Burkholderia pseudomallei infection manifests as mediastinal/hilar lymphadenopathy: A case report

Rationale: This case report presents the diagnosis and etiology of hilar/mediastinal lymphadenopathy in a male patient. Patient concerns: A 49-year-old man presented with fever and dyspnea after physical exertion. Diagnosis: The patient was diagnosed with melioidosis by cultivation of lymph node aspirate on blood agar using the VITEK 2 compact system. Interventions: The patient was treated with ceftazidime intravenously, combined with trimethoprim/sulfamethoxazole orally for 1 week. Once the patient was discharged, he began a 12-week course of trimethoprim/sulfamethoxazole. Outcomes: The patient recovered after treatment with ceftazidime and trimethoprim/sulfamethoxazole. Conclusions: Melioidosis is an infectious disease that mainly occurs in tropical regions. It can cause severe sepsis and pneumonia, and the infection in some patients may become chronic. Endobronchial ultrasound-transbronchial needle aspiration is a useful technique in the diagnosis of patients with hilar/mediastinal lymphadenopathy.

Linfedema asociado al cáncer de mama: factores de riesgo, diagnóstico y tratamiento quirúrgico / Breast cancer related lymphedema: risk factors, diagnosis and surgical treatment

Resumen El linfedema asociado al cáncer de mama es una de las complicaciones más subestimadas y debilitantes del tratamiento de esta entidad. Ocurre como resultado de la interrupción del flujo linfático en asociación a otros factores. La incidencia varía dependiendo del tipo tratamiento recibido, existiendo mayor riesgo en los casos en los que se realiza mastectomía total, disección axilar, radioterapia, y en los pacientes en los cuales los ganglios están positivos para cáncer, hubo una mayor cantidad de linfonodos resecados, se utilizaron taxanos o padecen de obesidad. El diagnóstico clínico y a través de técnicas de imágenes es fundamental para evaluar el estado funcional del sistema linfático. Los objetivos principales en el manejo del linfedema son limitar la morbilidad del paciente, mejorar la funcionalidad y la calidad de vida. Existen procedimientos que buscan prevenir el desarrollo del linfedema asociado al cáncer de mama. Una vez establecido, el tratamiento puede ser conservador y quirúrgico. El tratamiento quirúrgico incluye procedimientos fisiológicos (reconstructivos) y resectivos. El éxito depende de una buena selección de los pacientes y la realización de un tratamiento individualizado. A continuación, se presenta una revisión en cuanto a la incidencia, factores de riesgo, estrategias diagnósticas y técnicas quirúrgicas con énfasis en el tratamiento microquirúrgico.

Breast cancer related lymphedema is one of the most underestimated and debilitating complications of the treatment of this entity. Occurs as result of the interruption of the lymphatic flow in association with other factors. The incidence varies depending on the type of treatment received; being a higher risk in cases in which total mastectomy, axillary dissection, radiotherapy are performed; and in patients in whom the lymph nodes are positive for cancer, there was a greater number of harvested lymph nodes, taxanes were used or in obese patients. Clinical diagnosis and imaging techniques are essential to assess the functional status of the lymphatic system. The main objectives in the management of lymphedema are to limit patient morbidity, improve functionality and quality of life. There are procedures that seek to prevent the development of breast cancer related lymphedema. Once established, the treatment can be conservative and surgical. Surgical treatment includes physiological (reconstructive) and excisional procedures. Success depends on a good selection of patients and the performance of an individualized treatment. The following is a review regarding the incidence, risk factors, diagnostic strategies and surgical techniques with emphasis on microsurgical treatment.

Comparison of short-term effect of totally laparoscopy versus open radical total gastrectomy with D2 lymph node dissection on local advanced upper gastric cancer / 肿瘤研究与临床

Objective To explore the short-term effect of totally laparoscopic radical total gastrectomy with D2 lymph node dissection for treatment of local advanced upper gastric cancer. Methods Clinical data of 112 patients with local advanced upper gastric cancer who underwent totally laparoscopic or open radical total gastrectomy with D2 lymph node dissection in Affiliated Cancer Hospital of Shanxi Medical University from June 2016 to June 2018 were analyzed. The patients were divided into totally laparoscopic radical total gastrectomy with D2 lymph node dissection group (totally laparoscopic gastrectomy group, 54 cases) and open surgery radical total gastrectomy with D2 lymph node dissection group (opening gastrectomy group, 58 cases). The perioperative conditions and postoperative pathological conditions between the two groups were compared. Results All the 112 operations were technically successful. Compared with the opening gastrectomy group, the operating time of the totally laparoscopic gastrectomy group was longer [(240 ±47) min vs. (203 ±30) min], and the estimated blood loss was reduced [(103±21) ml vs. (260±34) ml], and the length of operative incision on body surface was shorter [(4.3±0.8) cm vs. (17.0±1.3) cm], and the differences between the two groups were statistically significant (all P< 0.05). There were no significant differences in the distance between the upper incision edge and tumor and the number of excised lymph node between the two groups (both P> 0.05). Compared with the opening gastrectomy group, the pain degree in 3-5 d after operation was slighter in the totally laparoscopic gastrectomy group, and the ratio of postoperative complications was lower, and the time of intestinal recovery and postoperative hospital stay was shorter, and the differences between the two groups were statistically significant (all P<0.05). Conclusion Totally laparoscopic radical total gastrectomy with D2 lymph node dissection for local advanced upper gastric cancer has advantages in operation safety, the time of postoperative recovery and the number of postoperative complications, and the effect of lymph node dissection can reach the level of open surgery.

Occult papillary thyroid carcinoma presenting with cervical neck lymph node metastasis

A 74-year-old male patient was conducted total thyroidectomy with functional neck dissection and final pathologic report confirm occult thyroid carcinoma. Although the frequency of occult thyroid cancer (OTC) has decreased owing to developments in cervical ultrasonography and improved accuracy of histological tests, rare cases are still reported. Due to the decreased frequency of OTC, a benign cervical neck lymph node mass is sometimes diagnosed, which can result in delays to more accurate diagnoses and appropriate treatment. Therefore, we report our case.

Linfedema: actualización en el diagnóstico y tratamiento quirúrgico / Lymphedema: update in diagnosis and surgical treatment

El linfedema es la acumulación de fluido rico en proteínas en el intersticio, secundario a anomalías en el sistema de transporte linfático. En países desarrollados se relaciona más frecuentemente al tratamiento quirúrgico del cáncer. El diagnóstico clínico y a través de técnicas de imágenes es fundamental para evaluar el estado funcional del sistema linfático. Los objetivos principales en el manejo del linfedema son limitar la morbilidad del paciente, mejorar la funcionalidad y la calidad de vida. El tratamiento quirúrgico es una alternativa cuando las medidas conservadoras ya no son suficientes. Existen procedimientos que buscan prevenir el desarrollo del linfedema y técnicas que incluye procedimientos fisiológicos (reconstructivos) y resectivos que se utilizan cuando el linfedema ya está establecido. El éxito depende de una buena elección de los pacientes y la realización de un tratamiento individualizado. A continuación se presenta una revisión en cuanto a las últimas estrategias diagnósticas y actualización en las técnicas quirúrgicas con énfasis en el tratamiento microquirúrgico.

Lymphedema is the accumulation of protein-rich fluid in the interstitium, secondary to abnormalities in the lymphatic transport system. In developed countries it is more often related to surgical treatment of cancer. The clinical diagnosis and through imaging techniques is fundamental to evaluate the functional status of the lymphatic system. The main objectives in managing lymphedema are to limit patient morbidity, improve functionality and quality of life. Surgical treatment is an option when conservative measures are no longer sufficient. There are procedures that seek to prevent the development of lymphedema, and techniques that include physiological (reconstructive) and resective procedures that are used when lymphedema is already established. Success depends on a good selection of patients and the completion of an individualized treatment. The following is a review article of the latest diagnostic strategies and update in surgical techniques with emphasis on microsurgical treatment.

Mechanisms and implications of cancer cell dormancy in head and neck carcinoma / 华西口腔医学杂志

Disease metastasis and relapse in many cancer patients several years (even decades) after surgical remission have been recently acknowledged as cases of cancer dormancy. Although cases of minimal residual disease are well documented, knowledge on its biological mechanisms and clinical implications remains limited. To date, numerous reviews have summarized the three potential models that may explain this phenomenon, including the angiogenic, immunologic, and cellular dormancy. In this study, we discuss newly uncovered mechanisms governing tumor cell dormancy in head and neck cancer, emphasizing on the crosstalk between dormant tumor cells and their microenvironments. Additionally, we explore the mechanisms on the reactivation of dormant residual tumor cells in anatomical sites, including the lymph nodes and bone marrow.

Application of thrombelastography in antiplatelet therapy in children with Kawasaki disease / 中国小儿急救医学

Objective To evaluate the efficacy of antiplatelet agents in patients with Kawasaki dis-ease (KD) by using thrombelastography (TEG). Methods A retrospective study of KD patients admitted in our hospital from May 2016 to December 2016 was conducted. Platelet inhibition rates of Arachidonic acid pathway(AA％ ) and Adenosine diphosphate pathway were assessed using TEG platelet mapping. The effects of aspirin and dipyridamole on platelet inhibition were compared,and the differences of platelet inhibition rates in different aspirin dose and duration of medication were determined. Results There were significant individual differences in the inhibition of platelets by aspirin and dipyridamole. The inhibition rate of aspirin on platelets[M(P25 ,P75 )] was 62. 45％ (35. 58％ ,90. 95％ ),which was higher than that of dipyridamole [23. 75％ (11. 60％ ,48. 38％ )],there was significant difference (P < 0. 01). The incidence of dipyridamole resistance in children with KD ( 56. 75％ ) was higher than that in patients with resistance to aspirin (35. 71％ ),and there was significant difference (P < 0. 01). There was a linear correlation between platelet inhibition rates of two antiplatelet agents in children with KD (r = 0. 351,P < 0. 01). There was no significant difference in the effect of aspirin and dipyridamole on platelet inhibition rate after 4 days of administration. There was no significant difference in the effect of different doses of aspirin on AA％ . Conclusion TEG is an effective way to evaluate the efficacy of antiplatelet therapy in children with KD.

Methylation status of CDH1 gene in invasive ductal carcinoma of breast and its clinical significance / 重庆医学

Objective To explore the significance of gene promoter methylation of CDH1 in breast invasive ductal carcinoma.Methods The gene promoter methylation of CDH1 and E-cadherin expression status in breast cancer tissues,adjacent tissues and normal breast tissues were detected by using methylation specific polymerase chain reaction (PCR) and immunohistochemistry (SP) method.The clinicopathological data (genetic background,age,tumor size,axillary lymph node metastasis,tumor cells grading,clinical staging and molecular subtype) were collected,and analysed the clinical significance of gene promoter methylation of CDH1 in breast cancer.Results Among the 250 patients with breast cancer,113 cases were found gene promoter methylation of CDH1,and the methylation rate was 45.20％.Compared with patients with unmethylated CDH1 gene promoter,the E-cadherin protein expression was reduced in patients with methylated CDH1 gene promoter,there was statistically significant difference (x2 =21.360,P＜0.01).The univariate analysis showed that statistically significant differences were found in axillary lymph node metastasis (x2=19.086,P＜0.01),histological grading of tumor (x2 =8.487,P=0.014),CerbB-2 expression (x2=9.475,P=0.002) and molecular typing (x2 =25.482,P＜0.01) between patients with methylated and unmethylated CDH1 gene promoter.The COX regression analysis showed that there was significant difference in 5-year survival rate between patients with methylated and unmethylated CDH1 gene promoter(P＜0.01).Conclusion Methylation of CDH1 gene promoter causes decreasedexpression of mRNA,and is associated with axillary lymph node metastasis in breast cancer,which suggests that methylation of CDH1 gene promoter plays a certain role in breast cancer progression.

Immunomagnetic Nanosphere-based Strategy for Rapid, Efficient and Accurate Detection of Lymphnode Metastatic Carcinoma Cells / 分析化学

A strategy based on immunomagnetic nanospheres ( IMNs ) for rapid, efficient and accurate detection of lymphnode metastasis carcinoma cells ( LNMCCs ) was developed in this study. First, IMNs processing magnetism and biological targeting were fabricated by the approach developed by our group previously. Then, LNMCCs in lymph node fine needle aspiration ( LNFNA) specimens were separated and enriched by the immunomagnetic isolation using IMNs. At last, the captured cells were identified with Wright's staining and immunocytochemistry ( ICC) . The separation and enrichment of LNMCCs with immunomagnetic isolation could reduce the background interference of LNFNA specimens effectively; the identification with Wright ' s staining and ICC offered more reliable information for accurate diagnosis, so the sensitivity, specificity and overall diagnostic accuracy had an obvious improvement compared with the conventional cytologic diagnosis. Besides, the simple and rapid incubation of LNFNA specimens with IMNs needed just 5 min, so the cytomorphology of captured LNMCCs could be intactly retained, which enabled to provide important basis for classifying lymphnode metastasis carcinoma ( LNMC ) and the subsequent pathological study. Moreover, the specific capture of epithelial carcinoma cells in LNFNA specimens with IMNs could make a definite diagnosis of the captured cells as LNMCCs, thus realizing the differentiated diagnosis of LNMC and malignant lymphoma. Additionally, this strategy exhibited successful LNMCCs detection in LNFNA specimens from 110 patients and had higher sensitivity ( 98 . 0%) , specificity ( 100 . 0%) , and overall diagnostic accuracy (98. 2%) than the conventional cytologic diagnosis. Therefore, it was a new attempt to use IMNs for detection of LNMCCs in LNFNA specimens from LNMC patients, and offered new ideas for LNMC diagnosis and study.

Modelo experimental de pesquisa do linfonodo sentinela no canal anal de cadela utilizando-se tecnécio e azul de metileno

Os benefícios da identificação do linfonodo sentinela no tratamento do câncer em vários órgãos e locais já estão bem definidos, porém há uma carência de estudos em relação ao câncer de canal anal, principalmente pela ausência de modelos experimentais com esse fim. Neste estudo propôs-se um modelo para pesquisado linfonodo sentinela no canal anal em cães. Foram elecionados 13 cães mestiços da espécie Canis familiaris, fêmeas, com peso aproximado de 10,9kg e idade variando de 12 a 24 meses, provenientes do Centro de Controle de Zoonoses do Município de Fortaleza; distribuídas em dois grupos (I e II) de acordo com o local de injeção dos marcadores no canal anal. Após anestesia geral, as cadelas do grupo I receberam injeção de 0,5 ml de 99m Tc e 5ml de azul de metileno 1% em região anterior do canal anal, e as cadelas do grupo II receberam injeção dos marcadores na região posterior do canal anal. Após 30 minutos da injeção do radiofármaco, as regiões inguinais foram dissecadas em busca de linfonodos marcados com o corante vital ou radiofármaco através da captação de radiatividade do linfonodo pelo aparelho Gamma-Probe. Posteriormente, foi realizada laparotomia do animal em busca de linfonodos marcados em cadeias ilíacas e pararretais. Todos os linfonodos marcados foram retirados e enviados para análise histopatológica. No total, foram marcados 34 linfonodo sem ambos os grupos. O método de detecção com azul de metileno 1%corou 13,6 vezes mais linfonodos no grupo I e 15,8 mais linfonodos no grupo II, com baixa concordância pelo coeficiente de Kappa. A curva ROC comparando os dois métodos mostrou maior especificidade do radiocolóide. Ambos os métodos encontraram mais linfonodos em cadeia ilíaca direita tanto no grupo I como no grupo II...

The benefits of the sentinel node detection on the treatment of various neoplasms are already well defined, but there’s a lack of studies regarding the anal canal cancer, especially due to the lack of an experimental model specifically for that. This study aims to propose an experimental model for the detection of the sentinel lymph node in the anal canal of dogs. The experimentwas performed at the Laboratory of Experimental Surgery Pr. SaulGoldenberg,linked to the Department of Surgery, Faculty of Medicine of theFederal University of Ceará. 13 healthy bitches from the species CanisFamiliariswith mean weight of 10,9kg and mean estimated age between 12 and 24 months were selected through the Municipal Centre of Zoonosis of Fortaleza (CCZ), distributed in two groups (Iand II) defined by the site of injection of the nodal markers in the anal canal. The bitches were anesthetized by a veterinarian and then the animals from Group Ireceived 0,5ml of 99mTc and 0,5ml of methylene blue dye at the anterior region of the anal canal; and the Group IIreceived the same dosis of those markers at the posterior region of the anal canal. After 30 minutes, the inguinal region was bilaterally incised to dissect marked nodes by blue dye and radioactive irradiation with the help of a gamma-probe device. Then a laparotomy was performed to search for marked nodes in iliac and pararretal region at the same way. All marked nodes were sent to histological analysis. 34 nodes were found in both groups, and the methylene blue dye marked 13,6 more nodes on group I and 15,8 more nodes on group II than the radiocolloid...

Role of FNAC in cytological diagnosis of metastatic lymph node.

Background: FNAC not only confirms the presence of metastatic disease, but also gives the clue regarding the nature and origin of primary malignancy Aim and objective: To Assess the usefulness of FNAC in diagnosis of metastatic lymph node. Data were arranged according to lymph node involved and morphological diagnosis. Study design: Study material comprises of 56 lymph node aspirate diagnosed metastatic carcinoma in cytology out of total 383 cases of Lymphnode aspiration in a one year. Method: All FNACs were performed using a 22 gauge needle. An average minimum of 4 slides were made, Slides were routinely stained with both leishmann, Giemsa and Papanicolaou (PAP) stains. Results: Out of total 383 lymph node aspirate 56 cases showed metastasis Lymphnode while 327 cases showed other lesion of lymph node. Cervical lymph node was the commonest group involved. Metastasis from squamous cell carcinoma was the most common diagnosis made on cytology. Conclusion: In our study we feel that FNAC of lymph nodes as a first line of investigation in developing countries. It is not only useful in the diagnosis of suspected or unsuspected metastatic neck nodes, but can also help in starting the specific therapy in time thus reducing mortality and morbidity.

Unusual Presentation of a Caseating Lymphadenitis Causing Abnormal Lymphadeno-Duodenal Communication.

Aim: To describe the imaging features of a case of abnormal lymphadeno-duodenal communication caused by caseating lymphadenitis. Presentation of Case: The case discussed is of a thirty-five year old Indian woman who presented with abdominal pain, vomiting, fever, loss of appetite and later diagnosed with abnormal lymphadeno-duodenal communication caused by caseating lymphadenitis. Discussion: Caseating lymphadenitis is a chronic disease process that occurs anywhere in the human body and its prevalence varies from region and country. Here, we report a case of lymph node with caseous necrosis causing abnormal lymphadeno-duodenal communication which was diagnosed by Computed tomography. This poses a great diagnostic challenge for a variety of reasons which include its non-specific symptoms, wide range of causes and the complications in the case of a delayed diagnosis. Abdominal involvement can occur in the peritoneum and the mesentery. Imaging plays a very important role to assess the cause of caseating lymph nodes and identify the complications. Conclusion: As abnormal lymphadeno-duodenal communication is an unusual condition and rarely reported, it is important to consider the possibility of tuberculosis as one of the underlying etiology. A high index of suspicion needs to be maintained for timely diagnosis and accurate treatment.

Cutaneous tuberculosis: epidemiologic, etiopathogenic and clinical aspects - Part I

Cutaneous tuberculosis (CTB) is the result of a chronic infection by Mycobacterium tuberculosis, M. ovis and occasionally by the Calmette-Guerin bacillus. The clinical manifestations are variable and depend on the interaction of several factors including the site of infection and the host's immunity. This article revises the current knowledge about this disease's physiopathology and immunology as well as detailing the possible clinical presentations.

The expression of thymosin beta 4 in the liver tissues and its clinical significance in children with hepatoblastoma / 安徽医科大学学报

Objective To investigate the expression of thymosin beta4 ( Tβ4 ) in the liver tissues of children with hepatoblastoma ( HB) , and further study the function of Tβ4 in HB metastasis in vitro. Methods Immunohisto-chemistry (IHC) was used to determine expression of Tβ4, E-cadherin andβ-catenin in liver tissues from 19 chil-dren with HB,and further to analyze its function in metastasis of HB cells. Results The positive rate of Tβ4 ( P<0.01 ) in HB liver tissues was significantly higher than it in the adjacent tissues. The positive rates of Tβ4 and nu-clearβ-catenin in HB with lymphnode metastasis were significantly higher than in HB without lymphnode metastasis ( P <0.01 ) . While expression of E-cadherin in HB with lymphnode metastasis was lower than in HB without lymphnode metastasis ( P<0.01 ) . Scratch-wound assay showed that HepG2 cells with Tβ4 knockdown had signifi-cantly lower metastatic ability (P<0.05). Conclusion Tβ4 plays an important role in HB metastasis, suggesting it is a potential target for HB metastasis.

Interstitial Lung Disease and Profound Hypoxaemia in a Severely-malnourished Child with Very Severe Pneumonia and Potential Lymph-node Tuberculosis: An Uncommon but Serious Co-morbidity.

A nine-month old boy was initially admitted at the Acute Respiratory Infection Unit of Dhaka Hospital of icddr,b and soon after transferred to the Intensive Care Unit of the same hospital. The boy had problems of very severe pneumonia (confirmed by radiology), severe hypoxaemia, severe malnutrition, and Down’s syndrome. The patient was treated according to the hospital protocol for the management of pneumonia and malnutrition. During the hospital stay, hypoxaemia was persistent with very little improvement of pneumonia; a number of differentials, such as pneumocystis jirovecii pneumonia, lymph-node tuberculosis, were added to the problems. Subsequently, the patient’s hypoxaemia improved with the empirical use of antitubercular drugs. However, the patient again developed persistent hypoxaemia and, after unsuccessful treatment for a hospital-acquired pneumonia, the problems further expanded to include interstitial lung disease (ILD). This was confirmed by high-resolution computed tomography, and the patient was treated with prednisolone for 6 months, along with antitubercular drugs. He fully recovered from ILD, hypoxaemia, and pneumonia both clinically and radiologically. Therefore, severely-malnourished children having wet cough and pneumonia with persistent hypoxaemia should be assessed for the possible existence of interstitial lung disease. This may help provide a prompt and appropriate management to reduce morbidity and deaths in such patients.

Relationship between preoperative plasma D-dimer level and the lymph-node metastasis characteristics in colorectal cancer patients / 国际外科学杂志

Objective To determine the relationship between preoperative plasma D-dimer level and the lymphnode metastasis characteristics in colorectal cancer patients.Methods A total of 106 patients with colorectal cancer were studied in order to evaluate this relationship.Their preoperative plasma D-dimer levels were measured.Results were correlated with the clinicopathological findings.Results Significantly different plasma D-dimer levels were found with respect to histologic N(P ＜ 0.001).The number of lymph node metastases was found to have the strongest association with D-dimer level among the significant clinicopathologic factors (Spearman rank correlation,P ＜0.001).The most useful cutoff of the plasma D-dimer levels for diagnosis of lymph node metastasis was determined to be 0.4 μg/mL.Conclusion Plasma D-dimer levels can help assess lymph node metastasis in patients with eophageal cancer and should be measured preoperatively.

Anaphylaxis to Patent Blue V: a case series

Blue dyes such as Patent Blue V (PBV) have been used in medical procedures for decades, and in the United Kingdom they are routinely utilised in sentinel lymph node biopsy (SLNB) for staging the axilla in early breast cancer. However, it has long been recognised that such dyes are associated with anaphylaxis. It has recently been estimated in a prospective study that allergy to PBV occurs with a frequency of 0.9%. Since repeated SLNB (and therefore further exposure to PBV) is increasingly being advocated for the small proportion of patients who develop a local (in-breast) recurrence, and because anaphylaxis can be life-threatening, it is important that those individuals that are allergic to PBV are recognised on their first medical exposure. The measurement of serum mast-cell tryptase (MCT) and skin prick test (SPT) are used in the investigation of suspected anaphylaxis because positive results are supportive of type-1 mediated hypersensitivity. Here we report the clinical features, MCT results and SPT results that pertain to a series of four patients referred to our drug allergy clinic with suspected anaphylaxis following SLNB. We recommend that all patients that show clinical evidence of allergy following exposure to PBV are referred to a specialist drug allergy service for further evaluation to investigate the cause.

Progress in Kawasaki disease with coronary artery lesions / 国际儿科学杂志

Kawasaki disease,which is an acute multisystem vasculitis of unknown cause,leads to pathognomonic feature of coronary artery lesion.Recent studies show that genetic polymorphism,neutrophils,monocytes,cytokines and other factors are involved in the development of coronary artery disease.Long-term use of anticoagulant drugs may reduce coronary artery damage.

Role of Imprint Cytology in Diagnosis of Lymph Node Lesions.

Introduction: Imprint cytology is proved to be rapid inexpensive tool in the diagnosis of various lymph node lesions. Objective: The present study was conducted to correlate the diagnostic accuracy, sensitivity and specificity of imprint cytology of various lymph node lesions with histopathological diagnosis. 102 cases were included in the study comprising inflammatory lesion, tubercular lymphadenitis, lymphomas and metastatic carcinomas. Material and Method: From 102 cases of lymph node excision, imprint smears were taken and stained with Hematoxylin & Eosin and Papanicolaou stains. The findings of imprint cytology were then compared with final histopathological diagnosis. Result: When compared with final histopathological diagnosis, imprint smears showed overall diagnostic accuracy of 97.8% with sensitivity and specificity of 95.05% and 98.69% respectively. Accuracy rate for metastatic lymphadenopathy was 100%, whereas, for tubercular lymphadenitis it was 98.04% and for lymphomas 96.04%. Conclusion: Imprint cytology proved to be very useful for diagnosis of metastatic tumour as it gave 100% diagnostic accuracy, sensitivity and specificity. Imprint cytology is also considered to be useful in superficial ulcers to differentiate between benign and malignant lesions without surgical intervention.

Unusual complication of cervical tuberculous lymphadenopathy.

Lymphadenopathy is the most common form of extrapulmonary tuberculosis; cervical region being the most frequent site. Yet, tuberculous cervical lymphadenopathy is rarely associated with Internal Jugular Vein (IJV) thrombosis. We report right IJV thrombosis with isolated cervical tuberculous lymphadenopathy in a 22-year-old woman. Anti-tuberculous treatment resulted in complete regression of lymphadenopathy but anticoagulation treatment failed to restore the caliber of thrombosed IJV to normal. Thrombosis of adjacent IJV is a potential complication of delay in diagnosis and treatment of cervical lymphnode tuberculosis.