Nuclear morphology in breast lesions: refining its assessment to improve diagnostic concordance

2021 ◽  
Author(s):  
Ayaka Katayama ◽  
Michael S Toss ◽  
Matthew Parkin ◽  
Takaaki Sano ◽  
Tetsunari Oyama ◽  
...  
Keyword(s):  
Nuclear Morphology ◽  
Breast Lesions ◽  
Diagnostic Concordance

Interobserver Reproducibility in Diagnosis of Breast Lesions. A Panel in Puglia (Italy)

1998 ◽  
Vol 84 (3) ◽  
pp. 354-359 ◽  
Author(s):  
Carmela Giardina ◽  
Rosanna Clemente ◽  
Saverio Fusilli ◽  
Simonetta Bianchi ◽  
Angelo Paradiso
Keyword(s):  
Kappa Statistics ◽  
Breast Lesions ◽  
Interobserver Reproducibility ◽  
Breast Pathology ◽  
In Situ Carcinoma ◽  
Diagnostic Difficulties ◽  
Diagnostic Concordance ◽  
The Moment ◽  
Pair Wise Comparison

Background Given the incidence of breast cancer, histologic agreement is necessary to select the proper treatment. Methods & study design Twelve pathologists working in Puglia (Italy) independently evaluated a set of 88 slides of breast lesions. The set included 31 cases which presented difficulties at the moment of first diagnosis (problem cases) and 57 cases without problems (routine cases). Each pathologist was requested to classify lesions according to four categories: A, benign; B, atypical proliferation; C, in situ carcinoma; D, invasive carcinoma. For each case, the definite diagnosis was considered that provided by most of the pathologists (prevalent diagnosis). For the evaluation of degree of agreement, kappa statistics were utilized. Results Among routine cases, agreement was observed in 68.4% of cases (38/57) and in 29% of problem cases (9/31). The pair-wise comparison between all participating pathologists showed a good overall agreement, (kappa mean, 0.66; range, 0.57-0.76). The agreement of each pathologist with the prevalent diagnosis was high for invasive (mean kappa, 0.88) and benign lesions (mean kappa, 0.83) followed by in situ carcinoma (mean kappa, 0.64). The lowest value observed was for atypical lesions (mean kappa, 0.25). Conclusions The results showed a good overall degree of diagnostic concordance among participating pathologists, all working in the Italian region of Puglia. The findings emerging from the study are comparable to those of other studies performed with selected pathologists specifically specialized in breast pathology. Moreover, the study confirmed the diagnostic difficulties for borderline lesions and the necessity of further investigation for sclerosing lesions with discordant diagnoses.

An adrenocortical oncocytoma with unusual mitochondrial inclusions and cytoplasmic crystals

1994 ◽  
Vol 52 ◽  
pp. 250-251
Author(s):  
W.T. Gunning ◽  
G.D. Haselhuhn ◽  
E.R. Phillips ◽  
S.H. Selman
Keyword(s):  
Adrenal Gland ◽  
Salivary Glands ◽  
Mitotic Activity ◽  
Diagnostic Criteria ◽  
Vascular Invasion ◽  
Benign Neoplasm ◽  
Benign Tumors ◽  
Nuclear Morphology ◽  
Case Presentation ◽  
Microscopic Evidence

Within the last few years, adrenal cortical tumors with features concordant with the diagnostic criteria attributed to oncocytomas have been reported. To date, only nine reported cases exist in the literature. This report is the tenth case presentation of a presumptively benign neoplasm of the adrenal gland with a rare differentiation. Oncocytomas are well recognized benign tumors of the thyroid, parathyroid, and salivary glands and of the kidney. Other organs also give rise to these types of tumors, however with less frequency than the former sites. The characteristics generally used to classify a tumor as an oncocytoma include the following criteria: the tumor is 1) usually a solitary circumscribed mass with no gross nor microscopic evidence of metastasis (no tissue nor vascular invasion), 2) fairly bland in terms of mitotic activity and nuclear morphology, and 3) composed of large eosinophillic cells in which the cytoplasm is packed full of mitochondria (Figure 1).

201Tl Scintigraphy in the Evaluation of Palpable and Nonpalpable Breast Lesions: Correlation with Mammography and Ultrasonography

1997 ◽  
Vol 36 (08) ◽  
pp. 282-288 ◽  
Author(s):  
T. Atasever ◽  
A. Özdemir ◽  
I. Öznur ◽  
N. I. Karabacak ◽  
N. Gökçora ◽  
...  
Keyword(s):  
Final Diagnosis ◽  
Lower Sensitivity ◽  
Breast Lesions ◽  
Breast Cancers ◽  
Combined Use ◽  
Malignant Breast ◽  
Malignant Lesions ◽  
Benign Breast Lesions ◽  
Palpable Breast ◽  
Metastatic Sites

Summary Aim: Our goal was to determine the clinical usefulness of TI-201 to identify breast cancer in patients with suspicious breast lesions on clinical examination, and/or abnormal radiologic (mammography and/or ultrasonography) findings. Methods: TI-201 scintigraphy were performed in sixty-eight patients with 70 breast abnormalities (51 palpable, 19 nonpalpable) and compared with mammography and ultrasonography (US). Early (15 min) and late (3 h) images of the breasts were obtained following the injection of 111 MBq (3 mCi) of TI-201. Visual and semiquantitative interpretation was performed. Results: Final diagnosis confirmed 52 malignant breast lesions and 18 benign conditions. TI-201 visualized 47 of 52 (90%) overall malignant lesions. Thirty-eight of 40 (95%) palpable and 9 of 12 (75%) nonpalpable breast cancers were detected by TI-201 scintigraphy. The smallest mass lesion detected by TI-201 measured 1.5x1.0 cm. Eleven breast lesions were interpreted as indeterminate by mammography and/or sonography. TI-201 scintigraphy excluded malignancy in 7 of 8 (88%) patients with benign breast lesions interpreted as indeterminate. Five of the 18 (28%) benign breast lesions showed TI-201 uptake. None of the fibroadenoma and fibrocystic changes accumulated TI-201. TI-201 scintigraphy, mammography and ultrasonography showed 90%, 92%, 85% overall sensitivity and 72%, 56%, 61% overall specificity respectively. Twenty-one of the 28 (75%) axillary nodal metastatic sites were also detected by TI-201. In malignant and benign lesions, early and late lesion/contralateral normal side (L/N) ratios were 1.58 ± 0.38 (mean ± SD) and 1.48 ± 0.32 (p >0.05), 1.87 ± 0.65 and 1.34 ± 0.20 (p<0.05) respectively. The mean early and late L/N ratios of malignant and benign groups did not show statistical difference (p>0.05). Conclusion: Overall, TI-201 scintigraphy was the most specific of the three methods and yielded favourable results in palpable breast cancers, while it showed lower sensitivity in nonpalpable cancers and axillary metastases. Combined use of TI-201 scintigraphy with mammography and US seems to be useful in difficult cases, such as dense breasts and indeterminate breast lesions.

Sign in / Sign up

Export Citation Format

Share Document