Comparative utility of fine-needle aspiration biopsy vs. ultrasound in detecting residual disease after radiofrequency ablation for papillary thyroid microcarcinoma: a retrospective case series

Use of fine-needle aspiration biopsy and frozen section in the management of the solitary thyroid nodule

Fine-needle aspiration biopsy of metastatic Ewing's sarcoma with MIC2 (CD99) immunocytochemistry.

Fine-Needle Aspiration Biopsy of Thyroid Nodules: Advantages, Limitations, and Effect

Fine needle aspiration biopsy (FNAB) has been in practice for quite sometime now. It is however not commonly requested for by doctors at the University of Benin Teaching Hospital, Benin City. This study was carried out to determine the awareness and utilization of FNAB. It aims at encouraging medical practitioners to avail themselves of the benefits of this procedure as an aid to diagnosis of some tumours. Whereas 112 out of 113 (99.1%) of doctors surveyed have heard of FNAB and 112 (99.1%) think that FNAB is necessary, only 49 doctors (43.3%) have ever requested for it. Although 46 out of 56 (82.1%) doctors claimed that fine-needle aspiration cytology (FNAC) is relevant to the management of their patients, as high as 89.1% of them have low request (0-5times) for the procedure. Only 2 out of 110 doctors (1.8%) have requested for FNAC on more than 10 occasions. Also all of those who made these requests were doctors in Consultant category. This, coupled with the fact that 102 out of 113 (90.3%) of doctors did not have adequate knowledge of the utilization of FNAB as a diagnostic procedure for tumour detection during undergraduate training, implies that the experience with the utilization of FNAB among consultants was acquired during postgraduate training. There is need to emphasize the usefulness of FNAC as a diagnostic procedure in tumour detection during undergraduate training. The contribution of FNAB to the overall health care delivery system is highlighted. Keywords: Fine needle aspiration biopsy, Awareness, Utilization. Annals of Biomedical Sciences Vol. 6 (2) 2007: pp. 6-12

The role of fine needle aspiration biopsy in deep lobe parotid tumors: Comparison of preoperative cytology and postoperative histopathologic results.

Compte-rendu de la quarante-sixième réunion de l’American Society for Therapeutic Radiology and Oncology (ASTRO). Atlanta, 3–7 octobre 2004

Hyperparathyroidism is not a rare disease; if a parathyroid adenoma is confirmed, the treatment of choice is the surgical resection. Diagnostic use of fine-needle aspiration biopsy (FNAB) for histological confirmation in patients with hyperparathyroidism is controversial. And spontaneous remission of hyperparathyroidism caused by bleeding or infarction of the adenoma rarely occurs. Here we have reported two cases of hyperparathyroidism in which spontaneous remission occurred due to the use of FNAB for diagnosis. The remission was confirmed after surgical removal and pathological review of the adenoma. The first patient diagnosed with primary hyperparathyroidism (PHPT) had neck pain and severe swelling 4 days after FNAB, and spontaneous remission due to intracapsular hemorrhage was confirmed after surgery. In the second patient receiving hemodialysis treatment for end-stage renal disease, hyperparathyroidism spontaneously resolved after FNAB and the parathyroid hormone (PTH) levels normalized after surgery. The first patient maintained a normal level of PTH for 6 years, and the second patient received kidney transplantation 6 years after surgery, and the normal level of PTH was confirmed for 13 years. Caution is needed while performing FNAB for diagnosis of hyperparathyroidism and during decision making regarding whether to observe the patient or perform surgery after spontaneous remission due to bleeding or infarction.

Cytologic findings in a case of T-cell rich B-cell lymphoma: potential diagnostic pitfall in FNA of lymph nodes.

Diagnosis of acute rejection after liver transplantation is based mainly on clinical signs and the liver core biopsy findings. In this study we retrospectively analyzed our data on the routine use of fine-needle aspiration biopsy (FNAB) after 63 pediatric liver transplantations. A total of 824 FNABs was taken during the postoperative hospitalization, with a mean of 13 biopsies per patient. Forty-nine acute rejection episodes were diagnosed and treated after 39 transplantations (62%). The FNAB analysis detected rejections often before clinical signs. At the time of rejection diagnosis, fever was present in 38% of the patients, and serum bilirubin and alanine aminotransferase were elevated in only 19% and 13%, respectively. The rejections responded well to oral methylprednisolone, and lymphoglobulins were needed in only two episodes (4%). The results indicate that FNAB is a safe and sensitive method for the diagnosis and follow up of acute cellular rejection in pediatric liver recipients.

A total of 135 fine-needle aspiration (FNA) biopsies from varying sites were performed in 123 children (mean, 10.5 years; range, one day to 18 years) over a five-year period. One hundred thirty (96.3%) biopsy specimens were satisfactory for evaluation. Seventy-nine cases were nonneoplastic (60.8%); among these cases, a specific diagnosis of infectious disease was made in 17 (13.1%). A diagnosis of neoplastic disease was made in 50 (38.5%) cases, of which 14 (10.8%) were benign, 28 (21.5%) were malignant, and 8 (6.2%) were neoplasms of uncertain biologic potential. The sensitivity of pediatric FNA biopsies was 90.6%, specificity 100%, positive predictive value 100%, negative predictive value 94.7%, and efficiency of the test 96.5%. There were no false-positive diagnoses and there were four false-negative diagnoses, three of which involved aspirates of the central nervous system (CNS). Ancillary studies, including immunocytochemistry (20 cases), electron microscopic examination (18 cases), microbiologic culture (8 cases), cytogenetic studies (7 cases), and flow cytometry (3 cases), were performed on the aspirated material, enabling a more specific diagnosis or supplying additional information in many cases. Definitive diagnosis by FNA biopsy enabled radiation therapy and/or chemotherapy to be administered for unresectable malignant neoplasms, provided material for culture of infectious lesions, identified benign lesions not needing surgery, and aided the surgeon in planning the extent of surgery in resectable malignant neoplasms. These results support the greater use of FNA biopsy in the pediatric population.

To review the literature on the utility of fine-needle aspiration biopsy in the diagnostic management of nodular thyroid disease. Relevant articles published in major English-language medical journals during the last 10 years. Articles were reviewed to assess the results of fine-needle aspiration biopsy and its effect on thyroid management and cost of care. Fine-needle aspiration biopsy of the thyroid gland is safe, inexpensive, minimally invasive, and highly accurate in the diagnosis of nodular thyroid disease. Four cytologic diagnostic categories are used. Rates for these categories, based on data pooled from seven series, were as follows: benign, 69%; suspicious, 10%; malignant, 4%; and nondiagnostic, 17%. Analysis of recent data suggests a false-negative rate of 1% to 11%, a false-positive rate of 1% to 8%, a sensitivity of 65% to 98%, and a specificity of 72% to 100%. Limitations of fine-needle aspiration are related to the skill of the aspirator, the expertise of the cytologist, and the difficulty in distinguishing some benign cellular adenomas from their malignant counterparts. The introduction of fine-needle aspiration has had a substantial effect on the management of patients with thyroid nodules. The percentage of patients undergoing thyroidectomy has decreased by 25%, and the yield of carcinoma in patients who undergo surgery has increased from 15% to at least 30%. Fine-needle aspiration has decreased the cost of care by 25%. Fine-needle aspiration biopsy is safe, accurate, and cost-effective. The procedure has a central role in the management of thyroid nodules and should be used as the initial diagnostic test.

We examined the relative accuracy of fine-needle aspiration biopsy (FNAB) and frozen section (FS) in the diagnosis of salivary gland tumors; FNAB completely and accurately diagnosed 35 (88%) of 40 cases, including ten (100%) of ten nonneoplastic lesions, 20 (87%) of 23 benign, and five (71%) of seven malignant tumors. No complications were encountered with this procedure. These results compare favorably with previously published reports. Twenty-one of 40 tumors diagnosed by FNAB and FS at surgery. Sixteen (76%) of 21 of these were correctly diagnosed by FNAB, and 15 (71%) of 21 by FS. Cystic lesions gave the most diagnostic difficulties both on FNAB and FS. Worldwide, FNAB has been demonstrated to be a cost-effective, accurate, and safe procedure. Furthermore, the use of FNAB allows for better preoperative management and overall treatment planning.

Usefulness of Fine-Needle Aspiration Biopsy before Performing Ultrasound-Guided Vacuum-Assisted Excision Ku Sang Kim, Ra Mi Kim, Hyun Ee Yim, Doo Kyoung Kang, Tae Hee Kim, Hyun-Joo Shin, Ji Young Kim, Yongsik Jung Departments of Surgery and Biomedical Informatics, Ajou University School of Medicine, Suwon; Department of Surgery, Dongtan Jeil Hospital, Hwasung; Departments of Pathology and Radiology, Ajou University School of Medicine, Suwon, Korea

To evaluate the usefulness of fine-needle aspiration biopsy of the breast in separating ductal carcinoma in situ (DCIS) from infiltrating ductal carcinoma, the authors reviewed 16 preoperative fine-needle aspiration biopsies from biopsy-proven exclusive DCIS and 39 fine-needle aspiration biopsies from infiltrating ductal carcinomas with or without an in situ component. Seven (44%) of the DCIS and eight (21%) of the infiltrating ductal carcinomas had inadequate material for diagnosis on the aspiration biopsy. Five (32%) of the DCIS and 29 (74%) of the infiltrating ductal carcinomas caused suspicion or had positive results for malignancy. Four (25%) of the DCIS and two (5%) of the infiltrating ductal carcinomas showed atypical cells. Morphologic features of the atypical or malignant cells in the adequate specimens from these two lesions were similar except that the cells from the infiltrating ductal carcinomas showed more irregular nuclear spacing (94% vs. 44%, P less than 0.01) and more pronounced nuclear overlapping (65% vs. 33%) than those from the DCIS. In addition, the fine-needle aspiration biopsies of the DCIS tended to be hypocellular (less than 10 cells/10X) (44% vs. 6.5%, P less than 0.05) and to contain benign epithelial cells (22% vs. 6.5%) and macrophages (33% vs. 13%). Although the suspicion of DCIS might be raised when hypocellularity, benign epithelial cells, and macrophages are noted in a fine-needle aspiration biopsy of the breast that has positive results or causes suspicion for malignancy, fine-needle aspiration biopsy cannot be relied upon to distinguish DCIS from infiltrating ductal carcinoma.

To show the usefulness of fine-needle aspiration biopsy (FNAB) in the diagnosis of cervicofacial masses in children. Case series. Pediatric otolaryngology referral center, ambulatory and hospitalized patients. Seventeen pediatric (age, < 18 years) patients with cervicofacial masses. Fine-needle aspiration biopsy. Cytologic diagnosis, resolution of mass, and need for further surgical diagnosis or treatment. Following FNAB, 10 patients underwent open surgery; in seven, the surgery was indicated based on FNAB diagnosis; in three, surgery provided diagnoses where FNAB was insufficient. Based on FNAB data, seven patients were observed without surgery. Fine-needle aspiration biopsy is a useful early step in diagnosing cervicofacial masses in children.