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Y S Erozan

Publications and source records attributed to Y S Erozan.

At least 37 records · Page 2Linked to original sources
PubMed1992

The Bethesda System. A proposal for reporting abnormal cervical smears based on the reproducibility of cytopathologic diagnoses.

In the Bethesda System, noninvasive squamous abnormalities are classified as atypical squamous cells of undetermined significance (ASQUS), low-grade squamous intraepithelial lesions, and high-grade squamous intraepithelial lesions. The Bethesda System eliminates two diagnostic distinctions that are made in the dysplasia/carcinoma in situ and cervical intraepithelial neoplasia (CIN) classifications, CIN1 vs koilocytotic atypia and CIN2 vs CIN3, and maintains three others, negative vs ASQUS, ASQUS vs koilocytotic atypia, and CIN1 vs CIN2. To determine whether the diagnostic distinctions preserved in the Bethesda System are made more consistently than those eliminated, we analyzed the interobserver reproducibility of two cytopathologists in classifying 257 smears. The findings indicate that the distinctions retained in the Bethesda System are more reproducible than those eliminated. Specifically, cases classified as koilocytotic atypia were distinguished from CIN1 no more reproducibly than predicted by chance, whereas CIN2 and CIN3 were distinguished as consistently as any other pair of diagnoses examined. In 13 cases in which there was interobserver discordance, one reviewer classified the smear as ASQUS and the other reviewer diagnosed CIN2 or CIN3. The findings in this study suggest that smears showing koilocytotic atypia and/or CIN1 may be reported as low-grade squamous intraepithelial lesions without further specification. In contrast, smears showing high-grade squamous intraepithelial lesions may be further classified as CIN2 or CIN3 in accordance with the Bethesda guidelines. Since the diagnosis of ASQUS is applied to smears showing a wide spectrum of changes, management of patients with the diagnosis of ASQUS will be facilitated by providing an explanatory note and/or recommendations when appropriate.

Carcinoma in Situ↗
PubMed1991

Stereotactic brain biopsy in the diagnosis of malignant lymphoma.

Fifteen patients with cerebral involvement by malignant non-Hodgkin's lymphoma were identified, among more than 200 patients who underwent stereotactic biopsy at The Johns Hopkins Hospital. All but one of these cases were diagnosed accurately by the stereotactic biopsy procedure. In 12 of 14 patients, the material was adequate to classify the lymphoma according to the Working Formulation. Because all but one of the lesions were intermediate or high-grade neoplasms, a diagnosis of lymphoma was often possible by conventional light microscopic examination alone. Monotypic light chain expression was demonstrated by immunohistochemical techniques in six patients, and positivity for B-cell markers was observed in an additional case. In one instance, two stereotactic biopsy specimens were interpreted as being suggestive of lymphoma, but necrosis and inflammation prevented a definitive diagnosis. Nine patients had no known risk factors for cerebral lymphoma, and the diagnosis often was unsuspected clinically.

Adolescent↗
PubMed1990

Recovery of intraocular Toxocara canis by pars plana vitrectomy.

Pars plana vitrectomy has been used in cases of ocular toxocariasis to remove vitreous opacities due to chronic inflammation and to relieve vitreo-retinal traction causing macular distortion and retinal detachment. To date, the diagnosis of intraocular Toxocara infection in vitrectomy cases has been presumptive, based on characteristic clinical findings, the presence of eosinophils, and corroborative immunodiagnostic tests. The authors report a case in which a vitrectomy for vitreopapillary traction recovered an intact Toxocara canis organism.

Adolescent↗
PubMed1989

Fine-needle core and aspiration biopsy. A new method for diagnosis of prostatic carcinoma.

Fine-needle aspiration of the prostate has failed to gain widespread acceptance among pathologists more familiar with histologic sections. The authors aspirated 27 freshly excised radical prostatectomy specimens with needles of varying caliber and type and found a 22-gauge Turner needle (Cook Incorporated, Bloomington, IN) which obtained large tissue fragments suitable for cell block preparation as well as high quality cytologic specimens. Thirty men with prostate nodules each had 14-gauge transperineal core biopsy and fine-needle aspiration. In 20 cases, cytologic smears and cell blocks and core biopsies agreed on a diagnosis: 12 benign and eight carcinoma. Of seven cases that were atypical by cytologic smears, five were benign on cell block and core; one was benign on cell block and carcinoma on core; and one was carcinoma on cell block and core. Three cases with scant specimens and diagnoses of carcinoma by cytologic smears were benign on cell blocks and cores: one contained seminal vesicle on review; one had repeat benign biopsies; and one had three microscopic foci of low-grade carcinoma in his radical prostatectomy specimen. This fine-needle aspiration technique provides histologic sections which are especially useful to those gaining experience with cytologic specimens of the prostate. Cases with discordant diagnoses on cell block and cytologic preparations warrant further evaluation.

Biopsy, Needle↗
PubMed1989

The role of the saccomano technique in sputum cytopathologic diagnosis of lung cancer.

The Saccomanno technique of sputum preparation is widely used. This study evaluates the role of this preparation in conjunction with fresh smears in the diagnosis of lung cancer. All sputum samples from September 1973 to July 1975 showing atypia were randomized and negative controls added. The Saccomanno and fresh smears were evaluated independently and blindly and classified as negative, atypical, suspicious, or cancer. When each preparation was compared with the original diagnosis, the diagnostic accuracy for 55 squamous carcinomas was similar (fresh 95%, Saccomanno 86%) but significantly less in the Saccomanno preparations of 22 small cell carcinomas (fresh 100%, Saccomanno 24%) and 26 adenocarcinomas (fresh 96%, Saccomanno 52%). Four cases negative on fresh smears were suspicious or diagnostic of cancer on the Saccomanno slides. There were no cases of small cell carcinoma in which the Saccomanno preparations added information not available on the fresh smears. The authors conclude that in conjunction with fresh smears, the Saccomanno preparation may contribute to the diagnosis of non-small cell carcinomas but does not appear to aid in the diagnosis of small cell carcinoma.

Adenocarcinoma↗
PubMed1989

Intraoperative CT-guided serial microbiopsy of brain lesions and concomitant use of CT air and angiographic studies.

The value of step-by-step confirmation of the location of the brain biopsy probe is demonstrated, using serial CT scanning to confirm the exact source of the sample tissue. Concomitant use of CT angiography and a CT air study makes possible the biopsy of small areas and of areas near major cerebral vessels, as well as of lesions near critical areas like the optic chiasma, basal ganglia, midbrain, and other complex lesions. The pathologist on-line examination of the CT-confirmed serial samples enables the surgeon to obtain the most informative tissue for the ultimate histopathological diagnosis. Our experience with the technique is illustrated by examples of its application in some complex cases.

Biopsy↗
PubMed1988

Diagnostic value of cytopathology in Barrett esophagus and associated carcinoma.

Barrett esophagus, the columnar-lined distal esophagus acquired as a consequence of chronic gastroesophageal reflux, is associated with the development of columnar epithelial dysplasia and esophageal adenocarcinoma. To determine the efficacy of cytopathology in identifying Barrett esophagus and related neoplasia, observations were compared on 150 esophageal cytology samples with concurrent endoscopic biopsy specimens. Sixty-six specimens that contained benign columnar epithelium in either cytologic or biopsy material were identified. Distinctive-type Barrett mucosa with incomplete intestinalization, considered diagnostic of Barrett esophagus, was found in 34 of 66 cases (52%) and was present only in cytologic material in 11 cases. Twenty-two specimens contained cardiac-type mucosa (present only in cytology in ten cases), a finding of uncertain significance due to lack of localization of the sample with respect to the gastroesophageal junction. Fundic-type mucosa was not observed in any specimen. Two cases of distinctive-type Barrett mucosa with columnar epithelial dysplasia were identified in both biopsy and cytology specimens. Among eight Barrett-associated carcinomas (seven adenocarcinomas and one squamous), cytologic material was diagnostic for malignancy in seven and highly suspicious in one. It was concluded that cytopathologic studies are a useful adjunct to biopsy histopathology in the diagnosis of Barrett esophagus and associated carcinoma. The role of cytopathology in the diagnosis of Barrett-related columnar epithelial dysplasia requires further study, and at present a cautious approach with biopsy confirmation is recommended.

Barrett Esophagus↗
PubMed1988

Fine-needle aspiration cytology of monomorphic adenomas.

The diagnostic accuracy of fine-needle aspiration of salivary gland lesions is now widely accepted. The cytologic appearance of two rare monomorphic variants of pleomorphic adenomas is described. The trabecular-tubular adenoma consisted of a trabecular arrangement of uniform small cells with scant basophilic cytoplasm and round nuclei. No mucoid spheres were present. The canalicular adenoma also had a distinctive cytologic appearance consisting of papillae and interconnected canaliculi lined by a layer of columnar epithelium. Monomorphic adenomas have unique morphologic appearances that can be recognized in fine-needle aspiration cytology. Preoperative diagnosis can greatly aid the surgeon in the planning of definitive surgical excision of salivary gland neoplasms.

Adenoma↗
PubMed1987

Intraoperative CT monitoring during stereotactic brain surgery.

This paper reports our experience in performing the entire stereotactic surgical procedure with a CT scanner, which shows that target shifting can occur as the probe approaches the target. Therefore, when sampling of small targets or specific sites within larger targets is desired. CT confirmation of the probe's position ensures that the specific area seen on CT is biopsied.

Adolescent↗
PubMed1986

Multilingual translation techniques in the analysis of narrative medical text.

The feasibility of computer translation of scientific and medical documents is controversial. This report describes a minicomputer-based translation system (TRANSOFT) that employs word order rearrangement followed by word-for-word translation and resolution of ambiguities based on context. This translation system was applied to an entire medical textbook written in German and to short medical texts written in French, Italian, Spanish and Turkish. Results suggest the versatility of TRANSOFT for narrowly defined translation problems. As foreign language medical documents and medical records become increasingly available in computer readable form through word processing, computerized typesetting and hospital information systems, computer translation methods may provide a rapid and inexpensive means of obtaining draft translations.

Computers↗
PubMed1986

Fine-needle aspiration of the liver. A comparison of smear and rinse preparations in the detection of cancer.

Fifty-nine successive cases of fine-needle aspiration (FNA) of the liver were reviewed to determine the efficacy of various rinse and smear preparations in rendering a diagnosis of cancer. Preparations included Papanicolaou- and Diff-Quik-stained smears, Millipore filters, cytocentrifugation, and cell blocks. Of 33 of 59 cases diagnostic for cancer, 90% were positive on rinse, 78% on smear, and 69.6% on both rinse and smear. Seven cases (21.2%) were diagnostic on rinse preparation only and would otherwise have been interpreted as equivocal. Papanicolaou smears and cell block rinses were most valuable to evaluate malignancy in the liver, using the FNA technic. The authors believe rinse preparations justify their cost for assessment of cancer and are essential to establish the diagnosis in a significant number of cases.

Biopsy, Needle↗
PubMed1986

Sputum cytopathology: use and potential in monitoring the workplace environment by screening for biological effects of exposure.

Sputum cytopathologic monitoring detects squamous cell lung cancers at an extremely early stage (x-ray negative). It holds further potential for preventing disease by detecting epithelial alterations which reflect environmental hazards. The addition of sputum cytology screening to screening by chest x-ray film does not significantly reduce mortality from all types of lung cancer, but preliminary analysis of Johns Hopkins Lung Project data suggests that mortality from squamous cell carcinoma is reduced. Quantitative automated cytopathology systems and biochemical/immunological cell markers enhance understanding of these precursors and offer great promise for increasing capacity, accuracy, and usefulness in cytopathology screening of workers. Cytological specimens collected over years of screening workers considered at risk may be important to eventually understanding development and prevention of major occupational diseases.

Carcinoma, Squamous Cell↗
PubMed1986

Quality control in cytopathology.

Quality control in cytopathology involves specimen collection, preparation, screening, and final diagnosis. The measures to assure the optimal performance and to detect the malfunctions in these areas are discussed. Careful selection and application of proper procedures, proper training and continuing education of cytotechnologists and pathologists, and reasonable workload for screening cytotechnologists and important factors in quality assurance.

Pathology, Clinical↗
PubMed1986

Cytopathologic diagnosis of pulmonary neoplasms in sputum and bronchoscopic specimens.

Cytopathologic techniques have been used for the detection and diagnosis of pulmonary neoplasms for many years. Cytopathologic examination of sputum is the most effective method for the detection of early squamous cell carcinoma, but it is not effective for diagnosing peripheral neoplasms, such as adenocarcinomas, in their early stages. Advanced neoplasms of any type, however, can be diagnosed in sputum. The cytopathologic examination of bronchoscopically obtained specimens is a valuable adjunct to biopsies in visible lesions. In addition, it may provide the only microscopic diagnosis in certain peripheral tumors or help in the localization of radiologically occult carcinomas detected by sputum cytology. Although cytopathologic diagnosis of cancer is highly accurate, certain benign conditions can mimic cancer and care must be taken in their interpretation. The type of neoplasm can be accurately diagnosed in well-differentiated carcinomas and small cell carcinomas but less accurately in poorly differentiated and large cell carcinomas. Utilization of proper collection and preparation techniques is crucial for optimal cytopathologic diagnosis.

Adenocarcinoma↗
PubMed1986

Adenocarcinoma arising in adenomyosis detected by atypical cytology.

Adenocarcinoma in adenomyosis is unusual and in most cases is associated with adenocarcinoma in the surface endometrium. In the latter, the diagnosis is made in the removed specimen because of the finding of adenocarcinoma in curettings. In contrast, adenocarcinoma arising in adenomyosis without surface endometrial changes is extremely rare and presents major diagnostic problems. The two cases reported herein demonstrate the significance of atypical vaginal cytology in the recognition of such lesions.

Adenocarcinoma↗
PubMed1985

Thiotepa effects on urinary cytology in the interpretation of transitional cell cancer.

In recent years we have witnessed increased reliance on 2 modalities in the management of patients with superficial transitional cell cancer of the bladder, that is intravesical chemotherapy for the control of existing and recurrent disease, and urinary cytology for the diagnosis of persistent or new neoplastic cells. This development has prompted some concern as to whether the use of chemotherapy might affect the morphological appearance of cells so as to make the interpretation of cytological specimens in this setting unreliable. We describe morphological differences between neoplastic cells and normal as well as cancer cells exposed in situ and in vitro to thiotepa. An appreciation of these differences has permitted accurate diagnosis of urinary cells in the presence or absence of cancer despite the regular use of this agent. Thus, it appears that the status of bladder cancer can be monitored successfully by an assessment of urinary cytology in the context of long-term treatment and prophylaxis with this agent.

Carcinoma, Transitional Cell↗