ABSTRACT
METHODS: Personal experience with fine-needle aspiration biopsy (FNAB) performed in 114 patients (42 males and 72 females) with hepatic angiomas, in whom imaging techniques did not allow a definite diagnosis, is reported. FNAB was made on 57.9% of the cases for atypical US pattern of the nodule, on 52.6% for a previous cancer history, with both conditions on 10.5%. The procedure was carried out by cyto-assistance for collecting material and a rapid stain diagnosis with an average of 2 biopsies per patient. Diagnostic accuracy was evaluated with following laparoscopy in 25 cases; surgery in 4 cases; angiography in 6 cases and US follow-up for 1 year at least in 78 cases (1 drop-out). RESULTS: One false-negative and 4 false-positives were detected with an overall accuracy of 96%. Two minor accidents were observed, due to a profuse bleeding of giant angiomas and resolved with medical care. CONCLUSIONS: Therefore, in case of angiomas larger than 5 cm, the use of laparoscopy after FNAB to control the bleeding and to confirm the diagnosis is suggested.
Subject(s)
Biopsy, Needle/methods , Hemangioma/pathology , Liver Neoplasms/pathology , Liver/pathology , Ultrasonography, Interventional , Biopsy, Needle/adverse effects , Biopsy, Needle/instrumentation , Biopsy, Needle/statistics & numerical data , Cytodiagnosis , Female , Follow-Up Studies , Hemangioma/diagnostic imaging , Humans , Liver/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Male , Middle Aged , Risk Factors , Sensitivity and SpecificityABSTRACT
The authors report their experience from 136 fine needle ultrasound (FN-US)-guided biopsies and laparoscopies. The pancreatic diseases considered by these methods were as follows: 9 cases of Pancreatitis, 11 cases of Pancreatic cysts, 5 cases of endocrine cancer, 109 cases of Exocrine cancer and 2 not conclusive cases. Diagnostic accuracy of FNB and laparoscopy was evaluated for each group and, in particular, for cancer patients. In the latter group, FNB helped to detect abdominal diffusion in 25 cases (33%) while laparoscopy, including laparoscopic washing, revealed a micro-diffusion in 31 cases (55%), the latter not shown previously by CT, RNM and US. The combination of these methods allows us to confirm the advanced stage of the majority of pancreatic cancers at onset. Furthermore, this seems to be a very reliable method to select resectable patients, thus avoiding useless, sometimes hazardous and expensive further investigation.
Subject(s)
Pancreatic Diseases/diagnostic imaging , Pancreatic Diseases/diagnosis , Biopsy, Needle , Diagnosis, Differential , Female , Humans , Laparoscopy , Male , Middle Aged , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/diagnostic imaging , UltrasonographyABSTRACT
From May 1988 to June 1990, 260 patients with abdominal focal disease underwent ultrasonically guided percutaneous fine needle biopsy. The technique of so-called "FNAB-CYT" is described. The procedure entailed very few complications: the mortality rate was 0% and the morbidity rate was 1.5%. The specificity of the technique was 100%, and sensitivity was 93.43%. False-negative diagnoses were made in 8 cases, and in 5 patients the cytologic diagnoses were uncertain. There were no false-positives. The possibility of an immediate control of the collected material by the pathologist avoids the risk of inadequate samples and reduces the number of biopsies for the patient. Comparison among diagnoses on rapid and definitive preparations and histologic ones was carried out to evaluate the diagnostic efficiency of the cytologic procedure. In our experience, a rapid staining of the smears allowed a correct cytologic diagnosis in 87.7% of the cases within approximately 5 min of the biopsy. On the basis of our experience, the authors recommend FNAB-CYT as a routine first-level (less invasive) procedure for diagnosis of abdominal focal disease.