This study aimed to examine the diagnostic accuracy and clinical efficacy of initial CT-guided percutaneous biopsy of the vertebral lesions. A total of 305 percutaneous biopsies of the vertebral lesions were performed under either CT guidance (n=127) or C-arm guidance (n=178). The diagnostic accuracy rate was evaluated by comparing the histopathological diagnosis with the ultimate diagnosis. The histopathological diagnosis was consistent with the ultimate diagnosis in 108 (85.0%, 108/127) cases of CT-guided biopsy and in 135 (75.8%, 135/178) cases of C-arm guided biopsy and there was a significant difference. The accuracy of diagnosis based on biopsies varied with different diseases, including primary benign or malignant tumors, metastatic tumors, inflammatory lesions and fractures. A second biopsy or further examinations were required for patients with negative result obtained in the initial biopsy. The complication rate was 3.1% (4/127) in CT-guided biopsy and 7.3% (13/178) in C-arm guided biopsy. In conclusion, CT-guided percutaneous biopsy is an accurate and safe technique for biopsy of the vertebral lesions.
Biopsy, Needle ; methods ; Diagnosis, Differential ; Humans ; Radiography, Interventional ; adverse effects ; methods ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Spinal Diseases ; diagnosis ; Tomography, X-Ray Computed ; adverse effects ; methods

Biopsy, Fine-Needle ; Bronchi ; diagnostic imaging ; pathology ; Endosonography ; adverse effects ; methods ; Humans ; Thoracic Neoplasms ; diagnostic imaging

Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered.
Biopsy/adverse effects/methods ; Carcinoma, Renal Cell/*pathology ; Early Detection of Cancer/adverse effects/*methods ; Humans ; Incidental Findings ; Kidney/*pathology ; Kidney Neoplasms/*pathology

Small renal masses (SRMs) are defined as radiologically enhancing renal masses of less than 4 cm in maximal diameter. The incidence of renal cell carcinoma (RCC) has increased in recent years, which is mainly due to the rise in incidental detection of localized SRMs. However, the cancer-specific mortality rate is not increasing. This discrepancy may be dependent on the indolent nature of SRMs. About 20% of SRMs are benign, and smaller masses are likely to have pathologic characteristics of low Fuhrman grade and clear cell type. In addition, SRMs are increasingly detected in elderly patients who are likely to have comorbidities and are a high-risk group for active treatment like surgery. As the information about the nature of SRMs is improved and management options for SRMs are expanded, the current role of renal mass biopsy for SRMs is also expanding. Traditionally, renal mass biopsy has not been accepted as a standard diagnostic tool in the clinical scenario because of several issues about safety and accuracy. However, current series on SRM biopsy have reported high diagnostic accuracy with rare complications. Studies of modern SRM biopsy have reported diagnostic accuracy greater than 90% with very high specificity. Also, current series have shown very rare morbid cases caused by renal mass biopsy. Currently, renal biopsy of SRMs can be recommended in most cases except when patients have imaging or clinical characteristics indicative of pathology and in cases in which conservative management is not considered.
Biopsy/adverse effects/methods ; Carcinoma, Renal Cell/*pathology ; Early Detection of Cancer/adverse effects/*methods ; Humans ; Incidental Findings ; Kidney/*pathology ; Kidney Neoplasms/*pathology

Adult ; Aged ; Biopsy, Fine-Needle ; adverse effects ; methods ; Bronchi ; diagnostic imaging ; pathology ; Endosonography ; adverse effects ; methods ; Female ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging

Biopsy, Fine-Needle ; adverse effects ; methods ; Bronchi ; diagnostic imaging ; pathology ; Endosonography ; adverse effects ; methods ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Neoplasm Staging

The diagnosis of exogenous ochronosis is often challenging and requires a high index of suspicion. Herein, we report a case of exogenous ochronosis in a Chinese patient. The condition was caused by the use of bleaching agents, including creams containing hydroquinone. We demonstrate the use of dermoscopy as an invaluable tool for the early recognition of the condition, as well as in the selection of an appropriate site for a skin biopsy.
Alkaptonuria ; Biopsy ; Bleaching Agents ; adverse effects ; China ; Dermoscopy ; methods ; Humans ; Hydroquinones ; adverse effects ; Male ; Melanosis ; drug therapy ; Middle Aged ; Ochronosis ; diagnosis ; therapy ; Skin ; drug effects ; pathology ; Treatment Outcome

INTRODUCTIONThere are limited data on the use of endosonography-guided fine-needle aspiration (EUS-FNA) to determine the nature of left adrenal lesions. We described our experience in performing EUS-FNA of left adrenal lesions.

CLINICAL PICTUREDuring a 20-week period, data on consecutive patients who underwent EUS with or without EUS-FNA were prospectively captured. Patients with a left adrenal mass and who underwent EUS-FNA formed our study population.

TREATMENTEUS-FNA.

OUTCOMEA total of 119 consecutive patients underwent diagnostic EUS +/- FNA, during which the left adrenal gland was routinely examined. Twelve of these patients underwent EUS as part of lung cancer staging and among these 12 lung cancer patients, 2 had left adrenal masses detected by computed tomography (CT). EUS detected left adrenal nodules in 2 other patients which were not visualised by CT. The overall prevalence of a left adrenal mass was 3.4%; in the subgroup with confirmed lung cancer, the prevalence was 33.3%. All 4 patients were male, with a mean age of 76.3 years (range, 67 to 87). The mean size of the left adrenal lesion was 30.4 mm (range, 9 to 84.8). EUS-FNA of the left adrenal lesions was performed under Doppler guidance. The mean number of needle passes was 2 (range, 1 to 4). A cellular aspirate was obtained in all patients. No procedural complications occurred. Metastatic non-small cell lung cancer was diagnosed in 2 patients, including a lesion missed on CT. For the other 2 cases, EUS-FNA revealed benign adrenal cells.

CONCLUSIONSEUS-FNA appears safe and useful for the evaluation of left adrenal masses.

Adrenal Gland Neoplasms ; diagnostic imaging ; pathology ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; adverse effects ; methods ; Endosonography ; adverse effects ; Humans ; Prospective Studies ; Singapore

OBJECTIVETo compare the complication rates induced by three liver biopsy methods.

METHODSOne thousand five hundred fifty-seven liver biopsies were performed from 1995 to 2006 by the senior author of the present article. The patients were grouped into a non-ultrasound-guided biopsy group (783 cases), a partially ultrasound-guided group (485 cases) and an ultrasound-guided group (289 cases). The observed complications such as death, hemorrhage, pneumothorax, pain, choleperitoneum and vasovagal syncope were compared between these three groups.

RESULTSOnly 1 patient in the non-ultrasound-guided group died. Seven patients (45%), 4 in non-ultrasound-guided group, 2 in partially ultrasound-guided group and 1 in ultrasound-guided group, had hemorrhage complications. The hemorrhage complication rates between partially ultrasound-guided group and ultrasound-guided group had no significant differences and both were lower than those of the non-ultrasound-guided group. Thirty-five patients, 23 in non-ultrasound-guided group and 12 in partially ultrasound-guided group, suffered from pneumothorax; but the rates between the two groups were not significantly different. Forty-eight patients (45%), 28 in non-ultrasound-guided group, 17 in partially ultrasound-guided group and 3 in ultrasound-guided group, had severe pain and the rate in the ultrasound-guided group was significantly lower than those of the other two groups.

CONCLUSIONLiver biopsy performed under ultrasound guidance is the safest and most reliable way to do the procedure. It should be recommended in clinical practices.

Adolescent ; Adult ; Aged ; Biopsy ; adverse effects ; methods ; Child ; Humans ; Liver ; diagnostic imaging ; pathology ; Middle Aged ; Ultrasonography ; Young Adult

Ultrasound (US)-guided fine needle aspiration (US-FNA) has played a crucial role in managing patients with thyroid nodules, owing to its safety and accuracy. However, even with US guidance, nondiagnostic sampling and infrequent complications still occur after FNA. Accordingly, the Task Force on US-FNA of the Korean Society of Thyroid Radiology has provided consensus recommendations for the US-FNA technique and related issues to improve diagnostic yield. These detailed procedures are based on a comprehensive analysis of the current literature and from the consensus of experts.
Biopsy, Fine-Needle/*methods ; Consensus ; Fibrinolytic Agents/adverse effects/therapeutic use ; Humans ; Radiology ; Sensitivity and Specificity ; Thyroid Nodule/*diagnosis/therapy/*ultrasonography