ABSTRACT
OBJECTIVE: To evaluate the diagnostic accuracy of a modified scrape cell block (SCB) technique in a large series of patients. The technique was especially developed and tested for fine-needle aspiration of thyroid and parathyroid nodules. STUDY DESIGN: Eighty-two ultrasound-guided fine-needle aspiration specimens with the sonographic aspect of a thyroid (n = 33) or a possible parathyroid nodule (n = 49) were studied. Immunohistochemistry (IHC) was used on cell blocks containing plasma, thromboplastin, and selected 3-dimensional cell aggregates scraped off Papanicolaou-stained smears. Antibodies for chromogranin A, thyroglobulin, parathyroid hormone, calcitonin, and carcinoembryonic antibody (CEA) were used. In cases of reduced immunosensitivity or suspected metastases or rare primary tumors, additional IHC markers were employed. RESULTS: Chromogranin A was expressed in all 28 parathyroid adenomas (PA), in 7 of 8 hyperplastic parathyroid glands, and in 13 of 14 medullary thyroid carcinomas (MTC). When combining positivity for chromogranin A and calcitonin/CEA, the specificity for the detection of MTC was 100%. Parathyroid hormone was expressed in 26 of 36 parathyroid nodules (72.2%). When combining follicular microarchitecture and expression of chromogranin A, the specificity for the detection of parathyroid tissue was 97%. CONCLUSION: With the modified SCB technique, accurate cytological diagnoses were obtained in 97.6% of 82 patients.
Subject(s)
Parathyroid Glands/pathology , Thyroid Gland/pathology , Thyroid Nodule/diagnosis , Thyroid Nodule/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Fine-Needle/methods , Calcitonin/metabolism , Carcinoma, Medullary/diagnosis , Carcinoma, Medullary/metabolism , Carcinoma, Medullary/pathology , Carcinoma, Neuroendocrine/diagnosis , Carcinoma, Neuroendocrine/metabolism , Carcinoma, Neuroendocrine/pathology , Child , Chromogranin A/metabolism , Female , Humans , Immunohistochemistry/methods , Male , Middle Aged , Parathyroid Glands/metabolism , Parathyroid Hormone/metabolism , Thyroglobulin/metabolism , Thyroid Gland/metabolism , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/metabolism , Thyroid Neoplasms/pathology , Thyroid Nodule/metabolism , Young AdultSubject(s)
Bone Diseases, Metabolic/diagnosis , Bone Diseases, Metabolic/surgery , Dermatologic Surgical Procedures/methods , Ossification, Heterotopic/diagnosis , Ossification, Heterotopic/surgery , Scalp Dermatoses/diagnosis , Scalp Dermatoses/pathology , Scalp Dermatoses/surgery , Skin Diseases, Genetic/diagnosis , Skin Diseases, Genetic/surgery , Aged , Diagnosis, Differential , Humans , Male , Treatment OutcomeABSTRACT
Gastrointestinal stromal tumours (GISTs) are fairly rare neoplasms, constituting less than 3 % of all gastrointestinal malignancies. The integration of molecularly targeted treatment regimes (i.e., tyrosine kinase inhibitors) in clinical oncology has revolutionized the management of patients with irresectable GISTs or metastatic disease. Malignant GISTs usually display increased glucose metabolism and therefore (18)F-fluorodeoxyglucose (FDG) uptake within the scope of positron emission tomography (PET) scans. Nowadays, dual-modality FDG PET/CT (computed tomography) imaging is of considerable value in diagnostic work-up of patients with GISTs acquiring functional and anatomic information simultaneously. The following article sheds light on the impact of FDG PET and combined FDG PET/CT imaging in initial disease evaluation, detection of tumour recurrence and the early assessment of treatment response to molecularly targeted agents such as imatinib mesylate or sunitinib maleate.
