Evaluation of diagnostic accuracy of fine needle aspiration cytology in different masses

Pre-operative fine needle aspiration is a reliable widely used method for obtaining a rapid diagnosis which can direct further planning of therapy. The procedure enables the clinician to obtain a definitive diagnosis in a high percentage of patients with minimal cost or expenditure of time -and is useful in delineating patients with metastatic disease or primary bone neoplasm such as multiple myeloma or lymphoma to avoid unnecessary surgery. In the present work, a comparative study was carried out on 137 patients with superficially accessible masses to access the accuracy of cytodiagnosis. Fine needle aspiration proved to have a valuable role even in undiagnosed cases as it could differentiate between benign and malignant tumors. Cytologically undiagnosed breast cases were attributed to the presence of dense sclerotic stroma which yielded unsatisfactory smears, the same explanation for one of the cases of thyroid swelling was suspected, while the other case which was suspicious is explained by the similar features of benign and malignant well differentiated follicular tumors. 2 out of 11 cases of salivary glands were misclassified with regard to the type of malignancy. The accuracy rate was 100% in cases with osseous tumors, lymphadenopathy, subcutaneous soft tissue masses as well as liver nodules

Interleukin-2 production and expression of interleukin-2 receptor by activated peripheral blood T-lymphocytes in hodgkin's disease

Patients with Hodgkin's disease [HD] often show. T-cell dysfunction irrespective of the stage and grade of the disease. This study investigated the relationship between peripheral blood lymphocytic interleukin-2 [IL-2] production and IL-2 receptor [IL-2R] expression and the clinical stage and pathological type of the disease before and after treatment in patients with Hodgkin's disease. Interleukin-2 production and IL-2R expression were estimated in total of 20 patients with Hodgkin's lymphoma and 15 apparently healthy individuals of matched age and sex. The patients group was selected to represent the various clinical stages and the different pathological types. There was a statistically significant decrease in IL-2 production [P<0.001] and IL-2R expression [P <0.001] after stimulation with phytohaemagglutinin [PHA] in untreated Hodgkin's lymphoma patients regardless of their clinical stage or pathological type as compared to the normal control group. There were significant decrease in the IL-2R expression and IL-2 production in patients with late clinical stages [III and IV] and pathological types [mixed cellularity and lymphocytic depletion] than in patients with early clinical stages [I and II] and pathological types [lymphocytic predominance and nodular sclerosis]. This may be due to expansion of the malignant cell clones and reduction in normal T cell mass. The improvement in the expression of IL-2R and the production of IL-2 after effective treatment suggests a regression in the mass of malignant cell clones with replacement of normal cell clones. The detection of IL-2 production and IL-2R expression in HD seems to be of some value in clinical management and monitoring of individual patients