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H T Strawbridge

Publications and source records attributed to H T Strawbridge.

10 recordsLinked to original sources
PubMed1985

Management implications from routine needle biopsy of hyperfunctioning thyroid nodules.

To evaluate the diagnostic and treatment consequences of using a routine needle biopsy procedure on all thyroid nodules without a radioisotopic scintigraphic study, 12 patients with documented hyperfunctioning thyroid nodules were retrospectively evaluated regarding the physical and cytologic observations obtained after a fine-needle (22 to 27-gauge) aspiration biopsy (FNB) procedure. Among the seven solid lesions, features of marked cellularity and nuclear pleomorphism were present in three and moderate sheets of epithelium in four raising the suspicion of underlying malignancy, while five mixed (cystic and solid) lesions were larger than 3 cm, hemorrhagic, and recurrent, with two having detectable sheets of epithelium. Evidence for concomitant lymphocytic thyroiditis was seen in five of 12 (42%) patients, and nine had positive serum antithyroid antibody titers as well. In conclusion, total reliance on FNB without scintigraphy could lead to operations on hyperfunctioning thyroid adenomas for suspected malignancy, of whom the vast majority would be benign, and could expose some unprepared patients with thyrotoxicosis to surgical morbidity. Routine thyroid hormone suppression therapy for apparently benign inflammatory or cystic degenerative lesions could also induce hyperthyroidism in patients with hyperfunctional or autonomous (nonsuppressible) nodules. When using an initial FNB approach, the need for thyroid function studies and scintigraphy before undertaking surgery or thyroid hormone feeding, as well as the consequences of omitting such studies, should be considered.

Adult↗
PubMed1984

Medullary carcinoma of the thyroid in fine-needle aspiration biopsies.

A study of fine-needle aspiration biopsies (FNAB) in six cases of medullary carcinoma of thyroid (MCT) revealed that the presence of spindle cells in addition to the more usually recognized polygonal cells is a common feature and a significant clue to the diagnosis. Both spindle and polygonal cells contain cytoplasmic granules that stain positively for calcitonin by the immunoperoxidase technic. Amyloid, when present, can be identified presumptively in the Papanicolaou stain. This can be confirmed by restaining with Congo red. Both immunoperoxidase staining for calcitonin and amyloid staining for Congo red work well on the decolorized Papanicolaou-stained smears.

Adult↗
PubMed1981

Role of cytology in management of lesions of the breast.

Study of 3,724 cytologic specimens mainly obtained by fine needle aspiration biopsy of breast lesions has demonstrated several advantages in clinical management: confirmation of clinical or other impression without open biopsy; avoidance of open biopsy in inoperable instances; avoidance of operation for certain benign lesions; excision under local anaesthesia on an ambulatory basis of other benign lesions; more efficient operating room scheduling; reduction in the number of operations for benign lesions, and the institution of more effective and humane preoperative counseling. It is concluded that these benefits alone justify the use of the method, and there is no compelling need to abandon the routine use of premastectomy frozen sections. Indeed, the problems created by abandoning frozen section routinely appear to be a prime reason for the lack of wider application of the method.

Anesthesia, Local↗
PubMed1980

Reappraisal of the value of testicular biopsy in the investigation of infertility.

One hundred and forty-two biopsies were reviewed to reappraise the value and indications for testicular biopsy in the investigation of infertility. These biopsies were categorized within the following morphologic patterns: normal, hypospermatogenesis, maturation arrest, Sertoli cell-only syndrome, and Klinefelter's syndrome. The morphology of the biopsies was correlated with the available sperm count, and the contribution of the biopsy to the patient's treatment was assessed. Testicular biopsy has proved most useful in azoospermia for the identification of obstruction. In oligospermia, biopsy appears to be of little use.

Biopsy↗
PubMed1978

Carcinomatous pseudothyroiditis: a problem in differential diagnosis.

A 51-year-old woman presented with a painful, rapidly enlarging thyroid gland. The serum concentrations of the thyroid hormones were initially at the upper limit of normal, and the uptake of radioactive iodine by the thyroid was completely depressed. Although subacute thyroiditis was suspected, a biopsy specimen from the thyroid showed malignant disease and no evidence of inflammation. At the time of right subtotal lobectomy metastatic breast carcinoma was diagnosed. Thus, primary or secondary malignant disease of the thyroid can simulate thyroiditis and present a serious problem in differential diagnosis.

Adenocarcinoma, Papillary↗
PubMed1977

Combined ultrasound and needle aspiration cytology in the assessment and management of hypofunctioning thyroid nodule.

We evaluated the efficacy of combining B-scan bistable and gray-scale ultrasound with needle aspiration cytology in assessing and managing solitary hypofunctioning solid and cystic nodules. Of the 150 cases surveyed, 90 had surgical follow-up histology for comparison to preoperative aspiration cytology results. Overall neoplasm rate in these 90 cases was 66%, increasing to 93% if colloid nodules were included. Adequate material for cytology preoperatively was obtained in 83 (92%). In cases with adequate preoperative needle aspiration cytology, there were 66 solid and 17 cystic or mixed lesions. Overall accuracy for differentiating benign from malignant nodules for solid lesions was 63 of 66 (95%), compared to 15 of 17 (88%) for predominantly cystic or mixed lesions. Of the 17 cases of proven carcinoma, correct preoperative cytology diagnosis for malignancy was obtained in 12 (71%). Malignancy was most often correctly diagnosed for solid papillary and metastatic cancer lesions. No false-positives were noted and atypical adenomas and Hürthle-cell adenomas have been correctly diagnosed. The simplicity and safety of these diagnostic procedures justify their use for "selective" surgery and particularly for those cases that have been initially assigned to conservative, nonsurgical therapy.

Adenoma↗
PubMed1976

Application of special diagnostic techniques in the management of nodular goitre.

The primary challenge in the management of nodular goitre is to establish which thyroid nodules are malignant. Since selection of patients for operation on the basis of palpation of nodules alone gives a low yield of malignant disease, physicians have sought criteria for selection that combine the information obtained from special laboratory procedures with thoughtful clinical appraisal. Such special procedures, which include radioisotope scintiscanning, echography by B-mode ultrasonography, and either large- or fine-needle aspiration and cytologic examination of the aspirate, are considered valuable in a proposed clinical approach to the management of thyroid nodules.

Biopsy, Needle↗