• The Korean Journal of Cytopathology
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• v.19 no.1
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• pp.41-46
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• 2008

In an attempt to better define the cytologic characteristics of schwannomas, we have reviewed aspirates and corresponding histologic sections from 23 schwannomas. Of this number, the original cytologic diagnoses were: schwannoma in 14 cases (61%), benign soft tissue tumor in 2 cases (9%), and insufficient specimen in 7 cases (30%). The cytologic findings common to all cases of schwannoma included fragments of tightly cohesive fascicles with variable cellularity and corresponding Antoni type A area. The Antoni type B area, consisting of scattered spindle cells and some histiocytes and lymphocytes against a myxoid background, was seen in 14 cases. Fibrillary stroma was seen in 12 cases. The tumor cells had spindle- or ovalshaped nuclei, with pointed ends and indistinct cell borders. Nuclear palisading was seen in 10 cases, and distinctive Verocay bodies were seen in 5 cases. In ancient schwannomas, there were no Verocay bodies. Most schwannomas have distinct cytomorphologic features that allow correct diagnosis. The major problem with fine needle aspiration cytology of these tumors is the high frequency of poor cellularity, particularly in lesions with cystic degeneration. Of 7 cases with insufficient specimen, 4 showed marked cystic changes and 1 showed marked hyaline changes on histologic sections. In conclusion, we believe that if cytopathologist reminds the situation such as cystic degeneration or hyaline degeneration, the correct diagnosis of the schwannoma will be easily made.

• The Korean Journal of Cytopathology
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• v.17 no.1
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• pp.27-31
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• 2006

Periductal mastitis is a specific clinicopathologic entity, and is referred to by several names: recurrent subareolar abscess, squamous metaplasia of the lactiferous duct, and Zuska's disease. Clinically, the differentiation of periductal mastitis from other benign lesions and carcinomas around the nipple frequently proves a difficult proposition. We reviewed the fine needle aspiration cytology (FNAC) of 14 cases of periductal mastitis, which had been diagnosed either radiologically, histologically, or clinically. The patient group included 13 female patients, and one male. The majority of the patients in this group had presented with subareolar masses. All cases evidenced characteristic anucleated squamous cell clusters within a mixed inflammatory background. A diagnosis of periductal mastitis can be rendered fairly readily on excisional biopsy. However, FNAC is considered to be superior to excisional biopsy as an initial diagnostic procedure for any palpable mass in subareolar lesions of the breast. FNAC can also be a useful diagnostic technique in cases of periductal mastitis, even in the early phases of the disease. A definitive diagnosis of subareolar abscess via FNAC will enable the clinician to select the most appropriate medical or surgical treatment.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.168-172
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• 2002

Objectives: This study was done to determine the diagnostic efficacy of fine needle aspiration cytology (FNA), frozen section biopsy (FSx) and ultrasonography in a palpable thyroid mass. Materials and Methods: During the period from July 1999 to March 2002, the medical records of 98 patients who underwent a thyroidectomy for thyroid mass, at the Department of Surgery, Chonbuk National University Hospital, were reviewed retrospectively. Ninety eight cases were classified according to whether the FNA cytological diagnosis inadequate, benign, suspicious, or malignant and the FSx diagnosis benign or malignant and the ultrasonographic examination was benign, suspicious, or malignant. The diagnostic correlations of ultrasonography, FNA cytology, frozen section, and both FNA cytology and frozen section with definite histologic diagnosis were evaluated. Results: According to the FNA cytological interpretation, 76 cases were diagnosed as benign, 6 cases suspicious, 13 cases malignant, and 3 cases inadequate. The sensitivity and specificity for FNA were 86.3% and 95.9% and for FSx 95.5% and 100% respectively. The diagnostic accuracy of FNA and FSx were 93.5% and 98.9% respectively. Based on a definite histologic diagnosis, the ultrasonographic examination had a sensitivity and a specificity of 77.2% and 78.9%. Conclusion: The results confirm that FNA cytology is a reliable and useful tool in the initial evaluation of a palpable thyroid mass compared to the ultrasonographic examination. Intraoperative FSx is a valuable diagnostic procedure to confirm the cytological diagnosis with undetermined or unsatisfactory cytological diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7769-7773
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• 2014

Background: Some tumor types are related to HIV, including non-Hodgkin lymphoma (NHL). The morbidity and mortality of NHL has remained high, even after highly active antiretroviral therapy (HAART) was introduced. We collected cases of AIDS with NHL, and evaluated the imaging features and strategies for diagnosis. Materials and Methods: There were 27 patients with AIDS and tumors confirmed by pathology. There were 9 patients with Burkitt lymphoma, 16 with diffuse large B cell lymphomas (DLBCLs), and 2 with primary central nervous system (PCNS) lymphomas. All of the patients underwent a series of imaging studies. Three radiologists analyzed the images, and any disagreement was discussed until consensus was reached. Results: The radiologic manifestations of AIDS with NHL were mainly masses and lymphadenopathy, 3 patients having one mass and 12 two or more masses. 7 patients had lymphadenopathy in one site and 3patients had lymphadenopathy in two or more sites. Coarse mucosal folds, thickening of the gastrointestinal wall, and lumen narrowing were typical manifestations of NHL within the gastrointestinal tract. There were 4 patients with masses and 5 with lymphadenopathy inthe 9 with Burkitt lymphoma, and 11 patients with masses 5 with lymphadenopathy in the 16 with DLBCLs. Conclusion: NHL is a malignancy that usually occurs in patients with AIDS. Imaging is an important method by which to evaluate lesions, masses, and lymphadenopathy. Fine needle aspiration biopsy and stereotaxis biopsy are useful methods by which to diagnose NHL.

• Tuberculosis and Respiratory Diseases
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• v.38 no.1
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• pp.45-52
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• 1991

Clinical analysis was performed on 306 patients with cervical lymphadenopathy who were diagnosed histologically by fine needle aspiration biopsy cytology (FNABC) and/or excisional biopsy from Jan 1986 to Jan 1990 at Hanyang University hospital. The results obtained were as follows: 1) Of 306 patients with cervical lymphadenopathy, 216 (70.6%) were inflammatory lesions, and 90 (29.4%) malignant lesions. Tuberculous lymphadenitis of inflammatory lesions was most common (134 cass: 62%). Of malignant lesions, metastatic cancer was more frequent (75 cases: 83.3%). 2) The sex ratio were as follows: inflammatory lesion; M:F=1 : 1.8 (tuberculous lymphadenitis;M : F=1:2.3) malignant lesion; M : F=1.5 : 1 (metastatic cancer; M : F=2.6 : 1) 3) The peak age of inflammatory lymphadenopathy was 20-29 years old (38.9%), and that of malignant lesion 50-59 years old (46.7%). 4) In more than half of tuberculous lymphadenitis and metastatic cancer, the location of enlarged lymph nodes was one side of the neck and the number was more than one. 5) The common primary sites of metastatic cancer were lung and stomach. In 11 cases (14.7%), the primary site could not be found. 6) The sensitivity and the specificity of fine needle aspiration biopsy cytology (FNABC) was 0.83 & 1.0 in metastatic cancer respectively.

• Korean Journal of Clinical Laboratory Science
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• v.46 no.3
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• pp.99-105
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• 2014

Isolating total DNA from small samples using traditional methods is difficult and inefficient mainly due to loss of DNA during filtration and precipitation. With advances in molecular pathology, DNA extraction from micro-dissected cells has become essential in handling clinical samples. Genomic DNA extraction using small numbers of cells can be very important to successfully PCR amplify DNA from small biopsy specimens. We compared our experimental genomic DNA extraction method (A) with two other commercially available methods: using spin columns (B), and conventional resins (C), and determined the efficacy of DNA extraction from small numbers of cells smeared on a glass slide. Approximately 50, 100, 200, 500 and 1000 cells were isolated from fine needle aspiration biopsy (FNAB) slides aspirated from histologically proven papillary thyroid carcinoma masses. DNA was extracted using the three techniques. After measuring DNA quantity, PCR amplification was performed to detect the ${\beta}$-globin and $BRAF^{V600E}$ gene mutations. DNA extracted by method (A) showed better yield than the other methods in all cell groups. With our method, a suitable amount of genomic DNA to produce amplification was extracted from as few as 50 cells, while more than 100 to 200 cells were required when methods (B) or (C) were applied. Our genomic DNA extraction method provides high quality and improved yields for molecular analysis. It will be especially useful for paucicellular clinical samples which molecular pathologists often confront when handling fine needle aspiration cytology, exfoliative cytology and small biopsy specimens.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.3611-3615
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• 2012

Objective: The objective of this study was to establish the diagnostic accuracy, specificity and sensitivity of fine needle aspiration cytology(FNAC) for intra-oral tumors, comparing with histopathology as the gold standard. Materials and methods: Forty cases of FNA cytology from intraoral tumors was performed in AFID along with the demographic data and clinical information and then diagnosed at AFIP, Rawalpindi. Then the cytology results obtained per FNAC were compared with the histopathological biopsy results of the same lesions. The following variables were recorded for each patient: Age, gender, site of biopsy, diagnosis. The data were entered and analyzed using Open-epi version 2.0. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Cohen Kappa was further applied to compare the agreement between the biopsy and FNAC diagnoses. A p-value of < 0.05 was considered as statistically significant. Results: Among the total patients included in the study there were 24 males and 16 females, with a ratio of 1.5:1. Age of the patients ranged from 24 to 80 years with a mean of 52 years. A total of six sites were aspirated from the oral cavity with maximum (11) aspirates taken from alveolar ridge. The results of FNAC revealed that there were 32 malignant and 8 benign aspirates. Confirmation through histopathological analysis came for 31/32 malignant cases while one was falsely given positive for malignancy on FNAC. Among a total of 40 cases, 31(77%) cases diagnosed were found to be malignant and remaining 9(23%) were benign. The FNAC results revealed 32 malignant and 8 benign lesions. Histopathology of the subsequent surgically excised specimen showed malignant lesions in 31(77%) and benign in 9(23%) patients. As a whole, it was found that the absolute sensitivity for introral FNAC was 100% and specificity 89% with positive predictive value of 97% and negative predictive value of 100%. Conclusion: Cytological diagnosis was almost corroborative with final histopathological diagnosis in all cases, with very few exceptions, exhibiting high diagnostic accuracy.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4973-4976
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• 2016

Objective: This article concerns evaluation of the sensitivity, specificity and accuracy of FNAB for pre-surgical diagnosis of benign and malignant lesions of major and minor salivary glands of patients treated in the Department of Head and Neck Surgery of Erasto Gartner Hospital. Methods: This retrospective study analyzed medical records from January 2006 to December 2011 from patients with salivary gland lesions who underwent preoperative FNAB and, after surgical excision of the lesion, histopathological examination. Results: The study had a cohort of 130 cases, but 34 cases (26.2%) were considered unsatisfactory regarding cytology analyses. Based on the data, sensitivity was 66.7% (6/9), specificity was 81.6% (71/87), accuracy was 80.2% (77/96), the positive predictive value was 66,7% (6/9) and the negative predictive value was 81.6% (71/87). Conclusion: Despite the high rate of inadequate samples obtained in the FNAB in this study the technique offers high specificity, accuracy and acceptable sensitivity.

• The Korean Journal of Cytopathology
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• v.18 no.2
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• pp.161-164
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• 2007

Metastasis to the thyroid gland is very rare in clinical practice. We recently encountered a 65-year-old woman who presented with a large thyroid nodule that mimicked the cytologic features of a papillary thyroid carcinoma on fine needle aspiration biopsy (FNAB). Although initially diagnosed as a papillary thyroid carcinoma, a thorough clinical work-up revealed multiple lesions in the bones, liver, and nasal cavity, which were confirmed as metastases of a malignant melanoma. Despite a thorough physical examination, however, the primary skin lesion could not be identified. Although FNAB shows a high degree of accuracy in diagnosing primary thyroid tumors, it is less accurate in diagnosing metastases to the thyroid gland. A thorough clinical history with appropriate immunohistochemical staining assays is necessary for the accurate diagnosis of metastatic malignant melanoma.