Cytohistopathological Correlation Research Articles

International Academy of Cytology standardized reporting of breast fine-needle aspiration cytology with cyto-histopathological correlation of breast carcinoma.

The International Academy of Cytology (IAC) has developed a standardized approach for reporting the findings of breast fine-needle aspiration cytology (FNAC). Accordingly, there are five chief categories of breast lesions, C1 (insufficient material), C2 (benign), C3 (atypical), C4 (suspicious), and C5 (malignant). The prognostication and management of breast carcinoma can be performed readily on the basis of this classification system. The aim of this study was to classify various breast lesions into one of the above-named categories and to further grade the C5 lesions specifically using the Robinson system. The latter grades were then correlated with modified Scarff-Bloom-Richardson (SBR) grades. This retrospective study was undertaken in the pathology department of a hospital located in the urban part of the city of Bangalore. All FNAC procedures performed on breast lumps spanning the year 2020 were included in the study. A total of 205 breast lesions was classified according to the IAC guidelines into C1 (6 cases, 2.9%), C2 (151 cases, 73.7%), C3 (13 cases, 6.3%), C4 (5 cases, 2.5%), and C5 (30 cases, 14.6%) groups. The C5 cases were further graded using Robinson's system. The latter showed a significant correlation with the SBR system (concordance=83.3%, Spearman correlation=0.746, Kendall's tau-b=0.736, kappa=0.661, standard error=0.095, p≤.001). A standardized approach for FNAC reporting of breast lesions, as advocated for by the IAC, improves the quality and clarity of the reports and assures diagnostic reproducibility on a global scale. Further, the cytological grading of C5 lesions provides reliable cyto-prognostic scores that can help assess a tumor's aggressiveness and predict its histological grade.

A clinical, cyto-histopathological and immunohistochemical study of spindle cell lesions of breast in a tertiary care hospital

Spindle cell lesions in the breast are a diverse group of entities that can be either benign or malignant. Spindle cell lesions often pose a challenge to the diagnosing clinician because of the vast differential diagnoses, the rarity of these lesions and the histological similarities. We aim to conduct this study to profile these rare lesions of the breast and correlate the cyto-histopathological features on FNAC with immunohistochemical characteristics to determine its efficacy.A total 260 patients, suffering from spindle cell lesions of the breast, attending the outpatient and in-patient services were included in this 5 year study (3 years of retrospective cases and 2 years of prospective cases) conducted at Department of Pathology, JNMCH, AMU, Aligarh.: Only Diagnosed cases of Spindle cell lesions of breast were included in the study. The study sample comprised of 260 cases (105 cytological cases and 220 histopathological cases with 65 cases that are common to both) Apart from diagnosed cases of Spindle cell lesions of breast all other breast lesions either reactive benign or malignant were excluded.Total number cases of breast lesions received in the Department of Pathology during 5 year study period were 15,270 out of which 9700 cases were of Histopathology and 5570 were of Cytopathology. Among 15,270 cases, a total number of 15,010 (98.29%) cases belonged to non-spindle cell lesions which were excluded from the study and the remaining cases i.e., 260 (1.7%) cases diagnosed as spindle cell lesions of breast constituted the study group. Of the total260 cases, 105 cases were of cytopathology and 220 cases were of histopathology and cases common to both i.e., those cases which had cyto-histopathological correlation were 65 cases (20%). The highest incidence of spindle cell lesions occurred in 4 decade of life comprising of 126/260 cases (48.46%).Spindle cell lesions are not so common in breast, accounts for 1.7% of cases only. The workup involves thorough histopathological examination due to considerable morphological overlap and an elaborate IHC studies since no single Immunohistochemical marker is sufficient/specific to clinch the final diagnosis. Hence, it is difficult to make the final diagnosis of spindle cell lesions of breast on histopathology alone in majority.

Evaluation of pap smears with cyto-histopathological correlation–our experience at a tertiary care hospital in Telangana

Background: The World Health Organization states that cervical carcinoma is the fourth most common cancer among women worldwide. Pap smear is the simplest and easiest test to detect this prevalent cancer at its nascent stages. Aims and Objectives: This study aims to evaluate Pap smears using the conventional method (Bethesda 2014) and correlate the abnormal smears with cervical biopsy. Materials and Methods: The study is a combined retrospective and prospective study, from January 2021 to August 2023. Pap smears received were evaluated according to Bethesda 2014. Those cases categorized as Epithelial Cell Abnormality (ECA), were correlated with corresponding histopathology on cervical biopsy. Results: Out of the 615 pap smears in this study, 525 cases (91%) were categorized as Negative for Intraepithelial Lesion or Malignancy, 53 cases (9%) as Epithelial Cell Abnormality, and 37 cases (6%) as unsatisfactory. In the Negative for Intraepithelial Lesion or Malignancy category, 353 cases (67.2%) were reactive cellular changes including inflammation, four cases (0.7%) were squamous metaplasia, and 24 cases (4.6%) were atrophic smears. In the ECA category–21 cases (39.6%) were Atypical squamous cells of undetermined significance, two cases (3.8%) were Low-grade squamous intraepithelial lesion, five cases (9.4%) were Atypical squamous cells-cannot exclude HSIL(ASC-H), 14 cases (26.4%) were High grade squamous intraepithelial lesion (HSIL) and 3 cases (5.6%) were squamous cell carcinoma (SCC) cervix, seven cases were of ECA-glandular type (13.2%). On histopathological correlation, the maximum correlation was found for HSIL and SCC cases, 71% and 100%, respectively. Conclusion: Pap smear is a crucial screening tool to diagnose cervical carcinoma at its nascent stage. This study showed a positive correlation for high-grade lesions on Pap smears.

Rapid on-site evaluation and cell blocks: getting the most from the least invasive method in cytopathology

Fine needle aspiration cytology (FNAC) sampling is a minimally invasive procedure done to identify the pathology behind superficial and deep-seated lesions. Rapid on-site evaluation (ROSE) can be an adjunct to the FNACs. Our study aimed to identify the role of ROSE in diagnostic adequacy and to check the benefit of cell block (CB)/cell buttons prepared from the ROSE samples. A prospective study was conducted where all patients referred for FNAC were included. ROSE using 1% aqueous toluidine blue stain and CB/cell button preparations were done for the identification of various cytological lesions. Among 600 cases included in the study most common age group was third and fourth decades with a mean age of 41.6 years and M: F ratio of 1:1.7. Ultrasound-guided procedures were done in 20% of cases. CB preparation was available in 14% of cases. Most CBs were from the cases wherein ROSE was performed 81% (77 out of 86), with CB helping in making an accurate diagnosis in 17% of cases. Lymph nodes 26%, and thyroid 23% were the most common sites for sampling with the highest number of repeat procedures from non-ROSE cases (14%). The non-diagnostic rate for non-ROSE cases was 7.7% (23/300) even after the repeat procedures as compared to 1.3% (4/300) for ROSE. Three slides on average were consumed in ROSE-performed procedures, as compared to an average of 5 slides in non-ROSE. The average turnaround time was 1.7 days for non-ROSE cases and 1.05 for ROSE cases respectively. Cyto-histopathological correlation was available in 40% of cases with a sensitivity of 98.1%, specificity of 96.7%, positive predictive value of 90%, negative predictive value of 99.4%, and diagnostic accuracy of 97%. The correlation of CB, number of slides consumed, and turnaround time among the 2 groups were statistically significant (P value < 0.001). ROSE is a method used to assess material aspirated at the time of FNAC procedures to determine the adequacy and to an extent to identify whether the lesion is neoplastic or non-neoplastic. CBs have helped in increasing diagnostic accuracy apart from the fact that the paraffin-embedded tissue material can be used for further studies.

Role of fine needle aspiration cytology (FNAC) in head and neck lesions in coastal population at a tertiary care hospital – A study of 500 cases

Head and neck swellings are a very common presentation encountered by clinicians and patients across all age groups. Various lesions give rise to head and neck lumps. Swellings can arise from soft tissues, lymph nodes, thyroid gland, salivary glands etc. FNAC being minimally invasive, quick and inexpensive helps in differential diagnosis of head and neck masses.A retrospective study was conducted at Karwar institute of medical sciences Karwar from January 2018 to December 2021 in coastal population, to evaluate the role of FNAC in palpable head and neck masses and also to study their distribution and To evaluate the diagnostic accuracy, sensitivity and specificity of FNAC in diagnosing Head and neck lesions and cyto-histopathological correlation (wherever possible). 500 patients with head and neck swelling underwent FNAC. FNAC diagnosis was correlated with detailed clinical history and investigations. Out of 500 fine needle aspiration procedures 35.6% (178) were of lymph node, 33.8% (169) were of thyroid, 9.6% from salivary gland (48), 17.8% (89) from skin and soft tissue swellings and 3.2% (16) inconclusive. The present study concluded that most of the swellings in head and neck region are benign and affect females more than males. Overall accuracy rate more than 90% and diagnostic accuracy in differentiating non-neoplastic lesions from neoplastic lesions is well established. Our study found that fine needle aspiration cytology to be an easy, safe, rapid, convenient, least invasive, accurate and relatively complication-free outpatient method for diagnosis of lesions of the head and neck

A 12-year Experience with 298 Fine Needle Aspirations of Thyroid Nodules in a Single Institution: Analysis of Bethesda System of Thyroid Cytopathology Reporting and Cytohistopathological Correlation

A 12-year Experience with 298 Fine Needle Aspirations of Thyroid Nodules in a Single Institution: Analysis of Bethesda System of Thyroid Cytopathology Reporting and Cytohistopathological Correlation

Comparative Study of FNAC and Histopathology in Diagnosis of Thyroid Swelling

IntroductionFine Needle Aspiration Cytology (FNAC) is important for pre-operative and pre-treatment diagnosis of benign and malignant thyroid lesions, thus decreasing the incidence of unwanted surgeries. The objective of this research is to compare the FNAC and Histopathological findings of thyroid swelling.MethodsThe present study is a cross sectional study conducted on 30 patients in the Department of Otorhinolaryngology Head and Neck Surgery, College of Medical Sciences, Bharatpur, Nepal from January 2022 to December 2022. Thyroid swelling presented to OPD were examined clinically after thorough history taking and admitted to indoor and subsequently underwent surgery were included in this study. After Histopathology they were compared with preoperative FNAC report. In all cases, informed consent was taken prior to the surgery.ResultsFNAC shows thirteen (28.57%) non neoplastic and twenty-two (71.43%) neoplastic. Among non neoplastic thyroid swelling, colloid goiter was common. Among neoplastic thyroid swelling Papillary carcinoma was the most common. Cyto-histopathological correlation of 35 cases was done. Out of thirty-five cases fifteen (42.87%) were non neoplastic and twenty (57.15%) were neoplastic. Colloid goiter was most common. Sensitivity of our study was 88.24%, Specificity was 55.56 % and accuracy was 71.43%.ConclusionsFNAC is a quick, safe, and reliable first-line diagnostic test for thyroid nodules. However, histopathology is the gold standard for the diagnosis of thyroid cancer and provides detailed information on the tumor size, location, and histological type.

Diagnosis of Low-Grade Urothelial Neoplasm in the Era of the Second Edition of the Paris System for Reporting Urinary Cytology.

The Paris System for Reporting Urinary Cytology (TPS) is considered the gold standard when it comes to diagnostic classifications of urine specimens. Its second edition brought some important changes, including the abolition of the diagnostic category of "low-grade urothelial neoplasm (LGUN)", acknowledging the inability of cytology to reliably discern low-grade urothelial lesions. In this retrospective study, we assessed the validity of this change, studying the cytological diagnoses of histologically diagnosed low-grade urothelial carcinomas during a three-year period. Moreover, we correlated the sum of the urinary cytology diagnoses of this period with the histological diagnoses, whenever available. Although all the cytological diagnoses of LGUN were concordant with the histological diagnoses, most low-grade urothelial carcinomas were misdiagnosed cytologically. Subsequently, the positive predictive value (PPV) of urinary cytology for the diagnosis of LGUN was 100%, while the sensitivity was only 21.7%. Following the cyto-histopathological correlation of the sum of the urinary cytology cases, the sensitivity of urinary cytology for the diagnosis of high-grade urothelial carcinoma (HGUC) was demonstrated to be 90.1%, the specificity 70.8%, the positive predictive value (PPV) 60.3%, the negative predictive value (NPV) 93.6% and the overall accuracy 77.2%, while for LGUN, the values were 21.7%, 97.2%, 87.5%, 58.6% and 61.9%, respectively. Risk of high-grade malignancy was 0% for the non-diagnostic (ND), 4.8% for the non-high-grade urothelial carcinoma (NHGUC), 33.3% for the atypical urothelial cells (AUCs), 65% for the suspicious for high-grade urothelial carcinoma (SHGUC), 100% for the HGUC and 12.5% for the LGUN diagnostic categories. This study validates the incorporation of the LGUN in the NHGUC diagnostic category in the second edition of TPS. Moreover, it proves the ability of urinary cytology to safely diagnose HGUC and stresses the pivotal role of its diagnosis.

Malignant pleural effusion and pericardial effusion, an unusual presentation of metastatic adenoid cystic carcinoma of the floor of mouth: A case report with cyto-histopathological correlation.

Adenoid cystic carcinoma (ACC) is an uncommon tumour that represents 5%-10% of salivary gland tumours and 1% of all head and neck malignancies. It is characterised by a protracted clinical course with late metastasis and poor long-term prognosis. We report the case of a 38-year-old woman presenting with pulmonary and pleural metastases, on the background of ACC of the floor of mouth, which had been treated 4 years ago with surgical excision and radiotherapy. Cytological evaluation of the pleural effusion showed exfoliated ACC tumour cells. Despite palliative chemotherapy, the patient developed disease progression including metastatic spread to the pericardium, and died of disease within a year. This case illustrates an unusual presentation of ACC and highlights the importance of considering this entity when encountering a basaloid neoplasm in extra-salivary locations.

A cytohistopathological correlation study of skin lesions in leprosy: An experience in a tertiary care hospital in South India

Objectives: Leprosy is a granulomatous disease caused by Mycobacterium leprae. Early detection and clinical diagnosis remain a challenge, especially in paucibacillary cases and initial lesions during early phases of leprosy. Use of cytological methods can reduce time for diagnosis, especially in peripheral centers. The present study was taken up to calculate the correlation between cytology and histopathology of skin lesions in leprosy. Materials and Methods: This study is a 2-year retrospective observational study taken up in the Department of Pathology, Rangaraya Medical College and Government General Hospital, Kakinada, Andhra Pradesh. A total of 49 cases of clinically suspected leprosy were included in the study. Skin biopsies and cytological smears were examined in all cases. Results: A total of 49 cases of clinically suspected leprosy were included in the study. The age incidence ranged between 9 and 72 years. There was a male preponderance. The overall diagnostic accuracy of fine-needle aspiration smears was 83.3% and that of slit-skin smears was 62.1%. Conclusions: Cytological examination being a simple, less time-consuming, and easy technique can enhance the diagnostic accuracy in detection of leprosy and act as an adjunct to clinical diagnosis.

FNAC (Fine needle aspiration cytology) and histopathological correlation and reclassification of thyroid neoplasm in accordance with WHO classification 2022

While assessing whether a patient requires surgery or conservative treatment, the thyroid FNAC is crucial. “The Bethesda System of Reporting Thyroid Cytopathology” was introduced to resolve the problem of standardising terminology in Thyroid FNA diagnosis. This study aims to evaluate the histopathological correlation and to also assess the diagnostic accuracy of TBSRTC at an institutional level with respect to histopathology. Additionally, reclassification of these cases in accordance with new Update of WHO Classification of Thyroid tumors 2022.This is a 3-year retrospective study of thyroid lesions from August 2019 to August 2022 comprising of 160 cases. Data was retrieved from institutional database and analysed. Fine needle aspiration Cytology- Histopathological correlation followed by determination of diagnostic accuracy of TBSRTC was done using Sensitivity, Specificity, PPV, NPV and accuracy. Reclassification was done on the 160 histopathological diagnosis based on the new updated classification.Study showed female predominance and largest cohort belonged to the age group of 21–40 years. Cytohistopathological correlation was done and 4 discordant cases were identified. The Sensitivity, Specificity, PPV, NPV and Accuracy was found to be 95.77, 98.87, 98.55%, 96.7% and 97.5% respectively. On reclassification, the tumors were now classified based on cell of origin and maximum no. of cases were identified under the category of Follicular- cell derived.FNAC is a sensitive and specific method of evaluating thyroid lesions. TBSRTC shows excellent diagnostic accuracy in detecting malignant lesions and can be used for screening neoplasm. The new classification demonstrates classification based on tumour cell of origin. It is crucial for Clinicians and Pathologists to be informed of new terminologies and classification schemes to aid more therapeutic options for patients.

Toluidine Blue Stain as a Rapid Onsite Tool for Preliminary Diagnosis in Imprint Smears of Bronchoscopic Biopsy: A Cytohistopathological Correlation.

Introduction Lung cancer is currently the most common cause of cancer-related mortality, with 11.4% of cancers and 18% of cancer-related deaths worldwide whereas Indian figures are 6.9 and 9.3%, respectively. Hence, the need for early diagnosis. Bronchial biopsy has the highest sensitivity among all the samples that can be obtained by bronchoscopic techniques in case of endobronchial lesions. Imprint cytology has emerged as an important cytological method. Toluidine blue has been studied for its use as rapid onsite stain for cytological evaluation on various samples of cytology in different anatomic sites. This has helped in quick and less expensive, preliminary reporting. Objectives This article aims to assess the efficacy of onsite toluidine blue stain on imprint smears of bronchoscopic biopsies to diagnose malignancy in suspected cases of lung carcinoma. Study Type Prospective study on accuracy of a diagnostic test. Materials and Methods A total of 100 cases of bronchoscopy were included in the study. The patients were clinico-radiologically suspected to have brochogenic carcinoma and all of them were subjected to biopsy. Imprint smears were prepared from the bronchoscopy biopsy specimens. Smears were stained onsite with toluidine blue stain, and histopathology sections were stained with hematoxylin and eosin, also confirmed by immunohistochemistry. Results Sensitivity and specificity of onsite toluidine blue stain for malignancy reporting were 97.9 and 80%, respectively, when compared to histopathology as standard. Conclusion Toluidine blue can be used as an onsite staining method on imprint smears of bronchoscopic biopsy for preliminary detection of lung malignancy.

Utility of the Proposed Sydney System for Classification of Fine-Needle Aspiration Cytopathology of Lymph Node: A Retrospective Study at a Tertiary Care Center

Introduction: Fine-needle aspiration cytology (FNAC) is an established first-line technique for the evaluation of lymphadenopathy and, with the help of ancillary testing, can in many instances obviate the need for an open biopsy. The Sydney system was recently proposed to provide consensus guidelines for the performance, classification, and reporting of lymph node FNAC. The present study was undertaken to evaluate its utility and study the impact of rapid on-site evaluation (ROSE). Material and Methods: A retrospective analysis in which 1,500 lymph node FNACs was reviewed and assigned a diagnostic category from the Sydney system. Cyto-histopathological correlation and adequacy parameters were evaluated. Observation and Results: The cervical group of lymph nodes was the commonest group aspirated (89.7%). A total of 1,205/1,500 (80.3%) cases were category II (benign), and necrotizing granulomatous lymphadenitis was the most common pathology. The 750 cases with ROSE were subclassified as follows: 15 category I (inadequate), 629 category II (benign), 2 category III (atypia of undetermined significance), 9 category IV (suspicious for malignancy), and 95 category V (malignant). Among 750 cases without ROSE, 75 cases were in category I, 576 in category II, 3 in category III, 6 in category IV, and 90 in category V. Category I was thus significantly lower in the ROSE group compared to the non-ROSE group. Overall, the risk of malignancy was L1-0%, L2-0.20%, L3-100%, L4-92.3%, and L5-100%. Accuracy parameters revealed a sensitivity of 97.7%, specificity of 100%, PPV of 100%, NPV of 99.10%, and diagnostic accuracy of 99.54%. Discussion and Conclusion: FNAC can be used as the 1st line of treatment for lymph node pathology. ROSE can be used as an add-on to FNAC for reducing unsatisfactory rates and help triage material for ancillary testing whenever possible. The Sydney system should be implemented for achieving uniformity and reproducibility.

Seven-year retrospective analysis of pleural effusion cytologies and cytohistopathological correlation

Seven-year retrospective analysis of pleural effusion cytologies and cytohistopathological correlation

Bronchoalveolar Lavage in Diagnostic Evaluation of Pulmonary Diseases- An Institutional Experience.

Bronchoalveolar lavage (BAL) is a widely accepted investigative tool for the diagnosis of pulmonary lesions. This study was done to find out the usefulness of BAL in diagnosis of pulmonary lesions from central Indian patient population. A cross-sectional prospective study was performed over a period of three years. All the BAL specimens of patients presenting to Department of Pulmonary Medicine and Tuberculosis during a period of January 2017 to December 2019 were included in the study. Cyto-histopathologic correlation was done, wherever available. Of total 277 cases, there were 178 (64.5%) males and 99 (35.5%) females. The age of patients ranged from 4 years to 82 years. In 92 (33%) cases, specific infective etiology could be identified on BAL cytology, the most common being tuberculosis (26%) followed by fungal infections (2%). Rarely, infections like nocardia, actinomycosis, and hydatidosis were also identified. Eight cases (3%) of malignancy were identified which included two cases of adenocarcinoma, one case of small cell carcinoma, three cases of poorly differentiated carcinoma, and two cases suspicious for malignancy. Some rare diagnoses like diffuse alveolar damage, pulmonary alveolar microlithiasis, and pulmonary alveolar proteinosis could be identified on BAL. BAL is useful in primary diagnosis of infections and malignancies of lower respiratory tract. BAL may aid in diagnostic workup of diffuse lung diseases. A combination of clinical information, high-resolution computed tomography, and BAL analysis may furnish an assured diagnosis to the clinician and obviate need for invasive procedures.

Cytohistopathological Correlation of 884 Cervical Pap Smears as Bethesda System 2014: A Hospital-Based Study

Cervical carcinoma is most common in Indian women of which Rural women are predominantly affected. The most common etiological factor is human papillomavirus (HPV ). The present study aims to assess the diagnostic accuracy, sensitivity, specificity, and different patterns of cervical Pap smears by comparing histological findings. The index study is a retrospective cross-sectional analytical study. The data was collected at the pathology department from May 2017 to December 2019 according to hospital ethical protocol. Cervical Pap smears received by the pathology department underwent Pap staining. A total of 884 Pap smears were satisfactory and included in the study. The age of enrolled women was 46.4 ± 9.7 years. 800 cervical Pap smears were reported as negative for intraepithelial lesion (NILM), and 84 Pap smears were reported as abnormal. Abnormal pap smears included 64 (7.1%) atypical squamous cell-undetermined significance (ASC-US), 9 (1.01%) low-grade squamous intraepithelial (LSIL), 5 (0.56%) high-grade squamous intraepithelial lesion cannot be ruled out (ASC-H), 3 cases (0.33%) of high grade squamous intraepithelial lesion (HSIL), 2 cases (0.22%) of atypical glandular cell-not specific otherwise (AGC-NOS) and 1 case (0.11%) of squamous cell carcinoma. The cytohistological correlation was found in 56 patients, including 41.07% with chronic cervicitis, 26.75% with chronic cervicitis with squamous metaplasia, 5.35% with cervical polyps, 3.57% with CIN-1, 14.28% with carcinoma in situ, 7.14% with squamous cell carcinoma (keratinizing), 1.78% with squamous cell carcinoma (non-keratinizing) patients. Cytohistological correlation of 56 cases revealed sensitivity (83.33%), specificity (94.73%), PPV (88.23%), NPV (92.3%) and accuracy (91.07%). The cervical Pap test is cost-effective, almost as sensitive, and accurate as histology in screening for cervical lesions.

A rare case report of fibrous hamartoma of infancy: Cyto-histopathological correlation

Fibrous hamartoma of infancy is a rare, benign soft tissue tumor that typically occurs within the first two years of life. The histogenesis is unclear. It is most commonly found in the axilla, shoulder, inguinal region, and chest wall and is usually a solitary malformation located in the subcutaneous tissue or reticular dermis. Local recurrence is uncommon and treatment is largely successful by local excision. The clinical course is typically benign and prognosis excellent. We describe a 7-month-old male with a mass on his left arm that progressively increased in size. The management of a subcutaneous mass in the pediatric patient presents a clinical challenge. The differential diagnosis includes numerous benign and malignant soft tissue tumors. The physical appearance and characteristics of a subcutaneous mass on a child may suggest a malignant process; however, Fibrous Hamartoma of Infancy should be included within the differential diagnosis.

Evaluation of Fine Needle Aspiration Cytology in Thyroid Lesions with Histopathological Correlation

Background: Thyroid diseases are considered the commonest endocrine disorders worldwide. Fine needle aspiration cytology (FNAC) is the mosteasy, reliable screening test in diagnosing thyroid lesions. Objectives: To determine the frequency of Bethesda system diagnostic categories and cyto-histopathological correlation of FNAC results. Material and methods: This study comprised 488 thyroid FNA smears. cyto-histopathological correlation was conducted on surgically excised cases. Results: Out of 488 of thyroid FNAC smears, thyroidectomy was done for one hundred cases. Sensitivity, specificity, PPV, NPV and accuracy of FNAC were 82.8%, 94%, 88.9%, 90.4% and 89.9% respectively. Conclusion: FNAC is a highly sensitive and specific method in diagnosing different thyroid lesions.

Cytomorphological Study of Hepatic Lesions by FNAC

Introduction: Fine Needle Aspiration Cytology (FNAC) is a simple, safe, very low-cost and rapid procedure for diagnostic purpose which makes surgical intervention and exploratory laparotomy unnecessary. The introduction of modern diagnostic imaging techniques, mainly ultrasonography (USG) and Computerized Tomography (CT), has enabled the detection and location of lesions in sites such as liver, which are not easily accessible to surgical biopsies.&#x0D; Aim: To assess the utility of FNAC in the diagnosis of liver lesions. To study the cytomorphological features, age and sex distribution of liver lesions.&#x0D; Materials and methods: The study included 24 liver lesions which were detected clinically or radiologically. USG guided FNA was done in all cases. The smears were stained with Haematoxylin and eosin (H and E), May Grunwald Giemsa (MGG) and Papanicolaou’s stains. A cyto-histopathological correlation was done wherever possible. From the residual material, additional slides and cell blocks were prepared. Special stains were used whenever required. In doubtful cases immunohistochemistry (IHC) was done on formalin-fixed paraffin cell blocks and immunocytochemistry on conventional smears wherever necessary and possible.&#x0D; Results: All the lesions were found to be malignant. Out of 24 liver FNA cases, maximum lesions were seen in females and the affected age group for liver malignancies was 51-60 years. Out of 24 liver FNA cases, 20 cases were metastatic and 4 were primary cases. Among metastatic cases, maximum cases were of metastatic adenocarcinoma and the primary lesions of liver included all cases of hepatocellular carcinoma. Conclusion: Fine needle aspiration cytology of liver is a simple, safe, repeatable and rapid diagnostic procedure. In case of hepatic lesions, it is of outmost advantage in recognizing the nature of lesion i.e., primary, and metastatic as well as in early diagnosis of lesion so that patient can be treated as early as possible.&#x0D;

Study of cyto-histopathological correlation in thyroid lesions at rural tertiary care hospital

Fine Needle Aspiration Cytology of the thyroid gland is firmly established as an important test for the evaluation of thyroid diseases and an effective test for the preoperative diagnosis of solitary thyroid nodule. : 1. To correlate cytological and histopathological finding in thyroid lesions.; 2. To find out the spectrum of thyroid lesions in our rural hospital. : Prospective study of 2 years duration was undertaken in our institution. Total 110 cases were included in this study. All had FNAC examination as an outpatient procedure. Out of 110 cases, 64 were operated and specimens were sent for histopathology.Out of the 111 patients studied, on cytology 104 were non-neoplastic lesions, 3 were neoplastic, and 3 were inadequate. Out of 111 patients, Histopathology of 65 thyroid specimens showed 28 Colloid/Nodular goiter, 14 Multinodolar goiter, 5 Lymphocytic thyroiditis, 7 Hashimoto’s thyroiditis,1 Granulomatous thyroiditis,3 follicular carcinoma, 1 undifferentiated Anaplastic carcinoma,1 Medullary carcinoma, 1 papillary carcinoma.: By comparing the result of FNAC and histopathology, FNAC had higher accuracy, sensitivity of 80% and specificity 100% in the diagnosis of neoplastic thyroid lesions. FNAC is safe, inexpensive and less invasive diagnostic method with excellent patient compliance. FNAC can be used in the management of thyroid swelling to avoid unnecessary surgery on conditions like thyroiditis. FNAC with the help of imaging techniques is helpful in diagnosis of neoplastic lesion.