Ains-To evaluate all thyroid fine needle aspirations (FNA) done over a six year period to assess the accuracy and value of the technique. Methods-There were 335 FNAs of which 184 had subsequent histology and 49 others had clinical follow up, providing 233 patients for analysis. All cytology and histology was reviewed with no significant alterations in diagnosis. The FNAs were classified into three groups: benign, suspicious (recommend excision), and malignant. The histology and medical records were reviewed to determine whether the cytology was accurate. Results-There were 130 benign FNAs, 126 had non-malignant histology or normal clinical follow up, and four had malignancies on histology (two lymphomas, one follicular carcinoma, and one carcinoma not otherwise specified Fine needle aspiration (FNA) cytology was first described in the 1930s by Martin and Ellis.' It is a standard procedure used in the assessment of patients with a thyroid swelling and it can answer two clinical questions: whether the nodule needs surgical removal, and, if malignant, whether it is amenable to surgery as tumours such as anaplastic carcinomas and lymphomas may require other treatments. In one centre the introduction of thyroid FNA cytology decreased the number of surgical biopsies by 50% and doubled the tumour detection rate.2The aim of this study was to audit FNA cytology in a large centre to calculate its sensitivity and specificity. This study has large numbers with histological verification, which tends to be low in many previously published studies. We evaluated 233 FNA cytologies performed to assess a thyroid swelling. Histology was available in 184, the outcome in the remaining 49 was assessed by reviewing medical records. MethodsThree hundred and seven patients (33 male, 274 female) had 335 FNA cytology of thyroid over a six year period ; 184 subsequently had surgical biopsy or excision. Of the 123 patients with no subsequent histology, medical records were found for 49 and these were reviewed. The overall follow up time was 2.7 years.FNA cytology was performed by the same operator (a radiologist) using a 19 G needle on a 20 ml syringe and applying negative pressure. All cytology and histology was reviewed in a blind fashion. None of the original diagnoses were changed as a result of this review.

The results of needle aspiration cytology of solid renal lesions in Brighton from 1977 have been reviewed. Thirty-one lesions were aspirated and of the 21 malignant tumours, cytology accurately diagnosed 19 (90%) when sufficient material was sent for analysis. Of the eight avascular solid renal space-occupying lesions aspirated, cytology gave a correct differentiation (benign versus malignant) in seven (87%). The results compare favourably with those of other published experience. A modification is suggested to the accepted diagnostic pathway.

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Summary In this study, we used immunohistochemical and biochemical analysis to show that gp200-MR6, a 200 kDa molecule that is functionally associated with the human interleukin 4 (IL-4) receptor complex, is expressed at high levels on normal breast epithelial tissues, at lower levels on in situ carcinomas, and that the expression is lost in the invasive carcinoma of the breast. Furthermore, a preliminary study showed that benign epithelial hyperplasia of the breast expresses the gp200-MR6 heterogeneously. Two populations of cells have been observed: MR6 positive and MR6 negative. Interestingly, MR6-positive cells were observed to have different morphology from those that were MR6 negative; the nuclei of the former were larger and rounded in shape, whereas the nuclei of the latter were relatively small and oval in shape. In sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and Western blotting, monoclonal antibody MR6 detects the same molecular weight molecule in both normal and transformed tissue, indicating that the molecule is not a product of a truncated gene. The intensity of the gp200-MR6 bands correlates with the immunohistochemical data, indicating that the molecule is expressed at high levels in normal tissue and at lower levels in malignant tissue. These results suggest that analysis of gp200-MR6 expression may be useful in tumour grading and prognostic evaluation in breast cancer. Moreover, the molecule may be involved early in the process of tumorigenesis of the breast, in which a loss or a down-regulation of gp200-MR6 could contribute towards tumour development and progression via an effect on cell growth and differentiation.

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Six patients with mesangiocapillary glomerulonephritis and intramembranous dense "deposits" developed terminal renal failure and were transplanted, three from living and three from cadaver donors. Eight renal biopsy specimens were obtained from five of the grafts, from 1 to 26 months following transplantation. All six biopsy specimens taken later than seven months following the graft showed recurrence of dense intramembranous "deposits" in the basement membranes of glomeruli, and of Bowman's capsule and tubular basement in five. Recurrence of "deposits" was associated with deposition of C3 on immunofluorescent study in all but one specimen; in addition, IgM was found in two specimens, but IgG and early complement components were absent. Only two patients, however, showed glomerular proliferation associated with profuse proteinuria. In the other subjects the recurrence of the "deposit" was not associated with clinical findings. Graft loss, which occurred in two patients, was predominantly from rejection.

SmryMonoclonal antibody MUC 2-63 recognses neuroenic tumours and has been used successfilly for radiimaging human malignant ghomas. We now show that the MUC 2-63 antigen has the same tissue distibution and molecular weght rae as the CD44 antigen and confirm the identity of these two molecule in bcking studies using MUC 2-63 and the CD44 anti-framework antibody FIO44-2. Thus not only MUC 2-63 but also other anti-CD44 monodcnal antibodies should prove useful in imaging and, perhaps, therapy of brain tumours.The CD44 molecule was orginally defined by the monoclonal antibody FIO 442 and found predominantly on lymphohaemopoietic tissues and brain (Dalhau et al., 1980, Stoll et al., 1989 al., 1989;Stamenkovic et al., 1989). It is acquired by medullary thymocytes during T-cell maturation in the thymus and is up-regulated on memory T cells (Dalchau et al., 1980;Haynes et al., 1983; Sanders et al., 1988). CD44 is also present at low levels on normal epithelium, but is highly expressed on carcnomas, including those of the colon (Daar & Fabre, 1983; Stamenovic et al., 1989). In human brain the molecule has a molkeular weight of 90kDa, while a lymphoid form of 80-90kDa (CD44H) and an epitheial form of 160 kDa (CD44E) have been described (McKenzie et al., 1982;Stamenkovic et al., 1989 Stamenkovic et al., , 1991 Brown et al., 1991). The diferences between these and other isoforms, ranging in molcular weight from 85 to 250 kDa, lie in the membraneproximal region and result from alternative splicing of at least ten different exons and from post-translational modifications (Brown et al., 1991; Jackson et al., 1992; Screaton et al., 1992; Tolg et al., 1993).Many functions involving cell-cell and cell-extracellular matrix interactions have been attributed to CD44, and are likely to be mediated by different isoforms (Belitsos et al., 1990; Staovic et al., 1991;Jalkanen & Jalkanen, 1992). Such interactions play a role in cell development, activation and migration (Berg et al., 1989; Miyake et al., 1990; Ritter & Crispe, 1992;Haegel et al., 1994

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