Cytology Reports Research Articles

Reasons for truly negative cytology reports preceding the diagnoses of invasive cervical cancer-Results of a false-negative cytology audit in Polish Cervical Cancer Screening Programme.

False-negative (FN) results in cervical cancer (CC) screening pose significant risk for participants and should be audited. The aim of the study was to analyse the results of audit of FN slides collected in 2010-2013 in Polish Cervical Cancer Screening Program (CCSP) and to seek for risk factors of obtaining true-negative result (TN; not containing abnormal cells as confirmed in audit) before CC diagnosis. Screening database was merged with National Cancer Registry to identify negative slides preceding histologically confirmed CC diagnosis up to 42 months. Two blinding slides were randomly assigned per each FN. The whole set was reassessed independently by three pathologists with 30 years of experience in cytology evaluation. Final audit result was established in the case of ≥2 coherent reports. Agreement rates and kappa (κ) coefficients were calculated. Logistic analysis of risk factors for obtaining TN result was performed. Of 374 included FNs, 204 were considered abnormal (54.6%) and 91 were confirmed negative for intraepithelial neoplasia (24.3%). Agreement between experts was moderate for FNs (κ = 0.266) and fair for blinding slides (κ = 0.142) when grouping abnormal slides. Adenocarcinoma diagnosis elevated the risk of TN result (OR = 3.83); detection of macroscopic changes on the cervix and smoking lowered the risk (OR = 0.39, OR = 0.40 respectively). Misinterpretation was the main reason for FN cytology in the CCSP which indicated the need of further personnel training to increase screening quality. Rather low agreement between auditors requires further insight. A standardised process of auditors' selection should be planned to increase audit quality.

A Descriptive Study of Different Methods of Cervical Cancer Screening among Ever-Married Women in 35-Year and 45-Year Cohorts in Kalutara District, Sri Lanka.

Screening for cervical cancer in Sri Lankan females with Pap smears (conventional cytology) has shown no marked reduction in cervical cancer incidence over the past two decades. The study aims to compare the efficacy of Pap smear, with other screening tools such as Liquid Based Cytology (LBC) and Human Papilloma Virus/deoxyribonucleic acid (HPV/DNA) (using cobas 4800) in detection of underlying cervical intraepithelial neoplasia (CIN) and cervical cancer among 35 and 45 year old ever married women in Kalutara districtin Sri Lanka. Women from 35-year cohort and 45-year cohort were selected from all Public Health Midwife areas (n=413) in Kalutara district by random sampling. Pap smear, LBC, and HPV/DNA specimen were collected s from women who attended the Well Woman Clinics (WWC) . Women with positive results from any method were confirmed by colposcopy. Results: Of the, 510 and 502 women in the 35-year cohort and 45-year cohort, respectively, included in the analysis, nine women among 35-year cohort (1.8%) and 7 women among 45-year cohort (1.4%) had cytological abnormality (positive results) with Pap smears. Thirteen women among 35-year cohort (2.5%) and 10 women among 45-year cohort (2%) age groups had cytological abnormality (positive results) with Liquid Based Cytology reports. Total of 32 women among 35-year cohort (6.2%) and 24 women among 45-year cohort (4.8%) were positive for HPV/DNA test. Of the women tested positive on screening, colposcopy revealed that HPV/DNA method was superior to Pap and LBC for detecting CIN while the results of latter two were comparable. The CIN detection rate by colposcopy was high with HPV/DNA screening with cobas 4800, whereas the detection rate by LBC was insignificantly higher than Pap smears.

Histopathological analysis of ovarian cancer in Benghazi medical center (BMC) in Benghazi - Libya from the years 2020-2021

Ovarian cancer is a growth of cells that forms in the ovaries. The cells multiply quickly and can invade and destroy healthy body tissue. Tumors of the ovary are remarkably varied as they may arise from any of the three cell types in the normal ovary. A retrospective study was conducted on 48 cases of ovarian specimens diagnosed as ovarian tumors in the Oncology department at Benghazi Medical Center from January 2020 to December 2021. The files were conducted by the staff members of the Oncology department, and the students divided themselves into groups to obtain the data from the department, the data were age, type of ovarian cancer, histological and cytological reports (microscopic description) and diagnosis. Twelve patients were in the age range 51-60 years old as the highest number followed by the age range 61-70 years of age at 11 patients. Most of the ovarian tumors were seen in patient in postmenopausal age more than 45 years of age with a percentage of 78.7%. Surface epithelial tumors were the most found at followed by metastatic tumors while germ cell tumors were not found in our sample. The most common subtype of ovarian tumors observed in this study was serous cystadenocarcinoma low grade and endometrioid adenocarcinoma, while the least common tumor seen was papillary mucinous cystadenocarcinoma. Concerning the occurrence of bilateral versus unilateral tumors, most of the cases were bilateral. The aim of our research was to study the histological types of ovarian cancer in Benghazi Medical Center in Benghazi - Libya from the years 2020-2021.

Accuracy of cytological grading in the carcinoma breast and its correlation with pathological prognostic parameters.

Breast carcinoma is a significant contributor to cancer deaths worldwide. Tumor grade is an important parameter in planning out the treatment. Histology is the gold standard for grading the carcinoma breast. However, fine-needle aspiration cytology (FNAC) is still an important first-line diagnostic procedure in many parts of the world. Grading on cytology will help in pre-operative management. Although cytological grading of the carcinoma breast is a topic of research for many years, it is not yet included as a part of routine cytology reports. A prospective study was conducted over a period of 1 year at Kalinga Institute of Medical Sciences. A total of 42 cases of carcinoma breast, diagnosed on FNAC and subsequently confirmed on histology, were included. Cytological grading was performed using Robinson's grading system, and the results were compared with the histological grade. Also, the cytological grades were correlated with various pathological prognostic parameters such as tumor size, lymph node status, lympho-vascular invasion, estrogen and progesterone receptor status, Her-2-neu expression, and Ki-67 index. The kappa measure of agreement and Fisher's exact test were used for statistical analysis. A moderate kappa measure of agreement (k = 0.415) was found between cytological and histological grades with an overall concordance rate of 66.67%. The accuracy of cytological grading was higher with increasing cytological grade. Except for estrogen receptor expression, none of the other prognostic parameters have a statistically significant correlation with cytological grade. Tumor grading on cytology can be helpful in planning treatment, especially in resource-constrained settings. Subjective variation in assessing different parameters and non-inclusion of mitosis in this system might be the reasons behind wrong grading in some cases. Inclusion of mitosis in the scoring system can improve the accuracy of cytological grading and its importance in prognosis.

Clinical pathologists should limit modifier terms used to denote probability of a diagnosis: a survey-based study.

To examine the probability estimates for modifying terms used by clinical pathologists when interpreting cytologic samples and compare these to probability estimates assigned to these terms by clinicians, and to provide restricted, standardizing terms used in cytology reports. 49 clinical pathologists and 466 Veterinary Information Network members responded to 2 similar surveys. Online surveys were distributed to diplomates of the European College of Veterinary Clinical Pathologists and clinician members of the Veterinary Information Network, made available between March 17, 2022, through May 5, 2022. Respondents assigned a range of probabilities to each of 18 modifier terms used by clinical pathologists to denote probability associated with diagnoses; clinicians identified terms that would affect their treatment decisions in cases of canine lymphoma. Respondents then provided thoughts about restricting and standardizing modifying terms and assigning numeric estimates in reports. 49 clinical pathologists and 466 clinicians provided responses. For many terms, probability ranges agreed between the 2 groups. However, differences in estimated probability inferred by a term existed for at least 6 terms. Modifying terms could be restricted to 7 largely nonoverlapping terms that spanned the range of probabilities. Clinicians preferred having numeric estimates of probability, but clinical pathologists resisted providing such estimates in reports. Reducing and standardizing the number of modifying terms to reflect specific probability ranges would reduce disagreement between the clinical pathologist's intended probability range and the clinician's interpretation of a modifying term. This could result in fewer errors in interpretation and better patient care.

ACR TI-RADS Score combined with cytopathology classification improves the risk stratification of indeterminate thyroid nodules.

The aim of this retrospective study was the elaboration of a new diagnostic model that integrate cytological reports (2017 Bethesda System for Reporting Thyroid Cytopathology) with ultrasonographic features (based on ACR TI-RADS score) to achieve a more accurate definition of indeterminate thyroid nodule malignancy risk. Ninety patients submitted to thyroidectomy were divided in three classes: low malignancy risk (AUS/FLUS with TI-RADS 2/TI-RADS 3 and FN/SFN with TI-RADS 2), intermediate malignancy risk (AUS/FLUS with TI-RADS 4/TI-RADS 5 and FN/SFN with TI-RADS 3/TI-RADS 4), and high malignancy risk (FN/SFN with TI-RADS 5). The surgical approach should be recommended in high-risk patients (81.82% of malignancies), carefully evaluated in intermediate risk (25.42%), whereas a conservative approach can be adopted in low-risk patients (0.00%). The integration of these two multiparametric systems in a Cyto-US score has proven to be a feasible and reliable aid to achieve a more accurate definition of malignancy risk.

Age Related Cytoarchitectural Comparison of Histopathological Changes in Thyroid Nodule

Objective: To compare age related histomorphological changes through cytology (Bethesda category) and histopathology in thyroid nodules. Study design and setting: This cross sectional study was conducted at the Department of Anatomy, BMSI, JPMC Karachi from 31-March-2021 to 31-August-2021. Methodology: Total n=120 patients of all ages, genders and ethnicities that underwent surgery for thyroid nodules were included after taking duly signed consent. On the basis of cytological reports (FNAC) patients were grouped according to age and gender. Processed paraffin blocks were sectioned at a thickness of 5µm and then were stained with Haematoxylin and Eosin (H&E) for histological evaluation. Masson trichrome stain was used to observe fibrosis, that was measured through Image J Fiji software. Results: We evaluated that out of 120 patients, male to female ratio was 1:5.67. Among various ethnic groups; Urdu speaking (40.8%) with mean age of 40.3% were commonly affected. Histopathological examination revealed that most common benign lesion was colloid nodular hyperplasia and papillary carcinoma was the most common malignant lesion. Highest percentage of fibrosis (36%) was seen in middle aged participants (p-0.045). Basement membrane thickness with lowest percentage (12%) was observed in younger age participants while highest (31%) was measured in older aged participants (p-0.001). Accuracy score of FNAC showed sensitivity 59%, specificity 96.6%, accuracy 86%, positive predictive value (PPV) 86% and negative predictive value (NPV) 87%. Conclusion: With progression in age thyroid gland undergo histomorphological changes, early diagnosis will help in categorical nomenclature and its implications for subsequent management of patients with thyroid lesions

Lymphangioleiomyomatosis in lymph node cytology: Another "Floating Island" to visit.

Lymphangioleiomyomatosis (LAM) is a rare disease with variable presentations. The neoplastic cells in LAM demonstrate a unique and diagnostically important "myomelanocytic" phenotype. Cytologic reports of LAM are infrequent and have not in the past emphasized the floating island pattern in which circumscribed aggregates of lesional cells are rimmed by appliques of flattened endothelium. This case illustrates the cytology of LAM and emphasizes that the floating island cytoarchitectural pattern more classically associated with entities such as hepatocellular carcinomas may be seen in cytological preparations of LAM at unanticipated body sites.

Bronchoalveolar lavage hemosiderosis in lightly active or sedentary horses.

Hemosiderophages in bronchoalveolar lavage fluid (BALF) are commonly ascribed to exercise-induced pulmonary hemorrhage (EIPH). Little information exists regarding the presence of these cells in horses that perform light or no work and that are referred for respiratory problems. Evaluate the presence of hemosiderophages in BALF of horses suspected of respiratory disease without history of or risk factors for EIPH and determine predictors of hemosiderophages in BALF in this population. Observational retrospective cross-sectional study using STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Bronchoalveolar lavage fluid cytology reports of 353 horses evaluated for respiratory disease between 2012 and 2022 at the Cummings School for Veterinary Medicine were reviewed retrospectively. Horses with a history or likelihood of having performed past strenuous exercise were removed, and the remaining 91 horses were divided into hemosiderin-positive (HSD-POS) and hemosiderin-negative groups based on Perls' Prussian blue staining. Potential predictors for the presence of hemosiderophages in BALF (history, clinical evaluation, baseline lung function, airway reactivity, BALF cytology, and hemosiderin score) were compared between the 2 groups, using univariate and multivariate analyses. Horses with a diagnosis of severe equine asthma (sEA; odds ratio, 11.1; 95% confidence interval, 3.2-38.5; P< .001) were significantly more likely to be HSD-POS than horses with mild-to-moderate equine asthma. Hemosiderophages were found in the BALF cytology in a subset of horses that perform light or no work and presented for respiratory signs; these cells were found more frequently in horses with sEA. The link between hemosiderophages and sEA highlights previously unstudied pathology associated with this common disease.

Thyroid FNA cytology: The Eastern versus Western perspectives.

This commentary describes differences in the practice of thyroid fine‐needle aspiration cytology (FNAC) between the West and the East. Clinical management strategies are different in the East and the West, as are the statistics related to thyroid FNAC. When thyroid cytology reports from other institutions and countries are evaluated, it is important to be aware of these background differences before clinical management strategizing.

Triple Assessment in Diagnosis of Thyroid Nodules and Its Comparison With Histopathology.

Thyroid nodules are more common than previously realised, and the rate of prevalence is hugely impacted by the method of detection and their easy access. No single test is sufficient to access the thyroid nodule at any given time. Hence this necessitates the need for clinicians to use an evidence-based protocol for their assessment and diagnosis. To determine the likelihood of malignancy in individuals who have thyroid nodules of any size, by a) performing a triple assessment, including a history and physical examination, an ultrasound of the neck and fine needle aspiration and cytology(FNAC) b) predicting the percentage of correlation between findings of malignancy on FNAC and final histopathological diagnosis c) identifying and validate individual risk factors in the clinical examination and ultrasound imaging that point towards a nodule being malignant Methods: Patients presenting with thyroid nodules in a clinically euthyroid state were studied over a time period of 18 months. Seventy-five patientswere included in this study. Patients having external cytology and ultrasonography reports were reassessed if they consented to the study.If the pathologists thought the smears were sufficient, slide reviews were accepted. A senior consultant conducted the clinical evaluation. Prior to doing the FNACs, the designated radiologist performed the majority of the ultrasonograms. If the physicians believed it was necessary, ultrasound-guided FNACs were performed. According to Bethesda criteria, the cytology was reported. The outcome of the histopathological analysis was used as the gold standard for diagnosis in this investigation. Out of75 patients included in the study, the older age group (50-70) patients had mostly malignant lesions (92%). In the younger age group (20-39), about 77% had benign lesions. Benign lesions were more common in females than males according to the histopathology study. Seventy-three percent of fixed swellings turned out to be malignant. About 86% of patients who had extrathyroidal extension ended up being found to have malignant lesions but even 41% of patients who didn't have any extrathyroidal extension also turned out to be having malignant lesions. However, the presence of pressure symptoms didn't necessarily translate to being an indicator of malignancy. Ninety-seven percent of patients who had punctate microcalcifications turned out to have malignant lesions. Hypoechogenicity on imaging also is an important marker of malignancy, with about 87% of patients who had hypoechogenicity having malignant lesions proven on histopathology. All the patients who had solid lesions on imaging were proven to have malignant lesions. About 77% of patients who had cystic features ended up having benign lesions. Hence, it is a very significant marker. Intranodular vascularity, taller than wider lesions and positive lymph nodes on imaging were proven to have malignant lesions. FNAC is an important diagnostic tool. It is made out that the reporting of FNAC more or less matched the histopathological diagnosis in almost all categories. There are definite correlations in the role of triple assessment as a standard protocol in the diagnosis of thyroid nodules and guiding its management.

The international system for reporting serous fluid cytopathology: The initial project survey.

An international panel in the field of body fluid cytology, supported by the International Academy of Cytology and the American Society of Cytopathology, conducted a survey to identify opinions and explore existing practice patterns regarding body fluid cytopathology. The study group, formed during the 2018 European Congress of Cytology in Madrid, generated a survey of 54 questions related to the practice and taxonomy of body fluid cytology. The survey was available online from 28 August 2018 until 10 December 2018. Participants were invited through the websites and listserves of the professional societies. The survey collected 593 international participant responses. Questions pertained to practice patterns and diagnostic language. Information was collected regarding credentials, work setting, work volume (4-10,000 samples) and years in practice (0-60 years). The responses revealed variations in diagnostic practice and sample management. Direct smears and ThinPrep® preparations are the most popular methods, followed by Cytospin® and SurePath®. Most (70%) respondents perform ancillary studies on their material, with over 50% preferring a cell block preparation. Approximately 32% indicated that they are capable of performing genetic studies on the samples. Nearly 78% of participants would accept a two-stage cytology report, with a preliminary assessment followed by a final diagnosis that accounts for ancillary studies to generate a more precise cytological interpretation. Approximately one-third (36%) never report adequacy on body fluid samples. Most (78%) report a general category result (negative, atypical, suspicious, or positive) and 22% provide a detailed surgical pathology type report. Most (73.6%) participants believe that both Papanicolaou stains and a modified Giemsa stain (eg Diff Quik) should be standard preparations for all serous fluid cytology. The results of the survey demonstrated strong support for the development of a unified system for reporting body fluid cytopathology among respondents.

Review of Three Cytology Reporting Systems in the Diagnosis of Thyroid Lesions: A Study of Fifty Cases

Review of Three Cytology Reporting Systems in the Diagnosis of Thyroid Lesions: A Study of Fifty Cases

A diagnostic dilemma: unusual case report of a dermoid cyst embellished with a tattoo in the midline of neck

Dermoid cysts are benign congenital tumours of ectoderm origin usually arising from the midline where the fusion of embryonic structures of both sides occurs. They are true hamartomas focal malformations that can resemble neoplasms grossly and even microscopically. We hereby presented a case of a 25 year old male presented with complaints of a midline neck swelling for 5 years which was found just beneath a symbol tattooed in the skin overlying the swelling. The USG, fine needle aspiration cytology and multislice CT scan reports strongly suggested findings of a dermoid cyst. However, there was a diagnostic challenge faced when chest CT suggested old granulomatous changes around the swelling region. After thorough history taking, physical examination and radiological investigations, the swelling was successfully excised with a complete margin which was sent for histo-pathological examination, results of which correlated with the initial diagnosis of it being a dermoid cyst with foreign-body reactions.

Prediction of cervical cancer precursor lesions by quantitative methylation specific PCR: A retrospective study.

This study was undertaken to evaluate the performance of FAM19A4 and hsa-mir-124-2 hypermethylation as a triage tool for women who are at risk of developing cervical cancer or high-grade cervical cancer precursor lesions by taking into consideration the cytology report, histology diagnosis, and human papillomavirus (HPV) status. A total of 330 cervical ThinPrep samples were retrospectively collected and used for DNA isolation. HPV DNA was detected by real-time polymerase chain reaction (PCR), and HPV genotypes were identified by Sanger-based sequencing. DNA extracts were bisulphite-treated, and hypermethylation of FAM19A4 and hsa-mir-124-2 genes was detected by a quantitative methylation-specific PCR (qMSP) test using the QIAsure Methylation assay. Hypermethylated genes were detected in 27 (9.6%) cervical samples, mostly found in women diagnosed with high-grade squamous intraepithelial legions (77.8%) or cervical intraepithelial neoplasia grade 3 (CIN3) (72.7%). The sensitivity and the specificity of the qMSP test for predicting CIN3 lesions among women with high-risk HPV was 75% and 91%, respectively. There was a significant correlation between high-grade cervical cancer precursor lesions and detection of hypermethylated genes in samples positive for high-risk HPV. Our results suggest that the QIAsure Methylation test can be used as a triage tool to identify women at risk for cervical cancer progression.

Score system for cytological evaluation of fine-needle aspiration specimens to predict the diagnosis of papillary thyroid carcinomas

IntroductionAccording to the World Health Organization's classification of endocrine tumors, papillary thyroid carcinoma (PTC) accounts for almost 90 % of malignant thyroid neoplasms. This study aimed to create a point system based on cytomorphological criteria for evaluating FNA products from thyroid nodules to predict the risk of papillary thyroid carcinomas. MethodsThis was an analytical observational study based on a retrospective analysis of cytological reports and surgical specimens from January 1, 2016, to December 31, 2021. Cytological slides were analyzed using the following ten variables: Nuclear Grooves; Intranuclear Pseudoinclusion; Cellularity; Colloid (Quantity); Clarified Chromatin; Overlapping nuclei; Irregular Nuclear Membrane; Multinucleated Giant Cells; Psamoma bodies; and Papillae. We categorized these variables quantitatively from zero to three points as follows: zero (absent), one (mild), two (moderate), and three (intense). ResultsCytologies of 254 (4.9 %) cases were analyzed. The cut-off point was defined in this study as 6 ± 1 points. For the prediction of cases in benign, values < 5 points, malignant, values > 7 points and indeterminate, 5–7 points. Among the benign, there were 64 (69.5 %) cases <5 points, 17 (18.4 %) from 5 to 7 points and 11 (11.9 %) >7 points. Among the malignant ones, there were 12 (8.6 %) cases <5 points, 19 (13.6 %) from 5 to 7 points and 108 (77.6) >7 points. ConclusionIn this context, through the quantitative analysis of the ten suggested cytological variables, scored from 0 to 3, a final score > 7 is suspicious for malignancy, while a score < 5 is related to benign lesions.

Analysis of the related factors of atypical squamous cells of undetermined significance (ASC-US) in cervical cytology of post-menopausal women.

Atrophy of the reproductive tract mucosa caused by the decrease of estrogen may increase the detection rate of ASC-US in cervical cytology of post-menopausal women. In addition, other pathogenic infections and inflammation can change the cellular morphology and increase the detection rate of ASC-US. However, further studies are needed to elucidate whether the high detection rate of ASC-US in post-menopausal women leads to the high referral rate of colposcopy. This retrospective study was conducted to document ASC-US in cervical cytology reports at the Department of Cytology at Gynecology and Obstetrics, Tianjin Medical University General Hospital between January 2006 and February 2021. We then analyzed 2,462 reports of women with ASC-US at the Cervical Lesions Department. A total of 499 patients with ASC-US and 151 cytology with NILM participants underwent vaginal microecology tests. The average reporting rate of ASC-US in cytology was 5.7%. The detection rate of ASC-US in women aged > 50 years (7.0%) was significantly higher than that in women aged ≤50 years (5.0%) (P<0.05). The CIN2+ detection rate was significantly lower in the post- (12.6%) than in pre-menopausal (20.5%) patients with ASC-US (P <0.05). The prevalence of abnormal reporting rate of vaginal microecology was significantly lower in the pre-menopausal group (56.2%) than that in the post-menopausal group (82.9%) (P<0.05). The prevalence of bacterial vaginosis (BV) (19.60%) was relatively high in the pre-menopausal group, but the abundance of bacteria-inhibiting flora (40.79%) was mainly an abnormality in the post-menopausal group. The vaginal microecological abnormality rate of the women with HR-HPV (-) of ASC-US was 66.22%, which was significantly higher than that of the HR-HPV (-) and the NILM group (52.32%; P<0.05). The detection rate of ASC-US in women aged > 50 years was higher than that ≤50 years, but the detection rate of CIN2+ was lower in the post-menopausal women with ASC-US. However, vaginal microecological abnormalities may increase the false-positive diagnosis rate of ASC-US. The vaginal microecological abnormalities of the menopausal women with ASC-US are mainly attributed to infectious diseases such as BV, and it mainly occurs in the post-menopausal women was bacteria-inhibiting flora. Therefore, to avoid the high referral rate for colposcopy, more attention should be paid to the detection of vaginal microecology.

Allergic Rhinitis in Preschoolers: A Systematic Review of Diagnostics.

Most studies that seek to analyze the prevalence of allergic rhinitis do not include preschool children and the diagnosis in this age group is difficult. Identify complementary tests to the diagnosis of allergic rhinitis in preschool children and verify if there is scientific robustness to propose a diagnostic algorithm for this condition in this age group. Systematic review of the literature in four databases: SCIELO, PubMed/MEDLINE, LILACS and SCOPUS. Each article was initially chosen by title, abstract and by the keywords "allergic rhinitis," "diagnosis" and "preschool." Those articles selected entered the complete reading and data extraction phase. The study was registered in the International Prospective Register of Systematic Reviews under number CRD42020207053. Fourteen articles were suitable for analysis. In the assessment using Quality Assessment of Diagnostic Accuracy Studies - 2, all studies had at least one domain considered "high risk" or "undetermined risk." Seven reports of nasal cytology, seven of specific IgE, four of immediate hypersensitivity skin test, one of nasal nitric oxide, three of total IgE and one of urinary leukotriene E4 were found. Eight articles evaluated more than one diagnostic test. There are no defined criteria for the diagnosis of allergic rhinitis in preschool children. Nasal cytology, serum specific IgE and immediate hypersensitivity skin test were the most used tests. A reliable diagnostic criterion in this age group is necessary so that in the future it is possible to propose a diagnostic algorithm for allergic rhinitis in preschool children.

Cytopathological profile of patients with hepatic lesion: A hospital-based cross-sectional study from North-east India

Background: Cancer is not a notifiable disease in India. The data pertaining to liver cancer and hepatic lesions are very limited in India. Aims and Objectives: The current study was intended to observe the proportion of different types of liver lesions reported from private hospitals in Mizoram and also to study the association of liver malignancies in relation to gender and age. Materials and Methods: This is a cross-sectional study design. The data were collected from the cytopathology data base of a private laboratory (Genesis Laboratory) in Aizawl, Mizoram. Data regarding 204 patients with hepatic lesions, who have been referred from three private hospitals to a private laboratory in Mizoram from January 15, 2018, to November 31, 2021, were included in the study. Details regarding cytopathology reports of image-guided fine needle aspiration cytology of liver mass, age, and gender were collected. Air-dried smears received at a private laboratory were routinely stained with Leishman-Giemsa and Papanicolaou stains, Ziehl-Neelsen staining was done wherever needed. From the cytopathological diagnosis made, the frequency and patterns of various hepatic lesions were then analyzed using SPSS Version 22. Results: Out of 204 cases, 15 (7.35%) cases were reported as inadequate samples and 4 cases (1.96%) were inconclusive in diagnosis. Hence, remaining 185 study participants were included in the final analysis. The mean age was 58. Majority 122 (65.40%) were males and in the age group 41–60 years (49.19%). Majority of the lesions were malignant 145 (78.37%) and remaining 40 (21.62%) were benign lesions. The most common malignant lesion found was hepatocellular carcinoma (HCC) 87 (47.02%), followed by metastatic carcinoma 31 (16.75%). Liver malignancies were found to be higher among males (74.5%) as compared to females (14.3%), but were not statistically significant (P=0.08). The proportion of males (52.5%) versus females (36.5%) diagnosed with HCC was statistically significant (P=0.03). Conclusion: The most commonly reported liver malignancy was HCC. The proportion of males diagnosed with HCC was higher than females in the present study.

Association of High TPO Antibody Titer with Differentiated Thyroid Carcinoma: A Case-Control Study

Background: The most common well-differentiated thyroid carcinomas are papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC). PTC accounts for 80–90% of all thyroid cancers, and follicular carcinoma accounts for 10–15% of all thyroid cancers. Common established risk factors for thyroid carcinoma are head-neck irradiation, a positive family history, and a few genetic disorders. High anti-thyroglobulin antibodies (TgAb) have already been established as predictive markers for thyroid carcinoma, but anti-thyroid peroxidase antibodies (TPO Ab) have not been established as predictive markers till now. Objective: To find out the association of high TPO Ab titer with differentiated thyroid carcinoma (DTC). Patients and Methods: This case-control study was carried out at the National Institute of Nuclear Medicine &amp; Allied Sciences (NINMAS), Dhaka, from September 2020 to November 2021. A total of 52 cytologically diagnosed DTC patients who underwent thyroidectomy were selected as cases. Another 52 age- and sex-matched healthy individuals who had sonographically normal thyroid glands and a biochemically euthyroid state were selected as controls. The total number of participants was 104. Written informed consent was obtained from each of the participants. A detailed history was taken, and a thorough clinical examination was carried out on each patient. High resolution ultrasonography (HRUS) of the thyroid gland, serum thyroid-stimulating hormone (TSH) level, and fine needle aspiration cytology (FNAC) report of the thyroid nodule of each participant were collected. Serum TPO antibody levels were measured in patients with DTC prior to thyroid surgery, as well as in the control group, in the NINMAS laboratory using the CLIA method. After the collection of all the required data, analysis was done by SPSS 24.0. Results: The mean age of the cases was 35.8 ± 13.3 years and 34.6 ± 13.0 years in the control groups. Female patients were predominant in both the case and control groups (63.5% and 69.2%, respectively). Both groups were statistically almost similar in terms of age and sex. Around 46.2 % (n=24) patients in the case group had high serum TPO Ab levels and 15.4 % (n=8) of participants in the control group had high serum TPO Ab levels. The mean serum TPO Ab level in the case group was 306.77± 452.57 U/mL, and the mean serum TPO Ab level in the control group was 75.85±181.47 U/mL. Serum TPO antibody level was significantly higher in the case group compared to the control group (306.77±452.57 vs 75.85±181.47 U/mL, p = 0.001). Conclusion: There was a significant association of high TPO Ab titer found with DTC Bangladesh J. Nuclear Med. 26(1): 34-38, 2023