• Title/Summary/Keyword: Incidental breast lesions

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Incidental Breast Lesions on Chest CT: Clinical Significance and Differential Features Requiring Referral (흉부 전산화단층촬영에서 우연히 발견된 유방 병변: 임상적 중요성 및 진료 의뢰가 필요한 특징적 영상 소견)

  • Choi, Yun Jung;Kim, Tae Hoon;Cha, Yoon Jin;Son, Eun Ju;Gweon, Hye Mi;Park, Chul Hwan
    • Journal of the Korean Society of Radiology
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    • v.79 no.6
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    • pp.303-310
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    • 2018
  • Purpose: To evaluate the CT features of incidental breast lesions on chest CT and to suggest useful criteria for referral to a specialized breast unit. Materials and Methods: Between May 2009 and April 2014, enhanced chest CT examination reports containing the key word 'breast' were reviewed retrospectively. Patients who had incidental breast lesion and were referred to a specialized breast unit and then underwent pathological confirmation or follow-up over a 1-year period were included. Finally, 86 patients (all female, mean age, $48.9{\pm}12.6years$) were enrolled. Two radiologists evaluated lesion characteristics, including size, shape, margins, and enhancement. The correlations between the CT features and pathologies were evaluated, and the diagnostic accuracy of CT features in various combinations was assessed. Results: Among the CT features, irregular shape, non-circumscribed margin, and high contrast enhancement were different between malignant and benign lesions (p < 0.05). The combination of non-circumscribed margin and high contrast enhancement had the highest accuracy (97.7%). Conclusion: Reliable CT features for incidental malignant breast masses are irregular shape, non-circumscribed margin, and high contrast enhancement. The combination of non-circumscribed margin and high contrast enhancement could help distinguish incidental malignant breast lesions and indicate referral to a specialized breast unit.

Clinical Investigation of Incidentally Found Thyroid Carcinoma in Mass Screening (집단 검진에서 발견된 갑상선 우연암종에 대한 임상적 고찰)

  • 김은서;장항석
    • Korean Journal of Bronchoesophagology
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    • v.7 no.2
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    • pp.168-173
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    • 2001
  • Background and Objectives: The introduction of highly sensitive imaging techniques has made it possible to detect many non-palpable nodules, or“incidentaloma”in the thyroid. Discovery of these lesions raises concerns about their malignancy, but the optimal strategy for managing these lesions has not been clearly established. This study was designed to evaluate the usefulness of ultrasonographic exam with new diagnostic criteria and presume the value of mass screening for thyroid cancer. Materials and Methods : Mass screening for thyroid cancer were carried out in conjunction with mass screening for breast cancer. The subjects were 630 women aged 30 years or over. Thyroid glands were examined with 10 MHz transducer ultrasonography by one radiologist. Needle aspiration biopsy were performed when suspicious of malignancy under the new diagnostic criteria. Results and Conclusion : The new ultrasonographic criteria to diagnose thyroid cancer provided useful information and ensured more accurate evaluation. 7 cases of thyroid cancer were discovered and successfully managed. It should be further demonstrated that there is sufficient value of mass screening for thyroid cancer to perform it independently despite early cancer detection.

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Treatment of Pseudoangiomatous Stromal Hyperplasia of the Breast: Implant-Based Reconstruction with a Vascularized Dermal Sling

  • Jung, Bok Ki;Nahm, Ji Hae;Lew, Dae Hyun;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.42 no.5
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    • pp.630-634
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    • 2015
  • Pseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign mesenchymal lesion with incidental histologic findings. Surgical excision is recommended as the treatment of choice for PASH, although the recurrence rates after excision range from 15% to 22%. A 46-year-old-female presented with a six-month history of bilateral breast enlargement and painful sensation mimicking inflammatory carcinoma. Imaging studies demonstrated innumerable enhancing nodules in both breasts. Due to the growth of the lesions and progressive clinical symptoms, bilateral subcutaneous mastectomy was performed. Grossly, the specimens were round and well-circumscribed, and the histologic examination revealed PASH. After mastectomy, we created a pocket with the pectoralis major muscle and a lower skin flap, which was deepithelized. Anatomical mammary implants were inserted, and the nipple areolar complex was transferred to a new position as a free graft. The aesthetic result was satisfactory after twelve months of follow-up.

Cytologic Features of Pseudoangiomatous Stromal Hyperplasia of the Breast - A Case Report with Review of Literature - (유방의 거짓혈관종모양 버팀질증식의 세포소견 - 1예 보고 -)

  • Lee, Jin-Sook;Shin, Dong-Hoon;Park, Do-Youn;Choi, Kyuug-Un;Lee, Chang-Hoon;Sol, Mee-Young;Kim, Jee-Yeon
    • The Korean Journal of Cytopathology
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    • v.16 no.1
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    • pp.25-30
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    • 2005
  • Pseudoangiomatous stromal hyperplasia (PASH) was initially described by Vuitch et al. as a benign breast lesion, consisting of mammary stromal proliferations which simulate vascular lesions, and which might be mistaken for a low-grade angiosarcoma. This condition occasionally presents as a palpable mass in postmenopausal women, but is more frequently encountered as an incidental component in premenopausal women. Clinical, radiological, and fine-needle aspiration (FNA) findings associated with this condition can mimic those observed in conjunction with a phyllodes tumor or a fibroadenoma. The cytological features of PASH are generally nonspecific, and its diagnosis by FNA cytology is fairly difficult. In this study, we report a case on PASH, manifesting as a palpable mass.

Incidental Abnormal FDG Uptake in the Prostate on 18-fluoro-2-Deoxyglucose Positron Emission Tomography-Computed Tomography Scans

  • Kang, Pil Moon;Seo, Won Ik;Lee, Sun Seong;Bae, Sang Kyun;Kwak, Ho Sup;Min, Kweonsik;Kim, Wansuk;Kang, Dong Il
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8699-8703
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    • 2014
  • 18-fluoro-2-deoxyglucose positron emission tomography-computed tomography ($^{18}F$-FDG PET/CT) scans are commonly used for the staging and restaging of various malignancies, such as head and neck, breast, colorectal and gynecological cancers. However, the value of FDG PET/CT for detecting prostate cancer is unknown. The aim of this study was to evaluate the clinical value of incidental prostate $^{18}F$-FDG uptake on PET/CT scans. We reviewed $^{18}F$-FDG PET/CT scan reports from September 2009 to September 2013, and selected cases that reported focal/diffuse FDG uptake in the prostate. We analyzed the correlation between $^{18}F$-FDG PET/CT scan findings and data collected during evaluations such as serum prostate-specific antigen (PSA) levels, digital rectal examination (DRE), transrectal ultrasound (TRUS), and/or biopsy to confirm prostate cancer. Of a total of 18,393 cases, 106 (0.6%) exhibited abnormal hypermetabolism in the prostate. Additional evaluations were performed in 66 patients. Serum PSA levels were not significantly correlated with maximum standardized uptake values (SUVmax) in all patients (rho 0.483, p=0.132). Prostate biopsies were performed in 15 patients, and prostate cancer was confirmed in 11. The median serum PSA level was 4.8 (0.55-7.06) ng/mL and 127.4 (1.06-495) ng/mL in the benign and prostate cancer groups, respectively. The median SUVmax was higher in the prostate cancer group (mean 10.1, range 3.8-24.5) than in the benign group (mean 4.3, range 3.1-8.8), but the difference was not statistically significant (p=0.078). There was no significant correlation between SUVmax and serum PSA, prostatic volume, or Gleason score. $^{18}F$-FDG PET/CT scans did not reliably differentiate malignant or benign from abnormal uptake lesions in the prostate, and routine prostate biopsy was not usually recommended in patients with abnormal FDG uptake. Nevertheless, patients with incidental prostate uptake on $^{18}F$-FDG PET/CT scans should not be ignored and should be undergo further clinical evaluations, such as PSA and DRE.