• Title/Summary/Keyword: Diagnostic pathology

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Importance of Peer Review in Toxicological Pathology and Its Practical Approach (독성병리 Peer Review의 중요성과 실제적 접근방법)

  • 손우찬;김배환;장동덕;한범석;양기화;이영순
    • Toxicological Research
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    • v.20 no.1
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    • pp.1-11
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    • 2004
  • Evaluation of toxicological pathology is to some extend subjective judgments by pathologist and the accuracy of pathologist's works is based on the individual training and experiences. It has been required to establish a peer review system for toxicologic pathology and these review system has been employed by various practice of toxicological pathology. It would be pointed out that the possible causes of drifts in pathology are due to 1) lack of knowledge or experience of individual pathologists, 2) poorly maintained consistence of grading among animals in study, 3) different interpretation of findings between pathologists, or 4) pathology data processing. Example cases of diagnostic errors and current practice of peer review including tissue selection criteria, documentation and problem resolution for short-term and carcinogenicity studies were introduced. For sound regulatory system and high integrity of practice in toxicological pathology, current approaches of peer review system were reviewed.

The Efficiency of Cell Block in the Diagnosis of Non-gynecologic Cytology (비 산부인과 세포 검사 진단에 있어서세포 군집절편(Cell-Block)법의 유용성)

  • Han, Seung Hee;Youn, Mi Ja;Park, Byung Kyu;Lim, Byung Soo;Ahn, Mi Jung;Yang, Chul Kyu;Jeon, Geum Hee;Sung, Ha Ok
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.1
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    • pp.38-42
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    • 2004
  • Because of the lack of resources on the importance of cell block, the diagnosis of cytologic specimen has been overlooked. Out of 1,243 cases of non-gynecologic cytology specimen, about 87.1% has been proven to be diagnostically useful. About 0.9% of those were rendered diagnostic by cell block alone. If cell block was not made it could have resulted in misdiagnosis. The effect on making cell block might not be directly linked to the patient but to the pathologist, it can be a helpful secondary tool in lowering the chance of giving false negative results hence. Giving the patient the opportunity of an adequate treatment. This study has proven that cell block has diagnostic value in non-gynecologic cytology. We are doing our best to increase the production rate of cell block and to improve the quality of cytology smears and cell block, so that we can increase the accuracy of diagnosis.

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Diagnostic Accuracy, Sensitivity, Specificity and Positive Predictive Value of Fine Needle Aspiration Cytology (FNAC) in Intra Oral Tumors

  • Gillani, Munazza;Akhtar, Farhan;Ali, Zafar;Naz, Irum;Atique, Muhammad;Khadim, Muhammad Tahir
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3611-3615
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    • 2012
  • Objective: The objective of this study was to establish the diagnostic accuracy, specificity and sensitivity of fine needle aspiration cytology(FNAC) for intra-oral tumors, comparing with histopathology as the gold standard. Materials and methods: Forty cases of FNA cytology from intraoral tumors was performed in AFID along with the demographic data and clinical information and then diagnosed at AFIP, Rawalpindi. Then the cytology results obtained per FNAC were compared with the histopathological biopsy results of the same lesions. The following variables were recorded for each patient: Age, gender, site of biopsy, diagnosis. The data were entered and analyzed using Open-epi version 2.0. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Cohen Kappa was further applied to compare the agreement between the biopsy and FNAC diagnoses. A p-value of < 0.05 was considered as statistically significant. Results: Among the total patients included in the study there were 24 males and 16 females, with a ratio of 1.5:1. Age of the patients ranged from 24 to 80 years with a mean of 52 years. A total of six sites were aspirated from the oral cavity with maximum (11) aspirates taken from alveolar ridge. The results of FNAC revealed that there were 32 malignant and 8 benign aspirates. Confirmation through histopathological analysis came for 31/32 malignant cases while one was falsely given positive for malignancy on FNAC. Among a total of 40 cases, 31(77%) cases diagnosed were found to be malignant and remaining 9(23%) were benign. The FNAC results revealed 32 malignant and 8 benign lesions. Histopathology of the subsequent surgically excised specimen showed malignant lesions in 31(77%) and benign in 9(23%) patients. As a whole, it was found that the absolute sensitivity for introral FNAC was 100% and specificity 89% with positive predictive value of 97% and negative predictive value of 100%. Conclusion: Cytological diagnosis was almost corroborative with final histopathological diagnosis in all cases, with very few exceptions, exhibiting high diagnostic accuracy.

Cytopathology of Urinary Tract Neoplasms (요로 종양의 세포병리)

  • Hong, Eun-Kyung
    • The Korean Journal of Cytopathology
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    • v.17 no.1
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    • pp.1-17
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    • 2006
  • Urine cytology is the most useful technique for detecting either primary or recurrent neoplasms in the urinary tract. Although urine cytology is the traditional method of detecting these neoplasms, its diagnostic accuracy has been underevaluated because of low sensitivity. The cytologic interpretation of urinary samples is not an easy task, even with some expertise in this area, for many reasons. In low-grade urothelial carcinoma, no reliable or reproducible diagnostic cytologic criteria can be provided because of the lack of obvious cytologic features of malignancy, which is one of the main factors lowering its diagnostic accuracy. Many diagnostic markers have been developed recently to enhance its diagnostic yield, but the results have not been satisfactory. However, urine cytology plays a role in detecting high-grade urothelial carcinoma or its precursor lesions. It still shows higher specificity than any of the newly developed urine markers. Understanding the nature of urine samples and the nature of neoplasms of the urinary tract, recognizing their cytologic features fully, and using cytologic findings under appropriate conditions in conjunction with a detailed clinical history would make urine cytology a very valuable diagnostic tool.

Diagnostic Features of Fine Needle Aspiration Cytology of Pleomorphic Adenoma, Adenoid Cystic Carcinoma, and Mucoepidermoid Carcinoma of Salivary Gland (타액선 종양 중 다형성 선종, 선양 낭포성암, 및 점막 표피암의 세침흡인 세포학적 감별)

  • Nam, Eun-Sook;Jo, Won-Bo;Han, Jung-Ho;Kim, In-Sun
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.60-67
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    • 1990
  • To evaluate the diagnostic findings of salivary gland tumors, we reexamined aspiration cytology smears of 7 cases of pleomorphic adenoma, 3 cases of adenoid cystic carcinoma, and 3 cases of mucoepidermoid carcinoma, performed during April 1986 to March 1990, which were comfirmed by surgical excision and histologic diagnosis. The results obtained are summarized as follows : 1. All cases of pleomorphic adenoma showed branching cellular clusters of epithelial and myoepithelial cells. Acellular elements including myxomatous and chondroid components were observed. There were no cellular pleomorphism and nucleoli. Keratinizing squamous epithelial cells and keratin pearls were noted. 2. The smears of adenoid cystic carcinoma showed cell bails or cell cords containing a central hyaline core. Nuclear atypism and the nucleoli were frequently observed. There were no keratinizing squamous epithelial cells. 3. The smears of mucoepidermoid carcinoma showed mainly sheets or clusters of intermediate cells and some mucin-producing cells. Some nuclear pleomorphism was observed. Mucinous material and many inflammatory cells were present in the background.

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Lack of Correlations among Histopathological Parameters, Ki-67 Proliferation Index and Prognosis in Pheochromocytoma Patients

  • Ocal, Irfan;Avci, Arzu;Cakalagaoglu, Fulya;Can, Huseyin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1751-1755
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    • 2014
  • Background: In this study prognostic correlations of histopathologic parameters and the Ki-67 proliferation index and as well as the diagnostic value of immunohistochemical markers in pheochromocytomas were evaluated. Materials and Methods: A total of 22 patients diagnosed with a pheochromocytoma between 2000-2010 in Izmir Katip Celebi University Ataturk Training and Research Hospital were included. Diagnostic value of the PASS scoring system, and prognostic correlations of histopathologic parameters and Ki-67 proliferation index were investigated. SPSS for Windows 17.0 software was used for statistical analysis. Results: There was no statistically significant correlation between recurrence and clinicopathologic parameters or the PASS score (PASS>4). In addition, there were no statistically significant correlations between PASS score and clinicopathologic parameters, such as diameter (5 cm), weight (>100g), gender (female/male ratio) and age (25-45/45-55/>55). Besides, there were no significant correlation between diameter and clinicopathological parameters and also recurrence. However, there was a statistically significant correlation between Ki-67 proliferation index and capsule invasion (p=0.047). Conclusions: Some but not most of the findings in our study were concordant with the literature. To clarify relationships, investigations with standard scoring systems which are not affected by subjective factors and feature appropriate histopathological criteria should be made on larger study groups.

Cytologic Features of Endodermal Sinus Tumor of Ovary in the Ascitic Fluid - Report of a Case - (난소에서 발생한 내배엽동 종양의 복수의 세포학적 소견 - 1례 보고 -)

  • Jeong, Eun-Sun;Kim, Young-Shin;Kang, Chang-Suk;Shim, Sang-In
    • The Korean Journal of Cytopathology
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    • v.6 no.2
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    • pp.204-208
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    • 1995
  • The cytologic findings of endodermal sinus tumor of the ovary are reported. The cytologic preperations were obtained from ascitic specimens. The findings on Papanicolaou-stained smears included a clean background and poorly preserved atypical cells loosely arranged in irregular or papillary groups. At high magnification, the cells had ill-defined and microvacuolated cytoplasms, with an increased nuclear-cytoplasmic ratio and prominent nucleoli. Hyaline globules characteristic of the alpha-fetoprotein (AFP)-synthesizing cells of endodermal sinus tumor were observed within the cells with periodic-acid-Schiff(PAS) stain. The presence of PAS-positive hyaline globules can be regarded, therefore, as a diagnostic clue to endodermal sinus tumor in an appropriate clinical setting and in the presence of AFP production. The cytologic findings in a cell block is important, in addition to smears, to obtain more diagnostic clues. A preliminary cytomorphologic diagnosis of this highly malignant tumor is valuable as a guide in planning further immunocytochemical and serologic studies.

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Cytologic Classification of Fibrocystic Disease of the Breast - A Proposal for Use of Cytologic Criteria Grading System - (유방 섬유낭성 질환의 세포학적 진단의 분류 - 세포학적 소견에 의한 등급점수표의 이용에 대한 제안 -)

  • Yoon, Hye-Kyoung;Kim, Chan-Hwan;Joo, Jong-Eun;Khang, Shin-Kwang
    • The Korean Journal of Cytopathology
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    • v.5 no.2
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    • pp.106-112
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    • 1994
  • Fine needle aspiration biopsy has been proved as a safe, accurate and cost-effective diagnostic modality in palpable breast lesions. Cytologically, fibrocystic disease can be classified into 3 categories as nonproliferative breast disease, proliferative breast disease without atypia, and proliferative breast disease with atypia. This terminology for fine needle aspirates is compatible with that of diagnostic histopathology. Cytologic differentiation of nonproliferative disease from proliferative breast disease is important, since the risk of cancer development in cases of atypical hyperplasia is 4-5 times higher than that of general population. Twenty five fine needle aspirates of fibrocystic disease confirmed by subsequent histopathology were re-evaluated and classified into 3 categories depending on their architectural and nuclear features. In addition, these aspirates were scored according to the cytologic grading system, devised by Masood et al. and based on six cytologic criteria. Concordance rates between cytomorpholgic diagnosis and cytologic diagnosis using the cytologic criteria grading system and histologic diagnosis were 88% and 92%, respectively.

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Cytology of Crush Preparation in Central Nervous System Lesions (중추신경계 병변의 압착도말 세포학적 소견)

  • Yang, Young-Il;Park, Sul-Mi;Kim, Young-Joo;Khang, Shin-Kwang
    • The Korean Journal of Cytopathology
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    • v.5 no.2
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    • pp.79-89
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    • 1994
  • This study was performed in order to evaluate the accuracy and the usefulness of the cytology of crush preparation in central nervous system (CNS) lesions. Forty four intraoperative biopsies were performed at the time of craniotomy including 34 benign and 10 malignant lesions. Crush preparations were prepared from tiny tissue fragments of craniotomy products. All cases were stained with toluidine blue. Intraoperative diagnoses made on cytologic examination were compared with the final paraffin section diagnoses. Comparison between the results of the cytologic and histologic findings revealed an overall diagnostic accuracy of 88.6%. This study attests to the diagnostic accuracy of cytologic examination in CNS lesions. The detailed cytologic features are described and important criteria for the cytodiagnosis of CNS lesions are discussed. This review leads us to think that cytologic examination by crush preparation in CNS lesions is considered as a simple, safe and highly diagnostically accurate method.

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A Study of Usefulness of Fine Needle Aspiration Cytology of the Thyroid Lesions (갑상선 병변의 세침흡인 세포검사의 유용성에 관한 연구)

  • Kwon, Kye-Hyun;Jin, So-Young;Lee, Dong-Wha
    • The Korean Journal of Cytopathology
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    • v.7 no.2
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    • pp.111-121
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    • 1996
  • Fine needle aspiration cytology(FNAC) is preferred because of simplicity, safety, and reliability in the evaluation of patients with thyroid nodule or hyperplasia. However, there are a few limitations such as false-negative or false-positive cases and non-diagnostic material. To evaluate the usefulness of FNAC in thyroid lesions, we reviewed 704 FNAC cases of thyroid nodules from 1988 to 1994 at Soonchunhyang University Hospital. The results are as follows. 1. Among 704 FNAC cases of thyroid gland, 571(81.1%) cases were benign, 12(1.7%) were suspicious, 71(10.1%) were malignancy, and 50(7.1%) were material insufficiency. The cytologic diagnoses of the benign lesions included 168 cases of follicular neoplasm, 139 cases of adenomatous goiter, 162 cases of follicular lesion such as follicular neoplasm or adenomatous goiter, 61 cases of Hashimoto's thyroiditis, 13 cases of subacute thyroiditis, and 28 cases of colloidal nodule or benign nodule. The malignant lesions included 68 cases of papillary carcinona, two medullary carcinomas and a case of metastatic colon cancer. 2. The average number of cytologic smear slides was $4.12{\pm}1.81$ in material insufficiency and $5.63{\pm}1.79$ in diagnostic cases. This difference was statistically significant(p<0.00001). 3. Histological assessment of 150 cases revealed 2 false negative and 1 false positive cases. The false negative cases were a case of marked sclerosis in papillary carcinoma and an occult case of papillary carcinoma. The false positive case resulted from pseudo-ground glass nuclei due to marked dry artifact. 4. Comparison between the FNAC and the histologic diagnosis revealed that FNAC had a sensitivity of 93.5%, a specificity of 99.2%, a false negative rate of 6.6%, a false positive rate of 0.8%, and an overall diagnostic accuracy of 98.0%. Therefore, FNAC of thyroid gland is a very reliable diagnostic method with excellent accuracy rate.

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