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Balbaloglu H, Deniz O, Ozaydin RY, Tasdoven I, Karadeniz Cakmak G. Parathyroid fine needle aspiration with PTH washout: Can it lead to parathyroid cell seeding in primary hyperparathyroidism? Medicine (Baltimore) 2024; 103:e37754. [PMID: 38608096 PMCID: PMC11018208 DOI: 10.1097/md.0000000000037754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/08/2024] [Indexed: 04/14/2024] Open
Abstract
Although parathyroid fine-needle aspiration (P-FNA) with parathyroid hormone (PTH) washout is effective in detecting preoperative parathyroid lesions, it also presents risks such as fibrosis, hematoma, and, in rare cases, tumor seeding. This study aimed to investigate whether P-FNA with PTH washout leads to the seeding of parathyroid cells along the path of the needle. A retrospective analysis was conducted on patients undergoing minimally invasive parathyroidectomy guided by preoperative PTH washout. Permanent pathology reports, imaging data, and postoperative serum parathyroid hormone and calcium levels were assessed to determine the effectiveness and safety of the procedure. Complications following P-FNA with PTH washout were also reviewed using data from the patient registration system of Bulent Ecevit University. The procedure accurately localized parathyroid adenomas in 87 patients who underwent ultrasound-guided parathyroidectomy following preoperative P-FNA and PTH washout. Postoperatively, 75 patients showed normal parathyroid hormone and calcium levels. Two patients required secondary surgery for contralateral adenomas. Critically, there was no evidence of P-FNA with PTH washout-induced parathyromatosis or seeding during the follow-up. Effective adenoma localization is crucial for successful minimally invasive surgery of hyperparathyroidism. Our study indicates that combining preoperative P-FNAB with PTH washout and imaging enhances adenoma detection, especially when intraoperative PTH measurements are not available, thus improving surgical outcomes. Notably, we found no evidence of cell implantation after P-FNA, suggesting the safety and efficacy of this method for preventing parathyroid cell seeding.
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Affiliation(s)
- Hakan Balbaloglu
- Bulent Ecevit University School of Medicine, Department of General Surgery, Zonguldak, Turkey
| | - Oguzhan Deniz
- Bulent Ecevit University School of Medicine, Department of General Surgery, Zonguldak, Turkey
| | - R. Yigit Ozaydin
- Bulent Ecevit University School of Medicine, Department of General Surgery, Zonguldak, Turkey
| | - Ilhan Tasdoven
- Bulent Ecevit University School of Medicine, Department of General Surgery, Zonguldak, Turkey
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Das O, Mohin M, Dey S, Kar A, Singhania P, Adhikari S, Chowdhury S, Chatterjee U. Cytological findings of phosphaturic mesenchymal tumor: Report of a case with summary of prior published cases. Diagn Cytopathol 2024; 52:E44-E47. [PMID: 37897246 DOI: 10.1002/dc.25245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
Phosphaturic mesenchymal tumor (PMT) is a rare neoplasm causing tumor-induced osteomalacia (TIO) and is characterized by secretion of FGF23, renal phosphate wasting and hypophosphataemia. It can be completely cured by resection and therefore its diagnosis is of utmost importance. Although the histology is well described, there is sparse literature on cytology of PMT and only three cases have been described so far. A 45-year-old lady presented with a non-tender mass in hard palate for 2 years from which fine-needle aspiration was done. The smears were paucicellular and showed bland spindle cells embedded in osteoid-like stromal matrix in a hemorrhagic background. Here we take the opportunity to describe the cytological findings of PMT along with its cytological differentials and a summary of prior published cases.
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Affiliation(s)
- Oindrila Das
- Department of Pathology, IPGME&R, Kolkata, India
| | - Md Mohin
- Department of Pathology, IPGME&R, Kolkata, India
| | - Soumya Dey
- Department of Pathology, IPGME&R, Kolkata, India
| | - Anish Kar
- Department of Endocrinology, IPGME&R, Kolkata, India
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3
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Goh Q, Tong C. Spontaneous resolution of primary hyperparathyroidism post-biopsy-related neck haematoma. J R Coll Physicians Edinb 2023; 53:252-254. [PMID: 37642421 DOI: 10.1177/14782715231196602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Spontaneous or fine-needle aspiration (FNA)-induced remission of primary hyperparathyroidism (PHPT) is an extremely rare phenomenon with variable outcomes. We report a 75-year-old Male who initially presented with left ureteric calculi and was found to have PHPT. Imaging studies including ultrasound neck, parathyroid sestamibi scan and computed tomography of thorax, abdomen, and pelvis failed to identify the culprit lesion and exploratory parathyroidectomy was planned. Before surgery, he underwent FNA for cytology of a right cold thyroid nodule which was complicated with a large neck haematoma and dysphagia. The cytology of the aspirated fluid was consistent with a benign cyst. One month after the procedure, serum calcium and phosphate normalised along with resolution of haematoma. He remained in biochemical remission at 1-year follow-up with the latest ultrasound of neck showing resolution of a large colloid nodule that was previously seen occupying the right thyroid lobe.
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Affiliation(s)
- QingCi Goh
- Department of Medicine, Hospital Melaka, Melaka, Malaysia
| | - ChinVoon Tong
- Department of Medicine, Hospital Melaka, Melaka, Malaysia
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Launay M, Blond L, Geffre A, Trumel C, Layssol-Lamour C. Effect of needle gauge on pain and specimen quality of ultrasound-guided fine needle sampling without aspiration of the canine spleen. Vet Radiol Ultrasound 2023; 64:936-944. [PMID: 37461325 DOI: 10.1111/vru.13277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 05/25/2023] [Accepted: 05/29/2023] [Indexed: 09/14/2023] Open
Abstract
Modifications of splenic parenchyma are common ultrasonographic findings in dogs. Splenic fine needle aspiration (FNA) is a rapid, safe procedure, routinely performed in veterinary institutions. However, 22-gauge (G) needle usually reported is selected according to general practice and the most appropriate needle size to be used remains unclear. The aim of this prospective, single-center, methods comparison study was to assess the effect of needle size on cytologic specimens' evaluation and animal welfare during the procedure. Dogs underwent ultrasound-guided splenic FNA using 23, 25, and 27G needles. Needles were compared based on initial and then detailed cytologic evaluation. The initial evaluation assessed overall cellularity, cell preservation, hemodilution, and detailed cytologic evaluation referred to exhaustive splenic components. Welfare evaluation was performed based on a scoring system. A total of 54 dogs were included in this study with 54 of 54 welfare evaluations and 35 of 54 cytologic evaluations by one or two European College of Veterinary Clinical Pathology-certified cytologists. The final cytologic diagnosis was unchanged regardless of the needle size. For the initial evaluation, 23G needles provided significantly higher cellularity than the 27G needles. For detailed cytologic evaluation, only the richness in mesothelial cells and stroma was affected by needle size. Pain induced by the procedures was considered low using 23, 25, and 27G needles with the 27G needle producing the least adverse reactions. Findings from the current study supported using needle gauges smaller than the previously published standard 22G needle for spleen ultrasound-guided fine needle nonaspiration in dogs. Due to higher cellularity and lower pain scores, authors recommend the use of 23G needles with a nonaspiration technique.
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Affiliation(s)
- Mahéva Launay
- Department of Imaging, Centre Hospitalier Vétérinaire Languedocia, Montpellier, France
| | - Laurent Blond
- Department of Imaging, Centre Hospitalier Vétérinaire Languedocia, Montpellier, France
| | - Anne Geffre
- Department of Clinical Sciences, Ecole Nationale Vétérinaire de Toulouse, Toulouse, France
| | - Catherine Trumel
- Department of Clinical Sciences, Ecole Nationale Vétérinaire de Toulouse, Toulouse, France
- Centre Régional d'Exploration Fonctionnelle et de Ressources Expérimentales (CREFRE), Université de Toulouse, INSERM, UPS, ENVT, Toulouse, France
| | - Catherine Layssol-Lamour
- Department of Clinical Sciences, Ecole Nationale Vétérinaire de Toulouse, Toulouse, France
- Centre Régional d'Exploration Fonctionnelle et de Ressources Expérimentales (CREFRE), Université de Toulouse, INSERM, UPS, ENVT, Toulouse, France
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Yıldız E, Kuzu S, Günebakan Ç, Özdemir M, Bucak A, Kahveci OK. Is the combined use of ultrasonography (USG) and fine needle aspiration biopsy (FNAB) safe in parotis masses? Retrospective comprehensive comparison of 123 cases. Ir J Med Sci 2023; 192:1861-1865. [PMID: 36097318 DOI: 10.1007/s11845-022-03155-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/06/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of the study was to compare final pathology results with ultrasonography (USI) and fine needle aspiration biopsy (FNAB) results in parotis masses. METHODS A total of 123 patients with primary parotis mass who applied to our center between 2010 and 2020 were selected for the study. Among these, 100 patients with preoperative USI, preoperative FNAB, and postoperative final pathology were included in the study. USI, FNAB, pathology results, surgery types, and demographic characteristics of the patients were analyzed. RESULTS According to the postoperative final pathology, preoperative USI sensitivity was found to be 100%, specificity was 55, positive predictive value was 84.31%, negative predictive value was 100%, and accuracy was 86.89%. Preoperative FNAB had a sensitivity of 85.7%, a specificity of 92.1%, a positive predictive value of 82.1%, a negative predictive value of 90.2%, and a diagnostic accuracy of 89.3%, according to the postoperative final pathology. CONCLUSION Preoperative USI and preoperative FNAB are very valuable diagnostic tools in the evaluation of parotis lesions. When used together, they provide highly accurate and important data for the surgeon.
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Affiliation(s)
- Erkan Yıldız
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey.
| | - Selçuk Kuzu
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
| | - Çağlar Günebakan
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
| | - Murat Özdemir
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
| | - Abdulkadir Bucak
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
| | - Orhan Kemal Kahveci
- Department of Otolaryngology, Healty Science University Hospital, Afyonkarahisar, Turkey
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Saoud C, Lossos C, Ali SZ. Polymethylmethacrylate-induced foreign body reaction presenting as bilateral parotid lesions: A case report of dermal filler adverse reaction diagnosed on fine needle aspiration. Cytopathology 2023; 34:385-387. [PMID: 36967650 DOI: 10.1111/cyt.13233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/06/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Dermal filler injections are being increasingly used as a non-surgical option for facial cosmetic procedures. However, their use has been implicated in multiple adverse events including immediate, early onset, and late onset complications. AIM We present a case of dermal filler-induced foreign body reaction presenting as bilateral parotid lesions and diagnosed using fine needle aspiration. CONCLUSION This case elucidate the risk of delayed adverse events in patients with dermal filler injections and stresses the importance of awareness by patients and providers for such events.
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Affiliation(s)
- Carla Saoud
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Chen Lossos
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Syed Z Ali
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Turgut B, Bakdik S, Öncü F, Küçükosmanoğlu İ, Eren Karanis Mİ, Kerimoğlu RS, Saraçoğlu M. Diagnostic Yield of Transabdominal Ultrasound-Guided Core Needle Method in Biopsies of Pancreatic Lesions. Ultrasound Q 2023; 39:109-116. [PMID: 36856702 DOI: 10.1097/ruq.0000000000000633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
ABSTRACT In this study, it was aimed to contribute to the selection of the method to perform pancreatic lesion biopsies.Data of patients, who had undergone a percutaneous biopsy because of pancreatic masses in our institution in the period between January 2015 and November 2019, were evaluated retrospectively. The percutaneous biopsy method, the type of needle used in the procedure, and periprocedural complications were listed. Pathology and cytology reports in the archive were reviewed, and biopsy results were divided into 3 groups as benign, malignant, and inadequate. Of 308 patients included in the study, the diagnostic accuracy was verified in 124 patients through the assessment of surgical outcomes, results of biopsies from metastatic lesions, or follow-up findings. The verified results were classified as true-positives and true-negatives.Of a total of 308 patients included in the study, 23 underwent a fine-needle aspiration biopsy (FNAB) and 285 underwent a core needle biopsy (CNB). No statistical differences were observed in sample acquisition success and complications between the groups.Of the lesions with a confirmed pathological diagnosis, 67.74% were malignant and 32.26% were benign. The diagnosis was correct in 107 of 112 CNB patients (95.54%) and 9 of 12 FNAB patients (75.00%). When the success of the 2 methods was compared, it was found that outcomes of CNB were statistically more successful compared with those of FNAB.A transabdominal ultrasound-guided percutaneous CNB is a safe method with a high diagnostic yield to perform a biopsy of the pancreas.
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Affiliation(s)
- Bekir Turgut
- Department of Radiology, University of Necmettin Erbakan, Meram Medical Faculty Hospital, Konya
| | - Süleyman Bakdik
- Department of Radiology, University of Necmettin Erbakan, Meram Medical Faculty Hospital, Konya
| | - Fatih Öncü
- Department of Radiology, University of Gazi, Medical Faculty Hospital, Ankara
| | | | | | - Ramazan Saygin Kerimoğlu
- Department of gastroenterology surgery, University of Health Sciences, Konya City Hospital, Konya, Turkey
| | - Mustafa Saraçoğlu
- Department of gastroenterology surgery, University of Health Sciences, Konya City Hospital, Konya, Turkey
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Lee JG, Chang YS, Kim BY. A Case of Diffuse Thyroid Hematoma after Ultrasound-Guided Fine Needle Aspiration. Medicina (B Aires) 2023; 59:medicina59040690. [PMID: 37109648 PMCID: PMC10142616 DOI: 10.3390/medicina59040690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Ultrasound-guided fine needle aspiration is an easy, safe, and efficient method of diagnosing thyroid diseases. Recent guidelines and studies have demonstrated that this test has a low incidence of complications; thus, most guidelines do not provide recommendations for post-exam care. However, the risk of serious and fatal bleeding in selected patients with bleeding tendency exists. Although screening tests for coagulation are not always necessary, a thorough assessment of past medical history needs to be made to identify disorders affecting coagulation function and bleeding risk factors, such as the use of antithrombotic drugs. This is a case report of a 70-year-old female patient who continued to take edoxaban and suffered bilateral thyroid hematoma a few hours after ultrasound-guided thyroid fine needle aspiration. The patient successfully recovered after undergoing conservative treatment.
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Park JY, Choi W, Hong AR, Yoon JH, Kim HK, Kang HC. A Comprehensive Assessment of the Harms of Fine-Needle Aspiration Biopsy for Thyroid Nodules: A Systematic Review. Endocrinol Metab (Seoul) 2023; 38:104-116. [PMID: 36891657 PMCID: PMC10008658 DOI: 10.3803/enm.2023.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGRUOUND There have concerns related with the potential harms of fine-needle aspiration biopsy (FNAB). We aimed to summarize the clinical complications and evaluate the safety of FNAB. METHODS Studies related with the harms of FNAB were searched on MEDLINE, Embase, Cochrane library, and KoreaMed from 2012 to 2022. Also, studies reviewed in the previous systematic reviews were evaluated. Included clinical complications were postprocedural pain, bleeding events, neurological symptoms, tracheal puncture, infections, post-FNAB thyrotoxicosis, and needle tract implantation of thyroid cancers. RESULTS Twenty-three cohort studies were included in this review. Nine studies which were related with FNAB-related pain showed that most of the subjects had no or mild discomfort. The 0% to 6.4% of the patients had hematoma or hemorrhage after FNAB, according to 15 studies. Vasovagal reaction, vocal cord palsy, and tracheal puncture have rarely described in the included studies. Needle tract implantation of thyroid malignancies was described in three studies reporting 0.02% to 0.19% of the incidence rate. CONCLUSION FNAB is considered to be a safe diagnostic procedure with rare complications, which are mainly minor events. Thorough assessement of the patients' medical condition when deciding to perform FNABs would be advisable to lower potential complications.
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Affiliation(s)
- Ji Yong Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Wonsuk Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - A Ram Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jee Hee Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Kyung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
- Corresponding author: Hee Kyung Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, 264 Seoyang-ro, Hwasun-eup, Hwasun 58128, Korea Tel: +82-61-379-7620, Fax: +82-61-379-7628, E-mail:
| | - Ho-Cheol Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
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10
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Lin YY, Zhu Y, Wang YX, Wang B. Horner Syndrome subsequent to ultrasound-guided cervical lymph node fine-needle aspiration - A case report and literature review. J Clin Ultrasound 2023; 51:203-209. [PMID: 36165415 DOI: 10.1002/jcu.23349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/22/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Horner Syndrome (HS) is characterized by symptoms of ipsilateral miosis, ptosis, enophthalmos, and facial anhidrosis, which is caused by the damaged oculosympathetic pathway. HS is rarely reported as postoperative complications of fine-needle aspiration (FNA). We report a case of HS triggered by Ultrasound-guided FNA during thyroid cancer management and conducted the literature review. A 31-year-old male with differentiated thyroid cancer underwent total thyroidectomy and regional lymph node dissection as well as radioactive iodine ablation, presented with persistently elevated tumor marker of thyroglobulin and suspicious left level IV and V cervical lymph nodes by neck ultrasound. Ultrasound-guided left cervical lymph nodes FNA for cellular diagnosis was performed, and typical manifestations of HS appeared immediately after the procedure. Subsequent ultrasound evaluation of the same area demonstrated a subtle strip of the hypo-echogenic area in the superior pole of the suspected level IV structure, suggesting sympathetic ganglia with the visible originating nerve fiber on the superior pole. All of the patient's symptoms of HS were resolved 2 months after the incidence. Cervical sympathetic ganglia can be similar in size, shape, and ultrasound characteristics to a malignant lymph node. Thorough ultrasound examination by directly comparing the potential ganglia with a typical malignant lymph node, and paying attention to any potential root fibers on the target is key to avoiding ganglia injury before the neck invasive procedures.
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Affiliation(s)
- Yu Yang Lin
- The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Ying Zhu
- The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Yi Xuan Wang
- The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Bei Wang
- The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
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Caputo A, Cretella P, Ciliberti V. Factors affecting the risk of disease transmission during fine-needle aspiration cytology. J Med Ultrason (2001) 2023; 50:113-114. [PMID: 35925500 DOI: 10.1007/s10396-022-01247-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/10/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Alessandro Caputo
- Department of Pathology, University Hospital of Salerno, Largo Città d'Ippocrate 1, 84131, Salerno, SA, Italy.
| | - Pasquale Cretella
- Department of Advanced Biomedical Sciences, University "Federico II", Naples, Italy
| | - Valeria Ciliberti
- Department of Pathology, University Hospital of Salerno, Largo Città d'Ippocrate 1, 84131, Salerno, SA, Italy
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Bonsignore A, Drommi M, Frigiolini F, Roncallo A, Ventura F, Buffelli F, Fulcheri E. A Rare Case of Fatal Thyroid Hemorrhage After Fine-Needle Aspiration: Case Report and Review of the Literature. Am J Forensic Med Pathol 2022; 43:291-295. [PMID: 35960205 PMCID: PMC9390222 DOI: 10.1097/paf.0000000000000761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Sudden death due to massive hemorrhage after a mini-invasive ambulatory diagnostic procedure is extremely rare. Fine-needle aspiration (FNA) of thyroid nodules is very safe, displaying a low rate of complications, all of which mild and often self-limiting. In few cases do these complications necessitate surgical decompression, and rarely does FNA of a thyroid nodule lead to the death of the patient.We report a case of sudden death caused by respiratory insufficiency after compression of the vascular and nervous structures of the neck and obstruction of the upper airways by hemorrhages dissecting the thyroidal and perithyroidal tissues in a 78-year-old woman. These hemorrhages were the result of vascular lacerations caused during diagnostic FNA of a nodule suspected of malignancy. In such cases, it is important to conduct a complete autopsy and histological analysis to ascertain the origin of massive hemorrhage involving the structures of the neck and to attribute the cause of death to the aforementioned procedure. The forensic pathologist must bear in mind that even extremely small damage, such as that produced by a fine needle, may cause a fatal hemorrhage in subjects with a subverted anatomo-pathological picture (such as, for example, the massive fibrosis of an organ).
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Affiliation(s)
- Alessandro Bonsignore
- From the Department of Legal and Forensic Medicine, University of Genova
- IRCCS—Ospedale Policlinico San Martino
| | - Martina Drommi
- From the Department of Legal and Forensic Medicine, University of Genova
| | | | - Anna Roncallo
- From the Department of Legal and Forensic Medicine, University of Genova
| | - Francesco Ventura
- From the Department of Legal and Forensic Medicine, University of Genova
- IRCCS—Ospedale Policlinico San Martino
| | | | - Ezio Fulcheri
- Clinical Pathology Unit, IRCCS—Istituto Giannina Gaslini
- Department of Pathology, San Martino Hospital, University of Genova, Genova, Italy
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13
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Kim YK, Goak IS, Kim YJ, Jin HY, Lee KA. A rare case of acute transient thyroid swelling without hematoma after fine needle aspiration. Korean J Intern Med 2022; 37:693-694. [PMID: 35249317 PMCID: PMC9082444 DOI: 10.3904/kjim.2021.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/14/2021] [Indexed: 11/27/2022] Open
Affiliation(s)
- Young Ki Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - In Sun Goak
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Yu Ji Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Heung Yong Jin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Kyung Ae Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
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14
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Li Y, Yang F, Huang YY, Cao W. Comparison between computed tomography-guided core and fine needle lung biopsy: A meta-analysis. Medicine (Baltimore) 2022; 101:e29016. [PMID: 35244081 PMCID: PMC8896491 DOI: 10.1097/md.0000000000029016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/17/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND This meta-analysis was conducted to compare the safety and diagnostic performance between computed tomography (CT)-guided core needle biopsy (CNB) and fine-needle aspiration biopsy (FNAB) in lung nodules/masses patients. METHODS All relevant studies in the Pubmed, Embase, and Cochrane Library databases that were published as of June 2020 were identified. RevMan version 5.3 was used for all data analyses. RESULTS In total, 9 relevant studies were included in the present meta-analysis. These studies were all retrospective and analyzed outcomes associated with 2175 procedures, including both CT-guided CNB (n = 819) and FNAB (n = 1356) procedures. CNB was associated with significantly higher sample adequacy rates than was FNAB (95.7% vs 85.8%, OR: 0.26; P < .00001), while diagnostic accuracy rates did not differ between these groups (90.1% vs 87.6%, OR: 0.8; P = .46). In addition, no differences in rates of pneumothorax (28.6% vs 23.0%, OR: 1.15; P = .71), hemorrhage (17.3% vs 20.1%, OR: 0.91; P = .62), and chest tube insertion (5.9% vs 4.9%, OR: 1.01; P = .97) were detected between these groups. Significant heterogeneity among included studies was detected for the diagnostic accuracy (I2 = 57%) and pneumothorax (I2 = 77%) endpoints. There were no significant differences between CNB and FNAB with respect to diagnostic accuracy rates for lung nodules (P = .90). In addition, we detected no evidence of significant publication bias. CONCLUSIONS CT-guided CNB could achieve better sample adequacy than FNAB did during the lung biopsy procedure. However, the CNB did not show any superiorities in items of diagnostic accuracy and safety.
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Affiliation(s)
- Yong Li
- Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Fang Yang
- Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ya-Yong Huang
- Department of Radiology, Xuzhou Central Hospital, 199 South Jiefang Road, Xuzhou, China
| | - Wei Cao
- Department of Radiology, Xuzhou Central Hospital, 199 South Jiefang Road, Xuzhou, China
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15
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Zheng BW, Wu T, Xu SC, Yin TH, Tan L, Lian YF, Ren J. Acute transient swelling of the thyroid following fine-needle aspiration: A case series. J Clin Ultrasound 2022; 50:236-242. [PMID: 34240426 DOI: 10.1002/jcu.23043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
Acute transient swelling (ATS) of the thyroid is a rare complication following fine-needle aspiration (FNA) of thyroid nodules. We present 31 cases with 35 nodules encountered at our institute and reported in the literature, to provide further information. The incidence rate in our institute was 0.46%. Of these nodules, 74.3% (26/35) were solid, 65.7% (23/35) exhibited hypervascularity, and 77.2% (27/35) were benign or follicular neoplasms. Although most cases (87.1%, 27/31) occurred within 2 h after FNA, four patients experienced delayed ATS after 7 h to 2 days. Therefore, awareness of this complication, especially its delayed occurrence, should be raised.
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Affiliation(s)
- Bo-Wen Zheng
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, China
| | - Tao Wu
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, China
| | - Shi-Cheng Xu
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, China
| | - Ting-Hui Yin
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, China
| | - Lei Tan
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, China
| | - Yu-Fan Lian
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, China
| | - Jie Ren
- Department of Medical Ultrasonics, The Third Affiliated Hospital of Sun Yat-sen University, Guangdong Province Key Laboratory of Hepatology Research, Guangzhou, Guangdong, China
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16
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Michnová U, Traboulsi E, Peková B, Ryška A. Cribriform - morular thyroid carcinoma: a rare entity. Cesk Patol 2022; 58:107-110. [PMID: 35882545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
We present a case report of a 51-year-old patient who underwent totalization of thyroidectomy - resection of the right thyroid lobe for growth progression of the largest nodule from which a fine needle aspiration biopsy (FNAB) was performed and was cytologically suspected of malignancy. Nodule was a graywhite colored tumor with a solid structure, histologically with an unusual morphology and immunoprofile, called cribriform morular thyroid carcinoma (CMTC). Usually, the tumor behaves indolently with a good prognosis. CMTC can be familial or sporadic, predominantly as a solitary or a multifocal lesion, often associated with autosomal dominant adenomatous polyposis syndrome (FAP), so it is necessary to point this out in the report. The syndrome of familial adenomatous polyposis was ruled out, the APC gene mutation was somatic.
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17
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Imaoka K, Nishihara M, Nambu J, Yamaguchi M, Kawasaki Y, Sugino K. Acute diffuse thyroid swelling after fine-needle aspiration: A case report and review of the literature. J Clin Ultrasound 2021; 49:720-723. [PMID: 33908030 DOI: 10.1002/jcu.23008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/19/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
Fine-needle aspiration (FNA) is the first-line and a cost-effective examination method of nonfunctional thyroid nodules. Acute transient thyroid swelling after an FNA is a rare complication, and to date, only 14 cases have been reported in the English literature. Herein, we report a case of a 26-year-old woman with acute transient thyroid swelling, which occurred after an ultrasound-guided FNA of a thyroid nodule. Although the patient had undergone an FNA without complication 2 years previously, the second FNA caused acute thyroid swelling. The present case emphasizes the potential risk of acute thyroid swelling associated with every FNA procedure.
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Affiliation(s)
- Kouki Imaoka
- Department of Surgery, Akane-Foundation, Tsuchiya General Hospital, Hiroshima, Japan
| | - Masahiro Nishihara
- Department of Surgery, Akane-Foundation, Tsuchiya General Hospital, Hiroshima, Japan
| | | | - Megumi Yamaguchi
- Department of Surgery, Akane-Foundation, Tsuchiya General Hospital, Hiroshima, Japan
| | - Yukari Kawasaki
- Department of Surgery, Akane-Foundation, Tsuchiya General Hospital, Hiroshima, Japan
| | - Keizo Sugino
- Department of Surgery, Akane-Foundation, Tsuchiya General Hospital, Hiroshima, Japan
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18
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Abstract
The recent coronavirus infectious disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is placing health systems in serious challenges worldwide. Shocking statistics each day has prompted the World Health Organization to officially declare the COVID-19 outbreak as a pandemic in March 2020. Preliminary studies have shown increased mortality in patients with solid cancers and infection by SARS-CoV-2. Until now, the evidence on the behavior of COVID-19 in patients with a history of thyroid cancer remains scarce, and most of the recommendations given are based on common sense. Therefore, in this viewpoint, we present a brief review of several challenges we are frequently facing during this pandemic and a series of recommendations based on what we have implemented in our clinical practice at a university hospital currently mostly dedicated to COVID-19.
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Affiliation(s)
- Anabella Smulever
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
| | - Erika Abelleira
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
| | - Fernanda Bueno
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
| | - Fabián Pitoia
- Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina.
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19
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Lanzolla G, Marcocci C, Marinò M. Occurrence of Graves' hyperthyroidism and Graves' orbitopathy after fine-needle aspiration biopsy of thyroid nodules. J Endocrinol Invest 2020; 43:1033-1034. [PMID: 32077044 DOI: 10.1007/s40618-020-01199-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/12/2020] [Indexed: 10/25/2022]
Affiliation(s)
- G Lanzolla
- Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - C Marcocci
- Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - M Marinò
- Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
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20
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Kong YC, Bhoo-Pathy N, O’Rorke M, Subramaniam S, Bhoo-Pathy NT, See MH, Jamaris S, Teoh KH, Bustam AZ, Looi LM, Taib NA, Yip CH. The association between methods of biopsy and survival following breast cancer: A hospital registry based cohort study. Medicine (Baltimore) 2020; 99:e19093. [PMID: 32028433 PMCID: PMC7015568 DOI: 10.1097/md.0000000000019093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 12/20/2019] [Accepted: 01/08/2020] [Indexed: 01/31/2023] Open
Abstract
Percutaneous biopsy in breast cancer has been associated with an increased risk of malignant cell seeding. However, the importance of these observations remains obscure due to lack of corroborating evidence from clinical studies. We determined whether method of biopsy is associated with breast cancer survival. This hospital registry-based cohort study included 3416 non-metastatic breast cancer patients diagnosed from 1993 to 2011 in a tertiary setting. Factors associated with biopsy methods were assessed. Multivariable Cox regression analysis was used to determine the independent prognostic impact of method of biopsy. Overall, 990 patients were diagnosed by core needle biopsy (CNB), 1364 by fine needle aspiration cytology (FNAC), and 1062 by excision biopsy. Excision biopsy was significantly associated with more favorable tumor characteristics. Radiotherapy modified the prognostic impact of biopsy method (Pinteraction < .001). Following multivariable analysis, excision biopsy was consistently associated with lower risk of mortality compared to FNAC in women receiving adjuvant radiotherapy (adjusted hazard ratio: 0.81, 95%CI: 0.66-0.99), but not in those who did not receive adjuvant radiotherapy (adjusted hazard ratio: 0.87, 95%CI: 0.65-1.17). While the risk of mortality was not different between patients undergoing FNAC and CNB when radiotherapy is administered, in the absence of radiotherapy, CNB was associated with higher risk of mortality than FNAC (adjusted hazard ratio: 1.57, 95%CI: 1.16-2.12). Given that our results contradict with findings of previous clinical studies assessing the prognostic impact of method of biopsy in women with breast cancer, further studies are warranted.
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Affiliation(s)
- Yek-Ching Kong
- Clinical Epidemiology Unit, National Clinical Research Centre, Level 3, Dermatology Block, Kuala Lumpur Hospital
| | - Nirmala Bhoo-Pathy
- Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Michael O’Rorke
- Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital Site, Belfast, UK
| | - Shridevi Subramaniam
- Clinical Epidemiology Unit, National Clinical Research Centre, Level 3, Dermatology Block, Kuala Lumpur Hospital
| | - Nanthini T. Bhoo-Pathy
- Julius Centre University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Anita Z. Bustam
- Department of Clinical Oncology, Faculty of Medicine, University of Malaya, Kuala Lumpur
| | | | | | - Cheng-Har Yip
- Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
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21
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Jin Kim H, Koon Kim Y, Hoon Moon J, Young Choi J, Il Choi S. Thyroid core needle biopsy: patients' pain and satisfaction compared to fine needle aspiration. Endocrine 2019; 65:365-370. [PMID: 31203562 DOI: 10.1007/s12020-019-01973-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 05/27/2019] [Indexed: 01/21/2023]
Abstract
PURPOSE The purpose of this study was to compare patients' pain and satisfaction of fine needle aspiration (FNA) and core needle biopsy (CNB) for a thyroid nodule. METHODS We consecutively enrolled patients with thyroid nodules who underwent ultrasound-guided FNA or CNB in our institution. The patients answered a questionnaire about pain scores during the procedure, immediately after the procedure and 20 min after the procedure, and any complication after the biopsy. Through a phone interview which was conducted 2 weeks after the procedure, a researcher asked the patients about residual pain and overall subjective satisfaction score about the procedures. Patients were also asked to report any complication or complaint after the procedures on the phone interview. RESULTS The 167 patients who had undergone thyroid FNA (n = 87) or CNB (n = 80) were included. The pain scores were not significantly different between the two groups during the procedure and after the procedure. Overall satisfaction scores after 2 weeks were not different, either. There was no acute or delayed major complication in both groups. CONCLUSIONS Differences regarding patients' pain and satisfaction scores between CNB and FNA were not demonstrated.
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Affiliation(s)
- Hyo Jin Kim
- Department of Radiology, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Yeo Koon Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea.
| | - Jae Hoon Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sang Il Choi
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea
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22
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Marco-Doménech SF, Fernández-García P, Navarro-Ballester A, Cifrián-Pérez M, Escobar-Valero Á, Ibáñez-Gual MV. Cost-effectiveness of hydrogel plugs in CT-guided lung biopsies. Radiologia (Engl Ed) 2019; 61:153-160. [PMID: 30772002 DOI: 10.1016/j.rx.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 11/04/2018] [Accepted: 01/02/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Using a hydrogel plug decreases the number of cases of pneumothorax and reduces the need for pleural drainage tubes in CT-guided lung biopsies. We aimed to analyze the cost-effectiveness of using hydrogel plugs. MATERIAL AND METHODS We analyzed 171 lung biopsies divided into three groups: Group 1 (n=22): fine-needle aspiration cytology (FNAC) without hydrogel plugs; Group 2 (n=89): FNAC with hydrogel plugs; and Group 3 (n=60): FNAC plus core-needle biopsy (CNB) with hydrogel plugs. We calculated the total costs (direct and indirect) in the three groups. We analyzed the percentage of correct diagnoses, the average and incremental rations, and the most cost-effective option. RESULTS Total costs: Group 1 = 1,261.28 + 52.65 = € 1,313.93; Group 2 = 1,201.36 + 67.25 = € 1,268.61; Group 3 = 1,220.22 + 47.20 = € 1,267.42. Percentage of correct diagnoses: Group 1 = 77.3%, Group 2 = 85.4%, and Group 3 = 95% (p = 0.04). Average cost-effectiveness ratio: Group 1 = 16.99; Group 2 = 14.85; and Group 3 = 13.34. CONCLUSIONS Group 3 was the best option, with the lowest average cost-effectiveness ratio; therefore, the most cost-effective approach is to do FNAC and CNB using a dehydrated hydrogel plug at the end of the procedure.
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Affiliation(s)
- S F Marco-Doménech
- Servicio de Radiología Diagnóstica y Terapéutica, Hospital General Universitario de Castellón, Castellón de la Plana, España; Unidad Predepartamental de Medicina, Universidad Jaume I (UJI), Castellón de la Plana, España.
| | - P Fernández-García
- Servicio de Radiología Diagnóstica y Terapéutica, Hospital General Universitario de Castellón, Castellón de la Plana, España; Unidad Predepartamental de Medicina, Universidad Jaume I (UJI), Castellón de la Plana, España
| | - A Navarro-Ballester
- Servicio de Radiología Diagnóstica y Terapéutica, Hospital General Universitario de Castellón, Castellón de la Plana, España
| | - M Cifrián-Pérez
- Servicio de Radiología Diagnóstica y Terapéutica, Hospital General Universitario de Castellón, Castellón de la Plana, España
| | - Á Escobar-Valero
- Unidad Predepartamental de Medicina, Universidad Jaume I (UJI), Castellón de la Plana, España
| | - M V Ibáñez-Gual
- IMAC. Departamento de Matemáticas. Universidad Jaume I (UJI), Castellón de la Plana, España
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23
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Midia M, Odedra D, Shuster A, Midia R, Muir J. Predictors of bleeding complications following percutaneous image-guided liver biopsy: a scoping review. Diagn Interv Radiol 2019; 25:71-80. [PMID: 30644369 PMCID: PMC6339629 DOI: 10.5152/dir.2018.17525] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/08/2018] [Accepted: 07/02/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Percutaneous tissue biopsy is a mainstay of diagnostic and interventional radiology, providing a minimally invasive method for diagnosing malignant and benign disease. The purpose of this review was to collect and summarize the best available evidence regarding the risk factors associated with bleeding complications in image-guided liver biopsy. METHODS A literature review was performed, searching Medline, EMBASE, CINAHL, the Cochrane Library, the National Institute for Health and Care Excellence (NICE) and Canadian Agency for Drugs and Technology in Health (CADTH) databases for any studies evaluating bleeding complications in image-guided liver biopsy. A total of 68 articles, published between January 1994 and April 2015, were reviewed in full, with 34 ultimately eligible for inclusion in the review. RESULTS Bleeding of any kind occurred in up to 10.9% of image-guided liver biopsies, with major bleeding episodes ranging from 0.1% to 4.6% and minor bleeding events occurring in up to 10.9% of biopsies. The overall rate of bleeding was, however, found to be less than 2%. Several risk factors (patient, operator, and procedure-related) were identified as potentially indicative of an increased risk of post-biopsy bleeding. Patient-related risk factors included patient age (>50 years or <2 years), inpatient status (8/12 vs. 4/12, P < 0.001), comorbidities and/or concurrent diagnoses and coagulation status (rate of bleeding was 3.3% for international normalized ratio [INR] 1.2-1.5 vs. 7.1% for INR >1.5, P < 0.001). There was no consensus on impact of operator experience (>200 biopsies/year vs. <50/year) on post-biopsy bleeding rate. Procedure-related risk factors included needle size (cutting biopsy vs. fine needle aspiration, P < 0.001) and the presence of a patent track on post-biopsy ultrasound (P < 0.001). Lastly there was no difference found between targeted vs. nontargeted biopsies and number of needle passes. CONCLUSION Reported rate of post-biopsy bleeding ranges between 0% and 10.9%, although the vast majority of studies reported bleeding rates under 2%. Several patient, operator, and procedure-related risk factors are associated with a higher risk of bleeding following liver biopsy.
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Affiliation(s)
- Mehran Midia
- From the Department of Radiology (M.M. , D.O.), McMaster University School of Medicine, Hamilton, ON, Canada; Department of Radiology (A.S.), Thunder Bay Health Sciences, Thunder Bay, ON, Canada; St Francis Health (R.M.), Topeka, Kansas, USA; Motion Research (J.M.), Ancaster, ON, Canada
| | - Devang Odedra
- From the Department of Radiology (M.M. , D.O.), McMaster University School of Medicine, Hamilton, ON, Canada; Department of Radiology (A.S.), Thunder Bay Health Sciences, Thunder Bay, ON, Canada; St Francis Health (R.M.), Topeka, Kansas, USA; Motion Research (J.M.), Ancaster, ON, Canada
| | - Anatoly Shuster
- From the Department of Radiology (M.M. , D.O.), McMaster University School of Medicine, Hamilton, ON, Canada; Department of Radiology (A.S.), Thunder Bay Health Sciences, Thunder Bay, ON, Canada; St Francis Health (R.M.), Topeka, Kansas, USA; Motion Research (J.M.), Ancaster, ON, Canada
| | - Ramin Midia
- From the Department of Radiology (M.M. , D.O.), McMaster University School of Medicine, Hamilton, ON, Canada; Department of Radiology (A.S.), Thunder Bay Health Sciences, Thunder Bay, ON, Canada; St Francis Health (R.M.), Topeka, Kansas, USA; Motion Research (J.M.), Ancaster, ON, Canada
| | - Jeffrey Muir
- From the Department of Radiology (M.M. , D.O.), McMaster University School of Medicine, Hamilton, ON, Canada; Department of Radiology (A.S.), Thunder Bay Health Sciences, Thunder Bay, ON, Canada; St Francis Health (R.M.), Topeka, Kansas, USA; Motion Research (J.M.), Ancaster, ON, Canada
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24
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Abstract
RATIONALE The term cystic breast lesions is a sonographic diagnosis, which can be categorized as simple, complicated or complex. The complex cysts are deemed as having a low risk of breast cancer. The highly aggressive invasive ductal carcinomas among complex cysts, in particular, are infrequent reported. PATIENT CONCERNS A 56-year-old female with a breast complex cyst who, after fine-needle aspiration, complained about oozing with fluid as well as skin ulceration that did not heal. DIAGNOSES An advanced HER-2-enriched invasive ductal carcinoma was diagnosed. INTERVENTIONS The patient received neoadjuvant chemotherapy of anti-HER-2 target drug, palliative surgery and following postoperative chemotherapy. OUTCOMES The patient was in good general condition at 6 months follow-up after surgery. LESSONS Meticulous ultrasound evaluation of Breast Imaging Reporting and Data System (BI-RADS) category is crucial and indispensable when a complex cyst is found. The radiologist and clinician should be fully awake to its possibility of malignancy, especially fast-growing one in post-menopausal women. Excision biopsy may be preferred for diagnosis.
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MESH Headings
- Biopsy, Fine-Needle/adverse effects
- Biopsy, Fine-Needle/methods
- Breast/pathology
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Female
- Fibrocystic Breast Disease/pathology
- Humans
- Middle Aged
- Neoadjuvant Therapy/methods
- Treatment Outcome
- Ultrasonography, Mammary/methods
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Affiliation(s)
| | | | - Xin He
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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25
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Abstract
RATIONALE There have been many reports of non-thyroidal lesions which can be mistaken for thyroidal lesions on ultrasound (US) examination. However, it is not known that pyriform sinus fistula (PSF) can manifest as an incidental thyroid nodule and cause serious complication on fine-needle aspiration (FNA). PATIENT CONCERNS We present a 34-year-old man with PSF incidentally detected on US. US examination showed hypoechoic nodule with several bright echogenic spots at the uppermost part of left thyroid gland. With the suspicion of thyroid cancer, although there would have been some morphologic changes between the 2 US examinations, FNA was performed. DIAGNOSES Cytologic specimen revealed some clusters of ciliated columnar cells mixed with inflammatory and lymphoid cells. On computed tomography (CT) before FNA, there were tiny air bubbles within the thyroid nodule. Laryngoscopy revealed fistula originating from the pyriform sinus. INTERVENTIONS After FNA, he had to undergo tracheostomy and removal of abscess due to infectious complication. OUTCOMES The deep neck abscesses and infections were controlled after the treatment. At 1 year after FNA, successful chemocauterization with 40% trichloracetic acid solution was performed for PSF found on laryngoscopy. LESSONS PSF can manifest as an incidental thyroid nodule mimicking thyroid cancer. Special care should be taken when FNA is planned for the nodule with air foci and morphologic changeability at the uppermost part of left thyroid gland.
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Affiliation(s)
- Soo Chin Kim
- Department of Radiology, Seoul National University Hospital Healthcare System Gangnam Center
| | | | | | - Eun Jae Chung
- Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
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26
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Li H, Li W, Zhou QY, Fan B. Fine needle biopsy is superior to fine needle aspiration in endoscopic ultrasound guided sampling of pancreatic masses: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2018; 97:e0207. [PMID: 29595661 PMCID: PMC5895392 DOI: 10.1097/md.0000000000010207] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The comparison between endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) and EUS guided fine needle biopsy (FNB) in sampling pancreatic masses is still controversial. METHODS A systematic search was conducted in PubMed and Web of Science to identify all relevant randomized controlled trials (RCTs). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated for dichotomous outcomes of interest (specimen adequacy, diagnostic accuracy, complications, and technical success), while mean difference (MD) and 95% CI were pooled for continuous variables (number of needle passes required for diagnosis). RESULTS Eleven RCTs were identified with a total of 694 EUS-FNA cases and 688 EUS-FNB cases. Compared with EUS-FNA, EUS-FNB had a better specimen adequacy (OR: 1.83, 95% CI: 1.27-2.64), higher diagnostic accuracy (OR: 1.62, 95% CI: 1.17-2.26), and fewer number of needle passes (MD: 0.69, 95% CI: 1.18 to 0.20). No significant difference was found in complications (OR: 1.01, 95% CI: 0.27-3.78) and technical success (OR: 0.13, 95% CI: 0.02-1.07). CONCLUSION EUS-FNB is superior to EUS-FNA in sampling pancreatic masses.
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Affiliation(s)
- Hong Li
- Department of Pathology, The Central Hospital of Enshi Autonomous Prefecture
| | - Wei Li
- Department of Pathology, The Central Hospital of Enshi Autonomous Prefecture
| | - Qiu-Yuan Zhou
- Department of Pathology, The Central Hospital of Enshi Autonomous Prefecture
| | - Bin Fan
- Department of Hepatobiliary Surgery, The Central Hospital of Enshi Autonomous Prefecture, Enshi, China
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Lee KL, Chen TJ, Won GS, Chou YH, Chiou HJ, Wang HK, Lai YC, Lin YH, Wang J. The use of fine needle aspiration and trends in incidence of thyroid cancer in Taiwan. J Chin Med Assoc 2018; 81:164-169. [PMID: 29174930 DOI: 10.1016/j.jcma.2017.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 09/30/2017] [Accepted: 09/30/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Thyroid cancer is the most prevalent endocrine malignancy, and the incidence of thyroid cancer has increased worldwide. Fine needle aspiration (FNA) for cytology of thyroid tissue is used for differentiating thyroid cancers from benign thyroid nodules. Overuse of FNA may detect subclinical thyroid cancer and play a role in the increased incidence of thyroid cancer. The aim of this study was to evaluate trends in incidence of thyroid cancer and the use of palpation-guided FNA thyroid and ultrasound-guided FNA thyroid in Taiwan. METHODS By retrospectively analyzing a cohort dataset of one million people randomly sample to represent as NHI beneficiaries of Taiwan National Health Insurance Research Database from 2004 to 2010, patients who received palpation-guided and ultrasound-guided thyroid FNA were identified. Individuals who were diagnosed as having thyroid cancer were determined. Age-standardized, yearly rates of palpation-guided thyroid FNA and ultrasound-guided FNA, and age-standardized, yearly incidence rates of thyroid cancer were calculated. RESULTS In the study period, a total of 541 patients were newly diagnosed with thyroid cancer, 14,240 individuals received palpation-guided thyroid FNA, and 3823 individuals underwent ultrasound-guided thyroid FNA. There was a 94.8% increase in the age-standardized annual incidence rate of thyroid cancer. The age-standardized rates of palpation-guided thyroid FNA and ultrasound-guided thyroid FNA increased by 10.9% and 349.3%, respectively. CONCLUSION FNA for cytology of thyroid tissue, especially ultrasound-guided FNA, was conducted by physicians more frequently in Taiwan. Increased use of FNA, especially ultrasound-guided FNA for cytology of thyroid tissue, may attribute to the increased incidence of thyroid cancer in Taiwan.
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Affiliation(s)
- Kang-Lung Lee
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Institute of Hospital and Health Care Administration, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
| | - Ging-Shing Won
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yi-Hong Chou
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC; Yuanpei University of Medical Technology, Hsinchu, Taiwan, ROC.
| | - Hong-Jen Chiou
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Hsin-Kai Wang
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Yi-Chen Lai
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Yung-Hui Lin
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Jane Wang
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Radiology, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
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Affiliation(s)
- I S Whitaker
- Department of Anatomy, University of Cambridge, Cambridge, UK.
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Tang WK, Bhatia KSS, Pang ASW, Ahuja A. Acute diffuse thyroid swelling: A rare complication of fine-needle aspiration. J Clin Ultrasound 2017; 45:426-429. [PMID: 28220939 DOI: 10.1002/jcu.22432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/01/2016] [Accepted: 10/24/2016] [Indexed: 06/06/2023]
Abstract
We present a case illustrating the rare complication of acute generalized thyroid swelling shortly after sonographic-guided fine needle aspiration of a thyroid nodule. Ultrasound revealed the presence of characteristic linear hypoechoic avascular areas interspersed throughout the gland suggestive of edema. The patient was treated conservatively, with near complete normalization of the thyroid within 24 hours. Recognition of this potential complication is important, as the rapid onset of diffuse thyroid enlargement is often alarming but typically has a transient and self-limiting course. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:426-429, 2017.
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Affiliation(s)
- Wai Kiu Tang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, SAR, China
| | - Kunwar S S Bhatia
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, SAR, China
| | - Angel S W Pang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, SAR, China
| | - Anil Ahuja
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, SAR, China
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Qiu XF, Yang GS, Chen BT, Ma L. [One-puncture one-needle TRUS-guided prostate biopsy for prevention of postoperative infections]. Zhonghua Nan Ke Xue 2017; 23:630-634. [PMID: 29723457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To explore the feasibility and effectiveness of "one-puncture one-needle" transrectal ultrasound (TRUS)-guided prostate biopsy in the prevention of postoperative infections. METHODS We retrospectively analyzed the clinical data about "one-puncture one-needle" (the observation group) and "one-person one-needle" (the control group) TRUS-guided prostate biopsy performed in the Second People's Hospital of Guangdong Province from January 2005 to December 2015, and compared the incidence rates of puncture-related infection between the two strategies. By "one-puncture one-needle", one needle was used for one biopsy puncture, while by "one-person one-needle", one needle was used for all biopsy punctures in one patient and the needle was sterilized with iodophor after each puncture. RESULTS Totally, 120 patients received 6+1-core or 12+1-core "one-person one-needle" and 466 underwent 12+1-core "one-puncture one-needle" TRUS-guided prostate biopsy. There were no statistically significant differences between the two groups of patients in age, the prostate volume, the serum PSA level, or the detection rate of prostate cancer (P >0.05). Compared with the control group, the observation group showed remarkably lower incidence rates of puncture-related urinary tract infection (7.5% vs 0.9%, P <0.05), fever (5.0% vs 1.1%, P <0.05), bacteriuria (2.5% vs 0.2%, P <0.05), and total infections (16.7% vs 2.6%, P<0.05) postoperatively. Two cases of bacteremia or sepsis were found in each of the groups, with no significant difference between the two. CONCLUSIONS "One-puncture one-needle" TRUS-guided prostate biopsy can effectively prevent puncture-related infections.
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Affiliation(s)
- Xiao-Fu Qiu
- Department of Urology, The Second People's Hospital of Guangdong Province, Guangzhou, Guangdong 510317, China
- Department of Urology, The Second People's Hospital of Guangdong Province, Southern Medical University, Guangzhou, Guangdong 510317, China
| | - Guo-Sheng Yang
- Department of Urology, The Second People's Hospital of Guangdong Province, Guangzhou, Guangdong 510317, China
- Department of Urology, The Second People's Hospital of Guangdong Province, Southern Medical University, Guangzhou, Guangdong 510317, China
| | - Bo-Te Chen
- Department of Urology, The Second People's Hospital of Guangdong Province, Guangzhou, Guangdong 510317, China
| | - Li Ma
- Department of Ultrasound, The Second People's Hospital of Guangdong Province, Guangzhou, Guangdong 510317, China
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Suh CH, Baek JH, Park C, Choi YJ, Lee JH. The Role of Core Needle Biopsy for Thyroid Nodules with Initially Indeterminate Results on Previous Fine-Needle Aspiration: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol 2017; 38:1421-1426. [PMID: 28473343 PMCID: PMC7959904 DOI: 10.3174/ajnr.a5182] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 02/13/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sonography-guided fine-needle aspiration leads to relatively frequent cases of indeterminate cytology for the diagnosis of thyroid nodules. PURPOSE Our aim was to evaluate the efficacy and safety of core needle biopsy for the examination of thyroid nodules with initially indeterminate results on fine-needle aspiration. DATA SOURCES A computerized search of the MEDLINE and Embase databases was performed to identify relevant original articles. STUDY SELECTION Studies investigating the use of core needle biopsy for thyroid nodules with initially indeterminate results on previous fine-needle aspiration were eligible for inclusion. DATA ANALYSIS The pooled proportions for nondiagnostic results, inconclusive results, malignancy on core needle biopsy, the ability of core needle biopsy to diagnose malignancy, and the related complications of the procedure were analyzed. DATA SYNTHESIS The meta-analytic pooling was based on a random-effects model. Nine eligible studies, involving 2240 patients with 2245 thyroid nodules, were included. The pooled proportion for nondiagnostic results was 1.8% (95% CI, 0.4%-3.2%), and the pooled proportion for inconclusive results was 25.1% (95% CI, 15.4%-34.9%). The pooled proportion for malignancy was 18.9% (95% CI, 8.4%-29.5%). With regard to the diagnostic performance for malignancy, the sensitivity of core needle biopsy varied, ranging from 44.7% to 85.0%, but the specificity was 100% in all cases. No major complications of core needle biopsy were observed. LIMITATIONS The relatively small number of included studies and retrospective nature were limitations. CONCLUSIONS Core needle biopsy has low nondiagnostic result rates and high specificity for the diagnosis of malignancy. It is a safe diagnostic technique with a higher diagnostic yield, especially when molecular testing is not available or fine-needle aspiration did not yield enough cells for molecular testing.
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Affiliation(s)
- C H Suh
- From the Department of Radiology and Research Institute of Radiology (C.H.S., J.H.B.,Y.J.C., J.H.L.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology (C.H.S., C.P.), Namwon Medical Center, Jeollabuk-Do, Republic of Korea
| | - J H Baek
- From the Department of Radiology and Research Institute of Radiology (C.H.S., J.H.B.,Y.J.C., J.H.L.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - C Park
- Department of Radiology (C.H.S., C.P.), Namwon Medical Center, Jeollabuk-Do, Republic of Korea
- Department of Radiology (C.P.), Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Y J Choi
- From the Department of Radiology and Research Institute of Radiology (C.H.S., J.H.B.,Y.J.C., J.H.L.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - J H Lee
- From the Department of Radiology and Research Institute of Radiology (C.H.S., J.H.B.,Y.J.C., J.H.L.), University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Kim RS, Chevez-Barrios P, Bretana ME, Wong TP, Teh BS, Schefler AC. Histopathologic Analysis of Transvitreal Fine Needle Aspiration Biopsy Needle Tracts for Uveal Melanoma. Am J Ophthalmol 2017; 174:9-16. [PMID: 27818205 DOI: 10.1016/j.ajo.2016.10.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/20/2016] [Accepted: 10/26/2016] [Indexed: 01/12/2023]
Abstract
PURPOSE Perform the first in vivo examination of fine needle aspiration biopsy (FNAB) scleral tracts to determine the incidence of iatrogenic extension of tumor cells. DESIGN A prospective, consecutive, observational case series. METHODS This study was performed in a clinical/surgical setting at Retina Consultants of Houston and Houston Methodist Hospital, Houston, Texas, and included 10 patients who were scheduled for enucleation as primary treatment for uveal melanoma. Treatment included FNAB, enucleation, and histopathologic analysis. The primary outcomes were tumor location and dimension as identified by B-scans and histopathologic analysis. Tumor type was classified by gene expression profile and American Joint Committee on Cancer staging. Twenty-five- or 27-gauge needles were used for FNAB under direct visualization. Cell blocks of acquired specimens were examined using hematoxylin-eosin stain and double immunostain using HMB45 with red chromogen and Ki67 with brown 3,3'-diaminobenzidine chromogen. RESULTS Mean follow-up after enucleation was 20.4 months (range 9.9-31.7). All biopsy specimens had adequate yields for genomic analysis. No enucleation specimen contained tumor cells within sclera, pars plana, or pars plicata. One specimen contained a small collection of tumor cells within the anterior vitreous in the quadrant of the biopsy site. No patient developed an orbital recurrence. Four patients developed nonorbital metastatic uveal melanoma during the study period. Three of them died, and 1 is alive with hepatic metastasis. CONCLUSIONS No iatrogenic extension of tumor was reported. FNAB is a safe procedure that produces a high cellular yield for cytologic and genomic analyses with minimal risk of extraocular dissemination.
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Affiliation(s)
- Ryan S Kim
- Retina Consultants of Houston, Houston, Texas
| | - Patricia Chevez-Barrios
- Ophthalmology, Pathology, and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Pathology and Laboratory Medicine, Weill Cornell Medicine, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas
| | | | - Tien P Wong
- Retina Consultants of Houston, Houston, Texas
| | - Bin S Teh
- Department of Radiation Oncology, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas
| | - Amy C Schefler
- Retina Consultants of Houston, Houston, Texas; Blanton Eye Institute, Houston Methodist Hospital, Weill Cornell Medicine, Houston, Texas.
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Ohtsuka Y, Nemoto T, Kunii N, Hanazawa T, Okamoto Y. [Three Cases of Neck Swelling after FNAC (fine-needle aspiration cytology)]. Nihon Jibiinkoka Gakkai Kaiho 2016; 119:1225-1230. [PMID: 30035906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fine-needle aspiration cytology (FNAC) is considered a safe procedure, but it causes massive neck swelling and airway obstruction rarely. Neck swelling after FNAC is caused by two mechanisms: by hematoma or by release of vasodilator substances in thyroid cells and nerve terminals. The latter condition was previously reported as an acute and frightening swelling of the thyroid, but is not named appropriately. For convenience, we therefore refer to the condition as dTSaFNA (diffuse thyroid swelling after fine-needle aspiration) in this report. dTSaFNA is usually transient and rarely results in airway obstruction. We report one case of thyroid hematoma and two cases of dTSaFNA. All three cases were treated in hospital and recovered completely.
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Chiappetta M, Rosella F, Dall'armi V, Pomes LM, Petracca Ciavarella L, Nachira D, Pirronti T, Margaritora S, Granone P. CT-guided fine-needle ago-biopsy of pulmonary nodules: predictive factors for diagnosis and pneumothorax occurrence. Radiol Med 2016; 121:635-43. [PMID: 27132130 DOI: 10.1007/s11547-016-0639-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/05/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate variables that could predict diagnosis during CT-guided fine-needle aspiration. METHODS Data from 249 patients who underwent FNAB from January 2010 to December 2012 were analyzed in a retrospective observational study. RESULTS Mean age was 66.7 ± 11.5 years, male/female ratio 158/91 (63 vs. 37 %). The nodules were in right lung in 123 patients (49 %), in left lung in 126 patients (51 %), the upper, lower and middle lobe localizations were, respectively in 122 (49 %), 100 (40 %) and 17 (6 %) patients. Mean nodule-chest wall distance was 63.89 ± 21.38 mm. The tumor location, the needle diameter, the presence of necrosis or cavitation, the node-chest wall distance and the number of passages were not related to the diagnostic outcome (p = NS). The nodule diameter was predictive of diagnosis. Odds ratio for a 10-30 mm tumor was 2.51 (95 % OR: 1.24-5.08, p value = 0.011), the odds ratio for a 30-50 mm tumor was 2.39 (95 % OR: 1.22-4.69, p value = 0.011), and the odds ratio for a tumor larger than 50 mm was 4.44 (95 % OR: 1.89-10.44, p value = 0.001). Post-procedure pneumothorax occurred in 62 cases (25 %). The determinant factors for pneumothorax occurrence were emphysema, odds ratio 6.87 (95 % CI 1.07-44.10, p value = 0.04), and the number of pleural passages, odds ratio of 5.47 (95 % OR: 1.92-15.58), 7.44 (95 % OR: 2.58-21.5), 6.13 (95 % OR: 2.07-18.11) p value = 0.001 for one, two, three or more of three passages, respectively. CONCLUSIONS In our experience, nodule size is the most important diagnostic factor during fine-needle aspiration, while the number of passages and the presence of emphysema constitute risk factors for pneumothorax occurrence.
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Affiliation(s)
- Marco Chiappetta
- Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy.
| | - Francesco Rosella
- Department of Bioimaging and Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital-Catholic University, Rome, Italy
| | - Valentina Dall'armi
- Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Rome, Italy
| | - Leda Marina Pomes
- Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy
| | | | - Dania Nachira
- Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy
| | - Tommaso Pirronti
- Department of Bioimaging and Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital-Catholic University, Rome, Italy
| | - Stefano Margaritora
- Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy
| | - Pierluigi Granone
- Department of Thoracic Surgery, Catholic University of Sacred Heart, Largo F. Vito n 1, Rome, Italy
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Pang E, Crystal P, Kulkarni S, Murphy K, Menezes RJ. An Audit of Pain Experienced During Image-Guided Breast Biopsy Procedures at an Academic Center. Can Assoc Radiol J 2016; 67:250-3. [PMID: 26831731 DOI: 10.1016/j.carj.2015.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 09/15/2015] [Accepted: 10/28/2015] [Indexed: 11/20/2022] Open
Affiliation(s)
- Emily Pang
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Pavel Crystal
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Joint Department of Medical Imaging, Toronto, Ontario, Canada
| | - Supriya Kulkarni
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Joint Department of Medical Imaging, Toronto, Ontario, Canada
| | - Kieran Murphy
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Joint Department of Medical Imaging, Toronto, Ontario, Canada
| | - Ravi J Menezes
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada; Joint Department of Medical Imaging, Toronto, Ontario, Canada.
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Kaliszewski K, Zubkiewicz-Kucharska A, Wojtczak B, Strutyńska-Karpińska M, Zaleska-Dorobisz U, Leśków E. Ultrasound Guided Fine-Needle Aspiration Biopsy of Thyroid Nodules: Does Radiologist Assistance Decrease the Rate of Unsatisfactory Biopsies? ADV CLIN EXP MED 2016; 25:93-100. [PMID: 26935503 DOI: 10.17219/acem/60084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ultrasound guided fine-needle aspiration biopsy (UG-FNAB) is the main presurgical, minimally invasive, accurate and generally safe procedure for the diagnosis of thyroid pathology. At present it is recommended as a valuable diagnostic tool for the management of thyroid nodules. OBJECTIVES This study aimed to evaluate if a radiologist's assistance in the UG-FNAB procedure decreased the rate of unsatisfactory biopsies. MATERIAL AND METHODS Over a 3-year period, 385 (100%) patients were enrolled to the study. All individuals had UG-FNAB performed for the first time due to multiple nodules of the thyroid gland. Patients with a family history of thyroid cancer, receiving radioactive iodine and other predispositions for thyroid malignancy were excluded. 184 (47.79%) patients were examined using UG-FNAB with a radiologist's assistance (group 1) and 201 (52.21%) without such support (group 2). All biopsies were performed by the same surgeon. All specimens obtained were examined by two cytologists experienced in thyroid pathology. RESULTS The specimens from the UG-FNAB were more frequently diagnostic when obtained from procedures performed with a radiologist's assistance (77.8% vs. 56.8%, p < 0.0001). The cellularity of the specimens obtained from the UG-FNAB performed with a radiologist's assistance was higher than those obtained without such support (66.7% vs. 56.9%, p < 0.0001). CONCLUSIONS UG-FNAB of the thyroid nodules performed with a radiologist's assistance makes it possible to obtain more valuable specimens, which may improve diagnostic accuracy in the preoperative management of thyroid pathology.
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Affiliation(s)
- Krzysztof Kaliszewski
- 1st Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Poland
| | | | - Beata Wojtczak
- 1st Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Poland
| | - Marta Strutyńska-Karpińska
- 1st Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Poland
| | | | - Elżbieta Leśków
- Department of Pathomorphology, Wroclaw Medical University, Poland
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Lodewijk L, Vriens MR, Vorselaars WMCM, van der Meij NTM, Kist JW, Barentsz MW, Verkooijen HM, Rinkes IHMB, Valk GD. SAME-DAY FINE-NEEDLE ASPIRATION CYTOLOGY DIAGNOSIS FOR THYROID NODULES ACHIEVES RAPID ANXIETY DECREASE AND HIGH DIAGNOSTIC ACCURACY. Endocr Pract 2015; 22:561-6. [PMID: 26720251 DOI: 10.4158/ep151036.or] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The time between the moment of referral for the diagnostic workup for thyroid nodules and the outcome can be worrisome for patients. In general, patients experience high levels of anxiety during the evaluation of a lesion suspicious for cancer. Therefore, the implementation of same-day fine-needle aspiration cytology (FNAC) diagnosis is becoming standard-of-care for many solid tumors. Our aim was to assess the feasibility of same-day FNAC diagnosis for thyroid nodules and to assess patient anxiety during the diagnostic process. METHODS For feasibility of same-day FNAC diagnosis, we assessed the proportion of patients receiving a diagnosis at the end of the visit. Accuracy was measured by comparing histology with the FNAC result. Patient anxiety was measured by the State Trait Anxiety Inventory at 6 moments during the diagnostic workup. RESULTS Of the 131 included patients, 112 (86%) were female, and the mean age was 53 years. All patients, except those with a nondiagnostic FNAC result (n = 26; 20%), had a diagnosis at the end of the day. There were only two discordant results. Anxiety levels at the beginning of the day were high throughout the group, State Trait Anxiety Inventory (STAI) score 43.1 (SD 2.0) and decreased significantly more in patients with a benign FNAC result (STAI score 30.2), compared to patients with a malignant or indeterminate result (STAI score 39.6). CONCLUSION Distress of patients with a thyroid nodule undergoing same-day FNAC diagnostics was high. Same-day FNAC diagnosis is feasible and accurate for the evaluation of thyroid nodules. Therefore, same-day FNAC diagnosis seems a safer, more patient-friendly approach to diagnose thyroid nodules.
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Honar N, Jooya P, Haghighat M, Imanieh MH, Dehghani SM, Zahmatkeshan M, Javaherizadeh H. Complications of blind versus ultrasound-guided percutaneous liver biopsy in children. Arab J Gastroenterol 2015; 16:90-3. [PMID: 26526508 DOI: 10.1016/j.ajg.2015.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 05/23/2015] [Accepted: 09/28/2015] [Indexed: 02/05/2023]
Affiliation(s)
- Naser Honar
- Gastroenterohepatology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Jooya
- Gastroenterohepatology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Haghighat
- Gastroenterohepatology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hadi Imanieh
- Gastroenterohepatology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohsen Dehghani
- Gastroenterohepatology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Zahmatkeshan
- Gastroenterohepatology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hazhir Javaherizadeh
- Gastroenterohepatology Research Center, Nemazee Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
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Ishimoto H, Yatera K, Uchimura K, Oda K, Takenaka M, Kawanami T, Tanaka F, Mukae H. A serious mediastinum abscess induced by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): a case report and review of the literature. Intern Med 2015; 54:2647-50. [PMID: 26466704 DOI: 10.2169/internalmedicine.54.4465] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 75-year-old man with interstitial pneumonia and enlarged mediastinal lymph nodes underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). He developed a high-grade fever seven days after EBUS-TBNA was performed; laboratory and radiologic findings showed intense inflammatory reactions, with swelling of the mediastinal lymph nodes on chest computed tomography. Mediastinal lymph node abscess was diagnosed, and it worsened in spite of systemic antibacterial treatment. Surgical treatment using a median sternotomy was performed, and the cultivation of surgically obtained mediastinal lymph node abscess fluid revealed Streptococcus intermedius. Combined treatment with antibiotics and surgical treatment was effective, leading to remission.
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Affiliation(s)
- Hiroshi Ishimoto
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan
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41
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Ünlütürk U, Ceyhan K, Çorapçıoğlu D. Acute suppurative thyroiditis following fine-needle aspiration biopsy in an immunocompetent patient. J Clin Ultrasound 2014; 42:215-218. [PMID: 23893617 DOI: 10.1002/jcu.22077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 01/17/2013] [Accepted: 06/12/2013] [Indexed: 06/02/2023]
Abstract
The thyroid gland is remarkably resistant to infectious agents owing to several protective mechanisms. Acute suppurative thyroiditis after fine-needle aspiration (FNA) in an immunocompetent patient is very rare. We report the case of a 50-year-old immunocompetent male patient who presented with painful cervical swelling, fever, and chills after an FNA of the thyroid. His physical and laboratory examination suggested an acute suppurative thyroiditis. Repeat FNA results were consistent with thyroid abscess. Physicians should be aware of the probability of acute bacterial thyroiditis after FNA.
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Affiliation(s)
- Uğur Ünlütürk
- Department of Endorinology and Metabolism, Ankara University School of Medicine, Sihhiye, 06100, Ankara, Turkey
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42
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Nasrollah N, Trimboli P, Rossi F, Amendola S, Guidobaldi L, Ventura C, Maglio R, Nigri G, Romanelli F, Valabrega S, Crescenzi A. Patient's comfort with and tolerability of thyroid core needle biopsy. Endocrine 2014; 45:79-83. [PMID: 23673868 DOI: 10.1007/s12020-013-9979-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/04/2013] [Indexed: 01/19/2023]
Abstract
Recently, the core needle biopsy (CNB) has been proposed as a complementary test for thyroid nodules with inconclusive cytology by fine-needle aspiration (FNA). However, there have been no reports regarding patient comfort during and after CNB or tolerability of this procedure. Here we aimed to investigate and compare comfort with and tolerability of the CNB and FNA procedures. A 21 gauge needle was used for collection in CNB procedures, and a 23 gauge needle was used for collection in FNA procedures. Sixty-one consecutive patients underwent both biopsies and were asked to evaluate their comfort during and after these procedures by a structured questionnaire. A total of 58 (95 %) patients reported local pain during both biopsies. Two patients reported pain only during CNB, and one reported no pain. Mild pain was reported in 87 % of CNB cases. Local pain after biopsy was reported in 29 % of FNA and 45 % of CNB. The occurrence of pain in the first minutes following CNB was significantly higher than FNA (p = 0.008), while there was not a significant difference in pain at later time points after the procedures. Finally, patients were asked to evaluate the degree of tolerability of the two sampling techniques, and FNA and CNB were reported as tolerable in 82 and 83 %, respectively. The results from a questionnaire evaluating patients' comfort level showed no significant difference between the tolerability of CNB and FNA. This finding suggests that CNB may be performed with a reasonable level of patient comfort.
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43
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Guimarães MD, Bitencourt AGV, Gross JL, Marchiori E, Chojniak R. Improving the outcome and reducing the risks of imaging-guided transthoracic biopsies of lung lesions. Tumori 2013. [PMID: 24326860 DOI: 10.1700/1361.15123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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44
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Carlin SP, García-Botella A, Diez-Valladares L, Perez-Aguirre E, Ortega L, Mendez R, Torres AJ. Dissemination of hepatocellular carcinoma in subcutaeous tissue after fine needle aspiration cytology (FNAC). Hepatogastroenterology 2013; 60:1839-1840. [PMID: 24719916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The hepatocellular carcinoma (HCC) is the fifth most frequent tumor in the world, and the third cause of death related to cancer. Histological samples obtained from diseased liver likely to have HCC are currently prescribed in selected patients in whose imaging studies and tumor markers are not sufficient for the diagnosis. In recent years, a risk of tumoral seeding along needle tract of FNAC to obtain histological samples has been reported. We present a case of tumor implantation of HCC cells in the needle tract, a year and four months after a percutaneous fine needle aspiration cytology (FNAC).
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45
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Leboulleux S, Borget I, Labro S, Bidault S, Vielh P, Hartl D, Dauchy S, Chougnet CN, Girard E, Azoulay S, Mirghani H, Berdelou A, Lumbroso J, Deandreis D, Baudin E, Schlumberger M, Laurent S. Frequency and intensity of pain related to thyroid nodule fine-needle aspiration cytology. Thyroid 2013; 23:1113-8. [PMID: 23384309 DOI: 10.1089/thy.2012.0461] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Quality of life is an important issue in endocrine tumors because of the high prevalence of benign tumors and the indolent course of most malignant tumors. OBJECTIVE To evaluate the frequency and the intensity of pain and anxiety in patients undergoing thyroid nodule fine-needle aspiration cytology (FNAC) and to identify factors associated with pain. METHODS Single center prospective study in the setting of a one-stop outpatient diagnostic clinic for thyroid nodules. Pain was evaluated using a 100-mm visual analogue scale (VAS) immediately following (VAS1) and 30 minutes after (VAS2) FNAC and was considered significant if ≥ 30. Anxiety symptoms were assessed prior to FNAC using a self-report measure questionnaire: the state form of Spielberger State-Trait Anxiety Inventory (STAI, form Y-A). FNAC was performed with a 25-gauge needle and a moderate aspiration and two passes for each nodule. RESULTS Two hundred eighteen consecutive patients (163 females, 55 males; mean age 53 years, range 12-84 years) undergoing FNAC of one to three nodules were included. VAS1 was ≥ 30 in 24% of the patients and VAS(2) was ≥ 30 in 13% of the patients. Independent significant factors correlated to a VAS1 of ≥ 30 were age under 25 years and the number of nodules being biopsied. Independent significant factors correlated to a VAS2 of ≥ 30 were VAS1 ≥ 30 and female sex. No correlation was found between pain and nodule size or nodule depth, nor the duration of application of the eutectic mixture of local anesthetics (EMLA) patch prior to FNAC. The mean STAI score for anxiety was 37 ± 12. The average STAI score was significantly higher in women (39) than in men (33; p = 0.01). There was no significant correlation between STAI score and age under 25 years, previous FNAC, number of nodules biopsied, or acetaminophen administration, but the STAI score was significantly correlated to VAS1 and VAS2. CONCLUSIONS FNAC-related pain is frequent and correlates with the number of nodules biopsied, age under 25 years, female sex, and anxiety.
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Affiliation(s)
- Sophie Leboulleux
- 1 Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, University Paris-Sud , Villejuif, France
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Halenka M. Non-surgical management of thyroid abscess with ultrasound-guided fine-needle application of an antibiotic followed by sclerotization with absolute alcohol. MINERVA ENDOCRINOL 2013; 38:281-287. [PMID: 24126548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Thyroid abscess is a relatively rare yet dramatic condition of the thyroid gland requiring immediate therapeutic intervention. Traditionally, more or less aggressive surgical approaches and administration of broad-spectrum antibiotics have been used. Clinically less severe disease allows non-surgical treatment as well. The case report describes successful treatment of a large abscess of iatrogenic origin after biopsy of a cystic cavity. A combination of broad-spectrum antibiotics was used based on culture results, administered both orally and by repeated application directly into the abscess cavity using an ultrasound-guided fine-needle approach. Concurrent repeated evacuation of the cavity replaced drainage. Ultimately, a small residual cavity with sterile contents was managed by sclerotization with absolute alcohol. Clinical condition permitting, thyroid abscess may be successfully treated by repeated application of a targeted antibiotic, using a fine needle and ultrasound guidance, directly into the abscess cavity, with repeated evacuation replacing drainage.
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Affiliation(s)
- M Halenka
- Third Department of Internal Medicine, Division of Endocrinology, University Hospital and Faculty of Medicineand Dentistry, Palacky Universit, Olomouc, Czech Republic -
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47
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Affiliation(s)
- A R L Medford
- North Bristol Lung Centre, Southmead Hospital, Westbury-on-Trym, Bristol, England.
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Matsuyama M, Ishii H, Kuraoka K, Yukisawa S, Kasuga A, Ozaka M, Suzuki S, Takano K, Sugiyama Y, Itoi T. Ultrasound-guided vs endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer diagnosis. World J Gastroenterol 2013; 19:2368-2373. [PMID: 23613631 PMCID: PMC3631989 DOI: 10.3748/wjg.v19.i15.2368] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 01/23/2013] [Accepted: 02/06/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To clarify the effectiveness and safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of pancreatic cancer (PC).
METHODS: Patients who were diagnosed with unresectable, locally advanced or metastatic PC between February 2006 and September 2011 were selected for this retrospective study. FNA biopsy for pancreatic tumors had been performed percutaneously under extracorporeal ultrasound guidance until October 2009; then, beginning in November 2009, EUS-FNA has been performed. We reviewed the complete medical records of all patients who met the selection criteria for the following data: sex, age, location and size of the targeted tumor, histological and/or cytological findings, details of puncture procedures, time from day of puncture until day of definitive diagnosis, and details of severe adverse events.
RESULTS: Of the 121 patients who met the selection criteria, 46 had a percutaneous biopsy (Group A) and 75 had an EUS-FNA biopsy (Group B). Adequate cytological specimens were obtained in 42 Group A patients (91.3%) and all 75 Group B patients (P = 0.0192), and histological specimens were obtained in 41 Group A patients (89.1%) and 65 Group B patients (86.7%). Diagnosis of malignancy by cytology was positive in 33 Group A patients (78.6%) and 72 Group B patients (94.6%) (P = 0.0079). Malignancy by both cytology and pathology was found in 43 Group A (93.5%) and 73 Group B (97.3%) patients. The mean period from the puncture until the cytological diagnosis in Group B was 1.7 d, which was significantly shorter than that in Group A (4.1 d) (P < 0.0001). Severe adverse events were experienced in two Group A patients (4.3%) and in one Group B patient (1.3%).
CONCLUSION: EUS-FNA, as well as percutaneous needle aspiration, is an effective modality to obtain cytopathological confirmation in patients with advanced PC.
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Bessey LJ, Lai NBK, Coorough NE, Chen H, Sippel RS. The incidence of thyroid cancer by fine needle aspiration varies by age and gender. J Surg Res 2013; 184:761-5. [PMID: 23623584 DOI: 10.1016/j.jss.2013.03.086] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 03/21/2013] [Accepted: 03/27/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fine needle aspiration (FNA) is the standard to evaluate thyroid nodules for malignancy. The aim of this study was to determine the influence of patient age and gender on the rate of thyroid nodule malignancy by FNA. METHODS A database of 3981 consecutive patients who underwent thyroid FNA between 2002 and 2009 was reviewed. The percentages of benign, indeterminate, and malignant biopsies based on patient age and gender were determined. Statistical analysis was performed using SPSS (SPSS Inc, Chicago, IL). RESULTS Our patient population included 2766 women (mean age ± SD, 52 ± 15.2) and 964 men (mean age ± SD, 59 ± 13.8). Of the 3722 (93.5%) patients with diagnostic FNAs, 196 (5.3%) had malignant FNA cytology. Malignant FNAs were twice as frequent in patients age ≤45 versus those >45 (8.1% versus 4.0%, P < 0.001). Overall, men had more indeterminate (10.2% versus 6.3%, P < 0.001) and malignant (6.7% versus 4.8%, P = 0.034) FNAs than women. Malignant FNAs in men were greatest in patients over age 45 (6.0% versus 3.2%, P = 0.001). The incidence of malignant FNAs for women peaked in their age 30s (10.4%), whereas the incidence of malignant FNAs for men peaked 10 y later in their age 40s (12.1%). Both men and women had the lowest incidence of malignant FNAs in their age 70s (2.3% and 1.9%, respectively). CONCLUSIONS The typical 5% risk of thyroid nodule malignancy on FNA varies depending on a patient's age and gender. A patient's age and gender should, therefore, be considered when counseling someone of his or her risk of thyroid cancer by FNA.
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Affiliation(s)
- Laurel J Bessey
- Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, Wisconsin
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50
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Nayak L, DiMaio M, Jeffrey RB. Extraglandular extension of parotid actinomycosis after sonographically guided fine-needle aspiration. J Ultrasound Med 2013; 32:715-716. [PMID: 23525398 DOI: 10.7863/jum.2013.32.4.715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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