• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4689-4692
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• 2013

Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

• The Korean Journal of Cytopathology
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• v.16 no.2
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• pp.106-109
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• 2005

We report a case of Warthin's tumor of the parotid gland in a 53 year old man, which is incorrectly diagnosed as squamous cell carcinoma. Fine needle aspiration cytology(FNAC) smear obtained from the right parotid gland revealed scattered epithelial cell clusters or nests in a diffuse inflammatory and necrotic background. Some epithelial cells had squamoid appearance showing variable sized bizarre shaped nuclei. They had abundant of dense eosinophilic keratinized cytoplasm. Occasionally, parakeratotic cells were also present. These cytologic findings with significant atypia and necrotic background made diagnosis as squamous cell carcinoma. But, the resection specimen from this patient showed classic Warthin's tumor in addition to abundant areas of inflammation and squamous metaplasia. Metaplastic or infarcted Warthin's tumor in the salivary gland may be confused with false positive diagnosis of malignancy on FNAC. Therefore, cytopathologist should have adequate awareness of potential of erroneous diagnosis in FNAC of Warthin's tumor.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.74-78
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• 1994

A case of retroperitoneal paraganglioma is presented with fine needle aspiration cytologic features. A 57-year-old woman complained of abdominal discomfort and left flank pain for 2 years. The abdominal CT scan revealed an ovoid mass left to the abdominal aorta. Percutaneous fine needle aspiration was performed from the mass. The smear revealed cellular sheets or groups on hemorrhagic background. The tumor cells were ovoid, round to spindle shaped with mild to moderate cellular pleomorphism. The nuclei were round to ovoid and had evenly dispersed chromatin and small nucleoli. The cytoplasm was amphophilic, finely granular and poorly defined. Cells having large or spindle nuclei were quite frequently observed, however, mitosis was not present The cytologic findings suggested paraganglioma, but the frequent spindle cell pattern and the pleomorphism made it difficult to exclude other endocrine tumors and sarcomas. The clinical, histological and ultrastructural findings as well as cytologic findings contributed to confirmatory diagnosis.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.35-40
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• 1994

A case of poorly differentiated "insular" carcinoma of the thyroid is presented and discussed with references to the literature. Un fine needle aspiration cytology of our case, the aspirates were highly cellular with tumor cells appearing as dispersed isolated cells as well as in dense clusters and syncytial formations. Occasional microfollicles containing colloid were evident. Most of nuclei were fairly uniform with considerable variability and a few showed definite atypical features. Nuclear grooving was additional features. Necrotic debris was not seen. Our cytologic findings were correlated well with histology, confirming typical insular pattern of tumor cells with the presence of occasional pleomorphic cells and papillary carcinoma-like features. With much attention to cytological features of insular carcinoma, it would be possible to diagnose a preoperative suggestive diagnosis, even though not definitive.

• The Korean Journal of Cytopathology
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• v.17 no.1
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• pp.63-68
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• 2006

Inflammatory myofibroblastic tumor (IMT), normally referred to as inflammatory pseudotumor, is a fairly rare condition. Fine needle aspiration cytology (FNAC) of IMT has only rarely been reported. Here, we describe one such case of pulmonary inflammatory myofibroblastic tumor. A 30-year-old man presented with a 2.8cm-sized mass in his lung. Chest CT revealed a well defined, poorly enhancing mass. FNAC showed some fascicular or swirled clusters of spindle cells, admixed with occasional inflammatory cells and foamy histiocytes. The majority of the tumor cells evidenced bland, elongated nuclei, but infrequent pleomorphic nuclei. Some of the tumor cells evidenced nuclear grooves and intranuclear inclusions. Although the cytological differentiation of IMT from malignant lesions is not immensely problematic, due to the general paucity of cytological and nuclear atypia, a definite cytological diagnosis of IMT cannot be rendered simply by FNAC. Therefore, a diagnosis of IMT may be suggested via exclusive diagnosis.

• Korean Journal of Head & Neck Oncology
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• v.10 no.2
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• pp.192-199
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• 1994

Since 1950s, fine needle aspiration(FNA) cytology has become increasingly popular and numerous reports have demonstrate its accuracy, safety and cost-effectiveness. To evaluate the role of diagnostic FNA cytology in the thyroid nodule, authors compared preoperative cytologic findings with postoperative histologic diagnosis in two hundred two thyroid nodules underwent surgical resection at Department of Surgery, Pusan Paik Hospital. from July 1990 to December 1993. FNA and thyroidectomy was performed primarily by one Head and Neck surgeon and specimen was interpreted by several pathologists. One hundred seventy two FNAs(85%) were interpreted as positive for benign lesion or carcinoma and thirty(15%, cystic in 25, non-cystic lesion in 5 cases) were unsatisfactory specimens for interpretation. The preoperative cytologic diagnosis of 172 cases revealed 'benign' in 112. 'suspicious cancer' in 10 and 'cancer' in 50 cases. Postoperative pathologic diagnosis showed 'nodular goiter' in 64. 'benign tumor' in 43, 'thyroiditis' in 4 and 'cancer' in 61 cases. The value of preoperative FNA diagnosis for thyroid cancer yielded a sensitivity of 85.2%, a specificity of 92.7%, false negative rate 5.2%, false positive rate 4.5% and positive predictive value and overall accuracy were 86.6% and 90.1% respectively. Preoperative rate of malignancy could be increased up to 35.5% by using FNA.

• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.7-13
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• 1999

Background and Objective： The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1：2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.

• 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.1
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• pp.41-46
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• 2008

In an attempt to better define the cytologic characteristics of schwannomas, we have reviewed aspirates and corresponding histologic sections from 23 schwannomas. Of this number, the original cytologic diagnoses were: schwannoma in 14 cases (61%), benign soft tissue tumor in 2 cases (9%), and insufficient specimen in 7 cases (30%). The cytologic findings common to all cases of schwannoma included fragments of tightly cohesive fascicles with variable cellularity and corresponding Antoni type A area. The Antoni type B area, consisting of scattered spindle cells and some histiocytes and lymphocytes against a myxoid background, was seen in 14 cases. Fibrillary stroma was seen in 12 cases. The tumor cells had spindle- or ovalshaped nuclei, with pointed ends and indistinct cell borders. Nuclear palisading was seen in 10 cases, and distinctive Verocay bodies were seen in 5 cases. In ancient schwannomas, there were no Verocay bodies. Most schwannomas have distinct cytomorphologic features that allow correct diagnosis. The major problem with fine needle aspiration cytology of these tumors is the high frequency of poor cellularity, particularly in lesions with cystic degeneration. Of 7 cases with insufficient specimen, 4 showed marked cystic changes and 1 showed marked hyaline changes on histologic sections. In conclusion, we believe that if cytopathologist reminds the situation such as cystic degeneration or hyaline degeneration, the correct diagnosis of the schwannoma will be easily made.

• The Korean Journal of Cytopathology
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• v.18 no.2
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• pp.126-132
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• 2007

The aim of this study was to evaluate the diagnostic value of fine needle aspiration cytology (FNAC) for the assessment of palpable enlarged lymph nodes. The authors reviewed the results of 1,346 FNACs of palpable enlarged lymph nodes performed at Pusan National University Hospital from 1998 to 2004. Of the 1,346 cases, 1,265 (94.0%) were satisfactory and 81 (6.0%) unsatisfactory. Cytologic diagnoses were judged in 488 cases, based on subsequent histologic diagnoses, clinical follow up, or both. Global results for all malignancies (lymphoid and non-lymphoid neoplasms) based on cases with final diagnoses, showed a sensitivity of 87.4% and a specificity of 98.7%. The overall diagnostic accuracy was 93,2%, and the false negative rate reduced from 12,6% to 7,3% when lymphomatous cases were excluded. The annual data for this period showed that the number of diagnostic lymph node biopsies and the rate of inadequately sampled material markedly decreased. Gene rearrangement studies for IgH and TCR ${\gamma}$ were helful in 30 cases. FNAC is a useful initial diagnostic procedure for the evaluation of palpable enlarged lymph nodes. However, the technique should be assisted by the appropriate ancillary studies and by proper interpretation by a cytopathologist.