Background Image-guided core-needle biopsy as a minimally invasive procedure has partially replaced excisional biopsy of the lymph node. However, it is still a great challenge to pathologists. The aim of this study wa...Background Image-guided core-needle biopsy as a minimally invasive procedure has partially replaced excisional biopsy of the lymph node. However, it is still a great challenge to pathologists. The aim of this study was to survey and evaluate the accuracy of pathological diagnosis using the ultrasonography （US）-guided core-needle biopsy （CNB） of the lymph node.Methods Lymph node CNBs of 1119 consecutive patients from the Chinese People＇s Liberation Army （PLA） General Hospital were reviewed retrospectively. Biopsies were performed following outpatient procedures with direct US guiding by using 18-gauge cutting needle. The tissues of CNB were prepared according to the routine paraffin embedding and hematoxylin-eosin staining. Ancillary studies, including acid-fast staining and immunohistochemical staining, were performed when necessary.Results The age range was 1 year old to 85 years old. Locations of the lymph node were as follows： cervical area （n=482）, clavicular region （n=-227）, retroperitoneum （n=-150）, axilla （n=93）, groin （n=79）, abdomen/mesentery （n=44）,submaxillary region （n=-33）, postauricular region （n=4）, iliac rosa （n=3）, parotid （n=2）, hepatic hilar region （n=1）, and elbow （n=1）. The histological diagnoses were conclusive in 815 cases （73%） and inconclusive in 304 cases （27%）. The conclusive cases mainly included metastatic carcinoma （n=-449）, tuberculosis （n=111）, lymphoma/leukemia （n=124）, reactive hyperplasia （n=-87）, and other rare diseases （n=44）. The reasons for inconclusive cases were insufficient material for diagnosis, noncompliance of outpatients, or crushing artifacts of tissues caused by operation.Conclusions US-guided CNB can obtain lymphoid tissues from nearly all parts of the body for diagnostic purposes.Conclusive pathological diagnosis can be made in most of cases when adequate material was provided. Besides metastatic carcinoma,lymphomas with special immunophenotype can be accurately diagnosed 展开更多
Computed tomography (CT)-guided lung biopsy is a common diagnostic procedure that is associated with various complications, including pneumothorax, hemoptysis and parenchymal hemorrhage. Systemic air embolism is a ver...Computed tomography (CT)-guided lung biopsy is a common diagnostic procedure that is associated with various complications, including pneumothorax, hemoptysis and parenchymal hemorrhage. Systemic air embolism is a very rare (0.07%) but potentially lifethreatening complication. We report a fatal case of air embolism to the cerebral and coronary arteries confirmed by head and chest CT, followed by a review of the literature.展开更多
This study was designed to define possible preoperative predictors of positive surgical margin after laparoscopic radical prostatectomy. We retrospectively analyzed the records of 296 patients with prostate cancer dia...This study was designed to define possible preoperative predictors of positive surgical margin after laparoscopic radical prostatectomy. We retrospectively analyzed the records of 296 patients with prostate cancer diagnosed by prostate biopsy, and eventually treated with laparoscopic radical prostatectomy. The prognostic impact of age, prostate volume, preoperative prostate-specific antigen, biopsy Gleason score, maximum percentage tumor per core, number of positive cores, biopsy perineurat invasion, capsule invasion on imaging, and tumor laterality on surgical margin was assessed. The overall positive surgical margin rate was 29.1%. Gleason score, number of positive cores, perineural invasion, tumor laterality in the biopsy specimen, and prostate volume significantly correlated with risk of positive surgical margin by univariate analysis （P 〈 0.05）. Gleason score （odds ratio [OR] = 2.286, 95% confidence interval [95% CI] = 1.431-3.653, P= 0.001）, perineural invasion （OR = 4.961, 95% CI = 2.656-9.270, P〈 0.001）, and number of positive cores （OR = 4.403, 95% CI = 1.878-10.325, P = 0.001） were independent predictors of positive surgical margin at the multivariable logistic regression analysis. Patients with perineural invasion, higher biopsy Gleason scores and/or a large number of positive cores in biopsy pathology had more possibility of capsule invasion. The positive surgical margin rate in patients with capsule invasion （49.5%） was much higher than that with localized disease （17.8%）. In contrast, prostate volume showed a protective effect against positive surgical margin （OR = 0.572, 95% CI = 0.346-0.945, P = 0.029）. Gleason score, perineural invasion, and number of positive cores in the biopsy specimen were preoperative independent predictors of positive surgical margin after laparoscopic radical prostatectomy while prostate volume was a protective factor against positive surgical margin.展开更多
文摘Background Image-guided core-needle biopsy as a minimally invasive procedure has partially replaced excisional biopsy of the lymph node. However, it is still a great challenge to pathologists. The aim of this study was to survey and evaluate the accuracy of pathological diagnosis using the ultrasonography （US）-guided core-needle biopsy （CNB） of the lymph node.Methods Lymph node CNBs of 1119 consecutive patients from the Chinese People＇s Liberation Army （PLA） General Hospital were reviewed retrospectively. Biopsies were performed following outpatient procedures with direct US guiding by using 18-gauge cutting needle. The tissues of CNB were prepared according to the routine paraffin embedding and hematoxylin-eosin staining. Ancillary studies, including acid-fast staining and immunohistochemical staining, were performed when necessary.Results The age range was 1 year old to 85 years old. Locations of the lymph node were as follows： cervical area （n=482）, clavicular region （n=-227）, retroperitoneum （n=-150）, axilla （n=93）, groin （n=79）, abdomen/mesentery （n=44）,submaxillary region （n=-33）, postauricular region （n=4）, iliac rosa （n=3）, parotid （n=2）, hepatic hilar region （n=1）, and elbow （n=1）. The histological diagnoses were conclusive in 815 cases （73%） and inconclusive in 304 cases （27%）. The conclusive cases mainly included metastatic carcinoma （n=-449）, tuberculosis （n=111）, lymphoma/leukemia （n=124）, reactive hyperplasia （n=-87）, and other rare diseases （n=44）. The reasons for inconclusive cases were insufficient material for diagnosis, noncompliance of outpatients, or crushing artifacts of tissues caused by operation.Conclusions US-guided CNB can obtain lymphoid tissues from nearly all parts of the body for diagnostic purposes.Conclusive pathological diagnosis can be made in most of cases when adequate material was provided. Besides metastatic carcinoma,lymphomas with special immunophenotype can be accurately diagnosed
文摘Computed tomography (CT)-guided lung biopsy is a common diagnostic procedure that is associated with various complications, including pneumothorax, hemoptysis and parenchymal hemorrhage. Systemic air embolism is a very rare (0.07%) but potentially lifethreatening complication. We report a fatal case of air embolism to the cerebral and coronary arteries confirmed by head and chest CT, followed by a review of the literature.
文摘This study was designed to define possible preoperative predictors of positive surgical margin after laparoscopic radical prostatectomy. We retrospectively analyzed the records of 296 patients with prostate cancer diagnosed by prostate biopsy, and eventually treated with laparoscopic radical prostatectomy. The prognostic impact of age, prostate volume, preoperative prostate-specific antigen, biopsy Gleason score, maximum percentage tumor per core, number of positive cores, biopsy perineurat invasion, capsule invasion on imaging, and tumor laterality on surgical margin was assessed. The overall positive surgical margin rate was 29.1%. Gleason score, number of positive cores, perineural invasion, tumor laterality in the biopsy specimen, and prostate volume significantly correlated with risk of positive surgical margin by univariate analysis （P 〈 0.05）. Gleason score （odds ratio [OR] = 2.286, 95% confidence interval [95% CI] = 1.431-3.653, P= 0.001）, perineural invasion （OR = 4.961, 95% CI = 2.656-9.270, P〈 0.001）, and number of positive cores （OR = 4.403, 95% CI = 1.878-10.325, P = 0.001） were independent predictors of positive surgical margin at the multivariable logistic regression analysis. Patients with perineural invasion, higher biopsy Gleason scores and/or a large number of positive cores in biopsy pathology had more possibility of capsule invasion. The positive surgical margin rate in patients with capsule invasion （49.5%） was much higher than that with localized disease （17.8%）. In contrast, prostate volume showed a protective effect against positive surgical margin （OR = 0.572, 95% CI = 0.346-0.945, P = 0.029）. Gleason score, perineural invasion, and number of positive cores in the biopsy specimen were preoperative independent predictors of positive surgical margin after laparoscopic radical prostatectomy while prostate volume was a protective factor against positive surgical margin.
