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1.
BMJ Case Rep ; 14(9)2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479880

RESUMO

A 57-year-old man was admitted to our department reporting persistent low back and leg pain; this patient had undergone chemotherapy 1 year earlier for acute myeloid leukaemia (AML). During chemotherapy, he exhibited bilateral pneumonia due to Candida tropicalis, which was treated by specific antibiotic therapy, and septicaemia by Enterococcus faecalis MRI showed the presence of spondylodiscitis. A CT-guided needle biopsy was performed and the culture from the excised material tested positive for C. tropicalis We report a rare case of spondylodiscitis by C. tropicalis in a patient treated for AML, which, in turn, was followed by sepsis from E. faecalis and C. tropicalis Without adequate treatment, the disease is progressive, and leads to vertebral destruction with secondary kyphosis and neural or spinal cord compression. Although MRI has high sensitivity in the diagnosis of spondylodiscitis, open or needle biopsy allows to identify the aetiology.


Assuntos
Discite , Compressão da Medula Espinal , Biópsia por Agulha , Discite/diagnóstico por imagem , Discite/tratamento farmacológico , Humanos , Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade
2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 43(4): 584-589, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34494530

RESUMO

Objective To investigate the clinical value of core-needle biopsy(CNB)for low-risk papillary thyroid microcarcinoma(PTMC)after radiofrequency ablation(RFA). Methods A total of 190 patients(including 142 females and 48 males,20-74 years old)with unifocal low-risk PTMCs[mean volume of(106.29±96.15)mm3]treated by RFA from June 2016 to September 2018 were evaluated in this study.During the RFA procedure,enlarged ablation was performed.Patients were followed up 1,3,6,12 months after RFA and every 6 months thereafter.The volume of ablation area and the volume reduction ratio(VRR)were calculated.To evaluate the ablation performance,CNB was performed to the central zone,the peripheral zone,and surrounding thyroid parenchyma 3 or 6 months after RFA. Results The mean follow-up time was(30.04±12.41)months.The mean volume of tumor significantly decreased from(106.29±96.15)mm3 to(1.47±8.00)mm3.Two ablated tumors were diagnosed to have residue by CNB and underwent additional RFA.No recurrence,metastatic lymph nodes,or distal metastasis were found during the follow-up.All the patients were tolerable to RFA and CNB procedure. Conclusion CNB can be used to evaluate the ablation performance after RFA for low-risk PTMC.


Assuntos
Carcinoma Papilar , Ablação por Radiofrequência , Adulto , Idoso , Biópsia por Agulha , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide , Ultrassonografia de Intervenção , Adulto Jovem
3.
Medicine (Baltimore) ; 100(34): e26985, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34449467

RESUMO

BACKGROUND: The management of aspirin before transrectal prostate puncture-guided biopsy continues to be controversial. The conclusions in newly published studies differ from the published guideline. Therefore, an updated meta-analysis was performed to assess the safety of continuing to take aspirin when undergoing a transrectal ultrasound-guided prostate biopsy (TRUS-PB). METHODS: We searched the following databases for relevant literature from their inception to October 30, 2020: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Medline, Web of Science, Sinomed, Chinese National Knowledge Internet, and WANGFANG. Studies that compared the bleeding rates between aspirin that took aspirin and non-aspirin groups were included. The quality of all included studies was evaluated using the Newcastle-Ottawa Scale. Revman Manger version 5.2 software was employed to complete the meta-analysis to assess the risk of hematuria, hematospermia, and rectal bleeding. RESULTS: Six articles involving 3373 patients were included in this meta-analysis. Our study revealed that compared with the non-aspirin group, those taking aspirin exhibited a higher risk of rectal bleeding after TRUS-PB (risk ratio [RR] = 1.27, 95% confidence interval [CI] [1.09-1.49], P = .002). Also, the meta-analysis results did not reveal any significant difference between the 2 groups for the risk of hematuria (RR = 1.02, 95%CI [0.91-1.16], P = .71) and hematospermia (RR = 0.93, 95%CI [0.82-1.06], P = .29). CONCLUSION: Taking aspirin does not increase the risk of hematuria and hematospermia after TRUS-PB. However, the risk of rectal bleeding, which was slight and self-limiting, did increase. We concluded that it was not necessary to stop taking aspirin before undergoing TRUS-PB.


Assuntos
Aspirina/efeitos adversos , Biópsia por Agulha/efeitos adversos , Inibidores da Agregação Plaquetária/efeitos adversos , Aspirina/administração & dosagem , Ensaios Clínicos como Assunto , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/etiologia , Hematúria/induzido quimicamente , Hematúria/etiologia , Hemospermia/induzido quimicamente , Hemospermia/etiologia , Humanos , Masculino , Inibidores da Agregação Plaquetária/administração & dosagem , Próstata/patologia , Neoplasias da Próstata/patologia , Ultrassonografia de Intervenção
4.
Oncol. (Guayaquil) ; 31(2): 155-163, 31 de agosto 2021.
Artigo em Espanhol | LILACS | ID: biblio-1284458

RESUMO

Introducción: Los nódulos tiroideos se presentan entre el 4 al 8 % de la población, de los cuales hasta el 15% tienen etiología neoplásica. Las nódulos sospechosos de malignidad requieren la realización de punción, aspiración con aguja fina (PAAF) y la citología maligna reportada mediante sistema Bethesda tiene que ser corroborada con el estudio anatomopatólógico una vez realizada la excisión nodular. El objetivo del presente estudio es presentar la experiencia de un centro de referencia de pacientes con nódulos tiroideos. Metodología: Se realizó un estudio descriptivo, transversal, retrospectivo en el Servicio de Endocrinología del Hospital General del Norte de Guayaquil IESS CEIBOS, desde Junio 2017 a Julio 2019. El Universo estuvo compuesto por todos los casos con diagnóstico de nódulo tiroideo que requirieron PAAF. Se utiliza en sistema Bethesda para los reportes. Resultados: Fueron 349 casos de pacientes con nódulos tiroideos, mujeres (89%), edad entre 60 ­ 69 años (26%). 71 casos (21%) BETHESDA I; 220 casos (63%) BETHESDA II; 11 casos (3%) BETHESDA III; 15 casos (4%) BETHESDA IV; 15 casos (4%) BETHESDA V; y 17 casos (5%) BETHESDA VI. Malignidad de los nódulos tiroideos post en BETHESDA I 1%; de BETHESDA II 21%; BETHESDA III 56%, BETHESDA IV, 33%; BETHESDA V 71%; y BETHESDA VI 100%. Conclusión: La citología Benigna (Bethesda II) fue la más predominante, seguido de la Citología Insatisfactoria (Bethesda I) con un 21%.En la población estudiada el riesgo real de malignidad en los nódulos tiroideos que fueron intervenidos quirúrgicamente de las Categorías de diagnóstico citopa-tológicas BETHESDA II, IV, V y VI, confirmado por histopatología; fueron similares a lo esperado en-contrándose dentro del rango estimado por el Sistema Bethesda 2017. La categoría citopatológica Bethesda III (AUS/FLUS) presentó una tasa de malignidad más alta que el límite superior descrito por el Sistema Bethesda 2017, confirmando la necesidad de mayores estudios en este tipo de pacientes.


Introduction: Thyroid nodules occur between 4 to 8% of the population, of which up to 15% have neoplastic etiology. Nodules suspected of malignancy require puncture, fine needle aspiration (FNA) and the malignant cytology reported by the Bethesda system must be corroborated with the pathological study once the nodular excision has been performed. The objective of this study is to present the experience of a referral center for patients with thyroid nodules. Methodology: A descriptive, cross-sectional, retrospective study was carried out in the Endocriology Service of the General Hospital of the North of Guayaquil IESS CEIBOS, from June 2017 to July 2019. The Universe was made up of all the cases with a diagnosis of thyroid nodule that required PAAF. It is used in the Bethesda system for reports. Results: There were 349 cases of patients with thyroid nodules, women (89%), aged between 60 - 69 years (26%). 71 cases (21%) BETHESDA I; 220 cases (63%) BETHESDA II; 11 cases (3%) BETHESDA III; 15 cases (4%) BETHESDA IV; 15 cases (4%) BETHESDA V; and 17 cases (5%) BETHESDA VI. Post thyroid nodule malignancy in BETHESDA I 1%; of BETHESDA II 21%; BETHESDA III 56%, BETHESDA IV, 33%; BETHESDA V 71%; and BETHESDA VI 100%. Conclusion: Benign cytology (Bethesda II) was the most predominant, followed by Unsatisfactory Cytology (Bethesda I) with 21%. In the population studied, the real risk of malignancy in thyroid nod-ules that underwent surgery from the Diagnostic Categories cytopathological BETHESDA II, IV, V and VI, confirmed by histopathology; were similar to what was expected, and were within the range esti-mated by the 2017 Bethesda System. The Bethesda III cytopathological category (AUS / FLUS) pre-sented a higher malignancy rate than the upper limit described by the 2017 Bethesda System, con-firming the need for further studies in this type of patient.


Introdução: Os nódulos tireoidianos ocorrem em 4-8% da população, dos quais até 15% têm etiologia neoplásica. Os nódulos com suspeita de malignidade requerem punção, aspiração por agulha fina (FNA) e a citologia maligna relatada pelo sistema de Bethesda deve ser corroborada com o estudo patológico, uma vez que a excisão nodular tenha sido realizada. O objetivo deste estudo é apresentar a experiência de um centro de referência para pacientes com nódulos tireoidianos. Metodologia: Foi realizado um estudo descritivo, transversal e retrospectivo no Serviço de Endocrinologia do Hospital Geral do Norte de Guayaquil IESS CEIBOS, de junho de 2017 a julho de 2019. O Universo foi composto por todos os casos com diagnóstico de nódulo tireoidiano que exigia FNA. É usado no sistema Bethesda para relatórios. Resultados: Houve 349 casos de pacientes com nódulos tireoidianos, mulheres (89%), com idades entre 60-69 anos (26%). 71 casos (21%) BETHESDA I; 220 casos (63%) BETHESDA II; 11 casos (3%) BETHESDA III; 15 casos (4%) BETHESDA IV; 15 casos (4%) BETHESDA V; e 17 casos (5%) BETHESDA VI. Malignidade pós-nódulo tireoidiano em BETHESDA I 1%; de BETHESDA II 21%; BETHESDA III 56%, BETHESDA IV, 33%; BETHESDA V 71%; e BETHESDA VI 100%. Conclusão: A citologia benigna (Bethesda II) foi a mais predominante, seguida da Citologia Insatisfatória (Bethesda I) com 21%. Na população estudada, o risco real de malignidade em nódulos de tireoide operados das Categorias de Diagnóstico Citopático tológico BETHESDA II, IV, V e VI, confirmados por histopatologia; foram semelhantes ao esperado, e estiveram dentro da faixa estimada pelo Sistema Bethesda 2017. A categoria citopatológica Bethesda III (AUS / FLUS) apresentou uma taxa de malignidade superior ao limite superior descrito pelo Sistema Bethesda 2017, confirmando a necessidade de mais estudos nesse tipo de paciente.


Assuntos
Humanos , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Biópsia por Agulha Fina , Biópsia por Agulha , Estudos Transversais
6.
Int J Lab Hematol ; 43 Suppl 1: 23-28, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34288439

RESUMO

This paper aims to emphasize the importance of applying international consensus guidelines to detect qualitative and quantitative abnormalities of megakaryocytes on smears of bone marrow aspirates (BMA) for a shared and harmonized diagnostic path between different laboratories. Careful evaluation of megakaryocytes on BMA smears represents a cornerstone in the diagnosis of most clonal and nonclonal hematological diseases. Images associated with the detailed morphologic description of normal, reactive, abnormal, and dysplastic megakaryocytes are also reported together with examples of similar cells that, if not promptly identified, can lead to a morphological misdiagnosis.


Assuntos
Células da Medula Óssea/citologia , Células da Medula Óssea/patologia , Medula Óssea/patologia , Megacariócitos/citologia , Megacariócitos/patologia , Biópsia por Agulha , Diagnóstico Diferencial , Histocitoquímica/métodos , Humanos , Microscopia/métodos , Trombopoese
7.
Int J Comput Assist Radiol Surg ; 16(8): 1393-1401, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34224068

RESUMO

PURPOSE: We present the validation of PROST, a robotic device for prostate biopsy. PROST is designed to minimize human error by introducing some autonomy in the execution of the key steps of the procedure, i.e., target selection, image fusion and needle positioning. The robot allows executing a targeted biopsy through ultrasound (US) guidance and fusion with magnetic resonance (MR) images, where the target was defined. METHODS: PROST is a parallel robot with 4 degrees of freedom (DOF) to orient the needle and 1 DOF to rotate the US probe. We reached a calibration error of less than 2 mm, computed as the difference between the needle positioning in robot coordinates and in the US image. The autonomy of the robot is given by the image analysis software, which employs deep learning techniques, the integrated image fusion algorithms and automatic computation of the needle trajectory. For safety reasons, the insertion of the needle is assigned to the doctor. RESULTS: System performance was evaluated in terms of positioning accuracy. Tests were performed on a 3D printed object with nine 2-mm spherical targets and on an anatomical commercial phantom that simulates human prostate with three lesions and the surrounding structures. The average accuracy reached in the laboratory experiments was [Formula: see text] in the first test and [Formula: see text] in the second test. CONCLUSIONS: We introduced a first prototype of a prostate biopsy robot that has the potential to increase the detection of clinically significant prostate cancer and, by including some level of autonomy, to simplify the procedure, to reduce human errors and shorten training time. The use of a robot for the biopsy of the prostate will create the possibility to include also a treatment, such as focal ablation, to be delivered through the same system.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Biópsia Guiada por Imagem/métodos , Neoplasias da Próstata/diagnóstico , Robótica/métodos , Software , Biópsia por Agulha/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Imagens de Fantasmas , Projetos Piloto , Ultrassonografia
8.
Br J Radiol ; 94(1125): 20210475, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34289324

RESUMO

OBJECTIVES: To determine biopsy device failures, causative factors, complications and sample quality of the 16G end-cut Biopince™ and side-notch Bard™ needles. METHODS: All ultrasound-guided non-targeted liver biopsies between 01/01/2016 and 31/12/2018 were included. Operator, device, number of failures, complications and repeat biopsies were recorded. Histopathology samples were reviewed for all cases of needle failure and a group with no failures, and graded "yes/no" for the presence of steatosis, inflammation and fibrosis. The pathology slides from these cases were reviewed to assess biopsy sample quality (length and portal tract number). The failure and no-failure groups were compared in terms of device type/histology, and sample quality was compared between the needle types. RESULTS: 1004 patients were included. 93.8% (n = 942) required one needle pass to obtain a sample and 6.2% (n = 62) required >1 pass due to needle failure. Total of 76 needle failures, more with end-cut than side-notch needles (8.7% vs 2.9%) (p < 0.001). No needle failures resulted in complication. The presence of liver fibrosis was associated with fewer needle failures (p = 0.036). The major complication rate was 0.4% (4/1044). A biopsy with >10 portal tracts was obtained in 90.2% of specimens > 20 mm long, compared with 66% of 16-20 mm biopsies and 21% of <16 mm biopsies. The target of >10 portal tracts was achieved in 10/26 (38.5%) of side-notch biopsies and 64/90 (71.1%) of end-cut biopsies (p = 0.004). CONCLUSION: Ultrasound-guided liver biopsy is safe and sample quality is consistently good when a core >20 mm long is obtained. The end-cut biopsy device generated reliably good quality biopsy samples; however, the needle failure rate was significantly higher than the side-cut needle. ADVANCES IN KNOWLEDGE: Ultrasound-guided liver biopsy specimen quality is consistently good when a core >20 mm long is obtained which can be achieved with a single pass using the 16G BiopinceTM end-cut needle, although the needle failure rate is significantly higher than the 16G Max-Core™ Bard™ side-notch needle.


Assuntos
Falha de Equipamento/estatística & dados numéricos , Fígado/patologia , Ultrassonografia de Intervenção/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha/instrumentação , Biópsia por Agulha/métodos , Desenho de Equipamento , Feminino , Humanos , Biópsia Guiada por Imagem/instrumentação , Biópsia Guiada por Imagem/métodos , Fígado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
9.
Nihon Shokakibyo Gakkai Zasshi ; 118(6): 562-570, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-34108356

RESUMO

Contrast medium-enhanced computed tomography revealed a mass in the liver of a 65-year-old man. The edge but not the center of the mass was enhanced. Ultrasonography-guided percutaneous needle biopsy revealed the diagnosis of angiosarcoma of the liver, and it was treated with chemotherapy. Angiosarcoma of the liver has various appearances on imaging and is not often diagnosed while patients are alive. If the tumor is difficult to diagnose by imaging and thought to be unresectable, a biopsy can help in guiding treatment, but treatment should be adapted with caution.


Assuntos
Hemangiossarcoma , Neoplasias Hepáticas , Idoso , Autopsia , Biópsia por Agulha , Hemangiossarcoma/diagnóstico por imagem , Humanos , Fígado , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Ultrassonografia
10.
Vet Surg ; 50(5): 933-943, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33969898

RESUMO

OBJECTIVE: Design 3D printed skull contoured brain biopsy guides (3D-SCGs) from computed tomography (CT) or T1-weighted magnetic resonance imaging (T1W MRI). STUDY DESIGN: Feasibility study. SAMPLE POPULATION: Five beagle dog cadavers and two client-owned dogs with brain tumors. METHODS: Helical CT and T1W MRI were performed on cadavers. Planned target point was the head of the caudate nucleus. Three-dimensional-SCGs were created from CT and MRI using commercially available open-source software. Using 3D-SCGs, biopsy needles were placed into the caudate nucleus in cadavers, and CT was performed to assess needle placement accuracy, followed by histopathology. Three-dimensional-SCGs were then created and used to perform in vivo brain tumor biopsies. RESULTS: No statistical difference was found between the planned target point and needle placement. Median needle placement error for all planned target points was 2.7 mm (range: 0.86-4.5 mm). No difference in accuracy was detected between MRI and CT-designed 3D-SCGs. Median needle placement error for the CT was 2.8 mm (range: 0.86-4.5 mm), and 2.2 mm (range: 1.7-2.7 mm) for MRI. Biopsy needles were successfully placed into the target in the two dogs with brain tumors and biopsy was successfully acquired in one dog. CONCLUSION: Three-dimensional-SCGs designed from CT or T1W MRI allowed needle placement within 4.5 mm of the intended target in all procedures, resulting in successful biopsy in one of two live dogs. CLINICAL SIGNIFICANCE: This feasibility study justifies further evaluation of 3D-SCGs as alternatives in facilities that do not have access to stereotactic brain biopsy.


Assuntos
Neoplasias Encefálicas/veterinária , Doenças do Cão/patologia , Imageamento por Ressonância Magnética/veterinária , Modelos Anatômicos , Impressão Tridimensional , Crânio , Animais , Biópsia/veterinária , Biópsia por Agulha/métodos , Biópsia por Agulha/veterinária , Encéfalo , Neoplasias Encefálicas/patologia , Cadáver , Doenças do Cão/diagnóstico , Cães , Estudos de Viabilidade , Imageamento por Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/veterinária
11.
BMC Cancer ; 21(1): 501, 2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-33947348

RESUMO

BACKGROUND: The objective of this study is to investigate the clinical significance and risk factors of upgrading in the International Society of Urological Pathology (ISUP) Grade Group System in men undergoing robot-assisted radical prostatectomy (RARP) for prostate cancer. METHODS: A total of 583 patients diagnosed with prostate cancer by systematic biopsy were treated with RARP without neoadjuvant therapy from November 2011 to December 2018. Clinicopathological data were obtained from our clinical records. ISUP grade upgrading (IGU) was defined as 'ISUP grade in prostatectomy specimen determined to be higher than that in the biopsy specimen'. Clinicopathological factors, including age, PSA, prostate volume at biopsy (PV), PSA density, clinical stage, body mass index (BMI), interval from biopsy to prostatectomy, maximum percentage of cancer involvement per core (%CI), total number of biopsy cores, percentage of cancer positive biopsy cores (%PC), and sampling density were analyzed to detect potential risk factors of IGU. Biochemical recurrence (BCR) rates were calculated to analyze the effect of IGU on cancer prognosis. RESULTS: In univariate analysis, BMI was a positive predictor of IGU, while %CI, %PC, and sampling density were negative predictors of IGU. BMI and %PC were statistically significant predictors of IGU in multivariate analysis. For cases diagnosed as ISUP grade group 2 or higher at biopsy, there was a significant difference in BCR rates between cases with and without IGU. CONCLUSIONS: The results from our cohort showed that elements of both high-grade cancer risk (such as BMI) and sampling efficiency (such as %PC) contribute to IGU. Excluding cases diagnosed as ISUP grade group 1 at biopsy, BCR-free rates were significantly worse in cases with IGU, highlighting the need for more accurate pathological diagnosis at biopsy.


Assuntos
Prostatectomia/métodos , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Idoso , Análise de Variância , Biópsia por Agulha , Índice de Massa Corporal , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Próstata/patologia , Antígeno Prostático Específico/análise , Prostatectomia/estatística & dados numéricos , Neoplasias da Próstata/química , Fatores de Risco , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos , Sociedades Médicas , Urologia
13.
Cardiovasc Intervent Radiol ; 44(8): 1223-1230, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34021378

RESUMO

PURPOSE: To assess the effect of extrapleural autologous blood injection (EPABI) technique on pneumothorax development before and after coaxial needle withdrawal (CNW) and intervention rate for pneumothorax. To analyze the risk factors of pneumothorax and parenchymal hemorrhage. MATERIALS AND METHODS: The records of 288 patients who had lung biopsies were analyzed. Of these patients, 188 received EPABI (group-A) before penetrating the parietal pleura, and the remaining did not (group-B). Intraparenchymal autologous blood patch injection was applied at the end of the procedure. The pneumothorax rates before/after CNW and intervention requirement for pneumothorax were compared between groups. The risk factors of pneumothorax before/after CNW and parenchymal hemorrhage were assessed with stepwise logistic regression. RESULTS: The pneumothorax rate before CNW was significantly lower in group-A (5.92%) than in group-B (19.10%) (p = 0.029). Pneumothorax risk before CNW was reduced if EPABI was applied and skin-to-pleura distance increased. The pneumothorax rate after CNW was similar between two groups (group-A: 6.94%, group-B: 8%), while emphysema grade along the needle path and procedure duration was the significant risk factor. The intervention requirement for pneumothorax was significantly lower in group-A (6.38%) than in group-B (16%) (p = 0.012). Needle aspiration requirement was significantly reduced in group-A. The rate of external drainage catheter and chest tube placement was similar in both groups. The risk factors of parenchymal hemorrhage were overall emphysema grade of the lung, target-to-pleura distance, and target size. CONCLUSION: Use of EPABI along with IAPBI significantly decreased the pneumothorax rate during biopsy procedure and the intervention rate compared to IAPBI-alone.


Assuntos
Placa de Sangue Epidural/métodos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pneumotórax/terapia , Radiografia Intervencionista/métodos , Tomografia Computadorizada por Raios X/métodos , Idoso , Biópsia por Agulha/efeitos adversos , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Pessoa de Meia-Idade , Pneumotórax/etiologia , Estudos Retrospectivos , Resultado do Tratamento
14.
Virchows Arch ; 479(1): 215-220, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34028621

RESUMO

Multilocular thymic cyst (MTC) and germ cell tumors are common diseases that impact the mediastinum. Correctly diagnosing these diseases can be difficult because several other conditions can mimic them. We report a male patient with MTC associated with mediastinal seminoma. A needle biopsy of the mediastinal tumor revealed numerous epithelioid cell granulomas that mimicked sarcoidosis or mycobacterial infection. However, large atypical cells positive for Oct3/4 and KIT were noted between the granulomas; thus, we diagnosed the patient with mediastinal seminoma. The resected tumor, after chemotherapy, consisted of multiple cystic lesions, and a residual germ cell tumor was first considered. However, thymic medulla-specific elements, namely, POU2F3-positive thymic tuft cells and rhabdomyomatous myoid cells accompanying the epithelium, led to the correct diagnosis of MTC. Our case underscores the importance of recognizing the histological features associated with mediastinal seminoma and provides novel findings for MTC pathogenesis, namely, the presence of thymic tuft cells.


Assuntos
Biomarcadores Tumorais/análise , Proliferação de Células , Células Epitelioides , Cisto Mediastínico , Neoplasias do Mediastino , Fatores de Transcrição de Octâmero/análise , Seminoma , Biópsia por Agulha , Células Epitelioides/química , Células Epitelioides/patologia , Humanos , Masculino , Cisto Mediastínico/química , Cisto Mediastínico/patologia , Cisto Mediastínico/terapia , Neoplasias do Mediastino/química , Neoplasias do Mediastino/patologia , Neoplasias do Mediastino/terapia , Seminoma/química , Seminoma/patologia , Seminoma/terapia
15.
BMJ Case Rep ; 14(5)2021 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980551

RESUMO

Following an uncomplicated CT-guided transthoracic biopsy, a patient becomes unconscious and subsequently dies despite immediate cardiac resuscitation. The patient felt well during the procedure but started complaining about dizziness and chest pain when he sat up. When he again was put in a supine position, cardiac arrest was noted. A CT scan performed when the symptoms initiated was afterwards rigorously reviewed by the team and revealed air located in the left ventricle, aorta and right coronary artery.We present a rare but potentially lethal complication following CT-guided transthoracic needle biopsy-systemic vascular air embolus. Knowledge and evidence about the complication are sparse because of low incidence and varying presentation. However, immediate initiation of treatment can save a life, and awareness of the complication is therefore crucial.


Assuntos
Embolia Aérea , Biópsia por Agulha , Embolia Aérea/etiologia , Humanos , Biópsia Guiada por Imagem/efeitos adversos , Pulmão , Masculino , Agulhas , Tomografia Computadorizada por Raios X
16.
J Clin Neurosci ; 88: 102-107, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33992167

RESUMO

OBJECTIVE: Proton magnetic resonance spectroscopy (1H-MRS) can benefit the differentiation of gliomas preoperative grading and facilitate guiding biopsy. This study was to investigate the optimal metabolite or metabolic ratios of MRS for the biopsy target delineating by using the technique of MRS imaging guided frame-less stereotactic biopsy. METHODS: During a 4 year period between the Sep 2012 and Oct 2016, 57 patients (25 women, 32 men; mean age, 46.4) with histologic diagnosis of glioma, who underwent the 1H-MRS imaging guided frameless stereotactic biopsy, were retrospectively reviewed. The metabolite or metabolic ratios values of MRS was measured. And the sensitivity, specificity, accuracy as well as the area under the curve (AUC) of those parameters for glioma grading are calculated based on the receiver operating characteristic curve (ROC) analysis. RESULTS: 65 stereotactic biopsy samples from 57 patients were histopathologically clarified to HGGs (25) or LGGs (40) for quantitative analysis. The Cho, Cho/NAA and Cho/Cr values of LGGs group were significantly lower than that of HGGs (P = 0.09, 0.001, 0.003), and the NAA value of LGGs group was significantly higher than that of HGGs (P = 0.001). The cutoff value of 3.65 for the Cho/NAA ratio provided the best combination of sensitivity (92.0%), specificity (95.0%), and diagnostic accuracy (93.8%) for identifying glioma grade, which was superior to other parameters. CONCLUSION: The results of our study provided evidence that Cho/NAA ratio had the superior diagnostic performance in distinguishing glioma grade, indicating that the spot of highest Cho/NAA ratio was optimal metabolic targets for spectroscopic guided tissue sampling in homogenous glioma.


Assuntos
Neoplasias Encefálicas/patologia , Glioma/patologia , Biópsia Guiada por Imagem/métodos , Gradação de Tumores/métodos , Espectroscopia de Prótons por Ressonância Magnética/métodos , Adulto , Biópsia por Agulha/métodos , Neoplasias Encefálicas/cirurgia , Feminino , Glioma/cirurgia , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Técnicas Estereotáxicas
18.
Am J Surg ; 221(6): 1167-1171, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33810833

RESUMO

BACKGROUND: Surgical decisions for ductal carcinoma in situ (DCIS) are based on lesion sizes. This study aims to determine the accuracy of pre-operative imaging in estimating the size of DCIS. METHODS: This was a retrospective review of clinicopathologic data of patients treated for DCIS with breast conserving surgery (BCS) between 2012 and 2018. Mammographic and sonographic lesion sizes were compared with final pathology sizes. RESULTS: For the 152 lesions visible on mammography, mean size on imaging was significantly smaller when compared to final pathology (2.3 vs. 3.6 cm, p < 0.001). The mean difference of 1.3 cm was a significant underestimation with a correlation coefficient of 0.367 (p < 0.001). For 48 sonographically visible lesions, the radiologic size was significantly smaller than pathologic size (1.7 vs. 4.1 cm, p < 0.001), but the degree of underestimation was not significantly correlated (p = 0.379). CONCLUSION: DCIS size was significantly underestimated by imaging. This must be taken into consideration during surgical planning.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Mamografia , Ultrassonografia Mamária , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
Radiol Med ; 126(7): 956-962, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33843004

RESUMO

PURPOSE: To demonstrate the utility of a biopsy performed just before vertebroplasty in patients with diagnosis of vertebral compression fracture (VCF) and no history of neoplastic or hematologic diseases. BACKGROUND: Osteoporosis is the most frequent cause of vertebral compression fracture, with trauma and pathologic vertebral weakening being other common causes. Since secondary fractures at imaging investigation can present as simple compression fractures, it is important to identify an underlying pathology. The aim of this paper is to evaluate the frequency of unexpected positive histology in vertebral samples withdrawn from patients undergoing a vertebroplasty to evaluate if a vertebral biopsy can routinely be used in case of VCF and when a secondary cause is not suspected. METHODS: We retrospectively evaluated the results of 324 biopsies performed from February 2003 to March 2019 just before vertebroplasty in 1183 patients diagnosed with one or more vertebral compression fractures and with no history of neoplastic or hematological diseases and with no suspicious findings for secondary fractures at imaging. RESULTS: Biopsy was not diagnostic in 9/324 cases (2.8%); osteoporosis was the diagnosis in 295 cases (91%); in the remaining 20 cases (6.2%), histology was positive for an underlying pathology: 12/20 (60% of positive cases) multiple myeloma; 5/20 (25%) lymphoma/leukemia; 1/20 (5%) spondylitis; 1/20 (5%) metastasis; 1/20 (5%) hemangioma. A significantly higher incidence of positive biopsies was found in patients younger than 73 (p = 0.01) with 17 of 20 (85%) positive biopsies. No complications related to the bioptic maneuver were found, according to CIRSE guidelines on percutaneous needle biopsy. CONCLUSIONS: Vertebral biopsy is a safe procedure with no related complications. In our series, an unexpected diagnosis was found in 6% of cases with impact on patient's clinical management. Positive unexpected histology was significantly higher in younger patients. In conclusion, we believe that a biopsy is useful and should be performed on all patients with vertebral compression fractures before a vertebroplasty.


Assuntos
Biópsia por Agulha/estatística & dados numéricos , Fraturas por Compressão/diagnóstico , Vértebras Lombares/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico , Vertebroplastia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas por Compressão/cirurgia , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Período Pré-Operatório , Estudos Retrospectivos , Fraturas da Coluna Vertebral/cirurgia
20.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 52(2): 279-285, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-33829703

RESUMO

Objective: The deep learning method was used to automatically segment the tumor area and the cell nucleus based on needle biopsy images of breast cancer patients prior to receiving neoadjuvant chemotherapy (NAC), and then, the features of the cell clusters in the tumor area were identified to predict the level of pathological remission of breast cancer after NAC. Methods: 68 breast cancer patients who were to receive NAC at Jiangsu Province Hospital were recruited and the hematoxylin-eosin (HE) stained preoperative biopsy sections of these patients were collected. Unet++ was used to establish a segmentation model and the tumor area and nucleus of the needle biopsy images were automatically segmented accordingly. Then, according to the nuclei in the automatically segmented tumor area, the features of the cells in the tumor were constructed. After that, effective features were selected through the feature selection method and the classifier model was constructed and trained with five-fold cross validation to predict the degree of post-NAC pathological remission. Results: Predictions were made based on the needle biopsy images of the 68 patients. The model that combined the 10-dimensional features selected with the minimal redundancy-maximum-relevancy approach (mRMR) and training with the random forest (RF) classifier had the highest prediction accuracy, reaching 82.35%, and an area under curve ( AUC) value of 0.908 2. Conclusion: This model automatically segments tumor areas and cell nucleus on the biopsy images. The features of the cell clusters which are analyzed and identified in the tumor area can be used to predict the pathological response of the patient to NAC. The method is reliable and replicable. In addition, we found that the textural features of cells in the tumor area was a useful predictor of patient response to NAC, which further confirmed that cell cluster in the tumor area is of great significance to the prediction of treatment outcome.


Assuntos
Neoplasias da Mama , Terapia Neoadjuvante , Biópsia por Agulha , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Humanos , Imageamento por Ressonância Magnética , Resultado do Tratamento
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