PubMed Health⌕ Search

Biomedical subjects

M W Stanley

Publications and source records attributed to M W Stanley.

At least 73 records · Page 4Linked to original sources
PubMed1991

Cytologic assessment of tumor cell kinetics: applications of monoclonal antibody Ki-67 to fine-needle aspiration smears.

Rates of tumor-cell proliferation often provide prognostic information about a given neoplasm. Previously available methods for accessing cell kinetics are time consuming and expensive, and often require special equipment or radioactive reagents. Monoclonal antibody Ki-67 binds a nuclear antigen expressed in proliferating but not in resting cells. We studied Ki-67 immunostaining of fine-needle aspiration smears from 40 benign and malignant masses. Labeling indices ranged from 0 (thyroid follicular adenoma) to 75 percent (pulmonary oat-cell carcinoma). Frozen section immunostaining (11 cases) and flow cytometric assessment of cell proliferation (8 cases) were in good agreement with Ki-67 labeling indices on smear material. We suggest that this method provides a rapid, inexpensive, and dependable means of assessing tumor-cell kinetics in cytologic preparations.

Antibodies, Monoclonal↗
PubMed1990

Mucin production by pleomorphic adenomas of the parotid gland: a cytologic spectrum.

Mucinous salivary gland aspirations represent a special differential diagnostic problem. Considerations include pleomorphic adenoma, Warthin's tumor, chronic obstructive sialadenitis, and low-grade mucoepidermoid carcinoma. We herein discuss three cases that illustrate a spectrum of mucin production by pleomorphic adenomas. The literature is reviewed, and the possible distinction of pleomorphic adenoma from low-grade mucoepidermoid carcinoma is considered.

Adenoma, Pleomorphic↗
PubMed1990

Negative images of bacilli and mycobacterial infection: a study of fine-needle aspiration smears from lymph nodes in patients with AIDS.

In patients with the acquired immunodeficiency syndrome (AIDS), four cases of mycobacterial infection in which bacilli appeared as cylindrical, nonstaining "negative images" have been previously described. These may have been extracellular or within histiocyte cytoplasm, and they have been described in aspirations from liver, lymph node, and bone marrow and in bronchoalveolar lavage fluid. We report three additional examples of this finding in fine-needle aspirations from lymph nodes in AIDS patients infected with Mycobacterium avium-intracellulare. Our findings support the concept that these negative images of bacilli are diagnostic of mycobacterial infection. Air-dried Romanovsky-stained material is required for their identification.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Reactive type II pneumocytes in bronchoalveolar lavage fluid from adult respiratory distress syndrome can be mistaken for cells of adenocarcinoma.

A growing body of literature illustrates that bronchoalveolar lavage is a reliable and efficient means of diagnosing primary and secondary malignancies in the lung. Its safety in severely compromised patients often makes it preferable to other biopsy procedures. However, a variety of reparative and degenerative pulmonary disorders may result in cytologic alterations so severe that pneumocytes resemble cells of malignancy. We describe four patients with the adult respiratory distress syndrome from whom lavage fluid showed gland-like groups of malignant-appearing cells morphologically consistent with adenocarcinoma. Transbronchial biopsy sections in one case and lavage fluid electron microscopy in another showed that these pseudomalignant cells were reactive Type II pneumocytes with surface microvilli, cell junctions, and numerous cytoplasmic myelin figures. Careful clinicopathologic correlation is the best way to ensure accurate diagnosis in these cases.

Adenocarcinoma↗
PubMed1990

Fine-needle aspiration of lymph nodes in patients with acute infectious mononucleosis.

We studied lymph node fine-needle aspirations from 10 patients with primary Epstein-Barr virus (EBV) infections (infectious mononucleosis). There were five males and five females, aged 15-54 yr. The diagnoses were confirmed by blood morphology and heterophil antibody (HA) and EBV-specific serologic studies. Nine patients were HA-positive, nine were viral capsid antigen (VCA)-IgM-positive, and all 10 were VCA-IgG-positive and anti-EBV nuclear antigen (EBNA)-negative. Five patients were referred for fine-needle aspiration biopsies for clinically suspected malignant lymphoma (ML). Four of these patients had been tested for HA prior to fine-needle aspiration, with negative results in three cases. The heterophil-positive patient was referred for fine-needle aspiration due to very impressive unilateral cervical adenopathy. Cytologically, all cases showed atypia consisting of greater numbers of large immunoblastic lymphocytes than are usually seen in the reactive lymph node. Two cases were cytologically suspicious for malignant lymphoma but included a considerable background of polymorphic immunoblasts. We suggest that polymorphic immunoblastic proliferations in lymph node cytology are suggestive of infectious mononucleosis. Since several reactive and neoplastic processes mimic this pattern, cases not followed by both confirmatory serologic studies and resolution of adenopathy should be pursued by excisional lymph node biopsy.

Adolescent↗
PubMed1990

Fine-needle aspiration of fibroadenomas of the breast with atypia: a spectrum including cases that cytologically mimic carcinoma.

We herein report the cytologic and histologic findings in 11 cases of cytologically atypical fibroadenoma (FA). These ranged from cases recognizable as FA but showing epithelial atypia to cases that, even on review, completely mimicked the needle aspiration picture of ductal breast carcinoma. A retrospective review of 45 cases of previously excised FA showed that focal atypia is common (27%). Possible physiologic explanations for atypia in FA, along with strategies for avoiding false diagnoses of malignancy in aspiration smears, are discussed.

Adenofibroma↗
PubMed1990

Improved early detection of recurrence in prostatic carcinoma following hormonal therapy. Combined use of palpation and fine needle aspiration cytology.

Fifty-nine hormonally treated prostatic carcinoma patients were prospectively followed by rectal examination and fine needle aspiration cytology at six-month intervals for periods ranging from six to one hundred twenty months (median follow-up 48 mos). The cytologic findings and clinical impressions were divided into four or five categories, respectively, ranging from benign to clearly malignant. Cytologic material and clinical descriptions suitable for evaluation were available for 306 follow-up examinations. Of these, 209 were cytologically benign (including 191 without and 18 with clinical evidence of malignancy). The remaining 97 examinations showed cytologic evidence of malignancy of which 50 were clinically apparent (51.5%). While the correlation of clinical and cytologic findings was good (91.4%) in cases with no evidence of disease activity, our findings indicate that many recurrences which are occult to clinical examination may be detected by cytologic examination.

Aged↗
PubMed1989

Metaplastic carcinoma of the breast: fine-needle aspiration cytology of seven cases.

We describe the cytomorphology of seven cases of metaplastic carcinoma of the breast studied by fine-needle aspiration cytology and by histology. All seven cases contained foci of ductual adenocarcinoma. This finding was combined with heterologous mesenchymal elements in four cases, a spindle-cell pattern of growth in one case, and extensive squamous-cell metaplasia in two cases. Both carcinomatous and metaplastic components were present on smears in four cases (57%). Thus in three cases (43%), the diagnosis was not possible on smear material alone. Differential diagnostic considerations are discussed.

Adenocarcinoma↗
PubMed1989

Cystosarcoma phyllodes of the breast: a cytologic and clinicopathologic study of 23 cases.

Twenty-three cases of cystosarcoma phyllodes of the breast were studied clinically and by fine-needle aspiration (FNA) cytology as well as by tumor histology. The median patient age was 52 yr. The total actuarial survival at 5 yr was 90%, and the recurrence-free survival was 70%. A combination of stromal elements (tissue fragments and/or single spindle cells) and epithelial tissue was required to make the diagnosis on smear material. In FNA smears, stromal elements were absent in two cases, and ductal elements were not seen in three. Thus, the dimorphic pattern essential to this diagnosis was not present in five (22%) cases. An evaluation of tumor factors reported to be of prognostic significance was performed on histologic sections of resected tumors. Comparison of these data with FNA results indicates that little prognostic information can be obtained from FNA alone in most cases.

Adolescent↗
PubMed1989

Mucinous breast carcinoma and mixed mucinous-infiltrating ductal carcinoma: a comparative cytologic study.

In its pure form, mucinous breast carcinoma (MC) has a much better prognosis than infiltrating ductal carcinoma (IDC). Mixed MC-IDC has the prognosis of IDC. We compared the fine-needle aspiration (FNA) cytology and histology of nine cases of pure MC with 13 cases of mixed MC-IDC. While typical of pure MC, abundant mucin (3+/3+) was noted in smears from three cases of mixed tumor and is thus necessary but not sufficient for a diagnosis of pure MC. Cellular pleomorphism has been said not to be a feature of MC; however, we found occasional large cells markedly different from the typical small uniform cells of MC in four pure and seven mixed tumors. Cytologic features indicative of a mixed tumor include one or more smears totally without mucin, scantly amounts of mucin, or necrosis. A combination of features indicative of pure mucinous carcinoma in FNA included abundant mucin on all smears, no pleomorphism, and no necrosis. Many cases will have smear patterns that are not typical of either profile and should probably be designated as carcinoma with a mucinous component.

Adenocarcinoma, Mucinous↗
PubMed1989

Association of human immunodeficiency virus-induced immunosuppression with human papillomavirus infection and cervical intraepithelial neoplasia.

Human papillomavirus infection plays an important causal role in cervical intraepithelial neoplasia and carcinoma. The rate of infection with human papillomavirus as well as the incidence of cervical intraepithelial neoplasia and carcinoma are increased in immunosuppressed patients. We report a possible association between infection with human immunodeficiency virus and cervical intraepithelial neoplasia with human papillomavirus infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Determination of false negative rate in fine-needle aspiration of prostate. Study of sequential aspirations in 30 untreated carcinoma patients.

Despite several studies comparing the diagnostic accuracy of core needle biopsy and fine-needle aspiration (FNA) in the diagnosis of prostatic adenocarcinoma, no clear picture of the false negative rate for FNA is available. We studied 101 follow-up FNA evaluations in 30 patients with untreated well-differentiated carcinoma. The patients were followed for a median of two years and seven months and had from two to seven FNA follow-up evaluations (median = 2.5 evaluations per patient). If three inadequate evaluations are omitted, the combined rate of positive plus suspicious FNA biopsies was 92.9 percent (88.8% plus 4.1%, respectively). The residual false negative rate was 7.1 percent. The clinical features and follow-up data are described. A semiquantitative definition of "suspicious for malignancy" is suggested. We conclude that in experienced hands. FNA is a highly efficacious method for the diagnosis of prostatic adenocarcinoma.

Adenocarcinoma↗
PubMed1989

Fine-needle aspiration biopsy. Diagnosis of cancerous masses in the office.

Fine-needle aspiration biopsy is a rapid, inexpensive, atraumatic, and accurate way of diagnosing many cancers. It can be applied to any palpable mass. Deep lesions can also be sampled if visualization is guided by computed tomography, ultrasound, or fluoroscopy. Proper technique is essential in obtaining biopsy material, and interpretation of the smear requires special training. Patients accept the procedure, and even a repetition of it if necessary, very well.

Adolescent↗
PubMed1988

Foamy alveolar casts: diagnostic specificity for Pneumocystis carinii pneumonia in bronchoalveolar lavage fluid cytology.

Pneumocystis carinii pneumonia (PCP) is a major infectious complication of immunodeficiency states, including the acquired immunodeficiency syndrome (AIDS). Bronchoalveolar lavage (BAL) is a safe and effective procedure for making this diagnosis. In addition to the characteristic organisms, both histologic and cytologic material often reveals exudate in the form of foamy alveolar casts (FACs). To test the diagnostic utility of FACs in BAL fluids, we compared 20 PCP-positive and 28 PCP-negative fluids as assessed by silver stains. All PCP-positive fluids contained FACs on Papanicolaou-stained material. Only one PCP-negative lavage contained FACs, and transbronchial biopsy in this case revealed PCP. We suggest that FACs in BAL fluids are highly sensitive and specific for the diagnosis of PCP.

AIDS-Related Complex↗
PubMed1988

The significance of leukemia and lymphoma cells in cerebrospinal fluid contaminated by blood containing malignant cells: a probabilistic approach based on the Poisson frequency distribution.

The significance of malignant cells in a body fluid is often difficult to determine if that fluid is contaminated by blood containing malignant cells. This problem is most often seen in examination of CSF from patients with lymphoma or leukemia. We suggest a statistical model of this problem in which the numbers of malignant cells in the blood and the fluid specimen are related to the number of red blood cells. Using the Poisson distribution, the probability of finding the observed number of malignant cells in the fluid is calculated and used as the basis for suggesting whether these cells are likely to represent contamination effect or true involvement of the fluid by the malignancy. The limitations and applicability of this process are discussed.

Blood Cells↗
PubMed1988

Primary spindle-cell sarcomas of the breast: diagnosis by fine-needle aspiration.

Primary breast sarcomas (excluding cytosarcoma phyllodes and its sarcomatous recurrences) are rare neoplasms. Few have been described in the aspiration cytology literature. We report the cytologic features of two cases of stromal sarcoma (both with the pattern of malignant fibrous histiocytoma) and two cases of angiosarcoma. The dominant cytologic features included individual atypical spindle cells and fragments of collagenous stroma. Tumor giant cells were present in one stromal sarcoma. Features of possible significance in the diagnosis of angiosarcoma include obvious vessel formation by atypical spindle cells, bridging of adjacent tumor fragments by spindle cells, and microacinar structures lined by atypical spindle cells. The differential diagnostic considerations in spindle-cell breast aspirations are discussed.

Adult↗
PubMed1988

Basal-cell adenoma of the salivary gland: a benign adenoma that cytologically mimics adenoid cystic carcinoma.

We describe the fine-needle aspiration cytology of two cases of basal-cell adenoma (BCA) of the parotid gland. Both consisted of groups of small uniform cells with scant cytoplasm and occasional single cells. Small amounts of metachromatic stroma were present in smears from one case. The cytologic and histologic similarities between (BCA) and the solid type of adenoid cystic carcinoma are emphasized. Unequivocal distinction between these two entities may not be possible by cytologic criteria alone.

Adenoma↗