Diagnostic value of the examination of clots in cytology.
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Biopsy, Needle↗
Biomedical subjects
E Martin-Bates
Publications and source records attributed to E Martin-Bates.
Pathologist variation in reporting cervical borderline epithelial abnormalities and cervical intraepithelial neoplasia.
AIMS: To evaluate the interobserver variation in the diagnosis of cervical intraepithelial lesions, including the new category "borderline abnormalities of uncertain significance" (BAUS) which has not been tested before. METHODS: Biopsy specimens of 122 patients were reviewed by five histopathologists and the diagnoses subjected to kappa statistical analysis. RESULTS: There was poor interobserver agreement in all categories, particularly between BAUS and normal tissue. CONCLUSIONS: The current guidelines for the histological diagnosis of cervical intraepithelial neoplasia and BAUS are poorly reproducible.
Biopsy↗
EB9, a new antibody for the detection of trophozoites of Pneumocystis carinii in bronchoalveolar lavage specimens in AIDS.
AIM: To prepare a monoclonal antibody (EB9) against the trophozoite form of Pneumocystis carinii and to test its efficacy for detecting infection with this organism. METHOD: The sensitivity and specificity of the EB9 antibody were assessed by comparing it with other conventional stains (Papanicolaou, Giemsa and Grocott) and 3F6 antibody in 33 bronchoalveolar lavage specimens from HIV positive patients suspected of having P carinii pneumonia. RESULTS: P carinii infection was detected in 15 of 33 patients. In 14 cases the organism was detected by two or more of the staining methods used; however, EB9 failed to detect infection in two cases which were positive by other staining techniques. In one case P carinii infection was detected by EB9 only. CONCLUSION: The results of this study suggest that P carinii infection in the lung may occur in two forms: the cyst form and the trophozoite form, which may explain the observed variation in response to treatment.
Acquired Immunodeficiency Syndrome↗
Use of fine needle aspiration cytology for investigating lymphadenopathy in HIV positive patients.
The cytological diagnoses of 27 lymph node aspirates were compared with the histological diagnoses or clinical outcome in 23 HIV positive patients. There was agreement between the cytological and histological diagnoses in 14 of the 16 surgically biopsied cases. The clinical outcome in the remaining 11 cases was consistent with the cytodiagnosis. Fine needle aspiration (FNA) is a reliable, minimally traumatic, cost effective method with high specificity. It is suitable for an initial rapid diagnosis in HIV positive patients with lymphadenopathy.
Adult↗
Evaluation of immunocytochemical staining as a method of improving diagnostic accuracy in a routine cytopathology laboratory.
Immunocytochemical stains in a routine cytopathology laboratory can be used to distinguish between benign and malignant cells, and to identify tumour type. In our laboratory 30 problematic cases were selected for immunocytochemical stains and the results analysed in this paper. The following markers were used: cytokeratin (CAM5.2), carcinoembryonic antigen (CEA), kappa and lambda light chains, leucocytic common antigen (LCA), chorionic gonadotrophin (hCG), prostate specific antigen (PSA), L26, UCHL1, S100-protein and vimentin. Twelve FNA (four lymph nodes, one parotid swelling, two from lungs, two from pleura and chest wall, one from lumbar region, two from soft tissue masses), and 18 effusions (12 pleural effusions, five ascitic fluids, one pericardial effusion) were investigated. We found immunocytochemical stains of value in formulating the cytological diagnosis in 11/12 of FNA and 15/18 of effusions.
Cytodiagnosis↗
Evaluation of fine needle aspiration of the male breast for the diagnosis of gynaecomastia.
Fine needle aspiration of the male breast can present problems of diagnosis because the cytological presentation of gynaecomastia can be confused with that of adenocarcinoma. We reviewed breast aspirates from 24 male patients in order to determine the accuracy of cytology as a method of diagnosing gynaecomastia. Discrepancies were observed between the original cytology reports on one hand and the review cytology and biopsies on the other. Of the 24 aspirates from the male breast, the cytology was reported as negative in 16 cases, suspicious in three cases and malignant in five. In four cases of the negative group, a specific diagnosis of gynaecomastia was made. In two of the negative cases the subsequent biopsies revealed adenocarcinoma. Of the five cases reported on the original cytology as adenocarcinoma, two on review showed the features of florid gynaecomastia and this was confirmed on biopsy and three confirmed the initial diagnosis of adenocarcinoma. The cytological features of gynaecomastia which distinguish it from adenocarcinoma are discussed.
Adenocarcinoma↗
Intramuscular and intermuscular lipoma: neglected diagnoses.
Fifty-four cases of lipoma arising either within or between skeletal muscles are presented. Of these, 52 were identified in a systematic review of 2478 tumours of adipose tissue diagnosed and treated in one hospital over a 25 year period. Intramuscular lipomas account for 1.8% of fatty tumours, arise predominantly in middle to late adult life and, in our series, are commonest on the trunk. They may be divided into infiltrative and well-circumscribed types, respective local recurrence rates being 19 and 0%. Intermuscular lipomas are comparatively rare, 0.3% of fatty tumours, have a similar age distribution and arise most often in the anterior abdominal wall; none of the seven cases recurred. It is important that both pathologists and surgeons appreciate the significant tendency of infiltrative intramuscular lipomas to recur. Hence, preventative surgical measures may be undertaken and worries that the lesion may be sarcomatous can be avoided. Differential diagnosis, most importantly from well-differentiated liposarcoma, is discussed.
Female↗
Spindle cell lipoma: a clinicopathological study with some original observations.
Forty-one cases of spindle cell lipoma, an entity first described in 1975, are presented. Of these, 38 were identified in a systematic review of 2478 tumours of adipose tissue diagnosed and treated in one hospital over a 25 year period. This lesion, therefore, accounts for about 1.5% of adipocytic neoplasms and is outnumbered by conventional benign lipomas by approximately 60 to 1. The remaining three were referred cases. Seventy-five per cent of the lesions arose, as expected, on the back of the neck, upper back or shoulder, almost exclusively in males between 40 and 70 years of age. Ten lesions were identified at unusual sites: six in the limbs, three on the face and one on the trunk. One lesion arose within skeletal muscle, a previously unreported phenomenon, and this case showed both cartilaginous and osseous metaplasia. Only one of the 41 tumours has recurred locally. The range of histological features in spindle cell lipoma is described and the differential diagnosis is discussed.
Adipose Tissue↗
Fatal toxic epidermal necrolysis associated with Hodgkin's disease.
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Adenocarcinoma↗