Fine needle aspiration biopsy

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Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

Fine-needle aspiration biopsy (FNAB) is considered the standard irst- line method of evaluating thyroid nodules, due to its high accuracy and low invasiveness [1-3]. This method has significantly reduced the operation rate for benign nodules. Unfortunately, unsatisfactory or nondiagnostic results present a dilemma for clinicians and radiologists managing thyroid nodules, particularly nodules with high nondiagnostic rates in repeat biopsies or high malignancy rates. The Bethesda System for Reporting Thyroid Cytopathology [4] recommends nondiagnostic rates of ideally less than 10% of all FNABs; however, up to 21% of nodules have nondiagnostic results in initial FNAB and up to 50%-63% in repeat biopsies [5-9]. The recommended risk of malignancy of nondiagnostic nodules in the Bethesda system is 1%-4%; however, malignancy rates ranging from 2% to 51% have been reported [3,7,10-13].
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Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)

Malignancy rates for Bethesda III subcategories in thyroid fine needle aspiration biopsy (FNAB)

OBJECTIVES: Most thyroid diseases are nodular and have been investigated using ultrasound-guided fine needle aspiration biopsy (FNAB), the reports of which are standardized by the Bethesda System. Bethesda category III represents a heterogeneous group in terms of lesion characteristics and the malignancy rates reported in the literature. The objective of the present study was to evaluate the differences in the malignancy rates among Bethesda III subcategories.

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Fine-Needle Aspiration Biopsy as a Preoperative Procedure in Patients with Malignancy in Solitary and Multiple Thyroid Nodules.

Fine-Needle Aspiration Biopsy as a Preoperative Procedure in Patients with Malignancy in Solitary and Multiple Thyroid Nodules.

Interesting observations have been reported by Ravetto et al. [20], who suggested that the probability of malignancy in a thyroid nodule is significantly reduced after a "negative" (no cancer suspicion) FNAB result. This group has confirmed that the risk of malignancy in such cases ranges from 0.4% to 4%. Ravetto preferred to follow these patients every 2 years and to perform a repeat fine-needle aspiration biopsy after 4–5 years. The indolent course of thyroid cancer in some cases justifies a long interval between clinical follow-up examinations, as noted by Mazzaferri et al. [21]. Based on the available literature concerning this issue, the thyroid nodules most often qualifying for FNAB are those with 131 J uptake of less than or equal to that of the normal surrounding tissues and other surrounding nodules. Thus, all cold and warm (indeterminate) nodules are biopsied one or more times [20]. In Ravetto et al.’s study, autonomous nodules were biopsied in 2.29% of the patients, although we agree with the opin- ion of some authors concerning the disqualification of hot (autonomous) nodules for FNAB. These nodules are very exceptionally malignant, and they need careful monitoring [20].
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Scleral necrosis in patients with posterior uveal melanomas evaluated by transcleral fine needle aspiration biopsy and treated by

Scleral necrosis in patients with posterior uveal melanomas evaluated by transcleral fine needle aspiration biopsy and treated by

cal SNEC is unknown, it is possible that focal radiation cumulatively increases the local inflammation caused by the plaque implantation and fine needle aspiration biopsy (FNAB) procedures. Given that many centers are adopting FNAB as a means of obtaining clinically rele- vant information about tumor diagnosis and prognosis prior to treatment, and the transcleral fine needle aspi- ration biopsy (tsFNAB) approach seems to be preferred over the transvitreal route because it minimizes the risks of retinal detachment and vitreous hemorrhage, the au- thors felt the importance of analyzing the impact of such procedures on the outcome of these patients.
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Patterns of Lymph Node Pathology; Fine Needle Aspiration Biopsy as an Evaluation Tool for Lymphadenopathy: A Retrospective Descriptive Study Conducted at the Largest Hospital in Africa.

Patterns of Lymph Node Pathology; Fine Needle Aspiration Biopsy as an Evaluation Tool for Lymphadenopathy: A Retrospective Descriptive Study Conducted at the Largest Hospital in Africa.

mycobacterial infection), 8% comprised HIV reactive nodes; in the remainder no specific pa- thology was identified (nonspecific reactive lymphoid hyperplasia). Kaposi sarcoma (KS) accounted for 2.5% of lymph node pathology in this sample. Concomitant lymph node pa- thology was diagnosed in four cases of nodal KS (29% of the subset). The co-existing pa- thologies were TB and Castleman disease. HIV positive patients constituted 49% of this study sample and the majority (64%) of this subset had CD4 counts less than 350 cells/ul. 27% were HIV negative and in the remaining nodes, the HIV status of patients was un- known. The most common lymph node pathologies in HIV positive patients were Mycobac- terial infection (31%), HIV reactive nodes (15%), non-Hodgkin lymphoma (15%) and nonspecific reactive lymphoid hyperplasia (15%). Only 8.7% were of Hodgkin lymphoma. In contrast, the most common lymph node pathologies in HIV negative patients were nonspe- cific reactive lymphoid hyperplasia (45%), carcinoma (25%) and Mycobacterial infection (11%). In this group, non-Hodgkin lymphoma and Hodgkin lymphoma constituted 9% and 8%, respectively. There were more cases of high-grade non-Hodgkin lymphoma in the HIV positive group compared to the HIV negative group. FNA and lymph node biopsy had statis- tically significant good agreement with regard to Hodgkin lymphoma (K 0.774, SE 0.07, 95% CI 0.606-0.882, p=0.001), non-Hodgkin lymphoma (K 0.640, SE 0.07, 95% CI 0.472- 0.807, p=0.001), carcinoma (K 0.723, SE 0.069, 95% CI 0.528-0.918, p=0.001), and myco- bacterial infection (K 0.726, SE 0.07, 95% CI 0.618-0.833, p=0.001).
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Diagnosis of Aelurostrongylus abstrusus verminous pneumonia via sonography-guided fine-needle pulmonary parenchymal aspiration in a cat

Diagnosis of Aelurostrongylus abstrusus verminous pneumonia via sonography-guided fine-needle pulmonary parenchymal aspiration in a cat

We describe herein the radiographic features, and, for the first time in the veterinary literature, to our knowl- edge, the associated sonographic pulmonary parenchy- mal features of A abstrusus. Image-guided percutaneous fine needle aspiration is less invasive than fine-needle biopsy or excisional biopsy, and may be associated with lower morbidity and mortality, as in the case of image- guided percutaneous biopsy in people and percutane- ous fine-needle aspiration biopsy in dogs and cats. 11,12

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DIAGNOSTIC UTILITY OF USG-GUIDED FNAC IN HEPATIC LESIONS

DIAGNOSTIC UTILITY OF USG-GUIDED FNAC IN HEPATIC LESIONS

18. Guo Z, Kurtycz DF, Salem R, et al. Radiology guided percutaneous fine needle aspiration biopsy of the liver: retrospective study of 119 cases evaluating diagnostic effectiveness and clinical complications. Diagn Cytopathol 2002;26(5):283-289.

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Análise comparativa de métodos de diagnóstico para linfadenite caseosa em ovinos sintomáticos e assintomáticos

Análise comparativa de métodos de diagnóstico para linfadenite caseosa em ovinos sintomáticos e assintomáticos

SUMMARY – Caseous Lymphadenitis (CL) is considered a cronic contagious disease caused by Corynebacterium pseudotuberculosis affecting sheep and goats causing economical losses. The diagnostic is based on microorganism culture and respective identification. However no clinical and/ or visceral cases need alternative methods for detection. In spite of a range of diagnostic methods, few studies demonstrate the usefulness of fine-needle aspiration biopsy (FNAB) method. The aim of this study was to evaluate the sensitivity and specificity of diagnostic methods for CL in symptomatic (n=26) and asymptomatic (n=129) sheeps, using specimes collected from lymph nodes by FNAB assay. These techniques were performed using PCR targeting the pld gene (phospholipase D), on biochemical identification and culture, cytodiagnostic searching the aetiological agent. The serologic test of ELISA method was also applied in all ovine sera. Clinical samples recovered in FNAB given suitable and enough samples to perform the identification of C. pseudotuberculosis, implementing CL diagnostics. Among all techniques used here, ELISA and PCR demonstrated higher sensitivity (92%), whereas microorganism culture (98%) and cytodiagnostic (94%) presented higher specificity.
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Radiol Bras  vol.49 número1

Radiol Bras vol.49 número1

The great relevance of the study developed by Rocha et al. is in the high degree of sensitivity of fine needle aspiration biopsy (FNAB) observed in cases of lymph nodes considered to be suspi- cious and indeterminate (87.1%), allowing to avoid the sentinel lymph node procedure in 70.1% of patients. And, in the cases where

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Rev. Bras. .  vol.75 número2 en v75n2a16

Rev. Bras. . vol.75 número2 en v75n2a16

N, Bouccara D, Groussard O, Bok B, Sterkers O. [Results of fine needle aspiration biopsy, frozen section diagnosis and definite histological re- sults in thyroid pathology. Report of 163 cases] Analyse des résultats de la cytoponction, de lexamen histologique extemporané et définitif dans le traitement chirurgical de la pathologie thyroïdienne: à propos de 163 cas. Rev Laryngol Otol Rhinol. (Bord) 2003;124(1):59-63.

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Arq Bras Endocrinol Metab  vol.42 número4

Arq Bras Endocrinol Metab vol.42 número4

Thyroid cancer detected by ultrasound - guided fine-needle aspiration biopsy. Yokozawa T, Miyauchi A, Kuma K, Sugawara M[r]

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Arq. Bras. Oftalmol.  vol.72 número4

Arq. Bras. Oftalmol. vol.72 número4

Purpose: To access the reliability of fine-needle aspiration biopsy in harvesting a sufficient amount of viable melanoma cells to establish a cell culture and maintain a melanoma cell line from an animal model of uveal melanoma. Methods: For this study, fifteen male New Zealand albino rabbits had their right eye surgically inoculated with uveal melanoma cell line 92.1. The animals were immunosupressed with cyclosporine A using a dose schedule previously published. The animals were followed for 12 weeks. Intraocular tumor growth was monitored weekly by indirect ophthalmoscopy. After the fourth week, one animal was sacrificed per week preceded by fine-needle aspiration biopsy using a sharp 25-gauge, 1-inch long needle. Two separate aspirates were made from different areas of the tumor. Each aspirate was flushed to a separate cell culture media and sent for cell culture. The cells were frozen after two weeks when there were at least 1 million cells, which is enough to maintain a cell line. Cells were defrosted for HMB-45 immuno-stains to confirm the melanoma origin. Results: Cell growth was observed from the samples harvested from 11 out of the 15 animals inoculated with uveal melanoma. All cell cultures, after defrost, immunoassayed positive for HMB-45. Conclusion: Fine needle aspiration biopsy seems to be a reliable method to harvest cells from solid intraocular melanomas in an animal model, to establish cell culture and to maintain a melanoma cell line.
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Radiol Bras  vol.49 número5

Radiol Bras vol.49 número5

Because of its superficial location, the thyroid is easily accessible to ultrasound or thermographic exploration and to aspiration biopsy. Imaging studies provide more precise in- formation regarding TN volume, extent, and characteristics. Fine needle aspiration biopsy (FNAB) is considered the most sensitive preoperative method for the identification of malignant TN, whereas ultrasound is the test most frequently used because of its practicality and its utility in guiding a biopsy of the nodule (8) .

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J. Bras. Patol. Med. Lab.  vol.41 número5

J. Bras. Patol. Med. Lab. vol.41 número5

Although fine-needle aspiration biopsy (FNAB) of the thyroid gland is the most important presurgical proceeding in defining the malignancy of a nodular lesion, it has limitations such as shared cytological morphology between malignant and benign lesions. Galectin-3, a ß-galactoside-binding lectin is expres- sed mainly by malignant thyroid neoplasms. Fifty-seven specimens, including 14 papillary carcinomas, 22 follicular carcinomas and 21 follicular adenomas were tested for immunohistochemical staining against galectin-3. Normal thyroid adjacent to neoplastic tissue was also examined in 48 cases. All cases of papillary carcinoma were cytoplasmic stained, 18 cases of follicular carcinoma were cytoplas- mic stained, and one case of follicular adenoma showed nuclear staining. No case of normal thyroid showed immunoreactivity. Sensitivity, specificity, positive predictive value and negative predictive value were respective 88%, 98%, 96%, and 94%. Galectin-3 expression is a valuable evidence of malignancy in cases where cytomorphological features are not conclusive. This immunomediated method could increase diagnosis accuracy for FNAB, thus making surgery indication more precise.
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Arq Bras Endocrinol Metab  vol.53 número4

Arq Bras Endocrinol Metab vol.53 número4

Lymph node metastases already occurred at the time of diagnosis on nearly 50% of MTC patients. In about two thirds of those patients, calcitonin levels re- main elevated even after extensive surgery (3). Neck US is the most sensitive tool to detect lymph node metastases in patients with papillary thyroid carcinoma (PTC), and this also applies to MTC patients (4 ) . Al- though fine needle aspiration biopsy (FNAB) of suspect lymph nodes is a value diagnostic tool for lymph node metastases, small or cystic lymph nodes may be non- diagnostic due to lack of tumor cells. The measurement of thyroglobulin (TG) levels in FNAB specimens from lymph nodes suspicious of recurrent PTC can serve as an adjunct to the cytologic diagnosis (5). Therefore, a similar approach could be used measuring calcitonin for diagnostic of lymph node MTC metastasis. In this context, a recent study evaluated the usefulness of cal- citonin assay in FNA washout (6). This paper brings a report of a case in which this technique was success- fully used to identify MCT metastasis in a small lymph node, illustrating the potential clinical applicability of this method.
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Clinics  vol.69 número5

Clinics vol.69 número5

The type of needle is the most important source of variation in biopsy techniques (5); fine-needle aspiration biopsy (FNAB) uses cytological techniques for analysis, whereas cutting-needle biopsy provides larger tissue sam- ples that are suitable for histological evaluation (6,7). Nearly all comparisons of FNAB and cutting-needle biopsy have been based only on the capacity to differentiate between benign and malignant lesions. In the contemporary oncolo- gical context of personalized medicine, such preliminary diagnoses are used only for staging purposes. Because up to 75% of the patients do not undergo surgical resection, tissue specimens collected for therapeutic planning purposes should allow for more complete diagnoses, including the determination of biomarker profiles (8,9). Macrobiopsies provide more adequate and high-quality tissue samples for such purposes than do microbiopsies (i.e., FNABs) (10). The objectives of this study were to compare the performance of cutting and fine needles in CT-guided biopsies of lung
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URACY OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS  OF NECK MASSES

URACY OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF NECK MASSES

ABSTRACT: OBJECTIVE: Fine Needle Aspiration Cytology is being used as a diagnostic modality for neck masses. This study is done to evaluate the role of Fine Needle Aspiration Cytology in the diagnosis of neck masses. A correlation was done between cytology and histopathology, to assess the accuracy of Fine Needle Aspiration Cytology in the diagnosis of neck masses. SETTING: Department of Otorhinolaryngology, Vina yaka Mission’s Medical College and Hospital, Karaikal, Pondicherry (U.T). DESIGN: A Prospective study. MATERIALS AND METHODS: Data for this study was collected from patients attending OPD and admitted in Vinayaka Mission’s Hospital, Department of Otorhinolaryngology, attached to Vinayaka Mission’s Medical College, Karaikal. 100 patients presenting with neck masses to our institution between September 2011 and August 2013 were included in the study. After a detailed clinical examination, relevant investigations and a valid informed consent, Fine Needle Aspiration Cytology of the neck swelling was performed, followed by biopsy and histopathological examination of the neck swelling. The result of Fine Needle Aspiration Cytology was correlated with result of Histopathological examination of neck swelling. STATISTICAL ANALYSIS USED: The result of this study was calculated by using the method of Galen and Gambino for substantiating the correlation. RESULTS: The histopathological correlation of Fine Needle Aspiration Cytology in our study was 92%. The sensitivity, specificity and efficiency of Fine Needle Aspiration Cytology in our study were 87.5%, 100% and 98% respectively. CONCLUSION: Fine Needle Aspiration Cytology is an excellent first line method for investigating patients presenting with neck masses. Since the masses of the neck are easily accessible, Fine Needle Aspiration Cytology is a diagnostic procedure which suits well for such a situation.
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Braz. j. .  vol.75 número5

Braz. j. . vol.75 número5

testicular teratomas can metastasize2,3 Fine needle biopsy aspiration cytology (FNAC) presents a useful procedure in cases of metastatic cervical lymph nodes of GCTs, but the use of FNAC for the diagnosis of the primary testicular tumor is not advocated. 4 In our case the FNAC

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FNAC AS A DIAGNOSTIC TOOL IN SALIVARY GLAND TUMOURS

FNAC AS A DIAGNOSTIC TOOL IN SALIVARY GLAND TUMOURS

examination. A prior informed consent was taken from the patient after explaining the procedure. The procedure was repeated in cases where the aspiration was acellular or inconclusive. Excision biopsies were received in all the cases and the histopathology findings correlated with the FNAC findings and diagnoses.

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