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Malignant
Terms modified by Malignant Selected AbstractsLetter: The Superiority of Dermabrasion over Laser Abrasion in the Prophylaxis of Malignant and Premalignant DiseaseDERMATOLOGIC SURGERY, Issue 2 2007FIACS, LAWRENCE M. FIELD MD No abstract is available for this article. [source] Mast cell tumours (mastocytosis) in the horse: A review of the literature and report of 11 casesEQUINE VETERINARY EDUCATION, Issue 4 2008T. S. Mair Summary Mast cell tumours are uncommon tumours in horses, compared to some other species of domesticated animals. They are most frequently located in the skin, but they can also arise at other sites, including the upper respiratory tract and eye. Cytology or histopathology is required for diagnosis. Treatment options include surgical excision, laser ablation, cryotherapy, intralesional injection of corticosteroids or water, and radiotherapy. Malignant and systemic forms are very rare. [source] Malignant or borderline mucinous cystic neoplasms have a larger number of loculi than mucinous cystadenoma: A retrospective study with MRJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 1 2007Yoshikazu Okamoto MD Abstract Purpose To determine whether there is any correlation between the number of loculi and the pathological grade of malignancy in mucinous cystic tumors of the ovary. Materials and Methods We retrospectively studied MR images of 67 pathologically proven mucinous cystic tumors of the ovaries. Of these 67 cases, 38 were cystadenomas and 29 were malignant lesions (18 borderline malignancy and 11 adenocarcinomas). We counted the number of loculi and measured the maximum diameter of masses on MRI. We compared the number, the maximum diameter, and the ratio of the number of loculi to the maximum diameter in each adenoma and malignancy using Student's t -test. Results The mean number of loculi was 18.2 in cystadenoma and 80.9 in malignant lesions. The mean maximum diameter of tumors was 13.0 cm in cystadenoma and 18.7 cm in malignant lesions. The mean ratio of the number of loculi to the maximum diameter was 1.3 in adenoma and 5.4 in malignant lesions. The differences between the benign and malignant lesions were statistically significant in number (P = 0.001), maximum diameter (P = 0.011), and ratio (P = 0.002). Conclusion Ovarian mucinous neoplasm of borderline malignancy and mucinous adenocarcinomas had a larger number of loculi than adenomas. J. Magn. Reson. Imaging 2007;26:94,99. © 2007 Wiley-Liss, Inc. [source] Florid cutaneous and mucosal papillomatosis with acanthosis nigricans revealing a primary lung cancerJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2000Ugo Bottoni Abstract This is the report of an 80-year-old patient with diffuse brownish hyperpigmentation and velvety thickening of the skin with onset 1 year before. Warty lesions on his limbs were present as well as papillomatous and verrucous lesions on his lips, mouth and eyelid conjunctivae with hyperkeratosis of the nipples. Biopsies, performed at different sites, showed histological pictures consistent with a diagnosis of acanthosis nigricans (AN) with florid cutaneous and mucosal papillomatosis. This type of AN is frequently associated with internal malignancy. In our patient serum levels of tissue polypeptide antigen, carcinoembryonic antigen, cytokeratin fragment and squamous cell carcinoma antigen were high and chest computed tomography scan indicated a large tumour infiltrating the right lung and extending to the mediastinum. Cytological examination of bronchial drainage revealed the presence of neoplastic cells, non-small cell type carcinoma. The most frequent cancer associated with malignant AN is gastric adenocarcinoma. Lung tumour has rarely been reported with AN. Malignant AN is sometimes associated with other cutaneous and mucosal warty lesions, as in our patient. These various skin and mucosal lesions are the expression of a systemic epithelial disorder and may help clinicians to suspect a malignant form of AN. [source] Delayed radiotherapy-related effusions: Malignant or not malignant, that is the question?RESPIROLOGY, Issue 5 2008Sanjay H. CHOTIRMALL No abstract is available for this article. [source] Reply to the letter: Delayed radiotherapy related effusions: Malignant or not malignant, that is the question?RESPIROLOGY, Issue 5 2008John E. HEFFNER No abstract is available for this article. [source] Telomerase activity as a potential marker in preneoplastic bladder lesionsBJU INTERNATIONAL, Issue 4 2000F. Lancelin Objective To assess telomerase activity (involved in cell immortalization and detectable in most malignant tumours but not in normal somatic tissues) as a marker in cancer diagnosis. Patients and methods Tissue telomerase activity was assayed by two different techniques, the telomeric repeat amplification protocol-polymerase chain reaction (TRAP-PCR) and a telomerase PCR-enzyme linked immunosorbent assay. Malignant and inflammatory bladder lesions and their adjacent normal tissues were assessed for telomerase activity in a group of 18 patients, 14 of whom had urothelial carcinoma and four a nonspecific inflammatory lesion of the bladder. Results Eleven of the 14 tumour samples analysed were telomerase-positive and two of the three telomerase-negative tumour samples had a detectable ,telomerase inhibitor'. In the apparently normal tissues next to bladder tumours, four of the 14 specimens were telomerase-positive. Interestingly, these lesions were always next to high-grade muscle-invasive bladder tumours (pT2G3). Two of the four nonspecific inflammatory lesions (one of cystitis glandularis and one of severe dysplasia), known to be preneoplastic lesions, were also telomerase-positive. Conclusion These results strongly suggest that the reactivation of telomerase may be an early event in bladder carcinogenesis, preceding morphological changes related to malignant transformation. Telomerase activity may therefore be useful both as an indicator of malignant potential in preneoplastic lesions, e.g. cystitis glandularis and severe dysplasia, and as a prognostic marker of bladder tumour relapse or progression. [source] Evaluation of malignant and benign gastric biopsy specimens by mRNA expression profile and multivariate statistical methodsCYTOMETRY, Issue 5 2007Orsolya Galamb Abstract Background: mRNA expression array and multivariate statistical analysis of gastric biopsies can yield insight into the molecular biology basis of local alterations, supporting expression-based identification of morphological alterations. Methods: From 11 patients with erosive gastritis(EG), 5 with adenocarcinoma (GC), 11 with atrophic gastritis (AG) gastric biopsies were collected, total RNA isolated, T7 amplification and expression analysis of 1047 mRNAs was performed using commercial glass arrays (Clontech, USA). After microarray quality control, applicable data were available from 7 EG, 4 GC, and 5 AG. Multivariate statistical and cell functional analysis were performed. Real-time RT-PCR and immunohistochemistry were used for validation. Results: GC was characterized by overregulated v-raf, v-erb-a, BCL2-associated- athanogene, immediate-early-response-3, Polo-like kinase, CDK-2, cyclin-C, Pin1 genes, and downregulated ADP-ribosyltransferase, sialophorin and DCC. AG cases had increased PDGF-receptor, TGF-,-receptor-3, and decreased death-associated-protein-3, ,-1-catenin, topoisomerase-1 levels. In EG upregulation of IGF-receptor-1, CD9, transferrin receptor, integrins, and underexpression of keratin-5, caspase-4 was found. Discriminant analysis could reclassify all samples correctly using four parameters. Conclusions: mRNA expression array analysis of gastric biopsies yields previously known and new data in the evaluation of local gastric alterations. © 2007 Clinical Cytometry Society [source] Fine needle aspiration cytology in the diagnosis of bone lesionsCYTOPATHOLOGY, Issue 2 2005U. Handa Objective:, Fine needle aspiration cytology (FNAC) in combination with radiological examination has recently gained clinical recognition for evaluating skeletal lesions. We evaluated our experience with the use of FNA in diagnosing bone lesions with emphasis on areas of difficulty and limitations. Materials and Methods:, Over a period of 5 years FNA was performed in 66 cases of bone lesions. Aspirations were done by cytopathologists using 22-gauge needle. Out of 66 cases unsatisfactory aspirate was obtained in 12 cases. Cytohistological correlation was available in 19 cases. Results:, Adequate aspirates were categorized into neoplastic (27 cases) and non-neoplastic (27 cases) lesions. Of the 27neoplastic aspirates, 20 were malignant (12 primary, 8 metastatic deposits) and 7 were benign. In the malignant group osteosarcoma was correctly diagnosed in 3 cases while other 3 were labeled as sarcoma NOS because of lack of osteoid. Metastatic deposits were sub-typed in 6 cases; from renal cell carcinoma (3 cases), proststic adenocarcinoma, follicular carcinoma thyroid, and squamous cell carcinoma. Neoplastic group comprised of 6 cases of cysts and 21 cases of chronic osteomyelitis. Thirteen cases were diagnosed as tuberculous osteomyelitis. Conclusions:, FNA is a frequent indication in metastases in the bone where distinct cytologic features can even identify an unknown primary. However, diagnosis of primary tumours of the bone is limited by precise subtyping of the tumours. FNA has emerged as a cost effective tool for initial diagnosis of both neoplastic and non-neoplastic lesions of the bone. [source] Mesothelioma Symposium 11.30,12.30 Tuesday 16 September 2003CYTOPATHOLOGY, Issue 2003Darrel Whitaker Dr The diagnosis of malignant mesothelioma on the cytology of serous effusions is a two-phase process. First is to determine that the effusion is malignant based on morphological features such as a highly cellular fluid with many large three dimensional cell aggregates, and/or the recognition of minor malignant criteria including prominent cell engulfment, uniformly present very prominent nucleoli, or the finding of very large (giant) cells. In cell block sections, strong positive staining with EMA often with cell membrane accentuation provides compelling support for a cytological diagnosis of malignancy. Second is to recognize that the malignant cells have a mesothelial phenotype and do not represent metastatic malignancy (usually adenocarcinoma). Criteria in support of mesothelioma include the lack of a ,two cell' population, that is one native (mesothelial) and one foreign (metastatic), cells with abundant dense staining cytoplasm, the presence of ,windows' where mesothelioma cells lie in close apposition and intracytoplasmic glycogen presenting either as small peripheral vacuoles on MGG stained smears or large yellow refractile crescents on Papanicolaou stained smears. In addition, mesothliomas often possess connective tissue stromal cores occurring as either well-formed collagen within papillary aggregates or lying free as pink (MGG) or light green (Pap) amorphous material in the background of the smear or in loose association with mesothelioma cells. Finally small orange staining squamous-like cells can occasionally be identified and sometimes this may be a very prominent finding and has resulted in the false impression of a squamous cell carcinoma. Almost certainly these cells represent apoptotic tumour cells. The connective tissue mucin hyaluronic acid may be found as a net-like pattern in the smear background or as large hard-edged magenta-stained vacuoles on MGG-stained smears. Cell block sections provide architectural information and it is usually possible to separate mesothelioma aggregates with their cuboidal cells, central nuclei and abundant dense cytoplasm arranged in solid, papillary or hollow clusters from those of adenocarcinoma with less dense, often foamy cytoplasm, often composed of columnar cells with elongated nuclei. Aggregate form in adenocarcinoma can be variable but true acini are a rare finding. These cell block sections provide an ideal medium for histochemistry (PAS with and without diastase digestion) and immunocytochemistry. By using a panel of antibodies (Calretinin and CK 5/6, BerEp4, CEA, B72.3) it is almost always possible to distinguish mesothelioma from metastatic adenocarcinoma. Calretinin and CK 5/6 positive staining and absent staining with BerEp4, CEA and B72.3 is considered diagnostic of mesothelioma. [source] Stereotactic biopsy and cytological diagnosis of solid and cystic intracranial lesionsCYTOPATHOLOGY, Issue 3 2003L. M. Collaço Cytological smears from 115 consecutive cases of stereotactic biopsies of intracranial lesions were reviewed. Ninety-five lesions were solid and 20 cystic. Material from 90 solid and 13 cystic lesions was sent both for cytological and histological examination. In 66 of the solid lesions, the cytological diagnosis was confirmed by histology (five were benign lesions and 61 malignant tumours: 56 primary brain tumours, three metastases and two lymphomas). In 24 cases with discrepant cytology and histology, the histology was inconclusive or insufficient in 14 cases, while cytology established the diagnosis of astrocytoma grade II (seven cases), metastases (two cases), gliosis (one case) and benign (four cases). Necrosis of tumour type was observed cytologically in six patients representing glioblastoma (two cases), anaplastic astrocytoma (one case), lymphoma (one case) and normal brain (two cases) histologically. Three cases reported cytologically as benign were primary brain tumour (two cases) and gliosis (one case). One smear of a glioblastoma was insufficient for cytological diagnosis. Cystic lesions were cytologically benign in 17 cases and malignant in three cases. Histology from the cyst wall confirmed the malignant diagnosis in three cases and showed tumour in six more cases, a benign process (two cases), changes induced by radiotherapy for arteriovenous malformation (one case) and insufficient material (one case). In conclusion, cytology from solid brain lesion allows an accurate diagnosis and subtyping of tumours in a majority of cases, and can thus be used to choose type of therapy. In cystic brain tumours, however, examination of the cystic fluid, is often inconclusive and a biopsy from the cyst wall should be performed if there is clinical or radiological suspicion of tumour. [source] An audit of ,equivocal' (C3) and ,suspicious' (C4) categories in fine needle aspiration cytology of the breastCYTOPATHOLOGY, Issue 4 2001R. A. Deb An audit of ,equivocal' (C3) and ,suspicious' (C4) categories in fine needle aspiration cytology of the breast We have audited the frequency of use and outcome of the ,equivocal/atypia probably benign' (C3) and ,suspicious of malignancy' (C4) category for breast cytology in our Unit. A total of 14 935 cytological specimens were reported by at least one of the three pathologists with a special interest in breast pathology, according to five categories of the NHSBSP guidelines for cytology reporting, 1992; 3.7% (555 cases) and 3.9% (587 cases) of cases were classified as equivocal (C3) and suspicious (C4), respectively, giving a total rate (C3 + C4) of 7.6%. Of the C3 cases, 68% were subsequently benign and 32% were malignant. Of the C4 cases, 19% were subsequently benign and 81% malignant. The commonest benign lesions in both categories were fibroadenomas (7.6% of C3 and 19.8% of C4), fibrocystic change (14.3% of C3 and 12.5% of C4), radial scars (6.2% of C3 and 10.4% of C4) and papillomas (6.2% of C3 and 6.3% of C4). Of the malignant lesions (particularly those classified as C3), a high proportion were low grade or special type cancers. The categories of atypia probably benign (C3) and suspicious of malignancy (C4) in breast cytology provide a strategy for classification of problematic or uncertain cases; this maintains the predictive value of the benign (C2) and malignant (C5) categories, and allows separation of these difficult cases into clinically useful groups with differing probabilities of malignancy. [source] Patients Spend More Time With the Physician for Excision of a Malignant Skin Lesion Than for Excision of a Benign Skin LesionDERMATOLOGIC SURGERY, Issue 3 2004Steven R. Feldman MD Background. Currently, there is a difference in reimbursement between excision of malignant and benign lesions. There is concern that there is not sufficient rationale for differential reimbursement for these two procedures. Objective. To assess whether there is a difference in physician work involved with excision of benign versus malignant skin tumors. Method. We searched National Ambulatory Medical Care Survey data for visits at which excision of benign and malignant skin lesions was performed. We compared the time spent with the physician at these two types of visits. To exclude confounding issues unrelated to the excision that would affect the time of visit, we excluded visits at which multiple diagnoses were addressed. Results. The mean time spent with the physician at visits for excision of benign lesions was 22.9±1.0 minutes. The mean time spent with the physician at visits for excision of malignant lesions was 30.0±1.7, 30% longer (p < 0.001). The longer time for excision of malignant lesions remained significant after controlling for age, gender, and race. Conclusion. Excision of malignant lesions involves more physician work than does excision of benign lesions. Elimination of differential compensation for benign versus malignant skin lesion procedures would not enhance the accuracy of reimbursement. In the absence of any compelling rationale to change the existing differential reimbursement, the proposals to do so are not warranted. [source] Keratoacanthoma: A Clinico-Pathologic EnigmaDERMATOLOGIC SURGERY, Issue 2004Robert A. Schwartz MD Background. Keratoacanthoma (KA) is an extraordinary entity. Once considered a benign neoplasm that resembled a highly malignant one (pseudomalignancy), it is now viewed in an opposite light as a cancer that resembles a benign neoplasm (pseudobenignity). Objective. The goal was to delineate the malignant potential of this neoplasm based on the author's experience and a review of recent data and research and to emphasize the KA as a possible part of an autosomal dominant familial cancer syndrome, the Muir,Torre syndrome. Methods. This is a review of the literature. Results. In this work, the KA is reviewed with recent advances emphasized. Conclusion. KA is an abortive malignancy that rarely progresses into an invasive SCC. The KA may serve as a marker for the important autosomal dominant familial cancer syndrome, the Muir,Torre syndrome, as a result of a defective DNA mismatch repair gene. [source] Clinical pathologic correlations for diagnosis and treatment of nail disordersDERMATOLOGIC THERAPY, Issue 1 2007Olympia I. Kovich ABSTRACT:, Clinicopathologic correlation is crucial to the correct diagnosis of disorders of the nail unit. This chapter will explore four common clinical scenarios and how pathology can help differentiate between their various etiologies. These include: dark spot on the nail plate (melanin versus heme), subungual hyperkeratosis (onychomycosis versus psoriasis), longitudinal melanonychia (benign versus malignant), and verrucous papule (verruca versus squamous cell carcinoma). Consideration must be given to both when to perform a biopsy and the location of the biopsy site, which must be based on an understanding of the origin of the changes. An overarching principle is that lesions within the same differential diagnosis may be present concomitantly, such as malignant melanoma of the nail unit associated with hemorrhage. Therefore, even with a biopsy-proven diagnosis, the clinician must always monitor lesions of the nail unit for appropriate response to treatment and consider an additional biopsy for recalcitrant lesions. [source] Use of topical immunomodulators in organ transplant recipientsDERMATOLOGIC THERAPY, Issue 1 2005Bradley T. Kovach ABSTRACT:, Solid organ transplant recipients are a growing population at increased risk for the development of cutaneous premalignant and malignant lesions, resulting in significant morbidity and mortality. Topical immunomodulators, in particular imiquimod, have shown efficacy in the management of multiple malignant, precancerous, and viral conditions. The ability to locally induce an immune response, presumably against tumor and viral antigens, and induce apoptosis makes topical immunomodulators a promising therapeutic option in organ transplant recipients. Although limited, data have begun to accumulate on the use of imiquimod in transplant patients for the management of superficial, nodular, and infiltrative basal cell carcinomas; in situ and invasive squamous cell carcinomas; condyloma acuminata; and common warts. As more experience is gathered, the role of imiquimod and other topical immunomodulators in the care of OTRs will be clarified. The authors reviewed the existing data on the use of topical imiquimod in OTRs with mention of its presumed mechanisms of action and other immunomodulators with potential efficacy against cancerous and precancerous lesions. [source] Influence of hormones and hormone metabolites on the growth of schwann cells derived from embryonic stem cells and on tumor cell lines expressing variable levels of neurofibromin,DEVELOPMENTAL DYNAMICS, Issue 2 2008Therese M. Roth Abstract Loss of neurofibromin, the protein product of the tumor suppressor gene neurofibromatosis type 1 (NF1), is associated with neurofibromas, composed largely of Schwann cells. The number and size of neurofibromas in NF1 patients have been shown to increase during pregnancy. A mouse embryonic stem cell (mESC) model was used, in which mESCs with varying levels of neurofibromin were differentiated into Schwann-like cells. NF1 cell lines derived from a malignant and a benign human tumor were used to study proliferation in response to hormones. Estrogen and androgen receptors were not expressed or expressed at very low levels in the NF1+/+ cells, at low levels in NF1+/,cells, and robust levels in NF1,/,cells. A 17,-estradiol (E2) metabolite, 2-methoxy estradiol (2ME2) is cytotoxic to the NF1,/, malignant tumor cell line, and inhibits proliferation in the other cell lines. 2ME2 or its derivatives could provide new treatment avenues for NF1 hormone-sensitive tumors at times of greatet hormonal influence. Developmental Dynamics 237:513,524, 2008. © 2008 Wiley-Liss, Inc. [source] Making the diagnosis with only two levels of nongynecologic cell blocks as opposed to three is more cost effectiveDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2010Gina Zanchelli-Astran D.O. Abstract Two hundred forty-three of 246 cases in phase I (98.8%) and 246 of 247 cases in phase II (99.6%) had adequate or the same material present on the level two cell blocks. Sixty-nine cases were malignant (28.1%), 20 were atypical (8.1%), 157 were benign (63.8), and 16 were signed out on the cell block only (6.5%) in phase I. In phase II, 69 (27.9%) cases were malignant, 22 (8.9%) were atypical, 156 (63.2%) were benign, and 18 (7.3%) were signed out based on material present in the cell block. Fifteen cases in phase I (6.1%) and 17 (6.9%) in phase II needed immunohistochemical staining for further evaluation. Twenty-four upper urinary tract (UUT) cases were signed out as malignant (49.0%), 10 were atypical (20.4%), and 15 were benign (30.6%) in phase I. In phase II, 18 (56.3%) UUT were malignant, 8 (25.0%) were atypical, and 6 (18.7%) were benign. In phase I, 13 (26.5%) and in phase II, 18 (56.3%) were graded on the cell block only. On comparing the two phases, there was no significant difference in the amount of diagnostic material present between the level three and level two cell blocks (98.8% and 99.6%, respectively) or the number of cases diagnosed based on the cell block (6.5% and 7.3%, respectively). Cases signed out as malignant, atypical, and benign were similar in both phases. Likewise, the cases that required immunohistochemical staining to aid in the diagnosis between phase one and phase two were similar (6.1% and 6.9%, respectively). respectively). Diagn. Cytopathol. 2010. © 2010 Wiley-Liss, Inc. [source] Preparation of thyroid FNA material for routine cytology and BRAF testing: A validation studyDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2010Giancarlo Troncone M.D., Ph.D. Abstract V600E BRAF mutation is emerging as an independent marker of papillary thyroid carcinoma aggressive behavior. Papillary thyroid carcinomas harboring this mutation should be extensively resected. However, this requires an unquestionable cytological diagnosis of malignancy. Thus, cytological specimens should be properly handled to provide both morphological and molecular information. Here, we assessed whether our method of preparation of fine-needle aspiration material is suitable for both tests. A series of 128, routinely performed, fine-needle aspirations was analyzed. Each nodule was punctured three times. A representative Diff-Quik smear prepared from the first two passages was evaluated onsite. When microscopy was diagnostic (n = 44), the third needle pass was dedicated to harvest material for BRAF testing; in the remaining cases (n = 84), additional direct smears for cytology were prepared and the remaining material in the needle plus the needle rinsing was collected for BRAF testing. Cellularity was adequate in 126/128 (98%) cases. Cytological diagnoses were inadequate (2%), benign (85%), follicular lesion of undetermined significance (5%), follicular neoplasms (2%), suspicious for malignancy (2%), and malignant (4%). Higher average of extracted DNA concentration was observed in the dedicated pass group (25.9 vs 7.95 ng/,l). However, the rate of successful exon 15 BRAF amplification was similar with (43/44; 97.7%) or without (79/84; 94%) the dedicated pass. Thus, our protocol is suitable for both tests. Whenever necessary BRAF testing may also be performed on the residual samples of thyroid nodules, without interfering with routine cytology. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source] Evaluation of aspiration cytology of the liver space occupying lesions by simultaneous examination of smears and cell blocksDIAGNOSTIC CYTOPATHOLOGY, Issue 8 2009Ujjawal Khurana M.D. Abstract This study was undertaken to compare the efficacy of cytologic smears and histological sections from cell blocks in diagnosis of space occupying lesions (SOLs) of the liver and to classify the lesions on the basis of combined cytohistologic diagnosis. The study was conducted on 50 patients who had radiologically detected SOL/SOLs in the liver and ultrasound-guided fine needle aspiration of liver was done. In all the cases, both smears and cell blocks were made. Forty-seven cases were diagnosed as malignant and three as benign on both cytologic smears and cell blocks. Hepatocellular carcinoma was diagnosed in 8 (16%) cases and metastasis in 39 (78%) cases. The subtyping of malignancy could not be done on 11 (22%) cytologic smears and 8 (16%) cell block sections. However, on combined cytohistologic correlation, 17 (34%) out of these 19 (38%) cases could be subtyped. Sensitivity of cytologic smears and cell blocks in subtyping of malignancy was 72.3% and 82.9%, respectively. Combined cytohistologic diagnosis was found to be significantly better than isolated cytologic and cell block diagnosis (P , 0.05). To conclude, FNA of the SOLs of the liver is an effective procedure for diagnosing malignancy. However, cytological examination alone may fail to pinpoint the type of the tumor. Concomitant examination of cell block not only confirms the malignancy but also helps in subtyping it. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] Bone lesions: Role of sediment cytologyDIAGNOSTIC CYTOPATHOLOGY, Issue 6 2009Surbhi Shah M.B.B.S. Abstract This study was conducted to evaluate the role of sediment cytology of biopsy specimen fixatives, which is usually discarded, in early diagnosis of bone lesions. Cytological smears prepared from sediments of biopsy specimen fixatives (sediment cytology) were used to study 65 bone specimens biopsied with suspicion of malignancy. The cytological diagnosis was then compared with histological diagnosis, taking the latter as gold standard. Smears were adequately cellular and showed good preservation of cellular morphology. Some of the smears showed microfragments of tissue. Cytology labeled 29 lesions as malignant, 26 lesions as benign, 3 as inflammatory, and 7 smears as inconclusive because of low cell yield. Sediment cytology was able to correctly diagnose 58 of 65 lesions. There was no false-positive or false-negative case. The sediment cytology could be considered as an easy and effective diagnostic tool that can provide early diagnosis for the lesion of bone. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] Usefulness of lavage cytology during endoscopic transpapillary catheterization into the gallbladder in the cytological diagnosis of gallbladder diseaseDIAGNOSTIC CYTOPATHOLOGY, Issue 6 2009Ph.D., Yoshiki Naito M.D. Abstract Many studies have reported methods of cell collection involving percutaneous transhepatic cholangiodrainage (PTCD) and fine-needle aspiration cytology for the diagnosis of gallbladder disease. However, few studies have described the use of a transpapillary approach, i.e., endoscopic transpapillary catheterization into the gallbladder (ETCG). In this study, we analyzed cells collected by ETCG to evaluate its usefulness in the cytological diagnosis of gallbladder disease. The subjects were 19 patients who had undergone ETCG for the diagnosis of gallbladder disease. Of these patients, 11 and 8 had gallbladder cancer and benign gallbladder disease, respectively. We also evaluated the diagnostic accuracy of PTCD cytology performed in 15 patients with gallbladder cancer. Specimens were cytologically diagnosed as normal or benign, indeterminate, suspected malignancy, malignant, and inadequate in 47% (9/19), 11% (2/19), 0% (0/19), 37% (7/19), and 5% (1/19) of patients, respectively. Specimens were diagnosed as malignant, indeterminate, normal or benign, and inadequate in 7, 2, 1, and 1, respectively, of the 11 patients diagnosed with gallbladder cancer. The sensitivity and specificity of ETCG cytology were 78 and 100%, respectively, whereas the diagnostic accuracy of PTCD cytology was 20% (3/15). None of the patients developed complications of ETCG. Despite its technical difficulty, ETCG for bile cytology allows the collection of adequate cell numbers from patients with benign disease or gallbladder cancer and facilitates a cytological diagnosis, making it a useful method for collecting cells. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] A retrospective study of the diagnostic accuracy of fine-needle aspiration for breast lesions and implications for future useDIAGNOSTIC CYTOPATHOLOGY, Issue 12 2008Christina Day M.D. Abstract In recent years, the use of fine-needle aspiration (FNA) in the diagnosis of breast lesions has declined in many institutions. We sought to evaluate the role of FNA for breast lesions and the annual rate of the procedure at our institution over a 4½ year period (May 2002,October 2006). A total of 831 FNAs were performed, with 258 (31%) having histologic follow-up. The number of FNAs obtained was 159 from 5/02 to 4/03, 192 from 5/03 to 4/04, 194 from 5/04 to 4/05, 191 from 5/05 to 4/06, and 95 from 5/06 to 10/06. Each case was placed into one of four categories: nondiagnostic (9%), benign (77.5%), atypical/suspicious (5.5%), or malignant (8%). Surgical tissue was available for 37% of nondiagnostic cases, 22% of benign cases, 80% of atypical/suspicious cases, and 72% of malignant cases. The overall sensitivity and specificity for FNA was 83 and 92% respectively. The overall positive and negative predictive values were 83 and 92% respectively. There were no false-positive cases, indicating a positive predictive value of 100% for a Dx of malignancy. For cases with surgical follow-up, the false-negative rate was 5.4%. Although there is a national trend away from FNAs of breast lesion, this has not been the experience at our institution. Although FNA may not be ideal in the initial evaluation of suspicious lesions, we argue that FNA for clinically benign palpable lesions and recurrent carcinomas has significant value. Diagn. Cytopathol. 2008. © 2008 Wiley-Liss, Inc. [source] Post-thyroid FNA testing and treatment options: A synopsis of the National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference,,DIAGNOSTIC CYTOPATHOLOGY, Issue 6 2008Lester J. Layfield M.D. Abstract The National Cancer Institute (NCI) sponsored the NCI Thyroid Fine Needle Aspiration (FNA) State of the Science Conference on October 22,23, 2007 in Bethesda, MD. The 2-day meeting was accompanied by a permanent informational Web site and several on-line discussion periods between May 1 and December 15, 2007 (http://thyroidfna.cancer.gov). This document addresses follow-up procedures and therapeutic options for suggested diagnostic categories. Follow-up options for "nondiagnostic" and "benign" thyroid aspirates are given. The value of ultrasound examination in the follow-up of "nondiagnostic" and "benign" thyroid aspirates is discussed. Ultrasound findings requiring reaspiration or surgical resection are described as are the timing and length of clinical and ultrasonographic surveillance for cytologically "benign" nodules. Options for surgical intervention are given for the diagnostic categories of "atypical/borderline," "follicular neoplasm," "suspicious for malignancy" and "malignant" (http://thyroidfna.cancer.gov/pages/info/agenda/). Diagn. Cytopathol. 2008;36:442,448. © 2008 Wiley-Liss, Inc. [source] Evaluation of performance of EUS-FNA in preoperative lymph node staging of cancers of esophagus, lung, and pancreasDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2008H. Q. Peng M.D. Abstract We reviewed the cytologic and histologic diagnoses and EUS report of 77 consecutive patients who had undergone EUS-FNA preoperative staging for esophageal, lung, and pancreatic cancers at our institution. A total of 122 EUS-FNA lymph nodes were identified. Thirty of 77 cases had histologic follow-up. Using surgical node staging and/or surgical resection as the reference standard, the sensitivity, specificity, accuracy, and positive and negative predictive values were 75%, 95%, 89%, 86%, and 90%, respectively, for EUS-FNA node staging. We compared cytologically malignant and benign lymph node groups with eight EUS parameters including the total number of lymph nodes found by EUS, the shape, margin, long axis, short axis, echogenicity, location of the lymph node, and EUS tumor staging. We found that the short axis is the best EUS feature to predict malignancy. Lymph nodes found in an abdominal location in esophageal and lung cancer are likely malignant. Diagn. Cytopathol. 2008;36:290,296. © 2008 Wiley-Liss, Inc. [source] Fine-needle aspiration cytology of Hürthle cell carcinoma of the thyroidDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2008Howard Her-Juing Wu M.D. Abstract Specific criteria for the diagnosis of fine-needle aspiration (FNA) of Hürthle Cell Carcinoma (HCC) have rarely been discussed in the literature. A retrospective review of 35 FNA cases with the diagnosis of Hürthle cell lesion or Hürthle cell neoplasm was performed. In each case, there was a subsequent surgical excision. The FNA specimens were divided according to histologic diagnoses as HCC (12 cases), Hürthle cell adenoma (HCA) (14 cases), and benign nonneoplastic Hürthle cell lesions (BNHCL) (9 cases). Each case was examined using a semiquantitative scoring system for the following 11 features: presence or absence of colloid, lymphocytes, and transgressed blood vessels (each scored 0 or 1); the percentage of nuclear enlargement, small cell dysplasia, large cell dysplasia, nuclear crowding, and cellular dyshesion (each scored 0,3); and age, gender, and size of lesion. When diagnosed by FNA as either Hürthle cell neoplasm or Hürthle cell lesion, males were much more likely to have malignant tumors than females. Statistically significant cytologic features that favored malignant (HCC) over benign lesions (HCA and BNHCL) included small cell dysplasia, large cell dysplasia, nuclear crowding, and cellular dyshesion. The presence of colloid and lymphocytes favored a benign lesion. Nuclear enlargement and large tumor size are significantly more common in neoplasms than BNHCL. Diagn. Cytopathol. 2008;36:149,154. © 2008 Wiley-Liss, Inc. [source] A comparative analysis of core needle biopsy and fine-needle aspiration cytology in the evaluation of palpable and mammographically detected suspicious breast lesionsDIAGNOSTIC CYTOPATHOLOGY, Issue 11 2007Shailja Garg M.B.B.S. Abstract The present study was undertaken to compare the efficacy of needle core biopsy (NCB) of the breast with fine-needle aspiration cytology (FNAC) in breast lesions (palpable and non-palpable) in the Indian set-up, along with the assessment of tumor grading with both the techniques. Fifty patients with suspicious breast lesions were subjected to simultaneous FNAC and ultrasound-guided NCB following an initial mammographic evaluation. Cases were categorized into benign, benign with atypia, suspicious and malignant groups. In cases of infiltrating duct carcinomas, grading was performed on cytological smears as well as on NCB specimens. Both the techniques were compared, and findings were correlated with radiological and excision findings. Out of 50 cases, 18 were found to be benign and 32 malignant on final pathological diagnosis. Maximum number of patients with benign diagnosis was in the fourth decade (42.11%) and malignant diagnosis in the fourth as well as fifth decade (35.48% each). Sensitivity and specificity of mammography for the diagnosis of malignancy was 84.37% and 83.33%, respectively. Sensitivity and specificity of FNAC for malignant diagnosis was 78.15% and 94.44%, respectively, and of NCB was 96.5% and 100%, respectively. But NCB had a slightly higher specimen inadequacy rate (8%). NCB improved diagnostic categorization over FNAC by 18%. Tumor grading in cases of IDC showed high concordance rate between NCB and subsequent excision biopsy (94.44%) but low concordance rate between NCB and FNAC (59.1%). NCB is superior to FNAC in the diagnosis of breast lesions in terms of sensitivity, specificity, correct histological categorization of the lesions as well as tumor grading. Diagn. Cytopathol. 2007;35:681,689. © 2007 Wiley-Liss, Inc. [source] Cyto-histological correlations inprimary, recurrent, and metastatic bone and soft tissue osteosarcoma.DIAGNOSTIC CYTOPATHOLOGY, Issue 5 2007Institut Curie's experience Abstract To determine diagnostic cytomorphologic features of osteosarcoma on fine-needle aspiration materials, we reviewed the cytologic material and corresponding histologic slides of 126 tumors in 107 patients. Fifty-five (43.6%) tumors were primary, 31 (24.6%) were recurrent, and 40 (31.8%) were metastatic. Review of original cytology reports revealed that 120 (95.3%) tumors were diagnosed as malignant. Six (4.7%) cases were reported as suspicious, false-negative, or unsatisfactory samples. Our findings showed that osteoblastic roundish cells, spindle-shaped cells, reactive giant cells, and osteoid were the most consistent features representative of osteosarcoma. Periosteal reactions, fractures with callous formation, giant cells of osteoclastic type in various conditions, chondrosarcoma with enchondral ossification are entities to consider in the differential diagnosis. Diagn. Cytopathol. 2007;35:270,275. © 2007 Wiley-Liss, Inc. [source] Role of computerized morphometric analysis in diagnosis of effusion specimensDIAGNOSTIC CYTOPATHOLOGY, Issue 10 2006B. Arora M.D. Abstract The present study was undertaken to compare morphometric analysis of cells in 100 effusion samples, with unaided cytological diagnosis. All the cases in the form of Leishman's stained smears were subjected to computerized-interactive morphometry (CIM) by usage of Image analysis software. On routine cytological examination, 44 cases were benign, 26 were malignant, and 30 cases were placed in "atypical" category. On morphometry, values for mean nuclear area (MNA) and mean cytoplasmic area (MCA) in benign cases were found to be 58.39 ± 12.22 ,m2 and 185.70 ± 43.69 ,m2, while for malignant cases were 120.12 ± 16.28 ,m2 and 274.65 ± 61.01 ,m2, respectively (P < 0.001, P < 0.001, highly significant). Significant differences were also noted among benign, atypical, and malignant cases for MNA (P < 0.001). The differences between atypical and malignant cases for N/C (nuclear/cytoplasmic) ratio were also found to be statistically significant (P < 0.001). Finally, 46 cases were found to be benign, 39 malignant, and 15 in the category of atypical cases. CIM helps in better and quicker sorting for malignant cells. MNA and N/C ratio are the most significant parameters in differentiating various cells in effusions. MCA constitutes as another useful parameter. Salient features of CIM, including their applications in the light of current study, are discussed. Diagn. Cytopathol. 2006;34:670,675. © 2006 Wiley-Liss, Inc. [source] Fine-needle aspiration of neurilemoma (schwannoma).DIAGNOSTIC CYTOPATHOLOGY, Issue 6 2006A clinicocytopathologic study of 116 patients Abstract The preoperative fine-needle aspiration cytology (FNAC) diagnoses in 116 surgically excised neurilemomas were reviewed and compared with the corresponding histopathologic diagnoses made on surgical specimens and with clinical data. In addition, the utility of adjunctive techniques was analyzed and other spindle-cell lesions in the differential diagnoses were discussed. An unequivocal, benign diagnosis was rendered by FNAC in 80 cases, 67 of which were correctly labelled as neurilemoma in a review of the original cytology reports. There were 6 false-positive malignant diagnoses while 23 smears were considered insufficient and 7 inconclusive as to whether benign or malignant. On reevaluation, the diagnostic smears in most cases contained spindle cells with wavy nuclei embedded in a fibrillar, occasionally collagenous, and/or myxoid matrix and Antoni A/Antoni B tissue fragments. A moderate to abundant admixture of round to oval cells was also frequent. Nuclear palisading was seen in 41 smears with distinctive Verocay bodies in 10. Markedly pleomorphic nuclei were seen in smears from 8 ancient and 6 conventional neurilemomas, and slight to moderate nuclear pleomorphism was observed in 38 additional cases. Thus most neurilemomas have distinct cytomorphologic features that allow correct diagnosis. The major problem in FNAC of neurilemoma is to obtain sufficient material. Furthermore aspirates showing predominantly Antoni A features, nuclear pleomorphism, and/or myxoid changes can easily be confused with other types of benign or malignant soft-tissue tumors. Diagn. Cytopathol. 2006;34:403,412. © 2006 Wiley-Liss, Inc. 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