• 대한세포병리학회지
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• 제15권2호
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• pp.101-105
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• 2004

Fine needle aspiration (FNA) cytological examination is an appropriate method for the evaluation of pulmonary nodules. In major types of lung cancer, Its diagnostic accuracy is quite high. However, it is sometimes difficult, using this technique, to differentiate between some unusual phenotypes including adenosquamous carcinoma, bronchioloalveolar carcinoma (BAC), neuroendocrine tumor, mucoepidermoid carcinoma, and sclerosing hemangioma. Here, we present a case involving extremely well differentiated adenosquamous carcinoma, mimicking benign lesions, such as pulmonary scar and adenomatoid malformation with squamous metaplasia. The patient was a 68-year-old man presenting with a solitary pulmonary nodule$(1.6\times1.6cm)$, which was incidentally found at the periphery of the right lower lobe. FNA revealed some clusters of glandular cells with minimal atypia, in addition to squamous cells at a nearly full maturational state. Histological examination verified the cytological diagnosis on a lobectomy specimen. The tumor exhibited a well differentiated adenocarcinoma component, mimicking the bronchioles in scarred lung tissue. and a well differentiated squamous cell carcinoma component, mimucking the squamous cell nests of adenoacanthoma, in the other organs. In the present case, the possibility of adenosquamous carcinoma should have been considered if squamous cells were seen in the FNA from the peripheral pulmonary nodule, even though they appeared to be benign.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3411-3413
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• 2014

Background: Cytology for breast lesions is a safe, rapid and cost-effective with a high specificity and sensitivity. Objective: To determine the cytomorphologic patterns of breast lesions identified among a group of Sudanese patients. Materials and Methods: This study included 759 patients undergoing either a fine needle aspiration FNA, nipple discharge (ND) smears or breast skin scraping (SS) at a cytology clinic in Khartoum. Clinical and demographic data were reviewed. Stained smears were categorized into: inadequate sample, normal breast, benign lesion, suspicious, or malignant neoplasm. Results: Of the 759 cases, 734 (96.71%) were FNA, 18 (2.37%) ND and 7 cases (0.92%) SS. For 28 cases, FNA was done under ultrasound guidance. Females were 720 (94.86%). Benign lesions were 423 (55.75%) and 248 (32.67%) were malignant and 77 (10.14%) of smears were normal without any detected abnormality. Ten (1.31%) cases were suspicious for malignancy, and only one case (0.13%) was reported as inadequate. Most lesions were observed among the age group 30 years and above. Conclusions: Most patients investigated have benign lesions, one third of cytological smears were malignant. FNAC is a useful tool for investigating breast lesions in limited-resource settings.

• Journal of Digestive Cancer Research
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• 제5권2호
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• pp.120-124
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• 2017

A-49-year-old male patient with no specific medical history was admitted to the clinic because of persistent epigastric pain radiating to back for 4 months. He had multiple parenchymal tumors in body and tail of pancreas, para-spinal muscle, and mediastinum on abdomen CT image. Cytologic examination of the pancreas which was done by endoscopic ultrasound guided fine needle aspiration (EUS-FNA) showed adenocarcinoma, whereas histological examination of the para-spinal mass showed undifferentiated sarcoma. Histologic examination of the pancreatic mass was made through endoscopic ultrasound guided fine needle biopsy (EUS-FNB) for accurate diagnosis, and the histologic examination of both the pancreas and posterior mediastinal mass showed the same undifferentiated sarcoma. Therefore, we reviewed the cytopathic tissue obtained from the pancreas for the first time, and it was confirmed to be similar to histologic findings in the mediastinal mass.

• Tuberculosis and Respiratory Diseases
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• 제56권5호
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• pp.505-513
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• 2004

목 적 : 폐암이 인접장기를 침범하거나 림프절이나 원격장기에 전이가 되었는지를 아는 것은 폐암의 병기결정에서 가장 중요한 요소가 된다. 본 연구에서는 폐암 환자에서 촉진 되지 않는 경부 림프절에 대하여 초음파 유도하의 세침흡인 세포검사의 임상적 유용성을 알아보고자 하였다. 방 법 : 조직학적으로 폐암으로 확진 된 환자 중 경부 진찰 상 경부 림프절이 촉지 되지 않고 흉부 전산단층 촬영소견 상 편측에 종격동 임파절이 1 cm이상 커지지 않은 46명을 대상으로 하였다. 대상 환자의 나이의 중앙값은 62세 (37-73)였으며 남자가 34명, 여자가 12명이였다. 조직학적 분류는 편평상피암이 16명(34.7%), 선암이 20명(43.4%), 소세포폐암이 10명(21.7%)이였다. 초음파를 이용하여 단축이 0.5 cm이상의 림프절 종대가 관찰되면 초음파 유도하 세침흡인을 시행한 뒤 Papanicolau염색을 시행하였다 결 과 : 대상 환자 중 비소세포폐암 36명중 14명(38.8%)에서 초음파 상 경부 임파절의 증대가 관찰되었고 14명중 8명(57.1%)에서 비소세포폐암(선암 6례, 편평상피세포암 2례), 6명(42.8%)에서 양성 병변으로 진단되었고 전체 림프절 크기의 평균은 $0.98cm{\pm}0.17$ 이고 흉부 전산 단층 촬영 소견 상 동측의 종격동에 1 cm이상의 림프절 증대가 관찰되어 임상적 림프절 병기가 2이상 경우와 경부 악성 림프절 전이와 유의한 차이가 있었다(p=0.01). 임상적 병기가 IIIa이하로 수술적 치료의 대상이 되는 18의 환자 중 3명(11.1%), 이중 종격동 림프절이 양성인 IIIa 환자 명중 2명(33.3%)에서 경부 림프절 전이가 있었다. 소세포폐암의 경우 10명중 5명(50%)에서 발견되어 검사 상 모두 소세포 폐암으로 진단 되었다. 결 론 : 경부 림프절에서 초음파 유도하의 세침흡인세포검사는 안전하며 폐암환자의 경부 림프절 전이의 진단과 함께 정확한 병기 설정에 유용하고 소세포 폐암 환자의 비침습적인 진단에 보완적인 역할을 할 것으로 사료된다.

• 대한영상의학회지
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• 제81권1호
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• pp.147-156
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• 2020

목적 이 연구의 목적은 유방암으로 수술한 환자에서 림프절 재발을 진단함에 있어 미세침흡인세척액 cytokeratin fragment 21-1 (이하 CYFRA 21-1) 측정의 진단적 가치와 적절한 역치값을 평가하는 것이다. 대상과 방법 64명의 유방암 수술을 받은 환자에서 재발이 의심되는 총 64개의 림프절에 대해 미세침흡인세포검사와 미세침세척액 CYFRA 21-1 검사를 시행하였다. 최종 진단은 fine-needle aspiration 세포검사 및 2년 이상의 추적관찰로 하였다. 재발 림프절과 양성 림프절의 CYFRA 21-1의 농도를 비교하였다. 진단수행도와 역치값은 수신기작동특성곡선을 이용하여 구했다. 결과 비진단적 결과와 상관없이, CYFRA 21-1의 중간 농도는 양성 림프절보다 재발 림프절에서 유의하게 높았다(p < 0.001). 적절한 역치값은 1.6 ng/mL였다. 림프절 재발에 대한 CYFRA 21-1의 민감도, 특이도, 양성예측도, 음성예측도 및 정확도는 각각 90.9%, 100%, 100%, 98.1%, 98.4%였다. 결론 미세침세척액에서 CYFRA 21-1 농도 측정은 역치값을 1.6으로 하였을 때 우수한 진단수 행도를 보여주었다. 이 결과는 미세침세척액 CYFRA 21-1 농도 측정이 유방암 수술 환자에서 액와림프절 재발을 진단하는데 있어 유용함을 보여준다.

• 한국간담췌외과학회지
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• 제26권1호
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• pp.91-97
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• 2022

Backgrounds/Aims: Metastatic lesions of the pancreas (PMET) account for 1%-5% of all malignant solid pancreatic lesions (SPL). In this study we evaluated the utility of endoscopic ultrasonography with fine needle aspiration (EUS-FNA) in diagnosing PMET. Methods: Patients who underwent EUS-FNA at a community referral center between 2011-2017 for SPL were identified. Clinical, radiologic, and EUS-FNA features of those with PMET were compared to those with primary solid tumors of the pancreas: pancreatic adenocarcinoma (PDAC) and neuroendocrine tumors (PNET). Results: A total of 191 patients were diagnosed with solid pancreatic malignancy using EUS-FNA: 156 PDAC, 27 PNET, and eight (4.2%) had PMET. Patients with PMET were less likely to have abdominal pain (25.0% vs. 76.3% vs. 48.2%; p < 0.01) or obstructive jaundice (37.5% vs. 58.3% vs. 0%; p < 0.01) compared to PDAC and PNET. Those with PMET were more likely to have mass lesions with/without biliary or pancreatic ductal dilatations (100% vs. 86.5% vs. 85.2%; p < 0.01) and lower CA19-9 (82.5 ± 43.21 U/mL vs. 4,639.30 ± 11,489.68 U/mL vs. 10.50 ± 10.89 U/mL; p < 0.01) compared to PDAC and PNET. Endosonographic features were similar among all groups. Seven (87.5%) patients with PMET had a personal history of malignancy prior to PMET diagnosis. The primary malignancy was renal cell carcinoma in five PMET. Conclusions: PMET are exceedingly rare, comprising less than 5% of SLP. Patients with PMET are less likely to present with symptoms and mostly identified by surveillance imaging for the primary malignancy.

• 대한세포병리학회지
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• 제7권2호
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• pp.202-206
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• 1996

Metaplastic carcinoma of the breast is a morphologically heterogenous group of neoplasms characterized by ductal adenocarcinoma with extensive squamous differentiation, a spindle-cell pattern of growth, and/or heterologous mesenchymal elements. We experienced a case of metaplastic carcinoma diagnosed by fine needle aspiration(FNA) and confirmed by radical mastectomy in a 46 year-old woman. The FNA cytologic findings included atypical squamous cells with kertinization tying singly and in clusters in a necrotic background. In addition, scattered spindle cells with pleomorphic large nuclei and prominent nucleoli were present in a hemorrhagic and necrotic background. The histopathologic findings showed moderately differentiated squamous cell carcinoma and highly pleomorphic sarcoma with chondroid component. The immunohistochemical stain revealed focal positive reaction for cytokeratin as well as diffuse reactivity for vimentin in the sarcomatous area.

• 대한세포병리학회지
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• 제7권2호
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• pp.207-212
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• 1996

Angiosarcoma of the bone is rare with an incidence of 0.13%. It may be solitary or multiple. Its cytologic findings by FNA have rarely been reported. We report a case of angiosarcoma of the rib in a 66 year-old man. FNA revealed single or clusters of round to oval shaped cells in a hemorrhagic and myxoid background. The large central nuclei had irregular nuclear membrane, chromatin clumping and prominent nucleoli. The cytoplasm was scanty with an eosinophilic distinct cytoplasmic border. Erythrophagocytosis by malignant cells was also found. Histopathologic examination confirmed the diagnosis of angiosarcoma revealing irregular and complex anastomosing vascular channels lined by malignant round tumor cells, protruding into the lumen. Immunohistochemical staining revealed diffuse strong positive reaction to factor VIII-related antigen and CD31.

• 대한세포병리학회지
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• 제15권1호
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• pp.70-73
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• 2004

The incidence of endometriosis in post-operative abdominal scars is rare. We describe two cases of abdominal endometriosis diagnosed by fine needle aspiration (FNA). Both patients presented with subcutaneous masses at previous cesarean section scars with cyclic symptoms of pain. The cytologic smears were cellular and comprised two distinct cell populations consisting of epithelial and stromal components. An epithelial component consisted of flat sheets of polygonal cells and the second stromal component showed crowded clusters of spindle cells or isolated single cells. Hemosiderin-laden macrophages were found in the background. FNA offers a safe and effective tool for diagnosis of abdominal wall endometriosis.

• 대한세포병리학회지
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• 제9권1호
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• pp.99-104
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• 1998

Anaplastic large cell lymphoma(ALCL) is an uncommon type of non-Hodgkin's lymphoma(NHL) populated with anaplastic, often bizarre cells that express CD30 (Ki-1) antigen. The unusual histologic and cytologic features may cause confusion with other neoplasms, such as poorly differentiated carcinoma, melanoma, Hodgkin's disease, or true histiocytic lymphoma. Although the cytologic features of ALCL have been well described, there are few reports about cytologic findings of the sarcomatold variant of ALCL. We experienced a case of fine needle aspiration(FNA) cytologic findings of ALCL which mimicks malignant fibrous histiocytoma. FNA cytology of chest wall mass in a 62-year-old female with a history of peripheral T-cell lymphoma(Lennert lymphoma) revealed a heterogeneous population of single cells and poorly cohesive cells with large, pleomorphic nuclei and spindle cells gathering around vascular structures within an inflammatory background. Additional features of the neoplastic cells were eccentric, multilobated nuclei with occasional 'wreath-like' configuration; abundant cytoplasm with vacuolization; and prominent nucleoli. The cytologic features suggested sarcoma, especially malignant fibrous histiocytoma. The diagnosis was made retrospectively with an aid of immunocytochemical staining.