• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.143-146
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• 2004

Background and Object: The role of fine needle aspiration cytology (FNAC) and frozen section (FS) in management of thyroid neoplasms continues to generate considerable controversy. We reviewed our current experience to determine the clinical utility of FNAC and FS in our surgical management and investigated reliability of FNAC and FS in planning the extent of thyroid resection. Material and Method: 212 patients who had operations for thyroid disease from May 1996 to November 2003 were included our retrospective study. FNAC was undertaken in 175 patients and FS was done in 148 patients. Result: The sensitivity and specificity of FNAC were 72.1% and 100%, respectively, and those of FS were 67.2% and 100%. The results of FNAC were benign (n=72) , malignancy (n=31), indeterminate (n=9), and nondiagnostic (n=63). The results of FS were benign (n=95), and malignancy (n=53). The 9 indeterminate cases on FNAC were benign (n=6) and malignancy (n=3) on final pathology, and benign (n=7) and malignancy (n=2) on FS. The false negative of FNAC were micro papillary carcinoma (n=6) and follicular carcinoma (n=6). The false negative of FS were micropapillary carcinoma (n=10) and follicular carcinoma (n=2). Conclusion: When results of FNAC are interpreted as indeterminate, FS is a valuable tool. FS is helpful in determining the extent of thyroidectomy when results of FNAC were follicular neoplasm. However we always concerned about micropapillary carcinoma and follicular carcinoma although FNAC and FS were benign.

• The Korean Journal of Cytopathology
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• v.17 no.1
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• pp.69-74
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• 2006

Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma, which occurs predominantly in adolescents and young adults. The cytological characteristics of this condition have been described only rarely in the literature. Here, we report a case of alveolar soft part sarcoma. A 28-year-old man presented with a mass in his right buttock, which had persisted for three years. The mass was subjected to a fine needle aspiration cytology (FNAC). The smears were cellular. The observed tumor cells were round or polygonal, and exhibited vesicular nuclei with prominent nucleoli and finely granular cytoplasm. Naked nuclei were frequently detected. Tumor cells were arranged singularly, but occasionally in a pseudoalveolar pattern.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.189-193
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• 1999

Objectives: Fine needle aspiration cytology(FNAC) is a well established preoperative diagnostic procedure in the thyroid nodules. However, diagnostic accuracy of FNAC varies according to the size and the structural characteristics of thyroid nodule. We performed the ultrasound guided FNAC(US-guided FNAC) for impalpable thyroid nodule, and estimated the sampling accuracy rate through a comparison study between the cytologic diagnosis and the final histologic diagnosis of the postoperative specimens in order to determine clinical efficacy of the US-guided FNAC. Materials and Methods: We evaluated 117 patients underwent US-guided FNAC from January 1997 to December 1998. These patients had 129 thyroid nodules to need cytologic examination. Whereas the nodules were so no graphically classified into cystic, solid, and mixed type according to echo pattern, the aspirated thyroid specimens were classified into benign, malignant, suspicious, and insufficient. Results: Positive sampling for diagnositc examination was achieved in 75 nodules(58.1%), and US-guided FNAC in our study showed the accuracy rate of 95.2%, false positivity rate of 0%, and false negativity rate of 5.5%. Conclusions: US-guided FNAC is a powerful techniques for evaluating cytologic characterics and allowing a reliable diagnositc result in the impalpable thyroid nodule. However, the experienced technique is recommanded in order to obtain the sufficient samples for reliable results.

• The Korean Journal of Cytopathology
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• v.6 no.2
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• pp.140-147
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• 1995

In a six-year period (1988. 5-1994. 4), fine needle aspiration cytology(FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139(43.2%), suspicious malignancy in 7(2.2%), negative in 164(50.8%), and insufficient material in 12(3.8%). Malignant lesions consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic examination in 70 cases. There were 2(0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. The overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.

• The Korean Journal of Cytopathology
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• v.9 no.1
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• pp.85-88
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• 1998

We described the findings of fine needle aspiration cytology of the lung from a patient with Wegener's granulomatosis. Early diagnosis and prompt treatment of the patients with Wegener's granulomatosis is essential for a better prognosis. However, the variety of clinical presentations and nonspecific radiologic infiltrates of Wegener's granulomatosis frequently make the diagnosis difficult. Although an open lung biopsy is required for a firm diagnosis, fine needle aspiration cytology & biopsy preparation can also provide an adequate tissue sample, when the findings of fine needle aspiration are considered with clinical manifestations and ANCA value in the serum. The cytologic smears showed scattered necrotic tissue fragments entrapping many neutrophils and occasional epithelioid cells. Multinucleated giant cells were infrequently observed. Ziehl-Neelsen stain for acid fast bacilli was negative. All the cytologic features recapitulated the histopathologic findings of purulent and necrotizing granulomatous inflammation seen in Wegener's granulomatosis.

• The Korean Journal of Cytopathology
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• v.11 no.1
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• pp.47-52
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• 2000

Diffuse sclerosing papillary carcinoma(DSPC), a variant of papillary carcinoma of the thyroid, is characterized by diffuse involvement of one or both thyroid lobes, and histologic features such as prominent sclerosis, intense lymphocytic infiltrate, numerous psammoma bodies, and squamous metaplasia together with the characteristic cytoarchitectural pattern of classical papillary carcinoma. We experienced a case of fine needle aspiration cytologic(FNAC) findings of DSPC, which was confirmed by histologic examination of the thyroidectomy specimens. The patient was 26 years old female who presented with diffuse firm enlargement of the thyroid gland with enlargement of many cervical lymph nodes. FNAC smears showed numerous psammoma bodies, many lymphocytes, metaplastic squamous cells, absence of stringy colloid, and epithelial cells showing classical features of papillary carcinoma, such as nuclear grooves, intranuclear unclusions, and ground glass chromatin pattern.

• The Korean Journal of Cytopathology
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• v.10 no.2
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• pp.179-184
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• 1999

The columnar cell variant of papillary carcinoma is a rare tumor of the thyroid, associated with aggressive behavior, early metastasis, and a rapidly fatal course. We present the fine needle aspiration cytologic(FNAC) findings of columnar ceil variant of papillary carcinoma with cytohistologic correlation. In the smears, the tumor fragments showed mainly papillary pattern and a few scattered individual cells were present around the papillary fragments. The tumor cells were columnar or cuboidal and exhibited pseudostratification of the nuclei. The nuclei were oval to elongated with finely stippled chromatin and inconspicous nucleoli. Neither nuclear grooves nor intracytoplasmic inclusion was found. The FNAC diagnosis was consistent with papillary carcinoma. Total thyroidectomy was done and the histologic finding of the mass showed a predominantly papillary and focal solid proliferation of columar cells with marked nuclear pseudostratification. The unique histopathologic features and highly aggressive nature of columnar ceil variant of papillary carcinoma require that this variant should be differeniated from common papillary carcinoma of the thyroid.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3611-3615
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• 2012

Objective: The objective of this study was to establish the diagnostic accuracy, specificity and sensitivity of fine needle aspiration cytology(FNAC) for intra-oral tumors, comparing with histopathology as the gold standard. Materials and methods: Forty cases of FNA cytology from intraoral tumors was performed in AFID along with the demographic data and clinical information and then diagnosed at AFIP, Rawalpindi. Then the cytology results obtained per FNAC were compared with the histopathological biopsy results of the same lesions. The following variables were recorded for each patient: Age, gender, site of biopsy, diagnosis. The data were entered and analyzed using Open-epi version 2.0. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Cohen Kappa was further applied to compare the agreement between the biopsy and FNAC diagnoses. A p-value of < 0.05 was considered as statistically significant. Results: Among the total patients included in the study there were 24 males and 16 females, with a ratio of 1.5:1. Age of the patients ranged from 24 to 80 years with a mean of 52 years. A total of six sites were aspirated from the oral cavity with maximum (11) aspirates taken from alveolar ridge. The results of FNAC revealed that there were 32 malignant and 8 benign aspirates. Confirmation through histopathological analysis came for 31/32 malignant cases while one was falsely given positive for malignancy on FNAC. Among a total of 40 cases, 31(77%) cases diagnosed were found to be malignant and remaining 9(23%) were benign. The FNAC results revealed 32 malignant and 8 benign lesions. Histopathology of the subsequent surgically excised specimen showed malignant lesions in 31(77%) and benign in 9(23%) patients. As a whole, it was found that the absolute sensitivity for introral FNAC was 100% and specificity 89% with positive predictive value of 97% and negative predictive value of 100%. Conclusion: Cytological diagnosis was almost corroborative with final histopathological diagnosis in all cases, with very few exceptions, exhibiting high diagnostic accuracy.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.596-603
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• 2021

Objective: To evaluate the feasibility and diagnostic performance of ultrasound (US)-guided fine-needle aspiration cytology and core-needle biopsy (US-FNAC/CNB) for the diagnosis of laryngo-hypopharyngeal masses. Materials and Methods: This was a single-center prospective case series. From January 2018 to June 2019, we initially enrolled 40 patients with highly suspicious laryngo-hypopharyngeal masses on laryngoscopic examinations. Of these, 28 patients with the mass involving or abutting the pre-epiglottic, paraglottic, pyriform sinus, and/or subglottic regions were finally included. These patients underwent US examinations with/without subsequent US-FNAC/CNB under local anesthesia for evaluation of the laryngo-hypopharyngeal mass. Results: Of the 28 patients who underwent US examinations, a laryngo-hypopharyngeal mass was identified in 26 patients (92.9%). US-FNAC/CNB was performed successfully in 25 of these patients (96.2%), while the procedure failed to target the mass in 1 patient (3.8%). The performance of US caused minor subclinical hematoma in 2 patients (7.7%), but no major complications occurred. US-FNAC/CNB yielded conclusive results in 24 (96.0%) out of the 25 patients with a successful procedure, including 23 patients with squamous cell carcinoma (SCC) and 1 patient with a benign mass. In one patient with atypical cells in US-FNAC, additional direct laryngoscopic biopsy (DLB) was required to confirm SCC. Among the 26 patients who received US-FNAC/CNB, the time from first visit to pathological diagnosis was 7.8 days. For 24 patients finally diagnosed with SCC, the time from first visit to the initiation of treatment was 25.2 days. The mean costs associated with US-FNAC/CNB was $272 under the Korean National Health Insurance Service System. Conclusion: US-FNAC/CNB for a laryngo-hypopharyngeal mass is technically feasible in selected patients, providing good diagnostic performance. This technique could be used as a first-line diagnostic modality by adopting appropriate indications to avoid general anesthesia and DLB-related complications.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.1
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• pp.97-102
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• 2013

Objective: The aim of this study was to develop an automated computer-aided diagnostic system for diagnosis of thyroid cancer pattern in fine needle aspiration cytology (FNAC) microscopic images with high degree of sensitivity and specificity using statistical texture features and a Support Vector Machine classifier (SVM). Materials and Methods: A training set of 40 benign and 40 malignant FNAC images and a testing set of 10 benign and 20 malignant FNAC images were used to perform the diagnosis of thyroid cancer. Initially, segmentation of region of interest (ROI) was performed by region-based morphology segmentation. The developed diagnostic system utilized statistical texture features derived from the segmented images using a Gabor filter bank at various wavelengths and angles. Finally, the SVM was used as a machine learning algorithm to identify benign and malignant states of thyroid nodules. Results: The SVMachieved a diagnostic accuracy of 96.7% with sensitivity and specificity of 95% and 100%, respectively, at a wavelength of 4 and an angle of 45. Conclusion: The results show that the diagnosis of thyroid cancer in FNAC images can be effectively performed using statistical texture information derived with Gabor filters in association with an SVM.