The aim of this study was to determine the diagnostic accuracy and frequency of complications of lung biopsy procedures with or without CTF guidance of needle insertion. Records and images of 99 consecutive percutaneous coaxial cutting needle lung biopsy procedures performed on 85 patients were reviewed retrospectively. Fifty-seven and 42 procedures had been done with and without CTF guidance, respectively. Histological results were compared to diagnosis after surgery or after a follow-up period of 12 months. Diagnostic accuracy and the occurrence of pneumothorax and/or bleeding related to the procedures were registered. The level of accuracy of the diagnosis was comparable. The diagnostic accuracy was 96% (50/52) and 95% (34/36) sensitivity 95% (35/37) and 93% (26/28), specificity 100% (15/15) and 100% (8/8) with CTF and conventional CT techniques, respectively. There were fewer post procedure pneumothoraces using the CTF than conventional technique [26% (15/57) vs. 38% (16/42)], but the difference was not statistically significant (P = 0.274). The insertion of a chest tube was required in only one (2%) procedure using the CTF technique, while this was needed in four (10%) using the conventional technique. Small or large hemorrhages occurred in 23% of the procedures, with no apparent difference between the two groups. In conclusion, CTF-guided biopsy of lung lesions provides high diagnostic accuracy, comparable to that of conventional CT-guided procedures, with a low rate of complications, even for small tumors.
Two cases of congenital anomalies, one cyst and one sinus, presenting in the suprasternal notch are reported. No communication with deeper structures was found at surgery, and histology was compatible with previous descriptions of subcutaneous bronchogenic cysts. The literature is reviewed, and the similarity between these lesions and many cases of branchial fistula is stressed.
Increased expression of cyclin A2 protein has been detected in different types of cancers. However, its prognostic importance appears to differ between tumours. The significance and precise mechanisms behind cyclin A2 overexpression remain to be elucidated. We used real-time PCR to examine CCNA2 amplification in tumour cells isolated by laser microdissection and in total tumour tissue in colon cancer patients in which overexpression of cyclin A2 protein had been revealed by immunohistochemistry (n = 22 patients). The results were verified by FISH. CCNA2 amplification was not detected in either the isolated tumour cells or the total tumour tissue. We verified our methods by demonstrating amplification of CCNA2 by real-time PCR in three out of eight breast tumours that overexpressed cyclin A2 protein (this frequency is consistent with the findings of others). However, FISH did not reveal any CCNA2 amplification in the breast tumours, but it did reveal polysomy of chromosome 4 or segments of chromosome 4 in three tumour tissue samples, indicating the importance of verifying the real-time PCR results with another method. To conclude, the increased cyclin A2 protein expression in these patients could not be explained by CCNA2 amplification in isolated colonic tumour cells.
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