Fine Needle Aspiration Cytology In Evaluation Research Articles

Comparison of aspiration vs non-aspiration techniques in fine-needle cytology of thyroid lesions

Aim:To compare the efficacy of fine-needle non-aspiration cytology (FNNAC) with that of fine-needle aspiration cytology (FNAC) of thyroid lesions.Materials and Methods:FNAC and FNNAC techniques were studied in 50 cases of thyroid lesions. All the needle-sampling procedures were done by a single operator. The samples were assessed cytologically and evaluated using five parameters, that is, background blood or clot, amount of cellular material, degree of cellular degeneration, and degree of cellular trauma and retention of appropriate architecture.Statistical Analysis:Wilcoxon signed rank test was performed using SPSS14 software. Differences between all the individual parameters as observed in FNAC and FNNAC smears were insignificant.Results and Conclusion:After evaluation of FNAC and FNNAC on the basis of these scores, greater numbers of diagnostically superior samples were obtained by FNNAC; however, by FNAC more number of diagnostically adequate smears were observed. The numbers of unsuitable smears were also more by FNNAC technique.

Role of fine‐needle aspiration cytology in evaluation of cutaneous metastases

Skin is an uncommon site for metastasis. This study was done to evaluate the role of FNAC as an important tool for investigating cutaneous and subcutaneous nodules in patients with known malignancy or as a primary manifestation of an unknown malignancy. All the FNAC done from January 2003 to August 2008 were reviewed (n = 55,556). Ninty-five patients (49 males and 46 females with age range of 4-96 years) with cutaneous/subcutaneous nodules which were diagnosed as metastasis were analyzed. Primary tumors of skin/subcutis were excluded from the study. In our study, 63 out of 95 cases had a known primary malignancy. Of these, five had underlying hematological malignancy and 58 patients had solid organ tumors. Lung carcinoma was seen to metastasize most commonly to skin in males and breast carcinoma in females. The most common site for a cutaneous/subcutaneous metastasis was chest wall [40 followed by abdominal wall (14) and scalp (9)]. Multiple site involvement was also observed (8). In 32 cases primary site was not known. They were most commonly diagnosed as poorly differentiated carcinoma followed by adenocarcinoma. FNAC can diagnose a variety of tumors in the skin and support the diagnosis of a metastasis in case of a known primary and offer a clue to underlying malignancy in case of an occult primary.

A Case of Diffuse Hemorrhage into the Thyroid Gland after Fine Needle Aspiration, and This was Treated by Arterial Embolization

Although hematoma formation after fine needle aspiration cytology fine needle aspiration cytology (FNAC) is a most common complication and most of these hematomas are self-limiting with minimal pain, a massive intra-thyroidal hemorrhage that produces acute airway obstruction had rarely been reported on. A 60-year old female underwent ultrasound-guided FNAC for evaluation of nodules that were in the right lobe (0.5 cm) and left lobe (3 cm) of her thyroid gland. Two hours later, the patient experienced swelling and progressive pain in the anterior neck. She visited an emergency room with dyspnea at 6 hours after FNAC. On the initial examination, her vital signs were stable and the oxygen saturation was 100%. On physical examination, her thyroid gland was tender and diffusely enlarge d. Neck CT revealed diffuse enlargement of the thyroid gland with heterogeneous hyper-attenuated areas that were suspicious for intra-thyroidal hemorrhage and a highly enhanced area in the left lower lobe of the thyroid. No definite bleeding focus was identified on the angiography that was done through the carotid artery, but the left superior thyroid artery was severely congested and partial embolization was done. After embolization her neck pain and tenderness decreased over several days and the patient was discharged on the 6 th hospital day. We report here on a case of diffuse hemorrhage into the thyroid gland after FNAC, and this was successfully treated with arterial embolization.

Fine Needle Aspiration Cytology Evaluation for Classifying Breast Cancer Using Artificial Neural Network

Thirteen cytology of fine needle aspiration image (i.e. cellularity, background information, cohesiveness, significant stromal component, clump thickness, nuclear membrane, bare nuclei, normal nuclei, mitosis, nucleus stain, uniformity of cell, fragility and number of cells in cluster) are eval uated their possibility to be used as input data for arti ficial neural network in order to classify the brea st pre- cancerous cases into four stages, namely malignant, fibroadenoma, fibrocystic disease, and other benign diseases. A total of 1300 reported breast pr e-cancerous cases which was collected from Penang General Hospital and Hospital Universiti Sains Mala ysia, Kelantan, Malaysia was used to train and test the artificial neural networks. The diagnosis syste m which was developed using the Hybrid Multilayered Perceptron and trained using Modified Recursive Prediction Error produced excellent diagnosis performance with 100% accuracy, 100% sensitivity and 100% specificity.

Comparison of unsatisfactory aspirates in fine needle aspiration performed by surgical medical officers and pathologists

The evaluation of fine-needle aspiration cytology (FNAC) is based on a satisfactory cell yield, which is highly operator-dependent. The aim of this study was to compare the proportion of unsatisfactory aspirates obtained by surgical medical officers and pathologists. FNAC case reports were retrospectively reviewed and cases grouped according to organ/site and person who performed the FNA procedure. An aspirate was deemed 'adequate' when a diagnostic report was issued; and 'unsatisfactory' when a report contained terms such as 'unsatisfactory sample' or 'inadequate cellularity for interpretation'. The results showed of a total of 1,248 FNAC reports reviewed, 610 (48.9%) aspirations were performed by medical officers and 638 (51.2%) by pathologists. The most common organs subjected to FNA were breast (68.9%), thyroid (17%), lymph node (9.3%) and others (salivary glands and soft tissue lumps) (4.8%). The overall proportion of unsatisfactory aspirates was 16.7%. Of aspirates performed by medical officers, 26.4% were unsatisfactory compared to 7.5% obtained by pathologists (P<0.001). Pathologists had significantly lower proportion of unsatisfactory aspirates in all organs compared to medical officers. Thyroid lesions had the highest number of unsatisfactory aspirates when performed by medical officers. Hands-on training in aspiration techniques for medical officers and the use of cytospin smears and cell block in bloody thyroid aspirates will be conducted.

Evaluation of FNAC in diagnosis of hepatic lesion

The fine needle aspiration cytology (FNAC) of liver was performed on 90 cases. The diagnostic yield was 83.4%. The main indication of FNAC was hepatomegaly with abnormal ultrsonographic (USG) / computed tomographic (CT) findings. The USG guided FNA was very helpful in making cytological diagnosis of hepatic masses in 90% of cases. Among the hepatic lesions 23.3% were benign, 67.7% were malignant, 6.6% were non-representative and 2.2% were suspicious of malignancy. Metastatic tumours were the most common and constituted 70.4% while the hepatocellular carcinoma accounted for 26.2% of malignant liver lesions.

Scalp Needlestick Injury During Fine-Needle Aspiration Cytologic Evaluation Without Needle Manipulation William Tell in the Laboratory, Not Quite

to the editor—Galed-Placed et al. 1 suggest using a modified method of fine-needle aspiration cytologic evaluation (FNAC) that eliminates manipulation of the contaminated needle to reduce the risk of occupational infection in healthcare personnel while retaining diagnostic accuracy. The modified method of FNAC eliminates excess needle manipulation by aspirating 2 mL of air into the syringe so that, subsequent to the procedure, the residual air can be used to empty the material in the needle. We describe a case of scalp injury in a cytopathologist who used this modified method of FNAC. The cytopathologist aspirated 2 mL of air into a syringe before connecting a 25-gauge needle and performing FNAC on a thyroid nodule. She then proceeded to extract the cytologic material for examination. When she depressed the plunger, the high level of pressure inside the syringe (probably caused by a colloidal clot that was clogged the needle) caused the needle to shoot out. The needle hit the table where the cytopathologist was working and bounced, lodging in the scalp on the top of her head. The cytopathologist was referred to the emergency department and then to the infectious diseases department. The thyroid specimen had been obtained from a patient with no known bloodborne infections. After the exposure, the cytopathologist was followed up for 6 months, and results of virological and biochemical analyses remained normal. FNAC has been performed in our hospital since 1993. More than 32,000 procedures have been performed to date, with only 4 occupational exposures reported (0.01% of procedures). Among healthcare workers, accidental needlestick injury is a major cause of occupational infection 2 and is the most common type of parenteral contact, accounting for approximately two thirds of occupational exposures. 3 More than 90% of needlestick injuries involve hands, but most anatomic sites have been affected. 4 However, a review of data from the Italian SIROH (Studio Italiano Rischio Occupazionale da HIV Group) database on occupational exposures revealed that the head was involved in 11 (0.03%) of 36,421 percutaneous injuries; 10 cases were due to nail scratches, and 1 case involved a dentist who hit his head on an instrument. 3

Thyroid nodules in Graves disease and the risk of thyroid carcinoma.

The risk of thyroid carcinoma in patients with Graves disease has been particularly emphasized when nodules coexist with thyroid hyperplasia; a surgical approach has been suggested. To detect thyroid nodules early in patients with Graves disease and to evaluate the risk of carcinoma. The study group included 315 consecutive outpatients with Graves hyperthyroidism not previously treated with surgery or radioiodine therapy. Thyroid ultrasonography was performed at the time of enrollment and repeated annually in all patients; fine-needle aspiration (FNA) was carried out in those patients with nodules and repeated after 2 years or at shorter intervals. One hundred six of 315 patients with Graves disease had thyroid nodules 8 mm in diameter or larger detected by ultrasonography. In 49 patients, nodules were present at the time of the first examination; in 57 patients, nodules developed during follow-up. Fine-needle aspiration cytology results revealed features of carcinoma in only 1 patient; this was confirmed by histologic examination of excised thyroid tissue. The nodules with normal cytologic features at the time of the first examination did not show any clinical and/or cytologic evolution toward malignancy during follow-up. Ultrasonographic evidence of nodules was frequently found among our patients with Graves disease, but malignant FNA cytologic findings of the examined nodules were rare at the time of diagnosis and throughout the course of the disease. When FNA cytologic evaluation does not indicate malignancy, the presence of thyroid nodules in patients with Graves disease does not indicate an aggressive therapeutic approach.

Fine Needle Aspiration and Frozen Section Diagnosis in the Management of Thyroid Nodules

Fine needle aspiration (FNA) is a valuable technique in the evaluation of thyroid nodules. A total of 182 FNAs of the thyroid performed at the Sultan Qaboos University Hospital were reevaluated and 153 were found to be adequate (84%). The cytological results of FNA were divided into neoplastic and non-neoplastic groups. Subsequent histology was obtained in 53 patients with an intraoperative frozen actions (FS) in 27 patients. Papillary carcinoma was found to be the most common, accounting for 70% of these cases with histological follow-up in the neoplastic group. The utility of performing FNA in all thyroid nodules and an intraoperative frozen section only in selected cases is discussed.

Stereotaxic needle-core biopsy and fine-needle aspiration cytologic evaluation of nonpalpable breast lesions.

Stereotaxic needle-core biopsy and fine-needle aspiration cytologic evaluation of nonpalpable breast lesions.

Clarifying the role of fine-needle aspiration cytologic evaluation and frozen section examination in the operative management of thyroid cancer : Kopald KH, et al. Arch Surg 124:1201, 1989

Clarifying the role of fine-needle aspiration cytologic evaluation and frozen section examination in the operative management of thyroid cancer : Kopald KH, et al. Arch Surg 124:1201, 1989

Clarifying the role of fine-needle aspiration cytologic evaluation and frozen section examination in the operative management of thyroid cancer.

The final histologic diagnoses of 486 patients who underwent thyroidectomy at UCLA Medical Center from March 1975 to August 1988 were reviewed. There were 146 patients with a diagnosis of thyroid malignant neoplasm. All patients who had preoperative fine-needle aspiration cytologic evaluation, intraoperative frozen section analysis, or both were included in the present study. Carcinoma was diagnosed by frozen section in 87 (69%) of 126 cases. Frozen section analysis was incorrect in 39 (31%) of 126 cases. Fine-needle aspiration was performed in 62 patients. A malignant neoplasm was identified by fine-needle preoperative fine-needle aspiration and intraoperative frozen section analysis, and carcinoma was detected by both methods in 32 (57%) of 56 cases. Fine-needle aspiration cytologic evaluation is extremely valuable in the diagnosis of thyroid cancer and is at least as accurate as frozen section analysis with less morbidity and expense. When fine-needle aspiration demonstrates malignant neoplasm, thyroid resection may be planned with confidence.

Fine-needle aspiration of parotid tumors

We evaluated the accuracy and usefulness of fine-needle aspiration cytologic evaluation of intraparotid masses in 64 patients who underwent subsequent surgery. Adequate specimens for cytologic evaluation were obtained in 46 of the 64 patients (72 percent). Thirty-three lesions in this group (72 percent) were benign and 13 (28 percent) were malignant. There was agreement of cytologic with final histologic diagnosis with regard to distinction of malignant from benign lesions in 43 of the 46 cases (93 percent). Eleven of 13 malignant tumors (sensitivity 85 percent) and 32 of 33 benign lesions (specificity 97 percent) were predicted. Exact tissue diagnosis was correctly determined in 34 of the 46 tumors (74 percent). There were no instances of hematoma, infection, facial nerve injury, implantation of tumor, or other complications as a result of 71 aspirations performed in 64 patients. Information gained by fine-needle aspiration was often valuable in assessing the suitability and extent of surgical treatment.