Anaplastic (undifferentiated) carcinoma of pancreas, an uncommon variant: Diagnosed on endoscopic-guided fine needle aspiration

Anaplastic carcinoma of pancreas (ACP) are rare pancreatic neoplasms. They are well known to be associated with more aggressive tumor behavior and less favorable prognosis than usual pancreatic ductal adenocarcinoma. Endoscopic-guided fine needle aspiration (EUS-FNA) is now a widely accepted modality in diagnosis of pancreatic lesions. However, only a few reports are available describing cytological features of anaplastic carcinoma. Here, we report two cases of ACP diagnosed on EUS-FNA.

La relevancia del análisis molecular en el diagnóstico y manejo de los nódulos tiroideos, y su utilidad como medida de control de calidad entre citopatólogos / The importance of molecular analysis in the diagnosis and management of thyroid nodules and its utility as a quality control metric among cytopathologists

Los nódulos tiroideos son una ocurrencia común. Aunque la mayoría de los nódulos son benignos y asintomáticos, un pequeño porcentaje de ellos puede ser maligno. Por esta razón, es crucial identificar los nódulos malignos y proporcionar el tratamiento apropiado

Ultrasound /Computed tomography Guided Fine Needle Aspiration Cytology of Abdominal Lesions

Background:Abdominal masses always are mystery in clinical prac?ce. Improvements have taken place in fine needle aspira?on cytology with technical advances in imaging methods of ultrasound and CT. Aims:To study the u?lity of guided FNAC in the diagnosis of abdominal lesions and categories the abdominal lesions. To study cytological features of abdominal lesions and correlate with histopathological features wherever possible. Materials and methods: The study included 82 abdominal lesions. History, clinical features, radiological inves?ga?ons were obtained in each case. USG or CT guidance was used and the FNA procedure was done. Smears were stained with Giemsa and viewed under the microscope for diagnosis. Diagnos?c yield was 95%. Extra material obtained was given for cell block. Results: The age was from 14 years old to 82 years and majority of them were in the age group of 40 – 60 years. Male to female ra?o is 1:1.1. Among 82 cases, 45 cases (54.87%) were malignant, followed by 17 cases (20.74%) benign, 14 cases (17.08%) inflammatory, 04 cases (4.87%) suspicious of malignancy and 02 cases (2.44%) unsa?sfactory for evalua?on. Majority of the cases are in liver and hepatocellular carcinoma was the most common malignant lesion. In 60 cases histopathological correla?on was available and for these cases the diagnos?c accuracy is 95%, sensi?vity is 92.1%, specificity is 100% and p value is <0.001 which is highly significant. Conclusion:Abdominal fine needle aspira?on cytology is simple, cost effec?ve, rapid and repeatable procedure which helps in categorizing the abdominal lesions.

Value of immunohistochemical IMP3 expression with endoscopic ultrasound-guided-fine needle aspiration (EUS-FNA) in diagnosing pancreatic lesions: Review Article

Pancreatic cancer (PC), a lethal condition with a poor prognosis, ranks fourth among the most common causes of cancer-related mortality as early diagnosis of PC is so tricky. Consequently, most cases at the time of initial diagnosis already harbor metastasis. PC cases' early detection and survival depend mainly on improving diagnostic approaches. This review sheds light on the role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as a minimally invasive method in early PC diagnosis and differentiation between different pancreatic lesions. The discovery of new diagnostic and prognostic markers for PC will raise the accuracy of proper diagnosis, and in turn, patients will gain better survival and prognosis. Insulin-like growth factor II mRNA binding protein3 (IMP3) is overexpressed in several malignant tumors, including pancreatic cancer, which may raise its role in diagnosis and prognosis as well as its therapeutic benefit for PC.

Comparative Study of Conventional Ziehl Neelsen and Modified Bleach Method of Ziehl Neelsen with CBNAAT in the Diagnosis of Tuberculous Lymphadenitis

Tuberculosis is one of the major health problems in developing countries like India. Even though lungs are the commonly involved organs in Tuberculosis, extrapulmonary presentations are on the rise nowadays. Among the various types of presentations of extrapulmonary tuberculosis, lymphadenitis is the most common presentation. A spectrum of investigations is available for diagnosis, and molecular methods like CBNAAT and PCR analysis are highly reliable. But their disadvantage is their cost and requirement of trained personnel. FNA is the first line of investigation but is lacking in sensitivity and culture method is time consuming. So, Modified Ziehl Neelsen method with low cost and less time may be considered as an alternative. We wanted to evaluate the sensitivity of the Modified Bleach Ziehl Neelsen method and compare the Modified and Conventional Ziehl Neelsen Method in association with the CBNAAT in the diagnosis of TB lymphadenitis.METHODSDiagnostic validation study was conducted with 30 clinically suspected cases of tuberculosis. FNA was done and aspirated material was spread on 2 slides. Slides were stained with H & E stain and convention Ziehl Neelsen stain. Part of the aspirate material was centrifuged with 5 % sodium hypochlorite. Sediment was smeared on a slide and stained with Ziehl Neelsen stain. Remaining material was subjected to CBNAAT assay.RESULTSCorrelation shows that 9, 6, and 11 out of 30 cases were positive for tuberculosis in Conventional, Modified and CBNAAT methods respectively. Sensitivity was 81.81 %; specificity was 94.74%, positive predictive value was 90% and negative predictive value was 90% for Conventional Ziehl Neelsen Method and 54.55%, 94.73%, 85.71% and 78.26%, respectively for modified bleach method.CONCLUSIONSConventional method is found to be more sensitive than modified method. CBNAAT negative results do not rule out TB. So, they should be correlated with cytology and microbiological studies.

Comparison of liquid-based cytology with conventional cytology in the evaluation of abdominal masses

Context: Liquid-based cytology. Aims: Utility of liquid-based cytology (LBC) was compared to conventional smear cytology in ultrasound-guided fine-needle aspirates of abdominal masses. Settings and Design: This was a prospective comparative study conducted in collaboration with surgery and pediatrics surgery departments of our institute. Subjects and Methods: Thirty patients presenting with evidence of abdominal mass were enrolled for the study and underwent fine-needle aspiration cytology. The material was processed for the preparation of conventional smears and residual material was rinsed into cytolyt for LBC by Thin Prep method and into cell block fluid. The smears prepared from both the methods were compared by two independent and experienced pathologists for adequacy, cellularity, architectural pattern, cytoplasmic preservation, nuclear preservation, and background. Results: Cellularity was frequently higher in the conventional smears than on Thin Prep slides (P value = 0.025). Recognition of architecture was better on the conventional smears (P value = 0.001). Cytoplasm was better preserved on the conventional smears (P value = 0.001) but difference in the preservation of nuclear details was not statistically significant on slides prepared from both the techniques. The background of Thin Prep slides is significantly cleaner than direct smears (P value = 0.001). Non epithelial elements such as mucin and neurofibrillary tangles were better preserved on direct smears (P value = 0.001) but diagnostic accuracy of both the methodologies showed no statistically significant difference (P value = 0.226). Conclusions: The Thin Prep technique utilizes expensive equipment and reagents. It also generates certain morphological artefacts in slides with which a cytologist needs to get familiar. When used in isolation, it may not consistently provide any added advantage in the diagnosis of such lesions and should be used as an adjunct to conventional smears. It may be preferred in situations where material has to be transported for processing or is required for ancillary tests.

Endobronchial ultrasound-guided transbronchial needle aspiration combined with either endoscopic ultrasound-guided fine-needle aspiration or endoscopic ultrasound using the EBUS scope-guided fine-needle aspiration for diagnosing and staging mediastinal diseases: a systematic review and meta-analysis

The present systematic review and meta-analysis aimed to evaluate the available evidence base on endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) combined with either endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or endoscopic ultrasound using the EBUS scope-guided fine-needle aspiration (EUS-B-FNA) for diagnosing and staging mediastinal diseases. PubMed, Web of Science, and Embase were searched to identify suitable studies up to June 30, 2019. Two investigators independently reviewed articles and extracted relevant data. Data were pooled using random effect models to calculate diagnostic indices that included sensitivity and specificity. Summary receiver operating characteristic (SROC) curves were used to summarize the overall test performance. Data pooled from up to 16 eligible studies (including 10 studies of 963 patients about EBUS-TBNA with EUS-FNA and six studies of 815 patients with EUS-B-FNA) indicated that combining EBUS-TBNA with EUS-FNA was associated with slightly better diagnostic accuracy than combining it with EUS-B-FNA, in terms of sensitivity (0.87, 95%CI 0.83 to 0.90 vs. 0.84, 95%CI 0.80 to 0.88), specificity (1.00, 95%CI 0.99 to 1.00 vs. 0.96, 95%CI 0.93 to 0.97), diagnostic odds ratio (413.39, 95%CI 179.99 to 949.48 vs. 256.38, 95%CI 45.48 to 1445.32), and area under the SROC curve (0.99, 95%CI 0.97 to 1.00 vs. 0.97, 95%CI 0.92 to 1.00). The current evidence suggests that the combination of EBUS-TBNA with either EUS-FNA or EUS-B-FNA provides relatively high accuracy for diagnosing mediastinal diseases. The combination with EUS-FNA may be slightly better.

Comparative Analysis of Cell Block Preparation Versus Smear Examination in the Fine Needle Aspirates of Head & Neck Lesions with Application of IHC Markers on Cell Block Preparation

Introduction: Diagnostic cytology is the science of interpretation of cells that are exfoliated from the epithelial surfaces or removed from various tissues. The aim of this study was to assess the utility of cell block in increasing the cytodiagnosis of fine needle aspirates of head and neck lesions and to apply immunohistochemical markers on cell blocks. Material and methods: Total sample of 50 patients of head and neck lesions were received in the Department of Pathology, after approval from the Institutional Ethics Committee. Informed consent of the patient was taken. Relevant history of the patient was taken as per the written proforma. Patients of all age group presenting with head and neck lesions underwent FNAC and histopathological examination was included in the study. Results: Thus FNAC served better than cell block in determining the cellularity (kappa κ – statistic = -0.04, P 0.0002) while on morphological preservation grounds,superior nuclear and cytoplasmic characteristics were observed in cell block in comparision to FNAC (κ – statistic= -0.08).Overall Sensitivity and positive predictive value of cell block method with imunohistochemistry (96% and 100% respectively) proved to be better as compared to FNAC alone (88.8% and 95.65%). Conclusion: The diagnostic value of a Cell Block technique with immunohistochemistry is found to be superior to FNAC smears for the diagnosis of benign and malignat lesions of head and neck region. Taking into consideration the advantages of Cell Block method an excellent complementary tool for improving cytodiagnosis, we can recommend that cell blocks preprations should be routine practice so as to augment the information that is obtained solely from FNAC smear cytology.

Peripheral lymphadenopathy and FNA: a two-year evaluation at a tertiary care centre

Background: Lymphadenopathy is an age old affliction of mankind and a very common presentation in clinical practice. The main purpose of an FNA biopsy of abnormal peripheral lymph nodes is to determine whether further surgical excision of the lymph node is indicated for histopathological examination. The aim of the present study was to evaluate the role of fine needle aspiration cytology in patients with superficial lymphadenopathy and to correlate with histopathology wherever possible.Methods: A two-year study was undertaken at the Central Diagnostic Laboratory at A.J. Institute of Medical Sciences, Mangalore. Patients of all age groups referred to the Central Diagnostic Laboratory for FNA of superficial lymph nodes were included in the study. All the slides of the cases were reviewed and impression recorded.Results: Out of 200 cases, 73% were non neoplastic, 27% were neoplastic. Cases occurred most commonly in age group of 21-30 years. The male to female ratio was 1.7:1 and most common site of lymph node aspiration was cervical lymph node in (n =107) 53.5% cases. Reactive hyperplasia was the most common non- neoplastic cause of lymphadenopathy seen in 34.5% cases and metastasis to lymph node was the most common cause of neoplastic lymphadenopathy seen in 22% of the cases. The sensitivity was 90%, specificity was 100% and accuracy was 96.2%.Conclusions: FNA is a very efficient, simple, safe, inexpensive and economical test for detecting the various causes of lymphadenopathy.

Sperm fine-needle aspiration (FNA) mapping after failed microdissection testicular sperm extraction (TESE): Location and patterns of found sperm / 亚洲男科学杂志(英文版)

We sought to evaluate the ability of fine-needle aspiration (FNA) mapping to find sperm and to guide sperm retrieval after failed microdissection testicular sperm extraction (micro-TESE) in nonobstructive azoospermic men. In this study of consecutive male infertility cases, interventions included testicular FNA mapping and subsequent sperm retrieval. Outcomes included the frequency and location of found sperm on FNA maps after failed micro-TESE and the salvage sperm retrieval success. Among 548 patients undergoing FNA mapping from 2010 to 2016, 82 men with previous micro-TESE procedures were identified. The mean time between micro-TESE and FNA mapping was 2.2 years. A total of 2825 (1424 on right and 1401 on left) sites were mapped. At least one site revealed mature sperm in 24 (29.3%) of 82 men with prior failed micro-TESE procedures. There was an equal likelihood of detecting sperm in either testis (6.1% right; 5.7% left; P = 0.58). Digital 'heat maps' revealed differences in sperm findings within the testis with mature sperm more likely found in the testis periphery rather than centrally. Fifteen (62.5%) patients subsequently underwent sperm retrieval procedures guided by FNA maps. Sufficient sperm were retrieved in all cases, and in 10 (66.7%) of 15 cases, extra sperm were frozen for future use. In a significant proportion of failed micro-TESE procedures representing the largest study to date, sperm were detected by FNA mapping and could be reliably retrieved through FNA map-guided surgical sperm retrieval. When present, sperm were more likely to be found in the testis periphery rather than centrally with FNA mapping.

Ultrasonographic Interval Changes in Solid Thyroid Nodules after Ultrasonography-Guided Fine-Needle Aspiration

OBJECTIVE: None of the previous studies have investigated the interval change in ultrasonography (US) features of solid thyroid nodules (STNs) after US-guided fine-needle aspiration (US-FNA). This study aimed to assess the prevalence and characteristics of US interval changes in STNs after US-FNA. MATERIALS AND METHODS: This study included 257 STNs in 257 patients in whom thyroid US and initial US-FNA had been performed by two radiologists from January 2015 to June 2015. One of the radiologists performed single needle puncture in all cases, whereas the other radiologist used double or triple needle punctures. Follow-up US examinations were performed after 12.0 ± 6.0 months. We evaluated the prevalence and characteristics of post-FNA US interval changes through a retrospective analysis. In addition, multiple factors were correlated with post-FNA US interval changes. RESULTS: The number of needle punctures was one (n = 91), two (n = 163), and three (n = 3). Of the 257 STNs (mean diameter, 11.9 mm) in 257 patients, 35 (13.6%) showed an interval change in US features on follow-up US. Among them, 17 STNs (6.6%) showed newly developed malignant US features, including hypoechogenicity (n = 5), microcalcifications (n = 2), a spiculated margin (n = 4), hypoechogenicity with a spiculated margin (n = 5), and microcalcifications with non-parallel orientation (n = 1). Between patients who showed presence and absence of US interval changes, there were no significant differences in patient age, sex, nodule size, dichotomization, and location, Korean Thyroid Imaging Reporting and Data System categorization after FNA, practitioners involved, number of needle punctures, cytological findings, and interval between FNA and US follow-up (p > 0.05). CONCLUSION: Awareness of US interval changes after US-FNA of STNs may be helpful for the management of STNs.

Evaluation of Modified Core-Needle Biopsy in the Diagnosis of Thyroid Nodules

OBJECTIVE: Core needle biopsy (CNB) of the thyroid is an additional diagnostic method for non-diagnostic or indeterminate cytology samples. We sought to evaluate a new modified core biopsy technique and compare the concordance of its diagnosis with the final diagnosis of the surgically resected specimen. MATERIALS AND METHODS: A retrospective analysis was conducted on 842 patients who had a thyroid CNB with or without a previous fine-needle aspiration from August 2002 to March 2015; 38% of patients ultimately underwent thyroidectomy. We divided the patients into two groups for comparison: conventional group (n = 329) and new modified technique group (n = 513) that enabled sampling of not only the lesion but also the margin and surrounding parenchyma. The diagnostic conclusiveness of CNB and concordant rate with thyroidectomy was compared between the two groups. RESULTS: The overall diagnostic conclusiveness did not exhibit a significant increase (77% in the conventional technique group and 75% in the modified technique group, p = 0.408). In terms of the diagnostic concordance rate between CNB and thyroidectomy, no overall significant increase was observed (83% in the conventional technique group and 88% in the modified technique group, p = 0.194). However, only in follicular-patterned lesions (nodular hyperplasia, follicular neoplasm, and follicular variant of papillary thyroid carcinoma), a significant increase in the diagnostic concordance rate was observed (83% in the conventional group and 94% in the modified technique group, p = 0.033). CONCLUSION: Modified CNB technique can be beneficial for the accurate diagnosis of follicular-patterned thyroid lesions.

Diagnostic value of endoscopic ultrasound guided fine needle aspiration combined with the new category of papanicolaou society of cytopathology in solid pancreatic lesions / 中华消化杂志

Objective To study the diagnostic value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) combined with the new category of papanicolaou society of cytopathology in solid pancreatic lesions (SPL) rapid on-site evaluation (ROSE).Methods From February 2011 to October 2014,225 patients with SPL who underwent EUS-FNA and obtained the cytological diagnosis were enrolled.The lesions were finally diagnosed according to pathological results,imaging and follow-up data,and then the sensitivity,specificity,and accuracy of EUS-FNA in the diagnosis of SPL were calculated based on the new papanicolaou society of cytopathology terminology.Logistic stepwise regression analysis was performed to analyze the risk factors.Results Among 225 patients with SPL,96 cases (42.7％)had uncertain cytological diagnosis,17.3％ (39/225) could not be diagnosed,8.0％ (18/225) were atypical lesions,and 17.3％ (39/225) were suspicious malignant carcinomas.Among 129 cases (57.3％)with certain cytological diagnosis,15.1％ (34/225) were benign lesions,14.7％ (33/225) were tumors (benign or others) and 27.6％ (62/225) were malignant tumors.When atypical lesions were added into non-tumor lesions or tumor lesions,the sensitivity,specificity and accuracy of diagnosis were 87.3 ％,91.7％,88.2％,and 94.7％,72.2％,90.3％,respectively.Serum CA125≥14 kU/L (odds ratio (OR) =7.13,95％ confidence interval (CI) 2.02 to 25.22,P=0.002) and history of biliary disease (OR=3.85,95％CI 1.22 to 12.51,P=0.022) were two independent risk factors of pancreatic tumors.Conclusions Despite of a high percentage of uncertain cytological diagnosis,EUS-FNA still has high diagnostic value in SPL when combined with the new papanicolaou society of cytopathology terminology.Furthermore,serum CA125≥14 kU/L and history of biliary disease may help to diagnose pancreatic tumors.

Diagnostic Value of Endoscopic Ultrasonography-guided Fine Needle Aspiration for Digestive System Neoplasms / 胃肠病学

Imaging examinations such as CT,MRI and ultrasonography are of great importance for the diagnosis of digestive system neoplasms. However,some digestive system neoplasms are difficult to be detected at early stage and make qualitative diagnosis by conventional imaging techniques because of their unique clinical characteristics. Compared with conventional imaging techniques,endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA)can not only detect the early lesions,but also make accurate qualitative diagnosis. The development and improvement of EUS-FNA greatly improve the diagnostic level of digestive system neoplasms. In this paper,the diagnostic value of EUS-FNA in digestive system neoplasms was reviewed.

Core Needle Biopsy of the Thyroid: 2016 Consensus Statement and Recommendations from Korean Society of Thyroid Radiology

Core needle biopsy (CNB) has been suggested as a complementary diagnostic method to fine-needle aspiration in patients with thyroid nodules. Many recent CNB studies have suggested a more advanced role for CNB, but there are still no guidelines on its use. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology has developed the present consensus statement and recommendations for the role of CNB in the diagnosis of thyroid nodules. These recommendations are based on evidence from the current literature and expert consensus.

Thyroid Cytology in India: Contemporary Review and Meta-analysis

Fine-needle aspiration cytology (FNAC) is a screening test for triaging thyroid nodules, aiding in subsequent clinical management. However, the advantages have been overshadowed by the multiplicity of reporting systems and a wide range of nomenclature used. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was formulated in 2007, to give the world a uniform thyroid cytology reporting system, facilitating easy interpretation by the clinicians. Here, we review the status of thyroid FNAC in India in terms of various reporting systems used including a meta-analysis of the previously published data. An extensive literature search was performed using internet search engines. The reports with detailed classification system used in thyroid cytology were included. The meta-analysis of published data was compared with the implied risk of malignancy by TBSRTC. More than 50 studies were retrieved and evaluated. TBSRTC is currently the most widely used reporting system with different studies showing good efficacy and interobserver concordance. Ancillary techniques have, as of now, limited applicability and acceptability in thyroid cytology in India. Twenty-eight published articles met the criteria for inclusion in the meta-analysis. When compared with TBSRTC recommendations, the meta-analysis showed a higher risk of malignancy for categories I and III. Thyroid FNAC is practiced all over India. TBSRTC has found widespread acceptance, with most institutions using this system for routine thyroid cytology reporting. However, reasons for a high malignancy risk for categories I and III need to be looked into. Various possible contributing factors are discussed in the review.

RE: Thyroid Core Needle Biopsy: The Strengths of Guidelines of the Korean Society of Thyroid Radiology

No abstract available.

Increasing diagnostic effectiveness of thyroid nodule evaluation by implementation of cell block preparation in routine US-FNA analysis

ABSTRACT Objective Ultrasound-guided fine-needle aspiration (US-FNA) biopsy has proven to be an accurate and efficient tool in thyroid nodule evaluation. We evaluated whether cell block adds to the diagnostic accuracy of US-FNA. Subjects and methods Three hundred twenty-eight consecutive patients underwent US-FNA, cytology and cell block evaluation. Six slides were prepared for each patient and stained by Papanicolaou and Giemsa techniques. The residual hemorrhagic aspirate in the syringe and needle was fixed in 10% formalin and paraffin-embedded (cell block). The histological sections were examined as a complementary diagnostic tool to US-FNA. Results The study population comprised 89% females and the mean age was 57.4 ± 13.7 years. The mean nodule size was 2.3 ± 1.2 cm. US-FNA cytological results were as follows: Bethesda I, 17.1% (n = 56); Bethesda II, 61.6% (n = 202); Bethesda III, 9.5% (n = 31); Bethesda IV, 5.8% (n = 19); Bethesda V, 2.4% (n = 8), and Bethesda VI, 3.6% (n = 12). Cell blocks were obtained in 100% of cases and were considered diagnostic in 89.6%. Combined cytological and cell block (cyto-cell block) results were as follows: unsatisfactory, 4.3% (n = 14); benign, 72.6% (n = 238); indeterminate, 11.3% (n = 37); follicular lesion, 5.8% (n = 19); suspicious for malignancy, 2.4% (n = 8), and malignant, 3.6% (n = 12). The sensitivity and specificity for cyto-cell block was 100% and 90%, respectively, and the accuracy was 94%. Cyto-cell block analysis reduced the rate of unsatisfactory samples (p < 0.001). Conclusions The cyto-cell block interpretation improved the efficiency of US-FNA. This simple, fast and low-cost technique should be used as an adjunctive test in thyroid nodule evaluation. Arch Endocrinol Metab. 2016;60(4):367-73.

Utilización de la PAAF guiada por ecografía en el Hospital Carlos Andrade Marín / Echography-guided use of Puncture Breast Echography in the Carlos Andrade Marin Hospital

Introducción: El objetivo del presente estudio es describir la frecuencia con la que realizamos este examen y el tipo de tejidos obtenidos con el procedimiento. Materiales y Métodos: La muestra obtenida fue de 300 pacientes a quienes se les realizó una PAAF desde septiembre 2014 a diciembre del mismo año. Los resultados se presentan en tablas de frecuencia clasificadas por órgano puncionado y resultado citológico. Resultados: En los cuatro meses, el órgano más puncionado fue la glándula tiroides (73%); el segundo lugar, la mama (19.3%); siguen, los ganglios cervicales (5%); ganglios axilares (1.3%); y, finalmente, las glándulas salivales (1.3%). Discusión: La PAFF guiada por ultrasonografía es uno de los procedimientos diagnósticos más utilizados en todo el mundo, cuando se trata de lesiones accesibles e identificables por ecografía. De allí la alta frecuencia de su uso en nuestro medio y particularmente en el HCAM, cuyos resultados son similares a los reportes de estándares internacionales.

Introduction: The objective of this study was describing the frequency this procedure is performed and detailing the kind of tissue samples obtained. Methods: Descritptive study that included 300 patients who underwent Fine Needle Aspiration (FNA) guided by ultrasound to obtain samples from different organs for cytology at Carlos Andrade Marin hospital. Results: During a four-month period 192(73%) subjects underwent FNA of the thyroid gland; 57(19.3%) of the breast; 14(5%) from cervical lymph nodes; 4(1.3%) from axillary lymph nodes AND 2 (1.3%) samples were taken from salivary glands. Discusion: FNA guided by ultrasound is a frequent procedure worldwide performed when accessible lesions are identified by ultrasound. That explains the frequency of its use anda particularly at Carlos Andrade Marin Hospital. Our reports are simResumen

Accuracy of Cytological Analysis in Metastatic Lymphadenopathy; a Retrospective Study.

Background: Presently, fine needle aspiration (FNA) biopsy is the preliminary, non-invasive test for diagnosis of suspected lymphadenopathy. Apart from its diagnostic yield, it helps identifying the origin, grading and typing of the metastatic lesions in many cases. Methods: In the present study, data of 369 patients with suspected neoplastic lymphadenopathy presenting to the surgical and medical outpatient department of our institute over a period of 3 years was collected. FNA biopsy was performed on the most prominently visible and palpable lymph node. The use of special stains was performed in selected cases. Results: Of 369 cases studied, cytological diagnosis was offered in 358 cases, while unsatisfactory smears were reported in 11 cases. Of these 358 cases where a cytological diagnosis of either primary or metastatic lymphadenopathy was given, 244 were males and 114 were females. Metastatic tumors in the lymph nodes were reported in 307 cases and lymphoma in 51 cases. The distribution of lymphadenopathy revealed involvement of cervical group in 222 cases, axillary group in 57 cases, supraclavicular in 28 cases & inguinal in 24 cases. The commonest primary tumor, metastasizing to lymph nodes was squamous cell carcinoma (52.44%). Conclusion: In our study, FNA biopsy proved to be a safe and non-expensive technique that provided a high diagnostic accuracy with zero false positive results, confirmed the presence of secondaries where primary tumor was evident and guided the response to medical treatment.