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PubMed1978

The influence of retrograde contrast medium on urinary cytodiagnosis: a preliminary report.

It has been recommended that before retrograde brushing of upper urinary tract lesions to diagnose malignancy the contrast medium should be washed away with saline because of possible cellular distortion. There were 21 paired specimens from 19 patients submitted for urinary cytodiagnosis. One specimen was a contrast medium wash, similar in pH and osmolality to urine, and the other a saline wash. Cellular detail was adequate for cytodiagnosis in 20 of the 21 contrast medium specimens. Of 7 specimens from patients with malignancy 3 were diagnosed correctly as malignant, 1 was classified as suspicious and 3 were falsely negative in the contrast wash group. Of the 3 falsely negative diagnoses 2 were changed to malignant when the paired saline wash specimens were examined. Urologists should not discard the contrast medium specimen prior to retrograde brushing but should send it along with a saline wash specimen for cytodiagnosis because the discarded contrast material and irrigant may have diagnostic cells.

Contrast Media↗

PubMed1996

[Two patients with acute promyelocytic leukemia whose relapse was noted by cytodiagnosis of middle ear discharge].

Patient 1 was a 36-year-old male and diagnosed as APL in April 1989, and treated with BHAC-DMP and BHAC-AMP. In January 1990, a diagnosis of exudative otitis media was made, but intractable. In June, left facial paralysis appeared and cytodiagnosis of the discharge from the middle ear confirmed leukemic cells. Otitis media and facial paralysis improved after high dose Ara-C, but developed again 5 months later. The condition improved after high dose Ara-C and irradiation of the temporal bones. In September 1992, he died of recurrence but no aggravation in facial paralysis or otitis media. Patient 2 was a 24-year-old female and diagnosed as APL in July 1989, and treated with BHAC-DMP. In May 1990, exudative otitis media was appeared. In July, recurrence was observed but improved by high dose Ara-C. In October, otitis media was aggravated again, and cytodiagnosis confirmed leukemic cell infiltration. She was treated with high dose Ara-C and irradiation of the temporal bones, then achieved complete remission. Maintenance therapy was continued until August 1992, she has been alive. When exudative otitis media developed during the course of leukemia, cytodiagnosis of the discharge from the middle ear should be performed. High dose Ara-C and irradiation of the temporal bone were effective.

Adult↗

PubMedDate not supplied

Recurring staphylococcal scalded skin syndrome-like bullous mastocytosis: the utility of cytodiagnosis and the rapid regression with steroids.

We report a male infant with onset of an extensive bullous eruption at the age of 45 days. Staphylococcal scalded skin syndrome (SSSS) was suspected. Bullous mastocytosis was diagnosed by cytodiagnosis and confirmed by histologic examination. Three serious relapses were noted in a 2-year follow-up, and SSSS was again suspected because of high fever and leukocytosis with neutrophilia in an infectious context. Cytodiagnosis revealed the presence of mast cells and permitted rapid diagnosis of recurrences of bullous mastocytosis. Systemic corticotherapy dramatically improved the cutaneous lesions and general symptoms. This case report emphasizes the utility of cytodiagnosis in extensive blistering diseases in infancy and the possibility of obtaining rapid healing by using steroids.

Diagnosis, Differential↗

PubMed1974

Observer variation and quality control of cytodiagnosis.

The aim of quality control of a laboratory investigation is to ensure that similar results are obtained on the same material at different centres. To investigate its practicability in cytodiagnosis, the same cytological material was examined independently at six centres. Each centre supplied material from 20 cases, providing a total of 120 cases, ie, 100 cases excluding the donor centre's own material. The degree of agreement between the centres was studied using (a) the standard National Health Service cytology report terminology, (b) the centre's own terminology, and (c) the recommended recall time. The results revealed close agreement between five out of six centres in the reports obtained in relation to dysplasia and malignancy, namely, less than 3% false negative results and not more than 1.7% false positive results. The recommended recall time provided a similar order of agreement after discrepancies due to the management of inflammatory conditions had been eliminated. There was marked disagreement in the diagnosis of both presence and type of infection. The results indicate that improvement in the quality of cytological material would increase the consistency of cytodiagnosis. Cytodiagnosis itself, being an expression of opinion, does not appear to be an appropriate field for quality control.

Candida albicans↗

PubMed1982

Morphometry and cytodiagnosis of breast lesions.

Cells aspirated from breast lesions and smeared on slides were subjected to computer assisted morphometric analysis. Three groups of cases were studied. The first were those collected from patients with known benign and malignant lesions. The second group were 143 unselected consecutive aspirates from breast lesions and the third, a group with a needle aspirate cytodiagnosis "suspicious of malignancy". The analysis showed the malignant cells to have larger nuclei with more anisokaryosis and more variation in the nuclear cytoplasmic ratios when compared with benign cells. When this form of semiautomatic analysis was applied to the "suspicious" group the accuracy of cytodiagnosis was improved.

Biopsy, Needle↗

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↗

PubMed2004

Cytodiagnosis of neoplasms of the central nervous system in cerebrospinal fluid samples with an application of selective immunostains in differentiation.

In this study cytological findings in specimens of cerebrospinal fluid (CSF) of central nervous system (CNS) tumours (16 primaries, 57 metastatic and 12 suspicious) are presented, which were diagnosed over a period of 7 years in 85 patients (50 females and 35 males) with an age range of 2-76 years. The follow-up included information from clinicians and a review of medical charts, histological correlation and/or further investigations following cytodiagnosis. The patients clinically presented with signs and symptoms of meningeal involvement. The primary tumours included six medulloblastomas, eight gliomas (four glioblastomata multiforme, two anaplastic astrocytomas, and two ependymomas) and two germinomas. The metastatic tumours were 14 melanomas, 19 breast carcinomas, four leukaemias, six B-cell lymphomas, five adenocarcinomas of gastrointestinal origin, seven carcinomas of lung, one retinoblastoma and one neuroblastoma. Twelve cases were reported as suspicious. On further investigations, four of these were from a primary tumour (two glioblastomata multiforme and two anaplastic astrocytomas) while the other eight cases were of a metastasis (one B-cell lymphoma, three breast carcinomas, three melanomas and one adenocarcinoma of gastrointestinal origin). Using a panel of selective immunostains in some of the cases supported the cytological diagnosis and this was considered useful in furthering cytodiagnosis. In 75 of the patients the CSF samples were obtained on a spinal tap while in 10 patients the samples were received as ventricular CSF. There were no false-positive cases. The results of our study suggest that CSF cytology in the diagnosis of CNS tumours is quite reliable and reflects involvement of leptomeninges or the ventricles. Furthermore, the use of selective immunostains can be helpful in confirming the cytological impression and source of the tumour.

Adolescent↗

PubMed1992

[Cytodiagnosis in chronic laryngitis].

The cytodiagnosis is a simple noninvasive procedure which requires close cooperation between the clinician and an experienced cytologist. It enables important diagnostic and therapeutic recommendations on the basis of morphological findings. A total of 1000 smears of the larynx obtained from 430 patients with chronic laryngitis were examined. In a case- controlled study of 143 patients with chronic hyperplastic laryngitis, smokers and/or laryngeal dysplasia patients with a 9.6% risk for malignant transformation, were identified as risk groups needing cytological screening at intervals of 6 months to a year. In the cytodiagnostic evaluations the main emphasis should be placed on dysplasias and metaplasias. Performed systematically, cytologically assisted early examination of the larynx expands the diagnostic possibilities, and is a useful supplement to biopsy. In the risk group chronic hyperplastic laryngitis, cytodiagnosis can be used to screen suspicious lesions for tumors. Although it cannot replace histological examination, it is highly suitable for the early diagnosis and effective follow-up of precancerous epithelial changes of the larynx.

Adult↗

PubMedDate not supplied

A simple intraductal aspiration method for cytodiagnosis in nipple discharge.

OBJECTIVE: To increase cytodiagnostic accuracy for women with spontaneous nipple discharge using a simple intraductal aspiration method. STUDY DESIGN: We compared the cytodiagnostic accuracy of the conventional squeezing collection method and intraductal aspiration by intravenous catheter in a total of 146 women with spontaneous nipple discharge in a single duct without a mass; they had been pathologically identified at Kaohsiung Medical University Hospital. RESULTS: Adequate specimens were collected in 96.6% (141/146 cases) of the sample by the intraductal aspiration method as compared to 76.0% collected by the conventional squeezing method (P < .05). An adequate specimen should consist, at a minimum, of six cohesive clusters of well-preserved epithelial cells, with each cluster composed of at least five cells other than foam cells. The cytologic diagnosis was divided into five categories: positive in 9 cases, suspicious in 10, negative with atypical findings in 59, negative in 33 and inadequate specimens in 35 cases that employed the squeezing method. These results were less satisfactory than with the intraductal aspiration method: the smears were positive in 17 cases, suspicious in 14, negative with atypical findings in 78, negative in 32 and inadequate specimens in 5. Our results showed a sensitivity of 92.3% and specificity of 93.9% for the intraductal aspiration method as compared to a sensitivity of 52.9% and specificity of 89.3% for the squeezing method. Among the 27 cancers in this series, correct cytodiagnosis, including suspicious cases, was made in 24 cases by intraductal aspiration, with an accuracy of 88.9%, as compared to the 33.3% (9/27) accuracy of the squeezing method (P < 0.5). CONCLUSION: For patients with spontaneous nipple discharge, the intraductal aspiration method provides much more accurate cytodiagnosis than does the conventional squeezing method.

Adolescent↗

PubMed1987

Aspiration of musculoskeletal tumors for cytodiagnosis and DNA analysis.

Preoperative fine-needle aspirates of 25 soft tissue tumors and four bone tumors were used for cytodiagnosis and flow cytometric DNA ploidy analysis. The results were compared with the histopathologic diagnosis and flow cytometric DNA ploidy analysis on tissue samples after surgery. There was good agreement between the cytodiagnoses and histopathologic diagnoses with regard to benign tumor or sarcoma. There was good agreement between the ploidy determinations in aspirates and tissue samples in 20 out of the 26 tumors that could be analyzed. Aneuploid cell populations were found in 13 tumors cytologically classified as sarcoma and in one tumor classified as unspecified malignant tumor. These 14 tumors also showed aneuploid cell populations in the tissue samples and were histologically diagnosed as high-grade malignant sarcomas. The combined evaluation of preoperative cytodiagnosis and DNA ploidy on aspirates may give valuable prognostic information.

Adult↗

PubMedDate not supplied

Cytodiagnosis for pelvic tuberculosis.

A 25 yr old married woman with complaints of lower abdominal pain for 2 months, was found to have a irregular nontender mass in pelvis, adherent to uterus. Her Papanicolaou smear was inflammatory. To confirm the diagnosis of either ovarian malignancy or pelvic tuberculosis made on the basis of observations during exploratory laparotomy, ovarian biopsy was taken. The imprint cytodiagnosis was tuberculosis. The patient was then managed surgically and the previous diagnosis was reconfirmed by histopathology. Imprint cytodiagnosis appears to be a valuable technique whenever facilities for frozen section are not available.

Adult↗

PubMed1992

A new method of intraoperative cytodiagnosis for more precisely locating the occult neoplasms of the pancreas.

We have done endoscopic retrograde pancreatography-aspiration cytology for 81 consecutive patients in whom there had been neither pancreatic mass nor duct stenosis; cancer cells were detected in four cases (5%). This report reviews a new method of intraoperative cytodiagnosis, which was done for these four cases, to locate the original lesion of the cancer cells. This method involved dividing the pancreatic neck at a right angle to the main pancreatic duct. A catheter was then inserted in both the caudal and cranial ducts of Wirsung. With the aid of an intravenous injection of secretin, pure pancreatic secretions were collected separately and used for intraoperative cytodiagnosis. With this method, all four occult neoplasms of the pancreas were correctly identified as to whether they were located in the cranial, caudal, or both portions. In one case in which carcinoma in situ extended throughout the entire pancreas, total pancreatectomy had been indicated by the positive results obtained from both portions. Likewise, in the other three cases in which, the occult neoplasms were limited to the cranial or caudal pancreas, either a Whipple procedure (one case) or a caudal pancreatectomy (two cases) had been quite correctly indicated. Since this method is simple, safe, and reliable, it is beneficial to the patient with occult neoplasm, because it prevents blind resection of the entire pancreas without any fear of leaving the neoplastic lesion behind.

Adenocarcinoma↗

PubMed1991

[The usefulness of cytodiagnosis in nonpalpable breast lesions].

The paper underlines the importance of early diagnosis in the treatment of breast tumours and emphasises the value of cytodiagnosis as a very sensitive and specific predictive method for detecting impalpable lesions. In conclusion, the Authors affirm that cytodiagnosis, together with the introduction of new diagnostic instruments such as the TRC Mammotest, allows the diagnostic and therapeutical approach to impalpable breast tumours to be improved. It adds to the already high sensitivity of mammography and to the high predictive specificity of cytology, thus contributing to the reduction of the so-called "bioptic cost".

Adult↗

PubMedDate not supplied

Fine needle aspiration cytodiagnosis of clinically suspected tuberculosis in tissue enlargements.

A retrospective study of the use of fine needle aspiration (FNA) cytology to confirm a clinical suspicion of tuberculosis in tissue enlargements was performed, using 70 cases. The criteria required to make an FNA cytodiagnosis of tuberculosis were reassessed, and the sensitivity and predictive value of cytology for diagnosing such aspirates was determined. All but 2 of the 70 aspirates contained adequate cellularity. The adequate samples were diagnosed as 40 cases of caseating tuberculosis, 11 cases of noncaseating tuberculosis and 17 cases of acute necrotizing granulomatous inflammation suspicious for tuberculosis. Subsequent histologic study verified the cytologic diagnosis in 27 of 27 biopsied caseating lesions, 4 of 7 biopsied noncaseating cases and 5 of 8 necrotizing cases. The six cases with a false-positive cytodiagnosis of tuberculosis were histologically diagnosed as one Lennert's lymphoma, two reactive lymph nodes and three necrotizing metastatic carcinomas. The sensitivity of FNA cytology for the diagnosis of tuberculosis was 100%, with the predictive value of a positive result being 88%. The findings in this study emphasize that all criteria for the diagnosis of tuberculosis in FNA samples must be utilized and that particular caution should be exercised in making a diagnosis of acute necrotizing tuberculosis.

Biopsy, Needle↗

PubMedDate not supplied

Critical evaluation of the cytodiagnosis of fibrogastroendoscopic samples obtained under direct vision.

The reliability and efficiency of the cytodiagnosis of fibrogastroendoscopic biopsy samples obtained under direct vision in 676 cases during a five-year period were reviewed. The critical evaluation showed a cytodiagnostic sensitivity of 93.54%, a specificity of 98.79%, a false-negative rate of 6.46%, a false-positive rate of 1.21%, a predictive value of a positive result of 98.01%, a predictive value of a negative result of 96.00%, a prevalence rate of 38.91%, an overall diagnostic accuracy of 96.75% and a chi-square value of 5.50 (P less than .05). These results were comparable to those obtained by histologic study in the same cases; the combined use of both cytology and histology to analyze the samples obtained gave the best results. These findings reemphasize the important role of fibrogastroendoscopic cytodiagnosis in establishing the existence of gastric cancer and shows that the technique is accurate and efficient. The types of statistics useful for assessing such data are discussed.

Cytodiagnosis↗

PubMedDate not supplied

[Cytodiagnosis of suspect lesions of the esophagus and stomach. Histocytological correlations in 435 cases].

This report analyses the results obtained using endoscopic cytodiagnosis in upper gastrointestinal lesions. Cytological and bioptic samples were taken from 435 lesions, in 435 patients. Specificity was 0.99% and sensitivity 0.9%. The accuracy of the endoscopic sampling and in preparing the cytological slides had a decisive influence on the obtaining of these results. The time required for a good cytological sample is the same as required for a biopsy. As employed the cytodiagnosis of esophago-gastric lesions was really useful, and indeed essential in diffuse mucosal lesions.

Biopsy↗

PubMed1983

[Cytophotometric and automated cytodiagnosis].

The different validity of DNA-cytophotometric parameters to morphometric ones for the automated cytological diagnosis of cancer is discussed and demonstrated for prostatic-, cervical- and lymph-node cytology by own measurements. Nuclear-DNA-cytophotometry used for the automation of cytological diagnosis of malignancy has the following advantages compared to image analysis: 1) DNA-cytophotometry mostly yields more sensitive parameters for the diagnosis of malignancy than image analysis does and thus results in greater diagnostic accuracy. 2) Cytological diagnosis of malignancy may often be possible in earlier stages of the tumor-history with nuclear-DNA-parameters compared to morphological parameters. 3) The prognostic validity of nuclear-DNA-distribution is probably greater than of cytomorphological parameters. 4) The parameters of nuclear-DNA-distribution for cytodiagnosis and grading of malignancy are the same for most of the human tumors in contrast to morphological parameters which are different for histogenetically different tumor. 5) Processing time for the automated diagnostic procedure of the slides will be much shorter if the Feulgen-stain for DNA is used instead of the Papanicolaou-stain for image analysis. One disadvantage of nuclear DNA-measurements as a diagnostic toll is the fact that cytopathologists cannot fully control the diagnostic process and results with their own eyes in Feulgen-stained slides. Meanwhile, however, even in other medical disciplines diagnosis are made by objective measurements of parameters which are not discernible by the human eye. That diagnostic procedure has to be accepted which yields the most accurate and reproducible diagnosis in the shortest time. It is recommended to combine cytomorphological and DNA-cytophotometric parameters as diagnostic tools for automated cytodiagnosis in Feulgen-stained slides.

Autoanalysis↗

PubMed1993

Surgical resection of potentially curable pancreatic cancer with improved preservation of endocrine function--further evaluation of intraoperative cytodiagnosis.

Very early detection of pancreas cancer is most desirable, since it permits less invasive surgery which has a correspondingly greater chance of success. The present study investigated both surgical outcome and postsurgical quality of life in 8 patients whose occult neoplasms were successfully treated. In all 8 patients, cytology of the pancreatic secretion obtained during endoscopic retrograde pancreatography (ERP) was positive, although no pancreatic tumor was detected by ERP, other examinations or intraoperative inspection. In these 8 patients, our method of intraoperative cytodiagnosis to locate occult neoplasms of the pancreas (Surgery 1992; 111: 294-300) was used (1). Using this method of cytodiagnosis, we were able to avoid total pancreatectomy in 6 patients (75%; 3 pancreatoduodenectomies and 3 caudal pancreatectomies), but not in the other 2 patients. Histopathological study of the resected specimens indicated that the extent of pancreatic resection was quite appropriate in all 8 patients. There were 6 minimally invasive carcinomas, one carcinoma in situ and one borderline lesion. Neither nodal involvement nor severe invasion was found on microscopic inspection, and all have been disease-free for 23 +/- 13 months after surgery. In the 6 patients with partial pancreatectomies, both postoperative quality of life and general health were good, with no insulin-dependent diabetes developing. Thus, our cytology-guided surgical technique is very useful not only for locating occult and potentially curable neoplasms, but also for avoiding blind resection of the entire pancreas, permitting better preservation of pancreatic endocrine function.

Aged↗