• Title/Summary/Keyword: In-situ diagnosis

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Ductal carcinoma in situ arising within a fibroadenoma of breast (유방의 섬유선종에서 발생한 관상피내암)

  • Won, Tae Wan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.454-458
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    • 2017
  • Fibroadenoma are one of the most common benign tumors of the breast in young women. Fibroadenoma may be associated with fibrocystic change, proliferative epithelial changes, and extremely rarely with carcinoma. We report here two cases of malignancy arising from a breast fibroadenoma. The patients were 19 and 51 years old and presented with a lump of recent onset. A 19-year-old female patient was diagnosed with mass excision at another hospital, and re-excision was performed at the hospital. Ultrasonography and cytologic examination revealed fibroadenoma and malignancy in a 51-year-old female patient, who was treated with wide excision. The pathological report of the two cases was revealed as DCIS in a fibroadenoma. Because carcinoma arising within a fibroadenoma is so rare, there are few reports of its characteristics or guidelines for treatment. Careful analysis of the unusual carcinoma arising within a fibroadenoma of the breast led to appropriate diagnosis and treatment of various types of lesions. Herein, we report two cases of DCIS arising within a fibroadenoma of the breast and provide a review of the literature.

Prenatal diagnosis of a de novo ring chromosome 11

  • Park, Ju-Yeon;Lee, Moon-Hee;Lee, Bom-Yi;Lee, Yeon-Woo;Ryu, Hyun-Mee;Park, So-Yeon
    • Journal of Genetic Medicine
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    • v.4 no.1
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    • pp.80-83
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    • 2007
  • A 36-year-old pregnant woman was referred for amniocentesis at 19.5 weeks gestation because of advanced maternal age and evidence of increased risk for Edward syndrome in the maternal serum screening test. Cytogenetic analysis of the cultured amniotic fluid cells revealed mosaicism for ring chromosome 11: 46,XX,r(11)[65]/ 45,XX,-11[16]/ 46,XX [34]. Parental karyotypes were normal. A targeted ultrasound showed intrauterine grow th restriction (IUGR). Cordocentesis was performed to characterize the ring chromosome and to rule out tissue specific mosaicism. Karyotype was confirmed as 46,XX,r(11) (p15.5q24.2)[229]/45,XX,-11[15]. And a few new form of ring w ere detected in this culture. The deletion of subtelomeric regions in the ring chromosome were detected by fluorescent in situ hybridization (FISH). The pregnancy was terminated. The fetal autopsy showed a growth-retarded female fetus with rocker bottom feet. We report a case of prenatally detected a de novo ring chromosome 11.

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Use of Artificial Intelligence for Reducing Unnecessary Recalls at Screening Mammography: A Simulation Study

  • Yeon Soo Kim;Myoung-jin Jang;Su Hyun Lee;Soo-Yeon Kim;Su Min Ha;Bo Ra Kwon;Woo Kyung Moon;Jung Min Chang
    • Korean Journal of Radiology
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    • v.23 no.12
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    • pp.1241-1250
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    • 2022
  • Objective: To conduct a simulation study to determine whether artificial intelligence (AI)-aided mammography reading can reduce unnecessary recalls while maintaining cancer detection ability in women recalled after mammography screening. Materials and Methods: A retrospective reader study was performed by screening mammographies of 793 women (mean age ± standard deviation, 50 ± 9 years) recalled to obtain supplemental mammographic views regarding screening mammography-detected abnormalities between January 2016 and December 2019 at two screening centers. Initial screening mammography examinations were interpreted by three dedicated breast radiologists sequentially, case by case, with and without AI aid, in a single session. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and recall rate for breast cancer diagnosis were obtained and compared between the two reading modes. Results: Fifty-four mammograms with cancer (35 invasive cancers and 19 ductal carcinomas in situ) and 739 mammograms with benign or negative findings were included. The reader-averaged AUC improved after AI aid, from 0.79 (95% confidence interval [CI], 0.74-0.85) to 0.89 (95% CI, 0.85-0.94) (p < 0.001). The reader-averaged specificities before and after AI aid were 41.9% (95% CI, 39.3%-44.5%) and 53.9% (95% CI, 50.9%-56.9%), respectively (p < 0.001). The reader-averaged sensitivity was not statistically different between AI-unaided and AI-aided readings: 89.5% (95% CI, 83.1%-95.9%) vs. 92.6% (95% CI, 86.2%-99.0%) (p = 0.053), although the sensitivities of the least experienced radiologists before and after AI aid were 79.6% (43 of 54 [95% CI, 66.5%-89.4%]) and 90.7% (49 of 54 [95% CI, 79.7%-96.9%]), respectively (p = 0.031). With AI aid, the reader-averaged recall rate decreased by from 60.4% (95% CI, 57.8%-62.9%) to 49.5% (95% CI, 46.5%-52.4%) (p < 0.001). Conclusion: AI-aided reading reduced the number of recalls and improved the diagnostic performance in our simulation using women initially recalled for supplemental mammographic views after mammography screening.

Prenatal Diagnosis of a Satellited Chromosome 8p Results from a de novo Cryptic Translocation between Chromosomes 8 and 22 (산전 진단에서 관찰된 8번과 22번 염색체 사이의 미세 전좌에 의한 8번 염색체 단완 위성체)

  • Oh, Ah-Rum;Lee, Bom-Yee;Choi, Ene-Yuong;Ryu, Hyun-Mee;Lee, Seung-Jae;Jung, Ji-Ye;Park, So-Yeon
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.135-138
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    • 2011
  • The authors of the present study report the prenatal detection of a chromosomal abnormality with additional satellites on the distal short arm of chromosome 8. A 35-year-old woman was referred for amniocentesis because of her advanced maternal age and positive result for maternal serum screening test. Cytogenetic analysis of cultured amniocytes showed a satellite 8p chromosome. The satellite 8p chromosome was positive for nucleolus organizer region (NOR) staining. The parents' karyotypes were normal. Fluorescence in situ hybridization (FISH) study for metaphases of fetal amniocytes revealed a cryptic translocation of chromosomes 8p and 22p. The fetal karyotype was described as 46,XY,8ps.ish t(8;22)(p23.3;p11.2) (D8S504-;D8S504+)dn. The parents decided to continue the pregnancy and a phenotypically normal boy was born at 38 weeks of gestation. In case of de novo terminal NORs detected prenatally, more accurate cytogenetic and molecular analysis should be performed in order to rule out cryptic chromosomal rearrangement among other chromosomes.

Applicability of Vegetation Index and SPAD Reading to Nondestructive Diagnosis of Rice Growth and Nitrogen Nutrition Status (식생지수와 SPAD를 이용한 벼 생육 및 질소영양상태의 비파괴적 진단 가능성 검토)

  • Kim Min-Ho;Shin Jin-Chul;Lee Byun-Woo
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.50 no.6
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    • pp.369-377
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    • 2005
  • Precise application of topdressing nitrogen (N) fertilizer is indispensible for securing high yield and good quality of rice and minimizing N losses to the environment as well. For precise N management, growth and nitrogen nutrition status (NNS) should be diagnosed rapidly and accurately. The objective of the study was to evaluate the applicability of vegetation index (VI) calculated from hyperspectral canopy reflectance measurement and SPAD reading to nondestructive in situ diagnosis of growth and NNS of rice. Canopy reflectance, SPAD read­ing, growth parameters, and NNS characteristics were measured from various N treatments to evaluate the relationships among them for two cropping seasons from 2001 to 2002. The correlation coefficient of VIs with variables of growth and NNS increased positively as rice canopy became more closed. Regardless of growth stages, VIs had significantly high correlations with LAI, shoot dry weight (DW), shoot N content and nitrogen nutrition index (NNI). Those correlation coefficients increased steadily before heading stage as rice grew up. However, tiller number and leaf N concentration showed significantly high correlations with VIs only at and after panicle initiation stage (PIS). Among the VIs, RVIgreen had significantly higher correlation with the measured parameters than the other VIs: it showed correlation coefficients greater than 0.8 with leaf and shoot N concentration and DW, and much higher coefficients greater than 0.9 with LAI, shoot N content, and NNI. At LAI of below 2.5, VIs had non-significant or low correlations with the growth and NNS indicators due to the background effects. SPAD reading had significantly high correlation with leaf N concentration and NNI at each growth stage. In addition, it had significant correlations with variables of growth and NNS at PIS and booting stage, particularly, at booting stage. Though SPAD reading had a significantly high correlation value at a given growth stage in each year, it showed very weak relationship with variables of growth and NNS when pooled across growth stages and years. In conclusion, RVIgreen was found to be the most reliable VI to estimate the growth and NNS of rice around at PIS, but SPAD reading had much limitations.

Screening Examination of Breast Cancer: Review of the Recommended Guidelines (유방암 선별검사의 경계연령에 대한 고찰)

  • Shin, Myung-Ho;Hwang, Mi-Soo;Park, Bok-Hwan
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.342-346
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    • 1999
  • Background: Delays in breast cancer diagnosis may occur in young women due to a low index of suspicion. The purpose of this study was to compare mammography and breast sonography in detection of breast cancer and to suggest a reasonable guideline for breast cancer screening examination. Materials and Methods: Among 820 patients, 102 patients were under 35 years and 122 patients were above 60 years of age. We reviewed medical records, mammograms and/or ultrasonography of 49 patients under 35 years and 48 patients above 60 years of age with pathologically-proven breast cancer. Pathological reports were as follows Invasive ductal carcinoma(IDC) was present 61.2% of patients in the young age group and ductal carcinoma in situ(DCIS) in 16.3%. IDC was present in 66.6% of the patients in the old age group, and DCIS in 8.33%. We analyzed mammography and ultrasonography to evaluate their usefulness in detecting breast cancer in patients under 35 years and over 60 years of age. Results: The mammographic results are as follows : 1) detection rate of lesion: 83.8%(under 35yrs), 100%(over 60yrs) 2) sensitivity of cancer: 67.6%(under 35yrs), 91.2%(over 60yrs) The ultrasonographic results are as follows : 1) detection rate of lesion: 100% 2) sensitivity of cancer: 87.2%(under 35yrs), 96.7%(over 60yrs) The breast cancer detection rate in women under 35 years old was comparable to that of women above 60 years old in our study. Conclusion: A striking histologic finding in the two groups was a higher incidence of nuclear Grade II and III tumors. This finding correlates with the reported increased incidence of high grade tumors in young women and may correlate with the poorer prognosis of breast cancer in young patients. We conclude that early screening examination is helpful for early detection of breast cancer in women under age 35.

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Relationship between the Expression of Sodium Iodide Symporter and the Findings of $^{99m}Tc-MIBI$ Scintimammography in the Primary Breast Cancer (원발성 유방암에서 Sodium Iodide Symporter의 발현과 $^{99m}Tc-MIBI$ 유방스캔의 관계)

  • Seok, Ju-Won;Kim, Seong-Jang;Kwak, Hi-Suk;Lee, Chang-Hun;Kim, In-Ju;Kim, Yong-Ki;Bae, Young-Tae;Kim, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.6
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    • pp.325-332
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    • 2002
  • Purpose: Human Na+/I- symporter (hNIS) is known to be expressed in many tissues other than thyroid gland. The breast cancer cells are one of them and the possibility of radioiodine therapy in treatment of the breast cancer may be suggested. We investigated the expression rate of hNIS and the relationship between the expression of hNIS and the finding of 99mTc-MIBI scintimammographv in the breast cancer Materials and Methods: Surgically proved 56 patients with breast cancer were the subjects of this study The expression of hNIS were evaluated by immunohistochemistry and the results were compared to the findings of 99m7c-MIBI scintimammography. Results: Overall expression rate of hNIS was 41.1% in 56 patients. According to the pathologic diagnosis, it was 42.9% in 49 patients with invasive ductal carcinoma and 28.6% in the 7 patients with ductal carcinoma in situ. The expression rate of hNIS in the 41 cases with a focal increased uptake at he breast lesion on 99m7c-MIBI sointimammogram was 31.7%. That in the 15 cases without any abnormal uptake on the scan was significantly higher(65.7%, p<0.05). Conclusion: The expression rate of hNIS in the patients with breast cancer was not so high. The rate was higher in the patients with no increased uptake at the breast lesion on 99m7c-MIBI scintimammography.

Clinical Characteristics and Genetic Analysis of Prader-Willi Syndrome (Prader-Willi 증후군의 임상 양상 및 유전학적 진단에 관한 고찰)

  • Lee, Ji Eun;Moon, Kwang Bin;Hwang, Jong Hee;Kwon, Eun Kyung;Kim, Sun Hee;Kim, Jong Won;Jin, Dong Kyu
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1126-1133
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    • 2002
  • Purpose : Prader-Willi syndrome(PWS) is a complex disorder affecting multisystems with characteristic clinical features. Its genetic basis is an expression defect in the paternally derived chromosome 15q11-q13. We analyzed the clinical features and genetic basis of PWS patients for early detection and treatment. Methods : We retrospectively studied 24 patients with PWS in Department of Pediatrics, Samsung Medical Center, from September 1997 to September 2001. We performed cytogenetic and molecular genetic techniques using high resolution GTG banding techniques, fluorescent in situ hybridization and methylation-specific PCR for CpG island of SNRPN gene region. Results : The average birth weight of PWS patients was $2.67{\pm}0.47kg$ and median age at diagnosis was 1.3 years. The average height and weight of PWS patients under one year at diagnostic time were located in a 3-10 percentile relatively, and a rapid weight gain was seen between two and six years. Feeding problems in infancy and neonatal hypotonia were the two most consistently positive major criteria in over 95% of the patients. In 18 of the 24 cases(75%), deletion of chromosome 15q11-q13 was demonstrated and one case among 18 had an unbalanced 14;15 translocation. In four cases without any cytogenetic abnormality, it may be considered as maternal uniparental disomy and the rest showed another findings. Conclusion : We suggest diagnostic testing for PWS in all infants/neonates with unexplained feeding problems and hypotonia. It is necessary for clinically suspicious patients to undergo an early genetic test. As the genetic basis of PWS was heterogenous and complex, further study is required.

Staging of Esophageal Cancer Using Positron Emission Tomography : Comparing to Computed Tomography (양전자방출단층촬영술(PET)을 이용한 식도암 환자의 병기 결정 -전산화단층촬영술(CT)과의 비교-)

  • 심영목;박승준;김병태;김성철
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.388-393
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    • 1999
  • Background: Correct preoperative staging of esophageal cancer is a prerequisite for adequate treatment. We prospectively compared the accuracy of positron emission tomography (PET) with [fluorine-18]FDG in the staging of esophageal cancer to that of computed tomography (CT). Material and Method: The findings of FDG PET and of chest CT including lower neck and the upper abdomen of 20 biopsy-proven squamous cell carcinoma patients (male, 19; female, 1; mean age, 61) were compared with the pathologic findings obtained from a curative esophagectomy with lymph node dissection. Result: The sensitivities of FDG PET and CT for diagnosis of primary tumor were the same, 90.0% (18/20). Both FDG PET and CT failed to show the primary tumor in 2 of 20 patients; one had a 1cm sized carcinoma in situ and the other had T1 stage cancer. By using the results of the pathologic examinations of 193 removed lymph node groups, we calculated the diagnostic sensitivities, specificities and accuracies of PET and CT (*$\chi$2 p < 0.005). Sensitivity** Specificity Accuracy* PET 55.6%(30/54) 97.1%(135/139) 85.5%(165/193) CT 13.0%(7/54) 98.6%(137/139) 74.6%(144/193) One of four patients with a false-positive for PEThad had active pulmonary tuberculosis. Among the 24 tumor involved lymph node groups, PET failed to show tumor metastasis in 5 lymph node groups abutting the tumor and in 14 lymph node groups located where the decay correction was not performed. Conclusion: Based on the above findings, it is suggested that [F-18]FDG-PET is superior to CT in the detection of nodal metastases and in the staging of patients with esophageal cancer.

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Conservative Surgery and Primary Radiotherapy for Early Bresst Cancer: Yonsei Cancer Center Experience (조기 유방암에서 보존적 수술후 방사선치료: 연세암센터 경험)

  • Suh Chang Ok;Lee Hy De;Lee Kyung Sik;Jung Woo Hee;Oh Ki Keun;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.337-347
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    • 1994
  • Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation in 1991 and treated one hundred and fourty patients during the next three years. Purpose : To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five Patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results : Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven Patients were N0 and 27 patients were Nl. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occured at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation pneumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer is Proven to be safe and comfortable treatment method without any major complication. Long-term follow up is needed to evaluate our treatment results in terms of loco-regional control rate, survival rate, and cosmetic effect.

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