• Title/Summary/Keyword: 절제생검

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Role of MRI in Diagnostic Evaluation of Papillary Lesions of the Breast (유방의 유두상 병변의 진단에서 자기공명영상의 역할)

  • Lee, So-Mi;Kim, Hye-Jung;Gwak, Yeon-Joo;Lee, Hui-Joong;Jang, Yun-Jin;Shin, Kyung-Min;Park, Ji-Young;Jung, Jin-Hyang
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.1
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    • pp.41-46
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    • 2010
  • Purpose : To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of papillary lesions of the breast. Materials and methods : Among 45 papillary lesions diagnosed at ultrasonography-guided core biopsy (USCB), 27 benign papillary lesions in 22 patients who underwent breast MRI were reviewed. The excsional biopsy was performed in 1-10 days after MRI was done. In MRI findings, lesions were considered suspicious if they show irregular, rim enhancement, or linear enhancement in morphologic evaluation, or washout enhancement pattern of delayed phase in dynamic enhancement characteristics. Diffusionweighted images were analyzed according to visibility of lesions. MRI findings were correlated with pathologic results at excisional biopsy. Results : At excisional biopsy, two lesions (9%) were diagnosed malignant in 22 benign papillary lesions without atypia by USCB and 4 (80%) were malignant in 5 benign papillary lesions with atypia by USCB. Among 18 lesions detected on MRI, 16 lesions showed suspicious findings on MRI, 11 lesions (69%) were diagnosed as benign and 5 (31%) were malignant. Among 12 lesions detected on diffusion weighted imaging, 10 lesions were diagnosed as benign and 2 were malignant. MRI findings were not significantly correlated with pathologic results at excisional biopsy. Conclusion : MRI findings were not useful to predict malignancy in benign papillary lesions diagnosed at USCB, because MRI findings of these were mostly suspicious (88.9%, 16/18). The benign papillary lesion should be included in the false positive lesion on breast MRI.

Usefulness of Preoperative Breast MRI in Breast Cancer Diagnosed After Excisional Biopsy (유방 절제 생검 후 유방암이 진단된 환자에서 수술 전 자기공명영상의 유용성)

  • Wui, Jung-Hyun;Kang, Bong-Joo;Cha, Eun-Suk;Kim, Sung-Hun;Jung, Na-Young;Choi, Jae-Jeong
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.161-169
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    • 2008
  • Purpose : The aim of this study was to evaluate the usefulness of MRI performed after excisional biopsy to diagnose residual cancer and additional lesions. Materials and Methods : A total of 16 patients who had breast cancer diagnosed by excisional biopsy underwent preoperative breast MRI between March 2005 and August 2007 were included. MRI findings were considered positive for residual cancer if focal, thick, or irregular rim enhancement or adjacent enhancing lesion was identified around the postoperative biopsy cavity. And additional lesions separated from biopsy cavity including multifocal, multicentric, or contralateral lesion were evaluated. We evaluated the diagnostic accuracy of MRI, comparing MRI with histopathologic finding, and the impact of MRI on surgical planning. Results : The sensitivity and specificity of MRI for detecting residual disease considering rim enhancement were 85.7%(6/7) and 55.6%(5/9). Additional lesions including multifocal, multicentric, or contralateral lesion were found in 6 patients. In 7 patients, results of MRI findings changed surgical treatment planning. Conclusion : The pattern of rim enhancement on MRI after excisional biopsy is not differential point to evaluate remnant lesion. But MRI has an important role to help the detection of multifocal or multicentric, or contralateral breast malignancies, resulting in beneficial change in surgical treatment planning.

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Tuberculous Cervical Lymphadenitis (결핵성 경부 임파선염)

  • Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.957-963
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    • 1997
  • 결핵성 임파선염은 아직도 한국에서 많이보는 질환이며 젊은여자 성인 특히 아시아인이나 흑인에서 가장 흔하다. 이 질환은 두경부에 흔히 무통성으로 서서히 림프절이 커지는 양상을 보이나 인체내 결절이 있는 어디나 오며 종격동 결절에도 온다. scrofula(선통(腺病))는 다양한 종양, 비종양성 종괴, 감염질환 특히 경부임파선염 풍과 구별되야만 한다. 비록 병력, 역학, 임상양상 흉부 엑스선 그리고 결핵반응검사로써 만족할만한 진단을 내리지만 절제생검으로 조직 및 배양이 필요하기도 하다. 궤양이나 만성 누공 형성을 막기위해 부분생검이나 절개 및 배농은 반드시 피해야 한다. 치료는 항결핵화학요법이며 가끔 외과적 적출술이 약물요법과 더불어 요구되기도 한다.

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The Significance of Sentinel Node Biopsy in Malignant Melanoma and Squamous Cell Carcinoma of Lower Extremities (하지에 발생한 악성흑색종 및 편평상피세포암에서 소속 림프절 생검의 의미)

  • Kim, Jae-Do;Lee, Gun-Woo;Kwon, Young-Ho;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.69-73
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    • 2010
  • Purpose: Sentinel lymph node (SLNB) is the first confronted lymph node from primary lesion of tumor through lymphatic drainage, which is important for determining early metastasis and setting guidelines for treatment. We reported significant of sentinel lymph node biopsy in malignant melanoma (MM) and squamous cell carcinoma (SCC) of lower extremities. Materials and Methods: Twenty-five cases of surgically treatment and being possible for follow up more than 1 year among the patients who were diagnosed as MM and SCC in this institution from Sep. 2005 to Jan. 2009, and 10 cases of them were performed SLNB. Average age was 64 years old, and 15 cases of male and 10 cases of female were in this group. Results: 3 years overall survival rate was 100% and 3 years disease-free survival rate was 76%. Metastasis occurred in total 6 patients, 4 cases of inguinal lymph nodes, 1 case of soft tissue around knee, 1 case of left achilles tendon. In 15 cases of not performing SLNB, overall survival rate was 93.3% and disease-free survival rate was 73.3%. In 10 cases of performing SLNB, overall survival rate was 100% and disease-free survival rate was 90%. And only 1 case showed positive finding in the biopsy, and none of the 10 cases showed metastasis in follow-up. Conclusion: SLNB leads simpler and less complications compared to prior elective lymph node dissection, and shows high degree of accuracy. Throughout the SLNB, setting guidelines for treatment by accurate staging is thought to be helpful for increasing the survival rate in the patient with MM and SCC.

Chest Wall Implantation of Lung Cancer after Fine Needle Aspiration Biopsy - 2 cases - (세침 흡입생검 후 발생한 폐암의 흉벽전이 -2례 보고-)

  • 강정신;조현민;윤용한;이두연
    • Journal of Chest Surgery
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    • v.31 no.6
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    • pp.629-633
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    • 1998
  • Implantation of malignant cells along the needle aspiration tract is an extremely rare potential complication following a percutaneous fine needle aspiration biopsy of a lung carcinoma. The dissemination of malignant cells by a needle aspiration biopsy may convert an operable and potentially curable lesion into a fatal disease. We report two cases of chest wall implantation of carcinoma of the lung after a thin needle aspiration biopsy. A fifty-five year old male was successfully treated by a radical full-thickness excision of the chest wall and immediate reconstruction with the latissimus dorsi musculocutaneous island flap. A sixty-eight year old female was treated with a partial-thickness excision of the chest wall and skin graft due to superimposed infection and ulceration of the metastatic chest wall carcinoma. One case lived for 31 months up to November 1994, and the other's condtion has been uneventful for 3 months up to now.

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A CASE REPORT OF TUBERCULOUS CERVICAL LYMPHADENITIS ON SUBMANDIBULAR AREA (악하부에 발생한 결핵성 경부 임파선염)

  • Lee, Seung-Ho;Kim, Chang-Lyong;Park, Mun-Seong;Kim, Young-Woon;Jung, Soong-Ryong;Lee, Jong-Ho;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.456-461
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    • 1995
  • Tuberculosis, a chronic infectious granulomatous disease, is presumed to be quite a rare entity. Because of the development of chemotherapy and the improvement of nutritional conditions, incidence of tuberculosis have reduced. For these reasons, tuberculosis may be overlooked in the differential diagnosis whenever dealing with a submandibular swelling. Diagnosis of tuberculous lymphadenitis consists of historical data, physical findings, laboratory tests and histologic examination. The treatment of choice seems to be surgical excision and long term antituberculosis chemotherapy. Surgery provides a rapid tissue diagnosis, because the histological examination of the excisional biopsy is the most reliable diagnostic test. This is the report of a case of tuberculous cervical lymphadenitis on left submandibular area with no evidence of the involvement of lung.

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Irritation Fibroma Associated with Ectopic Eruption of the Maxillary Incisor (상악 중절치의 이소맹출로 인해 발생한 자극성 섬유종)

  • Jeong, Younwook;Kang, Chungmin;Kim, Seunghye;Lee, Jaeho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.207-212
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    • 2016
  • Irritation fibroma is a common hyperplastic lesion of the oral mucosa that can occur in response to chronic irritation or trauma. This report presents an unusual case of irritation fibroma associated with ectopic eruption of the maxillary left central incisor in a patient with Angelman syndrome. Considering the patient's medical history and cooperative ability, excisional biopsy under intramuscular sedation using midazolam was performed. The patient exhibited successful healing without lesion recurrence. It is important to perform histopathological examination followed by excisional biopsy, because other benign or malignant tumors may mimic the clinical appearance of an irritation fibroma.

Use of Mammary Lymphoscintigraphy and Intraoperative Radioguided Gamma Probe in Sentinel Lymph Node Biopsy of Breast Cancer (유방암 환자의 전초림프절 생검에서 유방림프신티그라피와 수술 중 감마프로우브의 유용성)

  • Kim, Soon;Zeon, Seok-Kil;Kim, Yu-Sa
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.6
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    • pp.478-486
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    • 2000
  • Purpose: The sentinel lymph node is defined as the first draining node from a primary tumor and reflects the histologic feature of the remainder of the lymphatic basin status. The aim of this study was to evaluate the usefulness of lymphoscintigraphy and intraoperative radioguided gamma probe for identification and removal of sentinel lymph node in breast cancer. Materials and Methods: Lymphoscintigraphy was performed preoperatively in 15 patients with biopsy proven primary breast cancer. Tc-99m antimony sulfide colloid was injected intradermally at four points around the tumor. Imaging acquisition included dynamic imaging, followed by early and late static images at 2 hours. The sentinel lymph node criteria on lymphoscintigraphy is the first node of the highest uptake in early and late static images. We tagged the node emitting the highest activity both in vivo and ex vivo. Histologic study for sentinel and axillary lymph node investigation was done by Hematoxylin-Eosin staining. Results: On lymphoscintigraphy, three of 15 patients had clear lymphatic vessels in dynamic images, and 11 of 15 patients showed sentinel lymph node in early static image and three in late static 2 hours image. Mean detection time of sentinel lymph node on lymphoscintigraphy was $33.5{\pm}48.4$ minutes. The sentinel lymph node localization and removal by lymphoscintigraphy and intraoperative gamma probe were successful in 14 of 15 patients (detection rate: 93.3%). On lymphoscintigraphy, 14 of 15 patients showed $2.47{\pm}2.00$ sentinel lymph nodes. On intraoperative gamma probe, $2.36{\pm}1.96$ sentinel lymph nodes were detected. In 7 patients with positive results of sentinel lymph node metastasis, 5 patients showed positive results of axillary lymph node (sensitivity: 72%) but two did not. In 7 patients with negative results of sentinel lymph node metastasis, all axillary nodes were free of disease (specificity: 100%). Conclusion: Sentinel lymph node biopsy with lymphoscintigraphy and intraoperative gamma probe is a reliable method to predict axillary lymph node metastasis in breast cancer, and unnecessary axillary lymph node dissection can be avoided.

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Atypical Ductal Hyperplasia: Risk Factors for Predicting Pathologic Upgrade on Excisional Biopsy (침생검 조직검사에서 진단된 비정형 관상피증식증: 수술적 절제 생검에서 악성으로 진단될 가능성을 예측할 수 있는 위험인자들)

  • Ko Woon Park;Boo-Kyung Han;Sun Jung Rhee;Soo Youn Cho;Eun Young Ko;Eun Sook Ko;Ji Soo Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.632-644
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    • 2022
  • Purpose To determine the incidence of atypical ductal hyperplasia (ADH) in needle biopsy and the upgrade rate to carcinoma, and to evaluate difference in findings between the upgrade and non-upgrade groups. Materials and Methods Among 9660 needle biopsies performed over 48 months, we reviewed the radiologic and histopathologic findings of ADH and compared the differences in imaging findings (mammography and breast US) and biopsy methods between the upgrade and non-upgrade groups. Results The incidence of ADH was 1.7% (169/9660). Of 112 resected cases and 30 cases followed-up for over 2 years, 35 were upgraded to carcinoma (24.6%, 35/142). The upgrade rates were significantly different according to biopsy methods: US-guided core needle biopsy (USCNB) (40.7%, 22/54) vs. stereotactic-vacuum-assisted biopsy (S-VAB) (16.0%, 12/75) vs. USguided VAB (US-VAB) (7.7%, 1/13) (p = 0.002). Multivariable analysis showed that only US-CNB (odds ratio = 5.19, 95% confidence interval: 2.16-13.95, p < 0.001) was an independent predictor for pathologic upgrade. There was no upgrade when a sonographic mass was biopsied by US-VAB (n = 7) Conclusion The incidence of ADH was relatively low (1.7%) and the upgrade rate was 24.6%. Surgical excision should be considered because of the considerable upgrade rate, except in the case of US-VAB.