Sensitivity Of FNAC Research Articles

Detection of Breast Lumps with Fine Needle Aspiration Cytology: Experience of 50 Cases in Bangladesh

Background: Detection of breast lump is very crucial. Objective: This study was carried out to evaluate the effectiveness of FNAC as a diagnostic method for breast lump. Methodology: This cross sectional study was conducted among 50 women with breast lump at Popular Medical College Hospital, Dhaka, Dhaka Medical College Hospital and Ad-Din Barrister Rafique Ul Huq Hospital, Dhaka during the period of November 2021 to April 2022. This study was conducted using convenient type of non-probability sampling technique. Data were collected by face to face interview, clinical examination and findings of both cytological and histopathological examination. Results: The study revealed the most benign breast lesion (89.45%) were below the age of 40 years and most of the breast cancer (91.2%) were above the age of 40 years. The study showed that 29 cases (58.0%) were diagnosed as benign clinically but cytologically 30(60.0%) cases were benign. Clinically 14(27.0%) cases were malignant but cytologically 13(26.0%) cases malignant. Clinical diagnosis of 8(7.5%) cases were uncertain, whereas cytologically 2(4.0%) cases were suspicious of malignancy and 1(2.0%) case was atypical. The comparison study between cyological and final histopathological diagnosis showed that out of 28 benign lesions diagnosed cytologically among which only 2 cases were found malignant histologically like false negative 2 (7.20%). 13 malignant cases were diagnosed cytologically which were confirmed histologically like no false positive was found. The study found that sensitivity of FNAC 85.3% of the presence of breast cancer and specificity 100.0% for absence of breast cancer. They also showed that the negative predictive value of FNAC for benign breast lump was 93.5% and positive predictive value for malignant breast lump was 100.0% and the overall diagnostic accuracy was 95.40%. Conclusion: In conclusion, FNAC can be used as a diagnostic method in the management of breast lump which has reasonable sensitivity and specificity. Journal of Current and Advance Medical Research, July 2023;10(2):65-69

The efficacy and assessment value of the level of thyroglobulin wash-out after fine-needle aspiration cytodiagnosis in the evaluation of lymph node metastasis in papillary thyroid carcinoma

ObjectiveThe purpose of this study was to evaluate the efficacy and clinical value of US, FNAC,FNA-Tg and FNAC + FNA-Tg, as well as the cutoff values of FNA-Tg to evaluate LN metastasis.MethodsWe analyzed the diagnostic value of different US signs, the efficiency of US, FNAC, FNA-Tg and FNAC + FNA-Tg among the LN- and LN + groups, and the cutoff value of FNA-Tg to evaluate LN metastasis. We punctured LNs multiple times and measured the levels of FNA-Tg. Furthermore, the LNs were marked with immunohistochemical Tg and LCA to distinguish the presence of Tg in the para-cancerous tissue of the LNs.ResultsThe s-Tg and FNA-Tg of the LN + group were higher than those of the LN- group (P = 0.018, ≤ 0.001). The LN + group had more abnormal US signs than the LN- group. The cutoff value of FNA-Tg was 3.2 ng/mL. US had a high sensitivity (92.42), but the specificity was not satisfactory (55.1). FNA-Tg had a higher sensitivity (92.42 vs. 89.39), specificity (100 vs. 93.88), and accuracy (92.42 vs. 83.27) than FNAC. However, the sensitivity of FNAC + FNA-Tg increased further, while the specificity and accuracy decreased slightly. The presence of Tg in the normal lymphocytes adjacent to the cancer was confirmed.ConclusionUltrasonography provides a noninvasive, dynamic, multidimensional assessment of LNs. With a cutoff value of 3.2 ng/mL, FNA-Tg has higher accuracy and a lower false-negative rate than various single diagnoses. However, FNAC combined with FNA-Tg does not cause additional pain to patients and offers a higher diagnostic efficacy and clinical value.

Changes of Serum Midkine as a Dynamic Prognostic Factor in Detection for Thyroid Cancer and Comparison with Fine-Needle Aspiration

Background: Midkine plays a significant role in the pathophysiology of malignant and other diseases since it is involved in a number of physiological processes, including development, reproduction, and repair. Different types of cells express this protein. Thus, in healthy conditions, significant MDK expression is observed in lymphocytes, the epidermis, and the bronchial epithelium. The sample obtained during fine needle aspiration can help in the diagnosis of or rule out disorders like cancer. Blood is the most practical and least likely bodily fluid to pollute while diagnosing illnesses. Finding successful prognostic markers in patients with well-defined thyroid cancer was the goal of the current investigation.Methods: Midkine level was measured in serum samples by using Elisa technique for 80 patients (40 patient was diagnosed with papillary thyroid carcinoma and another 40 with benign thyroid goiter), Age (25-55) from Iraqis people.Results: The current study revealed highly significant difference the median serum level of medkine in the TC patients was much higher than that of BTT patients with a highly significant difference The sensitivity and specificity of the test at cut off value of medkine=129 pg/ml were 90% for both. While FNA result, the sensitivity and specificity of FNAC was 80.77% and 89.66% respectively.Conclusions: The thyroid cancer group's serum MDK result was noticeably higher than that of the healthy control groups. proposed that the midkine might serve as a biochemical marker for thyroid cancer early identification and diagnosis.Keywords: Thyroid cancer; Papillary thyroid carcinoma; Midkine; ELISA; FNA

COMPARATIVE EVALUATION OF CELL BLOCK METHOD AND SMEAR CYTOLOGY IN FINE NEEDLE ASPIRATION CYTOLOGY OF PALPABLE THYROID LESION IN PATIENTS ATTENDING KIST MEDICAL COLLEGE TEACHING HOSPITAL

Background: Most patients with thyroid diseases present with palpable neck swelling. Accurate evaluation of thyroid nodules is crucial as they can be neoplastic. The use of fine needle aspiration and smear cytology for the detection of malignant thyroid lesions is the usual practice. However, it has its limitations and diagnostic pitfalls. Cell block analysis can be a useful adjunct to smears for establishing a more definitive cytopathologic diagnosis. This study was aimed to evaluate cytology and cell block findings in the patients of palpable thyroid lesions. Methods: A cross sectional, hospital-based comparative, observational study was conducted in Department of Pathology after receiving ethical approval from Institutional Review Committee. The study was conducted from 1st August 2022 to 1st August 2023. Statistical analysis of the diagnostic utility of cell block was evaluated taking into account sensitivity and specificity. Results: Among the 50 cases diagnosed as non-neoplastic by smear cytology, 2 were found to be neoplastic by cell block and similarly among the 5 cases which were not diagnosed by cytology, 2 cases were confirmed to be non-neoplastic thyroid lesions by cell block. Sensitivity of FNAC to detect neoplastic lesions was 66.6% and specificity was 100%, while cell block had 100% sensitivity and 100% specificity to detect those lesions. Conclusions: As both smear cytology and cell block procedures are done in a single setting, combination of two procedures has beneficial effect not only to support diagnosis but also to establish new diagnosis.

Reliability of Fine Needle Aspiration Cytology for Salivary Gland Tumours Meta-Analytical Study

Abstract Background Fine needle aspiration (FNA) cytology is a safe, reliable, minimally invasive and cost- effective technique for the diagnosis of salivary gland lesions. Aim and objectives to assess the accuracy, sensitivity and specificity of FNAC for diagnosis of salivary gland tumors in comparison with biopsy as definite diagnostic tool for these tumors. Subjects and methods This is a Retrospective and prospective studies, was carried out on Patients diagnosed with salivary gland tumors, treated with surgical management. Result FNA was associated with statistically significant fewer nondiagnostic results, Pooled analysis of all studies (n = 3605) revealed that rate of nondiagnostic results is 2.992% with 95% CI of rate 91.10–95.09 with absence of publication bias. Conclusion Fine needle aspiration biopsy is an important diagnostic tool for evaluating parotid gland tumors. It is more accurate in detecting benign tumors. In tumors greater than 2 cm and extending to the deep lobe, the sensitivity of fine needle aspiration biopsy is high. The use of fine needle aspiration biopsy in conjunction with clinical and radiological evaluation may help to reduce false positive and false negative results Funding Sources This research received no grant from any funding agency in the public, commercial or not-for-profit sectors.

Assessment of thyroid lesions using fine-needle aspiration cytology in accordance with The Bethesda System and its histopathological correlation - A prospective study.

Background: Fine Needle Aspiration Cytology is a first-line diagnostic technique that provides an accurate and precise diagnosis for assessing thyroid abnormalities. This study was conducted to analyze the cytology smears of thyroid lesions using The Bethesda system of reporting thyroid cytology and to correlate the cytological findings with histopathology diagnosis to determine the diagnostic accuracy of FNAC. Materials and methods: A prospective cross-sectional study was carried out. FNAC of thyroid lesions of 203 patients were examined and reported as per the Bethesda system for reporting thyroid cytopathology. Of these, 33 patients underwent surgery, whose histopathological findings were compared and correlated with respective cytopathological diagnoses. The IBM SPSS (Statistical Package for the Social Sciences) software version 27 was used for data analysis. Results: Among 203 cases evaluated, there were 11 Non-diagnostic (Category I) cases, 171 benign (Category II) cases, 4 cases of atypia of undetermined significance (Category III), 7 were suspicious for Follicular Neoplasm (Category IV), 2 were suspicious for malignancy (Category V) and 8 were malignant (Category VI). Out of 203 patients, only 33 patients underwent surgery, of whom 26 (78.79%) were benign and 7 (21.21%) were malignant on histopathology. The corresponding values for sensitivity, specificity, and diagnostic precision of FNAC were 71.42%, 100%, and 93.93% respectively, while positive and negative predictive values were determined as 100% and 92.85% respectively. Conclusions: The study shows that thyroid tumors can be successfully categorized and reported cytologically as per The Bethesda system.

A STUDY OF CORE-CUT BIOPSY AND FNAC FINDINGS IN A CLINICALLY PALPABLE BREAST LUMP

Aims And Objectives To nd the sensitivity and specicity of FNAC and Core-Cut biopsy. To study the efcacy of FNAC and Core-Cut biopsy with that of Histopathological (gross specimen) study in diagnosing a breast lump. To nd limitations of FNAC and Core-Cut biopsy Materials and Method: This is Hospital based Interventional study at Tertiary care centre in the department of General Surgery. All patients admitted during the period of 24 months with palpable breast lump coming under the eligibility criteria will be subjected for FNAC and Core-Cut biopsy after obtaining informed consents. Data Entry is done by using MS Excel and Analysis is done by using Suitable Statistical tests. Results: Our study of 70 patients, age incidence was ranged from 18 to 70 years. The age incidence for the benign lesions ranged from 18 years to 64 years (Mean age 38.5 years, SD= 12.56 years). The incidence for the malignant lesions ranged from 25 to 70 years (mean age 51.06 years, SD= 10.62 years). Out of total 70 patient, 49 patients had lump in right breast, 21 had lump in left breast. Our study True positive for FNAC was 38(54.28%) True negative was 26 (37.14%) and false positive was 0 and false negative were 6 (0.08%), which lead to the interpretation of sensitivity of 86 % for FNAC and specicity of 81.12% for FNAC. Our study True positive for Core-Cut biopsy was 42(60%) True negative was 26(38%) and False positive was 0(0%) and false negative was 02(2.85%), which lead to the interpretation of sensitivity of 95% for Core-Cut biopsy and specicity of 92.85 % for Core-cut biopsy. For Core-Cut biopsy in our study positive and negative predictive value was found to be 100% and 59.09% respectively Conclusion: As Both Sensitivity and Specify of Core-Cut biopsy is far superior than FNAC, and more number of False Negative reports in FNAC, where we can miss the Malignant breast Lump, we conclude that, Core-Cut Biopsy is far superior to FNAC in the diagnostic approach of breast cancer and, especially in cases of doubt, it is preferable to proceed directly with Core Cut biopsy.

Salivary Gland Lesions: A Clinico-Pathological Correlation.

To study the usefulness of clinical features, histopathological and radiological features in diagnosis and management of salivary gland lesions. Prospective study conducted at the department of ENT of a tertiary care centre in central India. A total of 162 patients who were treated over a period of 2 years for salivary gland lesions were studied with regards to correlation between clinical diagnosis, cytological examination and radiological features with histopathological diagnosis. Mean age group was 23.94 (± 15.43) years. There was slight male preponderance. Commonest presenting complaint was swelling. The most common gland involved was minor salivary glands followed by parotid gland. Sensitivity of clinical diagnosis, USG and FNAC for neoplastic lesions was found to be 80%, 95.65% and 79.61% respectively. Specificity of clinical diagnosis, USG and FNAC for neoplastic lesions was found to be 100%, 100% and 97.23% respectively. At the end of the study we concluded that combination of thorough clinical examination, radiological and cytological examination help in proper diagnosis, but it should always be confirmed on histopathology because some surprises are expected with regards to the nature of salivary gland lesions.

CORRELATION OF FINE NEEDLE ASPIRATION CYTOLOGY AND HISTOPATHOLOGY OF SOLITARY THYROID NODULE

Fine needle aspiration cytology is commonly used to screen lesions in pathology including thyroid lesions.It is mainly used to identify malignant lesions which then can be excised and examined by histopathology. FNAC uses the cytological features to distinguish between benign and malignant lesions. In our study, 60 patients were taken, age ranging from 15 to 65 years. Initially patients were clinically evaluated and FNAC followed by histopathological examination was performed on the excised thyroid lesions.In our study, majority were females and neck swelling was the commonest presentation. Majority were benign lesions. Malignant lesions were 18%.While comparing lesions in FNAC and histopathology, sensitivity of FNAC was found to be 84.61% and specificity to be 93.61%. The accuracy of FNAC obtained was 91.6 %.Thus,sensitivity and specificity of FNAC was high and can be used to screen thyroid solitary nodules

Advantages of the cell block technique over the FNAC and correlation with histopathology of most prevalent breast lesions in the community at the tertiary care center

Breast lumps are a common cause of concern in both young and older women throughout the world. Fine needle aspiration of breast lesions is an important and widely practiced method of providing a preoperative diagnosis in women presenting with a lump in the breast. Cell blocks that are made from the aspirates help in preserving the architecture, and the nuclear morphology and help in preserving the material for immunohistochemical studies. The present study aims to highlight the role of FNAC and cell block in the diagnosis of breast lesions. This was a two-year prospective study of 72 patients presenting with palpable breast lesions referred for FNAC to the Department of Pathology JJMMC, Davangere from 1st July 2015 to 30th June 2017. After a detailed history, general physical & local examination, informed consent was taken and FNAC was performed under aseptic precautions. A part of the aspirate was fixed, then processed as cell blocks, and stained with H&E. Wherever lumpectomy or radical surgery was performed the histopathology was correlated with cytomorphological findings.: The present study showed a diagnostic accuracy of 85.71% in the FNAC diagnosis. The sensitivity and specificity of FNAC in diagnosing breast lesions were found to be 82.60% and 87.23%. PPV and NPV were 76% and 91.11% respectively. When cell blocks were used the diagnostic accuracy increased to 88.57%. Diagnosis by using cell block showed a sensitivity of 79% specificity of 93.47%, PPV of 86.36%, and NPV of 89.58%.: From the results of our study, it can be concluded that the accuracy of diagnosing breast lesions preoperatively can be increased when FNAC is combined with the cell blocks from the aspirates. The cell blocks also help to preserve the aspirated material for future reference and immunohistochemistry can also be applied for a more accurate diagnosis.

THE CORRELATION BETWEEN CYTOLOGICAL ASSESSMENT OF HEAD AND NECK SWELLING AND HISTOPATHOLOGY

Head and also the neck swellings can come from lymph nodes, the thyroid, or the salivary glands. The FNAC is used for prognostic as well as the therapeutic purposes, helping surgeons decide on treatment. This study compared sensitivity, diagnostic accuracy and also the specificity of cytological diagnoses of head and the neck swellings with histopathology. This 2-year retrospective study included 500 pathology cases from Fakir Mohan Medical College and Hospital, Balasore, Odissa. The FNAC of head and neck tumors that were palpable corresponded with histopathological results. Descriptive statistics were used to evaluate the specificity, sensitivity and also the diagnostic accuracy of cytology. Lymph nodes (56.23%) had the most aspirates, followed by the thyroid (27.54%) and salivary gland (9.1%). Overall diagnostic accuracy, specificity, sensitivity of FNAC were 73.8%, 99.3%, and 94.5%, respectively. FNAC is considered as a reliable, accurate and also a cost-effective method for diagnosing palpable head and neck lesions, allowing the surgeon to monitor or modify his surgical approach.

Prevalence of Solitary Thyroid Nodule in Patients Admitted in Hospital of Dera Ismail Khan, KPK, Pakistan

Solitary nodules are a typical thyroid disease appearance. Solitary thyroid nodules are little swellings that are ordinarily impalpable glands. Solitary thyroid nodules are typically benign. With a mean age of 35 years, ladies are more likely than males to develop cancer (10–20%). An endocrine gland called the thyroid is located in the lower front and sides of the neck. Its primary purpose is to regulate basal metabolic rate. It also promotes somatic and psychic growth and is crucial for calcium metabolism. The identification, examination, and treatment of thyroid nodules can be difficult. These lumps frequently develop near the thyroid gland's border and are enormous in size, causing them to feel or seem like a lump in front of the neck. A multitude of variables, including age, sex, food, iodine deficiency, and even therapeutic and ambient radiation exposure, affect the occurrence of these nodules in a given population. This study was conducted in hospital of Dera Ismail Khan, KPK,Pakistan to determine the prevalence of solitary thyroid nodules in patinets admitted in the hospital. The results indicates that females between the ages of 26 and 30 are more likely to have thyroid nodules. Swelling at the front of the lower neck is the most frequent presenting ailment. The majority of patients presented between 6 months and 3 years after the edoema first appeared. The sensitivity and specificity of FNAC in the current investigation were 92% and 98%, respectively, while sensitivity and specificity of USG were 70 and 90%, respectively. Histopathology verified all malignant tumours on FNAC, demonstrating its superiority. USG and FNAC aids in proper management planning as a result, preventing the need for additional surgery. Keywords: Solitary thyroid nodule; Thyroid neoplasm; Neck swelling; Body mass index; Pakistan

Comparison of Fine needle aspiration followed by histopathology and sonographic features of thyroid nodule to formulate a diagnosis: A cross-sectional study

Thyroid nodules are solid lumps filled with fluid that develop inside the thyroid gland. Due to their small size, the majority of them go undetected and are asymptomatic. However, some of them are cancerous. Objectives: To compare the diagnostic accuracy of Fine needle aspiration followed by histopathology and sonographic features of thyroid nodule Methods: In this study, 274 participants were included. All of them were detected with the solitary euthyroid nodule. All the patients considered in the present study had normal values of T4 and TSH as euthyroid nodules were supposed to be studied. All the participants were subjected to undergo a USG as per the TIRADS system and FNAC wherever it was applicable. The biopsy report of the excised sample was considered a gold standard. Result: The classification of FNAC was more specific than the TIRADS system, however, the sensitivity of both the classification was the same. Micro-calcification was most specific and sensitive in the individuals that underwent a USG. Irregular margins had a specificity of 88% and nodules taller-than-wider in shape were 91% specificity. A total of 7 patients had shown benign features on cytology, whereas, they were suspiciously malignant on USG (TIRADES 4 and 5) and showed malignancy in final evaluation after the surgery. Conclusion: The sensitivity of both FNAC and USG in the diagnosis of malignancy of thyroid nodule is equal, however, the specificity of FNA is more (90%). FNAC is a minimally invasive procedure that can be opted for the differentiation of benign and malignant lesions with an accuracy of 86%. Patients showing high-risk features on sonography are subjected to repeat the FNAC and they should also be referred for a surgical biopsy to make a definitive diagnosis.

A Clinico Pathological Correlation of FNAC and Histopathology of Thyroid Swellings: A Hospital-Based Prospective Study

Background: Fine needle aspiration cytology is a diagnostic tool in which cells are extracted from palpable swelling using FNAC gun or syringe and needle. It is a simple, speedy, safe, cost effective and accurate technique being used worldwide. But, pitfalls come along making the correlation with histopathology often necessary. Materials and Methods: This study was a prospective study conducted among 30 patients undergoing thyroidectomy for thyroid swellings in ENT department, Bangalore Medical College and Research Institute, Bangalore. Patients were evaluated by detailed history, clinical examination, preoperative FNAC, thyroid function tests. Results: Thirty patients who underwent thyroidectomy for thyroid swelling during the study period was selected. Among 30 cases all specimen was sent for gross and microscopic examination. Two cases of malignant neoplasms were detected, one of which was benign according to FNAC. Most common lesion was multinodular goiter. Correlation of FNAC and histopathology for benign and malignant lesions, sensitivity of FNAC was found to be 50%, specificity 100%, negative predictive value of 96.5 % and positive predictive value of 100%. p-value<0.01, showing that there is a strong positive correlation between FNAC and histopathology findings. Conclusion: Thyroid pathologies are frequently encountered in otolaryngology clinics. Often the initial FNAC is a cost effective and minimally invasive procedure for the preoperative assessment of patients with thyroid swelling. Even though the clinical presentation may be similar in benign and malignant thyroid swellings, FNAC is the key to initial evaluation of thyroid swellings as well as to plan the surgery. Keywords: Fine Needle Aspiration Cytology, Histopathology, Thyroid swellings.

Prospective study to assess the clinical, cytological and histopathological findings of salivary gland lesions

Background: The purpose of FNAC is not only to provide a definite specific diagnosis. But it is also used in conjunction with clinical and radiological findings to provide the best possible initial assessment from which management can be planned. Keeping histopathological diagnosis as gold standard sensitivity, specificity and diagnostic accuracy of FNAC was calculated. Thus, the present study aims to correlate cytomorphological features of salivary gland lesions in FNAC and the corresponding histopathology in suspicious malignant cases. Materials & Methods: This is a prospective study done on 50 fine needle aspirates obtained from patients who visit department of pathology in SMS Medical College, Jaipur with various major salivary gland disorders. Patient’s age, clinical history, ultrasonogram findings were recorded. Results: The mean age of patients was 48.3 yrs. The predominance of males about 60% of cases. Impression obtained was that incidence of non-neoplastic and benign lesions were higher (92%) than malignant (8%). Based on cytological findings, among the benign neoplastic lesions, pleomorphic adenoma was the most common constituting about 36%. Mucoepidermoid carcinoma is the most common malignant neoplasm constituting about 2%. The diagnostic accuracy of benign lesions & malignant lesions was predicted to be 87% & 78% respectively.

CYTOLOGICAL AND HISTOPATHOLOGICAL CORRELATIVE STUDY OF LYMPH NODES IN A TERTIARY CARE HOSPITAL

Context: 1 Lymph nodes are one of the most frequently sampled tissues and lymphadenopathy are rst evaluated by ne needle aspiration cytology . Lymphadenopathy is one of the commonest presentations in surgical department with varied etiology ranging from Reactive, Inammatory condition to malignancy. Aims: The aim of present study was to evaluate the correlation between the cytological and histopathological diagnosis of lymph node FNAC and Biopsies and to evaluate the sensitivity, specicity and predictive value of FNAC of lymph nodes diagnosed as tuberculosis and metastatic carcinoma. Settings and Design: The study is done in SMMCHRI for a period of one year which included a total of 174 patients referred from surgical department who underwent FNAC of lymph nodes, out of which 89 patients had lymph node biopsies for histopathological evaluation. Methods and Material: Aspiration smears and histopathological slides were evaluated and results were calculated for sensitivity, specicity and predictive value of FNAC and henceforth Cytological and Histopathological correlation is studied. Statistical analysis used: Sensitivity, Specicity, Predictive value and Diagnostic accuracy are calculated Results: Reactive lymphadenitis was seen in 35 patients followed by tubercular granulomatous lymphadenitis in 26 patients and malignant lesions in 28 patients. Correlating the ndings, we could achieve 100% sensitivity and 96.9% specicity for tubercular lymphadenopathy and 100% and 98.6% for metastatic deposits respectively. Conclusions: We have found FNAC as a satisfactory tool in diagnosis of tubercular and malignant lymphadenopathy. FNAC when used in conjunction with clinical, radiological and laboratory investigations can be a cost-effective method for the diagnosis of lymphadenopathy

Reclassification of Salivary Gland Aspirates Based on "The Milan System for Reporting Salivary Gland Cytology": A Five-Year Retrospective Study.

Introduction:The Milan System for reporting salivary gland cytopathology helps standardize reporting systems across institutions, improve communication between clinicians and pathologists and guide the clinical management of patients.Aims:This study was undertaken to evaluate the utility of the Milan system classification in cytology reporting.Settings and Design:The present study is a retrospective study conducted over a period of five years in tertiary care centre.Methods and Materials:All the cases of salivary gland aspirates were reviewed and reclassified into six diagnostic categories according to the Milan system of reporting salivary gland cytology (MSRSGC). Cytological diagnosis was correlated with the histopathological diagnosis wherever available.Results:A total of 258 cases were classified using the Milan system as non-diagnostic (20.9%), non-neoplastic (26.3%), atypia of undetermined significance (4.7%), neoplasm benign (37.5%), neoplasm of uncertain malignant potential (3.5%), suspicious for malignancy (0.4%), and malignancy (6.6%). Cytohistological discordance was noted among 8/76 cases (10.5%). The sensitivity and specificity of FNAC were 75% and 98.5%, respectively. The risk of malignancy was 14.2% for Category I, 9% for II, 50% for III, zero for IVA and IVB, and 83.3% for category VI.Conclusions:The new classification system helps pathologists to standardize reporting leading to better clinical and surgical management.

The clinical profile & management of thyroid nodule: hospital based analysis

Introduction: Fine Needle Aspiration Cytology has become the mainstay in the initial evaluation of thyroid nodule followed by ultrasound scan and thyroid profile. The purpose of this study is to evaluate the distribution of solitary nodule, and to assess the risk factors for malignancies presenting in patients with solitary thyroid nodule. Materials & Methods: Total of 100 cases were included in the study. Ultrasound of neck was done in all cases to rule out multinodular goiter. FNAC was done in all the cases and was the main investigation for evaluation of the solitary nodule. The clinically diagnosed cases of thyroid were further evaluated as per the proforma. Results: Male to female ratio was 1:6.3. Peak incidence was observed in 3rd & 4th decades of life. Nearly 60 patients had nodules occurred on right lobe. Sensitivity of FNAC for benign lesion was 62% and for malignant lesion was 100%. The commonest histopathological reports were colloid goiter and follicular adenoma. The incidence of malignancy was 14%. Six cases had hypocalcemia and seven patients had wound dehiscence. Discussion & Conclusion: In addition to know whether the clinically palpable nodule is cystic or solid, ultrasonogram is useful to know the nature of the rest of thyroid gland showing the clinical solitary nodule is true solitary nodule or simply dominant nodule of a multinodular goitre. FNAC and thyroid profile are the most important investigations that help in its diagnosis. Hemi thyroidectomy is the most appropriate and least expensive procedure that can be done for its treatment.

Diagnostic Accuracy of FNAC in Solitary Thyroid Nodule A Single Institutional Experience

Background: In this study, we aimed to evaluate the value of FNAC in the diagnosis of solitary thyroid nodule, and asses the correlation with the histopathology. Materials and Methods: Prospectively FNACs of 90 cases of solitary thyroid nodule was compared with histopathology from July 1 2013 till June 31 2015. Results: The sensitivity and specificity of FNAC in our study is 77.7% and 98.7 respectively, the positive predictive value and negative predictive value is 87.5% and 97.5%respectively. Discussion: In our study, FNAC is proved to be an invaluable tool for pre-operative diagnosis of thyroid lesions, and its Bethesda system concords with histopathology results. Keywords: Solitary thyroid nodule; Fine needle aspiration cytology; Thyroid malignancy; Sensitivity; specificity.

“A CLINICAL STUDY ON ABERRATIONS OF NORMAL DEVELOPMENT AND INVOLUTION OF BREAST AND ITS MANAGEMENT IN UPPER ASSAM”

ANDI of breast is a common phenomenon. They are more common than breast malignancy. In this study an attempt was made to study the spectrum of diseases that come under ANDI of breast, their clinical presentation, treatment and also to nd out the clinical and cytohistological correlation. Study group includes 152 cases of Upper Assam who attended the Surgery OPD of AMCH during the study period and also all the patients who were admitted in the department of surgery under the clinical diagnosis of ANDI of breast. Conrmation of diagnosis was made on the basis of history, clinical examination, pathological and radiological investigations. Pathological investigations include FNAC and HPE. Radiological investigations include Ultrasonography and mammography. The following observations were made in the present study: Ÿ The commonest disease encountered was broadenoma of breast (14.47%) followed by mastalgia (23.68%) brocystic disease (14.47%) breast cyst (9.87%). The less common are duct ectasia, scleroding adenosus and phyllodes tumour, 9.87% each. Ÿ Majority are present in the second, third and fourth decades of life. All broadenoma, brocystic disease and phyllodes tumour are present in the third decade. Youngest patient was of 11 years and oldest was of 47 years. mean age of presentation was 27.45 years and the standard deviation was 7.13. Ÿ 86.84% had regular menstrual history and 13.16% had irregular menstrual history. Majority were nulliparous (46.05%). The highest parity was 4. Ÿ 94.08% did not give history of OCP use and 98.68% did not give history of lactation. Ÿ The commonest presentation was pain in the breast (76.32%) followed by lump (71.05%). Ÿ Majority cases presented to the hospital within 3-6 months of their onset of symptoms. The minimum duration of symptom was 1 month and the maximum was 12 months. Ÿ Right breast was involved more commonly 961.84%) than the left (38.16%). Ÿ Upper outer quadrant was involved most commonly involved (34.21%) and the least commonly involved was the central quadrant (1.32%). Ÿ The majority of the breast lumps (85.05%) had size less than 5cm in their greatest dimension. 14.95% had size more than 5cm. Ÿ 63.82% of the lumps had rm consistency whereas 6.58% had soft consistency. There was no positive family history in majority of the patients (89.47%). Ÿ The correlation between clinical diagnosis and histopathological diagnosis had the following ndings: For broadenoma the sensitivity of FNAC is 84.9% and HPE is 86.54% .Both have positive predictive value of 100%.For breast cyst the sensitivity of FNAC is 93.3%.For phyllodes tumour the sensitivity of FNAC is 85.7% and HPE is 75%.. Ÿ In the management, 41.45% cases underwent excision followed by aspioration of cyst in 7.89%, microdochectomy in 7.24%, wide local excision in 3.29% and simple mastectomy in 1.97%. Among conservative treatment 14.47%b were given evening primrose oil, 12.50% were given topical analgesic and breast support and danazol was given in 5.26%. The cases were followed up at three monthly interval for a period of one year and there was no recurrence during this period.