title: Role of fine-needle aspiration in clinical management of transplant patients.
abstract: Fine-needle aspiration (FNA) of superficial and deep seated lesions has been used with high sensitivity and specificity in the diagnosis of neoplastic and non-neoplastic entities. However, studies of FNA in post-transplant patients are virtually absent. Six hundred and seventy-four allograft recipients (cardiac 288, renal 250, lung 131 and heart-lung 5) were reviewed. A total of 30 (25 heart, 4 lungs and 1 renal transplant) patients underwent an FNA procedure. There were 26 males and 4 females. Ages ranged from 18-63 yr (mean 48 yr). The most common entity aspirated was post-transplant lymphoproliferative disorder (PTLD) in 12 cases, followed by inflammatory lesions in 10 cases, malignant epithelial neoplasms in 3 cases, and 1 case each of malignant mesenchymal tumor, pulmonary infarction, hamartoma of liver, fatty changes of liver, and a benign vascular lesion. Surgical or autopsy tissue was available in 19 cases (63.3%). There was an agreement between tissue diagnosis and FNA material in 18 cases (94.7%). One (5.2%) false negative case was recorded. This was a liver aspirate showing benign liver elements, which a surgical biopsy proved to be a bile duct hamartoma. No false positive cases were recorded. FNA is a highly sensitive and specific diagnostic tool in the management of post-transplant patients.
authors.affiliation: Department of Pathology, Loyola University Medical Center, Maywood, Illinois, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Siddiqui
authors.forename: V B
authors.initials: VB
authors.lastname: Reddy
authors.forename: M J
authors.initials: MJ
authors.lastname: Castelli
authors.forename: P
authors.initials: P
authors.lastname: Gattuso
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology; D008232:Lymphoproliferative Disorders / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000209:etiology; D016377:Organ Transplantation / Q000009:adverse effects* / Q000473:pathology*; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000209:etiology; D012680:Sensitivity and Specificity; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000209:etiology; D014184:Transplantation, Homologous / Q000009:adverse effects