Cystic Meningiomas: A Radiological and Histological Study and Pre Operative Diagnostic Errors

INTRODUCTION: Meningiomas are solid neoplasms, cysts are extremely rare, diagnostically elusive, and behave differently. Therefore, a study was initiated comparing our cases with various series. This is the second largest series so far reported. We tried to hypothesize how to eliminate diagnostic errors in this study, while few interesting points were discovered. MATERIAL AND METHODS: All meningiomas operated in the last seventeen years were reviewed. It was a retrospective study. Diagnostic errors, clinical behaviour and histopathology were reviewed. Planning of surgery and prognostication demands that the diagnosis be established pre-operatively and since these tumours may mimic other brain tumour types on radiology , factors that may lead to better diagnostic accuracy were tried to be established. Categorization of the tumours with different cyst types according to various classifications was done. The follow up period was two months to ten years. RESULTS: Out of 530 meningiomas, we found 20 with cystic changes.. There mean age was 47.5 years. The commonest symptoms were raised intra cranial pressure, hemiparesis, memory loss, behavioral changes, vision loss, papilloedem and cranial nerve palsies. The most common histological variety was meningothelial meningioma. The incidence of high grade or malignant tumors was 30 %. Based on radiology, the highest diagnostic accuracy was achieved in 62.5% cases only. CONCLUSION: Cystic meningiomas continue to pose diagnostic challenges. Multi-planar contrast magnetic resonance imaging (MRI) will help in establishing accurate diagnosis, it reveals cysts missed on computed tomography (CT) scans. This would lead to accurate prognostication and better surgical planning with the aim of preventing recurrences.

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Diagnostic Accuracy of Xeromammography

Tumori Journal ◽

10.1177/030089168106700510 ◽

1981 ◽

Vol 67 (5) ◽

pp. 447-453 ◽

Cited By ~ 1

Author(s):

Valter Castiglione ◽

Adelaide D'Antona ◽

Luigi Dellafiore ◽

Luisa Ferrario ◽

Guido Luzzatti ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Malignant Tumors ◽

Age Groups ◽

Disease Process ◽

Diagnostic Errors ◽

Benign Tumors ◽

Radiologic Investigation ◽

Pathologic Processes ◽

Sclerosing Adenosis

The analytical study of the case material has allowed a precise evaluation of the distribution by age groups of the different pathologic processes of the breast, of the localization and dimensions of malignant tumors, as well as the diagnostic accuracy for those cases histologically ascertained and those with a follow-up. The diagnostic accuracy and the consequent reliability of the xeroradiographic method for the diagnosis of breast cancer is distinctly superior to that reported in the literature for traditional mammography, whereas for the differential diagnosis between circumscribed dysplastic manifestations and benign tumors xeromammography is not sufficiently reliable. The authors critically discuss the results and in particular the problem of false positives, which also include diagnostic errors that cannot be avoided in that they directly derive from the pathologic morphology of the disease process (plasma cell mastitis and sclerosing adenosis). As regards the problem of false negatives, they can be reduced within certain limits by resorting to other instrumental investigations. However, there are cases (1% of the malignant neoplasias histologically ascertained) that present a completely negative xeroradiographic finding. These are the limits of the radiologic investigation which cannot in any way be surmounted.

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Neurosurgical management of a giant colloid cyst with atypical clinical and radiological presentation

Journal of Neurosurgery ◽

10.3171/2014.7.jns14242 ◽

2014 ◽

Vol 121 (5) ◽

pp. 1185-1188 ◽

Cited By ~ 5

Author(s):

Joel Woodley-Cook ◽

Jaime L. Martinez ◽

Anish Kapadia ◽

David G. Munoz ◽

Aditya Bharatha ◽

...

Keyword(s):

Vision Loss ◽

Obstructive Hydrocephalus ◽

Memory Loss ◽

Final Diagnosis ◽

Colloid Cyst ◽

Ct Scans ◽

Mr Images ◽

Diagnostic Dilemma ◽

Foramen Of Monro ◽

Histopathological Investigation

The finding of a colloid cyst on neuroimaging is often incidental. These lesions are usually located at the foramen of Monro, are hyperdense on CT scans, and generally demonstrate signal intensity of water on MR images, although this depends on their content. When symptomatic, they frequently present with headaches and nausea due to an obstructive hydrocephalus. The authors describe a case of a giant colloid cyst in a patient presenting with complete left-sided vision loss and progressive memory loss, two very atypical findings in colloid cyst presentation. Imaging findings were also atypical, and this case proved to be a diagnostic dilemma because of its clinical and radiological presentation. Histopathological investigation was of utmost importance in the final diagnosis of a colloid cyst. To the authors' knowledge this colloid cyst is larger than any other described in the literature.

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“ROLE OF FNAC IN THE DIAGNOSIS OF SALIVARY GLAND LESION”

10.36106/ijsr/4305248 ◽

2021 ◽

pp. 69-71

Author(s):

Rifat Qureishi ◽

M.H. Usmani ◽

U.R. Singh ◽

P.C. Kol

Keyword(s):

Salivary Gland ◽

Diagnostic Accuracy ◽

Malignant Tumors ◽

Histopathological Examination ◽

Standard Procedure ◽

Neck Region ◽

Invasive Procedure ◽

Sensitivity Index ◽

Cytologic Diagnosis ◽

Wide Range

Background: Fine needle aspiration cytology (FNAC) has been used for diagnosis of salivary gland lesions for many years. Various studies in the existing literature have shown a wide range of sensitivity and diagnostic accuracy of cytologic diagnosis. FNAC is a safe, simple, cost effective, 1-4 accurate and minimal invasive procedure for the evaluation of salivary gland lesions. FNAC is not only useful in planning denitive preoperative 2,5-6 diagnosis but also can prevent unnecessary surgical intervention. Salivary gland swelling occur more commonly in 3rd decade of life with equal sex incidence. Parotid is one of the most commonly involved glands in the head & neck region swellings. FNAC appears to be highly sensitive for benign tumours and highly specic for malignant tumors and it should be the rst line of investigation in evaluating the salivary gland pathologies. 7 Early diagnosis and appropriate management carries good prognosis. Methods: Patients with suspected salivary gland enlargements, referred for FNAC, were included in this study. FNAC was performed by using the standard procedure. Cytologic diagnosis was compared with histopathologic diagnosis wherever it was available. Results: In the present study conducted in the department of pathology, Shyam Shah Medical College Rewa MP, over a period of 5 years, 152 Patients with suspected salivary gland enlargements were retrospectively appraised. The benign lesions of salivary gland were 133 (87.5%), out of which Pleomorphic adenoma was diagnosed in 75 (56.39%) cases, clinical correlation was found in 58 (77.33%) cases. 29 cases were subsequently correlated with histopathological examination 26 correctly correlated and the diagnostic accuracy of FNAC was found to be 89.65%. Inammatory lesions were proved correct in 08 out of 10 cases after histopathology. Therefore, accuracy of FNAC was 80.0%. Malignant lesions of salivary gland were found in 19 cases, out of which 15 (78.94%) cases correlated with clinical diagnosis. 13 cases were subjected to histopathology 10 correctly correlated and the diagnostic accuracy of FNAC was found to be 76.92%. Overall diagnostic accuracy of FNAC was 84.61%. Conclusion:In conclusions it can be established that FNAC is an efcient and accurate procedure with high sensitivity index, and its usefulness is enhanced due to it being a relatively easy procedure which can be carried out even on outdoor patients.

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Development of Novel Deep Multimodal Representation Learning-based Model for the Differentiation of Liver Tumors on B-Mode Ultrasound Images

10.21203/rs.3.rs-143117/v1 ◽

2021 ◽

Author(s):

Masaya Sato ◽

Tamaki Kobayashi ◽

Yoko Soroida ◽

Takashi Tanaka ◽

Takuma Nakatsuka ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Diagnostic Performance ◽

Liver Tumors ◽

Malignant Tumors ◽

Representation Learning ◽

Ultrasound Images ◽

Blood Biomarkers ◽

Liver Nodules ◽

Representation Model ◽

Multimodal Representation

Abstract Recently, multimodal representation learning for images and other information such as numbers or language has gained much attention due to the possibility of combining latent features using a single distribution. The aim of the current study was to analyze the diagnostic performance of deep multimodal representation model-based integration of tumor image, patient background, and blood biomarkers for the differentiation of liver tumors observed using B-mode ultrasonography (US). First, we applied supervised learning with a convolutional neural network (CNN) to 972 liver nodules in the training and development sets (479 benign and 493 malignant nodules), to develop a predictive model using segmented B-mode tumor images. Additionally, we also applied a deep multimodal representation model to integrate information about patient background or blood biomarkers to B-mode images. We then investigated the performance of the models in an independent test set of 108 liver nodules, including 53 benign and 55 malignant tumors. Using only the segmented B-mode images, the diagnostic accuracy and area under the curve (AUC) values were 68.52% and 0.721, respectively. As the information about patient background such as age or sex and blood biomarkers was integrated, the diagnostic performance increased in a stepwise manner. The diagnostic accuracy and AUC value of the multimodal DL model (which integrated B-mode tumor image, patient age, sex, AST, ALT, platelet count, and albumin data) reached 96.30% and 0.994, respectively. Integration of patient background and blood biomarkers in addition to US image using multimodal representation learning outperformed the CNN model using US images. We expect that the deep multimodal representation model could be a feasible and acceptable tool that can effectively support the definitive diagnosis of liver tumors using B-mode US in daily clinical practice.

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Spontaneous C1-2 CSF Leak Treated with High Cervical Epidural Blood Patch

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100007654 ◽

2008 ◽

Vol 35 (1) ◽

pp. 102-105 ◽

Cited By ~ 6

Author(s):

Philip WH Peng ◽

Richard Farb

Keyword(s):

Epidural Blood Patch ◽

Spontaneous Intracranial Hypotension ◽

Memory Loss ◽

Csf Leak ◽

Cerebellar Tonsil ◽

Iodinated Contrast ◽

Blood Patch ◽

Magnetic Resonance Imaging Mri ◽

Fluid Collections ◽

High Cervical

Spontaneous intracranial hypotension (SIH) is a condition caused by spontaneous spinal cerebrospinal fluid (CSF) leaks. Clinically, it is characterized by orthostatic headache and may respond well to epidural blood patch. Other neurological presentations of SIH include diplopia, memory loss, hearing deficits, Parkinsonism, ataxia, obtundation and even coma.Magnetic resonance imaging (MRI) is crucial in the diagnosis of this condition. Typical radiological features include diffuse pachymeningeal enhancement, descent of the cerebellar tonsil, a decrease in the size of prepontine and perichiasmatic cisterns, and subdural fluid collections. However, radiological imaging such as radionuclide cisternography or spinal MRI are not reliable in detecting the site of leakage. Myelography with iodinated contrast followed by thin-cut computed tomography (CT) or MRI of the entire spine has been shown as the technique of choice in defining the location of the CSF leak.

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Preparation of Magnetic Resonance Nano Contrast Agent and Its Adoption in Diagnosis of Breast Cancer

Science of Advanced Materials ◽

10.1166/sam.2021.4075 ◽

2021 ◽

Vol 13 (9) ◽

pp. 1611-1621

Author(s):

Rong Guo ◽

Binbin Ma ◽

Jiaqiu Nie

Keyword(s):

Breast Cancer ◽

Differential Diagnosis ◽

Magnetic Resonance ◽

Contrast Agent ◽

Malignant Tumors ◽

Nipple Discharge ◽

Mri Contrast Agent ◽

Cytotoxicity Test ◽

Mri Contrast ◽

Magnetic Resonance Imaging Mri

This study aimed to explore the value of preoperative mammography in the differential diagnosis of benign and malignant tumors of nipple discharge. A biocompatible T1 contrast agent KMnF3 nanoparticle was first developed in the research, and then RGD-coupled KMnF3 nanoparticles were further synthesized as a highly sensitive tumor-targeted magnetic resonance imaging (MRI) contrast agent. While the nanoparticle was characterized physically, cytotoxicity test and MRI test in breast cancer mice were performed, and the excised tumors were subjected to immunostaining and tumor electron microscope section processing. At the same time, 60 patients with nipple discharge were screened to participate in the research, and the prepared MRI nano contrast agent was used for the differential diagnosis of breast benign/malignant tumors of nipple discharge. In the experiment, the synthetic nanoparticles were tested by Fourier transformed infrared (FTIR), which proved that the designed RGDtu/KMnF3 nanoparticles were successfully synthesized. The quantitative analysis of the synthesized nanoparticles showed that the relaxation efficiency reached 23.12 mM−1s−1, and there was no obvious toxicity. After staining, the microscope showed that the tumor was proliferating. After intravenous injection of low-dose RGDtu/KMnF3 contrast agent, nanoparticles were found in the tumor tissue. It was found that the synthesized nanoparticles enhanced the contrast of tumors with a volume of less than 50 mm3 by observing tumor slices. The imaging of the patient’s breast showed that the X-ray classification of galactography based on this contrast agent was statistically significant in distinguishing benign/malignant lesions of nipple discharge (X2 = 58.700, P < 0.01).

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Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19)

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-0285 ◽

2020 ◽

Vol 58 (7) ◽

pp. 1070-1076 ◽

Cited By ~ 179

Author(s):

Giuseppe Lippi ◽

Ana-Maria Simundic ◽

Mario Plebani

Keyword(s):

Diagnostic Accuracy ◽

Diagnostic Errors ◽

Laboratory Diagnosis ◽

Test Results ◽

Rt Pcr ◽

Viral Recombination ◽

Technical Issues ◽

Diagnostic Window ◽

Novel Coronavirus ◽

And Storage

AbstractA novel zoonotic coronavirus outbreak is spreading all over the world. This pandemic disease has now been defined as novel coronavirus disease 2019 (COVID-19), and is sustained by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As the current gold standard for the etiological diagnosis of SARS-CoV-2 infection is (real time) reverse transcription polymerase chain reaction (rRT-PCR) on respiratory tract specimens, the diagnostic accuracy of this technique shall be considered a foremost prerequisite. Overall, potential RT-PCR vulnerabilities include general preanalytical issues such as identification problems, inadequate procedures for collection, handling, transport and storage of the swabs, collection of inappropriate or inadequate material (for quality or volume), presence of interfering substances, manual errors, as well as specific aspects such as sample contamination and testing patients receiving antiretroviral therapy. Some analytical problems may also contribute to jeopardize the diagnostic accuracy, including testing outside the diagnostic window, active viral recombination, use of inadequately validated assays, insufficient harmonization, instrument malfunctioning, along with other specific technical issues. Some practical indications can hence be identified for minimizing the risk of diagnostic errors, encompassing the improvement of diagnostic accuracy by combining clinical evidence with results of chest computed tomography (CT) and RT-PCR, interpretation of RT-PCR results according to epidemiologic, clinical and radiological factors, recollection and testing of upper (or lower) respiratory specimens in patients with negative RT-PCR test results and high suspicion or probability of infection, dissemination of clear instructions for specimen (especially swab) collection, management and storage, together with refinement of molecular target(s) and thorough compliance with analytical procedures, including quality assurance.

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TP53-Deficient Angiosarcoma Expression Profiling in Rat Model

Cancers ◽

10.3390/cancers12061525 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1525 ◽

Cited By ~ 1

Author(s):

Urszula Smyczyńska ◽

Damian Strzemecki ◽

Anna M. Czarnecka ◽

Wojciech Fendler ◽

Michał Fiedorowicz ◽

...

Keyword(s):

Rat Model ◽

Malignant Tumors ◽

Gene Expression Pattern ◽

Tca Cycle ◽

Telomere Maintenance ◽

Specific Gene ◽

Positron Emission ◽

Short Overall Survival ◽

Magnetic Resonance Imaging Mri ◽

Microarray Expression

Sarcomas are a heterogeneous group of malignant tumors, that develop from mesenchymal cells. Sarcomas are tumors associated with poor prognosis and expected short overall survival. Efforts to improve treatment efficacy and treatment outcomes of advanced and metastatic sarcoma patients have not led to significant improvements in the last decades. In the Tp53C273X/C273X rat model we therefore aimed to characterize specific gene expression pattern of angiosarcomas with a loss of TP53 function. The presence of metabolically active tumors in several locations including the brain, head and neck, extremities and abdomen was confirmed by magnetic resonance imaging (MRI) and positron emission tomography (PET) examinations. Limb angiosarcoma tumors were selected for microarray expression analysis. The most upregulated pathways in angiosarcoma vs all other tissues were related to cell cycle with mitosis and meiosis, chromosome, nucleosome and telomere maintenance as well as DNA replication and recombination. The downregulated genes were responsible for metabolism, including respiratory chain electron transport, tricarboxylic acid (TCA) cycle, fatty acid metabolism and amino-acid catabolism. Our findings demonstrated that the type of developing sarcoma depends on genetic background, underscoring the importance of developing more malignancy susceptibility models in various strains and species to simulate the study of the diverse genetics of human sarcomas.

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Fine-Needle Aspiration Biopsies of Ovarian Masses: A Reliable Technique

Acta Cytologica ◽

10.1159/000449362 ◽

2016 ◽

Vol 60 (5) ◽

pp. 465-474 ◽

Cited By ~ 2

Author(s):

Maral Mokhatri ◽

Golsa Shekarkhar ◽

Zahra Sarraf

Keyword(s):

Diagnostic Accuracy ◽

Fine Needle Aspiration ◽

Malignant Tumors ◽

Invasive Procedure ◽

Needle Aspiration ◽

Histological Diagnosis ◽

Diagnostic Modality ◽

Reliable Technique ◽

Fine Needle ◽

Ovarian Masses

Objective: In gynecology, fine-needle aspiration (FNA) has an overall accuracy of 94.5% in differentiation between benign and malignant tumors. The purpose of this study was to determine reliable cytological criteria for categorizing ovarian masses into benign and malignant categories, their subtypes, and also to evaluate FNA accuracy in the diagnosis of ovarian tumors in relation to histopathological findings. Study Design: A prospective study was performed on all patients with a preoperative diagnosis of ovarian tumor who were referred to our hospital between August 2013 and August 2015. During surgery, FNA was performed using an 18-gauge needle by a pathologist. Aspirated material was spread on clean glass slides and stained with Papanicolaou and Wright-Giemsa stains. The cytological findings and results were compared with the histological diagnosis. Results: Of the 81 cases in this study, there was a discrepancy between the cytological and histological diagnosis in 9 cases. The overall cytological diagnostic accuracy in our study was 88.9% with a sensitivity and specificity of 78.1 and 95.5%, respectively. Conclusion: FNA of an ovarian mass is a minimally invasive procedure with acceptable diagnostic accuracy, especially when differentiating between benign and malignant lesions, and can be considered as a useful diagnostic modality for choosing an appropriate management course.

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