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Zhang J, Dong A, Wang Y. FDG PET/CT in a Case of Solitary Mixed Squamous Cell and Glandular Papilloma of the Lung With High CEA Level. Clin Nucl Med 2024; 49:e288-e289. [PMID: 38704655 DOI: 10.1097/rlu.0000000000005025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
ABSTRACT Solitary mixed squamous cell and glandular papilloma of the lung is an extremely rare benign neoplasm. We describe FDG PET/CT findings in a case of solitary mixed squamous cell and glandular papilloma of the lung with high serum carcinoembryonic antigen level (63.3 ng/mL; reference, <5 ng/mL). The tumor showed intense FDG uptake with SUVmax of 23.8 mimicking lung cancer.
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Affiliation(s)
- Jun Zhang
- From the Department of Cardiothoracic Surgery, The Second Affiliated Hospital, Jiaxing University, Jiaxing, Zhejiang Province, China
| | - Aisheng Dong
- Department of Nuclear Medicine, The First Affiliated Hospital of Naval Medical University
| | - Yang Wang
- Department of Pathology, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
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2
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Matsuda K, Matsuzaki H, Fujiwara D, Makiyama K, Oshima T. Usefulness of Intraoperative Narrow-Band Imaging in the Site Diagnosis of Respiratory Papillomatosis. Laryngoscope 2024; 134:1820-1824. [PMID: 37776250 DOI: 10.1002/lary.31089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/28/2023] [Accepted: 09/19/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE Narrow-band imaging (NBI) is considered useful for detecting respiratory papillomatosis. However, the choice between preoperative and intraoperative NBI depends on the facility. We investigated the usefulness of NBI and determined whether preoperative NBI can replace intraoperative NBI with a comparable detection rate. METHODS In this retrospective cohort study conducted at single a tertiary care center, patients with respiratory papillomatosis treated between 2017 and 2022 were enrolled. We systematically compared preoperative white light imaging (WLI) with preoperative and intraoperative NBI. The primary endpoints were the papilloma detection rate and lesion site assessed by the Derkay scoring system. The secondary endpoints were the risk factors for increased Derkay scores. RESULTS The study included 127 patients with papilloma. Intraoperative NBI yielded significantly higher Derkay scores than preoperative WLI (p < 0.001) and preoperative NBI (p = 0.004). The papilloma detection rates of preoperative WLI and preoperative NBI were not significantly different. Intraoperative NBI detected more lesions than preoperative NBI in 37 of 127 (29%) patients; the overall number of additional lesions was 47 of 279 (17%). Compared with preoperative NBI, intraoperative NBI yielded significantly higher scores for the vocal cords (p = 0.005), false vocal cords (p = 0.010), and ventricle of the larynx (p < 0.001). Elevated Derkay scores were significantly associated with male sex (p = 0.012) and alcohol consumption (p = 0.007). CONCLUSION Intraoperative NBI is more accurate in detecting papillomatous lesions, and preoperative NBI cannot replace intraoperative NBI. LEVEL OF EVIDENCE 4 Laryngoscope, 134:1820-1824, 2024.
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Affiliation(s)
- Keishi Matsuda
- Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroumi Matsuzaki
- Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Dai Fujiwara
- Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Kiyoshi Makiyama
- Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Takeshi Oshima
- Department of Otorhinolaryngology-Head and Neck Surgery, Nihon University School of Medicine, Tokyo, Japan
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Zhou J, Li M, Liu D, Sheng F, Cai J. Differential Diagnosis of Benign and Malignant Breast Papillary Neoplasms on MRI With Non-mass Enhancement. Acad Radiol 2023; 30 Suppl 2:S127-S132. [PMID: 36906443 DOI: 10.1016/j.acra.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 03/11/2023]
Abstract
RATIONALE AND OBJECTIVES To explore the differential diagnosis of benign and malignant papillary neoplasms on MRI with non-mass enhancement. MATERIALS AND METHODS A total of 48 patients with surgically confirmed papillary neoplasms showing non-mass enhancement were included. Clinical findings, mammography and MRI features were retrospectively analyzed, and lesions were described according to the breast imaging report and data system (BI-RADS). Multivariate analysis of variance was used to compare the clinical and imaging features of benign and malignant lesions. RESULTS Fifty-three papillary neoplasms were shown on MR images with non-mass enhancement, including 33 intraductal papilloma and 20 papillary carcinomas (9 intraductal papillary carcinoma, 6 solid papillary carcinomas, and 5 invasive papillary carcinoma). Mammography showed amorphous calcification in 20% (6/30), of which 4 were in papilloma and 2 were in papillary carcinoma. On MRI, papilloma mostly showed linear distribution in 54.55% (18/33), clumped enhancement in 36.36% (12/33). Papillary carcinoma showed segmental distribution in 50% (10/20), clustered ring enhancement in 75% (15/20). ANOVA showed age (p = 0.025), clinical symptoms (p < 0.001), apparent diffusion coefficient (ADC) value (p = 0.026), distribution pattern (p = 0.029) and internal enhancement pattern (p < 0.001) were statistically significant between benign and malignant of papillary neoplasms. Multivariate analysis of variance suggested that the internal enhancement pattern was the only statistically significant factor (p = 0.010). CONCLUSIONS Papillary carcinoma on MRI with non-mass enhancement mostly showed internal clustered ring enhancement, while papilloma mostly showed internal clumped enhancement; additional mammography is of limited diagnostic value, and suspected calcification occurs mostly in papilloma.
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Affiliation(s)
- Juan Zhou
- Department of Radiology, 5th Medical Center of Chinese PLA General Hospital, 8 Dongda St, Fengtai District, Beijing, 100071 China.
| | - Mei Li
- Department of Radiology, PLA Middle Military Command General Hospital, Wuhan, China
| | - Dongqing Liu
- Department of Radiology, 5th Medical Center of Chinese PLA General Hospital, 8 Dongda St, Fengtai District, Beijing, 100071 China
| | - Fugeng Sheng
- Department of Radiology, 5th Medical Center of Chinese PLA General Hospital, 8 Dongda St, Fengtai District, Beijing, 100071 China
| | - Jianming Cai
- Department of Radiology, 5th Medical Center of Chinese PLA General Hospital, 8 Dongda St, Fengtai District, Beijing, 100071 China
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4
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Sripawadkul W, Khzam RA, Tang V, Zein M, Dubovy SR, Galor A, Karp CL. Anterior segment optical coherence tomography characteristics of conjunctival papilloma as compared to papilliform ocular surface squamous neoplasia. Eye (Lond) 2023; 37:995-1001. [PMID: 36402855 PMCID: PMC10050070 DOI: 10.1038/s41433-022-02309-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/24/2022] [Accepted: 11/08/2022] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To describe the anterior segment optical coherence tomography (AS-OCT) appearance of conjunctival papilloma and identify differentiating features from papilliform ocular surface squamous neoplasia (OSSN). METHOD A retrospective chart review of individuals clinically diagnosed with conjunctival papilloma (n = 10) or papilliform OSSN (n = 10) based on slit lamp features. Data on demographics, tumour characteristics, and primary treatment were collected. AS-OCT features were assessed including epithelial thickness and reflectivity, a corrugated epithelial surface, presence of an overhanging edge, presence of intrinsic spaces and posterior shadowing. Histopathology was available in 5 papilloma and 3 OSSN specimens. RESULT Overall, the majority of individuals in both groups were white males. OSSN lesions were more likely to involve the limbus (80% vs.10%, p = 0.005) and the bulbar conjunctiva (100% vs. 20%, p < 0.001) compared to papillomas. On AS-OCT, maximum epithelial thickness was thicker in papilloma compared to OSSN (936 ± 533 vs. 637 ± 207 µm, p = 0.009). The feature that best differentiated papilloma from OSSN was an overhanging edge (100% vs. 0%, p < 0.001), where the epithelial lesion was seen on top of underlying normal epithelium. Other features more common in papilloma compared to OSSN included a corrugated epithelial surface (70% vs.10%, p = 0.02), the presence of intrinsic spaces (100% vs. 50%, p = 0.03), and posterior shadowing (100% vs. 40%, p = 0.01). CONCLUSION AS-OCT shows differentiating features between papilloma and OSSN with an overhanging edge as a distinctive AS-OCT feature of papilloma.
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Grants
- P30 EY014801 NEI NIH HHS
- Research to Prevent Blindness (RPB)
- NIH Center Core Grant P30EY014801, Dr. Ronald and Alicia Lepke Grant, The Lee and Claire Hager Grant, The Robert Farr Family Grant, The Grant and Diana Stanton-Thornbrough, The Robert Baer Family Grant, The Roberto and Antonia Menendez Grant, The Emilyn Page and Mark Feldberg Grant, The Calvin and Flavia Oak Support Fund, The Robert Farr Family Grant, The Jose Ferreira de Melo Grant, The Richard and Kathy Lesser Grant, The Honorable A. Jay Cristol Grant, The Michele and Ted Kaplan Grant, The Carol Soffer Grant, and the Richard Azar Family Grant(institutional grants).
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Affiliation(s)
- Wathanee Sripawadkul
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
- Department of Ophthalmology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | - Rayan Abou Khzam
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
| | - Vincent Tang
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
| | - Mike Zein
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
| | - Sander R Dubovy
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
- Florida Lions Ocular Pathology Laboratory, Miami, FL, USA
| | - Anat Galor
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
- Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL, USA
| | - Carol L Karp
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA.
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5
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Konaka Y, Endoh M, Sasage T, Nakahashi K, Suzuki H, Ogata S, Shiono S. [Growing Mixed Squamous Cell and Glandular Papilloma Difficult to Differentiate from Primary Lung Cancer:Report of a Case]. Kyobu Geka 2022; 75:731-734. [PMID: 36156526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 76-year-old woman was referred to our hospital due to abnormal chest radiography findings. Chest computed tomography (CT) revealed a nodule in the right lower lobe. Fluorodeoxyglucose-positronemission tomography (FDG-PET) showed abnormal accumulation in the nodule. Bronchoscopy did not provide a definitive diagnosis. Since the nodule tended to increase in size, primary lung cancer was suspected and surgery was performed. During the surgery, pathological diagnosis of squamous cell carcinoma was made, and a right lower lobectomy was performed. Subsequently, a pathological diagnosis of mixed squamous cell and glandular papilloma (mixed papilloma) was made. She has had no sign of recurrence for approximately four years since the surgery.
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Affiliation(s)
- Yoshiyuki Konaka
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
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6
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Haga N, Ito K, Kasai Y, Masuya D. [Solitary Mixed Squamous and Glandular Papilloma of the Peripheral Lung:Report of a Case]. Kyobu Geka 2022; 75:652-655. [PMID: 35892308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A 76-year-old woman was admitted because of a 25 mm solitary nodule in right S10 on chest computed tomography (CT). 18 fluoro deoxyglucose-positron emission tomography (FDG-PET) indicated accumulation with standardized uptake value( SUV) max 5.2. The serum carcinoembryonic antigen( CEA) and squamous cell carcinoma antigen( SCC) level was elevated. Although the diagnosis was not established by bronchofiberscopy, lung cancer was suspected and the video assisted thoracoscopic surgery (VATS) was carried out. Since no malignant cells were detected by intra-operative pathology, partial resection of the right lower lobe was performed. The postoperative pathological examination revealed features of mixed squamous and glandular papilloma.
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Affiliation(s)
- Nanase Haga
- Department of Thoracic Surgery, Sumitomo Hospital, Osaka, Japan
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7
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Wu C, Yang JF, Zhang Q, Liu W, Liao K, Hu B. Successful cholangioscopic electrocoagulation for biliary papillomatosis: Report covering six cases (with video). Gastroenterol Hepatol 2021; 44:546-551. [PMID: 33617929 DOI: 10.1016/j.gastrohep.2020.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 11/29/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Biliary papillomatosis is a rare type of papillomatosis. Depending on the location of the disease, radical surgical resection or liver transplants are the treatment of choice. These radical surgical options may be unrealistic in patients who are not surgical candidates or who are unwilling to consider surgery. AIMS To evaluate the effectiveness of endoscopic electrocoagulation for the biliary papillomatosis. METHODS In this case series, we report six patients with unresectable biliary papillomatosis who underwent cholangioscopic electrocoagulation using needle knife and their clinic follow up information. RESULTS After patients received cholangioscopy with electrocoagulation of the residual biliary papilloma, the daily T-tube drainage volume increased to 200-400ml with improvement in the drainage content and significant relief of clinical symptoms, such as jaundice and abdominal pain. CONCLUSION This method of using electrocoagulation to directly target and destroy tumor tissue is a safe and effective alternative for those with unresectable disease, and this method has shown to enhance T-tube drainage volume and improve patients' overall clinical symptoms.
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Affiliation(s)
- Chuncheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, China
| | - Juliana F Yang
- Department of Internal Medicine, Division of Digestive and Liver Diseases, The Vanderbilt University Medical Center, Nashville, TN, USA
| | - Qiongying Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, China
| | - Ke Liao
- Department of Gastroenterology, West China Hospital, Sichuan University, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, China.
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Sekine M, Goto F, Saito K, Kaneda S, Yamamoto H, Murakami T, Okami K. Localized Maxillary Sinus Papilloma: Management of Incidental Lesion. Tokai J Exp Clin Med 2021; 46:17-21. [PMID: 33835470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
Most maxillary sinus papillomas are confirmed when they have extended beyond the nasal cavity and are rarely found while localized in the maxillary sinus. We experienced two cases of localized papilloma in the maxillary sinus. Case 1 was a 69-year-old man with a localized left maxillary sinus lesion detected during a routine imaging examination. As the lesion was likely to be papilloma, we recommended that the patient undergo diagnostic surgery, which he refused. He experienced bloody rhinorrhea 1 year and 9 months after the first visit, and computed tomography (CT) showed increased lesions and bone destruction. Histological examinations revealed squamous cell carcinoma ex inverted papilloma. He died 5 years after the first visit. Case 2 was a 46-year-old woman in whom positron emission tomography/CT showed a localized right maxillary sinus lesion. Tissue biopsy results indicated oncocytic papilloma. Endoscopic resection was performed later. On an imaging examination, sinonasal papilloma was determined accidentally to be a localized lesion of the maxillary sinus. A detailed interpretation of the CT scan was useful in estimating sinonasal papilloma. Tissue biopsy or diagnostic surgery should be performed when sinonasal papilloma is suspected during appropriate image evaluation.
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Affiliation(s)
- Motoki Sekine
- Department of Otolaryngology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
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Luo L, Wang J, Xia J, Zhang R, Yao X. False-Positive Uptake of 131I From Basal Cell Papilloma in a Patient With Metastatic Papillary Thyroid Cancer. Clin Nucl Med 2021; 46:358-360. [PMID: 33492860 DOI: 10.1097/rlu.0000000000003506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT A 64-year-old woman with metastatic papillary thyroid cancer underwent a total thyroidectomy followed by 2 courses of 131I therapy. The posttherapeutic whole-body scan after the second dose of 131I therapy showed multifocal bone metastasis. In addition, there is focal abnormal intense radiotracer uptake at the right inguinal region. SPECT/CT revealed that this abnormal focal radioactivity was from a superficial skin lesion. Further physical examination revealed a raised, approximately 1-cm, irregular grayish-brown lesion on the right groin skin. Histopathological examination confirmed the diagnosis of basal cell papilloma (seborrheic keratosis).
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Affiliation(s)
- Lingling Luo
- From the Department of Nuclear Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People's Republic of China
| | - Jiaqiong Wang
- Department of Radiology, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL
| | - Junyong Xia
- From the Department of Nuclear Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People's Republic of China
| | - Ran Zhang
- From the Department of Nuclear Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People's Republic of China
| | - Xiaobo Yao
- From the Department of Nuclear Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People's Republic of China
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10
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Fisher CP, Romak JJ, Benito DA, Sataloff RT. Diverse Endoscopic Techniques for Diagnosing Recurrent Respiratory Papillomatosis. Ear Nose Throat J 2019; 98:473-474. [PMID: 30897951 DOI: 10.1177/0145561319837450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Casey P Fisher
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Jonathan J Romak
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Daniel A Benito
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
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11
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Uysal Yazici M, Azapagasi E, Mulazimoglu S. A rare cause of laryngeal stenosis. Intensive Care Med 2019; 45:1149-1150. [PMID: 30617462 DOI: 10.1007/s00134-018-05508-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 12/13/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Mutlu Uysal Yazici
- Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
| | - Ebru Azapagasi
- Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Selcuk Mulazimoglu
- Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, Ankara, Turkey
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12
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Jackowska J, Klimza H, Winiarski P, Piersiala K, Wierzbicka M. The usefulness of narrow band imaging in the assessment of laryngeal papillomatosis. PLoS One 2018; 13:e0205554. [PMID: 30300415 PMCID: PMC6177196 DOI: 10.1371/journal.pone.0205554] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 09/27/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES/HYPOTHESIS Recurrent respiratory papillomatosis (RRP) is a benign disease caused by human papillomavirus 6 and 11. The characteristic feature of this disease are wart-like lesions covering the respiratory epithelium with a predilection for the larynx. There is no curative treatment for the disease. The goal of the treatment is a total surgical removal of the papillomatous lesions in order to reduce the number of relapses. Therefore, a good visualization method of papillomas is crucial during surgery. The aim of the study was to compare the accuracy of narrow band imaging (NBI) to the use of white light alone in detecting RRP. METHODS The study was carried out between April 2013 and November 2015 at Poznan University of Medical Sciences, Department of Otolaryngology, Poland. Rigid endoscopy with conventional white light (WL) and NBI (CV-260SL processor and CLV- 260SL light source, Olympus Optical Co. Ltd, Tokyo, Japan) was performed in all patients during direct laryngoscopy. All anatomical sites of the larynx and trachea were assessed using the Dikkers scale and Derkay total site scoring system with WL and NBI. The consensus was reached as to the number of lesions seen in WL compared to NBI. RESULTS During 36 microlaryngoscopies, the number of papillomas detected in the larynx (by Derkay total site score) differed significantly between white light endoscopy and NBI (Wilcoxon test p = 0.000655). In endoscopy with NBI, a mean of 1.3 more papillomas in Derkay total site score was detected in comparison to white light endoscopy NBI showed additional areas of diseased tissue in 15/36 (41.67%) patients. CONCLUSIONS NBI as an additional tool during microlaryngoscopy can improve the detection of papillomatous lesions.
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Affiliation(s)
- J. Jackowska
- Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - H. Klimza
- Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland
- * E-mail:
| | - P. Winiarski
- Department of Otolaryngology, Otolaryngological Oncology and Maxillofacial Surgery, Uniwersytet Mikolaja Kopernika Collegium Medicum, Bydgoszcz, Poland
| | - K. Piersiala
- Student Research Group at the Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland
| | - M. Wierzbicka
- Department of Otolaryngology, Head and Neck Surgery, Poznań University of Medical Sciences, Poznań, Poland
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13
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Nijs J, Moors G, Demuynck K, Geyskens P, Grouwels P, Kuypers M, Verbrugge H. HPV papilloma in the lung in a Crohn's disease patient treated with Infliximab. Acta Gastroenterol Belg 2018; 81:439-440. [PMID: 30350537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- J Nijs
- Department of Internal Medicine, Sint-Trudoziekenhuis ; (2) Department of Gastroenterology, UZ Leuven
| | - G Moors
- Department of Gastroenterology, UZ Leuven
| | - K Demuynck
- Department of Internal Medicine, Sint-Trudoziekenhuis
| | - P Geyskens
- Department of Surgery, Sint-Trudoziekenhuis
| | - P Grouwels
- Department of Radiology, Sint-Trudoziekenhuis
| | - M Kuypers
- Department of Emergency Medicine, Sint-Trudoziekenhuis
| | - H Verbrugge
- Department of Internal Medicine, Sint-Trudoziekenhuis, Sint-Truiden
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14
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Abstract
A series of 291 ductogalactograms was reviewed to detect radiologic signs pathognomonic of single or multiple papillomas. These lesions were found in 24% of the patients. Ductogalactography is the only method that can reach a diagnosis in many patients with nipple discharge. It has a good reliability (76%); we had no false-positives or false-negatives as regards malignant lesions in our series.
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15
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Abstract
The authors report on a series of 529 consecutive patients examined on physical examination, mammography, nipple discharge cytology and galactography. The criterion for galactography was essentially bloody nipple discharge (73% of cases). Serous nipple discharge was not considered worthy of routine galactography since it is associated with an extremely low incidence of breast cancer. Surgical excision and histologic examination of the discharging duct was performed in 200 cases. Eighteen cases of breast cancer were detected (10 infiltrating, 8 intraductal) of which 9, 6, 7 or 7 were suspected on physical examination, mammography, cytology or galactography, respectively. All combined tests suspected 13 of 18 breast cancers; 3 intraductal breast cancers were biopsied because of evidence of multiple papillomas on galactography, and 2 infiltrating breast cancers were operated because of persistent bloody nipple discharge in the absence of any other sign. No breast cancer was suspected on galactography alone. Galactography is indicated in the presence of bloody nipple discharge, and a biopsy should be performed when breast cancer or multiple papillomas are suspected. The diagnosis and excision of a single papilloma (breast cancer was never misdiagnosed as a single papilloma on galactography) is not worthwhile since a single papilloma is a benign lesion, and the benefit of its excision is still unclear.
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Affiliation(s)
- S Ciatto
- Centro per lo Studio e la Prevenzione Oncologica, Florence
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16
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Wacławek M, Miłoński J, Kowalski A, Kikowski Ł, Olszewski J, Zielińska-Bliźniewska H. [Narrow-band imaging endoscopy for diagnosis of adult laryngeal papillomatosis - case raports]. Wiad Lek 2018; 71:1418-1423. [PMID: 30448820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The laryngeal papillomas belong to the group of non-malignant tumours. The risk of getting sick increases with the number of contingent sexual contacts, smoking, alcohol abuse and untreated gastro-oesophageal reflux. This paper describes five cases presenting different levels of exposure to the risk factors and variable course of adult laryngeal papillomatosis. These people, in addition to routine diagnostics, were examined using endoscopy with the use of narrow beam of light, which turns out to be a useful diagnostic tool in the case of laryngeal papillomatosis.
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Affiliation(s)
- Magdalena Wacławek
- Klinika Otolaryngologii, Onkologii Laryngologicznej, Audiologii I Foniatrii, Ii Katedry Otolaryngologii, Uniwersytet Medyczny w Łodzi, Łódź, Polska
| | - Jarosław Miłoński
- Klinika Otolaryngologii, Onkologii Laryngologicznej, Audiologii I Foniatrii, Ii Katedry Otolaryngologii, Uniwersytet Medyczny w Łodzi, Łódź, Polska
| | - Andrzej Kowalski
- Klinika Otolaryngologii, Onkologii Laryngologicznej, Audiologii I Foniatrii, Ii Katedry Otolaryngologii, Uniwersytet Medyczny w Łodzi, Łódź, Polska
| | - Łukasz Kikowski
- Ośrodek Terapii Hiperbarycznej Creator Sp. Z O.O. Nzoz W Łodzi, Łódź, Polska
| | - Jurek Olszewski
- Klinika Otolaryngologii, Onkologii Laryngologicznej, Audiologii I Foniatrii, Ii Katedry Otolaryngologii, Uniwersytet Medyczny w Łodzi, Łódź, Polska
| | - Hanna Zielińska-Bliźniewska
- Klinika Otolaryngologii, Onkologii Laryngologicznej, Audiologii I Foniatrii, Ii Katedry Otolaryngologii, Uniwersytet Medyczny w Łodzi, Łódź, Polska, Zakład Alergologii I Rehabilitacji Oddechowej Ii Katedry Otolaryngologii, Uniwersytet Medyczny W Łodzi, Łódź, Polska
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Choi HJ, Ko KH, Jung HK. Shear Wave Elastography for Surgically Verified Breast Papillary Lesions: Is It Effective for Differentiation Between Benign and Malignant Lesions? J Ultrasound Med 2017; 36:2007-2014. [PMID: 28708299 DOI: 10.1002/jum.14293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/26/2016] [Accepted: 12/28/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of shear wave elastography (SWE) for differentiating benign from malignant breast papillary lesions METHODS: B-mode ultrasound (US) and SWE were available in 56 surgically confirmed papillary lesions (48 [85.7%] benign and 8 [14.3%] malignant). The diagnostic performances of US, SWE parameters, and combined US with SWE parameters were calculated by receiver operating characteristic curve analysis and compared. RESULTS The highest area under the receiver operating characteristic curve (Az ) value for US was 0.500 (95% confidence interval [CI], 0.363, 0.637). The sensitivity was 100% (8 of 8), and the specificity was 0% (0 of 48). False-positive biopsy results were obtained in 48 (85.7%) of 56 lesions. The Az value for mean elasticity (0.721; 95% CI, 0.585, 0.833) was higher than that for B-mode US (P < .01) and the highest with the optimal cutoff value of 44.3 kPa (sensitivity, 75%; specificity, 75%). By adding the mean elasticity cutoff value of 44.3 kPa to B-mode US, the performance was increased (Az , 0.781; 95% CI, 0.585, 0.833) with sensitivity of 87.5% and specificity of 68.8%, and false-positive biopsy results were reduced to 26.8%. CONCLUSIONS The additional use of SWE to B-mode US may be effective for differentiating benign and malignant breast papillary lesions, with a significant decrease in the false-positive biopsy rate.
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Affiliation(s)
- Hye Jeong Choi
- Department of Radiology, CHA Bundang Medical Center, CHA University, Bundang-gu, Korea
| | - Kyung Hee Ko
- Department of Radiology, CHA Bundang Medical Center, CHA University, Bundang-gu, Korea
| | - Hae Kyoung Jung
- Department of Radiology, CHA Bundang Medical Center, CHA University, Bundang-gu, Korea
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18
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Sakata T, Nakaya M, Otsu M, Sunazawa T, Wakabayashi Y. Autologous Pericardial Patch Repair for Papillary Fibroelastoma on an Aortic Valve Leaflet. Tex Heart Inst J 2017; 44:144-146. [PMID: 28461803 DOI: 10.14503/thij-16-5822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A 50-year-old man with no history of cardiovascular disease was referred to our hospital because of an abnormal electrocardiogram. Echocardiograms and computed tomograms revealed a 9-mm mass on the underside of an aortic valve leaflet. We chose surgical treatment, to prevent embolic events. The tumor's appearance and intraoperative frozen section were consistent with myxoma. We resected the tumor and its attachment, including the free margin of the aortic valve leaflet, and repaired the defect with use of a glutaraldehyde-treated autologous pericardial patch. The postoperative histopathologic diagnosis was papillary fibroelastoma. Six months later, echocardiograms showed mild aortic regurgitation and no recurrence of the aortic valve mass. Papillary fibroelastoma and myxoma can be difficult to distinguish intraoperatively, yet the diagnosis has considerable influence on the surgical strategy, including whether valve-sparing excision is an option. Therefore, it is necessary to at least suspect both entities if the tumor characteristics are unusual. This case is instructive for surgeons and pathologists.
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Li LJ, Yao JY, Zhou XC, Zhao XB, Zhong WJ, Ou B, Luo BM, Hao SY, Zhi H. What Help Could Ultrasound Elastography Give to the Diagnosis of Breast Papillary Lesions? Ultrasound Med Biol 2017; 43:903-910. [PMID: 28256344 DOI: 10.1016/j.ultrasmedbio.2017.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 12/02/2016] [Accepted: 01/05/2017] [Indexed: 06/06/2023]
Abstract
On the basis of results of our previous studies and the findings of other scholars, the most common histologic type of false-positive diagnosis with strain elastography (SE) was papilloma. The objectives of our study were to evaluate whether SE could contribute to conventional ultrasound differentiation between benign and malignant papillary lesions and between papillary lesions and other common benign breast lesions. Data on 89 papillary lesions at our hospital, including 74 benign and 15 malignant papillary lesions, were included in our study. In addition, 198 non-papillary benign tumors were selected as the control group, including 126 fibroadenomas and 72 cases of fibrocystic mastopathy. All patients gave written informed consent. All patients with breast lesions underwent conventional ultrasound and SE examination. Breast Imaging Recording and Data System (BI-RADS) category and SE score were compared with respect to sensitivity, specificity and accuracy in differentiating between benign and malignant papillary lesions. We then explored the possibility of using BI-RADS combined with SE to differentiate papillary lesions from non-papillary benign tumors. For differentiating between benign and malignant papillary lesions, the area under the receiver operating characteristic curve (AUC) of BI-RADS was 0.568, whereas the AUC values of SE score, strain ratio and BI-RADS combined with SE were 0.517, 0.584 and 0.509, respectively (p > 0.05). For differentiating between papillary lesions and non-papillary benign lesions, the AUC of BI-RADS combined with SE was 0.835, which was higher than the values for BI-RADS (0.775) and SE (SE score: 0.648, strain ratio: 0.661) (p < 0.001). The specificity and accuracy of BI-RADS combined with SE were significantly higher than those for BI-RADS alone without a decrease in sensitivity (p < 0.05). SE could not improve the diagnostic efficiency of BI-RADS in differentiating between benign and malignant papillary lesions. However, BI-RADS combined with SE could improve the specificity of BI-RADS without decrease in sensitivity for differentiating breast papillary lesions from non-papillary benign lesions.
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Affiliation(s)
- Lu-Jing Li
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Ji-Yi Yao
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xin-Chuan Zhou
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xin-Bao Zhao
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Wen-Jing Zhong
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Bing Ou
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Bao-Ming Luo
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Shao-Yun Hao
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Hui Zhi
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China.
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Hayashi T, Tachibana S, Nakao K, Tokitsu K, Morita T, Kishima G. [Solitary Peripheral Pulmonary Squamous Cell Papilloma;Diagnostic Significance of 18F-fluorodeoxyglucose Positron Emission Tomography Findings]. Kyobu Geka 2017; 70:309-312. [PMID: 28428529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The patient was a 79-year-old woman who had received enucleation of right pulmonary papilloma 7 years earlier. She experienced bloody sputum and was therefore referred to our hospital. Chest computed tomography revealed a mass shadow(21 mm) in the right upper lobe (S2). By bronchoscopy, there was no bulging lesion in the visible range. SCC and CEA increased to 6.4 ng/ml and 6.42 ng/ml, respectively. Whole-body 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased FDG uptake in the region of the right-lung mass shadow (maximum standardized uptake value 12.95). Since malignancy could not be ruled out, a wedge resection was performed. The post-operative histopathologic diagnosis was squamous cell papilloma. Our literature review showed 12 out of 14 cases with solitary papilloma of the peripheral lung to have increased FDG uptake. Ki-67 positive cells were confirmed in the basal layers of the epithelium, and active cell proliferation of the papilloma is likely to be a cause of increased FDG uptake.
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Affiliation(s)
- Tetsuya Hayashi
- Department of Chest Surgery, Settsu Hikari Hospital, Settsu, Japan
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Abstract
INTRODUCTION F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful for the staging and assessment of treatment response in patients with lymphoma. Occasionally, benign lesions demonstrate avid FDG uptake and result in false positive findings. CASE We report the case of an 82-year-old man presenting with cutaneous lesions, which were histopathologically diagnosed as intravascular lymphoma. FDG-PET/CT for staging demonstrated an FDG-avid mass extending from the right maxillary sinus to the nasal cavity, moderate uptake in the adrenal glands, mild uptake in the knee and the foot, and faint uptake in the skin and subcutaneous tissue of the legs. He subsequently underwent biopsy of the paranasal mass, which was diagnosed as oncocytic Schneiderian papilloma without lymphoma invasion. Glucose transporter (GLUT) 1 staining was highly positive in the papilloma cells, resulting in high FDG avidity. After completion of chemotherapy, the abnormal FDG uptakes in the skin, soft tissue, and adrenal glands disappeared on PET/CT. However, avid FDG uptake persisted in the sinonasal Schneiderian papilloma for 15 months before regression. CONCLUSION Benign tumors with oncocytic components may show avid FDG uptake. Therefore, correct diagnosis of oncocytic Schneiderian papilloma on FDG images is difficult when other accompanying malignant tumors, especially lymphoma, are present. If post-therapeutic PET/CT images show a discordant lesion, oncocytic tumors, albeit uncommon, should be considered in the differential diagnoses.
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Affiliation(s)
- Masamichi Koyama
- Department of Nuclear Medicine
- Correspondence: Masamichi Koyama, Department of Nuclear Medicine, The Cancer Institute Hospital of JFCR, Ariake, Koto-ku, Tokyo, Japan (e-mail: )
| | | | | | | | - Kengo Takeuchi
- Division of Pathology, The Cancer Institute Hospital of JFCR, Tokyo, Japan
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22
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Ozkur E, Falay T, Turgut Erdemir AV, Gurel MS, Leblebici C. Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas. Dermatol Online J 2016; 22:13030/qt7933q377. [PMID: 27136629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 03/15/2016] [Indexed: 06/05/2023] Open
Abstract
Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva.
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Affiliation(s)
- Ezgi Ozkur
- Istanbul Training and Research Hospital.
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23
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Wong MW, Bair MJ, Shih SC, Chu CH, Wang HY, Wang TE, Chang CW, Chen MJ. Using typical endoscopic features to diagnose esophageal squamous papilloma. World J Gastroenterol 2016; 22:2349-2356. [PMID: 26900297 PMCID: PMC4735009 DOI: 10.3748/wjg.v22.i7.2349] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/12/2015] [Accepted: 11/19/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To better understand some of the superficial tiny lesions that are recognized as squamous papilloma of the esophagus (SPE) and receive a different pathological diagnosis.
METHODS: All consecutive patients with esophageal polypoid lesions detected by routine endoscopy at our Endoscopy Centre between October 2009 and June 2014 were retrospectively analysed. We enrolled patients with SPE or other superficial lesions to investigate four key endoscopic appearances (whitish color, exophytic growth, wart-like shape, and surface vessels) and used narrow band imaging (NBI) to distinguish their differences. These series endoscopic images of each patient were retrospectively reviewed by three experienced endoscopists with no prior access to the images. All lesion specimens obtained by forceps biopsy were fixed in formalin and processed for pathological examination. The following data were collected from patient medical records: gender, age, indications for esophagogastroduodenoscopy, and endoscopic characteristics including lesion location, number, color, size, surface morphology, surrounding mucosa, and surface vessels under NBI. Clinicopathological features were also compared.
RESULTS: During the study period, 41 esophageal polypoid lesions from 5698 endoscopic examinations were identified retrospectively. These included 24 patients with pathologically confirmed SPE, 11 patients with squamous hyperplasia, three patients with glycogenic acanthosis, two patients with ectopic sebaceous glands, and one patient with a xanthoma. In the χ2 test, exophytic growth (P = 0.003), a wart-like shape (P < 0.001), and crossing surface vessels under NBI (P = 0.001) were more frequently observed in SPE than in other lesion types. By contrast, there was no significant difference regarding the appearance of a whitish color between SPE and other lesion types (P = 0.872). The most sensitive characteristic was wart-like projections (81.3%) and the most specific was exophytic growth (87.5%). Promising positive predictive values of 84.2%, 80.8%, and 82.6% were noted for exophytic growth, wart-like projections, and surface vessel crossing on NBI, respectively.
CONCLUSION: The use of three key typical endoscopic appearances - exophytic growth, a wart-like shape, and vessel crossing on the lesion surface under NBI - has a promising positive predictive value of 88.2%. This diagnostic triad is useful for the endoscopic diagnosis of SPE.
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Sedloev T, Bassarova A, Angelov K, Vasileva M, Asenov Y. Combination of Juvenile Papillomatosis, Juvenile Fibroadenoma and Intraductal Carcinoma of the Breast in a 15-Year-old Girl. Anticancer Res 2015; 35:5027-5029. [PMID: 26254403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 06/03/2015] [Indexed: 06/04/2023]
Abstract
UNLABELLED The association of juvenile papillomatosis with carcinoma is proven, but very rare, as there exist several reported cases. CASE REPORT A 15-year-old girl with no family history of breast cancer presented with two masses in the left breast. The excisional biopsy on both lumps revealed juvenile fibroadenoma and juvenile papillomatosis epithelial proliferation multiple cystic expanded channels. In some of these channels, cytological features of intraductal carcinoma were observed. We performed a full immunohistochemical examination of the juvenile papillomatosis. The patient refused any further surgical or adjuvant treatment. There are no signs of recurrence in the 15 year follow-up. DISCUSSION This case is a diagnostic and therapeutic challenge, taking into account the patient's age and the controversial treatment recommendations. Good collaboration between surgeons and pathologists is essential for an accurate diagnostic process and aims to avoid under- or overtreatment.
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Affiliation(s)
- Theophil Sedloev
- Department of Surgery, Queen Joanna University Hospital, Sofia, Bulgaria
| | - Assia Bassarova
- Department of Pathology, Akerhus University Hospital, Oslo, Norway
| | - Kostadin Angelov
- Department of Surgery, Aleksandrovska University Hospital, Sofia, Bulgaria
| | - Mariela Vasileva
- Department of Surgery, Aleksandrovska University Hospital, Sofia, Bulgaria
| | - Yavor Asenov
- Department of Surgery, Queen Joanna University Hospital, Sofia, Bulgaria
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Matsushima T, Kitamura K, Fukui M, Kinoshita K, Fukushima T, Kuromatsu C, Maeyama R, Hasuo K. Choroid plexus papillomas. Prog Exp Tumor Res 2015; 30:181-93. [PMID: 3628805 DOI: 10.1159/000413676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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26
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Hansen LB. [Accidental discovery of 18F-fluorodeoxyglucose PET/CT-positive papilloma in sinus sphenoidalis in a patient with recurrence of breast cancer]. Ugeskr Laeger 2015; 177:V06140318. [PMID: 25650580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A patient suspected for metastatic breast cancer went through an 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT). Along with metastatic lymph nodes in the neck it showed high 18F-FDG uptake in a polypoidal structure in the sinus sphenoidalis. When asked she had no related symptoms due to the sphenoid polyp and the CT-scan showed no bone destruction. To rule out malignancy a biopsy was made showing benign sinonasal papilloma of oncocytic origin. High 18F-FDG PET uptake can be seen in benign structures and should therefore not be the only predictor for malignancy.
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27
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Choi SH, Jo S, Kim DH, Park JS, Choi Y, Kook SH, Chung EC, Lee SY. Clinical and imaging characteristics of papillary neoplasms of the breast associated with malignancy: a retrospective cohort study. Ultrasound Med Biol 2014; 40:2599-2608. [PMID: 25220267 DOI: 10.1016/j.ultrasmedbio.2014.06.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 06/23/2014] [Accepted: 06/30/2014] [Indexed: 06/03/2023]
Abstract
Papillary neoplasms of the breast comprise a broad range of pathologies ranging from papillomas to papillary carcinomas and have been associated with breast cancers. In this study, we evaluated the clinical, mammographic and sonographic features of papillary breast neoplasms from benign papillary breast lesions to malignancy-associated papillary lesions. A total of 194 lesions in 179 patients were analyzed, including 117 benign papillomas, 24 atypical papillomas, 41 benign papillomas with malignancies and 12 papillary carcinomas found between January 2003 and August 2011 in our institution. Statistically significant clinical factors included patient age (p = 0.001), lesion multiplicity (p = 0.009) and peripheral location (p = 0.003). Among these factors, the odds ratio for malignancy was 8.9 for bilateral multiple lesions. Visibility (p = 0.001) and density (p = 0.039) were significant factors for malignancy in mammograms, and echo patterns (p = 0.006), boundary (p = 0.001) and vascularity (p = 0.005) were significant features on ultrasound that differentiated malignancies from benign lesions. Overall, when papillary breast lesions are located bilaterally and peripherally in older patients, they are correlated with breast cancers. Additionally, for papillary breast lesions that appear highly dense on mammograms and/or exhibit positive vascularity on ultrasound, the probability of malignancy is relatively high.
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Affiliation(s)
- Seon Hyeong Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Radiology, School of Medicine, Graduate School, Hanyang University, Seoul, Korea.
| | - Sangwon Jo
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong-Hoon Kim
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Seon Park
- Department of Radiology, School of Medicine, Graduate School, Hanyang University, Seoul, Korea
| | - Yoonjung Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Shin-Ho Kook
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Chul Chung
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So-Yeon Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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28
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Yoon JH. Biliary papillomatosis: correlation of radiologic findings with percutaneous transhepatic cholangioscopy. J Gastrointestin Liver Dis 2013; 22:427-433. [PMID: 24369325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM To correlate the radiologic findings with percutaneous transhepatic cholangioscopy (PTCS) in patients with pathologically confirmed biliary papillomatosis. METHODS Thirteen patients diagnosed with pathologic papillomatosis or intraductal papillary neoplasms of the bile ducts were retrospectively reviewed. The imaging results from ultrasonography, multi-detector computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP) and percutaneous cholangiography (PTC) were correlated with the findings of PTCS. RESULTS Papillary neoplasms of the bile ducts usually appeared on ultrasound as a non-shadowing echogenic mass (60%) within dilated bile ducts. Localised dilatation of the bile duct with mild enhancing nodularities was the most common multi-detector CT finding (61.5%), followed by localised biliary dilatation with mild wall thickening (15.4 %). MRCP showed that the bile duct was locally dilated and filled with material of intermediate signal intensity (60%). An abnormal filling defect (71.4%) was the most common finding when PTC was used. In six patients who underwent PTCS, underlying fish egg-like intraluminal nodularities were noted with or without multifocal cauliflower-like papillary masses. In nine cases, the pathologic finding was intraductal papillary cholangiocarcinoma in the underlying biliary papillomatosis. Three patients were diagnosed as papillomatosis with high grade dysplasia and one as villous adenoma with underlying papillomatosis. CONCLUSIONS Imaging is useful for detecting bile duct tumours that cause obstruction, but its ability to detect fine features of intraductal papillary tumours is limited. Percutaneous transhepatic cholangioscopy is an effective approach that allows the direct visualisation and tissue confirmation of growing papillary tumours.
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Affiliation(s)
- Jung-Hee Yoon
- Department of Radiology Haeundae Paik Hospital, Inje University, College of Medicine, Busan, Republic of Korea;
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29
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Aguilar-Davidov B, Ramírez-Muciño A, Culebro-García C, Sotomayor M, Castillejos-Molina R, Feria-Bernal G, Rodríguez-Covarrubias F. Performance of computed tomographic urography for the detection of bladder tumors in patients with microscopic hematuria. Actas Urol Esp 2013; 37:408-11. [PMID: 23398811 DOI: 10.1016/j.acuro.2012.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 09/20/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Our objective was to evaluate the sensitivity, specificity, predictive value, and accuracy of computed tomographic urography for the detection of bladder tumors in patients with microscopic hematuria. MATERIAL AND METHODS Patients with microscopic hematuria initially evaluated with computed tomography and cystoscopy from January 2006 to December 2009 were evaluated. Computed tomography detecting a bladder lesion suspicious of malignancy was considered positive. Cystoscopy was classified as positive when a lesion requiring biopsy or resection was found. Performance characteristics of computed tomography were determined by comparing with cystoscopic and pathological findings. RESULTS A total of 112 patients were eligible for analysis. Seven tumors were found on cystoscopy; of these, 2 were correctly diagnosed by computed tomography and 5 were missed. An additional case was considered erroneously positive. The results are a sensitivity of 29%, specificity of 99%, positive predictive value of 67%, negative predictive value of 95%, and accuracy of 95%. CONCLUSIONS Although computed tomography has a high specificity its sensitivity is limited. For this reason conventional cystoscopy should be considered the standard for bladder evaluation of patients with microscopic hematuria.
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Affiliation(s)
- B Aguilar-Davidov
- Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México D.F., México
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Sohn YM, Park SH. Comparison of sonographically guided core needle biopsy and excision in breast papillomas: clinical and sonographic features predictive of malignancy. J Ultrasound Med 2013; 32:303-311. [PMID: 23341387 DOI: 10.7863/jum.2013.32.2.303] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical factors and sonographic features of benign papillomas of the breast proven by sonographically guided 14-gauge core needle biopsy and their upgrade or malignancy rate after sonographically guided vacuum-assisted excision or surgical excision. METHODS We reviewed the medical records of patients who underwent core needle biopsy from July 2005 to December 2011. We evaluated 39 benign papillomas without atypia in 34 patients. The papillomas were diagnosed by core needle biopsy and underwent surgical or vacuum-assisted excision. After core needle biopsy, imaging-histologic correlation was performed to determine concordance. The upgrade and malignancy rates were assessed after surgical or vacuum-assisted excision, and associated clinical and radiologic factors, including patient age, lesion size, distance from the nipple, sonographic features, and American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category were evaluated. RESULTS Three lesions (7.7 %) among 39 papillomas were upgraded to papilloma with atypia after surgical excision. There was no malignancy after excision. The upgrade rates for BI-RADS categories 3, 4a, 4b, and 4c were 0%, 6.9%, 0%, and 20%, respectively. There were no significant differences in the upgrade to papilloma with atypia in terms of the presence of symptoms, lesion size, distance from the nipple, BI-RADS category, or imaging-histologic correlation. CONCLUSIONS Prediction of papilloma with atypia, not malignancy, was challenging because there were no associated clinical or radiologic factors to predict papilloma with atypia before excision. However, there was no malignancy after excision. Therefore, intensive surveillance is preferable to immediate surgical excision for benign papillomas diagnosed on core needle biopsy.
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Affiliation(s)
- Yu-Mee Sohn
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea.
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Chiorean AR, Duma MM, Dudea SM, Bolboaca S, Dumitriu D, Eniu D, Sfrangeu SA. Typical and unusual sonoelastographic patterns of breast cystic lesions: impact on BI-RADS classification. Ultraschall Med 2012; 33:E138-E144. [PMID: 20972948 DOI: 10.1055/s-0029-1245699] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE To describe the sonoelastographic appearance of breast cysts (simple, complicated-cysts with sedimentation and complex-cysts with internal solid parts). To assess the influence of sonoelastography on the BI-RADS classification of complicated cysts. MATERIALS AND METHODS A prospective study was conducted and all cysts diagnosed by the same radiologist between May 2007 and July 2008 in our breast unit were included. Each lesion was assessed according to BI-RADS and the Tsukuba elasticity score using a Hitachi 8500 US device. Cytology or histopathology was obtained for complicated and complex cysts. RESULTS 49 simple, 43 complicated and 14 complex cysts were detected. The elasticity patterns were divided into 4 categories: typical BGR (blue-green-red) pattern, appearance similar to that described for solid. lesions, variants of BGR, an inverse score of 3. The BGR pattern was predominant in breast cysts. Atypical elasticity patterns were mostly associated with complicated and complex cysts. BI-RADS classification of complicated cysts before and after elastography showed a statistically significant difference in terms of final category assessment (most of the complicated cysts were downgraded to BI-RADS 2 after elastography). CONCLUSION Being aware of the wide spectrum of elastographic patterns of breast cysts and considering elastography when assessing the BI-RADS category of complicated cysts may lead radiologists to better patient management.
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MESH Headings
- Adult
- Biopsy, Fine-Needle
- Breast/pathology
- Breast Neoplasms/classification
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/classification
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/classification
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Squamous Cell/classification
- Carcinoma, Squamous Cell/diagnostic imaging
- Carcinoma, Squamous Cell/pathology
- Diagnosis, Differential
- Elasticity Imaging Techniques/methods
- Female
- Fibrocystic Breast Disease/classification
- Fibrocystic Breast Disease/diagnostic imaging
- Fibrocystic Breast Disease/pathology
- Humans
- Middle Aged
- Papilloma/classification
- Papilloma/diagnostic imaging
- Papilloma/pathology
- Prospective Studies
- Sensitivity and Specificity
- Ultrasonography, Mammary/methods
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Affiliation(s)
- A R Chiorean
- Radiology, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj Napoca
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Kim SR, Park JK, Park SJ, Min KH, Lee MH, Han HJ, Chung CR, Choi KH, Chung MJ, Lee YC. Solitary bronchial squamous papilloma presenting as a plaque-like lesion in a subject with asthma. Am J Respir Crit Care Med 2011; 183:555-6. [PMID: 21325086 DOI: 10.1164/ajrccm.183.4.555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Abiko T, Koizumi S, Takanami I, Tanaka F. 18F-FDG-PET/CT findings in primary pulmonary mixed squamous cell and glandular papilloma. Ann Nucl Med 2010; 25:227-9. [PMID: 21188658 DOI: 10.1007/s12149-010-0454-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Accepted: 11/05/2010] [Indexed: 11/25/2022]
Abstract
A 55-year-old female had an abnormal shadow on chest radiograph. Computed tomography (CT) revealed a 26-mm tumor mass in the left upper lobe. No malignant findings were obtained by bronchoscopic cytology or histopathological diagnostics, but on positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) examination the maximum SUV was 9.01 in accordance with the tumor mass shadow on CT. Video-assisted thoracoscopic surgery was performed as clinically suspected of lung cancer, and the diagnosis was pulmonary mixed squamous cell and glandular papilloma (PMSGP). Primary PMSGP is extremely rare, and this is the first to describe the PET findings of this disease.
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Affiliation(s)
- Tomohiro Abiko
- Department of surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
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Hatzung G, Grunwald S, Zygmunt M, Geaid AA, Behrndt PO, Isermann R, Kohlmann T, Ohlinger R. Sonoelastography in the diagnosis of malignant and benign breast lesions: initial clinical experiences. Ultraschall Med 2010; 31:596-603. [PMID: 20614414 DOI: 10.1055/s-0029-1245526] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE This prospective study aimed to compare sonoelastography, B-mode ultrasonography, and mammography in terms of their ability to distinguish benign from malignant breast lesions. We also assessed how the diagnostic value of sonoelastography differs between palpable and clinically occult lesions. MATERIALS AND METHODS Evaluation revealed a total of 97 lesions (66 benign; 31 malignant) without histological confirmation at the time of the initial examination. The sensitivity, specificity, positive (PPV) and negative predictive value (NPV) as well as efficiency were calculated. These parameters were separately assessed for palpable lesions and for non-palpable lesions. We subsequently compared these results. RESULTS Sonography had a sensitivity of 97% and a specificity of 82% (PPV: 71 %, NPV: 98%, efficiency: 87%). For mammography, the respective figures were 84% and 89% (PPV: 79%, NPV: 92%, efficiency: 88%). Sonoelastography had a sensitivity of 71% and a specificity of 48% (PPV: 39%, NPV: 78%, efficiency: 56%). The combination of sonography and sonoelastography yielded a sensitivity of 100% and a specificity of 38% (PPV: 43%, NPV: 100%, efficiency: 58%). The sensitivity and specificity were not statistically different between the groups of palpable and non-palpable lesions. CONCLUSION Sonoelastography is easily performed and not very time-consuming. Used by itself, the method is not more efficacious than alternative techniques. When used in conjunction with B-mode ultrasonography, the latter's sensitivity was increased, albeit at the expense of specificity.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnostic imaging
- Adenocarcinoma, Mucinous/pathology
- Adult
- Aged
- Biopsy/methods
- Breast/pathology
- Breast Diseases/diagnostic imaging
- Breast Diseases/pathology
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Carcinoma, Ductal/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/pathology
- Elasticity Imaging Techniques/methods
- Female
- Fibroadenoma/diagnostic imaging
- Fibroadenoma/pathology
- Humans
- Middle Aged
- Papilloma/diagnostic imaging
- Papilloma/pathology
- Prospective Studies
- Sensitivity and Specificity
- Ultrasonography, Mammary/methods
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Affiliation(s)
- G Hatzung
- Gynecology & Obstetrics, Ernst-Moritz-Arndt University Greifswald, Germany
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36
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Wu J, Zhang J. [Pulmonary squamous cell papilloma: report of a case]. Zhonghua Bing Li Xue Za Zhi 2010; 39:484-485. [PMID: 21055182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Aydın E, Taştan E, Aydoğan F, Çaydere M. An unusual localization of fungiform papilloma. Kulak Burun Bogaz Ihtis Derg 2010; 20:214-217. [PMID: 20626332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In this article, we presented a 54-year-old male who was admitted with complaints of nasal obstruction with snoring and mouth breathing for one year. Anterior rhinoscopy revealed a mass arising from the inferior nasal concha on the left side. After computed tomography evaluation, endoscopic examination and incisional biopsy, the mass was removed en bloc endoscopically. The histopathological analysis resulted in a diagnosis of a fungiform papilloma. Fungiform papillomas arise almost exclusively on the nasal septum, while inverted papillomas predominantly affect the lateral nasal wall. To our knowledge, no previous report of fungiform papilloma involving the inferior concha has been published in the English literature.
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Affiliation(s)
- Emine Aydın
- Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, Turkey.
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Lin HW, Richmon JD, Emerick KS, de Venecia RK, Zeitels SM, Faquin WC, Lin DT. Malignant transformation of a highly aggressive human papillomavirus type 11-associated recurrent respiratory papillomatosis. Am J Otolaryngol 2010; 31:291-6. [PMID: 20015762 DOI: 10.1016/j.amjoto.2009.02.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 02/23/2009] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective is to present an uncommon case of squamous cell carcinoma (SCC) arising from extensive recurrent respiratory papillomatosis (RRP) involving the upper and lower airway and temporal bone. STUDY DESIGN This is a case report and a review of the literature. METHODS We describe a case of a 24-year-old woman with a history of human papillomavirus (HPV) type 11 since childhood originating in the larynx and trachea, then progressing to involve the distal pulmonary alveoli and right middle ear through the eustachian tube. Papillomatous growth was treated with multiple surgeries including laser cytoreduction of laryngotracheal papillomatosis and radical mastoidectomy, followed by a trial of chemotherapy. Despite this aggressive treatment regimen, papillomatous growth progressed with recurrence in the right eustachian tube, middle ear, and mastoid eventually extending to involve the calvaria and scalp. RESULTS The patient underwent a composite resection of involved tissues, including the scalp, auricle, and lateral temporal bone, with reconstruction using a latissimus dorsi free flap. Final pathologic analysis revealed an extensive infiltrative well-differentiated SCC arising from the papilloma. A review of the literature on aggressive respiratory papillomatosis suggests that malignant transformation of juvenile-onset RRP occurs exclusively in cases positive for HPV-11. CONCLUSIONS We report an unusual case of SCC originating from extensive RRP involving the airway, temporal bone, and scalp and describe the medical and surgical management. Although the incidence of juvenile-onset RRP transformation to SCC is very low, the presence of HPV-11 as a risk factor for malignant transformation of RRP is becoming evident.
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Affiliation(s)
- Harrison W Lin
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA.
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Chryssagis K, Liangos A, Westhof F, Batz G, Diegeler A. Transesophageal echocardiography for detection of a papillary fibroelastoma of the aortic valve. Hellenic J Cardiol 2010; 51:170-174. [PMID: 20378521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Papillary fibroelastoma (PF) is a benign cardiac tumor, typically attached to the cardiac valves. It is usually found incidentally at autopsy or surgery. It is rarely symptomatic, but can cause myocardial infarction, cerebral infarction and systemic embolism, even in young patients, and sometimes results in sudden death. We report on a case of a PF attached to the nodulus arantii of the left coronary cusp in a 56-year-old woman. She was referred to our institution due to a non ST-elevation myocardial infarction diagnosed by troponin positive-test. No other embolic source was identified. Diagnosis was obtained by two-dimensional echocardiography and confirmed by transesophageal echocardiography. After complete surgical removal of the tumor, we reconstructed the left coronary cusp with autologous pericardium. The histology revealed the diagnosis of a PF. Intraoperative transesophageal echocardiography confirmed complete restoration of aortic valve cusp coaptation. The clinical course was uneventful.
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Jeong JH, Park H, Moon SW, Mun JS, Myoung BH, Kim DH, Kim HD, Han C. [A case of macroscopically unvisualized mucin-hypersecreting biliary papillomatosis diagnosed by microscopy]. Korean J Gastroenterol 2009; 53:206-210. [PMID: 19835224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The mucin-hypersecreting biliary papillomatosis is a premalignant neoplasm characterized by intraductal papillary proliferation involving extensive areas of the intrahepatic and/or extrahepatic bile duct. We report a case of mucin-hypersecreting biliary papillomatosis manifested as obstructive jaundice and diagnosed only by microscopy, with a review of literatures. A 74-year-old female, who had a past history of cholecystectomy about 13 years ago, was admitted to our hospital with jaundice. A CT scan showed marked dilatation of intrahepatic and extrahepatic bile duct without intraductal filling defect or extrabiliary mass. During endoscopic retrograde cholangiopancreatography, mucin extrusion from the duodenal major papilla and dilated common bile duct with amorphous filling defects was noted. Percutaneous transhepatic biliary drainage for cholangioscopy was failed. In the operation field, there was a lot of mucin but was no visible mass at the common bile duct with bare eyes and cholangioscopy. However, papilloma was detected at the random biopsy specimen by microscopy. The patient underwent partial resection of common bile duct and choledocho-jejunal anastomosis.
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Affiliation(s)
- Jong Hyeok Jeong
- Department of Gastrointestinal Medicine, Saint Carollo Hospital, Suncheon, Korea
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41
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Carvalho MJ, Dias M, Gonçalo M, Fernandes G, Rodrigues V, de Oliveira CF. What is the diagnostic value of nipple discharge cytology and galactography in detecting duct pathology? EUR J GYNAECOL ONCOL 2009; 30:543-546. [PMID: 19899412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The present study aimed to evaluate the diagnostic value of nipple discharge (ND) cytology and galactography. Ninety-four patients submitted to duct excision, representing a total of 98 duct excisions, were retrospectively analyzed from January 1997 to May 2007. Histology of ducts excised revealed 35% duct ectasia (DE), 31% duct papilloma (DP), 20% potential malignant transforming lesions (PMTL), 6% breast cancer (BC), 1% adenoma and 6% normal breast tissue. Cytology had a sensibility and specificity in detecting duct pathology of, respectively, 40% and 61.3%, a positive predictive value (PPV) of 53.8% and a negative predictive value (NPV) of 47.5%. Concerning malignant and PMTL, cytology had a sensibility and specificity of, respectively, 46.2% and 62.3%, a PPV of 25% and a NPV of 82.5%. Breast cancer was never suggested by positive cytology. Galactography had a sensibility and specificity in detecting duct pathology of, respectively, 77.4% and 29.2%, a PPV of 58.5% and a NPV of 50%. For malignant and PMTL, galactography had a sensibility and specificity of, respectively, 80% and 26.7%, a PPV of 19.5% and a NPV of 85.7%. However, galactography never suggested a diagnosis of cancer. Cytology and galactography performed together in 49% showed a low Kappa Index (KI < 1), allowing us to conclude that cytology and galactography detect different pathologies. Cytology showed a poor performance in predicting histological diagnosis in face of ND. Galactography had a good sensibility in excluding malignant lesions and PMTL. Galactography was significantly more sensitive for duct pathology but cytology was more specific for malignant lesions and PMTL.
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Affiliation(s)
- M J Carvalho
- Department of Gynaecology, University Hospital of Coimbra, Coimbra, Portugal.
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42
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Beguiristain A, Jiménez R, Ruiz-Montesinos I, Echenique Elizondo M. [Diffuse biliary papillomatosis]. Cir Esp 2008; 83:39-40. [PMID: 18208749 DOI: 10.1016/s0009-739x(08)70496-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Affiliation(s)
- Masamichi Koyama
- Department of Nuclear Medicine, Cancer Institute Hospital, Tokyo, Japan.
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Ballesio L, Maggi C, Savelli S, Angeletti M, Rabuffi P, Manganaro L, Porfiri LM. Adjunctive diagnostic value of ultrasonography evaluation in patients with suspected ductal breast disease. Radiol Med 2007; 112:354-65. [PMID: 17440697 DOI: 10.1007/s11547-007-0146-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2006] [Accepted: 10/20/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the adjunctive diagnostic value of breast ultrasonography (US) in the study of benign ductal breast disease. MATERIALS AND METHODS Fifty-two patients underwent US examinations for bloody nipple discharge, palpable retroareolar masses, retroareolar opacities or ductal pattern on mammography. US enabled visualisation of mammary-duct ectasia (simple or pseudocystic, retroareolar and/or peripheral) and focal masses (endoluminal or periductal, with ill-defined or regular margins). All patients with nipple discharge underwent cytological evaluation. After the US examination, all focal masses with ill-defined margins underwent fine-needle aspiration biopsy (FNAB), if necessary. The benign alterations were followed up. RESULTS In 38/52 cases, US diagnosed mammary-duct ectasia and in 30/52 cases, the presence of focal masses (mean size 7 mm). In the nine women who underwent biopsy, histopathological evaluation diagnosed five solitary papillomas, one solitary papilloma with a focal area of ductal carcinoma in situ (DCIS), two multiple papillomas of the nipple and one papillomatosis. CONCLUSIONS High-frequency US plays an important role in the detection of benign ductal disease both for the diagnosis and classification of focal masses and mammary-duct ectasia. US can be used as a complementary imaging method to galactography or as a valuable alternative when galactography is not available.
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Affiliation(s)
- L Ballesio
- Dipartimento di Scienze Radiologiche, Policlinico Umberto I, Viale del Policlinico 155, I-00161 Rome, Italy
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45
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Affiliation(s)
- Eugene Lin
- Department of Radiology, Virginia Mason Medical Center, Seattle, WA 98111, USA.
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46
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Udaka T, Shiomori T, Nagatani G, Hisaoka M, Kakeda S, Korogi Y, Suzuki H. Oncocytic schneiderian papilloma confined to the sphenoid sinus detected by FDG-PET. Rhinology 2007; 45:89-92. [PMID: 17432078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We report a 55-year-old man with oncocytic schneiderian papilloma confined to the sphenoid sinus, which was initially detected by positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) at a very early stage. Based on CT and MRI findings, we suspected that the tumor was most likely benign; however, positive uptake in FDG-PET suggested malignancy. The patient underwent endoscopic resection of the tumor, and the histopathological diagnosis turned out to be oncocytic schneiderian papilloma. FDG-PET is thought to be a powerful tool to search for malignant lesions, but the present case demonstrates the fallibility of this technique. This should be taken into consideration when interpreting FDG-PET images.
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Affiliation(s)
- Tsuyoshi Udaka
- Department of Otorhinolaryngology, University of Occupational and Environmental Health, Kitakyushu, Japan
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47
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Affiliation(s)
- Wael Magdy El-Saify
- The Breast Unit, Department of General Surgery, University Hospital of North Tees, Stockton-on-Tees, United Kingdom.
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Rad MHR, Alizadeh E, Ilkhanizadeh B. Recurrent laryngeal papillomatosis with bronchopulmonary spread in a 70-year-old man. Tuberk Toraks 2007; 55:299-302. [PMID: 17978930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Recurrent laryngeal papillomatosis (RRLP) which is characterized by wart like growths in the larynx is a rare benign disease seen in children and young adults and a few cases are reported in old aged adults. The spread of RRLP throughout the respiratory tract occurs rarely; and involvement of the distal bronchi, bronchioles, and lung parenchyma is very rare. We report a case of tracheobronchial and pulmonary spread of RRLP in a 70-year-old man after two previous surgeries. Despite the rarity of this disease in adults, the correct diagnosis may be suggested by a characteristic combination of clinical, radiographic, and pathologic features.
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Schönberger J, Marienhagen J, Agha A, Rozeboom S, Bachmeier E, Schlitt H, Eilles C. Papillary microcarcinoma and papillary cancer of the thyroid <or=1 cm: modified definition of the WHO and the therapeutic dilemma. Nuklearmedizin 2007; 46:115-20; quiz N41-2. [PMID: 17690788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
AIMS Major controversies exist regarding the treatment of papillary microcarcinoma of the thyroid (PMC). Prior to 2003 PMC was defined by the WHO as a papillary carcinoma of 1 cm or less in diameter. In 2004 that definition changed, with the new classification requiring that the tumour also must be found incidentally. PATIENTS, METHODS In this study we reviewed the clinical records of 67 patients with papillary tumours of the thyroid <or=1 cm, taking into account the new WHO definition (54 pts. with incidentally found PMC, median age: 53 years, 13 pts. with suspicion of thyroid neoplasm before resection, median age: 38 years). Clinical presentation, surgical treatment, further therapy and follow-up are presented. RESULTS Median tumour size was 7 mm in both groups (1-10 mm). Multicentric tumours were found in 15 pts. (22%), 8 had more than one PMC on the same side, and 7 displayed PMC bilaterally. Eleven (16%) of the primary tumors had metastatic involvement of regional lymph nodes at the time of initial surgery or during follow-up. Two patients showed distant metastases. No correlation between tumour size and multifocality or the presence of lymph node metastases could be seen. The gender of patients was the only significant independent variable for all patients; age and lymph node involvement was significantly different between incidentally and non-incidentally found PMC. CONCLUSIONS Despite the majority of patients with PMC having an excellent outcome, there are also cases showing an unfavorable course. Currently no predictive parameter exists to anticipate the course and long-term outcome for an individual patient. Until this problem is solved, each patient should have the option to decide for him or herself whether to be treated similarly or differently than for conventional thyroid cancer.
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Affiliation(s)
- J Schönberger
- Department of Nuclear Medicine, University of Regensburg, 93042 Regensburg, Germany.
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Abe K, Tanaka Y, Takahashi M, Kosuda S, Hayashi K, Tanabe T, Iwasaki Y, Aida S, Kawauchi T, Yamamoto M, Kita T, Kaji T. Pulmonary spread of laryngeal papillomatosis: radiological findings. ACTA ACUST UNITED AC 2006; 24:297-301. [PMID: 16958405 DOI: 10.1007/s11604-005-1560-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2005] [Accepted: 12/22/2005] [Indexed: 10/24/2022]
Abstract
Laryngeal papillomatosis is a rare benign disease seen in children and young adults. The spread of laryngeal papillomas throughout the respiratory tract occurs rarely; and involvement of the distal bronchi, bronchioles, and lung parenchyma is very rare. We report a case of pulmonary spread of laryngeal papillomatosis in a 34-year-old man, focusing on the radiological evidence. Chest radiographs showed pulmonary nodules, but computed tomography scans more clearly demonstrated multiple small nodules showing cavitations and distributed centrilobularly. Pulmonary nodules and cavitations progressed gradually through the 6-year follow-up. The combination of clinical and characteristic radiological features suggests a diagnosis of pulmonary spread of laryngeal papillomatosis.
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Affiliation(s)
- Katsumi Abe
- Department of Radiology, Nihon University School of Medicine, 30-1 Ooyaguchikamimachi, Tokyo, Japan.
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