• Title/Summary/Keyword: biopsy grade

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The Western and Oriental Medical approach to gastric diseases (위장관 질환에 대한 양, 한방적인 접근)

  • Lee, Yong-Koo
    • Journal of Haehwa Medicine
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    • v.8 no.1
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    • pp.827-836
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    • 1999
  • Numerous persons complained dyspepsia even though no specific objective findings are revealed by imaging study, laboratory examinations and other clinical research. To find out of so many symptoms what they are, I would to approach by two ways. One way is oriental medical literatural study and the other is Helicobacter pylori infection that is accepted as one of most important causal factors of many gastric diseases. Background/Aims: Recently, the role of Helicobacter pylori as a causal factor in the etiology of gastric cancer, peptic ulcer, gastritis and low-grade gastric mucosa-associated lymphoid tissue(MALT) lymphoma is well known. Using endoscopy, biopsy urease testing and histology are recommanded as the tests of choice. Serological test is not recommanded at the moment because of its low sensitivity and espicially low specificity. The urea breath test is more sensitive and specific noninvasive test than serologic test, but it is not widely available yet. Methods/Results: We studied 90 cases by diagnostic endoscopy as a screening test for the persons complaining gastrointestinal symptoms. As a result eighteen persons are revealed to be Helicoacter pylori infected histologicaly. Conclusion: More specific literatural studies are requied.

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Atypical periosteal reaction and unusual bone involvement of ameloblastoma: A case report with 8-year follow-up

  • Charoenlarp, Pornkawee;Silkosessak-Chaiudom, Onanong;Vipismakul, Vichittra
    • Imaging Science in Dentistry
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    • v.51 no.2
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    • pp.195-201
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    • 2021
  • Unusual radiographic findings of intraosseous ameloblastoma have been reported and discussed. In the case discussed herein, cone-beam computed tomography (CBCT) clearly showed many radiographic features that were ambiguous on conventional radiographs, including an ill-defined periphery, extensive superficial buccal extension with minimal lingual extension, obvious bucco-crestal expansion, and multiple triangular (Codman's triangle-like) areas of periosteal reaction. Based on the above-mentioned findings, the differential diagnosis was a long-term infected benign or low-grade malignant lesion. An incisional biopsy was performed, and the histopathologic diagnosis was acanthomatous ameloblastoma. Recurrence of the lesion was clearly detected on CBCT images at 4 and 8 years after surgery. These unusual radiographic findings have never been reported to be associated with ameloblastoma, and thus may contribute to novel concepts in radiographic interpretation in the future. This report also underscores the important role played by CBCT as a comprehensive diagnostic tool and for definite confirmation of recurrence.

A Case of Bronchiolitis Obliterans Organizing Pneumonia After Thoracotomy (개흉술후 발생한 Bronchiolitis Obliterans Organizing Pneumonia 체험 1례)

  • 원경준;박종호;백희종;이향림;조재일
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.1040-1043
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    • 1997
  • We report a patient who suffered from bronchiolitis obliterans organizing pneumonia(BOOP) after Ivor Lewis operation for esophageal cancer. The patient presented low grade fever, dry cough and mild dyspnea at day after operation. Chest roentgenograms and chest CT revealed bilateral patchy and infiltrative shadows. The respiratory symptoms worsened and respiratory failure developed with mild elevation of WBC count despite of conservative treatment. An open lung biopsy was done and the biopsy specimen showed bronchiolitis obliterans organizing pneumonia(BOOP). After several weeks of steroid therapy, there were marked clinical, physiological and roentgenographic improvements. Our experience suggests that BOOP may be one of the underlying pathology in a number of patients presenting with ARDS after thoracotomy. Since steroid therapy may improve survival in these patients, thoracic surgeons should heighten their index of suspicion for this entity. Early histologic diagnosis should be considered in patients with treatment-resistant ARDS after thoracotomy.

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Correlation Of Human Papillomavirus Infection and Postmenopausal Squamous Atypia in Cervical Cytology (자궁경부 세포진에서 인유두종바이러스감염과 폐경후 편평세포 비정형성과의 연관성)

  • Chun, Yi-Kyeong;Moon, In-Gul;Hong, Sung-Ran;Kim, Hye-Sun;Choi, Jong-Sun;Park, Ji-Young;Park, Jong-Sook;Kim, Tae-Jin;Kim, Hy-Sook
    • The Korean Journal of Cytopathology
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    • v.15 no.2
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    • pp.81-85
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    • 2004
  • Postmenopausal squamous atypia (PSA) is a phenomenon characterized by cellular alterations mimicking condyloma in the uterine cervix of postmenopausal women. It is not associated with human papillomavirus (HPV) infection. The aim of this study is to correlate findings with HPV infection and the cytohistologic findings of PSA. Eighty-three smears from postmenopausal women, initially interpreted as ASCUS and low-grade squamous intraepithelial lesions(LSIL), were reviewed according to the criteria of PSA. Fifty-eight cases were subsequently reclassified as PSA. Forty cases categorized as PSA were available for HPV-DNA detection by a nested polymerase chain reaction. Eight of these 40 cases(20%) showed biopsy-proven LSIL lesions. The HPV-DNA was detected in 42.5%(17/40), compared to 25%(5/20) of control cases. The HPV-DNA detection rate of biopsy-proven LSIL was 62.5%(5/8). It has been concluded that cytologic differential diagnosis of PSA from LSIL is difficult due to because of poor histologic and viral correlation.

The Role of Thallium-201 Scintigraphy in Bone and Soft Tissue Tumor (근골격계 종양에서 탈륨 스캔의 역할)

  • Shin, Duk-Seop
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.117-128
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    • 2003
  • Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

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Case Report of Verrucous Carcinoma Arising in Sacral Pressure Sore (천골욕창에 발생한 우췌양 암종 1례)

  • Jeong, Jaehoon;Heo, Chan Yeong;Kwon, Soon Sung;Baek, Rong Min;Minn, Kyeong Won
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.520-523
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    • 2007
  • Purpose: Verrucous carcinoma is a rare, low-grade and well-differentiated squamous cell carcinoma, representing as a warty tumor. Estimation of the incidence for cutaneous lesions is not available because they are rare. We describe a case of verrucous carcinoma, a rare type, complication of a chronic pressure ulcer of duration more than 15 years. Methods: A 17-year-old boy presented with a large lesion involving the sacral area, which had been neglected for about 15 years. He had a history of surgical extirpation 2 years ago, but not cured. Examination revealed a cauliflower-like mass arising from an irregularly oval-shaped tumor which was $6.0{\times}4.5cm$ in size with signs of infection and ulcer. The lesion involved the sacrococcygeal area, spreading to both medial gluteal regions. The perianal skin did not appear to be directly affected. Results: A preoperative punch biopsy revealed a extremely well differentiated verrucous carcinoma. There were positive results in immunohistochemistry in the items of p53, p63, Ki-67. An 'en-bloc' excision of the tumor with the clinically normal surrounding tissue was carried out. Reconstruction was achieved by local regional flap. Histopathological findings of the excised area fully confirmed the preoperative biopsy report. It remained free of recurrence for a period of about 8 months. Conclusion: We believe that in patients with buttock involvement, regardless of the extent of such tumors, surgical therapy should be considered as the first-choice of treatment as reconstruction can be performed without excessive impairment for the patient.

Diagnostic and Prognostic Relevance of Bone Marrow Microenvironment Components in Non Hodgkin's Lymphoma Cases Before and After Therapy

  • Soliman, Amira H
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5273-5280
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    • 2016
  • Objective: To evaluate stromal cells of the bone marrow microenvironment (BMM) in bone marrow trephine biopsy (BMTB) specimens, with a focus on fibronectin, tumor necrosis factor- alpha (TNF-${\alpha}$) and L-selectin in Non-Hodgkin's lymphoma (NHL) patients, before and after therapy. Materials and Methods: A total of 80 de novo NHL patients, 64 with B-cell lymphomas 80%, (follicular cell lymphoma (FCL) in 32, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) in 12, and diffuse large cell lymphoma in 20) and 16 with T-cell lymphomas (20%) all diagnosed as T-Lymphoblastic lymphomas, were evaluated before and after therapy. For comparison, 25 age and sex matched BM donors, were included as a control group. BMTB material and BM aspirates were taken for morphological assessment of stromal cells, the plasma of these samples being examined for $TNF{\alpha}$ and L-selectin by ELISA, and fibronectin by radial immunodiffusion (RID). Results: BM stromal cells comprising reticular macrophages and fibroblasts were elevated in 53.3% of NHL cases at diagnosis, while BM fibronectin levels were decreased and BM $TNF{\alpha}$ and L-selectin were higher than in controls (p<0.05). In NHL cases, elevated values of BM $TNF{\alpha}$ and BM L-selectin were associated with signs of aggressive disease, including >1 extra nodal sites, detectable B symptoms, high grade, BM and CNS invasion, and a high International prognostic index (IPI) (p<0.05). Conclusion: BMM components, $TNF{\alpha}$, L-selectin and fibronectin, in NHL can be useful in evaluating disease activity, extent and response to treatment and as prognostic markers according to the IPI.

Angiocentric Immunoproliferative Lesions(AILs) in Nose (코의 Angiocentric Immunoproliferative Lesions(AILs))

  • Han Ji-Youn;Kim Jae-You;Lee Youn-Soo;Chung Su-Mee;Kim Min-Shik;Yoon Sei-Chul;Kim Hoon-Kyo;Cho Seung-Ho;Kim Byung-Kee;Lee Kyung-Shik;Kim Dong-Jip
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.16-21
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    • 1996
  • Lymphomatoid granulomatosis, polymorphic reticulosis, midline malignant reticulosis, or lethal midline granuloma have similar histologic features of an angiocentric and angiodestructive lymphoreticular proliferation representing the same nosologic entity. The term 'angiocentric immunoproliferative lesion' (AIL) was proposed by Jaffe, Costa, and Martin. The malignant potential of AILs is originally uncertain, but the facts that AILs have a relatively short survival, and most of them usually progress to an overt malignant lymphoma and survival is inversely proportional to the large, atypical lymphoreticular cells suggest that AILs are malignane. We experienced 17 AILs in nose during 16-year period and retrogradely analized them to recognize the problems in the diagnosis and to establish the further therapeutic strategies. The results were as follows; Twelve of total 17 patients who had diagnosed as histologic grade 1 and 2 had received radiation therapy as an initial treatment and the complete response rate was 91.7%(11/12), but 6 out of 11 had local recurrence and 5 had progress to overt maligant lymphoma within 2years. Three patients with the histologic grade 3 and 2 with unclear histologic grade had received CHOP chemotherapy and there was 1 case with complete response. Two patients with unclear histologic grade had been proved to be malignant histiocytosis by bone marrow biopsy during the clinical course. The overall duration of survival was 2 - 119 months and the 5-year survival rate was 71.9%. And the achievement of initial complete response was the most important prognostic factor of overall survival(P=0.006). Our results suggest that the treatment strategy according to the histologic grading scheme is efficient and more aggressive combination chemotherapy may be necessary to achieve complete response in patients with histologic grade III and II, because most of them progress to overt malignant lymphoma during its process.

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Patterns of care and treatment outcomes for primary thyroid lymphoma: a single institution study

  • Cha, Hyejung;Kim, Jun Won;Suh, Chang-Ok;Kim, Jin Seok;Cheong, June-Won;Lee, Jeongshim;Keum, Ki Chang;Lee, Chang Geol;Cho, Jaeho
    • Radiation Oncology Journal
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    • v.31 no.4
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    • pp.177-184
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    • 2013
  • Purpose: The aim of this study was to analyze the patterns of care and treatment outcomes in patients with primary thyroid lymphoma (PTL) in a single institution. Materials and Methods: Medical records of 29 patients with PTL treated between April 1994 and February 2012 were retrospectively reviewed. Diagnosis was confirmed by biopsy (n = 17) or thyroidectomy (n = 12). Treatment modality and outcome were analyzed according to lymphoma grade. Results: The median follow-up was 43.2 months (range, 3.8 to 220.8 months). The median age at diagnosis was 57 years (range, 21 to 83 years) and 24 (82.8%) patients were female. Twenty-five (86.2%) patients had PTL with stage IEA and IIEA. There were 8 (27.6%) patients with mucosa-associated lymphoid tissue (MALT) lymphoma and the remaining patients had high-grade lymphoma. Patients were treated with surgery (n = 2), chemotherapy (n = 7), radiotherapy (n = 3) alone, or a combination of these methods (n = 17). Treatment modalities evolved over time and a combination of modalities was preferred, especially for the treatment of high-grade lymphoma in recent years. There was no death or relapse among MALT lymphoma patients. Among high-grade lymphoma patients, 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 75.6% and 73.9%, respectively. Complete remission after initial treatment was the only significant prognostic factor for OS (p = 0.037) and PFS (p = 0.003). Conclusion: Patients with PTL showed a favorable outcome, especially with MALT lymphoma. Radiotherapy alone for MALT lymphoma and chemotherapy followed by radiotherapy for high-grade lymphoma can be effective treatment options for PTL.

A Case Report of the Primary Lung Lymphoma (폐 종괴로 발현한 원발성 폐림프종 치험 1예)

  • Kim, Ye-Ree;Youn, Seong-Yuk;Yoo, Kwang-Ha;Ahn, Chul-Min;Kim, Hyung-Joong;Jin, Choon-Jo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.272-278
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    • 1999
  • The primary lymphoma in the lung is very rare. Moot of the primary pulmonary lymphomas, which represent 3-4 % of extra-nodal lymphomas, are low-grade B-cell lymphoma. The low-grade B-cell lymphomas progress slowly and the prognosis of these are more favorable than that of the nodal lymphomas. However, high-grade forms progress rapidly with more severe course. The diagnosis of primary pulmonary lymphomas generally relies on the histopathologic findings of lung specimens obtained by surgical excision of the lesions or open-lung biopsy. Recently, less aggressive biopsies(transbronchial, transthoracic) and/or immunocyto-chemical, immunochemical and gene rearrangement studies on materials obtained by bronchoalveolar lavage have been used occasionally. The treatment of the primary pulmonary lymphomas has not been precisely codified. Several clinical data suggest that limited surgery or non-aggressive chemotherapy can provide long-term survival in patients with such slowly developing neoplasm, and demonstrated the need for the development of noninvasive diagnootic methods. In this study, we report a case of high-grade B-cell lymphoma of the lung which was treated with combination chemotherapy.

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