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Sample records for needle aspiration biopsies

  1. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    MedlinePlus

    ... Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ultrasound-guided thyroid biopsy ... Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During a fine needle aspiration ...

  2. Thin needle aspiration biopsy of endocrine organs.

    PubMed

    Koss, L G

    1979-01-01

    The purpose of this paper is to summarize the advantages and disadvantages of the fine needle aspiration technique in reference to the endocrine organs. The principles of technique and interpretation are presented. The application of aspiration biopsies to the breast, the prostate, the pancreas and the thyroid are briefly discussed. PMID:485094

  3. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors

    PubMed Central

    Song, In Hye; Song, Joon Seon; Sung, Chang Ohk; Roh, Jong-Lyel; Choi, Seung-Ho; Nam, Soon Yuhl; Kim, Sang Yoon; Lee, Jeong Hyun; Baek, Jung Hwan; Cho, Kyung-Ja

    2015-01-01

    Background: Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. Methods: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Results: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. Conclusions: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected. PMID:26148740

  4. Fine-needle aspiration biopsy. When is it most beneficial?

    PubMed

    Peterson, I M; Brink, W J

    1990-09-01

    When fine-needle aspiration biopsy is done skillfully, it is an accurate, efficient, and cost-effective method for diagnosing many diseases in selected patients. This article describes its uses for palpable masses of the thyroid, breast, and peripheral lymph nodes and some nonpalpable lesions. The authors also discuss its advantages and disadvantages and technical considerations that affect accuracy. PMID:2399196

  5. Low coherence interferometry approach for aiding fine needle aspiration biopsies.

    PubMed

    Chang, Ernest W; Gardecki, Joseph; Pitman, Martha; Wilsterman, Eric J; Patel, Ankit; Tearney, Guillermo J; Iftimia, Nicusor

    2014-01-01

    We present portable preclinical low-coherence interference (LCI) instrumentation for aiding fine needle aspiration biopsies featuring the second-generation LCI-based biopsy probe and an improved scoring algorithm for tissue differentiation. Our instrument and algorithm were tested on 38 mice with cultured tumor mass and we show the specificity, sensitivity, and positive predictive value of tumor detection of over 0.89, 0.88, and 0.96, respectively. PMID:25375634

  6. Does large needle aspiration biopsy add pain to the thyroid nodule evaluation?

    PubMed

    Carpi, Angelo; Rossi, Giuseppe; Nicolini, Andrea; Iervasi, Giorgio; Russo, Matteo; Mechanick, Jeffrey

    2013-01-01

    Thyroid large needle aspiration biopsy is disregarded because it is thought to be associated with pain. This is in contrast with our 32 years long experience. We surveyed reports of pain in patients examined with fine needle aspiration biopsy (78, 87.2% women, mean age 59 years) or FNAB+large needle aspiration biopsy (48, 87.5% women, mean age 60 years). Each patient was questioned regarding a) no unpleasant sensation (score "0"); b) unpleasant sensation ("1"); c) mild pain (no analgesic used; "2"); or d) pain (analgesic used; "3"). The mean size of the needle used was for FNAB 22.3±0.7 or 20.8±1 gauge in the fine needle aspiration or fine needle aspiration plus large needle aspiration biopsy group, respectively (p<.0001). The number of percutaneous punctures was higher in the fine needle aspiration plus large needle aspiration biopsy group. However, the pain score in the fine needle aspiration biopsy or fine needle aspiration biopsy plus large needle aspiration biopsy group was not significantly different. Large needle aspiration biopsy after fine needle aspiration biopsy does not add any discomfort or pain and therefore in light of the demonstrable benefits, should be included in clinical algorithms for the evaluation of thyroid nodules. PMID:23536779

  7. Combination of needle aspiration and core needle biopsy: A new technique of stereotactic biopsy

    PubMed Central

    Wani, Abrar Ahad; Wani, M. Afzal; Ramzan, Altaf U.; Nizami, Furqan A.; Malik, Nayil K.; Shafiq, S.; Ahmad, Rais; Kumar, Ashish; Lone, Iqbal; Makhdoomi, Rumana

    2016-01-01

    Aim: The study aims at describing the results of using a new technique to acquire the tissue sample in stereotactic biopsy of brain lesions. Materials and Methods: The study was performed in 19 patients over a period of 5 years in which we used the new technique, i.e., Abrar and Afzal technique (AT) of obtaining tissue biopsy. It is a combination of core tissue biopsy and needle aspiration techniques. The technique was devised to acquire greater amount of tissue for pathologic study. Results: While we could give pathologic diagnosis in 18 patients out of 19 (94.7%), in one patient, the tissue sample revealed only inflammatory cells and definitive diagnosis could not be reached. There was no significant morbidity or any mortality in the series. Conclusion: Abrar and Afzal technique is a reasonably accurate technique of acquiring larger tissue sample in stereotactic brain biopsy without any additional risks. It can be done with little modification of the conventional equipment available with the stereotactic system. PMID:27057212

  8. Fine needle aspiration biopsy in pediatric ophthalmic tumors and pseudotumors.

    PubMed

    O'Hara, B J; Ehya, H; Shields, J A; Augsburger, J J; Shields, C L; Eagle, R C

    1993-01-01

    In an eight-year period (1983-1990) approximately 500 fine needle aspiration biopsies (FNABs) of eye lesions were processed in our laboratory. Eighty-one of the cases, obtained from 77 pediatric patients (ranging from 4 weeks to 16 years of age), were the subject of this study. The specimens included 73 intraocular and 8 orbital aspirates. Forty-four of the specimens were from diagnostic procedures, whereas 37 were obtained from surgical specimens immediately after enucleation. Eight FNABs (four diagnostic and four postenucleation) were deemed inadequate for cytologic diagnosis. Of the remaining 73 cases, 38 were diagnosed as malignant (34 retinoblastomas, 3 medulloepitheliomas, 1 rhabdomyosarcoma), and all were confirmed upon subsequent histologic examination. Four cases were diagnosed as suspicious for malignancy; all of them proved to be malignant (two retinoblastomas, two rhabdomyosarcomas). One orbital aspirate contained cells suggestive of a glial origin and was confirmed histologically as pilocytic astrocytoma. Ten cases were reported as compatible with Coats' disease; all were confirmed to be benign by histologic examination (three cases) or clinical follow-up (seven cases). The remaining 20 benign aspirates (13 with inflammatory cells, 6 with macrophages and 1 with blood) proved to be from benign conditions by histologic examination (4 cases) or clinical follow-up (16 cases). There were no false-positive diagnoses. The overall accuracy of FNAB was 95%, and the accuracy of cytologic interpretation was 100%. We conclude that FNAB is a reliable and accurate diagnostic modality in the assessment of selected pediatric ophthalmic diseases. PMID:8465629

  9. Inadequate fine needle aspiration biopsy samples: Pathologists versus other specialists

    PubMed Central

    Gomez-Macías, GS; Garza-Guajardo, R; Segura-Luna, J

    2009-01-01

    Background: Fine needle aspiration biopsy (FNAB) is a simple, sensitive, quick and inexpensive method in which operator experience is essential for obtaining the best results. Methods: A descriptive study in which the aspiration biopsy cases of the Pathology and Cytopathology Service of the University Hospital of the UANL (2003–2005) were analyzed. These were divided into three study groups: Group 1, FNAB performed by a pathologist; Group 2, FNAB performed by specialists who are not pathologists, Group 3, FNAB guided by an imaging study with immediate evaluation by a pathologist. The samples were classified as adequate and inadequate for diagnosis, the organ, the size and characteristics of the lesions were taken into consideration. Results: A total of 1905 FNAB were included. In Group 1: 1347 were performed of which 1242 (92.2%) were adequate and 105 (7.7%) were inadequate. Of the 237 from Group 2, 178 were adequate (75.1%) and 59 inadequate (24.8%); in Group 3 there were 321 of which 283 (88.1%) were adequate and 38 (11.8%) inadequate. A statistically significant difference was found between FNAB performed by Group 1 (p< 0.001) and the other groups. A multivariate analysis was done where the organ punctured, the study groups, the size and characteristics of the lesion by study group were compared, finding that the most important variable was the person who performed the procedure. Conclusion: The experience and training of the person performing the aspiration biopsy, as well as immediate evaluation of the material when it is guided, substantially reduces the number of inadequate samples, improving the sensitivity of the method as well as reducing the need for open biopsies to reach a diagnosis. PMID:19621092

  10. MR-guided aspiration biopsy: needle design and clinical trials.

    PubMed

    Mueller, P R; Stark, D D; Simeone, J F; Saini, S; Butch, R J; Edelman, R R; Wittenberg, J; Ferrucci, J T

    1986-12-01

    Nonferrous needles of pure brass, titanium, or copper, and ferrous needles of different alloys of stainless steel were analyzed for the size, area, and distribution of the image artifact created when the needles were placed in a 0.6-T magnet. Results demonstrated that a stainless steel prototype needle (type 316) would be visible on magnetic resonance images and would provide an artifact similar to that seen in computed tomographic-guided biopsies. Further testing of this prototype included assessment of the effect on the artifact when changes were made in annealing properties, gauge, length, needle-tip geometry, pulse sequence, and orientation relative to the magnetic field. To date, three human liver biopsies have been successfully and safely performed using a stainless steel type 316 needle. PMID:3786706

  11. Core needle biopsy versus fine needle aspiration biopsy in breast--a historical perspective and opportunities in the modern era.

    PubMed

    Nassar, Aziza

    2011-05-01

    Breast fine-needle aspiration biopsy (FNAB) by palpation is on the decline, due to its limitations in diagnostic accuracy, decreased sensitivity, and its replacement with core needle biopsy (CNB). Despite its decreasing utility, superficial fine-needle aspiration (FNA) in breast is still the main modality for evaluating metastatic lesions, recurrence, and axillary lymph node metastasis. New modalities including proteomic pattern expression and methylation profiling of breast lesions are other promising techniques that can be used as ancillary tests for refining the diagnosis of breast lesions using FNAB. Image-guided breast FNA proves to be a successful alternative with high sensitivity and specificity. In this review, the advantages, disadvantages, and inherent limitations of breast FNA and CNB, and new advanced techniques are discussed. PMID:20949457

  12. Syphilitic lymphadenitis diagnosed via fine needle aspiration biopsy.

    PubMed

    Jang, David W; Khan, Alifia; Genden, Eric M; Wu, Maoxin

    2011-08-01

    Syphilis is coming back in the recent a few decades especially in the gay and HIV populations. Since syphilis can be "the great mimic" clinically and pathologically, a case report with updated review can be helpful to the medical community. We report, a case of syphilitic lymphadenitis diagnosed via fine needle aspiration biopsy (FNAB). The pitfalls associated with the diagnosis of syphilitic lymphadenitis will be discussed. The patient's medical records were reviewed. The pertinent history, clinical course, and ancillary studies including FNAB cytology with special stains are presented. In addition to the case report, we discuss the diagnosis of syphilitic lymphadenitis and the role of FNAB cytology. This was a 37-year-old man presenting with a two-month history of a growing neck mass, night sweats, and a ten pound weight loss. The patient had been treated one month earlier for primary syphilis. Examination of the head and neck revealed a 3 cm right level II mass. FNAB cytology showed heterogeneous population of lymphocytes and plasma cells suggesting reactive changes. Modified silver staining of the cell block slide was performed and revealed spirochetes, consistent with syphilis. The patient's lymphadenitis resolved with a course of antibiotic treatment. Although lymphadenopathy is a rare presentation of syphilis, it should be included in the differential diagnosis for patients who offer a suspect history. FNAB with silver staining is an effective, minimally invasive way to confirm the diagnosis. PMID:21761579

  13. Capillary Versus Aspiration Biopsy: Effect of Needle Size and Length on the Cytopathological Specimen Quality

    SciTech Connect

    Hopper, Kenneth D.; Grenko, Ronald T.; Fisher, Alicia I.; TenHave, Thomas R.

    1996-09-15

    Purpose: To test the value of the nonaspiration, or capillary, biopsy technique by experimental comparison with the conventional fine-needle aspiration technique using various needle gauges and lengths. Methods: On fresh hepatic and renal tissue from five autopsies, multiple biopsy specimens were taken with 20, 22, and 23-gauge Chiba needles of 5, 10, 15, and 20-cm length, using the aspiration technique and the capillary technique. The resultant specimens were graded on the basis of a grading scheme by a cytopathologist who was blinded to the biopsy technique. Results: The capillary technique obtained less background blood or clot which could obscure diagnostic tissue, although not significantly different from the aspiration technique (p= 0.2). However, for the amount of cellular material obtained, retention of appropriate architecture, and mean score, the capillary technique performed statistically worse than aspiration biopsy (p < 0.01). In addition, with decreasing needle caliber (increasing needle gauge) and increasing length, the capillary biopsy was inferior to the aspiration biopsy. Conclusion: The capillary biopsy technique is inferior to the aspiration technique according to our study. When the capillary technique is to be applied, preference should be given to larger caliber, shorter needles.

  14. MDCT-Guided Transthoracic Needle Aspiration Biopsy of the Lung Using the Transscapular Approach

    SciTech Connect

    Rossi, Umberto G. Seitun, Sara; Ferro, Carlo

    2011-02-15

    The purpose of this study is to report our preliminary experience using MDCT-guided percutaneous transthoracic needle aspiration biopsy using the transscapular approach in the upper posterolateral lung nodules, an area that it is difficult or hazardous to reach with the conventional approach. Five patients underwent CT-guided percutaneous transthoracic needle aspiration biopsy of the lung via the transscapular approach. A coaxial needle technique was used in all patients. Biopsy was successful in all patients. No major complications were encountered. One patient developed a minimal pneumothorax next to the lesion immediately after biopsy, which resolved spontaneously. MDCT-guided percutaneous transthoracic needle aspiration biopsy of the lung via the transscapular approach is an effective and safe procedure that reduces the risk of pneumothorax in selected patients.

  15. Fine-needle aspiration biopsy and other biopsies in suspected intraocular malignant disease: a review.

    PubMed

    Eide, Nils; Walaas, Lisa

    2009-09-01

    Ocular oncologists require a strong indication for intraocular biopsy before the procedure can be performed because it carries a risk for serious eye complications and the dissemination of malignant cells. The purpose of this review is to evaluate the extent to which this restricted practice is supported by evidence from previous reports and to outline our main indications and contraindications. The different intraocular biopsy techniques in the anterior and posterior segment are discussed with a focus on our preferred method, fine-needle aspiration biopsy (FNAB). In the literature, complications are typically under-reported, which reduces the possibilities of evaluating the risks correctly and of making fair comparisons with other biopsy methods. In FNAB, the exact placement of the needle is critical, as is an accurate assessment of the size of the lesion. Fine-needle aspiration biopsy is usually not a reliable diagnostic tool in lesions < 2 mm in thickness. It is very advantageous to have a cytopathologist present in the operating theatre or close by. This ensures adequate sampling and encourages repeated biopsy attempts if necessary. This approach reduces false negative results to < 3%. Adjunct immunocytochemistry is documented to increase specificity and is essential for diagnosis and management in about 10% of cases. In some rare pathological processes the diagnosis depends ultimately on the identification of specific cell markers. An accurate diagnosis may have a decisive influence on prognosis. The cytogenetic prognostications made possible after FNAB are reliable. Biopsy by FNA has a low complication rate. The calculated risk for retinal detachment is < 4%. Intraocular haemorrhage is frequently observed, but clears spontaneously in nearly all cases. Only a single case of epibulbar seeding of malignant cells at the scleral pars plana puncture site of transvitreal FNAB has been documented. Endophthalmitis has been reported and adequate standard preoperative

  16. Free thyroxine in needle washout after fine needle aspiration biopsy of toxic thyroid nodules.

    PubMed

    Raikov, Nikolai; Nonchev, Boyan; Chaushev, Borislav; Vjagova, Diyana; Todorov, Svetoslav; Bocheva, Yana; Malceva, Daniela; Vicheva, Snejinka; Raikova, Asyia; Argatska, Antoaneta; Raikov, Miroslav

    2016-01-01

    The main diagnostic tool for toxic adenomas (TA) is radionuclide imaging indicated in patients with evidence of thyroid nodules in combination with thyrotoxic syndrome. Thyroid ultrasound and fine-needle aspiration biopsy (FNAB) are widely used for the valuation of thyroid masses. There is no literature data concerning the utility of FNAB and related tests for the diagnosis of hyperfunctioning thyroid nodules. The purpose of this study is to determine the levels of free thyroxine (FT4) in the needle washout after FNAB of hot thyroid nodules. The results of our study show that the FT4 levels in needle washout from TA were significantly higher than the surrounding parenchyma and correlated with the hormonal changes in patients with thyroid hyperfunctioning nodules. Further studies on a large number of patients are needed to refine the diagnostic value of this method and evaluate its importance in quantitative risk assessment of thyroid autonomy. PMID:26841375

  17. Management issues in breast lesions diagnosed by fine-needle aspiration and percutaneous core breast biopsy.

    PubMed

    Levine, Pascale; Simsir, Aylin; Cangiarella, Joan

    2006-06-01

    The use offine-needle aspiration biopsy or percutaneous core needle biopsy to diagnose breast lesions has increased during the past few decades. Although the benefits of these procedures are well known, controversies remain about the management of certain categories of breast lesions detected by these methods. This article discusses the management issues in categories of breast lesions, including papillary lesions, atypical lobular hyperplasia and lobular carcinoma in situ, and mucinous lesions diagnosed by the preoperative techniques of aspiration or core biopsy. PMID:16830962

  18. Tumor classification by electron microscopy of fine needle aspiration biopsy material.

    PubMed

    Collins, V P; Ivarsson, B

    1981-03-01

    The application of fine needle aspiration biopsy cytology to tumor diagnosis and classification is gaining increased acceptance. The classification of some poorly differentiated tumors may prove particularly difficult for the cytologist as well as for the pathologist. In such cases electron microscopic examination of fine needle aspiration biopsy material can be of great assistance. A simple, yet dependable, technique is described for the study of such material. The method has been shown to be of decisive importance in the classification of 80% of a selected series of cases submitted to ultrastructural analysis. Using this method, a preoperative diagnosis can be obtained in otherwise equivocal cases. PMID:7270154

  19. Fine needle aspiration biopsy of suspected metastatic cancers to the posterior uvea.

    PubMed Central

    Augsburger, J J

    1988-01-01

    This thesis presents the author's experience with diagnostic intraocular fine needle aspiration biopsy in 18 patients with a suspected metastatic choroidal or ciliary body tumor. The author has reviewed the literature on biopsy of intraocular tumors and has specified what he believes to be valid indications for diagnostic biopsy of posterior uveal tumors. He has evaluated the accuracy, limitations, and complications of diagnostic fine needle aspiration biopsy in this series and others, and he has suggested methods for improving the recovery of sufficient cells for cytologic diagnosis and lessening the risks of tumor cell seeding during the biopsy. The author has concluded that fine needle aspiration biopsy appears to be a relatively safe, generally reliable means of establishing the pathologic diagnosis of a choroidal or ciliary body tumor in highly selected patients suspected of having metastatic cancer. In spite of its apparent safety and reliability, however, the author has cautioned against the routine use of fine needle aspiration biopsy in patients with posterior uveal tumors since its long-term safety has not been established. The author has suggested that diagnostic fine needle aspiration biopsy of posterior uveal tumors be performed only in medical centers where there can be input from and cooperation among ophthalmologists, ophthalmic pathologists, and cytopathologists who are experienced in the diagnosis of intraocular malignancies. Images FIGURE 3 A FIGURE 3 B FIGURE 4 A FIGURE 4 B FIGURE 4 C FIGURE 4 D FIGURE 5 A FIGURE 5 B FIGURE 5 C FIGURE 5 D FIGURE 6 A FIGURE 6 B FIGURE 7 A FIGURE 7 B FIGURE 7 C FIGURE 7 D FIGURE 8 A FIGURE 8 B FIGURE 8 C FIGURE 8 D FIGURE 9 A FIGURE 9 B FIGURE 9 C FIGURE 9 D FIGURE 10 A FIGURE 10 B FIGURE 10 C FIGURE 11 PMID:2979028

  20. Percutaneous fine-needle aspiration biopsy of intra-abdominal masses.

    PubMed Central

    Ho, C. S.; Tao, L. C.; McLoughlin, M. J.

    1978-01-01

    Percutaneous fine-needle aspiration biopsies were performed in 51 patients with various intra-abdominal masses localized by palpation, radiologic studies, ultrasonography or radioisotope scanning. Biopsy specimens were considered positive for malignant disease in 35 (85%) of the 41 patients with such disease, including 26 (96%) of the 27 with metastases. There was one false-positive diagnosis of malignant disease from the biopsy specimens. Surgery became unnecessary as a result of aspiration biopsy in at least 12 patients. One patient showed evidence of intrahepatic bleeding during liver biopsy but recovered spontaneously, and the liver appeared normal at laparotomy 3 weeks later. Aspiration biopsy is an accurate, relatively painless, inexpensive and safe method of establishing a diagnosis of intraabdominal malignant disease. Considerable experience of the cytologist is necessary for good results. PMID:737606

  1. Thyroid Fine-Needle Aspiration Biopsy and Thyroid Cancer Diagnosis: A Nationwide Population-Based Study

    PubMed Central

    Huang, Li-Ying; Lee, Ya-Ling; Chou, Pesus; Chiu, Wei-Yih; Chu, Dachen

    2015-01-01

    Background Thyroid cancer is the most common endocrine gland malignancy and fine-needle aspiration biopsy is widely used for thyroid nodule evaluation. Repeated aspiration biopsies are needed due to plausible false-negative results. This study aimed to investigate the overall relationship between aspiration biopsy and thyroid cancer diagnosis, and to explore factors related to shorter diagnostic time. Methods This nationwide retrospective cohort study retrieved data from the Longitudinal Health Insurance Database in Taiwan. Subjects without known thyroid malignancies and who received the first thyroid aspiration biopsy after 2004 were followed-up from 2004 to 2009 (n = 7700). Chi-square test, Kaplan-Meier survival analysis, and Cox proportional hazards model were used for data analysis. Results Of 7700 newly-aspirated patients, 276 eventually developed thyroid cancer (malignancy rate 3.6%). Among the 276 patients with thyroid cancer, 61.6% underwent only one aspiration biopsy and 81.2% were found within the first year after the initial aspiration. Cox proportional hazards model revealed that aspiration frequency (HR 1.07, 95% CI 1.06–1.08), ultrasound frequency (HR 1.02, 95% CI 1.01–1.03), older age, male sex, and aspiration biopsies arranged by surgery, endocrinology or otolaryngology subspecialties were all associated with shorter time to thyroid cancer diagnosis. Conclusions About 17.4% of thyroid cancer cases received more than two aspiration biopsies and 18.8% were diagnosed one year after the first biopsy. Regular follow-up with repeated aspiration or ultrasound may be required for patients with clinically significant thyroid nodules. PMID:26020790

  2. Fine needle aspiration of the thyroid

    MedlinePlus

    Thyroid nodule fine needle aspirate biopsy; Biopsy - thyroid - skinny-needle; Skinny-needle thyroid biopsy ... under your shoulders and your neck extended. The biopsy site is cleaned. A thin needle is inserted ...

  3. Cytopathologic diagnosis of fine needle aspiration biopsies of thyroid nodules

    PubMed Central

    Misiakos, Evangelos P; Margari, Niki; Meristoudis, Christos; Machairas, Nickolas; Schizas, Dimitrios; Petropoulos, Konstantinos; Spathis, Aris; Karakitsos, Petros; Machairas, Anastasios

    2016-01-01

    Fine-needle aspiration (FNA) cytology is an important diagnostic tool in patients with thyroid lesions. Several systems have been proposed for the cyropathologic diagnosis of the thyroid nodules. However cases with indeterminate cytological findings still remain a matter of debate. In this review we analyze all literature regarding Thyroid Cytopathology Reporting systems trying to identify the most suitable methodology to use in clinical practice for the preoperative diagnosis of thyroid nodules. A review of the English literature was conducted, and data were analyzed and summarized and integrated from the authors’ perspective. The main purpose of thyroid FNA is to identify patients with higher risk for malignancy, and to prevent unnecessary surgeries for benign conditions. The Bethesda System for Reporting Thyroid Cytopathology is the most widely used system for the diagnosis of thyroid FNA specimens. This system also contains guidelines for the diagnosis and treatment of indeterminate or suspicious for malignancy cases. In conclusion, patients who require repeated FNAs for indeterminate diagnoses will be resolved by repeat FNA in a percentage of 72%-80%. PMID:26881190

  4. Cytopathologic diagnosis of fine needle aspiration biopsies of thyroid nodules.

    PubMed

    Misiakos, Evangelos P; Margari, Niki; Meristoudis, Christos; Machairas, Nickolas; Schizas, Dimitrios; Petropoulos, Konstantinos; Spathis, Aris; Karakitsos, Petros; Machairas, Anastasios

    2016-02-16

    Fine-needle aspiration (FNA) cytology is an important diagnostic tool in patients with thyroid lesions. Several systems have been proposed for the cyropathologic diagnosis of the thyroid nodules. However cases with indeterminate cytological findings still remain a matter of debate. In this review we analyze all literature regarding Thyroid Cytopathology Reporting systems trying to identify the most suitable methodology to use in clinical practice for the preoperative diagnosis of thyroid nodules. A review of the English literature was conducted, and data were analyzed and summarized and integrated from the authors' perspective. The main purpose of thyroid FNA is to identify patients with higher risk for malignancy, and to prevent unnecessary surgeries for benign conditions. The Bethesda System for Reporting Thyroid Cytopathology is the most widely used system for the diagnosis of thyroid FNA specimens. This system also contains guidelines for the diagnosis and treatment of indeterminate or suspicious for malignancy cases. In conclusion, patients who require repeated FNAs for indeterminate diagnoses will be resolved by repeat FNA in a percentage of 72%-80%. PMID:26881190

  5. Percutaneous CT-Guided Core Needle Biopsy Versus Fine Needle Aspiration in Diagnosing Pneumonia and Mimics of Pneumonia

    SciTech Connect

    Thanos, Loukas; Galani, Panagiota Mylona, Sophia; Pomoni, Maria; Mpatakis, Nikolaos

    2004-08-15

    The purpose of this study was to determine the diagnostic value of percutaneous core needle biopsy (CNB) relative to fine needle aspiration (FNA) in patients with pneumonia and pneumonia mimics. In this prospective study we present our experience with 48 thoracic FNAs and CNBs carried out on 48 patients with pneumonia and pneumonia mimics. Samples were obtained from all patients using both CNB (with an automated 18-G core biopsy needle and a gun) and FNA (with a 22-G needle). A specific diagnosis was made in 10/48 cases (20.83%) by FNA and in 42/48 (87.5%) by CNB. The main complications encountered were pneumothorax (n = 4) and hemoptysis (n = 2), yielding a total complication rate of 12.5%. We concluded that CNB using an automated biopsy gun results in a higher diagnostic accuracy for pneumonia and pneumonia mimic biopsies than FNA. Complications should be considered and proper patient observation should follow the procedure.

  6. CT gantry tilt: utility in transthoracic fine-needle aspiration biopsy. Work in progress.

    PubMed

    Stern, E J; Webb, W R; Gamsu, G

    1993-06-01

    The authors used a gantry tilt of 20 degrees in five patients to allow fine-needle aspiration biopsy of peripheral pulmonary lesions that were difficult to approach with a vertical alignment because of overlying ribs. This method allowed a direct approach to the lesion in all five cases, with the entire needle path visible in the scanning plane, avoidance of vital structures, and traversal of a minimal amount of normal lung parenchyma. PMID:8497650

  7. The diagnosis of cancer in thyroid fine needle aspiration biopsy. Surgery, repeat biopsy or specimen consultation?

    PubMed

    Stanek-Widera, A; Biskup-Frużyńska, M; Zembala-Nożyńska, E; Śnietura, M; Lange, D

    2016-03-01

    Fine needle aspiration biopsy (FNA) is the only diagnostic method that allows a preoperative diagnosis of thyroid carcinoma. An unequivocal diagnosis of a malignant change is achievable only in cases in which all cytological criteria of carcinoma are met. The aim of the study was to evaluate the necessity of repeat thyroid FNA in patients with papillary thyroid carcinoma verified on consultative examination (CE). We analyzed cytology reports of thyroid FNA and CE that resulted in the diagnosis of papillary carcinoma. Evaluation of the correlation of the cytological diagnosis with the histopathology report was based on data obtained after the surgery. Between 2010 and 2015 in the Institute of Oncology (IO) there were 184 cancers diagnosed on CE or in thyroid FNA performed primarily in IO. Additionally, 74 patients were subjected to repeat biopsy after confirmation of cancer in CE. Histopathological diagnosis of cancer was obtained in 62 (100%) cases that were doubly confirmed with cytological examination. The remaining 12 patients were operated on outside the institute. From 110 FNA primarily performed in the IO, histopathological verification was achievable in 92 cases, from which 92 (100%) provided a confirmation of cancer, and the remaining 18 patients were operated on outside the institute. High (100%) specificity of cancer diagnosis in FNA established primarily and verified on CE (second independent assessment) indicates that repeat FNA in order to confirm the diagnosis is unnecessary. PMID:27179270

  8. Needle tract implantation of papillary thyroid carcinoma after fine-needle aspiration biopsy.

    PubMed

    Ito, Yasuhiro; Tomoda, Chisato; Uruno, Takashi; Takamura, Yuuki; Miya, Akihiro; Kobayashi, Kaoru; Matsuzuka, Fumio; Kuma, Kanji; Miyauchi, Akira

    2005-12-01

    Although fine-needle aspiration biopsy (FNAB) is a useful tool for diagnosing thyroid carcinoma, there are some risks of complications. In this study, we investigated tumor implantation by FNAB of papillary carcinoma. We compared the characteristics of the main tumors and implanted tumors of patients showing FNAB implantations. Between 1990 and 2002, 4912 patients underwent FNAB and were diagnosed as having papillary carcinoma. We encountered 7 cases of needle tract implantation, which account only for 0.14%. We reviewed these 7 cases as well as 3 other patients who underwent FNAB in other hospitals. The intervals between FNAB and detection of the implanted tumor ranged from 2 to 131 months. For these 10 patients, the main tumors in 6 were diagnosed as poorly differentiated carcinoma, and 7 showed extrathyroid extension. Five showed the development of implanted tumor after comparatively shorter intervals (2-68 months), and we classified these as the short interval group. The remaining 5 were classified as the long interval group, because tumor development occurred after 87-131 months. All 5 cases in the short interval group involved preoperatively detectable lymph node metastasis; those in the long interval group did not. The MIB-1 labeling index of the implanted tumor was high in 4 cases in the short interval group, but it was low in all cases in the long interval group. The implanted tumors could be surgically removed without recurrence at the focal sites. These findings indicate that, although high growth activity in the metastatic lesions may be a risk factor of FNAB, inducing the growth of implanted tumors along the needle tract within a short interval after the procedure, FNAB remains the most useful technique for diagnosing thyroid carcinoma. The incidence of implantation was low, and when it did occur, the tumors could be surgically removed without recurrence. PMID:16311845

  9. Fine needle aspiration of the thyroid

    MedlinePlus

    Thyroid nodule fine needle aspirate biopsy; Biopsy - thyroid - skinny-needle; Skinny-needle thyroid biopsy ... cleaned. A thin needle is inserted into the thyroid, and a sample of thyroid cells and fluid ...

  10. Biopsy Needle Advancement during Bone Marrow Aspiration Increases Mesenchymal Stem Cell Concentration

    PubMed Central

    Peters, Anne E.; Watts, Ashlee E.

    2016-01-01

    Point-of-care kits to concentrate bone marrow (BM)-derived mesenchymal stem cells (MSCs) are used clinically in horses. A maximal number of MSCs per milliliter of marrow aspirated might be desired prior to use of a point-of-care system to concentrate MSCs. Our objective was to test a method to increase the number of MSCs per milliliter of marrow collected. We collected two BM aspirates using two different collection techniques from 12 horses. The first collection technique was to aspirate BM from a single site without advancement of the biopsy needle. The second collection technique was to aspirate marrow from multiple sites within the same sternal puncture by advancing the needle 5 mm three times for BM aspiration from four sites. Numbers of MSCs in collected BM were assessed by total nucleated cell count of BM after aspiration, total colony-forming unit-fibroblast (CFU-F) assay, and total MSC number at each culture passage. The BM aspiration technique of four needle advancements during BM aspiration resulted in higher initial nucleated cell counts, more CFU-Fs, and more MSCs at the first passage. There were no differences in the number of MSCs at later passages. Multiple advancements of the BM needle during BM aspiration resulted in increased MSC concentration at the time of BM collection. If a point-of-care kit is used to concentrate MSCs, multiple advancements may result in higher MSC numbers in the BM concentrate after preparation by the point-of-care kit. For culture expanded MSCs beyond the first cell passage, the difference is of questionable clinical relevance. PMID:27014705

  11. Biopsy Needle Advancement during Bone Marrow Aspiration Increases Mesenchymal Stem Cell Concentration.

    PubMed

    Peters, Anne E; Watts, Ashlee E

    2016-01-01

    Point-of-care kits to concentrate bone marrow (BM)-derived mesenchymal stem cells (MSCs) are used clinically in horses. A maximal number of MSCs per milliliter of marrow aspirated might be desired prior to use of a point-of-care system to concentrate MSCs. Our objective was to test a method to increase the number of MSCs per milliliter of marrow collected. We collected two BM aspirates using two different collection techniques from 12 horses. The first collection technique was to aspirate BM from a single site without advancement of the biopsy needle. The second collection technique was to aspirate marrow from multiple sites within the same sternal puncture by advancing the needle 5 mm three times for BM aspiration from four sites. Numbers of MSCs in collected BM were assessed by total nucleated cell count of BM after aspiration, total colony-forming unit-fibroblast (CFU-F) assay, and total MSC number at each culture passage. The BM aspiration technique of four needle advancements during BM aspiration resulted in higher initial nucleated cell counts, more CFU-Fs, and more MSCs at the first passage. There were no differences in the number of MSCs at later passages. Multiple advancements of the BM needle during BM aspiration resulted in increased MSC concentration at the time of BM collection. If a point-of-care kit is used to concentrate MSCs, multiple advancements may result in higher MSC numbers in the BM concentrate after preparation by the point-of-care kit. For culture expanded MSCs beyond the first cell passage, the difference is of questionable clinical relevance. PMID:27014705

  12. Comparison of ultrasound-guided core biopsy versus fine-needle aspiration biopsy in the evaluation of salivary gland lesions.

    PubMed

    Douville, Nicholas J; Bradford, Carol R

    2013-11-01

    Ultrasound-guided core biopsy provides many benefits compared with fine-needle aspiration cytology and has begun to emerge as part of the diagnostic work-up for a salivary gland lesion. Although the increased potential for tumor-seeding and capsule rupture has been extensively discussed, the safety of this procedure is widely accepted based on infrequent reports of tumor-seeding. In fact, a review of the literature shows only 2 cases of salivary tumor seeding following biopsy with larger-gauge needle characteristics, with 2 reported cases of salivary tumor seeding following fine-needle aspiration cytology. However, the follow-up interval of such studies (<7 years) is substantially less than the 20-year follow-up typically necessary to detect remote recurrence. Studies on tumor recurrence of pleomorphic adenoma, the most common salivary gland lesion, suggest that as many as 16% of tumor recurrences occur at least 10 years following initial surgery, with average time to recurrence ranging anywhere from 6.1 to 11.8 years postoperatively. Despite the benefits of ultrasound-guided core biopsy over fine-needle aspiration biopsy, which include both improved consistency and diagnostic accuracy, current studies lack adequate patient numbers and follow-up duration to confirm comparable safety profile to currently accepted fine-needle aspiration cytology. In this report we: (1) compare the relative benefits of each procedure, (2) review evidence regarding tumor seeding in each procedure, (3) discuss time course and patient numbers necessary to detect tumor recurrence, and (4) describe how these uncertainties should be factored into clinical considerations. PMID:23109044

  13. Pleural needle biopsy

    MedlinePlus

    ... et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 19. Ly A. Fine-needle aspiration biopsy technique and specimen ... Respiratory system. In: Watson N. Chapman and Nakielny's Guide ...

  14. Unusual forms of immature sporulating Coccidioides immitis diagnosed by fine-needle aspiration biopsy.

    PubMed

    Ke, Yong; Smith, Corey W; Salaru, Gratian; Joho, Kim L; Deen, Malik F

    2006-01-01

    Coccidioidomycosis is an endemic infection acquired by inhalation of the spores (arthroconidia) of the thermally dimorphic fungus, Coccidioides immitis. The arthroconidia transform into spherical cells called mature spherules in the lung. Immature spherules and other atypical forms of immature C immitis have rarely been found in vivo. We report on a case that presented unusual forms of immature sporulating C immitis in a fine-needle aspiration specimen. A 36-year-old Chinese woman, living in New Jersey for the past 10 years, presented with fever, night sweats, hemoptysis, and an abnormal chest radiograph approximately 9 months after a brief vacation trip to the Grand Canyon in Arizona. She was treated with antibiotics for 4 weeks without improvement. Subsequent chest computed tomography showed a 3-cm cavitary lesion in the right lower lobe of the lung. Fine-needle aspiration biopsy revealed diverse morphologic forms of a fungus that was confirmed by culture as immature sporulating C immitis. PMID:16390247

  15. Image-Directed Fine-needle Aspiration Biopsy of the Thyroid with Safety-engineered Devices

    SciTech Connect

    Sibbitt, Randy R. Palmer, Dennis J.; Sibbitt, Wilmer L. Bankhurst, Arthur D.

    2011-10-15

    Purpose: The purpose of the present study was to integrate safety-engineered devices into outpatient fine-needle aspiration (FNA) biopsy of the thyroid in an interventional radiology practice. Materials and Methods: The practice center is a tertiary referral center for image-directed FNA thyroid biopsies in difficult patients referred by the primary care physician, endocrinologist, or otolaryngologist. As a departmental quality of care and safety improvement program, we instituted integration of safety devices into our thyroid biopsy procedures and determined the effect on outcome (procedural pain, diagnostic biopsies, inadequate samples, complications, needlesticks to operator, and physician satisfaction) before institution of safety devices (54 patients) and after institution of safety device implementation (56 patients). Safety devices included a patient safety technology-the mechanical aspirating syringe (reciprocating procedure device), and a health care worker safety technology (antineedlestick safety needle). Results: FNA of thyroid could be readily performed with the safety devices. Safety-engineered devices resulted in a 49% reduction in procedural pain scores (P < 0.0001), a 56% reduction in significant pain (P < 0.002), a 21% increase in operator satisfaction (P < 0.0001), and a 5% increase in diagnostic specimens (P = 0.5). No needlesticks to health care workers or patient injuries occurred during the study. Conclusions: Safety-engineered devices to improve both patient and health care worker safety can be successfully integrated into diagnostic FNA of the thyroid while maintaining outcomes and improving safety.

  16. Fine-needle aspiration biopsy in children: experience in 70 cases.

    PubMed

    Verdeguer, A; Castel, V; Torres, V; Olagüe, R; Ferris, J; Esquembre, C; Vallcanera, A; Muro, M D

    1988-01-01

    Results of 70 fine-needle aspiration biopsies (FNAB) were evaluated retrospectively in 61 pediatric patients. Over a period of 9 months all mass lesions suspected being malignant were aspirated. Twelve of the 70 aspirations were performed in children having known tumours, in order to exclude recurrence or metastasis. The others were carried out to obtain a diagnosis. Satisfactory specimens were obtained from 58 (83%). There were 21 benign diagnoses, 36 malignant diagnoses, and 1 with suspected malignancy. Correlation of histologic and cytologic diagnoses was possible in 45 cases. The diagnostic sensitivity and specificity were 95% and 80%, respectively. We have found FNAB more accurate in the diagnosis of malignancies than in benign lesions. The results suggest that this is a useful technique for obtaining a first diagnosis of malignancy, as well as for excluding recurrence or metastatic disease. PMID:3352542

  17. Preparation and Using Phantom Lesions to Practice Fine Needle Aspiration Biopsies

    PubMed Central

    Shidham, Vinod B.; Varsegi, George M.; D'Amore, Krista; Shidham, Anjani

    2009-01-01

    Currently, health workers including residents and fellows do not have a suitable phantom model to practice the fine- needle aspiration biopsy (FNAB) procedure. In the past, we standardized a model consisting of latex glove containing fresh cattle liver for practicing FNAB. However, this model is difficult to organize and prepare on short notice, with the procurement of fresh cattle liver being the most challenging aspect. Handling of liver with contamination-related problems is also a significant draw back. In addition, the glove material leaks after a few needle passes, with resulting mess. We have established a novel simple method of embedding a small piece of sausage or banana in a commercially available silicone rubber caulk. This model allows the retention of vacuum seal and aspiration of material from the embedded specimen, resembling an actual FNAB procedure on clinical mass lesions. The aspirated material in the needle hub can be processed similar to the specimens procured during an actual FNAB procedure, facilitating additional proficiency in smear preparation and staining. PMID:19893483

  18. Preparation and using phantom lesions to practice fine needle aspiration biopsies.

    PubMed

    Shidham, Vinod B; Varsegi, George M; D'Amore, Krista; Shidham, Anjani

    2009-01-01

    Currently, health workers including residents and fellows do not have a suitable phantom model to practice the fine- needle aspiration biopsy (FNAB) procedure. In the past, we standardized a model consisting of latex glove containing fresh cattle liver for practicing FNAB. However, this model is difficult to organize and prepare on short notice, with the procurement of fresh cattle liver being the most challenging aspect. Handling of liver with contamination-related problems is also a significant draw back. In addition, the glove material leaks after a few needle passes, with resulting mess. We have established a novel simple method of embedding a small piece of sausage or banana in a commercially available silicone rubber caulk. This model allows the retention of vacuum seal and aspiration of material from the embedded specimen, resembling an actual FNAB procedure on clinical mass lesions. The aspirated material in the needle hub can be processed similar to the specimens procured during an actual FNAB procedure, facilitating additional proficiency in smear preparation and staining. PMID:19893483

  19. Nonimage-guided fine needle aspiration biopsy of palpable axillary lymph nodes in breast cancer patients.

    PubMed

    Marti, Jennifer L; Ayo, Diego; Levine, Pascale; Hernandez, Osvaldo; Rescigno, John; Axelrod, Deborah M

    2012-01-01

    We report the utility of office-based, nonimaged guided fine needle aspiration of palpable axillary lymph nodes in breast cancer patients. We examine the sensitivity and specificity of this procedure, and examine factors associated with a positive fine needle aspiration biopsy result. Although the utility of ultrasound-guided fine needle aspiration biopsy (FNA) of axillary lymph nodes is well established, there is little data on nonimage guided office-based FNA of palpable axillary lymphadenopathy. We investigated the sensitivity and specificity of nonimage-guided FNA of axillary lymphadenopathy in patients presenting with breast cancer, and report factors associated with a positive FNA result. Retrospective study of 94 patients who underwent office-based FNA of palpable axillary lymph nodes between 2004 and 2008 was conducted. Cytology results were compared with pathology after axillary sentinel node or lymph node dissection. Nonimage-guided axillary FNA was 86% sensitive and 100% specific. On univariate analysis, patients with positive FNA cytology had larger breast tumors (p = 0.007), more pathologic positive lymph nodes (p < 0.0001), and were more likely to present with a palpable breast mass (p = 0.006) or with radiographic lymphadenopathy (p = 0.002). FNA-positive patients had an increased presence of lymphovascular invasion (p = 0.001), higher stage of disease (p < 0.001), higher N stage (p < 0.0001), and higher rate of HER2/neu expression (p = 0.008). On multivariate analysis, radiographic lymphadenopathy (p = 0.03) and number of positive lymph nodes (p = 0.04) were associated with a positive FNA result. Nonimage-guided FNA of palpable axillary lymphadenopathy in breast cancer patients is an inexpensive, sensitive, and specific test. Prompt determination of lymph node positivity benefits select patients, permitting avoidance of axillary ultrasound, sentinel lymph node biopsy, or delay in receiving neoadjuvant therapy. This results in time and cost savings

  20. Ultrastructural aspects of human liver tumours collected by thin needle aspiration biopsy.

    PubMed

    Bârsu, M; Ghiurcă, V; Poruţiu, D; Badea, R

    1989-01-01

    Fourteen liver tumor samples, obtained by echographically-guided thin needle aspiration biopsy were electron microscopically studied, pointing out the ultrastructural aspects that allowed the diagnosis of primary and secondary liver neoplasia, and those providing indications for malignancy degrees. Criteria of electronoptic differential diagnosis between dysplastic and malignant lesions are presented. The paper suggests that electron microscopy may be helpful in establishing the forms of liver carcinoma, difficult to be determined only by cytologic examination, and for the early diagnosis mandatory to increase the resectability rate of malignant hepatoma. PMID:2533967

  1. Diagnosing a parotid lump: fine needle aspiration cytology or core biopsy?

    PubMed

    Howlett, D C

    2006-04-01

    Fine needle aspiration cytology (FNAC) has been widely adopted for the cytological diagnosis of parotid lumps. FNAC does have drawbacks, even under optimum conditions and may be associated with poor levels of diagnostic accuracy, particularly outside the specialized clinic environment. Ultrasound-guided core biopsy (USCB) is a relatively recently described technique in the parotid gland which has been well tolerated and has demonstrated a high degree of diagnostic accuracy in several studies. This article discusses the merits and pitfalls of FNAC, together with the technique of USCB and also highlights the potential advantages benefit provided by USCB in parotid diagnosis. PMID:16585720

  2. A portable, low coherence interferometry based instrument for fine needle aspiration biopsy guidance

    NASA Astrophysics Data System (ADS)

    Iftimia, Nicusor V.; Bouma, Brett E.; Pitman, Martha B.; Goldberg, Brian; Bressner, Jason; Tearney, Guillermo J.

    2005-06-01

    A portable, low coherence interferometry (LCI) based instrument for fine-needle aspiration biopsy guidance is presented. The instrument consists of a fiber-based low coherence interferometer, a data acquisition, processing and display unit, and a probe. The probe, consisting of a 250μm diameter single-mode optical fiber inserted within the bore of a fine needle, is used to illuminate tissue and collect light from tissue at the tip of the needle. Light returning out of the probe is detected by the LCI system, which is capable of measuring depth-resolved information (reflectivity, spectra, birefringence) with a spatial resolution of 10μm over a depth range of approximately 1.4mm. The LCI based instrument can be used to guide the fine needle during biopsy procedures to potentially diagnose neoplasms, infections, inflammations, or infiltrations. The design and performance of the instrument, as well as preliminary measurements on excised breast tissue specimens, are presented in detail.

  3. Ultrasound-guided fine needle aspiration biopsy of portal vein thrombosis in liver cirrhosis: results in 15 patients.

    PubMed

    De Sio, I; Castellano, L; Calandra, M; Romano, M; Persico, M; Del Vecchio-Blanco, C

    1995-01-01

    Between 1988 and 1992 ultrasound-guided fine needle aspiration biopsies of thromboses in the main branches of the portal vein were carried out in 15 patients with liver cirrhosis. The aims of the study were to evaluate the usefulness, feasibility and diagnostic accuracy of this procedure in cirrhotics with known or suspected hepatocellular carcinoma. The procedure was carried out only in patients with a platelet count > or = 40,000/microL and prothrombin activity > or = 40%. A single pass, with a 22 gauge spinal needle, was performed in the portal vein lumen. Diagnosis of the aetiology of the portal vein thrombosis was obtained in all 15 cases. In 12 cases, a cytological diagnosis of hepatocellular carcinoma was made. In one case, the neoplastic cells aspirated were compatible with adenocarcinoma, and a subsequent colonoscopy confirmed the presence of colonic cancer. The material aspirated was compatible with chemically-induced thrombosis in one patient who had undergone several percutaneous ethanol injection sessions for treatment of hepatocellular carcinoma, and in the last case only blood was aspirated, thus ruling out the coexistence of hepatic cancer. We conclude that fine needle aspiration biopsy of portal vein thrombosis is a feasible, low risk procedure that facilitates the diagnosis of hepatocellular carcinoma when fine needle biopsy of focal liver lesions fails. Fine needle aspiration biopsy of portal vein thrombosis is also useful in excluding neoplastic aetiology of portal vein thrombosis. PMID:8580410

  4. Fine-Needle Aspiration Followed by Core-Needle Biopsy in the Same Setting: Modifying Our Approach.

    PubMed

    Joudeh, Amani A; Shareef, Sameera Q; Al-Abbadi, Mousa A

    2016-01-01

    Fine-needle aspiration biopsy (FNAB) is a well-established initial diagnostic tool. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis. Consequently, patients have to undergo another diagnostic procedure. The second procedure is either repeat FNAB, core-needle or open biopsy, and can be inconvenient and costly. In some centers, the FNAB is immediately followed by core-needle biopsy (CNB) in the same setting after assuring adequacy on the initial FNAB utilizing rapid on-site specimen evaluation (ROSE). It is argued that implementing such an approach will eventually have additional critical advantages that include the following: (a) it is more convenient to patients to have both procedures in one visit, (b) the tissue procured by both procedures will be more adequate, enabling cytopathologists to reach an accurate diagnosis, and (c) it is ultimately a cost-effective approach if we take into consideration the avoidance of a potential second more invasive diagnostic procedure. Since we are living in an era of patient-centered medicine coupled with cost-cutting strategies, we present here a brief review of the topic with analysis of this alternative approach, review of the pertinent literature and shed light on a few scenarios that justify this approach. PMID:26963594

  5. Value of endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of solid pancreatic masses

    PubMed Central

    Voss, M; Hammel, P; Molas, G; Palazzo, L; Dancour, A; O'Toole, D; Terris, B; Degott, C; Bernades, P; Ruszniewski, P

    2000-01-01

    AIM—To assess the feasibility and diagnostic accuracy of endoscopic ultrasound guided fine needle biopsy (EUS-FNAB) in patients with solid pancreatic masses.
METHODS—Ninety nine consecutive patients with pancreatic masses were studied. Histological findings obtained by EUS-FNAB were compared with the final diagnosis assessed by surgery, biopsy of other tumour site or at postmortem examination, or by using a combination of clinical course, imaging features, and tumour markers.
RESULTS—EUS-FNAB was feasible in 90 patients (adenocarcinomas, n = 59; neuroendocrine tumours, n = 15; various neoplasms, n = 6; pancreatitis, n = 10), and analysable material was obtained in 73. Tumour size (⩾ or < 25 mm in diameter) did not influence the ability to obtain informative biopsy samples. Diagnostic accuracy was 74.4% (adenocarcinomas, 81.4%; neuroendocrine tumours, 46.7%; other lesions, 75%; p<0.02). Overall, the diagnostic yield in all 99 patients was 68%. Successful biopsies were performed in six patients with portal hypertension. Minor complications (moderate bleeding or pain) occurred in 5% of cases.
CONCLUSIONS—EUS-FNAB is a useful and safe method for the investigation of pancreatic masses, with a high feasibility rate even when lesions are small. Overall diagnostic accuracy of EUS-FNAB seems to depend on the tumour type.


Keywords: pancreas; tumour; endoscopic ultrasound; fine needle aspiration biopsy PMID:10644320

  6. Diagnosing breast lesions by fine needle aspiration cytology or core biopsy: which is better?

    PubMed

    Tse, Gary M; Tan, Puay-Hoon

    2010-08-01

    Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) are widely used in diagnosing breast lesions, with both achieving high sensitivity and specificity. Whether FNAC or CNB is better remains highly controversial. In this review, the advantages and disadvantages of each of these methods are discussed, especially in relation to specific problematic groups of breast lesions. In general, CNB has a slight advantage with lower inadequate and suspicious rates, allowing easier grade assessment and ancillary testings (hormome receptors, HER2) in cases of cancers. FNAC cannot reliably predict invasion in a malignant aspirate, whereas CNB, although useful in confirming invasion in carcinomas, has a much lower efficacy in predicting invasion when only in situ carcinoma is detected. The other problematic areas are papillary breast lesions and fibroepithelial lesions, notably phyllodes tumors. In papillary lesions, FNAC diagnosis is inaccurate, but with CNB, one can confidently diagnose papillary lesion, although there is still significant false positive and false negative rates, even with immunohistochemistry. For fibroepithelial lesions, using either FNAC or CNB to differentiate between a phyllodes tumor from fibroadenoma is also inaccurate. As management of breast diseases necessitates the triple approach (clinical, imaging and pathological), an awareness of the limitations of these very useful diagnostic modalities by all specialists is prudent, especially when dealing with these specific groups of breast lesions. PMID:20526738

  7. Tumour seeding after fine-needle aspiration and core biopsy of the head and neck--a systematic review.

    PubMed

    Shah, Keval S V; Ethunandan, Madan

    2016-04-01

    Although fine-needle aspiration cytology (FNAC) and core needle biopsy are essential diagnostic investigations of lumps in the head and neck, seeding along the needle track has long been a concern, and various factors have been implicated. We therefore searched the Medline database for relevant English language papers published between 1970 and 2014, excluding those on the thyroid and parathyroid, and systematically reviewed them to assess the risk. In the 610 articles reviewed we found only 7 reports of seeding (5 after FNAC and 2 after core needle biopsy). Tumours were found between 3 months and 3 years after the procedure in 4 cases, and in 3, tumour cells were found along the needle track between 0 and 33 days after the procedure. The needles varied in size from 18 - 22 gauge (G) and there were 3 to 4 passes. Four cases occurred after investigation of a mass in the salivary glands, and 3 after assessment of a cervical lymph node. Disease was benign in one and malignant in 6. Seeding along the needle track after FNAC or core needle biopsy of a lump in the head and neck is rarely reported, and an accurate estimate of its incidence is difficult to ascertain. Crude estimates suggest 0.00012% and 0.0011% after FNA and core needle biopsy, respectively. A distinction should be made between seeding that is seen shortly after the procedure and the development of tumour along the needle track. PMID:26837638

  8. NSCLC subtype prediction using cytologic fluid specimens from needle aspiration biopsies.

    PubMed

    Cho, Arthur; Hur, Jin; Hong, Yoo Jin; Lee, Hye-Jeong; Kim, Young Jin; Kim, Hee Yeong; Lee, Ji Won; Shim, Hyo Sup; Choi, Byoung Wook

    2013-03-01

    This study evaluated the diagnostic usefulness of tumor marker concentrations in cytologic fluids (CF) for subtyping non-small cell lung cancer (NSCLC) and assessed the relationship between fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake with serum and CF tumor marker levels. This prospective study included 88 patients diagnosed with adenocarcinoma or squamous cell carcinoma (SCC). Cytokeratin-19 fragment (CYFRA 21-1), carcinoembryonic antigen (CEA), and squamous cell carcinoma antigen (SCCA) concentrations in the CF samples were correlated with serum tumor marker concentrations, (18)F-FDG uptake, and NSCLC subtype. Fifty-eight patients were diagnosed with adenocarcinoma. Multivariate analysis revealed higher CF and serum SCCA levels; smoking status predicted SCC from adenocarcinoma. CF SCCA showed the highest accuracy (83%) in distinguishing between SCC and adenocarcinoma. CF samples obtained during routine needle aspiration biopsy procedure contain tumor marker levels sufficient to distinguish between SCC and adenocarcinoma; CF SCCA had the highest diagnostic accuracy. PMID:23429366

  9. Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging

    PubMed Central

    Akıncı, Muzaffer; Bulut, Serap Pamak; Erözgen, Fazilet; Gürbüzel, Mihriban; Gülşen, Gökçe; Kocakuşak, Ahmet; Gülen, Mehmet; Kaplan, Rafet

    2016-01-01

    Objective Diagnosis of axillary nodal involvement is significant in the management of breast cancer as well as in predicting prognosis. In this prospective study, we evaluated the efficiency of US-guided fine needle aspiration biopsy (FNAB) in preoperative axillary staging of early breast cancer. Material and Methods Between January 2011 and July 2013, 46 women were prospectively enrolled in the study. Ultrasound guided-FNABs for axillary assessment were performed preoperatively. Cytology results were compared with histopathology reports to determine its sensitivity, specificity, negative and positive predictive value and accuracy. Results Nineteen cases that had malignant cytology on FNAB also had axillary involvement in axillary lymph node dissection (ALND) without any false-positive results. The sensitivity and specificity of US-guided FNAB were 63.3% and 100%, respectively. US-guided FNAB was accurate in predicting the status of the axilla in 76.1% of patients. Conclusion Although this technique is favorable due to its minimally invasive nature, it is not as effective as sentinel lymph node biopsy (SLNB) in terms of detecting axillary metastasis preoperatively. The low sensitivity and low accuracy rates decrease the usefulness of the technique. Therefore, it seems that US-guided FNAB alone could not replace SLNB. Nevertheless, combining some other molecular studies may be useful in increasing the technique’s sensitivity. These issues should be determined by comprehensive clinical trials. PMID:27528822

  10. Thyroid cancer detected by ultrasound-guided fine-needle aspiration biopsy.

    PubMed

    Yokozawa, T; Fukata, S; Kuma, K; Matsuzuka, F; Kobayashi, A; Hirai, K; Miyauchi, A; Sugawara, M

    1996-09-01

    A greater percentage of thyroid cancers can be detected by ultrasound-guided fine-needle aspiration biopsy (UG-FNAB) than by ordinary FNAB. A group of 678 patients were selected sequentially as having been diagnosed with benign nodules by the conventional FNAB method. We reexamined these patients by UG-FNAB and investigated the types of thyroid cancer that were missed by the conventional FNAB. Of the 678 patients diagnosed with benign nodules (using conventional FNAB), 571 (84.2%) demonstrated the same diagnosis when UG-FNAB was used. The remaining 107 patients (15.8%) studied were suspected of having a malignancy after UG-FNAB had been performed. Surgical specimen histology proved thyroid cancer in 99 of the 107 patients: 93 had papillary carcinoma, 4 had follicular carcinoma, 1 had medullary carcinoma and 1 had anaplastic carcinoma. Two drawbacks were noted when conventional FNAB was used: (1) cancer lesions difficult to palpate (n = 55) (e.g., small cancers with or without benign lesions or cancers associated with Hashimoto's thyroiditis or Graves' disease); and (2) palpable cancers with insufficient cell material for analysis (n = 44) (e.g., cystic carcinoma and cancers with calcified lesions. UG-FNAB is a powerful technique for detecting microcancers, cystic carcinomas, cancers associated with benign nodules, Hashimoto's thyroiditis, or coarse calcifications. PMID:8678961

  11. Lymphangiography and fine-needle aspiration biopsy: ineffective for staging early prostate cancer

    SciTech Connect

    Kidd, R.; Crane, R.D.; Dail, D.H.

    1984-05-01

    Four hundred thirty-six patients with carcinoma of the prostate had lymphangiography (LAG) as part of their initial evaluation before treatment. Fine-needle aspiration biopsy (FNAB) of abnormal opacified lymph nodes was performed routinely. The positivity rate of LAG and FNAB in each clinical stage was compared with the positivity rate predicted for that stage, based on published series of patients with carcinoma of the prostate who underwent pelvic lymph node dissection (LND). Within each clinical stage, the relation of the outcome of LAG/FNAB to histologic tumor grade (Gleason score) and serum acid phosphatase levels was evaluated. LAG/FNAB was of very limited value in patients with less than clinical stage C disease and of no value in patients with a Gleason score of less than 6. Since no two study populations are exactly alike, any evaluation or comparison of tests used to stage patients with carcinoma of the prostate should state the distribution of its patients by clinical stage.

  12. EUS - Fine- Needle Aspiration Biopsy (FNAB) in the Diagnosis of Pancreatic Adenocarcinoma: A Review.

    PubMed

    Kalogeraki, Alexandra; Papadakis, Georgios Z; Tamiolakis, Dimitrios; Karvela-Kalogeraki, Iliana; Karvelas-Kalogerakis, Mihailos; Segredakis, John; Papadakis, Michael; Moustou, Eleni; Datseri, Galateia; Tzardi, Maria

    2016-01-01

    Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS) is a relatively new technology that employs endoscopy and high-frequency ultrasound (US). EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT) scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP) brushing, CT-guided biopsies, and transabdominal ultrasound (US) have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB) has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities such as tumors

  13. The contribution of vacuum-assisted modified Menghini type needle to diagnosis of US-guided fine needle aspiration biopsy of the thyroid

    PubMed Central

    Birgi, Erdem; Ergun, Onur; Türkmenoğlu, Tuğba Taşkın; Tatar, İdil Güneş; Durmaz, Hasan Ali; Hekimoğlu, Baki

    2016-01-01

    PURPOSE We aimed to determine the contribution of vacuum-assisted modified Menghini type needle to diagnosis of ultrasound-guided fine needle aspiration biopsy (FNAB) of the thyroid evaluated by a pathologist at the bedside. METHODS A total of 147 thyroid nodules in 138 patients (122 women, 16 men) were included in this prospective study. Sonographic features of nodules, number of aspirations, pain and pain severity during the process, hemorrhage, and presence of sample obtained for cell block analysis were recorded and analyzed with the results of aspiration biopsy. RESULTS Using the 21G modified Menghini type needle, a diagnosis could not be reached in 14.3% of nodules. Adequate samples for cell block analysis were obtained in 47 nodules (32%), 17 of which contributed to the diagnosis. While the difference between diagnostic cytopathology results and the contribution of the cell block were statistically significant, obtainability of cell block samples was not significantly correlated with the number of aspirations or the presence of a cystic component in the nodule. CONCLUSION FNAB with 21G vacuum-assisted modified Menghini type needle is a safe procedure with very low complication rates. In addition to the cytologic smear samples, microtissue fragments obtained with this method help pathologists in the diagnosis of thyroid nodules. PMID:26714056

  14. A Case of Gastrointestinal Stromal Tumor That Underwent Endoscopic Ultrasound-Guided Aspiration with a 25-Gauge Biopsy Needle

    PubMed Central

    Tomizawa, Minoru; Shinozaki, Fuminobu; Motoyoshi, Yasufumi; Sugiyama, Takao; Yamamoto, Shigenori; Ishige, Naoki

    2016-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is performed to obtain specimens for pathological analysis. For this procedure, 19-gauge (19G), 22-guage (22G), and 25-guage (25G) needles are available. The needles are classified into aspiration type and biopsy type. A 56-year-old woman underwent upper gastrointestinal endoscopy that showed a 38-mm-diameter submucosal tumor. The elevated lesion was diagnosed as a submucosal tumor of the stomach. Contrast-enhanced computed tomography showed a low-density area on the luminal surface of the gastric wall, which was covered with a thin layer of gastric mucosa. EUS showed a hypoechoic lesion in the submucosal layer. Color Doppler image showed a pulsating vascular signal extending into the center of the hypoechoic lesion from the periphery. EUS-FNA was performed with a 25G biopsy needle. The specimen tissue consisted of spindle-shaped cells. The cells were positive for CD117 and CD34. The submucosal tumor was diagnosed as a gastrointestinal stromal tumor.

  15. A randomized controlled cross-over trial and cost analysis comparing endoscopic ultrasound fine needle aspiration and fine needle biopsy*

    PubMed Central

    Aadam, A. Aziz; Wani, Sachin; Amick, Ashley; Shah, Janak N.; Bhat, Yasser M.; Hamerski, Christopher M.; Klapman, Jason B.; Muthusamy, V. Raman; Watson, Rabindra R.; Rademaker, Alfred W.; Keswani, Rajesh N.; Keefer, Laurie; Das, Ananya; Komanduri, Srinadh

    2016-01-01

    Background and study aims: Techniques to optimize endoscopic ultrasound-guided tissue acquisition (EUS-TA) in a variety of lesion types have not yet been established. The primary aim of this study was to compare the diagnostic yield (DY) of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) to endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for pancreatic and non-pancreatic masses. Patients and methods: Consecutive patients referred for EUS-TA underwent randomization to EUS-FNA or EUS-FNB at four tertiary-care medical centers. A maximum of three passes were allowed for the initial method of EUS-TA and patients were crossed over to the other arm based on on-site specimen adequacy. Results: A total of 140 patients were enrolled. The overall DY was significantly higher with specimens obtained by EUS-FNB compared to EUS-FNA (90.0 % vs. 67.1 %, P = 0.002). While there was no difference in the DY between the two groups for pancreatic masses (FNB: 91.7 % vs. FNA: 78.4 %, P = 0.19), the DY of EUS-FNB was higher than the EUS-FNA for non-pancreatic lesions (88.2 % vs. 54.5 %, P = 0.006). Specimen adequacy was higher for EUS-FNB compared to EUS-FNA for all lesions (P = 0.006). There was a significant rescue effect of crossover from failed FNA to FNB in 27 out of 28 cases (96.5 %, P = 0.0003). Decision analysis showed that the strategy of EUS-FNB was cost saving compared to EUS-FNA over a wide range of cost and outcome probabilities. Conclusions: Results of this RCT and decision analysis demonstrate superior DY and specimen adequacy for solid mass lesions sampled by EUS-FNB. PMID:27227104

  16. Ultrasound guided fine needle aspiration biopsy of parathyroid gland and lesions

    PubMed Central

    Dimashkieh, Haytham; Krishnamurthy, Savitri

    2006-01-01

    Background Parathyroid gland and their tumors comprise a small proportion of non-palpable neck masses that are investigated by ultrasound (US) guided fine needle aspiration biopsy. We reviewed our institution's cases of US guided FNAB of parathyroid gland and their lesions to determine the role of cytology for the preoperative diagnosis of parathyroid gland and their lesions. Method All cases of FNAB of parathyroid gland and lesions in the last 10 years were reviewed in detail with respect to clinical history and correlated with the histopathologic findings in available cases. The cytologic parameters that were evaluated included cellularity assessed semiquantitatively as scant, intermediate or abundant (<50, 51–500 or >500 cells), cellular distribution (loose clusters, single cells/naked nuclei, rounded clusters, two- and three-dimensional clusters, and presence of prominent vascular proliferation), cellular characteristics (cell size, nuclear shape, presence/absence of a nucleolus, degree of mitosis, amount of cytoplasm, and appearance of nuclear chromatin), and background (colloid-like material and macrophages). Immunostaining for parathyroid hormone (PTH) was performed on selected cases using either destained Pap smears or cell block sections. Results Twenty cases of US-guided FNAB of parathyroid glands and their lesions including 13 in the expected locations in the neck, 3 in intrathyroid region, 3 in thyroid bed, and 1 metastatic to liver were studied. Majority of the cases showed intermediate cellularity (51–500 cells) with round to oval cells that exhibited a stippled nuclear chromatin, without significant pleomorphism or mitotic activity. The cells were arranged in loose two dimensional groups with many single cells/naked nuclei around the groups. Occasionally macrophages and colloid like material was also encountered. There was no significant difference in the cytomorphologic features between normal gland, hyperplasia adenoma, or carcinoma

  17. Cytological diagnosis of metastatic malignant melanoma by fine-needle aspiration biopsy.

    PubMed

    Lindsey, Kathryn G; Ingram, Courtney; Bergeron, Joseph; Yang, Jack

    2016-07-01

    Despite increased surveillance and public awareness, the incidence of melanoma is increasing. Frequently, fine-needle aspiration is employed for the diagnosis of metastatic disease, and aspirated material is used for cytogenetic and molecular studies to guide treatment options. The pairing of a significant diagnosis with the numerous morphologic variants of melanoma can make the cytologic evaluation disquieting. We present selected examples of our experiences and a brief review of the literature to provide cytodiagnostic clues for this malignancy. The clinical history is foremost, although the fine-needle aspiration (FNA) of metastatic melanoma can provide a diagnosis before identification of the primary lesion in up to 20% of cases. If a history of melanoma is assured, negative results in sampling of pulmonary and subcutaneous nodules should be suspected as false negatives. The smearing pattern usually features poorly cohesive cells. Frankly malignant, spindled, and epithelioid cell shapes are most common, and cytoplasmic vacuoles, if sought on Romanowsky-stained specimens, can usually be found. The telltale feature of melanin production, although diagnostic, is only present in 50% of cases. Finally, eccentric placement of nuclei, nucleoli, and nuclear pseudoinclusions are accessory features for the cytologic interpretation of melanoma. Numerous morphologic patterns of melanoma are potentially seen, but a stepwise approach to diagnosis usually produces a successful result. PMID:27199077

  18. Diagnostic value of fine needle aspiration biopsy in non-thyroidal head and neck lesions: a retrospective study of 866 aspiration materials

    PubMed Central

    Göret, Ceren Canbey; Göret, Nuri Emrah; Özdemir, Zeynep Tuğba; Özkan, Esra Akyüz; Doğan, Meryem; Yanık, Serdar; Gümrükçü, Gülistan; Aker, Figen Vardar

    2015-01-01

    Aim: We aimed to investigate the diagnostic value of fine needle aspiration biopsy (FNAB) and compared our FNAB results of non-thyroidal head and neck lesions with excisional biopsy results. Materials and methods: A total of 866 aspiration material taken from different parts of head and neck region out of thyroid were evaluated at Haydarpasa Numune Training and Research Hospital Pathology Laboratory, between January 2002 and May 2013 and 248 of which has histopathologic response were included in the study. Patients depending on origin of the masses were divided into three categories as; salivary gland, lymph nodes and soft tissue/cystic lesions. The sensitivity, specificity, diagnostic accuracy values of fine needle aspiration biopsies have been investigated for all the series and individually for each category. Findings: Diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive values of non-thyroidal head and neck masses were respectively; For all of the series; 94.6%, 97.9%, 96.7%, 95.9%, 97.2%, Salivary gland: 88.9%, 100%, 98.8%, 100%, 98.7%, Lymph nodes: 94.7%, 89.3%, 92.9%, 94.7%, 89.2%, Soft tissue/cystic lesions: 100%, 100%, 100%, 100%, 100%. For all of the series; there were 4 false negative (FN) cases; and 3 false positive (FP) cases. Conclusion: FNAB in the diagnosis of head and neck masses; it is an easy, cheap and usefull procedure. PMID:26464615

  19. Large needle aspiration biopsy and galectin-3 determination in selected thyroid nodules with indeterminate FNA-cytology

    PubMed Central

    Carpi, A; Naccarato, A G; Iervasi, G; Nicolini, A; Bevilacqua, G; Viacava, P; Collecchi, P; Lavra, L; Marchetti, C; Sciacchitano, S; Bartolazzi, A

    2006-01-01

    Thyroid fine-needle aspiration biopsy (FNA)-cytology is widely used for the preoperative characterisation of thyroid nodules but this task is difficult for follicular lesions, which often remain undefined. We propose a strategy for improving the preoperative characterisation of selected follicular thyroid proliferations, which is based on large needle aspiration biopsy (LNAB) and galectin-3 expression analysis. Eighty-five thyroid specimens were obtained by LNAB (20-gauge needles) from thyroid nodules with indeterminate follicular FNA-cytology. Aspirated material was processed as a tissue microbiopsy to obtain cell blocks for both cyto/histo-morphological evaluation and galectin-3 expression analysis, by using a purified monoclonal antibody to galectin-3 and a biotin-free immunoperoxidase staining method. Preoperative diagnosis was compared to the final histology. LNAB and cell-block technique allow a preliminary distinction between nodules with a homogeneous microfollicular/trabecular structure, as frequently observed in tumours, and lesions with mixed normo–micro–macrofollicular architecture, as observed in goitre. Furthermore, LNAB provides optimal substrates for galectin-3 expression analysis. Among 85 cases tested, 14 galectin-3-positive cases were discovered preoperatively (11 thyroid cancers and three adenomas confirmed at the final histology), whereas galectin-3-negative cases were 71 (one carcinoma and 70 benign proliferations at the final histology). Sensitivity, specificity and diagnostic accuracy of this integrated morphologic and phenotypic diagnostic approach were 91.6, 97.2 and 95.3%, respectively. In conclusion, LNAB plus galectin-3 expression analysis when applied preoperatively to selected thyroid nodules candidate to surgery can potentially reduce unnecessary thyroid resections. PMID:16804521

  20. CT-Guided Percutaneous Fine-Needle Aspiration Biopsy of the Inferior Vena Cava Wall: A Posterior Coaxial Approach

    SciTech Connect

    Kos, Sebastian Bilecen, Deniz; Baumhoer, Daniel; Guillaume, Nicolas; Jacob, Augustinus L.

    2010-02-15

    A 72-year-old man was referred to our department with an incidentally diagnosed bronchogenic carcinoma of the right upper lobe. Positron emission tomography (PET) combined with computed tomography (PET-CT) revealed an unexpected hot spot in the ventral wall of the infrarenal segment of the inferior vena cava (IVC). Diagnostic biopsy of this lesion was performed under CT guidance with semiautomated 20G fine-needle aspiration (FNA) through a 19G coaxial needle. Cytology revealed few carcinoma cells, which led to the remarkable diagnosis of a distant metastasis to the IVC wall. Both the immediate postinterventional CT control and the further surveillance period of the patient were unremarkable; in particular, no signs of bleeding complications were detected. We conclude that coaxial FNA of an IVC wall lesion is technically feasible and may even help diagnose distant metastasis.

  1. The role of fine needle aspiration cytology and core biopsy in the diagnosis of palpable breast masses

    PubMed Central

    Kocaay, Akin Firat; Celik, Suleyman Utku; Sevim, Yusuf; Ozyazici, Sefa; Cetinkaya, Omer Arda; Alic, Kamil Bulent

    2016-01-01

    Background: The modern approach to palpable breast masses is to get cytopathologic diagnosis before definitive surgery. We aimed to compare fine needle aspiration cytology (FNAC) with core biopsy in histopathologic diagnosis of palpable breast masses. Materials and Methods: Data were collected on 123 women who have suspicious palpable breast masses from 2007 to 2010. Results: Of the 123 patients, core biopsies were performed on 64 patients (Group 1) and FNAC on 59 patients (Group 2). Malignancy was confirmed in 25 out of 32 clinically suspicious patients in Group 1 (78.1%), and 20 out of 21 participants in Group 2 (95.2%). Among the clinically suspicious patients, 81.8% of 33 patients in Group 1, and 90.3% of 31 patients in Group 2 were identified malignancy. Sensitivity was 100% for core biopsy and 95% for FNAC. Specificity was 100% in both procedures. False negativity rate in FNAC were 5%. Conclusion: Sensitivity and specificity showed that in the case of true histopathologic classification, core biopsy is superior to FNAC. Nevertheless, FNAC's role as a fast, simple and cheap diagnosis cannot be ignored. It is an effective diagnostic tool in most patients, in comparison to the correct and specific typing of core biopsies in benign lesions which protect patients from the open biopsy.

  2. Fine needle aspiration biopsy of metastatic malignant mesothelioma with myxoid change and signet ring cells: A case report and review of the literature.

    PubMed

    Mishra, Manisha M; Farver, Carol F; Chute, Deborah J

    2016-01-01

    Malignant mesothelioma (MM) is a rare neoplasm, which is most commonly encountered in cytology through effusion specimens. Fine needle aspiration biopsy of MM, particularly the epithelioid subtype, can be a source of diagnostic difficulty and may mimic sampling of an adenocarcinoma. This is the first case report to demonstrate abundant extracellular myxoid material and numerous intracellular vacuoles, including signet ring cells, in a fine needle aspirate of metastatic MM. A review of the literature for myxoid change and vacuoles in fine needle aspiration biopsies of MM discloses that vacuoles are found in up to 35% of aspirates of MM, but myxoid change is very rare, reported in <5% of the cases. Cytologists should be aware of this rare morphologic pattern of metastatic epithelioid MM. PMID:27014364

  3. Establishing an accurate diagnosis of a parotid lump: evaluation of the current biopsy methods - fine needle aspiration cytology, ultrasound-guided core biopsy, and intraoperative frozen section.

    PubMed

    Howlett, D C; Skelton, E; Moody, A B

    2015-09-01

    The optimum technique for histological confirmation of the nature of a parotid mass remains controversial. Fine needle aspiration cytology (FNAC), which has traditionally been used, is associated with high non-diagnostic and false negative rates, and ultrasound (US)-guided core biopsy and frozen section have been explored as alternatives. US-guided core biopsy is more invasive than FNAC, but is safe, well-tolerated, and associated with improved diagnostic performance. Although frozen section offers better specificity than FNAC, it has a number of important drawbacks and cannot be considered as a primary diagnostic tool. US-guided core biopsy should be considered as the initial diagnostic technique of choice, and in units where the accuracy of FNAC is good it can be used when FNAC is equivocal or non-diagnostic. PMID:25886878

  4. Needle biopsy of the breast.

    PubMed

    Millis, R R

    1984-01-01

    Recently, there has been a considerable increase in the use of both fine-needle aspiration biopsy (aspiration cytology) and tissue-core needle biopsy of the breast. In patients with suspected breast cancer, needle biopsy is frequently used to confirm the diagnosis before treatment is planned. This allows a more thoughtful approach to the patient and full screening for possible metastatic disease prior to definitive surgery. Needle biopsy techniques are simple, rapid, can be performed in the doctor's office, and save time, equipment, and hospital beds. Complications are few. Aspiration cytology has the advantage that it is quick to perform, the preparation can be examined almost immediately and, in the event of an unsatisfactory smear, the procedure can be repeated. However, the diagnosis is based on purely cytological evaluation, and the information obtained is somewhat limited. Reported accuracy rates range from 42 to 96%. False positive reports are rare but have occurred in most centers, and a high degree of accuracy will only be obtained by experienced practitioners. Tissue-core needle biopsy has the advantage that the diagnosis is based on histopathological assessment, but the procedure is slightly more time consuming, is more traumatic for the patient, and the equipment is more expensive. Accuracy rates range from 67 to 98.5%. During the past 4 years, 329 tissue-core (Tru-Cut) biopsies have been performed in the Guy's Hospital Breast Unit, with an accuracy rate of 83% in the diagnosis of carcinoma. The procedure has been acceptable to most patients, and complications have been minimal. Studies comparing the use of aspiration cytology and tissue-core needle biopsy in the diagnosis of mammary carcinoma have produced variable results. Both methods have advantages and disadvantages, and the choice of technique must depend on the clinical situation and the preferences and skills of the practitioners involved in the management of the patient. PMID:6377049

  5. Assessment of Factors Affecting the Usefulness and Diagnostic Yield of Core Biopsy Needles with a Side Hole in Endoscopic Ultrasound-Guided Fine-Needle Aspiration

    PubMed Central

    Inoue, Tadahisa; Okumura, Fumihiro; Mizushima, Takashi; Nishie, Hirotada; Iwasaki, Hiroyasu; Anbe, Kaiki; Ozeki, Takanori; Kachi, Kenta; Fukusada, Shigeki; Suzuki, Yuta; Sano, Hitoshi

    2016-01-01

    Background/Aims A barbed puncture needle with a side hole was recently developed to improve sample quality and quantity in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). In this study, we retrospectively assessed the usefulness of this puncture needle. Methods Factors affecting diagnostic yield, safety, and diagnostic accuracy were investigated in 76 patients who consecutively underwent EUS-FNA for neoplastic lesions at our hospital between January and December 2013. Results The procedure was successful in all cases; the rates of sample collection and determination of the correct diagnosis were 92.1% and 89.5%, respectively. The mean number of needle passes required for diagnosis was 1.1. Complications included mild intraluminal bleeding in two patients (2.6%). Multivariate analysis revealed that lesion size (≤20 mm) was significantly associated with a decreased chance of determining the correct diagnosis. Conclusions Core biopsy needles with a side hole are safe and provide a satisfactory diagnostic yield. However, the side hole may potentially reduce the rate of making the correct diagnosis in small lesions. PMID:25963081

  6. Fine needle aspiration biopsy of the liver: Algorithmic approach and current issues in the diagnosis of hepatocellular carcinoma

    PubMed Central

    Wee, Aileen

    2005-01-01

    The role of fine needle aspiration biopsy (FNAB) in the evaluation of focal liver lesions has evolved. Guided FNAB is still useful to procure a tissue diagnosis if clinical, biochemical and radiologic findings are inconclusive. Major diagnostic issues include: (i) Distinction of benign hepatocellular nodular lesions from reactive hepatocytes, (ii) Distinction of well-differentiated hepatocellular carcinoma (WD-HCC) from benign hepatocellular nodular lesions, (iii) Distinction of poorly differentiated HCC from cholangiocarcinoma and metastatic carcinomas, (iv) Determination of histogenesis of malignant tumor, and (v) Determination of primary site of origin of malignant tumor. This review gives a general overview of hepatic FNAB; outlines an algorithmic approach to cytodiagnosis with emphasis on HCC, its variants and their mimics; and addresses current diagnostic issues. Close radiologic surveillance of high-risk cirrhotic patients has resulted in the increasing detection of smaller lesions with many subjected to biopsy for tissue characterization. The need for tissue confirmation in clinically obvious HCC is questioned due to risk of malignant seeding. When a biopsy is indicated, core needle biopsy is favored over FNAB. The inherent difficulty of distinguishing small/early HCC from benign hepatocellular nodular lesions has resulted in indeterminate reports. Changing concepts in the understanding of the biological behavior and morphologic evolution of HCC and its precursors; and the current lack of agreement on the morphologic criteria for distinguishing high-grade dysplastic lesions (with small cell change) from WD-HCC, have profound impact on nomenclature, cytohistologic interpretation and management. Optimization of hepatic FNAB to enhance the yield and accuracy of diagnoses requires close clinicopathologic correlation; combined cytohistologic approach; judicious use of ancillary tests; and skilled healthcare teams. PMID:15941489

  7. Peripancreatic Tuberculous Lymphadenitis with Biliary Obstruction Diagnosed by Endoscopic Ultrasound-guided Fine-needle Aspiration Biopsy.

    PubMed

    Yamada, Reiko; Inoue, Hiroyuki; Yoshizawa, Naohiko; Kitade, Takashi; Tano, Shunsuke; Sakuno, Takashi; Harada, Tetsuro; Nakamura, Misaki; Katsurahara, Masaki; Hamada, Yasuhiko; Tanaka, Kyosuke; Horiki, Noriyuki; Takei, Yoshiyuki

    2016-01-01

    A 57-year-old man with a history of tuberculosis (TB) was found to have a pancreatic head mass, accompanied by stenosis of the common bile duct. Due to the inherent difficulty in differentiating pancreatic carcinoma from an inflammatory mass, endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) was thus performed. The pathological findings confirmed granuloma with caseous necrosis, and the results of the QuantiFERON TB2G test were positive. Accordingly, the patient was diagnosed with peripancreatic TB and thereafter was successfully treated with anti-TB therapy. Based on the findings of this case, we conclude that EUS-FNAB is a useful modality for the diagnosis of pancreatic TB. PMID:27086805

  8. Diagnosis and typing of systemic amyloidosis: The role of abdominal fat pad fine needle aspiration biopsy

    PubMed Central

    Halloush, Ruba A; Lavrovskaya, Elena; Mody, Dina R; Lager, Donna

    2009-01-01

    Introduction: Systemic amyloidosis (SA) has a broad nonspecific clinical presentation. Its diagnosis depends on identifying amyloid in tissues. Abdominal fat pad fine needle aspiration (FPFNA) has been suggested as a sensitive and specific test for diagnosing SA. Materials and Methods: Thirty-nine FPFNA from 38 patients (16 women and 20 men, age range 40–88 years) during a 15-year period were reviewed. Smears and cell blocks were stained with Congo red (CR). A panel of antibodies (serum amyloid protein, serum amyloid A, albumin, transthyretin, kappa light chain and lambda light chain) was used on six cell blocks from five patients. The FNA findings were correlated with clinical and histological follow-up. Results: FPFNAs were positive, confirmed by CR in 5/39 (13%), suspicious in 1/39 (3%), negative in 28/39 (72%), and insufficient for diagnosis in 5/39 (13%) of cases. In all the positive cases, SA was confirmed within 2–16 weeks. Among the 28 negative cases, SA was diagnosed in 21, the rest were lost to follow-up. Among the insufficient cases, SA was diagnosed in four and one was lost to follow-up. Specificity was 100%, whereas sensitivity was 19%. SA typing using cell block sections was successful in three, un-interpretable in one, and negative in two cases. Conclusion: FPFNA for SA is not as good as previously reported. This may be due to different practice setting, level of experience, diagnostic technique, or absence of abdominal soft tissue involvement. A negative result of FPFNA does not exclude SA. Immune phenotyping of amyloid is possible on cell block. PMID:20165547

  9. Thyroid Paraganglioma Diagnosed by Fine-Needle Aspiration Biopsy, Correlated With Histopathological Findings: Report of a Case.

    PubMed

    Çetin, Şenay; Kir, Gözde; Yilmaz, Müberra

    2016-07-01

    Thyroid paragangliomas are rare neuroendocrine tumors. They are difficult to diagnosis by fine-needle aspiration biopsy (FNAB) and can be misdiagnosed as other types of thyroid disease. Here, we present an unusual case of primary thyroid paraganglioma diagnosed by FNAB. A 66-year-old woman presented with multinodular goiter. Ultrasound (US)-guided FNAB of the 3 cm nodule in the superior portion of the right lobe of the thyroid was performed. The cytological smears showed single cells or loose clusters of round to ovoid cells with oval granular nuclei. To differentiate between thyroid paraganglioma and other thyroid neoplasms, cell block material from the FNAB specimen was immunohistochemically stained with antibodies to thyroglobulin, calcitonin (CT), AE1-AE3, carcinoembryonic antigen (CEA), synaptophysin, chromogranin A (CH-A), neuron-specific enolase (NSE), thyroid transcription factor-1 (TTF-1), parathyroid hormone (PTH), and S-100. Immunohistochemical staining was positive for synaptophysin, CH-A, NSE, and S-100, and negative for thyroglobulin, CT, AE1-AE3, PTH, CEA, and TTF-1. Congo red staining was also negative. Paraganglioma and other neuroendocrine neoplasms were considered in the differential diagnosis. A total thyroidectomy was performed, and a final diagnosis of paraganglioma was made. Paraganglioma is a rare neuroendocrine tumor of the thyroid and should be considered in the differential diagnosis based on cytology of thyroid neuroendocrine tumors. Immunohistochemistry should be performed when making a diagnosis of thyroid paraganglioma, particularly when evaluating fine-needle aspiration smears. Diagn. Cytopathol. 2016;44:643-647. © 2016 Wiley Periodicals, Inc. PMID:27162199

  10. Evaluation of fine needle aspiration biopsy in oral cavity and head and neck region with different stains techniques.

    PubMed

    Santos, Ana Paula Candido dos; Sugaya, Norberto Nobuo; Pinto, Décio dos Santos; Lemos, Celso Augusto

    2015-01-01

    The present study aimed to evaluate the Fine Needle Aspiration Biopsy in different staining techniques in nodular lesions of the oral cavity and head and neck region, as their sensitivity, specificity and accuracy, staining with Panoptic, Papanicolaou and Hematoxylin-Eosin (H&E) stains. 46 patients who sought the Clinic of the Discipline of Clinical Stomatology at FOUSP were selected consecutively, with nodular lesions in the oral cavity and head and neck region. The material obtained by FNAB was sent on 6 different slides, stained by the method of Panoptic, Papanicolaou and H&E, to the same pathologist only with the clinical diagnosis. After the final report of FNAB, the biopsy report was issued, serving as gold standard. After the calculations, the results of sensitivity, specificity and accuracy for Panoptic staining were 28.6%, 76% and 15.4%, respectively. The result of sensitivity, specificity and accuracy for Papanicolaou staining were 71.4%, 76.7% and 23.3%, respectively. The result of sensitivity, specificity and accuracy for H&E staining were 82.1%, 23.3%, 28.6%, respectively. We can conclude, according to the methodology of this study that, H&E and Papanicolaou stains showed the same sensitivity of diagnosing malignant neoplasms. H&E stain showed a better specificity for diagnosing benign neoplasms, compared with Papanicolaou and Panoptic stains. H&E stain showed better accuracy, to give definitive diagnosis, followed by Papanicolaou and Panoptic stains. PMID:26083094

  11. Fine needle Aspiration Biopsy (FNAB) in the initial evaluation and diagnosis of palpable soft tissue lesions and with histologic correlation

    PubMed Central

    Ogun, Gabriel Olabiyi

    2015-01-01

    Introduction Fine-needle aspiration biopsy (FNAB) as a means of evaluation of palpable soft tissue lesions is poorly utilized in our environment despite the fact that it safe, cheap, quick and easy to perform. Methods All cases of cases of palpable soft tissue lesions of the trunk and extremities where FNAB was used as the initial evaluation tool were reviewed. Furthermore, the records for corresponding cases that had open excision biopsy and ultimately had histologic diagnosis out of these cases were also retrieved and correlated with the final diagnosis from FNAB. Results Out of 142 aspirates, only 107(75.3% of cases) fulfilled the inclusion criteria for the study. The age range was from 0-85 years (mean = 41.2 yrs.) with a roughly equal male:female ratio. The lesions were located in the trunk -56 cases, upper arm -7, forearm -1, hand -1, thigh -28, leg -7 and the foot-7. The FNAB was diagnosed as benign in 56 (52.3%) cases, malignant in 48 (44.8%) cases and suspicious of malignancy in 3(2.8%) cases. The cases were cytomorphologically classified into the following categories: Lipomatous (32 cases), epithelia (18), spindle cell (14), inflammatory (13) pleomorphic (11), small round (6), myxoid (5), epitheloid/ polygonal (1) and others (7). The sensitivity and specificity of diagnosed cases with FNAB as either benign or malignant when correlated with histology were 95% and 100% respectively. Conclusion FNAB is a valuable tool in the initial evaluation of palpable soft tissue lesions especially in primary soft tissue neoplasms and clinically suspected metastatic carcinomas. PMID:26090002

  12. Thyroid Fine Needle Aspiration Biopsies in Children: Study of Cytological-Histological Correlation and Immunostaining with Thyroid Peroxidase Monoclonal Antibodies

    PubMed Central

    Hoperia, Victoria; Larin, Alexander; Jensen, Kirk; Bauer, Andrew; Vasko, Vasily

    2010-01-01

    Context. There is limited data comparing results of fine needle aspiration biopsies (FNABs) to histological diagnosis in children. Design. FNABs were performed in 707 children and cytological results were compared to histology in 165 cases. The usefulness of immunostaining with anti-TPO monoclonal antibodies (MoAb47) on FNAB samples was examined in 54 operated patients. Results. Among unsatisfactory, benign, suspicious, and malignant FNAB, the histological diagnoses were benign in 12/12 (100%), 69/70 (98.5%), 40/50 (80.0%), and 0/33 (0%), respectively. After surgery, malignancy was established in 44/165 (26.6%) cases. The sensitivity, specificity, and positive and negative predictive values were 95.4%, 55.8%, 61.7%, and 95% with standard FNAB; and 100%, 75%, 73.3, and 100% with MoAb47. Among suspicious FNAB, positive MoAb47 staining was a reliable marker for exclusion of malignancy. Conclusion. Benign and malignant FNAB accurately predict histological diagnosis. In suspicious FNAB, MoAb47 immunostaining may be a useful adjunct to standard cytology. PMID:20652042

  13. The Reliability of Fine-Needle Aspiration Biopsy in Terms of Malignancy in Patients With Hashimoto Thyroiditis

    PubMed Central

    Kapan, Murat; Onder, Akin; Girgin, Sadullah; Ulger, Burak Veli; Firat, Ugur; Uslukaya, Omer; Oguz, Abdullah

    2015-01-01

    The aim of this study was to analyze the presence of malignancy in patients with Hashimoto's thyroiditis and to investigate the reliability of preoperative fine-needle aspiration biopsy (FNAB). The retrospective study included 44 patients who were operated on for nodular goiter between December 2010 and October 2011. The patients underwent thyroidectomy following a cytologic analysis plus FNAB. Hashimoto's thyroiditis was confirmed on histopathology in all patients. FNAB results were defined as benign in 14 (31.8%), suspicion for malignancy in 17 (38.6%), malignant in 9 (20.5%), and inadequate in 4 (9.1%). Following the thyroidectomy, presence of papillary thyroid carcinoma and follicular variant of papillary thyroid carcinoma were detected in 10 patients (22.7%) and 1 (2.3%) patient, respectively. The FNAB results were interpreted in terms of malignancy, which revealed the sensitivity as 80%; specificity, 40%; false positives, 69.2%; false negatives, 14.3%; positive predictive value, 31.8%; negative predictive value, 85.7%; and diagnostic accuracy, 50%. The coexistence of Hashimoto's thyroiditis with papillary thyroid carcinoma is quite common. The FNAB results for such cases are hard to evaluate, and they are likely to increase the number of false positives. PMID:25692426

  14. Aspiration and Biopsy: Bone Marrow

    MedlinePlus

    ... Help a Friend Who Cuts? Aspiration and Biopsy: Bone Marrow KidsHealth > For Teens > Aspiration and Biopsy: Bone Marrow Print A A A Text Size What's in ... Risks If You Have Questions What It Is Bone marrow aspirations and biopsies are performed to examine bone ...

  15. Endoscopic ultrasound-guided fine-needle aspiration with on-site cytopathology versus core biopsy: a comparison of both techniques performed at the same endoscopic session

    PubMed Central

    Lin, Michael; Hair, Clark D.; Green, Linda K.; Vela, Stacie A.; Patel, Kalpesh K.; Qureshi, Waqar A.; Shaib, Yasser H.

    2014-01-01

    Background: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) with bedside cytopathology is the gold standard for assessment of pancreatic, subepithelial, and other lesions in close proximity to the gastrointestinal tract, but it is time-consuming, has certain diagnostic limitations, and bedside cytopathology is not widely available. Aims: The goal of this study is to compare the diagnostic yield of EUS-guided FNA with on-site cytopathology and EUS-guided core biopsy. Methods: Twenty-six patients with gastrointestinal mass lesions requiring biopsy at a tertiary medical center were included in this retrospective analysis of a prospective cohort. Two core biopsies were taken using a 22 gauge needle followed by FNA guided by a bedside cytopathologist at the same endoscopic session. The diagnostic yield and test characteristics of EUS core biopsy and EUS FNA with bedside cytopathology were examined. Results: The mean number of passes was 3.2 for FNA, and the mean procedure time was 39.4 minutes. The final diagnosis was malignant in 92.3 %. Sensitivity and specificity were 83 % and 100 %, respectively, for FNA, and 91.7 % and 100 %, respectively, for core biopsy. Diagnostic accuracy was 92.3 % for FNA and 84.6 % for core biopsy. The two approaches were in agreement in 88.4 % with a kappa statistic of 0.66 (95 % confidence interval 0.33 – 0.99). Conclusions: An approach using two passes with a core biopsy needle is comparable to the current gold standard of FNA with bedside cytopathology. The performance of two core biopsies is time-efficient and could represent a good alternative to FNA with bedside cytopathology. PMID:26135096

  16. Navigational transbronchial needle aspiration, percutaneous needle aspiration and its future.

    PubMed

    Arias, Sixto; Yarmus, Lonny; Argento, A Christine

    2015-12-01

    Peripheral lung nodule evaluation represents a clinical challenge. Given that many nodules will be incidentally found with lung cancer screening following the publication of the National Lung Screening Trial (NLST), the goal is to find an accurate, safe and minimally-invasive diagnostic modality to biopsy the concerning lesions. Unfortunately, conventional bronchoscopic techniques provide a poor diagnostic yield of 18-62%. In recent years advances in technology have led to the introduction of electromagnetic navigational bronchoscopy (ENB) as a tool to guide sampling of peripheral lung nodules. The same principle has also recently been expanded and applied to the transthoracic needle biopsy, referred to as electromagnetic transthoracic needle aspiration (E-TTNA). An improved diagnostic yield has afforded this technology a recommendation by the 2013 3(rd) Edition ACCP Guidelines for the Diagnosis and Management of Lung Cancer which state that "in patients with peripheral lung lesions difficult to reach with conventional bronchoscopy, ENB is recommended if the equipment and the expertise are available (Grade 1C)". In this review we will discuss the technology, devices that are available, techniques and protocols, diagnostic yield, safety, cost effectiveness and more. PMID:26807280

  17. Navigational transbronchial needle aspiration, percutaneous needle aspiration and its future

    PubMed Central

    Arias, Sixto; Yarmus, Lonny

    2015-01-01

    Peripheral lung nodule evaluation represents a clinical challenge. Given that many nodules will be incidentally found with lung cancer screening following the publication of the National Lung Screening Trial (NLST), the goal is to find an accurate, safe and minimally-invasive diagnostic modality to biopsy the concerning lesions. Unfortunately, conventional bronchoscopic techniques provide a poor diagnostic yield of 18–62%. In recent years advances in technology have led to the introduction of electromagnetic navigational bronchoscopy (ENB) as a tool to guide sampling of peripheral lung nodules. The same principle has also recently been expanded and applied to the transthoracic needle biopsy, referred to as electromagnetic transthoracic needle aspiration (E-TTNA). An improved diagnostic yield has afforded this technology a recommendation by the 2013 3rd Edition ACCP Guidelines for the Diagnosis and Management of Lung Cancer which state that “in patients with peripheral lung lesions difficult to reach with conventional bronchoscopy, ENB is recommended if the equipment and the expertise are available (Grade 1C)”. In this review we will discuss the technology, devices that are available, techniques and protocols, diagnostic yield, safety, cost effectiveness and more. PMID:26807280

  18. Expert system support using Bayesian belief networks in the diagnosis of fine needle aspiration biopsy specimens of the breast.

    PubMed Central

    Hamilton, P W; Anderson, N; Bartels, P H; Thompson, D

    1994-01-01

    AIM--To develop an expert system model for the diagnosis of fine needle aspiration cytology (FNAC) of the breast. METHODS--Knowledge and uncertainty were represented in the form of a Bayesian belief network which permitted the combination of diagnostic evidence in a cumulative manner and provided a final probability for the possible diagnostic outcomes. The network comprised 10 cytological features (evidence nodes), each independently linked to the diagnosis (decision node) by a conditional probability matrix. The system was designed to be interactive in that the cytopathologist entered evidence into the network in the form of likelihood ratios for the outcomes at each evidence node. RESULTS--The efficiency of the network was tested on a series of 40 breast FNAC specimens. The highest diagnostic probability provided by the network agreed with the cytopathologists' diagnosis in 100% of cases for the assessment of discrete, benign, and malignant aspirates. Atypical probably benign cases were given probabilities in favour of a benign diagnosis. Suspicious cases tended to have similar probabilities for both diagnostic outcomes and so, correctly, could not be assigned as benign or malignant. A closer examination of cumulative belief graphs for the diagnostic sequence of each case provided insight into the diagnostic process, and quantitative data which improved the identification of suspicious cases. CONCLUSION--The further development of such a system will have three important roles in breast cytodiagnosis: (1) to aid the cytologist in making a more consistent and objective diagnosis; (2) to provide a teaching tool on breast cytological diagnosis for the non-expert; and (3) it is the first stage in the development of a system capable of automated diagnosis through the use of expert system machine vision. PMID:8027370

  19. Fine needle aspiration cytology of gastric carcinoma.

    PubMed Central

    Allen, D. C.; Irwin, S. T.

    1997-01-01

    Four patients between 58 and 81 years of age undergoing investigation and endoscopic biopsy for gastric carcinoma also were subjected to direct-vision fine needle aspiration cytology of their mucosal lesions which yielded malignant cells. The relevance of this technique is discussed regarding both intrinsic and extrinsic lesions of the gastrointestinal tract. Images Fig 1. (a) Fig 1. (b) Fig 2. (a) Fig 2. (b) PMID:9414941

  20. Recurrence of renal cell carcinoma diagnosed using contralateral adrenal biopsy with endoscopic ultrasound-guided fine-needle aspiration

    PubMed Central

    TANIMOTO, AZUSA; TAKEUCHI, SHINJI; YAEGASHI, HIROSHI; KOTANI, HIROSHI; KITAI, HIDENORI; NANJO, SHIGEKI; EBI, HIROMICHI; YAMASHITA, KANAME; MOURI, HISATSUGU; OHTSUBO, KOUSHIRO; IKEDA, HIROKO; YANO, SEIJI

    2016-01-01

    A 76-year-old female in whom a renal cell carcinoma (RCC) lesion was resected 19 years previously presented to our hospital with cognitive dysfunction. Magnetic resonance imaging and computed tomography revealed nodules in the brain, lung, adrenal gland and a pelvic osteolytic lesion. To identify the primary cancer site, the present study performed endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of the left adrenal lesion. Consequently, the pathological findings of the tissue obtained by EUS-FNA were similar to those of the previous nephrectomy specimen, revealing that the adrenal lesion was the recurrence of RCC. The majority of the metastatic lesions in the patient were reduced in size by the multiple kinase inhibitor, pazopanib. Contralateral adrenal metastasis of RCC is rare and the use of EUS-FNA in the diagnosis of adrenal lesions remains to be elucidated. This is a rare case of adrenal lesion, diagnosed by EUS-FNA. Therefore, EUS-FNA is considered to be a useful diagnostic modality of adrenal metastases from unidentified primary tumor types. PMID:27073657

  1. Postbrushing and fine-needle aspiration biopsy follow-up and treatment options for patients with pancreatobiliary lesions: the Papanicolaou Society of Cytopathology guidelines.

    PubMed

    Kurtycz, Daniel; Tabatabai, Z Laura; Michaels, Claire; Young, Nancy; Schmidt, C Max; Farrell, James; Gopal, Deepak; Simeone, Diane; Merchant, Nipun B; Field, Andrew; Pitman, Martha Bishop

    2014-04-01

    The papanicolaou society of cytopathology (PSC) has developed a set of guidelines for pancreatobiliary cytology including indications for endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) biopsy, techniques of EUS-FNA, terminology and nomenclature for pancreatobiliary cytology, ancillary testing, and postprocedure management. All documents are based on the expertise of the authors, a review of the literature, discussions of the draft document at several national and international meetings over an 18 month period and synthesis of online comments of the draft document on the PSC web site [www.papsociety.org]. This document selectively presents the results of these discussions and focuses on the follow-up and treatment options for patients after procedures performed for obtaining cytology samples for the evaluation of biliary strictures and solid and cystic masses in the pancreas. These recommendations follow the six-tiered terminology and nomenclature scheme proposed by Committee III. PMID:24639399

  2. Fine needle aspiration biopsy of an osteoclast-rich undifferentiated urothelial carcinoma: A cytology case report and review of the literature

    PubMed Central

    Purohit, Chetna N.; Bui, Marilyn M.; Hakam, Ardeshir

    2010-01-01

    Osteoclast-rich undifferentiated carcinoma of urinary bladder (ORUCUB) is a very rare and an unusual variant of high-grade urothelial carcinoma. Here, we report an extraordinary case of metastatic ORUCUB, diagnosed by fine needle aspiration (FNA) biopsy, in a 74-year-old Hispanic male who presented with a palpable, tender left groin mass and a known previous history of high-grade carcinoma of urinary bladder and prostatic cancer. To the best of our knowledge, diagnosis of ORUCUB by FNA is the first case report in FNA cytology to be published to date. A review of the literature is emphasized on the cytological, histological and immunohistochemical features and differential diagnoses of giant cell tumor. PMID:20976205

  3. Predictors of False-Negative Results from Percutaneous Transthoracic Fine-Needle Aspiration Biopsy: An Observational Study from a Retrospective Cohort

    PubMed Central

    Suh, Young Joo; Lee, Jae-hoon; Hong, Sae Rom; Im, Dong Jin; Kim, Yun Jung; Hong, Yoo Jin; Lee, Hye-Jeong; Kim, Young Jin; Choi, Byoung Wook

    2016-01-01

    Purpose We investigated factors predictive of false-negative pulmonary lesions with nonspecific benign cytology results on percutaneous transthoracic fine-needle aspiration biopsy (FNAB). Materials and Methods We included 222 pulmonary lesions that had a nonspecific benign result from percutaneous transthoracic FNAB between March 2005 and December 2012, and were confirmed by subsequent pathologic results or adequate clinical follow up over at least 2 years. Clinical, imaging, and biopsy procedure-related findings were compared between lesions with a final diagnosis of malignancy (false-negative) and lesions with a benign diagnosis (true-negative). Multivariate logistic regression analysis was performed to identify significant predictors of false-negatives. Results Of 222 lesions, 115 lesions were proved to be false-negatives, and 107 were true-negatives. Compared with the true-negatives, false-negative lesions showed significantly older age (p=0.037), higher maximum standardized uptake value (SUVmax) on positron emission tomography (p=0.001), larger lesion size (p=0.007), and lesion characteristics of a subsolid nodule (p=0.007). On multivariate logistic regression analysis, SUVmax, lesion size, and lesion characteristics were significant predictors of false-negative results. Conclusion Among the clinical, radiologic, and procedure-related factors analyzed, high SUVmax, large lesion size, and subsolid lesions were useful for predicting malignancy in pulmonary lesions with nonspecific benign cytology results on FNAB. PMID:27401658

  4. Genomic characterization of patient-derived xenograft models established from fine needle aspirate biopsies of a primary pancreatic ductal adenocarcinoma and from patient-matched metastatic sites

    PubMed Central

    de Abreu, Francine B.; Gardner, Timothy B.; Gordon, Stuart R.; Barth, Richard J.; Colacchio, Thomas A.; Wood, Matthew; Kacsoh, Balint Z.; Bouley, Stephanie J.; Cui, Jingxuan; Hamilton, Joanna; Choi, Jungbin A.; Lange, Joshua T.; Peterson, Jason D.; Padmanabhan, Vijayalakshmi; Tomlinson, Craig R.; Tsongalis, Gregory J.; Suriawinata, Arief A.; Smith, Kerrington D.

    2016-01-01

    N-of-1 trials target actionable mutations, yet such approaches do not test genomically-informed therapies in patient tumor models prior to patient treatment. To address this, we developed patient-derived xenograft (PDX) models from fine needle aspiration (FNA) biopsies (FNA-PDX) obtained from primary pancreatic ductal adenocarcinoma (PDAC) at the time of diagnosis. Here, we characterize PDX models established from one primary and two metastatic sites of one patient. We identified an activating KRAS G12R mutation among other mutations in these models. In explant cells derived from these PDX tumor models with a KRAS G12R mutation, treatment with inhibitors of CDKs (including CDK9) reduced phosphorylation of a marker of CDK9 activity (phospho-RNAPII CTD Ser2/5) and reduced viability/growth of explant cells derived from PDAC PDX models. Similarly, a CDK inhibitor reduced phospho-RNAPII CTD Ser2/5, increased apoptosis, and inhibited tumor growth in FNA-PDX and patient-matched metastatic-PDX models. In summary, PDX models can be constructed from FNA biopsies of PDAC which in turn can enable genomic characterization and identification of potential therapies. PMID:26934555

  5. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

    PubMed Central

    2016-01-01

    Purpose: The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. Methods: This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. Results: The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Conclusion: Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules. PMID:27068131

  6. Pleural needle biopsy

    MedlinePlus

    ... of the pleural membrane. Pleural biopsy can diagnose tuberculosis , cancer, and other diseases. If this type of ... lung cancer , malignant mesothelioma , and metastatic pleural tumor ), tuberculosis, other infections, or collagen vascular disease. Risks There ...

  7. Syringe and Needle Size, Syringe Type, Vacuum Generation, and Needle Control in Aspiration Procedures

    SciTech Connect

    Haseler, Luke J.; Sibbitt, Randy R.; Sibbitt, Wilmer L.; Michael, Adrian A.; Gasparovic, Charles M.; Bankhurst, Arthur D.

    2011-06-15

    Purpose: Syringes are used for diagnostic fluid aspiration and fine-needle aspiration biopsy in interventional procedures. We determined the benefits, disadvantages, and patient safety implications of syringe and needle size on vacuum generation, hand force requirements, biopsy/fluid yield, and needle control during aspiration procedures. Materials and Methods: Different sizes (1, 3, 5, 10, and 20 ml) of the conventional syringe and aspirating mechanical safety syringe, the reciprocating procedure device, were studied. Twenty operators performed aspiration procedures with the following outcomes measured: (1) vacuum (torr), (2) time to vacuum (s), (3) hand force to generate vacuum (torr-cm{sup 2}), (4) operator difficulty during aspiration, (5) biopsy yield (mg), and (6) operator control of the needle tip position (mm). Results: Vacuum increased tissue biopsy yield at all needle diameters (P < 0.002). Twenty-milliliter syringes achieved a vacuum of -517 torr but required far more strength to aspirate, and resulted in significant loss of needle control (P < 0.002). The 10-ml syringe generated only 15% less vacuum (-435 torr) than the 20-ml device and required much less hand strength. The mechanical syringe generated identical vacuum at all syringe sizes with less hand force (P < 0.002) and provided significantly enhanced needle control (P < 0.002). Conclusions: To optimize patient safety and control of the needle, and to maximize fluid and tissue yield during aspiration procedures, a two-handed technique and the smallest syringe size adequate for the procedure should be used. If precise needle control or one-handed operation is required, a mechanical safety syringe should be considered.

  8. Ultrasonographic and non-enhanced CT features of acute transient thyroid swelling following fine-needle aspiration biopsy: report of four cases.

    PubMed

    Yamada, Keiko; Toda, Kazuhisa; Ebina, Aya; Motoi, Noriko; Sugitani, Iwao

    2015-07-01

    We report four cases of acute transient thyroid swelling following fine-needle aspiration biopsy, a rare complication of still unknown origin. The ultrasonographic pattern was fairly similar to that in previous reports: swelling of the thyroid with a patchy and heterogeneous appearance and diffusely scattered hypoechoic "cracks" that showed no blood flow signals with color Doppler ultrasound. There were also some features that differed from those in previous reports. Though thyroid swelling is typically diffuse and bilateral, it was unilateral or asymmetrical in some of our cases. While thyroid swelling is said to resolve spontaneously within 1-20 h, abnormal ultrasonographic findings persisted for more than 48 h in one case. Unlike previous reports, we have experienced cases with ultrasonographic findings of concomitant minor subcapsular hematomas. In one case, CT demonstrated not only thyroid swelling but also abnormal attenuation in perithyroid tissue extending to the retro-hypopharyngeal space and to the paraesophageal mediastinum. Although vasodilatation and diffuse vascular leakage are speculated to be the underlying mechanisms, our ultrasonograms at the time of the complication failed to demonstrate enlarged intrathyroidal vessels or hypervascularity with color Doppler ultrasound. More awareness and a description of the cases may help to clarify the pathogenesis of this self-limited complication. PMID:26576797

  9. Should fine needle aspiration cytology in breast assessment be abandoned?

    PubMed

    Litherland, Janet C

    2002-02-01

    Fine needle aspiration cytology (FNAC) has been used extensively in the U.K. for the diagnosis of breast lesions over the past 15 years. More recently, large gauge needle biopsy has been used to address many of the problems which have been encountered with fine needle aspiration. This paper reviews the evolution of the use of these procedures and the advantages and disadvantages of each. In considering whether to abandon the use of fine needle aspiration cytology in breast assessment, each individual unit should make a decision based upon their own audited results. However, even if FNAC is retained, it is important to be able to complement cytological diagnosis with core biopsy as there are indisputable advantages, e.g. in the diagnosis of mammographically detected microcalcification. As always, a multi-disciplinary approach is ultimately essential for effective patient management. PMID:11977938

  10. Core Needle Biopsy Is a More Conclusive Follow-up Method Than Repeat Fine Needle Aspiration for Thyroid Nodules with Initially Inconclusive Results: A Systematic Review and Meta-Analysis

    PubMed Central

    Pyo, Jung-Soo; Sohn, Jin Hee; Kang, Guhyun

    2016-01-01

    Background: This study investigated the appropriate management of thyroid nodules with prior non-diagnostic or atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) through a systematic review and meta-analysis. Methods: This study included 4,235 thyroid nodules from 26 eligible studies. We investigated the conclusive rate of follow-up core needle biopsy (CNB) or repeat fine needle aspiration (rFNA) after initial fine needle aspiration (FNA) with non-diagnostic or AUS/FLUS results. A diagnostic test accuracy (DTA) review was performed to determine the diagnostic role of the follow-up CNB and to calculate the area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve. Results: The conclusive rates of follow-up CNB and rFNA after initial FNA were 0.879 (95% confidence interval [CI], 0.801 to 0.929) and 0.684 (95% CI, 0.627 to 0.736), respectively. In comparison of the odds ratios of CNB and rFNA, CNB had more frequent conclusive results than rFNA (odds ratio, 5.707; 95% CI, 2.530 to 12.875). Upon subgroup analysis, follow-up CNB showed a higher conclusive rate than rFNA in both initial non-diagnostic and AUS/FLUS subgroups. In DTA review of followup CNB, the pooled sensitivity and specificity were 0.94 (95% CI, 0.88 to 0.97) and 0.88 (95% CI, 0.84 to 0.91), respectively. The AUC for the SROC curve was 0.981, nearing 1. Conclusions: Our results show that CNB has a higher conclusive rate than rFNA when the initial FNA produced inconclusive results. Further prospective studies with more detailed criteria are necessary before follow-up CNB can be applied in daily practice. PMID:27077724

  11. Lung needle biopsy

    MedlinePlus

    ... when there is an abnormal condition near the surface of the lung, in the lung itself, or on the chest wall. Most often, it is done to rule out cancer. The biopsy is usually done after abnormalities appear on a chest x-ray or CT ...

  12. Evaluation of large-needle biopsy for the diagnosis of cancer.

    PubMed

    Roussel, F; Nouvet, G

    1995-01-01

    The arguments for a choice between a large or fine needle in the diagnosis of tumors are still unclear. This paper reviews the advantages and disadvantages of large-needle biopsy and fine needle aspiration. Reports indicate that although the procedures have the same diagnostic efficacy, the risk of tumor seeding is far higher following large-needle biopsy. For this reason it should be avoided for the diagnosis of cancer. The risk of tumor seeding after fine needle aspiration may be reduced by performance through a cover of normal parenchyma, by maintaining suction during withdrawal of the needle and by examining samples for quality during the procedure. PMID:7762331

  13. Percutaneous needle biopsy of the irradiated skeleton

    SciTech Connect

    Edeiken, B.; deSantos, L.A.

    1983-03-01

    Percutaneous needle biopsy was performed in 20 patients who had radiologic abnormalities after irradiation of the skeleton. The biopsies were performed to determine the nature of the bone changes and to differentiate radiation necrosis from metastases or local tumor extension. Eleven patients had tumors, two of which were radiation-induced sarcomas; nine patients did not show evidence of tumor. One patient had osteomyelitis rather than the suspected tumor. The value of percutaneous needle biopsy in the postirradiated skeleton is discussed.

  14. Getting to the point: indications for fine-needle aspiration of internal organs and bone.

    PubMed

    Wypij, Jackie M

    2011-05-01

    The technique of fine-needle biopsy (fine-needle aspiration or fine-needle fenestration) for cytologic evaluation can be extended to many sites beyond the traditional lymph node and skin. Intra-abdominal, intrathoracic, and bone lesions can be easily and rapidly evaluated cytologically. Percutaneous fine-needle aspiration and fine-needle fenestration are useful, accurate, and inexpensive techniques with a rapid turnaround time, and outpatient applicability. For most pets, these minimally invasive techniques do not require anesthesia or analgesia. Although risks are inherent with any invasive procedure, complications are uncommon even with visceral and intrathoracic fine-needle biopsy. Attention to appropriate technique and close patient monitoring minimize the morbidity and improve the diagnostic utility. The low cost, low risk, minimal invasiveness, and high diagnostic yield make fine-needle biopsy particularly attractive to clients. In combination with ultrasound guidance and newer staining techniques, these diagnostic procedures are invaluable to the veterinary clinician. PMID:21596347

  15. Transbronchial needle aspiration with a new electromagnetically-tracked TBNA needle

    NASA Astrophysics Data System (ADS)

    Choi, Jae; Popa, Teo; Gruionu, Lucian

    2009-02-01

    Transbronchial needle aspiration (TBNA) is a common method used to collect tissue for diagnosis of different chest diseases and for staging lung cancer, but the procedure has technical limitations. These limitations are mostly related to the difficulty of accurately placing the biopsy needles into the target mass. Currently, pulmonologists plan TBNA by examining a number of Computed Tomography (CT) scan slices before the operation. Then, they manipulate the bronchoscope down the respiratory track and blindly direct the biopsy. Thus, the biopsy success rate is low. The diagnostic yield of TBNA is approximately 70 percent. To enhance the accuracy of TBNA, we developed a TBNA needle with a tip position that can be electromagnetically tracked. The needle was used to estimate the bronchoscope's tip position and enable the creation of corresponding virtual bronchoscopic images from a preoperative CT scan. The TBNA needle was made with a flexible catheter embedding Wang Transbronchial Histology Needle and a sensor tracked by electromagnetic field generator. We used Aurora system for electromagnetic tracking. We also constructed an image-guided research prototype system incorporating the needle and providing a user-friendly interface to assist the pulmonologist in targeting lesions. To test the feasibility of the accuracy of the newly developed electromagnetically-tracked needle, a phantom study was conducted in the interventional suite at Georgetown University Hospital. Five TBNA simulations with a custom-made phantom with a bronchial tree were performed. The experimental results show that our device has potential to enhance the accuracy of TBNA.

  16. Transbronchial needle aspiration in the staging of bronchogenic carcinoma.

    PubMed

    Benov, E; Michev, K; Kostadinov, D; Vlasov, V

    1996-01-01

    To evaluate the usefulness of transbronchial needle aspiration biopsy (TBNA) for the diagnosis of mediastinal involvement, we have prospectively examined 316 patients with morphologically verified bronchogenic carcinoma. The percentage of positive aspirations (149 of 316) from the three basic lymph node groups in the mediastinum was not significantly different. Tumor cells were aspirated from the mediastinum in 75 of 112 patients with radiologically positive findings and in patients with 74 of 204 radiologically negative findings. Mediastinal involvement was verified even in 61 of 196 patients with a normal endoscopic picture. Metastases were proved in 14 of 39 patients with peripheral versus 135 of 277 patients with central carcinoma. Tumor cells were aspirated in 47 of 76 patients with undifferentiated small cell carcinoma, 92 of 227 patients with squamous cell carcinoma, and 10 of 13 patients with adenocarcinoma. Our results suggest that TBNA being a highly diagnostic and less invasive method, will prove its clinical importance. PMID:18493418

  17. Transbronchial Needle Aspiration in the Staging of Bronchogenic Carcinoma

    PubMed Central

    Benov, Emil; Kostadinov, Dimitar; Vlasov, Vesselin

    1996-01-01

    To evaluate the usefulness of transbronchial needle aspiration biopsy (TBNA) for the diagnosis of mediastinal involvement, we have prospectively examined 316 patients with morphologically verified bronchogenic carcinoma. The percentage of positive aspirations (149 of 316) from the three basic lymph node groups in the mediastinum was not significantly different. Tumor cells were aspirated from the mediastinum in 75 of 112 patients with radiologically positive findings and in patients with 74 of 204 radiologically negative findings. Mediastinal involvement was verified even in 61 of 196 patients with a normal endoscopic picture. Metastases were proved in 14 of 39 patients with peripheral versus 135 of 277 patients with central carcinoma. Tumor cells were aspirated in 47 of 76 patients with undifferentiated small cell carcinoma, 92 of 227 patients with squamous cell carcinoma, and 10 of 13 patients with adenocarcinoma. Our results suggest that TBNA being a highly diagnostic and less invasive method, will prove its clinical importance. PMID:18493418

  18. Fine-needle aspiration by vacuum tubes.

    PubMed

    Holmquist, N D

    1989-07-01

    Fine-needle aspiration of subcutaneous masses, accepted in many parts of Europe and the Americas as a routine diagnostic technique, employs a syringe holder to facilitate the creation of a vacuum to withdraw cells. This investigation demonstrates that a vacuum tube used in venipuncture can be used to supply the negative pressure to suck cells into the needle. This apparatus is more readily available than a syringe holder in hospitals and clinics, and particularly provides the operator with a more dexterous approach to the mass because the fingers holding the needle can be much closer to the mass being immobilized by the other hand. PMID:2750713

  19. Radiofrequency Cauterization with Biopsy Introducer Needle

    PubMed Central

    Pritchard, William F.; Wray-Cahen, Diane; Karanian, John W.; Hilbert, Stephen; Wood, Bradford J.

    2014-01-01

    PURPOSE The principal risks of needle biopsy are hemorrhage and implantation of tumor cells in the needle tract. This study compared hemorrhage after liver and kidney biopsy with and without radiofrequency (RF) ablation of the needle tract. MATERIALS AND METHODS Biopsies of liver and kidney were performed in swine through introducer needles modified to allow RF ablation with the distal 2 cm of the needle. After each biopsy, randomization determined whether the site was to undergo RF ablation during withdrawal of the introducer needle. Temperature was measured with a thermistor stylet near the needle tip, with a target temperature of 70°C–100°C with RF ablation. Blood loss was measured as grams of blood absorbed in gauze at the puncture site for 2 minutes after needle withdrawal. Selected specimens were cut for gross examination. RESULTS RF ablation reduced bleeding compared with absence of RF ablation in liver and kidney (P < .01), with mean blood loss reduced 63% and 97%, respectively. Mean amounts of blood loss (±SD) in the liver in the RF and no-RF groups were 2.03 g ± 4.03 (CI, 0.53–3.54 g) and 5.50 g ± 5.58 (CI, 3.33–7.66 g), respectively. Mean amounts of blood loss in the kidney in the RF and no-RF groups were 0.26 g ± 0.32 (CI, −0.01 to 0.53 g) and 8.79 g ± 7.72 (CI, 2.34–15.24 g), respectively. With RF ablation, thermal coagulation of the tissue surrounding the needle tract was observed. CONCLUSION RF ablation of needle biopsy tracts reduced hemorrhage after biopsy in the liver and kidney and may reduce complications of hemorrhage as well as implantation of tumor cells in the tract. PMID:14963187

  20. Fine Needle Aspiration in Thyroid Nodules - One Year Experience

    PubMed Central

    Ahmeti, Irfan; Simonovska, Lliljana; Krstevska, Branka; Ristevska, Nevena

    2015-01-01

    AIM: To estimate suspect nodule for benign or malignant characteristics, and to verify cytological features of the node with the fine needle aspiration (FNA) under ultrasound. DESIGN: A total of 106 patients were analyzed. FNA biopsy was performed at outpatient clinic via ultrasound. Inform consent was signed for each patient. Preparation of procedure with local anaesthesia was made by assistant nurse. PROCEDURE: Parallel approach of ultrasound guided fine needle aspiration (USGFNA) was used for each patient. This approach allows the operator to observe needle penetration, location and pathway of the entire needle within the neck, thyroid and nodule, which remain visible on the monitor. As a side effect commonly noticed mild pain and dizziness were recorded. RESULTS: General findings: According the gender, 96 (90.5%) of them were women and 10 (9.5%) men. Median age was 47 ± 9 years. Cytological findings: 5 patients were with papillary carcinoma, 3 with Hurtle cell metaplasia, 1 follicular tumour and 1 with unclear differentiation. CONCLUSION: Close collaboration between endocrinologists, morphologists and surgeons in a multidisciplinary frame is the key to correct preoperative thyroid cancer diagnosis and optimal treatment. FNA biopsy remains the most accurate diagnostic method in detecting thyroid cancer.

  1. The Effect of Radiotherapy on Ultrasound-Guided Fine Needle Aspiration Biopsy and the Ultrasound Characteristics of Neck Lymph Nodes in Oral Cancer Patients after Primary Treatment

    PubMed Central

    Lo, Wu-Chia; Cheng, Po-Wen; Wang, Chi-Te; Shueng, Pei-Wei; Hsieh, Chen-Hsi; Chang, Yih-Leong; Liao, Li-Jen

    2016-01-01

    Objectives To investigate the effect of radiotherapy (RT) on ultrasound-guided fine needle aspiration (USgFNA) and sonographic characteristics in the assessment of cervical lymph nodes (LNs) in oral squamous cell carcinoma (OSCC) patients after primary treatment. Materials and Methods 88 treated OSCC patients underwent 111 USgFNAs of the neck LNs after US evaluation. Among them, 48 USgFNAs were performed on 40 patients following RT and 63 USgFNAs on 48 patients without previous RT. The results of USgFNA and the US characteristics were compared between these two groups. Results USgFNA had a sensitivity of 88.0%, specificity of 91.4%, positive predictive value (PPV) of 88.0%, negative predictive value (NPV) of 91.4% and accuracy of 90.0% in patients without previous RT, and a sensitivity of 97.1%, specificity of 83.3%, PPV of 94.3%, NPV of 90.9% and accuracy of 93.5% in those with previous neck RT. The ranges of the short-axis and long-axis length were 13.3 ± 8.0 mm (mean ± SD) versus 17.8 ± 9.1 mm, and 18.6 ± 9.0 mm versus 24.4 ± 10.9 mm for recurrent LNs from patients with, versus without, previous RT (both ps < 0.05), respectively. 76.5% (26/34) of the recurrent nodes after RT and 48% (12/25) of the recurrent nodes without previous RT exhibited an irregular margin (p < 0.05). Additionally, irradiated recurrent LNs had a significantly decreased percentage of discernable calcification compared with non-irradiated recurrent nodes (48% versus 20.6%, p < 0.05). Conclusions RT had influence on sonographic characteristics but no influence on USgFNA in diagnosing recurrent LNs in treated OSCC patients. PMID:26954569

  2. The current role of percutaneous needle biopsies of renal tumours.

    PubMed

    Volpe, Alessandro; Terrone, Carlo; Scarpa, Roberto M

    2009-06-01

    The role of percutaneous biopsy of renal masses has been traditionally limited by concerns about its safety, accuracy and sampling errors. The increasing incidence in the diagnosis of incidental small renal masses (SRMs), the development of conservative and minimally invasive treatments for low risk renal cell carcinomas (RCCs) and the discovery of novel targeted treatments for metastatic disease are now leading to wider indications for renal tumor biopsy. Percutaneous biopsy of renal tumors can be performed in an outpatient setting under ultrasound and/or CT guidance. 18 gauge needles loaded in an automatic biopsy gun are used to retrieve cores and 21 gauge needles to obtain FNA specimens through a 17 gauge coaxial cannula placed close to the tumor. A careful check of the quality of biopsies and aspirates is paramount to maximize the diagnostic yield of the procedure. With the development of new biopsy techniques the risk of tumor seeding appears negligible and significant bleeding is unusual and very rarely clinically significant. In centres with expertise, needle core biopsy with or without FNA can provide adequate specimens for an accurate diagnosis in over 90% of cases. Incidental SRMs are frequently detected in elderly patients and have a very heterogeneous biological behaviour At surgery up to one third have benign histologies and most of those that are malignant are low grade RCCs. Pretreatment percutaneous biopsy can significantly decrease the number of unnecessary surgeries for benign disease and assist the urologist in clinical decision making, especially for elderly and unfit patients who are possible candidates for active surveillance and/or minimally invasive ablative therapies. Finally, there is potential for stratifying initial therapy of metastatic RCC by histological subtype on needle biopsies. PMID:19760866

  3. Fine needle aspiration cytology of lesions of liver and gallbladder: An analysis of 400 consecutive aspirations

    PubMed Central

    Barbhuiya, Mustafa; Bhunia, Shushruta; Kakkar, Manisha; Shrivastava, Braj; Tiwari, Pramod K; Gupta, Sanjiv

    2014-01-01

    Background: Patients presenting with mass lesions of liver and gallbladder are a common occurrence in a cancer hospital in north central part of India. Fine-needle aspiration cytology (FNAC) serves as first line of pathological investigations, but there are pros and cons involved. Aim: The main objective of the present study was to establish adequacy of the procedure and to find out diagnostic pitfalls. An attempt was made to analyze inconclusive and inadequate aspirations. Materials and Methods: A total of 400 consecutive fine-needle aspirates of liver, belonging to 328 cases over a period of 2 years, were analyzed. Hematoxylin and eosin and May-Grόnwald-Giemsa stains were used. Chi-square test was carried out to compare significant degree of difference in different kind of diagnosis. Results: Out of 400 aspirations, 289 (72.2%) were adequate, 75 (18.7%), inconclusive and 36 (9%), inadequate. Among positive aspirations the most common was metastatic adenocarcinoma, 128 (44.2%). The positive diagnosis and adequate aspirations were significantly high (P < 0.0001). Major differential diagnostic problems were: Distinguishing the poorly differentiated hepatocellular carcinoma from the metastatic adenocarcinoma; and leukemia/lymphoma from other malignant round cell tumors. Common diagnostic pitfalls were repeated aspirations from the necrotic area and aspiration of atypical, disorganized and reactive hepatocytes, adjacent to a metastasis. No complications were observed. Conclusion: FNAC can be used successfully for the diagnosis of liver and gallbladder lesions, thus avoiding open biopsy. Study indicates the potential of using FNAC in clinical intervention where the incidence of gall-bladder and liver cancer is very high and open biopsy and surgery are not an option. PMID:25190979

  4. PET-Based Percutaneous Needle Biopsy.

    PubMed

    El-Haddad, Ghassan

    2016-07-01

    PET can be used to guide percutaneous needle biopsy to the most metabolic lesion, improving diagnostic yield. PET biopsy guidance can be performed using visual or software coregistration, electromagnetic needle tracking, cone-beam computed tomography (CT), and intraprocedural PET/CT guidance. PET/CT-guided biopsies allow the sampling of lesions that may not be clearly visible on anatomic imaging, or of lesions that are morphologically normal. PET can identify suspicious locations within complex tumors that are most likely to contain important diagnostic and prognostic information. PMID:27321036

  5. Fine-needle aspiration cytology of superficial lymph nodes.

    PubMed

    Cardillo, M R

    1989-01-01

    A series of 244 enlarged superficial lymph nodes was examined by fine-needle aspiration cytology. Twenty-nine smears (11.9%) were inadequate for study. Of the remaining 215, 108 were negative, 13 suspicious for malignancy, and 94 positive. Forty-five excisional biopsies were performed correlating the cytologic and histologic findings. There were two cytologic false-negative results; both were patients who had been treated for carcinoma and whose aspirates were cytologically negative. Of the 13 samples reported as suspicious for malignancy, there were three epidermoid carcinomas, nine reactive hyperplasias, and one non-Hodgkin's lymphocytic lymphoma. Of the positive cases, 83 were metastatic tumors, and 11 were malignant lymphomas (two non-Hodgkin's lymphomas and nine Hodgkin's lymphomas). The criteria used in the interpretation of these aspirates and the problems of differential cytological diagnosis are discussed. In spite of the drawbacks of inadequate and false-negative smears, fine-needle aspiration cytology is valuable in preliminary diagnosis of diseased lymph nodes and subsequent management. PMID:2776599

  6. Transseptal fine needle aspiration of a large left atrial tumour.

    PubMed

    Wong, Chi Wing; Ruygrok, Peter; Sutton, Timothy; Ding, Patricia; van Vliet, Chris; Occleshaw, Christopher; Smith, Warren

    2010-07-01

    The diagnosis of cardiac tumours is often based on images without tissue diagnosis or tissue obtained at surgery. Percutaneous myocardial biopsy via a transvenous approach has been described in literatures but this technique is not feasible with left atrial tumours. We report a patient presenting with heart failure and left atrial tumour. The diagnosis of spindle cell neoplasm was established pre-operatively via successful transseptal fine needle aspiration of cells from a left atrial tumour. We believe this technique worth consideration to aid pre-surgery diagnosis. PMID:19656723

  7. Risk of tumor cell seeding through biopsy and aspiration cytology

    PubMed Central

    Shyamala, K.; Girish, H. C.; Murgod, Sanjay

    2014-01-01

    Cancer cells, besides reproducing uncontrollably, lose cohesiveness and orderliness of normal tissue, invade and get detached from the primary tumor to travel and set up colonies elsewhere. Dislodging neoplastically altered cells from a tumor during biopsy or surgical intervention or during simple procedure like needle aspiration is a possibility because they lack cohesiveness, and they attain the capacity to migrate and colonize. Considering the fact that, every tumor cell, is bathed in interstitial fluid, which drains into the lymphatic system and has an individualized arterial blood supply and venous drainage like any other normal cell in our body, inserting a needle or a knife into a tumor, there is a jeopardy of dislodging a loose tumor cell into either the circulation or into the tissue fluid. Tumor cells are easier to dislodge due to lower cell-to-cell adhesion. This theory with the possibility of seeding of tumor cells is supported by several case studies that have shown that after diagnostic biopsy of a tumor, many patients developed cancer at multiple sites and showed the presence of circulating cancer cells in the blood stream on examination. In this review, we evaluate the risk of exposure to seeding of tumor cells by biopsy and aspiration cytology and provide some suggested practices to prevent tumor cell seeding. PMID:24818087

  8. Progression of Infection after Surgical CT Navigation-Assisted Aspiration Biopsy of a Vertebral Abscess.

    PubMed

    Spyropoulou, Vasiliki; Valaikaite, Raimunda; Dhouib, Amira; Dayer, Romain; Ceroni, Dimitri

    2016-01-01

    Background Context. Computed tomography- (CT-) guided fine-needle aspiration biopsy of the vertebral body is an important tool in the diagnostic evaluation of vertebral osteomyelitis. The procedure is considered simple to perform and it is considered a safe procedure with few complications. Purpose. The purpose of this study was to describe an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, to better understand the relationship between surgical procedure and complication, and to reflect on how to avoid it. Study Design/Setting. Case report and literature review. Methods. The medical records, laboratory findings, and radiographic imaging studies of an 11-year-old boy, with an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, were reviewed. Results. We report a case of vertebral osteomyelitis of L3 caused by methicillin-sensitive Staphylococcus aureus (MSSA). Following a computed tomography-guided aspiration biopsy of the vertebral body of L3, vertebral osteomyelitis rapidly progressed into the vertebral body of L4 as well as the L3-L4 disk. Conclusions. Based on the present case, one should consider that a CT-guided fine-needle aspiration biopsy of the vertebral body may be complicated by a progression of a vertebral osteomyelitis into both the intervertebral disk and also the adjacent vertebral body. PMID:26949558

  9. Progression of Infection after Surgical CT Navigation-Assisted Aspiration Biopsy of a Vertebral Abscess

    PubMed Central

    Spyropoulou, Vasiliki; Valaikaite, Raimunda; Dhouib, Amira; Dayer, Romain; Ceroni, Dimitri

    2016-01-01

    Background Context. Computed tomography- (CT-) guided fine-needle aspiration biopsy of the vertebral body is an important tool in the diagnostic evaluation of vertebral osteomyelitis. The procedure is considered simple to perform and it is considered a safe procedure with few complications. Purpose. The purpose of this study was to describe an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, to better understand the relationship between surgical procedure and complication, and to reflect on how to avoid it. Study Design/Setting. Case report and literature review. Methods. The medical records, laboratory findings, and radiographic imaging studies of an 11-year-old boy, with an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, were reviewed. Results. We report a case of vertebral osteomyelitis of L3 caused by methicillin-sensitive Staphylococcus aureus (MSSA). Following a computed tomography-guided aspiration biopsy of the vertebral body of L3, vertebral osteomyelitis rapidly progressed into the vertebral body of L4 as well as the L3-L4 disk. Conclusions. Based on the present case, one should consider that a CT-guided fine-needle aspiration biopsy of the vertebral body may be complicated by a progression of a vertebral osteomyelitis into both the intervertebral disk and also the adjacent vertebral body. PMID:26949558

  10. Adequate histologic sectioning of prostate needle biopsies.

    PubMed

    Bostwick, David G; Kahane, Hillel

    2013-08-01

    No standard method exists for sampling prostate needle biopsies, although most reports claim to embed 3 cores per block and obtain 3 slices from each block. This study was undertaken to determine the extent of histologic sectioning necessary for optimal examination of prostate biopsies. We prospectively compared the impact on cancer yield of submitting 1 biopsy core per cassette (biopsies from January 2010) with 3 cores per cassette (biopsies from August 2010) from a large national reference laboratory. Between 6 and 12 slices were obtained with the former 1-core method, resulting in 3 to 6 slices being placed on each of 2 slides; for the latter 3-core method, a limit of 6 slices was obtained, resulting in 3 slices being place on each of 2 slides. A total of 6708 sets of 12 to 18 core biopsies were studied, including 3509 biopsy sets from the 1-biopsy-core-per-cassette group (January 2010) and 3199 biopsy sets from the 3-biopsy-cores-percassette group (August 2010). The yield of diagnoses was classified as benign, atypical small acinar proliferation, high-grade prostatic intraepithelial neoplasia, and cancer and was similar with the 2 methods: 46.2%, 8.2%, 4.5%, and 41.1% and 46.7%, 6.3%, 4.4%, and 42.6%, respectively (P = .02). Submission of 1 core or 3 cores per cassette had no effect on the yield of atypical small acinar proliferation, prostatic intraepithelial neoplasia, or cancer in prostate needle biopsies. Consequently, we recommend submission of 3 cores per cassette to minimize labor and cost of processing. PMID:23764163

  11. Evolution of transbronchial needle aspiration technique

    PubMed Central

    Liu, Qing-Hua; Ben, Su-Qin; Xia, Yang

    2015-01-01

    Transbronchial needle aspiration (TBNA) is an established technique to collect cell and tissue specimens from lesions outside the airway wall, generally guided by flexible bronchoscope under the direct visualization of the puncture site. TBNA has been utilized for 30 years, and now there is renewed interest in utilizing it in conjunction with endobronchial ultrasound. Although the basic operational principles have remained the same, conventional TBNA (cTBNA) and endobronchial ultrasound-guided TBNA (EBUS-TBNA) have been greatly improved over the years with the increased application in clinic and the advance of new technology. In this article we briefly discussed the evolution of TBNA technique and its future. PMID:26807269

  12. Efficacy of needle biopsy in postradiation thyroid disease

    SciTech Connect

    Rosen, I.B.; Palmer, J.A.; Bain, J.; Strawbridge, H.; Walfish, P.G.

    1983-12-01

    Retrospective review was carried out of 124 patients with nodular disease of the thyroid gland and a history of radiation exposure who had undergone needle aspiration biopsy. Latency period from time of radiation varied from 2 to 50 years; but in 92 patients it exceeded 2 decades. Our patient group included those with occupational exposure and a past history of radiation for cancer. Incidence of cancer in the entire group was 49% but, for solitary lesions, this was increased to 56%, while only a 30% incidence of cancer was found in cases of multinodular goiters. Accuracy of needle aspiration biopsy overall was 74%: for the group with cancer--90%, for the group with adenomas--65%, and for the group with ''benign'' tumors--83%. Further assessment of needle technique indicated a sensitivity of 70%, specificity of 90%, positive predictive value of 90%, and negative predictive value of 83% to 65%. The accuracy could be increased to 84% if all adenomas were considered as possible malignancies. Eighteen percent of our patients had second tumors in the head and neck or breast area. Near-total thyroidectomy was considered to be the preferred procedure without accidental nerve injury and was done in one case of hypoparathyroidism after excision of an extensive tracheal invasive cancer. No evidence of death, recurrence, or metastasis as a result of thyroid cancer has been noted. While needle biopsy is indispensable to intelligent management, the history of radiation to the head and neck area must be preeminent in the selection of patients for surgical treatment. Conservative management appears to be reasonable in those patients with ''benign'' cytology, a less than 1 cm nodule, multinodularity, a functioning thyroid scan result, but persistence in the face of a lack of response to conservative management does not appear to be warranted.

  13. Chest Wall Dissemination of Nocardiosis after Percutaneous Transthoracic Needle Biopsy

    SciTech Connect

    Shimamoto, Hiroshi Inaba, Yoshitaka; Yamaura, Hidekazu; Sato, Yozo; Kamiya, Mika; Miyazaki, Masaya; Arai, Yasuaki; Horio, Yoshitsugu

    2007-07-15

    We described a case of chest wall dissemination after percutaneous transthoracic needle biopsy. A 65-year-old man had a lung nodule which was suspected to be lung carcinoma. He underwent percutaneous transthoracic needle biopsy using an 18G semiautomated biopsy needle and pathologic diagnosis showed organizing pneumonia. Two months after the biopsy, chest wall dissemination occurred. Implantation of carcinoma along the biopsy route was suspected, but the mass was actually due to pulmonary nocardiosis.

  14. Transbronchial needle aspiration. An underused diagnostic technique.

    PubMed

    Dasgupta, A; Mehta, A C

    1999-03-01

    (by watching video) Review pathology slides Acquisition of skills with cytology needles should precede the use of the histology needle. Increasing education and experience can also increase diagnostic yields. Transbronchial needle aspiration has been proven to be accurate in staging lung cancers, identifying inoperable carcinomas, and diagnosing a variety of lung diseases. Few complications have been encountered and the technique is less invasive and less costly than surgical procedures. Drawing on evidence from published literature, we suggest the following guidelines for TBNA: All patients presenting with mediastinal or hilar adenopathy or both, should have 22-ga and/or 19-ga TBNA as the initial procedure. These procedures would help diagnose malignant and nonmalignant diseases, and stage lung cancers. All patients with evidence of submucosal and peribronchial disease should have 22-ga needle cytology sampling. In patients with visible endobronchial disease, 22-ga TBNA should be optional. In the presence of a necrotic or a hemorrhagic tumor, or in a patient with a bleeding diathesis, TBNA would be helpful. In all patients with Type III and IV peripheral nodules, TBNA should be the initial diagnostic procedure. There remains no doubt about the diagnostic usefulness of TBNA. Guidelines must be developed to ensure that pulmonary fellows are adequately trained in this procedure. Regional workshops with hands-on experience targeted to practicing pulmonologists organized by the ACCP would help popularize the procedure. Initial low yields should not discourage pulmonologists from using the procedure. Collaboration between thoracic surgeons, oncologists, and pulmonary physicians is essential to set up TBNA programs within institutions. With time, as more and more pulmonologists attain expertise in TBNA, the full potential of this nonsurgical, cost-effective, and safe procedure will be realized. PMID:10205716

  15. [Technic of fine needle aspiration cytology of the thyroid gland: coagulation inhibiting and stabilizing additives].

    PubMed

    Schröder, F; Poley, F

    1988-04-01

    In the fine needle aspiration cytology of the thyroid gland by the moistening of cannule and syringe with heparin or citric sodium rather disadvantages for the evaluation are the result. Artificial changes are most clearly to be seen in heparin. ACD-buffer does indeed not bring about any artefacts, does, however, also not show any provable advantages. In the fine needle biopsy the additives mentioned are entirely avoidable. PMID:3388921

  16. Transbronchial needle aspiration: where are we now?

    PubMed

    Xia, Yang; Wang, Ko-Pen

    2013-10-01

    Lung cancer, as the leading cause of cancer-related motility and mortality worldwide, usually ends up with poor prognosis, despite abundant progress of therapeutic approaches. Early diagnosis and staging is extremely critical and directly affects clinical managements and outcomes. Transbronchial needle aspiration (TBNA), serving as an effective tool, has been widely used for mediastinal and hilar lung cancer staging. Recent advance in bronchoscopy introduces ultrasound probe to regular bronchoscope, resulting in TBNA procedures real-time visualized. Here, we summarize the advantages and disadvantages of conventional TBNA (cTBNA) and ultrasound-guided TBNA by comparing the instruments, methodology as well as the anatomy. We believe these two techniques are not competitive but complementary, judging the indications of patients for different technique would be a raising issue applied for pulmonologists. PMID:24255782

  17. Fine-Needle Aspiration as a Method of Diagnosis of Subcutaneous Fat Necrosis of the Newborn.

    PubMed

    Schubert, Pawel Tomasz; Razak, Rubina; Jordaan, Henry Francois

    2016-05-01

    A 5-day-old boy presented with cellulitis-like, fluctuant lesions since birth. Clinically, subcutaneous fat necrosis was suspected, but an infective lesion could not be excluded. By performing a fine-needle aspiration biopsy, a diagnosis was established within minutes. PMID:27125326

  18. Fine needle aspiration cytology of epididymal nodules

    PubMed Central

    Shah, Vinaya B; Shet, Tanuja M; Lad, Shilpa K

    2011-01-01

    Background: The incidence of non neoplastic lesions are much more common in epididymis. Clinically, epididymal nodules are easily accessible to fine needle aspiration cytology (FNAC) procedure. There are very few literature reports documenting the role of cytology in evaluation of epididymal nodules. Thus, we studied patients presenting with palpable epididymis nodules in the out patient department (OPD) from a tertiary care general hospital. Aim: This study is aimed to put forth the diagnostic utility of FNAC in palpable lesions of epididymis. Materials and Methods: A total of 40 palpable epididymal nodules were aspirated as a routine OPD procedure as part of this study. Smears were fixed in isopropyl alcohol and air dried. In all the cases, wet fixed papanicoloau stained and air dried giemsa stained smears were studied. Zeihl Neelsen stain was performed in cases which yielded caseous aspirate. Results: Except for two cases of adenomatoid tumor of epididymis all other lesions were nonneoplastic and included 14 cases (35%) of tuberculous granulomatous inflammation, 10 (25%) cystic nodules (9 spermatoceles and 1 encysted hydrocele), 5 (12.5%) of nonspecific inflammations, 3 (7.5%) filarial infection, 3 (7.5%) sperm granulomas and 3 (7.5%) adenomatous hyperplasia of rete testes. Except for the two tumors, one adenomatous hyperplasia and one tuberculous lesion, no other lesion was excised. Follow up and response to therapy was available in 78% patients and resolution indicated appropriateness of the diagnosis Conclusions: Thus, as most of the lesions in epididymis are non neoplastic responding to medical line of treatment and FNAC served to aid diagnosis of non specific inflammation and avoid surgical excision in most cases. PMID:21897542

  19. Human Equilibrative Nucleoside Transporter 1 Expression in Endoscopic Ultrasonography-Guided Fine-Needle Aspiration Biopsy Samples Is a Strong Predictor of Clinical Response and Survival in the Patients With Pancreatic Ductal Adenocarcinoma Undergoing Gemcitabine-Based Chemoradiotherapy

    PubMed Central

    Yamada, Reiko; Mizuno, Shugo; Uchida, Katsunori; Yoneda, Misao; Kanayama, Kazuki; Inoue, Hiroyuki; Murata, Yasuhiro; Kuriyama, Naohisa; Kishiwada, Masashi; Usui, Masanobu; Ii, Noriko; Tsuboi, Junya; Tano, Shunsuke; Hamada, Yasuhiko; Tanaka, Kyosuke; Horiki, Noriyuki; Ogura, Toru; Shiraishi, Taizo; Takei, Yoshiyuki; Katayama, Naoyuki; Isaji, Shuji

    2016-01-01

    Objectives This study aimed to clarify whether pretreatment human equilibrative nucleoside transporter (hENT1) expressions in endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) specimens obtained from resectable, borderline resectable, and locally advanced unresectable pancreatic ductal adenocarcinoma (PDAC) are concordant with those in the resected specimen after gemcitabine-based chemoradiotherapy (Gem-CRT) and to validate the utility of hENT1 expression using EUS-FNAB samples as a prognostic marker. Methods We evaluated the relationship between hENT1 expressions assessed by immunohistochemical staining and clinical outcomes in 51 of 76 patients with PDAC who were diagnosed by EUS-FNAB and received preoperative Gem-CRT. Results The concordance rate of hENT1 expressions was 89.2% (K = 0.681). Median survival time (month) in the 51 whole patients and 37 patients with resection was significantly longer in hENT1 positive than in hENT1 negative: 25.0 and 30.0 versus 9.0 and 9.0, respectively. A multivariate analysis confirmed that hENT1 expression was an independent prognostic factor in both whole patients and those with resection. Regardless of T3 and T4, hENT1-positive patients with resection had significantly better prognosis than hENT1-negative patients, whose prognosis was similar to those without resection. Conclusions The assessment of hENT1 expression using EUS-FNAB samples before Gem-CRT provides important information on patients with PDAC who can benefit from curative-intent resection. PMID:26784908

  20. Transthoracic needle aspiration: the past, present and future.

    PubMed

    Chockalingam, Arun; Hong, Kelvin

    2015-12-01

    Transthoracic needle aspiration (TTNA) has been used to diagnose disease in the lung for many decades. Thanks to advances in technology and cytopathology, the diagnostic power, accuracy, safety, and efficacy of TTNA are constantly improving. The transition from fluoroscopy to computed tomography (CT) has yielded better visualization, and ability to enhance sophistication of tools used to biopsy. In addition, needles are being refined for obtaining better biopsy samples and increased capabilities. Because of the minimally invasive nature of TTNA, it is becoming a strong alternative to surgical intervention. In the future, these developments will continue and TTNA will become more efficient, and potentially open a door to personalized medicine. However, there are complications due to this procedure, which include pneumothorax, hemorrhage, air embolism, and others which are very rare. Probability of complication increases when patients are older, have significant past medical history, have larger lesions, and are uncooperative during procedure. Indications, contraindications, and other considerations should be contemplated before a patient is elected for TTNA. PMID:26807277

  1. Transthoracic needle aspiration: the past, present and future

    PubMed Central

    Chockalingam, Arun

    2015-01-01

    Transthoracic needle aspiration (TTNA) has been used to diagnose disease in the lung for many decades. Thanks to advances in technology and cytopathology, the diagnostic power, accuracy, safety, and efficacy of TTNA are constantly improving. The transition from fluoroscopy to computed tomography (CT) has yielded better visualization, and ability to enhance sophistication of tools used to biopsy. In addition, needles are being refined for obtaining better biopsy samples and increased capabilities. Because of the minimally invasive nature of TTNA, it is becoming a strong alternative to surgical intervention. In the future, these developments will continue and TTNA will become more efficient, and potentially open a door to personalized medicine. However, there are complications due to this procedure, which include pneumothorax, hemorrhage, air embolism, and others which are very rare. Probability of complication increases when patients are older, have significant past medical history, have larger lesions, and are uncooperative during procedure. Indications, contraindications, and other considerations should be contemplated before a patient is elected for TTNA. PMID:26807277

  2. Fine Needle Aspiration Cytology Diagnosis of an Urachal Adenocarcinoma

    PubMed Central

    Thirunavukkarasu, Balamurugan; Yadav, Siddharth; Kumar, Rajeev; Gamanagatti, Shivanand

    2016-01-01

    Urachal Carcinoma (UC) is a rare malignancy of urinary bladder. It is usually found in adults in advanced stages because the tumour often grows outside the bladder without producing clinical symptoms. Most of the cases are mucinous, intestinal or signet ring cell adenocarcinoma and the diagnosis is usually made on biopsy. Radiographic images of this tumour may show characteristic features with a midline solid or cystic mass in the anterior wall of bladder associated with small calcification, which is considered as a pathognomonic sign for the diagnosis of UC. We report a case of UC in an adult, whose radiographic images suggested an urachal tumour and Fine Needle Aspiration (FNA) cytology revealed an adenocarcinoma. Laparoscopic partial cystectomy with umbilectomy and pelvic node dissection was done without further histopathological confirmation. Surgical intervention of UC on the basis of FNA diagnosis has not been reported in the literature. PMID:27190817

  3. Fine Needle Aspiration Cytology Diagnosis of an Urachal Adenocarcinoma.

    PubMed

    Thirunavukkarasu, Balamurugan; Mridha, Asit Ranjan; Yadav, Siddharth; Kumar, Rajeev; Gamanagatti, Shivanand

    2016-04-01

    Urachal Carcinoma (UC) is a rare malignancy of urinary bladder. It is usually found in adults in advanced stages because the tumour often grows outside the bladder without producing clinical symptoms. Most of the cases are mucinous, intestinal or signet ring cell adenocarcinoma and the diagnosis is usually made on biopsy. Radiographic images of this tumour may show characteristic features with a midline solid or cystic mass in the anterior wall of bladder associated with small calcification, which is considered as a pathognomonic sign for the diagnosis of UC. We report a case of UC in an adult, whose radiographic images suggested an urachal tumour and Fine Needle Aspiration (FNA) cytology revealed an adenocarcinoma. Laparoscopic partial cystectomy with umbilectomy and pelvic node dissection was done without further histopathological confirmation. Surgical intervention of UC on the basis of FNA diagnosis has not been reported in the literature. PMID:27190817

  4. Management of thyroid nodules: scanning techniques, thyroid suppressive therapy, and fine needle aspiration

    SciTech Connect

    Ashcraft, M.W.; Van Herle, A.J.

    1981-03-01

    For the differentiation of benign from malignant thyroidal disease, ultrasound displays anatomic but not histologic features. Other visualization techniques can be used including isotope scanning (radioiodine, 99m technetium, 241 americium fluorescence, 131 cesium, 67 gallium, 75 selenomethionine, 201 thallium, 32 phosphorus, 99m Tc-bleomycin, 197 mercury, 133 xenon), thermography, x-ray techniques (plain films, computed tomographic scan, xeroradiography, chest x-ray barium swallow, lymphography, angiography), and thyroid hormone suppression. Needle biopsy can be done by core biopsy (Vim-Silverman and drill biopsy), large needle biopsy for histologic processing and fine needle aspiration for cytologic interpretation. The latter is the safest, most reliable, and most cost-effective technique currently available to differentiate between benign and malignant thyroidal disease and has great promise for the future.

  5. Hollow needle cataract aspiration in antiquity.

    PubMed

    Pérez-Cambrodí, Rafael J; Ascaso, Francisco J; Diab, Fathi; Alzamora-Rodríguez, Antonio; Grzybowski, Andrzej

    2015-12-01

    The dislocation of the crystalline lens or couching technique was the predominant procedure to surgically remove cataracts until the 18th century A.D. However, in the Middle Ages, some Arab physicians tried to aspirate the opaque lens by means of a glass tube following a paracentesis. Some literary sources attributed the origins of this technique to Antyllus of Alexandria, a Greek surgeon who lived in the 2nd century A.D. in the Roman Empire. Nevertheless, this statement remains unclear and is probably the consequence of posterior interpretations or incorrect translations of the manuscripts. In recent years, the discovery of the hollow needles from Montbellet (France) and Viladamat (Spain), in archaeological settlements dated between the 1st century and 3rd century A.D., has reopened the possibility of cataract extraction as an option in the surgical management of soft cataracts in the antiquity. In any case, these findings are exceptional, and thus, probably this technique was not widely practised and very likely disparaged by the medical community. PMID:26385516

  6. Endobronchial ultrasound-transbronchial needle aspiration and its practical application.

    PubMed

    Currie, G P; McKean, M E; Kerr, K M; Denison, A R; Chetty, M

    2011-08-01

    Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) has emerged over the past decade as one of the most exciting and innovative developments in the field of respiratory medicine. This procedure allows sampling of mediastinal lymph nodes and masses in both malignant and benign disease and overcomes some of the disadvantages associated with mediastinoscopy and blind transbronchial needle aspiration. We describe the clinical use, indications for and limitations of EBUS-TBNA along with several illustrated clinical examples. PMID:21546452

  7. Endoscopic and endosonography guided fine-needle aspiration.

    PubMed

    Antillon, M R; Chang, K J

    2000-10-01

    Endoscopic ultrasound-guided fine-needle aspiration is emerging as the preferred technique for the cytologic diagnosis of various gastrointestinal lesions. This technique may not be routinely available, but there is still a role for endoscopic or endoscopic ultrasound-assisted fine-needle aspiration. This article provides an overview of the evolution of these various techniques and discusses the advantages, disadvantages, indications, and contraindications of each. PMID:11036536

  8. Management implications from routine needle biopsy of hyperfunctioning thyroid nodules.

    PubMed

    Walfish, P G; Strawbridge, H T; Rosen, I B

    1985-12-01

    To evaluate the diagnostic and treatment consequences of using a routine needle biopsy procedure on all thyroid nodules without a radioisotopic scintigraphic study, 12 patients with documented hyperfunctioning thyroid nodules were retrospectively evaluated regarding the physical and cytologic observations obtained after a fine-needle (22 to 27-gauge) aspiration biopsy (FNB) procedure. Among the seven solid lesions, features of marked cellularity and nuclear pleomorphism were present in three and moderate sheets of epithelium in four raising the suspicion of underlying malignancy, while five mixed (cystic and solid) lesions were larger than 3 cm, hemorrhagic, and recurrent, with two having detectable sheets of epithelium. Evidence for concomitant lymphocytic thyroiditis was seen in five of 12 (42%) patients, and nine had positive serum antithyroid antibody titers as well. In conclusion, total reliance on FNB without scintigraphy could lead to operations on hyperfunctioning thyroid adenomas for suspected malignancy, of whom the vast majority would be benign, and could expose some unprepared patients with thyrotoxicosis to surgical morbidity. Routine thyroid hormone suppression therapy for apparently benign inflammatory or cystic degenerative lesions could also induce hyperthyroidism in patients with hyperfunctional or autonomous (nonsuppressible) nodules. When using an initial FNB approach, the need for thyroid function studies and scintigraphy before undertaking surgery or thyroid hormone feeding, as well as the consequences of omitting such studies, should be considered. PMID:4071393

  9. Fine needle biopsy of abdominal organs in dogs -- indications, contraindications and performance technique.

    PubMed

    Glińska-Suchocka, K; Jankowski, M; Kubiak, K; Spuzak, J; Dzimira, S; Nicpoń, J

    2013-01-01

    Recent years have seen in both human and veterinary medicine the development of numerous techniques allowing for evaluation and classification of changes in individual organs and tissues. Despite introduction of such techniques into diagnostics as among others, CT, MRI, CEUS or elastography, biopsy is still considered a "golden standard" and it is a procedure performed in order to obtain a final diagnosis. There are many biopsy techniques, such as fine needle aspiration biopsy, core biopsy as well as methods of performing a procedure, e.g. blind biopsy, biopsy under USG control and biopsy during laparotomy. In the article usefulness of biopsy techniques in relation to diagnostics of individual abdominal organ, as well as the procedure technique, contraindication and complications are discussed. PMID:24597324

  10. Percutaneous Biopsy of Osteoid Osteomas Prior to Percutaneous Treatment Using Two Different Biopsy Needles

    SciTech Connect

    Laredo, Jean-Denis Hamze, Bassam; Jeribi, Riadh

    2009-09-15

    Biopsy is usually performed as the first step in percutaneous treatment of osteoid osteomas prior to laser photocoagulation. At our institution, 117 patients with a presumed diagnosis of osteoid osteoma had a trephine biopsy before a percutaneous laser photocoagulation. Biopsies were made using two different types of needles. A Bonopty biopsy needle (14-gauge cannula, 16-gauge trephine needle; Radi Medical Systems, Uppsala, Sweden) was used in 65 patients, and a Laurane biopsy needle (11-gauge cannula, 12.5-gauge trephine needle; Laurane Medical, Saint-Arnoult, France) in 43 patients. Overall biopsy results were positive for osteoid osteoma in 83 (70.9%) of the 117 cases. The Laurane needle provided a significantly higher positive rate (81.4%) than the Bonopty needle (66.1%; p < 0.05). This difference was not due to the size of the nidus, which was similar in the two groups (p < 0.05) and may be an effect of differences in needle caliber (12.5 vs. 14 gauge) as well as differences in needle design. The rate of positive biopsy results obtained in the present series with the Laurane biopsy needle is, to our knowledge, the highest rate reported in series dealing with percutaneous radiofrequency ablation and laser photocoagulation of osteoid osteomas.

  11. Aspiration biopsy of testis: another method for histologic examination

    SciTech Connect

    Nseyo, U.O.; Englander, L.S.; Huben, R.P.; Pontes, J.E.

    1984-08-01

    The most important method for evaluating the pathogenesis of male infertility is open testicular biopsy. Herein the authors describe a method of aspiration biopsy of testis for histologic examination. Sexually mature dogs and rats treated with chemotherapeutic agents and ionizing radiation were followed with periodic testicular aspiration biopsy during and after treatment. The histologic findings from the aspiration biopsy compare with the results of routine histologic examination in assessing spermatogenetic activity and delineating pathologic changes. The puncture in the experimental animals was performed under general anesthesia. In human patients testicular biopsy could be done under local anesthesia in an outpatient clinic. The procedure would be less painful, minimally invasive, and more cost-effective.

  12. Fine-needle aspiration cytology in the management of salivary gland tumors: an Australian experience.

    PubMed

    Stow, Nicholas; Veivers, David; Poole, Alan

    2004-02-01

    We conducted a retrospective study of 104 cases of salivary gland tumors that were initially assessed by fine-needle aspiration biopsy (FNAB). Based on subsequent histopathologic analysis of excised specimens, we found that preoperative FNAB was highly sensitive and specific for both benign and malignant tumors-including the most common, pleomorphic adenomas and squamous cell carcinomas, respectively. Despite its possible drawbacks, we conclude that preoperative FNAB is a useful tool in the management of salivary gland tumors. PMID:15008447

  13. Acute Suppurative Thyroiditis Accompanied by Thyrotoxicosis after Fine-Needle Aspiration: Treatment with Catheter Drainage

    PubMed Central

    Demirpolat, Gulen; Aydin, Mehtap

    2014-01-01

    Fine needle aspiration (FNA) biopsy is commonly used in the diagnosis of thyroid diseases. Serious complications are rare and this procedure is generally safe. Acute supurative thyroiditis (AST) after FNA has been seldomly reported. We report a case of a 57-year-old women with diabetes mellitus who developed AST with thyrotoxicosis after FNA. She was successfully treated by sonographically guided percutaneous drainage and antithyroid agent. PMID:25584265

  14. Transbronchial needle aspiration: development history, current status and future perspective

    PubMed Central

    Yang, Huizhen; Zhang, Yuan; Wang, Ko-Pen

    2015-01-01

    Background Transbronchial needle aspiration (TBNA) technology was underutilized by clinicians because it is “blind”. Recent development of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) renewed the interest and confident of TBNA. TBNA without EBUS is referred as conventional transbronchial needle aspiration (C-TBNA). Methods This paper focuses on C-TBNA technology development history, present situation and future development to do a detailed introduction. Results TBNA is a simple, cost effective and minimally invasive technique for diagnosing disease of the mediastinum and lung in adult as well as children patients. Conclusions More improvements of TBNA technology should be made, including employing technological advances to perfect the instruments and techniques, focusing on patient comfort, optimizing yield, simplifying instruments, maximizing ease of use and minimizing training requirements for the pulmonologist. The ideal TBNA scope deserves further evaluation and study. PMID:26807275

  15. Fine needle aspiration cytology of cervical lymph node involvement by ovarian serous borderline tumor

    PubMed Central

    Chen, Longwen; Butler, Kristina A.; Bell, Debra A.

    2016-01-01

    Serous borderline tumor (SBT) involving a cervical lymph node is extremely rare. In addition, fine needle aspiration (FNA) cytology of the involved cervical lymph node shares tremendous morphologic similarity with other low-grade papillary carcinomas. Thus, it can be easily misdiagnosed as metastatic carcinoma. A 42-year-old female had a history of bilateral SBT and postbilateral salpingo-oophorectomy. She presented with left cervical lymphadenopathy 6 months later. FNA cytology showed a low-grade papillary neoplasm with psammoma bodies. Needle core biopsy along with immunostains was diagnostic of cervical lymph node involvement (LNI) of SBT. although extremely rare, cervical LNI can be found in patients with SBTs. FNA cytology, sometimes, is indistinguishable from metastatic papillary adenocarcinoma. Cell block or needle core biopsy is essential to make the correct diagnosis.

  16. Steerable real-time sonographically guided needle biopsy.

    PubMed

    Buonocore, E; Skipper, G J

    1981-02-01

    A method for dynamic real-time ultrasonic guidance for percutaneous needle biopsy has been successful in obtaining cytologic and histologic specimens from abdominal masses. The system depends on a real-time ultrasonic transducer that has been rigidly attached to a laterally placed steerable needle holder. Using simple trigonometric functions, a chart has been derived that gives the exact angulation and needle length to produce quick, reliable, guided needle placements. Examples of successful renal, hepatobiliary, and retroperitoneal biopsies are presented. Advantages of this technique include speed, accuracy, low cost, three-dimensional format, and the omission of contrast media and radiation. PMID:6781264

  17. How to increase the yield of transbronchial needle aspiration (TBNA)?

    PubMed Central

    Chen, Cheng

    2015-01-01

    Transbronchial needle aspiration (TBNA) is a relatively sensitive, accurate, and safe technique in the diagnosis and staging of lung cancer. There are many factors influencing the yield of TBNA, such as location and the size of the mediastinal lymphadenopathy (MLN), types of the needle used and the experience of the bronchoscopist. Furthermore, knowledge of anatomy, guidance, availability of rapid on-site evaluation (ROSE) and the number of aspirates, preparation of specimen and interpretations of the cytology and histology of specimens all play important roles. Especially, whether an endobronchial ultrasound (EBUS) is required for TBNA in the diagnosis of mediastinal masses is currently a disputed subject.

  18. Fine-needle aspiration cytology of metastatic nasopharyngeal carcinoma.

    PubMed

    Viguer, José M; Jiménez-Heffernan, José A; López-Ferrer, Pilar; Banaclocha, Marcos; Vicandi, Blanca

    2005-04-01

    Cytological features of nasopharyngeal carcinoma (NPC) were reviewed in an attempt to select cytological criteria that permit a specific recognition of metastases. For this purpose, 54 fine-needle aspiration (FNA) procedures from 43 patients with NPC were analyzed. Thirty-two (59.3%) procedures were performed before the histological diagnosis. In 25 (46.3%) procedures, smears showed many neoplastic single cells, clusters, and abundant lymphoid cells (mixed pattern). A dissociated (single cell) pattern consisting of individual neoplastic and lymphoid cells was seen in 18 (33.3%) cases. Finally, 11 (20.4%) cases showed cohesive epithelial clusters (cohesive pattern) without relevant cellular dissociation or lymphoid cells. Squamous-cell differentiation was seen in three of these cases. Most single neoplastic cells presented as large, pleomorphic naked nuclei. Other interesting findings were granulomas (n = 3), prominent eosinophilic infiltrates (n = 4), and suppurative changes (n = 5). In most smears with mixed and dissociated patterns, a nasopharyngeal origin could be suggested. On the contrary, those smears with a cohesive pattern were indistinguishable from other head and neck carcinomas. The presence (on cervical lymph nodes) of a dissociated or mixed (single cells and groups) architectural pattern of large, anaplastic cells and naked nuclei accompanied by an abundant lymphoid component is highly suggestive of undifferentiated NPC. Cytology offers a rapid diagnosis, establishes the necessity of a complete cavum examination, and helps in avoiding unnecessary and harmful biopsies. PMID:15754369

  19. Toward improving fine needle aspiration cytology by applying Raman microspectroscopy

    NASA Astrophysics Data System (ADS)

    Becker-Putsche, Melanie; Bocklitz, Thomas; Clement, Joachim; Rösch, Petra; Popp, Jürgen

    2013-04-01

    Medical diagnosis of biopsies performed by fine needle aspiration has to be very reliable. Therefore, pathologists/cytologists need additional biochemical information on single cancer cells for an accurate diagnosis. Accordingly, we applied three different classification models for discriminating various features of six breast cancer cell lines by analyzing Raman microspectroscopic data. The statistical evaluations are implemented by linear discriminant analysis (LDA) and support vector machines (SVM). For the first model, a total of 61,580 Raman spectra from 110 single cells are discriminated at the cell-line level with an accuracy of 99.52% using an SVM. The LDA classification based on Raman data achieved an accuracy of 94.04% by discriminating cell lines by their origin (solid tumor versus pleural effusion). In the third model, Raman cell spectra are classified by their cancer subtypes. LDA results show an accuracy of 97.45% and specificities of 97.78%, 99.11%, and 98.97% for the subtypes basal-like, HER2+/ER-, and luminal, respectively. These subtypes are confirmed by gene expression patterns, which are important prognostic features in diagnosis. This work shows the applicability of Raman spectroscopy and statistical data handling in analyzing cancer-relevant biochemical information for advanced medical diagnosis on the single-cell level.

  20. FNAC Versus Core Needle Biopsy: A Comparative Study in Evaluation of Palpable Breast Lump

    PubMed Central

    Saha, Abhijit; Mukhopadhyay, Madhumita; Sarkar, Koushik; Saha, Ashis Kumar; Sarkar, Diptendra KR

    2016-01-01

    Introduction Breast carcinoma is the most common malignant tumour and the leading cause of carcinoma death in women in world. The main purpose of FNAC or CNB of breast lumps is to confirm cancer preoperatively and to avoid unnecessary surgery in specific benign conditions. Aims and Objective The objective of the study was to compare between Fine Needle Aspiration Cytology (FNAC) and Core Needle Biopsy (CNB) in the diagnosis of breast carcinoma with final histological diagnosis from excision specimen as it is gold standard. Materials and Methods A prospective study was done on 50 cases. Patients undergoing all three procedures (Fine Needle Aspiration Cytology and Core Needle Biopsy done at Department of Pathology; subsequent excision surgeries done at Department of General Surgery) were selected. May Grunwald Giemsa (MGG) and Papaniculou (PAP) staining were performed on cytology smears. Haematoxylin and Eosin (H&E) staining was done on both the CNB and tissue specimens obtained from subsequent excision surgeries to see the histological features. Results FNAC showed sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 69%, 100%, 100%, 38.1%, and 74% respectively in diagnosing carcinoma. CNB had sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 88.3%, 100%, 100%, 53.3% and 86%. Both FNAC and CNB showed statistically significant correlation with confirmatory HPE of excision specimen (p-value <0.05) in the diagnosis of breast carcinoma. Conclusion Fine needle aspiration cytology (FNAC) is a rapid, less complicated, economical, reliable and relevant method for the preoperative pathological diagnosis of breast carcinoma in a developing nation like ours. If the initial FNAC is inadequate, core needle biopsy (CNB) can be a useful second line method of pathological diagnosis in order to minimize the chance of missed diagnosis of breast cancer. PMID:27042469

  1. Rosai Dorfman disease diagnosed by fine-needle aspiration cytology in a young man with HIV infection

    PubMed Central

    Sall, Abibatou; Touré, Awa Oumar; Ndiaye, Fatou Samba; Sène, Abdoulaye; Sall, Fatimata Bintou; Faye, Blaise Félix; Seck, Moussa; Diop, Saliou

    2015-01-01

    Key Clinical Message RDD (Rosai Dorfman disease) is a rare and benign histiocytic proliferative disorder of unknown etiology. FNAC (Fine-needle aspiration cytology) is a useful and reliable tool for the diagnosis of RDD, and as such, biopsy is avoidable. PMID:26509029

  2. [The value of ultrasound-controlled fine-needle biopsy in the diagnosis of possible neck tumors].

    PubMed

    Knapp, I; Mann, W; Wachter, W

    1989-12-01

    From October 1985 to July 1988 we performed a study to examine 106 patients with head and neck tumours, by using ultrasound as a guiding system for fine-needle aspiration biopsy. It could be shown that this method has a high diagnostic significance at the neck with a low rate of risks. In a first step puncture was effected to obtain material for cytology, if necessary also for a bacteriological examination. Normally, in a second step a fine-needle cutting biopsy was done to obtain histological material. The combined use of aspiration and cutting needle biopsy achieved correct tumour status in 91.5%, whereas in 73.6% the correct type of lesion was diagnosed. A false status assessment and errors in identifying the lesions occurred in 2 of 106 cases; there of was one false negative status assessment. In cases of benign neck cysts, neck abscesses and non-specific lymphadenopathy, a cutting neck biopsy is not required, provided the clinical diagnosis is in accordance with the result of aspiration cytology and the further clinical progress. The advantage of the ultrasound-guided puncture compared with palpation-guided puncture is the certainty of locating the region of interest even in deep lesions without an appreciable risk of complications. In our opinion, ultrasound-guided fine needle aspiration biopsy is indicated in all cases of unclear head and neck tumours which could be treated conservatively if the result of the puncture is non-malignant. PMID:2692578

  3. "Dry" pleural mesothelioma successfully diagnosed on endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA).

    PubMed

    Lococo, Filippo; Rossi, Giulio; Agostini, Lorenzo; Filice, Angelina; Paci, Massimiliano; Rapicetta, Cristian; Ricchetti, Tommaso; Tenconi, Sara; Piro, Roberto; Sgarbi, Giorgio

    2014-01-01

    The acquisition of histologic material is obligatory in order to establish the diagnosis of malignant pleural mesothelioma (MPM). In particular, tissue acquisition in cases of "dry" MPM (focal pleural thickening without pleural effusion or mediastinal lymph node involvement) is usually performed via a thoracoscopic pleural biopsy. In contrast, the techniques for performing echoendoscopic (transbronchial or transesophageal) needle aspiration of pleural lesions have only rarely been reported due to the theoretical limitations of tissue acquisition in such cases. We herein report the first case of "dry" MPM successfully diagnosed via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a 73-year-old man presenting with a pleural mass in the right costovertebral recess, adjacent to the carina. The patient underwent radical resection, and a definitive pathological examination confirmed the diagnosis of epithelioid MPM. PMID:24583437

  4. Effects of percutaneous needle liver biopsy on dairy cow behaviour.

    PubMed

    Mølgaard, L; Damgaard, B M; Bjerre-Harpøth, V; Herskin, M S

    2012-12-01

    In cattle, percutaneous needle liver biopsy is used for scientific examination of liver metabolism. The impact of the biopsy procedure is, however, poorly investigated. Our aim was to examine the behaviour of dairy cows during and after liver biopsy. Data were collected from 18 dry cows. Percutaneous needle liver biopsies (after administration of local anaesthesia (2% Procaine)) and blood samples were taken during restraining. During the control treatment, animals were restrained and blood sampled. During the biopsy procedure, cows showed increased restlessness (P=0.008), frequency of head shaking (P=0.016), and decreased rumination (P=0.064). After biopsies, tail pressing (P=0.016) and time spent perching (P=0.058) increased. Time spent upright (P=0.10) and number of leg movements (P=0.033) increased during the night as compared to controls. Thus, liver biopsy induced behavioural changes for up to 19 h--and particularly for behaviour previously associated with pain. Even though the exact welfare impact of percutaneous needle liver biopsies in cows is not known, and the magnitude of the behavioural changes was limited, pain always has negative effects on animal welfare. Therefore, if the present biopsy procedure--involving several biopsy passes--is to be used, improvement of the anaesthetic protocol as well as the inclusion of analgesics should be considered. PMID:22542802

  5. Primary Amyloidosis of Celiac/Para-Pancreatic Lymph Nodes Diagnosed by Endosonography-Guided Fine Needle Aspiration

    PubMed Central

    Akbar, Nuralhuda; Kubbara, Aahd; Nawras, Ali

    2015-01-01

    Introduction. Primary amyloidosis is a disorder resulting from the deposition of fibrillary protein in extracellular tissue. Diagnosis of primary amyloidosis in the celiac/para-pancreatic lymph nodes via endoscopic ultrasound-guided fine needle aspiration has not been reported in the literature. In this article, we report our first observation. Our patient is a 64-year-old Caucasian man who was referred to our institution from an outlying hospital for recurrent abdominal pain. Radiological imaging revealed an enlarged abdominal lymph node that was already biopsied under computed tomography needle guidance but diagnosis was not achieved on pathological examination. At our institution, endoscopic ultrasound-guided fine needle aspiration showed enlarged para-celiac/pancreatic lymph nodes. Endosonography-guided fine needle aspiration revealed the diagnosis of primary amyloidosis. The patient tolerated the procedure well with follow-up as an outpatient. Conclusions. Lymph node involvement in amyloidosis is not uncommon. However, the involvement of the pancreatic/celiac lymph nodes by amyloidosis is obscure in this case. This case shows a rare presentation of amyloidosis diagnosed for the first time by the technique of endosonography-guided fine needle aspiration. In the future, this might serve as an establishment to standardize diagnosing abdominal lymph node amyloidosis, once suspected, by endosonography-guided fine needle aspiration. PMID:26904706

  6. Primary Amyloidosis of Celiac/Para-Pancreatic Lymph Nodes Diagnosed by Endosonography-Guided Fine Needle Aspiration: A Case Report.

    PubMed

    Akbar, Nuralhuda; Kubbara, Aahd; Nawras, Ali

    2015-01-01

    Introduction. Primary amyloidosis is a disorder resulting from the deposition of fibrillary protein in extracellular tissue. Diagnosis of primary amyloidosis in the celiac/para-pancreatic lymph nodes via endoscopic ultrasound-guided fine needle aspiration has not been reported in the literature. In this article, we report our first observation. Our patient is a 64-year-old Caucasian man who was referred to our institution from an outlying hospital for recurrent abdominal pain. Radiological imaging revealed an enlarged abdominal lymph node that was already biopsied under computed tomography needle guidance but diagnosis was not achieved on pathological examination. At our institution, endoscopic ultrasound-guided fine needle aspiration showed enlarged para-celiac/pancreatic lymph nodes. Endosonography-guided fine needle aspiration revealed the diagnosis of primary amyloidosis. The patient tolerated the procedure well with follow-up as an outpatient. Conclusions. Lymph node involvement in amyloidosis is not uncommon. However, the involvement of the pancreatic/celiac lymph nodes by amyloidosis is obscure in this case. This case shows a rare presentation of amyloidosis diagnosed for the first time by the technique of endosonography-guided fine needle aspiration. In the future, this might serve as an establishment to standardize diagnosing abdominal lymph node amyloidosis, once suspected, by endosonography-guided fine needle aspiration. PMID:26904706

  7. Archival Fine-Needle Aspiration Cytopathology (FNAC) Samples

    PubMed Central

    Killian, J. Keith; Walker, Robert L.; Suuriniemi, Miia; Jones, Laura; Scurci, Stephanie; Singh, Parvati; Cornelison, Robert; Harmon, Shannon; Boisvert, Nichole; Zhu, Jack; Wang, Yonghong; Bilke, Sven; Davis, Sean; Giaccone, Giuseppe; Smith, William I.; Meltzer, Paul S.

    2010-01-01

    Microarray technologies provide high-resolution maps of chromosome imbalances and epigenomic aberrations in the cancer cell genome. Such assays are often sensitive to sample DNA integrity, voiding the utility of many archival pathology specimens and necessitating the special handling of prospective clinical specimens. We have identified the remarkable preservation of higher-molecular weight DNA in archival fine-needle aspiration cytopathology specimens from patients greater than 10 years of age. We further demonstrate the outstanding technical performance of 57 fine-needle aspiration cytopathology samples for aberration detection on high-resolution comparative genomic hybridization array, DNA methylation, and single nucleotide polymorphism genotyping platforms. Forty-four of 46 malignant aspirates in this study manifested unequivocal genomic aberrations. Importantly, matched Papanicolaou and Diff-Quik fine-needle aspiration cytopathology samples showed critical differences in DNA preservation and DNA integrity. Overall, this study identifies a largely untapped reserve of human pathology specimens for molecular profiling studies, with ramifications for the prospective collection of clinical biospecimens. PMID:20959611

  8. MR-guided fine needle aspiration of breast lesions: Initial experience

    SciTech Connect

    Wald, D.S.; Weinreb, J.C.; Newstead, G.; Flyer, M.; Bose, S.

    1996-01-01

    Fine needle aspiration (FNA) is a minimally invasive procedure that is used to obtain cytologic specimens of suspicious lesions in the breast. The goal of this study was to evaluate the logistics and limitations of MR-guided FNA using a prototype breast localization coil. MR-guided FNAs were attempted on 18 lesions (detected on mammography and/or palpation) in 16 patients. Patients were prone with their compressed mediolaterally between two plates in a circularly polarized RF coil. Lesion position was determined by reference to fiducial makers that corresponded to a grid of holes placed at 5 mm intervals in compression plate. FNA was performed with a 22G non-ferromagnetic needle. FNA was successful for 11 of 18 lesions (61%). Of the seven unsuccessful cases, there were four in which the lesions were too posteriorly placed to be accessed through the compression plate by the needle. Three cases were too anteriorly placed to be effectively immobilized and, although successfully localized, were insufficiently sampled by the FNA technique. MR-guided FNA is possible using a prototype breast localization device in a select group of patients. Current coil design limits its use in performing MR-guided FNA on the most anteriorly and posteriorly placed breast lesions. Unique requirements of FNA under MR guidance as compared to needle localization and biopsy have been identified. Modifications in localization hardware and cytology aspiration needles should overcome these restrictions. 15 refs., 3 figs.

  9. Diagnostic Challenges in the Fine Needle Aspiration Biopsy of Chronic Sclerosing Sialadenitis (Küttner's Tumor) in the Context of Head and Neck Malignancy: A Series of 4 Cases.

    PubMed

    Leon, Marino E; Santosh, Neetha; Agarwal, Amit; Teknos, Theodoros N; Ozer, Enver; Iwenofu, O Hans

    2016-09-01

    Chronic sclerosing sialadenitis (CSS) is a benign chronic inflammatory condition of the salivary gland. Clinically, CSS patients may present with a neck mass, often suggesting a neoplastic process. Fine-needle aspiration (FNA) is frequently used to evaluate these lesions. We present a series of 4 patients with CSS, in whom all but one had history of squamous cell carcinoma. The previous diagnosis of malignancy appeared to influence the interpretation of the cytologic preparations. Four patients who had undergone resection of a neck nodule that eventually was diagnosed as CSS were identified. FNA was performed in all 4 cases, and the final cytologic diagnosis in these cases included squamous cell carcinoma, basaloid neoplasm, and salivary gland neoplasm. During intraoperative consultation, the lesions were identified as benign, atrophic salivary gland with chronic inflammation, or sialadenitis with atypical glands. All resected specimens were submitted for histopathological examination and were considered diagnostic for CSS. CSS is a potential pitfall in the FNA interpretation of salivary gland lesions, especially if there is a previous history of head and neck malignancy. Awareness of this entity, adherence to strict cytologic criteria, and careful clinicopathologic correlation are helpful in preventing misinterpretation and unnecessary surgical intervention. PMID:26909791

  10. MR-compatible biopsy needle with enhanced tip force sensing

    PubMed Central

    Elayaperumal, Santhi; Bae, Jung Hwa; Christensen, David; Cutkosky, Mark R.; Daniel, Bruce L.; Costa, Joannes M.; Black, Richard J.; Faridian, Fereydoun; Moslehi, Behzad

    2015-01-01

    We describe an instrumented biopsy needle that provides physicians the capability to sense interaction forces directly at the tip of the needle’s inner stylet. The sensors consist of optical fiber Bragg gratings (FBGs), and are unaffected by electromagnetic fields; hence the needle is suitable for MR-guided procedures. In comparison to previous instrumented needles that measure bending strains, the new design has additional sensors and a series of micro-machined holes at the tip. The holes increase strain sensitivity, especially to axial forces, without significantly reducing the stiffness or strength. A comparison of the dynamic forces measured with the new needle and those obtained using a force/torque sensor at the needle base shows that the enhanced tip sensitivity is particularly noticeable when there is significant friction along the needle sleeve. PMID:26509189

  11. Photoacoustic image-guided needle biopsy of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Kim, Chulhong; Erpelding, Todd N.; Akers, Walter J.; Maslov, Konstantin; Song, Liang; Jankovic, Ladislav; Margenthaler, Julie A.; Achilefu, Samuel; Wang, Lihong V.

    2011-03-01

    We have implemented a hand-held photoacoustic and ultrasound probe for image-guided needle biopsy using a modified clinical ultrasound array system. Pulsed laser light was delivered via bifurcated optical fiber bundles integrated with the hand-held ultrasound probe. We photoacoustically guided needle insertion into rat sentinel lymph nodes (SLNs) following accumulation of indocyanine green (ICG). Strong photoacoustic image contrast of the needle was achieved. After intradermal injection of ICG in the left forepaw, deeply positioned SLNs (beneath 2-cm thick chicken breast) were easily indentified in vivo and in real time. Further, we confirmed ICG uptake in axillary lymph nodes with in vivo and ex vivo fluorescence imaging. These results demonstrate the clinical potential of this hand-held photoacoustic system for facile identification and needle biopsy of SLNs for cancer staging and metastasis detection in humans.

  12. Interpretation of negative results in fine needle aspiration of discrete pulmonary lesions.

    PubMed Central

    Winning, A J; McIvor, J; Seed, W A; Husain, O A; Metaxas, N

    1986-01-01

    A retrospective analysis was carried out on a consecutive series of 181 percutaneous fine needle aspiration biopsies of discrete pulmonary lesions, in which the outcome was established in 95%. In primary bronchial carcinoma the technique had a sensitivity of 86%. There was no relationship between the size, location, or radiological appearance of the lesion and the incidence of false negative results. The principal reason for failure to diagnose malignancy was inadequacy of the material provided for cytological examination. For metastatic neoplasms of non-bronchial origin the procedure had a sensitivity of 42% and a significantly greater false negative rate than for primary bronchial malignancy. For the entire series 72 (40%) of the procedures failed to produce a definite diagnosis, 29 (40%) of these cases subsequently proving to be malignant. A positive diagnosis was established in only 16% of patients with benign conditions. Review of published reports and consideration of the role of this and other biopsy techniques in the investigation of discrete pulmonary lesions lead to the conclusion that needle aspiration biopsy seems particularly appropriate in the investigation of inoperable patients with probable bronchial carcinoma in whom sputum cytology and bronchoscopy do not yield a diagnosis. PMID:3824273

  13. Scalp Melanoma Diagnosed by Fine Needle Aspiration Cytology in a Tertiary Health Center

    PubMed Central

    Zarami, A. B.; Satumari, N. A.; Ahmed, M.

    2015-01-01

    Melanoma is one of the most aggressive malignant skin neoplasms worldwide with more than 20% of world melanoma seen in black Africa and Asia. Late presentation due to ignorance, poverty, and lack of adequate health facility in Nigeria is always the norms. We present this case report because of precision in diagnosis, using fine needle aspiration cytology (FNAC) to reemphasize that the technique is cheap, cost effective, and quick that can reduce the burden of incisional biopsy before definitive surgery and improve early detection of the disease especially in developing countries. PMID:26664783

  14. Scalp Melanoma Diagnosed by Fine Needle Aspiration Cytology in a Tertiary Health Center.

    PubMed

    Zarami, A B; Satumari, N A; Ahmed, M

    2015-01-01

    Melanoma is one of the most aggressive malignant skin neoplasms worldwide with more than 20% of world melanoma seen in black Africa and Asia. Late presentation due to ignorance, poverty, and lack of adequate health facility in Nigeria is always the norms. We present this case report because of precision in diagnosis, using fine needle aspiration cytology (FNAC) to reemphasize that the technique is cheap, cost effective, and quick that can reduce the burden of incisional biopsy before definitive surgery and improve early detection of the disease especially in developing countries. PMID:26664783

  15. CT guided percutaneous needle biopsy of the chest: initial experience

    PubMed Central

    Lazguet, Younes; Maarouf, Rachid; Karrou, Marouan; Skiker, Imane; Alloubi, Ihsan

    2016-01-01

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015. Diagnosis was achieved in 18 patients (75%), negative results were found in 3 patients (12,5%). Biopsy was repeated in these cases with two positive results. Complications were seen in 7 patients (29%), Hemoptysis in 5 patients (20%), Pneumothorax in 1 patient (4,1%) and vaso-vagal shock in 1 patient (4,1%). CT Guided Percutaneous Needle Biopsy of the Chest is a safe, minimally invasive procedure with high sensitivity, specificity and accuracy for diagnosis of lung lesions.

  16. Optimizing prostate needle biopsy through 3D simulation

    NASA Astrophysics Data System (ADS)

    Zeng, Jianchao; Kaplan, Charles; Xuan, Jian Hua; Sesterhenn, Isabell A.; Lynch, John H.; Freedman, Matthew T.; Mun, Seong K.

    1998-06-01

    Prostate needle biopsy is used for the detection of prostate cancer. The protocol of needle biopsy that is currently routinely used in the clinical environment is the systematic sextant technique, which defines six symmetric locations on the prostate surface for needle insertion. However, this protocol has been developed based on the long-term observation and experience of urologists. Little quantitative or scientific evidence supports the use of this biopsy technique. In this research, we aim at developing a statistically optimized new prostate needle biopsy protocol to improve the quality of diagnosis of prostate cancer. This new protocol will be developed by using a three-dimensional (3-D) computer- based probability map of prostate cancer. For this purpose, we have developed a computer-based 3-D visualization and simulation system with prostate models constructed from the digitized prostate specimens, in which the process of prostate needle biopsy can be simulated automatically by the computer. In this paper, we first develop an interactive biopsy simulation mode in the system, and evaluate the performance of the automatic biopsy simulation with the sextant biopsy protocol by comparing the results by the urologist using the interactive simulation mode with respect to 53 prostate models. This is required to confirm that the automatic simulation is accurate and reliable enough for the simulation with respect to a large number of prostate models. Then we compare the performance of the existing protocols using the automatic biopsy simulation system with respect to 107 prostate models, which will statistically identify if one protocol is better than another. Since the estimation of tumor volume is extremely important in determining the significance of a tumor and in deciding appropriate treatment methods, we further investigate correlation between the tumor volume and the positive core volume with 89 prostate models. This is done in order to develop a method to

  17. Pulmonary artery intimal sarcoma diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration.

    PubMed

    Caraway, Nancy P; Salina, Davide; Deavers, Michael T; Morice, Rodolfo; Landon, Gene

    2015-01-01

    Intimal sarcoma of the pulmonary artery is a rare intraluminal malignant neoplasm that has an aggressive biological behavior, and early diagnosis may improve patient outcome. We describe a case of pulmonary artery intimal sarcoma diagnosed on cytologic material obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy with rapid on-site evaluation (ROSE). The aspirate showed loosely cohesive clusters of pleomorphic malignant spindled and epithelioid cells. An immunostain panel did not demonstrate any definitive mesenchymal or epithelial differentiation. The tumor's intraluminal origin was supported by radiographic imaging studies. Subsequently, the patient received preoperative chemotherapy and underwent tumor resection with reconstruction. This report describes the cytomorphologic features of this rare intravascular tumor and demonstrates how EBUS-TBNA with ROSE was instrumental in obtaining optimal cytologic sampling for ancillary studies, thus expediting the management. PMID:25745502

  18. Basic technique in endoscopic ultrasound-guided fine needle aspiration for solid lesions: How many passes?

    PubMed

    Petrone, Maria Chiara; Arcidiacono, Paolo Giorgio

    2014-01-01

    Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has evolved to become an indispensable tool for tissue acquisition in patients with luminal and extra luminal gastrointestinal cancers. Despite the extensive use of EUS-FNA, there still exists a wide variation in the number of samples required to ensure acquisition of diagnostic material from different kind of lesions. There are several factors that may influence the number of fine needle passes made during EUS-FNA, but the main factor seems to be the presence of a Cytopathologist during the EUS procedure. The diagnostic yield of EUS-FNA with rapid on-site evaluation (ROSE) in most studies exceeds 90%. Nevertheless, ROSE is not available in many centers. Various studies have investigated the adequate number of needle passes that should be performed if ROSE is not used. Differences exist based on the nature of the target lesion: Five to seven passes for pancreatic masses, three passes for lymphnodes, only one pass for pancreatic cystic lesions. Consider using a core biopsy needle or a 19-G FNA needle for histology could improve the diagnostic yield. Even though EUS-FNA is widely available, some patients still do not receive conclusive diagnoses upon initial EUS-FNA. One way to maximize the benefits for patients might be to centralize cases to several well-equipped, high-volume centers with experienced endosonographers that have universal availability of ROSE. PMID:24949407

  19. Needle Fracture during Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspicious Thoracic Lymph Nodes

    PubMed Central

    Manière, Thibaut; Déry, Vincent

    2016-01-01

    Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is used to make a cytopathologic diagnosis of suspicious lesions located around the gastrointestinal tract. It is a safe technique with few complications. The most common complications of EUS-FNA are related to pancreatic lesions (pancreatitis, bleeding, and abdominal pain). Rare complications have been noted such as stent malfunction, air embolism, infection, neural and vascular injuries, and tumor cell seeding. There are very few studies examining equipment malfunctions. We report a case of needle fracture during the EUS-FNA of suspicious thoracic lymph nodes in a 79-year-old man investigated for unexplained weight loss. PMID:27555874

  20. Needle Fracture during Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Suspicious Thoracic Lymph Nodes.

    PubMed

    Adamowicz, Bartosz; Manière, Thibaut; Déry, Vincent; Désilets, Étienne

    2016-01-01

    Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is used to make a cytopathologic diagnosis of suspicious lesions located around the gastrointestinal tract. It is a safe technique with few complications. The most common complications of EUS-FNA are related to pancreatic lesions (pancreatitis, bleeding, and abdominal pain). Rare complications have been noted such as stent malfunction, air embolism, infection, neural and vascular injuries, and tumor cell seeding. There are very few studies examining equipment malfunctions. We report a case of needle fracture during the EUS-FNA of suspicious thoracic lymph nodes in a 79-year-old man investigated for unexplained weight loss. PMID:27555874

  1. Sclerosing hemangioma: A diagnostic dilemma in fine needle aspiration cytology

    PubMed Central

    Zeng, Jennifer; Zhou, Fang; Wei, Xiao-Jun; Kovacs, Sandor; Simsir, Aylin; Shi, Yan

    2016-01-01

    Sclerosing hemangioma of the lung is a benign neoplasm with a widely debated histogenesis. It has a polymorphic histomorphology characterized by a biphasic cell population of “surface cells” and “round cells” arranged in four general patterns: Papillary, solid, angiomatous, and sclerotic. This variability in histomorphology makes it difficult to diagnose sclerosing hemangioma by fine needle aspiration (FNA). We present a case of sclerosing hemangioma diagnosed on FNA with immunohistochemistry performed on an accompanied cell block. The clinical presentation, cytomorphology, immunohistochemistry, and differential diagnoses are discussed. PMID:27168758

  2. Endobronchial ultrasound-guided transbronchial needle aspiration of pulmonary artery tumors: A systematic review (with video).

    PubMed

    Harris, Kassem; Modi, Kush; Kumar, Abhishek; Dhillon, Samjot Singh

    2015-01-01

    Convex probe endobronchial ultrasound (CP-EBUS) was originally introduced as a diagnostic and staging tool for lung cancer and subsequently utilized for diagnosis of other malignant and benign mediastinal diseases such as melanoma, lymphoma, and sarcoidosis. More recently, CP-EBUS has been successfully used for the visualization and diagnosis of pulmonary emboli and other vascular lesions including primary and metastatic pulmonary artery (PA) tumors. In this review, we will underline the role of EBUS-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of pulmonary arterial tumors such as sarcomas and tumor emboli. We will concisely discuss the clinical applications of EBUS-TBNA and the types of pulmonary arterial tumors and their different diagnostic modalities. We searched the Cochrane Library and PubMed from 2004 to 2014 to provide the most comprehensive review. Only 10 cases of EBUS-TBNA for intravascular lesions were identified in the literature. Although many cases of EBUS and EUS-guided transvascular tumor biopsies were described in the literature, there were no reported cases of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for intravascular tumor biopsies. Except for one paper, all cases were published as case reports. PMID:26374576

  3. Core needle biopsy guidance based on EMOCT imaging (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Iftimia, Nicusor V.; Park, Jesung; Maguluri, Gopi

    2016-03-01

    We present a novel method, based on encoder mapping OCT imaging, for real-time guidance of core biopsy procedures. This method provides real-time feedback to the interventional radiologist, such that he/she can reorient the needle during the biopsy and sample the most representative area of the suspicious mass that is being investigated. This aspect is very important for tailoring therapy to the specific cancer based on biomarker analysis, which will become one of the next big advances in our search for the optimal cancer therapy. To enable individualized treatment, the genetic constitution and the DNA repair status in the affected areas is needed for each patient. Thus, representative sampling of the tumor is needed for analyzing various biomarkers, which are used as a tool to personalize cancer therapy. The encoder-based OCT enables samping of large size masses and provides full control on the imaging probe, which is passed through the bore of the biopsy guidance needle. The OCT image is built gradually, based on the feedback of an optical encoder which senses the incremental movement of the needle with a few microns resolution. Tissue mapping is independent of the needle speed, while it is advanced through the tissue. The OCT frame is analyzed in real-time and tissue cellularity is reported in a very simple manner (pie chart). Our preliminary study on a rabbit model of cancer has demonstrated the capability of this technology for accurately differentiating between viable cancer and heterogeneous or necrotic tissue.

  4. Diagnosis of Langerhans Cell Histiocytosis on Fine Needle Aspiration Cytology: A Case Report and Review of the Cytology Literature

    PubMed Central

    Kumar, Neeta; Sayed, Shahin; Vinayak, Sudhir

    2011-01-01

    A case of multifocal Langerhans cell histiocytosis in a two-year-old child is presented where fine needle aspiration was helpful in achieving a rapid and accurate diagnosis in an appropriate clinical and radiological setting. This can avoid unnecessary biopsy and guide the management especially where access to histopathology is limited. The highly characteristic common and rare cytological features are highlighted with focus on differential diagnoses and causes of pitfalls. PMID:21331166

  5. Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures

    PubMed Central

    Pichette, Julien; Goyette, Andréanne; Picot, Fabien; Tremblay, Marie-Andrée; Soulez, Gilles; Wilson, Brian C.; Leblond, Frédéric

    2015-01-01

    A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue. PMID:26600990

  6. Sensitivity analysis aimed at blood vessels detection using interstitial optical tomography during brain needle biopsy procedures.

    PubMed

    Pichette, Julien; Goyette, Andréanne; Picot, Fabien; Tremblay, Marie-Andrée; Soulez, Gilles; Wilson, Brian C; Leblond, Frédéric

    2015-11-01

    A brain needle biopsy procedure is performed for suspected brain lesions in order to sample tissue that is subsequently analysed using standard histopathology techniques. A common complication resulting from this procedure is brain hemorrhaging from blood vessels clipped off during tissue extraction. Interstitial optical tomography (iOT) has recently been introduced by our group as a mean to assess the presence of blood vessels in the vicinity of the needle. The clinical need to improve safety requires the detection of blood vessels within 2 mm from the outer surface of the needle, since this distance is representative of the volume of tissue that is aspirated durirng tissue extraction. Here, a sensitivity analysis is presented to establish the intrinsic detection limits of iOT based on simulations and experiments using brain tissue phantoms. It is demonstrated that absorbers can be detected with diameters >300 μm located up to >2 mm from the biopsy needle core for bulk optical properties consistent with brain tissue. PMID:26600990

  7. Percutaneous CT-guided fine-needle aspiration of pulmonary lesions: Results and complications in 409 patients.

    PubMed

    Laspas, F; Roussakis, A; Efthimiadou, R; Papaioannou, D; Papadopoulos, S; Andreou, J

    2008-10-01

    The purpose of this study was to report our centre's experience in the results and complications of percutaneous CT-guided lung biopsy. A retrospective review of 409 patients who underwent percutaneous CT-guided fine-needle aspiration of suspicious lung lesions for more than 5 years was carried out. Nodule sizes ranged from 0.6 to 10 cm. The calibre of the needle used was 21-23 G. Specimen adequacy and patient outcome were evaluated. Each case was reviewed for complications. Sufficient diagnostic material was obtained in 369 (90%) of the 409 fine-needle aspirations. Diagnosis was malignancy in 290 (70%) samples, four (1%) samples were suspicious for malignancy, 65 (16%) samples were negative for malignancy and definite benign findings were identified in 10 (3%) specimens. There were 25 false-negative cases and one false-positive case. Sensitivity was 92% and specificity 98%. Pneumothorax was the most common complication and occurred in 17 (4%) patients. Only one of them required thoracic drainage. Blood effusion around the lesion or along the needle track was detected on the post-biopsy CT in 8 (2%) patients. However, only one of them suffered from a mild haemoptysis. Percutaneous CT-guided biopsy is an effective and fast procedure for diagnosis of suspected pulmonary malignancy, with a low complication rate. PMID:19032391

  8. Fine needle aspirate flow cytometric phenotyping characterizes immunosuppressive nature of the mesothelioma microenvironment

    PubMed Central

    Lizotte, Patrick H.; Jones, Robert E.; Keogh, Lauren; Ivanova, Elena; Liu, Hongye; Awad, Mark M.; Hammerman, Peter S.; Gill, Ritu R.; Richards, William G.; Barbie, David A.; Bass, Adam J.; Bueno, Raphael; English, Jessie M.; Bittinger, Mark; Wong, Kwok-Kin

    2016-01-01

    With the emergence of checkpoint blockade and other immunotherapeutic drugs, and the growing adoption of smaller, more flexible adaptive clinical trial designs, there is an unmet need to develop diagnostics that can rapidly immunophenotype patient tumors. The ability to longitudinally profile the tumor immune infiltrate in response to immunotherapy also presents a window of opportunity to illuminate mechanisms of resistance. We have developed a fine needle aspirate biopsy (FNA) platform to perform immune profiling on thoracic malignancies. Matching peripheral blood, bulk resected tumor, and FNA were analyzed from 13 mesothelioma patients. FNA samples yielded greater numbers of viable cells when compared to core needle biopsies. Cell numbers were adequate to perform flow cytometric analyses on T cell lineage, T cell activation and inhibitory receptor expression, and myeloid immunosuppressive checkpoint markers. FNA samples were representative of the tumor as a whole as assessed by head-to-head comparison to single cell suspensions of dissociated whole tumor. Parallel analysis of matched patient blood enabled us to establish quality assurance criteria to determine the accuracy of FNA procedures to sample tumor tissue. FNA biopsies provide a diagnostic to rapidly phenotype the tumor immune microenvironment that may be of great relevance to clinical trials. PMID:27539742

  9. Fine needle aspirate flow cytometric phenotyping characterizes immunosuppressive nature of the mesothelioma microenvironment.

    PubMed

    Lizotte, Patrick H; Jones, Robert E; Keogh, Lauren; Ivanova, Elena; Liu, Hongye; Awad, Mark M; Hammerman, Peter S; Gill, Ritu R; Richards, William G; Barbie, David A; Bass, Adam J; Bueno, Raphael; English, Jessie M; Bittinger, Mark; Wong, Kwok-Kin

    2016-01-01

    With the emergence of checkpoint blockade and other immunotherapeutic drugs, and the growing adoption of smaller, more flexible adaptive clinical trial designs, there is an unmet need to develop diagnostics that can rapidly immunophenotype patient tumors. The ability to longitudinally profile the tumor immune infiltrate in response to immunotherapy also presents a window of opportunity to illuminate mechanisms of resistance. We have developed a fine needle aspirate biopsy (FNA) platform to perform immune profiling on thoracic malignancies. Matching peripheral blood, bulk resected tumor, and FNA were analyzed from 13 mesothelioma patients. FNA samples yielded greater numbers of viable cells when compared to core needle biopsies. Cell numbers were adequate to perform flow cytometric analyses on T cell lineage, T cell activation and inhibitory receptor expression, and myeloid immunosuppressive checkpoint markers. FNA samples were representative of the tumor as a whole as assessed by head-to-head comparison to single cell suspensions of dissociated whole tumor. Parallel analysis of matched patient blood enabled us to establish quality assurance criteria to determine the accuracy of FNA procedures to sample tumor tissue. FNA biopsies provide a diagnostic to rapidly phenotype the tumor immune microenvironment that may be of great relevance to clinical trials. PMID:27539742

  10. Pathological aspects of core needle biopsy for non-palpable breast lesions.

    PubMed

    Usami, Shin; Moriya, Takuya; Kasajima, Atsuko; Suzuki, Akihiko; Ishida, Takanori; Sasano, Hironobu; Ohuchi, Noriaki

    2005-01-01

    Recently, the incidence of non-palpable or noninvasive breast cancer has increased. Consequently, criteria for choosing procedures to obtain pathological materials had changed. Fine needle aspiration biopsy cytology (FNA) and core needle biopsy (CNB) are both reliable procedures for detecting breast cancer. However, for non-palpable lesions, the diagnostic accuracy of CNB is higher. The main limits of FNA are the high rate of insufficient sampling and inability to determine invasiveness. CNB is an established alternative to surgical biopsy, and CNB can avoid excess surgical biopsies in a large number of patients. In addition to accurate histological diagnosis, there is interest in obtaining prognostic information from CNB, especially for patients being considered for preoperative (neoadjuvant) therapy. CNB provides useful information about histologic type and grade. However, an unavoidable problem of CNB is underestimation of invasion. On the other hand, there is good concordance in particular for estrogen receptor (ER) and progesterone receptor (PR) between CNB and surgical excision. Several aspects of CNB remains controversial, such as diagnosing papillary lesions by CNB, problems regarding tumor cell displacement after CNB, and management of lobular neoplasia (LN) on CNB. PMID:16286907

  11. Metastatic tumor: the complementary role of the marrow aspirate and biopsy.

    PubMed

    Atac, B; Lawrence, C; Goldberg, S N

    1991-10-01

    To determine whether bone marrow aspiration or biopsy is more sensitive in the detection of nonhematologic metastatic involvement of marrow, all 1569 consecutive paired biopsy and aspirate samples obtained between January 1975 and January 1, 1986 in an 800 bed municipal hospital were reviewed. At least eight aspirate slides and 10 biopsy cross sections were examined for each pair. In 39 samples, both biopsy and aspirate identified metastatic tumor. No biopsies contained tumor that was not also seen on the aspirate. However, five aspirate slides contained metastatic malignancies not identified on biopsy. The hematologist or oncologist viewing individual cells in a monolayer at 1000 x magnification has the advantage of identifying very small clusters of tumor cells. That accounted for three of the five positive aspirate samples in which the biopsies were negative. The other two positive aspirate slides each contained tumor on only one of eight slides. The results of our study indicate that when carefully reviewed, the aspirate is at least as sensitive as the marrow biopsy for identifying metastatic tumor. Our results indicate that marrow aspirates and biopsies are useful and complementary examinations for identifying metastatic malignancy. PMID:1928232

  12. Core needle biopsies and surgical excision biopsies in the diagnosis of lymphoma-experience at the Lymph Node Registry Kiel.

    PubMed

    Johl, Alice; Lengfelder, Eva; Hiddemann, Wolfgang; Klapper, Wolfram

    2016-08-01

    Current guidelines of the European Society of Medical Oncology recommend surgical excision biopsies of lymph nodes for the diagnosis of lymphoma whenever possible. However, core needle biopsies are increasingly used. We aimed to understand the common practice to choose the method of biopsy in Germany. Furthermore, we wanted to understand performance of surgical excision and core needle biopsies of lymph nodes in the diagnosis of lymphoma. The files of 1510 unselected, consecutive lymph node specimens from a consultation center for lymphoma diagnosis were analyzed. Core needle biopsies were obtained frequently from lymph nodes localized in mediastinal, abdominal, retroperitoneal, or thoracic regions. Patients undergoing core needle biopsies were significantly older and suffered significantly more often from lymphoma than patients undergoing surgical excision biopsies. Although more immunohistochemical tests were ordered by the pathologist for core needle biopsies specimens than for surgical excision biopsies specimens, core needle biopsies did not yield a definite diagnosis in 8.3 % of cases, compared to 2.8 % for SEB (p = 0.0003). Restricting the analysis to cases with a final diagnosis of follicular lymphoma or diffuse large B-cell lymphoma, core needle biopsies identified a simultaneous low- and high-grade lymphoma (transformation) in 3.3 % of cases, compared to 7.6 % for surgical excision biopsies (p = 0.2317). In Germany, core needle biopsies are preferentially used in elderly patients with a high likelihood of suffering from lymphoma. Core needle appeared inferior to surgical excision biopsies at providing a definite diagnosis and at identifying multiple lymphoma differentiations and transformation. PMID:27236576

  13. Intranuclear Pseudo-inclusions and Grooves in Fine Needle Aspiration Cytology of Pulmonary Carcinoid Tumor.

    PubMed

    Mokhtari, Maral; Kumar, Perikala Vijayananda

    2016-02-01

    Cytologic findings of pulmonary carcinoid have been well described. We report new cytological findings in a case of carcinoid tumor. The patient is a 36-year-old man presenting with hemoptysis of about six months in duration. Chest CT scans showed a well-defined round polypoid lesion measuring 1 × 1 cm within the right upper lobe of the bronchus with hyperinflation of the right upper lobe. Trans-bronchial fine needle aspiration and biopsy were done. Cytologic smears showed isolated and loose clusters of uniform round to spindle shape cells with round centrally located nuclei, fine granular (salt and pepper) chromatin and pale cytoplasm. Intranuclear pseudo-inclusions and grooves were seen in some tumor cells. No mitotic figures or necrosis were evident. A cytological diagnosis of carcinoid tumor was made and histopathologic examination and subsequent immunohistochemical study confirmed the diagnosis. Carcinoid tumor may be reliably diagnosed on fine needle aspiration cytology smears. Intranuclear pseudo-inclusions and grooves may be evident in tumor cells. PMID:26838088

  14. Effectiveness and limitations of core needle biopsy in the diagnosis of thyroid nodules: review of current literature.

    PubMed

    Yoon, Jung Hyun; Kim, Eun-Kyung; Kwak, Jin Young; Moon, Hee Jung

    2015-05-01

    Fine needle aspiration (FNA) is currently accepted as an easy, safe, and reliable tool for the diagnosis of thyroid nodules. Nonetheless, a proportion of FNA samples are categorized into non-diagnostic or indeterminate cytology, which frustrates both the clinician and patient. To overcome this limitation of FNA, core needle biopsy (CNB) of the thyroid has been proposed as an additional diagnostic method for more accurate and decisive diagnosis for thyroid nodules of concern. In this review, we focus on the effectiveness and limitations of CNB, and what factors should be considered when CNB is utilized in the diagnosis of thyroid nodules. PMID:26018514

  15. Two cases of primary intraocular lymphoma: fine needle aspiration diagnosis and intravitreal methotrexate treatment.

    PubMed

    Zhao, Tantai; Li, Yunqin; Tang, Luosheng; Wei, Xin; Zhu, Xiaohua

    2011-02-01

    We described clinical process of two cases of intraocular lymphoma in aspects of early diagnosis by fine needle aspiration (FNA) and biopsy and treatment by intravitreal methotrexate (MTX). Two patients were suspected to have primary intraocular lymphoma (PIOL) with geographic yellow-white infiltrates and vitreous opacity. FNA confirmed malignant intraocular lymphoma in one patient and failed in the other patient due to complication of vitreous hemorrhage. Subsequent vitreous biopsy confirmed malignant intraocular lymphoma in the other patient. Both patients were treated by intravitreal methotrexate. In case 1 the tumor had complete remission and follow-up of 12 months had not found any signs of recurrence. In case 2 the patient died of brain metastasis 22 months after the ocular biopsy. Our findings demonstrate that although cytological examination of vitrectomy specimens remains the gold standard in diagnosis of PIOL, examination of FNA and biopsy increases the reliability of early diagnosing or excluding a PIOL. Individualized intravitreal methotrexate can be used to effectively treat PIOL. More effective integrated program treating primary central nervous system lymphoma/PIOL is worthy of looking forward to. PMID:21336740

  16. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of kidney lesions: A review.

    PubMed

    Lopes, Roberto Iglesias; Moura, Renata Nobre; Artifon, Everson

    2015-03-16

    Traditionally, treatment of renal lesions is indicated based only on imaging features. Although controversy exists about tissue sampling from small renal masses, renal biopsy is indicated in some cases. In this review, we discuss the rationale for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and summarize the recent advances in this field, providing recommendations for the practicing clinician. The use of EUS-FNA appears to be a safe and feasible means of confirming or excluding malignancy. EUS allows assessment and biopsy of masses or lesions within both kidneys and related complications are rare. The main advantages of EUS-FNA are that it can be done as an outpatient procedure, with good results, minimal morbidity and a short hospital stay. Nevertheless, EUS-FNA of renal masses should be indicated only in selected cases, in which there is potential to decrease unnecessary treatment of small renal masses and to best select tumors for active surveillance and minimally invasive ablative therapies. Additionally, some renal lesions may be ineligible for EUS-guided biopsy because of anatomical limitations. EUS-FNA renal biopsy will probably be best applied to central anterior renal masses, while tumors on the posterior aspect of the kidney, percutaneous access will probably be superior. PMID:25789096

  17. Needle localization breast biopsy: a model for multidisciplinary quality assurance.

    PubMed

    Howe, J R; Monsees, B; Destouet, J; Seib, J; Dehner, L P; Kraybill, W G

    1995-04-01

    As part of the quality assurance role of the Cancer Committee at Barnes Hospital, an institutional audit of Needle Localization Breast Biopsy (NLBB) was performed. Mammographic, operative, and surgical pathology reports from 370 consecutive patients at our institution undergoing both mammography and needle localization biopsy over a 34-month interval were reviewed. Carcinoma was diagnosed pathologically in 103 patients (28%), and 27% of these proved to be noninvasive. Sixteen patients were found to have histologic or clinical involvement of the axillary nodes; no patients with Tis lesions were found to have axillary nodal involvement. Of the patients, 73% were found to have either Stage 0 or Stage I disease, and 61% with an established malignancy had mastectomy (67% of patients with invasive carcinoma, 44% of those with carcinoma-in-situ), whereas 39% had some form of conservation therapy (33% of patients with invasive lesions, 56% of those with carcinoma-in-situ). Our results have been compared with other published studies, and important clinical indicators for evaluating the results of individual centers performing NLBB are discussed. It is concluded that NLBB is a safe and effective method of biopsying nonpalpable breast lesions, which allows for the identification of early stage breast carcinomas. In the present environment of concerns about the quality of care and costs, it is the responsibility of each center performing NLBB periodically to evaluate their results with this multidisciplinary procedure and to bring about change in those areas found to be deficient. PMID:7723366

  18. NEEDLE BIOPSY OF THE LIVER—General Considerations

    PubMed Central

    Molle, William E.; Kaplan, Leo

    1952-01-01

    Needle biopsy of the liver provides concrete diagnostic information that cannot be as readily obtained in any other way. This report reviews 401 liver biopsies in 312 patients. The major indications for use of this procedure are: To determine the cause of an obscure liver enlargement; to establish the cause of jaundice; to distinguish between malignant disease and cirrhosis of the liver; to determine when hepatitis has subsided; and to evaluate the results of treatment. At times, systemic disease that has not been recognized by other means may be diagnosed by this technique. There is risk in performing this test, and the 0.25 per cent mortality in this series compares favorably with that reported from other clinics. Where the diagnosis by biopsy could be compared with observations at operation or autopsy, the correct diagnosis was made by biopsy in 85 per cent of cases. Greater accuracy was obtained by two or more biopsic examinations in one case then by single biopsy. In several cases in which surgical operation was considered, biopsic information made it unnecessary, and vice versa. PMID:14886754

  19. [Clarification of breast lesions using core-cut, drill and fine needle biopsy].

    PubMed

    Junkermann, H; Anton, H W; Krapfl, E; Harcos, A; von Fournier, D

    1993-05-01

    Interest in needle biopsy methods (core cut-, drill-, and fine-needle biopsy) has recently increased considerably because of the rise in screening mammography and new developments in the therapy of breast cancer. In order to achieve adequate results using needle biopsy and to avoid complications, certain technical details must be strictly adhered to. An experienced surgeon can achieve a sensitivity of above 90% in the diagnosis of breast carcinoma with all three methods. Considering the advantages and disadvantages of these three methods of needle biopsy, we prefer--based on our own experience--high-speed core-cut biopsy for the morphological evaluation of breast lesions. PMID:8516437

  20. Advances in head and neck fine-needle aspiration and ultrasound technique for the pathologist.

    PubMed

    Jakowski, Joseph D; DiNardo, Laurence J

    2015-07-01

    The success of fine-needle aspiration (FNA) biopsy in the evaluation of head and neck (H&N) masses has already been established. Herein we outline the most recent advancement for the pathologist who performs traditional palpation-guided FNA (PGFNA) in the H&N while also incorporating ultrasound-guided FNA (UGFNA) into their practice. We provide an overview of the educational and training opportunities in H&N ultrasound and UGFNA with emphasis on the advantages and limitations for the pathologist. Throughout are useful clinical and technical pearls, many of which may also interest those who practice PGFNA, including local anesthesia use and FNA procedures in pediatric patients. PMID:25677264

  1. Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of adrenal lesions

    PubMed Central

    Patil, Rashmee; Ona, Mel A.; Papafragkakis, Charilaos; Duddempudi, Sushil; Anand, Sury; Jamil, Laith H.

    2016-01-01

    The use of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) appears to be a safe and feasible means of confirming or excluding malignancy in the adrenal glands. EUS-FNA with biopsy of suspicious masses in either adrenal gland allows for assessment of these lesions while keeping complications relatively rare. The main advantages of EUS-FNA are that it can be done as an outpatient procedure, with good results, minimal morbidity, and a short hospital stay. Nevertheless, EUS-FNA of adrenal masses should be indicated only in selected cases, in which there is potential to either decrease unnecessary treatment or guide therapy in cancer patients by aiding in either staging of malignancy or treatment of recurrence.v PMID:27366030

  2. Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of adrenal lesions.

    PubMed

    Patil, Rashmee; Ona, Mel A; Papafragkakis, Charilaos; Duddempudi, Sushil; Anand, Sury; Jamil, Laith H

    2016-01-01

    The use of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) appears to be a safe and feasible means of confirming or excluding malignancy in the adrenal glands. EUS-FNA with biopsy of suspicious masses in either adrenal gland allows for assessment of these lesions while keeping complications relatively rare. The main advantages of EUS-FNA are that it can be done as an outpatient procedure, with good results, minimal morbidity, and a short hospital stay. Nevertheless, EUS-FNA of adrenal masses should be indicated only in selected cases, in which there is potential to either decrease unnecessary treatment or guide therapy in cancer patients by aiding in either staging of malignancy or treatment of recurrence.v. PMID:27366030

  3. Tension pneumothorax as a severe complication of endobronchial ultrasound-guided transbronchial fine needle aspiration of mediastinal lymph nodes

    PubMed Central

    Szlubowski, Artur; Gil, Tomasz; Kocoń, Piotr; Ziętkiewicz, Mirosław; Twardowska, Magdalena; Kużdżał, Jarosław

    2015-01-01

    This article presents a case report of a patient suffering from bullous emphysema and chronic obstructive pulmonary disease, who was diagnosed with tension pneumothorax after undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Tension pneumothorax is a severe but rare complication of EBUS-TBNA. It can result from lung injury caused by the biopsy needle or, in patients suffering from bullous emphysema, from spontaneous rupture of an emphysematous bulla resulting from increased pressure in the chest cavity during cough caused by bronchofiberoscope insertion. The authors emphasize that patients should be carefully monitored after the biopsy, and, in the case of complications, provided with treatment immediately in proper hospital conditions. Patients burdened with a high risk of complications should be identified before the procedure and monitored with extreme care after its completion. PMID:26855656

  4. Yield of new versus reused endobronchial ultrasound-guided transbronchial needle aspiration needles: A retrospective analysis of 500 patients

    PubMed Central

    Dhooria, Sahajal; Sehgal, Inderpaul Singh; Gupta, Nalini; Ram, Babu; Aggarwal, Ashutosh Nath; Behera, Digambar; Agarwal, Ritesh

    2016-01-01

    Background: Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) requires a dedicated needle for aspiration of mediastinal lesions. There is no data on reuse of these needles. Methods: This is a retrospective study of patients who underwent EBUS-TBNA with either new or reused EBUS-TBNA needles. The needles were reused after thorough cleaning with filtered water and organic cleaning solution, disinfection with 2.4% glutaraldehyde solution followed by ethylene oxide sterilization. The yield of EBUS-TBNA was compared between the two groups. Results: A total of 500 EBUS-TBNA procedures (351 new, 149 reused needles) were performed. The baseline characteristics were different in the two groups with suspected granulomatous disorders (sarcoidosis or tuberculosis) being significantly more common in the new compared to the reused needle group. Similarly, the median, interquartile range number of lymph node stations sampled, and the total number of passes were significantly higher in the new versus the reused needle group. The diagnostic yield was significantly higher with new needle as compared to reused needle (65.2% vs. 53.7%, P = 0.02). On multivariate logistic regression analysis, clinical suspicion of granulomatous disorders (odds ratio 1.86 [95% confidence interval, 1.20-2.87], P = 0.005) was the only predictor of diagnostic yield, after adjusting for the type of needle (new or reused), total number of passes and the number of lymph node stations sampled. No case of mediastinitis was encountered in either group. Conclusions: The yield of EBUS-TBNA might be similar with single reuse of needles as compared to new needles. However, reuse of needle should be performed only when absolutely necessary. PMID:27578927

  5. Recent advances in endobronchial ultrasound-guided transbronchial needle aspiration.

    PubMed

    Nakajima, Takahiro; Yasufuku, Kazuhiro; Fujiwara, Taiki; Yoshino, Ichiro

    2016-07-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality for sampling of mediastinal and hilar lymph nodes as well as pulmonary lesions adjacent to the airway. Guidelines for staging of lung cancer suggest that EBUS-TBNA should be considered the best first test of nodal staging for radiologically abnormal lymph nodes that are accessible by this approach. The application of EBUS-TBNA in pulmonary medicine and thoracic oncology is expanding with its role in the diagnosis of sarcoidosis, lymphoma, and tuberculosis. Especially for patients with early-stage sarcoidosis with adenopathy and minimal changes in the lung parenchyma, EBUS-TBNA has a significantly higher diagnostic yield compared to the conventional bronchoscopic modalities. Multidirectional analysis of samples obtained by EBUS-TBNA has allowed assessment of lymphoma and molecular analysis in lung cancer. Histological evaluation with immunohistochemistry, flow cytometry, fluorescence in situ hybridization, and chromosome analysis can be performed if good-quality samples can be obtained. Molecular analyses such as identification of epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) fusion gene detection now are being performed routinely with good sampling. One of the advantages of EBUS-TBNA is the ability to perform repeat procedures in a minimally invasive way. Restaging of the mediastinum after induction therapy can be done safely and with ease compared to repeat surgical procedures. With improvement in molecular analysis technology, comprehensive gene expression analysis will become important in the management of patients with lung cancer. Further advances in EBUS technology and needles for tissue sampling likely will help bronchoscopists to acquire ideal tissue. PMID:27424821

  6. Percutaneous fine needle aspiration cytology of the pancreas: advantages and pitfalls.

    PubMed Central

    Kocjan, G; Rode, J; Lees, W R

    1989-01-01

    Fine needle aspiration of the pancreas was performed in 62 patients with radiological suspicion of malignancy. All fine needle aspirates were taken under computed tomography or ultrasound guidance. Fine needle aspirates were positive in 31 of 41 patients with histologically or clinically confirmed pancreatic carcinoma. There were no false positive results. The sensitivity of this method for detecting malignant disease was 86%. Cytology was not able to provide conclusive results of benign conditions. Difficulties were encountered in diagnosing well differentiated carcinoma and neuroendocrine tumours and distinguishing them from reactive epithelium and islet cell hyperplasia, respectively. This resulted in a 12.1% false negative rate. There were no complications in our series. Percutaneous fine needle aspiration proved a reliable method of diagnosing pancreatic carcinoma. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 PMID:2541174

  7. Fine-needle aspiration cytology of metastatic transitional cell carcinoma.

    PubMed

    Dey, Pranab; Amir, Thasneem; Jogai, Sanjay; Al Jussar, Aisha

    2005-04-01

    In this article we described the fine-needle aspiration cytology (FNAC) of five cases of metastatic transitional cell carcinoma (TCC). There were four cases of metastatic lymph nodes and one case of metastatic skin lesion. All of the TCC cases were primarily in the urinary bladder and were high grade on histopathology (grade 3). Three cases showed bladder muscle involvement and two cases showed superficial TCC at the time of primary diagnosis. FNAC smears showed abundant cellularity. The cells were present in discrete and small syncytial clusters. Nuclear position of the cell was central to eccentric. Many cells showed prominent nucleoli. Cercariform cells (CCs) were noted in four cases. These cells are malignant cells with a nucleated globular body and a unipolar nontapering cytoplasmic process. Two cases showed intranuclear inclusions. Prominent cytoplasmic vacuoles were noted in three cases. In addition, cell cannibalism and attempted pearl formations were noted in two cases.In conclusion, clinical history along with the certain cytological features such as the presence of CCs, cells with eccentric nuclei, and intranuclear inclusions are helpful to diagnose metastatic TCC on FNAC material. PMID:15754372

  8. Fine-Needle Aspiration Cytology of Epithelioid Leiomyoblastoma

    PubMed Central

    Thompson, Karen Sue; Jensen, Joanne

    1999-01-01

    Purpose. Epithelioid leiomyoblastomas comprise the majority of gastric sarcomas and are uncommon in other parts of the gastrointestinal tract. Diagnosis of this lesion by fine-needle aspiration cytology has been occasionally described in the literature. Two additional cases are herein reported. Subjects . A 66-year old male with an omental mass and a 47-year old male with a perihepatic tumor. Results and Discussion. Cytologic materials in both cases showed predominantly round or epithelioid cells, along with polygonal to spindle cells, occuring singly and in clusters, with oval to spindle-shaped nuclei.The nuclei were monotonous, usually banal, and centrally-located with only focal suggestion of pleomorphism and rare mitosis. Eosinophilic cytoplasm was noted in most of the cells, some demonstrating vacuolation. Electron microscopy supported a primitive smooth cell derivation of the neoplastic cells. Conclusions. The cytomorphology of the tumors of the two cases reported here is not adequately known. More cases need to be collected and studied. PMID:18521258

  9. Vanishing tumors of thyroid: histological variations after fine needle aspiration

    PubMed Central

    Bhatia, Parisha; Deniwar, Ahmed; Mohamed, Hossam Eldin; Sholl, Andrew; Murad, Fadi; Aslam, Rizwan

    2016-01-01

    Background Fine needle aspiration (FNA) can lead to changes that extensively replace cytological confirmed thyroid lesions. These lesions, so called “vanishing tumors” can be diagnostically challenging to pathologists and therapeutically challenging for endocrinologists and surgeons. We performed a retrospective analysis to identify these tumors. Methods Data of 656 patients referred for thyroid surgery was reviewed. Patients with suspicious lesions on neck ultrasound (US) underwent FNA. We compared FNA cytological and surgical pathological findings to identify vanishing tumors. FNA-induced changes such as cystic degeneration, hemorrhage, calcification, cholesterol crystals, fibrosis and granulation tissue were identified. Results Seventeen patients (2.5%) were identified with vanishing tumors. FNA cytology was indeterminate in seven (41.1%) and benign in ten (58.8%) patients. Surgical pathology in all nodules showed regressive changes partially or entirely replacing the tumor. The mean size of vanishing tumors was 2.4±1.5 cm in greatest dimension. Seven nodules (41.1%) were entirely replaced while remaining ten nodules showed partial replacement of tumors. Three (17.6%) nodules had focal areas of optically clear nuclei suspicious of papillary thyroid carcinoma (PTC); one showed an additional focus of follicular neoplasm (FN) of uncertain malignant potential. Conclusions FNA-induced changes can lead to obliteration of nodules rendering pathological diagnosis with no evidence of confirmed lesions. Pathologists and surgeons should be aware of this challenging scenario. PMID:27294033

  10. Toward robotic needle steering in lung biopsy: a tendon-actuated approach

    NASA Astrophysics Data System (ADS)

    Kratchman, Louis B.; Rahman, Mohammed M.; Saunders, Justin R.; Swaney, Philip J.; Webster, Robert J., III

    2011-03-01

    Needle tip dexterity is advantageous for transthoracic lung biopsies, which are typically performed with rigid, straight biopsy needles. By providing intraoperative compensation for trajectory error and lesion motion, tendon-driven biopsy needles may reach smaller or deeper nodules in fewer attempts, thereby reducing trauma. An image-guided robotic system that uses these needles also has the potential to reduce radiation exposure to the patient and physician. In this paper, we discuss the design, workflow, kinematic modeling, and control of both the needle and a compact and inexpensive robotic prototype that can actuate the tendon-driven needle for transthoracic lung biopsy. The system is designed to insert and steer the needle under Computed Tomography (CT) guidance. In a free-space targeting experiment using a discrete proportional control law with digital camera feedback, we show a position error of less than 1 mm achieved using an average of 8.3 images (n=3).

  11. Guided fine needle absorption biopsy in the diagnosis of cysts in maritime workers.

    PubMed

    Bartelik, W; Jaremin, B; Smolińska, D; Głombiowski, P

    Cysts in the organs of the abdominal cavity revealed in ultrasonographic examinations in patients with none or with unclear clinical symptoms cause diagnostic and fitness for work assessment problems. The aim of the study was to evaluate the usefulness of ultrasonography of cysts, combined with biochemical, bacteriological, cytological examinations and analysis of markers CEA and AFP of the fluid collected with fine needle aspiration biopsy (FAB). The study material examined were maritime workers who were submitted to these examinations for diagnostic purposes and/or previous to issue of certificate of health for work at sea. Examinations results provided support for usefulness of the method discussed in diagnosis and differentiation of inflammatory and neoplastic processes with simple cysts. This was crucial for final diagnosis, for decision about treatment and recognizing fitness for work at sea. It was concluded that the method FAB is safe both in hospital as well as in ambulatory conditions. PMID:7580347

  12. [The value of fine needle aspiration cytology in suspected neoplastic salivary gland enlargement].

    PubMed

    Schoengen, A; Binder, T; Krause, H R; Stussak, G; Zeelen, U

    1995-04-01

    Imaging offers little support in the management of salivary gland masses suggestive of a neoplastic lesion. There are also contraindications for a surgical biopsy in many cases. Fine-needle aspiration cytology (FNAC) is not yet widely recognized as a diagnostic tool. To date, 206 FNAC were carried out from 1986 through 1993 on 181 consecutive patients and were reviewed in the present study. Histological confirmation was possible in 174 tests, while 32 were confirmed on clinical follow-up. In sum, 192 samples were sufficient for interpretation, 10 were questionable by our standards and 4 were non-diagnostic. One hundred-seventy-one samples were true-negative, 27 true-positive, 4 false-negative and 4 false-positive. Sensitivity was 87.1% and specificity 97.7%. Out of 141 primary diagnostic procedures in which a final histologic diagnosis was available, FNAC was able to determine histogenesis in 113/124 benign lesions and 9/17 malignant masses. These included 65/67 pleomorphic adenomas and 21/22 adenolymphomas. In 8 cases a diagnosis of "adenoma" was made. Difficulties in interpretation were found in lesions that were mucoepidermoid carcinomas and, in part, adenoid cystic carcinomas. No complications occurred. Provided that there was sufficient experience in performing the aspiration technique and in cytologic interpretation, FNAC was found to be a quick, reliable, low-cost, easy-to-perform method with low risk in the management of nearly all benign and most malignant salivary gland lesions. PMID:7790235

  13. Painless giant cell thyroiditis diagnosed by fine needle aspiration and associated with intense thyroidal uptake of gallium

    SciTech Connect

    Sanders, L.R.; Moreno, A.J.; Pittman, D.L.; Jones, J.D.; Spicer, M.J.; Tracy, K.P.

    1986-05-01

    A 52-year-old woman presented with fever, goiter, and no evidence of pain or tenderness in the thyroid. A diagnosis of silent thyroiditis was made after obtaining evidence of biochemical thyrotoxicosis, intense gallium-67 citrate thyroidal localization, and cytologic thyroiditis. Fine needle aspiration biopsy of the thyroid revealed numerous giant cells in all areas of the thyroid, typical of subacute thyroiditis. This is believed to be the first time painless thyroiditis is reported with the classic cytologic feature of painful subacute thyroiditis.

  14. Image-Guided Fine Needle Cytology with Aspiration Versus Non-Aspiration in Retroperitoneal Masses: Is Aspiration Necessary?

    PubMed Central

    Misra, Rajiv Kumar; Mitra, Shaila; Jain, Rishav Kumar; Vahikar, Shilpa; Bundela, Archana; Misra, Purak

    2015-01-01

    Background: Although using fine needle cytology with aspiration (FNC-A) for establishing diagnoses in the retroperitoneal region has shown promise, there is scant literature supporting a role of non-aspiration cytology (FNC-NA) for this region. We assessed the accuracy and reliability of FNC-A and FNC-NA as tools for preoperative diagnosis of retroperitoneal masses and compared the results of both techniques with each other and with histopathology. Methods: Fifty-seven patients with retroperitoneal masses were subjected to FNC-A and FNC-NA. Smears were stained with May-Grunwald Giemsa and hematoxylin and eosin stain. An individual slide was objectively analysed using a point scoring system to enable comparison between FNC-A and FNC-NA. Results: By FNC-A, 91.7% accuracy was obtained in cases of retroperitoneal lymph node lesions followed by renal masses (83.3%). The diagnostic accuracy of other sites by FNC-A varied from 75.0%–81.9%. By FNC-NA, 93.4% diagnostically accurate results were obtained in the kidney, followed by 75.0% in adrenal masses. The diagnostic accuracy of other sites by FNC-NA varied from 66.7%–72.8%. Conclusions: Although both techniques have their own advantages and disadvantages, FNC-NA may be a more efficient adjuvant method of sampling in retroperitoneal lesions. PMID:25812734

  15. Should needle localization breast biopsy give way to the new technology; the advanced breast biopsy instrumentation.

    PubMed

    Hawasli, A; Zonca, S; Watt, C; Rebecca, A

    2000-07-01

    Between July 1995 and June 1997, 114 consecutive women underwent 118 breast biopsies for nonpalpable lesions. A limited procedure room and local anesthesia were used in 96.5 per cent of patients. Intravenous access was not established in 95 per cent of patients. Oral diazepam was given to 51 per cent of patients. Needle localization technique was used with a success rate of 97.5 per cent and average operative time of 18 minutes. Breast carcinoma was found in 29 (24.6 per cent) biopsies. A review of 99 of the 118 mammograms showed only 45 per cent of the lesions being amenable to the new technology, the advanced breast biopsy instrumentation. Advantages of the needle localization include short operative time; supine position for the patient; easy access to control bleeding; ability to choose a cosmetic site for the skin incision; minimal tissue removal before reaching the lesion; ability to maintain a sterile field; and applicability to almost any mammographic lesion identified, whether single or multiple. Disadvantages include the need for a separate procedure to place the wire and potential of missing the lesion in 2.5 per cent, requiring additional surgery. PMID:10917475

  16. Fine-needle aspiration cytology of soft tissue lesions: diagnostic challenges.

    PubMed

    Domanski, Henryk A

    2007-12-01

    Clinical and radiographic data provide important information in the evaluation of soft tissue lesions/neoplasms. Morphologic tissue and cytologic examination is considered to be a necessary part of the diagnostic work-up. The standard procedure for obtaining tumor tissue for morphologic evaluation has been incisional (open) or core needle biopsy. An increasing use of minimally invasive diagnostic procedures has resulted in better acceptance of fine-needle aspiration cytology (FNAC) in the diagnosis of soft tissue lesions. This article discusses challenges in FNAC of soft tissue lesions based on the experience at a multidisciplinary referral sarcoma center. Obtaining sufficient specimens from deeply seated small and necrotic/cystic lesions is technically a potential pitfall and misdiagnosis of cells from reactive zones surrounding the tumor as well as the correct evaluation of spindle cell lesions, rare soft tissue neoplasms, and "new entities" lacking reproducible cytological criteria are other important challenges in FNAC of soft tissues. The successful cytological evaluation of soft tissue lesions requires the application of strict, reproducible morphological criteria in the context of the clinical findings as well as ancillary techniques. The minimal criteria for diagnostic intervention in various clinical settings and the relative advantages and disadvantages of FNAC must be understood. FNAC of soft tissue lesions is facilitated when limited to specialized orthopedic-oncologic centers with a well-integrated multidisciplinary team and experience in the evaluation and therapy of soft tissue lesions. PMID:18008345

  17. Air Embolism Detected During Computed Tomography Fluoroscopically Guided Transthoracic Needle Biopsy

    SciTech Connect

    Hirasawa, Satoshi Hirasawa, Hiromi; Taketomi-Takahashi, Ayako; Morita, Hideo; Tsushima, Yoshito; Amanuma, Makoto; Endo, Keigo

    2008-01-15

    Air embolism is a rare but potentially fatal complication of percutaneous needle biopsy of the lung. We report a case of cerebral air embolism which occurred during computed tomography (CT)-guided needle biopsy. Air entering the aorta is depicted on CT-fluoroscopy images of the procedure.

  18. Cancer cell profiling by barcoding allows multiplexed protein analysis in fine needle aspirates

    PubMed Central

    Ullal, Adeeti V.; Peterson, Vanessa; Agasti, Sarit S.; Tuang, Suan; Juric, Dejan; Castro, Cesar M.; Weissleder, Ralph

    2014-01-01

    Immunohistochemistry-based clinical diagnoses require invasive core biopsies and use a limited number of protein stains to identify and classify cancers. Here, we introduce a technology that allows analysis of hundreds of proteins from minimally invasive fine needle aspirates (FNA), which contain much smaller numbers of cells than core biopsies. The method capitalizes on DNA-barcoded antibody sensing where barcodes can be photo-cleaved and digitally detected without any amplification steps. Following extensive benchmarking in cell lines, this method showed high reproducibility and achieved single cell sensitivity. We used this approach to profile ~90 proteins in cells from FNAs and subsequently map patient heterogeneity at the protein level. Additionally, we demonstrate how the method could be used as a clinical tool to identify pathway responses to molecularly targeted drugs and to predict drug response in patient samples. This technique combines specificity with ease of use to offer a new tool for understanding human cancers and designing future clinical trials. PMID:24431113

  19. Tracking the kinetics of intrahepatic immune responses by repeated fine needle aspiration of the liver

    PubMed Central

    Pembroke, Tom; Gallimore, Awen; Godkin, Andrew

    2015-01-01

    Liver disease is an increasing global health burden. The final sequalae of cirrhosis, liver failure and hepatocellular carcinoma are often the result of inflammation driven by intrahepatic lymphocytes. Accurate assessment of organ-specific diseases ideally employs tissue sampling though this is rarely performed. Here we report our experiences of utilising repeated fine needle aspirations (FNAs) to assess liver-derived leukocytes. In 88 patient samples, we obtained a mean of 36,959 lymphocytes from each FNA-derived biopsy (SD 22,319 cells, range 5034–91,242 cells) measured by flow cytometry. This quick technique required minimal analgesia compared to liver biopsy (p = 0.03); was well tolerated and safe, and hence repeated sampling up to 3 times within a week was feasible. We detail the technique to rapidly derive a single cell suspension suitable for multiparameter flow cytometry analysis. Finally we illustrate the importance of organ-derived sampling by showing that natural killer (NK) cells from FNA samples have a markedly altered phenotype compared to those assessed in peripheral blood. In combination these data validate FNA as a powerful and well-tolerated method of sampling intrahepatic lymphocytes to study the immunology of acute and chronic liver diseases. PMID:25914090

  20. Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer*

    PubMed Central

    Fernández-Bussy, Sebastián; Labarca, Gonzalo; Canals, Sofia; Caviedes, Iván; Folch, Erik; Majid, Adnan

    2015-01-01

    OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer. METHODS: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method). RESULTS: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma. CONCLUSIONS: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions. PMID:26176519

  1. [The role of fine-needle aspiration in the diagnosis of thyroid nodules].

    PubMed

    Marrazzo, Antonio; Casà, Luigi; David, Massimo; Lo Gerfo, Domenico; Noto, Antonio; Taormina, Piera

    2005-01-01

    The aim of this study was to prospectively evaluate the sensitivity, specificity and accuracy of fine-needle aspiration of thyroid nodules. From January 1978 to December 2003, 497 patients underwent fine-needle aspiration of thyroid nodules and then thyroidectomy. Fine-needle aspiration was performed with a fine 23-25 gauge and the aspirate was fixed and dyed with May-Grounwald-Giemsa method. The results of cytology were divided into four groups: positive for malignancy (77 patients), negative for malignancy (370 patients), suspect for malignancy (34 patients) and not diagnostic (16 patients). Suspect specimens also included follicular neoplasm and Hürthle cell neoplasm. Fine-needle aspiration results were compared with histopathologic analysis after thyroidectomy. There were 2 false-positive (0.5%) and 5 false-negative patients (1%). Sensitivity, specificity and accuracy were respectively 94.7%, 99% and 98.4%. This study confirms that fine-needle aspiration of thyroid nodules can be performed easily with high sensitivity, specificity and accuracy. PMID:15832740

  2. Real-time ultrasound-guided percutaneous renal biopsy with needle guide by nephrologists decreases post-biopsy complications

    PubMed Central

    Prasad, Narayan; Kumar, Shashi; Manjunath, Revanasiddappa; Bhadauria, Dharmendra; Kaul, Anupama; Sharma, Raj K; Gupta, Amit; Lal, Hira; Jain, Manoj; Agrawal, Vinita

    2015-01-01

    Background Percutaneous renal biopsy (PRB) can result in serious complications. The study is aimed to compare the biopsy yield and complications rate of the real-time ultrasonagram (USG)-guided PRB and needle tracking with and without needle guide in two different study periods. Methods We compared the yield and complications of 2138 kidney biopsies performed in two different periods, 1510 biopsies during the first period from April 2004–December 2010 and 628 biopsies during second period from January 2011–March 2013. All biopsies in both periods were performed by nephrologists. Radiologists provided the real-time image without needle guide during the first period while nephrologists performed both imaging and biopsy with needle guide during the second period. Results Of all the 2138 patients, 226 (10.5%) patients developed 118 minor and 108 major complications. Only 13 (2.1%) major complications occurred in the second period and 95 (6.7%) in the first period (P < 0.001). The relative risk of developing a major complication without guide was 3.04 times greater than that of the biopsies performed with use of the guide. The mean number of glomeruli per biopsy obtained during the second period (17.98 ± 6.75) was significantly greater than that of the first period (14.14 ± 6.01) (P = 0.004). The number of passes to acquire adequate tissue (P = 0.001) and percentage of cortex on biopsy (P = 0.001) were also significantly better in the second period. The optimal observation period post biopsy is 24 h. Conclusions Real-time USG imaging supported by needle guide device is associated with better biopsy yield and fewer complications. PMID:25815170

  3. A needle guidance system for biopsy and therapy using two-dimensional ultrasound

    SciTech Connect

    Bluvol, Nathan; Sheikh, Allison; Kornecki, Anat; Del Rey Fernandez, David; Downey, Donal; Fenster, Aaron

    2008-02-15

    Image-guided needle biopsies are currently used to provide a definitive diagnosis of breast cancer; however, difficulties in tumor targeting exist as the ultrasound (United States) scan plane and biopsy needle must remain coplanar throughout the procedure to display the actual needle tip position. The additional time associated with aligning and maintaining this coplanar relationship results in increased patient discomfort. Biopsy procedural efficiency is further hindered since needle pathway interpretation is often difficult, especially for needle insertions at large depths that usually require multiple reinsertions. The authors developed a system that would increase the speed and accuracy of current breast biopsy procedures using readily available two-dimensional (2D) US technology. This system is composed of a passive articulated mechanical arm that attaches to a 2D US transducer. The arm is connected to a computer through custom electronics and software, which were developed as an interface for tracking the positioning of the mechanical components in real time. The arm couples to the biopsy needle and provides visual guidance for the physician performing the procedure in the form of a real-time projected needle pathway overlay on an US image of the breast. An agar test phantom, with stainless steel targets interspersed randomly throughout, was used to validate needle trajectory positioning accuracy. The biopsy needle was guided by both the software and hardware components to the targets. The phantom, with the needle inserted and device decoupled, was placed in an x-ray stereotactic mammography (SM) machine. The needle trajectory and bead target locations were determined in three dimensions from the SM images. Results indicated a mean needle trajectory accuracy error of 0.75{+-}0.42 mm. This is adequate to sample lesions that are <2 mm in diameter. Chicken tissue test phantoms were used to compare core needle biopsy procedure times between experienced

  4. Ultrasound-guided percutaneous thoracoabdominal biopsy.

    PubMed

    Ojalehto, M; Tikkakoski, T; Rissanen, T; Apaja-Sarkkinen, M

    2002-03-01

    This review will discuss the benefits and disadvantages of ultrasound-guided percutaneous fine-needle aspiration and cutting needle biopsies. Clinical efficacy, cost-effectiveness, some controversies and safety will be reviewed. PMID:12010294

  5. A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules

    PubMed Central

    Tauro, Leo F.; Lobo, Geover J.; Fernandes, Hilda; George, Celine; Aithala, P. Sathyamoorthy; Shenoy, Divakar; Shetty, Prathvi

    2012-01-01

    Objectives Fine needle aspiration cytology (FNAC/FNA) is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC) is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis. Methods This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules (diagnosed by palpation) were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available (38 cases). Results The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88% diagnostic superiority and adequate specimens compared to 94% by FNA. Sensitivity was 50% for FNC and 100% for FNA while specificity was 100% for both techniques; accuracy score was 97.4% for FNC and 100% for FNA in predicting malignancy. While sensitivity was 75% for FNC and 100% for FNA; specificity was 100% for both techniques, and accuracy score was 97.4% for FNC and 100% for FNA in the prediction of neoplasia. Conclusion The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC. PMID:22496942

  6. Image-guided percutaneous needle biopsy in cancer diagnosis and staging.

    PubMed

    Gupta, Sanjay; Madoff, David C

    2007-06-01

    Image-guided percutaneous biopsy is a well-established and safe technique and plays a crucial role in management of cancer patients. Improvements in needle designs, development of new biopsy techniques, and continual advances in image-guidance technology have improved the safety and efficacy of the procedure. Lesions previously considered relatively inaccessible can now be safely biopsied. In this article, we review the various needle types, biopsy techniques, methods of safely assessing difficult-to-reach lesions, the advantages and disadvantages of various imaging modalities, and specific biopsy techniques applicable to different regions of the body. PMID:18070687

  7. Biological characteristics of HCC by ultrasound-guided aspiration biopsy and its clinical application

    PubMed Central

    Lin, Li-Wu; Lin, Xue-Ying; He, Yi-Mi; Gao, Shang-Da; Lin, Xiao-Dong

    2003-01-01

    AIM: To probe the pathological biological characteristics of hepatocellular carcinoma (HCC) by the ultrasound-guided aspiration biopsy and assess the clinical application value of this method. METHODS: The biopsy and DNA analysis by flow cytometry (FCM) were taken in 46 cases with HCC nodules, including 26 cases and 20 cases with nodules ≤ 3 cm and > 3 cm in diameters respectively, and 12 cases with intrahepatic benign hyperplastic nodules. They were taken in 22 cases of 46 cases with HCC before and after the therapy. Fine-needles and automatic histological incised biopsy needles were used. The fresh biopsy tissue was produced into the single cell suspension, which was sent for DNA detection and ratio analysis of cell period. The ratio of each DNA period of cell proliferation of each group was calculated and compared with each other. The DNA aneuploid (AN) and apoptosis cell peak were observed and their percentages were calculated. RESULTS: The ratios of S and G2/M periods of DNA, which reflect cell hyperproliferation, in the group with HCC tumors > 3 cm in diameter were markedly higher than those of the group with HCC nodules ≤ 3 cm in diameter and the group with the benign hyperplastic nodules (P < 0.01 except A:B of S period, P < 0.05). The ratios of the middle group were also apparently higher than those of the latter group (P < 0.01). The ratio of DNA AN of 46 cases with HCC nodules was 34.8% (16/46). None of the cases with the intrahepatic hyperplastic nodules appeared AN. The DNA AN appeared more apparently with the growth of the tumors. The AN ratio of the group with tumors > 3 cm in diameter was 55% (11/20), markedly higher than that of the group with tumors ≤ 3 cm in diameter which was 19.2% (5/26) (P < 0.01). The FCM DNA analysis of 22 specimens of hepatic carcinoma tissue before therapy showed that the aneuploid peaks appeared in 5 cases (22.7%). The ratio of G1 period rose after therapy while the S period and G2/M ratios fell (P < 0.01). The

  8. Ultrasound-guided fine needle biopsy of the spleen: high clinical efficacy and low risk in a multicenter Italian study.

    PubMed

    Civardi, G; Vallisa, D; Bertè, R; Giorgio, A; Filice, C; Caremani, M; Caturelli, E; Pompili, M; De Sio, I; Buscarini, E; Cavanna, L

    2001-06-01

    The aim of this study was to evaluate the clinical efficacy and safety of the ultrasound-guided fine needle biopsy (UG-FNB) of the spleen in a large population of patients. We collected retrospectively the findings concerning the application of UG-FNB of the spleen from eight Italian clinical centers that utilized this technique for at least ten years. A data schedule was sent to all centers to collect information about techniques, results, and complications of UG-FNB of the spleen. We analyzed 398 biopsy procedures both on focal lesions (257 cases) and on splenic parenchyma (141 cases). The overall accuracy was 90.9% for the series as a whole, 84.9% for cytological sampling, 88.3% for microhistological sampling, and 90.3% for both cytological and histological sampling (double biopsy). Tissue core biopsy yielded better overall accuracy in patients with suspected splenic involvement by lymphoma (90.9% vs. 68.5% for cytology). The complication rate was low (no death cases, less than 1% for major complications, and 5.2% for all complications). No predictive factors were able to detect high-risk situations. The operator's skill (higher number of performed procedures) was significantly related to better overall accuracy. Conversely, the complication rate was not affected. UG-FNB of the spleen is a very effective diagnostic procedure with low risk for the patient. Aspiration cytology and core needle biopsy showed similar diagnostic yields, except for the diagnosis of splenic lymphoma, in which core needle biopsy obtained better results. PMID:11343380

  9. [Percutaneous needle biopsy of the distal part of the choledochal duct].

    PubMed

    Pesić, V; Lisanin, L; Lukac, S; Zica, D; Kupresanin, S; Spasić, V; Nikosavić, S

    1996-01-01

    The indication for the biopsy was the finding of stenosis of uncertain etiology even after the endoscopy and the attempt of endoscopic or brush biopsy. The experiences with needle biopsy in 6 patients were presented in the study. The biopsy was done with the needles with diameter less than 1 mm (Chiba needle 0.6-0.95 mm), Otto-cut 0.8 mm and Vacu-cut 0.8 mm. Percutaneous cholangiography that was firstly performed, showed the site of stenosis of common bile duct distal part and simultaneously the other structures of interest for biopsy performance. The needle was guided under radioscopic control in one attempt. In that way, the precise diagnosis of pathologic process, which induced the obstruction in the early disease stage was made in all six patients. On the basis of cited results, the percutaneous needle biopsy was found to be efficient and safe method to reveal the type of lesion in this region, if necessary conditions existed. Percutaneous needle biopsy is a very valuable method, less invasive and less expensive compared to the surgical biopsies and other methods. It demonstrated reliable results in our conditions. PMID:9229968

  10. Secondary B-cell lymphoma diagnosed by fine-needle aspiration cytology and flow cytometry following penile carcinoma: A case report

    PubMed Central

    WANG, HUAN; QIU, LIAN-NV; WU, MAO; CHEN, WAN-YUAN; REN, LI-GANG; HE, XIANG-LEI; ZHOU, YONG-LIE

    2016-01-01

    The number of studies reporting lymphoma as a secondary tumor has gradually increased. However, few studies have reported that occurrence of lymphoma as a secondary tumor following treatment for penile carcinoma, particularly cases in which the lymphoma was diagnosed by fine-needle aspiration cytology and flow cytometry. The present study reports the case of a 62-year-old male patient who was troubled with frequent urination and repeated chest tightness for 5 years. The diagnosis upon admission was penile carcinoma. Two months subsequent to the tumor removal surgery, enlarged lymph nodes were extracted from the patient using fine-needle biopsy, to be analyzed using light microscopy and flow cytometry. Smear results indicated a large number of abnormal cells scattered in the right axillary lymph node. Flow cytometry immunophenotyping of fine-needle aspiration samples indicated the increased expression of cluster of differentiation (CD)79a, CD19, CD20, CD38, κ chain and human leukocyte antigen-DR, which supported a diagnosis of B-cell lymphoma. Thus, the patient was diagnosed with B-cell lymphoma based on the results of the fine-needle aspiration biopsy and flow cytometry. The method of diagnosis and causes of therapy-related leukemia are discussed in the present report. PMID:27073496

  11. The Utilization of Cytologic Fine-Needle Aspirates of Lung Cancer for Molecular Diagnostic Testing

    PubMed Central

    Roh, Michael H.

    2015-01-01

    In this era of precision medicine, our understanding and knowledge of the molecular landscape associated with lung cancer pathogenesis continues to evolve. This information is being increasingly exploited to treat advanced stage lung cancer patients with tailored, targeted therapy. During the management of these patients, minimally invasive procedures to obtain samples for tissue diagnoses are desirable. Cytologic fine-needle aspirates are often utilized for this purpose and are important not only for rendering diagnoses to subtype patients’ lung cancers, but also for ascertaining molecular diagnostic information for treatment purposes. Thus, cytologic fine-needle aspirates must be utilized and triaged judiciously to achieve both objectives. In this review, strategies in utilizing fine-needle aspirates will be discussed in the context of our current understanding of the clinically actionable molecular aberrations underlying non-small cell lung cancer and the molecular assays applied to these samples in order to obtain treatment-relevant molecular diagnostic information. PMID:26076721

  12. Technique of synovial biopsy of metacarpophalangeal joints using the needle arthroscope.

    PubMed

    Gáspár, Levente; Szekanecz, Zoltán; Dezso, Balázs; Szegedi, Gyula; Csernátony, Zoltán; Szepesi, Kálmán

    2003-01-01

    We demonstrate the technique, advantages, and disadvantages of metacarpophalangeal joint examination with needle arthroscope. We evaluated our experience from biopsies of 10 metacarpophalangeal joints of eight rheumatoid women aged 41-45 years. The procedures were performed using a 1-mm needle arthroscope. The synovium biopsy was taken with a microforceps. The procedure was performed under local anesthesia. The tight tension of the joint and traction of the finger is necessary for good visualization, but despite this visibility can be difficult. Needle biopsy is a useful method for the early diagnosis of rheumatoid arthritis. PMID:12548452

  13. Penile neurilemmoma: Utility of fine-needle aspiration cytology in diagnosis of a rare entity.

    PubMed

    Malhotra, Kiran Preet; Shukla, Saumya; Gupta, Anurag; Awasthi, Namrata Punit; Husain, Nuzhat; Dhayal, Lshwar Ram

    2014-07-01

    Subcutaneous lesions in the penis are of rare occurrence and encompass benign as well as malignant tumors. These include lipomas, leiomyomas, neurilemmomas and their malignant counterparts. A surgical excision at this site carries the risk of postoperative penile curvature and erectile dysfunction. We report a rare case of penile neurilemmoma which presented as a subcutaneous nodule on the dorsal surface of the penis. A fine-needle aspiration was performed which aided in the preoperative diagnosis and guided the extent of excision. We report this case to highlight the importance of needle aspiration as a simple outdoor procedure for penile lesions which can aid surgical approach and postoperative outcome. PMID:25538392

  14. Penile neurilemmoma: Utility of fine-needle aspiration cytology in diagnosis of a rare entity

    PubMed Central

    Malhotra, Kiran Preet; Shukla, Saumya; Gupta, Anurag; Awasthi, Namrata Punit; Husain, Nuzhat; Dhayal, lshwar Ram

    2014-01-01

    Subcutaneous lesions in the penis are of rare occurrence and encompass benign as well as malignant tumors. These include lipomas, leiomyomas, neurilemmomas and their malignant counterparts. A surgical excision at this site carries the risk of postoperative penile curvature and erectile dysfunction. We report a rare case of penile neurilemmoma which presented as a subcutaneous nodule on the dorsal surface of the penis. A fine-needle aspiration was performed which aided in the preoperative diagnosis and guided the extent of excision. We report this case to highlight the importance of needle aspiration as a simple outdoor procedure for penile lesions which can aid surgical approach and postoperative outcome. PMID:25538392

  15. Endoscopic ultrasonography with fine-needle aspiration: present situation and indications.

    PubMed

    Vila Costas, J J

    2005-12-01

    Endoscopic ultrasonography with fine-needle aspiration is a safe technique that allows the collection of tissue samples for histological diagnosis, as well as therapeutic maneuvers. It has better diagnostic accuracy versus other exploration techniques used for the staging of neoplasms in the gastrointestinal tract as well as in other organs. The risk for complications is extremely low, and the procedure has been shown to be cost-effective in many studies. In this paper we attempt to review the main present indications of endoscopic ultrasonography with fine-needle aspiration. PMID:16454609

  16. Transbronchial needle aspiration in peripheral pulmonary lesions: a systematic review and meta-analysis.

    PubMed

    Mondoni, Michele; Sotgiu, Giovanni; Bonifazi, Martina; Dore, Simone; Parazzini, Elena Maria; Carlucci, Paolo; Gasparini, Stefano; Centanni, Stefano

    2016-07-01

    Fluoroscopy-guided transbronchial needle aspiration (TBNA) has long been used in the diagnosis of peripheral pulmonary lesions (PPLs), although its diagnostic performance varies considerably.We conducted a systematic review and meta-analysis evaluating the accuracy of TBNA in the diagnosis of PPLs, comparing its diagnostic yield with transbronchial biopsy (TBB) and assessing the main predictors of a successful aspirate.In 18 studies, the overall TBNA yield was 0.53 (95% CI 0.44-0.61). TBNA showed a higher accuracy when directly compared to TBB (0.60 (95% CI 0.49-0.71) versus 0.45 (95% CI 0.37-0.54)). The subgroup analyses documented a higher TBNA yield when the computed tomography (CT) bronchus sign was present (0.70 (95% CI 0.63-0.77) versus 0.51 (95% CI 0.38-0.64)), when rapid on-site evaluation (ROSE) was performed (0.62 (95% CI 0.43-0.79) versus 0.51 (95% CI 0.42-0.60)), in the case of malignant lesions (0.55 (95% CI 0.44-0.66) versus 0.17 (95% CI 0.11-0.24)) and for lesions >3 cm (0.81 (95% CI 0.73-0.87) versus 0.55 (95% CI 0.47-0.63)).Conventional TBNA is a useful sampling technique for the diagnosis of PPL, with a higher diagnostic yield than TBB. The presence of CT bronchus sign, an underlying malignant process, lesion size >3 cm and ROSE employment are predictors of a higher yield. PMID:27174878

  17. Prostate biopsy

    MedlinePlus

    Prostate gland biopsy; Transrectal prostate biopsy; Fine needle biopsy of the prostate; Core biopsy of the prostate; Targeted prostate biopsy; Prostate biopsy - transrectal ultrasound (TRUS); Stereotactic ...

  18. Mediastinal abscess after endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review.

    PubMed

    Leong, Steven C; Marshall, Henry M; Bint, Michael; Yang, Ian A; Bowman, Rayleen V; Fong, Kwun M

    2013-10-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique that allows lung cancer nodal staging and biopsy of parabronchial and paratracheal tissue. Its simplicity, high diagnostic yield, ability to diagnose both benign and malignant conditions, and exceedingly low complication rate has resulted in rapid widespread adoption by surgeons and physicians. EBUS-TBNA-related complications, however, do occur and need to be considered when assessing the risk-benefit profile of performing the procedure, and if the patient represents with unexpected symptoms after the procedure. We describe a 64-year-old woman who presented with a mediastinal abscess 5 days after EBUS-TBNA. This case demonstrates the importance of considering EBUS-TBNA-related complications to guide relevant imaging decisions and antibiotic choices. We review the published literature regarding infective complications of EBUS-TBNA and propose possible pathophysiologies. These complications are likely to increase in frequency as the technique is more widely adopted. PMID:24162119

  19. 3D transrectal ultrasound prostate biopsy using a mechanical imaging and needle-guidance system

    NASA Astrophysics Data System (ADS)

    Bax, Jeffrey; Cool, Derek; Gardi, Lori; Montreuil, Jacques; Gil, Elena; Bluvol, Jeremy; Knight, Kerry; Smith, David; Romagnoli, Cesare; Fenster, Aaron

    2008-03-01

    Prostate biopsy procedures are generally limited to 2D transrectal ultrasound (TRUS) imaging for biopsy needle guidance. This limitation results in needle position ambiguity and an insufficient record of biopsy core locations in cases of prostate re-biopsy. We have developed a multi-jointed mechanical device that supports a commercially available TRUS probe with an integrated needle guide for precision prostate biopsy. The device is fixed at the base, allowing the joints to be manually manipulated while fully supporting its weight throughout its full range of motion. Means are provided to track the needle trajectory and display this trajectory on a corresponding TRUS image. This allows the physician to aim the needle-guide at predefined targets within the prostate, providing true 3D navigation. The tracker has been designed for use with several end-fired transducers that can be rotated about the longitudinal axis of the probe to generate 3D images. The tracker reduces the variability associated with conventional hand-held probes, while preserving user familiarity and procedural workflow. In a prostate phantom, biopsy needles were guided to within 2 mm of their targets, and the 3D location of the biopsy core was accurate to within 3 mm. The 3D navigation system is validated in the presence of prostate motion in a preliminary patient study.

  20. Effects of needle tip bevel and aspiration procedure on the morphology and developmental capacity of bovine compact cumulus oocyte complexes.

    PubMed

    Bols, P E; Ysebaert, M T; Van Soom, A; de Kruif, A

    1997-04-15

    Effects of the needle tip bevel and the aspiration procedure on the morphology of cumulusoocyte-complexes (COCs) and the developmental capacity of the oocytes after IVF were studied in 2 in vitro oocyte pick-up (OPU) simulations using a disposable ovum pick-up needle guidance system. In Experiment 1, the influence of the length of the needle bevel was investigated using a short and a long bevelled 20-g disposable needle. After being aspirated from slaughterhouse ovaries, the retrieved COCs were divided into 3 categories: 1) oocytes surrounded by a compact cumulus, 2) oocytes with an expanded cumulus, 3) partially naked oocytes. In Experiment 2, the influence of 5 different levels of aspiration vacuum for 3 different needle diameters (18-g, 19-g, 20-g) and 2 different needle bevels (long, short) was tested on the recovery and on the morphology of the cumulus investment of a fixed number of previously scored compact cumulus oocytes complexes (CCOCs), retrieved after slicing slaughterhouse ovaries. The re-retrieved COCs were allocated to Categories 1 and 3. The results show that the length of the needle bevel has a significant effect on oocyte recovery, in favor of the long-bevelled needle. As soon as higher aspiration vacua are used, a decrease of the number of CCOCs can be observed, which is less prominent for the short-bevelled needle compared to the long-bevelled one. The final number of blastocysts is similar for both needle types. In Experiment 2, the disposable needle system proved to be highly effective since nearly 80% of the CCOCs were retrieved. At low aspiration vacuum, up to 90% of the CCOCs withstand the aspiration procedure undamaged. Increasing the aspiration vacuum results in a decrease of the number of CCOCs, which is less pronounced using thinner needles. Averaged over all needle types, the prevalence of blastocysts expressed relative to the number of recovered oocytes decreases with higher aspiration vacuum. PMID:16728071

  1. Biopsy

    MedlinePlus

    ... SPR Practice Parameter for the Performance of Image-Guided Percutaneous Needle Biopsy (PNB). Amended 2014 (Resolution 39). ... Thomson KR, Venbrux AC, Morgan RA, eds. Image-Guided Interventions . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014: ...

  2. Comparison of Fine Needle Aspiration and Fine Needle Nonaspiration Cytology of Thyroid Nodules: A Meta-Analysis

    PubMed Central

    Song, Hongming; Wei, Chuankui; Li, Dengfeng; Hua, Kaiyao; Song, Jialu; Maskey, Niraj; Fang, Lin

    2015-01-01

    Background. Fine needle aspiration cytology (FNAC) and fine needle nonaspiration cytology (FNNAC) are useful cost-effective techniques for preoperatively assessing thyroid lesions. Both techniques have advantages and disadvantages, and there is controversy over which method is superior. This meta-analysis was performed to evaluate the differences between FNAC and FNNAC for diagnosis of thyroid nodules. Methods. Primary publications were independently collected by two reviewers from PubMed, Web of Science, Google Scholar, EBSCO, OALib, and the Cochrane Library databases. The following search terms were used: fine needle, aspiration, capillary, nonaspiration, sampling without aspiration, thyroid, and cytology. The last search was performed on February 1, 2015. Results. Sixteen studies comprising 1,842 patients and 2,221 samples were included in this study. No statistically significant difference was observed between FNAC and FNNAC groups with respect to diagnostically inadequate smears, diagnostically superior smears, diagnostic performance (accuracy, sensitivity, specificity, negative predictive value, and positive predictive value), area under the summary receiver operating characteristic curve, average score of each parameter (background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma, and retention of appropriate architecture), and total score of five parameters. Conclusion. FNAC and FNNAC are equally useful in assessing thyroid nodules. PMID:26491689

  3. Electromagnetic navigation transthoracic needle aspiration for the diagnosis of pulmonary nodules: a safety and feasibility pilot study

    PubMed Central

    Arias, Sixto; Feller-Kopman, David; Semaan, Roy; Wang, Ko Pen; Frimpong, Bernice; Oakjones Burgess, Karen; Thompson, Richard; Chen, Alex; Ortiz, Ricardo; Lee, Hans J.

    2016-01-01

    Background Pulmonary nodules remain a diagnostic challenge for physicians. Minimally invasive biopsy methods include bronchoscopy and CT guided transthoracic needle aspiration (TTNA). A novel electromagnetic guidance transthoracic needle aspiration (ETTNA) procedure which can be combined with navigational bronchoscopy (NB) and endobronchial ultrasound (EBUS) in a single setting has become available. Methods A prospective pilot study examining the safety, feasibility and diagnostic yield of ETTNA in a single procedural setting. All patients enrolled underwent EBUS for lung cancer staging followed by NB and ETTNA. Feasibility of performing ETTNA and a safety assessment by recording procedural related complications including pneumothorax or bleeding was performed. Diagnostic yield of ETTNA defined by a definitive pathologic tissue diagnosis was recorded. An additional diagnostic yield analysis was performed using a cohort analysis of combined interventions (EBUS + NB + ETTNA). All non-diagnostic biopsies were either followed with radiographic imaging or a surgical biopsy was performed. Results Twenty-four subjects were enrolled. ETTNA was feasible in 96% of cases. No bleeding events occurred. There were five pneumothoraces (21%) of which only two (8%) subjects required drainage. The diagnostic yield for ETTNA alone was 83% and increased to 87% (P=0.0016) when ETTNA was combined with NB. When ETTNA and NB were performed with EBUS for complete staging, the diagnostic yield increased further to 92% (P=0.0001). Conclusions This is the first human pilot study demonstrating an acceptable safety and feasibility profile with a novel ETTNA system. Further studies are needed to investigate the increased diagnostic yield from this pilot study. PMID:26904228

  4. Comparative single cell and flow DNA analysis in aspiration biopsies from breast carcinomas.

    PubMed

    Auer, G; Tribukait, B

    1980-11-01

    The DNA distribution patterns in fine needle aspirates from 17 breast carcinomas was analysed, using single cell and flow cytophotometric techniques. A good correlation was observed to exist between the modal DNA values obtained by the two methods. Advantages and disadvantages of the two methods are discussed. PMID:7010915

  5. Endoscopic ultrasound-guided fine needle aspiration: The wet suction technique

    PubMed Central

    Villa, Nicolas A.; Berzosa, Manuel; Wallace, Michael B.; Raijman, Isaac

    2016-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has become a fundamental tool in obtaining cytopathological diagnosis of pancreatic tumors. When sampling solid lesions of the pancreas, the endosonographer can use two suction techniques to enhance tissue acquisition; the dry and the wet suction techniques. The standard dry suction technique relies on applying negative pressure suction on the proximal end of the needle after the stylet is removed with a pre-vacuum syringe. The wet suction technique relies on pre-flushing the needle with saline to replace the column of air with fluid followed by aspiration the proximal end by using a prefilled syringe with saline. A new modified wet suction technique (hybrid suction technique) relies on preloading the needle with saline, but having continuous negative pressure with a pre-vacuum syringe to avoid manual intermittent suction. Tissue acquisition can be enhanced by applying fluid dynamic principles to the current aspiration techniques, such as the column of water used in the needle of the wet technique. In this review, we will focus on EUS-FNA using the wet suction technique for sampling of pancreatic solid lesions. PMID:26879162

  6. Endoscopic ultrasound-guided fine needle aspiration: The wet suction technique.

    PubMed

    Villa, Nicolas A; Berzosa, Manuel; Wallace, Michael B; Raijman, Isaac

    2016-01-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has become a fundamental tool in obtaining cytopathological diagnosis of pancreatic tumors. When sampling solid lesions of the pancreas, the endosonographer can use two suction techniques to enhance tissue acquisition; the dry and the wet suction techniques. The standard dry suction technique relies on applying negative pressure suction on the proximal end of the needle after the stylet is removed with a pre-vacuum syringe. The wet suction technique relies on pre-flushing the needle with saline to replace the column of air with fluid followed by aspiration the proximal end by using a prefilled syringe with saline. A new modified wet suction technique (hybrid suction technique) relies on preloading the needle with saline, but having continuous negative pressure with a pre-vacuum syringe to avoid manual intermittent suction. Tissue acquisition can be enhanced by applying fluid dynamic principles to the current aspiration techniques, such as the column of water used in the needle of the wet technique. In this review, we will focus on EUS-FNA using the wet suction technique for sampling of pancreatic solid lesions. PMID:26879162

  7. Fine-needle aspiration for diagnosis of tuberculous lymphadenitis in children in Bangui, Central African Republic

    PubMed Central

    2012-01-01

    Background Tuberculosis (TB) is a major cause of childhood morbidity and mortality in developing countries. One of the main difficulties is obtaining adequate specimens for bacteriological confirmation of the disease in children. The aim of this study is to evaluate the adequacy of fine-needle aspiration (FNA) for the diagnosis of TB. Methods In a prospective study conducted at the paediatric hospital in Bangui in 2007–2009, we used fine-needle aspiration to obtain samples for diagnosis of TB from 131 children aged 0–17 years with persistent lymphadenitis. Results Fine-needle aspiration provided samples that could be used for bacteriological confirmation of TB. Ziehl-Neelsen staining for acid-fast bacilli was positive in 42.7% of samples, and culture identified TB in 67.2% of cases. Of 75 samples that were stain-negative, 49 (65.3%) were culture-positive, while 12 stain-positive samples remained culture-negative. Ten of the 12 stain-positive, culture-negative samples were from patients who had received previous antimicrobial therapy. With regard to phenotypic drug susceptibility, 81/88 strains (91.1%) were fully susceptible to isoniazid, rifampicin, ethambutol and streptomycin, six (6.8%) were resistant to one drug, and one multidrug-resistant strain was found. Conclusions Fine-needle aspiration is simple, cost-effective and non-invasive and can be performed by trained staff. Combined with rapid molecular diagnostic tests, fine-needle aspirates could improve the diagnosis of TB and provide valuable information for appropriate treatment and drug resistance. PMID:23234495

  8. Role of Fine Needle Aspiration Cytology as a Diagnostic Tool in Orbital and Adnexal Lesions

    PubMed Central

    Khan, Lubna; Malukani, Kamal; Malaiya, Siddharth; Yeshwante, Prashant; Ishrat, Saba; Nandedkar, Shirish S.

    2016-01-01

    Purpose: To evaluate the role of fine needle aspiration (FNAC) as a diagnostic tool in cases of orbital and ocular adnexal masses. Cytological findings were correlated with histopathological diagnosis wherever possible. Methods: FNAC was performed in 29 patients of different age groups presenting with orbital and ocular adnexal masses. Patients were evaluated clinically and investigated by non-invasive techniques before fine needle aspiration of the masses. Smears were analyzed by a cytologist in all cases. Further, results of cytology were compared with the histopathological diagnosis. Results: The age of patients ranged from 1 to 68 years (mean: 29.79±19.29). There were 14 males and 15 females with a male to female ratio of 0.93:1. Out of 29 cases, 26 aspirates were cellular. Cellularity was insufficient in three (10.34%) aspirates. Out of 26 cellular aspirates, 11 were non-neoplastic while 15 were neoplastic on cytology. Subsequent histopathologic examination was done in 21/26 cases. Concordance rate of FNAC in orbital and ocular adnexal mass lesions with respect to the precise histologic diagnosis was 90%. Conclusion: When properly used in well-indicated patients (in cases where a diagnosis cannot be made by clinical and imaging findings alone), FNAC of orbital and periorbital lesions is an invaluable and suitable adjunct diagnostic technique that necessitates close cooperation between the ophthalmologist and cytologist. However, nondiagnostic aspirates may sometimes be obtained, and an inconclusive FNAC should not always be ignored. PMID:27621787

  9. Blind aspiration biopsy versus a guided hysteroscopic technique for investigation of the endometrium in infertile women.

    PubMed

    Ejzenberg, Dani; Simões, Manuel de Jesus; Pinheiro, Walter; Soares, José Maria; Serafini, Paulo Cesar; Baracat, Edmund Chada

    2016-09-01

    Embryo implantation failure and recurrent abortion are common indications for endometrial evaluation to determine the implantation window and diagnose endometrial anomalies. There are few research studies comparing the efficacy of different techniques used for endometrial sampling in infertile females during the luteal phase. Likewise, morphometric studies of the endometrium through aspiration biopsy are scant. A cross-sectional study of 30 infertile and 10 fertile females was carried out. The study participants underwent hysteroscopic and aspiration biopsies (pipelle) at the midluteal phase. Computer-assisted morphometric and pathological anatomy analyses were conducted independently by two pathologists blinded to the study. The two endometrial sampling biopsy techniques were compared through morphometric and pathological anatomy analyses using three parameters: a) the amount of material collected for the endometrial studies; b) the scope and origin of sampled materials; and c) the quality of the sample. Both biopsy techniques produced sufficient material for analysis. The directed biopsies yielded higher quality samples from targeted segments of the uterine cavity because samples were homogeneous and had no architectural distortion (p<0.05). Blood was present only in the samples obtained through a Pipelle. Endometritis was detected in 10% of the infertile women. Our findings suggest that hysteroscopic biopsies are superior to blinded aspiration biopsies. PMID:26806353

  10. CT-Guided Needle Biopsy of Deep Pelvic Lesions by Extraperitoneal Approach Through Iliopsoas Muscle

    SciTech Connect

    Gupta, Sanjay; Madoff, David C.; Ahrar, Kamran; Morello, Frank A.; Wallace, Michael J.; Murthy, Ravi; Hicks, Marshall E.

    2003-11-15

    We report our experience with computed tomography (CT)-guided coaxial needle biopsy of deep pelvic lesions by an extraperitoneal approach through the iliopsoas muscle, using a curved needle for difficult-to-reach lesions. We reviewed the records of all patients with pelvic masses who underwent CT-guided percutaneous biopsy via iliopsoas muscle between January 1999 and December 2001. Direct anterior or posterior approach to the lesion was obstructed by bowel, bladder, vessels, or bones in all patients. An 18-gauge guide needle was advanced through the iliopsoas muscle and a 22-gauge Chiba needle was used to perform the biopsy. A custom-tailored curved 22-g needle was used in 17 procedures when the location of the iliac vessels and the slope of the iliac wing obstructed a straight path to the lesion. Fifty-three patients underwent 57 CT-guided needle biopsies during the study period. The lesions comprised obturator (n = 25), internal iliac (n = 11), anterior external iliac (n = 4), and common iliac nodes (n = 4); soft tissue masses along pelvic side-wall (n = 6); adnexal lesions (n = 5); a loculated fluid collection, and a perirectal node. All lesions were safely accessed, and major vessels and viscera were avoided in all cases. Of the 57 biopsies, 53 (93%) yielded diagnostic specimens. No major complications were encountered. CT-guided coaxial needle biopsy by an anterolateral approach through the iliopsoas muscle, with the use of a curved needle in selected cases is safe and effective for obtaining samples from deep pelvic lesions.

  11. Telangiectatic variant of hepatic adenoma: clinicopathologic features and correlation between liver needle biopsy and resection.

    PubMed

    Mounajjed, Taofic; Wu, Tsung-Teh

    2011-09-01

    Telangiectatic hepatic adenoma (THA) is a benign neoplasm treated by resection. The role of liver needle biopsy in identifying THA before resection has not been evaluated. We identified 55 patients who have undergone resection for hepatic adenoma (HA), THA, or focal nodular hyperplasia (FNH) after needle biopsy. Needle biopsies and resections were evaluated for the following: (1) abortive portal tracts; (2) sinusoidal dilatation; (3) ductular reaction; (4) inflammation; (5) aberrant naked vessels; (6) nodules, fibrous septa, and/or central stellate scar. THA diagnosis was made if the lesion had the first 4 criteria and lacked criterion 6. Most patients (36 of 55), including patients with THA (12 of 16), had multiple lesions (0.2 to 14.4 cm). Patients with THA showed no difference in age, body mass index, prevalence of diabetes or glucose intolerance, or presence of oral contraceptive (OCP) use from patients with HA or FNH, but patients with THA had longer periods of OCP use than patients with HA. Thirty-one percent of THAs had tumor hemorrhage. Of sampled THAs, 27% showed steatosis compared with 76% of sampled HAs (P<0.05). All resected HAs and FNHs were correctly diagnosed on needle biopsy. Of 14 patients with resected THA, 3 histologic patterns were noted on needle biopsy: (1) All THA criteria and naked vessels were present in 6 patients (43%). (2) Consistent with HA: naked vessels only were present in 4 patients (29%). (3) Suggestive of THA: some but not all THA criteria were present in 4 patients (29%). No needle biopsy of a THA was misdiagnosed as FNH. Although evaluation of resection specimens is the gold standard for diagnosis of THA, liver needle biopsy is a useful diagnostic tool that leads to adequate treatment. PMID:21836491

  12. Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Lesions: A Systematic Review of Technical and Procedural Variables

    PubMed Central

    Jani, Bhairvi S.; Rzouq, Fadi; Saligram, Shreyas; Lim, Diego; Rastogi, Amit; Bonino, John; Olyaee, Mojtaba

    2016-01-01

    Endoscopic ultrasound (EUS)-guided tissue acquisition has emerged over the last decade as an invaluable diagnostic tool in approaching the different pancreatic lesions. Given the safety and minimal invasiveness of this approach combined with the high diagnostic yield, it became the standard of care when dealing with different pancreatic pathologies. However, some variables regarding this procedure remain not fully understood. These can influence the diagnostic yield of the procedure and include the presence of the on-site cytopathologist, the type and size of the needle used as well as obtaining aspiration versus core biopsy, the number of passes and the sampling technique, and the role of suction and stylet use among others. We performed a comprehensive literature search using PubMed, Google Scholar, and Embase for studies that assessed these variables. Eligible studies were analyzed using several parameters such as technique and procedure, with the aim of reviewing results from an evidence-based standpoint. PMID:27011940

  13. Fine needle aspiration cytology: a tool to diagnose cervical and vaginal endometriosis in low-income places.

    PubMed

    Oliveira-Filho, Manoel; Rao, Vietla S; Eleutério, José; Medeiros, Francisco C

    2013-01-01

    Regarded as infrequent, vaginal and cervical endometriosis is probably more common than is generally realized. The apparent rarity of the lesion may be ascribed to the limited awareness of its clinical appearance, combined with technical difficulty in obtaining suitable biopsy material for confirmation. Thus, clinical recognition and tissue confirmation become essential. This paper focuses on vaginal and cervical endometriosis, documenting the clinical, macroscopic, cytological and colposcopic findings in 4 cases seen at a single physical vaginal examination. Diagnosis in these patients was facilitated and improved by fine needle aspiration cytology and confirmed by histology. This technique, which is not used for the diagnosis of endometriosis, could be an option in low-income areas. PMID:23406608

  14. Effects of aspiration vacuum and needle diameter on cumulus oocyte complex morphology and developmental capacity of bovine oocytes.

    PubMed

    Bols, P E; Van Soom, A; Ysebaert, M T; Vandenheede, J M; de Kruif, A

    1996-04-01

    The effects of aspiration vacuum and needle diameter on the morphology of the cumulusoocyte-complex (COC) and developmental capacity of the oocyte after IVF was studied in 2 experiments using a disposable ovum pick-up needle guidance system whose construction permits its use in vitro. In Experiment 1, the relationship was determined between the aspiration vacuum, expressed in millimetre of mercury, and the actual amount of water aspirated by the system, expressed in millilitre per minute. In Experiment 2, five different levels of aspiration vacuum for 3 different needle diameters (18g, 19g and 21g) were tested in slaughterhouse ovaries. The cumulus-oocyte complexes (COCs) were divided into 3 categories: 1) oocytes with a compact cumulus, 2) oocytes with an expanded cumulus and 3) naked oocytes. The results show that a change of needle diameter can triple the amount of fluid actually aspirated. The highest oocyte recovery rates are obtained when using the thickest needle (18-g), regardless of the aspiration vacuum. On the average, for all needle types, more oocytes are recovered at the highest aspiration vacuum. For all needle diameters, the proportion of oocytes surrounded by a compact cumulus decreases progressively as the vacuum increases. Regardless of the vacuum applied, thinner needles result in a higher proportion of recovered COCs with a compact cumulus. At a high aspiration vacuum, naked oocytes become predominant regardless of the needle diameter. The prevalence of blastocysts, expressed in proportion to the recovered COCs, decreases as the aspiration vacuum increases, being especially noticeable between 70 and 130 mm Hg. PMID:16727859

  15. Archival fine-needle aspiration cytopathology (FNAC) samples: untapped resource for clinical molecular profiling.

    PubMed

    Killian, J Keith; Walker, Robert L; Suuriniemi, Miia; Jones, Laura; Scurci, Stephanie; Singh, Parvati; Cornelison, Robert; Harmon, Shannon; Boisvert, Nichole; Zhu, Jack; Wang, Yonghong; Bilke, Sven; Davis, Sean; Giaccone, Giuseppe; Smith, William I; Meltzer, Paul S

    2010-11-01

    Microarray technologies provide high-resolution maps of chromosome imbalances and epigenomic aberrations in the cancer cell genome. Such assays are often sensitive to sample DNA integrity, voiding the utility of many archival pathology specimens and necessitating the special handling of prospective clinical specimens. We have identified the remarkable preservation of higher-molecular weight DNA in archival fine-needle aspiration cytopathology specimens from patients greater than 10 years of age. We further demonstrate the outstanding technical performance of 57 fine-needle aspiration cytopathology samples for aberration detection on high-resolution comparative genomic hybridization array, DNA methylation, and single nucleotide polymorphism genotyping platforms. Forty-four of 46 malignant aspirates in this study manifested unequivocal genomic aberrations. Importantly, matched Papanicolaou and Diff-Quik fine-needle aspiration cytopathology samples showed critical differences in DNA preservation and DNA integrity. Overall, this study identifies a largely untapped reserve of human pathology specimens for molecular profiling studies, with ramifications for the prospective collection of clinical biospecimens. PMID:20959611

  16. Fine-needle aspiration cytology of the ovary.

    PubMed

    Ganjei, P

    1995-09-01

    FNA cytology has been shown to be highly accurate in diagnosing malignant tumors. In gynecology, an overall accuracy of 94.5% in the differentiation between benign and malignant tumors has been reported. Despite many controversial views regarding its safety, aspiration cytology has been accepted as an innocuous procedure that can be accomplished with minimal discomfort or complications and, in association with laparoscopy, assist in the management of ovarian cysts and masses. Although FNA cannot be considered the first-hand diagnostic procedure for ovarian cancer in postmenopausal patients, it may be extremely helpful in young women, even during pregnancy, to safely differentiate functional and other benign ovarian cysts from malignant ones. In postmenopausal women, especially those in the high risk group for surgical procedures and those undergoing a "second look" intervention following radiation or chemotherapy, aspiration cytology may provide sufficient information to warrant abandoning unnecessary surgery. During laparotomy for suspected unilateral disease, FNA may provide sufficient data about the opposite ovary to allow that organ to remain in place, thus preserving its function in a young patient. The pathologist must be familiar with the cytology of normal pelvic structures and the diagnostic criteria used to differentiate benign from malignant lesions, as well as potential diagnostic pitfalls, such as interpretation based on very few cells or the absence of appropriate clinical information. Although proper classification of ovarian masses can be achieved through FNA, the pathologist should be aware of its limitations, such as difficulties in differentiating adenomas from non-neoplastic cysts, and tumors of low malignant potential from well-differentiated carcinomas. Descriptive histologic terminology should be applied, and terms such as "suspicious" or "atypical" avoided. The aspirated material may not only be used for the diagnosis and classification of

  17. Is fine-needle aspiration diagnosis of malignancy adequate prior to major lung resections including pneumonectomy?

    PubMed

    Khorsandi, Maziar; Shaikhrezai, Kasra; Wallace, William; Brackenbury, Edward

    2012-08-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether a fine-needle aspiration (FNA) diagnosis is of sufficient reliability for the diagnosis of lung cancer prior to a major lung resection. Altogether, 112 papers were found using the reported search, of which 13 papers presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The tabulated studies include two meta-analyses, one systematic review, one randomized controlled trial (RCT) and nine cohort studies. The specificity reported for FNA in the diagnosis and staging of lung cancer ranged from 96.2 to 100%. One meta-analysis reported a specificity of 97%. Another meta-analysis reported a specificity of 98.8%. A systematic review reported a specificity of 97%. An RCT reported a specificity of 96.2-100%. We conclude that the FNA for lung cancer is reported to be highly specific prior to major lung resection with a very low false positive rate. However, although a false positive may occasionally be acceptable in lobectomies, where the lobes are often removed without histology, all steps should be taken to avoid a false positive result in pneumonectomy considering the serious consequences of embarking upon such an operation in the small number of patients with a false positive result, and we recommend that a positive FNA result should be confirmed by means of alternative sampling methods. We also acknowledge that obtaining an additional biopsy specimen would add to the risk of morbidity and costs; therefore, any benefits should be weighed against risks and additional costs. PMID:22611184

  18. Role of endobronchial ultrasound-guided transbronchial needle aspiration in the management of lung cancer.

    PubMed

    Yasufuku, Kazuhiro; Nakajima, Takahiro; Fujiwara, Taiki; Chiyo, Masako; Iyoda, Akira; Yoshida, Shigetoshi; Suzuki, Makoto; Sekine, Yasuo; Shibuya, Kiyoshi; Yoshino, Ichiro

    2008-06-01

    Endobronchial ultrasound (EBUS) is a promising new modality first introduced during the early 1990s. The radial probe EBUS was initially developed seeking for high-resolution imaging of processes in the airway wall and outside the airways. The structure of special importance was lymph nodes, walls of the central airways, and the mediastinum. After the development of miniaturized radial probes with flexible catheters having a balloon at the tip, it has been applied to aid bronchoscopists during biopsy of patients with respiratory diseases. In particular, the role of EBUS in transbronchial needle aspiration (TBNA) has been established. Radial probe EBUS-guided TBNA has increased the yield of TBNA of mediastinal lymph nodes, although it was still not a real-time procedure with target visualization. New convex probe EBUS (CP-EBUS) with the ability to perform real-time EBUS-guided TBNA (EBUS-TBNA) has emerged to overcome these problems. Indications for EBUS-TBNA are (1) lymph node staging in lung cancer patients; (2) diagnosis of intrapulmonary tumors; (3) diagnosis of unknown hilar and/or mediastinal lymphadenopathy; and (4) diagnosis of mediastinal tumors. Case series using EBUS-TBNA for mediastinal lymph node staging in lung cancer have reported a high yield, ranging from 89% to 98% (average 94.5%). To date, there are no reports of major complications related to EBUS-TBNA. EBUS-TBNA is a novel approach with a high diagnostic yield that is safe. The aim of this article was to review the current role of EBUS-TBNA for the management of lung cancer patients. PMID:18563521

  19. The value of forceps biopsy and core needle biopsy in prediction of pathologic complete remission in locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy

    PubMed Central

    Gao, Yuan-Hong; Liu, Guo-Chen; Kong, Ling-Heng; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-01-01

    Patients with pathological complete remission (pCR) after treated with neoadjuvant chemoradiotherapy (nCRT) have better long-term outcome and may receive conservative treatments in locally advanced rectal cancer (LARC). The study aimed to evaluate the value of forceps biopsy and core needle biopsy in prediction of pCR in LARC treated with nCRT. In total, 120patients entered this study. Sixty-one consecutive patients received preoperative forceps biopsy during endoscopic examination. Ex vivo core needle biopsy was performed in resected specimens of another 43 consecutive patients. The accuracy for ex vivo core needle biopsy was significantly higher than forceps biopsy (76.7% vs. 36.1%; p < 0.001). The sensitivity for ex vivo core needle biopsy was significantly lower in good responder (TRG 3) than poor responder (TRG ≤ 2) (52.9% vs. 94.1%; p = 0.017). In vivo core needle biopsy was further performed in 16 patients with good response. Eleven patients had residual cancer cells in final resected specimens, among whom 4 (36.4%) patients were biopsy positive. In conclusion, routine forceps biopsy was of limited value in identifying pCR after nCRT. Although core needle biopsy might further identify a subset of patients with residual cancer cells, the accuracy was not substantially increased in good responders. PMID:26416245

  20. Cloned foal derived from in vivo matured horse oocytes aspirated by the short disposable needle system

    PubMed Central

    Lee, Wonyou; Song, Kilyoung; Lee, Inhyung; Shin, Hyungdo; Lee, Byeong Chun

    2015-01-01

    Transvaginal ultrasound-guided follicle aspiration is one method of obtaining recipient oocytes for equine somatic cell nuclear transfer (SCNT). This study was conducted: (1) to evaluate the possibility of oocyte aspiration from pre-ovulatory follicles using a short disposable needle system (14-G) by comparing the oocyte recovery rate with that of a long double lumen needle (12-G); (2) to investigate the developmental competence of recovered oocytes after SCNT and embryo transfer. The recovery rates with the short disposable needle vs. the long needle were not significantly different (47.5% and 35.0%, respectively). Twenty-six SCNT embryos were transferred to 13 mares, and one mare delivered a live offspring at Day 342. There was a perfect identity match between the cloned foal and the cell donor after analysis of microsatellite DNA, and the mitochondrial DNA of the cloned foal was identical with that of the oocyte donor. These results demonstrated that the short disposable needle system can be used to recover oocytes to use as cytoplasts for SCNT, in the production of cloned foals and for other applications in equine embryology PMID:26119166

  1. Multimodal optical biopsy probe to improve the safety and diagnostic yield of brain needle biopsies (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Desroches, Joannie; Pichette, Julien; Goyette, Andréanne; Tremblay, Marie-Andrée.; Jermyn, Michael; Petrecca, Kevin; Leblond, Frédéric

    2016-03-01

    Brain needle biopsy (BNB) is performed to collect tissue when precise neuropathological diagnosis is required to provide information about tumor type, grade, and growth patterns. The principal risks associated with this procedure are intracranial hemorrhage (due to clipping blood vessels during tissue extraction), incorrect tumor typing/grading due to non-representative or non-diagnostic samples (e.g. necrotic tissue), and missing the lesion. We present an innovative device using sub-diffuse optical tomography to detect blood vessels and Raman spectroscopy to detect molecular differences between tissue types, in order to reduce the risks of misdiagnosis, incorrect tumour grading, and non-diagnostic samples. The needle probe integrates optical fibers directly onto the external cannula of a commercial BNB needle, and can perform measurements for both optical techniques through the same fibers. This integrated optical spectroscopy system uses diffuse reflectance signals to perform a 360-degree reconstruction of the tissue adjacent to the biopsy needle, based on the optical contrast associated with hemoglobin light absorption, thereby localizing blood vessels. Raman spectra measurements are also performed interstitially for tissue characterization. A detailed sensitivity of the system is presented to demonstrate that it can detect absorbers with diameters <300 µm located up to ˜2 mm from the biopsy needle core, for bulk optical properties consistent with brain tissue. Results from animal experiments are presented to validate blood vessel detection and Raman spectrum measurement without disruption of the surgical workflow. We also present phantom measurements of Raman spectra with the needle probe and a comparison with a clinically validated Raman spectroscopy probe.

  2. Correlation between Fine-Needle Aspiration Cytology and Histology for Palpable Breast Masses in a Nigerian Tertiary Health Institution

    PubMed Central

    Daramola, Adetola Olubunmi; Odubanjo, Mosebolatan Olatokunboh; Obiajulu, Fred John; Ikeri, Nzechukwu Zimudo; Banjo, Adekunbiola Aina Fehintola

    2015-01-01

    Background. Management of breast lumps can be challenging in resource poor settings. Fine-needle aspiration cytology (FNAC) especially when used with cell block can help improve affordability for the patients. Objective. To determine the diagnostic accuracy of FNAC of palpable breast lesions within a 5-year period. Methods. The findings obtained from FNAC of palpable breast lumps seen at the FNAC clinic of our department from January 2007 to December 2011 were retrieved and correlated with findings on histology of excisional biopsies. Results. A total of 1790 patients had FNAC of breast lumps during the 5-year period; 436 of them subsequently had biopsies. Our results compare favourably with the measures of test performance of the UK NHS Breast Screening Programme shown in brackets: absolute sensitivity 95.4% (>70%), complete sensitivity 99.2% (>90%), full specificity 88.9% (>65%), positive predictive value 99.6% (>99%), false-negative rate 0.8% (<4%), false-positive rate 0.4% (<0.5%), inadequate rate 3.2% (<15%), and suspicious rate 10.2% (<15%). Conclusion. Breast FNACs compare very well with histology of excisional biopsies and in experienced hands are extremely useful in the management of breast lumps. Further studies assessing the diagnostic accuracy of FNAC and cell blocks in our setting are recommended. PMID:26635977

  3. Image guided versus palpation guided core needle biopsy of palpable breast masses: a prospective study

    PubMed Central

    Hari, Smriti; Kumari, Swati; Srivastava, Anurag; Thulkar, Sanjay; Mathur, Sandeep; Veedu, Prasad Thotton

    2016-01-01

    Background & objectives: Biopsy of palpable breast masses can be performed manually by palpation guidance or under imaging guidance. Based on retrospective studies, image guided biopsy is considered more accurate than palpation guided breast biopsy; however, these techniques have not been compared prospectively. We conducted this prospective study to verify the superiority and determine the size of beneficial effect of image guided biopsy over palpation guided biopsy. Methods: Over a period of 18 months, 36 patients each with palpable breast masses were randomized into palpation guided and image guided breast biopsy arms. Ultrasound was used for image guidance in 33 patients and mammographic (stereotactic) guidance in three patients. All biopsies were performed using 14 gauge automated core biopsy needles. Inconclusive, suspicious or imaging-histologic discordant biopsies were repeated. Results: Malignancy was found in 30 of 36 women in palpation guided biopsy arm and 27 of 36 women in image guided biopsy arm. Palpation guided biopsy had sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 46.7, 100, 100, 27.3 per cent, respectively, for diagnosing breast cancer. Nineteen of 36 women (52.8%) required repeat biopsy because of inadequate samples (7 of 19), suspicious findings (2 of 19) or imaging-histologic discordance (10 of 19). On repeat biopsy, malignancy was found in all cases of imaging-histologic discordance. Image guided biopsy had 96.3 per cent sensitivity and 100 per cent specificity. There was no case of inadequate sample or imaging-histologic discordance with image guided biopsy. Interpretation & conclusions: Our results showed that in palpable breast masses, image guided biopsy was superior to palpation guided biopsy in terms of sensitivity, false negative rate and repeat biopsy rates. PMID:27488003

  4. Handheld array-based photoacoustic probe for guiding needle biopsy of sentinel lymph nodes

    NASA Astrophysics Data System (ADS)

    Kim, Chulhong; Erpelding, Todd N.; Maslov, Konstantin; Jankovic, Ladislav; Akers, Walter J.; Song, Liang; Achilefu, Samuel; Margenthaler, Julie A.; Pashley, Michael D.; Wang, Lihong V.

    2010-07-01

    By modifying a clinical ultrasound array system, we develop a novel handheld photoacoustic probe for image-guided needle biopsy. The integration of optical fiber bundles for pulsed laser light delivery enables photoacoustic image-guided insertion of a needle into rat axillary lymph nodes with accumulated indocyanine green (ICG). Strong photoacoustic contrast of the needle is achieved. After subcutaneous injection of the dye in the left forepaw, sentinel lymph nodes are easily detected, in vivo and in real time, beneath 2-cm-thick chicken breast overlaying the axillary region. ICG uptake in axillary lymph nodes is confirmed with fluorescence imaging both in vivo and ex vivo. These results demonstrate the clinical potential of this handheld photoacoustic system for facile identification and needle biopsy of sentinel lymph nodes for cancer staging and metastasis detection in humans.

  5. Endoscopic Ultrasound-Guided Fine Needle Aspiration versus Percutaneous Ultrasound-Guided Fine Needle Aspiration in Diagnosis of Focal Pancreatic Masses

    PubMed Central

    Okasha, Hussein Hassan; Naga, Mazen Ibrahim; Esmat, Serag; Naguib, Mohamed; Hassanein, Mohamed; Hassani, Mohamed; El-Kassas, Mohamed; Mahdy, Reem Ezzat; El-Gemeie, Emad; Farag, Ali Hassan; Foda, Ayman Mohamed

    2013-01-01

    Objective: Pancreatic carcinoma is one of the leading cancer morbidity and mortality world-wide. Controversy has arisen about whether the percutaneous approach with computed tomography/ultrasonography-guidance fine needle aspiration (US-FNA) or endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the preferred method to obtain diagnostic tissue. Our purpose of this study is to compare between the diagnostic accuracy of EUS-FNA and percutaneous US-FNA in diagnosis of pancreatic cancer. Patients and Methods: A total of 197 patients with pancreatic masses were included in the study, 125 patients underwent US-FNA (Group 1) and 72 patients underwent EUS-FNA (Group 2). Results: EUS-FNA has nearly the same accuracy (88.9%) as US-FNA (87.2%) in diagnosis of pancreatic cancer. The sensitivity, specificity, positive predictive value and negative predictive value for EUS-FNA was 84%, 100%, 100%, 73.3% respectively. It was 85.5%, 90.4%, 94.7%, 76% respectively for US-FNA. EUS-FNA had a lower complication rate (1.38%) than US-FNA (5.6%). Conclusion: EUS-FNA has nearly the same accuracy as US-FNA of pancreatic masses with a lower complication rate. PMID:24949394

  6. [The use of ultrasonically-guided needle aspiration cytology in the diagnosis of hepatic lesions].

    PubMed

    Geroni, P L; Caffi Avogadri, G M; Costardi, F

    1990-10-31

    The paper reports the results of 68 ultrasonically-guided fine needle aspirations of the liver. Histological confirmation was carried out in 24 cases and in 2 of these there was discrepancy with regard to the type of malignant neoplasia (hepatocarcinoma versus metastasis following adenocarcinoma). Following a discussion of the advantages and disadvantages of ultrasonically-guided fine needle aspiration of hepatic lesions in comparison to other techniques, including CT, RNM, angiography, laparoscopy and scintigraphy, the specificity, sensitivity and diagnostic accuracy of the method are determined. Particular emphasis is placed on the ease of performance, the possibility of reaching concealed targets, the limited nature of complications and the reduced cost. The Authors conclude that this technique should be preferentially used in the diagnosis of nodular hepatic lesions. PMID:2082208

  7. Minimally invasive diagnosis of a pericardial mass by CT-guided fine-needle aspiration.

    PubMed

    Llibre, Cinta; Saenz-Sardà, Xavier; Vilalta, Victòria; Tria, Laura; Llatjós, Maria; Ariza, Aurelio; Bayes-Genis, Antoni

    2016-01-01

    The preferred management of a cardiac mass remains controversial, but it often includes open-chest surgical excision to obtain an adequate tissue sample for histological workup. We herein report a less invasive approach in which an accurate and timely cytological diagnosis of pericardial angiosarcoma was reached by studying a CT-guided fine-needle aspiration cell block. The cell block showed proliferation of atypical cells with occasional mitotic figures, vasoformative features, and immunoreactivity to WT1, vimentin, CD31, CD34, ERG, and Ki67. Recourse to fine-needle aspiration and cell block study is a valuable diagnostic approach to be considered when a cardiac mass is percutaneously accessible. PMID:27131516

  8. Intrapulmonary schwannoma diagnosed with endobronchial ultrasound-guided transbronchial needle aspiration: case report.

    PubMed

    Watanabe, Keisuke; Shinkai, Masaharu; Shinoda, Masahiro; Ishigatsubo, Yoshiaki; Kaneko, Takeshi

    2014-11-01

    A 47-year-old woman was referred to our hospital for further examination of a lung tumor. CT of the chest revealed a round, well-defined 2.4-cm nodule in S2, adjacent to right superior lobe bronchus. Endobronchial ultrasonography showed a well-defined, hypoechoic tumor with echogenic capsule and posterior acoustic enhancement. Diagnosis of schwannoma was confirmed from the specimen obtained by endobronchial ultrasound-guided transbronchial needle aspiration. She underwent tumorectomy due to the possibility of obstructive pneumonia. Pathology diagnosis from the surgical specimen was also schwannoma. Endobronchial ultrasound-guided transbronchial needle aspiration and findings with endobronchial ultrasonography might be helpful in the diagnosis of intrapulmonary schwannoma. PMID:24907227

  9. Extrapleural locating method in computed tomography-guided needle biopsies of 1,106 lung lesions

    PubMed Central

    WEI, YUE-HUA; ZHOU, FU-XIANG; LI, YAN; ZHOU, YUN-FENG; ANISH, KRISHNA; XU, LI-YING; LIAO, MEI-YAN

    2015-01-01

    Transthoracic needle biopsy is considered to be safe and effective for the diagnosis of focal lung lesions. The aim of the present study was to evaluate factors affecting the accuracy and safety of automated cutting needle lung biopsy (ACNB) using a new extrapleural locating (EPL) method. Computed tomography (CT)-guided needle biopsies were performed on 1,065 patients between March 2005 and May 2012 using the EPL method. The locating needle remained in the chest following extrapleural positioning, while the radiologist confirmed the puncture angle and distance between the locating needle and lesion. The biopsy instrument was advanced into the lung, and the core needle was subsequently fired into the lesion based on the direction indicated by the locating needle. Univariate and multivariate regression analyses were used to evaluate the diagnostic accuracy and safety of the procedure. The sensitivity, specificity, positive predictive value and negative predictive value of the extrapleural method were 91.9, 100, 100 and 82.9%, respectively, and the overall diagnostic accuracy was 94.2%. Significant risk factors affecting accuracy were younger age, atelectasis, hemoptysis and lesion depth (P<0.03). Multivariate logistic regression analysis revealed that the risk of malignant lesions receiving a false-negative diagnosis decreased for each additional year of subject age [odds ratio (OR), 0.97; P=0.027] and increased with each millimeter increase in lesion depth (OR, 1.03; P=0.008). Among the 1,106 lesions biopsied, 207 were associated with pneumothorax, 251 with hemorrhage and 58 with hemoptysis. Multivariate analysis revealed that lesion size and emphysema affected pneumothorax incidence, while age, lesion location and depth and emphysema significantly affected hemorrhage incidence (P<0.05). In conclusion, low-dose, CT-guided ACNB with the EPL method provides a safe and accurate diagnosis. PMID:26640541

  10. Ultrasound guided fine needle biopsy of early hepatocellular carcinoma complicating liver cirrhosis: a multicentre study

    PubMed Central

    Caturelli, E; Solmi, L; Anti, M; Fusilli, S; Roselli, P; Andriulli, A; Fornari, F; Del Vecchio Blanco, C; de Sio, I

    2004-01-01

    Background: Because hepatic cirrhosis is a major risk factor for hepatocellular carcinoma, recent guidelines by the European Association for the Study of the Liver (EASL) on clinical management of hepatocellular carcinoma recommend periodic ultrasound surveillance of cirrhotic patients with immediate workup for nodules >1 cm; an increase in the frequency of screening is considered sufficient for smaller lesions. Aims: To determine the actual risk of hepatocellular carcinoma associated with the latter lesions and to assess the role of ultrasound guided-fine needle biopsy in their diagnosis Patients and methods: Data were analysed for 294 new nodular lesions <20 mm, including 48 that were <10 mm, detected during a prospective multicentre study involving ultrasound surveillance of 4375 patients with hepatic cirrhosis. In the absence of α fetoprotein (AFP) levels diagnostic of hepatocellular carcinoma, ultrasound guided-fine needle biopsy was performed (n = 274). AFP and fine needle biopsy diagnoses of malignancies (hepatocellular carcinoma and lymphoma) were considered definitive. Non-malignant fine needle biopsy diagnoses (dysplastic or regenerative nodule) were verified by a second imaging study. Diagnoses of hepatocellular carcinoma based on this study were considered definitive; non-malignant imaging diagnoses were considered definitive after at least one year of clinical and ultrasound follow up. Results: Overall, 258/294 (87.6%) nodules proved to be hepatocellular carcinoma, including 33/48 (68.7%) of those ⩽10 mm. Overall typing accuracy of ultrasound guided-fine needle biopsy was 89.4%, and 88.6% for lesions ⩽10 mm. Conclusions: In a screening population, well over half of very small nodules arising in cirrhotic livers may prove to be hepatocellular carcinoma, and approximately 90% of these malignancies can be reliably identified with ultrasound guided-fine needle biopsy. PMID:15306600