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ABSTRACT
PURPOSE: To understand the cause of atypical sonograpic findings by analyzing their pathologic correlation tointernal echogenicity of breast fibroadenoma. MATERIALS AND METHODS: Between January 1995 and April 1997, thepresence of 91 fibroadenomas in 81 patients was histopathologically proven. These mass lesions weresonographically interpreted and their descriptive criteria-internal echo content (both strength and homogeneity),the presence of septum, bilateral shadowing, and posterior echo pattern-were tabulated. A pathologist reviewedeach case and independently recorded the following data : cell type, the presence of septum, duct dilatation,calcification, fibrosis, hyalinization, and vascularity. We analyzed the correlation of sonographic withpathologic findings. RESULT: There was significant correlation between increased vascularity and increasedinternal echo strength and between increased fibrosis and decreased internal echo strength. There was nosignificant correlation between internal echo homogeniety or posterior shadowing and vascularity or stromalfibrosis, nor between hyalinization or cell type and internal echo strength, homogeneity or posterior shadowing.There was correlation between absent or thin capsule and the absence of bilateral shadowing. CONCLUSION: Increased vascularity or decreased stromal fibrosis might be the cause of atypical fibroadenoma.
Subject(s)
Humans , Breast , Fibroadenoma , Fibrosis , Hyalin , Shadowing Technique, Histology , UltrasonographyABSTRACT
PURPOSE: To classify perivascular change in the celiac trunk and SMA occurring in pancreatic disease and toevaluate its significance in differential diagnosis. MATERIALS AND METHODS: In 73 patients with pancreaticdisease (42, acute pancreatitis; 14, chronic pancreatitis; 17, panreatic cancer) abdominal CT findings wereretrospectively reviewed. We defined " infiltration" as linear or irregular density and "thickening" as presenceof a soft tissue mantle surrounding the vessel, and statistically evaluated the usefulness of these factors forthe differential diagnosis of pancreatic diseases. RESULTS: In 13/42 cases of acute pancreatitis (31%), 4/14 ofchronic pancreatitis (28.6%), and 6/17 of pancreatic cancer (35.3%), periceliac infiltration was observed; thefrequencies were not statistically significant (p=0.916). Peri-SMA infiltration was demonstrated in 9/42 of acutepancreatitis (21.4%), 4/14 of chronic pancreatitis (28.6%), and 5/17 of pancreatic cancer (29.4%); again, thesefrequencies were not statistically significant (p=0.758). Thickening of the celiac trunk and SMA was observed onlyin pancreatic cancer, in 3/17 (17.6%) and 7/17(41.2%) cases, respectively, with statistical significance (p<0.05). CONCLUSION: Thickening of the celiac trunk and SMA is a valuable finding in the differential diagnosis ofpancreatic inflammatory disease and pancreatic cancer. When applied to the differential diagnosis of pancreaticdisease, perivaseular change should be classified as either infiltration or thickening.
Subject(s)
Humans , Diagnosis, Differential , Mesenteric Arteries , Pancreatic Diseases , Pancreatic Neoplasms , Pancreatitis , Pancreatitis, Chronic , Tomography, X-Ray ComputedABSTRACT
PURPOSE: Percutaneous fine needle aspiration biopsy is known to be a useful diagnostic method for the diagnosis of various pulmonary diseases. Its diagnostic yield is high, and it is safe, but complications such as pneumothorax can occasionally occur. We reviewed the complications arising after needle aspiration biopsy and analyzed the risk factors of pneumothorax. MATERIALS AND METHODS: The medical records and radiographic studies of 157 patients with various pulmonary diseases who underwent needle aspiration biopsy of the lung between 1990 and 1996 were retrospectively reviewed. The clinical features, treatment, and courses of complications were reviewed, and risk factors of pneumothorax such as depth and size of lesion, diameter of needle, number of punctures, and obstructive pulmonary abnormalities were analyzed. RESULTS: Complications occurred in 40 of 157 cases (25.5%), namely pneumothorax in 26 (16.6%), hemoptysis in 11 (7%), hemothorax in two (1.3%), and recurrence of malignancy at the site of aspiration in one (0.6%). When the patients were divided into three groups according to depth of lesion, there were significant difference in the incidence of pneumothorax ; the results were as follows : less than 2cm, 12.9% ; between 2 and 4cm, 24.1% ; and larger than 4cm, 57.1% (p<0.05). In pulmonary function testing, FVC (forced vital capacity) of patients with pneumothorax was less than that of patients without (2.6+/-0.9L vs 3.1+/-0.8L, p<0.05), but FEV1 (forced expiratory volume in 1 second), FEV 1% (percentage of predicted FEV1), FEV1/FVC,and FVC%(percentage of predicted FVC) were not different between the two groups. The incidence of pneumothorax in patients with pleura-attached lesion (9%) was lower than that of those with non-attached lesion (26%, p=0.01). The age of patients, size of lesion, diameter of the needle, guidance methods and number of aspirations showed no significant relationship with pneumothorax. CONCLUSION: In needle aspiration biopsy of the lung, depth of lesion and passage of a needle through aerated lung are significant risk factors of pneumothorax.
Subject(s)
Humans , Aspirations, Psychological , Biopsy , Biopsy, Fine-Needle , Biopsy, Needle , Diagnosis , Hemoptysis , Hemothorax , Incidence , Lung Diseases , Lung , Medical Records , Needles , Pneumothorax , Punctures , Recurrence , Respiratory Function Tests , Retrospective Studies , Risk FactorsABSTRACT
PURPOSE: To evaluate the usefulness of the esophagogram using marshmallow bolus in the evaluation of the causes of variable esophageal-related symptoms. MATERIALS AND METHODS: Esophagograms using marshmallow bolus were performed on 44 patients with esophageal-related symptoms and on ten normal volunteers. Video fluoroscopic studies were also made. Patients were classified into three groups according to their esophageal-related symptoms ; those with dysphagia, those with globus symptom, and those with chest pain. Abnormal findings on an esophagogram with marshmallow were graded into three categories ; mild, moderate, and severe. Provocation of the same symptom wasalso evaluated. Esophageal manometric studies were performed on 16 patients and those results were compared with the results obtained from the esophagogram using marshmallow bolus. RESULTS: The provocation rate of the same symptom was 33% in the first group, 47% in the second, and 24% in the third. The provocation rate was highest inthe second group. The provocation rate was also higher in patients with a severe degree of abnormality on anesophagogram using marshmallow bolus. Where there were abnormal findings, an esophagogram using marshmallow bolus showed a higher abnormality rate than did a conventional esophagogram. In cases showing abnormal findings on the esophageal manometric study, an esophagogram using marshmallow bolus showed a higher provocation rate and more severe abnormality than in cases showing normal findings on manometric study. CONCLUSION: An esophagogram using marshmallow bolus will a useful radiologic screening modality for the evaluation of patients with esophageal-related symptoms.