Fine needle aspiration analysis of misdiagnosis of 2 cases with skin singular leiomyoma

This article reported that 2 cases with skin singular leiomyoma confirmed by pathology were misdiagnosed by fine needle aspiration biopsy, and the combination analysis of clinical history and pathological features of cells was as follows.

Combined use of fine needle aspiration cytology and full field digital mammography in preoperative assessment of breast masses

Objective: To evaluate the accuracy of these two methods and focus on the analysis and management of the false-negative cases. Methods: Results of full field digital mammography (FFDM) and fine needle aspiration cytology (FNAC) were obtained and analyzed from a consecutive of 102 women with palpable breast masses, results were correlated with the histopathological findings. Results: Of the 102 cases, malignancy was confirmed in 43 cases (42.16%) by final pathological examination, the sensitivity and specificity of cancer detection with FNA cytology was 90.7% (39/43) and 89.8% (53/59), re- spectively, the whole accuracy was 90.2% (92/102), with a positive predictive value of 86.7% (39/45) and a negative predictive value of 93.0% (53/57). FFDM gave a sensitivity of 88.4% (38/43), specificity of 83.1% (49/59), and whole accuracy 85.3% (87/102), the positive predictive value and negative predictive value was 79.2% (38/48) and 90.7% (49/54), respectively. All the FNAC-negative cancer cases were suggestive of malignancy by FFDM findings, however, the benign cases which present as equivocal finding by FNA cytology, could not be ruled out the presence of malignancy. Conclusion: FNAC and FFDM both are accurate, effective and economical diagnostic modalities, combined use of these two methods can reduced the misdiag- nosis rate of breast masses.

The efficacy of rapid on-site evaluation during endoscopic ultrasound-guided fine needle aspiration of pancreatic masses

Background:Endoscopic ultrasound(EUS)-guided fine needle aspiration(FNA)has become the preferred method to diagnose pancreatic masses due to its minimally invasive approach and diagnostic accuracy.Many studies have shown that rapid on-site evaluation(ROSE)improves diagnostic yield by 10–30%;however,more recent studies have demonstrated effective diagnostic accuracy rates without ROSE.Our study aims to examine whether the current standard of performing ROSE after each FNA pass adds diagnostic value during EUS-guided FNA of pancreatic masses.Methods:We conducted a retrospective case series on patients who underwent EUS-guided FNA of pancreatic masses between February 2011 and October 2014.All cases were performed by one of three endoscopists at Emory University Hospital.Patient demographics,radiologic details of pancreatic masses and pathology reports of the biopsied pancreatic masses were examined.Results:A total of 184 procedures performed in 171 patients were reviewed.The final pathology reports of the biopsied pancreatic masses showed 128(70%)with confirmed malignancy.Only 64(50%)of these 128 cases initially showed malignant cells during ROSE.Among these 64 cases,23%required 5 or more FNA passes to first detect malignant cells.Conclusions:The use of ROSE during EUS-guided FNA of pancreatic masses may increase the diagnostic yield,since malignant cells were often detected during later FNA passes that would otherwise be missed if tissue sampling stopped prematurely.In addition,sample preparation for ROSE may be suboptimal,since malignant cells were only detected in 50%of cases.

BRAF V600E突变检测在甲状腺乳头状癌中的临床价值

目的探讨基于细针穿刺(FNA)细胞学检查的BRAF V600E突变检测在甲状腺乳头状癌(PTC)的临床价值。方法选择2015年8月-2016年4月在宁波市第二医院行甲状腺结节FNA细胞学检查的患者126例,其中38例患者接受了手术切除并获得病理结果。所有患者均经多普勒超声检查并记录结节特点,利用FNA细胞学检查的标本进行BRAF V600E基因检测,分析各指标与PTC的关系。结果良性病变和PTC患者的结节形态、边界情况、手感、回声、BRAF V600E突变等的差异均有统计学意义(P均<0.05),其余指标的差异不显著(P均〉0.05)。BRAF V600E突变组和无突变组的中央区颈淋巴结转移、包膜、肿瘤大小、TNM分期、性别和年龄的差异均无统计学意义(P均〉0.05)。多因素Logistic回归分析显示边界、回声和BRAF V600E突变为恶性结节的独立危险因素,联合诊断的ROC曲线下面积(AUC)为0.834(0.764-0.903)。结论BRAF V600E突变检测是比较有效的PTC辅助诊断手段,但可能无法反应肿瘤的侵袭性。