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[The optimal diagnosis of recurrence and metastases in female genital cancer by needle biopsy (author's transl)].

The "true-cut" disposable biopsy needle was used for 95 needle biopsies in 42 patients who were suspected to have a recurrence or metastases of low lying gynaecological cancer. Up to 3 biopsies per patient were obtained. In 21 patients the clinical suspicion of malignant was verified by microscopic examination. The needle biopsies were done as often by the vaginal as by the rectal route. Because of the low incidence of complications the needle biopsy was recommended for the definite diagnosis and follow-up examination of suspicious low lying gynaecological tumors.

Biopsy, Needle

[Needle biopsies of areas suspicious of recurrence in patients with gynaecological tumors (author's transl)].

With the biopsy needle of Franzén, 403 needle biopsies were carried out in 263 patients with gynaecological malignant tumors. In 152 cases the results of the aspiration cytology were compared with microscopic examinations or with the clinical course for at least 6 months. In 88 cases with probable recurrence the needle biospy showed a positive or suspicious result in 73 cases. A positive needle biopsy result was confirmation of recurrent tumor whereas a negative result did not rule out a recurrence. Aspiration cytology is a valuable ancillary method in the diagnosis of the recurrence of gynaecological tumors.

Biopsy, Needle

Prostatic needle biopsy: comparison of needles.

To clarify the advantages of the 2 most commonly used biopsy needles results of 100 routine needle biopsies of the prostate are evaluated. The series includes patients selected for study concerning the medical treatment of benign prostatic hyperplasia.

Biopsy, Needle

The effect of skeletal muscle needle biopsy on blood constituents, muscle glycogen and heart rate of cattle.

Muscle samples from Friesian bulls were obtained using the Bergström percutaneous biopsy needle. The samples (100 to 200 mg) were suitable for metabolite and enzymic analyses and histological examination in relation to meat quality. The physiological response to biopsy was assessed by measuring serum free fatty acid and blood glucose concentrations, plasma creatine kinase activity and heart rate. Muscle glycogen concentration was also measured. These parameters were unchanged by the experimental procedure, with the exception of blood glucose and heart rate which showed significant increases. The experimental animals showed no adverse effects after repeated biopsy and it is concluded that the technique is suitable for investigating beef muscle metabolism in vivo, and does not cause an unacceptable degree of stress.

Animals

Tumours of the orbit diagnosed by fine needle biopsy.

Fine needle aspiration biopsies were used for the diagnosis of orbital tumours. Examples of benign and malignant primary and metastatic orbital neoplasms, as well as inflammatory lesions diagnosed in this way are described. The method has proved of great value. This was specially true for processes located posteriorly in the orbit. The necessity for close cooperation between the ophthalmological and clinical cytological departments is emphasized.

Adult

Needle biopsy for muscle chemistry.

Needle biopsy can readily provide samples of human skeletal muscle for biochemical analysis. Muscle metabolites are measured by enzymic microanalytical techniques and electrolytes by neutron-activation analysis. This paper summarises the methods of analysis, gives the normal ranges for muscle contents of metabolites and electrolytes, and reviews the reported changes in a number of neuromuscular and metabolic disorders. Muscle is a fairly homogeneous tissue in health, but replacement with fat and fibrous tissue in myopathies causes error in analyses unless metabolites are referred to a reliable standard. It is recommended that needle-biopsy samples to be freeze-dried and dissected to remove connective tissue before analysis. Total creatine (phosphorylcreatine+free creatine) total adenosine+inosine nucleotides, and potassium and phosphorus separtely correlated very highly with sample dry weight after dissection, suggesting that these may be used as standards. When assessing whether a given metabolite is present in an abnormal amount, it is probaby advisable to check the content with reference to more than one standard, since one or more of these may be changed in disease.

Adenine Nucleotides

Pulmonary neoplasms diagnosed with transthoracic needle biopsy.

Results of transthoracic needle biopsy have been evaluated on the basis of fourteen years experience comprising 5300 procedures on 2726 patients. In 90.7% of the cases a diagnosis was established. Of these, 46.4% showed cytological evidence of primary or secondary malignancy. In 2.4% false positives and in 3% false negatives were noted. The most important complication was found to be pneumothorax, which was noted in 27.2%, but these cases did not as a rule call for treatment. Hemoptysis was observed in 2-5%. There was minor local bleeding around the lesion in 11% of the patients but this only required observation. In one case out of 1264 malignancies an implantation metastasis was found. There was a single case of air embolism with spontaneous recovery, but no mortality in this series. In our experience, needle biopsy represents a minor, inexpensive and safe procedure, which--with a simple technique--permits a direct approach to all kinds of localized lung lesion with a high degree of accuracy.

Aged

Bone marrow involvement in mycosis fungoides demonstrated by needle biopsy.

A bone marrow needle biopsy was performed in 19 patients with mycosis fungoides (MF). Two patients, one previously classified as stage 4 and the other with diffuse erythroderma had pathological bone marrow findings. Seventeen patients showed no evidence of bone marrow involvement, 10 of these were in the plaque stage. Bone marrow biopsy can be of value in assessing the stage of the disease.

Adult

Biliary hamartomas (von Meyenburg complexes) in liver needle biopsies.

2000 consecutive liver needle biopsies were examined for the occurrence of biliary hamartomas (von Meyenburg complexes, microhamartomas). In 12 biopsies (corresponding to 0.6 per cent) a total of 15 hamartomas were found as 2 biopsies contained 2 and 3 hamartomas, respectively. The incidence, morphology, location and differential diagnosis are discussed. In serial sections a communication between all the lumina in each hamartoma was found. In no case the diagnosis of biliary adenoma, congenital hepatic fibrosis or polycystic liver could be made. The hamartomas are of no clinical importance.

Aged

Stainable iron in aspirated and needle-biopsy specimens of marrow: a source of error.

Marrow iron was assessed in needle biopsy sections and in simultaneously obtained aspirated smears and aspirated clot sections from 251 patients. Significantly different amounts of stainable iron were observed in needle biopsy sections and aspirated smears in 15% of the specimens. The usual difference consisted of significantly less stainable iron in needle biopsy sections as compared to the aspirated smears (13%). Of clinical importance was the finding of absent stainable iron in 8% of the needle biopsy sections, in contrast to the definite deposits observed in the corresponding aspirated smear. Of similar interest was the observation that 6% of the needle biopsy sections had significantly less stainable iron than corresponding hemosiderotic smears. The amounts of stainable iron in needle biopsy sections were similar to the amounts observed in the corresponding aspirated clot sections. Evaluation of marrow iron using needle biopsy sections as well as aspirated clot sections differs from results observed in aspirated smears and could be a source of significant error in the assessment of iron stores.

Biopsy, Needle

Improved transvenous liver biopsy needle.

A modified type of the standard transvenous cholangiography biopsy needle is described. The modified tranvenous liver biopsy needle caused only minimal artefactual changes of the liver biopsy specimens. The new type of biopsy needle is a modified Menghini needle. The conventional Menghini needle should be avoided for transvenous catheter biopsies because of risk of leaving catheter fragments in the liver.

Adult

Prostatic biopsy. A morphologic correlation of aspiration cytology with needle biopsy histology.

One hundred and eighteen aspiration biopsies of the prostate are correlated with needle biopsies. The overall accuracy of the needle biospy is 85.6% and that of the aspirates is 86.6%. The author recommends that both techniques should be used simultaneously in the diagnosis of carcinoma of the prostate. Descriptions are given of benign and malignant cell types in prostatic aspirates, with special emphasis on the features differentiating benign atypia of prostatic cells from well-differentiated adenocarcinoma, as this is potentially an important source of false-positive reports in aspiration smears.

Aged

Radiographically guided needle biopsy of abdominal neoplasms--who, how, where, why?

Radiographically guided percutaneous needle biopsy is a safe, accurate, well-tolerated alternative to laparotomy for confirmation of advanced abdominal malignancy. Here we describe the indications and methodology for its performance. Eighty-two percent of 66 patients with proven abdominal neoplasms were successfully biopsied with a fine-caliber needle using a variety of guidance methods. Cross-sectional techniques, such as ultrasound and computed body tomography (CBT), provide the preferred monitoring techniques because of their excellent soft-tissue resolution and the capacity to determine tumor depth accurately. The ability of CBT to define the exact position of the biopsy needle tip in a mass makes it the preferable guide for biopsing of small, solid lesions.

Abdominal Neoplasms

Demonstration of protein AA in subcutaneous fat tissue obtained by fine needle biopsy.

Polarisation microscopy of material obtained by fine needle biopsy of subcutaneous tissue and stained with Congo red is a simple and reliable method for the diagnosis of systemic amyloidosis. It cannot, however, be used to differentiate histologically between different forms of amyloidosis. In the present study extracts of material obtained by fine needle biopsy of subcutaneous fat tissue from 13 patients were examined by double immunodiffusion with an antiserum against protein AA, a unique protein which forms a major part of the fibrils in secondary amyloidosis. Five of the patients showed amyloid deposits round the fat cells by conventional microscopy. In 3 of these, all with rheumatoid arthritis, protein AA was detected. Eight patients without amyloidosis and 2 with myelomatosis and amyloidosis showed no reaction with antiprotein AA antiserum. Thus the material obtained by fine needle biopsy of subcutaneous tissue could be used not only for the histological diagnosis of amyloidosis but also for a classification of systemic amyloidosis into secondary or primary based on the type of amyloid fibril protein involved.

Adipose Tissue

Comparison of stainable iron in aspirated and needle-biopsy specimens of bone marrow.

A comparison of stainable iron in simultaneously obtained aspirated smears and needle-biopsy specimens from 1,000 patients was undertaken. Significant differences occurred when iron was assessed as absent in the aspirated smear. In only 35% of the corresponding needle-biopsy specimens was iron absent. When only the aspirated smear was used, there was a significant overdiagnosis of iron deficiency. In general, iron tended to be less in the aspirated smear; however, correlations were better when iron stores were assessed as being present or increased in the aspirated smears, for stainable iron in the needle-biopsy specimen was always present in equal or greater amounts. Hemosiderotic smears (increased stainable iron) and needle-biopsy specimens (3+ -4+) correlated well. The aspirated smear and needle-biopsy are complementary procedures, and each has advantages. In the authors' experience, the needle-biopsy was preferable to the aspirated smear for evaluation of iron stores, particularly when iron stores were low or absent.

Biopsy, Needle

Technical procedures and staining methods for renal needle biopsies.

Procedures specifically developed for kidney needle biopsies are presented. These procedures may be applied to improve the slide quality of all small specimens. Fixation, processing, knife sharpening, cutting, and staining procedures used by the author are discussed. A modification of the Jones method for basement membranes is given.

Automation