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Biomedical subjects

S R Kini

Publications and source records attributed to S R Kini.

12 recordsLinked to original sources
PubMed1991

Cytologic and clinicopathologic features of abnormal nipple secretions: 225 cases.

A case review of 225 patients with abnormal breast nipple secretions (NS) was done to determine diagnostically useful clinical and cytologic features. The cytologic specimens and medical records from all patients and 45 concurrent breast biopsies were reviewed. Nipple discharge was attributed to fibrocystic disease (FCD) in 81 cases, physiologic disturbances in 62, papillomas in 18, ductal carcinoma (CA) in 5, miscellaneous benign disorders in 14, and unknown causes in 45. Although cytologic examination of NS was very specific in identifying malignancy, the sensitivity of cytology was low. Carcinoma was diagnosed or suspected cytologically in only three of the five CA cases, with no false-positive cytopathologic interpretations. Malignant NS were usually unilateral, hemorrhagic, mass-associated, and in older patients. Males with nipple discharge had a significantly higher incidence of breast cancer (two of nine; 22%) than women with abnormal NS (3 of 216; 1.5%). Papilloma NS were generally unilateral and hemorrhagic; FCD and physiologic NS were mostly serous or milky. Benign NS were not cytologically distinguishable. We conclude that cytologic examination of NS is a specific but insensitive method to identify underlying malignancy. Additional clinical features, including patient age, laterality and character of NS, and radiographic findings, were found to be diagnostically useful.

Adult↗
PubMed1991

Cytologic features of collagenous spherulosis of the breast.

Collagenous spherulosis is generally classified as a component of benign proliferative breast disease. Previous reports have described the histologic features of collagenous spherulosis, but we are unaware of cytologic descriptions of the condition. In this report, the cytologic features of collagenous spherulosis are described and the differential diagnosis is discussed.

Adult↗
PubMed1991

Fine needle aspiration diagnosis of hyperplastic and neoplastic follicular nodules of the thyroid. A morphometric study.

The differentiation of hyperplastic nodules, follicular adenomas and follicular carcinomas from fine needle aspiration (FNA) cytology smears may be difficult. To better define the diagnostic criteria, we studied the morphometric parameters of nuclear area (NA), nuclear:cytoplasmic ratio and nuclear roundness (NR) in single cells and cell aggregates. In addition, we quantitated the percentage of touching or overlapping nuclei (NO) and the percentage of extent of nuclear area of overlap (NAO) in cellular aggregates. We measured cellular samples from FNA aspirates obtained from 20 hyperplastic nodules, 21 follicular adenomas, 5 encapsulated follicular carcinomas and 22 invasive follicular carcinomas, all of which were subsequently confirmed by histologic examination. Cellular aggregates provided the maximum diagnostic information. Stepwise discriminant analysis revealed that nuclear size, nuclear roundness and the percentage NAO allow optimum differentiation of hyperplasia, adenomas and carcinomas. Clearly, all of the poorly differentiated carcinomas (large NA, low NR, high NO and NAO) could be reliably diagnosed. Discriminant analysis allowed the differentiation of carcinoma from adenoma in 20/22 carcinomas (91%) and all 21 adenomas (although 2 adenomas were called hyperplasias and 3 hyperplasias were called adenomas).

Adenoma↗
PubMed1990

ABC-immunoperoxidase staining of cytologic preparations: improvement of specificity.

Immunoperoxidase (IP) methods perfected on formalin-fixed, paraffin-embedded tissues (FFPE) and then applied to aspirate smears may result in high background staining and a significant number of false-positive results. This is especially true if polyclonal primary antibodies are used or if aspirates and fluids contain a high interstitial or serum protein content. Because of a recurring problem with antiserum to alpha-fetoprotein (AFP), AFP was selected as the primary test antibody with which to evaluate our avidin-biotin complex (ABC)-IP method. The same method, with diaminobenzidine (DAB) or aminoethylcarbazole (AEC) chromogens, was performed on six types of cytologic preparations of a fresh liver specimen. The liver did not stain for AFP in FFPE and frozen tissue; therefore, it could be used to evaluate potential false-positive staining of direct touch imprints, washed aspirate smears, and cytospins that were both air-dried and alcohol-carbowax-fixed. Initial chromogen incubation times were standardized to give identical results on AFP-positive fixed hepatoma and fetal liver controls. Cytologic preparations immunostained with ABC-IP with AEC chromogen resulted in varying background and hepatocyte staining. In comparison, the ABC-IP method using DAB chromogen resulted in no false-positive results and a clean background. The ABC-IP method with AEC standardized for sensitivity on a fixed tissue control required a markedly shortened chromogen incubation time to preclude significant false-positive staining of cytology specimens. It appears that use of AEC chromogen for this antibody with incubation time standardized on a FFPE tissue control and then applied to cytologic preparations also amplifies nonspecific and background staining, contributing difficulty in assessing a true-positive result.(ABSTRACT TRUNCATED AT 250 WORDS)

Avidin↗
PubMed1989

The significance of atypical apocrine cells in fine-needle aspirates of the breast.

Apocrine metaplastic cells are frequently present in fine-needle aspirates (FNAs) of breast lesions, especially fibrocystic disease. Occasionally, apocrine cells may be atypical and present diagnostic difficulties. The morphologic features of six breast FNAs that contained atypical apocrine cells in breast aspirates. In the six abnormal cases, the large, pleomorphic, atypical apocrine cells were the predominant cell type and occurred singly and in syncytial tissue fragments. The cells had large, eccentric, vesicular nuclei and usually multiple macronucleoli. The histologic diagnoses in the cases were apocrine carcinoma (five cases) and atypical apocrine metaplasia (one case). In comparison, benign apocrine cells are relatively small and uniform and arranged in cohesive, orderly sheets. It is concluded that, in breast FNAs, the predominance of atypical apocrine cells, occurring singly and in syncytia, should raise the suspicion of carcinoma.

Aged↗
PubMed1986

Malignant lymphoma in transplanted renal pelvis.

A middle-aged man with chronic renal failure received a renal transplant from his healthy daughter. Two years later, malignant lymphoma developed in the transplanted renal pelvis. The lymphoma was found to be B-cell immunoblastic lymphoma bearing monoclonal IgG and kappa immunoglobulin, and it was of recipient origin.

B-Lymphocytes↗
PubMed1985

The diagnosis of malignant follicular neoplasms of the thyroid by needle biopsy.

To test the value of needle biopsy for a diagnosis of follicular thyroid malignancy, we compared needle biopsy and surgical diagnoses for 1005 patients. There were 67 follicular carcinomas, 34 Hurthle cell carcinomas, and 39 follicular variants of papillary carcinoma. Malignancy was diagnosed or suspected by biopsy for 114 of the cancers (82%), considered "possible" for 24 (17%), and misdiagnosed as "benign" in 2. Sensitivity of fine-needle biopsy (FNB) for the diagnosis of 39 cancers approximated that of large-needle biopsy (LNB) for 101 cancers 2 cm or larger. Diagnostic specificity for cancer varied with the degree of cytologic or histologic abnormality. Specificity of FNB was comparable to LNB on nodules large enough for both procedures. Specificity of FNB on nodules too small for LNB was substantially less. The sensitivity of needle biopsy allows selection of many follicular nodules for observation. Knowledge of the probability of cancer for each cytologic or histologic diagnosis is useful in determination of the need for thyroid surgery.

Adenoma↗
PubMed1985

Signet ring cell lymphoma of the thyroid: a case report.

The first case of extranodal signet ring cell lymphoma involving the thyroid gland is reported in a 53-year-old woman with Hashimoto's thyroiditis. Since 1978, 24 cases of signet ring cell lymphoma, all involving primarily nodal tissue, have been documented in the literature. This rare neoplasm is believed to be a variant of non-Hodgkin's follicular lymphoma, which may be mistaken for metastatic poorly differentiated adenocarcinoma.

Adenocarcinoma↗
PubMedDate not supplied

Cytopathology of follicular lesions of the thyroid gland.

Fine needle biopsy is generally considered unreliable in the differential diagnosis of follicular lesions of the thyroid gland. To test this hypothesis, we correlated fine needle biopsy diagnoses with surgical diagnoses in 379 follicular lesions. From nuclear characteristics (especially size) and the architectural pattern of tissue fragments, the following observations were made. Differentiation of goiters (including hyperplastic ones) from neoplastic thyroid disease is quite accurate and no more than 1 to 2% of cancers should be missed. The specific cytologic diagnosis of follicular carcinoma is 75% accurate, and that of follicular variant of papillary carcinoma is over 95% accurate. Of histologically proved follicular carcinomas, almost three-quarters should be diagnosed as such or strongly suspected by fine needle biopsy. The remainder will be identified as cellular follicular adenomas, reaffirming the overlap of cytologic features of benign and malignant neoplastic disease. From cytologic and surgical pathologic data for each fine needle biopsy diagnosis of follicular lesion, a probability of cancer can be stated that is useful in management decisions.

Adenocarcinoma↗
PubMedDate not supplied

Cells of squamous cell carcinoma in pleural, peritoneal and pericardial fluids. Origin and morphology.

The records of two cytopathology laboratories, covering an aggregate of 33 years, were searched for pleural, peritoneal and pericardial fluids reported as containing cells of squamous cell carcinoma (SCC). This search embraced 9,297 serous fluids from 7,389 patients. Cells of SCCs were found in the fluids from only 46 patients, illustrating the infrequency of such a finding, with most of the SCC cells originating in primary neoplasms of the lung (16), female genital tract (8) or larynx (6). All of the recognized types of SCC cells were found in these fluids. Even so, SCC cells may be mistaken for cells of other neoplasms, such as adenocarcinoma and malignant mesothelioma. SCC cells in serous fluids should be identifiable if careful attention is paid to the morphologic features characteristic of SCC.

Body Fluids↗