ABSTRACT
The preparation and use of an alternate collection device for aspiration biopsy of the prostate is presented. The device is inexpensive and can be constructed from readily available office materials. Its use in conjunction with a liquid-phase collection of cellular products of aspiration biopsy by a backwash technique is described. Following this, a brief discussion of pattern recognition in cytological preparations of benign and malignant prostate epithelial aggregates is presented and illustrated.
Subject(s)
Biopsy, Needle , Prostate/pathology , Prostatic Neoplasms/pathology , Biopsy, Needle/instrumentation , Biopsy, Needle/methods , Cytodiagnosis , Epithelium/pathology , Fixatives , Humans , Male , Prostatic Neoplasms/diagnosisABSTRACT
Aspiration biopsy is a rapid and relatively painless technique for evaluating an abnormal prostate gland. It can be performed on outpatients without anesthesia and is easily tolerated. It sensitivity in detecting cancer is at least equivalent to that of core biopsies, in part because several areas of the prostate may be sampled in a relatively atraumatic fashion. Few complications are encountered. Adequate performance of aspiration biopsy of the prostate requires experience and diligence, both by the urologist, in obtaining adequate specimens, and by the processing laboratory and pathologist, in interpreting these specimens. It is hoped that aspiration biopsy will lead to the early diagnosis of prostatic cancer, effecting lower morbidity, reduced hospital cost, greater ease in performing radical prostatectomy, and more accurate techniques for predicting the prognosis in affected patients.
Subject(s)
Biopsy, Needle , Prostate/pathology , Prostatic Hyperplasia/pathology , Prostatic Neoplasms/pathology , Prostatitis/pathology , Biopsy, Needle/adverse effects , Biopsy, Needle/methods , Diagnosis, Differential , Humans , Male , Specimen HandlingABSTRACT
Aspiration biopsy of the prostate is contraindicated when active prostatitis is present. However, we have found prostatitis in 45.2 percent of 250 consecutive aspiration biopsy specimens, confirming that urologists have difficulty in distinguishing prostatitis from carcinoma on a clinical basis. The epithelial changes accompanying prostatitis also may be confused with carcinoma. We review the microscopic features which distinguish prostatitis from carcinoma. Because 14.1 percent of the patients with prostatitis in this study also had carcinoma, repeat follow-up biopsy is necessary if suspicion of carcinoma persists after adequate therapy for prostatitis.
Subject(s)
Prostate/pathology , Prostatitis/diagnosis , Biopsy, Needle , Carcinoma/diagnosis , Carcinoma/pathology , Diagnosis, Differential , Epithelium/pathology , Granuloma/diagnosis , Granuloma/pathology , Humans , Male , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/pathology , Prostatitis/pathologyABSTRACT
A perceived disadvantage of fine-needle aspiration biopsy of the prostate is that aspiration biopsies cannot be correlated with current tissue-grading systems. We compared patterns of cellular arrangement among 50 cases of prostate carcinoma studied in histologic and cytologic specimens obtained simultaneously. Cell patterns were independently scored in a semiquantitative fashion on both histologic and cytologic material, and "predicted Gleason scores" were assigned to the cytologic specimens. When carcinomas were classified as well differentiated (Gleason score 2 to 4), moderately differentiated (Gleason score 5 to 7), or poorly differentiated (Gleason score 8 to 10), there was 84 per cent agreement between histology and cytology. In no instance was there overlap between well-differentiated and poorly differentiated adenocarcinoma in the matched specimens. We believe that it is possible to accurately predict tissue patterns of prostate carcinoma and to estimate Gleason scores in aspiration biopsy specimens.
Subject(s)
Adenocarcinoma/pathology , Biopsy, Needle , Cytological Techniques , Prostatic Neoplasms/pathology , Adenocarcinoma/diagnosis , Diagnosis, Differential , Humans , Male , Prognosis , Prostatic Neoplasms/diagnosisABSTRACT
The history of needle biopsy is outlined from the early 19th century when the first use of needles for biopsy was recorded. The development of aspiration biopsy, largely at Memorial Hospital in New York in the 1930s, followed by its virtual disappearance in the 1940s and 1950s, and its reemergence in the 1960s, is traced. Special attention is given to the history of aspiration biopsy of the prostate from its origins up to the present day.
Subject(s)
Biopsy, Needle , Neoplasms/pathology , Prostatic Neoplasms/pathology , Cytodiagnosis , History, 19th Century , History, 20th Century , Humans , MaleABSTRACT
Reactions to contrast material during retrograde pyelography are rare. Two cases are reported, and the literature is reviewed.
Subject(s)
Drug Hypersensitivity , Iothalamate Meglumine/adverse effects , Mesylates/adverse effects , Urography , Adult , Female , Humans , Male , Middle AgedABSTRACT
In a study of 30 patients with hypernephromas, 23 patients manifested systemic effects of the tumor, and in 5 of these, the systemic effects were the presenting feature that led to the diagnosis. In contrast to this, only 17 patients had urologic complaints, and no single patient in this study had the classic triad of hematurial, loin pain, and mass. Weight loss (52 per cent), pyrexia, and elevated sedimentation rate (36 per cent) were seen most frequently. Anemia was seen in 25 per cent of patients. Other features seen in this group wer abnormalities in liver function, elevated alkaline phosphatase, hypertension, erythrocytosis, and hypercalcemia. In the majority of instances, removal of tumor was associated with remission of these effects. The effects were classified as those of a general toxic nature, those due to normal or abnormal production of hormones, and those due to production of abnormal substances by tumor cells. The evaluation of these effects was useful in making an early diagnosis and in follow-up care.
