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flare up following instrumentation, and active disease can be exacerbated. Organomegaly adjacent to the suspected lesion could be considered a relative contraindication to a skinny needle biopsy. Concern that seeding of the needle tract with tumor cells will occur secondary to needle biopsy cannot be supported. In more than 2,500 fine-needle aspiration biopsies performed at Toronto General Hospital, no evidence of seeding or tumor dissemination was reported.^ On the other hand, leakage from puncture of mobile ovarian tumors with tumor cell implantation is a more dangerous possibility.^ Thus, undiagnosed mobile or cystic masses, suggestive of an early ovarian neoplasm, should never be subjected to any blind biopsy procedure. Contraindications are summarized in Table II. Technique The actual technique of fine-needle aspiration biopsy is simple. Although Scandinavian workers^-"^ have developed a special apparatus for skinny needle biopsy, ordinary plastic syringes and standard needles which are readily available provide good results without the added cost of special equipment. The needle, usually 20 or 22 gauge, is locked onto a 10 to 20 cc syringe. The length of the needle depends on the approach to the involved site. A Wi inch needle is very suitable for transcutaneous biopsies, while a 3-inch spinal, or even a 6-inch pudendal needle may be necessary for the transvaginal or transrectal approach. Often an Iowa trumpet guide is helpful in reaching lesions high in the vagina, or amputation of the plastic sheath of a spinal needle can provide an adequate guide. Local anes- Table II. Contraindications to Fine-Needle Aspiration Biopsy Relative 1. Coagulopathy. 2. Adjacent organomegaly. Absolute 1. Acute or chronic PID. 2. Undiagnosed mobile or cystic ovarian mass. Fig. 1. Fine needle aspiration of a suspicious lymph node in the groin. The mass is immobilized and the needle is thrust sharply into its center. During entry into the mass no negative pressure should be applied to the syringe. For a lesion in the pelvis, the transvaginal and transrectal approach can be used, with the needle guided by the operator*s flnger or Iowa trumpet. thesia may precede needle insertion depending on the site of the lesion, but is usually not necessary. The suspicious mass is localized and the insertion site is prepped with an antiseptic solution. With no negative pressure on the syringe barrel, the needle is inserted into the mass (Figure 1). Negative pressure is then maintained while the needle is oscillated inside the lesion in several directions (Figure 2). The negative pressure must be released prior to needle removal from the interior of the mass. The aspirated cellular material is forced out of the needle onto one or more glass slides and immediately fixed (Figure 3). Although our cy-tologists prefer "Pro-Fixx,"* (2-propanol 68.5%, 2-propane 17.1%, and polyethylene glycol 6.9%), a less complex solution of 95% etha-nol has been found to be satisfactory by others.^ The slides are then stained by the routine Papanicolaou method and interpreted by a cyto-pathologist with special interest in this technique. If sufficient cellular material has been obtained,or if a second aspiration is done, the specimen can be flushed into a small container of normal saline. The suspension can be centrifuged in the laboratory and a cell block preparation stained for further delineation of cellular features. The aspirated material may contain various normal epithelial and mesenchymal elements, depending on the sampling route. A clear patient history and aspiration sampling site localization should always be indicated on the cytology requisition to facilitate interpretation. Often, necrotic debris may accompany malignant elements in the sample to further challenge the cytologist.^ Specimens may be unsatisfactory for several reasons. The most common problem is drying of cells on the slide with poor preservation of cellular detail because of inadequate or slow fixation. Error can easily be introduced by applying excessive negative pressure to the syringe before insertion or after withdrawal of the needle; this in- •••Pro-Fixx,"® Scientific Products. McGraw Park. 111. Fig. 2. Once the needle is in the approximate center of the mass, negative pressure is applied to the plunger of the syringe, and the needle is oscillated inside the lesion for 2-3 mm in all directions. Negative pressure must be re' leased prior to removal of the needle from the lesion to avoid contamination. 350 Vol. 43, No. 4 K
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1982 |
Identifier | NCHH-17-043 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 43 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-043.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-043 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
Description
Fixed Title * | Page 350 (images) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1982 |
Identifier | NCHH-17-043-0366 |
Form General | Periodicals |
Page Type | all; all images; diagram; all images; chart/table; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | ncmed431982mediv1_0366.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 43 |
Issue Number | 5 |
Page Number | 350 |
Health Discipline | Medicine |
Full Text | flare up following instrumentation, and active disease can be exacerbated. Organomegaly adjacent to the suspected lesion could be considered a relative contraindication to a skinny needle biopsy. Concern that seeding of the needle tract with tumor cells will occur secondary to needle biopsy cannot be supported. In more than 2,500 fine-needle aspiration biopsies performed at Toronto General Hospital, no evidence of seeding or tumor dissemination was reported.^ On the other hand, leakage from puncture of mobile ovarian tumors with tumor cell implantation is a more dangerous possibility.^ Thus, undiagnosed mobile or cystic masses, suggestive of an early ovarian neoplasm, should never be subjected to any blind biopsy procedure. Contraindications are summarized in Table II. Technique The actual technique of fine-needle aspiration biopsy is simple. Although Scandinavian workers^-"^ have developed a special apparatus for skinny needle biopsy, ordinary plastic syringes and standard needles which are readily available provide good results without the added cost of special equipment. The needle, usually 20 or 22 gauge, is locked onto a 10 to 20 cc syringe. The length of the needle depends on the approach to the involved site. A Wi inch needle is very suitable for transcutaneous biopsies, while a 3-inch spinal, or even a 6-inch pudendal needle may be necessary for the transvaginal or transrectal approach. Often an Iowa trumpet guide is helpful in reaching lesions high in the vagina, or amputation of the plastic sheath of a spinal needle can provide an adequate guide. Local anes- Table II. Contraindications to Fine-Needle Aspiration Biopsy Relative 1. Coagulopathy. 2. Adjacent organomegaly. Absolute 1. Acute or chronic PID. 2. Undiagnosed mobile or cystic ovarian mass. Fig. 1. Fine needle aspiration of a suspicious lymph node in the groin. The mass is immobilized and the needle is thrust sharply into its center. During entry into the mass no negative pressure should be applied to the syringe. For a lesion in the pelvis, the transvaginal and transrectal approach can be used, with the needle guided by the operator*s flnger or Iowa trumpet. thesia may precede needle insertion depending on the site of the lesion, but is usually not necessary. The suspicious mass is localized and the insertion site is prepped with an antiseptic solution. With no negative pressure on the syringe barrel, the needle is inserted into the mass (Figure 1). Negative pressure is then maintained while the needle is oscillated inside the lesion in several directions (Figure 2). The negative pressure must be released prior to needle removal from the interior of the mass. The aspirated cellular material is forced out of the needle onto one or more glass slides and immediately fixed (Figure 3). Although our cy-tologists prefer "Pro-Fixx"* (2-propanol 68.5%, 2-propane 17.1%, and polyethylene glycol 6.9%), a less complex solution of 95% etha-nol has been found to be satisfactory by others.^ The slides are then stained by the routine Papanicolaou method and interpreted by a cyto-pathologist with special interest in this technique. If sufficient cellular material has been obtained,or if a second aspiration is done, the specimen can be flushed into a small container of normal saline. The suspension can be centrifuged in the laboratory and a cell block preparation stained for further delineation of cellular features. The aspirated material may contain various normal epithelial and mesenchymal elements, depending on the sampling route. A clear patient history and aspiration sampling site localization should always be indicated on the cytology requisition to facilitate interpretation. Often, necrotic debris may accompany malignant elements in the sample to further challenge the cytologist.^ Specimens may be unsatisfactory for several reasons. The most common problem is drying of cells on the slide with poor preservation of cellular detail because of inadequate or slow fixation. Error can easily be introduced by applying excessive negative pressure to the syringe before insertion or after withdrawal of the needle; this in- •••Pro-Fixx"® Scientific Products. McGraw Park. 111. Fig. 2. Once the needle is in the approximate center of the mass, negative pressure is applied to the plunger of the syringe, and the needle is oscillated inside the lesion for 2-3 mm in all directions. Negative pressure must be re' leased prior to removal of the needle from the lesion to avoid contamination. 350 Vol. 43, No. 4 K |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-043.pdf |
Document Sort | all; nchh-17 |
Article Title | Fine-Needle Aspiration Biopsy In Gynecologic Oncology |
Article Author | Clarence L. Wilson, Ii,; John L. Currie |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-043 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Revision History | done |
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