ABSTRACT
Objective: The objective of the study is to analyze the influencing factors on the results of thyroid fine-needle aspiration biopsy (FNAB). Method: A total of 339 patients who underwent FNAB in our hospital from December 2018 to July 2021 were retrospectively selected. The patients were chosen according to the gender ratio, age, and thyroid ultrasound characteristics and were divided into three groups: (1) a 22G needle vacuum aspiration group (Group 1, n = 85), (2) a 22G biopsy needle non-vacuum aspiration group (Group 2, n = 50), and (3) a 25G biopsy needle non-vacuum aspiration group (Group 3, n = 204). Patients in these groups were evaluated for determining the FNAB dissatisfaction rate of pathological samples. A bivariate regression analysis of independent risk factors related to the unsatisfactory pathological diagnosis of samples was performed. Results: The specimen dissatisfaction rates of the three groups were 22/85 (25.9%), 15/50 (30%), and 18/186 (9.7%), respectively. The overall sample dissatisfaction rate was 55/339 (16.2%), and the sample satisfaction rate of Group 3 was higher than that of Groups 1 and 2 (P < 0.05). Logistic bivariate regression analysis showed that the age of the patients and the capillary sampling needles and aspiration methods were two independent risk factors for determining the dissatisfaction rate of FNAB pathological samples. Conclusion: A 25G capillary sampling aspiration biopsy needle was selected to perform FNAB in thyroid nodules without vacuum aspiration, which could effectively improve the accuracy of FNAB results with a high specimen satisfaction rate.
ABSTRACT
AIMS: To demonstrate clinicopathologic features of Stewart-Treves syndrome (STS) including clinical manifestations, morphology, immunophenotype (especially c-MYC amplification), differential diagnosis, pathogenesis, treatment and prognosis. METHODS AND RESULTS: 17 cases of STS were retrospectively archived, involving 6 cases of postmastectomy, 3 cases of postoperative cervical cancer and 8 cases of chronic lymphatic obstruction without history of malignancy. Seven of 9 cancer patients had undergone radiotherapy. All the patients presented with lymphedema as the first sign. The lesions appeared as multiple reddish blue macules or nodules with polypoid and coalesce. Microscopic examination revealed infiltrative proliferation of irregular vessels in dermis and subcutaneous tissue. The tumorous endothelial cells displayed pleomorphism in morphology. The heteromorphic tumor cells expressed CD34, CD31, ERG, D2-40, c-MYC and factor VIII. Despite various treatment modalities, all cases died in an average of 13.6 months, with 1 case of loss to follow-up. CONCLUSIONS: STS is an extremely rare malignancy that arises from congenital or secondary chronic lymphedema. STS uniquely overexpressed c-MYC. In spite of poor prognosis, early detection is important to facilitate a full range of available therapies, even an opportunity for curative treatment. A low threshold for biopsy and early referral to an experienced multidisciplinary team are highly recommended for optimum management.
ABSTRACT
Glomus tumors arising in the gastrointestinal tract are rare and generally benign mesenchymal neoplasms that account for approximately 1% of all gastrointestinal soft tissue tumors. We report a unique case of malignant glomus tumor arising in the ileum of an elderly Chinese woman with widespread metastasis. The patient underwent local tumor resection for a presumed gastrointestinal stromal tumor (GIST). However, brain metastasis developed 2 years later, followed by a lesion in colon 6 months later and a subcutaneous mass of abdominal wall 12 months later. Then, local resections of all metastatic tumors were performed. Histopathology and immunohistochemical findings supported the diagnosis of malignant glomus tumor. Microscopic examination revealed that the primary and metastatic tumor cells shared common features: oval to spindle-shaped, with sharply defined cell membranes, round uniform nuclei, atypical mitotic figures, and variable necrosis. Immunohistochemical staining revealed positive expression of vimentin, SMA, caldesmon, MLH1, MSH2, MSH6, PMS2, SDHB and P53. Even with distant metastasis, the patient has been followed up for 28 months after the third operation without any radiotherapy and chemotherapy. To the best of our knowledge, this is the first report of a malignant glomus tumor arising from the ileum that metastasizes to the brain and abdominal wall with relatively favorable prognosis.
