Clinical value of DNA image cytometry in effusions with atypia.

Malignant cells in serosal effusions provide essential information about the extent of malignant disease. The main aim of this study was to examine the additional diagnostic value of DNA image cytometry for cases with uncertainty in the cytological diagnosis. In addition, the feasibility of automated nuclei detection was investigated. Out of 457 cases, 33 samples in 32 patients were diagnosed with "atypia" (probably benign) and 21 as "suspicious for malignancy." DNA image cytometry was performed on these 54 cases and on an additional group of 14 cytologically malignant cases. The results show that automatic classification is useful for separation of control cells, i.e., lymphocytes and neutrophilic granulocytes from other mononuclear cells. In 21 cases an insufficient number of control cells were measured. Seventy-two percent of the cytologic malignant cases were aneuploid. In contrast, in none of the cases with "atypia" and in only 2 of the cases "suspicious for malignancy" was aneuploidy present (2 of the remaining 32, 6%). From the cases with follow-up, a malignancy in the pleural fluid was present in 2 out of 17 cases with "atypia" and in 5 out of 10 with a "suspicious for malignancy" cytologic diagnosis, respectively. In conclusion, the additional diagnostic value of DNA image cytometry in cases with a cytological diagnosis of "atypia" or "suspicious for malignancy" is limited. Diagn. Cytopathol. 1999;21:112-116.

Fine needle aspiration cytology of inflammatory pseudotumor of the lung (plasma cell granuloma). Report of four cases.

The fine needle aspiration (FNA) cytologic findings in four cases of inflammatory pseudotumor of the lung are described. Histologic material was available for comparison in three of the four cases. FNA of these lesions usually yielded moderately to poorly cellular smears. The smears showed a mixture of chronic inflammatory cells and tissue fragments, without a predominance of plasma cells. Characteristic cytologic findings were not observed. The cytologic findings can be distinguished from those of other circumscribed benign and malignant lesions, however. The diagnosis of an inflammatory pseudotumor of the lung may be suggested by a combination of roentgenographic (a localized density) and FNA findings, which may justify a more conservative surgical approach.

A comparison of high-frequency oscillation superimposed onto backup mechanical ventilation and conventional mechanical ventilation on the distribution of exogenous surfactant in premature lambs.

Twenty-six premature lambs were treated by tracheal instillation of [14C]labeled natural sheep surfactant before the onset of breathing or after the establishment of respiratory distress syndrome 30 min after birth. Half of both groups were subsequently ventilated for 3 h with 100% O2 by conventional mechanical ventilation (CMV) and half by high frequency oscillation superimposed onto backup mechanical ventilation (HFOV). Mean airway pressure, arterial blood pressures, and heart rate were recorded continuously. Arterial blood gases and pH were obtained every 15 min. After sacrifice, the distribution of radiolabeled surfactant was quantified and alveolar expansion was evaluated by morphometrics. At comparable oxygenation, mean airway pressures were significantly lower in the lambs treated with surfactant at birth (groups CMV-B and HFOV-B) than in lambs on CMV and treated with surfactant during RDS (group CMV-R). Mean airway pressures in both groups of lambs on HFOV (groups HFOV-B and HFOV-R) were comparable at values lower than in group CMV-R and higher than in group CMV-B. The distribution of radiolabeled surfactant was more homogeneous in lambs treated at birth and not different for both types of ventilatory assistance. Morphometrics demonstrated significantly better expansion of the alveoli of lambs ventilated with HFOV than of those on CMV, irrespective of the timing of surfactant administration. These results indicate that prophylactic surfactant administration at birth leads to a better distribution of surfactant than rescue treatment with surfactant after the establishment of respiratory distress syndrome and is not affected by a subsequent type of ventilatory assistance.(ABSTRACT TRUNCATED AT 250 WORDS)