Extensive Tuberculous Lymphadenitis Mimicking Distant Lymph Node Metastasis on F-18FDG PET/CT in a Patient with a History of Malignant Melanoma

18-Fluoredeoxyglucose position emission tomography and computed tomography (F-18FDG PET/CT) scanning has been useful in the evaluation of malignant disorders and has been extensively used in cancer screening.1 However, F-18FDG uptake was not found to be specific for cancer diagnosis. Here, we describe increased F-18FDG uptake on PET/CT caused by extensive tuberculous lymphadenitis in a 62-year-old woman with malignant melanoma.ope

Thyroid nodules ≤ 5 mm on ultrasonography: are they "leave me alone" lesions?

The incidence of small thyroid malignancy has increased. However, there is no evidence-based guideline for managing thyroid nodules ≤ 5 mm on ultrasonography (US). We evaluated how to manage thyroid nodules ≤ 5 mm. Thyroid nodules ≤ 5 mm in size on US that had undergone surgery and US-guided fine-needle aspiration were eligible. A total of 3,117 thyroid nodules in 3,012 patients were included. The size changes of malignant and benign nodules during follow-up were evaluated. Thyroid malignancies were classified according to follow-up and surgery time within and after 12 months. Clinico-pathological characteristics were compared. Of 3,117 nodules, 1,639 nodules in 1,619 patients were benign and 1,478 in 1,427 were malignant. Only 5.8 and 1.2 % of malignant nodules and 6.8 and 4.2 % of benign nodules increased in size when a 2-mm and 3-mm change on US were referenced. Of 1,079 patients with an index malignancy ≤ 5 mm, extrathyroidal extension, lymph node metastasis, recurrence, and mortality were not significantly different between patients with and without follow-up and between patients with surgery within 12 months and after 12 months. None of the patients who underwent surgery had distant metastasis and none died of thyroid malignancy. In thyroid nodules ≤ 5 mm found on US, US-FNA could be recommended in cases of increased size during US follow-up if lateral LNM was not found because a delay in surgery did not impact cancer recurrence and mortality.ope

Positive Predictive Value of BI-RADS US Category 4 and 5 Lesions

Purpose: To retrospectively analyze the positive predictive values (PPVs) of the lesions classified as categories 4 and 5 by using Breast Imaging Reporting and Data System (BI-RADS) ultrasonography (US). Materials and Methods: Between January 2012 and April 2012, the 558 lesion of 494 patients were reported BI-RADS US category 4 and 5. We reviewed the frequency, pathologic or clinical course. The PPVs for category 4a, 4b, 4c and 5 were evaluated. Results: Among the 558 lesions, the 395 lesions were pathologically confirmed as benign lesions and the 148 lesions were pathologically confirmed as malignant lesions. The 15 lesions were not pathologically confirmed. Among them, the 11 lesions were failed to follow up and 4 lesions are reassessed as category 3 lesions at the time of biopsy, which was scheduled to follow up rather than biopsy. The PPV for category 4 was 15.1% and the PPVs for subcategory 4a, 4b and 4c 5 were 7.8%, 60.0% and 78.1%. And the PPV for category 5 was 98.7%. Conclusion: In our hospital, the PPVs for BI-RADS US category 4a, 4b, 4c and 5 were presented to show the range of BI-RADS US, so it was appropriately subcategorized.ope

Needle Localization of Breast in Referral Center

Purpose: To retrospectively analyze the recent trend of the needle localization of the breast in reference hospital. Materials and Methods: Between March 2010 and June 2012, the 1966 breast lesions of 1286 patients were localized using hook wired needle for surgery. We retrospectively reviewed the type, numbers of the lesion of each patient, reason of the localization, and surgical methods. Results: A total of 1966 localizations were performed during this period. A hook wire was inserted by the radiologist, guided by ultrasonography (1684 cases) or stereotactic X - ray guidance (282 cases). The cause of needle localization was categorized as breast cancer (922 cases), satellite lesion in breast cancer patient (486 cases), benign or high risk lesion (476 cases), and microcalcifications which are only seen in mammography (82 cases). The number of lesion in each patient was divided as 1 lesion (759 cases), 2 lesions (439 cases), 3 lesions (95 cases) and more than 4 lesions ( 11 cases). Conclusion: The numbers of diagnostic needle localization has decreased due to core needle biopsy and stereotactic biopsy. Relatively, needle localization of nonpalpable breast cancer has much more increased.ope