Incidence of unusual and clinically significant histopathological findings in routine discectomy

2006 ◽  
Vol 5 (5) ◽  
pp. 410-413 ◽  
Author(s):  
Adam S. Wu ◽  
Daryl R. Fourney

Object Routine histopathological examination of discectomy specimens remains common practice in many hospitals, although it rarely detects unsuspected clinically significant disease. Controversy exists as to the effectiveness of this practice. The objectives of this study were to compare the authors’ experience with a review of the literature. Methods In a retrospective database analysis the authors identified all intervertebral disc specimens obtained during spinal procedures over an 8-year period (1996–2004). Cases of benign (nonneoplastic and noninfectious) indications for surgery were included in the study, whereas cases of nonbenign indications were excluded. The final pathological diagnoses were reviewed, and a chart review was performed to determine whether any unexpected findings affected subsequent patient care. A total of 1858 discectomy specimens were identified: 1775 of these were obtained in 1719 routine discectomy procedures. Unexpected histopathological findings were identified in four cases, and none was clinically significant. Conclusions Routine histopathological examination of disc specimens is not justified. The decision to send specimens for pathological examination should be determined on a case-by-case basis after consideration of the clinical presentation, results of laboratory and imaging studies, and intraoperative findings.

2021 ◽  
Vol 38 (3) ◽  
pp. 322-325
Author(s):  
Ufuk UYLAS ◽  
Ramazan GUNDOGU ◽  
Egemen CICEK ◽  
Müfit ŞANSAL ◽  
Aydın AKTAŞ ◽  
...  

Sleeve gastrectomy is the most preferred surgical procedure in obese patients. In the literature, the necessity of pathological examination of the specimen is emphasized because of malignant case reports. In this study, we aimed to present the histopathological findings of the specimens of our patients who underwent sleeve gastrectomy due to obesity in the light of the literature. Patients who underwent sleeve gastrectomy due to obesity between 2014-2019 in our clinic were retrospectively screened. Endoscopy was not performed in patients with no symptoms. After the obesity committee, the patients were operated and the specimens were sent for routine histopathological examination. Patients' age, gender, body mass index, surgical procedure information, and histopathological features of resected gastric specimens were analyzed. A total of 411 patients were included in the study and there were 309 (75.2%) female patients. The overall mean age was 35 ± 10.3 and the mean body mass index was 44.7 ± 5.2 kg / m2. The pathology of 85 (20.7%) of the patients were reported as completely normal. Abnormal pathological findings were detected in 326 (79.3%) patients. No malignant finding was found in the specimen pathology results. The necessity of endoscopic examination before sleeve gastrectomy is controversial. Even if no malignant pathological result was detected in our study, we believe that routine pathological examination is required for medicolegal reasons.


Author(s):  
Adam S. Wu ◽  
Daryl R. Fourney

Object:Routine histopathological examination of intervertebral disc specimens is commonly performed in North American hospitals, but recent studies have questioned the utility of this practice in cases where the indication for surgery is a benign process such as degenerative disc disease. In this study, we have performed a cost-benefit analysis of this practice.Methods:We performed a cost-benefit analysis of routine histopathological examination of 1775 routine (non-neoplastic and non-infectious indications for surgery) and 70 non-routine (suspected neoplastic or infectious indications for surgery) discectomy specimens obtained over an eight-year period (1996 and 2004). Chart reviews were used to determine if any histopathology findings were clinically significant (i.e., affected subsequent patient care). Total costs were calculated. A literature review was conducted to compare our results with other published series.Results:We found four unexpected histopathology results among 1775 specimens obtained from routine cases, one of which was clinically significant. We calculated costs of $42,165.25 per unexpected histopathological finding and $168,625 per clinically significant histopathological finding. For non-routine surgeries, the cost per abnormal pathological finding was $116.67.Conclusions:In routine cases, histopathological examination of disc specimens is not justified. The decision to send specimens for pathological examination should be based on the surgeon's judgment.


2020 ◽  
Vol 23 (1) ◽  
pp. 10-12
Author(s):  
Nelema Jahan ◽  
Md. Mamunur Rahman ◽  
Mohammad Shahidul Alam ◽  
Md Saiful Islam

Background: A breast lump is the most common symptom associated with both benign and malignant breast diseases. Therefore, a distinction of benign from malignant lump is of importance for proper management. Though a definitive diagnosis is possible with imaging for all the lesions, histopathological study is proven essential for confirming the diagnosis. Objective: The objective of this study was to evaluate the role of USG and histopathological findings of different breast lump in diagnosis and their comparison. Methods: A prospective study was conducted over a period of one year from January 2017 to December 2017. A total of 116 patients were included in this study. All breast lumps underwent surgery and the ultrasound findings of these lumps were compared with the histopathological findings. Data were collected from these patients by a preformed questionnaire and finally the data were analyzed. Results: Out of 116 patients only 21 cases were reported as malignant in ultrasound report but histopathology revealed 31 malignant patients. On histopathological examination 10 benign cases turned out to be malignant. Conclusion: The present study was undertaken to evaluate in diagnosing breast mass lesions individually by ultrasound and compared with histopathology for definitive management of a patient. Journal of Surgical Sciences (2019) Vol. 23 (1) : 10-12


Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 660
Author(s):  
Stephen J. Goodswen ◽  
Paul J. Kennedy ◽  
John T. Ellis

Babesia infection of red blood cells can cause a severe disease called babesiosis in susceptible hosts. Bovine babesiosis causes global economic loss to the beef and dairy cattle industries, and canine babesiosis is considered a clinically significant disease. Potential therapeutic targets against bovine and canine babesiosis include members of the exportome, i.e., those proteins exported from the parasite into the host red blood cell. We developed three machine learning-derived methods (two novel and one adapted) to predict for every known Babesia bovis, Babesia bigemina, and Babesia canis protein the probability of being an exportome member. Two well-studied apicomplexan-related species, Plasmodium falciparum and Toxoplasma gondii, with extensive experimental evidence on their exportome or excreted/secreted proteins were used as important benchmarks for the three methods. Based on 10-fold cross validation and multiple train–validation–test splits of training data, we expect that over 90% of the predicted probabilities accurately provide a secretory or non-secretory indicator. Only laboratory testing can verify that predicted high exportome membership probabilities are creditable exportome indicators. However, the presented methods at least provide those proteins most worthy of laboratory validation and will ultimately save time and money.


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 728
Author(s):  
Jeong-Hyouk Choi ◽  
Koo-Han Yoo ◽  
Dong-Gi Lee ◽  
Gyeong-Eun Min ◽  
Gou-Young Kim ◽  
...  

Background and Objectives: Retroperitoneal schwannoma is a very rare case of schwannoma which commonly occurs in the other part of the body. However, it is difficult to distinguish schwannoma from other tumors before pathological examination because they do not show specific characteristics on imaging study such as ultrasound, computed tomography (CT), and magnetic resonance image (MRI). Case summary: A 60-year-old male showed a retroperitoneal cystic tumor which is found incidentally during evaluation of coexisted bladder tumor. Neurogenic tumor was suspicious for the retroperitoneal tumor through pre-operative imaging study. Finally, a schwannoma was diagnosed by immunohistochemical examination after complete surgical excision laparoscopically. Conclusion: As imaging technology is developed, there may be more chances to differentiate schwannoma from other neoplasm. However, still surgical resection and histopathological examination is feasible for diagnosis of schwannoma.


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