Lesions In Pediatric Age Group Research Articles

Rare presentation of Omental Cyst in Inguinal Hernia

Introduction: Inguinal hernia is one of the most frequent surgery performed by pediatric surgeons and majority of the hernias are indirect inguinal hernia. Mostly the sac is empty or might contain omentun , small bowel , ovaries , fallopian tubes etc. Rarely we see patients in which sac contains huge cystic lesion. We present a case report of patient who presented to us with swelling in left inguinal region and a preiminalry diagnosis of Left inguinal hernia was made later on it was found that the hernia sac contains a huge omental cyst which remained un-diagnosed till the time of surgey. Omental cyst is one of the rarest types of intraabdominal cystic lesions in pediatric age group.

Lymphangioma circumscriptum of thigh in a 12-year-old girl: report of a rare case

Abstract Clinical diagnosis of grouped vesicular lesions in pediatric age group needs a detailed history and meticulous dermatological assessment of the morphology. Lymphangioma circumscriptum (LC) is one rare condition suspected with classic clinical presentation. Frog spawn appearance and black vesicles are two clues for making a clinical diagnosis. Here, we report a case of LC over thigh in an adolescent girl in view of its rare age of presentation and unusual location.

A Study of Cytomorphological Spectrum of Head and Neck Lesions in Pediatric Age Group.

Fine Needle Aspiration Cytology (FNAC) is a well-established early diagnostic technique for evaluating mass lesions in adult patients. Now, FNAC in children is gaining acceptance and is used as a first-line investigation in diagnosis of pediatric lesions. To analyze the cytomorphologic spectrum of head and neck lesions in pediatric age group with histopathological correlation wherever possible and to study the utility of FNAC in pediatric head and neck lesions. A prospective study was carried out on all FNACs of head and neck lesions in pediatric age group (0-18 years), detected clinically or under radiological guidance for a period of 3 years from August 2018 to July 2021. The study included 238 cases. Most of the cases were seen in the age group of 13-18 years and with male to female ratio of 1.35:1. Most common site of FNAC was lymph nodes (70.2%) and the commonest lesion encountered was reactive lymphadenitis (50.8%). Second most common site was thyroid (15.9%). Soft tissue/bone, salivary gland, miscellaneous/skin lesions were also encountered. Among the 43 neoplastic lesions, benign (31 cases) were more common than the malignant (12 cases). The malignant cases included non-Hodgkins lymphoma, Hodgkins lymphoma, metastasis to lymph node, low-grade sarcoma, papillary thyroid carcinoma, and Langerhans cell histiocytosis of bone. Histopathological correlation was done in 32 cases (13.4%). Statistical analysis showed a sensitivity of 85.29% and specificity of 97.74%. Overall diagnostic accuracy was 96.3%. This study highlighted various cytomorphological patterns in head and neck lesions with high diagnostic accuracy in children. FNAC helps in proper planning of treatment modalities in head and neck masses in pediatric age group.

Role of magnetic resonance imaging in diagnosis of pediatric bone tumors

ObjectivesTo evaluate the diagnostic effect of MRI in pediatric patients with suspected bone tumors and other bone pathologies.BackgroundBony lesions in pediatric age group is a frequent cause of pain and swelling. MRI is used to evaluate such patients, and information delivered by MRI is used to diagnose these lesions, whether benign or malignant. In addition, information delivered by MRI is used to guide biopsy procedure.Patients and methodsThis was a prospective study that included 50 patients. All were referred to the MRI unit in the diagnostic Radiology Department at Menoufia University Hospital from Menoufia University Hospital clinics and private clinics from June 2015 to November 2018.ResultsOur study revealed that MRI plays a sensitive diagnostic role in most cases not solved by plain radiography, for example, characterization of bony lesions like fatty content, cysts with and without fluid–fluid levels, and cartilaginous matrix, and also in aggressive bone lesions, MRI is used for locoregional staging and noninvasive evaluation of response to neoadjuvant treatment.ConclusionMRI is a sensitive and specific tool in primary detection and staging of pediatric bone tumors and tumor-like conditions. MRI helps guide biopsy from the soft tissue components and increases the chance of obtaining a definitive diagnostic result.

Clinical, cytological and histopathological spectrum of pediatric lesions with emphasis on pediatric tumors

Introduction: To study the clinical, cyto morphological features of all pediatric lesions and categorize them as inflammatory, benign and malignant lesions and to correlate with histopathological diagnosis, wherever possible. Materials and Methods: All lesions in pediatric age group (0-14years) during a period of three years (2016-18) and total of 369 cases are detected clinically or under radiological guidance were included. Results: Out of 2911 fine needle aspirations during the study period, 369 were aspirations in children of pediatric age group, constituting 12.67% of all aspirations. Repeat aspirations were done in 4 cases, of which 3 cases were from different organs at same time and in one case 2 aspirations were done in 2 month follow up period. Majority of lesions were inflammatory lesions comprising 74.52% (275) of all lesions, followed by neoplastic lesions (12.19%). Nonspecific inflammatory lesions were more common (63.63%) than specific inflammatory lesions (36.36%). Neoplasms comprised 12.19% (45) cases, and about two third of them were benign lesions (60%). Overall, benign lesions constituted 7.31% of all lesions and malignant lneoplasms 4.87%. Highest incidence was seen in 12th year comprising 15.71% (58 lesions). Conclusion: FNAC is a rapid, easy, simple, minimally invasive technique well accepted in the adult population and also in pediatric age group. However with diagnostic accuracy of 91.30% in the present study as well as in previous studies, FNAC can be a reliable first line investigation in children. From this study it was clear that there is more widespread utilization of FNAC in children especially in enlarged cervical lymph nodes. Keywords: FNAC, Pediatric lesions, Pediatric tumors, Cytohistology, Fine needle aspiration.

Diagnostic utility of fine needle aspiration cytology in pediatric age group in a tertiary care centre

Background: Fine Needle Aspiration Cytology (FNAC) is a simple, cost effective, minimal invasive and a rapid diagnostic technique. The present study was designed to study the role of fine needle aspiration cytology and its utility in paediatric lesions. It also specifies the spectra of different lesions in the paediatric age group.Methods: The present study was performed in the Department of Pathology, in a tertiary care centre of Jammu, Jammu and Kashmir, India. All pediatric patients aged 0-17 years with palpable or deep-seated lesions were included in the study over a period extending from January 2017 to December 2018. The aim was to study the utility of FNAC in paediatric age group.Results: A total of 200 cases of FNAC in pediatric age group were studied. Out of total 200 cases maximum number of patients i.e. 59% were between 11-17 years. Male to female ratio was 1.7:1. A preponderance of lymph nodes over other sites i.e. 129/200 (64.5%) was noted.Conclusions: FNAC is a safe, rapid, accurate and cost-effective procedure with good patient acceptance with no essential morbidity and can be used as an initial screening tool in superficial and deep-seated lesions in pediatric age group.

Anomalies of the branchial arch apparatus in children: case series and review of literature

<p>Branchial apparatus develop between the 3rd and 7th weeks of embryonic life. There are five mesodermal arches separated by invaginations of ectoderm and endoderm. Branchial anomalies are result of aberrant embryonic development and are rarely seen in clinical practice. The objective of this article is to present few cases of branchial arch anomalies and to discuss the clinical presentation, diagnosis and surgical approach of such lesions in pediatric age group.</p>

A Prospective Observational Study of Breast Lumps in Adolescent Girls: Tertiary Care South Indian Teaching Hospital Experience.

The aim of the current study was to assess the incidence and varying clinical presentations of benign breast lumps in adolescent age group in a Tertiary care Medical College Hospital. This was a prospective, observational study of 6-year duration (2011 to 2017) conducted in a Medical College, South India. All adolescent age group patients visiting the outpatient department (OPD) with complaints of breast lump were enrolled into the study. Triple assessment comprising of clinical examination, imaging, and core biopsy was used for diagnosis and identification of type of tumor. Management of tumors was based on pathology of core biopsy. During the study duration (2011 to 2017), a total of 15 pediatric patients of age between 11 to 14 years, presented with complaints of breast lumps. The most common symptom included painless lump in breast in 11 patients (73.34%). The histopathological examination (HPE) reported 12 cases (80%) as fibroadenomas and only 3 cases (20%) were phyllodes tumors. Based on the results of HPE, majority of the patients (53.34%) underwent circumareolar cosmetic incision. The most common lesions in pediatric age group are benign fibroadenomas; however, phyllodes are also not rare, and to manage them appropriately, they should be diagnosed preoperatively with core biopsy. Cases of malignancy, including phyllodes tumors, ductal adenocarcinomas, and metastatic lesions, have been documented in children and adolescents. Therefore, malignancy should be considered in the diagnosis of a pediatric and adolescent breast mass until formally ruled out.

Cytomorphological spectrum of pediatric head and neck lesions-a comparative study in a tertiary teaching hospital in Western Uttar Pradesh, India

Background: Fine needle aspiration cytology (FNAC) is a well accepted as a diagnostic procedure in adult head and neck lesions. Its use in pediatric population is comparatively new. Only a few studies are available in archives of medical literature in pediatric population. Aims: The study the cytomorphological spectrum of head and neck lesions in pediatric age group. Histopathological correlation was done wherever possible. Material and methods: This was a hospital based, prospective type of study. Patients of age group between 0-12 years of age were included. Cases in two years between the time duration from January 2014 to December 2015 were evaluated for head and neck lesions on Cytopathology. Cytomorphological results were compared with other studies. Histopathological correlation was done wherever possible. Results: FNAC was performed on 1938 patients out of which 215 cases of 0-12 years of age group were included in this study. Cervical lymph nodes were most commonly affected (83.73%). Reactive lymphadenitis followed by granulomatous lymphadenitis was the most common pathology. Second most common site was skin and eyelid. Lesions of salivary glands, soft tissue and thyroid were also encountered. Histopathological correlation was possible in only 8.33% cases and concordant results were seen in 88.89% cases. Conclusions: FNAC plays a crucial role in the diagnosis of pediatric head and neck lesions. Preliminary diagnosis can be made and the spectrum of disease can be easily assessed. Histopathology was needed for confirmation of diagnosis in suspicious cases. Keywords: Fine needle aspiration cytology, Pediatric, Lesions, Cytology, Histopathology

Diagnosis of Palpable Abdominal Lesions in Pediatric Age Group with Fine Needle Aspiration Cytology (FNAC)

Diagnosis of Palpable Abdominal Lesions in Pediatric Age Group with Fine Needle Aspiration Cytology (FNAC)

Pediatric brain stem lesions: introduction of a scoring system for clinical evaluation and their treatment analysis

Brainstem lesions in pediatric age group include mainly gliomas. As these are not usually amenable to complete surgical resection, multimodality treatments are used. To assess treatment responses, Karnofsky's Performance Score (KPS) has been the gold standard; however, in pediatric patients, comprehensive neurological examination is more valuable. Our purpose was to formulate neurological examination based scoring system and compare its effectiveness with KPS. A retrospective analysis of 37 pediatric patients with brainstem lesions was performed. All these patients were assessed both pre- and post-treatment and in every follow up using standard KPS and our proposed scoring system, Kumar's and Samir's Score (K&SS). K&SS was devised choosing the common clinical features and those affecting outcome the most. Twenty-two features were hence selected, and points were allotted to each according to their functional importance, with range from 22 to 100. Twenty-seven had gliomas, and in nonglioma group, seven had brainstem tuberculosis (BSTB). Nineteen patients with BSG were less than 6 years of age. Most gliomas were pilocytic astrocytomas (n = 21). Outcome analysis of patients in both groups using KPS showed deterioration or no change in the scores in majority whereas using K&SS, most patients showed improvement. Gliomas form majority of pediatric brainstem lesions, with high occurrence of BSTB in nongliomatous group. Our proposed scoring system, based on comprehensive neurological examination, is more sensitive than KPS in treatment analysis of brainstem lesions.