Učestalost pločaste metaplazije u karcinoma prijelaznog epitela mokraćnog mjehura

Squamous metaplasia in transitional cell carcinoma of urinary bladder is considered as an adverse prognostic factor. Those patients have weaker response on therapy and lower survival rate. The aim of our study was to determine the incidence of squamous metaplasia in bioptic material according to histologic grade and growth pattern. In our study we used pathohistological data of 1781 patients operated for urinary bladder cancer in Department of Urology of Sestre milosrdnice University Hospital during the period from 1989 to 2000 squamousmetaplasia was found in 5.7% of patients. According to growth pattern, this phenomenon is more frequent in patients with solid growth pattern. In papillary cancers, the higher incidence of squamousmetaplasia was determined in G1 and G2 histologic grade, while in solid growth pattern, the most cases with squamous metaplasia or over 90% were of G3 histologic grade. Muscle layer invasion were present in high percentage of both, papillary and solid urothelial cancers with squamous metaplasia, which imply the high malignant potential of cancers with foci of squamous metaplasia.Pločasta metaplazija u karcinomima urotela mokraćnog mjehura smatra se jednim od važnih, prognostički lošijih znakova ove bolesti. Bolesnici s karcinomima urotela koji sadrže žarišta pločaste metaplazije, slabije reagiraju na terapiju, i imaju značajno kraće preživljavanje. Cilj istraživanja bio je utvrditi učestalost pločaste metaplazije u karcinomima urotela mokraćnog mjehura s obzirom na histološki gradus i način rasta. U radu je pregledana 1771 biopsija karcinoma mokraćnog mjehura pacijenata operiranih na Klinici za urologiju Kliničke bolnice «Sestre milosrdnice». Pločasta metaplazija nađena je u 102 (5,7%) bolesnika. Ova promjena je češće bila zastupljena u karcinomima solidnog načina rasta, osim kod papilarnih karcinoma urotela G1 i G2 stupnja diferenciranosti. Invazija u mišićni sloj stjenke mokraćnog mjehura nađena je u visokom postotku istraživanih karcinoma i papilarnog i solidnog načina rasta, što nedvosmisleno govori o značajnim visokim malignim potencijalima karcinoma urotela s ovom promjenom

Upalni pseudotumor vrata maternice: prikaz slučaja s pregledom literature

The third recorded case of an inflammatory pseudotumor (IPT) of the cervix is reported. IPT is considered to be a benign, self-limited lesion of obscure etiology. The condition is thought to be related to an unusual tissue response to injury, past fungal or bacterial infection and autoimmune disorders. In December 2003, an 18-year-old nulliparous woman presented in our hospital with dysfunctional bleeding. An incidental finding of a solitary leiomyoma-like mass, measuring 4.2 by 3.8 cm, originating from the cervix, was detected by gynecological examination. The tumor was surgically excised. Samples were stained by H&E, Gomori, pan-cytokeratin, vimentin, SMA, myoglobin, desmin, s-100, CD-68, Factor VIII and p53. Microscopic evaluation of H/E samples showed a distinctive mesenchymal lesion composed of spindle cells displaying morphological features of myofibroblasts, fibroblasts and histiocytes mixed with a considerable number of inflammatory cells. Immunohistochemical analysis showed a positive reaction to vimentin, SMA, myoglobin, CD-68, and some tumor cells were unexpectedly positive to s-100. Gomori and Factor VIII emphasized the reticulin/capillary network. Although extremely rare in this site, IPT should be taken into consideration if mesenchymal lesion or a tumor-like inflammatory and reparative-like lesion is a matter for differential diagnosis. Surgical resection is the commonest therapy, but corticosteroids, NSAIDs and chemotherapy are also used. Two years after IPT excision with no histological evidence of malignancy, our patient is feeling well with no signs of relapse. In this as well as in other similar cases we would suggest a long-term follow-up.Prikazujemo treći dosad opisani slučaj upalnog pseudotumora (IPT, od engl. inflammatory pseudotumor) vrata maternice. IPT se smatra dobroćudnom, samoograničavajućom tvorbom nejasne etiologije. Bolest se povezuje s neuobičajenom reakcijom tkiva na ozljedu, prijašnju gljivičnu ili bakterijsku infekciju i autoimunosne poremećaje. U prosincu 2003. 18-godišnja žena koja dotad nije rađala došla je u bolnicu radi disfunkcionalnog krvarenja. Na ginekološkom pregledu slučajno je na vratu maternice otkrivena odvojena nakupina slična leiomiomu veličine 4,2 x 3,8 cm. Tumor je kirurški uklonjen. U analizi uzoraka primijenjeni su: hemalaun-eozin (H&E), Gomori, pancitokeratin, vimentin, SMA, mioglobin, desmin, s-100, CD-68, faktor VIII i p53. Mikroskopska analiza uzoraka bojanih H/E pokazala je distinktivnu mezenhimnu tvorbu građenu od vretenastih stanica s morfološkim značajkama miofibroblasta, fibroblasta i histiocita pomiješanih sa znatnim brojem upalnih stanica. Imunohistokemijska analiza pokazala je pozitivnu reakciju na vimentin, SMA, mioglobin, CD-68, dok su pojedinačne tumorske stanice bile neočekivano pozitivne na S-100. Gomori i Faktor VIII naglašavali su retikulinsko-kapilarnu mrežu. Iako iznimno rijedak na ovome mjestu, upalni pseudotumor bi se diferencijalno dijagnostički trebao uzeti u obzir ako se radi o mezenhimalnoj tvorbi nalik tumoru ili reparativnoj promjeni. Pored kirurške resekcije koja je najčešći oblik liječenja, u liječenju ove tvorbe također se rabe i kortikosteroidi, nesteroidni protuupalni lijekovi te kemoterapija. Dvije godine nakon uklanjanja IPT bez histoloških naznaka zloćudne bolesti bolesnica se osjeća dobro i nema recidiva bolesti. U ovom kao i u drugim sličnim slučajevima preporučili bismo dugotrajno praćenje bolesnica

Upalni pseudotumor vrata maternice: prikaz slučaja s pregledom literature

The third recorded case of an inflammatory pseudotumor (IPT) of the cervix is reported. IPT is considered to be a benign, self-limited lesion of obscure etiology. The condition is thought to be related to an unusual tissue response to injury, past fungal or bacterial infection and autoimmune disorders. In December 2003, an 18-year-old nulliparous woman presented in our hospital with dysfunctional bleeding. An incidental finding of a solitary leiomyoma-like mass, measuring 4.2 by 3.8 cm, originating from the cervix, was detected by gynecological examination. The tumor was surgically excised. Samples were stained by H&E, Gomori, pan-cytokeratin, vimentin, SMA, myoglobin, desmin, s-100, CD-68, Factor VIII and p53. Microscopic evaluation of H/E samples showed a distinctive mesenchymal lesion composed of spindle cells displaying morphological features of myofibroblasts, fibroblasts and histiocytes mixed with a considerable number of inflammatory cells. Immunohistochemical analysis showed a positive reaction to vimentin, SMA, myoglobin, CD-68, and some tumor cells were unexpectedly positive to s-100. Gomori and Factor VIII emphasized the reticulin/capillary network. Although extremely rare in this site, IPT should be taken into consideration if mesenchymal lesion or a tumor-like inflammatory and reparative-like lesion is a matter for differential diagnosis. Surgical resection is the commonest therapy, but corticosteroids, NSAIDs and chemotherapy are also used. Two years after IPT excision with no histological evidence of malignancy, our patient is feeling well with no signs of relapse. In this as well as in other similar cases we would suggest a long-term follow-up.Prikazujemo treći dosad opisani slučaj upalnog pseudotumora (IPT, od engl. inflammatory pseudotumor) vrata maternice. IPT se smatra dobroćudnom, samoograničavajućom tvorbom nejasne etiologije. Bolest se povezuje s neuobičajenom reakcijom tkiva na ozljedu, prijašnju gljivičnu ili bakterijsku infekciju i autoimunosne poremećaje. U prosincu 2003. 18-godišnja žena koja dotad nije rađala došla je u bolnicu radi disfunkcionalnog krvarenja. Na ginekološkom pregledu slučajno je na vratu maternice otkrivena odvojena nakupina slična leiomiomu veličine 4,2 x 3,8 cm. Tumor je kirurški uklonjen. U analizi uzoraka primijenjeni su: hemalaun-eozin (H&E), Gomori, pancitokeratin, vimentin, SMA, mioglobin, desmin, s-100, CD-68, faktor VIII i p53. Mikroskopska analiza uzoraka bojanih H/E pokazala je distinktivnu mezenhimnu tvorbu građenu od vretenastih stanica s morfološkim značajkama miofibroblasta, fibroblasta i histiocita pomiješanih sa znatnim brojem upalnih stanica. Imunohistokemijska analiza pokazala je pozitivnu reakciju na vimentin, SMA, mioglobin, CD-68, dok su pojedinačne tumorske stanice bile neočekivano pozitivne na S-100. Gomori i Faktor VIII naglašavali su retikulinsko-kapilarnu mrežu. Iako iznimno rijedak na ovome mjestu, upalni pseudotumor bi se diferencijalno dijagnostički trebao uzeti u obzir ako se radi o mezenhimalnoj tvorbi nalik tumoru ili reparativnoj promjeni. Pored kirurške resekcije koja je najčešći oblik liječenja, u liječenju ove tvorbe također se rabe i kortikosteroidi, nesteroidni protuupalni lijekovi te kemoterapija. Dvije godine nakon uklanjanja IPT bez histoloških naznaka zloćudne bolesti bolesnica se osjeća dobro i nema recidiva bolesti. U ovom kao i u drugim sličnim slučajevima preporučili bismo dugotrajno praćenje bolesnica

Zamke u postavljanju dijagnoze pilomatriksoma primjenom aspiracijske citodijagnostike – prikaz sedam slučajeva

Background: Pilomatrixoma is a benign tumor with differentiation toward hair cells. It is a rare, benign, slow-growing skin tumor firstly described by Malhebre and Chenantais in 1880. It usually occurs as a solitary lesion mostly located in the head and neck as a firm, deep-seated nodule covered by normal skin. Case: Our study evaluate retrospectively the clinical and cytomorphologic features of seven cases of pilomatrixoma. In the smears stained with MGG malignancy was excluded. The diagnosis of pilomatrixoma was confirmed by pathologist. A semiquantitative method was used in evaluation of the following features: basaloid cells, shadow cells, inflammatory cells, giant cells, naked nuclei, and debris (0 absent, 1+ mild amount, 2+ moderate, 3+ abundant). The maximum score obtained in FNA was for basaloid cells 13/21, shadow cells 14/21 and giant cells 11/21 while in the histological sections, the maximum score for basaloid cells was 20/21 and for shadow cells 17/21. Conclusion: The presence of basaloid cells, ghost cells and giant cells in cytological smears and also clinical information as a localization in the head and neck region, then a slowly growing tumor of the skin or subcutaneous tissue will allow a conclusive diagnosis of pilomatrixoma by FNA.Pilomatriksom je benigni tumor porijekla stanica dlačnog folikula. On je rijetki, benigni, sporo rastući kožni tumor kojeg su prvi puta opisali Malhebre i Chenantais 1880. godine. Pojavljuje se obično kao pojedinačna lezija, najčešće na glavi i vratu kao tvrdi, dublje smješten čvor prekriven normalnom kožom. Naša studija retrospektivno evaluira kliničke i citomorfološke značajke sedam slučajeva pilomatriksoma. U razmazima koji su bili bojeni MGGom isključen je malignitet. Dijagnoza pilomatriksoma potvrđena je histološki. Upotrebljena je semikvantitativna metoda u analizi sljedećih karakteristika: bazaloidne stanice, anuklerane stanice, upalne stanice, divovske stanice, gole jezgre, i detritus (O negativno, 1+ mala zastupljenost, 2+ srednja zastupljenost, 3+ obilno). Maksimalan rezultat dobiven aspiracijskom citodijagnostikom iznosio je za bazaloidne stanice 13/21, anuklearne stanice 14/21 i divovske stanice 11/21, dok su histološkom analizom dobiveni rezultati za bazaloidne stanice 20/21 i za anuklearne stanice 17/21. Prisutnost bazaloidnih stanica, anuklearnih stanica i divovskih stanica u citološkim razmazima kao i kliničke informacije o lokalizaciji u području glave i vrata, te o sporo rastućem tumoru kože i potkožnog tkiva upućivat će u citodijagnostici na zaključnu dijagnozu pilomatriksoma

Sarkom svijetlih stanica – prikaz slučaja

The report covers the first case of clear cell sarcoma (malignant melanoma of soft tissue) recorded in the Croatian medical literature. It is a rare soft tissue tumor, constituting less than 1% of all soft tissue neoplasms, first reported by Enzinger in 1965. The tumor presents most often in adolescents and young adults, with its peak incidence in the third and fourth decade and slight female predominance. The tumor produces melanin, but it differs from melanoma in several important respects. The proper name for this neoplasm should be clear cell sarcoma of tendons and aponeuroses in order to prevent confusion with clear cell sarcoma of the kidney and other clear and spindle cell neoplasms. A 23-year-old female patient presented to our hospital with a 10 cm large, painless, lower right leg mass, and few palpable lymph nodes in the ipsilateral inguinum. Clinical examination (NMR, ultrasound ) showed an expansive tumor mass and few suspicious inguinal lymph nodes. Surgical treatment was indicated because of cytologically suspicious diagnosis of clear cell sarcoma or malignant melanoma . Histopathological and immunohistochemical analysis confirmed the origin of tumor cells and showed melanoma/ melanocytic differentiation including clear cell sarcoma (malignant melanoma of soft tissue). This case report provides evidence that the preoperative definitive diagnosis of primary CCSSP can be rendered if immunocytochemistry is used in addition to cytomorphology in a suitable clinical setting.U radu je prikazan prvi slučaj sarkoma svijetlih stanica (malignog melanoma mekih tkiva) zabilježen u hrvatskoj medicinskoj literaturi. Taj rijedak tumor mekih tkiva, koji čini manje od 1% svih novotvorina mekih tkiva, prvi je puta opisao Enzinger 1965. godine. Tumor se najčešće pojavljuje u adolescenata i mla|ih odraslih osoba, s najvećom incidencijom u trećoj i četvrtoj životnoj dekadi i nešto je češći u žena. Tumor proizvodi melaninski pigment, ali se ipak razlikuje od melanoma u više važnih značajki. Pravilan naziv za tumor trebao bi biti sarkom svijetlih stanica tetiva i aponeuroza kako bi se izbjegla zamjena sa sarkomima svijetlih stanica bubrega i drugim novotvorninama svijetlih i izduženih stanica. 23-godišnja pacijentica došla je u našu ustanovu s tumorskom masom na desnoj potkoljenici i nekoliko palpabilnih ingvinalnih čvorova. Klinički pregled (NMR i UZV) potvrdio je ekspanzivnu tumorsku masu i povećane ingvinalne limfne čvorove. Citološki se postavi sumnja na sarkom svijetlih stanica ili maligni melanom te se učini kirurški zahvat. Histokemijska i imunohistokemijska analiza potvrdila je melanocitnu diferencijaciju, tj. dijagnozu sarkoma svijetlih stanica (malignog melanoma mekih tkiva). Prikazani slučaj potvrdio je mišljenje da je preoperativna definitivna dijagnoza sarkoma svijetlih stanica mekih tkiva moguća ako se uz citomorfologiju i kliničke podatke učini i dodatna imunocitokemijska analiza

Zamke u postavljanju dijagnoze pilomatriksoma primjenom aspiracijske citodijagnostike – prikaz sedam slučajeva

Background: Pilomatrixoma is a benign tumor with differentiation toward hair cells. It is a rare, benign, slow-growing skin tumor firstly described by Malhebre and Chenantais in 1880. It usually occurs as a solitary lesion mostly located in the head and neck as a firm, deep-seated nodule covered by normal skin. Case: Our study evaluate retrospectively the clinical and cytomorphologic features of seven cases of pilomatrixoma. In the smears stained with MGG malignancy was excluded. The diagnosis of pilomatrixoma was confirmed by pathologist. A semiquantitative method was used in evaluation of the following features: basaloid cells, shadow cells, inflammatory cells, giant cells, naked nuclei, and debris (0 absent, 1+ mild amount, 2+ moderate, 3+ abundant). The maximum score obtained in FNA was for basaloid cells 13/21, shadow cells 14/21 and giant cells 11/21 while in the histological sections, the maximum score for basaloid cells was 20/21 and for shadow cells 17/21. Conclusion: The presence of basaloid cells, ghost cells and giant cells in cytological smears and also clinical information as a localization in the head and neck region, then a slowly growing tumor of the skin or subcutaneous tissue will allow a conclusive diagnosis of pilomatrixoma by FNA.Pilomatriksom je benigni tumor porijekla stanica dlačnog folikula. On je rijetki, benigni, sporo rastući kožni tumor kojeg su prvi puta opisali Malhebre i Chenantais 1880. godine. Pojavljuje se obično kao pojedinačna lezija, najčešće na glavi i vratu kao tvrdi, dublje smješten čvor prekriven normalnom kožom. Naša studija retrospektivno evaluira kliničke i citomorfološke značajke sedam slučajeva pilomatriksoma. U razmazima koji su bili bojeni MGGom isključen je malignitet. Dijagnoza pilomatriksoma potvrđena je histološki. Upotrebljena je semikvantitativna metoda u analizi sljedećih karakteristika: bazaloidne stanice, anuklerane stanice, upalne stanice, divovske stanice, gole jezgre, i detritus (O negativno, 1+ mala zastupljenost, 2+ srednja zastupljenost, 3+ obilno). Maksimalan rezultat dobiven aspiracijskom citodijagnostikom iznosio je za bazaloidne stanice 13/21, anuklearne stanice 14/21 i divovske stanice 11/21, dok su histološkom analizom dobiveni rezultati za bazaloidne stanice 20/21 i za anuklearne stanice 17/21. Prisutnost bazaloidnih stanica, anuklearnih stanica i divovskih stanica u citološkim razmazima kao i kliničke informacije o lokalizaciji u području glave i vrata, te o sporo rastućem tumoru kože i potkožnog tkiva upućivat će u citodijagnostici na zaključnu dijagnozu pilomatriksoma

Sarkom svijetlih stanica – prikaz slučaja

The report covers the first case of clear cell sarcoma (malignant melanoma of soft tissue) recorded in the Croatian medical literature. It is a rare soft tissue tumor, constituting less than 1% of all soft tissue neoplasms, first reported by Enzinger in 1965. The tumor presents most often in adolescents and young adults, with its peak incidence in the third and fourth decade and slight female predominance. The tumor produces melanin, but it differs from melanoma in several important respects. The proper name for this neoplasm should be clear cell sarcoma of tendons and aponeuroses in order to prevent confusion with clear cell sarcoma of the kidney and other clear and spindle cell neoplasms. A 23-year-old female patient presented to our hospital with a 10 cm large, painless, lower right leg mass, and few palpable lymph nodes in the ipsilateral inguinum. Clinical examination (NMR, ultrasound ) showed an expansive tumor mass and few suspicious inguinal lymph nodes. Surgical treatment was indicated because of cytologically suspicious diagnosis of clear cell sarcoma or malignant melanoma . Histopathological and immunohistochemical analysis confirmed the origin of tumor cells and showed melanoma/ melanocytic differentiation including clear cell sarcoma (malignant melanoma of soft tissue). This case report provides evidence that the preoperative definitive diagnosis of primary CCSSP can be rendered if immunocytochemistry is used in addition to cytomorphology in a suitable clinical setting.U radu je prikazan prvi slučaj sarkoma svijetlih stanica (malignog melanoma mekih tkiva) zabilježen u hrvatskoj medicinskoj literaturi. Taj rijedak tumor mekih tkiva, koji čini manje od 1% svih novotvorina mekih tkiva, prvi je puta opisao Enzinger 1965. godine. Tumor se najčešće pojavljuje u adolescenata i mla|ih odraslih osoba, s najvećom incidencijom u trećoj i četvrtoj životnoj dekadi i nešto je češći u žena. Tumor proizvodi melaninski pigment, ali se ipak razlikuje od melanoma u više važnih značajki. Pravilan naziv za tumor trebao bi biti sarkom svijetlih stanica tetiva i aponeuroza kako bi se izbjegla zamjena sa sarkomima svijetlih stanica bubrega i drugim novotvorninama svijetlih i izduženih stanica. 23-godišnja pacijentica došla je u našu ustanovu s tumorskom masom na desnoj potkoljenici i nekoliko palpabilnih ingvinalnih čvorova. Klinički pregled (NMR i UZV) potvrdio je ekspanzivnu tumorsku masu i povećane ingvinalne limfne čvorove. Citološki se postavi sumnja na sarkom svijetlih stanica ili maligni melanom te se učini kirurški zahvat. Histokemijska i imunohistokemijska analiza potvrdila je melanocitnu diferencijaciju, tj. dijagnozu sarkoma svijetlih stanica (malignog melanoma mekih tkiva). Prikazani slučaj potvrdio je mišljenje da je preoperativna definitivna dijagnoza sarkoma svijetlih stanica mekih tkiva moguća ako se uz citomorfologiju i kliničke podatke učini i dodatna imunocitokemijska analiza

Slabo diferencirani sinovijalni sarkom – prikaz slučaja

We report a rare case of primary poorly differentiated synovial sarcoma (SS) in axillary region confirmed by histology. SS accounts for 5-10% of soft tissue sarcomas. Approximately 20% of the cases have poorly differentiated appearance, most often characterized by undifferentiated round cell morphology resembling Ewing’s sarcoma. The differential diagnosis includes ES/PNET family of tumors, rhabdomyosarcoma, desmoid fibromatosis, and malignant melanoma. A 46-year-old female presented to our hospital complaining of a 10 cm slightly painful mass in the right axillary region of a 2-month duration. Clinical examination (CT, ultrasound ) showed an expansive tumor mass. Cytological analysis showed the diagnosis of suspected sarcoma. Surgical treatment was performed. Histopathological and immunohistochemical analysis confirmed the diagnosis of poorly differentiated SS. In spite of additional methods as immunocytochemistry, the poorly differentiated variant of SS can be easily mistaken for numerous other tumors in cytological smears due to its complex, overlapping morphology and still limited experience of cytopathologists in the field of rare soft tissue tumors. Nevertheless, recognition of this variant of SS is of a major concern for its worse prognosis.U radu prikazujemo rijedak slučaj primarnog slabo diferenciranog sinovijalnog sarkoma (SS) aksilarne regije čija je dijagnoza potvr|ena patohistološkom analizom. Sinovijalni sarkom čini 5-10% mekotkivnih sarkoma. Oko 20% slučajeva ima sliku slabo diferencirane varijante, malih okruglih stanica podsjećajući na Ewingov sarkom. Diferencijana dijagnoza uključuje ES/PNET skupinu tumora, rabdomiosarkom, desmoidnu fibromatozu i maligni melanom. Četrdesetšestogodišnja pacijentica primljena je u našu ustanovu žaleći se na lagano bolnu 10 cm veliku tumorsku masu u desnoj aksilarnoj regiji u trajanju od dva mjeseca. Klinički pregled (CT; UZV) potvrdili su ekspanzivnu tumorsku masu, a citološka analiza upućivala je na dijagnozu sarkoma te je učinjen operativni zahvat. Histološka i imunohistokemijska analiza potvrdila je dijagnozu slabo diferenciranog SS. Unatoč primjeni dodatnih metoda citološke analize, poput imunocitokemije, slabo diferencirana varijanta sinovijalnog sarkoma može se lako, zbog kompleksne, preklapajuće morfologije kao i ograničenog iskustva citologa na polju rijetkih tumora mekih tkiva, zamijeniti s drugim tumorima. Ipak prepoznavanje ove varijante SS od važnosti je zbog njegove lošije prognoze

Vrijednost citologije u dijagnostici lezija žlijezda slinovnica: naše iskustvo

The retrospective study was designed to evaluate salivary gland lesions diagnosed in the Department of Clinical Cytology and surgically treated in the Department of Head and Neck Surgery in the University Hospital for Tumors, Zagreb, Croatia between 1990 and 2004. We analyzed localization, histological type and concordance between cytology and final histological diagnosis. The study includes 286 patients treated for salivary gland lesions. All patients had fine-needle aspiration (FNA) cytology of the lesion before surgery. All the cytological specimens obtained were aspirated from palpable lesion or revealed during sonographic examination. The majority of lesions was localized in the parotid gland. There were 213 benign tumors, 40 benign lesions and 33 malignant tumors. The most common benign tumors were pleomorphic adenoma and Warthin\u27s tumor, while the most common malignant tumor was adenoid cystic carcinoma. Our results show overall accuracy of fine-needle aspiration cytology of 91%. The sensitivity in differentiating benign from malignant lesions was 61% and specificity was 95%. The positive predictive value was 61% and negative predictive value 95%. FNA cytology of salivary gland lesions is safe, easy to perform and valuable noninvasive method of preoperative diagnosis. It is accurate method and differentiates non-tumorous benign lesion, benign and malignant tumor, as well as grade of tumor malignancy.U retrospektivnoj studiji analizirane su lezije žlijezda slinovnica dijagnosticirane u Službi za kliničku citologiju i kirurški liječene u Službi za tumore glave i vrata Klinike za tumore u Zagrebu između 1990. i 2004. Analizirali smo lokalizaciju, histološki tip i podudarnost između citološkog i konačnog patohistološkog nalaza. Studija je uključila 286 bolesnika liječenih zbog lezija žlijezda slinovnica. Predoperativna obrada uključivala je citološku analizu kod svih bolesnika. Materijal za citološku analizu dobiven je aspiracijom iz palpabilne promjene ili pod kontrolom ultrazvuka. Većina lezija nalazila se u parotidnoj žlijezdi. Bilo je 213 dobroćudnih tumora, 40 dobroćudnih netumorskih promjena i 33 zloćudna tumora. Najčešći dobroćudni tumori bili su pleomorfni adenom i Warthinov tumor, najčešći maligni tumori bio je adenoid cistični karcinom. Naši rezultati pokazuju ukupnu točnost citološke analize 91%. Senzitivnost metode u razlikovanju benignih i malignih lezija bila je 61%, a specifičnost 95%. Pozitivna prediktivna vrijednost bila je 61%, a negativna prediktivna vrijednost bila je 95%. Citološka analiza lezija žlijezda slinovnica je sigurna, jednostavna i vrijedna neinvazivna metoda u preoperativnoj dijagnostici. Metoda je točna i razlikuje netumorske dobroćudne lezije, dobroćudne i zloćudne tumore, kao i stupanj diferenciranosti zloćudnih tumora

Vrijednost citologije u dijagnostici lezija žlijezda slinovnica: naše iskustvo

The retrospective study was designed to evaluate salivary gland lesions diagnosed in the Department of Clinical Cytology and surgically treated in the Department of Head and Neck Surgery in the University Hospital for Tumors, Zagreb, Croatia between 1990 and 2004. We analyzed localization, histological type and concordance between cytology and final histological diagnosis. The study includes 286 patients treated for salivary gland lesions. All patients had fine-needle aspiration (FNA) cytology of the lesion before surgery. All the cytological specimens obtained were aspirated from palpable lesion or revealed during sonographic examination. The majority of lesions was localized in the parotid gland. There were 213 benign tumors, 40 benign lesions and 33 malignant tumors. The most common benign tumors were pleomorphic adenoma and Warthin\u27s tumor, while the most common malignant tumor was adenoid cystic carcinoma. Our results show overall accuracy of fine-needle aspiration cytology of 91%. The sensitivity in differentiating benign from malignant lesions was 61% and specificity was 95%. The positive predictive value was 61% and negative predictive value 95%. FNA cytology of salivary gland lesions is safe, easy to perform and valuable noninvasive method of preoperative diagnosis. It is accurate method and differentiates non-tumorous benign lesion, benign and malignant tumor, as well as grade of tumor malignancy.U retrospektivnoj studiji analizirane su lezije žlijezda slinovnica dijagnosticirane u Službi za kliničku citologiju i kirurški liječene u Službi za tumore glave i vrata Klinike za tumore u Zagrebu između 1990. i 2004. Analizirali smo lokalizaciju, histološki tip i podudarnost između citološkog i konačnog patohistološkog nalaza. Studija je uključila 286 bolesnika liječenih zbog lezija žlijezda slinovnica. Predoperativna obrada uključivala je citološku analizu kod svih bolesnika. Materijal za citološku analizu dobiven je aspiracijom iz palpabilne promjene ili pod kontrolom ultrazvuka. Većina lezija nalazila se u parotidnoj žlijezdi. Bilo je 213 dobroćudnih tumora, 40 dobroćudnih netumorskih promjena i 33 zloćudna tumora. Najčešći dobroćudni tumori bili su pleomorfni adenom i Warthinov tumor, najčešći maligni tumori bio je adenoid cistični karcinom. Naši rezultati pokazuju ukupnu točnost citološke analize 91%. Senzitivnost metode u razlikovanju benignih i malignih lezija bila je 61%, a specifičnost 95%. Pozitivna prediktivna vrijednost bila je 61%, a negativna prediktivna vrijednost bila je 95%. Citološka analiza lezija žlijezda slinovnica je sigurna, jednostavna i vrijedna neinvazivna metoda u preoperativnoj dijagnostici. Metoda je točna i razlikuje netumorske dobroćudne lezije, dobroćudne i zloćudne tumore, kao i stupanj diferenciranosti zloćudnih tumora