Utility Of Fine Needle Aspiration Cytology Research Articles

Cytodiagnosis of an Ectopic Primary Meningioma of the Parapharyngeal Region

Abstract Cytological findings in meningiomas are not well characterized since cranial meningiomas are unapproachable and rarely aspirated. Extracranial meningiomas are rare with an incidence of 1%–2%. These lesions can pose diagnostic challenges to clinicians as well as cytopathologists. This rare case is reported for its novel presentation in the parapharyngeal space which was diagnosed on fine-needle aspiration and confirmed by histopathology and immunohistochemistry. Awareness of the cytological findings and the possibility of occurrence of meningiomas at an extracranial location is important to arrive at an accurate preoperative diagnosis. This case report highlights the usefulness of fine-needle aspiration cytology not only in the diagnosis of meningiomas at an unusual location but also in predicting biological behavior.

Plasmacytoma of the Sternum with Amyloid Deposition – A Cytological Diagnosis

Abstract Plasmacytoma with amyloid deposition to be diagnosed on cytology is rare. In the absence of typical clinical presentation and radiological findings, the diagnosis of plasmacytoma may not be suspected. Fine-needle aspiration cytology (FNAC) in these patients may help in early and definitive diagnosis, thus helping inappropriate management of such patients. We report a case of plasmacytoma of the sternum with amyloid deposition who presented with suprasternal swelling. Apart from being a rare and interesting finding, this case highlights the usefulness of FNAC in making an early diagnosis of patients having an atypical presentation.

Diagnostic Utility of Fine-Needle Aspiration Cytology (FNAC) and Frozen Section Against Histopathology in Evaluating Benign and Malignant Breast Lesions.

Breastlesions, particularlylumps, pose concerns for females, varying between benign and malignant conditions. Accurate differentiation solely through clinical assessment is challenging, necessitating a definitive diagnostic strategy. Fine-needle aspiration cytology (FNAC) is integral in the "triple approach" to breast evaluation, offering simplicity, reliability, and cost-effectiveness. However, FNAC has limitations, occasionally failing to yield definitive diagnoses due to inherent constraints. Contrarily, frozen-section analysis, a long-standing intraoperative diagnostic method, plays a crucial role in swift diagnosis during surgeries. Despite technological advancements, frozen sections serve specific diagnostic purposes, confirming carcinoma when FNAC is inconclusive and evaluating resected margins. However, freezing artifacts may affect tissue assessment, emphasizing the continued reliance on histopathology for guiding treatment decisions. This study was conducted at KVG Medical College and Hospital, Sullia, Karnataka, India. It aimed to analyze the morphological characteristics of benign and malignant breast lesions using FNAC, frozen section, and histopathology and evaluate the sensitivity, specificity, and predictive values of FNAC and frozen section against histopathology as the reference standard. Across-sectional investigationwas carried out at a tertiary care hospital's Department of Pathology, on 60 female patients who presented with palpable breast masses over a span of two and a half years. FNACwas conducted, and the observations were classified into five categories as per the International Academy of Cytology guidelines. In addition, intraoperative frozen-section analysis was undertaken. A comparative analysis was conducted between the FNAC and intraoperative frozen-section findings, juxtaposed with the subsequent histopathological diagnoses. FNAC revealed 51.7% malignant, 45% benign, and 3.3% inadequate cases; the frozen-section analysis indicated 51.6% malignant, 45% benign, and 3.3% deferred cases; histopathology showed 53.3% malignant, 45% benign, and 1.6% borderline cases. FNAC demonstrated 93.9% sensitivity, 100% specificity, 100% positive predictive value (PPV), 93.1% negative predictive value (NPV), and 96.7% accuracy. The frozen-section analysis exhibited 96.9% sensitivity, 100% specificity, 100% PPV, 96.4% NPV, and 98.3% accuracy. Intraoperative frozen-section analysis displays superior diagnostic utility compared to preoperative FNAC. However, histopathology remains the definitive gold standard. Integrating all three diagnostic modalities is crucial for precise diagnosis and effective patientmanagement.

Combined fine needle aspiration cytology and core needle biopsy in the same setting: A two-years' experience.

Fine needle aspiration cytology (FNAC) combined with rapid on-site evaluation (ROSE) and ancillary techniques is an accurate diagnostic tool for many pathologies. However, in some cases, it may not be sufficient for actionable diagnoses or molecular testing, especially for cases that require large immunohistochemical panels or cases in which histological features are mandatory for the diagnosis. Core needle biopsy (CNB), on the contrary, provides samples that are suitable for histological features and sufficient for all ancillary studies. However, CNB is often performed by radiologists or clinicians without the direct participation of cytopathologists, which can lead to missed or delayed diagnoses. This study reports on the experience of combining FNAC and CNB performed in one setting by cytopathologists. The aim was to evaluate the impact of CNB on FNAC and the diagnostic efficiency of the combined procedures. One hundred forty-two FNAC and CNB procedures performed in the same setting over a period of 2 years were analysed. The FNAC diagnoses were compared and integrated with the subsequent CNB diagnoses. The impact of CNB was categorized as follows: non-contributory, in cases of inadequate samples; confirmed, when the CNB and FNAC diagnoses were the same; improved, when the CNB diagnosis was consistent with the FNAC diagnosis and further specified the corresponding entity; allowed, when CNB produced a diagnosis that could not be reached by FNAC; changed, when the CNB changed the previous FNAC diagnosis. CNB confirmed the FNAC diagnosis in 40.1% of cases (n = 57/142). CNB improved the FNAC diagnosis in 47.2% of cases (n = 67/142). CNB allowed a diagnosis that could not be performed on FNAC in 2.1% of cases (n = 3/142). CNB changed a previous FNAC diagnosis in 2.1% of cases (n = 3/142). CNB was non-contributory in 8.4% of cases (n = 12/142). CNB produced a positive impact on the whole diagnostic procedure in 51.4% of total cases (n = 73/142). The combined FNAC and CNB resulted in actionable diagnoses in 91.5% of all cases (n = 130/142). A complete molecular assessment was successfully performed in 14.7% of cases (n = 21/142) utilizing either FNAC or CNB material. The combined use of FNAC and CNB in one setting improves the diagnostic accuracy of both procedures. This approach exploits the advantages of each procedure, enhancing the accuracy of the final diagnosis.

A rare case of actinomycosis in routine fnac of the face in a tertiary care center in Central India

Actinomycosis is a chronic suppurative bacterial infection. It is caused by gram-positive, non-acid fast, filamentous, anaerobic to microaerophilic bacilli. Actinomycosis on the root of the nose is a rare entity. We report a case of 38 years old male who presented with swelling over the root of the nose since birth. Mucoid material was aspirated. Microscopic examination reveals a filamentous structured colony and crystal against the granular proteinaceous background. Features suggest benign cystic lesion and secondary actinomycosis infection, negative with an acid-fast bacilli stain consistent with Actinomyces species. As stated in most of the literature, mainly males are affected by this condition. Very little information is available on the use of fine-needle aspiration cytology (FNAC) to diagnose these lesions. We are reporting a case of an actinomycotic lesion that was reliably diagnosed with FNAC. So, we emphasized here that FNAC is aninexpensive, rapid, and simple outpatient procedure that helps in the rapid diagnosis of Actinomycosis.

Significance of non-granulomatous cytomorphology on fine needle aspirate in lymphadenitis cases classified as tuberculous by using a composite reference standard.

Fine needle aspiration cytology (FNAC) is established as a first line investigation for tuberculous lymphadenitis (TBLA). We aimed to describe the various cytomorphologic features of tuberculosis (TB) on FNAC and their contribution in the diagnostic decision-making in suspected TBLA cases. Patients with presumptive TBLA were prospectively enrolled (n = 266) and subjected to routine diagnostic work-up for TB, including FNAC samples, and followed until the end of treatment. Patients were categorized as TB or non-TB cases based on a composite reference standard of which the various cytomorphologic patterns were compared. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy was calculated using cross-tabulation. Fifty-six patients were categorized as bacteriologically confirmed TB, 102 as clinically confirmed TB and 108 as non-TB. The most common cytomorphologic pattern among TB cases (59%) was granulomatous inflammation with necrosis, however, about one-third of tuberculous lymphadenitis patients presented with non-granulomatous inflammation, with 21% showing only necrosis and 13% presenting with a reactive pattern. The overall sensitivity and specificity of FNAC was 85% and 66%, respectively. We found that about one-third of TBLA patients presented without granulomas on FNA, highlighting the importance of considering TB in a wide spectrum of cytomorphology in a high TB burden setting. Our study supports the use of FNAC as a first-line investigation tool for diagnosing TBLA in a low-resource setting due to its relative simplicity and good sensitivity. However, the low specificity of FNAC, emphasizes the need for a second-tier confirmatory test with improved specificity.

A STUDY OF FINE NEEDLE ASPIRATION CYTOLOGY IN THE DIAGNOSIS OF CERVICAL LYMPHADENOPATHY

Background: Fine Needle Aspiration Cytology (FNAC) is a consistent and fairly priced method for evaluating lymphadenopathy. Lymph node FNAC is usually the rst step in the evaluation of enlarged lymph node. The etiology may range from a benign nonspecic inammation to lymphoproliferative disorders and metastatic malignancy. Aims and Objectives: To study role of FNAC as a diagnostic tool in enlarged cervical lymphadenopathy. Methods: The present study was a prospective and cross-sectional study. This Study was carried out over a period of 1 year (February 2022 to January2023) at department of pathology KPC Medical college &Hospital, Kolkata. 100 patients were included in this study. Results: Out of 100 cervical lymph node FNAC cases, reactive non-specic was the most common nding (52%) followed by tubercular (28%). Conclusion:This study highlights the usefulness of FNAC as a reliable diagnosis of cervical lymphadenopathy

A COMPARATIVE STUDY BETWEEN ZIEHL NEELSEN STAINING AND FLUORESCENCE MICROSCOPY IN THE DIAGNOSIS OF TUBERCULOUS LYMPHADENITIS ON FINE NEEDLE ASPIRATION CYTOLOGY

Introduction: Tuberculosis is a leading cause of morbidity and mortality in India which requires early diagnosis for treatment and control of infection. Fine needle aspiration cytology (FNAC) and Ziehl Neelson (ZN) staining of FNA samples have low specicity and sensitivity respectively in tuberculous lymphadenitis due to paucicellular nature of the disease. Fluorescent Microscopy has a well established role in detection of tuberculosis. Recently, WHO has recommended its use in extrapulmonary tuberculosis as an initial diagnostic tool. Material and Methods: This is a prospective study performed in Department of pathology and included 80 patients of suspected symptoms of tuberculous lymphadenitis. Fine needle aspiration was done and the material was sent for Fluorescent Microscopy. The rest of the material was used for preparing H&E stained and Z-N stained smears. Out of the total 80 cases, 47 cases were positive Result: for AFB on ZN staining and 56 cases showed Fluorescent Microscopy positivity, thus proving the important role of Fluorescent Microscopy in diagnosing tuberculous lymphadenitis. This difference was also statistically signicant (p value <0.05). Combined Conclusion: use of FNAC, ZN staining and Fluorescent Microscopy gives maximum diagnostic yield, greatly improving diagnostic value specially in patients with low bacillary load, those are likely to be missed on FNAC & ZN staining by increasing the rate of detection of tuberculous lymphadenitis

A CYTOLOGICAL AND HISTOPATHOLOGICAL CORRELATIVE STUDY ON NEOPLASTIC LESIONS WITH MILAN SYSTEM FOR REPORTING SALIVARY GLAND CYTOPATHOLOGY.

Salivary gland tumors are rare. Nevertheless, theaccurate preoperative diagnosis of themalignant potential of thelesion is essential for appropriate patient management. Therecently published Milan system for reporting salivary gland cytology (MSRSGC) is an effort to provide better communication regarding thenature of lesions to clinicians.Aim: To evaluate thediagnostic utility of fine-needle aspiration cytology (FNAC) of neoplastic salivary gland lesions and theMSRSGC applicability in risk stratification. This was a retrospective study of thecytological and histopathological correlation between neoplastic lesions of salivary gland lesions conducted over four years (August 2010- September 2014) in two tertiary care hospitals. There were 66cases of FNAC of salivary gland neoplasms. Thesensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of FNAC were analyzed. Therisk of malignancy for MSRSGC was calculated. Theoverall diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values were 93.94; 95.5; 99.8; 96.8, and 98.7%, respectively. By correlating thecytological diagnosis of benign neoplasm with histopathological diagnosis, therisk of malignancy was 0% and risk of neoplasm was 100%. For cases in thecategory suspicious of malignancy, risk of neoplasm was 100% and risk of malignancy was 85%. Thepresent study demonstrated that this salivary gland cytology reporting system was useful in classifying thelesions in well-delineated categories with ease. MSRSGC system of standardized reporting is helpful for guiding clinicians in appropriate management of thepatient. However, many multicenter studies with large sample sizes and long-term follow-up are needed along with wide propagation of its standardized reporting format to be adopted universally.

Differential diagnosis of diffuse sclerotic thyroid papillary carcinoma and Hashimoto's thyroiditis using fine-needle aspiration cytology, BRAFV600E , and ultrasound elastography.

BackgroundThe diffuse sclerosing variant of papillary thyroid carcinoma (DSV‐PTC) has ultrasound findings that are similar to Hashimoto's thyroiditis (HT), resulting in under‐diagnosis. DSV‐PTC combined with HT is also common, so early and accurate diagnosis of DSV‐PTC using a variety of diagnostic techniques, including FNAC, BRAFV600E mutation detection, and ultrasound elastography, is critical.ObjectiveTo assess the diagnostic value of fine‐needle aspiration cytology (FNAC) and BRAFV600E detection in combination with ultrasound elastography in the diagnosis of DSV‐PTC.MethodsWe performed a retrospective analysis of 40 patients with pathologically confirmed DSV‐PTC and 43 patients with HT admitted to our hospital's ultrasound department between January 2015 and December 2020. Preoperative FNAC, BRAFV600E mutation detection, and ultrasound elastography imaging were all performed on all patients. For a definitive diagnosis, the results of these tests were compared to postoperative pathological findings. The diagnostic value of FNAC, BRAFV600E mutation detection, ultrasound elasticity imaging, and their combination for DSV‐PTC diagnosis was assessed.ResultsThe mean elastic strain rate ratio (E1/E2) of the 40 DSV‐PTC cases was 5.75 ± 2.14, while that of the 43 HT cases was 2.81 ± 1.20. The receiver operating characteristic (ROC) curve was generated using the average value of E2/E1. The area under the ROC curve was 0.910, and the optimal E2/E1 cut‐off value was 4.500. When FNAC, BRAFV600E mutation detection, and ultrasound elasticity imaging detection were combined, the diagnostic sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of DSV‐PTC diagnosis were 92.5%, 95.3%, 93.2%, 94.9%, and 94.0%, respectively, which were significantly higher than the single technique (p < 0.05).ConclusionsThe use of FNAC, BRAFV600E mutation detection, and ultrasound elastography in combination is more helpful in establishing an accurate diagnosis of DSV‐PTC than using a single diagnostic technique alone.

Cytomorphological Study of Hepatic Lesions by FNAC

Introduction: Fine Needle Aspiration Cytology (FNAC) is a simple, safe, very low-cost and rapid procedure for diagnostic purpose which makes surgical intervention and exploratory laparotomy unnecessary. The introduction of modern diagnostic imaging techniques, mainly ultrasonography (USG) and Computerized Tomography (CT), has enabled the detection and location of lesions in sites such as liver, which are not easily accessible to surgical biopsies.&#x0D; Aim: To assess the utility of FNAC in the diagnosis of liver lesions. To study the cytomorphological features, age and sex distribution of liver lesions.&#x0D; Materials and methods: The study included 24 liver lesions which were detected clinically or radiologically. USG guided FNA was done in all cases. The smears were stained with Haematoxylin and eosin (H and E), May Grunwald Giemsa (MGG) and Papanicolaou’s stains. A cyto-histopathological correlation was done wherever possible. From the residual material, additional slides and cell blocks were prepared. Special stains were used whenever required. In doubtful cases immunohistochemistry (IHC) was done on formalin-fixed paraffin cell blocks and immunocytochemistry on conventional smears wherever necessary and possible.&#x0D; Results: All the lesions were found to be malignant. Out of 24 liver FNA cases, maximum lesions were seen in females and the affected age group for liver malignancies was 51-60 years. Out of 24 liver FNA cases, 20 cases were metastatic and 4 were primary cases. Among metastatic cases, maximum cases were of metastatic adenocarcinoma and the primary lesions of liver included all cases of hepatocellular carcinoma. Conclusion: Fine needle aspiration cytology of liver is a simple, safe, repeatable and rapid diagnostic procedure. In case of hepatic lesions, it is of outmost advantage in recognizing the nature of lesion i.e., primary, and metastatic as well as in early diagnosis of lesion so that patient can be treated as early as possible.&#x0D;

USG Guided Fine Needle Aspiration Cytology along with Immunocytochemistry to Diagnose Primary Malignant Mixed Mullerian Tumors: A Three-Year Study from a Tertiary Care Center.

Aims and Objectives:To study the diagnostic utility of fine-needle aspiration cytology (FNAC) and immunocytochemistry in diagnosing primary malignant mixed Mullerian tumors (MMMT).Materials and Methods:A 3-year retrospective study carried out in a tertiary care hospital, which included all the gynecological patients who underwent USG-guided FNAC of their abdominopelvic masses.Observations and Results:Out of the 324 total cases, 05 (1.5%) were reported as primary malignant mixed Mullerian tumors. Out of these 05 cases, 03 were ovarian, 01 was uterine, and 01 involved both uterus and one-sided adnexa. The FNA smears from the masses revealed cytomorphological features of a biphasic neoplasm with elongated pleomorphic spindle cells and dispersed, focal attempted acinar pattern, thus indicating the possibility of MMMT. Immunocytochemistry was further carried out which showed both vimentin and cytokeratin positivity. The diagnosis was confirmed on subsequent biopsy and immunohistochemistry (without any histopathological-cytological discrepancy).Conclusion:Though the literature is replete in establishing a histo-pathological diagnosis of MMMT, the diagnosis on USG-guided FNAC has been rarely described. Emphasis should be made on the careful examination of small sarcomatous elements in smears. Utilization of cell block and immunocytochemistry with histopathological correlation should be done to avoid misdiagnosis.

Fungal Granulomatous Thyroiditis in A Renal Transplant Recipient

Fungal granulomatous thyroiditis is a relatively rare entity. Aspergillus is the fungus that most commonly affects the thyroid gland and is generally missed until autopsy. Aspergillus granulomatous thyroiditis diagnosed antemortem and treated in renal transplant recipient patients are extremely rare. We report a 35-year-old female renal transplant recipient who presented with fever, generalized weakness, and loss of appetite; her clinical examination revealed a left thyroid lobe nodule. Fine needle aspiration cytology (FNAC) microscopic examination of the nodule revealed fungal granulomatous thyroiditis. Subsequent examination of FNAC material with special stain Gomori`s Methenamine Silver (GMS), 10% KOH (potassium hydroxide) mounting, and culture confirmed the presence of fungus Aspergillus flavus. This case emphasizes the need for thorough clinical examination and the utility of FNAC in examining thyroid nodules. J Microbiol Infect Dis 2021; 11(4):234-238.

Fine-Needle Aspiration Cytology in the Diagnosis of Breast Paraffinoma

Introduction: Paraffin injections for breast augmentation once a popular form of mammoplasty are now considered obsolete. It had been abandoned by clinicians because of its associated serious complications. The practice is however still available and is being practiced by nonmedically qualified people. Paraffin injection results in the formation of multiple foreign-body granulomas known as breast paraffinoma. The clinical features of breast paraffinoma can mimic and be mistaken for breast carcinoma or inflammatory breast carcinoma. The use of fine-needle aspiration cytology (FNAC) in the evaluation of patients with breast paraffinoma has not been fully evaluated. Methods: Retrospective review was performed on 30 patients who presented with breast paraffinoma between June 1, 2010, and June 30, 2020, who also had FNAC as part of their breast lump evaluation. Results: FNAC of 73.3% patients showed multinucleated giant cells and macrophages or histiocytes containing engulfed clear, empty intracytoplasmic vacuoles of varying sizes. In 13.3% of the patients, macrophages or histiocytes with engulfed clear intracytoplasmic vacuoles of varying sizes were seen. In 6.7% of patients, multinucleated giant cells containing engulfed vacuoles of varying sizes were seen, and in 6.7% of patients, hypocellular smears with large amount of clear spaces were seen. Oily droplets were seen in the background of all the smears, and there were no malignant cells seen. These features were compatible with breast paraffinoma. Conclusion: Most patients with breast paraffinoma can be managed conservatively and they do not require further treatment; FNAC with its characteristic features can provide the reliable diagnosis of breast paraffinoma and therefore sparing these patients from more invasive diagnostic procedures.

Giant cell tumor of tendon sheath—Use of fine-needle aspiration cytology for diagnosis

&lt;p class="Body"&gt;&lt;span lang="EN-US"&gt;Giant cell tumour of the tendon sheath (GCTTS) is a slow-growing, usually painless benign lesion of soft tissues&lt;span style="font-size: 8.33333px;"&gt;.&lt;/span&gt; We report the case of a 38-year-old male with a painless, slowly enlarging swelling on right thumb in order to highlight the role of fine-needle aspiration cytology (FNAC) in diagnosing GCTTS.&lt;/span&gt;&lt;/p&gt;

The utility of fine-needle aspiration cytology in differentiating granulomatous mastitis and tuberculous mastitis

Background: Tuberculous mastitis (TM) is a rare extrapulmonary presentation of tuberculosisaccounting for less than 1% of all diseases of the breast in the industrialized world. GranulomatousMastitis (GM) is an uncommon chronic inflammatory disease of the breast that almost always mimicscancer in young individuals, so it can be a diagnostic dilemma. Aims and objectives: The main aimof this study is to elucidate the utility of FNAC in differentiating granulomatous mastitis andtuberculous mastitis. Materials &amp; Methods: A retrospective observational study was conducted atthe department of pathology, Hindu Rao Hospital, Delhi. Cytology database was revealed for a periodof 4 years (2016-2019). The clinical details wherever available and cytological morphology ofindividual cases were noted and analysed. Results: In our study out of 20 cases 11 cases (55%)were found to be granulomatous mastitis and the other 9 cases (45%) were found to be tuberculousmastitis. All cases were of female patients only, with equal side distribution. In the cytologicalsmears of GM, three (27.3%) smears showed ductal epithelial cells, epithelioid cell granulomas wereseen in 11 (100%) cases and singly scattered epithelioid cells were seen in nine (81.8%) cases.Caseous necrosis was observed only in one case (9.09%) but necrotic material intermixed withdegenerated neutrophils and apoptotic bodies were seen in four cases (36.4%). Conclusion: FNACcan be an accurate method for differentiating tuberculous mastitis from granulomatous mastitis asper cytomorphological findings, along with confirmation by the demonstration of acid-fast bacilli andhence can help to decide the appropriate treatment protocols for such patients.

Isolated soft-tissue aspergilloma at the right lateral side of nose mimicking as tuberculoma

Aspergilloma is a mycotic infection and is characterized by a mass with soft-tissue attenuation without tissue invasion. Aspergilloma at the lateral aspect of the nose is a very rare location and poses clinical and diagnostic challenge as cytological examination mimics tuberculoma. We report the case of an immunocompetent elderly male with painless nodular swelling at the right side of the nose for 3 months with fine-needle aspiration cytology (FNAC) reported elsewhere as granulomatous inflammation suggestive of tuberculosis. Subsequently, repeat FNAC cytological examination with the application of special stain and submission of aspirated material for microbiological 10% potassium hydroxide mounting and culture-confirmed fungal infection as Aspergillus flavus. A high index of clinical suspicion, the utility of FNAC, application of special stains, and communication with pathologist and microbiologist clinches the diagnosis. The patient was successfully treated with antifungal therapy (Voriconazole) and swelling completely resolved after 6 weeks of treatment.

Fine Needle Aspiration Cytology Findings of Breast Lesions in Female Patients Presenting With Palpable Breast Lumps at Makerere University College of Health Sciences, Kampala-Uganda

Background: Palpable breast lumps are a common manifestation encountered by physicians during clinical practice. The use of fine-needle aspiration cytology (FNAC) method has proven to be quick, simple and cost-effective in the evaluation of these lumps for benign, atypical and malignant changes. This study aims to determine the type of breast lesions diagnosed by FNAC and to determine the age-wise distribution for such lesions. Methodology: A prospective study consisting of 291 females presenting with palpable breast lesions was carried out at Makerere College of Health Sciences (MakCHS) pathology laboratory from January 2019 to May 2019. FNAC results were grouped into tier five reporting categories as C1, C2, C3, C4 &amp; C5 in accordance to the International Academy of Cytology (IAC). Results: Out of the 291 cases examined, 14 (4.8%) were insufficient (C1), 192 (66%) were benign (C2), 9 (3.0%) were atypical (C3), 15 (5.2%) were suspicious of malignancy (C4) &amp; 61 (21%) were malignant (C5). In the benign category, lesions of fibroadenoma were the most commonly diagnosed constituting 110/192 (57.3%) whereas under the malignant category lesions of invasive ductal carcinoma were the most commonly diagnosed constituting 27/61(44.3%). The peak age group for benign lesions was 21-30 years whereas the peak age group for malignant lesions was 41-50 years. Conclusion: Fine-needle aspiration cytology (FNAC) was found to be an effective diagnostic tool in the categorization of palpable breast lumps into benign, malignant, atypical, suspicious and inadequate categories.

Knowledge, attitude, and practice toward glaucoma and its management among adult Saudi patients.

PURPOSE:To present the level of knowledge, attitude, and practice (KAP) for glaucoma management and their determinants among adult Saudi patients.METHODS:The study was conducted between January and June 2017. Glaucoma patients from the ophthalmology clinic were interviewed. Demographics and disease-related information were noted. The questionnaire included four K questions, seven A questions, and six P squestions. The correct response of questions were summed for K, A, and P, and the percentile was calculated. K and P scores were graded as excellent (more than >75%), good (51%–75%), poor (26%–50%), and very poor (≤25%). If A score was >50%, it was termed as positive.RESULTS:We interviewed 263 adult glaucoma patients. Their mean age was 61.6 ± 14.2 years. The excellent grade of knowledge about glaucoma and its management was 63 (24% [95% confidence interval (CI) 18.8–29.1]). Poor grade of knowledge was 95 (36.1% [95% CI 30.3–41.9]). The attitude toward glaucoma and its management was positive in 89 (33.8% [95% CI 28.1–39.6]). The practice to manage glaucoma was of excellent grade in 10 (3.8% [95% CI 1.5-6.1]). The overall excellent grade of KAP glaucoma patients was 17.9% (13.2–22.5). Good practice for glaucoma management was associated with a history of glaucoma surgery (P < 0.001), longer duration of glaucoma (P = 0.02), and young age (P = 0.004).CONCLUSIONS:Low KAP about glaucoma disease and medication among Saudi glaucoma patients is a matter of concern. Strategies are needed to improve the KAP of glaucoma patients.

Utility of fine-needle aspiration cytology in the diagnosis of fibrolamellar carcinoma with distant metastases

Utility of fine-needle aspiration cytology in the diagnosis of fibrolamellar carcinoma with distant metastases