ABSTRACT
Background: FNAC is a very useful procedure for the diagnosis of various hepatic lesions. USG-guided FNAC offers good accuracy without major complications and minimal intervention at less cost, the only major contraindication being severe hemorrhage & vascular lesion. Although imaging techniques have helped greatly with the early and accurate diagnosis of liver abscess, the appearances are often non-specific. There is some overlap between the radiologic features of liver abscesses, HCC and metastases too. Tumors, primary or secondary, may undergo extensive necrosis, with the resultant radiologic image of the cavitatory neoplasm mimicking abscesses; abscesses are accompanied by proliferative reactive changes, making radiologic differentiation from a neoplastic process almost impossible. In these situations, FNAC plays an essential complementary role. Material and Methods: All patients, irrespective of age and sex, who presented to the hospital from January 2011 to June 2013 with nodular liver lesions diagnosed clinically or radiologically, with normal range of prothrombin time (International normalized ratio- INR) were subjected to fine needle aspiration under radiological guidance. Smears made were stained with toluidine blue for rapid onsite evaluation (ROSE) for adequacy of diagnostic material. Hematoxylin and Eosin (H&E), Giemsa stain and Papanicolaou stain were done as per protocol. Results: Of the total aspirates, 22.5% (36 cases) were benign, 63.75%(102) were malignant, 13.75% (22) non-representative as they contained only few scattered hepatocytes and blood, which was inadequate for final opinion. FNAC was of help in diagnosing liver lesions successfully in 86.25% of cases. Conclusion: USG guided FNAC has proved to be a fairly precise & minimally invasive technique in diagnosis of hepatic lesions as the procedure is simple, economical and easily available. The results are obtained quickly without serious complications related to the procedure. In a nutshell, FNAC is a highly accurate diagnostic tool with high sensitivity & specificity.
ABSTRACT
Ulcerative colitis is a chronic inflammatory disease of unknown etiology characterized by periods of remission and relapses. This study has been carried out in a group of North Indian patients where the disease has shown an increasing prevalence and frequent relapses. Hence, there is a need to predict relapse for better management and to reduce morbidity. To assess the importance of biological and histological parameters in predicting relapse when the disease is in quiescent phase. A prospective study of twenty-six patients with quiescent ulcerative colitis was carried out in Dayanand Medical College and Hospital, Punjab. Only patients with clinical and endoscopic remission at the time of screening visit were included. Hemoglobin, erythrocyte sedimentation rate [ESR], C- reactive protein [CRP] and serum Interleukin-6 [IL-6] levels were measured. The baseline colonoscopic mucosal biopsies were retrieved and studied. Follow-up was conducted for one year at monthly interval or earlier if relapse occurred. Fifteen out of twenty-six patients [57.69%] had evidence of clinical relapse during the follow-up. Hemoglobin, ESR, CRP and Il-6 levels were not found to be significant predictors of relapse. Increased number of eosinophils and neutrophils in the lamina propria were observed to be associated with significantly higher relapse rate. A higher risk of relapse in patients with quiescent colitis can be predicted by the presence of increased number of eosinphils and neutrophils in the lamina propria