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mmon clinical scenario [1]. The prevalenceof thyroid nodules is ~18-40% in Chineseadults [2]; however, only 5-10 percent of allthyroid nodules are malignant. Although withthe development of the ultrasound technique,several ultrasonographic characteristics havebeen associated with thyroid malignancy[3], individual ultrasound features arenot accurate predictors of thyroid cancer.Thyroid fine-needle aspiration [FNA] hasbeen recommended by various organizationsfor the more precise preoperative diagnosisof thyroid nodules [4]. Non-diagnostic rateof FNA comparison and estimate betweenthe other studiesMaterials and Мethods: We performedover 100 FNA using one pass of the 21-Gneedle attached to a 10 ml syringe withoutlocal anesthesia in 2015. All the FNAswere performed without the guidance ofultrasound. Recent study 100 cases of themwere not selected for a specific method.Results: In total there were 100 patientsrecruited in the study with a mean ageof 45.94±13.13 years and 83.0% femalepatients.The Non-diagnostic rate was comparedbetween groups with different needlesizes and methods. In the 22 G group,non-aspiration showed a decreased NDrate as compared to aspiration [44.21 vs.76.76%, P<0.001;]. In the non-aspirationgroup, a lower ND rate was revealed in the25-G needle group compared to the 22-Gneedle group [34.97 vs. 44.21%, P=0.032;].Notably, the ND rate in the 25 G group wassignificantly lower than in the all 22 G group[34.97 vs. 58.13%, P<0.001;]. In the 21 Ggroups, aspiration showed a decreased NDrate as compared to aspiration [44.21 vs.76.76%, P<0.001;]. 21G aspiration groupshowed decrease twofold ND rate ascompared 22G aspiration group [31.63 vs.76.76%, P<0.001;]Conclusion: There have been studiesusing various needle types [regular needle,needle with a stylet or spinal needle [5]and different needle sizes from [21 G to27 G] with or without aspiration duringthe procedure. Numerous factors influencethe diagnostic rate in thyroid FNA, amongwhich the nodule component is an extremelyimportant factor [6]. In general, the morecystic the percentage of each nodule, thehigher the rate of non-diagnostic, with the lowest ND rate in the solid nodule using a25-G needle at 26.77% and the highest inthe cystic nodule using 22 G aspiration at85.19%. A similar trend was found in eachgroup with lowest rate of ND in the 25 Gnon-aspiration group and highest in the 22G aspiration group.
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Kidney transplantation is the best alternative treatment for end-stage renal disease and health-related quality of life and survival of the patients are improved compared with dialysis. Worldwide, more than 1.4 million patients with CKD receive renal replacement therapy with incidence growing by approximately 8% annually.1 Unfortunately, despite significant improvement in graft function, kidney transplants can still fail due to acute rejection and chronic allograft nephropathy.2 Kidney biopsy after transplantation, which has evaluated by Banff 09 classification is usefull method for diagnose of transplanted kidney disease.3,4Kidney graft rejection was diagnosed in 10 renal allograft biopsy specimens (bs) obtained from transplant patients followed up at our institute between 2015 and 2016. All specimens were evaluated as satisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissue was divided into two tips: one piece for routine H&E stain and special stains, including Masson’s trichrome, and PAS stain; another piece for immunofluorescence by frozen section, which were stained with IgA, IgM, IgG and complement component (C3, C4, C1q, C4d). All the renal biopsies were examined by the same pathologist.Out of 117 transplantations, 10 episodes of rejection selected. Among the 10 patients, 30% had an acute T cell rejection and 70% had a chronic allograft nephropathy. Interstitial inflammation (i1-7) was present in 7 bs (70%), tubulitis (t1-4,t2-2) in 6 bs (60%), transplant glomerulitis (g1-1, g2-2, g3-1) in 4 bs (40%), transplant interstitial fibrosis (ci1-2, ci2-2, ci3-2) in 6 bs (60%), tubular atrophy (ct1-6, ct2-2, ct3-1) in 9 bs (90%), mesangial matrix increase (mm1-5) in 5 bs (50%), vascular fibrosis intimal thickeness (cv1-3) in 3 bs (30%), arteriolar hyaline thickening (ah1-5) in 5 bs (50%), tubulitis (ti1-6, ti2-3, ti3-1) in 10 bs (100%) and peritubular capillaritis (ptc1-1, ptc2-2, ptc3-1) in 4 bs (40%). C4d deposition was present very mild in wall of the vessels and peritubular capillaries. Because of not good working Methenamin silver stain, we couldn’t demostrate glomerular basement membrane changes (cg) fully.We suggest that histopathological changes of transplant glomerulopathy might be accompanied by inflammation of the microvasculature, such as transplant glomerulitis and peritubular capillaritis. C4d deposition in the wall of the vessels and peritubular capillaritis is not always present in biopsy specimens of transplant glomerulopathy.
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Thyroid nodular lesions are the common clinical problem in the world. A variety of tests have been employed to separate benign from malignant thyroid nodules. These tests include isotope scanning and fine needle aspiration cytology (FNAC). Our research was based on the fact that the comparison of FNAC and thyroid isotope scan in thyroid nodule was not researched in Mongolia. Therefore, we want to evaluate the specimen adequacy of FNAC, and compare its result to thyroid isotope scanning in patients with thyroid nodule. The research was conducted on archive materials of FNAC and thyroid isotope scanning of patients with thyroid nodule who were treated in surgical department of The First Central Hospital from 2012 to 2015, and the statistic analyze was done by using SPSS 20 under the auspices of School of Pharmacy and Bio-Medicine,Department of pathology, Mongolian National University of Medical Sciences. We have collected the FNAC of 807 patients, including 34 patients (4.2%) were males and 773 patients (95.8%) were females. FNA cytology results were interpreted as benign in 495 cases (61.3%), follicular lesion of undetermined significance in 31 cases (3.8%), follicular neoplasm in 9 cases (1.1%) suspicious in 17 cases (2.1%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). We have got the result of thyroid isotope scanning of 43 (5.32%) patients out of 807 cases. On thyroid scan, 18 patients (41.9%) having cold nodule were labeled as suspicious for malignancy, 25 patients (58.1%) had hot nodule. The FNA diagnosis of 25 patients with a hot nodule following: 1 patient (4%) with neoplasm, 17 patients (68%) with benign results, 6 patients (24%) had non-diagnostic. The FNA diagnosis of 18 patients (41.9%) with cold nodule following: 1 patient (5.5%) with follicular lesion of undetermined significance, 10 patient (55.5%) with benign, 5 patient (27.7%) with non-diagnostic, 2 patient (11.1%) had malignant. The FNAC results were interpreted as benign in 495 cases (61.3%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). Two patients out of 18 patients with cold nodule diagnosed as malignancy by FNAC. The sensitivity and specificity of thyroid isotope scanning was 96% and 16.6%, respectively.