Fine-needle aspiration biopsy of angio-immunoblastic lymphadenopathy

In this article, we have described the fine-needle aspiration biopsy (FNAB) of five cases of angioimmunoblastic lymphadenopathy (AILD). FNAB of these cases showed large number of capillary fragments, along with polymorphous population of cells consisting of plenty of immunoblasts, plasma cells, eosinophils, and mast cells. Two cases showed clusters of clear cells. It is essential to have detailed clinical features for FNAB diagnosis of AILD. Histopathology is advisable in all the fresh cases. FNAB is helpful for screening and follow-up of AILD. Diagn Cytopathol 1996;15:412–414. © 1996 Wiley-Liss, Inc.     

Breast Cancer Detection With 99m-Tc-Sestamibi Scintigraphy, Mammography, and Fine-Needle Aspiration Cytology: Comparative Study in 64 Surgically Treated Patients

Background: In breast cancer, mammography (MG) fails to reveal malignancy in 10% to 15% of patients, and its sensitivity is limited by dense breast tissue. The aim of this study was to evaluate the usefulness of 99m-Tc-sestamibi scintimammography (SMM) in conjunction with MG and fine needle aspiration (FNA) cytology in the detection of low-stage breast cancer.Methods: A total of 64 women (median age 58 years, range 32–86 years), 53 (82.8%) with palpable and 11 (17.2%) with nonpalpable breast mass, underwent SMM; 61 patients had MG and 62 underwent FNA cytology. At histological examination, breast cancer was found in 59 (92.2%) of the women (pTis = 2, pT1a = 2, pT1b = 13, pT1c = 20, pT2 = 22).Results: Of the 61 patients who had MG, 45 (73.8%) showed signs of cancer or abnormalities. Of the 62 patients who had FNA cytology, 55 (88.7%) showed malignancy. In 5 (8.1%) patients, atypical ductal hyperplasia or complex sclerosing lesions were found. MG, SMM, and FNA cytology were 80.4%, 78.0%, and 96.5% sensitive, respectively, and their positive predictive value was 97.8%, 100%, and 100%, respectively. In all patients, cancer was at least detected by one of these three techniques.Conclusions: In women with suspicious MG or abnormal FNA cytology that required further investigations, SMM may be helpful in surgical planning and should be considered in most patients before biopsy as an additional noninvasive procedure.Presented at the 52 Annual Cancer Symposium of The Society of Surgical Oncology, Orlando, Florida, March 4–7, 1999.     

BRAFV600E基因突变检测在不确定意义（Bethesda Ⅲ和Ⅳ类）细胞学结果的甲状腺结节中的应用价值

目的:探讨BRAFV600E基因突变检测在首次细胞学诊断为Bethesda Ⅲ和Ⅳ类的甲状腺结节中的临床应用价值。方法:回顾性分析2016年1月至 2019年6月我院首次细胞学诊断为Bethesda Ⅲ和Ⅳ类,后于超声科行第二次超声引导下细针穿刺细胞学检查（FNAB）和BRAFV600E基因突变检测的甲状腺结节患者资料,以手术病理结果为甲状腺结节性质诊断的金标准,比较分析FNAB、BRAFV600E基因突变、FNAB联合BRAFV600E基因突变检测在病理诊断为不确定意义细胞学结果的甲状腺结节中的诊断效能。结果:92例首次细胞学结节为Bethesda Ⅲ和Ⅳ类的甲状腺结节均经手术病理证实。术后病理结果为恶性有54例,良性有38例。BRAFV600E 基因突变诊断甲状腺癌的准确率为81.5%,灵敏度为68.5%,特异度为100%,阳性预测值为100%,阴性预测值为69.1%。FNAB诊断甲状腺癌的准确率为72.8%,灵敏度为70.4%,特异度为76.3%,阳性预测值为80.9%,阴性预测值为64.4%。FNAB联合BRAFV600E基因突变检测诊断甲状腺癌的准确率为90.2%,灵敏度为92.6%,特异度为86.8%,阳性预测值为90.9%,阴性预测值为89.2%。FNAB联合BRAFV600E基因突变检测的准确率和灵敏度都较FNAB、BRAFV600E基因突变检测单独使用的诊断指标高,差异有统计学意义。结论:对于伴有可疑超声征象的甲状腺结节,在行首次或重复FNAB检查的同时联合BRAFV600E基因突变检测,有助于减少Bethesda Ⅲ和Ⅳ类细胞学的诊断,提高FNAB检查的诊断效能,为甲状腺结节的诊疗提供更可靠的依据。     

The Role of Tc-99 m-MIBI Scan in the Assessment of the Cystic Thyroid Nodule

PurposeA non-surgical therapeutic option requires assurance that a cystic thyroid nodule with non-diagnostic cytology is benign. This work was undertaken to determine whether Tc-99 m-MIBI scan (MIBI) findings can guide the best therapeutic option with confidence.Material and MethodsWe studied 81 cystic non-functioning thyroid nodules with non-diagnostic fine-needle aspiration biopsy (FNAB) report classified according to ATA 2015 ultrasonography (US) patterns for suspicion of malignancy. All had a MIBI to assess metabolic activity within the nodule as well as histopathological diagnosis. Diagnostic value analysis of MIBI as compared to the US pattern was determined.ResultsNone of the 11 patients with US pattern of benign showed positive MIBI, and all had a histopathological report of benign. Diagnostic value of MIBI on US pattern of very low suspicion showed sensitivity, specificity, PPV, and NPV of 100%, 78.9%, 42.9%, and 100%, respectively.ConclusionOur data shows that the only approach to a safe non-surgical treatment option in a cystic nodule with non-diagnostic FNAB is when no metabolic activity is seen on MIBI.     

Role of fine needle aspiration biopsy cytology in the diagnosis of infections

The role of fine needle aspiration biopsy (FNAB) cytology in diagnosing infections has expanded due to the increase in the number of immune compromised patients and the increasing role of FNAB in the developing world where infection is a major cause of illness. FNAB has become the first procedural test in cases where the clinical and imaging findings suggest an infectious lesion or where there is a differential diagnosis of infection or metastatic or primary tumor. This applies to FNAB of palpable or image directed or deep seated lesions accessed by EUS and EBUS. This article details a recommended approach and technique for FNAB of infectious lesions, and discusses the role of rapid on site evaluation and the application of ancillary testing including the rapidly expanding array of molecular tests based on FNAB material. The utility of recognizing suppurative and granulomatous infectious patterns in FNAB direct smears, and the specific cytomorphological features on routine Papanicolaou and Giemsa stains and on special stains of FNAB smears is described for a large number of bacterial, fungal, viral, parasitic, and protozoan infections. The role of cytopathologists is to now train cytopathologists in sufficient numbers to provide FNAB services, teach trainee cytopathologists and cytotechnologists, and to encourage our clinical colleagues to use FNAB in the diagnosis of infections and other lesions to the benefit of patients and the medical system. Diagn. Cytopathol. 2016;44:1024–1038. © 2016 Wiley Periodicals, Inc.     

Modified fine‐needle aspiration technique for diagnosis of granulomatous skin lesions with special reference to leprosy and cutaneous tuberculosis

Skin infections are commonly assessed by slit skin or scrape methods. Fine‐needle aspiration biopsy (FNAB) is highly effective especially with blanching of skin to ensure good yield and reduced bleeding. The aim of this study was to assess usefulness of cytology, especially modified FNAB technique, in diagnosis of leprosy and cutaneous tuberculosis and to identify specific cytological characteristics for diagnosis and classification. The study was conducted on 40 patients—25 cases of leprosy and 15 cases of cutaneous tuberculosis. Smears were prepared using modified FNAB technique, slit skin, and scrape methods (depending on type of lesion). Cytological diagnosis was confirmed by histopathology where the Ridley‐Jopling system was used to classify cases of leprosy. A similar attempt was made for diagnosis and classification of leprosy on cytology. Diagnoses rendered by both modalities were compared to assess the efficacy of cytological examination. Cytological diagnosis was made in 23 cases of leprosy and 12 cases of cutaneous tuberculosis. The smears showed good cellularity. A broad division into tuberculoid and lepromatous leprosy could be made fairly accurately on cytology. Maximum agreement among clinical, cytological, and histopathological diagnosis was observed in cases of tuberculoid leprosy. Smears of cutaneous tuberculosis were characterized by epithelioid cell granulomas with caseation. Overall accuracy of diagnosis was 92% in leprosy and 80% in tuberculosis. FNAB is an inexpensive and accurate procedure for diagnosis of leprosy and cutaneous tuberculosis. The modified technique yields good results. However, clinical correlation, acid‐fast staining, and culture are essential as they provide valuable supportive information. Diagn. Cytopathol. 2010. © 2009 Wiley‐Liss, Inc.     

甲状腺良恶性结节诊断中超声与FNAB的相关性

目的:探讨超声与细针穿刺活检(Fine-needle aspiration biopsy,FNAB)在甲状腺良恶性结节诊断中的相关性.方法:分析就113例门诊甲状腺结节患者的临床资料,每例均行甲状腺超声及FNAB检查.结果:超声提示80例恶性患者中FNAB提示51例恶性;超声提示33例良性中FNAB提示2例恶性.结论:超声提示甲状腺良恶性结节与FNAB具有较好的相关性,甲状腺结节的超声检查可以作为临床工作中决定是否行FNAB的重要依据.