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PubMed1992

Fine-needle aspiration biopsy of Ki-1-positive anaplastic large-cell lymphoma.

Five cases of Ki-1-positive anaplastic large-cell lymphoma diagnosed by fine-needle aspiration biopsy are reviewed, and cytologic, histologic, and ultrastructural findings in these cases are correlated. In all cases, the diagnosis of anaplastic large-cell lymphoma was suggested on the basis of the morphological appearance in aspiration smears. This diagnosis was confirmed by immunohistochemistry, which revealed strong positivity of most of the cells by Ki-1 antibody. Two of the lymphomas were T-cell type, one was B-cell type, and the remaining 2 were composed of null cells. In 2 cases, intracytoplasmic inclusions were seen in some of the tumor cells in aspiration smears. These were ultrastructurally correlated with large lysosomal bodies of variable morphology. Fine-needle aspiration combined with immunohistochemistry may be an effective technique for diagnosing this neoplasm.

Adolescent↗
PubMed1992

Aspiration biopsy cytology of papillary carcinoma of the breast.

The fine-needle aspirates of two cases of noninfiltrating papillary carcinoma (PC) and three examples of early invasive PC of the breast were examined. In three cases in which the tumors displayed cuboidal or polygonal cells the aspirates showed papilla-like clusters of tumor cells with relatively "strong" cellular cohesiveness. Single and small aggregates of tumor cells as well as hemosiderin-laden or foamy macrophages were also present. Aspirates from the two PCs predominantly consisting of tall columnar epithelial cells revealed only monolayered and multilayered epithelial fragments with folding in one case. In the other case large epithelial fragments and small tight clusters of polygonal tumor cells were present. No bipolar nuclei of myoepithelial cells were identified in all cases. No specific cellular features permitting the differentiation between noninfiltrating and early invasive breast PCs were identified in this small series. Staining for carcinoembryonic antigen using the peroxidase-antiperoxidase technique was performed on aspiration smears of three cases. It revealed a positive cytoplasmic reaction in two cases.

Aged↗
PubMed1992

Needle aspiration cytology, immunocytochemistry, and electron microscopic study of unusual pancreatic carcinoma with pleomorphic giant cells.

Needle aspiration cytology, immunocytochemistry, and electron-microscopic findings are presented in three cases of an unusual pancreatic carcinoma in which pleomorphic giant cells formed an integral part of the tumour. All three patients were elderly males (age range 66-83 years) and had pancreatic masses. Notable cytologic features in all cases were the presence of bizarre mononucleated and multinucleated, poorly cohesive tumour giant cells, rare spindle cells, with occasional cannibalism and cytophagocytosis. Immunocytochemical study of aspirated material showed diffuse staining of cytokeratin and EMA within the tumour cells, while B 72.3 was seen as focal trace stain. Electron microscopy of aspirated material demonstrated epithelial features and these were characterised by the presence of tonofilaments and surface microvilli. Based on our findings, it is felt that the bizarre giant cells in this unusual variant of pancreatic carcinoma are of epithelial origin. The differential diagnosis of other tumours that may be associated with predominant giant cells in pancreatic aspirates is appropriately discussed.

Aged↗
PubMed1993

Diagnostic pitfalls in thyroid fine-needle aspiration: a review of 394 cases.

To determine the diagnostic pitfalls of thyroid fine-needle aspiration (FNA), we reviewed 394 thyroid aspirates obtained between January 1986 and December 1990. Surgical follow-up was available for 150 aspirations. The cytologic diagnoses were categorized into four groups: benign, 57; indeterminate, 51; malignant, 33; and nondiagnostic specimen, nine. There were three false negative diagnoses (3%), which upon review were judged to be inadequate specimens. Three false positive diagnoses (7%) were identified: in the first two cases, follicular adenomas were mistaken for papillary carcinoma; in the third case, atypical Hürthle cells were mistaken for a Hürthle cell carcinoma. Our results showed a sensitivity of 93% and a specificity of 91% for the detection of malignancy. If indeterminate cases were considered positive, the specificity decreased to 50%, while the sensitivity increased to 97%. We conclude that: 1) certain follicular adenomas may display cytologic features mimicking papillary carcinoma; 2) as in follicular neoplasms, aspirates of Hürthle cell adenomas cannot be differentiated from Hürthle cell carcinomas; 3) with adequate sampling, false negative results can be markedly reduced.

Adolescent↗
PubMed1993

Fine-needle aspiration of six carotid body paragangliomas.

We report six carotid body paragangliomas diagnosed by fine-needle aspiration (FNA) in five patients. A total of eight aspirations were performed. The cytologic findings are characteristic: hemorrhagic background, hypo- to hypercellular smears (depending on the skill of the aspirator) with cells having delicate, ill-defined, vacuolated cytoplasm, pleomorphic nuclei with distinct nucleoli, rare intranuclear cytoplasmic inclusions, and prominent rosette formation. No complications arose in any of the eight aspirations. FNA is a safe, accurate means of diagnosing carotid body paragangliomas. It can provide essential information for treatment planning and patient management.

Adult↗
PubMed1993

Fine-needle aspiration cytology of the male breast in a cancer center.

All fine-needle aspirates (FNA) performed on the male breast at The University of Texas M. D. Anderson Cancer Center from 1985 to 1992 were reviewed, totaling 64. The patients' ages ranged from 19 to 86 years, with a mean of 56 years. Thirty-three patients had a history of an extramammary malignancy. The diagnoses established by FNA were gynecomastia (45), mammary carcinomas (6), neoplasms metastatic to the breast (5), suspicious for carcinoma (1), intra-mammary lymph node (1), and lipoma (1). In five cases the aspirates were nondiagnostic. Two of these proved to be gynecomastia on subsequent histologic examination. Of the six FNA cases initially thought to represent primary breast carcinomas, two were found to be secondary because of involvement of the underlying chest wall by mesothelioma (1), and mucinous adenocarcinoma, unknown primary (1). No false-positive diagnosis was rendered. We conclude that fine-needle aspiration of the male breast is a reliable means of assessment; however, unique problems may be encountered compared with aspiration of the female breast. These include the epithelial hyperplasia frequently associated with gynecomastia, the relatively equal frequency of primary and metastatic breast lesions when a malignant process is discovered, and chest wall lesions masquerading as breast lesions.

Adult↗
PubMed1994

Diagnosis of umbilical metastasis (Sister Mary Joseph's nodule) by fine-needle aspiration: an immunocytochemical study.

During a ten year period, since we introduced needle aspiration cytology at our institution, we have diagnosed five cases of umbilical metastasis (Sister Mary Joseph's nodule). In none of the cases was any false negative or false positive diagnosis rendered and the primary carcinoma was found below the diaphragm. In all the five cases, cell blocks of the aspirate were subsequently prepared, and highlighted the histologic features of the tumour which corresponded with the cytologic diagnosis. Immunohistochemical staining on the aspirate material in all the cases was considered quite useful in substantiating the cytohistologic diagnosis. Based on our findings, we suggest that fine-needle aspiration cytology as an initial diagnostic procedure in cases suspected of umbilical metastasis should be considered, since it is not only a simple, fast, accurate, and inexpensive diagnostic procedure, but can also save the patient from an invasive surgical procedure, the benefit of which is questionable.

Adenocarcinoma↗
PubMed1994

Fine-needle aspiration cytology of recurrent and metastatic mixed mesodermal tumors.

We report the cytological and clinical findings of 16 fine-needle aspirates (FNAs) performed on recurrent (n = 6) and metastatic (n = 10) mixed mesodermal tumors (MMMTs). The median interval between the primary diagnosis and FNA was 16 mo. Primary sites were the endometrium (n = 11), the ovary (n = 3), the cervix (n = 1), and pelvic soft tissue (n = 1). Primary tumors showed carcinoma with homologous mesenchymal components in 13 cases and focal heterologous elements in three (two chondrosarcomas and one rhabdomyosarcoma). The FNAs showed carcinoma in all 16 cases, with adenocarcinoma differentiation in three. Mesenchymal elements were identified in aspirates of three recurrent and two metastatic lesions. They were all homologous. aspirates. We conclude that mesenchymal components in FNAs of MMMTs are less likely to be seen in metastatic lesions, and that heterologous mesenchymal components are rarely seen in these aspirates even in recurrent disease. These findings confirm that the epithelial component is responsible for the malignant behaviour of MMMTs, and suggest that these lesions may need to be classified as sarcomatoid carcinomas rather than true carcinosarcomas.

Adenocarcinoma↗
PubMed1995

Comparison of immunoreactivity of neu oncoprotein in fine-needle aspirates and paraffin-embedded materials.

Expression of the neu oncogene has been extensively examined in frozen and paraffin section breast cancers; however, very few studies examine neu oncoprotein oncoprotein expression in fine-needle aspirates. To this effect, we compared the expression of neu oncoprotein in formalin-fixed paraffin-embedded breast cancers and the corresponding fine-needle aspirates of these cancers. There was 100% correlation between the expression of neu oncoprotein in the paraffin-embedded breast cancers and the fine-needle aspirates, indicating the suitability of fine-needle aspirates for the expression of neu oncoprotein in breast cancers.

Biopsy, Needle↗
PubMed1995

Extragonadal germ cell tumors: a fine-needle aspiration biopsy study.

Germ cell tumors (GCT) are neoplasms that originate predominately in the ovary and testis. Tumors of germ cell origin only very uncommonly arise in extragonadal sites. We have diagnosed ten primary malignant extragonadal GCT arising in the mediastinum, retroperitoneum, liver, and sacrococcygeal region by fine-needle aspiration biopsy (FNAB). Patient ages ranged from 1 to 54 years; the majority were males. Our series included three seminomas, three yolk sac tumors (YST), one choriocarcinoma, one embryonal carcinoma, and two mixed, poorly differentiated GCT. In aspirates, seminomatous elements are dissociated with uniform mononucleate cells having large vesicular nuclei and prominent nucleoli. A tigroid background is produced with Diff-Quik-stained smears. YST yields cohesive clusters of cells with large nuclei, vacuolated cytoplasm, and extracellular hyaline matrix (spheres or hyaline globules). Giant multinucleate tumor cells are seen in choriocarcinoma. Embryonal carcinoma yields cellular smears of hyperchromatic cells with scant cytoplasm arranged predominantly in glandular or papillary formations. Ultrastructural (four cases) and immunocytochemical (seven cases) studies of aspirated material corroborated our cytologic interpretations. Aneuploid tumor cells were found by flow cytometry in aspirated material from a YST. Subsequent histologic examinations were performed on eight, and all were confirmatory. Although extragonadal GCT are relatively uncommon, they need to be considered in FNAB material from midline mass lesions. Ancillary studies were useful in confirming their diagnosis.

Adult↗
PubMed1995

Fine-needle aspiration of normal tissue from enlarged salivary glands: sialosis or missed target?

Salivary gland enlargement by hypertrophy of normal-appearing parotid or submaxillary tissue is known as sialosis. It can be idiopathic, or may be associated with malnutrition, diabetes, bulimia, or alcoholism. When normal tissue is aspirated from an enlarged gland, one is tempted to diagnosed sialosis. We performed 26 such aspirates over a 5-yr period. In all cases, the cytology featured abundant acinar and ductal tissue in a clean (noninflammatory) background. Six cases were excluded when the records showed no return visits to the clinic. The remaining 20 patients included 9 men and 11 women, aged 24-92 yr (median 56), who harbored 12 parotid (2 bilateral) and 8 unilateral submaxillary enlargements. Clinical findings included ethanol abuse (2), diabetes (1), and previously diagnosed head and neck carcinoma (3). In six patients, the duration of the mass was described as months or years. Excision (6), reaspiration (3), radiographic evaluation (2), and clinical follow-up of patients not evaluated by other means (9 cases with median follow-up of 6 months) revealed no malignancies. One excised gland contained a pleomorphic adenoma measuring 0.5 cm in diameter. This had been diagnosed by repeat fine-needle aspiration (FNA) prior to surgery. We suggest that sialosis is a meaningful FNA diagnosis in patients who are carefully examined, skillfully aspirated, and reasonably followed.

Adult↗
PubMed2002

Lavage and nipple aspiration of breast ductal fluids: a source of biomarkers for environmental mutagenesis.

The acquisition of breast ductal fluid by nipple aspiration and ductal lavage are simple noninvasive procedures to sample breast tissue. Nipple aspiration fluid (NAF) obtained with gentle suction and a simple syringe-adapted apparatus may evaluate the secretory components that bathe the ductal epithelial cells. Evaluations have included the quantification of soluble markers (carcinoembryonic antigen and prostatic-specific antigen), DNA amplification, protein gel electrophoresis, and mutagenesis assays. It has been suggested that environmental mutagens in the breast ductal system may contribute to carcinogenesis. The feasibility of mutagenesis assays on NAF has been limited by the small size of the samples obtained. Three small clinical studies detected mutagens in 6-14% of the samples using the Salmonella Ames assay. Ductal lavage collects more of a cellular aspirate from the ductal system utilizing a microcatheter. Early studies on ductal lavage fluid have included cytology and methylation-specific PCR. Ductal lavage in a high-risk group has identified cellular atypia in 21% of those sampled. Samples obtained through the nipple, by aspiration or lavage, are the proteinaceous secretions from the ductal system and ductal epithelial cells. The fluid represents the cellular events and the dynamic secretory process of the breast and may include potential initiators of the carcinogenesis process in the cellular microenvironment. Fluid obtained by ductal lavage may allow for more detailed studies of the role of mutagens in breast cancer.

Adult↗
PubMedDate not supplied

Needle aspiration biopsy of the pre-epiglottic space.

Clinical staging of supraglottic carcinoma requires evaluation of the pre-epiglottic space (PES). To explore the role of fine needle aspiration biopsy of the PES in the staging of epiglottic carcinoma, endoscopic transvallecular fine needle aspiration biopsies of the PES were performed in 16 patients with epiglottic carcinoma. The results of aspiration cytology were compared with CT scanning and postoperative histopathologic sections of the PES after total or supraglottic laryngectomy. This preliminary report shows that needle aspiration biopsy of the PES is a safe and sensitive technique, having a high correlation with histopathologic follow-up. Needle biopsy, along with CT scan, is clinically useful in staging the PES, which cannot be examined directly.

Aged↗
PubMedDate not supplied

Scintigraphic assessment of aspiration in head and neck cancer patients with tracheostomy.

Tracheopulmonary aspiration commonly occurs in patients with dysphagia related to head and neck cancer. Scintigraphic studies were performed in 280 patients with head and neck cancer; 33% of these patients had tracheopulmonary aspiration. A subgroup of 18 tracheostomized patients had a tracheostomy tube with a removable obturator, so they could be studied with the tracheostomy open or occluded. When the tracheostomy was occluded the patients aspirated less frequently, and in significantly smaller quantities, than when it was open. When feasible, occluding the tracheostomy tube or permanent surgical closure may reduce or eliminate tracheopulmonary aspiration in these patients.

Deglutition↗
PubMed2004

Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration.

This study aims to compare the therapeutic effectiveness of continuous catheter drainage versus intermittent needle aspiration in the percutaneous treatment of pyogenic liver abscesses. Over a 5-year period, 64 consecutive patients with pyogenic liver abscess were treated with intravenous antibiotics (ampicillin, cefuroxime, and metronidazole) and randomized into two percutaneous treatment groups: continuous catheter drainage (with an 8F multi-sidehole pigtail catheter); and intermittent needle aspiration (18G disposable trocar needle). There was no statistically significant difference between the two groups regarding patient demographics, underlying coexisting disease, abscess size, abscess number, number of loculation of abscess, the presenting clinical symptoms such as fever, abdominal pain, and pretreatment liver function test. Although not statistically significant, the duration of intravenous antibiotics treatment before percutaneous treatment was longer with the catheter group, and the change of antibiotics after the sensitivity test was more frequent with the needle group. The needle group was associated with a higher treatment success rate, a shorter duration of hospital stay, and a lower mortality rate, although this did not reach statistical significance. In conclusion, this study suggests that intermittent needle aspiration is probably as effective as continuous catheter drainage for the treatment of pyogenic liver abscess, although further proof with a large-scale study is necessary. Due to the additional advantages of procedure simplicity, patient comfort, and reduced price, needle aspiration deserves to be considered as a first-line drainage approach.

Adult↗
PubMed1991

On the hippocampus and learned conditional responding: effects of aspiration versus ibotenate lesions.

To study the possible involvement of the hippocampus in learned conditional responding, rats with aspiration lesions of the hippocampus and others that had the hippocampus removed with ibotenic acid were trained on concurrent Pavlovian conditional and nonconditional discriminations. In agreement with the results reported by Ross et al. (1984), animals that had the hippocampus removed with aspiration were unable to learn the conditional discrimination, but learned the simple nonconditional discrimination without difficulty. In contrast, rats that had the hippocampus removed with ibotenic acid did not differ from controls in learning either discrimination. Furthermore, transfer test results were consistent with the hypothesis that ibotenate-lesioned rats performed conditional operations to solve the conditional discrimination problem. Histological analysis indicated that the ibotenate lesions resulted in the removal of the hippocampus and dentate gyrus with minimal involvement of other structures. In aspiration hippocampal animals there was less overall damage to the hippocampus, but there was also extensive damage to the axons passing in alveus and fimbria, together with bilateral loss of cells in the subicular complex, the cingulate gyrus, and the cortex. Since rats with ibotenate lesions had more complete removal of the hippocampus, yet learned both discriminations, the impaired conditional responding found in aspiration hippocampals must be due to extrahippocampal damage.

Animals↗
PubMed2004

Aberrant methylation of the adenomatous polyposis coli promoter 1A in bronchial aspirates from patients with suspected lung cancer.

Promoter hypermethylation is a major mechanism for gene silencing and offers a promising starting point for developing molecular biomarkers. The purpose of our study was to determine aberrant methylation of the adenomatous polyposis coli (APC) gene promoter 1A with respect to its prevalence and quantitative level in bronchial aspirates from patients with suspected lung cancer. Applying quantitative methylation-specific PCR, 155 bronchial aspirates from patients with non-small cell cancer (NSCLC) and small cell cancer (SCLC) of the lung as well as 67 bronchial aspirates from patients diagnosed for nonneoplastic lung disease were examined in a retrospective case-control study. Aberrant APC promoter 1A methylation was seen in 71% of NSCLCs, 38% of SCLCs and 42% of patients with nonneoplastic lung disease, being therefore not specific for the presence of primary lung cancer. In contrast, quantitative analysis showed a significantly higher methylation level of bronchial aspirates from NSCLC as compared to patients without neoplastic lung disease. Introducing a cutoff point that defined high level of APC hypermethylation NSCLC could be discriminated from cases without neoplastic disease with a specificity of 98.5% and a sensitivity of 39%. The data suggest that quantitative analysis of APC hypermethylation may serve as a biomarker of primary lung cancer.

Adenomatous Polyposis Coli Protein↗
PubMedDate not supplied

Implantation of artificial spermatocele with cup-shaped prosthesis for excretory azoospermia and chemical management of aspirated spermatozoa.

A cup-shaped silicon prosthesis was developed to treat patients with excretory azoospermia and chemical management of the aspirated spermatozoa was attempted prior to cervical insemination of the wives. These cup-shaped prostheses were implanted eight times in six patients, four of whom had congenital absence and two of whom had bilateral inflammatory obstruction of the vas deferens. The surgical technique was based on the method of Cruz (1980), which involved wrapping the tunica vaginalis over the top of the prosthesis. Aspirated spermatozoa were incubated in a modified Ringer's solution at 37 C for 30 minutes and used for the cervical insemination of the wives. Epididymal spermatozoa could be collected from all patients 10 to 20 weeks after the operation. The percentage of motile aspirated spermatozoa ranged from 0 to 20%. In two cases, the percentage of motile spermatozoa aspirated from the prosthesis increased markedly from 5 and 10% to 55 and 60%, respectively, after incubation of the spermatozoa in the medium. Cervical inseminations were tried in all of the wives from two to four times, but no pregnancy resulted during this study.

Adult↗