针吸细胞学诊断对乳腺癌防治普查应用的探讨

目的:探讨针吸细胞学诊断对乳腺癌早期诊断、普查防治的应用价值。方法:对2578例乳腺肿瘤将针吸细胞学与病理组织切片对照分析,并结合临床资料,从细胞学角度分析乳腺肿瘤的细胞学特点。结果:2578例乳腺肿块患者FNAC与病理组织学对照,总正确率为98.7%,恶性肿瘤诊断的正确率为96.4%,良性肿瘤诊断的正确率为98.2%,假阴性率为1.1%,潜在假阳性率为1.3%,无一例假阳性。结论:乳腺肿物针吸细胞学诊断是一种患者易于接受、操作简便快速、经济、准确的诊断技术,对乳腺疾病的诊断有较高的应用价值,是乳腺癌防治普查的有效方法。     

Fine needle aspiration cytology in tumoral calcinosis cases ＆ review of literature

Objective:To investigate them by the non-invasive technique of fine needle aspiration cytology(FNAC).Methods: In this study cases were described in which FNAC was indicative of tumoral calcinosis.Total numbers of cases studied were 18.Male to female ratio was 1∶8.11 cases(61.11%) were less than 20 years of age.3 cases had history of trauma in the past(16.67%).8 cases had lesions located in the hip region(44.44%).Results:The size of lesion varied from 2.5 to 4 cm.In none of the case diagnosis of tumoral calcinosis was considered clinically.All other investigations were normal and no significant family or medical history was present.Cytology in all cases showed only abundant acellular calcium.The patients on follow up were clinically well with no changes.Conclusion:The cases are interesting,since the cytohistological findings in the aspirate sample are strongly indicative of tumoral calcinosis.     

乳腺肿块细针吸取细胞学与术中冰冻切片诊断比较

目的：分析乳腺肿块细针吸取细胞学(FNAC)与术中冰冻切片诊断(IFSD)的不同特征，探索两者的临床应用价值。方法：对乳腺肿块205例分别进行FNAC和IFSD检查。结果：乳腺良性病变FNAC和IFSD的准确率分别为96．4％和98．6％，乳腺恶性肿瘤FNAC和IFSD的准确率分别为91．0％和97．0％。FNAC假阴性率为2．4％，无假阳性诊断；IFSD未出现假阴性和假阳性诊断。结论：乳腺肿块FNAC和IFSD检查是两种实用、可靠的诊断方法。     

Study of salivary gland lesions with fine needle aspiration cytology and histopothology along with immunohistochemistry

Salivary gland swelling is a common and important problem. Acute and chronic sialadenitis, different benign and malignant neoplasms are the common causes which present with salivary gland swelling. Imaging technique is not so helpful in pre-operative diagnosis; microscopical examination is required for diagnosis. Pre-operative core needle biopsy is hazardous and may damage facial nerve, lead to fistula formation or associated with tumour seeding. Fine needle aspiration cytology (FNAC) is however virtually risk-free. The study was done to assess the utility of FNAC and its accuracy and pitfalls with respect to histopathology and advantages of immunohistochemistry. The study was done with 40 cases of salivary gland swelling. After clinical examination, FNAC and histopathological examination along with immunohistochemistry was done and the results were correlated. Out of 40 cases, 25 involved the parotid gland, most common age group affected was 20 - 40 years and male: female ratio was 5: 3. Out of 40 cases 37 cases were cytologically and histopathologically correlated and rest 3 cases were different. Among these 3 cases, 2 were adenoid cystic carcinoma which was cytologically diagnosed as benign neoplasm (monomorphic adenoma). One case of Warthin's tumour was cytologically diagnosed as pleomorphic adenoma. The sensitivity of this study was found to be 71.43%, specificity 100% and accuracy was 93.10%. This study corroborates well with other studies including immunohistochemical findings. p53 expression was found to be related with nature of the neoplasm. FNAC is an important tool for early diagnosis of salivary gland lesions.     

Ultrasound guided fine needle aspiration cytology for diagnosis of mass lesions of liver

The therapeutic and prognostic evaluation of malignant neoplasia of liver depends mostly on morphologic diagnosis. Ultrasound guided fine needle aspiration cytology (FNAC) of liver has been proved to be a rapid, reliable and cost-effective method for cytological diagnosis of hepatic mass lesions. This study was undertaken to find out the frequency of different benign and malignant space occupying lesions (SOL) of liver from patients attending for FNAC in Mymensingh. Ultrasound guided FNAC was performed on 108 patients with hepatic mass lesions from September 2, 2001 to August 19, 2003. There were 67 (62.0%) males and 41 (37.96%) females with a mean age 53 year (SD +/- 14) ranging from 2 to 83 years. Samples were adequate in 101 (93.5%) and inadequate in 7 (6.5%). Out of 101 adequate samples only one was benign (liver abscess) and 100 were malignant. Of the malignant lesions hepatoblastoma was in 1 (1%), hepatocellular carcinomas in 8 (8%), metastatic adenocarcinomas in 73 (73%) and unclassified malignancies were in 18 (18%). Most of the hepatocellular carcinomas occurred in males (7 in 8). The frequency of metastatic adenocarcinoma was more in males (39 vs. 34) but the difference is not significant (p > 0.05). Ultrasound guided FNAC of liver is a rapid, reliable and cost-effective diagnostic method. It can be practice in any centres where ultrasound facility and specialist pathologists are available.     

Evaluation of fine needle aspiration and imprint cytology in the early diagnosis of breast lesions with histopathological correlation

Fifty-one breast lumps were studied by fine needle aspiration cytology (FNAC) and scrape imprint cytology. Of the 51 cases, 28 were malignant and included infiltrating duct carcinoma (22), well differentiated adenocarcinoma (2), mucinous, papillary and lobular carcinoma (one each) and malignant lymphoma (one). Benign lesions were mastitis, fibroadenoma and fibrocystic disease. The diagnostic accuracy of FNAC was 90.2% and that of imprint 94.1% with no false negatives. Two imprint smears and one aspirate designated suspicious were proved to be benign. The combination of FNAC and imprint cytodiagnosis gave a diagnostic accuracy of 96% thus proving their value in the rapid diagnosis of breast lesions.     

CT导向穿刺活检在骨骼病变诊断中的价值

目的探讨CT导引活检在骨骼病变的临床应用价值.方法对52例骨骼病变行CT导引下活检,每例常规取材2～3次.29例病灶区或灶周硬化明显者应用了Ackermann骨钻针,17例骨质破坏明显者应用了核心切割针,6例囊性或有明显液化区的病灶则细抽吸针.结果活检的诊断准确率90.4%(47/52).5例假阴性者包括2例增生硬化性病灶,3例液化性.结论 CT导引下骨骼活检是诊断骨病变重要手段,是一种安全、准确而有效的方法,对临床治疗决策具有重要的指导价值.     

365例淋巴结病变细针吸取细胞学检查诊断分析

目的总结我院开展细针吸取细胞学检查(FNAC)经验,探讨淋巴结病变FNAC的诊断价值.方法 3 223例FNAC检查涉及淋巴结病变的有1 208例,其中365例有组织学对照.结果细胞学诊断恶性病变的敏感性为88.2%,良性病变的特异性为91.2%,总符合率为89.7%.结论 FNAC 是实用性高的病理细胞学检查,特别是对于淋巴结病变的诊断有较高的实用价值.淋巴结病变的复杂多变,宜采用"三位一体"的操作程序,强调结合临床病史、X线片、CT等检查是提高诊断准确率的保证.     

TRANSTHORACIC FINE NEEDLE ASPIRATION CYTOLOGY IN DIAGNOSING NON-RESOLVING PNEUMONIAS – A STUDY OF 170 CASES

Role of transthoracic fine needle aspiration cytology (FNAC) in diagnosing 170 patients of non-resolving pneumonias was studied. There were 117 males and 35 females in the age range of 3 to 72 years. The neoplastic lesions diagnosed by FNAC included 51 primary lung cancers, 6 metastatic deposits, 1 malignant mesothelioma of pleura, 1 Hodgkin''s disease and 4 thymomas. Benign lesions included 56 pneumonias and abscesses of bacterial and chemical origin, 35 pulmonary tuberculosis, 2 fungal granulomas and 1 sarcoid granuloma. Aspiration cytology was inconclusive in 13 cases. The sensitivity of FNAC was 95.5 per cent in diagnosing malignant lesions accurately while the accuracy of cytological characterization was 95.3 per cent There were no false positive reports. FNAC also helped in diagnosing sputum-negative pulmonary tuberculosis. Minor complications like syncopal attacks and haemoptysis of less than 5 mL occurred in 8.2 per cent of patient.KEY WORDS: Biopsy, Cytodiagnosis, Thoracic neoplasms, Pneumonia     

经皮胸穿活检的临床应用及并发症探讨

目的探讨在CT引导下应用半自动同轴活检枪对胸部占位性病变经皮穿刺活检的临床可行性及安全性。方法56例胸部占位性病变的患者,采用半自动同轴活检枪在CT引导下行经皮穿刺活检术并送病理检查,统计穿刺活检的成功率及病理检查结果;术后行CT扫描,统计穿刺活检的并发症及穿刺活检的安全性。结果半自动同轴活检枪穿刺活检的成功率为92.9%(52/56);病理检查结果:穿刺成功的52例患者中,腺癌18例、鳞癌10例、小细胞癌9例、淋巴瘤2例、胸腺瘤2例、转移癌8例、真菌感染1例、肉芽肿性炎2例;穿刺活检的并发症:合并出血和或咯血的发生率32%(18/56)、气胸发生率19.6%(11/56)、死亡率1.8%(1/56);未发生穿刺点感染、针道种植转移等其他并发症。结论半自动同轴活检枪在CT引导下对胸部占位性病变经皮穿刺活检术是一种创伤小、相对安全、确诊率高的诊断方法,可在胸部占位性疾病临床诊断中广泛推广应用。     

CT引导经皮细针穿刺活检诊断胸腹部占位性病变23例

应用ＣＴ导向经皮穿刺活检胸腹部占位性病灶,明确病变性质,提高像诊断率,为临床治疗治疗提供准确论据。方法：采用ＧＥ９８００Ｑｕｉｃｋ及ＳｏｍａｔｏｎＡＲＣＣＴ扫描机对２３例胸腹部占位性病灶进行扫描定位,用１８Ｇ－２２Ｇ的抽吸及组织型活检针对病灶刺取材涂片并做组织切片病理检查。     

利用18G细针行颈椎及上胸椎椎体成形术

目的探讨利用18G穿刺针行颈椎及上胸椎椎体成形术的操作方法、临床疗效、及并发症。方法2003～2008年对9例颈椎及上胸椎转移性病变（12个椎体）行经皮椎体成形术.其中C5、C6、T3、T4、椎体各2个,C4、C7、T5、T7椎体各1个。在DSA机透视或和CT机联合监视下于局麻下将18G穿刺针经皮穿刺进入靶椎体,颈椎病变采用前外侧入路,上胸椎病变采用椎弓旁入路,在进行椎体静脉造影后注入聚甲基丙烯酸甲酯（PMMA）1～3.5ml。治疗后行CT检查了解椎体破坏及PMMA在椎体中弥散情况,对患者进行随访以观察临床疗效和并发症。结果所有病例术后PMMA填充病灶良好,术后一周左右患者疼痛症状均有不同程度减轻,未发生穿刺道出血及PMMA外溢所导致的并发症。结论利用18G细针穿刺行颈椎及上胸椎椎体成形术简单可行,创伤小,安全,并发症少,并且可取得满意的治疗效果。     

回形针体表定位CT导引下经皮肺穿刺活检的临床体会

目的介绍CT导引下使用回形针体表定位经皮肺穿刺活检的临床经验。方法回顾性分析采用回形针体表定位CT导引下经皮肺穿刺活检病人的临床资料，其中男26例，女12例，采用18～22G抽吸针，抽吸组织均做细胞学和组织学检查。结果38例均穿刺成功，穿刺成功率为100％，穿刺阳性诊断率为92％。结论回形针体表定位CT导引下经皮肺穿刺活检安全、准确、易行，在肺疾病的诊断和鉴别诊断方面起着重要的作用，值得推广应用。     

Diagnosis of breast lump by fine needle aspiration cytology and mammography

Breast carcinoma is the most common malignant tumour and the leading cause of death from cancer in women. A large number of patients in Bangladesh have been suffering from breast cancer. Now-a-days, Fine needle aspiration cytology (FNAC) is being performed as a pre-operative test to evaluate breast lump. FNAC is cost effective and can prevent unnecessary surgery. As FNAC became more reliable in diagnosing malignancy and thereby the use of frozen-section histology had been reduced by about 80%. But erroneous diagnosis is more common with FNAC than with histopathology. However, mammography can identify breast cancers too small to palpate on physical examination and theoretically beneficial to diagnose even noninvasive lesions. Present study aimed to see the accuracy of FNAC and mammography in the diagnosis of palpable breast lumps and to study their correlation. In this study 222 patients were included in the study and FNAC was done in all the patients. Mammography was done in 112 cases. Among these 112 patients 32 cases were found malignant. Histopathology was done in total 89 cases. Among 112 patients who were underwent mammography only 43 were found for histopathology. Finally, 36 cases were found malignant. Fibroadenoma is mostly found in below 20 years group and malignancy is mostly occurring in older age group. Mammography shows total 8 false positive and 5 false negative cases. FNAC shows only 1 false positive and 1 false negative case. On analysis mammography showed 82.76% sensitivity, 90.36% specificity, 75% Positive predictive value (PPV), 93.75% Negative predictive value (NPV) and 88.39% accuracy. FNAC showed 97.22% sensitivity, 99.46% specificity, 97.220% PPV, 99.46% NPV and 99.095% accuracy. Mammography was found to be less sensitive, specific and accurate in the diagnosis of breast lump though there is highly significant correlation among them. However, the study has shown a much higher performance of FNAC than other previous studies indicating the improved skill in cytological diagnosis to a satisfactory level.     

Role of fine needle aspiration cytology in the diagnosis of pulmonary lesions

Fine needle aspiration cytology (FNAC) is a rapid, reliable and cost-effective method in the diagnosis of lung lesions. Cells are collected from the lesions usually under fluoroscopic or CT-guidance for cytological examination. Due to lack of these highly sophisticated radiologic imaging techniques in our institute we performed this test under X-Ray film guidance. This study was carried out in 59 patients, who underwent FNAC of lung lesions in the department of Pathology, Mymensingh Medical College, Bangladesh to find out the specimen adequacy and frequency of both benign and malignant lesions of the lungs in our areas. Out of 59 cases 54 were males and 5 were females with age ranged from 20 to 82 years. Adequate samples were obtained in 50 (84.75%) cases of which 35 (70%) were malignant, 10 (20%) were benign and 5 (10%) were suspicious for malignancy. Malignant lesions comprised of squamous cell carcinoma in 20 (57.14%), adenocarcinoma in 1(2.86%), large cell carcinoma in 8 (22.86%) and small cell carcinoma in 6 (17.14%) cases. All the benign lesions were inflammatory in nature, which included abscess in 6 (60%), tuberculosis in 3 (30%) and chronic non-specific inflammation in 1 (10%) case. Majority of the malignant lung lesions were encountered in the 6th decade of life. As the method is simple, rapid, cost-effective and without major complications, so it can be practiced in any centres in our country where specialised radiologists and pathologists are available.     

CT透视下16G套管针穿刺活检纵隔及纵隔旁病灶

目的 探讨CT透视下同轴套管针穿刺纵隔及纵隔旁病灶的活检技术和临床应用价值.方法 CT图像结合激光定位灯确定穿刺点,取16G同轴套管针穿刺、18G自动活检枪摄取组织,同时作细胞学和组织学检查,部分加作免疫组化检查.全部病例的诊断经手术、病理或临床随访而得到证实.结果本组56例病灶,其中纵隔29例、纵隔旁27例,病灶最大径为12～40mm.穿刺到位率为100%.55例穿刺活检得到的组织细胞学报告与手术后病理或临床诊治结论相符合,1例无法作出明确的组织细胞学诊断,诊断准确率为98.2%.发生气胸4例,占7.1%（4/56）,其中1例作微创性胸腔闭式引流;少量咯血7例,占12.5%（7/56）;未发生血胸、感染、针道肿瘤种植等情况.结论采用16G粗针在CT透视下行纵隔及纵隔旁病灶穿刺活检是安全准确、经济实用的临床诊断方法.     

细针吸取细胞学检查在临床病理诊断中的应用

目的 探讨细针吸取细胞学检查在体表以及经体表可触及肿物的诊断价值.方法 对158例行细针吸取细胞学检查患者的结果与组织学诊断结果进行对照.结果 68例恶性肿瘤的敏感性为(63/68)92.6%,90例良性病变的特异性为(85/90)94.4%,148例获得正确诊断,10例病变虽未明确诊断,但均未因诊断意见不一致造成过度...     

淋巴结结核的针吸细胞学诊断价值探讨

目的:探讨针吸细胞学诊断淋巴结结核的的价值和鉴别诊断。方法:常规细胞学穿刺后进行细胞学阅片,观察细胞学特点。结果:淋巴结细胞学镜下以干酪型和增殖型为主,类上皮样细胞、干酪样坏死物及郎罕氏巨细胞为淋巴结结核中常见的诊断成分。结论:针吸细胞学可以快速、简便的诊断淋巴结结核,对于结核病变非典型细胞学改变可辅助其他检查协助诊断。     

经皮超声引导下肺外周型占位性病变穿刺活检60例

目的:探讨经皮超声引导下肺外周型占位性病变穿刺活检的临床应用价值。方法:对60例经X线及CT等影像学检查并为超声能显示的肺占位性病变的患者,进行超声引导下穿刺及病理组织检查确诊。结果:良性18例,恶性42例,经与手术切除后病理结果对照,组织病理学符合者53例(89.8%),有4例假阴性(6.84%),3例为坏死组织,未获得明确病理诊断结果。60例中,用18G活检针37例,能获得明确组织病理学结果30例,6例因标本破碎量少而影响诊断;用21G活检针23例,19例获得了明确病理诊断结果。发生并发症5例(8.3%),其中气胸2例,轻度咯血或痰中带血3例。结论:经皮穿刺肺活检诊断阳性率达80%～90%。适用于经体检、胸部X线片、痰检及纤维支气管镜等检查仍未能明确诊断的肺部外周型病灶。     

细针穿刺细胞学在颈部肿块中的诊断价值

目的:探讨细针穿刺细胞学(FNAC)对颈部肿块的诊断价值。方法:回顾性分析我院2010年2月-2011年2月186例颈部非甲状腺肿块患者的临床资料,比较细针穿刺涂片细胞学诊断与病理组织学结果的符合情况。结果:186例颈部肿块中,FNAC诊断与组织学诊断相符的病例为175例,符合率为94.1%。结论:细针穿刺细胞学检查是一种简便、易行、快速、安全、准确率较高的颈部肿块病理诊断检查方法,值得临床推广使用。