Diaforodiagnostic dilemma of a breast tumor in a patient with known history of chest sarcoidosis: a diagnostic approach

Open Medicine ◽  
2011 ◽  
Vol 6 (5) ◽  
pp. 537-540
Author(s):  
Thomai Stavrogianni ◽  
Elisavet Psoma ◽  
Olga Nikolaidou ◽  
Ekaterini Xinou ◽  
Persefoni Xirou ◽  
...  
Keyword(s):  
Breast Tumor ◽  
Fine Needle Aspiration Biopsy ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Left Breast ◽  
Pulmonary Sarcoidosis ◽  
Screening Mammography ◽  
Breast Ultrasound ◽  
Fine Needle ◽  
History Of

AbstractBreast sarcoidosis is extremely rare, substantially less frequent than other extrapulmonary manifestations of sarcoidosis. It can mimic a benign or malignant tumor of the breast. We describe the case of a patient with a history of pulmonary sarcoidosis referred to our hospital for a screening mammography. Mammographic findings raised the suspicion for a breast mass. An additional breast ultrasound and fine -needle aspiration biopsy were performed. Finally, patient underwent a excisional biopsy of the left breast and the histopathological report revealed sarcoidosis.

scholarly journals Predictive Factors of Malignancy in Cytology of Indeterminate Follicular and Hürthle Cell Neoplasms of the Thyroid Gland

2019 ◽  
Vol 103 (1-2) ◽  
pp. 9-14
Author(s):  
Bahadır Öz ◽  
Serap Doğan ◽  
Ertan Emek ◽  
Muhammed Akyüz ◽  
Alper Akcan ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Family History ◽  
Radiation Exposure ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Cytologic Diagnosis ◽  
Fine Needle ◽  
Solitary Nodule ◽  
History Of

The objective of the current study was to determine the risk of malignancy in patients with thyroid nodules with cytology of indeterminate follicular and indeterminate Hürthle cell neoplasm (HN). The cytologic diagnosis of follicular neoplasm (FN) or HN remains a diagnostic challenge. Often, surgery is recommended for such lesions. A retrospective analysis was performed on 80 patients who underwent thyroid surgery following a diagnosis of indeterminate FN and indeterminate HN in thyroid fine-needle aspiration biopsy. Sex; age; family history of thyroid cancer and radiation exposure; coexisting thyroid conditions, such as solitary nodule; multinodularity; cytologic diagnosis; sonographic features; type of surgical treatment; and histopathologic results were recorded. Of the 80 patients, 52 (65%) had FN on fine-needle aspiration biopsy cytology and 28 (35%) had HN. A total of 23 patients (28.7%) had primary thyroid cancers on surgical pathology, and 57 (71.3%) had benign diagnoses. Univariate analysis showed no differences between the benign and malignant groups by sex, nodule size, family history of thyroid cancer, history of radiation exposure, presence of solitary nodule or multinodularity in the nodular features. In multivariate binary logistic regression analysis, the factors that were statistically significant predictors of malignancy were microcalcification [odds ratio (OR), 10.9; 95% confidence interval (CI), 2.18–54.7; P = 0.004], being older than 45 years (OR, 4.2; 95% CI, 1.25–14.63; P = 0.02]. The independent predictors of malignancy in FN and HN are micorcalcification and being older than 45 years, the use of which may predict the risk of thyroid cancer.

Fine-Needle Aspiration Biopsy of Vertebral and Intervertebral Disc Lesions

2001 ◽  
Vol 125 (11) ◽  
pp. 1463-1468 ◽  
Author(s):  
Dattatreya M. Phadke ◽  
David R. Lucas ◽  
Shashi Madan
Keyword(s):  
Intervertebral Disc ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Second Primary ◽  
Disc Disease ◽  
Fine Needle ◽  
History Of ◽  
Needle Aspiration Biopsy

Abstract Background and Objectives.—Fine-needle aspiration biopsy (FNAB) is used extensively in the clinical workup of radiologically detected bony lesions. The aims of this study were to evaluate the diagnostic utility of FNAB of such radiologically detected vertebral and intervertebral disc lesions in patients with and without a known primary malignancy, to establish criteria for specimen adequacy, and to evaluate the diagnostic pitfalls. Design.—The cytologic material obtained by FNAB performed under computed tomographic guidance of 78 cases comprising 66 vertebral and 12 intervertebral disc lesions was reviewed and analyzed. The initial cytologic diagnosis was compared with the diagnosis after review in all 78 cases. Results.—Thirty-five cases (45%) were positive for malignancy, 1 case (1.3%) was suspicious for malignancy, 9 (11.5%) consisted of normal cellular elements with no evidence of malignancy, 21 (27%) were unsatisfactory/inadequate for diagnosis, and 12 (15.2%) were benign nonneoplastic lesions. Nonneoplastic lesions diagnosed included fracture callus, discitis/osteomyelitis, degenerative disc disease, and Paget disease. In 11 cases, FNAB gave the initial diagnosis of malignancy (8 occult carcinomas and 3 plasmacytomas). In 23 out of 36 cases with a clinical history of a known primary tumor, FNAB established the diagnosis of metastases, and in 1 case, a second primary was detected. Conclusions.—Fine-needle aspiration biopsy of radiologically suspected vertebral and intervertebral disc lesions in patients with a history of a known malignancy is useful to confirm the presence of metastases. In cases without any history of malignancy, FNAB can provide additional clues to aid in the subsequent workup and treatment of cases diagnosed with an unsuspected malignancy and other nonneoplastic lesions. Through assessment of the specimen adequacy, correct interpretation of the cytologic material available, and correlating with the clinical and radiologic findings, a definitive diagnosis can be made in most cases.

Breast Imaging for Interventional Pathologists

2013 ◽  
Vol 137 (1) ◽  
pp. 100-119 ◽  
Author(s):  
David Lieu
Keyword(s):  
Fine Needle Aspiration ◽  
Breast Imaging ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Breast Ultrasound ◽  
Ultrasound Guided ◽  
Core Needle ◽  
Fine Needle ◽  
Guided Biopsy ◽  
American Society

Context.—Pathologist-performed, ultrasound-guided fine-needle aspiration biopsy is one of the frontiers of pathology. The College of American Pathologists, American Society for Clinical Pathology, and American Society of Cytopathology offer courses and certificate programs for pathologists in this area. The courses emphasize the biopsy of masses in the thyroid and head and neck. There is little training in ultrasound-guided biopsy of breast masses. To successfully perform an imaging-guided biopsy of the breast, pathologists should understand the basics of mammography and breast ultrasound. Objective.—To review the basics of mammography and breast ultrasound to help interventional pathologists add ultrasound-guided, fine-needle aspiration and core-needle biopsies of the breast to their list of core competencies. Data Sources.—Classic and recent literature and textbooks on mammography and breast ultrasound. Conclusions.—The heart of early breast cancer detection is the screening mammogram. Abnormalities detected on screening, such as masses, densities, architectural distortions, nipple retraction, skin thickening, abnormal lymph nodes, and microcalcifications, will lead to a diagnostic mammogram and/or breast ultrasound. Lesions classified as Breast Imaging Reporting and Data System 4 or 5, and a few classified as 3 lesions, require biopsy. If the lesion is visible on ultrasound, ultrasound-guided fine-needle aspiration biopsy and/or core-needle biopsy is the procedure of choice. Suspicious lesions visible only on mammogram require stereotactic x-ray–guided biopsy. Interventional pathologists who understand the values and limitations of mammography and breast ultrasound are ready for the challenges of pathologist-performed, ultrasound-guided, fine-needle aspiration and core-needle biopsies of the breast.

Rosai-Dorfman Disease

2003 ◽  
Vol 127 (4) ◽  
pp. e197-e200
Author(s):  
Rubina S. Cocker ◽  
John Kang ◽  
Leonard B. Kahn
Keyword(s):  
Lymph Node ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Aspiration Biopsy ◽  
Magnetic Resonance Imaging Scan ◽  
Fine Needle ◽  
Rosai Dorfman Disease ◽  
Needle Aspiration Biopsy

Abstract To the best of our knowledge, this is the only reported case of isolated involvement by Rosai-Dorfman disease (RDD) of small, anterior cervical-midline lymph nodes, clinically presenting as a thyroid mass. Thyroid parenchymal involvement by RDD has been reported in only 3 cases in the literature. The present case shows involvement of RDD of a pretracheal and thyroid isthmic lymph node in a 38-year-old woman. The progressively enlarging, anterior neck mass was diagnosed as “lymph node” on a fine-needle aspiration biopsy specimen and subsequently interpreted to be an isthmic cyst on ultrasonography. A magnetic resonance imaging scan revealed foci of nodularity in the thyroid isthmus and pretracheal lymph node. Excisional biopsy of the 2 masses revealed typical features of sinus histiocytosis with massive lymphadenopathy in the lymph node. Review of the patient's previous fine-needle aspiration biopsy specimens also revealed the presence of similar features. Currently, the patient is well and has no other manifestation or recurrence of RDD.

Nonparasitic Splenic Cysts

1994 ◽  
Vol 35 (5) ◽  
pp. 447-451 ◽  
Author(s):  
T. M. J. Siniluoto ◽  
M. J. Päivänsalo ◽  
S. T. Lähde ◽  
M. J. Alavaikko ◽  
P. K. Lohela ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Clinical Value ◽  
Fine Needle ◽  
Splenic Cysts ◽  
Intracystic Hemorrhage ◽  
History Of ◽  
Cyst Rupture

Sixty-three patients with splenic cysts, multiple in 7 cases, were reviewed. Only 3 patients had a history of previous abdominal trauma. The cysts ranged in size from less than 1 cm to 15 cm. They were anechoic in 40 patients, hypoechoic in 16, isoechoic in 4, mixed in one, and in 2 cases the echogenicity could not be assessed due to thick marginal calcifications. The echogenic cysts were larger than the anechoic ones and frequently calcified, and the findings at surgery, fine-needle aspiration biopsy and follow-up suggested the echogenicity to be related to a fresh or previous episode of intracystic hemorrhage. Initially, surgical treatment was undertaken on 10 patients, electively in 9 cases and due to cyst rupture in one. At follow-up (n = 37), the size of the cyst had increased markedly over several years in only 2 patients, necessitating delayed surgery in one. Routine follow-up of asymptomatic splenic cysts was of no clinical value.

Cytologic Atypia in a 53-Year-Old Man With Finasteride-Induced Gynecomastia

2000 ◽  
Vol 124 (4) ◽  
pp. 625-627
Author(s):  
Robert L. Zimmerman ◽  
Franz Fogt ◽  
Dennis Cronin ◽  
Randall Lynch
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Biopsy ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Cytologic Diagnosis ◽  
Extreme Caution ◽  
Fine Needle ◽  
Cytologic Atypia ◽  
Cytoplasmic Vacuolization ◽  
Prostatic Epithelium

Abstract Finasteride has been associated with the development of gynecomastia. Although cytoplasmic vacuolization has been noted in prostatic epithelium in men taking this drug, we found no documentation of the cytologic changes in finasteride-associated gynecomastia. We present the case of a 53-year-old man who developed unilateral gynecomastia following finasteride therapy for alopecia. A fine-needle aspiration biopsy of the mass was diagnosed as adenocarcinoma on the basis of nuclear atypia and particularly because of cytoplasmic vacuolization. Subsequent excisional biopsy revealed benign gynecomastia with no evidence of malignant change. The ductal epithelium did exhibit cytoplasmic vacuolization similar to that described in the prostate following finasteride therapy. We believe this is the first reported case documenting the cytologic changes seen in gynecomastia secondary to finasteride therapy. Cytoplasmic vacuolization in this setting should not be considered evidence of malignancy in men with gynecomastia. As with gynecomastia in general, extreme caution should be used before rendering a cytologic diagnosis of malignancy.

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