BACKGROUND: Skin biopsy is an effective diagnostic tool commonly used in dermatology practice. Clinicopathologic correlation is important for diagnostic accuracy. OBJECTIVE: The purpose of this study was to investigate the distribution of skin biopsy specimens, and compare the pathologic diagnosis with the final dermatologic diagnosis. METHODS: This study included 4,018 skin biopsy specimens taken during a period of 10 years from June 1995 to May 2005 at the Department of Dermatology, Korea University Anam Hospital. RESULTS & CONCLUSION: Of all biopsy specimens, 61.49% were diagnosed as tumors, and 38.51% were diagnosed as non-tumors. For the tumors, 87.15% were benign, 4.23% were premalignant and 8.62% were malignant. The rate of concordance between pathologic diagnosis and final dermatologic diagnosis was 76.69%, and the rate of discordance between them was 4.18%. The rate of description without a pathologic diagnosis in pathologic reports was 18.94%. The rate of concordance was higher in tumors (89.65%) than in non-tumors (56.00%), and the rate of description in pathologic reports was higher in non-tumors (39.08%) than in tumors (6.32%). There was no significant difference in the rates of discordance between tumors and non-tumors. The rate of concordance was higher in malignant tumors (95.72%) than in benign tumors (89.77%) or premalignant tumors (74.76%). The rate of description in pathologic reports was higher in premalignant tumors (18.45%) than in benign tumors (6.27%) or malignant tumors (0.95%). There was no significant difference in the rates of discordance between the three groups.
Biopsy ; Dermatology ; Diagnosis* ; Korea ; Skin Diseases* ; Skin* ; Statistics as Topic*

BACKGROUND: Ultrasonography is an important diagnostic tool for many aspects of clinical medicine. It is a non-invasive method of examination that provides high-resolution images in real time. However, some dermatologists may be anxious about the efficacy of ultrasonography. OBJECTIVE: To evaluate the diagnostic accuracy and to assess the utility of diagnostic ultrasonography for subcutaneous benign lesions. METHODS: The study included 96 patients with subcutaneous benign lesions who underwent ultrasonography and then received a pathologic diagnosis after biopsy or surgery at our hospital from July 2010 to December 2012. This study evaluated the number of cases in which the preoperative diagnosis after ultrasonography or just after physical examination agreed to the pathologic diagnosis. RESULTS: Ultrasonography significantly increased the diagnostic yield of subcutaneous benign lesions (after physical examination, 54.2%; after ultrasonography, 84.4%; p<0.001). The sensitivity for the diagnosis of lipoma (after physical examination, 70%; after ultrasonography, 92.5%; p<0.001) and the specificity for the diagnosis of epidermal cyst (after physical examination, 84.1%; after ultrasonography, 94.2%; p<0.001) significantly increased after ultrasonography. The sensitivity for the diagnosis of epidermal cyst and pilomatricoma also tended to increase after ultrasonography. CONCLUSION: The study results suggested that ultrasonography is useful for diagnosis and/or preoperative examination of subcutaneous benign lesions.
Biopsy ; Clinical Medicine ; Epidermal Cyst ; Humans ; Lipoma ; Physical Examination ; Pilomatrixoma ; Sensitivity and Specificity ; Statistics as Topic

PURPOSE: To investigate whether volumetric analysis based on T2WI and contrast-enhanced (CE) T1WI can distinguish between isocitrate dehydrogenase-1 mutation-positive (IDH1(P)) and -negative (IDH1(N)) glioblastomas (GBMs). MATERIALS AND METHODS: We retrospectively enrolled 109 patients with histopathologically proven GBMs after surgery or stereotactic biopsy and preoperative MR imaging. We measured the whole-tumor volume in each patient using a semiautomatic segmentation method based on both T2WI and CE T1WI. We compared the tumor volumes between IDH1(P) (n = 12) and IDH1(N) (n = 97) GBMs using an unpaired t-test. In addition, we performed receiver operating characteristic (ROC) analysis for the differentiation of IDH1(P) and IDH1(N) GBMs using the tumor volumes based on T2WI and CE T1WI. RESULTS: The mean tumor volume based on T2WI was larger for IDH1(P) GBMs than IDH1(N) GBMs (108.8 +/- 68.1 and 59.3 +/- 37.3 mm3, respectively, P = 0.0002). In addition, IDH1(P) GBMs had a larger tumor volume on CE T1WI than did IDH1(N) tumors (49.00 +/- 40.14 and 22.53 +/- 17.51 mm3, respectively, P < 0.0001). ROC analysis revealed that the tumor volume based on T2WI could distinguish IDH1(P) from IDH1(N) with a cutoff value of 90.25 (P < 0.05): 7 of 12 IDH1(P) (58.3%) and 79 of 97 IDH1(N) (81.4%). CONCLUSION: Volumetric analysis of T2WI and CE T1WI could enable IDH1(P) GBMs to be distinguished from IDH1(N) GBMs. We assumed that secondary GBMs with IDH1(P) underwent stepwise progression and were more infiltrative than those with IDH1(N), which might have resulted in the differences in tumor volume.
Biopsy ; Glioblastoma* ; Humans ; Isocitrate Dehydrogenase* ; Magnetic Resonance Imaging ; Retrospective Studies ; ROC Curve ; Statistics as Topic* ; Tumor Burden

Screening for prostate cancer was performed to estimate the incidence of prostate cancers and to detect early prostate cancers in the Korean population. 501 volunteers who were older than 50, not within the urological practice and from the general population of Pusan city were screened from March 1993 to October 1994. The screening methods used were I-PSS, prostate specific antigen (PSA), digital rectal examination (DRE), transrectal ultrasonography (TRUS), and uroflow with or without transrectal systematic biopsy of prostate. Biopsy was recommended in cases of PSA greater than 4 ng/ml or suspicious nodule on DRE or lesion on TRUS or when more than two of these findings were discovered. 443 participants satisfied the criteria for data analysis. The biopsy rate was 47.7%. Prostate cancer was found in eight, yielding a detection rate of 1.8%. Five of these eight cases were localized cancers. These findings suggest that screening for prostate adenocarcinoma on Koreans is efficient and necessary to detect cancers in the early stages. Apparently the detection rate of prostate cancer in Korean population is not low as previously expected.
Adenocarcinoma ; Biopsy ; Busan ; Digital Rectal Examination ; Incidence ; Mass Screening* ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Statistics as Topic ; Ultrasonography ; Volunteers

OBJECTIVETo evaluate the liability of sentinel node biopsy in the treatment of early stage oral tongue carcinoma with clinically negative neck.

METHODSEighteen patients with T1 or T2 oral tongue carcinoma were enrolled in the prospective study. Preoperative lymphoscintigraphy and intra-operative hand-held gamma probe techniques were used to detect the sentinel lymph nodes. The sentinel lymph node biopsies were sent to frozen section pathology and the results were compared with specimen of routine selective neck dissection (I ∼ III or I ∼ IV). The accuracy of cervical metastasis prediction was compared between sentinel node biopsy and tumor thickness.

RESULTSSentinel lymph nodes were identified in all 18 cases. The numbers of sentinel lymph nodes of level Ib, IIa and III were 6, 22 and 2, respectively. In this series, positive sentinel lymph nodes were revealed in 4 cases, which were also positive in the postoperative routine histology.In other cases, both sentinel lymph nodes and routine histology were negative. Both the sensitivity and specificity were 100%. Sentinel lymph node biopsy obviously improved the specificity of predicting cervical metastasis comparing with the tumor thickness. (100% vs. 36.4%).

CONCLUSIONSentinel node biopsy is effective and reliable in the treatment of early stage oral tongue cancer, and deserves clinical application.

Humans ; Lymph Nodes ; surgery ; Mouth Neoplasms ; diagnosis ; Prospective Studies ; Sentinel Lymph Node Biopsy ; methods ; statistics & numerical data ; Tongue Neoplasms ; diagnosis

Clinical and pathological studies were carried out on 78 patients of ovarian cancer from January 1985 to March 1991. The results are as follows : l. Among 78 patients of ovarian cancer, the age group from 51 to 60 years old was most common which was 18 cases(23.1%). 2. When classified according to the cell type, epithelial cell origin cancers were 59 cases (75.6%), ovarian cancers from germ cell origin 9 cases(11.5%), sex cord stromal cancers 3 cases(3.8%), and metastatic cancers 7 cases(8.9%) respectively. 3. When classified according to the FIGO staging, stage I were 34 cases(43.5%), stage II 8 cases(10.3%), stage III 23 cases(29.5%) and stage IV 13 cases(16,7%), respectively. 4. Preoperative mean CA 125 value of stage I ovarian cancer was 130.2+/-57.3U/ml, stage II 74.2+/-144.4U/ml, stage III 376.9+/-296.8U/ml and stage IV 433.9+/-148.2U/ml respectively. and Also preoperative mean CEA value of stage I ovarian cancer was 3.4+/-3.2ng/ ml, stage II 6.9+/-4.3ng/ml, stage III 4.7+/-4.4ng/ml and stage IV 4.6+/-6.3ng/ml respectively. 5. When classified according to the physical examination, the most common finding was palpable mass which were 38 cases(43.7%), the second, abdominal pain 30 cases(38.4%) and the third, abdominal distension 21 cases(26.9%) 6. When classified according to the operation, ipsilateral oophorectomy was 15 cases(25.5%), ipsilateral oophorectomy and contralateral ovary wedge resection 6 cases(10.2%), total abdominal hysterectomy 17 cases(28.8%), total abdominal hysterctomy and omentectomy 14 cases(23.7%), total abdominal hysterectomy and omentectomy and debulking tumor resetion 4 cases(6.7%) and biopsy only 3 cases(5.1%) respetctively. 7. When calssifide according to the postoterative endometrial finding, atrophic pattern was 28 cases(65.7%), proliferative pattern 10 cases(28.6%) and secretory pattern 2 cases(5.7%) respectively.
Abdominal Pain ; Biopsy ; Epithelial Cells ; Female ; Germ Cells ; Humans ; Hysterectomy ; Middle Aged ; Ovarian Neoplasms* ; Ovariectomy ; Ovary ; Physical Examination ; Statistics as Topic*

In a six-year period (from May 1988 to April 1994), fine needle aspiration cytology (FNAC) of 322 pulmonary lesions from 296 patients were performed at Soonchunhyang University Hospital. Of these 322, malignancy was diagnosed cytologically in 139 (43.2%), suspicious malignancy in 7 (2.2%), negative in 164 (50.8%), and insufficient material in 12 (3.8%). Malignant lesion consisted of 54 cases of adenocarcinoma, 50 cases of squamous cell carcinoma, 18 cases of small cell carcinoma. They were verified by histologic confirmation in 70 cases. There were 2 (0.6%) false positive cases due to florid bronchoalveolar hyperplasia and atypical bronchial epithelial cells associated with granulomatous lesion. Overall accuracy rate was 90%, the sensitivity 84.3% and the specificity 94.7%.
Adenocarcinoma ; Biopsy, Fine-Needle ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Epithelial Cells ; Humans ; Hyperplasia ; Lung* ; Needles* ; Sensitivity and Specificity ; Statistics as Topic*

BACKGROUND/AIMS: Repeat endoscopy with biopsy is often performed in patients with previously diagnosed gastric cancer to determine further treatment plans. However, biopsy results may differ from the original pathologic report. We reviewed patients who had a negative biopsy after referral for gastric cancer. METHODS: A total of 116 patients with negative biopsy results after referral for biopsy-proven gastric cancer were enrolled. Outside pathology slides were reviewed. Images of the first and second endoscopic examinations were reviewed. We reviewed the clinical history from referral to the final treatment. RESULTS: Eighty-eight patients (76%) arrived with information about the lesion from the referring physician. Among 96 patients with available outside slides, the rate of interobserver variation was 24%. Endoscopy was repeated at our institution; 85 patients (73%) were found to have definite lesions, whereas 31 patients (27%) had indeterminate lesions. In the group with definite lesions, 71% of the lesions were depressed in shape. The most common cause of a negative biopsy was mistargeting. In the group with indeterminate lesions, 94% had insufficient information. All patients with adequate follow-up were successfully treated based on the findings in the follow-up endoscopy. CONCLUSIONS: A negative biopsy after referral for biopsy-proven gastric cancer is mainly caused by mistargeting and insufficient information during the referral.
Adult ; Aged ; Aged, 80 and over ; Biopsy/statistics & numerical data ; Diagnostic Errors/*statistics & numerical data ; Female ; Gastroscopy/*statistics & numerical data ; Humans ; Male ; Middle Aged ; Observer Variation ; Referral and Consultation/statistics & numerical data ; Reoperation/statistics & numerical data ; Republic of Korea ; Retrospective Studies ; Stomach/*pathology ; Stomach Neoplasms/*pathology ; Young Adult

Endoscopic biopsy is necessary to confirm a histopathologic diagnosis. Currently, 6 to 8 biopsies are recommended for diagnosis of a suspected malignant lesion. However, multiple biopsies may result in several problems, such as an increased risk of bleeding, procedure prolongation, and increased workload to pathologists. The aim of this study was to clarify the optimal number of endoscopic biopsy specimens required in diagnosis of advanced gastrointestinal cancer. Patients who were diagnosed with advanced gastrointestinal cancer during endoscopy were included. Five specimens were obtained sequentially from viable tissue of the cancer margin. Experienced pathologists evaluated each specimen and provided diagnoses. A total of 91 patients were enrolled. Fifty-nine subjects had advanced gastric cancer, and 32 had advanced colon cancer. Positive diagnosis rates of the first, second, and third advanced gastric cancer specimens were 81.3%, 94.9%, and 98.3%, respectively, while positive diagnosis rates of advanced colon cancer specimens were 78.1%, 87.5%, and 93.8%. Further biopsies did not increase positive diagnosis cumulative rates. This study demonstrated that three specimens were sufficient to make correct pathologic diagnoses in advanced gastrointestinal cancer. Therefore, we recommend 3 or 4 biopsies from viable tissue in advanced gastrointestinal cancer to make a pathologic diagnosis during endoscopy.
Adult ; Aged ; Biopsy/*statistics & numerical data ; Colorectal Neoplasms/*diagnosis/pathology ; *Endoscopy, Digestive System ; Female ; Humans ; Male ; Middle Aged ; Stomach Neoplasms/*diagnosis/pathology

Granular cell tumor is mostly benign and thought to be of Schwann cell origin. The head and neck, particularly tongue, breast, and upper respiratory tract are frequently involved. Recently, we have experienced a case of granular cell tumor of the right thigh in a 30-year old male, diagnosed by fine needle aspiration cytology which revealed distinct cytologic features. The smear revealed cellular aspirates with clear background. The tumor cells showed uniform small nuclei and abundant eosinophilic, granular cytoplasm with hazy cell border. Mitoses were not found.
Adult ; Biopsy, Fine-Needle ; Breast ; Child* ; Cytoplasm ; Eosinophils ; Granular Cell Tumor ; Head ; Humans ; Lupus Nephritis* ; Male ; Mitosis ; Neck ; Paraganglioma ; Respiratory System ; Statistics as Topic* ; Thigh ; Tongue