乳腺恶性淋巴瘤细针吸取细胞学诊断

目的讨论细针吸取细胞学诊断乳腺恶性淋巴瘤病例的细胞形态学特征，鉴别诊断和诊断价值。（方法）对7例患者的临床、病理及细胞学资料进行回顾性分析。（结果）在4918例乳腺肿瘤病例中，发现7例恶性淋巴瘤，占乳腺恶性肿瘤的1．08％（7／647）。7例均为非何杰金淋巴瘤，对照分析其细胞学、组织学及超微结构等形态学表现，证明细胞学结果是可靠的。（结论）细针吸取细胞学诊断乳腺恶性淋巴瘤具有安全、方便和可重复性等优点，诊断时需与良性淋巴组织增生、小细胞未分化癌和具有浆细胞样特征的腺癌鉴别。     

Cytomorphologic Patterns of Breast Lesions in Sudanese Patients: Lessons Learned from Fine Needle Aspiration Cytology

Background: Cytology for breast lesions is a safe, rapid and cost-effective with a high specificity and sensitivity.Objective: To determine the cytomorphologic patterns of breast lesions identified among a group of Sudanesepatients. Materials and Methods: This study included 759 patients undergoing either a fine needle aspirationFNA, nipple discharge (ND) smears or breast skin scraping (SS) at a cytology clinic in Khartoum. Clinical anddemographic data were reviewed. Stained smears were categorized into: inadequate sample, normal breast,benign lesion, suspicious, or malignant neoplasm. Results: Of the 759 cases, 734 (96.71%) were FNA, 18 (2.37%)ND and 7 cases (0.92%) SS. For 28 cases, FNA was done under ultrasound guidance. Females were 720 (94.86%).Benign lesions were 423 (55.75%) and 248 (32.67%) were malignant and 77 (10.14%) of smears were normalwithout any detected abnormality. Ten (1.31%) cases were suspicious for malignancy, and only one case (0.13%)was reported as inadequate. Most lesions were observed among the age group 30 years and above. Conclusions:Most patients investigated have benign lesions, one third of cytological smears were malignant. FNAC is a usefultool for investigating breast lesions in limited-resource settings.     

针刺快速细胞学诊断在肺及纵隔肿瘤手术中的应用

目的：探讨细针穿刺细胞学诊断在肺及纵隔肿瘤手术中的应用价值。方法：对79例肺部肿块、12例纵隔肿瘤术中应用细针穿刺细胞学诊断，并与术后病理结果对照。结果：肺部肿块细胞学诊断准确率为97．5％（77／79），细胞类型诊断准确率为93％（55／59），纵隔肿瘤细胞学诊断准确率为100％。结论：对未定性的肺及纵隔肿瘤本操作具有容易、安全，快速和无非发症的优点，可避免盲目进行扩大肺组织切除，尽最大限度保留健康肺组织。     

乳腺肿物细针穿刺细胞学诊断的研究

目的　对细针穿刺细胞学诊断在乳腺肿物穿刺中的应用进行评价。方法　细针穿刺乳腺触及到实变处肿物吸取组织细胞涂片 ,采用瑞氏 -姬姆萨复合染色 ,显微镜下观察细胞排列、结构、背景特点、细胞形态等方面对乳腺肿物良恶性判定 ,并与病理组织学诊断进行对比分析。结果　乳腺肿物 3 3 2 5例细针穿刺 ,总准确率为 98 1% ;65 5例乳腺癌的诊断准确率为 10 0 % ;在部分良性病例 (乳腺纤维腺瘤 )的诊断准确率为 88% ;疑癌 94% ,描述性报告 7%确诊为乳腺癌。结论　细针穿刺细胞学诊断对于临床诊断良恶性病变有独到价值。且对恶性病例诊断更为可靠。此诊断技术简便 ,费用低 ,值得推广应用。     

323例乳腺肿块针吸细胞学诊断分析(英文)

目的探讨乳腺癌针吸细胞学(FNAC)诊断准确性。方法分析1326例乳腺肿块针吸细胞学诊断,并与323例手术后病理组织学诊断结果对比。结果本组 FNAC 诊断敏感性为97.1%,特异性为97.3%,假阳性率为2.7%,假阴性率为2.9%,诊断符合为97.2%。结论乳腺肿块 FNAC 检查是一种实用价值很高的诊断方法。文中对影响 FNAC 诊断的因素进行了讨论。     

323例乳腺肿块针吸细胞学诊断分析

目的 探讨乳腺癌针吸细胞学(FNAC)诊断准确性。方法 分析1326例乳腺肿块针吸细胞学诊断,并与323例手术后病理组织学诊断结果对比。结果 本组FNAC诊断敏感性为97.1％,特异性为97.3％,假阳性率为2.7％,假阴性率为2.9％,诊断符合为97.2％。结论 乳腺肿块FNAC检查是一种实用价值很高的诊断方法。文中对影响FNAC诊断的因素进行了讨论。     

Accuracy of Fine Needle Aspiration Cytology in Head and Neck Masses

In ENT clinical practice patients with neck swelling is a common presentation. To know their exact nature a simple, sensitive and diagnostic tool is required to prevent unnecessary costlier investigation and corresponding treatment. Fine needle aspiration cytology (FNAC) is a very safe, sensitive and diagnostic tool. This study was done to know the diagnostic accuracy, sensitivity and specificity of the FNAC in head and neck masses. Present prospective study was done in 179 patients of head and neck masses which were subjected to FNAC and their results were later correlated with histopathological examination report (HPR) wherever available. Out of 179 FNAC, HPR available only in 152 cases. In present study 104 cases (58.10 %) of lymph node, 35 cases (19.55 %) of thyroid gland, 17 cases (9.49 %) of salivary gland, 12 cases (6.70 %) of soft tissue and 11 cases (6.14 %) of miscellaneous swellings were present. The sensitivity, specificity, positive predictive value and negative predictive value of present study were 81.8, 95.0, 81.8 and 95.0 % respectively. The accuracy was 92.10 %.     

针吸细胞学诊断恶性骨肿瘤93例分析

目的：为了探讨针吸细胞学在恶性骨肿瘤诊断中的价值。方法;对９３例Ｘ线片显示溶骨性破坏的病例,回顾性分析术前针吸细胞学与术后组织学诊断。结果;恶性肿瘤诊断符合率为８３．８７％,假阴性率１６．１３％,无假阳性。在诊断符合的７８例中,分型诊断符合率７５．６４％。：结论;针吸细胞学是一种简便,安全,快速诊断恶性骨肿瘤的重要方法。     

涎腺上皮性肿瘤针吸细胞学检查

目的 :探讨涎腺上皮性肿瘤的细胞学特征,以提高针吸细胞学确诊率。 方法 :对253例有组织学对照的涎腺上皮性肿瘤细针吸取细胞学诊断标本进行分析。 结果: 针吸细胞学诊断涎腺上皮性肿瘤的总准确率为95.7%,其中良性准确率为98.1%(203/207例),恶性准确率为84.8%(39/46例)。同一类型的涎腺上皮性肿瘤中常有不同的细胞学特征,少数高分化涎腺癌可呈良性细胞学表现。 结论: 针吸细胞学对涎腺上皮性肿瘤的诊断具有较好的敏感性和特异性,镜下缺乏组织学结构及针吸成分少是造成误诊的主要原因。     

Diagnostic Accuracy of Fine Needle Aspiration Cytology versus Concurrent Core Needle Biopsy in Evaluation of Intrathoracic Lesions: a Retrospective Comparative Study

Background: Transthoracic fine needle aspiration (FNA) cytology and core needle biopsy (CNB) are twocommonly used approaches for the diagnosis of suspected neoplastic intrathoracic lesions. This study comparedthe diagnostic accuracy of FNA cytology and concurrent CNB in the evaluation of intrathoracic lesions. Materialsand Methods: We studied FNA cytology and concurrent CNB specimens of 127 patients retrospectively, usinghematoxylin and eosin (H&E), immunohistochemistry, and, on certain occasions cytochemistry. Informationregarding additional tissue tests was derived from the electronic archives of the Department of Pathology andLaboratory Medicine as well as patient records. Diagnostic accuracy was calculated for each test. Results: Of 127cases, 22 were inconclusive and excluded from the study. The remaining 105 were categorized into 73 (69.5%)malignant lesions and 32 (30.5%) benign lesions. FNA and CNB findings were in complete agreement in 63 cases(60%). The accuracy and confidence intervals (CIs) of FNA and CNB for malignant tumors were 86.3% (CI:79.3-90.7) and 93.2% (CI: 87.3- 96.0 ) respectively. For epithelial malignant neoplasms, a definitive diagnosis wasmade in 44.8% of cases by FNA and 80.6% by CNB. The diagnostic accuracy of CNB for nonepithelial malignantneoplasms was 83.3% compared with 50% for FNA. Of the 32 benign cases, we made specific diagnoses in 16with diagnostic accuracy of 81.3% and 6.3% for CNB and FNA, respectively. Conclusions: Our findings suggestthat FNA is comparable to CNB in the diagnosis of malignant epithelial lesions whereas diagnostic accuracy ofCNB for nonepithlial malignant neoplasms is superior to that for FNA. Further, for histological typing of tumorsand examining tumor origin, immunohistochemical work up plays an important role.     

涎腺区病变细针吸取细胞学诊断

１１４例涎腺区病变进行了细针吸取细胞学诊断。７９％为良性（包括６２例肿瘤及２８例其他病变），２１％为恶性（２４例）。与术后组织学诊断进行比较，总符合率为９３．９％，误诊率为６．１％，均为假阴性。对涎腺区肿瘤细胞学特点进行描述，对误诊原因进行分析。     

乳腺针吸细胞学诊断假阳性病例分析

１２５６例乳腺良性病变中有１９例（１．４８％）细胞学误诊为可疑癌、高疑癌、甚至癌。１９例中有９例（４７．４％）纤维囊性乳腺病,３例（１５．８％）纤维腺瘤,２例（１０．５％）巨大纤维腺瘤,２例（１０．５％）导管内乳共状瘤,２例（１０．５％）慢性乳腺炎和１例（５．３％）男性乳腺发育。涂片中细胞量过多或过少,细胞退变,增生活跃的导管上皮细胞有轻度异型而双极课核细胞或大汗腺化生细胞学辅助诊断成分不明确,以     

全视野数字化乳腺摄像与细针穿刺细胞学检查对乳腺肿块的诊断意义

目的评估细针穿刺活检与数字化乳腺摄像在乳腺肿块定性诊断中的准确性。方法102例乳腺肿块患者(年龄17～76岁,中位年龄50岁)均进行细针穿刺活检与数字化乳腺摄像检查,且所有患者均入院手术获得病理诊断,所得结果与最终的病理学诊断结果进行对照分析。结果102例患者中,最终病理确诊为乳腺癌者43例(42.2%),细针穿刺活检对乳腺癌检测的敏感性为90.7%(39/43),特异性为89.8%(53/59),总准确率为90.2%(92/102)。数字化乳腺摄像检查对乳腺癌的敏感性也是88.4%(38/43),而特异性是83.1%(49/59),总的准确率是85.3%(87/102)。细针穿刺活检假阴性的乳腺癌可通过数字化乳腺摄像检查得到正确诊断。结论细针穿刺活检与数字化乳腺摄像都是诊断乳腺疾病的准确有效方法,两者联合应用能够降低乳腺肿块的误诊率。     

细湿针穿刺细胞学检查诊断直肠癌

[目的]为了进一步探讨直肠癌诊断的新途径，运用穿刺针吸细胞学在其它疾病的检查诊断方法，应用于直肠癌的诊断。[方法]总结分析了经细湿针45例针吸细胞学检查诊断直肠癌的病例。[结果]其结果与术后病理诊断完全符合，提示其对直肠癌诊断正确率100％。[结论]细湿针穿刺细胞学诊断直肠癌，不需特殊医疗器械、操作方法简单易行、无大出血感染之危、损伤小、安全可靠、不会引起肿瘤种植。因此认为细湿针穿刺细胞学诊断直肠癌比临床上常用的细干针穿刺细胞学诊断方法具有更高的成功率和正确率。     

Intraoral and Oropharyngeal Lesions: Role of Fine Needle Aspiration Cytology in the Diagnosis

The oral cavity is affected by a wide range of pathologic lesions, for which a morphologic diagnosis is required for proper management. Fine needle aspiration (FNA) is being increasingly used for preliminary diagnoses of such lesions. This is retrospective analysis of intraoral and oropharyngeal lesions diagnosed with FNAC over a period of 7 years. Out of total 55 cases, a definite diagnosis could be made on cytology in 50 cases (90.9 %). These 50 cases were further included in the study. Thirty cases were reported as non-neoplastic and 20 as neoplastic (11 benign and nine malignant). The diagnoses were made taking into account the background material (blood, mucin) and the predominant cells present (neutrophils, lymphoid cells, macrophages, hemosiderin laden macrophages, squamous cells, basaloid cells, spindle cells, giant cells). Histopathological diagnosis was available in 17 cases and corresponded with FNA diagnosis in 16 cases (94.12 %). No significant complications were seen in patients undergoing these FNAs. It can be concluded that FNA is a simple and rapid diagnostic test that can be useful for preliminary assessment of oral and oropharyngeal lesions.     

820例乳腺肿块针吸细胞学诊断分析

目的探讨我院乳腺肿块针吸细胞学诊断的准确率及误诊原因。方法分析820例乳腺肿块针吸细胞学检查结果,其中498例肿块切除后行组织学检查,比较针吸细胞学与病理组织学诊断结果。结果820例乳腺肿块中良性病变583例,恶性肿瘤237例,498例针吸细胞学与组织学诊断符合率为95.78%。结论乳腺肿块针吸细胞学诊断准确率高,能较准确地鉴别病变良恶性,对临床具有重要的指导意义。     

Diagnostic Accuracy,Sensitivity, Specificity and Positive Predictive Value of Fine Needle Aspiration Cytology (FNAC) in Intra Oral Tumors

Objective: The objective of this study was to establish the diagnostic accuracy, specificity and sensitivity of fineneedle aspiration cytology(FNAC) for intra-oral tumors, comparing with histopathology as the gold standard.Materials and methods: Forty cases of FNA cytology from intraoral tumors was performed in AFID along withthe demographic data and clinical information and then diagnosed at AFIP, Rawalpindi. Then the cytologyresults obtained per FNAC were compared with the histopathological biopsy results of the same lesions. Thefollowing variables were recorded for each patient: Age, gender, site of biopsy, diagnosis. The data were enteredand analyzed using Open-epi version 2.0. Diagnostic accuracy, sensitivity, specificity, positive predictive value andnegative predictive value were calculated. Cohen Kappa was further applied to compare the agreement betweenthe biopsy and FNAC diagnoses. A p-value of < 0.05 was considered as statistically significant. Results: Among thetotal patients included in the study there were 24 males and 16 females, with a ratio of 1.5:1. Age of the patientsranged from 24 to 80 years with a mean of 52 years. A total of six sites were aspirated from the oral cavity withmaximum (11) aspirates taken from alveolar ridge. The results of FNAC revealed that there were 32 malignantand 8 benign aspirates. Confirmation through histopathological analysis came for 31/32 malignant cases whileone was falsely given positive for malignancy on FNAC. Among a total of 40 cases, 31(77%) cases diagnosed werefound to be malignant and remaining 9(23%) were benign. The FNAC results revealed 32 malignant and 8 benignlesions. Histopathology of the subsequent surgically excised specimen showed malignant lesions in 31(77%) andbenign in 9(23%) patients. As a whole, it was found that the absolute sensitivity for introral FNAC was 100%and specificity 89% with positive predictive value of 97% and negative predictive value of 100%. Conclusion:Cytological diagnosis was almost corroborative with final histopathological diagnosis in all cases, with very fewexceptions, exhibiting high diagnostic accuracy.     

Diagnostic Accuracy of Ultrasonography in Differentiating Benign and Malignant Thyroid Nodules Using Fine Needle Aspiration Cytology as the Reference Standard

Background: In Pakistan thyroid cancer is responsible for 1.2% cases of all malignant tumors. Ultrasonography(US) is helpful in detecting cancerous thyroid nodules on basis of different features like echogenicity, margins,microcalcifications, size, shape and abnormal neck lymph nodes. We therefore aimed to calculate diagnosticaccuracy of ultrasound in detection of carcinoma in thyroid nodules taking fine needle aspiration cytology asthe reference standard. Materials and Methods: A cross-sectional analytical study was designed to prospectivelycollect data from December 2010 till December 2012 from the Department of Radiology in Aga Khan UniversityHospital, Karachi, Pakistan. A total of 100 patients of both genders were enrolled after informed consent viaapplying non-probability consecutive sampling technique. Patients referred to Radiology department of AgaKhan University to perform thyroid ultrasound followed by fine-needle aspiration cytology of thyroid noduleswere included. They were excluded if proven for thyroid malignancy or if their US or FNAC was conductedoutside our institution. Results: The subjects comprised 76 (76%) females and 24 males. Mean age was 41.8±SD12.3 years. Sensitivity and specificity with 95%CI of ultrasound in differentiating malignant thyroid nodulefrom benign thyroid nodule calculated to be 91.7% (95%CI, 0.72-0.98) and 78.94% (0.68-0.87) respectively.Reported positive predictive value and negative PV were 57.9% (0.41-0.73) and 96.8% (0.88-0.99) and overallaccuracy was 82%. Likelihood ratio (LR) positive was computed to be 4.3 and LR negative was 0.1. Conclusions:Ultrasonography has a high diagnostic accuracy in detecting malignancy in thyroid nodules on the basis offeatures like echogenicity, margins, micro calcifications and shape.     

胸腔肿物穿刺细胞学误诊病例分析

我院于1980-1986年,胸腔穿刺578例,其中238例有组织学对照。细胞学诊断假阳性7例,假阴性3例及20例分型错误。本文指出引起假阳性诊断的主要原因是:1.涂片中细胞量少;2.细胞退变;3.反应性组织细胞易与恶性细胞相混淆;4.不典型增生的柱状细胞难与类癌和高分化腺癌鉴别。引起假阴性诊断的原因是:1.未将组织学标准与细胞学诊断结合,2.漏诊。并对引起分型错误的原因加以讨论。     

细针吸取细胞学诊断甲状腺结节的探讨

目的：探讨细针吸取细胞学诊断甲状腺结节的准确性及误诊因素。方法：对3939例甲状腺结节进行了细针吸取细胞学检查，其中581例获病理组织学对照。细胞学诊断分四类：良性、恶性、可疑恶性和标本不足。结果：细胞学诊断良性占42％(248／581)，恶性占17％(98／581)，可疑恶性占29％(167／581)，标本不足占12％(68／581)。细胞学诊断敏感性为68％(95／140)，特异性为99％(438／441)。结论：仔细检查甲状腺、坚持严格的细胞学诊断标准、标本不足重复穿刺，对提高细针吸取细胞学诊断甲状腺结节的准确率有重要意义。