• Title/Summary/Keyword: Fine-Needle

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Value of Contrast-Enhanced Ultrasonography in the Differential Diagnosis of Enlarged Lymph Nodes: a Meta-Analysis of Diagnostic Accuracy Studies

  • Jin, Ya;He, Yu-Shuang;Zhang, Ming-Ming;Parajuly, Shyam Sundar;Chen, Shuang;Zhao, Hai-Na;Peng, Yu-Lan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2361-2368
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    • 2015
  • Objective: To evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating between benign and malignant enlarged lymph nodes using meta-analysis. Materials and Methods: Pubmed, Embase, SCI and Cochrane databases were searched for studies (up to September 1, 2014) reporting the diagnostic performance of CEUS in discriminating between benign and malignant lymph nodes. Inclusion criteria were: prospective study; histopathology as the reference standard; and sufficient data to construct $2{\times}2$ contingency tables. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in identification of benign and malignant lymph nodes. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: The pooled sensitivity, specificity and AUROC were 0.92 (95%CI, 0.85-0.96), 0.91 (95%CI, 0.82-0.95) and 0.97 (95%CI, 0.95-0.98), respectively. After omitting 3 outlier studies, heterogeneity decreased. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Publication bias was not significant. Conclusions: CEUS is a promising diagnostic modality in differentiating between benign and malignant lymph nodes and can potentially reduce unnecessary fine-needle aspiration biopsies of benign nodes.

Thyroid Nodules with Atypia or Follicular Lesions of Undetermined Significance (AUS/FLUS): Analysis of Variables Associated with Outcome

  • Kayilioglu, Selami Ilgaz;Dinc, Tolga;Sozen, Isa;Senol, Kazim;Katar, Kagan;Karabeyoglu, Melih;Tez, Mesut;Coskun, Faruk
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10307-10311
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    • 2015
  • Background: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p=0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p=0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.

Surface Characteristics of Anodized and Hydrothermally-Treated Ti-6Al-7Nb Alloy (양극산화와 열수처리한 Ti-6Al-7Nb 합금의 표면 특성)

  • Kim, Moon-Young;Song, Kwang-Yeob;Bae, Tae-Sung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.21 no.1
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    • pp.33-42
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    • 2005
  • This study was performed to investigate the surface properties and in vitro biocompatibility of electrochemically oxidized Ti-6Al-7Nb alloy by anodic spark discharge technique. Discs of Ti-6Al-7Nb alloy of 20 mm in diameter and 2 mm in thickness were polished sequentially from #300 to 1000 SiC paper, ultrasonically washed with acetone and distilled water for 5 min, and dried in an oven at $50^{\circ}C$ for 24 hours. Anodizing was performed using a regulated DC power supply. The applied voltages were given at 240, 280, 320, and 360 V and current density of $30mA/cm^2$. Hydrothermal treatment was conducted by high pressure steam at $300^{\circ}C$ for 2 hours using a autoclave. Samples were soaked in the Hanks' solution with pH 7.4 at $36.5^{\circ}C$ during 30 days. The results obtained were summarized as follows; 1. The oxide films were porous with pore size of $1{\sim}5{\mu}m$. The size of micropores increased with increasing the spark forming voltage. 2. The main crystal structure of the anodic oxide film was anatase type as analyzed with thin-film X-ray diffractometery. 3. Needle-like hydroxyapatite (HA) crystals were observed on anodic oxide films after hydrothermal treatment at $300^{\circ}C$ for 2 hours. The precipitation of HA crystals was accelerated with increasing the spark forming voltage. 4. The precipitation of the fine asperity-like HA crystals were observed after being immersed in Hanks' solution at $37^{\circ}C$. The precipitation of HA crystals was accelerated with increasing the spark forming voltage and the time of immersion in Hanks' solution. 5. The Ca/P ratio of the precipitated HA layer was equivalent to that of HA crystal as increasing the spark forming voltage and the time of immersion in Hanks' solution.

NECROSIS OF A PAROTID GLAND PLEOMORPHIC ADENOMA : A CASE REPORT (이하선 다형성 선종의 괴사)

  • Ryu, Sun-Youl;Baek, Sung;Park, Hong-Ju;Choi, Hong-Ran
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.2
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    • pp.165-169
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    • 2004
  • Pleomorphic adenoma is the most common neoplasm of the parotid gland, generally presenting as a slowly growing, firm, well-circumscribed, painless nodule. It is often difficult to separate into benign and malignant categories because its bland histomorphologic and cytologic features. This tumor can be rarely associated with cystic change, hemorrhagic necrosis, or spontaneous infarction. Necrosis of lesional tissue may be associated with malignant transformation, particularly in a pleomorphic adenoma. We report a case of 50-year-old woman presented with a enlarging right parotid mass. Computed tomographic scan demonstrated a right superficial lobe mass with ill-defined border. The preoperative fine needle aspiration yielded necrotic debris and atypical squamous elements that were thought to be compatible with high degree of mucoepidermoid carcinoma. A total parotidectomy with intraoperative frozen section revealed extensive necrosis and diagnosed as malignant tumor. This tumor was finally diagnosed as a pleomorphic adenoma with necrosis on permanent sections. Caution should be exercised in evaluation of the parotid neoplasms with central necrosis to avoid misdiagnosis of such lesions as malignancy.

Xanthogranulomatous Pancreatitis Mimicking a Pancreatic Cancer on CT and MRI: a Case Report and Literature Review

  • Park, Jong Min;Cho, Seung Hyun;Bae, Han-Ik;Seo, An Na;Kim, Hye Jung;Lee, So Mi;Yi, Jae Hyuck;Lim, Jae-Kwang;Cho, Chang Min
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.3
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    • pp.185-190
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    • 2016
  • Xanthogranulomatous inflammation is a rare benign condition involving various organs. However, its pancreas involvement is very rare. To the best of our knowledge, only 17 cases have been described in the literature. Interestingly, all reported 17 cases due to various causes underwent surgical resection. Here, we present a case of xanthogranulomatous pancreatitis in a 63-year-old man. He presented with epigastric pain and solid mass mimicking ductal adenocarcinoma in the body and tail of pancreas on magnetic resonance imaging. The patient was diagnosed as xanthogranulomatous pancreatitis via endoscopic ultrasound-guided fine needle aspiration. After that, he was followed up and monitored without any surgical treatment. Here, we show imaging findings and serial image changes of xanthogranulomatous pancreatitis for this case.

Profile of Lymphadenopathy in Kashmir Valley: a Cytological Study

  • Qadri, Sumyra Khurshid;Hamdani, Nissar Hussain;Shah, Parveen;Lone, Mohammad Iqbal;Baba, Khalil Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3621-3625
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    • 2012
  • Lymphadenopathy is one of the commonest and significant manifestations of local as well as systemic ailments, especially malignancies. Fine needle aspiration cytology (FNAC) helps in diagnosing the disease itself, in general, but more importantly ruling out malignancy, in particular. Hence it saves much of the cost and use of resources incurred with excision biopsy of such lymph nodes. This prompted us to study the cytologic patterns of lymphadenopathy in our setting and the diagnostic utility of FNAC in the evaluation of lymphadenopathy. In this retrospective observational study, 1,579 patients (953 males and 626 females) with lymphadenopathy who were subjected to FNAC over a period of three years (January 2009 to December 2011) were studied. The cervical region was involved in most of the cases (76%) followed by the axillary region (17.5%). Metastatic malignancy (38.2%) was the commonest cause of lymphadenopathy followed by reactive lymphoid hyperplasia (36.9%), tuberculosis (9.1%) and lymphomas (8.6%). Squamous cell carcinoma (32.2%) followed by adenocarcinoma (21.9%) were the most frequent metastatic tumors. FNAC is a useful diagnostic tool in the management of patients presenting with lymphadenopathy and should be considered before more invasive and costly procedures are performed, particularly in developing countries.

A Clinical Study on Surgical Thyroid Nodules (외과적 갑상선 결절에 대한 임상적 고찰)

  • Park Hyeon-Jung;Moon Sang-Eun
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.2
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    • pp.234-243
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    • 1993
  • The thyroid nodules are the most common endocrine disease requiring surgical management. Up to date, various diagnostic techniques and surgical management have been developed. Authors analysed 2285 cases of thyroid nodules who were treated at Department of Surgery, Pusan National University for the duration of 10 years from January 1980 to December 1989 and the results obtained were summerized as follows: 1) Patients were composed of 1727 cases(75.8%) of benign nodule and 558 cases(24.5%) of malignant nodule. Benign nodule was prevalent in forth and fifth decade comparing with malignant nodule was sixth and fifth decade. The sexual distribution revealed female preponderance with 1:10.8 in benign nodule and 1:9.3 in malignant nodule. 2) The histopathologic classfication of benign nodule in decreasing order of frequency were follicular adenoma 1009 cases(54.8%), adenomatous goiter 573 cases(33.3%), simple cyst 65 cases(3.8%), and Hashimoto's thyroiditis 52 cases(3.0%). The malignant disease were papillary adenocarcinoma 460 cases(82.4%), follicular adenocarcinoma 69 cases(12.4%), undifferentiated carcinoma 13 cases (2.0%), and medullary carcinoma 7 cases(1.0%). 3) Fine needle aspiration cytology was performed in 1758 cases and it showed 80.5% of sensitivity, 96.5% of specificity, 19.5% of false negative and 80% of accuracy. 4) The location of nodule was 87.7%, in unilateral, 12.2% in bilateral. 5) On the radioiodine scanning, the incidence of benign nodule with cold nodule was 83.9% and the incidence of benign nodule with hot nodule was 7.5%. The incidence of thyroid carcinoma with cold nodule was 88.3% and the incidence of thyroid carcinoma with hot nodule was 4.6%. 6) Most cases of benign nodules were treated with lobectomy 82.6%, subtotal thyroidectomy 10.1% and subtotal lobectomy 3.0%. Malignant nodules were treated with lobectomy and/or isthmusectomy 37.6%, total thyroidectomy 17.7%, subtotal thyroidectomy 15.4%, and any thyroidectomy and neck dissection 13.5%. 7) Postoperative complications were developed in 3.8% of benign nodules and 13.8% of malignant nodules.

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Warthin's Tumor of the Parotid Gland (이하선의 Warthin씨 종양)

  • Lee Kang-Young;Chung Woong-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.177-180
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    • 1996
  • Warthin's tumor is a benign and slow growing tumor found exclusively in the parotid gland or the periparotid lymph nodes. It mostly affects males between the age of forty to seventy years and is closely related with smoking history. Between January 1981 and June 1996, 42 patients underwent surgical excision of Warthin's tumor of the parotid gland; which made up 10.6% of all parotid gland surgeries(398 cases) during the same period. Their ages ranged from 36 to 75 years with a mean age of 56 years. There were 33 male and 9 female patients with a 4.3 : 1 male to female ratio. The majority of the tumors were situated in the parotid tail whereas one was in the deep lobe. Bilateral simultaneous involvements of the parotid gland were found in 4 patients(9.5%) ; therefore total of 46 parotid glands were involved. Four(8.7%) of the 46 parotid glands had multifocal tumors ranginging from two to three lumps. Tumor sizes varied from 1.5 to 6.0cm with mean diameter of 3.lcm. Of the 42 patients, 26(61.9%) were diagnosed preoperatively or peroperatively by means of CT scans, ultrasound, 99m-Tc. scan, fine needle aspiration cytology or intraoperative frozen section biopsy. Of the 46 tumors, 30 underwent a superficial(n=29) or total(n=1) parotidectomy and for 16 cases with tumors suspected preoperatively or peroperatively of being single Warthin's tumor, only enucleation was performed. No cases of recurrence were identified during the follow up period regardless of type of operation performed, however the postoperative complication rate was much higher in the parotidectomy group(33.3%) than in the enucleation only group(12.5%). We feel that an enucleation procedure may be appropriate for the patients with single Warthin's tumor.

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A Clinical Observation of Fine Needle Aspiration Cytology in the Neck Mass (경부 종류의 세침 흡인 세포학적 검사에 대한 임상적 고찰)

  • Lim Jong-Hak;Kim Jae-Jun;Lee Dong-Hwa;Hur Kyung-Bal
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.31-36
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    • 1992
  • Neck mass is common neoplasms, but it poses a diagnostic dilemma for the physician. The differential diagnosis include neoplastic, inflammatory and developmental causes. The FNAC is one of the most valuable tests in the initial assessment and differential diagnosis of the neck mass. FNAC was performed with 267 cases of the neck mass, during the period from April, 1988 to October, 1990 at the department of General Surgery, Soon Chun Hyang. University Hospital. Thyroid lesions were excluded from this analysis. Final diagnosis was based on resection histology in 58 cases, and surgical specimens were compared with FNAC. The following results were obtoired ; 1) Of 267 cases, there we re 9 cases(3.4%) of congenital lesion, 74 cases(27.7%) of inflammatory lesion, 40 cases(15.0%) of benign tumor, 12 cases(4.5%) of primary malignant tumor, 37 cases(13.8%) of metastatic tumor, 75cases(28.1%) of reactive hyperplasia, 20 cases(7.5%) of unsatisfactory. In the pathologic classification, inflammatory lesion was the most common. 2) In the 58 cases of excisional biopsy, sensitivity 93.8%, specificity 95.2%, false positive 11.8%, false negative 2.4%, positive predictive value 88.2%, negative predictive value 97.6%, accuracy 94.8%. 3) The most common disease was the tuberculous lymphadenitis (53 cases, 19.8%). sensitivity 57.9%, specificity 100.0%, false positive 0.0%, false negative 17.0%, positive predictive value 100.0%, negative predictive value 83.0%, accuracy 86.2%.

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Immunohistochemical Expression of Galectin-3, Cytokeratin 19 and HBME-1 in Papillary Microcarcinoma of the Thyroid Gland (갑상선 미세 유두암종에서 Galectin-3, Cytokeratin 19와 HBME-1의 발현)

  • Kim, Jin-Hwan;Lee, Sang-Sook
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.133-137
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    • 2007
  • With the wide use of ultrasonography and fine needle aspiration of the thyroid gland, the incidence of papillary microcarcinoma of the thyroid gland is rapidly increasing nowadays. To improve the diagnostic accuracy of histopathologic findings of papillary thyroid carcinoma, various molecular markers have been used recently. We analysed the expression of galectin-3, cytokeratin 19 and HBME-1, using immunohistochemical technique in 37 cases of papillary microcarcinoma of the thyroid gland to evaluate the diagnostic value of these molecular markers. Immunohistochemically, galectin-3 expression was found in 37 cases of papillary microcarcinoma. Its localization was mostly cytoplasmic. Cytokeratin 19 expression was found in 36 cases. It was mostly localized to the cytoplasm and membrane. HBME-1 expression was found in all cases. Its localization was plasma membrane. The expression of these three molecular markers was negative in the adjacent normal thyroid tissue and accompanying benign lesions, although there are scattered foci of incomplete positive staining in cases of Hashimoto's thyroiditis. Our findings suggest that the immunohistochemical staining using antibodies for galectin-3, cytokeratin 19 and HBME-1 is an useful adjunctive method for the histopathological diagnosis of a papillary microcarcinoma of the thyroid gland.