Malignant Swellings Research Articles

Predictors of malignant swelling in space-occupying cerebellar infarction

BackgroundMalignant swelling is a fatal complication that can occur abruptly in space-occupying cerebellar infarction. We aimed to establish markers that predict malignant swelling in cerebellar infarction.MethodsWe retrospectively analysed data of...

Distribution of Non-thyroid Neck Swellings according to Tissue of Origin and Their Radio-pathological Correlation

Introduction: Neck swellings are commonly found and can be presented as simple benign to malignant. Due to extensive differential diagnosis and similar presentation, the evaluation of neck swellings is more challenging. Most of the cases can be diagnosed after a detailed history and clinical examination of the head and neck, but the final diagnosis will be achieved by histopathological examination. Materials and Methods: The study was conducted from February 2020 to February 2023 on the basis of retrospective and prospective sampling. This study included all the patients with neck swellings, excluding thyroid, who had undergone excisional or incisional biopsy. The present study was carried out on 74 patients with non-thyroid neck swellings, which were classified five into main headings, i.e. lymph node swelling, salivary gland swellings, adipose tissue, neural tissue and skin and soft-tissue swellings as miscellaneous. Data were collected from patient records for retrospective sampling and radiological investigation, and ultrasonography (USG) and excisional or incisional biopsy were done for prospective sampling. A radiological and pathological correlation was analysed as benign and malignant. Results: Out of the 74 patients, n = 60, 81% were benign and n = 14, 19% were malignant. The most common swelling according to the tissue of origin was lymph node (n = 31, 41.9%) followed by salivary gland n = 15 (20.3%), adipose tissue (n = 7, 9.5%) and neural tissue (n = 6, 8.1%) origin. Other soft-tissue swellings were 20.3%. The overall sensitivity, specificity, positive predictive value, negative predictive value and radiological (USG) diagnosis accuracy to differentiate between benign and malignant are very similar to gold standard histopathological examination. Conclusion: Lymph node swellings were the most common swelling involving the neck region. USG diagnosis is highly sensitive for diagnosing malignant swellings but less good at confirming benign swellings. Radiological diagnosis is not a substitute for conventional surgical histopathology but is regarded as a precious complement in diagnosis. Newer diagnostic techniques are required to be infallible and accurate for further management.

English

Papilloma is a benign tumour projecting above the surface of the skin. It grows from the epithelial tissue; develops as finger like fronds. Human contact with human papilloma virus (HPV) is one of the important causes for its occurrence. It feels rubbery and semisolid in consistency. Papilloma is a slow growing and long-lasting common tumor seen in various parts of the body like skin, breast, cervix, conjunctiva, etc. Its location on the exposed parts of the body like, around the face, neck, limbs, etc. causes much discomfort. Hence most of them prefer an early medical and surgical intervention to restore the cosmetic profile of the body to avoid growing physiopsychological discomforts. Clinical resemblance of any such swellings may require a meticulous examination and evaluation to differentiate them from other commonly seen external growths from the body surface; like sebaceous cyst, dermoid cyst, wart, haemangioma, neurofibroma, etc. One such clinical rare case of unusually large papilloma in an elderly lady aged about 65 years was presented with a swelling in her left popliteal region and excised under local anaesthesia, will be presented along with discussions. Human body is prone to show some solitary or multiple swellings on the inner or outer surface of the body. For the clinical diagnosis of a swelling, it is important for a clinician to know its source of origin. Swellings may arise from the skin, subcutaneous tissue, muscle, vessel, nerve, bone, etc. It is also important to consider whether it is a congenital or acquired defect or it is caused due to any trauma, or could be a mere inflammatory response which lasts temporarily.1 An abnormal growth of cells which grow more rapidly than other normal cells in the body are called neoplasms. They may be benign (harmless) or malignant (cancerous). Benign swellings are usually localized, may grow big without spreading or invading into other structures whereas malignant swellings can spread and invade the nearby tissues directly or through the blood or lymph nodes to different organs through metastasis, hence they need a thorough clinical evaluation. Soft tissue swelling especially in the young individuals often may be missed or delayed in the diagnosis of malignancy due to asymptomatic nature of the lesion with unfamiliar age. The nature of the swelling, its duration, location, and tissue of origin also matters in the final diagnosis. Hence it is important to differentiate a benign swelling from a malignant swelling at the earliest. 2

Evaluation of oral and maxillofacial swellings using ultrasonographic features.

PurposeThe aim of this study was to evaluate the characteristic features of oral and maxillofacial swellings that could be seen on ultrasonographic examinations.Materials and MethodsFifty patients with oral and/or maxillofacial swellings were randomly selected, thorough case histories and clinical examinations were done, ultrasonographic examinations with Doppler imaging were performed, and the features of every group were studied. Finally, histopathological evaluations were performed to identify the final diagnosis, according to which patients were classified into 5 groups; group I: inflammatory/space infection and abscess swellings, group II: cystic swellings, group III: lymph node swellings, group IV: benign swellings, and group V: malignant neoplastic swellings.ResultsA significant association (P<0.05), with a contingency coefficient of 0.88, was found between the histopathological and ultrasonographic diagnoses, with ultrasonography having a diagnostic accuracy of 89% in diagnosing maxillofacial swellings. The diagnostic accuracy of ultrasonography was 100% for lymph node and malignant swellings, followed by 98% for inflammatory and cystic swellings and 92% for benign swellings. The sensitivity of the ultrasonographic diagnosis was 100% for cystic, lymph node, and malignant swellings, followed by 91% for inflammatory swellings and 86% for benign swellings.ConclusionUltrasonographic features with Doppler imaging greatly aid in obtaining accurate diagnoses of oral and maxillofacial swellings. Ultrasonography is a recommended imaging tool for differentiating maxillofacial swellings and classifying them accurately.

Study and correlation of clinical, radiological, cytological, and histopathological findings in the diagnosis of thyroid swellings

Objectives: To study the clinical profile of patients with thyroid swellings. To study the radiological findings of these patients. To study the histopathological outcome. To correlate these factors in order to make diagnosis of malignant thyroid swellings in patients more accurate. Study Design: The present study: 'Study and correlation of clinical, radiological, cytological with histopathological findings in the diagnosis of thyroid swellings' was carried out in Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi Wardha from July 2013 to October 2015 It was carried out as a cross sectional observational study involving OPD based patients requiring further management. The sample size was fixed at 60 patients. All the patients of any age and either gender having goitre requiring surgery were included. Every patient was evaluated in terms of detailed history, thorough examination and relevant investigations. Results: Out of 60 patients, 51 (85%) were female and 9 (15%) were males. Maximum i.e. 22 (36.67%) cases belonged to the age group 41-60 years. More than half i.e. 34 (56.67%) of the patients came with a swelling on one side of the neck. 11 (18.33%) patients came with complains of Solitary nodule of Thyroid. The main complaint was anterior neck and was of grade 3 as per WHO Grading in 28 patients (46.67%). The duration of swelling was between 1-7 years in 30 (50%) patients followed by < 1 year in 17 (28.33%) patients. On clinical examination, 53 (88%) were diagnosed as benign and remaining 7(22%) as malignant swellings. Later on FNAC (done under ultra sound guidance), 8 (13%) patients were diagnosed with malignant swellings. Malignancy was noted in 13 (21.67%) cases on histopathology. A correlation between the diagnosis made pre-operatively on clinical examination, USG and FNAC was made with the Gold Standard for diagnosis of malignant thyroid swellings i.e. Histopathology. Conclusion: Goitre was common in females of middle age and majority had single lobe enlargement. Most of them presented with large goitres which were present since many years. On clinical evaluation, the symptoms suggestive of malignancy were pressure symptoms and lymph node enlargement. Multinodular goitre and colloid cysts were the commonest findings on FNAC. FNAC is a reliable tool of investigation for thyroid nodule. Using a thorough clinical examination, ultrasound and FNAC, a surgeon can reliably diagnose malignancy in thyroid glands and choose appropriate surgery for the treatment of the same. Histopathology is gold standard for confirmation of the diagnosis of malignancy post operatively.

Clinical applications of ultrasonography in diagnosing head and neck swellings

Background: Ultrasonography is well-known for its application in medicine, and has been recently gaining importance for its use in the orofacial region. Aims and Objective: The present study aims to determine the efficacy of ultrasonography in diagnosing soft tissue swellings of the head and neck. Materials and Methods: Thirty patients with the head and neck soft tissue swelling were included in the study and all were subjected to ultrasonography. Various findings were recorded such as shape, boundary, echo-intensity, ultrasound architecture, presence of necrosis, posterior echoes, ultrasound characteristic of lesion, and vascularity, and an ultrasonography diagnosis was made. After obtaining final diagnosis sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the test was calculated in various types of swelling. Results: In case of an inflammatory swelling, ultrasonography had a sensitivity of 100%, specificity of 89.5%, PPV of 84.6%, NPV of 100%, and accuracy of 93.3%. In cystic swellings, ultrasonography had a sensitivity of 85.7%, specificity of 100%, PPV of 100%, NPV of 95.8%, and accuracy of 96.67%. In nonodontogenic benign tumor, ultrasonography had a sensitivity of 100%, specificity of 100%, PPV of 100%, NPV of 100%, and accuracy of 100%. In malignant swellings, ultrasonography had a sensitivity of 80%, specificity of 100%, PPV of 100%, NPV of 96.2%, and accuracy of 96.67%. Conclusion: From the present study, it can be concluded that ultrasonography is highly accurate in diagnosing benign neoplasms, followed by soft tissue cystic swellings and malignant neoplasms, followed by inflammatory swellings of the head and neck region.

To evaluate the efficacy of ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings

AimTo evaluate the efficacy of Ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings. Material and methodsThe study was conducted on forty-five patients with maxillofacial swellings. The clinical diagnosis, radiographic diagnosis and ultrasonographic diagnosis were made which was compared to the histopathological diagnosis. The maxillofacial swellings included cystic lesions, benign swellings, malignant swellings, lymphadenopathies and abscesses and space infections. ResultsThe diagnostic accuracy and contingency coefficient was evaluated considering histopathology as gold standard. The diagnostic accuracy of ultrasound was found to be 92.30% in the diagnosis of cystic lesions, 87.5% in benign tumors, 81.8% in malignant tumors, 100% in lymphadenopathies and 90% in space infections and abscesses. The contingency coefficient of 0.934 was obtained when ultrasonography was compared to the histopathology, which was highly significant. Similar significant results were obtained comparing ultrasonography with clinical diagnosis (0.895) and radiographic diagnosis (0.889). ConclusionUltrasonography provides accurate imaging of the head and neck region and provides information about the nature of the lesion, its extent, and relationship with the surrounding structures. As the conventional and digital radiography enable the diagnosis of the presence of the disease, but do not give any indication of its nature. So, together with clinical and histopathological examinations, real time ultrasound imaging works out as a valuable adjunct in the diagnosis of orofacial swellings.

Regional perfusion in the treatment of malignant swellings of the limbs

Regional perfusion in the treatment of malignant swellings of the limbs