• Korean Journal of Head & Neck Oncology
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• v.16 no.1
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• pp.52-57
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• 2000

Purpose: The purpose of the study was to evaluate the sensitivity, specificity and accuracy between the FNAC and intraopevative frozen biopsy based upon the Final histologic diagnosis. Method: Authors studied 232 cases of thyroid nodule operated at Department of Surgery, College of Medicine, Chosun University, from January 1992 to December 1998. The medical records of these patients were studied retrospectively. The cytology of FNAC and the frozen section was compared to the final histologic diagnosis. 232 cases were analysed in regard to correlation of FNAC diagnosis and Intraoperative frozen section with final pathology, preoperative thyroid scan, thyroid function test, ultrasonography, final histopathology of the specimens, and surgical operation methods. 174 cases who underwent FNAC for diagnosis before operation, and Intraoperative frozen-section biopsy were classified according to whether the clinical diagnosis was benign, suspicious or malignant and evaluated the specificity sensitivity and accuracy. Result: Comparing with final histopathology, FNAC as a diagnostic test for thyroid nodules demonstrated an accuracy of 81.3%, a sensitivity of 87.5%, a specificity 86.5% with a false positivity of 2.9%, false negativity of 4.3%, respectively. and Intra-operative frozen section demonstrated an accuracy of 86.8%, a sensitivity of 87.5%, a specificity 92.1%. In the benign lesion, there was no difference in accuracy between FNAC(95.6%) and frozen section(95.1%) but, in the suspicious malignant lesion, frozen section(46.2%) was superior to FNAC(32.0%), and in the malignant disease, FNAC(97.1%) was superior to frozen section(92.3%). Conclusion: Intraoperative frozen section biopsy is useful in patients undergoing surgery for a thyroid nodule with a 'suspicious' malignant lesion and could reduce inadequate extensive excision without missing malignancy and second operation and help to determine the resection margin. It adds no information in patients with a diagnosis of malignancy following FNAC assessment and is of limited use in those in whom a benign lesion is diagnosed.

• The Korean Journal of Cytopathology
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• v.8 no.2
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• pp.120-128
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• 1997

Fine needle aspiration cytology of breast lesion is well known as a simple, economic and effective diagnostic modality. For the evaluation of cytohistologic correlation, 256 cases of cytologic smears and subsequent histologic sections during 2-year period from Jan. 1995 to Dec. 1996 were reviewed. 1. Fifteen cases(5.9%) were proven as insufficient for evaluation, and 13 of them were fibrocystic change histologically. One case of carcinoma exhibiting sufficient amount of aspirates with no malignant cells on smear was regarded as inadequate. 2. Cytohistologic correlation of 240 cases revealed sensitivity 87.0%, specificity 100.0%, positive predictive value 100.0%, negative predictive value 97.0%, false positive rate 0.0% and false negative rate 13.0%. Total diagnostic accuracy is 95.7%. 3. Total 6 cases of negative were due to small amount of aspirates containing scantiness of malignant cells in two and underestimation in four. 4. Diagnostic concordance rates of fibrocystic change and fibroadenoma were 95.5% and 80.0%, respectively. Diagnostic discrepancies were noted in 7 cases of fibrocystic change and 6 cases of fibroadenoma, however, cytologic discrimination of two entities was not easy in seven of them. 5. In a case of phyllodes tumor and a case of duct ectasia, the discrepancy was due to targeting error. Other three cases(lymphoma, adenomyoepithelioma and granulomatous mastitis) were misinterpreted because of poor acquaintance with those entities. Diagnostic accuracy of fine needle aspiration cytology of breast lesions are relatively high. However, good technique on aspiration and adequate interpretation are necessary to reduce the false negative rate and the discrepancy between cytologic and histologic diagnoses.

• The Korean Journal of Cytopathology
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• v.1 no.2
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• pp.139-146
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• 1990

The application of fine needle aspiration (FNA) cytology to the soft tissue tumors had been neglected. In recent years, however, FNA has been used increasingly in the preoperative diagnosis of these tumors due to its usefulness and accuracy. We present 3 cases of liposarcoma, myxoid, myxoid with round cell, and pleomorphic, diagnosed by FNA cytology with histologic confirmation. Good correlation between histologic and FNA cytologic findings was found. Although the cytologic appearances of liposarcomas varied with histologic type, the main criterion was the presence of atypical multivacuolated lipoblast with characteristically scalloped nuclei.

• The Korean Journal of Cytopathology
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• v.4 no.1
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• pp.1-8
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• 1993

This study was performed in order to evaluate the accuracy and the usefulness of the fine needle aspiration cytology (FNAC) on the breast lesions, to compare the FNAC findings between fibroadenoma and fibrocystic disease, and to determine the accuracy of cytologic Black's nuclear grading. The subjects in this study were 110 cases of FNAC, later confirmed by biopsy, between January 1988 and December 1991. The results are as follows ; 1 Comparison between the results of the FNAC and the histologic findings revealed that FNAC had a sensitivity of 96.6%, a specificity of 100%, a false negative rate of 3.4% a false positive rate of 0.0%, and an overall diagnostic accuracy of 98.2%. 2 Semi-quantitative evaluation of epithelial celluarity, stroma, and naked nuclei in the smears of aspirate showed high celluarity in 56.7% of the aspirates from fibroadenoma and in 0% of those from fibrocystic disease. Abundant stroma was found in 46.7% of the fibroadenoma and none of fibrocystic disease. Numerous naked nuclei were found in 60% of the fibroadenoma and 4.5% of the fibrocystic disease. The overall diagnostic accuracy was 98% 3. In order to determine the accuracy of Black's nuclear grading of FNAC on breast carcinoma, we retrospectively studied 38 cases of ductal carcinomas diagnosed by FNAC with subsequent histologic confirmation. The concordance rate with histology was 94.7%. These results suggest that FNAC of breast is a diagnostically accurate method, and provide for the preoperative differential diagnosis between fibroadenoma and fibrocystic disease. Our results also suggest that the evaluation of nuclear grading of FNAC can predict clinical outcome and decide the way of management of breast cancer.

• The Korean Journal of Cytopathology
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• v.19 no.2
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• pp.111-118
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• 2008

Background : Cervicovaginal cytology is a screening test of uterine cervical cancer. The sensitivity of cervicovaginal cytology is less than 50%, but studies of cytologic/histologic correlation are limited. We analyzed the diagnostic accuracy of cervicovaginal cytology in the detection of the squamous epithelial lesions of the uterine cervix and investigate the cause of diagnostic discordance. Materials and Methods : We collected a total of 481 sets of cervicovaginal cytology and biopsies over 5 years. The cytologic diagnoses were categorized based on The Bethesda System and the histologic diagnoses were classified as negative, flat condyloma, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III, or squamous cell carcinoma. Cytohistologic discrepancies were reviewed. Results: The concordance rate between the cytological and the histological diagnosis was 79.0%. The sensitivity and specificity of cervicovaginal cytology were 80.6% and 92.6%, respectively. Its positive predictive value and negative predictive value were 93.7% and 77.7%, respectively. The false negative rate was 19.4%. Among 54 false negative cytology cases, they were confirmed by histology as 50 flat condylomas, 2 CIN I, 1 CIN III, and 1 squamous cell carcinoma. The causes of false negative cytology were sampling errors in 75.6% and interpretation errors in 24.4%. The false positive rate was 7.4%. Among 15 false positive cytology cases, they were confirmed by histology as 12 atypical squamous cells of undetermined significance (ASCUS) and 3 low grade squamous intraepithelial lesions (LSIL). The cause of error was interpretation error in all cases. The overall diagnostic accuracy of cervicovaginal cytology was 85.7%. Conclusions : Cervicovaginal cytology shows high overall diagnostic accuracy and is a useful primary screen of uterine cervical cancer.

• The Korean Journal of Cytopathology
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• v.15 no.1
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• pp.40-44
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• 2004

To evaluate the quality of fine needle aspiration cytology diagnosis on malignant salivary gland neoplasms, cytologic findings were correlated with histologic diagnosis of 56 surgically removed malignant salivary gland tumors. Seven cases (12.5%) were insufficient, 23 cases (41.1%) were diagnosed as malignant, 17 (30.4%) cases were accurately diagnosed by histologic subtype, and 9 cases (16%) were diagnosed as benign. Five out of 9 false negative cases were misdiagnosed as pleomorphic adenomas. Except the cases with insufficient specimen, overall sensitivity was 81.6%, and the sensitivity varied according to the histologic subtype; 91% in salivary duct carcinoma, 100% in carcinoma ex pleomorphic adenoma, 50% in mucoepidermoid carcinoma, 63% in adenoid cystic carcinoma, and 50% in acinic cell carcinoma. The diagnostic accuracy differed among cytopathologists irrespective of periods after acquisition of board of pathologists. These results confirm that salivary gland neoplasm can be easily misdiagnosed in fine needle aspiration cytology and a great caution should be given in diagnosing the benign appearing salivary aspirates to avoid under-diagnosis of malignant neoplasm with low grade cytologic atypia.

• Tuberculosis and Respiratory Diseases
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• v.47 no.4
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• pp.488-497
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• 1999

Background : Identification of the histologic cell type of lung cancer is important because it is related to the treatment modality and prognosis. Currently, many diagnostic methods are used to determine the cell type. We have studied to evaluate the histologic accuracy of each diagnostic methods in lung cancer. Method : 168 cases were analysed retrospectively, who underwent curative thoracotomy for lung cancer in Seoul National University Hospital from January, 1994 to February, 1997. Sputum cytology, percutaneous needle aspiration(PCNA), percutaneous needle biopsy(PCNB), bronchial washing cytology and flexible bronchoscopic biopsy were evaluated respectively. The k coefficient was applied to evaluate the degree of concordance between the histologic diagnosis obtained by each methods and the one derived from thoracotomy. Results : The k value in sputum cytology was 0.86. In the 34 cases with squamous cell carcinoma(SQ), 32 cases were finally diagnosed as having such by thoracotomy. 7 of the 8 cases with adenocarcinoma(AD) turned out to have the same. The k value in PCNA was 0.51. In the 31 cases with SQ, only 14 cases were finally diagnosed as having such. All of the 3 cases with small cell carcinoma(SC) turned out to have the same. The k value in PCNB was 0.77. The diagnosis was correct in 13 of the 16 patients with SQ and in 30 of the 32 cases with AD. The k value in bronchial washing cytology was 1.0. In all of the 29 cases with SQ and all of the 7 cases with AD, the diagnosis was correct. The k value in flexible bronchoscopic biopsy was 0.77. The diagnosis was correct in 51 of the 52 cases with SQ and in 1 of the 2 cases with SC. Conclusion : The concordance rate with the final histologic diagnosis in sputum cytology, PCNB, bronchial washing cytology and flexible bronchoscopic biopsy were excellent ($k{\geq}0.75$), while that in PCNA was fair (k=0.53). Because PCNA showed lower concordance rate than other diagnostic methods, PCNA is recommended to perform with PCNB.

• 대한세포병리학회:학술대회논문집
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• 2008.05a
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• pp.12-12
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• 2008

• Korean Journal of Head & Neck Oncology
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• v.4 no.1
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• pp.5-11
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• 1988

CT examination has been used in the preoperative examination of patients with head and neck cancer. The accuracy of CT in detecting nodal metastases has not been well established. We studied 35 patients (41 neck specimens) with head and neck cancer who underwent neck dissection. Surgical pathologic findings were compared with preoperative CT scan to establish the diagnostic accuracy for cervical lymph node metastases. The results of physical examination, CT scans of neck and histologic examinations were compared each other. The overall diagnostic accuracy of CT was 83.3%. Comparison with clinical accuracy shows the CT scan to be superior to the clinical examination in spite of careful physical examination, particularly in detecting occult metastases.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10961-10966
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• 2015

Background: Minor cervical cytologic abnormalities include atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL). Approximately 10-20% of women with minor cytologic abnormalities have histologic high-grade squamous intraepithelial or worse lesions (HSIL+). In Thailand, women with minor cytologic abnormalities have a relatively high risk of cervical cancer, and referral for colposcopy has been suggested. A triage test is useful in the selection of women at risk for histologic HSIL+ to reduce the colposcopy burden. The aim of this study was to assess the performance of high-risk HPV DNA test in triage of women with minor cytologic abnormalities in northern Thailand. Materials and Methods: All women with ASC-US/LSIL cytology who were referred to our colposcopy clinic from October 2010 to February 2014 were included. HPV DNA testing was performed using Hybrid Capture 2 (HC2). All patients received colposcopic examination. Accuracy values of HC2 in predicting the presence of histologic HSIL+ were calculated. Results: There were 238 women in this study (121 ASC-US and 117 LSIL). The HC2 positivity rate was significantly higher in the LSIL group than in ASC-US group (74.8% versus 41.0%, p<0.001). Histologic HSIL+ was detected in 9 women (7.4%) in the ASC-US group and 16 women (13.7%) in the LSIL group (p=0.141). There was no histologic HSIL+ detected among HC2-negative cases (sensitivity and negative predictive value of 100%). The performance of HC2 triage was highest among women aged >50 years with ASC-US cytology. An increase in the cut-off threshold for positive HC2 resulted in a substantial decrease of sensitivity and negative predictive value. Conclusions: HPV DNA testing with HC2 shows very high sensitivity and negative predictive value in triage of women with minor cervical cytologic abnormalities in northern Thailand. An increase of the cut-off threshold for HC2 triage is not recommended in this region.