• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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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.

• 대한세포병리학회지
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• 제1권1호
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• pp.18-26
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• 1990

CT guided percutaneous fine-needle aspiration (FNA) of the liver for both cytologic and histologic examination has great value in diagnosing liver malignancy. From March, 1986 to April, 1990, 62 patients with the clinical impression of liver malignancy underwent CT guided percutaneous FNA biopsy. Of these, 43 cases were reviewed for this study, 19 were reported to be liver cell carcinoma, 2 were adenocarcinoma, 11 were reported as anaplastic cell present, and the rest (11 cases) were negative (9) or necrotic (2). Among the 11 cases of the last group, 9 were diagnosed as liver cell carcinoma and 2 were necrotic histologically. Retrospective review, in order to clarify the cause of cytologic diagnostic error, of both cytologic and histologic slides of all cases showed discordance of 23% between these diagnoses and sensitivity is 93.9% and specificity is 90.9%. The reasons were as follows ; 1) the lack of awareness of tumor cells of well differentiated liver cell carcinoma (4 cases), 2) missed tumor cells due to too scanty cellularity (1 case), 3) improper smear (2 cases) and no tumor cell In the cytologic smears (3 cases). In such cases, at the initiation of FNA, a correct diagnosis of liver malignancy could only be made by a combination of cytologic and histologic examinations. However after three years' experience we can conclude that cytomorphologic features of liver cell carcinoma are sufficiently distinctive from other liver malignancies to be diagnostic.

• Tuberculosis and Respiratory Diseases
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• 제42권4호
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• pp.584-587
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• 1995

저자들은 좌측유방에 분비물이 동반된 무동의 종물을 주소로 내원한 젊은여성에서 일반적인 항생제투여 및 배농등의 치료에 반응하지 않아 실시한 세침흡인 및 생검상 만성 염증성 육아종성변화로 나타나 유방결핵으로 진단된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한세포병리학회지
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• 제8권1호
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• pp.93-97
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• 1997

A case of cervical chordoma diagnosed by fine needle aspiration is discussed. A 41year-old male was admitted due to dyspnea on neck flexion. Radiologic image revealed a retrotracheal superior mediastinal solid mass. Aspiration cytology showed many clusters of oval or large polygonal cells having abundant eosinophilic or bubbly cytoplasm in an amorphous blue-gray mucoid background. The nuclei were round and showed size variation, coarse granular chromatin, and indistinct nucleoli. Some cells contained brown granular pigments in the cytoplasm. Mitoses were rarely found. The cytoplasm was strongly positive for PAS stain. Immunohistochemical stains using cell block revealed positive reaction for cytokerain, EMA, vimentin, and S-100 protein. The confirmative diagnosis was made by following excisional biopsy. Electron microscopic study revealed large pools of intracytoplasmic glycogen and microfilaments. This is the first case of cervical chordoma diagnosed by aspiration cytology to our knowledge in Korean literature.

• 핵의학기술
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• 제14권2호
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• pp.181-185
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• 2010

갑상선암 환자의 경부 림프절에서 미세침흡인생검술(fine needle aspiration biopsy, FNAB)을 시행하며 얻은 미세침세척액의 티로글로불린(thyroglobulin, Tg)측정법의 진단적 성적과 유용성을 알아보고자 FNAB 세포검사의 결과와 비교하였다. 갑상선암의 경부림프절 전이가 의심되어 초음파 시행한 총 37명의 환자 48개의 FNAB 검체를 대상으로 하였고, 수술 후 조직검사결과 또는 장기간 영상 추적검사를 기준으로 하여 세포검사와 미세침세척액 티로글로불린(FNAB-Tg)측정법을 비교하여, 각 검사의 특이도, 민감도 및 정확도를 평가하였다. 추가적으로 Tg-항체가 양성일때 FNAB-Tg 검사에는 어떠한 영향을 미치는지 Tg-항체 검사를 같이 시행한 34명을 대상으로 분석하여 보았다. FNAB 검체의 세포검사에서 전이 음성인 36개 검체 중 35개 검체에서 음성을 보였고, 전이 양성인 12개 검체 중 9개 검체에서 양성을 보였다. FNAB-Tg측정법의 경우 전이 음성인 36개의 검체 중 32개의 검체에서 음성을 보였고, 전이 양성인 12개의 검체 중 12개 검체 모두 양성을 보였다. 따라서 세포검사의 민감도와 특이도는 각각 75.0% (9/12)와 97.2% (35/36)였고, 위음성이 25% (3/12)였다. 반면에 FNAB-Tg 측정법의 민감도와 특이도는 각각 100% (12/12)와 88.9% (32/36)였고, 위양성이 11.1% (4/36)였다. 정확도는 두 검사 모두 91.7% (44/48)였다. Tg-항체에 대한 검사 결과를 얻을 수 있는 34명을 따로 분석한 결과, Tg-항체의 존재 유무가 FNAB-Tg 측정법의 진단 성능에 영향을 주지 않음을 확인할 수 있었다. FNAB 검체를 이용한 세포검사는 특이도가 높고 반면, FNAB-Tg 측정법은 민감도가 높은 검사임을 확인할 수 있었다. 따라서 림프절 전이가 의심되는 갑상선환자에서 FNAB를 시행할 때 세포검사와 FNAB-Tg 측정법은 동시에 시행되어야 할 상호보완적인 검사들이다.

• 대한세포병리학회지
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• 제8권2호
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• pp.194-198
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• 1997

Extraskeletal mesenchymal chondrosarcoma is a relatively rare tumor and its cytologic findings have rarely been reported. We experienced a case of mesenchymal chondrosarcoma of soft tissue of the right lateral neck diagnosed by fine needle aspiration biopsy in a 59 year-old man. Cytologic findings showed two cell components. One was an undifferentiated, small cell component with moderate amount of cytoplasm and spindle nuclei. The second population was a chondroid component. These cytologic findings were diagnostic to mesenchymal chondrosarcoma.

• Tuberculosis and Respiratory Diseases
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• 제68권5호
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• pp.267-272
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• 2010

Background: Pulmonary sarcoidosis often involves mediastinal or hilar lymph nodes in the lung parenchyma. Mediastinoscopy is the gold standard for diagnosis, but it is invasive and expensive. Transbronchial needle aspiration using conventional bronchoscope is less invasive than mediastinoscopy, but its diagnostic accuracy is in question due to the blind approach to targeting lymph nodes. Transbronchial needle aspiration (TBNA) via endobronchial ultrasound (EBUS) has high diagnostic value due to direct visualization of lymph nodes and to its relatively safeness. The purpose of this study was to assess the usefulness of EBUS-TBNA in the diagnosis of pulmonary sarcoidosis. Methods: Twenty-five patients with symptoms of sarcoidosis were enrolled into this study. Core tissue was obtained for a definitive diagnosis. Endobronchial biopsy, transbronchial lung biopsy, and bronchoalveolar lavage were performed to verify diagnosis. For patients without a confirmed diagnosis after the above procedures were performed, the additional procedures of mediastinoscopy or video-associated thoracoscopic surgery were performed to confirm a final diagnosis. Results: A total 25 EBUS procedures were done and 50 lymph nodes were aspirated. Thirty-three (37) out of 50 lymph nodes were consistent with non-caseating granuloma, confirming sarcoidosis as the final diagnosis. Sarcoidosis was the final diagnosis for all 25 patients, and 21 required EBUS-TBNA for a final diagnosis. There were no complications associated with the procedure. Conclusion: EBUS-TBNA is already a well-known procedure for diagnosing mediastinal or hilar lymphadenopathy. We used EBUS-TBNA for the diagnosis of pulmonary sarcoidosis and our results showed 84% diagnostic accuracy and no complications related to the procedure. EBUS-TBNA is a reliable and practical diagnostic modality in the diagnosis of pulmonary sarcoidosis.

• 대한세포병리학회지
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• 제5권2호
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• pp.172-175
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• 1994

Anaplastic carcinoma of the thyroid is one of the most malignant tumors and survival for longer than three years after diagnosis is exceptional. Multinucleated giant cells of osteoclastlike appearance are seen un some of the anaplastic carcinoma, but only three cases in which the diagnosis was made by fine needle aspiration (FNA) cytology are reported in the international literature. We experienced a case of anaplastic carcinoma with osteoclastlike giant cells in a 66-yr-old female, diagnosed by FNA cytology. The smears revealed two cell populations: multinucleated giant cells and large polygonal or spindle shaped malignant cells. The FNA cytodiagnosis of anaplastic thyroid carcinoma containing osteoclastlike giant cells was substantiated by subsequent biopsy.

• Korean Journal of Radiology
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• 제20권1호
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• pp.158-165
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• 2019

Objective: Recent studies demonstrated that core needle biopsy (CNB) can effectively reduce the possibility of inconclusive results and prevent unnecessary diagnostic surgery. However, the effectiveness of CNB in patients with suspicious thyroid nodules has not been fully evaluated. This prospective study aimed to determine the potential of CNB to assess thyroid nodules with suspicious ultrasound (US) features. Materials and Methods: Patients undergoing CNB for thyroid nodules with suspicious features on US were enrolled between May and August 2016. Diagnostic performance and the incidence of non-diagnostic results, inconclusive results, conclusive results, malignancy, unnecessary surgery, and complications were analyzed. Subgroup analysis according to nodule size was performed. The risk factors associated with inconclusive results were evaluated using multivariate logistic regression analysis. Results: A total of 93 patients (102 thyroid nodules) were evaluated. All samples obtained from CNB were adequate for diagnosis. Inconclusive results were seen in 12.7% of cases. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for diagnosis of malignancy were 93.8%, 100%, 100%, 78.9%, and 95%, respectively. None of the patients underwent unnecessary surgery. The diagnostic performance was not significantly different according to nodule size. On multivariate logistic regression analysis, larger nodule size and shorter needle length were independent risk factors associated with inconclusive results. Conclusion: Samples obtained by CNB were sufficient for diagnosis in all cases and resulted in high diagnostic values and conclusive results in the evaluation of suspicious thyroid nodules. These findings indicated that CNB is a promising diagnostic tool for suspicious thyroid nodules.

• Clinical Endoscopy
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• 제55권5호
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• pp.637-644
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• 2022

Background/Aims: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is integral to the diagnosis of gastrointestinal (GI) subepithelial tumors (SETs). The impact of different EUS-FNB tissue sampling techniques on specimen adequacy and diagnostic accuracy in SETs has not been fully evaluated. This study aimed to compare the diagnostic outcomes of slow-pull (SP) and standard suction (SS) in patients with GI SETs. Methods: In this retrospective comparative study, 54 patients were enrolled. Medical records were reviewed for location and size of the target lesion, FNB needle type/size, technical order, specimen adequacy, diagnostic yield, and adverse events. The acquisition rate of adequate specimens and diagnostic accuracy were compared according to EUS-FNB techniques. Results: The mean lesion size was 42.6±36.4 mm, and most patients were diagnosed with GI stromal tumor (75.9%). The overall diagnostic accuracies of the SP and SS techniques were 83.3% and 81.5%, respectively (p=0.800). The rates of obtaining adequate core tissue were 79.6% and 75.9%, respectively (p=0.799). No significant clinical factors affected the rate of obtaining adequate core tissue, including lesion location and size, FNB needle size, and final diagnosis. Conclusions: SP and SS had comparable diagnostic accuracies and adequate core tissue acquisition for GI SETs via EUS-FNB.