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Histological Follow-up (histological + follow-up)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Improvement of diagnostic accuracy and screening conditions with liquid-based cytology

DIAGNOSTIC CYTOPATHOLOGY, Issue 11 2006
Doris Schledermann M.D.
Abstract The aim of this population-based study was to compare the histological follow-up diagnoses of cervicocytological neoplasia (dysplasia, carcinoma in situ and carcinoma) in conventional Papanicolaou (CP) smear and ThinPrep® PapTestÔ samples (TP). All cytological samples from the County of Funen, Denmark, in the periods 2000 (n = 34,832) and 2002 (n = 29,995) were included in the study. In 2000 and 2002, the specimens were CP and TP, respectively. The detection rate of , mild dysplasia was 0.8% in CP and 1.4% in TP, showing a 75% increase in TP when compared with CP (p < 0.001). Histological follow-up of , moderate dysplasia revealed a neoplastic lesion in 77.1% and 87.9% in CP and TP, respectively (P < 0.001). The present study indicates that the diagnostic accuracy of cervical cytology is improved with liquid-based cytology. In addition, we focus on the optimized cellular material that shows the diagnostic details very clearly to the microscopist and leads to radically improved screening conditions. Diagn. Cytopathol. 2006;34: 780,785. © 2006 Wiley-Liss, Inc. [source]

Split sample comparison of ThinPrep and conventional smears in endoscopic retrograde cholangiopancreatography-guided pancreatic fine-needle aspirations,

DIAGNOSTIC CYTOPATHOLOGY, Issue 2 2005
Momin T. Siddiqui M.D.
Abstract Fine-needle aspiration (FNA) of pancreatic lesions is a common procedure to establish a tissue diagnosis before chemotherapy or surgery. In this study, the authors attempt to compare the diagnostic value of the ThinPrep (TP) method with conventional smears (CSs) in samples obtained by endoscopic retrograde cholangiopancreatography (ERCP)-guided pancreatic FNAs. Material obtained, prospectively, from ERCP-guided pancreatic FNAs was split to prepare CSs (2,5 slides) first, the remainder being rinsed in PreservCyte, and in the laboratory, 1 TP slide was prepared. The diagnostic categories of unsatisfactory, benign, reactive, suspicious for malignancy, and malignant were compared. Fifty-one pancreatic FNAs prepared by split sample method yielded the following results: TP yielded unsatisfactory, 6 cases; benign, 3 cases; reactive, 5 cases; suspicious for malignancy, 11 cases; and malignant, 26 cases; in contrast, CS yielded unsatisfactory, 13 cases; benign, 4 cases; reactive, 3 cases; suspicious for malignancy, 13 cases; and malignant, 18 cases. Histological follow-up was available in 21 cases (reactive, 8 cases; suspicious for malignancy, 1 case, and malignant, 12 cases). The foregoing data indicate a higher sensitivity in detection of pancreatic adenocarcinoma by the TP method (TP, 91% vs. 58% CS) with equivalent specificity (100%). In addition, TP provides better preservation and cytological detail. Diagn. Cytopathol. 2005;32:70,75. © 2005 Wiley-Liss, Inc. [source]

Borderline nuclear change; can a subgroup be identified which is suspicious of high-grade cervical intraepithelial neoplasia, i.e. CIN 2 or worse?

CYTOPATHOLOGY, Issue 5 2002
J. M. Edwards
Borderline nuclear change; can a subgroup be identified which is suspicious of high-grade cervical intraepithelial neoplasia, i.e. CIN 2 or worse? Only 10% of first borderline smears are associated with a histological high-grade (HG) abnormality, i.e. CIN 2,3, invasive malignancy or glandular neoplasia on subsequent investigation. The advantages of highlighting this subgroup are obvious but is this possible? From 1996 and 1997, 242 borderline smears with histological follow-up were examined by two independent experienced observers (observer 1 and 2) without prior knowledge of further investigation results. For each smear a profile of nuclear details was produced, also noting the type of cell mainly affected by the process; then the observers were asked to assess the degree of worry of HG disease for each smear i.e. whether the smear fell into group 1 borderline changes indicative of low-grade (normal, inflammatory, CIN1/HPV) disease (BL/LG) or group 2 difficult borderline smear, HG disease (CIN 2,3, invasive neoplasia or glandular neoplasia) cannot be excluded (BL/HG). Observer 1 selected a group of BL/HG with a PPV for HG disease of 38%, with observer 2 having a PPV of 50%; this compared with the overall laboratory HG disease PPV for borderline smears of 14%. Both observers found the most useful criterion to be the increase in nuclear:cytoplasmic ratio. Our results show that it is possible to separate a small group of borderline smears which should be classified as ,borderline/high grade lesion difficult to exclude' (BL/HG). Both observers had some success in arriving at this classification although their method of selecting out this group was quite different. [source]

The fine needle aspiration biopsy diagnostic criteria of proliferative breast lesions: A retrospective statistical analysis of criteria for papillomas and radial scar lesions

DIAGNOSTIC CYTOPATHOLOGY, Issue 7 2007
Andrew Field F.R.C.P.A.
Abstract This study aimed to analyze statistically the accuracy of fine needle aspiration biopsy cytological criteria in diagnosing epithelial hyperplasia with atypia (EHA), papillary lesions (PAP), and radial scar/complex sclerosing lesions (RS/CSL). The 42 criteria studied were extracted from a literature review and those developed and used in our department. Cytological cases with diagnoses of EHA, PAP, and RS/CSL for the period of 1997,2001 were correlated with relevant histological follow-up and the positive predictive power of these diagnoses have been presented in an earlier publication. Some 77 cases with definite, specific histological diagnoses of atypia or a more severe lesion, PAP and RS/CSL, were reviewed and scored using 55 cytological criteria. As the group of EHA and RS/CSL yielded a smaller number of cases, these were grouped together in the statistical analysis and compared to PAP. The cytological features, which were most diagnostic for PAP, were stellate (Odds ratio 1.75) and meshwork (Odds ratio 3.29) tissue fragments, while the presence of tubular structures was inversely proportional to the histological outcome of PAP. True papillary fragments were uncommon and not statistically significant in diagnosing PAP of the breast. Diagn. Cytopathol. 2007;35:386,397. © 2007 Wiley-Liss, Inc. [source]

Weeding atypical glandular cell look-alikes from the true atypical lesions in liquid-based Pap tests: A review

DIAGNOSTIC CYTOPATHOLOGY, Issue 1 2007
Moira D. Wood M.D.
Abstract The purpose of this review is to identify features that separate atypical glandular cells (AGC) associated with glandular neoplasia from its mimickers, both benign and neoplastic. We reviewed cases of AGC diagnosed on liquid-based Pap tests (LBP) for which corresponding histological follow-up was available. A review of the literature for similar studies in LBP tests was also conducted. We find that certain benign mimics can be reliably separated from AGC, but recommend caution in attempting to increase specificity at the risk of losing sensitivity. Although accounting for only a small percentage of diagnoses AGC require a thorough clinical evaluation, including colposcopy. Most cases are ultimately found to be benign. When evaluating smears suspicious for AGC, it is important to examine the subtle features which make truly atypical cells discernible from their numerous benign mimickers. Diagn. Cytopathol. 2007;35:12,17. © 2006 Wiley-Liss, Inc. [source]

Long-term antiviral therapy for recurrent hepatitis C after liver transplantation in nonresponders: Biochemical, virological, and histological impact

LIVER TRANSPLANTATION, Issue 1 2009
Thomas Walter
More than 50% of patients with a recurrent posttransplant hepatitis C virus infection fail to respond to antiviral treatment. The aim of this study was to evaluate the interest of a long-term antiviral treatment maintained for more than 48 weeks. Seventy treated patients, with a histological follow-up > 1 year, were enrolled in this observational, retrospective study. The duration of antiviral treatment, tolerance, and occurrence of virological, biochemical, and histological responses were recorded. Thirty-two patients were nonresponders after 48 weeks of treatment. Combined antiviral therapy was maintained for >12 months in 26 and for >18 months in 21. Twelve patients had to discontinue their treatment. At 48 weeks, the rates of virological response and sustained virological response were 37% and 24.3%, respectively; at the end of the follow-up, they were 48.5% and 35.7%. Virological response was significantly associated with a higher incidence of biochemical and histological response, regardless of its time of occurrence (before or after 6 months). Even in the absence of virological response, the rate of progression of fibrosis was significantly slowed in patients treated for more than 6 months. Our results show the feasibility, safety, and efficacy of long-term antiviral therapy in nonresponder patients with a recurrent posttransplant hepatitis C virus infection. Liver Transpl 15:54,63, 2009. © 2008 AASLD. [source]

Are posttransplantation protocol liver biopsies useful in the long term?

LIVER TRANSPLANTATION, Issue 9 2001
Marina Berenguer MD
Controversy exists about the usefulness of yearly protocol liver biopsies after liver transplantation, mainly among patients with normal transaminase levels. The aim of this study is to determine (1) the prevalence and cause of histological liver injury in transplant recipients with a minimum histological follow-up of 1 year (n = 254), and (2) the correlation between histological findings and transaminase values. The main indication for liver transplantation was viral-related cirrhosis (61%; 86% caused by hepatitis C virus [HCV]). Protocol liver biopsies were performed yearly for the first 5 years in HCV-infected transplant recipients and at 1 and 5 years in the remaining patients. Histological liver injury included several categories of liver damage (hepatitis, rejection, steatohepatitis, cholangitis, and Budd-Chiari,like lesions). Among biopsy specimens categorized as hepatitis, severe hepatitis was defined as the presence of stage 3 or greater fibrosis. The prevalence of liver injury increased significantly with time (42% v 56% at 1 and 5 years, respectively; P = .09) and was significantly greater in patients who underwent transplantation for HCV-related cirrhosis than in those who underwent transplantation for other reasons (P = .0001). The most frequent category of liver injury was hepatitis (97% and 96% at 1 and 5 years, respectively). Although a proportion of patients with liver injury (12% to 29%) had normal transaminase values, this percentage was almost null in patients with severe hepatitis. Normal histological characteristics were found in the vast majority of non,HCV-infected transplant recipients with normal transaminase values. Given the high prevalence of abnormal histological findings, particularly the increase over time of those defined as severe, protocol liver biopsies are clearly justified in HCV-infected transplant recipients. Conversely, given the rarity of abnormal histological findings, protocol liver biopsies should be questioned in non,HCV-infected transplant recipients with normal transaminase values. [source]