• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6067-6072
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• 2012

Background: Breast cancer in developing countries is on the rise. There are currently no guidelines to screen women at risk in India. Since mammography in the western world is a well-accepted screening tool to prevent late presentation of breast cancer and improve mortality, it is intuitive to adopt mammography as a screening tool of choice. However, it is expensive and fraught with logistical issues in developing countries like India. Materials and Methods: Our breast cancer screening camp was done at a local district hospital in India after approval from the director and administrators. After initial training of local health care workers, a one-day camp was held. Clinical breast examination, mammograms, as well as diagnostic evaluation with ultrasound and fine needle aspiration biopsy were utilized. Results: Out of total 68 women screened only 2 women with previous history of breast cancer were diagnosed with breast cancer recurrence. None of the women in other groups were diagnosed with breast cancer despite suspicious lesions either on clinical exam, mammogram or ultrasound. Most suspicious lesions were fibroadenomas. The average cost of screening women who underwent mammography, ultrasound and fine needle aspiration was $30 dollars, whereas it was $16 in women who had simple clinical breast examination. Conclusions: Local camps act as catalysts for women to seek medical attention or discuss with local health care workers concerns of discovering new lumps or developing breast symptoms. Our camp did diagnose recurrence of breast cancer in two previously treated breast cancer patients, who were promptly referred to a regional cancer hospital. Further studies are needed in countries like India to identify the best screening tool to decrease the presentation of breast cancer in advanced stages and to reduce mortality.

• 대한세포병리학회지
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• 제10권2호
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• pp.127-131
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• 1999

Among total 108 cases of biopsy-proven fibroadenomas of the breast which obtained from the files of the Asan Medical Center during one year period from October 1998 to September 1999, 23 cases cytologically diagnosed as high risk group were reviewed to retrieve the mis-loading factors. Initial cytologic diagnoses of 23 cases were proliferative breast lesion with atypia(high risk) on 21 cases(91.3%) and papillary neoplasm in 2 cases(8.7%). When we reanalysed 23 cases by Masood scoring system, they were classified as one non-proliferative breast lesion(4.3%), 16 proliferative breast lesions without atypia (69.6%), and 6 proilferative breast lesions with atypia(25.1%). None were subject to the category of carcinoma. Cytologic features loading to the overdiagnosis of high grade epithelial lesions were as follows; cellular dissociation without nuclear atypia, nuclear pleomorphism, anisonucleosis, and occasional macronucleoli without nuclear enlargement, lack of myxoid stroma, and few naked stromal cells. To avoid cytologic overdiagnosis of fibroadenoma, mild to moderate nuclear pieomorphism without nuclear enlargement and cellular dissociation without nuclear atypia should not be regarded as criteria of high risk group.

• 디지털융복합연구
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• 제14권1호
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• pp.305-310
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• 2016

최근 초음파검사의 접근이 일반화되면서 한국에서는 갑상선암발생율의 연간변화율이 24.5%로 상승하였다. 이에 고식적 갑상선암의 위험요인인 전리방사선과 요오드식이 이외의 갑상선암의 위험요인을 파악하고자 하였다. 2011년 1월부터 2013년 3월까지 종합검진센타에서 초음파검사 후 미세침흡인검사로 진단된 양성결절 260명과 악성 결절 151명의 여자를 대상으로 나이, 혈액학적 수치, 비만지수, 허리둘레, 폐경여부, 유방결절 유무, 자근근종 유무, 지방간 유무를 비교하였다. 연구 결과 갑상선암 그룹에서 비만인 경우, 유방의 결절과 자궁근종이 있는 경우가 많았으며 갑상선자극호르몬 수치가 양성결절그룹보다 높게 나타났다. 향후 갑상선 및 갑상선암에 영향을 끼치는 요인들을 정립시키기 위한 연구가 지속적으로 필요할 것이다.

• 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.

• Tuberculosis and Respiratory Diseases
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• 제74권4호
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• pp.177-180
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• 2013

We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA.

• Tuberculosis and Respiratory Diseases
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• 제56권6호
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• pp.628-637
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• 2004

연구배경 : 경피폐세침흡인생검술은 비교적 간편하고 안전한 검사이기 때문에 여러 가지 폐병변의 진단에 유용한 검사로 알려져 있으나 때때로 기흉 등의 합병증이 발생할 수 있다. 저자들은 경피폐세침흡인생 검술 후 발생하는 합병증의 빈도 및 합병증 중 제일 많은 부분을 차지하는 기흉의 위험인자를 알아보고자 하였다. 대상 및 방법 : 1988년에서 2002년 사이에 다양한 폐병변의 진단을 목적으로 경희의대부속병원 호흡기내과에서 경피폐세침흡인생검술을 시행 받은 403명을 대상으로 의무기록과 방사선검사결과를 후향적으로 검토하여 자료를 수집하였다. 결 과 : 총 403명의 환자들 중(남자 245명, 여자 158명) 209명이 악성질환으로, 194명이 양성질환으로 나타났으며, 평균연령은 $58.5{\pm}12.7$세였고, 검침의 평균 깊이는 $6.3{\pm}1.7cm$, 193명이 흡연자였다. 합병증으로는 기흉이 48명, 경미한 객혈이 4명으로 총 발생률은 12.9%였다. 48명의 환자 중 35명이 20% 미만의 기흉으로 산소공급만으로 치료를 받았고, 11명이 50% 이상의 심한 기흉으로 흉관삽입을 시행 받았으며 나머지 2명은 주사기 흡인으로 치료받았다. 기흉발생의 위험요인에 대한 다변량분석을 시행한 결과 병변의 크기와 위치, 검침의 위치, 병변의 진단 등은 관계가 없었으나 환자의 나이와 성별(p<0.05), 검침의 깊이(p<0.001)는 기흉의 발생과 밀접한 관계를 보였다. 흡연유무(p<0.005)뿐만 아니라 흡연량(p<0.001) 또한 기흉발생과 의미 있는 관계를 나타냈으며 각각 4.0%에서 23.1%까지 다양한 발생률을 보인 검사자도 기흉발생의 의미 있는 독립적 위험인자로 나타났다. 한편 산소공급만으로 치료받은 35명의 검침의 평균깊이는 $6.7{\pm}1.6cm$인데 비해 나머지 13명의 심한 기흉환자는 $8.2{\pm}1.2cm$로 검침의 깊이가 깊을수록 심한 기흉이 발생함을 알 수 있었다. 결 론 : 경피폐세침흡인생검은 합병증이 적은 비교적 안전한 검사이며 검사 후 발생하는 가장 흔한 합병증인 기흉의 독립적인 위험인자로는 환자의 나이와 성별, 검침의 깊이, 검사자, 흡연유무 및 흡연량 등이다.

• Tuberculosis and Respiratory Diseases
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• 제42권5호
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• pp.685-694
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• 1995

연구목적: 경피적 세침 흡입 생검술은 여러 가지 흉부내 병소의 진단에 널리 이용되는 시술로 안전하고 정확성이 뛰어난 검사법으로 현재 보편적으로 이용되고 있다. 이에 저자들은 흉부 병소의 진단에 있어서 다른 진단 방법에 비하여 보다 안전하며 간편하게 진단을 얻을 수 있는 이러한 흡입 생검술을 이용하여 최근 10년간 930명 환자 1,005예의 폐병변을 진단하는데 있어서 이의 진단 성적 및 합병증 발생변도에 대하여 보고하고자 한다. 방법: 한양대학교 의과대학 부속병원 내과를 내원하여 흉부내 여러가지 병변을 가진 환자 930명 1,005예를 대상으로 경피적 세침 흡입 생검술을 1983년 11월부터 1995년 6월까지 시행하였는데, 이중 남, 여 비는 1.9:1로서 대부분의 환자는 40~60대 였다. 환자는 시술을 하기전에 단순 흉부 촬영을 시행하였고 대부분의 경우 컴퓨터 단층 촬영을 같이 시행하여 생검할 위치와 방향을 정하였다. 양면 영화혈관촬영기술 사용하고 22G 또는 20G Westcott needle을 이용하여 시술하였고 이의 검체를 이용하여 병리학적 진단을 얻었으며 이러한 시술을 통해 악성 및 양성 질환에서의 진단 민감도를 알아보고 시술후 합병증의 발생 여부를 관찰하였다. 결과: 경피적 세침 흡입 생검술 결과 악성 질환은 총 930명중 540명(58.1%)였고 양성 질환은 322명(34.6%)이었고 진단 민감도는 악성 질환에서 96.1%였고 양성질환에서는 91.0%였다. 정확한 진단을 얻지 못한 경우는 68명(7.3%)이었고 519명의 악성 질환으로는 편평세포암 31.7%, 선암 24.7%, 소세포암 16.7%, 전이암 14.2%, 대세포암 6.2% 기타 6.5%였으며, 시술후 합병증으로는 기흉 12.3%로 이중 흉관 삽입이 필요한 경우는 0.6%에 불과하였고 3.6%에서 소량의 객혈을 나타냈으며 시술로 인한 사망환자는 발생하지 않았다. 결론: 흉부 악성 및 양성 병소의 진단에 있어서 경피적 흡인 생검을 이용하여 비교적 높은 민감도를 얻을 수 있었으며 치료를 요하는 합병증도 적어 세침 흡입 생검이 흉부 병소 진단에 안전하며 간단하고 유용한 진단방법으로 생각된다.

• 대한세포병리학회지
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• 제1권1호
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• pp.36-42
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• 1990

The fluoroscopy-guided fine needle aspiration biopsy has been gaining widespread acceptance as a rapid and effective method to make a pre-operative diagnosis of mediastinal tumors including thymoma, malignant lymphoma, and metastatic carcinoma. Although thymoma is a most common tumor of the superior mediastinum, most cytopathologists are not experted in cytologic diagnosis of this tumor because of limited experience. In order to define the diagnostic cytologic features of thymoma, we have retrospectively reviewed imprinting smears and corresponding tissue sections from four cases of this tumor. All cases revealed an apparent biphasic pattern of epithelial cell clusters and lymphocytes with occasional branching capillary fronds extending from three dimensional epithelial cell clusters. Epithelial cell clusters predominated in one case and lymphocytes in two cases. Mixed epithelial cell and lymphocyte type represented in one of four cases. In the lymphocyte predominant type, the presence of epithelial cell clusters and small mature lymphocytes are helpful features to differentiate from a malignant lymphoma.

• 대한세포병리학회지
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• 제8권1호
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• pp.98-102
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• 1997

Sinonasal undifferentiated carcinoma(SNUC) is a distinct, relatively rare neoplasm arising in the nasal cavity and paranasal sinuses composed of undifferentiated epithelial cells and clinically characterized by a fulminant course. We report a case of SNUC in a 56-year old man who have had bilateral neck masses since one month ago before coming to our hospital. The paranasal computed tomography showed soft mass density in the left maxillary sinus and the nasal cavity with bone destruction in the anterior medial and the inferior maxillary sinus wall. This mass was extruded into the left orbital wall. Biopsy of the nasal mass and fine needle aspiration(FNA) of the neck mass were done. FNA revealed medium-sized neoplastic cells forming clusters or individually dispersed. Nuclei were round to oval, slightly to moderately pleomorphic, and hyperchromatic. Chromatin was finely granular, but occasionally was coarsely granular. Nucleoli varied from large to inconspicuous and the cytoplasm was scanty.

• Clinical and Experimental Pediatrics
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• 제53권11호
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• pp.971-974
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• 2010

Pulmonary cryptococcosis is rare in immunocompetent subjects. Here, we present the case of a 16-year-old boy who was referred to our pediatric department for the management of multiple consolidations detected on chest radiography, which was routinely performed when the patient was being evaluated for an ankle fracture. Fine needle aspiration biopsy was performed, and the definitive diagnosis was established as cryptococcal pneumonia. After 8 weeks of antifungal treatment, the pulmonary nodules on the chest radiographs disappeared.