Fine Needle Aspiration Cytology Examination Research Articles

The Accuracy of Histopathological and Cytopathological Techniques in the Identification of the Mycetoma Causative Agents

Mycetoma is a devastating neglected tropical disease, caused by various fungal and bacterial pathogens. Correct diagnosis to the species level is mandatory for proper treatment. In endemic areas, various diagnostic tests and techniques are in use to achieve that, and that includes grain culture, surgical biopsy histopathological examination, fine needle aspiration cytological (FNAC) examination and in certain centres molecular diagnosis such as PCR. In this retrospective study, the sensitivity, specificity and diagnostic accuracy of grain culture, surgical biopsy histopathological examination and FNAC to identify the mycetoma causative organisms were determined. The histopathological examination appeared to have better sensitivity and specificity. The histological examination results were correct in 714 (97.5%) out of 750 patients infected with Madurella mycetomatis, in 133 (93.6%) out of 142 patients infected with Streptomyces somaliensis, in 53 (74.6%) out of 71 patients infected with Actinomadura madurae and in 12 (75%) out of 16 patients infected with Actinomadura pelletierii. FNAC results were correct in 604 (80.5%) out of 750 patients with Madurella mycetomatis eumycetoma, in 50 (37.5%) out of 133 Streptomyces somaliensis patients, 43 (60.5%) out of 71 Actinomadura madurae patients and 11 (68.7%) out of 16 Actinomadura pelletierii. The mean time required to obtain the FNAC result was one day, and for the histopathological examinations results it was 3.5 days, and for grain it was a mean of 16 days. In conclusion, histopathological examination and FNAC are more practical techniques for rapid species identification than grain culture in many endemic regions.

UNUSUAL PRESENTATION OF ACINIC CELL CARCINOMA OF THE RIGHT PAROTID GLAND WITH LOCOREGIONAL LYMPH NODE METASTASIS IN A 18 YEARS OLD MALE: A CASE REPORT WITH REVIEW OF LITERATURE

Acinic cell carcinoma (ACC) is a slow growing and low grade epithelial neoplasm of the salivary glands, in which few tumor cells exhibiting acinar cell differentiation that is characterized by presence of cytoplasmic zymogen secretory granules in the tumor cell. Most frequently ACC occur in parotid gland with the initial presentation somewhat at younger age than other parotid gland neoplasms and preferentially more in female with female: male ratio is 3:2 and median age at time of presentation is 52 years. “Fine needle aspiration cytology (FNAC)” examination may also be useful tool for confirmation of the diagnosis. The treatment of tumor is essentially by surgical excision of the gland. In histo-pathological examination; the most common presentation of tumor is solid sheet and nesting pattern of the growth followed by microcystic, papillary-cystic and follicular pattern . The purpose of the present case is to present the clinical, cytological and histopathological features of of ACC of the parotid glands of 18 years old male child which initially present as a benign cystic lesion of parotid gland than finally diagnosed as ACC with metastasized to regional lymph nodes. To conclude, ACC is frequently arising in parotid gland and metastasis to the intra-salivary gland lymph nodes is a very rare finding in young male. Intra­-operative frozen section might be helpful in the di­agnosis of parotid gland ACC because of low specificity and sensitivity of CT scan and FNAC examination of ACC. The histo-morphological examination of paraffin embedded H/E stained section is the main tool to explain the microscopic findings of ACC and to classify ACC of parotid gland. Specail stain like PAS, PAS-D and IHC examination might useful for diagnosis of ACC. Surgery with adjuvant post-operative radiation therapy is acceptable for final outcome of disease and the tumor should be managed uncompromisingly, despite of its slow growing and low malignant behaviour, due to its metastatic prospective which usually confirmed by distant metastasis and recurrence. Hence, these tumors require a long-term follow-up.
 Key words: ACC: Acinic cell carcinoma

A Comparative Study on Aspiration Cytology and Histopathology in Diagnosis of Thyroid Nodule and Its Correlation.

Fine Needle Aspiration Cytology (FNAC) is an initial diagnostic test that has been found to be simple and cost effective but it is associated with pitfalls due to difference in correlations between FNAC and Histopathological Examination (HPE). A study was undertaken with a total of 112 patientspresenting with thyroid nodule who underwent thyroid surgeries. Preoperative FNAC and postoperative HPE were evaluated to calculate sensitivity, specificity, positive and negative predictive value and accuracy. In our study we found sensitivity to be 81.48%, specificity 95.29%, positive predictive value 84.61%, Negative predictive value 94.18% and accuracy to be 91.16%. Thus we can conclude that FNAC is a simple, safe and cost-effective diagnostic modality in the investigation of Thyroid nodule with high specificity and accuracy.

Validity of UPREP liquid based cytology in FNAC examination for palpable lesions type of article – original article

Background: Liquid-based cytology (LBC) is a technique that enables cells to be suspended in a monolayer, through which better morphological assessment is possible. There are very few studies done to evaluate the outcomes between conventional and UPREP LBC method. A successful validation of UPREP LBC will go a long way in providing both affordable and accurate management of cancers in developing countries. Methods: This study was carried out as a comparative study among 110 all adults who were advised to undergo Fine Needle Aspiration Cytology (FNAC) examination for palpable lesions in thyroid, breast and lymph node in our tertiary care hospital. Conventional FNAC was taken for 55 participants and for the UPREP LBC group (55 participants), the same procedure was repeated and instead of air, preservative solution was drawn into the syringe. Various cytological parameters including cellularity, background, monolayer, cellular morphologic change, nuclear changes and inflammatory infiltrate were studied. Results: Among the individual lesions involving breast, thyroid and lymph node, breast carcinoma was highest in both the groups (25.4%) followed by fibroadenoma of the breast (20%) and Hashimoto’s thyroiditis (18.2%). Statistically significant differences were observed between the conventional and UPREP groups. Informative background was increasingly better in the conventional group compared to the UPREP group (p<0.001) while background debris was absent in most of the patients in UPREP group (p<0.001). Details pertaining to nucleus and cytoplasm were better perceived in the UPREP group compared to the conventional group (p<0.001). Conclusion: Manual liquid based cytology like UPREP LBC is an accurate, less expensive alternative procedure to automated LBC with the advantage of providing monolayer, absence of obscuring blood or debris, better nuclear and cytoplasmic morphology.

Subconjunctival nodule due to Setaria equina erratic migration in a horse: First case report

An 18-month-old Arabian-English filly resident in southwest France was referred for evaluation of a conjunctival mass in the right eye (OD). A pink, solid, and mobile nodular formation, measuring approximately 1.2×0.8cm was found under the superior nasal bulbar conjunctiva during an ophthalmic examination that was otherwise normal. The mass was surgically removed using a standing procedure. Cytological examination of fine-needle aspirates from the mass revealed a mixed eosinophilic-lymphocytic inflammation. Histological examination confirmed the dense and diffuse eosinophilic-lymphocytic infiltrate of the mass, and it revealed several cross sections of a parasitic nematode. The morphometric diagnosis identified an immature form of a filarial worm, and molecular analysis of the mitochondrial cytochrome c oxydase subunit 1 (cox1) and 12S rRNA gene sequences led to further identification of the specimen as Setaria equina. Microfilaremia was not observed on fresh blood smears. There have been no signs of local recurrence after 18months, nor any evidence of intraocular involvement. To the authors' knowledge, this is the first documented case of subconjunctival setariasis due to Sequina in a horse.

Ultrasound-guided fine-needle aspiration of axillary lymph nodes in breast cancer: Diagnostic accuracy and role in surgical management.

The objective of this study was to evaluate the accuracy of fine needle aspiration cytology (FNAC) of axillary lymph nodes (LN) in breast cancer, to compare the results of FNAC and pathological examination, and to distinguish patients with 1 to 2 metastatic LNs from those with ≥3 metastatic LNs in patients with FNAC-positive patients. This study included 198 breasts of 196 patients with breast cancer who underwent FNAC and surgery for the primary and axilla without neoadjuvant chemotherapy from January 2010 to August 2016. Axillary nodal status was assessed by ultrasound (US), and whether FNAC-positive had three or more suspicious LNs on US imaging was examined. The results of FNAC were positive in 75 (38%), negative in 97 (49%), suspicious in 2 (1%), indeterminate in 5 (2.5%), and insufficient in 19 patients (9.5%). FNAC sensitivity, specificity, positive predictive value, and negative predictive value were 62.6%, 100%, 100%, and 62.0%, respectively. Whereas 53% (18/34) of patients with false-negative FNAC had one metastatic LN on final pathology, 61% (47/77) patients who were FNAC-positive had three or more metastatic LNs. In the FNAC-positive patients, all patients had ≥3 metastatic LNs if they had ≥3 suspicious LNs on US imaging. Patients with positive cytology were more likely to have ≥3 positive LNs compared to false-negative cytology patients. Patients with ≥3 abnormal LNs on US and positive FNAC might require axillary dissection.

Correlation of fine needle aspiration cytology and histopathological examination in thyroid swellings: a prospective study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Thyroid swellings are not an uncommon condition. Physical examination, laboratory investigation, thyroid imaging, and cytology can be used to evaluate thyroid swellings. After a physical examination, ultrasonography and thyroid function tests, fine needle aspiration (FNA) cytology should be implemented. Although FNA cytology is a common method to evaluate the nodule, false negative and false positive results are not rare. Hence histopathology examination is confirmatory. Information gathered from history, physical examination, ultrasound and intraoperative appearance of thyroid swelling dictate further management. The purpose of the study is to correlate preoperative FNAC and postoperative histopathology in thyroid swellings.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study of 52 in-patients with thyroid lesions was treated at UIORL-RGGGH MMC Chennai. FNAC and USG were used as preoperative tools for determining the procedure to be performed and was followed by HPE postoperatively for further&lt;strong&gt; &lt;/strong&gt;management. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Diagnostic categorization of 52 thyroid swellings were based on FNAC and histopathology. According to FNAC, 88.46% swellings were benign lesions and 11.54% were a malignancy. According to HPE, 82.69% were benign lesions and 17.31% were a malignancy. In our study, the collection of thyroid cases emphasizes the false negativity of FNAC. Cases suspicious of malignancy were decided based on intraoperative changes and were given a note of caution to the pathologists for a meticulous evaluation of slides.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; FNAC is a simple, safe and cost-effective modality of investigation for thyroid disease but in cases of false negativity histopathology is confirmatory. The false positive results were found to be nil however there is a low percentage of false negative results which has to be confirmed by HPE.&lt;/p&gt;

Cytological evaluation of breast lesions with histopathological correlation in patients present with breast lump

Background: Breast carcinoma is the leading cause of death with cancer in women. Management of breast lumps can be challenging in resource poor settings. Fine needle aspiration cytology of breast is an important mode of diagnosis and forms a part of triple assessment, which includes FNAC (fine needle aspiration cytology), mammography and clinical examination. Objective: To examine the cytological details in aspirated smears from lumps in the breast, to evaluate the role of FNAC in improving the quality of diagnosis by comparing with histopathological features and to separate malignant lesions that require more radical therapy from benign ones that may be conservatively managed. Methods: A prospective study is carried out on 100 patients with breast lump over a period of one year including 4 bilateral, 49 left sided and 47 right sided lesions at territory hospital, Chandkheda, Ahmedabad, Gujarat. Histopathology examination were obtained in 27 cases. All the aspirates and histopathology slides were stained with H &amp; E stain. Results: Out of 100 cases of FNAC breast 80 cases were diagnosed as benign and 20 cases were diagnosed as malignant. Histopathological correlation was done on 27 cases and all were confirmed by FNAC. Conclusion: FNAC is a safe, simple, and cost-effective outpatient procedure associated with negligible complication. And along with histopathological correlation it increases the diagnostic accuracy. That helps the clinicians for early diagnosis and specific management thus reducing morbidity and mortality.

Cytological features of basal cell adenocarcinoma of the salivary glands.

The cytological features of basal cell adenocarcinoma (BAC) of the salivary gland, a rare carcinoma, have not been well described. This study included patients who were histopathologically diagnosed with BAC and who underwent preoperative fine-needle aspiration cytological examination. Cytological characteristics, including background, arrangement and shape of the neoplastic cells, nuclear and cytoplasmic features, and presence of stromal spindle cells, were reviewed. Seven patients were enrolled in the study. The cytological specimens were cellular and composed of large or small clusters with occasional discohesive neoplastic cells at the periphery. The predominant cellular morphology was spindle-shaped in four cases, and small round-shaped in three cases. These neoplastic cells were tightly packed, showed high cellularity and overlapping nuclei, and had mildly to moderately enlarged round to oval nuclei with occasional small nucleoli and scant cytoplasm. Stromal spindle cells were observed around the basaloid cells in three cases (42.9%). All histology-proven stromal spindle cell-positive cases had stromal spindle cells in the cytological specimens. The study findings clearly demonstrate the relatively high frequency of stromal spindle cells in cytological specimens of BAC. This finding is characteristic of BAC, although basal cell adenoma of salivary gland frequently has stromal spindle cells in the cytological specimens. The characteristic that differentiates BAC from basal cell adenoma is the presence of tightly packed and high cellular clusters with discohesive neoplastic cells. An understanding of these cytological features can aid the cytodiagnosis of BAC.

The cyto-histopathological evaluation of breast lesions in a tertiary care hospital- A two years study

The cyto-histopathological evaluation of breast lesions in a tertiary care hospital- A two years study - ACHR- Print ISSN No: - 2581-5725 Online ISSN No:- 2456-9267 Article DOI No:- 10.18231/2456-9267.2019.0007, IP Archives of Cytology and Histopathology Research-IP Arch Cytol Histopathol Res

Cytological features of basal cell adenoma of salivary glands: Analysis of 19 cases emphasizing stromal spindle cells.

Basal cell adenoma (BCA) of the salivary gland is a relatively rare benign tumor. Although the presence of stromal spindle cells is a characteristic histopathological feature, this finding has not been the focus of much attention in the cytodiagnosis of BCA. Thus, we analyzed the cytological features of BCA, especially the presence of stromal spindle cells. Patients who were histopathologically diagnosed with BCA and underwent preoperative fine-needle aspiration cytological examination were enrolled in this study. The cytological characteristics including arrangement and shape of the neoplastic cells, nuclear and cytoplasmic features, and the presence of stromal spindle cells were reviewed. Nineteen patients were enrolled in the study. The cytological specimens were cellular and composed of small or large clusters or both. The neoplastic cells had scant cytoplasm and small round to oval nuclei. Basement membrane-like material was observed in 57.9%, and peripheral palisading was noted in 84.2%. Loose aggregates of stromal spindle cells were present in 63.2%, and the stromal spindle cells shown in the histological examination of 85.7% of cases were expressed in the cytological specimens. This study clearly demonstrated the relatively high frequency of stromal spindle cells in cytological specimens of BCA. This finding is characteristic of BCA, and therefore, the combination of cytological features, including packed clusters of neoplastic cells with scant cytoplasm and small nuclei, peripheral palisading, and basement membrane-like material, and the presence of stromal spindle cells could increase the diagnostic success of BCA.

Cutaneous Rhinosporidiosis Presenting as Cutaneous Horn and Verrucous Plaque.

Sir, A 52-year-old male presented with a growth over the right little finger and the left popliteal fossa since 1 year. He gave a recurrent history of nasal stuffiness, difficulty in breathing, and change in voice. He was diagnosed and operated for nasal rhinosporidiosis four times within the last 3 years. He had a habit of regular pond bathing. Dermatological examination showed a verrucous plaque measuring 3 × 4 cm2 covering the entire palmar and medial aspect of the right little finger along with a horn-like projection over the right popliteal fossa. Examination of nasal mucosa revealed a polypoidal, grape-like growth with a red shiny surface covering the medial aspect of right anterior nare [Figure 1a–d]. His blood counts, erythrocyte sedimentation rate (ESR), blood sugar, liver, and renal function tests were within normal limits. Serology for human immunodeficiency virus (HIV) was negative. Systemic examination was unremarkable. Chest X-ray and ultrasound abdomen and pelvis were normal. Histopathology from lesions over finger and growth over right popliteal fossa showed multiple thick-walled mature sporangia-releasing endospores, with surrounding areas showing marked inflammatory reaction suggestive of cutaneous rhinosporidiosis [Figure 2a and b]. Patient was started on tablet dapsone 100mg/day and tablet cotrimoxazole double strength twice daily. However, there was minimal improvement in skin lesions despite 2 months of treatment.Figure 1: (a) Polypoidal growth inside the right anterior nare. (b) Verrucous plaque on the palmar aspect ofright little finger . (c) Verrucous plaque on the dorsal aspect of right little finger. (d) Cutaneous horn in the popliteal fossaFigure 2: (a) Hematoxylin and eosin; 100×: multiple sporangia in various stages of maturation. (b) Hematoxylin and eosin; 400×: sporangia-containing endosporesDiscussion Rhinosporidiosis is a chronic granulomatous infection caused by Rhinosporidium seeberi.[1] It commonly affects mucosa with nasopharynx (70%) being the most common site involved followed by ocular (15%), oral, and genital mucous membranes. Four forms of rhinosporiosis have been described – nasal, ocular, cutaneous, and disseminated. Cutaneous lesions are generally associated with mucosal lesions. Based upon the modes of spread, three morphological presentations of cutaneous rhinosporidiosis have been described i.e., (1) satellite lesions, in the skin adjacent to the nasal rhinosporidiosis; (2) generalized cutaneous type, occurring via hematogenous dissemination; and (3) primary cutaneous type without any visceral involvement associated with direct inoculation of organisms on the skin. Cutaneous lesions are usually in the form of friable warty growths.[2] Other presentations such as verrucous plaques, polypoidal growths, subcutaneous nodules, furuncle, ecthyma, and friable nodules have been reported.[34] Because of varied clinical presentations, it can be easily confused with tuberculosis verrucosa cutis, warts, cutaneous leishmaniasis, bacillary angiomatosis, granuloma pyogenicum, Kaposi's sarcoma, and deep mycoses such as cryptococcosis. Clinical diagnosis is usually confirmed by fineneedle aspiration cytology and histopathological examination of the resected tissue. However, definitive diagnosis is made by histopathology which shows sporangia at various stages of maturation consisting of large, thick-walled spherical structures, and smaller daughter cells termed endospores, which can be seen with fungal and routine hematoxylin and eosin staining.[4] Though definitive treatment remains surgical excision with cauterization, recurrence rate is still high due to incomplete excision and accidental spillage of sporangia to the adjacent tissue. Among medical treatments, dapsone has been found to be somewhat effective which arrests the maturation of the sporangia, inducing stromal fibrosis and accelerating its degenerative changes.[5] Our case had nasal rhinosporidiosis and skin lesions were on the right little finger and left popliteal fossa possibly due to autoinoculation. The presence of nasal rhinosporidiosis which was previously proven by histopathology and culture led to the suspicion of cutaneous involvement, which was further supported by histopathology from the skin lesion. The patient was started on dapsone and cotrimoxazole (double dose) without appreciable improvement after 2 months, which was expected. Among various presentations, verrucous plaque-like morphology has been reported by many authors.[34] However, cutaneous horn-like presentation of rhinosporidiosis has been reported by few.[4] Our patient had two types of morphologies, verrucous plaque and cutaneous horn, and we believe it will add to the pool of evidences of atypical presentations of cutaneous rhinosporidiosis. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Prevalence of thyroid incidentaloma detected by high-resolution ultrasound and their potential risk of malignancy in healthy individuals in Basrah Province

Background: This study conducted to define the prevalence and potential risk of malignancy of thyroid incidentaloma in a healthy population using high-resolution ultrasound. Patients and Methods: A cross-sectional prospective study between December 2017 and March 2018, included 1200 asymptomatic adults participants (1000 women aged 15–70 years and 200 men aged 19–65 year). The prevalence of thyroid incidentaloma, their distribution according to age and sex, nodule size, ultrasound characteristics, and risk stratification of malignancy using Thyroid Imaging Reporting and Data System (TI-RADS) grade were studied. Fine-needle aspiration cytology (FNAC) examination was done for some specific patients. Results: The prevalence of thyroid incidentaloma was 27.3%. Thyroid incidentaloma were more prevalent in females and elderly people in both sexes mainly in 60–75-year-old peoples. Nodules were solitary in 244 (74.4%) and multiple in 84 (25.6%) patients. The size of 186 nodules (45.1%) were

Role of Ultrasound-Guided Fine-Needle Aspiration Cytology of Omentum in Diagnosis of Abdominal Tuberculosis

To evaluate the efficacy of ultrasound-guided (USG) fine-needle aspiration cytology examination (FNAC) of the omentum in the diagnosis of abdominal tuberculosis (TB). Retrospective review was conducted of data from patients who presented with clinically suspected peritoneal TB between June 2016 and April 2018. We included patients in whom imaging showed omental thickening with or without ascites. Additional features that were assessed on imaging included ascites, the presence of mesenteric or retroperitoneal adenopathy, ileocecal thickening, and involvement of solid abdominal organs. Ultrasound-guided FNAC of the omentum was performed using a 22-gauge needle. The cytologic assessment was done for granulomatous inflammation, bacilli on Zeihl-Neelson stain, and for other pathology if any. During the study period, 35 omental FNACs were done. Of these patients, malignancy was reported in eight (22.8%). Of the remaining 27 patients, positive results for TB were reported in 19 patients (70.4%). In these 19 patients with positive FNAC, the median age was 33 years (range 10-63 years), with eight males (42.1%). Ascites was present in 14 (73.7%), abdominal lymphadenopathy was present in 9 (47.4%), ileocecal thickening and involvement of solid abdominal organs were reported in 3 (15.8%) and 4 (21%) patients, respectively. Granulomatous inflammation was reported in 17 (89.5%) and acid-fast bacilli in 10 (57.6%) patients. The Genexpert analysis was done in two patients, with a positive result in one patient. Ultrasound-guided FNAC of the omentum is helpful to diagnose abdominal TB in patients having omental thickening with or without other abnormal findings.

Benign and malignant lesions of the breast: clinico-pathological perspective from a government teaching hospital in West Bengal, India

Background: While breast cancer is one of the most commonly diagnosed cancer more than half of the women develop some benign disease of breast in their lifetime. The current study was conducted to describe the clinico-pathological findings associated with breast diseases and study their relationship.Methods: A record-based cross-sectional study was conducted on the samples of breast tissue obtained by fine needle aspiration cytology (FNAC) examination. The clinical variables like age, sex, presenting complaint, involved side (right/left/both) etc. were taken from the clinical notes sent, and nature of the aspirate, histopathological diagnosis, nature of the diagnosed disease (benign/malignant), and axillary metastasis were taken as variables from pathological examination.Results: The mean age of the patients was 33.49 years (±13.24 years) with majority belonging to 20-40 years. Among the 184 specimens examined, 94.57% belonged to female patients. The most frequent presentation was with lump (95.11%). Complaint arising out of right breast (47.83%) were higher compared to left breast (40.76%). Involvement of the supero-lateral quadrant was seen in 75.54%. In 30.44% of the cases the material was bloody or blood-mixed. Majority of the patients (86.41%) were diagnosed with benign disease commonest being fibroadenoma. Ductal carcinoma was the commonest malignant lesion. Younger age group, absence of bloody discharge and absence of peau d’orange were associated with benign lesion in a statistically significant way (p-value &lt;0.001).Conclusions: In consonance with published literature the findings suggest association of older age group with malignant lesions. Blood-mixed aspirate, peau d’orange appear to be danger signs.

Etiopathological study of pediatric neck masses in a rural population

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Neck mass in pediatric age group is a common clinical condition encountered by an ENT Specialist. Detailed clinical examination and knowledge of the common neck masses in children, which differ from those in adults is vital in early diagnosis and treatment. Diagnostic modalities such as Ultrasonography, Computerised Tomography, Fine needle aspiration cytology (FNAC) and histopathological examination aids in the diagnosis of superficial neck masses. The majority of neck masses in the pediatric population are congenital or inflammatory in origin and some are neoplastic. This study was conducted to establish the various causes of neck masses and the site of origin of neck masses in pediatric patients attending ENT OPD.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 50 patients in the age group of 1 month to 18 years presenting with neck masses to the ENT OPD of Vinayaka Mission’s Medical College and Hospital, Karaikal were included in the study. This was a prospective study conducted for a period of 2 years. All the cases underwent FNAC. Biopsy and histopathological examination was done in cases where the cytological diagnosis was inconclusive. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Of the 50 cases clinically evaluated, 24 were lymph node swellings, 7 were thyroid swellings, 8 were salivary gland swellings, 10 were congenital neck swellings, with 1 swelling being due to other cause.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Inflammatory swelling arising from the Lymph nodes were the commonest cause of neck swelling in pediatric patients. Neck swellings were located most commonly in the Submandibular triangle in the study.&lt;/p&gt;

Cyto-Morphological, Biochemical and Radiological Correlation of Various Thyroid Lesions at a Tertiary Care Center

Background: Fine needle aspiration cytology (FNAC) is a cost-effective and time saving diagnostic test used to specifically distinguish between benign and malignant lesions by cytology. Aim: To evaluate the cytomorphological pattern, thyroid hormone profile and radiological findings in early detection of various thyroid diseases. Objective: To correlate the findings of FNAC, thyroid hormone profile and radiological features in diagnosis of various thyroid lesions Methods: 100 patients with thyroid swellings underwent FNAC along with complete thyroid hormone profile& USG Thyroid. Result: 93 female and 7 male patients were evaluated. Mean age of patients was 38.62±14.2. Ninety-four patients had non-neoplastic and 6 had neoplastic lesions. Colloid goiter was the predominant group among non-neoplastic lesions, followed by Hashimoto’s thyroiditis whereas follicular neoplasm was seen more frequently among neoplastic group. Majority of patients (71%) were in euthyroid state, followed by hypothyroid state and least in hyperthyroid state. In our study 88% of benign lesions were hyper-echoic and all malignant lesions were hypo-echoic. Most of the cystic nodules were benign and showed macro-calcification whereas all malignant lesions showed micro-calcification. Most of the benign lesions showed peripheral hypervascularisation and all malignant lesions showed internal hypervascularisation. There was a statistically positive significant correlation between FNAC findings and radiological features with P<0.001. Conclusion: FNAC and radiological examination play significant role in an accurate diagnosis of neoplastic and non-neoplastic lesions of thyroid gland. Thyroid profile also plays a very important role in sub-typing of non-neoplastic lesions.

Exploring the Diagnostic Efficacy of Fine-Needle Aspiration Cytology in Thyroid Nodules ≥ 4 cm: Results from a Tertiary Health Care Center in Jharkhand

Abstract Background Any nodules of the thyroid, ≥ 4 cm, are generally associated with false-negative results for malignancy on fine-needle aspiration cytology (FNAC), which generally are confirmed cases of malignancy after histopathologic examinations. Methods A retrospective hospital-based study was done in which data of patients having thyroid lesions ≥ 4 cm were reviewed. We checked the FNAC and histopathologic examination done on these lesions. Ultrasonography (USG)–guided aspiration records were also assessed. Sensitivity and specificity of FNAC for the detection of neoplastic or malignant lesions was determined. Results A total of 192 patients (57 female) were included in study. Preoperative fine-needle aspiration (FNA) biopsies were categorized as negative for malignancy (n = 183, 63%), suspicious (n = 6, 4%), and malignant (n = 4, 2%). Final pathology of nodule was found to be benign in 157 (81.35%) patients, whereas in 36 (18.65%) patients, nodules were found to be malignant. Conclusion In this study, we found the malignancy rate of thyroid nodules ≥ 4 cm to be similar to the accepted malignancy rate of smaller thyroid nodules. We missed 32 cases of malignancy on FNAC. Because of high incidence of thyroid malignancy, all nodules ≥ 4 cm must undergo histopathologic examination.

Cytohistological Correlation of Palpable Breast Mass: A Study of 300 Cases

Background: The present study is aimed at correlation of cytological and histological findings of palpable breast mass and evaluate efficacy of FNAC as a first line of investigation modality in breast lump.Material Method: Total 378 female patients with breast lump were subjected to fine needle aspiration cytology examination and reported by using five tire system for breast cytology. Out of 378 cases, in 300 cases cytological findings were correlated with histological diagnosis.Results: In present study, all benign, malignant and suspicious cases on cytology were well correlated with their histological diagnosis. The sensitivity, specificity and positive predictive value of FNAC for palpable breast lump are 97.7%, 98.8% and 97.7% respectively.Conclusion: FNAC of breast lump is an effective, rapid, cost effective, though simple diagnostic procedure with excellent patient compliance. It is giving high accuracy rates when practiced by and experienced hand; making it one of the most reliable modality for evaluation of palpable breast mass. DOI: 10.21276/APALM.1385

Correlation of Fine Needle Aspiration Cytology and Histopathology of the Neck Swellings Presenting at National Academy of Medical Sciences, Kathmandu, Nepal

IntroductionNeck masses are frequently found in clinical practice. A spectrum of pathological lesions ranging from inflammation to benign and highly malignant manifestation is observed. Fine needle aspiration cytology (FNAC) of neck masses is a quick, easy, safe and cheap technique in the diagnosis which has been a well-accepted procedure in diagnosing various swellings. Histopathology is a gold standard technique in diagnosing any swelling which also provide detail architecture, however it also requires OT setings, more manpower, expensive, time consuming, more traumatic and can sometimes become difficult.ObjectiveThe objective of our study was to evaluate the frequencies of neck swellings and how efficacy FNAC is in diagnosing neck masses by correlating the gold standard histopathological examination.MethodologyA Hospital based descriptive cross sectional prospective study was conducted in 50 patients with neck swellings presenting in the surgery OPD and admitied patient for some other reasons. FNAC and histopathological examinations were done from those lesions and were compared. The sensitivity, specificity and accuracy rates were calculated. Data entry and analysis was performed using SPSS.ResultsA total of 50 patient were subjected to both FNAC and histopathology examination (HPE). Out of 50 cases, 25 were male and 25 were female. The age ranged from 16 to 82 years. Lymph nodes 22 (44%) was the most common case, followed by thyroid 17 (34%), salivary glands 10 (20%) and soft issue 1 (2%).Among all Tubercular lymphadenitis (18%) followed by papillary carcinoma of thyroid (14%),metastatic carcinoma of lymph node, NHL, and pleomorphic adenoma 10% each. The sensitivity of FNAC in diagnosing neck masses is 90.08%, specificity is of 98.53%, and diagnostic accuracy is of 87.64%.ConclusionFNAC is a simple, fast, inexpensive, and minimally invasive technique which can be used as the first line investigation in diagnosing neck swellings.Birat Journal of Health SciencesVol.2/No.1/Issue 2/ Jan - April 2017, page: 206-210