Fine-needle aspiration of the breast: cell counts as an illusion of adequacy. A clinical cytopathologist's point of view.
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Biopsy, Needle↗
Biomedical subjects
J S Abele
Publications and source records attributed to J S Abele.
Diabetic fibrous mastopathy: additional considerations.
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Adult↗
A step-wise logistic regression analysis of hepatocellular carcinoma. An aspiration biopsy study.
Fine needle aspiration biopsy (FNAB) has become a popular method to diagnose mass lesions of the liver. Although several reports have listed FNAB criteria to be used to diagnose both primary and metastatic tumors of the liver, none have separated key cytologic criteria from secondary criteria. We reviewed the FNAB smears from 35 patients with proven hepatocellular carcinoma and 74 patients with proven metastatic tumors in the liver. All specimens were coded as to the presence or absence of the following variables: polygonal cells with centrally placed nuclei; well-defined, granular cytoplasm; large nucleoli; small cytoplasmic vacuoles; large cytoplasmic vacuoles; bile; polymorphonuclear leukocytes; malignant cells separated by sinusoidal vessels; endothelial cells surrounding tumor cell clusters; multinucleated tumor giant cells; basophilic intracytoplasmic inclusions; eosinophilic intracytoplasmic inclusions; and intranuclear cytoplasmic inclusions. A step-wise logistic regression analysis was performed on the data to determine the variables predictive of hepatocellular carcinoma. The statistical analysis selected polygonal cells with centrally placed nuclei, malignant cells separated by sinusoidal capillaries, and bile as the key cytologic criteria for hepatocellular carcinoma. Endothelial cells surrounding tumor cell clusters and intranuclear cytoplasmic inclusions were selected as secondary criteria by this analysis.
Biopsy, Needle↗
Direct smears versus rinse/filtration technics.
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Biopsy, Needle↗
Do the prognoses of papillary and follicular thyroid carcinomas differ?
Our 44 patients with follicular thyroid carcinoma had a survival rate similar to patients of the same age and sex with papillary carcinoma. By matching our patients by age and sex, this study appears to show that the biologic behavior of differentiated thyroid carcinomas is better correlated with the age and sex of the patients than with the pathologic classification of papillary carcinoma or follicular carcinoma; therefore, it is unnecessary to distinguish between patients with papillary carcinoma and follicular carcinoma from a prognostic standpoint. A classification considering all well-differentiated thyroid carcinomas as one disease with behavioral variability due to constitutional factors such as age and sex should be adopted.
Adenocarcinoma↗
Fine-needle aspiration of palpable breast masses. A program for staged implementation.
Fine-needle aspiration (FNA) can provide a morphologic diagnosis of palpable breast masses in an accurate, efficient, inexpensive, and safe manner. However, how one acquires the skill to perform the FNA and interpret the resulting smears, while protecting the patient from the risk of false-positive or false-negative results, is scarcely considered. We used a three-phase program to acquire experience with FNA while providing services for 205 patients over a 16-month period. We performed FNA sequentially in vitro, in vivo, and finally in vivo for clinical use. With available literature and this graduated implementation program, physicians totally inexperienced with FNA can achieve results similar to those of medical centers having experience with thousands of patients.
Biopsy, Needle↗
Milk of calcium within tiny benign breast cysts.
Small amounts of milk of calcium settling to the bottom of multiple tiny benign breast cysts produce the mammographic picture of clustered linear and curvilinear calcifications when imaged in lateral projection with a horizontal x-ray beam. These calcifications, although benign, may be confused with the microcalcifications of carcinoma. Milk of calcium is found much more frequently in small breast cysts than anywhere else in the body. It is not at all uncommon, occurring in more than 4% of women undergoing diagnostic mammography. Fortunately, the overall mammographic appearance of milk of calcium cysts is quite characteristic, permitting them to be a differentiated from malignant breast microcalcifications with a high level of confidence.
Breast Diseases↗
Fine-needle aspiration biopsy in the management of thyroid nodules.
A prospective study was carried out of 136 patients with thyroid nodules. In all of the cases, fine-needle aspiration (FNA) cytology was used in the clinical management. Of the specimens taken, 129 were satisfactory for cytology; 5 were clearly malignant and the diagnosis was confirmed during surgical operation. The diagnosis of follicular neoplasm or "suspicious for malignancy" was made in 29 patients. Operations were done in 21; adenoma was found in 15, cancer in 2 and multinodular goiter in 4. The cases in which a benign diagnosis was made are being followed clinically. From these data and a review of the literature, a plan for the management of patients with thyroid nodules can be outlined. FNA biopsy of the thyroid is an excellent method for eliminating unnecessary operations in patients with thyroid nodules.
Biopsy, Needle↗
Ocular metastases from systemic melanoma.
We studied two patients, a 72-year-old man and a 27-year-old woman, with metastatic melanoma documented by cytologic examination of the ocular fluids. Neither patient had a clinically detectable ocular mass. Fine-needle aspiration with cytologic examination may be useful in the diagnosis of metastatic ocular melanoma.
Adult↗
Sensitivity of human ovarian carcinoma cells to interferon and other antitumor agents as assessed by an in vitro semi-solid agar technique.
To determine the sensitivity in vitro of human ovarian carcinoma cells to the antiproliferative effects of human leukocyte interferon, 18 samples of ascitic fluid from 15 affected patients were cultured in semi-solid agar by the technique of Hamburger and Salmon. Cultures were examined at weekly intervals after initiation and the number and size of each tumor colony recorded. Growth as defined by increase in total tumor colony number with time was obtained in 45% of the samples, or 53% of the patients, or 67% of the ascitic fluid samples with tumor cells demonstrated by Pap smear. No growth occurred in samples from recently treated patients or in samples devoid of tumor cells as assessed by Pap smear. Response to interferon directly incorporated into the agar culture system or preincubated with cells prior to their inclusion in culture was defined as reduction in total colony number by greater than or equal to 50% and partial response by greater than or equal to 25% reduction. The response rate for samples, The nontreated controls of which showed evidence of growth, was 71%, and that of samples that contained tumor colonies with no increase in growth during the culture period was 75%. Sensitivity to interferon was not related to the histology or grade of the tumor or to the stage of the disease. In general the responsiveness of the tumor cells to interferon ran parallel to the overall responsiveness to a variety of other chemotherapeutic agents. As this culture system has been proven by other investigators to be predictive of in vivo resistance to antitumor drugs with considerable accuracy and also to be predictive of in vivo response to a lesser degree, it will be important to determine whether similar relationships between in vitro and in vivo sensitivity obtain for interferon.
Adult↗
Further experience in testing the sensitivity of human ovarian carcinoma cells to interferon in an in vitro semisolid agar culture system: comparison of solid and ascitic forms of the tumor.
We studied the in vitro growth characteristics of 10 solid-tumor samples of patients with ovarian carcinoma using a semisolid agar culture technique. Tumor cell colonies were observed in 8 of 10 samples, but sufficient number of tumor colonies to evaluate the effects of interferon and other antitumor agents were obtained in only four samples. As compared with cell suspensions prepared from ascitic fluid samples, solid-tumor samples had markedly lower viability, 39% vs 89%, and had more tumor cells, 81% vs 28%. Also, whereas the maximum increase in tumor-colony number occurred during the first week of growth in both solid- and ascitic-fluid-derived samples grown concurrently from the same donors, increase in tumor colony number was sustained for longer periods in ascitic-fluid-derived cultures. The ascitic-fluid-derived tumor colonies were more sensitive to the antiproliferative effects of interferon than colonies derived from solid-tumors. At a concentration of 300 units/ml incorporated into the agar for the duration of the culture, three of four ascitic fluid samples showed a reduction in tumor colony number by greater than or equal to 25%, whereas none of the solid-tumor samples were affected by the interferon to that degree. In contrast, solid-tumor samples showed greater response to cis platinum and Adriamycin than did ascitic-fluid-derived cultures. Such studies and observations are critical in designing clinical trials for the use of interferon in the treatment of malignancy and the judicious selection of patients and route of administration most likely to provide optimal results, especially in view of present critical shortages in availability of interferon.
Adult↗
Spinal-fluid pleocytosis estimated by the Tyndall effect.
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Cerebrospinal Fluid↗
Smearing techniques for the concentration of particles from fine needle aspiration biopsy.
Fine needle aspiration biopsy of palpable masses yields a variety of specimens. Some are fluid, whereas others are semisolid; some contain numerous particles, whereas others contain no identifiable particulate fragments. Not surprisingly, no single smearing technique can reasonably be expected to provide good results with such a variety of specimens. This article describes a family of techniques, of which one or more are applicable to virtually any fine needle aspiration biopsy specimen. The techniques described and illustrated include the two-step, one-step, absorption, and watch-glass techniques.
Biopsy, Needle↗
A step-wise logistic regression analysis of papillary carcinoma of the thyroid.
Fourteen cytologic features seen in fine needle aspirates of papillary carcinoma of the thyroid were subjected to a step-wise logistic regression analysis to determine which are predictive of papillary carcinoma. The study cases included 38 histologically proven papillary carcinomas and 54 other palpable thyroid nodules. The three most important variables in making the prediction of papillary carcinoma were intranuclear inclusions, papillary structures without vessels and cells with metaplastic cytoplasm.
Biopsy↗
Neuroblastoma diagnosed by fine needle aspiration biopsy.
Small-cell malignancies of childhood are a source of diagnostic difficulty, both in cytology and histology. Four cases of neuroblastoma are presented that were diagnosed by fine needle aspiration cytology. The importance of a complete history, physical examination and laboratory evaluation is stressed. In addition to the usual description of cytologic detail obtained by routine methods, a new method of study is introduced: the potential use of plastic embedding and histochemical studies in small-cell tumors is discussed.
Adolescent↗
Cytology of well-differentiated and poorly differentiated hemangiosarcoma in fine needle aspirates.
The cytologic descriptions of fine needle aspirates from one well-differentiated and one poorly differentiated hemangiosarcoma are reported and correlated with the histologic findings. Aggregates of two to ten cells predominated in the aspirate from the well-differentiated tumor. In Papanicolaou-stained smears and filter preparations, single nuclei, resembling intravascular nuclear protrusions in a punch biopsy specimen, projected from some of these cell groups. Shallow longitudinal invaginations characterized the hyperchromatic nuclei. Erythrophagocytosis and cytoplasmic vacuoles were evident in Wright's-stained smears. Individual binucleate cells predominated in aspirates from the poorly differentiated tumor. Their nuclei exhibited thicker membranes, more prominent nucleoli and clearer parachromatin than did those of cells from the well-differentiated tumor. Cytoplasmic projections were common and sometimes quite complex. While these cytologic features are not pathognomonic, they are indicative of a malignant neoplasm and can be combined with clinical and other histopathologic data to provide a complete diagnosis.
Adult↗