Risk of Malignancy Associated with Cytologic Diagnostic Categories Before and After Paris System Implementation

2020 ◽  
Vol 9 (6) ◽  
pp. S11
Author(s):  
Rana Aldrees ◽  
Isam-Eldin Eltoum
Keyword(s):  
System Implementation ◽  
Diagnostic Categories ◽  
Before And After ◽  
Risk Of Malignancy

scholarly journals The Milan System, from Its Introduction to Its Current Adoption in the Diagnosis of Salivary Gland Cytology

2021 ◽  
Vol 2 (2) ◽  
pp. 114-122
Author(s):  
Esther Diana Rossi
Keyword(s):  
Salivary Gland ◽  
Daily Practice ◽  
Needle Aspiration ◽  
Classification Systems ◽  
Diagnostic Categories ◽  
International Group ◽  
The Everyday ◽  
Neoplastic Process ◽  
Risk Of Malignancy ◽  
Well Differentiated

Salivary gland masses are often encountered in the everyday practice of cytopathology. It is commonly known that the cytologic interpretation of these lesions can pose diagnostic problems due to overlapping cytomorphologic features. Fine needle aspiration (FNA) of salivary lesions shows good to excellent sensitivity and specificity in differentiating a neoplastic from a non-neoplastic process and in diagnosing common tumors such as pleomorphic adenoma. However, its value is limited in diagnosing specific neoplastic entities especially those with well-differentiated morphology. In light of this gap, an international group of pathologists has proposed a management-oriented, tiered classification for reporting salivary gland FNA specimens, “The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC)”. Similar to other classification systems, the MSRSGC scheme comprises six diagnostic categories, which were linked with a specific risk of malignancy (ROM) and management. In this review article, the author evaluated the published literature on FNA in diagnosing salivary gland lesions with the adoption of the Milan system since its introduction in the daily practice of salivary cytopathology.

Somatoform Dissociation Discriminates Among Diagnostic Categories Over and Above General Psychopathology

1999 ◽  
Vol 33 (4) ◽  
pp. 511-520 ◽  
Author(s):  
Ellert R.S. Nijenhuis ◽  
Richard van Dyck ◽  
Philip Spinhoven ◽  
Onno van der Hart ◽  
Marlene Chatrou ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Mood Disorder ◽  
Somatoform Disorders ◽  
Adjustment Disorder ◽  
Dissociative Disorder ◽  
General Psychopathology ◽  
Diagnostic Categories ◽  
Bipolar Mood Disorder ◽  
Somatoform Dissociation ◽  
Before And After

Objective: The primary aim of this study was to investigate the hypothesis that somatoform dissociation would differentiate among specific diagnostic categories after controlling for general psychopathology. Method: The Somatoform Dissocation Questionnaire (SDQ-20), the Dissociative Experiences Scale, and the Symptom Checklist-90-R were completed by patients with DSM-IV diagnoses of dissociative disorders (n = 44), somatoform disorders (n = 47), eating disorders (n = 50), bipolar mood disorder (n = 23), and a group of consecutive psychiatric outpatients with other psychiatric disorders (n = 45), mainly including anxiety disorders, depression, and adjustment disorder. Results: The SDQ-20 significantly differentiated among diagnostic groups in the hypothesised order of increasing somatoform dissociation, both before and after statistically controlling for general psychopathology. Somatoform dissociation was extreme in dissociative identity disorder, high in dissociative disorder, not otherwise specified, and increased in somatoform disorders, as well as in a subgroup of patients with eating disorders. In contrast with somatoform dissociation, psychological dissociation did not discriminate between bipolar mood disorder and somato form disorders. Conclusions: Somatoform dissociation is a unique construct that discriminates among diagnostic categories. It is highly characteristic of dissociative disorder patients, a core feature in many patients with somatoform disorders, and an important symptom cluster in a subgroup of patients with eating disorders., dissociation

Evaluation of outcomes before and after electronic medical record (EMR) and computerized physician order entry (CPOE) system implementation in an outpatient oncology setting

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 17058-17058 ◽  
Author(s):  
C. A. Harshberger ◽  
B. Brockstein ◽  
G. Carro ◽  
W. Jiang ◽  
W. Spath ◽  
...  
Keyword(s):  
Medical Record ◽  
User Satisfaction ◽  
Cancer Center ◽  
Computerized Physician Order Entry ◽  
System Implementation ◽  
Order Entry ◽  
Record System ◽  
Before And After ◽  
Data Points ◽  
Physician Order Entry

17058 Background: Computerized physician order entry (CPOE) in electronic medical records (EMR) has been recognized as an important tool in optimal health care provision that can reduce errors and improve safety. The objective of this study is to describe documentation completeness and user satisfaction of medical charts before and after outpatient oncology EMR/CPOE system implementation in a hospital based outpatient cancer center within three treatment sites and with sixteen physicians. Methods: A retrospective chart review was conducted on 32 randomly selected patients to date, who received one of the following regimens: FOLFOX, carboplatin-paclitaxel, CHOP-rituximab, or AC between 1999 and 2006. Charts were case matched with physician and regimen to compare documentation completeness. Completeness scores were assigned to each chart based on the number of documented data points found out of the 33 data points assessed. A user satisfaction survey of the paper chart and EMR/CPOE system was conducted among the physicians (n=16), nurses (n=43), and pharmacists (n=8) who worked with both systems. Results: The mean percentage of identified data points successfully found in the EMR/CPOE charts was 94% vs. 68% in the paper charts (p<0.001). Regimen complexity did not alter the number of data points found. The survey response rate was 64% and the results showed that satisfaction was statistically significant in favor of the EMR/CPOE system. The time required to find the data points will be assessed by having a physician, nurse, and pharmacist review the same charts. Data on 112 charts will be presented. Conclusions: Using EMR/CPOE systems improves completeness of medical record and chemotherapy order documentation and improves user satisfaction with the medical record system. No significant financial relationships to disclose.

Choledochal Cyst and Malignancy: A Plea for Lifelong Follow-Up

2017 ◽  
Vol 29 (02) ◽  
pp. 143-149 ◽  
Author(s):  
Thomas Wirth ◽  
Joachim Kuebler ◽  
Claus Petersen ◽  
Benno Ure ◽  
Omid Madadi-Sanjani
Keyword(s):  
Choledochal Cyst ◽  
Abdominal Ultrasound ◽  
Current Data ◽  
Elevated Risk ◽  
Long Term Outcomes ◽  
Cyst Excision ◽  
Before And After ◽  
Risk Of Malignancy

AbstractPrevious research has confirmed that patients with choledochal cyst have an elevated risk of cholangiocarcinoma and gallbladder carcinoma. Current data suggest a risk of malignancy of 6 to 30% in adults with choledochal cyst. Malignancy has also occasionally been identified in children and adolescents. Multiple factors, including the age of the patient, cyst type, histological findings, and localization, have an impact on the prognosis. Information on long-term outcomes after cyst excision is limited. However, recent data suggest a lifelong elevated risk of up to 4% of cancer development following operation. This paper presents a review of the literature on cancer in patients with choledochal cyst before and after excision. A postoperative follow-up concept that consists of annual controls of CA19–9 and abdominal ultrasound is introduced.

scholarly journals Malignancy Rate in Thyroid Nodules with Atypia or Follicular Lesion of Undetermined Significance

2020 ◽  
Vol 24 (02) ◽  
pp. e221-e226
Author(s):  
Hamdan Ahmed Pasha ◽  
Rahim Dhanani ◽  
Ainulakbar Mughal ◽  
Kaleem S. Ahmed ◽  
Anwar Suhail
Keyword(s):  
Thyroid Nodules ◽  
Follicular Carcinoma ◽  
Needle Aspiration ◽  
Diagnostic Categories ◽  
Risk Of Malignancy ◽  
Bethesda System ◽  
Needle Aspiration Cytology ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Undetermined Significance

Abstract Introduction Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) is one of the six diagnostic categories of the Bethesda System for Reporting Thyroid Cytopathology. The prevalence of malignancy among Bethesda category III cytology is variable, ranging from 5% to 37% in the literature. Objective To determine the rate of malignancy in thyroid nodules reported as Bethesda category III. Methods A total of 495 patients underwent surgical intervention for thyroid nodules from January 2015 to December 2017. The present study included 81 cases reported as Bethesda category III, and their medical records were reviewed. Results Out of 495 fine-needle aspiration cytology samples, 81 (16.4%) samples were labeled as AUS/FLUS. Among these 81 patients, the mean age was 43.0 years (± 13.9), with only 11 (14%) patients older than 55 years of age. Most of our patients were female (n = 69; 85.2%), and the rest were male. The rate of malignancy based on the final histology was of 33.3% (n = 27). The majority were 17 cases (21%) of papillary carcinoma, followed by follicular carcinoma (n = 6) (7.4%). Conclusion The risk of malignancy can be higher than it is commonly believed, and guidelines should be based on the data from the institutions themselves for a better assessment of the outcomes.

Pleureaergüsse: Zytohistologie als wesentliche Option zum Ausschluss oder zur Bestätigung einer bösartigen Ursache

2021 ◽  
pp. 1-3
Author(s):  
Franz Stanzel
Keyword(s):  
International System ◽  
The Body ◽  
Future Research ◽  
Pleural Effusions ◽  
Serous Fluid ◽  
Pleural Biopsy ◽  
Diagnostic Categories ◽  
Unknown Significance ◽  
Risk Of Malignancy ◽  
Fluid Cytology

The International System for Reporting Serous Fluid Cytology (TIS) was recently developed. Given its novelty, most studies looking into the risk of malignancy (ROM) of serous effusion diagnostic categories were published before the development of TIS. We searched the database of our department for pleural effusions diagnosed in the last five years, excluding those without a corresponding pleural biopsy. Cases were reviewed and reclassified according to the TIS. A cytohistological correlation was performed. In total, 350 pleural effusion specimens with one or more corresponding pleural biopsies were included. After reclassification, 5 (1.43%) were nondiagnostic (ND), 253 (72.29%) were negative for malignancy (NFM), 7 (2.00%) had atypia of unknown significance (AUS), 14 (4.00%) were suspicious for malignancy (SFM), and 71 (20.57%) were malignant (MAL). Calculated ROM was 40% for ND, 20.16% for NFM, 42.86% for AUS, 78.57% for SFM, and 100% for MAL. Effusion cytology sensitivity and specificity were 60.29% and 98.56%, respectively. This is the first publication looking into the cytohistological correlation of a retrospective cohort of pleural effusions based on the TIS. We add to the body of data regarding the ROM for TIS categories, highlighting areas of potential future research.

Risk of malignancy associated with the diagnostic categories proposed by the Papanicolaou Society of Cytopathology for pancreaticobiliary specimens: An institutional experience

2021 ◽  
Author(s):  
Miguel S. Gonzalez‐Mancera ◽  
Saman S. Ahmadian ◽  
Carmen Gomez‐Fernandez ◽  
Jaylou Velez‐Torres ◽  
Merce Jorda ◽  
...  
Keyword(s):  
Diagnostic Categories ◽  
Risk Of Malignancy ◽  
Institutional Experience

RISK STRATIFICATION UTILIZING THE MILAN SYSTEM OF CLASSIFICATION FOR SALIVARY GLAND CYTOLOGY : A CYTOHISTOLOGICAL CORRELATION STUDY IN TERTIARY CARE HOSPITAL IN HIMACHAL PRADESH

2021 ◽  
pp. 22-24
Author(s):  
Monica Sarohi ◽  
Kavita Mardi
Keyword(s):  
Salivary Gland ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Management ◽  
Care Hospital ◽  
Conventional System ◽  
Diagnostic Categories ◽  
Risk Of Malignancy

Introduction- Milan system is an evidence based system derived from the literature which correlates diagnostic categories with risk of malignancy and clinical management strategies. The goals of this system were to standardize salivary gland cytology reporting across institutions and provide a framework for guiding clinical management. It is a tier based classication having six diagnostic categories. The conventional system was used for diagnosis before the advent of Milan system. In this study, FNAC done for all sa Material and methods- livary gland lesions over a period of two years from 2018 - 2020 in department of pathology, IGMC Shimla are included. All cases are categorized according to MSRSGC and correlated with histopathological follow up wherever available. We calculated the sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy of FNA using the Milan system. We also calculated the ROM was for each category. All the cases were Results: categorized as per MSRSGC and were 14%, 45.4%, 0%, 31.4%, 0.6%, 0.6% and 8% in category I, II, III, IVA, IVB, V and VI respectively. ROM for category I, II, IVA, IVB, V and VI was 0%, 0%, 2.6%, 0%, 100% and 87.5% respectively. The sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy was 98.51%, 66.67%, 98.51%, 66.67% and 97.14% respectively. Milan system is an Discussion: effective tool for diagnosing salivary gland lesions. It offers advantages over the conventional system such as risk of malignancy, management options for each category and a better communication both institute wise and between clinicians and cytopathologists.

Sign in / Sign up

Export Citation Format

Share Document