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Selected AbstractsFine-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. [source] Utility of cell blocks in the diagnosis of thyroid aspiratesDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2006Niria Sanchez M.D. Abstract Cell blocks (CBs) are often prepared with fine-needle aspirates (FNAs) from multiple organs as an adjunct to smears in the diagnosis of aspirated lesions. However, the literature contains few reports on their utility with regard to specific organ sites. At our institution, CBs are made routinely on FNAs when there is sufficient material remaining after smear preparation, with thyroid representing the largest volume. The aim of this study was to determine the utility of CBs in the diagnosis of thyroid lesions. From January 2002 to April 2004, 546 thyroid FNAs were performed. Eighty-two (15%) cases, from 60 females and 20 males (age range, 17,88 yr; mean, 50 yr), had CBs and formed the basis of this study. Seventy-four (90%) of the cases were performed by the radiologist or the clinician and 8 (10%) by the pathologist, all of which had an immediate assessment for adequacy. One to 7 passes were performed with an average of 3/case. The needles were immediately rinsed in Hanks' Balanced Salt Solution after smear preparation. CBs were made on bloody specimens/those with tissue fragments. Cell-block slides were reviewed for the presence of cellular elements and classified into three categories: (1) contributory, (2) noncontributory, or (3) provides additional information. Of the 82 cases, 23 (28%) were neoplastic, 51 (62%) were nonneoplastic, and 8 (10%) were nondiagnostic. Fifteen of the neoplastic cases had confirmatory biopsies, 9 of which were papillary carcinoma. The overall cellularity of the CBs was low, varying from 0 to 2 follicular groups in the noncontributory CBs and 3 to 6 follicular groups or papillary formations in the contributory CBs. CBs were contributory in 25 (31%) cases: 5 neoplastic (1 follicular neoplasm, 3 papillary carcinoma, and 1 suspicious for papillary carcinoma), 18 nonneoplastic, and 2 nondiagnostic. CBs were noncontributory in 56 (68%) cases: 18 neoplastic (4 papillary carcinomas, 1 suspicious for papillary carcinoma, 4 Hürthle cell neoplasms, and 9 follicular neoplasms), 33 nonneoplastic, and 5 nondiagnostic. One case was categorized as provided additional information because the CB showed material that was not present on the slides; however, it was still nondiagnostic. In summary, CBs did not help in the majority of cases. They were contributory in only 25 (31%) of the 82 cases, and of the 23 neoplastic cases, only 5 (22%) CBs were contributory. The contribution of the CBs in the diagnosis of thyroid lesions was minimal because of the low cellularity. On-site assessment of specimen adequacy often results in fewer passes, thus contributing to the low cellularity present in cell-block preparations. Ancillary studies may require additional passes. Diagn. Cytopathol. 2006; 34:89,92. © 2006 Wiley-Liss, Inc. [source] Use of transrectal ultrasound-guided biopsy in the diagnosis of pelvic malignanciesJOURNAL OF CLINICAL ULTRASOUND, Issue 9 2006Ludwig Rinnab MD Abstract Purpose. To describe our experience with transrectal ultrasound (TRUS)-guided needle biopsy of pelvic malignancies. Methods. Eleven patients with clinical suspecion of advanced malignant pelvic tumor were referred to our institution with a history of unsuccessful CT-guided biopsy, although a target lesion was demonstrated on pelvic CT or MRI. Cholin-PET and FDG-18-PET were also obtained individually in each patient. TRUS was performed using a commercially available three-dimensional scanner. Biopsies were performed with an 18G biopsy gun. In 9 of 11 patients, biopsy was successfully performed under analgesia, whereas general anesthesia was required in the other 2 patients. Results. The lesions were identified with TRUS in all patients, and biopsies were taken successfully under TRUS guidance. In all patients, the harvested material was of excellent quality and was adequate for definitive pathological diagnosis. Pathological results included 6 nodal metastases from transitional cell carcinoma, 1 case of lymph node metastasis from prostate cancer, 1 paravesical recurrence of cervical cancer, 1 metastasis from cecal cancer, and 2 cases of paravesical metastasis of a gastric cancer. Conclusion. TRUS-guided biopsy is a useful technique for the diagnosis of pelvic malignancies. It is faster and less expensive than CT-guided biopsy, and in most cases sufficient material can be harvested for a definitive pathological diagnosis. © 2006 Wiley Periodicals, Inc. J Clin Ultrasound, 2006 [source] Phylogeny, phylogeography, and geographic variation of Sylvisorex howelli (Soricidae), an endemic shrew of the Eastern Arc Mountains, TanzaniaJOURNAL OF ZOOLOGY, Issue 4 2005William T. Stanley Abstract The Eastern Arc Mountains of eastern Africa are notable for the high levels of endemism exhibited by various forest-dwelling organisms of this ancient montane archipelago. There has been virtually no assessment of the variation among populations of small mammal species living on these unique mountains, but recent faunal surveys have produced sufficient material to initiate such studies. Cranial morphometric and DNA sequence data were examined from six populations of Sylvisorex howelli Jenkins, 1984, an endemic shrew found in several different massifs of the Eastern Arc Mountains, to assess variation across the archipelago in the context of various hypotheses of historical biogeography. Twenty-two cranial measurements were analysed using principal components analysis. Age classes (based on tooth wear) and sex had little effect on the variation exhibited by the variables studied. Overall, specimens of S. howelli from the East Usambara Mountains are smaller than specimens from other known populations. The mitochondrial ND2 and 12S rRNA genes from representatives of each montane population of S. howelli in addition to several crocidurine taxa from eastern Africa and three soricine outgroup species were sequenced to assess phylogenetic relationships among these taxa. Neither maximum likelihood, maximum parsimony, nor Bayesian analyses support monophyly of the genus Sylvisorex, but S. howelli populations were consistently recovered as a well-supported clade. Over 40 individuals of S. howelli from six disjunct montane ranges, comprising the entire known distribution of the species, were sequenced for 504 base pairs of ND2 to investigate phylogeographic patterns. Phylogenetic analysis recovered six reciprocally monophyletic haplotype clades grouped by locality. Branch lengths are consistent with relatively long periods of isolation among populations from the Uluguru, Ukaguru, Nguru, Nguu, East Usambara and West Usambara Mountains, with low levels of diversity observed within each population. These results are interpreted within the historical context of the Eastern Arc Mountains. [source] Use of magnetic enrichment for detection of carcinoma cells in fluid specimensCANCER, Issue 1 2002Eric Kielhorn B.S. BACKGROUND Ascites fluid or a pleural effusion are common events in metastatic carcinoma, but they also can be associated with several other medical conditions. The standard for determination of malignancy in these situations is cytologic evaluation of these fluids. Although this method is frequently successful, there are times when it fails, even when the patient has a malignancy, either because of insufficient cells in the fluid or for other reasons. This study addresses this problem taking advantage of the recent advances in technology for detection of rare epithelial cells in liquid specimens. METHODS The authors examined fluid specimens from 59 patients to determine the frequency of recovery of epithelial cells compared with that achieved by conventional cytopathology. The Dynal CELLection Epithelial Enrich (Dynal AS, Oslo, Norway) method was used. This method is based on immunomagnetic selection of cells binding to EpCAM antibodies. Carcinoma cells were confirmed by morphology and, when there was sufficient material, by E-cadherin staining. RESULTS Grouping the cases by cytologic diagnosis, the authors found malignant cells using the cell enrichment assay in 11 of 12 malignant cases, 2 of 5 atypical cases, and 3 of 42 negative cases. Further investigations were conducted on the five cases that were cytologically negative or atypical but yielded epithelial cells after immunomagnetic enrichment. Four cases ultimately were proven malignant by other methods and one had incomplete follow-up. CONCLUSIONS The new methods available for epithelial cell enrichment in liquids may be used successfully on cytologic fluid specimens and may lead to increased sensitivity for detection of malignancy, and consequently more accurate staging. Cancer 2002;94:205,11. © 2002 American Cancer Society. [source] 4261: FNA biopsies for genomic analysis and adjuvant therapy for uveal melanomaACTA OPHTHALMOLOGICA, Issue 2010L DESJARDINS Purpose Recent changes in the management of uveal melanoma include the use of biopsies for genomic analysis and the identification of patients with a high risk of metastasis. We wish to describe our first experience with fine needle aspiration (FNA), genome profiling and adjuvant therapy protocol for high risk patients Methods we have started a multicentric adjuvant phase III trial of intravenous fotemustine (FOTEADJ) for high risk uveal melanoma patients. Patients with tumor of 15 mm or more in diameter with retinal detachment or extrascleral extension, patients with tumors of 18 mm or more in diameter and patients with loss of chromosome 3 and gain of entire 8q were considered high risk and eligible. Tumour genome profiling was achieved by array-CGH on a NimbleGen 72K microarray, after whole genome amplification (WGA) in cases of FNAs Local treatment consisted in enucleation or proton beam radiotherapy. FNA was offered to patients treated by radiotherapy for a tumor of 5 mm of thickness or more. Results Between May 2009 and May 2010, 74 patients were offered to participate. Only 16 patients were included because of various reasons: technical problems with the biopsy (13 samples evaluable out of 26 FNA), refusal of the biopsy or the protocol or non inclusion criteria. There has been some improvement in our results since the introduction of WGA for FNA specimens Conclusion Proposing fine needle aspiration biopsy and obtaining sufficient material is not always easy. Including patients in randomized protocols is always a challenge. During the first year for FOTEADJ, only 22% of the eligible patients were enrolled but this percentage is greatly improving with time and experience . [source] | ||||||||||