Comparative study of fine needle aspiration cytology and tru-cut biopsy in the diagnosis of breast lesions

Background: Breast carcinoma is one of the most researched cancers across the world. FNAC is often used as a first priority investigation in patients with breast lump. Tru-cut biopsy is useful in preoperative knowledge of prognostic parameters with the help of IHC markers ER, PR, Her2 neu. The technique is reliable, simple and reproducible which can be used even in resource poor countries like India. To analyze the sensitivity, specificity, positive predictive values and negative predictive values and the diagnostic accuracy (efficacy) of fine needle aspiration cytology and trucut biopsy. Methods: The study included 82 patients presenting with palpable breast lesions. All patients underwent FNAC followed by Tru-cut biopsy under ultrasound guidance. ER, PR, HER2 Neu, cytokeratin immunostaining was done in malignant cases. The data collected analysed statistically. Results: The sensitivity, specificity, PPV, NPV of FNAC were 96.61 %, 95.65 %, 98.28%, 90.91% respectively and that of trucut biopsy were 100%, 100%, 100%, and 100 % respectively. Conclusions: Out of total 82 patients, maximum no of cases (57) were duct carcinoma accounting 69.50% on FNAC and Tru-cut biopsy. IHC was done in all carcinomas. Maximum (46 cases) were luminal type. The present study emphasizes that tru-cut biopsy can serve as confirmative diagnostic tool over FNAC and provides information regarding prognostic factors and treatment modalities based on IHC markers.

Sonographic evaluation of thyroid nodule based on thyroid imaging reporting and data system classification and its correlation with fine needle aspiration cytology findings

Background: Thyroid nodules, common clinical occurrences, often require diagnostic assessment. Ultrasonography (USG) is primary non-invasive method for detection, with advancing technology enhancing detection capabilities. Fine needle aspiration cytology (FNAC) remains standard but poses risks and expenses. American college of radiology-thyroid image reporting and data system (ACR-TIRADS), introduced in 2017, offers a systematic scoring system based on ultrasound features. This study aims to evaluate USG guided by ACR-TIRADS for accurate nodule classification. Methods: A 1.5-year study at department of radio-diagnosis of BSMCH evaluated thyroid nodules using high-resolution USG based on ACR-TIRADS criteria, followed by FNAC for selected cases, comparing results for concordance. Results: Out of 47 thyroid nodules evaluated, 19.1% were malignant and 80% benign. ACR-TIRADS demonstrated sensitivity, specificity, and accuracy of 66.7%, 87.8%, and 82.9%, respectively. Higher ACR-TIRADS categories correlated with an increased risk of malignancy. Suspicious USG features such as hypo-echogenicity, taller-than-wide shape, lobulated margin, and punctate echogenic foci exhibited significant predictive value for malignancy, with varying levels of sensitivity and specificity. Overall, USG parameters demonstrated notable accuracy in identifying malignant nodules. Conclusions: ACR-TIRADS 2017 reliably predicts thyroid nodule malignancy, reducing unnecessary FNAC procedures, minimizing patient discomfort, and optimizing healthcare resources.

Coexistence of microfilaria and chronic lymphocytic thyroiditis: a rare case report

Filariasis is a common health problem in tropical countries of Southeast Asia. The commonest site of involvement is the lymphatic system where the adult worms can remain viable for long periods. Though the patients can remain asymptomatic, the clinical presentation with hydrocele, fever, localised swelling and/or lymphedema are commonly seen. Localization of the parasite at various other sites like breast, lungs, and thyroid have been uncommonly described. We report a case of an elderly female who presented with a large anterior neck mass associated with a recent history of change in voice. Radiological investigations revealed a soft tissue mass in the neck along with multiple lesions in the thyroid which were suspicious of malignancy. Fine needle aspiration cytology, however, revealed microfilariae coexisting with chronic lymphocytic thyroiditis. This case highlights the importance of critical screening of cytology smears to identify the parasites at unusual locations. A correct diagnosis on a simple and inexpensive investigation like fine needle aspiration cytology can help in administering appropriate therapy at the earliest and avoiding unnecessary interventions.

Sonomammographic and sonoelastographic evaluation of benign and malignant breast lesions and its correlation with fine needle aspiration cytology

Background: Breast cancer affects 25.8% of women worldwide. Mammography and ultrasound have sensitivity, but invasive breast biopsies and aggressive biopsies are essential. Sonoelastography is a non-invasive imaging method that can measure tissue stiffness related to different pathologic conditions, such as cancer. Objective is to assess the diagnostic accuracy of sonomammography and sonoelastography in diagnosing breast lesions as benign or malignant in correlation with fine needle aspiration cytology (FNAC) as gold standard. Methods: This study was conducted on 52 female patients with breast mass and sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), kappa and p value of conventional gray scale ultrasound and ultrasonography (USG) elastography were calculated and compared with that of FNAC. Ultrasound was performed using grayscale and elastography mode on GE LOGIQ P9 ultrasound equipment with a 7-12 MHz linear-array transducer. All cases with breast lesions identified on ultrasound elastography underwent FNAC. Results: The sensitivity, specificity, PPV, NPV of sonoelastography were 78.5, 94.7, 84.6, 92.3 with kappa 0.75 and p value <0.0001. Similarly, sensitivity and specificity for strain ratio were 85.7 and 97.4, and that for size ratio were 85.7 and 100 respectively. These results are comparable to or better than results for conventional ultrasound. Conclusions: Breast elastography makes it easier to classify BIRADS 3 category lesions which are benign but still confused as malignant on conventional USG. BIRADS category 3 and 4 lesions with benign findings on sonoelastography can be downgraded to category 2 and 3 respectively thus reducing the number of false positive malignancy cases and biopsy.

Bacillus Calmette-Guerin lymphadenitis in children: an underdiagnosed entity

Background: Bacillus Calmette-Guerin (BCG) lymphadenitis is a common complication after BCG vaccination. Fine needle aspiration cytology (FNAC) is a feasible and cost-effective procedure for the diagnosis and management of this entity. Awareness of this entity in cytology is important to avoid misdiagnosis, as the cytomorphologic features are very similar to tuberculosis. The present study described the clinical presentation and detailed cytomorphologic features in patients with BCG lymphadenitis. Methods: This was a retrospective study from 2018 to 2022 involving a total of 27 patients who presented with isolated left axillary or cervical lymphadenopathy. Results: Age at presentation ranged from 1 to 24 months. The male- to-female ratio was 2.75:1. Majority of the children had enlargement of the left axillary lymph nodes followed by cervical nodes. Cytomorphology showed the presence of dense acute and chronic inflammatory cells, epithelioid cell granulomas, multinucleated giant cells, histiocytic aggregates, reactive lymphoid cells, lymphohistiocytic clusters and calcification. Necrotic background was present in 25 (92.6%) cases. Ziehl-Neelsen staining for acid-fast bacilli was positive in 17 (62.9%) cases. Conclusions: A high index of clinical suspicion for BCG lymphadenitis should be kept in mind for children who are recently vaccinated. Diagnosis of this entity is based primarily on clinical grounds. However, cytology and microbiological examination are encountered as part of clinical work up of lymph node swelling. FNAC in conjunction with clinical presentation is useful for diagnosis of BCG lymphadenitis and avoid an unwarranted tubercular treatment.

Agreement between sonographic features and fine needle aspiration cytology in the diagnosis of thyroid nodules in a Tertiary Hospital

Objective@#Management of thyroid nodules relies on the Thyroid Imaging Recording and Data System (TIRADS) for sonographic findings and the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). The proponents aimed to determine the concordance between sonographic TIRADS findings and cytological diagnosis by TBSRTC in the evaluation of malignancy of patients with thyroid nodules.@*Methodology@#Sonographic and cytology results collected from 2018 to 2022 were obtained to determine whether there is an agreement between TIRADS and TBSRTC findings.@*Results@#Two hundred sixty-two (262) samples were obtained. Overall accuracy of predicting TIRADS category was highest for echogenic foci. Thyroid nodule distribution was highest for TIRADS 3 and 4 sonographically and TBSRTC II cytologically. There is low agreement between TBSRTC and TIRADS in the categorization of nodules as benign, implying that nodules may show sonographic features suspicious of malignancy despite being categorized as TBSRTC I or II by cytology. However, nodules categorized as TBSRTC III to VI show sonographic features suspicious for malignancy at the very least.@*Conclusion@#The correctness of TIRADS prediction is highest for echogenic foci although not significantly higher than other parameters. The overall predicting power of TIRADS for the absence of malignancy is high for TIRADS 1 and 2, whereas TIRADS 5 predicts a 31.11% risk of malignancy making it a strong indication for FNAC. However, prediction of malignancy in TIRADS 3 and 4 nodules must be in association with other factors since a significant percentage may turn out to be TBSRTC II.

Study of breast lesions in cytology and its histopathological correlation

Background: Breast cancer is commonly diagnosed malignancy in females and is leading cause of death. Malignant lesions mostly occur after menopause. Fine needle aspiration cytology is minimally invasive technique, used in triple test and produces speedy results. It can able to differentiate between benign and malignant lesions of breast lump. Our study aims to categorize the breast lesion and to correlate FNAC with histopathological studies. Methods: This retrospective study was done in department of pathology from July 2021 to May 2023.107 cases were undergone FNAC and slides were examined and lesions were categorized. Tissue biopsies were obtained, processed and histological sections were made and examined. The FNAC findings were correlated and analyzed with histological findings. Results: Right breast lesions (55%) were more in our study than left breast lesions (42%). Totally 77 cases were diagnosed as benign lesions by FNAC of which 37 cases were biopsied and histological diagnosis of all cases shown as benign category. 6 cases were diagnosed as proliferative breast disease with atypia of which only one case was received for biopsy and diagnosed as atypical ductal hyperplasia. 12 cases were diagnosed as malignancy and 6 biopsies were received with 5 cases were diagnosed as malignant lesions. Sensitivity and Specificity of FNAC in breast lesions were 100% and 97.43% respectively. Conclusions: FNAC is rapid and valuable tool with high sensitivity, specificity and low false positivity. It is useful in preoperative evaluation and avoids unnecessary surgical intervention.

Breast mass - An uncommon clinical manifestation of ovarian carcinoma: A case report and brief literature review

Metastasis from non-mammary malignant neoplasms to the breast is rare and represents 0.2%-1.3% of all breast malignancies. Fine needle aspiration cytology (FNAC) is the first line of investigation for any breast lump and cyto-morphological appearance of primary breast malignancies is well documented. Occasionally metastasis to the breast may be the initial presentation and can masquerade clinically as primary breast malignancy. The present case describes the clinical and cytological challenges in an unusual case of ovarian carcinoma with initial presentation as breast mass, mimicking as inflammatory carcinoma. In cytology the breast lesion was initially misdiagnosed as primary breast carcinoma and subsequently diagnosed as metastatic ovarian carcinoma based on core needle biopsy findings, aberrant immuno-profile and clinical findings; thus making the complex case worthy of discussion.

Diagnostic utility of special stains in defining the spectrum of maxillofacial pathologies

Background: The Fine needle aspiration cytology (FNAC) is considered as a valuable and distinguished diagnostic test in the initial assessment of the patients presenting with a mass in the head and neck region or when a recurrence is suspected after previous treatment. Aims: This study was therefore designed to elucidate the efficacy of FNAC as an alternate diagnostic tool to histopathology in head and neck swellings and evaluation of staining efficacy of PAP and MGG stain over Haematoxylin and eosin (H and E) in routine cytopathological smears. Settings and Design: The study was conducted in the Department of Oral and Maxillofacial Pathology, where FNAC samples were collected from 150 patients with head and neck swellings. Materials and Methods: All the slides were stained with H and E, Papanicolaou (PAP), and May Grunewald Giemsa (MGG) stains. The cytopathological diagnosis was compared with histopathological diagnosis based on H and E stained sections obtained from paraffin-embedded formalin-fixed biopsy specimen of benign and malignant neoplasms. Statistical Analysis Used: The resulting data were analyzed using SPSS software version 19. Differences between the variables were analyzed using Pearson Chi-square test and Kruskal–Wallis test wherever applicable. Results: The FNAC as a diagnostic tool has sensitivity of 84.8%, 72.72%, and 78.78%, specificity of 62.5%, 75%, and 75%, and accuracy of 80.48%, 73.14%, and 78.04% in H and E, MGG, and PAP stain, respectively. PAP stain was the most efficient stain when all qualitative parameters are taken into consideration with maximum sensitivity and specificity for achieving definitive cytodiagnosis. Conclusions: The FNAC is an inexpensive and minimally invasive technique to diagnose different types of head and neck swellings and complement histopathological diagnosis.

Diagnostic efficacy of fine needle aspiration cytology in soft tissue tumors and cytohistological correlation

Background: Soft tissues are the supportive tissue of various organ as well as the nonepithelial, extraskeletal structure. Fine needle aspiration cytology (FNAC) is a rapid diagnostic technique with limited patient morbidity for diagnosing soft tissue tumours. However, FNAC of soft tissue lesion has not been widely used because of concern about its diagnostic accuracy. The difficulties arise in exact typing and diagnosis of low-grade sarcomas. This study was undertaken to study the acceptability and diagnostic efficacy of cytodiagnosis as compared conventional histological diagnosis and determine distribution of soft tissue tumours according to age and sex. Methods: The study was conducted in the department of pathology, RNT Medical College, Udaipur for period of 1 year. FNAC was done in 77 cases of suspected soft tissue tumors. In 51 cases biopsy resorted and HPE carried out. On the correlation of FNAC diagnosis with histopathological diagnosis the sensitivity, specificity, accuracy and positive predictive were calculated. Results: Maximum number of cases noted were in 40 to 60 years of age with wide range of 11 months to 81 years. Male to female ratio was 1.8:1. Out of total 51 cases 38 found benign and rest were found malignant. Lipomas were the commonest soft tissue tumors. Overall sensitivity obtained in the study using cytology as compared to histopathology was 100%, specificity was 67%, positive predictive value was 54%, negative predictive value was 100%. Conclusions: Cytology though with pitfall, can serve as a diagnostic tool especially when a rapid diagnosis is required.

A CLINICOPATHOLOGICAL STUDY OF PATIENTS WITH CERVICAL LYMPHADENOPATHY BY FNAC AND ITS HISTOPATHOLOGICAL CORRELATION

Background- Cervical lymphadenopathy is one of the most frequent clinical presentation of patients attending out patient department and also the most common manifestations of underlying pathology of the head and neck region, with numerous differential diagnoses such as neoplasms and infections Fine needle aspiration cytology (FNAC) is considered as a safe, easy, quick and also the first line diagnostic technique for evaluation of cervical lymphadenopathy. The study comprised of 150 Materials and methodpatients clinically presenting with cervical lymph node swelling coming for FNAC to the department of pathology. Out of 150 patients, 25 patients underwent surgery and histopathological correlation was done for these patients. Results: Among the 150 cases majority of the patients were males 70 % with M:F ratio 2.33:1.Age of the patients ranged from 1 to 90 years with a mean age of 40.44 years.Most of the lymph node lesions were seen in the age group of 21-30 years(20.67%). Level IIb lymph node was most commonly affected(36%).In FNAC 63.70 % cases were benign and 36.29 % cases were malignant.Among the benign lesions Reactive lymphoid hyperplasia was most common(25.9%) and in the malignant lesions metastatic carcinoma was most common(19.25%). In HPE 82.5% were benign and 17.5% were malignant.There was a strong correlation among the FNAC and HPE findings where reactive lymphoid hyperplasia was found to be most common benign lesion. Conclusion: Fine Needle Aspiration Cytology is a rapid, safe, efficient, cost-effective and the first line investigation for diagnosis of cervical lymph node lesions. Histopathological examination however remains the gold standard for definitive diagnosis of in certain malignant lymph node lesion.

A STUDY OF CORE-CUT BIOPSY AND FNAC FINDINGS IN A CLINICALLY PALPABLE BREAST LUMP

Aims And Objectives To ?nd the sensitivity and speci?city of FNAC and Core-Cut biopsy. To study the ef?cacy of FNAC and Core-Cut biopsy with that of Histopathological (gross specimen) study in diagnosing a breast lump. To ?nd limitations of FNAC and Core-Cut biopsy This is Hospital based Materials and Method: Interventional study at Tertiary care centre in the department of General Surgery. All patients admitted during the period of 24 months with palpable breast lump coming under the eligibility criteria will be subjected for FNAC and Core-Cut biopsy after obtaining informed consents. Data Entry is done by using MS Excel and Analysis is done by using Suitable Statistical tests. Results: Our study of 70 patients, age incidence was ranged from 18 to 70 years.The age incidence for the benign lesions ranged from 18 years to 64 years (Mean age 38.5 years, SD= 12.56 years). The incidence for the malignant lesions ranged from 25 to 70 years (mean age 51.06 years, SD= 10.62 years). Out of total 70 patient, 49 patients had lump in right breast, 21 had lump in left breast. Our study True positive for FNAC was 38(54.28%) True negative was 26 (37.14%) and false positive was 0 and false negative were 6 (0.08%), which lead to the interpretation of sensitivity of 86 % for FNAC and speci?city of 81.12% for FNAC.Our study True positive for Core-Cut biopsy was 42(60%) True negative was 26(38%) and False positive was 0(0%) and false negative was 02(2.85%), which lead to the interpretation of sensitivity of 95% for Core-Cut biopsy and speci?city of 92.85 % for Core-cut biopsy. For Core-Cut biopsy in our study positive and negative predictive value was found to be 100% and 59.09% respectively As Both Sensitivity and Specify of Core-Cut biopsy is far superior than FNAC, and more number of Conclusion: False Negative reports in FNAC, where we can miss the Malignant breast Lump, we conclude that, Core-Cut Biopsy is far superior to FNAC in the diagnostic approach of breast cancer and, especially in cases of doubt, it is preferable to proceed directly with Core Cut biopsy.

Cytological spectrum of lymph node lesions in fine needle aspiration cytology

Background: Fine needle aspiration cytology (FNAC) is becoming preoperative method of choice for diagnosis and management of various lumps and lesions since few decades. It helps clinician to decide mode of treatment in most cases in both non-neoplastic and neoplastic disorders. As cervical, axillary and inguinal lymphadenopathies are commonly encountered clinical problems, in this study, we evaluated the utility of FNAC for assessment of lymphadenopathy. Methods: This was a retrospective observational study done during the period between January 2016 to December 2019 in a private laboratory centre affiliated with private multispeciality hospital in Bhopal Madhya Pradesh. The FNAC procedure was done without radiological guidance for palpable lymph nodes of cervical, axillary, and inguinal regions. 10ml syringe and 23/24-gauge needles were used along with a plunger for FNAC procedure. Smears were made by standard smearing technique. Slides were stained with Papanicolaou (PAP), Lieshman and Giemsa stain and Diff-Quik methods. Ziehl-Neelson (ZN) staining for acid fast bacilli was done wherever required. Results: Total 128 cases of lymphadenopathy were assessed. Cervical lymph nodes were most commonly (77.3%) involved and reactive lymphadenitis (34.3%) was most common diagnosis on FNAC. Tubercular lymphadenitis was most common in young adults and reactive nonspecific lesions were most common in paediatric group. Metastatic carcinomas were most common after 50 years age group. Conclusions: Fine needle aspiration is simple, rapid and cost-effective method to know the cause of lymphadenopathy and also a reliable method to categorize the cause of lymphadenopathy into reactive, inflammatory, metastatic, and lymphoproliferative, avoiding the necessity of biopsy.

Evaluation of Efficacy of IAC Yokahama Reporting System For Breast Cytology – A Single Institutional Experience.

Purpose: Breast fine needle aspiration cytology (FNAC) has a long history of providing accurate, rapid and cost-effective diagnosis of palpable breast lesions. Recently, International Academy of Cytology (IAC) at Yokohama proposed a new reporting system for breast cytology, in order to bring uniformity across the globe. Any new classification system needs to be validated for its practical applicability. Objectives: This study was conducted to categorize the breast lesions as per this classification and further determine the diagnostic efficacy and risk of malignancy in each category. Material and methods: This was a cross sectional observational analytical study. All the cases presenting to cytology OPD from Janurary 2020 upto December 2022, (N=296) with breast lesions for FNAC were included in the study. All the cases were divided into five categories as per the newly proposed IAC Yokohama reporting system. The risk of malignancy for each category was determined and diagnostic efficacy was evaluated.Results:The sample were distributed as follows: insufficient material 4.39%, benign 66.21%, atypical 10.47%, suspicious for malignancy 1.35% and malignancy 17.56%. Histopathology was obtained in 88 cases, out of which 82 (93.18%) showed concordant diagnosis. The sensitivity and specificity were 85.71% and 98.11% respectively. Risk of malignancy (ROM) in each category was as follows-benign (0.01%), atypia (71.4%), suspicious (100%) and malignancy (96.66%) respectively.Conclusion:The high efficacy of FNAC obtained in the present study, when IAC Yokohama reporting system was applied, confirms the usefulness of this scheme in reporting breast lesions. A risk-based stratification is essential in the present era to guide and alert the clinician about the subsequent management plan and the ROM.

Clinico-cytomorphological features and thyroid function tests of different thyroid lesions – A hospital-based cross-sectional study

Background: Thyroid gland is an endocrine organ. The non-neoplastic and neoplastic conditions affecting the gland can manifest as the swelling of the gland with thyroid dysfunction. Based on cytology, the diseases can be categorized into non-neoplastic, benign neoplastic, and malignant neoplastic conditions and according to hormone status, the lesions of thyroid can be categorized in hypothyroid, euthyroid, or hyperthyroid condition. Aims and Objectives: Our study was done to find out the various cytomorphological spectrum of thyroid diseases and to record their common clinical presentation along with hormonal status in a tertiary care hospital in Northern Odisha. Materials and Methods: A total of 220 cases of thyroid disorder were taken for analysis over a period of 2 years. Patients demographic data, brief clinical features, finding on FNAC (cytomorphology), and thyroid function status were analyzed with appropriate statistical method. Results: The predominant age group affected was 21–40 years and total female to male patient ratio was 5.5:1. Most common presentations were heat intolerance (22.27%), cold intolerance (28.63%), and tachycardia (27.72%) apart from thyroid enlargement. Most common non-neoplastic lesion were multinodular and colloid goiter constituting 38.18% of total cases and most common neoplastic lesion was papillary carcinoma constituting 14.55% of total cases. Thyroid function test showed predominantly euthyroid states for all conditions. Conclusion: As the rest part of India, this part of Odisha also showed that thyroid disorders are more common in females and the most affected age group is 21–40 years. Multinodular and colloid goiter are the most common thyroid lesions. Most of the cases present with euthyroid state.

Study of Correlation of High-Resolution Ultrasonography and Ultrasonography Guided Fine Needle Aspiration Cytology in Diagnosis of Pure Neuritic Leprosy in a Tertiary Care Hospital

This study assesses the features of high-resolution ultrasonographic and ultrasound-guided FNAC of peripheral nerves and correlates the findings in clinically suspected cases of pure neuritic leprosy (PNL). As per the study protocol, clinically screened pure neuritic leprosy cases from January 2017 to June 2018 were subjected to high resonance ultrasonography and ultrasonography-guided FNAC. The aspirated material was stained with modified ZN stain for AFB. Nerves showed hypoechogenicity, loss or distorted echogenic rim, and fibrillary echotextures in ultrasonography. Epithelioid cells, epithelioid cell granuloma was found in the histopathology sections of FNAC specimens with the presence of AFB in some cases. From these findings it may be concluded that HRUS and ultrasound-guided FNAC could be incorporated as rapid and reliable diagnostic tools for PNL. It may enlighten the future path as an early indicator of neural damage and be critical and useful to prevent the disabilities.

Role of FNAC in head and neck region lymphadenopathy - A tertiary care centre experience

Background: FNAC (Fine Needle Aspiration Cytology) is a well accepted technique and plays an important role in early diagnosis of head and neck lesions. It is a safe and inexpensive outdoor procedure. Materials and methods: This study was carried out over a period of 9 months (January 2021 to September 2021). A total of 60 patients with head and neck lymphadenopathy were subjected to FNAC at a tertiary care centre in Vadodara, Gujarat. All reports were recorded and data was entered and analyzed using Microsoft excel. Results: In the present study, the various causes of head and neck lymphadenopathy were classified according to cytomorphological patterns. Among the diagnostic outcome, overall prevalence of granulomatous lymphadenitis was 35% (21 cases), reactive hyperplasia was 26.67% (16 cases), secondary metastases were 18.33% (11 cases), lymphoma was 10% (6 cases) and acute non-specific lymphadenitis was 10% (6 cases). Conclusion: FNAC is simple, quick, inexpensive and safe diagnostic procedure which also is an useful adjunct to histopathology.

Role of FNAC in the diagnosis of salivary gland lesions - A tertiary care hospital experience

Introduction: Swelling of salivary glands, specifically parotid and submandibular gland presents as a common problem and being readily visible creates havoc among patients. In addition parotid/ submandibular swellings also remain a diagnostic challenge among clinicians. The aim of this study was to examine the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) as a tool for diagnosis of salivary gland lesions. Materials and Methods: This prospective observational study was done for 6 months from January 2022 to June 2022 at Dhiraj General Hospital, SBKSMI and RC, Waghodia, Gujarat. In present study, total 42 cases were taken with salivary gland lesions that underwent FNAC in Pathology department. Results: In the present study, we had included 42 cases of salivary gland lesions. Out of 42cases, 12 (28.5%) cases were neoplastic and 30 (71.5%) cases were non-neoplastic. Among 12 neoplastic cases, 8 (67%) cases were found out to be benign and 4(33%) cases were diagnosed as malignant. Among malignant lesions, mucoepidermoid carcinoma has the highest number of cases (50%) followed by Carcinoma-ex pleomorphic adenoma and Adenoid cystic carcinoma. Conclusion: We found a good concordance between FNAC and final histology. Awareness of the therapeutic implications and limitations of the cytological interpretation amongst both the clinicians and the cytopathologists should enable FNAC to its best advantage.

CORRELATION BETWEEN HIGH-RESOLUTION ULTRASONOGRAPHY AND ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION CYTOLOGY FOR THE DETECTION OF MALIGNANT NODULES

Aims: Our study aims to evaluate the effectiveness of high-resolution real-time gray-scale ultrasonography with ultrasound-guided ?ne-needle aspiration cytology (FNAC) in identifying thyroid cancer nodules. Thyroid nodules are a frequent medical condition brought on by a number of thyroid problems. By palpating them, they can be detected in 4%–8% of adults, in 10%–41% of adults by ultrasonography (US), and in 50% of people by pathologic examination at autopsy. The thyroid gland's pathological states and thyroid gland morphology can be accurately assessed by using HRUSG. Our study's objective is to evaluate the reliability of HRUSG in identifying malignant nodules with the help of ultrasound-guided ?ne-needle aspiration cytology. It is a retrospective study of 50 patients Settings and Design: (aged 16–63 years) who were examined with high-resolution ultrasound (HRUSG) of the thyroid gland and for ultrasound- guided FNAC between January 2022 till August 31, 2022 This study comprised 50 patients with thyroid Material and methods nodules identi?ed by ultrasonography. Each nodule's properties were identi?ed. Following that, the outcomes were differentiated with Ultrasound-guided FNAC. Sensitivity, speci?city, positive predictive value, Stastistical Analysis used: negative predictive value and accuracy were used Out of 50 nodules examined, 10 (20%) were found to be malignant Results: on cytology. In this study with the aid of Gray-scale ultrasound features of thyroid nodules ,malignant thyroid Conclusions nodules can be differentiated from those with benign ones. HRUSG ?ndings of hypoechogenicity, microcalci?cation, and poorly de?ned margins have high diagnostic accuracy for identifying malignant thyroid nodules as mentioned in our study

Bacille Calmette-Guérin vaccine induced lymphadenitis in infants and children masquerading with tubercular lymphadenitis at tertiary care hospital in North India

Background: Bacille calmette–guerin (BCG) vaccine containing live-attenuated Mycobacterium bovis was first used in humans to prevent tuberculosis in 1921. It is a safe vaccine. However, there can be minor adverse reactions such as pain, swelling, and redness at local injection site. The lesser known severe adverse reactions such as lymphadenitis, BCG osteitis, and disseminated BCG infection can be present after BCG vaccination. Aims and Objectives: The aim of the study was to report the cases of BCG lymphadenitis diagnosed by fine needle aspiration cytology (FNAC) after BCG vaccination in infants and children. Materials and Methods: All the infants and children (1 month–2 years) who presented with regional lymphadenopathy for FNAC after BCG vaccination were included in the study. Results: Total 21 patients with BCG lymphadenitis were recruited. In all the cases, the lymphadenitis involved ipsilateral left axillary lymph nodes. In three patient sites of involvement included the left supraclavicular lymph nodes and in other three patients left cervical lymph nodes along with left axillary lymph node. Sixteen patients had suppurative granulomatous lymphadenitis (SGLA) on FNAC and positive for Ziehl–Neelsen (ZN) staining for acid fast bacilli (AFB), while rest nine had non-suppurative granulomatous lymphadenitis (NSGLA) with negative for ZN staining for AFB. Conclusion: Early diagnosis of BCG lymphadenitis can help in proper management. Furthermore, it can prevent unnecessary anti tubercular treatment in children.