Peripheral lymphadenopathy in children, comparison of fine needle aspiration cytology with open biopsy

To compare the results of Fine Needle Aspiration Cytology [FNAC] with open biopsy in cases of Peripheral Lymphadenopathy. A comparative study. Department of Paediatric Surgery and Department of Pathology, Nishtar Medical College and Hospital, Multan from January 2004 to September 2004. Patients presenting with Peripheral Lymphadenopathy in Paediatric Surgery out patient department were included in study. Relevant history and clinical findings were entered in performa and patients were submitted to investigations like FNAC and open lymphnode biopsy, after getting consent, on OPD basis. Results of both FNAC and histopathology in 54 patients were available for comparison at the end of study. FNAC showed tuberculosis in 36 [66.67%], lymphoproliferative process in 16 [29.63%] and poor yield in 2 [3.71%] cases. Whereas open lymphnode biopsy on histopathology confirmed tuberculosis in 42 [77.78%], Hodgkins lymphoma in 4.[7.42%], Non Hodgkins in 6 [11.13%] and reactive hyperplasia in 2 [3.71%] cases. Sensitivity of FNAC in tuberculosis was 85.7% with a specificity of 100% in cases of tuberculosis while it was 71.5% in cases of lymphomatous process with an overall sensitivity of 78.5% in peripheral lymphadenopathy. In our setup lymphnode biopsy should be performed in all suspected cases to avoid long term morbidity and mortality especially in clinically malignant illnesses

Anorectal malformations

A total of 1326 patients with anorectal malformations were admitted to the department of paediatric surgery, Nishtar Medical College, Mutton, during January, 1984 to June, 1993. Amongst them, 990 were males and 336 were females; 862 patients had high [including intermediate] and 464 had low variety of anorectal malformations [ARM]. Two hundred and thirty seven [237] i.e. 17.88% babies had associated anomalies. Low variety cases were treated either by dilatations [77] or anoplasty [271] or cut-back [83] or anal transpositioning [33]. Patients with high variety underwent preliminary colostomy. A total of 102 pullthroughs were performed. Posterior sagittal anorectoplasty was performed in 61 cases. The remaining 41 cases underwent abdomino-sacro-parineal and sacro-perineal pullthroughs. Post-colostomy complications were seen in 115 out of 828 cases and pullthrough operation was followed by various complications in 33 patients. Mortality following pullthrough was 1.9%. Posterior sagittal anorectoplasty is safe and effective method of dealing with high and intermediate variety of anorectal malformations