Utility Of FNAC Research Articles

Utility of FNAC in diagnosis of thyroid lesions and to correlate histopathological studies

The Incidence and prevalence of Thyroid lesion is gradually increasing and has become common among women. Thyroid cancer is most common cancer of endocrine system and occurs in all age groups including children. Fine needle aspiration cytology is the first line diagnostic method of Thyroid nodules and is rapid, cost effective and a minimally invasive procedure. Therefore it is widely accepted and more thyroid cases are diagnosed at an early stage. The aim of this study is to assess the Diagnostic accuracy of FNAC by correlating its results with histopathological findings. FNAC procedure was performed on 50 patients with thyroid swellings under aseptic conditions after taking consent of the patient. The results obtained by FNAC were compared with Histopathological findings. : Out of 50 cases, 47 were female and 3 were male. The age of presentation ranged from 16 to 71 years in our study with the mean age being 43.5. Most of cases were of Nodular goiter (23%) followed by Multi Nodular goiter(21%) followed by Hashimoto thyroiditis (18%). Sensitivity of our study was 73.91% and Specificity of our study was 80.95% and diagnostic accuracy was 75%.: Awareness and understanding of thyroid lesions is of great importance as most of these disorders can be treated medically or by surgical intervention. FNAC, which is simple, minimally invasive and rapid procedure, has low false positive rate for diagnosis of thyroid malignancy at an early stage. It can be used as first line method in assessing the nature of lesion.

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 & 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.

Cytodiagnosis of extramedullary plasmacytoma

Extramedullary plasmacytoma is a rare malignancy constituting 3-5% of all plasma cell malignancies. Nearly 80% occurs in the upper autodigestive tract, while other sites include gastrointestinal tract, lymph node, bladder, CNS, breast, thyroid, testis, parotid and skin. The utility of FNAC in the diagnosis of plasmacytoma has only been elaborated in few cases to date.A 50 years old man presented to our hospital with a mass on the chest wall measuring 3x2x2cms for one month. A cytological diagnosis of plasmacytoma was made which was confirmed on histopathology.

Utility of FNAC in salivary gland swellings with clinico-histological correlation in a tertiary care hospital

Utility of FNAC in salivary gland swellings with clinico-histological correlation in a tertiary care hospital - JDPO- Print ISSN No: - 2581-3714 Online ISSN No:- 2581-3706 Article DOI No:- 10.18231/j.jdpo.2020.032, IP Journal of Diagnostic Pathology and Oncology-IP J Diagn Pathol Oncol

Utility of FNAC as a Diagnostic Role in Lymphadenopathy Cases of Different Age Groups

Utility of FNAC as a Diagnostic Role in Lymphadenopathy Cases of Different Age Groups

A Study of Diagnostic Utility of FNAC and Mammography in Breast Lumps

A Study of Diagnostic Utility of FNAC and Mammography in Breast Lumps

A study on the utility of ultrasound guided fnac in lung lesions

Introduction: Primary confirmation of Lung lesions by Ultrasound guided FNAC. It is useful for to differentiate Infective, Benign and Malignant lesions of lung. AIM: To study and confirm Cytological features of different types of lung lesions. 2. To assess the overall utility of FNAC in lung Pathology. Methods: Present study done over a period of two years, from Feb 2017- Jan 2019. During the above period 57 cases are studied, in the Department of pathology, Govt Medical College, Kadapa, AP. The above cases were categorised based on cytological features obtained by FNAC. Materials required for FNAC – 10 ml sterile disposable syringe with 25-22G needles. Suitable fixative is Isopropyl Alcohol. Alcohol fixed slides taken up for H&E staining. Results: Ultrasound guided FNAC of the Lung were performed on 57 cases. Out of 57 cases 48 (84.21%) cases were Primary neoplastic lesions, which are Squamous cell carcinoma, followed by large cell carcinoma 7 (12.28%) cases, Adeno carcinoma 2 (3.50%) cases.

Role of FNAC in evaluation and diagnosis of head and neck lesions: A retrospective study at tertiary care center

Background: FNAC is very simple, quick, cost effective and minimally invasive technique used to diagnose different type of swelling occur in lymph node, thyroid gland, soft tissue and salivary gland in head and neck region. Aim and Objective: To evaluate role and utility of FNAC in diagnosis of palpable head and neck lesionsMethods: Our study has included 260 patients presented with palpable swelling in head and neck region at our hospital from January 2017 to January 2019. FNAC procedure has been and smears are stained with H & E stain and pap stain. Cyto histopathological correlation were done wherever possible. Results: Out of 260 cases, Lymph node (57.69%) is most common site of aspiration where TB lymphadenitis (53.33%) was most common diagnosed lesion. Thyroid gland lesions constitute 64 cases (24.61%) followed by salivary gland lesions 26 cases (10%), soft tissue lesions 16 cases (6.15%). FNAC was inconclusive in 7 cases (2.69%).Conclusion: FNAC serves as a guide to appropriate therapeutic management whether to locally excise a benign tumor or plan radical surgery and helps as an adjunct to histopathology.

Utility of FNAC in the Diagnosis of Bone Tumors

Utility of FNAC in the Diagnosis of Bone Tumors

To Evaluate Diagnostic Utility of FNAC for Palpable Thyroid Lesion and Comparison with Ultrasound and Thyroid Profile

To Evaluate Diagnostic Utility of FNAC for Palpable Thyroid Lesion and Comparison with Ultrasound and Thyroid Profile

Retrospective analysis of head and neck masses diagnosed by cytology in a tertiary care centre

Introduction: Fine Needle Biopsy of head and neck masses as a minimally invasive technique is particularly suitable in this sensitive area where an incisional biopsy can cause problems. A cytological diagnosis of a non-neoplastic lesion or confirming suspected metastatic or recurrent tumor can obviate the need for surgery. FNAC can effectively distinguish between benign and malignant cystic lesions of the head and neck. Aim: The aim of this study is to categorise the various head and neck lesions diagnosed by cytology and to assess the diagnostic utility of FNAC. Materials and Methods: All the cases of head and neck masses diagnosed by cytology during the period of one year were analysed. Age and sex distribution was noted. Lesions were mainly categorised into lesions of thyroid, salivary gland and lymph node. Each group were then subcategorised into various groups depending upon the neoplastic and nonneoplastic nature. In some cases histopathologic correlation was done. Results: Thyroid lesions formed 61.5 % (475) of the total number of head and neck masses. 99% of the cases were benign lesions. Lymphadenopathies formed 34 % (262) of the total number of head and neck masses. Most common diagnoses were reactive lymphadenitis (43.5%) followed by granulomatous lymphadenitis (12.5%). Salivary gland lesions formed 4.5 % (35) of the total number of head and neck masses. Sialadenitis was the most common among the benign lesions (40 %) and pleomorphic adenoma was commonest among neoplasms (37 %). Conclusion: FNAC is a reliable, safe, cost-effective and minimally invasive procedure. FNAC can be advised as a primary diagnostic tool.

Clinicocytomorphological spectrum of palpable Lymphadenopathies in Kumaon region of Uttarakhand

Background: To study the cytological patterns of lymphadenopathy in our setting to determine the demographic parameters and the clinical presentation of the various causes of lymphadenopathy in adults and children and the diagnostic utility of FNAC in the evaluation of lymphadenopathy. This would help the doctors attending patients in this region to have a basic idea about prevalence of different clinical profiles of palpable lymphadenopathy for easier case detection and better therapeutic outcome. Material & Methods: FNAC was performed using a 22 or 23 gauge needle attached to 20 ml disposable plastic syringe mounted on a syringe holder for single hand grip was used, Slides will be fixed in 95% ethyl alcohol for cytological evaluation using Papanicolaou staining (PAP) and Hematoxylin and Eosin (H&E) stain. Smears are kept air-dried for May–Grunwald–Giemsa staining and Ziehl Neelsen stain. Results: Out of 665 cases, 372 cases (55.9%) were males while 293 cases (44.1%) were females. Male to female ratio is 1.3: 1. Out of total, 76.1% cases were benign and 23.9% cases were malignant. Keywords: FNAC, Lymphadenopathy, Reactive, Granulomatous, Kumaon

Utility of FNAC in the Clinicopathologic Evaluation of Benign Thyroid Lesions

Background: Thyroid swellings are common clinical presentations in the male and females, majority of them are benign in nature and do not require surgery. Fine needle aspiration cytology in the diagnosis of thyroid lesions is an easy and cost-effective method. Aim of this study was to assess the effectiveness of FNAC in the evaluation of benign thyroid lesions by clinical, histopathologic analysis and compare the consistency of the results with the literature. Materials and Methods: Over a period of 3 years prospective study done from January 2001 to December 2003 in the cytopathology department, Sri Venkateswara Medical College, Tirupati, Andhra Pradesh. Two hundred and fifty (250) cases of palpable and clinically benign thyroid lesions were analyzed by fine needle aspiration, preceded by thorough clinical evaluation. Out of these 250 cases only 65 patients under went surgical excision and these were available for histopathological correlation. Staining techniques used are Haematoxylin and Eosin and May-Grun Wald Giemsa stain. Results: out of 250 cases, 65 were available for histopathological correlation. Among which 10 had malignant, which were excluded from the present study. Out of 55 benign thyroid lesions 20(36.3%) cases were Multinodular goiter, 17(30.9%) were Follicular adenoma, 10(18.1%) were Hashimoto’s thyroiditis. Sensitivity, specificity, positive predictive value, negative predictive values were 90,100,100 & 98.21 % respectively. Finally accuracy rate was 98.46%. Conclusion: Fine needle aspiration cytology is a simple, cost effective, rapid to perform procedure with high degree of accuracy and is recommended as first line investigation for the diagnosis of thyroid lesions.

Editorial: Advances in Diagnosis of Hematological Disorders

Over the last two decades, the advances in diagnostic techniques have greatly enabled to dissect the various hematological disorders, especially in the field of hemato-oncology into various subtypes based upon the various characteristics of cell surface antigens, glycoproteins, intracytoplasmic antigens which can be easily identified by flow cytometric studies. Identification of various mutations by various cytogenetic studies starting from conventional cytogenetics, FISH ,qualitative and quantitative PCR studies have provided the correct diagnosis, prediction of prognosis and monitoring of therapy. These techniques have helped in identifying the minimal residual disease. In solid tumors, use of immunohistochemistry is commonly used for characterization and typing of various malignancies in addition to cytogenetics and molecular studies. Immunohistochemistry technique is simple, cost effective and enables the pathologist for correct diagnosis and currently being used in all centers. Development of techniques such as micro array is an additional tool for better characterization, subtyping of various disorders etc. Presently, various blood disorders are classified not only on morphological features alone but by multiple parameters based upon on natural course of the disease, prognostic factors, molecular diagnostic techniques and therapeutic responses. Various international classifications have been used for classification such as French American & British (FAB) , World Health Organization (WHO) etc. These classifications are being reviewed and updated periodically to enable the clinicians for correct diagnosis, and to plan the current therapies to improve the long term survivals. In the present symposium the use of flow cytometry in various hematological disorders [1] along with utility of FNAC, lymphnode biopsy, immunohistochemistry and molecular diagnosis in pediatric lymphomas [2] and present status of childhood myelodysplatic syndrome [3] have been reviewed and each manuscript provides the state of art information. Flowcytometry provides the characteristics of any subtype single cells such as red cells, white cells & platelets. The cells of the interest are labelled with fluorescently conjugated moncolonal antibiodies. The flurochrome gets activated as these cells pass through a laser beam. The emitted flurorescene is measured in two scatters; forward and side scatter [4]. Using the above principals flowcytometry has helped to provide definitive diagnosis of various red cells, white cells and platelet disorders. Flowcytometric studies have not only helped in sub classification of Glanzmann’s thrombocytopenia into three subtypes but have helped in carrier detection also. Immunophenotyping has become standard for diagnosis, predicting the prognosis and helping in planning the treatment of leukemia and lymphoma. At some centers it is also being used to monitor the minimal residual disease (MRD) with the help of aberrant leukemia associated immunophenotype. Expression of CD 56 along with high expressions of CD-34 are predictors of poor prognosis in acute myeloid leukemia (AML), while in acute promyelocytic leukemia expression of CD-2 and CD-56 and presence of short PML-RARA transcript are poor prognostic factors. Other molecular techniques which are being employed for further characterization of leukemia include mutation analysis by ARMS-PCR ,PCR and restriction analysis, PCR and sequencing. All these techniques are currently being used at leading centers in the country for accurate diagnosis and for monitoring of therapy. Diagnosis of lymphoma starts from the clinical suspicion to fine needle aspiration cytology and ending with molecular diagnosis. The advent of targeted therapy has improved the five year survival in lymphomas of childhood to 70–80 %, only when V. P. Choudhry (*) Sunflag Pahuja Centre for Blood Disorders, Sunflag Hospital, Sector 16 A, Faridabad, Haryana 121002, India e-mail: vedpchoudhry@yahoo.co.in

Fine‐needle aspiration cytology diagnosis of metastatic nonhaematological neoplasms of the breast: A series of seven cases

Metastatic neoplasms of the breast are rare. Mammary metastases as the initial presentation are even more infrequent and can simulate a primary malignancy clinically and radiologically. Recognition of metastatic tumors in the breast is important because it would prevent unnecessary mutilating surgery and would lead to appropriate treatment of the primary tumor. There is a broad variety of cytological appearances reported about primary tumors and few reports about secondary breast malignancies, specially diagnosed by FNAC. This study was carried out to examine the clinical and cytomorphologic features of metastatic breast tumors found in 12 de Octubre University Hospital during a period of 20 years. It confirms the utility of FNAC and describes findings that can help in the differential diagnosis that sometimes can be very difficult. Seven cases of nonhematological metastatic neoplasms of the breast were identified from the files of the Department of Pathology of the 12 de Octubre University Hospital from a total of 64,000 aspirates. We included only metastatic tumors from extramammary nonhematological neoplasms. There were nine cases of hematological metastatic neoplasm that were excluded. They were diagnosed with FNAC and confirmed by histopathology, with at least three years of follow up. The breast lump was the first manifestation of malignancy in one case of synovial sarcoma. The other six cases had been previously diagnosed of cancer. These included one malignant melanoma, one alveolar rhabdomyosarcoma, one mixed müllerian tumor, one medullary carcinoma of thyroid, one colonic adenocarcinoma, and one gastric adenocarcinoma. The period of time between primary tumor and metastases ranged from one month to eight years. An accurate cytologic diagnosis was made in all the cases. Immunocytochemistry was available but diagnosis could be made with cytomorphology alone in the seven cases. Fine-needle aspiration cytology is an excellent first line diagnostic modality that is particularly informative when clinical previous data are known. If metastatic disease is suspected, the material obtained by FNAC may provide a definitive diagnosis and prevent open surgical biopsy or mastectomy. We concur with previous reports that FNAC is a reliable, rapid, secure, and cost-effective approach to the diagnosis of palpable metastatic breast tumors.