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Abstract Introduction: The fine-needle cytology is being used as a first line of investigation in the diagnosis of head and neck swellings, as it is simple, cost effective and less invasive as compared to biopsy. Objective: The aims of this study were to evaluate the results of the fine-needle non-aspiration cytology of cervical lymphadenopathy and to study the factors influencing the rate of non-diagnosis results. Methods: This retrospective study was conducted on selected patients with cervical lymphadenopathy that had undergone a fine-needle non-aspiration cytology followed by a histological biopsy. The sensitivity, specificity, positive predictive value and negative predictive value of fine-needle non-aspiration cytology for diagnosing tuberculosis were estimated. The risk factors of non-diagnosis results were evaluated. Results: The sensitivity, specificity, positive predictive value rates of fine-needle non-aspiration cytology for tuberculosis were 83.3%, 83.3%, 78.9% and 86.9% respectively. In total, 47 out of the 131 samples (35.8%) were considered non-diagnosis. Of the non-diagnosis samples, 84.2% (38 out of 47) were benign mostly due to tuberculosis (30 cases). Among the studied factors, only tuberculosis (confirmed by histopathological examination) was significantly associated with non-diagnosis cytology (p = 0.02, Odds-Ratio = 2.35). Conclusion: Tuberculosis is currently the commonest cause of cervical lymphadenopathy in North Africa. Fine-needle non-aspiration cytology is safe and accurate in the diagnosis of cervical tuberculous lymph node that is associated with the risk of non-diagnosis cytology.
Resumo Introdução: A punção não aspirativa com agulha fina tem sido utilizada como primeira linha de investigação no diagnóstico de tumores de cabeça e pescoço, por ser uma técnica simples, custo-efetiva e menos invasiva quando comparada à biópsia. Objetivo: Os objetivos deste estudo foram avaliar os resultados de citologia por punção não-aspirativa com agulha fina de linfadenopatias cervicais e estudar os fatores que influenciam a taxa de falha diagnóstica. Método: Este estudo retrospectivo foi realizado em pacientes selecionados com linfadenopatia cervical submetidos a punção não aspirativa com agulha fina, seguida por biópsia histológica. Foram estimadas a sensibilidade, especificidade, o valor preditivo positivo e valor preditivo negativo da punção não aspirativa com agulha fina para o diagnóstico de tuberculose. Os fatores de risco dos resultados com falha diagnóstica foram avaliados. Resultados: As taxas de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo da punção não aspirativa com agulha fina para tuberculose foram de 83,3%, 83,3%, 78,9% e 86,9%, respectivamente. Das 131 amostras, 47 (35,8%) foram consideradas como falha diagnóstica. Das amostras não diagnosticadas, 84,2% (38 de 47) eram benignas, principalmente devido à tuberculose (30 casos). Entre os fatores estudados, apenas a tuberculose (confirmada pelo exame histopatológico) estava significativamente associada à citologia com falha diagnóstica (p = 0,02, odds ratio = 2,35). Conclusão: A tuberculose é atualmente a causa mais comum de linfadenopatia cervical no norte da África. A punção não aspirativa com agulha fina é uma técnica segura e precisa no diagnóstico de linfonodos cervicais associados ao risco de citologia com falha diagnóstica.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Tuberculosis, Lymph Node/diagnosis , Biopsy, Fine-Needle/methods , Lymph Nodes/pathology , Tuberculosis, Lymph Node/pathology , Retrospective StudiesABSTRACT
Aim and objectives: To compare the conventional and the Bethesda system for reporting thyroid cytopathology (TBSRTC), to correlate the cases with histology wherever available and to determine the sensitivity, specificity and false positive rates of both the methods. Material and methods: A Total of 240 patients who presented with thyroid gland swelling were subjected to thyroid fine needle aspiration cytology (FNAC) and the smears were made followed by H&E staining and reporting was done The convential system used at our centre includes description of microscopic findings of the case along with an impression at the end. The categorization according to the Bethesda system of reporting thyroid cytology were done using criteria published in the atlas and related literature. The cytological diagnosis was correlated with the histological diagnosis wherever it was available. The sensitivity, specificity, false positive rates were calculated considering cytology as screening test for differentiating between neoplastic and non-neoplastic lesions. Results: When the results of the conventional system were compared with the Bethesda adapted method was found to be more superior. Sensitivity of Bethesda system was significantly high (100%) as compared to conventional system (77%). Specificity of Bethesda system was also significantly high (82.5%) as compared to conventional system (69%). Conclusion: Our findings were consistent with others who used the Bethesda cytopathology reporting system.
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BACKGROUND: Although using fine needle cytology with aspiration (FNC-A) for establishing diagnoses in the retroperitoneal region has shown promise, there is scant literature supporting a role of non-aspiration cytology (FNC-NA) for this region. We assessed the accuracy and reliability of FNC-A and FNC-NA as tools for preoperative diagnosis of retroperitoneal masses and compared the results of both techniques with each other and with histopathology. METHODS: Fifty-seven patients with retroperitoneal masses were subjected to FNC-A and FNC-NA. Smears were stained with May-Grunwald Giemsa and hematoxylin and eosin stain. An individual slide was objectively analysed using a point scoring system to enable comparison between FNC-A and FNC-NA. RESULTS: By FNC-A, 91.7% accuracy was obtained in cases of retroperitoneal lymph node lesions followed by renal masses (83.3%). The diagnostic accuracy of other sites by FNC-A varied from 75.0%-81.9%. By FNC-NA, 93.4% diagnostically accurate results were obtained in the kidney, followed by 75.0% in adrenal masses. The diagnostic accuracy of other sites by FNC-NA varied from 66.7%-72.8%. CONCLUSIONS: Although both techniques have their own advantages and disadvantages, FNC-NA may be a more efficient adjuvant method of sampling in retroperitoneal lesions.
Subject(s)
Humans , Biopsy, Fine-Needle , Diagnosis , Eosine Yellowish-(YS) , Hematoxylin , Kidney , Lymph Nodes , NeedlesABSTRACT
Objective To investigate the clinical efficacy of the curettage and aspiration technique in laparoscopic radical gastrectomy for the treatment of gastric cancer.Methods The clinical data of 55 patients who received laparoscopic radical gastrectomy by curettage and aspiration technique with Peng's multifunctional operative dissector at the Shaoxing People's Hospital from June 2008 to February 2011 were retrospectively analyzed.Tumors located at the upper stomach in 10 patients,at the middle stomach in 15 patients and at the lower stomach in 30 patients.The numbers of patients had tumor in TNM stage Ⅰ,Ⅱ,Ⅲ A were 16,35 and 4.Patients were followed up via phone call and out-patient examination till October 2013.Results Laparoscopic radical gastrectomy was successfully carried out on all the 55 patients.Of the 55 patients,39 received laparoscopic distal subtotal gastrectomy and 16 received laparoscopic total gastrectomy.The operation time,volume of intraoperative blood loss,number of lymph nodes dissected,distances of proximal and distal resection margins to the tumors,time to flatus,time to fluid diet and duration of postoperative hospital stay and incidence of postoperative complications were (241 ± 42)minutes,(273±115)mL,32 ±9,(5.8±1.4)cm,(5.1 ±l.7)cm,(78 ±24)hours,(95 ±17)hours,(12 ±4)days and 7.3％ (4/55),respectively.Two patients were complicated with pulmonary infection,1 with anastomotic fistula,1 with incisional infection,and all of them were cured by symptomatic treatment.No patients died perioperatively.All the 55 patients were followed up for 12.0-55.0 months,and the mean time of follow-up was 35.9 months.The cumulative 48-month survival rate was 54.8％.The postoperative recurrence and metastasis rate was 10.9％ (6/55).Peritoneal metastasis was detected in 2 patients,liver metastasis in 1 patient,para-aortic nodes metastasis in 1 patient,residual gastric metastasis in 1 patient,and bone metastasis in 1 patient.Conclusion Laparoscopic radical gastrectomy by curettage and aspiration technique is safe and feasible,with the advantages of minimal trauma,low morbidity and quick recovery.
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The two sampling techniques were studied in 50 patients presenting with enlargement of thyroid gland. They were sampled by fine needle aspiration (FNA) and by non-aspiration (NA - a needle without application of aspiration pressure). Cell samples were cytologically assessed and were scored (0, 1 & 2) using five objective parameters which includes background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture. Non-aspiration performed better than FNAC for criteria background blood or clot and retention of appropriate architecture with statistically significant difference. Non-aspiration also scored better than FNAC for the other parameters as well as cumulatively. Smears were then cytologically assessed as diagnostically inadequate, adequate and superior. Greater number of diagnostically adequate specimens were obtained by FNAC than by NA but the number of diagnostically superior specimen were obtained significantly more frequently by the non-aspiration technique. Thus, the non-aspiration technique combined with FNAC can result in obtaining good quality cellular material in thyroid lesions.
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Most purulent maxillofacial infections are of odontogenic origin. Treatment of infection includes the surgical intervention, such as incision and drainage, and adjunctive treatment. The use of high-dose antibiotics is also indicated. The choice of an antibiotics should be based on the knowledge of the usual causative microbes and the results of antibacterial sensitivity test. We have undertaken clinical studies on 119 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from January 2000 to December 2007. Many anaerobic microbes are killed quickly when exposed to oxygen. Thus the needle aspiration techniques and the transfer under inert gas were used when culturing. The aim of this study was to obtain informations for the bacteriologic features and the effective antimicrobial therapy against maxillofaical odontogenic infections. The obtained results were as follows: 1. The most frequent causes of infections were odontogenic (88.3%), and in odontogenic cause, pulpal infections were the most common causes(53.8%). 2. The buccal and submandibular spaces (respectively 23.5%) were the most frequent involved fascial spaces, followed by masticator spaces (14.3%). 3. The most common underlying medical problems were diabetes (17.6%), however the relation with prognosis was not discovered. 4. The complications were the expiry, mediastinitis, necrotizing fasciitis, orbital abscess, and osteomyelitis. 5. The most common admission periods were 1-2 weeks, and the most patients were discharged within 3 weeks. However, patients who admitted over 5 weeks were about 10%. 6. A total of 99 bacterial strains (1.1 strains per abscess) was isolated from 93 patients (78.2%). The most common bacterium isolated was Streptococcus viridans (46.2%), followed by beta-hemolytic group streptococcus (10.1%). 7. Penicillins (penicillin G 58.3%, oxacillin 80.0%, ampicillin 80.0%) have slightly lower sensitivity. Thus we recommend the antibiotics, such as glycopeptides (teicoplanin 100%, vancomycin 100%) and quinolones (ciprofloxacin 90.0%) which have high susceptibility in cases in which penicillin therapy failed or severe infections.
Subject(s)
Humans , Abscess , Ampicillin , Anti-Bacterial Agents , Drainage , Fasciitis, Necrotizing , Glycopeptides , Mediastinitis , Needles , Orbit , Osteomyelitis , Oxacillin , Oxygen , Penicillins , Prognosis , Quinolones , Streptococcus , Surgery, Oral , Vancomycin , Viridans StreptococciABSTRACT
PURPOSE: The study was conducted to evaluate the usefulness of syringe aspiration technique (SAT) to correctly differentiate between esophageal and tracheal intubation in emergency department. METHODS: This study, which was comprised of a prospective series of cases, was conducted in the emergency department of an university hospital. A 50 mL catheter-tip syringe was attached to the end of the tracheal tube following intubation. The syringe plunger was then withdrawn or aspirated with 50 mL of air. The ability to withdraw air into the syringe without resistance and without syringe plunger rebound was considered evidence of tracheal intubation. If resistance was met as the syringe was aspirated or if the syringe plunger rebounded following aspiration, esophageal intubation was assumed. RESULTS: Seventy patients were enrolled in the study. Tracheal intubation was performed in 46 patients, and esophageal intubation was performed in 24 patients. Of the 46 tracheal intubations, the SAT correctly indicated tracheal placement in 45 and was indeterminate in 1 case because of blockage of the endotracheal tube by gastric material resulting from aspiration. All 24 esophageal intubation were corrected identified. CONCLUSION: This study suggests that the SAT is a safe and effective device for determining endotracheal tube position in patients with various clinical conditions requiring urgent airway control in the emergency department.