Biomedical subjects

B J Guidos

Publications and source records attributed to B J Guidos.

6 recordsLinked to original sources

PubMed2001

Cytomorphology of small-cell (neuroendocrine) carcinoma on ThinPrep cytology as compared to conventional smears.

Small-cell (neuroendocrine) carcinoma of the female genital tract is an uncommon, aggressive neoplasm that occurs most commonly in the cervix and rarely in the vagina. Although the cytologic findings have been reported on conventional smears, the cytologic diagnosis of primary vaginal small-cell carcinoma on ThinPrep material has not been previously reported. We present a case of a 46-yr-old woman who underwent cervical/vaginal biopsies as a result of abnormal cells seen on the ThinPrep Pap Test. Small to medium-sized cells with scant cytoplasm were present singly and in loose, cohesive clusters. Nuclear molding was noted in a few cellular groups. The differential diagnosis included a high-grade squamous intraepithelial lesion, small-cell (neuroendocrine) carcinoma, endometrial adenocarcinoma, and lymphoma. Subsequent tissue biopsies with immunohistochemical staining confirmed a diagnosis of small-cell carcinoma of the vagina. The cytologic features of small-cell (neuroendocrine) carcinoma on slides prepared by the ThinPrep Pap Test are discussed and compared to those on conventional cervicovaginal smears.

Carcinoma, Neuroendocrine↗

PubMed2001

Immature teratoma of the ovary on fluid cytology.

A case of an immature teratoma of the ovary in the peritoneal fluid of a 10-yr-old girl who presented with a pelvic mass is presented and discussed. The ThinPrep preparation showed a few tight clusters of small tumor cells with a high nuclear/cytoplasmic ratio, round to oval nuclei with evenly distributed chromatin and one to two small distinct nucleoli, and scanty cytoplasm. The presence of immunohistochemical-confirmed glial tissue on the cell block preparation confirmed the diagnosis of an immature ovarian teratoma. The differential diagnosis of fluid cytology is discussed.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2000

Specimen adequacy and the ThinPrep Pap Test: the endocervical component.

The ThinPrep Pap Test (Cyryc Corp., Boxborough, MA) has proven to be effective in decreasing the number of cervical specimens limited for interpretation by blood/inflammatory exudate as compared to conventional smears. However, its effectiveness in decreasing the number of preparations which lack an endocervical component is less well-established. The purpose of this 1-yr study (January 1998-December 1998) was to determine if the collecting instruments used by physicians played a role in the lack of an endocervical component on ThinPrep slides. On implementation of the ThinPrep Pap Test for cervical cytology, the broom-type sampling device (Papette, Wallach Surgical Devices, Inc., Millford, CT) was the FDA-approved collecting instrument. Subsequently the combined plastic spatula/Zelsmyr Cytobrush (Medscand, Inc., Hollywood, FL) were approved. A survey was sent to 102 physicians in seven primarY care sites and two private obstetrics-gynecology practices affiliated with the Loyola University Health Care System. One site used the broom only, one site used the spatula/cytobrush, five sites used the broom/cytobrush, and in two sites, two different sets of collecting instruments were utilized. Of the 10,241 ThinPrep samples, 620 (6%) were obtained with the broom only, 432 (4.3%) with the spatula/cytobrush, and 9,189 (89.7%) with the broom/cytobrush. An endocervical component was absent in 24% (range, 13.7-25%) of the cervical samples collected with the broom only, 10% (range, 8.4-12.5%) with the spatula/cytobrush, and 13% (range, 6.2-18.8%) with the broom/ cytobrush. The spatula/cytobrush and the broom/cytobrush showed statistical significance (P < 0.001) over the broom alone in the collection of an endocervical component. The results of this study indicate that the collecting instruments used by the physician(s) played a role in the adequacy (endocervical component) of the specimen processed by the ThinPrep method. Diagn. Cyto

Adolescent↗

PubMed2000

Detection of endometrial adenocarcinoma with the ThinPrep Pap test.

The ThinPrep Pap Test (Cytyc Corp., Boxborough, MA) was introduced in the Loyola University Medical Center (LUMC) Cytopathology Laboratory in March 1997. This study presents a 26-month retrospective review of the cervicovaginal specimens on all patients who had a cytologic diagnosis of adenocarcinoma either by conventional (CS) or ThinPrep (TP) methods. From March 1997 through May 1999, 16,139 conventional smears and 29,589 TP Pap tests were sent to the LUMC cytopathology laboratory. The three diagnostic glandular categories included: atypical glandular cells of undetermined significance (AGUS); suspicious for adenocarcinoma, endometrial adenocarcinoma, and adenocarcinoma; not otherwise specified (nos). Cytohistologic correlation was performed on all available cases. Since endometrial adenocarcinoma occurs most frequently in peri- and postmenopausal patients, the percentage of patients over the age of 50 was determined for each method; 4,669 (29%) of the women receiving a CS were age 50 or over and 6,839 (23%) of the women who received the TP Pap test were in this age group. Sixteen endometrial lesions were identified on cytology, one (adenocarcinoma) with the CS method and 15 (six AGUS; suspicious for adenocarcinoma, four endometrial adenocarcinomas, and five adenocarcinomas; nos) with the TP method. The one CS case had biopsy confirmation. Fourteen of the 15 TP cases (93%) were confirmed by biopsy; one (7%) case had no follow-up. The TP Pap test yielded a higher percentage of endometrial adenocarcinomas (0.05%) as compared to CS (0.01%). Traditionally, CS has not been a method for the early detection of endometrial glandular lesions. However, of the patients diagnosed as having an endometrial adenocarcinoma in this study, the TP Pap test contributed to an increase in the detection of these lesions as compared to CS. The age group for the two methods was comparable.

Adenocarcinoma↗

PubMed1999

Use of the Thin Prep Pap Test in clinical practice.

The Thin Prep Pap Test (Cytyc Corp., Boxborough, MA) received approval by the Food and Drug Administration in May 1996 as an alternative to the traditional conventional smear. The present direct-to-vial study assessed the utility of thin-layer technology for cervicovaginal screening in clinical practice. From May 1997-February 1998 (10 mo), 15,006 cervical smears were processed and evaluated; of these, 5,423 (36.1%) were conventional smears (CS) and 9,583 (63.9%) were Thin Prep slides (TP). Both methods were analyzed to compare specimen adequacy and detection rates of cervical lesions. The TP method reduced the "satisfactory but limited by" rate by 97% and the unsatisfactory rate by 63%. For low-grade squamous intraepithelial lesions (LSILs), TP slides yielded 3.6% (348/9,583) as compared to 0.98% (53/5,423) for CS, an increase of 267%. The TP method detected a threefold increase in the number of high-grade squamous intraepithelial lesions (HSILs) of 1.0% (100/9,583), as compared to 0.3% (17/5,425) for the CS group. The atypical squamous cells of undetermined significance/squamous intraepithelial lesion (ASCUS SIL) ratio was reduced by 54% in the TP group. In routine usage in our laboratory, the Thin Prep Pap Test yielded a significant increase in the detection of LSILs and HSILs as compared to conventional smears. Specimen adequacy was significantly improved.

Evaluation Studies as Topic↗

PubMedDate not supplied

The AcCell series 2000 as a support system for training and evaluation in educational and clinical settings.

Providing effective training, retraining and evaluation programs, including proficiency testing programs, for cytoprofessionals is a challenge shared by many academic and clinical educators internationally. In cytopathology the quality of training has immediately transferable and critically important impacts on satisfactory performance in the clinical setting. Well-designed interactive computer-assisted instruction and testing programs have been shown to enhance initial learning and to reinforce factual and conceptual knowledge. Computer systems designed not only to promote diagnostic accuracy but to integrate and streamline work flow in clinical service settings are candidates for educational adaptation. The AcCell 2000 system, designed as a diagnostic screening support system, offers technology that is adaptable to educational needs during basic and in-service training as well as testing of screening proficiency in both locator and identification skills. We describe the considerations, approaches and applications of the AcCell 2000 system in education programs for both training and evaluation of gynecologic diagnostic screening proficiency.

Automation↗