Diagnostic dilemma of parotid lipomas: imaging versus fine needle aspiration cytology.

Lipomas are common soft tissue neoplasms; however, they are found rarely in the parotid gland region. The purpose of this study was to analyze the diagnostic challenges of this rare condition. We performed a retrospective analysis of 11 patients with parotid lipomas, treated from November 2009 to February 2014. The mean age at diagnosis was 46.6 ± 2.9 years, and the study population included 8 males and 3 females. Computed tomography (CT) and/or magnetic resonance imaging (MRI) were performed in radiological diagnosis. Fine needle aspiration (FNA) was performed in all cases (including two times in five patients, for a total of 16 biopsies) and results were diagnostic in four instances. Specificities of the CT, MRI, and FNA cytology tests were 100%, 100%, and 25% respectively. CT and/or MRI scans were more reliable than FNA cytologies for accurate diagnosis of parotid lipomas.

Fine needle aspiration cytology of head and neck masses: a cytohistopathological correlation study with emphasis on false positives and false negatives.

OBJECTIVES: This study aims to evaluate the accuracy ratio of fine needle aspiration (FNA) cytology in the diagnosis of non-thyroidal head and neck masses. PATIENTS AND METHODS: Between 2000 January and 2003 December, the pathology reports of 571 patients (297 males, 274 females; mean age 45 years; range 4 to 83 years) with non-thyroidal head and neck masses who underwent FNA cytology during a four year period were retrospectively analyzed. Cytopathological and histopathological results of the samples were recorded. The smear results indicating an inconsistency were reviewed. The possible causes of the false positivity and false negativity were investigated. RESULTS: Of a total of 571 patients, 181 had a confirmed histopathological diagnosis. The overall accuracy ratio, specificity, sensitivity, negative predictive value and positive predictive value of FNA in the diagnosis of the head and neck masses were 83%, 85%, 81%, 84%, 83%, respectively. CONCLUSION: The FNA has a high accuracy, sensitivity, specificity, negative and positive predictive values in the diagnosis of head and neck masses. If the major causes of misdiagnosis including inadequate sampling and misinterpretation are avoided, the diagnostic accuracy ratio of FNA in the head and neck and will be improved.

Do prostatic infarction, prostatic inflammation and prostate morphology play a role in acute urinary retention?

OBJECTIVE: To investigate whether there is a role of prostatic infarction, prostatic inflammation and prostate morphology in acute urinary retention (AUR) etiology. METHODS: Ninety-eight consecutive male patients who were admitted to our clinic with either AUR or lower urinary tract symptoms (LUTS) were involved in the study. Patient age ranged from 43 to 88 years (median age 70). Group 1 consisted of 53 (54%) patients with AUR, and Group 2 consisted of 45 (46%) patients with LUTS. In Group 1 and Group 2, 58.4% (n:31) and 62.2% (n:28) of the patients underwent transurethral prostate resection, 41.6% (n:22) and 37.8% (n:17) of the patients underwent suprapubic transvesical prostatectomy, respectively. Each patient was asked about the factors: smoking habits, taking previous general anesthesia and preexisting cardiovascular disease such as hypertention and atherosclerotic coronary vascular disease which may lead to AUR via prostatic infarct. Prostatic infarction, prostatic inflammation and prostatic morphology were examined in the patients' specimen. RESULTS: Mean age, median serum prostate-specific antigen (PSA) level, and prostatic inflammation ratio were significantly higher in Group 1. There were not significant differences between the groups regarding prostate volume, prostatic infarction ratio and a type of prostatic morphology. In the present study, except for taking previous general anesthesia and preexisting cardiovascular disease, only prostatic inflammation was found important contributory factor on AUR. AUR risk was 3.03 times higher in the patients with prostatic inflammation (95%CI 1.28-7.15) (p = 0.01). CONCLUSIONS: No significant effect of prostatic infarction was found on occurrence of AUR which was more frequent in elderly patients. Prostatic inflammation may have an important risk factor in AUR etiology. Additionally, serum PSA levels were higher in AUR group. No association was found between a type of prostatic morphology and AUR.