ABSTRACT
Background: In India a large number of patients have been suffering from breast cancer and with each passing year, the number is increasing. Fine needle aspiration cytology (FNAC) is an inexpensive, simple and highly accurate means of diagnosing both benign and malignant breast lesions. The procedure provides a rapid and non-morbid diagnosis before the operation which enables the patient and the surgeon to discuss and plan therapeutic alternatives in a rational atmosphere. Aims & Objective: To find out the common causes of breast lesions, to evaluate role of FNAC in the diagnosis of them, their risk categorization for development of cancer and to conduct cytohistological correlation wherever possible. In addition the sensitivity, specificity, positive & negative predictive value of FNAC in breast lesions are carried out. Material and Methods: The present study was carried out on 407 patients who presented with palpable lump in the breast in the Department of Pathology, Government Medical College, Ahmedabad over a period of one year. FNAC slides were examined under light microscope after H&E, Papanicolaou & May-Grunwald –Giemsa staining and were categorized as Unsatisfactory sample, inflammatory, Benign, Atypical probably benign, suspicious probably malignant and Malignant. Cytological Diagnosis was correlated with histological findings wherever possible. Results: Cytologically, the lesions were categorized in, Unsatisfactory 28 (6.87%), inflammatory 64 (15.72%), Benign 229 (56.26%), Atypical probably benign 8 (1.96%), suspicious probably malignant 8 (1.96%) and Malignant 70 (17.19%). Out of these 407 cases, 161 cases (39.55%) were available for histopathological examination. The most common benign lesion in this study was fibroadenoma 178/229 (77.72%) and the most common malignant lesion was infiltrating ductal carcinoma 51/70 (72.85%). The sensitivity and specificity of FNAC came out to be 98.08%, 98.86% respectively& positive & negative predictive value of FNAC were 99.35% &96.66% respectively. Conclusion: The FNAC of breast is cheap, safe and highly accurate preoperative method for diagnosis of breast lesions. Preoperative categorization of breast lesions is utmost important for management of the patient.
ABSTRACT
Background: Plasma cell leukemia (PCL) is a rare, yet aggressive plasma cell (PC) neoplasm, variant of multiple myeloma (MM), characterized by high levels of PCs circulating in the peripheral blood. PCL can either originate de novo (primary PCL) or as a secondary leukemic transformation of MM (secondary PCL) and is characterized by circulating PCs >2×109/L in peripheral blood and a peripheral blood plasmacytosis >20%. Aims & Objective: Present study was undertaken to analyze the main clinical & pathological features of PCL. For diagnostic purpose the morphological appearances and confirmation by immunophenotyping are emphasized rather than more sophisticated testing methods that may not be widely available. Material and Methods: A descriptive study was carried out in the department of Pathology, in a tertiary care teaching hospital, Ahmedabad, India during year 2009-2013. We investigated the important clinical characteristics, pathological, biochemical & radiological features, immunophenotype, & prognostic factors of 7 patients of PCL. Results: Common clinical features at diagnosis were anaemia, renal insufficiency, bone pain, splenomegaly or hepatomegaly. Anaemia, leucocytosis, thrombocytopenia & plasmacytosis were seen in peripheral blood. Plasma cell marker - CD 38 & CD 138 were expressed in all cases. Serum β2-microglobulin, serum LDH were increased & serum albumin was decreased in all 7 cases & were associated with poor prognosis. The median survival time from diagnosis was 9 months. Conclusion: Plasma cells have characteristic morphological features which can be easily identified on peripheral blood & bone marrow examination.CD 38 & CD 138 are excellent plasma cell markers. Increased serum β2-microglobulin & serum LDH & decreased serum albumin are potent poor prognosis factors. PCL is aggressive neoplasm with poor response to chemotherapy & low median survival time from diagnosis.
ABSTRACT
Background: Cervical lymphadenopathy is a common clinical presentation across patients of all age group. The aetiology may range from a benign nonspecific inflammation to lymphoproliferative disorders and metastatic malignancy. Aims & Objective: The present study was undertaken to study non neoplastic and neoplastic lesions of enlarged lymph nodes by Fine needle aspiration cytology (FNAC) in patients presenting with cervical lymphadenopathy referred to cytopathology department from the OPD/IPD of Civil Hospital, Ahmedabad over a period of two years (November 2011 to November 2013). Materials and Methods: A total of 2018 patients were subjected to FNAC of cervical lymph nodes over two years period (November 2011 to November 2013). Since in 113 patients, either the aspirate was inadequate or the opinion equivocal, the remaining 1905 cases were analysed. Results: Overall tuberculous lymphadenitis was the most common finding (898/1905, 46%), followed by reactive hyperplasia (624/1905, 33%). Malignant pathology accounted for 16% (306/1905) of cervical lymph node enlargement, most of which was due to metastatic squamous cell carcinoma (179/306, 58%). Conclusion: FNAC is an excellent first line of investigation and when used with a proper combination of experience and diligence, it can efficiently help at arriving in exact diagnosis.