Evaluation of morphometric diagnosis accuracy in thyroid cytology

Decision making in pathology is changing toward quantitative criteria. Quantitative measurements obviously can demonstrate minimal differences, not readily identifiable to human vision. Morphometry is the quantitative description of geometric characteristics of objects. This study aims at testing the feasibility of this new technique using available instruments and software and selecting useful parameters and their thresholds for discrimination of benign versus malignant lesions of thyroid. The cases were selected based on surgical pathology reports of fine needle aspiration thyroid specimens from the pathology department of Dr. Shariati hospital between October 2003 to March 2004. Patients whose surgical pathologic reports were unavaible were excluded. At least 100 cells, selected by a zone guided manner, were measured for each patient. Totally 67 patients were enrolled for the study, 36 with benign pathology diagnosis and 31 with malignant lesions. In a pilot study to test reproducibility of measurements, a single cell was selected and measured 20 times. Coefficient of variation remained below 2% for all measurements, except for nuclear diameter which has been excluded from analysis. Benign cells were different from malignant ones in mean nuclear perimeter [Peri], mean nuclear area [Area], nuclear area to perimeter ratio [A/P], cluster diameter, mean gray level [in 256 gray levels] and standard deviations of Peri, Area and A/P [P-values < 0. 05] but not in CV of nuclear area, intercellular standard deviation of gray levels, intracellular CV of gray levels and its standard deviation. The receiver Operator Characteristic curve analysis was performed for parameters with significant difference and sensitivities and specificities calculated for different cut-off values. The highest sensitivity was reached for nuclear perimeter, nuclear area, cluster diameter and nuclear area to perimeter ratio equal to 93%.55 and for cluster diameter equal to 89%.55%. The results are comparable to classic cytology practice, and this technique is recommended screening of thyroid FNA specimens

[ case report of kikuchi's disease]

Kikuchi's disease is a necrotizing lymphadenitis that is prevalent in Japan and is being increasingly recognized in other areas of the world. It usually occurs in women in their late 20s or early 30s and manifests as a posterior cervical adenopathy. It resolves spontaneously, usually over a period of several weeks to 6 months. Its initial clinical appearance is commonly similar to that of a lymphoma, and it can be pathologically misdiagnosed as such. We report a case of Kikuchi's disease that occurred in a 51-year-old Iranian woman. We discuss the clinical features, differential diagnosis, and pathology of this case in an effort to assist otolaryngologists in diagnosing this benign and uncommon entity

Mean density of hemoglobin a better discriminator of iron deficiency anemia from thalassemia minor

Distinguishing two common hypochromic microcytic anemias [i.e. iron deficiency anemia and thalassemia] needs expensive laboratory test not readily available everywhere. For better discrimination of minor thalassemia from iron deficiency anemia some formulas are available, of them four formulas of England, Mentzer, Shine and MDHL are compared here and superiority of MDHL proved. The four indices were calculated for 108 proved thalassemia minor patients and 199 iron deficients [total 307cases]. The best cut-off point for each index was selected by received operator characteristics analysis the highest sensitivity possible to separate thalassemics form iron deficient. Sensitivity, specificity and efficacy of indices were compared. Mentzer's index [sensitivity: 93.5, specificity: 82.0, efficacy: 86.64] and MDHL [sensitivity: 95.4, specificity: 80.9, efficacy: 85.99] had better results. Interpretation: it seems that these indices can be used to screen microcytic anemic patients, reserving haemoglobin electrophoresis, genetic studies, serum iron and ferritin measurement for selected patients, lowering public health costs

Serum ferritin and iron status of a Saudi population assessed from birth to adolescence

The serum iron, total iron binding capacity. and serum ferritin were measured in a normal Saudi population of both sexes, covering ages from birth to adolescence. Normality was assured by including only those subjects whose haemoglobin concentrations fell within the accepted range for Saudi Arabians in the particular sex and age group. Both serum iron and ferritin levels conformed to recognized patterns. The serum iron was highest at birth, lowest in children aged 6 to 12 months, and in adolescent girls. The serum ferritin after peaking during the first four weeks of life, also reached its lowest levels in young children and adolescent girls. In the age groups between 12 to 14 years. individuals are expected to have precarious iron stores, necessitating supplementation. Comparison was also made with several published series and differences in the Saudi iron status stressed

Hematological reference values assessed from birth to adolescence in Saudi subjects in the area of Jeddah

A study of basic haematological values inclusive of the Hb concentration Hct ratio, RBC count, MCV, MCH, MCHC, total and differential leucocyte counts and platelet counts was undertaken in a reference Saudi population in the area of Jeddah from birth to adolescsnce. A total of 843 males and 830 females were investigated. Significant differences in some of the values were found between the sexes at variable periods of physiological development. Comparison with published series from other countries also revealed some differences especially the higher Saudi RBC counts and lower MCV and MCH values. These were discussed and related to the high rate of occurrence of alpha thalassaemia in the Saudi population. The total and differential leucocyte count found for Saudi Arabians fell midway between those reported from Caucasian and tropical communities