吸入 細胞檢査의 診斷的 意義 및 評價 : 여러 人體 藏器에서 經驗한 1005例를 中心으로 An Analysis of 1,005 Cases from Various Human Organs

高一香,石東壽 인제대학교 1987 仁濟醫學 Vol.8 No.2

吸入 細胞檢査(Aspiration Biopsy Cutology, ABC)는 目的 病巢에서 細針을 揷入하여 吸入한 微細組織切片을 細胞學的 檢査法으로 判讀 診斷하는 檢査法이다. 매우 簡單하고 迅速한데 比해 正確性과 安定性이 높고, 뿐만 아니라 患者에게 心的 肉體的 負擔과 合倂症이 적고 低廉한 費用으로 行할 수 있어 最近 우리나라에서도 漸次的으로 利用度가 높아지고 있다. 短點이라면 僞陰性 結果가 不可避하다는 것이다. 이를 最少限으로 줄이기 爲해서는 技法의 熟練과 判讀하는 病理專門醫들의 豊富한 經驗이 必要하다. 本 硏究 結果 診斷의 正確度는 90%이었으며 將次 向上될 것으로 期待된다. An analysis of 1,005 cases of Aspiration Biopsy Cytology (ABC) performed at Seoul Paik Hospital from February 1984 to September 1986 was reviewed. The following results were obtained. 1.Number of the test performed is 173 in 1984, 387 in 1985 and 445 in 1986, respectively. 2.Aspiration Biopsy Cytology was most frequently applied to lymph node with incidence of 394 (39%), breast 296 (29%), thyroid 132 (13%), deep organs 86 (9%) and others 97 cases (10%). 3.The most frequently made Aspiration Biopsy Cytology diagnosis was mammary dysplasia of 144 cases followed by reactive hyperplasia of lymph node 118, lymph node malignancy 73 and adenomatous goiter 50. Malignancy is the most frequent diagnosis made in this study, occupying over 23% of the test performed. The result is indirectly suggested that the Aspiration Biopsy Cytology is an important tool for detection of the malignant lesion. 4.Histological diagnosis was made in 116 cases and diagnostic accuracy of Aspiration Biopsy Cytology ranged from 75.1(81.1)% to 94.3(98.0)%. The mean accuracy is 89.3(91.5)%. 5.There were 3(2.6%) cases of false positive and 9(7.8%) false negative reports of Aspiration Biopsy Cytology. The former consists of 1 case of granuloma and 2 cases of osteomyelitis reported as highly suspicious Aspiration Biopsy Cytology impresssion. The fault was made due to atypical epitheloid cells and active osteoblasts. The false nagative consists of 3 cases of sampling error, 4 cases of misinterpretation and 2 cases of diagnostic difficulty; one well differenciated follicular carcinoma impressed as adenomatous goiter in Aspiration Biopsy Cytology and the other well differenciated duct adenocarcinoma of breast with impression of papilloma in Aspiration Biopsy Cytology. 6.Diagnosis of non-neoplastic lesion is also significantly effective. For example; diagnosis of tuberculosis is more effectively made with combination study of Aspiration Biopsy Cytology and acid fast (rhodamine) stain. 7.Aspiration Biopsy Cytology is an extention of morphologic diagnosis within both diagnostic cytology and histopathology. It is quite valuable method previously underused and wider use of this established and simple procedure is encouraged.

담도협착의 감별진단에 대한 내시경적 쇄자 세포진 검사와 흡인 담즙 세포진 검사의 전향적 비교연구 - 담도협착에 대한 쇄자 세포진 검사의 전향적 비교연구

최호순(Ho Soon Choi),이성구(Sung Koo Lee),김명환(Myung Hwan Kim),서동진(Dong Jin Suh),민영일(Young Il Min),유은실(Eun Sil Yu) 대한소화기학회 1996 대한소화기학회지 Vol.28 No.6

N/A Background/Aims: Tissue biopsy from the biliary tree is difficult because of the focal and sclerotic or small annular nature, lower cellularity and well differentiated tumor. Biliary cytology is an effective tnethod of obtaining a tissue diagnosis for bile duct stricture, and thie diagnostic sensitivity of endoscopic brush cytology (EBC) is reported as between 40% and 70% for malignant bile duct strictures. In this study, we prospectively analyzed the diagnostic value of endoscopic brush cytology and aspiration bile cytology in patients with extrahepatic bile duct strictures. Methods: 30 patients with extrahepatic bile duct strictures diagnosed at endoscopic retrograde cholangiopancreatography underwent endoscopic brush cytology and aspiration bi]e cytology. 25 patients had malignant strictures and 5 patients had benign strictures, brushings were taken using a cytology brush(6Fr) or double lumen brush(8Fr) passed with a guide wire through the stricture. Results: The sensitivity and accuracy of brush cytology (60%; 15/25, 67%; 20/30) were significantly greater than bile cytology (20%; 5/25, 33%; 10/30). No false positive results were reported in brush cytology (specificity; 100%), but negative predictive value (33%; 5/15) was relatively low. There were no procedure related complications and the average sampling time was about five minutes. Conclusions: Endoscopic brush cytology is an effective, safe method of obtaining a tissue diagnosis for bile duct strictures, therefore EBC should be done routinely in bile duct strictures, but further prospective studies will be required to evaluate other new techniques such as endobiliary forceps biopsy or endoscopic fine needle aspiration or EBC with DNA flow cytometry because negative results do not exclude malignancy.(Korean J Gastroenterol 1996; 28: 832-844)

조직학적으로 확진된 복강내 악성병변에 대한 세침흡입 세포학적 검사의 진단적 가치

김남동(Nam Dong Kim),장우익(Woo Ik Chang),권상옥(Sang Ok Kwon),이광훈(Kwang Hoon Lee),배선우(Seon Woo Bae),김태승(Tae Seung Kim) 대한내과학회 1987 대한내과학회지 Vol.33 No.2

N/A An ultrasound-guided percutaneous aspiration cytology was performed with a 22 G Chiba needle in 65 patients with intraabdominal malignancy confirmed by histologic diagnosis and the results were as follows: 1) Malignancy was confirmed by an exploratory laparotomy in 22 patients and by an aspiration biopsy in 43 patients. 2) The diagnostic accuracy of fine needle aspiration cytology was demonstrated in 89.1% of the patients. 3) The aspiration biopsy was diagnostic in 2 patients, even when the aspiration cytology was non-diagnostic. 4) There were no serious complications of the fine needle aspiration. In conclusion, the fine needle aspiration cytology with ultrasound guidance is safe, simple and accurate diagnostic method in the evaluation of space-occupying intra-abdominal malignancy. Histologic examination of tissue fragment obtained from the aspirated material appear to increase the yield of malignancy on aspiration cytology.

폐질환에 있어 세포검사와 조직검사의 진단 일치율 및 정확도에 대한 조사 연구

김성철 ( Sung-chul Kim ),노정환 ( Joung-whan Ro ),김태전 ( Tai-jeon Kim ) 대한임상검사과학회 2009 대한임상검사과학회지(KJCLS) Vol.41 No.4

Lung cancer is a type of cancer with high mortality; its 5-year survival rate is at a low 14%. Related cytological tests include sputum, bronchial brushing, bronchial washing and fine needle aspiration cytology test etc. From the test specimens in which sputum, bronchial brushing, bronchial washing, and fine needle aspiration cytology were performed, the sensitivity, specificity and accuracy between cytology test and histology test. In the sputum test, sensitivity was 27.71% and specificity was 98.02%, and the bronchial brushing test showed sensitivity of 93.33% and a specificity of 91.3%. The bronchial washing test was a sensitivity of 53.7% and its specificity was 98.9%, and the fine needle aspiration cytology test showed sensitivity and specificity were 88.46% and 72.97%, respectively. In the specimens diagnosed as normal at the sputum test, malignant diagnosis was found in 21 specimens of bronchial brushing, 30 cases of bronchial washings and 37 cases of fine needle aspiration cytology specimens. In the specimens diagnosed as normal at the bronchial washing test, malignant diagnosis was found in 5 specimens of sputum, 7 specimens of bronchial brushin and 1 cases of fine needle aspiration cytology. One specimens found to be normal in fine needle aspiration cytology turned out to maligant in sputum test. The result of this research shows that, in diagnosis lung cancer, a test method of high sensitivity and specificity should be pursued. However, depending on the location and malignancy of the illness, diagnosis may not be obtained in some cases. Therefore, we conclude that the cytological tests performed for lung cancer testing such as sputum, bronchial brushing, bronchial washing, and fine needle aspiration cytology should be carried out in a mutually complementary manner.

유방의 세침흡인 세포검사: 수기 액상세포검사법(Liqui-$PREP^{TM}$)과 고식적 도말법과의 비교

정지윤,김정식,김영수,김혜정,박지영,Jeong, Ji-Yun,Kim, Jeong-Shik,Kim, Young-Su,Kim, Hye-Jung,Park, Ji-Young 대한세포병리학회 2008 대한세포병리학회지 Vol.19 No.1

Fine needle aspiration (FNA) cytology of the breast is a useful method for diagnosing breast lesions. Yet making the definite diagnosis with performing FNA is limited by some problems, such as the low cellularity, the poor preservation and the obscuring background. Recent studies have found that liquid-based cytology solves such problems, but it is an expensive method and it is limited by the loss of the background information. The purpose of this study is to compare the Liqui-$PREP^{TM}$, a new manual liquid-based method of cytology, and the conventional smears for analyzing breast FNA cytology materials. A total of 31 randomized FNA specimens of breast were studied. In each case, both the conventional smears and the Liqui-$PREP^{TM}$ method were performed, and the smears were evaluated for cellularity, cellular preservation, the background, the cytologic features and the architectural arrangement. The cellularity and architectural arrangement were equal for both preparations. The Liqui-$PREP^{TM}$ specimens showed better cellular preservation, loss of the obscuring background, no overlapping of cells and a smaller area to screen compared with the conventional smears. Moreover, it has the potential advantages of being able to use the remaining specimens for immunohistochemical study and ploidy analysis, and it can reduce the costs for preparation compared with the other liquid-based methods of cytology. But some background information is lost in the Liqui-$PREP^{TM}$ specimens, the same as the other liquid-based methods of cytology. In conclusion, the Liqui-$PREP^{TM}$ and conventional smears showed good correlation, but they have their respective advantages and disadvantages. These results suggest that Liqui-$PREP^{TM}$ can contribute to making the accurate diagnosis with performing breast FNA cytology when it is used along with other methods.

Comparison of liquid-based cytology (CellPrepPlus) and conventional smears in pancreaticobiliary disease

( Myeong Ho Yeon ),( Hee Seok Jeong ),( Hee Seung Lee ),( Jong Soon Jang ),( Seungho Lee ),( Soon Man Yoon ),( Hee Bok Chae ),( Seon Mee Park ),( Sei Jin Youn ),( Joung-ho Han ),( Hye-suk Han ),( Ho C 대한내과학회 2018 The Korean Journal of Internal Medicine Vol.33 No.5

Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and brushing cytology are used worldwide to diagnose pancreatic and biliary malignant tumors. Liquid-based cytology (LBC) has been developed and it is currently used to overcome the limitations of conventional smears (CS). In this study, the authors aimed to compare the diagnostic value of the CellPrep-Plus (CP; Biodyne) LBC method with CS in samples obtained using EUS-FNA and brushing cytology. Methods: This study prospectively enrolled 75 patients with pancreatic or biliary lesions from June 2012 to October 2013. For cytological analyses, including inadequate specimens, benign and atypical were further classified into benign, and suspicious and malignant were subcategorized as malignant. Sensitivity, specificity, accuracy, and positive predictive values (PPV) and negative predictive values (NPV) were evaluated. Results: In the EUS-FNA based cytological analysis of pancreatic specimens, CP had a sensitivity of 60.7%; specificity, 100%; accuracy, 77.1%; PPV, 100%; and NPV, 64.5%. CS had a sensitivity of 85.7%; specificity, 100%; accuracy, 91.7%; PPV, 100%; and NPV, 83.3%. In the brushing cytology based analysis of biliary specimens, CP had sensitivity of 53.1%; specificity, 100%; accuracy, 54.5%; PPV, 100%; and NPV, 6.3%. CS had a sensitivity of 78.1%; specificity, 100%; accuracy, 78.8%; PPV, 100%; and NPV, 12.5%. Conclusions: Our study found that CP had a lower sensitivity because of low cellularity compared with CS. Therefore, CP (LBC) has a lower diagnostic accuracy for pancreatic EUS-FNA based and biliary brush cytology based analyses compared with CS.

수술 전 세침흡인세포검사에서 악성으로 의심되었던 이하선 양성 종양 1예

이은정(Eun Jung Lee),황혜진(Hye Jin Hwang),변형권(Hyung Kwon Byeon) 대한두경부종양학회 2015 대한두경부 종양학회지 Vol.31 No.1

Fine needle aspiration cytology as a diagnostic workup of parotid gland tumor is a simple and useful method. Although fine needle aspiration cytology could not predict accurate diagnosis in all cases, it is usually helpful in differentiating malignancy and benign lesions. A 35-year-old female was found to have a parotid mass for 1 year. Preoperative evaluation including computed tomography and magnetic resonance imaging were non-diag- nostic, but, fine needle aspiration cytology on parotid mass showed the suspicion of a low-grade mucoepider-moid carcinoma. Superficial parotidectomy and selective neck node dissection were done based on cytology. However, final pathological examination confirmed benign pleomorphic adenoma. Here, the diagnostic accuracy and cautions in interpretation of result of fine needle aspiration cytology is discussed with respect to the case.

폐암의 세침흡인 생검의 세포병리학적 연구

홍순원,이광길 대한병리학회 1990 Journal of Pathology and Translational Medicine Vol.24 No.4

갑상선 결절의 임상양상과 미세침흡인검사의 의의

원진호,한희정,채수홍,김현진,송민호,김영건 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

We evaluated clinical manifestation of nodular thyroid disease and fine-needle aspiration cytology results to establish an appropriate diagnostic approach to thyroid nodule. We examined 594 patients who visited Chungnam National University Hospital with one or more thyroid nodules between Jan. 1996 and Dec. 1998. Fine-needle aspiration cytology was carried out after clinical evaluation including medical history, physical examination(hardness,size, multinodularity,fixation) and laboratory test(scan, thyroid function test). Among the 594 cases, 53 cases(8.9%) were diagnosed as cancer and 457 cases(77%) were diagnosed as benign nodule. None of these factors - age, sex. soft and firm nodule, multinodularity, thyroid scan, thyroid sonography, and thyroid function test - were significant to predict cancer in our study. The prevalence of cancer was significantly higher in hard nodule(28. 5%,39/137) than firm(3.8%,12/316) or soft nodule(0%,0/72). There was size difference between malignant(24.2±62.8ml) and benign nodules(12.6±26.1ml),but the size difference wasn't shown to an indicator to say whether malignant or benign. The prevalence of cancer in relation to fixation was significantly higher in fixation(50%,19/38) and partial fixation nodule(33%,4/12) than movable nodules(5.8%,28/476). Rapid growing, vocal cord palsy,and lymphadenopathy among the medical history had higher relative risk to cancer (relative risk= 14, 4.8, 10.2. respectively). We also examined 67 cases which were diagnosed by histology after operation and, through comparison between the results of histology and cytology., evaluated the effectiveness of fine-needle aspiration cytology. Sensitivity, specificity, false negative rate, and false positive rate of fine-needle aspiration cytology were 92-100%, 47-63%, 0-20%, 0-50%,respectively. Our data suggests that thyroid nodules of the patients which are characterized firm, fixed, rapid growing, lymphadenopathy, and vocal cord palsy require more careful evaluation for thyroid cancer. We also recommand thyroid aspiration cytology in first step evaluation to rule out thyroid cancer.

천골의 세침흡인검사로 진단된 전이성 간세포암종

심정원,고일향,Shim, Jung-Weon,Ko, Ill-Hyang 대한세포병리학회 1990 대한세포병리학회지 Vol.1 No.2

Bone metastasis of hepatocellular carcinoma appears to be peculiar when clinical manifestation of liver disease is not apparent, and initial diagnosis of metastatic hepatocellular carcinoma by fine needle aspiration cytology is rarely obtained. We experienced a case of 45-year-old man with metastatic hepatocellular carcinoma in the sacrum, which was diagnosed by fine needle aspiration cytology. The intrahepatic mass, measuring 1.2 cm in diameter and kept unchanged in size for two years, was never proved to be hepatocellular carcinoma histopathologically. The aspirated neoplastic cells were mostly in sheets, showing abundant acidophilic cytoplasm and large, round, centrally located nuclei with single, prominent acidophilic mucleoli. In the cell block section, diagnosis of metastatic well-differentiated hepatocellular carcinoma was made without difficulty, and definite trabecular fashion with sinusoidal endothelial cell lining was found.