Fine Needle Aspiration Cytology In Diagnosis Research Articles

Cytopathological diagnosis of filariasis by fine-needle aspiration cytology in different body locations: A retrospective study of 5 years in central India

Background: Filariasis is one of the common health problems in tropical countries. The parasite causing the disease primarily resides in lymphatic channels or lymph nodes. It can remain viable in these places for decades. The clinical presentation may vary from superficial palpable swelling to pain and erythema. The cytopathological diagnosis of microfilaria on fine-needle aspiration cytology (FNAC) helps in prompt recognition of the disease. Aim: The aim of the study was to analyze the presence of microfilariae (MF) diagnosed on FNAC from different body locations based on clinicopathological data and cytopatholgical features. Methods: It was a retrospective observational study in which cases of MF over last 5 years which were diagnosed on FNAC were analyzed. Results: Of 34069 cases of FNAC and 45623 cases of fluid cytology, 27 cases (0.033%) of filariasis were diagnosed on cytopathology smears. The various sites included the skin and soft tissue (8 cases), lymph node (6 cases), breast (5 cases), pleural fluid (4 cases), scrotal swelling (3 cases), and thyroid gland (1 case). Eosinophilia was found in 18 cases (66.67%). The background showed inflammatory infiltrate in 17 cases (62.96%), while florid reactive mesothelial hyperplasia was seen in 2 cases (7.4%). We found 4 cases (14.81%) of incidental malignancies along with MF (3 breast and 1 pleural fluid). Conclusion: Although rare, filariasis should always be suspected as a differential diagnosis of FNAC in different body location swellings. A careful attitude while screening cytopathological smears helps to diagnose MF even in asymptomatic cases.

The role of fine-needle aspiration cytology in papillary thyroid carcinoma cases

Aim: Thyroid diseases are among the most common diseases in our country and all over the world. Fine-needle aspiration cytology (FNAC) is a useful and simple method for diagnosing papillary thyroid carcinoma (PTC) and can be used as a first step. The aim of this study was to determine the diagnostic value of FNAC in PTC cases by comparing FNAC and histopathological findings and to present our experiences.Material and Methods: This retrospective study evaluates 800 cases who underwent thyroidectomies in our center and had a histopathological examination in the pathology clinic. The age, gender, operation procedure, FNAC findings, and histopathological results of PTC cases were recorded.Results: Of 800 thyroidectomy cases, 119 (14.9%) were diagnosed with PTC; 50 (42%) were classic PTC cases and 69 (58%) were papillary microcarcinoma (PMC) cases. Of the 50 classic PTC cases, 45 had FNAC, which were included in the study. Of these, the positivity rate was 84.5% when atypia of undetermined significance (AUS) cases and suspected malignancies were included with those diagnosed with malignancy. Of 45 PTC cases, 3(6.6 %) were inadequate, 4 (8.9 %) were benign, 7 (15.5 %) were AUS, 4 (8.9 %) were suspected of follicular neoplasm, 18 (40 %) were suspected of malignancy, and 9 (20 %) were diagnosed as malignant. Conclusion: In our study, the false positivity rate was 0.5% and the false negative rate was 8.9%. Carcinomas in the follicular pattern can only be diagnosed by histopathological approach. FNAC is currently the gold standard for diagnosing PTC. However, a benign FNAC diagnosis should be viewed with caution as false-negative results do occur. When a benign FNAC diagnosis is given, surgery is necessary if there is any clinical suspicion of malignancy.

Evaluation of role of cell block with immunohistochemistry in differentiating hepatocellular carcinoma from metastatic adenocarcinoma

Background: Fine-needle aspiration cytology (FNAC) is an increasingly common procedure in the diagnosis of neoplastic lesions of the liver, particularly in differentiating primary hepatocellular carcinoma (HCC) from metastatic adenocarcinoma (MA). However, there are certain limitations of FNAC. Sometimes, FNAC does not yield sufficient material for the precise diagnosis and the risk of the wrong diagnosis by FNAC cannot be excluded from the study. The aim of the study was to overcome such problems using a cell block (CB) technique along with immunohistochemistry (IHC) to diagnose and differentiate HCC from MA. Materials and Methods: This was a prospective study, conducted in a tertiary care hospital in Darjeeling district of West Bengal, over a period of 1 year. A total of 52 adult cases presenting with liver mass suspicious of malignancy were studied; CB with a histopathological examination and IHC for Hep par1 and CD10 were done in all cases. Results: In our study of 52 cases, CB with IHC was found superior in differentiating primary HCC from MA than only CB with a diagnostic accuracy of 96.15% and 92.31%, respectively. Among the IHC markers, Hep par1 was found more useful than CD10 with a diagnostic accuracy of 94.23% and 82.6%. However, CD10 was found to have greater diagnostic utility than Hep par1 in the context of poorly differentiated HCC. Conclusions: IHC study with Hep par1 and CD10 may be useful in differentiating HCC from the MA of the liver. Therefore, CB along with IHC improves the diagnostic accuracy of FNAC diagnosis.

Diagnostic Accuracy of Fine-Needle Aspiration Cytology in Head and Neck Lesions from a Tertiary Health Facility in Southwestern Nigeria.

Background:Fine-needle aspiration cytology (FNAC) is widely employed as an initial investigative tool in the diagnosis of various lesions in the body, however, it is limited in the provision of precise architectural detail of lesions. This is said to be responsible for the wide variation in the documented usefulness and accuracy relative to histopathology. This study aimed to correlate cytopathological and histopathological examination (HPE) of head and neck lesions, and assess the usefulness and accuracy of FNAC in our center.Materials and Methods:This was a retrospective study that utilized historical data obtained from case notes and histopathology records of 91 patients that had both FNAC and HPE done for head and neck lesions in our center during the study. The FNAC results were correlated with that of the histopathological diagnosis to obtain the accuracy of the FNAC diagnosis. Diagnostic validity of FNAC in terms of sensitivity, specificity, and predictive value were also evaluated.Results:A total of 91 FNAC-HPE sample pairs were included. The Sensitivity and specificity for benign lesion was 95.4% and 42.3%, respectively, while for sensitivity and specificity for malignant lesion was 31.8% and 96.9%, respectively. The overall Sensitivity and specificity for cytology was 96.8% and 30.4%, respectively.Conclusion:FNAC appears to be a useful tool in the initial assessment of head and neck lesions in our center, however, the high rate of missed diagnosis especially as concerned malignancies has dire negative treatment implications. There is need to develop capacity for improved skill in making cytopathologic diagnoses among anatomical pathologists involved in the use of FNAC as diagnostic and screening tool.

Clinical study and management of non-thyroidal neck swellings

Background: Swellings in the neck are common and are encountered frequently in General Surgery. A diagnosis may be possible based on clinical examination alone but, investigations are required to clarify the diagnosis and, to exclude a diagnosis of malignancy. With this background, the present study is conducted in an effort to find out the causes for non-thyroidal neck swellings, and to assess the various investigations and management available for treating these neck swellings.Methods: The study was conducted on newly diagnosed non thyroidal neck swelling cases coming to the Dept. of General Surgery, ENT, Oro- Maxillofacial and Pulmonary Medicine (OPD and IPD), Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune. The study was conducted from July 2017 to July 2019. Data collection included history taking, clinical examination, and radiological investigation and histopathological examination by specific pathologist throughout the study. After confirmation of diagnosis, patients were subjected to further management.Results: Among 100 patients, male to female ratio was 1:1. The Mean age of the participants is 40.41±12.85 years. There was statistically significant association between tobacco addiction and malignant neck swelling. Considering HPE as gold standard, the sensitivity and specificity of fine needle aspiration cytology (FNAC) diagnosis is 81.8% and 100% respectively.Conclusions: The overwhelming amount of possible diseases linked to a swelling in the neck, makes it of utmost importance to follow a strict protocol for appropriate diagnosis making and prompt treatment so as to prevent diagnostic delay.

Analysis of pathological diagnosis by fine needle aspiration cytologyand paraffin in thyroid disease

Objective To explore an economical and effective method for the diagnosis of thyroid diseases by fine needle aspiration cytology (FNAC). Methods The clinicopathological diagnosis of 1200 cases of thyroid diseases in our department was analyzed. Results There were 827 cases (68.9%) of thyroid carcinoma, 267 cases (22.2%) of thyroid adenoma, 66 cases (5.5%) of thyroid cyst, 31 cases (2.6%) of hyperthyroidism, and 9 cases (0.8%) of thyroiditis. FNAC cell diagnosis and postoperative paraffin standard comparison, benign lesions diagnosed percentage were 28.4% and 31.1% respectively, Diagnosis of malignant change percentage were 65.5% and 68.9% respectively, FNAC diagnosis of benign and malignant diagnosis efficiency cells percentage were 91.3% and 95.1% respectively, The specificity of the diagnosis of benign and malignant lesions compared percentage, there was no statistically significant difference (χ2=7.145, P>0.05). Conclusion FNAC method is reliable, convenient and economical in diagnosing thyroid diseases. It can also be used for preoperative diagnosis of thyroid surgery. Key words: Fine needle aspiration cytology; Thyroid disease; Pathological experiments

Computerized Cytological Features for Papillary Thyroid Cancer Diagnosis-Preliminary Report.

Fine needle aspiration cytology (FNAC) is the final diagnosis of thyroid nodules before surgery. It is important to further improve the indeterminate FNAC diagnosis results using computerized cytological features. This retrospective cross-sectional study included 240 cases, of whom 110 had histologic diagnosis of papillary thyroid cancers (PTC), 100 had nodular/adenomatous goiters/hyperplasia (benign goiters), 10 had follicular/Hurthle cell carcinomas, and 20 had follicular adenomas. Morphological and chromatic features of FNAC were quantified and analyzed. The result showed that six quantified cytological features were found significantly different between patients with a histologic diagnosis of PTC and patients with histologic diagnosis of benign goiters in multivariate analysis. These cytological features were used to estimate the malignancy risk in nodules with indeterminate FNAC results. The Area Under the Receiver Operating Characteristics (AUROC) of the diagnostic accuracy with a benign or malignant nature was 81.3% (p < 0.001), 78.7% (p = 0.014), and 56.8% (p = 0.52) for nodules with FNAC results of atypia, which is suspicious for malignancy and follicular neoplasm, respectively. In conclusion, quantification of cytological features could be used to develop a computer-aided tool for diagnosing PTC in thyroid nodules with indeterminate FNAC results.

Impact of non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) on risk of malignancy in patients undergoing lobectomy/thyroidectomy for suspected malignancy or malignant fine-needle aspiration cytology findings: a systematic review and meta-analysis.

The second version of The Bethesda System for Reporting Thyroid Cytopathology endorsed the introduction of non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) as a distinct entity with low malignant potential into clinical practice. Consequently, the risk of malignancy (ROM) of cytological diagnoses has changed, but the magnitude of the change remains uncertain. The present systematic review was undertaken to obtain more robust information about the true impact of NIFTP on the ROM among patients undergoing surgery following a fine-needle aspiration cytology (FNAC) diagnosis of suspicious for malignancy (Bethesda V) or malignant (Bethesda VI). As they are managed surgically, these two diagnostic categories are the primary entities that are clinically impacted by the advent of NIFTP. Systematic review and meta-analysis. A comprehensive literature search of online databases was performed in November 2018. The search was conducted looking for data of histologically proven NIFTP with preoperative FNAC. One-hundred fifty-seven articles were identified and nine were included in the study. Overall, there were 13,752 thyroidectomies with a cancer prevalence of 45.7%. When NIFTP was considered non-malignant, the pooled risk difference for ROM was 5.5%. Applying meta-analysis, the pooled prevalence of NIFTP among nodules with FNAC of Bethesda V or Bethesda VI was 14 and 3%, respectively. This meta-analysis shows that the inclusion of NIFTP leads to a reduction in the ROM for the Bethesda V and Bethesda VI FNAC diagnostic categories by 14 and 3%, respectively. Clinicians should be aware of these data to avoid overtreatment.

Fine-Needle Aspiration Cytology in Diagnosis of Tuberculous Lymphadenitis: Experience From a Tertiary Hospital in Tanzania

Abstract Objectives Tuberculous lymphadenitis is among the common causes of lymphadenopathy in low-resource countries. Data regarding diagnosis of tuberculous lymphadenitis based on fine-needle aspiration cytology of the lymph nodes are scant in our setting. The current study was conducted to determine the usefulness of fine-needle aspiration materials in the diagnosis of Tb lymphadenitis among patients who presented with enlarged lymph nodes. Methods A prospective study was conducted at Muhimbili National Hospital for the duration of 1 year (April 2016 to March 2017). Patients with enlarged lymph nodes were subjected to fine-needle aspiration cytology and smears were stained with Papanicolaou stain as well as Ziehl Nielsen (ZN). Criteria for diagnosing TB on cytology included granulomas, caseous necrosis, and epithelioid cells. All aspirates were subjected to GeneXpert assay for Mycobacterium tuberculosis. All cases diagnosed with TB based on cytological materials were initiated anti-TB. Follow-up of patients was done and response to treatment was used to confirm the diagnosis. Results One hundred sixteen cases were studied. Out of 116 cases of lymph nodes aspirated, 58 cases (50%) were diagnosed as tuberculous lymphadenitis. Females represented the majority of the cases, 31/58 (53%), and the most affected age group was 18 to 35 years. Cytomorphology of TB was found in 40/58 cases (68%) and ZN positivity for acid-fast bacilli (AFB) was found in 14/58 (24%) while Gene Xpert assay was positive in 29/58 (50%) of cases. The response to treatment was 100%. Conclusion Fine-needle aspiration cytology (FNAC) has shown to be simple, safe, and with higher accuracy in diagnosis of tuberculous lymphadenitis based on evaluation of cytomorphology with complementation of ZN stain for AFB in TB endemic areas. The diagnostic accuracy can be further increased by GeneXpert analysis, which can test the drug resistance of the Mycobacterium.

Diagnostic accuracy of fine needle aspiration cytology of thyroid nodules

Background Routine application of fine needle aspiration cytology (FNAC) has decreased unnecessary referral of thyroid nodules for surgical treatment and has also increased the cancer rates found in surgery materials. Success of thyroid FNAC depends on skilled aspiration, skilled cytological interpretation and rational analysis of cytological and clinical data. The aim of this study was to determine the diagnostic accuracy rates of thyroid FNAC results obtained in our institution. Methods The data from FNAC and thyroidectomy reports of patients presenting with goiter and who had been evaluated from 1st January 2014 to 1st March 2018 were used. There were 149 patients in total who had undergone thyroidectomy following FNAC. The Bethesda System for Reporting Thyroid Cytology was used in all cytological diagnoses. Results The sensitivity of thyroid FNAC for malignant cases was 57.89%, specificity was 88.10%, false-positive rate was 11.90%, false-negative rate was 42.11%, positive predictive value was 52.38%, negative predictive value was 90.24% and accuracy rate was 82.52%. "Focus number" variable was detected as the factor that affected the accurate prediction of FNAC and thyroidectomy results by the pathologist. Conclusions This study showed that there was a moderate conformity between thyroid FNAC and thyroidectomy cyto-histopathological diagnosis in malignant cases. As two or more nodules have a negative effect on the physician's diagnosis of malignant nodules, we think that a more sensitive approach is needed in the determination of these cases. Sampling defects may affect this non-matching.

Pattern of pediatric fine needle aspiration cytology and its utility in management of head and neck swellings in a tertiary hospital in northwestern Nigeria

Childhood malignancies have emerged as an important cause of morbidity and mortality globally. Diagnosis need to be accurate and fast to reduce this. Fine Needle Aspiration Cytology (FNAC) is an accepted modality employed in the diagnosis of adult and pediatric tumors. This study aims to review the pattern of pediatric FNAC from all sites done over a 10-year period, and its utility in the management of head and neck swellings. Records of all pediatric FNAC within the 10-year study period were retrospectively retrieved and analyzed. Data regarding age, sex, site of biopsy and FNAC diagnoses were extracted. Subsequent histologic diagnoses from the head and neck region were correlated with initial FNAC diagnoses from the same region. Data were presented in frequencies and percentages in tabular form. Accuracy, sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of head and neck lesions were calculated. A total of 301 pediatric FNAC were recorded. There were 160 (53.8%) males and 141 (46.2%) females with a M: F ratio of 1.1:1. The average age was 7.2 ± 3.9 years. The highest frequency of 134 (44.5%) was seen in the 5-10 years age group. Benign cytological diagnoses were rendered in 243 (80.7%) while the remaining 58 (19.3%) were malignant. Of the total, 244 FNAC were from head and neck Swellings, 209(80.7%) were benign while the remaining were malignant. Sixty-two (62) cases of head and neck FNAC had subsequent histologic tissue diagnoses (considered the gold standard) which were compared with prior FNAC results. FNAC of the head and neck showed an accuracy 82.1%, sensitivity of 53.0%, specificity of 93.3%, PPV and NPV of 75.0% and 84.0% respectively. FNAC is an easy, fast, cheap and minimally invasive screening tool that is accurate for diagnosis in the management of pediatric head and neck swellings in our setting.

Comparative Study between Total Thyroidectomy and Hemithyroidectomy in Treatment of Solitary Thyroid Nodules Diagnosed as Follicular Lesions by Fine-Needle Aspiration Cytology

Background: Thyroid nodular (TN) lesions are a common clinical problem in the world. These are more common in women and in areas of iodine deficiency. Exposure to ionizing radiation in childhood and adolescence increases the risk of solitary thyroid nodule and thyroid carcinoma. Objective: Determination of the optimal surgical approach for individuals undergoing thyroidectomy for solitary thyroid nodule identified as indeterminate follicular lesion on preoperative fine needle aspiration cytology (FNAC) diagnosis and to estimate the long term outcome of patients treated by lobectomy for solitary follicular thyroid nodule. Patients and methods: From June 2017 to June 2019, 50 patients having a solitary thyroid nodule with a cytological diagnosis of “indeterminate follicular lesion” were selected prospectively. Results: There were 26 women and 24 men with a mean age of 56 years (range: 28-83). Hemithyroidectomy (HT) was performed in 25 patients (50%) and a total thyroidectomy (TT) in 25 (50%). Postoperative morbidity was 3.50% in patients who underwent HT and 9.75% in those who underwent TT. At the histological analysis 3 (12%) patients of hemithyroidectomy group had a malignant lesion. Conclusions: Considering the high rate in which HT represents the adequate treatment, and the low rate of reoperation morbidity, HT seems to be the preferable initial surgical approach for indeterminate follicular lesions. Long-term ultrasonographic follow-up seems advisable.

Utility of fine needle aspiration cytology on thyroid lesions

Introduction: Fine needle aspiration cytology (FNAC) is slightly invasive, cost effective and gold standard for thyroid nodule diagnosis. Aim: The aim of the study is to correlate the pre-operative and post-operative findings of FNAC with histopathology and detect pitfills of FNAC. Materials and methods: The study is retrospective and consists of about 100 cases which were recruited from department of pathology, GEMS & Hospital for a period of September 2017 to February 2019. The available cases from department were considered for the study. Fine needle aspiration results were compared with histological diagnosis. Observation and results: FNAC diagnosis showed benign lesions in 86 patients, malignant in 14 patients and histopathological findings exhibited benign in 88 and malignant in 7 cases. Sensitivity, specificity and accuracy of the study to diagnose malignant lesions were calculated and are 75%, 98% and 98.3% respectively. Conclusion: FNAC has evolved as most accurate, sensitive and specific tool for screening of thyroid patients initially and hence minimized the takeover of un-necessary surgeries. However, histopathological diagnosis remains to be confirmatory.

Breast Cancer in a Sample of Yemeni Female Patients: Forensic Dermatoglyphic Traits and Clinico-Pathological Features

Background:Breast cancer has a major impact on health of women worldwide and Yemen is not in exception. Fingerprints play an important role, which is highly individualistic and could be recognized as a powerful tool in diagnosis of various diseases, furthermore, their medico-legal importance. Objective:To study the clinico-pathological aspects of breast cancer and the role of fingerprints as screening test. Methods:Prospective study of 68 female patients with breast cancer came to modern histopathology laboratory - Aden during the period from January - June 2018. All the patients suffering from breast lumps were referred for Fine Needle Aspiration Cytology diagnosis as well as fingerprints of their both hands were taken. Results:Most of the participants (45.6%) aged between 40-49 years old, females from urban areas consisted 57.4%, and about 51.5% of females in this study were illiterate. Females who had 1-3 child consisted 33.8%. Regarding the breast lump, 54.4% of females had tumor size 2-5 cm, while skin change and fixed tumor to skin presented in same rate (14.8%). No pain and no nipple discharge present in 85.2% and 91.2% respectively in females' study. The females with palpable axillary lymph nodes and right breast side tumor consisted the same percentage (58.8%). Regarding the result of fine needle aspiration cytology, the invasive ductal carcinoma presented with high rate (85.3%), while stage II present with 36.8%. In relation to the finger print patterns; the loop patterns presented high rate in the little digit with 30.4%, while whorls patterns presented in index digit in 33.6% of patients. The loops and whorls patterns revealed significant association with breast cancer with a P-value of 0.005 and 0.028 respectively. Conclusion:The social, behavioral, and hereditary factors play an important role in the development of breast cancer in addition to reproductive history, beside that the fingerprints are genetically determined factors that can be used as simple and cost-effective screening test for breast cancer. Keywords:Breast carcinoma, fingerprints, Dermatoglyphic, forensic, Yemeni female. Citation:Bin Thabit MA, Abdullah NA, Alnoban MS. Breast Cancer in a sample of Yemeni female patients: forensic dermatoglyphic traits and clinico-pathological features. Iraqi JMS. 2019; 17(2): 135-145. doi: 10.22578/IJMS.17.2.7

CYTODIAGNOSIS OF HEPATIC LESIONS AND THEIR ASSOCIATION WITH SERUM ALPHA FETOPROTEIN LEVELS

Background: Liver is a common organ for lodgement of various infections and metastasis from other parts of body. Fine needle aspiration cytology (FNAC) plays a major decisive diagnostic role and combined with USG diagnostic accuracy is 90-95% minimizing the need of biopsy. An increased in serum AFP concentration has been observed in Hepatocellular Carcinoma (HCC) and is an important serum tumor marker. Methods: The present study was done, with the aim of studying the cytomorphological features of hepatic lesions and their association with serum Alpha Fetoprotein (AFP) levels. Study was conducted on 56 patients who underwent USG guided FNAC for diagnosis of liver lesions. Cytomorphological pattern of liver lesions were studied and serum AFP levels of the same cases were measured. Results: Maximum number of cases was in age group of 61-70 years. Male: Female ratio was 1.4:1. 82.1% cases were malignant. Most common malignancy was Metastatic deposits of Adenocarcinoma (MDA). HCC was diagnosed in 5.4% cases. Serum AFP levels in HCC were 459.93 ± 41.69 ng/mL.15.4 % of the cases of MDA and 8.3% of the cases of Metastatic deposits of Poorly Differentiated Carcinoma (MDPDC) showed raised serum AFP levels. Association between cytodiagnosis and serum AFP range was statistically significant. Sensitivity=100%, specificity=81.4%, PPV=27.3% and NPV= 100% were obtained when serum AFP was used to differentiate metastatic lesions with HCC taking &lt; 8.5ng/mL as cut off. Conclusion: USG guided FNAC of the liver is a rapid, reliable and economical screening test. Serum AFP has been the most widely used tumor marker for diagnosing HCC but raised levels are also seen in other hepatic lesions decreasing its specificity.&#x0D; Keywords: Liver, FNAC, Serum Alpha fetoprotein levels

Fine-needle aspiration cytology and cell block in diagnosis and subtyping of hepatoblastoma.

Hepatoblastoma (HB) constitutes less than 1% of all pediatric malignancies and is the most common malignant tumor of liver in children. The fine-needle aspiration cytological (FNAC) diagnosis and sub-typing of this tumor is challenging, which is of critical importance from its treatment point of view. All cases with a clinicoradiological impression of "HB" during the study period of 1 year were subjected to ultrasound-guided (USG) FNAC and cell blocks were prepared in all cases. Detailed cytopathological examination was carried out based on the cytomorphological pattern and the cell blocks were used to correlate the findings and the final diagnoses were confirmed with the histopathological findings. Four cases were included during this study period. All were children, whose age ranged from 3 months to 10 years. All of them presented with mass per abdomen and increased serum alfa-feto protein (AFP) levels. On a detailed cytological examination, the clinical impression of HB was confirmed in all four cases with a subsequent histological correlation. Based on their distinct cytomorphological pattern, three of them were accurately sub-typed as"fetal type," wile the fourth was an "embryonal type of HB." All four cases had the evidence of extramedullary hematopoeisis. We conclude that a precise preoperative FNAC diagnosis with accurate sub-typing of HB is possible purely on cytomorphologic basis which has prognostic and therapeutic implications. Cell blocks are of great use for ancillary studies. Extramedullary hematopoiesis serves as an important "clue" in diagnosis.

The comparison of accuracy of ultrasonographic features versus ultrasound-guided fine-needle aspiration cytology in diagnosis of malignant thyroid nodules

To compare the diagnostic accuracy of sonographic features with ultrasound-guided fine-needle aspiration (FNA) cytology in the detection of malignant thyroid nodules. This analytical cross-sectional study was conducted on patients with the diagnosis of thyroid nodule, who underwent ultrasound-guided FNA in Shahid Beheshti teaching hospital, Babol, northern Iran, between 2015 and 2017. The characteristics of the nodules obtained from ultrasonography were recorded. Regression analysis was used to assess the relation between sonographic findings and malignancy. We also used a receiver operator characteristics analysis to estimate the ability of ultrasound to predict the characteristic features of malignancy, as estimated by the area under the curve. In total, 898 thyroid nodules were included in the study, of which 55 (6.1%) were malignant and 843 (93.9%) were benign. There were significant positive associations between malignancy and hypoechogenicity [odds ratio (OR) 3.577, 95% confidence interval (CI) 2.045-6.256], fine calcification (OR 5.849, 95% CI 2.642-12.949), irregular margin (OR 4.366, 95% CI 2.284-8.345) and taller-than-wide shape (OR 5.199, 95% CI 2.125-12.721). The overall accuracies of hypoechogenicity, irregular margin, taller-than-wide shape and fine calcification were 0.804, 0.729, 0.705 and 0.575, respectively. According to the present study, the use of ultrasonography (along with ultrasound-guided FNA) is very effective in the diagnosis, follow-up, and indication for surgery of a thyroid nodule.

Fine needle aspiration cytology (FNAC) of cystic soft tissue lesions and end tissue metamorphosis-a three year study

Objective: Superficial soft-tissue masses may be seen in clinical practice, but a systematic approach may help to achieve a definitive diagnosis or differential diagnosis for soft tissue lesions. The cystic lesions constitute a heterogeneous group with highly varied etiology, cytology and diversified histopathology. The aim of this study is to investigate the accuracy of FNAC diagnosis of varied cystic lesions of soft tissue lesions by comparing with the radiological and histopathology diagnosis. Materials and methods: Fine needle aspirations were done using a 22-24 gauge disposable needle and a 5cc to 10 cc disposable syringe for suction. Wet-fixed smears with isopropyl alcohol were stained with hematoxylin and eosin (HxE). Dry-fixed smears were stained with Leishman Giemsa along with Papanicolaou stains (PAP) were studied for cytological details and diagnosis. The excised surgical specimen and biopsy samples of the cases were processed routinely and stained with HxE and immunohistochemistry (IHC) panel was applied. Results: Examined cystic soft-tissue masses were found as superficial (82%) and deep (18%). Superficial lesions were categorized into mesenchymal tumors, skin appendage lesions, tumor like lesions, pseudoudo tumoural soft tissue lesions or parasitic /inflammatory lesions. Deeper lesions with cystic presentation were mostly (74%) malignant. The differential diagnosis was done according to the age of the patient, anatomic location of the lesion, salient imaging features and clinical manifestations. Conclusion: Although the fine needle aspiration cytology of the cystic lesions, imaging characteristics of the lesions discussed are not always corresponding to the histopathologic findings what we assume, combining them with lesion location and clinical features may allow the diagnosticians to suggest a specific diagnosis in most cases.

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

Should we perform fine needle aspiration cytology of subcentimetre thyroid nodules? A retrospective review of local practice.

In light of the rising rate of incidentally detected subcentimetre thyroid nodules due to improved surveillance and diagnostic imaging, the decision of whether to perform fine needle aspiration cytology is increasingly pertinent. We aim to assess (1) the sampling adequacy of fine needle aspiration cytology, (2) malignancy rate, (3) thyroidectomy rate and (4) diagnostic accuracy of fine needle aspiration cytology. A total of 245 subcentimetre nodules in 220 patients underwent fine needle aspiration cytology between 2011 and 2014. Medical records were reviewed for cytology results, subsequent management and histopathological results in the event the patient underwent thyroidectomy. Sampling adequacy was calculated as the percentage of diagnostic results (Bethesda II-VI). Malignancy rate was defined as the percentage of Bethesda IV-VI diagnoses. Amongst patients with Bethesda IV-VI diagnoses who underwent thyroidectomy, their cytology reports were correlated with post-operative histopathological findings. The sampling adequacy of fine needle aspiration cytology was 77.1%. Malignancy rate (Bethesda IV-VI) was 9.7%. The respective malignancy rates in the < 5 mm nodule group and ≥ 5 mm nodule group were 6.67 and 10.0%. In total, 79.2% (19/24) of the malignant nodules underwent surgical excision. The rest declined surgery and/or were lost to follow-up. Amongst the malignant nodules which were surgically resected, 84.2% (16/19) had definitive malignant histology. Five of these demonstrated multifocal carcinoma and/or extrathyroidal extension of carcinoma on histology. Initial fine needle aspiration cytology and subsequent histopathological diagnoses matched in all cases except for three that had false-positive fine needle aspiration cytology results. Majority of our patients with suspicious cytology results subsequently underwent thyroidectomy, notwithstanding the relatively lower diagnostic accuracy of fine needle aspiration cytology in subcentimetre thyroid nodules.