scholarly journals Challenges of Preoperative Diagnosis and Management of Scalene Intramuscular Angioma

2015 ◽  
Vol 5 (1) ◽  
pp. 20
Author(s):  
Lei Zhang ◽  
Beverly Wang ◽  
Julie Goddard
Keyword(s):  
Fine Needle Aspiration ◽  
Preoperative Diagnosis ◽  
Needle Aspiration ◽  
Fatty Tissue ◽  
Scalene Muscle ◽  
Fine Needle ◽  
Spindle Cells ◽  
Atrophic Muscle ◽  
History Of ◽  
Operative Findings

Intramuscular angioma of scalene muscle is rare with only five cases reported so far. Four of them have not been suspected before surgery; one was diagnosed preoperatively by core biopsy. Preoperative diagnosis is important for management. Awareness of cytologic features could help preoperative diagnosis when need of ruling out malignancy and coagulopathy make fine needle aspiration a choice. We herein demonstrate a new case of a 27 year old male with history of hepatocellular carcinoma, who presented with a 6 cm left supraclavicular mass. The fine needle aspiration was paucicellular; however, the bland ovoid to spindle cells with a whirling and luminal arrangement in the background of blood, fatty drops and degenerate muscle are suggestive of intramuscular angioma. The magnetic resonance imagines (MRI) demonstrate a T1 isointense and T2 hyperintense ill-defined lesion splaying anterior and mid scalene muscles with subtle vascular voids at periphery. These features in combination with cytology findings indicate intramuscular angioma. The pre-operative findings are correlated to the histologic picture of mixed capillaries and varying sized venues intervening with fatty tissue and atrophic muscle. Intraoperatively, the mass is adjacent to the brachial plexus rootlets, interdigitating with the scalene muscle and pushing the carotid sheath, left subclavicular artery and vein aside. Following embolization, the mass is resected with minimal bleeding. Our case suggests that scalene intramuscular angioma can be successfully managed by surgery after embolization; preoperative diagnosis rendered by cytologic features and imaging characters would aid the planning of surgery.

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.

scholarly journals Cured primary hyperparathyroidism after fine-needle aspiration biopsy-induced parathyroid disappearance

2017 ◽  
Vol 2017 ◽  
Author(s):  
Elda Kara ◽  
Elisa Della Valle ◽  
Sara De Vincentis ◽  
Vincenzo Rochira ◽  
Bruno Madeo
Keyword(s):  
Primary Hyperparathyroidism ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Complete Disappearance ◽  
List Type ◽  
Fine Needle ◽  
Time Period ◽  
History Of

Summary Spontaneous or fine-needle aspiration (FNAB)-induced remission of primary hyperparathyroidism (PHPT) may occur, especially for cystic lesions. However, the disease generally relapses over a short time period. We present a case of PHPT due to an enlarged hyperfunctioning parathyroid that underwent long-term (almost 9 years) clinical and ultrasonographic remission after the disappearance of the lesion following ultrasound (US)-assisted FNAB. A 67-year-old woman with PHPT underwent biochemical and US examinations that confirmed the diagnosis and showed a lesion suggestive for parathyroid adenoma or hyperplasia. US-FNAB of the lesion confirmed its parathyroid nature by means of elevated levels of parathyroid hormone within the needle washing fluid. At the second visit, the patient referred slight neck swelling that resolved spontaneously in the days after the US-FNAB. At subsequent follow-up, the enlarged parathyroid was not found; it was visible neither with US nor with magnetic resonance imaging. Biochemical remission persists after 9 years. This is the first reported case of cure of PHPT after US-FNAB performed on a hyperfunctioning parathyroid resulting in its complete disappearance over a period of 9 years of negative biochemical and ultrasonographic follow-up. Learning points: Spontaneous or fine-needle aspiration-induced remission of primary hyperparathyroidism can occur. Both circumstances may present disease relapse over a variable time period, but definite remission is also possible even though long-term periodic follow-up should be performed. Parathyroid damage should be ruled out in case of neck symptomatology after parathyroid fine-needle aspiration or spontaneous symptomatology in patients with history of primary hyperparathyroidism.

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.

Management of Thyroid Nodules in Deceased Donors With Comparison Between Fine Needle Aspiration and Intraoperative Frozen Section in the Setting of Transplantation

2019 ◽  
Vol 29 (4) ◽  
pp. 316-320 ◽  
Author(s):  
Albino Eccher ◽  
Ilaria Girolami ◽  
Antonia D’Errico ◽  
Gianluigi Zaza ◽  
Amedeo Carraro ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Thyroid Nodules ◽  
Frozen Section ◽  
Clinical History ◽  
Needle Aspiration ◽  
Transmission Risk ◽  
Fine Needle ◽  
Intraoperative Frozen Section ◽  
History Of ◽  
Deceased Donors

Introduction: Newly discovered thyroid nodules in deceased donors are investigated to rule out cancer that can be transmitted, but there are no established protocols. The aim of the study was to compare fine needle aspiration versus intraoperative frozen section in the donor management with limited time. Methods: Data were extracted only from the records of Italian second opinion consultation service in the years 2016 to 2017 and included donor details, pathology diagnoses, complications, transmission risk profile, and impact on transplantation. Results: Among 31 deceased donors with thyroid nodules, we documented 4 with a clinical history of cancer and 27 with a newly discovered nodule. The latter was evaluated by thyroidectomy with frozen section in 22 and fine needle aspiration in 5. Among all donors, 7 had papillary thyroid carcinoma with negligible transmission risk, whereas 8 with unacceptable risk. Two donors presented major bleeding after thyroidectomy, with organ discard in 1 case. Transplantation was delayed in 4 cases that were evaluated with frozen section. Discussion: There was no uniform approach for the investigation of thyroid nodules. Our results showed that fine needle aspiration was more accurate and useful than frozen section. Fine needle aspiration had minor economic impact and a far less rate of bleeding/hemodynamic complications, potentially delaying and compromising organ recovery. Our results suggested considering fine needle aspiration as a first step in the evaluation of thyroid nodules in donors.

scholarly journals Metastases to the Pancreas Encountered on Endoscopic Ultrasound-Guided, Fine-Needle Aspiration

2015 ◽  
Vol 139 (10) ◽  
pp. 1248-1252 ◽  
Author(s):  
Judy C. Pang ◽  
Michael H. Roh
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Prior History ◽  
Ultrasound Guided ◽  
Cytologic Examination ◽  
Fine Needle ◽  
Pancreatic Masses ◽  
History Of ◽  
Primary Neoplasms

Metastatic lesions in the pancreas are very uncommon and may be difficult to differentiate from the more commonly encountered primary neoplasms derived from the exocrine and endocrine pancreas because of the significant overlap in clinical presentation, imaging, and cytologic features. Metastasis to the pancreas may occur years after treatment of the primary neoplasm and is often not considered on initial evaluation because of the rarity of such events. The possibility of a metastasis to the pancreas should be entertained in patients with any prior history of malignancy because a proper diagnosis is essential in identifying surgical candidates, or avoiding potentially unnecessary surgery and facilitating triage to more appropriate nonoperative therapy. Herein, we describe intrapancreatic metastases secondary to renal cell carcinoma, melanoma, and lung carcinoma, as documented by cytologic examination of endoscopic ultrasound-guided fine-needle aspiration of the pancreatic masses.

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