• Title, Summary, Keyword: fine needle aspiration biopsy

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Diagnostic Accuracy of Fine Needle Aspiration Cytology versus Concurrent Core Needle Biopsy in Evaluation of Intrathoracic Lesions: a Retrospective Comparative Study

  • Eftekhar-Javadi, Arezoo;Kumar, Perikala Vijayananda;Mirzaie, Ali Zare;Radfar, Amir;Filip, Irina;Niyazi, Maximilian;Sadeghipour, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7385-7390
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    • 2015
  • Background: Transthoracic fine needle aspiration (FNA) cytology and core needle biopsy (CNB) are two commonly used approaches for the diagnosis of suspected neoplastic intrathoracic lesions. This study compared the diagnostic accuracy of FNA cytology and concurrent CNB in the evaluation of intrathoracic lesions. Materials and Methods: We studied FNA cytology and concurrent CNB specimens of 127 patients retrospectively, using hematoxylin and eosin (H&E), immunohistochemistry, and, on certain occasions cytochemistry. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology and Laboratory Medicine as well as patient records. Diagnostic accuracy was calculated for each test. Results: Of 127 cases, 22 were inconclusive and excluded from the study. The remaining 105 were categorized into 73 (69.5%) malignant lesions and 32 (30.5%) benign lesions. FNA and CNB findings were in complete agreement in 63 cases (60%). The accuracy and confidence intervals (CIs) of FNA and CNB for malignant tumors were 86.3% (CI: 79.3-90.7) and 93.2% (CI: 87.3-96.0) respectively. For epithelial malignant neoplasms, a definitive diagnosis was made in 44.8% of cases by FNA and 80.6% by CNB. The diagnostic accuracy of CNB for nonepithelial malignant neoplasms was 83.3% compared with 50% for FNA. Of the 32 benign cases, we made specific diagnoses in 16 with diagnostic accuracy of 81.3% and 6.3% for CNB and FNA, respectively. Conclusions: Our findings suggest that FNA is comparable to CNB in the diagnosis of malignant epithelial lesions whereas diagnostic accuracy of CNB for nonepithlial malignant neoplasms is superior to that for FNA. Further, for histological typing of tumors and examining tumor origin, immunohistochemical work up plays an important role.

Comparison of Pre-Operation Diagnosis of Thyroid Cancer with Fine Needle Aspiration and Core-needle Biopsy: a Meta-analysis

  • Li, Lei;Chen, Bao-Ding;Zhu, Hai-Feng;Wu, Shu;Wei, Da;Zhang, Jian-Quan;Yu, Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7187-7193
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    • 2014
  • Background: The aim of this meta-analysis was to compare sensitivities and specificities of fine needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of thyroid cancer. Materials and Methods: Articles were screened in Medline, the Cochrane Library, EMBASE and Google Scholar, and subsequently included and excluded based on the patient/problem-intervention-comparison-outcome (PICO) principle. Primary outcome was defined in terms of diagnostic values (sensitivity and specificity) of FNA and CNB for thyroid cancer. Secondary outcome was defined as the accuracy of diagnosis. Compiled FNA and CNB results from the final studies selected as appropriate for meta-analysis were compared with cases for which final pathology diagnoses were available. Statistical analyses were performed for FNA and CNB for all of the selected studies together, and for individual studies using the leave-one-out approach. Results: Article selection and screening yielded five studies for meta-analysis, two of which were prospective and the other three retrospective, for a total of 1,264 patients. Pooled diagnostic sensitivities of FNA and CNB methods were 0.68 and 0.83, respectively, with specificities of 0.93 and 0.94. The areas under the summary ROC curves were 0.905 (${\pm}0.030$) for FNA and 0.745 (${\pm}0.095$) for CNB, with no significant difference between the two. No one study had greater influence than any other on the pooled estimates for diagnostic sensitivity and specificity. Conclusions: FNA and CNB do not differ significantly in sensitivity and specificity for diagnosis of thyroid cancer.

Critical Evaluation of Fine Needle Aspiration Cytology as a Diagnostic Technique in Bone Tumors and Tumor-like Lesions

  • Chakrabarti, Sudipta;Datta, Alok Sobhan;Hira, Michael
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3031-3035
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    • 2012
  • Background: Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. Methods: The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Results: Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. Conclusion: FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

  • Cheng, Pu;Chen, En-Dong;Zheng, Hua-Min;He, Qiu-Xiang;Li, Quan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4689-4692
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    • 2013
  • Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

Study of Autoantibody Concentration Distribution by Thyroid Fine Needle Aspiration Biopsy (갑상선 조직 검사에 따른 자가 항체 농도 분포 연구)

  • Kim, Jean-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.9
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    • pp.4320-4325
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    • 2013
  • This study was investigated the correlation between thyroid fine needle aspiration biopsy and serological test's concentrations. I examined fifty patients who were diagnosed with thyroid cancer from June 2012 to December 2012 in Pathology of a certain university hospital. Healthy fifty people were selected as a control group. Thyroid function tests were used as variables. In conclusion, The thyroglobulin and autoantibody was showed positive correlations in cancer groups. also Thyroglobulin Ab was showed a little correlation. If we examine this study items, we will get help in early diagnosis.

Fine Needle Aspiration Cytologic Findings of Metastatic Sex Cord Tumor with Annular Tubules to the Neck - A Case Report - (경부에 전이한 Sex Cord Tumor with Annular Tubules의 세침흡인 세포소견 - 1예 보고 -)

  • Oh, So-Yeong;Kang, Myoung-Jae;Chung, Myoung-Ja;Moon, Woo-Sung;Lee, Dong-Geun
    • The Korean Journal of Cytopathology
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    • v.8 no.2
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    • pp.185-189
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    • 1997
  • A sex cord tumor with annnular tubules is a relatively rare ovarian neoplasm. The cytologic findings from a fine needle aspiration biopsy of neck metastasis of a sex cord tumor with annnular tubules are described. The origin of the neck metastasis was the right ovary, and the tumor was diagnosed six years ago. The cytologic findings were characterized by tumor cells arranged in solid or follicular patterns. The tumor cells formed rosette-like or complex tubular structures with central rounded or coalesced hyaline materials. It was difficult to distinguish this tumor cytologically from granulosa cell tumor, thyroid follicular neoplasm, Sertoli-Leydig cell tumor, and Brenner tumor, but complex tubular structures were helpful in discriminating between these tumors.

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Fine Needle Aspiration Cytology of Mantle Cell Lymphoma - A Case Report - (외투세포 림프종의 세침흡인 세포학적 소견 - 1예 보고 -)

  • Kim, Han-Seong;Park, Sung-Hye
    • The Korean Journal of Cytopathology
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    • v.12 no.1
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    • pp.53-56
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    • 2001
  • Cytologic features of a case of mantle cell lymphoma is presented, which was obtained by fine needle aspiration cytoloby and confirmed by excisional biopsy of axillary lymph node. A 67-year-old female alleged palpable masses in both axillae for several months. Additional multiple lymphadenopathies were found in the both neck and inguinal areas. The main cytologic feature was carpeting on monotonous slightly atypical small lymphocytes without heterogeneous components. The nuclei of these lymphocytes are slightly larger than benign small lymphocyte and relatively round with some Indentation. Nucleolus was not prominent and no mitosis was found. Their cytoplasm was scanty and cyanophilic in Papanicolaou's stain. The histiocytic cells, which had bland-looking banded nuclei and abundant cytoplasm, corresponding to pink histiocytes were shown. Excisional blopsy of lymph nodes was diagnosed as mantle ceil lymphoma, diffuse type.

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Fine Needle Aspiration Cytologic Findings of Gastric Inflammatory Myofibroblastic Tumor- A case report - (위에 발생한 염증성 근섬유모세포성 종양의 세침흡인 세포학적 소견 -1 예 보고-)

  • Lee, Ji-Hye;Shin, Bong-Kyung;Kim, Chung-Yeul;Cho, Seong-Jin;Kim, Han-Kyeom;Kim, In-Sun
    • The Korean Journal of Cytopathology
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    • v.12 no.2
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    • pp.117-120
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    • 2001
  • Inflammatory myofibroblastic tumor, histologically characterized by the presence of bland-locking spindle cells and infiltration of chronic inflammatory cells, is extremely rare in the gastric wall. We report a case of gastric inflammatory myofibroblastic tumor In a 27-month-old boy. The fine needle aspiration biopsy from the mass showed loose clusters or scattered spindle cells and inflammatory cells, predominantly of lymphocytes and plasma cells. The spindle cells resembled fibroblasts or myofibroblasts. Differential diagnosis from benign and malignant diseases involving abdominal cavity was discussed.

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Cytopathologic Diagnosis of Pulmonary Diseases by Transthoracic Fine Needle Aspiration Biopsy (경흉세침흡인 생검에 의한 폐질환의 세포병리학적 진단)

  • Park, In-Ae;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.27-35
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    • 1990
  • The authors report series of 360 cases of transthoracic fine-needle aspiration cytology (TFNA) from Oct. 1982, through Aug. 1986 at the Seoul National University Hospital. A diagnosis of neoplastic lesion was established in 50.3% of the cases. A non-neoplastic diagnosis was made in 38.5%, nondiagnostic one in 6.5% and inadequate one in 4.7% of the total. Statistical findings on cytological diagnoses were as follows. Specificity was 100% ; sensitivity, 92% ; predictive value for positive, 1.0 ; predictive value for negative, 0.9 ; concordance rate, 84.2% ; diagnostic accuracy in non-neoplastic lesion, 65.4%, and typing accuracy in malignant tumor, 0.77.

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Cytologic Findings of Fine Needle Aspiration Biopsy of Ancient Schwannoma (퇴행성 신경초종의 세침흡인 생검에 대한 세포학적 소견)

  • Joo, Hee-Jae;Lee, Kwang-Gil
    • The Korean Journal of Cytopathology
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    • v.1 no.2
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    • pp.158-163
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    • 1990
  • Ancient (degenerated) schwannomas are benign tumors that display pronounced degenerative changes including cyst formation, calcification, hemorrhage, and hyalinization. The tumors are usually infiltrated by large numbers of inflammatory cells such as neutrophils, lymphocytes, siderophages, and histiocytes. They are located in deep locations such as the retroperitoneum and must be differentiated from malignant soft tissue tumors because spindle cells with nuclear atypia may be present. In the fine needle aspiration biopsy. The cytologic findings of two cases of ancient schwannoma occurring in posterior mediastinum and retroperitoneum, respectively, are described. Computerized tomographic findings of both cases showed changes of cystic degeneration or necrosis. A case occurred in retroperitoneum revealed features of destruction of vertebral body to suggest a malignant soft tussue tumor radiologically. The cytologic findings of aspiration biopsy of both tumors revealed that the tumor cells were spindle in shape with elongated nuclei. Some of tumor cells were arranged in a palisading fashion. Cell structures that resemble the Verocay bodies were observed. Some of the tumor cells showed pleomorphic bizarre nuclei, but no mitotic activity or chromatin clumping was seen. Inflammatory cells, siderophages and histiocytes were scattered in fibrillar material. These cytologic findings are important in the diagnosis of ancient schwannoma and in the differentiation of this tumor from the malignant spindle cell tumor.

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