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Cancer
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Clinical examination and mammography often detects breast cancer. However, the diagnosis can be confirmed by biopsy. Ultrasound is usually performed first to differentiate cancer from a benign tumor. Percutaneous core needle biopsy is preferred. Stereotactic biopsy and ultrasound-guided biopsy are also common. In some cases, a surgical biopsy must be done when a deep lesion is located. Inherited gene mutations can be detected in the saliva or blood. Biomarkers have greatly affected the diagnosis of breast cancer. They help determine risks for developing the disease and guide screening as well as monitoring.
Mammography and Interventional Breast Procedures
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Currently, many needles are available for percutaneous needle breast biopsy. These needles are divided into two categories, fine needle (20 to 23 gauge) and core needle (14 to 18 gauge). Both fine and core needle can be used either manually or in an automated biopsy gun. Unlike the fine needle aspiration biopsy, which collects some cellular material for cytologic evaluation, core needle biopsy is able to provide tissue that can be analyzed histologically in the same manner as surgical specimens. Most core needles consist of an inner trocar with a sample notch at its distal end and an outer cutting cannula (Fig. 32).
Rhabdomyosarcoma
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Gideon Sandler, Andrea Hayes-Jordan
Imaging for staging should precede biopsy in order to determine the best anatomical approach to the tumor, suggest which area is best representative of the underlying disease, and avoid radiological artifact at the biopsy site that may affect the interpretation of the images. Enough tissue for pathological, biological, cytogenetic, and treatment protocol studies should be procured. Incisional, excisional, and core-needle biopsies are acceptable depending on the circumstances. Fine-needle aspiration biopsy should not be used as the samples are inadequate for the evaluation of tissue architecture. Open, laparoscopic, or thoracoscopic techniques can be used for intra-abdominal or intrathoracic primary or metastatic disease. Core-needle biopsy is less invasive and is being successfully used in most anatomic locations, though it has a slightly higher rate of diagnostic failure. Multiple cores are required for diagnosis. Unplanned incisional or needle biopsies may complicate surgical excision and compromise the preservation of cosmesis and function (Table 61.4: Procedure 1).
Biopsy strategies for intermediate and high suspicion thyroid nodules with macrocalcifications
Published in Current Medical Research and Opinion, 2023
Sungmok Kim, Jae Ho Shin, Yon Kwon Ihn
Our study has limitations. First, selection bias may have been introduced due to retrospective study design. Second, unpaired comparisons were made between FNAB and CNB, and the sample sizes were relatively small, especially for the rim type and the entirely calcified type macrocalcifications due to rarity, which may have caused underestimation of malignancy potentials11. Nevertheless, statistical significances in analyzing the mode of biopsy (FNAB vs. CNB) and factors affecting the poor FNAB performance were achieved. We speculate that further studies are necessary to strengthen the superior performance of CNB for thyroid nodules with macrocalcification. Third, variability among FNAB operators and pathologists may have affected the unsatisfactory rates of FNAB and CNB; nonetheless, our results reflect a routine daily practice. Lastly, generalizability of our results may be limited due to different types of core needle biopsy calibers and mode of CNB (automatic vs. semi-automatic mechanism).
Biomarkers of lymphoma in Sjögren’s syndrome: what’s the latest?
Published in Expert Review of Clinical Immunology, 2022
Ioanna E. Stergiou, Athanasios-Dimitrios Bakasis, Stavroula Giannouli, Michael Voulgarelis
Imaging techniques are widely used for lymphoma diagnosis, staging, and assessment of response to therapy [152]. Salivary gland ultrasonography (SGUS) has gained attention in the last decade as an effective imaging technique for the detection of typical pSS structural abnormalities [153]. Recently, reliable ultrasound definitions and a novel SGUS scoring system have been developed by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) SGUS task force group [154]. In 2014, Theander et al. reported that SGUS could discriminate pSS patients at high-risk for lymphoma development, a finding lately also demonstrated by Coiffier et al. in 2021 [155,156]. However, the limitation of these studies was their retrospective design. A recently published prospective study assessed the OMERACT score in pSS patients with clinical findings suspicious for lymphoma development. The patients subsequently underwent US-guided core-needle biopsy. pSS-lymphoma patients showed more inhomogeneous glandular pattern and higher OMERACT score compared to those without lymphoma (100% vs. 69.2% higher OMERACT; p = 0.0407). Eight suspicious for lymphoma features were identified for focal lesions: OMERACT grade 3, very hypoechoic, homogenous, oval shape, well-defined margins, presence of septa, color-Doppler vascularization, posterior acoustic enhancement. The simultaneous presence of 6/8 and 7/8 suspicious features was significantly higher among pSS-lymphoma patients, compared to pSS patients without lymphoma (88.9% vs. 28.6%, p = 0.034 for 6/8 features; 77.8% vs. 14.3%, p = 0.040 for 7/8 features) [157].
Idiopathic Granulomatous Mastitis: Etiology, Clinical Manifestation, Diagnosis and Treatment
Published in Journal of Investigative Surgery, 2022
Yulong Yin, Xianghua Liu, Qingjie Meng, Xiaogang Han, Haomeng Zhang, Yonggang Lv
Ultimately and critically important, the diagnosis of IGM depends on histopathologic examination. Open biopsy has been used for diagnosis in some studies [61], including lesion resection and even mastectomy. Percutaneous needle biopsy has been widely applied and increasingly adopted in suspected cases. Fine-needle aspiration cytology (FNAC) is a simple, fast and is minimally invasive, but its diagnostic sensitivity is low [62]. Several studies have demonstrated that only 21% of IGM cases have been diagnosed using FNAC alone, even patients suffered FNAC often need further open biopsies to make a definite diagnosis [35, 63, 64]. Although granulomas cannot be found via needle biopsy in up to 15% of cases, they are virtually always present in biopsy specimens [44]. Therefore, open biopsy may be necessary for difficult diagnostic cases, or when core-needle biopsy is insufficient.