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Biomedical subjects

G Leiman

Publications and source records attributed to G Leiman.

53 records · Page 3Linked to original sources
PubMedDate not supplied

Cytologic detection of cervical granuloma inguinale.

Two cases of granuloma inguinale detected cytologically on routine Papanicolaou-stained cervical smears are presented; the cytologic and histologic features are described in detail, and the electron microscopic appearances are shown. The suitability of the Papanicolaou stain in the detection of granuloma inguinale is discussed, with emphasis on possible differential diagnoses to be considered. It is concluded that a definitive diagnosis of granuloma inguinale can be made on routine Papanicolaou-stained smears showing the following spectrum of changes: intact capillaries indicative of epithelial and stromal ulceration; a marked inflammatory cell infiltrate consisting predominantly of neutrophils; epithelioid histiocytes representing granuloma formation; and Donovan bodies located in characteristic single or multiple intracytoplasmic vacuoles within large histiocytes. Recognition of this cytologic picture may enable early diagnosis, even in nonendemic areas, of a potentially disfiguring venereal disease.

Adult↗
PubMedDate not supplied

Simulation of primary cervical cancer screening by the PAPNET system in an unscreened, high-risk community.

OBJECTIVE: To evaluate the performance of the PAPNET system as a primary cervical cancer screening modality in an unscreened population with a high prevalence of cervical cancer and its precursor lesions. STUDY DESIGN: Consecutive cervical smears from 3,106 women, screened and reported in the usual manner, were submitted for analysis by the PAPNET system. The original manual screening diagnoses were compared with those obtained by PAPNET analysis. By inclusion of normal and abnormal smears, this evaluation not only provided quality assurance for the laboratory but also simulated primary screening by automation. RESULTS: Comparison of the two methods of screening showed statistically significant superiority of the PAPNET over conventional screening (89.6% vs. 63.8%, respectively) in low grade lesions, including atypical squamous and atypical glandular cells of uncertain significance (ASCUS and AGUS, respectively) and low grade squamous intraepithelial lesion. Conversely, there was no significant difference between PAPNET and manual detection (87.5% vs. 94.6%) for more significant abnormalities, including high grade squamous intraepithelial lesions and invasive carcinoma. CONCLUSION: The PAPNET system, which would probably not be affordable as a quality assurance modality only in the public health sector of this country, was shown to be more than sufficiently effective as a primary screening method for the large numbers of women likely to undergo cervical cancer screening in anticipated mass population programs.

Automation↗
PubMedDate not supplied

Pseudomyxoma peritonei associated with ovarian mucinous tumors. Cytologic appearance in five cases.

The cytologic findings in five cases of pseudomyxoma peritonei associated with ovarian mucinous tumors are reported. The evidence suggests that if mucinous or gelatinous ascitic fluid is received in the laboratory and is shown to contain a dual cell population of round cells of mesothelial origin and spindle-shaped cells of fibroblastic origin together with lakes of fibrillar mucin, a cytologic diagnosis of pseudomyxoma peritonei can be made with confidence. It will usually indicate mucinous neoplasia of the appendix or ovary. In the case of ovarian neoplasia, the tumor is most likely to be a low-malignant-potential mucinous tumor. The patient's prognosis, however, will be that of mucinous carcinoma rather than of usual borderline tumors of the ovary.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

Asbestos bodies in fine needle aspirates of lung masses. Markers of underlying pathology.

Analysis of 52 transthoracic-mass aspirates that contained asbestos bodies (ABs) showed the mass to be due to pathology other than (or superimposed upon) asbestosis in every case. Malignancy accounted for 30 masses, all of which were carcinomas except for one mesothelioma. The remaining 22 lesions were benign, with tuberculosis or lung abscesses accounting for the majority. Fine needle aspiration (FNA) detection of the pathology (benign or malignant) associated with ABs was diminished, probably due to asbestos-induced fibrosis. Other diagnostic methods, including bronchial studies, mediastinoscopy and even exploratory thoracotomy, were required to document 20% of the neoplasms and 50% of the benign lesions. The results of this series support the view that ABs in FNA specimens from localized or dominant parenchymal lung masses are significant markers of underlying pathology, whether or not cellular evidence of that pathology is observed in the aspirated material.

Asbestosis↗
PubMedDate not supplied

Fine needle aspiration cytology of mucinous cystadenocarcinoma of the pancreas. Further observations.

Mucinous cystadenocarcinoma of the pancreas is among the few potentially curable malignancies of this organ; recognition of the differences between this and other pancreatic tumors is thus of paramount importance. A second example of mucinous cystadenocarcinoma of the pancreas diagnosed by fine needle aspiration, performed under ultrasonographic guidance, is presented, emphasizing both the radiographic distinction from other cystic lesions plus cytologic features not previously stressed. In essence, the cytodiagnosis relies less on cell morphology, which is characteristically bland and relatively monomorphic, than on the presence of extracellular mucin, which must be distinguished from amorphous background material and necrotic debris. The possibility of diagnosing benign mucinous and serous cystadenomas by imaging and cytology is addressed.

Biopsy, Needle↗
PubMedDate not supplied

Benign neurilemmoma (schwannoma) masquerading as a pleomorphic adenoma of the submandibular salivary gland.

A case of solitary benign neurilemmoma (schwannoma) arising in the submandibular region is presented. The tumor was mistaken clinically for an enlarged submandibular salivary gland. Fine needle aspiration cytology made an erroneous diagnosis of a pleomorphic adenoma, predominantly stromal in composition. Histology of the resection specimen resulted in the correct diagnosis of a benign schwannoma. Review of the needle aspirate demonstrated cytologic features that should enable both the correct diagnosis of this neoplasm and its distinction from pleomorphic adenoma, which it mimicked in this location.

Adenoma, Pleomorphic↗
PubMedDate not supplied

Fine needle aspiration cytology of parotid sarcoidosis.

Granulomatous lesions of the salivary gland are rare; as such, there have been few reports of the cytologic features of granulomatous sialadenitis in general, and salivary gland sarcoidosis in particular. A case of systemic sarcoidosis involving both parotid glands, diagnosed initially by fine needle aspiration (FNA) cytology, is presented. The specific cytologic features included histiocytes of both epithelioid and giant multinucleated types, without background necrosis. The FNA cytologic differential diagnosis of bilateral parotitis is discussed.

Adult↗
PubMedDate not supplied

Primary malignant pleural tumors (mesotheliomas) presenting as localized masses. Fine needle aspiration cytologic findings, clinical and radiologic features and review of the literature.

The cytologic and histologic appearances of four localized primary malignant pleural tumors occurring in three patients subjected to fine needle aspiration are presented. In one case, the radiographic mass was the only manifestation of what was found to be a diffuse epithelial mesothelioma at surgery. Two other patients had localized primary sarcomatous mesotheliomas, of low grade and high grade, respectively. In the latter patient, a second metachronous but identical tumor appeared on the contralateral side during follow-up. The clinical findings, radiologic features and cytologic differential diagnosis of both the epithelial and the sarcomatous variants are discussed, together with a review of the literature pertinent to localized primary malignant pleural tumors.

Adult↗
PubMedDate not supplied

Nonaspiration fine needle cytology. Application of a new technique to nodular thyroid disease.

The basic principle underlying fine needle aspiration (FNA) is the aspiration of cellular material from target masses, often utilizing fairly high suction pressures. The procedure requires a needle and a syringe, advisedly held in a syringe holder, enabling single-handed suction to be exercised. Mastery of the technique is variable, with few operators acquiring consistent skill. A new technique, pioneered in France but essentially unpublicized, eliminates active aspiration, replacing it by the principle of capillary suction of fluid or semifluid material into a thin channel (a fine needle). This nonaspiration sampling method was tested in a consecutive series of 50 solid thyroid nodules. Simultaneously performed conventional FNAs served as controls. Cell samples were cytologically assessed as unsuitable, diagnostic/adequate or diagnostic/superior, without knowledge of the sampling method employed. Diagnostically superior specimens were obtained significantly more frequently by the nonaspiration technique in 36 benign lesions and 13 neoplasms. The method of nonaspiration fine needle cytology ("cytopuncture") is described and illustrated, and the implications for its use in other sites are discussed.

Biopsy, Needle↗
PubMedDate not supplied

Endometriosis of the rectovaginal septum. Diagnosis by fine needle aspiration cytology.

The cytologic picture seen in two cases of rectovaginal endometriosis diagnosed by fine needle aspiration (FNA) cytology is presented in detail. The cell pattern differed considerably from that previously described in fluid specimens and more closely resembled the exfoliation observed in direct endometrial samples. No previous report appears to exist on the diagnosis of rectovaginal endometriosis by FNA.

Adult↗
PubMedDate not supplied

Cytologically detected chlamydial changes and progression of cervical intraepithelial neoplasias. A retrospective case-control study.

Fifty-four patients with Chlamydia-associated changes on the cervical smears, in whom adequate follow-up had been obtained over a two-year period, were investigated. The progression to biopsy-proven cervical intraepithelial neoplasia (CIN) III in this group was 42.6%, significantly higher than the 15.8% progression rate noted in a control group of patients with similar cytologic abnormalities but unassociated with Chlamydia. This finding suggests that Chlamydia may be a cocarcinogen or a potentiating agent in the progression of CIN.

Adult↗
PubMedDate not supplied

Cells of nucleus pulposus in cerebrospinal fluid: a case report.

A case is presented in which inadvertent needling of the nucleus pulposus produced unusual cells in cerebrospinal fluid which caused diagnostic difficulty. The case in documented to alert those involved in the diagnostic cytology of cerebrospinal fluid to yet another source of extraneous cellular material in fluid obtained by lumbar puncture.

Cerebrospinal Fluid↗
PubMedDate not supplied

Squamous carcinoma of the breast: diagnosis by aspiration cytology.

Squamous carcinoma is a rarely encountered lesion in the breast, and its diagnosis by aspiration cytology is unreported. Six cases of squamous carcinoma occurring in the breast, all diagnosed preoperatively by cytology, are discussed. Cytologic and histopathologic features of both primary and secondary carcinomas, pure and metaplastic types, are described, together with aspects of etiology, morphology and prognosis.

Adult↗