CYTODIAGNOSIS BY NEEDLE PUNCTURE AND ASPIRATION OF ORAL MALIGNANT TUMORS

抄録

This study comprises a total of 856 cases with suspicious clinical diagnosis of malignant tumors which were cytologically examined by us during the past 8 years. Of 856 cases, 184 were examined by the needle puncture and aspiration mostly on their non-ulcerated facial and oral lesions, before the treatments were given. In this paper, the results of the 184 cases are analysed and shown. The needle in this study is redesigned for new application with 15, 16 and 17 gauge of 4 to 7 cm in length, having a mandrin which is attached closely to the inner surface of the needle in order to avoid contamination of the tissue to be aspirated with surface epithelial cells. The needle has been used differently in each lesion according to its nature. Phase contrast microscopy (abbreviated to PCM) has been applied to observe the specimen, saving time and work untill getting the results, but for the better confirmation of the findings the Papanicolaou (abbreviated to Pap.) staining was additionally applied. If the material by aspiration was obtained more than needed, the surplus was used for the usual histological examination, and in such a case the surgical biopsy could be omitted. The findings of aspiration cytology have been confirmed through their clinical and histological examinations. Of 184 cases, 88 had the final histological diagnosis, 49 of which were malignant tumors and the remaining 39 were non-malignant lesions. Out of a total of 49 cases of malignant tumors, cytological examination yielded a positive diagnosis of cancer in 62.5% by PCM alone, and in 80.6% by the combination of PCM and Pap. staining. Out of 39 cases with non-malignant lesions, cytological examination yielded a false positive diagnosis in 11 cases, by PCM alone. Six cases of these 11 were diagnosed as pleomorphic adenoma histologically. The tumor is believed to be not malignant but posseses a possible malignancy in nature. Then the cytological results of Class IV (suggestive of malignancy) of these cases give us a specific meaning that we can find the existence of the tumor and take a appropriate preparation for the following treatment. The cytological and histological examination by aspiration is a time-saving method of confirming a diagnosis without surgical incision through normal tissue in our fields. The process by aspiration prevents a possible infection and dangerous fungating of the tumors.