• The Korean Journal of Cytopathology
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• v.4 no.2
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• pp.133-139
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• 1993

A case of presacral chordoma in a 55-year-old male diagnosed by aspiration biopsy cytology Is reported. Cytologically, three cell types were recognized in a mucoid background. large, mononucleated or binucleated physaliphorous cells with vacuolated bubbly cytoplasm; small, uniform and rounded non-vacuolated cells; and cells with microvacuolated and plump cytoplasm. The diagnosis of chordoma was possible because typical radiological and cytomorphological features were supported by the results of special staining and immunohistochemical staining with the cell block specimen obtained from the fine needle aspiration.

• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.7-13
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• 1999

Background and Objective： The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1：2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.

• The Korean Journal of Cytopathology
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• v.1 no.2
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• pp.158-163
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• 1990

Ancient (degenerated) schwannomas are benign tumors that display pronounced degenerative changes including cyst formation, calcification, hemorrhage, and hyalinization. The tumors are usually infiltrated by large numbers of inflammatory cells such as neutrophils, lymphocytes, siderophages, and histiocytes. They are located in deep locations such as the retroperitoneum and must be differentiated from malignant soft tissue tumors because spindle cells with nuclear atypia may be present. In the fine needle aspiration biopsy. The cytologic findings of two cases of ancient schwannoma occurring in posterior mediastinum and retroperitoneum, respectively, are described. Computerized tomographic findings of both cases showed changes of cystic degeneration or necrosis. A case occurred in retroperitoneum revealed features of destruction of vertebral body to suggest a malignant soft tussue tumor radiologically. The cytologic findings of aspiration biopsy of both tumors revealed that the tumor cells were spindle in shape with elongated nuclei. Some of tumor cells were arranged in a palisading fashion. Cell structures that resemble the Verocay bodies were observed. Some of the tumor cells showed pleomorphic bizarre nuclei, but no mitotic activity or chromatin clumping was seen. Inflammatory cells, siderophages and histiocytes were scattered in fibrillar material. These cytologic findings are important in the diagnosis of ancient schwannoma and in the differentiation of this tumor from the malignant spindle cell tumor.

• The Korean Journal of Cytopathology
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• v.10 no.1
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• pp.79-84
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• 1999

Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked slant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46- year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like slant cells and mononuclear cells.

• The Korean Journal of Cytopathology
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• v.5 no.2
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• pp.106-112
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• 1994

Fine needle aspiration biopsy has been proved as a safe, accurate and cost-effective diagnostic modality in palpable breast lesions. Cytologically, fibrocystic disease can be classified into 3 categories as nonproliferative breast disease, proliferative breast disease without atypia, and proliferative breast disease with atypia. This terminology for fine needle aspirates is compatible with that of diagnostic histopathology. Cytologic differentiation of nonproliferative disease from proliferative breast disease is important, since the risk of cancer development in cases of atypical hyperplasia is 4-5 times higher than that of general population. Twenty five fine needle aspirates of fibrocystic disease confirmed by subsequent histopathology were re-evaluated and classified into 3 categories depending on their architectural and nuclear features. In addition, these aspirates were scored according to the cytologic grading system, devised by Masood et al. and based on six cytologic criteria. Concordance rates between cytomorpholgic diagnosis and cytologic diagnosis using the cytologic criteria grading system and histologic diagnosis were 88% and 92%, respectively.

• Korean Journal of Radiology
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• v.20 no.1
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• pp.166-170
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• 2019

Objective: To establish a cost-effective and easily available phantom for training residents in ultrasound-guided fine needle thyroid nodule targeting punctures. Materials and Methods: Tofu, drinking straws filled with coupling gel, a urine tube, and 21-gauge needles were used to generate a phantom thyroid with nodules for training. Twelve radiology residents were involved in the study. The puncture success rates were recorded and compared before and after phantom training using the Wilcoxon signed-rank test. Results: On ultrasonography, tofu mimicked the texture of the thyroid. Drinking straws filled with coupling gel mimicked vessels. The urine tube filled with air mimicked the trachea, and 21-gauge needles mimicked small nodules in the transverse section. The entire phantom was similar to the structure of the thyroid and surrounding tissues. The puncture success rates of radiology residents were significantly increased from 34.4 ± 14.2% to 66.7 ± 19.5% after training (p = 0.003). The phantom was constructed in approximately 10 minutes and materials cost less than CNY 10 (approximately $ 1.5) at a local store. Conclusion: The tofu model was cost-effective, easily attainable, and effective for training residents in ultrasound-guided fine needle thyroid nodule targeting punctures in vitro.

• Clinical Endoscopy
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• v.57 no.3
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• pp.384-392
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• 2024

Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is a standard diagnostic method for biliary tract cancer (BTC), and samples obtained in this manner may be used for comprehensive genomic profiling (CGP). This study evaluated the utility of EUS-TA for CGP in a clinical setting and determined the factors associated with the adequacy of CGP in patients with BTC. Methods: CGP was attempted for 105 samples from 94 patients with BTC at the Aichi Cancer Center, Japan, from October 2019 to April 2022. Results: Overall, 77.1% (81/105) of the samples were adequate for CGP. For 22-G or 19-G fine-needle biopsy (FNB), the sample adequacy was 85.7% (36/42), which was similar to that of surgical specimens (94%, p=0.45). Univariate analysis revealed that 22-G or larger FNB needle usage (86%, p=0.003), the target primary lesions (88%, p=0.015), a target size ≥30 mm (100%, p=0.0013), and number of punctures (90%, p=0.016) were significantly positively associated with CGP sample adequacy. Conclusions: EUS-TA is useful for CGP tissue sampling in patients with BTC. In particular, the use of 22-G or larger FNB needles may allow for specimen adequacy comparable to that of surgical specimens.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.645-657
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• 2022

Purpose To evaluate and compare the diagnostic outcomes of ultrasonography (US)-guided fine needle aspiration (FNA) and core needle biopsy (CNB) performed on the same thyroid nodule using a surgical specimen for direct comparison. Materials and Methods We included 89 thyroid nodules from 88 patients from February 2015 to January 2016. The inclusion criterion was thyroid nodules measuring ≥ 20 mm (mean size: 40.0 ± 15.3 mm). Immediately after surgical resection, FNA and subsequent CNB were performed on the surgical specimen under US guidance. FNA and CNB cytopathologic results on the specimen were compared with the surgical diagnosis. Results Among the 89 nodules, 30 were malignant and 59 were benign. Significantly higher inconclusive rates were seen in FNA for malignant than benign nodules (80.0% vs. 39.0%, p < 0.001). For CNB, conclusive and inconclusive rates did not differ between benign and malignant nodules (p = 0.796). Higher inconclusive rates were seen for FNA among cancers regardless of US features, and in the subgroup of size ≥ 40 mm (62.5% vs. 22.9%, p = 0.028). Eleven cancers were diagnosed with CNB (36.7%, 11/30), while none was diagnosed using FNA. Conclusion In this experimental study using surgical specimens, CNB showed a potential to provide improved diagnostic sensitivity for thyroid cancer, especially when a conclusive diagnosis is limited with FNA.

• Journal of Digestive Cancer Research
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• v.10 no.1
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• pp.16-21
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• 2022

Diagnosis of gastric subepithelial tumors (SETs) is sometimes difficult with conventional endoscopy or tissue sampling with standard biopsy, so non-invasive imaging modalities such as endoscopic ultrasound (EUS) and computed tomography are used to evaluate the characteristics of SETs features (size, location, originating layer, echogenicity, shape). However imaging modalities alone is not able to distinguish among all types of SETs, so histology is the gold standard for obtaining the final diagnosis. For tissue sampling, mucosal cutting biopsy and mucosal incision-assisted biopsy and EUS-guided fine-needle aspiration or biopsy (EUS-FNA or EUS-FNB) is commonly recommended. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used for resection of SETs involving the mucosal and superficial submucosal layers, could not treat adequately and safely the SETs involving the deep mucosa and muscularis propria. Submucosal tunneling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) is used as a therapeutic option for the treatment of SETs with the development of reliable endoscopic closure techniques and tools.

• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.276-280
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• 2015

Cryptococcal pneumonia usually occurs in immunocompromised patients with malignancy, acquired immune deficiency syndrome, organ transplantations, immunosuppressive chemotherapies, catheter insertion, or dialysis. It can be diagnosed by gaining tissues in lung parenchyma or detecting antigen in blood or bronchoalveolar lavage fluid. Here we report an immunocompetent 32-year-old male patient with diabetes mellitus diagnosed with cryptococcal pneumonia after a ultrasound-guided percutaneous supraclavicular lymph node core needle biopsy. We treated him with fluconazole at 400 mg/day for 9 months according to the guideline. This is the first case that cryptococcal pneumonia was diagnosed from a percutaneous lymph node biopsy in South Korea.