A method of teaching fine needle aspiration biopsy of the thyroid gland.

OBJECTIVE: To design an in vitro method of teaching the technique of fine needle aspiration biopsy of the thyroid gland. STUDY DESIGN: A "resuscitation" manikin is used to simulate an adult patient and a thyroid gland is placed on the manikin. RESULTS: The gland can be examined and aspirated. Subsequent microscopic evaluation permits the correlation of aspiration technique and specimen adequacy. CONCLUSION: This in vitro method should shorten the learning process for a novice aspirator and may help reduce the rate of inadequate specimens.

Fine needle aspiration cytology of fibrous hamartoma of infancy.

BACKGROUND: Fibrous hamartoma of infancy (FHI) is an uncommon, benign lesion with a distinctive histologic appearance, usually occurring as a small, rapidly growing soft tissue swelling developing in the first two years of life. Apart from one publication, there appear to be few descriptions of the fine needle aspiration biopsy (FNAB) features of this lesion. Detailed information on the clinical and FNAB findings in a patient with FHI is presented. CASE: An 8-month-old female had a firm mass on the posterior aspect of the arm. FNAB produced smears that displayed moderate cellularity, loosely lying and clustered fibroblastic-appearing cells, fatty tissue and collagenous material without evidence of significant nuclear atypia or mitoses. CONCLUSION: In the appropriate clinical setting, if the pathologist performing the microscopic evaluation can be confident that all the tissues with features as described are exclusively from the nodule, it is likely that a confident diagnosis of FHI can be made.

Fine needle aspiration biopsy of superficial sites in patients with hemostatic defects.

OBJECTIVE: To ascertain the incidence and types of complications of fine needle aspiration biopsies (FNABs) of superficial sites in patients with uncorrected congenital or acquired hemostatic defects. STUDY DESIGN: All patients with hemostatic defects who were seen in a community-based, private fine needle aspiration and medical laboratory practice were identified. Prospectively and retrospectively collected data concerning complications, biopsy findings and laboratory data on the hemostatic defects were collated and analyzed. RESULTS: Twenty-one patients encountered over a period of about nine years were identified. Warfarin sodium therapy was the most common cause of a hemostatic defect (12 patients), and lymph nodes were the most often aspirated structure (7 patients). Other than a small echymosis in one patient, there were no complications. CONCLUSION: FNAB of superficial sites using the technique described is a safe procedure in patients with uncorrected hemostatic defects.

Pathology of APUDomas.

The pathology of APUDomas involves two main areas. The first is the biochemical aspects of these tumours and the use of biochemical tests to investigate a patient suspected of having an APUDoma, and the other is the histopathology of these tumours. This review is devoted to the histopathological considerations.

Tuberculous fasciitis and tenosynovitis. An unusual presentation of miliary tuberculosis.

A case of miliary tuberculosis presenting initially as pyogenic fasciitis and tenosynovitis is described. The unusual presenting clinical features suggestive of a noninfectious inflammatory condition resulted in delayed diagnosis. Tuberculous fasciitis and tenosynovitis were diagnosed by the presence of acid-fast bacilli in histopathologic sections and confirmed by the growth of Mycobacterium tuberculosis from cultures of tissue specimens.

Intramammary lymph nodes.

AIMS: To determine the prevalence and pathology of intramammary lymph nodes in breast specimens. METHODS: All breast specimens examined by a single pathologist over 70 months in a large teaching hospital were studied retrospectively. All the surgical pathology reports were reviewed. Relevant glass slides from cases in which intramammary lymph nodes were identified were also reexamined. RESULTS: Breast specimens (n = 682) were examined. Seven lymph nodes were found in five patients. The specimens comprised 533 biopsy specimens, 29 segmental resections, 22 reduction mammoplasties, 77 modified radical mastectomies and 20 gynecomastia mastectomies. No clinically relevant microscopical abnormalities were found in four lymph nodes and slight sinus histiocytosis was seen in two nodes. One node contained metastatic adenocarcinoma and benign glandular epithelial inclusions. CONCLUSION: Although rare, intramammary lymph nodes may be detected by careful gross examination of breast specimens even in the absence of clinical identification. They can occur in any quadrant of the breast and can display a variety of pathological conditions. Pathologists should be alert to the existence and potential importance of these lymph nodes.

The histopathology of rectosigmoid biopsies from adults with bloody diarrhea due to verotoxin-producing Escherichia coli.

The histopathology of rectosigmoid biopsies from 20 patients with bloody diarrhea resulting from verotoxin-producing Escherichia coli infection is reported. The biopsies displayed a range of appearances, from normal to mild, nonspecific inflammation to acute infectious-type colitis. Surface-adherent or invasive bacteria were not identified. The morphologic features of infectious colitis and the absence of bacteria suggest that verotoxin may be responsible for the pathologic changes.