scholarly journals Diagnostic approach to peripheral solitary pulmonary lesions

2002 ◽  
Vol 55 (11-12) ◽  
pp. 501-505 ◽  
Author(s):  
Mirna Djuric

Introduction Peripheral localization and lack of symptoms are reasons why it is difficult to establish the diagnosis of peripheral pulmonary lesions commonly of malignant nature. Therefore thoracotomy often represents a diagnostic and therapeutic method at the same time. There is a need to define an adequate and optimal diagnostic approach to these lesions in order to establish their etiology, if possible, at low costs. Material and methods This retrospective study included 50 patients with peripheral solitary pulmonary lesions (PSPL) who underwent thoracotomy at the Institute of Lung Diseases in Sremska Kamenica. In all patients both bronchoscopy and transthoracic puncture were performed prior to surgery. Having evaluated the diagnostic procedures, their proper sequence has then been applied in the prospective group of another 50 patients admitted to the Institute for similar lesions. Results In the retrospective group the etiology of PSPL was established by bronchoscopy in 4% and using transthoracic puncture in 58% of patients, with sensitivity, specificity and accuracy of 78.78%, 100% and 85.1%, respectively. In the prospective group, transthoracic puncture (TTP) provided the final diagnosis in 70% of patients, with 86.2% sensitivity, 100% specificity and 90% accuracy. Conclusion Transthoracic puncture is a method of choice in preoperative diagnostics of solitary peripheral pulmonary lesions, quite like thoracotomy in cases where applied diagnostic procedures were inefficient.

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Ivana Fratrić ◽  
Dragan Šarac ◽  
Jelena Antić ◽  
Marina Đermanov ◽  
Radoica Jokić

Introduction. The aim of this study is to present our treatment protocol for impalpable testis. Material and Methods. In a retrospective study we analyzed clinical data including diagnostic procedures, intraoperative findings, final diagnosis, treatment modality, and outcome of patients with impalpable testis who underwent surgery from January 2010 until December 2015. Results. Ninety-one patients were admitted under the diagnosis of impalpable testis. In 39 patients ultrasound detected testis in the inguinal canal and orchidopexy was done. In 25 patients (48.08%) laparoscopy showed the entrance of the spermatic cord into the inguinal canal. Open exploration of the inguinal canal was done, testicular remnant removed, and appropriate testicular prosthesis implanted. Twenty patients (20/52) underwent orchidopexy of the abdominal testis (46.51%), 4 of which underwent Fowler-Stevens procedure in two stages, and in 16 patients deliberation of the testis and spermatic cord was sufficient to place the testis into the scrotum. Conclusions. Excision of the testicular nubbin is highly recommendable, as well as implantation of the testicular prosthesis at the time of orchiectomy.


2019 ◽  
Vol 1 (10) ◽  
pp. 48-53
Author(s):  
V. N. Korolyov ◽  
D. V. Gogoleva ◽  
O. A. Gladkov ◽  
A. M. Mikita

2015 ◽  
Vol 54 (05) ◽  
pp. 211-216 ◽  
Author(s):  
A. Baskin ◽  
G. Amzalag ◽  
F. Buchegger ◽  
R. Miralbell ◽  
O. Ratib ◽  
...  

SummaryAim: To assess the frequency and the significance of incidental pulmonary lesions with 18F-fluorocholine (18F-FCH) PET/CT in prostate cancer (PCa) patients. Patients, methods: 225 consecutive PCa patients referred for 18F-FCH PET/CT (median age 68 years) were retrospectively evaluated for the presence of lesions in the lungs: 173 referred for restaging and 52 for initial staging regarding their high risk of extra prostatic extension. The final diagnosis was based on histopathological or on clinical and radiological follow-up. Results: 13 patients had 18F-FCH positive pulmonary and 8 patients malignant lesions: 5 patients (38%) had a primary lung cancer (2 squamous cell carcinomas, 1 papillary adenocarcinoma, 1 typical pulmonary carcinoid, 1 bronchioloalveolar carcinoma) and 3 patients (23%) PCa metastases. Benign lesions were found in 5 subjects (38%). SUVmax and maximum diameter were neither significantly different in primary and metastatic tumors nor between malignant and benign lesions. Conclusions: Although our results suggest that incidental uptake in the lungs in PCa patients are nonspecific, their detection may have a significant impact on patient management knowing that more than 60% represent malignant diseas.


2020 ◽  
Vol 103 (6) ◽  
pp. 585-593

Objective: To evaluate the accuracy of transvaginal ultrasonography (TVS) and saline infusion sonography (SIS) in use for the diagnosis of endometrial polyps and submucous myoma compared to hysteroscopy. Histopathology was considered as the gold standard for final diagnosis. Materials and Methods: The present retrospective study was conducted at Bhumibol Adulyadej Hospital, Bangkok, Thailand between January 2014 and December 2017. Medical records of 150 patients who attended for hysteroscopy and histopathological diagnosis were reviewed. The accuracy of TVS and SIS for the diagnosis of endometrial polyps and submucous myoma were determined. Results: Out of 150 enrolled cases, endometrial polyp was the most frequent hysteroscopic finding in participants of the present study (92/150). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of TVS, SIS, and hysteroscopy compared to pathologic reports for detection endometrial polyps were 71.7% versus 93.5% versus 97.8%, 38.5% versus 52.2% versus 68.2%, 80.5% versus 88.7% versus 92.8%, 27.8% versus 66.7% versus 88.2%, and 64.4% versus 85.2% versus 92.1%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of TVS, SIS, and hysteroscopy for detection of submucous myoma were 81.6% versus 92.1% versus 94.7%, 66.7% versus 86.9% versus 100%, 77.5% versus 92.1% versus 100%, 72.0% versus 86.9% versus 90.9%, and 75.4% versus 90.2% versus 96.6%, respectively. The kappa value from TVS, SIS, and hysteroscopy when the histopathologic reports were overall intrauterine abnormalities, endometrial polyps and submucous myoma were 0.45/0.43/0.72, 0.77/0.76/0.89, and 0.92/0.92/1.00, respectively. Conclusion: Sensitivity, specificity, PPV, NPV, accuracy, and kappa value of SIS for detecting endometrial polyps and submucous myoma were better than TVS. Keywords: Ultrasonography, Saline infusion sonography, Hysteroscopy, Accuracy


2021 ◽  
Vol 07 (01) ◽  
pp. E25-E34
Author(s):  
Arash Najafi ◽  
Michael Wildt ◽  
Nicolin Hainc ◽  
Joachim Hohmann

Abstract Purpose Renal lesions are frequent random findings on CT, MRI, and conventional ultrasound. Since they are usually found accidentally, the respective examinations have not been performed optimally to provide a conclusive diagnosis, making additional multiphase contrast-enhanced examinations necessary. The aim of the study is to correlate CEUS findings with the final diagnosis and to determine whether it is a suitable method for the conclusive characterization of undetermined renal lesions. Materials and Methods All CEUS examinations of focal renal lesions performed at our institute between 2007 and 2014 were retrospectively examined. 437 patients with a total of 491 lesions and 543 examinations were included. 54 patients had bilateral lesions. One patient had three lesions in one kidney. Histology was available in 49 cases and follow-ups in 124 cases. The sensitivity, specificity, positive and negative predictive value as well as positive and negative likelihood ratios were calculated. Results There were 54 malignant and 437 benign lesions. The sensitivity and specificity were 0.981/0.954 overall, 1.000/0.956 for cystic lesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for the histologically confirmed lesions. Bosniak classification was consistent in 289 of 301 lesions (96%). Only 12 lesions (3.9%) were falsely assessed as malignant. Conclusion CEUS is an appropriate method for the clarification of undetermined renal lesions. The characterization of cystic lesions according to Bosniak is adequately possible, especially for potentially malignant lesions (types III and IV).


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