• Journal of Genetic Medicine
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• v.8 no.1
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• pp.35-43
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• 2011

Purpose: We evaluated indications for chorionic villus sampling (CVS), the positive predictive value of CVS for fetal chromosomal abnormalities, and the fetal loss rate after CVS at CHA Medical Center. Materials and Methods: We reviewed the medical records of 511 cases of CVS performed between 67 and 120 days of gestation for prenatal cytogenetic diagnosis from April 2000 to April 2010. Fetal karyotypes were obtained by direct and indirect culture methods. Results: The most common indications for CVS were abnormal ultrasonic findings including increased nuchal translucency (294/635, 46.3%). The positive predictive value of abnormal karyotyping according to indication for CVS was highest in cases with abnormal parental karyotypes (14/21, 66.7%). Mosaicism revealed by CVS comprised 3.1% of the sample (16/509). Amniocentesis revealed two cases of true mosaicism and 11 cases of confined placental mosaicism. The fetal loss rate within 4 weeks of the procedure was 1.2% (6/511). Conclusion: If CVS is performed by an expert clinician, it is a feasible and reliable procedure for prenatal genetic diagnosis. When CVS indicates mosaicism, the finding should be confirmed by amniocentesis to distinguish true mosaicism from confined placental mosaicism.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.5.1-5
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• 1978

Since Ikeda in traduced flexible fiberoptic bronchoscope in 1968, use of bronchoscopy was expanded rapidly. Wide use of flexible bronchoscopy enabled us to get tissue diagnosis with more ease and safety. Authors analyzed 71 cases of tissue biopsy of 233 bronchoscopies from June '76 to. Jan. '78 and concluded as following : 1. 233 bronchoscopies af 20 Month duration, cases which needed tissue biopsy were 71 cases (30.5%). 2. Chief complaints af above cases are coughing, dyspnea, sputum, chest pain, hemoptysis in frequency. 3. Biopsy sites were as following in frequency: Rt.upper lobe, Lt. main bronchus, Lt. upper lobe, Rt. main bronchus, Lt. lower lobe. 4. The final diagnosis of biopsied cases were cancer 80%, tuberculosis 15%, and malignant mesothelioma, anthracosis, aspergillosis, were one case each. 5. Among 57 case of lung cancer, biopsy confirmed cases were 36 cases (63%). 6. Pathologic finding of 36 case of Biopsy confirmed lung cancer was as following: Squamous cell ca : 64% Anaplastic ca : 25% Adeno ca : 2.8% Unclassified: 2.8% 7. Bronchographies were done in 36cases (51%), one quarter of cases before biopsy, and three quarters of cases after biopsy. 8. Cytology was requested in 76% of cases with following results; PAP class V 15%, class IV 7.5%, class III 1.8%.

• Tuberculosis and Respiratory Diseases
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• v.48 no.4
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• pp.438-447
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• 2000

Background : Transbronchial lung biopsy (TBLB) is a relatively simple and convenient procedure to obtain lung tissue from a patient with diffuse or localized lesion on chest radiographs, whose disease cannot be diagnosed through routine tests. The authors tried to evaluate the diagnostic value of TBLB, especially, the concordance between CT scan and TBLB with respect to the location of the lesion and diagnostic yield according to tumor-bronchus relationship. Method : We reviewed the medical records, plain chest films, and chest CT scans of 278 patients who underwent TBLB at Kyungpook National University Hospital between January 1996 and June 1998. Results : One hundred and sixteen (41.7 %) patients were diagnosed by TBLB. Diagnostic yield of TBLB of malignant tumors tended to be higher than that of benign diseases (64.7% versus 53.9%, p=0.09). Of primary lung cancers, TBLB was more diagnostic in adenocarcinoma and small-cell carcinoma than other cell types (p<0.01) and, of benign diseases, more diagnostic in tuberculosis than in non-tuberculous diseases (p<0.05). There was no significant difference in the diagnostic rate according to the location of the tumor. The diagnostic rate tended to increase with the size of tumor (p=0.06). The diagnootic rate of TBLB did not differ according to the pattern of lesion in benign diseases. However, in malignant diseases TBLB was more diagnostic in diffuse/multiple nodular lesions than in localized lesions(p<0.05). According to the tumor-bronchus relationship, TBLB was more diagnootic in type I/II groups than in other types. CT scan and TBLB showed a strong correlation with respect to the localization of the lesion (r=0.994, p<0.01). Conclusion : The above results show that TBLB is useful in the diagnosis of lung disease. CT scan and TBLB showed a strong correlation in determining the location of the lesion. Diagnostic yield of TBLB is higher in lesions with 'bronchus sign' (type I and II). TBLB and other diagnootic methods such as transthoracic needle aspiration are expected to complement one another in the diagnosis of lung diseases.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1011-1018
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• 1997

Background : To evaluate how efficaciously and safely we can make transthoracic lung biopsy with an 18-gauge automated biopsy device. Methods : We performed 130 transthoracic needle biopsies including 16 repeat biopsies in 114 patients with a pulmonary mass using an l8-gauge biopsy device (ASAP 18, Microvasive-. Eighty-three biopsies were performed by an experienced radiologist and 47 by several less experienced radiologists. All biopsies were guided by biplane fluoroscopy. Results : We successfully obtained sufficient tissue(>2-mm in the length) in 128(985) of 130 biopsies. Biopsy provided the specific diagnosis in 97 (85%) of 114 patients including 78 (88%) of 89 patients with a malignant tumor and 19 (90%) of 21 patients with a benign condition. The diagnosis could not be made in the remaining four patients. Of interest to note was the superb capability (74/74) of biopsy to make a distinction between small cell carcinoma and non-small cell carcinoma. There was no significant difference in the diagnostic yields between the experienced and less experienced radiologists. Of the total 130 biopsies, pneumothorax appeared in 13 (10%), among which treatment was required in 2 (2%), Mild, self-limiting hemoptysis was nod in seven (5%), but in no case was the treatment required. Conclusion : We conclude transthoracic lung biopsy with an 18-gauge automated device is an effective procedure for the specific diagnosis of benign and malignant lung disease. It is safe with the complication rate comparable to that of fine-needle aspiration biopsy as well.

• The Korean Journal of Nuclear Medicine
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• v.37 no.3
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• pp.171-177
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• 2003

PURPOSE: To asess the ability of FDG PET for the detection of bone marrow infiltration compared to iliac crest biopsy in patients with lymphoma. MATERIALS AND METHODS: Seventy-three patients (30 females and 43 males, mean age of 47 years old) with malignant lymphoma (4 Hodgkin's disease, HD and 69 Non-Hodgkin's lymphoma, NHL) were included. FDG PET was performed for staging in 53 patients and to assess treatment response after the completion of chemotherapy in 20 patients. Final conclusions were based on biopsy, other imaging studies, or clinical follow-up. RESULTS: There were 54 (74%) of the 73 patients in whom FDG PET and iliac crest biopsy were concordant. Forty-seven of the 54 patients showed concordant negative results while the remaining 7 patients had concordant positive results. Of 19 patients with discordant results, FDG PET accurately detected bone marrow infiltration in 6 patients with negative iliac crest biopsy. On the contrary, iliac crest biopsy identified bone marrow infiltration in 12 or the 19 patients. In remaining one of the 19 patients with discordant results, iliac crest biopsy was true negative but FDG PET was falsely positive. CONCLUSION: FDG PET seems to be an adjunct in detecting marrow infiltration that may not be revealed by iliac crest biopsy at staging. For the assessment of treatment roponse, it may be less helpful than biopsy in detecting microscopic residual disease in the bone marrow.

• Tuberculosis and Respiratory Diseases
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• v.56 no.4
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• pp.374-380
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• 2004

Although exophytic endobronchial lesions can readily be diagnosed by routine forceps biopsy through the fiberoptic bronchoscope, submucosal or peribronchial tumor can be difficult to diagnose. So we evaluated the diagnostic utility of transbronchial needle aspiration (TBNA) through the fiberoptic bronchoscope in patients presenting with endoscopic abnormalities suggestive of submucosal or peribronchial tumor. Patients and Methods : Retrospective review of 120 lung cancer patients who were found to have the lesions suggestive of peribronchial and submucosal tumor during fiberoptic bronchoscopy was performed from Jan. 1994 to Dec. 2002 at Severance Hospital, Yonsei University College of Medicine. Results : Forcep biopsy was positive in 63 cases (52.5%) and TBNA in 91 (75.8%), which was significantly better than forcep biopsy (p=0.001). The combination of forceps biopsy and TBNA was positive in 106 cases (88.3%), which was significantly better than forceps biopsy alone (p=0.0001). The difference of TBNA yield according to cell type or bronchoscopic appearance of lesion was not significant, but it showed the relatively better result in small cell carcinoma. Conclusions : We concluded that TBNA significantly increase the yield over forcep biopsy alone in the detection of submucosal or peribronchial bronchogenic carcinoma.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.320-331
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• 2023

Mammography has been the standard screening method for breast cancer. In women with suspicious calcifications and architectural distortion identified on mammography or digital breast tomosynthesis only without detected on breast US, stereotactic biopsy and mammography-guided preoperative localization is one of the method for pathologic diagnosis. This review aims to describe the indication, contraindication, technique of stereotactic biopsy, clip placement after stereotactic biopsy, and digital breast tomosynthesis-guided stereotactic biopsy. In addition, this article reviews mammography-guided preoperative localization using a wire or non-wire device.

• Proceedings of the KAIS Fall Conference
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• 2009.05a
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• pp.603-606
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• 2009

본 연구는 폐 병소의 경피적 흡인 생검을 시행하는데 있어 기흉 발생에 영향을 미치는 요인을 7가지로 나누어 분석하여, 국소적인 폐 병소를 보인 25~85세 사이의 104명의 환자를 대상으로, 병변의 위치, 병변의 크기, 병변의 깊이, 성별, 나이, 생검 시간, 생검 횟수로 나누어 기흉 발생과의 연관성을 연구하였다. 그 결과는 다음과 같다. 1. 위치에 따른 기흉 발생률은 우하엽에서 27.3%, 우상엽 24.3%, 좌하엽 15%, 좌상엽 12% 순으로 나타났으며, 병변의 크기에 따른 기흉 발생률은 0~2.0cm에서 24.0%, 2.1~4.0cm에서 18.2%, 4.1cm 이상에서 20.0%이었으며, 병변의 깊이에 따른 기흉 발생률은 0cm에서 6.7%, 0.1~2.0cm에서 24.2%, 2.1cm이상인 경우가 26.8%이며, 성별에 따른 기흉의 발생은 남성 21.7%, 여성 17.1%로 나타났으며, 나이에 따른 기흉 발생은 40세 이하가 25%, 41~50세가 11.7%, 51~60세가 14.3%, 61~70세가 24.1%, 70세 이상이 24.1%로 나타났고, 생검 시행 횟수에 따른 기흉 발생률은 4회 이상에서 28.6%, 2회 이하에서 20.5%, 3회에서 17.4%로 각각 나타났다. 이 모두는 통계적으로 유의한 차이는 없었다(P=0.484, 0.859, 0.088, 0.581, 0.758, 0.658). 2. 생검에 걸리는 시간에 따른 기흉 발생률은 0~10.0분에서 3.8%, 10.1~20.0분에서 24.2%, 21분 이상에서 40%로 시간이 오래 걸릴수록 기흉 발생률은 증가하였으며 통계적으로 유의한 차이가 있었다(P=0.005).

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.1000-1004
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• 2021

Percutaneous transthoracic needle biopsy (PTNB) is a minimally-invasive procedure that is an indispensable tool for evaluating pulmonary lesions. Though extremely rare, tumor seeding of the pleura and chest wall can occur as a complication. Given that the breast is located anterior to the thorax, needle tracking through the breast is inevitable when PTNB is performed using the anterior approach. We describe tumor seeding of metastatic pulmonary ameloblastoma in the pectoralis muscle layer of the breast along the needle track of PTNB in a 51-year-old female presenting with a palpable lump in the right breast.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.899-906
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• 1997

Background : The percutaneous pleural needle biopsy have been regarded as cornerstone in the diagnosis of lymphocyte dominant pleural effusions of which acid fast bacilli smear and cytologic exam was negative. However, the complications of percutaneous pleural needle biopsy is not rare and its diagnostic efficacy is not always satisfactory. Recently, pleural fluid adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) are widely accepted as markers of tuberculous pleurisy and malignant pleural effusion respectively. We designed this study to re-evaluate the role of percutaneous pleural needle biopsy in the diagnosis of lymphocyte dominant exudative pleural effusions whose AFB smear, cytologic exam was negative. Method : Retrospective analysis of 73 cases of percutaneous pleural needle biopsy in case of lymphocyte dominant exudative pleural effusions whose AFB smear and cytoloic exam was negative from Jan 1994 to Feb 1996 was done. Result : In 35 cases, specific diagnosis was obtained(all cases were tuberculous pleurisy), and in 30 cases specific diagnosis was not obtained in spite of getting adequate pleural tissues, and in the other 8 cases, percutaneous pleural biopsy failed to get pleural tissues. In 9 cases, complications were combined including pneuomothorax and hemothorax. All 49 cases of pleural effusions whose ADA value was higher than 40IU/L and satisfying other categories were finally diagnosed as tuberculous pleurisy, however, the pleural biopsy confirmed only 28 cases as tuberculous pleurisy. In 6 cases of pleural effusions of which CEA value is higher than 10ng/ml, the pleural biopsy made specific diagnosis in no case. Final diagnosis of above 6 cases consisted of 4 malignant effusions, 1 malignancy associated effusion and 1 tuberculous pleurisy. Conclusion : In the diagnosis of 73 cases of lymphocyte dominant pleural effusions of which acid fast bacilli smear and cytologic exam was negative, percutaneous pleural biopsy diagnosed only in 35 cases. In the diagnosis of tuberculous pleurisy, the positive predictive value of higher ADA than 40 IU/L in lymphocyte dominant pleural effusion with negative AFB smear and negative cytologic exam was 100%. And the diagnostic efficacy of pleural biopsy was 57%. In cases of effusions with high CEA than 10ng/ml 83% and 0% respectively. Finally, we concluded that percutaneous pleural needle biopsy in the diagnosis of AFB smear negative and cytologic exam negative lymphocyte dominant exudative pleural effusion was not obligatory. especially in effusions with high ADA and low CEA value.