Diagnóstico citológico en patología tiroidea: estudio bajo ultrasonido con asistencia del citopatólogo / Fine needle aspiration in thyroid pathology study with ultrasound and cytophatologist asistance

El estudio de lesiones tiroídeas con citología aspirativa con aguja fina (PAAF) es el método más eficiente en el diagnóstico de éstas. Presentamos 640 casos consecutivos, estudiados entre 2006-2010, con obtención de muestra por radiólogo bajo ultrasonido y asistencia “in situ” del citopatólogo, quién efectuó frotis concentrados, realizando el diagnóstico inmediato de calidad de muestra. Este método, exclusivo de nuestra clínica a nivel nacional, proporcionó material suficiente en 99,53 por ciento de los casos. Se usó clasificación de Bethesda para categorizar diagnósticos. 77,39 por ciento de los diagnósticos fueron benignos, 9,26 por ciento neoplasia folicular, 9,42 por ciento malignos, y en conjunto 2,93 por ciento correspondieron a lesiones foliculares de significado incierto, atípicas y no diagnósticas. En 75 casos con diagnóstico de carcinoma papilar o neoplasia folicular hubo correlación histológica, con un 87 por ciento de exactitud para neoplasia (100 por ciento en carcinoma papilar).

The study of thyroid lesions with fine needle aspiration cytology (FNAC) is the most efficient diagnostic in this topic. We report 640 consecutive cases studied between 2006-2010, with samples that were collected by radiologist using ultrasound and on-site assistance of the cytopathologist; who made concentrated smears and immediate diagnosis of the sample quality. This method, unique in our hospital in Chile, gave sufficient material in 99.53 percent of cases. Bethesda classification was used to categorize diagnoses. 77.39 percent of diagnoses were benign, 9.26 percent were follicular neoplasm, 9.42 percent were malignant, and 2.93 percent all together belonged to follicular lesions of uncertain significance, atypical and non diagnostic. 75 cases diagnosed as papillary carcinoma or follicular neoplasm, had histological correlation, with 87 percent accuracy for neoplasia (100 percent in papillary carcinoma).

Modificación de la reabsorción ósea con terapia hormonal de reemplazo en la postmenopausia / Modification of bone resorption with replacement hormonal therapy in postmenopause

Eighty three postmenopausal women without replacement hormonal therapy, 54 postmenopausal women receiving replacement hormonal therapy and 16 premenopausal women (considered as control group) were studied. Hydroxyproline was measured in an early morning urine sample, after one day of diet without meat or gelatin. Urinary hydroxyproline in premenopausal women was 33.7ñ7.9 mg/g creatinine. The figure for postmenopausal women with hormonal replacement therapy was 33.5ñ7.9 mg/g creatinine. Postmenopausal women without replacement therapy had an urinary hydroxyproline of 47.4ñ8.5 mg/g creatinine, significantly higher than that of premenopausal and supplemented women. In 21 postmenopausal women, hydroxyproline was measured before and after 3 months of replacement therapy; values decreased 35.5ñ11 percent in this period and there was a direct correlation between initial values and the degree of reduction (r=0.69, p<0.001). Postmenopausal women receiving hormone replacement therapy have a urinary hydroxyproline excretion similar to that of premenopausal women