Correlación entre resultados de citología y anatomía patológica en nódulos tiroideos intervenidos quirúrgicamente / Correlation between cytology results and pathological anatomy in surgically treated thyroid nodules / Correlação entre resultados de citologia eanatomia patológica em nódulos tireoidianos tratados cirurgicamente

INTRODUCCIÓN: Los nódulos tiroideos son habituales y pueden ser detectados por ultrasonido hasta en el 60% de la población general. La punción aspiración con aguja fina (PAAF) es una herramienta imprescindible en la actualidad para evaluar nódulos tiroideos. El objetivo de este estudio es describir la correlación entre la citología de un nódulo tiroideo y la histología luego de la exéresis quirúrgica, y así evaluar el valor diagnóstico de la PAAF. MATERIAL Y MÉTODO: Estudio observacional, descriptivo y retrospectivo. Se incluyeron todos los pacientes que fueron sometidos a tiroidectomía en el período comprendido entre enero de 2014 y diciembre de 2016. Se excluyeron a los pacientes cuya intervención estuvo motivada por un mal manejo del perfil hormonal, refractario al tratamiento médico, ya que no presentaban nódulos tiroideos, y los pacientes de edad pediátrica...

INTRODUCTION: Thyroid nodules are common and can be detected by ultrasound in up to 60% of the general population. Fine-needle aspiration citology (FNAC) is currently an essential tool for evaluating thyroid nodules. The aim of this study is to describe the correlation between cytology of a thyroid nodule and histology after surgical excision, and thus to evaluate the diagnostic value of FNAC. MATERIAL AND METHOD: Observational, descriptive and retrospective study. All patients who underwent thyroidectomy in the period between January 2014 and December 2016 were included. Patients whose intervention was motivated by poor hormonal profile management, refractory to medical treatment, were excluded because they had no nodules thyroid, and pediatric patients…

INTRODUÇÃO: Os nódulos tireoidianos são comuns e podem ser detectados por ultrasom em até 60% da população em geral. A aspiração com agulha fina (FNAP) é atualmente uma ferramenta essencial para avaliar os nódulos tireoidianos. O objetivo deste estudo é descrever a correlação entre citologia de um nódulo tireoidiano e histologia após a excisão cirúrgica, e assim avaliar o valor diagnóstico de FNAB. MATERIAL E MÉTODO: Estudo observacional, descritivo e retrospectivo. Todos os pacientes que foram submetidos a tireoidectomia no período entre janeiro de 2014 e dezembro de 2016. Foram incluídos os pacientes cuja intervenção foi motivada por uma má gestão do perfil hormonal, refratária ao tratamento médico, porque não possuíam nódulos tireóide e pacientes pediátricos...

Cáncer diferenciado de tiroides y tiroiditis de Hashimoto en el Instituto Nacional de Oncología y Radiobiología (2006 - 2010) / Differentiated thyroid cancer and Hashimoto's Thyroiditis at the National Institute of Oncology and Radiobiology (2006-2010)

Objetivos: describir el comportamiento del cáncer de tiroides en los pacientes con tiroiditis de Hashimoto. Métodos: se realizó un estudio observacional, descriptivo, longitudinal y retrospectivo, con 71 pacientes portadores de tiroiditis de Hashimoto, tratados en el Instituto Nacional de Oncología y Radiobiología desde 2006 hasta 2010. Resultados: la tiroiditis de Hashimoto con la presencia de nódulos fue más frecuente en los grupos de edades entre 50 y 59 años. El sexo más afectado fue el femenino. De los 71 pacientes que integraron nuestro universo de estudio, a 12 (16,9 por ciento) se les diagnosticó carcinoma de tiroides de la variante papilar y todos del sexo femenino, y la incidencia del cáncer tiroideo aumentó con la edad. El hipoparatiroidismo transitorio fue la complicación posoperatoria más importante. Conclusiones: a mayor tiempo de evolución de la tiroiditis de Hashimoto mayor probabilidad de que aparezca un nódulo de tiroides y de adquirir un cáncer de tiroides. El manejo de los nódulos tiroideos asociados a la tiroiditis de Hashimoto es el mismo que el de los nódulos tiroideos sin tiroiditis. Para su evaluación nos apoyamos en la citología aspirativa con aguja fina, la ecografía, la biopsia por congelación, los factores pronósticos y de riesgos, también en la biopsia por inclusión en parafina. Se considera a la citología aspirativa con aguja fina de valor, en la exploración de un nódulo tiroideo(AU)

Objectives: to describe the behavior of the thyroid cancer in patients with Hashimoto's thyroiditis. Methods: retrospective, longitudinal, descriptive and observational study of 71 patients suffering Hashimoto's thyroiditis and treated at the National Institute of Oncology and Radiobiology during 2006 through 2010. Results: Hashimoto's thyroiditis associated with thyroid nodules was more frequent in 50-59 years group and women were the most affected. Twelve (16.9 percent) out of 71 patients who formed the universe of study were diagnosed with papillary thyroid carcinoma, all of them women. The incidence of thyroid cancer increased with the age. Transient hypoparathyroidism was the most important postoperative complication. Conclusions: the longer evolution of Hashimoto's thyroiditis, the greater probability of occuring thyroid nodules, with the risk of developing thyroid cancer. The management of nodular Hashimoto's thyroiditis is the same as that of thyroid nodule without thyroiditis. For their assessment, the main methods are fine needle aspiration biopsy, echography, freezing biopsy, prognostic and risks factors, and paraffin biopsy. Fine needle aspiration biopsy has is very important in the screening of a thyroid nodule(AU)

Use of fine needle aspirate from peripheral nerves of pure-neural leprosy for cytology and PCR to confirm the diagnosis: A pilot study.

Background: The diagnosis of pure neural leprosy (PNL) remained subjective because of over-dependence of clinical expertise and a lack of simple yet reliable diagnostic tool. The criteria for diagnosis, proposed by Jardim et al., are not routinely done by clinicians in developing country as it involves invasive nerve biopsy and sophisticated anti-PGL-1 detection. We conducted a study using fi ne needle aspiration cytology (FNAC) coupled with Ziehl Neelsen staining (ZN staining) and Multiplex- Polymerase Chain Reaction (PCR) specifi c for M. leprae for an objective diagnosis of pure neural leprosy (PNL), which may be simpler and yet reliable. Aim: The aim of the study is to couple FNAC with ZN staining and multiplex PCR to diagnose pure neural leprosy patients rapidly, in simpler and yet reliable way. Methods: Thirteen patients of PNL as diagnosed by two independent consultants were included as case, and 5 patients other than PNL were taken as control in the study. Fine needle aspiration was done on the affected nerve, and aspirates were evaluated for cytology, ZN staining and multiplex- PCR. Results: Out of the 13 cases where fi ne needle aspiration was done, M. leprae could be elicited in the nerve tissue aspirates in 5 cases (38.4%) with the help of conventional acid-fast staining and 11 cases (84.6%) with the help of multiplex PCR. On cytological examination of the aspirates, only 3 (23%) cases showed specifi c epithelioid cells, whereas 8 (61.5%) cases showed non-specifi c infl ammation, and 2 (15.3%) cases had no infl ammatory cells. Conclusion: Our study demonstrates that in the fi eld of laboratory diagnosis of PNL cases, FNAC in combination with ZN staining for acid-fast bacilli (AFB) and Multiplex-PCR can provide a rapid and defi nitive diagnosis for the majority of PNL cases. FNAC is a less-invasive, outdoor-based and simpler technique than invasive nerve biopsy procedure. Thus, this study may enlighten the future path for easy and reliable diagnosis of PNL.

Citodiagnóstico en otorrinolaringología: diez años de experiencia en el Hospital Barros Luco Trudeau 2001 a 2010 / Citodiagnostic in otorhinolaryngology: ten years of experience in Barros Luco Hospital 2001 to 2010

Introducción: Dentro del estudio diagnóstico de pacientes con masa cervical la punción por aspiración con aguja fina (PAAF) es una herramienta útil debido a su facilidad y seguridad. Objetivo: Evaluar el rendimiento de las PAAF realizadas en nuestro servicio en los últimos diez años. Material y método: Estudio retrospectivo y descriptivo. Se obtuvieron los datos de pacientes sometidos a PAAF en el Servicio de Otorrinolaringología del Hospital Barros Luco Trudeau entre los años 2001 a 2010 y se correlacionaron con las biopsias definitivas atingentes. Resultados: Se realizaron 197 PAAF, de las cuales 140 (71%) fueron aptas para estudio citológico y 77 tenían biopsias concomitantes. Se obtuvo una sensibilidad de 46°%, especificidad de 85°%, valor predictivo positivo de 74°% y valorpredictivo negativo de 62°%. La localización para la cual se obtuvo un mejor rendimiento de la técnica fue para glándulas salivales y los diagnósticos con mejor rendimiento fueron carcinoma escamoso y tumor mixto. Discusión: La PAAFes una herramienta subutilizada. Obtuvimos una alta tasa de muestras insuficientes para estudio diagnóstico y, en nuestro medio, es útil para descartar neo-plasia maligna en masas de glándulas salivales y metástasis de carcinoma escamoso.

Introduction: Fine needle aspiration (FNA) is an useful tool for the diagnostic evaluation of patients with a cervical mass, because of its feasibility and safety. Aim: To determine the accuracy of FNA cytology in our hospital over the last ten years. Material and method: A retrospective and descriptive study. Data were obtained from patients undergoing FNA in the Department of Otolaryngology, Hospital Barros Luco Trudeau from 2001 to 2010 and compared with the corresponding histology report of the original surgical specimen. Results: A total of 197 FNA procedures were performed in 143 patients. A definite cytological diagnosis was made in 140 patients (71%%). 77 patients had corresponding histology samples. The sensitivity was 46%%, specificity 85%%, positive predictive value 74% and negative predictive value 62%. The location for which we obtained a better performance of the technique was in salivary glands and the best performing diagnosis was squamous cell carcinoma. Discussion: FNA is an underused diagnostic tool with a high rate of non diagnostic samples. It is useful to rule out malignancy in salivary gland masses and metastatic squamous cell carcinoma in lymph nodes.

Evaluation of suspicious thyroid nodules by fine needle aspiration technique

Fine needle aspiration [FNA] cytology was performed to diagnose and evaluate the accuracy of solitary thyroid nodule [STN]. Histopathology was used as gold standard to compare the results of FNA. The study included 180 patients [138 females and 42 males], from different Ministry Hospitals in Riyadh, Kingdom of Saudi Arabia [KSA] between January 2008 - June 2010. All cases were investigated and examined clinically and the final diagnosis was STN. The cases were operated and evaluated for histopathological findings. On FNA 138 patients [76.6%] had benign lesion, 25 patients [14%] showed unsatisfactory lesions and 17 patients [9.4%] had malignant lesions. On histopathology, 144 patients [80%] were confirmed to have benign lesions and 36 patients [20%] have malignant lesions. The commonest type of malignancy in FNA and histopathology was papillary carcinoma. The results of FNA compared to the histopathological results showed 80% sensitivity, 20% specificity, 10% positive predictive value, 90% negative predictive value and 26% diagnostic accuracy. FNA is a more sensitive technique than specific in detecting thyroid malignancy

Indications for endoscopic ultrasound and diagnosis on fine needle aspiration and cytology

To determine common indications for requesting Endoscopic Ultrasound [EUS] and to describe the diagnosis made after endoscopic ultrasound/Fine-Needle Aspiration and Cytology [FNAC] during two years at a tertiary gastrointestinal unit. Cross-sectional descriptive study. The study was carried out in Gastrointestinal Department of Military Hospital, Rawalpindi, from March 2006 to February 2008. One hundred and eighty nine patients who underwent EUS during study period at Military Hospital were included in the study. Patients too ill [hypoxemic/hypotensive] to undergo procedure safely and those with complete esophageal blockage at upper end by tumour not allowing scope/EUS probe to advance beyond were excluded. EUS was done with Olympus Exera EUS 160, linear or radial scope, as required. EUS findings were recorded against indications as enlarged lymph nodes, tumour, staging, normal or incomplete. Fine-Needle Aspiration [FNA] was done as per findings on EUS using 21-22 G needle. An on-site cytopathologist made the provisional cytopathological diagnosis. Final cytology/histopathology report was given after review of slides by consultant histopathologists at Armed Forces Institute of Pathology [AFIP], Rawalpindi, and were documented as tuberculosis, malignancy, chronic pancreatitis or reactive hyperplasia. Data was analyzed for documentation of patients' age, gender, common indications, findings on EUS/FNAC, using SPSS version 10. Percentages and frequencies were calculated for the presence of these above-mentioned variables. Of the 189 patients, 145 [77%] were male and 44 [23%] female. Age was 18-80 years [mean 49 years]. Major indications for referral were lymphadenopathy in 92 [49%], suspected growth pancreas in 57 [28%], growth of stomach in 20 [11%] and a heterogeneous group included esophageal, liver, retroperitoneal masses, rectal and other pathologies. Findings on EUS included lymphadenopathy in 76, mostly in sub-carina and AP window. Mass in pancreas was seen in 36, followed by stomach tumour in 17 and esophagus in 9. FNAC was done in 142 out of 189 patients. Final diagnosis out of 67 FNAC/histopathology of lymph nodes were tuberculosis in 26 and malignant lesions in 23. These included metastatic adenocarcinoma in 8, lymphoproliferative disorder in 7, metastatic squamous cell carcinoma in 5, small cell carcinoma in 2 and anaplastic in 1. Pancreatic tumours were adenocarcinoma in 16, poorly differentiated in 3 and neuroendocrine in 2. Stomach tumours were found in 11, and included lymphomas 5, GIST 3, carcinoids 2, metastatic choriocarcinoma 1 and adenocarcinoma in 1. Therapeutically, 3 celiac blocks and one pancreatic pseudocyst drainage was done. The main indication of EUS and pathology of mediastinal and celiac nodes were metastatic malignancy and tuberculosis. Pancreatic adenocarcinoma was another common cause for asking EUS

Biopsia por aspiración con aguja fina en lesiones mamarias: experiencia institucional / Fine needle aspiration biopsy of breast lesions: institutional experience

Background. With the advent of new diagnostic technologies and the fear of low diagnostic accuracy, there has been a reduction in the use of fine needle aspiration (FNA) for diagnosis of breast lesions. The objectives of the present study were to establish the diagnostic accuracy and complications associated with FNA of breast lesions. Material and methods. We retrospectively reviewed FNA of breast lesions done in a tertiary referral center in Mexico City from 1999 through 2001. We analyzed demographic, radiologic and pathological variables in order to establish diagnostic accuracy of FNA. The gold standard was considered the histopathologic study of the specimen or the clinical follow-up of benign lesions. Categorical variables were analyzed with the method and statistical significance was considered at p < 0.05. Results. We identified 300 patients with a mean age of 50 years (range, 20-86). Fifty-three percent were postmenopausal. In ninety-three percent of patients, FNA was performed in the outpatient clinic. Nonpalpable lesions were aspirated under ultrasound guidance. Mean size of the lesion was 2.27 cm (range 0.7-10 cm). Thirty-one percent of patients had definite diagnosis of malignancy. The only variables associated with cancer diagnosis were the BTRADS category and the presence of palpable adenopathy. Cancer was diagnosed in 6.5% of lesions categorized as BTRADS 0-3 compared to 56.2% for lesions BTRADS 4-5 (p < 0.0001). Positive predictive value and specificity of FNA were 100%. Sensitivity, negative predictive value and accuracy were 82.6%, 92.8% and 94.7%, respectively. The most common diagnosis of false negative lesions were lobular and papillary carcinomas. There were no significant complications associated with FNA. Conclusions. Diagnostic accuracy of FNA for breast lesions is very high with minimal complications. Positive predictive value of 100% allows to establish therapy based on its results.

Antecedentes. El advenimiento de nuevas tecnologías diagnósticas, así como el temor a baja exactitud diagnóstica, han reducido el papel de la biopsia por aspiración con aguja fina (BAAF) en lesiones mamarias. El objetivo del presente estudio fue el establecer la exactitud diagnóstica y complicaciones de la BAAF en esta indicación. Material y métodos. Estudio retrospectivo de BAAF de lesiones mamarias realizadas en nuestra institución de 1999 a 2001. Se analizaron variables demográficas, radiológicas e histopatológicas para establecer la exactitud diagnóstica. Se definió como estándar diagnóstico al análisis histopatológico del tejido o bien al seguimiento clínico en caso de lesiones benignas dejadas para observación. Las variables categóricas se analizaron con la prueba de . Se estableció como significativa a una p < 0.05. Resultados. Fueron identificados 300 pacientes con una edad promedio de 50 años (20-86). Fueron posmenopáusicas 53.3%. En 93.3% de los casos se realizó BAAF de lesión clínicamente palpable y en el resto de una lesión visible por ultrasonido. El tamaño promedio de la lesión fue de 2.27 cm (0.7-10 cm). De las pacientes, 30.7% tuvieron diagnóstico definitivo de lesión maligna. Las únicas variables asociadas al diagnóstico de cáncer fueron la clasificación radiológica de BI-RADS y la presencia de adenomegalias palpables. La incidencia de cáncer en pacientes con BI-RADS de 0 a 3 fue de 6.5% vs. 56.2% en aquellas con BI-RADS 4 o 5 (p < 0.0001). Tanto el valor predictivo positivo como la especificidad de la BAAF fueron de 100%, con una sensibilidad de 82.6% y valor predictivo negativo de 92.8%, para una exactitud diagnóstica de 94.7%. Las causas más frecuentes de falsos negativos fueron el carcinoma lobulillar infiltrante y el carcinoma papilar. No se presentaron complicaciones significativas en ningún caso asociadas con la BAAF. Conclusiones. La exactitud diagnóstica de la BAAF en lesiones mamarias es muy elevada, con una incidencia mínima de complicaciones. Un valor predictivo positivo de 100% permite basar la terapéutica en sus resultados. El diagnóstico de benignidad por BAAF permite el seguimiento seguro de lesiones mamarias.

Comparative study between multihole and conventional fine-needle aspiration cytology of head and neck masses as regard diagnostic efficacy and cost effectiveness

This research demonstrated a randomized study comparing diagnoses obtained using both types of needles in FNA biopsies of head and neck masses to determine whether the specimen from fine-needle aspiration [FNA] biopsy of head and neck masses has greater diagnostic accuracy when using multihole needles, rather than using the conventional needles. Eighty-eight [88] patients had [91] FNA biopsies with both multihole and single-hole, 22-gauge needles. Biopsies were randomized and were unknown to the cytopathologist. No statistically significant differences were noted in quantity of specimen material obtained quality of fixation. There was a great difference and diagnostic value between the multihole and the conventional fine needle. It was found that the multihole needle in FNA biopsy of head and neck masses provide more advantages in such masses, but with a greater cost than the conventional needles

Comparative evaluation of grading of breast carcinomas in fine needle aspirates by two methods.

BACKGROUND & OBJECTIVES: Fine needle aspiration (FNA) material is increasingly being used to determine various prognostic parameters in patients with carcinoma breast. It was recommended that cytological grading should be part of all FNA reports of breast carcinoma so that preoperative prognostication could be done on it. However, the most reliable method for cytological grading that closely reflects the most widely used histological grading system is yet to be determined. This study was undertaken to compare results of two cytological grading methods to see which corresponded better to the histological grade. METHODS: In a double-blind study, cytological grading of 52 patients with breast carcinoma was carried out using two different grading systems (Robinson's and Mouriquand's methods) and the grades compared with the histological grading to find out which reflected histological grades more closely. RESULTS: By Robinson's method 28.8, 46.2 and 25 per cent aspirates were graded as I, II and III respectively. Using Mouriquand's grading 9.6, 69.2 and 21.2 per cent aspirates were graded correspondingly. Comparison of the two methods showed a concordance in 40 (76.9%) cases. Both cytological grading systems showed a concordance of 71.2 per cent with the histological grading. Robinson's cytological grading showed a diagnostic accuracy of 80.76 per cent with 77.77 per cent specificity while Mouriquand's method had an accuracy of 84.60 per cent with 33.33 per cent specificity. INTERPRETATION & CONCLUSION: Though the Robinson's and Mouriquand's grading systems were found to have similar concordance with histological grading, Robinson's method was considered better because of its simplicity, and specificity.

Correlation between serum levels of triiodothyronine [T[3]] and thyroxin [T[4]] and severity of clinical manifestations of uncontrolled thyrotoxicosis

The present study was carried out on 30 patients with uncontrolled thyrotoxicosis. Twenty seven patients [90%] were female and three [10%] were male. Their ages ranged between 17 and 56 years with a mean age of 36.6 years. Results revealed a significant correlation between the mean serum level of total triiodothyronine [TT3] and some, but not all, symptoms and signs of thyrotoxicosis. No significant correlation was found with respect to total thyroxin [TT4] level. A significant direct positive correlation was found between Wayne's score and the serum levels TT3 and TT4 [p<0,05]. An inverse relationship existed between serum levels of thyroid stimulating hormone [TSH] and those of TT3 and TT4 [p<0.05]. Fine needle aspiration cytology [FNAC] was not conclusive in pre-operative diagnosis of the disease as compared to post-operative paraffin section biopsies