Aspiration biopsy of prostate

Needle biopsy of the prostate has been widely practiced for more than twenty-five years, whereas transrectal aspiration biopsy, first described fifty years ago, has not. We describe our experience using the transrectal aspiration biopsy and correlate the results with histologic studies of the prostate obtained by conventional needle biopsy and surgical specimens. Aspiration needle biopsy of the prostate has a high degree of diagnostic accuracy, it causes minimal inconvenience and discomfort, the results are rapidly available, the ease of entering the suspected area in the prostate is more precise than with conventional needle biopsy, and sampling of prostate can be greater. The disadvantages of aspiration biopsy are that the technique, being unfamiliar to most urologists, must be learned and requires an experienced cytologist for interpretation. Cytologic evaluation by aspiration biopsy and the histologic diagnosis by conventional needle biopsy are complementary.     

Aspiration biopsy of the prostate gland

Aspiration biopsy is a rapid and relatively painless technique for evaluating an abnormal prostate gland. It can be performed on outpatients without anesthesia and is easily tolerated. It sensitivity in detecting cancer is at least equivalent to that of core biopsies, in part because several areas of the prostate may be sampled in a relatively atraumatic fashion. Few complications are encountered. Adequate performance of aspiration biopsy of the prostate requires experience and diligence, both by the urologist, in obtaining adequate specimens, and by the processing laboratory and pathologist, in interpreting these specimens. It is hoped that aspiration biopsy will lead to the early diagnosis of prostatic cancer, effecting lower morbidity, reduced hospital cost, greater ease in performing radical prostatectomy, and more accurate techniques for predicting the prognosis in affected patients.     

Aspiration biopsy of thoracic lesions

We have performed percutaneous needle aspiration biopsy of intrathoracic lesions under fluoroscopic control on 50 patients. Lesions as small as 1 to 1·5 cm. in diameter were aspirated. Thirty of the 36 cases of malignant neoplasm were diagnosed by this method. Of the 14 non-neoplastic cases, granuloma was diagnosed in two, and in eight of the remaining 12 the clinical diagnosis was supported by the nature of the aspirated material. Pneumothoraces are to be expected as a complication of the method. Most will be asymptomatic; a small proportion will require treatment. There will also be the occasional haemoptysis. The procedure can be quickly performed and it is well tolerated by the patient. It causes less discomfort than bronchoscopy or scalene lymph node biopsy. The interpretation of the cytological material presents no undue difficulty to the pathologist experienced in conventional pulmonary exfoliative cytology.     

经会阴前列腺穿刺与经直肠前列腺穿刺活检在前列腺癌诊断的初探

目的 对比经会阴与经直肠前列腺穿刺活检在前列腺癌诊断中的阳性率及并发症。方法 回顾分析2017年1月到2019年12月行前列腺穿刺活检的病例,经直肠组187例,经会阴组68例。结果 经直肠组阳性穿刺率为34.7%,经会阴组阳性穿刺率为29.4%,两组无统计学差异（P>0.05）。穿刺后经直肠组和经会阴组的血尿发生率分别为40.1%、42.6%,尿潴留发生率分别为6.9%、7.3%,直肠出血发生率分别为1.1%、0%,差别无统计学意义（P>0.05）。穿刺后经直肠组和经会阴组的会阴肿胀的发生率分别为2.6%、13.2%,两组有统计学差异（P<0.05）。结论 超声引导下经直肠、经会阴前列腺穿刺活检均为前列腺癌诊断的有效方法。两者穿刺阳性率无明显差异,但并发症各有特点。     

Aspiration biopsy of primary neoplasms of bone

Aspiration biopsy of bone is a simple and relatively safe diagnostic tool that had a diagnostic accuracy of 72 per cent in thirty-one patients who had a primary bone tumor that was suspected of being malignant and of 83 per cent in twelve patients who had a suspected giant-cell tumor. However, twenty-six primary lesions of bone that were thought likely to be benign were not as easily and definitively diagnosed (an accuracy rate of 23 per cent), and for these lesions, multiple needle-aspiration samples or open biopsy provides greater diagnostic accuracy.     

MRI-spectroscopy-guided prostate biopsy

Prostate cancer is currently one of the main causes of urological practice workload. Patients with negative prostate biopsies may pose serious problems to the urologist in the decision making process for follow-up due to the lack of definitive data in the follow-up algorithm. MRI spectroscopy seems to open a diagnostic window evaluating prostatic metabolic changes. The performance of perineal prostatic biopsy with stabilizer and template enables selective biopsy of the suspect voxels following the spectroscopic study, simulating the Rubick's cube.     

Systematic prostate biopsy before transurethral resection of the prostate

PURPOSE: With the aim of evaluating the clinical significance of systematic prostate biopsy before transurethral resection of the prostate (TUR-P), clinical data were reviewed retrospectively in patients who had underwent prostate biopsy prior to scheduled TUR-P. PATIENTS AND METHODS: Between July, 1994 and June, 2000, TUR-P was scheduled in a total number of 456 patients with clinically diagnosed benign prostatic hyperplasia (BPH). RESULTS: In 218 (47.8%) out of 456 cases, prostatic biopsy was conducted prior to TUR-P due to abnormally elevated serum prostate specific antigen (PSA) levels of 4.0 ng/ml or more, revealing only 22 (10.1%) cases of prostatic cancer. Between these 22 cases with biopsy proven prostatic cancer and 189 cases with BPH confirmed both by biopsy and following TUR-P, statistically significant differences were noted in age (p < 0.05), prostate volume (p < 0.0001) and PSA density (p < 0.01). CONCLUSION: Considering the low positive rate of preoperative prostatic biopsy, it might be suggested that a considerable number of biopsy could be avoided in patients with clinically diagnosed BPH. Based on the results obtained from this study, prostatic biopsy might be unnecessary before TUR-P for those with prostate volume greater than 60 ml or PSA density less than 0.15.     

Aspiration biopsy cytology in diagnosis of thyroid cancer

Aspiration biopsy cytology (ABC) is a diagnostic method that has been used extensively in Sweden for a quarter of a century. The technical steps involved in this biopsy procedure are described, and the differences from large needle biopsy techniques are pointed out. An overview is given of the different pathologic conditions that present as thyroid nodules and are recognizable by ABC. The accuracy of the method as a preoperative diagnostic tool has been shown to be superior to other clinical methods. ABC enables the surgeon not only to better select patients with thyroid nodules for surgery, but also to plan a definite operative strategy in papillary, medullary, and anaplastic neoplasms. In follicular neoplasms, however, the method cannot distinguish with certainty between adenoma and carcinoma. ABC has drastically reduced the number of diagnostic surgical operations for benign lesions. It requires no anesthesia. It has no complications and there is good patient acceptance, even in children.     

Aspiration puncture biopsy in the preoperative diagnosis of adrenal tumors

The results of fine-needle aspiration puncture (AP) and cytologic examination in the preoperative period in 4 patients with various lesions of the adrenals are discussed. AP was conducted under local anesthesia and control by ultrasonic examination; no complications occurred. Analysis of the cytologic findings allowed preoperative morphological verification of the process, as a result of which the initial clinical diagnosis was changed in 2 of the 4 cases. With an exactly established preoperative cytologic diagnosis a rational therapeutic tactics can be chosen, and the necessity of using complicated examination methods, diagnostic laparotomy among others, obviated.     

Clinical interpretation of the prostate biopsy

Pathologic evaluation of the prostate biopsy provides the clinician with a wealth of information. Identifying needle biopsy parameters predictive of pathological stage and tumor volume at radical prostatectomy has become a major focus in the field of prostate pathology. From a review of the literature, the following factors are strongly predictive of extraprostatic disease; tumor involvement of greater than 25%, greater than two positive cores, cancer involvement greater than 3 mm, and perineural invasion. Such information could prove useful in patient counseling and identifying high-risk patients who may be good candidates for adjuvant therapy trials.     

Thin-needle aspiration biopsy of the prostate

The authors summarize the current status of thin-needle aspiration biopsy of the prostate and evaluate the accomplishments and limitations of this method of diagnosis. Historical developments, indications, technique, contraindications, complications, cytology of aspirates, diagnostic efficacy of aspirates, and grading of prostatic carcinomas are discussed.