The Significance of Atypical Urine Cytology in the Face of Normal Investigations—Is Extended Investigation and Follow-Up Required?

Objective: To examine the natural history of patients identified with atypical urine cytology in the face of normal investigations, and thus provide guidance on the need for extended follow-up and investigation of such patients. Patients and methods: All patients identified over a 2-year period to have atypical urine cytology on Cytospin analysis and Papanicolaou staining were audited over a 5-year follow-up period. Clinical records, histopathology and radiology databases were independently searched. Patients were intensively investigated with cystoscopy and a range of upper tract imaging. Results: 126 patients were identified to have atypical urine cytology, and 77 of these had no urothelial tumour found. In these normal patients, only 12/48 who had further samples taken showed persistent atypia. 11/77 normal patients had another urological pathology which may have explained their atypical urine cytology. No patient presenting for the first time later went on to develop urothelial malignancy in the face of negative initial investigations. Conclusion: In the group of patients in which cystoscopy and urography show no urothelial malignancy, the finding of atypical urinary cytology does not predict the development of later urothelial tumour, and does not require prolonged follow-up, repeat cytological testing or further imaging.

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Filum terminale lipomas: imaging prevalence, natural history, and conus position

Journal of Neurosurgery Pediatrics ◽

10.3171/2014.2.peds13528 ◽

2014 ◽

Vol 13 (5) ◽

pp. 559-567 ◽

Cited By ~ 22

Author(s):

Michael J. Cools ◽

Wajd N. Al-Holou ◽

William R. Stetler ◽

Thomas J. Wilson ◽

Karin M. Muraszko ◽

...

Keyword(s):

Natural History ◽

Incidental Finding ◽

Tethered Cord ◽

Filum Terminale ◽

Presenting Symptoms ◽

Asymptomatic Patients ◽

History Analysis ◽

History Of ◽

Clinical Records

Object Filum terminale lipomas (FTLs) are being identified with increasing frequency due to the increasing utilization of MRI. Although an FTL may be associated with tethered cord syndrome (TCS), in many cases FTLs are diagnosed incidentally in patients without any symptoms of TCS. The natural history of FTLs is not well defined. Methods The authors searched the clinical and imaging records at a single institution over a 14-year interval to identify patients with FTLs. For patients with an FTL, the clinical records were reviewed for indication for imaging, presenting symptoms, perceived need for surgery, and clinical outcome. A natural history analysis was performed using all patients with more than 6 months of clinical follow-up. Results A total of 436 patients with FTL were identified. There were 217 males and 219 females. Of these patients, 282 (65%) were adults and 154 (35%) were children. Symptoms of TCS were present in 22 patients (5%). Fifty-two patients underwent surgery for FTL (12%). Sixty-four patients (15%) had a low-lying conus and 21 (5%) had a syrinx. The natural history analysis included 249 patients with a mean follow-up time of 3.5 years. In the follow-up period, only 1 patient developed new symptoms. Conclusions Filum terminale lipomas are a common incidental finding on spinal MRI, and most patients present without associated symptoms. The untreated natural history is generally benign for asymptomatic patients.

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Natural History of Microprolactinomas: Six-Year Follow-up

Neurosurgery ◽

10.1227/00006123-198302000-00008 ◽

1983 ◽

Vol 12 (2) ◽

pp. 180-183 ◽

Cited By ~ 85

Author(s):

Martin H. Weiss ◽

James Teal ◽

Peggy Gott ◽

Robert Wycoff ◽

Richard Yadley ◽

...

Keyword(s):

Natural History ◽

Tumor Growth ◽

Surgical Intervention ◽

Short Term ◽

Significant Growth ◽

The Face ◽

History Of ◽

Early Surgical Intervention

Abstract A 6-year follow-up of patients harboring microprolactinomas suggests that few patients (3 of 27) demonstrate significant growth of their tumor during this time. The major hazard for such patients who are not treated seems to be their risk for the development of premature osteoporosis in the face of sustained hyperprolactinemia. The risks of this complication may exceed the risks of early surgical intervention in selected patients. This short term risk of tumor growth (about 10%) must be weighed in the decision about therapeutic endeavors.

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Natural history of helicobacter pylori infection from infancy to adulthood: A 21-year follow-up cohort study

Gastroenterology ◽

10.1016/s0016-5085(01)80628-4 ◽

2001 ◽

Vol 120 (5) ◽

pp. A128-A128 ◽

Cited By ~ 1

Author(s):

H MALATY ◽

D GRAHAM ◽

A ELKASABANY ◽

S REDDY ◽

S SRINIVASAN ◽

...

Keyword(s):

Helicobacter Pylori ◽

Cohort Study ◽

Natural History ◽

Helicobacter Pylori Infection ◽

History Of

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The natural history of pituitary apoplexy: long term follow-up study

Endocrine Abstracts ◽

10.1530/endoabs.65.p301 ◽

2019 ◽

Author(s):

Ayesha Shaikh ◽

Natasha Shrikrishnapalasuriyar ◽

Giselle Sharaf ◽

David Price ◽

Maneesh Udiawar ◽

...

Keyword(s):

Natural History ◽

Pituitary Apoplexy ◽

Follow Up Study ◽

Long Term Follow Up ◽

History Of

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The natural history of benign thyroid nodules: 10 years follow-up

Endocrine Abstracts ◽

10.1530/endoabs.70.aep860 ◽

2020 ◽

Author(s):

Valeria Ramundo ◽

Giorgio Grani ◽

Rocco Bruno ◽

Giuseppe Costante ◽

Domenico Meringolo ◽

...

Keyword(s):

Natural History ◽

Thyroid Nodules ◽

History Of ◽

Benign Thyroid Nodules ◽

Benign Thyroid

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Unruptured intracranial aneurysms in children: 18 years’ experience in a tertiary care pediatric institution

Journal of Neurosurgery Pediatrics ◽

10.3171/2019.4.peds18703 ◽

2019 ◽

Vol 24 (2) ◽

pp. 184-189 ◽

Cited By ~ 1

Author(s):

Daniel-Alexandre Bisson ◽

Peter Dirks ◽

Afsaneh Amirabadi ◽

Manohar M. Shroff ◽

Timo Krings ◽

...

Keyword(s):

Carotid Artery ◽

Natural History ◽

Internal Carotid Artery ◽

Intracranial Aneurysms ◽

Internal Carotid ◽

Tertiary Care ◽

Unruptured Intracranial Aneurysms ◽

History Of ◽

Mean Size

OBJECTIVEThere are little data in the literature on the characteristics and natural history of unruptured intracranial aneurysms in children. The authors analyzed their experience with unruptured intracranial aneurysms in the pediatric population at their tertiary care pediatric institution over the last 18 years. The first objective was to assess the imaging characteristics and natural history of these aneurysms in order to help guide management strategies in the future. A second objective was to evaluate the frequency of an underlying condition when an incidental intracranial aneurysm was detected in a child.METHODSThe authors conducted a Research Ethics Board–approved retrospective review of incidental intracranial aneurysms in patients younger than 18 years of age who had been treated at their institution in the period from 1998 to 2016. Clinical (age, sex, syndrome) and radiological (aneurysm location, type, size, thrombus, mass effect) data were recorded. Follow-up imaging was assessed for temporal changes.RESULTSSixty intracranial aneurysms occurred in 51 patients (36 males, 15 females) with a mean age of 10.5 ± 0.5 years (range 9 months–17 years). Forty-five patients (88.2%) had a single aneurysm, while 2 and 3 aneurysms were found in 3 patients each (5.8%). Syndromic association was found in 22 patients (43.1%), most frequently sickle cell disease (10/22 [45.5%]). Aneurysms were saccular in 43 cases (71.7%; mean size 5.0 ± 5.7 mm) and fusiform in the remaining 17 (28.3%; mean size 6.5 ± 2.7 mm). Thirty-one aneurysms (51.7%) arose from the internal carotid artery (right/left 1.4), most commonly in the cavernous segment (10/31 [32.3%]). Mean size change over the entire follow-up of 109 patient-years was a decrease of 0.6 ± 4.2 mm (range −30.0 to +4.0 mm, rate −0.12 ± 9.9 mm/yr). Interval growth (2.0 ± 1.0 mm) was seen in 8 aneurysms (13.3%; 4 saccular, 4 fusiform). An interval decrease in size (8.3 ± 10.7 mm) was seen in 6 aneurysms (10%). There was an inverse relationship between aneurysm size and growth rate (r = −0.82, p < 0.00001). One aneurysm was treated endovascularly with internal carotid artery sacrifice.CONCLUSIONSUnruptured pediatric intracranial aneurysms are most frequently single but can occur in multiples in a syndromic setting. None of the cases from the study period showed clinical or imaging signs of rupture. Growth over time, although unusual and slow, can occur in a proportion of these patients, who should be identified for short-term imaging surveillance.

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Faculty Opinions recommendation of Natural history of imatinib-naive GISTs: a retrospective analysis of 929 cases with long-term follow-up and development of a survival nomogram based on mitotic index and size as continuous variables.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13356067.14726207 ◽

2011 ◽

Author(s):

Richard Riedel

Keyword(s):

Natural History ◽

Retrospective Analysis ◽

Mitotic Index ◽

Continuous Variables ◽

Long Term Follow Up ◽

History Of

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Faculty Opinions recommendation of The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic follow-up of untreated bladder outlet obstruction.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.722513190.793513452 ◽

2016 ◽

Author(s):

Richard Inman

Keyword(s):

Urinary Tract ◽

Natural History ◽

Bladder Outlet Obstruction ◽

Lower Urinary Tract ◽

Outlet Obstruction ◽

Lower Urinary Tract Dysfunction ◽

History Of ◽

Lower Urinary

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The spontaneous resolution of a vortex vein varix: case report

BMC Ophthalmology ◽

10.1186/s12886-021-01861-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sara L Weidmayer ◽

Hakan Demirci

Keyword(s):

Case Report ◽

Natural History ◽

Extended Period ◽

Spontaneous Resolution ◽

Case Presentation ◽

Clinical Resolution ◽

History Of ◽

Vortex Vein ◽

Insight Into

Abstract Background The natural course of a vortex vein varix, though not well understood, has been known to remain stable. However, here we report a novel case of a vortex vein varix that resolved after an extended period of monitoring. Case presentation An asymptomatic 96-year-old Caucasian man was found to have a vortex vein varix. At his previous examination 13 months prior, his fundus was normal. At 13 months of observation, his vortex vein varix become clinically undetectable. Further follow-up confirmed continued absence of the varix. Conclusion This case demonstrates the development then clinical resolution of a vortex vein varix with no clear identifiable factors for its evolution. This case is novel and offers new insight into the natural history of some vortex vein varices, implicating venous congestion as an instigator and venous collateralization as its alleviator, suggesting that vortex vein varices are likely more common than previously reported since some may be temporary and under-identified.

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