RESUMEN
We aimed to study the accuracy of clinical coding within oral surgery and to identify ways in which it can be improved. We undertook did a multidisciplinary audit of a sample of 646 day case patients who had had oral surgery procedures between 2011 and 2012. We compared the codes given with their case notes and amended any discrepancies. The accuracy of coding was assessed for primary and secondary diagnoses and procedures, and for health resource groupings (HRGs). The financial impact of coding Subjectivity, Variability and Error (SVE) was assessed by reference to national tariffs. The audit resulted in 122 (19%) changes to primary diagnoses. The codes for primary procedures changed in 224 (35%) cases; 310 (48%) morbidities and complications had been missed, and 266 (41%) secondary procedures had been missed or were incorrect. This led to at least one change of coding in 496 (77%) patients, and to the HRG changes in 348 (54%) patients. The financial impact of this was £114 in lost revenue per patient. There is a high incidence of coding errors in oral surgery because of the large number of day cases, a lack of awareness by clinicians of coding issues, and because clinical coders are not always familiar with the large number of highly specialised abbreviations used. Accuracy of coding can be improved through the use of a well-designed proforma, and standards can be maintained by the use of an ongoing data quality assurance programme.
Asunto(s)
Codificación Clínica/normas , Auditoría Odontológica , Procedimientos Quirúrgicos Orales/normas , Factores de Edad , Procedimientos Quirúrgicos Ambulatorios/normas , Codificación Clínica/economía , Gestión Clínica , Costos y Análisis de Costo , Registros Odontológicos/normas , Diagnóstico Bucal/normas , Grupos Diagnósticos Relacionados/economía , Recursos en Salud/normas , Humanos , Hipercolesterolemia/clasificación , Hipertensión/clasificación , Garantía de la Calidad de Atención de Salud , Reoperación , Fumar , Reino UnidoRESUMEN
In this study a review of 1948 nipple discharge (ND) samples from 1530 patients in the age range of 18-83 years was undertaken to determine whether cytological findings from ND smears could provide useful diagnostic information regarding various breast lesions. The study included 1494 females and 36 males and was carried out during a period of 20 years 8 months. The clinical information in all patients was obtained from clinicians (coauthors), medical records and a review of biopsies in 205 patients who had undergone surgery following the cytodiagnosis. Of the ND samples examined, 1480 were unilateral while 468 were from 234 bilateral ND. The cytodiagnoses were: benign 624, inadequate (despite two to three repeat samples) 492, inflammatory 96, papillary lesion not otherwise specified (NOS) 229, suspicious 22 (21 females, one male) and malignant 67 (63 females, four males). A breast biopsy in the 22 suspicious cases revealed breast carcinoma in 18 cases (females n = 17, male n = 1), atypical ductal hyperplasia (female n = 1), fibroadenoma (female n = 1) and a papilloma in two females. In the 67 cases with a diagnosis of malignancy 65 revealed a breast carcinoma in the biopsy (female n = 62, male n = 3) while one female was diagnosed as fibroadenoma and one male as florid gynaecomastia. In 63 cases (females n = 61; males n = 2) with clinical lumpy areas consistent with the diagnosis of fibrocystic condition in ND, the biopsy confirmed a fibrocystic process. In 53 of 229 cases with ND findings suggestive of a papillary lesion (NOS) the biopsy revealed a papilloma in 41 cases while in 12 cases no lesion was found. In the remaining cases of all the groups only a clinical follow-up and appropriate investigations were performed with no untoward outcome. Based on our study it is felt that cytological examination of ND smears seems to be a reasonably specific method in the diagnosis of malignant and suspicious cases but may be somewhat less specific for other diagnoses.
Asunto(s)
Enfermedades de la Mama/diagnóstico , Exudados y Transudados/citología , Pezones/metabolismo , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedades de la Mama/patología , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Neoplasias de la Mama Masculina/diagnóstico , Neoplasias de la Mama Masculina/patología , Carcinoma Ductal/diagnóstico , Carcinoma Ductal/patología , Citodiagnóstico/métodos , Femenino , Fibroadenoma/diagnóstico , Fibroadenoma/patología , Ginecomastia/diagnóstico , Ginecomastia/patología , Humanos , Hiperplasia/diagnóstico , Hiperplasia/patología , Inflamación/diagnóstico , Inflamación/patología , Masculino , Persona de Mediana Edad , Papiloma Intraductal/diagnóstico , Papiloma Intraductal/patologíaRESUMEN
In this study cytological findings in specimens of cerebrospinal fluid (CSF) of central nervous system (CNS) tumours (16 primaries, 57 metastatic and 12 suspicious) are presented, which were diagnosed over a period of 7 years in 85 patients (50 females and 35 males) with an age range of 2-76 years. The follow-up included information from clinicians and a review of medical charts, histological correlation and/or further investigations following cytodiagnosis. The patients clinically presented with signs and symptoms of meningeal involvement. The primary tumours included six medulloblastomas, eight gliomas (four glioblastomata multiforme, two anaplastic astrocytomas, and two ependymomas) and two germinomas. The metastatic tumours were 14 melanomas, 19 breast carcinomas, four leukaemias, six B-cell lymphomas, five adenocarcinomas of gastrointestinal origin, seven carcinomas of lung, one retinoblastoma and one neuroblastoma. Twelve cases were reported as suspicious. On further investigations, four of these were from a primary tumour (two glioblastomata multiforme and two anaplastic astrocytomas) while the other eight cases were of a metastasis (one B-cell lymphoma, three breast carcinomas, three melanomas and one adenocarcinoma of gastrointestinal origin). Using a panel of selective immunostains in some of the cases supported the cytological diagnosis and this was considered useful in furthering cytodiagnosis. In 75 of the patients the CSF samples were obtained on a spinal tap while in 10 patients the samples were received as ventricular CSF. There were no false-positive cases. The results of our study suggest that CSF cytology in the diagnosis of CNS tumours is quite reliable and reflects involvement of leptomeninges or the ventricles. Furthermore, the use of selective immunostains can be helpful in confirming the cytological impression and source of the tumour.
Asunto(s)
Biomarcadores de Tumor/líquido cefalorraquídeo , Neoplasias del Sistema Nervioso Central/líquido cefalorraquídeo , Neoplasias del Sistema Nervioso Central/diagnóstico , Líquido Cefalorraquídeo/citología , Citodiagnóstico , Adolescente , Adulto , Anciano , Niño , Preescolar , Citodiagnóstico/métodos , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia/diagnósticoRESUMEN
The aim of this study was to evaluate the diagnostic value of fine needle aspiration cytology (FNAC) in the assessment of palpable supraclavicular lymph nodes. The material was analysed in 218 cases with enlarged supraclavicular lymph nodes in which FNAC was performed by the conventional method. In all cases cytological examination was performed on-site after staining the smears by the Papanicolaou method. In addition, air-dried smears, fixed smears, filter preparations from needle washings and cell blocks were studied. The FNAC diagnosis was supported by examining cell blocks which added the reliability of histological architecture; further support was obtained by tissue biopsy and/or comparison with the primary tumour in some of the cases. Eleven cases were diagnosed as inflammatory lesions and 41 cases were unsatisfactory because of scanty/acellular samples (despite two to three repeat samplings). However, in five of these, malignant tumours were later found on biopsy, which was done for persistent enlargement of the supraclavicular lymph node(s). Fifty-three cases were diagnosed as negative for malignancy (normal cellular elements, n=15; reactive elements, n=38) and 12 cases were suspicious of malignancy. In 11 cases a diagnosis of lymphoma was made on histology and in 90 cases metastatic tumours were diagnosed. The overall sensitivity was 92.7%, specificity 98.5%, positive predictive value 97.3% and the negative predictive value was 94.8%. Based on our study we feel that FNAC of palpable supraclavicular lymph nodes as a first line of investigation is a cost-effective procedure and is not only useful in the diagnosis of various lesions but can also help in deciding on appropriate management. Furthermore, the histological architecture from cell blocks can be correlated with cytology, and such material can be used for appropriate histochemical and immunomarker studies, which can be useful in enhancing the diagnosis.
Asunto(s)
Biopsia con Aguja Fina , Ganglios Linfáticos/patología , Enfermedades Linfáticas/diagnóstico , Metástasis Linfática/patología , Adolescente , Adulto , Anciano , Clavícula , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Inflamación , Linfadenitis/patología , Enfermedades Linfáticas/patología , Linfoma/patología , Masculino , Persona de Mediana Edad , Palpación , Valor Predictivo de las Pruebas , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: Leiomyosarcoma of the breast is a rare tumor. Here we present a case in an elderly female in which the diagnosis was suggested from an aspirate sample. CASE: An 80-year-old female presented with an irregular, firm mass in the left breast of a few months' duration. In view of the clinical suspicion of a tumor, fine needle aspiration was performed. It showed a large number of dissociated cells and compact sheets of spindly and round cells with pleomorphic, hyperchromatic and anaplastic nuclei; mitoses; nucleoli; and somewhat-vacuolated, eosinophilic cytoplasm. Examination of the cell block, tumor tissue and immunostaining further suggested the cytologic impression of a leiomyosarcoma. CONCLUSION: Although leiomyosarcoma of the breast is very rare, fine needle aspiration cytology may allow the diagnosis to be suggested. Correlation with cell block findings and the application of appropriate immunostains as an adjuvant to standard cytologic and histologic stains may allow a more confident diagnosis.
Asunto(s)
Neoplasias de la Mama/patología , Leiomiosarcoma/patología , Anciano , Anciano de 80 o más Años , Biopsia con Aguja , Neoplasias de la Mama/metabolismo , Femenino , Humanos , Inmunohistoquímica , Leiomiosarcoma/metabolismoRESUMEN
Pericardial effusions are not uncommon in patients with an advanced malignancy Rarely malignancies may present initially with a pericardial effusion. Cytological examination of pericardial fluid may be valuable in differentiation of these cases. However, a metastatic tumour in serous effusion may not always show the functional differentiation of the primary tumour. In such a situation, although a wide range of special studies have been suggested for the diagnosis of malignancy we have found the use of a panel of a few common immunostains to be useful in confirming or suggesting the site of a primary tumour. The material for this study consisted of 76 pericardial fluids obtained between January 1991 and October 1998 from 46 males (mean age 59 years) and 30 females (mean age 52 years). Metastatic malignancy was diagnosed in 22 of the 76 patients and in 7/22 cases pericardial effusions were the initial presentation. The subsequent follow-up in the seven cases revealed adenocarcinoma of lung (n = 2), small cell anaplastic carcinoma of lung (n = 1), squamous cell carcinoma lung (n = 1), melanoma leg (n = 1), non-Hodgkin's lymphoma retroperitoneal lymph nodes (n = 1) and carcinoma of the breast (n = 1). Of the remaining 15 cases with a known history of malignancy, eight had cancers (three adeno; two small cell; one poorly differentiated, and two squamous cell types) of the lung; breast (n = 3); colon (n = 1); melanoma (n = 2) and non Hodgkin's lymphoma (n = 1). Immunostains which were useful in the diagnosis were EMA, CEA, cytokeratin, B72.3, HMB45, vimentin, S100, LCA, L26 and kappa and lambda light chains.
Asunto(s)
Neoplasias de la Mama/patología , Neoplasias Pulmonares/patología , Linfoma no Hodgkin/patología , Metástasis de la Neoplasia/patología , Derrame Pericárdico/patología , Adenocarcinoma/patología , Adenocarcinoma/secundario , Biomarcadores de Tumor/análisis , Carcinoma de Células Pequeñas/patología , Carcinoma de Células Pequeñas/secundario , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/secundario , Neoplasias del Colon/patología , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Metástasis Linfática , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
In this study the features of small cell malignancies found in the liver by fine needle aspiration cytology (FNAC) and immunostains required for a diagnosis and differential diagnosis are presented. The material consisted of 197 fine needle aspirates which were performed under image guidance between January 1982 to October 1999. Of these, 30 were diagnosed as small cell malignancies. The age of patients ranged between 46 and 68 years. The aspirated material was examined using Papanicolaou-stained filter preparations and cell blocks, the latter stained with hematoxylin and eosin and a panel of immunoperoxidase stains. The diagnoses based on a correlation of relevant clinical history, cytohistological findings and immunostaining were: metastatic small cell anaplastic carcinoma of lung (n = 6); neuroendocrine tumour (n = 9); non-Hodgkin's lymphoma (n = 4); well-differentiated cholangiocarcinoma (n = 2); metastatic carcinoma of the prostate (n = 2); metastatic adenocarcinoma (n = 4) and metastatic carcinoma breast (n = 3). This study emphasizes the wide range of neoplasms that enter into the differential diagnosis of small cell malignancies found in the liver and a correlation of clinical, cytohistological and immunostaining findings which seem to be useful in suggesting a diagnosis.
Asunto(s)
Biopsia con Aguja , Neoplasias Hepáticas/patología , Anciano , Anciano de 80 o más Años , Biomarcadores , Citodiagnóstico/métodos , Diagnóstico Diferencial , Humanos , Técnicas para Inmunoenzimas , Neoplasias Hepáticas/secundario , Persona de Mediana EdadRESUMEN
BACKGROUND: Cytologic descriptions of the diagnosis of the rare primary carcinoma of the gallbladder are sparse. The obstacles to the diagnosis are ascribed to vague symptoms and inaccessibility of the gallbladder to biopsy. We describe two cases of primary squamous cell carcinoma of the gallbladder that were diagnosed using fine needle aspiration (FNA) cytology. CASES: Both patients were elderly females with vague symptoms of abdominal pain, jaundice, loss of weight, anorexia and mild fever. Imaging studies showed enlargement of the gallbladder with a soft tissue mass in the fundus and abnormally thickened wall, indicative of a tumor. Also, in case 1, gallstones and enlarged, matted paraaortic and porta hepatis lymph nodes were present. FNA of the gallbladder was done after selection of a suitable puncture site and needle positioning, which was confirmed by computed tomography. The aspirated material was collected as needle and syringe washings, and from half the material filter preparations were made and stained for cytologic study, while the remainder was used for making cell blocks for histologic study. Both cases showed cytohistologic features of a moderately well differentiated, necrotizing squamous cell carcinoma characterized by keratinizing malignant cells with orangeophilic cytoplasm. In both cases immunostaining for high-molecular-weight keratins (AE1/AE3) and cytokeratin (CAM 5.2) was positive, while staining for carcinoembryonic antigen, B72.3 and other markers was negative. CONCLUSION: This study further confirmed that with the widespread use of more-sophisticated imaging techniques, the gallbladder is becoming more readily accessible to visualization. In view of this, FNA cytodiagnosis holds promise as a noninvasive technique in the diagnosis of gallbladder neoplasms.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias de la Vesícula Biliar/diagnóstico , Anciano , Biopsia con Aguja , Carcinoma de Células Escamosas/patología , Citodiagnóstico , Femenino , Neoplasias de la Vesícula Biliar/patología , HumanosRESUMEN
While the presence of apocrine cells in fibrocystic conditions of the female breast is a common finding in a fine-needle aspirate (FNA) of the breast, such a finding in gynecomastia has only been reported recently in a single case report. This study was undertaken in 100 cases with adequate cellular samples which had been diagnosed as gynecomastia from aspirates which were obtained using a 22-gauge needle and a 5-ml syringe maintaining negative pressure. The material was collected as needle and syringe washings in 30% ethyl alcohol in physiologic saline and the cytologic preparations were made on 3-microm Schleicher and Schuell filters and were stained by the Papanicolaou method. In 3 of the 100 cases, sheets of apocrine cells were noted in addition to clusters of hyperplastic ductal cells. The findings were further confirmed histologically in cell blocks which were made in the 3 cases. Based on our findings, it was concluded that apocrine cells in gyneco- mastia are found in about 3% of cases, and such a finding should be regarded as nonneoplastic, thus avoiding the need of surgical excision.
Asunto(s)
Ginecomastia/patología , Adulto , Biopsia con Aguja , Gránulos Citoplasmáticos/patología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Ten neuroendocrine tumors (NET) in the liver are presented, in which the diagnosis was made on fine needle aspiration cytology and cell blocks from the aspirate. In seven of the patients with liver metastasis, a biopsy-proven extrahepatic primary NET had been previously diagnosed, while in three patients no extrahepatic neoplasm could be identified, suggesting that the NET may have been a primary in the liver. Based on cytomorphological findings the cases were typed as either round cell type, spindle cell type or polygonal cell type. In all cases, immunopositivity for neuroendocrine markers provided reliable evidence of the cell of origin and distinguished them from well-differentiated hepatocellular carcinoma, adenocarcinomas and other neoplasms, which sometimes may present a diagnostic dilemma.
Asunto(s)
Neoplasias Hepáticas/patología , Neoplasias Primarias Desconocidas/patología , Tumores Neuroendocrinos/patología , Anciano , Biomarcadores de Tumor/análisis , Biopsia con Aguja , Tumor Carcinoide/química , Tumor Carcinoide/patología , Tumor Carcinoide/secundario , Carcinoma de Células de los Islotes Pancreáticos/química , Carcinoma de Células de los Islotes Pancreáticos/patología , Carcinoma de Células de los Islotes Pancreáticos/secundario , Humanos , Técnicas para Inmunoenzimas , Neoplasias Hepáticas/química , Neoplasias Hepáticas/secundario , Persona de Mediana Edad , Neoplasias Primarias Desconocidas/química , Tumores Neuroendocrinos/química , Tumores Neuroendocrinos/secundario , Neoplasias Pancreáticas/química , Neoplasias Pancreáticas/patologíaRESUMEN
Secretory carcinoma (SC) of the breast is a rare variant of breast malignancy and its cytological features in fine needle aspirates have only recently been described. In this communication, our experience with four cases of SC of the breast is presented in which the diagnosis was established on fine needle aspiration cytology (FNAC). In all cases, the samples were cellular and featured diffuse, prominent, intracytoplasmic vacuoles and secretion in malignant cells and occasional signet-ring like forms. The cytodiagnosis of SC in all the cases correlated with subsequent examination of cell blocks of the aspirate and tissue. Cytochemical stains showed diffuse positivity for mucin by alcian blue stain in the vacuolated cells which was periodic acid-Schiff positive and resistant to diastase digestion. Oil-red O staining was negative. Immunopositivity to carcinoembryonic antigen, cytokeratin (CAM 5.2), B72.3 and epithelial membrane antigen was found in malignant cells. The cytodiagnostic criteria for SC of the breast, characteristic cytological features which are useful in a correct FNAC diagnosis and differentiation from other pertinent breast carcinomas, are discussed.
Asunto(s)
Neoplasias de la Mama/diagnóstico , Carcinoma/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja , Neoplasias de la Mama/patología , Carcinoma/patología , Diagnóstico Diferencial , Femenino , Histocitoquímica/métodos , Humanos , Persona de Mediana EdadRESUMEN
Since calcific deposits in soft tissue may clinically resemble a tumor, it is feasible to investigate them by fine-needle aspiration (FNA) cytology. In this presentation we describe a case in the breast with extensive accumulation of acellular liquid calcific material which was sampled by the noninvasive technique of FNA, and which was indicative of nonfamilial soft-tissue calcinosis. A 48-yr-old, perimenopausal woman on a routine mammogram showed a well-defined, 1-cm partially cystic opacity in the left upper quadrant of the breast. All other investigations were normal, and no significant family or medical history was present. Under ultrasound guidance FNA was done, and about 1 ml of thick whitish fluid was obtained. Cytopreparations only showed abundant acellular calcium. The patient refused any further treatment and elected to be under the care of her family physician, according to whom she was clinically well with no changes in mammograms for the last 2 yr. The case is interesting, since the cytohistologic findings in aspirate sample appeared to be strongly indicative of soft-tissue calcinosis, which to our knowledge has not been previously reported.
Asunto(s)
Biopsia con Aguja , Enfermedades de la Mama/patología , Calcinosis/patología , Calcio/análisis , Femenino , Humanos , Persona de Mediana EdadRESUMEN
OBJECTIVE: To assess the utility of fine needle aspiration cytology in the diagnosis of sialadenitis with crystalloid formation in four patients that presented with a swelling of the parotid gland. STUDY DESIGN: The swelling was aspirated in all the cases using a 22-gauge needle, and aspirates were submitted as needle and syringe washings in a cytology fixative (30% ethyl alcohol in physiologic saline). From these washings filter preparations were made on Sartorius or Gelman filters (pore size, 3 microns) and stained by the Papanicolaou method. Additionally, cell block preparations were made from the aspirate. After processing, sections were cut and stained by hematoxylin-eosin, Prussian blue, alcian blue, mucicarmine, and Von Kossa and congo red stain. No air-dried smears were made, and no electron microscopic studies were done. RESULTS: Stained cytologic preparations and cell blocks showed numerous nonbirefringent crystalloids of varying sizes and shapes appearing as rectangles, needles, squares and rods mixed with neutrophils and rare multinucleated giant cells. No salivary gland components were seen, and all special staining was negative. CONCLUSION: Fine needle aspiration cytology not only provided an accurate diagnosis of sialadenitis with crystalloids but also resulted in adopting conservative management and avoiding unnecessary surgery.
Asunto(s)
Biopsia con Aguja , Sialadenitis/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Cristalización , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To analyze cases suggestive of cutaneous/subcutaneous metastatic deposits from a known carcinoma or as the first manifestation of an unknown carcinoma using fine needle aspiration cytology (FNAC). STUDY DESIGN: The study group consisted of 146 patients (86 males and 60 females) ranging in age from 34 to 82 years. In 135 cases there was a previous history of carcinoma, and in these cases FNAC showed the tumor to be similar to the carcinoma that had been treated by surgery and/or radiotherapy. In 11 patients no tumor had been found previously, and the site of the unknown primary was suggested by immunostaining. Aspirations were performed using a 22-gauge needle. The material was collected in 30% ethyl alcohol, and filter preparations and cell blocks were made. RESULTS: The size of metastatic nodules ranged from 1.5 to 2 cm. The sites of metastases were on the chest wall (n = 35), back (n = 8), abdomen (including umbilicus) (n = 46), head and neck (n = 35), upper extremity (n = 12), lower extremity ((n = 6), penile skin (n = 1) and vulva (n = 3). The sites of known primary carcinomas were breast (n = 39), lung (n = 35), gastrointestinal tract (n = 38), endometrium (n = 2), cervix (n = 3), urinary tract (n = 4), prostate (n = 3), hand (n = 1), scalp (n = 1), tongue (n = 1), brain (n = 1), ear (n = 3) and ovary (n = 4). The sites of primary carcinomas unknown at the time of aspiration and found after FNAC were the gastrointestinal tract (n = 3), lung (n = 2), prostate (n = 1), breast (n = 3), liver (n = 1) and kidney (n = 1). No false negatives or positives were observed, and no second primary tumors were found. Cytologic preparations were sufficient for diagnosis and typing in tumors with a known primary tumor. Immunostaining was helpful in establishing a diagnosis of carcinoma and in determining the likely primary site in tumors with unknown primaries. CONCLUSION: Cutaneous and subcutaneous metastatic deposits from previously known carcinomas can be diagnosed rapidly and accurately utilizing FNAC. A combination of FNAC and immunostaining may also help define the site of an unknown primary.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/secundario , Células Epiteliales/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/secundario , Adenocarcinoma Papilar/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/patología , Carcinoma de Células Pequeñas/patología , Neoplasias del Colon/patología , Femenino , Humanos , Neoplasias Pulmonares/patología , Persona de Mediana Edad , Neoplasias Ováricas/patología , PronósticoRESUMEN
Adenoid cystic carcinoma (ACC) of the breast is a rare variant of breast malignancy and has a better prognosis than its counterpart in the salivary glands. In this communication, our experience with seven cases of ACC of the breast is presented in which the diagnosis was established on fine-needle aspiration cytology (FNAC). The cytologic samples in all cases were cellular and featured three-dimensional clusters of uniform ductal epithelial cells with cystic spaces, bland nuclei, fine chromatin, and scanty cytoplasm arranged around spheres or cores of homogenous material. The cytodiagnosis of ACC in all cases correlated with subsequent examination of cell blocks of the aspirate and tissue. The cytodiagnostic criteria for ACC of the breast which are useful in a correct FNAC diagnosis are discussed.
Asunto(s)
Neoplasias de la Mama/patología , Carcinoma Adenoide Quístico/patología , Adulto , Anciano , Biopsia con Aguja , Neoplasias de la Mama/metabolismo , Carcinoma Adenoide Quístico/metabolismo , Femenino , Histocitoquímica , Humanos , Persona de Mediana Edad , Moco/metabolismoRESUMEN
Calcinosis cutis is an uncommon condition, and calcific deposits in patients with end-stage renal disease are now somewhat rare, due to improvement in management. Since calcific deposits may clinically resemble a tumor, it is feasible to investigate them by fine-needle aspiration cytology (FNAC). A 52-yr-old male with a history of end-stage renal failure presented with a 2-cm mass in the left chest wall. Within 6 mo the mass enlarged to nearly four times its original size. In view of clinical suspicion of malignancy, FNAC was performed. Cytopreparations showed abundant calcium, indicative of soft-tissue calcinosis. The case is interesting, since the known history of end-stage renal failure enabled the FNAC diagnosis of soft-tissue calcinosis.
Asunto(s)
Calcinosis/patología , Enfermedades Pulmonares/patología , Biopsia con Aguja , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We recently diagnosed subcutaneous fat necrosis in a newborn female infant using fine needle aspiration cytology. The neonate had perinatal asphyxia and her mother a difficult labor, but otherwise the neonate was well developed and healthy and within a few days developed well-defined areas of subcutaneous induration all over. On cytologic examination of the aspirated material, many necrotizing fat cells were found with refractile, needle-shaped crystals arranged in a sheaflike or starburst pattern. Subcutaneous fat necrosis of the newborn is uncommon today, and although the histologic findings from excised tissue are known, this appears to be the first case in which the diagnosis was possible from a sample of fine needle aspirate.