Humans ; Frozen Sections ; Adenoma/diagnosis* ; Bronchial Neoplasms/surgery*

Post-polypectomy surveillance has become a major indication for colonoscopy as a result of increased use of screening colonoscopy in Korea. However, because the medical resource is limited, and the first screening colonoscopy produces the greatest effect on reducing the incidence and mortality of colorectal cancer, there is a need to increase the efficiency of postpolypectomy surveillance. In the present report, a careful analytic approach was used to address all available evidences to delineate the predictors for advanced neoplasia at surveillance colonoscopy. Based on the results of review of the evidences, we elucidated the high risk findings of the index colonoscopy as follows: 1) 3 or more adenomas, 2) any adenoma larger than 10 mm, 3) any tubulovillous or villous adenoma, 4) any adenoma with high-grade dysplasia, and 5) any serrated polyps larger than 10 mm. In patients without any high-risk findings at the index colonoscopy, surveillance colonoscopy should be performed five years after index colonoscopy. In patients with one or more high risk findings, surveillance colonoscopy should be performed three years after polypectomy. However, the surveillance interval can be shortened considering the quality of the index colonoscopy, the completeness of polyp removal, the patient's general condition, and family and medical history. This practical guideline cannot totally take the place of clinical judgments made by practitioners and should be revised and supplemented in the future as new evidence becomes available.
Adenoma/*diagnosis/surgery ; Adenoma, Villous/diagnosis/surgery ; Colonic Polyps/pathology/*surgery ; *Colonoscopy ; Colorectal Neoplasms/*diagnosis/surgery ; Databases, Factual ; Humans ; Republic of Korea ; Risk Factors ; Time Factors

Primary pleomorphic adenoma of the lung is a type of pulmonary adenoma that is extremely rare, and it predominantly occurs in the proximal airway. We recently experienced a case of a peripheral solitary pulmonary nodule that was discovered on the CT scans. We performed wedge resection with video-assisted thoracoscopic surgery and we firmly diagnosed this lesion as pulmonary pleomorphic adenoma according to the histology. We report here on a rare benign tumor that was diagnosed as a primary pleomorphic adenoma located in the lung periphery.
Adenoma, Pleomorphic/*diagnosis/pathology/surgery ; Adult ; Female ; Humans ; Lung Neoplasms/*diagnosis/pathology/surgery

To investigate the diagnosis and surgical treatment of adrenocortical oncocytoma. The clinical data from three cases of adrenocortical oncocytomas (ACOs) were retrospectively analyzed and discussed in light of the relevant literature. In these three cases, one presented with virilization, while the other two cases had no typical clinical features. The tumor was completely encapsulated and was non-invasive. Microscopically, the tumor cells showed neither mitosis nor necrosis, with abundant eosinophilic cytoplasm. No recurrence or metastasis was discovered after close follow-up observation for 12-24 months. Adrenocortical ACOs are rather rare, and most of them are benign. It was hard to make a confirmed diagnosis of ACOs before surgery. Resection of tumor is the best choice, and close follow-up observation is essential.
Adenoma, Oxyphilic ; diagnosis ; pathology ; surgery ; Adrenal Cortex Neoplasms ; diagnosis ; pathology ; surgery ; Adrenocortical Adenoma ; diagnosis ; pathology ; surgery ; Child ; Female ; Humans ; Middle Aged

Adenoma ; diagnosis ; surgery ; Early Diagnosis ; Endoscopy ; Forecasting ; Humans ; Microsurgery ; Pituitary Neoplasms ; diagnosis ; surgery ; Radiosurgery ; Surgical Procedures, Operative ; methods ; trends

BACKGROUND/AIMS: Brunner's gland adenoma is a rare benign tumor of the duodenum. Although several cases of successful endoscopic polypectomy have been reported, the studies on the safety and usefulness of endoscopic polypectomy are extremely rare. Therefore, we report the results of 10 cases of Brunner's gland adenoma treated by endoscopic polypectomy. METHODS: Between November 1998 and January 2003, 10 cases of Brunner's gland adenoma were diagnosed. The mean age of the cases (6 male, 4 female) was 60.4 years. They were located in the bulb (9) and the second portion (1) of the duodenum. All cases were diagnosed and removed by endoscopic polypectomy. RESULTS: The size of the tumor ranged from 1.0 to 3.5 cm in diameter. Pedunculated polyps were found in three cases. In other seven cases, semipedunculated polyps were observed and, three of them were presented as submucosal tumor. All cases had no malignant foci. There was no complication such as bleeding, perforation, and pancreatitis after endoscopic polypectomy. During follow-up period (range 1~39 months) after endoscopic polypectomy, there was no complication and recurrence of the lesions. CONCLUSIONS: Endoscopic polypectomy was a safe and useful method for the treatment of duodenal Brunner's gland adenoma without complication and recurrence.
Adenoma/diagnosis/*surgery ; Adult ; Aged ; *Brunner Glands ; Duodenal Neoplasms/diagnosis/*surgery ; *Endoscopy, Gastrointestinal ; English Abstract ; Female ; Humans ; Male ; Middle Aged

Pleomorphic adenoma (PA) is a rare benign tumor in the pharynx. We presented a case with a huge PA in the pharynx. MRI displayed oropharyngeal mass, considering benign tumor. Preoperative fine-needle aspiration and cytology biopsy were important to confirm the diagnosis of PA preliminary. Extracapsular complete dissection for PA was performed under general anesthesia with tracheotomy subsequently. Postoperative histopathological examination confirmed the diagnosis of PA. The patient was discharged a week after operation and no recurrence was found in the following 8 months.
Adenoma, Pleomorphic ; diagnosis ; surgery ; Biopsy, Fine-Needle ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local ; Pharyngeal Neoplasms ; diagnosis ; surgery ; Pharynx

OBJECTIVETo investigate the causes of misdiagnosis and the surgical treatment of primary hyperparathyroidism (PHPT).

METHODSThe clinical data of 26 patients with PHPT from July 2008 to January 2013 in The Affiliated Hospital of Chengde Medical College and The Fourth Hospital of Hebei Medical University were retrospectively analyzed, including preoperative diagnosis and operative method. The level of serum calciumion and serum parathyroid hormone (PTH), Ultrasonography, CT, (99)mTc-methoxy isobutylis onitrile ((99)mTc-MIBI) were used in the diagnosis before operation. All patients accepted surgical treatment after the level of serum calciumion decreased to normal.

RESULTSThe level of PTH was examined 10 min after resection, which declined more than 50%. After pathological examination, 23 cases were diagnosed as parathyroid adenoma, 2 cases were parathyroid hyperplasia, and 1 case was parathyroid carcinoma. The level of serum calciumion and serum parathyroid hormone were returned to the normal level after operation. All patients recovered with no postoperative complication.Followed up lasted from 6 months to 5 years, no case recurred.Sixteen cases with symptoms experienced significant improvement in signs, including 10 cases with clinical symptoms completely disappeared.

CONCLUSIONSThe test of serum calciumion and serum PTH, Ultrasonography, CT, (99)mTc-MIBI are helpful to reduce the misdiagnose rate of primary hyperparathyroidism before operation. The examination of serum parathyroid hormone in operation is helpful to reduce the operation range and time.

Adenoma ; Diagnosis, Differential ; Hamartoma ; Humans ; Nasal Cavity ; surgery ; Paranasal Sinuses ; Respiratory Mucosa

Objective: To explore the feasibility and application value of intraoperative direct immunohistochemical (IHC) staining in improving the diagnosis accuracy in difficult cases of bronchiolar adenoma (BA). Methods: Nineteen cases with single or multiple pulmonary ground-glass nodules or solid nodules indicated by imaging in Cancer Hospital of Chinese Academy of Medical Sciences from January to July 2021 and with difficulty in differential diagnosis at frozen HE sections were selected. In the experimental group, direct IHC staining of cytokeratin 5/6 (CK5/6) and p63 was performed on frozen sections to assist the differentiation of BA from in situ/micro-invasive adenocarcinoma/adenocarcinoma/invasive mucinous adenocarcinoma. In the control group, two pathologists performed routine frozen HE section diagnosis on these 19 cases. The diagnostic results of paraffin sections were used as the gold standard. The sensitivity and specificity of BA diagnosis, consistency with paraffin diagnosis and time used for frozen diagnosis were compared between the experimental group and the control group. Results: The basal cells of BA were highlighted by CK5/6 and p63 staining. There were no basal cells in the in situ/microinvasive adenocarcinoma/adenocarcinoma/invasive mucinous adenocarcinoma. In the experimental group, the sensitivity and specificity with aid of direct IHC staining for BA were 100% and 86.7%, respectively, and the Kappa value of frozen and paraffin diagnosis was 0.732, and these were significantly higher than those in the control group (P<0.05). The average time consumption in the experimental group (32.4 min) was only 7 min longer than that in the control group (25.4 min). Conclusions: Direct IHC staining can improve the accuracy of BA diagnosis intraoperatively and reduce the risk of misdiagnosis, but require significantly longer time. Thus frozen direct IHC staining should be restricted to cases with difficulty in differentiating benign from malignant diseases, especially when the surgical modalities differ based on the frozen diagnosis.
Humans ; Paraffin ; Sensitivity and Specificity ; Adenocarcinoma in Situ ; Adenoma/diagnosis* ; Adenocarcinoma, Mucinous/surgery* ; Frozen Sections/methods*