• Tuberculosis and Respiratory Diseases
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• 제64권5호
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• pp.356-361
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• 2008

연구배경: 국내에서 굴곡성 기관지경에 의해 기도 내 이물이 확인된 성인 환자에서 흡인의 위험도에 따른 임상적 특징 및 이물 제거 방법 및 결과에 대한 보고가 없어 본 연구를 계획하였다. 방법: 1994년 12월부터 2004년 12월까지 경희대학교 부속병원에서 굴곡성 기관지경을 시행하여 기도 내 이물이 확인되었던 29명의 성인 환자를 대상으로 면밀한 의무 기록을 바탕으로 후향적 분석을 시행하였다. 결과: 14명은 흡인의 위험인자가 없었던 반면 15명은 흡인의 위험도가 높은 중추신경계 질환을 가지고 있었다. 전체 환자 중, 7명(24.1%)은 흡인에 대한 과거력이 없었다. 22명의 환자가 호흡기 증상이 확인되었는데, 기침(62.0%), 호흡곤란(44.8%), 발열(20.7%), 천명(13.8%), 흉통(10.3%) 및 객혈(0.4%) 순이었다. 흡인의 위험인자가 없는 환자의 92.8%가 증상이 발생한 반면 흡인 위험도가 높은 환자에서는 60%에서만 증상이 발생하였다(p=0.005). 또한 진단이 되기까지 증상 발생 기간이 각각 4일과 2일로 흡인 위험도가 높은 환자들에서 더 길었고(p=0.007), 3일 이내의 급성 호흡기 증상이 발생한 경우가 더 적었다(p=0.048). 6명(20.9%)의 환자가 단순 흉부 방사선에서 이상 소견이 없었던 반면 23명에서는 이물의 음영(11명), 폐렴(8명), air trapping(5명) 및 무기폐(3명) 등의 소견이 관찰되었다. 흡인의 위험도에 따른 기도 내 이물에 의한 방사선학적 특징에는 차이가 없었다. 흡인 위치로는 우측 기관지가 16예로 가장 많은 빈도를 보였고 우측 하엽 기관지가 가장 흔한 위치였다. 흡인 이물의 종류로는 치아가 11예로 가장 많은 빈도를 보였다. 흡인의 위험도가 높은 환자들에서 의학적 처기가 기도 내 이물 흡인이 발생하는 가장 흔한 경우였다. 모든 대상 환자의 기도 내 이물은 큰 부작용 없이 성공적으로 모두 제거되었으며 alligator jaw biopsy forceps이 이물 제거를 위해 가장 많이 사용되었다. 결론: 본 연구는 흡인의 위험도가 높은 환자에서는 이물 흡인의 과거력이 명확하지 않고 비전형적인 호흡기 증상을 보이는 경우가 많아 진단이 지연되거나 간과될 가능성이 높고 특히 의학적 처치 시 가장 많이 발생한다는 것을 보여주었다. 따라서 흡인의 위험성이 높은 환자에서 이물 흡인에 대한 적극적인 검사와 주의가 필요할 것으로 사료된다.

• 대한세포병리학회지
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• 제8권1호
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• pp.93-97
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• 1997

A case of cervical chordoma diagnosed by fine needle aspiration is discussed. A 41year-old male was admitted due to dyspnea on neck flexion. Radiologic image revealed a retrotracheal superior mediastinal solid mass. Aspiration cytology showed many clusters of oval or large polygonal cells having abundant eosinophilic or bubbly cytoplasm in an amorphous blue-gray mucoid background. The nuclei were round and showed size variation, coarse granular chromatin, and indistinct nucleoli. Some cells contained brown granular pigments in the cytoplasm. Mitoses were rarely found. The cytoplasm was strongly positive for PAS stain. Immunohistochemical stains using cell block revealed positive reaction for cytokerain, EMA, vimentin, and S-100 protein. The confirmative diagnosis was made by following excisional biopsy. Electron microscopic study revealed large pools of intracytoplasmic glycogen and microfilaments. This is the first case of cervical chordoma diagnosed by aspiration cytology to our knowledge in Korean literature.

• 대한세포병리학회지
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• 제11권1호
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• pp.53-58
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• 2000

Pilomatrixoma is a benign tumor which usually occur as a solitary, firm nodule in the head and neck, and upper extremities of young people. This tumor is occasionally encountered during aspiration biopsy of subcutaneous masses, but only a small number of cases are correctly diagnosed prior to excision. We report five cases of pilomatrixoma. Four cases occurred in the neck and one case in the back. The characteristic fine needle aspiration cytologic features are shadow cells and basaloid cells in the background of inflammatory cells, including some multinucleated giant cells. The shadow cells were recognized in all five cases. These cells were pale, anucleated cells with relatively distinct cell borders. $May-Gr\ddot{u}nbald-Giemsa$ stain is useful for the identification of shadow cells. The recognition of shadow cells appears to be essential for accurate diagnosis of pilomatrixoma.

• 대한세포병리학회지
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• 제16권1호
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• pp.57-60
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• 2005

A patient with actinomyces infection of the submandibular soft tissue was diagnosed by fine needle aspiration cytology (FNAC). A 38-year-old woman presented with a right submandibular mass which slowly grew in size over one month. Clinically and radiologically, the lesion was considered as tuberculous lymphadenitis or cellulitis. The polymerase chain reaction for tuberculosis was done by aspirated specimen but the result was negative. The smears of aspiration cytology showed characteristic colonies (sulfur granules) of actinomyces in inflammatory background. After antibiotic therapy for eight months, the patient has been well, showing no detectable mass. This patient was simply and rapidly diagnosed by FNAC and can avoid unnecessary surgical biopsy.

• 대한세포병리학회지
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• 제5권2호
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• pp.113-119
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• 1994

Thirty cases of Kikuchi's lymphadenitis, diagnosed by fine needle aspiration cytology, were reviewed to determine the main cytologic features helpful in reaching a diagnosis. The patients(mean age 26.6 years, male: female = 1:3.8) presented with lymphadenopathy (cervical 24, submandibular 3, and axillary 1) with or without fever and local tenderness. Excisional biopsy was done for confirmation in 5 cases and the remaining 25 cases showed the similar cytologic and clinical features. In the aspiration smears of all cases, there was a heterogenous celluar mixture including frequent extracellular karyorrhectic nuclear debris, phagocytic histiocytes, plasmacytoid monocytes, and a variable number of polymorphous lymphocytes such as immunoblasts, activated large lymphocytes, and small mature lymphocytes. The characteristic cytologic features of Kikuchi's lymphadenitis were the following: (1) frequent extracelluar karyorrhectic nuclear debris in the background : (2) phagocytic histiocytes with eccentrically placed crescentic nuclei and abundant pale cytoplasm containing phagocytized karyorrhectic debris : (3) plasmacytoid monocytes, which were medium-sized cells with eccentrically placed round nuclei and amphophilic cytoplasm : (4) no neutrophilic background.

• 대한세포병리학회지
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• 제17권2호
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• pp.99-107
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• 2006

In the investigation of superficial lymphadenopathy of unknown cause, fine needle aspiration (FNA) cytology plays an invaluable role. It enables the differentiation of benign lymphadenopathy from lymphoid and non-lymphoid malignancies, obviating the need for open biopsy, and allowing the triage of patients. Cytopathologists should be familiar with the typical FNA patterns of benign lymphadenopathy, and recognize and differentiate among categories. In a minority of cases of benign lymphadenopathy, FNA can render a specific diagnosis. Benign lymphadenopathies are generally categorized into reactive lymphoid hyperplasia (RLH), inflammatory or infectious processes, and benign lymphoproliferative disorders. RLH characteristically presents with a heterogeneous and polymorphous smear composed of normal cellular constituents of lymph nodes, in contrast with the homogeneous or monomorphic smear of most lymphomas. The caveat is that various malignant disorders may also present with polymorphous populations. It is also important to recognize thatbenign lymphoid smears may sometimes contain atypical cells that raise the suspicion of malignancy. Clinical information should always be the integral part of the diagnostic criteria in FNA of lymphadenopathy. If there is any doubt about the benign nature of the smear, it is prudent to suggest biopsy and ancillary studies.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4689-4692
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• 2013

Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

• 대한세포병리학회지
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• 제17권1호
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• pp.27-31
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• 2006

Periductal mastitis is a specific clinicopathologic entity, and is referred to by several names: recurrent subareolar abscess, squamous metaplasia of the lactiferous duct, and Zuska's disease. Clinically, the differentiation of periductal mastitis from other benign lesions and carcinomas around the nipple frequently proves a difficult proposition. We reviewed the fine needle aspiration cytology (FNAC) of 14 cases of periductal mastitis, which had been diagnosed either radiologically, histologically, or clinically. The patient group included 13 female patients, and one male. The majority of the patients in this group had presented with subareolar masses. All cases evidenced characteristic anucleated squamous cell clusters within a mixed inflammatory background. A diagnosis of periductal mastitis can be rendered fairly readily on excisional biopsy. However, FNAC is considered to be superior to excisional biopsy as an initial diagnostic procedure for any palpable mass in subareolar lesions of the breast. FNAC can also be a useful diagnostic technique in cases of periductal mastitis, even in the early phases of the disease. A definitive diagnosis of subareolar abscess via FNAC will enable the clinician to select the most appropriate medical or surgical treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4323-4328
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• 2015

Background: Breast cancer is the most common cause of deaths of cancer in women. Nowadays, following completion of imaging methods, mainly fine needle aspiration biopsy (FNAB) and core biopsy methods have been used for establishing cytopathological diagnosis although discussions regarding superiority continue. Materials and Methods: Those with a complaint of "mass in breast" along with those diagnosed to have a mass as a result of routine physical examination among all patients applying to our clinic between 01.01.2009 and 31.12.2011 were retrospectively assessed. Totals of 146 and 64 patients with complete radiological observation who had undergone FNAB and core biopsies, respectively, were evaluated. Postoperative pathological results of patients of both groups receiving surgery were also taken into consideration. All results were compared in terms of false positivity/negativity, sensitivity/specifity, surgery types and distribution of postoperative results with regard to diagnoses along with those of malignant/benign masses with regard to quadrants determined. Results: Diagnostic malignancy power of mammographic BIRADS classification was 87.3%. However, the value was 75% in the core biopsy group. Sensitivity and specifity following comparison of FNAB and postoperative pathology results of those receiving surgery were 85.4% and 92.9% while they were 93.5% and 100% in the core biopsy group. Diagnostic malignancy power, calculated by determining AUC in ROC analysis, of FNAB was 89.1% while that of core biopsy was 96.7%. Conclusions: It was shown that core biopsy is superior to FNAB in terms of sensitivity, specificity and accurate histopathological classification. However; quick, cheap and basic diagnosis by means of FNAB should not be ignored. Sensitivity of FNAB is rather high in experienced hands and furthermore it would be expected to be lower than with core biopsy.

• 대한두경부종양학회지
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• 제18권2호
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• pp.168-172
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• 2002

Objectives: This study was done to determine the diagnostic efficacy of fine needle aspiration cytology (FNA), frozen section biopsy (FSx) and ultrasonography in a palpable thyroid mass. Materials and Methods: During the period from July 1999 to March 2002, the medical records of 98 patients who underwent a thyroidectomy for thyroid mass, at the Department of Surgery, Chonbuk National University Hospital, were reviewed retrospectively. Ninety eight cases were classified according to whether the FNA cytological diagnosis inadequate, benign, suspicious, or malignant and the FSx diagnosis benign or malignant and the ultrasonographic examination was benign, suspicious, or malignant. The diagnostic correlations of ultrasonography, FNA cytology, frozen section, and both FNA cytology and frozen section with definite histologic diagnosis were evaluated. Results: According to the FNA cytological interpretation, 76 cases were diagnosed as benign, 6 cases suspicious, 13 cases malignant, and 3 cases inadequate. The sensitivity and specificity for FNA were 86.3% and 95.9% and for FSx 95.5% and 100% respectively. The diagnostic accuracy of FNA and FSx were 93.5% and 98.9% respectively. Based on a definite histologic diagnosis, the ultrasonographic examination had a sensitivity and a specificity of 77.2% and 78.9%. Conclusion: The results confirm that FNA cytology is a reliable and useful tool in the initial evaluation of a palpable thyroid mass compared to the ultrasonographic examination. Intraoperative FSx is a valuable diagnostic procedure to confirm the cytological diagnosis with undetermined or unsatisfactory cytological diagnosis.