Uterine torsion of 90 degrees: case report

Uterine torsion is defined as a rotation of uterus more than 45 degrees along its long axis. However, a pathologic rotation of the uterus beyond 45 degrees-torsion of the entire uterus-is rarely seen in obstetrical practice, authors report a case of torsion of the uterus by 90 degrees. The patient, a 30-year-old gravida 3 para 2 at 37 weeks’ gestation with a singleton pregnancy, her prior obstetrical history included two uncomplicated term vaginal deliveries, and the current pregnancy had been uncomplicated until the date of presentation was admitted to the obstetrical unit  with  labour at 37 weeks 5 days ,on obstetric examination the patient was in labour with transversal presentation of the fetus so an emergency caesarean section (CS) was carried out for. At the time of CS, the diagnosis of uterine torsion of 90 degrees was made. After the delivery of the baby, uterus returned to anatomical position and the torsion corrected spontaneously. The patient recovered and was discharged home with her baby on the third postoperative day. Uterine torsion is an infrequently reported and potentially dangerous complication of pregnancy that occurs mainly in the third trimester.

Primary omental gangrene presenting as acute abdomen

Primary omental gangrene is a very rare but important cause of an acute abdomen. We came across a case of an acute abdomen which was taken up for emergency laparoscopic appendicectomy. On laparoscopy, torsion of the free part of the omentum, leading to distal gangrene, was found. Intraoperative diagnosis of primary omental gangrene was made. Preoperative diagnosis of this condition is difficult. Through our case report, we want to highlight about this rare cause of pain abdomen as knowledge of this pathology is important to the surgeon because it mimics the other common causes of the acute surgical abdomen.

Utility Of Squash Cytology In Diagnosing Cns Lesions

BACKGROUND: The different modalities used for intraoperative consultation of CNS lesions are squash smear cytology, frozen sections & fluid cytology. The intraoperative diagnosis of squash cytology enables the surgeon to take decision regarding treatment. Squash technique requires small sample size, needs minimal technical equipment, is less expensive and gives better morphological detail. The present study was taken to assess the diagnostic accuracy of intraoperative squash cytology of CNS lesions. MATERIALAND METHODS: It is a prospective study conducted for one and half year in the department of Pathology. All lesions of brain and spinal tract comprised the study group. The stain used for squash cytology was rapid haematoxylin and eosin. The squash diagnosis was compared with gold standard histopathology. RESULTS: Total 96 cases were studied. Male to female ratio was 1.13:1. The overall concordance rate was 89.13% (including both complete and partial agreement cases). Good correlation was noted in diffuse astrocytoma (100%) and least correlation was noted in anaplastic oligodendroglioma (28.5%). CONCLUSION: Squash cytology is a rapid and simple technique for intraoperative diagnosis with high overall accuracy.

Accuracy and utility of intraoperative squash smear cytology in neurosurgical practice

Background: Intraoperative squash smear cytology (ISSC) is a rapid and reliable diagnostic tool that provides guidance to the neurosurgeon for precise targeting of the lesion and its surgical resection. It also helps the surgeon to modify the approach at surgery at times based on the preliminary impression of the lesion on cytology. Objectives: The present study was undertaken to assess the utility of ISSC for cytomorphological diagnosis in a resource-limited setting. The accuracy of the method was assessed by correlating cytological diagnosis with histopathological diagnosis. Materials and Methods: A total of 106 cases of central nervous system (CNS) tumors were examined by squash smear technique for cytological diagnosis which were then compared with histopathological diagnosis provided on paraffin-embedded sections. Results: Cytohistological correlation was available in all the 106 cases included in the study. Of these 106 cases, 96 were concordant with the final histopathological diagnosis, while 10 were discordant. Thus, complete correlation with final histopathological diagnosis was observed in 90.56% of cases. Conclusion: Intraoperative squash smear cytology proved to be a simple, rapid, and inexpensive technique for intraoperative consultation of CNS tumors in the absence of frozen section facility.

Utility Of Squash Smear Cytology In Intraoperative Diagnosis Of Central Nervous System Lesions

INTRODUCTION- The accurate diagnosis of disease tissue is elementary to the precise diagnosis and proper management of central nervous system lesions. Although histopathology is gold standard, in neurosurgical practice intraoperative cytological diagnosis is now well established and emerge as a dependable standalone diagnostic tool. The rapidity at which sufficient preliminary information for optimal surgery is provided to neurosurgeons, help him take crucial decision regarding patients management. Overall soft nature of CNS lesions ,best suited for smear cytology, which in fact is the major restriction while performing intraoperative Frozen section consultation. So the present study was done to assess the utility of squash cytology in intraoperative diagnosis of CNS lesions. MATERIALAND METHODS-In this prospective study 142 patients with clinical diagnosis of CNS lesions were studied. Patients clinical and radio imaging findings were taken into account while evaluating squash smear preparation. Squash diagnosis was latter correlated with final histopathological diagnosis . RESULTS– Out of 142 cases, cytological diagnosis was offered in 136 cases. In 6 cases no opinion was possible on cytology. Cyto-histological correlation was seen in 127 out of 136 cases, 9 cases remained discordant. Thus overall diagnostic accuracy of squash cytology in intraoperative diagnosis of CNS lesions in our study was 93.38%. CONCLUSION- Intraoperative squash cytology is easy ,rapid, reliable and cost-effective technique for neurosurgical consultation with fairly high accuracy. Knowledge of clinicoradiological details help to further improve the diagnostic accuracy

Recent application and outlooks of fluorescent diagnostic techniques in clinic / 医疗卫生装备

Current problems and demands of intraoperative diagnosis were presented. Basic theories and classification of fluorescent diagnostic techniques were introduced, and the advantages compared with traditional pathology were also analyzed.Current research and application status of fluorescent diagnostic techniques were summarized and analyzed in two aspects:spectroscopy analysis and image analysis,and it was indicated that fluorescent diagnosis was important for research and clinical application.Furthermore,future development directions of fluorescent diagnostic techniques were analyzed,and improving accuracy and combining diagnosis with clinical treatment were growing trends in fluorescent diagnostic techniques.

Role of squash smear technique in intraoperative diagnosis of CNS tunmors.

Background: Neurosurgical practice frequently requires intraoperative consultation to optimize surgical procedure. Frozen section and Squash smear cytology can offer the same. As brain tissue is friable & predisposed to show ice crystal artefacts, frozen section is often difficult to interpret. Squash smear examination provides good cytological details to offer diagnosis in most cases except where anatomical correlation is needed. Present study was undertaken to evaluate the efficacy of Squash smear in absence of frozen section facility. Aims & Objective: To evaluate the value of Squash smear cytology for rapid intraoperative diagnosis in CNS lesions and its correlation with final histomorphological diagnosis. Material and Methods: Total 35 case of CNS tumours were examined by squash smear technique for cytomorphological analysis followed by histomorphological correlation on paraffin section. Results: Complete correlation with histomorphological findings was observed in 82.35% of cases. Complete correlation was observed more with glial neoplasm. Conclusion: Squash smear preparation proved to be a simple, inexpensive and rapid technique for intraoperative consultation of CNS tumours and can be effectively utilized as a diagnostic tool for intraoperative diagnosis in absence of frozen section facility.

Study of Tumors by Imprint Cytology.

Introduction: The intraoperative diagnostic accuracy of a tumor is an essential part in patients’ work-up. If the surgeon finds it malignant during surgery, widespread dissection including lymph nodes can be done simultaneously and thus preventing the need of second surgery. Objective: The aim of this study is to determine the accuracy of imprint cytology (IC) for the intraoperative diagnosis in patients with tumor and its usefulness in low facility set up. The diagnostic accuracy of IC has been compared with histopathological examination (HPE), the gold standard diagnostic. Material and methods: This study included 55 patients presenting as a tumor mass of different organs with clinically diagnosed as malignant. In the operation theater, smears for IC were made from cut surfaces of tumors. These ware stained with Papanicolaou stain and hematoxylin and eosin (H&E) stain. The results of IC were compared with HPE using H&E staining. Results: This study included tumor specimens of five from lymph nodes, three from cervix, 31 from breast, four from gastrointestinal tract (GIT), three from parotid gland, five from ovary, one from uterine corpus and three from skin. Table 3 shows categorization of benign and malignant tumors. Locally infiltrative tumors have been shown in benign tumor list. The result of my study is as follows: IC for benign and locally infiltrative tumors gave 100% accuracy and that for malignant tumor it was 34/35 (97%) accuracy. The only case which was misdiagnosed as reactive lymph node (LN), which was turned out to be as Hodgkin’s lymphoma. Conclusion: Intraoperative IC is a useful method for evaluating tumors. The simplicity of technique can be used at small centers with low facility set-up.

Training pathologist's ability of rapid intraoperative diagnosis of central nervous system tumors / 中华医学教育探索杂志

Training pathologist's ability of rapid intraoperative diagnosis of central nervous system tumors is of great importance to decide ranges of clinical operation and to promote pathological diagnosis level.Pathologist made frozen section,fully understood the clinical data and operation,mastered correct method of slice reading,learned comprehensive analysis,and exercised psychological quality thus to make rapid intraoperative diagnosis correctly.