Computed Tomography Guided Fine Needle Aspiration of Lung Lesions Suspected to be Bronchogenic Carcinoma: Experience of a Tertiary Care Hospital

CT guided FNAC is a simple and safe procedure of diagnostic value in patients with lung lesionssuspected to have lung malignancy. We undertook a study on 41 patients and were able to diagnose/rule out malignancy in 85.37% of these patients, while in 14.63 % of patients the smears were nondiagnostic. Once malignancy was diagnosed in these patients, then the next most important step wasto categorize the lesions. 44% of patients had squamous cell carcinoma, 12.12 % had adenocarcinoma,9.75% had small cell carcinoma, 7.31 % had poorly differentiated carcinoma, 4.87% each hadmetastasis & tuberculosis and 2.43% had aspergillosis. Squamous cell carcinoma was the commonestsubtype in our study, which is contrary to changing trends in incidence of lung carcinoma whereadenocarcinoma has replaced squamous cell carcinoma as the commonest lung malignancy. Threeof our patients had minor complication in the form of mild pneumothorax, and it resolved in all patientswithin 24 hours.

Ultrasound Guided Fine Needle Aspiration Cytology of Gallbladder Lesions Suspected to be Carcinoma Gallbladder: Experience of a Tertiary Care Hospital

Gallbladder carcinoma is the most common biliary tract malignancy in the world. Radiologicalinvestigations are helpful in diagnosing the gallbladder diseases especially carcinoma in most of thecases, but confirmation of diagnosis requires cytopathological correlation. We have undertaken astudy on 29 patients, who underwent ultrasound guided FNAC for evaluation of gallbladder lesionssuspected to be carcinoma gallbladder. 82.75% of patients had malignancy or suspicion of malignancyand 10.34% patients had abscesses, while in 6.9 % patients FNAC was inconclusive. Adenocarcinoma(NOS) was the most common diagnosis and was found in 62.6 % of patients. Poorly differentiatedcarcinoma, cytology suspicious of malignancy and abscesses were present in 7 % of patients each.Papillary carcinoma and squamous cell carcinoma were only seen in 3.44 % patients each. None ofthe patients in our study developed any minor or major complications during the procedure. A precisecytological examination is required not only to diagnose or rule out gallbladder malignancy, but alsofor prognostication of these carcinomas.

Bilateral Krukenberg Tumor.

Adrenal Myelolipoma is a rare tumor that is benign in nature and unilateral. It is usually asymptomatic with just a few millimeters in size but they can grow over 30 cms becoming a life threat to the patient. This tumor is generally considered as a type of hormonally inactive neoplasm which is composed of variable amounts of mature adipose tissue and normal hematopoeitic elements. These may not account for extramedullary sites of haemotopoiesis and are not associated with any specific hematologic disorder. Rarely, Adrenal Myelolipomas occur in association with Adrenocortical Adenoma or Adrenocortical Carcinoma. We report a case of Adrenocotical Adenoma with Myelolipoma in a 35 year old female who presented with pain in the right upper abdomen. The radiological appearance resembled adrenocortical carcinoma. This case emphasize the importance of this combination as a pitfall in the correct diagnosis and management of patient with Adrenal mass.

A Cytological (FNAC) Study of Cervical Lymph Nodes In Tertiary Care Centre.

In a retrospective crossectional observational study of seventy four patients who underwent FNAC of cervical lymph nodes over a period of 6 months were included in the study. Four patients whose aspiration yielded inadequate material were excluded from the study. Cytological reporting was done according to standard guidelines and the diagnosis was classified as nonspecific reactive lymphadenitis (42.8%), tuberculous lymphadenitis (30%), metastasis (14.3%), acute supportive lymphadenitis (5.7%), lymphoma (5.7%) and leukemic infiltration (1.4%). In large number of cases FNAC alone is enough for diagnosis in proper clinical setting and surgical procedures like biopsy can be avoided even in tertiary care settings.This study highlights the usefulness of FNAC as a reliable method for diagnosis of cervical lymphadenopathy.

Glioblastoma Multiforme Metastasizing to Humerus and Craniospinal Axis.

Glioblastoma multiforme (GBM) is the most common malignant brain tumour. GBM metastasizing to humerus has never been reported. This is the first such case of recurrent GBM to be reported in medical literature with both extracranial and cerebrospinal dissemination. Our case amply demonstrated the need to keep vigil and high index of suspicion while interpreting the clinical and radiological findings in GBM wih a risk of CSF spread and systemic metastases.

Primary Pulmonary Adenoid Cystic Carcinoma with Lumbar Vertebral Metastasis: Response to Gefitinib.

Primary adenoid cystic carcinoma of lungs with vertebral metastases at presentation is a rare entity with very few treatment options. We report a case of 78-year old non-smoker female who was investigated for low backache and found to have adenoid cystic carcinoma of right lung with lumbar vertebral metastasis. She refused palliative radiation therapy to lumbar spine because of her inability to move and severe pain. She received oral gefitinib and reported remarkable relief in symptoms.

Congenital Leukemia.

Congenital leukemia is a rare disease that can manifest soon after birth. Cutaneous involvement consists of red, brown or purple papules or nodules and purpura. We present a case of congenital myelomonblastic leukemia in a seven week old infant who had petechiae and subcutaneous nodules. Diagnosis was established by the presence of leukemic cells in bone marrow and involved skin along with cytochemical characterization of these cells.

Cutaneous Sarcoidosis.

We present a case of exclusive cutaneous sarcoidosis with no clinical or radiological evidence of disease anywhere else in the body.Exclusive cutaneous involvement is rare and is reported in about 4.5%patients of sarcoidosis.

Crossed Fused Renal Ectopia-Inferior Ectopia Type.

Crossed Fused Ectopia a rare condition is presented here with a discussion on its clinical presentation dignosis and management.

Hydatid Cyst in Rectovesical Pouch

A 23 year old man presented with pain abdomen & burning micturation. Ultrasound & CT scan of abdomen showed hydatid cyst in rectovesical pouch. Surgery was performed and pathology of the excised mass confirmed the diagnosis. This case of primary hydated cyst in rectovessical pouch is being presented because of its rarity.