• Title/Summary/Keyword: Histopathologic findings

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Surgery in Patients with Previous Resection of the Epileptogenic Zone Due to Intractable Epilepsy (일차 수술후 재발한 난치성 간질환자에 대한 수술)

  • Kim, Jae-Yeoup;Choi, Ha-Young;Kim, Young-Hyeoun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1300-1307
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    • 2001
  • Purposes : This study reports the possible causes of seizure recurrence in patients underwent previous epilepsy surgery, and surgical strategy for resection of the additional epileptogenic zone locating at the distant area to the site of first resection. Methods : A total of 10 patients with previous surgery due to intractable epilepsy were studied. Five of these underwent standard temporal lobectomy, four extratemporal resection, and one corticoamygdalectomy. Seizure outcome of these were class III-IV. Evaluation methods for reoperation included MRI, 3D-surface rendering of MRI, PET, prologned video-EEG recording with surface electrodes and subdural grid electrodes. Additional resection was done in the frontal lobe in two, in the temporal lobe in three, in the parietal lobe in two, and in the supplementary sensori-motor area in two. Tumor in the superior frontal gyrus in the left hemisphere was removed in one patient. Extent of resection was decided based on the results of ictal subdural grid EEGs and MRI findings. Awake anesthesia and electrocortical stimulation were performed in the two patients for defining the eloquent area. Results : Histopathologic findings revealed extratemporal cortical dysplasia in six, hippocampal sclerosis and cortical dysplasia of the temporal neocortex in one, neuronal gliosis in two, and meningioma in one. Previous pathology of the five patients with cortical dysplasia in the second operation was hippocampal sclerosis plus cortical dysplasia of the temporal neocortex. After reoperation, seizure outcomes were class I in six, class II in three, class III in one at the mean follow-up period of 17.5 months. Characteristically, patients in class II-III after reoperation showed histopathologic findings of hippocampal sclerosis plus temporal neocortical cortical dysplasia plus extratemporal cortical dysplasia. Conclusions : Seizure recurrence after epilepsy surgery was related with the presence of an additional epileptogenic zone distant to the site of first operation, and the majority of the histopathology of the surgical specimens was cortical dysplasia. In particular, hippocampal sclerosis plus temporal neocortical cortical dysplasia was highly related with seizure recurrence in patients with previous operation. In these patients, multimodal evaluation methods were necessary in defining the additional epileptogenic zone.

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Accuracy of FDG-PET/CT for Detection of Incidental Pre-Malignant and Malignant Colonic Lesions - Correlation with Colonoscopic and Histopathologic Findings

  • Kunawudhi, Anchisa;Wong, Alexandra K;Alkasab, Tarik K;Mahmood, Umar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4143-4147
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    • 2016
  • Purpose: We evaluated all PET/CTs acquired for patients without a primary diagnosis of colorectal cancer, and compared results for those who had subsequent colonoscopy within 6 months, to assess the accuracy of FDG PET/CT for detection of incidental pre-malignant polyps and malignant colon cancers. Materials and Methods: Medical records of 9,545 patients who underwent F-18 FDG PET/CT studies over 3.5 years were retrospectively reviewed. Due to pre-existing diagnosis of colorectal cancer, 818 patients were excluded. Of the remainder, 157 patients had colonoscopy within 6 months (79 males; mean age 61). We divided the colon into 4 regions and compared PET/CT results for each region with colonoscopy and histopathologic findings. True positive lesions included colorectal cancer, villous adenoma, tubulovillous adenoma, tubular adenoma and serrated hyperplastic polyp/hyperplastic polyposis. Results: Of 157 patients, 44 had incidental colonic uptake on PET/CT (28%). Of those, 25 had true positive (TP) uptake, yielding a 48% positive predictive value (PPV); 9% (4/44) were adenocarcinoma. There were 23 false positive (FP) lesions of which 4 were hyperplastic polyp, one was juvenile polyp and 7 were explained by diverticulitis. Fifty eight patients had false negative PET scans but colonoscopy revealed true pre-malignant and malignant pathology, yielding 23% sensitivity. The specificity, negiative predictive value (NPV) and accuracy were 96%, 90% and 87%, respectively. The average SUVmax values of TP, FP and FN lesions were 7.25, 6.11 and 2.76, respectively. There were no significant difference between SUVmax of TP lesions and FP lesions (p>0.95) but significantly higher than in FN lesions (p<0.001). The average size (by histopathology and colonoscopy) of TP lesions was 18.1 mm, statistically different from that of FN lesions which was 5.9 mm (p<0.001). Fifty-one percent of FN lesions were smaller than 5 mm (29/57) and 88% smaller than 10 mm (50/57). Conclusions: The high positive predictive value of incidental focal colonic FDG uptake of 48% for colonic neoplasia suggests that colonoscopy follow-up is warranted with this finding. We observed a low sensitivity of standardly acquired FDG-PET/CT for detecting small polyps, especially those less than 5 mm. Clinician and radiologists should be aware of the high PPV of focal colonic uptake reflecting pre-malignant and malignant lesions, and the need for appropriate follow up.

Traumatic Brain Injury in a Pomeranian Dog: Clinical, Computed Tomography, and Necropsy Findings (포메라니언 종에서 발생한 외상성 뇌손상 증례보고; 임상적, 전산화 단층촬영, 부검 소견)

  • Lee, Hee-Chun;Choi, Eul-Soo;Cho, Kyu-Woan;Kang, Byeong-Teck;Kim, Ju-Won;Yu, Chi-Ho;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.579-583
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    • 2010
  • An 18-month-old intact male Pomeranian dog was presented because of traumatic head injury from a fall. Based on physical and neurological examination, brain injury was suspected. On plain skull radiographs, bony fragment following fracture was identified in the region of the right occipital bone. On computed tomography (CT) images, there were specific findings associated with an intracranial hemorrhage. The patient expired few hours after diagnosis, and performed necropsy. On gross findings, intracerebral hemorrhage and edema was detected and those were consistent with CT images. This report describes the clinical findings, CT imaging characteristics, necropsy findings, and histopathologic features of severe traumatic brain injury in a dog.

Fine Needle Aspiration Cytology of Metastatic Wilms' Tumor in the Lung - Report of Two Cases - (폐로 전이한 Wilms 종양의 세침흡인 세포학적 소견 - 2예 보고 -)

  • Kim, Wan-Seop;Kim, Nam-Hoon;Koh, Young-Hyeh;Park, Moon-Hyang;Lee, Jung-Dal
    • The Korean Journal of Cytopathology
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    • v.7 no.2
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    • pp.218-224
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    • 1996
  • We describe two cases of metastatic Wilms' tumor in the lung with emphasis on the cytologic features of specimens obtained by needle aspiration. One of them was extrarenal Wilms' tumor. The findings were correlated with the histopathologic features of the primary lesion. Cellular components in the fine needle aspiration cytology (FNAC) slides included blastemal, epithelial, stromal and inflammatory cells with immature tubular differentiation and rosette formation. Recognition of these cellular components in FNAC smears help in establishing FNAC diagnosis of Wilms' tumor. The blastemal cells were represented by small to medium sized cells with scanty cytoplasm having ill-defined borders and round to slightly oval nuclei with evenly dispersed chromatin and small marginated nucleoli. They were seen in our two cases. The differential diagnosis includes neuroblastoma, malignant lymphoma, malignant rhabdoid tumor, clear cell sarcoma, Ewing's sarcoma and embryonal rhabdomyosarcoma. In conclusion, making a definite cytologic diagnosis of metastatic Wilms' tumor may be possible by light and electron microscopy and immunohistochemical staining. The above findings may contribute to the diagnosis of FNAC of metastatic Wilms' tumor.

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Fine Needle Aspiration Cytology of Apocrine Carcinoma of the Breast - Two case report - (유방의 아포크린 암종의 세침흡인 세포학적 소견 - 2예 보고 -)

  • Jin, So-Young;Lee, Dong-Wha;Kwak, Jeong-Ja
    • The Korean Journal of Cytopathology
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    • v.3 no.2
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    • pp.67-74
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    • 1992
  • Apocrine carcinoma is a rare form of breast malignancy and is composed of entirely or predominantly of apocrine type epithelial cells. Apocrine metaplastic cells are frequently noted in fine needle aspiration cytology(FNAC) of breast lesions, especially fibrocystic disease. These apocrine cells may occasionally be atypical, to make a diagnostic difficulty. Two cases of apocrine carcinoma of the breast diagnosed by FNAC are described, and differential cytologic points between apocrine metaplasia and apocrine carcinoma are discussed. The first case is a right breast mass of a 37-year-old woman for 20 days. The smears show many single or sheets of large cells on bloody background. Each cell has a large vesicular nuclei with multiple macronucleoli and abundant eosinophilic granular cytoplasm. The second case is a left breast mass of a 35-year-old woman for one month. The smears show similar findings as seen in the first one. Histopathologic findings of both cases are typical of apocrine carcinoma. Electron microscopy demonstrates variable numbers of large osmiophilic granules in diameter of $200\sim600nm$ in both cases.

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A Case of Metastatic Carcinoma of the Skin (피부전이암 1예)

  • Mun, Byung-Chun;Hwang, Kae-Yong;Choi, Jong-Soo;Choi, Won-Hee;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.357-360
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    • 1986
  • We report a case of metastatic carcinoma of the skin in 62-year-old male who showed multiple nodules on the anterior chest, scalp, face and left axilla for 2 months' duration. He suffered from lower abdominal discomfortness for 6 months. Histopathologic findings revealed atypical cell nests and some tubular or glandular formation in the dermis and subcutaneous fat tissue. Material in the lumen showed diastase resistant and PAS positive, and alcian blue positive at pH 2.4, but negative pH 0.4. So it represented sialomucin. We did not find primary site of malignant tumor. In view of clinical and histopathological findings, it was considered to be originated from the large intestine.

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Differencies in Risk Factors for Cervical Dysplasia with the Applied Diagnostic Method in Serbia

  • Antic, Ljiljana Gojko;Vukovic, Dejana Srboljub;Vasiljevic, Mladenko Drago;Antic, Dragan Zivojin;Aleksopulos, Hristos Georgios
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6697-6701
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    • 2014
  • Background: In the etiology of cervical cancer not only HPV infection is important, but also other factors such as demographic influences andsexual and reproductive health attitudes, as well as others related to preventive measure usage (or non usage). The aim of this study was to examine factors associated with cervical dysplasia in asymptomatic women who were examined by routine cytology and cervical biopsy for early detection of cervical cancer. Materials and Methods: Socio-demographic and other characteristics were obtained from medical files of 85 examinees with pathologic cytologic findings (Pap test) and histopathologic (HP) findings after biopsy. Results: ccording to the Pap test result, a greater probability for development of cervical dysplasia was noted with examinees having a larger number of sexual partners (OR= 5.01, 95% CI 1.04-24.10), and those who are afraid of the Pap finding. Risk factors for development of cervical dysplasia according to the bioptic finding were early beginning with sexual activities, presence of any STD in personal medical history and fear of the Pap test finding. Conclusions: The only risk factor found to be important for both methods was fear of the Pap testing finding.

DIAGNOSTIC ACCURACY OF $^{18}F$-FDG IN NODAL NEGATIVE ORAL SQUAMOUS CELL CARCINOMA (구강암 환자에서 경부 임파절 평가에 대한 $^{18}F$-FDG PET(Fluorine 18-Labelled Deoxyglucose Positron Emission Tomography)의 유용성)

  • Choi, Eun-Joo;Kang, Sang-Hoon;Kim, Ki-Ho;Nam, Woong;Kim, Hyung-Jun;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.597-600
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    • 2007
  • PET is one of the most widely used verification methods for evaluation of metastasis on the lymph nodes of the neck in oral cancer patients. The purpose of this study was to assess the correlation between PET findings and histopathologic findings in patients who had been diagnosed as squamous cell carcinoma and performed neck dissection. Thirty-four necks in 25 patients had been evaluated on pathologic lymph nodes and the data were compared with preoperative PET scan. The sensitivity of PET at the level of the neck was 72.7%, specificity was 60%, and accuracy was 79.2%. Since FDG-PET show high false-positive results, it should be used with other diagnostic tools for evaluation of lymph node metastasis.

Crush Cytologic Findings of Myxopapillary Ependymoma in Spinal Cord - A Case Report - (점액 유두상 상의세포종의 압착도말 세포학적 소견 - 1예 보고 -)

  • Jung, Soo-Jin;Yang, Young-Il
    • The Korean Journal of Cytopathology
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    • v.10 no.1
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    • pp.73-78
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    • 1999
  • Myxopapillary ependymoma generally arise in the conus medullaris and filum terminale of adult spinal cord. These tumors are readily recognized due to unique histopathologic features, however, their cytologic features are not well described. When only a tiny sample is obtained, cytologic examination using crush preparation may be a useful diagnostic tool to help appropriate intraoperative diagnosis. We present the crush cytologic features of myxopapillary ependymoma arising in thoracic and lumbar spinal cord of a 13-year-old boy. The patient had complained of paraparesis and back pain for 1 month. The MRI image revealed a relatively well demarcated intramedullary mass in T11-L1 levels. Crush preparation for cytology were peformed by biopsy material. Crush cytologic findings revealed high cellularity and small sized branching papillary clusters on fibrillary or mucinous background. The tumor cells had uniform round or elongated nuclei. The cytoplasmic process of tumor cells were attached to the vascular wall. Between the tumor cells and vascular walls, the perivascular collar of globoid acellular stroma with metachromatic reaction on toluidin blue stain was noted. The crush preparation of myxopapillary ependymoma is considered as a simple and highly accurate diagnostic tool for differentiation from other intramedullary neoplasms of central nervous system.

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Soft Tissue Masses Showing Low Signal Intensity on T2-weighted Images: Correlation with Pathologic Findings (T2강조영상에서 저신호강도를 보이는 연부 조직 종양: 병리소견과의 비교)

  • Song, You Seon;Lee, In Sook;Choi, Kyung Un;Cho, Kil Ho;Lee, Sung Moon;Lee, Young Hwan;Kim, Jeung Il
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.279-289
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    • 2014
  • Objective: The aims of this article are to differentiate soft tissue masses showing low signal intensity on T2-weighted images (T2WIs) according to the histopathologic findings. Conclusion: To know relatively small numbered soft tissue masses with low signal intensities on T2WIs adding characteristic location, morphology, signal intensities on other sequences might be helpful for differential diagnosis of mostly non-specific soft tissue tumors on MRI.