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Biomedical subjects

E Ravinsky

Publications and source records attributed to E Ravinsky.

16 recordsLinked to original sources
PubMed1996

Contribution of transmission electron microscopy to fine-needle aspiration biopsy diagnosis: comparison of cytology and combined cytology and transmission electron microscopy with final histological diagnosis.

This report evaluates 74 fine-needle aspiration biopsies processed for transmission electron microscopy with subsequent surgical procedure. The specificity of diagnosis obtained by cytology alone was compared to that obtained by cytology and electro microscopy, using histologic diagnosis as the gold standard. When cytology gave a diagnosis of malignancy but could not give tumor category or type, electron microscopy could correctly give both. When cytology could give tumor category but not type, electron microscopy correctly identified type in the majority of cases. When cytology gave tumor category and type, electron microscopy confirmed the diagnosis. Transmission electron microscopy is very helpful when the cytopathologist can diagnose malignancy but cannot give tumor category and/or type. When the cytopathologist is specific in his/her diagnosis, TEM is not as helpful.

Adenocarcinoma↗
PubMed1993

Fine-needle aspiration biopsies of metastatic neuroendocrine tumors in liver: use of transmission electron microscopy and protein A gold technique in diagnosis.

Five fine-needle aspiration biopsies of liver were studied to evaluate the use of electron microscopy and protein A gold technique in the diagnosis of metastatic neuroendocrine tumors. All five cases had cytologic features suggestive of neuroendocrine tumors and neurosecretory granules on ultrastructural examination. The aspirates were stained by the immunoperoxidase technique and the postembedding protein A gold technique using the antibody to chromogranin A. Three cases were positive for chromogranin A by both immunoperoxidase and protein A gold techniques. Two cases were positive by protein A gold technique and negative by immunoperoxidase technique. Confirmation of neurosecretory granules by immunochemistry is ideal, since ultrastructurally they can be mimicked by other electron-dense inclusions. Advantage of the protein A gold technique is the use of the same material for both ultrastructural evaluation and the protein A gold technique.

Adult↗
PubMed1984

Ovarian hyperthecosis associated with pseudosarcomatous changes in the endometrial stroma.

This report documents a case of ovarian hyperthecosis associated with endometrial adenocarcinoma and pseudosarcomatous changes within the endometrial stroma. Previous descriptions of endometrial pseudosarcoma have emphasized its association with a history of exogenous progestogen administration; however, since this patient was not taking any medication, the source of the progestogen effect in the present case is presumed to be the hyperplastic ovarian cortex. Progestogen effects on target organs associated with ovarian hyperthecosis have not been described. However, the ovarian cortex does have progestogen forming potential, and pseudodecidual transformation of ovarian cortex seen in the present case and in other cases of ovarian hyperthecosis is presumptive evidence of progestogen formation.

Adenocarcinoma↗
PubMed1981

Dilation and evacuation: a preferred method of midtrimester abortion.

A comparison between two methods of therapeutic termination of midtrimester pregnancies was performed. Twenty-nine patients at 13 to 16 weeks' gestation underwent dilation and evacuation (D and E). A second group, of 29 patients at 16 to 19 weeks' gestation underwent therapeutic abortion by prostaglandin F2 alpha instillation. There was a significantly lower complication rate (6.9% versus 55%) and a shorter hospital stay of 1 full day in the D and E group. Also, the blood loss was not significantly greater in the D and E group.

Abortion, Therapeutic↗
PubMed1979

Ovarian ectopic pregnancy in association with a copper-7 intrauterine device in situ.

A case is reported of a primary ovarian pregnancy in a patient with a Cu-7 intrauterine device. A brief review of the literature on this subject is exposed. As the action of intrauterine devices on the ovulatory mechanism and tubal transport of the ovum is still unknown, further studies should be carried out to explain this association.

Adult↗
PubMedDate not supplied

Fixation techniques for fine needle aspiration biopsy smears prepared off site.

OBJECTIVE: To identify a simple, cost-effective, reliable fixation method for fine needle aspiration biopsy (FNAB) yielding a specimen suitable for mail transport. STUDY DESIGN: Smears prepared from 59 FNABs of surgical specimens were fixed by continuous fixation in 95% ethanol, spray fixation, air drying, ethanol fixation for either 5 minutes or 4 hours followed by spray fixation, or fixation in 95% ethanol for either 30 minutes or 4 hours followed by air drying. Fixation was graded as unsatisfactory, suboptimal, average, good or excellent. RESULTS: Of smears continuously fixed in ethanol, 96.6% were graded as excellent. Of smears fixed in ethanol followed by spray fixation, 93.2% were excellent irrespective of fixation time; 64.4% of spray-fixed smears were excellent and 27.1% good. Of air dried smears, 93.2% were unsatisfactory or suboptimal; 83.0% of smears fixed in ethanol for 30 minutes and 74.6% of smears fixed for 4 hours prior to air drying were unsatisfactory or suboptimal. CONCLUSION: Fixation of smears in 95% ethanol followed by spray fixation produces excellent results, comparable to those with continuous fixation in ethanol. Spray fixation is generally good but not consistently excellent. Air drying or fixation in ethanol followed by air drying yields unsatisfactory or suboptimal results in most cases.

Biopsy, Needle↗
PubMedDate not supplied

Cytodiagnosis of lymphoid proliferations by fine needle aspiration biopsy. Adjunctive value of flow cytometry.

OBJECTIVE: To determine the accuracy of fine needle aspiration biopsy (FNAB) complemented by flow cytometry (FC) for the diagnosis of reactive and neoplastic lymphoid proliferations and subclassification of malignant lymphomas. STUDY DESIGN: Forty-one FNABs of lymphoid lesions on which FC had been performed were evaluated retrospectively. All cases were correlated with histology or clinical follow-up. RESULTS: Twelve FNABs were diagnosed as reactive. Eleven of the 12 were confirmed as reactive on follow-up. One was a case of posttransplant lymphoproliferative disorder. Twenty-five FNABs diagnosed as lymphoma were confirmed by histology. In 22 of these 25 cases, there was 100% correlation between the subclassification given on FNAB with FC and that given on histology. Two of the remaining cases, which were correctly called follicular center cell lymphoma, showed discrepancies in grading. One case called Hodgkin's disease on FNAB was T-cell lymphoma on histology. Of four FNABs given an inconclusive diagnosis, two were lymphoma on follow-up, and two were reactive. CONCLUSION: FNAB examination, when it includes immunophenotyping by FC, is a useful technique for distinguishing reactive lymphoid proliferations from malignant lymphomas and for the subclassification of lymphomas.

Adolescent↗
PubMedDate not supplied

Fine needle aspiration biopsy findings in lymphoepithelial carcinoma of salivary gland.

OBJECTIVE: To study the fine needle aspiration cytology of lymphoepithelial carcinoma of salivary gland (LECSG). STUDY DESIGN: Needle aspirates from five primary and two metastatic LECSGs were reviewed. RESULTS: Three aspirates showed very scant cellularity with rare tumor cells originally misinterpreted as lymphohistiocytic cells. Six fine needle aspiration biopsies (FNABs) contained medium to large polygonal and spindled cells with one or more prominent nucleoli. Five aspirates also displayed a heterogeneous population of lymphoid cells, while a sixth had much necrotic debris and only a few lymphocytes admixed with tumor cells. CONCLUSION: In the clinical setting of an Inuit or Chinese patient with a salivary gland mass, an FNAB with these features should suggest the possibility of LECSG.

Adult↗
PubMedDate not supplied

Fine needle aspiration biopsy of a small round cell tumor exhibiting both neural and myogenic differentiation. A case report.

BACKGROUND: Divergent differentiation may not be detected in the limited material available in a fine needle aspiration biopsy (FNAB). CASE: A small round cell malignancy showed neural features ultrastructurally on FNAB, in keeping with primitive neuroectodermal tumor, but desmin and actin positivity on surgical biopsy, suggesting rhabdomyosarcoma. CONCLUSION: Accurate classification of small round cell tumors by FNAB is more likely to occur when both electron microscopy and immunocytochemistry are employed since these tumors may express divergent differentiation.

Adult↗
PubMedDate not supplied

Cytologic features of primary adenoid cystic carcinoma of the uterine cervix. A case report.

BACKGROUND: Adenoid cystic carcinoma of the cervix is a rare, aggressive neoplasm generally found in postmenopausal women. CASE: A cervical cytology specimen was obtained by endocervical brush from an 80-year-old woman with histologically confirmed primary adenoid cystic carcinoma of the cervix. Both small cells arranged in a cribriform (cylindromatous) pattern and moderately dysplastic squamous cells (high grade squamous intraepithelial lesion) were evident. CONCLUSION: Although the endocervical brush technique may yield well-preserved cells and tissue fragments morphologically characteristic of adenoid cystic carcinoma of the cervix, confusion with more common tumors, such as endometrial adenocarcinoma, still may create cytologic diagnostic difficulties.

Aged↗
PubMedDate not supplied

Fine needle aspirates of follicular lesions of the thyroid gland. The intermediate-type smear.

In order to evaluate fine needle aspirates of thyroid lesions with features intermediate between those of follicular neoplasms and colloid nodules, 38 aspirates in which a definitive diagnosis had not been made were reviewed. On review, ten aspirates were excluded from the "intermediate" category; seven were reclassified as unsatisfactory and one as a cellular colloid nodule. Two papillary carcinomas showed a complex pattern not identified in smears from other lesions; these aspirates were also classified separately for independent evaluation. The remaining 28 aspirates were characterized by syncytial-type tissue fragments with mild nuclear atypia. The association of syncytial-type tissue fragments and orderly sheets and fragments forming a honeycomb pattern in the same aspirate indicated a colloid nodule, though a two-disease process could not be excluded. Of the aspirates containing only syncytial-type tissue fragments, 50% were from adenomas, 25% were from carcinomas, and 25% were from colloid nodules. Criteria to distinguish between the various follicular lesions were not identified in these smears.

Adenoma↗
PubMedDate not supplied

Differentiation of Hashimoto's thyroiditis from thyroid neoplasms in fine needle aspirates.

In order to refine the cytodiagnostic criteria for distinguishing Hashimoto's thyroiditis from thyroid neoplasms, aspirates from six cases of Hashimoto's thyroiditis, five Hürthle cell neoplasms and one papillary carcinoma associated with Hashimoto's thyroiditis were reevaluated. Distinguishing characteristics were cell arrangements, nuclear chromatin pattern and nucleolar appearance. Hashimoto's thyroiditis was characterized by flat sheets and clusters of epithelial cells with oncocytic changes or occasionally by cohesive tissue fragments with cells well oriented one to the other. Thyroid neoplasms were characterized by loosely cohesive, syncytial-type tissue fragments with crowded overlapping cells poorly oriented one to the other and/or numerous isolated single cells. The nuclear chromatin of Askanazy cells in Hashimoto's thyroiditis was bland and even while that of neoplastic cells was finely granular, coarsely granular or irregularly clumped. Macronucleoli were present in Hürthle cell tumors but not in the Askanazy cells of Hashimoto's thyroiditis. Epithelial cellularity, lymphoid cellularity, cellular polymorphism and nuclear pleomorphism were not useful criteria for making the differential diagnosis between the two conditions. An admixture of epithelial cells and lymphoid cells indicated Hashimoto's thyroiditis but was not helpful in ruling out an associated neoplasm.

Biopsy, Needle↗
PubMedDate not supplied

Cytology of peritoneal washings in gynecologic patients. Diagnostic criteria and pitfalls.

A total of 226 peritoneal washing specimens obtained from gynecologic patients over a three-year period was reviewed. The diagnostic problems encountered were: differentiating reactive mesothelium from low-grade malignancies; distinguishing between benign ovarian tumors, ovarian tumors of borderline malignancy and low-grade ovarian malignancies; and potential false-positive diagnoses in endometriosis. Low-grade malignancies could be distinguished from reactive mesothelium by evaluating subtle cytologic criteria and by comparing the cells to those of the tumor on histologic section. The differentiation of low-grade epithelial malignancies from benign epithelial lesions caused difficulties that could only be resolved by evaluating the histologic material. Positive peritoneal washings increased the stage in 8 of 110 patients undergoing initial surgery for gynecologic malignancy. Two of 76 patients undergoing a second-look laparotomy had positive washings without histologic evidence of tumor. These ten patients did less well than did those with similar histology but negative washing cytology, despite receiving additional therapy because of the cytologic findings.

Adnexa Uteri↗
PubMedDate not supplied

Cytology of argyrophilic carcinoma of the breast.

Aspirations of breast lesions from 57 patients were studied by evaluating Grimelius-stained smears in order to determine the cytologic features of argyrophilic carcinoma and the reliability of argyrophilia as a characteristic of malignancy. The cytologic preparations were compared with histologic material. Sixteen benign lesions, 24 carcinomas correctly diagnosed by cytology and 5 carcinomas with technically inadequate smears were argyrophil negative. Five of 12 carcinomas with equivocal cytology were argyrophilic. There was perfect to case-to-case correlation between argyrophilia seen on histologic slides and on smears. The smears of the 5 argyrophilic carcinomas and 2 of the argyrophil-negative carcinomas with equivocal cytology shared features in common not seen in the other 50 smears: elongated cells with eccentric, round-to-oval nuclei and granular or opaque cytoplasm. These features can alert the pathologist to the possibility of malignancy in smears with equivocal cytology. A positive stain for argyrophilia will further increase the index of suspicion.

Adenofibroma↗
PubMedDate not supplied

Processing fine needle aspiration biopsies for electron microscopic examination. Experience implementing a procedure.

While processing needle rinses from fine needle aspiration biopsy material for electron microscopy, we experienced difficulties not fully outlined previously. Problems in preservation were traced to the time elapsed before glutaraldehyde was added to the needle rinse, which had been held in a physiologic transport medium; a tendency toward hypotonicity of the commercially prepared transport medium; and vigorous handling of the needle rinse. When these problems were dealt with, preservation improved dramatically. The problem of scanty material available for ultrastructural evaluation was dealt with by decreasing the number of smears made and filtering the needle rinse to capture tissue fragments. Implementation of the procedure required leadership, good communication, motivated cytotechnologists and cytopathologists, and continuous supervision and monitoring. In cases with adequately cellular well-preserved material available for electron microscopy, ultrastructural evaluation made a contribution of clinical value to the diagnosis in 48% of cases.

Biopsy, Needle↗