A Structured Pre- and Post-Operative Voice Therapy Program for Benign Vocal Fold Lesions

Benign vocal fold lesions (BVFLs) are acquired structural anomalies of the vocal folds, and these are primarily a result of vocal abuse or phonotrauma. Phonotraumatic lesions are not generally regarded as recurrent, provided that appropriate behavioral changes are made after resolution or surgical removal. Voice therapy plays a crucial role in this aspect. The aim of this article is to propose a structured pre- and post-operative voice therapy program for patients undergoing surgical intervention for BVFLs. Voice therapy post-surgery has been proven to reduce the rate of recurrence in BVFLs. Having a standard treatment protocol is a useful tool for the therapist, particularly one without extensive voice training.

Las lesiones benignas de los pliegues vocales (LBPV) son anomalías estructurales adquiridas de los pliegues vocales, y son principalmente el resultado de un abuso vocal o fonotrauma. Las lesiones fonotraumáticas generalmente no se consideran recurrentes, siempre que se realicen cambios apropiados en el comportamiento después de la resolución o la excisión quirúrgica. La terapia vocal juega un papel crucial en este aspecto. El objetivo de este artículo es proponer un programa estructurado de terapia de voz pre y postoperatorio para pacientes que son expuestos a una intervención quirúrgica para LBPV. Se ha demostrado que la terapia de voz después de la cirugía reduce la tasa de recurrencia en LBPV. Tener un protocolo de tratamiento estándar es una herramienta útil para el terapeuta, particularmente uno sin un entrenamiento extenso en patología de la voz.

Management of Giant Mandibular Ameloblastoma — A Case Report

Ameloblastomas are rare, locally invasive and slowly growing and tumours with high recurrence rate. If they are not treated on time, they can reach an emormous size. Benign mandibular swellings are broadly divided into odontogenic and non-odontogenic tumours. Ameloblastoma is one of the most common benign tumours of odontogenic origin which developed from epithelial cells and its elements and dental tissues in their various phases of development. Patients with Giant Ameloblastomas are very rare but they are widely found and diagnosed in developing countries because of painless growth and patient’s fear of Surgery leading to delayed treatment. This paper presents a case of large Ameloblastoma of left side of mandible in a 25-year-old female patient which was successfully resected in toto. Patient refused for free fibula flap re-construction of the defect because of her apprehension for donor site morbidity

Clinical-radiological-pathological Characteristics of 297 Cases of Surgical Pathology Confirmed Benign Pulmonary Lesions in Which Malignancy Could Not Be Excluded in Preoperative Assessment: A Retrospective Cohort Analysis in a Single Chinese Hospital / 中国肺癌杂志

BACKGROUND@#Low dose computed tomography (LDCT) for lung cancer screening is widely employed in China as a result of increasing cancer screening awareness. Although some pulmonary lesions detected by LDCT are cancerous, most of the pulmonary nodules are benign. It is important to make effective preoperative differentiation of pulmonary lesions and to obviate the need for surgery in some patients with benign disease.@*METHODS@#From January 1, 2017 to December 31, 2018, patients in our institution with surgical pathology confirmed benign pulmonary lesions in which malignancy could not be excluded in preoperative assessment were enrolled in this study. Retrospective analysis of clinical data was conducted.@*RESULTS@#297 cases were collected in this study. Prevalence of benign disease in patients underwent resection for focal pulmonary lesions is 9.8% in our institution. In 197 patients (66.3%), pulmonary lesions were detected by LDCT screening. A total of 323 assessable pulmonary lesions were detected by chest CT. The average diameter of pulmonary lesions was (17.9±12.1) mm, and 91.0% of which were greater than or equal to 8 mm. Solid nodules accounted for 65.6% of these lesions. Imaging characteristics suggesting malignancy were common, including spicule sign (71/323, 22.0%), lobulation (94/323, 29.1%), pleural indentation (81/323, 25.1%), vascular convergence sign (130/323, 40.2%) and vacuole sign (23/323, 7.1%). 292 patients (98.3%) underwent video-assisted thoracoscopic surgery (VATS). Pulmonary wedge resection was performed in 232 cases (78.1%), segmental resection in 13 cases (4.4%) and lobotomy in 51 cases (17.2%). Surgical complications occurred in 4 patients (1.3%). The most frequent findings on surgical pathology analysis were: infectious lesions in 98 cases (33.0%), inflammatory nodules in 96 cases (32.3%), and hamartoma in 64 cases (21.5%).@*CONCLUSIONS@#Solid nodules accounted for most of these benign pulmonary lesions in which malignancy could not be excluded preoperatively, and imaging characteristics suggesting malignancy were common. VATS is an important biopsy method to identify etiology and pathology for lesions. The most frequent benign pulmonary diseases that are suspected to be malignant and underwent surgical resection are: infectious lesions, inflammatory nodules and hamartoma.

Clinical-radiological-pathological Characteristics of 297 Cases of Surgical Pathology Confirmed Benign Pulmonary Lesions in Which Malignancy Could Not Be Excluded in Preoperative Assessment: A Retrospective Cohort Analysis in a Single Chinese Hospital / 中国肺癌杂志

BACKGROUND@#Low dose computed tomography (LDCT) for lung cancer screening is widely employed in China as a result of increasing cancer screening awareness. Although some pulmonary lesions detected by LDCT are cancerous, most of the pulmonary nodules are benign. It is important to make effective preoperative differentiation of pulmonary lesions and to obviate the need for surgery in some patients with benign disease.@*METHODS@#From January 1, 2017 to December 31, 2018, patients in our institution with surgical pathology confirmed benign pulmonary lesions in which malignancy could not be excluded in preoperative assessment were enrolled in this study. Retrospective analysis of clinical data was conducted.@*RESULTS@#297 cases were collected in this study. Prevalence of benign disease in patients underwent resection for focal pulmonary lesions is 9.8% in our institution. In 197 patients (66.3%), pulmonary lesions were detected by LDCT screening. A total of 323 assessable pulmonary lesions were detected by chest CT. The average diameter of pulmonary lesions was (17.9±12.1) mm, and 91.0% of which were greater than or equal to 8 mm. Solid nodules accounted for 65.6% of these lesions. Imaging characteristics suggesting malignancy were common, including spicule sign (71/323, 22.0%), lobulation (94/323, 29.1%), pleural indentation (81/323, 25.1%), vascular convergence sign (130/323, 40.2%) and vacuole sign (23/323, 7.1%). 292 patients (98.3%) underwent video-assisted thoracoscopic surgery (VATS). Pulmonary wedge resection was performed in 232 cases (78.1%), segmental resection in 13 cases (4.4%) and lobotomy in 51 cases (17.2%). Surgical complications occurred in 4 patients (1.3%). The most frequent findings on surgical pathology analysis were: infectious lesions in 98 cases (33.0%), inflammatory nodules in 96 cases (32.3%), and hamartoma in 64 cases (21.5%).@*CONCLUSIONS@#Solid nodules accounted for most of these benign pulmonary lesions in which malignancy could not be excluded preoperatively, and imaging characteristics suggesting malignancy were common. VATS is an important biopsy method to identify etiology and pathology for lesions. The most frequent benign pulmonary diseases that are suspected to be malignant and underwent surgical resection are: infectious lesions, inflammatory nodules and hamartoma.

The Profile of Oral Lesions in Patients Attending Oral Diagnosis Clinic at the College of Dentistry, University of Basra, Iraq

Objective: Oral health refers to the health of our mouth and ultimately, supports and reflects the health of the entire body. So this study is designed to assess the profile of oral lesions in patients attending an oral diagnosis clinic at a College of Dentistry, University of Basra, Iraq. Patients and methods: The study was conducted in an outpatient clinic of Oral Diagnosis Department, College of Dentistry. Total 13184 patients attended during a period of study from October 2014 to June 2016; among them, 494 patients have oral lesions. The examination was done by an oral medicine specialist. The questionnaire form was filled for each patient. Results: Among the 13184 dental patients, only 494 (3.74%) patients had oral lesions; 232 (47%) were males and 262 (53%) were females. The most frequent age group was 20-39 years for 50.2% of the total examined patients. The most common oral lesions diagnosed by this study were the ulcerative lesions found in 184 (37.2%) patients, while myofascial pain dysfunction syndrome (MFPDS) was found in 113 (22.9%) patients. The ulcerative lesions were more common in males than in females; while MFPDS were more in females than in the males. The most common site affected by oral lesions was Temporomandibular joint (TMJ) found in 115 (23.3%) patients and lower lip affected by oral lesions found in 108 (21.9%) patients; while buccal mucosa affected was found in 71 (14.4%) patients from the total patients. Conclusion: The routine examination of the oral cavity is essential in identifying several oral lesions and this helps to establish early diagnosis and accurate treatment to get a better prognosis, in addition to that it establishes the baseline data in oral diseases for future oral health programs.

Scrutinizing the patients with breast lump on fine needle aspiration cytology

Background: One of the most common medical problems, women face today, is a lump in the breast. These lumps may range from simple inflammatory to malignant. In case of carcinoma, early and accurate diagnosis can save the patient from metastases thus reducing mortality and morbidity. The aim of the present study is to see the spectrum of lesion in breast lump specimens in Ibn e Sina Hospital, Multan Medical and Dental College, Multan over a period of ten years.Methods: This retrospective study was carried out in the Department of Pathology, Multan Medical and Dental College Multan, Pakistan. Data were gathered from the archives of Pathology laboratory, comprising of years 2007 t0 2017, after approval from Institutional Ethical Review Committee. All the patients presented with complaint of any kind of swelling of breast were included in this study. All the demographic and clinical details of the patients were collected on proforma. Fine needle aspiration technique was used to take sample from the suspected lesional area. Descriptive statistics was used to analyze the data.Results: A total of 2039 patients were presented with complaint of lump/swelling in their breast unilaterally or bilaterally. There were 628 (30.8%) benign lesions, 872 (42.8) malignant lesions, 229 cases with atypical cells. Mastitis/inflammatory lesions were seen in 167 (8.2%) cases and tuberculous granulomas were observed in 83 (4.07%) cases. Twenty cases were of miscellaneous types including lipoma, phylloda, simple cysts etc.Conclusions: Findings of present study show that majority of breast lumps were malignant, benign, inflammatory and tuberculous respectively.

Clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy / 中华消化外科杂志

Objective To investigate the clinical efficacy of laparoscopic spleen-preserving distal pancreatectomy (Kimura method and Warshaw method) for benign lesions of pancreatic body and tail.Methods The retrospective cohort study was conducted.The clinicopathological data of 39 patients with benign lesions of pancreatic body and tail who underwent laparoscopic spleen-preserving distal pancreatectomy in the Second Affiliated Hospital of Nanchang University between March 2008 and January 2018 were collected.Of 39 patients,28 undergoing Kimura method (splenic artery and vein-preserving distal pancreatectomy) were allocated into the Kimura group,and 11 undergoing Warshaw method (cutting splenic vessels and preserving short gastric vessels)due to serious adhesion between pancreatic body and tail and splenic hilum were allocated into the Warshaw group.Observation indicators:(1) operation situations;(2) postoperative situations;(3) follow-up situations.Followup using outpatient examination and telephone interview was performed to detect blood glucose level and tumor recurrence of patients up to March 2018.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range) and comparison between groups was done using nonparametric rank-sum test.Comparisons of count data were analyzed using chi-square test or Fisher exact probability.Results (1) Operation situations:39 patients received laparoscopic spleen-preserving distal pancreatectomy,operation time and volume of intraoperative blood loss of 39 patients were respectively (194 ±58)minutes and 100 mL (range,30-800 mL).The operation time and volume of intraoperative blood loss were respectively (197±56)minutes,100 mL (range,30-800 mL) in the Kimura group and (186±63)minutes,150 mL (range,30-450 mL) in the Warshaw group,with no statistically significant difference between groups (t =0.494,Z =-0.597,P＞ 0.05).(2) Postoperative situations:time to anal exsufflation and duration of hospital stay were respectively (2.6±0.8)days,(9.2±7.3)days in 39 patients and (2.4±0.6)days,(7.5±4.2)days in the Kimura group and (2.8±1.3)days,(13.5±11.1)days in the Warshaw group,with no statistically significant difference between groups (t=-0.720,-1.736,P＞0.05).Seven patients had postoperative complications.The incidence of complication was 2/28 in the Kimura group,1 patient with pancreatic leakage at 5 days postoperatively was cured by 15-day B ultrasound guided catheter drainage,and 1 who was diagnosed as pulmonary infection by chest CT examination at 5 days postoperatively was discharged from hospital after 8-day anti-infection and sputum-inductive treatments.The incidence of complication was 5/11 in the Warshaw group,3 patients with sustained fever at 5 and 7 days postoperatively who were diagnosed as grade 1 splenic infarction by epigastric enhanced CT examination were improved and discharged from hospital by antibiotic and low molecular weight heparin treatments,and then epigastric enhanced CT re-examination at 3 months postoperatively showed recovery of splenic perfusion;1 with pancreatic leakage at 7 days postoperatively was cured by 18-day conservative treatment;1 who was diagnosed as delayed gastric emptying by upper gastrointestinal contrast at 16 days postoperatively was improved and then discharged from hospital by 15-day placement of intestinal feeding tube and nutrition support therapy.There were statistically significant differences in the incidences of overall complication and splenic infarction between groups (x2 =5.485,4.878,P＜0.05) and no statistically significant difference in the incidence of other complications between groups (P＞0.05).(3) Follow-up situations:39 patients were followed up for 12 months (range,2-64 months).During the follow-up,six patients had normal blood glucose level,and all patients had good quality of life,without recurrence.Conclusions Laparoscopic spleen-preserving distal pancreatectomy for the benign lesions of pancreatic body and tail is satisfactory in short-and long-term curative effects.The incidences of complication and splenic infarction of Kimura method are lower than that of Warshaw method.

New recognition of the relationship between gallbladder benign lesions and gallbladder cancer / 中华消化外科杂志

With the development of imaging technology,the detection rate of gallbladder benign lesions has increased year by year.And part of the diseases may evolve into gallbladder cancer through a series of pathophysiologic processes.There are some misunderstandings in the understanding of gallbladder benign lesions for surgeons,so it is difficult for the clinical decision-making.The relationship between gallbladder benign lesions and gallbladder cancer should be correctly understood.Surgeons can neither exaggerate the risk of gallbladder cancer nor miss optimal timing of operation.The key point of the diagnosis and treatment of gallbladder benign lesions should be based on making full use of imaging data and strictly grasp pre-and intraoperative indications,and it is important to identify the malignant transformation of gallbladder benign lesions as soon as possible and carry out standardized treatment.

A comparative study of FNAC breast lesions and BI-RADS grading with a focus on grade 4 and grade 5 categories

Breast carcinoma is showing an increasing trend amongst urban women population. Breast Imaging Reporting and Data System (BI-RADS) is a widely accepted risk assessment procedure for carcinoma breast in clinical practice. Fine needle aspiration cytology (FNAC) is an established and important preoperative diagnostic modality. We have done a two year comparative study of these two procedures in the department of Pathology, at Gandhi Hospital from June 2014 to May 2016. We have done 720 FNACs for breast lesions during this period and compared the results with BI-RADS classification by mammography / ultrasound screening at the department of radiology, Gandhi Hospital. Out of total 720 patients who underwent FNAC, BI-RADS grading was available for only 540 cases. Cytological patterns were compared with BI-RADS grading for these 540 cases. The Concordance and Discordance among these findings are discussed with special emphasis on grade 4 and Grade 5 BI-RADS lesions in which carcinoma breast risk is high.

Analysis of ultrasound guided percutaneous lung biopsy and ultrasound image / 实用医学杂志

Objective Analysis of ultrasound guided percutaneous lung biopsy and ultrasound examina-tion results,to explore the application value of ultrasound in the diagnosis of benign and malignant lung mass. Methods Application of percutaneous biopsy guided by ultrasound in 109 cases by X-ray and CT examination revealed lung mass patients,analysis of biopsy results and ultrasonographic characteristics,biopsy success rate and complication also be observed. Results The experimental group of 109 cases comprised 98 cases of peripheral mass and 9 cases of central mass with pulmonary consolidation ,81 cases of malignant lesions(74.3％),26 cases benign lesions(23.9％),2 cases were falied(1.8％). 107 cases were success at first operation ,and 5 cases had hemoptysis( incidence 3.8％). The echo types of malignant lesions and benign lesions had significant difference(χ2=2.422,P<0.05),but both of them had intersecting. Malignant lesions were larger than benign lesions(t=1.58, P < 0.05),but the size of malignant lesions with benign lesions had intersecting. Patients with malignant lesions had more or abundant flow,patients with benign lesions had none or fewer flow(χ2=8.471,P<0.05). but they also had intersecting. Conclusions Ultrasonography of benign and malignant lesions in peripheral pulmonary mass and central type with consolidation has certain characteristics. Ultrasound guided percutaneous lung biopsy has major value in determining the pathological type of lung mass and it is safe ,reliable and easy to process.

Analysis of ultrasound guided percutaneous lung biopsy and ultrasound image / 实用医学杂志

Objective Analysis of ultrasound guided percutaneous lung biopsy and ultrasound examina-tion results,to explore the application value of ultrasound in the diagnosis of benign and malignant lung mass. Methods Application of percutaneous biopsy guided by ultrasound in 109 cases by X-ray and CT examination revealed lung mass patients,analysis of biopsy results and ultrasonographic characteristics,biopsy success rate and complication also be observed. Results The experimental group of 109 cases comprised 98 cases of peripheral mass and 9 cases of central mass with pulmonary consolidation ,81 cases of malignant lesions(74.3％),26 cases benign lesions(23.9％),2 cases were falied(1.8％). 107 cases were success at first operation ,and 5 cases had hemoptysis( incidence 3.8％). The echo types of malignant lesions and benign lesions had significant difference(χ2=2.422,P<0.05),but both of them had intersecting. Malignant lesions were larger than benign lesions(t=1.58, P < 0.05),but the size of malignant lesions with benign lesions had intersecting. Patients with malignant lesions had more or abundant flow,patients with benign lesions had none or fewer flow(χ2=8.471,P<0.05). but they also had intersecting. Conclusions Ultrasonography of benign and malignant lesions in peripheral pulmonary mass and central type with consolidation has certain characteristics. Ultrasound guided percutaneous lung biopsy has major value in determining the pathological type of lung mass and it is safe ,reliable and easy to process.

The Clinical Effect of Ultrasound Guided Minimally Invasive Rotary Cutting on Breast Benign Lesions / 昆明医科大学学报

Objective To study the safety and effect of ultrasound guided minimally invasive rotary cutting for treatment of benign breast lesions. Methods A single-center, prospective, randomized, controlled study method was used, 84 patients with breast benign lesions were randomly divided into observation group and control group, 42 patients in each group. Patients in the observation group were treated with ultrasound guided minimally invasive rotary cutting, patients in control group were treated with traditional surgery. The intraoperative and postoperative related indicators were compared between two groups. Results The intraoperative blood loss, length of incision, operation time in breast benign unilateral single and unilateral and bilateral lesions in the observation group were significantly less than those in the control group, with statistically significant difference (P<0.01) . The healing time, postoperative pain score, complications in breast benign unilateral single and unilateral and bilateral lesions in observation group were less than those in the control group, with statistically significant difference (P<0.01) . And the postoperative satisfaction, and the excellent rate of beauty in breast benign unilateral single、unilateral and bilateral lesions were better than control group, with statistically significant difference (P<0.01) . There was no breast deformation in observation group after treatment, and there were 3 patients of breast deformation in the control group has 3 patients, accounting for 7.14%. Conclusion Ultrasound guided minimally invasive rotary cutting is significantly superior to the traditional treatment in security and effectiveness for treatment of breast benign lesions in one single and unilateral multiple and bilateral lesions.

Oral approaches for benign lesions- a novel approach.

Introduction -Cosmetically acceptable surgical results are the demand of this modern era. Aesthetic facial look has lots of impact on financial, social and personnel life. Material and Methods- A total of twenty cases were studied in the Department of ENT at Hind Institute of Medical Sciences (HIMS), Barabanki, Uttar Pradesh. FNAC, USG and CECT were done and only benign lesions were selected which could be approached intraorally. Results-There were 20 patients aged between fifteen years to sixty years. There were ten cases of submandibular swellings, four cases of sebaceous cyst, three cases of lipoma and two cases of parapharyngeal space swelling and one case of plunging ranula. The mean operation time of the IOA group was significantly longer than that of the TCA group, but decreased gradually with surgical experience. The mean hospital stay of the IOA group was significantly shorter than that of the TCA group. Conclusions-The innovative surgical approaches were studied and meticulous, cosmetically acceptable results which were highly appreciated by the patients and their attendants were achieved. The stay in the hospital and complication rates were also quite low in intraoral approach than conventional external approach. Hence, intraoral approaches should be used for benign lesions which are amenable to surgery.

Prevalencia de lesiones benignas y desórdenes potencialmente malignos que afectan la mucosa bucal en pacientes adultos Facultad de Odontoloía UCV / Injury prevalence of benign and potencially malignant disorders affecting the mouth in patients mucosal Faculty of Dentistry UCV

Se realiza un estudio de tipo documental, retrospectivo, transversal. La población del presente estudio estuvo representada por un total de 9.000 historias diagnosticadas en el Laboratorio Central de Histopatología Bucal "Dr. Pedro Tinoco" de la Facultad de Odontología de la U.C.V., durante el período 1988-2008. La muestra evaluada quedó conformada por un total de Cuatro Mil Ciento Sesenta y Seis (4.166) casos, los cuales fueron seleccionados de manera intencional no probabilística a partir de la población antes mencionada siguiendo criterios de inclusión y exclusión. La prevalencia de Lesiones Benignas y Desórdenes Potencialmente Malignos que afectan la Mucosa Bucal es alta (46,2%) con respecto a la muestra total estudiada (9000 casos). De acuerdo al Grupo Etario observamos un intervalo de edad entre 15 y 97 años, una media de 47,3 años y Desv. Tip de 16,5 (Y ± s : 47,3 ± 16,5). En relación a la distribución por Género, en nuestro estudio existe un predominio de las lesiones de la mucosa bucal por el sexo femenino (69,7%). En base al diagnóstico clínico se identificaron 77 lesiones diferentes. El Fibroma Traumático fue la lesión más común con 1042 casos (25,01%), seguida por la Leucoplasia con 764 casos (18,33%), la Hiperplasia Fibrosa por Prótesis Dental con 447 casos (10,73%). En referencia a las diferentes localizaciones anatómicas mayormente afectadas en este estudio: el Reborde Alveolar ocupó el primer lugar (1134 casos; 27,2%), seguida por Los Carrillos (639 casos; 15,33%), Labio Inferior (522 casos; 12,5%), Encías (493 casos; 11,8%).En referencia al grado de Concordancia global entre el Diagnóstico Clínico e Histopatológico fue del 75,9 % de los casos (3.161 casos de 4.166). Situación que nos permite asumir que la concordancia global es satisfactoria.

A study of documentary, retrospective, cross. The study population was represented by a total of 9,000 stories diagnosed at the Central Laboratory of Oral Histopathology "Dr. Pedro Tinoco " in the Faculty of Dentistry at UCV, during the period 1988-2008 . The sample studied was composed of a total of Four Hundred Sixty Six Thousand (4,166 ) cases , which were selected intentionally not random from the population above following inclusion and exclusion criteria . Injury prevalence Benign and Potentially Malignant Disorders affecting Mucosa is high ( 46.2 %) compared to the total study sample (9000 cases). According to Age Group observed an age range between 15 and 97 years , an average of 47.3 years and 16.5 Desv.Tip (Y ± s : 47.3 ± 16.5). Regarding the Gender distribution in our study there is a prevalence of oral mucosal lesions in females (69.7 %). Clinical diagnoses based on 77 different lesions were identified. The Traumatic fibroma was the most common injury in 1042 patients (25.01%), followed by leukoplakia with 764 cases (18.33%), Fibrous Hyperplasia By Dental Implants with 447 cases (10.73%). Referring to different anatomical locations most affected in this study: Alveolar Flange ranked first (1134 cases , 27.2 %), followed by The Cheeks (639 cases , 15.33%), Lower Lip (522 cases; 12.5%), Gum (493 cases, 11.8%). Referring to the degree of overall concordance between the Clinical and Histopathological diagnosis was 75.9% of cases (3,161 of 4,166 cases). This situation allows us to assume that the overall agreement is satisfactory.

Correlation of tumor size and histopathological characteristics for presumed renal cell carcinoma / 中华泌尿外科杂志

ObjectiveTo analyze the incidence of benign lesions in patients undergoing surgery for presumed renal cell carcinoma (RCC) and investigate the correlation of tumor size and histopathological characteristics.MethodsFrom Jan 2003 to Sep 2010,1531 patients (1042 males,489 females with average age of 55.1 years (15 -89 years) underwent nephrectomy.There were 1123 radical nephrectomies and 408 partial nephrectomies for solitary renal cortical neoplasms presumed to be RCC in preoperative imaging study.The pathological tumor size,the percentage of benign lesions and histologic subtypes were analyzed retrospectively.The correlation of Fuhrman grading and tumor size in clear cell type RCC and papillary RCC was investigated as well.Results Pathological examinations revealed that there were 81 (5.3％)benign lesions of 1531 patients.The incidence of benign lesions was 7.8％ in renal masses smaller than 4.0cm,3.8％ in masses with 4.1 - 7.0 cm,and 1.1％ in masses larger than 7.0 cm ( P ＜ 0.01 ).Angiomyolipoma was the most predominant histologic subtype in benign renal lesions with a frequency of 69.5％,52.6％ and 33.3％ in ≤4.0 cm,4.1 - 7.0 cm and ＞ 7.0 cm subgroups,respectively.Oncocytoma was present in 13.6％,15.8％ and 33.3％ of the benign lesions in the above 3 subgroups (P =0.47).One thousand four hundred and fifty cases of malignancies (94.7％) were identified.The frequency of clear cell type RCC was 91.7％ in malignant tumors smaller than 4.0 cm,88.1％ in 4.1 - 7.0 cm malignancies,and 77.6％ in tumors ＞7.0 cm； the frequency of papillary RCC was 4.0％,4.2％ and 7.7％ in the above 3 subgroups,and the frequency of chromophobe cell RCC was 3.6％,5.2％ and 6.3％ accordingly ( P ＜0.01 ).One thousand three hundred and seventeen cases of clear cell type RCC and papillary RCC with definite Fuhrman grading were identified.The probability of high grade tumors increased with size,while the probability of low-grade lesions decreased (r =0.94,P ＜ 0.01 ),especially for tumors smaller than 11.0cm.ConclusionsPatients in the present study population show a low incidence of benign renal lesions.Benign lesions are less common in larger tumors than in smaller ones.The proportion of clear cell type RCC decreases in larger tumors,however papillary RCC and chromophobe cell RCC are increasing.The probability of high-grade tumors increases with size.The correlation between tumor size and histopathological characteristics may be helpful in patients counseling and decision-making.

Correlação entre achados anatomopatológicos de lesões mamárias não palpáveis exames de imagem / Correlation between anatomophatological real find of non-palpable breast lesion and test of image

Objetivos: Descrever cirurgias guiadas por agulhamento de lesões mamárias não palpáveis e avaliar sua correlação anatomopatológica. Métodos: Realizou-se um estudo descritivo, retrospectivo, a partir da análise dos prontuários de pacientes da Clínica de Mastologia do Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG). Foram selecionados todos os casos de pacientes submetidas à biópsia cirúrgica de lesão mamária não palpável após agulhamento guiado por mamografia ou ultrassonografia, durante o período de 3/8/2004 a 25/5/2006. Foram analisadas as seguintes variáveis: idade da paciente à época da cirurgia, tipo de lesão mamária apresentada ao exame de imagem e resultado anatomopatológico. Resultados: Houve um total de 261 cirurgias. Foram elegíveis 236 casos. A idade média das pacientes foi de 50,9 anos (19-91 anos). Em 120 casos (50,85%), a biópsia foi realizada em virtude de microcalcificações mamárias; em 95 casos (40,25%), por nódulo; em 15 casos (6,36%), por assimetria focal e em 6 casos (2,54%), por distorção arquitetural. O resultado anatomopatológico foi benigno em 170 casos (72,03%) e maligno em 66 (27,97%). Conclusões: A casuística do Serviço de Mastologia do IPSEMG está de acordo com os dados encontrados na literatura. A biópsia cirúrgica de lesões mamárias não palpáveis guiada por agulhamento é um procedimento capaz de estabelecer o correto diagnóstico diferencial dessas lesões, diagnosticar o câncer de mama em fases iniciais e promover a remoção completa das lesões em tempo cirúrgico, frequentemente, único.

Objectives: To describe surgical biopsies after wire localization of non palpable mammary lesions and to consider their anatomopathological correlation. Methods: A descriptive and retrospective study was realized through analysis of handbooks of patients at Mastology Clinics of the Instituto de Previdência dos Servidores do Estado de Minas Gerais (IPSEMG). All cases of patients submitted to surgical biopsy of non-palpable mammary lesion after wire localization for mammography or ultrasound, during the period of 8/3/2004 to 5/25/2006, were selected. The variables analyzed were: age of the patient at the time of the surgery, type of breast lesion presented during the tests of image and anatomopathological result. Results: There were a total of 261 surgeries, which 236 cases were elected. The average age of the patients was 50,9 years (19-91 years). In 120 cases (50.85%) the biopsy was made due to the mammary microcalcifications; in 95 cases (40.25%) for nodule; in 15 cases (6.36%) for focal asymmetry and in 6 cases (2.54%) for architectural distortion. The anatomopathological result was benign in 110 cases (12.03%) and malignant in 66 (27.91%). Conclusions: The casuistic of the Mastology Service of IPSEMG is compatible with the data founded in literature. The surgical management of non-palpable breast lesions after wire localization is a procedure which is able to establish the differential diagnostic of these lesions, breast cancer diagnosis in early stage and to promote the complete removal of the injuries in frequently single surgical time.

Comparative Analysis on Mammography and MRI Features of Breast Benign Lesions / 实用放射学杂志

Objective To study the relationship of X-ray and MRI features of breast benign lesions with histopathology.Methods The X-ray and MRI features of breast benign lesions in 48 cases were analyzed retrospectively and compared to the histopathogic results.Results There were 18 cases with fibroadenoma and 12 cases with mammoplasia,8 cases with breast galactocele,8 cases with adenosis of breast accompanied by chronic inflammation and 2 cases with lipoma.The structure and vessels of breast were normal mostly in breast benign lesions.The margins of the lesions were clear and the density of lesions was uniformity.The calcifications inside the lesions appeared as granular with definite and smooth margins,less in amounts,growth as plexus-like or diffusive.The lesions were circular,oval or patchy shadows and homogeneous iso-or hypo-intensity on T1WI,iso-or slight hyperintensity on T2WI,and obviously homogeneous enhanced in 4 cases after administration of contrast medium.Conclusion Mammography is the first choice for the breast benign lesions,while MRI can improve the diagnostic accurate rate.