To evaluate the efficacy of ultrasound (US)-guided automated core biopsy of thyroid nodules, 74 biopsies were performed in 61 consecutive patients with an 18-gauge short-throw (1.1-cm excursion) biopsy gun. Results were correlated with diagnoses made at surgery (n = 38) or at sonographic follow-up of at least 6 months (n = 36). Sensitivity, specificity, and accuracy of diagnoses made with automated core biopsy were 84%, 95%, and 91%, respectively. US-guided biopsy with an automated biopsy gun allowed accurate assessment of thyroid nodules.

The conceptual view of natural killer (NK) cell malignancies has recently undergone a significant evolution. The majority of such diseases are associated with Epstein-Barr virus (EBV), while only a limited number of EBV-negative cases has been reported. We report an unusual case of NK cell lymphoma/leukemia showing a monomorphic histology, absence of intracytoplasmic azurophilic granules, and no EBV association. The patient was a 57-year-old woman who died 26 months after the diagnosis. Autopsy revealed tumor infiltration in the liver, spleen, lymph node, blood, and bone marrow. There was no involvement of the skin or nasal cavity throughout the clinical course. The tumor showed the monotonous proliferation of medium-sized cells without intracytoplasmic azurophilic granules. Phenotypic analysis showed CD2+, CD3/Leu4–, cytoplasmic CD3ε+, CD4–, CD5–, CD7+, CD8–, CD16–, CD38+, CD56+, CD57–, TdT–, granzyme B–, and TIA1+ phenotype. There were no detectable rearrangements of T cell receptor genes or immunogloublin heavy chain genes. Furthermore, there were no EBV-encoded small RNAs. These findings provide information to improve the understanding of poorly defined entities, i.e. aggressive NK cell lymphoma/leukemia and blastic NK cell lymphoma/leukemia.

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