RESUMEN
OBJECTIVE: To study fine needle aspiration cytology (FNAC) findings of tonsillar lesions with histological controls and to assess its role in the diagnostic evaluation of tonsillectomy specimens. METHODS: This study consisted of 112 cases that required tonsillectomy, comprising 55 (49.1%) men and 57 (50.9%) women. The ages ranged between 20 and 62 years. The clinical diagnosis in 101 cases was chronic tonsillitis, whereas 11 were suspected of neoplasia. FNAC was performed before tonsillectomy under general or local anaesthesia or on fresh specimens using a 21-G needle. The smears were stained using Wright-Giemsa and Papanicolaou methods. Histological examination was carried out on surgical specimens of all cases and, when required, immunohistochemistry was performed on histological sections. The diagnostic outcomes between FNAC and surgical biopsy were compared. RESULTS: In this study, 106 cases were diagnosed as chronic tonsillitis/follicular hyperplasia, four cases as non-Hodgkin's lymphoma, one as Hodgkin's lymphoma and one as monophasic synovial sarcoma. All malignant cases were diagnosed by FNAC, but synovial sarcoma was incorrectly diagnosed as squamous cell carcinoma. Five cases clinically suspected of neoplasia were correctly diagnosed as chronic tonsillitis on cytology. CONCLUSION: Tonsillar aspiration is a safe procedure and is useful in the evaluation of tonsillectomy specimens. However, ancillary tests on cytological material are often needed when neoplasia is suspected and would help clinical management and allow histological examination of cases diagnosed cytologically as lymphoma.
Asunto(s)
Tonsila Palatina/patología , Tonsilectomía , Adulto , Biopsia con Aguja Fina , Femenino , Enfermedad de Hodgkin/patología , Humanos , Linfoma no Hodgkin/patología , Masculino , Persona de Mediana Edad , Sarcoma Sinovial/patología , Adulto JovenRESUMEN
Cell cultures were derived from tendons or ligamentous material from patients with carpal tunnel syndrome (CTS), Dupuytren's contracture (DP), tendopathia nodosa (TN) and hallux valgus (HV). The ultrastructure of the operation specimens as well as of the cell monolayers was investigated, using a floating sheet method in order to preserve both cell-to-cell contacts and the orientation of the monolayers. The histologic features of the tissues obtained in the operations were correlated with the ultrastructure of the cells in culture derived from these specimens. In DP, above all in the nodules, an activation of the capillary endothelium in the vicinity of myofibroblasts and mast cells was observed. In CTS the collagen fibrils varied extremely in diameter. In DP and TN biopsies a splicing process of helicoidly arranged fibrils could be seen. A disintegration of elastic fibers in the fibrillar and amorphous components was found in DP nodules, HV and TN tissues. Transitional forms between fibroblasts and myofibroblasts were observed not only in DP but also-though in a smaller percentage--in the cultures derived from the other patients. The cells showed organelles for active protein synthesis and transport. Autophagocytosis and the formation of multilamellated bodies took place in TN and HV cultures. In CTS, DP and TN cultures cells were connected via gap junctions. In some cultures, above all in those derived from CTS, monocilia were found. In CTS cultures the formation of intracellular collagen occurred. Growth parameters were rather low in HV cultures. PLmax (maximal pulse labelling index) values were higher in TN cultures than in DP and HV cultures. Plating efficiency (PE) values were higher in cultures derived from cell-rich and capillarized tissues than in biopsies with few cells.
Asunto(s)
Síndrome del Túnel Carpiano/patología , Contractura de Dupuytren/patología , Hallux Valgus/patología , Tendones/patología , Adulto , Anciano , Recuento de Células , División Celular , Células Cultivadas , Femenino , Humanos , Masculino , Microscopía Electrónica , Persona de Mediana Edad , Tendones/ultraestructuraRESUMEN
Surgical biopsies of dissected transverse carpal ligaments of patients with idiopathic carpal tunnel syndrome were examined with an electron microscope revealing collagen fibrils with varying diameters. Morphometric analysis of transversely cut collagen fibrils was performed on photomicrographs exhibiting fibrils with a small diameter comparable to that in normal tissue as well as fibrils with a large diameter that could not be observed in normal tissue.
Asunto(s)
Síndrome del Túnel Carpiano/patología , Colágeno/análisis , Humanos , Ligamentos/ultraestructura , Microscopía ElectrónicaRESUMEN
Morphometric parameters were evaluated in order to analyze the relation between number and covered area of collagen fibrils in normal and carpal tunnel syndrome tissue. This analysis revealed that in normal tissue twice as many collagen fibrils as in pathological tissue occupy an equal area. Taking these facts into account, some hypotheses are advanced.
Asunto(s)
Síndrome del Túnel Carpiano/patología , Colágeno , Tejido Conectivo/patología , Biopsia , Humanos , Ligamentos/patologíaRESUMEN
Orthopedic surgery on the distal lower extremities can be performed with conduction anesthesia of the sciatic nerve at the popliteal fossa, supplemented by blocking of the femoral nerve with ischemia or partial deprivation of blood supply. The technique of this method of anesthesia is described. It has proved its value in patients with high anesthesia risk as well as in out-patients.