• Title/Summary/Keyword: fine needle aspiration cytology

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A Case of Basal Cell Adenoma in the Parotid Gland (이하선에 발생한 기저세포선종의 치험례)

  • Lee, Joo Chul;Park, Eun Soo;Kwak, Jeong Ja
    • Archives of Craniofacial Surgery
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    • v.13 no.2
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    • pp.151-155
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    • 2012
  • Purpose: Basal cell adenoma of the salivary gland is an uncommon type of monomorphic adenoma. The most frequent location is parotid gland. It usually appears as a firm, mobile and slow-growing mass. Originally the term "basal cell adenoma" is described as a benign salivary gland tumor comprised of uniform appearing basaloid cells which are arranged in solid, trabecular, tubular, and membranous patterns. But the myxoid and chondroid mesenchymal like component as seen in pleomorphic adenoma is lacking in basal cell adenoma. We report a case of basal cell adenoma of parotid gland with review of the literatures. Methods: The 59-year-old female patient was referred to our department with a painless palpable mass in the left preauricular region for about 1 year. Movable and nontender subcutaneous mass was palpable. There was no evidence of cervical metastasis in computed tomography and ultrasonography. On fine needle aspiration cytology, pleomorphic adenoma was suspected. Under general anesthesia, superficial parotidectomy including tumor was performed. The biopsy result was basal cell adenoma. Results: Long-term follow-up for 54 months showed favorable result without evidence of recurrence except for temporary facial nerve weakness right after the surgery. Conclusion: Basal cell adenoma is the third most frequent benign tumor of the salivary gland, following pleomorphic adenoma and Warthin's tumor, although the incidence is low. The typical clinical feature of the basal cell adenoma is slowly growing, asymptomatic, and freely movable parotid mass. Basal cell adenoma should be also considered as a differential diagnosis of the parotid gland benign tumor.

The Surgical Management of Pediatric Thyroid Nodule (소아 갑상선 결절의 수술)

  • Oh, Heung-Kwon;Kim, Hyun-Young;Park, Kwi-Won;Jung, Sung-Eun;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.183-191
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    • 2006
  • Thyroid nodules are less common in children than in adults and their management is still controversial. The clinical presentations, operations, complications, histopathologic findings, and postoperative progressions of 34 pediatric patients that underwent thyroidectomy for palpable thyroid nodule at the Department of Surgery, Seoul National University Children Hospital between 1986 and 2003 were studied retrospectively by reviewing medical records and telephone interviews. The mean age of the patients was 11.8 years old. There were 23 females (67.6 %) and 11 males (32.4 %). Surgical indications were clinical need of histological confirmation (n=15), unresponsiveness to thyroxin replacement therapy (n=10), suggestion of the carcinoma on fine needle aspiration cytology (n=5), cosmetic purpose-a huge benign nodule (n=2), completion thyroidectomy for medullary thyroid carcinoma (n=1), and prophylactic thyroidectomy in a MENIIpatient (n=1). Unilateral Lobectomy was performed in 20 patients (57.1 %), subtotal thyroidectomy in 8 (22.9 %), total thyroidectomy in 5 (14.7 %), and completion thyroidectomy in 1 (2.9 %). Lymph node dissection was performed in 9 cases. Benign tumor was found in 23 patients (67.6 %), adenomatous goiter (n=18) and follicular adenoma (n=5). Malignant tumor was found in 11 children (32.4 %), 9 papillary carcinomas (26.5 %), and 2 medullary carcinomas (5.9 %). Of the 9 papillary carcinomas, 7 cases (77.8 %) had lymph node metastasis. No lymph node metastasis was found in 2 medullary carcinomas. Complications developed in 5 cases - transient hypocalcaemia (n=2), and temporary hoarseness (n=3). There was no mortality. Median follow-up period was 7.4 years (0.5-18 years). One patient showed recurrence in cervical lymph nodes 10 years after surgery and modified radical neck dissection was performed. Because of the high incidence of malignancy and advanced stage at initial presentation, more meticulous diagnostic work up is necessary for children with thyroid nodule, and more radical surgical treatment should be performed when malignant nodule is suggested.

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A Clinical Study of Thyroid Diseases (갑상선 질환에 관한 임상적 관찰)

  • Min Byoung-Sam;Nam Young-Soo;Park Chan-Heun;Pai Soo-Tong
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.112-121
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    • 1994
  • During the 7 years period from March 1987 to Febrary 1994, 344 patients with thyroid nodules, were admitted and operated at Department of Surgery, Collage of Medicine, Hallym university. We obtained following results: 1) The thyroid nodules were prevalent in female with ratio 1:17.1, both benign and malignant nodules were prevalent in the forth decade(37.8%:25.8%). 2) The duration of illness within 6 months was most common: 47.1% and within 1 years was 66.6%. 3) The most prominent symptoms & sign were palpable mass in anterior neck(96.8%). 4) The right-sided thyroid nodules were most common. 5) Thyroid scaning and thyroid function test were found to be not much value in differentiating malignancy. 6) Accuracy of the fine needle aspiration cytology was 75.5%. 7) There were 251 cases(73.0%) of benign and 93 cases(27.0%) of malignant nodules: most frequent benign nodule was adenomatous goiter(67.7%) and the most frequent malignant nodule was papillary adenocarcinoma (86.0%). 8) The most commonly performed surgical procedure was unilateral lobectomy with isthmectomy in both benign(41.0%) and malignant(33.3%). 9) Postoperative complications are as follows: transient hypothyroidism 22cases, transient hoaseness 16 cases, hypothyroidism 6 cases, wound infection 4 cases, hematoma 3 cases, permanent hoaseness 2 cases.

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A Clinical Study of Surgically Managed Thyroid Nodule (외과적으로 처치한 갑상선 결절)

  • Hong Kwan-Uye;Lee Myung-Bok;Moon Chul;Kim Ik-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.91-101
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    • 1994
  • Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

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A Case of Canine Uterine Adenocarcinoma with Negative Estrogen and Progesterone Receptor Expression (개의 에스트로겐과 프로케스테론 수용체 발현이 되지 않은 자궁 선암종 증례)

  • Cho, Hyang-Mi;Kim, Hyun-Wook;Kim, Hye-Jin;Choi, Ji-Hye;Jang, Jae-Young;Choi, Ul-Soo
    • Journal of Veterinary Clinics
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    • v.28 no.3
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    • pp.303-306
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    • 2011
  • A 12-year-old female mixed breed dog receiving a progesterone drug was referred for evaluation of an abdominal mass. Abdominal radiography and ultrasonography revealed a swollen uterus and an associated mass. Serum chemistry revealed hyperglobulinemia consistent with acute inflammation based on the results of serum protein electrophoresis. Fine needle aspiration of the mass guided by ultrasonography was performed for cytological evaluation. The cytological impression was consistent with adenocarcinoma. Exploratory laparotomy identified a uterine body mass, which was surgically removed for histopathology. Histology of the mass identified a uterine adenocarcinoma. Immunochemistry using anti-estrogen and progesterone receptor antibodies was performed and neoplastic cells were negative to both antibodies while some normal elements were reactive to both of them. Computer tomography demonstrated evidence of metastatic disease in the lung one week after the surgery and the dog died about 40 days after surgery.

A Case of Inflammatory Pseudotumor Completely Resolved by Steroid Therapy (스테로이드 요법으로 완치된 염증성 가종양 1예)

  • Bang, Seung-Ho;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.709-713
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    • 1993
  • Inflammatory pseudotumor, also known as plasma cell granuloma, is a rare, benign tumor that affects at all ages and frequently involves the lung, gastrointestinal tract, and salivary gland. They are the most common, isolated, primary lesion of the lung in children less than 16 years of age, and usually present as circumscribed, peripheral, parenchymal tumors, which may be static or increase slowly in size without causing symptoms. Surgical excision is the treatment of choice bacause of the location and benign nature of this lesion. The prognosis after resection is excellent. Adjuvant therapeutic modalities include radiation and steroid therapy. Recently, we experienced a case of inflammatory pseudotumor of the lung, the diagnosis of which was made by percutaneous fine needle aspiration cytology examination. We tried steroid and the lesions of the lung was completely resolved. We report this case with a review of literatures.

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Quality Control Program and Its Results of Korean Society for Cytopathologists (대한세포병리학회 정도관리 현황 및 결과)

  • Lee, Hye-Kyung;Kim, Sung-Nam;Khang, Shin-Kwang;Kang, Chang-Suk;Yoon, Hye-Kyoung
    • The Korean Journal of Cytopathology
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    • v.19 no.2
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    • pp.65-71
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    • 2008
  • In Korea, the quality control(QC) program forcytopathology was introduced in 1995. The program consists of a checklist for the cytolopathology departments, analysis data on all the participating institutions' QC data, including the annual data on cytologic examinations, the distribution of the gynecological cytologic diagnoses, as based on The Bethesda System 2001, and the data on cytologic-histolgical correlation of the gynecological field, and an evaluation for diagnostic accuracy. The diagnostic accuracy program has been performed 3 times per year with using gynecological, body fluid and fine needle aspiration cytologic slides. We report here on the institutional QC data and the evaluation for diagnostic accuracy since 2004, and also on the new strategy for quality control and assurance in the cytologic field. The diagnostic accuracy results of both the participating institutions and the QC committee were as follows; Category 0 and A: about 94%, Category B: 4-5%, Category C: less than 2%. As a whole, the cytologic daignostic accuracy is relatively satisfactory. In 2008, on site evaluation for pathology and cytology laboratories, as based on the "Quality Assurance Program for Pathology Services" is now going on, and a new method using virtual slides or image files for determining the diagnostic accuracy will be performed in November 2008.

Recent Advances in Cancer Diagnosis: On an Overview of Diagnostic Cytopathologic Modalities and Ancillary Techniques (세포병리학적 기초에 의한 암진단의 발전: 진단방법과 보조기법)

  • Kim, Ki-Tai;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.1-11
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    • 1996
  • From the concepts of cellular pathology and of exfoliative cytology, as elucidated by Virchow and Papanicolaou respectively in the late 19th and early 20th century, have evolved the primary methods for the diagnosis of cancer today. From Papanicolaou's concept of exfoliative cytology developed fine needle aspiration biopsy in the early 1960's, this has become a major diagnostic procedure and has contributed to a significant reduction in open biopsies and, therefore, to medical cost-effectiveness immunobiochemical techniques provided us with a supplement to cancer diagnosis in the 1980's. The immunoperoxidase method, using monoclonal antibodies, is applied primarily as an ancillary measure to elucidate the nature of cancers The availability of specific monoclonal antibodies has greatly facilitated the identification of cell products or surface markers. For example, antibodies directed against intermediate filaments have proved to be of value in determining the histogenesis oi poorly differentiated neoplasms. Tumor markers may serve as biochemical indicators of the presence of a neoplasm. They can be detected In plasma and other body fluids. Their concentration can be applied as a diagnostic test, for monitoring the clinical course of known cancer, and as a screening measure to detect certain cancers in a population at risk. Flow cytometry is a useful tool for distinguishing several cell characteristics, such as the immunophenotype of leukemia-lymphoma cells, the DNA content of neoplastic cells, and cell proliferation rate. Molecular biologic techniques provided a giant step for the management of cancer patients encompassing diagnosis, prognostic evaluation, and therapy. Nucleic acid hybridization techniques are utilized as Southern, Northern, and dot blots and in situ hybridization. Molecular biology and its techniques may bring a blight new horizon for understanding cancer biology and in designing therapy on the basis of gene manipulation.

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Diagnosis and Treatment of Papillary Thyroid Microcarcinoma(PMC) (유두 미세 갑상선암의 진단 및 치료에 대한 고찰)

  • Yoon Kyung-Seok;Oh Sung-Soo;Park Sung-Gil;Chung Eul-Sam
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.228-235
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    • 1998
  • Objectives: Papillary microcarcinoma of the thyroid was evaluated as to the effectiveness of diagnostic modalities, lymphatic spread pattern, and therapeutic decision according to tumor size. Material and Methods: We retrospectively analyzed a clinicopathologic findings of 72 papillary microcarcinoma patients who were treated at the over 11 years between 1985 and 1995. The authors divided papillary microcarcinoma of the thyroid into two subgroups according to tumor size: $0{\leqq}5mm$ and $5<0{\leqq}10mm$. An analysis including age and gender distribution, diagnostic tools(thyroid sonogram, thyroid scan, thyroid function test, fine needle aspiration cytology, frozen section), pathological examination of lymphnode, and surgical procedures was carried out in each subgroups. Results: The carcinoma of smaller than 5mm were found in 32 patients, and of 6 -10mm were in 40 patients. The average age of patients was 45years and all of them were female. Cold nodules on thyroid scan were noticed in 53 patientss and normal findings were in 15 patients. Suspicious malignant lesions(fine calcification, solid mass, irregular margin) on thyroid sonography were detected in 23 patients and the sonography was more useful in detecting $0{\leqq}5mm$ small sized lesions than other diagnostic methods. FNAC were performed in 17 patients, and 7 patients were diagnosed as having thyroid papillary cancer. But diagnotic rate in $0{\leqq}5mm$ small sized lesions was very low(one of eights).Frozen section were performed in all patients, among these 15 patients were diagnosed as being benign diseases and false negative rates were higher in $0{\leqq}5mm$ small sized lesions than in $5<0{\leqq}10mm$ sized lesions(p-value<0.006). Only thyroidectomies were performed in 24 patients and thyroidectomy with node dissections in 48 patients. The lymphnode metastatic rates were much higher in multifocal lesions(61.5%) than in single lesion. The incidence of cervical lymphnode metastasis was 19.4% in $0{\leqq}5mm$ sized lesions and 47.9% in $5<0{\leqq}10mm$ sized lesions. Postoperative management were performed with TSH suppression therapy(T4, synthroid) in all patients and RI therapy in 29 patients. Conclusion: On the basis of our study, improved preoperative diagnostic tools for papillary microcarcinoma of the thyroid was helpful in the choice of surgical treatment. As a result of techninological progress(ultrasonography, FNAC), the pencentage of the discovery of papillary microcarcinoma has been increased. The thyroid ultrasonography was useful in detecting small sized lesions($0{\leqq}5mm$), but FNAC may not be beneficial in detecting small sized lesions($0{\leqq}5mm$). In the surgical procedure, thyroid lobectomy alone should be avoided because of the high rate of bilaterality and multifocality.

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A Clinical Analysis of Surgically Managed Thyroid Nodule (외과적으로 치료한 갑상선 결절에 대한 임상적 고찰)

  • Jung In-Kyu;Kim Lee-Su;Choi Won-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.9 no.1
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    • pp.16-24
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    • 1993
  • During 7 years, from Jan. 1986 to Dec. 1992, authors studied 208 cases of the surgically managed thyroid nodules at the Department of General Surgery, Han Kang Sacred Heart Hospital and obtained the following results. 1) Among the total 208 cases, male to female ratio was 1:11.2 in benign thyroid diseases and 1:9 in malignant thyroid diseases. The benign disease was prevalent between second and forth decade comparing with malignant disease between third and fifth decade. 2) The most common duration of illness was 3 months(26.0%). 3) Palpable neck mass was the most common chief complaint(100%). Palpitation. fatigue, and sweating were common complaints in patient with benign disease, and fatigue, palpitation, and sweating in malignant disease in decreasing order of frequency. 4) 55.8 % of lesions were in right lobe, 33.2% in left lobe, 5.8% in diffuse type, 4.8% in bilateral lobes, and 0.5% in isthmus. 5) The most common size of nodule was between 2.0cm and 3.9cm in diameter, which consisted of 55.1% of benign disease and 48.0% of malignant disease. 6) 86.5% of thyroid function test showed euthyroidism, 10.1% hyperthyroidism, and 3.4% hypothyroidism. 7) Thyroid scanning of 176 patients revealed cold nodules in 92.5% of benign diseases and in 92.9% of malignant diseases. 8) The most common benign disease was adenomatous hyperplasia(62.7%), and the most common malignant disease was papillary adenocarcinoma(80.0%). 9) Fine needle aspiration cytology was performed in 91 cases, and it showed 69.0% of sensitivity, 90.3% of specificity, and 83.5% of accuracy. 10) Frozen biopsy was performed in 109 cases. and it showed 93.9% of sensitivity, 100.0% of specificity, and 98.2% of accuracy. 11) The most commonly performed operation was unilateral lobectomy(including unilateral lobectomy with isthmectomy)(79.1%) in benign disease. and total thyroidectomy(62.0%) in malignant disease. 12) Postoperative complication showed 5 cases of wound infection (2.4%), 3 cases of transient hypoparathyroidism(1.4%), 3 cases of transient hoarseness(1.4%), 2 cases of postoperative bleeding(1.0%), 1 case of permanent hypoparathyroidism(0.5%), 1 case of permanent hoarseness(0.5%), and 1 case of postoperative pneumonia (0.5%).

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