• Title/Summary/Keyword: needle aspiration

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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.

Thyroid Hemiagenesis Associated with Papillary Thyroid Carcinoma : Report of a Case and Review of the Literature (갑상선 편측형성부전에 동반된 유두 갑상선암 1예)

  • Lee, Yong-Sang;Yun, Ji-Sup;Jeong, Jong-Ju;Nam, Kee-Hyun;Chung, Woong-Youn;Park, Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.161-164
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    • 2007
  • Thyroid hemiagenesis is a rare anomaly, which is the result of failure of embryologic development of a lobe of thyroid gland. It is more frequently found in the left lobe and in female patients. We, herein, report an extremely rare case of thyroid hemiagenesis associated with papillary thyroid carcinoma. A 69-year-old female presented with an incidentally discovered thyroid nodule in the right thyroid during a routine medical check-up. Ultrasonography(US) and computed tomography(CT) disclosed $0.7{\times}0.5cm\;and\;2.8{\times}2.2cm$ sized nodules in the right thyroid. The left thyroid, however, was not seen in the imaging studies of US and CT. Fine-needle aspiration of the small and large nodules showed papillary thyroid carcinoma and adenomatous hyperplasia, respectively. The patient underwent a right total thyroidectomy with central compartment node dissection. The operative findings and histologic examination confirmed the absence of the left thyroid associated with papillary thyroid carcinoma and ademonatous hyperplasia of the right thyroid.

Primary Splenic Paraganglioma in a Dog

  • An, Su-Jin;Moon, Jong-Hyun;Hwang, Tae-Sung;Lee, Hee-Chun;Yu, Do-Hyeon;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.35 no.4
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    • pp.155-160
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    • 2018
  • A 6-year-old intact female Shih-tzu dog was referred due to anorexia. Physical examination, complete blood count, serum chemical analysis, radiography, and ultrasonography were evaluated. Physical examination and hematological analysis showed normal findings. Abdominal radiographs and ultrasound revealed well-defined masses in the spleen. Other abdominal organs showed no significant abnormalities. Tissue samples taken via sono-guided fine needle aspiration of the splenic mass showed many bare nuclei, which were variable in size. Results of histopathological and immunohistochemical (IHC) analyses performed after splenectomy were consistent with paraganglioma. Based on these findings, we diagnosed this patient with a paraganglioma of splenic origin. Two months after splenectomy, abdominal ultrasonography revealed a new neoplastic lesion in the liver. The clients refused further management and the patient expired three months after initial diagnosis. Necropsy as well as histopathological and IHC examinations of other systemic organs including the liver, adrenal gland, kidney, brain, urinary bladder, lung, aortic body, carotid body, and pancreas were performed. The neoplastic tissue in the liver also demonstrated features of a paraganglioma, and there were no remarkable findings in all other organs.

One Case of Alveolar Rhabdomyosareoma arising from Intercostal Muscle (늑간근에 발생한 폐포성 횡문 근육종 1례 보고)

  • 김선한
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.598-604
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    • 1992
  • Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and acounts for 6% to 15% of all cases of childhood cancer, Rhabdomyosarcoma in seventh most common form of childhood neoplasms, following acute leukemia, tumors of the central nervous system, lymphoma neuroblastoma, Wilm`s tumor, bone tumor. Rhabdomyosarcoma can arise anywhere in the body, but primary site in the thorax is relatively rare. We experienced a case of aveolar rhabdomyosarcoma arising from intercostal muscle, A 12 year-old woman was suffered from the intermittent left chest pain radiating to the scapular area and dyspnea, On physical examination, pulmonary friction rub was heard on the left upper lobe area. Qn adimission, the chest simple radiography revealed a 7 x 6, 5cm sized radio-opaque mass with pleural effusion in the superior mediastinum and the CT showed a well difined radio-opaque mass including the destructed 2nd rib and pleural effusion. The percutaneous tra-nsthoracic needle aspiration biopsy was likely to show blastoma. After the chemotherapy[vincristine, actinomycin-D, cyclophosphamde] was done to treat blastoma, the pleural effussion was subsided and the mass was slightly decreased by 4.5x 4. 5cm. For treatment and diagnosis, we performed en-bloc resection and the defected chest was reconstucted with Gortex patch. Grossly, the specimen was colored graysh-white and arised in between two ribs The microscopic findings showed that the tumor cells were small round with scant pinkish cytoplasm on the H-E stain and the tumor cell nests were grouped by reticulum fibers and showed alveolar pattern on the silver stain The electromicroscopic finding presented that the cytoplasm contained tangled fibrillar and flocculent materials. The histopathologic findings were compatable with laveolar rhabdomyosarcoma. She was discharged without any complication. After discharge, she has been treated with radiation theraphy and chemotheraphy, and not recurred untill last follow-up We report a case of alveolar rhabdomyosarcoma arising to intercostal muscle, developed in 12 year-old waman, with brief review of literatures.

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Surgical Treatment of Well-Differentiated Fetal Adenocarcinoma - A case report - (태아성 선암종의 외과적 치료 1례보고)

  • Song, Dong-Seop;Chung, Won-Sang;Kim, Hyuck;Kim, Young-Hak;Kang, Jung-Ho;Lee, Chul-Bum;Jeon, Seok-Chol;Lee, Won-Mi;Hong, Eun-Kyung
    • Journal of Chest Surgery
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    • v.34 no.7
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    • pp.566-568
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    • 2001
  • WDFA(Well-differentiated fetal adenocarcinoma) histologically resembles pulmonary blastoma. It is also thought to be a subtype of pulmonary blastoma, which has differentiated epithelial features resembling the fetal lung among its epithelial features and sarcomatous features. We recently encounted a patient who underwent surgery for WDFA. A 19-year-old man had a mass shadow in the upper lobe of the left lung. The tumor was diagnosed as pulmonary blastoma as a result of fine needle aspiration biopsy, and left upper lobe lobectomy was performed. No sarcomatous features was observed on postoperative histologic assessment, and the patient was diagnosed as having WDFA. This case is reported with a discussion of the literatures.

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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.

Intramasseteric schwannoma treated with facelift incision and retrograde facial nerve dissection

  • Hwang, Jae Ha;Lee, Dong Gyu;Sim, Ho Seup;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.20 no.6
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    • pp.388-391
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    • 2019
  • Schwannoma is a slow-growing, well-demarcated, benign soft tissue tumor of the peripheral nerve sheath. It commonly develops in the head and neck region, usually in the parapharyngeal space. In this case, a 42-year-old woman visited the outpatient department to manage a painless mass on her left cheek. She had no history of concern and no neurological symptoms were observed. In the enhanced computed tomography scan, a 2.8×2.8×1.8 cm, heterogeneously enhanced tumor was detected in the left masseter muscle. A tumor resection under general anesthesia was planned. For the resection, a facelift incision was chosen; branches of the facial nerve were identified and retrogradely dissected. A well-marginated, yellowish, solid mass was found in the left masseter muscle. The mass was excised and given a histopathological diagnosis of schwannoma. A definite diagnosis of schwannoma, originating in the masseter muscle, is difficult to arrive at with radiographic findings alone; it is often misdiagnosed as intramuscular hemangioma. Histopathological examinations, including fine-needle aspiration or histological biopsy after surgery, are necessary. Using a facelift incision with retrograde facial nerve dissection, tumor resection in an intramasseteric lesion can be performed efficiently, without nerve damage, or leaving conspicuous scars on the face.