OBJECTIVETo study the basic morphological factors and the reliability and limitations of the diagnostic standards of fine needle aspiration cytology (FNAC) of breast masses which drafted.

METHODSA total of 4 309 fine needle aspiration biopsy cases of breast were performed and 951 cases of which were checked with their histological diagnosis.

RESULTSOf the 413 aspiration smear studies, relatively identical morphological features were found on the smears of lesions of the same nature. The sensitivity of diagnosis of malignant tumor in 732 cases, the specificity of diagnosis of benign lesion in 219 cases and the overall accuracy of diagnosis were 97.3%, 97.7%, and 97.4% respectively. The false negative rate, potential false positive rate and the overall misdiagnosis rate were 2.7%, 2.3% and 2.6% respectively, no false positive diagnosis case was found.

CONCLUSIONS(1) The differentiation and the arrangement pattern of the tubular epithelial cells and the amount of benign naked nuclear cells are the three essential factors in the analysis of morphological changes of FNAC of breast mass. (2) The examination of our diagnostic standards of FNAC of breast masses shows that the standards are very reliable but have certain limitations which need to be resolved by histopathological diagnosis.

Biopsy, Needle ; standards ; Breast Neoplasms ; diagnosis ; pathology ; Diagnostic Errors ; Female ; Humans ; Reproducibility of Results

Biopsy ; methods ; standards ; Chronic Disease ; Humans ; Liver ; pathology ; Liver Diseases ; diagnosis ; pathology ; Quality Control

The purpose of this study was to evaluate the usefulness of an ultrasound-guided fine-needle aspiration biopsy (US-FNAB) for the evaluation and treatment planning of nonpalpable thyroid lesions, including infracentimetric nodules. One hundred and twenty one patients underwent US-FNAB for 149 non-palpable solid nodules. Sixty-five patients underwent surgery, and 84 were followed up for at least 36 months. The results of the US-FNAB correlated with the pathological findings and clinical follow-up results. The nodules ranged from 0.3 to 2 cm in diameter, with a mean of 0.8cm. Among the 149 nodules, 115 were infracentimetric and 34 were centimetric or supracentimetric in size. Of the 149 thyroid nodules, US-FNAB was true positive in 43, true negative in 90, false positive in 7 and false negative in 1. In 8 cases, the lesion was inadequately sampled. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the US-FNAB for the infracentimetric nodules were 96.9, 93.4, 86.1, 98.6 and 94.4%, and for the centimetric or supracentimetric nodules, were 100, 90.5, 85.7, 100 and 93.9%, respectively. There were no significant differences in the results between the infracentimetric and centimetric or supracentimetric nodules. In conclusion, an US-FNAB is a useful tool for determining the treatment plan of non-palpable solid thyroid nodules, even when less than 1 cm in diameter, and shows high sensitivity, specificity and accuracy.
Adult ; Aged ; Biopsy, Needle/*methods/standards ; Female ; Human ; Male ; Middle Aged ; Sensitivity and Specificity ; Thyroid Nodule/*pathology/*ultrasonography

In recent years, the sural nerve biopsy has become a commonly performed procedure in the diagnostic work-up of patients with peripheral neuropathy. This paper reviews the diagnostic usefulness and limitations of this procedure. Based on 385 sural nerve biopsies, we found clinically helpful or relevant information in 45% of cases. In 24% of cases, specific diagnoses were obtained, among which vasculitic neuropathy was most common.
Biopsy/methods/standards ; Evaluation Studies ; Histological Techniques ; Human ; Peripheral Nervous System Diseases/classification/*diagnosis ; Spinal Nerves/*pathology ; Sural Nerve/*pathology

Frozen section diagnosis is a highly useful method of diagnosis. There were 4434 frozen sections, 24 false positive diagnosis, 65 false negative diagnosis and 30 deferred diagnosis. This method achieves the highest accuracy when there is a cooperation between experienced surgeon and reliable and careful pathologist. It is wise to defer the diagnosis of consult to other pathologist in difficult situation.
Biopsy/*standards ; False Negative Reactions ; False Positive Reactions ; *Frozen Sections ; Humans ; *Microtomy ; Neoplasms/*diagnosis/pathology ; *Predictive Value of Tests

Biopsy, Large-Core Needle ; Coloring Agents ; Hematoxylin ; Humans ; Immunohistochemistry ; Lymphoma ; pathology ; Pathology ; standards ; Pathology, Molecular ; Staining and Labeling

Adenocarcinoma ; classification ; pathology ; Adenocarcinoma, Mucinous ; pathology ; Biopsy ; Carcinoma, Ductal ; pathology ; Humans ; Male ; Neoplasm Grading ; methods ; standards ; Prostatic Neoplasms ; classification ; pathology

INTRODUCTIONIdentifying malignancy either preoperatively or intraoperatively can have a significant impact on the management of salivary gland tumours. We review our experience with fine needle aspiration cytology (FNAC) and frozen section (FS) for salivary gland lesions. We analyse the accuracy of both modalities and their influence on management.

MATERIALS AND METHODSRetrospective review of 114 patients who underwent salivary gland surgery, 91 with intraoperative FS and 68 with preoperative FNAC. Both sets of results were compared against each other and the final histopathological diagnosis.

RESULTSThe accuracy of FS was 92.3%, with a sensitivity and specificity of 62.5% and 100%. Histologic concordance was 92.4% for benign lesions, and 100% for malignant tumours. The accuracy of FNAC was 89.7%, with a sensitivity and specificity of 100%. The non-diagnostic rate was 10.3%. Histologic concordance for FNAC was inferior to that for FS, with only 64.2% of benign lesions and 50% of malignant tumours correctly identified. FNAC did not alter the management of benign disease even when a correct diagnosis was obtained.

CONCLUSIONOur results suggest that FNAC and FS are complementary in usefulness for malignant tumours. However, FNAC does not influence the management of benign lesions and routine FNAC for every patient may not be cost-effective.

Biopsy, Fine-Needle ; standards ; Frozen Sections ; Humans ; Intraoperative Care ; Retrospective Studies ; Salivary Gland Neoplasms ; diagnosis ; pathology ; Salivary Glands ; pathology ; Sensitivity and Specificity ; Specimen Handling

OBJECTIVE: To evaluate the retrieval rate and accuracy of ultrasound (US)-guided 14-G semi-automated core needle biopsy (CNB) for microcalcifications in the breast. MATERIALS AND METHODS: US-guided 14-G semi-automated CNB procedures and specimen radiography were performed for 33 cases of suspicious microcalcifications apparent on sonography. The accuracy of 14-G semi-automated CNB and radiology-pathology concordance were analyzed and the microcalcification characteristics between groups with successful and failed retrieval were compared. RESULTS: Thirty lesions were successfully retrieved and the microcalcification retrieval rate was 90.9% (30/33). Thirty lesions were successfully retrieved. Twenty five were finally diagnosed as malignant (10 invasive ductal carcinoma, 15 ductal carcinoma in situ [DCIS]) and five as benign. After surgery and mammographic follow-up, the 25 malignant lesions comprised 12 invasive ductal carcinoma and 13 DCIS. Three lesions in the failed retrieval group (one DCIS and two benign) were finally diagnosed as two DCIS and one benign after surgery. The accuracy of 14-G semi-automated CNB was 90.9% (30/33) because of two DCIS underestimates and one false-negative diagnosis. The discordance rate was significantly higher in the failed retrieval group than in the successful retrieval group (66.7% vs. 6.7%; p < 0.05). Punctate calcifications were significantly more common in the failed retrieval group than in the successful retrieval group (66.7% vs. 3.7%; p < 0.05). CONCLUSION: US-guided 14-G semi-automated CNB could be a useful procedure for suspicious microcalcifications in the breast those are apparent on sonography.
Adult ; Aged ; Biopsy, Large-Core Needle/*methods/standards ; Breast/*pathology ; Breast Diseases/pathology/radiography ; Breast Neoplasms/*pathology/surgery/ultrasonography ; Calcinosis/*pathology/ultrasonography ; Carcinoma, Ductal, Breast/*pathology/ultrasonography ; Carcinoma, Intraductal, Noninfiltrating/*pathology/radiography ; Female ; Humans ; Middle Aged ; *Ultrasonography, Interventional/standards ; Young Adult

PURPOSE: The purpose was to compare the frequency of metastatic and nonmetastatic lymph nodes diagnosed by fine needle aspiration biopsy cytology (FNAC) and thyroglobulin concentration from fine needle aspiration biopsy washout fluid (FNAB-Tg) in an indeterminate range (0.2-100 ng/mL), and to evaluate the most appropriate threshold value of FNAB-Tg in an indeterminate range. MATERIALS AND METHODS: We performed ultrasound-guided FNAB and FNAB-Tg in suspicious metastatic cervical lymph nodes of papillary thyroid carcinoma and performed surgery. Ninety-five lymph nodes with indeterminate values of FNAB-Tg ranging from 0.2-100 ng/mL in ninety-two patients were included in this study. The diagnostic performances in multiple Tg levels (0.7, 1.0, 5.0, 10.0, 20.0, 50.0) were evaluated to compare with FNAB cytology using sensitivity, specificity, and accuracy with area under the curve (AUC) analysis. RESULTS: Forty-two were metastatic lymph nodes and fifty three were nonmetastatic lymph nodes. FNAB-Tg ranged from 0.22 to 90.9 ng/mL in metastatic lymph nodes (mean; 34.3+/-33.3 ng/mL) and 0.20 to 56.7 ng/mL in nonmetastatic lymph nodes (mean; 4.9+/-11.1 ng/mL) (p<0.001). The most excellent diagnostic performance was displayed in 5 ng/mL of FNAB-Tg with AUC of 0.76, sensitivity, specificity, accuracy, 69.0, 83.0, and 76.8, respectively. However, there was no significant difference from 10 ng/mL FNAB. CONCLUSION: We ascertained that 5 ng/mL yielded the most excellent diagnostic performance among FNAB-Tg levels in the present setting with a large series with the indeterminate range (0.2-100 ng/mL) of FNAB-Tg values. These results need additional confirmation under different laboratory conditions.
Biopsy, Fine-Needle/*methods/standards/statistics & numerical data ; Body Fluids/metabolism ; Carcinoma, Papillary/*metabolism/*secondary/ultrasonography ; Humans ; Lymph Nodes/metabolism/pathology/ultrasonography ; Lymphatic Metastasis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin/*metabolism ; Thyroid Neoplasms/*metabolism/*secondary/ultrasonography ; Ultrasonography, Interventional