Evaluation of Thyroid Lesions by Fine Needle Aspiration Cytology According to Bethesda System.

Aim To study cytology of various Thyroid lesions based on Bethesda system and to evaluate diagnostic accuracy of cytology by comparing it with histomorphological diagnosis whenever available. Materials and method In this study Fine needle aspiration cytology of 330 patients of clinically palpable thyroid were evaluated from June 2019 to December 2021 and categorised according to TBSRTC. 38 patients underwent surgical management in our hospital. Sensitivity, specificity, positive predictive value, negative predictive value reported under bethesda system were obtained by comparing the cytological and histopathological diagnosis where ever possible. Result The distribution of various categories from 330 evaluated thyroid nodules was as follows: 2.73% Non Diagnostic, 83.03% Benign, 0% Atypia of undetermined significance, 9.70% FN, 0.61% Suspicious for malignancy and 3.94% malignant. Sensitivity, specificity, positive predictive value, negative predictive value was 100, 60, 94.29 and 100% respectively. The diagnostic accuracy was calculated to be 94.73%. Conclusion There is a clearcut distinction between the two ends of the spectrum of non-neoplastic and neoplastic lesions of thyroid. Diagnostic accuracy of Bethesda system for reporting cytopathology for better clinical management is proven by the present study.

Utility of Image Guided Fine Needle Aspiration Cytology in Intra-Thoracic Lesions with Emphasis on Lung Cancer Detection.

BACKGROUND AND AIMS: Fine Needle aspiration cytology has emerged as an essential pre-biopsy investigation to rule out or confirm malignancy in superficial as well as deep seated lesions. Radiological assistance has proved to be a blessing for obtaining adequate samples. With unwavering leading position of lung cancer in terms of incidence and mortality, it has become necessary to study the trends of our population and assess the usefulness of techniques aiding in early diagnosis. The objective is to obtain prevalence of lung cancer and utility of various methods in obtaining cytological material for assessment in intrathoracic lesions. MATERIAL AND METHODS: We conducted an observational analytic study at a tertiary care teaching hospital over a period of 3.5 years including a total of 307 patients with suspected lung malignancy. Samples were collected using image guided techniques including Fibre-optic bronchoscopy (FOB), Ultra-sonography (USG) and Computed tomography (CT). The smears were processed as per standard institutional protocol and were evaluated by a senior pathologist. RESULTS: Squamous cell carcinoma was the most frequent type of Primary lung malignancy, followed by adenocarcinoma. The malignancies were more common in males and in age group of 61 to 70 years. CONCLUSION: Respiratory cytology remains the initial mode of investigation in intra-thoracic malignancies. The high sensitivity, low-cost and rapidity of the results works its advantages for both the patient and the clinician. High cellular yield obtained with the use of trans-bronchial needle aspiration and bronchial brushing rationalizes their use as a screening test to establish both malignant as well as non-malignant diagnoses. Further improvement in utilization of the available modalities and addition of ancillary testing can reduce the need of invasive procedures.

Docosahexaenoic Acid (DHA) Inhibits Bone Morphogenetic Protein-2 (BMP-2) Elevated Osteoblast Potential of Metastatic Breast Cancer (MDA-MB-231) Cells in Mammary Microcalcification.

Microcalcification seems to be an assurance signature for the prediction of breast cancer malignancy. However, neither systematic study for deciphering the molecular mechanism of mammary microcalcification has yet been conducted, nor a mechanistic study has been performed to find out its prevention. Thus, this study firstly aimed at determining if malignant breast tissues/metastatic breast cancer cells exhibit elevated intrinsic osteoblast-like potential responsible for driving the pathological microcalcification in breast tumors. Here, tumor sample analysis showed higher levels of various osteogenic genes (e.g., Runx2, osterix), and increased ALP activity and calcification in malignant breast tissues when compared to benign tissues, indicating the existence of elevated osteoblast-like potential in malignant breast tissues as compared to benign tissues. Similarly, cell culture study found that metastatic MDA-MB-231 cells acquired a higher osteoblast-like potential as compared to less metastatic breast cancer MCF-7 cells. It was also noticed that osteoinducer bone morphogenetic protein 2 (BMP-2) increased osteoblast-like differentiation and calcification potential in breast cancer cells. Moreover, omega-3 fatty acid docosahexaenoic acid (DHA) showed an inhibitory effect on BMP-2 induced osteoblast-like potential presumably by abrogating BMP signaling. Thus, this study for the first time unraveled that DHA may mitigate microcalcification by blocking osteoblast-like potential of breast cancer cells.

A Molecular View of Pathological Microcalcification in Breast Cancer.

Breast microcalcification is a potential diagnostic indicator for non-palpable breast cancers. Microcalcification type I (calcium oxalate) is restricted to benign tissue, whereas type II (calcium hydroxyapatite) occurs both in benign as well as in malignant lesions. Microcalcification is a pathological complication of the mammary gland. Over the past few decades, much attention has been paid to exploit this property, which forms the basis for advances in diagnostic procedures and imaging techniques. The mechanism of its formation is still poorly understood. Hence, in this paper, we have attempted to address the molecular mechanism of microcalcification in breast cancer. The central theme of this communication is "how a subpopulation of heterogeneous breast tumor cells attains an osteoblast-like phenotype, and what activities drive the process of pathophysiological microcalcification, especially at the invasive or infiltrating front of breast tumors". The role of bone morphogenetic proteins (BMPs) and tumor associated macrophages (TAMs) along with epithelial to mesenchymal transition (EMT) in manipulating this pathological process has been highlighted. Therefore, this review offers a novel insight into the mechanism underlying the development of microcalcification in breast carcinomas.

Scar endometriosis: Diagnosis by fine needle aspiration.

Endometriosis is defined as the presence of a functioning endometrium outside the uterus. Abdominal wall endometriosis is a rare entity. Most of the abdominal wall endometriosis occurs in or around surgical scars following caesarean section or hysterectomy. We report a case of scar endometriosis following caesarean section and diagnosed by fine needle aspiration cytology (FNAC). Excision biopsy confirmed the FNAC diagnosis of scar endometriosis.

Metastatic Primary Signet Ring Cell Carcinoma of Rectum: A Case Report of 10-Year-old Male Child.

Signet ring cell carcinomas of the colon and rectum are well documented in the adult population, but the incidence is very low in the paediatric population. Signet ring cell carcinoma has more malignant potential, mostly present as advanced stage and carries very poor prognosis. We are describing a 10-year-old male patient who presented with acute intestinal obstruction; radiology revealed large bowel obstruction and was diagnosed metastatic primary signet ring cell carcinoma of rectum on biopsy. We have discussed the diagnostic work-up and the management of this rare entity. Due to the high mortality that can be caused by a delay in making the correct diagnosis, signet ring cell carcinoma of colorectum represents a special diagnostic and surgical challenge.