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S B Coghill

Publications and source records attributed to S B Coghill.

At least 19 recordsLinked to original sources
PubMed1997

The value of lymph node imprint cytodiagnosis: an assessment of interobserver agreement and diagnostic accuracy.

The aim of this study was to assess the reliability of cytodiagnosis of lymph node imprints without fixed tissue sections. One hundred randomly selected archival cases were used in the study. These air-dried May-Grünwald-Giemsa imprint slides were assessed independently and blind by three pathologists. Cases were assigned to one of four diagnostic categories: reactive changes, non-Hodgkin's lymphoma (NHL), Hodgkin's disease (HD) and secondary malignancy. Each broad diagnosis was compared with the 'correct' reviewed histological diagnosis to calculate interobserver agreement and diagnostic accuracy. The overall kappa score (+0.59) was indicative of moderate agreement. The mean pathologist diagnostic accuracy was 78%, with complete agreement with the histological diagnosis in 61% of cases. The main diagnostic difficulties were in the distinction between reactive changes and NHL and distinguishing NHL from HD. Further diagnostic classification, e.g. typing of lymphomas and subclassification of Hodgkin's disease, was not found to be reliable using the imprints alone. With these limitations in mind, pathologists should be able to use lymph node imprints for cytodiagnosis in selected cases. The study also emphasized the utility of imprints as a corollary to the histology and as a tool for cytology training and continuing education.

Adolescent↗
PubMed1996

Three infants of diabetic mothers with malformations of left-right asymmetry--further evidence for the aetiological role of diabetes in this malformation spectrum.

We report three babies with malformations of left-right asymmetry who were born to mothers with insulin-dependent diabetes mellitus. One infant had left isomerism and asplenia, one had polysplenia, and the third baby had situs inversus with a neural tube defect. Defects of left-right asymmetry have not previously been well recognized as part of the spectrum of anomalies associated with maternal diabetes. We believe that the association of maternal diabetes with these malformations in the infants is not coincidental, and that diabetes mellitus has an aetiological role in this spectrum of abnormalities. Two of the mothers had elevated HbA1C levels in pregnancy, and thus the malformations may be due to poor glycaemic control, although other teratogenic mechanisms associated with diabetes cannot be excluded. Finally, to our knowledge, the finding of left isomerism with asplenia (part of the spectrum of right isomerism) is rare. The occurrence of both forms of isomerism in different parts of the same body supports the model of random development of laterality following the interruption of normal developmental processes.

Abnormalities, Multiple↗
PubMed1994

Cell lysis due to ultrasound gel in fine needle aspirates; an important new artefact in cytology.

An important new artefact in cytopathology is described. The initial observation of the artefact followed contamination of a breast fine needle aspiration (FNA) sample by ultrasound gel which was used to localize the lesion. The changes proved reproducible ex vivo. The changes varied depending on the conditions and degree of contamination, and ranged from cell swelling to leakage of nuclear chromatin and cell lysis. This artefact is discussed in the context of other major sources of cytology artefact. Pathologists and radiologists should beware of the detrimental effects of ultrasound gel on cytology specimens.

Artifacts↗
PubMed1993

The histopathology of transcervical resection of the endometrium: an analysis of 200 cases.

The results of a series of 200 patients treated by transcervical resection of the endometrium are presented. The failure rate was 20% with a minimum follow up period of 18 months, although seven women (3.5%) had treatment beyond this interval. A second resection was performed in 14 patients with two later requiring a hysterectomy. An additional 26 women proceeded to hysterectomy following the initial resection. Specimen weight was inversely related to the need for further surgery with no secondary operations performed when more than 12 g of endometrium and myometrium had been resected. Age was also correlated with clinical outcome with patients under 35 years of age more likely to require further operative treatment. No histological feature could be identified which predicted failure of the procedure. The main role for histopathological assessment of transcervical resection specimens is in the provision of an accurate weight and the identification of the relatively rare cases harbouring endometrial or myometrial malignancy. Although endometrial resection appears to have resulted in fewer hysterectomies in the treatment of dysfunctional uterine bleeding, long-term follow-up is required before an accurate assessment of success can be established.

Adult↗
PubMed1992

Improve your hospital autopsy rate to 40-50 per cent, a tale of two towns.

In the light of medical audit, all pathology departments are scrutinizing their hospital autopsy rate. In most countries, the rate has fallen over the last few decades to between 10 and 20 per cent. However, it is still possible to achieve a much higher rate. We compare two neighbouring District General Hospitals (DGHs): Northampton, with the more usual autopsy rate of 11 per cent, and Kettering, with a higher rate of 40-50 per cent. These hospitals are comparable in almost every way except for the system used to request permission for an autopsy. These differences were evaluated and the following factors were found to be of importance in achieving a high rate: (1) centralization of death certificates within the mortuary and personal contact between the certifying doctor and the relatives within the bereavement room; (2) mortuary pathology technicians are designated as bereavement officers and act as coordinators between relatives, clinicians, and pathologists; and (3) regular clinico-pathological meetings and a positive attitude to autopsies by clinicians.

Autopsy↗
PubMed1992

Fine needle aspiration for the diagnosis and management of granulomatous disease.

Fine needle aspiration is a quick, minimally invasive and cost-effective technique for the diagnosis of granulomatous disease. Cytological diagnosis can often be specific, with the help of special stains and microbiological culture of aspirated material, particularly in the case of tuberculosis, the most common infective granulomatous disease in this country. At a fine needle aspiration clinic many cases of granulomatous disease, some from unusual sites, have been diagnosed and the use of more invasive investigations has been avoided. The problems involved in cytological diagnosis are discussed using seven cases as examples.

Adolescent↗
PubMed1992

Cost effectiveness of a fine needle aspiration clinic.

The resource implications of a Fine Needle Aspiration (FNA) Clinic at Northampton General Hospital have been evaluated over a 12 month period using a patient management questionnaire. A total of 490 cases from which fine needle aspirates were taken from superficial sites have been assessed (breast 381, thyroid 46, lymph node 44, salivary gland 9, soft tissue 10). Total resource savings (135,544 pounds) exceeded the expenses of the FNA clinic (27,290 pounds). Potential cost savings per case were the greatest for thyroid aspirates. The FNA clinic where the pathologist takes, stains and reports optimally prepared specimens, provides a high quality and accurate service on which clinicians can confidently base clinical management decisions. Unnecessary investigations and operations are avoided, allowing scant resources to be released for other procedures.

Ambulatory Care Facilities↗
PubMed1992

The Lensman microscope: tool or toy?

The experience of using the Lensman microscope for 1 year indicates that this inexpensive, pocket-sized instrument, which can be used at the bedside or in the outpatient department, can assess the quality of needle aspirates although it is not suitable for making definitive cytological diagnoses.

Biopsy, Needle↗
PubMed1991

Audit of diagnostic accuracy of FNA cytology specimens taken by the histopathologist in a symptomatic breast clinic.

One thousand and two patients with palpable breast lumps have had fine needle aspiration at a surgical symptomatic breast clinic where the pathologist takes, stains and immediately reports the aspiration cytology smears. High levels of complete sensitivity (95.7%) and specificity (100%) have been maintained with a combined complete sensitivity for aspiration cytodiagnosis, mammography and clinical assessment of 99.7%. Significant reductions of unnecessary biopsies and out-patient revisits have allowed major resource savings to be made. In view of the high degree of accuracy obtained by this approach to the investigation of palpable breast lesions, combined clinics with their benefits for the patient, both physical and psychological, should be encouraged.

Biopsy, Needle↗
PubMed1991

Fine needle aspiration cytology of the breast: factors affecting sensitivity.

At Northampton General Hospital a pathologist takes, stains and immediately reports aspirates at a fine needle aspiration clinic which is run in conjunction with a busy surgical breast clinic. The effect of various factors on the sensitivity of the technique have been quantified. Small tumour size, certain types of tumour and lesions difficult to palpate are causes of reduced sensitivity. Acellular samples had little effect on sensitivity. In this clinic trainee aspirators achieved good results early in their experience. After one year each had improved to the level of an experienced aspirator.

Biopsy, Needle↗
PubMed1991

Fine needle aspiration cytology of collagenous spherulosis of the breast.

We present a case of a 45-year-old woman with a benign breast lump in which collagenous spherulosis was an incidental finding. Since collagenous spherulosis has a similar appearance to adenoid cystic carcinoma of breast on fine needle aspiration cytology, the two conditions can easily be confused. The problem of making this important distinction is discussed.

Biopsy, Needle↗