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Biópsia com agulha grossa guiada por ultrassonografia para o diagnóstico dos tumores fibroepiteliais da mama; Ultrasound-guided core needle biopsy for the diagnosis of fibroepithelial breast tumors

RICCI, Marcos Desidério; AMARAL, Paulo Gustavo Tenório do; AOKI, Denis Seiiti; OLIVEIRA FILHO, Hélio Rubens de; PINHEIRO, Walter da Silva; FILASSI, José Roberto; BARACAT, Edmund Chada
Fonte: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Publicador: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Tipo: Artigo de Revista Científica
POR
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OBJETIVO: avaliar a taxa de concordância da biópsia percutânea com agulha grossa guiada por ultrassom seguida pela biópsia excisional em nódulos de mama palpáveis, sugestivos de tumores fibroepiteliais. MÉTODO: estudo retrospectivo que selecionou 70 biópsias com diagnóstico histológico de tumor fibroepitelial em 67 dentre 531 pacientes com lesões mamárias submetidas à biópsia percutânea com agulha grossa guiada por ultrassonografia, com transdutor linear de alta frequência (7.5 MHz), utilizando pistola automática Bard-Magnum e agulha 14 gauge. Foram incluídos os casos com diagnóstico de tumor fibroepitelial na biópsia percutânea ou biópsia excisional. Biópsias com diagnóstico histopatológico de fibroesclerose também foram incluídas no estudo. A força da concordância entre o resultado da biópsia percutânea e da biópsia excisional foi medida pelo coeficiente de Kappa. RESULTADOS: a biópsia excisional revelou 40 casos de fibroadenoma (57,1%), 19 de tumor filoide (27,2%) e 11 de fibroesclerose (15,7%). A taxa de concordância para o fibroadenoma foi substancial (k = 0,68; IC95% = 0,45 - 0,91), quase perfeita para o tumor filoide (k = 0,81; IC95% = 0,57 - 1,0) e moderada para a fibroesclerose (k = 0,58; IC95% = 0...

UPGRADING THE GLEASON SCORE IN EXTENDED PROSTATE BIOPSY: IMPLICATIONS FOR TREATMENT CHOICE

LEITE, Katia Ramos Moreira; CAMARA-LOPES, Lutz H. A.; DALL`OGLIO, Marcos F.; CURY, Jose; ANTUNES, Alberto A.; SANUDO, Adriana; Srougi, Miguel
Fonte: ELSEVIER SCIENCE INC Publicador: ELSEVIER SCIENCE INC
Tipo: Artigo de Revista Científica
ENG
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Purpose: To determine the incidence of overestimation of Gleason score (GS) in extended prostate biopsy, and consequently circumventing unnecessary aggressive treatment. Methods and Materials: This is a retrospective study of 464 patients who underwent prostate biopsy and radical prostatectomy between January 2001 and November 2007. The GS from biopsy and radical prostatectomy were compared. The incidence of overestimation of GS in biopsies and tumor volume were studied. Multivariate analysis was applied to find parameters that predict upgrading the GS in prostate biopsy. Results: The exact agreement of GS between prostate biopsy and radical prostatectomy occurred in 56.9% of cases. In 29.1% cases it was underestimated, and it was overestimated in 14%. One hundred and six (22.8%) patients received a diagnosis of high GS (8, 9, or 10) in a prostate biopsy. In 29.2% of cases, the definitive Gleason Score was 7 or lower. In cases in which GS was overestimated in the biopsy, tumors were significantly smaller. In multivariate analysis, the total percentage of tumor was the only independent factor in overestimation of GS. Tumors occupying less than 33% of cores had a 5.6-fold greater chance of being overestimated. Conclusion: In the extended biopsy era and after the International Society of Urological Pathology consensus on G...

The effect of the number of biopsy cores on the concordance between prostate biopsy and prostatectomy Gleason score - A prostate volume-controlled study

ANTUNES, Alberto A.; LEITE, Katia Ramos; DALL`OGLIO, Marcos F.; CURY, Jose; Srougi, Miguel
Fonte: COLLEGE AMER PATHOLOGISTS Publicador: COLLEGE AMER PATHOLOGISTS
Tipo: Artigo de Revista Científica
ENG
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Context.-Studies analyzing the concordance of biopsy and radical prostatectomy (RP) Gleason scores have limitations. Some included 2 or more centers, used historical controls from the early prostate specific antigen era or lacked a clear definition of the biopsy schemes. Furthermore, most did not control the results for prostate volume. Objective.-To confirm whether prediction of RP Gleason score can be optimized by taking more biopsy cores in a contemporary series of patients, with pathologic samples analyzed by the same pathologist, and controlling these results for prostate volume. Design.-The study comprised a retrospective case-control analysis of 393 patients with prostate cancer treated with RP. Patients were divided into 3 groups: those in group 1 underwent a 6-core biopsy; group 2, an 8-core biopsy; and group 3, a 10 or more-core biopsy. Concordance rates between biopsy and RP Gleason scores, as well as the rates of undergrading and overgrading, were determined for each biopsy scheme. Results.-Concordance rates were 60.9%, 58.3%, and 64.6% for patients from groups 1, 2, and 3, respectively (P = .18). When we analyzed patients with prostate volumes of less than 50 cm(3), concordance rates were 58.3%, 58.3%, and 65.1% for each group...

Ultra-sonografia mamária na identificação e orientação de biópsia percutânea das microcalcificações agrupadas; Breast sonography: role in detection and ultrasound-guided core biopsy of clustered microcalcifications

Castro, Flávio Spinola
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 14/01/2004 PT
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Os objetivos deste estudo são: 1) avaliar a capacidade de se demonstrar, através da ultra-sonografia, microcalcificações agrupadas, previamente identificadas pela mamografia. 2) identificar parâmetros mamográficos dos agrupamentos de microcalcificações e correlacionar com a positividade da ultra-sonografia na caracterização destas lesões. 3) avaliar a possibilidade de a ultra-sonografia mamária servir de guia de biópsias dirigidas, através de agulha grossa (biópsia percutânea de fragmento - "core biopsy"), nestas lesões. Entre dezembro de 2000 e abril de 2002, foram avaliadas através da ultra-sonografia, 68 pacientes com 70 focos de microcalcificações agrupadas na mamografia, suspeitas para neoplasia maligna, classificadas segundo critério de BI-RADSTM nas categorias 4 e 5, sem outras alterações mamográficas associadas, como distorções ou massas. Características das lesões na mamografia, como tamanho e profundidade do foco, foram avaliadas e os exames ultra-sonográficos foram classificados como positivos, quando as microcalcificações foram claramente identificadas e, negativos, quando não identificadas. Nas lesões positivas foram realizadas biópsias percutâneas de fragmento ("core biopsy"), através da ultra-sonografia e radiografia dos fragmentos. Nas negativas...

Experiência em pacientes com suspeita de hepatopatia crônica e contra-indicação para biópsia hepática percutânea utilizando a agulha de Ross modificada; Transjugular liver biopsy : experience in patients with suspected chronic liver disease and contraindication for percutaneous liver biopsy using modified Ross needle

Maciel, Antonio Carlos; Barros, Sergio Gabriel Silva de; Tarasconi, Dorvaldo Paulo; Severo Junior, Luiz Carlos Velho; Cerski, Carlos Thadeu Schmidt; Ilha, Darcy de Oliveira
Fonte: Universidade Federal do Rio Grande do Sul Publicador: Universidade Federal do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: application/pdf
POR
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OBJETIVOS. O trabalho visou introduzir em nosso meio a técnica de biópsia hepática transjugular orientada por métodos radiológicos para a obtenção do diagnóstico histológico em pacientes clínica e laboratorialmente diagnosticados com hepatopatia crônica e com pelo menos uma das contra-indicações à biópsia hepática percutânea: coagulopatia, ascite maciça e anemia crônica acentuada com insuficiência renal crônica ou obesidade mórbida. MÉTODOS. Biópsia hepática aspirativa foi obtida com agulha de Ross modificada, através da punção da veia jugular interna com cateterização da veia hepática direita sob controle fluoroscópico. RESULTADOS. Trinta e nove pacientes foram estudados, obtendo-se tecido hepático em 32 (82%) sendo satisfatório para diagnóstico histológico em 25 (64,1%), com concordância entre o diagnóstico pré e pós-biópsia em 11 (28,2%) e discordância em 14 pacientes (35,9%). O procedimento foi bem tolerado pela maioria dos pacientes; contudo um paciente apresentou sangramento retroperitoneal, necessitando cirurgia imediata para controle da hemorragia. CONCLUSÕES. A biópsia hepática transjugular é um método diagnóstico útil para o estudo histopatológico na suspeita de hepatopatia crônica com contra-indicações a biópsia hepática percutânea. Em nossa série foi obtido diagnóstico histopatológico em 64...

Testicular biopsy with Tru-Cut needle in conjunction with fibrin adhesive or nylon suture: assessment of post-biopsy testicular function in rams

Sartori, R.; Prestes, N. C.; Canavessi, AMO; Curi, P. R.; Bergfelt, D. R.
Fonte: Elsevier B.V. Publicador: Elsevier B.V.
Tipo: Artigo de Revista Científica Formato: 25-31
ENG
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Testicular biopsy has been a complementary technique for clinical and research purposes to evaluate reproductive function in males. However, hemorrhage, inflammation, degeneration, and adhesion are factors that might limit the use of this procedure. In order to minimize these potential problems, fibrin glue derived from snake venom, a tissue adhesive with sealing, hemostatic, and healing properties, was used in conjunction with bilateral testicular biopsy with the Tru-Cut needle and was compared with a more conventional technique that uses nylon suture. Thirty mature rams were randomly assigned to three groups of 10 animals each, as follows: nonsurgical control group (no scrotal surgery, or biopsy); biopsy + glue group (fibrin glue on puncture sites and skin incisions) and biopsy + suture group (compression with swab on puncture sites and suturing of skin incision). The surgeries of the rams in the biopsy groups were performed on the same day, which was designated Day 0 for all three groups. Data of scrotal circumference, number of spermatozoa per ejaculum, percentage of morphologically abnormal spermatozoa, spermatozoa motility, and serum testosterone concentrations from Days -7, 20, 40, 60, 80 and 100 were evaluated. There were no significant differences between groups within days for any of the parameters evaluated. In conclusion...

Use of fibrin glue derived from snake venom in testicular biopsy of rams

Sartori Filho, R.; Prestes, N. C.; Thomazini, I. A.; Mendes Giannini, Maria José Soares; Toscano, E.; Canavessi, A. M O; Barraviera, B.
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Artigo de Revista Científica Formato: 23-35
ENG
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Sequelae due to testicular biopsy such as hemorrhage, adhesion and fibrosis may be limiting factors to the use of this surgical procedure. Fibrin glue (FG) derived from snake venom was used to minimize these sequelae, as well as to evaluate its healing property in tunica vaginalis and scrotal skin of rams. Applicability of fibrin glue derived from snake venom was tested in different tissues of other animals such as in sciatic nerve and colon of rats and skin of rabbits. In the present study, 30 healthy adult rams were used. They were divided into 3 groups of 10 animals each as follows: G1: fibrin glue group (application of fibrin glue on puncture sites and skin incisions after bilateral testicular biopsy with a Tru-Cut needle); G2: swab/nylon group (hemostasis by compression with a swab on puncture sites and skin suturing with nylon after biopsy) and G3: control group (the animals were not subjected either to biopsy or to surgery). On the 20th day after biopsy, the presence of adhesion strands between the sites of skin incision and testicle was evaluated by palpation Adhesion strands were found in three testicles (15%) in G1 and in two testicles (10%) in G2. One hundred days after biopsy, orchiectomy was carried out and the material collected was assessed for subcutaneous (SC) and/or tunica vaginalis adhesions. G3 did not present any abnormality. Groups G1 and G2 presented four testicles each (20%) with adhesion between the tunics at biopsy site. On the other hand...

Gleason score and laterality concordance between prostate biopsy and prostatectomy specimens

Nepple,Kenneth G.; Wahls,Terry L.; Hillis,Stephen L.; Joudi,Fadi N.
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2009 EN
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Objectives: Prostate biopsy involvement and Gleason score guide treatment decisions in prostate cancer. We evaluated concordance in Gleason score and laterality between biopsy and radical retropubic prostatectomy (RRP) specimens and factors that influenced this relationship. Material and Methods: We reviewed 538 prostate cancer diagnoses at a Veterans Affairs medical center (2000-2005) to identify men with prostate biopsy and RRP specimens. During this time there was a move from limited (6 core) to extended (12 core) biopsy schemes. Discordance in Gleason score was defined as any change in Gleason score. Results: 152 men underwent RRP with biopsy showing Gleason < 7 in 56%, 7 in 36%, and > 7 in 8%. Biopsy involvement was unilateral in 59% and bilateral in 41%. Compared to the biopsy, RRP Gleason score was concordant in 76 (50%), higher in 51 (34%), and lower in 25 (16%). Bilateral involvement was concordant in 97%, while unilateral involvement was concordant in only 20%. Both Gleason score and laterality were concordant in only 26%. Gleason concordance was higher in those with 8 or more cores compared to < 8 cores taken (54% vs. 34%, p = 0.046), but concordance was not affected by age, PSA, prostate volume, or length of time from biopsy to RRP. During later years...

Reducing infectious complications after transrectal prostate needle biopsy using a disposable needle guide: is it possible?

Gurbuz,Cenk; Canat,Lutfi; Atis,Gokhan; Caskurlu,Turhan
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2011 EN
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PURPOSE: To investigate whether the use of a disposable needle guide results in a decreased incidence of infectious complication after transrectal prostate needle biopsy (TPNB). MATERIALS AND METHODS: Fifty five patients who underwent 10-core TPNB were randomized into two groups. A pre-biopsy blood and urine examination was performed in both groups. Group 1 (25 patients) underwent biopsy with disposable biopsy needle guide and Group 2 (30 patients) underwent biopsy with reusable biopsy needle guide. All patients had a blood and negative urine culture before the procedure. The patients received ciprofloxacin 500 mg twice a day beginning the day before the biopsy and continued for 3 days after. Serum C-reactive protein levels and urine and blood specimens were obtained 48h after the biopsy. Primary endpoint of the study was to determine the effect of needle guide on the bacteriologic urinary tract infection (UTI) rate and secondary end point was to determine symptomatic UTI. RESULTS: The mean age of the patients was 63.46 (range 55 to 68) years. There were no significant differences regarding the prostate-specific antigen level, prostate size, existence of comorbidity in two groups before the procedure. Bacteriologic and symptomatic UTI was detected in 4% vs. 6.6% and 4% vs. 3.9% in Group 1 and 2 relatively (P > 0.05). CONCLUSION: The use of a disposable needle guide does not appear to minimize infection risk after TPNB. Large scale and randomized studies are necessary to determine the effect of disposable needle guide on infection rate after TPNB.

How many cores should be taken in a repeat biopsy on patients in whom atypical small acinar proliferation has been identified in an initial transrectal prostate biopsy?

Aglamis,Erdogan; Kocaarslan,Ramazan; Yucetas,Ugur; Toktas,Gokhan; Ceylan,Cavit; Doluoglu,Omer Gokhan; Unluer,Erdinc
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2014 EN
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Objective To compare cancer detection rates according to the number of biopsy cores in patients on whom a repeat prostate biopsy was performed for atypical small acinar proliferation (ASAP). Materials and Methods The data of 4950 consecutive patients on whom prostate biopsies were performed were assessed retrospectively. A total of 107 patients were identified as having ASAP following an initial prostate biopsy, and they were included in the study. A six-core prostate biopsy (PBx) was performed on 15 of the 107 patients, 12 PBx on 32 patients, and 20 PBx on 60 patients. Cancer detection rates were compared according to the number of biopsy cores. The localization of the cancer foci was also evaluated. Results The cancer detection rates in patients on whom 6 PBx, 12 PBx, and 20 PBx were performed were 20% (3/15), 31% (10/32), and 58% (35/60), respectively, and a statistically significant difference was found (p = 0.005). When cancer detection rates in patients with total prostate specific antigen (PSA) < 10ng/mL, PSA density ≥ 0.15, normal digital rectal examination, and prostate volume ≥ 55mL were compared according to the number of biopsy cores, a significant difference was identified (p = 0.02, 0.03, 0.006, and 0.04...

Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy

Kobatake,Kohei; Mita,Koji; Kato,Masao
Fonte: Sociedade Brasileira de Urologia Publicador: Sociedade Brasileira de Urologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2015 EN
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Objectives To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy. Subjects and Methods The subjects comprised 278 participants who underwent transrectal prostate needle biopsy. They were randomly allocated to the gelatin sponge insertion group (group A: 148 participants) and to the non-insertion group (group B: 130 participants). In group A, the gelatin sponge was inserted into the rectum immediately after biopsy. A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum, and excretion of blood clots was confirmed. A blood test was performed before and after biopsy, and a questionnaire survey was given after the biopsy. Results Significantly fewer participants in group A required hemostasis after biopsy compared to group B (3 (2.0%) vs. 11 (8.5%), P=0.029). The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups. In multivariate analysis, only “insertion of a gelatin sponge into the rectum” emerged as a significant predictor of hemostasis. Conclusion Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms...

Correlation between surgical lung biopsy and autopsy findings and clinical data in patients with diffuse pulmonary infiltrates and acute respiratory failure

Canzian,Mauro; Soeiro,Alexandre de Matos; Taga,Marcel Frederico de Lima; Barbas,Carmen Silvia Valente; Capelozzi,Vera Luiza
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2006 EN
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INTRODUCTION: Surgical lung biopsy is an invasive procedure performed when other procedures have failed to provide an urgent and specific diagnosis, but there may be reluctance to perform it in critically ill patients with diffuse pulmonary infiltrates. PURPOSE: To evaluate the diagnostic accuracy, the changes in therapy and survival of patients with diffuse lung infiltrates, mostly presenting acute respiratory failure, who underwent surgical biopsy. METHODS: We retrospectively examined medical records and surgical lung biopsies from 1982 to 2003 of 63 patients older than 18 years with diffuse infiltrates. Clinical diagnoses were compared to histopathological ones, from biopsies and autopsies. Laboratory and epidemiological data were evaluated, and their relationship to hospital survival was analyzed. RESULTS: All histological specimens exhibited abnormalities, mostly presenting benign/inflammatory etiologies. Fifteen patients had an etiologic factor determined in biopsy, most commonly Mycobacterium tuberculosis. The preoperative diagnosis was rectified in 37 patients. Autopsies were obtained in 25 patients and confirmed biopsy results in 72% of cases. Therapy was changed for 65% of patients based on biopsy results. Forty-nine percent of patients survived to be discharged from the hospital. Characteristics that differed significantly between survivors and nonsurvivors included sex (P = 0.05)...

CT-guided biopsy of lung lesions: defining the best needle option for a specific diagnosis

Guimarães,Marcos Duarte; Marchiori,Edson; Hochhegger,Bruno; Chojniak,Rubens; Gross,Jefferson Luiz
Fonte: Faculdade de Medicina / USP Publicador: Faculdade de Medicina / USP
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
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OBJECTIVES: To evaluate the performance of fine and cutting needles in computed tomography guided-biopsy of lung lesions suspicious for malignancy and to determine which technique is the best option for a specific diagnosis. METHODS: This retrospective study reviewed the data from 362 (71.6%) patients who underwent fine-needle aspiration biopsy and from 97 (19.7%) patients who underwent cutting-needle biopsy between January 2006 and December 2011. The data concerning demographic and lesion characteristics, procedures, biopsy sample adequacy, specific diagnoses, and complications were collected. The success and complication rates of both biopsy techniques were calculated. RESULTS: Cutting-needle biopsy yielded significantly higher percentages of adequate biopsy samples and specific diagnoses than did fine-needle aspiration biopsy (p<0.05). The sensitivity, specificity, and accuracy of cutting-needle biopsy were 93.8%, 97.3%, and 95.2%, respectively; those of fine-needle aspiration biopsy were 82.6%, 81.3%, and 81.8%, respectively (all p<0.05). The incidence of pneumothorax was higher for fine-needle aspiration biopsy, and that of hematoma was higher for cutting-needle biopsy (both p<0.05). CONCLUSIONS: Our experience using these two techniques for computed tomography-guided percutaneous biopsy showed that cutting-needle biopsy yielded better results than did fine-needle aspiration biopsy and that there was no significant increase in complication rates to indicate the best option for specific diagnoses.

Assessment of 1183 screen-detected, category 3B, circumscribed masses by cytology and core biopsy with long-term follow up data

Farshid, G.; Downey, P.; Gill, P.; Pieterse, S.
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
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Discrete masses are commonly detected during mammographic screening and most such lesions are benign. For lesions without pathognomonically benign imaging features that are still regarded likely to be non-malignant (Tabar grade 3) reliable biopsy results would be a clinically useful alternative to mammographic surveillance. Appropriate institutional guidelines for ethical research were followed. Between Jan 1996–Dec 2005 grade 3B discrete masses detected in the setting of a large, population based, breast cancer screening programme are included. Patient demographics, fine needle aspiration biopsy (FNAB), core and surgical biopsy results are tabulated. The final pathology of excised lesions was obtained. Information regarding interval cancers was obtained from the State Cancer Registry records and also through long term follow-up of clients in subsequent rounds of screening. A total of 1183 lesions, mean diameter of 13.3 mm (plusminus8.3 mm) and mean client age of 55.1 years (plusminus8.8 years) are included. After diagnostic work up, 98 lesions (8.3%) were malignant, 1083 were non-malignant and a final histologic diagnosis was not established in two lesions. In the 27 months after assessment, no interval cancers were attributable to these lesions and during a mean follow up of 54.5 months...

Pleomorphic adenoma of the lacrimal gland: is there a role for biopsy?

Lai, T.; Prabhakaran, V.; Malhotra, R.; Selva-Nayagam, D.
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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Aim To review the literature on biopsy of lacrimal gland pleomorphic adenoma (LGPA) and to examine the validity of the prohibition against biopsy in LGPA. Method Literature review. Results LGPA is usually diagnosed preoperatively based on clinical and radiological characteristics, as current teaching advises complete excision without prior incisional biopsy. The caveat against biopsy is based on older studies that reported increased recurrence rates with increased risk of malignant transformation after incomplete excision or biopsy. On the basis of a detailed examination of the literature on biopsy of both LGPA and pleomorphic adenoma of the salivary glands, it appears that there is no clear evidence to support the claim that biopsy increases the risk of recurrence or of malignant transformation of LGPA. Conclusion Lacrimal gland tumours are uncommon lesions and optimal management depends to a great extent on a definite preoperative diagnosis. Preoperative biopsy should therefore be considered in all lacrimal gland mass lesions and management should be tailored to the biopsy findings. If surgical resection is then required, it may be prudent to excise the biopsy tract to ensure complete removal of the tumour.; T Lai, V C Prabhakaran...

Abklärung von Brustläsionen mittels Stanzbiopsie - eine retrospektive Studie; Large-core needle biopsy for evaluation of breast lesions - a retrospective study

Dusch, Robert
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
DE_DE
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Zur weiteren Abklärung von unklaren Herdbefunden der Brust wurden Alternativen zur invasiven operativen Diagnostik gesucht. Im Laufe der Zeit wurden verschiedene minimal invasive Methoden entwickelt. Zunächst wurde die Feinnadelaspirations-Zytologie etabliert, gefolgt von der Hochgeschwindigkeitsstanzbiopsie sowie der Vakuumsaugbiopsie. Gegenstand der Untersuchung war die Wertigkeit der Stanzbiopsie im Vergleich mit anderen Möglichkeiten der Gewebeentnahme bei unklaren Brustläsionen (FNAC und chirurgische Exzision). Über einen 2-Jahres-Zeitraum wurden in der Brustsprechstunde der Universitätsklinik Tübingen 200 suspekte Läsionen der Brust mittels sonographisch gestützter CNB und FNAC untersucht. Bei jeder Patientin wurde im Vorfeld eine klinische Untersuchung, gefolgt von einer Mammasonographie, Mammographie oder evtl. einer Magnetresonanztomographie durchgeführt. Bei insgesamt niedriger Komplikationsrate ermöglicht die Stanzbiopsie, kostengünstig und zuverlässig, Aussagen über die Dignität des Herdbefundes. Wir fanden in unserer Untersuchung eine Sensitivität der CNB von 98,68 %, eine Spezifität von 100 % bei einem positiven Vorhersagewert von 75,5 %. Es ergaben sich lediglich 2 falsch-negative Befunde im Vergleich mit dem histologischen Ergebnis im Operationspräparat. Bei den durchgeführten FNAC konnten 20...

Erfolg und Patientinnenakzeptanz der stereotaktischen Vakuumbiopsie zur Abklärung mammografisch suspekter Läsionen Längsschnittstudie von 1999 - 2007; Success and patient acceptance of stereotactic vacuum-assisted biopsy for diagnostic assessment of mammographically suspect lesions longitudinal study from 1999 - 2007

Johannsen, Eva Christina
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
DE_DE
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Ziel: Evaluierung der stereotaktischen Vakuumbiopsie in der Abklärung mammografisch verdächtiger Läsionen. Die Wertigkeit der Methode sollte anhand der technischen Erfolgsrate, der histologischen Sicherheit sowie der Patientinnenakzeptanz beurteilt werden. Material und Methode: Von April 1999 bis August 2007 wurden 953 mammografisch suspekte Mammaläsionen bei 856 Patientinnen mittels stereotaktischer Vakuumbiopsie in der Radiologischen Klinik der Universität Tübingen abgeklärt. Biopsieerfolg, histologisches Ergebnis der Vakuumbiopsie und nachfolgender Operationen, Komplikationen, Patientinnenakzeptanz und Ergebnisse der mammografischen Kontrolluntersuchungen wurden ausgewertet. Ergebnisse: In 97,1% der Fälle konnte eine komplette oder repräsentative Entfernung des vorgesehenen Areals erzielt werden. Nicht repräsentativ (=nicht diagnostisch) biopsierte Läsionen wurden operativ entfernt. Von diesen waren 69,8% benigne und 30,2% maligne. Entsprechend der BI-RADS® Klassifikation stieg der PPV für Malignität mit steigender BI-RADS® Klasse von 0% für Läsionen der BI-RADS® Kategorisierung 2 auf 15,8% für BI-RADS® 3-Befunde auf 26,5% für BI-RADS® 4-Läsionen bis auf 75,3% für BI-RADS® 5-Läsionen. Im Rahmen der Verlaufskontrolle trat in einem Fall ein Karzinom bei Z. n. benigner stereotaktischer Vakuumbiopsie auf. Histologische Unterschätzungen...

Surgical outcomes of borderline breast lesions detected by needle biopsy in a breast screening program

Flegg, Karen M; Flaherty, Jeffrey J; Bicknell, Anne M; Jain, Sanjiv
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
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BACKGROUND The Australian Capital Territory and South East New South Wales branch of BreastScreen Australia (BreastScreen ACT&SENSW) performs over 20,000 screening mammograms annually. This study describes the outcome of surgical biopsies of the breast performed as a result of a borderline lesion being identified after screening mammography and subsequent workup.A secondary aim was to identify any parameters, such as a family history of breast cancer, or radiological findings that may indicate which borderline lesions are likely to be upgraded to malignancy after surgery. METHODS From a period of just over eight years, all patients of BreastScreen ACT&SENSW who were diagnosed with a borderline breast lesion were identified. These women had undergone needle biopsy in Breastscreen ACT&SENSW and either atypical ductal hyperplasia (ADH), flat epithelial atypia (FEA), atypical lobular hyperplasia (ALH), radial scar/complex sclerosing lesion, papillary lesion, mucocoele-like lesion (MLL) or lobular carcinoma in situ (LCIS) was found. Final outcomes for each type of borderline lesion after referral for surgical biopsy were recorded and analysed. Results of the surgical biopsy were compared to the type of needle biopsy and its result, radiological findings and family history status. RESULTS Of the 94 surgical biopsies performed due to the presence of a borderline breast lesion...

Biópsia mamária realizada pela técnica de biópsia helicoide: estudo experimental; Breast biopsy performed by the helicoid biopsy technique: an experimental study

SOUZA, Eliel de; SOUZA, Leonardo Ferreira Nobre de; BATISTA, Milena da Costa; RODRIGUES, Julieta Alice Morena; SILVA, Isabelle Braz de Oliveira; CARRARA, Hélio Humberto Angotti; MARANHÃO, Técia Maria de Oliveira
Fonte: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Publicador: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Tipo: Relatório
POR
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OBJETIVO: avaliar o desempenho da biópsia helicoide na realização de biópsias mamárias. MÉTODOS: foi selecionado aleatoriamente uma amostra composta de 30 pacientes portadoras de câncer de mama submetidas à mastectomia. Foram excluídas as mulheres portadoras de tumor que tivessem consistência pétrea, não-palpável, com manipulação cirúrgica prévia ou que contivesse líquido. Utilizando-se o kit de biópsia helicoide e um equipamento de core biopsy com cânula e agulha de 14 gauge, respectivamente, coletou-se um fragmento por equipamento em área sã e nos tumores, em cada peça cirúrgica, totalizando 120 fragmentos para estudo histológico. Para a análise dos dados, definiu-se um nível de confiança de 95% e utilizou-se o software SPSS, versão 13; o índice de concordância Kappa e o teste paramétrico t de Student. RESULTADOS: a média das idades das pacientes foi de 51,6 anos (±11,1 anos). A core biopsy apresentou sensibilidade de 93,3%, especificidade de 100% e acurácia de 96,7%, enquanto a biópsia helicoide teve sensibilidade de 96,7%, especificidade de 100% e acurácia de 98,3%. Na comparação entre a histologia dos tumores e dos fragmentos de biópsias, houve alto grau de concordância nos diagnósticos (Kappa igual a 0...

A quantitative analysis of the response of short-finned pilot whales, Globicephala macrorhynchus, to biopsy attempts

Crain, Danielle
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Masters' project
Publicado em 26/04/2012
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Remote biopsy sampling is a common method used to obtain tissue samples from wild cetaceans. Using this technique, researchers typically obtain a small sample of skin and blubber using a biopsy tip fired from a crossbow or modified air rifle. Analysis of these tissues can provide important information on specific identity, sex, pollutant levels, diet, and reproductive status, which are critical to studies of free-ranging cetaceans. Biopsy sampling is generally considered to be a relatively benign procedure, but all prior attempts to evaluate its impact have been subjective assessments of the behavioral response of individuals at the surface. The goal of the present study is to provide a quantitative assessment of the immediate effects of biopsy attempts on the behavior of short-finned pilot whales (Globicephala macrorhynchus) equipped with digital acoustic recording tags (DTags) off Cape Hatteras, North Carolina. A biopsy attempt was defined as any instance of contact between a biopsy dart with an animal. A series of five metrics was examined to determine if behavior of whales was affected by a biopsy attempt, including: foraging behavior (number of dives, depth, and number of prey capture attempts); time spent within 3 m of the surface; fine-scale body orientation; fluke rate and amplitude; and group vocalization rate. The short-term reactions to biopsy attempts appear to be ephemeral and should not compromise the fitness of the animal...