Postoperative Histopathological Results Research Articles

Is it safe to operate selected low-risk endometrial cancer patients in secondary hospitals?

IntroductionThe aim of this study was to assess the accuracy of a preoperative screening algorithm in identifying low-risk endometrial cancer (EC) patients to ensure optimal care. MethodsA total of 277 patients with primary EC confirmed through biopsy underwent magnetic resonance imaging (MRI). Patients with risk factors for advanced high-risk EC, such as non-endometrioid histology, high-grade differentiation status, deep myometrial invasion, or spread beyond the uterine corpus, were systematically excluded. The remaining preoperatively screened patients with stage IA low-grade endometrioid EC (EEC) (n = 93) underwent surgery in a tertiary hospital. The accuracy of the preoperative diagnosis was evaluated by comparing the findings with the postoperative histopathological results. Disease-free survival (DFS) and overall survival (OS) were analyzed using 8-year follow-up data. ResultsPostoperative histopathological analysis revealed that all patients had grade 1–2 EEC localized to the corpus uteri. Only three patients had deep myometrial invasion (stage IB), but they remained disease-free after 6–9 years of follow-up. The median follow-up time for all patients was 8.7 years. The DFS was 7.6 years, and the OS was 8.6 years. Two patients with stage IA grade 1 EEC experienced relapse and, despite treatment, died of EC. No other EC-related deaths occurred. ConclusionsThe screening algorithm accurately identified low-risk EC patients without compromising survival. Therefore, the algorithm appears to be feasible for selecting patients for surgery in secondary hospitals.

TIRADS and BETHESDA correlation to histopathological results of thyroid nodules: a case series at Dr. Sardjito General Hospital, Yogyakarta

Early diagnosis of thyroid nodules is necessary to identify malignancy before surgery. Fine needle aspiration (FNA) and ultrasonography (USG) are supporting examinations for diagnosing thyroid tumors. There have been several previous studies related to the sensitivity of each investigation compared to postoperative biopsy findings. Both have different diagnostic values, and it is hoped that if these two diagnostic methods are applied before surgery, they will have a higher sensitivity value in determining the type of thyroid nodule compared to a single examination. A single-center retrospective case series study. Socio-demographic and clinical data were obtained from hospital records. This study included six thyroid nodule cases, consisting of three (50%) women and three (50%) men. Patients had the appearance and clinical symptoms of swelling in the neck (100%), of which 50% had symptoms of difficulty swallowing and 16% had symptoms of shortness of breath. Three (50%) patients underwent isthmolobectomy, and 3 (50%) patients underwent total thyroidectomy. Three (50%) patients suspected of approaching malignancy based on TIRADS and BETHESDA underwent total thyroidectomy with postoperative histopathological results of non-malignancy. Three (50%) patients with suspected benign nodules based on TIRADS and BETHESDA underwent isthmolobectomy, with postoperative histopathological results indicating non-malignancy. The concordance of the results of the ultrasound examination (TIRADS) and histopathology of thyroid nodules before surgery (BETHESDA) compared with the results of the postoperative histopathological examination was 50%.

Clinical characteristics and surgical outcomes in pediatric progressive restrictive strabismus

Objective: To investigate the clinical features, imaging manifestations, histopathological characteristics, and surgical outcomes in pediatric progressive restrictive strabismus. Methods: A retrospective case series study was conducted, including data from 9 cases (9 eyes) of pediatric progressive restrictive strabismus treated at Tianjin Eye Hospital from June 2017 to October 2022. The study compared the degree of globe protrusion in both eyes, changes in eyelid fissure height during internal and external rotation in the primary gaze, summarized clinical characteristics, and analyzed intraoperative conditions, surgical outcomes and postoperative histopathological results of strabismus correction surgery. Statistical analysis was performed using Wilcoxon signed-rank test and Friedman two-way analysis of variance. Results: All 9 cases involved unilateral onset, with 4 males and 5 females. Three cases affected the right eye, and six affected the left eye. Onset age ranged from 2 to 40 months. The degree of globe protrusion in the affected eyes was 13.00 (12.00, 13.00) mm for the right eye and 12.00 (12.00, 13.50) mm for the left eye, with no statistically significant difference (Z=-1.00, P=0.317). There were no significant changes in eyelid fissure height during internal rotation [8.00 (7.25, 8.00) mm], primary gaze [7.50 (7.00, 8.00) mm], and external rotation [8.00 (7.75, 8.00) mm] in the affected eyes (χ²=1.00, P=0.607). No apparent abnormalities were observed in head CT or MRI scans, serum, or immunological tests. However, orbital CT or MRI scans indicated thickening of different extraocular muscle bellies. Six out of nine cases underwent strabismus correction surgery, and postoperative examination revealed restriction in eye movement despite achieving orthophoria in the primary gaze. Tissue pathology of three cases showed increased collagen fiber proliferation in one, scattered bundles of smooth muscle fibers amid diffuse collagen fiber proliferation in another, and abnormal proliferation of striated muscle fibers with varying diameters, increased paired box (PAX)7-positive satellite cells expressing slow muscle myosin in the third case. Conclusions: Pediatric progressive restrictive strabismus presents with restrictive changes, without significant alterations in globe protrusion and eyelid fissure height. Imaging examinations reveal thickening of the extraocular muscle bellies in the affected eye. Although strabismus correction surgery improves eye position, postoperative eye movement remains restricted. Histopathological findings in some cases show abnormal proliferation of skeletal muscle fibers or collagen fibers.

Evaluation of testicular blood flow during testicular torsion surgery in children using the indocyanine green-guided near-infrared fluorescence imaging technique.

This study investigates the feasibility of the indocyanine green-guided near-infrared fluorescence (ICG-NIRF) imaging technique in evaluating testicular blood flow during testicular torsion (TT) surgery in pediatric cases. We retrospectively analyzed the eight pediatric patients with TT who underwent surgery in our hospital between February and July 2023. The intraoperative two-step method of ICG-NIRF imaging and testicular incision was used to evaluate the testicular blood flow, followed by a selection of different surgical methods. The removed testes were pathologically examined after surgery, and all patients were followed up 1 month after surgery to evaluate testicular blood flow using gray-scale ultrasound and color Doppler flow imaging (CDFI). Eight pediatric TT patients aged 1-16 years, with a median age of 11.5 years, were enrolled. Time from the onset ranged from 4 to 72 h (mean 26.13 ± 25.09 h). A total of eight testes were twisted, including four on the left side and four on the right side. The twisting direction of the testes was clockwise in four cases and counterclockwise in four cases. The rotation of torsion was 180°-1,080° (mean 472.5° ± 396°). There was no statistically significant difference in the imaging time between the four patients with testicular blood vessel imaging on both the torsional and normal sides (P > 0.05). The postoperative recovery was uneventful, with no complications during the follow-up period of 1 month. The postoperative histopathological results of three patients who underwent orchiectomy showed extensive hemorrhage, degeneration, and necrosis of the testicular tissue. Among the five patients who underwent orchiopexy, a gray-scale ultrasound and CDFI examinations showed uniform internal echo of the testes and normal blood flow signals in four patients. One patient with no testicular blood vessel imaging on the torsional side showed uneven internal echo of the testis and no blood flow signals. ICG-NIRF imaging is a feasible method to evaluate testicular blood flow during TT surgery. Testicular blood vessel imaging within 5 minutes after ICG injection might be the basis for testicular retention during TT surgery.

Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery

BackgroundAdministration of adjuvant or salvage radiotherapy (RT) after prostate cancer (PCa) surgery is supported by clinical evidence and is a widely adopted strategy. On occasion, we detect changes in prostate-specific antigen (PSA) levels, such as a transient elevation or decline, during RT. Thus, we retrospectively investigated the frequency of changes in PSA levels, their associations with histopathological parameters, PSA doubling time (PSADT), and biochemical recurrence (BR) of PCa.MethodsThis study included 23 consecutive patients who underwent surgery for PCa between 2012 and 2019, received salvage RT without hormone therapy, and exhibited changes in PSA levels during RT. The prostatic bed was irradiated with a total dose of 64 to 66 Gy. BR was defined as consecutive PSA levels exceeding 0.2 ng/mL or having to start hormone therapy because of PSA elevation after salvage RT.ResultsDuring salvage RT after PCa surgery, PSA levels transiently increased in 11 patients (47.8%) and decreased in 12 (52.2%). When factors associated with BR were examined in patients with transient PSA elevation, seminal vesicle invasion and preoperative PSA values were identified as being statistically significant. When factors for BR were examined in patients with a decline in PSA levels, the Gleason score and PSADT were identified as being significant. Among the cases of a decline in PSA levels during salvage RT, those who received a radiation dose of less than 36 Gy did not experience BR. Similarly, patients who exhibited changes in PSA levels during salvage RT and did not have perineural invasion did not experience BR.ConclusionThis is the first study to examine the histopathological factors possibly affecting BR in patients undergoing salvage RT after PCa surgery. The results indicate that in patients with transient PSA elevation, seminal vesicle invasion is a significant risk factor. On the other hand, in patients with a decline in PSA levels during irradiation, the Gleason score and perineural invasion were found to be potential risk factors for BR. These findings suggest that a thorough examination of postoperative histopathological results may be necessary for the optimal management of patients with PCa.

The Diagnostic Value of Fine-Needle Aspiration Cytology in Cervical Lymphadenopathy in Correlation to Postoperative Histopathological Results in a Tertiary Care Center in Saudi Arabia.

Background Lymphadenopathy is a frequently encountered presentation in the clinical practice. Cervical lymphadenopathy implies that the cervical nodal tissue measures more than 1 cm in diameter. It requires prompt and accurate diagnosis to begin an appropriate treatment plan. Fine-needle aspiration cytology (FNAC) is considered an initial diagnostic method due to its simplicity, minimal invasiveness, quick availability of results, and low risk of complications. This study aimed to evaluate the diagnostic value of FNAC by comparing the cytological and histological diagnoses of patients with cervical lymph node enlargement at Aseer Central Hospital, Southern Region, Saudi Arabia. Methodology This observational, retrospective, record review study was conducted at the Otorhinolaryngology Head and Neck Surgery Department in Aseer Central Hospital, Abha, Saudi Arabia. Using a data collection sheet, the data of 102 patients were collected from electronic records and reviewed retrospectively. The study included patients who underwent cervical lymph node excision biopsy between 2020 and 2023 due to enlargement of the cervical lymph node. The cytological diagnoses were compared with the histopathological diagnoses of the same enlarged cervical lymph nodes. Results The most common FNAC findings were lymphomas and reactive lymph nodes (26.2% and 19.7%, respectively). The positive predictive value of FNAC was 100% and the negative predictive value was 86.7%. Overall, the diagnostic accuracy was 95.3%. Conclusions FNAC is a safe diagnostic method with minimal invasiveness and complications. This study showed that FNAC and tru-cut biopsy have good diagnostic value in examining patients with cervical lymphadenopathy regardless of their limitations and drawbacks. They have good sensitivity, specificity, positive and negative predictive values, and accuracy.

Papillary Thyroid Carcinoma Within Mature Teratoma Ovarian: A Rare Case Report

Papillary thyroid carcinoma is a rare germ cell tumor. We report a case of a 50-year-old woman who presented with an enlarged abdomen since a year ago. From the physical and ultrasound examinations, the patient was then diagnosed with a suspected malignant ovarian cyst. Postoperative histopathology results showed papillary thyroid carcinoma arising within mature cystic teratoma. Then, the patient was examined for thyroid ultrasonography, which revealed a benign nodule on the left thyroid. This result was supported by normal results of thyroid function and anti-thyroglobulin antibody tests, which was a sign of benign condition. The anatomical pathologists then concluded that the primary was of ovarian origin. Differentiating the primary source of papillary thyroid carcinoma, either from the ovary or thyroid, is essential to plan further proper management. Here, the report aims to describe how to diagnose papillary thyroid carcinoma arising within mature teratoma of the ovary and its management strategy.

Correlation of Thyroid Fine Needle Aspiration Biopsy With Histopathological Results.

Introduction Fine needle aspiration biopsy (FNAB) is an effective method used in the differential diagnosis of thyroid nodules. The Bethesda system has contributed to the determination of clinical approaches by bringing standardization to cytopathology reporting. However, the rate of cytological-histological incompatibility varies between 10% and 30%. Results differ according to clinics in the literature. These results create a need to reevaluate the efficacy and safety of fine needle aspiration biopsy. In this study, we aimed to evaluate the diagnostic accuracy of FNAB of thyroid nodules by correlating the cytopathology results of FNAB with the results of postoperative histopathology. Methods In this retrospective study, thyroid FNAB results and postoperative histopathology results of patients who underwent thyroidectomy operations in our clinic between January 2018 and December 2021 were compared. Accuracy, sensitivity (Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), false positive rate (FPR), and false negative rate (FNR) were calculated. Cases with nondiagnostic FNAB results were excluded from the calculations.FNAB results with a follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN) and suspicious for malignancy were included in the malignant group. Results A total of 304 patients were included in the study. The male/female ratio was 1:3.3. As a result of the study, malignancy was detected histopathologically in 47 (15.46%) patients. The commonest malignancy detected was papillary carcinoma. According to the Bethesda system, the results were evaluated in six categories. The incidence of malignancy in the Bethesda categories were 0%, 4%, 40%, 69.2%, 100%, and 100%, respectively. Accordingly, the specificity and sensitivity of FNAB for detecting malignancy were 98.7% and 66.6%, respectively. The accuracy was 93.5%. The false positive rate, false negative rate, positive predictive value, and negative predictive value were 1.20%, 33.3%, 91.4%, and 93.8%, respectively. Conclusion Thyroid FNAB is an effective method used with satisfactory reliability in the differential diagnosis of malignancies of thyroid nodules. Still, it has some limitations. This article demonstrates higher rates of malignancy in Bethesda categories III and IV. Therefore, clinical approaches are gaining importance in these categories.

Rheumatism as a cause of cardiac hemangioma: a rare case report and review of literature with special focus on etiology

BackgroundCardiac hemangioma is a very rare benign tumor of the heart which accounts for 1–2% of all primary cardiac tumors. Multiple cardiac hemangiomas are even rarer with only three cases published in the literature. Pathologically it can be divided into cavernous hemangioma, capillary hemangioma, arteriovenous hemangioma, mixed-type hemangioma, and so on. At present, the etiology of cardiac hemangioma is not completely clear. In this study, we present multiple cardiac hemangiomas located in the right atrium and discuss the new unreported possible cause (rheumatism) of cardiac hemangioma. This is the fourth case of multiple cardiac hemangiomas in the medical literature and the first time to present rheumatism as the cause of cardiac hemangioma.Case presentationA 53-year-old man presented to the clinic with intermittent chest tightness and shortness of breath for 2 years. On echocardiography, multiple soft tissue masses in the right atrium were found. The patient had rheumatic heart disease with severe mitral stenosis and moderate tricuspid regurgitation. Two masses with a diameter of about 20 mm and 15 mm were seen in the right atrium. One mass was located on the inferior margin of the fossa ovalis and the other was adjacent to the inferior vena cava. Both masses were successfully removed surgically. The mitral valve replacement and tricuspid valve plasty were performed at the same time. The postoperative histopathology results confirmed the diagnosis of cavernous hemangioma.ConclusionThe occurrence of multiple hemangiomas in the heart is possible, especially in the presence of rheumatism. Rheumatism is one of the possible etiologies of cardiac hemangioma. Cardiologists and cardiac surgeons should be aware of its occurrence and should consider cardiac hemangioma as a differential diagnosis especially in rheumatic heart disease patients when they present with soft tissue cardiac masses for accurate management.

Expression of Salivary Immediate Early Response Gene X-1 as a Predictor of Malignancy in Epithelial Ovarian Tumor

Objective: This diagnostic study aims to determine the expression of salivary IEX-1 as a predictor of malignancy in epithelial ovarian tumors. 
 Methods: Samples were obtained from ovarian cancer patients who were scheduled for elective surgery. Patients' saliva was collected before surgery and used as the study's research material. Research subjects who met the inclusion and exclusion criteria were divided into two groups based on the post-operative histopathological results, benign and malignant epithelial ovarian tumors. The salivary IEX-1 expression was examined using the Real Time qPCR method. We compared and analyzed the salivary IEX-1 expression ​​in benign and malignant epithelial ovarian tumors. 
 Results: The results of this study were obtained from 47 epithelial ovarian tumors subjects, 22 malignant tumors and 27 benign tumors. The mean salivary IEX-1 expression in benign epithelial ovarian tumors was higher (1.976) than the malignant tumors (0.554) (p<0.001). The AUC value of IEX-1 expression was 0.949 (95% CI 0.894-1,000), cut off point of salivary IEX-1 is ≥ 0,9115 with sensitivity 84%, specificity 86,4%, positive predictive value 82.6% and negative predictive value 87.5%. There was a significant correlation between salivary IEX-1 expression and malignant epithelial ovarian tumors with an OR 5.031 (95% CI 2.039-12.4; p<0,001)
 Conclusion: Salivary IEX-1 expression declines in tandem with the development of malignant epithelial ovarian tumors, providing a very sensitive and specific indicator of the presence of these malignant tumors.
 Keywords: Expression of IEX-1, Malignant epithelial ovarian tumor, Salivary IEX-1, Tumor Marker.

Radiological and clinicopathological findings of breast cancer during the COVID-19 pandemic: a comparative study with the pre-pandemic era.

The diagnosis and surgical treatment delays that occurred during the coronavirus disease-2019- (COVID-19) pandemic may have affected breast cancer presentation. This study aimed to determine whether there was a difference in the clinicopathological characteristics of breast cancers during the pandemic by comparing them with similar cases from the previous year. The study also aimed to determine the radiological findings of breast cancers during the pandemic. A retrospective review was made of patients who underwent surgery for breast cancer between March 11, 2020, and December 11, 2020 (the pandemic group). These patients were compared with similar patients from the previous year (the pre-pandemic group). The postoperative histopathology results of both groups were compared, and the preoperative radiological findings of the pandemic group were defined. There were 71 patients in the pandemic group and 219 patients in the pre-pandemic group. The tumor size was significantly greater, lymph node involvement was more frequent, and waiting time for surgery was longer in the pandemic group (P < 0.001, P = 0.044, P = 0.001, respectively). There was no significant difference between the groups in respect of in situ/invasive tumor distribution, histological type and histological grade of tumor, the presence of lymphovascular/perineural invasion, multifocal/multicentric focus, and Breast Imaging Reporting and Data System Classification (P > 0.15). The radiologic findings of breast cancer during the pandemic typically showed characteristics of malignancy. Patients diagnosed with breast cancer during the COVID-19 pandemic had larger tumor sizes, more frequent lymph node involvement and longer waiting time for surgical treatment. Screening programs should be continued as soon as possible by taking necessary precautions.

A DEFICIENCY OR DEVELOPMENTAL DEFECT IN PANETH CELLS MAY LEAD TO ACUTE APPENDICITIS IN CHILDREN

Objective The aim of this study was to investigate whether there were differences in the Paneth cells between children with acute appendicitis (AA) and those with normal appendix (NA), and to reveal the distribution of and morphological changes in Paneth cells in appendix inflammation. Materials and Methods The data of 63 patients who underwent appendectomy diagnosed with acute appendicitis between January 2021 and December 2022, including age, gender, operative diagnosis, and postoperative histopathological examination results, were analyzed retrospectively. To evaluate the distribution and changes of Paneth cells throughout AA and NA groups, samples with hematoxylin and eosin (H &amp; E)-stained sections were obtained from the Department of Histopathology's archives. Selected blocks were stained with Masson-Trichrome. The number of Paneth cells and the degree of granular density in the appendicitis tissues were statistically evaluated and compared with the results of the control group. Results A total of 63 appendectomies were performed, including 31 incidental appendectomies and 32 performed for preoperative diagnosis of acute appendicitis. There were no statistically significant differences between the groups that underwent surgery for AA and the NA in terms of gender and age (p&gt;0.05). It was observed that the number of Paneth cells and granule density decreased significantly in acute appendicitis (AA) group (p&lt;0.05). Conclusion Reduction or developmental deficiency in Paneth cells, which results in the loss of protective secretion, may increase the appendix's susceptibility to bacterial infection by allowing organisms to adhere and move across the mucosa. Such enhancement of infection may contribute to the pathogenesis of appendicitis.

The Evaluation of Dynamic Thiol/Disulfide Homeostasis in Papillary Thyroid Carcinoma

Objectives: Aim of this study is to analyze the correlation between thiol/disulfide homeostasis (TDH) and papillary thyroid carcinoma (PTCA) and to reveal the possible impact of TDH on the development of PTCA. Material and Methods: Preoperative venous blood sampling was obtained from the patients having applied to our hospital due to euthyroid nodular goiter and detected with suspected malignancy or malignant cytology in FNAB, according to the BETHESDA system. Those whose postoperative histopathological results proved the presence of PTCA were involved in this study. Healthy volunteers who were without any thyroid nodules and thyroid dysfunction. Results: The number of participants in the patient and control groups was 34 and 101, respectively. Compared to the control group, native thiol (μmol/L), total thiol (μmol/L), and native thiol/total thiol × 100 values were ascertained to be lower in the patient group with PTCA; however, these values were not statistically significant. Disulfide, disulfide/native thiol × 100, and disulfide/total thiol × 100 values were detected to be lower in the patient group with PTCA, but not statistically significant. When the patients with PTCA were assessed within themselves, TDH parameters were not associated with the PTCA subtype, the number of foci, the presence of lymphovascular invasion, and the presence of metastatic lap. Conclusion: Considering the parameters of PTCA and TDH, the results were not statistically significant. And besides postoperative histopathological findings such as the PTCA subtype, the number of foci, the presence of lymphovascular invasion, and presence of metastatic lap were not correlated with THD parameters.

Preliminary assessment of the effectiveness of neoadjuvant chemotherapy in breast cancer with the use of ultrasound image quality indexes

Objective:Neoadjuvant chemotherapy (NAC) in breast cancer requires non-invasive methods of monitoring its effects after each dose of drug therapy. The aim is to isolate responding and non-responding tumors prior to surgery in order to increase patient safety and select the optimal medical follow-up. Methods:A new method of monitoring NAC therapy has been proposed. The method is based on image quality indexes (IQI) calculated from ultrasound data obtained from breast tumors and surrounding tissue. Four different tissue regions from the preliminary set of 38 tumors and three data pre-processing techniques are considered. Postoperative histopathology results were used as a benchmark in evaluating the effectiveness of the IQI classification. Results:Out of ten parameters considered, the best results were obtained for the Gray Relational Coefficient. Responding and non-responding tumors were predicted after the first dose of NAC with an area under the receiver operating characteristics curve of 0.88 and 0.75, respectively. When considering subsequent doses of NAC, other IQI parameters also proved usefulness in evaluating NAC therapy. Conclusions:The image quality parameters derived from the ultrasound data are well suited for assessing the effects of NAC therapy, in particular on breast tumors.

LBODP072 Squamous Cell Carcinoma Or Fungal Infection? An Unusual Presentation Of Anterior Hypopituitarism

Abstract Introduction Intracranial squamous cell carcinomas are rare tumours with a poor prognosis. Lack of specific imaging characteristics mandates a high index of clinical suspicion and ultimately histopathological confirmation. Chronic invasive fungal rhinosinusitis (CIFRS) is often difficult to distinguish from Sino nasal squamous cell carcinomas (SNSCC) in clinical practice. Our case draws attention to the fact that biopsy results are necessary in discriminating between the two entities, due to the diagnostic conundrum in context of Anterior Hypopituitarism. Case detailsWe report a case of 78-year-old lady who presented with a 3-month history of increasing headache, lethargy and confusion. There was no change in urinary habit. On examination she had right sided ptosis and restricted eye movements with a reported 4-week duration. Primary care physicians referred her for ophthalmic assessment. Past medical history was significant for absent vision in the affected eye due to Ischaemic optic neuropathy since 2018. A CT Angiogram was organised which revealed a large soft tissue mass that could not be differentiated from the optic chiasma. Differentials included chondrosarcoma, chordoma, invasive pituitary macroadenoma and skull base Plasmacytoma. Subsequent MRI imaging suggested appearances could be consistent with aggressive fungal sinusitis. Endocrine investigations showed partial anterior hypopituitarism. ManagementEmpiric treatment was started with Intravenous anti-fungals and steroids, alongside appropriate pituitary hormone replacement. Her case was discussed in the Skull Base Multi-disciplinary Team (MDT) meeting. She was then transferred to the regional tertiary centre for surgical intervention, where she underwent debridement of the Ethmoid sinus, Sphenoid Sinus and Anterior base of skull for presumed chronic invasive fungal sinusitis. Post-operative imaging displayed satisfactory debulking of the central skull base tumour. Histopathology from sphenoid sinus reported invasive squamous cell carcinoma. The post-operative imaging and histopathology results were discussed in the regional MDT and considering the advanced stage a decision was made for best supportive care. Within 2 months neurological symptoms progressed and further imaging demonstrated radiological tumour progression. Discussion Sinonasal Squamous cell carcinoma (SNSCC) is a rare tumour and thus pose difficulty in detection. Presentation usually occurs at an advanced stage since initial symptoms are nonspecific and the tumour remains indolent for many months to years. There is limited evidence in relation to detection and follow up of these cases. Clinical presentation and radiological appearance can be varied. This case highlights the need for histological confirmation of the diagnosis to guide appropriate treatment pathways and ensure compassionate, appropriate care. Presentation: No date and time listed

Correlations between Contrast-Enhanced Ultrasound Imaging and Histopathological Results in Salivary Gland Lesions.

The purpose of this study was to search for correlations between contrast-enhanced ultrasound (CEUS) imaging and histopathological results in salivary gland lesions and to determine the accuracy of CEUS in the preoperative differentiation of salivary gland tumours according to postoperative histopathological results. The study included 54 consecutive patients with 63 salivary gland lesions who underwent CEUS examination prior to surgical treatment at the Department of Otolaryngology, Medical University of Łódź (Poland) in 2019-2022. The accuracy of CEUS in differential diagnostics of salivary gland lesions was later verified against final histological diagnosis. Among 63 salivary gland lesions, 26 were categorized as malignant or with malignant potential, and 37 were benign. There was a correlation between professional photographs of CEUS imaging and microscope slides containing postoperative specimens. A strong heterogeneous enhancement was observed mainly in benign lesions, with while weak heterogeneity mostly among the malignant or with malignant potential lesions. A pattern of contrast enhancement in specific structures reflected histopathological images. These results suggest that contrast-enhanced ultrasonography is a promising tool for the preoperative diagnostics of salivary gland lesions.

Multidetector computed tomography assessment of venous invasion in hepatic alveolar echinococcosis

PurposeThe objective of this study was to correlate multidetector computed tomography (MDCT) findings in hepatic alveolar echinococcosis (HAE) with intraoperative and postoperative histopathological results to identify reliable MDCT criteria for the diagnosis of HAE venous invasion.MethodsA total of 136 HAE patients who underwent CT examination were included in this study. The lesion-vessel contact angle, irregular wall, lumen stenosis and occlusion were evaluated.ResultsA total of 614 veins were estimated. In total, 510 veins were invaded, and 104 veins were not. The invasion rate was 83.06%. In single CT findings, with a cutoff value of > 180° determined by receiver operating characteristic (ROC) curve analysis, the lesion-vessel contact angle performed the best (area under the ROC curve, AUC = 0.907, 95% confidence interval, 95% CI 0.872–0.941, p < 0.001), with a sensitivity, specificity and positive likelihood ratio (PLR) of 84.90%, 88.46%, and 7.35, respectively. Irregular wall and lumen stenosis showed the lowest diagnostic performance. Diagnostic performance was the highest when combining these criteria and signs (AUC = 0.932, 95% CI 0.905–0.960, p < 0.001).ConclusionThe lesion-vessel contact angle > 180° had the best sensitivity and specificity in the diagnosis of HAE venous invasion, and good interobserver agreement had been noted. The diagnostic performance of the lesion-vessel contact angle > 180° had been further improved with the addition of lumen occlusion accompanied by irregular wall or lumen stenosis.Graphical abstract

Evaluation of Bethesda IV-V thyroid nodules: clinical experience

Introduction: The malignancy rate in cases operated for thyroid nodule is approximately 5-10%, and although this rate shows significant differences according to Bethesda categories, there is a high risk of malignancy in categories IV and V compared to other categories. In our study, we examined the clinicopathological factors affecting the success of cytological diagnosis in nodules diagnosed with Bethesda IV-V.&#x0D; Material and Method: A total of 780 patients who were diagnosed with thyroid nodules and underwent surgery at our center between 2011 and 2021 were included in the study. The preoperative cytological diagnoses of the patients were categorized using the Bethesda classification system. The demographic data of the patients, Bethesda classification of the nodules, and postoperative histopathological examination results were evaluated in subgroups, and their significance was determined.&#x0D; Results: The age group with the highest number of cases was 45-59 years, and the female/male ratio of the whole cohort was 3:1. The rate of palpable nodules was 41.8% for the malignant diagnosis group and 58.2% for the benign diagnosis group. In both malignant and benign groups,

Diagnostic accuracy of fine needle aspiration biopsy versus postoperative histopathology for diagnosing thyroid malignancy.

Ultrasound-guided fine needle aspiration biopsy (FNAB) is currently widely used for the initial screening of patients with thyroid nodules enabling prevention of unnecessary surgery. The purpose of this study was to retrospectively analyse the diagnostic accuracy of thyroid FNAB compared with postoperative histopathology of a large cohort from Azerbaijan. We evaluated the FNAB results of 738 patients who underwent thyroid surgery at the National Centre of Oncology in Azerbaijan. The measures of diagnostic accuracy were calculated for the ultrasound-guided preoperative FNAB results (based on the six diagnostic categories of the Bethesda classification) compared with postoperative histopathologic results (benign or malignant) for correspondent areas. Considering both DC V and DC VI categories (387 cases) as 'cytologic-positive' and DC II category (72 cases) as 'cytologic-negative', we found 14 false-positive and 10 false-negative results. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy were 97.4%, 86.1%, 96.4%, 81.6% and 94.8%, respectively. Conversely, when considering only the DC VI category as 'cytologic-positive', the sensitivity, specificity, PPV, NPV and diagnostic accuracy of FNA were 93.2%, 100%, 100%, 81.6% and 97.1%, respectively. The results of our cohort demonstrated high levels of diagnostic accuracy, supporting FNAB's role as a reliable diagnostic tool in the preoperative evaluation of thyroid nodules. The sensitivity, specificity, NPV, PPV and accuracy of thyroid FNAB in our institution were comparable with those of other institutions.

Assessing the correlation between FDG PET findings of IDC breast carcinoma and histopathology of coexisting ductal carcinoma in-situ.

Ductal carcinoma in-situ (DCIS) often coexists with invasive ductal carcinoma (IDC) of the breast. DCIS is considered as a non-obligate precursor of IDC when both coexist. 18F-fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG PET/CT) imaging is commonly used in the staging and follow-up assessment of breast cancer. In this study, we aimed to assess if there is any correlation between primary tumor PET and histopathology findings and histopathological features of the coexisting DCIS. FDG PET/CT images and histopathology results of the patients with newly diagnosed breast cancer (IDC) with coexisting DCIS were analyzed in this retrospective study. The grade and size of the primary tumor and histopathological features of the coexisting DCIS (nuclear grade and architectural pattern) were obtained from the postoperative histopathology results. Maximum standardized uptake values (SUV: SUVmax and SULmax) of the primary tumor normalized by weight and lean body mass were measured. Statistical analysis was performed to assess the correlation between various parameters of IDC and DCIS. This study included sixty-two (62) patients with IDC-DCIS. Primary tumor grade was significantly correlated and associated with the nuclear grade of the coexisting DCIS (polychoric correlation r = 0.736, and Fisher exact test, PV < 0.001, respectively). Primary tumor SUV was not correlated with the nuclear grade and architectural pattern of the coexisting DCIS (polyserial correlation r = 0.172, PV = 0.155, and Point Bi-Serial correlation r = -0.009, PV = 0.955, respectively). Median primary tumor size was marginally significantly different among DCIS nuclear grades but it was not significantly different in comedo and non-comedo cases (Kruskal-Wallis test PV = 0.053, and Mann-Whitney U test PV = 0.890, respectively). Primary tumor grade is correlated with the nuclear grade of the coexisting DCIS. SUV of primary tumor does not seem to be correlated with the histopathological features of coexisting DCIS (nuclear grade and architectural pattern) but this may be further studied in a larger number of patients.