Positive Fine Needle Aspiration Cytology Research Articles

Magnetic resonance imaging of the parotid gland using the STIR sequence.

The object of this study was to determine the efficiency of the short tau inversion recovery (STIR) sequence in the assessment of salivary disease. Sixteen patients with tumours either in or adjacent to the parotid gland were imaged using a 1.5T Philips Gyroscan, with a standard head coil. T1-weighted spin-echo and STIR sequences were obtained in multiple planes and assessed independently by each of the authors. Positive fine needle aspiration cytology or histological proof of the nature of the imaged lesions was obtained for every patient. T1-weighted spin-echo images were most useful for visualizing anatomical structures and for identification of the facial nerve. All lesions were visible with T1-weighted images but were very much more conspicuous in the STIR sequences, for which a minimal lesion resolution of 6 mm was achieved. No contrast enhancement was required. It was not possible to determine the pathological nature of the lesion by scan appearance only. Our conclusion is that a combination of T1-weighted spin-echo and STIR sequences in the axial and coronal planes is the preferred protocol for salivary gland imaging.

IMPACT OF FINE NEEDLE ASPIRATION CYTOLOGY ON THE MANAGEMENT OF SOLITARY THYROID NODULES

To evaluate the impact of the routine use of fine needle aspiration cytology (FNAC) on the management of solitary thyroid nodules, 102 consecutive patients were assessed in regard to the proportion of patients being subjected to surgery and the corresponding yield of malignancy. This cohort was compared with a historical control where FNAC was not routinely applied as a diagnostic selection criterion. The percentage of patients operated on had decreased from 95% to 60% (P less than 0.001) without any significant decrease in the field of malignancy: 18.6% vs 17.6% (P = 0.97). The yield of malignancy of patients operated on had increased from 18.4% to 26.2%. Of those not subjected to surgery, 14 patients or 14% of the original cohort experienced spontaneous complete resolution of their nodules after a mean follow-up period of 5.5 months (s.d. = 3.5) (non-resected group). In the retrospective evaluation of diagnostic discriminants to maximize yield of malignancy while minimizing unnecessary surgery for thyroid nodules, the use of combined parameters of clinical suspicion, positive FNAC and age greater than or equal to 50 years detected 100% of malignancies with only 50% of patients requiring surgery. This was superior to other modalities including clinical parameters and expensive investigations of radionuclide scans and ultrasonography. In conclusion, the use of FNAC in the evaluation of solitary thyroid nodules has resulted in a decreased proportion of patients requiring surgery and cost saving while maintaining the yield of malignancy.

Efficacy of fine needle aspiration cytology in the diagnosis of tuberculous cervical lymphadenopathy

The results of a consecutive series of 1,349 fine needle aspiration (FNA) biopsies from the head and neck region of 1,193 patients has been reviewed in order to evaluate the efficacy of this method in the diagnosis of tuberculous lymphadenopathy (TBLN). Of the 108 patients whose fine needle aspiration cytology (FNAC) showed granulomatous changes, 68 had subsequent surgery and histological confirmation of the cytological appearance. Sixty-three had TBLN, thus the specificity of FNAC was 93 per cent in diagnosing tuberculous related granulomatous lymphadenopathy. One false positive FNAC was reported histologically to be metastatic mucoepidermal carcinoma. Of the 1,193 patients, 90 patients had subsequently TBLN confirmed histologically. Of these 90 patients, FNA from 69 showed granulomatous changes or acid fast bacilli (AFB), thus the sensitivity of FNAC in detecting tuberculous lymphadenopathy was 77 per cent. Fifty-two cytological smears were stained for acid fast bacilli. Nineteen (37 per cent) contained AFB. It is evident from this review that FNAC is an efficient way to detect cervical tuberculous lymphadenopathy.