• Clinical and Experimental Pediatrics
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• v.49 no.2
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• pp.162-166
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• 2006

Purpose : There are few reports in Korean literature on the diagnostic efficacy of fine needle aspiration cytology(FNAC) for pediatric cervical lymphadenopathy. This study examined the diagnostic value of FNAC on cervical lymphadenopathy in children. Methods : Data from 57 pediatric patients(aged 0.3 to 14 years) who underwent FNAC due to cervical lymphadenopathy between January 2001 and March 2005 was reviewed retrospectively. Results : Reactive cervical lymphadenitis was the most common result of the FNAC(52.5 percent). Malignant disease were revealed in 14 percent of all cases. The sensitivity, specificity was 86 percent and 96 percent, respectively. The positive and negative predictive values for malignant disease was 75 percent and 98 percent, respectively. There were two false-positive cases on FNAC; one case of Langerhans cell histiocytosis, and another with infectious mononucleosis. A false-negative case on FNAC was found to be acute lymphocytic leukemia. In seven cases(12 percent), the final diagnosis was confirmed by an open biopsy after the FNAC. There were four FNAC cases where the specimen was not satisfactory for making a diagnosis(7 percent). There were no serious complications of the FNAC procedure. Conclusion : FNAC had a high diagnostic efficacy for evaluating children with cervical lymphadenopathy.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.339-347
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• 1996

Background : Transthoracic fine needle aspiration and biopsy(TNAB) has become a frequently used technique in the investigation of the intrathoracic lesions because of its safety, reliability, and accuracy. Method : Data on 125 patients who underwent TNAB from 1990 through 1994 were studied to determine the diagnostic sensitivity, accuracy and complications of this procedure as related to lesion type and location. Results : 1. The over-all diagnostic sensitivity of TNAB was 61.6%(77 of 125 patients). 2. The diagnostic yields were as high as 89.9% for malignant lesions, but a specific diagnosis of benign lesions were obtained only in 30% of benign lung lesions. 3. The correlation between results of TNAB cytology and of final histology was as high as 88.2%. 4. Lung lesions that were greater than 3cm in size had a higher proportion of correct diagnosis(73.3%) as compared with lesions 3cm or less in size(38.1%). But there was no significant difference between the central and peripheral lung lesions. 5. There were no serious complications to TNAB. In 12.8% of the procedures a pneumothorax developed, indicating a chest tube in 1.6% of the procedures. In 2 cases, minimal hemoptysis developed which did not require treatment. Conclusion : In our experience, TNAB represents a minor and safe procedure, which permits a direct approach to localized malignant lung lesions with a high degree of accuracy.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.600-604
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• 2018

Background and Objectives This study aimed to identify a reliable preoperative predictive factor for the development of thyroid cancer in patients with atypia of undetermined significance (AUS) identified by fine needle aspiration biopsy (FNAB). Subjects and Method This was a retrospective cohort study. Two hundred and ninety-nine patients diagnosed with AUS by preoperative FNAB who underwent curative thyroid surgery at our institution between September 2005 and February 2014 were analyzed. Clinical, radiological and molecular features were investigated as preoperative predictors for postoperative permanent malignant pathology. Results The final pathologic results revealed 36 benign tumors including nodular hyperplasia, follicular adenoma, adenomatous goiter, nontoxic goiter, and lymphocytic thyroiditis, as well as 263 malignant tumors including 1 follicular carcinoma and 1 invasive follicular carcinoma; the rest were papillary thyroid carcinomas. The malignancy rate was 87.9%. The following were identified as risk factors for malignancy by univariate analysis: $BRAF^{V600E}$ gene mutation, specific ultrasonographic findings including smaller nodule size, low echogenicity of the nodule, and irregular or spiculated margin (p<0.05). Multivariate analysis revealed that only $BRAF^{V600E}$ mutation was a statistically significant risk factor for malignancy (p<0.05). When $BRAF^{V600E}$ mutation was positive, 98.5% of enrolled patients developed malignant tumors. In addition, the diagnostic rate of malignancy in these cases was approximately 16-fold higher than BRAF-negative cases. Conclusion Patients with AUS thyroid nodules should undergo $BRAF^{V600E}$ gene mutation analysis to improve diagnostic accuracy and if the mutation is confirmed, surgery is recommended due to the high risk of malignancy.

• Korean Journal of Radiology
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• v.20 no.8
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• pp.1300-1310
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• 2019

Objective: To measure the diagnostic accuracy of percutaneous transthoracic needle lung biopsies (PTNBs) on the basis of the intention-to-diagnose principle and identify risk factors for diagnostic failure of PTNBs in a multi-institutional setting. Materials and Methods: A total of 9384 initial PTNBs performed in 9239 patients (mean patient age, 65 years [range, 20-99 years]) from January 2010 to December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PTNBs for diagnosis of malignancy were measured. The proportion of diagnostic failures was measured, and their risk factors were identified. Results: The overall accuracy, sensitivity, specificity, PPV, and NPV were 91.1% (95% confidence interval [CI], 90.6-91.7%), 92.5% (95% CI, 91.9-93.1%), 86.5% (95% CI, 85.0-87.9%), 99.2% (95% CI, 99.0-99.4%), and 84.3% (95% CI, 82.7-85.8%), respectively. The proportion of diagnostic failures was 8.9% (831 of 9384; 95% CI, 8.3-9.4%). The independent risk factors for diagnostic failures were lesions ≤ 1 cm in size (adjusted odds ratio [AOR], 1.86; 95% CI, 1.23-2.81), lesion size 1.1-2 cm (1.75; 1.45-2.11), subsolid lesions (1.81; 1.32-2.49), use of fine needle aspiration only (2.43; 1.80-3.28), final diagnosis of benign lesions (2.18; 1.84-2.58), and final diagnosis of lymphomas (10.66; 6.21-18.30). Use of cone-beam CT (AOR, 0.31; 95% CI, 0.13-0.75) and conventional CT-guidance (0.55; 0.32-0.94) reduced diagnostic failures. Conclusion: The accuracy of PTNB for diagnosis of malignancy was fairly high in our large-scale multi-institutional cohort. The identified risk factors for diagnostic failure may help reduce diagnostic failure and interpret the biopsy results.

• Journal of the Korean Society of Radiology
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• v.18 no.5
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• pp.551-556
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• 2024

This study aims to evaluate the diagnostic concordance and accuracy by comparing thyroid lesions diagnosed with the artificial intelligence-based computer-aided diagnosis (CAD) system, S-Detect^TM, to the results of fine-needle aspiration biopsy(FNAB). A retrospective study was conducted involving 60 patients at N Hospital in Gyeongnam from May 2023 to September 2023. The study used S-Detect^TM to analyze ultrasound findings and malignancy risk of thyroid nodules and compared these findings with FNAB results to determine accuracy. The study assessed the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of S-Detect^TM and evaluated the diagnostic concordance between the two methods using Kappa analysis. S-Detect^TM demonstrated a sensitivity of 90.5%, specificity of 83.2%, accuracy of 88.3%, PPV of 80.7%, and NPV of 92.7%. The Kappa value for diagnostic agreement between S-Detect^TM and FN AB was 0.719 (p<0.05), indicating a high level of agreement between the methods. Therefore, the CAD system S-Detect^TM proves valuable in distinguishing between malignant and benign thyroid lesions and could reduce unnecessary tissue examinations when used appropriately before thyroid fine-needle aspiration.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.369-375
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• 1999

Chordoma is a slow-growing malignant neoplasm arising from the remnants of the primitive notochord. It accounts for 1 to 4% of all malignant bone tumors. It occurs exclusively along the spinal axis. Authors experienced four cases of chordoma occurred in the sacrococcygeal region. There were two male and two female patients, with a mean age of 63.5 years(range, 57~75 years). Tissue was obtained by wide excision in two patients, by incisional biopsy in one patient and by needle biopsy in the other. Adjuvant radiation therapy was performed on all the patients after their biopsy. The mean diameter of the tumors was 7.6cm(range, 5.5 to 13.0cm). Grossly, tumor was multiobulated, soft and myxoid gelatinous mass. Microscopically, the tumor showed lobulated feature divided by fibrous septa within it. There were physaliphorous cells with vacuolated bubbly cytoplasm. And small uniform, round, and non-vacuolated tumor cells were also present. On immunohistochemical stain, all the cases were immunoreactive for cytokeratin, epithelial membrane antigen(EMA) and vimentin, respectively. One of the 4 cases was positive for S-100 protein. All the cases were negative for CEA.

• Journal of Yeungnam Medical Science
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• v.21 no.1
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• pp.74-81
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• 2004

Purpose: To evaluate the computed tomography (CT) findings of pulmonary cryptococcosis in immunocompetent patients. Materials and Methods: CT scans of 25 patients with biopsy-proven cryptococcosis [surgery (n=3), percutaneous needle biopsy (n=21), and bronchoscopic biopsy (n=1)] were analyzed. Thirteen patients were men and 12 patients were women, with a mean age of 53.7 years. Presenting symptoms were cough, sputum, and dyspnea and 12 patients presented with incidentally found chest radiographic abnormalities. Results: Nodule or multiple conglomerate nodules (n=10, 40%) and segmental or lobular consolidation (n=9, 36%) were most common, followed by mixed patterns (n=5, 20%). Predilection sites were lower lobe (n=21/37, 57%) and subpleural areas (n=23, 92%). Air bronchograms within consolidations (n=11/14, 79%) with mild volume loss (n=10/14, 71%) were common. While interlobular septal thickening (n=11, 44%) and cavitation or central low-attenuations (n=11, 44%) were relatively common, lymphadenopathy (n=2, 8%) or free pleural effusions (n=1, 4%) were uncommon. Conclusion: Nodules or airspace consolidation with a predilection of lower lobe and subpleural area are the most common appearances of pulmonary cryptococcosis in immunocompetent patients.

• The Korean Journal of Cytopathology
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• v.1 no.1
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• pp.43-50
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• 1990

The authors report 16 cases of mediastinal fine-needle aspiration cytology from Jan. 1985 to Mar. 1988 at the Seoul National University Hospital. Among them, diagnostic material were obtained in fifteen cases, establishing the diagnosis of 7 thymomas, 2 germinomas, 2 neurogenic tumosr, 1 lymphoma, and 3 meastatic carcinomas. The 9 cytologic diagnoses could be confirmed by histologic examination in 8 patients and by another cytologic method in one patient, allowing concordance rate of 77%.

• The Korean Journal of Cytopathology
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• v.16 no.1
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• pp.47-51
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• 2005

Plasmablastic lymphoma (PBL) is a recently described aggressive B-cell neoplasm, which usually manifests as a localized disease of the oral mucosa in individuals infected with human immunodeficiency virus (HIV). Recently we encountered a case of plasmablastic lymphoma manifesting in the left maxillary sinus and cervical lymph node of a previously healthy HIV-negative man, 48 years of age. we conducted a fine-needle aspiration smear of the cervical lymph node, and this was found to be highly cellular with numerous large cells exhibiting eccentrically positioned nuclei, prominent nucleoli, and moderate quantities of basophilic cytoplasm. A biopsy of the mass in the maxillary sinus evidenced diffuse growth of similar plasmablastic cells. These tumor cells were negative for the leukocyte common antigens, CD20, CD3, CD30, and EMA. However, the cells tested positive for CD79a and CD138/syndecan-1. The tumor cells also exhibited L-light-chain restriction. The Ki-67 proliferation index was measured at almost 100%. The patient was diagnosed with plasmablastic lymphoma. After three cycles of combination chemotherapy and radiotherapy, the patient went into complete remission, and currently remains in this state.

• The Korean Journal of Cytopathology
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• v.8 no.2
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• pp.109-114
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• 1997

Transbronchial fine needle aspiration(TBNA) is one of the cytologic methods in diagnosing lung cancers. TBNA can be used in cases of hilar, mediastinal or lung masses adjacent to the bronchi. We analyzed and compaired the findings of 27 cases of TBNA and bronchial washing and brushing(BW/BB) in lung cancers confirmed by either biopsy or surgical resection between Jun, 1996 and May, 1997 in Asan Medical Center. They were 18 cases of non-small cell carcinomas(eight squamous cell carcinomas, nine adenocarcinomas, and one large cell undifferentiated carcinoma), eight cases of small cell carcinomas, and one case of metastatic hepatocellular carcinoma. The sensitivity of TBNA was 37%(10/27) and false negative was 63%(17/27). Although the sensitivity of BW/BB w3s 56%(15/27), it was not different statistically from that of TBNA(Chi square, p=0.38). Overall sensitivity of TBNA and BW/BB in this series was 70%(19/27). Forty-seven percent of false negative TBNA(8/17) were positive in BW/BB. The findings suggest that the addition of TBNA to the standard BW/BB increases diagnostic yield in cytologic diagnosis of lung cancer.