Retrospective study of the concordance between clinical and histopathological diagnosis in oral pathology / Estudio retrospectivo de la concordancia entre diagnóstico clínico e histopatológico en patología oral

Objectives: Evaluate the agreement between the clinical and histopathological diagnosis of oral lesions in patients submitted to biopsies. Identify the most frequent oral lesions and their correlation with age, gender, and anatomical location. Methods: A retrospective study of 368 pathological examinations collected between 2008 and 2018, corresponding to biopsies performed at the Clínica Universitária Egas Moniz. A detailed analysis of the histopathological reports attached to the patients' files was made and the variables gender, age, anatomical site, clinical diagnosis, and histopathological diagnosis was evaluated. Results: The most affected gender was female (55%); the most common age group was 61-70 years old; The most biopsied anatomical location was the gum (23.9%); the five most common pathological entities were fibroma(26.4%),root cyst(8.7%),oral lichen planus(7.6%), hemangioma (6.3%) and oral leukoplakia (6.0%). On agreement, 74.5% of the cases were concordant and 25.5% discordant. The most concordant lesions were Radicular Cyst (90.6%), Traumatic Injury (87.5%), Hemangioma (82.6%), Fibroma (82.5%) and Mucocele (82.5%). Conclusion: this study proves a significant level of agreement between clinical and histopathological diagnosis in this particular area, consistently obtained in a ten years period of time.

Objetivos: Evaluar el nivel de acuerdo entre el diagnóstico clínico e histopatológico de lesiones orales en pacientes sometidos a biopsias. Identificar las lesiones orales más frecuentes y su correlación con la edad, el sexo y la ubicación anatómica. Métodos: Estudio retrospectivo de 368 exámenes patológicos recogidos entre 2008 y 2018, correspondientes a biopsias realizadas en la Clínica Universitária Egas Moniz. Se realizó un análisis detallado de los informes histopatológicos adjuntos a los archivos de los pacientes y se evaluaron las variables de género, edad, sitio anatómico, diagnóstico clínico y diagnóstico histopatológico. Resultados: El género más afectado fue femenino (55%); el grupo de edad más común fue de 61-70 años; La ubicación anatómica más biopsiada fue la encía (23,9%); las cinco entidades patológicas más comunes fueron fibroma (26,4%), quiste radicular (8,7%), liquen plano oral (7,6%), hemangioma (6,3%) y leucoplasia oral (6,0%). Según el grado de acuerdo, el 74,5% de los casos fueron concordantes y el 25,5% discordantes. Las lesiones más concordantes fueron Quiste Radicular (90,6%), Lesión Traumática (87,5%), Hemangioma (82,6%), Fibroma (82,5%) y Mucocele (82,5%). Conclusión: este estudio demuestra un nivel significativo de acuerdo entre el diagnóstico clínico e histopatológico en esta área en particular, obtenido consistentemente en un período de diez años de tiempo

Caracterización clinicopatológica de pacientes con cáncer de esófago en el Hospital Mario Muñoz Monroy, Matanzas / Clinic-pathologic characterization of patients with esophagus cancer in the Hospital Mario Muñoz Monroy of Matanzas

Introducción: el cáncer de esófago se considera una entidad poco frecuente, con comportamiento agresivo y curso clínico progresivo. El objetivo de este trabajo es caracterizar clínico y patológicamente a los pacientes con cáncer esofágico diagnosticados en el hospital estudiado. Materiales y Métodos: se realizó un estudio descriptivo, longitudinal y prospectivo en 35 pacientes atendidos en el Servicio de Gastroenterología del Hospital Militar Docente “Dr. Mario Muñoz Monroy”, en la ciudad de Matanzas, desde enero del 2012 hasta diciembre del 2013, con el diagnóstico endoscópico e histológico de cáncer de esófago. Se analizaron variables como grupo etáreo, sexo, factores de riesgo, manifestaciones clínicas, tiempo de aparición de los síntomas, tipo endoscópico y tipo histológico que fueron representadas en tablas por frecuencias absolutas y relativas. Resultados: predominó el sexo masculino (85,7 %), con edades mayores de 60 años (88,6 %). La dieta inadecuada, la ingestión de alcohol y tabaquismo fueron factores de riesgo predominantes. La disfagia fue el principal motivo de consulta en dichos pacientes. Todos los casos se diagnosticaron entre los 3 y 6 meses del inicio de los síntomas. endoscópicamente predominó el tipo polipoide o vegetante (63,2 %). La mayoría de los casos estuvieron localizados en el tercio medio esofágico (34,2 %). El carcinoma de células escamosas fue el más frecuente histológicamente (52,6 %).

Background: the esophagus cancer is considered a little frequent entity, but having an aggressive behavior and a progressive course. The aim of this term is clinically and pathologically characterizing the patients with esophageal cancer diagnosed in the mentioned hospital. Methods: we carried out a prospective, cross-sectional, descriptive study in 35 patients who were assisted in the Gastroenterology Service of the Teaching Military Hospital “Dr. Mario Muñoz Monroy”, in Matanzas, from January 2012 to December 2013, with the endoscopic and histological diagnosis of esophageal cancer. We analyzed variables like age group, gender, risk factors, clinical manifestations, time of symptoms appearance, endoscopic and histological kinds that were represented in tables per absolute and relative frequencies. Outcomes: male gender predominated (85,7 %), with predominance of ages more than 60 years (88,6 %). The inadequate diet, alcohol consumption and drinking were predominant risk factors. Dysphagia was the main motive of these patients consultation. All the cases were diagnosed between 3 and 6 months after the symptoms began. Endoscopically there it was a predominance of the polypoid or vegetative kind of cancer (63,2 %). Most of the cases were located in the esophageal medial third (34,2 %). The squamous cell carcinoma was histologically the most frequent one (52,6 %).

The application of disposable coaxial biopsy instrument in lung biopsy / 实用放射学杂志

Objective To evaluate the clinical application value of a new type of Bard Max-Core coaxial biopsy system and com-pare the effectiveness and safety of different diameter biopsy guns.Methods This retrospective study included 286 patients who re-ceived CT-guided percutaneous lung biopsy using Bard MC disposable biopsy system.We divided patients into three groups:1 6G, 18G,and 20G group.Then,we evaluated the biopsy effectiveness,histological diagnosis rate and complication incidence of this new type of Bard Max-Core coaxial biopsy system.Results All lung biopsy specimens were successfully obtained.The total histological diagnosis rate was 80.8%.Patients with malignant lesions had higher histological diagnosis rate than patients with benign lesions. The histological diagnosis rate in 1 6G group was the highest among three groups.There was no significant difference among three groups regarding to the rate of diagnosis of malignant lesions.Group with 1 6G had the highest histological diagnosis rate among three groups in diagnosing begin lesions.The incidences of pneumothorax in three groups had no significant difference.The incidence of bleeding in 1 6G group was the highest among three groups.Conclusion The new Bard MC disposable coaxial biopsy system is a safe and effective instrument for lung biopsy.We should select the biopsy needles with appropriate diameter according to the fully as-sessment of patients'preoperative conditions.

Positive predictive values of Breast Imaging Reporting and Data System (BI-RADS®) categories 3, 4 and 5 in breast lesions submitted to percutaneous biopsy / Valores preditivos positivos das categorias 3, 4 e 5 do Breast Imaging Reporting and Data System (BI-RADS®) em lesões mamárias submetidas a biópsia percutânea

Objective To evaluate the BI-RADS as a predictive factor of suspicion for malignancy in breast lesions by correlating radiological with histological results and calculating the positive predictive value for categories 3, 4 and 5 in a breast cancer reference center in the city of São Paulo. Materials and Methods Retrospective, analytical and cross-sectional study including 725 patients with mammographic and/or sonographic findings classified as BI-RADS categories 3, 4 and 5 who were referred to the authors' institution to undergo percutaneous biopsy. The tests results were reviewed and the positive predictive value was calculated by means of a specific mathematical equation. Results Positive predictive values found for categories 3, 4 and 5 were respectively the following: 0.74%, 33.08% and 92.95%, for cases submitted to ultrasound-guided biopsy, and 0.00%, 14.90% and 100% for cases submitted to stereotactic biopsy. Conclusion The present study demonstrated high suspicion for malignancy in lesions classified as category 5 and low risk for category 3. As regards category 4, the need for systematic biopsies was observed. .

Objetivo Avaliar o sistema BI-RADS como fator preditivo de suspeição para malignidade em lesões mamárias, correlacionando os achados radiológicos e os resultados histológicos por meio do cálculo do valor preditivo positivo das categorias 3, 4 e 5 em serviço de referência em diagnóstico e tratamento de câncer de mama da cidade de São Paulo. Materiais e Métodos Estudo retrospectivo, analítico e transversal contendo casuística de 725 pacientes com achados mamográficos e/ou ultrassonográficos classificados nas classes 3, 4 e 5 do BI-RADS e que foram encaminhadas para realização de biópsia percutânea. Os exames foram revisados e o cálculo do valor preditivo positivo foi feito utilizando-se equação matemática específica. Resultados Os valores preditivos positivos encontrados das categorias 3, 4 e 5 foram 0,74%, 33,08% e 92,95%, respectivamente, para os casos de biópsias orientadas pelo ultrassom, e 0,00%, 14,90% e 100% para os casos orientados por estereotaxia. Conclusão Este estudo demonstrou alta suspeição para malignidade em lesões classificadas na categoria 5 e diminuto risco para a categoria 3. Quanto à categoria 4, ficou constatada a necessidade de biópsias sistemáticas. .

Caracterización videoendoscópica e histológica de pacientes con cáncer colorrectal en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández / Videoendoscopic and histological characterization of patients with colorectal cancer in the Teaching Clinico-surgical Hospital Comandante Faustino Pérez Hernández

Introducción: en Cuba, el cáncer colorrectal constituye la tercera causa de mortalidad después del cáncer de pulmón y próstata. Se realizó este trabajo con el objetivo de caracterizar endoscópica e histológicamente a los pacientes con cáncer colorrectal diagnosticados en el hospital estudiado. Métodos: se realizó un estudio descriptivo con 76 informes de videocolonoscopia realizadas en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, desde junio de 2006 a junio de 2010, lo que constituyó el universo de trabajo. Se excluyeron los informes donde el proceder no pudo realizarse completo o no presentaban el resultado histológico de la lesión diagnosticada. Se analizaron las variables: grupo etario, sexo, localización de la lesión, aspecto endoscópico, variedad histológica y presencia de lesiones sincrónicas, estas fueron representadas en tablas y gráficos por frecuencias absolutas y relativas. Resultados: el grupo etario más frecuente fue de 50 a 64 años, con predominio del sexo masculino (56,6 %). La localización más frecuente fue en el colon rectosigmoide (34,2 %). El aspecto endoscópico más encontrado fue el ulcerado (63,2 %). La variedad histológica más frecuente fue el adenocarcinoma moderadamente diferenciado (52,6 %), predominando la presencia de adenomas sincrónicos (43,4 %). Conclusiones: los pacientes mayores de 50 años siguen siendo los más propensos a padecer de cáncer colorrectal. El aspecto endoscópico ulcerado, localizado en el rectosigmoide, histológicamente diagnosticado como adenocarcinoma moderadamente diferenciado, responden a un diagnóstico tardío.

Introduction: in Cuba, colorectal cancer is the third cause of mortality after lung and prostate cancer. We developed our work with the objective of arriving to an endoscopic and histological characterization of the patients with colorectal cancer diagnosed in the mentioned hospital. Method: we carried out a descriptive study with 76 reports of videocolonoscopies made in the Teaching Clinico-surgical Hospital Comandante Faustino Pérez Hernández, from June 2006 to June 2010, and that was the universe of our work. We excluded the reviews where the procedure could not be completely finished or that were lacking of the diagnosed lesion histological result. We analyzed the following variables: age group, gender, lesion localization, endoscopic aspect, histological variety and presence of synchronic lesions. They were represented in tables and charts showing the absolute and relative frequencies. Results: the most frequent age group was the one comprehending people aged 50-64 years old, with predomination of the male gender (56,6 %). The most frequent localization was the rectosigmoid colon (34,2 %). The most common endoscopic aspect we found was the ulcerated one (63,2 %). The most frequent histological variety was the moderately differenced adenocarcinoma (52,6 %), predominating the synchronic adenomas (43,4 %). Conclusions: patients elder 50 years old are still the ones who tend more of suffering from colorectal cancer. The ulcerated endoscopic aspect, found in the rectosigmoid colon, histologically diagnosed as moderately differentiated carcinoma, is the result of a late diagnosis.

Clinical and CT Histological Diagnosis of Orbital Tumors / 华中科技大学学报（医学）（英德文版）

The clinical manifestation and characteristics of CT image of 117 cases of orbital tumors in our hospital were investigated. The hemangioma had the highest incidence, and the less common tumors were, in sequence of incidence, pseudotumor, dermoid cysts, neurilemmoma, polymorphous adenoma and meningioma. The sensitivity in diagnosis of orbital tumor by CT was 93.3%. The coincidence of CT histological diagnosis with pathology were 83.3 %, 82.6 % and 71.4% for dermoid.cysts, hemangioma, and pseudotumor respectively, but the general coincidence of CT histological diagnosis with pathology was only 67.8 %. When CT was combined with ultrasound, cytological examination and clinical manifestations, the accuracy of histological diagnosis could be improved to 83.3 %.

Clinical and CT Histological Diagnosis of Orbital Tumors / 华中科技大学学报（医学）（英德文版）

The clinical manifestation and characteristics of CT image of 117 cases of orbital tumors in our hospital were investigated. The hemangioma had the highest incidence, and the less common tumors were, in sequence of incidence, pseudotumor, dermoid cysts, neurilemmoma, polymorphous adenoma and meningioma. The sensitivity in diagnosis of orbital tumor by CT was 93.3%. The coincidence of CT histological diagnosis with pathology were 83.3 %, 82.6 % and 71.4% for dermoid.cysts, hemangioma, and pseudotumor respectively, but the general coincidence of CT histological diagnosis with pathology was only 67.8 %. When CT was combined with ultrasound, cytological examination and clinical manifestations, the accuracy of histological diagnosis could be improved to 83.3 %.

Analysis of Treatment Results for Pineal Region Tumors

The authors think that the more desirable treatment for pineal region tumors is definitive surgery with a histological diagnosis and that a conservative approach consisting of shunting and radiation therapy no longer seems to be appropriate. We report the result of a retrospective review of the presentation, treatment, and outcome of the seventeen patients treated between June, 1989 and June, 1994. Nine patients were males and eight patients were females, and the age ranged from 13 to 51 years(mean age about 32 years old). Histological verification was available in fourteen tumors;six by an occipital transtentorial approach and five by an infratentorial supracerebellar approach and two by a stereotaxic biopsy and one by a frontotemporal craniotomy for ectopic germinoma. Germinomas were the most common type. Three of the seventeen patients died of tumor progression. Because the great variety of tumor found in the pineal region must be treated in different ways and because improved microsurgical and stereotaxic surgical techniques have made mortality and morbidity rates acceptably low, a biopsy diagnosis should be obtained.