Fine Needle Research Articles

Ultrasonographic and cytological characterization of ultrasound-guided fine-needle aspiration cytology of cervical lymph nodes for false-negative and false-positive diagnosis.

The primary goal of this study was to examine the ultrasound and cytological characteristics of inconsistent cases (false negatives and false positives)of ultrasound-guided fine-needle aspiration cytology (US-FNAC) of cervical lymph nodes, to investigate factors influencing the diagnostic accuracy of fine-needle aspiration, and to improve diagnostic efficiency. The results of US and FNAC of cervical lymph nodes in 562 cases treated at our institution from February 2019 to June 2021 were retrospectively analyzed. FNAC cytology results were compared with the final diagnostic results (242 surgical resections/core-needle biopsy, 320 cases followed up for more than 1year), and the final diagnostic results were taken as the gold standard, and the ultrasound features and clinicopathology-related features were systematically retrospectively analyzed in cases of inconsistency. The overall diagnostic accuracy of US-FNAC for cervical lymph nodes was 94.9%, with a false-negative rate of 6.7% and a false-positive rate of 3.8%. Analyzing the cases, sampling error due to factors associated with ultrasound features, such as larger, more numerous nodes, non-solid, hypoechoic, inhomogeneous, and increased vascularity are the main causes of false-negative diagnosis, while smaller nodules, overlapping cytologic patterns, and overinterpretation by pathologists are associated with false-positive FNAC results. Proper interpretation of cytomorphologic and ultrasound features can improve diagnostic accuracy, and diagnostic misdiagnosis should be carefully observed, the identification of both features should be enhanced to reduce interpretation errors and sampling errors and to reduce the rate of misdiagnosis and missed diagnoses in fine needle aspiration of lymph nodes.

The predictive association between radiological findings and lung cancer development in patients exposed to sulfur mustard gas: 4 decades follow up of 719 victims

BackgroundRespiratory diseases are the leading cause of morbidity and mortality in the survivors exposed to Sulfur Mustard (SM). The late abnormalities can be present as chronic bronchitis, tracheobronchial stenosis, asthma, bronchiectasis, airway narrowing, lung fibrosis, and lung cancers. This study aims to investigate the association between radiological findings and lung cancer development in patients exposed to sulfur mustard gas.MethodsWe entered 719 victims exposed to SM during the Iran–Iraq war into our follow-up study in a consensus manner. They were periodically followed with Chest HRCT scans from 2001 to an interval of 2014–2019. The mean year interval between exposure and the last follow-up was 38 years. For confirming the lung cancer in those with evidence of malignancy in their imaging, fine needle aspiration/biopsy and/or surgical intervention were done.ResultsAmong 719 patients, 57% were free from any pathologic findings in their HRCT scan. Among the subjects who had the abnormal radiologic findings, Air Trapping (AT), Lung Fibrosis (LF), Bronchiectasis (B), and the evidence of lung cancer were found in 265 (36.9%), 207 (28.8%), 151 (21.0%), and 42 (5.8%), respectively. Adenocarcinoma (38.1%) was the most common type of cancer. The right lung was involved more than the left one regarding LF, B, and cancer (p value < 0.05). Considering the laterality, a significant correlation was found between the side of LF and B and the tumor side. Furthermore, it was shown that the lung lobes with LF were statistically correlated to tumor-involved lobes. The relative risk of AT and B existence for tumor development was 11.73 [4.87–28.26] and 10.14 [5.12–20.090], respectively. The most predictive finding was LF which caused the risk of developing tumor 17.75 [7.35–42.86] times higher in the patient with this pathology. By each increment of the number of LF and B, the risk of developing tumors increased by 51% and 76%, respectively.ConclusionIn survivors exposed to Sulfur Mustard, those with bronchiectasis and lung fibrosis have a significantly higher risk of developing lung cancers, so a close follow-up of these victims is recommended.Trial registration This study was confirmed by the institutional review board and ethics committee at Shiraz University of Medical Sciences (SUMS) with the ethical code IR.SUMS.MED.REC.1399.637.

The Informativeness Improving of Fine Needle Aspiration Biopsy under Ultrasound Navigation in Surgical Endocrinology

Purpose : Determination of the effectiveness of using a vacuum fine-needle aspiration biopsy compared to fine-needle aspiration biopsy. Material and methods : An original experimental sample has been developed for performing a vacuum fine-needle aspiration biopsy. Also in the course of the study, an improvement of the device was carried out, associated with the peculiarity of using high pressure (over –0.5 bar), consisting in throwing cytological material from the needle directly into the lumen of the syringe, and its distribution along the walls of the piston with impregnation with a separating tissue membrane. From January to November 2022, 118 vacuum fine-needle aspiration biopsy were performed using a modified technique. Results : During vacuum fine-needle aspiration biopsy, it was possible to achieve the absence of uninformative cytological material (Bethesda 1) and the receipt of 4.2 % (n = 5) of the amount of atypia of indeterminate value, which indicates the effectiveness of this method. Conclusions : 1. When performing vacuum fine-needle aspiration biopsy, the stage of taking cytological material is facilitated, which is associated with the creation of a high discharge and filling of the cytological material of the lumen of the needle, this feature contributes to fewer needle movements in the biopsy area and a decrease in the production of blood elements in the aspirate. 2. The use of high discharge does not affect the excessive traumatization of the thyroid parenchyma compared to fine-needle aspiration biopsy. 3. The ability to select the level of discharge depending on the data of multiparametric ultrasound examination, allows you to individualize the procedure. 4. The use of modification in the form of isolation of cytological material in a syringe reduces the loss of cytological material and increases the effectiveness of the technique.

Mean Micronuclei Score in Fine-Needle Aspiration Cytology of Patients with Malignant Breast Lump in the Department of Pathology in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Micronucleus is used as a biomarker of chromosomal instability, which is one of the hallmarks of neoplastic transformation. As micronuclei score increases with malignancy, it can be an effective and inexpensive adjunct to breast fine needle aspiration cytology, in diagnosing breast lumps, especially detecting grey lesions between benign and malignant tumours. The aim of this study is to find out the mean micronuclei score in fine-needle aspiration cytology of patients with malignant breast lumps in the Department of Pathology in a tertiary care centre. A descriptive cross-sectional study was conducted among patients with malignant breast lumps in the Department of Pathology in a tertiary care centre between 1 May 2020 to 31 May 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: IRC/2139/021). The fine-needle aspiration cytology of breast lumps was diagnosed as per National Health services breast screening program guidelines. The mean micronuclei score was calculated. Convenience sampling was done and data were collected from the hospital records in the Department. Point estimate and 95% Confidence Interval were calculated. Among 20 malignant breast aspirates, the mean micronuclei score was found to be 8.30±3.75 (3-19, 95% Confidence Interval). The mean micronuclei score in fine-needle aspiration cytology of malignant breast lumps was found to be similar when compared to similar studies conducted in similar settings. biomarker; breast neoplasm; chromosomal instability; fine-needle aspiration.

The Bethesda system for reporting thyroid fine needle aspirates: A study of 1763 patients; with histopathological correlations, in eastern India.

Fine-needle aspiration cytology (FNAC) is an important test for triaging patients with thyroid nodules. The 2007 National Cancer Institute Thyroid Fine-Needle Aspiration State-of-the-Science Conference helped instigate the recent publication of The Bethesda System for Reporting Thyroid Cytopathology (TBS). Terminology and therefore the probability of malignancy vary between pathologists and institutions. The purpose of this study was to evaluate a single institution's experience to determine if sub-classification (neoplasm versus lesion) aids in identifying patients at higher risk for malignancy. Also, an effort in regional and worldwide variation of significance of adoption of Bethesda classification has been evaluated. From 2018 to 2021, all patients with thyroid lesions' were evaluated for FNAC correlation with the surgical diagnosis. During this period, 1763 thyroid FNACs were reported. Histopathological examination (HPE) outcome data was available in 444 (25.2%) cases. The cytologic-histologic diagnostic discrepancy rate was 11.5%. The sensitivity and specificity of thyroid FNA for the diagnosis of malignancy were 71.4% and 49.5%, respectively. In our study, the maximum cases were benign (84.5%). The malignancy risk for the different categories in our study, as seen by follow-up HPE, has corroborated well with the Bethesda System. The current results indicated that FNAC provides an accurate diagnosis of thyroid malignancy. The classification is directly related to the risk of malignancy in each category and this helps in accurate clinical management of that category.

S1119 Safety and Efficacy of Pediatric Endosonography: A Multi-Center Retrospective Cohort Study

Introduction: Endoscopic ultrasound (EUS) is widely used in the adult population for a wide range of diagnostic and therapeutic purposes. In the pediatric population, the use of EUS has been historically diagnostic, however, EUS-guided therapy is increasing. In this retrospective study, we aim to describe the safety and efficacy profiles of EUS in pediatric patients across a spectrum of EUS procedures. Methods: This is a retrospective multi-center cohort study of pediatric patients who underwent EUS procedures for diagnostic or therapeutic purposes between January 2011 and March 2022. Data including demographics, procedural details, and adverse events (AE) were collected. Outcomes were diagnostic success, defined as successful diagnosis using only EUS without any additional diagnostic tools, and therapeutic success, defined as using only EUS without additional therapeutic interventions. Results: 61 pediatric patients between the age of 0 to 18 years underwent 77 EUS procedures, of which 35 were females (56.5%). The mean age at the procedure was 16.2 ± 4.2 years and the median weight was 70.2 kg (IQR 49.7-91.2). The indications for EUS were gastrointestinal lumen evaluation ± fine needle biopsy/aspiration (FNB/A), pancreaticobiliary tree evaluation ±FNB/A, surveillance for tumor syndrome, suspected lymph node (LN), or gastrointestinal (GI) mass, celiac plexus block and cyst gastrostomy creation (Table). The median procedure time was 35 minutes (IQR 18 – 49). The diagnostic success rate was 98.7% and the therapeutic success rate was 100%. The complication rate was 2.6% which included 2 cases of pancreatitis after fine-needle aspiration of the pancreas. No case had any anesthesia-related complications. Conclusion: In this multicenter retrospective cohort study, the use of EUS in pediatrics has shown to be safe and effective in a wide range of diagnostic and therapeutic intents. Table 1. - Baseline characteristics, procedural and clinical outcomes of pediatric patient EUS procedures N=77 (%) Females 35 (56.5) Weight (n=66) 70.2 [49.7 – 91.2] Age at procedure (years) 16.2 ± 4.2 Indication Diagnostic GI lumen Evaluation 9 (11.7) GI lumen Evaluation with FNB/A 5 (6.5) Pancreaticobiliary tree evaluation 37 (48.1) Pancreaticobiliary tree evaluation with FNB/A 6 (7.8) Surveillance for tumor syndrome 7 (9.1) Suspected LN or mass 8 (10.4) Therapeutic Celiac Plexus Block 1 (1.3) Cystgastrostomy 4 (5.2) Anesthesia Type Monitored Anesthesia Care (MAC) 48 (62.3) General Anesthesia 29 (37.7) Mean procedure Time in minutes (N= 59) 35.0 [18.0 - 49.0] Diagnostic Success 76 (98.7) Therapeutic Success (n=5) 5 (100) EUS related complications 2 (2.6) Anesthesia complications 0 (0) EUS = endoscopic ultrasound, FNA/B = fine needle aspiration/biopsy, LN = lymph node.Continuous variables presented as mean ± SD or median (IQR).Categorical variables presented as n (%).

AN ALTERNATE APPROACH: TRANSESOPHAGEAL BRONCHOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION (EUS-B-FNA) TO ASSESS PLEURAL MESOTHELIOMA

AN ALTERNATE APPROACH: TRANSESOPHAGEAL BRONCHOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION (EUS-B-FNA) TO ASSESS PLEURAL MESOTHELIOMA

Evaluation of Fine-needle Aspiration Cytology (FNAC) Sensitivity Compared to PCR for Diagnosing Tuberculosis Lymphadenitis

Background: Tuberculosis (TB) is a major healthcare burden in Sudan and other developing countries, it is considered the second most common cause of death from infectious diseases after those due to AIDS. In Sudan, TB lymphadenitis (TBLA) remains one of the major health problems. This descriptive cross-sectional study was conducted at the University of Medical Sciences and Technology (UMST) and Total Labcare Diagnostic Center (TDC). The study aims to compare the sensitivity of Fine Needle Aspiration Cytology (FNAC) smears with that of the Polymerase Chain Reaction (PCR) for the diagnosis of TBLA.&#x0D; Materials and Methods: Fifty-five dry smears were obtained using fine-needle aspiration (FNA) from an enlarged lymph node. PCR was applied to detect the target gene (IS6110). May-Grunwald-Giemsa (MGG) or Diff quick stains were used.&#x0D; Results: Two (4%) patients with TBLA were non-necrotic, while fifty-three of them (96%) were necrotic. Moreover, 17 (30%) fine-needle lymph node aspiration specimens were confirmed by PCR to be positive for Mycobacterium tuberculosis complex (MTB complex) while 38 (70%) of them were negative.&#x0D; Conclusion: There was no significant difference between the sensitivity of PCR and that of FNAC (P-value = 0.33).

Diagnostic efficacy of ultrasonography-guided fine needle aspiration cytology on thyroid swellings

IntroductionPatients presenting with a thyroid nodule, if malignant, may call for removal. A good screening tool with high diagnostic value for preoperative evaluation is preferred. Through real-time visualization of the needle to aspirate from the suspicious site, ultrasonography-guided fine-needle aspiration cytology could be an excellent screening tool.Materials and methodA cross-sectional descriptive study was conducted at Ganesh Man Singh Memorial Academy of Ear Nose Throat–Head and Neck Studies, Kathmandu, Nepal, from September 2018 to November 2019. We included 59 subjects of 15–72 years meeting the inclusion criteria. All study participants underwent preoperative ultrasonography-guided fine-needle aspiration cytological evaluation of thyroid nodule, which was correlated with their histopathological findings to determine diagnostic values.ResultThe sensitivity, specificity, and accuracy of ultrasonography-guided fine-needle aspiration cytology of thyroid nodule was 96.96%, 61.53%, and 81.35%, respectively. On stratification according to size, high sensitivity of 100% was observed in evaluating lesions of size < 2 cm and > 4 cm. There was a good inter-rater agreement between findings of ultrasonography-guided fine-needle aspiration cytology and histopathology with a kappa coefficient of 0.607.ConclusionUltrasonography-guided fine needle aspiration cytology is a reliable procedure to evaluate thyroid lesions with high diagnostic value. It is an excellent tool for evaluating small, non-palpable nodules.

Enhanced endoscopic ultrasound imaging for pancreatic lesions: The road to artificial intelligence.

Early detection of pancreatic cancer has long eluded clinicians because of its insidious nature and onset. Often metastatic or locally invasive when symptomatic, most patients are deemed inoperable. In those who are symptomatic, multi-modal imaging modalities evaluate and confirm pancreatic ductal adenocarcinoma. In asymptomatic patients, detected pancreatic lesions can be either solid or cystic. The clinical implications of identifying small asymptomatic solid pancreatic lesions (SPLs) of < 2 cm are tantamount to a better outcome. The accurate detection of SPLs undoubtedly promotes higher life expectancy when resected early, driving the development of existing imaging tools while promoting more comprehensive screening programs. An imaging tool that has matured in its reiterations and received many image-enhancing adjuncts is endoscopic ultrasound (EUS). It carries significant importance when risk stratifying cystic lesions and has substantial diagnostic value when combined with fine needle aspiration/biopsy (FNA/FNB). Adjuncts to EUS imaging include contrast-enhanced harmonic EUS and EUS-elastography, both having improved the specificity of FNA and FNB. This review intends to compile all existing enhancement modalities and explore ongoing research around the most promising of all adjuncts in the field of EUS imaging, artificial intelligence.

Robotic-assisted Bronchoscopy and Cone-beam CT: A Retrospective Series.

Robotic-assisted Bronchoscopy and Cone-beam CT: A Retrospective Series.

Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer.

Background/AimsIntralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety. MethodsIntralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment. ResultsAlthough stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed. ConclusionsIntralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis (clinical trial number, UMIN000037567).

Pengembangan Baja Paduan Tahan Peluru Melalui Proses Hot-Forging Terhadap Morfologi Dan Sifat Mekanik

Laterite steel is steel that has a nickel content of up to 2%. The nickel content can produce steel with superior properties such as: high strength, corrosion resistance, and good weldability properties. With the superior nature of laterite steel is needed in the main tool of the indonesian national tantara weapon system. To find out the performance of damage to bulletproof materials, then conducted research on this laterite steel as a tough armour material by conducting research in the form of mechanical properties testing (Hardness, and Impact) and microstructures (Metalography). Samples are prepared in accordance with ASTM standardization. Based on the results of the hardness test, the average values of F and T samples were 663.9 HVN and 170.7 HVN. Material F qualifies as a ballistic resistant material (armour) because the hardness obtained in accordance with the classification and can withstand bullet penetration well. Then the impact test obtained the average value of the F and T samples is 9 joules and 148 joules. For F samples, the type of fault is a granular fracture and a T sample of the type of fault is a tenacious fracture. As a result of metallographics, sample F has a corrected phase is upper bainite as a matrix and martensite is generally shaped like a fine needle. Then the T sample has a formed phase is dominated by ferrite with soft and tenacious properties. As well as perlite as a matrix with quite hard and strong properties.

Pancreatic Cancer Patient-derived Organoids Can Predict Response to Neoadjuvant Chemotherapy.

To evaluate if patient-derived organoids (PDOs) may predict response to neoadjuvant (NAT) chemotherapy in patients with pancreatic adenocarcinoma. PDOs have been explored as a biomarker of therapy response and for personalized therapeutics in patients with pancreatic cancer. During 2017-2021, patients were enrolled into an IRB-approved protocol and PDO cultures were established. PDOs of interest were analyzed through a translational pipeline incorporating molecular profiling and drug sensitivity testing. One hundred thirty-six samples, including both surgical resections and fine needle aspiration/biopsy from 117 patients with pancreatic cancer were collected. This biobank included diversity in stage, sex, age, and race, with minority populations representing 1/3 of collected cases (16% Black, 9% Asian, 7% Hispanic/Latino). Among surgical specimens, PDO generation was successful in 71% (15 of 21) of patients who had received NAT prior to sample collection and in 76% (39 of 51) of patients who were untreated with chemotherapy or radiation at the time of collection. Pathological response to NAT correlated with PDO chemotherapy response, particularly oxaliplatin. We demonstrated the feasibility of a rapid PDO drug screen and generated data within 7 days of tissue resection. Herein we report a large single-institution organoid biobank, including ethnic minority samples. The ability to establish PDOs from chemotherapy-naive and post-NAT tissue enables longitudinal PDO generation to assess dynamic chemotherapy sensitivity profiling. PDOs can be rapidly screened and further development of rapid screening may aid in the initial stratification of patients to the most active NAT regimen.

Bleeding risk of intramuscular injection of COVID‐19 vaccines in adult patients with therapeutic anticoagulation

Bleeding risk of intramuscular injection of COVID‐19 vaccines in adult patients with therapeutic anticoagulation

Comparative Study of Tru-Cut Biopsy and FNAC in A Clinically Palpable Breast Lump

Background &amp; Objective: Fine-needle aspiration cytology (FNAC) is frequently used to evaluate a breast lump, for it is safe, reliable, and time saving outdoor procedure for evaluation of breast lumps. However, in recent times, the diagnosis of breast lesions has mostly become dependent on Tru-cut biopsies with a gradual reduction in the rate of performing fine-needle aspiration cytology (FNAC). The present study was undertaken to compare the diagnostic accuracy of Tru-cut Biopsy and Fine Needle Aspiration Cytology (FNAC) in the evaluation of a clinically palpable breast lump.&#x0D; Methods: This cross-sectional study was conducted in the in Department of Surgery, Rajshahi Medical College &amp; Hospital, Rajshahi, Bangladesh over a period of one year from July 2019 to June 2020. A total of 60 women with clinically palpable breast lumps were consecutively included in the study. All patients underwent FNAC and Tru-cut Biopsy to make a provisional (clinical) diagnosis of breast lump followed by histopathology of the excision biopsy taken during surgery to confirm the diagnosis. The diagnostic accuracies (sensitivity, specificity, positive and negative predictive values) of the two diagnostic modalities (FNAC and Tr-cut Biopsy) were then judged by comparing them with the histopathological diagnosis of the excision biopsy.&#x0D; Result: In the present study majority (86.7%) of the lesions was malignant in terms of histopathology with almost all being infiltrating carcinoma (98%). Only 8(13.3%) cases were benign breast lesions and all of them were fibroadenoma. While Tru-cut or Core-needle biopsy (CNB) diagnosed 85% of the lesions as malignant, FNAC diagnosed 65% of lesions as malignant. The sensitivity of CNB was observed to be 98.1% and its specificity was 100%. In contrast, the sensitivity of FNAC was much lower (65%), although its specificity was comparable to that of CNB (100%). While the overall diagnostic accuracy of CNB was 98.3%, that of FNAC was 78.3%. The test of agreement between Tru-cut biopsy and FNAC using kappa-statistics showed that the two diagnostic modalities had moderate agreement in differentiating malignant breast tumours from the benign ones (k-value = 0.494, p &lt; 0.001).&#x0D; Conclusion: The study concluded that Tru-cut biopsy and FNAC both are hundred percent specific in excluding a benign breast lesion. However, the sensitivity of FNAC is much lower compared to that of CNB with overall diagnostic accuracy of Tru-cut biopsy being much higher than FNAC.&#x0D; Ibrahim Card Med J 2021; 11 (1): 21-27

Activation of Subcutaneous Mast Cells in Acupuncture Points Triggers Analgesia.

This review summarizes experimental evidence indicating that subcutaneous mast cells are involved in the trigger mechanism of analgesia induced by acupuncture, a traditional oriental therapy, which has gradually become accepted worldwide. The results are essentially based on work from our laboratories. Skin mast cells are present at a high density in acupuncture points where fine needles are inserted and manipulated during acupuncture intervention. Mast cells are sensitive to mechanical stimulation because they express multiple types of mechanosensitive channels, including TRPV1, TRPV2, TRPV4, receptors and chloride channels. Acupuncture manipulation generates force and torque that indirectly activate the mast cells via the collagen network. Subsequently, various mediators, for example, histamine, serotonin, adenosine triphosphate and adenosine, are released from activated mast cells to the interstitial space; they or their downstream products activate the corresponding receptors situated at local nerve terminals of sensory neurons in peripheral ganglia. The analgesic effects are thought to be generated via the reduced electrical activities of the primary sensory neurons. Alternatively, these neurons project such signals to pain-relevant regions in spinal cord and/or higher centers of the brain.

Breast filariasis presenting fibroadenoma like nodules: a rare diagnosis.

India has still not eradicated filariasis, which is still endemic throughout the country. This study focuses on the breast asanon-typicalbut notuncommonsite of breast diseasecharacterizedby nematodescausingobstructionof lymphatic vesselscaused by filariasis. The case described herein involves a 26-year-old married female who presented with a subcutaneous nodule in her left breast. Clinical interrogation of this case as part of the pathological diagnosis, phlebotomy was performed by venepuncture in order to examine peripheral blood smears under a microscope. Nonetheless, the peripheral blood smear did not show microfilariae of the disease. Furthermore, fine needle aspiration cytology was also performed to identify possible things for the study. It was diagnosed that the fine-needle aspiration cytology smears of various lesions indicate the lump carried microfilariae. Conclusively the lymphatic swelling was confirmed to be caused by Wuchereria bancrofti in fine-needle aspiration cytology examination without evidence in peripheral blood smears. It was shown that the subject had filariasis, and the patient responded well to daily treatment with diethylcarbamazine citrate for 42days.

Influence of Vitrification Device, Warming Protocol, and Subsequent In Vitro Culture on Structural Integrity of Testicular Fragments from Adult Domestic Cats.

The objective of the study was to evaluate the integrity of cat testicular tissues after vitrification with different devices followed by different warming conditions. The influence of vitro culture for 24 hours after warming also was examined. Testicular tissues from adult domestic cats were dissected in small fragments that were vitrified using Cryotop® or threaded on fine needles, warmed (directly at 37°C or with a preliminary 10 seconds exposure to 50°C), and/or cultured in vitro for an additional 24 hours. For each treatment group, tissues were assessed based on histology, apoptosis, and sperm DNA integrity. Results showed that fragments of testicular tissues were efficiently cryopreserved (maintaining the quality of all cell types) with vitrification with Cryotop followed by direct warming at 37°C, and additional culture of 24 hours at 38.5°C. These encouraging results are paving the road to optimize preservation protocols and use them for systematic banking of tissues from genetically valuable felids.

Managing the Lesion and Counseling Patient Post–Breast Biopsy

AbstractBreast cancer is the leading cause of cancer deaths worldwide among women. Early diagnosis and prompt treatment offers a chance for cure and long-term survival among afflicted women. Triple assessment which includes clinical examination, radiological imaging and histopathological evaluation has become a standard of care in the evaluation of breast cancer. Radiological imaging involves mammography, ultrasound, and magnetic resonance imaging while pathological evaluation can be done on fine needle, core-needle, and surgical excision biopsy specimens with core needle biopsy being the workhorse for diagnosis. While triple assessment has increased the diagnostic yield and helps in the identification of early lesions, an increasing subset of patients present with a situation where the imaging and pathological characteristics of a lesion do not correlate with each other thereby causing diagnostic and therapeutic dilemma. Imaging and pathology concordance and discordance present distinctly under differing circumstances in the care of the patient. While those with concordant findings proceed to treatment or follow up directly and hence benefit from the early treatment, those with discordant findings are beset with a delay in the diagnosis and should be subjected to further evaluations for confirming or refuting a diagnosis. This article reviews the salient features of image-guided breast biopsy and the outcomes and management options in imaging and pathology concordance and discordance. We also discuss the role of a radiologist in the counselling of the patient before and after receiving the pathological report after biopsy.