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Introducción: El nódulo tiroideo es un hallazgo común en la actualidad y, por sus características ecográficas, constituye una lesión distinta al parénquima glandular, con una prevalencia alta en la población general. Objetivo: Describir el uso del sistema Bethesda como método de diagnóstico de nódulos tiroideos y el grado de malignidad. Métodos: Se efectuó un estudio descriptivo y retrospectivo de 1771 pacientes con diagnóstico de nódulo tiroideo, a quienes se les realizó citología por aspiración con aguja fina en el Departamento de Anatomía Patológica del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba durante el cuatrienio 2016-2019. Resultados: En la serie predominó el grupo etario de 41-50 años y la edad media fue de 49,51±13,14 años. Asimismo, sobresalió la categoría II del sistema Bethesda (73,8 %); en tanto, de los 204 diagnosticados correspondientes a la categoría III, 111 fueron intervenidos quirúrgicamente y 29 de estos presentaron neoplasias malignas (27,6 %). El grado de malignidad osciló entre 22,8 y 36,0 %. Conclusiones: La aplicación del sistema Bethesda fue muy útil para el diagnóstico citopatológico de nódulos tiroideos y el grado de malignidad se correspondió con cifras adecuadas.
Introduction: The thyroid nodule is a common finding nowadays and, for its echographic characteristics, it constitutes a lesion different to the glandular parenchyma, with a high prevalence in the general population. Objective: To describe the use of the Bethesda system as diagnostic method of thyroid nodules and the degree of malignancy. Methods: A descriptive and retrospective study of 1 771 patients with diagnosis of thyroid nodule was carried out, who underwent fine needle aspiration cytology, in the Pathology Department of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba during 2016-2019. Results: In the series there was a prevalence of the 41-50 age group and the mean age was of 49,51±13,14 years. Also, the category II of the Bethesda system was notable (73.8 %); as long as, of the 204 diagnosed corresponding to the category III, 111 were surgically intervened and 29 of them presented mlignancy (27.6 %). The degree of malignancy oscillated between 22.8 and 36.0 %. Conclusions: The application of the Bethesda system was very useful for the cytopathologic diagnosis of thyroid nodules and the degree of malignancy corresponded with appropriate figures.
Subject(s)
Thyroid Nodule , Biopsy, Fine-NeedleABSTRACT
Objective:The aim of this study is to investigate the expression of p53 and PD-L1 in ultrasound-guided core needle biopsy specimens of breast cancer, and to analyze their application value.Methods:Ninety-eight patients who underwent ultrasound-guided coarse needle puncture biopsy and radical operation admitted to our hospital from Aug. 2021 to Sep. 2022 were selected as the study objects. The clinical data of patients were collected, the expression of p53 and PD-L1 in puncture biopsy specimens and radical surgical excision specimens were detected by immunohistochemical experiment, and the consistency was analyzed. Statistical test was used to analyze the relationship between the expression of p53 and PD-L1 and the pathological parameters of patients.Results:In 98 patients, the positive rate of p53 and PD-L1 in core needle biopsy specimens was 48.0% and 55.1%, respectively. The positive rate of p53 and PD-L1 in radical operative specimens was 62.2% and 61.2%, respectively. The concordance rates of p53 and PD-L1 were 63.6% ( κ=0.441, P<0.001) and 65.3% ( κ=0.505, P<0.001) between core needle biopsy specimens and radical operative specimens. Taking the results of radical operative specimens as the standard, the cases with positive expression of p53 and PD-L1 in core needle biopsy specimens were all positive in radical operative specimens, and the specificity was 100%. p53 was determined negative in 25 coarse needle biopsy specimens, however, p53 was positive in radical surgical specimens, and the false negative rate of coarse needle puncture was 49.0 %. PD-L1 was determined negative in 20 coarse needle biopsy specimens, but it was determined positive in radical operative specimens, and the false negative rate of coarse needle puncture was 41.7 %. There was no significant correlation between the consistency rate of p53 and PD-L1 expression and the number of puncture cores, the length of puncture cores, the length of invasive carcinoma and the proportion of invasive carcinoma (all P>0.05). The expressions of p53 and PD-L1 in core needle biopsy specimens were significantly correlated with tumor size, pTNM stage and Ki67 (all P<0.05), but not with age, BMI, family history, histological type or Nottingham histological grade (all P>0.05) . Conclusion:The concordance rates of p53 and PD-L1 expression between ultrasound-guided core needle biopsy specimens and radical resection specimens of breast cancer were 63.6% and 65.3%, respectively, and the specificity of positive detection results were both 100%, which has certain guiding significance for the clinical treatment of breast cancer.
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OBJECTIVE@#To explore the protocol for diagnosing thyroid nodules based on core needle biopsy (CNB) and study the biomarkers' application in distinguishing indeterminate samples.@*METHODS@#Patients with thyroid nodules treated at Peking University First Hospital from 2015 to 2020 were reviewed. In the study, 598 cases with CNB and matched resected specimens were retrieved. According to "diagnostic categories of thyroid CNB" proposed by the Korean Endocrine Pathology Thyroid Core Needle Biopsy Study Group, the CNB samples were diagnosed as follows: Ⅰ, unsatisfactory; Ⅱ, benign; Ⅲ, indeterminate; Ⅳ, follicular neoplasm; Ⅴ, suspicious for malignancy; and Ⅵ, malignant. The samples of CNB Ⅲ were stained by immunohistochemistry (IHC) using antibodies against CK19, Galectin-3, HBME-1, and CD56, and detected by next-generation sequencing (NGS) using an OncoAim® thyroid cancer multigene assay kit (Singlera Genomics) that detected 26 genes. Taking the resected specimens' classification as the gold standard, the predictive value of CNB for determining the malignancy of thyroid nodules and the biomarkers for distinguishing the samples of CNB Ⅲ was calculated.@*RESULTS@#The study included 598 patients, of which none were CNB Ⅰ, 40 cases were CNB Ⅱ, 40 cases were CNB Ⅲ, 32 cases were CNB Ⅳ, 35 cases were CNB Ⅴ, and 451 cases were CNB Ⅵ. The predictive value of CNB Ⅳ for determining follicular neoplasm was sensitivity (Sen) 100.00% and specificity (Sep) 100.00%, CNB Ⅴ-Ⅵ for determining malignancy was Sen 94.55% and Sep 100.00%, CNB Ⅱ for determining benign lesions was Sen 75.00% and Sep 99.80%. The predictive value of biomarkers for determining malignancy in cases of CNB Ⅲ was Sen 96.30% and Sep 92.31% by NGS, and Sen 81.48% and Sep 92.30% by IHC.@*CONCLUSION@#The Korean "diagnostic categories of thyroid CNB", which considers the histological specificity of CNB samples and the habits of clinicians, have strong operability, high diagnosis rate, and high clinical value. Under this framework, the cases of CNB Ⅵ should be treated with surgical operation, the cases of CNB Ⅴ-Ⅵ are recommended to be treated as malignant neoplasms, and the major cases of CNB Ⅱ could be followed up without worrisome except the one considered malignant by ultrasound. The value of biomarkers in distinguishing the cases of CNB Ⅲ is significant.
Subject(s)
Humans , Thyroid Nodule/surgery , Biopsy, Large-Core Needle/methods , Thyroid Neoplasms/surgery , BiomarkersABSTRACT
Abstract Objective: This study aimed to perform a meta-analysis to investigate the diagnostic safety and accuracy of Ultrasound-Guided Core Needle Biopsy (US-CNB) Axillary Lymph Nodes (ALNs) region in patients with Breast Cancer (BC). Methods: The authors searched the electronic databases PubMed, Scopus, Embase, and Web of Science for clinical trials about US-CNB for the detection of ALNs in breast cancer patients. The authors extracted and pooled raw data from the included studies and performed statistical analyses using Meta-DiSc 1.4 and Review Manager 5.3 software. A random effects model was used to calculate the data. At the same time, data from the Ultrasound-guided Fine-Needle Aspiration (US-FNA) were introduced for comparison with the US-CNB. In addition, the subgroup was performed to explore the causes of heterogeneity. (PROSPERO ID: CRD42022369491). Results: In total, 18 articles with 2521 patients were assessed as meeting the study criteria. The overall sensitivity was 0.90 (95% CI [Confidence Interval], 0.87‒0.91; p = 0.00), the overall specificity was 0.99 (95% CI 0.98‒ 1.00; p = 0.62), the overall area under the curve (AUC) was 0.98. Next, in the comparison of US-CNB and US-FNA, US-CNB is better than US-FNA in the diagnosis of ALNs metastases. The sensitivity was 0.88 (95% CI 0.84‒ 0.91; p = 0.12) vs. 0.73 (95% CI 0.69‒0.76; p = 0.91), the specificity was 1.00 (95% CI 0.99‒1.00; p = 1.00) vs. 0.99 (95% CI 0.67‒0.74; p = 0.92), and the AUC was 0.99 vs. 0.98. Subgroup analysis showed that heterogeneity may be related to preoperative Neoadjuvant Chemotherapy (NAC) treatment, region, size of tumor diameter, and the number of punctures. Conclusion: US-CNB has a satisfactory diagnostic performance with good specificity and sensitivity in the preoperative diagnosis of ALNs in BC patients.
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Los quistes constituyen una cavidad patológica revestida por una pared de tejido conectivo definida y con un tapiz epitelial. Se tuvo como objetivo determinar la correlación de los diagnósticos clínico y citológico en los quistes congénitos Cervicofaciales. Se realizó un estudio retrospectivo de los pacientes con diagnóstico clínico, citológico y/o histológico de quiste tirogloso, branquial y demodé, atendidos en el hospital Universitario Carlos Manuel de Céspedes de Bayamo, durante cinco años. Se calculó la sensibilidad, especificidad y seguridad del diagnóstico clínico y la biopsia por aspiración con aguja fina (FNAC) para cada quiste. El diagnóstico clínico fue de 93,3%, 60,0% y el 100,0 % para los quistes tirogloso branquial y dermoide respectivamente. Encontramos mayor tendencia al error clínico en los quistes branquiales, donde las confusiones más frecuentes se presentan con linfoadenopatías inflamatorias. El diagnóstico por aspiración con aguja fina fue de 93.3% y el 60% para los quistes tirogloso y branquial respectivamente. Se concluyó que el diagnóstico clínico no es suficiente en ocasiones, por lo que es preciso recurrir a medios diagnósticos complementarios, como la biopsia por aspiración con aguja fina; sin embargo esta prueba no es 100% segura.
Cysts constitute a pathological cavity lined by a defined connective tissue wall and with an epithelial tapestry. The objective was to determine the correlation of clinical and cytological diagnoses in congenital cervicofacial cysts. A retrospective study of patients with clinical, cytological and/or histological diagnosis of thyroglossal, branchial and demodé cysts, attended at the Carlos Manuel de Céspedes University Hospital in Bayamo, for five years, was conducted. We calculated the sensitivity, specificity and safety of clinical diagnosis and fine needle aspiration biopsy (FNAC) for each cyst. The clinical diagnosis was 93.3%, 60.0% and 100.0% for branchial thyroglossal and dermoid cysts respectively. We found a greater tendency to clinical error in branchial cysts, where the most frequent confusions occur with inflammatory lymphadenopathy. The diagnosis by fine needle aspiration was 93.3% and 60% for thyroglossal and branchial cysts respectively. It was concluded that clinical diagnosis is sometimes not sufficient, so it is necessary to resort to complementary diagnostic means, such as fine needle aspiration biopsy; However, this test is not 100% safe.
Os cistos constituem uma cavidade patológica revestida por uma parede de tecido conjuntivo definida e com uma tapeçaria epitelial. O objetivo foi determinar a correlação dos diagnósticos clínicos e citológicos em cistos cervicofaciais. Foi realizado um estudo retrospectivo de pacientes com diagnóstico clínico, citológico e/ou histológico de cistos tireoglossos, branquiais e demodé, atendidos no Hospital Universitário Carlos Manuel de Céspedes, em Bayamo, por cinco anos. Foram calculadas a sensibilidade, especificidade e segurança do diagnóstico clínico e da punção aspirativa por agulha fina (PAAF) para cada cisto. O diagnóstico clínico foi de 93,3%, 60,0% e 100,0% para cistos branquiais tireoglosso e dermóide, respectivamente. Encontramos maior tendência ao erro clínico nos cistos branquiais, onde as confusões mais frequentes ocorrem com linfadenopatia inflamatória. O diagnóstico por punção aspirativa por agulha fina foi de 93,3% e 60% para cistos tireoglossos e branquiais, respectivamente. Concluiu-se que o diagnóstico clínico às vezes não é suficiente, sendo necessário recorrer a meios diagnósticos complementares, como a punção aspirativa por agulha fina; No entanto, este teste não é 100% seguro.
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SUMMARY OBJECTIVE: This study aimed to evaluate the effect of the neutrophil-to-lymphocyte ratio on the differentiation of benign and malignant masses in the submandibular triangle. METHODS: We retrospectively evaluated 48 patients who underwent surgery for submandibular gland masses between January 2013 and February 2023. The patient's age, gender, preoperative complete blood count and imaging findings, postoperative histopathological diagnosis, and hemogram data were analysed. Patients were evaluated according to their postoperative histopathological diagnoses and categorised into four main groups: sialolithiasis, sialadenitis, benign tumours, and malignant tumours. Benign submandibular gland disease formations were evaluated under group B and malignant tumour formations under group M. RESULTS: A preoperative fine needle aspiration biopsy was performed on 19 patients due to sialadenitis, pleomorphic adenoma, and malignant diseases other than sialolithiasis. One patient died among the patients with malignant disease and the remaining 7 patients were compared with the benign group of 40 patients regarding preoperative and postoperative neutrophil-to-lymphocyte ratio. In the benign group, the neutrophil-to-lymphocyte ratio was 2.64 preoperatively and decreased to 2.34 in the first postoperative year. The preoperative neutrophil-to-lymphocyte ratio decreased from 4.79 to 1.77 postoperatively in the malignant group. A statistically significant difference was observed (p<0.05). CONCLUSION: This is the first study to demonstrate that the neutrophil-to-lymphocyte ratio can be used as a biomarker in submandibular gland masses and has prognostic significance in malignant masses. In addition to fine needle aspiration biopsy results, neutrophil-to-lymphocyte ratio can be used as a biomarker.
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Abstract Objective Breast cancer (BC) biomarkers, such as hormone receptors expression, are crucial to guide therapy in BC patients. Antiandrogens have been studied in BC; however, limited data are available on androgen receptor (AR) expression test methodology. We aim to report the core needle biopsy (CNB) accuracy for AR expression in BC. Methods Patients diagnosed with stage I-III invasive BC from a single institution were included. Androgen receptor expression was evaluated by immunohistochemistry (IHC) using 1 and 10% cutoff and the AR expression in surgical specimens (SS) was the gold standard. Kappa coefficients were used to evaluate the intraprocedural agreement. Results A total of 72 patients were included, with a mean age of 61 years old and 84% were Luminal A or B tumors. The prevalence of AR expression in all BC samples was 87.5% using a cutoff ≥ 10% in SS. With a cutoff value ≥ 1%, CNB had an accuracy of 95.8% (Kappa value = 0.645; 95% confidence interval [CI]: 0.272-1.000; p< 0.001) and 86.1% (Kappa value = 0.365; 95% CI: 0.052-0.679; p< 0.001) when ≥ 10% cutoff was used for AR positivity. Androgen receptor expression in CNB (cutoff ≥ 1%) had a sensitivity of 98.5%, specificity of 60%, positive predictive value of 97.0%, and a negative predictive value of 76.9% in the detection of AR expression in SS. Conclusion Core needle biopsy has good accuracy in evaluating AR expression in BC. The accuracy of CNB decreases with higher cutoff values for AR positivity.
Resumo Objetivo Biomarcadores, como a expressão de receptores hormonais, são cruciais para guiar a terapia de pacientes com câncer de mama. Apesar de ter sido estudado, poucos dados estão disponíveis sobre o método de testagem. Buscamos avaliar a precisão da biópsia com agulha de grande calibre (CNB, na sigla em inglês) para a expressão de receptores androgênicos (AR, na sigla em inglês) no câncer de mama. Métodos Foram incluídos pacientes de uma única instituição diagnosticados com câncer de mama invasivo estágio I-III. A expressão de AR foi avaliada por imunohistoquímica, com valores de cutoff de 1 e 10%. A expressão de AR em espécimes cirúrgicos foi o padrão ouro. O coeficiente Kappa foi usado para avaliar a concordância entre procedimentos. Resultados Foi incluído um total de 72 pacientes, com idade média de 61 anos; 84% eram tumores luminais A ou B. A prevalência da expressão de AR em todas as amostras foi de 87.5%, com cutoff ≥ 10%. Com um valor de cutoff ≥ 1%, a CNB teve precisão de 95.8% (Kappa = 0.64; intervalo de confiança [IC] 95%: 0.272-1.000; p< 0.001) e 86.1% (Kappa = 0.365; CI95%: 0.052-0.679]; p< 0.001) quando um cutoff ≥ 10% foi usado para AR positivo. A expressão de AR na CNB (cutoff ≥ 1%) teve a sensibilidade de 98.5%, especificidade de 60%, valor preditivo positivo de 97.0% e valor preditivo negativo de 76.9% na detecção. Conclusão -Biópsia com agulha de grande calibre tem uma boa precisão em avaliar a expressão de AR no câncer de mama. A precisão do método cai com valores elevados de cutoff para AR positivo.
Subject(s)
Humans , Female , Breast Neoplasms/diagnosis , Immunohistochemistry , Receptors, Androgen , Biomarkers, Tumor , Biopsy, Large-Core NeedleABSTRACT
Protocol biopsy (PB) is a planned needle biopsy of transplanted kidney and pathological observation for timely diagnosing the potential complications in transplanted kidney and guiding clinical interventions and adjusting immunosuppression regimen before an onset of dysfunction of transplanted kidney.With accurate information, it may grasp the baseline data of transplanted kidney histopathology.If detected early, timely measures may avert the existence of subclinical rejection or viral infection, avoid inflammation or injury and prevent various complications to ensure a better prognosis of transplanted kidney.At the same time, it is imperative to recognize the disadvantages of procedural biopsy, such as invasiveness, time consuming, greater patient discomfort and medical expenditure.This review focused upon the advantages and disadvantages of PB and its clinical application value.In light of the latest advances of clinical researches, favorable factors of PB are optimized for better long-term functional survival of transplanted kidney.
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ABSTRACT Objective: Cytological analysis and Bethesda classification of thyroid nodules is the standard method of diagnosing differentiated thyroid carcinoma (DTC). However, even for nodules with a non-malignant cytological diagnosis, there is a not insignificant risk of cancer. There are doubts whether this lack of certainty would influence patient prognosis. Our aim was to compare patients with DTC, classified according to the preoperative cytological diagnosis, regarding their evolution. Subjects and methods: A retrospective study was carried out with 108 DTC patients submitted to total thyroidectomy (TT) between 2009 and 2015, divided into three groups according to preoperative cytological diagnosis (Bethesda classification): classes I/II, III/IV, and V/VI. Groups were compared for evolution considering response to treatment at last evaluation as well as time disease free. Statistical analysis used ANOVA, chi squared, and Kaplan-Meier curves with p<0.05 considered significant. Results: Groups differed for time between nodule puncture and TT [in months; V/VI (2.35 ± 2.48) < III/IV (7.32 ± 6.34) < I/II (13.36 ± 8.9); p < 0.0001]. There was no significant difference between groups for evolution at final evaluation (disease free status; classes I/II: 71.4%; classes III/IV: 60%; classes V/VI: 66.6%; p = 0.7433), as well as time disease free (in months; classes I/II: 34.57 ± 25.82; classes III/IV: 38.04 ± 26.66; classes V/VI: 30.84 ± 26.34; p = 0.3841). Conclusions: DTC patients classified according to preoperative cytological diagnosis did not differ for evolution. Although patients with non-malignant cytological diagnoses were submitted to TT later, this did not affect the evolution of the cases.
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Objective:To compare the safety and clinical value of percutaneous computed tomography (CT)-guided fine-needle aspiration biopsy (CT-FNA) with CT-guided core-needle biopsy (CT-CNB) in diagnosis of pancreatic lesions.Methods:We retrospectively analyzed the clinical data of patients with pancreatic lesions who underwent percutaneous CT-guided biopsy from January 2017 to January 2022 at the First Affiliated Hospital of Zhengzhou University. A total of 454 patients (251 men, 203 women) were enrolled in this study with age of (60.5±11.6) years old. They were divided into the CT-FNA group ( n=300) and the CT-CNB group ( n=154) according to the biopsy method. The one-time diagnosis rate, accuracy, sensitivity, false negative rate and incidence rate of complications of the two groups were compared. Results:The one-time diagnosis rate and accuracy rate in the CT-CNB group were slightly higher than those in the CT-FNA group, but the differences were not statistically significant [92.2%(142/154) vs. 86.0%(258/300), χ 2=3.74, P=0.053; 97.4%(150/154) vs. 92.0%(276/300), χ 2=0.16, P=0.690]. Compared with the CT-FNA group, the CT-CNB group had a higher sensitivity and a lower false negative rate, and the differences were statistically significant [97.2%(138/142) vs. 91.5%(260/284), χ 2=4.89, P=0.036; 2.8%(4/142) vs. 8.5%(24/284), χ 2=4.89, P=0.036]. Common complications in the two groups were pain, hematoma and pancreatitis, and there was no statistically significant difference in the incidences of complication [9.0%(27/300) vs. 9.1%(14/154), χ 2<0.01, P=0.975]. Conclusions:Both CT-FNA and CT-CNB were safe for diagnosis of pancreatic lesions, with high diagnostic yields and with similar safety and accuracy. When compared with CT-FNA, CT-CNB has a higher sensitivity and a lower false negative rate.
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Objective:To explore the safety and feasibility of optimized pathological evaluation system of donor's kidney and modified surgery during adult dual kidney transplantation(DKT)and evaluate its effectiveness to provide more alternative protocols for kidney transplantation from extended criteria donors.Methods:DKT was performed in 10 recipients using the same protocol from June 2019 to May 2021.And retrospective reviewing was performed for clinical data, including characteristics of donors and recipients, optimized pathological evaluation system, modified surgery, treatment regimens, complications and follow-ups.Results:There were 8 male and 2 female donors with an age of(57.9±12.8)years and BMI(24.1±4.1)kg/m 2.The percentage of DCD was 70% and DBD 30%.The serum creatinine before procurement was 107.6(93.3-163.5)μmol/l.Zero-point puncture biopsy was performed for both kidneys and optimized pathological evaluation system was implemented(Banff criteria & Remuzzi score). The pathological results indicated that glomerular sclerosis for left and right kidneys were 2.0(1.5-2.0)and 1.5(1.0-2.0). And Remuzzi score for left and right kidneys were(4.4±1.2)and(3.6±1.5)points respectively.All recipients were male with an age of(43.1±9.0)years and BMI(22.2±1.9)kg/m 2.All PRAs were negative pre-operation.Modified surgery was performed in all recipients(two kidneys were implanted outside iliac vessels without patch and artery of superior kidney was anastomosed to internal iliac artery). Operative duration was(195±54.3)min and serum creatinine before discharge 125.0(102.0-199.0)μmol/L.Renal dynamic scintigraphy indicated that glomerular filtration rate was(30.0±8.2)ml/min for left kidney and(29.2±13.9)ml/min for right kidney.MRA results indicated that morphologies of renal arteries and veins were regular.The time between operation and discharge was(22.4±4.7)days.Compared with SKT, serum creatinine before discharge of DKT was lower and DGF incidence of DKT was higher without statistical significance.The time between operation and discharge was longer for DKT than that for SKT( P<0.05). The complications consisted of 20% donor derived infection(DDI)and 50% DGF.And there was no surgical complication associated with vessels and ureter.Renal function remained stable during 6-month follow-ups. Conclusions:Optimized pathological evaluation system of donor's kidney and modified surgery during adult dual kidney transplantation are both safe and feasible.The postoperative function of transplanted dual kidney is successfully restored.However, long-term follow-ups are required for evaluating its effectiveness.
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Introducción. El cáncer de pulmón es la primera causa de mortalidad por cáncer a nivel mundial, lo que hace que sea considerado un problema de salud pública. Existen diferentes hallazgos imagenológicos que hacen sospechar la presencia de cáncer de pulmón, uno de los cuales son los nódulos pulmonares; sin embargo, estos también pueden verse en entidades benignas.Métodos. Se incluyeron 66 pacientes con biopsia de nódulo pulmonar en la Clínica Reina Sofía, en la ciudad de Bogotá, D.C., Colombia, entre el 1° de marzo del 2017 y el 28 de febrero del 2020. Se analizaron las características demográficas de los pacientes, las características morfológicas e histopatológicas de los nódulos pulmonares y la correlación entre sus características imagenológicas e histopatológicas. Resultados. El 69,2 % de los nódulos estudiados tenían etiología maligna, de estos el 55,5 % era de origen metástasico y el 44,5 % eran neoplasias primarias de pulmón, con patrón sólido en el 70,6 % de los casos. El patrón histológico más frecuente fue adenocarcinoma. Respecto a las características radiológicas, en su mayoría los nódulos malignos medían de 1 a 2 cm, de morfología lisa y distribución múltiple, localizados en lóbulos superiores. Conclusiones. La caracterización de los nódulos pulmonares brinda información relevante que orienta sobre los diagnósticos más frecuentes en nuestro medio, cuando se estudian nódulos sospechosos encontrados incidentalmente o en el seguimiento de otro tumor. Como el nódulo es la manifestación del cáncer temprano del pulmón, establecer programas de tamización que permitan el diagnóstico oportuno, es hoy día una imperiosa necesidad, para reducir la mortalidad.
Introduction. Lung cancer is the leading cause of cancer mortality worldwide, which makes it a public health problem. There are different imaging findings that suggest the presence of lung cancer, one of which is pulmonary nodules; however, these can also be seen in benign entities. Methods. A total of 66 patients with pulmonary nodule biopsy at Clínica Reina Sofía, in the city of Bogotá D.C. were included between March 1, 2017 and February 28, 2020. The demographic characteristics of the patients, the morphologic and histopathologic characteristics of the pulmonary nodules and their correlation with their pathological diagnosis were analyzed.Results. 69.2% of the nodules studied had malignant etiology, of these 55.5% were of metastatic origin, and 44.5% were primary lung neoplasms, with a solid pattern in 70.6% of the cases. The most frequent histological pattern was adenocarcinoma. Regarding the radiological characteristics, most of the malignant nodules measure 1 to 2 cm, of smooth morphology and had multiple distribution, located in the upper lobes. Conclusions. The characterization of pulmonary nodules provides relevant information that guides the most fre-quent diagnoses in our setting, when suspicious nodules found incidentally or in the follow-up of another tumor are studied. As the nodule is the manifestation of early lung cancer, establishing screening programs that allow timely diagnosis is an urgent need to reduce mortality.
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Humans , Solitary Pulmonary Nodule , Lung Neoplasms , Pathology , Biopsy, Needle , Diagnostic Imaging , DiagnosisABSTRACT
Abstract Objective: To assess the technique, efficacy, and safety of computed tomography (CT)-guided percutaneous biopsies of head and neck masses. Materials and Methods: This was a retrospective, single-center study of CT-guided percutaneous core-needle biopsies of head and neck masses. For the analysis of diagnostic accuracy, biopsy results were compared with the final diagnosis, which was determined by histological examination and clinical follow-up. Results: We evaluated 74 biopsies performed in 68 patients. The mean age of the patients was 55.6 years. Most of the lesions (79.7%) were located in the suprahyoid region, and the maximum diameter ranged from 11 mm to 128 mm. The most common approaches were paramaxillary (in 32.4%), retromandibular (in 21.6%), and periorbital (in 14.9%). Five patients (6.8%) developed minor complications. The presence of a complication did not show a statistically significant association with any clinical, radiological, or procedure-related factor. Sufficient material for histological analysis was obtained in all procedures. Thirty-eight biopsies (51.4%) yielded a histological diagnosis of malignancy. There was a false-negative result in three cases (8.3%), and there were no false-positive results. The procedure had a sensitivity of 92.7%, a specificity of 100%, and an accuracy of 96.0%. Conclusion: Our results demonstrate that CT-guided percutaneous core-needle biopsy of head and neck lesions is a safe, effective procedure for obtaining biological material for histological analysis.
Resumo Objetivo: Avaliar a técnica, eficácia e segurança das biópsias percutâneas guiadas por tomografia computadorizada (TC) de lesões de cabeça e pescoço. Materiais e Métodos: Este estudo retrospectivo e unicêntrico incluiu pacientes submetidos a biópsia percutânea guiada por TC de lesões de cabeça e pescoço. Para avaliação da acurácia diagnóstica, os resultados da biópsia foram comparados com o diagnóstico final determinado por avaliação histológica ou acompanhamento clínico. Resultados: Foram avaliadas 74 biópsias realizadas em 68 pacientes. A média de idade dos pacientes foi de 55,6 anos. A maioria das lesões (79,7%) estava localizada na região supra-hioide e o maior diâmetro variou de 11 a 128 mm. Os acessos mais comuns utilizados foram paramaxilar (32,4%), retromandibular (21,6%) e periorbital (14,9%). Cinco pacientes (6,8%) desenvolveram complicações menores e não houve associação estatisticamente significante entre a presença de complicações e fatores clínicos, radiológicos ou relacionados ao procedimento. Foi obtido material suficiente para análise histológica em todos os casos. Trinta e oito biópsias (51,4%) tiveram diagnóstico histológico de malignidade. Houve três (8,3%) resultados falso-negativos e nenhum falso-positivo, demonstrando sensibilidade de 92,7%, especificidade de 100% e acurácia de 96,0%. Conclusão: Nossos resultados demonstram que a biópsia percutânea guiada por TC de lesões de cabeça e pescoço é um procedimento seguro e efetivo para obter material para análise histológica.
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La aspiración con aguja fina (ACAF) es una técnica ampliamente utilizada por su alta seguridad y fácil uso. Sin embargo, al usarse en conjunto con la evaluación rápida de la muestra en el sitio de la toma (ROSE, del inglés, Rapid On- Site Evaluation), disminuyen los tiempos necesarios para la evaluación y el diagnóstico, mejora la calidad de la muestra, disminuye el número de punciones por procedimiento y limita la necesidad de repetir la prueba, lo que hace que el uso combinado de ambas técnicas sea de gran utilidad y cada vez más solicitado en los servicios de imágenes diagnósticas y patología. ROSE, además, permite una clasificación adecuada del material recolectado para cultivos, estudios de citometría de flujo y pruebas moleculares. Particularmente, en los pacientes con nódulos tiroideos, la realización de ROSE durante el procedimiento de evaluación ecográfica y punción, puede garantizar que la muestra extraída sea suficiente y adecuada para el diagnóstico, y, así mismo, permite evaluar la necesidad de estudios complementarios de manera inmediata, brindando un diagnóstico rápido y preciso, disminuyendo los costos relacionados con la repetición del procedimiento y la morbilidad asociada a complicaciones por punciones múltiples
Fine needle aspiration (FNA) is a widely used technique due to its high safety and ease of use. However, when used in combination with Rapid On-Site Evaluation (ROSE), there is a reduction in the time required for evaluation and diagnosis, as well as an improvement in the sample quality, a reduction in the number of needle passes and the need to repeat the test, which makes the combined use of both techniques very useful and increasingly requested in the diagnostic imaging and pathology services. ROSE also allows a proper classification of the collected material for cultures, flow cytometry studies and molecular tests. Particularly in patients with thyroid nodules, the performance of ROSE during the ultrasound evaluation and biopsy procedure can guarantee that the sample extracted is sufficient and adequate for the diagnosis, and, likewise, an immediate evaluation for the need for complementary studies can be achieved, providing a fast and accurate diagnosis, reducing the costs related to repeating the procedure, and the morbidity associated with complications from multiple biopsies
Subject(s)
Biopsy, Fine-Needle , Pathology , Specimen Handling , Thyroid Nodule , DiagnosisABSTRACT
OBJECTIVES: This study aimed to evaluate the clinical and imaging predictive factors for the diagnosis of phyllodes tumors in patients with inconclusive results from core needle biopsy (fibroepithelial lesions). METHODS: We retrospectively analyzed data of patients who underwent surgical excision of breast lesions previously diagnosed as fibroepithelial lesions. Numeric variables were analyzed using the Shapiro-Wilk and t-tests, and categorical variables were analyzed using the chi-square and Fisher's exact tests. Multivariate logistic regression was performed to calculate odds ratios and detect predictive factors for the diagnosis of PT. RESULTS: A total of 89 biopsy samples were obtained from 77 patients, of which 43 were confirmed as fibroadenomas, 43 as phyllodes tumors, and 3 as other benign, non-fibroepithelial breast lesions. The mean tumor size was 3.61 cm (range, 0.8-10 cm) for phyllodes tumors and 2.4 cm (range, 0.8-7.9 cm) for fibroadenomas. The predictive factor for phyllodes tumor diagnosis was lesion size >3 cm (p<0.001). CONCLUSION: Our data indicate that fibroepithelial lesions of the breast larger than 3 cm are more likely to be phyllodes tumors.
Subject(s)
Humans , Breast Neoplasms , Neoplasms, Fibroepithelial , Phyllodes Tumor/surgery , Phyllodes Tumor/diagnosis , Retrospective Studies , Diagnosis, Differential , Biopsy, Large-Core NeedleABSTRACT
OBJECTIVE@#To analyze the results of percutaneous core needle biopsy for bone tumors in upper limbs with pathologic fracture and to find the possible factors that could impact the results.@*METHODS@#The including criteria for this study was the patients who had received percutaneous core needle biopsy and definitive surgery, whose tumor was located at upper limb with pathologic fracture. From January 2015 to December 2019, seventy-seven patients were enrolled. There were 55 males and 22 females. The median age was 27 years old (range:5 to 88 years old). The tumor located at humerus in 67 cases, radius in 8 cases and ulna in 2 cases. If the pathologic diagnosis of core needle biopsy was the same with the definitive surgery, it was defined as "correct". If the pathologic diagnosis of biopsy for benign or malignant was right but the exact diagnostic name was not the same with definitive surgery, it was defined as "supportive". If the pathologic diagnosis of biopsy for benign or malignant was not correct, it was defined as "wrong". We retrospectively analyzed the accuracy and impact factors for core needle biopsy.@*RESULTS@#The result was "correct" in 63 cases(81.8%), "supportive" in 14 cases(18.2%), and "wrong" in 0 cases. We analyzed the gender, age, location, fracture displacement, the destroyed type for bone tumor, soft tissue mass, fluid area in the tumor as the factors. The results showed the rate for "correct" was significantly higher when the tumor had soft tissue mass (@*CONCLUSION@#The accuracy of percutaneous core needle biopsy for upper limb bone tumor with pathologic is high and acceptable. The biopsy chosen the soft tissue mass area can increase the accuracy.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Biopsy, Large-Core Needle , Bone Neoplasms , Fractures, Spontaneous , Retrospective Studies , Soft Tissue Neoplasms , Upper ExtremityABSTRACT
Objective To investigate the clinical value of core-needle biopsy(CNB)for low-risk papillary thyroid microcarcinoma(PTMC)after radiofrequency ablation(RFA). Methods A total of 190 patients(including 142 females and 48 males,20-74 years old)with unifocal low-risk PTMCs[mean volume of(106.29±96.15)mm
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Biopsy, Needle , Carcinoma, Papillary/surgery , Radiofrequency Ablation , Thyroid Neoplasms , Ultrasonography, InterventionalABSTRACT
Ultrasound guided needle biopsy or catheterization is a rising operation in clinical diagnosis and treatment. However, poor visualization under ultrasound is the main disadvantage of this technique. This paper summarized the basic methods used to solve such problem, as well as the corresponding product technical requirements.
Subject(s)
Catheters , Needles , Ultrasonics , Ultrasonography , Ultrasonography, InterventionalABSTRACT
In this study, we reported seven patients who underwent diagnostic evaluation through core-needle biopsy (CNB) of the spleen. After biopsy, gelatin sponge particles mixed with hemocoagulase were gradually injected using a coaxial introducer needle. One patient received microwave ablation following the CNB. All patients were followed up by computed tomography to rule out bleeding or accidental injuries both immediately after the biopsy and within 24 h. Adequate specimens for pathologic examination were obtained from all patients, and the biopsy technical success rate was 100%. No serious complications were observed in our case series. There was no evidence of postbiopsy bleeding. Therefore, injection of gelatin sponge particles mixed with hemocoagulase or microwave ablation may be effective options to prevent hemorrhage after splenic core-needle biopsies
ABSTRACT
Objective: The objective is to evaluate the application of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) in the diagnosis of the left-lobe hepatocellular carcinoma (HCC) in cirrhotic patients with contraindication to percutaneous biopsy. Materials and Methods: Thirty-eight consecutive patients with liver cirrhosis and suspected left-lobe HCC and with contraindication for percutaneous biopsy undergoing EUS-FNB between January 2011 and December 2014 were included in this study. The final diagnosis was obtained through histopathology of surgical samples or clinical and imaging results with follow-up. Using the final diagnosis as the gold standard, the diagnostic performance of EUS-FNB for HCC detection was evaluated. Results: Among 38 patients, EUS-FNB was successfully performed in 34 cases, in which adequate biopsy specimens were obtained for histopathological examination in 30. For the 30 patients with biopsy results, 25 cases were confirmed to have HCC, while five cases had benign lesions according to the final diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates of EUS-FNB in the diagnosis of HCC were 88.0% (22/25), 100.0% (5/5), 100.0% (22/22), 62.5% (5/8), and 90.0% (27/30), respectively. Self-limiting bleeding occurred in three patients. Conclusions: EUS-FNB is a sensitive and safe diagnostic modality for cirrhotic patients with suspected HCC located in the left lobe, especially those for whom percutaneous biopsy is contraindicated