• Tuberculosis and Respiratory Diseases
• /
• v.43 no.6
• /
• pp.916-924
• /
• 1996

Bacground : Percutaneous needle aspiration biopsy (PCNA) is one of the most frequently used diagnostic methcxJs for intrathoracic lesions. Previous studies have reponed wide range of diagnostic yield from 28 to 98%. However, diagnostic yield has been increased by accumulation of experience, improvement of needle and the image guiding systems. We analysed the results of PCNA performed for one year to evaluate the diagnostic yield, the rate and severity of complications and factors affecting the diagnostic yield. Method : 287 PCNAs undergone in 236 patients from January, 1994 to December, 1994 were analysed retrospectively. The intrathoracic lesions was targeted and aspirated with 21 - 23 G Chiba needle under fluoroscopic guiding system. Occasionally, 19 - 20 G Biopsy gun was used for core tissue specimen. The specimen was requested for microbiologic, cytologic and histopathologic examination in the case of obtained core tissue. Diagnostic yields and complication rate of benign and malignant lesions were ca1culaled based on patients' chans. The comparison for the diagnostic yields according to size and shape of the lesions was analysed with chi square test (p<0.05). Results : There are 19.9% of consolidative lesion and 80.1% of nodular or mass lesion, and the lesion is located at the right upper lobe in 26.3% of cases, the right middle lobe in 6.4%, the right lower lobe 21.2%, the left upper lobe in 16.8%, the left lower lobe in 10.6%, and mediastinum in 1.3%. The lesion distributed over 2 lobes is as many as 17.4% of cases. There are 74 patients with benign lesions, 142 patients with malignant lesions in final diagnosis and confirmative diagnosis was not made in 22 patients despite of all available diagnostic methods. 2 patients have lung cancer and pulmonary tuberculosis concomittantly. Experience with 236 patients showed that PCNA can diagnose benign lesions in 62.2% (42 patients) of patients with such lesions and malignant lesions in 82.4% (117 patients) of patients. For the patients in whom the first PCNA failed to make diagnosis, the procedure was repeated and the cumulative diagnostic yield was increased as 44.6%, 60.8%, 62.2% in benign lesions and as 73.4%, 81.7%, 82.4% in malignant lesions through serial PCNA. Thoracotomy was performed in 9 patients with benign lesions and in 43 patients with malignant lesions. PCNA and thoracotomy showed the same pathologic result in 44.4% (4 patients) of benign lesions and 58.1% (25 patients) of malignant lesions. Thoracotomy confirmed 4 patients with malignat lesions against benign result of PCNA and 2 patients with benign lesions against malignant result of PCNA. There are 1.0% (3 cases) of hemoptysis, 19.2% (55 cases) of blood tinged sputum, 12.5% (36 cases) of pneumothorax and 1.0% (3 cases) of fever through 287 times of PCNA. Hemoptysis and blood tinged sputum didn't need therapy. 8 cases of pneumothorax needed insertion of classical chest tube or pig-tail catheter. Fever subsided within 48 hours in all cases. There was no difference between size and shape of lesion with diagnostic yield. Conclusion: PCNA shows relatively high diagnostic yield and mild degree complications but the accuracy of histologic diagnosis has to be improved.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.27 no.6
• /
• pp.570-574
• /
• 2005

Keratoacanthoma is a benign, self-limited epithelial lesion that closely resembles Squamous cell carcinoma(SCC). Keratoacanthoma occur primarily exposed skin in male patients over 45 years of ages. although etiology is unknown, sunlight, genetic, and human papillomavirus factor have been considered. in clinical feature, rapid enlargement occurs over 4$\sim$8 weeks, resulting ultimately in a hemispheric, firm, elevated, asymptomatic nodule that contains a central plug of keratin. When fully developed, the keratoacanthoma contains a core of keratin surrounded by a concentric collar of raised skin. Over the next 4$\sim$8 weeks, static lesion persists. Then undergoes spontaneous regression over the next 6$\sim$8weeks period by expulsion of the keratin core with resorption of the mass. In histologic feature, Keratoacanthoma consists of hyperplastic squamous epithelium growing into the underlying connective tissue. The surface is covered by a thickened layer of parakeratin with central plugging. Epithelium cell shows dysplastic features and the margins the normal adjacent epithelium is elevated. The differential diagnosis includes SCC. Keratoacanthoma present as a exophytic lesion with horny keratin occupying a depression on the top of the lesion, persists static period and undergoes rapid growth compared with SCC. Keratoacanthoma is usually treated by surgical excision or curettage of the base, spontaneous regression does not occur in every case. A 60 years old male who present facial lesion visit our hospital and surgical excision was done. Biopsy result was keratoacanthoma. We report case with review of literatures.

• Archives of Craniofacial Surgery
• /
• v.17 no.1
• /
• pp.5-8
• /
• 2016

Background: Lobular keloid appears to be a consequence of hypertrophic inflammation secondary to ear piercings performed under unsterile conditions. We wish to understand the pathogenesis of lobular keloids and report operative outcomes with a literature review. Methods: A retrospective review identified 40 cases of lobular keloids between January, 2005 and December, 2010. Patient records were reviewed for preclinical factors such as presence of inflammation after ear piercing prior to keloid development, surgical management, and histopathologic correlation to recurrence. Results: The operation had been performed by surgical core extirpation or simple excision, postoperative lobular compression, and scar ointments. Perivascular infiltration was noted in intra- and extra-keloid tissue in 70% of patients. The postoperative recurrence rate was 10%, and most of the patients satisfied with treatment outcomes. Conclusion: Histological perivascular inflammation is a prominent feature of lobular keloids. Proper surgical treatment, adjuvant treatments, and persistent follow-up observation were sufficient in maintaining a relatively low rates of recurrence.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.3
• /
• pp.1269-1274
• /
• 2014

Breast tubular adenomas are rare benign breast tumors and detailed descriptions of their sonographic appearance are necessary for differential diagnosis from fibroadenomas or breast cancers. This study investigated twenty-one histology-proved tubular adenomas in 17 patients and also included 48 fibroadenomas in 35 patients as a control group. There was no significant difference between the two groups with clinical presentation, which was age, tumor location, tumor number (p>0.05). Statistic analysis showed three significant factors in the differential diagnosis of tubular adenomas and fibroadenomas, including macro-lobulation (p=0.01), "tiny branch like" patterns (p=0.001) and vascularity (p=0.02). Other ultrasonographic features such as echogenicity, border, uniformity of echotexture, posterior acoustic enhancement, lateral wall shadowing were of no clinical significance (p>0.05). Calcifications were seen in three tubular adenomas which were different from those of carcinomas. Although tubular adenomas have some typical characteristics on sonography, surgery and core needle biopsy are still needed for complex cases to exclude progress to malignancy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.6
• /
• pp.654-659
• /
• 2007

We performed sinus bone graft using some amount of autogenous bone and $BioOss^{(R)}$ and covered the sinus window with $Ossix^{(R)}$ membrane in these case series. After 4 to 6 months after operation, histopathologic examinations of trephine core biopsy showed following results. 1. There were bone density of 39.2% to 41.2% four months after operation, and we could observe the favorable early new bone formation. 2. Active bony remodeling of woven and lamellar bone was observed during 4 to 6 months healing period. 3. There were no significant differences between two groups. And also there were no significant differences between 4 months and 6 months.

• Investigative Magnetic Resonance Imaging
• /
• v.19 no.3
• /
• pp.191-195
• /
• 2015

We present a 53-year-old woman with a large chest wall mass in the interpectoral space, which was eventually confirmed as a lipogranuloma resulting from hydrogel implant rupture. Ultrasonography (US) showed reduced implant volume with surrounding peri-implant fluid collection, suggesting the possibility of implant rupture. A heterogeneously hypoechoic mass was found between the pectoralis major and minor muscles adjacent to the ruptured implant. On magnetic resonance imaging (MRI), there was a large mass in the left interpectoral space of the upper inner chest wall. The mass showed slightly high signal intensity (SI) on pre-contrast T1-weighted image (WI) with mixed iso and high SI on T2-WI. The signal of the mass was suppressed using the water suppression technique but not with the fat suppression technique on T2-WI. The mass showed diffuse enhancement upon contrast enhancement. The enhancing kinetics showed persistent enhancement pattern. US-guided core needle biopsy revealed a lipogranuloma and removal confirmed a ruptured PIP hydrogel implant.

• Journal of Clinical Otolaryngology Head and Neck Surgery
• /
• v.29 no.2
• /
• pp.301-306
• /
• 2018

Immunoglobulin G4-related disease (IgG4RD) is a chronic inflammatory condition characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, as well as varying degrees of fibrosis. We report a case of a 70-year-old man with a rapid-growing cervical mass for several months. Computed tomography and positron emission tomography showed a huge, ill-defined mass involving left thyroid lobe and encasing the common carotid artery, which was clinically and radiologically suspicious for anaplastic thyroid carcinoma. Ultrasonography-guided core needle biopsy was performed and histopathology examination revealed to be consistent with IgG4RD, and the IgG4/IgG ratio was 0.6. After oral corticosteroid was administered, the mass was dramatically resolved. Because IgG4RD often presents as a single localized and infiltrated mass lesion, it can be confused and misdiagnosed as a malignancy. Thus, clinicians should consider IgG4RD as a differential diagnosis in a rapid-growing neck mass to prevent unnecessary and excessive treatments.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.30 no.1
• /
• pp.61-64
• /
• 2019

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Vocal fold paralysis secondary to sarcoidosis is extremely rare but it can develop as a result of compressive lymphadenopathy, granulomatous infiltration, and neural involvement. We report the case of a 56-year-old woman who presented with unilateral vocal fold paralysis and enlarged supraclavicular lymph nodes. Computed tomography of the neck revealed multiple, enlarged, and matted lymph nodes at the cervical level of IV. An ultrasound-guided core needle biopsy of the lymph node was performed, and a histopathological diagnosis of sarcoidosis was made by validating the presence of noncaseating granuloma. After implementation of steroid therapy, the patient exhibited immediate recovery from vocal fold paralysis. Although an extremely rare disease, sarcoidosis should be included in the differential diagnosis of vocal fold paralysis. Accurate diagnosis and prompt steroid treatment may reduce the morbidity of patients with vocal fold paralysis secondary to sarcoidosis.

• Journal of the Korean Society of Radiology
• /
• v.84 no.5
• /
• pp.1176-1180
• /
• 2023

Granular cell tumors (GCTs) are rare soft tissue tumor, originating from neural or perineural cells. We present a case of axillary GCT in a 69-year-old woman with breast cancer history and discuss the various radiologic findings. US revealed a circumscribed oval heterogeneous iso- and hyperechoic mass in the left axilla. Chest CT showed a well-defined, oval, and mildly enhancing mass in the left axilla on the lateral aspect of the pectoralis muscle. A final diagnosis of GCT was made through US-guided core needle biopsy. Follow-up US showed no significant changes in the axillary GCT. Familiarity with GCT may facilitate early diagnosis and subsequent management.

• Korean Journal of Radiology
• /
• v.20 no.6
• /
• pp.947-955
• /
• 2019

Degenerating nodules (DNs), which primarily manifest as benign thyroid nodules, are one of the main causes of discordance in ultrasonography (US) and cytological assessments. Intranodular hemorrhage is one of the mechanisms contributing to discordant nodules, and an impaired blood supply may explain further DN shrinkage and infarction. The surgical specimens can be divided into acute and chronic stages based on the histological changes, which usually mimic the US features of malignant tumors. Serial US follow-up should be recommended instead of other unnecessary procedures. However, repeated fine-needle aspiration, diagnostic surgery, or core-needle biopsy may still be necessary for indeterminable or highly suspicious DNs.