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PubMed1989

Indications for aspiration of amoebic liver abscess.

A two-part study was undertaken to determine whether aspiration of amoebic liver abscess (ALA) prevents complications. Eighty patients studied prospectively were randomised into aspiration or non-aspiration groups and were treated with metronidazole. Common factors in patients with complicated diseases were determined to formulate and test indications for aspiration. Records of all patients with ALA admitted to King Edward VIII Hospital, Durban, between October 1983 and December 1984 were analysed to test the validity of the criteria derived from the first part of the study. The findings suggest that aspiration influences the course and outcome of ALA and that the criteria are valid although not necessarily complete.

Evaluation Studies as Topic↗
PubMed1989

Micropipette aspiration of guinea pig megakaryocytes: absence of fragmentation and dependence on maturation stage.

Platelet release has been alternatively viewed as a fragmentation of platelet territories demarcated within the cytoplasm of mature megakaryocytes or as a later event involving segmentation of proplatelet pseudopodia extended from the cell. The mechanical constraints on platelet release were evaluated by measuring the resistance of guinea pig megakaryocytes to aspiration into micropipettes of similar diameter to the width of naturally forming proplatelet projections. Application of increasing negative pressure to the surface of the cells resulted in progressively longer extensions being drawn into the pipette until maximal extension lengths were reached. None of the passively aspirated cytoplasmic extensions fragmented off the cells even at the highest aspiration pressure under physiologic study conditions. The longest extensions were aspirated from megakaryocytes of the most advanced maturation stage, and a proportion of the mature cells yielded very long extensions over 50 mu and up to 150 mu in length. Surprisingly, the ease of aspiration did not correlate to cell size during any stage of maturation. The mechanical behavior of guinea pig megakaryocytes indicates a large availability of surface for extension in mature cells ideal for active proplatelet projection. The lack of mechanical fragility suggests that platelet release is a very late maturational event not yet initiated in the "mature" megakaryocytes available for study from marrow harvests.

Animals↗
PubMedDate not supplied

Fine needle aspiration diagnosis of cysticercosis in soft tissue swellings.

The cytomorphologic criteria for diagnosing cysticercosis in fine needle aspirates are described. A retrospective analysis of aspirates from 62 cases with subcutaneous swellings in various sites showed the presence of the parasite in 25 cases. In another 31 cases, the aspiration smears contained no larval parts, but did contain an inflammatory reaction (consisting of large numbers of eosinophils and palasading histiocytes) suggestive of a parasitic cyst. Corresponding histologic material from 19 of these cases were diagnostic of cysticercosis in 9 cases and suggestive of cysticercosis in 10. However, histology was diagnostic of cysticercosis in six cases that produced acellular aspirates. These results show that fine needle aspiration cytology can diagnose or suggest cysticercosis in many cases, but may be falsely negative in a few.

Animals↗
PubMed1986

Micropipette aspiration of human platelets: influence of rewarming on deformability of chilled cells.

Recent studies using micropipette elastimetry have shown that the circumferential microtubule supporting the discoid form of resting platelets has a direct influence on the resistance of the cell to deformation. However, the findings did not resolve whether the mere presence of microtubules, their organization into coils, or location under the cell wall was responsible for resistance to aspiration into micropipettes. In the present study platelets were cooled to 2 degrees to 4 degrees C to remove microtubules completely. The chilled cells were then rewarmed to 37 degrees C, and the influence of microtubule reassembly on resistance to deformation in micropipettes measured at intervals up to 1 hour. Chilled platelets without microtubules were aspirated more than twice as far as control platelets at all negative pressures from 1 to 10 cm H2O (tensions 4 to 41 X 10(-2) dynes/cm). At negative tensions beyond 32.5 X 10(-2) dynes/cm (8 cm H2O), the aspirated lengths of control platelets plateaued until the cells finally fragmented. Aspirated segments of chilled platelets continued to increase in length on exposure to greater negative pressure. Twenty minutes after rewarming at 37 degrees C, chilled cells began to return toward normal resistance to aspiration when only 6% had recovered discoid shape. The range of deformability at this time was narrow, indicating that partial recovery was not caused by development of two cell populations, one with and one without microtubules. The return toward normal resistance continued at 30 minutes when 75% of platelets were discoid, and was identical to that in control platelets after 1 hour at 37 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkaloids↗
PubMedDate not supplied

Fine needle aspiration of ovarian masses. II. Correlative cytologic and histologic study of nonneoplastic cysts and noncelomic epithelial neoplasms.

A wide variety of neoplasms and nonneoplastic cysts involves the ovary. Seventy-seven ovarian masses were aspirated using fine needles. They included 32 nonneoplastic cysts of various types, 29 celomic epithelial neoplasms, 10 germ cell neoplasms and 6 other neoplasms. The study was performed in order to elucidate the cytologic features of aspirates from these lesions and correlate them with the histologic features. Material aspirated from malignant neoplasms resulted in abundantly cellular specimens while aspirates from benign neoplasms and nonneoplastic cysts showed only scanty cells. Follicular cysts and corpus luteum cysts showed similar cell types but with various degrees of cellularity and incidence of cell types. Cysts lined by a single layer of cuboidal cells, such as paraovarian and paratubal cysts, were very similar cytologically. The three types of germ cell neoplasms encountered showed features which were diagnostic of each entity. It was difficult to discriminate between some of the types of the sex cord and mesenchymal neoplasms. Aspiration cytology can achieve a satisfactory classification of ovarian masses. It has a specific role to play especially in young patients, in whom preservation of ovarian function is advisable.

Biopsy, Needle↗
PubMedDate not supplied

Fine needle aspiration of ovarian masses. I. Correlative cytologic and histologic study of celomic epithelial neoplasms.

The ovary is commonly involved by a wide variety of neoplasms and nonneoplastic masses. Seventy-seven ovarian masses were aspirated using fine needles. They included 29 neoplasms classified as being of celomic epithelial origin. The study was performed in order to elucidate the cytologic features of material aspirated from these neoplasms and to correlate them with the histologic features. As expected, material aspirated from malignant neoplasms was much more cellular than material obtained from benign neoplasms. By studying the background material, nuclear and cytoplasmic features of the epithelial cells, as well as the presence of other structures such as psammoma and hyaline bodies, a fairly specific pattern can be recognized for each neoplasm. Using aspiration cytology, a conclusion can be made regarding the malignant or benign nature as well as the specific type and classification of the ovarian neoplasms. Aspiration cytology, especially with the increased use of laparoscopy, has a specific role to play in the diagnosis of celomic epithelial neoplasms of the ovary. It is a valuable method when preservation of ovarian function or minimizing surgical trauma to the patient is desirable.

Adenocarcinoma↗
PubMedDate not supplied

Percutaneous fine-needle aspiration biopsy of the liver. Cytodiagnosis of hepatic cancer.

Percutaneous fine-needle aspiration biopsies of the liver were performed on 21 patients with a clinical suggestion of hepatic malignancy. Under the guidance of the liver scan, several aspirations at the suspect areas were made in each case, with an average of 3.4 punctures and 13.8 smears per case. The biopsies were positive in 13 cases: 12 metastatic carcinomas and 1 hepatocellular carcinoma. There were no false-positive or false-negative results in this series. On the 13 patients with proven hepatic malignancy, 47 punctures had been performed. Of these 47 punctures, 34 (72.3%) were positive for malignant cells. Neoplastic tissue or cells were found from at least one aspirate in these 13 biopsies. Liver biopsies by Menghini technique were also performed on five patients with proven hepatic malignancy in this series. Of these five biopsies, only two showed evidence of malignancy. Typing of the tumors and determination of the primary sites based on cytomorphologic features in all the malignant cases were attempted. Origins of neoplastic cells were suggested in 11 cases and all confirmed in the follow-ups. The punctures and aspirations of these 21 biopsies did not reveal any immediate complication. Multiple fine-needle liver aspirations under the guidance of liver scan are of great diagnostic value with high accuracy in detecting hepatic malignancy.

Adenocarcinoma↗
PubMed1988

Fine needle aspiration biopsy of suspected metastatic cancers to the posterior uvea.

This thesis presents the author's experience with diagnostic intraocular fine needle aspiration biopsy in 18 patients with a suspected metastatic choroidal or ciliary body tumor. The author has reviewed the literature on biopsy of intraocular tumors and has specified what he believes to be valid indications for diagnostic biopsy of posterior uveal tumors. He has evaluated the accuracy, limitations, and complications of diagnostic fine needle aspiration biopsy in this series and others, and he has suggested methods for improving the recovery of sufficient cells for cytologic diagnosis and lessening the risks of tumor cell seeding during the biopsy. The author has concluded that fine needle aspiration biopsy appears to be a relatively safe, generally reliable means of establishing the pathologic diagnosis of a choroidal or ciliary body tumor in highly selected patients suspected of having metastatic cancer. In spite of its apparent safety and reliability, however, the author has cautioned against the routine use of fine needle aspiration biopsy in patients with posterior uveal tumors since its long-term safety has not been established. The author has suggested that diagnostic fine needle aspiration biopsy of posterior uveal tumors be performed only in medical centers where there can be input from and cooperation among ophthalmologists, ophthalmic pathologists, and cytopathologists who are experienced in the diagnosis of intraocular malignancies.

Adult↗
PubMed1986

Preliminary experiences with CO2-laser and ultrasonic aspirator in brain surgery.

The basic problems and potential of CO2-laser and ultrasound aspirator in brain surgery are presented on the basis of experience with the Sharplan 733A CO2-laser and the Sonotec ultrasound aspirator. Complete removal of meningiomas and gliotic scar and partial removal of malignant astrocytomas by CO2-laser and ultrasound aspirator was performed. There were no complications related to the surgical procedure. The main advantage of the CO2-laser was precise cutting of neural tissue and rapid evaporation for debulkment of tumor. The ultrasound aspirator was especially useful for rapid internal debulkment by fragmentation and aspiration of soft tumors. On the basis of these experiences the surgical theater should be equipped with these and other instruments in such a way that they can be readily and interchangeably used in any neurosurgical procedure.

Adolescent↗
PubMed1987

Fine-needle aspiration biopsy: a reproducibility study and a correlation with the tru-cut biopsy in the evaluation of renal allotransplants.

Forty patients receiving a living related donor kidney transplant in the last 12 months were subjected to evaluation by Fine Needle Aspiration Biopsies (FNABs) and Tru-cut biopsies. The reproducibility of the transplant aspiration cytology was tested by comparing 90 double FNABs (FNAB1 and FNAB2). Furthermore, the accuracy of FNABs was assessed by comparison with 30 kidney transplant Tru-cut biopsies obtained simultaneously. Statistical analysis showed no significant difference (P greater than 0.1) between FNAB1 and FNAB2 and both correlated positively with the Tru-cut biopsies. All the 25 acute rejection episodes documented by Tru-cut biopsies were positive in the simultaneously obtained FNABs. FNABs failed to diagnose histologically documented chronic rejection, humoral rejection, and a case of disseminated intravascular coagulation. In one case with deteriorating graft function, Tru-cut biopsy showed normal histology, yet transplant aspiration cytology showed cyclosporin nephrotoxicity. Sensitivity of transplant aspiration cytology was found to be 90.9% and specificity was 100%. We have concluded that FNAB when performed frequently, especially if double aspirates are obtained, is safe, sensitive and highly specific for diagnosis of renal transplant rejection. Humoral and chronic rejections are major limitations.

Biopsy, Needle↗
PubMedDate not supplied

Immunoperoxidase detection of carcinoembryonic antigen in fine needle aspirates of breast carcinoma. Correlation with studies in tissue sections.

The peroxidase-antiperoxidase technique was used to demonstrate the presence of carcinoembryonic antigen (CEA) in fine needle aspirates and the corresponding tissue sections in 50 cases of carcinoma of the breast. The incidence of CEA positivity in the aspiration smears was 76%. A good correlation was observed between the results in the aspiration smears and in the tissue sections: 82% in the initial correlation and 90% when additional tissue sections from four of nine discordant cases proved to be positive for CEA. Five cases remained positive for CEA in the aspiration smears and negative for CEA in the tissue sections. This preliminary data indicates that aspiration smears can be used to demonstrate the CEA status in mammary carcinomas.

Biopsy, Needle↗
PubMed1988

Fine-needle aspiration cytology of focal liver lesions. Advantages and limitations.

Fine-needle aspiration cytology of focal liver lesions was performed 192 times in 175 patients over a 5-year period. Ultrasonic guidance was used for 153 punctures; the others were done peroperatively or on a palpable mass. A correct diagnosis of malignancy was obtained in 89/111 cases (80.2%), and of metastases (adenocarcinoma) to the liver in 71/84 (84.5%). The total of nonrepresentative aspirates was 26 (13.5%). The overall accuracy of cytologic evaluation was 87.5%, with 79.5% sensitivity and 100% specificity in malignant disease. The predictive values of positive and negative results were, respectively, 100% and 75.8%. There were no false positive tests, but 12.5% false negatives. No complications following the aspiration procedure were seen. Fine-needle aspiration biopsy is simple and safe, but the relatively high proportion of nonrepresentative aspirates is a problem. Possibly a more aggressive approach with multiple punctures may lessen this incidence and enhance the diagnostic accuracy in hepatic malignancy.

Adolescent↗
PubMed1988

Fine needle aspiration biopsy. Applications in the diagnosis of lymphoproliferative diseases.

A review of fine needle aspiration biopsies of lymph nodes was performed to determine accuracy and reproducibility among observers for the diagnosis of malignant lymphomas and lymphoproliferative diseases and to identify problem areas in the diagnosis of lymphomas and lymphoproliferative diseases by this biopsy method. Not including cases of carcinoma, 85% of the lymphomas and lymphoproliferative processes were correctly identified by seven of eight observations from a blind review without clinical information. Four problem areas in diagnosis from aspirates were identified: (a) distinction of lymphoid hyperplasia from non-Hodgkin's lymphoma by relying significantly on polymorphism versus monomorphism of the smear pattern; (b) separating undifferentiated carcinoma from large cell lymphoma; (c) overinterpreting extensive lymphoid polymorphism as Hodgkin's disease; and (d) diagnosing some aspirates of granulomatous lymphadenopathy, viral infection, or nodes with extensive necrosis as Hodgkin's disease. From the analysis of this series, a programmed approach was developed for diagnosing lymph node aspirates. History, physical examination, correct performance of the aspiration biopsy, and proper handling of the specimen are the four basic elements. Microscopic evaluation includes assessment of overall cellularity, pattern of cell arrangement, identification of predominant cell type, and background elements.

Adult↗
PubMedDate not supplied

Value of aspiration cytology of the thyroid in metastatic disease.

Metastases may simulate primary malignant tumors of the thyroid, causing problems in the diagnosis and management of patients with a history of cancer. In the seven-year period of July 1978 through June 1985, 8 of 549 needle aspirates of the thyroid contained metastatic tumor, 6 of which were subsequently confirmed by histologic study. The primary sites of origin were the breast, kidney, colon and stomach as well as lymphoma. The cytologic features observed in the aspiration biopsy material from the six cases were characteristic of each of the primary tumors. Three of the patients had had prior resections of carcinomas (breast, colon and stomach) while in three patients the cytologic diagnosis of the thyroid aspirates led to the discovery of the primary tumor (kidney and two lymphomas). One case of lymphoma/leukemia and one case of previously biopsied lung carcinoma were confirmed on clinical grounds. It is of critical importance that primary thyroid neoplasms occurring in patients known to have primary tumors elsewhere be distinguished from disseminated tumors involving the thyroid. Our experience suggests that fine needle aspiration is of considerable value in this differential diagnosis. Needle aspirates of the thyroid are also of value in leading to the diagnosis of unsuspected nonthyroidal primary cancer.

Adult↗
PubMed1987

Fine needle aspiration cytology in the management of euthyroid goitre.

The role of fine needle aspiration cytology was examined in a series of 115 euthyroid patients referred with thyroid enlargement presenting consecutively to a joint medical and surgical thyroid clinic from April 1985 to December 1986. Needle aspiration was performed at first clinic attendance and repeated two to six months later in 39 subjects. Patients were classified according to cytological features of the thyroid aspirate. A diagnosis of benign colloid goitre was made in 59 patients, lymphocytic thyroiditis in 11, thyroid cyst in 32 and in addition there were 13 reports of suspicious or malignant cytological features. Malignancy was confirmed histologically in six patients in this group and five more had follicular adenomata. There were two false positive reports of 'suspicious' cytological features. During a median period of observation of 11.4 months one false negative cytological diagnosis has emerged in a further patient with follicular adenoma. Accuracy in the diagnosis of thyroid neoplasia of 97 per cent has thus been achieved. Fine needle aspiration cytology has replaced isotope and ultrasound scanning in our practice. The number of 99mTc scans performed in the investigation of goitre fell from 77 in 1984 to three in 1986. Neoplastic tissue was removed at operation in 40 per cent of cases proceeding to surgery (20 subjects), compared with a predicted rate of 9.6 per cent if all solitary nodules had been removed. Aspiration cytology performed at first clinic attendance has led to improved selection of patients for surgery and hence economy in their management.

Adolescent↗
PubMed1986

Pathologic nature of cystic thyroid nodules selected for surgery by needle aspiration biopsy.

Sixty euthyroid patients with cystic hypofunctioning thyroid nodules were selected for operation by the criteria of evidence of needle aspiration of cyst fluid with malignant cytologic findings, suspicion of malignancy on the basis of recurrent cyst fluid formation after at least two aspirations, or incomplete decompression after aspiration. Other factors such as size (greater than 3 cm in diameter), history of radiation, and cervical lymphadenopathy were given weight. Radiation exposure occurred in 14% of patients. Surgical pathologic findings revealed malignancy in 32%, adenoma in 43%, and colloid nodule in 25%, with a total neoplasia rate of 75%. The types of malignant tumors included six papillary, six mixed, three follicular, and four Hurthle. Surgical treatment included 26 near total thyroidectomies, 34 partial thyroidectomies, and four neck dissections without major morbidity or deaths. Cytologic false-negative rates were 50% cancer, 50% Hurthle cell 50%, and 60% adenoma, even after nucleopore filtration, emphasizing the value of surgical selection on the basis of cyst response to aspiration. Cytologic false-positive rate in the colloid group was 6% and 25% for false (solid) positive for echography. Bloody fluid occurred in all types of lesions but was more common in the cancer group. Thyroid ultrasonography does not appear to be an important way to assess thyroid nodular disease and has been, in our estimation, superseded by needle aspiration cytology. It should be recognized that cystic thyroid nodules, when selected for operation on the basis of the above mentioned needle biopsy and clinical criteria, have the same frequency of neoplasia and cancer as solid hypofunctioning thyroid nodules. Hence, it is recommended that all cystic lesions of the thyroid gland be assessed in accordance with such criteria to exclude underlying cancer.

Adenoma↗
PubMed1987

Needle aspiration cytology of breast masses.

Needle aspiration cytology has been reported to be a highly sensitive and specific method of evaluation of solid breast masses when used by a single individual or closely knit group of clinicians and cytopathologists. This report summarizes the experience in 86 patients in whom needle aspiration cytology and excisional biopsy of solid breast masses were performed. All clinical evaluations, including needle aspirations and excisional biopsies, were performed by surgical residents in the Breast Clinic of Grady Memorial Hospital. The cytologic and histologic interpretations were performed by members of the Department of Pathology without direct interaction with the patients. Of the entire group of 86 patients, 27 had cancer and 59 had benign breast disease. There were no false-positive findings and five (11.9%) false-negative findings. The sensitivity of fine-needle aspiration was 73.7 per cent and specificity 100 per cent. The results are compatible with previously reported studies and it is believed that needle aspiration cytology is an integral part of evaluation of breast masses.

Adult↗
PubMed1986

Growth in semisolid agar of prostate cancer cells obtained from bone marrow aspirates.

Thirty-one bone marrow aspirations were performed on patients with prostatic carcinoma metastatic to bone. After separation over a Ficoll-Hypaque gradient viable nucleated cells were cultured in semisolid agar. Colony formation occurred in 14 of 27 (52%) nonbacterially contaminated cultures. Characterization of cells from the colonies showed them to be consistent with malignant prostate cells. After staining, these cells were periodic acid-Schiff positive, prostatic acid phosphatase positive, and prostatic specific antigen positive. Other studies demonstrated the cells to be karyotypically abnormal, ultrastructurally similar to epithelial cells, and capable of secondary colony formation. Three bone marrow aspirate specimens did not have metastatic prostatic carcinoma detected by standard methods but did demonstrate colony formation. However, colony formation was most frequently seen when a radionuclide scan was positive at the aspiration site and when tumor cells were microscopically detectable by Wright staining of a smeared aspirate. The potential utility of colony forming cultures in prostate cancer is discussed. In working with bone marrow aspirates, additional cell separation procedures may be required to calculate and maximize plating efficiencies.

Agar↗