Showing papers by "Stephen S. Raab published in 1996"
TL;DR: It is concluded that accuracy of telecytology is high, but less than that of light microscopy.
Abstract: Although cervical-vaginal telecytology is a promising tool, diagnostic accuracy has not been extensively evaluated. The authors examined the accuracy of five cytotechnologists who retrospectively reviewed 50 cervical-vaginal smears using the video monitor, and 2 months later, using the light microscope. Accuracy was expressed in terms of crude agreement with the original diagnosis and number of false positives (FPs) and false negatives (FNs). With a greater than one step difference as discrepant, the group crude agreement using the video monitor and the light microscope was 85.6% and 95.6%, respectively. The group number of FNs and FPs for the light microscope was 8 and 7, respectively, and for the video monitor was 34 and 7, respectively. There was a wide range of individual performance. We conclude that accuracy of telecytology is high, but less than that of light microscopy. The major reason for lower telecytologic accuracy was undercalling dysplasia.
92 citations
Journal Article•
TL;DR: Key cytologic criteria can be learned and effectively applied with high accuracy and are concluded to be indicative of low-grade transitional cell carcinoma of the bladder.
44 citations
TL;DR: It is concluded that renal FNAB is useful in evaluating renal masses and there is excellent correlation for nuclear grade.
Abstract: Renal fine-needle aspiration biopsy (FNAB) is used in several clinical scenarios: in patients with classic radiographic lesions; in non-operable patients with presumed high stage disease; and in patients with radiographic problematic lesions Although overall, FNAB is a sensitive test, its role in the latter two populations has not been clearly established To investigate the utility of FNAB in these patients, we retrospectively evaluated 43 renal FNABs in regards to diagnostic accuracy and clinical outcome FNAB diagnoses were: malignant (36), suspicious (6), and insufficient (1) Our results indicate: 1) renal FNAB is accurate in patients with high stage lesions; 2) FNAB is less accurate in patients with radiographic problematic lesions; 3) the FNAB diagnosis of malignant increases the post-FNAB probability of malignancy, whereas the diagnosis of suspicious decreases the probability; and 4) there is excellent correlation for nuclear grade We conclude that renal FNAB is useful in evaluating renal masses
37 citations
TL;DR: It is possible to separate artifact from actual pathology on post‐LEEP cytobrush specimens, and recognition of the characteristic changes seen on cytologic specimens obtained immediately following diathermy loop treatment will allow accurate identification of true abnormalities.
Abstract: Loop electrosurgical excision procedure (LEEP) is gaining popularity in the United States as an alternative to other ablative and cone methods of treatment for preneoplastic conditions of the uterine cervix. The major advantage is that it is an outpatient procedure using local anesthesia. Post-LEEP evaluation of the endocervical canal can be accomplished by either endocervical curettage or cytobrush. We reviewed the immediate post-LEEP cytobrushes from 33 patients. Artifact related to the procedure was seen in all cases and included: 1) elongated endocervical cells with cytoplasmic "tails" and streaming nuclei ("taffy pulled"); 2) loose cellular aggregates with coalesced cytoplasm and "hockey stick" nuclei; 3) sheets of cells with frothy cytoplasm and shrunken thumbprinted nuclei; 4) nuclear enlargement; and 5) smudgy nuclear chromatin. The background ranged from bloody coagulum to watery proteinaceous material. Original diagnoses were negative in 25 cases. Eleven (44%) were considered abnormal on review. Of these, four were interpreted as having squamous intraepithelial lesions (SIL), one was atypical squamous cells of undetermined significance (ASCUS), and six had atypical glandular cells of undetermined significance (AGUS). It was not always possible to grade the degree of dysplasia. There was review agreement with 14 negatives, one SIL, one ASCUS, and one unsatisfactory specimen. Three AGUS were upgraded to SIL, and one unsatisfactory specimen was considered atypical on review. In conclusion it is possible to separate artifact from actual pathology on post-LEEP cytobrush specimens. Recognition of the characteristic changes seen on cytologic specimens obtained immediately following diathermy loop treatment will allow accurate identification of true abnormalities.
15 citations
TL;DR: Although limited in funds, cytopathology is widely practiced and serves an important role in the medical system of Vietnam, and there are regional differences in Vietnam in the employment of common techniques, such as fine needle aspiration biopsy.
Abstract: OBJECTIVE: To determine the differences and similarities between cytopathology practice in Vietnam and North America. STUDY DESIGN: Through the sponsorship of Friendship Bridge, we traveled to Hanoi and Ho Chi Minh City, Vietnam, in January 1994. By visiting hospitals and medical centers in each city, we observed how economic, demographic and social factors affected cytopathology practice. RESULTS: In Vietnam, the resources of the medical system, cytopathology in particular, are devoted to diagnosis rather than prevention. Consequently, screening tests, such as the Papanicolaou smear for the detection of cervical-vaginal lesions, are not performed on a routine basis. There are regional differences in Vietnam in the employment of common techniques, such as fine needle aspiration biopsy. CONCLUSION: Although limited in funds, cytopathology is widely practiced and serves an important role in the medical system of Vietnam.
6 citations
TL;DR: The introduction of inexpensive, diagnostically accurate procedures, such as breast FNA, may prove to be of great benefit in countries with scant medical resources.
Abstract: In the Socialist Republic of Vietnam, breast cancer is the second leading cause of cancer death in women. Prior to 1994, in certain regions of Vietnam, such as the South, the only diagnostic modalities for breast lesions were clinical examination and open surgical biopsy, a procedure prohibitively expensive for many women. In January 1994, two American cytopathologists conducted a 3-day breast fine needle aspiration (FNA) seminar at the Ho Chi Minh City Cancer Center, Ho Chi Minh City. After the seminar, 754 breast FNAs were performed from January 1994 to January 1995. The sensitivity and specificity of breast FNA were 96% and 83%, respectively, and there were nine false positive and seven false negative diagnoses. The overall diagnostic accuracy of breast FNA is within the range of previously reported accuracies, indicating that breast FNA can be learned quickly and practiced proficiently. A main role of breast FNA in Vietnam is in the diagnosis of high-stage, inoperable breast tumors. The relative af-fordability of breast FNA enables many women with breast lesions to undergo a diagnostic procedure. The introduction of inexpensive, diagnostically accurate procedures, such as breast FNA, may prove to be of great benefit in countries with scant medical resources.
2 citations
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