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FNA Specimens (fna + specimen)

Distribution by Scientific Domains

Medical Sciences	90%

Selected Abstracts

Fine needle aspiration biopsy of epithelioid hemangioendothelioma of the oral cavity: Report of one case and review of literature

DIAGNOSTIC CYTOPATHOLOGY, Issue 3 2006
Guo-Xia Tong M.D., Ph.D.
Abstract Epithelioid hemangioendothelioma (EHE) is an uncommon vascular tumor with biological behavior intermediate between hemangioma and angiosarcoma. It rarely occurs in the oral cavity. We report a case of an 81-yr-old woman with a 2-mo history of a 2 × 2 cm2 submucosal buccal mass. Fine needle aspiration (FNA) smears were paucicellular and showed mainly single atypical large epithelioid cells in a bloody background. The atypical cells had abundant dense cytoplasm, some with fine vacuoles. Occasionally, cells with large cytoplasmic lumina were seen. Cytology preparations from fresh tissue received for frozen section revealed numerous neoplastic cells with large intracytoplasmic lumina, some of which contained red blood cells. In addition, cells with distinct intranuclear inclusions were present. Histologic sections and immunohistochemical stains confirmed the diagnosis of EHE. Although the histologic features of EHE are well recognized, reports of FNA cytology findings are sparsely existent in the literature as several case reports. The characteristic cytological features of EHE are reviewed in this report. We believe that the diagnosis of this rare tumor can be suggested when an adequate FNA specimen is obtained. Diagn. Cytopathol. 2006;34:218,223. © 2006 Wiley-Liss, Inc. [source]

Unsuspected systemic amyloidosis diagnosed by fine-needle aspiration of the salivary gland: Case report

DIAGNOSTIC CYTOPATHOLOGY, Issue 1 2004
Ph.D., Tamar Giorgadze M.D.
Abstract Amyloidosis of the head and neck region may represent a local amyloidoma or a manifestation of systemic disease. Involvement of major salivary glands by either primary or secondary forms of amyloidosis is very rare. We describe a case of systemic amyloidosis that initially presented as submandibular gland mass and was diagnosed by fine-needle aspiration (FNA). A 69-year-old male presented with submandibular mass. His past medical history was significant for left forearm melanoma that was excised 6 years ago and tricuspid valve endocarditis after valvular replacement 3 months prior to FNA of the submandibular gland. The patient had no symptoms or clinical and laboratory data suggestive of amyloidosis. FNA specimen showed salivary gland tissue and abundant amorphous material, which stained positive for amyloid with Congo red stain and showed typical birefringence when examined by polarized microscopy. Further workup of the patient revealed generalized amyloidosis with multiorgan involvement by the disease. This case demonstrates that FNA can be a useful technique in the diagnosis of unsuspected amyloidosis. Diagn. Cytopathol. 2004;31:57,59. © 2004 Wiley-Liss, Inc. [source]

Detection of a subset of CD30+ anaplastic large cell lymphoma by interphase fluorescence in situ hybridization

DIAGNOSTIC CYTOPATHOLOGY, Issue 2 2003
Hyung Ju C. Shin M.D.
Abstract T/null-cell anaplastic large cell lymphoma (ALCL) is a morphologically and clinically heterogeneous group of non-Hodgkin's lymphoma; to date several morphologic variants have been described on histologic specimens. However, the cytologic features of these variants in the fine-needle aspiration (FNA) specimens have not been well evaluated. The t(2;5)(p23;q35) has been identified in a subset of T/null-ALCL and is known to be associated with a favorable prognosis. We reviewed the cytomorphologic characteristics in 24 FNA specimens of ALCL. In all cases, the diagnosis was confirmed on histologic specimens, and immunohistochemical studies for anaplastic lymphoma kinase (ALK) protein expression were performed on the aspirates. The presence of ALK breakpoints were evaluated in nine cases, using a DNA break-apart probe on chromosome 2 covering the ALK gene by fluorescence in situ hybridization (FISH) techniques. Two hundred cells per case were examined. The results were expressed as the percentage of cells containing more than two signals of chromosome 2 to the total number of cells counted. FNA sites included lymph nodes (20), lung (2), breast (1), and soft tissue (1). The median age of the patients was 56 yr (range, 17,75 yr). Twenty cases had systemic involvement; in four cases, skin was the primary site with secondary involvement of the lymph nodes. All cases were CD30+ by immunohistochemistry; 20 were of T-cell phenotype and 4 were null cell type. The cytologic evaluation revealed typical anaplastic morphology (common type) with many "hallmark cells" in 16 (67%) cases. Other morphologic variants identified were small cell pattern in five cases, monomorphic pattern in two cases, and lymphohistiocytic pattern in one case. FISH studies showed that six (66.7%) of nine cases had at least two signals of chromosome 2, consistent with ALK breakpoints. With careful cytomorphologic evaluation in conjunction with appropriate immunohistochemical studies, a diagnosis of ALCL can be confidently made in the FNA specimens in the cellular aspirates and its morphologic variants also can be recognized. Furthermore, the FNA specimen is suitable in detecting ALK breakpoints by FISH study, permitting rapid identification of a subset of patients with ALCL, who may have a favorable prognosis. Using a commercially available probe, detection of ALK breakpoints in the FNA specimens is simple and can be a useful diagnostic adjunct in cases where distinction from other lymphomas or lymphoid lesions is morphologically difficult. Diagn. Cytopathol. 2003;29:61,66. © 2003 Wiley-Liss, Inc. [source]

Overexpression of CD7 in classical Hodgkin lymphoma-infiltrating T lymphocytes,

CYTOMETRY, Issue 3 2009
Adam C. Seegmiller
Abstract Background: Diagnosis of Hodgkin lymphoma (HL) is sometimes complicated by the scarcity of neoplastic cells in a reactive inflammatory background. Immunophenotyping by flow cytometry (FC) has not played a significant role in HL diagnosis because of its consistent failure to identify these neoplastic cells. However, HL-infiltrating T cells have been shown to play a role in HL pathogenesis. This study characterizes the FC immunophenotype of these T lymphocytes to determine whether they can be used to assist in the diagnosis of HL. Methods: Cell suspensions from 76 lymph nodes involved by HL and 156 lymph nodes with reactive lymphadenopathy (LAD) were analyzed by flow cytometry to assess the expression of T-cell antigens. Results: The CD4:CD8 ratio and CD7 expression in both CD4(+) and CD8(+) T cells are increased in HL compared with reactive lymph nodes and there are significant differences between these features in different subtypes of HL. However, only the expression of CD7 in CD4(+) T cells distinguishes between HL and reactive LAD. This is especially true for classical HL in younger patients. Using a CD7 mean fluorescence intensity (MFI) cutoff value generated by this data, 37/47 FNA specimens were correctly diagnosed. Conclusions: There are significant differences in the immunophenotypes of HL-infiltrating T cells. Of these, the CD7 expression in CD4(+) T cells discriminates between HL and reactive LAD, suggesting that this could be a useful and practical adjunctive tool in the diagnosis of HL. It may also further our understanding of the pathophysiology of this disease. © 2008 Clinical Cytometry Society [source]

Clinical significance of cultures collected from fine-needle aspiration biopsy

DIAGNOSTIC CYTOPATHOLOGY, Issue 2 2008
Laura A. Granville M.D.
Abstract The rate of positive cultures in fine-needle aspiration biopsy (FNAB) specimens is evaluated, and the value of submitting FNAB culture is assessed. Review of 3,300 FNAB specimens from 2,416 patients were tabulated for culture results, when obtained from the FNAB material. For positive culture results, clinical impact was assessed. Of 3,300 FNAB specimens and 2,416 patients, 185 had cultures performed (6% of specimens, 8% of patients). Of the 185 cultured specimens, 63 (34%) were positive and 122 (66%) were negative. Of the 63 positive cultures, 23 (12% of all FNAB cultures) had a significant impact on patient care. In our institution the FNA culture rate is 6%. When cases with clinical or microscopic suspicion of infection are cultured, 34% are positive for aerobic or anaerobic bacteria, mycobacteria or fungus. Culture in FNA specimens is a useful adjunct to diagnosis and impacts care in 12% of patients cultured at FNAB. This method can be used to triage patients with suspected infectious diseases and can aid in managing patients who may have recurrent infections. Diagn. Cytopathol. 2008;36:85,88. © 2008 Wiley-Liss, Inc. [source]

Clear-cell adenocarcinoma of the female genital tract: Presence of Hyaline stroma and tigroid background in various types of cytologic specimens

DIAGNOSTIC CYTOPATHOLOGY, Issue 6 2005
Surapan Khunamornpong M.D.
Abstract Hyaline basement membrane-like stromal material and tigroid background are distinctive cytologic features observed in Diff-Quik (DQ)- or Giemsa-stained smears of clear-cell adenocarcinoma (CCA) of the female genital tract. However, it is uncertain how often these features are present in different types of cytologic specimens, and which type of preparation is optimal for this diagnosis. We therefore reviewed the cytologic features of CCA in three types of specimens, including 15 scrape cytology specimens, 7 fine-needle aspiration (FNA) specimens, and 15 peritoneal cytology specimens, with emphasis on the features observed in DQ-stained smears. The cell morphology in scrape cytology specimens and FNA specimens was comparable, whereas in peritoneal cytology specimens, the cytoplasm was better preserved. Most tumor cells had fragile cytoplasm containing variable amounts of fine vacuoles, and round nuclei with distinct or prominent nucleoli. Hyaline stroma was present in 93% of scrape cytology specimens, 71% of FNA specimens, and 80% of peritoneal cytology specimens. Tigroid background was observed in 47% of scrape cytology specimens, 43% of FNA specimens, but in none of the peritoneal cytology specimens. Formation of a tigroid background may be prevented by the abundant fluid content in peritoneal cytology specimens. Hyaline stroma and tigroid background were uncommonly seen in scrape smears from other types of primary ovarian tumors, mainly juvenile granulosa cell tumor and yolk sac tumor. However, the additional presence of papillary structures allows CCA to be readily distinguished from these other tumors. We propose that scrape cytology offers the best approach for the intraoperative cytologic diagnosis of CCA. Diagn. Cytopathol. 2005;32:336,340.© 2005 Wiley-Liss, Inc. [source]

Detection of a subset of CD30+ anaplastic large cell lymphoma by interphase fluorescence in situ hybridization

Molecular Classification of Thyroid Nodules by Cytology,,§

THE LARYNGOSCOPE, Issue 4 2008
Nitin A. Pagedar MD
Abstract Objectives: Fine needle aspiration (FNA) biopsy of thyroid nodules provides cytologic specimens whose interpretation can direct patients toward either thyroidectomy or observation. Approximately 20% of FNA specimens yield an indeterminate result. Recent studies have characterized differences in gene expression between benign and malignant conditions, most often using whole tissue. Our goal was to determine the feasibility of quantitative polymerase chain reaction (qPCR)-based gene expression analysis in cytologic samples. For five genes shown to be over-expressed in thyroid carcinomas (fibronectin, galectin-3, Met/HGFR, MUC1, and GA733-precursor), we compared expression among pathologic states. Study Design: Prospective laboratory analysis of 20 thyroidectomy specimens. Methods: Routine microscopy was performed. Cytologic samples were obtained from the dominant nodules, and RNA was extracted. Preliminary analysis using fluorometry and reverse-transcriptase (RT)-PCR was performed. Expression levels of the test genes in nodules and from control samples were measured by real-time qPCR. Fold changes in gene expression were compared. Results: Only one specimen did not yield sufficient intact RNA for gene expression analysis. RT-PCR revealed satisfactory RNA recovery in all other specimens. qPCR showed significant over-expression of fibronectin in the papillary carcinomas compared with the goiters (P = .0013), follicular adenomas (P = .0014), and follicular carcinomas (P = .0001). Differences in both fibronectin and MUC1 expression between the follicular carcinomas and the follicular adenomas were also significant (P = .025 and .045, respectively). Conclusions: Cytologic specimens were a satisfactory source of tissue for qPCR-based gene expression analysis. Both fibronectin and MUC1 were differentially expressed in follicular adenomas and follicular carcinomas, and fibronectin expression differed in papillary carcinomas compared with the other lesions. These results may form the basis of a clinical predictor for lesions with indeterminate or suspicious cytology. [source]

Endoscopic ultrasound of pancreatic cystic lesions

ANZ JOURNAL OF SURGERY, Issue 9 2010
Shyam Prasad
Abstract Background:, The impact of endoscopic ultrasonography (EUS) on the management of pancreatic cystic lesions remains unclear, and there are no published studies of the Australian experience in this area. The aim of this study was to review the experience of EUS for such lesions within our institution. Methods:, A retrospective review was undertaken of data collected prospectively over a two-year period within the EUS database of St. Vincent's Hospital. Patients who underwent EUS for suspected pancreatic cystic lesions were identified. Data were collected on demographic variables, EUS findings, the results of EUS-guided fine-needle aspiration (FNA) and the findings on clinical and radiological follow-up. Results:, Fifty-nine patients were identified. Two thirds were female. Most lesions were located at the pancreatic head. Median diameter was 25 mm. FNA was performed in 36 cases (61%). On cytology, six (17%) showed features of mucinous tumours and five (14%) showed adenocarcinoma. The remainder contained either non-specific benign cells or insufficient epithelial tissue. Follow-up data on 48 cases (83%), after a median duration of 15 months, revealed that 15 lesions (31%) had been resected, including six serous and six mucinous tumours. The level of carcinoembryonic antigen in FNA specimens appeared to be higher in mucinous than in serous neoplasms. Twenty-four lesions had undergone repeat radiological imaging: only three had grown in size. Conclusions:, EUS and FNA are useful procedures for assessing pancreatic cystic lesions. Malignant features are demonstrated in only a small minority. The majority of the remainder show no signs of progression during follow-up. [source]

4261: FNA biopsies for genomic analysis and adjuvant therapy for uveal melanoma

ACTA OPHTHALMOLOGICA, Issue 2010
L 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]