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Cyst Fluid (cyst + fluid)
Selected AbstractsCytological features of cystadenocarcinoma in cyst fluid of the parotid gland: Diagnostic pitfalls and literature reviewDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2010Akihiko Kawahara C.T., C.M.I.A.C., Ph.D. Abstract Cystadenocarcinoma is a rare malignant tumor, with an estimated incidence of 2% of malignant salivary gland tumors. Cytological diagnosis of cystadenocarcinoma is important for differential diagnosis between benign lesions and malignant tumors with cystic growth. We report a case of cystadenocarcinoma causing difficulty in cytological diagnosis. A 23-year-old man presented with an asymptomatic mass in the left parotid gland that had been present for 2 years. The mass was elastic hard, measuring 30 × 35 mm in diameter. Preoperative fine-needle aspiration cytology (FNAC) showed a small number of tumor cell clusters in the cystic fluid. The cluster was arranged in a ball-like structure and was cohesive with overlapping. Tumor cells had a small vacuolated, soap-bubble appearance in the cytoplasm. The papillary-cystic variant of acinic cell carcinoma (ACC-PCV) was suggested from these findings on FNAC. Histologically, the tumor was not encapsulated, but formed large cystic spaces against a background of fibrous connective tissue. The tumor cells in the cystic dilated duct showed papillary structures, which were continuous with the lining cuboidal cells. There was neither a definite double-layered arrangement in cystic ducts and solid islands nor histological findings characteristic of the papillary-cystic or follicular pattern of ACC-PCV. As tumor cells with a small vacuolated, soap-bubble appearance of the cytoplasm are common findings of both cystadenocarcinoma and ACC-PCV, they are of little use for differentiation; however, they are so characteristic that the majority of benign salivary gland lesions with cystic structures can be excluded, if enough attention is paid. Diagn. Cytopathol. 2010. © 2009 Wiley-Liss, Inc. [source] K-Ras and microsatellite marker analysis of fine-needle aspirates from intraductal papillary mucinous neoplasms of the pancreas,DIAGNOSTIC CYTOPATHOLOGY, Issue 9 2006Karen E. Schoedel M.D. Abstract Preoperative diagnosis of pancreatic cystic lesions is difficult despite the combination of cytomorphology, radiographic imaging characteristics, and fluid tumor markers such as carcinoembryonic antigen. Intraductal papillary mucinous neoplasms (IPMNs) represent a subset of preinvasive pancreatic cystic neoplasms and are associated with accumulated genetic mutations, especially K-ras and tumor suppressor genes such as p53. Application of molecular techniques to cyst fluid obtained by endoscopic ultrasound guided fine-needle aspiration (EUSFNA) may contribute to preoperative assessment. Sixteen patients with pancreatic cystic lesions had cyst fluid obtained by preoperative pancreatic EUSFNA or intraoperative aspiration. All patients subsequently underwent surgical resection of the pancreas and IPMN was documented in all (6 adenomas, 6 borderline tumors, and 4 carcinomas). DNA was extracted from the cyst fluids and mutational analysis for K-ras point mutations and loss of heterozygosity (LOH) analysis using a preselected panel of genomic loci were performed. LOH was observed in 3 of 4 carcinomas as compared to 4 of 11 adenomas and borderline lesions (1 was QNS). LOH and K-ras mutations were both acquired in 2 of 4 carcinomas and in 1 of 12 adenoma/borderline lesions. Although the study is small, molecular analysis for LOH and K-ras mutations is useful in the preoperative evaluation of cystic pancreatic lesions. Increasing degree of neoplasia appears to correlate with increased genetic abnormality using a panel of selected genomic markers. Diagn. Cytopathol. 2006;34:605,608. © 2006 Wiley,Liss, Inc. [source] CA9 level in renal cyst fluid: a possible molecular diagnosis of malignant tumoursHISTOPATHOLOGY, Issue 7 2009Guorong Li Aims:, The preoperative differentiation of malignant renal cystic tumours from benign lesions is critical, and it remains a common diagnostic problem. The aim was to examine if the Carbonic anhydrase 9 (CA9) level in cyst fluid can provide a molecular diagnosis of malignant cyst. Methods and results:, Twenty-eight patients with a cystic renal mass were included. Fine-needle aspiration was performed to obtain the fluid. Postoperative pathology confirmed that there were 16 cystic renal cell carcinomas. Twelve benign cystic tumours were used as controls. One hundred microlitres of supernatant of cyst fluid was used to measure the CA9 protein level, which was measured by an enzyme-linked immunosorbent assay technique. CA9 was strongly detected and considered as positive in the cyst fluid of all 16 cystic malignant tumours (>1000 pg/ml), whereas its expression was negative in 11/12 benign cystic tumours (<300 pg/ml). The difference in percentages of positive CA9 between malignant and benign renal cystic tumours was significant (P < 0.001). Conclusion:, The fluid of malignant cystic renal tumours contains a high level of CA9 protein. The measurement of CA9 level in cyst fluid may be used as a molecular diagnosis for differentiation between malignant and benign renal cystic masses. [source] Percutaneous drainage of hydatid cyst of the liver: long-term resultsHPB, Issue 4 2002KY Polat Background Previously surgical operation was the only accepted treatment for hydatid liver cysts. Recently percutaneous management has become more preferable because of its low morbidity rate and lower cost. Patients and methods In all, 101 patients harbouring 120 hydatid cysts of the liver were treated by percutaneous drainage between October 1994 and December 1997. Of these cysts, 89 were in the right liver and 31 in the left liver. Thirty-one patients had had previous operations for hydatid disease. All cysts had an anechoic or hypoechoic unilocular appearance on ultrasound scan. The mean dimension of the cysts was 7.5 ± 2.9 cm (range 3,10.4 cm). All patients received oral albendazole 10 mg/kg perioperatively. After aspiration under sonographic guidance, cysts were irrigated with 95% ethanol. Results The amount of cyst fluid aspirated was 220 ± 75 ml and the amount of irrigation solution used was 175 ± 42 ml. Four patients developed mild fever and three had urticaria. Mean length of hospital stay was 2.1 ± 0.7 (range 1,4) days, and patients were followed up for 43,62 months (mean 54 ± 5.4 months). Maximal cyst diameter decreased from 7.5 ± 2.9 cm to 3.2 ± 15 cm (p<0.001). Sonographic examinations revealed high-level heterogeneous echoes in the cyst cavity (heterogeneous echo pattern), while the cyst cavity was completely obliterated by echogenic material (pseudotumour echo pattern). Discussion Most hydatid cysts of the liver can be managed successfully by acombinationof drugtherapyand percutaneous drainage. [source] Concentration of aluminium in breast cyst fluids collected from women affected by gross cystic breast diseaseJOURNAL OF APPLIED TOXICOLOGY, Issue 1 2009Ferdinando Mannello Abstract Gross cystic breast disease (GCBD) is the most common benign breast disorder, but the molecular basis of cyst formation remains to be identified. If the use of aluminium-based antiperspirant salts is involved in the etiology of gross breast cyst formation, it might be expected that aluminium would be at elevated levels in human breast cyst fluid (BCF). Aluminium was measured by ICP-MS in 48 samples of BCF, 30 samples of human blood serum and 45 samples of human breast milk at different stages of lactation (colostrum, intermediate, mature). The median level of aluminium in apocrine type I BCF (n = 27, 150 µg l,1) was significantly higher than in transudative type II BCF (n = 21, 32 µg l,1; P <0.0001). By comparison, aluminium measurements gave a median concentration of 6 µg l,1 in human serum and 25 µg l,1 in human breast milk, with no difference between colostrum, intermediate and mature milk. Levels of aluminium were significantly higher in both types of BCF than in human serum (P <0.0001). However when compared with human breast milk, aluminium levels were only significantly higher in apocrine type I BCF (P <0.0001) and not in transudative type II BCF (P = 0.152). It remains to be identified why such high levels of aluminium were found in the apocrine type I BCF and from where the aluminium originated. However, if aluminium-based antiperspirants are found to be the source and to play any causal role in development of breast cysts, then it might become possible to prevent this common breast disorder. Copyright © 2008 John Wiley & Sons, Ltd. [source] Laparoscopic excision of large ovarian cystsJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2002Hesham A.F. Salem Abstract Objective: The aim of this study was to check the ability of operative laparoscopy to help in the management of large ovarian cysts that may reach above the level of the umbilicus. Material and methods: Fifteen cases oflarge ovarian cysts reaching above the level of the umbilicus were chosen. Clinical and ultrasonic diagnosis denied any signs of malignancy. Pneumoperitoneum and a 5 mm trocar were inserted safely in the left midclavicular line below the ninth costal margin. This trocar allowed us to inspect the peritoneal cavity thoroughly. Another 5 mm trocar was inserted suprapubically in the contralateral side of the cyst and better inspection of the cyst and peritoneal cavity was then done. In the case of an apparently benign cyst, aspiration of the cyst fluid was done after puncturing its wall, then the cyst was removed as usual. Results: In all of these cases, there was no laparoconversion and no other complications were recorded. Nine cases were mucinous and six were serous cystadenomas. The mean operation time was 53.66 ± 14.7 min. Conclusion: Laparoscopic excision of large ovarian cysts is possible, and safe in suitable conditions, with immediate laparoconversion at hand at any time. [source] Incidence of Unsuspected Metastases in Lateral Cervical Cysts,THE LARYNGOSCOPE, Issue 10 2000Christine G. Gourin MD Abstract Objective Solitary cystic squamous cell carcinoma metastases may be difficult to distinguish clinically from a benign cervical cyst. We sought to identify the incidence of solitary cystic squamous cell carcinoma metastasis in patients presenting with apparently benign cervical cysts. Study Design Retrospective review. Methods The records of all patients who presented with isolated lateral cervical cysts between 1983 and 1999 were reviewed. Patients with a clinically apparent primary malignancy, a history of head and neck cancer, a history of irradiation, or age less than 18 years were excluded from analysis, as were patients with a histological diagnosis of nonsquamous cell malignancy or those without a final histological diagnosis. Results One hundred twenty-one adult patients presented with an initial diagnosis of lateral cervical cyst. Metastatic squamous cell carcinoma was demonstrated histologically after surgical excision in 12 patients (9.9%). The incidence of malignancy was significantly greater in patients greater than 40 years of age (23.5%, P < .0001). Results of preoperative fine-needle aspiration (FNA) were negative for malignancy in five cases of metastatic squamous cell carcinoma. Panendoscopy with directed biopsies revealed an occult primary in the base of tongue in three patients, tonsil in one patient, and nasopharynx in one. No primary was found in six patients, despite repeated examinations and close follow-up. Conclusions Solitary cervical cysts in patients older than 40 years of age should be presumed to be carcinoma until proven otherwise. A negative FNA result may be misleading, because of hypocellularity of the cyst fluid. Excisional biopsy should be undertaken with provisions made for frozen-section analysis of the specimen and contingency panendoscopy with directed biopsies of Waldeyer's ring if frozen-section histological examination reveals malignancy. [source] K-Ras and microsatellite marker analysis of fine-needle aspirates from intraductal papillary mucinous neoplasms of the pancreas,DIAGNOSTIC CYTOPATHOLOGY, Issue 9 2006Karen E. Schoedel M.D. Abstract Preoperative diagnosis of pancreatic cystic lesions is difficult despite the combination of cytomorphology, radiographic imaging characteristics, and fluid tumor markers such as carcinoembryonic antigen. Intraductal papillary mucinous neoplasms (IPMNs) represent a subset of preinvasive pancreatic cystic neoplasms and are associated with accumulated genetic mutations, especially K-ras and tumor suppressor genes such as p53. Application of molecular techniques to cyst fluid obtained by endoscopic ultrasound guided fine-needle aspiration (EUSFNA) may contribute to preoperative assessment. Sixteen patients with pancreatic cystic lesions had cyst fluid obtained by preoperative pancreatic EUSFNA or intraoperative aspiration. All patients subsequently underwent surgical resection of the pancreas and IPMN was documented in all (6 adenomas, 6 borderline tumors, and 4 carcinomas). DNA was extracted from the cyst fluids and mutational analysis for K-ras point mutations and loss of heterozygosity (LOH) analysis using a preselected panel of genomic loci were performed. LOH was observed in 3 of 4 carcinomas as compared to 4 of 11 adenomas and borderline lesions (1 was QNS). LOH and K-ras mutations were both acquired in 2 of 4 carcinomas and in 1 of 12 adenoma/borderline lesions. Although the study is small, molecular analysis for LOH and K-ras mutations is useful in the preoperative evaluation of cystic pancreatic lesions. Increasing degree of neoplasia appears to correlate with increased genetic abnormality using a panel of selected genomic markers. Diagn. Cytopathol. 2006;34:605,608. © 2006 Wiley,Liss, Inc. [source] Concentration of aluminium in breast cyst fluids collected from women affected by gross cystic breast diseaseJOURNAL OF APPLIED TOXICOLOGY, Issue 1 2009Ferdinando Mannello Abstract Gross cystic breast disease (GCBD) is the most common benign breast disorder, but the molecular basis of cyst formation remains to be identified. If the use of aluminium-based antiperspirant salts is involved in the etiology of gross breast cyst formation, it might be expected that aluminium would be at elevated levels in human breast cyst fluid (BCF). Aluminium was measured by ICP-MS in 48 samples of BCF, 30 samples of human blood serum and 45 samples of human breast milk at different stages of lactation (colostrum, intermediate, mature). The median level of aluminium in apocrine type I BCF (n = 27, 150 µg l,1) was significantly higher than in transudative type II BCF (n = 21, 32 µg l,1; P <0.0001). By comparison, aluminium measurements gave a median concentration of 6 µg l,1 in human serum and 25 µg l,1 in human breast milk, with no difference between colostrum, intermediate and mature milk. Levels of aluminium were significantly higher in both types of BCF than in human serum (P <0.0001). However when compared with human breast milk, aluminium levels were only significantly higher in apocrine type I BCF (P <0.0001) and not in transudative type II BCF (P = 0.152). It remains to be identified why such high levels of aluminium were found in the apocrine type I BCF and from where the aluminium originated. However, if aluminium-based antiperspirants are found to be the source and to play any causal role in development of breast cysts, then it might become possible to prevent this common breast disorder. Copyright © 2008 John Wiley & Sons, Ltd. [source] |