Katharine Liu

Concordance of histopathologic and cytologic grading in musculoskeletal sarcomas: Can grades obtained from analysis of the fine-needle aspirates serve as the basis for therapeutic decisions?

Utilization of fine‐needle aspiration (FNA) for the diagnosis of musculoskeletal lesions has been de‐emphasized by many clinicians because of concerns regarding the techniques ability to supply all information necessary for prognostication and appropriate selection of therapy. Paramount among the concerns is the belief that FNA is incapable of supplying precise subtyping and grading in many cases. Secondary concerns regarding the use of FNA involve its perceived inability to supply adequate tissue for ancillary studies including immunohistochemistry and molecular diagnostic analysis. The authors investigated the ability of FNA to accurately subtype and grade a series of 107 primary sarcomas of the musculoskeletal system.

Diagnosis of hematopoietic processes by fine-needle aspiration in conjunction with flow cytometry: A review of 127 cases

Although fine‐needle aspiration (FNA) is accepted as the method of choice for the initial evaluation of lymph nodes for metastatic carcinomas, its utility as the initial diagnostic procedure for hematopoietic processes is less established. We review our experience over a 3‐year period with 127 FNA cases accompanied by flow cytometric (FC) analysis from 117 patients. Fifty cases had subsequent histologic examination. A hematopoietic process was identified in 85 cases, a reactive process in 27 cases, and a nonhematopoietic process in 15 cases. All non‐Hodgkin lymphomas (NHL) were B‐cell processes except for one T‐cell lymphoma. By FNA/FC, 44 NHL had sufficient findings to be subtyped; of these, 27 had subsequent histologic examination. The correlation between the FNA/FC and histologic classification in these cases of NHL was 100%. One case was insufficient for diagnosis by FNA and six cases were inadequate for FC. We conclude that FNA in conjunction with FC can be used as the initial diagnostic approach for both primary and recurrent hematopoietic processes. Diagn. Cytopathol. 2001;24:1–10.

Fine-needle aspiration : Comparison of smear, cytospin, and cell block preparations in diagnostic and cost effectiveness

We compared the results of smears to those of cytospin and cell block preparations from fine‐needle aspirations to determine the cost effectiveness of each and to determine which should be routinely obtained. We reviewed 844 cases, 361 of which had both smears and cytospins, and 483 of which had both smears and cell blocks. Smears alone were diagnostic in 94% of cases (796/844 cases), cytospins alone diagnostic in 43% of cases (154/361 cases), and cell blocks alone diagnostic in 57% of cases (277/483 cases). Cytospins contributed additional information beyond that obtained from smears in 2% (7/361) and cell blocks in 12% (57/483) of cases. When smears were nondiagnostic, cytospins contributed additional information in 10% (2/21) of cases and cell blocks contributed additional information in 44% (12/27) of cases. The cost of providing a diagnosis from smear alone is

Fine-needle aspiration findings in idiopathic retroperitoneal fibrosis

212, from cytospin alone is

Fine‐needle aspiration with flow cytometric immunophenotyping for primary diagnosis of intra‐abdominal lymphomas

352, and from cell block alone is

Logistic regression analysis of myxoid sarcomas: A cytologic study

392. The cost for additional information established by cytospin is

“Dedifferentiated” chordoma: A case report of the cytomorphologic findings on fine-needle aspiration

7,736 and by cell block the cost is

Diagnosis of anaplastic large‐cell lymphoma, including multifocal osseous KI‐1 lymphoma, by fine‐needle aspiration biopsy

1,906. Smears are superior to either cytospins or cell blocks in providing a diagnosis. It is not cost‐effective to obtain either cytospins or cell blocks in addition to smears on all cases. However, it is cost‐effective to obtain cell blocks when the immediate smear evaluation is nondiagnostic. Diagn. Cytopathol. 1998;19:70–74.

Diagnosis of posttransplant granulocytic sarcoma by fine-needle aspiration cytology and flow cytometry

Idiopathic retroperitoneal fibrosis (IRF) is an inflammatory and fibrosing process that can be complicated by periureteral encasement, ureteral obstruction, and subsequent renal failure if left untreated. Unfortunately, treatment is often delayed due to the nonspecific nature of the presenting signs and symptoms. Clinical, radiologic, and microscopic findings in IRF, if examined independently, are all nonspecific for its diagnosis. Rendering a diagnosis of IRF by fine‐needle aspiration (FNA) requires supportive clinical and radiologic data and systematic evaluation of entities in the differential diagnosis.

Radiologically‐determined diameter, pathologic diameter, and reactive zone surrounding pulmonary neoplasms: Implications for transthoracic fine‐needle aspiration of pulmonary neoplasms

Cytomorphology in conjunction with immunophenotypic characterization is becoming increasingly used for the primary diagnosis of non‐Hodgkins lymphomas (NHL). This combination is especially advantageous for the diagnosis of intra‐abdominal and intrathoracic lymphomas, since unlike superficial lesions, open biopsy of deep‐seated tissues is more invasive and more costly, and is associated with a higher risk. We report the cytologic and immunophenotypic features of intra‐abdominal NHL obtained by fine‐needle aspiration (FNA). Twenty‐two cases of intra‐abdominal lesions obtained by image‐guided FNA where flow cytometry was also performed were reviewed. Of the 22 studied cases, 7 were classified as large‐cell lymphoma, 5 as follicular center‐cell lymphoma, 2 as small noncleaved‐cell lymphoma, 2 as lymphoplasmacytoid lymphoma, one as small lymphocytic lymphoma, and one as marginal‐zone lymphoma. In the remaining 4 cases where the immunophenotypic pattern was not definitive, the cytomorphologic features were of small cleaved cells in 3 cases and of mixed small cleaved and large cells in one case. We successfully classified 9 of the 10 patients on whom histologic confirmation was obtained. The successful primary classification of most intra‐abdominal non‐Hodgkins lymphomas can be done with a combination of cytology and flow cytometry, and this can be the initial approach in patients with deep‐seated lesions. Diagn. Cytopathol. 1999;21:98–104.