Definitive Diagnosis In Majority Research Articles

DIAGNOSTIC YIELD OF ABRAMS PLEURAL BIOPSY IN PATIENTS PRESENTING WITH LYMPHOCYTIC EXUDATIVE PLEURAL EFFUSION.

Background: Pleural effusion is the one of the most common clinical conditions encountered in pulmonology clinics and the routinely performed tests on pleural fluid do not provide definitive diagnosis in majority of the cases. Medical thoracoscopy with pleural biopsy under direct vision of the abnormal area provides the highest diagnostic yield. Abrams closed needle pleural biopsy is a conventional and cheaper procedure which can help in the definitive diagosis in cases of undiagnosed pleural effusion. Objectives: To determine the diagnostic yield of abrams pleural biopsy in patients presenting with lymphocytic exudative pleural effusion. Study Design: Cross Sectional Study. Setting: Department of Pulmonology Nishtar Hospital Multan; Tertiary care hospital of 1180 beds. Period: Six months. Results: There were 145 patients diagnosed with lymphocytic exudative pleural effusion. Of these 145 study cases, males were 83/145 (57.2%) whereas females were 62/145 (42.8%). Mean age of our patients was 41.62 ± 13.63 years while mean duration of illness was 7.0 ± 3.24 weeks. When the frequencies of various diagnosis established on the basis of histopathology results obtained from the tissue specimen obtained with Abrams pleural biopsy was noted, Tuberculosis was the major cause of lymphocytic exudative pleural effusion as its frequency was noted to be in 81/145 (55.9%) of our patients while malignancy was present in 26/145 (17.9%) of our study cases whereas the histopathology turned out to be inconclusive in 38/145 (26.2%) showing non-specific inflammation. The diagnostic yield of Abrams pleural biopsy turned out to be 73.8% whereas it was unable to establish diagnosis in 26.2%. Conclusion: Abrams needle pleural biopsy is simple, reliable and safe method of diagnosis with a good diagnostic yield. Routine use of this procedure in patients with lymphocytic exudative pleural effusion can lead to a definitive diagnosis in majority of patients.

Combined CT guided tru-cut biopsy and imprint cytology in the diagnosis of bone tumors and tumor like lesions

Background: Bone lesions are often histologically heterogenous. The advantage of tru-cut biopsies in this context is that they provide a safe and accurate biopsy technique that can be performed in less specialized centers. In this series we found combination of biopsy and cytology helpful in diagnosing bone lesions. However clinical picture and radiologic features are vital in arriving at a final diagnosis.Aims and Objective: 1) To assess the diagnostic accuracy of combined CT guided tru-cut biopsy and imprint cytology in the diagnosis of bone tumors and tumor like lesions. 2)To analyze the spectrum of different bone lesions.Materials and Methods: 108 consecutive cases of bone lesions for which CT guided tru-cut biopsy and imprint cytology were done between June 2010 and april 2012 were retrospectively studied. Both smears and biopsies were categorized into five groups.Correlation between biopsy and cytology were also evaluated.Results: Total number of cases were 108 of which 8 cases were inconclusive . In 100 cases a useful opinion could be given. There were 36 cases of primary bone tumors, 13 cases of plasma cell neoplasms, 42 metastatic tumors, 9 non neoplastic lesions and 8 inconclusive cases. Conclusion: Preliminary diagnosis of bone lesions before definitive therapy helps to avoid unnecessary surgical procedures. Tru cut biopsies supplemented by imprint cytology can provide definitive diagnosis in majority of cases.Asian Journal of Medical Sciences Vol.7(6) 2016 40-42

Morphological spectrum of mediastinal lesions with special emphasis on evaluation of needle biopsy: An experience from a tertiary care hospital.

Background & objectives:Mediastinal lesions are uncommon and are infrequently encountered in routine clinical practice. Hence, there is a need for more elaborate studies of mediastinal lesions to make the pathologists and clinicians aware of the large spectrum of these lesions. The present study describes the histomorphological spectrum of various mediastinal lesions in a tertiary care hospital in India, along with the discussion of some unusual and interesting cases. Considering the limited diagnostic material obtained in guided biopsies, the adequacy of such tissue for providing a definite opinion was also evaluated.Methods:This was a retrospective study performed on 125 mediastinal masses diagnosed on surgically resected specimens as well as needle biopsies over a period of two years (January 2012-December 2013). A few cases had inadequate diagnostic material, making a total of 116 cases which were further evaluated.Results:A total of 116 patients of mediastinal lesions were included in the study. Most of the lesions were in 21-30 yr age group, with male:female ratio of 1.7:1. Anterior mediastinal compartment was most commonly involved. Majority of the cases (62.1%) were of neoplastic nature, with benign tumours (34.5%) being more common than malignant ones (27.6%). Thymoma followed by lymphoma constituted the most common mediastinal tumours. One-third of the total cases were diagnosed on needle biopsy samples. All cases where needle biopsy was followed by resection specimen showed concordant diagnosis. The percentage adequacy of biopsy was 91.7 per cent and the diagnostic accuracy was 100 per cent.Interpretation & conclusions:This study provides the histomorphological spectrum and biological diversity of the mediastinal lesions. It also emphasizes that biopsy is sufficiently adequate, with the help of a comprehensive immunohistochemistry panel, for providing a definite diagnosis in majority of cases.