mammographic and sonographic features of male breast diseases at King Hussein Medical Centre

To describe the mammographic and sonographic features of male breast diseases, and to correlate the radiological, cytological and histopathological diagnoses. This is a retrospective descriptive study that was conducted at King Hussein Medical Centre, Amman, Jordan between January 1st 2004 and December 31st 2007. The mammograms and breast ultrasounds of 88 symptomatic male patients were reviewed and analyzed. A total of 24 patients with unilateral breast masses underwent fine-needle aspiration, eight of them with suspected malignant lesions underwent further true cut biopsy and surgery. The radiological, cytological and histopathological diagnoses were correlated. Sixty one [70%] patients had gynaecomastia, 15 [17%] had fatty breasts [pseudo-gynaecomastia], eight [9%] had primary breast carcinoma, two [2%] had lipomas, one [1%] had abscess, and one [1%] had hematoma. The characteristic radiological features were confirmed by fine-needle aspiration cytology in 16 patients and by both cytology and histopathology studies in eight cases. Radiological findings provide characteristic diagnostic appearances for certain important male breast disease. The radiological features can be accurately correlated with pathological diagnosis

Fine-Needle aspiration of thyroid nodules has high sensitivity and specifity

To evaluate the cytological accuracy of fine needle aspiration [FNA] of solitary thyroid nodules in correlation with post-surgical histological findings. A total of 105 patients with clinically palpable solitary thyroid nodules were included in the study. Thyroid function tests were initially performed. Subsequently, thyroid ultrasound and FNA of the thyroid nodules were performed exclusively for all euthyroid patients with normal TSH. Only 88 patients underwent thyroid surgery. One hundred [95%] patients were euthyroid and 5 [5%] were hyperthyroid. Thyroid ultrasound of euthyroid patients showed solid nodules in 44 [41%] patients, cystic nodules in 35 [31%] patients, multinodular goiter in 15 [12%] patients, diffuse enlargement of the gland in 6 [4%] patients. FNA showed benign lesions in 58 patients, 2 no definite diagnosis in 13, papillary carcinoma in 13, follicular neoplasms in 11, autoimmune disease in 3 and Hurthle cell neoplasm in 2. FNA of thyroid nodules had sensitivity of 95% and specificity of 90%. This procedure is cost effective, reliable and highly accurate for rapid diagnosis of thyroid disease, and has reduced the need for unnecessary surgery

Scintimammography with 99M technetium - methoxyisobutylisonitrile versus X-Ray mammography in the evaluation of breast masses

To evaluate the diagnostic accuracy of scintimammography using 99m Technetium - methoxyisobutylisonitrile [99mTc-MIBI] in the detection of breast cancer in comparison with conventional mammography. A total of 113 patients with clinically suspicious breast masses and/or positive mammograms suggesting breast cancers were included in this study. After 10 minutes of 99mTc-MIBI injections, one anterior image in the prone positive and two lateral prone images were acquired for 10 minutes eash. Another set of images was taken in the same position after 60 min of injection. One-hundred and nineteen lesions [92 palpable and 27 non-palpable] were detected. There were 75 malignant and 44 benign lesions according to the histopathology findings obtained during excisional biopsies. The relation with the histopathology showed that the overall sensitivity and specificity of scintimammography were 68% and 73% respectively. However for palpable lesions, the sensitivity and specificity were 79% and 76% respectively. Sensitivity was not dependent on the density of the breast tissue. The sensitivity and specificity of mammography were 89% and 43% respectively, and did not depend on the tumor size. In 60% of false-negative mammograms, 99mTc-MIBI was able to diagnose malignancy [True-positive]. Imaging with 99mTc-MIBI showed a high diagnostic accuracy for the detection of breast cancer and could be used as a complementary imaging modality to conventional mammography in diagnosing breast cancer at an earlier stage particularly in patients with dense breasts