Browsing by Author "Chande, Hassan Mwinchande"

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    Fine needle aspiration cytology as a diagnostic tool at the Institute of Anatomical Pathology, Catholic University of Nijmegen, the Netherlands, from 1973 to 1987
    (University of Dar es Salaam, 1993) Chande, Hassan Mwinchande
    Fine needle aspiration cytology (FNAC) is part of the diagnostic workup for patients with lesions from various body sites at the Institute of Pathological Anatomy, Catholic University of Nijmegen. The sites subjected to FNAC included masses in the head and neck, thorax and mediastinum, the breast, intra-abdominal organs, bones and soft tissues. The study material collected consisted of FNA from 1973 to 1987 which were analysed by the author from 1987 through 1989. The staining technique used was mainly that of Papanicolaou and May Grunwald Giemsa, and in special cases Giemsa (Diff-Quick) staining or immunocytochemistry or electron microscopical examination were performed to aid in the diagnosis. The reviewed cases comprised all body sites except breast, body effusions e.g. ascites, pleural and pericardial effusions: Of the 1654 cases selected, 1221 (73.8%) had good quality cytological smears for diagnosis and 433 (33%) were not suitable for diagnosis. Of the 1221 cases, 464 (28%) were cytologically diagnosed as malignant and 757 (45.8%) were benign. Histological examination revealed 855 (54.7%) malignant lesions, 425 (25.7%) benign and in 374 (22.6%) the slides or information were not available (Table I). Of the 1221 cytology cases 557 (45.6%) were from the head and neck region, 129 (10.5%) from the thorax, 334 (27.3%) from the abdomen, 56 (4.6%) were bone lesions, and a miscellaneous group of 145 (11.8%) cases. There were a total of 522 lymph node aspirates from various anatomic sites. Of these 227 (43.4%) were diagnosed as malignant and 295 (56.5%) were benign. When cytological examination was compared with histological diagnosis, the general accuracy rate for inflammatory conditions was 48.2%. The accuracy rate for metastatic lesions, when FNA was compared with histological diagnosis, was 87.4%. Of the metastatic conditions, squamous cell carcinoma had an accuracy of 88.9% when cytological examination was compared with histological diagnosis, while that for adenocarcinoma was 66.6%. The overall sensitivity of the test was 65.2% with a specificity of 96.7% and positive predictive value of 97.4%.