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1.
Cytopathology ; 27(2): 115-21, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25810099

RESUMO

OBJECTIVE: In our Pathology Department, fine needle aspiration (FNA) of palpable thyroid nodules is performed by cytopathologists who ensure correct sample management and rapid on-site evaluation (ROSE). Conversely, ultrasound (US)-guided FNAs have traditionally been carried out by endocrinologists and radiologists in outside clinics, where the presence of a cytopathologist is not always feasible. To overcome this limitation, cytopathologists have started to perform US-guided FNAs themselves. This study retrospectively evaluates 1 year of this novel practice. METHODS: A total of 2225 US-guided FNAs were performed in our clinic by cytopathologists, whereas 1490 aspirates were taken by a group of non-cytopathologists. Among these, 756 FNAs were taken by a single experienced endocrinologist. The distribution of the Bethesda classification categories was evaluated in each of these groups. RESULTS: FNAs performed by cytopathologists were more often diagnostic and better prepared than those taken by non-cytopathologists, including those taken by the experienced endocrinologist (P < 0.01). The latter operator yielded a higher rate of suspicious and malignant FNAs, reflecting a more appropriate clinical triage of worrisome nodules. CONCLUSION: Although the endocrinologist's evaluation is crucial to select clinically relevant thyroid nodules, cytopathologists can reliably perform US guidance in addition to their traditional expertise in sampling, specimen preparation and ROSE.


Assuntos
Citodiagnóstico , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Médicos , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Manejo de Espécimes , Neoplasias da Glândula Tireoide/patologia
3.
Pathol Res Pract ; 211(9): 702-5, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26187370

RESUMO

Hepatic epithelioid hemangioendothelioma is a rare vascular neoplasm with an unpredictable malignant potential. Different therapeutic options are available, depending on the basis of disease extension and the patient's overall condition. A correct pathological diagnosis is necessary and is often based on scant material. Here, we report a case diagnosed on fine needle aspiration and on a small surgical biopsy. In addition, we will review the literature. The patient is a 54-year-old woman who presented with persistent pain in the right hypochondrium and suffered from weight loss. Ultrasound examination and CT scan showed several focal and confluent hepatic lesions. Thus, an ultrasound-guided fine-needle aspiration (US-FNA) was performed. A cytological diagnosis of vascular proliferation with epithelioid component was performed. Afterwards, a hepatic "small biopsy" (SB) was made. Histological and immunohistochemical data were consistent with a hepatic epithelioid hemangioendothelioma diagnosis. The patient, however, is in good general condition and is waiting for a hepatic transplantation; repeated total CT scan showed no signs of metastasis. The literature was reviewed in order to define the pathological features that were helpful in the cytological and histological diagnosis of hepatic epithelioid hemangioendothelioma, and to better understand if pathological data is prognostically useful.


Assuntos
Hemangioendotelioma Epitelioide/patologia , Neoplasias Hepáticas/patologia , Biomarcadores Tumorais/análise , Biópsia , Erros de Diagnóstico , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Feminino , Hemangioendotelioma Epitelioide/química , Hemangioendotelioma Epitelioide/cirurgia , Humanos , Imuno-Histoquímica , Neoplasias Hepáticas/química , Neoplasias Hepáticas/cirurgia , Transplante de Fígado , Pessoa de Meia-Idade , Tomografia por Emissão de Pósitrons , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X , Listas de Espera
4.
Cytopathology ; 21(5): 300-10, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20132132

RESUMO

OBJECTIVE: To evaluate the diagnostic efficiency of fine needle aspiration cytology/flow cytometry (FNAC/FC) in the diagnosis and classification of non-Hodgkin lymphoma (NHL) in a series of 446 cases and to compare the results with those of previous experiences to evaluate whether there had been an improvement in FNAC/FC diagnostic accuracy. METHODS: FNAC/FC was used to analyse 446 cases of benign reactive hyperplasia (BRH), NHL and NHL relapse (rNHL) in 362 lymph nodes and 84 extranodal lesions. When a diagnosis of NHL was reached, a classification was attempted combining FC data and cytological features. Sensitivity, specificity and positive and negative predictive values (PPV and NPV) of FNAC/FC in the diagnosis and classification of NHL were calculated and compared with those available in the literature. RESULTS: FNAC/FC provided a diagnosis of NHL and rNHL in 245 cases and of BRH in 188 cases. In nine cases, the diagnosis was 'suggestive of NHL' (sNHL) and in four cases was inadequate. Histology and clinical follow-up confirmed 102 cases of NHL and detected one false positive. In 18 cases of BRH diagnosed by FNAC/FC, histological examination revealed 14 BRH and four NHL (false negatives). All nine cases diagnosed as sNHL were confirmed by histology. Including sNHL cases as false negatives, statistical analysis showed 94.9% sensitivity, 99.4% specificity, 99.6% PPV and 93.4% NPV in the diagnosis of NHL. A specific subtype was diagnosed in 125 cases and confirmed in 67 of 70 cases that had histological biopsies. Statistical analysis did not demonstrate significant improvements between the present series and previous studies either in diagnosis or in classification of NHL. CONCLUSIONS: FNAC/FC is a fundamental tool in the diagnosis and classification of NHL but the exiguity of diagnostic material and other technical and clinical limitations will probably continue to limit further improvement of the technique.


Assuntos
Citometria de Fluxo/métodos , Imunofenotipagem/métodos , Linfoma não Hodgkin/patologia , Biópsia por Agulha Fina/métodos , Citodiagnóstico , Erros de Diagnóstico/prevenção & controle , Feminino , Humanos , Linfonodos/patologia , Linfoma não Hodgkin/classificação , Linfoma não Hodgkin/imunologia , Masculino , Valor Preditivo dos Testes , Reprodutibilidade dos Testes
5.
J Clin Pathol ; 58(11): 1170-4, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16254106

RESUMO

AIMS: Tumour angiogenesis is essential for carcinogenesis and facilitates the process of tumour development and metastasis. Vascular endothelial growth factor (VEGF) is a well characterised angiogenetic factor and is known to play a crucial role in new vessel development. To gain further insight into the effects of microvessel density and VEGF expression in colon cancer, their relation with tumour proliferation, ploidy status, and p53 expression was investigated in colon cancer. METHODS: Tissue samples of 50 archived colon cancers were analysed by immunohistochemistry for VEGF, p53, and the endothelial cell marker, von Willebrand factor (VWF), using specific antibodies. The same samples were re-cut for flow cytometric studies to obtain S phase fraction (SPF) and ploidy status. RESULTS: A positive significant correlation was found between SPF and angiogenesis. The median microvessel count in high SPF tumours was significantly higher than in low SPF ones. No association was found between VEGF expression and SPF. A positive correlation was found between ploidy status and p53 expression and microvessel count. Furthermore, a positive correlation was established between DNA ploidy, VEGF expression, and microvessel count. CONCLUSION: This study provides evidence that in colon cancer, tumour growth may be stimulated by vascular supply, and the lack of a correlation between tumour cell proliferation and VEGF expression indicates that these two parameters may be regulated by separate mechanisms. Furthermore, the positive correlation between microvessel density, VEGF expression, and ploidy status provides more evidence that genetic alterations are involved in tumour angiogenesis.


Assuntos
Neoplasias do Colo/patologia , Neovascularização Patológica/patologia , Ploidias , Adulto , Idoso , Idoso de 80 Anos ou mais , Proliferação de Células , Neoplasias do Colo/irrigação sanguínea , Neoplasias do Colo/genética , DNA de Neoplasias/genética , Feminino , Citometria de Fluxo , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas de Neoplasias/metabolismo , Neovascularização Patológica/genética , Neovascularização Patológica/metabolismo , Fase S , Proteína Supressora de Tumor p53/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Fator de von Willebrand/metabolismo
6.
Histopathology ; 46(5): 561-8, 2005 May.
Artigo em Inglês | MEDLINE | ID: mdl-15842638

RESUMO

AIMS: There is considerable evidence that links COX-2 to the development of cancer. The aim of our study was to assess, by immunohistochemistry, COX-2 expression in ductal carcinoma in situ (DCIS) and its possible correlation with HER-2/neu, vascular endothelial growth factor (VEGF) expression and other common immunohistochemical parameters (p53, ER, PGR, Ki67). METHODS AND RESULTS: Tissue samples of 49 archival cases of DCIS without any invasive component were analysed for COX-2, HER-2/neu, VEGF, oestrogen and progesterone receptors, Ki67 and p53 by immunohistochemistry using specific antibodies. COX-2 expression was detected in 43 (87.8%) tissue samples, of which 12 (24.5%) were graded as weak, 22 (44.9%) as moderate and nine (8.4%) as high expression. Only six (12.2%) lesions were negative for COX-2 expression. VEGF expression was detected in 93.8% of samples; 66.7% of lesions were found to be positive for HER-2/neu expression. Furthermore, COX-2 expression was significantly correlated with VEGF expression (P = 0.003). A significant positive correlation was also observed between COX-2 and HER-2/neu expression (P < 0.0001). CONCLUSIONS: Our results suggest that COX-2 is highly expressed in DCIS and takes part in the molecular pathway implicated in progression of breast cancer and may provide a rationale for targeting COX-2 in preinvasive breast cancer therapy.


Assuntos
Neoplasias da Mama/patologia , Carcinoma in Situ/patologia , Carcinoma Ductal de Mama/patologia , Prostaglandina-Endoperóxido Sintases/biossíntese , Adulto , Idoso , Biomarcadores Tumorais/análise , Neoplasias da Mama/metabolismo , Carcinoma in Situ/metabolismo , Carcinoma Ductal de Mama/metabolismo , Ciclo-Oxigenase 2 , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/análise , Proteínas de Membrana , Pessoa de Meia-Idade , Prognóstico , Receptor ErbB-2/análise , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Estatística como Assunto , Proteína Supressora de Tumor p53/análise , Fator A de Crescimento do Endotélio Vascular/análise
7.
Cancer Lett ; 208(2): 227-34, 2004 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-15142682

RESUMO

This study was designed to elucidate the possible relationship between tumour related genes and angiogenesis in colon cancer. The protein expression of p53, bcl-2, Von Willebrand factor and vascular endothelial growth factor (VEGF) were analysed by immunohistochemistry in 57 paraffin-embedded colon cancer. The results showed that microvessel density (MVD) was lower in VEGF negative tumours than in VEGF positive ones (P<0.0001). MVD and VEGF in p53 negative tumours were significantly lower than in p53 positive tumours (respectively, P=0.003 and P<0.0001). Moreover, positive correlations were recorded between VEGF expression and MVD, and bcl-2 expression (respectively, P<0.0001 and P=0.009). Our data confirm the central role of VEGF in angiogenesis and suggest direct correlations among p53, bcl-2 and VEGF expression in colon cancer.


Assuntos
Neoplasias do Colo/química , Neovascularização Patológica/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/análise , Proteína Supressora de Tumor p53/análise , Fator A de Crescimento do Endotélio Vascular/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/irrigação sanguínea , Neoplasias do Colo/patologia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias
8.
Pathologica ; 96(5): 430-2, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15688979

RESUMO

BACKGROUND: Inflammatory myofibroblastic tumor (IMT) of the lung is a rare condition that may mimic cancer. CASE: We describe a case of inflammatory myofibroblastic tumor discovered by a routine chest X-ray in a 26-year-old male patient, primarily diagnosed by fine needle aspiration biopsy. The clinical, cytopathological and differential diagnostic findings of this rare entity are briefly discussed. CONCLUSION: IMT may be diagnosed accurately on needle cytology samples, provided that other pseudoneoplastic and neoplastic entities can be excluded from its differential diagnosis.


Assuntos
Biópsia por Agulha Fina , Granuloma de Células Plasmáticas Pulmonar/patologia , Adulto , Diagnóstico Diferencial , Humanos , Achados Incidentais , Neoplasias Pulmonares/diagnóstico , Masculino , Granuloma de Células Plasmáticas Pulmonar/diagnóstico , Granuloma de Células Plasmáticas Pulmonar/cirurgia , Toracotomia
9.
Anal Quant Cytol Histol ; 23(3): 178-84, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11444186

RESUMO

OBJECTIVE: To assess the possible contribution by a multiparametric quantitative approach to the cytologic diagnosis of oxyphilic cell (OC) thyroid lesions. STUDY DESIGN: Ten cases of chronic lymphocytic (Hashimoto) thyroiditis and 10 nodular goiters containing oxyphilic cells plus 20 cases of tumors subsequently classified as oxyphilic cell adenomas (10 cases) or oxyphilic cell well-differentiated carcinomas (10 cases) were evaluated. The study was performed on May-Grünwald-Giemsa-stained smears for planimetric measurements. The same smears were destained and Feulgen restained for densitometric measurements. The latter were performed using static cytometry equipment measuring 100 and 20-30 lymphocytes per case for the determination of integrated optical density (IOD). The following parameters were considered: nuclear area, perimeter, maximum diameter, form ELL, form PE, IOD, 5c exceeding rate (5cER) and visual classification of histograms as euploid, polyploid and aneuploid. RESULTS: Mean nuclear area of carcinomas was smaller than that of adenomas, goiter and thyroiditis. Nuclear area was larger in adenomas than in other benign lesions and carcinomas. All the other planimetric parameters were similar in the lesions examined. Four carcinomas and three adenomas were aneuploid, and all the rest were euploid. All the cases of thyroiditis and goiter were euploid or polyploid; four thyroiditis cases showed polyploid histograms and 5cER values > 1. CONCLUSION: Morphometric and densitometric procedures have a limited role in the discrimination of OC lesions, but small nuclear area values may be useful in distinguishing OC carcinoma from other lesions. The role of densitometry seems even more limited because aneuploid histograms may be found among adenomas and carcinomas. Further studies are needed to explain polyploidy and 5cER > 1 in Hashimoto thyroiditis.


Assuntos
Bócio Nodular/patologia , Células Oxífilas/patologia , Tireoidite Autoimune/patologia , Biópsia por Agulha , DNA de Neoplasias/análise , Densitometria , Diagnóstico Diferencial , Bócio Nodular/genética , Humanos , Ploidias , Tireoidite Autoimune/genética
10.
Diagn Cytopathol ; 25(2): 86-93, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11477710

RESUMO

Between January 1, 1992 and December 31, 1997, a cytopathological diagnosis of follicular variant of papillary thyroid carcinoma (FVPC) was made on a series of 16 out of 18 patients with palpable nodules who underwent fine-needle aspiration biopsy (FNAB) in our Department. The results of aspiration biopsy were followed by histopathological examination of the surgically excised tissues. There were three false-negative aspirations (16.6%), of which two were probably bound to fine-needle sampling and one due to a mixture of benign and malignant cells which had originally gone unrecognized. The accuracy of the cytopathologic diagnosis in this variant was 88.8%. An analysis of the diagnostic cytopathological criteria was performed, which demonstrated the importance of both architectural features (monolayered and branching sheets, microacinar structures, and their combinations) and nuclear features (presence of nuclear grooves). Background -bound features were mainly represented by dense, nonfilamentous colloid. The cytopathologic findings in FVPC were compared to those found in a series of 10 usual papillary carcinomas (UPC) and 10 follicular neoplasms (FN). These latter had originally been diagnosed by FNAB and were subsequently classified histologically as follicular adenoma (n = 6), follicular carcinoma (n = 3), or adenomatoid colloid nodule (n = 1). Statistical evaluation was performed on the cytopathological findings in the three classes of lesions (FVPC, UPC, and FN) as to their presence and relative frequency or absence by using a nonparametric one-way ANOVA (Kruskall-Wallis) and, where necessary, a Mann-Whitney U test. Papillary cellular fragments and multinucleated giant cells (P < 0.005), nonfilamentous dense colloid, squamoid cells, and syncytia were significantly more represented in UPC than in FVPC (P < 0.05), while histiocytes were significantly more frequent in FVPC (P < 0.005). Other nuclear and/or background features were significant only in the distinction between papillary carcinomas as a group and FN. The cytological differential diagnosis of the FVPC is briefly discussed with relevance to the possible pitfalls caused by its peculiar cyto- and histomorphology.


Assuntos
Carcinoma Papilar/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Idoso , Biópsia por Agulha , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Am J Clin Pathol ; 115(6): 805-13, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11392875

RESUMO

Basal cell carcinomas (BCCs) may be subdivided into primary with a favorable biologic course (BCC1) and recurrent and/or metastatic (BCC2). No clear association between primary tumor location, histologic subtype, or other clinicopathologic variables and predisposition for BCC2 has been found. Histopathologic criteria are limited for prognostication. To identify prognostic factors useful for planning therapy, we studied cyclin D1 immunohistochemical expression, DNA ploidy, and epiluminescence light microscopic (ELM) patterns in 60 cases of BCC (30 BCC1 and 30 BCC2) in the head and neck region, half of which were hyperpigmented. Cyclin D1 was absent in 27 cases, expressed at low level in 4 cases, and overexpressed in 30 cases. Seven BCCs were euploid, 28 exhibited a mixed cellular population, and 25 were aneuploid. Among aneuploid tumors, hypodiploidy was found in 12. Among the 30 pigmented carcinomas, only 15 showed a typical ELM pattern. No association between pigmentation and more aggressive biologic behavior of BCC was found. These results and follow-up data seem to indicate that an unfavorable outcome can be predicted by hyperexpression of cyclin D1, aneuploidy, and an atypical ELM pattern for pigmented cases. A definite hypodiploid peak was associated with worse prognosis. The analysis of cyclin D1 expression and DNA ploidy may help identify BCC with an aggressive phenotype and a poor clinical outcome.


Assuntos
Carcinoma Basocelular/diagnóstico , Ciclina D1/metabolismo , DNA de Neoplasias/genética , Neoplasias de Cabeça e Pescoço/diagnóstico , Ploidias , Neoplasias Cutâneas/diagnóstico , Carcinoma Basocelular/genética , Carcinoma Basocelular/metabolismo , Ciclina D1/imunologia , Seguimentos , Neoplasias de Cabeça e Pescoço/genética , Neoplasias de Cabeça e Pescoço/metabolismo , Humanos , Imuno-Histoquímica , Medições Luminescentes , Microscopia/métodos , Prognóstico , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/metabolismo , Pigmentação da Pele
13.
Diagn Cytopathol ; 23(2): 77-81, 2000 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10888749

RESUMO

Recent studies on paraffin-embedded tissue have shown that the cyclin-dependent kinase inhibitor p27(Kip1) is expressed in normal thyroid cells, whereas it is downregulated in neoplastic cells. This prospective study was undertaken to assess whether p27(Kip1) staining may also be applied to fine-needle aspiration biopsy (FNAB) samples of the thyroid. We present here our preliminary results on 100 FNABs examined for p27(Kip1) expression. p27(Kip1) expression was assessed by immunocytochemistry; the technique was optimized on smears prepared from a normal thyreocyte cell line (TL5), which conspicuously expresses p27(Kip1), and then applied to FNAB samples prospectively collected from 80 cases of nodular goiter and 20 cases of thyroid neoplasms (10 papillary carcinomas and 10 follicular neoplasms). The TL5 cell culture smears showed that methanol fixation, followed by heat-induced antigen retrieval, is the most suitable technique for p27(Kip1) staining on cytological samples. The FNAB smears similarly treated showed high p27(Kip1) expression (75%) in goiter and a significantly lower expression (35%) in neoplasms (P < 0.0001). Our preliminary results show that: 1) p27(Kip1) protein expression can be reliably assessed on cytological samples; and 2) p27(Kip1) stains nonneoplastic and neoplastic samples in a different fashion, and thus is a useful tool in thyroid cytology.


Assuntos
Proteínas de Ciclo Celular , Inibidores Enzimáticos/metabolismo , Proteínas Associadas aos Microtúbulos/metabolismo , Glândula Tireoide/metabolismo , Proteínas Supressoras de Tumor , Adenocarcinoma Folicular/diagnóstico , Adenocarcinoma Folicular/metabolismo , Biópsia por Agulha , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/metabolismo , Linhagem Celular , Inibidor de Quinase Dependente de Ciclina p27 , Técnica Indireta de Fluorescência para Anticorpo , Bócio Nodular/diagnóstico , Bócio Nodular/metabolismo , Humanos , Estudos Prospectivos , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/metabolismo
14.
J Clin Pathol ; 52(12): 880-7, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10711250

RESUMO

AIM: To investigate whether there is loss of the p27Kip1 protein in developing cervical cancer and whether p27Kip1 immunoreactivity has any relation to the proliferative indicator Ki-67. METHODS: The expression of p27Kip1 and Ki-67 was assessed by immunohistochemistry in serial sections from normal epithelium (13), low grade (27) and high grade (19) squamous intraepithelial lesions (LSIL, HSIL), and invasive cervical cancer (23). In the SIL cases the presence of human papillomavirus (HPV) genomic sequences was assessed by in situ hybridisation. The results were evaluated by image analysis, and reported as mean score of the percentage of p27Kip1 and of Ki-67 positive cells in each histological group. RESULTS: In general, p27Kip1 immunostaining was related to squamous differentation, and was intense in normal epithelium (47%), while it was reduced in SIL lesions as an effect of the decreased number of differentiating cells. However, decrease in the p27Kip1 expression was more evident in LSIL (36%) than in HSIL (39%); in the latter, p27Kip1 had a different intraepithelial distribution in that the staining extended to the basal cells. The average levels of p27Kip1 were similar in SIL lesions associated to low, intermediate, and high risk HPV types. Compared with normal epithelium and dysplasia, invasive cancer showed significantly lower p27Kip1 levels (23%). There was no relation between p27Kip1 and Ki-67 labelling indices in any of the histological groups examined. CONCLUSIONS: A reduction in p27Kip1 protein occurs in cervical cancer independently of the proliferative status. The changes in p27Kip1 expression may be related to the unregulated kinetics of developing cervical cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Proteínas de Ciclo Celular , Quinases Ciclina-Dependentes/antagonistas & inibidores , Antígeno Ki-67/metabolismo , Proteínas Associadas aos Microtúbulos/metabolismo , Proteínas Supressoras de Tumor , Displasia do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/metabolismo , Colo do Útero/metabolismo , Inibidor de Quinase Dependente de Ciclina p27 , Células Epiteliais/metabolismo , Feminino , Humanos
15.
Diagn Cytopathol ; 19(5): 323-9, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9812223

RESUMO

DNA ploidy was evaluated by image cytometry in a series of 84 hepatocellular carcinomas diagnosed by fine-needle aspiration biopsy. In the series were included eight cases originally diagnosed as suspect and reclassified as well-differentiated hepatocarcinoma. The study was retrospectively performed on Papanicolaou-destained, Feulgen-restained smears. The 5c exceeding rate and the visual interpretation of the corresponding histograms were evaluated and compared with size of the tumors, serum alpha-fetoprotein values, hepatic functional staging, and patient survival. Sixty-eight cases were aneuploid and 16 euploid (9 diploid and 7 polyploid). Four of the eight cytologically suspect cases were aneuploid. Statistical analysis showed an association between size and cytologic grading, 5c exceeding rate and cytologic grading, and between aneuploidy and multiple tumors; in a Cox multivariate DNA content analysis, aneuploidy and multiple tumors were the two prognostically significant variables. DNA ploidy evaluation by static cytometry of hepatic tumors may be useful in the diagnosis on cytologic samples and could represent an independent prognostic parameter in predicting the survival outcome of patients with hepatocellular carcinoma.


Assuntos
Carcinoma Hepatocelular/genética , DNA de Neoplasias/análise , Neoplasias Hepáticas/genética , Ploidias , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Carcinoma Hepatocelular/mortalidade , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Citometria por Imagem , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , alfa-Fetoproteínas/análise
16.
J Oral Maxillofac Surg ; 55(10): 1094-7, 1997 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9331232

RESUMO

PURPOSE: Fine-needle aspiration biopsy (FNAB) is frequently used in the diagnosis of lesions occurring in the head and neck region. This study evaluated the correlation between the findings on FNAB and the histological findings observed after surgery. MATERIALS AND METHODS: A review of 218 patients who underwent FNAB of a head or neck tumor was performed. Cytological reports were classified into the following diagnostic categories: negative or positive for malignant cells and unsatisfactory. False-positive, false-negative, true-positive (sensitivity), and true-negative (specificity) rates were calculated. RESULTS: Twelve specimens did not allow an adequate diagnosis (5.5%). Among benign tumors, 96.2% of the cases were correctly diagnosed, and 3.8% were nondiagnostic specimens. Among malignant tumors, 86.4% of cases were correctly identified. There were two (3.4%) false-negatives and six (10.2%) nondiagnostic specimens, with a total false-negative rate of 13.6%. CONCLUSIONS: Sampling errors present a minor problem with FNAB. Most nondiagnostic or incorrect specimens were caused by nonhomogenous lesions, with poor placement of the needle and an insufficient amount of aspirated material. FNAB is a useful modality for the diagnosis of head and neck masses.


Assuntos
Biópsia por Agulha/estatística & dados numéricos , Neoplasias de Cabeça e Pescoço/patologia , Adenolinfoma/patologia , Adenoma Pleomorfo/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Cistos/patologia , Citodiagnóstico , Técnicas de Diagnóstico por Cirurgia , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/patologia , Sensibilidade e Especificidade , Sialadenite/patologia , Neoplasias Cutâneas/patologia
17.
Radiol Med ; 93(6): 726-31, 1997 Jun.
Artigo em Italiano | MEDLINE | ID: mdl-9411521

RESUMO

We investigated the role of CT in guiding fine-needle biopsy (FNB) in small (< 2 cm phi) lung lesions, reviewing 2109 CT-guided biopsies of peripheral lung nodules performed 1983 to 1993. "Peripheral" refers to non intrabronchial lesions, independent of the nodule position in the chest. Two hundred lesions < 2 cm phi were selected, 52 of them with complete clinical and surgical follow-up. This group was compared with 195 lung lesions > 2 cm phi for CT-guided FNB sensitivity, specificity and diagnostic accuracy. Cytologic specimens were positive for malignancy in 40/52 cases (76.9%) and negative in 12 (23.1%). Clinical-surgical follow-up confirmed all the positive cytologic findings (40 cases), while 2 of the extant 12 cases were false negatives (95.20% sensitivity, 100% specificity and 96.15% diagnostic accuracy). 158 of 195 nodules > 2 cm phi and with clinical-surgical follow-up (81.3%) were positive for malignancy and 34 were negative (17.43%) (98.75% sensitivity, 97.14% specificity and 98.46% diagnostic accuracy). Pneumothorax occurred in 33 patients (16.5%) with nodules < 2 cm phi as a complication of biopsy. Hemoptysis occurred in 15 patients (7.5%). In the whole group of lung lesions, the complications were pneumothorax in 80 patients (4.1%), hemoptysis in 199 (10.4%) and hypotensive vagal crises in 92 patients (4.8%). We conclude that CT is the best guidance for FNB also in small lung nodules, providing high sensitivity and specificity and low complication rates. Finally, the result of this procedure depends on the operator's skills.


Assuntos
Biópsia por Agulha/métodos , Pneumopatias/patologia , Neoplasias Pulmonares/patologia , Humanos , Pneumopatias/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
18.
Radiology ; 202(3): 870-3, 1997 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-9051049

RESUMO

The technical feasibility and safety of a suprasternal approach in the computed tomography (CT)-guided biopsy of lesions in the middle mediastinum was studied in 30 patients. Patients were positioned on their back with their head hyperextended. Biopsies were performed with local anesthesia and 22-gauge needles. Adequate biopsy material for diagnosis was obtained in 25 (83%) of 30 patients. A single biopsy specimen was sufficient in 14 patients, but as many as three biopsy specimens were necessary in 16 patients. Nineteen (63%) patients had various histotypes of lung cancer. In 24 (89%) of 27 adequate specimens, findings at fine-needle aspiration biopsy were consistent with findings at pathologic examination. No major complications were observed. CT-guided biopsy of middle mediastinum lesions was safe and successful with a suprasternal approach.


Assuntos
Biópsia por Agulha/métodos , Neoplasias do Mediastino/diagnóstico , Radiografia Intervencionista , Tomografia Computadorizada por Raios X , Adulto , Idoso , Feminino , Humanos , Pulmão/patologia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico por imagem , Linfonodos/patologia , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Pessoa de Meia-Idade
19.
Cytopathology ; 8(6): 366-72, 1997 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-9439888

RESUMO

FNA biopsy of 51 orbital masses is critically reviewed. Aspiration was performed with a 23 G needle inserted by an ophthalmologist; the smears were prepared by a cytologist. Forty-two cases (83%) were correctly diagnosed as benign or malignant either with (68%) or without (15%) correct specification of the histology. There were two false-negative and seven inadequate cases. Immunocytochemical stains were performed in five cases using the following antibodies: L26 (Pan B), UCHL1 (Pan T), kappa and lambda immunoglobulin light chains (three cases) in order to distinguish inflammatory pseudotumours from low-grade non-Hodgkin's lymphomas. In two cases we used CAM 5.2 (a monoclonal cytokeratin cocktail) and vimentin to ascertain the epithelial origin of two metastatic tumours. In five other cases cytospins were not adequately cellular for immunocytochemistry. Insufficient material and one false-negative sample were obtained from very fibrotic lesions or from posteriorly located lesions. The results are discussed and compared with other series reported in the literature. Orbital FNA biopsy may be considered a useful tool in the diagnostic approach to orbital masses in which the relatively high number of inadequate aspirations is offset by a low cost-benefit ratio.


Assuntos
Biópsia por Agulha , Citodiagnóstico , Oftalmopatias/patologia , Adenocarcinoma/secundário , Antígenos de Diferenciação de Linfócitos B/análise , Antígenos de Diferenciação de Linfócitos T/análise , Carcinoma de Células Escamosas/patologia , Neoplasias Oculares/patologia , Granuloma de Células Plasmáticas/patologia , Histocitoquímica , Humanos , Hiperplasia/imunologia , Hiperplasia/patologia , Cadeias kappa de Imunoglobulina/análise , Cadeias lambda de Imunoglobulina/análise , Imuno-Histoquímica , Tecido Linfoide/imunologia , Tecido Linfoide/patologia , Linfoma não Hodgkin/patologia , Sensibilidade e Especificidade
20.
Diagn Cytopathol ; 15(5): 442-6, 1996 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8989552

RESUMO

A case of osteomyelitis caused by Paracoccidioides brasiliensis primarily diagnosed by means of fine-needle aspiration biopsy is reported here in a 60-yr-old Italian patient who had lived in Venezuela for 40 yr. The cytologic and electron microscopic features of the exudate aspirated from a left femoral osteolytic area are described, and the differential diagnosis of this mycotic infection is discussed briefly.


Assuntos
Osteomielite/patologia , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/patologia , Biópsia por Agulha , Blastomicose/patologia , Diagnóstico Diferencial , Histocitoquímica , Humanos , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Osteomielite/microbiologia
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