Objective: The purpose of this study was to determine the accuracy of the pathologic diagnosis of papillary breast lesions when evaluated by percutaneous biopsy. Materials and Methods: A total of 2307 consecutive breast lesions, diagnosed by percutaneous biopsy, were retrospectively reviewed. Of these, 45 lesions were papillary lesions; 15 of the 45 cases were lost to follow-up or had not had imaging follow-up and were excluded. The remaining 30 papillary lesions constituted the study population. Subsequent surgical excision or imaging follow-up (a minimum of 6 months) was performed and correlated with the initial diagnoses. Results: Of the 30 lesions, 11 intraductal papillomas were diagnosed with stereotactic vacuum assisted biopsy (SVAB). Surgical excision was performed on four lesions (36.4%). Pathologic findings in all four lesions (100%) were benign. Of the 13 papillary lesions diagnosed with ultrasound-guided core needle biopsy, three (23.1%) demonstrated papillomatosis. Subsequent surgical excision was performed on 11 (84.6%) of the 13 papillary lesions, including two of the three papillomatosis. Pathology was benign in all. The two (18.2%) other lesions, initially diagnosed as papillomatosis and benign papilloma, were a fibroadenoma and organizing papillomatosis, respectively, at surgery. The six lesions that were sampled with fine needle aspiration (FNA) demonstrated intraductal papillary lesions, two (33.3%) of which had cytologic atypia. Surgical excision was performed on all six (100%) with benign breast tissue in four (66.7%) including one of the lesions demonstrating atypia. The two (33.3%) other lesions demonstrated high-grade invasive papillary carcinoma with in-situ components. Conclusion: Surgical excision is warranted when a percutaneous breast biopsy demonstrates a papillary lesion with atypia or when there is radiologic-pathologic discordance. Otherwise, these lesions can be followed conservatively. Furthermore, for improved diagnostic accuracy, indeterminate intraductal lesions should undergo biopsy with CNB or stereotactic vacuum assisted biopsy and not fine needle aspiration. The cytologic diagnosis of papillary lesions is considered only preliminary by fine needle aspiration, and should await surgical resection and histologic examination to further classify these lesions.
Brenner tumors represent about 1.4% to 2.5% of ovarian tumors and are rarely malignant. Extensive amorphous calcification in a solid mass or solid component in a multilocular cystic mass is a characteristic finding of Brenner tumor of the ovary on CT and MRI. We present clinical, radiologic,
Purpose:Improved knowledge of breast care and increased breast cancer screening is needed in underserved populations. Our purpose was to develop computer-based games to teach the principles of breast cancer detection and the benefits and limitations of mammography in a way that is culturally
Gynecomastia is the most common disorder of the breast in men, and is associated with cirrhosis, hypogonadism, chronic renal failure, and as a side effect from a wide range of drugs. We present the case of a 36-year-old man with bilateral gynecomastia as well as neurofibromatosis type 1 (NF1
Objective We reviewed our excisional biopsy findings in cases when core needle biopsy (CB) found lobular neoplasia (LN) as a primary diagnosis. We also correlated the core needle biopsy and excisional biopsy findings according to the quantitative and qualitative extent of lobular neoplasia found on the core needle biopsy specimen. Design We reviewed the mammographic findings and correlated the histopathological findings of core needle biopsy and subsequent surgical excision in cases when the diagnosis on core needle biopsy was lobular neoplasia. On the core needle biopsy the quantity of lobular neoplasia was categorized as involving one to two lobules, three to four lobules, or more than four lobules and qualitatively the lobular neoplasia was characterized as either atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS). Results In the twelve cases with lobular neoplasia alone on core needle biopsy, excision showed lobular neoplasia in seven cases, atypical ductal hyperplasia (ADH) in three cases, intraductal carcinoma in one case, and in one case infiltrating carcinoma (17% with carcinoma). From the ten cases when the diagnosis was lobular neoplasia and atypical intraductal hyperplasia on core needle biopsy, excision showed lobular neoplasia in four cases, ADH in two cases, intraductal carcinoma in two cases, and in two cases infiltrating carcinoma (40% with carcinoma). The quantitative or qualitative characterization of the lobular neoplasia on core needle biopsy did not prove to be a predictor of outcome in the subsequent excisional biopsies. Conclusions Although these results must be confirmed by larger studies our findings suggest that excisional biopsy should be performed when lobular neoplasia is diagnosed on core needle biopsy regardless of the radiologic findings or extent of lobular neoplasia on core needle biopsy.
The aim of this article is to assess the incidence of venous/lymphatic intravasation during hysterosalpingography (HSG), using iodinated non-ionic hydrosoluble contrast media, and the consequences that this condition involves. We have considered the major complications following intravasation; 1395 HSG performed in 9 years at our institute have been examined. The examination was performed through the application of exo-cervical cups or intracavitary Sholkoff catheters, injecting an average of 6 mL of non-ionic hydrosoluble contrast medium, with an iodine concentration of 320 to 370 mg I/mL. HSG was performed with digital equipment, under fluoroscopic control. We observed in 14 of 1395 patients (1%), 19 cases of intravasation; among them, 11 were venous (5 bilateral, 6 monolateral) and 3 were lymphatic (monolateral). Seven of fourteen patients presented HSG alterations of the tubal patency, represented by hydrosalpinx (4 patients, 5 tubes), monolateral tubal occlusion (1 patient, 1 case), bilateral tubal occlusion (1 patient, 2 cases), 1 case of monolateral salpingectomy, 1 case of Asherman's syndrome, and a mullerian malformation as the bicornuate uterus (1 case). Two patients showed concomitance of two alterations. 567 patients with alterations of the uterine/tubal patency did not report lymphatic-venous vessels intravasation or major complications. No patient with intravasation presented pulmonary or cerebral complications, or pelvic vessels thrombosis or late pelvic inflammatory disease. The venous/lymphatic opacification during HSG, using iodinated non-ionic hydrosoluble contrast media, does not represent a complication of the examination, because it is not linked to major complications. This event is not associated to predisposing anatomic conditions, such as tubal occlusion or endometrial-myometrial inflammation.
Nilay ŞEN Metin AKBULUT Şermin ÇOBAN Başak YILDIRIM Süleyman Ender DÜZCAN Pamukkale University School of Medicine, Deparment of Pathology, Denizli Pamukkale University School of Medicine, Deparment of Gynecology, Denizli Anahtar sözcükler : Sklerozan stromal tumör, over, patoloji
Primary abdominal pregnancy is a rare form of ectopic pregnancy. Secondary abdominal pregnancy after rupture of the uterus is extremely uncommon. We present a case of uterine rupture at 21 weeks of gestation with an intact extra-uterine abdominal amniotic sac and fetal demise, diagnosed preoperatively by sonography and MR. The fetus was delivered at emergency laparotomy and the uterine tear was repaired.
In vivo spectroscopy and imaging of the ovary at 3T can provide diagnostic information preoperatively on patients with ovarian masses. Here is the first report of a case where the in vivo MRI and MRS at 3T were undertaken on a patient with an ovarian mass distinguishing the malignant from the cystic component. Spectroscopy on biopsies obtained intraoperatively and recorded at 8.5T provided a diagnosis of poorly differentiated malignant tumor. The MR studies were undertaken blind and the diagnosis subsequently confirmed histologically.
Objective:To determine the role of magnetic resonance imaging (MRI) in surgical planning for females with pelvic floor dysfunction.Methods:This study included 29 females, 17 nulliparous females considered as control subjects and 12 patients with different varieties of pelvic floor dysfunctio
