Navegando por Palavras-chave "Biopsia por agulha"
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- ItemAcesso aberto (Open Access)Acurácia diagnóstica da biópsia percutânea com agulha grossa orientada por estereotaxia nas lesões mamárias categoria BI-RADS® 4(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2007-12-01) Moutinho, Maria Silvia Petty [UNIFESP]; Elias, Simone [UNIFESP]; Kemp, Claudio [UNIFESP]; Nazário, Afonso Celso Pinto [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)PURPOSE: to assess the accuracy (rate of correct predictions) of stereotactic core needle biopsy (CNB) of risk category BI-RADS® 4 breast lesions. METHODS: a retrospective analysis of category BI-RADS® 4 breast lesions that had been submitted to a stereotactic core-needle biopsy from June 1998 to June 2003. Patients with histological benign results consistent with the radiographic image were referred to mammographic follow-up. Patients with malign diagnosis and papillary lesions were submitted to standard specific treatment. Excisional biopsies were performed when results were benign, but in disagreement with the mammographic image. It was considered as a gold-standard attendance: (1) the mammographic follow-up of low suspicion lesions with benign results at CNB, which stayed unchanged for, at least, three years, and (2) surgical resection when specimen results were malign or benign, but with a high suspicion on mammography. Sensitivity (S) specificity (E) and overall accuracy of stereotactic CNB were statistically analyzed. RESULTS: among the 118 non-palpable lesions of category BI-RADS® 4 submitted to CNB, the results obtained were: 27 malign cases, 81 benign, and ten lesions with atypical or papillary lesions. The statistical analysis comprised 108 patients (atypical and papillary lesions were excluded). CNB sensitivity was 87.1% and specificity 100%. The positive predictive value was 100% and the negative, 95.1%. False negatives occurred in 3.7% (4/108) of cases. The prevalence of malign diagnostics in the BI-RADS® 4 lesions of this sample was 29.7 (31/118).The accuracy of this method in this casuistic was 96.3%. CONCLUSIONS: these results support stereotactic CNB as an extremely reliable alternative to open biopsy, in the diagnosis and definition of breast lesions. In positive results, it is possible to indicate the appropriate therapy, and, in negative (when mammography shows low suspicion), it allows a follow up.
- ItemAcesso aberto (Open Access)O diagnóstico do carcinoma metastático de coróide pela biópsia aspirativa com agulha fina (BAAF): relato de caso(Conselho Brasileiro de Oftalmologia, 2003-01-01) Corrêa, Zélia Maria da Silva [UNIFESP]; Irion, Luciane Cristina Dreher; Marcon, Ítalo Mundialino; Goldhardt, Raquel; Travi, Giovanni Marcos; Universidade Federal de São Paulo (UNIFESP); Fundação Faculdade Federal de Ciências Médicas de Porto Alegre; Serviço de Oftalmologia da Santa Casa de Porto Alegre; Santa Casa de Porto AlegrePURPOSE: To report a case of a patient with lung carcinoma in which the first detected metastasis was to the choroid, how it was diagnosed and confirmed. METHODS: A 35 year-old white male, while being treated for a solitary pulmonary condensation, reported sudden loss of vision, pain, discharge and red eye (right eye) for 10 days. During the ophthalmic examination a nonregmatogenous retinal detachment as well as multiple choroidal tumors were confirmed by diagnostic ocular ultrasound. Fine-needle aspiration biopsy (FNAB) was suggested to diagnose a possible metastatic disease. Fine-needle aspiration biopsy was performed under peribulbar anesthesia with sedation. A transvitreous route was chosen through a sclerotomy 4 mm from the limbus. The procedure was monitored via binocular indirect ophthalmoscopy. Two sample aspirates were obtained from different tumour foci. After fine-needle aspiration biopsy, the aspirates were sent for processing, fixation and stained with Papanicolaou and HE. RESULTS: Cytology confirmed the diagnosis of multiple metastatic tumors. Immunocytochemistry of ocular and lung aspirates revealed a common cell origin by a pankeratin (AE1/AE3) positive test. Regardless of systemic treatment with chemotherapy and improvement of the ocular status, the patient died 4 months after cytological diagnosis of metastatic carcinoma of the choroid. CONCLUSIONS: Fine-needle aspiration biopsy was efficient to diagnose and correlate ocular cytology with the primary tumor by imunohistochemical methods in this case. Fine-needle aspiration biopsy should still be used only in selected cases and further research will be necessary for it to become a standard diagnostic procedure in ophthalmology.
- ItemAcesso aberto (Open Access)O uso da biópsia aspirativa com agulha fina (BAAF) no diagnóstico de lesão iriana suspeita: relato de caso(Conselho Brasileiro de Oftalmologia, 2001-08-01) Corrêa, Zélia Maria da Silva [UNIFESP]; Marcon, Ítalo Mundialino [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade Federal de Ciências Médicas de Porto AlegreTo report the case of a patient who presented with a solid anterior segment intraocular mass in his right eye, and the diagnostic investigation chosen by the authors. Diagnostic uncertainty and patient's refusal to agree with the treatment caused the authors to perform a fine needle aspiration biopsy of the lesion. Biopsy was performed by corneal puncture, through the aqueous and the tumor. Cytology of the specimen obtained by the biopsy determined the therapeutic strategy for this case. Cytology diagnosis was consistent with primary malignant melanoma of the choroid of mixed cell type. Enucleation of the eye was suggested due to the position of the tumor and its potential to spread distant metastases. After enucleation, anatomopathological examination of the eye presented a similar result to cytology. The patient is currently been followed, with no signs of metastasis 2 years after enucleation.