Differentiation between bening, reactive and malignant cells in serosal body fluids by Ag NOR staining

Argyrophilic nucleolar organizer regions [AgNORs] were determined in 94 pleural, pericardial and peritoneal effusions. The results were correlated with cytologic diagnosis to determine the diagnostic potential of this technique. Cytologically the number of normal, reactive and malignant effusions were 32, 28 and 34 respectively. The mean AgNOR counts for normal, reactive and malignant specimens were 1.365, 2.328 and 4.747 respectively. The cut-off points between normal-reactive and reactive-malignant specimens were 1.84 and 3.53 respectively. All of the malignant specimens [100%] had AgNOR counts above 3.53. Neither reactive nor normal specimens had AgNOR counts above 3.53. 82.1% of reactive specimens had AgNOR counts above 1.84 and 87.5% of normal specimens had AgNOR counts below this point. There was a statistically significant difference between the AgNOR counts in normal, reactive and malignant effusions [p<0.001]. We conclude that the AgNOR method is a specific diagnostic tool for serosal cavity effusions, especially when malignancy is suspected

role of radionuclide scanning, songraphy and fine needle aspiration cytology in palpable throid nodule diagnosis

One hundred consecutive patients with palpable thyroid nodules were enrolled in this study at Mashhad University of Medical Sciences. There were 19 males and 81 females. Age range was between 7-66 years. Most of the lesions were located in the right lobe of thyroid. 93 thyroids had a single nodule on physical examination. 99 patients had sonography. 74 of them had single and 18 had multiple nodules and one showed no nodule. In 80 cases thyroid scan was performed. In 6 patients despite a palpable thyroid nodule, scan was considered normal. 69 patients had cold nodule which was cystic in 24 cases. Fine needle aspiration [FNA] and cytology were done in all of the patients. In 4 patients FNA was considered malignant and in 10 patients it was suspicious to malignancy. 9 patients had surgery and 5 had cancer. According to the present study, FNA is the most accurate tool to select the malignant nodules and to decide on the most suitable surgical intervention