Supplementary tissue-core histology from fine-needle transthoracic aspiration biopsy

Biopsies of 150 consecutive suspected lung cancers were performed with fine needles having circumferentially beveled tips that produced cytology and tiny tissue cores suitable for histology. Visible tissue cores were aspirated in 92% (n = 138) and histologic diagnoses were obtained in 72% (n = 108). There were 118 (79%) proven malignant and 27 (18%) proven benign lesions. Sensitivity and specificity of cancer diagnoses were 97% and 100%, respectively. Biopsy histology was the only positive cancer specimen in two biopsies (1.7%). Biopsy cytology was the only positive cancer specimen in 20 cases (17.2%). Biopsy cytology and histology agreed with the proven cell type in 71.8% and 78.6% of cancers, respectively. As expected, when large-cell undifferentiated carcinoma was regarded as a nonspecific cell type consistent with either poorly differentiated adenocarcinoma or poorly differentiated epidermoid carcinoma, biopsy-cell-type accuracy increased greatly. Specific benign diagnoses were obtained in 44% of the 27 biopsies of proven benign lesions: cytology (four), core histology (five), and bacteriology (nine). Simple and complicated pneumothorax occurred in 10% and 4% of biopsies, respectively. It was concluded that biopsy with fine, circumferentially beveled needles can produce useful histology to supplement biopsy cytology.     

Cervical cytology screening in the Army

A survey of 748 Army women showed an excellent screening rate for cervical cytology without the use of a screening programme. The women's knowledge regarding results of smears was, however, poor, even in cases with proven carcinoma. Frequent movement of the women because of postings makes follow-up cytology difficult, and a proposal is put forward for a positive reporting system. In this survey severe dyskaryosis suggestive of carcinoma of the cervix was seen presenting under the age of 35 years.     

妇科体检中应用TCT结合高危型HPV检测对宫颈上皮内瘤变的筛查价值

目的探讨妇科体检中应用液基细胞学（TCT）检查结合高危型HPV检测对子宫颈上皮内瘤病变的筛查价值。方法本院2010年1月～2011年12月6973例妇科体检宫颈液基薄层细胞学检查,采用美国新柏氏液基薄层细胞学（TCT）检测系统制片,细胞学诊断采用TBS分级系统。结果6973例液基薄层细胞学检查结果中,细胞学异常者为372例,阳性检出率为5．33％。372例细胞学检查阳性中,ASCUS286例（包含少量非典型鳞状上皮细胞）,占76．88％;LSIL28例,占i7．53％;ASCU—H27例,占7．26％;HSIL22例,占5．91％,非典型腺细胞（AGUS）6例,占1．61％,宫颈鳞癌（SCC）3例,占0．81％;对372例TCT阳性患者行HPV分型检测进行分流,286例ASCUS高危型或低危型HPV阳性者中154例进行阴道镜检查,对细胞学结果ASCUS以上的不论HPV检测是否阳性共计240例均进行阴道镜检查后行宫颈组织学活检,诊断CINI。Ⅲ患者126例,其中CINI36例,CINII36例,CINⅢ54例,宫颈鳞癌6例,慢性宫颈炎伴鳞化38例,HPV亚临床感染33例。宫颈上皮内瘤变的病理诊断符合率分别为ASCUS43．97％,LSIL96．55％,ASC—H100％,HSIL96．65％,SCC100％,AGUC：33．33％。结论液基薄层细胞学（TCT）检测系统是宫颈上皮内瘤变筛查的一种有效方法,宫颈或阴道炎症、HPV病毒感染都会引起宫颈细胞学的异常,有一定的局限性,对于细胞学检查异常的患者进行HPv病毒检测,即便细胞学异常级别较低,一旦合并高危型HPV病毒感染,也有宫颈上皮内瘤变的发生;TCT阳性、HPV阳性者再进行阴道镜检查取组织学,提高了诊断宫颈上皮内瘤变的符合率,对宫颈上皮内瘤变的及时干预和治疗,能有效预防宫颈癌的发生。     

Small-cell carcinoma of the lung. Cytological, roentgenologic, and clinical findings in a consecutive series diagnosed by fine-needle aspiration biopsy.

Small-cell anaplastic carcinoma was diagnosed cytologically in 54 of 2,726 consecutive transthoracic fine-needle aspiration biopsies. Histological material was available in 31 cases (28 anaplastic small-cell carcinomas, 1 carcinoid tumor, 1 adenocarcinoma, and 1 reticulum-cell sarcoma). Fine-needle aspiration cytology is reliable enough to permit a definite diagnosis of small-cell carcinoma, especially when combined with the roentgenograms and clinical findings.     

甲状腺转移癌的超声影像表现

目的:探讨甲状腺转移癌的超声表现及诊断价值.方法:对10例经超声引导下穿刺活检证实为甲状腺转移癌的超声图像特点进行分析.结果:本组甲状腺转移癌超声图像表现为甲状腺内多结节型、孤立结节型、弥漫钙化灶型、回声不均型,7例合并钙化灶,3例无钙化灶,9例病变区血流信号异常增多.结论:甲状腺转移癌超声表现多样,无特征性,确诊需依靠穿刺活检.     

周围型肺癌与肺结核球的同层CT动态增强研究

目的　采用同层动态CT增强扫描评价肺孤立性结节。方法　选择直径≤ 4cm的周围型肺癌 2 9例和肺结核球 7例 ,行同层动态CT增强研究 ,绘制其时间 -密度曲线。结果　肺癌与肺结核球的动态增强峰值差别较大。结论　同层CT动态增强扫描有助于肺癌与肺结核的鉴别诊断     

宫颈薄层液基细胞学上皮细胞异常与宫颈活检病理分析

目的分析宫颈薄层液基细胞学上皮细胞异常与宫颈活检组织病理学诊断的符合率及对子宫颈病变的诊断价值。方法通过对本院妇产科2008年8月-2011年4月的2052例患者做薄层液基细胞学检测，TBS报告方式进行宫颈细胞学检查。对诊断意义不明的不典型鳞状细胞（ASC—US）以上患者231例，在阴道镜下做宫颈活检，将其结果作对照回顾性分析。结果宫颈薄层液基细胞学检测结果显示：不典型鳞状上皮细胞（ASC—H）检出率为7．21％，低度鳞状上皮内病变（L—SIL）检出率为1．21％，高度鳞状上皮内病变（H—SIL）检出率为0．19％。阴道镜下宫颈活检病理诊断符合率分别为ASC—H85．4％、L—SIL92．0％、H—SIL100％。结论液基细胞学与病理组织学有较高的符合率，对高级别CIN和宫颈癌诊断准确率高，配合阴道镜病理活检能及早发现CINⅢ级或原位癌，宫颈薄层液基细胞学检测结果诊断为宫颈上皮异常，均应做宫颈活检．以防漏诊。     

Imaging of the breast treated with quadrantectomy and radiotherapy. Interpretative difficulties in diagnosing asymptomatic recurrences]

This study was aimed at evaluating the incidence of breast carcinoma recurrences in a group of female patients treated with QU.A.RT. July 1989 to December 1990, 111 asymptomatic patients underwent physical examination, mammography (in both cranio-caudal and 45 degrees oblique projections), and US with 7.5 and 10 MHz probes. The study population was made of patients operated between 1984 and 1989 and subsequently treated with radiotherapy. Twenty-seven cases with suspect mammographic and US findings were selected and submitted to cytology with needle biopsy under US or stereotaxic guidance. Ten of them exhibited recurrences (9%) at cytology. Of the extant 17 cases, 5 had inflammatory lesions, 1 had liponecrosis, and 11 patients presented with no pathologic cells. The interpretative difficulties of mammographic and US findings were also examined. Problems were found to be related to both correct execution of the technique due to the treatment the breast is submitted to (volumetric reduction and structural distortion) and to correct image interpretation. Therefore we conclude that the two diagnostic methods be combined for they are complementary in the early detection of breast carcinoma recurrence.     

34例盲、升结肠癌的CT分期

目的评估盲、升结肠癌的CT诊断价值。方法均经病理证实的34例盲、升结肠癌患者行全腹部CT检查,观察其CT表现,并和病理作对照分析。结果CT显示早期盲、升结肠癌2例,显示中、晚期结肠癌32例。CT肿瘤分期正确23例占67.6%,估高5例占14.7%,估低6例占17.7%。结论CT对早期盲、升结肠癌无明显价值,而对中晚期癌肿价值较大,可指导临床手术及治疗方案的制定。     

Imaging features of leptomeningeal metastases

AIMS: To assess the range of appearances, and accuracy of various methods of diagnosing leptomeningeal metastases. MATERIALS AND METHODS: In a retrospective study, the notes and imaging of all patients with a radiological and/or CSF cytological diagnosis of leptomeningeal metastasis (LM) were identified, and assessed for the following: age and sex, primary tumour type, presenting symptoms, initial radiological and cytological diagnosis, radiological appearances and length of survival following diagnosis. Discordance between the CSF cytology and radiological diagnosis of LM was also noted. RESULTS: 41 positive cases (36 female) of LM were identified over a 2.7 year period (diagnosis based on: imaging only--19 cases, cytology only--6, both--16 cases). The average age was 48 years, and the most frequent primary tumour was breast carcinoma (27/41). Two thirds of patients presented with at least one cranial or spinal nerve palsy. Where performed, contrast-enhanced CT was normal in 40% (10/25), with LM mistaken for parenchymal disease in a further 24% (6/25). CSF cytology was positive in 85% (22/26). Gadolinium-enhanced MRI was positive in all cases where it was performed (25/25). Pial enhancement and nodularity was the commonest finding (67%), but other manifestations included nodular disease, neural enhancement and white matter changes. Prognosis was uniformly poor. CONCLUSION: Leptomeningeal metastatic disease has a poor prognosis, and treatment regimen may differ from those of parenchymal CNS metastases. CT is normal or misleading in two thirds of patients, and CSF cytology may also be negative. Gadolinium-enhanced T1-weighted MRI complements CSF cytology, and is the investigation of choice in patients with a non-haematological primary tumour and suspected LM.     

Detection of thyroid carcinoma in wall of a cystic lesion by FDG PET

PURPOSE: Three cases are described, in which positron emission tomography (PET) led to the diagnosis of carcinoma in solitary thyroid nodules (STN), which were considered benign by clinical assessment, ultrasonography, and fine needle aspiration cytology (FNAC). MATERIALS AND METHODS: These 3 cases were from a group of 51 patients with solitary thyroid nodules that were nonfunctioning or "cold" on pertechnetate scans that were later studied with FDG PET scanning. RESULTS: Of the entire group, 28 patients showed the nodule to be nonfunctioning on FDG scans. Of these, 3 showed one or more small foci of intense FDG uptake in the periphery. On histopathology, these sites were found to harbor carcinoma, papillary carcinoma in 2 patients and a follicular variant of papillary carcinoma in one. CONCLUSIONS: These cases demonstrate the usefulness of FDG PET in detection of cancer that may lurk in the wall of a cystic thyroid nodule, often misinterpreted as benign by conventional methods.     

Abdomino-pelvic computed tomography in the management of ovarian carcinoma

121 CT scans were obtained in 75 women with ovarian cancer, including 108 scans of the abdomen and pelvis and 13 of the pelvis alone. 70 patients had epithelial carcinoma. In 48 cases, pelvic CT was performed within 3 weeks after surgery, confirming the operative findings in all but 6. In the abdomen, CT identified intrahepatic deposits and minimal ascites not seen at surgery; however, small peritoneal deposits not usually shown by CT were readily found at surgery. CT was superior to clinical examination, detecting unsuspected disease and delineating areas of known disease more accurately. It was also helpful in assessing suitability for repeat laparotomy. In 7 cases, CT demonstrated an operable lesion which had been thought to be inoperable. In 65 cases (59%), CT contributed additional information which was helpful in management, proving it to be an important noninvasive investigation in patients with ovarian carcinoma.     

肺癌的肺动脉供血初步探讨

目的：对肺癌的肺动脉供血进行临床研究。材料和方法：对４３例支气管肺癌进行选择性肺动脉ＤＳＡ，并对其结果进行回顾性分析。结果：肺癌表现为血管结构异常和肿瘤染色。其肿瘤染色范围／肿瘤面积＞５０％者３１例，占７２％，肿瘤染色范围／肿瘤面积＜３０％仅４例，占９％。结论：作者认为：１肺动脉参与肺癌的供血，并且是主要供血动脉之一；２供血情况与肿瘤侵犯肺动脉程度有关；３肺动脉ＤＳＡ对肺癌诊疗很有帮助。     

多层螺旋CT仿真结肠镜诊断直、结肠病变

目的: 研究多层螺旋CT(MSCT)仿真结肠镜诊断结肠病变的临床价值.材料和方法: 应用MSCT对63例患者行一次屏气全结肠容积扫描,包括直结肠癌39例,息肉19例,多憩室2例,慢性结肠炎2例,纤维脂肪瘤1例.除憩室、慢性结肠炎2例外,均经手术和常规结肠镜活检病理证实.用工作站软件获取仿真结肠镜CTVC、多平面重建MPR、表面遮盖显示SSD和透明显示Raysum等图像进行分析比较.结果: MSCTVC能够显示结肠癌的大体分型、大于5.0mm的癌结节和溃疡;有利于显示大于3.0mm的息肉检出,与常规结肠镜比较直结肠癌肿检出率为100%;直结肠息肉检出率为92.3%.MPR能直观反映息肉和癌肿处肠壁及肠周受侵状况,对癌肿肠周受侵判断正确率达100%.结合SSD更有助于对假阳性的鉴别.Raysum在显示癌肿的长度上占优势,判断正确率达100%,结论: MSCTVC、MPR、SSD、Raysum检查结肠占位性病变的临床应用价值各有不同,4种后处理技术的结合,更有助于病变的检出与病变的定位、定性.MSCT仿真结肠镜将为直结肠病变的检查开创新的临床途径.     

DSA在肺癌介入性诊疗中的应用价值：（附80例分析）

为了评价DSA在肺癌介入性诊疗中的应用价值,本文分析了80例肺癌支气管动脉数字减影血管造影、灌注(BAI)、栓塞(BAE)的诊疗资料。认为DSA 的应用,不仅能协助肺癌的分类、分期,而且还能使肺癌的介入治疗更简便,经济,安全。     

Value of x-ray computed tomography in evaluating the spread and therapeutic strategy in cancer of the bladder

Fifty four computed (CT) examinations were performed on patients with bladder carcinoma. A pathological assessment was obtained in 24 cases and the accuracy of CT in local staging was 91%. The accuracy of CT in detecting lymph nodes invasion was also 91%. Moreover, CT is helpful in the follow-up of patients under treatment. As it provides a correct pre-therapeutic evaluation in 83% cases, CT appears as an effective examination to perform in the evaluation of bladder carcinoma.     

CT对喉癌诊断价值的评价

目的：对喉癌的CT诊断做一个恰当的评价。材料和方法：22例喉癌患者均行CT扫描并于扫描后经手术及病理征实．CT扫描间隔及层厚均为4—5mm，扫描时间为2．0sec/层。结果：CT能清晰地显示肿瘤生长的位置，病变范围及浸润深度．其对喉癌侵及范围判断的符合率可达95．4%。结论：CT检查对于喉癌的诊断及对肿瘤侵犯的范围判断有很大的帮助．     

Ultrasound-guided fine needle aspiration cytology of carcinoma involving the intra-abdominal oesophagus.

Ultrasound-guided fine needle aspiration cytology (FNAC) of carcinoma of the intra-abdominal oesophagus was attempted on 21 patients with a 21 G spinal needle using a percutaneous anterior epigastric approach. The results were compared with those of endoscopic biopsy and brush cytology. The ultrasound-guided FNAC had a positive yield in 20/21 (95.2%) compared with 18/21 (85.7%) for endoscopic biopsy and 18/21 (85.7%) for brush cytology (P greater than 0.59). The combination of US-guided FNAC with endoscopic biopsy and the brush cytology achieved a positive yield in 21/21 (100%) whereas combining endoscopic biopsy and brush cytology produced a positive yield of 19/21 (90.5%). Two patients developed temporary epigastric pain. We recommend US-guided FNAC as a safe and effective technique that can be used alone or as an adjunct to endoscopic procedures for the diagnosis of carcinoma of the intra-abdominal oesophagus.     

肾前筋膜增厚的CT表现对鉴别诊断胰腺炎与胰腺癌的价值

目的：评价肾前筋膜增厚的CT表现在鉴别胰腺炎与胰腺癌诊断中的价值。方法：回顾性分析63例临床及CT复查证实为胰腺炎的肾前筋膜增厚征象，并与25例手术病理证实为胰腺癌的CT表现对照。胰腺炎中43例及25例胰腺癌做平扫加增强，20例胰腺炎仅做平扫。结果：胰腺炎组肾前筋膜增厚59例（占93％），其中急性胰腺炎肾前筋膜增厚49例（占98％），慢性胰腺炎肾前筋膜增厚10例（占77％）。胰腺癌25例中，1例肾前筋膜增厚，占4％。结论：肾前筋膜增厚的征象对胰腺炎与胰腺癌的诊断有鉴别意义。     

Transrectal ultrasound-guided biopsy of recurrent cervical carcinoma

The objective of this study was to evaluate the feasibility, safety and diagnostic accuracy of transrectal ultrasound (TRUS)-guided core biopsy for recurrent carcinoma of the uterine cervix in patients with non-diagnostic vaginal cytology and transvaginal punch biopsy.17 patients with clinical and imaging suspicion of recurrent carcinoma of the cervix, and with negative cytology and punch biopsy, were referred for TRUS-guided biopsy of a recurrent mass. Data were collected with respect to demography, previous diagnosis, treatment received, size and location of the recurrent lesion, and biopsy results. Adequate samples were obtained for all patients. TRUS-guided biopsy was technically successful in all of the patients and provided histological diagnosis of recurrence in 16 patients. One of the patients had post-radiation fibrosis. There were no procedure-related complications. In conclusion, TRUS-guided biopsy for recurrent cervical cancer is a feasible, safe and accurate method for establishing a histopathological diagnosis. It should be considered in patients with non-diagnostic vaginal cytology and punch biopsy.