• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.42-45
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• 2000

Background and Objectives: To review efficacy of the fine-needle aspiration cytology(FNAC) in patients with salivary glands lesions. Materials and Methods: From January 1994 through June 1999, FNACs and surgical biopsies were carried out on 109 patients with salivary gland diseases. The medical records were reviewed retrospectively. Benign tumor was found in 81 patients, and malignant tumor was in 19 patients. Nine patients had inflammatory lesion. Results: In 6 of 109 cases the aspiration was inadequate. Of the remaining 103 patients, FNAC correctly diagnosed 87 lesions(84.5%). For benign tumor lesions, the accuracy was 91%(71/78), and for malignant lesions 55.6%(10/18). The accuracy for inflammatory lesions was 85.7%(6/7). Regarding the capacity to discriminate between neoplastic and nonneoplastic lesions, sensitivity, specificity and total diagnostic accuracy were 99%, 85.7% and 84.5% respectively. Regarding the capacity to discriminate between malignant and benign tumors, sensitivity and specificity were 55.6% and 97.4% respectively. FNACs misdiagnosed malignant tumors as benign lesions in eight patients, in which three were with adenoid cystic carcinomas. Carcinoma ex pleomorphic adenoma, malignant lymphoma and mucoepidermoid carcinoma 'were others. Conclusion: FNAC showed high accuracy to diagnose benign lesions in salivary gland diseases. But the accuracy was rather low for malignant lesions. If a salivary gland lesion was suspected for malignant tumor, other diagnostic methods such as tissue biopsy should be seriously considered.

• The Korean Journal of Cytopathology
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• v.17 no.2
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• pp.120-125
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• 2006

Distinguishing small cell carcinoma from other lung malignancies is of great clinico-therapeutic significance. Small cell carcinoma is an aggressive tumor with a tendency to metastasize early. Survival time if untreated is low but this tumor is highly responsive to chemotherapy. We have occasionally experienced difficulties in differentiation between adenocarcinoma and small cell carcinoma of the lung in fine needle aspiration cytology (FNAC). The aim of this study was to investigate the possibility of distinguishing small cell carcinoma from adenocarcinoma of the lung in FNAC. We evaluated cytomorphological features of FNAC specimens from 62 small cell carcinomas and 57 adenocarcinomas from the lung that were confirmed by biopsy and/or immunohistochemistry on cell block. Cytomorphological details of the two tumors were compared. Nuclear smearing and nearly absent cytoplasm were the most distinct findings in small cell carcinoma compared to adenocarcinoma (p<0.05). Necrotic background, architecture and chromatin pattern, nuclear molding and nucleoli were significantly different (p<0.05). Nuclear size, nuclear membrane nature and nuclear size variation however were not helpful in distinguishing the two tumors. Combining several features described above, small cell carcinoma can be properly differentiated from adenocarcinoma on FNAC. FNAC is proposed as a diagnostic tool of small cell carcinoma of the lung in the case of inaccessibility to biopsy, and so may allow the proper therapeutic strategies to be determined in such cases

• Journal of the Korean Society of Radiology
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• v.11 no.4
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• pp.227-234
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• 2017

This study evaluated the usefulness of the elasticity score and strain ratio in the differential diagnosis of benign and malignant nodules in thyroid elastography. We performed a retrospective analysis based on the results of fine needle aspiration cytology. The Chi-square test and the Mann-Whitney U test were used to analyze the difference between the five degrees of elasticity score and strain ratio according to the benign and malignant thyroid nodules. ROC curve analysis was used to determine the elasticity score and the best cut-off value of the strain ratio for the prediction of malignant nodules. There was a statistically significant difference (p=0.000) between the homogeneity of the elasticity score and the difference of the strain ratio between the benign and malignant nodule groups. On the ROC curve analysis, the elasticity score and the srain ratio for predicting benign and malignant nodules were determined as AUC 0.842, 0.700, cut-off value 3, 2.49 (p=0.001). Therefore, the elasticity score and strain ratio may be useful in the differential diagnosis of thyroid nodules.

• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.277-286
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• 1997

We have reviewed a 9-year experience with 47 patients treated for salivary tumors which arose In the parotid gland (23 patients; 48.9%), submandibular gland (15 Patients, 31.9%), minor salivary gland (8 patients; 17.0%), and sublingual gland (1 patient; 2.1%). The age of patients ranged from 12 to 71 with a mean of 42.9 years. The male to female ratio showed a female preponderance, 19:28 (1:1.5). An asymptomatic mass (91.5%) was most common presentation. With fine-needle aspiration, the predictive value of a neoplasm was 88.9%. Histopathologically, the most common salivary gland tumors was Pleomorphic adenoma(57.4%). The pleomorphic adenoma was most common in benign tumor group, and the mucoepidermoid carcinoma was most common in malignant tumor group. Of the salivary gland tumors, the incidence of cervical metastasis was 22.2%. Major postoperative complications were facial nerve paralysis and wound infection.

• The Korean Journal of Cytopathology
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• v.19 no.1
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• pp.34-40
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• 2008

Fine needle aspiration (FNA) cytology of the breast is a useful method for diagnosing breast lesions. Yet making the definite diagnosis with performing FNA is limited by some problems, such as the low cellularity, the poor preservation and the obscuring background. Recent studies have found that liquid-based cytology solves such problems, but it is an expensive method and it is limited by the loss of the background information. The purpose of this study is to compare the Liqui-$PREP^{TM}$, a new manual liquid-based method of cytology, and the conventional smears for analyzing breast FNA cytology materials. A total of 31 randomized FNA specimens of breast were studied. In each case, both the conventional smears and the Liqui-$PREP^{TM}$ method were performed, and the smears were evaluated for cellularity, cellular preservation, the background, the cytologic features and the architectural arrangement. The cellularity and architectural arrangement were equal for both preparations. The Liqui-$PREP^{TM}$ specimens showed better cellular preservation, loss of the obscuring background, no overlapping of cells and a smaller area to screen compared with the conventional smears. Moreover, it has the potential advantages of being able to use the remaining specimens for immunohistochemical study and ploidy analysis, and it can reduce the costs for preparation compared with the other liquid-based methods of cytology. But some background information is lost in the Liqui-$PREP^{TM}$ specimens, the same as the other liquid-based methods of cytology. In conclusion, the Liqui-$PREP^{TM}$ and conventional smears showed good correlation, but they have their respective advantages and disadvantages. These results suggest that Liqui-$PREP^{TM}$ can contribute to making the accurate diagnosis with performing breast FNA cytology when it is used along with other methods.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.600-604
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• 2018

Background and Objectives This study aimed to identify a reliable preoperative predictive factor for the development of thyroid cancer in patients with atypia of undetermined significance (AUS) identified by fine needle aspiration biopsy (FNAB). Subjects and Method This was a retrospective cohort study. Two hundred and ninety-nine patients diagnosed with AUS by preoperative FNAB who underwent curative thyroid surgery at our institution between September 2005 and February 2014 were analyzed. Clinical, radiological and molecular features were investigated as preoperative predictors for postoperative permanent malignant pathology. Results The final pathologic results revealed 36 benign tumors including nodular hyperplasia, follicular adenoma, adenomatous goiter, nontoxic goiter, and lymphocytic thyroiditis, as well as 263 malignant tumors including 1 follicular carcinoma and 1 invasive follicular carcinoma; the rest were papillary thyroid carcinomas. The malignancy rate was 87.9%. The following were identified as risk factors for malignancy by univariate analysis: $BRAF^{V600E}$ gene mutation, specific ultrasonographic findings including smaller nodule size, low echogenicity of the nodule, and irregular or spiculated margin (p<0.05). Multivariate analysis revealed that only $BRAF^{V600E}$ mutation was a statistically significant risk factor for malignancy (p<0.05). When $BRAF^{V600E}$ mutation was positive, 98.5% of enrolled patients developed malignant tumors. In addition, the diagnostic rate of malignancy in these cases was approximately 16-fold higher than BRAF-negative cases. Conclusion Patients with AUS thyroid nodules should undergo $BRAF^{V600E}$ gene mutation analysis to improve diagnostic accuracy and if the mutation is confirmed, surgery is recommended due to the high risk of malignancy.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1570-1574
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• 2021

Post-partum galactocele is a common benign disease among breastfeeding women, whereas retromammary and peri-implant galactocele are relatively rare conditions. Herein, a 34-year-old, 1 month-postpartum female, who had augmentation mammoplasty and a 1-month history of breast pump use, presented with left breast enlargement for 2 weeks. An initial left breast US revealed hyperechoic peri-implant fluid collection. Additional US-guided fine needle aspiration was done using a 21G-needle, draining the milk component in the process, and cytologic results revealed numerous crystals, suggestive of galactocele. Various diseases, especially breast implant-associated anaplastic large cell lymphoma, can cause peri-implant fluid collection in an augmented breast. Thus, correlating imaging features with clinical information and cytologic analysis plays an important role in appropriate management.

• Tuberculosis and Respiratory Diseases
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• v.41 no.6
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• pp.624-631
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• 1994

Background: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. Method: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; Results: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic "fungus ball" pattern were observed in 53.8% of the 52cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed fine needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9%(12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. Conclusion: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1225-1233
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• 1997

Background : Cervical tuberculous lymphadenitis(CTL) is one of the most common extra-pulmonary tuberculosis. Recently overall incidence of pulmonary tuberculosis has decreased, but the incidence of tuberculous lymphadenitis has not decreased. Its duration of treatment is still controversial and the pathogenesis, prognosis and relationship with other site tuberculous are poorly published. So we did a retrograde study of 120 cases of confirmed CTL about its clinical manifestations. Method : All patients were applied fine needle aspiration(FNA) of palpable enlarged cervical lymph nodes and 114 patients were examined for AFB smear and 34 patients for TB culture with aspirated fluid. 57 patients were examined Mantoux test(5TU with PPD-S). With above methods, a total of 120 patients was diagnosed as having CTL. Results : 1) CTL is most prevalent in young women between the age of 20~30 years and the incidence of CTL in female is 2.5 times higher than that of male. It is located most commonly in the posterior cervical area. The most common presenting symptom is painless palpable enlarged cervical lymph nodes. 2) With FNA of enlarged cervical lymph nodes, the percentage of histopathological positivity is 82.3%. The percentage of AFB smear positivity is 38.6%, and that of TB culture positivity is 17.6%(p<0.001). 3) Pulmonary tuberculosis is noted in 79 cases(65.8%). And 42 cases(53.5%) of them had minimal pulmonary tuberculosis. In 14 cases(11.7%), other extrapulmonary tuberculosis coexsisted and pleural tuberculosis was most Common in the order. 4) CTL was treated with anti-tuberculous medication(first line drug) and median treatment duration was 18.5months. During treatment, the size of involved lymph nodes decreased gradually in 62 cases(75.8%), newly developed lymph nodes were found in 25 cases(30.4%), fluctuation formation in 22 cases(26.8%) and fistula formation in 14 cases(17.0%). Conclusion : CTL is prevalent in women between the age of 20~40 years and it involves posterior cervical area most commonly. CTL is treated with long-term anti-tuberculous chemotherapy. We think it is one manifestation of systemic disease and frequently coexisting with pulmonary tuberculosis. Despite anti-tuberculous chemotherapy, the size of involved lymph nodes was increased, new lymph nodes were developed or fluctuation and fistula formed in involved lymph nodes. After sufficient medication, when the patient felt pressure discomfort from enlarged lymph node or fistula was formed, we recommended total excision of involved lymph nodes.

• Korean Journal of Head & Neck Oncology
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• v.14 no.2
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• pp.244-252
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• 1998

The thyroid nodules are the most common endocrine disease requiring surgical management. We perfomed a clinical study of 298 cases with thyroid nodules, who were admitted to and operated at the Department of Surgery, College of Medicine, Gyeong sang National University from January 1987 to April 1997 and the results were summarized as follows: 1) Patients were composed of 214 cases(71.8%) of benign nodule and 84 cases(28.2%) of malignant nodule. Benign and malignant nodules were prevalent in fifth decade. 2) The sex distribution showed a preponderance of females with ratio of 5.88:1 in benign nodule and 11:1 in malignant nodule. 3) The nodules were located in the right lobe(134 cases, 44.9%), the left lobe(121 cases, 40.6%), both lobes(34 cases, 11.4%), and isthmus(8 cases, 2.7%). The possibility of malignancy was higher in the solid rather than cystic lesions. 4) Radioactive iodine scintiscans were perfomed in 273 cases and revealed cold nodules in 237 cases(86.8%), 58 of these cases(24.4%) were malignant. 5) According to the histopathologic classification, benign nodules included follicular adenomas 136 cases(63.5%), adenomatous goiters 67 cases(31.3%), Hurthle cell adenomas 4 cases(1.9%), cysts 3 cases(1.4%) and thyroiditis 4 cases(1.4%). In malignant nodules, papillary carcinomas 72 cases(85.7%), follicular carcinoma 8 cases(9.5%), undifferentiated carcinoma 2 cases(2.4%), medullary carcinoma 1 case(1.2%) and malignant lymphoma 1 case(1.2%). 6) The most commonly performed operative procedure was a lobectomy with isthmusectomy(85.5%) for bengn nodules and a total thyroidectomy(51.2%) for malignant nodules. 7) The rate of complications was higher in the cases with malignant nodules(20.2%) than in the benign cases(0.5%). The recurrence rate was 8.3%(7 cases).