Predictive value of fine needle aspiration biopsy of axillary lymph nodes in preoperative breast cancer staging.

OBJECTIVE: Diagnosis of axillary nodal involvement is significant in the management of breast cancer as well as in predicting prognosis. In this prospective study, we evaluated the efficiency of US-guided fine needle aspiration biopsy (FNAB) in preoperative axillary staging of early breast cancer. MATERIAL AND METHODS: Between January 2011 and July 2013, 46 women were prospectively enrolled in the study. Ultrasound guided-FNABs for axillary assessment were performed preoperatively. Cytology results were compared with histopathology reports to determine its sensitivity, specificity, negative and positive predictive value and accuracy. RESULTS: Nineteen cases that had malignant cytology on FNAB also had axillary involvement in axillary lymph node dissection (ALND) without any false-positive results. The sensitivity and specificity of US-guided FNAB were 63.3% and 100%, respectively. US-guided FNAB was accurate in predicting the status of the axilla in 76.1% of patients. CONCLUSION: Although this technique is favorable due to its minimally invasive nature, it is not as effective as sentinel lymph node biopsy (SLNB) in terms of detecting axillary metastasis preoperatively. The low sensitivity and low accuracy rates decrease the usefulness of the technique. Therefore, it seems that US-guided FNAB alone could not replace SLNB. Nevertheless, combining some other molecular studies may be useful in increasing the technique's sensitivity. These issues should be determined by comprehensive clinical trials.

[Clinical follow-up of patients who ingested narcotic filled bags as a rare cause of mechanical bowel obstruction: case report]. / Mekanik barsak obstrüksiyonunun nadir bir nedeni olrak uyusturucu posetleri yutan iki hastanin klinik takibi: olgu sununu.

Two patients were admitted to the emergency service of Haseki Education and Research Hospital due to ingestion of narcotic filled bags. Incomplete mechanical bowel obstruction developed in one of them. Both patients were treated conservatively with cleansing enema and were discharged from the hospital without any complication. We present clinical follow-up of these patients with literature review.

[Rupture of an incidental giant liver hemangioma caused by blunt abdominal trauma]. / KUNT BATIN TRAVMASINA BAGLI RASTLANTISAL DEV KARACIGER HEMANJIOM RUPTURU.

A patient with blunt abdokminal trauma due to a traffic accident was admitted to our clinic and operated urgently because of hemodynamic shock. Operative exploration revealed rupture of a congenital giant cavernous liver hemangioma, then a partial hepatic resection was performed. Liver abscess and pleural effusion occurred in the postoperative period and the abscess was drained by a CT- guided cathetei: However the catheter drainage get infected. As a conclusion, if a liver hemangioma is detected incidentally on routine check-up studies, these people, carrying potential risk ofrupture should be warned about high risk jobs.