Fine Needle Aspiration Cytology Of Lesions Research Articles

Cytological Analysis of Thyroid lesions According to the Bethesda System for Reporting Thyroid Cytology and their Correlation with Histopathology: A Prospective Study

Introduction: Fine-needle aspiration cytology (FNAC) has a crucial role in differentiating between nonneoplasticand neoplastic lesions of the thyroid. It is a quick outpatient department (OPD) procedure. It greatlyaffects the treatment decision. The current study was done to evaluate the role of FNAC as a diagnostic tool inthyroid lesions and establish a clinico-cytological and histological correlation.Aim: To study efficacy of Bethesda system for reporting (TBSRTC) FNAC of thyroid in view of offering guidancefor patient management, for review of distribution of diagnostic categories and correlation with histopathology.Materials and Methods: It is a prospective study of thyroid lesions carried out at the Department of Pathology, CAIMS,Karimnagar over a period of 3 years (January 2020 to January 2023) A total of 303 patients of neck swelling (thyroid),with satisfactory cases on 290 patients in cytology were undertaken for histopathology. Their clinico-cytological,biochemical, and histological correlation was done only in 133 patients only. Their statistical analysis was done.Results: Majority of cases were non neoplastic. The accuracy of cytodiagnosis was 89.3% and overall malignancyrate on histopathology was 16% (37 cases).Conclusion: FNAC of lesions in thyroid gland has a high accuracy in differentiating between malignant andbenign lesions. It is safe cost effective, minimally invasive, and OPD procedure. Using FNAC as the first line ofinvestigation which streamline the reporting terminologies and the number of surgeries on thyroid lesion hasreduced greatly.

Ultrasound-guided fine-needle aspiration cytology of lesions in the head and neck performed without local anaesthesia - An analysis of pain perception.

Ultrasound-guided fine-needle aspiration cytology is commonly carried out in the head and neck. The aim was to examine the amount of pain experienced by patients undergoing this procedure carried out without the use of local anaesthetic. A questionnaire was given to 109 consecutive patients undergoing ultrasound-guided fine-needle aspiration cytology containing a visual analogue scale. Patients were asked to mark with a vertical line on the 100 mm horizontal scale amount of pain they experienced during the biopsy. The pain was subsequently categorised as 'no pain', 'mild pain', 'moderate pain' or 'severe pain' based on previous pain studies. Hundred patients completed the visual analogue scale section of the questionnaire satisfactorily. Twenty-one patients experienced no pain, 62 experienced mild pain and 17 experienced moderate pain. No patients experienced severe pain. Further analysis showed that females had significantly higher visual analogue scale scores (Mann-Whitney test: U = 925.5, z = 2.211, P = 0.027). Patients who were aware that they were going to have a biopsy had significantly lower visual analogue scale scores than those who were not aware (Mann-Whitney test: U = 859.5, z = 2.263, P = 0.024). Ultrasound-guided fine-needle aspiration cytology is generally a well-tolerated procedure with pain scores being higher in females. It is advised that patients are told by the referring clinician the need for biopsy as this reduces the amount of pain experienced.

Cyto-histopathological correlation of skin adnexal tumors: A short series

Background:Skin adnexal neoplasms are relatively rare and thus uncommonly encountered in routine pathology practice.Aims:The present study was conducted with the aim to diagnose various skin adnexal tumors on fine-needle aspiration cytology (FNAC) followed by confirmation on histopathology and immunohistochemistry of the excised tumor.Materials and Methods:A total of 11 cases of superficial nodular swellings of the skin were studied over a period of 2 years from 2015 to 2016. FNAC of the swelling was performed and slides were stained with Giemsa stain. Following FNAC, the swelling was excised and subjected to histopathological examination. Immunohistochemistry was performed in some cases for confirmation.Results:It was observed that overall incidence of adnexal tumors (ATs) encountered on FNAC was very low. Typing of ATs on cytology was possible in 82% cases (9/11 cases) with diagnostic accuracy of 88% (8/9 cases). Most common tumor encountered in the study was nodular hidradenoma followed by pilomatrixoma, trichoepithelioma, cylindroma, chondroid syringoma, and trichilemmal cyst. Majority of the cases were benign except one case, which subsequently turned malignant.Conclusion:FNAC is a simple, safe, and cost-effective tool in diagnosing skin ATs. Cytological diagnosis of these lesions is depends on clinical correlation and cytomorphological features. FNAC in lesions suspected to be malignant can guide the surgeon regarding extent of excision.

Diagnostic utility of fine-needle aspiration cytology of lesions involving bone.

Fine-needle aspiration (FNA) is utilized in the diagnostic work-up of bone lesions in a number of institutions, either in isolation or in conjunction with core biopsy. We report our experience with FNA of bone-based lesions, including comparison of this approach with concurrent core biopsy specimens. Retrospective review over a 5-year period (2011-2015) revealed 233 cases of bone FNAs. The most commonly encountered diagnosis was malignant neoplasm (160 cases, 68.7%); within this group of malignancies, 103 cases (64.4%) represented metastatic carcinoma. Benign lesions were encountered infrequently (9 cases, 3.9%). While 37 cases (15.9%) revealed "no evidence of malignancy," 12 cases (5.2%) showed atypical findings, 3 cases (1.3%) demonstrated inflammatory conditions, and 12 aspiration biopsies were deemed nondiagnostic (5.2%). In 202 cases, concurrent core biopsies were performed following FNA and rapid on-site evaluation (ROSE). Comparison of the FNA and core biopsy diagnoses among malignant neoplasms revealed 19 diagnostic discrepancies, including 16 cases with a false-negative FNA (7.9% of all FNAs with concurrent core biopsy) and 3 cases with a false-negative core biopsy (1.5% of all cases with corresponding FNA). Our findings indicate that FNA of bone lesions is a useful diagnostic technique with high sensitivity, particularly when the cytologic findings are interpreted in conjunction with the core biopsy and pertinent clinical and radiologic findings. In addition, ROSE followed by open, dynamic communication with the performing radiologist leads to an extremely low rate of inadequate core biopsy specimens, resulting in optimal patient diagnosis and management. Diagn. Cytopathol. 2017;45:608-613. © 2017 Wiley Periodicals, Inc.

A Study of Fine Needle Aspiration Cytology of Thyroid Lesions with Histopathological Correlation

Background: Fine Needle Aspiration Cytology (FNAC) is important for pre-operative and pre-treatment diagnosis of benign and malignant thyroid lesions, thus decreasing the incidence of unwanted surgeries. Objectives: The present study aims to classify various cytomorphological lesions of the thyroid according to The Bethesda System for Reporting of Thyroid Cytopathology (TBSRTC) and correlate these with histopathology wherever possible. Material & Methods: A prospective study was conducted in a tertiary care centre of Western Uttar Pradesh to evaluate the diagnostic accuracy of FNAC in lesions of thyroid during a 2 year period. The cytological findings were classified according to the recent TBSRTC. Cyto-histopathological correlation was done in all the cases subjected to surgery. Results: Out of total 281 cases studied, 247(87.90%) were benign, 4(1.42%) were neoplastic, 5(1.78%) were suspicious for malignancy, 7(2.49%) were suspicious for a follicular neoplasm, 11(3.91%) were Atypia of undetermined significance and 7(2.49%) were inadequate. Cyto-histopathologic correlation of 134 cases was done. Sensitivity, specificity and diagnostic accuracy of the study for malignant lesions were 96.7%, 100 % and 97.0% respectively. Conclusions: FNAC is a safe, simple, highly accurate, economical and universally accepted modality for evaluation of thyroid lesions especially in developing countries such as India. FNAC helps in avoiding unwanted surgeries in patients diagnosed to have a benign pathology based on cytology. Those that are grouped in the suspicious or indeterminate categoryon cytology include lesions of uncertainty that are finally confirmed on histopathology. Keywords: FNAC, Thyroid, Histopathology correlation, Diagnostic Accuracy, Sensitivity, Specificity.

Plasmacytoma of tonsil diagnosed by fine-needle aspiration cytology

Extramedullary plasmacytoma of tonsil is rare. Even though biopsy is necessary for final diagnosis, fine-needle aspiration cytology (FNAC) can provide useful information in the management of such cases. We report a case of plasmacytoma of tonsil diagnosed by FNAC in a 43-year-old man who presented with a swelling in the right tonsillar area. FNAC smears revealed sheets of plasma cells at various stages of maturation. Subsequent histopathological and immunohistochemical studies confirmed the diagnosis of plasmacytoma. This case is reported for the rarity of site for extramedullary plasmacytoma and to highlight the usefulness of FNAC in lesions of tonsil.