Correct Cytologic Diagnosis Research Articles

Fine-needle aspiration biopsy of liver focal lesions ultrasonically guided with a real-time probe. Report on 126 cases.

Ultrasonically guided fine-needle biopsy of focal liver lesions was performed in 126 patients to obtain a definitive diagnosis. Percutaneous target puncture and tissue aspiration were guided by a real-time linear-array probe with a central canal for needle insertion. The procedure is simple and rapidly performed; a correct cytological diagnosis was established in 94% of the punctured masses. No adverse reactions of clinical significance were observed. Fine-needle biopsy with ultrasound guidance by real-time scanning may be the procedure of choice to obtain a tissue diagnosis in patients with hepatic masses.

Ultrasound guided fine-needle biopsy of mass lesions affecting the hepatobiliary tract.

Ultrasound guided fine-needle biopsy of mass lesions affecting the hepatobiliary tract in 67 patients is reported. A free-hand approach was used without a special biopsy transducer. All aspirates were sufficient and relevant. A correct cytologic diagnosis was reached in 91 per cent of the 57 malignant cases. In addition, malignancy was correctly suggested in 5 cases. In 33 per cent of the cases with unknown primary tumor, cytology determined the origin of the malignancy. No complications occurred.

Cytodiagnosis of soft tissue tumors and tumor-like conditions by means of fine needle aspiration biopsy.

In the evaluation of soft tissue tumors primary sarcomas must be differentiated from other malignancies, such as cancer metastases, malignant lymphomas, as well as benign tumors and tumor-like conditions. As far as possible this should be done without open biopsy to avoid local spread. Fine needle aspiration biopsy as opposed to thick needle biopsy utilizes smaller needle diameters up to 0.8 mm with assumed negligible risks of local or distant tumor spread. Such a fine needle aspiration biopsy for cytodiagnosis was supposed to increase the reliability of the preoperative diagnosis. In a consecutive series of 187 patients referred to an orthopedic oncology group because of suspected malignancy fine needle aspiration biopsy was made. In 129 cases with histology and in 49 non-operated cases with at least 2 years of clinical follow-up the reliability of the method is analyzed. In 163 cases the aspirated material was sufficient for a diagnosis and 152 cytological reports were correct regarding the diagnosis of a malignancy contra a benign tumor or tumor-like condition. Thirty-five of 43 malignancies were primary soft tissue sarcomas, 28 of these with a correct cytologic diagnosis of sarcoma. Eight were malignant lymphomas or carcinomas. Fourty-nine patients with 48 benign and one malignant cytological diagnosis were not operated upon. At least 2 years of clinical follow-up confirmed a benign diagnosis in these cases. The total reliability is thus around 85%. Fine needle aspiration biopsy is considered to be a very valuable complement to other investigations in the diagnostic work-up of soft tissue tumors.

Rapid cytological diagnosis of basal cell carcinoma of the skin.

Cytological diagnosis in a series of 153 skin lesions is presented. The diagnosis in each case has been compared with the clinical assessment and, where available, the biopsy result (85 lesions). Of 131 basal cell carcinomas, a cytological diagnosis was possible in 124 while biopsyl failed to identify two of the 73 lesions studied. A correct cytological diagnosis was made in five squamous cell carcinomas and in one malignant melanoma. Basal cell papillomas and solar keratoses were not accurately identified. We thus conclude that with this very simple, rapid, and inexpensive method a clinical diagnosis of basal cell carcinoma is reliably confirmed with advantages for both the clinic and the laboratory.

Percutaneous cytodiagnosis of carcinoma of the pancreas and bile duct.

Fifty-one percutaneous fine-needle aspiration biopsies guided by selective angiography and 57 by percutaneous transhepatic cholangiography (PTC) were performed in 88 patients. Fifty-two of the patients had a tumor localized to the pancreas and 19 a tumor of the extrahepatic biliary tract. In 17 patients the suspicion of neoplasia was possible to rule out. In 60% of the patients with pancreatic carcinoma and in 53% of the patients with biliary duct carcinoma correct cytological diagnosis was obtained. No false positive results were found. The diagnostic reliability was the same under guidance of angiography as PTC. The experience of the examiner markedly influenced the accuracy of the method. Exact correlation between the cytologic and histologic reports was found in cases where representative material was obtained at the aspiration. None of the 108 punctions was followed by complications. Since the method is harmless and has a high success rate especially in experienced hands it is an important adjunct to the management of pancreatic and bile duct lesions.

Cytological Diagnosis of Colon Cancer

From January 1970 to December 1973, 114 cases of colon cancers and 22 cases of benign colon diseases were examined by direct visions brushing cytology at the Cancer Institute Hospital. The results of this study are as follows:The correct cytological diagnosis of 114 cases with colon cancers is 91.3%. The false positive cases of 22 cases without colon cancers is one case. The size of cell, nucleus and nucleolus of adenocarcinoma papillo tubulare are large and numbers of nucleoli are incre ase. The size of cell and nucleus of adenocarcinoma scirrhosum is slightly large and nuclear predominance is apparent. There is much vacuolization in the cytoplasm of adenocarcinoma muconodulare.