ABSTRACT
Background: Advances in medical technology has revolutionized patient care. Ultrasound (USG)-guided fine-needle aspiration cytology (FNACs) is enlarging the realm of diagnostic cytology. This merger has increased the diagnostic accuracy especially in inaccessible body sites like the gall bladder (GB) masses. Impalpable, deep, and small lesions are now no longer a dilemma, thanks to image-guided FNACs. Objectives: The objective of the study was to study the ultrasound-guided FNACs of GB masses for a 10 year period and evaluate the efficacy of ultrasound-guided FNACs in GB lesions. Materials and Methods: USG-guided FNACs were collected and analyzed over a 10 year period (2007–2016) in the Department of Pathology North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. This is a retrospective study and is in accordance with the ethical standards as laid by the Helsinki Declaration, 2000. Descriptive statistics were used for analysis. Results: The age ranges from 27 to 83 years and the mean age was 53.2 years. The majority were females which constituted around 94.3% (50) and males constituted around 5.7% (3). Out of all the adequate cases (42 in number) that were evaluated, 37 (88%) were malignant and 5 (12%) were benign and inflammatory; 11 out of 53 cases (20.8%) were inadequate. Conclusion: Although FNAC is established as a reliable diagnostic method, our study of 10 years has further proven that this test has stood the test of time, and with our high diagnostic yield and in the hands of a dedicated radiologist and cytopathologist, it will prove to surpass its expectations.
ABSTRACT
A 5 year old boy with a history of fall from a height of about 4 feet, presented after one week with swelling, watering and discharge of the right eye. He had severe conjunctival chemosis with superior displacement of the globe. Computed Tomography (CT) showed a linear low attenuation tract in the right orbit extending from the inferolateral wall up to the left uncinate process of the ethmoid bone with increasing Hounsfield unit after 10 days. The parents did not agree for early exploration. After 10 days an exploration was done and a large linear and irregular wooden foreign body (FB) measuring 4.5 x 1.5 cm2 was removed from the right orbit and a smaller one from the nasal cavity. Four weeks post surgery, his vision was 6/9 in the right eye with the eyeball in the normal position. This case was challenging because of the late presentation, parents not agreeing for early exploration, difficulty in diagnosing by CT and a large and very deep penetrating FB.