• Title/Summary/Keyword: Ultrasound-guided fine needle aspiration cytology

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The Usefulness of Ultrasound-Guided Fine Needle Aspiration Cytology of Impalpable Neck Nodes in Patients with Lung Cancer (폐암 환자에서 촉진되지 않는 경부 림프절에 대한 초음파 유도 하 세침흡인 세포검사의 유용성)

  • Kim, Hee Kyoo;Ha, Seung In;Kim, Yu Ri;Park, Chan Bog;Oak, Chul Ho;Jang, Tae Won;Jung, Maan Hong;Oh, Kyung Seung;Chun, Bong Kwon;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.505-513
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    • 2004
  • Background : In lung cancer patients, the presence of metastatic neck nodes is a crucial indicator of inoperabilty. So thorough physical examination of neck is always mandatory, but sometimes those are hardly palpable even by the skillful hand. Ultrasonography is a useful diagnostic method in detection of small impalpable lymph nodes and in guidance of fine needle aspiration biopsy. In this study we evaluated the clinical usefulness of ultrasonography(USG) and ultrasound-guided fine needle aspiration cytology(US-FNA) in lung cancer patients without palpable neck nodes. Methods and Materials : From Sep 2002 to Sep 2003, 36 non-small cell lung cancer patients (20 adenocarcinoma, 16 squamous cell cancer) and 10 small cell lung cancer patients without palpable neck nodes on physical examiation were enrolled. patients who had contralateral mediastinal nodal enlargement(>1cm) on chest CT were excluded. After the routine check of USG on the neck, US-FNA was done in cases with enlarged neck nodes (${\geq}5mm$ in the short axis). The presence of enlarged lymph node on USG, and of malignant cells on cytology were evaluated by the histological type and the patients' clinical stage of lung cancer. Results : Among 36 non-small lung cell cancer patients, 14 (38.8%) had enlarged neck nodes on USG, and 5 of 10 small cell lung carcinoma patients. The mean diameter of the neck nodes was 9.8 mm (range, 7-12 mm). US-FNA of 14 non-small cell lung cancer patients revealed tumor cells in eight patients (57.1%). In 5 small cell lung cancer pateints, tumor cells were found in all cases. By the result of US-FNA, the clinical stage of 8 out of 36 (22.2%) non-small cell lung cancer patients had changed, including two cases of shift from the operable IIIa to the inoperable IIIb. In small cell lung cancer patients their clinical stage was not changed after US-FNA, but their pathological diagnosis was easily done in two cases, in whom endobronchial lesions were not found on bronchoscopy. Conclusions : USG and US-FNA of neck node seem to be safe, sensitive and cost-effective diagnostic tools in the evaluation of lung cancer patients without palpable neck nodes.

Successful remission with L-CHOP for primary mediastinal B-cell lymphoma in a young Maltese dog

  • Chang, Seiyoung;Kim, Hakhyun;Kang, Ji-Houn;Kang, Byeong-Teck;Chang, Dongwoo;Na, Ki-Jeong;Yang, Mhan-Pyo
    • Journal of Biomedical and Translational Research
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    • v.19 no.4
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    • pp.140-145
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    • 2018
  • A one-year-old, intact female, Maltese dog was presented with a history of anorexia and regurgitation. Thoracic radiographs and ultrasonography scans suggested an abnormal mass in the cranial mediastinal region, and computed tomography confirmed the origin of this mass. Ultrasound-guided fine needle aspiration cytology showed the presence of intermediate to large lymphoid cells showing mitotic figures. B-cell lymphoma was confirmed by the result of a polymerase chain reaction assay for antigen receptor rearrangement, therefore the patient was diagnosed with primary mediastinal large B-cell lymphoma (PMBL). The patient underwent L-CHOP (L-asparaginase, cyclophosphamide, doxorubicin, vincristine, prednisolone)-based chemotherapy, and showed complete tumoral remission from the beginning of chemotherapy. Seventytwo weeks after the completion of chemotherapy, the patient is still alive without any evidence of metastasis or relapse. A standardized treatment protocol has yet to be established for primary mediastinal lymphoma in dogs. This case report describes the complete remission of PMBL by an L-CHOP-based chemotherapy protocol in a young Maltese. Clinicians should consider that L-CHOP based chemotherapy may be useful against PMBL in dogs.

Diagnostic Value of CYFRA 21-1 Measurement in Fine-Needle Aspiration Washouts for Detection of Axillary Recurrence in Postoperative Breast Cancer Patients (유방암 수술 후 액와림프절 재발 진단에 있어서의 미세침세척액 CYFRA 21-1의 진단적 가치)

  • So Yeon Won;Eun-Kyung Kim;Hee Jung Moon;Jung Hyun Yoon;Vivian Youngjean Park;Min Jung Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.147-156
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    • 2020
  • Purpose The objective of this study was to evaluate the diagnostic value and threshold levels of cytokeratin fragment 21-1 (CYFRA 21-1) in fine-needle aspiration (FNA) washouts for detection of lymph node (LN) recurrence in postoperative breast cancer patients. Materials and Methods FNA cytological assessments and CYFRA 21-1 measurement in FNA washouts were performed for 64 axillary LNs suspicious for recurrence in 64 post-operative breast cancer patients. Final diagnosis was made on the basis of FNA cytology and follow-up data over at least 2 years. The concentration of CYFRA 21-1 was compared between recurrent LNs and benign LNs. Diagnostic performance and cut-off value were evaluated using a receiver operating characteristic curve. Results Regardless of the non-diagnostic results, the median concentration of CYFRA 21-1 in recurrent LNs was significantly higher than that in benign LNs (p < 0.001). The optimal diagnostic cut-off value was 1.6 ng/mL. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CYFRA 21-1 for LN recurrence were 90.9%, 100%, 100%, 98.1%, and 98.4%, respectively. Conclusion Measurement of CYFRA 21-1 concentration from ultrasound-guided FNA biopsy aspirates showed excellent diagnostic performance with a cut-off value of 1.6 ng/mL. These results indicate that measurement of CYFRA 21-1 concentration in FNA washouts is useful for the diagnosis of axillary LN recurrence in post-operative breast cancer patients.

Correlation of Ultrasonographic Findings and Cytologic or Histopathologic Diagnoses of Splenic Lesions in Dogs : 124 cases (개에서 비장 병변의 초음파 소견과 세포학 및 조직병리 진단과의 상관관계 : 124 마리)

  • Kim, Jun-Young;Lee, Nam-Soon;Choi, Mi-Hyun;Kim, Wan-Hee;Youn, Hwa-Young;Hwang, Cheol-Yong;Kim, Dae-Yong;Lee, In-Hyung;Choi, Min-Cheol;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.134-140
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    • 2012
  • This retrospective study was performed to describe and evaluate ultrasonographic characteristics of splenic disorders and to pursue any relationship with cytologic or histopathologic diagnoses. Medical records were reviewed for patients that had undergone both abdominal ultrasonographic procedures and ultrasound-guided fine-needle aspiration (FNA) or surgical biopsy of splenic lesions or necropsy from January 2002 to July 2011 at Seoul National University Hospital for Animals. Total 124 dogs, 76 cases with FNA and 48 cases with biopsy, were available for this investigation. The age of dogs ranged from 2 to 17 years ($mean{\pm}SD$ = $9.54{\pm}3.34$ years), with the gender distribution of 61 females (26 spayed) and 63 males (40 neutered). In breed distribution, 114 were purebred dogs and 10 were mixed breed dogs. The dogs represented 26 breeds, with 113 dogs categorized into small-sized breeds. The ultrasonographic appearances of splenic disorders could be classified into 10 types including normal appearance, depending on the distribution and echogenicity of splenic lesions as well as the increase in spleen size and diffuse parenchymal changes. Among 124 cases, 44 (35.4%) had hypoechoic nodules/masses with the highest frequency, followed by 23 (18.5%) with multiple small hypoechoic nodules. Of 124 cases, 70 (56.5%) were benign and 54 (43.5%) were malignant lesions at cytologic or histopathologic results. Each ultrasonographic appearance had variable cytologic or histopathologic diagnoses. However, diffuse heterogenicity and diffuse hypoechogenicity were significantly associated with malignancy (p < 0.05), whereas hyperechoic nodules/masses were more often associated with benignity (p < 0.05). Based on our results, it may be considered that the ultrasonographic examination for spleen could be able to provide the least information necessary for benign and malignant lesions in prioritizing differential diagnoses.