세침 흡인 생검을 이용한 안와 후반부 종양의 진단

사호석,오동은,김윤덕,Ho-Seok Sa,Dong-Eun Oh,Yoon-Duck Kim 대한안과학회 2005 대한안과학회지 Vol.46 No.9

Purpose: To evaluate the effectiveness and safety of fine-needle aspiration biopsies of mass lesions located in the posterior orbit. Methods: Eight patients with mass lesions in the posterior orbit underwent fine-needle aspiration biopsy with 21-gauge needles using the freehand technique. Results: Fine-needle aspiration biopsies were performed easily and safely. One patient developed subconjunctival hemorrhage following biopsy, but no major complications were observed. Diagnostic specimens were obtained in 6 patients (75%). Of these diagnostic cases, 3 were benign, and the other 3 were malignant. In 3 of 6 patients we performed surgical excisions, while in the others we performed radiotherapy and/or chemotherapy. In 2 patients (25%) the cytologic specimens were inadequate. Conclusions: Fine-needle aspiration biopsy is useful and safe in evaluating orbital mass lesions, especially when they are not surgically accessible due to their location in the posterior orbit.

이하선 Warthin 종양의 세침흡인검사 후 발생한 육아종성 괴사 1예

오현식(Hyeon Sik Oh),이은섭(Eun Sub Lee),조용태(Young Tae Jo),권민수(Minsu Kwon) 대한두경부종양학회 2018 대한두경부 종양학회지 Vol.34 No.2

Fine needle aspiration is usually performed as a preoperative cytologic evaluation in salivary gland tumors, and complications of the lesion after fine needle aspiration are scarcely developed. The secondary change of tissue by fine needle aspiration can make the diagnostic and subsequent therapeutic difficulties for clinicians and require a careful approach. Fine needle aspiration can cause variety of changes in Warthin tumor, and it is presumed that those changes are mainly caused by the infarction of the mass due to vascular injury and following inflammatory reactions. We would introduce our experience of granulomatous and necrotic change after fine needle aspiration on parotid Warthin tumor with consequent difficulties in diagnostic and surgical approach to the patient.

Diagnostic accuracy of 22/25-gauge core needle in endoscopic ultrasound-guided sampling: systematic review and meta-analysis

( Hyoung-chul Oh ),( Hyun Kang ),( Jae Young Lee ),( Geun Joo Choi ),( Jung Sik Choi ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.6

Background/Aims: To compare the diagnostic accuracy of endoscopic ultrasound- guided core needle aspiration with that of standard fine-needle aspiration by systematic review and meta-analysis. Methods: Studies using 22/25-gauge core needles, irrespective of comparison with standard fine needles, were comprehensively reviewed. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic curves for the diagnosis of malignancy were used to estimate the overall diagnostic effi ciency. Results: The pooled sensitivity, specificity, and DOR of the core needle for the diagnosis of malignancy were 0.88 (95% confidence interval [CI], 0.84 to 0.90), 0.99 (95% CI, 0.96 to 1), and 167.37 (95% CI, 65.77 to 425.91), respectively. The pooled sensitivity, specificity, and DOR of the standard needle were 0.84 (95% CI, 0.79 to 0.88), 1 (95% CI, 0.97 to 1), and 130.14 (95% CI, 34.00 to 495.35), respectively. The area under the curve of core and standard needle in the diagnosis of malignancy was 0.974 and 0.955, respectively. The core and standard needle were comparable in terms of pancreatic malignancy diagnosis. There was no significant difference in procurement of optimal histologic cores between core and standard needles (risk ratio [RR], 0.545; 95% CI, 0.187 to 1.589). The number of needle passes for diagnosis was significantly lower with the core needle (standardized mean difference, .0.72; 95% CI, .1.02 to .0.41). There were no significant differences in overall complications (RR, 1.26; 95% CI, 0.34 to 4.62) and technical failure (RR, 5.07; 95% CI, 0.68 to 37.64). Conclusions: Core and standard needles were comparable in terms of diagnostic accuracy, technical performance, and safety profile.

Comparison of the Diagnostic Yield of the Standard 22-Gauge Needle and the New 20-Gauge Forward-Bevel Core Biopsy Needle for Endoscopic Ultrasound-Guided Tissue Acquisition from Pancreatic Lesions

( Shinya Fujie ),( Hirotoshi Ishiwatari ),( Keiko Sasaki Junya Sato ),( Hiroyuki Matsubayashi ),( Masao Yoshida ),( Sayo Ito ),( Noboru Kawata ),( Kenichiro Imai ),( Naomi Kakushima ),( Kohei Takizawa 대한간학회 2019 Gut and Liver Vol.13 No.3

Background/Aims: To compare the diagnostic yield of 20-gauge forward-bevel core biopsy needle (CBN) and 22-gauge needle for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of solid pancreatic masses. Methods: The use of 20-gauge CBN was prospectively evaluated for 50 patients who underwent EUS-FNA from June 2016 to December 2016. Data were compared with those obtained by a retrospective study of 50 consecutive patients who underwent EUS-FNA using standard 22-gauge needles between December 2016 and April 2017. At least two punctures were performed for each patient; the sample from the first pass was used for cytology with or without histology and that from the second pass was used for histology. Sample quantity was evaluated using the sample obtained from the second pass. Results: There was no significant difference in the diagnostic accuracy rate between the first and second passes (20-gauge CBN: 96% [48/50]; standard 22-gauge needle: 88% [44/50]). Samples >10× power fields in length were obtained from 90% (43/48) and 60% (30/50) of patients using the 20-gauge CBN and standard 22-gauge needle, respectively (p=0.01). Technical failure occurred for two patients with the 20-gauge CBN. Conclusions: Diagnostic accuracy of the 20-gauge CBN was comparable to that of the 22-gauge needle. However, two passes with the 20-gauge CBN yielded a correct diagnosis for 100% of patients when technically feasible. Moreover, the 20-gauge CBN yielded core tissue for 90% patients, which was a performance superior to that of the 22-gauge needle. (Gut Liver 2019;13:349-355)

A multicenter comparative study of endoscopic ultrasound-guided fine-needle biopsy using a Franseen needle versus conventional endoscopic ultrasound-guided fine-needle aspiration to evaluate microsatellite instability in patients with unresectable pancre

Tadayuki Takagi,Mitsuru Sugimoto,Hidemichi Imamura,Yosuke Takahata,Yuki Nakajima,Rei Suzuki,Naoki Konno,Hiroyuki Asama,Yuki Sato,Hiroki Irie,Jun Nakamura,Mika Takasumi,Minami Hashimoto,Tsunetaka Kato 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.1

high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needlefor MSI evaluation in patients with UR-PC. Methods: A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) orEUS-FNB using 22-G needles at three hospitals in Japan (2018–2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33)were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patientswho underwent EUS-FNB and those who underwent EUS-FNA. Results: No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwentEUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained usingEUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariateanalysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. Conclusions: EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

갑상선 결절의 수술 범위 결정시 세침흡인세포검사와 동결절편생검의 유용성

이영돈,조현준,Yeoung Don Lee,M.D. and Hyeoun Jun Cho,M.D. 대한갑상선-내분비외과학회 2001 The Koreran journal of Endocrine Surgery Vol.1 No.1

Purpose: Traditionally the extent of thyroidectomy in patients with nodular thyroid disease has been based on fine needle aspiration cytology and intraoperative frozen section examination. The value of routine frozen section examination for intraoperative diagnosis of thyroid cancer and determination of extent of thyroidectomy is controversial and needs to be evaluated. Methods: We reviewed the fine needle aspiration cytology, frozen section examination, and final pathology of 142 consecutive patients who underwent thyroidectomy for nodular thyroid mass in an 3-year period. The diagnosis were classified as indeterminant, benign, or malignant. The utility and impact of the diagnosis from fine needle aspiration or frozen section on the operative procedure performed was analyzed. Results: Fine needle aspiration cytology (FNA) as a diagnostic test for thyroid nodules demonstrated an indeterminant rate of 23.9% (34 patients), with diagnostic accuracy of 93.9% for malignant disease. In frozen section (FS) results, the indeterminant rate was 19.7%, and the diagnostic accuracy 98.3% for malignant disease. Of the 50 patients with the benign results on FNA, 3 patients was diagnosed as malignancy on FS. Of the 34 patients with indeterminant results on FNA, the intraoperative FS diagnosis showed 16 patients of benign, 3 patients of malignancy, and diagnosis on 15 patients was deferred to permanent section; in 15 patients, benign disease was diagnosed in 12 patients, and 3 patients were diagnosed as malignancy. And one of 10 patients with inadequate result on FNA was diagnosed as malignancy on FS. Therefore the decision about the extent of surgical thyroid resection was changed in 7 patients (4.9%) based on the FS results, and including the 16 patients diagnosed as benign on FS with indeterminant results on FNA, overall, in 23 patients (16.2%) the intraoperative surgical decision was affected by FS. Conclusion: The fine needle aspiration cytology and intraoperative frozen section examination showed the limitation on diagnosis of follicular neoplasm, but intraoperative frozen section examination proved useful in determining the extent of operation and affected intraoperative decision making in thyroid surgery. (Korean J Endocrine Surg 2001;1:78-83)

갑상선 결절의 임상양상과 미세침흡인검사의 의의

원진호,한희정,채수홍,김현진,송민호,김영건 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

We evaluated clinical manifestation of nodular thyroid disease and fine-needle aspiration cytology results to establish an appropriate diagnostic approach to thyroid nodule. We examined 594 patients who visited Chungnam National University Hospital with one or more thyroid nodules between Jan. 1996 and Dec. 1998. Fine-needle aspiration cytology was carried out after clinical evaluation including medical history, physical examination(hardness,size, multinodularity,fixation) and laboratory test(scan, thyroid function test). Among the 594 cases, 53 cases(8.9%) were diagnosed as cancer and 457 cases(77%) were diagnosed as benign nodule. None of these factors - age, sex. soft and firm nodule, multinodularity, thyroid scan, thyroid sonography, and thyroid function test - were significant to predict cancer in our study. The prevalence of cancer was significantly higher in hard nodule(28. 5%,39/137) than firm(3.8%,12/316) or soft nodule(0%,0/72). There was size difference between malignant(24.2±62.8ml) and benign nodules(12.6±26.1ml),but the size difference wasn't shown to an indicator to say whether malignant or benign. The prevalence of cancer in relation to fixation was significantly higher in fixation(50%,19/38) and partial fixation nodule(33%,4/12) than movable nodules(5.8%,28/476). Rapid growing, vocal cord palsy,and lymphadenopathy among the medical history had higher relative risk to cancer (relative risk= 14, 4.8, 10.2. respectively). We also examined 67 cases which were diagnosed by histology after operation and, through comparison between the results of histology and cytology., evaluated the effectiveness of fine-needle aspiration cytology. Sensitivity, specificity, false negative rate, and false positive rate of fine-needle aspiration cytology were 92-100%, 47-63%, 0-20%, 0-50%,respectively. Our data suggests that thyroid nodules of the patients which are characterized firm, fixed, rapid growing, lymphadenopathy, and vocal cord palsy require more careful evaluation for thyroid cancer. We also recommand thyroid aspiration cytology in first step evaluation to rule out thyroid cancer.

세침흡인검사로 진단된 부갑상선 선종 1예

김혜수,이은경,황성하,김명숙,이은희,이종민,김석영,차봉연,이광우,손호영,강성구 대한내분비학회 2000 Endocrinology and metabolism Vol.15 No.4·5

세침 폐생검 세포검사의 진단적 의의

김영철(Young Chol Kim),박용주(Yong Ju Park),김두섭(Doo Sub Kim),홍득민(Duk Min Hong),양윤식(Yoon Shig Yang),심원보(Won Bo Shim),윤중근(Jung Geun Yoon),김종인(Jong In Kim),이성주(Seong Joo Lee),이태원(Tae Won Lee) 대한내과학회 1991 대한내과학회지 Vol.41 No.6

N/A Seventy-five patients with either pulmonary nodules or masses that could not be confirmed with sputum examination or bronchoscopic examination underwent transthoracic fineneedle aspiration with 22 or 23 gauze needles under fluoroscopy for cytologic diagnosis. There were 51 men and 24 women, and the age range was 43-78 years old. The lesion distribution and sizes were as follow: 48 cases in the right lung, 2l cases in the left lung, 23 cases under 4 cm in size, and 52 cases over 4 cm in size. There were no meaningful correlations in lesion size or site with malignant or benign cytologic findings. Among the 46 malignant cases squamous cell carcinoma was 32 cases, large cell carcinoma 5 cases, small cell carcinoma 4cases, lymphoma 3 cases, and bronchioalveolar carcinoma 2 cases. Among the other cases, pulmonary tuberculosis was. 11 cases and lung abcess 3 cases. Among the 49 cases proven malignant after operation or follow-up by now, 46 cases were malignant at fine- needle aspiration biopsy cytology (sensitivity 93.9%), and among the 23 cases proven benign after follow up, all showed no malignancy by fine-needle aspiration biopsy cytology (specificity 100%). Three cases failed in the follow-up due to various causes. In the benign cases, there were some who had difficulty in being diagnosed with this procedure alone, but we were helped a great deal in differentiating malignancies by this procedure. Complications were minimal, but 5 cases of pneumoth-orax occurred, and 2 cases among these needed closed thoracotomy and soon improved. In conclusion, transthoracic fine-needle aspiration biopsy cytology is very helpful in diagnosing patients with lung nodules or masses that failed to be confirmed with sputum examination or bronchoscopic procedure and in differentiating a malignant state from a benign one, with minimal complications. So, active clinical trial of this procedure is recommended.

세침흡인된 갑상선의 여포상 선종과 여포상 암종의 형태계측학적 연구

주영채,차희정,민수기,김준미,황태숙,Chu, Young-Chae,Cha, Hee-Jung,Min, Soo-Kee,Kim, Joon-Mee,Hwang, Tae-Sook 대한세포병리학회 1998 대한세포병리학회지 Vol.9 No.1

Fine needle aspiration cytology of "cold" nodules of the thyroid has proved to be of great value in their preoperative diagnosis. Most types of thyroid tumors are readily recognizable from characteristic cellular patterns in the smears of needle aspirates. But follicular neoplasms present some problems because the cytomorphology of the adenomas frequently is same as in carcinoma. For differentiation of benign from malignant follicular neoplasms of the thyroid we tested the usefulness of two objective parameters - nuclear area and perimeter - by morphometry. This study was made on fine needle aspirates from 30 cases with cytologic diagnosis of follicular neoplasm of thyroid. The histologic classification was follicular adenoma in 22 cases and follicular carcinoma in 8 cases. As a reference group we used seven caes with nodular hyperplasia. The smears of aspirates were stained by Papanicolaou method. On each slide 200 randomly selected cells with intact nuclei were measured. The mean value of nuclear area are $25.32{\pm}5.50{\mu}m^2,\;34.08{\pm}7.50{\mu}m^2\;and\;39.97{\pm}6.63{\mu}m^2$ in nodular hyperplasia, follicular adenoma, and follicular carcinoma, respectively. The mean value of perimeter are $19.48{\pm}2.26{\mu}m,\;22.95{\pm}2.65{\mu}m\;and\;24.78{\pm}2.23{\mu}m$ in nodular hyperplasia, follicular adenoma and follicular carcinoma, respectively. The mean nuclear areas and perimeters of cells from follicular adenoma were significantly larger than those from nodular hyperplasia (p<0.05). The mean nuclear areas and perimeters of cells from follicular carcinoma were larger than those from follicular adenoma but the differences are not significant statistically(p>0.05). Therefore, morphometric assessment alone is inadequate to predict malignancy in thyroid aspirates.