupying lesions. Such lesions can exert significant pressure on the globe, be responsible for altered vision, and result in proptosis. When noninvasive techniques fail to confirm or rule out the suspicion of a neoplastic lacrimal or adnexal lesion, FNA may be of use in establishing a diagnosis in an efficient, reliable, timely, cost-effective, and safe manner. During the 14-yr interval from 1986-1999, 77 orbital/ocular needle aspiration biopsies were conducted by staff ophthalmologists at Allegheny General Hospital (Pittsburgh, PA). Review of the diagnoses for these specimens revealed seven primary solid-tissue lesions of the lacrimal gland and other adnexal glands, all arising in adult patients (age range, 45-92 yr; mean age, 74 yr). Primary lacrimal and adnexal gland neoplasms were found to represent approximately 9% of orbital fine-needle aspirations (7/79). The 7 cases included 3 lacrimal gland lesions diagnosed as benign mixed tumors, 3 lesions diagnosed as adenoid cystic carcinoma of the lacrimal gland, and 1 tumor diagnosed as sebaceous carcinoma of the meibomian holocrine glands. Cytologic diagnoses were rendered using standard criteria for salivary gland-type tumors. Tissue confirmation was available from surgical follow-up in 4 of the 7 cases, with 100% correlation. Although primary neoplasms of the lacrimal gland and glands of the eyelids are rare, accurate diagnoses of such lesions may be established with minimally invasive aspiration techniques. Preoperative aspiration biopsy diagnoses provide a great advantage to ophthalmic surgeons who routinely operate in a conservative fashion in an area of the body requiring great attention to cosmesis. Our experience indicates that FNA is a reliable and effective tool in the diagnosis and management of primary lacrimal and ocular adnexal tumors.

Adenocarcinoma, Sebaceous↗
PubMed1992

Effects of fine needle aspiration on subsequent mammograms.

The effects of fine needle aspiration on subsequent mammography were studied in a group of women who were referred with palpable breast lumps. Fifty-two women aged between 36 and 73 (median 53) years underwent mammography before and within 5 days of needle aspiration. Preaspiration and postaspiration mammograms were examined 'blind' by one radiologist. In ten cases, a difference was seen between the preaspiration and postaspiration films. In seven (aged 36-50 years) this was due to aspirated cysts. In three the differences were unexpected and were more significant, although the radiological diagnosis was not altered. If this proportion is extrapolated for a large number of patients then significant numbers of artifacts from fine needle aspiration might be seen on mammograms. It is possible that some might be interpreted falsely as malignant and some small cancers might be obscured. Women accepted mammography more readily before aspiration than after.

Adult↗
PubMed2006

Randomized clinical trial to determine the effect of nasogastric drainage on tracheal acid aspiration following oesophagectomy.

BACKGROUND: The aim of this study was to investigate tracheal acid aspiration after oesophagectomy and to determine whether it is influenced by nasogastric (NG) drainage. METHODS: Thirty-four patients undergoing oesophagectomy were randomized to one of three methods of NG drainage: a single-lumen tube with free drainage and 4-hourly aspiration, a sump-type tube on continuous suction drainage, or no NG tube. A tracheal pH probe was used to collect information on acid aspiration for 48 h after surgery. A pH < 5.5 was considered abnormal (normal pH 6.8-7.2). Total time with tracheal pH < 5.5, number of reflux episodes and longest reflux time were compared between groups. RESULTS: There was significant and persistent tracheal acid aspiration in all patients. Patients with a sump-type tube had a significantly shorter total time with tracheal pH < 5.5 than those in the other groups (sump-type tube versus single-lumen tube, P = 0.0069; sump-type tube versus no tube, P = 0.0071). Patients randomized to no NG tube experienced more respiratory complications after surgery than those who had either single-lumen or sump-type tubes (seven of 12 versus four of 22 patients; P = 0.023). Insertion of a NG tube was necessary in the first week after surgery in seven of 12 patients in this group. CONCLUSION: Routine NG drainage after oesophagectomy is necessary. A sump-type NG tube is better at preventing tracheal acid aspiration and may reduce the incidence of respiratory complications.

Acids↗
PubMed2006

Large tube section is the key to successful coronary thrombus aspiration: findings of a standardized bench test.

Thrombus removal by aspiration is one of the adjunctive techniques used to avoid embolization during PCI for acute myocardial infarction. Numerous devices are now available, but little is known about the mechanical rationale used in comparing them. The aim of the present study was to determine parameters to obtain optimal thrombus aspiration (TA). Heparin- and antiplatelet-free blood samples were aspirated into 3 mm diameter standardized glass tubes to create a 30 mm long thrombus. Thrombus formation took place at room temperature over a period of 6 or 12 hr. Various catheters were tested using a variable vacuum device: three with right-angle distal tip (0.038'', 0.067'', and 0.070'') and one with a beveled distal (length of the beveled, 0.054''; inner diameter catheter, 0.040''). The single endpoint was complete thrombus aspiration. A total of 103 TAs were presented for the four catheters. For 6- or 12-hr-old thrombus for a given catheter, there was no significant difference in vacuum pressure required to succeed TA (P = 0.47). For 6- or 12-hr-old thrombus, the larger the contact area is, the lower the pressure needed to aspirate the thrombus. Moreover, a beveled distal tip length (0.054'') does not make it possible to succeed TA at a lower pressure. The main factor for successful TA for thrombi > or = 6 hr is inner diameter and not immediate thrombus contact area.

Chi-Square Distribution↗
PubMed2006

A pilot study with a new, rapid-exchange, thrombus-aspirating device in patients with thrombus-containing lesions: the Diver C.E. study.

BACKGROUND: In patients with acute coronary syndromes (ACS), distal embolization of thrombotic material is more likely to play a key role in the pathogenesis of myocardial no-reflow during percutaneous coronary intervention (PCI). Thus, interventional techniques able to reduce thrombus burden at the culprit vessel might improve final myocardial reperfusion. OBJECTIVE: To evaluate a new rapid-exchange thrombus-aspirating catheter, the Diver C.E., in patients with thrombotic coronary lesions undergoing PCI. METHODS: Fifty patients with acute myocardial infarction (n = 44) or with non-ST-elevation ACS and angiographic evidence of coronary thrombus (n = 6) undergoing urgent PCI were prospectively enrolled. The Diver C.E. was used to aspirate coronary thrombus from the culprit lesion after placement of the guidewire. Adjunctive balloon inflations and stent implantation were used to achieve good angiographic result. Angiographic coronary flow (by means of TIMI score and corrected TIMI frame count, cTFC), thrombus score (TS), and myocardial perfusion (by means of postintervention myocardial blush grade, MBG) were assessed in all patients. RESULTS: The device could be successfully employed in 96% of the cases (48/50) and yielded significant (P < 0.0001) acute reduction in thrombus burden (TS: predevice 3.5 +/- 0.8, postdevice 2.5 +/- 0.9) and improvement in coronary flow (TIMI grade: predevice 1.0 +/- 0.9, postdevice 2.0 +/- 0.9; CTFC predevice 71 +/- 31, postdevice 39 +/- 26). Final TIMI grade 0-1 was observed in one patient only (2%). A significant (P = 0.02) correlation was found between preintervention TS and efficacy of thrombus aspiration. A more pronounced acute reduction of thrombus burden after thrombus aspiration (TS reduction > or = 2) was associated with a better postintervention angiographic myocardial perfusion (MBG 2.3 +/- 0.9 vs 1.7 +/- 0.8; P = 0.05). CONCLUSIONS: This new, easy-to-use, device is able to reduce thrombus burden and to improve coronary flow in patients with thrombus-containing lesions. The improvement in myocardial perfusion associated to greater thrombus removal highlights the importance of thrombus aspiration in the management of thrombus-burdened coronary lesions.

Angioplasty, Balloon, Coronary↗
PubMed2003

Nipple aspirate fluid cytology in breast carcinoma.

BACKGROUND: Nipple aspirate fluid (NAF) cytology is a simple noninvasive method to study cells exfoliated into the ductal system of the breast. In the current study, the significance of cytologic findings in NAF was determined by correlating them with histopathologic findings from corresponding breast tissue. Cytologic-histologic correlations of NAF were performed in only a few studies. METHODS: Nipple aspirate fluid was collected by breast massaging and by using a breast aspiration device from 74 women with biopsy confirmed intraductal or invasive carcinoma with or without a history of preoperative neoadjuvant chemotherapy. Cytospin preparations were Pap stained. The number of epithelial cells was quantitated and foamy macrophages were semiquantitatively scored. Cytologic findings were categorized as insufficient for diagnosis (less than 10 epithelial cells), benign, mild atypia, marked atypia or suspicious, and malignant. Finally, they were correlated with tissue findings. RESULTS: Nipple aspirate fluid was obtained from 74 women, including 24 who had received preoperative neoadjuvant chemotherapy. The median age of patients was 54 years. A mean volume of 57 microL NAF and a mean of 149 epithelial cells were obtained. Foamy macrophages were present in 51 (70%) of the specimens. There was a significant correlation between the presence of epithelial cells and foamy macrophages (P < 0.001). Patients treated with chemotherapy had fewer epithelial cells in their NAF compared with patients who were not treated with chemotherapy. Thirty specimens (41%) were inadequate for diagnosis, 34 were (46%) benign, 5 (7%) were mildly atypical, 1 (1%) was markedly atypical, and 4 (5%) were malignant. Of the five cases with mildly atypical cytology, three were intraductal papilloma, one was low-grade papillary intraductal carcinoma, and one was low-grade intracystic papillary carcinoma with invasion in the corresponding tissue specimen. The single case with markedly atypical NAF cytology had extensive ductal carcinoma in situ (DCIS). Of the four cases with malignant NAF cytology, two were extensive DCIS and two had invasive carcinoma with extensive DCIS in the breast specimen. Overall, 3 (27%) of 11 cases of DCIS were detected in NAF and only 2 (4%) of 52 invasive carcinomas including the only two cases with extensive DCIS were detected in NAF. CONCLUSION: The probability of detecting malignant cells in NAF is dependent on the extent of DCIS and nipple involvement by DCIS. Nipple aspirate fluid is not a sensitive test for detecting invasive carcinoma of the breast. Atypical cytology in NAF is associated with papillary lesions in the underlying breast.

Adult↗
PubMed2003

Breast hamartoma: fine-needle aspiration cytologic finding.

BACKGROUND: Breast hamartoma is an unusual, well-circumscribed, tumor-like mass entering into the differential diagnosis of benign breast disease. To the authors' knowledge, the cytology of these lesions has not been well described. Although fine-needle aspiration is a well established procedure for the detection of breast carcinoma, its utility in classifying benign breast disease is less clear. METHODS: Fine-needle aspirates from eight patients with histologically proven hamartomas were reviewed. None of the cases had a preoperative fine-needle aspiration diagnosis of hamartoma. Cytologic characteristics were retrospectively evaluated in a semiquantitative manner and compared with the histologic findings. RESULTS: The aspirates were moderately cellular and contained sheets of both bland ductal cells and lobular units. Adipose tissue was present in varying amounts. Bipolar stromal nuclei were readily apparent, whereas intact stromal fragments were less prominent. Cytologic atypia was uniformly absent. CONCLUSIONS: The cytology of breast hamartomas shows considerable overlap with other benign breast disease and is unlikely to be interpreted as malignant. The findings of intact lobular units and a relative paucity of stroma in an aspirate from a well circumscribed breast lesion may suggest the diagnosis of hamartoma.

Adolescent↗
PubMed2005

Phenotypic diversity of intrahepatic and extrahepatic cholangiocarcinoma on aspiration cytology and core needle biopsy: case series and review of the literature.

BACKGROUND: Cholangiocarcinoma (CC) represents approximately 10% of primary liver malignancies and can mimic metastatic adenocarcinoma. METHODS: The authors retrospectively reviewed the cytopathology files at the University of Texas Medical Branch to identify patients who were diagnosed with intrahepatic or extrahepatic CC by aspiration cytology between 1995 and 2004. Brush cytology specimens of extrahepatic CC were excluded. All diagnoses were confirmed as CC by clinical, imaging, and histopathologic findings and by chart review. RESULTS: Cytopathology files from 13 patients with CC diagnosed by FNA were retrieved. The male:female ratio was 5:8, and the patients ranged in age from 29 years to 74 years (mean age, 59 years). In 12 of 13 patients, aspirates were obtained by ultrasound guidance; and, in 1 patient, computed tomography guidance was used. Three patients had aspirates only, 10 patients also had core biopsies, and 1 patient had cell block preparations. The phenotypic distribution of CC according to the World Health Organization (WHO) histologic classification was 9 adenocarcinoma (intrahepatic), not otherwise specified (NOS) (69%); 2 gastric foveolar type (extrahepatic) CCs (15%); 1 intestinal type (extrahepatic) CC (8%); and 1 sarcomatous/spindle cell type (intrahepatic) CC (8%). One adenocarcinoma, NOS was well differentiated CC with bland tubular architecture, and one was pleomorphic. Ancillary histochemical and immunochemical stains were performed on 5 of 13 specimens, which included 4 core biopsies and 1 aspirate with Mucicarmine positivity (3 specimens), carcinoembryonic antigen positivity (3 specimens), and a cytokeratin 7 (CK7)-positive/CK20-negative pattern (2 specimens). The 1 sarcomatous/spindle cell type CC was chromogranin-negative and low molecular weight keratin (cell adhesion molecule 5.2)-positive, which excluded metastatic carcinoid. CONCLUSIONS: Classification of intrahepatic and extrahepatic CC in aspiration cytology specimens was achieved in a reliable manner concordant with the WHO histologic classification. Special types of CC with bland nuclear features posed a diagnostic challenge on cytologic evaluation, particularly the well differentiated CC with tubular architecture and the gastric foveolar type CC with mucin-producing tumor cells. The addition of core biopsy and/or ancillary studies, such as histochemical and immunochemical stains, were helpful in reaching the correct diagnosis.

Adult↗