Liver and splenic sarcoidosis: Diagnostic procedures

Introduction Clinical studies indicate involvement of the liver and spleen in approximately 20-30% of patients affected with sarcoidosis and their detection should be based on a standardized diagnostic procedure. Diagnostic procedures Ultrasonography is a reliable and safe method to assess changes related to size and structure of the affected organs that are pathognomonic for sarcoidosis. Further evaluation may include computerized tomography or magnetic resonance, while percutaneous needle aspiration biopsy or laparoscopy may also be applied when indicated. The most important criterion used for final diagnosis is pathohistological evidence of epithelioid noncaseating granuloma in bioptic material along with already established sarcoidosis of the lungs or some other organ. Material and methods The study on the incidence of liver and spleen sarcoidosis included a group of 130 patients affected with sarcoidosis hospitalized at the Institute of Pulmonary Diseases and Tuberculosis, Clinical Center of Serbia, over the period 2002-2003. Results The analysis evidenced that 31.5% of sarcoidosis patients had pathognomonic echographic findings of abdominal organs: splenomegaly (13%), hepatomegaly (10.8%) and hepatosplenomegaly (7.7%). Three patients underwent surgical treatment of liver and spleen sarcoidosis. Conclusion Pathognomonic findings of liver and spleen sarcoidosis were evidenced in approximately one third of sarcoidosis cases and they represented a significant parameter for further therapy, particularly in chronic patients.

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Assessment of Lesions Detected at Mammographic Screening: Performance at First or Repeat Screening in the Florence Programme

Journal of Medical Screening ◽

10.1177/096914139400100311 ◽

1994 ◽

Vol 1 (3) ◽

pp. 188-192 ◽

Cited By ~ 11

Author(s):

Stefano Ciatto ◽

Marco Rosselli Del Turco ◽

Daniela Giorgi ◽

Doralba Morrone ◽

Sandra Catarzi ◽

...

Keyword(s):

Diagnostic Procedures ◽

Final Diagnosis ◽

Needle Aspiration ◽

Mammographic Screening ◽

Surgical Biopsy ◽

Predictive Values ◽

Screening Performance ◽

The Cost ◽

Benign Biopsy ◽

Biopsy Rate

To evaluate the assessment criteria and the results achieved in the detection of breast lesions at mammographic screening. Review of cases assessed in the last screening round of Florence city (FC.- first screening round: 29 522 subjects) and Florence district (FD — repeat screening round: 13 268 subjects) programmes. Methods – Referral and biopsy rates, predictive values, and prevalence of cancers detected by screening were determined, as well as the frequency of the diagnostic procedures used at assessment, and their contribution to the final diagnosis according to the mammographic appearance of the suspected lesion. Assessment costs were estimated. Referral rate (FC 4.2%; FD 1.8%), referral positive predictive value (FC 18.7%; FD 28.3%), surgical biopsy rate (FC 0.96%; FD 0.6%), benign/malignant biopsy ratio (FC 0.20; FD 0.13), and prevalence of cancers detected by screening (FC 0.78%; FD 0.5%) were all within the European Community (EC) recommended standards for screening performance. The benign biopsy rate was considerably lower than that of recommended standards. The cost for each subject assessed was 179 000 Italian lire at the first and 116 000 lire at repeat screening. The cost for each subject screened that was attributable to assessment was 7600 lire at the first or 2100 lire at repeat screening. Limited referral rates and costs were achieved and the proportion of cancers detected by screening was high. The number of referrals was further reduced at repeat screening, and assessment had a limited impact on total screening costs. Detail or magnification mammography, palpation, sonography, and fine needle aspiration cytology all contributed to the final diagnosis and should be immediately available at the assessment clinic. The observed benign biopsy rate was particularly low and suggests that EC recommended standards should be modified.

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Fine needle biopsy of abdominal organs in dogs – indications, contraindications and performance technique

Polish Journal of Veterinary Sciences ◽

10.2478/pjvs-2013-0118 ◽

2013 ◽

Vol 16 (4) ◽

pp. 835-842 ◽

Cited By ~ 4

Author(s):

K. Glińska-Suchocka ◽

M. Jankowski ◽

K. Kubiak ◽

J. Spużak ◽

S. Dzimira ◽

...

Keyword(s):

Fine Needle Aspiration Biopsy ◽

Final Diagnosis ◽

Fine Needle Biopsy ◽

Needle Aspiration ◽

Fine Needle ◽

Performance Technique ◽

Abdominal Organs ◽

Golden Standard ◽

And Performance

Abstract Recent years have seen in both human and veterinary medicine the development of numerous techniques allowing for evaluation and classification of changes in individual organs and tissues. Despite introduction of such techniques into diagnostics as among others, CT, MRI, CEUS or elastography, biopsy is still considered a “golden standard” and it is a procedure performed in order to obtain a final diagnosis. There are many biopsy techniques, such as fine needle aspiration biopsy, core biopsy as well as methods of performing a procedure, e.g. blind biopsy, biopsy under USG control and biopsy during laparotomy. In the article usefulness of biopsy techniques in relation to diagnostics of individual abdominal organ, as well as the procedure technique, contraindication and complications are discussed.

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Fine-needle aspiration cytology in Hodgkin’s lymphoma

Vojnosanitetski pregled ◽

10.2298/vsp0503195n ◽

2005 ◽

Vol 62 (3) ◽

pp. 195-200

Author(s):

Ruzica Nedeljkov-Jancic ◽

Biljana Mihaljevic ◽

Andrija Bogdanovic ◽

Milan Petrovic

Keyword(s):

Lymph Node ◽

Fine Needle Aspiration ◽

Plasma Cells ◽

Final Diagnosis ◽

Needle Aspiration ◽

Fine Needle ◽

Tissue Sections ◽

Clinical Center ◽

Precise Diagnosis ◽

Needle Aspiration Cytology

Background. Cell composition of tumor tissue in Hodgkin?s lymphoma is considered to be specific. According to some authors, precise cytomorphological analysis of the specimen obtained by fine needle enables the diagnosis of the histologically well-defined form of lymphoma in a high percentage of cases. However, other authors consider the precise diagnosis of HL based on cytological analysis of a lymph node puncture specimen extremely difficult. The aim of this study was to a assess the diagnostic accuracy of cytomorphological analysis, as well as the possibility of application of this method in establishing the preliminary or even final diagnosis of this form of lymphoma. Methods. Thirty four samples were analyzed, obtained by fine needle aspiration, in patients examined and treated at the Institute of Hematology, Clinical center of Serbia, Belgrade. Smears were stained by May-Gr?nvald-Giemsa and Papanicolau methods. Results. The finding of typical multinucleate Reed-Sternberg cells in the smears of lymph node puncture specimen was diagnostically significant, as well as the finding of mononuclear variances of the neoplastic cells of anunusual morphology (Hodgkin?s cells). The cell environment in the background of the above-mentioned tumor cells was heterogeneous. It was composed of small lymphocytes, plasma cells, eosinophils and reticular cells. These cell forms, found in cell preparations, resembled those seen in the tissue sections of the relevant extirpated lymph nodes. The comparison of the cytological findings in the fine needle specimen to the subsequently established histological diagnoses of HL revealed a high correlation of 85.2%. Conclusion. Cytological examination of fine needle lymph node specimens is still significant for the diagnosis of HL in spite of the development of more sophisticated methods used for verification of the diagnosis of this neoplasm.

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The ability of isolated fine needle aspiration of lymph nodes to provide complete diagnostic information without necessitating additional diagnostic procedures: A retrospective cohort study.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e18341 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e18341-e18341

Author(s):

Nathan Tidwell ◽

Taylor Leslie Barnett ◽

Connor H Thrun ◽

Brendan C Graham ◽

Lindsey Jean Graham

Keyword(s):

Lymph Nodes ◽

Fine Needle Aspiration ◽

Diagnostic Procedure ◽

Diagnostic Delay ◽

Diagnostic Procedures ◽

Needle Aspiration ◽

Fine Needle ◽

History Of ◽

Clinical Records ◽

Second Procedure

e18341 Background: Diagnostic fine needle aspiration (FNA) of pathologically enlarged lymph nodes is a relatively safe, quick, and well-tolerated procedure that can be quickly analyzed to identify the presence of malignant cells. Though proven very useful to assess for the presence or absence of malignancy for staging purposes, the procedure’s ability to provide adequate tissue to appropriately diagnose a new malignancy and perform all necessary predictive and prognostic studies has not been explored. Methods: We retrospectively reviewed clinical records of patients who underwent FNA of a pathologically enlarged lymph node for the purpose of obtaining a tissue diagnosis at our institution between January 2010 and December 2015. We then assessed the percentage of patients that required a second diagnostic procedure independent of the FNA result. Procedures done for therapeutic purposes (such as resection) were not counted as a second procedure. We also collected data on the type of procedure used to obtain FNA, patient history of malignancy, and whether the diagnosis was benign or malignant. Results: We identified 594 FNA procedures that fit the study criteria. Of these, 277 (46.6%) required an additional diagnostic procedure. Among the 277 that required a second procedure, 237 (85.6%) were benign and 40 (14.4%) were malignant on primary FNA (P < 0.0001). Of the 237 benign FNAs that required a second procedure, 84 (35.5%) had the diagnosis changed to malignant after the second procedure (P < 0.001). There was no difference between procedure used to obtain the FNA (bronchoscopy, endoscopy, percutaneous) or patient age in the need for a second procedure. Conclusions: Though fine needle aspiration is a useful procedure for establishing the presence or absence of metastatic disease, our analysis suggests that the ability of the procedure to reliably diagnose or provide sufficient tissue for ancillary testing is limited. Nearly half of the patients in this study were subjected to the risks, cost, and diagnostic delay associated with a second procedure.

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Rapid assessment of fine needle aspiration and the final diagnosis--how often and why the diagnoses are changed

CytoJournal ◽

10.1186/1742-6413-3-25 ◽

2006 ◽

Vol 3 ◽

pp. 25 ◽

Cited By ~ 18

Author(s):

Carolyn Woon ◽

Ricardo H Bardales ◽

Michael W Stanley ◽

Edward B Stelow

Keyword(s):

Fine Needle Aspiration ◽

Diagnostic Yield ◽

Rapid Assessment ◽

Diagnostic Procedures ◽

Final Diagnosis ◽

Needle Aspiration ◽

Additional Material ◽

Fine Needle ◽

Inter Observer Variability ◽

Ancillary Studies

Background: On-site rapid interpretation (RI) of fine needle aspiration (FNA) has been shown to increase the diagnostic yield of FNA and decrease the need for repeat diagnostic procedures. Because the pathologist interprets only a fraction of the sample and has limited resources available at such times, an occasional RI diagnosis will be changed at the time of the final diagnosis. We investigated how often these changes in diagnoses occur and the possible reasons for the changes. Methods: All cytology reports from 1/1/02 to 12/31/03 from a single institution were reviewed. Cases with RI with discrepant final diagnoses were noted. The discrepant diagnoses were categorized depending on how they were changed. Possible sources for changed diagnoses were noted. Results: Between 1/1/02 and 12/31/03 there were 1368 RIs of FNAs. Of these 80 (5.8%) had discrepancies between the RIs and final diagnoses. Seventy-eight cases had additional slides and/or cell block at time of final diagnosis. 16 cases had ancillary studies available at final diagnosis. Consultant pathologists were used in 7 cases. Different pathologists interpreted the RI and final diagnosis in 31 cases. Conclusion: Although uncommon, discrepancies between RIs and final diagnoses occur 5.8% of the time at our institution. Most commonly, this involves a change of diagnosis from either non-diagnostic or benign to malignancy. Although much of this is likely due to the presence of additional material and information at the time of final diagnosis, the number of cases that had different pathologists involved in the RI and final diagnosis suggests that inter-observer variability may also play some role.

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F.N.A.C. AS DIAGNOSTIC TOOL OF PAROTID TUMORS AND ASSOCIATED PITFALLS IN CORRELATION WITH HISTOPATHOLOGY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i1.1153 ◽

2020 ◽

Vol 4 (1) ◽

Author(s):

Bhawana Pant ◽

Sanjay Gaur ◽

Prabhat Pant

Keyword(s):

Preoperative Diagnosis ◽

Histopathological Examination ◽

Clinical Information ◽

Final Diagnosis ◽

Needle Aspiration ◽

Histopathological Diagnosis ◽

Cytological Diagnosis ◽

Tertiary Referral Centre ◽

Clear Cut ◽

Parotid Tumors

F.NA.C has been used for ages as a safe and economical tool for fast preoperative diagnosis of parotid tumors. It has certain pitfall which sometimes leads to misdiagnosis and consequently it may have affect on treatment of the tumors. Keeping in view of the diverse classification of parotid tumors’ information from cytology should be combined with radiology as well as clinical diagnosis. Aim: To discuss some cases where there was discrepancy between cytological diagnosis and histopathological result and also suggest measures to improve the efficacy of F.N.A.C. Material and methods: The study includes 50 cases of parotid tumours who presented to the department of ENT at Government medical college Haldwani which is a tertiary referral centre during 2009 to 2016. Only adult patients were included and inflammatory swelling were excluded from the study. All patients evaluated Contrast enhanced computerized tomography(CECT) and Magnetic resonance imaging (MRI) followed by Fine needle aspiration cytology .Preoperative diagnosis was made upon the findings of the above investigations and different types of parotid surgeries were done. . Final diagnosis was made on histopathological examination. Result :The most common tumour came out to be pleomorphic adenoma (23 cases-46%) followed by mucoepidermoid carcinoma(12cases-24%). In ten cases there was no clear cut association between cytological diagnosis and final histopathological diagnosis. Conclusion: FNAC is highly sensitive and specific technique for diagnosis of many salivary gland swellings. FNAC can be used preoperatively to avoid unnecessary surgery and biopsy. Details of clinical information and radiologic features may help the pathologist to arrive at the appropriate diagnosis and reduce false interpretation. Pitfalls may also occur with improper technique of FNAC which can be overcome by proper caution.

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Increse of newly - detected in situ cancers in non-palpable breast lesions

Acta chirurgica iugoslavica ◽

10.2298/aci0601073m ◽

2006 ◽

Vol 53 (1) ◽

pp. 73-75

Author(s):

N. Miletic ◽

D. Stojiljkovic ◽

M. Inic ◽

M. Prekajski ◽

A. Celebic ◽

...

Keyword(s):

Breast Tissue ◽

Malignant Disease ◽

Clinical Stage ◽

Diagnostic Procedures ◽

Basal Membrane ◽

Needle Aspiration ◽

Screening Mammography ◽

Significant Difference ◽

Malignant Lesions

Great importance in detecting cancer in the phase of in situ lays in the fact that the epithelial layer is deprived of blood and lymph vessels, so metastases may develop only when basal membrane has been broken. This paper includes 46 operated women in whom it preoperatively had been verified suspect non-palpable lesion. The preoperative diagnostics included use of high- resolution mammography, aimed mammography, palpatory examination, as well as fine-needle aspiration (FNA), biopsy and cytologic analysis of the sample. The methodology of this work implies the use of stereotaxic marking, specimen mammography and ex-tempore pathohistology analysis. Out of 46 investigated patients in clinical stage T0N0M0, in whom there were no signs of malignant disease, and according to suspect lesion of initial screening mammography, malignant lesions of breast tissue were diagnosed in 19 patients (41%) intraoperatively. Three of these lesions (15,8%) were histopathologically verified as in situ. Comparing our results with data of the Institute of oncology and radiology of Serbia hospital registry (IORS) for the year 2001, from 1173 patients registered with malignant lesions, only 16 ones (1,4%) had in situ cancer, operated on the basis of the suspect mammography of clinical stage T0N0M0. Statistically significant difference was found related to the number of detected cancers in this early phase of the breast malignant disease. This limits surgical intervention to tumorectomy, with preservation of the remaining breast tissue, what brings to healing, justifying in that way, screening examinations and routine application of the most contemporary diagnostic procedures.

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Space reconstruction of the aneurysms of the vertebrobasilary confluence based on conventional angiography: Our experience

Acta chirurgica iugoslavica ◽

10.2298/aci0802075n ◽

2008 ◽

Vol 55 (2) ◽

pp. 75-78

Author(s):

I.M. Nikolic ◽

M.Lj. Rakic ◽

E.E. Slavik ◽

G.M. Tasic ◽

B.M. Djurovic ◽

...

Keyword(s):

Blood Vessels ◽

Diagnostic Procedures ◽

Conventional Angiography ◽

Two Dimensional Image ◽

Diagnostic Protocol ◽

Clinical Center ◽

Golden Standard ◽

Preoperative Diagnostic ◽

Third Dimension ◽

Initial Results

Besides current development of the new diagnostic procedures conventional angiography still represents the golden standard in the diagnosing of intracranial aneurysms. Since it gives a two-dimensional image if the presentation of the third dimension is wanted it is necessary to apply appropriate algorithm structures and computers. In this study we show our experience in the application of space reconstruction of blood vessels and aneurysms of the vertebrobasilary confluence in 6 patients operated at the Institute for Neurosurgery, Clinical Center of Serbia. Intraoperative finding in all patients matched the finding that we got by space reconstruction of the blood vessels, which was possible to observe from different angles. Postoperative course in all patients was satisfying. Upon discharge the patients were without rough lateralization of the pyramidal system. Our initial results and their practical agreement with the interoperative finding give us right to recommend this method as the standard for the preoperative diagnostic protocol.

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The Utility of Rapid On-Site Evaluation during Bronchoscopic Biopsy: A 2-Year Respiratory Endoscopy Central Experience

BioMed Research International ◽

10.1155/2019/5049248 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Hansheng Wang ◽

Na Wei ◽

Yijun Tang ◽

Yunyun Wang ◽

Guoshi Luo ◽

...

Keyword(s):

Lung Cancer ◽

International Association ◽

Final Diagnosis ◽

Needle Aspiration ◽

European Respiratory Society ◽

Macroscopic Appearance ◽

Visible Lesion ◽

Bronchoscopic Biopsy ◽

Site Evaluation

Background. Rapid on-site evaluation (ROSE) is commonly used to evaluate the adequacy of biopsy materials in fine-needle aspiration; however, the diagnostic performance of ROSE during fiber optic bronchoscopy (FOB) biopsy under direct vision is rarely reported. Here, we evaluated the role of ROSE during FOB biopsy of visible lesion in trachea or bronchi. Methods. The role of ROSE was prospectively evaluated in consecutive bronchoscopy specimens obtained between January 2016 and January 2018. The agreement and accuracy between ROSE and final histopathological interpretation were assessed. The frequency and possible reasons for discrepancy between ROSE and definitive histopathology results were identified. Histological and cytological classification was performed according to the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society (IASLC/ATS/ERS) criteria of lung ADCs classification. Results. The study enrolled 651 patients, of which 33 were excluded because of insufficient cells. Final diagnosis of malignancy was achieved in 462 cases (74.8%), whereas 156 cases (25.2%) were nonmalignant. ROSE and pathology were well correlated for the diagnosis of squamous cell carcinoma (SCC) (Kappa = 0.718, p<0.05), adenocarcinoma (AdC) (Kappa = 0.662; p<0.05) and small cell lung cancer (SCLC) (Kappa = 0.955; p<0.05). In 24 cases diagnosed as malignant by ROSE and nonmalignant by pathology, the lesion tissues were surgically excised and re-analyzed, and the 24 cases were finally confirmed as malignant by pathology. Conclusions. ROSE technique allows bronchoscopists to obtain viable and adequate material for the diagnosis of histopathology, and provides them with an onsite preliminary diagnosis especially in cases with inconclusive macroscopic appearance. ROSE and pathology should be used in combination to increase the accuracy of diagnosis.

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Cost Effectiveness of Transbronchial Needle Aspiration

Canadian Respiratory Journal ◽

10.1155/1999/508741 ◽

1999 ◽

Vol 6 (4) ◽

pp. 332-335 ◽

Cited By ~ 14

Author(s):

Jennifer A Crocket ◽

Eric YL Wong ◽

Dale C Lien ◽

Khanh Gia Nguyen ◽

Michelle R Chaput ◽

...

Keyword(s):

Cost Effectiveness ◽

Cost Effective ◽

Diagnostic Procedures ◽

Needle Aspiration ◽

Benign Disease ◽

University Hospital ◽

High Yield ◽

Transbronchial Needle Aspiration ◽

Computed Tomographic ◽

The Cost

OBJECTIVE: To evaluate the yield and cost effectiveness of transbronchial needle aspiration (TBNA) in the assessment of mediastinal and/or hilar lymphadenopathy.DESIGN: Retrospective study.SETTING: A university hospital.POPULATION STUDIED: Ninety-six patients referred for bronchoscopy with computed tomographic evidence of significant mediastinal or hilar adenopathy.RESULTS: Ninety-nine patient records were reviewed. Three patients had two separate bronchoscopy procedures. TBNA was positive in 42 patients (44%) and negative in 54 patients. Of the 42 patients with a positive aspirate, 40 had malignant cytology and two had cells consistent with benign disease. The positive TBNA result altered management in 22 of 40 patients with malignant disease and one of two patients with benign disease, thereby avoiding further diagnostic procedures. The cost of these subsequent procedures was estimated at $27,335. No complications related to TBNA were documented.CONCLUSIONS: TBNA is a high-yield, safe and cost effective procedure for the diagnosis and staging of bronchogenic cancer.

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