Role of fine needle aspiration cytology (FNAC) in the diagnosis of prostatic lesions with histologic correlation.

This study was carried-out to evaluate the diagnostic accuracy of fine needle aspiration cytology (FNAC) and the role of FNAC in the diagnosis of prostatic lesions. FNAC was performed on 64 patients presented with enlarged prostate. Cytological diagnosis by fine needle aspiration (FNA) of the prostate was compared with histological diagnosis in 60 patients. Of these, 42 cases were cytologically diagnosed as benign lesions, 18 cases as malignant. In remaining 4 cases, materials were inadequate for diagnosis in one case and biopsy materials were not available in 3 cases. On histological examination, 42 cases which were cytologically diagnosed as benign, 40 cases were found to be benign and 2 cases were malignant histologically leading to 2 false negative diagnoses. Of the 18 cases diagnosed cytologically as malignant (considering atypical hyperplasia and carcinoma as malignant), 15 cases were proved to be so by histological examination. So there were false positive diagnoses in 3 cases. No patient suffered from any complication following the aspiration biopsy. The sensitivity of this study for detection of prostatic carcinoma was 88 percent; specificity was 93 percent and diagnostic accuracy 91.7 percent. In this prospective study, FNAC of prostate was found to be associated with high diagnostic yields. These data support the value of transrectal FNAC as sensitive, easy to perform method for sampling of an enlarged prostate. The procedure may be used as an efficient primary screening tool in the diagnosis of prostatic lesions. Frequent use of this technique in our country should be encouraged.

Histopathological types of malignant lesions of esophagus and stomach.

Upper part of gastrointestinal tract is common site of malignancy. Histological types of malignancy of esophagus and stomach may vary in different countries and also in different regions in the same countries. To find out the frequencies of different histological malignancies in Mymensingh region of Bangladesh, we analyzed the histopathological reports of 259 biopsy specimens examined in one pathology laboratory in Mymensingh town during the period from 6th January 2002 to 29th April 2004. Endoscopic biopsies were 234 (90.35%) and surgical biopsy specimens were 25 (9.35%). Male patients were 193 (72.52%) and female patients were 66 (25.48%). Specimens of esophagus were 73 (28.19%) and of stomach were 186 (71.81%). Out of 69 (94.53%) adequate samples of esophagus 46 (74.19%) were squamous cell carcinoma and 16 (25.81%) were adenocarcinoma. Adequate samples of stomach were 177 (95.16%) in which malignancies were found in 119 (67.23%). All the malignant tumor of stomach were in adenocarcinoma of which 82 (68.91%) were intestinal type, 17 (14.29%) were diffuse type and 20 (16.81%) mixed type. Intestinal type of gastric adenocarcinoma was found to be significantly associated with male patients (p < 0.005). From the present study it is suggested that in the Mymensingh region the common form of malignant lesion of esophagus may be squamous cell carcinoma followed by adenocarcinoma. Adenocarcinoma is the most common type of gastric malignancy of which intestinal type is more common

Ultrasound guided fine needle aspiration cytology for diagnosis of mass lesions of liver.

The therapeutic and prognostic evaluation of malignant neoplasia of liver depends mostly on morphologic diagnosis. Ultrasound guided fine needle aspiration cytology (FNAC) of liver has been proved to be a rapid, reliable and cost-effective method for cytological diagnosis of hepatic mass lesions. This study was undertaken to find out the frequency of different benign and malignant space occupying lesions (SOL) of liver from patients attending for FNAC in Mymensingh. Ultrasound guided FNAC was performed on 108 patients with hepatic mass lesions from September 2, 2001 to August 19, 2003. There were 67 (62.0%) males and 41 (37.96%) females with a mean age 53 year (SD +/- 14) ranging from 2 to 83 years. Samples were adequate in 101 (93.5%) and inadequate in 7 (6.5%). Out of 101 adequate samples only one was benign (liver abscess) and 100 were malignant. Of the malignant lesions hepatoblastoma was in 1 (1%), hepatocellular carcinomas in 8 (8%), metastatic adenocarcinomas in 73 (73%) and unclassified malignancies were in 18 (18%). Most of the hepatocellular carcinomas occurred in males (7 in 8). The frequency of metastatic adenocarcinoma was more in males (39 vs. 34) but the difference is not significant (p > 0.05). Ultrasound guided FNAC of liver is a rapid, reliable and cost-effective diagnostic method. It can be practice in any centres where ultrasound facility and specialist pathologists are available.

Role of fine needle aspiration cytology in the diagnosis of pulmonary lesions.

Fine needle aspiration cytology (FNAC) is a rapid, reliable and cost-effective method in the diagnosis of lung lesions. Cells are collected from the lesions usually under fluoroscopic or CT-guidance for cytological examination. Due to lack of these highly sophisticated radiologic imaging techniques in our institute we performed this test under X-Ray film guidance. This study was carried out in 59 patients, who underwent FNAC of lung lesions in the department of Pathology, Mymensingh Medical College, Bangladesh to find out the specimen adequacy and frequency of both benign and malignant lesions of the lungs in our areas. Out of 59 cases 54 were males and 5 were females with age ranged from 20 to 82 years. Adequate samples were obtained in 50 (84.75%) cases of which 35 (70%) were malignant, 10 (20%) were benign and 5 (10%) were suspicious for malignancy. Malignant lesions comprised of squamous cell carcinoma in 20 (57.14%), adenocarcinoma in 1(2.86%), large cell carcinoma in 8 (22.86%) and small cell carcinoma in 6 (17.14%) cases. All the benign lesions were inflammatory in nature, which included abscess in 6 (60%), tuberculosis in 3 (30%) and chronic non-specific inflammation in 1 (10%) case. Majority of the malignant lung lesions were encountered in the 6th decade of life. As the method is simple, rapid, cost-effective and without major complications, so it can be practiced in any centres in our country where specialised radiologists and pathologists are available.