• Title/Summary/Keyword: ultrasound guided aspiration

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The role of needle-based confocal laser endomicroscopy in the diagnosis of pancreatic neuroendocrine tumors

  • Masanori Yamada;Kazuo Hara;Nobumasa Mizuno;Shin Haba;Takamichi Kuwahara;Nozomi Okuno;Yasuhiro Kuraishi;Takafumi Yanaidani;Sho Ishikawa;Tsukasa Yasuda;Toshitaka Fukui
    • Clinical Endoscopy
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    • v.57 no.3
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    • pp.393-401
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    • 2024
  • Background/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a highly accurate method for diagnosing pancreatic neuroendocrine tumors (PNETs); however, some PNETs are difficult to diagnose. Recently, the efficacy of needle-based confocal laser endomicroscopy (nCLE) in diagnosing solid pancreatic masses has been reported. However, the efficacy of nCLE in the diagnosis of PNETs remains unknown and only a small number of cases have been reported. Hence, this study aimed to evaluate the efficacy of nCLE in the diagnosis of PNETs. Methods: This single-center retrospective study evaluated 30 consecutive patients with suspected PNETs on contrast-enhanced computed tomography, who consented to nCLE combined with EUS-FNA and were diagnosed using EUS-FNA or surgical resection. The diagnostic criteria for PNETs using nCLE were based on the nesting and trabecular and glandular arrangement of tumor cell clusters surrounded by capillary vessels and fibrosis, as reported in previous studies. Results: The diagnosis using nCLE was classified into three categories: misdiagnosis in three cases (10%), non-diagnostic in six cases (20%), and diagnostic in 21 cases (70%). nCLE was able to diagnose PNET in one of the two cases with inconclusive EUS-FNA. Conclusions: Although further development of the resolution and optimization of the diagnostic criteria are required, nCLE may constitute a useful diagnostic option in cases of inconclusive EUS-FNA for PNETs.

Development of Basic Techniques for Ultrasound-guided Follicular Aspiration II. Anesthesic Methods and Development of a Disposable Simplified Needle Guidance System for Ovum Pick-up (초음파유도 난포란 채취를 위한 기본 기술의 개발 II. 소의 마취방법과 채란기구의 개발)

  • 최민철;조성근;강태영;박준규;손우진;이효종
    • Journal of Embryo Transfer
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    • v.12 no.2
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    • pp.211-218
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    • 1997
  • This experiment was carried out to develop the anesthetic methods for ultrasonography and a new simplified disposable needle guidance device for ovum pick-up(OPU) in cows. Three different anesthetic methods were applied as. 1) epidural analgesia only with 2% lidocaine(20~30 ml), 2) epidural analgesia with 2% under general sedation with xylazine, 3) epidural analgesia with 2% lidocaine under general sedation with detomidine. We evaluated the anesthetic effects with items such as relaxation of anal sphincter, tail movement and rectal wall, retractability of both ovaries, additional anesthesia and possibility of OPU. Through this experiment, the above three anesthetic methods were applicable to OPU, but the epidural anlagesia under general sedation with detomldine was most effective for OPU. We developed a new disposable needle guidance device with stainless steel tube. With this, disposable needles can be easily attatchable to any other intravaginal probes. And also, it was found to he practical, economic and effective for OPU with the recovery rate of 51.2%.

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Development of Basic Techniques for Ultrasound-guided Follicular Aspiration I. Measurement of Size of Ovaries, Follicles and Corpora Lutea of Korean Native Cows by Ultrasonography (초음파유도 난포란 채취를 위한 기본 기술의 개발 I. 초음파상에 나타난 한우 난소, 난포 및 황체의 크기 측정)

  • 최민철;강태영;조성근;최상용;손우진;이효종
    • Journal of Embryo Transfer
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    • v.12 no.2
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    • pp.203-209
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    • 1997
  • This study was carried out to compare the actual size(length and height) of ovaries, follicles and corpora lutea of Korean native cow with those on sonograms. We used 3 different probes(3.5 MHz abdominal probe, 6.5 MHz transvaginal probe and 5.0 MHz transrectal probe) and a calipher for measurements of ovaries, follicles and corpora lutea on sonograms and actual size. Under water immersion, 157 ovaries were scanned with 3 probes and measured in actual size and compared each other. The average height and width of ovaries of Korean native cows were 17.40$\pm$3.99 and 34.23$\pm$6.02mm, respectively. In comparison of height, length of ovaries and preovulation follicles, we found that image with a transvaginal probe was nearly the same as the actual size(p<0.01), but with an abdominal probe the image was appeared larger than the actual size. In measurement(diameter) of preovulation follicles the transvaginal probe was proven to be more accurate to the actual size than other probes and in corpus luteum measurement all probes were accurate. In the comparison of number of follicles by different size ranges, there was no statistical difference in the count of follicles over 10 mm in diameter between the transvaginal probe and naked eyes.

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Masticator space abscess in a 47-day-old infant

  • Kim, Eun-Hee;Jeon, Ju-Hee;Shim, Yoon-Hee;Lee, Kyu-Seok;Kim, So-Young;Kim, Eun-Ryoung
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.350-353
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    • 2011
  • A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about $2.0{\times}1.5cm$ that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.

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.

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.

Diagnostic Performance of Core Needle Biopsy for Characterizing Thyroidectomy Bed Lesions

  • So Yeong Jeong;Jung Hwan Baek;Sae Rom Chung;Young Jun Choi;Dong Eun Song;Ki-Wook Chung;Won Woong Kim;Jeong Hyun Lee
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.1019-1027
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    • 2022
  • Objective: Thyroidectomy bed lesions frequently show suspicious ultrasound (US) features after thyroid surgery. Fine-needle aspiration (FNA) may not provide definitive pathological information about the lesions. Although core-needle biopsy (CNB) has excellent diagnostic performance in characterizing suspicious thyroid nodules, no published studies have evaluated the performance of CNB specifically for thyroidectomy bed lesions. Therefore, we aimed to evaluate the diagnostic performance and safety of CNB for characterizing thyroidectomy bed lesions. Materials and Methods: A total of 124 thyroidectomy bed lesions in 113 patients (79 female and 34 male; age, 23-85 years) who underwent US-guided CNB between December 2008 and December 2020 were included. We reviewed the US imaging features of the target lesions and the histories of previous biopsies. The pathologic results, diagnostic performance for malignancy, and complications of CNB were analyzed. Results: All samples (100%) obtained by CNB were adequate for pathological analysis. Pathological analysis revealed inconclusive results in two lesions (1.6%). According to the reference standard, 50 lesions were ultimately malignant (40.3%), and 72 were benign (58.1%), excluding the two inconclusive lesions. The performance of CNB for diagnosing malignant thyroidectomy bed lesions in the 122 lesions had a sensitivity of 98.0% (49/50), a specificity of 100% (72/72), positive predictive value of 100% (49/49), and negative predictive value of 98.6% (72/73). Eleven lesions were referred for CNB after prior inconclusive FNA results in thyroidectomy bed lesions, for all of which CNB yielded correct conclusive pathologic diagnoses. According to the pathological analysis of CNB, there were various benign lesions (58.9%, 73/124) besides recurrence, including benign postoperative lesions other than suture granuloma (32.3%, 40/124), suture granuloma (15.3%, 19/124), remnant thyroid tissue (5.6%, 7/124), parathyroid lesions (4%, 5/124), and abscesses (1.6%, 2/124). No major or minor complications were associated with the CNB procedure. Conclusion: US-guided CNB is accurate and safe for characterizing thyroidectomy bed lesions.

Diagnostic value of Thyroglobulin Measurement with Fine-needle Aspiration Biopsy for Lymph Node Metastases in Patients with a History of Differentiated Thyroid Cancer

  • Zhang, Hai-Shan;Wang, Ren-Jie;Fu, Qing-Feng;Gao, Shi;Sun, Bu-Tong;Sun, Hui;Ma, Qing-Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10905-10909
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    • 2015
  • Purpose: The aim of this study was to evaluate the diagnostic value of FNA-Tg for detecting lymph node metastases in patients with a history of differentiated thyroid cancer (DTC). Materials and Methods: A total of 58 patients with DTC diagnosis and evidence of single or multiple suspicious cervical lymph nodes were assessed. All underwent total or near-total thyroidectomy with (35 cases) or without (23 cases) radioiodine (RAI) ablation, followed by thyroid stimulating hormone (TSH) suppression therapy. A total of 68 lymph nodes were examined by ultrasound-guided fine needle aspiration (US-FNA) for both cytological examination and FNA-Tg measurement. Serum Tg and anti-thyroglobulin antibody (TgAb) levels were also measured. Diagnostic performance including sensitivity, specificity, accuracy, positive (PPV) and negative predictive value (NPV) of FNAC and FNA-Tg were calculated and compared. The Spearman's rank correlation coefficient was used to estimate the relationship between FNA-Tg and serum TgAb. Results: The FNA-Tg levels were significantly higher with DTC metastatic lymph nodes (median 927.7 ng/mL, interquartile range 602.9 ng/mL) than non-metastatic lymph nodes (median 0.1 ng/mL, interquartile range 0.4 ng/mL) (p<0.01). Considering 1.0 ng/mL as a threshold value for FNA-Tg, the sensitivity, specificity, accuracy, PPV and NPV of FNA-Tg were 95.7%, 95.5%, 95.6%, 97.8% and 91.3%, respectively. The sensitivity and accuracy of the combination of FNAC and FNA-Tg were significantly higher than that of FNAC alone (p<0.05). The diagnostic performance of FNA-Tg was not significantly different between cases with or without RAI ablation, and the serum TgAb levels did not interfere with FNA-Tg measurements. Conclusions: Measurement of FNA-Tg is useful. The combination of FNAC and FNA-Tg is more sensitive and accurate for detecting lymph node metastases in patients with a history of DTC than FNAC alone. Serum TgAbs appear to be irrelevant for measurement of FNA-Tg.

Xanthogranulomatous Pancreatitis Mimicking a Pancreatic Cancer on CT and MRI: a Case Report and Literature Review

  • Park, Jong Min;Cho, Seung Hyun;Bae, Han-Ik;Seo, An Na;Kim, Hye Jung;Lee, So Mi;Yi, Jae Hyuck;Lim, Jae-Kwang;Cho, Chang Min
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.3
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    • pp.185-190
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    • 2016
  • Xanthogranulomatous inflammation is a rare benign condition involving various organs. However, its pancreas involvement is very rare. To the best of our knowledge, only 17 cases have been described in the literature. Interestingly, all reported 17 cases due to various causes underwent surgical resection. Here, we present a case of xanthogranulomatous pancreatitis in a 63-year-old man. He presented with epigastric pain and solid mass mimicking ductal adenocarcinoma in the body and tail of pancreas on magnetic resonance imaging. The patient was diagnosed as xanthogranulomatous pancreatitis via endoscopic ultrasound-guided fine needle aspiration. After that, he was followed up and monitored without any surgical treatment. Here, we show imaging findings and serial image changes of xanthogranulomatous pancreatitis for this case.

A case of McKusick-Kaufman syndrome

  • Son, Se-Hyung;Kim, Yoon-Joo;Kim, Eun-Sun;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Clinical and Experimental Pediatrics
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    • v.54 no.5
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    • pp.219-223
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    • 2011
  • McKusick-Kaufman syndrome (MKS) is an autosomal recessive multiple malformation syndrome characterized by hydrometrocolpos (HMC) and postaxial polydactyly (PAP). We report a case of a female child with MKS who was transferred to the neonatal intensive care unit of Seoul National University Children's Hospital on her 15th day of life for further evaluation and management of an abdominal cystic mass. She underwent abdominal sonography, magnetic resonance imaging, genitography and cystoscopy which confirmed HMC with a transverse vaginal septum. X-rays of the hand and foot showed bony fusion of the left third and fourth metacarpal bones, right fourth dysplastic metacarpal bone and phalanx, right PAP and hypoplastic left foot with left fourth and fifth dysplastic metatarsal bones. In addition, she had soft palate cleft, mild hydronephroses of both kidneys, hypoplastic right kidney with ectopic location and mild rotation, uterine didelphys with transverse vaginal septum and low-type imperforated anus. She was temporarily treated with ultrasound-guided transurethral aspiration of the HMC. Our patient with HMC and PAP was diagnosed with MKS because she has two typical abnormality of MKS and she has no definite complications of retinal disease, learning disability, obesity and renal failure that develop in Bardet-Biedl syndrome, but not in MKS until 33 months of age. Here, we describe a case of a Korean patient with MKS.