• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1570-1574
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• 2021

Post-partum galactocele is a common benign disease among breastfeeding women, whereas retromammary and peri-implant galactocele are relatively rare conditions. Herein, a 34-year-old, 1 month-postpartum female, who had augmentation mammoplasty and a 1-month history of breast pump use, presented with left breast enlargement for 2 weeks. An initial left breast US revealed hyperechoic peri-implant fluid collection. Additional US-guided fine needle aspiration was done using a 21G-needle, draining the milk component in the process, and cytologic results revealed numerous crystals, suggestive of galactocele. Various diseases, especially breast implant-associated anaplastic large cell lymphoma, can cause peri-implant fluid collection in an augmented breast. Thus, correlating imaging features with clinical information and cytologic analysis plays an important role in appropriate management.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.97-97
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• 1993

Primary tumor arises infrequently in the parotid gland and generally, only about 20 to 40 percent of which prove to be malignant. They are characterized by histopathologic diversity, slow tumor growth, significant proportion of patients who have received previous treatment elsewhere. We have reviewed retrospectively 101 cases of parotid gland tumors which were treated for the recent eight years (1985-1992), Non-neoplastic tumor-like lesions were all excluded.

• Tuberculosis and Respiratory Diseases
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• v.45 no.5
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• pp.1058-1066
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• 1998

Background: Actinomycotic infection is uncommon and primary actinomycosis of the lung and chest wall has been less frequently reported. This disease may present as chronic debilitating illness with radiologic manifestation simulating lung tumor, pulmonary infiltrating lesion, or chronic suppuration. Diagnosis of choice was not definded yet and role of bronchoscopy on diagnosis was not described yet. Methods: From 1989 to 1998, we experienced 17 cases of thoracic actinomycosis. We have reviewed the case notes of 17 patients with thoracic actinomycosis. The mean age at presentation was $53{\pm}13$ years, 11 were male. Results: Cough, hemoptysis, sputum production, chest pain and weight loss were the commonest symptoms. The mean delay between presentation and diagnosis was $6.6{\pm}7.8$ months. There were six patients who presented with a clinical picture of a suppurative lesion and eleven patients were suspected of having primary lung tumor initially. In no cases was made an accurate diagnosis at the time of hospital admission. Associated diseases were emphysema (1 case), bronchiectasis (2 cases) and tuberculosis (2 cases). Bronchoscopic findings were mucosal swelling and stenosis(n=4), mucosal swelling, stenosis and necrotic covering (n=2), mass (n=3), mass and necrotic covering (n=1) and normal(n=6). Radiologic findings were mass lesion(n=8), pneumonitis(n=3), atelectasis(n=3), pleural effusion(n=2), and normal(n=3). Final diagnosis was based on percutaneous needle aspiration and biopsy (n=3), bronchoscopic biopsy specimens (n=9), mediastinoscopic biopsy (n=1) and histologic examination of resected tissue in the remaining patients(n=4) who received surgical excision. Among 17 patients, 13 were treated medically and the other 4 received surgical intervention followed by antibiotic treatment. Regarding the surgically treated patients, suspected malignancy is the most common indication for operation. However. both medically and surgically treated patients achieved good clinical results. Conclusion: Thoracic actinomycosis is rare. but should still be considered in the differential diagnosis of a chrinic, localized pulmonary lesion. Thoracic actinomycosis may co-exist with pulmonary tuberculosis or lung cancer. If the lesion is located in the central of the lung. the bronchoscopy is recommanded for the diagnosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.2
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• pp.151-156
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• 2006

Purpose : The aim of this study was to determine the accuracy of clinical and radiologic assessments in detecting positive cervical lymph nodes in oral cancer. Materials and Methods : We had reviewed the preoperative clinical, radiologic and postoperative histopathologic reports of 46 patients who had been diagnosed as oral cancer and underwent surgical excision combined with neck dissection (52 sides of neck) in the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University from the July 1, 1992 to the April 30, 1999. Results : The results were as follows 1. The male to female ratio was 4.38 : 1 and the mean age was 57. 2. Sensitivity values for the preoperative assessment of cervical lymph node metastasis in oral cancer were 62.5 % in clinical examination and 50.0 % in radiologic assessments. Specificity values were 77.8 % in clinical examination and 94.4 % in radiologic assessments. 3. False positive values were 44.4 % in clinical examination and 20.0 % in radiologic assessments. False negative values were 17.6 % in clinical and 19.0% in radiologic assessments. 4. Overall efficiency values were 73.1 % in clinical examination and 80.8 % in radiologic assessments. Summary : There were some limits on the accuracy of clinical and radiologic assessments in the preoperative detection of the cervical lymph nodes in oral cancer. To improve the accuracy, it is important to communicate between clinician and radiologist, and adjunctive diagnostic measures, ultrasound and fine needle aspiration cytology, were helpful increasing the overall efficiency. In the high risk sites (oral tongue and floor of the mouth) the false negative value is higher and the overall efficiency in radiologic evaluation is lower than those of the low risk sites (gingiva and alveolar ridge, retromolar trigone and buccal mucosa ). The elective neck dissection should be considered in the high risk sites.

• Journal of the Korean Society of Radiology
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• v.13 no.2
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• pp.201-207
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• 2019

This study has evaluated whether the method of using the combination of different risk group, according to K-TIRADS classification and K-TIRADS classification in thyroid ultrasonography is useful in a differential diagnosis of benign and malignant nodules. The subject was patients underwent thyroid ultrasonography and retrospective analysis were performed based on the results of fine needle aspiration cytology. A chi-square test was performed for the difference analysis of the score system in K-TIRADS and different risk group according to the benign and malignant of thyroid nodule. The optimized cut off value was determined by the K-TIRADS score and different risk group to predict malignant nodule through ROC curve analysis. In the differential verification result of K-TIRADS and different risk group, according to the classification of benign and malignant nodule group each showed significant difference statistically(p=.001). In the point classification according to K-TIRADS for the prediction of benign and malignant in ROC curve analysis showed AUC 0.786, Cut-off value>2(p=.001), and in the different risk group, it was decided as AUC 0.640, Cut-off value>2(p=.001). When discovering the nodule in thyroid ultrasound, it is considered that the K-TIRADAS which helps in identifying benign and malignant thyroid nodules, it is considered to be helpful in the differential diagnosis of thyroid nodules, than the classification system according to Different risk group, and when applying the classification system according to K-TIRADS, it is considered that it can reduce unnecessary fine needle aspiration cytology and could be helpful in finding the malignant nodules early.

• The Korean Journal of Nuclear Medicine
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• v.34 no.2
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• pp.119-128
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• 2000

Purpose: The aim of this study was to investigate the diagnostic role of $^{99m}Tc$-Tetrofosmin in detection of breast cancer and compared with that of $^{99m}Tc$-MIBI. Material and Methods: Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. Results: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of $^{99m}Tc$-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-Tetrofosmin were 31,10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of $^{99m}Tc$-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin acintimammographies and its size was 0.5 cm. Conclusion: $^{99m}Tc-Tetrofosmin\;and\;^{99m}Tc-MIBI$ were non-invasive and useful in detection of breast cancer and $^{99m}Tc$-Tetrofosmin was comparable to the $^{99m}Tc$-MIBI in detection of primary breast cancer.

• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.42-45
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• 2000

Background and Objectives: To review efficacy of the fine-needle aspiration cytology(FNAC) in patients with salivary glands lesions. Materials and Methods: From January 1994 through June 1999, FNACs and surgical biopsies were carried out on 109 patients with salivary gland diseases. The medical records were reviewed retrospectively. Benign tumor was found in 81 patients, and malignant tumor was in 19 patients. Nine patients had inflammatory lesion. Results: In 6 of 109 cases the aspiration was inadequate. Of the remaining 103 patients, FNAC correctly diagnosed 87 lesions(84.5%). For benign tumor lesions, the accuracy was 91%(71/78), and for malignant lesions 55.6%(10/18). The accuracy for inflammatory lesions was 85.7%(6/7). Regarding the capacity to discriminate between neoplastic and nonneoplastic lesions, sensitivity, specificity and total diagnostic accuracy were 99%, 85.7% and 84.5% respectively. Regarding the capacity to discriminate between malignant and benign tumors, sensitivity and specificity were 55.6% and 97.4% respectively. FNACs misdiagnosed malignant tumors as benign lesions in eight patients, in which three were with adenoid cystic carcinomas. Carcinoma ex pleomorphic adenoma, malignant lymphoma and mucoepidermoid carcinoma 'were others. Conclusion: FNAC showed high accuracy to diagnose benign lesions in salivary gland diseases. But the accuracy was rather low for malignant lesions. If a salivary gland lesion was suspected for malignant tumor, other diagnostic methods such as tissue biopsy should be seriously considered.

• Journal of the Korean Society of Radiology
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• v.11 no.4
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• pp.227-234
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• 2017

This study evaluated the usefulness of the elasticity score and strain ratio in the differential diagnosis of benign and malignant nodules in thyroid elastography. We performed a retrospective analysis based on the results of fine needle aspiration cytology. The Chi-square test and the Mann-Whitney U test were used to analyze the difference between the five degrees of elasticity score and strain ratio according to the benign and malignant thyroid nodules. ROC curve analysis was used to determine the elasticity score and the best cut-off value of the strain ratio for the prediction of malignant nodules. There was a statistically significant difference (p=0.000) between the homogeneity of the elasticity score and the difference of the strain ratio between the benign and malignant nodule groups. On the ROC curve analysis, the elasticity score and the srain ratio for predicting benign and malignant nodules were determined as AUC 0.842, 0.700, cut-off value 3, 2.49 (p=0.001). Therefore, the elasticity score and strain ratio may be useful in the differential diagnosis of thyroid nodules.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.600-604
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• 2018

Background and Objectives This study aimed to identify a reliable preoperative predictive factor for the development of thyroid cancer in patients with atypia of undetermined significance (AUS) identified by fine needle aspiration biopsy (FNAB). Subjects and Method This was a retrospective cohort study. Two hundred and ninety-nine patients diagnosed with AUS by preoperative FNAB who underwent curative thyroid surgery at our institution between September 2005 and February 2014 were analyzed. Clinical, radiological and molecular features were investigated as preoperative predictors for postoperative permanent malignant pathology. Results The final pathologic results revealed 36 benign tumors including nodular hyperplasia, follicular adenoma, adenomatous goiter, nontoxic goiter, and lymphocytic thyroiditis, as well as 263 malignant tumors including 1 follicular carcinoma and 1 invasive follicular carcinoma; the rest were papillary thyroid carcinomas. The malignancy rate was 87.9%. The following were identified as risk factors for malignancy by univariate analysis: $BRAF^{V600E}$ gene mutation, specific ultrasonographic findings including smaller nodule size, low echogenicity of the nodule, and irregular or spiculated margin (p<0.05). Multivariate analysis revealed that only $BRAF^{V600E}$ mutation was a statistically significant risk factor for malignancy (p<0.05). When $BRAF^{V600E}$ mutation was positive, 98.5% of enrolled patients developed malignant tumors. In addition, the diagnostic rate of malignancy in these cases was approximately 16-fold higher than BRAF-negative cases. Conclusion Patients with AUS thyroid nodules should undergo $BRAF^{V600E}$ gene mutation analysis to improve diagnostic accuracy and if the mutation is confirmed, surgery is recommended due to the high risk of malignancy.

• Tuberculosis and Respiratory Diseases
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• v.44 no.5
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• pp.1083-1093
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• 1997

Background : So far, there have been numerous reports on organ damage due to cryptococcosis, however, cases of lung localization have been infrequently reported. Recently pulmonary cryptococcosis has been reported more frequently than before due to enhanced diagnostic techniques and increased underlying diseases. Method : The author, therefore, analyzed the clinical manifestations of 5 cryptococcosis cases that we experienced at Hanyang University Hospital from 1985 to 1996 and 9 cases reported in Korea from 1984 and 1996 retrospectively. The following results were obtained. Results : Cryptococcosis occurred frequently over sixth decade and the male to female ratio was 3.6 : 1. Underlying diseases included acute rejection after kidney transplantation, rheumatoid arthritis, autoimmune hepatitis, diabetes mellitus and state of bilateral adrenalectomy. Remaining 8 cases had no evidence of an underlying disease. Because the symptoms were subacute & nonspecific, and not improved by conventional antibiotics, 6 patients of 14 pulmonary cryptococcosis patients were treated as pulmonary tuberculosis before correct diagnosis was made. There were three asymptomatic cases. According to the results of CXR, solitary alveolar consolidation was the most common finding(8 cases) followed by diffuse infiltration(5 cases). It also showed pleural effusion, hilar lymphadenopathy and cavity formation that was rarely reported in world literature. The diagnasis was made through fine needle aspiration biopsy in 10 cases, open thoracotomy in 2 cases, transbronchial lung biopsy in 1 case. and thoracentesis with pleural biopsy in 1 case. Only one case showed positive result in sputum stain and culture, serum latex agglutination test for cryptococcus neoformans. Treatment modalities were various such as fluconazole, amphotericin B, flucytosine, ketoconazole, surgery and it's combination. After 1990 year, there was a trend that fluconazole or ketoconazole are more used than other therapeutic modalities. Conclusion : Because the symptoms are subacute & nonspecific and not improved by conventional antibiotics, pulmonary cryptococcosis is likely to misdiagnosis as pulmonary tuberculosis in Korea. Because the diagnosic yield of sputum stain, culture and serologic test for pulmonary cryptococcosis is low, histologic diagnosis is need in most pulmonary cryptococcosis.