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C V Fanning

Publications and source records attributed to C V Fanning.

12 recordsLinked to original sources
PubMed1995

Fine-needle aspiration cytology of seminoma: a review of 16 cases.

We report the cytomorphologic features of 16 fine-needle aspiration (FNA) biopsies of seminoma obtained from 16 male patients. The aspirates included two primary gonadal tumors (one occurring in a cryptorchid testis), two primary mediastinal tumors, and 12 metastases (two with unknown primaries). Analysis of the aspirates revealed a primarily dispersed cell population of large cells with scant to moderately abundant cytoplasm. The nuclei were round to slightly irregular, had finely granular chromatin, and had either one central prominent nucleolus or two to three smaller nucleoli. Variable numbers of lymphocytes and plasma cells were intermingled with the tumor cells. Only a few cases had epithelioid histiocytes or the characteristic "tigroid" background. The cytologic features of the metastases were distinctive and were considered diagnostic for therapeutic management. In six cases, an initial diagnosis of seminoma by FNA biopsy identified the neoplasm as germ cell in origin rather than other neoplasms in the differential diagnosis, thereby expediting therapeutic management.

Adult↗
PubMed1995

Core needle biopsy and fine-needle aspiration in the diagnosis of bone and soft-tissue lesions.

Although core needle biopsy (CNB) and fine needle aspiration (FNA) procedures are widely used for the diagnosis of epithelial neoplasms, these procedures have not gained popularity on patients suspected of having bone or soft-tissue neoplasms. This article describes the University of Texas, M.D. Anderson Cancer Center experience with CNB and FNA procedures in bone and soft tissue performed in over 800 patients.

Biopsy, Needle↗
PubMed1994

Diagnosing intramuscular myxoma by fine-needle aspiration: a multidisciplinary approach.

The gross and microscopic appearances of aspirates from ten intramuscular myxomas are reported. The specimens were obtained from seven women and three men, ages 43 to 75, who had tumors involving the muscles of the thigh (7), upper arm (2), and forearm (1). Magnetic resonance (MR) imaging performed in six of the ten cases revealed well-defined, sharply demarcated tumors exhibiting low signal intensity relative to muscle on the T1-weighted images. The tumors were hyperintense to muscle on T2-weighted images. All aspirated tissues were clear, tenacious, and viscous. Smears contained few spindled and histiocytoid cells in an abundant mucoid background. Spindle cells demonstrated long cytoplasmic processes that in areas intertwined to form fibrillar tangles. Nuclei were oval to spindled with fine chromatin and inconspicuous nucleoli. Capillaries were sparse with simple (non-plexiform) branching. The differential diagnosis of myxoid lesions of the extremities includes benign entities such as myxoid schwannoma and neurofibroma, mesenchymal repair, and ganglion cyst, as well as malignant neoplasms such as myxoid liposarcoma, fibrosarcoma, malignant fibrous histiocytoma, and extraskeletal chondrosarcoma. The findings of this study revealed that, although the cytologic features were suggestive of intramuscular myxoma, a definitive diagnosis was often difficult, owing to scant cellularity and lack of distinctive cytologic features. The MR imaging findings may be utilized as an adjunct to the cytologic features to more confidently suggest a diagnosis of intramuscular myxoma.

Adult↗
PubMed1993

Spindling artifact of urothelial cells in post-laser treatment urinary cytology.

We reviewed 22 post-laser (Nd:YAG laser) coagulation bladder washes collected immediately after treatment. All washes demonstrated a striking artifact of cellular spindling. These spindled cells occurred singly, in loose clusters, and in lamellar stacks and had elongated nuclei with dense chromatin and bipolar cytoplasm that was fused in the stacks. Concurrent biopsies demonstrated similar cytologic changes. The spindling is a nonspecific epithelial response to heat. Conventionally electrocauterized epithelia show this artifact in biopsies, but since only the base of the lesion and surrounding urothelium are subjected to heat with electrocautery, the relatively few spindled epithelial cells created presumably go undetected in cytology specimens. With laser treatment, however, the whole urothelial surface of the lesion is coagulated, producing a much greater number of spindled cells. It is important to avoid misinterpreting the spindled cells as cells from a mesenchymal neoplasm or a sarcomatoid carcinoma, mistakes that were made in some of our initial cases. Malignancy cannot be evaluated when cells exhibit spindling artifact; this judgement should be made on undistorted cells. Thus, pre-laser and post-laser washes should be submitted for evaluation of malignancy.

Artifacts↗
PubMed1992

Peritoneal washing cytology in women: diagnostic pitfalls and clues for correct diagnosis.

The significance of peritoneal washing cytology in the management of patients with gynecologic cancer is well established. Its microscopic evaluation, however, is not always straightforward. Previous studies have identified some of the conditions that may result in misinterpretation of cytologic results. This report reviews the literature and describes other sources of diagnostic difficulties and clues for correct diagnosis. In addition, an outline for distinguishing endosalpingiosis from borderline and well-differentiated serous carcinoma is proposed.

Ascitic Fluid↗
PubMed1991

Fine-needle aspiration cytology of alveolar soft-part sarcoma.

Alveolar soft-part sarcoma (ASPS) is a rare soft-tissue tumor. Few cases have been reported in the aspiration cytology literature. We discuss the fine-needle aspiration (FNA) cytologic features of ASPS in four patients. The smears were characterized by single cells and clusters of cells associated with thin-walled vasculature, resulting in a distinct pseudoalveolar pattern. The cells had abundant granular cytoplasm and large round nuclei with prominent central nucleoli. Binucleated and occasional multinucleated cells were present. Numerous stripped tumor nuclei were a consistent feature. Periodic acid-Schiff (PAS)-positive diastase-resistant granules were demonstrable within the intact and fragmented cytoplasm. Electron microscopy of aspirated material identified granules and crystals with the characteristic lattice pattern. To conclude, the FNA cytologic features of ASPS are characteristic. Confirmation by special stains and electron microscopy of FNA material is possible. The differential diagnostic considerations include renal cell carcinoma, paraganglioma, granular cell tumor, clear cell sarcoma, and epithelioid sarcoma.

Adult↗
PubMed1990

Fine needle aspiration cytology of chondroblastoma of bone.

Between 1979 and 1987 12 patients with chondroblastoma underwent fine needle aspiration (FNA). There were eight female and four male patients (age range, 11-35 years) with lesions of the proximal humerus (three cases), distal femur (two cases), proximal tibia (two cases), proximal femur, distal tibia, talus, navicular bone, and fifth metacarpal (one case each). The radiologic features of the tumors were not entirely typical of chondroblastoma in the majority of patients. The aspirate was diagnosed as chondroblastoma in seven cases, was considered strongly suggestive of chondroblastoma in one case, was found to be diagnosable as chondroblastoma on review in one case, and was nondiagnostic in two cases. The remaining case, which showed giant cell tumor-like areas in addition to typical chondroblastoma on histologic sections from the curettage, was interpreted as giant cell tumor on FNA. There was no case in which an aspirate was erroneously diagnosed as chondroblastoma. On FNA, chondroblastoma had three dominant cytologic components: neoplastic mononuclear cells (chondroblasts), multinucleated osteoclast-like giant cells, and chondroid matrix fragments. The chondroblasts tended to lie individually in smears creating a pebbled appearance. They most commonly had round to oval nuclei with fine, evenly distributed chromatin and distinct longitudinal grooves, but indented, lobulated, and pyknotic nuclei were also observed. Their cytoplasm was dense and opaque with rounded well-defined borders. Multinucleated osteoclast-like giant cells were randomly admixed and were indistinguishable from those seen in other bone neoplasms. Chondroid matrix stained magenta with the Diff-Quik stain and green to violet with Papanicolaou. The cytologic features of the chondroblasts are the diagnostic hallmark of chondroblastoma and may allow FNA to become a valuable preoperative technique in the management of these patients.

Adolescent↗
PubMed1989

Fine-needle aspiration cytology of peripheral T-cell lymphoma. A cytologic, immunologic, and cytometric study.

The diagnosis of peripheral T-cell lymphoma (PTCL) is difficult. This entity can be misdiagnosed as Hodgkin's disease or a reactive process such as nonnecrotizing granulomatous lymphadenitis or it can present a problem in lymphoma classification. Fine-needle aspirates from 13 patients with histologically proven PTCL were evaluated by cytology, immunochemistry, and flow cytometry. Of the 13 patients with PTCL, initial cytologic diagnoses were atypical lymphocytic infiltrate (2), mixed-cell lymphoma (6), mixed-cell lymphoma with associated histiocytes (2), large cell lymphoma (2), and small cell lymphoma (1). Surface marker studies were performed on cytospin preparations. Antibodies against cytotoxic-suppressor (Leu-2a) and helper-inducer (Leu-3a,b) antigens were used in 11 cases. Ten lymphomas demonstrated helper phenotype and one showed phenotypic heterogeneity in two different sites. The most prominent cytologic features of PTCL were a variable combination of small, intermediate, and large lymphoid cells with irregular nuclei, presence of epithelioid histiocytes, and atypical mononuclear cells. Flow cytometry studies showed a diploid stem line with intermediate proliferative activity (mean S-phase of 6.7%) in most cases, despite the clinical aggressiveness of this neoplasm.

Adult↗
PubMed1989

Leukemic lymphadenopathy: diagnosis by fine needle aspiration.

We report cytologic findings in 6 patients (2 with a history of chronic myelogenous leukemia and 2 with a history of acute lymphoblastic leukemia) who presented with generalized or localized lymphadenopathy of undetermined etiology. Fine needle aspiration of enlarged lymph nodes resulted in the initial diagnosis of leukemia (1 case) or blast crisis of leukemia (2 cases), confirmation of involvement by leukemia at presentation (1 case), or confirmation of relapse of leukemia (2 cases). The average number of cells in the aspirates was 20 million, sufficient for performing immunophenotypic studies, flow cytometry, cytogenetic studies, and electron microscopy. The cytological features, combined with the ancillary studies, resulted in the diagnosis and subclassification of the leukemias as follows: chronic myelogenous leukemia, blast crisis (lymphoid); chronic myelogenous leukemia, blast crisis (undifferentiated); common acute lymphoblastic leukemia; acute lymphoblastic leukemia (T-cell), acute lymphoblastic leukemia (T-cell); and malignant lymphoma, small lymphocytic type.

Adolescent↗
PubMed1988

Osteosarcoma and the role of fine-needle aspiration. A study of 51 cases.

Fifty-one patients were evaluated by fine-needle aspiration (FNA) as part of the diagnosis, staging, and management of osteosarcoma. All patients had histologic confirmation of osteosarcoma. Five patients underwent two aspirations each; thus, the total number of aspirates reviewed was 56. Aspirations were performed by interventional radiologists using fluoroscopic guidance. The cytologic features of osteosarcoma were divided into five groups: (1) pleomorphic (malignant fibrous histiocytoma-like); (2) epithelioid; (3) chondroblastic; (4) small cell; and (5) mixed. Although osteoid-like material was seen, it could not be distinguished readily from dense collagen. The chondroid matrix of chondroblastic osteosarcoma was recognized as a granular film with scattered clear bubbles. Fine-needle aspiration was diagnostic of sarcoma in 45 of 56 aspirates (80.4%). In eight aspirates, the cellularity of the smears was insufficient for diagnosis due to extensively osteoblastic tumors (six), necrotic tumor (one), and undetermined causes (one). In three aspirates, failure was attributed to poor cellular preservation due to unknown factors. The authors conclude that FNA is a useful tool in the multidisciplinary diagnosis and management of osteosarcoma. Aspirates should only be evaluated with full knowledge of the clinical and radiographic findings. The most significant limitation of FNA is the inability to detect osteoid.

Adult↗
PubMed1987

Osteosarcoma chemotherapy effect: a prognostic factor.

Chemotherapy has become a routine part of the treatment of osteosarcoma. However, the precise role of preoperative chemotherapy remains in question. Between 1979 and 1982, a group of 40 patients were treated by multimodality therapy consisting of preoperative chemotherapy (intra-arterial cis-platinum and systemic adriamycin), surgery, and postoperative chemotherapy. Survival in this group is 64%, while continuous disease-free survival is 58%. Although age, sex, tumor size, site, and classification were found to be prognostic factors, histologic evidence of response to preoperative chemotherapy, measured as percent tumor necrosis, was found to be the most significant prognostic factor. When continuous disease-free survival was calculated as a function of tumor necrosis it was 91% in patients with greater than or equal to 90% tumor necrosis, while it was 14% in patients with less than 90% tumor necrosis. At initial presentation, 7% of patients were judged limb-salvage candidates. But due to the local effects of preoperative chemotherapy, 60% ultimately underwent limb-salvage surgery. Preoperative arteriograms were a reliable means of monitoring response to chemotherapy and served as an indicator of residual viable tumor. Using arteriogram directed planes of section, postchemotherapy, specimens were "mapped" and analyzed for chemotherapy effect. When present, residual viable tumor was preferentially found at the interface of tumor and normal anatomic structures; "sanctuary sites." It is necessary that standard methods for analyzing postchemotherapy specimens be developed; a technique is described.

Bone Neoplasms↗