Aspiration Biopsy Technique Research Articles

Effect of a Combined Aspiration and Core Biopsy Technique on Quality of Core Bone Marrow Specimens

For cases requiring both a bone marrow aspirate and core biopsy, using the same needle and site (i.e., a combined technique) can decrease time, expense, and discomfort compared with the independent (direct) collection of each specimen. The benefits of the combined approach should not be achieved at the expense of specimen quality. In this study, core bone marrow samples obtained from the proximal humerus of 26 dogs by a combined technique immediately posteuthanasia were compared with core samples obtained directly from the opposite humerus. Both core samples from each dog were compared for relative overall quality. Biopsies were unsuccessful in four dogs using the combined technique and in one dog by the direct technique. Marrow length was shorter and hemorrhage artifact was more common using the combined technique. There were no differences in cellularity, megakaryocyte count, the myeloid/erythroid ratio (M/E ratio), iron stores, or diagnostic quality. Direct core biopsy remains the ideal technique; however, the degree of compromise was small in the samples obtained from the combined technique. For clinical patients, the advantages of the combined technique must continue to be weighed against potential loss of diagnostic sensitivity.

Ultrasound-Guided Fine-Needle Aspiration Biopsy of the Thyroid: Methods to Decrease the Rate of Unsatisfactory Biopsies in the Absence of an On-Site Pathologist

PurposeThe rate of unsatisfactory samples from ultrasound-guided fine-needle aspirations of thyroid nodules varies widely in the literature. We aimed to evaluate our thyroid ultrasound-guided fine-needle aspiration biopsy technique in the absence of on-site microscopic examination by a pathologist; determine factors that affect the adequacy rate, such as the number of needle passes and needle size; compare our results with the literature; and establish an optimal technique. Materials and MethodsWe performed a retrospective review of cytopathology reports from 252 consecutive thyroid ultrasound-guided fine-needle aspiration biopsies performed by a radiologist between 2005 and 2010 in our hospital’s radiology department. Sample adequacy, the number of needle passes, and needle size were determined. There was an on-site cytologist who prepared slides immediately after fine-needle aspiration but no on-site microscopic assessment of sample adequacy to guide the number of needle passes that should be performed. Cytopathology biopsy reports were classified as either unsatisfactory or satisfactory samples for diagnosis; the latter consisted of benign, malignant, and undetermined diagnoses. ResultsSeventy-seven biopsies were performed with 1 needle pass, 124 with 2 needle passes, and 51 with 3 needle passes. The rates of unsatisfactory biopsies were 33.8%, 23.4% (odds ratio [OR] 0.599 [95% confidence interval {CI}, 0.319-1.123]; P = .110), and 13.7% (OR 0.312 [95% CI, 0.124-0.788]; P = .014), respectively. ConclusionIn a hospital in which there is no on-site pathologist, a 3-pass method increases the specimen satisfactory rate by 20% compared with 1 pass, achieves similar rates to the literature, and provides a basis for further improvement of our practice.

A brief chronicle of cytology: From Janssen to Papanicolaou and beyond

The aim of our study was to outline and present the major hallmarks in the history of clinical cytology. For this purpose, an extensive research in modern literature and the PubMed database was undertaken. Furthermore, we studied original papers and books of the pioneers in cytopathology. The development of the first microscope by Hans and Sacharias Janssen is a hallmark in biological sciences, since the study of microcosmos was made feasible. From the discovery of single cells by Robert Hooke and the cell theory by Schleiden and Schwann till the establishment of exfoliative cytology by George Papanicolaou and the invention of fine-needle aspiration biopsy technique by Martin and Ellis, there is a three-century continuum of important discoveries and research. Today, flow cytometry and the introduction of molecular techniques have revolutionized medicine and are expected to change the face of cytology in the near future.

Amyloidomas of soft parts: Diagnosis by fine‐needle aspiration

A tumoral mass of amyloid (amyloidoma) arising in the soft tissues of the distal extremities is exceedingly unusual, and applying the fine-needle aspiration (FNA) biopsy technique to specifically diagnose this condition is even more infrequent. Herein, we report an example of two separate amyloidomas arising in the right calf of an otherwise asymptomatic elderly man who was referred to the sarcoma clinic because these masses clinically and radiographically simulated a malignant neoplasm. The fine-needle aspirate yielded amorphous, acellular, dense blue material on Romanowsky-stained smears and smudgy acellular cyanophilic material on Papanicolaou-stained smears. The aspirate procured cell-block contained hyalinized eosinophilic acellular material on H&E stain that was Congo-red positive and displayed yellow-green birefringence with polarization. Unlike prior assertions to the contrary, a diagnosis of amyloidoma is possible using FNA cytopathology even in patients without a known underlying amyloidogenic disorder.

Anaplastic pancreas carcinoma diagnosed by fine needle aspiration biopsy technique

Anaplastic pancreas carcinoma diagnosed by fine needle aspiration biopsy technique

M5.2 Down-regulation of SOCS-3 signaling is associated with increased endothelial inflammatory response in women with preeclampsia

Prolactin (PRL) is a hormone that plays a crucial role during pregnancy and lactation. The Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway, which is an important pathway in signal transduction from PRL to target cells, can be modulated by various factors, including suppressor of cytokine signaling-3 (SOCS-3). PRL may increase and decrease SOCS-3 expression, and its actions are mostly dependent on additional factors such as the photoperiod. There is also evidence for a relationship between suckling and SOCS-3 expression in the mammary gland. The aim of this study was to examine the influence of seasonality and physiological status on SOCS-3 expression levels in ovine mammary glands. Mammary gland fragments were obtained from 18 Polish Longwool ewes, and the fine-needle aspiration biopsy technique was used on 4 groups of animals under specific physiological and photoperiodic conditions: non-lactating ewes during long days (LD; n = 6), ewes on day 30 (n = 6) or day 56 of lactation (n = 6) and non-lactating ewes during short days (SD; n = 6). SOCS-3 mRNA levels were measured by real-time PCR. The results of this study confirmed that SOCS-3 mRNA expression in sheep is dependent on the season and stage of lactation. The highest expression of the examined factors was noted in the mammary glands of non-lactating sheep during SD, and the lowest levels were observed in ewes on day 30 of lactation. The transcript levels observed in the tissues collected from non-lactating sheep during SD and LD were higher (74% and 41%, respectively) compared with the expression observed on day 30 of lactation. On day 56 of lactation, the SOCS-3 mRNA level was similar to that observed in the udders of non-lactating sheep during LD. These results indicate that SOCS-3 could play an integrating role between hormones and other factors that are involved in the physiological functions of the mammary gland.

Thyroid tumor marker genomics and proteomics: Diagnostic and clinical implications

Two systems biology concepts, genomics and proteomics, are highlighted in this review. These techniques are implemented to optimize the use of thyroid tumor markers (TTM). Tissue microarray studies can produce genetic maps and proteomics, patterns of protein expression of TTM derived from preoperative biopsies and specimens. For instance, papillary and medullary thyroid cancers harbor RAS, RET, and BRAF genetic mutations. Follicular thyroid cancers harbor translocations and fusions of certain genes (PAX 8 and PPAR-gamma). Proteomic analysis from various tissue sources can provide useful information regarding the overall state of a thyroid cancer cell. Understanding the molecular events related to these genetic and protein alterations can potentially clarify thyroid cancer pathogenesis and guide appropriate molecular targeted therapies. However, despite the realization that these emerging technologies hold great promise, there are still significant obstacles to the routine use of TTM. These include equivocal thyroid nodule tissue morphologic interpretations, inadequate standardization of methods, and monetary costs. Interpretative shortcomings are frequently due to the relative scarcity of cellular material from fine-needle aspiration biopsy (FNAB) specimens. This can be rectified with large needle aspiration biopsy (LNAB) techniques and is exemplified by the favorable performance of galectin-3 determinations on LNAB specimens.

Pancreatobiliary drainage using the EUS-FNA technique: EUS-BD and EUS-PD

The recent progression of endoscopic ultrasonography (EUS) enables EUS-guided transmural drainage based on the EUS-guided fine-needle aspiration biopsy technique. Prior to the development of EUS-guided drainage procedures, the options for treating obstruction of the pancreatobiliary system included surgical drainage, percutaneous drainage using ultrasound and radiological guidance, and endoscopic (non EUS-guidance) transmural drainage. Today, using EUS guidance and dedicated accessories, it is possible to create bilio- or pancreato-digestive anastomosis, EUS-guided biliary drainage (EUS-BD), and EUS-guided pancreatic drainage (EUS-PD). The recent literature describes that EUS-BD and EUS-PD have acceptable success and complication rates. These procedures are anticipated for use as alternatives to surgery or percutaneous drainage when endoscopic transpapillary procedures fail.

Fine Needle Aspiration Biopsy Mempunyai Peranan Penting dan Akurasi Tinggi Sebagai Metode Diagnostik Preoperatif Tumor Tulang

ABSTRACT Fine Needle Aspiration Biopsy (FNAB) technique is gaining increasing popularity in the diagnosis of musculoskeletal lesions because it offers some advantages such as rapid , easy , with minimal complications, but its applicability in diagnosis of bone tumors however has some limitations. This research was aimed to explore the roles of FNAB and its accuracy as the preoperative diagnostic method compared to histopathology examination from open biopsy or operation as a gold standard. Research design was descriptive study and diagnostic test from cases of bone tumors which were aspirated over a period of three years in Anatomic Pathology Laboratory of Saiful Anwar Hospital Malang. The data was collected with cross sectional method. Of the 106 patients who were subjected to FNAB, 22 cases were diagnosed as benign bone tumor,49 were primary malignant bone tumor,24 were metastatic malignant bone tumor,1 cases was suspicious malignant tumor, 5 cases were non neoplastic lesions, and 5 cases were inadequate/ inconclusive for diagnosis. Of the 16 cases which was analized with diagnostic test, sensitivity of FNAB as preoperative diagnostic method was 100 %, specificity was 90,91%, positive predictive value was 83,33 % and negative predictive values was 100 % . Overall, diagnostic accuracy of FNAB was 93,75 %.It can be concluded that

Fine‐Needle Aspiration Biopsy of Benign Thyroid Nodules: An Evidence‐Based Review

Since the development of fine-needle aspiration biopsy (FNAB) techniques, preoperative diagnosis and subsequent strategies for patient treatment have changed and evolved greatly. This is true also for thyroid FNAB: the vast majority of thyroid nodules are benign, and hence do not necessarily require surgical treatment. A comprehensive Medline and Cochrane Library search was performed evaluating FNAB in the thyroid. In the last decade more than 400 articles on the subject have been published. Data in relation to the experience with FNAB at the Karolinska University Hospital since its introduction were also reviewed. The development of FNAB since the 1960s at the Karolinska University Hospital is described. During the period 1992-1996 the accuracy of the clinical routine was evaluated by studying the outcomes of almost 4,000 FNAs of the thyroid. The results were good, with only a few false-negative and false-positive results, but the problem of differentiating follicular adenoma from follicular carcinoma remained a significant problem. The use of immunological analysis has greatly increased the possibility of obtaining valuable information on cellular characteristics. A successful FNAB service rests on several factors, and the importance of clinical conferences between all specialists involved in the diagnosis and treatment of patients with thyroid disorders cannot be overemphasized. At the Karolinska University Hospital there are weekly conferences where patients are discussed both pre- and postoperatively. These conferences lead to optimal interaction between the different specialists and, most important, substantial improvement in the clinical management of patients with thyroid disorders.

A 5-year-old girl with a congenital ganglioneuroma diagnosed by fine needle aspiration biopsy: a case report.

IntroductionGanglioneuroma is a rare, benign, neuroblastic tumor arising mainly from the central or peripheral autonomic nervous system, especially the sympathetic system. The most affected anatomical sites are the posterior mediastinum, retroperitoneum, adrenal gland and head and neck soft tissue. In the current literature, reports of ganglioneuroma diagnosed by fine-needle aspiration and its cytological appearance are scarce.Case PresentationA 5-year-old girl presented with a mass in the cervical region since birth. Laboratory routine tests were within normal limits, ultrasonography demonstrated a solid and well-circumscribed lesion in the soft tissues of the cervical region. Fine needle aspiration biopsy was carried out, and the obtained smears showed a mixture of mature ganglion cells and groups of spindle cells suggestive of schwann cell origin. A diagnosis of ganglioneuroma was suggested. Core biopsy and surgical resection confirmed this diagnosis.ConclusionCongenital ganglioneuroma of the cervical region is an uncommon soft tissue benign neoplasm of neuroblastic origin, and it should be considered in the differential diagnosis of head and neck pediatric soft tissue tumors. Fine needle aspiration biopsy technique is a reliable method that can be used with confidence when dealing with pediatric soft tissue tumors.

P-385: Comparison of endometrial aspiration biopsy techniques: Specimen adequacy

P-385: Comparison of endometrial aspiration biopsy techniques: Specimen adequacy

Large-needle percutaneous aspiration biopsy of the testicle in men with nonobstructive azoospermia

Two hundred thirteen testicular specimens of men with nonobstructive azoospermia were obtained by large-needle percutaneous aspiration biopsy. The mean values of the number of seminiferous tubules per histologic section, dimension, weight, and the fraction of biopsies with spermatogenetic cells (53, 0.2 x 0.3 x 0.62 cm, 385 mg, and 63%, respectively) were similar to those obtained by open or other surgical biopsy techniques that were used for assisted fertilization in the same type of patients.

Bilateral epibulbar granulocytic sarcomas: a case of an 8-year-old girl with acute myeloid leukaemia

An 8-year-old girl with a history of acute myeloid leukaemia (AML) presented with bilateral ocular discomfort, conjunctival injection, photophobia, and epiphora. Clinical examination and high-frequency ultrasound showed bilateral epibulbar tumours. Granulocytic sarcomas were suspected and leukaemic infiltration was confirmed by fine-needle aspiration biopsy based cytopathologic examination. Epibulbar granulocytic sarcoma in AML is rare (particularly in a child). We describe the first high-frequency ultrasound images and illustrate the use of a minimally invasive fine-needle aspiration biopsy technique to confirm our diagnosis.

Comparison of Endometrial Aspiration Biopsy Techniques

Comparison of Endometrial Aspiration Biopsy Techniques

Mediastinum thymoma diagnosed by FNA and thinprep technique: A case report

Thymoma is a primary tumor of the thymus epithelial cells. It may be asymptomatic or accompanied with atypical clinical symptoms or paraneoplastic syndromes, such as myasthenia gravis. The biological behavior of thymomas is unpredictable. The invasion of the capsule or the adjacent tissues is the major diagnostic criterion for the malignant behavior of these tumors. This is an interesting case of thymoma diagnosed by fine-needle aspiration biopsy (FNA) and ThinPrep technique, in a 54-year-old female patient with a history of gastric adenocarcinoma. Cytology of the mediastinum mass revealed a mixed population of epithelial cells and lymphocytes. The tumor was excised and the histopathological examination supported the cytological diagnosis. Thymomas commonly constitute a problem in differential diagnosis of mediastinum masses. FNA biopsy in correlation with ThinPrep technique and immunocytochemistry may play a significant role in clarifying the nature of these lesions and may contribute to the early management and choice of the optimal therapeutic manipulation.

Punção aspirativa por agulha fina guiada por ultra-sonografia de nódulos tireoidianos: estudo de 63 casos

Neste trabalho foi revisada a técnica empregada na execução da punção aspirativa por agulha fina guiada por ultra-sonografia, e são descritos os seus benefícios no diagnóstico de nódulos tireoidianos. Foram realizadas punções aspirativas por agulha fina em 63 pacientes do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, encaminhados ao Serviço de Radiodiagnóstico, no período de agosto de 2001 a junho de 2002. Dos 63 pacientes estudados, 58 (92%) eram do sexo feminino e cinco (8%) eram do sexo masculino, com uma relação mulher/homem de cerca de 11:1. Trinta e um pacientes (49%) se situaram na quinta e sexta décadas de vida. Oitenta e nove por cento dos pacientes apresentaram-se com nódulos múltiplos ao exame ecográfico; apenas 11% dos pacientes tinham nódulo único. Em relação aos laudos citológicos dos nódulos puncionados, 47% foram benignos, 31%, suspeitos, 17%, inadequados e apenas 5%, malignos. Todos os nódulos malignos (três pacientes) tiveram o diagnóstico citológico de carcinoma papilífero. Dos nódulos benignos, 93% foram diagnosticados como hiperplasia nodular e apenas 7% tiveram diagnóstico de tireoidite. Dos laudos considerados inadequados, 70% foram considerados hemorrágicos, sendo 30% considerados hipocelulares. Os dados encontrados no nosso trabalho estiveram de acordo com os encontrados na literatura médica.

CT-guided Percutaneous Lung Biopsy in Children

To describe techniques and evaluate outcomes of computed tomography (CT)-guided percutaneous lung biopsy in children. Between April 1992 and June 2003, 64 patients (32 male, 32 female) with a mean age of 10.8 years (0.6-20 years) were referred for 75 lung biopsies. Most biopsies were performed for suspected malignancy (n = 24; 32%) or to distinguish posttransplantation lymphoproliferative disorder from fungal infection in immunocompromised patients (n = 17; 23%). All children referred to the pediatric interventionalists in two children's hospitals for CT-guided biopsy of parenchymal or pleural-based lesions in the thorax were studied. Prospectively gathered procedural data were reviewed for medical history and indications for procedure, admission status, type of anesthesia, technical approach (core vs aspiration biopsy), procedural modifications, lesion size, number of passes required, and immediate complications. Medical records were retrospectively reviewed for diagnostic outcome, impact on patient management, and delayed complications. Procedures were performed under deep sedation whenever possible (n = 61; 81%) with use of a coaxial core biopsy technique (n = 56; 75%), a fine needle aspiration biopsy technique (n = 15; 20%), or both (n = 4; 5%). Mean lesion diameters were 2.5 cm (range, 1-10 cm) in the core biopsy group and 1.0 cm (range, 0.5-1.7 cm) in the aspiration biopsy group. Sixty-four biopsies (85%) were diagnostic. There was one major complication (1.3%), a tension pneumothorax treated with intraprocedural placement of a chest tube. Percutaneous CT-guided lung biopsy is a safe and accurate diagnostic procedure in children that obviates open surgical biopsy in most patients.

Monitoring intrahepatic CD8+ T cells by fine-needle aspiration cytology in chronic hepatitis C infection.

Infection of the liver with hepatitis C virus (HCV) causes compartmentalization of CD8+ cytotoxic T cells to the site of disease. These cells are thought to be involved in viral clearance during interferon therapy. The repetitive analysis of the intrahepatic immune response is hampered by the difficulty to obtain the intrahepatic T cells. The fine-needle aspiration biopsy (FNAB) technique was evaluated for its use to obtain liver-derived CD8+ T cells in a minimally invasive way. In 26 chronic HCV patients who were evaluated for Peg-interferon and ribavirin combination therapy, pre-treatment FNABs and peripheral blood specimens were obtained simultaneously with liver tissue biopsies, and CD3+ and CD8+ T cells were quantified by immunocytochemistry. The CD8+/CD3+ ratio was significantly higher in the FNABs than in peripheral blood (P < 0.01), and similar to those in portal areas in the tissue biopsies. A significant correlation was observed between numbers of CD3+CD8+ T lymphocytes in the FNABs and the numbers of CD8+ cells in the lobular fields or in the portal tracts of the liver tissue biopsies, but not with CD3+CD8+ T lymphocytes in peripheral blood. Finally, the ratio of CD8+/CD3+ T lymphocytes in FNABs was significantly higher in those patients who responded rapidly to therapy when compared with slow responders at 4 weeks of treatment (P = 0.02). These findings demonstrate that the intrahepatic T-cell composition is reflected in FNABs, and that the FNAB technique can be used for predicting early virological response to therapy of patients chronically infected with HCV.

Diagnosis Of The Severely Anaemic Patients Using The Bone Marrow Aspiration Biopsy Technique

Objective:To highlight the usefulness of bone marrow aspiration in the diagnosis of severely anaemic patients. Methods:Fifty two patients, 26 males and 26 females aged 16 to 40 years were drawn from the wards and clinics of University of Benin Teaching Hospital, Benin. The criteria for inclusion in the study were unexplained anaemia; suspicion of leukaemia and aplastic anaemia. Patients with easily diagnosable haemoglobinopathies such as HbSS were excluded from the study. Bone marrow aspirated from either the patients' anterior or posterior superior iliac spine were stained and examined. Smears were fixed in alcohol, stained with Leishman stain and examined under the microscope. Pearl's stain for haemosiderin was used to confirm presence of iron in the marrow. Results:The smears were suggestive of acute myeloblastic leukaemia in 21 out of 52 patients or 40.4%; acute lymphoblastic leukaemia in 10 out of 52 patients or 19.2%; and megaloblastic anaemia in 5 patients or 9.6%. Hypocellularity was confirmed in 15 (28.9%) patients. Conclusion:It is concluded that bone marrow aspiration with the Klime-Salah needle is a practical and cheap technique for the diagnosis of the severely anaemic patient. Key Words: Severe Anaemia, Bone Marrow Aspiration, Diagnostic Biopsy Orient Journal of Medicine Vol.15(3&4) 2003: 19-22