Fine-needle aspiration diagnosis of hydatid cyst.

The diagnosis of hydatid disease outside endemic areas is usually not suspected. Hydatid cysts in imaging studies can be confused with hepatic tumors, abscesses, cystadenomas, liver cysts or other lesions. Serology is the usual confirmatory test, but cytologic diagnosis has been described. Aspiration of the cysts has not been employed as a routine diagnostic method for fear of spillage and anaphylactic reactions. We report a case of unsuspected hepatic echinococcosis that was confirmed by fine-needle aspiration of the lesion and cytologic confirmation without complications.

Comparison of the endocervical brush and the endocervical curettage for the evaluation of the endocervical canal.

OBJECTIVE: To evaluate and compare the efficacy in obtaining an adequate endocervical sampling using the endocervical brush and the endocervical curettage. METHODS: Analysis of the cytology and histology of samples obtained from patients referred to the University of Puerto Rico School of Medicine Tertiary Care Center Anaplasia Clinics for colposcopy due to an abnormal Pap smear having atypical cells or higher as classified according to the Bethesda System. All patients underwent evaluation of the endocervical canal with an endocervical brush and an endocervical curettage. RESULTS: Fifty three of fifty-eight patients had correlating endocervical brush Papanicolaou smear and endocervical curettage. Only five patients presented discrepancies. All endocervical brush samples had sufficient tissue for diagnosis. CONCLUSION: The endocervical curettage is operator dependent, is difficult to perform in patients with a stenotic cervical os or in menopausal patients. The endocervical brush is easier to use, malleable and has a lower processing cost. In view of these findings evaluation of the endocervix can be safely performed with the use of an endocervical brush. When used properly, the endocervical brush has a sensitivity of 90%, a specificity of 92.1% and a positive predictive value of 87.5%.

Fine needle thyroid aspiration: university hospital experience.

Fine needle thyroid aspiration (FNTA) as a diagnostic tool of thyroid disease was started at the University District Hospital (UDH) in 1983. FNTA was performed in 54 willing patients from December 1984 through December 1985. If no medical contraindications existed, thyroid surgery was recommended in order to assess diagnostic accuracy. Surgery was done in 34 (63%) patients; while not in 20:3 for medical reasons, 2 lost to follow-up, 3 refused, 7 had inappropriate FNTA, and 5 for unknown reasons. None had complications to FNTA. Cytology was classified as Class O: inadequate; Class 1: benign; Class 2: indeterminate; and Class 3: malignant. "Non-benign" cytology was obtained in 14 patients: 7 indeterminate (class 2) and 7 malignant (class 3). Four of these had carcinoma confirmed by surgery. Of the 19 with benign FNTA (class 1) only one has thyroid carcinoma. One patient had inadequate sample (Class O). The sensitivity was 80%, specificity 65%, and diagnostic accuracy 67%. All these statistical values are within the range reported in fifteen reviewed series. Thus, FNTA at UDH had a diagnostic value comparable to that described in the literature. It may be utilized as a safe, reliable tool complementary to clinical data in order to reduce the amount of unnecessary thyroid surgery, carry out earlier diagnoses of malignant nodules and increase the yield of carcinoma among those operated.