No abstract available.
Carcinoid Tumor/*diagnosis/*pathology/ultrasonography ; Colonoscopy ; Cysts/*pathology/surgery ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/*diagnosis/*pathology/ultrasonography ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

We report a case of prenatally diagnosed congenital perineal mass which was combined with anorectal malformation. The mass was successfully treated with posterior sagittal anorectoplasty postnatally. On ultrasound examination at a gestational age of 23 weeks the fetal perineal mass were found on the right side. Any other defects were not visible on ultrasonography during whole gestation. Amniocentesis was performed to evaluate the fetal karyotyping and acetylcholinesterase which were also normal. As the fetus grew up, the mass size was slowly increased more and more. At birth, a female neonate had a perineal mass on the right side as expected. During operation, the anal sphincteric displacement was found near the mass and reconstructed through posterior sagittal incision. This is the first reported case of prenatally diagnosed congenital perineal mass, after birth which was diagnosed as lipoblastoma and even combined with anorectal malformation. This case shows that it can be of clinical importance to be aware of this rare fetal perineal mass in prenatal diagnosis and counseling.
Adult ; Amniocentesis ; *Anal Canal/abnormalities/pathology/ultrasonography ; *Digestive System Abnormalities/diagnosis/pathology/ultrasonography ; Female ; Gestational Age ; Humans ; Infant, Newborn ; *Lipoma/diagnosis/pathology/ultrasonography ; Male ; *Perineum/pathology/ultrasonography ; Pregnancy ; Prenatal Diagnosis ; *Rectal Neoplasms/diagnosis/pathology/ultrasonography ; *Rectum/abnormalities/pathology/ultrasonography ; Ultrasonography, Prenatal/*methods

Mucosa-associated lymphoid tissue (MALT) lymphoma is a typical primary gastrointestinal lymphoma, particularly in the stomach. Although primary rectal lymphoma is rare, it may present as a subepithelial tumor. Several techniques have been proposed for a tissue diagnosis in subepithelial tumor, including endoscopic ultrasonography (EUS)-guided fine needle aspiration (EUS-FNA), EUS-guided trucut biopsy (EUS-TCB), and tacked biopsy. However the diagnostic efficacy of these techniques appears to be limited. The unroofing technique involves removal of the overlying mucosa, thereby exposing the subepithelial lesion. It was originally reported as a method for endoscopic treatment of colorectal lymphangioma. In this case, a subepithelial tumor of the rectum was diagnosed using the endoscopic unroofing technique. This is a useful modality for the diagnosis of subepithelial tumor, because it provides histologic results in a safe and rapid manner.
Adult ; Antigens, CD20/metabolism ; Colonoscopy ; Humans ; Immunohistochemistry ; Intestinal Mucosa/surgery ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/ultrasonography ; Male ; Rectal Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography Scanners, X-Ray Computed

We developed and validated a novel Korean prostate cancer risk calculator (KPCRC) for predicting the probability of a positive initial prostate biopsy in a Korean population. Data were collected from 602 Koreans who underwent initial prostate biopsies due to an increased level of prostate-specific antigen (PSA), a palpable nodule upon digital rectal examination (DRE), or a hypoechoic lesion upon transrectal ultrasound (TRUS). The clinical and laboratory variables were analyzed by simple and multiple logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was computed to compare its performance to PSA testing alone. Prostate cancer was detected in 172 (28.6%) men. Independent predictors included age, DRE findings, PSA level, and prostate transitional zone volume. We developed the KPCRC using these variables. The AUC for the selected model was 0.91, and that of PSA testing alone was 0.83 (P < 0.001). The AUC for the selected model with an additional dataset was 0.79, and that of PSA testing alone was 0.73 (P = 0.004). The calculator is available on the website: http://dna.korea.ac.kr/PC-RISC/. The KPCRC improved the performance of PSA testing alone in predicting the risk of prostate cancer in a Korean population. This calculator would be a practical tool for physicians and patients.
Aged ; Area Under Curve ; Biopsy, Needle ; *Digital Rectal Examination ; Humans ; Internet ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate/pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis/pathology/ultrasonography ; ROC Curve ; Republic of Korea ; Risk

OBJECTIVETo evaluate the detection of prostate cancer in different prostate specific antigen (PSA) level and the predict value of PSA, digital rectal examination (DRE), transrectal ultrasound scan (TRUS) and PSA density (PSAD).

METHODSThe clinical data of 634 cases who had underwent transrectal ultrasound guided systematic sextant prostate biopsies between April 1996 to December 2002 due to being suspicious of prostate cancer were retrospectively analyzed. The detection of prostate cancer in different PSA groups, namely PSA < or = 4.0, 4.1-, 10.1-, > 20.0 microg/L, and the predict values of PSA, DRE, TRUS and PSAD were statistically analyzed using t test, chi2 test and logistic regression analysis.

RESULTSThe rates of prostate cancer detection in different PSA groups were 11.6%, 26.8%, 39.8% and 68.6%, respectively. The higher the PSA, the higher the rate of prostate cancer detection, the same was the positive predictive value of DRE and TRUS. The sensitivity and specificity of PSA > 4.0 microg/L were 93.0% and 33.0%, and the efficiency of DRE and TRUS were very low. Logistic regression analysis indicated that PSAD was the most risk factor of prostate cancer in the group of PSA 4.1-20.0 microg/L (OR = 687.09 +/- 646.96, P = 0.000).

CONCLUSIONSThe rates of prostate cancer detection in different PSA groups are different compared with other countries. The screening roles of DRE and TRUS are dependent on PSA level. Utilization of the screening protocol which to stratify cases into three PSA groups, namely PSA < or = 4.0, 4.1 - 20.0, > 20.0 microg/L, can elevate the positive rate of prostate biopsies without sacrificing cancers detected.

Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Digital Rectal Examination ; methods ; Early Diagnosis ; Endosonography ; Humans ; Logistic Models ; Male ; Mass Screening ; Middle Aged ; Predictive Value of Tests ; Prostate ; diagnostic imaging ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; diagnosis ; pathology ; Retrospective Studies ; Ultrasonography ; methods