Outcomes of high-risk breast lesions diagnosed using image-guided core needle biopsy: results from a multicenter retrospective study

PURPOSEThe clinical management of high-risk lesions using image-guided biopsy is challenging. This study aimed to evaluate the rates at which such lesions were upgraded to malignancy and identify possible predictive factors for upgrading high-risk lesions.METHODSThis retrospective multicenter analysis included 1.343 patients diagnosed with high-risk lesions using an image-guided core needle or vacuum-assisted biopsy (VAB). Only patients managed using an excisional biopsy or with at least one year of documented radiological follow-up were included. For each, the Breast Imaging Reporting and Data System (BI-RADS) category, number of samples, needle thickness, and lesion size were correlated with malignancy upgrade rates in different histologic subtypes. Pearson’s chi-squared test, the Fisher–Freeman–Halton test, and Fisher’s exact test were used for the statistical analyses.RESULTSThe overall upgrade rate was 20.6%, with the highest rates in the subtypes of intraductal papilloma (IP) with atypia (44.7%; 55/123), followed by atypical ductal hyperplasia (ADH) (38.4%; 144/375), lobular neoplasia (LN) (12.7%; 7/55), papilloma without atypia (9.4%; 58/611), flat epithelial atypia (FEA) (8.7%; 10/114), and radial scars (RSs) (4.6%; 3/65). There was a significant relationship between the upgrade rate and BI-RADS category, number of samples, and lesion size Lesion size was the most predictive factor for an upgrade in all subtypes.CONCLUSIONADH and atypical IP showed considerable upgrade rates to malignancy, requiring surgical excision. The LN, IP without atypia, pure FEA, and RS subtypes showed lower malignancy rates when the BI-RADS category was lower and in smaller lesions that had been adequately sampled using VAB. After being discussed in a multidisciplinary meeting, these cases could be managed with follow-up instead of excision

Normal ve komplike gebelerde renkli doppler ultrasonografi'nin yeri

TEZ649Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1999.Kaynakça (s. 73-80) var.82 s. : res. ; 30 cm.

Mediastinal hemangioma (Case report)

İyi huylu vasküler tümörler, mediastende nadir olup mediastinal hemanjiyom aralarında en sık görülenidir. Bununla birlikte, tüm mediastinal tümörler içerisinde sıklığı %0,5’ten azdır [1-4]. Posterior mediastinal hemanjiyomlar, anterior yerleşimli olanlara göre daha az görülürler [4,5]. Hemanjiyomlar, vasküler genişliklerine göre kapiller, kavernöz veya venöz olarak adlandırılırlar [6,7]. Bu çalışmada mediastinal kavernöz hemanjiyomlu bir olgu akciğer grafisi ve kontrastlı bilgisayarlı tomografi (BT) bulguları ile sunulmaktadır.We present radiographic and computed tomographic findings of a mediastinal hemangioma, a very rare benign vascular tumor that comprises less than 0.5% of all mediastinal masses. Posteroanterior chest film showed a homogeneous opacity in the left upper zone that was contiguous with the mediastinum. Computed tomography demonstrated a mediastinal mass with inhomogeneous contrast enhancement and a small calcification

Case report: Pedunculated leiomyosarcoma of the inferior vena cava

Leiomyosarcoma of the inferior vena cava is a rare mesenchymal tumor which originates from the smooth muscle cells of the vascular wall. Its radiographic presentation varies from that of intraluminal lesions resulting in obstruction of the inferior vena cava to those of giant retroperitoneal masses extending to the surrounding perivascular tissues although still with minimal intraluminal protrusion. In this report, we present one such case in which a 31-year-old woman had complaints of severe abdominal pain, abdominal distension and vomiting. Computed tomography demonstrated a giant well-defined right-sided retroperitoneal mass extending from the subhepatic region down to the pelvis. She was operated on and the tumor was discovered to be attached to the wall of the inferior vena cava with a peduncle, a leiomyosarcoma being proven histologically. CT features of this rare tumor are presented in this report.Leiomyosarcoma of the inferior vena cava is a rare mesenchymal tumor which originates from the smooth muscle cells of the vascular wall. Its radiographic presentation varies from that of intraluminal lesions resulting in obstruction of the inferior vena cava to those of giant retroperitoneal masses extending to the surrounding perivascular tissues although still with minimal intraluminal protrusion. In this report, we present one such case in which a 31-year-old woman had complaints of severe abdominal pain, abdominal distension and vomiting. Computed tomography demonstrated a giant well-defined right-sided retroperitoneal mass extending from the subhepatic region down to the pelvis. She was operated on and the tumor was discovered to be attached to the wall of the inferior vena cava with a peduncle, a leiomyosarcoma being proven histologically. CT features of this rare tumor are presented in this report

Cystic nephroma: Report of two pediatric cases

Cystic nephroma(CN) is an uncommon benign renal neoplasm that is characterised as a well circumscribed encapsulated mass that contains multiple noncommunicating fluid-filled locules. Microscopically, the locules are lined by epitelium and separated by a distinct $stroma^{1}$. Since its first discription in 1892 by Edmunds, there have been a little over 100 cases $reported^{1-3}$. Here, we report two pediatric cases, one male, one female with unilateral CN's.Cystic nephroma(CN) is an uncommon benign renal neoplasm that is characterised as a well circumscribed encapsulated mass that contains multiple noncommunicating fluid-filled locules. Microscopically, the locules are lined by epitelium and separated by a distinct $stroma^{1}$. Since its first discription in 1892 by Edmunds, there have been a little over 100 cases $reported^{1-3}$. Here, we report two pediatric cases, one male, one female with unilateral CN's

Breast metastasis of rhabdomyosarcoma: A case report

Metastasis to the breast in the pediatric age group is extremely rare. After leukemia and lymphoma, rhabdomyosarcoma and neuroblastoma are the most common tumors to metastasize to the breast in this age group. Without a known primary, the diagnosis can be a challange. Here, a pediatric patient with widespread metastases to both breasts from embryonal rhabdomyosarcoma imaged by ultrasound and magnetic resonance is presented.Metastasis to the breast in the pediatric age group is extremely rare. After leukemia and lymphoma, rhabdomyosarcoma and neuroblastoma are the most common tumors to metastasize to the breast in this age group. Without a known primary, the diagnosis can be a challange. Here, a pediatric patient with widespread metastases to both breasts from embryonal rhabdomyosarcoma imaged by ultrasound and magnetic resonance is presented

Unenhanced spiral CT in the diagnosis of acute appendicitis

AMAÇ Kontrastsız spiral bilgisayarlı tomografinin (BT) akut apandisit tanısındaki rolünü değerlendirmek. GEREÇ VE YÖNTEM Akut apandisit kliniği bulunan 34'ü (%52) kadın, 31'i (%48) erkek toplam 65 hastaya oral ve intravenöz kontrast madde verilmeden spiral modda BT inceleme yapıldı. Alınan topogram üzerinde L1 vertebra üst platosu düzeyinden iliyak kanat üst kesimine kadar 10 mm kolimasyon ve 8 mm/sn masa hızı; bu düzeyden asetabuler çatı düzeyine kadar ise 5 mm kolimasyon ve 5 mm/sn masa hızı ve 1.5 sn'lik kesit süresi kullanılarak çekim gerçekleştirildi. BT'de transvers çapı 6 mm'den fazla olan apendiks ve/veya apendikolite eşlik eden apendiks çevresinde iltihabi değişikliklerin gözlenmesi akut apandisit varlığını düşündürdü. BT sonuçları cerrahi uygulanan hastalarda operasyon bulguları ve patoloji sonuçları ile karşılaştırıldı. Operasyona alınmayan hastalar ise 3 ay süresince takip edildi. BULGULAR BT'de 65 hastanın 28'sinde (%43) akut apandisit düşünüldü ancak bunların 25'inde %38) operasyon ve patolojik inceleme sonucunda akut apandisit saptandı. Yirmibir (%32) hasta BT'de normal olarak değerlendirilirken; 16 hastada (%25) akut apandisite benzer klinik yaratan apandisit dışı patolojiler saptandı. Olguların 25’i gerçek pozitif, 35’i gerçek negatif, 3’ü yalancı pozitif ve 2’si yalancı negatifti. Kontrastsız spiral BT incelemenin akut apandisit tanısındaki duyarlılığı %93, özgüllüğü %92, doğruluk oranı %95, pozitif tahmin değeri %89 ve negatif tahmin değeri %95 olarak bulundu. SONUÇ Akut apandisit kliniği bulunan hastaların değerlendirilmesinde kontrastsız spiral BT doğru, güvenilir ve etkili bir yöntemdir. Ayrıca akut apandisit belirtilerini taklit eden diğer patolojileri göstermesi de avantajdır.PURPOSE: To evaluate the role of unenhanced spiral computed tomography (CT) in the work-up of patients with suspicious symptoms of acute appendicitis. MATERIALS AND METHODS: Sixty-five patients with suspected acute appendicitis (34 (52%) women and 31 (48%) men), were studied with spiral CT without administration of IV or oral contrast. From the upper L1 vertebral plate to the superior border of the iliac wings, slices of 10 mm collimation with 8 mm/sec table speed were taken, and from that level to the acetabular roof level, 5 mm thick slices were obtained with a table speed of 5 mm/sec and tube rotation time of 1.5 sec. The diagnosis of acute appendicitis was made by seeing a dilated appendix vermiformis greater than 6 mm in diameter and/or an appendicolith accompanied by periappendiceal inflammatory changes. The findings were compared with surgical and pathological results. Those patients who were not operated on were followed-up for 3 months. RESULTS: Acute appendicitis was diagnosed in 28 (43%) of the 65 patients. Of the 28 patients with a CT diagnosis of acute appendicitis, 25 (38%) had acute appendicitis proven by surgery and pathology. Twenty-one (32%) patients had a normal CT study and 16 (25%) patients had non-appendiceal pathologies. There were 25 true-positives, 35 true negatives, 3 false positives and 2 false negatives. Non-contrast helical CT had a sensitivity of 93%, specificity of 92%, accuracy of 95%, positive predictive value of 89% and negative predictive value of 95% in the diagnosis of acute appendicitis. CONCLUSION: Non-contrast CT is an accurate, reliable and efficacious method in the diagnosis of acute appendicitis. It also has the advantage of showing other pathologies mimicking the symptoms of acute appendicitis

Infantile malignant osteopetrosis

Osteopetrosis, also known as marble bone disease, is a rare in which osteoclast dysfunction causes defective bone resorption and increased bone mass. This disease has been classified into four types. The most severe and rare form is infantile malignant osteopetrosis. So we reported and discussed two siblings patients with infantile malignant osteopetrosis with new knowledge in the literature.Osteopetrosis, also known as marble bone disease, is a rare in which osteoclast dysfunction causes defective bone resorption and increased bone mass. This disease has been classified into four types. The most severe and rare form is infantile malignant osteopetrosis. So we reported and discussed two siblings patients with infantile malignant osteopetrosis with new knowledge in the literature