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We describe a case of lactating adenoma in pregnant woman, 32 week of gestation. Typical features of disease presented in this article was revealed by clinical and microscopic methods and it make possible to diagnose the process before operation. The diagnosis was confirmed by histological investigation of surgical material., Competing Interests: The authors declare no conflict of interest.

Cytological study is a highly specialized type of laboratory analysis of the cellular composition of biological material and is to assess the morphological characteristics of cellular elements. The modern development of digital technologies is increasingly forming the interest of specialists to such a section as telepathology (digital pathology), which is a process of virtual microscopy with the transformation of classical cytological preparations into digital. Most morphologists currently use some forms of digital imaging, such as static images obtained by optical cameras mounted under a microscope. The development of more high quality image and resolution in the digital pathology promotes the use of telepathology, including telecitology in their daily work for training specialists, counselling of medications, monitoring the quality of diagnosis., Competing Interests: The authors declare no conflict of interest.

Analysis of the cellular composition of the eyeball conjunctival prints and evaluation of the informative of the cytomorphological method of research in the diagnosis of dry eye syndrome (DES). Cytological examination using impression cytology was performed in 72 patients: 60 patients with DES and 12 without eye disease (control group). The main component of cytological sample in patients with DES are (a) squamous epithelium (hyperkeratocytes); (b) groups and clusters of flattened epithelial cells; (c) a small amount (up to five in the preparation) of goblet cells. Impression cytology method improves the accuracy of diagnosis of DES., Competing Interests: The authors declare no conflict of interest.

Diagnosis of peritoneal microcanceromatosis is the most important task allowing to determine treatment strategy for patients with stomach cancer. Laparoscopy combined with peritoneal flushing and subsequent cytological examination should be performed to detect the peritoneal microcanceromatosis at the preoperative stage. The objective of this work was to improve cytological diagnostics of peritoneal washings using immunocytochemical techniques and the cell block method. The work was carried out on the basis of 276 surgical peritoneal washings in patients with stomach cancer who were on treatment in the department of high-tech surgery of the Moscow Clinical Scientific Centre of the State Budgetary Healthcare Institution named after Loginov A.S. from June 2016 to June 2018. As a result, the optimal panel of monoclonal antibodies (Ber-EP4, CEA, CK20) was chosen, which increased the sensitivity from 52% to 96% and the specificity of cytological diagnosis from 80% to 98%, and the overall accuracy of the method from 67% to 98%., Competing Interests: The authors declare no conflict of interest.

The research is devoted to the study of the occurrence of abnomal cells in buccal epithelium in patients with chronic generalize periodontitis. Buccal cytograms of 102 patients were examined. It was established that cells with karyopycnosis, karyorexis and karyolysis are a sensitive index of the initial stage (mild severity) in periodontitis. The number of buccal cells with these features was increased in 2.1; 3.0; 13.4 times for chronic generalized periodontitis of mild, moderate and severe degree, respectively. The obtained data shown the accumulation of cytological anomalies (micronucleus, protrusion of the nucleus and other) in patients with chronic generalized periodontitis., Competing Interests: The authors declare no conflict of interest.

Cytological diagnosis by effusions is currently the only reliable method of morphological verification of the diagnosis, it has prognostic significance and determines the choice of treatment strategy. At the same time, the variability of normal mesothelial cells causes significant difficulties in its differential diagnosis with reactive mesothelium, malignant mesothelioma and cancer metastasis, which requires additional analytical methods. A retrospective study of cytological preparations for 2017 was conducted, as well as the effectiveness of the use of fluorescent immunocytochemistry (FITZ) on the test system "biochip" in combination with a traditional cytological study was evaluated. During the period of November 2017 - July 2018, 46 exudates of serous cavities were studied, which showed that 9 patients (19.6%) were diagnosed with metastatic effusion, 31 (66.7%) patients had reactive exudate, suspicion of the malignant nature of serous fluid was expressed in 4 patients (8.7%), and 4.8% of persons (2 samples) failed to make an accurate diagnosis. After an additional FITZ study using the "Biochip" test system, the number of patients diagnosed with metastatic effusion increased to 7 (25.9%) due to a decrease in the percentage of cases of unspecified effusion. The combined use of traditional cytology and fluorescent immunocytochemistry in the diagnosis of effusion fluids at the stage of emergency medical care to the patient complements each other and contributes to a faster and more reliable diagnosis, as it allows to confirm the malignancy of the test material, and to assume the primary focus., Competing Interests: The authors declare no conflict of interest.

The study was organized to establish criteria of cytological diagnostic of pathology of parathyroid glands under various forms of hyperparathyroidism. The ultrasound examination of pathology of parathyroid glands was applied to 74 patients with hyperparathyroidism aged 24-66 years (20 males and 54 females). The examination was applied to 11 patients with primary hyperparathyroidism (bone visceral form), 51 patients with secondary hyperparathyroidism of severe course and 12 patients with tertiary hyperparathyroidism (post-transplantation). The 109 samples of expanded parathyroid glands were visualized and subjected to fine-needle aspiration biopsy. The cytologic material was colored with azure-eosin according Pappenheim method and analyzed using light microscopy technique. The cytological material was informative in 105 (96%) findings. The elements of tissue of parathyroid glands were detected in 99 (90.8%) samples. The main cytomorphologic indications of adenoma of parathyroid gland were follicle-like and papillary structures of main parathyrocites detected in all patients with primary hyperparathyroidism; main parathyrocites at various stages of secretory cycle - in 64% of patients and macrophages - in 50% of patients. The characteristic cytomorphologic indications of hyperplasia of parathyroid gland turned out to be situated in groups, papillary and branching structures with expressed intercellular contacts, main dark parathyrocytes detected in 88% of patients with secondary hyperparathyroidism, parathyrocytes at various stages of secretory cycle (53% of patients) and small basophilic granules of secretion of parathyrocites in cytoplasm and/or extracellular space (31% of patients). The distinctive cytological indications of tissue of parathyroid gland under tertiary hyperparathyroidism included prevalence of main light parathyrocites situated in small clusters and groups with ill-defined intercellular contacts and presence of large basophilic secretory granules in cytoplasm of parathyrocites, extracellular space and colloid-like substance (92% of patients). The comparative analysis detected similar cytological indications in tissue of parathyroid gland and strictly definite criteria characteristic for primary, secondary and tertiary hyperparathyroidism. The relationship between structural functional condition of tissue of parathyroid gland and development of either form of hyperparathyroidism is discussed. The cytomorphologic characteristics of tissue of parathyroid gland under primary, secondary and tertiary hyperparathyroidism can be included in algorithm of pre-surgery diagnostic.

The increasing of number of diseases of thyroid actualizes searching for new solutions in differential diagnostic. Nowadays, the technique of fluid cytology is started to be applied under cytological analysis of puncture sample of thyroid. However, experience of application of technique of fluid cytology in interpretation of cytological sample is limited. The article presents results of analysis of samples of fine needle aspiration biopsy of thyroid from 126 patients. In case of traditional cytological analysis aspirate was putted on glass right away. In case of technique of fluid cytology patient was re-punctured and sample was placed into vial with preservative solution. At re-puncture increasing number of analysis with non-diagnosed samples was observed (40.6% in comparison with 17.8% under traditional cytological analysis). However, in 50% of patients with non-informative samples in traditional cytological analysis implementation of technique of fluid cytology permitted to establish proper diagnosis. In diagnostic of non-tumor affections of thyroid the best results demonstrated by technique of fluid cytology (86.6% as compared with 47.2% under technique of fluid cytology). However, in diagnostic of benign tumor affections of thyroid the best accuracy was demonstrated by traditional cytological analysis (61.1% as compared with 33.3% of technique of fluid cytology). Both techniques demonstrated similar results in category of malignant affections of thyroid. The diagnosis of cancer or suspicion to cancer was established in 85.7% of cases under technique of fluid cytology and in 82.7% of cases under traditional cytological analysis). The analysis of cytological pictures of various diseases of thyroid in technique of fluid cytology demonstrated specifics and differences from traditional cytology that are to be considered. At the same time, observations convincingly testify that in number of cases traditional and fluid techniques supplement each other. Besides, technique of fluid cytology permits preserving and transport puncture samples and in case of necessity to apply additional clarifying diagnostic techniques that in turn increases effectiveness of cytological diagnostic of affections of thyroid.

The article presents the results of intravital studying of cytomorphologic characteristics of elements of tissue of parathyroids obtained under thin-needle aspiration biopsy in patients with hyperparathyroidism. The analysis was applied to 84 fragments of cell material from node formations in projection of anatomic localization of parathyroids and in projection of lobes and isthmus of thyroid gland. The cytologic preparations colored with Pappenheim azure-eosin staining were analyzed using light microscopy. The results were compared with data of histological study of post-operation material. The following cytomorphologic signs of tissue of parathyroids under hyperparathyroidism: heterogeneity of population of cells of glandular epithelium--presence of main (dark, light) and oxyphilous parathyrocytes with prevalence of main parathyrocytes; occurrence of expressed intracellular contacts in groupings of parathyrocytes with formation of rosette-strand like structures or compact assemblies as well as occurrence of dark polymorphic granules positioned in cytoplasm of epithelium cells and intercellular medium.

The diagnostic of tumor cells circulating in blood is one of most perspective and actively developing directions in cytology. The most of proposed techniques for this purpose are based on using immune cytochemical or molecular genetic modes to characterize cells. At the samne time, growing spread receives technique of separation of circulating tumor cells based on their larger size in comparison with other blood cells (ISET). The article presents clinical monitoring of application of mentioned technique to verify diagnosis and onset of treatment in female patient with reiterated ineffective diagnostic punctures of pancreas.

Cervical cancer (CC) is the 2nd malignant tumor in Republic of Kazakhstan (RK). The quantity of late stage CC diagnoses remains high. Annual reports (2011-2012) of 19 cytology laboratories were analyzed. Study of the incidences and detection of early forms of cervical cancer screening was conducted. The investigation showed incomplete screening coverage of the female population in Kazakhstan, and a shortage of specialists (Cytopathologists, cytotechnicians). The peculiarities of CC during formal and informal screening were detected. Measures to increase female screening coverage are proposed. Among them creation of a reference laboratory at the national level, adoption of the training methods of the International Academy of Cytology (IAC), periodic testing of cytopathologists, training by specialists from Kazakhstan and experts from IAC.

The study was organized to assess the sensitivity of combined technique of diagnostics of pre-cancer and cervix cancer consisted of liquid cytology and detection of clinically significant amount of Human Papillomavirus DNA in cervical samples of cervix. The cervical samples of 62 women were collected to into medium for liquid cytology and Papanikolau's stained in the system B&D TriPath. The results were evaluated according the Bethesda classification. Concurrently with the same material, the polymerase chain reaction technique in real time was applied using the Cobas 4800 device. To specify the cytological diagnosis ASC-US and under L-SIL and H-SIL the immunocitochemical detection of oncomarkers p16INK4a and Ki-67 was implemented using additionally prepared glass of the same material obtained by the liquid cytology technique. The study detected Human Papillomavirus DNA of oncogenic types in 12 cases out of 13 H-SIL (92.3%) < and in 3 cases out of 4 L-SIL (75%). In 31 female patients with ASC-US no clinically significant amount of Human Papillomavirus DNA was detected. This result correlated with the results of immunocitochemical analyses where expression of marker p16INK4a was not present. In 5 out of 9 female patients (55.6%.) aged 21-24 years with cytological diagnosis NILM Human Papillomavirus DNA was detected. The cytological analysis detected in 53 out of 63 female patients the atypical cells of cervix pavement epithelium (85.5%). The combined technique detected pathology in 58 female patients (93.5%). The cytological analysis of Human Papillomavirus was complemented by testing with Cobas 4800 device because this system permits to detect 14 highly oncogenic types of Human Papillomavirus with separate genetic typing of Human Papillomavirus of 16 and 18 types.

The paper shows the rate of pathomorphism, by comparing the major cytometrical indices of squamous-cell cancer of the lung before and after single-stage intratumoral chemotherapy on the basis of studies of puncture and intraoperative specimens from 13 patients. Morphometry of 1950 relatively preserved tumor cells was made. The degree of intratumor chemotherapeutic action on tumor cells was objectively reflected in a significant difference in the mean values of the area of the cytoplasm (from 325.1 +/- 7.52 microm2 in the puncture specimens before administration of chemicals to 426.2 +/- 12.67 microm2 in the intraoperative specimens after their administration) and nuclei (from 127.9 +/- 3.45 to 179.7 +/- 7.86 microm2) and in the nuclear shape ratio (from 1.32 +/- 0.02 to 1.48 +/- 0.02).

Computer microscopy with nuclei ploidy visualization of tumour cells provides additional objective signs of malignant transformation of uterine cervix multilayer epithelium. Nuclear ploidometry is a differential diagnostic procedure which allows more precisely than routine methods to establish benign stages of neoplastic processes: intraepithelial neoplasia I (2.5-3.4); borderline stage--intraepithelial neoplasia of the II-III degree (3.5-4.5) and diagnose malignant tumours--infiltrating carcinomas in mean values of tumour cell ploidy more than 4.5 (keratinized carcinoma--5.4; non-keratinized one--5.8).

In this article are examining the requirements to diagnostic methods in periodontics. Author comprises clinical radiology and cytomorphometric methods in diagnostics of chronic gingivitis and initial periodontitis.

Results are available of clinical and cytological diagnosis for 200 patients with histologically established benign lesions of the mammary gland. The use of cytological method at the presurgery stage decreases the number of unjustified carcinoma suspects up to 5%. True cytological diagnosis is established in 90% of mastopathies, 84.6% of fibroadenomas and 80.8% of the inflammation cases. Pseudopositive conclusions about carcinoma were made in 2 cases (1% of all the examinees). Thus, the precision of the presurgical cytological diagnosis of benign breast lesions is 94%. This allows to consider it as a highly efficient method of presurgical morphological diagnosis.

Results of cytological diagnosis in the static telepathology mode are analyzed. Three expert cytologists made the diagnosis on the basis of images of cytological preparations obtained from 94 patients with tumors of soft tissues and bones. A total of 113 diagnoses were correct: benign or malignant type of the tumor and its histological type were identified. In general, a total of 152 (88.9%) diagnoses were correct as regards their significance for treatment strategy. Errors classified as groups 3 and 4 were the most significant (erroneous assessment of tumor type--benign or malignant--in 6.4% cases). Analysis of discrepancies between cytological and pathoanatomical diagnoses and data of routine optic microscopy of similar cytological preparations of the same material (bone and soft tissue tumors) showed the same value: 6.8% of cytological and pathoanatomical diagnoses were at disagreement (groups 3 and 4 of errors). Therefore, telepathology can be resorted to for consultations and discussion of obscure cases. It is particularly important for a morphologist to discuss complex cases by means of telepathology at a specialized institution, distant from him or her.

The approbation and comparative assessment of the methods of early active detection of thyroid diseases were performed among the population of the endemic region. The ultrasound examination of the thyroid gland is thought to be the most effective method at the first stage of the screening examination since it is very exact (98%), specific (99%) and sensitive (99%) when detecting both diffuse and nodular alterations of the organ. The possibility to combine the ultrasound examination with the thin-needle aspiration puncture biopsy allows not only to detect the patients and form the groups of risk of probable diseases, but also to make the diagnosis and determine the methods of treatment during the mass examination.

The author compares the efficacy of detecting chlamydial infection by the following methods: morphocytological analysis of urogenital smears under light microscope by indirect signs, such as 1) neutrophil histiocyte macrophagal reaction; 2) lymphoid infiltration with the presence of young forms; 3) basal-cell hyperactivity with dysplasia; 4) proliferation of the cylindrical epithelium with dysplasia, and 5) dystrophic changes in the epithelium; detection of chlamydial antigen by immunofluorescence and enzyme immunoassay; and detection of specific antibodies. A total of 240 patients were examined at the Regional Family Planning Center (163 women and 43 men of fertile age and 34 children and adolescents). Chlamydial origin of inflammation suspected from the above cytomorphological signs in 208 (87%) patients was confirmed by virological studies: chlamydial antigen was detected in 67% and specific antibodies in diagnostic titers in 20% of patients. This latter group was administered a course of specific antichlamydial therapy after detection of chlamydial antigen. The author concludes that patients with morphocytological signs of chronic inflammation listed above detected in the urogenital smears should be referred to a group at risk of chlamydiasis. The proposed method of screening is rapid, economic, and easily available.

Cytological diagnosis of retroperitoneal tumors in 173 children (1985-1996) has been evaluated, using aspiration biopsy (165), imprint smears (84) and cytohistological examination (128). Fine-needle biopsy data were confirmed in 99%; histological examination--97.3%.

The data on the cytological diagnosis of breast cancer in 4.410 patients tuated at the Clinic of the Institute in 1993-1996 are presented. There was histological evidence on 1,479 patients. The sensitivity of cytological examination was 97.2, specificity--92.4, predictive value of positive test--97 and that of negative test--93%. Correlations between cytological evidence, histological pattern, stage and size of tumor are discussed.

20-year experience in the intraoperative study of more than 3000 goiters led the authors to the conclusion that the most correct verification of the pathologic process may be performed only by means of intraoperative stereomorphological and histotopographic examination of the biopsy. In case of nodular hyperplasia of follicular and macropapillary structures the most adequate term is adenomatous goiter. The term borderline thyroid tumor is also suggested although it needs further discussion by both clinicians and morphologists.

84 tracheal tumors the correct diagnosis of which was established during roentgenoendoscopical investigation combined with urgent cytological diagnosis are reported. Cytological fast diagnosis can be considered a reliable method of morphological diagnostics.

Main advantages of the cytological method are demonstrated: possibilities of obtaining material from areas which are hardly accessible for open biopsy, investigation of bone tumor before or during the operation, etc. Detailed biological characteristics of tumor cells by means of DNA-flow cytometry, roentgenological and clinical data help to establish correctly a morphological variant of bone tumor and thus to choose an adequate therapeutical method.

4 cases of papillary epithelial tumors (PET) of the pancreas which were initially diagnosed erroneously are described in females aged 12, 14, 14 and 41 years. PET are circumscribed tumors up to 10 cm in diameter containing numerous cysts. Cyto- and histologically they are papillary-solid tumors with hyalinosis, myxomatosis, hemorrhage and necrosis. Zymogen type granules, ring-membranous inclusions were found electron microscopically. Some cells have a structure of oncocytes. Differential diagnostic features of PET are specified.

Buccal epitheliocytes collected from healthy and sick children aged 1 to 5 years were examined. The maximal and minimal size of epitheliocytes was measured and their mean size estimated, as was the percent share of cell cytolysis. An integral index derived on the basis of these measurements reflects the degree of change in the quantitative parameters characterizing the buccal epitheliocytes and is in positive correlation with deviations of hematological parameters from the norm in children with bronchopulmonary and somatic disease.

The following pulmonary lesions were studied: carcinoma, carcinoid, tuberculoma, chondromatous hamartoma, chronic non-specific inflammatory process. Material was obtained through fiber bronchoscopy and roentgeno-endoscopical examination. Pappenheim staining in the modification of Astrakhantsev-Nechaeva and Ziehl-Neelsen staining were used. 80 cases within 1993 were studied, among them 71 peripheral lung carcinomas. 3 carcinoids, 3 tuberculoses, 1 non-specific inflammation. Basic cytological criteria are summarized which will improve the quality of the presurgical diagnosis.

An algorithm has been derived and a computer program based on it developed, which helps to the dentist to carry out fluorescent cytological investigations and make a tentative rapid diagnosis using a PC. The algorithm is based on a simple standard assessment of the cytological preparation. Efficacy of differential diagnosis of labial and buccal cancer and precancer is 91.9 +/- 3.2%.

The causes of errors in cytological diagnosis in 615 patients with carcinoma and benign lesions of the lung and in 847 patients with those of oesophagus are studied and systematized. Percentage of errors was 15.93 for the lung diseases and 4.48 for diseases of the oesophagus. The error causes are subdivided into objective and subjective ones.

Data of examinations of 1176 patients with different diseases of soft tissues have shown that the arsenal of diagnostic methods which can be used under laboratory conditions has become wider. Of special value is the method of aspiration biopsy which must be introduced into medical practice. In obscure and doubtful cases the examination must be complex, including soft-tissue roentgenography, echography, thermography and radionuclide examination. Angioscintigraphy of soft tissues is an important method in differential diagnostics when the tumor is localized on extremities. Fairly promising is the method of magnetic resonance computed tomography.