Application-of-the-proposed-sydney-system-in-reporting-of-the-lymph-node-cytopathology—a-retrospective-study

Introduction: Fine needle aspiration cytology (FNAC) is a widely accepted first line of investigation to diagnose the cause of lymphadenopathy. A standardized categorization and reporting system for lymph node cytology was proposed in 20th International Congress of Cytology at Sydney which consisted of 5 categories (L1, L2, L3, L4, L5) with management recommendations for each. Aims and Objective: To review the application of the Sydney system in achieving a uniform standardized approach for classifying and reporting lymph node cytology and to assess the risk of malignancy (ROM) for each category. : A 2 year single institute retrospective study. Clinical details were collectedMaterials and Methods from the patient records and cytology smears were reviewed by 2 cyto-pathologists as per the Sydney system. Histological correlation was done wherever possible. Statistical analysis was performed. 437 cases were re-Results: evaluated, with mean age of 39.66 years, slight male preponderance and cervical lymph node being the most common site. L2/Benign was the most common category with reactive lymphoid hyperplasia being the most common diagnosis and metastatic squamous cell carcinoma was the most common L5/malignant diagnosis. Histopathological correlation was available for 40 (9.1%) cases and the highest calculated risk of malignancy (ROM) was for L4 and L5 categories (100% each). The diagnostic accuracy of the proposed Sydney system in our study was 96.66%. TheConclusion: proposed Sydney system improves the diagnostic accuracy and standardizes the reporting of lymph node cyto- pathology. It improves the patient care by giving management recommendation to the clinicians.

Características histológicas de la gastritis crónica reportadas en las biopsias gástricas de niños de 1 a 16 años de edad en el Hospital Infantil de San José, durante el período comprendido entre septiembre de 2008 a septiembre de 2010 / Histological characteristics of chronic gastritis reported in gastric biopsies from children aged 1 to 16 years at the Hospital Infantil de San José from september 2008 to september 2010

La gastritis es una inflamación del revestimiento de la mucosa gástrica en respuesta a una lesión. Puede ser aguda, crónica o mixta y estar asociada con metaplasia intestinal y atrofia. Los factores etiológicos son múltiples y varían desde irritantes, químicos, inmunológicos y genéticos, hasta infecciosos; dentro de estos últimos se destaca el bacilo Helicobacter pylori como el agente causal más común. Objetivo: Caracterizar los hallazgos histológicos de la gastritis crónica en niños de 1 a 16 años de edad internados en el Hospital Infantil de San José, durante el período comprendido entre septiembre de 2008 a septiembre de 2010. Materiales y métodos: Se realizó un estudio observacional descriptivo, de corte transversal. La información se obtuvo de los reportes de biopsias gástricas de niños entre 1 a 16 años de edad, evaluados en el Hospital Infantil de San José entre septiembre de 2008 y septiembre de 2010. Resultados: Se revisaron 826 reportes de biopsias gástricas de niños con gastritis crónica, y se pudo observar que el 59,2% de la muestra eran niñas y el promedio de edad fue de 9 años. El Helicobacter pylori estuvo presente en el 58,96% de la población, la atrofia gástrica en el 0,7% y la metaplasia intestinal en el 1%. Se identificó que la presencia de este microorganismo estuvo relacionada con el grado de inflamación crónica y el grado de actividad neutrofílica polimorfonuclear. Conclusiones: La infección por Helicobacter pylori es frecuente en la gastritis crónica en la infancia y su presencia se relaciona con el grado de inflamación crónica y de actividad neutrofílica polimorfonuclear.

Gastritis is an inflammation of the lining of the gastric mucosa which occurs in response to an injury. It can be acute, chronic or mixed, and it can be associated with intestinal metaplasia and atrophy. There are multiple etiologic factors including irritation, chemical, immunological, genetic and infectious factors. Among the latter, Helicobacter pylori is the most common causative agent. Objective: The objective of this study was to characterize histologic findings of chronic gastritis in children aged 1-16 years at the Hospital Infantil de San José from September 2008 to September 2010. Materials and methods: This was an observational and descriptive cross sectional study. Information was obtained from gastric biopsy reports from children between 1 and 16 years of age who had been evaluated at the Hospital Infantil de San José from September 2008 to September 2010. Results: We reviewed 826 reports of gastric biopsies from children with chronic gastritis. 59.2% of the sample was female, and the mean age was 9 years. Helicobacter pylori was present in 58.96% of this population, gastric atrophy was present in 0.7% and intestinal metaplasia in 1%. It was found that the presence of Helicobacter pylori was related to the degree of chronic inflammation and polymorphonuclear neutrophil activity levels. Conclusions: Helicobacter pylori infection is common in chronic gastritis in children and its presence is related to the degree of chronic inflammation and polymorphonuclear neutrophil activity.

Nodular Gastritis and Pathologic Findings in Children and Young Adults with Helicobacter pylori Infection

PURPOSE: The aim of this study was to investigate the pathologic characteristics of nodular gastritis in children and young adults infected with Helicobacter pylori (H. pylori). MATERIALS AND METHODS: A total of 328 patients were enrolled in this study, and the diagnosis of H. pylori infection was done with gastroduodenal endoscopy concomitant with a CLO

Evaluation of Endoscopic and Histological Change of Gastritis Related to Helicobacter pylori Eradication in Children / 대한소아소화기영양학회지

PURPOSE: The aims of this study are to investigate the effect of the eradication of H. pylori on histological change of gastric mucosa in children with H. pylori gastritis and to determine whether the histological grading by the Sydney system is valuable in predicting the effect of treatment. METHODS: 1) Histological scores by the Sydney system and the endoscopic characteristics were assessed before and at least four weeks after anti-H. pylori therapy in 42 children with H. pylori gastritis. 2) In 32 children treated with omeprazole, amoxicillin and clarithromycin (OAC), pretreatment histological scores and endoscopic findings were compared between the eradicated and the noneradicated to evaluate their predictive value for the successful eradication. RESULTS: 1) In the eradicated (27 cases), nodular gastritis significantly decreased from 89% to 63% (p<0.05). There was an significant improvement in the mean activity score from 2.06 before treatment to 0.24 after treatment (p<0.01). The mean inflammatory score also improved from 2.61 before treatment to 1.89 after treatment (p<0.05). Lymphoid follicles significantly decreased from 48% to 15% (p<0.05). Epithelial damage improved in all 4 cases. But in the noneradicated (15 cases), there was no significant change in the frequency of nodular gastritis, the mean activity score, the mean inflammatory score and the frequency of the lymphoid follicles. 2) In 32 children treated with OAC, there was a tendency that the higher was the pretreatment score of the bacterial density, the lower was the eradication rate of H. pylori (p=0.072). CONCLUSION: The loss of the polymorphonuclear cell infiltration is the most prominent histological change after successful eradication. There may be negative correlation of the grade of the bacterial density with the success rate of the anti-H. pylori therapy.

H. pylori infection and the correlation to chronic active gastritis detected by the histological criteria of the sydney system.

In Thailand, chronic active gastritis and chronic atrophic gastritis have not been given frequent mention. Our aim is to present the relationships of the many variables in histological classification of chronic bacterial gastritis by the Sydney System. This paper presents the prevalence of chronic active gastritis by studying the degree of H. pylori infection detected by the Modified Toluidine Blue staining (MTBs) and histological grading, using the Sydney System. A total of 355 dyspeptic patients who underwent endoscopy in Kawila hospital, Chiang Mai, northern Thailand from January 1996 to January 1998, were included in the study. Overall, 284 patients (80.3 %) had an H. pylori infection. Diagnosis varied from normal, chronic gastritis, and acute gastritis to chronic active gastritis in 11 (3.1 %), 95 (26.8 %), 0 (0 %), 249 (70.1 %) patients respectively. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of neutrophils presented with lymphocytes are 85.2, 90.1, 97.2, and 60.4 %, respectively. We conclude from the study that chronic active gastritis is a very common condition in Thailand. If chronic active gastritis is present, H. pylori is usually detected, and the degree of infection is well correlated to the degree of inflammation.

The comparison of histologic gastritis in patients with duodenal ulcer, chronic gastritis, gastric ulcer and gastric cancer

This study was designed to investigate the differences of histologic gastritis according to the endoscopic diagnosis, and between H. pylori positive and negative gastritis, using the Sydney system. A total of 122 patients (42 duodenal ulcer, 31 chronic gastritis, 35 gastric ulcer and 14 gastric cancer) underwent endoscopy with biopsies from the antrum and body. Among the 122 patients, 104 (85%) were H. pylori positive. H. pylori density of the antrum was significantly higher in duodenal ulcer than in chronic gastritis, gastric ulcer, and gastric cancer. The positivity of intestinal metaplasia was lowest in duodenal ulcer and highest in gastric cancer. H. pylori density as well as grade of activity, inflammation and atrophy were significantly higher in the antrum than in the body in duodenal ulcer, while in chronic gastritis, gastric ulcer and gastric cancer there was no difference of H. pylori density, activity, inflammation and atrophy between the antrum and body. The grade of activity and chronic inflammation were significantly higher in H. pylori positive patients than in H. pylori negative patients in both the antrum and body. In conclusion, the gastritis of duodenal ulcer was mainly localized to the antrum, while the gastritis of chronic gastritis, gastric ulcer or gastric cancer was rather uniform in the antrum and body. H. pylori seemed to be related to the development of chronic inflammation and activity.