• Title/Summary/Keyword: False Diagnosis

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Fine Needle Aspiration Cytology of Thyroid Nodules: Assessment of diagnostic accuracy and evaluation of each cytologic diagnosis (갑상선 결절의 세침흡인 세포검사: 진단성적의 검토 및 세포학적 진단의 평가)

  • Park, In-Ae;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.10 no.1
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    • pp.43-53
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    • 1999
  • We retrospectively reviewed the results of 1,850 fine needle aspiration cytology(FNAC) of thyroid nodules performed from 1990 to 1991 in the Department of Pathology, Seoul National University Hospital. Among 1,528 cases and 322 cases aspirated by clinicians and a pathologist, 465 cases(30.4%) and 13 cases(4.0%) of the aspirates were inadequate, respectively. In 227 cases, correlation of the FNAC diagnosis and histologic diagnosis was done. Excluding the inadequate cases, the sensitivity nor the detection of neoplasm(malignancy together with follicular adenoma) was 86.4% and the specificity was 70.7%. The overall diagnostic accuracy was 79.0%. There were 16 false-positive cases(7.0%), and 19 false-negative cases(8.4%). The predictive value of each cytologic diagnosis was 92% in papillary carcinoma, and 100%, in Hashimoto's thyroiditis. The expectancy of malignancy was 52.8% in "suspicious malignancy" and 26.7% in "atypical lesion".

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Evaluation of Usefulness for Diagnosis of Lung Cancer on Integrated PET-MRI Using Decision Matrix (판정행렬을 기반한 일체형 PET-MRI의 폐암 진단 유용성 평가)

  • Kim, Jung-Soo;Yang, Hyun-Jin;Kim, Yoo-Mi;Kwon, Hyeong-Jin;Park, Chanrok
    • Journal of radiological science and technology
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    • v.44 no.6
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    • pp.635-643
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    • 2021
  • The results of empirical researches on the diagnosis of lung cancer are insufficient, so it is limited to objectively judge the clinical possibility and utilization according to the accuracy of diagnosis. Thus, this study retrospectively analyzed the lung cancer diagnostic performance of PET-MRI (Positron Emission Tomography-Magnetic Resonance Imaging) by using the decision matrix. This study selected and experimented total 165 patients who received both hematological CEA (Carcinoembryonic Antigen) test and hybrid PET-MRI (18F-FDG, 5.18 MBq/kg / Body TIM coil. VIVE-Dixon). After setting up the result of CEA (positive:>4 ㎍/ℓ. negative:<2.5㎍/ℓ) as golden data, the lung cancer was found in the image of PET-MRI, and then the SUVmax (positive:>4, negative:<1.5) was measured, and then evaluated the correlation and significance of results of relative diagnostic performance of PET-MRI compared to CEA through the statistical verification (t-test, P>0.05). Through this, the PET-MRI was analyzed as 96.29% of sensitivity, 95.23% of specificity, 3.70% of false negative rate, 4.76% of false positive rate, and 95.75% of accuracy. The false negative rate was 1.06% lower than the false positive rate. The PET-MRI that significant accuracy of diagnosis through high sensitivity and specificity, and low false negative rate and false positive rate of lung cancer, could acquire the fusion image of specialized soft tissue by combining the radio-pharmaceuticals with various sequences, so its clinical value and usefulness are regarded as latently sufficient.

Application of artificial neural network to differential diagnosis of lung lesion: Preliminary results

  • Lee, Hae-Jun;Lee, Yu-Kyung;Hwang, Kyung-Hoon
    • Proceedings of the Korea Information Processing Society Conference
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    • 2011.04a
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    • pp.1614-1615
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    • 2011
  • It is difficult to differentially diagnose between lung cancer and benign inflammatory lung lesion due to high false positive rate on F-18 FDG-PET. We investigated whether application of artificial neural network to this diagnosis may be helpful. We reviewed the medical records and F-18 FDG PET images of 12 patients, selecting clinical and PET variables such as SUV. For selected variables and confirm, multilayer neural perceptron was applied in crossvalidation method and compared to visual interpretation. Neural network correctly classified the lung lesions in 83%, and reduced greately the false positive rate. However, false negative rate was not influenced. Application of neural network to the differential diagnosis between lung cancer and benigh inflammatory lesion may be helpful. Further studies with more patients are warranted.

Fine Needle Aspiration Biopsy Cytology of Breast Tumors (세침 천자 검사로 진단된 유방종양의 세포병리학적 연구)

  • Kim, In-Sook;Lee, Jung-Dal
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.51-59
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    • 1990
  • Fine needle aspiration biopsy cytology (FNA) for diagnosis of a variety of breast tumors has been proven to be a simple, safe, and cost saving diagnostic methodology with high accuracy. Cytologic specimens from 1,029 fine needle aspirations of the breast during last 3-year period were reviewed and subsequent biopsies from 107 breast lesions were reevaluated for cytohistological correlation. FNA had a sensitivity of 81.6% and a specificity of 98.3%. One oui of 107 cases biopsied revealed a false positive result (0.9%) and the case was due to misinterpretation of apocrine metaplastic cells in necrotic backgound as malignant cells. A false negative rate was 8.4% (9 of 107 cases biopsied). Six of 9 false negative cases were resulted from insufficient aspirates for diagnosis, and remaining three of 9 false negative cases revealed extensive necrosis with no or scanty viable cells on smears. The results indicate that for reducing false positive and false negative rates of FNA, an experienced cytopathologist and a proficient aspirator are of great importance.

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Determination of false positives in PCR diagnostics based on the internal transcribed spacer (ITS) of Gyrodactylus salaris using RFLP (RFLP를 이용한 Gyrodactylus salaris의 internal transcribed spacer(ITS) PCR 위양성 판별)

  • Min Seong Kim;Hee Jung Choi;Ji-Min Jeong;Mun-Gyeong Kwon;Seong Don Hwang
    • Journal of fish pathology
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    • v.37 no.1
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    • pp.147-153
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    • 2024
  • The World Organization for Animal Health (WOAH) recommends two protocols (ITS and COI) for conventional PCR of G. salaris diagnosis. However, ITS PCR protocol may yield false-positive results, leading to unnecessary countermeasures. It's difficult to distinguish between G. salaris and false-positive by similar amplicon size of PCR, since the amplicon size of ITS PCR in G. salaris and false-positive was 1,300 and 1,187 bp, respectively. The nucleotide sequences of ITS false-positive in rainbow trout is 99.7% identical to previously reported host genome sequences of rainbow trout (Oncorhynchus mykiss) and 95.3 to 89.1% identical to those of other salmonid fish species. To reduce false-positive PCR band, PCR was performed by the different annealing temperature, but PCR bands were still detected. In RFLP analysis by HaeIII, the PCR product of G. salaris was digested into four bands of 512, 399, 234 and 154 bp, while the false-positive was digested into seven bands of 297, 263, 242, 144, 93, 80 and 68 bp. In the RFLP patterns digested by HindIII, G. salaris showed two bands of 659 and 640 bp, while false-positive had one fragment of 1,187 bp without any digestion. Therefore, the RFLP method of ITS PCR with HaeIII and HindIII can be used for differentiation between G. salaris and false-positive. These results might provide important information on the improvement of PCR diagnostic method of G. salaris.

Diagnosis of Human Immunodeficiency Virus Infection (사람면역결핍바이러스 감염의 진단)

  • Shi Nae Yu
    • The Korean Journal of Medicine
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    • v.99 no.1
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    • pp.32-36
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    • 2024
  • Early diagnosis and early treatment of human immunodeficiency virus (HIV) infection are essential for clinical and public health benefits. Diagnostic algorithms for early diagnosis are being emphasized, and rapid tests at the point of care have been expanded to improve voluntary testing rates. Despite advances in laboratory diagnostic tests, early HIV infection can still be missed due to window periods, and it is crucial to recognize the limitations of testing methods and the potential for false negative and false positive results.

Diagnostic Usefulness and Limitation of Fine Needle Aspiration Cytology of Lymph Node - Analysis of 176 Cases Confirmed by Biopsy - (림프절 세침흡인 세포검사의 진단적 유용성과 한계 - 생검으로 확진한 176 예의 분석 -)

  • Kim, Hee-Sung;Kim, Dae-Soo;Oh, Young-Lyun;Ko, Young-Hyeh;Ree, Howe-J.
    • The Korean Journal of Cytopathology
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    • v.10 no.1
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    • pp.35-42
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    • 1999
  • The accuracy of fine needle aspiration cytology(FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases(43.6%) were diagnosed as tuberculosis, 4(10.3%) as granulomatous lymphadenitis, 3(7.7%) as necrotizing lymphadenitis, and 15(38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.

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Frozen Section -Application in the Surgical Pathology- (동결절편법(Frozen Section) -외과병리 영역에서의 적용에 대하여-)

  • Chai, Won-Hee;Lee, Tae-Sook;Hong, Suk-Jae
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.179-183
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    • 1986
  • The frozen section technique is a means of intraoperative pathological diagnosis, and a procedure of great value to the surgeon. This method should be accurate, rapid and reliable. This method serves useful purposes, such as determining the presence of tumor, its type(especially whether it is benign or malignant), the adequacy of a biopsy of a suspected lesion, and the conditions of the surgical margins. But, it bears many disadvantages, the most of which is the danger of incorrect diagnosis. We studied the indications, the limitations, and the accuracy of the frozen section method and the materials studies was total of frozen section during recent 3 years. The overall accuracy of the frozen section diagnosis of 809 cases was 98.1% with 0.5% of false negative, 0% of false positive, 0.5% of incorrect histological diagnosis or grading errors, and 0.9% of deferred cases. The tissues submitted were lymph node, gastrointestinal tract, skin subcutaneous tissues in decreasing oder of frequency. The false positive case is not present, while the false negative cases were 4.

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TRAUMATIC FALSE ANEURYSM OF THE LINGUAL ARTERY - A CASE REPORT- (설동맥에 발생한 외상성 위동맥류)

  • Min, Gyung-In;Lee, Ju-Hyun;Seo, Kyung-Suk;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.6
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    • pp.551-555
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    • 2001
  • False aneurysms(Pseudoaneurysms) and arteriovenous fistulas have only rarely been reported in the facial region. In this region the false aneurysm arises most frequently in the superficial temporal and facial artery, but other branches of the external carotid are sometimes involved, including the maxillary and lingual artery. False aneurysms can be occurred by blunt trauma that either laceration or rupture the full thickness of the arterial wall. The diagnosis of a false arterial aneurysm can be often made solely on the basis of physical examination. Angiography is helpful for conformation, for delineating the lesion and its vascular supply, and for ruling out the presence of associated vascular lesions such as arteriovenous fistulas. Ultrasonography may also be useful in delineating lesions that are not easily accessible for physical examination. Treatment of false aneurysms is excision, ligation, and arterial embolization. This is a case of false aneurysm of the lingual artery after facial trauma caused by traffic accident. The lesion was successfully treated by embolization and ligation of the lingual and facial branches of the external carotid artery.

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Diagnostic Pitfalls in Breast Fine Needle Aspiration Cytology: False Positive and False Negative (유방 세침흡인 세포검사의 진단적 함정: 위양성과 위음성)

  • Park, Kyeong-Mee
    • The Korean Journal of Cytopathology
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    • v.18 no.2
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    • pp.112-118
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    • 2007
  • Fine needle aspiration cytology (FNAC) has become a highly preferred, minimally invasive diagnostic tool of choice in the diagnosis of a palpable breast mass owing to its sensitivity, specificity, cost-effectiveness, and expediency. Although breast needle biopsies have been widely employed recently due to the increased detection rate of non-palpable early lesions, the importance of the use of FNAC cannot be underestimated. It comprises part of the diagnostic triad for the breast along with a physical examination and mammography, which together contribute to an increasing diagnostic accuracy. The differential diagnosis of a benign and malignant lesion is of the utmost importance in the diagnosis of breast lesions, and therefore the understanding of the possible diagnostic pitfalls is of great importance.