Eosinophilic Gastroenteritis Presenting as Small Bowel Obstruction.

Eosinophilic gastroenteritis is a rare disease of unknown etiology characterized by eosinophilic infiltration of bowel wall to a variable depth. A 38 year old female presented with loose stool and vomiting since 3 days. She gave history of pain abdomen and weight loss since six months. Barium study revealed ascending colon stricture just proximal to the hepatic flexure ? malignant. A colonic biopsy was done, which was reported as edematous colonic mucosa with mild increase in eosinophils. Intra-operatively, a dense long segment stricture was found in the ascending colon extending to the caecum which warranted a right hemicolectomy. Histopathology revealed dense infiltration of eosinophils in the entire thickness of ileal and caecal wall. The diagnosis of eosinophilic gastroenteritis was made. Patient responded well to steroids. The case is being reported to highlight its rarity due to caecal involvement, presentation as intestinal obstruction and missed diagnosis on endoscopic biopsy.

Study of Cervical Pap Smears in a Tertiary Hospital.

Cancer of the cervix is the third most common cancer in women. In India and other developing countries cervical cancer is the leading cause of morbidity and mortality. Cancer of cervix is readily preventable, and can be diagnosed at the pre-invasive stage with adequate and repetitive cytological screening with Papanicolaou (Pap) smears. Objectives: This is a retrospective study aimed to evaluate all previously conducted cervical smears examined at a teaching tertiary hospital during a two year period. Methods: Detailed clinical data and Pap smear cytology reports were obtained and data noted in a structured proforma. All the smears were reported as per the 2001 Bethesda system. Results: A total of 560 Pap smears were examined. Maximum number of patients was in the age group of 31 – 40 years (fourth decade). There were 32 unsatisfactory or inadequate samples (5.71%). A total of 498 smears were reported as Negative for Intraepithelial Lesion or Malignancy (NILM), of which 95 (16.96%) showed normal cytological findings and 403(71.96%) were inflammatory. Out of a total of 433(77.32%) abnormal Pap smears, only 30(6.92%) cases were reported to have epithelial cell abnormality. The 30 abnormal cases comprised of 13 cases with ASC-US, 11 cases of LSIL, two cases of HSIL, three cases of invasive squamous cell carcinoma and one case of adenocarcinoma cervix. Conclusion: Premalignant and malignant lesions of cervix can be diagnosed easily by Pap smears. The epithelial cell abnormality rate in our study was 5.36%.

Cytodiagnosis of salivary gland lesions.

Objectives: The purpose of the present study was to analyse the relative frequency and distribution of different salivary gland lesions,to evaluate the diagnostic accuracy and efficacy of FNAC in diagnosing these lesions and to correlate the FNAC finding with histopathological diagnosis wherever possible. Method : During the five year period of study ,hundred cases were studied .FNAC was done in eightyone cases and sixtynine cases were available for histopathological examination.Cyological and histological correlation was possible in fifty cases.For cytological examination smears were stained with Leishmann,H & E and PAP. Result : The results were analysed statistically by sensitivity,specificity ,positive and negative predictive values.In our study there was equal distribution of salivary gland lesion among both sexes.Maximium number of lesions were found in parotid followed by submandibular gland.The overall diagnostic accuracy of FNAC in diagnosing the malignant lesions was 90%. Conclusion: The diagnostic accuracy and low false positive and false negative diagnosis obtained in this study warrants FNAC to be utilized as first line diagnostic procedure in the evaluation of patients with suspected salivary gland lesions. Histopathological diagnosis however,still remains the gold standard.