Echinococcosis of the liver and biliary tree: ultrasound, CT and post-operative evaluation

The sonographic and CT appearances of echinococcal lesions of the liver were studied in 100 patients. A classification of these lesions, that reflects the pathology and natural history of the disease [type I, simple fluid-filled cysts, type IR, lesions containing undulated membranes that represent detached endocysts secondary to rupture, type II lesions that contain daughter cysts and/or formed echogenic material called matrix, and type III, dead, densely calcified lesions], was proposed. The natural progression of hepatic echinococcal cysts is from type I to type III. Daughter cyst formation is part of the natural aging process. When hydatid cysts are infected, they lose their characteristic sonographic appearance and become hyperechoic on CT. These lesions were hypodense [30-40 HU] and did not show enhancement after intravenous contrast enhancement. Precise evaluation of the lesions arising from correlative use of ultrasound and CT permits proper staging and treatment

Fine needle aspiration biopsy in the diagnosis of thyroid nodules

The fine needle aspiration [FNA] biopsy was performed on solid thyroid nodules [ultrasonographically proved] from 1989 to 1991 and results were reviewed. All the 194 biopsies were investigated histologically after thyroid surgery. Two cases with an insufficient FNA sample, 4 with an incidental occult papillary carcinoma and 2 cases with carcinoma outside the nodule investigated by FNA biopsy were excluded from the series, leaving 186 histologically confirmed nodules in the final analysis. Three [3%] of the 107 cases with an FNA biopsy diagnosis of benign, 4 [8%] of the 52 with an FNA diagnosis of equivocal, 3 [20%] of the 15 with an FNA diagnosis of equivocal, 3 [20%] of the 15 with an FNA diagnosis of suspicious and all 12 [100%] with an FNA diagnosis of malignant were histologically malignant. If only an unequivocally malignant cytologic finding is considered positive, FNA biopsy had a diagnostic specificity of 100%, a sensitivity of 55% and an accuracy of 95% among of the histologically confirmed cases. It is concluded that FNA biopsy is a practical method with considerable diagnostic value in the evaluation of thyroid nodules

value of fine needle aspiration in the diagnosis of breast lumps

A study of 552 consecutive fine needle aspirations [FNAS] of the breast in 480 cases is presented. The study was performed between 1989 and 1992. Patients ranged in age from 16 to 69 years with a mean of 42. All cases underwent subsequent excisional biopsy of the breast due to the early experience of both the clinicians and the pathologist with the technique. Correlations between the FNA cytology and the surgical pathology findings revealed that FNA had a sensitivity of 79.4%, a specificity of 100% and a predictive value of a positive diagnosis of 100%. The overall diagnostic accuracy was 92.4%. These results are comparable with those in other published series