Fine-needle aspiration biopsy of the liver: a multicenter study of 602 radiologically guided FNA.

With improved radiologic techniques fine-needle aspiration (FNA) is becoming a rapid, effective diagnostic method in evaluating a wide range of liver masses. Review of six hundred two radiologically guided liver aspirates performed over a ten-year period forms the basis of this report.

Evaluation of cellular residue in the ThinPrep PreservCyt vial.

The ThinPrep Pap Testtrade mark is a fluid-based method used for the collection and preparation of cervicovaginal samples. The collection device(s) is/are rinsed in Cytyc's ThinPrep PreservCyt medium and a thin-layer slide is prepared using the ThinPrep 2000 automated processor. The purpose of this study was to determine the detection rates for cervical lesions utilizing an additional ThinPrep slide. Fifty-four cervical samples processed by the ThinPrep method were reviewed. An additional thin-layer slide was obtained from the cellular residue for each case utilizing a new filter. Case selection criteria included cases with a few equivocal cells, a few diagnostic cells, or several low-grade dysplastic cells seen on the original ThinPrep slide. The original slides and repeat slides were reviewed by two cytopathologists and two cytopathology fellows. Fifty-four patients were included in the study, mean age 35 years (range: 16-76). The original diagnoses included: 17 negative cases, 22 atypical squamous cells of undetermined significance (ASCUS), 10 low-grade squamous intraepithelial lesions (LGSILs), four high-grade squamous intraepithelial lesions (HGSILs), and one case of atypical glandular cells of undetermined significance (AGUS). On the repeat slides the diagnosis remained the same in 42 (77.8%) cases, diagnostic cells were not present in 10 (18.5%) cases, fungal elements consistent with candida were detected on the repeat smear in one case (1.8%), and higher grade dysplastic cells were found in two cases (3.7%). Our study showed that the ThinPrep method provides a representative, diagnostic sample on the slide. Repeat processing adds little to the overall diagnosis.

Utilization of fine-needle aspiration cytology in the diagnosis of neoplastic superior vena caval syndrome.

Superior vena caval syndrome often presents as an acute or subacute oncologic emergency that requires immediate action, usually with high-dose radiotherapy. With improved chemotherapeutic regimens for various malignancies, prompt and appropriate treatment of the syndrome is possible. Tissue diagnosis, therefore, is pursued, but invasive procedures are commonly associated with technical difficulties and complications. We find fine-needle aspiration biopsy a rapid, highly reliable, and well-tolerated procedure in selected situations and herein report 17 patients with initial presentation of superior vena caval syndrome efficaciously diagnosed with fine-needle aspiration cytology. The cell types were eight lung small-cell carcinomas, four poorly differentiated adenocarcinomas, two undifferentiated large-cell carcinomas, and one each of malignant large-cell lymphoma, myxoid liposarcoma, and thymic large-cell neuroendocrine carcinoma. Further experience, however, is warranted with this widely available procedure.

Role of p53 immunohistochemistry in differentiating reactive gliosis from malignant astrocytic lesions.

P53 immunohistochemistry has been used to distinguish between malignant tumors and morphologically similar benign processes. In the central nervous system, a major diagnostic dilemma is caused by overlapping features of benign reactive astrocytic lesions and low-grade astrocytomas, especially with small biopsies. P53 immunoreactivity in astrocytes could be useful in differentiating benign reactive lesions from malignant astrocytomas. An immunohistochemical study on 110 brain lesions from 108 patients using a monoclonal antibody (DO-7) against p53 protein was conducted. Using the modified Ringertz and World Health Organization system, the specimens included 22 astrocytomas, 12 anaplastic astrocytomas, 42 glioblastoma multiforme tumors, three nonglial tumors, and 56 reactive astrocytic lesions to 25 neoplasms, nine infectious processes, six cerebrovascular disorders,one metabolic disorder, two vascular malformations, eleven degenerative/demyelinating lesions, and two unknown primary lesions. Immunoreactive astrocytic tumors included 12 (54%) astrocytomas, nine (75%) anaplastic astrocytomas, and 38 glioblastoma multiforme tumors (90%). Among the reactive astrocytic lesions, only five (9%) cases of progressive multifocal leukoencephalopathy were immunoreactive. These data demonstrate that p53 immunoreactivity in astrogliosis is unusual but is to be expected in astrocytomas and can help to differentiate reactive from neoplastic astrocytic lesions.