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Biopsy Results (biopsy + result)
Selected AbstractsAssociation of exfoliation syndrome and central retinal vein occlusion: an ultrastructural analysisACTA OPHTHALMOLOGICA, Issue 1 2010Robert Ritch Abstract. Purpose:, To evaluate prospectively the frequency with which exfoliation syndrome (XFS) occurs in patients with central retinal vein occlusion (CRVO) by clinical examination and ultrastructural examination of conjunctival biopsy specimens. Methods:, Prospective observational case series. Thirty-six eyes of 36 consecutive patients with CRVO were investigated for XFS by slit-lamp examination and conjunctival biopsy when XFS was not clinically visible on examination. Results:, A clinical diagnosis of XFS or a positive biopsy result for exfoliation material (XFM) was present in 22 of the 36 patients (61%; 95% confidence interval 45,75%). Twelve of these 22 patients (54%) had a clinical diagnosis of XFS. Aggregates of XFM were identified ultrastructurally in the biopsy specimens in 10 of 24 patients with no clinical signs of XFS (42%). Patients with and without XFS had similar distribution of age, gender, race and prevalence of systemic disorders. Twelve of the 22 (54%) XFS patients had neither glaucoma nor ocular hypertension prior to the CRVO. Conclusion:, In accordance with previous retrospective and histological studies, this prospective, in vivo study suggests that CRVO is commonly associated with XFS. [source] Value of post-nasal space biopsy in patients with adult onset serous otitis mediaCLINICAL OTOLARYNGOLOGY, Issue 3 2006A.H. Sadr Background. Otitis media with effusion (OME) is common in children but this is not the case in adults. In adults it can be associated with nasopharyngeal neoplasms (NPN). It is accepted practice in the UK to biopsy the posterior nasal space (PNS) to rule out neoplasms. We believe this routine practice is no longer justified in view of modern methods of examination of PNS. Aims and objectives. To identify the incidence of NPN in adults with otitis media with effusion without any other signs and symptoms suggestive of NPN. We also identified the presenting symptoms and signs of all patients who were diagnosed with NPN during the study period. Methods. This is a retrospective study of 158 adult onset otitis media who had a posterior nasal space biopsy performed. The patients with positive and negative biopsy results were analysed for their presenting signs and symptoms. Results. Only 58 patients had OME as the sole presentation. The rest had other signs or symptoms in addition to OME. All patients with OME as the sole presentation had negative biopsy results and all patients with a positive biopsy result for NPN had other symptoms or signs in addition to OME. Conclusions. The role of PNS biopsy in adults with isolated OME seems to be questionable in view of the limited information it provides. This may be due to wider use of endoscopes which enable us to detect small abnormalities in PNS. [source] The impact of diabetes and obesity on liver histology in patients with hepatitis CDIABETES OBESITY & METABOLISM, Issue 3 2003F. Friedenberg Aim:, An association between diabetes mellitus and HCV has been recognized previously. No study has examined whether there is an independent association between the degree of hepatic fibrosis and the incidence of diabetes in HCV patients when controlling for other risk factors. Methods:, We reviewed the charts of 264 consecutive patients with chronic HCV infection at a referral liver centre from January 1991 to December 1999. Demographic background, medical history, laboratory and liver biopsy results were retrieved. Results:, The prevalence of diabetes was 16.3%. Gender, intravenous drug use, steatosis scores, aminotransferase levels and iron studies were similarly distributed in patients with and without diabetes (all p > 0.05). In contrast, mean age was greater in the diabetic group (49.8 vs. 44.3, p = 0.003). The prevalence of diabetes was substantially higher in African-Americans (p = 0.001) and those with BMI > 30 (p = 0.015). Although the fibrosis score was higher in diabetics (, = 0.14, p = 0.03), that association did not remain significant when controlling for diabetes risk factors (p > 0.3). The degree of steatosis and fibrosis both tended to increase with increasing BMI (, = 0.47, p < 0.001 and , = 0.13, p = 0.03, respectively). Even after controlling for diabetes, age, gender, race, and current alcohol use, those associations remained (both p < 0.001). Conclusions:, The prevalence of diabetes in our group of HCV patients was high, consistent with other studies. Diabetes is not an independent predictor of degree of fibrosis. Body mass index is an independent predictor of both fibrosis and steatosis in HCV patients. [source] Comparison of conventional Papanicolaou smears and fluid-based, thin-layer cytology with colposcopic biopsy control in central Italy: A consecutive sampling study of 461 casesDIAGNOSTIC CYTOPATHOLOGY, Issue 1 2009Siavash Rahimi M.D. Abstract The aim of this study was to compare the cytologic diagnosis and specimen adequacy of conventional Papanicolaou (CP) and fluid-based, thin-layer [ThinPrep (TP), Cytyc, Boxborough, MA] cervical cytology in a population from central Italy. CP and TP samples were collected simultaneously using a consecutive sampling method on women presenting for cervical screening. Colposcopy was performed as clinically indicated, and biopsy results were compared with cytologic diagnoses. Among the 461 patients included in the study, 413 were negative at both CP and TP, 9 had unsatisfactory results at both tests and 39 patients presented abnormal results at CP, TP or both. Cohen's Kappa was 0.77 showing good agreement between CP and TP test results. Histological data were available for 20 (51.28%) of the 39 patients with at least one positive test. Among the 13 patients with HSIL at histology, 7 had HSIL at CP (sensitivity 53.85%) and 5 at TP (sensitivity 38.46%). For all three patients with squamous cell carcinoma (SCC) at histology, CP and TP had shown the same diagnosis (sensitivity 100%). The positive predictive values were 33.33% for CP and 25.0% for TP regarding the LSIL diagnosis and 100% for both CP and TP regarding HSIL and SCC diagnoses. Our results may be influenced by the consecutive sampling procedure. Diagn. Cytopathol. 2009. © 2008 Wiley-Liss, Inc. [source] Role of systematic ultrasound-guided staging biopsies in predicting extraprostatic extension and seminal vesicle invasion in men with prostate cancerJOURNAL OF CLINICAL ULTRASOUND, Issue 3 2002Koji Okihara MD Abstract Purpose To assess the presence of extraprostatic extension and seminal vesicle invasion in men with prostate cancer, we performed systematic staging biopsies targeting neurovascular bundles, seminal vesicles, and other extraprostatic tissues before the men underwent radical prostatectomy. We retrospectively evaluated the clinical efficacy of these systematic staging biopsies compared with digital rectal examination (DRE) and transrectal sonography (TRUS). Methods Two hundred forty-four candidates for prostatectomy who had a diagnostic biopsy Gleason score of 8 or higher and/or indications of extraprostatic extension (eg, seminal vesicle invasion) by DRE or TRUS underwent staging biopsies using an 18-gauge Tru-Cut needle under real-time TRUS guidance between June 1997 and March 2000. We determined the number of staging biopsy cores to be taken based on the Gleason score of the diagnostic biopsy as well as abnormal DRE and/or TRUS findings. The chi-square test was used to evaluate the statistical significance of differences. Results There were no complications of staging biopsy. In 75 (31%) of the 244 patients, results of the staging biopsies were positive. The clinical stage was upgraded by staging biopsy in 18 (24%) of these 75 patients. After the staging biopsies, 90 patients underwent radical prostatectomy. Among these 90 patients, staging biopsy specimens were positive for cancer in 20 (47%) of the 43 patients who received neoadjuvant therapy and in 1 (2%) of the 47 patients who did not receive neoadjuvant therapy. There were no false-positive staging biopsies in either group. Among the 90 patients who underwent radical prostatectomy, the false-negative rate for the prediction of organ-confined disease was 43% (30/69) for staging biopsies compared with 29% (10/34) for TRUS. The diagnostic accuracy of staging biopsies (67%; 60/90) was higher than that of DRE (52%; 47/90; p < 0.05) but lower than that of TRUS (79%; 71/90; p = 0.066). Conclusions Staging biopsies can reliably sample extraprostatic tissue, including the seminal vesicles and neurovascular bundles. Positive staging biopsy results can aid in the selection of treatment options and in the prediction of outcome for individual patients by providing definitive histologic confirmation of locally advanced disease. Conventional predictive variables for staging can be applied when the results of staging biopsies are negative. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:123,131, 2002; DOI 10.1002/jcu.10052 [source] Predicting immunosuppressant dosing in the early postoperative period with noninvasive indocyanine green elimination following orthotopic liver transplantationLIVER TRANSPLANTATION, Issue 1 2008Brian M. Parker Twenty adult patients undergoing orthotopic liver transplantation (OLT) were enrolled in this study, with the noninvasive indocyanine green plasma disappearance rate (ICG-PDR) measured both during and after OLT to assess the relationship between ICG-PDR and the ability of patients to achieve therapeutic postoperative tacrolimus immunosuppressant blood levels. Liver function was determined at both 2 and 18 hours post reperfusion with the ICG-PDR k value (1/min). Postoperative standard serum measures of liver function as well as liver biopsies were also collected and analyzed. The median ICG-PDR k value for the study group at 2 hours post reperfusion was 0.20 (0.16, 0.27), whereas at 18 hours post reperfusion, it was 0.22 (0.18, 0.35). The median change in the k value between the two ICG-PDR measurements was 0.05 (,0.02, 0.07) with P = 0.02. There was an interaction between the postoperative day 1 (18 hours post reperfusion) ICG-PDR k value and the linear increase in the tacrolimus blood level, such that the greater the k value was, the more gradual the observed rise was in tacrolimus over time [that is, the longer it took to achieve a therapeutic blood level (>12 ng/mL), P = 0.003]. Of the 16 patients that received tacrolimus, comparable dosing on a per kilogram body weight basis was observed. Also, no significant association between ICG-PDR k values and postoperative liver biopsy results was seen. This study demonstrates that the ICG-PDR measurement is a modality with the potential to assist in achieving adequate blood levels of tacrolimus following OLT. Liver Transpl 14:46,52, 2008. © 2007 AASLD. [source] Liver biopsy results in patients with sickle cell disease on chronic transfusions: Poor correlation with ferritin levelsPEDIATRIC BLOOD & CANCER, Issue 1 2008Lina B. Karam MD Abstract Background: Chronic transfusions are effective in preventing stroke and other complications of sickle cell disease. The aim of this study was to determine whether serum ferritin levels correlated with liver iron content in sickle cell patients on chronic transfusion. Procedure: Forty-four liver biopsy specimens from 38 patients with homozygous sickle cell anemia (HbSS) and one patient with sickle thalassemia receiving chronic transfusions were studied. Five patients underwent a second liver biopsy for follow up. Three ferritin measurements were used to calculate a mean for each patient. The association between serum ferritin levels and liver iron quantitation was measured using the Spearman rank correlation, and sensitivity and specificity were determined for selected threshold values of serum ferritin. Results: Serum ferritin levels ranged from 515 to 6076 ng/ml, liver iron concentration ranged from 1.8 to 67.97 mg/g dry weight. The amount of iron per gram liver dry weight was moderately correlated with serum ferritin values (r,=,0.46). The correlation of duration of transfusion with serum ferritin (r,=,0.40) and with liver iron content (r,=,0.41) also indicated moderate correlation. Liver biopsy results led to changes in the management after 29/44 (66%) of the biopsies. Serum ferritin ,2500 ng/ml predicted high liver iron content (,7 mg/g), with a sensitivity of 62.5% and a specificity of 77.8%. Conclusion: We found a poor correlation between serum ferritin levels and liver iron content (LIC). Despite being on chelation therapy, many patients on chronic transfusion had high levels of liver iron. Measurement of LIC is highly recommended in these patients. Pediatr Blood Cancer 2008;50:62,65. © 2007 Wiley-Liss, Inc. [source] Nasopharyngeal carcinoma: differences in presentation between different ethnicities in the New Zealand settingANZ JOURNAL OF SURGERY, Issue 4 2010Ilia Ianovski Abstract Introduction:, There is an elevated incidence of nasopharyngeal carcinoma (NPC) in the Maori and Pacific Island (MPI) population as well as the Asian population in New Zealand; however, no studies have been conducted to evaluate how the two populations differ in their clinical presentation according to the TNM stage. Methods:, A retrospective review was conducted of all patients presenting to the Auckland City Hospital ENT department with a newly diagnosed NPC between the years 1995 and 2007 inclusive. The patient's radiological and biopsy results were reviewed, and each patient was staged according to the TNM stage at presentation as per the revised 2002 American Joint Committee on Cancer staging criteria. The Fisher's exact test was used to compare the differences between ethnicities in the T and N stages of the disease at presentation; the Cochran,Armitage Trend test was used to look for statistically significant trends. Results:, There was a statistically significant difference in T stage at presentation between MPIs and Asians (P < 0.0001), with a positive, statistically significant (P < 0.0001) trend indicating that MPIs present with greater T stage. A statistically significant difference in the N stage at diagnosis between MPIs and Asians, independent of the T stage, was found at stages T2 (P= 0.046) and T4 (P= 0.0083), with a statistically significant trend (T2 ,P= 0.009; T4 ,P= 0.026). Conclusions:, These results show that MPIs have a more advanced local NPC disease than Asians at presentation, and that for specific T stages, the nodal disease is also more advanced than that found in Asians. [source] Enzyme-linked immunospot assay for interferon-gamma in the diagnosis of tuberculous pleurisyCLINICAL MICROBIOLOGY AND INFECTION, Issue 2 2009L.-N. Lee Abstract Patients presenting with pleural effusion of undetermined aetiology were prospectively enrolled, and an enzyme-linked immunospot (ELISPOT) assay on pleural fluid and peripheral blood was performed. Forty patients were studied, including 19 with culture- or biopsy-confirmed (n = 15) or clinically compatible (n = 4) tuberculous pleurisy, and 21 with pleural effusions due to non-tuberculous causes. The sensitivity, specificity and positive and negative predictive values of the assay were 94.7%, 85.7%, 85.7% and 94.7%, respectively, on pleural fluid, and 77.8%, 90.5%, 87.5% and 82.6%, respectively, on blood. Antigen-specific, interferon-gamma-secreting T-cells were concentrated eight to ten times in pleural fluid as compared with blood. Among the seven patients not suitable for pleural biopsy and three patients whose biopsy results were non-diagnostic, nine had positive ELISPOT result with pleural fluid. The ELISPOT assay for interferon-gamma can accurately diagnose tuberculous pleurisy and is helpful for patients not suitable for pleural biopsy and those whose biopsy results are non-diagnostic. [source] Value of post-nasal space biopsy in patients with adult onset serous otitis mediaCLINICAL OTOLARYNGOLOGY, Issue 3 2006A.H. Sadr Background. Otitis media with effusion (OME) is common in children but this is not the case in adults. In adults it can be associated with nasopharyngeal neoplasms (NPN). It is accepted practice in the UK to biopsy the posterior nasal space (PNS) to rule out neoplasms. We believe this routine practice is no longer justified in view of modern methods of examination of PNS. Aims and objectives. To identify the incidence of NPN in adults with otitis media with effusion without any other signs and symptoms suggestive of NPN. We also identified the presenting symptoms and signs of all patients who were diagnosed with NPN during the study period. Methods. This is a retrospective study of 158 adult onset otitis media who had a posterior nasal space biopsy performed. The patients with positive and negative biopsy results were analysed for their presenting signs and symptoms. Results. Only 58 patients had OME as the sole presentation. The rest had other signs or symptoms in addition to OME. All patients with OME as the sole presentation had negative biopsy results and all patients with a positive biopsy result for NPN had other symptoms or signs in addition to OME. Conclusions. The role of PNS biopsy in adults with isolated OME seems to be questionable in view of the limited information it provides. This may be due to wider use of endoscopes which enable us to detect small abnormalities in PNS. [source] Rare atypical squamous cells of undetermined significance (ASCUS): A clinically significant diagnosis?DIAGNOSTIC CYTOPATHOLOGY, Issue 1 2002H. Daniel Hoerl M.D. Abstract To determine the clinical significance of rare atypical squamous cells of undetermined significance (ASCUS) in cervical screening, we studied 748 ASCUS cases prospectively noted to have rare abnormal cells. Comparing the rare ASCUS (RASC) group (defined as five or fewer abnormal cells) statistically to cases diagnosed as within normal limits (WNL), ASCUS unqualified as to number of cells low-grade squamous intraepithelial lesion (LGSIL), and high-grade SIL (HGSIL), we found that the probability of the RASC patients having an abnormal cytology (ASCUS/SIL) or biopsy (dysplasia) result within 1 yr was greater than that of the WNL group, but less than that for ASCUS unqualified, LGSIL, or HGSIL. When only ThinPrep® specimens or cases with subsequent definitive SIL/dysplasia were considered, the RASC group was not significantly different from the WNL group. We conclude that RASC increases the risk of a subsequent abnormal cytology/biopsy result in conventional smears, but only when the threshold for abnormality is a subsequent ASCUS. It did not predict dysplasia (SIL/CIN) in those conventional samples. RASC did not have the power to predict any subsequent abnormality and did not appear to be clinically significant in ThinPrep® samples. Diagn. Cytopathol. 2002;27:5,9. © 2002 Wiley-Liss, Inc. [source] | ||||||||||